PMID- 3804218 TI - Rheumatoid nodules in liver. PMID- 3804219 TI - Citizens: a new ally for research. PMID- 3804220 TI - Remediable behavioral symptomatology in Alzheimer's disease. PMID- 3804221 TI - Consultation-liaison intervention in somatization disorder. PMID- 3804223 TI - A longitudinal account of staff adaptation to AIDS patients on a psychiatric unit. AB - As more patients with AIDS and AIDS-related syndromes are admitted to psychiatric units, staffs must meet new diagnostic and therapeutic challenges while adapting to the unique stresses of treating these patients. The authors discuss several case vignettes to illustrate how the staff of a voluntary acute-stay psychiatric unit progressed over a two-year period from having difficulty treating AIDS patients within the usual therapeutic milieu to directly confronting the issues raised by the disease both among themselves and in the patient community. The authors believe that the staff's ability to cope with AIDS patients may have strongly influenced the patient community's ability to cope, and that clinical experience and educational programs were major contributors to the staff's adaptation. They conclude with several recommendations for psychiatric staffs beginning to treat AIDS patients. PMID- 3804222 TI - The child as a witness. AB - The increasing participation of children in judicial proceedings raises two central issues: the competency of the child as a witness and the effects on the child of testifying about a traumatic experience. After discussing these issues, the authors present the recommendations of forensic child psychiatrists on how to improve the judicial process to elicit more accurate testimony from child witnesses--for example, by videotaping a child's testimony to avoid repeated interrogations, using anatomically correct dolls and pictures to allow the child to recount events through displacement, and using one skilled interviewer throughout the proceeding to allow rapport to develop between interviewer and child. They then discuss the role of the child psychiatrist in court proceedings involving child witnesses. PMID- 3804224 TI - Patient housing options as viewed by parents of the mentally ill. Housing Committee, California Alliance for the Mentally Ill. AB - The housing committee of the California Alliance for the Mentally Ill, an organization of parents of mentally ill adults, surveyed 350 members on the housing needs of their sons and daughters. The parents reported that their offspring had a high degree of residential instability, and parents expressed the need for wider choices in housing options and more vocational and rehabilitation programs. Parents reported that patients were most satisfied with living at home or in semi-independent living situations and least satisfied with living on the streets or in state hospitals. PMID- 3804225 TI - Continuous treatment teams in the care of the chronic mentally ill. AB - Since deinstitutionalization began, the model of service delivery for the chronic mentally ill has been characterized first by the mere availability of services and then by continuity of care as coordinated through the case manager system. However, there is increasing evidence that the continuity of care model has neglected an element crucial to its success--continuity of caregivers. Continuity of caregivers means that a single, continuous treatment team is responsible for patients in both inpatient and outpatient settings. The author discusses several programs that have successfully used continuous treatment teams, the theoretical considerations supporting use of the teams, and the problems be encountered after trying to implement such teams at a public psychiatric hospital in Washington, D.C. PMID- 3804226 TI - A survey of psychiatrists' practices related to the use of tricyclic antidepressants. AB - Four groups of psychiatrists were surveyed about their clinical practices in relation to the use of tricyclic antidepressants to determine if there is any unanimity about procedures. The four groups were U.S. experts in the pharmacotherapy of depression, faculty who taught the pharmacotherapy of depression in accredited departments of psychiatry, general psychiatrists in Virginia who treated depressions with drugs, and non-U.S. experts. The authors report on practices related to dosage buildup, side effects, concurrent medical conditions, blood level information, and maintenance on tricyclics. They found moderate to high consensus on most issues; exceptions were treatment of a patient with chronic hypertension and maintenance dosage and duration. PMID- 3804227 TI - Shifting competency during hospitalization: a model for informed consent decisions. AB - The demonstration of factual understanding should be sought when determining a patient's ability to give informed consent, but a patient's failure to demonstrate understanding should not always be equated with an inability to competently consent to or refuse treatment. The authors demonstrate the clinical use of a number of standards other than factual understanding. Judgments about competency are derived both from the patient's clinical condition and the risks and benefits inherent in the decision the patient is asked to make. Since both of these conditions may shift during the course of treatment, clinical competency is subject to continual reassessment using a variety of competency standards. The authors demonstrate the use of their model of shifting competency at five junctures in the treatment of a delusional patient. PMID- 3804228 TI - Follow-up of participants in a vocational rehabilitation program at a state hospital. PMID- 3804229 TI - Using a drug audit program to reduce polypharmacy in a state psychiatric hospital. PMID- 3804230 TI - The asylum as refuge. PMID- 3804231 TI - Nurses as educators. PMID- 3804232 TI - DSM-III preview. Psychotic and mood disorders. PMID- 3804233 TI - Reducing environmental stress for a suicidal ten-year-old. PMID- 3804234 TI - Allen v. Illinois: the fifth amendment and the sexually dangerous person. PMID- 3804235 TI - Geographic mobility and the homeless mentally ill. PMID- 3804236 TI - Capitation payment and mental health care: a review of the opportunities and risks. AB - Capitation as a method of health care reimbursement has grown dramatically during the past two decades and may have a marked impact on funding for mental health services in coming years. The author defines capitation within the context of various health care reimbursement approaches, presents arguments for and against capitation, reviews the record of capitation for general medical care, and discusses proposals for capitation systems for high-risk patient groups. The potential benefits and risks of capitating mental health services for the general population and for high-risk groups are explored, and initial activities to develop a capitation system for chronic patients in two New York counties are described. PMID- 3804237 TI - Guidelines for short-term inpatient psychotherapy. AB - The authors propose guidelines for conducting psychotherapy in short-term general hospitals. They divide short-term psychiatric hospitalization into three phases, each of which presents different therapeutic tasks and calls for different therapeutic interventions and techniques. In phase one, when the patient is typically most distressed, the therapist and the patient must establish a therapeutic alliance and agree on the goals of therapy, a treatment contract, and limits on acting-out behavior. In phase two, the period of greatest comfort for the patient, the therapist must encourage the patient to focus on his goals while keeping the issue of discharge in the forefront of therapy. In phase three, the therapist helps the patient cope with separation issues that arise as he prepares for discharge. PMID- 3804238 TI - The prosecution of psychiatric patients for assaults on staff: a preliminary empirical study. AB - A survey of five public hospitals yielded nine cases in which staff pressed charges against patients who assaulted them. Examining the effects of prosecution on the patients, the legal system, and the staff, the authors found that two patients benefited, three showed little or no change, and four were lost to follow-up. The legal system was responsive to the request to prosecute, although sometimes reluctantly, in six cases, but uncooperative in the rest. In five of the cases, staff were satisfied with the outcome of the legal intervention, even though it benefited only two of those patients. Among the authors' recommendations for dealing with assaults are to use appropriate clinical measures first, address any systems problems that an assault suggests, and, because prosecution may alienate patients from the treatment system, obtain consultation from a psychiatrist outside the patient's care system before proceeding. PMID- 3804240 TI - Social network density and rehospitalization among young adult patients. AB - The authors interviewed 30 patients under age 40 who had been hospitalized repeatedly to determine the relationship between social network density, or the extent to which network members know one another, and rehospitalization. They found that moderate levels of network density were associated with fewer days in the hospital. Time spent in the hospital was not related to network size, and patient diagnosis was not a good predictor of hospitalization. The authors hypothesize that a moderately dense network is optimal for psychologically vulnerable individuals because it can be maintained under stress. PMID- 3804239 TI - Factors affecting the decision to prosecute mental patients for criminal behavior. AB - Several authors have argued that under certain circumstances it is both necessary and therapeutic to bring criminal charges against psychiatric patients who have committed assaults or manifested other criminal behavior. Others have argued that prosecution may impair therapeutic alliances and may lead to increased litigation by patients. In this paper the authors present four cases in which patients in the public mental health system were prosecuted, and they discuss factors that affect the decision to pursue prosecution. They argue that both clinicians and legal professionals need specific training to help them recognize the differences between behavior that a patient's illness prevents him from controlling and impulsive behavior, stemming from character pathology, that can appropriately be addressed by criminal sanctions. PMID- 3804241 TI - Changing mental health services in Madrid: international issues. AB - With the backing of a socialist government that came to power in 1982, mental health services in Spain are shifting away from institutional and custodial care toward community-based services. Provincial governments now control most mental health programs as a result of a law passed in 1983. In Madrid, mental health service priorities include preventing psychiatric hospitalization, developing a range of residential facilities, reducing the population of chronic patients in hospitals, and improving the quality of hospital care. A network of 20 health promotion centers is being developed to serve newly identified patients, while long-stay hospital patients who can be discharged will become the responsibility of social services. From an international perspective, the most interesting aspect of the Spanish transformation is how the country will deal with the problems other nations have encountered in implementing systems reforms. PMID- 3804242 TI - Feigned psychosis in a 14-year-old girl. PMID- 3804244 TI - Court-ordered psychiatric evaluation of juveniles. PMID- 3804243 TI - Mediating retention or release of the potentially dangerous patient. PMID- 3804245 TI - Homeless veterans. PMID- 3804246 TI - Secondary substance abuse. PMID- 3804247 TI - Olfactory hallucinations. PMID- 3804248 TI - Missouri takes steps to narrow insurance gap. PMID- 3804249 TI - NJ enacts trust fund pool for indigent care. PMID- 3804251 TI - Analysts see '87 bond volume of under $10 billion. PMID- 3804250 TI - Tort reform not enough, GAO says. PMID- 3804252 TI - Inpatient use declines: persistent but slower. PMID- 3804253 TI - Diversity key to targeting women's market. PMID- 3804254 TI - Study outlines six hottest ad strategies. PMID- 3804255 TI - Insurers set to fight managed care plan fraud. PMID- 3804256 TI - Hospitals keep contracts with HMOs and PPAs. PMID- 3804257 TI - CEOs tied down by HMO/PPA red tape. PMID- 3804258 TI - More private, less government PPA antitrust action. PMID- 3804259 TI - Defining quality: Jacobs tackles it head-on. PMID- 3804260 TI - Turf war heats up between CA rehabs and SNFs. PMID- 3804261 TI - Group practices concentrate on regional mergers. PMID- 3804262 TI - Public watchdog Wolfe unleashes on providers. Interview by Clay Mickel. PMID- 3804263 TI - Supply resale to MDs, others hinges on CEO. PMID- 3804264 TI - Dialysis reuse to be resolved. PMID- 3804265 TI - Multis channel '87 budgets into capital plans. PMID- 3804266 TI - 80% of hospitals to expand ambulatory services. PMID- 3804267 TI - Tax law: benefits more uniform but confusing. PMID- 3804268 TI - What's an HMO? 51% of respondents don't know. PMID- 3804269 TI - Low prices: a strategy for the foolhardy? PMID- 3804270 TI - '86 bond volume drops back to $8.7 billion. PMID- 3804271 TI - Another bad year for hospital credit downgradings. PMID- 3804272 TI - CEOs see major payment changes within two years. PMID- 3804273 TI - Effective planning can defuse discharge risks. PMID- 3804274 TI - Self-insured plan cuts rates 50%. PMID- 3804275 TI - Market testing: hospitals' forgotten man? PMID- 3804276 TI - Gregory goes for the big market: purchasers. PMID- 3804277 TI - MD sales reps bring success to Ohio clinic. PMID- 3804278 TI - Insurers moving to get data before contracting. PMID- 3804279 TI - Hospital design follows the crowd to ambulatory care. PMID- 3804280 TI - Responding to fraud investigations by insurers. PMID- 3804281 TI - Will the malpractice pocket become deeper? PMID- 3804282 TI - Caterpillar's Wright brings employer interest to PhysPRC. PMID- 3804283 TI - Before you buy, take time to involve medical staff. PMID- 3804284 TI - ACS expels rural traveling surgeon. PMID- 3804285 TI - Florida doctors use EDs as forum for malpractice. PMID- 3804286 TI - Mortality data release to hold "no surprises". Interview by Cathy Tokarski. PMID- 3804287 TI - Powerhouse MD Buyline doubles size in 1986. PMID- 3804288 TI - Clinical research trials pay off for these multis. PMID- 3804289 TI - Investor-owned systems up 68%: AHA directory. PMID- 3804290 TI - Use of personal computers increases 40% in '86. PMID- 3804291 TI - Deciduous molar root variation. PMID- 3804292 TI - Mortality load disclosed by inbreeding in different castes of Andhra Pradesh. PMID- 3804293 TI - Changes in body density, fatfolds and girths at 2.3 kg increments of weight loss. PMID- 3804294 TI - Adipose tissue distribution: the stability of principal components by sex, ethnicity and maturation stage. PMID- 3804295 TI - Subcutaneous fatness and stature: relationship from infancy to adulthood. PMID- 3804296 TI - Interobserver measurement reliability in anthropometry. PMID- 3804297 TI - Anthropometric prediction of component tissue masses in the minor limb segments of the human body. PMID- 3804298 TI - Anatomical segmentation in humans and the prediction of segmental masses from intra-segmental anthropometry. PMID- 3804299 TI - The plethysmometric measurement of total body volume. PMID- 3804301 TI - [Detecting L. donovani circulating antigen by McAb in the diagnosis of kala azar]. PMID- 3804300 TI - A gravity model of human population structure. PMID- 3804302 TI - [Investigation of non-specific immune suppression in DBA/1 mouse infected by L. donovani]. PMID- 3804303 TI - [SPA-ELISA in the detection of leptospiral antibodies in the sera of leptospirosis patients]. PMID- 3804304 TI - [Effects of pontine central gray electric stimulation and lidocaine microinjection on phrenic discharge]. PMID- 3804305 TI - [The study of the blood vessels and nerves of the flexor carpi radialis as a transplantation flap]. PMID- 3804306 TI - [Studies on the composition and stability of chromium (III)-amino-acid-nicotinic acid mixed ligand complexes]. PMID- 3804307 TI - [An investigation of lung cancer among asbestos workers]. PMID- 3804308 TI - [Gas chromatographic analysis for methanol and fusel oil in potable spirits]. PMID- 3804309 TI - [Study on antifertility activity of anordrin analogs]. PMID- 3804310 TI - [Quantitation of human serum apolipoprotein B100 by rocket immunoelectrophoresis]. PMID- 3804311 TI - [Study of incompatibility in vitro of injection of rifamycin sodium with 45 injections]. PMID- 3804312 TI - [Airborne allergenic pollens in the southern area of Chengdu]. PMID- 3804313 TI - [Clinical analysis of subphrenic abscess in 93 cases]. PMID- 3804314 TI - [Preparation of 99mTc-PI as a cholescintigraphic agent and its clinical applications]. PMID- 3804315 TI - [Computerized tomography in multiple sclerosis]. PMID- 3804316 TI - [Study on the location of proximal small intestinal cancers in mice by N-methyl N'-nitro-N-nitrosoguanidine]. PMID- 3804317 TI - Intervention in atherosclerosis and the pathologist. PMID- 3804318 TI - Prudent laboratory usage, cost containment, and high quality medical care: are they compatible? AB - Inappropriate laboratory use by physicians is partly responsible for the rapid rise in health care costs. This use falls into three categories--over-, under-, and misutilization. Overuse creates information overload for the physician and has a detrimental effect on patient care. Abnormal results are frequently obscured by massive amounts of requested information. Studies show that laboratory use is greater for younger physicians and that increased use is not associated with better outcome of care. Overuse ranges from 26 per cent to 98 per cent for selected tests. Unnecessary tests can be eliminated with no adverse effect on quality. Laboratory use can be improved by a variety of approaches including education, feedback, implementation of administrative changes and, finally, financial incentives or disincentives; the last has proven the most effective. All the approaches should be reinforced by cost-conscious clinical settings that foster a "why" rather than a "why not" philosophy. Improving laboratory use may reduce costs and maintain quality. PMID- 3804320 TI - Abnormal formation of the prothrombinase complex: factor V deficiency and related disorders. AB - A membrane-bound, Ca2-dependent complex of the cofactor factor Va and the enzyme factor Xa comprises the prothrombinase coagulation complex, which catalyzes the proteolytic conversion of prothrombin to thrombin. In normal hemostasis, the platelet is presumed to supply the surface membrane and thus constitutes the site at which an enzymatically functional complex assembles and thrombin generation occurs. Factor Va, the two subunit protein produced by thrombin activation of factor V, is an essential, nonenzymatic cofactor of the prothrombinase complex. Factor Va performs its cofactor role in part by binding to the platelet membrane and functioning as the membrane receptor for factor Xa in a 1:1 stoichiometric complex of high affinity (Kd = 10(-10) M). Factor Va also appears to participate in the binding of prothrombin to the enzymatic complex. Because deletion of factor Va from the prothrombinase complex decreases the rate of thrombin generation by four orders of magnitude, the essential role it plays is easily understood. Therefore, in the evaluation of factor Va function in the prothrombinase complex, the ability of factor Va to support various binding interactions with the platelet, factor Xa, and prothrombin must be considered. Factor Va can be made available from two potential blood compartments: the plasma and platelets. Approximately 80 per cent of the total blood factor V circulates in plasma whereas the remaining 20 per cent is contained within platelet granules. The relative contribution of plasma versus platelet factor V to factor Va binding interactions in the prothrombinase complex are not clearly defined. However, data from our laboratory and several others suggest that factor V stored and released from platelets is of utmost importance in maintaining normal hemostasis. A discussion of these data relative to congenital and acquired deficiencies of both plasma and platelet factor V is the subject of this report. PMID- 3804319 TI - Formation and regulation of platelet and fibrin hemostatic plug. AB - Formation of a hemostatic plug represents one of the earliest responses to vessel wall injury. Platelets react to any discontinuity in the vascular endothelium through initial contact, spreading, and formation of a thrombus (or aggregate). This development of a primary hemostatic plug requires platelet membrane receptors through which the adhesive macromolecules, von Willebrand factor (vWF) and fibrinogen, anchor platelets to the vessel wall and link them to each other. There are two receptor pathways--classic and alternative--for the binding of vWF to platelets; the latter induced by thrombin, and adenosine diphosphate (ADP) is shared with fibrinogen. Synthetic peptides, patterned after known binding domains of adhesive molecules, have been designed to inhibit their interactions with platelet receptors. A secondary hemostatic plug, composed of platelets enmeshed in fibrin, results from the action of thrombin, which is not only essential for formation of fibrin but also for exposure of platelet receptors for adhesive molecules and for "activation" of factors V and VIII. Thrombin generation is greatly enhanced through the activity of the prothrombinase complex formed on the surface of platelets, perturbed endothelial cells, and leukocytes. A pivotal event is activation of factor X through the intrinsic and extrinsic coagulation pathways. Binding of factors IXa and VIIa to the vascular endothelium represents a localized mechanism for factor Xa generation. Formation of a platelet and fibrin thrombus is controlled by regulatory mechanism: prostacyclin, endogenous heparin-antithrombin III complex, thrombomodulin-protein C-protein S system, and the fibrinolytic system. The balance of all components--vessel wall, platelets, adhesive and coagulation proteins, regulatory mechanisms--determines the effectiveness of the hemostatic plug in maintaining the structural and functional integrity of the circulatory system. An approach to detection of hemostatic derangements in patients at risk evolves from a full understanding of inherited and acquired deficiencies affecting each step of hemostatic plug formation and from selective use of laboratory tests. PMID- 3804321 TI - Limitations of the forensic external examination in determining the cause and manner of death. AB - The accuracy of the cause and manner of death based on a medical examiner external examination of the body and review of other evidence was investigated. The authors retrospectively identified 185 such forensic cases in which an autopsy was performed subsequently at a major teaching hospital. Autopsy disclosed a change in the manner of death in only one instance. Of the 89 natural deaths, the cause of death based on external examination was erroneous in 26 (29 per cent). The majority of the errors was the result of an overdiagnosis of arteriosclerotic cardiovascular disease, hypertensive cardiovascular disease, and cancer. PMID- 3804322 TI - Neoplastic endocrine cells in carcinomas of the small intestine: histochemical and immunohistochemical studies of 24 tumors. AB - Endocrine cells in 24 primary carcinomas and in the nonneoplastic mucosa of the small intestine were investigated histochemically and immunohistochemically with antisera against serotonin and 10 kinds of peptide hormones. Argyrophil-positive endocrine cells were found in four of eight duodenal, all of eight jejunal, and six of eight ileal carcinomas. The density of the positive cells was higher in the ileal tumors than in the duodenal and jejunal ones. Immunoreactive endocrine cells were detected in three duodenal, six jejunal, and five ileal carcinomas. Immunoreactive serotonin cells were present most frequently and most densely without respect to the site of origin of the carcinomas. In general, the population of endocrine cells among the tumor cells was higher in the ileal carcinomas than in the duodenal and jejunal ones. The ileal carcinomas frequently and densely demonstrated somatostatin, peptide YY, neurotensin, glucagon, and glicentin cells in addition to serotonin cells. The kinds of endocrine cells and the relative frequency of each kind of endocrine cell in carcinomas of the small intestine were similar to those in the nonneoplastic mucosa from which the carcinomas originated. This is the first systematic immunohistochemical study on endocrine cells in carcinoma of the small intestine. PMID- 3804323 TI - Cocaine and the heart. AB - There is increasing evidence that cocaine can have serious adverse effects on the heart. Angina, myocardial infarction, coronary artery spasm, arrhythmia, and sudden death have been reported in association with its use. There have been only two reports of actual myocardial pathology. In an attempt to clarify the pathophysiology of cocaine-associated cardiotoxicity and to search for pathologic changes that might be useful forensically, we reviewed random microscopic sections of hearts from 30 cases of cocaine-associated death seen by the San Francisco Medical Examiner. The age of the patients at death ranged from 25 to 74 years (mean 33.9 years). Pathologic findings included the presence of mild atherosclerotic coronary artery disease without evidence of thrombosis in three cases, associated with mild interstitial fibrosis in one case as well as mild focal myocardial fibrosis without coronary disease in four other cases. The most notable abnormality was the presence of myocardial contraction bands in 28 (93 per cent) cases. In comparison to 20 control cases of death secondary to sedative hypnotic overdose, the hearts from the cases of cocaine-associated contained significantly more myocardial contraction bands (P less than .001; two-sided). The diffuseness of the contraction bands correlated directly with the level of cocaine found in the urine and blood at autopsy during routine screening. The presence and number of contraction bands in these cases was independent of other drugs found in the urine and blood, the number of sections of myocardium examined, and a history of attempted resuscitation. Contraction bands may act to supply the anatomic substrate for the arrhythmias associated with cocaine use. They may also provide a morphologic marker that can be sought in suspected cases of lethal cocaine overdose. Their presence may also suggest a cause of death in cases of sudden and unexpected death in which autopsy reveals no other pathology, and a drug screen is positive for cocaine. PMID- 3804324 TI - Additional cases of angiomyolipoma with regional lymph node involvement. PMID- 3804325 TI - The probability question in prostatic tissue sampling. PMID- 3804326 TI - Population structure of Sicily: beta-thalassemia and HbS. AB - The population structure of two alleles with similar characteristics, HbS and beta-thalassemia, was studied in the same area in Sicily. It was observed that beta-thalassemia has uniform frequencies over the island, and that HbS shows a South-North cline. A singularity exists for HbS in the town of Butera, where the frequency of the S gene is six times higher than the island average. It was suggested that HbS entered Sicily from Greece (or directly from North Africa) when the beta-thalassemia allele was already established in the Island. PMID- 3804327 TI - Deficiency of AMP deaminase in erythrocytes. AB - Six individuals with complete deficiency of erythrocyte AMP deaminase have been discovered. They are all healthy and have no hematological disorders. The deficiency is only in isozyme E, which is the erythrocyte type isozyme, and is inherited as an autosomal recessive trait. The frequency of the mutant gene is surprisingly high, one heterozygote in about 30 of the population in Japan, Seoul, and Taipei. The ATP level is approximately 50% higher in AMP-deficient erythrocytes compared to that of control cells. Degradation of adenine nucleotide is slower in the deficient erythrocytes than in the control erythrocytes. PMID- 3804328 TI - Single cell translocations in couples with multiple spontaneous abortions. AB - Single cell translocations have been previously reported to occur in normal lymphocyte cultures. Comparison of the frequency of these in 140 individuals referred for a history of multiple miscarriages and 415 individuals referred for a history of multiple miscarriages and 415 individuals referred for other reasons showed a significantly greater number of single cell translocations in the former group. This group also had a significantly greater number of other types of single cell structural abnormalities. Increased chromosome instability, chromosome mosaicism, residual fetal trophoblasts, and immunological differences are discussed in considering the possible etiology. PMID- 3804329 TI - Characterization of a series of electrophoretic and enzyme activity variants of human glucose-phosphate isomerase. AB - A total of 3438 cord blood samples were screened for variants of erythrocyte glucose-phosphate isomerase. The five different electrophoretic, three activity/deficiency, and one thermostability variants distributed among 27 unrelated Caucasian families of that population, plus two electrophoretic variants previously described from three Amerindian tribes were subsequently examined for cryptic variation using activity and thermostability criteria. Although thermostability differences were observed between electrophoretic variants, no microheterogeneity within any one class of variant was detected. PMID- 3804330 TI - A heritable fragile 12q24.13 segregating in a family with the fragile X chromosome. AB - A fragile site on chromosome 12, at 12q24.13, was found in the lymphocytes of two members of a family during the study for detection of a fragile X chromosome. The site was found to be heritable and folate-sensitive, and it fulfills all four criteria for a fragile site. It thus can now be confirmed as the heritable fragile site FRA12C. PMID- 3804331 TI - Two complementation groups of Fanconi's anemia differ in their phenotypic response to a DNA-crosslinking treatment. AB - The two genetic complementation groups reported for Fanconi's anemia (FA) correspond to two phenotypic classes as characterized by measurements of the rate of DNA semiconservative synthesis after 8-methoxypsoralen photoaddition. This test allows a rapid genetic classification of FA patients which appears to be a prerequisite for investigations of the biochemical defect(s) in FA. PMID- 3804332 TI - Alpha-interferon and fragility at 16q22. A study on 15 selected controls and 146 selected patients. AB - Inducibility or enhancement of fragility at 16q22 by alpha-interferon has been found in a Danish laboratory and in our laboratory. Several other studies were not able to confirm these findings. We present the results of a large study on peripheral blood lymphocytes of 15 selected controls and 146 selected patients treated in vitro by alpha-interferon. In some of our patients parallel studies with distamycin A were performed. Both interferon and distamycin A induced the same fragility, but only in some patients. Both agents were not consistently able to enhance a spontaneously expressed 16q22 fragility. 16q22 is the location of the metallothionein genes, whose transcription is induced by interferon. The induction of the metallothionein gene transcription and the 16q22 fragility, however, do not seem to be directly related. To explain our findings we advance the hypothesis that fragility at 16q22 may be a modification induced by virus(es) with selective tropism for cells which are differently influenced by a pleiotropic action of interferon. PMID- 3804333 TI - C-band length variability and reproductive wastage. AB - The possible influence of total Y chromosome length and the C-band size variability of chromosomes 1, 9, 16, and Y, on reproductive wastage was investigated. One hundred couples with recurrent reproductive wastage and 106 control couples with at least two healthy children and no miscarriages were cytogenetically studied. Total Y chromosome length was evaluated as the Y/F index and the C-band size was analyzed quantitatively according to the linear measurement method of Balicek et al. (1977). The different degrees of mitotic contraction were corrected on the basis of the linear correlation found between heterochromatin and euchromatin length. Statistical comparison between results of Y chromosome from both samples demonstrated, in the test group, an increase in the mean value of the Y/F index, but the increase of Y C-band length did not reach significance. In addition mean values of C-band length on chromosomes 1, 9, and 16 in couples from the test group and especially those who had had two or more abortions, were lower than those in the controls. Among the latter the frequency of chromosomes included in the category of very large heterochromatin size is higher. However these length differences have been demonstrated only in specific subgroups, and in each one for a different chromosome. Our results indicated that Y chromosome length as well as C-band size variabilities are not directly related to reproductive wastage. PMID- 3804334 TI - Genetic analysis of febrile convulsions: twin and family studies. AB - Thirty-two twin pairs and 673 sibship-cases with febrile convulsions (FC) were studied. Twin study: The pairwise concordance rate for FC was 56% (10/18 pairs) in monozygotic and 14% (2/14 pairs) in dizygotic twins (P less than 0.05). Intra pair similarity of clinical symptoms in concordant twin pairs was greater than that in sibship-cases. Sibship-pair study (population): In sibship-pair study a large positive correlation of some clinical symptoms - in particular, age at onset of FC, exogenous factors, and degree of fever (P less than 0.001 for each) was indicated. Compared with FC children with no family history, those with such family history had a higher frequency of age at onset between 8 and 19 months, exogenous factors, low degree of fever before onset of convulsions, many recurrences, and recurrence after age 3 (P less than 0.01-0.001 for each). Morbidity risk among near relatives was highest in first-degree relatives (16%) than in second (4.0%) or third-degree relatives (4.1%). The following differences were found: siblings (24%) greater than parents (12%), uncles (4.5%) greater than aunts (3.5%), male cousins (4.4%) greater than female cousins (3.8%). Segregation ratio, influence by affection of father or mother, and maternal preponderance were analysed. Similar findings were also observed in the clinic study. A multifactorial mode of inheritance for FC receives some support from this study, and the heritability was estimated to be 75% in the population study. The results may be useful for genetic counselling for FC. PMID- 3804335 TI - Familial paracentric inversions inv(2)(q31q35) and inv(8)(q22.3q24.13) ascertained through reproductive abnormalities. AB - Two cases of familial paracentric inversion, one in the long arm of chromosome 2 and the other in the long arm of chromosome 8, are described. The first was ascertained in a woman who was studied because of recurrent abortions. The second was ascertained in the father of a girl with the trichorhinophalangeal syndrome and an interstitial deletion in 8q. The latter is the first case in which unequal crossing over in an inversion loop can be inferred in a male carrier of a paracentric inversion. The reasons for the relatively low frequency of paracentric inversions observed and factors which affect the pregnancy outcome are discussed. PMID- 3804336 TI - A monozygotic twin pair with Rett syndrome. AB - A five-year-old, monozygotic, Turkish female twin pair with Rett syndrome is described. The twins are almost completely concordant in all clinical signs. This observation suggests a genetic cause of Rett syndrome. PMID- 3804337 TI - Prenatal diagnosis of a 46,XX,inv(12)pat/47,XX,i(Xq),inv(12)pat. AB - A 46,XX,inv(12)pat/47,XX,i(Xq),inv(12)pat was diagnosed prenatally in a 36-year old woman whose husband was a known carrier of a pericentric inversion of chromosome 12. The diagnosis was confirmed in fetal tissue. Terminal bromodeoxyuridine (BrdU) labelling demonstrated that in the line with 46 chromosomes one X was late replicating, while one X and the i(Xq) were late replicating in 100% of the cells with 47 chromosomes. We present the first case of this type of sex chromosome mosaicism. Genetic counseling presented difficulties since it was not possible to predict the fetal phenotype. PMID- 3804338 TI - Monosomy 21: a new case confirmed by in situ hybridization. AB - A new case of total monosomy 21 in a newborn is described. The diagnosis was first made using the cytogenetic data; it was then confirmed by the dosage of copper-superoxide dismutase (SOD-1) which showed a 50% decrease. In situ hybridization with a probe previously assigned to chromosome 21 was used to rule out the possibility of a partial monosomy with an unbalanced reciprocal translocation. PMID- 3804339 TI - Tentative assignment of hypomelanosis of Ito to 9q33----qter. PMID- 3804340 TI - Birth order, feeding care, and effectiveness of health education. PMID- 3804341 TI - Modified adult meals: a plausible alternative to orthodox weaning foods in a Nigerian community. PMID- 3804342 TI - Application of research results to health education. A target-group-specific media strategy to introduce a slimming-diet. PMID- 3804343 TI - Children's response to television food advertisements in Bahrain. PMID- 3804344 TI - [Eating behavior and life styles: research and action on nutrition in a rural area]. AB - Nutrition education has sometimes been portrayed as a normative discourse, forgetting that nutrition is at the heart of basic lifestyle habits. In fact, eating not only satisfies a basic need, it is a social and communication action that develops an interaction with a person's socio-economic and cultural framework. This article describes an educational programme that involved all 2,200 inhabitants of a small rural town in the south of France. The purpose of the study was to better define what was involved in the development of eating behaviours in order to adapt information for the population. Two hundred families, 28% of the town, were provided with a survey questionnaire. Questions about socio-economic and cultural data of the families, types of food provisions, cooking initiation, perceived knowledge of dietetics, and ways of sociability were included. This research permitted the identification of different profiles of eaters: working class families, the elderly, families without children, etc... The subsequent information campaign attempted to adapt its message to each category identified, taking into consideration economic and psychosocial factors, the attachment of the population to its culinary patrimony, and the pejorative vision of dietetics perceived by part of the population. The entire community collaborated at each stage of the programme. Conceived as a research project, it contributed to motivating the population to take an active role in the management of its health problems. PMID- 3804345 TI - [Role of the food industry in nutrition education]. AB - The way an individual feeds himself has a decisive influence on his health. Fortunately, this relationship is becoming better understood. Risks come from an imbalance. In the industrialized countries, this imbalance is due to an overabundance of food, while in the developing world, it is due to food shortages or inadequacies. In both cases, nutrition education can play an important role in improving the situation. The food industry contributes to nutritional education by offering products that correspond to the current needs of consumers and by informing them of product ingredients and nutritional characteristics. Given the important role that the industry plays in supplying the population, education is viewed as one of its social responsibilities. In the industrialised countries, food companies are already widely participating in this effort. All available communication channels are used, i.e. packaging, advertising, ad hoc information leaflets, educational materials in schools, professional associations, consumer agencies, etc... In the developing countries, nutrition education can have a beneficial influence where supplies are available but inadequately utilized. Despite communication problems that are more difficult to solve, food producers may also contribute to education in such situations, particularly through packages, information brochures and their distribution networks. It should not be forgotten that the improvement of consumer education remains the responsibility of those authorities in charge of education and health problems. While private companies are inclined more and more to participate, they can only contribute to relieving the problem. PMID- 3804347 TI - Some elements of the nutrition education policy of the World Health Organization. PMID- 3804346 TI - Nutrition education in the 80s. PMID- 3804348 TI - Pesticide residues in foods. PMID- 3804349 TI - How long should toxicity tests in rodents last? PMID- 3804350 TI - Risk assessment: British Toxicology Society Symposium. PMID- 3804351 TI - Charcoal-column haemoperfusion does not significantly enhance chlormethiazole removal. AB - A 26-year-old man had convulsions after taking an overdose of slow-release aminophylline tablets. The convulsions were treated with an infusion of chlormethiazole and theophylline was removed by charcoal-column haemoperfusion. It has been suggested that haemoperfusion might be useful for removing chlormethiazole and this was investigated. There was no evidence that charcoal column haemoperfusion could remove clinically significant amounts of chlormethiazole. PMID- 3804352 TI - Poisoning by chemical non-medicinal products in Brazil: clinical and laboratory findings in 132 patients. AB - One hundred and thirty-two patients with suspected exogenous intoxication were analysed according to clinical manifestation and toxicological results. Detection of toxic substances was performed in blood, urine and cerebrospinal fluid. The greatest occurrence of chronic exogenous intoxication was in males aged 21 to 50 years old. Peasants and industrial workers were the most affected. 70% of all patients showed neurological manifestations. There was clear predominance of central nervous system impairment associated with poisoning with herbicides and organophosphates. PMID- 3804353 TI - Childhood poisoning in Wales: experience of the Welsh National Poisons Unit (1984). AB - In 1984, 60% of all the enquiries made to the Welsh National Poisons Unit in Cardiff concerned children under 15, and 86% of the latter concerned children under 5. Nearly 60% of requests for information in childhood poisoning were about non-medicinal products and this contrasts with hospital admissions which are more often associated with medicinal products in this age group. Seasonal variability was noted for non-medicinal products such as pesticides and plant poisoning enquiries, whereas medicinal product enquiries remained constant over the year. The pesticides enquiries were greatest in Spring while those concerning plants were significantly greater in Summer. The latter was due to increased reports of ingestion of garden plants since the number of enquiries concerning house plants remained constant. Thus availability appears to be a major determinant of the risk of poisoning with any particular product in childhood. PMID- 3804354 TI - Poisoning associated with potassium. AB - A suicidal poisoning by intravenous administration of concentrated solution of potassium (K+) (chloride) is described in the study. A 30-year-old Caucasian female health professional was found dead in a motel. An intravenous needle was found inserted in the antecubital area in a right arm vein of the deceased. Attached to the needle, by a flexible tubing, was a 50 ml syringe four-fifths full of a clear liquid. Autopsy on the victim revealed pulmonary oedema and congestion. A routine toxicological analysis of biological samples ruled out the possibility of a drug overdose. However, the liquid from the syringe contained 1468 mmol of K+/l. Chloride ions were also present in high concentration in the liquid. The concentrations of K+ in the clear plasma and vitreous humour were 54 and 9.2 mmol/l respectively. It is suggested that the elevated level of K+ in the plasma or vitreous humour does not indicate necessarily a death due to the electrolyte. The evidence in this case is circumstantial and apparently can be expected to be so in any case where death is due to the intravenous infusion of a concentrated K+ solution. PMID- 3804355 TI - Formaldehyde-induced corrosive gastric cicatrization: case report. AB - A patient with poisoning due to formaldehyde ingestion is described. Endoscopy showed severe oesophageal burns and moderate gastric injury. Four weeks later endoscopy and barium examination revealed a normal oesophagus while the distal part of stomach was cicatrized. PMID- 3804356 TI - Paracetamol toxicity: is enzyme induction important? AB - A female patient receiving carbamazepine developed severe liver damage after an overdose of paracetamol. Antidotal therapy was not administered because her plasma paracetamol concentration was below that normally indicating the need for such therapy. Subsequently, carbamazepine was readministered and resulted in marked induction of the metabolism of a single dose of paracetamol. Antidotal therapy may be indicated if the plasma paracetamol concentrations are 70% or more of those shown in the conventional treatment line, if the patients are also receiving enzyme-inducing drugs. PMID- 3804357 TI - Seventh-nerve palsy and hepatitis associated with nitrofurantoin. AB - Adverse hepatic reactions to nitrofurantoin therapy are well reported and range from acute cholestatic or hepatitic injury to chronic active hepatitis [R G. Penn & J.P. Griffin (1982) Br. Med. J., 284, 1440-1442]. Neurological side-effects, predominantly sensorimotor peripheral polyneuropathy, have also been documented [R.G. Penn & J.P. Griffin (1982)]. We report the first case of combined neurological and hepatic reaction to nitrofurantoin; this occurred during repeated treatment with the drug. PMID- 3804358 TI - Acute poisoning by intentional ingestion of thallous malonate. AB - A 26-year-old man who ingested 10 g of thallous malonate was treated by gastric lavage and combined haemodialysis and haemoperfusion. At a blood flow of 100 ml/min, the average of thallium clearance values obtained by combined haemoperfusion and haemodialysis at two different times were 50.2 and 60.4 ml/min. Forty hours after ingestion, he died of cardiac failure. A higher concentration of thallium was found in the heart than in other organs, suggesting that the heart is the main target of thallium in the early stage of acute poisoning. PMID- 3804359 TI - Potassium permanganate induced oesophageal stricture. AB - A case of oesophageal stenosis following ingestion of potassium permanganate as an abortifacient is described. PMID- 3804360 TI - Detection of specific anti-hapten antibody-producing hybridoma cells in tissue sections of spleen and liver by hapten-enzyme conjugates using an immunoenzyme approach. AB - A method is presented for the detection of hybridoma cell growth in vivo by making use of the specific antigen (hapten) recognition properties of the produced monoclonal antibodies. Horseradish peroxidase (HRP)-labeled antigen was used for demonstration of intracellular specific antibodies in hybridoma cells. It appeared that intravenously injected anti-penicilloyl-producing hybridoma cells developed mainly in the red pulp of the spleen; to a lesser extent they were found in the liver. PMID- 3804361 TI - Production of monoclonal antibodies to salinomycin. AB - Protein conjugates of salinomycin were prepared and utilized to produce murine monoclonal antibodies (MAbs) in the BALB/c-P3X63.Ag 8.653 fusion system. Several antibodies were cloned, stabilized, and evaluated for cross-reactivity to other ionophorous antibiotics. Selected antibodies were used to develop quantitative assays for salinomycin by means of an enzyme-linked immunosorbent assay (ELISA). These assays were sensitive to 50 ng of salinomycin. PMID- 3804362 TI - Antigen-specific cell adherence assay: a new method for separation of antigen specific hybridoma cells. AB - A new method for the detection and separation of antigen-specific antibody producing cells on the basis of antibody-mediated recognition of solid-phase immobilized antigen molecules is described. Hybridoma cells are placed on microtiter plate wells coated with antigen molecules, and antigen-specific antibody-producing cells bind to the immobilized antigen molecules; antibody nonproducing or nonspecific antibody-producing cells can be easily separated from the bound cells by inverting the plate. Cells bound to solid-phase immobilized antigen molecules can readily be quantitated by counting under a light microscope, and the cells recovered can produce antibody in culture. Unspecific binding of cells in antigen-specific cell adherence assay (ASCAA) is optimally below 5%. Also, effect of drugs interfering with processes related to antibody production of antigen-specific cells can be detected and evaluated by ASCAA. PMID- 3804363 TI - Identification of a tumor-associated cell-surface antigen common to murine and human transformed cell lines. PMID- 3804364 TI - Auto-immunity. PMID- 3804365 TI - Murine natural monoclonal autoantibodies: a study of their polyspecificities and their affinities. AB - We have demonstrated that natural monoclonal antibodies (NmAbs) prepared from the spleens of either adult or neonatal non-immunized mice are polyspecific, i.e., they react with various self or non-self antigens. In the present study the polyspecificity of several NmAbs is analyzed in terms of dissociation constants (KDs) using a recently published sandwich-type immunoassay (Friguet et al. 1985). We calculated the NmAb KDs for various croos-reacting self (actin, myosin, tubulin, DNA) or non-self (spectrin, DNP-lysine, TNP-protein) antigens, and we compared the values obtained with those of experimentally-induced antibodies derived from immunized animals. The results show the NmAb KDs for macromolecule range between 10(-5) and 10(-10)M and, for a given antigen they are often of the same order of magnitude as those of induced monoclonal or polyclonal antibodies. On this basis, it appears that antibody specificity and affinity do not always correlate. In contrast to those of induced antibodies, the KDs for free hapten are high, whereas they are low when the same hapten is complexed to a macromolecule. Thus, it seems that although NmAbs and induced antibodies exhibit similar "functional affinities" for a macromolecule, they differ in their "intrinsic affinities" for a given epitope (hapten). Although the NmAbs examined exhibit similar broad reactivities for several antigens, their fine specificities for these antigens, as defined by the measurement of their KDs, are different. Thus, it appears that each NmAb can be considered unique. PMID- 3804366 TI - [Preventive chemotherapy in tuberculosis]. PMID- 3804367 TI - Alpha interferons in the treatment of hairy cell leukemia. PMID- 3804368 TI - A biological approach to optimize interferon treatment in hairy cell leukemia. AB - Progress with the clinical application of interferons to neoplastic diseases has been slow and complicated by the need for attention to a new spectrum of therapeutic and toxic effects manifested by the interferons. In this report, we present a new approach to define clinically effective but atoxic doses of interferon-alpha for treatment of hairy cell leukemia. In order to find in vivo biologically active interferon doses, the biochemical marker neopterin was selected as a means to assess a cellular interferon response in vivo. Subcutaneous administration of minimal doses of recombinant interferon-alpha-2 (5 8 X 10(5) U/day), which induced maximum neopterin release in serum and urine, proved to be clinically effective: Eight of nine patients responded to this dose regimen. This response rate was comparable to that of a conventional dose schedule (3 X 10(6) U/sqm/day) which was also applied to nine patients (eight responders). Whereas no difference in the clinical efficacy between the two therapeutic strategies could be established, toxicity was clearly confined to the conventional dose regimen. These preliminary results suggest that at least in hairy cell leukemia the therapeutic dose range of interferon can be separated from the toxic. PMID- 3804369 TI - Treatment of AIDS-associated Kaposi's sarcoma with recombinant alpha interferon. PMID- 3804370 TI - Treatment of metastatic malignant melanoma with recombinant interferon alpha 2. AB - Fifty-nine patients with metastatic malignant melanoma were entered into a phase II trial of recombinant alpha-2 interferon given in a dosage of 10 million IU/M2 subcutaneously three times per week for one year. Forty-five of these were evaluable for response. Of five evaluable patients with ocular primaries, none responded to interferon treatment. Four of 40 patients (10%) with cutaneous primaries achieved complete remission, and 6 further patients (15%) had partial remissions for a combined response rate of 25%. Two patients remain in complete remission 15+ and 32+ months after starting treatment. Responses were limited to subcutaneous, lymph node and lung metastases. The treatment schedule was well tolerated with the majority of patients receiving more than 70% of their predicted doses. Flu-like symptoms were the most common side effect. No evidence of cumulative toxicity was seen. We conclude that interferon is an active agent in metastatic malignant melanoma of cutaneous origin and that further trials are indicated. PMID- 3804371 TI - Characteristics of cloned and natural lymphokines: a comment on criteria which may be useful in establishing international standards. PMID- 3804372 TI - Lentil lectin inhibits cells producing graft-versus-host reaction but does not suppress hematopoietic stem cells in mice. AB - Treatment of mouse donors or recipients of allogeneic spleen cells with repeated injections of lentil lectin markedly suppressed regional and systemic graft versus-host reactions. The lectin acted selectively on lymphoid cells; hematopoietic stem cells were largely left unaffected. Repeated administration of the lectin decreased the number of lymphocytes and red blood cells and the amount of hemoglobin; other white blood cells increased in number. PMID- 3804373 TI - Lipopolysaccharides as complement inhibitors by complex formation with the purified third complement component (C3). AB - Lipopolysaccharides (LPS) from different bacteria in smooth or rough form (Y. enterocolitica, Y. pseudotuberculosis, E. coli, S. typhimurium, S. marcescens) strongly inhibited hemolytic C3 in incubation mixtures with purified C3. LPS from a core deficient mutant was still reactive, whereas lipid A no longer affected C3 activity. The physical state of LPS was critical for its effect on C3. Strand like LPS structures formed by Ca++-induced aggregation of solubilized LPS, as shown by electron microscopy, demonstrated the highest reactivity with C3. Inhibition of hemolytic C3 was found to be due to complex formation between LPS and C3 by a hydrophobic reaction. The binding capacity of 1 microgram LPS-R and LPS-S was as high as 125 ng C3 and 56 ng C3, respectively. The C3b fragment required different reaction conditions for maximal binding. The strong binding capacity of LPS for the complement component C3 raises the possibility that LPS act as inhibitors of complement by interruption of the reaction cascade at local infectious sites with gram-negative bacteria. PMID- 3804374 TI - Elemental concentrations within types 2 and 3 epithelial cells of the rat thymus. AB - The elemental composition (Na, Mg, P, S, Cl, K, Fe and Zn) of epithelial cells of rat thymus cortex has been determined using X-ray microanalysis of freeze-dried frozen sections. The cytoplasm contained highly significantly lower levels of potassium and phosphorus than the nuclei. When the results were compared with a previous study of the elemental levels in cortical thymocytes (using the same material), only differences in the P concentration were found. This is probably attributable to the greater degree of leptochromasia usually observed in epithelial cells compared with thymocytes. Since thymocyte maturation depends very closely on the microenvironment created by the epithelial cells, the great similarity in elemental levels observed in this study could be important in the control of cell division and maturation events. PMID- 3804375 TI - pH changes in the dermis during the course of the tuberculin skin test. AB - The response of six healthy young adults to tuberculin skin testing was studied. Five subjects developed a typical delayed-type hypersensitivity reaction to PPD with a local rise in skin temperature, and the sixth showed a less intense response; a considerable increase in blood flow velocity was seen in all reactions. All subjects showed a fall in pH in the dermis during the course of the reaction: in four subjects the pH minimum occurred at the time when the changes of erythema and induration were most prominent, in one subject the pH fall preceded the maximal clinical changes, and in the remaining subject a substantial fall in pH occurred with only transient erythema. It was concluded that the local tissue acidosis had resulted from the greatly increased metabolic demand of the lymphocytes and monocytes attracted into the dermis as part of the type IV delayed-type hypersensitivity reaction, and that the concurrent reactive hyperaemia was insufficient to clear the acidic metabolic products of the greatly increased cell population. PMID- 3804376 TI - Inhibition of human monocyte respiratory burst, degranulation, phospholipid methylation and bactericidal activity by pneumolysin. AB - The interaction between the pneumococcal toxin pneumolysin and human monocytes was examined. At non-cytotoxic concentrations (0.5-2.5 HU/10(6) cells) pneumolysin depressed the oxygen-dependent respiratory burst in monocytes, induced by opsonized zymosan or phorbol myristate acetate (PMA). This included depressed hexose-monophosphate shunt activity and hydrogen peroxide production. The toxin also depressed the ability of monocytes to degranulate (measured by release of lysozyme) in response to the above stimuli. Phospholipid transmethylation was also markedly decreased by pretreating monocytes with pneumolysin. These effects on monocyte functions were accompanied by a decreased ability of pneumolysin-treated monocytes to kill Streptococcus pneumoniae, the organism that produces the toxin. Cholesterol, which inhibits the haemolytic activity of the toxin, was shown to abrogate the effects of pneumolysin on monocytes. PMID- 3804377 TI - Stimulation of maturation of large immature histamine-containing basophilic cells from human peripheral blood, cord blood and bone marrow. AB - The development of FcR epsilon-bearing histamine-containing basophilic cells was studied in cultures of peripheral blood leucocytes and bone marrow leucocytes from normal individuals. The determination of basophilic cells was performed blindly. Before cultivation there were fairly similar numbers of basophilic cells in the samples from the three different sources (1.6 +/- 1.6 n = 13; 1.4 +/- 2.0 n = 21; 4.3 +/- 4.7 n = 8, respectively). During cultivation spontaneously appearing large blast-like basophilic cells were seen in good correspondence with a formation of histamine in the cultures (Spearman rank correlation coefficient = 0.9135, n = 13, P less than 0.001). This was more accentuated with bone marrow cells than with peripheral blood and cord blood cells. Conditioned medium (CM) was prepared from cells isolated from various tissues and stimulated by different means, e.g. peripheral blood from atopic individuals stimulated with allergen and unstimulated tonsil cells. Addition of the CM resulted in increased development of histamine-containing basophilic cells. Optimum stimulation was achieved with 10% CM. The basophilic stimulation by CM, as assessed as indices vs. unstimulated cultures, was more accentuated in cultures of peripheral blood cells than of bone marrow and cord blood cells (2.8 +/- 1.2; 1.8 +/- 0.5; 2.0 +/- 0.4, respectively). In contrast, the histamine formation was particularly evident in stimulated cultures of bone marrow cells, where more than four-fold increases of histamine were found. In bone marrow cells the histamine levels per basophilic cell also increased, whereas this was not the case in cord blood cells. A pronounced development of basophilic cells was achieved when using leukoagglutinin, provided the mitogen in the CM was eliminated. The formation of basophilic cells was prevented with mitomycin c and cycloheximide. In conclusion, the system described may provide important information on the development of histamine-containing basophilic cells at various maturation stages from different compartments, and mechanisms in a developing atopic disease. PMID- 3804378 TI - Suppression of IgE responses by hyperimmune serum in rats. AB - Recent work has shown that a relatively long-lasting suppression of egg albumin (EA)-specific IgE responsiveness occurs in the progeny of EA-immunized mother rats. This phenomenon can be duplicated by a course of EA-immune serum injections given to the neonatal progeny of normal mothers, and antigen-specific IgG was found to be the effective mediator. In order to elucidate further the mechanism of this selective suppression, the capacity of immune serum to suppress IgE responsiveness in adults was investigated. Pretreatment of adults with hyperimmune serum 3 weeks in advance of immunization was as effective as when the animals were neonatally treated. The possibility that the mediator responsible is the very small amount of EA-specific IgG remaining at the time of immunization was tested by injecting a small volume of immune serum simultaneously with immunization. This treatment also suppressed IgE responsiveness. The possibility that low levels of EA-specific antibody form complexes with the immunizing antigen is discussed. PMID- 3804379 TI - Effects of LS-2616 administration upon the autoimmune disease of (NZB x NZW) F1 hybrid mice. AB - Autoimmune (NZB X NZW) F1 female hybrid mice were treated with LS-2616, a recently developed substance with immunomodulating properties. Treatment was initiated at the age of 4 months (i.e. at the early stage of the disease) as well as at 7 months of age (i.e. after the development of established lupus-like disease). Control groups treated with cyclophosphamide and physiological saline were also studied. Beneficial therapeutic effects were obtained regardless of when the treatment was initiated and the dose of LS-2616 administered (1 and 8 mg/mouse/week). The effects of LS-2616 on longevity, splenomegaly and glomerulonephritis were pronounced and sometimes comparable to those of cyclophosphamide (1.8 mg/mouse/week). The results obtained suggest that LS-2616 may be useful in the treatment of autoimmune disease in man. PMID- 3804381 TI - The Ig class distribution of anti-phosphoryl choline responses in mice infected with parasitic nematodes. AB - The anti-phosphoryl choline antibody responses of resistant and susceptible strains of mice infected with microfilariae of Dipetalonema viteae or the gastrointestinal nematode parasite Trichinella spiralis were determined. The responses were characterized both in terms of their kinetics and the constituent role played by each immunoglobulin heavy-chain class. Infection with either parasite elicited detectable responses in all strains investigated. However, the kinetics of the response of each heavy-chain class within each strain could vary independently. Furthermore, differences were observed between the responses of inbred mouse strains that differ in their ability to control infection. It was not possible, however, to correlate these differences in the serological response with the ability of these animals to control infection. The results are discussed in relation to attempts to improve serological diagnostic assays. PMID- 3804380 TI - Evidence for a novel HLA antigen found on human extravillous trophoblast and a choriocarcinoma cell line. AB - We describe the characterization of a novel HLA Class I molecule, which we have isolated from chorionic cytotrophoblast cell membranes, and from a trophoblast derived choriocarcinoma cell line, BeWo; classical HLA Class I antigens are not expressed on these cells. This antigen is an electrophoretically non-polymorphic glycoprotein of approximately 40,000 molecular weight, which is found in association with beta 2 microglobulin, and which is detected by monoclonal antibodies recognizing monomorphic determinants of HLA Class I. Elucidation of the nature and origin of this molecule may provide valuable information regarding the immune barrier that exists between mother and fetus. PMID- 3804383 TI - Anti-cholera response elicited by a completely synthetic antigen with built-in adjuvanticity administered in aqueous solution. AB - Some synthetic peptides derived from the B subunit of cholera toxin, conjugated to tetanus toxoid have been shown by us to be efficient when administered in complete Freund's adjuvant (CFA), in induction of anticholera toxin response with neutralizing capacity. When the peptide CTP3, corresponding to residues 50-64 within the sequence of the B subunit, was attached to the hardly immunogenic A-L (multichain poly-DL-alanine) the resulting conjugate did not lead to a significant anti-peptide response even when given in CFA. On the other hand, when CTP3 was coupled to the immunogenic (T,G)-A-L, the resulting CTP3-(T,G)-A-L led, in CFA, to protective anti-cholera antibodies. Moreover, covalent attachment of the synthetic adjuvant N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) to the latter immunogen led to MDP-CTP3-(T,G)-A-L which, when administered in aqueous solution, elicited in rabbits antibodies with neutralizing capacity. PMID- 3804382 TI - Transfer of enhanced resistance against Listeria monocytogenes induced with ribosomal RNA and the adjuvant dimethyldioctadecylammonium bromide. AB - In this study we investigated the mechanism of enhanced resistance against Listeria monocytogenes induced with Listeria ribosomal RNA and the adjuvant dimethyldioctadecylammonium bromide (DDA). Mice immunized with DDA alone (which were not protected against Listeria-infection) were used as negative controls. Mice immunized with RNA plus DDA were found to have an increased capacity to mobilize polymorphonuclear leukocytes (PMNs) and macrophages to the inflamed peritoneal cavity compared to mice immunized with adjuvant alone. Intraperitoneal (i.p.) inflammation was induced by injection of the sterile irritant proteose peptone. The protective capacity of various cell-populations was investigated by i.p. transfer of cells to normal recipient mice and concomitant challenge of recipient animals with a lethal dose of viable Listeria. Inflammatory PMNs as well as inflammatory macrophages from mice immunized with RNA plus DDA protected recipient animals against listeriosis whereas cells from mice immunized with DDA alone failed to do so. Therefore, enhanced mobilization as well as activation of PMNs and macrophages may have contributed to the expression of protection against L. monocytogenes induced with RNA plus DNA. PMID- 3804385 TI - Dental caries in India. PMID- 3804384 TI - Regulation of breathing during oral feeding. PMID- 3804386 TI - Medical genetics in India. PMID- 3804388 TI - Chromosomal basis of recurrent fetal losses. PMID- 3804389 TI - Genetic counseling in pediatric practice. PMID- 3804387 TI - Fragile X syndrome: clinical, cytogenetic, biochemical and molecular features. PMID- 3804390 TI - Prenatal diagnosis of genetic disease by chorionic villi sampling. PMID- 3804391 TI - Indomethacin for closure of patent ductus arteriosus in preterm neonates. PMID- 3804392 TI - Higher risk of epilepsy in twins. PMID- 3804393 TI - Prediction of peak expiratory flow rate from height and weight. PMID- 3804394 TI - Aborted thoracopagus. PMID- 3804395 TI - Hypertension research: echocardiography in the measurement of left ventricular wall mass. Chicago, Illinois, September 25, 1984. PMID- 3804396 TI - Standardization in the measurement of left ventricular wall mass. Two-dimensional echocardiography. AB - Two-dimensional echocardiography is superior to M-mode echocardiography for estimation of left ventricular mass when left ventricular shape is markedly abnormal. Left ventricular mass measurement by two-dimensional echocardiography depends on careful experimental calibration of the echocardiographic instrument using either a standard phantom or actual heart slices, and appropriate geometric algorithm, and short axis images to determine myocardial cross-sectional area. Several well-validated algorithms are available, of which the short-axis area length technique is the simplest. In hypertensive heart disease, in which left ventricular shape is usually close to normal, two-dimensional echocardiography may offer a smaller standard error than M-mode, but this issue requires further evaluation. Further, it is uncertain whether the incremental accuracy of two dimensional echocardiography in hypertensive heart disease would offset its increased cost and complexity relative to M-mode echocardiography. PMID- 3804397 TI - Considerations in the standardization of measurement of left ventricular myocardial mass by two-dimensional echocardiography. AB - Optimization of two-dimensional determination of left ventricular mass requires minimizing sources of variability. To accomplish this goal, attention must be directed to the technical aspects of image acquisition, selection of a geometric model, and calibration of imaging and quantitation instrumentation. This paper considers the role of each of these factors in developing a strategy for measuring left ventricular mass with a degree of accuracy suitable for both clinical and investigative applications. PMID- 3804398 TI - Effect of age, sex, and body surface area on echocardiographic left ventricular wall mass in normal subjects. AB - M-mode echocardiography was used to estimate left ventricular wall mass in 136 older normal subjects (Group I: 78 men and 58 women, ages 20 to 97 years) and 105 younger normal subjects (Group II: 52 male and 53 female subjects, ages 1 day to 23 years). Echocardiographic left ventricular mass (in grams) was estimated from the following formula: left ventricular mass = 1.05 ([ left ventricular internal diastolic dimension + ventricular septal thickness (diastole) + posterior wall thickness (diastole)] - [left ventricular internal diastolic dimension]). In both groups, female subjects had a slightly smaller left ventricular mass than male subjects (mean difference 7.2% in Group I, p less than 0.05, and 3.6% in Group II, p = 0.05) for any given age and body surface area. Left ventricular mass varied linearly with body surface area and increased as a function of age. In group I subjects, echocardiographic left ventricular mass (in grams) could be estimated by the general formula: left ventricular mass = 124 (body surface area) + A +/- C, where A is the age-dependent intercept; +/- C encompasses a 95% prediction interval for normal values, which is assumed to be nearly constant (+/ 58 g); and body surface area is expressed in square meters. In the Group II (younger) subjects, with age not considered, left ventricular mass (in grams) could be estimated from the following formula: left ventricular mass = 115 (body surface area) -11 +/- C, where +/- C = +/- 32% and this 95% prediction interval varies as a percentage of the mean.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804399 TI - Considerations in the use of echocardiography in epidemiology. The Framingham Study. AB - To quantify potential biases in the use of echocardiography in epidemiologic studies, we assessed the relationship of sex, age, vital capacity, body fatness, and overt cardiovascular disease to prevalence of acceptable echocardiograms in 6148 Framingham men and women aged 17 to 90 years. Echocardiograms adequate to assess left ventricular chamber dimensions and wall thickness, aortic root, and left atrial dimensions as well as mitral and aortic valves were obtained in 4947 (80%) of the 6148 subjects. The prevalence of acceptable echocardiograms ranged from less than 50% for those more than 80 years of age to more than 96% for subjects under 30 years of age. A significant learning curve was apparent, particularly in the older subjects (more than 60 years of age) for whom prevalence of acceptable echocardiograms rose from a minimum of 28% during the first 5 months of studies to a maximum of 74 to 81% during studies 2 years later. The likelihood of unacceptable echocardiograms was slightly greater in men. Obesity (in subjects younger than 60 years of age), lower vital capacity, and overt cardiovascular disease were associated with unacceptable echocardiograms, independent of age. Consideration of these biases should aid in the interpretation and planning of epidemiologic and other studies using echocardiography. PMID- 3804400 TI - Measurement of left ventricular wall mass in pediatric populations. AB - This paper reviews the techniques for obtaining technically adequate echocardiograms for epidemiologic studies. When these techniques were applied to studies of pediatric populations the following objectives were achieved: reproducible echocardiograms, observations about the relationship of echocardiographic variables to cardiovascular variables, and information about the relationship of echocardiographic and electrocardiographic variables to each other and to blood pressure. We documented the precision of M-mode left ventricular chambers and dimensions, interobserver and intraobserver variability, and the day-to-day variability of these measures. Left ventricular wall mass was significantly larger than expected for age and body size in children with persistently elevated blood pressure. The relationship between the echocardiographic and electrocardiographic variables was poor. Moreover, the electrocardiographic measures of ventricular hypertrophy did not correlate with blood pressure. PMID- 3804401 TI - Future directions in the use of echocardiography. AB - The heart may play an active, passive, or incidental role in the pathogenesis of hypertension. Echocardiography probably contributes little to understanding of active mechanisms, although it may provide important information relative to structural and functional adaptive changes associated with development of left ventricular hypertrophy. Moreover, because other clinical conditions frequently coexist with hypertensive heart disease, echocardiography may provide another dimension in the assessment of obesity, coronary heart disease, mitral valve prolapse, idiopathic hypertrophic subaortic stenosis, and asymmetric septal hypertrophy in the overall problem. Critical in this understanding are the subtle changes that occur in the individual patient, reflecting the natural history of the disease or response to its treatment. Since technical problems preclude echocardiographic evaluation in all patients with hypertension, particular care must be exercised in making epidemiologic generalizations. PMID- 3804402 TI - Echocardiographic assessment of left ventricular diastolic performance in hypertensive subjects. Correlation with changes in left ventricular mass. AB - Left ventricular hypertrophy resulting from hypertension is accompanied by significant morbidity and mortality and in advanced stages may be irreversible. Hence, early detection of cardiac changes in hypertensive patients remains an important diagnostic goal. When the hypertrophy is mild or moderate, parameters of left ventricular diastolic function and measurements of left atrial size may facilitate the distinction between normal variation and pathologic increases in left ventricular mass. We measured left ventricular isovolumic relaxation time (IVRT, the time from aortic valve closure to mitral valve opening) and left atrial dimensions and correlated them to left ventricular mass index measured by M-mode echocardiography and rapid left ventricular filling by radionuclide ventriculography. In 20 subjects with untreated mild essential hypertension, IVRT was prolonged compared to a normotensive age-matched control group (91 +/- 23 vs 65 +/- 13 msec, p less than 0.0001). Left atrial dimension index was increased in patients compared to controls (1.9 +/- 0.4 vs 1.4 +/- 0.5 cm/m2, p less than 0.001), and this increase was related to prolonged IVRT (r = 0.46, p less than 0.001). Abnormal IVRT correlated with both increased left ventricular mass and decreased rapid ventricular filling in the hypertensive subjects. Thus, prolonged IVRT and borderline left atrial dimension may help identify subtle pathologic left ventricular mass increases in hypertensive subjects. PMID- 3804403 TI - Geometric considerations in determination of left ventricular mass by two dimensional echocardiography. AB - This review describes the technique of and advances in determination of left ventricular mass by two-dimensional echocardiography. Two-dimensional echocardiographic model systems, which require geometric assumptions, may have limited accuracy in mass determination if ventricular shape is deformed or the architecture is irregular, as it may be in various disease states. Recently developed techniques allow free angulation of the echocardiographic transducer with continuous recordings of the three-dimensional coordinates of each image without imposing restraints on transducer orientation. These developments have led to methods for accurate three-dimensional reconstruction of left ventricular mass, even in the presence of severe dilatation or deformity. With the interaction of two-dimensional echocardiography, a coordinate system for locating the transducer in three-dimensional space, and computer-aided echocardiographic contouring, it is possible to obtain left ventricular mass estimates with a high degree of accuracy from randomly oriented views without practical restriction on transducer motion or major geometric assumptions. PMID- 3804404 TI - I.C.D.S.: realities and course of desired changes. PMID- 3804405 TI - Infant growth in the perinatal period. PMID- 3804406 TI - Perinatal and infant mortality in urban slums under I.C.D.S. scheme. PMID- 3804407 TI - Renal function in relation to metabolic control in juvenile onset diabetes of different duration. PMID- 3804408 TI - Placental morphology and histopathology in low birth weight. PMID- 3804410 TI - Psychiatric disorders among children attending pediatric O.P.D. PMID- 3804409 TI - Mortality patterns in under six children in I.C.D.S. urban slum. PMID- 3804412 TI - Viral hepatitis in children. PMID- 3804411 TI - Are delinquents born or made by us? PMID- 3804413 TI - Neonatal systemic candidiasis. PMID- 3804414 TI - Hemolytic uremic syndrome. PMID- 3804415 TI - Congenital complete heart block in an infant of diabetic mother. PMID- 3804416 TI - Iodine deficiency. PMID- 3804417 TI - Management of immunization programme. PMID- 3804418 TI - Immunological study of bronchial asthma. PMID- 3804419 TI - Twin births at Madurai. PMID- 3804420 TI - Chromosome study of induced aborted Indian fetuses. PMID- 3804421 TI - Pseudomembranous colitis in children. PMID- 3804422 TI - Child labor. PMID- 3804423 TI - Misuse of steroids. PMID- 3804424 TI - Brain edema. PMID- 3804425 TI - Electrolyte content of water in Jaipur. PMID- 3804426 TI - Resistant tuberculosis. PMID- 3804427 TI - Bizarre trichobezoars. PMID- 3804428 TI - Sexual precocity in primary hypothyroidism. PMID- 3804429 TI - Oral rehydration solution--its erroneous use. PMID- 3804430 TI - Sjogren-Larsson syndrome. PMID- 3804431 TI - Copper and Indian childhood cirrhosis. PMID- 3804432 TI - Family health cards. PMID- 3804433 TI - [Intraoperative infusion therapy. Evaluation of the rate of administration and assessment of the effectiveness of infusion warmers]. AB - A look at the efficiency of infusion warmers from the clinician's point of view must be based on the infusion rates usually necessary in the operating room. Therefore a retrospective evaluation of 1,510 anesthesia records was made in order to register the flow rate of every infusion. As a general rule the flow rate did not exceed 1.5 1/h. Our past warming apparatus was found not very effective in this range under the standard conditions of a cold operating room with laminar air flow. A new in-line warmer, fast and easy to handle, proved superior in daily use. PMID- 3804434 TI - [Renal effects of dopamine in healthy adults with special reference to the excretion of phosphate and calcium]. AB - The intravenous application of 4 micrograms/kg/min dopamine (DA) over 3 h in 11 healthy volunteers resulted in an increase in inulin clearance and urine volume by about 10%, renal excretion of sodium and calcium being increased by DA by a factor of 5. We found a strong linear correlation between changes of renal excretion of sodium and calcium under DA (r = 0,90). The concentration of ionized calcium in whole blood was absolutely stable under DA in the range of 1.25 to 1.27 mmol/l. The application of the catecholamine also resulted in a significant reduction of plasma volume by a mean of about 10% and in a nonsignificant reduction of intravascular protein mass by 8%. The phosphaturic effect of DA was weak and unpredictable. We suppose that in the intact organism the pharmacologic effect of dopamine on the tubular handling of phosphate which seems to be experimentally proven, may be masked by other mechanisms with an antiphosphaturic action such as increased levels of growth hormone and/or insulin. PMID- 3804435 TI - [Anthropometric parameters]. AB - Anthropometry is defined as the comparative measurement and study of the human body. Anthropometric measurements have been used for many years to assess the nutritional status of individuals and populations in the United States. More recently anthropometric measurements have become a routine part of the nutrition assessment of surgical patients. Upper arm anthropometry and handgrip dynamometry are rapid and inexpensive tests for detecting malnutrition, but they are not useful for preoperative screening to predict postoperative morbidity because appropriate standards are missing in Europe. In a prospective study none of these preoperatively measured variables were of predictive value to postoperative complications, relating the method to its specificity, sensitivity, and validity. PMID- 3804436 TI - [Therapy using blood components. Prerequisites, indications and clinical use]. AB - The therapeutic benefit of blood components for specific substitution and volume replacement has been recognized for more than ten years. The increasing demand for blood and blood products, especially for albumin in connection with an only moderate growth of the base of blood donors has promoted the idea of a more efficient utilization of blood by specific replacement with blood components. The component therapy has reduced the side effects and improved the efficacy of blood transfusion and last but not least has led to a positive cost-effectiveness. Our clinical management of blood transfusion with a nearly complete use of components in surgical patients is presented. Particularly, the therapeutic strategy for massive transfusions by component therapy is discussed. In face of the technical and logistic problems, a transfusion schedule was developed which outlines the nearly exclusive therapeutic use of components. It applies with modifications and adjustment to the critical parameters to all cases of rapid and massive blood loss. In addition, diagnostic and therapeutic strategies are considered to preserve hemostasis or correct occurring hemostatic defects and to prevent thrombo-embolic events. PMID- 3804437 TI - Erythrocytes as a source of essential lipids for Treponema hyodysenteriae. AB - Mammalian erythrocytes were tested as a nutrient source for the spirochete Treponema hyodysenteriae, the etiologic agent of swine dysentery. Brain heart infusion (BHI) broth did not support growth of T. hyodysenteriae B204 or B78. However, BHI broth supplemented with washed bovine erythrocytes, erythrocyte membranes, or cholesterol was an excellent culture medium for these strains (4 X 10(8) to 10(9) cells per ml, final population densities). Small amounts of cholesterol (3 to 10 micrograms/ml of medium) were required for maximum cell yields of strain B204. Of various sterols and sterol-like compounds tested, cholestanol and sitosterol could substitute for cholesterol. BHI-dehydrated medium extracted with CHCl3-CH3OH (2:1, vol/vol) to remove lipids was used to prepare lipid-depleted culture broth. Lipid-depleted broth supplemented only with cholesterol did not support T. hyodysenteriae B204 growth. However, this same broth supplemented either with vesicles made from cholesterol and phosphatidylcholine or with washed erythrocytes was a good culture medium for the spirochete. Thus, both cholesterol and a phospholipid are needed for T. hyodysenteriae growth in lipid-depleted broth. Mammalian erythrocytes can be used by the spirochete as a source of these lipids. PMID- 3804438 TI - Cholesterol metabolism by Treponema hyodysenteriae. AB - The sterol content of cellular lipids of Treponema hyodysenteriae, the agent of swine dysentery, was determined. When cultured in lipid-depleted brain heart infusion broth containing vesicles made from [4-14C]cholesterol and phosphatidylcholine, T. hyodysenteriae cells incorporated radioactive label. Most (95%) of this radioactivity was associated with bacterial membrane preparations. Lipids were extracted from radiolabeled cells and fractionated by silicic acid column chromatography. Components of the neutral lipid fraction were separated by reversed-phase high-performance liquid chromatography and were detected by monitoring both radioactivity and UV absorption (210 nm) of the column effluent. Cholesterol represented only about 5% of the total radioactivity in the bacterial neutral lipids. The remaining radioactivity was associated with a compound that did not absorb light at 210 nm. This lipid was purified and, on the basis of results from thin-layer chromatography and mass spectrometry, was identified as cholesterol (5 alpha-cholestan-3 beta-ol), a sterol lacking the unsaturated bond of cholesterol. Cholestanol was also present in cell-free culture broth, but only after growth of the spirochete. These results are evidence that cholesterol is used by T. hyodysenteriae for membrane synthesis. Cholesterol is converted to cholestanol in T. hyodysenteriae cultures and cholestanol is a major component (approximately 9% by weight) of T. hyodysenteriae cell lipids. PMID- 3804439 TI - Effects of diet and genetics on Mycobacterium bovis BCG vaccine efficacy in inbred guinea pigs. AB - Strain 2 and strain 13 guinea pigs were vaccinated with Mycobacterium bovis BCG and placed on low-protein or protein-adequate diets. Five weeks later all animals were infected by the respiratory route with virulent Mycobacterium tuberculosis H37Rv organisms. Four weeks postchallenge, guinea pigs were skin tested with purified protein derivative and sacrificed. Protein deficiency resulted in significant reductions in body weight and thymus weight and in an impairment in the ability to control the M. bovis BCG vaccine organisms and to mount delayed hypersensitivity reactions. Protein deficiency also adversely affected the efficacy of the BCG vaccine as demonstrated by the numbers of virulent organisms recovered in spleens and lungs. Strain differences were observed in the number of leukocytes, thymus weight, and the responsiveness of blood lymphocytes to purified protein derivative stimulation. In general, strain 13 guinea pigs responded more dramatically to dietary insult than did their strain 2 counterparts. Protein deprivation completely abolished BCG vaccine protection in the lungs and spleens of strain 13 animals and significantly reduced the protection afforded to strain 2 animals. In both strains, the BCG vaccine protected normally nourished guinea pigs. There was no significant difference between strains with respect to susceptibility to pulmonary infection with virulent mycobacteria. Thus, diet and genetic pedigree each had a significant influence on BCG vaccine efficacy. PMID- 3804440 TI - Selective pressures and lipopolysaccharide subunits as determinants of resistance of clinical isolates of gram-negative bacilli to human serum. AB - Differences in molecular composition of lipopolysaccharides (LPS) between serum sensitive (S) clinical isolates of Escherichia coli and serum-resistant (R) clones derived by serial passage in serum were demonstrated to determine sensitivity or resistance to killing by normal human serum (NHS). LPS from R clones had a greater proportion of higher-molecular-weight, more highly O-antigen substituted subunits than LPS from their serum S parents. Utilization of a liposomal model with inserted LPS simulating bacterial cell walls established LPS as the site of serum bactericidal action. Liposomes containing S LPS were lysed, while liposomes containing R LPS were unaffected by NHS. R and S LPS were fractionated into higher (F1)- and lower (F2)-molecular-weight fractions. Liposomes containing R LPS or the F1 fraction of S and R LPS were not lysed by serum. Liposomes containing the F2 fraction of S or R LPS were lysed by serum analogous to that observed with liposomes containing intact S LPS. These findings establish LPS to be one site of serum bactericidal activity and demonstrate that the higher-molecular-weight, highly O-antigen-substituted LPS subunits mediate resistance to killing by NHS. PMID- 3804441 TI - Proline requirement for glucose utilization by Peptostreptococcus anaerobius ATCC 27337. AB - Resting cells of Peptostreptococcus anaerobius maintained under anaerobic conditions were unable to metabolize either glucose or alanine. The addition of proline to the appropriate suspension, however, resulted in the immediate utilization of both compounds. Fermentation of alanine by the cells required that stoichiometric concentrations of proline be present in the medium; and during the oxidation of alanine, proline was simultaneously reduced to the ring cleavage product delta-aminovaleric acid. Although proline was required to initiate glucose transport, stoichiometric amounts of the imino acid were not necessary for glucose fermentation. Proline also stimulated the uptake and concomitant phosphorylation of the nonmetabolizable glucose analog 2-deoxy-D-glucose. The proline requirement for glucose transport by P. anaerobius could be replaced by adding ferricyanide or simply by aerating the cell suspension. The initiation of sugar uptake by proline, ferricyanide, and O2 was attributed to the capacity of these compounds to function as electron acceptors, which permitted reoxidation of the (reduced) intracellular nucleotide pool and the formation (from an endogenous reserve) of the high-energy donor(s) required for the vectorial transport and phosphorylation of sugar. PMID- 3804442 TI - Contribution of Salmonella gallinarum large plasmid toward virulence in fowl typhoid. AB - Four strains of Salmonella gallinarum isolated from independent cases of fowl typhoid all possessed both an 85-kilobase and a 2.5-kilobase plasmid. Each plasmid was eliminated in turn from one of the strains by transposon labeling and curing at 42 degrees C. Elimination of the small plasmid had no effect on the high virulence of the strain for newly hatched and 2-week-old chickens. Whereas oral inoculation of 2-week-old chickens with the parent strain produced 90% mortality with characteristic signs of fowl typhoid, inoculation of the large plasmid-minus strain produced 0% mortality. A corresponding increase in the 50% lethal dose from log10 1.1 to greater than log10 7.3 was seen with the large plasmid-minus strain after intramuscular inoculation. Reintroduction of the large plasmid completely restored virulence. A role for the plasmid-linked virulence genes in both invasion and growth in the reticuloendothelial system is suggested by the failure of the large-plasmid-minus strain to penetrate to the liver and spleen after oral inoculation and by its increased clearance from the reticuloendothelial system after intravenous inoculation. These results clearly demonstrate that the large plasmid of S. gallinarum contributes toward virulence in fowl typhoid of chickens. PMID- 3804443 TI - Enhancement of endotoxin lethality and generation of anaphylactoid reactions by lipopolysaccharides in muramyl-dipeptide-treated mice. AB - Intravenous injection of muramyl dipeptide (MDP) and Salmonella lipopolysaccharides (LPS) enhanced lethal toxicity of the LPS in C57BL/6 mice. This was true for S (smooth)- and R (rough)-form LPS and free lipid A. Enhancement of toxicity was maximum when the LPS was administered 4 h after MDP, at which time the lethal doses for 50% of mice of S- and R-form LPS and free lipid A were between 1 and 10 micrograms, compared with more than 100 micrograms in normal animals. This sensitization was absent in endotoxin-resistant C3H/HeJ mice. Lethality usually commenced 15 h after LPS injection and was complete after 72 h. Higher doses of some S-form LPS (100 micrograms or more) administered 4 h after MDP led to a strong anaphylactoid reaction within 10 to 20 min of injection, with lethal outcomes in less than 1 h after LPS administration. This early anaphylactoid reaction was observed for various mouse strains, including LPS-resistant C3H/HeJ mice, but it was very weak or completely absent with R-form LPS or free lipid A even in concentrations of up to 1,000 micrograms. A strong anaphylactoid reaction comparable to that seen with S-form LPS was also obtained, after MDP treatment, with an LPS of low toxicity prepared from Bacteroides gingivalis. It is noteworthy that oral administration of MDP also contributed to the anaphylactoid reaction and enhanced the late-phase lethality of LPS. The present findings strongly suggest that the early- and late-phase reactions induced by MDP and LPS are caused by different mechanisms. PMID- 3804444 TI - Absence of significant cellulase activity in microbial flora of the female genital tract. AB - It has been postulated that toxic shock syndrome may be mediated by the hydrolysis of certain tampon fibers by bacteria of the female genital tract, leading to the release of glucose that would in turn serve as a substrate for the multiplication of staphylococci producing the toxic shock marker protein (TSST 1). We sought cellulolytic organisms among microorganisms isolated from the female genital tract throughout the menstrual cycle. A total of 288 aerobic and facultative vaginal isolates from 13 healthy female volunteers, aged 18 to 25, and 57 anaerobes from the same sources were screened for cellulase activity. No evidence of production of glucose or degradation of cellulose was found; hence, none of the strains could be described as cellulolytic. A total of 44 organisms (12.7%) showed weak endoglucanase activity as evidenced by minimal changes in the viscosity of the cellulose substrate, but this activity was not reproducible in all of the strains and was inconstantly observed on repeated examination. Five strains of Staphylococcus aureus isolated from cases of toxic shock syndrome also showed no cellulase activity. Cellulase activity does not appear to be a frequent or regular feature of the microflora of the human female genital tract. PMID- 3804445 TI - Relationship of cell surface morphology and composition of Streptococcus salivarius K+ to adherence and hydrophobicity. AB - The cell surfaces of a range of variants of Streptococcus salivarius HB, altered in cell wall antigen composition, were compared with those of the parent with respect to adherence, ability to adsorb to hexadecane, morphology, and exposure of lipoteichoic acid (LTA). Adherence to host surfaces was measured by using both saliva-coated hydroxyapatite beads and tissue-cultured HeLa cells, and interbacterial adherence was measured by using Veillonella alcalescens V1 cells. Progressive loss of the protease-sensitive fibril classes was generally associated with decreasing ability to adsorb to hexadecane. However, increased exposure of protein antigen C (AgC) increased the apparent hydrophobicity of the cell. This correlated with the finding that AgC was the most hydrophobic of the solubilized fibrillar cell wall antigens. Collectively, this demonstrates that adsorption to hydrophobic ligands is directly related to the density of the fibrillar layer on the cells and the properties and surface exposure of specific fibril classes. The involvement of hydrophobic interactions in AgC-associated attachment was suggested by its sensitivity to low levels of the hydrophobic bond breaking agent tetramethyl urea, although the reduction was not to the level of adherence observed with strains lacking AgC. However, hydrophobicity was less essential to other adherence reactions. Circumstantial evidence, including immunoelectron microscopy, showing that LTA was virtually absent from the fibrillar layer, whole-cell enzyme-linked immunosorbent assay, suggesting that surface exposure of LTA related inversely to the density of the fibrillar layer, and agarose gel electrophoresis, showing that LTA was not specifically associated with protein fibrillar antigens, strongly suggested that LTA does not confer hydrophobic properties to these cells and is not involved in adherence reactions associated with the cell wall protein antigens. PMID- 3804446 TI - Susceptibilities of macrophage populations to infection in vitro by Leishmania donovani. AB - Many studies have demonstrated differences in the resistance of strains of mice to infection by Leishmania donovani, Salmonella typhimurium, and Mycobacterium bovis BCG; this resistance/susceptibility phenotype seems to be controlled by a single gene. The present study investigated the susceptibility of liver, lung, peritoneal, and spleen macrophages to infection by L. donovani promastigotes in vitro; the objective was to determine if the susceptibility of animals was expressed by their macrophages when infected in vitro. This study indicated that the Lsh phenotype was only expressed by liver macrophages. The liver macrophages of the susceptible C57BL/6J strain were significantly more phagocytic than those of the resistant C57L/J strain; infection affected the phagocytic activity of the macrophage population. These results indicated that only liver macrophages can express the Lsh gene. Recognition of expression is in part due to its effect on the phagocytic activity of the macrophages. PMID- 3804447 TI - Determinants of the immunogenicity of live virulent and mutant Vibrio cholerae O1 in rabbit intestine. AB - Determinants of the capacity of live Vibrio cholerae O1 isolates to evoke specific immune responses in intestinal mucosa were studied in rabbits, using mucosal immunoglobulin A (IgA) antitoxin as the measured immune response. Antitoxin responses were evoked mostly by the primary inoculation and were dose dependent; secondary-type responses were modest and occurred only when the booster inoculum was large, i.e., 10(10) CFU. The efficiency of mucosal immunization correlated closely with the mucosal colonizing capacity of the infecting strain and was otherwise independent of toxin genotype (A+ B+ or A- B+) or whether the strain was motile or nonmotile. Live bacteria evoked mucosal antitoxin more efficiently than did purified cholera toxin. Prior immunization with a nontoxinogenic (A- B-) V. cholera strain interfered significantly with the induction of mucosal antitoxin by subsequent immunization with its fully toxinogenic (A+ B+) parent. These results demonstrate the marked efficiency with which live V. cholerae stimulate a specific enteric mucosal secretory IgA response. They support the view that mucosal colonization aids efficient delivery of bacterial antigens to responsive subepithelial lymphoid tissue. This might occur by transfer of colonizing bacteria through M cells into Peyer patches or by efficient delivery of secreted toxin to M cells by mucosa-associated organisms. Preexisting antibacterial immunity interferes with colonization, which may prevent efficient antigenic stimulation and which may explain the relatively weak response to booster immunization. The same process may also limit the efficacy of hybrid enteric bacterial vaccines when there is preexisting mucosal immunity to the carrier organism due to either natural exposure or prior immunization with another vaccine that uses the same carrier. PMID- 3804448 TI - Binding of Actinomyces naeslundii to glycosphingolipids. AB - The type 2 fimbrial lectin of Actinomyces naeslundii WVU45 mediated the binding of this bacterium to glycosphingolipids chromatographed on thin-layer silica gel plates. Radioiodinated bacteria attached to GM1, GD1b, and globoside. After chromatograms were treated with sialidase, the bacteria also bound to GD1a and GT1b. The actinomyces lectin apparently recognized the Gal beta 3GalNAc termini of these gangliosides and the GalNAc beta 3Gal terminus of globoside, suggesting that glycolipids containing these sequences may serve as receptors for A. naeslundii on mammalian cells. PMID- 3804449 TI - Analgesic effects of N-acetylmuramyl-L-alanyl-D-isoglutamine in decreasing the acetic acid-induced abdominal-writhing response. AB - A new pharmacological action of N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) is described. Pretreatment of male ddY mice with MDP, but not its biologically inactive analogs, significantly decreased the frequency of acetic acid-induced writhing movements more effectively than did acetylsalicylic acid (aspirin). The analgesic effect of MDP, however, was less than that of a narcotic antagonist, pentazocine. PMID- 3804450 TI - Similarities between IgE in human feces and a chymotrypsin-digest of an IgE myeloma protein. AB - Immunoglobulin E (IgE) in human feces was characterized by radioimmunoassays with different specificities of the second antibodies, and by immunoprecipitation techniques. The fecal IgE was compared with an intact IgE myeloma protein and with Fc'' fragments of the IgE molecules, obtained after prolonged chymotrypsin digestion of the IgE myeloma protein. The experiments showed that both the fecal IgE and Fc'' fragments shared the D epsilon 1 antigenic determinants while the intact IgE had both D epsilon 1 and D epsilon 2 determinants. They also shared thermal stability at 56 degrees C as compared to intact IgE. Fecal IgE and Fc'' fragments both showed rapid anodal migration in an electric field, different to that of intact IgE. A tandem crossed immunoelectrophoresis technique provided signs of immunological identity between the precipitates of fecal IgE and those of the Fc'' fragments. It is therefore likely that most, if not all, IgE in human feces consists of Fc" fragments. PMID- 3804452 TI - Detection of mouse IgE by CELISA. AB - The detection and quantitation of mouse IgE is usually impaired by the difficulty to obtain reliable antibody reagents which are fully specific for the epsilon chain - and reactive enough - to be used in an enzyme-linked immunosorbent assay (ELISA). An ELISA on cells (CELISA) was developed for the detection of mouse IgE, using rat basophilic leukemia (RBL) cells. It is based on the high affinity of the receptors for the Fc of IgE (Fc epsilon R) displayed on the surface of the RBL cells. Since the epsilon chain specific recognition is achieved by the biological receptor of IgE, the detection of cell-bound IgE does not need the use of epsilon chain specific antibodies. Instead, one can use any enzyme-coupled antibody capable to recognize the IgE through its light-chain epitopes. Interestingly, when the IgE bound to the RBL cells has a known specificity, it can be detected through its paratopes using the cognate antigen coupled to an enzyme. PMID- 3804451 TI - Modulatory effects of Streptococcus mutans on human neutrophil adherence and deoxyglucose uptake. AB - Suppression of human neutrophil adherence and deoxyglucose uptake was observed after direct interaction between neutrophils and serotype c of Streptococcus mutans, but not other serotypes. Since neutrophils comprise more than 95% of leukocytes in gingival crevicular fluid and constitute one of the first lines of defense in the oral cavity, the capacity of S. mutans serotype c to suppress neutrophil activation may explain its predominance over other serotypes, and its greater propensity for colonization of the oral cavity. PMID- 3804454 TI - Platelet-activating factor in late asthmatic response. AB - The role of platelet-activating factor (PAF) in the late asthmatic responses was studied. The concentrations of lyso-form of PAF in plasma were measured at 0 and 20 min, and 6 and 24 h after the antigen inhalation challenge among patients with bronchial asthma. PAF activities were measured by their aggregating ability of washed rabbit platelets after acetylation of lyso-PAF into the biological active form of PAF, when there were no detectable amounts of PAF in plasma. The concentrations of lyso-PAF were found to be significantly increased in patients with the late asthmatic response compared with patients with the single immediate response at 6 h after the antigen challenge. In contrast, lyso-PAF levels were not significantly different at 20 min after the antigen challenge between these two groups. PAF inactivator activity in plasma increased when there was a decrease in the lyso-PAF level. These results suggest that PAF may participate in the late asthmatic response and may provide a new insight into the pathogenesis and the treatment of bronchial asthma. PMID- 3804453 TI - Vitamin A acetate as a regulator of accessory cell function in delayed-type hypersensitivity responses. AB - Mice fed on a vitamin A acetate (VAA)-supplemented diet respond to concentrations of oxazolone which are too low to elicit contact sensitivity on a standard diet. This study has investigated whether enhanced responsiveness could be due to VAA induced changes in antigen-presenting cell function. The draining lymph nodes were used as the source for accessory cell populations, and cells from control and sensitized mice on either standard or VAA diet were compared in syngeneic and allogeneic responses. Their ability to induce delayed-type hypersensitivity reactions was also compared. There was no qualitative difference between accessory cells from the standard and VAA-fed groups respectively, but there was already a striking quantitative increase in the number of accessory cells which correlated with augmented sensitization. These findings are consistent with the postulate that the effect of VAA may be associated with regulation of accessory cell function, and that susceptibility to contact sensitization can be modified by quantitative changes in antigen presentation. PMID- 3804455 TI - Long-term follow-up of histamine turnover in mastocytosis. AB - To study the long-term histamine turnover in patients with mastocytosis, the urinary excretion of the main histamine metabolite tele-methylimidazoleacetic acid was measured. Eighteen patients, 10 with urticaria pigmentosa and 8 with systemic mastocytosis, were followed for several years (mean 4.2 years). Younger individuals (less than 30 years) had initially normal excretion or tended to normalize their excretion during follow-up, while older patients (greater than 30 years) often had systemic manifestations and higher excretion values, which increased in some cases during the observation period. PMID- 3804456 TI - Antigenic stimulation with proteins of cow's milk via the oral route in guinea pigs and rats. 1. Measurement of antigenically intact beta-lactoglobulin and casein in the gastrointestinal contents of duodenum, jejunum and ileum. AB - Guinea pigs and rats drinking cow's milk ad libitum have had the contents of their stomach, duodenum, jejunum and ileum examined for antigenically native, undigested beta-lactoglobulin and casein. The whey protein was present, in every case, in higher concentration and could be found, although in decreasing amounts, right down to the ileum. In the rat, casein could not be shown at any level of the small intestine and in the guinea pig only at the level of the duodenum. PMID- 3804457 TI - Changes of house dust mite-specific IgE, IgG and IgG subclass antibodies during immunotherapy in patients with perennial rhinitis. AB - House dust mite-specific IgE, IgG and IgG subclass antibody responses were evaluated during immunotherapy in perennial allergic rhinitis patients. It was found that IgG4 antibodies steadily increased during treatment, while IgG and IgG1 antibodies reached a plateau 6 months after the initiation of immunotherapy. IgE antibodies also increased during treatment. It was also found that the good clinical outcome was associated with the rate of increase of IgG4 antibodies, but not with IgG, IgG1 or IgE antibodies. PMID- 3804458 TI - An immunochemical investigation of the allergens from Ascaris suum perienteric fluid. Cross-reactivity, molecular weight distribution and correlation with phosphorylcholine-containing components. AB - An extract of Ascaris suum perienteric fluid was fractionated on Sephadex G-200 and the resulting high molecular weight (approx. 600,000 daltons) and low molecular weight (approx. 16,000 daltons) fractions examined for allergenicity using human sera. Radioallergosorbent (RAST) and RAST-inhibition assays showed that the high molecular weight fraction was 15- to 40-fold more potent than the low molecular weight fraction. Crossed radio-immunoelectrophoretic analysis showed that the high molecular weight fraction contained 10 allergens in contrast to the 6 comprising the low molecular weight fraction. Polyacrylamide gel electrophoretic studies in combination with RAST indicated that two high molecular weight glycoprotein-staining components may be major allergens. A. suum cross-reacted allergenically with Toxocara canis and various life cycle stages of Nippostrongylus brasiliensis but not with Strongyloides ratti or Schistosoma mattheei. The cross-reacting allergens were predominantly of high molecular weight and the molecular weight distribution pattern obtained for A. suum, T. canis and N. brasiliensis paralleled that obtained for the distribution of the carrier of the hapten phosphorylcholine (Pc). However, it was shown that the hapten per se was not allergenic. In contrast, analysis of the allergens from N. brasiliensis using sera from rats infected with the same parasite showed that the homologous allergens were predominantly of low molecular weight (approx. 20,000 daltons) and did not contain Pc. PMID- 3804459 TI - Immunocytochemical mapping of IgE/IgG binding sites within the birch pollen grain using serum from a patient undergoing hyposensitization therapy. Comparison with biochemically determined data. AB - Serum from an atopic patient undergoing a hyposensitization therapy to birch pollen allergens was used to carry out immunocytochemical mapping of specific IgE/IgG binding sites within ultrathin sections of birch pollen grains. There was a distinct rise in the density of specific IgG labelling in the course of therapy, whereas the density of IgE labelling remained fairly constant. However, the patterns of IgG and IgE binding in the pollen grain did not completely coincide since there was only IgE binding to certain pollen structures such as the apertural region. If the widely accepted concept of specific antibodies as 'blocking antibodies' is taken as a basis, the success of therapy must be questioned in this case because no IgG antibodies were formed to some of the allergens localized in the pollen grain and relevant to this patient. Very probably this result must be attributed to an incomplete pollen extract used in hyposensitization therapy. The results of the biochemical measurements (RAST, ELISA) agreed well with the immunocytochemical observations. PMID- 3804460 TI - Antibody synthesis in the rat liver: an association between antibody-forming cells in the liver and biliary antibodies following intravenous injection of horse erythrocytes. AB - The transient appearance of IgM in the bile of rats injected intravenously with horse erythrocytes (HRBC) correlated with the occurrence of anti-HRBC IgM secreting cells in the liver. Both responses were reduced in animals splenectomised at the time of immunisation. When rats were given 2 injections of HRBC spaced by 28 days, IgG, IgA and IgM antibody-forming cells (AFC) were detected in the liver along with IgM and non-IgM anti-HRBC antibody in bile. There was a 10-fold increase in the total numbers of mononuclear cells (MNC) retrievable from the liver at the height of the biliary antibody response, the majority of which were not AFC. These results suggest that antigen entering the spleen stimulates the release of a population of MNC which may localise in the liver and that a minor portion of these produces specific antibody which is secreted into bile. PMID- 3804461 TI - Further studies of patients with both honeybee- and yellow-jacket-venom-specific IgE. AB - Twenty-five sera from patients with high titers of both honeybee- and yellow jacket-venom-specific IgE were analyzed in RAST inhibition experiments, using each venom as the coupling and inhibiting antigen. Eight sera had unique antibody activity with no cross-reactivity between yellow-jacket- and honeybee-venom specific IgE. In 5 sera, the IgE antibody activity was directed at a major allergen in yellow jacket venom cross-reacting with a minor allergen in honeybee venom. Honeybee venom inhibited only the honeybee venom RAST; yellow jacket venom inhibited both the honeybee and the yellow jacket venom RAST. Five sera showed the opposite pattern with IgE antibody directed at a major allergen in honeybee venom cross-reacting with a minor allergen in yellow jacket venom. The fourth newly observed pattern was that of extensive IgE antibody cross-reaction found with 7 sera. Both honeybee venom and yellow jacket venom inhibited both the honeybee and yellow jacket venom RASTs. There were no clinical features such as age, sex, atopy or type of anaphylactic symptoms which could distinguish patients in each group. All but one patient had a history of multiple sting exposures. These data suggest multiple allergens in honeybee and yellow jacket venom with differing patterns of cross-reactivity and have important implications for proper venom immunotherapy. PMID- 3804462 TI - Immunohistologic comparison between armadillo-derived leprosin and standard lepromin skin tests in leprosy patients. AB - A comparison was made on the in situ immunological characteristics of dermal infiltrates of early (24-hour) and late (3-4 weeks) skin reactions in leprosy patients. The skin reactions were induced by armadillo-derived leprosin coupled to liposomes and standard Dharmendra lepromin. Most lymphocytes in the early reaction induced by both antigens were positive for Leu 4, Leu 3a, OKT8 and Ia like antigens indicating thereby the presence of activated T cells. The ratio of Leu 3a/OKT8+ cells were similar. In the late reaction elicited by both antigens, the lymphocytes in the granulomas were predominantly activated T lymphocytes expressing Leu 4, Leu 3a, OKT8 and Ia like antigens. Leu 3a+ cells were scattered diffusely amidst the epithelioid cells. In contrast, the OKT8+ cells were present mainly as 'a ring' in the periphery of the granuloma. A similar ratio of Leu 3a+/OKT8+ cells was observed in these granulomas. Macrophages in the granulomas expressed Ia like antigens. These observations indicate that the immunological characteristics of dermal infiltrates in the skin reaction induced by armadillo derived leprosin coupled to liposomes and standard Dharmendra lepromin appear to be identical. PMID- 3804463 TI - Release of thromboxane B2 and leukotriene C4 and reduction in renal perfusion in experimental anaphylactic reaction of isolated guinea pig kidney. AB - Isolated, perfused kidneys from ovalbumin-sensitized guinea pigs released large amounts of histamine, thromboxane (TX) B2 and less consistently leukotriene (LT) C4, and showed a marked reduction in perfusion rate (PR) following injection of the specific antigen, or antiserum to IgG1 and IgG2; both types of anaphylactic reaction being due to cross-linking of mast cell-sensitizing immunoglobulin. Infusion of low concentration of synthetic LTC4 caused reduction in PR, which was blocked by the antagonist FPL 55712. Large-dose bolus injections of histamine also reduced PR. It is concluded that the kidney is a target organ in anaphylaxis and that the reaction alters renal haemodynamics. PMID- 3804464 TI - Neonatal IgE injections do not modify Nippostrongylus brasiliensis-induced and mercuric chloride-induced IgE increase in the rat. AB - The effect of neonatal IgE injections on total IgE responses was studied in two rat models. After Nippostrongylus brasiliensis infection, no differences in serum IgE level and surface or cytoplasmic IgE expression were observed between IgE treated and control LOU/C rats. Likewise, after HgCl2 injection, IgE-treated Brown-Norway rats and controls showed no difference in serum IgE level or in the development of autoimmune glomerulonephritis and proteinuria. It has been concluded that IgE-class-restricted tolerance, induced by neonatal injections of IgE, cannot be observed in rats after strong IgE stimulation. PMID- 3804465 TI - Time- and temperature-related alterations in seminal plasma constituents after ejaculation. AB - The effects of temperature and incubation time were examined on the concentrations of the following seminal plasma constituents in ejaculates from seven healthy volunteers: prostatic acid phosphate (PAP), citric acid, testosterone, prostaglandin E (PGE), fructose, protein, putrescine and the polyamines spermidine and spermine. The results indicated that the majority of glandular products were stable up to 3 h after ejaculation when stored at room temperature, with the exception of the prostatic diamine putrescine, which appeared to undergo rapid metabolism. Prolonged periods of incubation resulted in a gradual reduction in the levels of fructose and a significant increase in the activity of PAP and the levels of spermidine. On the basis of these findings it appears that an evaluation of the functional integrity of the accessory sex glands can be carried out on semen up to 3 h after ejaculation. PMID- 3804466 TI - Increase in fluid viscosity during epididymal transit and the immobilization of rat epididymal spermatozoa. AB - A microcapillary method was developed to measure the viscosity of small volumes of undiluted epididymal fluid. Fluid from the cauda epididymis registered 82 +/- 17 centipoise which was much more viscous than fluid from the caput region (8 +/- 2 centipoise). Initiation of sperm motility was strongly suppressed in the viscosity range of 7 to 150 centipoise. A significant increase in the viscosity of fluid from the caput region was observed when immobilin in the fluid binds with a lectin from Jack fruit (Artocarpus heterophyllus). Thus, it is postulated that aggregation of the immobilin induced by a lectin-like material produced by the cauda epididymis may be a mechanism by which fluid viscosity is increased during epididymal transit. PMID- 3804467 TI - Exposure to ethanol during capacitation impairs the fertilizing ability of human spermatozoa in vitro. AB - To validate earlier findings, mainly in laboratory animals, the effect of ethanol on the fertilizing ability of human spermatozoa has been investigated. Ethanol added to the capacitation medium reduced the penetration of zona-free hamster eggs by human spermatozoa in a dose-dependent manner at concentrations from 50 to 500 mg % (0.05-0.5%). Fertilizing capacity was at least partially restored by washing in ethanol-free medium. Ethanol exposure before capacitation had a slight stimulatory effect on the penetration of spermatozoa into zona-free hamster ova. The motility of spermatozoa was not altered significantly, either quantitatively or qualitatively, by the presence of ethanol in the capacitation medium. These results suggest that the decrease in fertilizing ability of spermatozoa induced by ethanol during capacitation is due to a specific action on the capacitation process. PMID- 3804468 TI - Identification and androgen-dependence of proteins in the mouse vas deferens. AB - Proteins from 'luminal fluid' or from a homogenate of whole vas deferens were analysed by polyacrylamide gel electrophoresis under denaturing conditions. Four major bands with apparent molecular weights of 34.5, 36, 38 and 180 Kilodaltons (K) were observed in homogenates. In 'luminal fluid' the same protein pattern was observed except that 38 K band was missing. These four major bands probably originated from the vas deferens as they were not detected in plasma and were still present after ligation between the epididymis and vas deferens. After castration, there was a specific reduction of the 34.5 K MW protein band in both homogenate and 'luminal fluid'. When the androgen-dependence of proteins was investigated using radioactive methionine, the protein spectra from normal and castrated males showed that about 10 polypeptides were differentially induced or repressed by androgens. The synthesis of some proteins (MW's 24, 36 and 180 K) was decreased by castration while the synthesis of several others (MW's between 27 and 82 K) was increased. Most of these androgen-dependent proteins were detectable at 10 days of age. PMID- 3804469 TI - Fertility, fecundity, sex ratio and the accessory sex glands in male golden hamsters. AB - The ventral prostates, dorsolateral prostates, coagulating glands (anterior prostates), ampullary glands and/or seminal vesicles of male golden hamsters were excised bilaterally. The effects of these treatments on fertility, fecundity and sex ratio of offspring were studied. Total removal of the glands or ablation of the ventral prostates alone reduced fertility. The lack of secretions from the coagulating glands and seminal vesicles in the seminal fluid all favoured a higher proportion of male pups born in a litter. Absence of all or any of these glands did not appear to affect litter size. PMID- 3804470 TI - Diaphragmatic stimulation of the phrenic nerve as respiratory assist. PMID- 3804471 TI - Implantable cardiac defribilator to prevent "sudden death". PMID- 3804472 TI - Radiologic diagnosis by automation and computer-aid. PMID- 3804473 TI - The Programming Environment for Statistical Tabulation. AB - The Programming Environment for Statistical Tabulation (PEST) is a system which adopts an unusual approach to statistical computing. Most such systems present one or more complete programs which are controlled by parameters of varying degrees of complexity; PEST adopts a different method and provides an incomplete program to which extra instructions must be added to specify the analysis that is required. Designed originally as a replacement for a similar system written in Algol 60, it now uses instead the more powerful and flexible Algol 68. This much neglected language is ideal for the purpose, enabling an ordinary user to obtain results with a limited range of simple statements and at the same time allowing an experienced programmer free access to facilities that compare most favourably with those of comparable languages. The efficiency of modern Algol 68 compilers means that the overhead of compiling the user's instructions as often as required is small and incurs no disadvantage by comparison with conventional packages. PMID- 3804474 TI - A validation study of a simulation model for common source epidemics. AB - We consider an environment and a population of individuals who are susceptible to a disease caused by a pathogen spread from a common source. We view the sequence of events resulting in the illness of some individuals as consisting of three components: the introduction of the pathogens and their dispersion through the environment, the movement of susceptible individuals through the environment, and the physiological effects of exposure of susceptible individuals to various pathogen levels. We identify four important parameters: two for each of the first and third components. A computer simulation of a model with these features is developed and implemented to study a 1977 outbreak of toxoplasmosis. Questions of parameter estimation and model validation are considered in detail. PMID- 3804475 TI - Computerized prescription checking system. AB - This is a report on a validation system which was developed by utilizing medication history profiles of drugs prescribed to patients. Upon entering the current prescription data of a patient, the system will automatically retrieve the patient's history of past medication and the previous prescription, and print out the contents of both the current and previous prescriptions in order to validate the treatment. As a result of the Prescription Validation System, the safety of dispensing drugs by the pharmacists has been greatly improved compared to the past by checking on operator's errors of input of data, by identifying transcription error and by matching the spelling in the prescription. Medication instruction to the patients become more accurate since it is easier to monitor any changes on the prescription. PMID- 3804476 TI - A computational frame to study social behaviour in animals. AB - This paper presents new methods and procedures for studying collective behaviour in rats. The animals are assumed to be indistinguishable one from another and the behaviour of the group is represented analysed and interpreted in terms of the temporal evolution of a finite state probabilistic automaton. The automaton states are defined by measures on the clustering degree considered as a social response variable. The electronic system developed to carry out the cluster analysis and the automatic control of the social behaviour in the experimental environment includes a multimicroprocessor interacting with a 'social box' in which, together with classical sensors and effectors, a phototransistor based position sensor is included. Preliminary experiments show the discriminative power of the cluster automaton concerning sexual differences and emotivity, as well as the extensive of a basic mechanism of clustering as a collective response to stress. Pharmacologically, the new experimental medium proposed in this paper may be used to detect a new range of products affecting social but not individual behaviour. Also, well-known products, which in normal doses produce no detectable modification of individual behaviour, might have detectable effects on the collective level. Be this as it may, the experimental environment described constitutes a further experimental facility for the analysis and control of animal behaviour. PMID- 3804477 TI - Syntactic analysis of the epileptic electroencephalogram. AB - A full-scale scheme of the multi-level syntactic analysis of the epileptic EEG is presented and discussed in detail. An exhaustive description of basic procedures necessary to obtain a meaningful description of any set of epileptic EEG recordings is given; these procedures include algorithms for extraction of various elementary peaks from the EEG signal, for segmentation of the recording, for classification of the segments found into distinct groups of characteristic patterns and, finally, for calculation of the Levenshtein distance between the individual recordings, each recording regarded as a string of symbols taken to represent different classes of patterns. An example of global analysis in terms of such a distance, performed on a typical set of epileptic EEG recordings, is supplied to prove the feasibility of the scheme proposed. PMID- 3804478 TI - Determination of time constants in kinetic studies involving radiolabeled tracer molecules. AB - In tracer kinetic studies, two homogeneous well-mixed compartments may be related as precursor and product. The time constant for the product compartment can then be estimated from the two specific activity vs. time curves. We examine ten methods of estimating this time constant for data with several different error patterns, and conclude that the present practice of transforming the data to a straight line yields an inefficient but unbiased estimate of the time constant. A least squares estimate, appropriately weighted and taking into account that both precursor and product specific activities are subject to error is expected theoretically and found in practice, to be most efficient. It is however, mathematically complicated. A modified approach using a minimum chi 2 estimate in which precursor specific activities are treated as error-free, is almost as efficient. It is mathematically simple, and outperforms the currently used estimators. PMID- 3804479 TI - On fast algorithms for interval selection in event related potentials. AB - In this paper a computational algorithm is proposed which allows one to detect event related potentials (ERP) components and the way these components modify their amplitude with electrode location and with the variation in experimental conditions. The results of applying this algorithm to the ERPs obtained in two experimental situations (which require different modes of cognitive processing of a same visual information) are also exposed. PMID- 3804480 TI - Evaluation of a mathematical model analysing the relation between intradental nerve impulse activity and perceived pain in man. AB - In this investigation the usefulness and accuracy of the parameters of a mathematical model for the analysis of the effectiveness of different pain relieving procedures on pulpal pain were studied. The investigation was carried out using a previously developed mathematical/biological model on data from original subject recordings of Intradental Nerve Impulse Activity (INA) and pain estimations. Computer simulated INA and pain estimation curves were also used to enable calculation of the mathematical and biological conditions that are essential for the actual mathematical/biological model, and to facilitate the interpretation of the parameters of the model. It was shown by means of both real and simulated data that the mathematical model is well suited for the analysis of the effectiveness of some pain relieving procedures on pulpal pain. It was also shown that, by means of three new variables, the model could be made even more accurate and useful for this application. PMID- 3804481 TI - Calculation of Hill slopes predicted by the four ligand exponential model for a regulatory enzyme. AB - The Hill slopes predicted by the exponential model for a regulatory enzyme have been calculated by two separate methods, one analytical and the other numerical. Both methods are applicable to enzymes with up to 4 substrates; alternatively, one substrate may be replaced by an effector. The maximum or minimum Hill slope can also be ascertained by an extension of the analytical method. PMID- 3804482 TI - Amelioration of acute mountain sickness: comparative study of acetazolamide and spironolactone. PMID- 3804483 TI - Physiological changes in women during exercise in cold environments. PMID- 3804484 TI - The influence of mechanical vibrations on human response in tall buildings with reference to geomagnetic effects. PMID- 3804485 TI - Biological responses of audiogenic stress. PMID- 3804486 TI - Abstracts of the twenty-third annual meeting of the Japanese Society of Biometeorology. Nagakute, 30 November-1 December 1984. PMID- 3804487 TI - Patterns of nasopharyngeal cancer mortality in the United States. AB - We examined the geographic pattern of nasopharyngeal cancer (NP cancer) mortality in the United States using economic sub-regions (ESRs) as the basis for analysis. The distribution of 15,145 deaths from NP cancer over the years 1950-1979 revealed clustering in the 119 ESRs that was not detected in analyses of distribution by the 48 states, 506 state economic areas or 3,056 counties or combinations of counties of the coterminous United States. NP cancer mortality among white males was concentrated on the south-east Atlantic and Gulf coasts. This newly described pattern is not due to any recent changes in mortality rates and should provide leads to further epidemiologic study. PMID- 3804488 TI - Characterization of a novel neuroglandular antigen (NGA) expressed on abnormal human melanocytes. AB - Murine monoclonal antibodies (MAbs) were produced with reactivity to human malignant melanoma. Six MAbs, 3 of the IgGI (LS113, LS140, LS152) and 3 of the IgG2a (LS59, LS62, LS76) subclasses, were selected for their binding, with an identical pattern of reactivity, to a novel melanoma-associated antigen. As characterized by the enzyme-linked immunosorbent assay (ELISA), these MAbs were found to be positive on n-octyl-beta-D-glucopyranoside extracts of all 10 melanoma cell lines tested and on extracts of 22 metastatic melanoma tumors. The antibodies had minimal reaction with a panel of 14 normal adult tissue extracts. A degree of cross-reactivity was observed with 50% of 39 non-melanoma tumor extracts. The results obtained with the ELISA on cell line and tissue extracts were duplicated using the ABC method of peroxidase staining. The pattern of cross reactivity, as demonstrated by the intense staining of paraffin-embedded and frozen tissue sections of normal, benign and malignant tissues, defines the recognized protein as a neuroglandular antigen (NGA). Immunoadsorbents made with the antibodies were used to purify the antigen shed from cultured melanomas. All 6 MAbs recognized this purified antigen while 5 other antimelanoma antibodies did not react with it. On gel electrophoresis this antigen is a highly glycosylated glycoprotein with a protein core of 21 kDa. PMID- 3804489 TI - Risk factors for cutaneous malignant melanoma in a northern Italian population. AB - The relationship between cutaneous malignant melanoma (CMM) and the colour of skin, hair and eyes, the extent of sun exposure and reaction to it, education, and the occurrence of skin neoplasms in patients and their families was evaluated in a case-control study of 103 cases of CMM and 205 control subjects hospitalized for acute conditions other than malignant or hormonal disease. A significantly higher risk was associated with fair skin as compared to dark/medium skin (RR = 4.0; 95% CI: 1.5-10.5) and positive family history for CMM (RR = 8.1; 95% CI: 1.0 200.9). CMM seemed to occur more frequently, but not significantly so, in individuals with brown or blond hair, higher education and clinically diagnosed dysplastic naevi. Outdoor occupation and heavy sun exposure in the last 20 years seemed to increase the risk of CMM in sun-exposed sites but to be negatively associated with CMM in normally unexposed sites. PMID- 3804490 TI - Non-Hodgkin's lymphoma and farming: an expanded case-control study. AB - A previously published case-control study of agricultural risk factors involved male cases of non-Hodgkin's lymphoma registered under code 202 of the International Classification of Diseases (ICD). This study has been expanded with the inclusion of cases registered under ICD code 200, and additional controls. The expanded study comprises 100 ICD 200 cases and 83 ICD 202 cases registered during the period 1977-81, together with 338 controls selected from other cancer registrations during the same period. The largest relative risk for specific farming types was for orchard workers (odds ratio = 3.7, 90% confidence limits 1.1-12.1). No elevated risks were observed for exposure to farm animals, nor for potential exposure to phenoxy herbicides (odds ratio = 1.0, 90% confidence limits 0.7-1.5), or chlorophenols (odds ratio = 1.4, 90% confidence limits 0.8-2.3). The previous finding of an excess risk associated with fencing work was weakly supported by the expanded study (odds ratio = 1.4, 90% confidence limits 1.0 2.0). However, the previous finding of an excess risk associated with meat works employment was more strongly supported (odds ratio = 1.8, 90% confidence limits 1.2-2.6). One relevant risk factor is 2,4,6-TCP which is used in the treatment of pelts, but the excess risks do not appear to be confined to pelt department workers. An alternative hypothesis is that meat workers may be exposed to oncogenic viruses. PMID- 3804491 TI - Measurements of passive smoking and estimates of lung cancer risk among non smoking Chinese females. AB - Lifetime exposures to environmental tobacco smoke from the home or workplace for 88 "never-smoked" female lung cancer patients and 137 "never-smoked" district controls were estimated in Hong Kong to assess the possible causal relationship of passive smoking to lung cancer risk. Relative risks based on the husband's smoking habits, or lifetime estimates of total years, total hours, mean hours/day, or total cigarettes/day smoked by each household smoker did not show dose-response results. Similarly, when such categories as mean hours/day, or earlier age of initial exposure, were combined with years of exposure, there were no apparent increases in relative risk. However, when the data were segregated by histological type and location of the primary tumor, it was seen that peripheral tumors in the middle or lower lobes, or, less strongly, squamous or small-cell tumors in the middle or lower lobes, had increasing relative risks that might indicate some association with passive smoking exposure. PMID- 3804492 TI - Genetic instability in fibroblasts of patients with thyroid cancers (TC). AB - In cultured fibroblasts initiated from fresh tumor biopsies of 11 patients with thyroid tumors, 5 medullary carcinoma of the thyroid (MCT) and 6 papillary follicular, the chromosomes are relatively unstable when compared with those from control fibroblast cultures. Tumor-derived fibroblast samples showed a mean number of cells in metaphase with chromosome abnormalities at a frequency of 9.1% and a range of 6-13%, whereas 5 controls exhibited a mean frequency of 4% and a range of 3-5%. Our results indicate that genetic instability in thyroid cancer patients is present not only in peripheral blood cultures, as reported earlier, but in their fibroblast cultures as well. PMID- 3804493 TI - Establishment and characterisation of three new human ovarian carcinoma cell lines and initial evaluation of their potential in experimental chemotherapy studies. AB - Three new human cell lines have been established from biopsy specimens of ovarian cystadenocarcinomas: line JA-1 was derived from a primary "solid" tumour from an untreated patient, whilst the other lines were derived from ascites from patients previously treated with chlorambucil plus either cyclophosphamide (TR175) or cisplatin (TR170). Their in vitro characteristics are compared with those of the established SK-OV-3 line of similar origin. Each line has a distinct morphology and expresses a unique isozyme profile and karyotype. All 4 lines have comparable population doubling times of 28-38 hr. Only 3 lines reproducibly form colonies in soft agar, but the JA-1 line, which failed to clone, readily produces xenografts in nude mice. Drug sensitivity testing, using clonogenic or growth-inhibition assays, shows that these lines express a wide range of sensitivities to cisplatin (greater than 20-fold), with the TR175 cells proving particularly sensitive, but a narrower range of sensitivity (less than or equal to 10-fold) to adriamycin. Following 6 24-hr pulsed exposures in vitro to drug concentrations between IC50 and IC90 values, significant resistance develops to adriamycin in each line tested. In contrast, with cisplatin treatment, all lines retain their original sensitivities, except for TR170 cells exposed to the highest concentration, which express cisplatin resistance. PMID- 3804494 TI - Characterization of an animal model of metastatic colon carcinoma. AB - Although numerous animal tumor models have been used to study colon carcinoma, few display metastatic properties. We have characterized an animal tumor model that has 3 properties essential for the study of metastasis of colon carcinoma cells: epithelial cell origin; a reproducible pattern of metastatic behavior and the ability to be propagated both in vitro and in vivo to facilitate identification of biochemical correlates of metastasis. The K12/TR cell line was derived from a transplantable colon carcinoma induced by dimethylhydrazine in the BD-1X rat strain. Transmission electron microscopy of K12/TR cells demonstrated junctional complexes, desmosomes and surface microvilli characteristic of gastrointestinal epithelial cells. The epithelial cell origin of K12/TR was confirmed by demonstrating the presence of keratin, a marker of epithelial cells, but not vimentin, a constituent of mesenchymal cells. Secretion of CEA and Ca19-9 antigens by K12/TR cells in vitro was below the sensitivity of the assays (1 ng/ml and 6 U/ml respectively). K12/TR cells produced tumors following s.c. injection into syngeneic BD-1X rats, allogeneic RNU/rnuDF rats and xenogeneic CRL:nu/nuBR mice. Macroscopic lung metastases were observed in animals from all 3 groups. Distal lymph node metastases were more frequent in BD-1X rats than in nude rats or mice. The histological appearances of all tumors and metastases were similar, showing a moderate to poorly differentiated glandular carcinoma. Intrasplenic injections of K12/TR cells in nude mice resulted in liver colonization. Preferential growth of tumor cells at sites of trauma was also observed. The results show that the K12/TR system can be used as a model to study metastasis of colon carcinoma cells and may find utility in the testing of chemotherapeutic agents against metastatic lesions. PMID- 3804495 TI - Growth of a human colonic adenocarcinoma cell line (HT 29) on microcarrier beads: metabolic studies by 31phosphorus nuclear magnetic resonance spectroscopy. AB - A method allowing the growth of a human colon adenocarcinoma cell line (HT 29) on beaded polystyrene microcarriers has been developed by modifying the culture conditions used in monolayer cultures. Under optimized conditions, the cells became confluent 7 days after seeding and reached a density of 2.8 X 10(5) cells/cm2 of microcarrier (65% of the available area occupied). 31P NMR spectra were typically recorded on 300 X 10(6) cells continuously perfused at a flow rate of 15 ml/min in a specially designed NMR chamber in which the microcarrier beads were sequestered within the receiver coil volume. The in vivo spectrum displays a series of resonances assigned to nucleoside triphosphates (ATP and GTP), inorganic phosphate and various phosphomonoesters (mainly glucose-6-P and phosphorylcholine). Diphosphodiester resonances (DPDE, mainly UDP-N-acetyl glucosamine and UDP-N-acetylgalactosamine) were not detected in the in vivo spectrum and were only apparent in the spectrum of the perchloric acid extract of the cells, indicating that these compounds have a restricted mobility in the intracellular compartment. The intracellular pH of HT 29 cells was 7.2 during the perfusion with a medium buffered at pH 7.3. The internal pH decreased slowly (2 X 10(-3) pH unit/min) during anoxic perfusion, but severe intracellular acidosis occurred after 40 min of ischemia (2.7 X 10(-2) pH unit/min). Sequential recording of 31P NMR spectra has shown that HT 29 cells are able to maintain their high energy phosphorylated compound levels (ATP) when subjected to 100 min of anoxia and 40 min of total ischemia. PMID- 3804496 TI - Studies of skin tumorigenesis in PGK mosaic mice: many promoter-independent papillomas and carcinomas do not develop from pre-existing promoter-dependent papillomas. AB - The induction of mouse skin papillomas in two stages by initiation-promotion protocols has been studied extensively. On the basis of kinetics of induction and morphological observations of apparent progression to carcinomas, it has been argued that the papillomas sequentially advance to carcinomas through promoter dependent and promoter-independent premalignant stages. Although this hypothesis has been widely accepted, the step-wise development of the same cell population from papilloma to carcinoma has not been established at the cellular level. We show here that some carcinomas which morphologically appear to result from progression of promoter-dependent papillomas do not develop from sequential progression of the same cell population as was found in the original papillomas. Other initiated cells also participate during the growth of these tumors and may replace the original papilloma cells. We also present evidence that some tumors develop directly as promoter-independent papillomas without going through an apparent promoter-dependent papilloma stage. PMID- 3804497 TI - Anti-tumor effects of tumor necrosis factor in combination with chemotherapeutic agents. AB - The anti-tumor activity of partially purified tumor necrosis factor (TNF) was analysed in combination with chemotherapeutic drugs against intradermally transplanted Meth A sarcoma. Tumors were allowed to grow until they reached an average diameter of about 8 mm. TNF was given once i.v. (16,000 units as determined on L-M cells) and the chemotherapeutic agents adriamycin (1-10 mg/kg), 5-FU (3-100 mg/kg), cyclophosphamide (50-200 mg/kg) were applied once i.p. 4 hr after TNF injection. The strongest anti-tumor effects in normal BALB/c mice were observed when TNF was combined with the following doses of chemotherapeutic agents: cyclophosphamide 100 mg/kg, adriamycin 5 mg/kg, 5-FU 30-100 mg/kg. The most effective combinations induced complete regressions. When TNF was combined with varying doses of adriamycin and cyclophosphamide, bell-shaped dose-response curves were obtained. Experiments were repeated in Meth A sarcoma-bearing BALB/c nu/nu mice. In this case TNF combinations with cyclophosphamide and 5-FU did not induce tumor regressions. The highest dose of the chemotherapeutic agent was the most effective in drug combinations. Histological analysis revealed a potentiation of the TNF-induced necrosis by cyclophosphamide. Increased hyperemia and extravasation of erythrocytes could be found in tumors of animals treated with the drug combination. PMID- 3804498 TI - Medical technologic aid for the indigent of the world. PMID- 3804499 TI - Severe pulmonary stenosis and duct dependent coarctation in a neonate. An embryological impossibility? AB - A baby presented in cardiac failure with cyanosis on the first day of life. Investigations demonstrated severe pulmonary valve stenosis and duct-dependent coarctation of the aorta. This combination is impossible to explain using recognised embryological theories. PMID- 3804500 TI - Chyle: a masquerading etiology of pericardial effusion. AB - A 25-year-old man with massive pericardial effusion is presented. The high lymphocyte amount and cytological analysis of the aspirated fluid suggested tuberculous or malignant pericarditis. The chylous nature of the effusion was only recognized after hemipericardiectomy, when reaccumulation of fluid into the pleural space appeared. This was successfully managed by medium chain triglyceride diet. PMID- 3804501 TI - Congenital arrhythmia in a normal newborn. AB - We describe a case, unique to the best of our knowledge, in which bigeminal supraventricular premature contractions were detected in a normal newborn. These arrhythmias disappeared spontaneously after the twelfth day of life. Since they do not appear to evolve towards paroxysmal supraventricular tachycardia, treatment with antiarrhythmic drugs is not recommended. PMID- 3804502 TI - Effect of nitroprusside-induced fall in systemic pressure on coronary stenoses. AB - A fall in coronary pressure increases resistance across compliant coronary stenoses, probably because of passive collapse of the stenotic segment. The effects of a mechanically induced fall in coronary pressure were compared with the effects of a similar fall in pressure caused by intravenous sodium nitroprusside, a systemic and large coronary artery vasodilator. Seventeen dogs were studied in which a compliant circumflex coronary stenosis was produced by inflating an intracoronary balloon with saline. When coronary pressure was lowered from 105 +/- 3 to 78 +/- 3 mm Hg (P less than 0.001) by tightening a snare proximally on the circumflex coronary artery, the stenosis pressure gradient increased (9 +/- 1 to 17 +/- 3 mm Hg, P less than 0.005), flow fell (21 +/- 2 to 15 +/- 2 ml/mm, P less than 0.001) and stenosis resistance increased (0.67 +/- 0.15 to 2.06 +/- 0.68 units, P less than 0.05). When nitroprusside caused pressure to fall from 112 +/- 4 to 81 +/- 4 mm Hg (P less than 0.001), the stenosis pressure gradient did not change (16 +/- 1 to 16 +/- 1 mm Hg), flow increased (42 +/- 5 to 62 +/- 6 ml/min, P less than 0.001), and stenosis resistance decreased (0.46 +/- 0.07 to 0.32 +/- 0.06 units, P less than 0.01). These findings demonstrate that nitroprusside prevented passive collapse of the compliant stenoses as pressure fell, possibly by nitroprusside actively dilating the stenotic segment. Therefore a moderate fall in systemic pressure caused by a coronary vasodilator may not have deleterious effects on stenosis severity. PMID- 3804503 TI - Prediction of the extent of coronary artery disease with the evaluation of left ventricular wall motion abnormalities during atrial pacing. A cross-sectional echocardiographic study. AB - In patients with coronary artery disease, left ventricular performance during stress is affected by the degree of coronary stenosis. In order to verify whether there exists a relationship between the extent of wall motion abnormalities detectable during atrial pacing and the degree of coronary obstruction, 76 patients, without previous myocardial infarction, were studied. Each patient underwent cross-sectional echocardiography during transesophageal atrial pacing and exercise electrocardiography before coronary angiography. Of the 76 patients, 46 had significant coronary artery disease (stenosis greater than or equal to 75% of at least one major coronary vessel), while 30 had normal coronaries or a stenosis of less than 75%. Eighteen patients had single-, 14 had two- and 14 had three-vessel disease. For each patient a coronary score was obtained: the score used took into consideration the site, number and severity of the stenosis. This score was then correlated with the wall motion score, obtained from the analysis of 9 segments of the left ventricle. A weak correlation was obtained between wall motion score at rest and coronary score (r = -0.42), while the correlation between coronary score and the difference between wall motion score at rest and during transesophageal atrial pacing was slightly better (r = 0.53); this correlation further improved if wall motion score during pacing was considered (r = -0.63). If the patients with discordant diagnostic tests (echocardiography during transesophageal atrial pacing and exercise electrocardiography) were excluded, the correlation coefficient between coronary score and wall motion score during pacing increased even more (r = -0.77). IN CONCLUSION: (1) analysis of wall motion of the left ventricle during atrial pacing is useful for the non invasive evaluation of the severity of coronary disease; (2) cross-sectional echocardiography during atrial pacing, apart from being a useful diagnostic tool, is also a help in judging the degree of severity of coronary artery disease. PMID- 3804504 TI - Human leucocyte antigen in variant angina. AB - Human leucocyte antigen analysis of 45 patients with variant angina was performed to determine the presence of causative genetic factor(s). A significantly low frequency of human leucocyte antigen DQ omega 3 was found in these patients, as compared with that in 152 normal Japanese adults. There were no differences in frequencies of antigens between patients with normal and those with atherosclerotic coronaries. These data suggest that some genetic factor(s) may contribute to the pathogenesis of coronary spasm. PMID- 3804505 TI - Potential life-threatening cardiac arrhythmias associated with a conventional hypocaloric diet. AB - Nine obese children (mean age 12.7 years, mean overweight 74.2%) were treated for 3 weeks with a very low calorie diet containing high quality protein. Eight patients (patients A) received a commercially available diet (240 kcal/1004 kJ/day) and 1 patient (patient B) a homemade dietary regimen (500 kcal/2100 kJ/day). Both preparations were supplemented with micronutrients; however, the daily intake of minerals was significantly less in patient B. All patients were monitored for the appearance of cardiac arrhythmias by frequent 24-hour Holter recordings. In patients A the mean loss of body weight was 9.4 +/- 2.4 kg, patient B lost 8.7 kg. The mean daily nitrogen balance was negative (patients A: 10.2 g/day, patient B: 6.8 g/day). Frequent blood chemistry evaluations were unremarkable. On the 14th day of treatment patient B developed arrhythmias (ventricular couplets, non-sustained ventricular tachycardias); in patients A no ventricular dysrhythmias were observed. Our data suggest that very low calorie diets containing protein of high biologic value can be associated with potentially dangerous arrhythmias. PMID- 3804506 TI - Prevalence of mitral valve prolapse in healthy Saudi women. AB - Two-hundred-and-thirty-two Saudi young women were prospectively clinically examined for the presence of mitral valve prolapse. Phonocardiograms recorded in all subjects at rest in supine position revealed 10.7% incidence of systolic clicks and/or mid to late systolic murmurs. Echocardiographic studies were performed in supine, left lateral as well as sitting up positions. Twenty-eight subjects were found to have mitral valve prolapse. Of these, 21 subjects had mid to late systolic prolapse when the other seven subjects were found to have pansystolic prolapse (holosystolic). Eight of the 28 positive subjects had auscultatory evidence of mitral valve prolapse. It seems that mitral valve prolapse is more common than expected in healthy Saudi women population. PMID- 3804507 TI - Differentiation of patients with rheumatic fever from those with inactive rheumatic heart disease using the artificial subcutaneous nodule test, myocardial reactive antibodies, serum immunoglobulin and serum complement levels. AB - Thirty patients with acute rheumatic fever, and 20 with inactive rheumatic heart disease were studied in order to determine parameters which differentiate the two groups. Subcutaneous nodules developed following the subcutaneous injection of autologous blood in 16 of 26 patients with rheumatic fever but in none of the 20 with inactive rheumatic heart disease (P = 0.00001). Myocardial reactive antibodies were found in 14 of 30 patients with rheumatic fever, and in 4 of 20 with inactive rheumatic heart disease (P = 0.0505). Significantly higher values of IgG (P less than 0.001), IgA (P less than 0.01), C3 (P less than 0.001) and C4 (P less than 0.001) were observed in rheumatic fever patients. There was no significant difference in IgM levels. A combination of three variables (artificial subcutaneous nodules, IgA, and C3) had a sensitivity of 87% and a specificity of 100% for rheumatic fever. A combination of two variables (artificial subcutaneous nodules and IgA) had a sensitivity of 84% and a specificity of 100% for rheumatic fever. PMID- 3804508 TI - Prognostic implications of complex ventricular ectopy in patients with and without structural heart disease. A study based on programmed electrical stimulation. AB - Fifty-six patients with complex ventricular premature beats (Lown grade IVa, IVb), but no evidence of ventricular tachycardia on 48 hours of continuous monitoring were evaluated by programmed electrical stimulation. Thirty patients had coronary atherosclerotic heart disease, 3 had valvular heart disease, 2 had cardiomyopathy and 21 had no structural heart disease. Programmed stimulation identified two groups of subjects: Group I comprised 11 patients in whom ventricular tachycardia was induced and Group II comprised 45 patients (which included 21 patients without heart disease) in whom no ventricular tachycardia was induced. The incidence of left ventricular dysfunction (ejection fraction less than 40%) was significantly higher in Group I as compared to Group II (P less than 0.001). There was, however, no difference between the grade of ventricular ectopy, HV interval or the incidence of bundle branch block between the 2 groups. Patients with inducible ventricular tachycardia (Group I) were put on laboratory directed anti-arrhythmic drug therapy. Patients without inducible tachycardia (Group II) were not given anti-arrhythmic therapy. The patients were followed up for 34 +/- 10 months. The incidence of sudden death (36.3% vs 6.6%, P less than 0.001) was significantly higher in Group I as compared to Group II. No patients without structural heart disease died during the follow-up. Programmed electrical stimulation fails to induce ventricular tachycardia in patients with complex ventricular ectopy but no structural heart disease. It is, however, possible to define a high risk subset in patients with structural heart disease and complex ectopy. The high risk patients with inducible ventricular tachycardia do not seem to benefit by anti-arrhythmic drugs, which may independently increase the risk of sudden death in treated patients. Patients in whom ventricular tachycardia is not inducible have better left ventricular function, a good long term prognosis and do not require anti-arrhythmic agents. PMID- 3804509 TI - The effect of oral cimetidine on total and unbound serum lidocaine concentrations in patients with suspected myocardial infarction. AB - In this study, we prospectively evaluated the effect of oral cimetidine on serum lidocaine concentrations in 6 patients with suspected myocardial infarction. Compared to baseline lidocaine levels, total lidocaine concentrations increased by 8.2 +/- 7.8% at 6 hours, 16.4 +/- 9.0% at 12 hours and 27.9 +/- 9.4% at 24 hours after two doses of oral cimetidine. Unbound lidocaine concentrations increased by 14.3 +/- 4.1% at 6 hours, and 18.3 +/- 10.3% at 24 hours after cimetidine. In patients with myocardial infarction (3), total lidocaine concentrations increased by 24.2 +/- 10.4%, whereas unbound lidocaine increased by 8.9 +/- 10.2% at 24 hours. Therefore, increases in total lidocaine concentrations after cimetidine administration were considerably less than those previously reported and empiric dosage reductions of lidocaine in patients receiving cimetidine may not be appropriate. PMID- 3804510 TI - Aortic and mitral discontinuity with congenital subaortic aneurysm and normally connected great arteries: echocardiographic diagnosis in life. AB - A newborn with preductal coarctation and ventricular septal defect had a subaortic aneurysm which protruded into the left atrium causing intractable pulmonary oedema. The subaortic aneurysm was congenital. It was clearly identified by cross-sectional echocardiography which, in serial studies, showed it to be increasing in size. Predisposing to its development was the wide area of aortic and mitral discontinuity in association with the concordant ventricular connexion of the great arteries. The child remained in worsening pulmonary oedema after relief of the coarctation and banding of the pulmonary trunk and died after attempted relief of the left atrial obstruction. PMID- 3804511 TI - Coronary artery compression caused by abscess formation in infective endocarditis. AB - Two cases are reported in which abscess formation during the course of infective endocarditis resulted in critical compression of the left coronary artery. In one case this resulted in unstable angina. Chest pain during infective endocarditis may be due to coronary artery compression by an abscess; successful treatment may require surgery, including a coronary artery bypass procedure. PMID- 3804512 TI - Duality, dissociation, and memory creation in highly hypnotizable subjects. PMID- 3804513 TI - Opinions about hypnosis and self-hypnosis before and after hypnotic testing. PMID- 3804514 TI - Hypnotizability, imaging ability, and the detection of embedded objects. PMID- 3804515 TI - "Locus of control" as a therapeutic facet. PMID- 3804516 TI - Sex roles in addiction: defense or deficit? AB - Overly masculine, "macho" males and feminine, "seductive" females are found in clients addicted to alcohol and/or drugs. Contrary to expectations, on the Bem Sex-Role Inventory males (N = 60) rated themselves, in descending order, Undifferentiated, 38.5%; Feminine, 33%; Masculine, 17%; and Androgynous, 11.5%. Females (N = 36), more predictively, saw themselves as Feminine, 50%; Undifferentiated, 31%; Androgynous, 11%; and Masculine, 8%. Independent variables of age, income, marital status, severity of addiction, length of inpatient treatment, level of education, and parental marital status did not significantly affect the results. Extreme sex-role dress and behavior appear to be a defense against the overall damage resulting from the addictive disease rather than a contributor to or cause of the disease. PMID- 3804517 TI - Cognitive distortions among depressed and suicidal drug abusers. AB - A very high proportion of drug abusers have psychiatric problems, with depressive symptoms particularly common. Nonabusing depressed patients have been found to demonstrate elevated levels of cognitive distortions, relative to normals, and to benefit from therapies that address such cognitive distortions. The present study investigated the prevalence of cognitive distortions in a sample of 52 inpatient depressed and/or suicidal drug abusers. Levels of cognitive distortion were found to be comparable to those reported in other studies for noninpatient depressed subjects, but lower than those of nonabusing depressed inpatients. Within the present relatively homogeneous sample, degree of cognitive distortion was nevertheless related to levels of depression, hopelessness, and suicidality. It is concluded that cognitive therapy may be indicated for depressed drug abusers. PMID- 3804518 TI - The impact of raising the minimum drinking age on driver fatalities. AB - Time series analysis was used to obtain statistical tests of the impact of raising the drinking age on monthly driver fatalities in Illinois, Michigan, and Massachusetts. A control series design permitted comparison between younger drivers (21 or less years) and older drivers (25 and older) within states where the minimum drinking age was raised. Since the two groups share the same driving conditions, it was important to demonstrate that any reduction in fatalities was limited to the young age group within which the drinking age change occurred. In addition, control states were selected to permit a comparison between driver fatalities of the young age group (21 or less) in states with the law change and young drivers in states without the law change. Significant immediate reductions in fatalities among 21 and younger drivers in Illinois and Michigan were observed after these states raised their minimum drinking age. No significant reductions in any control series were observed. A linear decrease in young driver fatalities was observed after the drinking age was raised in Massachusetts. There was also a significant linear decrease in young driver fatalities in the Connecticut control series, perhaps due to increasing awareness among young drivers of the dangers of drinking and driving. PMID- 3804519 TI - Treating the drug user: considering the "demands" of therapeutic technologies and their implications for treatment planning, implementation, and outcome. AB - Continued confusion regarding the actual and potential interface between technical issues (techniques/therapies) and ideological-theoretical considerations (treatment as a planned change process) results in built-in failure in the treatment of drug users. Only a limited number of currently available "therapies" are generally used for planned treatment intervention or for institutionalized reflexive reactions. Limited consideration has been given to the planning and implementation "demands" of a selected number of critical variables which affect the "therapies" currently in use and/or which can be chosen to be used. This note is designed as a catalytic cognitive resource to facilitate changing this situation by exploring some of the factors associated with this self-defeating, self-fulfilling prophecy. PMID- 3804520 TI - Evaluation of the absorption from three ibuprofen formulations. AB - The pharmacokinetic differences between two sustained-release 300 mg (A) and 400 mg (B) formulations and a rapid-release 400 mg ibuprofen conventional sugar coated formulation (C) were compared after a single dose. Mean peak levels of 25.1 micrograms/ml for preparation A (2 X 300 mg), 31.3 micrograms/ml for preparation B (2 X 400 mg) and 68.5 micrograms/ml for preparation C (2 X 400 mg) were reached at 5.3, 3 and 2 hours respectively, after ingestion of the drugs. The individual plasma-level time-profiles for the majority of doses suggested prolonged absorption of product A and B. The absorption from formulations A and B was significantly slower (p less than 0.001 and p less than 0.05 respectively) than that from the conventional tablets. The bioavailability of ibuprofen from sustained-release capsules, was not found to differ significantly from that of ibuprofen from conventional tablets. The relative bioavailability was very close to 100% in almost all subjects (coefficient of variation 14% and 17%). Projections of plasma concentrations upon multiple dosing were made from single dose data. The dosage interval concentration ratio which reflects both the frequency and the entry of the drug into and from the body was much lower for sustained-release formulations (A: 3.0; B: 3.7; C: 12.9). PMID- 3804521 TI - Treatment of acute pain of ureteral and biliary colic with naproxen sodium administered by the parenteral route. AB - Non-steroidal, anti-inflammatory agents (NSAIDs), wellknown inhibitors of prostaglandins, have been used in the treatment of biliary and ureteral pain since the end of the 1970s. The efficacy and tolerance of a new injectable formulation of naproxen sodium in ureteral and biliary pain was investigated in 77 out-patients, observed in an emergency ward, and affected by acute lithiasic symptomatology. Forty-four patients received one 275 mg vial of naproxen sodium intramuscularly, while 33 patients were given one vial at the same dosage intravenously. In 56% of the cases complete relief of pain was achieved within 30 minutes of injection, while in 86% pain was completely relieved or greatly decreased within one hour. Side-effects (nausea, vomiting) occurred in three patients, but were linked to a simultaneous aggravation of the ureteral colic. PMID- 3804522 TI - Clinical experience with total arthroplasty and hemiarthroplasty of the shoulder using the Neer prosthesis. AB - A consecutive series of 28 shoulders in 26 patients, treated since 1982 by either total arthroplasty (11 shoulders) or hemiarthroplasty (17 shoulders), are reviewed. A glenoid osteotomy was also performed in five of the shoulders with a hemiarthroplasty. Overall 16 shoulders were completely satisfactory with little pain and satisfactory movement. Nine had a total arthroplasty. The average range of shoulder elevation after total arthroplasty (121 degrees +/- 29 degrees) was significantly better than after hemiarthroplasty (91 degrees +/- 39 degrees). Pain was still present in seven shoulders with a hemiarthroplasty but in only one with a total joint replacement. PMID- 3804523 TI - The Muller acetabular support ring. A preliminary review of indications and clinical results. AB - A series of 41 total hip arthroplasties with acetabular reinforcement by a Muller support ring is reviewed. The postoperative management was the same as that used in conventional cemented total hip arthroplasty. The overall clinical results and the radiological findings were most satisfactory after one to six years. Of the 30 hips available for functional assessment using the Merle d'Aubigne scale, 16 were excellent, 10 good, 2 fair, 1 poor and 1 bad. These results indicate that, regardless of the primary disorder, the Muller support ring has been helpful when dealing with severe osteoporosis, an acetabular floor lined by bone which does not allow adequate penetration of methyl methacrylate, a small acetabulum needing a small polyethylene socket and localised destruction of the acetabular roof or of the anterior or posterior acetabular pillar. A good result can only be guaranteed if the ring makes a perfect fit with the reamed acetabular cavity. PMID- 3804524 TI - A humeral modular prostheses for bone tumour surgery: a study of 56 cases. AB - Fifty six humeral prostheses were inserted from 1974 to 1984 for primary bone tumours of the shoulder. In 40 patients a proximal humeral resection was performed and in the remaining 16 cases a Tikhoff-Linberg procedure was employed. The length of humeral resection ranged from 9 cm to 24 cm. A detailed analysis of the oncological and functional results was made. The resection was well clear in 42 patients (75%), marginal in 12 (21.5%), and through tumour in 2 (3.5%). Eight local recurrences were noted. The functional results were satisfactory, the patients having a wide range of active rotation and being able to do sedentary work. A new modified humeral modular prosthesis was introduced in 1984 and is presented. PMID- 3804525 TI - Reconstruction of the lateral tibial condyle by a pedicled vascularized fibular graft after en bloc resection of giant cell tumour. AB - Two patients with giant cell tumour of the lateral tibial condyle underwent en bloc resection and reconstruction by pedicled vascularized fibular graft. Both had good functional results and rapid solid bony union. This procedure preserved the lateral stabilizing structures of the knee, allowed relatively early mobilization and provided some cartilagionous surface for articulation with the lateral femoral condyle. The procedure was technically simple compared with homograft reconstruction, prosthetic replacement or free vascularized bone grafts, and could be performed in less sophisticated centres. The operation also provided additional bone stock for subsequent fusion if necessary. PMID- 3804526 TI - Adamantinoma associated with fibrous dysplasia. AB - Three cases of adamantinoma of the tibia, seen in one hospital over a period of 7 years, are described. They illustrate the difficulty in differentiating this lesion from fibrous dysplasia on radiographic and histological grounds. Thermography may help in the differential diagnosis. PMID- 3804527 TI - Desmoplastic fibroma--a rare tumour in a rare site. AB - We report the occurence of a desmoplastic fibroma in the terminal phalanx of the big toe in a 42-year-old male. The tumour is rare, only 66 cases have been reported in the English language journals. The case history together with review of the literature is presented. PMID- 3804528 TI - [Congenital superior radioulnar synostoses. A study of 43 cases]. AB - Superior radioulnar synostosis is a rare abnormality which frequently gives rise to functional disability. Its pattern of inheritance is uncertain. We have studied 29 children, 18 boys and 11 girls, who had a total of 43 such synostoses. Twenty children had significant functional disability. Fourteen required operation, 10 undergoing a Judet's osteotomy and 4 osteotomy of the lower end of the radius. The dominant hand was placed in the position of function, and the other in 30-40 degrees of supination. The osteotomies were secured by pins and supported in a plaster splint. Use of the forearm and hand was improved in all cases. Operation is best carried out between the ages of 4 and 10, and a useful functional improvement can be expected. PMID- 3804529 TI - Bone strength measurements at the proximal tibia. Penetration tests and epiphyseal compressive strength. AB - Three penetration tests were obtained from corresponding locations at each condyle of 19 proximal tibiae. The patterns of condylar cancellous bone strength varied little between knees. The medial condyle was the strongest with an average medial to lateral strength ratio of 1.9, and in most knees the medial condyle was strongest centrally while the lateral condyle was strongest posteriorly. The penetration strength at 5 successive 2 mm levels beneath the resected subchondral surface also showed a constant pattern of variation. Bone strength decreased significantly at first except at the posterolateral site, then tended to level off. The reduction of strength was most pronounced in the centre of the condyles. The penetration tests were good predictors of the static compressive strength of the proximal tibia. Correlation coefficients of approximately 0.90 were obtained indicating statistically highly significant correlations (p less than or equal to 0.00001). The tests were carried out with equipment developed for in vivo measurements of cancellous bone strength during total knee replacement. The findings confirm the close relationship of these investigations to conventional compression tests. PMID- 3804530 TI - [Urinary concentration of cobalt and chromium in patients with a non-cemented total hip prosthesis]. AB - The concentrations of cobalt and chromium have been measured in the urine of 22 patients who had received uncemented hip prostheses made from cobalt, chromium and molybdenum alloy, and in 21 patients who had not received prostheses, using absorption spectrophotometry. The results were statistically analysed using the Wilcoxon test. The levels of cobalt in the urine in the patients with uncemented prostheses did not show a significant increase, indicating that there is no greater risk of cobalt toxicity. The concentration of chromium was significantly raised (p less than 10(-2) in the urine of patients with uncemented prostheses, and in three of these patients significant corrosion had occurred. PMID- 3804531 TI - The effect of Biostim (RU 41.740) on natural killer activity in different mouse organs. AB - The effect of Biostim, a mixture of two glycoproteins extracted from K. pneumoniae, on NK activity in lung, blood and spleen was investigated in mice. Marked increases in NK-cytotoxicity for YAC-1 targets were found after single or repeated administrations of this compound by the i.p. or the oral route in the absence of increases of serum IFN. The highest increases in NK activity were found in lymphoid cells recovered from the lung, active treatments with Biostim significantly increasing the proportion of both target-binding cells and lytic conjugate-forming NK cells. In addition to increasing the rate of clearance from lung and spleen of in vivo-injected radiolabelled YAC-1 cells, short (3 h) exposures to Biostim in vitro augmented the NK-cytotoxicity of murine and human cells. By showing that NK cells can also be a target of Biostim, these results can contribute to a better understanding of the mode of action of this immunomodulator. PMID- 3804532 TI - Influence of tetracyclines and light on the release of lysozyme from human granulocytes and monocytes. AB - Doxycycline inhibited the release of lysozyme from human granulocytes and monocytes exposed to non-opsonized zymosan particles. This effect was more marked for granulocytes than for monocytes. Oxytetracycline, however, did not influence the release. The difference between the drugs can be explained by differences in their lipid solubilities. The divalent cation chelator, EDTA, also reduced the release of lysozyme from leukocytes exposed to non-opsonized zymosan. Accordingly, the selective release of lysozyme from human leukocytes is divalent cation dependent. The inhibition of release by doxycycline is most likely also due to binding of these ions. When the cells were exposed to UVA light in the presence of doxycycline, the inhibition of lysozyme release was potentiated. Using irradiated cells, maximal inhibition was obtained at 20 micrograms doxycycline/ml. However, it is not clear whether these results have clinical relevance. PMID- 3804533 TI - Relationship between immune system and gram-negative bacteria. Acid-treated Salmonella minnesota R595 (Re) enhances immune responsiveness in patients with gynecologic malignancies. AB - Nine patients with gynecologic malignancies (six cervix, two endometrium and one ovary) were injected with acid-treated Salmonella minnesota R595 (Re). Patients received a total of four injections (at increasing doses from 0.5 to 3 micrograms) every 2 weeks. All patients, before treatment, had a severe impairment of their immune system either of cell-mediated immunity (leukocyte inhibiting factor activity) or non-specific immunity (polymorphonuclear cell and/or monocyte-mediated phagocytosis and killing). In contrast, the same patients displayed a normal Natural Killer cell frequency in their peripheral blood as evaluated in an agarose-single cell cytotoxic assay. At the end of the immunotherapeutic regimen, all the above immune functions significantly augmented likely via an immunomodulating effect exerted by the lipid A portion of Salmonella minnesota Re which represents the lipopolysaccharide molecule in these bacteria. This suggests a potential role for lipid A in the treatment of cancer related immunodeficiency. PMID- 3804534 TI - Effect of lentinan on pinocytosis in mouse peritoneal macrophages and the murine macrophage cell line C4M phi in vitro. AB - Lentinan, an immunopotentiating polysaccharide, stimulated the pinocytosis of horseradish peroxidase (HRP) or FITC-dextran by resident or thioglycollate elicited mouse macrophages from 10 to 50% in a dose dependent manner. Pinocytosis of HRP and FITC-dextran by C4M phi cells, a murine macrophage cell line, exhibiting a lower basic pinocytic activity than peritoneal cells, was augmented up to 310 and 120%, respectively, by lentinan. Mannan inhibited the HRP uptake by peritoneal macrophages via specific mannose receptors. This inhibitory effect was partly abolished, when lentinan was also added to the cells. Mannan was not able to inhibit pinocytosis of HRP by C4M phi macrophages, indicating little or no mannose receptor activity on these cells. Pinocytosis of FITC-dextran was not affected by mannan. Lentinan, opsonized in mouse sera inhibited the uptake of HRP by peritoneal macrophages by 30-35%. Opsonized lentinan and mannan added together caused 60% inhibition of HRP uptake in peritoneal macrophages indicating a possible functional relationship between the mannose and C3b receptors. The results demonstrate that lentinan activates the pinocytic function of macrophages predominantly via specific beta-glucan receptors. These mechanisms may contribute to the antitumor and immunopotentiating action of lentinan and other glucan-type polysaccharides. PMID- 3804535 TI - Effect of dipyridamole upon thymidine incorporation and capping in human lymphocytes. AB - Dipyridamole is a potent inhibitor of tritiated thymidine incorporation by PHA stimulated human lymphocytes. This effect is unrelated to the length of culture, to the level of response in untreated cultures, or to the proliferative index. This suggests that dipyridamole principally effects the membrane transport of thymidine. Dipyridamole inhibits sheep-erythrocyte-capping by E-rosettes. This effect cannot be mimicked by theophylline or cyclic nucleotides and cannot be reverted by adenosine. Pharmacological studies with colchicine and cytochalasin B suggest interference with cytoskeletal functions, probably of microtubules. This could be another site of action of dipyridamole beyond phosphodiesterase inhibition and adenosine metabolism. PMID- 3804536 TI - Pharmacological analysis of guinea-pig macrophage chemiluminescence responses to platelet activating factor and opsonized zymosan. AB - The luminol-dependent chemiluminescence (CL) response in vitro of guinea-pig C. parvum-activated peritoneal macrophages to platelet activating factor (PAF) has been compared with that to opsonized zymosan (OpZ). The response to PAF (5 X 10( 6) mol/l.) reached a peak within 1 min, that to OpZ (0.17 mg/ml) within 10-20 min. Peak responses to both stimuli were dose-dependently inhibited in a similar manner by p-hydroxymercuribenzoate (10(-5) - 10(-3) mol/l), sodium benzoate (10( 5) - 10(-3) mol/l.) and quinacrine (10(-6) - 10(-3) mol/l.). In contrast, the xanthine oxidase inhibitor allopurinol (IC50 vs OpZ, 220 mumol/l.; vs PAF greater than 1000 mumol/l.), the methylation-inhibiting combination homocysteine + 3 deazaadenosine (IC50 vs OpZ, 22 mumol/l.; vs PAF greater than 100 mumol/l.), the phospholipase A2 inhibitor and alkylating agent p-bromophenacylbromide (pBPB; IC50 vs OpZ, 2.6 mumol/l.; vs PAF 15 mumol/l.) and the beta-adrenoceptor agonist isoprenaline (IC50 vs OpZ, 0.1 mumol/l.; PAF greater than 10 mumol/l.) all exerted differential inhibitory effects on the CL responses to the two stimuli, though colour quenching by adrenochrome cannot be ruled out in the differential effect of isoprenaline. In screening studies, carried out with CL responses measured 2 or 5 min after PAF and OpZ, respectively, verapamil (less than or equal to 10(-4) mol/l.), trifluoperazine (less than or equal to 10(5) mol/l.) EDTA (less than or equal to 10(6) mol/l.), mannitol (less than or equal to 10(-2) mol/l.), metyrapone (less than or equal to 10(-5) mol/l.), SQ 22536 (less than or equal to 10 micrograms/ml.), iso-butyl methylxanthine (less than or equal to 10( 5) mol/l.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804537 TI - Anterior hypothalamic lesions decrease anaphylactic contractions in guinea pig trachea in vitro by reducing histamine and LTC4 reactivity. AB - Discrete lesions in the anterior hypothalamus (AHA) of the guinea pig brain reduce the anaphylactic contraction of the trachea in vitro after active in vivo sensitization by 40%. This difference in anaphylactic contraction does not correlate with a difference in homocytotropic antibodies but coincides with a decreased smooth muscle response to the anaphylactic mediators histamine and leukotriene C4. No difference in the beta-adrenoceptor function of the tracheal preparations can be found. The results suggest that AHA lesions afford protection against anaphylaxis in actively sensitized guinea pigs at least in part through a reduced smooth muscle response to anaphylactic mediators. PMID- 3804538 TI - Lipoprotein and lipid profiles of elite athletes in Olympic sports. AB - The aim of this work was to obtain an insight into the influence exerted upon plasma lipid parameters by high quality physical training in different specialties of nine Olympic sports. We compared the concentrations of serum cholesterol (TC), total lipids (TL), triglycerides (TG), HDL, LDL, VLDL, and % distribution of HDL, LDL, and VLDL of elite athletes (n = 127, age = 22.0 +/- 3.2 yrs) participating in regular training for over 3 years (2-4 h/day), separated into 11 groups of athletic specialties, with those obtained from a group of selected sedentary controls (n = 26, age = 25.3 +/- 4.5 yrs). We also compared the lipoprotein ratio factor (RF) values TC/HDL and LDL/HDL. The athletic disciplines examined were football, basketball, volleyball, boxing, wrestling, judo, sailing, skiing (slalom), track (two groups), and throwing-jumping. Football, volleyball, judo, SD and LD running, and the total sum of athletes had significantly higher HDL than the controls. Football, basketball, volleyball and all the disciplines taken together showed significantly lower LDL. Boxing, judo, and LD running had significantly lower VLDL and volleyball, SD, and LD running significantly lower %VLDL. Volleyball had significantly lower TL, boxing and volleyball lower TC, while judo, boxing, SD and LD running had lower TG. Sailing had significantly lower %HDL and higher %LDL and TL than the controls; wrestling, skiing, and throwing-jumping did not differ. In all the athletes taken together, VO2 max or relative body weight, with respect to HDL and TC/HDL, were found to be slightly correlated (r = 0.30, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804539 TI - Acute effect of cigarette smoking on physiologic response to graded exercise. AB - To assess the acute effect of cigarette smoking on physiologic response to graded exercise, eight physical education students were tested. The protocol included running on a treadmill for 5-min periods at the speed of 6, 8, 10, and 12 km/h. Each subject performed the exercise twice 1 week apart, once after abstaining from smoking for 24 h and once immediately after smoking two cigarettes. The following measurements were performed at each work load: HR, oxygen consumption, tidal volume, breathing frequency, pulmonary ventilation, and blood lactate. Running velocity corresponding to 4 mM lactate and to 170 HR were calculated. The average HR was higher after smoking at rest and at all work loads tested (P less than 0.05). The average VO2 was lower after smoking at all work loads above 6 km/h (P less than 0.05), and VE/VO2 was significantly higher (P less than 0.001) during smoking at all work loads above 6 km/h. No changes were found in the other parameters measured. No difference was found in the calculated work load corresponding to 4 mM blood lactate or 170 HR. It is concluded that although the acute effect of smoking two cigarettes by subjects accustomed to smoking does not dramatically affect their work capacity, it does significantly change their physiologic response, manifested by a higher HR, lower VO2, and lower breathing efficiency. PMID- 3804540 TI - Compensatory movements following gait perturbations: changes in cinematic and muscular activation patterns. AB - The present study was designed to investigate the neuronal control and biomechanical effects of stumbling reactions. To induce these perturbations, a specially prepared treadmill was used which allowed rapid and powerful changes of treadmill speed. EMG recordings of leg muscles were related to cinematic movement patterns. Following an accelerating impulse, the standing leg was displaced in a posterior direction compared with normal gait, with a premature touchdown of the contralateral, swinging leg, forward of the body axis. This was associated with simultaneous activation of the gastrocnemius and biceps femoris of the ipsilateral and the tibialis anterior muscles of the contralateral leg. Following deceleration, the standing leg was displaced in an anterior direction and the contralateral swinging leg touched the ground prematurely behind the body axis. This was associated with activation of the ipsilateral tibialis anterior and rectus femoris and contralateral tibialis anterior muscles. In both conditions, the activation of the lower leg muscles on both sides occurred with a latency of 60-70 ms, monosynaptic responses being absent. In both cases, early touchdown was associated with a forward extension of the arm. It is concluded that the EMG responses are mediated by a polysynaptic spinal pathway to keep the body center of gravity constant and to prevent falling. PMID- 3804541 TI - Effects of treadmill running on plasma glycosaminoglycans in adult rabbits. AB - Adult rabbits were subjected to running on a treadmill three times daily for 1, 5, and 30 days. The animals were injected with 35S-sulfate and killed 24 h later. The concentration of free and bound glycosaminoglycans (GAG) in plasma, as well as the specific radioactivities of the fractions, was determined. Thirty days of running produced a statistically significant increase in the concentrations of both free and bound plasma GAG, whereas only the latter fraction was increased after 5 days of running. Consistent changes in the specific radioactivities of the fractions were not discernible. PMID- 3804542 TI - Pattern of injury in handball and comparison of injured versus noninjured handball players. AB - A questionnaire was sent to 300 members (at random) of the Dutch Handball Association (response: 76%) (1) to study the injuries involved in handball and the resulting medical attention and (2) to compare injured versus non-injured players with respect to sex, age, somatotype, and sports participation. Group A was defined as players taking part in handball only (62%); 38% also regularly took part in other sports (group B). The male/female ratio in group B was approximately 4 times larger than in group A. The results showed that 51% of all players sustained at least one injury during handball in 1 year. The ratio of injuries/all players in our study did not differ much from the level in a comparable Danish study, 0.82 and 0.71, respectively. Nearly 60% of all handball injuries were localized in the lower compared with only 30% in the upper extremities. A general practitioner was consulted in nearly 40% of the injuries. Within group A, relatively more males were injured and also more frequently compared with females. Injuries in females did not differ from all injuries with respect to localization and medical attention. After comparison of injured versus noninjured players, we conclude that the role of somatotype is not elucidated and that sex and the number of sports might play an important role in the etiology of handball injuries, whereas age is only of minor importance. PMID- 3804543 TI - Dietary intake, anthropometric measurements, and blood lipid values in weight training athletes (body builders). AB - Dietary intake, plasma lipid levels, and anthropometric measurements were studied in 76 weight trained athletes (body builders) who had been following a consistent eating and training program for at least 2 years prior to the study. Dietary data were collected using the 7-day diet record. Nutrient analysis indicated that these athletes followed an atherogenic diet, characterized by a high-fat, high cholesterol intake. The high-cholesterol intake was due to a high egg intake, which varied from 0 to 81 eggs per week. Although those athletes with a high egg intake consumed significantly more fat and cholesterol than those with a low egg intake, plasma total cholesterol levels (mean = 182.9 +/- 25.7) did not differ over the range of egg intakes. Plasma HDL-cholesterol levels were higher and plasma triacylglycerol levels were lower at a high egg intake compared with that at a low egg intake. Plasma uric acid was not affected by the high animal protein intake. Despite the unfavorable intake of macronutrients, food alone supplied adequate amounts of micronutrients as compared with the RDA. Using different measurements of obesity, it was difficult to classify this group of athletes as overweight or obese, due to increased muscle development. PMID- 3804544 TI - Noninvasive determination of the anaerobic threshold in swimming. AB - The relationship between swimming velocity (V) and heart rate (HR) was determined in 60 swimmers. The athletes were asked to increase their work intensity progressively, from low to submaximal velocities; HRs were determined by a telemetric cardiofrequency meter. In all the athletes examined and for each style employed, the linearity of the V3-HR relationship was maintained up to a submaximal velocity (deflection velocity, Vd), beyond which the increase in work intensity exceeded the increase in HR. The test-retest correlation for Vd determined in nine pent-athletes was 0.99. Vd and anaerobic threshold (AT), determined through lactate measurements, were correlated in six swimmers (r = 0.84). Vd and average swimming velocities in a modern pentathlon swimming race (300 m free-style) were also correlated (n = 9, r = 0.91), thus suggesting that AT is critical in determining the speed in middle-distance swimming events. PMID- 3804546 TI - Exercise and the circadian variation in body temperature measures. AB - This study examined the existence of circadian rhythms in rectal temperature (Tr) and selected skin temperatures at rest and during light (82 W) and medium (147 W) exercise on a cycle ergometer. Each intensity was sustained for 5 min and then followed by a graded exercise test to exhaustion. The Tr and skin temperatures were also measured on cessation of exercise and 4 min post-exercise. Fifteen males participated, measurements covering six interspersed times of day. The mean exercise time to exhaustion of 19.83 min was independent of the time of day and caused a constant rise of 0.7 degree C in Tr. Significant rhythms were observed in Tr, Tc (chest), and Ta (arm) under all conditions: findings for Tl (leg) were nonsignificant at maximal exercise and post-exercise (P greater than 0.05). The crest time for Tl had a significant lead over that of Tr and the other skin sites which were in phase concordance, mean difference in crest times being 4.73 h at rest and 4.42 h during submaximal exercise. The results demonstrated constancy with time of day in the thermal load imposed by fixed exercise. This was reinforced when mean skin and mean body temperatures were computed. The general pattern did not apply to the exercised limb, the pre-exercise rhythm disappearing after 10 min exercise. Differential heat conductances according to skin sites are implicated in the phase differences between the leg and the other temperature sites. PMID- 3804545 TI - Effect of work load on free and sulfate-conjugated plasma catecholamines, prolactin, and cortisol. AB - The effects of maximal performance capacity and different work load intensities on the response of free and sulfate-conjugated plasma catecholamines, prolactin (PRL), and cortisol were studied in six healthy male volunteers. In a first experiment, the volunteers had to perform a step-wise incremental bicycle ergometer test to determine the onset of blood lactate accumulation (OBLA) and aerobic capacity (VO2 max). The levels of free noradrenaline (NE), adrenaline (Epi), and dopamine (DA) increased considerably, whereas no significant changes for sulfate-conjugated catecholamines, PRL, and cortisol were observed. In a second series of experiments with the same volunteers, the effects of 30 min exercise were studied at a constant work load intensity on 3 different days. Three intensities were used for each of the volunteers: 45%, 60%, and 75% of their aerobic capacity (i.e., below, close to, and above their OBLA). The values obtained for all parameters showed an intensity-dependent rise. The most important changes occurred at work load intensities above the OBLA. At the highest intensity, all parameters except sulfate-conjugated Ne and cortisol showed a significant increase. Although the physiologic parameters reached a steady state during exercise, there were no indications that this was the case with the values of the neuroendocrine parameters. Ten minutes after the exercise, the levels of the free catecholamines had declined considerably, whereas the values of the other parameters were unchanged or showed a further increase. PMID- 3804547 TI - Granuloma pyogenicum. PMID- 3804548 TI - Langerhans cells in the dermal infiltrate of hyperkeratosis lenticularis perstans. AB - Typical papules obtained from a patient with hyperkeratosis lenticularis perstans (HLP) were examined by light and electron microscopy. Dense cellular infiltrate, which consisted mainly of mononuclear cells, was observed in the dermis underlying the lesion. Electron microscopic studies revealed that these cells were mostly lymphocytic cells. In addition, several Langerhans cells were found in the infiltrate, some of which were apposed to the lymphocytic cells. These findings suggested that immunologic reactions via Langerhans cells might occur in HLP and further raises a possibility that Langerhans cells might be involved in the pathogenesis of HLP. PMID- 3804549 TI - Human notoedric scabies from contact with cats infested with Notoedres cati. AB - Forty-eight human contacts with cats infested with Notoedres cati were investigated; 30 (62.5%) of the contacts showed symptoms of notoedric scabies, and N. cati mites were recovered from 15 (50%) skin specimens. Intense pruritus without any mite burrows developed within a few hours of initial contact with the infested cats. People within the age group of 26-35 years were frequently infested. Hands and legs were the most common sites of lesions. Prolonged association with the infested cats was responsible for this cutaneous disease. The lesions in infested people subsided when the cats were segregated from humans. PMID- 3804550 TI - Delayed hypersensitivity reaction following a sea urchin sting. PMID- 3804551 TI - Pseudo-Kaposi's sarcoma in a drug addict. PMID- 3804552 TI - Unusual tinea corporis caused by Trichophyton verrucosum. PMID- 3804553 TI - Polymyositis: failure with immunosuppressive drugs or success by protecting cell membranes. PMID- 3804554 TI - Epidermolysis bullosa controlled by vitamin E. PMID- 3804555 TI - Determination and speciation of mercury in a dental work-place by cold vapour atomic absorption spectrometry and gas-liquid chromatography. AB - Cold Vapour Atomic Absorption Spectrometry (CVAAS) and Gas-Liquid Chromatography (GLC) have been used for determination and speciation of mercury. Total mercury, methylmercury, ethylmercury and phenylmercury concentrations in urine samples taken from students and staff of a dental work-place were investigated. Air samples were also analyzed. Detection limits, as three times the standard deviation, and in units of ng analyte per ml urine were found to be 1.7, 12, 2.4 and 21 for total mercury, methylmercury chloride, ethylmercury chloride and phenylmercury chloride, respectively. PMID- 3804556 TI - Comparative characterization of organic emissions from diesel particles, coke oven mains, roofing tar vapors and cigarette smoke condensate. AB - This paper reports the characterization of the extractable organics from diesel particulate emissions compared to other complex organics which have been reported to increase the risk of human lung cancer. Class fractions of diesel, cigarette smoke condensate, roofing tar, and coke oven extracts were obtained using liquid/liquid partitioning and silica gel chromatography. Capillary GC/MS was used to identify compounds in each extract fraction. This manuscript reports the mass distribution after fractionation of each extract, all identified fraction components and quantification of selected mutagenic and carcinogenic compounds. PMID- 3804557 TI - Determination of the speciation of chromium from a bicycle factory discharge. AB - The discharge from a bicycle factory in Dar-es-Salaam was analysed for dissolved trace metals so as to monitor what was being introduced onto the environment. An X-ray Fluorescence Spectrophotometer with a Si (Li) detector connected to a multichannel analyser Canberra 40 series was used for the analysis. Computation of the peaks and results was done by a Professional Deck 350 computer. The elements contained in the discharge were Ca (596 ppm), Ti (369 ppm), Cr (11 ppm), Zn (0.98%) and Sr (73.5 ppm). Further analysis of the speciation of chromium revealed that there was Cr(III) (9 ppm) and Cr(VI) 2 ppm. The level of Cr(VI) was considered too high considering its toxicity. PMID- 3804558 TI - Functioning ovarian tumors with peripheral steroid cell proliferation: a report of twenty-four cases. AB - Twenty-four cases of an unusual type of ovarian tumor with functioning stroma in which bands of steroid-hormone-producing cells were located adjacent to the tumor are presented. The cells were of stromal lutein cell type in 14 cases, stromal Leydig cell type in two cases, and hilus cell type in eight cases. Of the tumors with peripheral lutein cells, 11 were monodermal teratomas, including eight examples of struma ovarii, two strumal carcinoids, and one trabecular carcinoid; the other three tumors in this group were a dermoid cyst, a dysgerminoma containing syncytiotrophoblast cells, and a metastatic carcinoid. The tumors with peripheral stromal Leydig cells were a struma ovarii and a strumal carcinoid. Three of the tumors with peripheral hilus cells were mucinous cystadenomas, four were cysts of probable rete origin, and the eight was a dermoid cyst. The patients' ages ranged from 13-82 (average 58) years. Eighty percent of the patients were postmenopausal; one was pregnant. Forty-two percent of the patients had androgenic manifestations, 29% had evidence of hyperestrinism, and one (4%) had evidence of progesterone excess. In 29% of the cases there was no clinical evidence of hormonal imbalance. Those tumors with peripheral stromal Leydig cells or hilus cells were accompanied by androgenic manifestations in over one-half the cases, and those tumors with peripheral lutein cells had a slightly higher association with estrogenic rather than androgenic changes. Human chorionic gonadotropin and its beta subunit were demonstrated by the immunoperoxidase technique in some neoplastic cells in 4 of the 17 cases in which it was performed. Ovarian tumors with peripheral steroid-hormone-producing cells should be distinguished from the typical ovarian tumor with functioning stroma, which contains lutein cells scattered throughout its stroma. PMID- 3804559 TI - Epidemiology of cystic mesothelioma. PMID- 3804560 TI - Early improvement of left ventricular function during caloric restriction in obesity. AB - Left ventricular function (LVF) was studied in 25 obese patients (four males and 21 females) by serial poligraphic measurements, namely systolic time intervals (STI), during a short period of dieting (2721 kJ/day (650 kcal/day) as single daily meal regimen). In the same period, all the patients underwent also three standardized exercise tests at the cycloergometer. At the end of the study (20th day), statistically significant differences were obtained in weight loss (P less than 0.001); two main parameters of STI, namely pre-ejection period index (PEPI) and PEP/LVET ratio were lowered (P less than 0.001): furthermore, peak and recovery systolic blood pressure (SBP) and heart rate (HR) during exercising, were also significantly reduced. These data suggest that an improvement of LVF and cardiac performance are present since the early phases of caloric restriction in obesity. PMID- 3804561 TI - Changes in serum lipids after gastric bypass surgery. Lack of a relationship to weight loss. AB - Serum lipid levels were measured in 65 obese patients before and a mean of 13.4 +/- 0.2 months after gastric bypass surgery performed to facilitate weight reduction. The 58 women studied lost an average of 39.8 +/- 1.2 kg thereby reducing their mean body mass index from 41.9 +/- 0.7 to 26.8 +/- 0.6. Postoperatively, total cholesterol, LDL cholesterol, and triglyceride levels were significantly lower and HDL cholesterol levels significantly higher than preoperative values (for each of the four comparisons P less than 0.0001). Whereas before surgery 83 percent of the women had levels of total, LDL, or HDL cholesterol indicative of an increased risk of coronary heart disease, after surgery only 24 percent did so. Preoperative cholesterol abnormalities in the seven men were not as severe as were those in the women, and the men's postoperative cholesterol changes were not as marked. Correlations of the difference between pre- and post-operative weight and the difference between pre- and post-operative lipid levels showed that weight loss accounted at most for just 8 percent of the simultaneous lipid change. The data indicate that gastric bypass surgery for morbid obesity produces a favorable change in serum lipid profiles and suggest that the change is due primarily to factors other than the associated weight reduction. PMID- 3804563 TI - Changes in histological features and nerve growth factor content of the submandibular gland in the genetically obese (ob/ob) mouse. AB - Changes in the submandibular glands were studied cytologically in the genetically obese (ob/ob) mouse. In the ob/ob mice, the acini of the glands were mainly composed of mucous cells; in contrast to an abundance of serous cells in the lean controls. The convoluted tubular portions of the glands of the obese mice were composed of cells with reduced numbers of granules, as compared with the controls. The immunocytochemical reactivity to an antiserum against nerve growth factor (NGF) was mostly restricted to the convoluted tubular cells and tubular lumen in both male and female control mice. In the male and female obese mice, weak reactivity to NGF was found in the convoluted tubular cells, while none was observed in the tubular lumen. The reactivity to anti-NGF was lower in females than in males in both the obese and control mice. These changes may be related to the hypoactivity of the sympathetic nervous system in the obese mouse. PMID- 3804562 TI - Effects of ileal interposition on body weight and intestinal morphology in dogs. AB - Interposition of a segment of terminal ileum into the proximal jejunum has been shown to cause weight loss and hypertrophy of the pancreas and intestines of rats. To further evaluate the potential of ileal interposition as an anti-obesity procedure, weight loss, liver histology and intestinal morphology were studied in normal adult mongrel dogs. A 40 to 45-cm segment of distal ileum was transposed isoperistaltically on its vascular pedicle to the proximal jejunum (n = 14). Control dogs (n = 4) underwent transection and reanastomosis without interposition. Interposition resulted in a mean weight loss of 3.9 kg or 16 percent of body weight, over a 12-week period compared to a mean gain of 2.6 kg (11 percent of preop.) in the controls (P less than 0.025). Liver histology (n = 3) showed minimal fatty infiltration in one dog. Grossly, the transposed ileal segment did not show any consistent elongation or thickening of the bowel wall. Microscopically, there was complete jejunalization of the mucosa of the ileal segment which was indistinguishable histologically from the adjacent jejunal mucosa. Because of the variability of the weight response (-8.6 to +0.9 kg), further studies are required to evaluate the potential of this experimental procedure to achieve weight loss. PMID- 3804564 TI - The thermogenic properties of ephedrine/methylxanthine mixtures: human studies. AB - The thermogenic effect of an over-the-counter preparation containing 22 mg ephedrine, 30 mg caffeine and 50 mg theophylline was investigated in human volunteers with a predisposition to obesity and also in the lean. The ephedrine/methylxanthines mixture was twice as effective as ephedrine alone in increasing the fasting metabolic rate of both subject groups, and it normalized the reduced thermogenic response to a 1.25-MJ meal observed in those predisposed to obesity. Measurements of 24-h energy expenditure in a respirometer indicate that the mixture had no effect on the daily metabolic rate of the lean, but was effective in causing a significant 8 percent increase in the 24-h energy expenditure of those subjects predisposed to obesity. These studies indicate that relatively mild doses of dietary methylxanthines in combination with ephedrine can raise daily energy expenditure of those predisposed to obesity, mainly by correcting their defective thermogenic response to food. Such ephedrine/methylxanthine preparations could be useful as aids in the treatment of obesity. PMID- 3804565 TI - Estimated overweight and obesity in Mexican American school children. AB - The prevalence of overweight and obesity in Mexican American children 6 to 17 years of age was estimated in 1972 (n = 1269) and 1983 (n = 868). Children were classified as overweight or obese on the basis of the body mass index (weight/stature2), the triceps skinfold, or both, relative to reference data for white children in NHANES-1. Overweight was defined as greater than or equal to 90th percentiles, while obesity was defined as greater than or equal to 95th percentiles of age- and sex-specific reference data. Over the entire age range, there was a significant increase in the prevalence of overweight and obesity between 1972 and 1983, but there was variation with age and sex. Fewer children were classified as overweight or obese when the two criteria were used together than when they were used individually. The results suggest that the body mass index and the triceps skinfold may vary in sensitivity as indicators of overweight and obesity particularly in 10- to 17-year-old children. Children classified as obese by the body mass index had significantly larger estimated midarm muscle circumferences than those classified as obese by the triceps skinfold or by both the body mass index and the triceps skinfold. PMID- 3804567 TI - Physical activity and fitness in obese children. AB - Daily physical activity and physical fitness were studied in 31 obese and 31 normal-weight children matched for age and sex. The ages of the children ranged from 5.7 to 16.1 years. The history of their physical activity was examined using a questionnaire completed by the child and the parents. Physical fitness was measured using a two-stage exercise test on a bicycle ergometer. There were no significant differences in daily activities between the obese and the non-obese children, while the sports grades at school were lower and participation in the training teams of sports clubs was less frequent among obese than normal-weight subjects. The obese children were physically less fit than the normal-weight subjects as judged from the pedalling time in exercise test (P less than 0.05) and from the maximum oxygen consumption (VO2 max) related to lean body mass (LBM) (P less than 0.001). Twenty-seven children participated for 1 year in a weight reduction programme which comprised individual nutrition counselling, guidance on physical activities and supportive therapy. The reduction in weight was successful in 25 out of 27 children and VO2 max increased on average from 44.2 to 47.1 ml/min/kg of LBM (P less than 0.025). There was no change in the time used for physical activities during the weight reduction period although the children's participation in the training teams of sports clubs increased. It was concluded that obese children are less fit than their non-obese counterparts. Weight reduction results, however, in an improvement of the maximum oxygen consumption towards normal. PMID- 3804566 TI - Upper body and centralized adiposity in Mexican Americans and non-Hispanic whites: relationship to body mass index and other behavioral and demographic variables. AB - Mexican Americans have a higher prevalence of NIDDM, more overall obesity and more centralized adiposity than non-Hispanic whites, but have thus far not been characterized as to whether they have greater upper body adiposity. Waist-to-hip circumferences (WHR, a measure of upper body adiposity) and subscapular-to triceps skinfold ratios (centrality index, a measure of centralized adiposity) were determined in 725 Mexican Americans and 226 non-Hispanic whites as part of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular risk factors. Mexican American females had higher centrality indices and WHRs than non-Hispanic white females, even after adjustment for demographic (age, menopausal status) and behavioral variables (body mass index, parity, cigarette smoking, alcohol consumption, exercise, and oral contraceptive and estrogen use). Mexican American males had higher centrality indices than non Hispanic white males, but differences in WHR disappeared after adjustment for overall adiposity (body mass index). Of the demographic and behavioral variables, only age and body mass index were consistently related to regional body fat distribution. The lack of an association between body fat distribution and behavioral variables suggests that genetic factors may play the principal role in determining body fat distribution. Surprisingly, the distributions of centrality index and WHR were relatively independent of one another suggesting that they may be used as distinct, independent predictors of metabolic diseases. PMID- 3804568 TI - The chemical stimuli of human skin surface for the attachment response of Schistosoma mansoni cercariae. PMID- 3804569 TI - Humoral and cellular responses to homologous extracts of Nematospiroides dubius and Nippostrongylus brasiliensis. PMID- 3804570 TI - Immunosuppressive effects of extracts of helminthic parasites in C57BL mice. PMID- 3804571 TI - The role of host generated free radicals in helminth infections: Nippostrongylus brasiliensis and Nematospiroides dubius compared. PMID- 3804572 TI - Complete resistance to challenges with Hymenolepis nana cysticercoids derived from mouse, rat and beetle in mice. PMID- 3804573 TI - Electrophoretic studies on the Anisakis simplex complex (Ascaridida:Anisakidae) from the Mediterranean and North-East Atlantic. PMID- 3804574 TI - Structure and composition of the metacercarial cyst wall of Sphaeridiotrema globulus (Trematoda). PMID- 3804575 TI - Developmental arrest of Haemonchus contortus in sheep treated with a corticosteroid. PMID- 3804576 TI - Primary nephrotic syndrome in Iran: clinicopathological study of 310 cases. AB - Three hundred and ten children with primary nephrotic syndrome were studied since 1972. 190 patients are classified as nephrosis (61%); including minimal glomerular lesions (22.9%), diffuse mesangial proliferation (6.77%) and focal and segmental sclerosis (31.6%). Corticoresponsivity was limited: 53.75% with a higher success rate in minimal glomerular lesions: 74% versus 38% of diffuse mesangial proliferation and 42.5% focal and segmental sclerosis. Immunosuppressive drugs were used for 96 patients corticodependent or resistant. They were more effective in dependent than resistant cases 94% versus 38%. A total of 149 cases were followed (mean: 3.9 years). In the last evaluation 67% were in remission, 8.10% in chronic renal failure and 24.8% with other abnormalities. PMID- 3804577 TI - IgA nephropathy: Henoch-Schonlein purpura and Berger's disease in one patient. AB - A patient is described who had an attack of Henoch-Schonlein purpura with no renal dysfunction at 4 years of age. She recovered with conservative management. There were no further episodes of Henoch-Schonlein purpura and her urinalysis remained normal for the next 11 years. At age 15, she developed repeated bouts of gross hematuria and proteinuria, and a renal biopsy was performed 3 years later. Light microscopy showed mesangial proliferative glomerulonephritis with granular, mesangial deposits of IgA by immunofluorescence and numerous, electron-dense deposits in mesangial regions by electron microscopy. These findings were consistent with a diagnosis of Berger's disease. The occurrence of Henoch Schonlein purpura at 4 years and Berger's disease at 15 years in the same patient suggests that these two conditions are related. PMID- 3804578 TI - Probable air embolism during Tenckhoff catheter placement. AB - Acute cardiovascular collapse occurred in a 15-year-old girl during peritoneoscopic placement of a Tenckhoff catheter. The case demonstrates a potential complication of this procedure: air embolism. A review of the management and prevention of this problem is provided. PMID- 3804579 TI - Acute renal failure due to cisplatin. AB - A case of acute renal failure associated with cisplatin therapy for a stage IV neuroepitelioma of the chest wall is described. This case was associated with a normal magnesium concentration and with presence of fibrinogen in the Tubular Basement Membrane and of IgG in the interstitial infiltrates. Immunological activation was evidentiated by fine needle aspiration biopsy (FNAB) at the time of renal biopsy. PMID- 3804580 TI - Cisplatin nephrotoxicity: symptomatic hypomagnesemia and renal failure. AB - Cisplatin is an inorganic platinum compound used in the treatment of solid tumors. Clinical trials have proved its efficacy whilst recognising the nephrotoxicity of the drug. We report the case of a 14 1/2 year old female with an epidermoid carcinoma of the lung, who developed acute renal failure following two courses of Cisplatin. The predominant features were symptomatic hypomagnesaemia, hypocalcaemia and hypokalaemia which were corrected following the administration of intravenous magnesium. Renal failure persisted for several months and the patient died due to her primary disease. Electrolyte disturbances should be anticipated when high dose Cisplatin is used. PMID- 3804581 TI - Fever due to Clostridium difficile during hemodialytic treatment. AB - A ten-year-old on hemodialysis had a prolonged unexplained fever secondary to Clostridium difficile antibiotic-associated colitis and posed a great diagnostic challenge. PMID- 3804583 TI - Is alexithymia a disconnection syndrome? A neuropsychological perspective. AB - Efforts to relate the syndrome of alexithymia to cerebral dysfunction have generally taken the form of comparing the literal, concretistic, nonimaginative and affect-impoverished cognitive and communicative style of alexithymic patients to similar types of behavior seen in individuals with right-hemisphere damage or commissural disconnection. It is argued that the formulation of a neuropsychological typology of psychiatric syndromes like alexithymia has much heuristic merit as long as appropriate theoretical and methodological caution is exercised in drawing inferences about patterns of cerebral organization in nonneurological populations. PMID- 3804582 TI - Cancer mortality in psychiatric patients: the Iowa Record-linkage Study. AB - Of 5,412 patients admitted to the University of Iowa Psychiatric Hospital over a ten-year period, forty-six died of cancer during follow-up, which did not differ significantly from expected. Significant excess mortality from cancer was present within the first two years of follow-up. At risk during this period were women and patients with organic mental disorders. A review of relevant literature is presented. PMID- 3804584 TI - Psychopathology in medical inpatients and its relationship to length of hospital stay: a pilot study. AB - A composite screening instrument measuring depression, anxiety, cognitive dysfunction, and pain identified 40 percent of a sample of general medical inpatients (30% of total patients before exclusions) as having significant psychopathology or pain, a reasonable number based on clinical incidence literature. These identified patients' hospital length of stay did not differ from the length of stay for other patients. The screen identified 21 percent as very depressed, 19 percent as very anxious, 15 percent as having cognitive dysfunction, and 11 percent with high pain levels. Depression, anxiety, and pain frequently occurred together. Further study is required to refine the instrument and assess its effectiveness at targeting patients for psychiatric intervention. PMID- 3804585 TI - Hepatitis in 101 consecutive suburban cocaine and opiate users. AB - The records of 101 cocaine and/or heroin drug abusing patients admitted consecutively to Fair Oaks Hospital were evaluated for history of IV drug abuse, antigen and serum antibody evidence of hepatitis A and B infection, and elevation of serum SGPT. One patient, an IV user, had hepatitis B antigen present in his blood. No patient had acute hepatitis A (IgM) antibody present. Forty-five out of fifty-three (84.9%) IV abusers were Hep B Ab positive, while two out of twenty nine non-IV abusers (6.9%) were positive. Twenty of fifty-three (43.4%) IV users had positive hepatitis A Ab while one of twenty-nine (3.4%) of non-IV users were positive. Thirty-five of fifty-five (63.6%) IV users had elevated SGPT compared to five of forty-one (12.2%) in non-IV users. IV users tended to be older than non-IV users. The data presented in this article indicate that there is a greatly increased incidence of both hepatitis A and B in IV drug users compared to non-IV users and that the hepatitis B incidence is increased in a far greater amount than could be expected in a normal population. The type of drug injected (heroin, other opiates, or cocaine) was not an important determinant. The presence of hepatitis B antibodies in any drug abusing patient who denies IV use is a strong indication that they may not be telling the truth about their past drug abuse. It makes little difference whether drug abusing patients live in the inner city or the suburbs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804586 TI - Behavioral disturbance, embolism, and mitral stenosis. AB - The hypothesized equivalence of behavioral disturbances (BD) and embolic (E) events in predicting subsequent events in mitral stenosis patients was tested by a retrospective comparison of clinical courses. Behavioral disturbances, presenting in twenty patients, were followed by 9.6 BD, 13.8 E, and 5.3 fatal events per 100 patient years. Embolic events, presenting in thirty-three patients, were followed by 1.9 BD, 8.4 E, and 3.4 fatal events per 100 patient years. Forty-six patients presenting with neither event subsequently had 2.7 BD, 7.3 E, and 3.6 fatal events per 100 patient years. It is concluded that a behavioral disturbance in the setting of mitral stenosis is a predictive of an embolic event as is an embolic event itself. PMID- 3804587 TI - The psychological experience of pregnancy. AB - The goal of this investigation was to evaluate objectively the psychological experience of pregnancy. Previous research, using symptoms checklists, interview information, and projective testing strategies has suggested that pregnancy presents a woman with emotional and psychological changes. The goal of this study was to substantiate objectively the assertion that pregnant women have different psychological experiences and emotional needs than nonpregnant women. To assess these needs a group of nineteen women experiencing their first pregnancy was compared to a nonpregnant control group on a variety of objective personality measures. The investigation results indicated that the pregnant women differed from the nonpregnant women on some fundamental dimensions of personality. These differences included a stronger introverted, inward personality orientation, and a lower level of self-acceptance and independence. Suggestions for future research are offered. PMID- 3804588 TI - Enduring psychiatric and neuropsychologic sequelae in the post-encephalitis patient. AB - Initial presentations of encephalitis are sometimes misdiagnosed as psychoses due to the predominance of psychiatric symptoms and frequently negative neurological work-ups. It is likely that many of these errors are never discovered. The patient described herein is an exception. Her symptoms, diagnosis, and treatment have now been followed for nearly two years and suggest not only that the initial diagnosis was in error but also that both psychiatric and organic symptoms can endure as sequelae of encephalitis. Questions regarding optimal treatment and reasons for clinical improvement are addressed. PMID- 3804589 TI - Non-verbal behaviour and body organ fantasies. Their relation to body image formation and symptomatology. AB - A deliberate analytic approach to various non-verbal manifestations may in some cases be a point of departure for exploring idiosyncratic representations of body organs and body image. Relevant clinical material is presented to illustrate how such representations may be developed. Further, I have attempted to suggest how the roots of body image formation reflect early levels of concept formation influenced by primary process and derived from an amalgamation of what has been called enactive and imagic modes of thinking (McLaughlin, 1984). The enactive mode comprises a combination of affective processes entwined with proprioceptive, visceral, motoric and sensory feeling. The imagic mode refers to visual, auditory, tactile and gustatory impressions (Horowitz, 1983). The pre-oedipal and oedipal determinants of an analysand's symptomatology and of his body image pathology are examined. Moreover, the pre-oedipal antecedents of his Oedipus and castration complex are illuminated. The psychic and somatic implications of his particular 'testicularization' of his body and of his body image fantasies are discussed. PMID- 3804590 TI - The ego and the self in the thought of Sigmund Freud. AB - An analysis of the development, nature, and inter-relations of the three main senses in which Freud used the term 'Das Ich' (the 'I'). They are: the ego--one's person as subject, who desires, thinks, feels, acts. The use of this concept is very flexible, ranging from a global sense which includes the whole psychic system, to the narrower idea of the conscious purposive agent, to the technical concept of the 'system ego': a psychic subsystem which plays the key role in organizing and directing the activity of the person as subject. the self--one's person as the object of one's narcissistic or aggressive cathectic investment: the person one believes, wishes, or hopes oneself to be, as distinct from the actual object, one's (or another's) actual person. The idea of such an object (nowadays called an 'intentional object') derives from Franz Brentano, Freud's teacher. the character--a stable syndrome of interrelated traits of behaviour or thought. Both the ego and the self have characters, which are formed in different ways, and which resemble each other only to a varying degree. PMID- 3804591 TI - Some enuretic derivatives in an adult analysis. AB - The paper traces the effects of early overstimulation--leading as it does to precocious erotization and rage. Together, these combine in a manic defence by denying deadness in inner psychic reality. The rage being such as the ego cannot cope with, reappears in the recurrent fugitive dream. The paper shows how the patient is most threatened in his dreams where he repeatedly protects himself from death by castration; where death means death of inner psychic reality. In life his rage is never overt but is principally mocking, putting the other in the open while he remains protected from risks. In the same way just as the patient is most threatened in sleep, so he is likewise threatened by the change of mind at the prospect of sexual arousal. The adoption of a fetish affords protection, as it serves to negate total psychic inner deadness. The fetish itself is a sort of screen against loss and grief where these affects have been previously sexualized. Likewise the earlier adoption of the phobia of spilling liquids brought the enuretic event under ego-control by making the risks more conscious and therefore more available to act as a screen against loss and grief. PMID- 3804592 TI - The influence of historical events on psychoanalysis: a case history. AB - Parts of the analysis of a patient are described, whose childhood had been overshadowed by serious traumatic experiences (death of father, flight). The interaction between these events which was dictated by recent history and the inner psychic world of the patient is investigated and consequences for the transference, countertransference and psychoanalytic technique are discussed. Special problems can arise when patient and analyst as members of the German post war generation are equally confronted by the Nazi past during the analytical process. PMID- 3804593 TI - The active and passive fantasy of rape as a specific determinant in a case of acrophobia. AB - Acrophobia is generally understood as a defensive reaction against the wish to lose control of sexual impulses, but the precise nature of some of the fantasies involved has not been extensively elaborated. Associations, memories, and the analysis of a re-enactment in the treatment of a young woman demonstrated that the wish to rape and be raped were specific determinants of her severe acrophobia. The case presented also illustrates that in a true hysterical phobia genital dynamics predominate, albeit coloured and influenced in part by important pre-oedipal determinants. PMID- 3804594 TI - Suddenly finding it really matters: the paradox of the analyst's non-attachment. AB - Psychological discoveries of a certain kind give rise to a particular sense of shock. When we are forced to look afresh at something whose importance we think we already know, we may find it has new and unexpected significance. Our previous understanding, genuine as it was, comes to seem rather shallow. Psychoanalysts must be open to such experiences, and I illustrate this with episodes from the history of psychoanalysis and with clinical examples. 'What really matters about this analysis?' is a question for which patient and analyst must each seek an answer, and both must allow it to take them by surprise. There is a parallel between the patient's need to give up his established ways of coping and the analyst's need not to cling on to his familiar ways of understanding. The paradox of non-attachment is that our understanding can only develop if we are not anxious to hold on to it. I relate this clinical observation to the idea of non attachment as found in spiritual tradition, and I draw on the work of Bion and Matte Blanco to locate these ideas within psychoanalytic theory. PMID- 3804595 TI - Positive projective identification. AB - This paper suggests that literature concerning projective identification has excessively focused on the projection of unwanted aspects of the self without giving adequate consideration to projective identification involving good qualities. It is proposed that clinical advantages may derive from dividing projective identification into positive and negative components. This division allows a more ready emphasis on the capacity for beneficial object relations which even psychotic individuals retain despite their obvious hostility. Case vignettes are provided to demonstrate positive projective identification and to emphasize the clinical usefulness of this concept. PMID- 3804596 TI - How does self psychology differ in practice? PMID- 3804597 TI - Assessing health status after inpatient rehabilitation in rheumatoid arthritis. AB - Evaluation of different therapy programmes, e.g. inpatient rehabilitation, in rheumatoid arthritis requires valid, reliable and sensitive instruments describing patient health status. Traditional measurements such as ESR, joint count or radiographic findings do not suffice for this purpose, particularly because they neglect the psychosocial dimensions of impairment. We report upon a questionnaire, MOPO scales, a German adaptation of the Arthritis Impact Measurement Scales. We found the questionnaire to be valid, reliable and sensitive to change. The main application of MOPO scales is in multidimensional measurement of patient health status and in detection and documentation of therapeutically induced change. PMID- 3804598 TI - Memory disturbance after stroke: frequency and associated losses. AB - 138 patients who survived an acute stroke had their memory assessed at 3 months. As a group these patients had no impairment of digit span when compared with published age-matched normal data. Immediate logical memory (of a story) was poor in 29 per cent, and 14 per cent could not draw a picture immediately after seeing it. Poor memory function was not associated with more severe strokes, but was associated with poor functional ability on everyday tasks. Poor visual recall was associated with lower abilities at ADL, independent of any effect of age. Statistically significant recovery was detected in immediate logical memory and visual recall between 3 and 6 months. PMID- 3804599 TI - Lay beliefs about the causes of rheumatoid arthritis: their implications for rehabilitation. AB - This paper reports research based on interviews with 29 people with rheumatoid arthritis of at least 5 years duration. One of the topics covered was the respondents' understanding of the cause of their condition in the light of continuing medical uncertainty about aetiology. The evidence suggests that, in developing explanations, individuals will combine elements of medical knowledge with "common-sense" beliefs derived from other sources. The difference between lay and professional concepts contributes to communication problems and, in situations of chronic illness, communication may be one of the most potent components of rehabilitation. It is suggested that better appreciation of the individual's beliefs about causality could help to overcome the difficulties. PMID- 3804600 TI - Loss of arm function after stroke: measurement, frequency, and recovery. AB - This study aims to establish the frequency of paralysis and other arm problems after stroke; the recovery of lost function; and to compare various tests of the affected arm. Thirteen per cent of the sample had no arm paralysis when first seen within 14 days. At 3 months 24 per cent of survivors had moderate or severe paralysis; 57 per cent could place nine pegs into holes within 50 seconds; 19 per cent had significant sensory disturbance; 5 per cent had shoulder pain; 8 per cent had restricted passive shoulder movement; and 17 per cent had some paralysis of the dominant arm. Between 3 and 6 months, improvement of motor power was seen in 40 per cent of patients, and 13 per cent of patients improved their function. Severity of initial paralysis was an important prognostic factor. PMID- 3804601 TI - A test battery to measure the recovery of voluntary movement control following stroke. AB - Tests of upper limb function and an activities of daily living (ADL) index were selected to measure recovery following stroke. Thirty stroke patients were assessed at intervals for up to 6 months to 1 year post-stroke using the battery. The results showed the ADL index is insensitive to upper limb recovery. All the tests measured recovery in some of the patients after 24 weeks post-stroke. Since the presentation and recovery of patients was variable, it is argued that it is necessary to offer a selection of assessment tests to measure recovery and to aid treatment planning. PMID- 3804602 TI - Aerobic capacity during two-arm and one-leg ergometric exercise. AB - Previous studies have shown that maximal oxygen uptake (VO2 max) measured during two-arm cranking and one-leg cycling is about 70-78 per cent of VO2 max measured during two-leg cycling. The present study investigated the maximal physiological responses of eight healthy untrained males during two-arm, one-leg, and two-leg ergometric exercise. Two-arm cranking and one-leg cycling were found to be 55 and 66 per cent of two-leg VO2 max, respectively. The % VO2 max at which the anaerobic threshold occurred during the two-arm and one-leg exercise conditions were 57 and 68 per cent, respectively. These findings suggest that when the active muscle mass is limited, a progressive exercise test using one leg may elicit a higher VO2 max than with two arms. PMID- 3804603 TI - Speleotherapy: a special kind of climatotherapy, its role in respiratory rehabilitation. AB - Speleotherapy, the use of the climate of caves, is an accepted but not widely known therapeutic measure in the treatment of chronic obstructive airway diseases. This study summarizes the therapeutic experiences of more than 4000 patients who were treated in a 10-year period in a hospital-cave complex in Tapolca, Hungary. A sharp and long-lasting clinical improvement and a significant recovery from airway obstruction could be observed in the overwhelming majority of patients. It is established that the microclimate of some caves can beneficially affect these disorders, but the cave should be considered as an optimal environment for complex respiratory rehabilitation. PMID- 3804605 TI - Abstracts of the Fourth World Congress of Biological Psychiatry. Philadelphia, Pennsylvania, USA, September 8-13, 1985. Part A. PMID- 3804604 TI - Remedial surgery for the adolescent with cerebral palsy: a 10-year survey of the numbers, types and results of operations on pupils at the Thomas De La Rue School, Tonbridge, Kent. AB - The Thomas De La Rue School caters for adolescents with cerebral palsy, many being severely disabled. Over the 10-year period (1967-77) out of a total of 355 pupils, 97 underwent surgery, a total of 147 operations, 145 orthopaedic, being performed, the majority on the lower limbs. The pupils involved, their parents, teachers and house-parents were invited to complete a questionnaire concerning the effectiveness of the operations, the anxieties and psychological problems resulting from surgery, and the effect on schooling. The results are discussed. PMID- 3804606 TI - Rapid determination of vitamin A (retinol) and vitamin E (alpha-tocopherol) in human serum by isocratic adsorption HPLC. AB - The simultaneous determination of alpha-tocopherol and retinol in human serum is reported. The separation is carried out by means of isocratic HPLC on adsorption columns. UV-Detection is possible by using either one wavelength for both compounds (300 nm), or after a lambda change mode with typical wavelengths for alpha-tocopherol (292 nm) and retinol (325 nm). According to short retention times (10 min) and rapid extraction the method is useful for clinical research and allows about 50 analyses per day and operator. Blood from 176 human volunteers was collected and alpha-tocopherol and retinol levels in serum determined with this method. Statistical evaluation of different selected groups shows typical significant differences of alpha-tocopherol and retinol concentrations in smokers and oral contraceptive users. PMID- 3804607 TI - Effect of chronic administration of excess dietary vitamin A and zinc on lipid metabolism in rats. AB - The effects of chronic feeding of excess dietary vitamin A and zinc on serum cholesterol, liver cholesterol and total liver lipids were studied in rats. Sixty four Sprague-Dawley female rats were randomly allocated to 4 groups: basal diet: 4848 micrograms of vitamin A and 61 mg of Zn/kg of diet; high Zn (33-fold excess of the requirement) + basal vitamin A; basal Zn + high vitamin A (154-fold excess of the requirement) and high Zn + high vitamin A. After 120 days serum cholesterol, liver cholesterol, total liver lipids, and vitamin A and zinc in the liver and kidney were measured. The mean serum cholesterol (+/- SE) for the 4 groups were: 121 (+/- 12.6), 159 (+/- 6), 133 (+/- 7.6) and 186 (+/- 7.6) mg/dl, respectively. Liver cholesterol and total lipids for the 4 groups were determined as 1.8 (+/- 0.05), 2.2 (+/- 0.09), 4.9 (+/- 0.12) and 4.6 (+/- 0.24) mg/g of tissue and 26.3 (+/- 0.7), 26.0 (+/- 1.1), 38.9 (+/- 0.9) and 40.3 (+/- 1.4) mg/g of tissue, respectively. Liver and kidney vitamin A levels were significantly higher in group C than in group D, suggesting increased vitamin A metabolism in the high dietary zinc + high vitamin A groups. In high dietary zinc groups, a significant elevation of serum cholesterol was observed regardless of the vitamin A levels. Total liver lipids and liver cholesterol were significantly higher in rats fed high vitamin A irrespectively of the zinc levels in the diet. PMID- 3804608 TI - Liquid chromatographic determination of carotenes in cattle serum and liver. AB - A liquid chromatographic (L.C.) method is described for the determination of carotenes in cattle serum and liver. Serum samples were extracted with petroleum ether following precipitation of proteins with ethanol. Liver samples were extracted with hexane following saponification. Final L.C. analysis was carried out on a Altex 5 microns ultrasphere column with a solvent systems of acetonitrile: chloroform (92:8 v/v) at 2 ml/minute. The only components in serum of cattle were alpha- and beta-carotene. The method required 500 microliters of serum and 25 minutes of elution time per sample. One hundred and eleven samples of blood serum and liver of cattle were analyzed simultaneously by the L.C. and a colorimetric method. The correlation of the concentration of carotenoids (colorimetric method) with carotenes (L.C.) were calculated and given in the text. PMID- 3804609 TI - Determination of 25-hydroxyvitamin D3 in sheep tissues by high-performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) method is described for the determination of 25-hydroxyvitamin D3 (25-OH-D3) in sheep tissue. The procedure involved saponification followed by chromatography on Sephadex LH-20 in order to remove extraneous material. Quantitation of 25-OH-D3 in tissue samples containing as little as 2 ng/g, was achieved by HPLC and ultraviolet detection at 254 nm in HPLC system. PMID- 3804610 TI - The effect of acute prolonged starvation on the concentrations of vitamin B6 aldehyde derivatives in whole blood. AB - Since plasma pyridoxal-x-5'o-phosphate (PLP) levels are used to assess vitamin B6 status low levels are frequently interpreted to indicate B6 deficiency. However plasma PLP is in a dynamic equilibrium with pyridoxal (PL) through the action of non specific alkaline phosphatases (ALP). The object of this study was to monitor possible disturbances of this equilibrium in whole blood during acute prolonged fasting (40 hrs) and the subsequent repletion period in 16 healthy male dogs. Mean plasma PLP decreased by 15 percent (p less than 0.025) and PL increased by 20 percent (p less than 0.05) at the end of the starvation period and returned to baseline values after 48 hrs of refeeding. However total plasma aldehyde (PLP and PL) B6 vitamer concentrations remained unchanged throughout the investigation period. A 35 percent increase in haemolysate PL was the only significant change (p less than 0.0005) in PLP and PL levels observed in erythrocytes during fasting. It is concluded that the use of plasma PLP alone to assess vitamin B6 status may be misleading in conditions with a disturbed plasma PLP/PL equilibrium. PMID- 3804611 TI - Interaction among niacin, vitamin B6 and zinc in rats receiving ethanol. AB - The interaction of niacin, vitamin B6 and zinc was studied in Wistar rats. Seventy animals were submitted to a four-week depletion period during which they were fed a corn grits diet with no niacin, vitamin B6 or zinc added. These animals also received a 32% ethanol solution. Thirty additional rats were used as controls. After the period of depletion, the deficient animals were divided into five subgroups of 10 animals each. Each group received either the deficient diet, the deficient diet plus niacin, the deficient diet plus vitamin B6, the deficient diet plus zinc, or the control diet for the following two weeks. Five rats from each group were killed weekly after 24-hour urine collection. N'methylnicotinamide (N'MN), N'methyl-2-pyridone-5-carboxamide (2 PYR) and 4 pyridoxic acid (4 PYR) were measured in urine by HPLC. Niacin repletion increased the excretion of niacin metabolites, N'MN and 2 PYR (p less than 0.01), in relation to deficient animals. Niacin and vitamin B6 metabolites increased with vitamin B6 repletion (p less than 0.01). Repletion with zinc alone was followed by an increase in urinary excretion of N'MN (p less than 0.05), 2 PYR (p less than 0.01) and 4 PYR (p less than 0.01). When the deficient rats were fed the control diet containing the three nutrients, all three metabolites increased (p less than 0.01). The main conclusion is that zinc repletion per se caused activation of niacin metabolism, increasing the excretion of niacin metabolites. This emphasizes the role of zinc in the function of these vitamins. PMID- 3804612 TI - Ascorbic acid status of smoking and nonsmoking adolescent females. AB - The nutritional status of a group of smoking (N = 11) and nonsmoking (N = 26) adolescent females, ages 14 to 17 years, was evaluated with respect to vitamin C. Dietary intakes of ascorbic acid (AA) were determined from two separate 24-hour food recalls. Plasma AA was determined via the 2,4-dinitrophenylhydrazine method. Significant differences were found between smokers and nonsmokers for vitamin C intake and plasma AA. Smokers had lower dietary intakes (27 +/- 11 mg/day) and plasma AA levels (0.32 +/- 0.19 mg/dl) than did nonsmokers (73 +/- 47 mg/day; 1.46 +/- 0.69 mg/dl). When plasma vitamin C values were adjusted for vitamin C intake, smokers still exhibited a significantly lower plasma AA concentration (0.48 mg/dl vs 1.38 mg/dl for nonsmokers). Cigarette smoking was associated with a significantly decreased AA status in the present group of adolescent females. PMID- 3804613 TI - Increase of gingival hydroxyproline and proline by improvement of ascorbic acid status in man. AB - The 4-hydroxyproline and proline content of periodontal tissue was measured in 24 adult volunteers with initially low and partially even deficient plasma vitamin C values, before and after peroral supplementation with 70 mg ascorbic acid daily for six weeks. The latter caused a statistically significant rise and normalization respectively of plasma ascorbic acid and simultaneously a statistically significant increase of the hydroxyproline and proline in periodontal tissue (p less than 0.01) but not before the plasma vitamin C level was above 0.9 mg/dl. The optimal plasma vitamin C level which was associated with the highest hydroxyproline and proline content in periodontal tissue ranged between 1.00-1.30 mg/dl corresponding to the total daily dietary ascorbic acid intake of about 100 mg. PMID- 3804614 TI - A nutrition study involving a group of pregnant women in Assisi, Italy. Part 1: Anthropometry, dietary intake and nutrition knowledge, practices and attitudes. AB - A study was conducted on a group of full term pregnant women in the gynaecology and obstetrics ward of the Assisi Hospital. The study included the anthropometric evaluation and a survey including information on eating habits, life styles, nutrition knowledge, food preferences and aversions during pregnancy, use of oral contraceptives, and cigarette smoking. A subset of 20 pregnant women was examined periodically from the beginning of the 2nd trimester until the end of pregnancy to ascertain anthropometric status and food consumption. In the same hospital the anthropometric measurements of 83 newborns were taken. In some cases there was a relatively small weight gain and therefore gain in body fat during pregnancy (6.3 kg), with obvious effects on the weight of their respective newborns. Eating habits showed notable quantitative and qualitative irrationalities and nutrition knowledge was poor. Oral contraceptives were not widely used. PMID- 3804616 TI - Plasma and liver cholesterol concentrations in mice fed semipurified diets differing in the amount of cholesterol and type of fat. AB - Male and female mice of two inbred strains were fed semipurified diets with or without added cholesterol (1%, w/w) containing 18% by weight of either coconut fat or corn oil. After 28 days coconut fat had produced higher concentrations of plasma cholesterol than corn oil in almost all groups, irrespective of whether the diets contained cholesterol or were cholesterol-free. On the cholesterol-free diets, the type of fat did not influence the concentration of liver cholesterol. Dietary cholesterol caused a marked increase in liver cholesterol, the magnitude of the effect being dependent on the strain of mice and being greater in females than males. In all groups fed cholesterol corn oil caused significantly higher concentrations of liver cholesterol than coconut fat. PMID- 3804615 TI - A nutrition study involving a group of pregnant women in Assisi, Italy. Part 2: Determination of vitamin nutriture. AB - A study was conducted on the biochemical vitamin status of sixty middle class parturient women ages 20-44 and 33 newborns in the gynaecology and obstetrics ward of the Assisi Hospital, Italy. Maternal venous blood obtained immediately after delivery and mixed venous-arterial cord blood was used to assess respectively the status of the mother and the neonate for vitamin A, thiamin, riboflavin and folate. Large percentages of the women were at risk (either marginal or deficient states), for thiamin (30%), riboflavin (42%) and folate (100%). In general, even though the mothers appear to be at risk for three out of the four vitamins studied, there is no indication that the infants are also at risk. Further research must be conducted to clarify the clinical implications of hypovitaminosis in pregnant women. PMID- 3804617 TI - Protein value of some industrial dairy products. AB - Digestibility, Retention and Protein Efficiency Ratio of milk retentate, rennet casein, acid-casein and two industrial caseinates were investigated on the rat. The PER of acid casein (3.15) and milk retentate (3.19) had the same value, whereas caseinates and rennet-casein had lower efficiency (between 2.95 and 2.57). Yet, the NPU data range in this decreasing order: milk retentate, rennet casein, caseinates and acid-casein. PMID- 3804618 TI - Elevated serum ferritin concentrations in master runners after a marathon race. AB - To evaluate iron stores in master runners, serum ferritin levels were measured 24 hrs before and 1, 24 and 168 hrs after a 42.2 km marathon race in 12 men and 7 women master runners. Mean ferritin concentrations were 88 and 50 ng/ml, respectively, before the race. Significant elevations in serum ferritin levels were observed 24 and 168 hrs after the race for men runners and 1, 24 and 168 hrs after the race for women runners. Serum ferritin levels elevated after a stressful event like a marathon race may no longer accurately reflect body iron stores. PMID- 3804619 TI - Eleven-year follow-up of changes in individuals' food consumption patterns. AB - In 101 healthy middle-aged persons of both sexes, changes in dietary were followed up for 11 years 1974 to 1984. As dietary indicators, the food consumption pattern, 8 factors obtained by factor analysis, was used. The factors were evaluated for changes with age in each person and each sex. Changes with age were observed for the food consumption patterns: There was a general tendency in the group for the staple food factor to change in the direction of a Westernized food the same time, the group generally changed in the direction of less intake of sweets and of animal fats. From the standpoint of nutrients, the changes over this period were a decrease in the energy intake, in the percentage of energy from carbohydrate, of energy from alcohol, which caused a slight increase in the percentage of energy from protein and fat. The main factors in the changes was physiological changes that accompany the process of aging, changes in the consciousness of health, and changes in the food environment. PMID- 3804620 TI - Physical conditions affecting food consumption patterns. AB - From the point of view of food counseling, we studied the coefficients of cross correlation in the relationship of physical conditions and eating behavior. For the 11 years from 1974 to 1984, we monitored 101 healthy middle-aged persons in terms of the food intake and several indicators of health. Of the various indicators, the systolic blood pressure (SBP), the diastolic blood pressure (DBP), total cholesterol in the serum (TOTAL-C), beta-lipoprotein (beta-LIPO), and relative weight, all risk factors in atherosclerosis, were used as physical conditions. For the diet indicator, we used eight factors in the food consumption pattern. We calculated the correlation for individuals between these indicators. The clinical data, with the exception of systolic blood pressure, affected the food consumption pattern, and a mutual feedback between the physical conditions and the diet seemed to be possible. The correspondence for the food intake of individuals to physical conditions did not contradict current knowledge about nutrition. PMID- 3804621 TI - Effects of aging and sex on the pituitary riboflavin metabolism of rats. PMID- 3804622 TI - Ascorbic acid in chronic alcoholics. PMID- 3804623 TI - Peripheral corneal diseases. PMID- 3804624 TI - Nutritional disorders affecting the peripheral cornea. PMID- 3804626 TI - Neuroophthalmology. PMID- 3804625 TI - Management strategies in peripheral ulcerative keratitis. PMID- 3804627 TI - Automated perimetry: principles and practice. PMID- 3804628 TI - Computerized optic disk imaging techniques. PMID- 3804629 TI - Botulinum in the treatment of adult motility disorders. PMID- 3804630 TI - Surgical treatment of pseudotumor cerebri. PMID- 3804631 TI - Amaurosis fugax: controversies in management. PMID- 3804632 TI - Advances in diagnosis and treatment of pituitary tumors. PMID- 3804633 TI - Advances in the treatment of carotid cavernous fistulas. PMID- 3804634 TI - Peripheral corneal degenerations and tumors. PMID- 3804635 TI - Experimental aspects and models of peripheral corneal disease. PMID- 3804636 TI - Climatic droplet keratopathy. PMID- 3804637 TI - Allergic disorders of the peripheral cornea. PMID- 3804638 TI - Mooren's ulcer. PMID- 3804639 TI - Superior limbic keratoconjunctivitis. PMID- 3804640 TI - Motility of rasH oncogene transformed NIH-3T3 cells. AB - A series of rasH oncogene-transformed cell lines were established from NIH-3T3 cells using the calcium phosphate precipitation method of transfection. The transfectant lines formed highly-invasive tumors when injected into athymic mice while the parent cells did not. When examined for motility in the micropore filter assay, all of the transfectant lines were motile in response to either laminin or fibronectin while the parent cells were not stimulated by either factor. These studies, therefore, indicate that transformation of NIH-3T3 cells with the rasH oncogene results in the generation of cells with increased capacity for motility relative to the parent cells. PMID- 3804641 TI - Involvement of membrane sugar receptors and membrane glycoconjugates in the adhesion of 3LL cell subpopulations to cultured pulmonary cells. AB - Lewis lung carcinoma cells are able to bind sugar residues, mainly alpha-D glucosyl and alpha-D-mannosyl derivatives as assessed by fluorescent neoglycoproteins binding assay. We have investigated the binding efficiency and shown that: 3LL tumor cells are heterogeneous with regards to their capability to recognize neoglycoproteins, as shown by fluorescence microscopy and flow cytofluorometry analyses; basically two distinct subpopulations could be evidenced which were called glucose-receptor-rich (or glucose-specific lectin rich, GLR 3LL) and glucose-receptor-poor (or glucose-specific lectin-poor, GLP 3LL) cells; those two subpopulations could be separated on the basis of their binding properties to neoglycoprotein-substituted microcarriers onto which GLR 3LL cells were able to rapidly adhere (2 h) while GLP 3LL cells were not. Some aspects of the biological behavior of these two selected populations were investigated in order to determine the possible involvement of 3LL cell membrane sugar receptors in cell-cell recognition and adhesion to other cells: namely C57 B1/6 mouse pulmonary cells maintained in primary culture. The two 3LL sublines bind to pulmonary cells but their adhesion kinetics were markedly different. Adhesion inhibition studies showed the adhesion process to be dependent upon the specificity of membrane lectins present on both the tumor cell surface (alpha-D glucose-specific) and on the pulmonary cells (alpha-L-fucose-specific). Surface sugar-specific receptors on mouse pulmonary cells were shown to bind beta-D galactose-, alpha-L-fucose and alpha-L-rhamnose substituted serum albumin. A neoglycoprotein bearing alpha-L-rhamnose residues was an efficient binder under the conditions of cell adhesion experiments and a potent cell adhesion inhibitor. A fucose-containing neoglycoprotein was shown to have a high inhibitory activity when used concomitantly to alpha-D-glucose-containing neoglycoproteins. Adhesion inhibition experiments, performed with cells the sugar specific receptors of which have been selectively inactivated, showed that the alpha-L-fucose specific receptors on pulmonary cell surface are partly responsible for the specificity of this cell-cell recognition process. PMID- 3804642 TI - Macrophage activity of regional lymph nodes of cancer patients and its relation to stages of cancer. AB - Macrophage activity of regional lymph nodes from patients with uterine cervical cancer and patients with gastric cancer was studied. Enhanced spreading of macrophages was observed in an early stage of these cancer patients, but the rate was decreased in advanced stage. In metastatic nodes, enhanced spreading was observed in many cases. Cytostatic activity of macrophages was elevated in stage II of uterine cervical cancer and in stage I of gastric cancer. Significant relation between the rate of spreading and the cytostatic activity was observed in these patients. The reasons for change of the macrophage activity in relation to tumor burden were discussed. PMID- 3804643 TI - An early-onset retinal dystrophy with dominant inheritance in the Abyssinian cat. Clinical and pathological findings. AB - The clinical and pathological features of an early-onset autosomal dominant photoreceptor degeneration in the Abyssinian cat are described. Ophthalmoscopic evidence of retinal disease at 8-12 weeks of age was always preceded by marked dilatation of the pupils, impairment of the pupillary light reflex, and nystagmus. The electroretinogram was unrecordable in all but one of the affected individuals examined. Abnormal photoreceptor development was observed by both light and electron microscopy in retinas of a 22-day-old kitten; in this individual, no outer segment material was detected, and inner segments showed impaired development which was more severe towards the posterior pole. In a 40 day-old kitten, the inner segments were relatively well-formed, whereas the outer segments, though present, showed marked disorganization and degenerative change. The retinas of older individuals showed more advanced photoreceptor degeneration, with thinning of the neural retina. This early-onset retinopathy, which may be classified as a rod-cone dysplasia, is distinct from the hereditary retinal dystrophy (progressive retinal atrophy) previously described in this breed. The gene symbol Rdy has been adopted. PMID- 3804644 TI - Rod ERGs in retinitis pigmentosa and cone-rod degeneration. AB - Rod amplitudes as a function of retinal illuminance were analyzed by determining the parameters of the best fit Naka-Rushton function for 15 normal subjects, 25 patients with rod-cone degeneration, and 10 patients with cone-rod degeneration. Rod b-wave implicit times were analyzed by determining the best linear fit to log retinal illuminance. Retinal illuminances necessary for a criterion b-wave implicit time and for a half-maximum amplitude response (log k) were highly correlated indices of rod sensitivity. Both measures were normal or near normal in patients of all ages with cone-rod degeneration, but significantly elevated in patients with rod-cone degeneration. These results suggest that the underlying mechanisms of rod degeneration are fundamentally different in these two forms of hereditary retinal degeneration. PMID- 3804645 TI - Contrast sensitivity of the human pattern electroretinogram. AB - Contrast thresholds for the pattern electroretinogram (PERG) were measured using lock-in amplifier retrieval of the retinal signal and a swept contrast display. Contrast sensitivity functions (CSF) developed from these PERG contrast thresholds were compared with those established psychophysically under identical stimulus conditions. Whereas the PERG CSF showed a band-pass characteristic across temporal frequency, the psychophysical CSF (and a temporal CSF developed from visual evoked potential contrast thresholds) had a low-pass pattern. Across spatial frequency, the PERG and psychophysical CSFs had similar shapes, although the PERG CSF peaked at a lower spatial frequency than the psychophysical CSF. PMID- 3804646 TI - Complementary components and local variations of the pattern electroretinogram. AB - Pattern electroretinograms have been presumed to arise from a combination of luminance and pattern detection activities. Since the responses at low spatial frequencies are linearly related to contrast and contain negligible pattern specific components, it is proposed that a retinal illuminance response for higher spatial frequencies can be computed from the optical transfer function of the eye. These computed responses are subtracted from pattern electroretinograms to reveal a pattern-specific response with a marked bandpass characteristic. The peak spatial frequency of the bandpass curve declines with increasing peripheral angle. For central vision, the peak amplitude of the pattern-specific response is larger than the retinal illuminance response, but, in the peripheral retina, the two responses are found to be almost equal. The possible origins of these signals are discussed, and it is concluded that the technique provides a method of obtaining separated illuminance and pattern responses from retinal regions having different properties of spatial selectivity. PMID- 3804647 TI - Analysis of glucose levels during glucocorticoid-induced cataract formation in chick embryos. AB - When 15-day-old developing chick embryos were administered hydrocortisone hemisuccinate sodium (HC; 0.25 mumol/egg), the content of glucose in the lens markedly increased from around 6 hr, and reached about 25-30-fold above the matched control at 24-48 hr. Thereafter, the glucose level declined and returned to the control level by 100 hr. The profile of lenticular glucose levels was similar to that of the appearance and disappearance of lens opacification. Prednisolone, as well as HC, produced cataract and the elevation of glucose in the lenses. Cortexolone and cortisone, which have weak or negligible glucocorticoid activity in developing chick embryo, could neither produce cataract nor the elevation of glucose in the lenses. An attempt was made to find similarity between this glucocorticoid-induced cataract and sugar cataract known in mammals. In both control and HC-induced cataract (stage IV-V) obtained 48 hr after HC administration, sorbitol, fructose, and glycosylation of protein could not be detected. Dehydration was observed in HC-induced cataractous lens. These data demonstrate that the glycosylation of lenticular protein and the accumulation of polyol were not involved in glucocorticoid-induced cataract formation in developing chick embryos. These results suggest a relationship between the elevation of glucose and cataract formation. However, when cataract formation was blocked by ascorbic acid treatment, the glucose level remained high. Therefore, any relationship between glucose level and cataract may be complex or indirect. PMID- 3804649 TI - Prevention of rod disk shedding by detachment from the retinal pigment epithelium. AB - The authors tested whether or not rod outer segment (ROS) disks are shed when the neural retina is detached from the retinal pigment epithelium (RPE). Adult Xenopus were injected with 3H-L-leucine. Later, when the distal disks of their ROSs were labeled with a band of 3H-leucine, their eyes were enucleated. Intact eyecups, eyecups with partially detached retinae, and retinae that were peeled completely away from the RPE were incubated in culture medium. Disk shedding was stimulated by changes in lighting, or the addition of 0.5 mM ouabain. Where the retina was attached, phagosomes in the RPE, and not the ROSs, contained most of the radiolabel. Where there was retinal detachment, ROSs were still heavily radiolabeled near their distal ends. It was concluded that mechanical retinal detachment prevents ROS disk shedding. PMID- 3804648 TI - Dynamic light scattering in the intact rabbit lens. Its relation to protein concentration. AB - The physical-chemical properties of highly concentrated protein systems as seen in the lens are poorly understood. Using the technique of dynamic laser light scattering spectroscopy, the authors have determined changes in the dynamics of lens proteins from the intact rabbit lens as a function of position and age. The authors have identified two heterogeneous populations of mobile scatterers with relaxation times of less than 0.5 msec and greater than 1 msec. A decrease in scattered light intensity at 90 degrees, an increase in protein concentration, and aging are associated with lengthening of the relaxation times of the less mobile population of scatterers. This data provides evidence for the existence of a gel-like structure of the lens proteins. PMID- 3804650 TI - Normal pattern electroretinograms in amblyopia. AB - Checkerboard reversal stimuli were used to evoke transient pattern electroretinograms (P-ERGs) from the eyes of 14 patients with amblyopia and 14 normal subjects. In the control group, and in normal eyes of patients, pattern electroretinograms were obtained with monocular central fixation. Amblyopic eyes were examined by monocular and binocular fixation, and the fixation point was shifted horizontally and/or vertically until the P-ERG reached its maximal amplitude. After adjusting visual fixation, there were no significant differences in amplitude between the normal and the amblyopic eyes. In addition, the differences between both eyes were compared with the right-left eye variability of the 14 normal subjects. In the amblyopic eyes, no P-ERG abnormality was observed. These results do not support previous reports of reduced P-ERG amplitudes and are in agreement with recent findings obtained under steady-state conditions. PMID- 3804651 TI - Orthogonal astigmatic axes in Chinese and Caucasian infants. AB - Caucasian infants are known to have a high incidence of astigmatism. The axis of greatest power is usually in the orientation orthogonal to the most common type found in Caucasian adults, with-the-rule astigmatism. We now find that Chinese infants also have a high incidence of astigmatism relative to adults, but its orientation is orthogonal to that of Caucasian infants. The source of this racial difference is not clear. It is unlikely to be due to the most obvious difference, the structure of the eyelids. PMID- 3804652 TI - Chronic stimulation of ocular sympathetic fibers in unanesthetized rabbits. AB - The goal of this study was to devise a technique to implant permanent electrodes in the cervical sympathetic trunk, to stimulate the ocular adrenergic fibers for periods of hours or days in awake, unrestrained rabbits. Electrodes were made of a silver wire soldered to a multistranded wire and enclosed in silicone. Two of these electrodes were wrapped around the preganglionic sympathetic nerve, their leads emerging through a hole in the back of the neck. Success of the procedure was confirmed by the mydriasis elicited by electrical stimulation of the nerve following surgery; threshold voltages for the pupillary response varied between 5 10 volts. In eight rabbits, suprathreshold sympathetic stimulation was performed on the following days by means of a portable stimulator using increasing frequencies (1, 3, 5, 8, and 10 Hz) during a 20-hr period. Dilation of the ipsilateral pupil and vasoconstriction in the ear, measured by the fall in temperature of the ear's surface, was observed as long as stimulation was maintained. Both effects were proportional to the frequency of stimulation. Maximal mydriasis was obtained at 8 Hz, whereas full vasoconstriction was elicited with 5 Hz. Intraocular pressure, measured in 10 rabbits with a Perkins tonometer at the end of a 24-hr stimulation period, did not differ from pre stimulation values. It was concluded that chronic stimulation of the sympathetic nerve allows to maintain known levels of adrenergic activity in the eye, and may be a useful method to study the actions of the adrenergic system on various ocular functions in unanesthetized animals. PMID- 3804653 TI - Chorionic gonadotropin decreases intraocular pressure and aqueous humor flow in rabbit eyes. AB - The effect of human chorionic gonadotropin (hCG) on the rabbit eye was studied. Intravitreal injections of hCG in albino rabbits provoked a reduction of intraocular pressure (IOP). Intravenous administration of hCG in single doses of 5,000-10,000 units in male pigmented rabbits caused a significant reduction in IOP from 1.5-5 hr after injection. When two successive intravenous doses of 5,000 units of hCG were given at 0 and 3 hr to pigmented rabbits, a significant reduction of net aqueous flow occurred, as measured by scanning fluorophotometry. These results indicate that the decrease in aqueous flow rate in the rabbit eye after administration of hCG can account for the reduction in IOP. PMID- 3804654 TI - Phosphorus-31 NMR spectroscopy of cultured human retinal pigmented epithelial cells. AB - Cultured human retinal pigmented epithelial cells were studied using phosphorus 31 nuclear magnetic resonance spectroscopy (P-31 NMR). Retinal pigmented epithelial cells from normal human donors were isolated and expanded using roller bottle culture. The P-31 NMR spectrum of the intact living cells was obtained at 121 MHz by casting the cells in agarose threads and perfusing the threads with culture medium. The cells remained viable at 37 degrees C in the NMR magnet for at least 24 hr, as determined by the stability of the phosphorus spectrum and by trypan blue dye exclusion at the end of the experiments. The intact cell spectrum showed resonances from phosphorylethanolamine, phosphorylcholine, inorganic phosphate, phosphodiesters, phosphocreatine, ATP, NAD+, and UDP-N acetylglucosamine, with phosphorylethanolamine, phosphorylcholine, and ATP being the major metabolites present. The resonances were assigned by making a perchloric acid (PCA) extract of the intact cells and running under high resolution conditions. The PCA extract spectrum also detected sugar phosphates, ADP and UTP, with the latter being approximately 20% of the nucleotide pool. These studies provide the basis for the study of normal and diseased human RPE cells by NMR spectroscopic methods. PMID- 3804655 TI - Acetazolamide effect on the inward permeability of the blood-retinal barrier to carboxyfluorescein. AB - The inward permeability of the blood-retinal barrier to carboxyfluorescein was determined in 12 cynomolgus monkeys. Probenecid (175 mg/kg), an inhibitor of active outward transport of carboxyfluorescein, did not affect the inward permeability, indicating that the inward permeability is independent of the active outward transport system. However, acetazolamide (20 mg/kg), which causes increased outward fluid movement across the retinal pigment epithelium (RPE), significantly reduced the inward permeability. Thus, inward diffusion of carboxyfluorescein interacts with outward fluid flow across the RPE. Since carboxyfluorescein has low lipid solubility and remains extracellular, it is concluded that the pathway of fluid movement and carboxyfluorescein diffusion across the RPE is paracellular. PMID- 3804656 TI - Permeability of the blood-retinal barrier to carboxyfluorescein in eyes with rhegmatogenous retinal detachment. AB - Outward and inward permeability of carboxyfluorescein across the blood-retinal barrier were measured fluorophotometrically in seven cynomolgus monkey eyes with experimental rhegmatogenous retinal detachment. Probenecid was used to inhibit outward transport of carboxyfluorescein. The outward permeability was 1.98 +/- 0.31 microliter/min in eyes with retinal detachment and 0.84 +/- 0.15 microliter/min in control eyes with vitrectomy alone (P less than 0.01). The inward permeability, determined separately following intravenous injection, was significantly lower than the outward permeability: 0.14 +/- 0.02 microliter/min for eyes with retinal detachment and 0.04 +/- 0.01 microliter/min for control eyes. Since the outward permeability minus the inward permeability in the presence of probenecid represents that fraction of tracer moving due to fluid flow, it may be concluded that outward flow of fluid across the blood-retinal barrier is a substantial contributor to carboxyfluorescein loss from the vitreous cavity following intravitreal injection. PMID- 3804657 TI - Automated morphologic evaluation of pulmonary arteries in primary pulmonary hypertension. AB - Pulmonary wedge angiograms have been shown to reflect the severity of pulmonary vascular disease in congenital heart disease. Thirteen pulmonary wedge angiograms with a balloon occlusion catheter were performed in 11 adult patients (five normals and six with primary pulmonary hypertension [PPH]) and their features related to the resting pulmonary artery pressure (PAP). Individual cine frames from each study were selected and digitized with a computer-assisted operator interactive program. By fitting densitometric profiles from the vessel segments, serial arterial cross-sectional diameters were calculated from mathematically derived points. There was a strong correlation between arterial taper (T, change in vessel caliber per unit axial length) and a power function of mean PAP with T = 0.304 X PAP-0.59, R = .91, P less than .001. These results demonstrate a correlation between an angiographically derived morphologic characteristic of the pulmonary vasculature (taper) and a hemodynamic parameter (PAP) in PPH. This offers a method to follow the course of the disease and the effects of drug therapy by assessing anatomic changes in the vessels. PMID- 3804658 TI - Improved immune-specificity in monoclonal radioimmunoimaging using dual radionuclide color functional maps. AB - Diagnostic radioimmunoimaging is potentially limited by tissue localization of radiolabeled antibody products through mechanisms other than antigen binding. Comparing the distributions of reactive and nonreactive products can distinguish tracer in targeted and nontargeted tissues. To achieve this in a single imaging procedure, dual photopeak scintigraphy was performed using 111In and 67Ga products. Melanoma-bearing athymic mice were coadministered intravenously subtype matched 111In melanoma-reactive and 67Ga melanoma-nonreactive murine monoclonal antibodies. Paired images from 245 and 93 keV windows were processed with a unique dual parameter color display program. The display algorithm expresses pixel counts from paired photo-peak images in polar coordinates and color-encodes angle as hue and magnitude as intensity. The color functional maps permitted ready distinction of immune from nonimmune uptake. Compared with single tracer imaging methods, this technique better depicts antigen distribution. PMID- 3804659 TI - Observer variation in quantitative assessment of rheumatoid arthritis. Part I. Scoring erosions and joint space narrowing. AB - Six observers, including two bone and joint radiologists, two general radiologists, and two senior radiology residents, compared scores to quantitate radiographic findings in the hands and wrists of patients with rheumatoid arthritis. In the scoring system used, erosions and joint-space narrowing are graded separately. This scoring system differs from other methods in that equivocal findings are not scored, while ankylosis, subluxation, and dislocation are scored, and data from postoperative joints are included. Total radiographic scores were highly significantly correlated for all observers (R = .908-.958, P less than .001), as were subtotal scores for erosions (R = .723-.931, P less than .001) and joint-space narrowing (R = 0.843-0.966, P less than .001). Analysis of proximal interphalangeal, metacarpophalangeal, and wrist-joint scores showed highly significant correlations for all observers in each location. Highly significant correlations were found among three separate readings of two bone and joint radiologists (R = .950-.961, P less than .001). This scoring system provides highly consistent and reproducible results, even in the hands of less experienced observers. PMID- 3804660 TI - Educational objectives for diagnostic radiology residency training. AB - A method of teaching radiology residents by identification of general and specific objectives to be accomplished during each time segment of the four-year training program has been developed. The objectives are incorporated into an educational contract that is signed by the resident and rotation director at the beginning of each rotation. The objectives are specific so that attainment can be evaluated. This gives definition to both the resident and the teacher. PMID- 3804661 TI - Proposal regarding post-residency education in radiology subspecialties. PMID- 3804662 TI - Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. PMID- 3804663 TI - A piece of the action. PMID- 3804664 TI - Faculty research productivity: the chairman's dilemma. PMID- 3804665 TI - 1986 liability reforms--a synopsis. PMID- 3804666 TI - Price competition in Iowa's health care market. PMID- 3804667 TI - Diagnosing depression. PMID- 3804668 TI - Chronic pelvic pain: evaluation and treatment. PMID- 3804669 TI - Amiodarone. PMID- 3804670 TI - Evidence that the amino acid composition of the particle proteins of plant viruses is characteristic of the virus group. II. Discriminant analysis according to structural biological and classification properties of plant viruses. AB - The amino acid composition (AAC) of the coat proteins (CPs) of 126 plant viruses or strains were analyzed by stepwise discriminant analysis. The criteria chosen for discrimination were: the structure of virus particles (3 clusters); the mode of of transmission of the viruses (6 clusters); and the grouping of viruses according to the classification of the International Committee on Taxonomy of Viruses (23 groups). Statistically significant correlations were obtained with different groups of discriminant amino acids. The results confirm that the AAC of the CPs contains all the information needed for a quantitative classification of plant viruses. These results and possible explanations of these clustering patterns are discussed. PMID- 3804671 TI - Correlation of cervical cytodiagnosis and histopathology--an exercise in quality control. PMID- 3804672 TI - Serial dilatation of peptic strictures of the oesophagus: a planned approach. PMID- 3804673 TI - Familial X-linked centronuclear myopathy. PMID- 3804674 TI - Mortality, morbidity and marital features of travellers in the Irish Midlands. PMID- 3804675 TI - Non-invasive assessment of valvular heart disease using Doppler echocardiography. PMID- 3804676 TI - Neurovascular traction injuries to the upper limb: management and prognosis. PMID- 3804677 TI - Female genital medicine in a general practice. PMID- 3804678 TI - Paroxysmal symptoms in multiple sclerosis. PMID- 3804679 TI - Benign familial neonatal convulsions. PMID- 3804680 TI - Resection of bronchial neoplasm in the elderly. PMID- 3804681 TI - Attendance for drug misuse to Dublin accident and emergency departments. PMID- 3804682 TI - The Irish in England--do they behave? PMID- 3804684 TI - Acupuncture: needless needles. PMID- 3804683 TI - The heart of the athlete. PMID- 3804685 TI - Involuntary movements and cognitive dysfunction in late onset schizophrenic outpatients. PMID- 3804686 TI - Cone biopsy of the cervix: 200 cases. PMID- 3804687 TI - Prevalence of vitamin D deficiency in the elderly in two rural areas in Ireland. PMID- 3804688 TI - Surgical treatment of the ununited scaphoid. PMID- 3804689 TI - Tuberculin skin testing. PMID- 3804690 TI - Archetypes of apocalypse. In dreams and fantasies, and in religious scripture. PMID- 3804691 TI - The impossible thinking. PMID- 3804692 TI - Psychoanalytic theory of psychosomatic patients. PMID- 3804693 TI - Legislation concerning patients' rights in Israel and in Britain. PMID- 3804694 TI - Atypical withdrawal syndrome due to propoxyphene. PMID- 3804695 TI - The effect of yerida (emigration) on the therapeutic relationship between Israeli psychotherapist and patient. PMID- 3804696 TI - Glucose transport across plasma membrane in human platelets. AB - Studies have been carried out in the presence of 2-deoxyglucose, by utilizing a technique of platelet rapid filtration. Kinetic data suggest that glucose uptake across plasma membrane is the rate limiting step in its utilization. 2 deoxyglucose is transported by facilitated diffusion. L-glucose is transferred at only 1/1200 of the rate of glucose. Transport system shows high affinity for substrate. Transport is inhibited by cytochalasin B, phloretin and N ethylmaleimide. Cytochalasin E does not affect 2-deoxyglucose uptake. Diamide can have activating or inhibitory effect. t-Butyl hydroperoxide is always activating. Insulin has no effect on rate transport. D-glucose, 3-O-methylglucose, non radioactive 2-deoxyglucose and D-mannose are strong competitors, whereas D galactose and D-fructose compete weakly with 2-deoxyglucose transport. PMID- 3804697 TI - Regulatory mechanisms of UDP-glucuronic acid biosynthesis in cultured human skin fibroblasts. AB - Kinetic parameters and regulatory properties of UDPGDH extracted from cultured human skin fibroblasts were determined and compared with those of UDPGDH from cornea and epiphysial-plate cartilage. Fibroblast enzyme showed an affinity for UDPG 7 times higher than cartilage enzyme and 42 times higher than cornea enzyme. UDP-xylose acted as a co-operative allosteric inhibitor, but under the same experimental conditions fibroblast enzyme was significantly less inhibited. These results were in agreement with the different GAG production of the cells we studied. Fibroblast UDPGDH activity was regulated by the NAD/NADH ratio and it was also affected by modifications of extracellular matrix composition. A significant increase of UDPGDH affinity for UDPG was observed after the treatment of the monolayers with Chase ABC. PMID- 3804698 TI - Erythrocyte membrane damages in hereditary spherocytosis. PMID- 3804699 TI - Role of hexokinase in the regulation of glucose metabolism in human erythrocytes. AB - Red blood cell glucose metabolism was studied in erythrocytes from a patient with trisomy 10 p which resulted in + 50% hexokinase specific activity, in normal controls and in cases of heterozygous hexokinase deficiency. The results obtained show that the hexokinase activity level is an important factor in the control of the erythrocyte's glycolytic rate while having no appreciable effect on the hexose monophosphate pathway under resting conditions. No clear conclusion could be drawn when an oxidative stress was present. PMID- 3804700 TI - Altered processing of alpha (I) collagen in a case of lethal osteogenesis imperfecta. AB - Cultured skin fibroblasts from a newborn with the lethal perinatal form of Osteogenesis imperfecta synthesized an over-hydroxylated form of pro alpha 1 (I) chain. The analysis of the CNBr peptides showed that over-hydroxylation occurred all along the molecule. PMID- 3804701 TI - Interrelationship between adenine and pyridine nucleotide metabolism in human erythrocyte life span. AB - Adenyl and pyridine nucleotide production has been tested in the whole erythrocyte population and in cells of different age, separated by Percoll density gradient. Both the cellular nucleotide production from adenine and nicotinic acid and the related phosphoribosyltransferase activities show a decrease during cellular life span. Pyridine nucleotide production decay in intact cells parallels the NAPRT pattern, while APRT decrease during senescence is greater than cellular adenine nucleotide production decay. PMID- 3804702 TI - Construction of glucose oxidase-loaded human erythrocytes: a model of oxidative cytotoxicity. AB - Human red blood cells were loaded with Glucose oxidase from Aspergillus niger by a standardized procedure of encapsulation involving transient hypotonic hemolysis followed by isotonic resealing. The amount of loaded enzyme activity, as evaluated by O2 consumption at 5 mM glucose, ranged from 40 to 75 mumoles O2/hr/ml of packed red cells at 37 degrees C. The red cells loaded with Glucose oxidase were found to behave as efficient glucose-consuming bioreactors. Moreover, at 5 mM glucose, no clear mechanism of H2O2-induced damage was apparent, with the exception of a significantly increased formation of methemoglobin (10% approximately) and of a several-fold stimulated intracellular rate of hexose monophosphate shunt activity, indicating glutathione peroxidase mediated draining of reduced glutathione for removal of bursts of H2O2. The Glucose oxidase-loaded red cells represent a convenient model system for cytotoxicity studies aiming at clarifying the effects of intracellularly formed H2O2. PMID- 3804703 TI - Glucose 6-phosphate dehydrogenase. PMID- 3804704 TI - Pathogenesis of respiratory failure in neuromuscular diseases: diagnosis and treatment. AB - In reviewing the pathogenesis of respiratory failure in neuromuscular diseases, with special reference to ventilatory pump, we propose specific tests of the respiratory muscle pump alongside the standard function tests for assessing the respiratory system. Accurate diagnosis must be followed by target therapy, which must be given as often and for as long as needed. Early evaluation and treatment of the respiratory problems are essential to prognosis, whether of survival or of quality of life, in neuromuscular diseases. PMID- 3804705 TI - Intra-arterial digital subtraction angiography of vascular lesions of the spinal cord. Personal experience. AB - IDSA studies were performed in 6 patients with AVM and hemangioblastomas of the spinal cord. IDSA appears to be the most suitable angiographic approach for the study and embolization of this kind of lesions of the spinal cord even when special conditions require repeating some injections on conventional angiography. PMID- 3804706 TI - Amyotrophic choreoacanthocytosis: is it really a very rare disease? AB - Amyotrophic choreoacanthocytosis (ACA) is a hereditary disease characterized by adult onset, hyperkinesias (with tongue and/or lip biting), neurogenic muscular atrophies, acanthocytosis and normal blood lipoprotein pattern. In this paper we cite 8 patients belonging to three families, describing 6 patients of two of the families. We query the supposed rarity of the disease. PMID- 3804707 TI - Neurocysticercosis: clinical and therapeutic considerations. Review of Italian literature. AB - We describe two cases of neurocysticercosis, the first with a spinal extramedullary form, the second with hydrocephalus secondary to basal cistern and convexity arachnoiditis. Praziquantel was given without evident benefit; this therapeutic response is discussed in relation to the clinical and radiological findings. The Italian literature is reviewed. PMID- 3804708 TI - Posttraumatic epidural hygroma with associated subdural spinal fluid collection. Case report. AB - We report a head-injured patient in whom CT scan revealed an extracerebral hypodense fluid collection separated into two compartments by a membrane, which was probably the torn dura mater. We briefly discuss the probable pathogenetic mechanism. PMID- 3804709 TI - Lumbosacral herpes zoster myelitis. AB - We present a case of herpes zoster (HZ) with some uncommon features, namely lumbar localization and muscle weakness with a distribution different from the site of cutaneous eruptions and sensory deficits. Spread of HZ virus from sensory ganglion to anterior horn cells seems the only possible explanation of these clinical features. Urinary retention and CSF data confirm the hypothesis of HZ myelitis. PMID- 3804710 TI - Subcortical neglect. AB - The unilateral neglect syndrome is defined as a lack of directed attention to one half of the space or the body. It has been reported mainly after cortical lesions of the right parietal or frontal lobe in man. However, there is strong experimental and clinical evidence for the existence of neglect syndromes of subcortical origin. The unilateral neglect syndrome is not the result of elementary sensory deficits. The failure in directed attention is dependent on an imbalance of hemispheric activation. PMID- 3804711 TI - Central pontine myelinolysis: diagnosis by computed tomography, magnetic resonance and evoked potentials. AB - The intravital diagnosis of central pontine myelinolysis has become possible with the introduction of computed tomography and magnetic resonance into neurological diagnostics. These tools are of special value when neurological signs of a ventral pontine lesion are lacking, as in the case we describe. Auditory evoked potentials likewise confirm their diagnostic value with regard both to the site of the lesion and to its dorsal extent toward the pontine tegmentum. PMID- 3804712 TI - Toxic myopathy induced by industrial minerals oils: clinical and histopathological features. AB - We report a case of subacute myopathy in a 47 years old man engaged on boiler maintenance at an oil-fired thermoelectric power station. The occupational history highlighted heavy exposure to inhalation of ash derived from mineral oil combustion and containing several elements, metals and metalloids, including vanadium and nickel. The presenting symptoms, clinical course and muscle histopathology suggest that exposure to toxic agents probably played an important part in the causation of the myopathy. PMID- 3804713 TI - Cerebrovascular insufficiency secondary to extrinsic compression of the internal carotid artery by a fibrous band. Case report. AB - We describe the case of a woman with positional transient ischemic attacks related to extrinsic compression of the internal carotid artery by a taut fibrous band between the sternocleidomastoid muscle and the carotid sheath. PMID- 3804714 TI - Unruptured intracavernous carotid artery aneurysm mimicking "painful ophthalmoplegia". Case report. AB - We report a case of intracavernous carotid artery aneurysm presenting an unusual clinical course and suggest possible pathogenetic mechanisms to explain the clinical picture. We discuss the differential diagnosis from other disorders producing unilateral ophthalmoplegia. PMID- 3804715 TI - Choroid plexus papillomas of the cerebellopontine angle in a child. AB - An 11-year-old girl was admitted with a 3-year history of decreasing hearing, and headache, occasional vomiting and poor school performance of 8 months duration. Neurologically she showed signs of a cerebellopontine angle mass. This was confirmed by CT scan, which showed an enhancing lesion in the right cerebellopontine angle. The lesion was totally removed, with excellent results. Histologically the tumor appeared to be a choroid plexus papilloma. Choroid plexus papillomas of the cerebellopontine angle are extremely rare in children. PMID- 3804716 TI - Herpes zoster myelitis: nervous system complications. AB - Transverse myelitis after a zoster viral infection is an exceptional occurrence. In this case we documented an antibody activity against varicella zoster (V-Z) in the cerebrospinal fluid in association with Coxsackie A enterovirus. The clinical course was atypical because of a second episode of myelitis 2 years after the first episode of neurologic viral complications. The positive outcome of therapy with Acyclovir is noteworthy. This case was retrieved in a review of neurologic complications observed in the last few years in patient affected by zoster in our hospital. PMID- 3804717 TI - Ataxia and hypothyroidism. PMID- 3804718 TI - Immediate spasticity following a TIA. PMID- 3804719 TI - Predicting dangerousness and the public health response to AIDS. PMID- 3804720 TI - The limits of compulsion in controlling AIDS. PMID- 3804721 TI - Morality and the health of the body politic. PMID- 3804722 TI - Pregnant women as fetal containers. PMID- 3804723 TI - A cardiac arrest and a second-hand report. PMID- 3804724 TI - The community as child abuser. PMID- 3804725 TI - Should undocumented aliens be entitled to health care? AB - Congress recently decided that undocumented aliens are ineligible for medical benefits under the 1966 Medicaid Act, overruling a judicial decision that would have required the federal government to reimburse states partially for the costs of providing free care. Is providing such care simply a matter of prudence and charity? Or do illegal aliens have strong moral claims to medical care that generate duties for hospitals and government agencies? PMID- 3804726 TI - The process of evaluating the artificial heart. PMID- 3804727 TI - Treating the condemned to death. AB - Psychiatrists should refrain from treating mentally ill prisoners on death row in order to restore their "competency to be executed." Such "treatment" renders them double agents, in the service of the state as well as the prisoner. Participation in an act that will bring about a prisoner's death is expressly forbidden by the AMA Code of Ethics. It recalls the behavior of Nazi physicians, who used their professional skills not to heal but to kill. PMID- 3804728 TI - The limits of science in on-the-job drug screening. AB - Mass drug screening offers a deceptively simple solution to the problem of drug use among workers. Even a very effective test is subject to error. In any given group of tested individuals, some will unavoidably be falsely accused. Even though scientific tests appear to provide efficient solutions to social and legal problems, these tests should not be accepted unless they also meet our standards for fair dealing. PMID- 3804729 TI - Response from HealthCare. PMID- 3804730 TI - Influenza A: prospects for prevention and control. III: Influenza prevention today (3). PMID- 3804732 TI - [Ulcers in congenital arteriovenous fistula of the lower extremities]. AB - Ulcers of the lower legs caused by arteriovenous fistulae show, on one hand, that diagnoses are often made carelessly and, on the other, that the treatment initiated is often inadequate. In both cases reported, there were several small arteriovenous fistulae in the lower legs, although no symptoms were observed for a long time. The ulcers, which then recurred chronically, resulted from very minor injuries. Their characteristics remained unnoticed for many years. Surgical intervention to remove these fistulae is not always simple because they cannot all be removed at once. Lower leg ulcers caused by arteriovenous shunts are an example of how difficult it can be to prove the cause of such lower leg ulcers. PMID- 3804731 TI - [Enlarged spectrum of tick transmitted spirochaetoses]. AB - After the successful identification of Borrelia burgdorferi as the cause of Lyme disease, a new tick-borne infection occurring in the United States, almost identical spirochaetes have been isolated from the tick Ixodes ricinus in Europe. As a result, the spirochaetal aetiology of skin diseases, which had long been recognized as tick-borne infections, namely erythema chronicum migrans with its neurological complications of the tick-borne meningopolyneuritis of Garin Bujadoux-Bannwarth, acrodermatitis chronica atrophicans and lymphadenosis cutis benigna, could be confirmed by means of microbiological, histological and serological methods. On the basis of case histories it had already been assumed for some time that anetodermia maculosa and the localised sclerodermas might also be caused by a tick-borne agent. The results of serological investigations have now strengthened this assumption, although microbiological confirmation is still lacking. PMID- 3804733 TI - [Psychosomatic aspects of parent-child relations in atopic eczema in childhood. II. Child-rearing style, the family situation in a drawing test and structured interview]. AB - To evaluate the style of education in this group of children, "scale versions" according to Stapf were used. Mothers of atopic children were found to be significantly more "strict" in their educational approach compared with control mothers (P less than 0.01). There was no significant difference between the two groups of fathers. In particular, mothers of atopic children significantly more often favored "grown-up" behavior in their children and the capacity to enjoy the joy of children was significantly less pronounced compared with controls. In the children's drawings, children with atopic eczema lacked the "friendly atmosphere" expressed in drawings of control children. Fathers of atopic children were drawn significantly smaller than the respective mothers. In animal drawings, children with atopic eczema mostly selected unpleasant or dangerous animals to describe their parents, brothers, or sisters. From the structured interviews, the following points were remarkable: atopic children more often display aggressive thoughts or behavior against their parents than do controls. Mothers of atopic children react less spontaneously and less emotionally to children's emotions. Maternal affection often takes place as a hygienic ritual or in a body and achievement-oriented fashion. Mothers of atopic children like them to behave in a "grown-up" manner. PMID- 3804735 TI - [Generalized argyrosis]. AB - A 58-year-old female patient presented with generalized argyria, caused by abuse of silver-containing tablets for a sore throat for 1.5 years. Diagnosis was confirmed by histology, electron microscopy, and X-ray microanalysis. A therapeutic trial with D-penicillamine was unsuccessful. PMID- 3804734 TI - [Dicarboxylic acids inhibit the growth of keratinocytes in vitro]. AB - The antiproliferative effect of three straight-chained saturated dicarboxylic acids was examined with neonatal mouse keratinocyte cultures. Adipic acid (C6), azelaic acid (C9), and sebacic acid (C10) were added to the cultures in concentrations ranging from 1 to 50 mmol/l. Proliferation was assayed by liquid scintillation counting of 3H-thymidine incorporation into DNA and by autoradiography. Fifty percent inhibition of 3H-thymidine incorporation was observed with 50 mmol/l adipic acid, 20 mmol/l azelaic acid, and 10 mmol/l sebacic acid, respectively. The antiproliferative effect was completely reversible after cessation of treatment. Moreover, treated cultures then showed a rebound effect with increased DNA synthesis. These results show that dicarboxylic acids exert reversible antiproliferative effects on keratinocytes. PMID- 3804736 TI - Pseudoscience. PMID- 3804737 TI - Comments on "Radon-222 and 222Rn progeny concentrations measured in an energy efficient house equipped with a heat exchanger". PMID- 3804738 TI - Misconceptions of medical students about radiological physics. PMID- 3804739 TI - Radiation protection in a pluralistic society. PMID- 3804740 TI - The effect of rare earth filtration on patient exposure, dose reduction, and image quality in oral panoramic radiology. AB - Rare earth intensifying screen material (Gd2O2S:Tb) was added to the standard Al filtration of an oral panoramic x-ray unit, resulting in a beam capable of achieving reductions in patient dose without a loss of image quality. The added rare earth filtration technique resulted in patient dose reductions of 21-56%, depending on anatomic sites, when compared to the conventional Al filtration technique. Films generated from both techniques were measured densitometrically and evaluated by a panel of practicing clinicians. Diagnostically significant differences were minimal. The results indicate that use of rare earth filters in oral panoramic radiography is an effective means of reducing exposures of dental patients to ionizing radiation. PMID- 3804741 TI - Field laser hazard calculations. AB - The authors develop formulae for laser hazard evaluation. Beam diameter, transmitted power through an optical system, nominal ocular hazard distance, and optical density required for eye protection may be calculated. A calculator program is provided which uses experimentally determined laser parameters to return the necessary safety information. PMID- 3804742 TI - Effects on energy absorption of orientation and size of animals exposed to 2.45 GHz microwave radiation. AB - Rat cadavers oriented perpendicularly to the electric field (parallel to the magnetic field) were exposed to 2.45-GHz microwave radiation. The weight of the cadavers ranged from approximately 5 to 320 g and their lengths ranged from approximately 5 to 22 cm. Average, whole-body specific absorption rates (SAR) were measured using calorimetric techniques, and local specific absorption rates were obtained from time-temperature profiles measured with a non-interacting thermistor probe. The average, whole-body SAR decreased gradually from 0.58 mW g 1 per mW cm-2 at 40 g (10.1 cm in length) to 0.38 mW g-1 per mW cm-2 at 320 g (22 cm in length). The average whole-body SAR decreased from 0.81 to 0.34 mW g-1 per mW cm-2 for cadavers ranging in weight from 5 g (5 cm in length) to 30 g, respectively. The local SAR in the brains decreased from approximately 0.95 mW g 1 per mW cm-2 at 40 g to 0.54 mW g-1 per mW cm-2 at 320 g. Between 5 g and 30 g the SARs in the brain varied from 0.52 to 1.11 mW g-1 per mW cm-2. The local SAR in the colon ranged from 1.05 mW g-1 per mW cm-2 to 0.24 mW g-1 per mW cm-2 for weights between 40 and 320 g. In the 5 to 30 g range, the SAR varied from 0.48 to 1.23 mW g-1 per mW cm-2. A comparison of these results with data previously reported for animals oriented parallel to the E-field showed that the average whole-body SARs were larger for animals weighing greater than 40 g when oriented perpendicularly to the E-field. The local SARs in the colon and brain were slightly higher for the parallel orientation in animals weighing greater than 40 g. The average, whole-body and local SARs were significantly higher for the parallel orientation for animals weighing less than 40 g. PMID- 3804743 TI - Alternatives to the BEIR relative risk model for explaining atomic-bomb survivor cancer mortality. AB - The apparent failure of the BEIR absolute risk model to explain the data on the Japanese atomic-bomb survivors does not imply that the BEIR relative risk model (RRM) is correct. RRM is objectionable in that it fits the data only in conjunction with an assumption not in accord with current knowledge and thinking. Contrary to what is widely believed, RRM is not a consequence of, or consistent with, initiator-promoter theories; models derived from initiator-promoter theories fit the data with fewer adjustable parameters and without requiring unpalatable assumptions. The preferable models give substantially lower radiation risks. PMID- 3804744 TI - Uncertainties associated with using quick-sort techniques to estimate neutron doses following criticality accidents. PMID- 3804745 TI - The relationship between water-system size and 222Rn concentration in North Carolina public water supplies. PMID- 3804746 TI - Correlation between 226Ra in soil, 222Rn in soil gas, and 222Rn inside adjacent houses. PMID- 3804748 TI - Use of 99mTc for calibrating survey meters. PMID- 3804747 TI - Evaluation of a terrestrial food-chain model using natural analogs. PMID- 3804749 TI - Dosimetry of aqueous 32P after soft-tissue infiltration following attempted intravenous administration. PMID- 3804750 TI - [Congenital malformations of the upper urinary tract. The Swiss Society of Urology. 41st annual meeting. 7-9 November 1985, St. Gall]. PMID- 3804751 TI - Pressure flow studies and their significance for surgical or conservative treatment. PMID- 3804752 TI - [Congenital abnormalities of the upper urinary tract--bases and results of surgical therapy]. PMID- 3804753 TI - [Late results following pyeloplasty surgery in high-grade hydronephrosis]. PMID- 3804754 TI - [Congenital sub-pelvic stenosis--kidney function in relation to time of surgery]. PMID- 3804755 TI - [The treatment of newborn infants with prenatally diagnosed abnormalities of the upper urinary tract]. PMID- 3804756 TI - ["Seesaw" reflux as a cause of recurrent urinary tract infections]. PMID- 3804757 TI - [Retrocaval ureter. Diagnostic and therapeutic methods]. PMID- 3804758 TI - [Mega-(poly-)calycosis, a rare anomaly of the kidney. Etiology, morphology, complications and therapy]. PMID- 3804759 TI - [Multicystic dysplastic kidneys in adults. Symptoms and therapy on the basis of 6 cases]. PMID- 3804760 TI - [Septic complications in polycystic kidney degeneration]. PMID- 3804761 TI - ["One-shot" prophylaxis in elective colon surgery. Effect of pharmacokinetics and action spectrum]. PMID- 3804762 TI - [Current aspects of surgery of nodular goiter]. PMID- 3804763 TI - Differences between mouse strains in their consumption of phenylthiourea (PTC). AB - Mice from 25 laboratory strains were given the choice of drinking a dilute (100 mg/litre) solution of phenylthiourea (PTC) or a control solution containing no PTC. The consumption of PTC by each strain was measured daily over a period of 10 days. There was considerable variation between strains in their consumption of PTC. The mean PTC consumption of the 13 albino strains was less than the mean of the 12 pigmented strains. Most strains showed a decrease in PTC consumption during the 10 days of the experiment and the albino strains showed, on average, a greater decrease than did the pigmented strains. Tests with congenic strains proved that the albino allele itself is not the cause of the reduced PTC consumption. The possibility of a gene which is linked to the albino locus and which has an effect on PTC consumption is discussed. PMID- 3804764 TI - Estimation of the true additive genetic variance sigma ki = 1 d2i in the presence of linkage disequilibrium. AB - Accurate estimates of the true additive genetic variance (sigma ki = 1 d2i) of a cross between two pure breeding varieties can be obtained from the additive genetic components of the first three ranks (D1, D2 and D3) when the latter are biased by the presence of linkage. Additive genetic variances of the lower ranks are directly equatable with sigma ki = 1 d2i because they incur minimal bias even when the predominating linkages are strong. More precise estimates of sigma ki = 1 d2i are however obtainable from the asymptotic regression analysis or a weighted least squares analysis. Estimates of sigma ki = 1 d2i when obtained from 784 hierarchically derived F7 families of the V2 X V12 cross of Nicotiana rustica were observed to be considerably larger than the additive genetic variance displayed by the F13 inbreds of the same cross for all the characters that showed significant excess of repulsion linkages. These results lend support to our commonly held view that the prediction procedures generally underestimate the probability of successful recovery of superior recombinant inbreds. PMID- 3804765 TI - The barrier to genetic exchange between hybridising populations. AB - Suppose that selection acts at one or more loci to maintain genetic differences between hybridising populations. Then, the flow of alleles at a neutral marker locus which is linked to these selected loci will be impeded. We define and calculate measures of the barrier to gene flow between two distinct demes, and across a continuous habitat. In both cases, we find that in order for gene flow to be significantly reduced over much of the genome, hybrids must be substantially less fit, and the number of genes involved in building the barrier must be so large that the majority of other genes become closely linked to some locus which is under selection. This conclusion is not greatly affected by the pattern of epistasis, or the position of the marker locus along the chromosome. PMID- 3804766 TI - On the choice of mathematical models for the estimation of lethal gene equivalents in man. AB - A range of mathematical models and error distributions was used to examine the validity of linear regression methods for the calculation of lethal gene equivalents. Because of the restricted span of inbreeding coefficient F values available in human studies and the limited number of data points, equivalent results were obtained with all combinations tested. It was concluded that linear regressions should be employed only for the detection of significant inbreeding effects in man and that their application to the estimation of lethal gene equivalents was not warranted. PMID- 3804767 TI - Directional selection and developmental stability: evidence from fluctuating asymmetry of dental characters in mice. AB - Developmental stability was assessed among lines of mice subjected to 11 generations of selection for increased (up line) and decreased (down line) widths of the first maxillary molar (M1), primarily to test the hypothesis that this stability would decline over time as a result of selection. Fluctuating asymmetry (FA) was used as an inverse measure of developmental stability, and was calculated for the M1 and a correlated character, the second mandibular molar (M2), in each generation. As measured by the regression of FA on generations, there was a statistically significant decline in stability only in the down selection line for the M2, and this trend did not differ significantly from that for the control line. The combined regressions obtained from pooling over all three lines were significantly different from zero in both molars, however, and this was taken to be evidence of a decline in stability due to increased homozygosity presumably generated by inbreeding during the selection experiment. The variation in FA among generations was greater for the selection lines than the control line for both molars, especially for the M2. The heritability of the M1 (and M2) was high, but there was no significant additive genetic variance for FA in either molar. PMID- 3804768 TI - The effects of linkage and density-dependent regulation on gene flow. AB - The rate of gene flow across a hybrid zone may be reduced by the presence of a physical barrier, by a reduction of population density caused by reduced fitness of hybrids (the "hybrid sink" effect), and by linkage. If the reduction in hybrid fitness is not extreme, the strength of the barrier to gene flow caused by these effects is B = w(rho *+/rho *0)2(W*+/W*0)(2/R + 1/r). Here, w is the width of the cline; rho * is the carrying capacity; W* is the mean fitness of the population, excluding effects of density; R is the strength of density-dependent regulation; and r is the harmonic mean recombination rate between the locus whose flow is being calculated, and loci under selection. +, 0 denote populations outside the hybrid zone, and at its centre, respectively. This relation is illustrated using data from hybrid zones in Bombina and Podisma, and its implications for interpretation of data from nature are discussed. PMID- 3804769 TI - Altered platelet function in patients with severe congestive heart failure. PMID- 3804770 TI - "Congestion": an infrequent feature in patients with chronic heart failure on therapy. PMID- 3804771 TI - Echocardiographic evaluation of patients with congestive heart failure. PMID- 3804772 TI - Restrictive cardiomyopathy. PMID- 3804773 TI - Potassium and heart failure. PMID- 3804774 TI - Indications for acute and chronic digitalis administration in heart failure. PMID- 3804775 TI - The effect of aortic valve replacement on left ventricular function in patients with aortic valvular disease. PMID- 3804776 TI - Azathioprine-induced reversible severe dyserythropoiesis as a cause of anemia. PMID- 3804777 TI - Barium granuloma mimicking rectal carcinoma. PMID- 3804778 TI - Gravid uterine rupture following cesarean section and intervening vaginal delivery. PMID- 3804779 TI - Effect of 1,2-dimethylhydrazine and hydrogen peroxide for the duodenal tumorigenesis in relation to blood catalase activity in mice. PMID- 3804780 TI - Epidemiologic studies and recent changes of peptic ulcer disease during the past 10 years: study of 2,548 cases collected during 1974 to 1983 in Hiroshima University Hospital. PMID- 3804781 TI - Epithelial phenotypic expression of human foetal gastrointestinal mucosa: an immunohistochemical analysis. PMID- 3804782 TI - Idiopathic retroperitoneal hematoma presenting as acute abdomen. PMID- 3804783 TI - Cellular immune competence of patients with lung cancer and other lung diseases. I. Analysis of peripheral blood lymphocyte subsets using monoclonal antibodies. PMID- 3804784 TI - Early changes in the gastric mucosa with MNNG exposure in the rat. PMID- 3804785 TI - Improvement in early detection of breast cancer by combining aspiration biopsy cytology and xeromammography. PMID- 3804786 TI - A cytogenetic study of heavy mental retardates. II. A study on heavy mental retardates with behavior disorders. PMID- 3804787 TI - A cytogenetic study of heavy mental retardates. III. A study on 114 karyotypes with banding techniques and incidence of chromosome abnormalities. PMID- 3804788 TI - Comparison of various serum protein values in the Japanese and the Japanese Americans resident in the United States. PMID- 3804789 TI - Programmed cell death. Cytochemical evidence for accumulation of calcium in mitochondria and its translocation into lysosomes: X-ray microanalysis in metamorphosing insect muscles. AB - The intersegmental muscles in the metamorphosing silkmoth Antheraea polyphemus were examined by two electron cytochemical procedures for demonstration of calcium compartmentation during the two-day period of degeneration after emergence. Muscle fibres were treated with either oxalate-pyroantimonate, or phosphate-pyroantimonate procedures. The elemental composition of the reaction product arising from the oxalate procedure was determined with electron probe X ray microanalysis of unstained thin sections by energy dispersive spectrometry and wavelength dispersive spectrometry. The wavelength dispersive data revealed high peaks of calcium and antimony in the electron-dense precipitates. No reaction was obtained in muscles after treatment with the phosphate pyroantimonate method. Shortly after the emergence of the moth, very few calcium deposits were found in the mitochondria, which also contained amorphous matrix densities. During the rapid lytic phase (17 and 30 h after ecdysis), the mitochondria, autophagic vacuoles sequestering mitochondria, and lysosomal dense bodies issuing from the latter were highly reactive in each muscle fibre. These results demonstrate that the collapse of tracheae (hypoxic conditions) is correlated with the calcium overload of mitochondria when the cell calcium homeostasis is apparently lost. Such calcium overload of the mitochondria appears to cause irreversible damage to these organelles which are then sequestered in autophagic vacuoles. This mitochondrial autophagic process leads to calcium translocation into a lysosomal compartment. We suggest that the calcium lysosomal stores may have a transient function of cell detoxification and stimulation of calcium-dependent degradative processes prior to the final muscle collapse. PMID- 3804790 TI - Binding of wheat germ agglutinin in the matrix of rat tracheal cartilage. AB - The binding of wheat germ agglutinin (WGA) to the extracellular matrix of rat tracheal cartilage was studied at both the light and electron microscopic levels. The detection of binding sites was accomplished by a postembedment method using the direct fluorescence technique for light microscopy and the avidin-biotin bridging system for electron microscopy. Distinct fluorescence was observed in the pericellular region of chondrocytes, and this fluorescence was completely removed after treatment with 4 M guanidine hydrochloride. By electron microscopy, the reaction products as found in the pericellular region were not observed in the interterritorial collagenous matrix, confirming a similar distribution as found by fluorescence microscopy. These results show that WGA-binding sites are present in pericellular matrical substances, which are known to be rich in proteoglycan and glycosaminoglycan complexes and which exhibit similar staining with antibodies to proteoglycans or with cationic dyes. As WGA binds to N-acetyl glucosamine and N-acetyl-neuraminic acid residues, the pericellular matrix of rat tracheal cartilage appears to consist of proteoglycan having a high concentration of these saccharides. PMID- 3804791 TI - The secretions of the cumulus-oocyte complex in relation to fertilization and early mouse embryonic development: a histochemical study. AB - A study has been made of the histochemical composition of the murine cumulus oocyte complex and zona pellucida following treatment of immature females with exogenous gonadotrophins. Selected developmental stages were studied in detail, namely the ovulated and unfertilized egg, the fertilized oocyte and the preimplantation embryo. In addition, the histochemical features observed in normal fertilized embryos have been compared with those of haploid and diploid parthenogenetic embryos at comparable stages following activation. Shortly after fertilization, glycosaminoglycans, which form a major component of the extracellular matrix surrounding the cumulus cells, become incorporated into the zona pellucida of the fertilized egg. In oocytes with few or no attendant cumulus cells, there appeared to be a diminished uptake of glycosaminoglycans and a reduced intensity of the zona staining reaction to Alcian Blue. In these oocytes, uptake of glycosaminoglycans appeared to be from the secretions lining the oviduct. There was little incorporation of the glycosaminoglycans from the extra cellular matrix of the surrounding cumulus cells into the zona pellucida in unfertilized or parthenogenetic eggs despite the activation stimulus. After fertilization or activation, the zona pellucida became increasingly PAS-positive. Enzymic studies clearly indicate that the composition of the zona pellucida of the early embryo is histochemically different from the zona that surrounds the oocyte in the preovulatory follicle. These findings are discussed in relation to the decreased viability of embryos from oocytes which have been ovulated. PMID- 3804792 TI - Arylsulphatase activity associated with phenanthrene induced digestive cell deletion in the marine mussel Mytilus edulis. AB - The acid hydrolase arylsulphatase has been localized at the ultrastructural level in digestive cells of the marine mussel Mytilus edulis for control and phenanthrene-treated (200 micrograms/l) animals. In untreated mussels the activity was generally restricted to the lysosomal-vacuolar system and the Golgi apparatus. It was associated with all types of vesicle, although not all individual vesicles were reactive. In heterolysosomes which were filled with precipitate the reaction product was most densely associated with the limiting membranes. Lipid inclusions commonly occurred in the digestive cells; these sometimes showed limited reaction for enzyme activity. The striking difference between normal and phenanthrene-treated samples was the presence in all treated animals of reaction product in the inter-cellular spaces and varying degrees of cytoplasmic activity in a number of digestive cells. This is interpreted as a sign of impending cell deletion. Sections for morphological examination showed evidence of increased digestive cell deletion in phenanthrene-treated mussels. The process results in release of membrane-bound bodies into the tubule lumen. PMID- 3804793 TI - Histochemical staining of sulphated and non-sulphated sialomucin in intestinal epithelium: practical difficulties associated with the KOH-AB 1.0-PAPS method. PMID- 3804794 TI - Incident light and SEM observation of bone cell colonized bioceramics. PMID- 3804795 TI - Diets of healthy Swedish children 4-24 months old. IV. Daily variation of energy and nutrient intake. AB - The day-to-day variations of energy and nutrient intake were studied in infants aged 4, 9, 15 and 24 months. There were 40, 40, 38 and 40 infants in the four groups, respectively. In the 4-month-old infants 3-day weighed food records were used, and in the infants of the other three ages, 7-day weighed food records. The smallest number of daily records required to classify the individual infants into the correct category with low or high intake with a specified degree of accuracy was calculated. Fewer daily records for energy and nutrient intake were needed for the 4-month-old infants than for the older ones. PMID- 3804796 TI - Energy, nutrient and food intake during infancy and early childhood. The Leiden Preschool Children Study. AB - In Leiden, The Netherlands, a longitudinal dietary survey was carried out among 124 children at the age of 4, 16 and 28 months. Food intake was measured using the 24-hour recall method. In general, the average intake of nutrients was in accordance with the recommendations, although the energy intake was 6 per cent below the recommended daily energy allowance at the age of 4 and 28 months, and 19 per cent at 16 months. The infants derived 82.5 per cent of their energy from breastmilk and/or formula at the age of 4 months. At 28 months the food intake resembled the average intake of Dutch adults more than at 16 months. The contribution of sweets and snacks to total energy increased from 2 per cent at 4 months to 9 and 19 per cent at the ages of 16 and 28 months respectively. The sweet and snack consumption showed a statistically significant tracking correlation at 4, 16 and 28 months. Mothers with a high eduction appeared to breastfeed their infants longer and to give them less sweets and snacks at 16 months. At 28 months the influence of educational level disappeared. It is concluded that the recommendations for preschool children need adjustment and the nutritional habits, which are developing during early childhood, should be corrected with respect to the consumption of sweets. PMID- 3804797 TI - The trace element content of hospital meals and potential low intake by elderly patients. AB - The metabolizable energy, protein, calcium, phosphorus, magnesium, zinc, copper, iron and manganese contents of a typical day's menu offered to patients in a teaching hospital were analysed. Results obtained were compared with the appropriate UK Recommended Daily Amounts (RDA), or where no British standards were available, American Recommended Daily Dietary Allowances (RDDA) for magnesium, phosphorus and zinc and American Estimated Safe and Adequate Dietary Intakes (ESADI) for copper and manganese. Patients on an acute geriatric ward selected meals, which, even if consumed entirely, provided approximately half the daily recommended dietary allowances for zinc and copper, less than the recommended daily amounts for iron and magnesium, but more than adequate content of energy, protein, calcium, phosphorus and manganese. PMID- 3804798 TI - Food intolerance in patients with oro-facial granulomatosis. AB - The study was initiated to investigate the role of food intolerance in the aetiology of oro-facial granulomatosis. Firstly, retrospective data were examined in 85 patients and in 16 of them it was evident that a food or flavouring was provoking the disorder. In a second series, eight patients completed a very-low allergen diet: seven individuals were found to be intolerant of certain foods, ingestion of which resulted in facial swelling. It is concluded that food intolerance is an aetiological factor in some patients with oro-facial granulomatosis. PMID- 3804799 TI - Cash-cafeteria school meals: an assessment of nutritional standards in relation to price paid. AB - An investigation has been made of the relationship between price paid by 13- to 18-year-olds for cash-cafeteria school meals and the amounts of energy and protein obtained. The nutritional value of these meals is compared with traditional school meals and Department of Education and Science nutrient targets. The findings demonstrate a strong positive relationship between price and protein content, and price and energy content. In conclusion the nutritional quality of cash-cafeteria school meals and methods of improving them by influencing food choice are discussed. PMID- 3804800 TI - [Sudden deafness today--a review]. AB - Sudden deafness is not a disease in itself. Unilateral impairment of inner ear function of acute onset is a symptom of unknown origin. Recent results of basic science and clinical research favour an alteration of physiological properties and/or a variety of different diseases as a cause of this inner ear dysfunction. It is important to recognise these factors by audiometric and clinical investigations in order to differentiate the resulting inner ear dysfunction from sudden deafness. Our task is to find the cause in almost every case of hearing impairment so that the term "sudden deafness--of unknown cause" can be abandoned. So far we prefer a conservative treatment. Indicators of unfavourable prognosis should be assessed carefully since they demand special treatment, for instance tympanotomy. PMID- 3804801 TI - [Madelung's lipomatosis of the neck--expression of an alcohol-induced endocrine disorder?]. AB - An uncommon case of a patient with Madelung's disease (Launois-Bensaude disease, multiple symmetrical lipomatosis) is reported. Moreover, the patient suffered from alcoholic hepatomegaly, an atrophic right kidney, Dupuytren's contracture of both hands, hyperuricemia and psoriasis. The etiology of Madelung's disease is discussed. PMID- 3804802 TI - [Acute unilateral deafness caused by mumps--a case description]. AB - Reports of the aetiology of mumps induced deafness in the auditory pathway have not appeared in the literature in recent years. It is now possible to distinguish between sensory deafness and other types of profound hearing loss by combining the results of promontory testing (PT) and electrocochleography (ECochG). A very extensive examination of a case of profound sudden hearing loss due to mumps is described. It was impossible to prove a relation between the mumps virus and sudden hearing loss in this case but the site of the lesion in the auditory pathway could be localised. The hearing loss in this case was of sensory type, profound, irreversible and resistant to treatment. PMID- 3804803 TI - Lymphocytes modulated by beta interferon express new non-HLA-A,B,C class I antigens. AB - Peripheral blood lymphocytes were cultured with recombinant beta interferon (INF lymph). Three days in culture and 5 X 10(4) units/ml produced the best modulatory effect. Platelet absorbed alloantisera previously shown to contain non-HLA-A,B,C class I antibodies were tested with the INF-lymph. The serologic reactivity could be blocked by turkey sera to human B2-microglobulin but not by turkey anti-Ia like. Absorption studies with INF-lymph obtained from donors expressing different HLA antigens indicated that the serologic reactivity is not due to HLA. Fourteen sera appeared to cluster in three groups, only one of which was found to be associated with HLA (HLA-A1). Antigenic modulation of INF-lymph obtained from HLA A1+ individuals with HLA-A1 typing alloantisera eliminated subsequent lysis mediated by HLA-A1 alloantibodies and complement but not lysis with platelet absorbed antibodies included in the cluster associated with HLA-A1. These findings suggest independence from HLA-A1 and coexpression of HLA-A1 and A1 associated class I antigens. Family studies indicated that the reactivities segregated with HLA thus mapping it to chromosome VI. Similar to what we have described with PHA, beta interferon modulates lymphocytes and induces the expression of new class I differentiation antigens probably analogous to the murine Qa-T1a antigens. PMID- 3804804 TI - Optimization of radiation therapy, III: A method of assessing complication probabilities from dose-volume histograms. AB - To predict the likelihood of success of a therapeutic strategy, one must be able to assess the effects of the treatment upon both diseased and healthy tissues. This paper proposes a method for determining the probability that a healthy organ that receives a non-uniform distribution of X-irradiation, heat, chemotherapy, or other agent will escape complications. Starting with any given dose distribution, a dose-cumulative-volume histogram for the organ is generated. This is then reduced by an interpolation scheme (involving the volume-weighting of complication probabilities) to a slightly different histogram that corresponds to the same overall likelihood of complications, but which contains one less step. The procedure is repeated, one step at a time, until there remains a final, single-step histogram, for which the complication probability can be determined. The formalism makes use of a complication response function C(D, V) which, for the given treatment schedule, represents the probability of complications arising when the fraction V of the organ receives dose D and the rest of the organ gets none. Although the data required to generate this function are sparse at present, it should be possible to obtain the necessary information from in vivo and clinical studies. Volume effects are taken explicitly into account in two ways: the precise shape of the patient's histogram is employed in the calculation, and the complication response function is a function of the volume. PMID- 3804805 TI - Primary radiation therapy for medically inoperable patients with endometrial carcinoma--stages I-II. AB - Surgery with or without adjuvant radiation is the established method of treating patients with Stage I and II adenocarcinoma of the endometrium. However, patients who are poor operative risks must be treated with radiation therapy only. We report on 73 such patients treated at the University of North Carolina between 1969 and 1980. All patients had an adenocarcinoma of the endometrium; 41 were FIGO Stage I, 32 Stage II. The minimum follow-up period was 4 years. Life table analysis shows a disease-free survival of 72% at 3 years and 57% at 5 years for Stage I patients. There was a strong correlation between histologic tumor grade and survival in these patients; the 5-year survival for grade 1 was 72%, for grade 2 59%, and for grade 3 31%. The difference between G1 and G3 is significant at the p = .045 level. Coexisting medical conditions were responsible for 12 deaths; almost as many as the 16 cancer-related deaths. Stage II patients have an actuarial disease-free survival of 36% at 3 years and 26% at 5 years, significantly worse than Stage I patients (p = .029 at 3 years). Failures were seen in 16/41 (39%) Stage I and 19/32 (59%) Stage II patients; 29/35 (83%) of these recurrences had component of local/pelvic failure and 15/35 (43%) of the recurrences were local/pelvic only. Specific suggestions on how to improve local therapy for these patients are presented. PMID- 3804806 TI - Local control with pre-operative radiotherapy alone versus "sandwich" radiotherapy for rectal carcinoma. AB - Forty-nine patients with primary adenocarcinoma of the rectum, clinically localized to the pelvis were treated with pre-op radiotherapy (RT) 1500 cGy/5 fx with AP/PA fields, followed by immediate curative resection. Patients staged as Astler-Coller B2, C1, or C2 were considered for post-op RT, 4140 cGy/23 fxs with a 4-field technique. There were 47 evaluable patients in this non-randomized study. Two groups of patients were analyzed, namely pre-op RT only (24 patients) and combined pre- and post-op ("sandwich") RT (23 patients). Two patients with pre-op RT only were considered inevaluable for recurrence because they died NED at 1 and 7 mo. All patients have been followed for greater than 1 year; 77% have been followed for greater than 2 yr. There has been only one local recurrence (LR), surprisingly in a Stage A pre-op RT patient who had no residual tumor in the final operative specimen. In the pre-op group which included 10 B2s, and 1 C2, 1500 cGy in 5 days (equivalent to 1940 cGy by the NSD formulation) was associated with no local recurrence. No distant metastases (DM) have developed in this group. In the "sandwich" RT group, which included 3 B2s, 1 C1, 17 C2s, and 1 D (localized to the pelvis, i.e. ovary), there were no LRs and 7 DMs (1 B2 and 6 C2s). Actuarial survival is 92% in the pre-op RT group at 2 and 3 yr, and 82% in the "sandwich" group at 2 and 3 yr. There have been no serious early or late complications related to RT in our pre-op group. The use of 1500 cGy in 5 days as pre-op RT with immediate surgery may prove, upon longer follow-up, to be sufficient for increasing local control, with minimum morbidity, in patients with B2 disease. Patients with C2 disease are being controlled locally with the "sandwich" regimen, but it is not clear whether pre-op RT alone may be adequate in this group as well. We are now addressing this question in a randomized study. PMID- 3804808 TI - Shielding block mounting with double-stick tape. AB - We describe a system of mounting radiotherapy shielding blocks using a double stick adhesive tape as an alternative to the screw-and-nut system generally employed. The method is easy to use and eliminates the dose perturbations that are caused by holes or slots in a blocking tray. More than 2 years of experience with this method has demonstrated its reliability in a clinical setting. PMID- 3804807 TI - A radiolucent bite-block apparatus. AB - A bite-block, patient immobilization apparatus has been constructed using all plastic parts. The apparatus may be used in C-T scanning without detriment to the images produced. The construction details are given and the procedure used to produce a bite block is described. A method to reduce electron backscattering onto the buccal mucosa from metal fillings is given. PMID- 3804810 TI - Adjuvant irradiation of rectal cancer. PMID- 3804809 TI - Display of organs and isodoses as shaded 3-D objects for 3-D therapy planning. AB - We have developed a technique that allows the user to assess and modify 3-D dose distributions in planning a treatment. Organs and superimposed isodoses can be displayed as shaded solid objects from any desired point of view. The graphic tools necessary are described in detail. Briefly, after the volumes of interest have been defined as contours taken from CT scans, the beam data can then be defined using the "beam's eye view" technique. Subsequently, the desired isodoses can be extracted from the three-dimensional dose matrices and displayed as a series of "barrel hoops" over the target volume. We have found this technique to be particularly useful for development of treatment plans where the spatial relationship of sensitive organs such as the spinal cord may change considerably within the treatment volume. Such a case is described in detail. PMID- 3804811 TI - Post-operative radiation therapy of rectal cancer. PMID- 3804812 TI - A failed attempt to implant radioactive AU-198 seeds in canine gastric and colonic mucosa using flexible fibroptic endoscopes and a flexible injector system. PMID- 3804813 TI - Posttreatment ureteral obstruction in invasive carcinoma of uterine cervix. AB - There were 2,016 new cases of invasive carcinoma of the cervix (Stages I-IV) who were seen from January 1951 to January 1981, in LSU Medical Center. One thousand, one hundred and five cases were Stages I and II (early stages), and 911 cases were Stages III and IV (advanced stages). One hundred and thirty-seven cases of early stages (12%) were recorded to have ureteral obstruction that developed after completion of the treatment for cervical carcinoma. Ninety-four (69%) of the 137 patients with ureteral obstruction in early stages are dead, and autopsy information is available in 28 cases. There was evidence of cervical carcinoma causing ureteral obstruction in 13 autopsy cases. Of the 66 patients who died and were not autopsied, 26 cases had biopsy-proven evidence of either persistent or recurrent cervical carcinoma. All 43 patients surviving in this group are biopsy negative or clinically with no evidence of disease (NED). One hundred and sixty three patients in advanced stages (18%) who did not have ureteral obstruction prior to definitive treatment for cervical carcinoma developed ureteral obstruction after completion of treatment. One hundred and forty-two (87%) of the 163 patients with ureteral obstruction in advanced stages are dead, and autopsy information is available in 36 cases. There was evidence of recurrent or persistent carcinoma causing ureteral obstruction in 25 cases (69%). Of the 106 patients who died and were not autopsied, 76 had biopsy-proven Ca (72%) in the pelvis and abdomen prior to death. In this group, 21 patients survived until January 1, 1985, and four of them had biopsy-proven Ca which caused ureteral obstruction. In both early and advanced stages, 13 patients with post-treatment ureteral obstruction were lost to follow-up, but the remaining 287 cases have been followed until death or at least 4 years after detection of the ureteral obstruction. The median follow-up was 64.2 months, and seven patients have survived beyond 10 years. This review shows that 12% of the patients with early stage and 18% with advanced stage carcinoma of the uterine cervix seen in this institution developed some degree of detectable ureteral obstruction. Biopsy proven evidence of recurrent or persistent carcinoma indicating the Ca to cause posttreatment ureteral obstruction in early stages of cervical carcinoma was 40% and in advanced stages was 66%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3804814 TI - Conservation treatment of early breast cancer: long term results and complications. AB - Results of radiation therapy following breast-conserving surgery were analyzed for 410 patients with clinical Stage I-II mammary carcinoma having a minimum and median follow-up time of 5 years and 11 years, respectively. Crude survival rates were 82.2% at 5 years, 62.5% at 10 years, and 45.4% at 15 years. Local-regional recurrence was observed in 9.7% of patients. Seventy-five percent of these recurrences could be controlled locally by further treatment. Both local recurrences and metastatic deaths were more frequent in patients in clinical Stage II and in patients 40 years of age or younger. The cosmetic result was judged good to excellent in 77% of patients, with unacceptable results in 6.7%. The majority of poor results were seen in patients receiving 60 Gy or more to the entire breast. Arm edema occurred in 25% of patients having had axillary dissection, and in 3.4% of patients without axillary surgery. Edema was confined mainly to patients having had axillary doses of 60 Gy or more, and was never disabling. This study demonstrates that excellent long-term results are obtainable with breast-conserving techniques in early breast cancer. Satisfactory cosmetic results and a very low complication rate can be expected if extensive axillary surgery is avoided in conjunction with axillary radiation, and if the radiation dose applied to large treatment volumes is restricted to 50 Gy. PMID- 3804815 TI - Improvement of tumor spheroid oxygenation by tetrachlorodecaoxide. AB - The benefit of Tetrachlorodecaoxide (TCDO) in improving tumor tissue oxygenation has been tested using multicellular tumor spheroids. Measurements of oxygen tension (PO2) values with O2-sensitive microelectrodes revealed a distinct enhancement of the spheroid oxygenation after both, bolus injection or continuous infusion of TCDO into the medium surrounding the spheroids. The effect of TCDO on local oxygenation appeared to be less pronounced in spheroid regions with low initial PO2 values compared to well-oxygenated areas of these cellular aggregates. By continuously infusing TCDO into the measuring system, a sustained increase of local PO2 was obtained which was proportional to the local steady state concentration of TCDO in the medium surrounding the tumor spheroids. During experiments with TCDO in vivo, this substance should, therefore, be tested for its potential of improving the oxygenation status of solid tumors, and hence, of sensitizing tumors to classical treatments, such as radiotherapy. PMID- 3804816 TI - Postoperative radiation therapy of rectal cancer. AB - Beginning in December 1975, at the Massachusetts General Hospital (MGH) patients with rectal carcinomas thought to be at high risk of local recurrence after potentially curative surgical resection, were entered on a treatment protocol of high dose postoperative radiation therapy. Treatment was given with X rays of 10 MeV, generally using a four-field box technique to a dose of 4500 cGy with a boost to 5040 cGy or higher when the small bowel could be excluded from the reduced field. One-hundred sixty-five patients who began their radiation therapy between December 1975 and December 1982 were entered into the study. The median age was 65 years. The median follow-up in the survivors was 56 months, with a minimum follow-up of 17 months. All but 10 patients were followed for more than 2 years. Of the entire group, the actuarial 5-year survival was 53%, with survival of 71% in patients with Stage B-2, 39% in Stage C-2, and 17% in Stage C-3. Local failure was seen in 5/53 patients with Stage B-2 disease and 0/7 of patients with Stage B-3 disease. In patients with positive lymph nodes, local failure occurred in 2/10 (20%) of patients with Stage C-1, 16/77 (21%) of Stage C-2, and 8/15 (53%) of patients with Stage C-3 disease. Compared to previous series of surgery alone, the local failure rate has been decreased by more than one-half in all patients, except those with Stage C-3. Efforts to maximize the radiation doses in all stages should be made to minimize local failure. For Stage C-3, newer strategies such as intraoperative radiation therapy should be employed to decrease the continuing high incidence of failures. PMID- 3804817 TI - Modification of tumor and normal tissue radioresponse in mice by N methylformamide. AB - The effects of the differentiation-inducing agent N-methylformamide (NMF) on the in vivo response of the murine tumor FSA and its pulmonary metastases to ionizing radiation were investigated. In addition, the radioresponse of acutely responding normal tissues was determined in mice receiving systemic NMF. A dosage of 300 mg/kg administered for 8 days had little effect on the FSA tumor growth, yet enhanced the growth inhibitory actions of ionizing radiation with dose enhancement factors ranging from 1.5 to 1.7. Administration of NMF also enhanced the radiation response of FSA micrometastases. The response to irradiation of hematopoietic tissue, jejunum, and testes in mice receiving NMF was also investigated. NMF administered before or before and after radiation enhanced the formation of endogenous spleen colonies, yet did not influence the LD50/30 for radiation. Jejunal crypt cell survival after radiation was slightly increased in mice receiving NMF, but the survival of spermatogonia after radiation was not affected. These data indicate that NMF administration results in an increase in the radiosensitivity of the FSA tumor and its metastases with no concomitant increase in the radiation response of the normal tissue tested. Thus, at least in this model system, a therapeutic gain is achieved through the combination of NMF and ionizing radiation. PMID- 3804818 TI - Cf-252 leukemogenesis in the C57BL mouse. AB - Radiation-induced leukemia/lymphomas were induced in C57BL mice using four weekly acute 60Co fractionated irradiation exposures (to 188 cGy, or graded doses of low dose rate (LDR) Cf-252 irradiation given in fractionated exposure sessions at four weekly intervals. The acute 60Co radiation produced 84% thymic lymphomas with a median survival time (MST) of 162 days for mice developing tumors. Mice were exposed to Cf-252 n + gamma radiation in graded doses of 50, 62.5, 80, 112, and 188 cGy per week repeated 4X. Mice exposed to Cf-252 radiation developed thymic lymphomas on a much delayed time schedule. Mice irradiated at 50-80 cGy Cf 252 were killed after the 60Co induced thymoma mice had died to detect tumors. At Cf-252 doses of 112 or 188 rads 79 or 70% of mice, respectively, developed thymic lymphomas and had similar survival times which gave an estimated leukemogenesis RBEn of approximately 1.0-2.0. These studies show that for Cf-252 n + gamma radiation, compared to 60Co for leukemogenic efficiency, had a much longer latent period, and had a low RBE (1.0-2.0) at the large doses per fraction used in these studies. Under the experimental fractionated conditions tested, Cf-252 neutrons were leukemogenic, but only slightly more so than fractionated 60Co. PMID- 3804819 TI - Response of human tumor blood flow to local hyperthermia. AB - The effect of heat on blood flow in human tumors was studied as a function of time during 1 hour of local hyperthermia induced by 915 MHz microwaves. Blood flow was determined from the rate of thermal clearance by use of the bio-heat transfer equation. The rate of thermal clearance was measured at intervals of approximately 10 minutes throughout the treatment session by turning off the microwave power for 50 seconds. Tumor blood flow increased by amounts varying from 15 to 250% during the first 20-50 minutes of heating at 41-45 degrees C, after which it remained relatively constant during the remainder of the treatment session. The sharp reduction in blood flow or vascular stasis reported in most transplantable rodent tumors after comparable heating was not observed in human tumors. The maximum blood flow observed in heated human tumors ranged from 10-40 ml/min/100 gm. The systematic error due to thermal conduction was estimated to be equivalent to a blood flow of less than 3 ml/min/100 gm. PMID- 3804820 TI - Heating deep seated eccentrically located tumors with an annular phased array system: a comparative clinical study using two annular array operating configurations. AB - Regional heating administered with an annular array to 12 patients with deep seated advanced malignant disease eccentrically located in the lower abdomen and pelvis is compared based on the annular array operating configuration. One configuration (4 quadrants active) delivers radiofrequency power with relative uniformity throughout the patient cross-section. The other (2 quadrants active) allows the radiofrequency power deposition to be shifted preferentially into the eccentrically located treatment volume. Phantom measurements have been made to demonstrate the redistribution of radiofrequency power that results when the annular array is operated in these respective configurations. Systemic responses (i.e. oral temperature rise, changes in blood pressure, and heart rate) to these regional hyperthermia applications are compared and are not significantly different with respect to these heating configurations. Temperature data obtained during treatment sessions using these two annular array operating configurations are analyzed based on the fraction of measured tumor and normal tissue temperatures exceeding or equal to a given index temperature. Although the two quadrant configuration is more efficient in delivering power to the treatment volume, this analysis does not indicate a significant gain in therapeutic heating as a result of this preferential power deposition. Treatment tolerance and heterogeneity with respect to tissue type and blood flow remained the dominant limiting factors with regard to temperatures achieved. PMID- 3804821 TI - Relationship between urinary tract infection and contraceptive methods. AB - To investigate the relationship between urinary tract infection (UTI) and contraceptive methods, a comparative survey of contraceptive methods and frequency of intercourse was conducted among young women with and without confirmed UTI. Women with a documented UTI had more frequent intercourse than those without infection. There was a statistically significant positive correlation between frequency of intercourse and UTI. When frequency of intercourse was statistically controlled for, there were no significant differences between those with and those without UTI regarding the type of contraceptive method used. PMID- 3804822 TI - Sleep patterns and problems in adolescents. AB - A sleep questionnaire was administered to 390 students in an urban high school. Total sleep hours per week appeared to decrease between the ages of 12 and 18 years. In general, girls slept more than boys. The quality of sleep and the perception of sleep adequacy also decreased with age. Reporting of the occasional use of sleep medications and alcohol at bedtime was 4.6% and 10.5%, respectively. These findings suggest that sleep problems among adolescents represent normal physiologic processes as well as some serious disturbances that may reflect the social pressures prevalent during adolescence. PMID- 3804823 TI - Smoking and adolescent pregnancy outcome. AB - Birth weight, length of gestation, fetal/neonatal death, and admission to neonatal intensive care were examined for 265 adolescents who smoked during pregnancy and 510 nonsmokers. After adjusting for potential confounding variables, adolescent smokers had infants weighing 222 g less than nonsmokers. Smokers were also 3.1 times more likely to have a small-for-gestational-age infant compared to the nonsmokers. Smoking status had little effect on low birth weight (less than 2500 g), preterm delivery (less than 37 weeks gestation), fetal/neonatal death, or neonatal intensive care admission. Attributable risks suggested that small-for-gestational-age births to adolescents potentially could be reduced by up to 40% and adolescent low birth weight reduced by as much as 14.5% if smoking during pregnancy was stopped. PMID- 3804824 TI - A new era in contraceptive counseling for early adolescents. AB - In a new era of increased concern about sexually transmitted diseases, the ethical focus of contraceptive counseling for the early adolescent has changed. A discussion of the ethical aspects of contraceptive counseling is included to emphasize contemporary concerns about informed consent and safe contraceptive methods. PMID- 3804825 TI - Adolescent females' preferences regarding use of a chaperone during a pelvic examination. Observations from a private-practice setting. AB - This study used a private-practice model to investigate teenagers' preferences regarding the presence of chaperones during the genitalia examination. One hundred adolescent female patients were asked to fill out a questionnaire listing their chaperone preference during the pelvic examination. During early adolescence (13-14 years), 60% of the adolescents preferred to be alone if they knew the male physician and 80% if they knew the female physician. Of those in midadolescence (15-17 years), 73% preferred to be alone with a known male physician and 79% with a known female physician. After age 19 years, 79% preferred to be alone either with a male or female physician, whom they knew. These data suggest that the sex of the physician makes little difference as to the mid- and late adolescent female's preference for a chaperone. Also, there seems to be a trend toward increased preference for the presence of a female nurse, and decreased preference for the mother's presence, with increasing age. PMID- 3804827 TI - Urinary tract infection with Staphylococcus saprophyticus. AB - A case of urinary tract infection with Staphylococcus saprophyticus is presented. This gram-positive organism can cause urethral symptomatology in males and females without history of catheterization or urinary tract abnormality. Evidence suggests that S. saprophyticus is a cause of sexually transmitted urethritis. PMID- 3804826 TI - Erythromelalgia in an adolescent male. AB - Erythromelalgia is a rare disorder. We present a case of a 17-year-old male with the diagnosis of primary erythromelalgia. PMID- 3804828 TI - A case of neuroleptic malignant syndrome in a mentally retarded adolescent. AB - The neuroleptic malignant syndrome is an uncommon but occasionally fatal reaction to antipsychotic medication characterized by fever, movement disorder, and stupor. A case is reported of a 16-year-old retarded male who progressed into coma after an injection of fluphenazine. The syndrome is discussed, and new pharmacological treatment approaches are reviewed. Brain-damaged patients are thought to be more susceptible to this syndrome. As recognition of the syndrome grows, there may well be more cases identified in the mentally retarded population. PMID- 3804829 TI - Young teens and tampons. A crisis in waiting. PMID- 3804830 TI - Secondary amenorrhea during periods of chronic depression or stress. PMID- 3804831 TI - Expanding careers along economically productive pathways. PMID- 3804832 TI - Drugs--client information and foreseeability. PMID- 3804833 TI - Employed spouse insurance. PMID- 3804834 TI - Laboratory animal medicine: no typical workday. PMID- 3804835 TI - Common bile duct obstruction secondary to chronic fibrosing pancreatitis: treatment by use of cholecystoduodenostomy in the dog. AB - Six small to medium-sized, middle-aged, female dogs with histories of acute pancreatitis developed clinical signs of extrahepatic biliary obstruction. Clinical findings were similar in the 6 dogs and included icterus. Serum biochemical analyses indicated high concentrations of total bilirubin and cholesterol and high alkaline phosphatase and alanine transaminase activities. Exploratory abdominal surgery was performed in each dog. Each dog had a firm mass involving the body of the pancreas, with obstruction of the distal portion of the common bile duct, marked peripancreatic inflammation, and omental adhesions. Cholecystoduodenostomy, using an open mucosal appositional technique for biliary redirection, was performed in each dog. Clinically, results of surgery were good to excellent (ie, lack of postoperative icterus, anorexia, lethargy, or weight loss and absence or infrequency of vomiting). The mean postoperative evaluation period for the 6 dogs was 35 months (range, 20 to 48 months); 5 dogs were alive and healthy at the end of the study. Histologic examination of tissue specimens of the pancreatic mass indicated chronic active fibrosing pancreatitis in the 6 dogs. PMID- 3804836 TI - Laryngotracheal injury associated with nasotracheal intubation in the horse. AB - Laryngotracheal damage following short-term nasotracheal intubation was studied in 7 healthy horses. A flexible fiberoptic endoscope was used to examine the upper respiratory tract of each horse before nasal intubation with a cuffed silicone endotracheal tube and again at 1 hour, 24 hours, and 48 hours after extubation. Any abnormalities still evident at 48 hours were evaluated at 7 days after extubation. Mucosal damage involved the nasal meatus (5 of 7 horses), the arytenoid cartilages (5 of 7 horses), the trachea (5 of 7 horses), the dorsal pharyngeal recess (4 of 7 horses), the vocal folds (3 of 7 horses), and the entrance to the guttural pouch (3 of 7 horses). Laryngeal injury was attributable to tube pressure on the arytenoid cartilages and vocal folds. Tracheal damage appeared to be a function of pressure exerted by the inflated cuff on the tracheal mucosa. PMID- 3804837 TI - Applicability of leukocyte esterase test strip in detection of canine pyuria. AB - A commercially available leukocyte esterase assay was evaluated for application in analyzing canine urine for the detection of pyuria. In 229 urine samples, the leukocyte esterase activity was compared with leukocyte concentrations, as assessed by microscopic sediment analysis and chamber cell counts. The leukocyte esterase assay was specific (93.2%) for canine pyuria, but was poorly sensitive (46.0%) and did not appear to be applicable to analysis of canine urine samples. PMID- 3804838 TI - Follow-up evaluation of horses after neonatal intensive care. AB - A follow-up study was conducted on 131 foals that were less than 7 days old when admitted to the University of Florida Veterinary Medical Teaching Hospital between 1981 and 1983. Of the 71 foals (54%) that survived to be discharged, 39 (55%) were alive at follow-up evaluation, 19 (27%) could not be located, and 13 (18%) had died. The owners of surviving foals were sent questionnaires and 72% responded. The horses were visited and examined, if geographically possible, and an age-matched stablemate or a sibling also was evaluated and used as a control. Thirteen foals (10% of total admitted) died 1 day to 2 years after discharge. Four (8%) died from suspected sequelae of their neonatal illness. Three other foals appeared stunted as yearlings, but by 2 years of age equaled or passed their stablemates and/or siblings in physical development. The owners' estimated value of the survivors averaged +29,812. The actual selling price of horses that went through sales ranged from +7,000 to +210,000. Most of the horses became useful, athletic adults; several have won major stakes races. All living foals appeared unaffected by the physiologic disorders and treatments they encountered as neonates and compared favorably with stablemates and siblings. PMID- 3804839 TI - Endocarditis caused by Corynebacterium sp in a dog. AB - Mitral valve bacterial endocarditis, caused by Corynebacterium sp, was diagnosed in a dog. The bacteria had characteristics unlike those commonly recognized for most species of Corynebacterium. The primary source of bacteremia was suspected to be a pilonidal cyst of the sacrum. The dog was treated with a first-generation cephalosporin for 6 weeks, and the pilonidal cyst was surgically removed. Physical examination 1 year after initial examination revealed no abnormalities other than a cardiac murmur. On echocardiographic examination 1 year after treatment, the vegetative lesion was still present; however, chamber dimensions had returned to normal. Wall thickness and contractility remained increased. PMID- 3804840 TI - Chylothorax associated with congestive cardiomyopathy in a cat. AB - Chylothorax associated with congestive cardiomypathy was diagnosed in a 10-year old male castrated domestic shorthair cat via analysis of pleural fluid. The triglyceride concentration in the pleural fluid was high (579 mg/dl), compared with that in serum (87 mg/dl), and the fluid cleared with ether. Evidence of atrial and left ventricular enlargement was found via electrocardiography and thoracic radiography. Left-sided cardiac dilatation and reduced systolic motion of the left ventricle were revealed by echocardiography. The cat was treated with digoxin, furosemide, and aspirin. Two months after initiation of treatment, fluid (265 ml) was aspirated from the pleural cavity. Two months after this procedure, the cat was doing well, with minimal pleural fluid production. PMID- 3804841 TI - Left hepatic vein attenuation for treatment of patent ductus venosus in a dog. AB - Patent ductus venosus was identified in a young dog. Surgical attenuation of the anomalous vessel was performed by partial ligation of the left hepatic vein. Clinical signs resolved after surgery, and laboratory values returned to normal. Jejunal venous portography, performed 8 weeks after surgery, revealed complete occlusion of the patent ductus venosus, with normal portal vasculature to the right and central divisions of the liver. Atrophy of the left hepatic division resulted. PMID- 3804842 TI - Multicentric basal cell tumors in a cat. AB - Four basal cell tumors were diagnosed in an adult spayed female domestic longhair cat. Surgical excision was curative. Basal cell tumors in cats usually are solitary, slow growing, benign epithelial neoplasms. The multicentric nature of these neoplasms in this patient was uncharacteristic of typical basal cell tumors in cats. PMID- 3804843 TI - Primary hyperparathyroidism in a dog: biochemical, bone histomorphometric, and pathologic findings. AB - An adult Keeshond had clinical signs associated with hypercalcemia, including inappetence, polyuria, polydipsia, and vomiting. Blood biochemical findings and urinary clearance studies were consistent with a diagnosis of primary hyperparathyroidism. Histomorphometric analysis of trabecular bone in an iliac crest biopsy indicated increased bone remodeling activity. Surgical exploration of the neck revealed an oval mass, which was removed by blunt dissection. Histologic diagnosis was parathyroid gland adenoma. The dog died because of renal failure on the eighth postoperative day. This report defines primary hyperparathyroidism in the dog, thus facilitating diagnosis for the veterinary clinician. PMID- 3804844 TI - Proliferative colitis in a pet ferret. AB - A 4-month-old male ferret was examined because of mucus-laden diarrhea of several days' duration. The diarrhea became bloody and the ferret became progressively anorexic and lost weight. Treatment with antibiotics did not result in amelioration of clinical signs. A biopsy specimen was obtained from the colon, which was thick and turgid. Proliferative colitis associated with Campylobacter sp infection was diagnosed histologically. Because of the poor prognosis and potential zoonotic hazard associated with Campylobacter, the ferret was euthanatized. PMID- 3804845 TI - Pupillotonia in a dog. AB - A 5-year-old German Shepherd Dog was examined because of anisocoria. Pupillatonia because of parasympathetic denervation of iris sphincter muscle was diagnosed. This finding, most commonly referred to as Adie's tonic pupil in human medical literature, illustrated such a case in a species other than man. Diagnosis consisted of measuring the change in size of the pupillary aperture in response to topical administration of 0.1% pilocarpine. It is hoped that this report will help practitioners to be cognizant of pupillatonia when sorting out anisocorias. PMID- 3804846 TI - Erythrocyte agglutination associated with heparin treatment in three horses. AB - In vitro erythrocyte agglutination developed in 3 hospitalized horses receiving heparin treatment. The agglutination caused artifactual decreases in erythrocyte counts and increases in mean corpuscular volume (MCV) values. Treatment of cell suspensions with trypsin eliminated the agglutination and the changes in erythrocyte count and MCV. Similar abnormalities in erythrocyte counts and MCV have been reported in healthy horses treated with heparin and have been cited as evidence of hemolysis and regenerative anemia. PMID- 3804847 TI - Repair of a coccygeal vertebral fracture in a dog, using a four-hole finger plate. AB - A 7-year-old Pointer was referred with a transverse fracture of the 12th coccygeal vertebra. A 4-hole 2-mm finger plate was applied to the dorsolateral aspect of the vertrebra, and the tail was placed in a protective splint. This case presents an alternate method of fixation of coccygeal fractures, and is recommended when the nerve and blood supplies to the tail are intact, and when a cosmetic appearance with minimal callus formation is desired. PMID- 3804848 TI - Alpha-mannosidosis in a Persian cat. AB - Alpha-mannosidosis, an inherited enzyme-deficiency disease, caused growth retardation, hepatomegaly, ocular abnormalities, and neurologic dysfunction in a Persian cat. Because of the clinical progression of this autosomal recessive, lysosomal storage disorder, the cat was euthanatized at 5 months of age. PMID- 3804849 TI - Cardiac fibrosarcoma in a dog. AB - A cardiac fibrosarcoma involving the right ventricular free wall, the interatrial septum, and proximal portion of the interventricular septum, with a 2-cm diameter protrusion into the right atrial lumen, was found at necropsy of a 2-year-old Miniature Schnauzer. Severe distortion of the tricuspid valve and narrowing of the aortic and pulmonic outflow tracts had caused the dog to develop right-sided cardiac failure and to have syncopal episodes. A tentative antemortem diagnosis of congenital pulmonic stenosis had been made on the basis of results of physical examination and diagnostic work-up. Evaluation of the case exemplifies the difficulty encountered in diagnosing cardiac tumors before the patient's death. PMID- 3804850 TI - Complications of blind-stitch abomasopexy: 20 cases (1980-1985). AB - Over a 5-year period, 20 adult Holstein cows were admitted to the New York State College of Veterinary Medicine because of complications following blind-stitch percutaneous abomasopexy for correction of left-displaced abomasum. Of the 20 cows, 16 were treated surgically, 2 were treated medically, and 2 were admitted to the pathology service for necropsy. Complications associated with the blind stitch technique included peritonitis, cellulitis, abomasal displacement or evisceration, complete forestomach obstruction, and thrombophlebitis of the subcutaneous abdominal vein. Because of the various complications associated with blind-stitch percutaneous abomasopexy, we concluded that it is not an appropriate procedure for correction of left displaced abomasum in valuable cattle, but may be used as an alternative for salvage in less valuable cows. PMID- 3804851 TI - Responses of atopic dogs to regional allergens: 268 cases (1981-1984). AB - Responses of atopic dogs to intradermal challenge with 60 allergens were determined and compared for 4 regions of the United States Twenty-seven allergens incited significantly higher responses in atopic dogs residing in northern Florida, when compared with dogs in Illinois; responses to 28 allergens were more significant in dogs residing in southern Florida vs Illinois. Only 1 allergen caused more responses in atopic dogs in northern Florida, compared with dogs in southern Florida. Females had a higher tendency to develop clinical signs of atopy. Dogs of the West Highland White Terrier, Cairn Terrier, English Setter, Irish Setter, Dalmatian, Lhasa Apso, Golden Retriever, and Labrador Retriever breeds were found to be predisposed to develop clinical signs of atopy. Dogs of the Poodle, Pug, German Shepherd Dog, Cocker Spaniel, Bulldog, Schnauzer, Doberman Pinscher breeds, of mixed breeding, and of terrier breeds other than the 2 aforementioned were not found to have a higher prevalence, when compared with the general hospital population. Of the atopic dogs evaluated in Florida, 79% had a significant response to flea antigen, compared with only 9% of atopic dogs evaluated in Illinois. PMID- 3804852 TI - The hologram as a model for analytical psychology. PMID- 3804853 TI - Evidence of collective memory: a test of Sheldrake's theory. PMID- 3804854 TI - A brief report: affect and archetype. PMID- 3804855 TI - Analytical psychology and the metapsychology of feelings: possible connections between Jung and Melanie Klein. PMID- 3804856 TI - Auditory stereocilia in the alligator lizard. AB - The normal anatomy of stereociliary tufts in the basilar papilla of the alligator lizard is described and demonstrated with scanning electron micrographs. Stereociliary tufts in the tectorial region differ from those in the free standing region in several ways. Tectorial stereociliary tufts are short (less than 10 micron in height), unidirectional in orientation, and covered with a tectorial membrane. Free-standing stereociliary tufts are very tall (up to 38 micron in height), bidirectional in orientation and not covered by a tectorial membrane or any other tectorial substance. The heights of the stereociliary tufts along the length and across the width of the basilar papilla were measured in serial light and transmission electron micrographs. Free-standing stereociliary tufts decrease progressively in height along the length of the basilar membrane, being tallest at the apical end and shortest at the basal end. Tectorial stereociliary tufts do not increase progressively along the length of the basilar membrane but do increase progressively across the width of the basilar membrane, being shortest on the neural side. Free-standing stereociliary tufts are structurally simple being a prominent specialization of the lizard cochlea. Tectorial stereociliary tufts are structurally more complicated conforming more closely to the general anatomical pattern of vertebrate auditory hair cells. PMID- 3804857 TI - Masking additivity in the hearing-impaired. AB - The purpose of the present study was to investigate how the effects of maskers combine in hearing-impaired listeners. The levels of two narrow bands of noise separated in frequency were selected so that each band individually produced the same amount of masking of a sinusoidal signal. Thresholds for the signal were then measured in the presence of both bands combined. For normal-hearing listeners, the effect of combining maskers was nonlinear, but, additive. A cube root transformation of the masking produced by the individual and combined maskers preserved an additive relation among the effects of these maskers. This type of nonlinear additivity also characterized the results from the hearing impaired listeners when the maskers were restricted to a region of normal sensitivity. In contrast, the effect of combining maskers was linear, additive without transformation, when the maskers were restricted to a region of significant loss. In many instances, the auditory filter model of masking may describe the detection performance of hearing-impaired listeners better than that of normal-hearing listeners. PMID- 3804858 TI - Segregation of efferent projections to different turns of the guinea pig cochlea. AB - Localized intracochlear injections of the fluorescent retrograde label diamidino yellow were used to investigate the organization of efferent projections from the brainstem to different turns of the cochlea, in the guinea pig. It was found that the location of small neurones within the lateral superior olive ipsilateral to the injection varied in a systematic manner when injections proceeded from base to apex of the cochlea. In addition, a cruder form of cochleotopic organization was present in that most of the large medial system efferent neurones were labelled only after injection into the 3 most basal turns of the cochlea. The decline of medial system efferent innervation proceeding from base to apex was most striking for the contralateral efferent neurones. The details of base to apex innervation density were different for the different nuclei of origin of the medial system, implying the existence of complex subsystems within the medial neurone population. PMID- 3804859 TI - Speculations about noise and the evolution of vertebrate hearing. AB - Two of the most conspicuous and celebrated properties of human hearing--the abilities to discriminate pitch and to localize sound sources, may have been secondary derivations to which the ear was preadapted by having evolved in the inevitable presence of noise. PMID- 3804860 TI - Collection of airborne micro-organisms on Nuclepore filters, estimation and analysis--CAMNEA method. AB - The total number of airborne micro-organisms collected on Nuclepore filters was determined by acridine orange staining and epifluorescence microscopy. The viable fraction of the total numbers varied significantly when actinomycete and fungal spores from different environments were stored on the filter surface for 1 week, although the microflora composition was not altered. A high correlation between viable and total counts was noted in environments where the airborne flora was dominated by fungal spores, while a low correlation was found for airborne bacteria. Peak values of the total counts registered in some work environments varied between 10(7) and 10(11) micro-organisms/m3. Size analysis showed a dominating fraction of respirable micro-organisms (aerodynamical diameter less than 5 micron). The investigation shows that it is of the utmost importance to combine viable counts with total count enumeration in the study of exposure to micro-organisms in work-related situations. PMID- 3804861 TI - Storage of pathogenic leptospires in liquid nitrogen. AB - The virulence and viability of various serovars of Leptospira interrogans were successfully preserved by storage in liquid nitrogen. Dimethyl sulphoxide at a final concentration of 2.5% (v/v) was added as cryoprotectant to a culture of leptospires grown in Ellinghausen-McCullough-Johnson-Harris medium. Ampoules were cooled at a controlled rate of 1 degree-3 degrees C/min to -70 degrees C, then transferred to the liquid phase of a liquid nitrogen storage unit. Glycerol was discounted as a cryoprotectant as it was found to be approximately 10 times more toxic than dimethyl sulphoxide to four of five serovars used in this study. The viability of nine strains has so far been observed over a period of 8-22 months storage in liquid nitrogen and full viability of all strains has been preserved over this period. Virulence of strains of serovars pomona and hardjo was well preserved, as demonstrated by challenge tests in guinea pigs and domestic pigs. PMID- 3804862 TI - A note on starch hydrolysis and beta-glucuronidase activity among flavobacteria. AB - Most flavobacteria tested with the fluorogenic substrate 4-methylumbelliferyl beta-D-glucuronide possessed beta-glucuronidase (GUD), but when some of the same strains were tested with the API ZYM gallery, all were negative for GUD. Conflicting reports also appear in the literature about starch hydrolysis among flavobacteria. We observed that the results obtained can depend on the medium used and the length of incubation. Our results indicate that GUD activity and starch hydrolysis are more widely distributed in the genus Flavobacterium than previously reported. PMID- 3804863 TI - Numerical classification of species of Vibrio and related genera. AB - Data from 1091 strains of the family Vibrionaceae collected in five different studies have been merged into a single data matrix and analysed in a taxonomic study. A set of 142 characters was selected to compare these data. Seventy-nine characters were common to all studies, but data for the other 63 characters were incomplete. Cultures of 90 strains, examined in more than one of the original studies, were used to estimate test error and inter-study variability. The data from these replicate strains also allowed the problem of merging data from different studies to be assessed. Taxonomic resemblance was estimated on the basis of 111 characters using the SSM coefficient and UPGMA clustering. A taxonomic analysis based on 999 strains, which included most of the major species of the family Vibrionaceae, gave 59 clusters and 44 unclustered strains. A table of properties of these phenons was produced. The results showed that data obtained from studies carried out at different times and in different locations, but using standard techniques, could be combined and used to provide useful taxonomic information. PMID- 3804864 TI - A probability matrix for the identification of species of Vibrio and related genera. AB - A matrix for the probabilistic identification of species of Vibrio and related genera has been constructed using the data from 1091 strains collected throughout the world and classified. Thirty-eight phenons are included in the matrix, 31 of these represent previously identified species or biovars and seven represent phenons which could not be identified and may represent new species. The identification matrix incorporates 81 characters although a subset of 30 tests can be used to distinguish the 38 phenons from each other. The additional 51 tests were included to assist the identification of some strains for which the initial 30 tests were inadequate. No significant cluster overlap was found at the 5% level and the identification score for the Hypothetical Median Organism of each cluster exceeded 0.9999 in all cases. PMID- 3804865 TI - Behavioral gerontology: application of behavioral methods to the problems of older adults. AB - Elderly persons are under-represented in research and clinical applied behavior analysis, in spite of data suggesting that behavior problems are quite prevalent in both community dwelling and institutionalized elderly. Preliminary investigations suggest that behavioral procedures can be used effectively in treating various geriatric behavior problems. We discuss a number of areas within behavioral gerontology that would profit from additional research, including basic field study, self-management, community caregiver training, institutional staff training and management, and geriatric behavioral pharmacology. Special considerations for adapting behavioral procedures are discussed, and suggestions for expanding the role of behavior analysis in geriatric care are offered. PMID- 3804866 TI - Modification of verbal behavior of the mentally impaired elderly by their spouses. AB - Speaking disorders frequently result in serious consequences for mentally impaired elderly people. Two examples are presented illustrating the modification of both excess and deficit rates of talking via differential reinforcement procedures. Two men exhibiting verbal disorders severe enough to impair social interactions and lead to possible nursing home placement were treated by teaching their spouses to reinforce positive and ignore undesired verbal responses. Problem behaviors were reduced sufficiently to permit continued home care, and alternative positive behaviors were increased. These findings suggest that verbal behavior of the mentally impaired elderly can be affected by applying systematic consequences and can be modified by relatively simple procedures. These procedures provide an alternative to the negative effects of labels associated with either aversive or deficient verbal behaviors, promote more positive activities, and enable continued residence at home. Further, this research provides support for the generality of the utility of training spouses to serve as behavior therapists for the impaired elderly. PMID- 3804867 TI - Telephone conversational skills training with socially isolated, impaired nursing home residents. AB - We evaluated the effectiveness of a comprehensive training program for enhancing the conversational skills of socially isolated, impaired elderly nursing home residents. A multiple baseline design across behaviors was used to train four subjects (aged 87, 85, 68, and 66), on four content-related conversational components: expressing common courtesies, making positive self-disclosures, asking questions, and making interjections and acknowledgements. Training procedures included instructions, modeling, behavior rehearsal, feedback, and reinforcement. Results showed positive effects with all four subjects; in two cases, changes were significant enough to affect untrained observers' perceptions of the elders' conversational skills. PMID- 3804868 TI - Enhancing the social environments of elderly nursing home residents: are high rates of interaction enough? AB - We investigated the social validity of a common intervention (i.e., serving food during a social hour) that has been reported to facilitate social interaction among nursing home residents. Using a group reversal design, rates of interaction were measured. In addition, the vocal content of the interactions was recorded and coded by raters blind to condition. Rates of interaction more than doubled during the treatment phases, but ineffective vocal behavior accounted for the bulk of the increase. Results suggest the need to examine the utility of such programs in nursing homes. PMID- 3804869 TI - Increasing distance and independence of ambulation in elderly nursing home residents. AB - We tested the effectiveness of a prompt-and-praise procedure for increasing walking distance and independence in eight nursing home residents. Walking distance and method of ambulation were observed just prior to mealtimes; in addition, mobility and social interaction were time-sampled in the living areas throughout the day. Treatment was lagged in a multiple baseline design across lunch and dinner meals within subjects, and across subjects within each of three units. In the mealtime setting, two subjects began walking the maximum scored distance during baseline; the other six subjects showed a marked increase in walking beginning with the first meal in which the intervention was applied. Six of the eight subjects also progressed to more independent means of ambulation. Generalization of walking to the second meal was observed in all four of the subjects in whom this could be assessed. Generalization across subjects was not observed nor was generalization to the living areas. Staff successfully implemented the procedures in the mealtime settings and the effects were maintained at the 4-month follow-up. PMID- 3804870 TI - Using reinforcement and cueing to increase healthy snack food choices in preschoolers. AB - We examined the effects of behavioral procedures to modify the food choices of preschoolers during a snack period at school (training setting) and at home (generalization setting). In the first experiment, we evaluated the usefulness of nutrition training and a generalization programming strategy of cueing to improve healthy snacking; in the second experiment we investigated the effect of nutrition training alone. In addition, three cases are presented that illustrate individualized procedures to facilitate generalization of healthy snacking to home. Results indicated that children's healthy snack choices increased in the preschool training setting, that generalization to home was achieved only when procedures to program it were implemented, and that the best results were found when the generalization procedures were tailored to the individual child. PMID- 3804871 TI - Stimulus fading and transfer in the treatment of self-restraint and self injurious behavior. AB - We conducted several manipulations of mechanical restraint properties during the course of treatment for two profoundly retarded adolescents who exhibited both self-restraint and self-injurious behavior. In study 1, a combination of prompting, differential reinforcement, and stimulus fading reduced one subject's self-restraint, which consisted of holding rigid tubes on his arms. Subsequently, stimulus control of both self-restraint and self-injurious behavior was transferred to tennis wrist bands. In study 2, a second subject's self-restraint- placing his hands in his pants--was immediately eliminated by the use of air splints. Additionally, differential reinforcement and air-pressure fading resulted in the complete mobility of his arms and a substantial increase in appropriate behaviors. Results of this investigation suggest that stimulus fading and transfer may be valuable components in the elimination of self-restraint. PMID- 3804872 TI - Naturalistic observations of beer drinking among college students. AB - We observed the beer drinking behavior of 308 university students in several bar and party settings. The following relationships were found: males drinking beer in bars consumed 0.92 oz per min; females drank less beer than males, and stayed in a bar for a longer time period; patrons drank significantly more beer when drinking in groups and when purchasing beer in pitchers versus cups or bottles; and intervals between party arrival and first drink and between party departure and last drink varied inversely with blood alcohol concentration. We discuss these findings with regard to developing interventions to prevent alcohol impaired driving. PMID- 3804873 TI - Treating self-injury: water mist spray versus facial screening or forced arm exercise. AB - In three experiments, the effect of water mist spray on self-injurious and collateral behaviors was compared with either facial screening or forced arm exercise. Water mist spray was as effective as facial screening in suppressing face-slapping in Experiment 1. However, it was not as effective as facial screening for self-injurious finger-licking in Experiment 2 or forced arm exercise for excessive ear-rubbing in Experiment 3. These results suggest that while water mist spray is effective, it may be less so than alternative procedures. In Experiments 2 and 3 there was a consistent decrease in the occurrence of untreated maladaptive behaviors. In addition, there was a moderate increase in appropriate social interaction in Experiment 2 and a substantial increase in Experiment 3. PMID- 3804874 TI - Functional analysis and treatment of severe pica. AB - A two-phase functional analysis of a profoundly retarded 19-year-old male's pica facilitated the design of an effective intervention containing no aversive components. In the first analysis, frequent staff-client interaction resulted in 25% and 66% less pica than limited and no interaction, respectively. Paradoxical effects were obtained in the second analysis, where no protective helmet resulted in 38% and 26% less pica than the helmet with face shield and helmet without face shield, respectively. On the basis of these analyses, limited interaction and no helmet conditions were combined in an effective, staff-implemented treatment at a medium-sized institution. PMID- 3804875 TI - Self-monitoring of attentional behavior versus self-monitoring of productivity: effects on on-task behavior and academic response rate among learning disabled children. AB - I investigated the differential effects of self-monitoring of attentional behavior and self-monitoring of productivity on on-task behavior and academic response rate. Subjects were four learning disabled children with significant attentional problems. Results indicated relatively equivalent increases in on task behavior over baseline during all treatment phases. Academic response rate also improved under both interventions, with self-monitoring of productivity showing a superior effect for one subject, an equivalent effect for one subject, and less clear results for two subjects. PMID- 3804876 TI - The effects of interspersed maintenance tasks on academic performance in a severe childhood stroke victim. AB - We examined the effects of task-sequencing variables on the academic performance of an 8-year-old severe stroke victim. Within a multiple baseline design, previously acquired (maintenance) task trials were systematically interspersed at designated points in treatment among new (acquisition) task trials. The results showed improvements in both academic responding and subjective ratings of motivation in each of four treated areas (spelling, reading, word-finding, and memory). Social validation data obtained from standardized school placement examinations suggested marked improvement in a variety of related areas of academic functioning. Results suggest that children suffering severe strokes may be capable of learning more than has previously been suspected, and that behavioral treatments may improve such children's functioning. PMID- 3804877 TI - Team sports for the severely retarded: training a side-of-the-foot soccer pass using a maximum-to-minimum prompt reduction strategy. AB - A program to teach three severely retarded adults to use a side-of-the-foot soccer pass was evaluated. A 9-step stimulus-response chain was taught using forward chaining. In contrast to usual practice, intensive physical prompts were provided initially to teach each response component, then systematically faded. Approximately 20 lessons (trials) were presented in 20-min sessions. A multiple baseline across subjects design showed that the three trainees achieved the no prompt criterion after 24, 29, and 22 sessions, respectively. Subanalyses indicated that successive response components were learned only after training was implemented. Follow-up data were obtained 57 and 276 days later in the training room and in a gymnasium; in both settings, criterion was achieved with fewer than three reinstructions. PMID- 3804878 TI - Role reversals: an analysis of therapeutic effects achieved with disruptive boys during their appointments as peer monitors. AB - Three 7-year-old boys with histories of negative interactions were appointed to monitor individual classmates during daily noon recess. As monitors, the boys awarded points to their classmates for playing appropriately and, on rare occasions, withdrew a point for negative interactions. The three boys immediately decreased their own rates of negative interactions during the sessions in which they were appointed as monitors. Two of the boys concomitantly increased their rates of positive interactions. Their reductions in negative interactions were not maintained during reversals and did not clearly generalize to the morning or afternoon recess periods. Subsequent appointment of the boys as peer monitors during the morning recess produced similar improvements in their behavior. Results suggest that appointment to the role of peer monitor may itself function as an intervention. PMID- 3804879 TI - Antibiotics and bacterial adhesion. PMID- 3804880 TI - Treatment of streptococcal and staphylococcal endocarditis. PMID- 3804881 TI - Distribution of metronidazole susceptibility factors in obligate anaerobes. AB - The distribution of metronidazole susceptibility factors in clinically important bacteria was studied to determine why obligate anaerobes were susceptible to metronidazole and facultative ones were not. With obligate and facultative anaerobes, nitroreductase activity, metronidazole uptake, pyruvate:ferredoxin oxidoreductase activity and drug susceptibility were estimated. Nitroreductase activity was distributed in the obligate anaerobes and some facultative ones such as Streptococcus faecalis. Propionibacterium acnes, Bifidobacterium adolescentis, Actinomyces israelii and most of the facultative anaerobes had no such activity. Bacteria with nitroreductase activity were able to absorb the drug. Pyruvate:ferredoxin oxidoreductase activity was distributed in all of the obligate anaerobes, whereas Prop. acnes, Bif. adolescentis, A. israelii and all of the facultative anaerobes had no such activity. Distribution of metronidazole susceptibility was the same as that of pyruvate:ferredoxin oxidoreductase activity. Therefore metronidazole may selectively inhibit obligate anaerobes with pyruvate:ferredoxin oxidoreductase activity. Nitroreductase activity may be necessary for drug uptake as well. PMID- 3804882 TI - Serum and bone concentrations of cefuroxime in patients undergoing knee arthroplasty. AB - Concentrations of cefuroxime were measured in the serum and femoral and tibial bone of 12 patients undergoing knee arthroplasty, following cefuroxime 1.5 g iv. The mean serum cefuroxime concentration was 112.4 mg/l at the time of application of the mid thigh tourniquet. The mean femoral bone concentration was 18.6 mg/kg and tibial bone was 15.5 mg/kg. These concentrations of cefuroxime appear adequate for prophylaxis against post-operative infection in knee arthroplasty. PMID- 3804883 TI - Cefoxitin versus gentamicin and metronidazole in prevention of post appendicectomy sepsis: a randomized, prospective trial. AB - Three hundred and seven patients with appendicitis were randomized to receive cefoxitin or gentamicin and metronidazole. For early appendicitis, a single preoperative dose of antibiotics was given. For late cases, the antibiotics were continued postoperatively for seven days. Both cefoxitin and gentamicin metronidazole were effective in the reduction of post-appendicectomy septic complications in early or late appendicitis and there was no statistically significant difference between them. Mild transient and reversible nephrotoxicity was detected in 1.9% of patients who received gentamicin-metronidazole for seven days. Nephrotoxicity was not detected in any other patients. The cost of cefoxitin is higher, but this has to be balanced against the costs of monitoring serum gentamicin and creatinine levels, and the need to adjust the gentamicin dosage in 19% of patients when gentamicin-metronidazole was used. Both cefoxitin and gentamicin-metronidazole are effective and safe when used carefully. Cefoxitin has a slight advantage in its lack of potential nephrotoxicity and ototoxicity. PMID- 3804884 TI - Randomised comparison of ceftriaxone and cefamandole therapy in lower respiratory tract infections in an elderly population. AB - Patients with pneumonia or bronchitis were randomized to receive ceftriaxone or cefamandole. A total of 30 of 38 patients were evaluable, 16 in the ceftriaxone group (average age 66.3 years) and 14 in the cefamandole group (average age 69.4 years). All but one had underlying diseases. Patients usually received 1 g of ceftriaxone intravenously every 12 h (mean duration 8.7 days) or 1.5 g of cefamandole intravenously every 6 h (mean duration 8.2 days). Adverse experiences attributable to the drugs were confined to one episode of discomfort at the infusion site in each group. Bacteriological results with ceftriaxone were 83% cured, 11% superinfected after eradication of pretherapy isolate, and 6% failed. Bacteriological results with cefamandole were 76% cured, 24% failed. Clinical results with ceftriaxone were 38% cured, 56% improved, 6% failed. Clinical results with cefamandole were 57% cured, 21% improved, 21% failed. Emergence of a resistant Serratia marcescens was seen in a ceftriaxone-treated patient. Disc diffusion susceptibility testing identified six of the seven pretherapy nonfastidious Gram-negative isolates as susceptible; however, two of the six could not be eradicated with the assigned drug and another two were eradicated with ensuing super-infection with susceptible isolates of Pseudomonas aeruginosa. In contrast, MBCs were an accurate guide to clinical outcome with nonfastidious Gram-negative bacilli. PMID- 3804885 TI - Trimethoprim resistance and trimethoprim usage in and around The Royal Free Hospital in 1985. PMID- 3804886 TI - Penetration activities of ciprofloxacin into muscle, skin and fat following oral administration. PMID- 3804887 TI - Pharmacokinetics of netilmicin administered once or twice-daily by subcutaneous injection. PMID- 3804888 TI - Rifampicin resistance in a strain of Brucella melitensis after treatment with doxycycline and rifampicin. PMID- 3804889 TI - Evolution, ecology and epidemiology of antibiotic resistance. Proceedings, Paul Ehrlich-Gesellschaft fur Chemotherapie and the British Society for Antimicrobial Chemotherapy. Bad Honnef (Bonn), 21-26 March 1986. PMID- 3804890 TI - Do plasmids influence the survival of bacteria? AB - Bacterial plasmids may contribute to the fitness of a particular bacterial clone to survive in a specific environment. In many cases, however, the determinants that confer the advantage are unknown. The advantages to be gained from plasmid carriage appear to outweigh potential disadvantages imposed by an increased metabolic demand. PMID- 3804891 TI - The influence of antibiotics on gut colonization. AB - Animal and human studies have suggested the concept of "colonization resistance" of the gastro-intestinal tract, which can be decreased by administration of antibiotics that inhibit the anaerobic portion of the normal flora of the gut. This effect can be prevented by the production, by resistant members of the flora, of bacterial enzymes that inactivate or destroy the antibiotic in question. Possible changes in the prevailing gut flora and the implications for the incidence of different infecting agents and for antibiotic therapy are discussed. PMID- 3804892 TI - Impact of orally administered antimicrobial agents on human oropharyngeal and colonic microflora. AB - Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin and doxycycline were given orally to 46 subjects for seven days. The numbers of aerobic and anaerobic bacteria in the oropharyngeal and colonic microflora were determined as were the concentrations of antimicrobial agents in saliva and faeces. Clindamycin, erythromycin and doxycycline were detected both in saliva and faeces. Phenoxymethylpenicillin, bacampicillin and doxycycline caused only minor changes in the microflora, while pronounced suppression of anaerobic bacteria was noticed when clindamycin was administered. Erythromycin decreased the aerobic bacteria in the oropharynx and both aerobic and anaerobic bacteria in the colon. New colonizing clostridia, enterobacteria and fungi were found both in the oropharynx and in the colon when erythromycin and clindamycin were administered. PMID- 3804893 TI - Epidemiology and chromosomal location of genes encoding multiresistance in Salmonella dublin. AB - Multiresistant Salmonella dublin strains isolated between 1971 to 1984 were investigated for their genetic and physical properties. It turned out that the multiresistance of the 1971 to 1973 isolates was plasmid-encoded. In the following years, however, the plasmid profiles of the strains were indistinguishable from sensitive isolates and the genes encoding the multiresistance were located on the Salmonella chromosome. PMID- 3804894 TI - The epidemiology of antibiotic resistance in hospitals. AB - Changes in antibiotic susceptibility among different species are a function of the interaction of bacterial genomes (chromosomes, plasmids, transposons) with specific host and environmental factors. Computer-assisted surveillance of resistance patterns and plasmid fingerprinting with restriction endonucleases have facilitated resistance gene tracking. Certain nosocomial plasmids have persisted for many years within specific centres, others are widely distributed by species and location, and others may have a narrow host range or undergo rapid molecular evolution. Klebsiella pneumoniae is most often the index species for the dissemination of nosocomial plasmids, which are frequently multiresistant. Acute increases in antibiotic resistance may be due to antibiotic selection pressures, introduction of new, well-adapted species, over-crowding and other environmental changes. The most resistant organisms are found in units where patients are immunocompromised, are subject to invasive procedures or remain for long periods. Although large-scale studies have not shown uniform increases in the prevalence of resistant bacteria, acute outbreaks in specific niches have resulted in increased patient morbidity, necessitating rapid changes in antibiotic usage. Further molecular epidemiological studies are required in order to understand better how to anticipate the spread of antibiotic resistance. PMID- 3804895 TI - Development of resistance in the past decade in central Europe. AB - In a multicentre study conducted by the Paul-Ehrlich-Gesellschaft we tested about 35,000 bacterial isolates from different hospitals in the Federal Republic of Germany, Berlin (West), Austria and Switzerland between 1975 and 1984. None of the bacterial species under test showed an increase in the number of resistant strains. A slight decrease in the percentage of resistant strains to some antibiotics was observed with Staphylococcus aureus; Klebsiella spp. showed a significant decrease in this respect. Because of this phenomenon and the introduction of new drugs, chemotherapy today is usually safer than ten years ago. However, in some places the amount of resistant strains was significantly different from the overall resistance. In comparison of these data with those from the U.S.A. (Atkinson & Lorian, 1984) no difference in an antibiotic-species pair exceeded 13%. PMID- 3804896 TI - Resistance to antibiotics at medical centres in different parts of the world. AB - The diameters of the zones of inhibition of consecutive clinical isolates around antibiotic susceptibility test discs at medical centres in different parts of the world were computer filed and analysed by a series of programs that evaluate test quality and compare results. Percentages of isolates resistant to ampicillin at 18 centres ranged from 16 to 73 for Escherichia coli and from 3 to 56 for Proteus mirabilis. Percentages resistant to chloramphenicol ranged from 2 to 48 for E. coli, from 5 to 52 for Klebsiella pneumoniae, and from 8 to 67 for Serratia marcescens. Gentamicin resistance did not exceed 4% at any of 18 centres and was less than 1 at 14 of them for isolates of E. coli, while K. pneumoniae showed less than 2% resistance at six centres but averaged 22% at another eight. Multi resistant isolates were ten-fold more frequent at eight centres than at the remaining six. Too few centres were sampled to characterize individual countries except in the United States where resistance seemed generally less prevalent. PMID- 3804897 TI - Resistance as a cause of treatment failure. AB - Clinicians and microbiologists both vary in their views on the usefulness of in vitro antibacterial sensitivity tests, and on the significance of in-vitro resistance. This seems to relate to the fact that conditions in most in-vitro tests are remote from those in the patient, and that at best the designation 'resistant' depends on a pragmatic consensus. Furthermore, results of treatment are difficult to assess in infected patients because of the many variables that affect outcome. Well-designed clinical trials, when they are feasible, and the results of animal experiments, strongly suggest that, when it can be assessed, there is a good correlation between in-vitro and in-vivo results. There is a need to improve the content of clinical reports on the subject sent by microbiologists to clinicians. PMID- 3804898 TI - New observations regarding evolution of trimethoprim resistance. AB - A clinically isolated strain of Escherichia coli, resistant to more than 1000 mg/l of trimethoprim, expressed chromosomal dihydrofolate reductase to a level 200-fold higher than that of drug sensitive E. coli K-12 strains, and this high cellular enzyme activity was found to increase further when the cells were cultured in the presence of trimethoprim. The induced increase in enzyme activity was dependent on the drug concentration. The increase was six-fold at 100 mg/l of trimethoprim. The aberrantly regulated dihydrofolate reductase gene mediating trimethoprim resistance could be transduced into E. coli K-12 or moved by recombination into an F' factor and then transferred into trans position in relation to the corresponding chromosomal gene. In either of these positions, the synthesis of dihydrofolate reductase could be induced to increase by adding trimethoprim to the culture medium. The observed induction was dependent on protein synthesis, since it could be abolished by chloramphenicol. No other folic acid analogue was found to induce increased expression of the dihydrofolate reductase gene. Also thymine starvation had no effect. Two further clinical isolates of E. coli, highly resistant to trimethoprim, were shown to produce drug resistant, plasmid-mediated dihydrofolate reductases, which were distinct from the earlier known enzyme types I and II. PMID- 3804899 TI - Ciprofloxacin: quinolones in practice. Madrid, 30-31 May, 1986. PMID- 3804900 TI - The efficacy and safety of ciprofloxacin in the treatment of chronic Pseudomonas aeruginosa urinary tract infection. AB - The efficacy of ciprofloxacin in the treatment of chronic Pseudomonas aeruginosa urinary tract infection was assessed in 16 patients with functional or anatomical abnormalities of the urinary tract. Depending on renal function the dosage varied from 100 mg once daily to 250 mg twice daily. All patients were treated for 14 days. Bacteriological cure was documented for seven patients (44%) during the 8 week follow-up period. In a further seven patients the urine was sterile during treatment but relapse occurred within four weeks of completing the course. Persistence was noted in two cases, one of which was associated with the development of resistance. No significant adverse reactions were recorded. Chronic P. aeruginosa infection of the abnormal urinary tract can be very difficult to eradicate and ciprofloxacin may offer a valuable alternative to potentially more toxic parenteral agents. PMID- 3804901 TI - Efficacy and safety of ciprofloxacin in patients with respiratory infections in comparison with amoxycillin. AB - Ciprofloxacin and amoxycillin were compared in the treatment of respiratory infections (pneumonia, acute bronchitis, exacerbation of chronic lung disease) in a study of 48 patients randomly assigned to ten days treatment with standard doses of either drug. Forty-eight patients were evaluated, 26 in the ciprofloxacin group and 22 in the amoxycillin group. The response to therapy was judged by clinical and bacteriological criteria. Ciprofloxacin was as effective as amoxycillin with a successful outcome in 81% and 82% of cases respectively. A specific bacterial cause was determined in just over half the cases (28 patients) and eradication rates were higher for ciprofloxacin than for amoxycillin, 87% and 64% respectively. In particular, amoxycillin was unsuccessful in two patients infected with Branhamella catarrhalis. Both regimens were safe and produced little, if any, adverse effect (one possible episode in each treatment group). Ciprofloxacin was found to be as effective in bacterial respiratory tract infections as amoxycillin. PMID- 3804902 TI - Treatment of respiratory tract infections with ciprofloxacin. AB - The efficacy and safety of ciprofloxacin in an oral dose of 750 mg twice daily, in the treatment of respiratory infections was studied in 129 patients. Ciprofloxacin showed broad in-vitro antibacterial activity and was highly effective in both Gram-negative and Gram-positive infections with a clinical cure rate of 96%. The major side effect was an interaction with theophylline particularly in the elderly patients. PMID- 3804904 TI - Ciprofloxacin for soft tissue infections. AB - Twenty-one patients with cellulitis or other bacterial soft-tissue infections were treated with oral ciprofloxacin. One patient developed nausea and vomiting and was withdrawn from the study, but 19 of the other 20 were clinically cured or improved. Only nine of the original 18 bacterial isolates were completely eradicated, however, the majority of the failures being staphylococci or streptococci. There was no evidence from disc sensitivity testing of resistance developing during treatment. No serious toxicity was seen. PMID- 3804903 TI - Treatment of skin and soft tissue infections with oral ciprofloxacin. AB - Thirty adult patients with severe skin and soft tissue infections (four with contiguous osteomyelitis) caused by a variety of bacterial pathogens were treated with oral ciprofloxacin. Favourable clinical responses were observed in 23 (92%) of the 25 evaluable cases. All Enterobacteriaceae and anaerobic bacteria were eradicated during treatment. Enterococci, Staphylococcus aureus, and Pseudomonas aeruginosa were usually eradicated but occasional strains persisted during treatment. Strains that persisted during treatment were associated with therapeutic failure in two cases, one with contiguous osteomyelitis and one with vascular gangrene. The only significant adverse reaction observed was nausea and/or vomiting in five of the 30 patients. PMID- 3804905 TI - Intravenous ciprofloxacin in the treatment of infection in immunocompromised patients. AB - We initially used ciprofloxacin to treat immunocompromised patients whose fever had failed to respond or had recurred in spite of multiple broad-spectrum antibiotics. Results in this group encouraged us to proceed with a randomized trial of ciprofloxacin plus benzylpenicillin versus our standard empirical regimen of netilmicin and piperacillin for the treatment of fever in immunocompromised patients. Although the numbers of patients in this study are at present too small for comparison to be made, the favourable results seen in the refractory treatment group appear to be borne out so far in those receiving ciprofloxacin as first-line therapy. PMID- 3804906 TI - Oral ciprofloxacin therapy of infection caused by multiply resistant bacteria other than Pseudomonas aeruginosa. AB - Of 125 patients treated with ciprofloxacin at the Columbia-Presbyterian Medical Center, New York, 34 had infections due to bacteria other than Pseudomonas aeruginosa. The mean age of the patients was 50 years (19-88 years) and most had significant underlying disease. There were nine lower respiratory infections, eight urinary tract infections, eight soft tissue infections, three osteomyelitis, and three intra-abdominal infections. The pathogens were: Escherichia coli, 7 (mean MIC 0.07 mg/l); Serratia marcescens, 6 (0.2 mg/l); Enterobacter spp., 5 (0.1 mg/l); Klebsiella pneumoniae, 3 (0.1 mg/l); Proteus mirabilis, 3 (0.06 mg/l); Cutrobacter freundii, 2 (0.06 mg/l), Staphylococcus aureus, 3 (0.5 mg/l); and one each of Acinetobacter anitratus. Haemophilus, influenzae, Salmonella enteritidis, Flavobacterium meningosepticum, and Streptococcus faecalis. Of these organisms 81% were resistant to ampicillin, 70% to carbenicillin, 22% to gentamicin, 49% to cefazolin and cephalexin, and 25% to cotrimoxazole. Ten patients had concomitant Ps. aeruginosa infections. Patients were treated orally with 500 mg or 750 mg ciprofloxacin every 12 h. The overall clinical response rate was 88%, and the bacteriological response 76%, and 65% if Ps. aeruginosa is included. Resistance to ciprofloxacin developed in one Staph. aureus and one Ser. marcescens (MIC greater than 2 mg/l). Toxicity was minor. Ciprofloxacin was effective and safe therapy of infections due to Gram-negative bacteria resistant to many of the currently available oral and parenteral agents. PMID- 3804907 TI - Pharmacokinetics of ciprofloxacin in healthy volunteers and patients with impaired kidney function. AB - The pharmacokinetics of ciprofloxacin were studied, in six healthy controls and in 18 patients with varying degrees of renal impairment, after administration of a single 100 mg intravenous dose. Pharmacokinetic parameters were calculated on a two compartment open model. The mean distribution volume was 2.1 (+/- 0.6) l/kg of ideal body weight; it did not correlate significantly with renal function. In the healthy volunteers 57 (+/- 9)% of the drug was eliminated by the kidney and 43% by other pathways. The renal clearance of ciprofloxacin correlated with creatinine clearance (rs = 0.93, P less than 0.001), and urinary excretion of the drug was markedly reduced in patients with the most severe degrees of renal impairment. Plasma clearance correlated with creatinine clearance (rs = 0.50, P less than 0.02). This together with the lack of correlation between non-renal clearance and renal function enables us to suggest an intravenous dosage schedule for patients with renal impairment. PMID- 3804908 TI - Prolonged exposure of mice to He-O2 at high pressure: effects on seizure and anesthesia liability. AB - Multiday exposures of CD-1 mice to He-O2 atmospheres at pressures from 30 to 100 atm result in marked increases of threshold pressures for type I high-pressure neurological syndrome seizures. The effect develops with a half time (t1/2) of 12 h and is reversible (t1/2 = 7 h). The maximum enhancement of Pc is attained at a conditioning pressure of 80 ATA. Pressure conditioning also results in suppression of the compression rate effect on Pc. Furthermore, reserpine blocks the increase in Pc during prolonged pressure exposure. The entire effect thus appears to be an extension in time of the monoaminergic compression rate effect on Pc. Pressure conditioning does not modify anesthesia tolerance, unlike N2 habituation which affects anesthesia threshold pressure as well as Pc. The results are compared with the effects of habituation to inert-gas narcotics and the implications of the data for an understanding of inert-gas high-pressure antagonism in intact animals are discussed. PMID- 3804909 TI - Effect of methylene blue on cardiac output response to exercise in dogs. AB - To determine whether the increase in cardiac output during mild to moderate exercise is related to an increase in the tissue redox potential, we compared the responses of cardiac output, total body oxygen consumption, and arterial blood lactate-to-pyruvate ratio (a measure of NADH/NAD) to treadmill exercise between dogs treated with normal saline and those treated with a hydrogen acceptor, new methylene blue. Normal saline was infused into the left atrium in the first group of dogs at a rate of 0.38 ml/min throughout the treadmill exercise (2.5 mph and 5.0 mph on a 6% incline, each for 20 min). In the second group, methylene blue was administered as a loading dose (4 mg/kg) before exercise, followed by a continuous infusion (0.15 mg X kg-1 X min-1) throughout exercise. A similar infusion of methylene blue was given to a third group of dogs without exercise; it reduced the arterial lactate-to-pyruvate ratio from 6.70 +/- 0.35 to 4.12 +/- 0.27 but had no or little effects on cardiac output, heart rate, arterial pressure, and left ventricular dP/dt and (dP/dt)/P. Treadmill exercise doubled cardiac output and increased total body O2 consumption three- to fourfold in the first two groups but increased arterial blood lactate-to-pyruvate ratio only in group 1 (6.0 +/- 0.54 to 9.97 +/- 0.91). The relationship between cardiac output and total body O2 consumption was unaffected by the simultaneous administration of methylene blue during exercise. Groups 1 and 2 also did not differ in their heart rate, left ventricular dP/dt and (dP/dt)/P, and plasma catecholamine responses to exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804910 TI - Fetal and uteroplacental heat production in sheep. AB - To separate heat production of the fetus from that of the placenta, endometrium, and uterine muscle, we measured total uterine heat production first with the fetus intact and then after the umbilical cord was snared and the fetus killed. Heat production was measured with the Fick principle using thermistors chronically implanted in a maternal artery and major uterine vein and a flowmeter placed on the common internal iliac artery. In nine ewes, carrying lambs weighing 4.46 +/- 0.42 (SE) kg, total uterine heat production fell from 10.6 to 2.9 W after fetal death. Uterine blood flow fell progressively to 90% of control levels during the first hour after death. The caloric equivalent for O2 averaged 4.1 cal/ml O2 for the uterus, 2.2 for the uteroplacenta, and 4.6 for the fetus per se. It was not possible to explain these results using a simple model of maternal fetal heat transfer. Rather, it was necessary to assume an additional pathway for heat transfer between small uterine veins on the surface of the uterus and cooler structures in the maternal abdomen, presumably the ventral abdominal wall. PMID- 3804911 TI - Cat lung hemodynamics: comparison of experimental results and model predictions. AB - Commonly, attempts have been made to learn about the structure and function of the pulmonary vascular bed from measurements of arterial and venous pressures and blood flow rate under steady-state conditions (e.g., from pressure vs. flow data) or dynamic conditions (e.g., from vascular occlusion data). Zhuang et al. (J. Appl. Physiol. 55: 1341-1348, 1983) have presented a detailed model of steady state cat lung hemodynamics based on direct measurements of anatomical and elasticity data. This model provides an opportunity to better understand the information content of the hemodynamic data. Therefore, in the present study we carried out a series of steady-state and dynamic experiments on isolated cat lungs. We then compared the results with those predicted by the model. We found that the model provided a good fit to the steady-state data. However, to fit the dynamic data, some modifications were necessary to account for the viscous behavior of the vessel walls and to move the first moment of the distribution of vascular resistance toward the arterial end of the vascular bed relative to that of the distribution of vascular compliance. Due to the sensitivity of the vascular resistance to small changes in vessel diameters and branching ratio, the modifications in morphometry represent small changes in morphometric data and are probably within the range of uncertainty in such data. The modifications had little effect on the steady-state model simulations but substantially improved the dynamic model simulations, suggesting that the dynamic data are quite sensitive to small changes in the relative distributions of vessel diameters and elasticity. PMID- 3804912 TI - Transendothelial albumin flux: evidence against asymmetric transport. AB - We examined the recent proposition (Circ. Res. 57: 903-905, 1985) that the interstitium-to-luminal transport of albumin is an active phenomenon. Studies were made using cultured bovine and sheep pulmonary-artery endothelial cells. The transendothelial 125I-albumin flux from the luminal-to-abluminal side was compared with the flux from the abluminal-to-luminal side. The endothelial cells were grown to confluence on gelatinized-polycarbonated filters separating the abluminal from the luminal compartments. The albumin concentration in each compartment was 1 g/100 ml to equalize the oncotic pressure gradients. The effect of hydrostatic pressure was eliminated by maintaining equal fluid levels in both compartments. The transendothelial albumin flux across the monolayer was measured by adding the 125I-albumin tracer either on the luminal or the abluminal side. A double-isotope method was also used to study bidirectional transendothelial flux of albumin at the same time for the same cultured endothelium. The results indicated that albumin flux from the luminal-to-abluminal side was equal to the flux from the abluminal-to-luminal side. Both bovine and sheep pulmonary artery endothelial cells in culture behave symmetrically for albumin, suggesting that albumin is not actively transported from the interstitium to the lumen. PMID- 3804913 TI - Synthesis of phosphatidylcholine by rat lung during choline deficiency. AB - The effect of choline deficiency on the de novo pathway for phosphatidylcholine (PC) synthesis in the lung was investigated in rats fed a washed soy protein (lipotrophic) diet deficient in choline and methionine for 2-3 wk. Lungs from lipotrophic rats showed a decreased content of choline and choline-phosphate (P less than 0.05) compared with control but no change in content of cytidine 5' diphosphocholine or PC. Isolated perfused lungs from lipotrophic rats were evaluated for choline and fatty acid utilization for PC synthesis. Lipotrophic lungs perfused with 5 microM [14C-methyl]-choline chloride showed increased incorporation into PC while there was no significant effect at saturating levels of choline (100 microM). There was increased incorporation of [1-14C]-palmitic acid into PC and diglyceride and increased incorporation of D-[U-14C]glucose into fatty acids of PC. Increased choline and glucose incorporation was not due to alteration of intracellular specific activity of these substrates. This study indicates the utilization of choline and fatty acid for PC synthesis is stimulated as a result of choline deficiency while lung CDP-choline concentration is maintained, possibly through regulation of choline phosphate cytidyl transferase activity. These mechanisms compensate for decreased choline availability to maintain the PC content of lungs. PMID- 3804914 TI - Effect of pressure on [3H]GABA release by synaptosomes isolated from cerebral cortex. AB - High hydrostatic pressure has been shown to produce neurological changes in humans which manifest, in part, as tremor, myoclonic jerks, electroencephalographic changes, and convulsions. This clinical pattern has been termed high-pressure nervous syndrome (HPNS). These symptoms may represent an alteration in synaptic transmission in the central nervous system with the inhibitory neural pathways being affected in particular. Since gamma-aminobutyric acid (GABA) transmission has been implicated in other seizure disorders, it was of interest to study GABAergic function at high pressure. Isolated synaptosomes were used to follow GABA release at 67.7 ATA of pressure. The major observation was a 33% depression in total [3H]GABA efflux from depolarized cerebrocortical synaptosomes at 67.7 ATA. The Ca2+-dependent component of release was found to be completely blocked during the 1st min of [3H]GABA efflux with a slow rise over the subsequent 3 min. These findings lead us to conclude that high pressure interferes with the intraterminal cascade for Ca2+-dependent release of GABA. PMID- 3804915 TI - Effect of age on lung mechanics and airway reactivity in lambs. AB - We studied airway reactivity (AR) to aerosolized histamine, carbachol, and citric acid in lambs 1 mo of age to adulthood. Awake lambs were intubated and studied in a plethysmograph that measured dynamic compliance (Cdyn), resistance of the lung (RL), and functional residual capacity (FRC). Pleural pressure was measured using a Silastic balloon in the pleural space, and airway opening pressure (Pao) was measured using a catheter placed 1-2 cm distal to the nasotracheal tube. At the ages of 1, 3, 5, and 7 mo and adulthood, measurements of Cdyn, RL, and FRC were obtained in 46 sheep (22 males, 24 females). AR to carbachol, histamine, and citric acid was measured in each sheep in randomized order on three separate days by giving increasing concentrations of the drug in a noncumulative fashion. The dose that would have caused a 35% reduction in Cdyn (ED65Cdyn), a doubling of RL (ED200RL), or a 50% increase in FRC (ED150FRC) was calculated. In both males and females, base-line Cdyn increased (r = 0.81, P less than 0.01) with age, as did FRC (r = 0.87, P less than 0.01). There was no significant change in RL in either sex with age or in the group as a whole. There was a significant increase in AR to both histamine and carbachol with increasing age as measured by a decrease in ED65Cdyn (P less than 0.01 and P less than 0.05, respectively) with age. There was no significant change in AR with age as measured by RL or FRC for any of the three bronchoconstrictors tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804916 TI - Late pulmonary responses induced by Ascaris allergen in conscious squirrel monkeys. AB - This study presents an antigen-dependent model of biphasic pulmonary changes to Ascaris suum in conscious squirrel monkeys. Animals with strong positive skin reactivity towards A. suum were trained to sit quietly in chairs and to breathe through face masks. Dynamic compliance (Cdyn) and pulmonary resistance (RL) were measured in these conscious animals before and for a period of 11 h after administration of an aerosol of Ascaris or ragweed antigen. The aerosol of Ascaris antigen induced reproducible increases (42%) in RL (P less than 0.001) and decreases (17%) in Cdyn (P less than 0.01) that peaked respectively 5 and 35 min after antigen challenge and lasted 60-90 min. After recovery, a second bronchoconstriction began between 2 and 8 h and peaked between 4 and 10 h after antigen challenge. Decreases in Cdyn (41%) were significantly greater (P less than 0.003) whereas mean increases in RL (44%) were similar during the late phase as compared with the first phase. The mean Cdyn decreases lasted a minimum of 2 h, whereas RL increases lasted less than 60 min. The time course of the responses varied from animal to animal but changes in individual animals were reproducible over a period of 6 mo. No significant correlation was observed between the cutaneous and the pulmonary responses to Ascaris and the late response was not reversed by aerosol administration of salbutamol (1.0 mg/ml). As a negative control animals were exposed to an aerosol of ragweed extract after which no immediate or late pulmonary response were observed. The results suggest that this primate model may be useful to study the pathophysiology of asthma in humans. PMID- 3804917 TI - Control of breathing in anesthetized dogs by a left-heart baroreflex. AB - Anesthetized open-chest dogs on cardiopulmonary bypass were used to test the hypothesis that breathing reflexly responds to distension of the left-heart chambers. Bypass perfusion withdrew systemic flow from the right atrium and returned it to the aorta after gas exchange. Ventricles were fibrillated. The left heart was isolated by tying all pulmonary veins, and it was perfused separately at low flow admitted through one pulmonary vein and withdrawn from the ventricle. Left-heart pressure was intermittently raised abruptly from a nominal base line of 0 by partial occlusion of outflow. Pressures from approximately 10 to 50 cmH2O caused proportional increases in breathing frequency and decreases in expiratory and inspiratory times. Changes occurred immediately, reached a plateau within approximately 20 s, and were sustained for periods of observation as long as 3 min. Recovery to base line followed stimulus removal. Vagal cooling to 8 degrees C prevented responses, but autonomic ganglion blockade with hexamethonium had no effect. I conclude that breathing may be stimulated by left-heart distension and that this is mediated by large myelinated vagal afferents. PMID- 3804918 TI - Effect of breath holding on ventilation maldistribution during tidal breathing in normal subjects. AB - To test the hypothesis that during the course of a multiple-breath N2 washout (MBNW) diffusion-dependent ventilation maldistribution is more apparent in the early breaths, whereas convection-dependent maldistribution predominates in the later breaths, we performed MBNW with 0-, 1-, and 4-s end-inspiratory breath holds (BH0, BH1, BH4, respectively) in five normal subjects. Each subject breathed with a constant tidal volume of 1 liter, at 10-12 breaths/min and at constant flow rates. For each breath we computed the slope of the alveolar plateau normalized by the mean expired N2 concentration (Sn), the Bohr dead space (VDB), and an index analogous to the Fowler dead space (V50). In all five subjects, Sn, VDB, and V50 decreased with breath holding, indicating diffusion dependence of these indexes. Over the first five breaths the rate of increase of Sn as a function of cumulative expired volume (delta Sn/delta sigma VE) decreased by 29 and 54% during BH1 and BH4, respectively, compared with BH0. In contrast, from breath 5 to the end of the washout there was no significant change in delta Sn/delta sigma VE during BH1 and BH4 compared with BH0. Our results provide further experimental support for the hypothesis that the increase of Sn as a function of cumulative expired volume after the fifth breath constitutes a diffusion-independent index of ventilation inhomogeneity. It therefore reflects alveolar gas inequalities among larger units.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804919 TI - Effects of indomethacin on estradiol-induced attenuation of hypoxic vasoconstriction in lamb lungs. AB - To determine whether cyclooxygenase products mediated the attenuation of hypoxic pulmonary vasoconstriction induced by estradiol, we measured pulmonary arterial pressure at a flow of 50 ml X min-1 X kg-1 (Ppa50) during steady-state exposures to inspired O2 tensions (PIO2) between 0 and 200 Torr in isolated lungs of juvenile ewes. Intramuscular estradiol (10 mg) 44-60 h before study significantly decreased perfusate concentrations of 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha), the stable metabolite of the pulmonary vasodilator, prostacyclin, but did not significantly affect the stimulus-response relationship between PIO2 and Ppa50. Estradiol (20 mg) 3-5 days before study increased 6-keto-PGF1 alpha concentrations and decreased Ppa50 at PIO2 of 10, 30, and 50 Torr. Indomethacin added to the perfusate of these lungs reduced 6-keto-PGF1 alpha to undetectable levels and altered the estradiol-induced attenuation, increasing Ppa50 at PIO2 of 10 and 30 Torr, but decreasing Ppa50 at PIO2 of 200 Torr. Despite these effects, Ppa50 remained lower than the values measured in lungs not treated with estradiol. These results suggest that the estradiol-induced attenuation of the hypoxic stimulus-response relationship was mediated only in part by cyclooxygenase products, the net effects of which were vasodilation at PIO2 of 10 and 30 Torr, but vasoconstriction at PIO2 of 200 Torr. PMID- 3804920 TI - Effects of prolonged simultaneous exposure of CD-1 mice to high pressures and inert gas narcosis. AB - Addition of N2 to the heliox used in pressure conditioning exposures reduces or suppresses the increase in convulsion threshold pressure (Pc) as well as the change in compression rate effect resulting from pressure exposures in the absence of N2; 18 atm N2 neutralizes the effect of 80 ATA total pressure so that Pc remains at a constant level throughout the conditioning period. Since N2 habituation is much slower than pressure conditioning (t1/2 6 days vs. 12 h), this precludes mere addition of pressure and N2 effects in this situation. In contrast to Pc, anesthesia tolerance of mice exposed to 80 ATA in the presence of 18 atm N2 increases even more (25%) than at the same PN2 but at a total pressure of only 18 ATA, indicating that pressure reversal of anesthesia does not extend to the habituation events. The implications of the striking asymmetry between the effects of protracted high pressure and inert gas narcotic exposures for an understanding of the nature of the supposed IG/HP antagonism are discussed. PMID- 3804921 TI - Upper airway dilating forces during wakefulness and sleep in dogs. AB - We measured the pressure within an isolated segment of the upper airway in three dogs during wakefulness (W), slow-wave sleep (SWS) and rapid-eye-movement (REM) sleep. Measurements were taken from a segment of the upper airway between the nares and midtrachea while the dog breathed through a tracheostoma. These pressure changes represented the sum of respiratory-related forces generated by all muscles of the upper airway. The mean base-line level of upper airway pressure (Pua) was -0.5 +/- 0.03 cmH2O during W, increased by a mean of 2.1 +/- 0.2 cmH2O during SWS, and was variable during REM sleep. The mean inspiratory related phasic change in Pua was -1.2 +/- 0.1 cmH2O during wakefulness. During SWS, this phasic change in Pua decreased significantly to a mean of -0.9 +/- 0.1 cmH2O (P less than 0.05). During REM sleep, the phasic activity was extremely variable with periods in which there were no fluctuations in Pua and others with high swings in Pua. These data indicate that in dogs the sum of forces which dilate the upper airway during W decreases during SWS and REM sleep. The consistent coupling between inspiratory drive and upper airway dilatation during wakefulness persists in SWS, but is frequently uncoupled during REM sleep. PMID- 3804922 TI - Permeability of barriers to albumin flux in lungs of sheep resuscitated from hemorrhagic shock. AB - We assessed pulmonary endothelial and epithelial permeability and lung lymph flow in nine adult sheep under base-line conditions and after resuscitation from profound hemorrhagic shock. Animals were mechanically ventilated and maintained on 1% halothane anesthesia while aortic pressure was held at 40 Torr for 3 h. Systemic heparin was not used. After reinfusion of shed blood, sheep recovered from anesthesia and we measured lung lymph flow (QL), lymph-to-plasma concentration ratio for proteins, and time taken to reach half-equilibrium concentration of intravenous tracer albumin in lymph (t1/2). Twenty-four hours after bolus injection of radio-albumin we lavaged subsegments of the right upper lobe and determined fractional equilibration of the tracer in the alveolar luminal-lining layer. In each sheep we had measured these parameters 7 days earlier under base-line conditions. Animals were killed, and the lungs were used for gravimetric determination of extravascular lung water (gravimetric extravascular lung water-to-dry weight ratio) 24 h after resuscitation from shock. Pulmonary endothelial injury after resuscitation was evidenced by marked increase in QL, without fall in lymph-to-plasma ratio. Time taken to reach half equilibrium concentration fell from 169 +/- 47 (SD) min in base-line studies to 53 +/- 33 min after shock. There was no evidence of lung epithelial injury. Gravimetric extravascular lung water-to-dry weight ratio was significantly increased in these animals killed 24 h after resuscitation (4.94 +/- 0.29) compared with values in our laboratory controls (4.13 +/- 0.09, mean +/- SD). These data demonstrate a loss of lung endothelial integrity in sheep after resuscitation from profound hemorrhagic shock. PMID- 3804923 TI - Intersubject variability in cardiac output-O2 uptake relation of men during exercise. AB - Intersubject variability in the relation between cardiac output (Q) and O2 uptake (VO2) was examined during supine cycling up to the maximum level in 40 normal untrained men age 27 +/- 4 (SD) yr. In individual subjects, Q increased linearly against VO2 in the submaximum exercise range. The SD of Q on VO2 was so small (0.47 +/- 0.25 l/min) that Q could be given by a linear function of VO2 as Q = K(VO2 - VO2 r) + Qr, where K, VO2 r, and Qr are the slope of the regression line, the resting VO2, and resting Q, respectively. K varied widely among the subjects studied, ranging from 5.5 to 10.3 and was independent of both physical characteristics and Qr, which ranged from 3.7 to 8.3 l/min. However, K correlated significantly with changes in heart rate, stroke volume, mean arterial pressure, and systemic vascular conductance. From these results, we concluded that the intersubject variability in the Q-VO2 relation was caused independently by individual variations in resting hemodynamics and in cardiovascular response to exercise. PMID- 3804924 TI - Muscle soreness and intramuscular fluid pressure: comparison between eccentric and concentric load. AB - This study investigates the dynamic and resting intramuscular pressures associated with eccentric and concentric exercise of muscles in a low-compliance compartment. The left and righ leg anterior compartments of eight healthy males (ages 22-32 yr) were exercised by either concentric or eccentric contractions of the same load (400 submaximal contractions at constant rate, 20/min for 20 min at a load corresponding to 15% of individual maximal dorsiflexion torque). Tissue fluid pressures were measured with the slit-catheter technique before, during, and after the exercise. Average peak intramuscular pressure generated during eccentric exercise (236 mmHg) was significantly greater than during concentric exercise (157 mmHg, P less than 0.001). Peak isometric contraction pressure in the eccentrically exercised compartment was significantly higher both within 20 min postexercise and on the second postexercise day (P less than 0.001). Resting pressure 2 days postexercise was significantly higher on the eccentrically exercised side (10.5 mmHg) compared with the concentrically exercised (4.4 mmHg, P less than 0.05). The ability to sustain tension during postexercise isometric contractions was impaired on the "eccentric" side. Soreness was exclusively experienced in the eccentrically exercised muscles. We conclude that eccentric exercise causes significant intramuscular pressure elevation in the anterior compartment, not seen following concentric exercise, and that this may be one of the factors associated with development of delayed muscle soreness in a tight compartment. PMID- 3804925 TI - Relationship between tracheal mucosal thickness and vascular resistance in dogs. AB - We have measured changes in tracheal mucosal thickness and tracheal vascular resistance in the dog. A probe was used to detect changes in height with time of the tracheal epithelium relative to an underlying cartilage. Tracheal vascular resistance was determined by perfusing a cranial tracheal artery at constant flow and measuring inflow pressure. Various drugs injected close-arterially were tested in 20 greyhounds anesthetized with pentobarbital sodium. Bradykinin, histamine, and methacholine significantly (P less than 0.01) decreased vascular resistance (-39.3 +/- 3.7, -47.3 +/- 4.2, and -22.5 +/- 5.2%, respectively) and increased the thickness of the mucosa (119.0 +/- 25.0, 61.9 +/- 25.0, and 46.3 +/ 6.4 micron). Substance P, vasoactive intestinal peptide, prostaglandin F2 alpha, and prostaglandin E, had large vasodilator actions (-31.4 +/- 5.0, -34.3 +/- 2.2, -21.9 +/- 2.8, and -31.5 +/- 2.4%) but only small effects on mucosal thickness (12.3 +/- 3.9, 13.0 +/- 3.4, 16.7 +/- 6.5, and 8.7 +/- 2.9 micron, respectively). Phenylephrine hydrochloride increased vascular resistance (19.8 +/- 1.7%) and decreased mucosal thickness (-23.9 +/- 3.1 micron). Thus airway vascular resistance and mucosal thickness always change in opposite directions, but drugs have different relative actions on the two variables. Even with large vasodilatations, the absolute changes in mucosal thickness were small and were unlikely to have an appreciable effect on tracheal airway resistance. PMID- 3804926 TI - Microvascular pressures measured by micropuncture in isolated perfused lamb lungs. AB - To investigate the influence of vasomotor tone and vessel compliance on pulmonary segmental vascular resistance, we determined the longitudinal distribution of vascular pressures in 15 isolated blood perfused lungs of newborn lambs. We measured pulmonary arterial and left atrial pressures and by micropuncture the pressures in 20- to 80-micron-diam subpleural arterioles and venules, both before and after paralyzing the vasculature with papaverine hydrochloride. In five lungs we also determined the microvascular pressure profile during reverse perfusion. In lungs with baseline vasomotor tone, approximately 32% of the total pressure drop was in arteries, approximately 32% in microvessels, and approximately 36% in veins. With elimination of vasomotor tone, arterial and venous resistances decreased to one-fifth and one-half of base-line values, respectively, indicating that vasomotor tone contributed mainly toward arterial resistance. During reverse perfusion, the pressure drop in veins was similar to that in arteries during forward perfusion, suggesting that the compliance of arteries and veins is comparable. We conclude that vascular tone and compliance are important factors that determine the distribution of segmental vascular resistance in lungs of the newborn. PMID- 3804927 TI - Platelet-activating factor increases lung vascular permeability to protein. AB - We studied the effects of platelet-activating factor (PAF) on pulmonary hemodynamics and microvascular permeability in unanesthetized sheep prepared with lung-lymph fistulas. Since cyclooxygenase metabolites have been implicated in mediating these responses, we also examined the role of the cyclooxygenase pathway. PAF infusion (4 micrograms X kg-1 X h-1 for 3 h) produced a rapid, transient rise in pulmonary arterial pressure (Ppa), pulmonary vascular resistance (PVR), plasma thromboxane B2 concentration (TxB2), and pulmonary lymph flow (Qlym). The lymph-to-plasma protein concentration ratio (L/P) did not change from base line. Pretreatment with the cyclooxygenase inhibitor, sodium meclofenamate, prevented the generation of TxB2 and the hemodynamic changes but did not prevent the increase in Qlym. The estimated protein reflection coefficient decreased from a control value of 0.66 +/- 0.04 to 0.43 +/- 0.06 after PAF infusion. We also studied the effects of PAF on endothelial permeability in vitro by measuring the flux of 125I-albumin across cultured bovine pulmonary artery endothelial cells (EC) grown to confluency on a gelatinized micropore filter and mounted within a modified Boyden chemotaxis chamber. PAF (10(-8) to 10(-4) M) had no direct effect on EC albumin permeability, suggesting that the increase in permeability in sheep was not the direct lytic effect of PAF. In conclusion, PAF produces pulmonary vasoconstriction mediated by cyclooxygenase metabolites. PAF also increases pulmonary vascular permeability to protein that is independent of cyclooxygenase products and is not the result of a direct effect of PAF on the endothelium. PMID- 3804928 TI - Leukocytosis of exercise: role of cardiac output and catecholamines. AB - The effect of propranolol (5 mg iv) on the leukocytosis of exercise was studied in seven normal young males. Leukocyte counts, plasma norepinephrine (NE), epinephrine (E), and cardiac output were measured at rest and in the steady state of several submaximal work loads when subjects exercised on a cycle ergometer. The results in control experiments were compared with those obtained on a different day with propranolol. Propranolol decreased heart rate at all work loads (P less than 0.001) but had no effect on the increase in cardiac output at increasing work loads. Plasma NE and E levels were similar at rest and in exercise in control and propranolol studies. There was no effect of propranolol on the increase in leukocyte counts with increasing work loads. Although propranolol did not affect the increase in total leukocyte count, the increase in lymphocyte count at higher work loads was less with propranolol. We conclude that the demargination of leukocytes from the pulmonary circulation in exercise is probably a mechanical effect of the increase in cardiac output. However, we have not excluded a contribution from a humoral event that would decrease the adherence of leukocytes to endothelium during exercise. The smaller increase in lymphocytes at higher work loads in the presence of propranolol suggests that catecholamines affect the lymphocyte count over and above their effect on cardiac output. PMID- 3804929 TI - Changes in flow-volume curve configuration with bronchoconstriction and bronchodilation. AB - Changes in the configuration of maximum expiratory flow-volume (MEFV) curves following mild degrees of bronchodilation or bronchoconstriction were studied in five normal and five asthmatic subjects. In a volume-displacement plethysmograph, MEFV curves were performed before and after inhalation of aerosolized isoproterenol (I) or histamine (H). Five filtered MEFV curves were averaged, and slope ratio vs. volume (SR-V) plots were obtained from averaged curves. Following I, maximal flows at 75% of the vital capacity (VC) were decreased in asthmatics but not in normal subjects. Flows at 50 and 25% of the VC increased in normal subjects and asthmatics, whereas VC's were unchanged. In asthmatics, sudden large decreases in flow (bumps) occurred at lower lung volumes following I. H reduced flows over the entire VC, with greater reductions occurring in asthmatics than in normals, particularly at low lung volumes. In asthmatics, VC was slightly reduced, and bumps in MEFV curve configuration occurred at higher lung volumes or were abolished entirely following H. A reduction in the amount of configurational detail appreciable in MEFV curves following histamine in asthmatics was best seen in SR-V plots. Following H, SR's decreased regularly with decreasing lung volume in all the asthmatics but in none of the normals. This was the single most striking finding of this study. Mild I- and H-induced perturbations of airway bronchomotor tone produced small but consistent changes in MEFV curve configuration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3804930 TI - Finite difference analysis of respiratory heat transfer. AB - A numerical computer model of heat and water transfer within the tracheobronchial tree of humans was developed based on an integral formulation of the first law of thermodynamics. Simulation results were compared with directly measured intraluminal airway temperature profiles previously obtained in normal human subjects, and a good correlation was demonstrated. The model was used to study aspects of regional pulmonary heat transfer and to predict the outcomes of experiments not yet performed. The results of these simulations show that a decrease in inspired air temperature and water content at fixed minute ventilation produces a proportionately larger increase in heat loss from extrathoracic airways relative to intrathoracic, whereas an increase in minute ventilation at fixed inspired air conditions produces the opposite pattern, with cold dry air penetrating further into the lung, and that changes in breathing pattern (tidal volume and frequency) at fixed minute ventilation and fixed inspiratory-to-expiratory (I/E) ratio do not affect local air temperature profiles and heat loss, whereas changes in I/E ratio at fixed minute ventilation do cause a significant change. PMID- 3804931 TI - Decline in lung liquid volume before labor in fetal lambs. AB - The volume of liquid in the fetal lung depends on the amount of liquid secreted across the pulmonary epithelium and the amount flowing through the trachea. Lung liquid volume (V1) and secretion rate Vs) were determined using an indicator dilution technique, while tracheal flow rate (Vtr) was measured simultaneously with a bubble flowmeter. Least-squares regression analysis showed that in 10 chronically instrumented fetal lambs, V1 increased from 51.0 ml at 119 days to 104.6 ml at 135 days (V1 = -347.65 + 3.35 X days; 95% confidence limits on slope: 1.89-4.81) before declining to 70.2 ml at 142 days gestation (V1 = 768.8 - 4.92 X days; 95% confidence limits on slope: -2.55 to -7.30). Similarly Vs increased from 7.4 ml/h at 119 days to 16.8 ml/h at 133 days (Vs = -72.35 + 0.67 X days; 95% confidence limits on slope: 0.21-1.14), before declining to 7.1 ml/h at 142 days (Vs = 159.07 - 1.07 X days; 95% confidence limits on slope: -0.56 to -1.57). Vtr did not change significantly with gestation. We conclude that V1 increases until 135 days gestation, after which it falls substantially. This fall in volume, which occurs well before the onset of labor, results predominantly from the decline in Vs. PMID- 3804932 TI - Chronic push-pull brain perfusion in unrestrained rhesus macaques. AB - A system was developed to permit perfusion of local brain regions and simultaneous peripheral blood sampling in free-moving caged monkeys. The system comprises a calvarial headpiece that contains multiple push-pull cannulas (PPC), a flexible stainless steel tether, a four-channel fluid swivel, and a surgical procedure for simultaneous multisite brain cannulation. Rhesus macaques were fitted surgically with an indwelling jugular catheter and PPC directed into the third ventricle, median eminence, and preoptic area. These animals were tethered for periods of 14-70 h during which brain perfusates and peripheral blood samples were collected at 10- to 30-min intervals through the tether-swivel assembly. Levels and pulsatile patterns of gonadotropin-releasing hormone in 10-min perfusate samples and luteinizing hormone and cortisol in sequential plasma samples were quantified by specific radioimmunoassays. The normal endocrine profiles in these animals suggest that this system provides a valuable method to study patterns of neurosecretions in an unrestrained simian. PMID- 3804933 TI - Complexity of lactate kinetics. PMID- 3804934 TI - Occupational stress: its causes and consequences for job performance. PMID- 3804935 TI - Toward an understanding of the burnout phenomenon. PMID- 3804936 TI - Biochemical markers of contraction in human myometrial smooth muscle cells in culture. AB - Phosphorylation of a light chain subunit of myosin by Ca2+ and calmodulin dependent myosin light chain kinase is believed to be essential for smooth muscle contraction. The biochemical properties of the myosin phosphorylation system in human myometrial smooth muscle cells in monolayer culture were compared with those of human myometrial tissue and nonmuscle cells in culture. Native myosin was isolated from other cellular proteins of crude homogenates by polyacrylamide gel electrophoresis (in the presence of pyrophosphate) and quantified by densitometry. The myosin content of myometrial smooth muscle cells in culture and that of myometrial tissue were similar and four- to five-fold greater than that of human endometrial stromal cells or skin fibroblasts in culture. The specific activities of myosin light chain kinase in homogenates of myometrial smooth muscle cells that were maintained in culture and in myometrial tissue were similar (2.05 +/- 0.18 and 1.60 +/- 0.37 nmol phosphate incorporated per min per mg protein, respectively). On the other hand, enzyme activity in skin fibroblasts was only 5% of that in myometrial smooth muscle cells. Myosin light chain kinase activity in myometrial smooth muscle cells was dependent upon Ca2+ and was inhibited reversibly by the calmodulin antagonist, calmidazolium. The intracellular Ca2+ concentration measured by quin2 fluorescence was 0.12 microM in resting cells and increased in a concentration-dependent manner with KCl to a maximal value of 0.47 microM. These results indicate that biochemical processes important for smooth muscle contraction are retained in human myometrial smooth muscle cells in culture. PMID- 3804937 TI - In vitro growth and differentiation of human kidney tubular cells on a basement membrane substrate. AB - Kidney cortical tubular cells, mainly proximal tubular cells, isolated from human kidney and grown either on a basement membrane substrate in chemically defined medium or on plastic in serum-supplemented medium, had substantial proliferative potential and could be propagated for more than 10 generations or 8 passages before senescence. Basement membrane produced on a plastic substrate by the HR-9 endodermal cell line could replace serum supplementation in promoting tubular cell growth. Tubular cells grown on an HR-9 basement membrane substrate exhibited stable epithelial morphology over an extended period of time; in the presence of 5% serum they differentiated into organized structures such as hemicysts and cell cords. Cells grown on plastic failed to differentiate and gradually degenerated. Tubular cells on HR-9 basement membrane were characterized by densely packed microvilli, abundant rough endoplasmic reticulum and free polysomes, basal cell membrane interdigitations, a well-developed endocytotic apparatus, and conspicuous junctional complexes--all features of the proximal tubular cell. Compared with cells on plastic substrate, there were higher levels of the brush border enzymes gamma-glutamyl transpeptidase, L-leucine aminopeptidase, and alkaline phosphatase in cells maintained on an HR-9 basement membrane substrate, further supporting the conclusion that a basement membrane substrate promoted differentiation of tubular cells. These data and morphological observations indicate that a basement membrane substrate can promote growth and both functional and morphologic differentiation of human kidney tubular cells. PMID- 3804938 TI - Specificity of anti-polynucleotide monoclonal antibodies from human-human hybridomas. AB - Nine human-human hybridoma clones, secreting monoclonal antibodies reactive with nucleic acids, were generated by fusing with lymphocytes of lung cancer or systemic lupus erythematosus patients. These hybridoma antibodies were classified into 5 types, in terms of reactivities with DNA, RNA, various synthetic nucleic acids and cardiolipin. Hybridoma clone SU-1 secreted antibody reacting with dsDNA, ssDNA and RNA (type I). Clone HL-321 did not react with these, but with poly (dT), poly (I) and poly (G) (type II). Clone HL-349 was reactive with almost all nucleic acids tested and also with cardiolipin (type III). Clones HF-4, HF-7, HB-7 and HL-259 reacted with ssDNA, poly (A), poly (G) and cardiolipin, but not with RNA (type IV). HB-5 and SH-9 antibodies were reactive only with poly (dT) (type V). PMID- 3804940 TI - Direct quantification of in vitro cell growth through image analysis. AB - Objective, accurate, non-intrusive measurement of in vitro cell growth was realized through microcomputerized video image analysis. Recently-released video and digitizing hardware and software were incorporated into an analytical system which accurately quantified visual differences between cultures on a cell number or fresh mass basis. Sequential measurements during culture incubation further detected and quantified subtle changes in colony area and density resulting from growth. Each measurement was acquired rapidly, without encroaching on the in vitro environment, so cell growth was undisturbed. Custom software routines coordinated the quantification of this detailed record into precise cumulative growth curves. PMID- 3804939 TI - Placental-derived mitogenic factor for human fetal adrenocortical cell cultures. AB - The human fetal adrenal cortex is one of the largest fetal organs and synthesizes precursors for placental estrogen production as part of the feto-placental unit. The factors controlling the rapid growth of the human fetal adrenal cortex during the second and third trimesters are not known. Placental regulation of the growth of human fetal adrenocortical cell cultures from second trimester fetuses was studied. A placental-derived mitogenic factor (PDMF) was detected in tissue homogenates of 14 to 22 week human placentas and stimulated adrenocortical cell number and [3H]thymidine incorporation into DNA 5-8 fold. PDMF has been partially purified by ammonium sulfate precipitation and anion exchange chromatography. PDMF is a heat sensitive protein with disulfide bonds required for activity. The growth stimulation by PDMF was significantly greater than that for basic or acidic fibroblast growth factor by 25-50% and epidermal growth factor by 3-4 fold. The placental hormones, progesterone, estriol, estradiol, placental lactogen and chorionic gonadotropin, either alone or in combination did not stimulate fetal adrenocortical cell growth, except for a 41% cell number increase by progesterone. Platelet-derived growth factor and insulin-like growth factors I and II were not mitogenic for these cells. These results show that the placenta contains a potent growth factor for human fetal adrenocortical cell cultures. This implies a direct role for the placenta in control of this fetal organ's growth, which would make the human feto-placental unit a bi-directional relationship. PMID- 3804941 TI - Current trends in levels of volatile N-nitrosamines in fried bacon and fried-out bacon fat. AB - Commercially processed bacon samples purchased from the Washington, DC, retail market have been periodically analyzed since 1971 for the presence of volatile N nitrosamines in the fried product. During that time, a downward trend in the concentration of N-nitrosopyrrolidine has been observed, and between 1978 and 1980 it plateaued at 4-30 ppb, with an average of 11 ppb. A recent survey, however, indicates a change in this downward trend, with N-nitrosopyrrolidine found at levels ranging from 1 to 65 ppb, average 21 ppb. Volatile N-nitrosamines were found at levels up to 110 ppb in the fried product and up to 85 ppb in the fried-out bacon fat. PMID- 3804942 TI - Titrimetric assay of pancreatic lipase in pharmaceutical preparations. AB - Lyophilized pancreas and pancreatic extracts are widely used in therapy of pancreatic exocrine function deficiencies. Among the measures for quality of the extracts, assay for lipolytic activity appears to be one of the best. However, assay precision is poor, because the specificity and mode of action of lipase requires careful optimization of the assay parameters, especially substrate and measurement conditions. In the method proposed here, substrate quality is improved by the use of sodium desoxycholate and a high-speed stirrer for more reproducible emulsions. Fatty acids are assayed by a titrimetric method, using an electronically monitored pH meter. A comparative statistical study of the U.S. Pharmacopeia method, the International Pharmaceutical Federation (FIP) method, and a modified FIP method showed the latter to have improved accuracy and reproducibility. PMID- 3804943 TI - Validation of liquid chromatographic method for assay of calcitriol and alfacalcidol in capsule formulations. AB - The validation of a liquid chromatographic procedure suitable for the determination of calcitriol and alfacalcidol in their respective formulations labeled to contain at least 0.25 micrograms drug per unit is described. The capsule content is diluted and chromatographed in 15-20 min on silica columns (5 micron) with a mobile phase of hexane-tetrahydrofuran-methylene dichloride isopropanol (72 + 12 + 12 + 4, v/v) with detection at 254 nm. The calibration curve is linear. Recoveries of "spikes" averaged 101% with a standard deviation of 2%. Precision was better than 1.5%. PMID- 3804944 TI - Liquid chromatographic determination and identification of morantel-related residues as precursors of 3-(3-methyl-2-thienyl) acrylic acid (CP-20,107) in bovine milk. AB - A simple liquid chromatographic (LC) method was developed to determine and identify incurred morantel-related residues in bovine milk by converting them to 3-(3-methyl-2-thienyl) acrylic acid (CP-20, 107). Key techniques in this method involve short-term digestion of milk in HCl to release residues convertible to CP 20, 107, isolation and alkaline hydrolysis of these precursors to CP-20, 107, and recovery of the product for LC analysis. Photochemical conversion of CP-20, 107 to its cis-isomer and separation by LC identifies the residue. A homolog (pyrantel), which is used as an internal standard, is hydrolyzed to 3-(2-thienyl) acrylic acid. These acrylic acid isomers are readily resolved by LC. The method was evaluated over the 1-4 ppb (ng/mL) range for accuracy and precision to assess its utility for withdrawal studies. Bovine milk supplemented with morantel at 1, 2, and 4 ppb and assayed in replicate (n = 7-8) over 4 trials gave mean values and standard deviations of 1.0 +/- 0.11, 2.0 +/- 0.24, and 4.0 +/- 0.44 ppb, respectively. A milk specimen containing physiologically incurred residues of morantel assayed 2.1 +/- 0.19 ppb in replicate (n = 5). PMID- 3804945 TI - Determination of depletion and statistical distribution of morantel-related residues in bovine milk following administration of morantel tartrate to dairy cows. AB - Residue depletion studies were conducted in dairy cattle to monitor morantel related residues in milk following oral administration of morantel tartrate (Rumate. Eleven lactating cows of various ages, periods of lactation, and known milk production were orally dosed with the bolus formulation of morantel tartrate with an actual dose range of 8.4-9.8 mg/kg body weight. Representative samples of milk were collected at 10-14 h intervals post-dose, and subsamples were assayed for the major and minor hydrolysis products of morantel-related residues, MAPA and CP-20,107. Residues assayed as precursors of MAPA peaked at the second milking (24 h post-dose) and were below 25 ppb (range: less than 12-24 ppb). Precursors of CP-20,107, which confirm the identity of morantel, also peaked at 24 h post-dose (range: 2.1-3.3 ppb) and declined rapidly thereafter. A statistical model was used to project the level of residues at the upper limit of 99% of the total target animal (i.e., dairy cattle) population with 95% confidence. The calculated peak levels from this model were 50 and 5.0 ppb for morantel-related residues convertible to MAPA and CP-20,107, respectively. PMID- 3804946 TI - Liquid chromatographic determination of amprolium in chicken tissues, using post column reaction and fluorometric detection. AB - A method is presented for determination of amprolium residues in chicken muscles by a liquid chromatographic post-column reaction system. The drug is extracted from muscles with methanol, and the extract is concentrated to 3-4 mL. This aqueous solution is rinsed with n-hexane and cleaned up by alumina column chromatography. The drug is separated from the interferences on a LiChrosorb RP-8 column, reacted with ferricyanide in alkaline solution, and quantitated by fluorometric detection at 367 nm (excitation) and 470 nm (emission). Recoveries of amprolium added to chicken muscles at levels of 0.1 and 0.2 ppm were 74.9 and 80.9%, respectively. The detection limit was 1 ng for amprolium standard and 0.01 ppm in chicken muscles. PMID- 3804947 TI - Determination of fluorene in fish, sediment, and plants. AB - Methods and their applications are described for the determination of fluorene in fish, sediment, and plants. Sample extracts are enriched by using 2 or more of the following: gel permeation, silica gel, potassium silicate, sulfuric acid impregnated silica gel, and activated carbon. Efficiency was improved by applying the adsorbents in combination or as tandem enrichment modules. Analyses by liquid chromatography (LC) with ultraviolet or fluorescence detection (LC/UV or LC/F) yielded limits of detection of 30, 3, and 30 ng/g and average recoveries of 80, 81, and 74% for fish, sediment, and plants, respectively. PMID- 3804948 TI - Determination of ochratoxin A in animal feed and cereal grains by liquid chromatography with fluorescence detection. AB - A liquid chromatographic (LC) method is described for determination of ochratoxin A in animal feeds and cereal grains. Samples are initially extracted with chloroform-ethanol (8 + 2) and 5% acetic acid in water. Extracts are purified using a silica gel cartridge followed by a cyano cartridge. The samples are evaporated, diluted to a known volume, and analyzed using a 10 cm column of 3 micron C18 and a fluorescence detector. The method was applied to a variety of animal feeds and cereal grains at levels of 1.0-0.005 ppm added ochratoxin A. The overall recovery was 90.6% +/- 3.6. PMID- 3804949 TI - Liquid chromatographic determination of ochratoxin A in coffee beans and coffee products. AB - A liquid chromatographic method for the determination of ochratoxin A in coffee beans (green and roast), instant coffee, and coffee drink is described. The sample is subjected to extraction with methanol-1% aqueous sodium bicarbonate (1 + 1) and C18 cartridge cleanup. The extract is chromatographed on a Nucleosil 5C18 column with a mobile solvent of acetonitrile-water-0.2M phosphate buffer pH 7.5 (50 + 47 + 3) containing 3 mM cetyltrimethylammonium bromide as an ion-pair reagent. Ochratoxin A is detected with a fluorometer (excitation 365 nm, emission 450 nm). The sensitivity was increased 20-fold by using ion-pair resolution. The detection limits corresponded to 2 micrograms/kg for coffee beans, 5 micrograms/kg for instant coffee, and 0.2 microgram/kg for coffee drink. The recoveries from coffee products were generally better than 80.7% and the relative standard deviations were 3.43-5.93%. The peak coinciding with ochratoxin A can be confirmed by treatment using alcohol (methanol, ethanol, or n-propanol) and H2SO4. PMID- 3804950 TI - Determination of cyclopiazonic acid in peanuts and corn by thin layer chromatography. AB - A thin layer chromatographic system including densitometry has been developed for determining cyclopiazonic acid in peanuts and corn. Samples are extracted with methanol-chloroform (20 + 80); the extract is stripped of most interferences by partitioning with aqueous sodium bicarbonate followed by acidification and repartitioning with chloroform. After thin layer chromatography and derivatization with dimethylaminobenzaldehyde-HCl spray, the toxin is quantitated by reflection densitometry at 540 nm. The recovery of cyclopiazonic acid averages 90% for peanuts and 85% for corn. The absolute detection limit is 25 ng per spot which translates to a detection limit of 125 micrograms/kg for a 50 g sample. PMID- 3804951 TI - Radioimmunoassay of deoxynivalenol in wheat and corn. AB - With the availability of antibody against deoxynivalenol triacetate (DON triacetate), a radioimmunoassay (RIA) for DON in wheat was developed. DON is extracted from the sample with acetonitrile-water (84 + 16), defatted with hexane, and then reacted with acetic anhydride to form DON-triacetate. The reaction mixture is loaded onto a C-18 cartridge to remove excess reagents and impurities. Acetylated DON is eluted from the cartridge with 50% methanol in water, and then analyzed by radioimmunoassay utilizing antiserum against DON triacetate and tritiated DON-triacetate. Overall recovery for DON added to wheat between 50 and 5000 ppb was 86% with a standard deviation of 7% and coefficient of variation of 8%. The limit of detection for DON was about 20 ppb. Analysis of 12 naturally contaminated wheat, corn, and mixed feed samples for DON revealed that RIA results agreed well with thin layer chromatographic analyses performed by other laboratories. PMID- 3804952 TI - Single-laboratory validation of EPA Method 8150 for determination of chlorinated herbicides in hazardous waste. AB - Method 8150, published in the second edition of Test Methods for Evaluating Solid Waste, Manual SW-846, required optimization, ruggedness testing, linearity determinations, precision tests, bias testing, gas chromatographic/mass spectrometric confirmation, and quality control guidelines for validation of the protocol. This single-laboratory validation, which is applicable to the determination of the herbicides dicamba, silvex, 2,4-D, 2,4-DB, 2,4,5-T, dinoseb, MCPP, MCPA, and dichlorprop in hazardous waste extracts, was completed and is described in this report. Final ruggedness testing of the optimized procedure gave a mean recovery of 89.3% with a standard deviation of 4.3%. Percent relative standard deviations are less than 10 (n = 20, each analyte) over a 10(2) linear range of concentration for MCPP and MCPA and over a 10(3) linear range of concentration for the other target herbicide esters. Instrumental detection limits for electron capture detection and mass spectrometric identity confirmation were determined and found to be matrix-dependent. PMID- 3804953 TI - Surrogate-assisted determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in fish by electron capture capillary gas chromatography. AB - Surrogate spiking the sample with 1000 parts per trillion (pptr) 1,3,7,8 tetrachlorodibenzo-p-dioxin (1378-TCDD) has doubled analytical throughput in determining toxic 2378-TCDD (analyte) at the low part-per-trillion level in fish, using multicolumn high resolution liquid chromatographic cleanup before quantitation by capillary gas chromatography with electron capture detection. The 1378- and 2378-TCDD were recovered equally and were well separated by the capillary column so that the earlier-eluting surrogate did not interfere with the quantitation of levels of analyte many-fold lower. Matrix interference contributed less than 1% bias in surrogate quantitation. Using surrogate recovery to correct for analyte losses during analysis, accuracy averaged (n = 7) 105% in determining 18 or 45 pptr 2378-TCDD added to fish without detectable bioincurred analyte. Analyses of selected fish with bioincurred 2378-TCDD gave results comparable to earlier work where recovery correction required a second analysis of sample fortified with analyte. With surrogate fortification, repeatability of determination (n = 3 or 4) improved markedly to less than 5% relative standard deviation at 37-46 pptr. PMID- 3804954 TI - Simultaneous gas chromatographic determination of dibutyltin and tributyltin compounds in biological and sediment samples. AB - A method is described for the simultaneous determination of nanogram amounts of dibutyltin and tributyltin compounds in biological and sediment samples. These compounds are converted to the corresponding chlorides with HCl, extracted with ethyl acetate-hexane (3 + 2) for biological samples and with hexane for sediment samples, and hydrogenated with sodium borohydride. The corresponding hydrides, Bu2SnH2 and Bu3SnH, are detected by electron-capture gas chromatography after cleanup by silica gel column chromatography. Detection limits are 1.0-2.0 and 0.5 1.0 ng/g, respectively, for biological and sediment samples. PMID- 3804955 TI - On-line trace enrichment for determination of aldicarb species in water, using liquid chromatography with post-column derivatization. AB - Liquid chromatography combining on-line trace enrichment together with a very selective detection technique is used for the determination of aldicarb, aldicarb sulfoxide, and aldicarb sulfone. Sensitivity is increased by loading a 10 mL volume of ground water on a concentrator column installed in the loop position of a 6-port injection valve. Switching the valves allows the concentrated material to be backflushed onto the analytical column by a methanol-water gradient mobile phase. Separation is followed by post-column hydrolysis to yield methylamine, and formation of a fluorophore with o-phthalaldehyde and 2-mercaptoethanol prior to fluorescence detection. The process requires virtually no sample cleanup and provides good precision on recoveries from different matrixes. Minimum detection limit, defined as 5 times baseline noise, is less than 70 ng/L for the 3 compounds. PMID- 3804956 TI - Sibling relationships of children with autistic, mentally retarded, and nonhandicapped brothers and sisters. AB - The subjects were 90 children between 6 and 15 years of age, 30 with autistic, 30 with mentally retarded, and 30 with nonhandicapped brothers or sisters. The children were questioned about their sibling relationships in an open-ended interview, and, in the case of children with handicapped siblings, they also responded to questions about particular problems they faced in regard to their brothers or sisters. In addition, mothers filled out a behavior rating scale in which they described the positive and negative aspects of their children's behavior toward the sibling. In general, children and mothers rated the sibling relationships positively. Group comparisons indicated that children with autistic and mentally retarded siblings did not differ on any self-report measures. Children with nonhandicapped siblings reported that their family relations were slightly more cohesive but otherwise did not differ in terms of their self reports from children with handicapped siblings. Mothers of nonhandicapped children, however, rated the sibling relationships more negatively than did mothers of handicapped children. Further analyses revealed that status variables (age, gender, family size) were not as highly correlated with the quality of sibling relationships with handicapped children as were specific problem areas (e.g., perceptions of parental favoritism, coping ability, concerns about the handicapped child's future). PMID- 3804957 TI - Children reared in a reverse isolation environment: effects on cognitive and emotional development. AB - Cognitive and emotional aspects of development in four infants reared in a reverse isolation environment because of congenital severe combined immunodeficiency disease were studied by psychological test performance and formal observation. The children were studied while they were inpatients and following their discharge after successful medical treatment was accomplished. Treatment time in reverse isolation varied from 10 to 52 months. Deficient self generated activity, including motor and motor-based cognitive skills such as expressive language, were observed in two of the four children. Deficits were also observed to be at least moderately reversible either upon discharge or in relation to an inpatient intervention program. Case material is discussed with reference to severe disruption of oral feeding experience, quality of parental involvement, and sensory isolation inherent in the environment. PMID- 3804958 TI - Autism and Piaget's theory: are the two compatible? AB - Autism is interpreted in Piagetian terms with particular reference to the question of whether the atypical cognitive development represents an exception to the similar sequence hypothesis. Findings from relevant research applying Piaget's theory to mental retardation, psychosis, and autism are reviewed. The apparent exceptions to the hypothesis presented in autistic individuals are explained by Piaget's two-factor theory of figurative versus operative functions. Many autistic individuals show an arrest in operative functions at the sensorimotor level while continuing to progress in figurative functions. The early arrest interferes with subsequent development of higher-level conceptual, symbolic, and social skills. Questions for research are offered. PMID- 3804959 TI - Effects of using object self-stimulation as a reinforcer on the prevocational work rates of an autistic child. AB - The purpose of this study was to examine the effects of object self-stimulation on the task-interrupting self-stimulatory behavior and prevocational work responses of a 13-year-old autistic boy. Using a multiple-baseline design across three different prevocational tasks, a systematic manipulation of object self stimulation was associated with increases in correct rates and decreases in task interrupting self-stimulatory behaviors. An analysis of these data indicates that self-stimulatory behavior may be shaped to facilitate performance proficiencies. Social validation information suggests that favorable generalized responding had occurred. On the basis of findings from this study, future research needs are discussed. PMID- 3804960 TI - Setting effects on the occurrence of autistic children's immediate echolalia. AB - This study was designed to assess the effects of setting familiarity on autistic children's immediate echolalia. Six autistic boys were presented with a receptive labeling task in several settings varying in familiarity of person, room, and task stimuli. The amount of immediate echolalia emitted during the task in each of the settings was recorded. The results indicated that the greatest amount of echolalia occurred in settings in which an unfamiliar person presented unfamiliar task stimuli. The second greatest amount of echolalia occurred when a familiar person presented the unfamiliar stimuli. The results are discussed in terms of previous literature, classroom design, and treatment procedures for autistic children. PMID- 3804961 TI - A validity analysis of selected instruments used to assess autism. AB - Differentiating autism from other handicapping conditions, especially mental retardation, has been a constant problem for public schools. This study investigated the effectiveness of three instruments to discriminate autistic from trainable mentally retarded children. The Autism Screening Instrument for Educational Planning, the Childhood Autism Rating Scale, and the Diagnostic Checklist for Behavior Disturbed Children, Form E-2 were administered to 20 autistic and 20 TMR students. Discriminant analysis was used to determine the best linear combination of scores that would separate the two groups of children. All three instruments were found to separate the two samples of children. However, the CARS and the ASIEP provided for a greater separation of groups. PMID- 3804962 TI - An open study of fenfluramine in hospitalized young autistic children. PMID- 3804963 TI - Clarification on Asperger's syndrome. PMID- 3804964 TI - A vote for Asperger's syndrome. PMID- 3804965 TI - Comments on "editorial: Treatment abuse and its reduction". PMID- 3804966 TI - [Role of computerized x-ray tomography in the radiological study of the ear]. PMID- 3804967 TI - Magnetic resonance imaging of hemorrhagic lesions: evolution of the intrinsic relaxation parameters from time of onset of symptoms. PMID- 3804969 TI - Manganese oxidation by Leptothrix discophora. AB - Cells of Leptothrix discophora SS1 released Mn2+-oxidizing factors into the medium during growth in batch culture. Manganese was optimally oxidized when the medium was buffered with HEPES (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid) at pH 7.5. Manganese-oxidizing activity in the culture medium in which this strain had been grown previously was sensitive to heat, phosphate, Tris, NaN3, HgCl2 NaCl, sodium dodecyl sulfate, and pronase; 0.5 mol of O2 was consumed per mol of MnO2 formed. During Mn2+ oxidation, protons were liberated. With sodium dodecyl sulfate-polyacrylamide gel electrophoresis, two protein-containing bands were detected in the spent culture medium. One band had an apparent molecular weight of 110,000 and was predominant in Mn2+-oxidizing activity. The second product (Mr 85,000) was only detected in some cases and probably represents a proteolytic breakdown moiety of the 110,000-Mr protein. The Mn2+-oxidizing factors were associated with the MnO2 aggregates that had been formed in spent culture medium. After solubilization of this MnO2 with ascorbate, Mn2+-oxidizing activity could be recovered. PMID- 3804968 TI - Podospora anserina does not senesce when serially passaged in liquid culture. AB - A procedure was developed for the prolonged growth of the ascomycete fungus Podospora anserina in liquid culture to determine the effects of such growth on the senescence phenotype. Senescence in P. anserina, which is maternally inherited and associated with the excision and amplification of specific mitochondrial plasmids, occurs when this species is grown on solid medium. In two independent experiments no evidence of senescence was observed as mycelia were serially passaged in liquid culture. Further, when separable mycelial masses, termed puff balls, from the liquid cultures were plated on solid medium, a significant increase in their average longevity was observed. The apparent immortality of P. anserina in liquid culture was not dependent upon mitochondrial DNA rearrangements, nor was it affected by the presence of a previously described senescence plasmid, alpha senDNA. Evidence was obtained indicating that growth in liquid culture exerts selective pressure to maintain the wild-type mitochondrial genome. PMID- 3804970 TI - Glucose uptake by the cellulolytic ruminal anaerobe Bacteroides succinogenes. AB - Glucose uptake by Bacteroides succinogenes S85 was measured under conditions that maintained anaerobiosis and osmotic stability. Uptake was inhibited by compounds which interfere with electron transport systems, maintenance of proton or metal ion gradients, or ATP synthesis. The most potent inhibitors were proton and metal ionophores. Oxygen strongly inhibited glucose uptake. Na+ and Li+, but not K+, stimulated glucose uptake. A variety of sugars, including alpha-methylglucoside, did not inhibit glucose uptake. Only cellobiose and 2-deoxy-D-glucose were inhibitory, but neither behaved as a competitive inhibitor. Metabolism of both sugars appeared to be responsible for the inhibition. Cells grown in cellobiose medium transported glucose at one-half the rate of glucose-grown cells. Spheroplasts transported glucose as well as whole cells, indicating glucose uptake is not dependent on a periplasmic glucose-binding protein. Differences in glucose uptake patterns were detected in cells harvested during the transition from the lag to the log phase of growth compared with cells obtained during the log phase. These differences were not due to different mechanisms for glucose uptake in the cell types. Based on the results of this study, B. succinogenes contains a highly specific, active transport system for glucose. Evidence of a phosphoenolpyruvate-glucose phosphotransferase system was not found. PMID- 3804971 TI - Regulation, initiation, and termination of the cenA and cex transcripts of Cellulomonas fimi. AB - We characterized the in vivo transcripts of two Cellulomonas fimi genes, the cenA gene, which encodes an extracellular endo-beta-1,4-glucanase (EC 3.2.1.4) and the cex gene, which encodes an extracellular exo-beta-1,4-glucanase (EC 3.2.1.91). By Northern blot analysis, cenA mRNA was detected in C. fimi RNA preparations from glycerol- and carboxymethyl cellulose-grown cells but not from glucose-grown cells. In contrast, cex mRNA was detected only in the preparations from carboxymethyl cellulose-grown cells. Therefore, the transcription of these genes is subject to regulation by the carbon source provided to C. fimi. By nuclease S1 protection studies with unique 5'-labeled DNA probes and C. fimi RNA isolated in vivo, 5' termini were found 51 and 62 bases before the cenA translational initiation codon and 28 bases before the cex translational initiation codon. S1 mapping with unlabeled DNA probes and C. fimi RNA which had been isolated in vivo but which had been 5' labeled in vitro with guanylyltransferase and [alpha 32P]GTP confirmed that true transcription initiation sites for cenA and cex mRNA had been identified. Comparative analysis of the DNA sequences immediately upstream of the initiation sites of the cenA and cex mRNAs revealed a 30-base pair region where these two sequences display at least 66% homology. S1 mapping was also used to locate the 3' termini of the cenA and cex transcripts. Three 3' termini were found for cenA messages, whereas only one 3' terminus was identified for cex mRNA. The transcripts of both genes terminate in regions where their corresponding DNA sequences contain inverted repeats. PMID- 3804972 TI - Dechlorination and para-hydroxylation of polychlorinated phenols by Rhodococcus chlorophenolicus. AB - In this paper we show that a polychlorophenol degrader Rhodococcus chlorophenolicus PCP-I initially attacked polychlorinated phenols (pentachlorophenol, 2,3,4,5-, 2,3,4,6-, and 2,3,5,6-tetrachlorophenol, and 2,3,5- and 2,3,6-trichlorophenol) by tetra- or trichlorohydroquinone-producing para hydroxylation. The novel hydroxyl group was set in position 4, whether or not a substrate had chlorine substituent in this position. The hydroxyl was in each case derived from water molecules, as was shown by following the incorporation of oxygen from H2(18)O into the reaction products. Nevertheless, the para hydroxylation reaction required the presence of molecular oxygen, whereas further metabolism of the reaction product, tetrachlorohydroquinone, proceeded also in anaerobiosis. All polychlorinated phenols were readily transformed at 41 degrees C, but none were transformed at 44 degrees C. In contrast to this, tetrachlorohydroquinone was metabolized at a high rate at 50 degrees C, but was not metabolized at 55 degrees C. Polychlorinated phenols were specific inducers of the para-hydroxylating enzymes; para-hydroxylated reaction products did not induce these enzymes. On the other hand, the degradation of tri- and tetrachlorohydroquinone was induced by any of the chlorophenols and also by hydroquinones. PMID- 3804973 TI - Dienelactone hydrolase from Pseudomonas sp. strain B13. AB - Dienelactone hydrolase (EC 3.1.1.45) catalyzes the conversion of cis- or trans-4 carboxymethylenebut-2-en-4-olide (dienelactone) to maleylacetate. An approximately 24-fold purification from extracts of 3-chlorobenzoate-grown Pseudomonas sp. strain B13 yielded a homogeneous preparation of the enzyme. The purified enzyme crystallized readily and proved to be a monomer with a molecular weight of about 30,000. Each dienelactone hydrolase molecule contains two cysteinyl side chains. One of these was readily titrated by stoichiometric amounts of p-chloromercuribenzoate, resulting in inactivation of the enzyme; the inactivation could be reversed by the addition of dithiothreitol. The other cysteinyl side chain appeared to be protected in the native protein against chemical reaction with p-chloromercuribenzoate. The properties of sulfhydryl side chains in dienelactone hydrolase resembled those that have been characterized for bacterial 4-carboxymethylbut-3-en-4-olide (enol-lactone) hydrolases (EC 3.1.1.24), which also are monomers with molecular weights of about 30,000. The amino acid composition of the dienelactone hydrolase resembled the amino acid composition of enol-lactone hydrolase from Pseudomonas putida, and alignment of the NH2-terminal amino acid sequence of the dienelactone hydrolase with the corresponding sequence of an Acinetobacter calcoaceticus enol-lactone hydrolase revealed sequence identity at 8 of the 28 positions. These observations foster the hypothesis that the lactone hydrolases share a common ancestor. The lactone hydrolases differed in one significant property: the kcat of dienelactone hydrolase was 1,800 min-1, an order of magnitude below the kcat observed with enol-lactone hydrolases. The relatively low catalytic activity of dienelactone hydrolase may demand its production at the high levels observed for induced cultures of Pseudomonas sp. strain B13. PMID- 3804974 TI - Nucleotide sequence and expression of clcD, a plasmid-borne dienelactone hydrolase gene from Pseudomonas sp. strain B13. AB - The clcD structural gene encodes dienelactone hydrolase (EC 3.1.1.45), an enzyme that catalyzes the conversion of dienelactones to maleylacetate. The gene is part of the clc gene cluster involved in the utilization of chlorocatechol and is carried on a 4.3-kilobase-pair BglII fragment subcloned from the Pseudomonas degradative plasmid pAC27. A 1.9-kilobase-pair PstI-EcoRI segment subcloned from the BglII fragment was shown to carry the clcD gene, which was expressed inducibly under the tac promoter at levels similar to those found in 3 chlorobenzoate-grown Pseudomonas cells carrying the plasmid pAC27. In this study, we present the complete nucleotide sequence of the clcD gene and the amino acid sequence of dienelactone hydrolase deduced from the DNA sequence. The NH2 terminal amino acid sequence encoded by the clcD gene from plasmid pAC27 corresponds to a 33-residue sequence established for dienelactone hydrolase encoded by the Pseudomonas sp. strain B13 plasmid pWR1. A possible relationship between the clcD gene and pcaD, a Pseudomonas putida chromosomal gene encoding enol-lactone hydrolase (EC 3.1.1.24) is suggested by the fact that the gene products contain an apparently conserved pentapeptide neighboring a cysteinyl side chain that presumably lies at or near the active sites; the cysteinyl residue occupies position 60 in the predicted amino acid sequence of dienelactone hydrolase. PMID- 3804975 TI - Bacterial carbon-phosphorus lyase: products, rates, and regulation of phosphonic and phosphinic acid metabolism. AB - Carbon-phosphorus bond cleavage activity, found in bacteria that utilize alkyl- and phenylphosphonic acids, has not yet been obtained in a cell-free system. Given this constraint, a systematic examination of in vivo C-P lyase activity has been conducted to develop insight into the C-P cleavage reaction. Six bacterial strains were obtained by enrichment culture, identified, and characterized with respect to their phosphonic acid substrate specificity. One isolate, Agrobacterium radiobacter, was shown to cleave the carbon-phosphorus bond of a wide range of substrates, including fosfomycin, glyphosate, and dialkyl phosphinic acids. Furthermore, this organism processed vinyl-, propenyl-, and propynylphosphonic acids, a previously uninvestigated group, to ethylene, propene, and propyne, respectively. A determination of product stoichiometries revealed that both C-P bonds of dimethylphosphinic acid are cleaved quantitatively to methane and, furthermore, that the extent of C-P bond cleavage correlated linearly with the specific growth rate for a range of substrates. The broad substrate specificity of Agrobacterium C-P lyase and the comprehensive characterization of the in vivo activity make this an attractive system for further biochemical and mechanistic experiments. In addition, the failure to observe the activity in a group of gram-positive bacteria holds open the possibility that a periplasmic component may be required for in vivo expression of C-P lyase activity. PMID- 3804976 TI - Electron microscopy of nickel-containing methanogenic enzymes: methyl reductase and F420-reducing hydrogenase. AB - Methanogens catalyze the hydrogen-dependent eight-electron reduction of carbon dioxide to methane. Two of the key catalysts in the eight-electron reduction pathway are the nickel-containing enzymes F420-reducing hydrogenase and methyl reductase. In the present study, the structures of these archaebacterial enzymes from Methanobacterium thermoautotrophicum delta H have been determined by electron microscopy. By negative stain techniques, F420 hydrogenase was found to be a ring structure with a diameter of 15.7 nm and an inner channel 4 nm in diameter. Shadow-casting experiments demonstrated that the rings were 8.5 nm deep, indicating a holoenzyme molecular weight of 8.0 X 10(5). Methyl reductase appeared to be an oligomeric complex of dimensions 8.5 by 9 by 11 nm, with a central stain-penetrating region. The morphology and known subunit composition suggest a model in which the subunits are arranged as an eclipsed pair of open trimers. Methyl reductase was also found in the form of larger aggregates and in paracrystalline arrays derived from highly concentrated solutions. The extremely large size of F420 hydrogenase and the methyl reductase supramolecular assemblies may have relevance in vivo in the construction of multiprotein arrays that function in methane biogenesis. PMID- 3804977 TI - Amino sugars in the glycoprotein toxin from Bacillus thuringiensis subsp. israelensis. AB - The carbohydrate content of purified Bacillus thuriniensis subsp. israelensis crystal toxin was determined by six biochemical tests, column chromatography on an amino acid analyzer, and the binding of 11 fluorescent lectins. The crystals contained approximately 1.0% neutral sugars and 1.7% amino sugars. The amino sugars consisted of 70% glucosamine and 30% galactosamine. No N-acetylneuraminic acid (sialic acid) was detected. The presence of amino sugars was confirmed by the strong binding of fluorescent wheat germ agglutinin and the weak binding of fluorescent soybean agglutinin. These lectins recognize N-acetyl-D-glucosamine and N-acetyl-D-galactosamine, respectively. The lectin-binding sites appeared evenly distributed among the protein subunits of the crystal. The sugars were covalently attached to the crystal toxin because wheat germ agglutinin still bound alkali-solubilized toxin which had been boiled in sodium dodecyl sulfate, separate by polyacrylamide gel electrophoresis, and transferred to nitrocellulose membranes. This study demonstrates the covalent attachment of amino sugars and indicates that the B. thuringiensis subsp. israelensis protein toxins should be viewed as glycoprotein toxins. The crystals used in the present study were purified on sodium bromide density gradients. Studies employing crystals purified on Renografin density gradients can give artificially high values for the anthrone test for neutral sugars. PMID- 3804978 TI - Structure of the Azotobacter vinelandii surface layer. AB - Electron microscopy of the Azotobacter vinelandii tetragonal surface array, negatively stained with ammonium molybdate in the presence of 1 mM calcium chloride, showed an apparent repeat frequency of 12 to 13 nm. Image processing showed dominant tetrad units alternating with low-contrast cruciform structures formed at the junction of slender linkers extending from corner macromolecules of four adjoining dominant units. The actual unit cell showed p4 symmetry, and a = b = 18.4 nm. Distilled water extraction of the surface array released a multimeric form of the single 60,000 molecular-weight protein (S protein) which constitutes the surface layer. The molecular weight of the multimer was estimated at 255,000 by gel filtration, indicating a tetrameric structure of four identical subunits and suggesting that this multimer was the morphological subunit of the S layer. Tetrameric S protein exhibited low intrinsic stability once released from the outer membrane, dissociating into monomers when incubated in a variety of buffers including those which served as the base for defined media used to cultivate A. vinelandii. The tetramer could not be stabilized in these buffers at any temperature between 4 and 30 degrees C, but the addition of 2 to 5 mM Ca2+ or Mg2+ completely prevented its dissociation into monomers. Circular dichroism measurements indicated that the secondary structure of the tetramer was dominated by aperiodic and beta-sheet conformations, and the addition of Ca2+ did not produce any gross changes in this structure. Only the tetrameric form of S protein was able to reassemble in vitro in the presence of divalent cations onto the surface of cells stripped of their native S layer. PMID- 3804979 TI - A Rhizobium meliloti mutant that forms ineffective pseudonodules in alfalfa produces exopolysaccharide but fails to form beta-(1----2) glucan. AB - A mutant of Rhizobium meliloti that elicited the formation of inactive nodules in alfalfa was found not to form beta-(1----2) glucan in vivo or in vitro. It was nonmotile because it lacks flagella. The 235-kilodalton protein which acts as an intermediate in beta-(1----2) glucan synthesis was undetectable in the mutant. These properties of the mutant are common to those of chvB mutants of Agrobacterium tumefaciens. Exopolysaccharide formation by the R. meliloti mutant was about double that by the wild type. PMID- 3804980 TI - Effect of light on several metabolites of carbohydrate metabolism in Phycomyces blakesleeanus. AB - The concentrations of all metabolites studied, except fructose 1,6-bisphosphate from wild-type Phycomyces blakesleeanus, were light dependent. This photoregulation appears to be independent of the mad gene product(s) and also independent of carotene biosynthesis regulation. However, the photoregulation of glyceraldehyde 3-phosphate, 2-phosphoglycerate, and phosphoenolpyruvate may be assigned to these mad and car S gene products. PMID- 3804981 TI - The effect of desipramine on body weight in depression. AB - Twenty-six patients with major depressive disorder were treated with desipramine for 4 weeks to determine the effect of the drug on body weight. Responders to desipramine showed a weight gain only at Weeks 3 and 4; nonresponders had a nonsignificant loss of weight. The increase in body weight of the responders was independent of dosage, sex, and hospitalization status. These findings suggest that the small increase in body weight that occurs in patients taking desipramine is associated with treatment response. In addition, desipramine may be a valuable treatment alternative for those patients in whom excessive weight gain is undesirable. PMID- 3804982 TI - Manic syndrome following head injury: another form of secondary mania. AB - Two cases of mania secondary to head injury are reported. Only four well documented reports of head trauma as a cause of secondary mania were found in an English and foreign literature search, although such a search is made difficult by the paucity of cases meeting modern diagnostic criteria for mania. Previous reviews of the causes of secondary mania have not included head injury, but the two case reports confirm that head injury may be an additional cause. A diagnosis of mania secondary to head trauma should be considered in manic patients with atypical age of onset, absence of previous psychiatric illness, negative family history for bipolar illness, and close temporal proximity of head trauma to subsequent mania. PMID- 3804983 TI - Management of antidepressant-induced side effects: a practical guide for the clinician. AB - The treatment of antidepressant-induced side effects is an important area of clinical concern. Attention to the untoward consequences of pharmacotherapy improves patient compliance and allows the physician to treat patients with the appropriate medication at an efficacious dosage. Based upon review of the literature and clinical experience, a general guide is offered to help the clinician determine treatment strategies that may be effective in dealing with some of the more commonly encountered side effects of the heterocyclic antidepressants and monoamine oxidase inhibitors. PMID- 3804984 TI - Refractory depression treated with high doses of monoamine oxidase inhibitor. AB - Two treatment-refractory cases of depression were treated with doses of monoamine oxidase inhibitors (MAOIs) that exceeded the recommended therapeutic range. Both patients improved without any side effects. It appears that high doses of MAOIs when used with caution in responsible patients may be another method for treating refractory depression. PMID- 3804985 TI - Diazepam in a patient with chronic schizophrenia complicated by agoraphobia. AB - A case of chronic schizophrenia complicated by agoraphobia expressed as an exacerbation of negative symptoms is presented. The patient responded to diazepam combined with behavior therapy. The need to recognize treatable factors contributing to negative symptoms of schizophrenia is discussed. PMID- 3804986 TI - Metoclopramide and depression. PMID- 3804987 TI - Unilateral brief-pulse ECT and bilateral sinusoidal ECT. PMID- 3804988 TI - Carbamazepine treatment for stuttering. PMID- 3804989 TI - Assessing dangerousness and responding appropriately: Hedlund expands the clinician's liability established by Tarasoff. AB - The complexities of the Tarasoff and Hedlund cases extended the liability of clinicians in situations in which patients communicate threats of harm to third parties. Because of these and other rulings, clinicians need to follow guidelines for staged responses to such threats and to document and substantiate their decisions. PMID- 3804990 TI - Correction of lithium levels for dose and blood sampling times. AB - Inconsistencies inherent in the clinical application of morning serum lithium levels can be eliminated by correcting the levels for variations in dosage schedule, rate of lithium elimination, and blood sampling time. In this report, graphs constructed from an accurate pharmacokinetic model of lithium elimination are used to convert the serum lithium level into the daily exposure of the body to lithium. This method facilitates safety and effectiveness in lithium treatment and enables outpatient blood samples for lithium levels to be conveniently drawn in the afternoon. PMID- 3804991 TI - Bromocriptine treatment of neuroleptic malignant syndrome. AB - Five patients with neuroleptic malignant syndrome were treated with bromocriptine mesylate 7.5-45 mg/day in three divided doses for at least 10 days. Response to therapy was assessed by monitoring vital signs and serum creatine kinase (CK) levels. In addition, a disability score was determined using a scale based on variables assessed on neurologic examinations. In all five patients, significant improvement was noted 24-72 hours after initiation of bromocriptine treatment and was accompanied in four patients by a rapid drop in serum CK levels. Resolution of confusion and mutism was noted within 24-48 hours after treatment. Normalization of vital signs occurred within 48 hours to 4 days, and resolution of extrapyramidal rigidity occurred within 1 week. In two patients, early discontinuation of bromocriptine resulted in relapse of neuroleptic malignant syndrome, which responded to reinstitution of the drug. The results suggest a therapeutic role for bromocriptine in the treatment of neuroleptic malignant syndrome. PMID- 3804992 TI - Coexisting central diabetes insipidus and psychogenic polydipsia. AB - A chronic schizophrenic patient is described in whom central diabetes insipidus and psychogenic polydipsia coexisted. A possible relationship between psychogenic polydipsia and failure of vasopressin release is hypothesized. PMID- 3804993 TI - Hypothermia caused by antipsychotic drugs in a schizophrenic patient. AB - In a schizophrenic patient, hypothermia was caused by combined treatment with zotepine, biperiden, and fluphenazine, although combined treatment with zotepine and biperiden had caused no side effects. Other side effects closely resembled those in neuroleptic malignant syndrome. PMID- 3804994 TI - Oxygen binding and subunit interaction of hemoglobin in relation to the two-state model. AB - Mills and Ackers (Mills, F.C., and Ackers, G.K. (1979) J. Biol. Chem. 254, 2881 2887) have reported the subunit interactions of hemoglobin to decrease on binding of the fourth molecule of oxygen to hemoglobin. This effect, which they called quaternary enhancement, is incompatible with the two-state Monod, Wyman, and Changeux allosteric model. Their free energy of binding of the fourth molecule ( 9.3 kcal/mol) has been compared with independent kinetic estimates which give 8.6 kcal/mol. This smaller value is consistent with literature values and allows reasonable representation of the equilibrium curve using the two-state model without invoking quaternary enhancement. PMID- 3804995 TI - Glucocorticoid-regulated expression from the 5'-flanking region of the rat alpha 1-acid glycoprotein gene. Requirement for ongoing protein synthesis. AB - The induction of alpha 1-acid glycoprotein (AGP) mRNA by glucocorticoids in rat hepatoma cells requires ongoing protein synthesis. Here we show that the 5' flanking region of the AGP gene confers glucocorticoid responsiveness on the expression of heterologous coding sequences. Moreover, the induction of beta globin mRNA directed by the AGP promoter is inhibited by concurrent treatment with cycloheximide, thereby suggesting that the requirement for protein synthesis is mediated through 5'-flanking sequences. Analysis of the effects of varying durations of cycloheximide treatment indicates that both the endogenous AGP gene and the transfected AGP-beta-globin chimeric gene are induced normally by dexamethasone during the first 1-2h of concurrent treatment. In addition, pretreatment with cycloheximide yields a decrease in the subsequent induction of both beta-globin and AGP RNAs. These data support the notion that a pre-existing and labile protein, perhaps in concert with the glucocorticoid receptor, acts through the 5'-flanking region of the AGP gene to stimulate transcription from the AGP promoter. PMID- 3804996 TI - Non-histone chromosomal protein HMG1 modulates the histone H1-induced condensation of DNA. AB - Circular dichroic spectra revealed that the previously known regular, asymmetric condensation of DNA by H1 histone was modulated by HMG1, a nonhistone chromosomal protein. Under approximately physiological salt and pH conditions (150 mM NaCl, pH 7), ellipticities at 270 nm were observed as follows: DNA, 9 X 10(3) degree, cm2/dmol nucleotide; DNA X H1 histone complex (1:0.4, w/w), -37 X 10(3) degree, cm2/dmol nucleotide, and DNA X H1 X HMG1 complex (1:0.4:0.4 w/w/w), -52 X 10(3) degree, cm2/dmol. HMG1 by itself did not distort the spectrum of DNA, showing that the effect of HMG1 on the DNA X H1 complex was not simply the summation of individual effects of HMG1 and H1 on the DNA spectrum. The effect of added HMG1 on the spectrum of the preformed DNA X H1 complex depended on the amount of HMG1 added and developed slowly (a day) as if a structure required annealing. The ternary complex, DNA X HMG1 X 1, seemed to represent a specific structure, since its formation depeNded on the reduced sulfhydryl state of HMG1; the disulfide form of HMG1, which was shown by circular dichroism to contain more random coil than did the reduced form, had no effect on the circular dichroic spectrum of the DNA X H1 complex. PMID- 3804997 TI - Occurrence of an endogenous inhibitor of platelet-activating factor in rat liver. AB - Hepatocytes obtained from livers derived from fed rats perfused with a collagenase-containing mixture were found to contain significant levels of platelet-activating factor activity as isolated by Silica Gel G thin layer chromatography. However, when soybean trypsin inhibitor was included in the collagenase-containing perfusion medium for hepatocyte preparation, platelet activating factor activity could not be detected on Silica Gel G chromatograms. Examination of the lipids extracted from freeze clamped perfused rat livers revealed low, but detectable, levels of platelet-activating factor. Further investigation of these observations indicated that a lipid-like inhibitor was present in freeze-clamped perfused livers as well as in hepatocytes isolated in the presence of soybean trypsin inhibitor. In each instance platelet-activating factor and this newly discovered inhibitor, which comigrated at the same RF value on Silica Gel G thin layer chromatography plates, could be separated by further chromatography on high performance thin layer plates. The present study shows that platelet-activating factor is present in unstimulated liver and that its detection is masked by an endogenous lipid-like inhibitor. PMID- 3804998 TI - Identification of a new protein synthesis initiation factor from wheat germ. AB - A previously unidentified factor has been isolated from wheat germ that stimulates globin mRNA-directed polypeptide synthesis in vitro. This factor is separated from eukaryotic initiation factor (eIF)-4B by chromatography on m7GTP Sepharose. eIF-4B binds to m7GTP-Sepharose, whereas the stimulatory factor does not. Further purification of the factor yields a preparation that contains one major polypeptide with a molecular weight of approximately 59,000, This factor enhances the binding of globin mRNA to 40 S ribosomal subunits in the presence of eIF-2, eIF-3, eIF-4A, and either eIF-4B or eIF-4F and has been designated eIF-4G. PMID- 3804999 TI - Nerve growth factor enhances the synthesis, phosphorylation, and metabolic stability of neurofilament proteins in PC12 cells. AB - Rat pheochromocytoma (PC12) cells grown in the presence or absence of nerve growth factor (NGF) were pulse-labeled with [35S]methionine or 32Pi, and neurofilament subunits were recovered by immunoprecipitation from cellular extracts. The neurofilament subunits, with apparent molecular masses on sodium dodecyl sulfate-polyacrylamide gels of 68 kDa (light, L), 145 kDa (medium, M), and 200 kDa (heavy, H), were all found to be expressed in PC12 cells grown in the absence and presence of NGF. H was expressed at very low levels and in a form that migrated more rapidly on sodium dodecyl sulfate gels than H from rat brain. M was synthesized as a more rapidly migrating precursor that underwent modification within 3 h after labeling to a slower migrating form that co migrated with M from rat brain. Analysis of the different M species by two dimensional gel electrophoresis indicated that they also had different isoelectric points consistent with differences in phosphate content. NGF treatment resulted in increased L synthesis and, to a lesser degree, M synthesis, but had no effect on H synthesis. NGF also increased the stability of the modified form of M. All three subunits were 32P-labeled, and NGF increased the incorporation of 32P into M and H. Neurofilament subunits were also immunoprecipitated from a soluble fraction of [35S]methionine-labeled PC12 cells. This soluble pool of subunits differed from the cytoskeleton-associated pool in the relative proportions of individual subunits, M being the predominant form in the former and L in the latter. PMID- 3805000 TI - Crystallization and structure determination of an autoimmune anti-poly(dT) immunoglobulin Fab fragment at 3.0 A resolution. AB - HED10 is an autoimmune antibody (IgG) which shows considerable specificity for the single-stranded DNA poly(dT). Production of Fab fragments by papain digestion resulted in heterogeneity as judged by isoelectric focusing gels, which had a marked negative effect on crystallization. However, a single species of Fab with a pI of 7.6 could be isolated in good yield by DEAE-cellulose chromatography, and good crystals were produced by the hanging drop vapor diffusion method. The space group was P21 with cell dimensions, a = 64.2, b = 90.0, c = 42.3 A, and beta = 96.7 degrees. These crystals diffract to about 2.2 A resolution. The structure of Fab HED10 was solved by the molecular replacement method using the known structure of McPC603 and is refined to R = 27.2% at 3.0 A resolution. Fab HED10 is more extended than McPC603 and has an elbow angle (between the variable and constant domains) of 162 degrees, very similar to that observed in Fab KOL. The majority of the hypervariable regions are visible in the model. PMID- 3805001 TI - The function of catalase-bound NADPH. AB - Catalase (H2O2:H2O2 oxidoreductase, EC 1.11.1.6) is of historical interest for having been the subject of some of the earliest investigations of enzymes. A feature of catalase that has been poorly understood for several decades, however, is the mechanism by which catalase remains active in the presence of its own substrate, hydrogen peroxide. We reported recently that catalase contains tightly bound NADPH. The present study with bovine and human catalase revealed that NADPH both prevents and reverses the accumulation of compound II, an inactive form of catalase that is generated slowly when catalase is exposed to hydrogen peroxide. Since the effect of NADPH occurs even at NADPH concentrations below 0.1 microM, the protective mechanism is likely to operate in vivo. This discovery of the role of catalase-bound NADPH brings a unity to the concept of two different mechanisms for disposing of hydrogen peroxide (catalase and the glutathione reductase/peroxidase pathway) by revealing that both mechanisms are dependent on NADPH. PMID- 3805002 TI - The enzyme defect in bovine protoporphyria. Studies with purified ferrochelatase. AB - Ferrochelatase was purified from the livers of normal and protoporphyria cattle by chromatography on Blue Sepharose CL-6B in order to investigate the enzyme defect in this disorder. The increase in specific activity (up to 2900-fold) indicated that the normal and protoporphyria enzymes were purified to a similar degree. The mutant enzyme had catalytic activity which was 10 to 15% of normal ferrochelatase, although the Michaelis constants for protoporphyrin and iron were similar. The molecular mass of the normal and protoporphyria enzyme protein was 40 kDa as evaluated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). In the presence of 15 mM sodium cholate, gel filtration demonstrated a similar size. However, at a lower concentration of sodium cholate (4 mM) the molecular mass was about 240 kDa, suggesting that the purified enzymes aggregate under this condition. Polyvalent antibodies were raised in rabbits using as antigens purified normal native enzyme and normal 40-kDa protein which had been further purified by preparative SDS-PAGE. In Western blots these antibodies complexed with both the normal and mutant 40-kDa proteins. The amount of 40-kDa protein in normal and protoporphyria mitochondrial fractions was also similar as evaluated by Western blots. These studies indicate that the ferrochelatase defect in bovine protoporphyria probably results from a point gene mutation that causes a minor change in enzyme structure. PMID- 3805003 TI - The binding of Ca2+, Mg2+ and Cd2+ to tryptic fragments of skeletal muscle troponin C. Cadmium-113 and proton NMR studies. AB - The structure of skeletal troponin C (sTnC) comprises two independently folded domains connected by an alpha-helical loop (Herzberg, O., and James, M.N.G. (1985) Nature 313, 653-659). Both the NH2-terminal domain TR1C (9-84) and the COOH-terminal domain TR2C (89-159) can be obtained by limited tryptic cleavage. Here we report on proton and cadmium-113 NMR studies of Ca2+, Mg2+, and Cd2+ binding to these two separated domains. Our studies indicate that both halves retain a structure in the apo- and Ca2+-forms which resembles that of the intact protein. The events accompanying Ca2+ binding to these fragments are consistent with a biphasic binding pattern for sTnC, where the two sites in the COOH terminal half are filled before those in the NH2-terminal half. Mg2+ only binds strongly to the two calcium-binding sites in the COOH-terminal half. The binding of this metal ion gives rise to a similar conformation for TR2C as that obtained with Ca2+. Whereas the binding of Ca2+ to the COOH-terminal part of sTnC takes place in a positive cooperative manner, the binding of this metal ion to TR2C occurs sequentially. Nevertheless, both Ca2+ ions bound to TR2C are in slow exchange (koff less than 10s-1). The binding of Mg24 both to sTnC and TR2C follows a sequential pattern with one site in slow exchange (koff less than 20 s 1) and one site in fast exchange (koff greater than 800 s-1). Binding of Cd2+ to TR2C occurs in a positive cooperative manner and results in the same conformation as observed with Ca2+. Cadmium-113 NMR spectra obtained at 5 degrees C confirm that two strong Cd2+-binding sites are localized in the COOH-terminal half and two weaker ones in the NH2-terminal half. It is concluded that these two proteolytic fragments comprise reasonable structural models for intact sTnC. PMID- 3805004 TI - Concentration and partitioning of intermediates in the fructose bisphosphate aldolase reaction. Comparison of the muscle and liver enzymes. AB - Chemical analysis of enzyme reaction intermediates has been used to compare the liver and muscle isozymes of rabbit aldolase at equilibrium and in their steady states to determine if they have properties that favor the direction of flow of glycolytic intermediates in their tissues of origin. For both enzymes at saturating concentrations of fructose 1,6-P2, the sum of intermediates in the steady state agreed with the total active enzyme calculated to be present. The two half-reactions, characterized by fructose 1,6-bisphosphate(Fru-P2):aldehyde exchange and DHAP:proton exchange were found to be of different importance in determining the rate of reaction with Fru-P2 with the liver enzyme being much more limited in the processing of DHAP. The chemical interconversions within each half-reaction are generally rapid compared with the release of products. The greater sensitivity of liver aldolase to inhibition by aldehydes in Fru-P2 cleavage seems to be a normal consequence of the higher level of the eneamine of DHAP in the forward steady state with the liver enzyme and probably should not be ascribed to a greater intrinsic affinity. An earlier report (Grazi, E., and Trombetta, G. (1979) Eur. J. Biochem. 100, 197-202) purporting to show a special interaction of glyceraldehyde-3-P with liver enzyme prior to proton abstraction from DHAP could not be reproduced. Examples are presented from the data that validate the use of the analytical methods used for analysis of intermediates in the case of the Schiff's base aldolases. PMID- 3805005 TI - Interaction of rat testis protein, TP, with nucleic acids in vitro. Fluorescence quenching, UV absorption, and thermal denaturation studies. AB - The nucleic acid binding properties of the testis protein, TP, were studied with the help of physical techniques, namely, fluorescence quenching, UV difference absorption spectroscopy, and thermal melting. Results of quenching of tyrosine fluorescence of TP upon its binding to double-stranded and denatured rat liver nucleosome core DNA and poly(rA) suggest that the tyrosine residues of TP interact/intercalate with the bases of these nucleic acids. From the fluorescence quenching data, obtained at 50 mM NaCl concentration, the apparent association constants for binding of TP to native and denatured DNA and poly(rA) were calculated to be 4.4 X 10(3) M-1, 2.86 X 10(4) M-1, and 8.5 X 10(4) M-1, respectively. UV difference absorption spectra upon TP binding to poly(rA) and rat liver core DNA showed a TP-induced hyperchromicity at 260 nm which is suggestive of local melting of poly(rA) and DNA. The results from thermal melting studies of binding of TP to calf thymus DNA at 1 mM NaCl as well as 50 mM NaCl showed that although at 1 mM NaCl TP brings about a slight stabilization of the DNA against thermal melting, a destabilization of the DNA was observed at 50 mM NaCl. From these results it is concluded that TP, having a higher affinity for single-stranded nucleic acids, destabilizes double-stranded DNA, thus behaving like a DNA-melting protein. PMID- 3805006 TI - Regulation of polypeptide chain initiation in Chinese hamster ovary cells with a temperature-sensitive leucyl-tRNA synthetase. Changes in phosphorylation of initiation factor eIF-2 and in the activity of the guanine nucleotide exchange factor GEF. AB - When cultures of the temperature-sensitive Chinese hamster ovary cell mutant tsH1 are shifted from 34 degrees C (permissive temperature) to 39.5 degrees C (nonpermissive temperature), protein synthesis is inhibited by more than 80%. This is due principally to a block in activity of polypeptide chain initiation factor eIF-2. In this paper we show that there is impairment of the ability of the guanine nucleotide exchange factor (GEF) to displace GDP from eIF-2 X GDP complexes in extracts from cells incubated at the nonpermissive temperature. Addition of GEF or of high concentrations of eIF-2 stimulates protein synthesis to the level observed in control cell extracts, suggesting that GEF is rate limiting for eIF-2 activity and overall protein synthesis at the nonpermissive temperature. Analysis of eIF-2 by two-dimensional gel electrophoresis and immunoblotting reveals an increase in the proportion of the alpha subunit in the phosphorylated form from 5.5 +/- 2.4% to 17.2 +/- 3.9% on shifting tsH1 cells from 34 to 39.5 degrees C. No such effect is seen in wild-type cells, which do not exhibit temperature-sensitive protein synthetic activity. Since the primary lesion in tsH1 cells is in their leucyl-tRNA synthetase, these results suggest a role for eIF-2 phosphorylation and GEF activity in coupling the rate of polypeptide chain initiation to the activity of the chain elongation machinery. PMID- 3805007 TI - Chromatin structure and methylation state of a thyroid hormone-responsive gene in rat liver. AB - The gene for S14 in the rat codes for an mRNA which in lipogenic tissues (liver, fat, mammary gland) responds both to L-triiodothyronine and a high-carbohydrate, fat-free diet. In an effort to understand the molecular basis for the tissue specific regulation of mRNA-S14 expression, we have examined the organization of this gene in chromatin. Specifically, we examined the distribution of DNase I hypersensitive sites and DNA methylation sites associated with a 25-kilobase chromosomal domain containing the S14 gene. Our results show that DNase I preferentially digests four regions of the DNA flanking the 5' end of the hepatic S14 gene which have characteristics of DNase I-hypersensitive sites. The sites, identified as HS-1, HS-2, HS-3, and HS-4, are located at or adjacent to the site of transcription initiation and at 1.2, 7, and 8 kilobases upstream from this site, respectively. In lactating mammary gland where the S14 gene is also highly expressed and regulated by L-triiodothyronine, sites HS-1, HS-2, and HS-4 are present, but HS-3 is absent. No hypersensitive sites were detected either within the gene or flanking the 3' end of the gene. In brain, kidney, and spleen, tissues in which mRNA-S14 is expressed at levels less than or equal to 10% of that found in euthyroid liver, sites HS-1 and HS-3 were absent. Despite the marked effect of thyroid state on the abundance of hepatic mRNA-S14, no significant alterations were observed in the DNase I sensitivity of hepatic chromatin containing the S14 gene. Analysis of the DNA methylation pattern at HpaII and HhaI sites showed a positive correlation of hypomethylation of the gene and the contiguous flanking regions with S14 gene expression. All HpaII/MspI sites and most HhaI sites either within or flanking the S14 gene were undermethylated in liver and lactating mammary gland. Although thyroid status had no generalized effect on the site-specific DNA methylation state of the hepatic S14 chromosomal domain, one site (H3) situated in the second exon close to the 3' terminus of the S14 gene appeared to undergo demethylation in the transition from hypo- to euthyroidism. In essence, our results show that the 5' DNA flanking region of the S14 gene contains a tissue-specific DNase I-hypersensitive site which, although not influenced by thyroid status, appears essential for the expression of S14 and its regulation by L-triiodothyronine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805008 TI - Deamidation, isomerization, and racemization at asparaginyl and aspartyl residues in peptides. Succinimide-linked reactions that contribute to protein degradation. AB - Aspartyl and asparaginyl deamidation, isomerization, and racemization reactions have been studied in synthetic peptides to model these spontaneous processes that alter protein structure and function. We show here that the peptide L-Val-L-Tyr-L Pro-L-Asn-Gly-L-Ala undergoes a rapid deamidation reaction with a half-life of only 1.4 days at 37 degrees C, pH 7.4, to give an aspartyl succinimide product. Under these conditions, the succinimide product can further react by hydrolysis (half-time, 2.3h) and by racemization (half-time, 19.5 h). The net product of the deamidation reaction is a mixture of L- and D-normal aspartyl and beta transpeptidation (isoaspartyl) hexapeptides. Replacement of the asparagine residue by an aspartic acid residue results in a 34-fold decrease in the rate of succinimide formation. Significant racemization was found to accompany the deamidation and isomerization reactions, and most of this could be accounted for by the rapid racemization of the succinimide intermediate. Replacement of the glycyl residue in the asparagine-containing peptide with a bulky leucyl or prolyl residue results in a 33-50-fold decrease in the rate of degradation. Peptide cleavage products are observed when these Asn-Leu and Asn-Pro-containing peptides are incubated. Our studies indicate that both aspartic acid and asparagine residues may be hot spots for the nonenzymatic degradation of proteins, especially in cells such as erythrocytes and eye lens, where these macromolecules must function for periods of about 120 days and 80 years, respectively. PMID- 3805009 TI - Molecular cloning and characterization of cDNA for androgen-repressible rat liver protein, SMP-2. AB - SMP-2 is a rat liver protein whose synthesis is influenced by both androgens and aging. The steady-state level of its mRNA is repressed by the androgen. Compared to the adult male, SMP-2 mRNA is found in higher amounts in the prepubertal and senescent male rat livers which show relative androgen insensitivity. A cDNA library in the plasmid pBR322 was constructed from the female rat liver which contains a high level of SMP-2 mRNAs. Recombinant plasmids were screened by differential colony hybridization to 32P-labeled single-stranded cDNAs from adult female and adult male hepatic poly(A)+ RNAs. From a total of 3500 recombinant clones, 11 highly female specific clones were identified. From these female specific colonies the SMP-2 cDNA-containing plasmid (pSP11) was identified by its ability to select an mRNA species whose translation product is immunochemically and electrophoretically indistinguishable from SMP-2. This insert represents a 571-base pair portion of the SMP-2 cDNA. Rescreening of the library at a high colony density using the 32P-labeled cDNA insert of pSP11 identified several positive clones with larger inserts. Hybrid-selected mRNA translation again confirmed these clones to carry SMP-2 cDNA sequences. The plasmid pSP4a containing a 1040-base pair cDNA insert of SMP-2 was characterized by DNA sequence analysis. The size of the cDNA insert of pSP4a is close to the estimated size of the SMP-2 mRNA. The cDNA sequence provides an open reading frame of 282 amino acid residues. A comparison of the translated amino acid sequence with the protein sequences of NBRF-PIR, PSQNEW, and LOSALA data bases did not establish any sequence homology with known proteins. Northern blot analysis using the 32P labeled cDNA insert of pSP4a confirms the androgenic repression of the SMP-2 mRNA. PMID- 3805010 TI - Heterologous desensitization of the inhibitory A1 adenosine receptor-adenylate cyclase system in rat adipocytes. Regulation of both Ns and Ni. AB - Adenosine, acting via A1 adenosine receptors, can inhibit adenylate cyclase activity in adipocytes. To assess the effects of chronic adenosine agonist exposure on the A1 adenosine receptor system of adipocytes, rats were infused with (-)-phenylisopropyladenosine or vehicle for 6 days and membranes were prepared. Basal as well as isoproterenol-, sodium fluoride-, and forskolin stimulated adenylate cyclase activities were significantly increased (approximately 2-fold) in membranes from treated animals. (-) Phenylisopropyladenosine-mediated inhibition of forskolin-stimulated adenylate cyclase activity was significantly (p = 0.0001) attenuated in membranes from treated rats (20.1 +/- 2.1% inhibition) versus controls (31.6 +/- 2.3% inhibition). Prostaglandin E1-induced inhibition of forskolin-stimulated adenylate cyclase activity was also attenuated: 11.7 +/- 3.6 versus 23.2 +/- 4.6% (p = 0.001). Using the A1 adenosine receptor agonist radioligand (-)-N6-(3 [125I]iodo-4-hydroxyphenylisopropyl)adenosine, 32% fewer high affinity binding sites were detected in membranes from treated animals (p less than 0.04). Photoaffinity labeling with N6-2-(3-[125I]iodo-4-azidophenyl)ethyladenosine revealed no gross difference in receptor structure. The number of beta-adrenergic receptors as well as the percentage of receptors in the high affinity state as assessed by (-)-3-[125I]iodocyanopindolol binding were the same in both groups. In membranes from treated rats, the amount of [alpha-32P]NAD incorporated by pertussis toxin into the alpha subunit of the inhibitory guanine nucleotide regulatory protein (Ni) was decreased by 37 +/- 11%. Concurrently, the quantity of label incorporated by cholera toxin into the alpha subunit of the stimulatory guanine nucleotide regulatory protein (Ns) was increased by 44 +/- 14% in treated membranes. Finally, the capacity of Ns solubilized from treated membranes to stimulate adenylate cyclase activity when reconstituted into cyc- S49 lymphoma cell membranes was enhanced by approximately 50% compared to control. Thus, heterologous desensitization, manifested by a diminished capacity to inhibit adenylate cyclase and an enhanced responsiveness to stimulatory effectors, can be induced in the A1 adenosine receptor-adenylate cyclase system of adipocytes. A decrease in Ni alpha subunit concomitant with an increase in Ns alpha subunit quantity and activity may represent the biochemical mechanism of desensitization in this system. PMID- 3805011 TI - Affinity labeling of a novel cholecystokinin-binding protein in rat pancreatic plasmalemma using new short probes for the receptor. AB - Previous biochemical characterizations of the cholecystokinin (CCK) receptor have used the "long" probe 125I-Bolton-Hunter-CCK-33 since it was the only CCK analogue with high affinity and high specific radioactivity which possessed an amino group available for chemical cross-linking. These studies have consistently identified a major binding protein of approximately 81 kilodaltons and have identified several minor proteins which were obtained under different cross linking conditions and in different laboratories. Because the receptor-binding region of CCK-33 (carboxyl-terminal heptapeptide) is so far removed from the radiolabel and from available amino groups (positions 1 and 11), this probe carries potential for proteolytic cleavage of label from receptor and for labeling "near neighbors" instead of the binding site. We therefore designed two "short" probes for the CCK receptor. 125I-Bolton-Hunter-Lys-Gly-CCK-8 has an epsilon-amino group available for cross-linking. 125I-Tyr-[Thr28,Nle31]CCK-25-33 has an alpha-amino group for cross-linking and has the major advantage of being labeled by oxidative means, unique for CCK derivatives. Both radioiodinated decapeptides were purified by reverse-phase high pressure liquid chromatography to yield specific radioactivity of 2,000 Ci/mmol; demonstrated saturable, specific, and high affinity binding to rat pancreatic plasma membranes; and retained full biological activity to stimulate amylase secretion. Using a variety of cross-linking methods, these probes each identified the same Mr = 85,000 95,000 protein in rat pancreatic plasmalemma, and CCK-8 competed for this labeling in a concentration-dependent manner (IC50 = 1 nM). No change in apparent mobility of this band was observed under reducing or nonreducing conditions, suggesting lack of covalent attachment to other subunits. The Mr = 85,000-95,000 species migrated differently on sodium dodecyl sulfate gels than any of the components previously identified using 125I-Bolton-Hunter-CCK-33, confirming the novel nature of this binding protein. These short probes should be very useful for further characterization of CCK receptors on this and other tissues. PMID- 3805012 TI - Induction of tissue-specific proline-rich protein multigene families in rat and mouse parotid glands by isoproterenol. Unusual strain differences of proline-rich protein mRNAs. AB - A dramatic induction of proline-rich protein mRNAs by the beta-agonist isoproterenol in the parotid and submandibular glands of both rats and mice has been demonstrated using Northern and dot-blot hybridizations and cell-free translation. Proline-rich protein mRNAs were either very low or not detectable in glands of control rats and mice. After 4 days of isoproterenol treatment, mRNAs encoding these unusual proteins comprised over 50% of the total glandular mRNAs. A 2-4-fold increase in proline-rich protein mRNAs was observed in rat parotid glands as soon as 4 h after treatment. The rat proline-rich protein multigene family encodes two groups of mRNAs with sizes ranging from 600 to 1100 bases. Cell-free translations gave about 10-12 proline-rich proteins. In glands of isoproterenol-treated mice, major species of proline-rich protein mRNAs were observed at 1050 and 1300 bases for BALB/cJ and DBA/2J mice and at 1100 and 1200 bases for CD-1 and C57BL/6J mice. Cell-free translations showed unusual differences in proteins synthesized from the four strains after isoproterenol treatment. AtT20 cells were transfected with a mouse proline-rich protein gene inserted into the plasmid pUC8 (pUMP2-BE). Transcription of proline-rich protein mRNA was induced by exposing these transfected cells to either isoproterenol or cAMP, plus theophylline. PMID- 3805013 TI - Antithrombin-III Denver, a reactive site variant. AB - Antithrombin-III Denver is a mutant protein which differs from the normal in being defective in serine protease binding (Sambrano, J. E., Jacobson, L. J., Reeve, E. B., Manco-Johnson, M. J., and Hathaway, W. E. (1986) J. Clin. Invest. 77, 887-893). It was isolated from the blood of an individual heterozygous for the abnormal gene by: affinity separation on heparin-Sepharose to obtain an antithrombin fraction, and gel filtration of the species present following complexing of the antithrombin fraction with a small excess of thrombin. The reduced, S-carboxymethylated protein formed a mixture of soluble tryptic peptides which was fractionated on Vydac C18. A single, unique peptide not present in a parallel experiment with normal antithrombin-III was isolated. This peptide was identified by sequence analysis and synthesis to correspond to residues 394-399 in the known sequence of the inhibitor, with leucine replacing reactive site P'1 residue Ser394. Although chromatograms of the tryptic peptides from the normal and mutant proteins were otherwise indistinguishable, the existence of additional residue replacements is not excluded. Measurements of the rate of thrombin binding by the mutant protein with p-aminobenzamidine as a fluorescent indicator showed that the second-order rate constant is reduced drastically. Meaningful measurements with the mutant protein could only be made in the presence of heparin and revealed a reduction of about 4000-fold in the rate constant. PMID- 3805015 TI - A novel group of very long chain polyenoic fatty acids in dipolyunsaturated phosphatidylcholines from vertebrate retina. AB - Dipolyunsaturated phosphatidylcholines from bovine retina contain a whole series of unusual fatty acids. Methyl esters from these acids are very strongly retained on polar and nonpolar gas-liquid chromatography stationary phases. On thin layers of silica-AgNO3, they separate as tetra-, penta-, and hexaenoic fatty acid methyl esters. After hydrogenation, the three polyunsaturated fractions give the same series of saturated methyl esters, having 20 (or 22)-36 carbon atoms. High pressure liquid chromatography, as well as gas-liquid chromatography, indicates that the new components of the three fractions are even-carbon homologs of well known polyenoic fatty acids of the n-6 and n-3 families, since they behave as series of 20-36-carbon tetraenoic (n-6), pentaenoic (n-3 and n-6), and hexaenoic (n-3) fatty acids. Their occurrence in phospholipid molecules also having docosahexaenoate (22:6) explains the separation of major dipolyunsaturated phosphatidylcholines from retina into dodecaenoic, undecaenoic, and decaenoic fractions after argentation thin layer chromatography. Using high pressure liquid chromatography, the latter are resolved into individual species having 10-12 double bonds and 42-58 carbon atoms. The unusual PCs are thus endowed not only with the highest degree of unsaturation, but with the longest hydrocarbon chains yet reported for vertebrate glycerophospholipids. It is shown that phosphatidylcholines containing the novel fatty acids are highly concentrated in photoreceptor membranes and that they occur in the retina of vertebrates so distant in evolution as fish, birds, and various mammals. PMID- 3805014 TI - Effects of sodium butyrate on human colonic adenocarcinoma cells. Induction of placental-like alkaline phosphatase. AB - We have examined the effects of the "differentiating agent," sodium butyrate, on the induction of alkaline phosphatase in human colonic tumor cell line LS174T. Culture of these cells in the presence of 2 mM butyrate caused this activity to increase from less than 0.0001 unit/mg of protein to greater than 0.7 unit/mg of protein over an 8-day period. This induction proceeded in a nonlinear fashion with a lag time of 2-3 days occurring before enzymatic activity began to rise. These increases in activity were accompanied by elevations in the content of a placental-like isozyme of alkaline phosphatase as demonstrated by "Western" immunoblots. Dome formation, indicative of differentiation in cultured cells, also required 3 days treatment with butyrate before becoming evident. The rate of biosynthesis of the enzyme, examined using metabolic labeling with L [35S]methionine and immunoprecipitation, was found to increase continuously between days 2 and 6 of butyrate treatment. "Northern" blot analysis indicated that treatment of these cells with butyrate caused greater than 20-fold induction of a 2700-base mRNA that hybridized to a cDNA probe for placental alkaline phosphatase. The mRNA for alkaline phosphatase produced by these cells upon butyrate treatment was approximately 300-400 bases smaller than the mRNA for alkaline phosphatase found in placenta. Human small intestine also contained two mRNAs that hybridized relatively weakly with the placental alkaline phosphatase probe. These results indicate that a placental alkaline phosphatase-like protein and mRNA are induced by butyrate in LS174T cells with a time course consistent with cellular differentiation preceding induction. PMID- 3805016 TI - Very long chain (C24 to C36) polyenoic fatty acids of the n-3 and n-6 series in dipolyunsaturated phosphatidylcholines from bovine retina. AB - A complete series of even-carbon chain polyenoic fatty acids having 20-36 carbons occur in dipolyunsaturated molecular species of phosphatidylcholine from bovine retina. Using oxidative ozonolysis, it is shown that very long chain tetraenes belong to the n-6 series, hexaenes to the n-3 series, and major pentaenes to the n-3 series of fatty acids (very long chain n-6 pentaenes also occur). Molecular ions are obtained by electron impact mass spectrometry of methyl ester derivatives which conclusively identify the major components of this novel group of fatty acids. Mass spectral patterns are similar for the major very long chain tetraenes, for the pentaenes, and for the hexaenes, but different for each group of unsaturation. Very long chain (C24 to C36) polyenes account for about half the weight (40 mol %) of the acyl chains of major dodecaenoic, undecaenoic, and decaenoic molecular species of bovine retina phosphatidylcholine, the other half being made up by docosahexaenoate (22:6 n-3). PMID- 3805017 TI - Transacylation of lyso platelet-activating factor and other lysophospholipids by macrophage microsomes. Distinct donor and acceptor selectivities. AB - Rabbit alveolar macrophage microsomes were found to acylate 1-[3H]alkyl-glycero-3 phosphocholine (GPC) (lyso platelet-activating factor) in the absence of any cofactors, indicating the presence of transacylation activity. The transacylation activity was comparable to the activity of acyl-CoA:1-alkyl-GPC acyltransferase. The fatty acyl moieties introduced into 1-[3H]alkyl-GPC from membrane lipids by microsomes were mainly 20:4 (n-6). A very similar acylation profile was observed for the acylation of 1-[3H]alkyl-GPC in intact macrophages, suggesting that the CoA-independent transacylation system plays a very important part in the acylation of 1-[3H]alkyl-GPC in cells. We also confirmed that 14C-labeled 20:4(n 6), 20:5(n-3), 22:4(n-6), and 22:6(n-3) were transferred well from diacyl-GPC to 1-alkyl-GPC in a CoA-independent manner. The transfer rates for 16:0, 18:0, and 18:1 from diacyl-GPC to 1-alkyl-GPC were very low in the presence and absence of CoA. On the other hand, the transfer of 20:4 from diacyl-GPE or diacyl-GPI to 1 alkyl-GPC or 1-acyl-GPC was markedly increased by the addition of CoA. The above results indicate that the transacylation system exhibits distinct donor and acceptor selectivities and CoA dependency. These transacylation reactions could be very important in the regulation of the levels and the availability of lysophospholipids, including lyso platelet-activating factor, and C20 and C22 polyunsaturated fatty acids in living cells. PMID- 3805018 TI - Modification of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides with the 2',3'-dialdehyde derivative of NADP+ (oNADP+). AB - Glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides is irreversibly inactivated by the 2,3'-dialdehyde of NADP+ (oNADP+) in the absence of substrate. The inactivation is first order with respect to NADP+ concentration and follows saturation kinetics, indicating that the enzyme initially forms a reversible complex with the inhibitor followed by covalent modification (KI = 1.8 mM). NADP+ and NAD+ protect the enzyme from inactivation by oNADP+. The pK of inactivation is 8.1. oNADP+ is an effective coenzyme in assays of glucose-6-phosphate dehydrogenase (Km = 200 microM). Kinetic evidence and binding studies with [14C] oNADP+ indicate that one molecule of oNADP+ binds per subunit of glucose-6 phosphate dehydrogenase when the enzyme is completely inactivated. The interaction between oNADP+ and the enzyme does not generate a Schiff's base, or a conjugated Schiff's base, but the data are consistent with the formation of a dihydroxymorpholino derivative. PMID- 3805019 TI - Purification and properties of uroporphyrinogen III synthase from human erythrocytes. AB - Uroporphyrinogen III synthase (hydroxymethylbilane hydro-lyase (cyclizing); EC 4.2.1.75), the fourth enzyme in the heme biosynthetic pathway, was purified to homogeneity from human erythrocytes. For enzyme purification and characterization, a sensitive coupled enzyme assay was used which generated the substrate, hydroxymethylbilane; the oxidized product, uroporphyrin III, was quantitated by high pressure liquid chromatography. Uroporphyrinogen III synthase was initially separated from delta-aminolevulinate dehydratase and hydroxymethylbilane synthase by a preparative anion exchange chromatographic step. Subsequent chromatography on hydroxyapatite, phenyl-Sepharose, and Sephadex G-100 purified the enzyme about 70,000-fold with an 8% yield. Homogeneous enzyme was obtained following a final C4-reversed phase high pressure liquid chromatographic step which removed a single major and several minor protein contaminants from the enzyme. The purified enzyme had a specific activity of over 300,000 units/mg, an isoelectric point of 5.5, and was thermolabile (t1/2 at 60 degrees C approximately 1 min). Molecular weight studies by gel filtration (Mr approximately equal to 30,000) and analytical sodium dodecyl sulfate polyacrylamide gel electrophoresis (Mr approximately equal to 29,500) were consistent with the enzyme being a monomer. Using hydroxymethylbilane as substrate, the purified enzyme formed uroporphyrinogen III in the absence of hydroxymethylbilane synthase or other cofactors. The pH optimum was 7.4 and the Km for hydroxymethylbilane was 5-20 microM. The enzyme was activated by Na+, K+, Mg+, and Ca2+ and was inhibited by Cd2+, Cu2+, Hg2+, and Zn2+. Amino acid composition analysis was performed, and the N-terminal sequence, Met-Lys-Val-Leu Leu-Leu, was determined by microsequencing. The availability of the purified enzyme should permit investigation of its reaction mechanism as well as facilitate biochemical and molecular studies of the genetic defect in congenital erythropoietic porphyria. PMID- 3805020 TI - Concanavalin A interactions with asparagine-linked glycopeptides. Bivalency of high mannose and bisected hybrid type glycopeptides. AB - We have previously reported that concanavalin A (ConA) is precipitated by a high mannose type glycopeptide (Brewer, C. F. (1979) Biochem. Biophys. Res. Commun. 90, 117-122; Bhattacharyya, L., and Brewer, C. F. (1986) Biochem. Biophys. Res. Commun. 137, 670-674). In the present study, we have investigated the ability of a series of high mannose and bisected hybrid type glycopeptides to bind and precipitate the lectin. The modes of binding of the glycopeptides were studied by nuclear magnetic relaxation dispersion (NMRD) techniques, and their affinities were determined by hemagglutination inhibition measurements. The stoichiometries of the precipitation reactions were investigated by quantitative precipitation analysis. The equivalence zones (regions of maximum precipitation) of the precipitin curves indicate that certain high mannose and bisected hybrid type glycopeptides are bivalent for lectin binding. From the NMRD and precipitation data, we have identified two protein binding sites on each glycopeptide: one site on the alpha(1-6) arm of the core beta-mannose residue involving a trimannosyl moiety which binds with high affinity (primary site); and the other site on the alpha(1-3) arm of the core beta-mannose residue involving an alpha-mannose residue(s), which binds with lower affinity (secondary site). These two types of sites bind to ConA by different mechanisms. Certain bisected hybrid type glycopeptides were found to possess only the primary ConA binding sites, but not the secondary sites, and hence were able to bind but not precipitate the lectin. Other related glycopeptides have only the secondary type sites and thus exhibit low affinity and are unable to precipitate the protein. The results are related to the possible structure-function properties of cell-surface glycopeptides. PMID- 3805021 TI - Concanavalin A interactions with asparagine-linked glycopeptides. Bivalency of bisected complex type oligosaccharides. AB - In the preceding paper (Bhattacharyya, L., Ceccarini, C., Lorenzoni, P., and Brewer, C.F. (1987) J. Biol. Chem. 262, 1288-1293), we have demonstrated that certain high mannose and bisected hybrid type glycopeptides are bivalent for concanavalin A (ConA) binding. In the present study, we have investigated the interactions of ConA with a series of synthetic nonbisected and bisected complex type oligosaccharides and related glycopeptides. The modes of binding of the carbohydrates were studied by nuclear magnetic relaxation dispersion techniques, and their affinities were determined by hemagglutination inhibition measurements. We find that certain bisected complex type oligosaccharides are capable of binding and precipitating the lectin. The corresponding nonbisected analogs, however, bind but do not precipitate the protein. The stoichiometries of the precipitin reactions were investigated by quantitative precipitation analyses. The equivalence zones (regions of maximum precipitation) of the precipitin curves indicate that the bisected complex type oligosaccharides are bivalent for lectin binding. Data for the nonbisected analogs are consistent with their being univalent. The nuclear magnetic relaxation dispersion and precipitation data indicate that nonbisected and bisected complex type carbohydrates bind with different mechanisms and conformations. The former class binds by extended site interactions with the protein involving the 2 alpha-mannose residues on the alpha(1-6) and alpha(1-3) arms of the core beta-mannose residue. The latter class binds by only 1 of these 2 mannose residues, which leaves the other mannose residue free to bind to a second ConA molecule. The role of the bisecting GlcNAc residue in affecting the binding properties of complex type carbohydrates to ConA is discussed, and the results are related to the possible structure-function properties of complex type glycopeptides on the surface of cells. PMID- 3805022 TI - Ligatin: a peripheral membrane protein with covalently bound palmitic acid. AB - The ligatin monomer is a polypeptide of Mr = 10,000 which is soluble in acidified chloroform:methanol, a characteristic similar to that of Folch-Lee proteolipid. The hydrophobicity of ligatin is also reflected by its ability to interpolate into the phosphatidylcholine bilayer as shown by a concentration-dependent change in membrane conductance. However, unlike other proteolipids the amino acid composition of ligatin is not enriched in hydrophobic amino acids (isoleucine, leucine, valine, methionine, phenylalanine, tryptophan). Instead, the hydrophobic character of ligatin could be explained, at least in part, by the covalent association of fatty acids, 1.4-1.7 mol of palmitate/10,000 g of protein, as revealed by gas chromatography mass spectrographic analyses. The post translational addition of fatty acid may therefore be the means by which ligatin acquires an affinity for membranes. PMID- 3805023 TI - Development of intercellular communication during the epithelial reorganization of a renal cell line (LLC-PK1). AB - Junctional permeability determinations after microinjection of the fluorescent tracer, Lucifer Yellow CH, show that the cells in confluent monolayers of the renal epithelial cell lines LLC-PK1 and A6 are interconnected by intercellular junctions. This cell-to-cell communication network permits the fluorescent dye to diffuse from the microinjected cell into multiple adjacent neighboring cells. Cell-to-cell diffusion of the fluorescent dye was not observed at pH 6.0. Full recovery occurred, however, when the pH of the extracellular medium was adjusted to 7.4. To provide a sensitive index of the averaged efficacy of junctional communication, we measured the number of cells that survived ouabain treatment in a 50% mixture of wild and ouabain-resistant mutant LLC-PK1 cells. Electron probe microanalysis in uncoupled cells showed that ouabain treatment produced two populations of cells, with totally different intracellular Na+ and K+ content. Under this condition, only 50% of the population survived after 48 h of treatment. When ouabain treatment was initiated 24 h after plating, however, 100% survival was observed, and the cells contained uniform intracellular Na+ and K+ concentration. This finding is consistent with the theory that this protective effect is mediated through the presence of the functional communicating intercellular junctions. When ouabain was applied at different times after plating, full protection is reached by 2 h. The early development of cell-to-cell communication, which precedes the development of the occluding junctions and several transport systems by several hours, is consistent with the involvement of the intercellular junctions in the synchronization of the polarization process. PMID- 3805024 TI - Monoclonal antibodies directed to chemically synthesized lactogangliotetraosylceramide, a leukemia-associated antigen having a novel branching structure. AB - Murine leukemia cells (M1), in their undifferentiated state, have been characterized by the presence of cancer-associated lactoganglio-series glycolipids, one of which was identified as lactogangliotetraosylceramide (LcGg4) having a novel branching at the II-Gal of lactosylceramide through GlcNAc beta 1- --3 and GalNAc beta 1----4 linkage, as shown below (Kannagi, R., Levery, S.B., and Hakomori, S. (1984) J. Biol. Chem., 259, 8444-8451): GalNAc beta 1----4 Gal beta 1----4Glc beta 1----1Cer GlcNac beta 1----3 Since this glycolipid is a very minor component, it has been difficult to obtain enough of the purified glycolipid for the preparation of a monoclonal antibody. We developed a method to chemically synthesize this glycolipid using a lactose unit, a ceramide unit, and two hexosamine donors as synthons and made the synthetic glycolipid available as an immunogen. The two monoclonal antibodies we obtained (YI328-18 and YI328-51, both IgG3) specifically recognized the novel branching structure and had no cross reactivity with gangliotriaosylceramide or lactotriaosylceramide. Thus, the antibodies were found to be useful probes to detect lactogangliotetraosylceramide expressed in undifferentiated M1 leukemia cells, which disappears on induced differentiation. The results of this study indicate a new strategy to establish monoclonal antibody directed to novel minor glycolipid markers or their artificially designed analogs, employing chemically synthesized glycolipid antigens. PMID- 3805025 TI - Chinese hamster ovary cell mutant with defective down-regulation of low density lipoprotein receptors. AB - A monensin-resistant clone (Monr-31) shows a related series of differences from its parental Chinese hamster ovary (CHO) cell line in the cellular response to several ligands. The uptake and metabolism of low density lipoprotein (LDL) in the mutant cells are defective. Accumulation of fluorescent-labeled LDL as well as internalization and degradation of 125I-LDL are greatly reduced in Monr-31 cells. The receptor number for LDL on the cell surface of Monr-31 is about one third that for CHO cells, but affinity constants for both cell lines are similar. Electrophoretic analysis shows a slightly reduced molecular weight of LDL receptor in Monr-31 cells in comparison to that in CHO cells. The internalization index (internalization plus degradation per binding) of LDL of the mutant is about one-half that of CHO cells, suggesting a failure of internalization of LDL as well as LDL binding. Hybrids (hyb-1, -2, and -3) between CHO and Monr-31 cells show LDL binding and LDL internalization activities comparable to that of CHO cells, suggesting that the altered LDL response in Monr-31 cells is recessive. Addition of exogenous LDL to culture medium down-regulates the LDL receptor activity of CHO, hyb-2, and hyb-3 cells, whereas no such down-regulation is seen in Monr-31 cells. Probably as a result of the failure of down-regulation, the prominent inhibition of sterol synthesis from acetate and 3-hydroxy-3 methylglutaryl-coenzyme A reductase observed in CHO cells is scarcely detectable in Monr-31 cells. As a correlated result, sterol synthesis from acetate is 6-fold higher in the mutant. The failure of down-regulation of LDL receptors in Monr-31 cells is discussed in relation to the altered binding and internalization of LDL. PMID- 3805026 TI - Evidence that arginyl-glycyl-aspartate peptides and fibrinogen gamma chain peptides share a common binding site on platelets. AB - Synthetic peptides corresponding to the carboxyl terminus of the fibrinogen gamma chain inhibit the binding of fibrinogen, fibronectin, and von Willebrand factor to platelets, yet the active decapeptide sequence has only been found in fibrinogen to date. In contrast, all three proteins contain Arg-Gly-Asp sequences, and peptides containing Arg-Gly-Asp are potent inhibitors of their binding to activated platelets. We have analyzed the relationship between these peptide sets by direct binding assays. H12 (gamma 400-411) inhibited the binding of an Arg-Gly-Asp-containing peptide to platelets with similar dose response to inhibition of fibronectin binding. We have previously reported that GPIIb-IIIa binds to immobilized Arg-Gly-Asp peptides and can be eluted by Arg-Gly-Asp containing peptides in solution. Both H12 and L10 (gamma 402-411) completely eluted GPIIb-IIIa bound to immobilized Arg-Gly-Asp peptides. Conversely, when GPIIb-IIIa was bound to immobilized L10, either L10 or an Arg-Gly-Asp peptide could elute it. Peptide specificity was established by the failure of Gly-Arg-Gly Glu-Ser-Pro or acetylated L10 to elute GPIIb-IIIa from the immobilized peptides. These results indicate that the two peptide sets interact with the same receptor which contains GPIIb-IIIa. PMID- 3805027 TI - Immunological evidence for gap junction polypeptide in plant cells. AB - A whole cell homogenate prepared from soybean (Glycine max (L.) Merr. cv. Mandarin) root cells (SB-1 cell line) was electrophoresed on a sodium dodecyl sulfate-polyacrylamide gel and transferred to nitrocellulose paper. The nitrocellulose was probed with a monospecific antibody capable of recognizing the Mr 27,000 polypeptide of rat liver gap junctions; this antibody was prepared from immune serum raised against gap junctions purified from V79 cells (Chinese lung fibroblasts). The immunoblots afforded two polypeptides migrating at Mr 29,000 and 48,000. This pattern of blotting was also observed when homogenates of soybean or poinsettia leaves excised from whole plants were probed with anti-V79 gap junction antiserum. Gap junction purification schemes, developed for rat liver (Hertzberg, E. L. (1984) J. Biol. Chem. 259, 9936-9943), were employed on soybean protoplast homogenates yielding a significant enrichment for the Mr 29,000 and 48,000 polypeptides as judged by Coomassie Blue staining and immunoblotting with anti-V79 gap junction antiserum. These immunological results provide the first reported evidence for a homologous gap junction polypeptide in plant cells. PMID- 3805028 TI - Myristyl and palmityl acylation of the insulin receptor. AB - The presence of covalently bound fatty acids in the insulin receptor has been explored in cultured human (IM-9) lymphocytes. Both alpha (Mr = 135,000) and beta (Mr = 95,000) subunits of the receptor incorporate [3H]myristic and [3H]palmitic acids in a covalent form. The effects of alkali and hydroxylamine on the labeled subunits indicate the existence of two different kinds of fatty acid linkage to the protein with chemical stabilities compatible with amide and ester bonds. The alpha subunit contains only amide-linked fatty acid while the beta subunit has both amide- and ester-linked fatty acids. Analysis by high performance liquid chromatography after acid hydrolysis of the [3H]myristate- and [3H]palmitate labeled subunits demonstrates the fatty acid nature of the label. Furthermore, both [3H]myristic and [3H]palmitic acids are found attached to the receptor subunits regardless of which fatty acid was used for labeling. The incorporation of fatty acids into the insulin receptor is dependent on protein synthesis and is also detectable in the Mr = 190,000 proreceptor form. Fatty acylation is a newly identified post-translational modification of the insulin receptor which may have an important role in its interaction with the membrane and/or its biological function. PMID- 3805029 TI - Use of a sensitive receptor binding assay to discriminate between full-length and truncated human recombinant tumor necrosis factor proteins. AB - A radioreceptor assay (RRA) capable of detecting picomolar concentrations of human recombinant tumor necrosis factor (TNF) was used to compare the relative binding affinities of genetically engineered full-length and truncated TNF proteins. The specific cell-surface receptors for TNF present on the human cervical carcinoma cell line ME-180 were characterized as having a Kd of 0.2 nM and a density of 2700 sites/cell. Conditions were then defined for an RRA that maximized the specific binding of 125I-TNF to this adherent cell line. Incubation of ME-180 cells with 125I-TNF at 37 degrees C in the presence of 0.02% sodium azide resulted in a 4-fold increase in assay sensitivity and a doubling of specific counts bound, as compared to binding done at 4 degrees C with or without sodium azide. Inhibition of receptor-ligand internalization under these conditions was a likely reason for the increases. This system was utilized to compare low concentrations of the full-length TNF protein and a genetically altered TNF protein (mutein) which lacks the 10 N-terminal amino acids and contains an N-terminal methionine. Previous studies showing the truncated TNF to be 2- to 3-fold lower in cytotoxic activity on a variety of tumor cell lines were corroborated by our findings that the mutein was also three and one-half times lower in relative affinity for the TNF receptor on ME-180 cells. These results suggest a possible role for these residues in receptor binding and illustrate the use of a highly sensitive RRA for the evaluation of TNF molecules altered by recombinant DNA technology. PMID- 3805030 TI - Reductive trapping of substrate to bovine plasma amine oxidase. AB - Plasma amine oxidases catalyze the oxidative deamination of amines to aldehydes, followed by a 2e- reduction of O2 to H2O2. Pyrroloquinoline quinone (PQQ), previously believed to be restricted to prokaryotes, has recently been proposed to be the cofactor undergoing reduction in the first half-reaction of bovine plasma amine oxidase (Ameyama, M., Hayashi, U., Matsushita, K., Shinagawa, E., and Adachi, O. (1984) Agric. Biol. Chem. 48, 561-565; Lobenstein-Verbeek, C. L., Jongejan, J. A., Frank, J., and Duine, J. A. (1984) FEBS Lett. 170, 305-309). This result is unexpected, since model studies with PQQ implicate Schiff's base formation between a reactive carbonyl and substrates, whereas experiments with bovine plasma amine oxidase have failed to provide evidence for a carbonyl cofactor. We have, therefore, re-examined putative adducts between substrate and enzyme-bound cofactor, employing a combination of [14C]benzylamine and [3H]NaCNBH3. The use of the relatively weak reductant, NaCNBH3, affords Schiff's base specificity and permits the study of enzyme below pH 7.0. As we show, enzyme can only be inactivated by NaCNBH3 in the presence of substrate, leading to the incorporation of 1 mol of [14C]benzylamine/mol of enzyme subunit at complete inactivation. By contrast, we are unable to detect any labeling with [3H]NaCNBH3, analogous to an earlier study with [3H]NaCNBH4 (Suva, R. H., and Abeles, R. H. (1978) Biochemistry 17, 3538-3545). We conclude, first, that our inability to obtain adducts containing both carbon 14 and tritium rules out the reductive trapping either of amine substrate with pyridoxal phosphate or of aldehyde product with a lysyl side chain and, second, that the observed pattern of labeling is fully consistent with the presence of PQQ at the active site of bovine plasma amine oxidase. PMID- 3805031 TI - Mechanisms of acetaminophen oxidation to N-acetyl-P-benzoquinone imine by horseradish peroxidase and cytochrome P-450. AB - Horseradish peroxidase rapidly catalyzed the H2O2-dependent polymerization of acetaminophen. Acetaminophen polymerization was decreased and formation of GSSG and minor amounts of GSH-acetaminophen conjugates were detected in reaction mixtures containing GSH. These data suggest that horseradish peroxidase catalyzed the 1-electron oxidation of acetaminophen and that GSH decreased polymerization by reducing the product, N-acetyl-p-benzosemiquinone imine, back to acetaminophen. Analyses of reaction mixtures that did not contain GSH showed N acetyl-p-benzoquinone imine formation shortly after initiation of reactions. When GSH was added to similar reaction mixtures at various times, 3-(glutathion-S-yl) acetaminophen was formed. The formation and disappearance of this product were very similar to N-acetyl-p-benzoquinone imine formation and were consistent with the disproportionation of 2 mol of N-acetyl-p-benzosemiquinone imine to 1 mol of N-acetyl-p-benzoquinone imine and 1 mol of acetaminophen followed by the rapid reaction of N-acetyl-p-benzoquinone imine with GSH to form 3-(glutathion-S yl)acetaminophen. When acetaminophen was incubated with NADPH, oxygen and hepatic microsomes from phenobarbital-pretreated rats, 1.2 nmol 3-(glutathion-S yl)acetaminophen/nmol cytochrome P-450/10 min was formed. Formation of polymers was not observed indicating that N-acetyl-p-benzoquinone imine was formed via an overall 2-electron oxidation rather than a disproportionation reaction. However, when cumene hydroperoxide was replaced by NADPH in microsomal incubations, polymerization was observed suggesting that cytochrome P-450 might also catalyze the 1-electron oxidation of acetaminophen. PMID- 3805032 TI - ADP-ribosylation of a Mr 21,000 membrane protein by type D botulinum toxin. AB - When crude membrane fraction from bovine adrenal gland was incubated with type D botulinum toxin in the presence of NAD, a membrane protein with a molecular weight of 21,000 was specifically ADP-ribosylated. This ADP-ribosylation occurred dependent on the dose of the toxin and was abolished by prior boiling ADP-ribose transfer to the membrane protein was significantly suppressed when agmatine and L arginine methyl ester were included in the reaction mixture. Dithiothreitol stimulated this ADP-ribosylation about 3-fold. Incubation of membrane fractions from mouse brain and pancreas with this toxin also resulted in ADP-ribosylation of a protein of the same molecular weight. These results suggested that type D botulinum toxin catalyzed transfer of an ADP-ribose moiety of NAD to the specific membrane protein common to secretory cells. PMID- 3805033 TI - The phosphorylation of the primary gene products of alpha-crystallin. AB - The alpha-crystallin primary gene product A2 and its post-translational modified counterpart A1 were isolated from calf lens cortex. The amino acid compositions determined from both chains were almost identical and in excellent agreement with that calculated from the reported sequence of A2. Chemical analysis of phosphate revealed 1 mol/mol of A1 and was negative in A2. Phosphoamino acid analysis demonstrated the presence of phosphoserine only in A1. Chymotryptic peptide maps of A2 and A1 resolved approximately 50 peptides and were strikingly similar. An apparent change in the relative mobility of one peptide was the only difference observed between A1 and A2. Phosphate analysis of this peptide obtained from A1 and A2 was positive only in the peptide from A1. Identical amino acid composition and the sequence Arg-Leu-Pro-Ser-Asn-Val-Asp-Gln-Ser-Ala-Leu was found for the peptide isolated from both chains, corresponding to residues 119 to 129 in the reported sequence of A2. These results indicate that the post-translational modification of A2 to A1 is the result of a phosphorylation reaction rather than a spontaneous nonenzymatic deamidation as previously suggested. PMID- 3805034 TI - The three-dimensional structure of acarbose bound to glycogen phosphorylase. AB - Acarbose, a pseudotetrasaccharide with a conduritol ring at the nonreducing terminus, is a naturally occurring inhibitor of amylases. It is shown here to be an inhibitor of glycogen phosphorylase and to bind more tightly to the enzyme than the equivalent malto-oligosaccharide substrate. X-ray crystallographic studies of the acarbose-phosphorylase a complex in the presence of glucose and caffeine reveal the structure of acarbose as bound to the storage site of phosphorylase. The acarbose binds in an orientation such that the conduritol ring makes no protein contacts. As with malto-oligosaccharides bound at this site, the observed conformation of acarbose is stabilized by O-2-O-3' hydrogen bonding and is similar to, but not identical with, that predicted by hard-sphere exo-anomeric effect calculations and justified by 1H nuclear magnetic resonance studies (Bock, K., and Pedersen, H. (1984) Carbohydr. Res. 132, 142-149). Intramolecular O2-O3' hydrogen bonds appear to play an important role in stabilizing the conformation observed in these studies, even for those residues closely associated with the protein. PMID- 3805035 TI - The role of phospholipase A activity in rat liver microsomal lipid peroxidation. AB - The involvement of phospholipase(s) A in lipid peroxidation of rat liver microsomes was investigated by: (a) determining the effects of phospholipase A inhibitors (p-bromophenylacyl bromide, chlorpromazine, mepacrine) on the accumulation of thiobarbituric acid reactivity or on levels of oxidized phospholipids in response to selected oxidative stimuli and (b) measurement of phospholipase A activities in response to these agents. Lipid peroxidation in response to various peroxidation systems was inhibited completely by exposure of microsomes to p-bromophenylacyl bromide (250 microM). The effectiveness of p bromophenylacyl bromide was dependent on the presence of glutathione (200 microM) in preincubation mixtures. Chlorpromazine (100 microM) and mepacrine (100 microM) also effectively inhibited peroxidation, and their potency was independent of glutathione. The accumulation of oxidized phospholipids in response to the potent peroxidation stimulus alloxan/ferrous ion was similarly inhibited by p bromophenylacyl bromide, although the level of oxidized phospholipid in response to the initiator ADP/ferrous ion was not affected. Microsomal phospholipase A1 activity, assessed using a liposomal substrate, was substantially enhanced by promoters of lipid peroxidation. Phospholipase A2 activity was not detected using a liposomal substrate but was evident using radiolabeled microsomes as endogenous substrate and was enhanced by oxidative stimuli. We conclude that phospholipase A activity may play an integral role in the microsomal lipid peroxidation mechanism. Based on this study, we hypothesize a role for phospholipases in facilitating propagation reactions. PMID- 3805036 TI - Activation of dopamine beta-monooxygenase by external and internal electron donors in resealed chromaffin granule ghosts. AB - Membrane ghosts derived from chromaffin vesicles of bovine adrenal medullas have been used to examine the mechanism of reduction of dopamine beta-monooxygenase in its compartmentalized state. The rate of the dopamine beta-monooxygenase catalyzed conversion of dopamine to norepinephrine is greatly stimulated by the presence of ATP, reflecting substrate hydroxylation on the ghost interior subsequent to the active transport of dopamine. We demonstrate a 2-3-fold increase in the turnover rate for ghosts resealed with 0.2-2 mM potassium ferrocyanide, conditions leading to a slight decrease in the rate of dopamine transport. These data provide the first evidence that an intravesicular pool of reductant can activate dopamine beta-monooxygenase, as required by models in which vesicular ascorbate behaves as enzyme reductant. Although there is sufficient catecholamine (endogenous plus substrate) to keep internal ferrocyanide reduced in these experiments, an additional 2-3-fold increase in turnover occurs in the presence of 0.2-2 mM ascorbate on the ghost exterior. The magnitude of this activation is found to be constant at all concentrations of internal ferrocyanide (both below and above saturation), implying that reductants on opposite sides of the membrane behave independently. Replacement of ascorbate by potassium ferrocyanide as external reductant leads to almost identical results, and we are able to rule out an inward transport of dehydroascorbate as the source of activation by external ascorbate. We conclude that external reductants are capable of reducing membrane-bound dopamine beta-monooxygenase from the exterior face of the vesicle, either by direct reduction or through a membrane-bound mediator. It appears that two viable modes for reduction of dopamine beta-monooxygenase may exist in vivo, involving the reduction of membrane-bound enzyme by cytosolic ascorbate as well as the reduction of soluble enzyme by the pool of intravesicular ascorbate present in chromaffin vesicles. PMID- 3805037 TI - Squalene synthetase. Solubilization and partial purification of squalene synthetase, copurification of presqualene pyrophosphate and squalene synthetase activities. AB - Squalene synthetase (farnesyldiphosphate:farnesyldiphosphate farnesyltransferase, EC 2.5.1.21) is an intrinsic microsomal protein that catalyzes the synthesis of squalene from farnesyl pyrophosphate via the intermediate presqualene pyrophosphate. We have solubilized this enzyme from yeast with a mixture of the detergents N-octyl beta-D-glucopyranoside and Lubrol PX. Approximately 50-fold purification of the solubilized activities has been achieved by chromatography on DEAE-cellulose and hydroxylapatite and by isoelectric focusing. The most highly purified preparation has one major band of protein with a molecular weight of 53,000 as estimated by electrophoresis under denaturing conditions. The enzyme may also have been modified by proteolysis during isolation since a 47,000 molecular weight species was also found. The two activities, presqualene pyrophosphate synthetase and squalene synthetase, copurified during isolation. PMID- 3805038 TI - Purification and characterization of phthalate oxygenase and phthalate oxygenase reductase from Pseudomonas cepacia. AB - An enzymatic system has been isolated that catalyzes dihydroxylation of phthalate to form 1,2-dihydroxy-4,5-dicarboxy-3,5-cyclohexadiene with consumption of NADH and O2. This system is comprised of two proteins: a flavo-iron-sulfur protein with NADH-dependent oxidoreductase activity and a nonheme iron protein with oxygenase activity. Phthalate oxygenase is a large (approximately 217 kDa) protein composed of apparently identical 48-kDa monomers. The active enzyme has one Rieske-type [2Fe-2S] center and one mononuclear iron/monomer. Removal of the mononuclear iron by incubation with EDTA or with o-phenanthroline inhibits oxygenation; ferrous ion completely restores activity. No other metals are effective. Phthalate oxygenase is specific for phthalate or other closely related compounds. However, only phthalate is tightly coupled to NADH oxidation and O2 consumption with a stoichiometry of 1:1:1. Phthalate oxygenase is chemically competent to oxygenate phthalate when artificially supplied with reducing equivalents and O2. Phthalate oxygenase reductase is required, however, for efficient catalytic activity. The reductase is a monomeric 34-kDa flavo-iron sulfur protein containing FMN and a plant-ferredoxin-type [2Fe-2S] center in a 1:1 ratio. Phthalate oxygenase reductase is specific for NADH but can pass electrons to a variety of acceptors, including: phthalate oxygenase, cytochrome c, ferricyanide, and dichlorophenolindophenol. This system is similar to other bacterial oxygenase systems involved in aromatic degradation including: benzoate dioxygenase, toluene dioxygenase, benzene dioxygenase, and 4-methoxybenzoate demethoxylase. However, phthalate oxygenase can be isolated in large quantities and is more stable than most other such systems. PMID- 3805039 TI - Alterations in inositol phosphate production during oxidative stress in isolated hepatocytes. AB - The level of inositol phosphates was measured in rat hepatocytes treated with 2 methyl-1,4-naphthoquinone (menadione) or tert-butyl hydroperoxide, which cause Ca2+ mobilization from intracellular stores and an increase in cytosolic free Ca2+ concentration. Although neither agent produced any apparent changes in the resting level of inositol phosphates, pretreatment of hepatocytes with either menadione or tert-butyl hydroperoxide, as well as with several sulfhydryl reagents, markedly inhibited the increase in inositol phosphates induced by both hormonal and nonhormonal stimuli. Addition of dithiothreitol to menadione- or tert-butyl hydroperoxide-treated hepatocytes reversed this inhibition and reestablished responsiveness to extracellular stimuli. Our findings suggest that the inhibition of the inositol phosphate response by menadione and tert-butyl hydroperoxide occurs through the modification of critical sulfhydryl group(s) and that the alterations in intracellular Ca2+ homeostasis occurring during the metabolism of menadione and tert-butyl hydroperoxide in hepatocytes are not mediated by inositol phosphates. PMID- 3805040 TI - Activation of alkaline phosphatase with Mg2+ and Zn2+ in rat hepatoma cells. Accumulation of apoenzyme. AB - In Reuber rat hepatoma cells (R-Y121B), alkaline phosphatase activity increased without de novo enzyme synthesis (Sorimachi, K., and Yasumura, Y. (1986) Biochim. Biophys. Acta 885, 272-281). The enzyme was partially purified by butanol extraction from the particulate fractions. The incubation of the extracted alkaline phosphatase with the cytosol fraction induced a large increase in enzyme activity (5-10-fold of control). The dialyzed cytosol was more effective than the undialyzed cytosol during an early period of incubation at 37 degrees C. This difference between the dialyzed and the undialyzed cytosol fractions was due to endogenous Na+. For maximal activation of the enzyme, both Mg2+ above 1 mM and Zn2+ at low concentrations (below 0.01 mM) were needed, although Zn2+ at high concentrations (above 0.1 mM) showed an inhibitory effect. Zn2+ and Mg2+ alone slightly increased alkaline phosphatase activity. This activation of the enzyme was temperature dependent and was not observed at 0 or 4 degrees C. Polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate showed that the increase in alkaline phosphatase activity did not involve the fragmentation of the enzyme and that 65Zn2+ bound to it during enzyme activation with 65Zn2+ and Mg2+. The cytosol fraction not only supplied Zn2+ to the nascent enzyme but also increased the maximal enzyme activity more than did direct addition of metal ions. Ferritin and metallothionein contributed to the activation of alkaline phosphatase with the metal ions. Since the binding of Zn2+ and Mg2+ to the nascent alkaline phosphatase is disturbed in Reuber rat hepatoma cells (R-Y121B), the apoenzyme is accumulated inside the cells. The binding of Zn2+ and Mg2+ to the apoenzyme readily takes place in the cell homogenates accompanied by an increase in catalytic activity without new enzyme synthesis. PMID- 3805041 TI - Protein control of prosthetic heme reactivity. Reaction of substrates with the heme edge of horseradish peroxidase. AB - Incubation of horseradish peroxidase with phenylhydrazine and H2O2 markedly depresses the catalytic activity and the intensity, but not position, of the Soret band. Approximately 11-13 mol of phenylhydrazine and 25 mol of H2O2 are required per mol of enzyme to minimize the chromophore intensity. The enzyme retains some activity after such treatment, but this activity is eliminated if the enzyme is isolated and reincubated with phenylhydrazine. The prosthetic heme of the enzyme does not react with phenylhydrazine to give a sigma-bonded phenyl iron complex, as it does in other hemoproteins, but is converted instead to the delta-mesophenyl and 8-hydroxymethyl derivatives. The loss of activity is due more to protein than heme modification, however. The inactivated enzyme reacts with H2O2 to give a spectroscopically detectable Compound I. The results imply that substrates interact with the heme edge rather than with the activated oxygen of Compounds I and II and specifically identify the region around the delta-meso carbon and 8-methyl group as the exposed sector of the heme. Horseradish peroxidase, in contrast to cytochrome P-450, generally does not catalyze oxygen transfer reactions. The present results indicate that oxygen-transfer reactions do not occur because the activated oxygen and the substrate are physically separated by a protein-imposed barrier in horseradish peroxidase. PMID- 3805042 TI - Structure and expression of murine malic enzyme mRNA. Differentiation-dependent accumulation of two forms of malic enzyme mRNA in 3T3-L1 cells. AB - Many murine cells express two mRNAs with markedly different sizes (2.0 and 3.1 kilobases (kb)) that hybridize with cDNA probes for cytosolic malic enzyme ((S) malate NADP+ oxidoreductase (oxaloacetate-decarboxylating, EC 1.1.1.40). A series of overlapping cDNA clones corresponding to 3129 nucleotides of malic enzyme mRNA was isolated and sequenced to determine the relationship between the two mRNAs and establish the primary structure of mouse malic enzyme. The larger mRNA has an open reading frame of 1716 nucleotides followed by a 3' untranslated region of 1348 nucleotides. The sequence of an exceptionally G/C-rich (88%) portion (65 nucleotides) of the 5' noncoding region was also established. An uncommon poly A addition signal (AUUAAA) is used during the processing of the 3.1-kb mRNA. The 2.0-kb mRNA results from the utilization of another poly A addition signal that truncates the 3' noncoding sequence by approximately 1 kb. The mRNA coding sequence indicates that the malic enzyme subunit contains 572 amino acid residues and has a Mr of 64,000. Two putative components of an NADP-binding domain are located between residues 100 and 165. During the differentiation of 3T3-L1 preadipocytes into adipocytes both the rate of synthesis and relative mRNA concentration for malic enzyme and another lipogenic enzyme, ATP-citrate lyase, are coordinately increased 5-7-fold. However, as preadipocytes approach confluence, the mRNA levels for both lipogenic enzymes transiently increase 3-4 fold, whereas the rates of synthesis of the two proteins are only slightly elevated. Thus, lipogenic enzyme expression is controlled at a pretranslational level during adipogenesis, but the accumulation of the same enzymes may also be subject to translational control in the fibroblast-like preadipocytes. In contrast, mRNA coding for a third enzyme required for lipogenesis, glycerol-3 phosphate dehydrogenase, is not detected in 3T3-L1 preadipocytes, but rapidly accumulates during adipocyte development. PMID- 3805043 TI - A novel procedure for the preparation and characterization of catalytically active fatty acid synthetase immobilized on sepharose beads. AB - A novel procedure for immobilization of enzymatically active fatty acid synthetase is presented. The enzyme is coupled to a Sepharose 4B matrix containing covalently attached antibodies which recognize, and bind specifically to, the thioesterase domain of this polyfunctional enzyme. A continuous flow system is described for assay of the immobilized enzyme. Fatty acid synthetase activity apparently is not limited by movement of substrates through the Nernst diffusion layer surrounding the matrix particles, since normal Michaelis-Menten kinetics are observed and reaction rates are independent of flow rate. The Km values for acetyl-CoA and malonyl-CoA, the pH/activity profile, and the reaction products are essentially the same as for the freely soluble enzyme, although the specific activity is lower by about 55%. The preparation and characterization of immobilized subunits of the enzyme could provide a valuable approach for studying the role of structural and functional subunit interactions in the enzyme. In addition, the immobilized enzyme offers a model for studying the properties of this enzyme in a highly structured environment such as might exist in vivo, permitting study of both physical and functional interactions of fatty acid synthetase with other lipogenic enzymes. PMID- 3805044 TI - Interaction of rat mammary gland thioesterase II with fatty acid synthetase is dependent on the presence of acyl chains on the synthetase. AB - The interaction between rat mammary gland thioesterase II and fatty acid synthetase has been studied by a variety of physicochemical techniques. Pyrene labeled thioesterase II does not exhibit increased fluorescence anisotropy when mixed with fatty acid synthetase, suggesting that the enzymes do not readily form a complex. Nevertheless, the functional interaction between the enzymes can be easily demonstrated by observing the hydrolysis, by unmodified thioesterase II, of acyl chains from their thioester linkage to the 4-phosphopantetheine of the fatty acid synthetase. This hydrolytic reaction is not inhibited even in the presence of a large excess of fatty acid synthetase with vacant 4' phosphopantetheine thiols, indicating that interaction occurs only between thioesterase and fatty acid synthetase species which carry acyl chains on the 4' phosphopantetheine thiols. A novel model system was devised which allowed us to explore the nature of the physical interaction between the two enzymes under conditions where the synthetase was actively engaged in acyl chain assembly. Fatty acid synthetase was treated with phenylmethanesulfonyl fluoride to inhibit its resident thioesterase activity, immobilized via a specific antibody to a column of Sepharose 4B, and exposed to the substrates required for acyl-enzyme assembly. When thioesterase II was introduced to the column, it passed through unretarded even though it efficiently catalyzed hydrolysis of the immobilized S acyl synthetase en route. These results indicate that the two enzymes associate when an acyl chain is present on the synthetase and that they dissociate rapidly following completion of the catalytic process. Thus, the mammary system differs from that of the avian uropygial gland in which the two enzymes associate to form a stable complex even in the absence of substrates. PMID- 3805045 TI - The elderberry (Sambucus nigra L.) bark lectin recognizes the Neu5Ac(alpha 2 6)Gal/GalNAc sequence. AB - Carbohydrate binding properties of a new plant lectin isolated from elderberry (Sambucus nigra L.) (SNA) bark were studied using the techniques of quantitative precipitation, hapten inhibition, and equilibrium dialysis. Purified SNA precipitates highly sialylated glycoproteins such as fetuin, orosomucoid, and ovine submaxillary mucin, but not their asialo derivatives. Hapten inhibition experiments showed that both D-Gal and D-GalNAc are weak inhibitors of SNA glycophorin precipitation, but neither New5Ac nor Neu5Gc is an inhibitor. A series of oligosaccharides which contain the terminal Neu5Ac(alpha 2-6)Gal sequence showed an extremely high inhibitory potency (1,600-10,000 times more inhibitory than Gal). On the other hand, oligosaccharides with the Neu5Ac(alpha 2 3)Gal linkage were only 30-80 times more inhibitory than Gal, thus showing a marked preference for the 2,6-linked isomer. Hapten inhibition with Gal and its epimers suggested that the equatorial OH at C-3 and the axial OH at C-4 of the D pyranose ring are strict requirements for binding. Conversion of the Neu5Ac residue to its 7-carbon analogue by selective periodate oxidation of its glyceryl side chain, followed by NaBH4 reduction, completely destroyed the ability of fetuin and orosomucoid to precipitate with SNA. Moreover, the same treatment of Neu5Ac(alpha 2-3)lactitol also abolished its ability to inhibit the precipitation reaction, suggesting that the glyceryl side chain of NBu5Ac (especially the C-8 and/or C-9 portion) is an important determinant for SNA. The increased inhibitory potency of various glycosides with beta-linked nonpolar aglycons suggested the presence of a hydrophibic interacting region adjacent to the carbohydrate binding site. The results of equilibrium dialysis using [3H] Neu5Ac(alpha 2-6)lactitol as ligand showed the presence of two equivalent, noninteracting carbohydrate binding sites in this tetrameric glycoprotein lectin (Ka = 3.9 X 10(5) M-1). PMID- 3805046 TI - Carbohydrate binding properties of complex-type oligosaccharides on immobilized Datura stramonium lectin. AB - The carbohydrate binding specificity of Datura stramonium agglutinin was studied by analyzing the behavior of a variety of complex-type oligosaccharides on a D. Stramonium agglutinin-Sepharose column. Oligosaccharides which contain Gal beta 1 ---4GlcNAc-beta 1----4(Gal beta 1----GlcNAc beta 1----2)Man units are retarded in the column so long as the pentasaccharide unit is not substituted by other sugars. Oligosaccharides which contain unsubstituted Gal beta 1----4GlcNAc beta 1 ---6(Gal beta 1----4GlcNAc beta 1----2)Man groups and those in which there is at least one Gal beta 1----4GlcNAc repeating unit present on an outer chain bind to the column and are eluted with buffer containing N-acetylglucosamine oligomers. Binding was not affected by the inner core portion of complex oligosaccharides nor by the presence of a bisecting N-acetylglucosamine residue. With these principles in mind, the column can be used as an effective tool for the analysis of complex-type, asparagine-linked sugar chains. PMID- 3805047 TI - The iodination sites of bovine thyrotropin. AB - Iodination of bovine thyrotropin (TSH) using a lactoperoxidase-catalyzed labeling method at pH 5.6 results in modification of both the alpha- and beta-subunits. In particular, 3 of the 5 tyrosine residues of the alpha-subunit and 9 of the 11 tyrosine residues in the beta-subunit are accessible to surface iodination. However, the reactivity of these tyrosine residues in bovine TSH toward iodination under these enzyme-catalyzed conditions follows the order alpha-Tyr-21 much greater than alpha-Tyr-92, -93, approximately equal to beta-Tyr-45, -54 greater than beta-Tyr-74 greater than beta-Tyr-18 approximately equal to beta-Tyr 112 greater than beta-Tyr-104 approximately equal to beta-Tyr-92 greater than beta-Tyr-7 greater than beta-Tyr-77. From reversed-phase high-performance liquid chromatography tryptic mapping, leucyl aminopeptidase M digestion, and microsequence analysis, it is clear that diiodination of the tyrosine residues is not favored for the beta-subunit with the exception of beta-Tyr-7, whereas diiodination was observed with alpha-Tyr-21 and alpha-Tyr-92/93. These data on iodination sites are evaluated in terms of the known receptor binding features of iodinated bovine TSH preparations as well as in terms of the surface accessibility of these specific residues as predicted from topographical algorithms based on an analysis of hydrophilic and hydrophobic regions of the subunits. The results provide an explanation for the anomalously low bound/total tracer ratio frequently observed in radioreceptor assay procedures for TSH and suggest a basis for further evaluation of the determinant loops associated with the hormone specificity of the beta-subunit. PMID- 3805048 TI - Increased procollagen mRNA levels in carbon tetrachloride-induced liver fibrosis in rats. AB - Carbon tetrachloride-induced liver damage is a well-characterized experimental model for studying liver fibrosis. We used this model to examine alpha 1(I), alpha 1(III), and alpha 1(IV) procollagen mRNA levels during the development of liver fibrosis. Rats were given 0.5 ml of carbon tetrachloride/kg of body weight for 1-6 weeks. The liver tissue was assayed for collagen content by measuring total hydroxyproline content. Specific increases in procollagen mRNAs were assayed by slot blot hybridization. There was a significant increase in hydroxyproline content of liver tissue following 3 weeks of carbon tetrachloride treatment. The increase in tissue collagen content correlated with an increase in alpha 1(I) procollagen mRNA levels. At 5 and 6 weeks of treatment, there was an increase in alpha 1(III) procollagen mRNA levels. alpha 1(IV) procollagen levels increased slightly with five injections of carbon tetrachloride treatment. These results suggest that specific increases in procollagen mRNAs in liver fibrosis parallel, but do not precede, increases in tissue collagen content. PMID- 3805049 TI - Structural analysis and specific expression of microsomal cytochrome P-450(M-1) mRNA in male rat livers. AB - cDNA clones for the P-450(M-1) mRNA, which exhibits a male-specific expression in rat livers, were isolated by using synthetic oligonucleotides as the probes. Sequence analysis of the cDNAs showed that P-450(M-1) mRNA contains 1,853 nucleotides in addition to a poly(A) chain, and a single open reading frame of 1,500 nucleotides encodes a polypeptide of 500 amino acids with a Mr = 57,187. The predicted NH2-terminal sequence of 30 amino acids agrees well with that of the purified protein determined by Edman degradation, and the predicted primary structure included all the partial sequences of six internal peptides of P-450(M 1) obtained by the proteolytic digestion and a conserved amino acid sequence containing a putative heme-binding cysteine, proximate to the COOH terminus of the molecules. P-450(M-1) showed relatively high sequence similarity with P-450b (Fujii-Kuriyama, Y., Mizukami, Y., Kawajiri, K., Sogawa, K., and Muramatsu, M. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 2793-2797) (52% similarity), P-450-3b (Ozols, J., Heinemann, F. S., and Johnson, E. F. (1985) J. Biol. Chem. 260, 5427 5434) (64%), P-450-1 (Tukey, R. H., Okino, S., Barnes, H., Griffin, K. J., and Johnson, E. F. (1985) J. Biol. Chem. 260, 13347-13354) (74%), P-450PBc1 (Leighton, J. K., DeBrunner-Vossbrinck, B. A., and Kemper, B. (1984) Biochemistry 23, 4598-4603) (71%), while its sequence similarity with 3-methylcholanthrene inducible P-450c and P-450d is rather low. Consequently, P-450(M-1) could be structurally classified into the phenobarbital-inducible type of P-450 gene family. RNA blot analysis using a synthetic oligonucleotide specific for P-450(M 1) revealed that P-450(M-1) mRNA was expressed exclusively in the livers of mature male rats in a sex-specific manner, but not in other tissues so far examined. PMID- 3805050 TI - High and low molecular weight rabbit secretory components. Evidence for the deletion of the second and third domains in the smaller polypeptide. AB - Rabbit secretory components exist in two forms which differ in apparent mass by about 25 kDa. Each of these two forms were reduced, carboxymethylated, and extensively digested with trypsin. The resulting peptides were purified by reverse-phase high performance liquid chromatography and characterized by NH2- and COOH-terminal sequence determination and/or amino acid analysis. They were aligned with the protein sequence predicted from the cDNA nucleotide sequence encoding the rabbit poly(Ig) receptor (Mostov, K. E., Friedlander, M., and Blobel, G. (1984) Nature 308, 37-43). All peptides belonging to the fourth and fifth domains except one (positions 488-496) were accounted for in both forms. In addition, limited tryptic proteolysis of the native low Mr secretory components produced the intact 18-kDa NH2-terminal domain (positions 1-117) and the 30-kDa fragment encompassing the fourth and fifth domains. These results suggest that the smaller polypeptide derives from the larger secretory component form by the deletion of the second and third domains. PMID- 3805051 TI - Purification of the ryanodine receptor and identity with feet structures of junctional terminal cisternae of sarcoplasmic reticulum from fast skeletal muscle. AB - The ryanodine receptor has been purified from junctional terminal cisternae of fast skeletal muscle sarcoplasmic reticulum (SR). The ryanodine receptor was solubilized with 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS) and stabilized by addition of phospholipids. The solubilized receptor showed the same [3H]ryanodine binding properties as the original SR vesicles in terms of affinity, Ca2+ dependence, and salt dependence. Purification of the ryanodine receptor was performed by sequential column chromatography on heparin agarose and hydroxylapatite in the presence of CHAPS. The purified receptor bound 393 +/- 65 pmol of ryanodine/mg of protein (mean +/- S.E., n = 5). The purified receptor showed three bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with Mr of 360,000, 330,000, and 175,000. Densitometry indicates that these are present in the ratio of 2/1/1, suggesting a monomer Mr of 1.225 X 10(6) and supported by gel exclusion chromatography in CHAPS. Electron microscopy of the purified preparation showed the square shape of 210 A characteristic of and comparable in size and shape to the feet structures of junctional terminal cisternae of SR, indicating that ryanodine binds directly to the feet structures. From the ryanodine binding data, the stoichiometry between ryanodine binding sites to the number of feet structures is estimated to be about 2. Since the ryanodine receptor is coupled to Ca2+ gating, the present finding suggests that the ryanodine receptor and Ca2+ release channel represent a functional unit, the structural unit being the foot structure which, in situ, is junctionally associated with the transverse tubules. It is across this triad junction that the signal for Ca2+ release is expressed. Thus, the foot structure appears to directly respond to the signal from transverse tubules, causing the release of Ca2+ from the junctional face membrane of the terminal cisternae of SR. PMID- 3805052 TI - Preliminary X-ray diffraction analysis of crystalline lectins from the seeds and leaves of Sophora japonica. AB - The Japanese Pogada Tree (Sophora japonica) contains at least four distinct lectins distributed among seeds, bark, and leaf tissues of the plant. All of these lectins are N-acetylgalactosamine-specific, have molecular weights of about 130,000, are glycoproteins and possess substantial sequence homology. However, they are products of distinct genes. We have crystallized Sophora lectins from bark, seeds, and two different lectins from leaves. Multiple crystal forms of each variety have been obtained by vapor diffusion with polyethylene glycol 4,000 solutions, and five of the crystal forms have been characterized by X-ray diffraction. The data demonstrates that at least in the case of leaf lectin II, the tetrameric molecule contains at least one exact dyad axis. Several of the crystals appear suitable for high resolution structure analysis. PMID- 3805053 TI - Functional elements of the human U1 RNA promoter. Identification of five separate regions required for efficient transcription and template competition. AB - We have determined the structure of the human U1 snRNA promoter by microinjection of several mutant U1 templates into Xenopus laevis oocytes. These deletion templates were assayed for their ability to express mature U1 RNA and for their ability to compete for limiting transcription factors. We have mapped five separate regions, called promoter elements A, B, C, D, and E. Element A, located between positions -8 and -50, stimulates transcription 3- to 5-fold increases the accuracy of initiation; element B (between -50 and -80) fixes the site of initiation and stimulates transcription greater than 100-fold; element C (upstream of -129) increases the efficiency of element B 3- to 5-fold; element D (between -191 and -231) is an orientation-independent and partially position independent enhancer responsible for a 100-fold stimulation of transcription; element E (between -335 and -393) increases the ability to compete with other snRNA genes 4-fold. All five promoter elements are required for effective competition with the wild-type U1 promoter suggesting that binding of transcription factor(s) to the complex is cooperative. The U1 RNA and some mRNA gene transcription complexes appear to share one or more transcription factors. PMID- 3805054 TI - Subunit exchange between membranous and soluble forms of bovine dopamine beta hydroxylase. AB - Dopamine beta-hydroxylase is present in the bovine adrenal medulla in two forms: soluble and membrane-bound. In a previous study, it was shown that the tetrameric, soluble form of the enzyme undergoes dissociation into two identical dimeric subunits and that this subunit dissociation is dependent on pH and ADP binding (Dhawan, S., Hensley, P., Osborne, J. C., Jr., and Fleming, P. J. (1986) J. Biol. Chem. 261, 7680-7684). Here we report the effect of pH and ADP on the dissociation of the membranous form of dopamine beta-hydroxylase into two nonidentical subunits. Negative stain electron microscopy of purified membranous hydroxylase showed largely tetrameric species together with occasional dimeric species. The tetrameric images of membranous hydroxylase were similar to, but clearly different from, previously published negative stain images of soluble hydroxylase (Duong, L. T., Fleming, P. J., and Ornberg, R. L. (1985) J. Biol. Chem. 260, 2393-2398). Quantitative binding of ADP to the membranous hydroxylase revealed the existence of two binding sites per dimeric subunit. ADP binding and low pH both promote dissociation of a hydrophilic, catalytically active subunit from the membranous enzyme reconstituted onto phospholipid vesicles. Kinetic analyses of reconstituted membranous hydroxylase activity were consistent with the existence of tetrameric and dimeric catalytic species in equilibrium. All of the hydrophilic subunits of the purified soluble hydroxylase bind to the hydrophobic subunits of the reconstituted membranous hydroxylase. We propose that, in the chromaffin granules, the soluble hydroxylase subunits are in equilibrium association with the membrane-bound hydroxylase subunits and that the hydrophilic subunits of both soluble and membranous hydroxylase are identical. PMID- 3805055 TI - Bacteriocuprein superoxide dismutase of Photobacterium leiognathi. Isolation and sequence of the gene and evidence for a precursor form. AB - The gene encoding the bacteriocuprein superoxide dismutase from Photobacterium leiognathi, American Type Culture Collection strain 25521, was cloned in a pUC12 vector and sequenced. The nucleotide sequence predicted a 22-residue leader peptide amino-terminal to the known bacteriocuprein sequence. The expected precursor bacteriocuprein was directly identified in the in vitro translation products of the cloned gene by polyacrylamide gel electrophoresis and automated Edman degradation. Enzymatically active bacteriocuprein that lacked the leader peptide was identified in sonic extracts of Escherichia coli hosts containing the cloned gene. A single transcript of 580 nucleotides was observed in blots of total P. leiognathi RNA, and a unique site of transcriptional initiation was identified by primer extension analysis. P. leiognathi bacteriocuprein is the first bacteriocuprein whose gene has been isolated and sequenced and the first copper-zinc superoxide dismutase in which a leader peptide has been found. The presence of a leader peptide suggests that the bacteriocuprein is localized in the membrane or periplasm, in contrast to the eukaryotic copper-zinc superoxide dismutases, which are cytoplasmic enzymes. Such a difference in intracellular location could be important for understanding the presence and function of the uncommon, bacteriocuprein superoxide dismutase in P. leiognathi. PMID- 3805056 TI - College football: to brace or not to brace. PMID- 3805057 TI - Giant-cell tumor of bone. AB - Of 327 patients who had a giant-cell tumor of bone and were seen at the Istituto Rizzoli, 293 were treated at the Institute, and 280 of these were followed for two to forty-four years. The distribution according to sex and age of the patient and site of the tumor was similar to the distributions in major reports of large series. The tumor usually involved the metaphysis and the epiphysis, but was occasionally limited to the metaphysis, and in only 2 per cent of the patients was it adjacent to an open growth plate. The tumor on occasion invaded the articular space, also involving the ligaments and the synovial membrane. Extension to an adjacent bone through the joint occurred in 5 per cent of the tumors. Our radiographic grading, which is roughly comparable with the staging system of Enneking et al., was Grade I in 4 per cent, II in 74 per cent, and III in 22 per cent of 266 patients before treatment. A pathological fracture was apparent on the first radiograph in 9 per cent of the patients. In the 280 patients with adequate follow-up, 331 surgical procedures were performed. The rate of local recurrence was 27 per cent in the 151 intralesional procedures, 8 per cent in the 122 marginal excisions, and zero in the fifty-eight wide or radical procedures. These results did not correlate with the radiographic grade of the lesion. Of the fifty-one local recurrences that were seen after treatment at our institution, 90 per cent appeared in the first three years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805058 TI - Treatment of displaced intra-articular fractures of the calcaneus using medial and lateral approaches, internal fixation, and early motion. AB - Twenty-two displaced intra-articular fractures of the calcaneus (in twenty-two patients) were treated by open reduction and internal fixation with a screw and one or two staples using a lateral and, when needed, a medial approach, followed by early motion. Despite the early motion, a nearly normal anatomical reduction was achieved and maintained in nineteen feet. After follow-up that ranged in duration from sixteen to seventy-two months, the clinical and radiographic result was rated as good in seventeen patients and fair in one, and there were four failures. Twenty-one of the twenty-two patients returned to work within six months. The average subtalar motion at follow-up was 75 per cent of normal. PMID- 3805059 TI - Herpetic infections in the fingers of infants. Report of five cases. PMID- 3805060 TI - Bilateral stress fracture of the lumbar pedicles in a ballet dancer. A case report. PMID- 3805061 TI - Sciatica caused by an avulsion fracture of the ischial tuberosity. A case report. PMID- 3805062 TI - Bipolar clavicular dislocation. Report of a case. PMID- 3805063 TI - Clinical significance of the erythrocyte sedimentation rate in orthopaedic surgery. PMID- 3805064 TI - The management of fractures in the patient with multiple trauma. PMID- 3805065 TI - Synovectomy of the knee for hemophilic arthropathy. PMID- 3805066 TI - Loosening of the porous coating of bicompartmental prostheses in patients with rheumatoid arthritis. PMID- 3805067 TI - Evaluation of the use of braces to prevent injury to the knee in collegiate football players. AB - Data were collected in 1984 from seventy-one schools that were members of Division I of the National College Athletic Association and in 1985 from sixty one of these schools to assess whether the use of so-called preventive braces for the knee was associated with a decrease in either the severity or the incidence (or both) of injuries to the knee in collegiate football players. Over-all, players who wore braces on the knees had significantly more injuries to the knee than players who did not. The severity of the injuries was no different in the two groups. Based on these findings, we cannot recommend the use of these braces in an attempt to prevent injury to collegiate football players. PMID- 3805068 TI - Condylar total knee arthroplasty after failed proximal tibial osteotomy. AB - Data were collected retrospectively on thirty-five patients who had a failed osteotomy of the proximal part of the tibia for unicompartmental osteoarthrosis of the knee that was treated with a cruciate condylar, total condylar, kinematic condylar, or cemented porous-coated anatomical total knee prosthesis. The patients were evaluated clinically and roentgenographically before and after the arthroplasty. The minimum period of follow-up was twenty-nine months (mean, forty four months). On the basis of the knee-rating scale of The Hospital for Special Surgery, 89 per cent of the patients had either an excellent or a good result after the arthroplasty. No result was a failure. One patient had loosening of the patellar component, but no other loosening was identified. The results of total knee arthroplasty after osteotomy of the proximal part of the tibia were found to be comparable with the results after arthroplasty in knees that had not had a prior osteotomy. The intraoperative and postoperative rates of complications were not higher, and no untoward technical difficulties were encountered at surgery. These data support the clinical impression that an osteotomy of the proximal part of the tibia does not "burn any bridges" insofar as a future successful arthroplasty is concerned. PMID- 3805069 TI - Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. AB - From 1960 through 1979, a closing-wedge varus osteotomy of the proximal part of the tibia was performed in thirty-one knees (twenty-eight patients) for painful osteoarthritis of the lateral compartment of the knee that was associated with a valgus deformity. The patients were followed for two to seventeen years (average, 9.4 years). Twenty-four knees (77 per cent) had either no pain or only occasional mild pain at the last evaluation. Six knees had moderate pain and one, severe pain. Six knees required a subsequent total knee arthroplasty at an average of 9.8 years after the osteotomy. No patient had an infection or non-union. Osteotomy of the proximal part of the tibia is a reasonable method of treating unicompartmental degenerative arthritis in a knee with a valgus deformity. Although some patients with as much as 20 degrees of anatomical valgus deformity obtained a good result in this series, osteotomy in the supracondylar region of the femur is probably preferable if the valgus angulation exceeds 12 degrees or if the tilt of the tibial articular surface that will result from the surgery will exceed 10 degrees. Correction beyond the normal 5 to 7 degrees of valgus angulation to zero degree of anatomical tibiofemoral alignment is recommended to prevent recurrence of the valgus deformity and to decrease the load on the lateral tibiofemoral compartment. PMID- 3805070 TI - Anaphylatoxin release in association with methylmethacrylate fixation of hip prostheses. AB - In a prospective study, thirty patients in whom a Charnley hip prosthesis was implanted with cement (methylmethacrylate) and fifteen who received a prosthesis without cement were studied. The activation of complement, as indicated by the release of anaphylatoxins (C3a and C5a), reduced activity of whole complement, and decreased levels of C3, C4, and C5 in plasma, was evaluated. Activation of complement was found when methylmethacrylate was used. In patients in whom components were fixed without cement, no formation of anaphylatoxins occurred, and only slightly reduced whole-complement activity and concentrations of C3, C4, and C5 in plasma were found. A dose-correlated release of the anaphylatoxins was found when monomethylmethacrylate was incubated in fresh serum. One explanation for the hemodynamic instability in these patients might be the biological effects of anaphylatoxins that are released in association with fixation by cement. PMID- 3805071 TI - Potential errors inherent in quantitative densitometric analysis of orthopaedic radiographs. A study after total hip arthroplasty. AB - We sought to determine whether x-ray densitometry could be used to provide quantitative information about the growth and resorption of bone in a retrospective analysis of the radiographs of patients who had a non-cemented hip prosthesis. We examined variables that were likely to be uncontrolled in routine orthopaedic radiographs for their effect on radiographic (film) density. Changes in film lots, exposure, target distance, field variability (heel effect), and femoral orientation were independently analyzed for radiographs of precisely oriented femora of cadavera and a radiology step-wedge. Despite attempts to normalize these variables, we found that retrospective comparison of serial radiographs of patients for densitometric analysis of change in the bone was prone to significant error. In uncontrolled radiographs, non-uniformity of exposure, intensity of the radiation field, target distance, and deviation in femoral rotation will be likely to result in substantial variations in the apparent thickness or density of the femoral cortex and make quantitative comparisons of serial radiographs unreliable. PMID- 3805072 TI - Late results after correction of hallux valgus deformity by basilar phalangeal osteotomy. AB - In a long-term follow-up study (average, 10.7 years) of 222 patients (351 feet), the results after proximal phalangeal osteotomy (the Akin procedure) for hallux valgus deformity were found to be unsatisfactory, both subjectively and objectively. The range of motion in the metatarsophalangeal joint was limited postoperatively in 90 per cent of the patients, and in 21 per cent there was recurrence of deformity. The appearance of the foot was poor in 75 per cent. Only 53 per cent of the patients expressed satisfaction with the result of the operation. There was a direct relationship between the development of subluxation or dislocation of the metatarsophalangeal joint and postoperative dissatisfaction of the patient. We concluded that the operation is biomechanically unsound because it does not address the principal mechanical factors that are responsible for the deformity: abnormal function of the adductor hallucis and the abnormal intermetatarsal angle. The Akin procedure is indicated only in combination with other operations that are designed to correct the two cited abnormalities. PMID- 3805073 TI - Arthrodesis of the first metatarsophalangeal joint as salvage for the failed Keller procedure. AB - Arthrodesis of the first metatarsophalangeal joint was performed in eleven patients (sixteen feet) after a Keller procedure had failed. Multiple intramedullary threaded Steinmann pins were used to fix the bone at the site of the arthrodesis, and a successful arthrodesis was achieved in each patient. Interposition of a graft of bone from the iliac crest was done in four feet with an excessively short hallux. Lateral metatarsalgia that was due to intractable keratoses on the plantar part of the foot was relieved in eleven (92 per cent) of the twelve feet that had it preoperatively. Cock-up deformity of the hallux was also improved. Residual stiffness of the interphalangeal joints, which was a major preoperative problem, was not improved. Arthrodesis of the first metatarsophalangeal joint is a useful procedure to salvage a failed result of the Keller procedure. PMID- 3805074 TI - Fracture of the patella treated by open reduction and external compressive skeletal fixation. AB - Open reduction combined with external compressive skeletal fixation was used to treat twenty-seven patients who had a separated fracture of the patella. Fixation was obtained by the use of two compressive clamps applied to stainless-steel pins that were inserted just proximal and distal to the proximal and distal poles of the patella. Range-of-motion exercises for the knee were begun at two weeks and the pins were removed at three to four weeks. All of the fractures healed. Twenty four patients regained a range of motion that was equal to that of the opposite knee. There was no evidence of chronic osteomyelitis. Osteoarthritis was noted in one patient who refused excision of a portion of the patella. PMID- 3805075 TI - Locked posterior dislocation of the shoulder. AB - Of forty patients with forty-one locked posterior dislocations of the shoulder, the diagnosis had been missed by the initial physician in the majority. A motor vehicle accident, a seizure, an alcohol-related injury, or electroshock therapy had caused the dislocation in these patients, and the average interval from injury to diagnosis was one year. Twenty-five of the forty-one dislocations had been diagnosed in less than six months. An axillary radiograph confirmed the diagnosis in all shoulders and demonstrated the approximate size of the impression defect. There were no associated displaced fractures of the humerus, but in twenty of the shoulders there was an undisplaced fracture of the proximal part of the humerus. The average length of follow-up was 5.5 years. For seven shoulders the deformity was accepted. Treatment in the others consisted of closed reduction, which was attempted in twelve shoulders and was successful in six of the twelve; transfer of the subscapularis tendon, which was attempted in nine shoulders and was successful in four; transfer of the lesser tuberosity, which was successful in all four shoulders that were so treated; hemiarthroplasty, which was performed in nine shoulders and was successful in six (the other three required revision); and total arthroplasty in ten shoulders, one of which dislocated postoperatively and was not treated. Once the diagnosis is established, the majority of patients with this lesion can be successfully managed. PMID- 3805076 TI - Lyme arthritis in children. An orthopaedic perspective. AB - The cases of forty-three children with clinical and serological evidence of Lyme arthritis that was diagnosed between August 1983 and July 1985 were evaluated. The mean length of follow-up was twenty months, with a range of five to thirty months. All of the children lived in or had visited an area where the disease was known to be endemic. Arthritis was the presenting feature in more than half of the children, and half of the children had initially consulted an orthopaedic surgeon, none of whom made the correct diagnosis. Only twenty patients had a history of erythema chronicum migrans, the characteristic rash that precedes the arthritis, and for only nineteen children was there any recollection of having been bitten by a tick. Three patients had Bell palsy and one had a popliteal cyst in conjunction with the arthritis. All of the patients had oligoarticular involvement. The knee was involved in all but two patients. Recurrent attacks of synovitis were common. Effusion was the only radiographic abnormality that was observed, and it was found in thirty-two patients. The sedimentation rate was elevated in thirty of thirty-six patients. Immunofluorescent serology for Lyme disease, which is sensitive and specific, was uniformly positive. Of thirty-three patients who were treated with oral administration of penicillin or tetracycline alone, thirty-one responded, while two patients who had recurrent attacks of the disease responded to parenteral administration of antibiotics. The remaining ten patients responded to combinations of orally and parenterally administered antibiotics. Longer follow-up is needed to further document the apparently low rate of relapse after antibiotic therapy in this young population. PMID- 3805077 TI - The role of hypertrophic chondrocytes in endochondral ossification and in the development of secondary centers of ossification. PMID- 3805078 TI - Metatropic dwarfism. Uncoupling of endochondral and perichondral growth. AB - Metatropic dwarfism is a rare heritable skeletal dysplasia that is thought to result from a defect in endochondral ossification. Histological studies have been few and have yielded inconsistent findings. In addition, no investigator has commented on the structure and function of the perichondral portion of the growth plate in patients who have metatropic dysplasia. To further characterize this disturbance, histological studies were carried out on autopsy specimens from the proximal part of the femur and the iliac crest of a patient who had this disorder. The major findings were: the absence of formation of normal primary spongiosa in the metaphysis; the presence of a thin seal of bone at the chondro osseous junction, with abnormal metaphyseal vascular invasion and arrest of endochondral growth; and normal-appearing perichondral ring structures with persistence of circumferential growth. These findings suggest an uncoupling of endochondral and perichondral growth and offer an explanation for the dumbbell shaped morphological structure of the osseous metaphysis that is seen in patients who have metatropic dysplasia. Other observations included prominence of the cartilaginous canals and vascular channels in the reserve zone; clumping of chondrocytes with enhanced staining of the pericellular matrix in the proliferative zone; a decreased ratio of cells to matrix in the hypertrophic zone, with intracellular metachromatic granules and incomplete evolution of chondrocytes; complete absence of an alcian-blue-positive zone of provisional calcification; and, finally, islands of dysplastic chondrocytes in the metaphysis. These abnormalities suggest that metatropic dysplasia is not simply a disorder of endochondral ossification. There appear to be associated defects in the longitudinal proliferation and maturation of chondrocytes and in the production of normal matrix. PMID- 3805079 TI - Staged salvage reconstruction of grade-IV and V spondylolisthesis. AB - Sixteen patients who had Grade-IV or V spondylolisthesis underwent a staged reconstruction for the salvage of a failed result of previous procedures. The indications for operation were incapacitating pain, radicular pain, pseudoclaudication, or the inability to stand upright. All patients had shown progression of the deformity after the previous surgery. At an average length of follow-up of fifty-two months, all patients had resumed normal activities and were free of the pain and symptoms of spinal stenosis. The complications included delayed union in six patients and a traumatic pseudarthrosis in one patient. In all of these patients a solid fusion was obtained after additional surgery. In five patients, neuropathy of the fifth lumbar-nerve root developed after surgery; it resolved in three patients. From this work, it is concluded that staged reconstructive surgery is feasible in patients who have Grade-IV or V spondylolisthesis with incapacitating pain and deformity that interfere with normal function. The benefits outweighed the risks in this very select group of patients. PMID- 3805080 TI - Measurement of the shape of the surface of the back in patients with scoliosis. The standing and forward-bending positions. AB - In order to determine if the configuration of the trunk is altered when a patient changes from an upright to a forward-bending position, the shape of the surface of the back of fifty-six patients who had adolescent idiopathic scoliosis was recorded, by means of Raster stereophotography, with each patient in three postures: standing erect, bending forward with the hands between the knees (forward bend 1), and bending forward with the hands touching the toes (forward bend 2). The effect of placing one foot on a block to produce a limb-length difference was also studied in the standing position (thirty patients) and in the forward-bending position (eighteen patients). The degree of rotation of the surface of the back and of kyphosis and lordosis of the surface of the trunk was measured from sections in the sagittal plane that were plotted from the computerized measurements of the surface of the back. Qualitatively similar rotation of the surface of the back was found in both the standing position and the forward-bending position. When the patient was in the forward-bending position, the degree of rotation of the surface of the back was minimally changed in the thoracic region but increased in the lumbar region. The amount of rotation of the surface of the back was similar in both forward bending with the hands to the knees and forward bending with the hands to the toes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805081 TI - Assessment of the risk of vertebral fracture in menopausal women. AB - The decision to institute prophylaxis in women with menopausal osteopenia is hampered by the absence of quantitative criteria for appraising the risk of fracture in the individual. We have developed standards for assessing the risk of fracture by relating the prevalence of atraumatic vertebral compression fractures to bone density in sixty-five menopausal women, forty-nine to ninety-two years old. To define the upper limit of the spectrum of bone density, we also studied thirty-one young women, seventeen to twenty-two years old. The density of trabecular bone in a vertebral body was determined by quantitative computed tomography and expressed in terms of milligrams per milliliter of dipotassium hydrogen phosphate. Twenty-five of the menopausal women exhibited at least one fracture (range, one to six fractures), and forty had no fracture. The bone density ranged from -9 to sixty-nine milligrams per milliliter in those with fractures and from twelve to 122 milligrams per milliliter in those without a fracture. The densities in the young women averaged 173 milligrams per milliliter and ranged from ninety-five to 248 milligrams per milliliter. The percentage of subjects with fractures increased as the bone density decreased. It was zero per cent in women with a density of seventy milligrams per milliliter or more, 38 per cent in women with a density between fifty and less than seventy milligrams per milliliter, 71 per cent in those with a density between thirty and less than fifty milligrams per milliliter, and 82 per cent in women with a density of less than thirty milligrams per milliliter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805082 TI - The use of computerized tomography in evaluating non-visualized vertebral levels caudad to a complete block on a lumbar myelogram. A review of thirty-two cases. AB - In thirty-two patients who demonstrated a complete or almost complete block on a lumbar myelogram, computerized tomography of the non-visualized vertebral levels caudad to the block was performed prior to surgical intervention. The purpose of this study was to evaluate the clinical value of computerized tomography in detecting a lesion that is caudad to the level of a myelographic block. For twenty-three patients the cause of the myelographic block was stenosis of the spine; for five patients, a combination of stenosis of the spine and herniation of a disc; for one patient, herniation of a disc between the fourth and fifth lumbar vertebrae alone; for two patients, arachnoiditis; and for one patient, kyphosis secondary to fracture. A total of fifty vertebral levels that could not be visualized because of the block were evaluated. Thirty (60 per cent) of the non-visualized vertebral levels, in nineteen (59 per cent) of the thirty-two patients, demonstrated stenosis of the spine or a herniated disc that was confirmed at the time of surgical treatment. The value of computerized tomography for the evaluation of the vertebral levels caudad to the level of a complete or almost complete block on a lumbar myelogram was threefold. First, it provided visualization of the vertebral levels that could not be evaluated by the myelography. Second, the findings on computerized tomography provided information that was essential for preoperative planning and it removed the so-called exploratory element from the operative procedure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805083 TI - Results of total knee arthroplasty after failed proximal tibial osteotomy for osteoarthritis. AB - The cases of twenty-one consecutive patients who had a minimally constrained total knee arthroplasty (six of whom had a cemented and fifteen, an uncemented prosthesis) after a failed proximal tibial osteotomy for osteoarthritis were compared with those of a non-consecutive group of twenty-one patients who had had a primary total knee arthroplasty for osteoarthritis. The groups were matched according to age and sex of the patient, type of prosthesis and fixation, and length of follow-up. At an average length of follow-up of 2.9 years, a good or excellent result was obtained in 81 per cent of the patients who had had a previous osteotomy. At an average length of follow-up of 2.8 years, a good or excellent result was obtained in 100 per cent of the patients who had had a primary arthroplasty. Two patients in the osteotomy group and none in the primary arthroplasty group required additional surgery. At the time of arthroplasty, technical difficulties in exposing the proximal part of the tibia were noted in three patients in the group that had undergone an osteotomy. The results of total knee arthroplasty after failed proximal tibial osteotomy approached but did not equal the results after primary total knee arthroplasty. PMID- 3805084 TI - The role of the posterolateral and cruciate ligaments in the stability of the human knee. A biomechanical study. AB - Injury to the posterolateral structures of the knee, including the popliteus tendon and arcuate complex, frequently results in poorly understood patterns of instability. To evaluate the static function of these tissues, we used a mechanical testing apparatus that allowed five degrees of freedom to test seventeen specimens from human cadavera at angles of flexion that ranged from zero to 90 degrees. Selective section of the lateral collateral ligament, popliteus-arcuate (deep) ligament complex, anterior cruciate ligament, and posterior cruciate ligament was performed. At all angles of flexion, the lateral collateral ligament and deep ligament complex functioned together as the principal structures preventing varus rotation and external rotation of the tibia, while the posterior cruciate ligament was the principal structure preventing posterior translation. However, at angles of flexion of 30 degrees or less, the amount of posterior translation after section of only the lateral collateral ligament and the deep structures was similar to that noted after isolated section of the posterior cruciate ligament. Isolated section of the posterior cruciate ligament did not affect varus or external rotation of the tibia at any position of flexion of the knee. When the posterior cruciate ligament was sectioned after the lateral collateral ligament and deep ligament complex had been cut, a large increase in posterior translation and varus rotation resulted at all angles of flexion. In addition, at angles of flexion of more than 30 degrees, external rotation of the tibia also increased. The application of internal tibial torque resulted in no increase in tibial rotation after isolated section of the anterior cruciate ligament or combined section of the lateral collateral ligament and deep ligament complex. However, combined section of all three structures increased internal rotation at 30 and 60 degrees of flexion. The increases in external rotation that were produced by section of the lateral collateral ligament and deep ligament complex were not changed by the addition of the section of the anterior cruciate ligament. PMID- 3805085 TI - Neural anatomy of the human anterior cruciate ligament. AB - The histology of the anterior cruciate ligament was studied by a modified technique of the Gairns gold chloride stain for neural elements. Three morphological types of mechanoreceptors and free nerve-endings were identified: two of the slow-adapting Ruffini type and the third, a rapidly adapting Pacinian corpuscle. Rapidly adapting receptors signal motion and slow-adapting receptors subserve speed and acceleration. Free nerve-endings, which are responsible for pain, were also identified within the ligament. These neural elements comprise 1 per cent of the area of the anterior cruciate ligament. PMID- 3805086 TI - Dynamic external fixation for comminuted intra-articular fractures of the distal end of the radius. AB - An external fixation device that allows motion of the wrist was developed for the treatment of severely comminuted intra-articular fractures of the distal end of the radius, and in specimens from cadavera that motion was demonstrated with the device in place. Thirty patients who had thirty-two comminuted intra-articular radial fractures were then treated with fixation using this device during a six month interval. Thirty-one of the wrists were examined at follow-up one and two years later. The first fifteen wrists that were allowed full flexion and extension immediately postoperatively had lost some volar tilt postoperatively. The other patients, for whom only flexion was allowed immediately postoperatively, while extension was allowed four weeks later, did not lose volar tilt. The device maintained the reduction of the fracture fragments and allowed the early return of a functional range of motion of the wrist. PMID- 3805087 TI - Postoperative ulnar-nerve palsy. Are there predisposing factors? AB - In a prospective study in which we attempted to identify the etiology of postoperative ulnar-nerve palsy, 6,538 patients were followed through surgery and convalescence. In seventeen patients (0.26 per cent), an ulnar-nerve palsy developed at varying times during the postoperative period. Of these seventeen patients, all were re-evaluated at an average of six months and eleven were re evaluated at an average of three and one-half years after operation. Bilateral nerve-conduction studies were done on all seventeen patients during the initial visit and on five of the eleven who were re-evaluated at an average of three and one-half years. Abnormal slowing of the conduction times was found in both nerves, suggesting a possible predisposition to this condition. Based on the results of the study, it is suggested that many patients may have a subclinical ulnar neuropathy that may become symptomatic as a result of the many maneuvers and manipulations that are associated with surgical procedures. PMID- 3805088 TI - Suprascapular neuropathy in volleyball players. AB - We examined ninety-six top-level volleyball players from eight teams that competed during the 1985 European Championships, and twelve players were found to have asymptomatic isolated paralysis of the infraspinatus of the dominant side. Three players were studied with electromyography and Cybex-II isokinetic dynamometry. The results revealed denervation of the infraspinatus and approximately a 22 per cent loss of strength of the affected arm during external rotation. These findings were attributed to repeated stress due to stretching of the nerve during cocking of the arm and follow-through when the athlete was serving. PMID- 3805089 TI - Synovectomy of the elbow in young hemophilic patients. AB - Synovectomy of twenty-three elbows was done in eighteen patients, eight to twenty five years old, who had severe hemophilia and were followed for eighteen to seventy months. Episodes of bleeding recurred in four elbows, and moderate pain persisted in three. A significant improvement in mobility was observed for pronation-supination in nine elbows and for flexion-extension in fourteen. No radiographic evidence of arthritis was seen. Synovectomy of the elbow, performed through a single lateral incision, appears to be a valuable surgical procedure in hemophiliacs in whom non-operative treatment has failed, and resection of the radial head should be done in adults when there is moderate or severe damage to the cartilage of the radial head. PMID- 3805090 TI - The malignant potential of enchondromatosis. AB - In a tri-institutional, retrospective study with long-term follow-up, forty-four patients who had multiple enchondromas were identified. Thirty-seven patients did not have hemangiomas (Ollier disease) and seven did (Maffucci syndrome). Of the thirty-seven patients who had Ollier disease, a low-grade chondrosarcoma developed in four; an astrocytoma, in one; and a granulosa-cell ovarian tumor, in one. In four of the seven patients who had Maffucci syndrome, there were six low grade chondrosarcomas, one high-grade osteosarcoma, one pancreatic adenocarcinoma, one biliary adenocarcinoma, and one astrocytoma. None of the patients in either group died of the skeletal sarcoma, but four of five patients who had a non-skeletal malignant lesion died. From life-table analyses of these patients, we estimated that the incidence of secondary chondrosarcoma in patients who have Ollier disease is about 25 per cent at the age of forty years, and that malignant degeneration is almost a certainty in patients who have Maffucci syndrome. We concluded that periodic surveillance of the brain and abdomen for occult malignant lesions is indicated in patients who have enchondromatosis. PMID- 3805091 TI - Intra-articular reconstruction of the anterior cruciate ligament with and without extra-articular supplementation by transfer of the biceps femoris tendon. AB - In a retrospective study to determine whether the efficacy of intra-articular reconstruction of the anterior cruciate ligament is improved by an extra articular transfer of the biceps femoris tendon, we compared the results in a group of forty-three patients in whom the advancement procedure had been done with those in a group of fifty patients in whom it had not. The minimum length of follow-up was twenty-four months. There was no significant difference between the two groups, and we concluded that advancement of the biceps femoris tendon does not improve the efficacy of an intra-articular reconstruction of the anterior cruciate ligament. PMID- 3805092 TI - Resection of the proximal third of the femur for chondrosarcoma: replacement with a metallic prosthesis. A note after fifteen years of follow-up. PMID- 3805093 TI - Leiomyosarcoma of the saphenous vein. A case report and review of the literature. PMID- 3805094 TI - Primary leiomyosarcoma of bone. A case report and review of the literature. PMID- 3805095 TI - Endometriosis in the biceps femoris. A case report and review of the literature. PMID- 3805096 TI - Reconstruction of the peroneal retinaculum using the peroneus quartus. A case report. PMID- 3805097 TI - Reconstruction of the superior peroneal retinaculum using a portion of the peroneus brevis tendon. A case report. PMID- 3805098 TI - Pronator syndrome associated with a persistent median artery. A case report. PMID- 3805099 TI - Degenerative stenosis of the lumbar spine. PMID- 3805100 TI - Mechanisms of cancer metastasis to bone. PMID- 3805101 TI - Excessive metal release due to loosening and fretting of sintered particles on porous-coated hip prostheses. Report of two cases. PMID- 3805102 TI - Osteoid-osteoma: intraoperative tetracycline-fluorescence demonstration of the nidus. PMID- 3805103 TI - Two useful procedures in aortic valvular replacement: the peeling off of the aortic valve and the sub-annular insertion of a valvular prosthesis. AB - Two useful procedures in aortic valvular surgery are described. One is an easy way to excise heavily calcified aortic leaflets. The other is the subannular placement of an aortic valve substitute which permits the use of a larger prosthesis. PMID- 3805104 TI - Late occlusion of aorto-bifemoral grafts. Causes and management. AB - Late occlusion occurred in 52 limbs of 37 bifurcated aorto-femoral grafts (37 patients). These were analysed to determine causal factors and the efficacy of various surgical techniques of repair. There were two principle causes: intimal hyperplasia (n = 19) and progressive atherosclerosis (n = 18), and then miscellaneous causes (n = 15). Surgical techniques included: repair of inflow by thrombectomy (n = 30), new aorto-femoral graft (n = 6), cross-over femoro-femoral (n = 3), and axillo-bifemoral graft (n = 2); repair of out-flow by profundoplasty (n = 18), addition of a new length of graft (n = 10), and femoro-popliteal bypass (n = 13). There were no immediate post-operative deaths but four rethromboses (7.6%) occurred and there were five amputations (9.6%). During the follow-up period (mean 19 months), four patients died (11%), 5 limbs reoccluded (9.4%), and two were amputated (4.2%). Patency rate was 90% for thrombectomy and 83% for new aorto-bifemoral graft. It was 86% for repair of the profunda femoris artery and 77% for femoro-popliteal bypass. Although no statistical analysis can be applied on this small number of patients, the present study suggests that: intimal hyperplasia is a frequent and probably under-estimated cause of late thrombosis; whenever feasible thrombectomy and profundoplasty are the most simple and effective procedure of repair. PMID- 3805105 TI - Reconstruction of portal vein with an autograft of splenic vein. AB - To re-establish the portal circulation following extensive resection of the portal vein, we interposed an autograft of the splenic vein between the portal and superior mesenteric veins during total pancreatectomy in three patients with cancer of the pancreas. The postoperative course in two patients was uneventful, and patency of the graft was demonstrated angiographically on the 41st and 78th postoperative days, respectively. In the remaining patient an episode of postoperative peritonitis occurred with leakage of the gastrointestinal anastomosis. The patient died on the 78th postoperative day from a massive metastasis to the liver. Autopsy revealed a narrowing of the graft due to technical failure and inflammatory changes, but there was no evidence of cancer invasion. Thus, the autograft of the splenic vein proved useful to bridge the portal vein system. PMID- 3805106 TI - The use of patch angioplasty to alter the incidence of carotid restenosis following thromboendarterectomy. AB - Eighty-nine consecutive patients were followed for twelve to twenty-four months after carotid thromboendarterectomy. Forty-seven underwent operations using a standard carotid closure; a second group of forty-two patients had a saphenous vein patch graft applied in closure. The patients were evaluated with carotid duplex scans at regular intervals to evaluate the incidence of early restenosis. Patients with positive duplex scans underwent arterial angiography or digital subtraction angiography. Operative mortality was zero. Twelve late deaths occurred; eleven due to cardiac disease. In the unpatched group, 19.1% of the patients developed significant restenosis (a luminal narrowing of greater than 50%) with only a 2.4% incidence occurring in the patched group, a statistically significant difference (p less that 0.05). There was a higher incidence of symptomatic restenosis in the unpatched group, though the results were not considered significant. Venous patch rupture was seen in three patients who have not been included in the study group. All of these had venous patches harvested from a distal greater saphenous vein site at the ankle. The authors recommend venous patch closure with a thicker patch taken from the proximal saphenous vein at the groin to reduce the incidence of early restenosis and to avoid venous patch rupture. Regular non-invasive evaluation is recommended to detect restenosis with careful clinical follow-up to evaluate neurologic complications. PMID- 3805107 TI - Heparin neutralising activity of whole blood in patients undergoing vascular surgery. AB - A test for measuring the heparin neutralizing activity in whole blood is described. This test was used in 13 patients having peripheral vascular surgery. The heparin neutralising activity (HNA) and fibrinogen concentration in the blood were measured on the day before operation. During operation, blood was withdrawn before and five minutes after administration of 10,000 units of heparin for the measurements of activated clotting time (ACT) and partial thromboplastin time (PTT). There was considerable variation in the ACT and the PTT values at five minutes after heparin administration which showed no correlation to the patients' weight. However, there was a significant linear correlation between the increase in ACT values and the HNA measured on the day before operation and a significant linear correlation between the HNA and the fibrinogen concentration. The results indicate that the ACT and PTT after giving heparin depended on HNA rather than the patients' weight, and are related to the fibrinogen concentration. PMID- 3805108 TI - Infrarenal aneurysm of abdominal aorta due to aorto-arteritis. Successful management of 2 cases. AB - Aneurysms of the infrarenal abdominal aorta are usually atherosclerotic rarely syphilitic and very uncommonly aortitic in etiology. We recently encountered two cases of infrarenal abdominal aortic aneurysm due to aortoarteritis. Both the patients were young, malnourished women without any evidence of tuberculosis. One of the patients presented with severe pain in the abdomen and signs of impending rupture of the aneurysm and the other had a frank ruptured aneurysm with peripheral circulatory failure. Both cases were managed successfully by surgery. Infrarenal abdominal aortic aneurysms due to aorto-arteritis are distinctly uncommon. Rupture of these aneurysms is even rarer and to the best of our knowledge this is the first reported case in English literature of successful surgical management of ruptured abdominal aortic aneurysm due to aorto-arteritis. PMID- 3805109 TI - Peri-aortic fibrosis: progression and regression. AB - The natural history and aetiology of peri-aortic fibrosis is unknown. In one of our patients in whom steroid treatment had successfully controlled the progression of the disease' cessation of treatment was associated with recurrence of the fibrosis, progressive ureteric obstruction and dilatation of the aorta. In another patient, graft replacement of the aorta was associated with regression of the fibrosis but in a third patient replacement of the aorta did not prevent progression to complete ureteric obstruction. It would seem that it is the presence of the fibrosis that engenders the aortic dilatation not the presence of a patent aorta, dilated or not. PMID- 3805110 TI - Delayed development and rupture of an aortic aneurysm after closed abdominal trauma. AB - A case is reported of a patient who, following the surgical repair of a lesion of the superior mesenteric artery secondary to a closed abdominal trauma, slowly developed an aneurysm of the abdominal aorta which subsequently ruptured. Surgical management of the aneurysm by aortic graft implantation proved successful. PMID- 3805111 TI - Biliary and portal obstruction by celiac artery aneurysm. AB - This report describes a unique case of biliary and portal obstruction by a massive celiac artery aneurysm. Severe portal hypertension with extensive retroperitoneal varices and a perforated gallbladder complicated the surgical management. A survey of the literature emphasized the novelty of this case. PMID- 3805112 TI - Experience with the vascular brush. AB - The history and use to date of the vascular brush are briefly outlined. The development of this new instrument was made possible by fibre-optic vascular endoscopy, but its use and capabilities are apparently not yet widely known. We regard the brush as the common sense solution for producing smooth bores after various peripheral vascular procedures such as endarterectomy and late arterial and venous thrombo-embolectomy operations. As a reamer and a smoothing instrument it exerts a powerful yet safe and self-limiting action, due to the compliant, impaling effect of the bristles at low intra-luminal pressure. Broadly speaking, the use of the brush is indicated when the smooth Fogarty balloon catheter is no longer capable of removing resistant residual tissue. The use of this instrument on a wider scale, eventually in disposable form, would seem to offer considerable promise in peripheral vascular surgery. PMID- 3805113 TI - Scintigraphic documentation of systemic-portal shunting. AB - Two unusual cases of iliac vein thrombosis are presented. They were studied with radionuclide venography of the left lower-extremity in which one of the collateral channels was the inferior mesenteric vein and showed the entire liver and lungs simultaneously. This vein does not appear to have been clearly identified with radioisotopic techniques previously. Using the anterior projection over the lungs and liver, ratios of liver to lungs, liver to (liver + lungs), right lung to (liver + lungs) and left lungs to (liver + lungs) were calculated. In patient 1, the shunted tracer represented 82% of the total activity and in patient 2 it was 21.5%. PMID- 3805114 TI - Arterial repair for simple and complex forms of transposition of the great arteries. AB - Transposition of the great arteries (TGA) has traditionally been repaired by redirection of atrial flow. Concern over the late development of right ventricular and sinus node dysfunction has prompted increased use of the arterial repair. This approach was utilized in 11 patients ranging in age from 7 days to 22 months (mean 5.3 months) and in weight from 2.6 to 12.2 kg (mean 5.1 kg). Five patients had intact ventricular septum and underwent primary repair electively or after poor response to balloon atrial septostomy. A large ventricular septal defect (VSD) was present in 6 patients, one of whom had coarctation of the aorta and one with type B interrupted aortic arch. Pulmonary artery banding was done in 3 of these patients in addition to subclavian artery aortoplasty and primary arch repair. Spontaneous VSD closure occurred in 2 banded patients. All patients had normal coronary artery distribution. Conduits were not used in any repair. There were 2 operative deaths caused by injury to the right coronary artery prior to establishing bypass in one patient and to left ventricular (LV) failure in a patient operated on at 5 months of age with an LV pressure of only one-half systemic level. The 9 surviving patients are well from 4 to 38 months after operation (mean 15 months). No patient has congestive heart failure and 5 receive no medications. Catheterization in 4 patients revealed widely patent coronaries in each. Trivial aortic insufficiency was noted in 1 patient. Each had mild to moderate supravalvar pulmonary stenosis (12 to 51 mmHg). LV function was normal in each case.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805115 TI - Acute ruptures of the thoracic aorta. Personal experience. AB - The statistical incidence, etiopathogenesis, diagnostics and surgical treatment of acute ruptures of the thoracic aorta are described. A personal series of 7 cases is reported; surgical techniques, benefits and risks of extracorporeal circulation during surgical treatments are analysed and discussed. PMID- 3805116 TI - Left ventricular aneurysm surgery. Determinants of results. AB - Between 1967 and 1983, 154 patients had reduction of left ventricular aneurysms by resection or plication. Seventy percent of patients had predominant angina; the remainder had predominant dyspnoea. Fifty-eight percent had associated coronary bypass grafting. Within the group, there were included 26 patients who had aneurysm resection for dyspnoea and who were evaluated by radionuclide angiography at a mean follow-up of 17 + 11 months. There was a 20% early mortality; this fell to 5% in the latter half of this experience. Patients whose major symptom was angina had a 5% early mortality. Those whose major symptom was severe dyspnoea had an early mortality of 30%. Patients who had aneurysm reduction alone had an early mortality of 17% and those who had associated bypass grafting had an early mortality of 9%. There was a 48% late mortality, attrition occurring at a steady rate and being predominantly due to cardiovascular causes. Of 95 patients available for review between one and thirteen years after operation, 60% were in New York Heart Association (N.Y.H.A.) functional class I, 36% in functional class II and 4% in classes III and IV. In patients whose predominant symptom was dyspnoea, radionuclide studies showed that global left ventricular performance at rest was not significantly changed by operation, despite clinical improvement. Long-term clinical outcome was determined more by pre-operative global ventricular function than by function of the residual contractile segment. Within the whole group, however, both early mortality and symptomatic improvement were more likely in patients with predominant angina. PMID- 3805117 TI - Late cardiac tamponade after open heart surgery. AB - Delayed cardiac tamponade after open heart surgery is relatively uncommon, but constitutes a life-threatening condition that must be diagnosed and managed promptly. We report 21 patients who developed cardiac tamponade 5 to 53 days after open heart operations. Possible etiological factors included anticoagulant therapy (19 patients), excessive mediastinal drainage in the postoperative period (10 patients), postpericardiotomy syndrome (4 patients), and coagulation disorders (1 patient). The clinical presentation was insidious and the diagnosis was often difficult to establish at the outset. A high index of clinical suspicion and echocardiography were the most reliable means to reach an early diagnosis. Twenty patients in whom delayed tamponade was suspected were operated and all of them survived. In one patient tamponade was not diagnosed antemortem and he died; on autopsy left heart compression by a large loculated clot was found. Decompression of the pericardial space can be accomplished by pericardiocentesis or by surgical means (subxiphoid pericardiotomy, median sternotomy, or thoracotomy). Although pericardiocentesis alone may be effective, mainly when the postpericardiotomy syndrome is the suspected etiology, we recommend open procedures since the presence of blood clots and adhesions has been a frequent finding. PMID- 3805118 TI - The elongation of the internal carotid artery. Diagnosis and surgical treatment. AB - Cerebro-vascular insufficiency is rarely caused by an abnormal elongation of the internal carotid artery (the ratio is 15% to 17% of symptomatic patients). The anomalies can be defined as: tortuosity, when the artery has a "C" or "S" shape; coiling, when the elongation is more evident and the artery forms one or more loops; kinking, when there is a sharp angulation of the first portion of the internal carotid artery. The etiology of these peculiar arterial modifications seems to be related to a congenital basis which may become exaggerated with ageing of the artery. Surgical correction should include intra-arterial inspection (TEA) as well as eliminating the pathological elongation. The Authors presents their 9 cases surgical experience. PMID- 3805119 TI - Late partial tamponade of the right atrium. A case report. AB - An unusual case of late partial tamponade of the right atrium is reported in a patient 35 days after aortic valve replacement. Chest x-rays, echocardiograms and ECG were not helpful. The diagnosis was made by emergency bedside right heart catheterization which showed a 7 cm H2O gradient between the junction of the superior vena cava and right atrium and also a 12 cm H2O pressure difference between the femoral vein and the right atrium with a normal capillary wedge pressure. Re-thoracotomy with evacuation of blood clots and control of bleeding points improved the hemodynamics dramatically. However the patient succumbed 3 weeks later due to irreversible brain damage. This is thought to be the first report of a late partial right atrial tamponade in the English medical literature. PMID- 3805120 TI - U1 precursors: variant 3' flanking sequences are transcribed in human cells. AB - Using RNase protection and oligonucleotide hybridization experiments, we have shown that U1 precursors are derived by transcription of 3' flanking sequences. A labeled SP6 transcript of one of the true U1 genes (pD2) was able to protect a subset of the 3' flanking sequences present in HeLa cytoplasmic U1 RNA. However, not all U1 precursors were protected using this probe, suggesting that variant U1 precursor 3' tail sequences are expressed in HeLa cells. This conclusion has been confirmed by hybridization of HeLa RNA samples with specific oligonucleotide probes representing variant U1 3' flanking sequences. Interestingly, these variant tail sequences contain the putative Sm antigen binding site, A(U)3-6G. The conservation of this flanking sequence through evolution suggests a possible functional role for these precursor tails in ordering protein binding to U1 RNA. PMID- 3805121 TI - Inhibition of in vitro nuclear transport by a lectin that binds to nuclear pores. AB - Selective transport of proteins is a major mechanism by which biochemical differences are maintained between the cytoplasm and nucleus. To begin to investigate the molecular mechanism of nuclear transport, we used an in vitro transport system composed of a Xenopus egg extract, rat liver nuclei, and a fluorescently labeled nuclear protein, nucleoplasmin. With this system, we screened for inhibitors of transport. We found that the lectin, wheat germ agglutinin (WGA), completely inhibits the nuclear transport of fluorescently labeled nucleoplasmin. No other lectin tested affected nuclear transport. The inhibition by WGA was not seen when N-acetylglucosamine was present and was reversible by subsequent addition of sugar. When rat liver nuclei that had been incubated with ferritin-labeled WGA were examined by electron microscopy, multiple molecules of WGA were found bound to the cytoplasmic face of each nuclear pore. Gel electrophoresis and nitrocellulose transfer identified one major and several minor nuclear protein bands as binding 125I-labeled WGA. The most abundant protein of these, a 63-65-kD glycoprotein, is a candidate for the inhibitory site of action of WGA on nuclear protein transport. WGA is the first identified inhibitor of nuclear protein transport and interacts directly with the nuclear pore. PMID- 3805122 TI - Sequential expression and differential function of multiple adhesion molecules during the formation of cerebellar cortical layers. AB - We have correlated the times of appearance of the neural cell adhesion molecule (N-CAM), the neuron-glia cell adhesion molecule (Ng-CAM), and the extracellular matrix protein, cytotactin, during the development of the chicken cerebellar cortex, and have shown that these molecules make different functional contributions to granule cell migration. Immunofluorescent staining showed distinct spatiotemporal expression sequences for each adhesion molecule. N-CAM was present at all times in all layers. However, the large cytoplasmic domain polypeptide of N-CAM was always absent from the external granular layer and was enriched in the molecular layer as development proceeded. Ng-CAM began to be expressed in the premigratory granule cells just before migration and later disappeared from cell bodies but remained on parallel fibers. Cytotactin, which is synthesized by glia and not by neurons, appeared first in a speckled pattern within the external granular layer and later appeared in a continuous pattern along the Bergmann glia; it was also enriched in the molecular layer. After we established their order of appearance, we tested the separate functions of these adhesion molecules in granule cell migration by adding specific antibodies against each molecule to cerebellar explant cultures that had been labeled with tritiated thymidine and then measuring the differential distribution of labeled cells in the forming layers. Anti-N-CAM showed marginal effects. In contrast, anti-Ng-CAM arrested most cells in the external granular layer, while anti cytotactin arrested most cells in the molecular layer. Time course analyses combined with sequential addition of different antibodies in different orders showed that anti-Ng-CAM had a major effect in the early period (first 36 h in culture) and a lesser effect in the second part of the culture period, while anti cytotactin had essentially no effect at the earlier time but had major effects at a later period (18-72 h in culture). The two major stages of cerebellar granule cell migration thus appear to be differentially affected by distinct adhesion molecules of different cellular origins, binding mechanisms, and overall distributions. The results indicated that local cell surface modulation of adhesion molecules of different specificities at defined stages and sites is essential to the formation of cerebellar cortical layers. PMID- 3805123 TI - Membrane glycoproteins involved in neurite fasciculation. AB - Lectin affinity chromatography combined with mAb production was used to identify chick neural cell surface molecules related to L1 antigen, a mouse neural glycoprotein implicated in cell-cell adhesion (Rathjen, F. G., and M. Schachner, 1984, EMBO (Eur. Mol. Biol. Organ.) J., 3:1-10). A glycoprotein, G4 antigen, isolated by mAb G4 from adult chick brain is described which comprises a major 135-kD component, a minor doublet at 190 kD, and diffusely migrating bands at 80 and 65 kD in SDS PAGE. This molecule is structurally related to mouse L1 antigen according to NH2-terminal amino acid sequence (50% identity) as well as the behavior of its components in two-dimensional IEF/SDS PAGE gels. A second chicken glycoprotein, F11 antigen, was isolated from adult chick brain using mAb F11. This protein has also a major 135-kD component and minor components at 170 kD and 120 kD. Both immunotransfer analysis with polyclonal antibodies to mAb G4 and to mAb F11 isolate and the behavior on IEF/SDS PAGE gels indicates that the major 135-kD component of F11 antigen is distinct from G4 antigen components. However, the 135-kD component of F11 antigen shares with G4 antigen and the neural cell adhesion molecule (NCAM) the HNK-1/L2 carbohydrate epitope. In immunofluorescence studies, G4 and F11 antigenic sites were found to be associated mainly with the surface of process-bearing cells, particularly in fiber-rich regions of embryonic brain. Although Fab fragments of polyclonal antibodies to mAbs G4 or F11 immunoaffinity isolate only weakly inhibit the Ca2+-independent aggregation of neural cells, they strongly inhibit fasciculation of retinal axons. Together these studies extend the evidence that bundling of axons reflects the combined effects of a group of distinct cell surface glycoproteins. PMID- 3805125 TI - The distribution of acetylcholine receptor clusters and sites of transmitter release along chick ciliary ganglion neurite-myotube contacts in culture. AB - Acetylcholine receptors accumulate along the length of cholinergic neuron skeletal muscle contacts in vitro. The main purpose of this study was to describe, in a quantitative way, the distribution of acetylcholine receptor clusters induced by ciliary ganglion neurons over a period of time extending from hours to weeks after contacts are established. Neurites were filled with Lucifer Yellow and receptor clusters were identified with rhodamine-bungarotoxin. A cluster located within 5 micron of a nerve process or 10 micron of the base of a growth cone was considered to be a neurite-associated receptor patch (NARP). The first synaptic potentials were evoked 20 min after growth cone-myotube contact, and, after 24 h of co-culture, greater than 60% of the nerve-muscle pairs tested were functionally connected. NARPs appear rapidly; the first clusters were detected approximately 6 h after the neurons were plated. They were composed of several small subclusters or speckles of rhodamine-bungarotoxin fluorescence. The initial accumulation of receptors may occur at the advancing tips of nerve processes because NARPs were found at greater than 80% of the growth cone-muscle contacts examined between 12 and 24 h of co-culture. Over the 3-wk period examined, the mean incidence of NARPs ranged between 1.0 and 2.6 per 100 micron of neurite-myotube contact, with the peak observed on the second day of co culture. During the first 3 d in culture, when the neurons were multipolar, nearly all of the primary processes induced one or more clusters. With time, as the neurons become unipolar (Role and Fischbach, 1987) NARPs persisted along the remaining dominant process. Measurements made during the third day of co-culture suggest that NARPs disappear along shorter neurites before they retract. Synaptic currents were detected by focal extracellular recording at 55% of the NARPs. The fact that spontaneous or evoked responses were not recorded at 45% suggests that contacts with clusters exhibit two functional states. Two types of presynaptic specialization at identified NARPs observed by scanning electron microscopy appear to be correlated with the functional state. PMID- 3805124 TI - Changes in the number of chick ciliary ganglion neuron processes with time in cell culture. AB - The purpose of this study was to describe the shape of chick ciliary ganglion neurons dissociated from embryonic day 8 or 9 ganglia and maintained in vitro. Most of the neurons were multipolar during the first three days after plating, with an average of 6.0 processes extending directly from the cell body. The neurons became unipolar with time. The remaining primary process accounted for greater than 90% of the total neuritic arbor. This striking change in morphology was not due to the selective loss of multipolar cells, or to an obvious decline in the health of apparently intact cells. The retraction of processes was neither prevented nor promoted by the presence of embryonic muscle cells. Process pruning occurred to the same extent and over the same time course whether the cells were plated on a monolayer of embryonic myotubes or on a layer of lysed fibroblasts. Process retraction is not an inevitable consequence of our culture conditions. Motoneurons dissociated from embryonic spinal cords remained multipolar over the same period of time. We conclude that ciliary ganglion neurons breed true in dissociated cell culture in that the multipolar-unipolar transition reflects their normal, in vivo, developmental program. PMID- 3805126 TI - Studies on the metabolism of retinol-binding protein by primary hepatocytes from retinol-deficient rats. AB - Studies were conducted to explore the regulation of retinol-binding protein (RBP) metabolism in cultured primary hepatocytes from retinol-deficient rats. Newly isolated hepatocytes from retinol-deficient rats contained elevated levels (3.4 fold) of RBP, compared to hepatocytes from normal (retinol-adequate) rats. Addition of retinol to retinol-depleted hepatocytes stimulated RBP secretion by the cells in a concentration-dependent manner. Maximal stimulation of RBP secretion was seen with a retinol level of 0.3 micrograms/ml. The effect of retinol was quite rapid, and was evident by 20 minutes after addition of retinol to the medium. Stimulation of RBP secretion was only seen during the first few hours after retinol addition. The effect of retinol was specific for RBP; thus, retinol had no effect on the secretion rates of transthyretin or albumin. Addition of retinoic acid also stimulated RBP secretion by retinol-deficient hepatocytes. Addition of dexamethasone to retinol-deficient cells did not maintain the initial rate of RBP secretion. Dexamethasone also had no effect on the secretion of transthyretin or albumin by these cells. The effects of retinol and of dexamethasone seen here with retinol-depleted cells differed dramatically from effects seen in other studies with normal (retinol-adequate) hepatocytes. Thus, with normal cells, dexamethasone maintains RBP, TTR, and albumin production and secretion rates close to initial rates. Also in normal hepatocytes, with ample retinol available within the cell, addition of exogenous retinol does not appear to influence RBP secretion. In contrast, and as shown previously in intact rats, in retinol deficiency the availability of retinol specifically regulates the secretion of RBP by hepatocytes. PMID- 3805127 TI - Characterisation of stroma-dependent blast colony-forming cells in human marrow. AB - Human bone marrow contains a population of haemopoietic progenitor cells that can be distinguished by their ability to adhere to preformed stromal layers (cultured in the presence of methylprednisolone [MP+] and form blast cell colonies. The stromal layers function in the colony assay after they have been heavily irradiated but not after they have been passaged. The binding of the progenitor cells to the stromal cells is complete after 2 hours of coincubation, and stromal layers of 9.6 cm2 can provide adhesion sites for at least 2,000 blast colony forming cells. The blast colony-forming cells were shown by micromanipulation to self-renew as well as to give rise to multipotential and lineage-committed colony forming progenitor cells. PMID- 3805128 TI - Peptide inhibitors of fibronectin, laminin, and other adhesion molecules: unique and shared features. AB - Synthetic peptides can specifically inhibit the function of certain adhesive glycoproteins in vitro and in vivo. We have compared the relative activities of a set of six variant synthetic peptides based on the sequence of fibronectin in terms of their ability to inhibit the interactions of fibroblasts with fibronectin, spreading factor/vitronectin, laminin, and native collagen gels. BHK (baby hamster kidney) and chick embryo fibroblasts spreading on these adhesive molecules displayed distinctive patterns of sensitivity to inhibition by this panel of peptides, which depended on the adhesive molecule rather than the cell type. For fibronectin, Gly-Arg-Gly-Asp-Ser was considerably more active than Arg Gly-Asp-Ser, whereas these two peptides displayed little difference in activity in inhibiting cell adhesion to spreading factor. For both proteins, the inverted peptide sequence Ser-Asp-Gly-Arg was also moderately active, whereas closely related peptides containing a transposition, a deletion, or a single, conserved amino acid substitution were much less active. For inhibiting interactions with laminin or native type I collagen gels, Gly-Arg-Gly-Asp-Ser was only weakly active, but the inverted peptide Ser-Asp-Gly-Arg unexpectedly continued to display inhibitory activity for both attachment proteins in both cell types. Our results indicate that different adhesive processes depend on distinct peptide recognition events by a cell. However, there may be a possible common denominator among attachment proteins in a moderate sensitivity to Ser-Asp-Gly-Arg. Our study also underscores the importance of examining a full set of peptide analogs when these novel inhibitors are used to characterize biological processes. PMID- 3805129 TI - Mitogenic effect of double-stranded RNA in human fibroblasts: role of autogenous interferon. AB - The synthetic double-stranded RNA polyinosinate-polycytidylate [poly(I).poly(C)] was mitogenic in cultures of human foreskin fibroblasts, as demonstrated by a stimulation of 3H-thymidine incorporation and an increase in cell density. Poly(I).poly(C) is a potent inducer of interferon (IFN)-beta in human fibroblasts. Single-stranded poly(l) or poly(C) were not mitogenic in human fibroblasts and did not stimulate IFN production. Antiserum to interferon (IFN) beta, added to poly(I).poly(C)-stimulated cultures in order to neutralize endogenously generated IFN, markedly amplified the mitogenic action. Under similar experimental conditions, antiserum to IFN-beta did not enhance the mitogenic action of epidermal growth factor (EGF). Dexamethasone enhanced the mitogenic action of poly(I).poly(C) in a manner similar to antiserum against IFN beta. This effect of dexamethasone correlated with its marked inhibitory action on poly(I).poly(C)-stimulated IFN production. Together with the results of other related studies, these findings support the notion of an evolutionary link between the generation of a mitogenic signal and IFN induction. In addition, these results support the concept that autocrine secretion of IFN-beta can exert negative feedback control of cell proliferation. PMID- 3805130 TI - Effects of nutritional and hormonal factors on the metabolism of retinol-binding protein by primary cultures of rat hepatocytes. AB - Studies were conducted to explore hormonal and nutritional factors that might be involved in the regulation of retinol-binding protein (RBP) synthesis and secretion by the liver. The studies employed primary cultures of hepatocytes from normal rats. When cells were cultured in Dulbecco's modified Eagle's medium alone, a high rate of RBP secretion was observed initially, which declined and became quite low by 24 hr. Supplementing the medium with amino acids maintained RBP and albumin secretion at moderate (but less than initial) rates for at least 3 days. Further addition of dexamethasone maintained the production and secretion rates of RBP, transthyretin, and albumin close to the initial rates for up to 3-5 days in culture. The effects of dexamethasone were not rapid and were not specific for RBP; half-maximal effects were seen at 10(-9) to 10(-8) M levels. Hormonally treated hepatocytes produced and secreted RBP, transthyretin, and albumin at both absolute and relative rates similar to physiological values, as estimated from rates reported by others from studies in vivo (with both rats and humans) and with perfused livers. Glucagon addition partially maintained the secretion rates of these 3 proteins, but less effectively than did dexamethasone. A number of other hormones, added singly or in combination, did not affect RBP production or secretion. Addition of retinol to the cultured normal hepatocytes was without effect upon RBP secretion. These studies show that supplementing the culture medium of hepatocytes with amino acids and dexamethasone maintains RBP production and secretion for several days. In normal hepatocytes, with ample supply of retinol available within the cell, addition of exogenous retinol does not appear to influence RBP metabolism or secretion by the cells. PMID- 3805131 TI - Murine macrophage heparanase: inhibition and comparison with metastatic tumor cells. AB - Circulating macrophages and metastatic tumor cells can penetrate the vascular endothelium and migrate from the circulatory system to extravascular compartments. Both activated murine macrophages and different metastatic tumor cells (B16-BL6 melanoma; ESb T-lymphoma) attach, invade, and penetrate confluent vascular endothelial cell monlayer in vitro, by degrading heparan sulfate proteoglycans in the subendothelial extracellular matrix. The sensitivity of the enzymes from the various sources degrading the heparan sulfate proteoglycan was challenged and compared by a series of inhibitors. Activated macrophages demonstrate a heparanase with an endoglycosidase activity that cleaves from the [35S]O4 = -labeled heparan sulfate proteoglycans of the extracellular matrix 10 kDa glycosaminoglycan fragments. The macrophages do not store the heparanase intracellularly but it is instead found pericellularly and requires a continuous cell-matrix contact at the optimal pH for maintaining cell growth. The degradation of [35S]O4 = -labeled extracellular matrix proteoglycans by the macrophages' heparanase is significantly inhibited in the presence of heparan sulfate (10 micrograms/ml), arteparon (10 micrograms/ml), and heparin at a concentration of 3 micrograms/ml. In contrast, other glycosaminoglycans such as hyaluronic acid, dermatan sulfate, and chondroitin sulfate as well as the specific inhibitor of exo-beta-glucuronidase D-saccharic acid 1,4-lactone failed to inhibit the degradation of sulfated proteoglycans in the subendothelial extracellular matrix. Degradation of this heparan sulfate proteoglycan is a two step sequential process involving protease activity followed by heparanase activity. However, the following antiproteases--alpha 2-macroglobulin, antithrombin III, leupeptin, and phenylmethylsulfony fluoride (PMSF)--failed to inhibit this degradation process, and only alpha 1-antitrypsin inhibited the heparanase activity. B16-BL6 metastatic melanoma cell heparanase, which is also a cell-associated enzyme, was inhibited by heparin to the same extent as the macrophage heparanase. On the other hand, heparanase of the highly metastatic variant (ESb) of a methylcholanthrene-induced T lymphoma, which is an extracellular enzyme released by the cells to the incubation medium, was more sensitive to heparin and arteparon than the macrophages' heparanase, inhibited at concentrations of 1 and 3 micrograms/ml, respectively. These results may indicate the potential use of heparin or other glycosaminoglycans as specific and differential inhibitors for the formation in certain cases of blood-borne tumor metastasis. PMID- 3805132 TI - Platelet-derived growth factor stimulation of [3H]-glucosamine incorporation in density-arrested BALB/c-3T3 cells. AB - G0/G1 traverse in density-arrested BALB/c-3T3 cells is controlled by multiple serum-derived growth factors. Platelet-derived growth factor (PDGF) initiates a proliferative response, whereas factors present in plasma facilitate progression through G0/G1. In the absence of competence formation, progression factors are unable to stimulate cell cycle traverse. We have identified the stimulation of a biochemical process specific to competence formation in BALB/c-3T3 cells. PDGF treated BALB/c-3T3 cells incorporated 5-10-fold more [3H]-glucosamine (GlcN) into acid-insoluble material as compared to platelet-poor plasma (PPP) treated cultures. Increased GlcN incorporation occurred in density-arrested BALB/c-3T3 cells in response to treatment with other competence factors, fibroblast growth factor, and Ca3 (PO4)2 and was not due to cell-cycle traverse. Stimulation of [3H]-GlcN incorporation by PDGF was time dependent, and increased incorporation of [3H]-GlcN into protein required de novo protein synthesis. Several mechanisms through which PDGF could increase GlcN incorporation into cellular material were examined. Results of these studies suggest an increase in the cellular capacity to glycosylate proteins is a response to or a part of competence formation. PMID- 3805133 TI - Growth-promoting effects of esterolytically inactive thrombin on macrophages. AB - It has been recognized for many years that alpha-thrombin, like other better known mitogens (eg, PDGF, EGF, etc) is capable of initiating proliferation in quiescent cells belonging to the fibroblast family. However, unlike these other peptides, thrombin is a serine protease whose function as a growth stimulator for fibroblasts is intimately linked to its esterolytic activity. Thus, while native alpha-thrombin is capable of evoking DNA synthesis in G0/G1-arrested cells, neither enzymatically inactive thrombin (eg, iPR2P-alpha-thrombin) nor partially degraded thrombin (eg, gamma-thrombin) shares in this capability. Data from our laboratory have shown that thrombin is chemotactic for peripheral blood monocytes and for cells belonging to the monocyte/macrophage family and that this activity is not dependent upon thrombin's enzymatic properties. Our recent findings demonstrate that thrombin also serves as a growth factor for these cells, and this mitogenic capability is independent of esterolytic function and resides in the same region of the molecule as that responsible for chemotaxis. Additionally, by means of techniques such as computer modeling and peptide synthesis, we have now been able to delineate a distinct mitogenic subsite within this chemotactic thrombin sequence. Thus, the sequence in the thrombin B chain that mediates chemotaxis represents a true cell interactive exosite additionally capable of stimulating growth and possibly other biological functions in cells of macrophage/monocyte lineage. PMID- 3805134 TI - The primary culture of epithelia from the secretory coil and collecting duct of normal human and cystic fibrotic eccrine sweat glands. AB - Isolated human eccrine sweat glands have been microdissected into their secretory and reabsorptive components. Complete separation of these epithelia was confirmed by differential uptake of Neutral Red stain by an intermediate section of gland containing the junction between the secretory coil and the collecting duct. Primary cultures were obtained from explants of both tissues in medium RPMI-1640 or Williams E supplemented with foetal calf serum, insulin, transferrin, epidermal growth factor and hydrocortisone. The cells in the initial coil cultures had an elongated morphology while those of ductal origin were polyhedral. After 10 days both cultures were composed of polyhedral cells of varying diameter. All these morphological types were of epithelial lineage, as demonstrated by the binding of a monoclonal antibody to cytokeratin, the intermediate filament specific for epithelial cells. Outgrowth from both secretory and reabsorptive epithelia were multilayered, with plentiful desmosomal connections and an underlying basal lamina. Ultrastructural features typical of the epithelial cell types present in intact eccrine sweat glands were absent in a high proportion of the proliferating cells but domes, indicative of transepithelial active ion transport, were present in dense cultures from the reabsorptive duct. Outgrowth was also obtained from the secretory and reabsorptive epithelia of sweat glands from two cystic fibrotic patients. Since the most characteristic malfunction of cystic fibrosis is the impaired ion transport in the eccrine sweat gland, the availability of cultured epithelia should provide a useful model for study of the disease. PMID- 3805135 TI - Characterization of early compartments in fluid phase pinocytosis: a cell fractionation study. AB - Flotation through a 5.6% Percoll gradient of pinosomes from Chinese hamster ovary (CHO) cells labelled during a 10 min internalization period with horseradish peroxidase (HRP), a solute, revealed two pinosomal populations, the expected low buoyancy population and an unexpected buoyant population. The buoyant pinosomes that sedimented similarly to plasma membrane were not an artifact of HRP trapping during homogenization or of cell surface-adherent HRP. No trapping or cell surface adherence of HRP could be detected by biochemical or cytochemical assays, even after internalization periods as short as 15 s to 1 min. With short uptake times, the buoyant pinosome population was the major HRP positive vesicle population, suggesting a precursor-to-product relationship between the two populations. In pulse-chase experiments, the buoyant pinosome population was shown to be highly exocytic and the precursor to later pinosomes. By electron microscope cytochemistry, rapidly labelled, HRP positive pinosomes (15 s to 1 min uptake) were typically smooth vesicles with a median diameter of approximately equal to 0.30 micron and a size range from approximately equal to 0.10 micron to greater than 1.0 micron in diameter. We suggest that these rapidly labelled structures are a very early stage in the intracellular processing of pinocytic vesicles. PMID- 3805136 TI - Basal body loss during fungal zoospore encystment: evidence against centriole autonomy. AB - The controversial question of the possible autonomy of centrioles, as shown by the persistence of all or part of them in the generative cell line throughout the life cycle of organisms, remains unresolved. All previous reports on shedding or withdrawal of cilia and flagella showed that their basal bodies (= centrioles) were retained in the cells where they may, or may not, subsequently disassemble. We show that in the fungus Neocallimastix sp. the basal bodies are discarded with the flagella when zoospores encyst. This shedding of basal bodies argues against centriolar persistence in any form and thus against their autonomy and endosymbiotic origin. PMID- 3805137 TI - Plasmalemmal vesicles and the effects of sterol-binding agents in rabbit aortic endothelium. AB - The rims of vesicle openings in capillary endothelium are reported to be highly sensitive to perturbation by the sterol probe filipin when this agent is administered by perfusion at 50 microM concentration in aldehyde fixative for 10 min. If, as supposed, this specific rim response reflects functionally significant aspects of membrane organization at the vesicle-plasmalemma boundary, then it would be expected to be a reproducible and universal feature of endothelial vesicles in general. In the present study, we have investigated in detail the response to filipin of rabbit and rat aortic endothelial plasmalemma. First, the effect of standard filipin treatment (150 microM, 3-20 h) was examined by freeze-fracture. The extensive generalized response observed, taken together with the effects of filipin seen by fluorescence microscopy of stripped aortic endothelial sheets, and the marked corrugation of the plasmalemma observed by freeze-fracture after tomatin treatment, indicate that substantial amounts of cholesterol are present in the membrane. Exposure of rabbit aortic endothelium to 50 microM filipin for 10, 20, 40 and 60 min enabled the progressive appearance of filipin deformations in the plasmalemma to be traced. Even at the very earliest stages of the response, there was no preferential association of filipin deformations with endothelial vesicle rims. Similar experiments in the rat gave the same result. Specific sensitivity of endothelial vesicle rims would, therefore, seem to be either non-universal in occurrence or non-reproducible, and so is unlikely to reflect any membrane property of fundamental significance to endothelial vesicle function. PMID- 3805138 TI - Pattern of DNA increase in macronuclear anlagen of Tetrahymena. AB - By combining cytophotometry with autoradiography, five stages of macronuclear anlagen can be discriminated by their DNA content until the end of the first cell cycle after conjugation in Tetrahymena. DNA increases from 2C to about 32C. Each S-phase is followed by a non-synthetic period. Comparing the mean nuclear DNA content after and before each S-phase revealed that 16C anlagen contain significantly less DNA than twice the amount of 8C anlagen. This is unlike the situation in other S-phases during which the amount of DNA is precisely doubled. In the second cell cycle after conjugation some of the cells increase their macronuclear G2 DNA content beyond the 64C stage, while the majority show a mean G2 content of about 64C. PMID- 3805139 TI - Intracellular pH in Dictyostelium: a 31P nuclear magnetic resonance study of its regulation and possible role in controlling cell differentiation. AB - Intracellular pH (pHi) has been measured in Dictyostelium discoideum cells by 31P nuclear magnetic resonance. Ax2 cells, newly harvested from growth medium, maintained a pHi of 7.33 +/- 0.04 (17) at an extracellular pH ranging from 3.5 to 6.5. Below pH 3.5 the cells tend to lyse, whereas at pH values above 6.5 their pHi rises though they remain viable. pHi regulation in acid medium is not dependent on external Na+ or any other inorganic ion and so most probably involves the electrogenic plasma membrane proton pump. No significant change in pHi was detected during development through to the slug stage. Mature stalk cells gave a very acidic phosphate signal (pH less than or equal to 5.5) which was probably vacuolar in origin. Indirect experiments had suggested that pHi might regulate the development of Dictyostelium cells, with low pHi favouring stalk cell and high pHi favouring spore cell differentiation. In particular, two inhibitors of the plasma membrane proton pump, diethylstilbestrol and zearalenone, had been shown to be stalk cell inducers. In the present studies measurements of pHi of cells exposed to these inducers failed to detect the expected drop in pHi. In addition, DIF-1 (a low Mr factor), the natural inducer of stalk cell formation, caused, if anything, a slight alkalinization of the cells. Thus the original theory linking pHi and cell differentiation is not supported by these results and therefore appears to require some modification. Finally, extract experiments revealed the existence of two unidentified abundant phospho-compounds with resonant frequencies close to inorganic phosphate. The existence of these compounds can complicate the interpretation of spectra gained from living Dictyostelium cells. PMID- 3805140 TI - Differential redistribution of lectin receptor classes on clonal rat myotubes and myoblasts. AB - To evaluate the relative mobilities of cell surface glycoconjugates during myogenesis we have studied the redistribution of fluorescein-conjugated plant lectins on L6 rat myogenic cells. Previous experiments had demonstrated that the receptors for the lectins soybean agglutinin (SBA), wheat germ agglutinin, concanavalin A and Lens culinaris agglutinin all were relatively uniformly distributed on both myoblasts and myotubes, and that SBA receptors were capable of rapid redistribution on myotubes but not myoblasts at 4 degrees C (Sawyer & Akeson, 1983). Here we show that when SBA-labelled myoblasts are incubated at 37 degrees C, or for extended times at 4 degrees C, the lectin aggregates as on myotubes. So it appears that SBA-binding components show a quantitative rather than qualitative change in their mobility during L6 differentiation. In addition, the redistribution of the three other lectins on myoblasts and myotubes was either less prominent (i.e. showing fewer apparent surface clusters) or occurred less rapidly than with SBA. None of these three lectins showed striking differences in mobility between myoblasts and myotubes. Thus, it appears that SBA binds to a subset of surface glycoconjugates that is relatively highly mobile, and that this mobility is specifically enhanced with differentiation. PMID- 3805141 TI - The occurrence of lampbrush chromosomes in early diplotene oocytes of Xenopus laevis. AB - Transmission electron microscopy has been used to study the chromosomes found in the early diplotene oocytes of Xenopus laevis. Chromosomes from 40 micron early diplotene oocytes were found to possess a normal lampbrush chromosome morphology. The contour length of the loops found on these chromosomes was measured, the mean value determined and compared with that for lampbrush chromosomes found on 300 micron mid-diplotene (Dumont stage II) oocytes. The mean contour length of the loops from 40 micron oocytes (12.33 +/- 6.5 micron) was longer than that for the 300 micron oocytes (7.897 +/- 5.22 micron). Analysis of variance showed these two values to be significantly different (P less than 0.01). The mean loop density (number of loops per 25 micron chromosome axis) was also determined for the two size classes of oocytes, being 9.33 +/- 2.05 per 25 micron of chromosome axis for the 40 micron size class and 11.2 +/- 2.435 per 25 micron of chromosome axis for the 300 micron size class. Analysis of variance showed these values to be significantly different (P less than 0.01). The results of the present study demonstrate that the lampbrush chromosomes found in 40 micron early diplotene oocytes possess a greater loop contour length and a lower density of loops than those found in 300 micron, mid-diplotene oocytes. Possible reasons for these observations are discussed. PMID- 3805142 TI - Cellulose microfibril orientation in Oocystis solitaria: proof that microtubules control the alignment of the terminal complexes. AB - In the green alga Oocystis solitaria microtubules control the regular deposition of cellulose microfibrils. Although it has frequently been suggested that the influence of the cortical microtubules is mediated through the alignment of structures in the plasma membrane, e.g. the cellulose-synthesizing enzymes, experimental proof is lacking. In Oocystis the putative cellulose-synthesizing units, the so-called terminal complexes, can be visualized following freeze fracture. With respect to the synthesis of a given layer of microfibrils two distinct situations are observable: terminal complex doublets occur before the start of cellulose formation, but are subsequently separated into single terminal complexes by pressure exerted by the crystallizing microfibrils. In order to investigate the effect of anti-microtubular substances on the orientation of the terminal complexes, the state of cellulose deposition at the time of drug application was marked by short (15-30 min) treatment with Congo Red, which causes a morphological change in the terminal complexes. The characteristic alignment of the terminal complexes, both doublets and fragmented single ones, is severely disturbed in cells treated with the herbicide amiprophosmethyl, which is known to interfere with the action of microtubules. The results provide strong evidence that microtubules control the alignment of the putative cellulose forming units in Oocystis. The observed pattern of interference indicates that the microtubules most probably achieve their control by imposing fluidity channels on the membrane and not via direct links with the terminal complexes. PMID- 3805143 TI - Two-directional pattern of movements on the cell surface of Amoeba proteus. AB - Particles of latex, glass and precipitated Alcian Blue were studied cinematographically on the surface of migrating Amoeba proteus and in the surrounding medium. The majority of the attached and all unattached particles flow steadily forward in the direction of the endoplasmic streaming and cell locomotion. Flow on the surface is faster than in suspension. Some particles stuck on the membrane move backwards from the frontal region. This retrograde transport is slower than the anterograde flow, and the rate decreases further when the particles approach cell regions adhering to the substratum, accurately following the pattern of the withdrawal of ectoplasm in the same zone. Both movements coexist in the same region and retrograde particles may pass anterograde ones at a distance less than their diameter. Transition from forward flow to backward transport occurs just behind the frontal cap, where the new ectoplasm is formed. The anterograde movement is interpreted as reflecting the general forward flow of the laterally mobile fluid membrane components, which become added to the frontal surface of the locomoting cell; the retrograde movement as retraction of membrane components that, externally, are linked to the transported material and, on the cytoplasmic side, to the contractile microfilamentous layer, as is postulated for cap formation in tissue cells. PMID- 3805144 TI - Rectilinear particle arrays in freeze-fracture replicas of the surface membrane of Paramecium tetraurelia. AB - Freeze-fracture replicas of the plasma membrane of unfixed, uncryoprotected Paramecium tetraurelia bear large rectilinear arrays of 11 nm particles arranged in 7-11 parallel rows. The arrays are of sufficient size to leave impressions in replicas of the underlying outer alveolar membrane, and are apparent as parallel ridges in replicas of the surface coat of deep-etched cells. By noting the location of arrays in replicas of identified portions of the cortex of P. tetraurelia, it has been possible to map the distribution of arrays over the cell surface. The arrays are found primarily over the anterior surfaces of the cell, covering an area that extends from the preoral suture over the left adoral field and a large portion of the anterior dorsal surface. Freeze-fracture analyses of cells taken from a number of different stages of a culture cycle suggest that the particle arrays are not replicated as an integral part of the cortex during cell division, but are assembled and oriented in the membrane as the cells mature. The appearance of small intramembranous particle complexes in the plasma membrane of cells in logarithmic growth phase supports this hypothesis, possibly representing an assembly stage in the formation of the larger particle arrays. The facts that the particle arrays are apparent in replicas of the surface coat of cells, are found primarily at the anterior of the cell body, and have a highly specific orientation with respect to the cell surface, strongly suggest that they function as chemoreceptors in P. tetraurelia. PMID- 3805145 TI - Alignment of fibroblasts on grooved surfaces described by a simple geometric transformation. AB - The response of chick heart fibroblasts to grooved substrata was studied using microfabricated grooves and new measures of shape and alignment derived from the moments of cell shapes. Cell shape and alignment were measured on 23 different sets of regular, parallel grooves, which ranged in width from 1.65 to 8.96 micron, and in repeat spacing from 3.0 to 32.0 micron. The grooves were of constant depth, 0.69 micron. Digitized video images were analysed to extract the zero-, first- and second-order moments of the cell shapes, from which were calculated three measures of cell shape, and three measures of cell alignment. Regression analyses of the measures against parameters of the substratum such as groove width, repeat spacing and the ridge width between grooves show that ridge width is the main parameter affecting cell alignment (alignment being inversely proportional to ridge width), although groove width has a small additional effect. All the differences in cell shape between the different grooves can be summarized to a very good approximation as simple geometrical stretch transformations of the shapes of cells on planar surfaces. Our principal measure of cell alignment, paraxial elongation, is a measure of the necessary transformation. This finding has the interesting biological implication that the shape and orientation adopted by cells, in response to the grooves, are not governed by independent cellular mechanisms. PMID- 3805146 TI - A gradient in the density of intramembrane particles is formed during capping induced by concanavalin A. AB - During capping of concanavalin A (ConA) by amoebae of Dictyostelium discoideum, each cell becomes polarized, with the ConA at one end and newly extended pseudopodia at the opposite end of the cell. This new polarity is stable until the cap is shed or internalized. Intramembrane particles (IMPs) are widely believed to represent large integral membrane proteins, many of which are ion pumps and channels. Since asymmetric ion currents have been implicated in the development of cell polarity, we have used morphological landmarks associated with the capped cells in freeze-fracture to make a morphometric analysis of the IMP distribution relative to the axis of polarization of the capped cell. Untreated cells in suspension extend pseudopodia randomly from their surfaces. In these cells the numerical density of IMPs is random. However, capped cells demonstrate a density gradient of IMPs with the lowest density usually in the pseudopodia and the highest in the cap. The difference in density between the cap and other regions of the cell is two- to threefold for all IMPs, but can be as much as sevenfold for greater than 12 nm IMPs. This study is the first to document that the numerical density of IMPs is altered in response to ligand induced capping and demonstrates that the distribution of IMPs in a capped cell is related to the axis of polarization of the cell. These results suggest that the development of cell polarity during capping in Dictyostelium amoebae may be due to the asymmetric distribution of IMPs, which may cause asymmetric ion currents across the cell. PMID- 3805147 TI - Elemental content of mast cell granules measured by X-ray microanalysis of rat thymic tissue sections. AB - Mast cell granules were examined by fully quantitative X-ray microanalysis of 20 cells in freeze-dried cryosections. The mast cells were situated mainly in the connective tissue of the thymic capsule of five adult male Carworth Sprague Europe rats. In addition 30 red blood cells were analysed from the same sections. Nineteen of the mast cells had granules rich in S and K. One cell had smaller granules, and in this cell the granules contained high [Ca] and [P] instead of high [S] and [K]. In the majority of cells (13) the S:K ratio was highly correlated and less than 2.2, whereas in the remaining six cells the individual granule ratios were very variable in any one cell and much higher. The mean granule [K] (994 +/- 57 mmol kg-1 dry wt) was about four times the mean cytoplasmic level of 227 +/- 81 mmol kg-1 dry wt. The existence of this difference in concentration between the granules and the cytoplasm suggests that the K in the granules must be bound. The relationship between the [K] and [S] is discussed with regard to the possible binding of heparin and amines in the granules. PMID- 3805148 TI - Tight and gap junctions in the intestinal tract of tunicates (Urochordata): a freeze-fracture study. AB - The intestinal tracts from seven different species of tunicates, some solitary, some colonial, were studied fine-structurally by freeze-fracture. These urochordates occupy an intermediate position phylogenetically between the vertebrates and the invertebrates. The various regions of their gut were isolated for examination and the junctional characteristics of each part investigated. All the species examined exhibited unequivocal vertebrate-like belts of tight junctional networks at the luminal border of their intestinal cells. No septate junctions were observed. The tight junctions varied in the number of their component strands and the depth to which they extended basally, some becoming loose and fragmented towards that border. The junctions consisted of ridges or rows of intramembranous particles (IMPs) on the P face, with complementary, but offset, E face grooves into which IMPs sometimes fractured. Tracer studies show that punctate appositions, the thin-section correlate of these ridge/groove systems, are sites beyond which exogenous molecules do not penetrate. These junctions are therefore likely to represent permeability barriers as in the gut tract of higher chordates. Associated with these occluding zonular junctions are intermediate junctions, which exhibit no identifiable freeze-fracture profile, and macular gap junctions, characterized by a reduced intercellular cleft in thin section and by clustered arrays of P face particles in freeze-fractured replicas; these display complementary aggregates of E face pits. The diameters of these maculae are rarely very large, but in certain species (for example, Ciona), they are unusually small. In some tissues, notably those of Diplosoma and Botryllus, they are all of rather similar size, but very numerous. In yet others, such as Molgula, they are polygonal with angular outlines, as might be indicative of the uncoupled state. In many attributes, these various junctions are more similar to those found in the tissues of vertebrates, than to those in the invertebrates, which the adult zooid forms of these lowly chordates resemble anatomically. PMID- 3805149 TI - Nuclear matrix generation during reactivation of avian erythrocyte nuclei: an analysis of the protein traffic in cybrids. AB - It has previously been shown that an internal nuclear matrix is generated during the reactivation of the chick erythrocyte nucleus in mouse L-cell cytoplasts. This experimental system has now been used to identify the major polypeptides that migrate into the nucleus during the reactivation process. Mouse L-cells were prelabelled with [35S]methionine, enucleated using cytochalasin B, and fused with 14- to 17-day embryonic chick erythrocytes. Sixteen hours post-fusion, the redistribution of the labelled proteins was examined by electron microscopic autoradiography, and two-dimensional polyacrylamide gel fluorography of the isolated nuclei was used to identify the major imported species. After allowing for cytoplasmic contamination, 15 nucleus-associated polypeptides were identified, two of which also matched with counterparts in the L-cell nuclear preparation. Five of the nucleus-associated polypeptides were tentatively identified (on the basis of one-dimensional gel matches) as nuclear matrix proteins; these five included the two that had counterparts in L-cell nuclei. The autoradiographic results showed that 16 h post-fusion, the specific activity (silver grains/unit area) of the reactivated nucleus was about half that of the cytoplasm, with no evidence for an accumulation of labelled protein at the nuclear periphery. When well-reactivated nuclei were distinguished from poorly reactivated nuclei on the basis of the extent of chromatin decondensation, it was found that their specific activities were quite similar, but because of the difference in size, the well-reactivated nuclei contained about twice as much labelled protein. Estimates of the protein traffic based upon the autoradiographic data indicated that the nuclei had increased in mass by 10-20% during the 16 h reactivation period. PMID- 3805150 TI - Chromosome condensation activity in ovulated metaphase II mouse oocytes assayed by fusion with interphase blastomeres. AB - Fusion of large and small karyoplasts produced from metaphase II mouse oocytes with interphase blastomeres from 2-cell and 8-cell embryos (volume ratio of partners, 1:1) results in premature chromosome condensation (PCC) of the interphase nucleus in the majority of the fusion products (hybrids). Fused under the same experimental protocol, oocyte-derived cytoplasts also induce PCC of the blastomere nucleus in the fusion products (cybrids) provided they originate from recently ovulated oocytes (141/2-15 h after injection of human chorionic gonadotrophin (HCG)). In cytoplasts derived from older oocytes (16-20 h post-HCG) chromosome condensation activity gradually decreases with time as can be inferred from the increasing proportion of cybrids retaining interphase blastomere nuclei. However, even the oldest cytoplasts (19-20 h post-HCG) can induce PCC if the cytoplast volume significantly exceeds the volume of the interphase partner (7:1). We postulate that the condensation activity is predominantly bound to the nuclear apparatus (most probably to the chromosomes), and that in the cytoplasm of metaphase II mouse oocyte it decreases with post-ovulatory age. PMID- 3805151 TI - Kinetics and differentiation of marrow stromal cells in diffusion chambers in vivo. AB - Rabbit marrow cells inoculated into diffusion chambers (10(7) cells/chamber) were implanted intraperitoneally into athymic mouse hosts and cultured in vivo for 20 days. A connective tissue consisting of bone, cartilage and fibrous tissues is formed by the stromal fibroblastic cells of marrow within the chambers. Cell kinetics and tissue differentiation have been studied using histomorphometric and biochemical analyses. Haemopoietic cell numbers decrease to less than 0.05% of the initial inoculum during the 20-day period. At 3 days an average of 15 stromal fibroblastic cells only are identifiable within the chambers. After 3 days there is a high rate of stromal cell proliferation with a doubling time of 14.5 h during the period from 3 to 8 days and an increase in the total stromal cell population by more than six orders of magnitude from 3 to 20 days. Thirteen to fourteen population doublings occur before expression of the first observable differentiation parameter, alkaline phosphatase activity. The data demonstrate that the mixture of connective tissues formed within the chamber is generated by a small number of cells with high capacity for proliferation and differentiation. This is consistent with the current hypothesis that stromal stem cells are present in bone marrow. PMID- 3805152 TI - Development of a three-dimensional extracellular matrix synthesized by human diploid fibroblasts in vitro. AB - Development and maturation of an extracellular matrix, synthesized by human gingival fibroblasts, have been studied microscopically. Pairs of demineralized, fibronectin-coated slices of human tooth root, 300 micron thick, were placed on confluent cell layers, defining a 0.5 mm wide space. The cultures were grown under standard conditions with ascorbic acid (50 micrograms ml-1) added daily. At various times up to 13 weeks, the cultures were fixed and the samples prepared for light and electron microscopy. Cells from the monolayer became attached to, and migrated up, the vertical root surface and, during the time studied, completely filled the space between the root slices with an extracellular matrix. A close association was seen between the cell membrane and collagen fibres in the demineralized surface initially. A thin layer of fibrillar material was deposited between the cell and the vertical surface, and eventually an extracellular matrix surrounding the cells and attaching to the root surface was present. Samples fixed in the presence of Ruthenium Red showed intense staining of the fibrillar material, indicating the presence of anionic molecules. Additional cells migrated onto the newly synthesized matrix and up the root surface. Growth of the fibrillar networks on either side, horizontally and vertically, continued and, eventually, an extracellular matrix attaching to the vertical surfaces completely filled the previously empty space. Immunocytochemical staining showed that the matrix contained hyaluronic acid, chondroitin sulphate, dermatan sulphate and fibronectin at this time. Collagen fibres were observed at 6 weeks, and at later times collagen types I, III and V were the primary matrix components. The fibroblasts attaching to the root slice and those present at the edge of the matrix had an elongated, polar form. The cells within the matrix frequently showed a stellate appearance with numerous extended processes, in contact with fibrillar material or collagen fibres. Fibroblast processes were at later times seen to enclose bundles of collagen fibres and to mediate cell-to-cell contact, occasionally via desmosome-like structures. The structure and composition of the matrix and the appearance and apparent behaviour of the cells were similar to that observed in the healing wound. This system thus could provide a model for studying various aspects of regeneration of extracellular matrix. PMID- 3805153 TI - Three-dimensional reconstruction of the chondriome of the unicellular red alga Rhodella reticulata. AB - Three cells of the unicellular red alga Rhodella reticulata were serially sectioned and photographed in a transmission electron microscope in order to analyse the organization of the mitochondrial system, or chondriome, which, on the basis of cursory examination, appeared to consist of an interconnected network of one to a few organelles. The chondriome of all three cells was traced and superimposed on acetate paper and a three-dimensional model using balsa wood was constructed of one cell. The chondriome was found to consist primarily of one large, anastomosing mitochondrion located principally at the cell periphery. In addition, it appears that some cells can contain a few small mitochondria that are not connected to the main body of the chondriome. This is the first study to reveal the three-dimensional nature of the chondriome in a red alga. PMID- 3805154 TI - Large-scale selection synchrony of Tetrahymena thermophila. AB - A method is described, based on the phagocytosis of colloidal ferrite particles, which gives highly synchronous populations of Tetrahymena thermophila. To ensure a successful synchrony, the cell culture doubling time, the limits of the phagocytic period and the distribution of cell stages must first be determined. Once these parameters are known, synchrony can be achieved under a variety of growth conditions and with cultures ranging in volume from a few millilitres to 12 litres or more. The main advantages of the method are that the apparatus required is simple, large volumes of cells can be handled easily, and the synchronous populations can be prepared within a few hours. In principle, the method should be applicable to any cell population in which phagocytosis occurs discontinuously over the cell cycle. PMID- 3805155 TI - Stimulation of actin synthesis by cytochalasin D is specific for the isoactins normally expressed in muscle or non-muscle cells. AB - Treatment of human muscle myotube cultures with 2 microM-cytochalasin D (CD) for 6 h stimulated synthesis of both the (muscle-specific) alpha-actin and the (non muscle) beta and gamma-actins usually expressed by these cells. In non-muscle (HEp-2) cell cultures, CD enhanced synthesis of beta and gamma-actin, but did not induce synthesis of alpha-actin, which is not normally present in these cells. Thus, synthesis of both muscle and non-muscle actins can be increased by CD, but enhancement of actin synthesis results from increases in the isoactins usually present, rather than induction of new isotypes. Comparison of CD-treated (fused) myotube cultures with (unfused) myoblast cultures indicated that beta and gamma actin synthesis was similarly enhanced in both cultures, but that alpha-actin synthesis was stimulated to a greater extent in the myoblast cultures. Desmin synthesis was also stimulated in the myoblasts but not the myotubes, suggesting that the effect of CD on synthesis of these developmentally regulated cytoskeletal proteins (alpha-actin, desmin) might be modulated by fusion or the state of differentiation of the muscle cell. PMID- 3805156 TI - Neutrophil leucocyte chemotaxis is not induced by a spatial gradient of chemoattractant. AB - Chemotaxis and directed locomotion of neutrophil leucocytes are generally thought to be determined by the directed response of the cell to stable, spatial gradients of chemoattractants. In most cases, however, cells are also exposed to characteristic temporal changes in the attractant concentration during the lifetime of the gradient, especially as it develops. We have attempted to test whether neutrophils can respond to a spatial gradient in which these temporal changes are essentially absent. Gradients of formyl-peptides were made across a narrow barrier of agarose gel that separated two fluid reservoirs, and the cells were observed cinematographically as they moved between gel and glass. In gradients predeveloped at low temperature, at which cell motion and responses to attractant were inhibited, neutrophils showed no tendency to accumulate up gradient when warmed to 37 degrees C. Yet their speed and turning behaviour was related to the local concentration of formyl-peptide. However, gradients that developed at 37 degrees C, whilst the cells were responsive, elicited directed locomotion. We also tested populations that were either spreading into or already evenly distributed across micropore filters to see how cells might sense directional cues. We reasoned that evenly distributed populations could accumulate in a spatial gradient only if cells were able to 'read' it. However, no redistribution occurred without an applied impulse of attractant. It seems that the oriented, temporal component of an attractant signal is essential if a directed response (i.e. non-random turning) is to occur; a spatial gradient of soluble attractant alone does not induce neutrophil accumulation or taxis. This finding has implications for the termination of the acute inflammatory response, for clinical tests of leucocyte behaviour and for morphogen signal interpretation by cells in developing tissues. PMID- 3805157 TI - Structural integrity of the nuclear matrix: differential effects of thiol agents and metal chelators. AB - Nuclear matrices, associated with over 80% of the chromosomal DNA, could be isolated from BHK nuclei by extraction with 2M-NaCl. The matrices were found to impose at least two levels of structural order upon nuclear DNA. From sedimentation studies it was inferred that metal depletion of the salt-extracted nuclei generated matrix structures, which sedimented at significantly lower rates than control matrices. Fluorescence microscopy revealed that the reduced sedimentation rate is a consequence of the increase in the radius of the DNA halo, i.e. the DNA loops emanating from the residual nucleus. Addition of Cu ions to nuclei prior to salt extraction was found to induce contraction of this DNA halo. These results indicate that Cu ions may play an important role in stabilizing one level of DNA folding. When metal depletion had been brought about by thiol agents, a second effect was observed to occur. Within 15 min, salt extracted nuclei disintegrated, generating irregularly shaped, slowly sedimenting structures. Disintegration only occurred when the full complement of DNA was still attached to the nuclear matrices. Analysis by sodium dodecyl sulphate polyacrylamide gel electrophoresis revealed that treatment with thiols did not detectably alter the polypeptide composition of DNA-depleted residual nuclei. Results of these experiments suggest that both metal-protein interactions and disulphide bonds are important in maintaining higher-order structure in the nucleus. A model to account for these observations is discussed. PMID- 3805158 TI - Selection of kidney cell types in primary glomerular explant outgrowths by in vitro culture conditions. AB - Adult guinea pig glomeruli were grown in vitro either in serum or in a chemically defined medium. Glomeruli were plated either directly into plastic flasks or into plastic flasks that had been coated with the extracellular matrix produced by the PF-HR-9 mouse teratocarcinoma endodermal cell line. Both the composition of the medium and the nature of the culture substrate affected whole glomerular attachment and the type of cells produced in culture. Quantitative studies demonstrated selection of cell types by different culture conditions. Three colony types, each composed of distinctive cell types, could be identified by morphological features. The cells constituting two of these colony types were epithelial in nature, but they were identified as different epithelial types by both histochemical and ultrastructural criteria. Previous studies suggested that one epithelial cell type was derived from the glomerular visceral epithelial cell. This study demonstrates that this cell type could be selectively grown in defined medium on plastic. A second cell type showed several features of renal tubular epithelial cells, including histochemical staining for catalase, cell surface microvilli and cilia, and formation of hemicysts and structures that resembled tubules after prolonged periods in culture. To demonstrate that the 'glomerulus-derived' tubular cells were indeed tubular epithelium, we isolated purified renal cortical tubules (greater than 99% pure) and cultured them on the HR-9 matrix in a serum-free chemically defined medium. The resultant outgrowths had morphological properties identical to those of the glomerulus-derived tubular cells. It seems likely that small tubular fragments attached to a minority of the glomeruli are the source of these glomerulus-derived tubular cells. Neither epithelial cell type could be subcultured on plastic, but both could be passaged on the HR-9 matrix. A third cell type, the spindle-shaped cell, was easily propagated on both plastic and the HR-9 matrix. The origin of this cell type is not clear. Our results demonstrate the important effect of culture conditions on the selection, growth and differentiation of kidney cell types in vitro. PMID- 3805159 TI - Metabolic alterations underlying the development of hypermetabolic necrosis in the substantia nigra in status epilepticus. AB - The substantia nigra pars reticulata (SNPR) has previously been shown to undergo tissue necrosis following status epilepticus induced by flurothyl in the rat. Even if the rat is ventilated, the SNPR develops necrosis if the epileptic period lasts more than 30 min. Rat brains were frozen in situ after 20 and 60 min of seizure activity and after 60 min of seizure activity followed by 60 min recovery. Labile energy metabolites were then analyzed in the SNPR and in the periaqueductal grey matter (PAG, control region). In the PAG, the metabolite changes during status epilepticus were similar to those reported for cerebral cortex and hippocampus. Measurements showed an unchanged ATP content and energy charge (97% and 98% of control, respectively) and an accumulation of lactate to 9.2 +/- 0.6 mumol/g in the 60-min group. In the PAG, all metabolites measured had returned to control values after 60 min of recovery. In the SNPR, the perturbation of the energy metabolites was much more pronounced during status epilepticus. The concentration of ATP decreased to 75 +/- 3%, the energy charge to 91% +/- 12% and the adenylate pool to 86.7 +/- 5.7% of control. Lactate accumulated to concentrations of 16.1 +/- 1.8 mumol/g and 24.9 +/- 2.3 mumol/g in the 20-min and 60-min groups, respectively. The concentration of lactate was still increased above control after 60 min recovery, whereas the concentration of ATP and the energy charge were lower than control. The findings demonstrate that sustained and intense neuronal activation can cause metabolic disturbance and thereby lead to necrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805160 TI - A modification of the method for the measurement of cerebral blood flow using [14C]iodoantipyrine in small animals. AB - We have modified the method for the measurement of cerebral blood flow using [14C]iodoantipyrine in small animals to overcome problems caused by rapid sequential arterial sampling. A second isotope, gamma-emitting [99mTc]pertechnetate, is infused together with [14C]iodoantipyrine. The 99mTc is counted externally by a detector placed over the chest. The arterial curve for [14C]iodoantipyrine can be reconstructed from a single arterial sample collected from the severed neck and the shape of the 99mTc chest curve. Because of the short half-life of 99mTc (6 h), all 14C measurements, including preparation of autoradiograms, may be made 3 days later. PMID- 3805161 TI - Multitracer studies in acute brain ischemia. PMID- 3805162 TI - Frontal blood flow changes in recovery from coma. AB - Two-dimensional studies of cortical blood flow were conducted in 20 closed head injury patients in a comatose state and subsequently in 9 patients as they recovered to an awake and responding state. Comatose patients showed a reduction of frontal flow compared to the resting pattern observed in age matched normal volunteers. In most patients the normal anterior-to-posterior flow gradient was reversed. Increases in global flow, while in coma, tended to exaggerate this reversal. Patients who survived showed a normalization of the regional flow pattern as they regained consciousness. The marked reduction of frontal blood flow in the comatose state was independent of locus of injury as determined by computed tomography (CT) scan data. Combined with previous CBF studies of sensory and cognitive activation, these findings suggest that frontal reduction may be a nonspecific effect of any state or condition involving reduced directed mental activity. This, in turn, raises questions about recent interpretations offered for frontal CBF reduction in psychiatric disease. PMID- 3805163 TI - Three-dimensional mapping of local cerebral perfusion in alcoholic encephalopathy with and without Wernicke-Korsakoff syndrome. AB - Seventeen severe chronic alcoholic patients with and without Wernicke-Korsakoff syndrome (WKS) were examined prospectively after being treated by withdrawal from alcohol. The WKS patients also received thiamine supplements. Three-dimensional measurements of local cerebral blood flow (LCBF) and local partition coefficients (L lambda) were made utilizing xenon contrast computed tomography (Xe CT-CBF). Results were displayed as color-coded brain maps before and after treatment and these were correlated with neurological and cognitive examinations. Before treatment chronic alcoholics without WKS (n = 10) showed diffuse reductions of LCBF values throughout all gray matter including hypothalamus, vicinity of nucleus basalis of Meynert, thalamus, and basal ganglia. Similar, but more severe, reductions were seen in patients with WKS (n = 7), however, white matter perfusion was also reduced. In WKS, most prominent reductions of LCBF were also seen in hypothalamus and basal forebrain nuclei but thalamus, basal ganglia, and limbic systems were severely reduced. After treatment, both groups with alcoholic encephalopathy showed marked clinical improvement and cerebral perfusion was restored toward normal. Chronic alcohol abuse, in the absence of thiamine deficiency, reduces CBF by direct neurotoxic effects. If thiamine deficiency is also present, more severe and localized hemodynamic reductions are superimposed. PMID- 3805164 TI - Nerve fibers containing neuropeptide Y in the cerebrovascular bed: immunocytochemistry, radioimmunoassay, and vasomotor effects. AB - Perivascular nerve fibers containing neuropeptide Y (NPY)-like immunoreactivity were identified around cerebral blood vessels of human, cat, guinea pig, rat, and mouse. The major cerebral arteries were invested by dense plexuses; veins, small arteries, and arterioles were accompanied by few fibers. Removal of the superior cervical ganglion resulted in a reduction of NPY-like material in pial vessels and dura mater. Pretreatment with 6-hydroxydopamine or reserpine reduced the number of visible NPY fibers and the concentration of NPY in rat cerebral vessels. Sequential immunostaining with antibodies toward dopamine-beta hydroxylase (DBH) (an enzyme involved in the synthesis of noradrenaline) and NPY revealed an identical localization of DBH and NPY in nerve cell bodies in the superior cervical ganglion and in perivascular fibers of pial blood vessels, suggesting their coexistence. Administration of NPY in vitro resulted in concentration-dependent contractions that were not modified by a sympathectomy. The contractions induced by noradrenaline, 5-hydroxytryptamine, and prostaglandin F2 alpha and the dilator responses to calcitonin gene-related peptide were not modified by NPY in rat cerebral arteries. However, the constrictor response to NPY was reduced by 70% in the presence of the calcium entry blocker nifedipine, and abolished following incubation in a calcium-free buffer. These data suggest an interaction of NPY at a postsynaptic site, which for induction of contraction may open calcium channels in the sarcolemma of cerebral arteries. PMID- 3805165 TI - Effect of theophylline on ischemically induced hippocampal damage in Mongolian gerbils: a behavioral and histopathological study. AB - We investigated the influence of the adenosine antagonist theophylline on the degree of hippocampal cell damage in the Mongolian gerbil following brief periods of forebrain ischemia. Male gerbils were randomly divided into nine groups. Ten minutes before surgery, four groups, which were later subjected to 1, 2, 3, or 5 min of bilateral carotid occlusion under halothane anesthesia, received theophylline (30 mg/kg, p.o.). Four groups served as nontreated ischemic controls; the ninth group was used to measure theophylline serum concentration. Neurological symptoms were classified by using a behavioral score. Fourteen days after ischemia, the brains were removed, and the hippocampus was histologically examined "blind" for the degree of cell damage in the CA1 sector, which was expressed as a semiquantitative histopathological score. There were no behavioral or histological abnormalities in either the control or theophylline group with 1 min of ischemia. With increasing duration of ischemia, the neurological symptoms worsened and the number of necrotic pyramidal cells increased significantly. The pretreatment with theophylline only moderately aggravated the neurological symptoms, whereas it enhanced the ischemic cell damage significantly. The results are discussed with respect to recent findings that theophylline may block putatively protective effects of endogenous adenosine, whose concentration in the brain is known to rise significantly during ischemia. PMID- 3805166 TI - Calcium accumulation and neuronal damage in the rat hippocampus following cerebral ischemia. AB - The present study was undertaken to correlate calcium accumulation with the development of neuronal necrosis following transient ischemia. After 10 min of forebrain ischemia in the rat--a period that leads to reproducible damage of CA1 pyramidal cells--determination of calcium concentration and evaluation of morphological signs of cell body necrosis in the dorsal hippocampus were performed at various recirculation times. Tissue calcium concentration was not different from control at the end of ischemic period and did not change after 3, 6, 12, or 24 h of recirculation. However, after 48 h, calcium content increased significantly, with a further increase being seen after 72 h. At early recovery periods, only scattered necrotic neurons were observed. After 48 h, only 2 of 12 hemispheres showed more than 25 necrotic cells per section. More conspicuous neuronal death was observed after 72 h. The results thus demonstrate that net accumulation of calcium in regio superior of the hippocampus precedes marked necrosis of CA1 pyramidal cells. The results suggest that one primary event in the delayed death of these cells is membrane dysfunction with increased calcium cycling. PMID- 3805167 TI - [Angiomyolipoma of the kidney. Attempt at a therapeutic codification]. AB - On the basis of the analysis of five original and of 181 previously published observations since 1975: the histological, histogenetic, evolutive and epidemiologic patterns of renal angiomyolipoma are exposed; the symptoms at presentation and the clinical manifestations are analysed; some morbid associations of this affection are considered and, particularly, its particular relationship with the tuberous sclerosis is debated; the diagnosis of these angiomyolipomas is studied with special regard to the role of modern radiologic explorations; finally, is propounded a therapeutic codification, which relies mainly on surgery. PMID- 3805168 TI - [Pelvic cancers: radioprotection of the small intestine by using a mammary prosthesis for postoperative irradiation. Apropos of 12 cases]. AB - A preventive technique of radiation injuries to small intestines with intrapelvic mammary prosthesis is described. It has been used for twelve cases in which 9 concerned rectal adenocarcinomas (local recurrences 7 and fixated tumors 2). After this short experience, we can recommend this reliable technique without important local complication and describe the irradiation technique. The indications of this method are precised because it is finally an unfrequent therapeutic. PMID- 3805169 TI - [Muscular tumors of the esophagus. Apropos of 9 cases and review of the literature]. AB - Between 1970 and 1983, nine cases of tumors of esophageal muscle and connective tissue were treated at the Centre Paul Lamarque. Leiomyoma (LM) (6 cases in this series) represented 0.8% of esophageal tumors reported from among 1,200 patients, while leiomyosarcoma (LMS) (3 cases in this series) were observed in 0.25%. LM is usually detected fortuitously and is asymptomatic, LMS provoking dysphagia of the "foreign body" type contrasting with the "monstrosity" of the radiologic image. Endoscopy and biopsy is justified only when LMS in suspected, since it could interfere with enucleation. Treatment is surgical, by enucleation without mucosal effraction for LM and esophageal resection for LMS. Adjuvant therapy has failed to provide evidence of efficacy. PMID- 3805170 TI - [Surgical treatment of chronic pancreatitis. Retrospective study of 221 cases]. AB - 221 patients have been operated for chronic pancreatitis, secondary to alcoholic intoxication in 92% of cases. Surgery was performed for a complication of the disease (69%), for intractable pain (30%), or for a false diagnostic of cancer; 265 operations were done, among which 41% of resections, 18.5% of internal derivations, and 14.3% of external derivations. Post-operative morbidity was 23.4% and hospital mortality was 6.4%. Late mortality was 35.5%, pancreatitis being responsible for more than half of those deaths during the first three post operative years. Iterative surgery was necessary in 37 cases. The risk of diabetes was multiplied by 3.2 after resection. Results were good in 50% of cases after 5 years. An important factor was the arrest of alcoholic intoxication. There was no significant difference between resection and derivation. Internal drainage should be preferred when possible. Surgery must be reserved to grave or invalidating complications of chronic pancreatitis. PMID- 3805171 TI - [Value of absorbable stapling in digestive surgery? Experimental study comparing TA metallic stapling, TA absorbable stapling and manual sutures]. AB - Absorbable staples, recently available for TA 55 instrument, has not been yet evaluated in gastro-intestinal surgery. This experimental work was designed to determine the feasibility and the reality of the advantages of the new material: the wound healing process of 3 techniques of intestinal closure (metal staples, Lactomer absorbable staples and polyglactin sutures) were compared. A double Roux en Y loop was performed on 9 dogs: each end was closed by one of these techniques, and recuperated at regular intervals (3 samples by dog). Twelve sutures were examined at 10 post-operative days, 14 at 25 days, and 10 at 130 days. Macroscopic examination showed major inflammatory adhesions around absorbable staples. Two fistulae have complicated absorbable stapling versus 0 with the 2 others techniques. Histologic review showed greater tissue trauma with Lactomer staples than metal staples; intense and prolonged inflammatory reaction was seen around absorbable staples, while metal staples were well tolerated. The difference in design of the 2 staples can explain the differences in the healing process. In spite of the interest for absorbable material, our experimental study shows the present superiority of the metal stapling and prompts improvements of absorbable staples for reliable use in gastro-intestinal surgery. PMID- 3805172 TI - [Intrathyroidal metastases of a nephroepithelioma. Reflections on 5 operated cases]. AB - Out of 3,340 thyroidectomies (237 for cancer), the authors report 5 cases of thyroid metastases due to clear cell renal cancer. They emphasize the slow development of these metastases. Two cases were operated on 11 years after nephrectomy and one after 27 years. In one case, an intrathyroid metastasis led to the discovery of renal carcinoma. In 3 cases, evolution was rapidly fatal (within the first year). One patient is still alive 6 years after thyroidectomy. The authors emphasize clinical grounds for diagnosis and expose pathology findings that favor longer survival when there is early removal of intrathyroid metastases. PMID- 3805173 TI - [Treatment of recurrent anterior dislocations of the shoulder by the technic of pre-glenoid stapling. Study of a series of 48 cases]. AB - Preservation of local muscular structures, and closure of the capsulo-periosteum detachment, are the two essential principles observed, when treating recurrent anterior shoulder dislocation by pre-glenoid stapling and also afford satisfactory results. This technique is used for capsulo-ligamentar lesions without alterations of the anterior edge of the glenoid cavity. If the strict technique is followed when placing the staple excellent stability result. If physiotherapy is started early, functional recovery is rapid. Sporting activities can be resumed within the third month after the operation. PMID- 3805175 TI - [Leiomyosarcoma of Meckel's diverticulum. Apropos of a new case]. PMID- 3805174 TI - [Immediate repair of urethroperineal fistulas after abdominoperineal amputation by means of a cutaneo-muscular flap of the gluteus maximus. Apropos of 2 successfully treated cases]. AB - Although a rare complication, the development of a urethro-perineal urinary fistula immediately after abdomino-perineal amputation is a difficult problem to solve. The fragility of the membranous urethra immediately in contact with the exenterated pelvic cavity which takes several weeks to fill in makes any attempt at isolated direct suture very hazardous. Secondary repair is also frequently difficult and the "functional prognosis is far from being always favourable". The major handicap resulting from the perpetuation of this type of fistula has led us to propose an attempt at immediate repair as soon as it is diagnosed with filling of the pelvi-perineal cavity by a cutaneo-muscular flap taken from gluteus maximus. In the two cases in which this treatment was performed, the fistula was cured and a good quality functional result was obtained. PMID- 3805176 TI - [Colon duplication]. PMID- 3805177 TI - [Focal pseudotumoral rhabdomyolysis]. PMID- 3805178 TI - [The hepaticocaval intersection: current anatomosurgical aspects. Apropos of 32 dissections]. AB - Segmental occlusive phlebography of IVC coupled with a slit in its posterior wall, injection of corrosive substances into portal and hepaticocaval network, biometry of the retrohepatic IVC and serial sections of injected livers from 32 fresh subjects has allowed definition of the hepaticocaval intersection which constitutes one of the rare current stumbling-blocks to hepatic surgery. Emergency surgery for hepaticocaval injuries exposes patients to the risk of gas embolus and massive haemorrhage. Using a median sternolaparotomy approach they require previous temporary hemostasis by quadruple clamping or intracaval shunt: in more than half of cases the length of the subhepatic, suprarenal IVC of less than 1 cm does not permit application of a clamp and necessitates introduction of an intracaval shunt by the atrial route. Cold surgery for certain hepatic tumors close to the intersection can benefit from vascular exclusion of liver but the right middle capsular and inferior phrenic veins must be clamped: clamping of the suprahepatic IVC is dependent on the site of the intersection in relation to diaphragm. The principal right hepatic vein, lacking collateral over 1 cm external to liver in 1 of 2 cases, can be controlled extraparenchymatously after mobilization of right liver, but caution is needed because of the predominance of "accessory" hepatic veins in 25% of cases. Control of hepatic veins external to liver on left side is dangerous since a common trunk is frequent (87.5%), collateral branches numerous and often vulnerable. Relations between intersection, diaphragm and right atrium also define modalities of treatment of hepatic lesions in membranes of terminal IVC and in Budd Chiari's syndrome. PMID- 3805179 TI - [Recurrence of a benign pleural mesothelioma 18 years after excision. Review of a series of 33 patients with a primary tumor of the pleura from 1958 to 1986]. AB - A 60 year old woman developed recurrence of a localized pleural mesothelioma 18 years after initial exeresis. Based on data from 33 cases of primary tumor of pleura treated in the UCH, Vaudois, Switzerland between 1958 and June 1986, symptomatology, treatment and prognosis of pleural mesothelioma a are discussed. Findings suggest the need for long-term follow up surveillance of patients with benign mesothelioma. PMID- 3805180 TI - [Gastropericardial fistula. Late complication of the treatment of hiatal hernia]. AB - An exceptional case of gastropericardial fistula is reported, the lesion developing from a gastric ulcer on an antireflux valve instituted ten years previously. A literature review showed 31 similar cases: 14 gastropericardial fistulae, 16 esophagopericardial fistulae and one jejunopericardial fistula. Three features common to all these fistulae were determined: the frequency of hiatus hernia in the genesis of these lesions, either from an ulcer on esophagitis or herniated stomach or from surgical complication; the extremely high mortality of these fistulae (68% mortality); the need for aggressive treatment. PMID- 3805181 TI - [Emergency surgery in colonic obstructions. Retrospective study of 70 cases]. AB - 70 patients with complete colonic obstruction requiring emergency surgery were treated at the "Clinique Chirurgicale C" between 1977 and 1984. Carcinoma was the cause of obstruction in 65 cases. Obstruction was situated on the right colon 8 times, on the splenic flexure 13 times, and on the left colon 49 times. In emergency obstruction of the right colon was treated by right hemicolectomy in 6 cases with 0 death. Obstruction of the splenic flexure was treated in 10 cases by simple loop colostomy, twice by resection with ileo-sigmoid anastomosis, 1 by resection without anastomosis with 5 deaths. Obstruction of the left colon was treated by simple loop colostomy in 46 cases. Of the 34 patients who survived after loop colostomy, 26 were reoperated and in 23 cases a resection could be performed with 2 deaths and the colostomy could be closed in a third stage in 20 cases without death. 5 years survival of curative resection was 57%. It is concluded that primary resection is the best treatment for obstruction of the right colon and of the splenic flexure. But three stage resection seems to be a good procedure for obstruction of the left colon with low mortality, low morbidity and good 5 year survival. PMID- 3805182 TI - [Must all ruptured aneurysms of the aorta be operated on?]. AB - Surgery is the only means of saving the life of patients with ruptured aneurysm of aorta, but it is universally accepted that the chance of survival is very low in case of prolonged collapse in patients over 80 years. Definition of pre operative factors of severity and analysis of their effect on postoperative mortality showed that neither advanced age nor collapse nor anuria on admission allowed exclusion of patients when evaluated singly. When associated, however, the mortality rate becomes very high, but in this case any result of less than 100% mortality implies progress and should incite operation. In contrast, when patients with aneurysms have been excluded on other grounds then the contraindication to surgery should be maintained in case of rupture. PMID- 3805183 TI - [Injuries of the thoracic duct during neck surgery]. AB - Although rarely published, operative injuries to thoracic duct in neck are by no means exceptional, and can occur during all types of surgery to lower cervical and supraclavicular regions. A case is reported and used as a basis for an analysis of diagnostic means and therapeutic possibilities of injuries detected during operation or those developing manifestations at a later stage. In the case reported, long-term medical treatment resulted in arrest of lymphorrhea within 37 days. PMID- 3805184 TI - [Liver abscess with pleuropulmonary fistula following hepatobiliary ascariasis in a 18-month-old infant. Apropos of a case with recovery for over 10 years]. AB - This study deals solely with the problem of intra-hepatic collected suppuration due to an ascaris migration through the liver ducts. It is due to the infestation of the intestine germs carried away by the worm but not by the ascaris itself which can die calcified inside the liver without hearing of it, provided no mechanical complication has happened, or if it has returned to the intestine environment. When the illness starts with hepatic colic, a pyrexy with a painful right hypochondria and a painful liver-swelling, if the positive diagnosis, that can have been made from the cutaneous allergy test, the R.A.S.T. [Radioallergosorbent Test]. the sonographic diagnosis, the cholangiography and the C.T. scan, can be proved only by curative aiming surgery, mainly in on endemic countries. The pre and post-operative anti-helmintics are strongly advised to avoid a reinfestation of the illness. PMID- 3805185 TI - [Hemorrhagic hepatic lesions in toxemia of pregnancy]. AB - One case of hepatic hemorrhage during toxemia of pregnancy is reported. This complication occurs in the last trimester of the pregnancy or immediately after labor. The diagnosis is usually made per-operatively. The anatomical lesions are subcapsular hematomes or spontaneous rupture of the liver. Surgery is only treatment and must be conservative. The very high mortality rate has generally been attributable not only to uncontrolled hemorrhage but also to disorders of hemostasis associated and to multiple organe failure. PMID- 3805186 TI - [Posterior approach to the elbow preserving the extensor apparatus. Its value in the osteosynthesis of humerus plate fractures]. AB - The authors describe a median posterior approach of the elbow with preservation of the triceps mechanism in continuity. Such an approach provides an excellent exposure of the elbow and of the lower part of the humeral shaft which can be used for the osteosynthesis of complex supra and intercondylar fractures. This approach can also be extended to the midshaft of the humerus, the radial head and the ulnar shaft. The repair is easy and strong enough to allow a rapid rehabilitation. PMID- 3805187 TI - [Bone metastases of colorectal cancers. Apropos of the disclosure of sigmoid adenocarcinoma by a huge pseudosarcomatous iliopubic metastasis]. PMID- 3805188 TI - [Splenic abscess: a new case]. PMID- 3805189 TI - [Ureteroduodenal fistula after nephrectomy. Apropos of a case]. PMID- 3805190 TI - [Bilio-thoracic fistulas of traumatic origin]. AB - Biliothoracic, biliopleural or biliobronchial fistulae are rarely seen after thoracoabdominal traumatism or hepatic or biliary abscess. We report a case of bilio-bronchocutaneous fistula without clinical biliptysis 6 months after hepatic bisegmentectomy for lacerations from thoracoabdominal trauma. The diagnosis was confirmed at cutaneous fistulography. Recovery was complete after a few weeks of drainage alone. This case serves as a basis for discussion of the aetiology of biliothoracic fistulae, the mechanisms of formation and the therapeutic options. PMID- 3805191 TI - [Present status of the Taylor method in perforated ulcer of the duodenal bulb]. AB - Therapy by Taylor's method was attempted in 61 of 96 patients with perforated ulcer of duodenal cap. Treatment was effective in 50 cases (more than 50%) and morbidity and mortality were low. Most operated cases were recipients of simple treatment for the perforation, more rarely combined with therapy for the ulcer disease. Postoperative mortality was very high (24% of patients operated upon) but appeared to be related mainly to associated risk factors. Only 8 of the patients treated by Taylor's method required recovery surgery, while this was necessary in 4 patients operated upon initially and given simple treatment for the perforation. These findings suggest efficacy of Taylor's method for treatment of perforated duodenal ulcer, avoiding operation or allowing treatment of the ulcer disease once the acute episode has passed. PMID- 3805192 TI - [Is vesicular cholesterolosis a particular anatomo-clinical form of cholesterol lithiasis? Apropos of a case of cholesterol polyp manifested by an acute complication]. AB - A case of cholesterolic polyp, revealed by the formation of an infundibulo-cystic enclave, is reported, the polyp having the appearance of a cholesterolic calculus, but a pediculated one, and one acting as a calculus. The extreme rarity of this complication is emphasized. Despite the frequency of associated lithiasis, the cholesterolosis are included in a different framework from lithiasis, that of the cholecystoses that on histology show typical pure parietal lesions without inflammation. Findings in this atypical case suggest possible common pathogenic factors for the two affections, and raise a proposal for inclusion of cholesterolosis within the nosologic framework of lithiasis. PMID- 3805193 TI - [Tubular grafts of the inferior vena cava for portacaval shunts. Principle, technic and preliminary clinical results]. AB - A technique for performance of portocaval shunt operations using tubular inferior vena cava grafts is proposed. The aim of this method is to avoid prosthetic or venous interposition with their risk of thrombosis. It is based on results of cadaver experimental studies and a clinical case. Different possible grafts are described, including useful sizes, advantages and inconveniences and clinical indications. Two types are selected: that resected from left surface of subhepatic vena cava for portocaval anastomosis and that obtained from anterior surface of infrarenal vena cava for mesentericocaval anastomosis. PMID- 3805194 TI - [Bilateral popliteal artery aneurysm revealing an entrapment]. AB - Popliteal entrapment syndrome is not so rare if usually researched by clinical examination. But it is very unusual to find a bilateral aneurysm when you first examine your patient. One of them was complicated by a rupture. The surgical management with bilateral venous grafts is described. PMID- 3805195 TI - [Post-traumatic intramural hematoma of the duodenum]. AB - A post-traumatic intramural hematoma of duodenum in a 9 year old child was detected during exploratory laparotomy but left undisturbed. Postoperative follow up during parenteral feeding included surveillance by repeated gastrografin follow through examinations, normal transit being restored by the 12th day. Intramural hematoma of duodenum is usually due to injury and often affects male children. Symptomatology is that of upper digestive occlusion. The principal investigation should be gastro-duodenal follow through examinations with gastrografin, because of the risk of an associated perforation, to reveal possible partial or total duodenal obstruction. Conservative treatment is possible, but in case of failure or in adults surgery is indicated with evacuation of the hematoma and in some cases a gastro-jejunostomy. PMID- 3805196 TI - [The common channel syndrome associated with cystic dilatation of the common bile duct. Apropos of a case complicated by lithiasis of the common channel]. AB - Perduodenoscopic retrograde cholangiography in a 15 year old boy with cystic dilatation of common bile duct demonstrated lithiasis of Vater's ampulla and collateral shunt for Wirsung's duct in the form of a functional Santorini duct. Cases of combined cystic dilatation of common bile and Vater's ducts reported in the literature are reviewed and a study conducted of frequency of cystic dilatation of common bile duct, its classification as described by Longmire and Hadat (enlarging that proposed by Alonso-Leij), and its diagnosis and complications. Routine retrograde cholangiography can delect lithiasis of Vater's ampulla and allow preoperative determination of therapy. Current investigatory procedures for these anomalies have allowed rediscussion of the etiopathogenicity of cystic dilatation of common bile duct and a tendency towards a duoalist hypothesis, without its definite confirmation at the present time. PMID- 3805197 TI - [Benign non-specific ulcer of the colon. 3 new cases]. AB - Three cases of solitaries ulcers of the colon verified by an anatomo-pathological examination of the excision piece are presented. The accent is put on the research of an etiologic factor. The part of a vascular pathology appears probable without been proved. In the ignorance in which we are, for the while, of the natural history of these ulcers, the treatment by surgical excision is justified to prevent acute complications. PMID- 3805198 TI - [Total duodenal diversion in reflux esophagitis after colic esophagoplasty]. AB - Five patients with severe reflux esophagitis were treated by retrosternal colic esophagoplasty for esophageal stenosis of caustic origin. In 4 cases there was anisoperistaltism and in one case isopersitaltism. Treatment was by antral cologastric anastomosis in all cases, with a undojejunostomy in 3 patients and a colojejunostomy on loop in Y in the 2 others. Mortality was absent and long-term results were very good. Colojejunostomy on loop in Y is a simpler procedure not requiring gastric resection and long-term results were similar. An even less complicated variant of the latter operation that does not require colic section is also described. Prophylaxis of reflux esophagitis after colic esophagoplasty is discussed, the Roux type deviation being proposed for the treatment of cologastric ulcer after esophagoplasty. PMID- 3805199 TI - [Single-stage total excision by transverse arthropediculo-costectomy of dorsal intraspinal hourglass tumors developing intrathoracically]. AB - Dorsal spinal tumours have sometimes an intrathoracic development. The authors report the technique that permits by transversoarthropediculocostectomy the complete removal of these hourglass lesions by one approach. The advantages and inconveniences are analysed and its indications discussed. PMID- 3805200 TI - [Peritonitis due to perforation of the intrahernial small intestine after a fall during cross-country skiing]. PMID- 3805201 TI - [Prolonged survival of retroperitoneal liposarcoma patients. Apropos of a case. Prognostic value of the histological type and site of iterative surgery]. PMID- 3805202 TI - [Letter referring to the article "Resorbable sutures in surgery" by G. Champault, P. Faure, J. C. Patel]. PMID- 3805203 TI - Method for complete separation of the high mobility group (HMG) proteins HMG I and HMG Y from HMG 14 and HMG 17 and a procedure for purification of HMG I and HMG Y. AB - A purification procedure which separates the four low-molecular-weight high mobility group (HMG) proteins, HMG 14, 17, I and Y, is described. The procedure includes chromatography on phosphocellulose and Blue Sepharose combined with reversed-phase high-performance liquid chromatography. The blue Sepharose column separates HMG I and Y completely from HMG 14 and 17, and should therefore be an useful tool for the identification of these proteins which in several reports have been confused with HMG 14 and 17. HMG I and Y on the one hand and HMG 14 and 17 on the other exhibited considerable differences in their affinities for Blue Sepharose, probably reflecting fundamental differences in biological function. PMID- 3805204 TI - Separation and heat stability of the corticosteroid-induced and hepatic alkaline phosphatase isoenzymes in canine plasma. AB - A convenient method has been developed for the separation of alkaline phosphates (AP) isoenzymes from canine plasma. The various forms of AP activity were extracted by ethanol and separated on an anion exchanger by fast protein liquid chromatography. In this way a complete discrimination was achieved between the increase in plasma AP activity due to liver disease and that due to corticosteroid induction. The corticosteroid-induced form of AP could be separated from the other isoenzymes because of its relative heat stability at 65 degrees C. A quantitation of the contribution of liver and corticosteroid-induced AP isoenzymes to the total plasma AP activity could be made from the respective heat inactivation plots. The separation of the isoenzymes may be valuable in the purification of the different isoenzymes for further characterization. PMID- 3805205 TI - Profiling of impurities in illicit amphetamine samples by high-performance liquid chromatography using column switching. AB - A simple high-performance liquid chromatographic method, suitable for routine profiling of impurities in illegally produced amphetamine, has been developed. Amphetamine is dissolved in acetonitrile-citrate buffer (pH 3) (2:8) and injected directly without further sample pre-treatment. The impurities are enriched on line on a C8 extraction column, while amphetamine and polar diluents are washed out with water. After washing for 1.5 min, a six-port valve is switched and an acetonitrile-0.2 M butylamine in water (pH 8) gradient elutes the impurities from the extraction column on to a C18 analytical column where they are separated. The compounds are monitored by UV detection at 220 and 254 nm. The total extraction and analysis time is 30 min. The method allows automated extraction and analysis to be performed. PMID- 3805206 TI - Behaviour of synthetic corticoids in ointment on 3-cyanopropyltrichlorosilane in high-performance thin-layer chromatography. PMID- 3805207 TI - Rapid chromatographic purification of the mitochondrial isoenzyme of beef heart malate dehydrogenase. PMID- 3805208 TI - High-performance liquid chromatographic determination of taurine in formulations as the dansyl derivative. PMID- 3805209 TI - Isolation and purification of phorbol from croton oil by reversed-phase column chromatography. PMID- 3805210 TI - Determination of mofebutazone and its 4-hydroxy metabolite in plasma and urine by high-performance liquid chromatography. PMID- 3805211 TI - [Analysis of bromadiolone (an anticoagulant rodenticide) in plasma, liver and kidney of the rat]. PMID- 3805212 TI - High-performance liquid chromatographic determination of several monoamines in brain tissue of DBA/2 mice during a single run of 20-25 minutes without prior clean-up of samples. PMID- 3805213 TI - Quantification of 2-keto-3-deoxyoctonate in (lipo)polysaccharides by methanolytic release, trifluoroacetylation and capillary gas chromatography. AB - Several conditions of acidic anhydrous methanolysis were examined to optimize the release and minimize the degradation of unphosphorylated 2-keto-3-deoxy-D-manno octonic acid (KDO) from bacterial lipopolysaccharides and polysaccharides. The reaction was monitored by capillary gas chromatography after derivatization by trifluoroacetic anhydride. The best results were obtained by use of 2 M hydrochloric acid at 60 degrees C for 2 h. Under these conditions a single KDO component appeared, and KDO was quantitatively released from all model compounds except when glycosidically linked to hexosamines. For quantitative cleavage of this linkage a reaction time of 6 h was required at 60 degrees C, giving rise to 5-10% of secondary KDO products. The KDO detection limit was about 250 pmol (50 ng) and the molar response was the same as for glucose. The KDO derivative gave a mass spectrometric fragmentation pattern consistent with a pyranosidic methylketoside methyl ester structure. Differentiation of KDO linkage types could be obtained by determination of the rates of KDO release by mild methanolysis. PMID- 3805214 TI - Quantitative thin-layer chromatography in accelerated stability studies for prediction of inherent sensitivity of drugs toward oxygen. AB - This paper discusses a novel technique for studying the inherent sensitivity of materials toward oxygen and the utility of quantitative thin-layer chromatography, as a tool in such studies. The degradation generally followed first order kinetics up to about 60% decomposition, indicating that the usual kinetic treatment applied to homogeneous systems can be used. The method can also detect degradation products, in many cases adding a considerable diagnostic element to its predictive value. Among the model compounds tested testosterone was the most stable with ca. 95% recovery following a 190-h exposure to air on standard silica gel plates. The half-life time of the other model substances under similar experimental conditions was estimated by means of direct measurements or by extrapolation, and found to range from approximately 300 h to 1 h 10 min with cortisone marking the upper value and cholesta-3,5-diene the lower one. PMID- 3805215 TI - Rapid purification of the main allergen of Lolium perenne by high-performance liquid chromatography. AB - The main allergen from rye grass (Lolium perenne) pollen was purified by size exclusion high-performance liquid chromatography. The purified allergen had a molecular weight of 32,000 daltons and was significantly more active in solid phase radioimmunoassay than the whole extract. The highly purified antigen can be obtained very rapidly and with a recovery of 30%. PMID- 3805216 TI - Determination of the heroin metabolite 6-acetylmorphine by high-performance liquid chromatography using automated pre-column derivatization and fluorescence detection. AB - An improved method for the determination of 6-acetylmorphine in the urine of drug addicts receiving morphine was developed. A newly introduced reversed-phase high performance liquid chromatographic system proved to be more sensitive than a normal-phase system used previously. By replacing the earlier manual derivatization procedure with an automated on-line pre-column method, both the reproducibility and efficiency were considerably improved. Coefficients of variation for repeated analyses typically ranged from 6 to 10% in the 1-100 micrograms/l concentration range. The detection limit was 1 microgram/l and the correction for recovery by calibration with blank urine samples spiked with 6 acetylmorphine was satisfactory. The analytical improvements achieved, however, did not increase the chance of detecting heroin use by drug addicts. PMID- 3805217 TI - Effect of end-capping of reversed-phase high-performance liquid chromatographic matrices on the analysis of vitamin A and its metabolites. PMID- 3805218 TI - Assay of phenylmercuric acetate and nitrate in pharmaceutical products by high performance liquid chromatography with indirect photometric detection. PMID- 3805219 TI - High-performance liquid chromatography systems for the analysis of analgesic and non-steroidal anti-inflammatory drugs in forensic toxicology. AB - High-performance liquid chromatography retention data are presented for over 40 analgesic drugs on an ODS-silica packing material to assist in the identification of these compounds. Three isocratic eluents prepared from isopropanol, formic acid and an aqueous phosphate buffer have been used. One eluent has been used for the analysis of paracetamol in whole blood. PMID- 3805220 TI - Determination of piperazine in working atmosphere and in human urine using derivatization and capillary gas chromatography with nitrogen- and mass-selective detection. AB - A reliable routine method is presented for the determination of piperazine down to the sub-ppm level in aqueous solutions and in urine. The method includes a two phase derivatization procedure with ethyl- or isobutyl chloroformate as the reagent, followed by a capillary gas chromatographic determination using nitrogen or mass selective detection. The addition of ammonia ensured a quantitative recovery. Detection limits for piperazine in urine were ca. 20 ng/ml using nitrogen-selective and ca. 1 ng/ml with mass-selective detection. The calibration plots were linear in the investigated range, 100-10,000 ng/ml with nitrogen selective and 30-3000 ng/ml with mass-selective detection. The precision was ca. 6% at a concentration of 300 ng/ml. Acid anhydrides were investigated as alternative reagents in the two-phase derivatization procedure, and heptafluorobutyric acid anhydride in aqueous solutions gave approximately 100% recovery. However, in urine the recoveries of the investigated acid anhydride derivatives were unsatisfactory. PMID- 3805221 TI - Gas chromatographic determination of tetramethylsuccinonitrile in poly(vinyl chloride) products in contact with food. AB - A method is described for the determination of tetramethylsuccinonitrile (TMSN) in poly(vinyl chloride) (PVC) products in contact with food. TMSN was extracted from PVC with dichloromethane, steam distilled, extracted from the distillate with dichloromethane, then determined with a gas chromatograph equipped with a nitrogen-phosphorus detector and a 6-ft. glass column packed with Chromosorb W coated with 5% Thermon 1000 plus 0.5% phosphoric acid. Recoveries between 98.3 and 100.6% were obtained in the range of 0.5-12.5 ppm of TMSN by the use of nitrobenzene as an internal standard. The detection limit was 0.05 ppm of TMSN in 1 g of PVC products. The highest residue to TMSN found in PVC products in contact with food was 13.9 ppm. PMID- 3805222 TI - Effects of modifier and molecular structure of some coumarins on retention in reversed-phase high-performance thin-layer and column chromatography. AB - Coumarins, furocoumarins and pyranocoumarins (29 compounds) were investigated in silanized silica (HPTLC RP-2 and RP-18 and HPLC RP-18)-water organic modifier (methanol, acetonitrile, dioxane, tetrahydrofuran and methanol containing acetic acid) systems. The physico-chemical properties of these compounds were characterized by their hydrophobicity parameters (RMw), determined by extrapolation of the linear relationships for retention data in binary solvent systems [RM = f(phi)] to pure water. The effect of individual substituents on retention was quantified by using the group contribution parameter delta RM or delta log k'. PMID- 3805223 TI - Simultaneous determination of biogenic amines and morphine in discrete rat brain regions by high-performance liquid chromatography with electrochemical detection. AB - A simple and sensitive method has been developed for the simultaneous determination of norepinephrine, epinephrine, dopamine, 5-hydroxytryptamine, 5 hydroxyindoleacetic acid, and morphine in discrete rat brain regions by reversed phase high-performance liquid chromatography with electrochemical detection. Perchloric acid extracts of the tissue were directly injected into the chromatographic system. Each of these compounds gave a linear response over the range of 20-160 ng/ml cerebellar homogenate (0.4-3.2 ng on column). Recoveries of these compounds, added to the homogenates, were complete when compared with standards dissolved in perchloric acid. The average between-run coefficients of variation for all these compounds were lower than 7.4% over the range of 20-160 ng/ml, and the within-run coefficients of variation at 20 ng/ml were lower than 8.7%. The present method has been applied to a study of the effects of intraperitoneal administration of morphine on biogenic amines in several discrete rat brain regions. PMID- 3805224 TI - Purification and some properties of three serine carboxypeptidases from Aspergillus niger. AB - Three enzymes exhibiting peptidyl-L-amino acid hydrolase and esterase activities have been purified by immobilized metal-ion affinity chromatography and ion exchange chromatography. The three enzymes were entirely free of the acid protease activity that normally exists along with them in the crude culture filtrates of Aspergillus niger. Although all three exo-peptidases possessed nearly identical molecular weights (ca. 140,000), isoelectric points (ca. 5.0) and other properties, their affinities for the two substrates tested, carbobenzoxy-L-Glu-L-Tyr and benzoyl L-arginine ethyl ester, differed. All three peptidases were inhibited by phenylmethanesulphonyl fluoride, indicating that they are serine carboxypeptidases. They were also inhibited by tosyl phenylalanine chloromethyl ketone, suggesting the presence of a histidyl residue in their active sites. The differences in the number of accessible histidyl residues on the enzyme surfaces could explain the differences in their retentions on Cu2+-iminodiacetate-Sepharose 6B. PMID- 3805225 TI - Determination of micro amounts of acrolein in air by gas chromatography. PMID- 3805226 TI - Solvent system for the rapid identification of phenylthiohydantoin derivatives of amino acids by high-performance liquid chromatography. PMID- 3805227 TI - Determination of bufexamac in cream and ointment by high-performance liquid chromatography. PMID- 3805228 TI - Packings and stationary phases in preparative column liquid chromatography. AB - Although the theoretical treatment of chromatographic processes on a preparative scale provides guidelines to the extent to which packing and stationary phase properties affect the target quantities such as sample input, throughput and resolution times sample input, a series of additional criteria were established to judge the quality of a packing in preparative column liquid chromatography. These include bed stability and flow resistance, chemical resistance and purity, solute accessibility, mass and biological recovery, fouling, regeneration and cost. Applying these criteria, the relative importance of physical and chemical structure parameters of packings and stationary phases was assessed. Commercial packings with mean particle diameters dp greater than 20 micron were listed for adsorption, size exclusion, ion-exchange and affinity chromatography. An analysis of the characteristic features of phase systems showed that adsorption media offer a high selectivity combined with adequate loadability, whereas ion exchangers and affinity media were best suited for biospecific solutes, particularly biopolymers, which can be attributed to their high selectivity and loadability. PMID- 3805229 TI - Use of temperature-sensitive gel for concentration of influenza virus from infected allantoic fluids. AB - Cross-linked, poly(N-isopropylacrylamide) gel was used to concentrate avian influenza virus from allantoic fluid. Placing the gel in virus-infected allantoic fluid at 4 degrees C caused the gel to swell and absorb small molecular weight solutes, while excluding avian influenza virus and other large particles. Warming the gel to 37 degrees C or more caused the gel to collapse. The gel remained functional after sterilization in an autoclave and could be reused to concentrate other samples of allantoic fluid. Using a combined concentration and elution technique, we were able to achieve an average of 84.2% virus recovery, while reducing the fluid volume from 90 ml to 7.6 ml. PMID- 3805230 TI - p-value and power computations in multiple look trials. AB - This paper presents at an instructive level detailed design, decision and computational aspects of p-values and power for clinical trials in which interim looks at accumulating data are planned. Background theory and an application are presented. In addition, a definition of the term p-value, appropriate for a trial in which interim looks are planned is proposed. The definition is intuitively consistent with that for a fixed sample size trial. That is, the p-value reflects the strength of the data against the null hypothesis. For trials incorporating group sequential methods, the p-value at a particular look reflects the conditional nature of the data collected through that look on the data collected through earlier looks. PMID- 3805231 TI - Impaired glucose tolerance in women using oral contraceptives: United States, 1976-1980. AB - Based on 75-g oral glucose tolerance test results from the second National Health and Nutrition Examination Survey (1976-1980), women 20-44 years reporting the use of oral contraceptives (OCs) had decreased glucose tolerance compared with women not using OCs in this age group. Estimates of decreased glucose tolerance after adjustment for age and body mass index were 15.4% (95% CI, 7.6-23.2%) in OC users vs 6.3% (95% CI, 4.5-8.1%) in nonusers. Oral contraceptive use was associated with elevations in 1 and 2 hour plasma glucose concentrations. The mean adjusted difference between OC users and nonusers at 1 and at 2 hours postchallenge was 14 and 13 mg/100 ml, respectively. Characteristics of study nonrespondents vs respondents were analyzed to estimate potential bias due to nonresponse. No appreciable biases were found, but this does not rule out the possibility that some bias may exist. PMID- 3805232 TI - The therapeutic efficacy of critical care units from two perspectives: a traditional cohort approach vs a new case-control methodology. AB - The therapeutic efficacy of critical care units-whether they do more good than harm and for whom--has not been established, except for patients who are admitted for life-sustaining interventions, such as mechanical support of ventilation. However, most patients are admitted for observation, and to facilitate intervention if deterioration occurs or complications develop. The objective of this study was to determine whether direct admission to critical care units reduced mortality rates. The population under study consisted of all 604 patients admitted to the medical service during a one month period. At the time of admission, the responsible residents rated patients as to how sick and stable they were. These ratings of illness severity and stability have been shown to be the most significant predictors of in-hospital mortality and morbidity, respectively; they were employed to stratify the patients prognostically. The first analysis utilized the entire cohort of 604 patients. After patients who would have been ineligible for entry into a trial were removed, direct admission to the unit was associated with a reduced mortality in only one group of patients: the unstable, moderately ill (p less than 0.05). "Unstable, severely ill" patients had high mortality rates when admitted to the floor or units, and stable patients (mildly or moderately ill) did equally well when admitted to either location. A further analysis revealed a possible explanation for these findings. Among the unstable, moderately ill patients, the rate of deterioration of pre-existing problems was significantly lower among patients directly admitted to the unit (p less than 0.05), whereas the rate of new complications did not differ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805233 TI - Using administrative data for longitudinal research: comparisons with primary data collection. AB - This paper discusses the advantages and disadvantages of using administrative data for longitudinal research, focusing on loss to follow-up. Comparisons between research relying on primary data collection and that using data bases are made. After development of a suitable framework, follow-up in several well-known projects based on primary data collection (the Seven Countries project on coronary heart disease, the Massachusetts research on long-term care and the Pittsburgh clinical trial of tonsillectomy) is compared with follow-up using the Health Services Commission data base in Manitoba, Canada. Overall follow-up in the Manitoba research compares favorably with participation and follow-up rates in other studies based on primary data collection. Initial nonresponse and nonlocation are major problems with studies using primary data; failure to locate earlier respondents in subsequent waves results in a wide range of overall response rates. Data bases do not require researchers to contact individuals and hence follow-up is simplified. Eight year follow-up rates in the Manitoba data base are almost always over 80% and often over 90%. Because records can be flexibly summarized for each individual over time, data bases facilitate certain types of longitudinal studies which would be difficult, if not impossible, to perform using other methodologies. If the desired data are available and recorded with acceptable accuracy, administrative data banks hold considerable promise for the health care researcher. PMID- 3805234 TI - Identifying profiles of service requirements in a non-institutionalized elderly population. AB - Studies of service requirements for non-institutionalized elderly have tried, more or less successfully, to consider the effects of the elderly environment. Here, the environment of elderly is explicitly introduced in a secondary analysis of a data bank on service requirements of a sample of elderly. The environment of the elderly is described in terms of their housing environment: the resources available and the physical characteristics of the housing. A cluster analysis was done on these variables in order to identify the context in which the service requirements would have to be met. Twelve living arrangement groups were obtained. A cluster analysis of the service requirements was run on each of these living arrangement groups. The profile of services obtained was much the same for each of these groups. Four different profiles were identified. Half of the sampled elderly were classified in the first profile as not requiring any services beyond those already available to middle-aged adults in the community. The group of elderly people (9%) in need of all the services that can be prescribed in the study were also those living in the most congenial social and physical environment, which suggests that they had found a living arrangement which met their level of service needs. One third of the sampled elderly needed help with heavy housework only. Another 6% of the elderly needed help with many activities of daily living, but did not have access to help. The analysis of service requirements should always explicitly consider the resources available to the individual whose needs are assessed. PMID- 3805235 TI - Black/white differences in bladder cancer patient survival. AB - Black bladder cancer patients have been found to have a substantially poorer survival experience than white patients; the 5-year relative survival rates are 71% for whites and 54% for blacks. To explore this difference in survival, data were analyzed on 4289 white and 380 black bladder cancer patients diagnosed during the period 1977-80 in three geographic areas covered by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The orientation of the analysis was to identify variables, using multivariable procedures, that were not only prognostic but which also were important in regard to explaining black/white differences in patient survival. Such variables are referred to as explanatory variables. Three variables were analyzed in regard to their importance as explanatory variables, i.e. histologic type, stage, and histologic grade, and all were found to be of roughly equal importance. The effects of other factors on black/white differences in survival are also discussed including the possible importance of lead-time bias and the possible lack of diagnosis of the more benign forms of bladder cancer in blacks. PMID- 3805236 TI - Sources of error in measurement of children's blood pressure in a large epidemiologic study: Bogalusa Heart Study. AB - Accurate and reliable measurement of blood pressure is essential in the determination of early hypertensive disease. Multiple blood pressure measures were determined by well trained field observers on a large number of children representing a total pediatric community. Changes in children's blood pressure levels with multiple measurements, as well as differences between field observers, were examined. A random effects analysis of variance model was used to determine specific contributors to blood pressure variability in an epidemiologic survey of children. Observer differences were found to be the largest preventable contributor to blood pressure variation. In addition, systolic blood pressure levels decreased approx. 2.5 mmHg from the first to the third blood pressure station. More than 86% of systolic blood pressure readings and 90% of diastolic blood pressure readings by two different observers on the same child were within 15 mmHg. These data emphasize the importance of both adequate training of field observers and the use of replicate blood pressure measurements by multiple observers to determine blood pressure levels accurately in an epidemiologic survey. PMID- 3805237 TI - The experimental paradigm and observational studies of cause-effect relationships in clinical medicine. AB - The paradigm of the randomized clinical trial (RCT) is proposed as a heuristic that can serve as a unified approach to guide the design not just of cause-effect studies of therapy, but also of studies of the etiology of disease. Three themes are developed in detail: that variability in the scientific paradigm of the randomized trial results in a wide range of techniques and methods being employed for the RCT, and that this extensive variability in clinical trial methods contributes substantially to the occurrence of conflicting trial results; that the scientific validity of observational surrogates for the RCT could be enhanced if investigators designed observational studies by incorporating the principles inherent in the RCT; and that there are two distinctive and competing strategies for designing case-control studies. The traditional strategy views case-control designs as statistical acts of sampling for cases and controls, but ignores the scientific reasoning that should guide the performance of case-control research. The alternative strategy requires that case-control studies adhere to the principles inherent in the RCT. PMID- 3805238 TI - Dendritic activities of spinal motoneurons in infant pigs and adult rabbits. PMID- 3805239 TI - [Effect of lipoprotein on LPL activity of guinea pig alveolar macrophages]. PMID- 3805240 TI - [Transient ischemic attacks as a precursor to cerebral infarction and its clinical features]. PMID- 3805241 TI - [Clinical non-operative measurement of progressing atherosclerosis. Clinical application and basic study of bile acid tolerance test]. PMID- 3805242 TI - [Radio-anatomical and clinical studies of the internal thoracic artery by selective angiography]. PMID- 3805243 TI - [Hepatitis B]. PMID- 3805244 TI - [Effects of epidural morphine on postoperative pain relief and respiratory function]. PMID- 3805245 TI - [The usefulness of MRI in the clinical diagnosis of brain tumors]. PMID- 3805246 TI - Isolation of influenza virus in Thailand during June-August, 1985. PMID- 3805247 TI - [Ethics concerning in vitro fertilization]. PMID- 3805248 TI - Predictors and indicators of quality of life in patients with closed-head injury. AB - This study examined predictors and indicators of quality of life in 71 patients with closed-head injury (CHI), 2-4 years postinjury. Predictors included premorbid characteristics and acute injury-related data. Indicators included follow-up data, e.g., neuropsychological functioning. Exploratory canonical correlation analyses demonstrated that the combination of the predictor variable, initial Glasgow Coma Scale score, and indicator variables of neuropsychological data in the areas of motor functioning, memory, and constructional ability were related most strongly to quality of life as reported by the patients. Severity of head injury and motor disability also related strongly to quality of life, based on reports by relatives (n = 68) on the Katz Adjustment Scale (Relatives' Form). These findings suggest that quality of life is adversely affected by increased severity of head injury and greater residual motor deficits. Implications of these findings for treatment and recovery are discussed. PMID- 3805249 TI - Subtraction in addition to addition: dual task performance improves when tasks are presented to separate hemispheres. AB - This research links neuro- and cognitive psychology by asking whether performance of two concurrent cognitive tasks is facilitated by presentation of each task to a different cerebral hemisphere. Subjects were required to perform two arithmetic problems which were presented simultaneously. One problem required addition; the other subtraction. In Experiment I, briefly exposed numbers were exposed for 100 ms and were arranged so that a digit at fixation had to be added to a top number and subtracted from a bottom number. In Experiment II, the numbers were reversed so that the addition task was below the subtraction task. During Bilateral/bihemispheric trials, the addition problem was presented to one visual field and the subtraction problem to the other visual field. During Unilateral/single hemisphere trials, the addition and subtraction problems were projected to only one visual field. Results indicated that a higher proportion of problems were correctly solved during the Bilateral/bihemispheric trials than during the Unilateral/single hemisphere trials. These data suggest that dividing simultaneous inputs so that each hemisphere is confronted with a task requiring only one kind of cognitive operation facilitates performance, perhaps by minimizing intertask interference. This study illustrates one kind of hemispheric cooperation which facilitates dual task performance. PMID- 3805250 TI - Neuropsychology of multiple sclerosis: a critical review. AB - Multiple sclerosis (MS) is a relatively common, chronic progressive neurological illness affecting individuals primarily in the third and fourth decades of life. Autopsy studies indicate that the disease preferentially attacks white matter throughout the CNS, including the cerebral hemispheres. This article reviews the current state of knowledge regarding cognitive dysfunction in MS and relates these findings to neuropathological changes. The view that affective disturbance may also result from cerebral demyelination is presented, along with a brief discussion of MS as a prototype "subcortical" dementia. Finally, methodological problems intrinsic to the study of MS are presented, and suggestions for future research are made. PMID- 3805251 TI - Biasing of alcoholic Korsakoff patients' semantic memory. AB - The extent to which the spelling of ambiguous words could be biased and the length of time this biasing could be maintained were investigated in three studies. Biasing occurred for amnesic Korsakoff patients but the effect was consistently more fragile than the biasing pattern of alcoholic control patients. Between-group differences were due to the differential dependency of amnesics' biasing upon the activation of semantic memory. The spelling bias of the alcoholic control patients appeared to be based on both semantic activation and episodic retention. PMID- 3805252 TI - Equivalent forms of the Boston Naming Test. AB - In order to develop a test of naming ability that is sensitive to changes in performance on repeated testing, but is unbiased by practice effects, the 85 items of the Boston Naming Test (BNT) were divided into two 42-item forms. Both forms were given to 15 healthy adult subjects, 24 patients with a clinical diagnosis of Alzheimer's disease, and 17 patients with other brain lesions. The reliability of the BNT was high as measured by coefficient alpha and interitem correlations. Performance on the two forms of the test was similar as indicated by mean scores and by correlations between scores. The BNT score includes uncued (spontaneous) and cued responses. When uncued responses were analyzed separately, the reliability and equivalence of the forms remained strong. Using uncued scores therefore does not alter the psychometric properties of the test, and considerably reduces administration time. The modification of the BNT described here should be useful in studies in which repeated measurements are obtained for the purpose of detecting changes in naming ability. PMID- 3805253 TI - Assessing children's memory productions of the Rey-Osterrieth Complex Figure. AB - This report describes developmental changes in children's memory productions of the Rey-Osterrieth Complex Figure and in the relation of memory to copy productions, and a method for evaluating these productions that is sensitive to parameters relevant to neuropsychological diagnosis. Based on protocols from a standardization sample of 454 children between the ages of 5 and 14 (Waber & Homes, 1985), a system was devised for objectively evaluating organization, production style, and accuracy. Normative findings are described and implications for the use of this instrument in the neuropsychological assessment of children discussed. PMID- 3805254 TI - Chronic low-level mercury exposure and neuropsychological functioning. AB - To measure the effects of chronic low-level exposure to inorganic mercury, the neuropsychological performances of 13 female dental auxiliary workers with elevated head mercury levels (as measured by an X-ray fluorescence technique) were compared with 13 workers with no measurable mercury levels. Workers with elevated mercury levels scored significantly less well on the Recurrent Figures, and SCL-90-R, but not on the WAIS, Rey's AVL, PASAT, BGT, Grooved Pegboard, and Finger Tapping tests. Chronic subtoxic levels of inorganic mercury appear to produce mild changes in short-term nonverbal recall and heightened distress generally, and particularly in categories of obsessive compulsion, anxiety and psychoticism, without alterations in general intellectual functioning, attention, verbal recall, and motor skills. PMID- 3805255 TI - Alternate form reliability and equivalency of the Rey Auditory Verbal Learning Test. AB - Assessed alternate form reliability and equivalency for the Rey Auditory Verbal Learning Test (AVLT) in a clinical sample. A test-retest, counterbalanced design was utilized with a diagnostically heterogenous group of 85 VA Medical Center patients. The mean test-retest interval was 140 min. Alternate form reliability coefficients were highly significant, all p less than .001, and ranged from .60 to .77. The forms yielded comparable means with differences of less than 1 point on each of the five learning trails and the postinterference (VI) and recognition trials. Total words recalled on trials I through V differed by less than 3 points across forms. From a statistical point of view, when the alternate form was administered second it was slightly more difficult than the original. In the reverse order, the two measures were comparable. Overall, differences between forms lacked clinical significance and the tests were judged to be equivalent measures. PMID- 3805256 TI - Accumulated strain mechanism for length determination of thick filaments in skeletal muscle. I. Experimental bases. AB - The kinetics of dissociation of myosin from both ends of thick filaments in glycerinated skeletal muscle fibres and myofibrils was studied in the presence of MgATP by use of an optical diffraction method and phase-contrast microscopy. The dissociation velocity, v (identical to -dL/dt where L is the length of thick filaments at time t), increased with increasing KCl concentration (0.225 to 0.5 M), or increasing pH (6.5 to 8.0) but hardly changed with temperature (5 and 25 degrees C), micromolar concentrations of Ca2+ or sarcomere length (2.4 and 2.75 micron). Over a wide range of filament length, the dissociation velocity could be expressed by v0exp(alpha L), where v0 and alpha are positive constants depending upon the dissociation condition. When the effects of crossbridge formation are minimized it was thus shown that the structural stability of thick filaments in a muscle fibre and a myofibril gradually decreases from the central part to the tips of the filaments. On the basis of these results we propose that the length of thick filaments is largely regulated by an accumulated strain mechanism in which the free energy of association of myosin molecules increases with filament length. PMID- 3805257 TI - Characterization and fibre type distribution of a new myofibrillar protein of molecular weight 32 kDa. AB - A new basic protein of molecular weight 32 kDa has been isolated and purified to homogeneity from skeletal muscles rich in type I fibres. By the use of a specific monoclonal antibody, the protein has been shown to be present in all type I fibres and some type II fibres, the number of which varies with the muscle and the region of the muscle sectioned. A protein of similar properties could not be isolated from rabbit muscles consisting predominantly of type II fibres. By fluorescence microscopy, the protein has been shown to be located in the Z-disc from which the presence of divalent cations, probably calcium, facilitates its extraction at low ionic strength. The protein is unusual in that its distribution does not correlate completely with the known muscle fibre types and in that as yet there is no evidence for the presence of an isoform in those cells that do not stain with the specific antibody for the 32 kDa protein isolated from slow muscles. PMID- 3805258 TI - The Z-band lattice in skeletal muscle before, during and after tetanic contraction. AB - Electron micrographs and optical diffraction patterns of the Z-band were studied in rat soleus muscle fixed before, during, and after tetanic contraction. We compared the morphology (small square or basketweave pattern) and dimensions of the Z-lattice of control and tetanized muscles near rest length. Z-bands of muscle fixed at rest and of muscle allowed to rest after a tetanic contraction exhibited the small square pattern. Z-bands from muscle fixed during tetanic contraction exhibited the basketweave pattern. Concomitant with the transition to basketweave, we observed an average increase of 20% in spacing between the axial filaments of the Z-lattice. Optical diffraction measurements of the A-band d10 spacing revealed that the Z/A ratio remained constant during the transition. We have modelled the small square to basketweave transformation as resulting from a change of curvature of constant length cross-connecting Z-filaments when the axial filaments increase their separation. PMID- 3805259 TI - An unusual Z-system in the obliquely striated muscles of crinoids: three dimensional structure and computer simulations. AB - The peculiar functional structure of the Z-line in the obliquely striated muscles of some feather stars is described. It is known that cross-striated muscles are characterized by linear and continuous Z-bands, and obliquely striated muscles by disconnected, obliquely aligned Z-elements. Owing to this discontinuous organization, the sarcomere can perform wide active lengthenings, shortenings, and even 'super-elongations' in the helical fibres. In contrast, the obliquely striated fibres of crinoids show markedly continuous and homogeneous oblique Z lines; such a structure is not compatible with 'super-performances' like sliding and shearing of the sarcomere elements, but instead could allow functions comparable to those characteristic of a cross-striated muscle (quick, short movements, mechanically amplifiable by bone levers). This odd situation, only interpretable in terms of evolutionary constraint, could be considered opposite and symmetrical to that of cross-striated 'super-contracting' muscles, where the Z-line is exceptionally fragmented to allow the sarcomere to super-contract. The possible architecture of a significant parameter such as the Z-line, which determines muscle fibre potential capacities, is analysed in detail: through qualitative-quantitative evaluation of electron micrographs, supported by statistical analysis of the data; and by computer simulations. The data obtained suggest that the most realistic conformation of the whole Z-complex in these muscles consists of a multiple system of continuous, ribbon-like helical planes running in parallel along the fibre from end to end and regularly cutting it with a constant thickness. The proposed model seems morphologically compatible with the experimentally verified situations and functionally compatible with the mechanical requirements for a normal contraction and for a balanced distribution of the involved strengths. PMID- 3805260 TI - The detection of brain antigens within the circulating immune complexes of patients with multiple sclerosis. AB - Immune complexes isolated from sera of patients with multiple sclerosis (MS) were analyzed for their antigenic content. Immune complexes precipitated with polyethylene glycol were inoculated into rabbits. The antisera raised were shown to react to MS and normal brain antigens by crossed immunoelectrophoresis, ELISA and nitrocellulose transfer. Additionally, these antisera reacted by co precipitation with the measles nucleocapsid antigen. As persistent viral infection has not been shown to occur in MS, these studies support the possibility that brain antigens within the immune complex share antigenic determinants with a specific viral antigen seen earlier in life by the host. PMID- 3805261 TI - Albumin leakage into cerebrospinal fluid of dogs lethally infected with R252 canine distemper virus. AB - Cerebrospinal fluid (CSF) form nine lethally infected and three convalescent gnotobiotic dogs infected with the R252 strain of canine distemper virus (CDV) was evaluated prior to and following infection. Lethally infected dogs had a mean seven-fold increase in CSF albumin concentration compared to the preinoculation value, not present in dogs destined to survive. Immunochemical examination of tissue from these dogs revealed prominent perivascular localization of albumin. Examination of CSF cells demonstrated mild leukocytosis in both groups at the time when encephalopathic deaths occurred, with decreased lymphocyte percentages, particularly Thy-1-bearing lymphocytes, in lethally infected dogs. These dogs also had more extensive expression of viral antigens in CSF and peripheral blood leukocytes at the time of death than did surviving dogs, and failed to make antibody to viral antigens. The findings link terminal breakdown of the blood brain barrier and extensive viral antigen expression in CSF leukocytes with experimental CDV infection resulting in death. PMID- 3805262 TI - A simplified method for the isolation of highly purified bovine retinal S antigen. AB - Retinal S antigen is a potent autoantigen used for the induction of experimental allergic uveoretinitis (EAU). EAU is an organ-specific disease and shows many similarities to other autoimmune diseases such as experimental encephalomyelitis. This paper describes the preparation of highly purified S antigen by using a one step ion-exchange method. High yields of the protein were obtained. S antigen prepared by this method induces a prolonged posterior uveoretinitis with cellular infiltration in the vitreous and specific loss of retinal photoreceptor cells. The purity of the protein was checked by silver-stained SDS-polyacrylamide gels and immunoblotting techniques. PMID- 3805264 TI - Selling health: a media campaign against tobacco. PMID- 3805263 TI - Toward a national medical care system: III. Payments to providers. PMID- 3805265 TI - A health security program for Massachusetts. PMID- 3805266 TI - Beyond Lalonde: creating health. PMID- 3805267 TI - Pregnancy and employment leave: legal precedents and future policy. PMID- 3805268 TI - Seat belt use among New York bar patrons. PMID- 3805269 TI - British general practice: perspectives on the home visit. PMID- 3805270 TI - Senate No. 451, The Commonwealth of Massachusetts. An act to establish a Massachusetts health security program. PMID- 3805271 TI - Incidence of premature sexual development in Puerto Rico. PMID- 3805272 TI - Platelet-activating factor: mediator of the third pathway of platelet aggregation? A study in three patients with deficient platelet-activating factor synthesis. AB - Thrombin, collagen, and Ca2+-ionophore A23187 aggregate platelets in the presence of inhibitors of the first (ADP-mediated) and second (cyclooxygenase-dependent) pathway of platelet activation. This aggregation, via a third pathway, was hypothesized to be mediated by the alkoxyether lipid platelet-activating factor (PAF). We recently demonstrated virtual absence of plasmalogen-type alkoxyether lipids and deficiency in key enzymes of their biosynthesis in Zellweger patients. We hypothesized that PAF synthesis might also be impaired. We report two Zellweger patients with an undetectable A23187-induced PAF synthesis of leukocytes (patients, less than 3 pmol PAF/10(8) granulocytes (PMN); four age matched controls, 249-2,757 pmol PAF/10(8) PMN; five adult controls, 291-5,433 pmol PAF/10(8) PMN). In a third patient, residual PAF synthesis was detected. However in all patients the thrombin-induced third mechanism of platelet aggregation was present. We therefore conclude that PAF may not be the mediator of the third pathway. PMID- 3805273 TI - Myocardial metabolism of free fatty acids. Studies with 14C-labeled substrates in humans. AB - Free fatty acids are considered to be the major energy source for the myocardium. To investigate the metabolic fate of this substrate in humans, 24 subjects underwent coronary sinus and arterial catheterization. 13 subjects were healthy volunteers and 11 subjects had symptoms of ischemic heart disease. [1-14C]oleate or [1-14C]palmitate bound to albumin was infused at a constant rate of 25 microCi/h. Oxidation was determined by measuring the 14CO2 production. The data demonstrated that a high percentage (84 +/- 17%) of the palmitate and oleate extracted by the myocardium underwent rapid oxidation. A highly significant correlation was present between the arterial level and the amount oxidized (r = 0.82, P less than 0.001 for palmitate; r = 0.77, P less than 0.001 for oleate). The isotope extraction ratio was greater than the chemical extraction ratio. This difference of 6 +/- 2 nmol/ml of blood in the young normal subjects was significantly less than the 12 +/- 4 nmol/ml observed in the ischemic heart disease patients (P less than 0.001). PMID- 3805274 TI - Membrane transport influences the rate of accumulation of cytosine arabinoside in human leukemia cells. AB - The role of membrane transport in the cellular accumulation of 1-beta-D arabinofuranosylcytosine (ara-C) was studied in freshly isolated human acute leukemia cells. Patient cells had low rates for ara-C transport as compared with human and murine experimental cells and correspondingly low binding capacities for the nucleoside transport inhibitor, nitrobenzylmercaptopurine riboside (NBMPR). At 1 microM ara-C, the rate of net cellular accumulation was close to the membrane transport rate, and NBMPR inhibited transport and accumulation to the same extent. The rate of ara-C accumulation was half maximal at only 3-5 microM, a level much lower than that required for murine cells (67-85 microM). At concentrations below 1 microM the rate of ara-C accumulation was determined primarily by the transport rate, but at higher concentrations above 10 microM, phosphorylation capacity was the principal determinant of the net uptake rate. This difference in the role of transport at high and low ara-C concentrations may explain, in part, the efficacy of high-dose ara-C in patients refractory to standard dose protocols. PMID- 3805275 TI - Direct evidence that decreased serum opsonization of Streptococcus pneumoniae via the alternative complement pathway in sickle cell disease is related to antibody deficiency. AB - Two approaches were used to demonstrate that reduction in serum opsonization of Streptococcus pneumoniae via the alternative complement pathway in children with sickle cell disease is related to a deficiency of antibodies to pneumococcal capsular polysaccharide. First, opsonization of S. pneumoniae mediated by the alternative pathway in patients' sera was restored to normal by addition of the purified IgG or IgM fraction of goat antiserum to capsular polysaccharide of the homologous serotype. Secondly, IgG antibody titers to capsular polysaccharide in patients' sera correlated significantly with alternative pathway-mediated opsonization; the correlation between titers of IgM anticapsular antibodies and opsonization approached statistical significance. The sum of the IgG and IgM anticapsular antibody titers correlated most significantly with opsonization. Our results suggest that reduction in alternative pathway-mediated opsonization in sera from children with sickle cell disease is related to low levels of both IgG and IgM anticapsular antibodies. PMID- 3805276 TI - Foam cell-forming J774 macrophages have markedly elevated acyl coenzyme A:cholesterol acyl transferase activity compared with mouse peritoneal macrophages in the presence of low density lipoprotein (LDL) despite similar LDL receptor activity. AB - Cholesteryl ester (CE) accumulation in arterial wall macrophages (foam cells) is a prominent feature of atherosclerotic lesions. We have previously shown that murine J774 macrophages, unlike mouse peritoneal macrophages, accumulate large amounts of CE from unmodified low density lipoprotein (LDL). We now report a direct comparison of acyl coenzyme A:cholesterol acyl transferase (ACAT) activity in J774 and mouse peritoneal macrophages. Despite similar chloroquine-inhibitable 125I-LDL degradation in the two macrophages, ACAT activity in LDL-treated J774 macrophages was 10-30-fold higher than that in LDL-treated mouse peritoneal macrophages. In contrast, acetyl-LDL (matched for degradation with LDL) caused marked stimulation of ACAT activity in mouse peritoneal macrophages. From these data we conclude that in the presence of LDL, J774 macrophages have a highly active ACAT cholesterol esterification pathway compared with mouse peritoneal macrophages; and in mouse peritoneal macrophages, there is a marked difference in the ability of acetyl-LDL vs. LDL to stimulate ACAT even when the lipoproteins are matched for degradation. PMID- 3805277 TI - Insulinlike growth factor I regulation of growth hormone gene transcription in primary rat pituitary cells. AB - We have previously shown that insulinlike growth factor I (IGF-I) inhibits growth hormone (GH) secretion and messenger RNA (mRNA) levels in pituitary cells. The effects of IGF-I on new GH mRNA synthesis rates in primary monolayer rat pituitary cells were therefore examined by nuclear runoff transcription assays. IGF-I (1.3 nM) treatment for 1 h inhibited GH gene transcription to 60% of controls. IGF-I (3.25 nM) maximally suppressed GH gene transcription to 30% of control values after 4 h. After 24 h treatment, GH transcription was suppressed to 48% of controls by 3.25 nM IGF-I. IGF-I (3.25 nM) also inhibited the twofold growth hormone-releasing hormone (GHRH) (10 nM)-stimulated GH gene transcription by 30% after 4 h. Transcription of the prolactin (PRL) gene was not suppressed in these cells by IGF-I. Relatively high doses of insulin (200 nM) also suppressed GH gene transcription, but epidermal growth factor and fibroblast growth factor did not change GH mRNA synthesis. The results show that IGF-I exerts a rapid and selective suppression of basal and GHRH-stimulated GH gene transcription. These data indicate a role for IGF-I in negative feedback of GH gene expression and provide evidence for the direct transcriptional regulation of the GH gene by IGF I in primary rat anterior pituitary cells. PMID- 3805278 TI - Membrane skeletal alterations during in vivo mouse red cell aging. Increase in the band 4.1a:4.1b ratio. AB - We have examined membrane protein profiles for alterations during red blood cell aging. To obtain populations of in vivo-aged red cells, we maintained mice in a state of continuous erythropoietic suppression for up to 8 wk using serial hypertransfusion. The circulating t1/2 of red cells from mice which had been erythropoietically suppressed for 8 wk was less than 1 d compared with a t1/2 of 15 d for red cells from normal animals. The most obvious alteration in membrane proteins was an increase in the ratio of the membrane skeletal components 4.1a:4.1b from 0.3 for the normal red cell population to greater than 1 for these old cells. The 4.1a:4.1b ratio thus appears to be a useful index of red cell age. Analyses of the density profile of cells aged in the hypertransfused mice disclosed that these old cells had a density range similar to that of controls, suggesting that cell density does not increase significantly with red cell age in the mouse. PMID- 3805279 TI - Differential control of heart rate and sympathetic nerve activity during dynamic exercise. Insight from intraneural recordings in humans. AB - We used microelectrode recordings of muscle sympathetic nerve activity (MSNA) from the peroneal nerve in the leg during arm exercise in conscious humans to test the concept that central command and muscle afferent reflexes produce mass sympathetic discharge at the onset of exercise. Nonischemic rhythmic handgrip and mild arm cycling produced graded increases in heart rate and arterial pressure but did not increase MSNA, whereas ischemic handgrip and moderate arm cycling dramatically increased MSNA. There was a slow onset and offset of the MSNA responses, which suggested metaboreceptor mediation. When forearm ischemia was continued after ischemic handgrip, MSNA remained elevated (muscle chemoreflex stimulation) but heart rate returned to control (elimination of central command). The major new conclusions are that: the onset of dynamic exercise does not produce mass, uniform sympathetic discharge in humans, and muscle chemoreflexes and central command appear to produce differential effects on sympathetic and parasympathetic responses. PMID- 3805280 TI - Lactic dehydrogenase isozymes, 31P magnetic resonance spectroscopy, and in vitro antimitochondrial tumor toxicity with gossypol and rhodamine-123. AB - Three compounds that share specific antimitochondrial properties are gossypol, rhodamine-123, and lonidamine. We compare the antiproliferative activities of these drugs against six human cell lines derived from breast (T47-D), pancreas (MiaPaCa, RWP-2), prostate (DU-145), colon (HCT-8), and cervix (HeLa) carcinomas. Tumor cells enriched in cathodal LDH isozymes (LDH4 and LDH5) are significantly more sensitive to gossypol and rhodamine-123. When compared for ability to inhibit growth of human marrow in soft agar, 10 microM gossypol shows little effect on colony formation whereas 10 microM rhodamine-123 completely prevents stem cell growth, suggesting that gossypol may have the most favorable therapeutic index. Within 24 h of drug administration, there is a relative increase in intracellular inorganic phosphate pools and a marked decline in soluble high-energy phosphates in sensitive tumor cells, as measured by 31P magnetic resonance spectroscopy. These studies suggest that specific antimitochondrial agents might be selectively administered on the basis of tumor LDH isozyme content and noninvasively monitored for antiproliferative activity by 31P spectroscopy. PMID- 3805281 TI - Detailed comparison of basal and food-stimulated gastric acid secretion rates and serum gastrin concentrations in duodenal ulcer patients and normal subjects. AB - We measured basal and peak acid outputs, food-stimulated acid secretion, and basal and food-stimulated serum gastrin concentrations in a large group of duodenal ulcer patients and normal subjects. Basal and peak acid outputs were significantly higher in ulcer patients. In contrast, acid secretion was similar in the groups when food was infused into the stomach and when sham feeding was combined with meal infusion to simulate normal eating. Meal-stimulated acid secretion, expressed as a percentage of peak acid output to correct for differences in secretory capacity, was lower in ulcer patients (P less than 0.002). Basal serum gastrin concentrations were higher in ulcer patients, which may have contributed to higher basal acid output. However, increases in serum gastrin after food were similar in the groups. Duodenal ulcer patients, as a group, have increased basal and maximal acid secretion, but the amount of acid secreted and gastrin released after eating is normal. PMID- 3805282 TI - Molecular heterogeneity of a lymphocyte glycoprotein in immunodeficient patients. AB - Previous evaluation of lymphocytes taken from patients with Wiskott-Aldrich syndrome (WAS) and other X-linked immunodeficiencies has revealed deficiencies of a lymphocyte sialoglycoprotein with a relative molecular mass of 115 kD (designated gpL-115) found in normal lymphocytes. The development of monoclonal antibodies to gpL-115 has permitted the detection of molecular heterogeneity in gpL-115 from the lymphocytes of immunodeficient patients. When lymphocytes from normal individuals were analyzed by immunoblotting, gpL-115 with only a single molecular species (115 kD) was detected. Lymphocytes from 17 immunodeficient patients were analyzed after overnight incubation. Two patients had no gpL-115 with an Mr of 115 kD, but gpL-115 with an Mr of either 95 or 135 kD was detected. Nine patients had gpL-115 with Mr equally of 95 and 115 Kd. Other patients exhibited gpL-115 with combinations of 95, 115, and 135 kD. The heterogeneity of the degraded gpL-115 suggests that WAS and other X-linked immunodeficiencies are due to a series of abnormalities, all of which involve gpL-115, and may explain the clinical heterogeneity of the diseases. PMID- 3805283 TI - HLA class II alpha chain gene polymorphisms in patients with insulin-dependent diabetes mellitus, dermatitis herpetiformis, and celiac disease. AB - We have investigated DNA polymorphism of the class II alpha chain genes in HLA typed patients with insulin dependent diabetes mellitus (IDDM; n = 79), celiac disease (CD; n = 46), dermatitis herpetiformis (DH; n = 53), and controls (n = 86). Preferential allelic associations of HLA genes and gene products have thus been constructed for susceptibility to these diseases. DR alpha and DQ alpha gene polymorphisms indicated heterogeneity of HLA DR3, DRw6, and DR7, and HLA DR2 and DRw6, respectively. In DR7 positive CD patients a 3.8-kilobase (kb) DR alpha fragment, which correlated with DQw3, was found in only 11% of patients compared with 45% of corresponding controls (P less than 0.05). An increased frequency of a DX alpha genotype UU in all three diseases was found (IDDM 59%, DH 45%, CD 48%, compared to 21% in controls, P less than 0.001), which is not explained solely by the increased frequencies of DR3-DX alpha U. We therefore conclude part of the genetic susceptibility for these three conditions is encoded by genes within the DQ-DX subregion. PMID- 3805284 TI - Macrophages are required for influenza virus infection of human lymphocytes. AB - Monocyte and lymphocyte surface-expressed viral antigens have been demonstrated after exposure of unseparated human mononuclear leukocytes to influenza virus in vitro. The current studies, using [35S]methionine pulse-labeled purified preparations of virus-exposed macrophages, depleted of lymphocytes, demonstrate that the presence of these viral proteins does represent new synthesis. However, purified lymphocytes, depleted of monocytes-macrophages and exposed to influenza virus, showed no detectable viral protein synthesis. In further experiments, unseparated mononuclear leukocytes were exposed to virus and subsequently separated by countercurrent centrifugal elutriation. Both macrophages and lymphocytes were then shown to synthesize influenza proteins. Cell-free control or influenza virus-infected macrophage-derived supernatant fluids did not facilitate influenza virus infection of the lymphocytes. The data suggest that macrophages are required for influenza virus infection of human lymphocytes, and raise the possibility that macrophage facilitation of an abortive infection of lymphocytes plays a role in the generation of effective immunity to viral antigens. PMID- 3805285 TI - Release of mitogenic factors by cultured preadipocytes from massively obese human subjects. AB - In this study, possible paracrine factors in adipose tissue from lean and obese subjects were sought. Conditioned media were prepared by incubation in alpha minimum essential medium of adipocyte precursors derived from lean and massively obese subjects. Adipocyte-precursor-derived conditioned media from the obese stimulated replication of cultured rat perirenal adipocyte precursors by about fourfold over control. The effect of media conditioned by precursors derived from lean subjects was much less evident. The mitogenicity of conditioned media was abolished by trypsin, indicating the protein nature of the mitogenic factor(s). Sephacryl S-200 chromatography of adipocyte-precursor-derived conditioned media from obese subjects revealed one major active fraction with molecular masses in the range of 25,000-40,000. Our results demonstrate that adipocyte precursors derived from massively obese subjects release factors mitogenic on cultured rat adipocyte precursors. These principles may act as paracrine factors contributing to the development of the adipocyte hyperplasia characteristic of massive obesity. PMID- 3805286 TI - Clonality of angioimmunoblastic lymphadenopathy and implications for its evolution to malignant lymphoma. AB - To investigate the relationship of the lymphoid hyperplasia of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) to supervening malignant lymphoma, we subjected DNA from lymph nodes and peripheral blood mononuclear cells from five AILD patients to Southern blot analysis to detect clonal rearrangements of immunoglobulin and T-cell receptor genes. Lymph nodes and peripheral blood from AILD patients were found to contain clones of lymphoid cells harboring either immunoglobulin or T-cell receptor gene rearrangements that, in some instances, regressed during the course of disease. A lymph node from one patient was involved by immunoblastic lymphoma and manifested an additional gene rearrangement pattern not seen in premalignant specimens from that patient. In contrast, DNA obtained from normal peripheral blood mononuclear cells and 11 examples of other forms of lymphoid hyperplasia showed no gene rearrangements. As a disorder of cellular immunoregulation in which lymphoid cells may escape normal growth controls, AILD provides a natural model to dissect stages of lymphomagenesis in man. PMID- 3805287 TI - Altered binding of 125I-labeled calmodulin to a 46.5-kilodalton protein in skin fibroblasts cultured from patients with cystic fibrosis. AB - The levels of calmodulin and calmodulin-binding proteins have been determined in cultured skin fibroblasts from patients with cystic fibrosis (CF) and age- and sex-matched controls. Calmodulin ranged from 0.20 to 0.76 microgram/mg protein; there was no difference between calmodulin concentration in fibroblasts from CF patients and controls. Calmodulin-binding proteins of 230, 212, 204, 164, 139, 70, 59, 46.5, and 41 kD were identified. A protein with a mobility identical to the 59-kD calmodulin-binding protein was labeled by antiserum against calmodulin dependent phosphatase. Although Ca2+/calmodulin-dependent phosphatase activity was detected, there was no different in activity between control and CF fibroblasts or in the level of phosphatase protein as determined by radioimmunoassay. Lower amounts of 125I-calmodulin were bound to the 46.5-kD calmodulin-binding protein in CF fibroblasts as compared with controls. The 46.5 kD calmodulin-binding protein may be reduced in CF fibroblasts or its structure may be altered resulting in a reduced binding capacity and/or affinity for calmodulin and perhaps reflecting, either directly or indirectly, the genetic defect responsible for cystic fibrosis. PMID- 3805288 TI - Quantitation of antibodies to Toxoplasma gondii in swine sera by enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for quantitation of antibodies to Toxoplasma gondii in swine sera. Because a commercial anti-swine IgG conjugate was directed also against swine IgM, the conjugate was absorbed with the IgM fraction to eliminate the interference of naturally occurring IgM antibodies that appeared consistently in sera collected from slaughtered pigs at an abattoir. The ELISA values of 0.2 or more observed in most of the sera successfully decreased to less than 0.2 by the use of absorbed conjugate. An attempt to use a protein A conjugate has failed. Evaluation of this system by comparing it with the latex agglutination test provided a high significant correlation, indicating its usefulness for serodiagnosis of swine toxoplasmosis. PMID- 3805289 TI - Metastatic uveal melanoma: an ocular melanoma associated antigen in the serum of patients with metastatic disease. AB - Two monoclonal antibodies, MAb8-1H and ME491, which bind to different determinants of the same highly glycosylated melanoma-associated antigen, were used to determine melanoma-associated antigen levels in serum samples from patients treated for primary choroidal or ciliary body melanoma and who subsequently developed systemic metastasis. An immunoassay was developed in which ME491 was absorbed to polystyrene beads in order to bind the melanoma-associated antigen present in serum. 125I-MAb8-1H was used to detect the bound antigen. This double-determinant immunoassay is both sensitive and reproducible. Supernatant fluids of tissue cultured melanoma cell lines served as positive standards for the calculation of melanoma-associated antigen units. The mean serum levels of melanoma-associated antigen were 7.7 units for patients with benign ocular conditions, 9.51 units for patients with choroidal melanoma without documented metastatic disease, and 48.3 units for patients with choroidal melanoma and documented systemic metastasis. The clinical implications of using this test as a screening method for the detection of metastatic disease is discussed. PMID- 3805290 TI - A specific radioimmunoassay for the detection of 19-nortestosterone residues in urine and plasma of cattle. AB - 19-Nortestosterone (Nandrolone) is illegally used as a growth promoter for meat producing animals. This work describes a radio-immunoassay (RIA) to detect, in cattle urine, Nandrolone and its metabolites. The antiserum was specific for 19 nortestosterone and its main metabolites, and to a lesser extent for Trenbolone (17 beta-hydroxyestra-4,9,11-trien-3-one). The sensitivity of this assay was 6 ug/l at 90 % B0/T binding. This assay can be used in forensic control of illegal treatment with 19-nortestosterone in meat production. PMID- 3805291 TI - Augmentative communication, evolution, and progress for nonspeaking children. AB - Technology has provided a recent emergence of augmentative communications systems for nonspeaking children. The effective use of such systems is dependent on the knowledge and skills of physicians, speech-language pathologists, educators, parents, and other professionals working with the child. This article examines the components of an augmentative system including the mode of communication, which includes choices among manual, non-electronic, and electronic systems. The advantages of each mode are discussed. Another major component, the symbol selection process, follows an ascending hierarchy from a representational code involving actual objects to a complex symbolic code with spelling and numerals. Clinical application at the Child Development and Rehabilitation Center of the Oregon Health Sciences University points to the need for thorough interdisciplinary team evaluation during system selection or modification. Data obtained from assessment of 28 multihandicapped children reveal necessary changes, additions, and follow-up for both the mode and symbol system in the majority of children examined. PMID- 3805292 TI - Sociologic aspects of adolescent fertility and childbearing among Hispanics. AB - This paper reviews several sociologic factors associated with fertility and childbearing among Hispanic teens. The influences of acculturation, patterns of prenatal care and pregnancy outcome among Hispanic adolescents are discussed. Statistics related to birth weight, to onset of prenatal care, and marital status of the mother are also reviewed by age and ethnicity. Suggestions on how to enhance health care access among Hispanic teens are provided. PMID- 3805293 TI - Parental recall of infant medical complications and its relationship to delivery method and education level. AB - Since relatively little is known as to why parents find it difficult to recognize when their high-risk infant ceases to be ill, this investigation examined parental reports of infant complications and the relationship these reports had with parental education level and method of delivery. Using a questionnaire format, 60 parents reported complications their infants experienced during NICU (neonatal intensive care unit) hospitalization. Maternal and paternal reports were comparable, although both significantly differed from actual diagnoses; parents underreported their infant's complications. Reported complications were not related to parental education level but were associated with method of delivery. Parents of Caesarean-section (C-section) infants identified a significantly smaller percentage of complications than did parents of vaginally delivered babies. It is suggested that (1) medical caregivers have the potential for helping parents more fully comprehend infant complications, (2) supplemental communication methods may be necessary for the task in (1), and (3) information communicated to parents may need to incorporate the current findings about parental education level and delivery method. PMID- 3805294 TI - Attitudes toward breastfeeding. AB - To understand why some lower socioeconomic status mothers delivering at a state university hospital breastfeed, while others do not, 26 attitude items were administered in a survey of 358 mothers. A factor analysis of these items yielded four interpretable factors: benefits to infant, social inconvenience, personal inconvenience, and physical inconvenience-medical benefits to child. These factors were significantly related to breastfeeding within each level of ethnicity and marital status. The results imply that emphasizing the benefits for the infant, and providing strategies for minimizing personal inconveniences, should promote breastfeeding in these populations. PMID- 3805295 TI - The impact of the threat of nuclear war on children and adolescents. PMID- 3805296 TI - Memory evaluation of alcoholics with Russell's revised Wechsler Memory Scale. AB - Fifty-four alcoholics and 30 nonalcoholics were tested on Russell's (1975) revision of the Wechsler Memory Scale (RWMS). Subjects were dichotomized into groups of old and young, and alcoholics were divided further into groups of short and long-term abusers. Groups were matched on socioeconomic status. Significant group differences were found on three of the four RWMS measures as a function of abuse status and on two of the measures as a function of age. In terms of severity of impairment, alcoholics were found to demonstrate only mild verbal and figural memory deficits when compared to age-matched controls. Results are discussed with regard to the clinical utility of the RWMS as a memory screening instrument with alcoholic patients and in terms of treatment implications. PMID- 3805297 TI - Effects of stress from current problems: comparison to major life events. AB - The present investigation evaluated the stressful effects of self-defined problematic situations on consequent depressive and anxiety symptomatology. It was hypothesized that the frequency of problems would be a meaningful predictor of distress apart from the stress associated with major life changes. A prospective design was used to evaluate this predictive relationship. Further, prior levels of distress served as relevant covariates to control for premorbid status. Results from 129 college students were found to be supportive of the major hypothesis. PMID- 3805298 TI - Cognitive and somatic item response pattern of pain patients, psychiatric patients, and hospital employees. AB - Standard psychological tests generally provide a single global score that reflects multidimensional constructs, such as depression and anxiety. This single score, however, integrates a range of item contents, including cognitive/affective, somatic, and behavioral characteristics of these multidimensional constructs. The present study was designed to compare the pattern of item endorsement among chronic pain patients (N = 50), psychiatric inpatients (N = 50), and hospital employees (N = 50) on the SCL-90-R (Derogatis, Rickels, & Rock, 1976). Pain patients reported the highest SCL-90 scale level of Somatization, while the psychiatric inpatients reported the highest level of Anxiety and Depression. Additionally, the within-scale pattern of item responses on the Anxiety and Depression scales differed among groups. Although psychiatric inpatients endorsed equivalent levels of somatic and cognitive items, the pain patients' reports of psychological distress were limited primarily to somatic signs of anxiety and depression. Thus, the interpretation of pain patients' psychological profiles and subsequent treatment recommendations may be inappropriate if based on normative data obtained from psychiatric and/or normal populations. PMID- 3805299 TI - Caffeine and memory performance on the AVLT. AB - The Auditory-Verbal Learning Test (AVLT) is a memory test that assesses recall of lists of words on single and multiple trials. College students (N = 33) were given the AVLT, either with or without a prior administration of 100 mg caffeine. Caffeine subjects recalled fewer words than did control subjects, both after single presentations of lists and across repeated trials. Caffeine subjects showed a greater deficit in recalling the middle-to-end portions of the lists. Personality scores on the Maudsley Personality Inventory showed a positive correlation of recall on a pretest with Neuroticism, and no correlation with Introversion. PMID- 3805300 TI - Stress inoculation therapy with anxiety and stress disorders of acute psychiatric inpatients. AB - Twenty-six consecutive inpatient psychiatric admissions with severe stress and anxiety disorders were assigned to three treatment groups: stress inoculation therapy; a combination of stress inoculation and medication therapy; and medication therapy. The dependent measures indicate that stress inoculation therapy was superior to chemotherapy from pre- to post-testing and from baseline to posttesting in reducing symptoms of depression, anxiety, and overall subjective distress. In a 3-year follow-up, subjects in the stress inoculation therapy group tended to require fewer readmissions for psychiatric problems than the other treatment groups. It is proposed that stress inoculation therapy is effective in reducing symptoms of severe anxiety and stress reactions of acute psychiatric inpatients and that medication sometimes may have an inhibitive effect upon possible gains through psychotherapy. PMID- 3805301 TI - Predictors of psychotherapy outcome for children at a community mental health center. AB - This study assessed the utility of multiple predictors of outcome for 268 child clients and their families who received psychotherapy at a community mental health center for children. Outcome was measured by the number of therapy sessions attended, the length of therapy, and improvement ratings of the child and family made by independent judges. Regression analyses revealed that the strongest predictors of outcome were previous exposure to therapy, therapist type (permanent professional staff vs. intern), family constellation, therapist experience, and referral source. Implications for treatment planning and future research are discussed. PMID- 3805302 TI - Effectiveness of the Mini-Mult in detecting MMPI pathology in the blind. AB - The Mini-Mult and MMPI were administered in random order to 60 blind male veterans admitted to a residential rehabilitation program. Mini-Mult scores predicted the presence or absence of MMPI pathology in 81.7% of the cases. Correlations between the individual Mini-Mult and MMPI scales were significant at the p less than .01 level, but not of sufficient magnitude to permit their interchangeability or to allow for profile diagnosis on the basis of Mini-Mult scores. Analysis of the false negatives raises questions about the clinical significance of an abnormal MMPI in the population studied. The results support the value of the Mini-Mult as a screening device, but not as a substitute for a detailed psychological assessment of the blind. PMID- 3805303 TI - Concurrent validity of the clinical symptom syndrome scales of the Millon Clinical Multiaxial Inventory. AB - This study examined relationships between the clinical symptom syndrome scales of the Millon Clinical Multiaxial Inventory (MCMI) and the various clinically meaningful mood or symptom states measured by the six Profile of Mood States (POMS) scales (N = 243). The MCMI symptom scale--POMS symptom/mood scale relationships found in this study were compared with MCMI symptom scale--MMPI and SCL-90 symptom/mood scale relationships reported in the MCMI manual (Millon, 1983). Results of the present investigation, when combined with results of the previous analyses reported in the MCMI manual, reveal a number of consistent associations of moderate strength between MCMI symptom scales and selected mood or symptom scales from the MMPI and Symptom Checklist-90 as well as from the POMS. Although most relationships between the MCMI symptom scales and the symptom/mood scales of the POMS, MMPI and SCL-90 were consistent with expectation, the Anxiety, Dysthymia and Psychotic Depression scales of the MCMI show limited ability to discriminate appropriately between anxiety and depression in several of the concurrent validity analyses considered herein. PMID- 3805304 TI - Comparison of MMPI clinical scale and critical item changes of adult outpatients and parents of child psychiatry outpatients during the 1970s. AB - The present investigation is a replication of the Holmes, Sabalis, Chestnut, and Khoury (1984) study of MMPI critical item endorsement changes and MMPI clinical scale shifts in the parents of children seen at the William S. Hall Psychiatric Institute, Columbia, South Carolina during the 1970s. The current study evaluates MMPIs (N = 749) of adult, female, and male psychiatric outpatients seen during the 1970s. The general MMPI changes observed in the adult psychiatric outpatient population were not similar to those changes seen in the parent population. However, an important specific change on the Masculine/Feminine Scale for the adult outpatients was discussed. PMID- 3805305 TI - An investigation of the utility of an MMPI posttraumatic stress disorder subscale. AB - This study attempted to cross-validate an MMPI subscale designed to diagnose posttraumatic stress disorder (PTSD). The PTSD subscale scores of 19 Vietnam combat veterans with a diagnosis of PTSD were compared to those of 40 Vietnam era veterans with a psychiatric diagnosis other than PTSD. Diagnostic hit rates were considerably lower than those reported in the original investigation despite several attempts to control for misdiagnosis. PMID- 3805306 TI - Factor analysis of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) in a brain-damaged sample. AB - The Wechsler Adult Intelligence Scale-Revised (WAIS-R) was factor analyzed for a sample of 100 diagnostically heterogeneous brain-damaged patients. Subjects were from two VA Medical Centers located in the Midwest with means for age, education, and Full Scale IQ of 52.31 (SD = 14.41), 11.37 (SD = 2.57), and 86.72 (SD = 10.78), respectively. A principal factor analysis followed by Varimax rotation provided evidence for the existence of three factors underlying the WAIS-R (i.e., Performance, Verbal, and Freedom from Distractibility). The present results are consistent with earlier studies that employed the 1939 and 1955 versions of Wechsler's Adult Intelligence Scale with neurologically impaired subjects. PMID- 3805307 TI - Factor structure of the WISC-R and ITPA for learning-disabled, emotionally disturbed, and control children. AB - There has been considerable interest in determining possible learning differences in specific populations of children. Stewart (1977) factor analyzed the WISC and ITPA for learning-disabled and mentally retarded samples and compared the results to a control group. He concluded that while the factors were quite similar, evidence suggested different learning processes in the groups studied. The present study (N = 301) enlarged and modified Stewart's study; it replaced the WISC with the WISC-R and the mentally retarded group with an emotionally disturbed sample. Three factors that emerged for all groups (linguistic, memory, and visual-motor) were similar to Stewart's findings. Additional factors highlighted motor skills and a separation in auditory and visual tasks for the learning-disabled group, an expressive factor for the emotionally disturbed, and a conceptual factor for the emotionally disturbed and control groups that was not found for the learning-disabled sample. Results suggested the need for individualized instruction. PMID- 3805308 TI - Psychotrope and alcohol use by women: one or two populations? AB - From a telephone survey of 1,673 Montreal women, all consenting psychotrope users and randomly selected controls (N = 179) then were interviewed in their homes as to psychotropic drug and alcohol use. The results presented are based on these in depth interviews. In the first phase of the analysis, the respondents were grouped according to whether they abstained from both alcohol and psychotropes, used alcohol alone, psychotropes alone, or both. The variables that distinguished these groups were determined by use of one-way analysis of variance. Some of these factors included age, level of education, anxiety, nervous tension, depression, subjective ratings of health, and responses to emotional upset. The second series of results involved correlation procedures to determine the covariates of alcohol and psychotrope use. Most significant of these findings were that psychotrope use was associated with anxiety, depression, and nervous tension, while alcohol use was not. Further, unlike alcohol use, psychotrope use was associated with a variety of coping techniques for dealing with emotional upset. The findings were interpreted to mean that there are two distinct populations. PMID- 3805309 TI - Inpatient behavior therapy: the St. Louis University model. AB - Many of the problems that impede the practice of behavior therapy on traditional psychiatric and medical inpatient services can be avoided by a separate behaviorally-oriented inpatient unit, but few guidelines exist for establishing such a unit. The present paper describes the inpatient Behavioral Treatment Unit developed at St. Louis University Medical Center. Critical administrative and clinical features of the Unit are discussed, including the administrative philosophy which emphasizes unit autonomy and participative management, the central role of nursing staff, the importance of the clinical team system, the development of referral sources, admission procedures and criteria, and basic approaches to assessment and treatment. PMID- 3805310 TI - Patterns of marital interaction associated with marital dissatisfaction and depression. AB - This research compared couples reporting high and low levels of marital interactions in which one spouse responds ineffectually to the rights-infringing behavior of the mate. The results of planned comparisons indicated that high frequencies of such interactions were associated with reports of marital dissatisfaction and depression in husbands and marital dissatisfaction in wives. When both spouses described their mates as transgressive and themselves as ineffectual responders to transgression, the dysfunction reported by both spouses was pronounced. Examination of partial correlation, coefficients indicated that each spouse's role in the interaction pattern contributed to its dysfunctional nature. PMID- 3805311 TI - Paradoxical intention vs stimulus control in the treatment of severe insomnia. AB - This study compared the effectiveness of paradoxical intention, stimulus control, information and a control group on severe sleep onset insomnia. Results showed that paradoxical intention and stimulus control were equally effective but significantly better than the information and control groups. It is suggested that treatment be adapted for each individual according to data collected from the intensive behavioral analysis of each case. PMID- 3805312 TI - Behavior analysis of pharmacological and contingency management interventions for self-injury. AB - Pharmacological and contingency management interventions are frequently used to treat self-injurious behavior but few comparative analyses of these therapeutic approaches have been conducted. The present studies evaluated the singular and combined effects of psychotropic medication and behavior modification programs on multiple forms of self-injury in two developmentally disabled children. In both cases, high rates of self-injurious responding persisted during medication administration but were reduced rapidly following the implementation of behavioral programming. Near-zero levels of self-injury were maintained while the children were weaned gradually from medication and during extended follow-up assessments. Issues relevant to clinical behavioral pharmacology and self injurious behavior are discussed. PMID- 3805313 TI - Analysis of demand conditions associated with reluctant speech. AB - An analysis of five demand conditions affecting the reluctant speech of a preschool child was conducted in the classroom. Results indicated that demand conditions that did not permit escape from academic demand tasks, ignored mute responses, prompted answers and enthusiastically praised verbal responses resulted in higher rates of speech. Further, replication of these procedures across escape conditions resulted in increased speech rates that approximated those of a non-mute peer in the same classroom. Follow-up data at 8 months indicated that in the classroom the subject spoke more often to more people using a greater number of words, subsequent to analysis and intervention. The classroom teacher also reported a marked improvement in speech rate and quality and considered the time spent in analysis worthwhile. The study provides a model for further analysis of conditions associated with reluctant speech. PMID- 3805314 TI - Controlled smoking: single case study with multicomponent intervention. AB - The case study of controlled smoking treatment reported here includes multicomponent behavioral interventions. Follow-up data of 30 months' duration are examined with particular reference to shifts in topographical aspects of smoking and a focus on other health-related behaviors. Cigarette smoking was reduced by 85% without compensatory shifts in topography and with successful long term maintenance. The need to specify detailed ingredients of multicomponent smoking packages for individual clients is discussed, paying particular attention to the potential for development of "positive addictions". PMID- 3805315 TI - Effect of "wet nights" on daytime behavior during concurrent treatment of enuresis and conduct problems. AB - The case study reported in this paper focuses on the relationship between bedwetting and misconduct after the implementation of behavior therapy for both problems. A 6 1/2-year-old girl was treated for enuresis and subsequently for conduct problems (lying, aggressiveness). After both bedwetting and misconduct displayed substantial and stable improvement, it was found that occasional nightly relapses in bedwetting were strongly associated with the occurrence of misconduct the following day. Implications of this finding are discussed. PMID- 3805317 TI - Class specific immunoglobulin response to individual polypeptides of Chlamydia trachomatis, elementary bodies, and reticulate bodies in patients with chlamydial infection. AB - Sera from 10 women with Chlamydia trachomatis culture positive cervicitis and sera from six men with C trachomatis positive non-gonococcal urethritis were studied for the presence of IgG, IgM, and IgA antibodies to polypeptides of C trachomatis elementary bodies and reticulate bodies using immunoblotting techniques. All the sera with IgG, IgM, or IgA immunoglobulins specific to C trachomatis recognised the major outer membrane protein (MOMP) of elementary bodies. IgG antibodies also detected several other proteins, whereas IgM immunoglobulins recognised only MOMP and proteins of 60 kD, 62 kD, and 66 kD. The IgA reacted with MOMP and the 60 kD and 62 kD proteins in elementary bodies. Class specific antibody response against the proteins of reticulate bodies was similar to that observed for elementary body antigens--with one substantial difference: no reaction was observed in the 60 kD and 62 kD positions. This suggests that 60 kD and 62 kD proteins are deficient in reticulate bodies. PMID- 3805316 TI - Comparison of erythrocyte antioxidative enzyme activities between two types of haemoglobin H disease. AB - The activities of erythrocyte antioxidative enzymes were measured in two groups of patients with different genotypes of haemoglobin (Hb) H disease: 21 with alpha thalassaemia 1 or alpha-thalassaemia 2 (alpha-thalassaemia 1/2) and 21 with alpha thalassaemia 1/Hb Constant Spring (HbCS). They were compared with 21 normal subjects. Both genotypes of Hb H disease had increased activities of erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase when compared with those of controls. Comparison of the two genotypes showed that subjects with alpha-thalassaemia 1/Hb CS, the more severe disease, had higher SOD and GSH-Px activities but lower catalase activity than those with alpha thalassaemia 1/2. This indicates that there are compensatory mechanisms in Hb H erythrocytes to cope with increased generation of oxygen free radicals as a result of increased excess beta chain. PMID- 3805318 TI - Glycoprotein abnormalities in colonic carcinomata, adenomata, and hyperplastic polyps shown by lectin peroxidase histochemistry. AB - A technique for lectin-peroxidase histochemistry was adapted for the study of formalin fixed paraffin embedded colonic tissue. Ten lectins with differing carbohydrate binding specificity were tested against 20 normal rectal biopsy specimens and tissue from 19 colonic carcinomata, 19 tubular or tubulovillous adenomata, and 19 hyperplastic polyps. None of the normal rectal biopsy specimens bound the lectins peanut agglutinin (PNA), Griffonia simplicifolia II (GSII), and Ulex europaeus I (UEAI), whereas 18 carcinomata, 12 adenomata, and 18 hyperplastic polyps showed affinity for one or more of these lectins. Hyperplastic colonic polyps are shown to possess similar abnormalities in glycoprotein structure to malignant and adenomatous colonic tissue. This may simply indicate a non-specific reaction to changed rates of cell proliferation but might represent a more fundamental association between hyperplastic polyps and adenocarcinomas. PMID- 3805319 TI - Morphometric data to FIGO stage and histological type and grade for prognosis of ovarian tumours. AB - The prognostic value of using histological typing, grading, and morphology, in addition to clinical staging, was assessed in 98 cases of invasive ovarian cancer of the common epithelial types (serous, mucinous, and endometrial). All of these cases had at least five years of follow up. When regression analysis was used, the International Federation of Gynaecology and Obstetrics' (FIGO) staging system was the best indicator for prognosis. Analysis of a combination of morphometric features was the second best indicator, being especially useful for the those patients with stage I disease. Variables that indicated a relatively poor prognostic outcome were mitotic index above 30; volume percentage epithelium above 65%; shortest nuclear axis above a mean of 1 X 1 micrometers. Histological typing of ovarian tumours was of limited value; mucinous tumours have a somewhat better prognosis than serous tumours, but the prognostic value of typing alone was found to be limited. Qualitative histological grading was useful, but the prognostic value of morphometric grading was better. Measurement of morphological features with an interactive computer program is simple and can be done by a pathologist or a technician: in future it is likely that such automated systems of measurement will improve the objectivity of tissue analysis. PMID- 3805320 TI - Morphometry of spermatozoa using semiautomatic image analysis. AB - Human sperm heads were detected and tracked using semiautomatic image analysis. Measurements of size and shape on two specimens from each of 26 men showed that the major component of variability both within and between subjects was the number of small elongated sperm heads. Variability of the computed features between subjects was greater than that between samples from the same subject. PMID- 3805321 TI - Nuclear diameter in parathyroid carcinomas. AB - Nuclear diameter was measured and mean nuclear diameter calculated in 18 parathyroid carcinomas. In 11 of the 18 tumours mean nuclear diameter was above the range previously reported for 55 parathyroid chief cell adenomas and provides a useful discriminant in histological diagnosis. PMID- 3805322 TI - Dipstick analysis for screening of paediatric urine. PMID- 3805323 TI - Screening for cryptosporidial infection. PMID- 3805324 TI - C-reactive protein concentration in suspected bacteraemia. PMID- 3805325 TI - Use of word processors for poster demonstrations. PMID- 3805326 TI - The pharmacological treatment of delusional depression: Part II. AB - This study investigated the pharmacological treatment of delusional depressives by assigning patients on a random double-blind basis to amitriptyline (AT) alone, perphenazine (PER) alone, or AT + PER. As reported in an earlier paper, the combination of AT + PER was the superior treatment with a response rate of 78% compared with 41% for AT alone and 19% for PER alone. This difference is both clinically and statistically significant (p less than 0.01). In this second article, the authors report that the patients on AT + PER had higher plasma levels of AT and its pharmacologically active metabolite nortriptyline (NT) than the patients on AT alone. Although the response rate had a direct relationship to AT + NT plasma levels, an analysis of variance showed that the group of patients treated with AT + PER still had a significantly higher response rate, even after controlling for the plasma levels of AT + NT (p less than 0.05). There was also a correlation between PER plasma levels and clinical response. PMID- 3805327 TI - The relationship between depression and the dexamethasone suppression test following alcohol withdrawal in a psychiatric population. AB - The authors administered at least one dexamethasone suppression test (DST) and Hamilton Rating Scale for Depression (HRSD) simultaneously to 30 psychiatric inpatients following detoxification from alcohol. Twenty-five of these were also interviewed using the NIMH Diagnostic Interview Schedule (DIS). Fifteen patients had two or three sequential DSTs at weekly intervals. Seven of the patients were clinically diagnosed as having a major depressive episode based on close observation over 2 to 4 inpatient weeks free of psychotropic medications. Fifty eight percent of the initial cortisol determinations with the first 2 weeks showed nonsuppression, as did 60% after 2 weeks. While the level of depressive symptoms was initially high (HRSD score greater than 20) for 48% of the 27 patients interviewed within 2 weeks of abstinence, depressive symptoms cleared within 2 weeks in half of these cases. There were no associations between DST results and the presence of DSM-III major depressive disorder (lifetime or current) as assessed by the NIMH DIS, scores on the HRSD, or the presence of liver disease (elevated admission SGOT or SGPT). By the 15th-day of abstinence an examination of the clinical course of depressive symptoms differentiated those patients with a persistent major depressive episode from those with transient, alcohol-related depressive symptoms. An early positive DST had a positive predictive value of 20% for a clinical diagnosis of a major depressive episode, and a negative predictive value of 73%. After 2 weeks the positive and negative predictive values were each 50%. PMID- 3805328 TI - Effects of one-week lithium treatment on skilled performance, information processing, and mood in healthy volunteers. AB - In a double-blind study, effects of lithium on skilled performance, information processing, and mood were studied in 12 healthy men. Lithium was administered for 1 week and the average, steady state, serum lithium concentration on the morning of testing was 0.8 mEq/liter. Lithium had a non-specific, minor, but consistent effect of prolonging reaction times. Most subjects reported increased anxiety, faintness-dizziness, nervousness-shakiness, and feeling "blue" during and immediately after lithium treatment. PMID- 3805329 TI - Desipramine in the treatment of children with attention deficit disorder. AB - Eighteen children with attention deficit disorder were treated with desipramine in a prospective open trial to assess its efficacy and safety. Improvement occurred within 4 weeks and was sustained without significant adverse effects for up to 52 weeks. PMID- 3805330 TI - The 2-mg dexamethasone suppression test in differentiating major depression with psychosis from schizophrenia. AB - The 2-mg dexamethasone suppression test (DST), performed in a drug-free acute exacerbation phase of illness shortly after admission, differentiated between major depression with psychosis and stringently diagnosed chronic schizophrenia. This has practical significance because effective drug treatment in each diagnostic group is different. Nonsuppression was seen in all six newly admitted patients in a drug-free acute exacerbation phase of illness with major depression with psychosis. Suppression was seen in all 20 newly admitted chronic schizophrenic patients in a drug-free acute exacerbation phase of illness, with the exception of two very agitated patients with mildly elevated 11 p.m. cortisol samples. Studies are briefly reviewed and suggest that nonsuppression with 1-mg DST may occur in the absence of pituitary-adrenal disinhibition and in the acute exacerbation phase of some chronic schizophrenic patients. PMID- 3805331 TI - View from the Nation's Capital. Executive Branch inaction: the case of neurotoxicity testing and regulation. PMID- 3805332 TI - View from the Nation's Courts. The physician's duty to warn: Tarasoff expanded. PMID- 3805333 TI - High-dose intravenous haloperidol in agitated cardiac patients. PMID- 3805334 TI - Torsades de pointes ventricular tachyarrhythmia associated with haloperidol. PMID- 3805335 TI - Haloperidol pharmacokinetics following gastric bypass surgery. PMID- 3805336 TI - Possible central effect of dantrolene sodium in neuroleptic malignant syndrome. PMID- 3805337 TI - TCA treatment complicated by hyperthyroidism. PMID- 3805338 TI - Maprotiline-induced ataxia. PMID- 3805339 TI - Amitriptyline excretion in human milk. PMID- 3805340 TI - Further experience and observations with lorazepam in the management of behavioral agitation. PMID- 3805341 TI - Baclofen-induced catatonia. PMID- 3805342 TI - Pentazocine-naloxone: an "abuse proof" drug can be abused. PMID- 3805343 TI - Pseudoakathisia associated with atenolol. PMID- 3805344 TI - Dichotic listening performance of articulatory-impaired children: directed attention, severity, and data analysis. AB - The present study compared the performance of articulatory-impaired and non articulatory-impaired children on a dichotic word task. The dichotic words were presented under three listening conditions: free recall, directed right, and directed left. In addition, different methods for analyzing ear preferences were computed and compared. Children between 5 and 9 years of age participated. Results indicated no significant differences between articulatory-impaired and non-impaired groups on ear preferences. The directed left condition failed to produce a significant difference between right and left ear scores for both groups. Data analysis showed similarities, except with the use of the phi coefficient. No correlations were established between the number and type of articulation errors and dichotic ear preferences. PMID- 3805345 TI - Differences in fundamental frequency, jitter, and shimmer among four types of infant vocalizations. AB - An inaudible voice variable, known to be influenced by stress-arousal in adults, was recently discovered to differ significantly among four situationally defined types of infant vocalizations. Other research suggests that jitter in adults also may be altered by stress-arousal. Further, there is a lack of normative data on jitter and shimmer in infant vocalizations. These findings prompted this study comparing F0, jitter, and shimmer among four situationally defined vocalizations ("pain," "hunger," "fussy," and "cooing") of 2-6-month-old infants. Data showed no significant difference in either jitter or shimmer among the four vocalizations; no significant difference in F0, jitter, or shimmer due to the sex or age of infant; a significant difference in F0 among "hunger," "cooing," and either "pain" or "fussy" vocalizations; and no significant difference in F0 between "pain" or "fussy" cries. PMID- 3805346 TI - Young adolescents' perception of their peers who wear hearing aids. AB - In order to evaluate the perceptions of young adolescents of their peers who wear hearing aids, observers were selected from four types of schools: rural, suburban, inner city, and a self-contained classroom for the hearing impaired. Observers made semantic differential ratings of two teen-aged peers, one of whom had normal hearing and one of whom had a moderately severe sensorineural hearing loss. Both boys spoke under three conditions: wearing a postauricular hearing aid, wearing a body aid, and wearing no aid at all. Results indicated at least partial support for the "hearing aid effect" (Blood and Blood, 1977) as evidenced by the differential perceptions of the observers as a function of the school they attended, differential reactions to the hearing impaired speaker and the one with normal hearing, and the absence, presence, and type of hearing aid worn. This study reports the perceptual similarities and differences among observer groups and between the two speakers. Further, it is suggested that the overall speech quality, in addition to the absence, presence, and type of hearing aid, is important to peer perceptions. PMID- 3805347 TI - A study of cleft palate speakers with marginal velopharyngeal competence. AB - This study was designed as a partial test of a previously hypothesized model for a subgroup of cleft speakers who show marginal velopharyngeal competence during speech. Specifically, speakers in the model were hypothesized to show minimal but consistent nasalization of speech by several criteria. Fifty-two subjects were selected because they met one of the criteria for the model, lateral x-ray films on /s/ that showed touch closure or a small velopharyngeal opening. The subjects were then examined by the other five criteria used for defining the hypothesized model, and were found to meet, in the majority, fewer than three. These findings indicate that lateral x-ray films are not sufficient for identifying this diagnostic subgroup, if it exists. Another possible conclusion is that the model proposed is too simplistic and that cleft palate speakers with marginal velopharyngeal competency typically show more variability in speech performance than was originally implied in the model. PMID- 3805348 TI - A forebrain atlas of the lizard Gekko gecko. AB - An atlas of the forebrain of the lizard Gekko gecko has been provided, which will serve as the basis for subsequent experimental tracing and immunohistochemical studies. Apart from a strongly developed medial cortex and septal area, the Tokay gecko shows all the main features of the forebrain of the lacertid-type lizards. When its convenience as an experimental animal is also taken into account, this species seems to be very suitable for studying the limbic system in reptiles. The atlas comprises topographical reconstructions of the telencephalon and diencephalon and a series of transverse sections of which the levels have been indicated in the reconstructions. The results obtained in the Gekko are briefly compared with those found in other lizards studied. PMID- 3805349 TI - Ascending pathways from the spinal cord in the hime salmon (landlocked red salmon, Oncorhynchus nerka). AB - The ascending pathways from the spinal cord of the hime salmon were anterogradely labelled by the cobaltic lysine method, and their courses and terminations were examined. Following application of the cobaltic lysine to the cut end of the spinal cord or injection of the cobalt at the 10th to 15th spinal segment, labelled axons were traced from the spinal cord to various regions in the rhombencephalon and the mesencephalon. The axons ascending from the dorsal funiculus gave off many terminals as they ascended to the lower medulla. This terminal area may be homologous to the nucleus funiculi dorsalis of other vertebrates, although cytoarchitectural differentiation of the area is not evident. The dorsal funicular fibers also formed some terminals in the vagus and glossopharyngeal motor nuclei and the nucleus fasciculi solitarii. The axons arising from the anterolateral funiculus ascended as the common trunk of the lemniscus spinalis. The lemniscus spinalis fibers distributed many axon terminals on their way through the lower medulla, and most probably made synaptic contacts with the peripheral dendrites of the cells of origin of the reticulospinal pathways throughout its rostrocaudal extent. They also projected to all the medullary cranial nerve motor nuclei (V, VI, VII, IX, and X). The rostral continuation of the lemniscus spinalis fibers entered the lemniscus lateralis and gave a rostrocaudally elongated terminal area in the nucleus lateralis of the torus semicircularis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805350 TI - Diencephalic catecholamine neurons (A-11, A-12, A-13, A-14) show divergent changes in the aged rat. AB - The effects of aging on diencephalic (A-11, A-12, A-13, A-14) catecholamine neurons in the F344 male rat were examined with Falck-Hillarp histofluorescence. In contrast to the age-related increase in A-12 perikaryal fluorescence intensity previously reported (Hoffman and Sladek: Neurobiol. Aging 1:27-37, '80), incertohypothalamic perikarya showed decreased (A-13) or unchanged (A-11, A-14) fluorescence intensity with age. Cell counts of fluorescent A-12 perikarya disclosed a 47% increase in the number of fluorescent A-12 neurons in 30-month old F344 rats relative to the 3-month-old controls; numbers of A-11 and A-13 fluorescent perikarya decreased with age, but the declines were not statistically significant. It is unlikely that the age-related increase in number of fluorescent A-12 perikarya is the result of proliferation of neurons in the aged F344 rat. Rather, the greater number of fluorescent A-12 perikarya in 30-month old F344 rats indicates that some A-12 neurons in 3-month-old F344 rats contain levels of dopamine that are subthreshold for detection with the Falck-Hillarp fluorescence technique, whereas virtually all A-12 perikarya in 30-month-old F344 rats contain detectable quantities of dopamine. These findings suggest that diencephalic catecholamine neurons exhibit divergent changes in transmitter content and cell number that may reflect varying degrees of functional integrity during brain aging. PMID- 3805351 TI - Localization of motoneurons innervating the extraocular muscles in Salamandra salamandra L. (Amphibia, Urodela). AB - The central innervation patterns of the extraocular muscles were investigated in the European fire salamander Salamandra salamandra L. by means of the horseradish peroxidase method. The ipsilateral portion of the nucleus nervi oculomotorii, which is located in the rostral ventral tegmentum mesencephali, supplies the musculi recti inferior and medialis and the musculus obliquus inferior without a clear somatotopic representation of the motoneurons. The musculus rectus superior is innervated mainly by a contralateral portion of this nucleus. A definite nucleus Edinger-Westphal could not be recognized. The nucleus nervi trochlearis, which rostrally joins the nucleus nervi oculomotorii with a gap of only about 40 micron between the nuclei, is situated completely contralateral to the musculus obliquus superior supplied by it. The nucleus nervi abducentis, innervating the musculus rectus lateralis, and the nucleus accessorius nervi abducentis, supplying the musculus retractor bulbi, are found in the ipsilateral medulla oblongata and exhibit a large rostrocaudal extension from the eighth cranial nerve to the first root of the vagus nerve. Dendrites of the nucleus nervi oculumotorii and of the nucleus accessorius nervi abducentis extend into neuropil areas receiving primary sensory afferents. PMID- 3805352 TI - Callosal connectivity of areas V1 and V2 in the newborn monkey. AB - The callosal connectivity of areas V1 and V2 in the newborn monkey has been investigated with the neuroanatomical tracers wheat germ agglutinin conjugated to horseradish peroxidase and free horseradish peroxidase. In the adult, callosal projecting neurons in cortex subserving the lower parafoveal visual field were found to extend from the V1/V2 border for a distance of 1-2.5 mm into V1 and 8 mm into V2. In the newborn, the tangential extent and total number of callosal projecting neurons were the same as in the adult. Within area V1, callosal projecting neurons in the adult and newborn were limited to supragranular layers. In the adult, axon terminals of callosal projections were located in layers 4B and 5 and were excluded from layer 4C. In the newborn, axon terminals were more extensively distributed than in the adult and invaded layer 4C. In area V2, the laminar distribution and the patchy location of callosal connections in regions of high cytochrome oxidase activity were similar in the newborn and adult animals. In both newborns and adults, the patchy distribution of callosal projections persisted when the neuroanatomical tracers were injected over extensive regions of the contralateral striate and extrastriate cortex. In the adult, area V1 and V2 project contralaterally to two heterotopic sites located in the fundus of the lunate sulcus and the superior temporal sulcus. This was also found to be the case in the newborn. In the adult the terminals of these heterotopic projections were focused in layer 4. This was not the case in the newborn, where after injection limited to the contralateral V1/V2 border they were more evenly distributed among the different cortical layers. Following extensive contralateral injection of tracer, terminals in cortex anterior to V2 were focused over layer 5 and the bottom of layer 4. PMID- 3805353 TI - Spatial segregation of synaptic inputs and outputs in a locust auditory interneurone. AB - Using intracellular injection of cobalt, processing for electron microscopy, and using on-section silver intensification, we have investigated the distribution of synapses on the metathoracic arborization of the TN1 intersegmental interneurone in the auditory system of the locust. Previous studies have indicated that inputs to this neurone from tympanal afferents are spatially segregated from its outputs to higher-order inhibitory interneurones. Branches in the area of input are characterised by a smooth appearance in Lucifer Yellow preparations, whereas branches in the main output area appear beaded. Sampling different areas of the TN1 arborization, we have found marked differences in the respective densities of input and output synapses. Labelled profiles in areas of beaded branching have an extremely high density of presynaptic sites, with a much smaller number of synaptic inputs. Smooth branches bear many input synapses, but we have found no output synapses on them. Our results indicate a good correlation between branch beading and presynaptic function and between smooth branches and postsynaptic function. These correlations enable us to predict synapse distribution on other insect neurones with a similar division in branch morphology and also extend our knowledge of the functioning of TN1 itself. PMID- 3805354 TI - Laminar and synaptic organization of the projection from the thalamic nucleus centralis to primary visual cortex in the cat. AB - The projection from the nucleus centralis (an intralaminar thalamic nucleus) to the primary visual cortex was examined with anterograde and retrograde tracing techniques. After large injections of horseradish peroxidase into areas 17 and 18 almost one-half of the neurons in the nucleus centralis were retrogradely labeled. An injection of 3H-proline into the nucleus centralis led to sparse anterograde labeling in layers 5 and 6 of areas 17 and 18. Large injections of peroxidase-conjugated wheat germ agglutinin (WGA) into the nucleus centralis led to similar anterograde labeling of layers 5 and 6 and, in addition, to a band in layer 1. No retrogradely labeled cells were seen in areas 17 or 18. The WGA labeled terminals in area 17 were examined in the electron microscope: they formed type 1 (asymmetric) synapses on dendritic spines. These observations suggest that the afferents from the nucleus centralis primarily contact pyramidal cells that project to subcortical targets. The findings are consistent with physiological studies suggesting that the nucleus centralis is involved in the modulation of cortical outflow with varying levels of arousal. PMID- 3805355 TI - Innervation of extraocular muscles in the rabbit. AB - The innervation of extraocular muscles in the rabbit was studied by using the methods of horseradish peroxidase (HRP) histochemistry, gross dissection, and quantitative morphology. Subdivisions of the oculomotor complex that innervate the superior rectus, inferior rectus, medial rectus, and inferior oblique and levator palpebrae are described, and our results are in agreement with previous accounts of the projections of this nucleus. Our analysis of the innervation of the lateral rectus and retractor bulbi muscles, however, differs from previous descriptions. The axons of approximately 80% of neurons in the abducens nucleus are in the VIth nerve and innervate the lateral rectus muscle, and approximately 15-20% are internuclear neurons both surrounding and intermingling with the motor neurons of the abducens nucleus. The interneurons project to the medial rectus subdivision of the contralateral oculomotor complex via the medial longitudinal fasciculus (MLF). Neurons in both the abducens and the accessory abducens nucleus innervate the retractor bulbi muscles via the VIth nerve. All neurons in the accessory abducens nucleus innervate the retractor bulbi muscles, but gross dissection revealed that the retractor bulbi is also innervated by the IIIrd nerve. The bases for differences between our data and previously published descriptions are discussed. The trochlear nucleus of the rabbit has not been previously studied by methods of axonal transport. The body of the nucleus, its caudal tail, the trajectories of axons entering the trochlear nerve, and soma size distributions are described. The trochlear nucleus contains approximately 900 neurons; most are motoneurons the axons of which travel in the trochlear nerve and decussate in the anterior medullary velum. Approximately 3% of trochlear motor neurons innervate the ipsilateral superior oblique muscle. Their soma size is significantly smaller than that of contralaterally projecting neurons. For comparative purposes, the innervation of extraocular muscles by the trochlear nerve was also investigated in several rodents and carnivores. In all animals studied, the percentage of trochlear neurons innervating the ipsilateral superior oblique muscle was strikingly uniform (2-4%). Gross dissection of the extraocular muscles revealed in the rabbit a muscle, innervated by the trochlear nerve, for which we propose the name "tensor trochleae." In the rabbit, this muscle is innervated by approximately one-third of the trochlear motor neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805356 TI - Descending pathways to the spinal cord in the hime salmon (landlocked red salmon, Oncorhynchus nerka). AB - Distribution and morphology of the cells of origin of the descending spinal pathways and their axonal courses were studied in the hime salmon, using retrograde labelling with cobaltic lysine and horseradish peroxidase (HRP). Following application of the tracers to the cut end of the spinal cord or injection of the tracers at the 10th to 15th spinal segment, neurons mainly labelled via the axons of passage were distributed in the mesencephalon and the rhombencephalon. Mesencephalic cell groups consisted of the nucleus pretectalis, the nucleus fasciculi longitudinalis medialis, and the nucleus ruber. The former two cell groups sent their axons to the fasciculus longitudinalis medialis. The axons of the nucleus ruber formed a separate loose bundle, the "tractus rubrospinalis." The rhombencephalic cell groups consisted of the rhombencephalic reticular formation, the Mauthner cells (one cell for each side), and the octavolateral area. The rhombencephalic reticular formation could be further subdivided into the nucleus reticularis superior, nucleus reticularis medius, and nucleus reticularis inferior. The axons of these cell groups joined the fasciculus longitudinalis medialis and the "tractus bulbospinalis." The Mauthner cell had two main gigantic dendrites, and its giant axons formed a conspicuous fiber of Mauthner throughout the rhombencephalon down to the spinal cord. The octavolateral area could be subdivided into the nucleus vestibularis magnocellularis, nucleus tangentialis, nucleus vestibularis descendens and nucleus intermedius. The axons of the nucleus vestibularis magnocellularis and nucleus intermedius entered the fasciculus longitudinalis medialis and/or the tractus bulbospinalis. Those of the nucleus vestibularis descendens and nucleus tangentialis formed the "tractus vestibulospinalis". The descending spinal pathways of the hime salmon were compared with those of other fishes and other vertebrates. The significance of these descending spinal pathways in the control of locomotion and sexual behavior is also discussed. PMID- 3805357 TI - Embryogenesis of arborization pattern and topography of individual axons in N. laminaris of the chicken brain stem. AB - This study examined the development of individual axon terminal fields in n. laminaris (NL) of the chicken brainstem. In their mature form axons from the nucleus magnocellularis (NM), second-order auditory neurons in the chicken brainstem, project bilaterally onto the NL. Axons from the ipsilateral and contralateral NM neurons form spatially segregated, elongated arbors in the dorsal and ventral neuropil of NL, respectively. The long axes of these arbors correspond to physiologically defined isofrequency bands. To assess the development of this stereotyped arborization pattern, 6-17-day embryonic chicken brain stems were maintained in vitro while injecting horseradish peroxidase into small groups of axons. Three-dimensional reconstructions were made from serial sections and projected onto a cartesian plane for quantitative analyses. At embryonic day 6 (E6), the ventral axons already course beneath the recently migrated NL neurons. The arrival of the dorsal NM axon branches is delayed and their paths are indirect. They first loop dorsally into the the ventricular layer, where they seem to make specific connections with migrating NL neurons and use these as guides to their appropriate positions in the NL. During the period from E9 to E17 the dorsal and ventral terminal fields become similar, each adopting properties of the other's initial pattern. The dorsal terminal fields extend to form bands similar to the early ventral terminal fields, while the ventral terminal fields narrow and appear to shift position in order to achieve the tonotopic specificity characteristic of the early dorsal terminal fields. The results show that a complex, mature pattern of neuronal connections can be formed during development by the combination and reorganization of two simple patterns- each shaped, in turn, by its respective axonal trajectory. PMID- 3805358 TI - Afferent and efferent connections of the dorsolateral precentral gyrus (area 4, hand/arm region) in the macaque monkey, with comparisons to area 8. AB - The afferent and efferent connections of the dorsolateral precentral gyrus, the primary motor cortex for control of the upper extremity, were studied by using the retrograde and anterograde capabilities of the horseradish peroxidase (HRP) technique in three adult macaque monkeys that had received HRP gel implants in this cortical region. Reciprocal corticocortical connections were observed primarily with the supplementary motor area (SMA) in medial premotor area 6 and dorsal bank of the cingulate sulcus, postarcuate area 6 cortex, dorsal cingulate cortex (area 24), superior parietal lobule (area 5, PE/PEa), and inferior parietal lobule (area 7b, PF/PFop, including the secondary somatosensory SII region). In these heavily labeled regions, the associational intrahemispheric afferents originated primarily from small and medium sized pyramidal cells in layer III, but also from layer V. The SMA projections were columnar in organization. Intrahemispheric afferents from contralateral homologous and nonhomologous frontal and cingulate cortices also originated predominantly from layer III, but the connections from contralateral area 4 were almost exclusively from layer III. The bilateral connections with premotor frontal area 6 and cingulate cortices were not observed with parietal regions; i.e., only ipsilateral intrahemispheric parietal corticocortical connections were observed. There were no significant connections with prearcuate area 8 or the granular frontal (prefrontal) cortex. Subcortical afferents originated primarily from the nucleus basalis of Meynert, dorsal claustrum, ventral lateral (VLo and VLc), area X, ventral posterolateral pars oralis (VPLo), central lateral and centromedian thalamic nuclei, lateral hypothalamus, pedunculopontine nucleus, locus ceruleus and subceruleus, and superior central and dorsal raphe nuclei. Lesser numbers of retrogradely labeled neurons were observed in the nucleus of the diagonal band, mediodorsal (MD), paracentral, and central superior lateral thalamic nuclei, nucleus limitans, nucleus annularis, and the mesencephalic and pontine reticular formation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805359 TI - Map of retinal position onto the cross section of the optic pathway of goldfish. AB - The position of a retinal cell is defined by the two polar coordinates: r, the distance from the optic disc, and theta, the angular (or clock-face) position. Axons of similar theta value were labeled by the punctate application of horseradish peroxidase (HRP) to optic axons in the retina, and axons of similar r value were labeled by the application of this same marker to a tectal fascicle. Labeled axons were traced in serial transverse sections of the optic pathway from the retina to the tectum to learn the map of the retinal surface onto the cross section of the pathway. Retinas were flat-mounted and treated for HRP to show the retinal origins of the labeled axons. Axons of similar r were clustered together, and the fraction of the pathway's cross-sectional area occupied by the cluster was about the same as the fraction of the retinal area occupied by the group of labeled somata. Axons of similar theta were also clustered, but the fraction of the cross-sectional area they occupied was larger than the fraction of retinal area occupied by their somata. The geometry of the clusters of labeled axons depended on the proximodistal location in the pathway. Near the retina both were strip-shaped, but the location and orientation of the strip varied. Both an r strip and a theta-strip were labeled in some pathways by dual applications of HRP; the two strips were mutually orthogonal at all levels. Each of r and theta mapped onto a separate axis. The axons from most peripheral retina (largest r) were everywhere adjacent to the pia, and axons of progressively more central retina (smaller r) were progressively more separated from the pia (except in the nerve, where the secondary fasciculation complicates the geometry by wrapping old axons in new pia). The map of the circular variable, theta, onto a line, required a discontinuity, the location of which differed, depending on the proximodistal level. From the retina to the chiasm, the discontinuity was at the ventral retinal radius (i.e., the right retinal clock-face positions were ordered 6-9-12 3-6 o'clock across the line); just central to the chiasm, the fibers reordered to put the discontinuity at the nasal radius (clock-face positions ordered 3-6-9-12 3); at the brachial bifurcation, the 3-6-9 half turned dorsally, the 9-12-3 half, ventrally.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805360 TI - Ultrastructural features and hormone-dependent sex differences of mormyrid electric organs. AB - The electric organ of mormyrid fishes is composed of action potential-generating cells called electrocytes that together produce a species-typical electric organ discharge (EOD). The electrocytes of mormyrids are disc-shaped cells with distinct anterior and posterior faces, and a series of evaginations of one face that form a stalklike structure that is the site of innervation by spinal electromotoneurons (Bass: J. Comp. Neurol. 244:313-330, '86a). Here, we describe the major ultrastructural features of mormyrid electrocytes, which include surface invaginations along each face, myonuclei, myofilaments, and neuromuscularlike junctions formed by the axons of spinal electromotoneurons. The degree of surface invaginations along the anterior face is the most dramatic interspecific variable and is usually greater for species with the longer duration EODs. Among species with sexually dimorphic EODs, natural males, or females treated with gonadal steroid hormones, have longer-duration EODs and thicker electrocytes with more surface invaginations along the anterior face. The results are discussed in relation to the action potential-generating properties of the electrocyte's membranes. PMID- 3805361 TI - Organization of corticogeniculate projections in the turtle, Pseudemys scripta. AB - The efferent pathways from the visual cortex to the dorsal lateral geniculate complex of turtles have been studied by using the orthograde and retrograde transport of horseradish peroxidase (HRP). Injections of HRP in the lateral thalamus retrogradely label neurons throughout the visual cortex. The majority of labeled neurons have somata in layer 2 of the lateral part of dorsal cortex (D2); a minority have somata in layer 3. Labeled neurons in layer 2 tend to have vertically oriented, fusiform somata and dendrites that ascend into layer 1. Labeled neurons in layer 3 have fusiform somata and dendrites, both oriented horizontally. Injections of HRP in visual cortex orthogradely label corticofugal axons. Those projecting to the lateral geniculate complex course laterally from the visual cortex, pass through the striatum (occasionally bearing varicosities), and enter the diencephalon in the ventral peduncle of the lateral forebrain bundle. Individual axons leave the ventral peduncle and run dorsally in the transverse plane, entering the dorsal lateral geniculate complex from its ventral edge. They continue dorsally, principally in the cell plate of the geniculate complex, where they bear varicosities. PMID- 3805362 TI - Vascular atrophy in the retinal degenerative rd mouse. AB - We have observed that the lectin Ricinus communis agglutinin I (RCA), which binds to terminal galactose moieties, serves as a marker for vasculature in the mouse retina. The binding of fluorescein-isothiocyanate-conjugated RCA was used to study the development of retinal vasculature in normal mice and in rd (retinal degeneration) mutant mice, which exhibit a massive loss of photoreceptor cells during the first month of life. In the normal mouse, retinal capillaries develop in an ordered manner and are concentrated in three major zones between the inner limiting membrane and the outer plexiform layer. In the rd mouse, the vessels appear to form normally but begin to degenerate by the end of the second postnatal week. By the end of the fourth postnatal week there is approximately a 35% reduction in the total number of vascular profiles in the rd retina compared to normal littermate controls. This reduction in vascularity is temporally associated with the photoreceptor degeneration. PMID- 3805363 TI - Increased in vitro cell-mediated immune response to staphylococcal antigens in atopic dermatitis. AB - Atopic dermatitis patients have both a chronic colonization of their skin with Staphylococcus aureus and a delayed cutaneous hyporesponsiveness to intradermally injected staphylococcal antigens. It has not been established whether the cutaneous anergy merely reflects a specific lymphocyte hyporesponsiveness to staphylococcal antigens. Therefore the lymphocyte proliferative response to staphylococci was assessed in twelve patients with slight to severe atopic dermatitis and in eleven healthy subjects. Compared to the normal subjects, the patients showed significantly higher stimulation indices with S. aureus Wood 46 (p less than 0.05) and purified S. aureus cell walls (p less than 0.05). There was no significant correlation between the lymphocyte stimulation and the clinical severity of the disease. Therefore, chronic colonization of the skin of atopic dermatitis patients by S. aureus does not correlate with a defect in the cellular immune response to the bacteria but may rather stimulate such a response. PMID- 3805364 TI - Status of ultraviolet A dosimetry in methoxsalen plus ultraviolet A therapy. AB - The carcinogenic risk of methoxsalen plus ultraviolet A treatment (PUVA) is almost certainly related to the cumulative UVA exposure dose. A reliable estimate of UVA dose is a major component, therefore, in determining the long-term safety of this treatment modality. Thirty-one UVA meters from twenty-nine different PUVA treatment centers were compared with a calibrated UVA meter. The results inferred that 95% of UVA meters used in PUVA centers are reading between 57% and 159% of the true UVA irradiance, a factor of 2.8 in relative sensitivity. This wide variation in accuracy between the UVA meters gives cause for concern. These variations were attributed to differences in calibration procedure, optical properties of the sensors, and, most importantly, poor quality control by the manufacturers. The situation that appears to have existed since the introduction of PUVA therapy can be improved only if dermatologists agree that the present inaccurate and uncertain approach to UVA measurements is unsatisfactory. Manufacturers of UVA meters should be encouraged to provide instruments as reliable as the dosimeters used in radiotherapy, in which the prescribed dose is probably within 5% of the true value. Ideally, a standard type of UVA meter with appropriate physical properties and an agreed calibration procedure should be used by all centers engaged in PUVA treatment. PMID- 3805365 TI - Transfer of hepatitis B virus by contaminated reusable needle electrodes after electrodesiccation in simulated use. AB - Reusable needle electrodes have been standard for electrodesiccation procedures commonly done by dermatologists. This study investigates the risk of transmission of hepatitis B virus by such electrodes during simulated use with electrodesiccation. Sterile needle electrodes were inoculated with either purified hepatitis B surface antigen (HBsAg+) concentrate or serum positive for both HBsAg and deoxyribonucleic acid (DNA) polymerase activity (a measure of infectious and replicating hepatitis B virus), followed by simulated use for electrodesiccation at various settings and rinsing of the tip with negative serum. The rinse serum was then assayed for HBsAg, DNA polymerase activity, and the presence of viral particles by electron microscopy. HBsAg could be transferred through the electrodesiccation procedure at all settings used. Although DNA polymerase activity was negative in the rinse serum, electron microscopy demonstrated transfer of HBsAg forms and complete virus. These results suggest a potential risk of spread of hepatitis B virus by reusable needle electrodes for electrodesiccation. PMID- 3805366 TI - Premature epiphyseal closure--a complication of etretinate therapy in children. AB - Two children are described who developed premature epiphyseal closure while receiving etretinate for treatment of congenital hyperkeratotic disorders. The first patient was an 8 1/2-year-old boy with nonbullous ichthyosiform erythroderma who had been on treatment for 6 years, 4 months when premature fusion of the right distal tibial epiphysis was detected. Shortness of stature, thinning of long bones, and traumatic fractures were also observed in this patient. The second child was an 11-year-old girl with systematized verrucous nevi in whom symmetric fusion of both elbow epiphyses and narrowing of the femoral epiphyses bilaterally were noted following treatment with etretinate for 5 years, 5 months. PMID- 3805367 TI - The dentate tongue as a manifestation of tension. PMID- 3805368 TI - Impotence in silicosis-associated scleroderma. PMID- 3805370 TI - Climatotherapy of psoriasis at the Dead Sea. PMID- 3805369 TI - Coexistence of Sezary syndrome and dysmyelopoiesis with an excess of myeloblasts. PMID- 3805371 TI - Oral mucosal hair: an ectodermal anomaly. PMID- 3805372 TI - Gentian violet and wound repair. PMID- 3805373 TI - Pimozide for delusions of bromosis. PMID- 3805374 TI - Notalgia paresthetica. PMID- 3805375 TI - Alcohol and acquired acrodermatitis enteropathica. PMID- 3805377 TI - Bart's syndrome. PMID- 3805376 TI - Simultaneous treatment with rifampin and ketoconazole. PMID- 3805378 TI - Structural abnormalities of the hair shaft. AB - Abnormalities of the hair shaft are varied and often confusing. They do require accurate recognition, which can be helpful in the diagnosis and management of a hair disorder, or in the detection of underlying disease. A reliable evaluation of hair shaft abnormality is dependent on familiarity with the vast structural variations in normal hair, the hair growth cycle, and the changes produced by weathering. These structural abnormalities can be congenital or acquired, and some are associated with hair fragility. The classification used here has the advantage of simplicity and is keyed to easy recognition of the abnormalities under the light microscope. The four major types of abnormality are fractures, irregularities, twisting, and extraneous matter affecting the hair shaft. The diagnostic features of the different hair shaft abnormalities are outlined. PMID- 3805379 TI - Skin tumors in the European PUVA Study. Eight-year follow-up of 1,643 patients treated with PUVA for psoriasis. AB - In the continuation of the European PUVA Study, 1,643 patients of the original cohort of 3,175 patients enrolled in this prospective study were reevaluated for skin tumors after an average observation period of 96 months. Thirty-six patients with a total of seventy-one tumors (forty squamous cell carcinomas, twenty-three basal cell carcinomas) were observed. In contrast to the U.S. sixteen-center study, we were unable to demonstrate a clinically relevant increase in the risk of tumors induced by psoralens with ultraviolet A (PUVA), and we also failed to show a clear relationship between PUVA exposure and tumor development. Almost all patients with tumors had been exposed to various carcinogens before the initiation of PUVA. No tumors were detected in patients without such prior treatment, although 10% of the patients had received more than 3,000 joules/cm2 total cumulative phototoxic PUVA dose during the observation period. The discrepancy between the results of the U.S. study and our findings may partly be explained by a variety of factors such as a different treatment approach, a different attitude toward sun exposure, and the overall lower incidence of skin cancer in the European population. PMID- 3805380 TI - Kyrle's disease. AB - Kyrle's disease is a chronic, genetically determined, hyperkeratotic disorder occurring in the middle forties. We report fourteen cases of this disorder in a population of 1.5 million over a period of 15 years. We observed a female/male ratio of 6:1. Straw-colored keratotic plugs and flat scale show a marked predisposition for the calf, the tibial region, and the posterior part of the thigh. They vary in size from 1 to 4 mm, and there is occasional plaque formation. No koebnerization or pruritus was noted, and no statistically significant association with hepatic, renal, or diabetic disorders could be demonstrated. Microscopic features showed a consistent pattern of keratotic plug formation, with the plug sitting in an invaginated atrophic epidermis, and underlying dermal histiocyte and lymphocyte aggregation. All lesions contained orthokeratosis and parakeratosis, with some sections showing abnormal keratinization. Sodium dodecylsulfate gel electrophoresis did not demonstrate the presence of abnormal keratin bands. PMID- 3805381 TI - Systemic lupus erythematosus in association with smoldering multiple myeloma. PMID- 3805382 TI - Antifungal efficacy of a combination of benzoic and salicylic acids in a novel aqueous vanishing cream formulation. PMID- 3805383 TI - Localized oral and perioral lesions in chronic graft-versus-host disease. PMID- 3805384 TI - Cutaneous mucinosis in the toxic oil syndrome. PMID- 3805385 TI - Pyoderma gangrenosum with simultaneous contiguous arthritis. PMID- 3805386 TI - A falling out following minoxidil: telogen effluvium. PMID- 3805387 TI - Dermatofibroma occurring in a smallpox vaccination scar. PMID- 3805388 TI - Coumadin versus heparin necrosis. PMID- 3805389 TI - Essentials for specialty and subspecialty training in dermatology. PMID- 3805390 TI - Peculiar papular skin lesions occurring in hepatitis B carriers. AB - Various cutaneous signs and syndromes have been associated with hepatitis B virus infection. This is a report of the clinical, pathologic, immunofluorescence, and immunoperoxidase studies of peculiar papular lesions that have been observed to occur during the chronic phase of hepatitis B virus infection. A total of thirteen patients positive for hepatitis B surface antigen (HBsAg) were studied. Twelve had asymptomatic, recurrent, erythematous papular lesions localized on the back, chest, and proximal areas of the upper extremities that lasted 6 to 7 days. The histopathology of these skin lesions showed a superficial and deep perivascular dermal mononuclear cell infiltrate. Immunoperoxidase studies for HBsAg and direct immunofluorescence for IgG, IgM, IgA, and C3 showed negative results. An abnormal host response to viral antigens other than HBsAg is suggested as a possible mechanism responsible for appearance of these skin lesions. PMID- 3805391 TI - On the pathogenesis of idiopathic guttate hypomelanosis. AB - Idiopathic guttate hypomelanosis is a common leukodermic dermatosis of obscure origin, consisting of small 2- to 5-mm achromic or hypopigmented macules, mainly affecting the exposed upper and lower extremities. In a group of 400 consecutive dermatologic patients, idiopathic guttate hypomelanosis was much more prevalent in women than in men. However, in both sexes this prevalence became more common with advancing age. In another group of fifteen patients with idiopathic guttate hypomelanosis and fifteen normal controls matched by age, sex, and skin type, the following was found: A cause-effect relationship between chronic actinic exposure and the development of idiopathic guttate hypomelanosis could not be established by statistical studies. A family aggregation survey disclosed a higher prevalence of idiopathic guttate hypomelanosis in the family of patients with idiopathic guttate hypomelanosis than in the control group. Epithelial atrophy, patchy absence of melanocytes and melanin, flattening of the rete pegs, and basket weave hyperkeratosis were the most prominent histologic findings of idiopathic guttate hypomelanosis. Minigrafts of normal skin implanted in idiopathic guttate hypomelanosis lesions did not modify the achromic defects, whereas intralesional triamcinolone with or without grafts improved the appearance of these lesions. PMID- 3805392 TI - A kindred with alopecia, keratosis, pilaris, cataracts, and psoriasis. AB - Three members of a family with numerous ectodermal abnormalities are described. These anomalies primarily include patchy alopecia beginning in childhood, premature cataracts, widespread keratosis pilaris, and psoriasis. The alopecia and premature cataracts appear to follow an autosomal dominant inheritance pattern with incomplete penetrance and appear to be linked. Psoriasis also occurs in several members of this family and probably represents a separate but possibly related genodermatosis. This kindred has features of both keratosis follicularis spinulosa decalvans and ichthyosis follicularis, and the disorder seems to fit into the group of follicular hyperkeratosis disorders. PMID- 3805393 TI - Paraproteinemia in patients with scleredema. Clinical findings and serum effects on skin fibroblasts in vitro. AB - Four patients with paraproteinemia and scleredema were studied. Histologic features included marked thickening and fibrosis of the dermis and subcutis. Variable amounts of mucin deposits were detected in the interfibrillar spaces. Serum from one patient significantly stimulated collagen production in normal skin fibroblast cultures, whereas serum from another patient stimulated collagen production in autologous cell cultures. Moreover, serum from one patient stimulated the [35S]sulfate incorporation into the fibroblasts. Circulating serum factors, possibly related to the paraprotein, may enhance the synthesis of extracellular macromolecules by dermal fibroblasts in these patients, thus providing a mechanism for dermal fibrosis. PMID- 3805394 TI - Computed tomography of ureteral tumors. AB - Ten patients with one or more ureteral tumors were examined with CT. The tumor was clearly recognizable as a soft tissue mass (average density 46 HU) filling the ureter in nine of the patients. In five of these patients the tumor was not detected by urography. Tumors less than 5 mm in diameter were missed on CT in one patient. Although most ureteral tumors are detectable with urography and retrograde pyelography, CT can be a valuable diagnostic tool. Computed tomography is particularly advantageous in patients with nonfunctioning kidneys and in those in whom retrograde pyelography is unsuccessful. PMID- 3805395 TI - Perinephric hemorrhage in autosomal dominant polycystic kidney disease: CT and MR findings. AB - Perinephric hemorrhage is a rare complication of autosomal dominant polycystic kidney disease (ADPKD). Of 66 patients in our series, it occurred in two (3%) and their clinical and radiologic findings are described. Computed tomography accurately delineated both hematomas and revealed an underlying ruptured hemorrhagic renal cyst in one patient. Computed tomography did not show the cause of hemorrhage in the other patient, but magnetic resonance (MR) imaging detected an underlying hemorrhagic cyst. Perinephric hemorrhage in ADPKD probably results from rupture of hemorrhagic renal cysts into the perinephric space. Computed tomography is the optimal method for its evaluation. However, MR may supplement CT findings since it detects more hemorrhagic cysts than CT and helps distinguish them from carcinomas. Perinephric hemorrhage in ADPKD can usually be managed conservatively. PMID- 3805396 TI - Computed tomography of retroperitoneal cystic lymphangiomas. AB - The CT features of retroperitoneal lymphangiomas are unilocular or multilocular cysts in the retroperitoneum and slightly and uniformly thickened wall that enhances following contrast medium administration. Three cases are reported. PMID- 3805397 TI - MR imaging of fetal brain. AB - Magnetic resonance (MR) imaging was used to evaluate normal fetal intracranial anatomy in axial, coronal, and sagittal planes. The T1 and T2 weighted images (WI) of aborted fetuses of varying gestational ages were correlated with anatomic sections. In the premature fetus three distinct intensity zones were seen on MR that were not visualized on gross specimens. Unmyelinated white matter displays low intensity on T1 W1 and high intensity on T2 W1. Maturational changes of the brain were observed with advancing fetal age. PMID- 3805398 TI - Selective three-dimensional MR imaging of the spine. AB - A recently developed selective three-dimensional (3D) Fourier transform imaging technique offers several advantages over conventional two-dimensional multislice magnetic resonance imaging of the spine. These advantages include improved signal to-noise ratio, thinner slices without gaps, and shorter echo time/repetition time pulse sequences. Five normal volunteers and 30 patients with a variety of spinal pathology were examined using surface coils. The 3D technique appears very promising and could become the major method for imaging the spine. PMID- 3805399 TI - CT appearance distinguishing benign nasal polyps from malignancies. AB - In many cases the common nasal polyp is confused clinically, radiographically, and, on occasion, pathologically with a tumor of the nasal vault and paranasal sinuses. Similarly, this distinction often cannot be made by CT. However, we have identified in 12 patients a CT appearance of looping, minimally or nonenhancing soft tissue densities within a mucoid density background matrix, that is associated with cases of polyposis (nine patients) and fungal disease (three patients). We believe that when this CT appearance is present, malignant disease can be essentially eliminated from the differential diagnosis. PMID- 3805400 TI - MR imaging of laryngeal cancer. AB - Forty-four consecutive patients with laryngeal carcinomas presenting at different stages of the disease were investigated by magnetic resonance (MR) imaging. Twelve patients (six with primary lesions and six with recurrent tumors) underwent laryngectomy, and the macro- and microscopic appearance of the slice specimens were correlated with MR imaging. In the remaining patients surgery was not performed, and MR results are compared with the laryngoscopic findings. Cancerous tissue was seen on T1-weighted images as a homogeneous mass of intermediate signal intensity. slightly higher than infrahyoid muscles. The MR examinations failed mainly in patients with tumor recurrence who had undergone previous radiation treatment. PMID- 3805401 TI - Quantitative evaluation of a dual energy CT system. AB - We have evaluated the accuracy of CT numbers produced by a prototype dual energy system. Solutions of known composition were scanned in simple cylindrical phantoms and the observed CT values in synthetic monochromatic images were compared with the expected values computed from published cross-section data. Although accuracy varied with both the composition of the solution and the energy selected for the synthetic monoenergetic image, for the solutions used the inaccuracy was less than the uncertainty of the photon cross-section data at 80 and 100 keV. Virtually no cupping artifact was present in the monoenergetic images. PMID- 3805402 TI - CT appearance of coronary aneurysm in Kawasaki disease. AB - Coronary aneurysms are the main complication of Kawasaki disease. The CT appearance of a left coronary aneurysm is reported. PMID- 3805403 TI - Computed tomography of aggressive fibromatosis in the posterior mediastinum. AB - We describe the CT appearance of aggressive fibromatosis that presented as a posterior mediastinal mass on chest radiography. PMID- 3805404 TI - CT evaluation of posterior mediastinal teratoma. AB - Plain radiography and CT features of a posterior mediastinal teratoma are presented. Computed tomography confirmed the posterior mediastinal origin of this mass, added information about its content, and revealed apparent sparing of the surrounding structures, thus playing an important role in surgical planning. PMID- 3805405 TI - CT demonstration of high attenuation pleural-parenchymal lesions due to amiodarone therapy. AB - We report a case in which CT demonstrated high attenuation pleural-parenchymal lesions (142-175 HU) and increased liver density (96.7 HU) in a patient on long term amiodarone therapy. PMID- 3805406 TI - Inversion of gallbladder secondary to traumatic herniation of liver: CT findings. AB - This report describes the CT and radioisotope diagnosis of a suprahepatic gallbladder with partial inversion of the liver resulting from traumatic rupture of the diaphragm. PMID- 3805407 TI - CT findings in lipomatosis of the gallbladder. AB - A case of fatty proliferation in the subserosa of the gallbladder wall (lipomatosis of the gallbladder) is presented. Ultrasonographic and CT findings are described. PMID- 3805408 TI - CT evaluation of limited splenic trauma. AB - One case is reported in which signs of limited splenic injuries were seen on initial CT evaluation. Delayed splenic rupture requiring splenectomy was observed by CT. These previously unreported signs of limited splenic trauma may add important management information to the current methods of diagnosing splenic injury. PMID- 3805409 TI - Clinical use of rapid T2 weighted partial saturation sequences in MR imaging. AB - Rapid T2 dependent field echo [partial saturation (PS)] sequences were used in 38 patients with brain tumors, intracerebral hematomas, and cerebral infarction as well as other neurological and abdominal disease. Reduction in the radiofrequency excitation angle (alpha) from 90 to 30 degrees produced an increase in lesion contrast as did change of echo time (TE) from 33 to 59 or 120 ms using repetition time (TR) values in the range of 120-500 ms. The PS sequence showing most lesion contrast was compared with conventional spin echo (SE 1,500/80 and SE 1,500/120) and inversion recovery (IR 1,500/500/44 and IR 1,500/100/44) sequences. Although PS sequences with TE = 39 ms were usually inferior to conventional SE sequences, those with TE = 59 or 120 ms were comparable and in some cases (particularly hematomas) superior. The PS sequences with alpha of approximately 30 degrees, TR of 80-250 ms, and TE of 60-120 ms offer considerable savings in time compared with conventional sequences although more work will be required to explore the limits of this approach and to optimize sequences at different field strengths. PMID- 3805410 TI - CT diagnosis of dorsal pancreas agenesis. AB - We report a case of agenesis of dorsal pancreas diagnosed by CT. This anomaly can easily be confused with pancreas divisum on endoscopic retrograde cholangiopancreatography alone. PMID- 3805411 TI - CT findings in acute thrombosis of superior mesenteric vein aneurysm. AB - The CT findings in a case of surgically proven thrombosed aneurysm of the superior mesenteric vein are described. The location of the aneurysm and recognition of the CT features of venous thrombosis may allow preoperative diagnosis. PMID- 3805412 TI - CT diagnosis of traumatic rupture of the cisterna chyli. AB - The CT findings are presented in a patient with chyloperitoneum and chyloretroperitoneum following blunt trauma to the cysterna chyli. The simultaneous demonstration of both intraperitoneal and extraperitoneal water density fluid appears to be specific for this injury. PMID- 3805413 TI - MR findings in extracranial cysticercosis. AB - A patient with disseminated cysticercosis involving orbit, tongue, parotid glands, epicardial fat, muscle, and subcutaneous tissues is presented. Magnetic resonance findings are described with emphasis on intraorbital and extracranial lesions. PMID- 3805414 TI - Computed tomography of lingual thyroid. AB - The CT findings of a lingual thyroid are presented. A round, well-defined, homogeneously enhancing mass at the base of the tongue suggested the diagnosis leading to the confirmatory isotope scan. PMID- 3805415 TI - Intracerebral hematoma developing during MR examination. AB - We report a case of a 78-year-old woman with cerebellar infarction who developed intracerebral bleeding during the magnetic resonance (MR) examination. The intensity of the hematoma was heterogeneous corresponding to the heterogeneous density shown on CT study that immediately followed the MR examination. PMID- 3805416 TI - MR imaging of Chiari II malformation associated with dysgenesis of cerebellum and brain stem. AB - Extensive cerebellar hypogenesis is rare in Chiari II malformation and, to our knowledge, has not been described in modern radiological literature. In our case near total absence of cerebellar tissue and "underdevelopment" of the brain stem were noted in a patient with several characteristic features of Chiari II malformation. PMID- 3805417 TI - Intraparenchymal meningioma in a child: CT and MR findings. PMID- 3805418 TI - Thalamic histoplasmoma: CT and MR imaging. PMID- 3805419 TI - Clivus chordoma in a child with tuberous sclerosis: CT and MR demonstration. PMID- 3805420 TI - Bilateral synovial cysts creating spinal stenosis: CT diagnosis. PMID- 3805421 TI - CT appearance of localized pulmonary amyloidosis. PMID- 3805422 TI - MR imaging of a fractured temporomandibular disk prosthesis. PMID- 3805423 TI - Clinical magnetic susceptibility mapping of the brain. AB - A field mapping technique was used to detect changes in the local magnetic field in 14 tumors, five hematomas, one lacunar infarct, and two cases of multiple sclerosis. These changes were attributed to variations in the tissue susceptibility. A partial or complete rim of changed susceptibility was detected at the margin of five of the tumors and localized changes were seen within two of the tumors. All five hematomas displayed susceptibility effects. These were seen at the rim of the hematoma in all cases but central effects were also seen in four cases. One area of probable lacunar infarction also displayed susceptibility effects. The effects described may be due to the paramagnetic contribution of species such as deoxyhemoglobin, methemoglobin, free ferric iron, hemosiderin, and other breakdown products of blood. Local field inhomogeneities due to changes in tissue susceptibility have implications for magnetic resonance (MR) image interpretation and the performance of MR spectroscopy. PMID- 3805424 TI - Rapid three-dimensional angiography with undersampled MR imaging. AB - Techniques for subtraction angiography with magnetic resonance imaging have been extended from two to three dimensions, and a novel method that reduces the expected data acquisition time by at least an order of magnitude is presented. Electrocardiogram-gated three-dimensional (3D) images are acquired by Fourier transform technique, and flow contrast is obtained by subtracting pairs of images acquired at different points in the cardiac cycle. The vascular tree is shown in 3D perspective by means of a surface detection and a 3D display program. Isotropic 3D angiography requires determining the disposition of the blood vessels in a matrix of cubical voxels. Using orthodox Fourier transform technique, for an image matrix with 256 voxels to the edge, a data acquisition with 256 X 256 = 65 K phase-encodings would be needed. If gated, this would require approximately 1 day. In this study we abbreviate the data acquisition by doing only 1/64 of the usual set of phase-encoding gradient pulses. Spatial resolution is undiminished, but aliasing or "wraparound" results in each of the two phase-encoded coordinates of the 3D image. This aliasing is rectified in a two stage process. First, 64 copies of the undersampled 3D arteriogram are juxtaposed in a two-dimensional grid pattern. This assembles many copies of the complete vascular tree. Because they occupy only a small fraction of ambient volume, these copies are unlikely to overlap or collide with one another. Second, a single copy of the vascular tree is isolated by a surface detection program that takes advantage of the fact that the vascular tree is topologically connected. Studies of the abdominal aorta are presented. PMID- 3805425 TI - MR flow imaging by velocity-compensated/uncompensated difference images. AB - The phase shifts acquired by motion of excited spins along magnetic field gradients can result in decreased signal intensity from blood vessels in conventional magnetic resonance images. The imaging technique can be modified with the use of additional gradient pulses so as to either compensate these phase shifts and increase the signal from the vessels or augment the phase shift and decrease the signal, without altering the signal from stationary tissues. Making a difference image from images made with and without sensitization to motion will cancel out the stationary tissues, leaving an image of the vessels alone. The technique does not require cardiac gating, shows veins as well as arteries, and can be performed in an interleaved manner to avoid registration errors due to patient motion. PMID- 3805426 TI - Gadolinium cryptelates as MR contrast agents. AB - Gadolinium cryptelates are complexes of a lanthanide metal ion with amino acids of macrocyclic polyamines. These compounds are water soluble and possess reduced relaxation properties similar to Gd diethylene triamine pentaacetic acid (DTPA). Three Gd cryptelates (Gd NOTA, DOTA, TETA) were evaluated. Gadolinium DOTA is the most stable Gd complex with a dissociation constant of 10(-28) and appears to have a greater serum stability than Gd DTPA. Gadolinium NOTA and Gd TETA have lower dissociation constants than Gd DTPA at 10(-17) and 10(-19). Gadolinium DOTA has tissue distribution properties similar to Gd DTPA, is rapidly excreted by the kidneys, and provides a high degree of contrast enhancement on magnetic resonance (MR) images, both systemically and within the CNS. Hence, Gd DOTA is an alternative water-soluble MR contrast agent to Gd DTPA. PMID- 3805427 TI - Comparison of CT with MR imaging of endobronchial tumors. AB - Twenty-nine patients suspected of having an endobronchial mass were examined by magnetic resonance (MR) and CT. Seventy-nine pathological and 319 normal bronchi were confirmed by bronchoscopy and/or operation in these patients. The studies were evaluated by two observers (A and B): By MR, only 72% (A) or 71% (B) of the pathological and 45% (A) or 43% (B) of the normal bronchi, respectively, were visualized. Computed tomography identified all pathological and 97% of the normal bronchi (A and B). Therefore, comparison between MR and CT was based only on those bronchi that were adequately visualized on MR as well as CT. For these bronchi the sensitivity of MR was 88% (A) or 77% (B) and of CT 96% (A) and 93% (B). Specificity was 92% (A) and 94% (B) for MR and 97% (A and B) for CT. At the present stage of development CT proved to be superior to MR in demonstrating endobronchial lesions. PMID- 3805428 TI - Variable CT appearance of plasma cell granuloma of the lung. AB - Plasma cell granuloma of the lung is an uncommon benign inflammatory pseudotumor. Although it typically presents as a solitary mass on chest radiography, several chest film appearances have been described. Three cases are presented that illustrate the variable range and nonspecificity of CT appearances of plasma cell granuloma of the lung. Computed tomography is useful in the evaluation of these lesions primarily to establish important anatomic relationships associated with each of the various manifestations. PMID- 3805429 TI - CT/bronchographic correlations in bronchiectasis. AB - Bronchiectasis is an irreversible bronchial dilation that may require surgery for successful treatment. Plain radiographic findings are usually not specific, and bronchography is often necessary for confirmation. We compared CT with bronchography to assess the utility of CT in diagnosing and determining the extent of bronchiectasis. Twenty-six bronchograms were performed in 14 patients. A segment-by-segment analysis of the presence, extent, and type of bronchiectasis was made. In 10 lungs, results of bronchography and CT were both negative, and in 10 other lungs results of CT and bronchography were both positive. In six lungs CT results were negative, but results of bronchography were positive. There were no false-positive CT diagnoses. In six of 10 lungs in which CT and bronchography demonstrated bronchiectasis the extent of disease was underestimated by CT. False negative CT occurred when there were small foci of cystic bronchiectasis (minimal degrees of cylindrical bronchiectasis), or when pulmonary opacities obscured the bronchi. In three cases, thin section (1.5 mm) CT demonstrated improved definition of bronchi but did not alter the estimated extent of bronchiectasis. We conclude that, although in 77% (20/26) of the lungs CT correctly detected or excluded bronchiectasis, CT was less sensitive than bronchography and underestimated the number of diseased segments. PMID- 3805430 TI - CT demonstration of prominent right hilar soft tissue collections. AB - Three cases of normal soft tissue collections of the right hilum which could be confused with thrombus of the right pulmonary artery or adenopathy are demonstrated. These abnormalities are due to normal accumulations of hilar fat and lymph nodes. Their typical appearance allows easy recognition. PMID- 3805431 TI - Contrast in rapid MR imaging: T1- and T2-weighted imaging. AB - Partial saturation (PS) is an imaging technique that is useful in applications that require rapid image acquisitions (imaging time less than 1 min). Image contrast in PS imaging, as in other magnetic resonance methods, depends on the often conflicting effects of differences in proton density, T1, and T2. Previous analyses of pulse sequence optimization to maximize image contrast have assumed 90 degrees pulses and examined the effects of varying repetition times (TR) and echo times (TE). In this paper we present theoretical calculations and images made with a 0.6 T imager to show that the radiofrequency pulse tip angle alpha, and not the pulse sequence timing parameters, is the most important parameter for producing image contrast. For large tip angles (alpha greater than or equal to 60 degrees), contrast is primarily determined by differences in T1, but for small tip angles (alpha approximately equal to 25 degrees), contrast is primarily due to differences in T2. The T2-weighted images can be produced as quickly as T1 weighted images by using a small pulse angle and a long TE; it is not necessary to use a long TR to reduce the effects of T1 differences. Optimum pulse angles are calculated, and the potential advantages and disadvantages of T2-weighted and T1-weighted PS imaging are discussed. PMID- 3805432 TI - CT diagnosis of acalculous cholecystitis. AB - Acalculous cholecystitis is an uncommon but potentially fatal complication of prolonged critical illness. Both clinical and biochemical parameters lack sufficient sensitivity and specificity to confidently make the diagnosis preoperatively. Over a 2 year period we have evaluated 16 patients with suspected acute acalculous cholecystitis by CT. Based on CT findings, a positive diagnosis of acalculous cholecystitis was made in seven of these patients and confirmed pathologically in six. Criteria used in reaching the CT diagnosis and potential advantages of CT over other imaging modalities in this clinical context are considered. PMID- 3805433 TI - CT and MR imaging in staging bladder neoplasms. AB - Thirteen patients with bladder carcinoma were examined by magnetic resonance (MR) imaging and CT to determine the relative accuracy of the modalities in staging bladder carcinoma. Magnetic resonance correctly identified the presence or absence of extravesical spread of carcinoma in 10 of 13 patients (77%). Two patients were understaged and one was overstaged. Computed tomography correctly staged nine of 13 patients (69%), with three patients understaged and one patient overstaged. Neither MR nor CT was able to determine depth of invasion of the bladder wall in the absence of extravesical spread. PMID- 3805434 TI - Changes in ego and moral development in adolescents: a longitudinal study. AB - A longitudinal study was designed to examine the relation between Loevinger's measure of ego development and moral development as indexed by Rest's Defining Issues Test in a sample of 123 adolescents at 12 to 14 years of age and four years later. Study I assessed differential rates of change and theoretically predicted directions of change in the two developmental functions and gender differences in ego development. Substantial ego stage movement occurred (60 per cent advancement, 40 per cent stability); moral growth was moderate. Girls scored a half ego stage ahead of boys; patterns of directional change were similar. Ego level and moral development related at either fixed point in time, but ego functioning in early adolescence did not predict subsequent moral development. Study II addressed adolescents' perceptions of parenting styles in relation to these social cognitive functions. Parental behaviours that involve loving or support related to higher ego levels; parental demanding associated with lower ego development in early adolescence. Traditional gender-related parent socialization was found among girls and boys with greater ego development. The mediating role of perceived childrearing styles was considered in relation to gender differences in ego development. PMID- 3805435 TI - Evaluating ego defense mechanisms using clinical interviews: an empirical study of adolescent diabetic and psychiatric patients. AB - Ego defense mechanisms were studied in three groups of early adolescents: diabetic patients, non-psychotic psychiatric patients, and healthy high school students. Defenses were assessed from ratings of open-ended, in-depth interviews. High levels of denial and low levels of asceticism were found in all three groups. Comparisons between groups indicated that psychiatric patients had a distinctive profile of defense usage, in comparison to adolescents from the other two groups. An independent measure of ego development was positively correlated with the defenses of altruism, intellectualization, and suppression, while it was negatively correlated with acting out, avoidance, denial, displacement, projection, and repression. The findings of substantial differences in defense usage between the psychiatric and non-psychiatric samples, and the size and directions of the correlations with ego development level, lend support to the validity of the defense codes. PMID- 3805436 TI - Identity crisis modality: a technique for assessing the structure of the identity crisis. AB - In this paper an interpretation of Erik Erikson's theoretical notions of the severity, prolongation, and aggravation of the identity crisis is presented and operationalized in terms of "identity crisis modality", a concept representing prevailing patterns of identity formation. The reliability and validity of the Identity Crisis Modality Chart (ICMC), an "objective-projective" instrument, is assessed and its various possible and unique uses, ranging from clinical applications to large scale national surveys, are discussed. PMID- 3805437 TI - The relative importance of identity status interview components: replication and extension. AB - The present study partially replicates and extends the work of Rogow et al. (1983) in probing the relative importance of Ego Identity Status Interview components for both sexes. Eighty female and sixty male students attending a New Zealand university were given the Ego Identity Status Interview with identity components of occupation, religion, politics, and sex role beliefs presented in counterbalanced order. Subjects were then asked to rank components in order of importance to their sense of identity and additional identity contents were explored through open-ended questions. This investigation revealed few sex differences in terms of number of content areas having a common rating, hit rates between single or paired content areas and overall identity ratings, rank order for importance of identity contents, or reported areas of additional identity concerns. In support of Rogow findings, this study suggests that identity not be viewed as a unitary structure and encourages the reporting of both component and overall identity status ratings to allow a more comprehensive means of researching the identity formation process. In general, the identity status approach provides a useful model for clinical research of ego synthesis in late adolescence. PMID- 3805438 TI - Psycho-social aspects of youth unemployment: an interpretative theoretical model. AB - By utilizing representative samples of short-term (n = 33), long term (n = 14) unemployed adolescents and YTS trainees (n = 49) in North-East Scotland, the present study attempted to identify psycho-social variables involved in the individual adolescent's ability to cope with unemployment. The research was built around a series of semi-structured interviews with all subjects. Results suggested a variety of apparent contradictions--family support vs. parental pressure; informal community-based education as helpful vs. school education as irrelevant; high aspirations as reinforcing or frustrating; peer groups as supportive or socially constraining; time structure as welcome or monotonous and restrictive; self-esteem being sapped or maintained aggressively and defensively high. From the data a theoretical model is offered which attempts to resolve the paradoxes by interpreting the experience of unemployment for young people in terms of positive and negative "trade-offs". PMID- 3805439 TI - The early outcome of admission to an adolescent unit: a report on 100 cases. AB - Data are presented on the outcome of 100 adolescents after discharge from an adolescent inpatient unit. Outcome is recorded in terms of placement at home, day care provision, and partial or full-time residential care provision, relating this to diagnosis, sex, age, duration of admission and evidence of family pathology. Of these only duration of admission was significantly related to outcome. More than two thirds (69 per cent) of all patients are discharged home. At six months, of those traced, 82 per cent are at home. Stability of outcome is the norm. This reflects the bio-psycho-social approach of the unit and refutes the notion that psychiatric institutional care for adolescents merely predicts a continued need for therapeutic resources. PMID- 3805440 TI - Measuring passionate love in intimate relationships. AB - Theorists such as Farber argue that in adolescence passionate love first appears in all its intensity. Both adolescence and passion are "intense, overwhelming, passionate, consuming, exciting, and confusing". As yet, however, clinicians have been given little guidance as to how to deal with adolescents caught up in their passionate feelings. Nor has there been much research into the nature of passionate love. In Section I of this paper, we define passionate love, explain the necessity of developing a scale to measure this concept, and review evidence as to the nature of passionate love. In Section 2, we report a series of studies conducted in developing the Passionate Love Scale (the PLS). We present evidence as to the PLS's reliability, validity, and relationship to other factors involved in close relationships. We end by describing how we have used this scale in family therapy to open conversations about the nature of passionate love/companionate love/and intimacy... and discussing profitable directions for subsequent research. PMID- 3805441 TI - Influence of temperature on associative growth of Streptococcus thermophilus and Lactobacillus bulgaricus. AB - Compatibility of Streptococcus thermophilus and Lactobacillus bulgaricus during associative growth as dependent on optimum growth temperature was determined. Optimum growth temperatures for 9 strains of S. thermophilus and 10 strains of L. bulgaricus ranged from 35 to 42 degrees C for S. thermophilus and 43 to 46 degrees C for L. bulgaricus. Streptococcus thermophilus and L. bulgaricus strains exhibiting similar to divergent optimum growth temperatures were combined (1:1 vol/vol) and incubated in milk at 37, 42, and 45 degrees C until pH 4.2 was reached. Initial and postincubation cell numbers were determined by plate count method. Streptococcus thermophilus strains reached greater cell numbers than L. bulgaricus at 37, 42, and 45 degrees C in 93.3% of the mixed culture trials. Average rod-coccus ratios obtained at 37, 42, and 45 degrees C were 1:2.2, 1:8, and 1:2.4, respectively. Optimum growth temperatures had no influence on growth of L. bulgaricus and S. thermophilus in mixed culture. Rather, temperature appeared to influence compatibility by determining the concentration or type of stimulatory factor(s) produced by L. bulgaricus. All strains of S. thermophilus exhibited an uncoupling of growth from acid production. Optimum temperature for acid production ranged from 2 to 8 degrees C above optimum growth temperature. These findings warrant consideration in the manufacture of yogurt and other fermented milk products. PMID- 3805442 TI - Improved media for differentiation of rods and cocci in yogurt. AB - Selected yogurt starters and commercial samples grew on Elliker's lactic agar supplemented with .1% Tween 80 and 50 micrograms/ml of 2,3,5-triphenyltetrazolium chloride to produce small, red Streptococcus thermophilus colonies and larger, white Lactobacillus bulgaricus colonies. The distinction was somewhat strain dependent but was satisfactory in most cases. Addition of 7% skim milk (11% solids) to lactic agar in place of 2,3,5-triphenyltetrazolium chloride allowed good rod-coccus differentiation, regardless of strain or yogurt brand. On this medium, called yogurt lactic agar, L. bulgaricus appeared as large white colonies surrounded by a cloudy zone and S. thermophilus as smaller white colonies devoid of a surrounding halo. Casein precipitation was responsible for the halo effect around the more acidogenic L. bulgaricus colonies. Yogurt lactic agar compared favorably with S. thermophilus and Lactobacillus agar media for the recovery of S. thermophilus and L. bulgaricus in single and mixed cultures. PMID- 3805443 TI - Requirement for a sulfhydryl group for sulfhydryl oxidase activity. AB - Sulfhydryl oxidase was isolated from bovine skim milk membranes using a transient covalent affinity chromatographic method. This preparation exhibited two chemically reactive sulfhydryl groups in the native enzyme and three in the denatured form, based on a subunit weight of 85 kdaltons. The kinetics of inactivation by carboxymethylation with iodoacetate indicated that modification of one sulfhydryl group per enzyme subunit caused complete loss of activity. These results, together with the enzyme's attachment to cysteinylsuccinamidopropyl-glass and the observed initial rate enzyme kinetics, strongly implicate a substituted-enzyme kinetic mechanism with a mixed disulfide as the intermediate enzyme form. PMID- 3805444 TI - Bioavailability of iron in goat milk compared with cow milk fed to anemic rats. AB - Bioavailabilities of iron from dehydrated whole and skim goat milk were investigated using iron-deficient rats. Hemoglobin regeneration efficiencies were determined as the percent conversion of dietary iron into hemoglobin. The respective hemoglobin regeneration efficiencies for groups fed whole goat milk, whole cow milk, skim goat milk, and skim cow milk were 50.6, 13.1, 26.0, and 13.0%, indicating that iron bioavailability of goat milk was greater than cow milk. However, rats fed each milk had negative net increases in hemoglobin concentrations, implying that the iron contents of each milk were not adequate. For animals consuming whole goat milk supplemented with ferrous sulfate, the slope relating hemoglobin iron gained versus iron intake was .95. Respective bioavailabilities relative to ferrous sulfate were 54, 14, 28, and 14% for the four sources of milk. Iron bioavailability of goat milk is superior to cow milk when fed to anemic rats. PMID- 3805445 TI - In vitro fermentation of sugars, grains, and by-product feeds in relation to initiation of ruminal lactate production. AB - In vitro fermentations of various sugars, grains, and by-products were conducted to investigate the relationships between soluble carbohydrates and initiation of ruminal lactate production. Fermentation of hexose sugars, both monosaccharides and disaccharides, resulted in greater accumulation of lactate than did fermentation of pentoses. Results of fermentation of grains and by-products, in order of greatest to least potential to produce lactic acid, were steam-flaked barley = barley = wheat greater than moisture corn = sorghum grain. Water-soluble fractions of the grains and by-products were more rapidly fermented to lactate than the insoluble fractions. Combining 10% soluble fractions from wheat, barley, and steam-flaked barley with 90% insoluble fractions from corn resulted in significant increases in lactate concentration. Analysis of sugar composition of these water soluble materials indicated that monosaccharides and disaccharides constitute 23 to 46% by weight. Data suggest that water-soluble materials play a role in initiation of lactate production from grains, and further production is dependent on starch fermentability. PMID- 3805446 TI - Predicting maternal protein and fat balances of growing and mature dry cows. AB - To examine factors affecting maternal protein and fat changes of dry cows, we fed a diet of silages at varying intakes. Conceptus-corrected balances (fat and protein) were computed and predicted from ration protein and energy densities (digestible, metabolizable, or total digestible nutrients), predry body weight, dry matter intake as percents of body weight or predry body weight, and square or natural log of each. Maximum daily dry matter intake was 1.8% of body weight. Observed energy density did not change with changing intake. Proportion of ingested energy apparently stored increased with dry matter intake/predry body weight, primarily at the expense of heat production. Partition of energy and nitrogen were not significantly affected by this intake expression. Cows in first and subsequent dry periods fed low intakes had positive maternal fat balances at energy intakes equal to or below established maintenance requirements. Body condition score of primiparous cows did not increase and their growth was related to dry matter intake, predry weight, total digestible nutrients, and protein percentage of the diet; daily maternal fat balance followed protein balance (2:1 ratio) up to energy intake 14% above maintenance, thereafter increasing to 4:1 ratio. In older cows, maternal daily fat balance varied primarily with digestible energy density of ration, intake, and to a lesser extent with predry weight and ration protein; protein balance was not closely related to factors studied. PMID- 3805447 TI - Effects of ruminal exposure on the amino acid profile of heated and formaldehyde treated soybean meal. AB - Rumen cannulated Holstein steers, fed corn silage and a corn-soybean grain mixture twice a day, were used to compare the effectiveness of heat and formaldehyde treatments in preserving the amino acid profile of soybean meal exposed to ruminal fermentation for 12 h. Formaldehyde treatments were 0, .3, .6, and .9 g/100 g soybean meal. Defatted soybean flakes treated at 250, 250, 215, and 180 degrees C for 30, 20, 20, and 25 min, respectively, and unheated soybean meal comprised the heat treatments. The in situ polyester bag technique was used to obtain estimates of ruminal degradation of the treated and untreated soybean meals and to obtain undegraded residues from the soybean meals following 12 h of rumen exposure. Diaminopimelic acid was used to assess the extent of bacterial contamination. Significant amounts of apparent diaminopimelic acid were detected in unexposed samples (2.0 to 7.6% of soybean nitrogen) and in residues (4.8 to 12.7% of residue nitrogen). Significant differences in amino acid contents were detected between untreated and heat-treated soybean meals and their respective residues. Formaldehyde treatment was effective in preserving the original amino acid profile of soybean meal. PMID- 3805448 TI - Digestibility of nitrogen in heat-damaged alfalfa. AB - In order to partition indigestible N in heat-damaged forages into its various chemical fractions, alfalfa (41.1% dry matter), stored in an upright stave silo, was not sealed, and heating was promoted. Silage was labeled as unheated silage (temperature below 20 degrees C); 35 degrees C silage (temperature near 35 degrees C, 5220 degrees C d); and 60 degrees C silage (temperature near 60 degrees C, 10,800 degrees C d). Total amino acid content of 60 degrees C silage was lower and acid detergent insoluble amino acid content was higher than in 35 degrees C or unheated silages. Apparent N digestibilities, determined using lactating dairy cows, were 47.5, 48.4, and 63.6% for 60 degrees C, 35 degrees C, and unheated silages. Estimates of true N digestibility were 76, 76, and 90%; true digestibility coefficients for amino acid N were 86, 92, and 95%; and true digestion coefficients for nonamino acid N were 67, 45, and 69% for 60 degrees C, 35 degrees C, and unheated silages. Two possible causes for depressed N digestibility of 60 degrees C silage were 1) the ratio of poorly digested nonamino acid N to highly digested amino acid N was higher in 60 degrees C silage than in 35 degrees C or unheated silage, and 2) amino acid N in 60 degrees C silage was digested less than amino acid N in 35 degrees C or unheated silage. Reasons for low digestibility of N in 35 degrees C silage are less clear, but evidence suggests formation of indigestible N complexes in digesta. PMID- 3805449 TI - Sire evaluation for multiple binary responses when information is missing on some traits. AB - A procedure of sire evaluation for multiple binary responses when information is missing for some traits is described. The genetic model assumes a conceptual underlying multivariate normal distribution rendered discrete by abrupt thresholds. Statistical inferences are made from a posterior distribution consisting of several conditionally independent likelihood functions and a multivariate normal prior distribution. Each likelihood function corresponds to a particular class of information available. Point estimators and predictors of fixed and random effects are the values that maximize the posterior distribution conditionally on heritabilities and genetic correlations. The procedure involves nonlinear maximization. An example involving joint selection for calving ease and skeletal development illustrates the principles. Application of the methodology as a potential means of removing bias due to selection for categorical traits is discussed. PMID- 3805450 TI - Sequential estimation of genetic and phenotypic parameters in multitrait mixed model analysis. AB - Single-trait and multitrait (2-, 3-, 4-, and 5-trait) restricted maximum likelihood methods were applied to the same set of data with complete information on all traits. Results suggest that parameter estimates from a data set vary depending upon the type of analysis (single- or multitrait model) and upon the other traits included in multitrait analysis. The choice of parameter estimation method for a breeding design should be based on the breeding goal. In parameter estimation or sire evaluation, traits included in a multitrait analysis should correspond to the traits of interest in the breeding goal. Multitrait analysis explores all intercorrelations simultaneously in parameter estimation and thus provides a complete picture of all interrelationships among traits. In contrast, single-trait analysis produces pairwise (simple) correlations and ignores the possible contribution of other related traits under study to the pairwise correlation. The 5-trait model analysis through canonical transformation was about 300% more efficient in terms of computer time than single-trait model analysis of the same 5 traits. In this study, parameter estimates converged faster under multitrait analysis through canonical transformation than under single-trait analysis. PMID- 3805451 TI - Factors affecting embryo transfer success in recipient heifers under field conditions. AB - Recipient age at transfer (less than 525 d old or more than 525 d old), season (fall, winter, spring, summer), method of synchronization (natural or induced), and transfer technique (surgical or nonsurgical transfer) were associated with success of embryo transfer in a log-linear analysis. In a separate analysis, no significant association was found between success of transfer and transfer to the left or right uterine horn. Summer had the lowest proportion of successful transfers (58.9%). Pregnancy rates were 83% using the surgical transfer method and 68% with transcervical transfers. Proportion of pregnancies following a second transfer was not different from the proportion after first transfers. Success of embryo transfer was highest if recipients were greater than 525 d old and if transfers were performed surgically in spring following synchronization of recipients with cloprostenol, an analog of prostaglandin F2 alpha. Probability of success was lowest for transfers to young, prostaglandin-synchronized recipients, performed nonsurgically in summer. PMID- 3805452 TI - Responses to controlling gastrointestinal parasitism in dairy cattle. AB - Sixty-eight Holstein heifers, paired on milk production potential and season of birth, were randomly assigned within pairs to a control or treatment group to evaluate the effect of raising replacement heifers on a prophylactic anthelmintic regimen. The anthelmintic, thiabendazole (6.6 g/100 kg body weight), was administered orally as a paste at 2.5, 3.5, 6, 9, and 14 mo of age and at parturition. The control group received no thiabendazole. Fecal samples were collected from both groups at the time of thiabendazole treatment. Days to first service were 457.1 and 457.8 for the control and treatment groups. There were no differences in services per conception or days to first calving. Nematode eggs per 5 g of feces were similar at 2.5 mo (.6 and .8), 3.5 mo (38.6 and 22.4), 6 mo (40.2 and 43.1), 9 mo (39.0 and 22.4), 14 mo (55.2 and 22.4), or parturition (16.5 and .4). There were no differences in body weight changes over the first 18 mo of age. Subsequent first lactations were similar (9422 and 8710 kg 305-d mature equivalent, for twice daily milking) as was actual milk production for the first 120 d of lactation. Under these environmental conditions and apparently low parasitism in this herd, thiabendazole did not substantially influence nematode egg count and had no effects on body weight gains or milk production. PMID- 3805453 TI - External factors that affect grades in graduate physiology. AB - Data from 251 students over 11 yr were used to evaluate factors affecting the final grade in a graduate animal anatomy and physiology course. Background information obtained on the first class day included major, major professor, degree(s) and location(s) of matriculation, and participation in science courses. A pretest was administered to identify each student's background. Final numerical grade was influenced by major, degree, College where bachelor's degree was obtained, and gender. Students from fisheries and wildlife had higher final numerical grade than other majors. Undergraduates scored lower than master's or doctoral students. Students from small colleges and foreign institutions obtained lower final numerical grades than students from agricultural universities and major colleges. Females had higher final grades (81.3 +/- 1.7) than males (79.6 +/- 1.7). Pretest score was indicative of final grade and was affected by degree, college of bachelor's degree, year, and organic chemistry. Master's students had pretest scores 6.1 higher than bachelor's students; students with organic chemistry scored higher than students with none, and foreign students score lowest of all groups by college of bachelor's degree. Change in score from pretest to final grade was affected by major, degree, gender, and pretest score. The student's background in biochemistry, cell physiology, and organic chemistry and motivation can affect success in graduate physiology and anatomy. PMID- 3805454 TI - Protein supply from undegraded dietary protein. AB - A summary of in vivo estimates of the amount of dietary protein from individual feedstuffs that escapes microbial degradation in the rumen is presented. Values range from approximately 20% for protein in barley, oats, wheat, and alfalfa silage to 65 to 70% for protein in fish meal and animal by-products. In vitro or in situ methods for estimating protein degradation can be used, but at this stage of development, the methodology is more useful in providing a relative ranking of feedstuffs on the basis of protein degradation than in providing absolute estimates of protein degradation. A number of factors influence protein breakdown in the rumen, including extent of crosslinking in the protein (disulfide bonds), retention time in the rumen, protein solubility, and processing and storage effects on protein. It is important to consider the amino acid content of the undegraded dietary protein, particularly lysine and methionine, two amino acids likely to be limiting for milk production. Strategies for using protected proteins in dairy cattle diets are discussed. PMID- 3805455 TI - Influence of milk fat, milk solids, and light intensity on the light stability of vitamin A and riboflavin in lowfat milk. AB - Retinyl palmitate and riboflavin were quantified in milk samples exposed to fluorescent light. Effects of compositional factors were determined by comparing rates of loss of riboflavin and vitamin A in milks with different amounts of milk fat and milk solids. Upon exposure to fluorescent light, rates of vitamin A and riboflavin loss were lower in whole milk than in skim milk. Riboflavin degraded more slowly in skim milk with 1% added nonfat dry milk than in skim milk with no added solids. No additional protective effect for riboflavin was found when added solids were increased from 1 to 3%. Compared with milk with no added solids, 1% added nonfat dry milk did not increased protection for vitamin A, but a protective effect was noted when the skim milk was fortified with 3% nonfat dry milk. Increasing light intensity increased the rates of loss of both vitamins, and riboflavin was lost at a greater rate. PMID- 3805456 TI - Association of sulfhydryl oxidase and xanthine oxidase in bovine mammary tissue. AB - The presence of antigenically active xanthine oxidase was indicated in various relatively purified preparations of sulfhydryl oxidase obtained from bovine milk. Evidence for formation of a complex of the two enzymes was obtained by double immunodiffusion. Furthermore, sodium dodecylsulfate-gel electrophoresis of sulfhydryl oxidase and xanthine oxidase model mixtures indicated that high molecular weight species were present that reacted with both antisulfhydryl oxidase and antixanthine oxidase. Similar gel electrophoretic patterns visualized by protein-dye binding methods revealed a distinct band (greater than 200 kdalton) was formed upon incubation of mixtures of the two enzymes, the presence of which was unaffected by reduction of protein disulfide bonds. Immunofluorescent staining techniques showed both enzymes in the apical plasma membrane. Because sulfhydryl oxidase previously has been shown to catalyze conversion of the dehydrogenase form of xanthine oxidase to the oxidase form, this conversion may occur when xanthine oxidase contacts sulfhydryl oxidase in the apical plasma membrane. This conversion and the resulting potential for production of active oxygen species could be significant to membranotropic processes, such as fat globule secretion, and to the oxidative stability of the milk fat globule membrane. PMID- 3805458 TI - Effects of diet nitrogen and forage nitrogen insolubility on performance of cows in early lactation. AB - Thirty-six Holsteins were allotted at parturition to six treatments to measure effects of diet nitrogen and increased insolubility of silage nitrogen on performance and ruminal, plasma, and milk constituents during the first 100 d of lactation. Diets contained 40% concentrate and 60% silage in dry matter. The six silage treatments were untreated corn silage (low nitrogen); untreated corn silage and untreated alfalfa silage (1:1); untreated corn silage and formaldehyde and formic acid-treated alfalfa silage (1:1); ammonia-treated corn silage (low nitrogen); treated corn silage and untreated alfalfa silage (1:1); or treated corn silage and treated alfalfa silage (1:1). Diets containing ammonia-treated corn silage had higher hot water-insoluble nitrogen and diets containing formaldehyde and formic acid-treated alfalfa had higher autoclaved rumen fluid insoluble and hot water-insoluble nitrogen that their respective untreated silage diets. Dry matter intake, daily yields of milk and its constituents, ruminal NH3 nitrogen, and plasma urea nitrogen were lower for cows consuming low nitrogen diets containing only corn silage compared with cows consuming high nitrogen diets containing alfalfa. Dry matter intake and milk protein yields were greater for cows consuming treated alfalfa compared with untreated alfalfa in the diet. Daily 4% fat-corrected milk yields tended to be higher for diets containing treated alfalfa than untreated alfalfa. Cows fed diets containing NH3-treated corn silage had similar milk, fat, and protein yields compared with diets containing untreated corn silage and urea in the concentrate. PMID- 3805457 TI - Calcium sources for milk production in Holstein cows via changes in dry matter intake, mineral utilization, and mineral source buffering potential. AB - Three supplemental sources of inorganic calcium (calcite flour, aragonite, albacar), each differing in particle size and rate of reactivity, provided .6 or .9% calcium in corn silage:grain (1:1 dry matter) diets of high producing dairy cows. All cows were fed calcite flour at .6% calcium during the first 4 wk of lactation. On d 29 of lactation 5 cows were assigned to each of the six diets. Peak milk yield paralleled dry matter intake and was higher when calcite flour and aragonite provided .9% calcium, intermediate when all sources provided .6% calcium, and lower when albacar provided .9% calcium. However, adaptations to calcium source and to particle sizes of a calcium source (.35 to 1190 mu) were made within 40 d by lactating Holsteins. Starch increased and pH decreased in feces of cows fed albacar. Increasing calcium in the diet provided more buffering capacity in the gastrointestinal tract. True absorption of calcium did not differ from linearity due to source when fecal calcium was regressed on ingested calcium but did vary as a function of diet percentage. Thus, calcium retention was increased when cows were fed .9 vs. .6% calcium. These data suggest that a slow reacting (coarser) inorganic calcium source should be fed at a higher amount to optimize feed intake and milk production. PMID- 3805459 TI - Dietary energy regulation during gestation on subsequent lactational response to soybean meal or dried brewers grains. AB - Forty-two Holstein cows were paired by body condition and mature equivalent milk production and fed either a high or low energy diet for the last 16 to 18 wk of lactation. Cows fed the high energy diet produced more milk (21.6 versus 17.6 kg/d), gained more body condition, and were heavier after calving (641 versus 591 kg) than cows fed the low energy diet. Beginning wk 3 postpartum, half the cows in each prepartum energy group were fed supplemental dried brewers grains or soybean meal. During wk 1 to 15 of lactation, cows from the high energy group produced more 3.5% fat-corrected milk (33.8 versus 31.3 kg/d), consumed less dry matter (23.2 versus 24.4 kg/d), and lost more body weight (-2.7 versus .9 kg/wk) compared with cows from the low energy group. Milk production, feed intake, and body weight change were not affected by protein source. The high amount of bound nitrogen in dried brewers grains resulting in decreased intestinal digestibility of escape protein may have been responsible for the lack of production response to this protein source. PMID- 3805460 TI - Approximating prediction error variances for multiple trait sire evaluations. AB - The coefficient matrix for multiple trait (milk, fat, and protein) mixed model equations may be too large to obtain prediction error variances from inverse elements. The commonly used reciprocals of diagonal elements may not be accurate approximations when sire relationships or multiple traits are included since much information is contained in offdiagonal elements. Approximations incorporating increased information from coefficient matrix were compared with actual prediction error variances for multiple trait evaluations for milk, fat, protein, and dollar value (relationships included) of 229 Ayrshire and 248 Brown Swiss bulls. Six approximations were selection index using number of daughter records, inverses of individual sire diagonal blocks, inverses of group and individual sire blocks, and inverses of all diagonal blocks and offdiagonal blocks associated with individual sires. All approximations under-estimated actual prediction error variances, but most, except selection index, were highly correlated (.90 to .99) with actual prediction error variances of sire evaluations for milk yield and product value for contemporary bulls. The approximation incorporating most information from the coefficient matrix is recommended for use on basis of high correlation with and closeness to actual prediction error variances. PMID- 3805461 TI - Comparison of heritability estimates from daughter on dam regression with three models to account for production level of dam. AB - Three models were used to estimate heritabilities for milk yields at different production levels and for different years as twice the regression of daughter residual effects on dam residual effects. The denominator is the residual mean square for dams. The numerator is the difference between the residual term for sum of dam's and daughter's records and sum of residual terms for records of dams and daughters. Model 1 included sire of daughter and herd-year-season of daughters only. Model 2 included sire of daughter, herd-year-season of dam, and herd-year-season of daughter. Model 3 included sire of daughter and herd-year season of dam and herd-year-season of daughter combination. The weighted mean estimates for each method were, respectively, .35, .38, .38 for milk production and .61, .67, .67 for fat test. Yearly time trends in heritability were slightly positive for both milk production and fat test. Standard errors of heritability estimates from model 1 were 40 to 50% smaller than those from models 2 and 3 due to the smaller number of effects in the model. Estimates for model 2 from low to high production levels averaged .30, .38, .38, and .42 for milk yield and .64, .68, .67, and .71 for fat test. PMID- 3805462 TI - Genetic and environmental differences between registered and grade Holstein cows. AB - Phenotypic and genetic measures of milk yield were compared for sire-identified registered and grade Holsteins in the United States. First lactation registered cows produced more milk within herd than did grades. Grades were culled more intensely than registered cows, resulting in higher average yield by maturity for remaining grades than for remaining registered cows. Average Cow Index milk was higher overall for grades until 1981. Within herd and year of first calving, registered cows were higher for yield, Cow Index, and sire Predicted Difference since 1974. Analyses for cows alive at a given time or cows with dam Cow Index overestimated grade genetic merit because of differences in selection intensity. No sire identification for two-thirds of grades resulted in substantial data loss and probably overestimation of grade genetic merit from sire-identified cows. Preferential treatment according to registry status was examined by comparing registered and grade yields within herd, year, and sire. Milk yield of registered cows was 95 kg higher than for grade paternal sisters in 1980 to 1984; bias in favor of registered cows was 3 kg for Cow Index milk. Bias would be proportional to herdmates of opposite registry status. Average genetic merit of sire identified registered and grade Holstein cows differed little. PMID- 3805463 TI - Projection of protein yield to 305 days. AB - Lactation records with at least 305 d in milk, information on milk and protein yields at each sample day, and completion dates during 1984 were obtained from the dairy records processing center in Provo, UT. Most of the 180,323 Holstein and 11,685 Jersey records were from Colorado, Idaho, Maryland, Ohio, Utah, and Washington. Protein yield between last sample day and 305 d was regressed on product of milk yield between last sample day and 305 d, protein percentage from partial record or at last sample day, and a quadratic function of days in milk. This function estimated a factor for each day of lactation to adjust last sample day or partial lactation protein percentage to expected protein percentage for remainder of lactation. Errors from projection with average percentage of partial records had smaller variance at less than 240 d in milk than did those from projection with last sample day percentage. For records with less than 240 d in milk, partial lactation protein percentage was adjusted by a quadratic function of days in milk jointed at 50 and 140 d. For records with 240 d or more in milk, last sample day protein percentage was adjusted by a quadratic without joint points. No difference between factors for first and later lactations was found. Holstein and Jersey factors were applied to records completed during 1982 and 1983 in addition to previously analyzed 1984 data to determine projection errors for partial records of 150 to 304 d in milk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805464 TI - Relationships of sexual activities in estrous cows to different frequencies of observation and pedometer measurements. AB - Sexual activities were observed continuously for 120 h in Holstein dairy cows during moderate climate. Pedometer measurements of motor activity were correlated with total activities initiated, total activities received, mounts received, and time in estrus. Twelve of 14 individual sexual activities also were correlated on a within-cow basis with pedometer-measured increases in motor activity; disoriented mounts and licking front were not correlated to pedometer increases. Although observations of four 1-h and four or six 30-min observations accounted for greater variation, pedometer increases in activity accounted for as much variation in total sexual activities as periodic observations of 30 min or 1 h for 1 to 3 X /d. Combining periodic observations with pedometer measurements resulted in greater coefficients of determination for analyses of sexual activities than with each individual factor. Sexual activities and pedometer increases also were correlated positively with body condition score and day postpartum, and they were correlated negatively with milk production and body weight change since calving. Although mounting and total sexual activities were shifted significantly from expected on a quartile basis, shifts were probably not of practical significance and provided little evidence for more frequent occurrence of estrous activity during nocturnal periods. Rather, the most marked decrease in mounting and total sexual activities occurred at milking and feeding times, indicating that dairy farmers should be more concerned with disruptions of activities by management practices rather than nocturnal occurrence of estrus. PMID- 3805465 TI - Estimating daily yields of cows milked three times a day. AB - Factors to estimate daily yield from one or two sampled milkings of cows milked three times a day were derived with data for 21 mo from seven Pennsylvania herds and data for 1 yr from five Utah herds. Accuracy of estimation increased with number of milkings weighed; standard deviation of error was nearly halved when information was included from two milkings instead of one. Fat yield did not increase as much as milk yield with increased time between milkings (interval); therefore, fat percentage factors increased with interval. If fewer milkings were sampled than weighed, fat yield was estimated by adjusting sample-day fat percentage. Effect of interval on protein yield was nearly the same as on milk yield. Therefore, milk factors are recommended for protein, and no adjustment to protein percentage is necessary if fewer milkings are sampled than weighed. Factors derived for milk were tested on records from 53 California and Oregon herds. Standard deviations of errors were similar to those from Utah and Pennsylvania data. PMID- 3805466 TI - Effect of pH and energy spilling on bacterial protein synthesis by carbohydrate limited cultures of mixed rumen bacteria. AB - Rumen contents were obtained from a cow fed 2.5 kg concentrates and 2.5 kg timothy hay twice daily, and the mixed rumen bacterial inoculum (pH 6.3) was separated from large feed particles and protozoa by centrifugation. Bacteria were incubated in artificial media at pH 6.7 and 6.0. When starch, sucrose, cellobiose, xylan, pectin, or a mix of carbohydrates were provided to pH 6.7 incubations at 1 mM/h for 10 h, fermentation was carbohydrate-limited, less than 20% of the carbohydrate was converted to lactate, molar ratio of methane to hexose fermented was as great as 49%, and pH remained constant. When initial pH was lowered to 6.0, methane production was nearly eliminated, volatile fatty acid production was reduced, and there was a small decrease (less than .5) in final pH. At pH 6.0, lactate production was increased in all incubations except xylan and pectin, and pH had a greater effect on acid production than the type of carbohydrate provided. Bacterial protein synthesis was reduced 34 to 69% when initial pH was 6.0, but these reductions were greater than decreases in carbohydrate utilization, increases in lactate, and associated decreases in adenosine 5'-triphosphate production. Because less adenosine 5'-triphosphate was used for protein synthesis, it appeared that low pH diverted energy to nongrowth functions. PMID- 3805467 TI - Relative value of solvent and expeller soybean meal for lactating dairy cows. AB - Nitrogen solubility and enzymatic and rumen in vitro degradabilities indicated protein from expeller soybean meal was more resistant to ruminal degradation than that from solvent soybean meal. This was confirmed in Trial 1 by reduced rumen ammonia and branched-chain volatile fatty acids, and by 64% more supplemental protein escaping the rumen when cows were fed expeller soybean meal. In Trial 2, rations supplemented with either solvent or expeller soybean meal, averaging 16.4% protein, were fed to 12 cows in a crossover study. Production averaged 35.3 kg/d but was not influenced by diet. A small but significant improvement in milk to feed ratio occurred with expeller soybean meal. In Trial 3, four sources of protein were fed to 20 cows in a 4 X 4 Latin square: 6.3% solvent, 4.1% expeller (plus .3% urea), 10.0% solvent, or 6.6% expeller soybean meal. Production of milk and milk components was similar on the diets containing 6.3 and 6.6% soybean meal, intermediate on 10.0% solvent, and least on the expeller-urea diet. Milk to feed was equal and greatest on diets containing 6.6% expeller and 10.0% solvent soybean meal, indicating comparable utilization of the expeller diet containing only 60% as much supplemental protein. PMID- 3805468 TI - Malt sprouts as a source of supplemental protein for ruminants. AB - Nitrogen solubility, ruminal degradation, and amino acid composition of pelleted malt sprouts, pelleted corn gluten feed, and soybean meal were studied. Four rumen-cannulated steers were fed diets containing 45% pelleted malt sprouts or 45% pelleted corn gluten feed in a 2 X 2 crossover design with 15-d periods. Ruminal degradation of dry matter and nitrogen from malt sprouts or corn gluten feed was estimated by disappearance of these components from polyester bags after 1, 2, 3, 4, 6, 8, 10, 12, 16, or 24 h of in situ fermentation. For comparison, degradation of soybean meal after 2, 4, 8, or 24 h was measured. Malt sprouts had less soluble nitrogen than corn gluten feed, but available crude protein contents were similar. Malt sprouts dry matter was degraded more slowly than was corn gluten feed dry matter. Nitrogen degradation rates of the two feeds, after correction for unavailable nitrogen, did not differ. Malt sprouts had higher concentrations of arginine, lysine, and aspartate than corn gluten feed; however, corn gluten feed had higher concentrations of the other amino acids measured. Malt sprouts would be expected to provide more amino acids of feed origin to the lower gut of ruminants, provided passage rates of the supplements are similar. PMID- 3805469 TI - Genetic change in milk yield estimated from simultaneous genetic evaluation of bulls and cows. AB - Genetic trend for milk yield in the artificially sired Holstein population in the northeastern United States was estimated from solutions for simultaneous genetic evaluations of bulls and cows for an animal model using mixed model equations and including all known relationships among the population by years of birth of 1960 to 1980 (1978 for bulls). First lactation milk records of 1,074,971 artificially sired cows sired by 6000 bulls in 20,065 herds were used. Averages of estimated genetic value by year of birth were similar from solutions after 10, 20, and 30 rounds of iteration of the mixed model equations. The trend in genetic value of bulls that entered artificial insemination was marked by slight negative change for three periods totaling 9 yr and substantial positive change averaging 105 kg/yr for the other 9 yr, which suggests that the dairy industry sacrificed milk yield in genetic value of bulls put into artificial insemination during those periods to selection criteria other than milk yield. There was little change in average genetic value of registered cows from 1960 to 1970. Gain in nonregistered cows totaled 177 kg for the same period. Gain from 1970 to 1980 was similar for both registered and nonregistered cows, 39.5 and 38.1 kg/yr, respectively. Average genetic value of nonregistered cows exceeded that of registered cows each year except 1960. PMID- 3805470 TI - Indicators of estrus in Holstein cows housed in tie stalls. AB - Fourteen lactating Holstein cows were observed between 40 and 150 d postpartum to identify physiological and behavioral changes associated with the day of estrus. Ovulation was predicted on 29 occasions from changes in concentrations of progesterone in milk. Estrus was detected by casual observation by the herdsperson 22 times, but only 13 were detected during a daily 30-min exercise period with an androgenized heifer. Morning milk yield and daily feed intake decreased on the day of estrus. Rectal temperature, afternoon milk yield, and number of changes in postural position during the previous night increased on the day of estrus. When an increase greater than one standard deviation from the within-cow mean was considered evidence of estrus, all measures indicated more false positives than true positives. A combination of elevated temperature, increased changes of postural position at night, and depressed feed intake accurately predicted estrus, but only on 6 occasions out of 29. PMID- 3805471 TI - Mohs surgeons and the ACC. PMID- 3805472 TI - An update on insulated needles. PMID- 3805473 TI - CO2 laser blepharoplasty: a comparison to cold steel and electrocautery. AB - Thirteen patients underwent blepharoplasty in a paired comparison study. A carbon dioxide laser was employed for one side while standard cold steel surgery and electrocautery was used on the contralateral side. In addition to reduced intraoperative time and bleeding, we found less postoperative ecchymosis and edema on the laser-treated side. Long-term follow-up showed no difference between the two sides when cosmetic end result and scars were compared. PMID- 3805474 TI - Carbon dioxide laser vaporization and curettage in the treatment of large or multiple superficial basal cell carcinomas. AB - Many of the standard forms of therapy for large or multiple superficial basal cell carcinomas are limited by significant postoperative pain, excessive scarring, and prolonged wound healing time. Combining traditional curettage with carbon dioxide laser vaporization creates a procedure that allows excellent visualization, due to the bloodless surgical field produced by the laser, minimal nonspecific thermal damage, rapid healing, and diminished postoperative pain. In addition, the speed and ease with which this procedure can be performed allow successful treatment of many lesions in a single outpatient session. We wish to report our results using this technique for the treatment of 52 patients with 370 superficial basal cell carcinomas. PMID- 3805475 TI - Biostimulation of wound healing by lasers: experimental approaches in animal models and in fibroblast cultures. AB - Recent evidence suggests that low-energy lasers, such as an He-Ne laser, might stimulate wound healing. In this review we are summarizing our recent observations indicating that low-energy lasers enhance collagen gene expression both in skin fibroblast cultures in vitro, as well as in animal models of wound healing in vivo. PMID- 3805476 TI - The pulsed dye laser: its use at 577 nm wavelength. AB - The ability to increase laser-induced cutaneous blood vessel damage selectivity is dependent upon optimizing various intrinsic laser parameters. Varying the laser emission wavelength, pulse duration, and/or incident energy dosage allows the clinician potential improvement in the laser treatment of cutaneous small blood vessel processes such as port-wine hemangioma and telangiectasia. The pulsed dye laser at 577 nm and a pulse duration of 300 to 400 microseconds, incorporates desired laser parameters into its design. Clinical evaluation of the therapeutic outcome with this laser reveals favorable results while significantly minimizing potential adverse side effects. PMID- 3805477 TI - Treatment of xanthelasma palpebrarum with the carbon dioxide laser. AB - Six patients with xanthelasma palpebrarum of the eyelids have been treated with the CO2 laser and followed for periods varying up to 4 years. Satisfactory cosmetic results were achieved in all patients without significant scarring, and no recurrence has been discovered thus far. PMID- 3805478 TI - Use of scleral eye shields for periorbital laser surgery. AB - A description of the technique used in preventing inadvertent injury to the eye during periorbital or eyelid laser surgery is given. PMID- 3805479 TI - New developments with the heavy metal vapor lasers for the dermatologist. AB - In controlled studies the heavy metal vapor lasers are important for dermatologic surgery, for vascular lesions, and for skin malignancies, especially those malignancies which cannot be treated by conventional means. The flexibility of the fiberoptic system for transmitting the lasers lends itself to laser vascular surgery, cancers of the skin, and mucous membranes. The heavy metal vapor laser is one of the few laser systems for clinical practice which include two different systems, thereby increasing applications. PMID- 3805480 TI - Toxicity of synergized and unsynergized nitromethylene heterocycle insecticide (SD 35651) to susceptible and resistant strains of Musca domestica (Diptera: Muscidae). PMID- 3805481 TI - Identification of resistance mechanisms in Culex pipiens (Diptera: Culicidae) from southern France: insensitive acetylcholinesterase and detoxifying oxidases. PMID- 3805482 TI - Survival of the lone star tick (Acari: Ixodidae) under flooding conditions: a laboratory evaluation. PMID- 3805483 TI - Area-wide systemic insecticide treatment for control of cattle grubs, Hypoderma spp. (Diptera: Oestridae): two approaches. PMID- 3805484 TI - Effect of ivermectin on survival and fecundity of horn flies and stable flies (Diptera: Muscidae). PMID- 3805485 TI - Development of resistance to malathion in cat flea (Siphonaptera: Pulicidae). PMID- 3805486 TI - Cumulative toxicity and delayed temperature effects of hydramethylnon on German cockroaches (Orthoptera: Blattellidae). PMID- 3805487 TI - [Use of the phenomenologic growth equation for describing and predicting weight change curves]. PMID- 3805488 TI - [Relation between the structure and carcinogenic activity of substituted benzidines]. PMID- 3805489 TI - [Mathematical model of the local hyperthermia of heterogeneous tumors]. PMID- 3805490 TI - [Correlation matrix of the connections between hemodynamic indices as a characteristic of autonomic homeostasis]. PMID- 3805491 TI - [Action of a low-frequency magnetic field on the inherent rhythm of the isolated frog atrium]. PMID- 3805492 TI - Immunization against the observational conditioning of snake fear in rhesus monkeys. PMID- 3805493 TI - Effects of continuous and partial reinforcement and methylphenidate on learning in children with attention deficit disorder. PMID- 3805494 TI - Orienting and schizophrenia: stimulus significance, attention, and distraction in a signaled reaction time task. PMID- 3805495 TI - Alcohol and the balanced-placebo design: the role of experimenter demands in expectancy. PMID- 3805496 TI - Comparative analysis of attentional deficits in hyperactive and learning-disabled children. PMID- 3805497 TI - Alcohol consumption as a self-handicapping strategy in women. PMID- 3805498 TI - Component analysis of cognitive skill training for the enhancement of hypnotic susceptibility. PMID- 3805499 TI - Level of processing as a determinant of hypnotic hypermnesia. PMID- 3805500 TI - Persistence of fear-reducing behavior: relevance for the conditioning theory of neurosis. PMID- 3805501 TI - Relations between the pleasant events schedule, depression, and other aspects of psychopathology. PMID- 3805502 TI - Age at first onset for nonbipolar depression. PMID- 3805503 TI - Panic disorder and agoraphobia with panic attacks: covariation along the dimensions of panic and agoraphobic fear. PMID- 3805504 TI - Psychopathology of social phobia and comparison to avoidant personality disorder. PMID- 3805506 TI - Dysfunctional attitudes and attribution style in healthy controls and patients with schizophrenia, psychotic depression, and nonpsychotic depression. PMID- 3805505 TI - Structural analysis of parent-child relationships in eating disorders. PMID- 3805507 TI - Predicting outcome in schizophrenics and nonschizophrenics of both sexes: the Zigler-Phillips Social Competence Scale. PMID- 3805508 TI - Depression and the response of others: is the effect specific? PMID- 3805509 TI - Respiratory responses of exercising asthmatic volunteers exposed to sulfuric acid aerosol. PMID- 3805510 TI - The characterization of ozone, sulfur dioxide, and nitrogen dioxide for selected monitoring sites in the Federal Republic of Germany. PMID- 3805511 TI - Dry deposition of ammonia at environmental concentrations on selected plant species. PMID- 3805513 TI - Present state of industrial waste management in Japan. PMID- 3805512 TI - A new audit technique for EPA Method 25. PMID- 3805514 TI - In situ methods to control emissions from surface impoundments and landfills. PMID- 3805515 TI - Noninvasive evaluation of cardiac risk before elective vascular surgery. AB - The prognostic utility for predicting cardiac events was determined for dipyridamole-thallium scintigraphy, exercise stress testing (when possible; n = 69) and multiple clinical variables in 100 consecutive patients admitted for elective surgical repair of peripheral vascular disease. After initial noninvasive evaluation, 11 patients were referred for coronary angiography and the remaining 89 patients had surgery without further cardiac studies. Fifteen patients (17%) had a postoperative myocardial infarction, one of which was fatal. Of these 15 patients, 14 had thallium redistribution and 3 had positive ST segment depression during stress testing. Among the many variables tested, the presence of redistribution on serial dipyridamole-thallium images was the most significant predictor of serious cardiac events. All 11 patients who had coronary angiography had both redistribution and multivessel coronary artery disease. Four of these 11 patients died during follow-up and 6 had coronary artery bypass surgery. It is concluded that dipyridamole-thallium imaging has significant prognostic utility in predicting postoperative myocardial infarction and death in patients with severe peripheral vascular disease, and is superior to exercise testing or clinical variables in determining cardiac risk. The odds for a serious cardiac event were 23 times greater in a patient with thallium redistribution than in a patient without redistribution, strongly suggesting that myocardial imaging may be used as a primary screening test before elective vascular surgery. PMID- 3805516 TI - Long-term follow-up after surgical correction of Wolff-Parkinson-White syndrome. AB - The long-term efficacy of surgical correction of Wolff-Parkinson-White syndrome was evaluated in 45 consecutive patients. Before surgery, 42 patients had reciprocating tachycardia and 12 had atrial fibrillation. The principal operative procedure was endocardial incision in 42 patients, endocardial cryoablation in 2 patients and epicardial cryoablation without dissection of the atrioventricular (AV) fat pad in 1 patient. Two patients had perioperative complications. One patient had bleeding that necessitated reoperation, and one had a right cerebral stroke with subsequent clearing of neurologic deficit. At postoperative electrophysiologic study, only the patient who underwent epicardial cryoablation had conduction over an accessory connection. Two others had intermittent delta waves in the early postoperative period but no accessory connection conduction at electrophysiologic study. During a mean follow-up of 3.1 years, the patient with ineffective cryoablation had recurrent orthodromic tachycardia, and one other patient had late recurrence of delta waves without arrhythmias. Four other patients had frequent palpitation, which was caused by premature ventricular complexes in three and sinus tachycardia in one. Seventeen patients had occasional "skipped beats" without recurrence of tachyarrhythmias. Twelve of 13 patients whose arrhythmias limited employment before surgery returned to work after surgery. By actuarial analysis at 1, 2 and 3 years, all patients were alive and 98% were free from tachyarrhythmias. Surgical correction of Wolff-Parkinson White syndrome provides excellent long-term results with low morbidity. Patients who are disabled by arrhythmias return to work after successful surgery. Delta waves may persist or recur without return of arrhythmias. Minor postoperative episodes of palpitation are common and do not correlate with tachyarrhythmias. PMID- 3805517 TI - Progression of hypertrophic cardiomyopathy into a hypokinetic left ventricle: higher incidence in patients with midventricular obstruction. AB - The development of segmental or generalized left ventricular hypokinesia is an unusual occurrence in patients with hypertrophic cardiomyopathy. To determine the incidence and possible pathophysiologic mechanisms responsible for this process, the serial clinical and laboratory data of 62 patients with the diagnosis of hypertrophic cardiomyopathy were analyzed. During a mean follow-up period of 8 years (range 2 to 21), 5 patients (Group A) developed left ventricular hypokinesia, whereas the remaining 57 patients (Group B) continued to exhibit the clinical and laboratory findings of hypertrophic cardiomyopathy. Three patients developed a dilated left ventricle with generalized hypokinesia; two other patients had segmental left ventricular wall motion abnormalities. None of these five patients who developed left ventricular hypokinesia had fixed coronary artery disease. The mean age, sex, mean duration of follow-up, presence of coronary myocardial bridges and angina pectoris, and an interventricular gradient were all similar in Groups A and B. Midventricular obliteration was seen in 4 (80%) of the 5 patients in Group A and in 4 (7%) of the 57 patients in Group B (p less than 0.001). Findings from this study reveal that segmental or generalized left ventricular hypokinesia can develop in patients with hypertrophic cardiomyopathy in the absence of fixed coronary artery disease. Such hypokinesia can occur after an acute myocardial infarction or it can develop gradually without clinical or electrocardiographic evidence of infarction. Patients with the mid-ventricular obliteration variant of hypertrophic cardiomyopathy are at a higher risk of developing segmental or diffuse left ventricular hypokinesia. PMID- 3805518 TI - Clinical significance of exercise-induced silent myocardial ischemia in patients with coronary artery disease. AB - Exercise-induced silent myocardial ischemia is a frequent feature in patients with coronary artery disease. The purpose of this study was to compare the clinical and angiographic characteristics of 269 patients who complained of chest pain during an exercise test (group I) with those of 204 who developed exercise induced silent myocardial ischemia (group II). Group I patients more frequently had anginal symptoms of class III and IV of the Canadian Cardiovascular Society than did group II patients, who had milder symptoms (p less than 0.001). The only angiographic difference observed between the two groups was a slightly but significantly higher left ventricular end-diastolic pressure in group II patients (p less than 0.05), who also showed a longer exercise duration (p less than 0.01) with a higher heart rate-systolic pressure product (p less than 0.01) and more pronounced ST segment depression at peak exercise (p less than 0.001). Moreover, ventricular ectopic beats during exercise were more frequently observed in group II patients (p less than 0.05). Coronary bypass surgery was performed in 45% of patients of group I and in 24% of patients of group II (p less than 0.05). Survival curves of medically treated patients did not show any statistically significant difference between the two groups. Thus, although patients with a defective anginal warning system may have more pronounced signs of myocardial ischemia and a greater incidence of ventricular arrhythmias during exercise, their long-term prognosis is not different from that of patients who are stopped by angina from the activity that is inducing myocardial ischemia. PMID- 3805519 TI - Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy. AB - Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients. In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of perfusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening. In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore, there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement. PMID- 3805520 TI - Sensing and pacing with floating electrodes in the right atrium and right atrial appendage. AB - Unipolar and bipolar floating atrial electrograms from 58 pacemaker patients were recorded and compared. Twenty-four floating unipolar electrodes and 29 floating bipolar electrodes were used at mid-right atrial level and five orthogonal atrial J leads within the right atrial appendage. Each signal was analyzed in the time domain: peak to peak deflection of P wave and QRS complex, duration of P wave and QRS complex and slew rate; and in the frequency domain: maximum of the energy spectrum and frequency at which a decrease of 3 dB from the maximal amplitude occurred. Atrial P (1.31 +/- 0.94 mV, mean +/- SD) and QRS (1.0 +/- 0.56 mV) waves from unipolar floating electrodes were comparable, whereas they were significantly different from bipolar floating electrodes (1.15 +/- 0.77 mV and 0.25 +/- 0.39 mV). Amplitudes of P waves from orthogonal J leads were largest (3.1 +/- 2.6 mV) and QRS complexes (0.21 +/- 0.13 mV) smallest. The P waves had the highest frequency content (17.1 +/- 19.4 Hz). It is concluded that atrial electrograms from orthogonal electrodes (bipolar or orthogonal J) offer superior sensing characteristics because of the large amplitude P wave and discriminating power between P and QRS waves (P/QRS voltage 15:1). An orthogonal J lead can thus be used for P synchronous pacing at the atrial level, whereas an orthogonal ventricular lead can be used for rate-response pacing systems. PMID- 3805521 TI - Doppler echocardiographic analysis of left ventricular filling in treated hypertensive patients. AB - Early detection and prevention of cardiac dysfunction is an important goal in the management of hypertensive patients. In this study, Doppler echocardiography was used to evaluate the pattern of left ventricular diastolic filling in 38 subjects: 18 treated hypertensive patients (blood pressure 141 +/- 17/83 +/- 10 mm Hg, mean +/- SD) without other coronary risk factors and 20 risk-free normotensive subjects of similar age (47 +/- 10 and 49 +/- 13 years, respectively). Peak velocity of late left ventricular filling due to the atrial contraction was greater in hypertensive compared with normotensive subjects (69 +/- 14 versus 52 +/- 13 cm/s; p less than 0.001). Peak velocity of late filling was significantly greater in hypertensive versus normotensive subjects in those aged 50 years or younger and those older than age 50 (65 +/- 12 versus 50 +/- 11; p less than 0.01 and 75 +/- 15 versus 56 +/- 15 cm/s; p less than 0.05, respectively). In hypertensive subjects, peak velocity of late filling did not correlate with routine indexes of hypertensive heart disease (including posterior wall thickness and left ventricular mass), systolic and diastolic blood pressure or duration of hypertension. These results indicate that increased velocity of late left ventricular filling may be independent of left ventricular hypertrophy and persist despite effective blood pressure control. PMID- 3805522 TI - Frequency and location of prominent left ventricular trabeculations at autopsy in 474 normal human hearts: implications for evaluation of mural thrombi by two dimensional echocardiography. AB - The frequency and location of prominent left ventricular trabeculations were studied in 474 autopsy specimens from subjects evenly distributed by sex and age. These structures were observed in 323 (68%) of the hearts, and their frequency was similar in male (72%) and female (65%) subjects. Neither the frequency nor the location varied appreciably with age. Among the 323 hearts with prominent left ventricular trabeculations, 172 (53%) exhibited 2 or more; thus, the total number of trabeculations was 582. Of these 582 trabeculations, 493 (85%) were septoparietal bundles that inserted into both the free wall and the septum. Trabeculations also were observed between two points on the ventricular septum in 37 (6%) of the hearts and between two points along the free wall in 36 (6%). Less common patterns included trabeculations between the ventricular septum and the posteromedial papillary muscle in 10 hearts (2%), the ventricular septum and the anterolateral papillary muscle in 2, the free wall and the posteromedial papillary muscle in 2, the two papillary muscles in 1 and the apex and the ventricular septum in 1. Accordingly, prominent left ventricular trabeculations are considered to be common variants of the normal human heart. Their size, shape and location may lead to their being misinterpreted, possibly as mural thrombi, by two-dimensional echocardiography. PMID- 3805523 TI - Lung biopsy findings in transposition of the great arteries with ventricular septal defect: potentially reversible pulmonary vascular disease is not always synonymous with operability. AB - Pulmonary vascular structure was analyzed in lung biopsy specimens taken from 28 children, aged 2 months to 15 years, with transposition of the great arteries and ventricular septal defect. Cellular intimal proliferation occurred in infants as young as 2 months, but it increased markedly between ages 7 to 9 and 10 to 12 months, and the increased obstruction was associated with a lower mean percent arterial medial thickness in patients older than 10 months than was found in younger patients. Early generalized arterial dilation appeared without the intimal fibrosis and dilation lesions characteristic of classical grade III and IV pulmonary vascular disease. Intimal abnormalities increased with age and pulmonary artery pressure, but mean percent arterial medial thickness was inversely related to mean pulmonary artery pressure (r = -0.5; p less than 0.0001). Nine patients survived intracardiac repair and six did not. Five of the patients who died were of similar age (12 months or less), had similar preoperative hemodynamic and pulmonary vascular abnormalities compared with the survivors and died after a clinical course compatible with pulmonary vascular disease. The findings emphasize that potential structural reversibility is not synonymous with "operability." Further studies are indicated on the function of the excessively muscularized pulmonary vascular bed of such infants. PMID- 3805524 TI - Cor triatriatum dexter: two-dimensional echocardiographic diagnosis. AB - Cor triatriatum dexter is a malformation resulting from lack of normal regression of the embryonic right valve of the sinus venosus. In this situation, the right atrium is divided by a membrane into two chambers. Two-dimensional echocardiography was used in the antemortem diagnosis of this rare cardiac anomaly in a neonate. Associated cardiac lesions were also documented. The patient died, and findings were verified at autopsy. PMID- 3805525 TI - Long-term survival in tricuspid atresia. AB - A patient is described who, at the age of 39, was diagnosed by cardiac catheterization as having congenital tricuspid atresia. Now 57 years old, this patient has never had surgery to correct or change this abnormality. Her survival is the longest reported for a patient with tricuspid atresia without surgical intervention. PMID- 3805526 TI - Closed chest catheter desiccation of the atrioventricular junction using radiofrequency energy--a new method of catheter ablation. AB - Closed chest catheter ablation of the atrioventricular (AV) junction has been performed with direct current or laser energy. The effect of 750 kHz radiofrequency energy on ablation of the AV junction was evaluated in 13 dogs. The radiofrequency energy was generated from an electrosurgical generator in the bipolar mode. The radiofrequency output was delivered between two distal electrodes (bipolar ablation) in eight dogs, and between the distal electrode and an external patch electrode (unipolar ablation) in another five dogs at varying power (watts) but with a constant pulse duration of 10 seconds. Complete AV block was achieved in 11 dogs and second degree AV block in 2. During the 4 to 7 day follow-up period, complete AV block persisted in 9 of the 11 dogs with initial complete heart block. The other two had return of AV conduction; one had persistent 2:1 AV block and the other had persistent first degree AV block. Of the two dogs with initial second degree AV block, one developed complete AV block, the other had resumption of 1:1 AV conduction with a normal PR interval. Energy was delivered in 1 to 13 applications per dog. One hundred to 700 J per application was delivered with bipolar ablation and 10 to 100 J with unipolar ablation. There was no damage to the catheter unless the catheter was repeatedly used in excess of 1,500 J of total energy. Ventricular arrhythmias were not observed. Pathologic examination showed well delineated coagulation necrosis at the AV junction without surrounding hemorrhage or mural thrombus. Microscopic findings consisted of necrosis with cell infiltration in the periphery of necrosis. Most injuries involved the AV node, the approaches to the AV node and the penetrating bundle. In conclusion, catheter ablation of the AV junction with radiofrequency energy is safe. It can effectively induce discrete areas of necrosis and produce various degrees of AV block. In addition, ablation by radiofrequency energy has distinct advantages as compared with catheter ablation with direct current or laser energy. PMID- 3805527 TI - Autonomic control of ventricular tachycardia: direct effects of beta-adrenergic blockade in 24 hour old canine myocardial infarction. AB - The purpose of this study was to determine whether alpha- or beta-adrenergic influences directly modulate the rate of spontaneous ventricular tachycardia occurring 24 hours after left anterior descending coronary artery occlusion. Chloralose-anesthetized, open chest dogs (n = 41) with ventricular tachycardia were studied. The left anterior descending artery was cannulated distally. Neither intracoronary saline solution nor phenylephrine (0.3 to 12 micrograms) changed the rate of ventricular tachycardia; however, isoproterenol (0.01 to 10 micrograms) produced dose-dependent increases in the rate. In six dogs, metoprolol, 5 mg given intravenously, slowed ventricular tachycardia from 174 +/- 10 (mean +/- SE) to 140 +/- 17 beats/min (p less than 0.05). This was accompanied by decreases in mean arterial pressure from 106 +/- 7 to 95 +/- 8 mm Hg, cardiac output from 2.6 +/- 0.3 to 1.6 +/- 0.3 liters/min and prolongation of atrioventricular conduction from 134 +/- 10 to 189 +/- 29 ms (all p less than 0.05) during atrial pacing at a cycle length of 300 ms. In 10 dogs, metoprolol (0.5 mg) given intracoronary, a dose that shifted the isoproterenol dose-response curve to the right, slowed ventricular tachycardia from 174 +/- 7.2 to 140 +/- 9.7 beats/min (p less than 0.05) without hemodynamic changes. Additional metoprolol (4.5 mg) given intravenously produced hemodynamic alterations, but ventricular tachycardia did not slow further. Therefore, beta- but not alpha adrenergic influences control the rate of ventricular tachycardia occurring 24 hours after left anterior descending coronary artery occlusion. Furthermore, beta adrenergic blockade slows ventricular tachycardia solely by a direct electrophysiologic effect on the tachycardia foci and not indirectly as a result of hemodynamic effects. PMID- 3805528 TI - A nonflow basis for the vulnerability of the subendocardium. AB - The functional consequences of a transmural gradient of metabolism in the heart were studied in 19 dogs. The technique of retrograde blood flow diversion after coronary occlusion was used to deplete the ischemic myocardium of blood flow. Blood flow was uniformly and equally depleted in all layers, averaging 0.044 ml/min per g. With oxygen supply a controlled variable, transmural differences in metabolic demand can be addressed. In groups of dogs severe myocardial ischemia was induced for periods of 20 to 90 minutes. No necrosis was noted after 20 minutes of ischemia. Beginning at 30 minutes of blood flow depletion, necrosis progressed from the endocardium toward the epicardium in a "wave front" pattern. At 90 minutes of ischemia, approximately 70% of the area at risk was necrotic. Thus, the relative vulnerability of the endocardium as compared with the epicardium is due to nonflow factors, and probably dictated by transmural differences in metabolic activity. It would appear that myocardial metabolism as compared with blood flow occupies a primary and overriding role during the first 20 minutes of ischemia. Furthermore, differences in transmural metabolism also dictate subendocardial vulnerability for ischemic periods greater than 20 minutes, irrespective of blood flow. The role of blood flow in these events may be to modulate the rate of the transmural wave front of progressing necrosis after 20 minutes of ischemia. PMID- 3805529 TI - Comparison of programmed stimulation and Holter monitoring for predicting long term efficacy and inefficacy of amiodarone used alone or in combination with a class 1A antiarrhythmic agent in patients with ventricular tachyarrhythmia. AB - The values of two Holter ambulatory electrocardiographic monitoring criteria and one programmed stimulation efficacy criterion reported to be predictive of the efficacy of amiodarone were compared in 70 patients taking amiodarone for sustained ventricular tachyarrhythmias. At baseline, all patients had ventricular tachycardia inducible by programmed stimulation. After amiodarone loading (935 +/ 271 mg for 16 +/- 7 days), efficacy was determined by a programmed stimulation criterion (ventricular tachycardia no longer inducible or less than or equal to 15 beats) and two Holter monitoring criteria (Holter I = greater than or equal to 85% reduction of ventricular premature complexes and abolition of couplets and triplets in 64 patients who had greater than or equal to 10 ventricular premature complexes/h or couplets or triplets or both before therapy; Holter II = abolition of triplets in 41 patients who had triplets before therapy). Amiodarone was effective in 12 of 70 patients by the programmed stimulation criterion, in 49 of 64 patients by Holter criterion I and in 37 of 41 patients by Holter criterion II. In assessing efficacy of amiodarone, programmed stimulation and Holter criteria were discordant in 69% of patients or more (p less than 0.001). There were 16 recurrences or sudden deaths during the entire follow-up period (19 +/- 19 months). Arrhythmia-free survival rates at 24 months of patients with efficacy and inefficacy by each criterion, respectively, were 90 and 78% by programmed stimulation, 84 and 62% by Holter criterion I (p less than 0.05) and 73 and 50% by Holter criterion II (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805530 TI - Efficacy of oral diltiazem to control ventricular response in chronic atrial fibrillation at rest and during exercise. AB - Although digoxin is often the first choice for control of ventricular response in chronic atrial fibrillation, it fails to slow exercise rates. Diltiazem, a calcium channel antagonist that slows atrioventricular conduction, was administered to 16 patients who failed to achieve adequate rate control on low level exercise testing despite digoxin therapy. Therapeutic response to diltiazem was assessed with submaximal and maximal exercise tests and 24 hour ambulatory electrocardiographic monitoring. During the diltiazem treatment phase, ventricular response at rest diminished (96 +/- 17 versus 69 +/- 10 beats/min, p less than 0.001) as did rate during submaximal exercise (155 +/- 28 versus 116 +/ 26, p less than 0.001), maximal exercise (163 +/- 14 versus 133 +/- 26, p less than 0.001) and average ventricular response during 24 hour monitoring (87 +/- 13 versus 69 +/- 10, p less than 0.001). Rate at rest decreased 26 +/- 15% and submaximal exercise rate diminished 24 +/- 12%. Thirteen (81%) of the 16 patients exhibited at least 15% slowing of rate at rest and during submaximal exercise. Eleven patients (69%) reported alleviation of symptoms. There was no change in serum digoxin levels during diltiazem treatment (1.3 +/- 0.5 versus 1.3 +/- 0.6 ng/ml, p = NS). On withdrawal of diltiazem, ventricular response returned to baseline values. Diltiazem is an effective agent for control of ventricular response, both at rest and during exercise, in digoxin-treated patients with chronic atrial fibrillation. PMID- 3805531 TI - How should we judge the efficacy of drug therapy in patients with chronic congestive heart failure? The insights of six blind men. PMID- 3805532 TI - Secondary neoplastic infiltration of the myocardium diagnosed by two-dimensional echocardiography in seven cases with anatomic confirmation. AB - In seven patients with different types of neoplasm, secondary myocardial infiltration was diagnosed in vivo by two-dimensional echocardiography and confirmed by direct inspection. In all patients, clinical and electrocardiographic findings were suggestive but nonspecific for myocardial involvement. Two patients had cardiac tamponade and three had pericardial effusion. In three patients, the echocardiographic diagnosis made it possible to plan specific therapy. Clinical, electrocardiographic and echocardiographic aspects are discussed. A two-dimensional echocardiographic examination should be performed in all patients when cardiac metastatic involvement is suspected from clinical electrocardiographic findings, because the in vivo diagnosis of such a condition may have important therapeutic implications for such patients. PMID- 3805533 TI - Idiopathic lymphoplasmacytic aortic valvulitis: observations in two elderly women with unexplained aortic insufficiency. AB - Two patients with a unique aortic valvulitis required aortic valve replacement. Both were elderly women who presented with evidence of systemic disease, including fever, arthralgia, myalgia, markedly elevated erythrocyte sedimentation rate, anemia, leukocytosis, hypoalbuminemia and renal insufficiency, in addition to progressive subacute aortic insufficiency. Histologic examination of the excised aortic valve revealed a lymphoplasmacytic infiltrate. Neither patient had evidence of other diseases that have been associated with aortic insufficiency. One should consider the judicious use of glucocorticosteroids for such patients. PMID- 3805534 TI - Enhancement of conduction in an accessory pathway by local noncaptured stimuli. AB - Subthreshold stimuli have been reported to prolong the refractory period of myocardial tissue. This report presents the first case of reproducible acceleration of a reentrant tachycardia by apparently subthreshold stimuli delivered to the os of the coronary sinus during the atrial refractory period in a child with incessant orthodromic tachycardia utilizing a posteroseptal pathway. Mechanisms by which these stimuli could influence the tachycardia circuit are proposed, and the potential usefulness of this finding for mapping tachyarrhythmias is discussed. PMID- 3805535 TI - Reperfusion and the plasma isoforms of creatine kinase isoenzymes: a clinical perspective. PMID- 3805536 TI - Quantitative morphology of the aortic arch. PMID- 3805537 TI - Exercise and incomplete right bundle branch block. PMID- 3805538 TI - The untalked about problem of false positive test results. PMID- 3805539 TI - Doppler detection of false pseudoaneurysm. PMID- 3805540 TI - Abstracts. 36th annual scientific session of the American College of Cardiology. New Orleans, Louisiana, March 8-12, 1987. PMID- 3805541 TI - The magnitude of the spontaneous production of histamine-releasing factor (HRF) by lymphocytes in vitro correlates with the state of bronchial hyperreactivity in patients with asthma. AB - In our previous studies we reported that lymphocytes from patients with asthma spontaneously produce histamine-releasing factor (HRF) in vitro. In an effort to examine whether spontaneous HRF production (SpHRF) by lymphocytes from patients with asthma is related to the state of bronchial hyperreactivity (BHR), 20 patients with mild to severe asthma were studied. Peripheral blood lymphocytes were cultured alone in a serum-free medium for 24 hours, and culture supernatant was assayed for HRF activity in two separate histamine-release tests with autologous basophils and normal basophils from known healthy donors. BHR was measured as bronchial reactivity to inhaled histamine and was expressed as a provocation concentration of histamine required to induce a 20% fall in FEV1 (PC20). The result of this study demonstrated that lymphocyte supernatant from all patients with asthma released significant amount of histamine from both autologous and normal basophils. Very high histamine release was usually induced by lymphocyte supernatant from severely ill patients who had PC20 less than 2 mg/ml. Statistical analysis demonstrated that the magnitude of the SpHRF significantly correlated (r = -0.86; p less than 0.001) with PC20. Since mast cell- and basophil-derived mediators have been implicated in the pathogenesis of BHR, high correlation between PC20 and SpHRF by lymphocytes suggests that the latter may contribute to the development of BHR. Further studies are required to disclose the exact relationship between SpHRF and BHR. PMID- 3805542 TI - Immunity and behavior. PMID- 3805543 TI - Iatrogenic pseudoanaphylaxis. AB - A nurse exposed accidentally to chymopapain by ocular exposure was treated vigorously for chymopapain anaphylaxis. Retrospective analysis of the case indicates that there was no evidence of IgE antibody against chymopapain, and the clinical events were inconsistent with anaphylaxis and could be explained by a vasovagal reaction and the cardiorespiratory effects of repeated intravenous epinephrine. Our assessment is that the nurse is currently in a state of good health; however, she did not accept our absence of allergic disease diagnosis and has sought "clinical ecology therapy." Although no litigation in this case has arisen, the legal implications of this case report are reviewed. PMID- 3805544 TI - Eustachian tube obstruction (ETO) after histamine nasal provocation--a double blind dose-response study. AB - Eustachian tube obstruction (ETO) has been reported to develop more frequently in subjects with allergic rhinitis (AR) than in subjects without AR after a single intranasal histamine challenge. The present double-blind crossover study was designed to confirm and extend this observation. In a pilot study, nebulization was demonstrated to be superior to insufflation in provoking ETO. Five subjects with AR and five subjects without AR were repeatedly challenged intranasally with nebulized normal saline or increasing doses of histamine (0.01, 0.1, 0.5, 1.0, 5, and 10 mg per nostril). Subjects with AR were selected on the basis of AR symptoms and IgE antibodies to allergens and were challenged in their nonallergy seasons. ETO was assessed by nine-step tympanometry and nasal airway resistance by anterior rhinomanometry before and after each challenge. Of nine ears in subjects with AR, ETO developed in five ears at 0.1 mg and in four ears at 0.5 mg. In contrast, in 10 ears of subjects without AR, ETO developed in two ears at 5 mg but did not develop in eight ears at doses as large as 10 mg. This test effectively discriminated subjects with AR from subjects without AR, groups that could not be similarly differentiated by nasal or skin responsiveness to histamine challenge. Saline challenges provoked ETO in three of nine ears of subjects with AR and in one of 10 ears of subjects without AR. These data suggest a hyperresponsiveness of the nasopharyngeal and/or tubal mucosa to histamine in subjects with AR that may predispose these patients to otitis media with effusion. PMID- 3805545 TI - The biologic activity of mast cell granules. VIII. In vivo and in vitro characterization of mast cell granule-derived inflammatory factors involved in rat late-phase reactions. AB - Intradermal injections of isolated mast cell granules (MCGs), as well as solubilized high-molecular-weight (HMW) (greater than 10,000 daltons) and low molecular-weight (LMW) (10,000 greater than MW greater than 500 daltons) fractionated granule constituents, can produce inflammatory responses termed late phase reactions (LPRs). The identity and mechanism of action of various inflammatory factor(s) contained within these fractions is incompletely established. Since rat LPRs are neutrophil-dependent responses, we analyzed the inherent neutrophil chemoattractant potential of HMW and LMW granule fractions using a 48-well microchemotaxis chamber. Although both HMW and LMW fractions attracted rat neutrophils, the LMW fraction was less active at equivalent protein concentrations. Checkerboard analysis demonstrated that the HMW fraction enhanced random migration of neutrophils, indicating that the HMW fraction contains factors that are primarily chemokinetic. To analyze further the HMW fraction, solubilized MCGs were sequentially fractionated with XM300 (MW greater than 300,000 daltons), and YM100 (300,000 greater than MW greater than 100,000 daltons), XM50 (100,000 greater than MW greater than 50,000 daltons), and YM10 (50,000 greater than MW greater than 10,000 daltons) ultrafiltration membranes. This process revealed that most in vivo inflammation-provoking activity as well as the in vitro chemoattractant activity resided in the XM300 and YM100 retentate fractions. Two of the major constituents of the HMW fraction, heparin and chymase, were evaluated for their contribution to the chemoattraction. Purified MCG heparin did not evoke neutrophil migratory responses in vitro or in vivo. Sepharose 4B chromatography of solubilized MCG demonstrated a peak of inflammation-provoking activity beginning at the void volume and tapering off near the 400,000 MW range. This in vivo activity was clearly separable from the chymase activity and represents the HMW inflammatory factors. These results demonstrate that both HMW and LMW granule fractions contain inflammatory activities capable of producing LPR in vivo and suggest that enhancement of neutrophil migration at sites of mast cell degranulation is one mechanism of action. PMID- 3805546 TI - Serum IgE antibodies to Trichophyton in patients with urticaria, angioedema, asthma, and rhinitis: development of a radioallergosorbent test. AB - A series of patients was identified who demonstrated immediate positive skin tests to intradermal Trichophyton extract. These skin responses did not correlate with other fungal skin tests and were present both in atopic and nonatopic patients. The individuals demonstrating positive immediate skin tests included patients with urticaria, angioedema, asthma, and/or rhinitis, as well as five of 34 normal control subjects. Most skin test positive individuals had a history of local fungal infection and clinical signs suggestive of fungal infection. By use of Trichophyton tonsurans extract linked to Sepharose as the immunosorbent, it was possible to measure IgE antibodies in 26/30 sera from skin test positive individuals. With strongly positive sera, RAST bound up to 30% of the radiolabeled anti-IgE added. The results confirm that most skin test positive individuals have IgE-mediated hypersensitivity to Trichophyton. These observations support the older view that absorption of dermatophyte allergen through the skin should be considered as a possible cause of allergic disease. PMID- 3805547 TI - The effects of albuterol on sulfur dioxide-induced bronchoconstriction in allergic adolescents. AB - Ten allergic subjects with exercise-induced bronchospasm were studied to determine whether albuterol could prevent sulfur dioxide (SO2)-induced bronchoconstriction. Albuterol or placebo (180 micrograms) were administered by metered-dose inhaler 20 minutes before a 10-minute exposure to SO2 or clean air during moderate exercise on a treadmill at an exercise level that by itself did not produce exercise-induced bronchospasm. Pulmonary functions (FEV1 and total respiratory resistance [RT]) were measured before the drug, after the drug, and after exposure to SO2 or clean air. Albuterol treatment produced significant bronchodilation and also prevented SO2-induced bronchoconstriction. Following SO2 inhalation after placebo, FEV1 decreased 15% (p less than 0.02) and RT increased 50% (p less than 0.03). Following SO2 inhalation after albuterol treatment, neither FEV1 or RT changed significantly. We conclude that albuterol, a beta 2 agonist, inhibits SO2-induced bronchoconstriction. This result suggests that the adrenergic nervous system or mast cell degranulation are involved in SO2-induced bronchoconstriction. PMID- 3805549 TI - Some principles in the peptide field. PMID- 3805548 TI - A model of immunologic lung injury induced by trimellitic anhydride inhalation: antibody response. AB - We studied lung injury induced in Sprague-Dawley rats by trimellitic anhydride (TMA) inhalation. Groups of 40 male and 20 female rats were exposed to TMA by inhalation at target concentrations of 0, 10, 30, 100, and 300 micrograms/m3, 6 hours per day, 5 days per week, for 2 weeks. Rats in each exposure group were sacrificed after 10 exposures or rested for 12 days and either sacrificed or received a 6-hour TMA challenge at their initial exposure levels and sacrificed at 24 hours. At each sacrifice, serum antibody to radiolabeled trimellityl rat serum albumin (RSA-TM) was measured by an ammonium sulfate technique, and lung pathology was determined. After 10 days of exposure, external hemorrhagic lung foci were directly related to the exposure concentration of TMA. Serum antibody binding of RSA-TM correlated with exposure concentration, hemorrhagic lung foci, and lung weight. There was healing of lung lesions 12 days after exposure with a return of lung lesions only 18 hours after the 6-hour inhalation challenge. A correlation between serum antibody to RSA-TM, hemorrhagic foci, and lung weight existed after challenge. This model clarifies two clinical entities observed in exposed workers, the late respiratory systemic and the pulmonary disease-anemia syndromes. PMID- 3805550 TI - Relative efficacy of maintenance therapy with theophylline, inhaled albuterol, and the combination for chronic asthma. AB - The relative benefit of maintenance therapy with theophylline, inhaled albuterol, and the combination was examined in 18 adolescents and adults with chronic asthma during a 3-month, randomized, double-blind, crossover trial. Theophylline and combination regimens were associated with significantly fewer days with symptoms (52% and 55%) than albuterol (72%). The greater frequency of symptoms during the albuterol regimen was increasingly apparent more than 4 hours after albuterol doses and was greatest between 4 and 8 A.M. Albuterol transiently inhibited histamine-induced bronchospasm to a much greater degree than did theophylline, and combining the drugs produced at least an additive effect. The effect of albuterol was completely absent by 4 hours, however, whereas that of theophylline persisted. Thus, in spite of greater acute effects on the airways, the transient duration of effect from inhaled albuterol appears to limit its usefulness as maintenance therapy, especially for patients with nocturnal symptoms. PMID- 3805551 TI - Sundown syndrome in institutionalized elderly. AB - To describe sundown syndrome and determine factors related to its occurrence, 59 demented and 30 nondemented nursing home residents aged 60 years and above were observed in the morning and the evening over two consecutive days using a Confusion Inventory. Physiologic, psychosocial, and environmental data were also recorded. In addition, Pfeiffer's Short Portable Mental Status Questionnaire, the Philadelphia Geriatric Center Morale Scale, Face-Hand Test, and sensory screening were completed. Among the 89 subjects, 11 were found to be sundowners, a prevalence rate of one in eight in the facility. No clear pattern of behaviors evolved but sundowners were found to increase restless and verbal behavior as evening approached. Sundowners were more likely to be demented, with greater mental impairment and organic involvement than nonsundowners. Among physiologic factors, odor of urine, being awakened frequently on the evening shift, and fewer medical diagnoses were significantly associated with sundowning. Significant psychosocial factors were current room residence of less than one month, more recent admission to the facility, and higher evening levels of confusion. No environmental factors were related. PMID- 3805552 TI - Prevalence of thyroid disease and abnormal thyroid tests in older hospitalized and ambulatory persons. AB - To determine the utility of laboratory tests for diagnosing thyroid disease in the hospitalized elderly, we measured serum thyroid-stimulating hormone (TSH), thyroxine (T4), free thyroxine index (FT4I), triiodothyronine (T3), and free triiodothyronine index (FT3I) in 125 geriatric inpatients, mostly men, and compared the results to those in elderly ambulatory patients. Hypothyroidism (TSH greater than 10 microU/mL with a low T4 and FT4I or clinical findings) was present in 7.8% (nine of 116) of male inpatients compared to only 0.7% of male ambulatory controls (P less than 0.01). Only a few women were studied but 17% (two of 12) were hypothyroid compared to 2.4% of ambulatory elderly women. Three of the hypothyroid inpatients had no clinical clue to their hypothyroidism. Further, decreased thyroid reserve or subclinical hypothyroidism (TSH greater than 10 microU/mL with a normal T4 and FT4I and no overt clinical findings), a condition which may lead to overt hypothyroidism, was more common in male inpatients (4.3%) than in male ambulatory controls (1.8% [P less than 0.01]). Thus, a clearly elevated serum TSH (greater than 10 microU/mL) was more common in inpatient (12.1%) than in ambulatory (2.4%) elderly men (P less than 0.01). Four inpatients and nine ambulatory controls had an elevated T4 and FT4I, but in only one (0.8%) inpatient and one (0.6%) control was a final diagnosis of hyperthyroidism made; the others had no clinical findings and a normal or low T3 and FT3I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805553 TI - Use of the dexamethasone suppression test with depressed and demented elderly. AB - Although some researchers have suggested that the dexamethasone suppression test (DST) may be useful in differentiating between major depression and dementia in the elderly, recent reports of abnormal DST results in nondepressed, demented elderly have questioned the validity of the test in this population. This study compared the frequency of abnormal DST results in three groups of elderly inpatients: depressed/not demented; demented/not depressed; and depressed and demented. Two geropsychiatrists independently evaluated 33 patients for symptoms of depression and/or dementia and then assigned each patient to one of the three groups. Subjects in the demented/not depressed group had a significantly larger proportion of abnormal DSTs (P less than .01), and the mean postdexamethasone, 4 PM blood cortisol level of the demented/not depressed group was significantly greater than the means of the other two groups (P less than .005). In this sample, the DST was more likely to identify dementia than depression. Until further investigations clarify the parameters of DST use in the elderly, the diagnosis of depression and dementia should continue to be determined by sensitive interpretation of clinical findings, history, and other diagnostic tests. PMID- 3805554 TI - Exercise conditioning in the elderly coronary patient. AB - We compared conditioning effects of a supervised exercise program in 100 elderly and younger patients with a recent coronary event. Twenty-one patients were greater than or equal to 62 years of age (mean, 65 years) and 79 were less than or equal to 61 years of age (mean, 48.7 years). While the elderly patients attained a lower peak exercise intensity on entry and on completion of the exercise protocol, they obtained a similar relative training benefit as the younger patients. Peak exercise intensity increased 68% in each group and submaximal (five METS) heart rate-blood pressure product decreased 27% in the older patients and 26% in the younger patients. Rate of entry into our program was substantially lower in the elderly patient group, 19% v 57% in younger patients (P less than 0.001) despite a similar inhospital recruiting effort. Thus, although elderly coronary patients obtain similar training benefits as younger patients, they are less likely to participate in a program designed to decrease cardiac disability. PMID- 3805555 TI - Risk factors for sleep disordered breathing in heterogeneous geriatric populations. AB - This cross-sectional, multivariate study investigated associations between sleep disordered breathing (SDB) and putative risk factors in a heterogeneous group of 720 individuals over the age of 50 years studied during all-night in-lab polysomnography. Results indicated that: aged men were more likely to show impaired respiration during sleep than aged women; excessive daytime somnolence and parasomniac symptoms (snoring, gasping during sleep) were associated with SDB but insomnia was not; obesity accounted for more variance in SDB than age per se, implying that the prevalence of SDB in some elderly persons could be related to the deposition of body fat seen as individuals grow older. All four risk factors (age, sex, obesity, and symptomatic status) were statistically significant and independent predictors of impaired respiration in sleep in the elderly. PMID- 3805556 TI - Usefulness of routine preoperative chest roentgenograms in elderly patients. AB - One hundred thirty-six charts of preoperative patients over the age of 59 years were reviewed to determine whether clinical criteria alone are sufficient to identify patients who would not benefit from preoperative chest roentgenograms. Thirty-four percent of the patients without risk factors and 62% of those in the high-risk group were found to have significant abnormalities on chest roentgenograms (P less than 0.05). Postoperative complications occurred in 20% of patients in the high-risk group compared to 11% complication-rate in patients without clinical risk factors. The difference is not statistically significant. The prevalence of abnormal preoperative chest roentgenograms among those over the age of 70 years (49%) was not significantly different from the prevalence in those between the ages of 60 and 70 years (59%); however, the incidence of major postoperative complications was significantly higher in the older group (17 v 4%, P less than 0.01). Because of the substantial prevalence of abnormal chest roentgenograms and postoperative complications, it is concluded that in the elderly preoperative patients, in particular those over the age of 70 years, chest roentgenograms should be done on all patients regardless of clinical history. PMID- 3805557 TI - Two-stage tuberculin testing with control antigens in patients residing in two chronic disease hospitals. AB - We studied the prevalence of tuberculin reactivity and anergy in 360 elderly patients residing in two municipal chronic disease hospitals. Eighty-five (26%) of the 323 patients tested had a positive reaction to a stage 1 tuberculin test and 12 (6%) of the 207 stage 1 tuberculin-negative patients exhibited a booster response to a stage 2 tuberculin test. Thirty percent of the same 207 patients had no response to an anergy panel of skin test antigens that included candida, mumps, and trichophyton. Nonresponders to tuberculin and the anergy panel had significantly higher one-year mortality rates compared to responders (44 v 20%, P = 0.001). Tuberculin-positivity among the 770 employees working in these facilities was 43%; 12 (4%) had a booster response. A survey of 29 randomly selected long-term care facilities in the Boston area indicated that all had a policy for pre-employment screening of employees, but less than 50% had a policy for patients and only one institution used two-stage testing. Routine tuberculin testing is recommended for long-term care facilities and the two-stage method is preferable in institutions with adequate resources. PMID- 3805558 TI - Recruitment of long-term care facilities for research. AB - We report the successful recruitment of a stratified random sample of nursing homes in the state of Maryland into three research studies funded by the National Institute on Aging. These studies examine the prevalence of infections and urinary tract instrumentation and the incidence of antimicrobial use in nursing home residents. Following selection of a facility, the administrator was telephoned and a meeting at the home was requested. At this meeting, the project was explained in detail using a packet of promotional information which included a project summary, a listing of project staff and their qualifications, and letters of support from influential organizations. A total of 61 eligible facilities were contacted in order to achieve a group of 53 participating homes with approximately 5000 beds. One hundred percent cooperation was achieved from all strata except small (less than or equal to 50 beds) proprietary comprehensive care facilities, and homes with both comprehensive and domiciliary beds. A direct, personal approach, backed by a carefully prepared study information and the support of medical and nursing home organizations resulted in successful recruitment of 53 (87%) of 61 homes sampled. PMID- 3805559 TI - The under-reporting of pressure sores in patients transferred between hospital and nursing home. PMID- 3805560 TI - Puncture of a nondeflatable Foley balloon using fluoroscopy. PMID- 3805561 TI - The headache of temporal arteritis. AB - Patients with temporal arteritis may be misdiagnosed because the headache does not affect the temples. The records of 24 patients with biopsy proven temporal arteritis were reviewed to determine the site and other qualities of headache. Past reports of the sites of headache in this disease were also reviewed. The temporal area was the sole site of headache in only six of 24 patients; the temple was included in pain that affected the frontal, vertex, and occipital areas in another seven patients. Two patients had generalized headaches. The headache did not involve the temple in seven patients and two patients did not experience headaches. Temporal arteritis should be considered in every elderly individual who begins to complain of headache, no matter what the site, quality, severity, or time pattern. PMID- 3805562 TI - Streptococcus bovis infection of the pulmonary valve in an elderly woman with a colonic polyp. PMID- 3805563 TI - Nephrotic syndrome in the elderly. AB - Study of hospital activity analysis data over a ten-year period in a district general hospital show that nephrotic syndrome is uncommon in the elderly. The spectrum of histology, however, is no different from the younger adults. The other interesting findings were: diabetic elderly with nephrotic syndrome may have minimal change, therefore should have renal biopsy; and occurrence of sero negative lupus nephritis in a 90-year-old male and a focal glomerulo-nephritis in a 75-year-old female. PMID- 3805564 TI - Funding for geriatric medicine fellowships. PMID- 3805565 TI - Dysphagia and organo-axial gastric volvulus. PMID- 3805566 TI - Uptake of cadmium in isolated kidney cells--influence of binding form and in vivo pretreatment. AB - Uptake of cadmium as 109CdCl2, 109Cd-cysteine, 109Cd-albumin and 109Cd metallothionein was studied in isolated kidney cells from rat. Cd as 109CdCl2 and 109Cd-albumin was taken up at similar rates. The uptake of cadmium as 109Cd cysteine was greater and that of 109Cd-metallothionein lower compared with that of the other substances. These observations were made on non-pretreated cells. In cells taken from rats pretreated with CdCl2 in vivo, the uptake of cadmium as 109CdCl2, 109Cd-cysteine and 109Cd-albumin was lower than in cells from non pretreated rats. However, the uptake of 109Cd-metallothionein was considerably enhanced in pretreated cells. In pretreated kidney cells the decreased uptake of Cd (as Cd-albumin) might be related to protection of the kidney against acute Cd toxicity and increased uptake of metallothionein-Cd might contribute to the explanation of renal damage in long-term Cd exposure. PMID- 3805567 TI - Cimetidine enhances and phenobarbital decreases parathion toxicity. AB - Parathion toxicity has been attributed to its metabolic product paraoxon which is formed in the mammal liver through the multiple oxidase enzymes. These are induced by barbiturates and inhibited by SKF 525 A and cimetidine. We assessed the effects of these drugs on the acute toxicity of parathion in rats by measuring the rate of survival at 24 h after the administration of the oral LD50 of parathion to four groups of rats: control and pretreated with the aforementioned drugs. Additional rats of these groups were used to measure the capability of liver isolated microsomes to transform p-nitroanisole to p nitrophenol. In the control and cimetidine groups we also measured the transformation of parathion to paraoxon and p-nitrophenol by the liver microsomes. Phenobarbital increased the survival 100% whereas cimetidine and SKF 525 A dramatically potentiated parathion toxicity. Phenobarbital increased the formation of p-nitrophenol but cimetidine and SKF-525 A produced the opposite effect. Paraoxon and p-nitrophenol from parathion were decreased by cimetidine. Our results strongly suggest that parathion itself is largely responsible of its toxicity and the inhibition of its metabolism is harmful rather than beneficial. PMID- 3805568 TI - Degeneration and regeneration of respiratory mucosa of rats after exposure to styrene. AB - The recovery process of pathological changes in the respiratory mucosa following exposure to styrene were experimentally studied to improve the understanding of the respiratory toxicity of styrene. Thirty male SD rats were exposed to 150 ppm or 1000 ppm of styrene for 4 h a day over 3 weeks (5 days a week). They were killed for examination at 1 day or 12 weeks after completion of the exposure sequence. Bilateral mucosal samples from the nasal septum and the trachea of the animals were examined for ciliary activity and subjected to electron microscopy. Complete functional and morphological recovery of the nasal and tracheal mucosa was observed at the 12th week post-exposure to 150 ppm of styrene. After exposure to 1000 ppm of styrene, almost normal function and morphology of the tracheal mucosa was found at the 12th week post-exposure, but the nasal mucosa continued to show decreased ciliary activity and an affected morphology. PMID- 3805569 TI - Evidence of differential hematopoietic compensation to lead intoxication in blood, liver and kidney. AB - The dependence of fluorescent porphyrin levels on the concentration of lead in blood, liver and kidney has been examined as functions of both the level and duration of dosing. Individually housed male Wistar COBS rats of 200 g were randomly selected for 3, 7, 21 and 35 day dosing periods in groups of: control, 50, 100 and 1000 ppm dosing in drinking water. The plot of all data points for porphyrin concentration against measured lead burden covers the same range of levels and closely resembles the scatter of data observed in humans. However, subsets of this plot defined by individual dose levels and durations yield well defined linear relationships. At all dose levels at 7 days the correlation of porphyrin concentration to lead tissue burden is negative in all tissues, showing a direct inhibition of hemopoiesis with lead burden. Depending on the tissue the slope becomes less negative, or, as in blood, positive at 21 and 35 days at all doses. This compensation is most rapid in blood, then liver and is least evident in kidney. The time at which compensation is observed is the same for all doses in each tissue and seems therefore, to depend on the rate of protein turnover in different tissue types. These results suggest that a direct correlation of porphyrin concentration to lead burden is not valid without knowledge of the dosing history. As well, evidence of compensation in one tissue does not imply successful compensation in other affected tissues where regeneration rates are slower.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805570 TI - Effects of some monocyclic aromatic solvents and their metabolites on brain dopamine in rabbits. AB - Adult male rabbits were exposed to high concentrations (750 ppm, 12 hours daily for 7 days) of toluene, xylenes, styrene, ethylbenzene, vinyltoluene (3 methylstyrene), and 7-methyl-styrene vapours or were dosed with 4 mM/kg/day i.p. of hippuric, methylhippuric, mandelic, phenylglyoxylic, and 7-methyl-mandelic acids. Styrene, vinyltoluene and ethylbenzene caused a marked depletion of striatal and tuberoinfundibular dopamine. Such an effect was also caused by treatment with phenylglyoxylic and mandelic acids. Dopamine depletion was associated with an increase in homovanillic acid concentration in the same regions. These results indicate that dopamine metabolism is a target for the neurotoxic effects of some monocyclic aromatic hydrocarbons and their metabolites, a lateral vinyl- or ethyl-chain being crucial for the structure/activity relationship of such compounds. PMID- 3805571 TI - The effect of carbon monoxide on hormone levels and organ weights in rats. AB - Male Wistar rats were exposed continuously for 1 or 2 months to 25 or 100 ppm CO. The concentrations of noradrenaline in the hypothalamus, corticosterone and thyroxine in serum and of adrenal catecholamines were estimated. After exposure to 25 ppm CO no significant changes were observed in the serum corticosterone and thyroxine, hypothalamic noradrenaline, adrenal catecholamines levels, or in the weights of lung, spleen, adrenal glands, liver and the whole body. Exposure to 100 ppm CO induced a decrease in hypothalamic noradrenaline and serum thyroxine and an increase in adrenal catecholamines and serum corticosterone. Whole-body and organ weights were unchanged except for a slight decrease in liver weight. The results suggest a non-specific stress response in the rat to 100 ppm CO whilst concentration of 25 ppm CO was without any stress effect. PMID- 3805572 TI - Double replica electroblotting: a method to produce two replicas from one gel. AB - Electroblotting is a method by which proteins or nucleic acids, separated by electrophoresis, are transferred, also by electrophoresis, from a gel to a so called transfer medium, e.g a nitrocellulose membrane. In some experiments, it is desirable to be able to obtain more than one replica from each gel and it has now proved possible to produce two replicas, which are almost identical, from one gel. This is achieved by applying one membrane on each side of the gel and change the direction of the current several times in such a way that the efficient transfer time is short in the beginning of the electroblotting and is increased for each cycle. This procedure will be referred to as 'double replica electroblotting'. Proteins were transferred at 100 V and the duration of an experiment with 2 h efficient transfer time in each direction was 7 h. The gel was more efficiently depleted of proteins after double replica electroblotting as compared to ordinary electrotransfer in one direction. Cathodically migrating proteins are also trapped on the membranes with this technique. Double replica electroblotting was used to produce two replicas from ordinary sodium dodecyl sulfate polyacrylamide gels as well as from 2-dimensional gels. PMID- 3805573 TI - A spectrophotometric assay for nanogram quantities of biotin and avidin. AB - Parameters and conditions of an enzyme based assay for biotin and avidin are presented. Biotinylated glucose-6-phosphate dehydrogenase when complexed with avidin becomes inactivated. Thus it was possible to construct a competitive assay system for biotin. The assay is sensitive between 100-500 ng/ml and could detect as little as 10 ng in 0.1 ml with a between run error of 2.4%. It requires a 60 min incubation at 21 degrees C and 5 min to assay. The avidin assay, based on the degree of inactivation of biotinylated-glucose-6-phosphate dehydrogenase in relation to the concentration of avidin, could detect as little as 0.25 ng in 0.1 ml or 2.5 ng/ml with an assay time of 10 min with a between run error of 3.9%. Both assays are rapid with significant improvements over other non-isotopic methods in sensitivity and comparable to radioisotopic methods in sensitivity with the added advantage of ease of method. PMID- 3805574 TI - A new HPLC analytical method for o-hydroxyhippuric acid in uremic serum. AB - o-Hydroxyhippuric acid (HHA) is formed in liver during the process of detoxication of salicylic acid which arises from either salicylic-containing dietary vegetables or hydrolysis of aspirin. Recently, HHA has also been shown as one of the so-called 'uremic toxins'. By derivatization of HHA with o phthaldialdehyde (OPA), the resulting fluorescent product can easily be measured with the limit of measurement somewhere below 3 pmol on high performance liquid chromatography. Using the method described, an approximately 85% recovery of added HHA in human sera was obtained. This analytical system is now being employed to determine the concentration of HHA in human sera of uremic patients. Determination of HHA content in human uremic patients is very important, since uremia is associated with defective binding of many acidic drugs to serum protein(s) and HHA replaces these drugs by tightly binding to these proteins. This could potentially affect the therapeutic effectiveness of various pharmacologic agents. PMID- 3805575 TI - Determination of protein by Coomassie dye-binding in agarose gels. AB - A variation of the Coomassie dye-binding assay for proteins is described. Protein samples were pipetted to the surface of agarose plates in uniformly sized spots and stained with Coomassie Blue G-250. The bound dye was determined by densitometric scanning using double wavelength and flying spot facilities. The response curves were linear in an about 10-fold concentration range with a lower detection limit of 0.5 microgram. No background correction was necessary because unbound dye and most substances known to interfere with other protein assays were removed during the staining and destaining of the agarose gels. Membrane proteins could be analyzed since the samples were applied as solutions in 1% sodium dodecyl sulfate. PMID- 3805576 TI - Methodologies for the application of monobromobimane to the simultaneous analysis of soluble and protein thiol components of biological systems. AB - A series of simple methodologies for the determination of the redox status of low molecular weight and protein thiols in biological systems is described. Based centrally upon the use of monobromobimane, we describe a standard in situ derivatisation procedure simultaneously resulting in maximal recovery of both free, reduced low molecular weight and bromobimane accessible protein thiols as their corresponding bimane adducts from intact biological systems. Test systems include isolated and cultured cells, tissue homogenates and body fluids such as blood plasma. Quantitation of the bimane adducts of cysteine and glutathione is achieved by reversed phase high performance liquid chromatography, whereas quantitation of the corresponding adducts of protein thiols is achieved by fluorescence spectroscopy following protein precipitation. Full validation data for quantitative estimates are described. Additionally we have coupled these procedures to prederivatization denaturation treatments of biological protein samples in order to quantitate pools of protein thiols which are inaccessible to bromobimane in samples of native protein. We have also coupled these procedures with prederivatization reductions of biological systems under study with dithiothreitol, rendering simultaneously both oxidized low molecular weight thiols and oxidized protein thiols accessible to derivatisation with monobromobimane. Thus, we have obtained quantitative determinations of cysteine and glutathione present in mixed disulfides with protein and in soluble low molecular weight disulfides and estimates of intraprotein disulfides in a number of test biological systems. PMID- 3805577 TI - Isoelectric focusing using non-amphoteric buffers in free solution: I. Determination of stable concentration profiles. AB - For large-scale separations of proteins, the use of simple non-amphoteric buffers in free solution and in multicompartment electrolyzers seems promising for industrial applications. The stabilization of a pH profile with this type of buffer requires the strict observation of two conditions: choice of an adequate buffer; stationary profiles of concentrations. During electrolysis in free solution, the ions of the buffer are displaced across the compartments by migration and by diffusion. To keep a stationary composition, the inflow and outflow of all individual ionic species through each compartment must be identical. At high current, diffusion may be neglected against migration and the ionic flows will be identical if the transport number of each ion is constant at each location within the cell. In these conditions, stationary compositions will be independent of the electric current. This condition of constant transport numbers implies the use of profiles of buffer concentrations different from those published up to now. The new equations for these profiles of concentrations are given in the present paper. The constant migration of the ions must be compensated in the end compartments of the isoelectric focusing cell to provide a stable steady state. Two methods are proposed in the literature: the buffer renewal method and the external recycling method (rheoelectrolysis). Here modified buffer renewal method is proposed. Using stationary mass balances, analytical equations are given to calculate the flows and the composition of the solutions to be recycled or added. Using these equations and the profiles of concentrations to keep constant transport numbers, it is demonstrated that only a renewal of the buffers in the end compartments may lead to stable pH profiles and thus to valid conditions of separation. PMID- 3805578 TI - Isoelectric focusing using non-amphoteric buffers in free solution: II. Apparatus and measures of pH stability. AB - Isoelectric focusing of amino acids or proteins requires a time-invariant pH gradient. The maintenance, in an electric field, of such profiles with simple non amphoteric buffers is possible in multicompartment cells using well determined concentration profiles. The method for determining these concentration profiles has been proposed in a preceding paper. A multicompartment cell has been built for the purpose of verifying the assumptions made. The technical characteristics of this cell will be described here. The time-stability of pH profiles obtained with sodium acetate/acetic acid buffers has been measured for concentration profiles determined so as to keep constant the transport number of each ion throughout the cell. Measured over a time span of 10 h and with a current density of 96 mA cm-2, the pH shift is, in the worst case, 0.009 pH unit/h. This corresponds to a much better stability than the one obtained with a constant concentration of sodium acetate in all compartments, and justifies the chosen concentration profiles based on the condition of constant transport numbers. The above mentioned method for the computation of the buffer concentration assumed a constant relative mobility of the ions. The experiments have shown the limits of this assumption, i.e. the variation of ionic mobilities with the ionic strength and the temperature diminishes the stability of the pH gradient. However, slight adjustments of the concentration in the end compartments allow some improvement of the stability. If the temperature could be precisely controlled in each compartment, a better pH stability than what has been achieved in these experiments should be reached. Two methods of compensation of the migration of ions in the end compartments (buffer renewal method and external recycling method) have been tested and will be discussed. PMID- 3805579 TI - Isoelectric focusing using non-amphoteric buffers in free solution: III. Separation of amino acids. AB - Separation of proteins or amino acids by isoelectric focusing in multicompartment devices has been proposed for large-scale purifications of biological mixtures. In the perspective of industrial applications, the present authors built a multicompartment apparatus and studied the pH profiles stabilized by simple non amphoteric buffers (acetic acid and sodium acetate). Mixtures of two amino acids were separated to test this device. A theoretical model comprising one dimensionless separation parameter is proposed to characterize these separations. This model allows one to calculate the purity of the recovered amino acids, the yield of a separation at steady-state or the time necessary to obtain a given concentration of an amino acid in one of the compartments of the isoelectric focusing cell. The separation parameter contains the physical parameters which intervene in the electric migration and in the diffusion. Values of this separation parameter have been experimentally determined for three amino acids under various experimental conditions. The results confirm the usefulness of this model in designing a multicompartment isoelectric focusing apparatus. PMID- 3805581 TI - The pre-press evolution. PMID- 3805580 TI - An individually designed database for medical photographic records. PMID- 3805582 TI - Videorecording and high-definition television systems for the late 1980s: a review. PMID- 3805583 TI - Computer graphics in a large photographic department. PMID- 3805584 TI - Light microscopy and electron microscopy: some photographic considerations. PMID- 3805585 TI - [Antenatal diagnosis of Lowe's syndrome based on histologic tests of the fetal eyes]. AB - Parents who had previously given birth to a male with Lowe's syndrome were watched during a second pregnancy and a prenatal sex diagnosis was performed by amniocentesis. The fetus was a male and in proportion to the high rate of risk (50%), parents require to stop this second pregnancy. Instead of later renal failure and, of course, mental retardation, it was the histological features of the fetus eyes which permit to diagnose and exhibit both congenital cataract and irido-corneal angle dysgenesis. PMID- 3805586 TI - [Etiology of endophthalmitis]. AB - Sixty p. cent of endophthalmitis were seen after recent ocular surgery. Another 14% were seen after surgery performed some years before. Non perforating trauma were responsible for 9.5%, and another 9.5% were seen complicating old ocular lesions by chemical, mechanical or infectious agents. Only in 7% the etiology was endogenous in one case general sepsis by meningococci, in another case, mycotic infection after prolonged systemic cortisone treatment, and one case in which endophthalmitis remained unexplained. Most cases complicating recent ocular surgery were seen after cataract extraction. PMID- 3805587 TI - [A rapid method: the 100-hue test]. AB - A new and fast method for scoring and assessing the 100-Hue test (Farnsworth Munsell) is reported. This method allows to simultaneously transcribe graphically the responses of the patient. This method reduces drastically the duration of examination and calculation, without modification of the principle of the 100-Hue Test. The qualitative and graphic validity, the statistical validity are analysed from 103 pathological subjects and 53 normal subjects. The two methods (Farnsworth-Kinnear and fast method) are examined comparatively. PMID- 3805588 TI - [Study of the visual field using automated static perimetry following panretinal photocoagulation in the diabetic]. AB - Twelve diabetic patients presenting a preproliferative or proliferative retinopathy were the subjects of our study. We studied the modifications of the visual fields, analyzed by computerized perimetry, after panretinal photocoagulation (PRP). For every patient, two techniques of PRP were applied, one on each eye: C: conventional scattered treatment, G: cluster technique. Computerized perimetry was done within 10 days prior to PRP, and 4 to 8 weeks following it. We used the Octopus 500, programs 36 (0 to 30 degrees) and 44 (30 to 60 degrees). It appears that, before any treatment, there is a loss of retinal sensitivity excepted the more central zone. Concerning the loss of sensitivity, although the number of laser burns, is greater in group G, there is no statistical significative difference between the 2 groups. Nevertheless, it seems to be more heterogeneous in group G. However, we have not studied the visual field modifications after confluent PRP using up to 5,000 500 micron laser burns. Although there is a loss of retinal sensitivity after PRP, none of our patients complained of it. PRP seems to us to be the only treatment able to prevent the natural evolution of preproliferative or proliferative diabetic retinopathies. PMID- 3805589 TI - [Present status of internal tamponade of the retina. Internal tamponade]. PMID- 3805590 TI - [Value of vitreoretinal video-endoscopy]. PMID- 3805591 TI - [Vascular and rhegmatogenous peripheral retinal changes in essential systemic arterial hypertension]. AB - The authors examined the peripheral retina of 106 patients affected by essential hypertension grading from 1st to 3rd, as classified by WHO. Research of peripheral retinal vascular alterations and of theoretically possible resulting degenerative changes (lattice degeneration, while without pressure and snail tract degeneration) was carried out. The study included a control group of 39 healthy subjects. A statistical analysis of the resulting data was performed. This showed that the frequency of retinal peripheral vasculopathy is higher in the hypertensive group and is significantly related to the severity of hypertensive retinal angiopathy. In the same way, the incidence of peripheral retinal degenerative changes proved to be significantly higher among the hypertensive group than in the control group. However, a correlation between the frequency of retinal degenerative processes and the presence of vascular changes could not be assessed. The results obtained are discussed, suggesting that peripheral retinal angiopathy could act as a risk factor leading to degenerative alterations on a formerly predisposed retinal tissue. PMID- 3805593 TI - [In vitro semi-automated morphometry of preserved human corneal endothelium]. AB - Cellular morphometry allows us to quantify the structural alterations of the corneal endothelium. Our study was a semi-automatized in vitro analysis of fresh and preserved corneal endothelium (MK medium cryopreservation). The equipment used was the Quantimeter 720 connected to a Digital PDP1123 computer. Nineteen corneas were studied and the following cellular parameters were established: perimeter, surface area, form factor and polymorphism coefficient. The computer program used was the SPSS/PC (Statistical Package for the Social Sciences) and the principal statistical tests were the Bartlett test and variance analysis. The statistical computerized study allowed us to compare the four cellular parameters and to establish the incidence rate of the conservation process on endothelial morphometry. The statistical and morphometry methods have proved to be reproducible and reliable and carry a supplementary quantitative element to analyse the influence of the conservation process. PMID- 3805592 TI - [Orbital zygomycosis (mucormycosis) in a healthy child. Treatment with ketoconazole]. AB - A case of orbital zygomycosis, probably mucormycosis, histologically demonstrated was observed in a healthy host. The etiologic agent could not be identified because of the unsuccessful cultures. No clinical antecedent allowed us to suppose that an immunological deficiency statement was present. It seemed that the fungus did not penetrates by the classical nasal and sinusal pathways. The fungus inoculation probably resulted from a subocular traumatism. The ketoconazole treatment, the only one possible in our case, was efficient. PMID- 3805594 TI - [Conjunctiva--Muller's muscle monobloc resection in the surgical treatment of minor ptosis]. AB - The Muller's muscle-conjunctival resection procedure is a relatively simple technique for mild ptosis, with good levator function and phenylephrine test positive. The advantages are: preservation of tarsus, very good and predictable results. PMID- 3805595 TI - [Suspension of the eyelid to the frontal muscle in the surgery of ptosis. Technic and indications]. AB - Twenty seven frontalis sling procedures were performed with use of autogenous fascia-lata. The choice of this procedure was performed sometimes at the first stage for severe ptosis with poor levator function: isolated congenital ptosis, blepharophimosis syndrome, Marcus Gunn Jaw-Winking ptosis, ptosis with severe myopathy, some traumatic ptosis. This procedure was also performed in a second stage after failure of the useful procedures (levator resection) and after verification that the levator was not exploitable. Sometimes the choice of the procedure is done during the exploration of the eyelid and the levator because there is not always "parallelism" between the levator function and his anatomy. So operative technique must always be performed by a complete anterior palpebral approach, the surgeon can passed the suspensory material from the tarsus to the roof of the orbit, just anterior to the levator aponeurosis, and then out above the eyebrow. The pulley this created by the periosteum of the superior orbital margin prevents vertical traction lines. The skin crease is created with sutures which pick up the tarsus and the lid retractors. If, during the explorations the levator is "exploitable", a super maximum levator resection will be performed at the first stage, the frontalis suspension will be maintained in case of failure of the levator resection. PMID- 3805596 TI - [Curietherapy of palpebral epithelioma with iridium-192. Method and results apropos of 192 cases treated at the Claudius-Regaud Center]. AB - Authors report a series of 192 eyelid epithelial tumors (187 patients) treated by curietherapy (192 iridium) at the Centre Claudius-Regaud, from January 1977 to December 1982. Curietherapy is an interstitial radiotherapy technique which inserts radio-active lines directly in the epithelial area. The first part of treatment consisted in using disposable vascular catheters as after loading procedure. In 90% of the cases, lesions were either on the lower lid or on the inner canthus. Tumors were mainly of basal cell type (77%). One thousand forty one tumors occurred in untreated patients: treatment was made for local recurrences in 51 cases. The control rate was 97% (186/192). Six recurrences were all observed in basal cell carcinoma. Four of them were cured by a second curietherapy, the two others needed a large surgical enucleation followed in one case by external radiotherapy. Late side effects essentially were functional and ocular. Functional side effects (19% of the series) consisted in eyelid hole reduction (5%), epiphora stenosis (6%), ectropion (4%) and loss of substance (4%). Ocular complications (3% of the series), were ulcerated cornea (one case) hypertrophic conjunctivitis (one case), iatrogenic cataract (two cases) and enucleation for recurrence (two cases). Iridium 192 curietherapy allowed a high local control rate. The best results were seen in untreated patients. Iatrogenic cataract eventually would be avoided by the use of lead contact lenses (recent utilisation not included in this series). PMID- 3805597 TI - [Initial approach to the contribution of informatics to strabismology]. AB - The authors report the results obtained in 300 cases of strabismus, during one year, on a Computer Apple IIe. The best use of a simple program gave 156 research keys, each fiche containing 60 keys. The authors pointed the high percentage of premature infants. They insist on the many future epidemiologic possibilities and the potentially better treatment choices. PMID- 3805598 TI - [The vertical element in strabismus]. PMID- 3805599 TI - Axial wedge osteotomy of the first metatarsal head (an adjunctive procedure for correction of hallux abducto valgus). AB - The authors have introduced an adjunctive procedure for correction of the osseous axial eversion of the first ray with hallux abducto valgus deformity. They believe that recurrence of bunion deformity is reduced with correction of this osseous abnormality. Consecutive illustrations are presented with recognition of the individual surgeon's ability to modify the procedure to allow for correction of deformities associated with hallux abducto valgus. PMID- 3805600 TI - Peroneus longus tendon lengthening. AB - This article presents lengthening of the peroneus longus tendon as an adjunctive procedure in the surgical correction of a plantarflexed first ray. The technique has enhanced the effectiveness of primary surgical procedures utilized in the correction of a plantarflexed first ray. Technical difficulty associated with lengthening of the peroneus longus tendon is minimal, and the incision placement introduced in this manuscript provides excellent exposure. PMID- 3805601 TI - The use of bone wax. AB - Bone wax is a nonabsorbable product used for providing hemostasis in bleeding bone. It may be used in podiatric surgery in areas of bleeding bone where bone healing and soft tissue attachment are not desired. As in any material implanted within body tissues, bone wax has possible side-effects. These may include foreign body reaction or increased susceptibility to infection. PMID- 3805602 TI - Retrospective analysis of intermetatarsal neuroma excision with preservation of the transverse metatarsal ligament. AB - The authors present a retrospective analysis of intermetatarsal neuroma excision with preservation of the transverse metatarsal ligament. They reviewed a series of 43 patients who had undergone a total of 59 such surgical resections. No other surgical procedures were performed on the foot. The patients included 36 women, and 7 men. Follow-up ranged from 1 year and 5 months to 6 years and 3 months with an average of 4 years and 3 months. Fifty-one of the neuromas removed were in the third interspace, three in the second interspace, and five in the fourth interspace. The surgical excision was performed in standard fashion except for the major modification of preservation of the transverse metatarsal ligament. There were 47 excellent or good results and, thus, the overall success rate was 79%. Seven patients had fair results and five had poor results. The results compare favorably with those reported by other authors who advocate transecting the transverse metatarsal ligament. The authors conclude that their approach to surgical excision of intermetatarsal neuromas is valid while preservation of the normal ligamentous anatomy is maintained. PMID- 3805603 TI - Diabetic osteoarthropathy versus diabetic osteomyelitis. AB - The differentiation between diabetic osteoarthropathy and osteomyelitis is a very difficult one to make, even in the presence of a pedal ulceration. However, considering present medical costs, the incorrect diagnosis of osteomyelitis can be a costly one, not only for the hospital, but also for the patient. In light of a normal white blood cell count, a benign 67Ga-citrate scan, and two noncontiguous areas of bone destruction, the diagnosis of diabetic osteoarthropathy can be made without the necessity of a bone biopsy. PMID- 3805604 TI - Bovine tendon lateral ankle stabilization procedure: xenograft bioprosthesis model GR 6 mm. AB - A surgical technique utilizing a bovine xenograft bioprosthesis has been developed for stabilizing a chronically unstable lateral ankle. With this new technique, minimal dissection of adjacent soft tissue is required, and the method allows for tissue ingrowth for strength and anastomosis to bone. However, a longer period of non-weightbearing is required to prevent inadequate incorporation of the graft. PMID- 3805605 TI - Biplane cuneiform osteotomy for juvenile metatarsus primus varus. AB - An operation combining the procedures of Cotton and Fowler on the medial cuneiform has been used for the correction of juvenile metatarsus primus varus and is presented in this manuscript. The procedure consists of a biplanar opening wedge osteotomy of the medial cuneiform with insertion of a bone graft and internal fixation. This surgical approach evolves from the procedures of Cotton (a sagittal plane correction of the depressed distal medial column in pes planus), and Fowler (a transverse plane correction of the medial column for metatarsus adductus). The operation has been utilized at St. Anne's Hospitals and provides excellent reduction of the intermetatarsal angle, with realignment of an oblique metatarsal-cuneiform joint. The operation is done with the Hohmann osteotomy/bunionectomy for realignment of the metatarsophalageal joint to correct hallux valgus that exists with juvenile metatarsus primus varus. PMID- 3805606 TI - Derotational akin osteotomy. AB - This paper will present a unique approach utilized at Atlanta Hospital and Medical Center for the correction of a plantar medial shearing callus of the hallux. The procedure is a modification of the Akin osteotomy. PMID- 3805607 TI - Total contact povidone-iodine perfusion cast for the treatment of neuropathic ulcers. AB - The total contact povidone-iodine perfusion cast is an effective, conservative treatment for the neuropathic ulcer. This is accomplished by redistribution of forces exerted on the foot, as well as the antiseptic environment established by the povidone-iodine. The case study presented demonstrates a cost-effective treatment for the diabetic neuropathic ulcer. PMID- 3805608 TI - Utilization of Silastic nerve caps for the treatment of amputation neuromas. AB - The following is a case history dealing with usage of the Swanson-Ducker designed Silastic nerve caps for the treatment of amputation-type neuromas. The authors will attempt to identify the pathology of a painful end bulb neuroma by discussing the normal anatomy and physiology of peripheral nerves, with possible etiologies and alternative treatment. PMID- 3805609 TI - Test of radiographic interpretation. Seronegative spondyloarthropathy (psoriatic arthritis). AB - Radiographs of the foot from five patients with different manifestations of the same disease are presented. Identify the specific radiographic abnormalities in each case, and name the disorder that is most likely responsible for the observed alterations. PMID- 3805610 TI - Verrucous squamous cell carcinoma. PMID- 3805611 TI - Consecutive bilateral failures of first metatarsophalangeal joint prostheses. PMID- 3805612 TI - [Morphological modifications in experimental hydrosalpinx]. AB - Hydrosalpinges were mechanically induced in rabbits by ligation of the proximal and distal ends of the oviduct. Isthmic and ampullary biopsies were obtained at 2, 4 and 6 months after ligation. Deciliation and decrease of epithelial height were observed in the ampulla, but not in the isthmus. Microstereological study shows a decrease of both the number and the relative volume of capillaries in the ampullary muscularis. Considering the parallelism of time and localization between deciliation and reduction of vascularization, we suggest that epithelial deciliation is caused by vascular disorders. Our study shows also adrenergic denervation occurring in the muscularis. PMID- 3805613 TI - [Effect of the etiology of sterility on the results of tubal microsurgery]. AB - The authors have carried out a prospective study from the 1 January 1977 to the 31 December 1981 on 168 women, 89.3% of whom (150/168) had pure distal tubal microsurgery and 10.7% (18/168) had mixed surgery. The results were studied in relationship to the aetiological reason for tubal sterility, which was: salpingitis in 60 cases = 35.7%; appendicitis in 23 cases = 13.7%, endometriosis in 29 cases = 17.3%, termination of pregnancy in 22 cases = 13.1% and unknown causes in 34 cases = 20.2%. The figures for intra-uterine pregnancies were 32.74% after 24 months using a classical method of determining it and 31% using an actuarial method. There was a significant difference between endometriosis and the four other aetiologies. These latter could not be differentiated between one another. The level of ectopic pregnancies was 5.3% at 24 months, or 6.3% using an actuarial method. It was higher after endometriosis. It would therefore appear from the results of this study that endometriosis seems to be poor from a prognostic point of view when compared with the other aetiological causes and the results shown in the literature. Finally the authors discuss in cases of endometriosis whether it is correct to carry out a second operation after the first or to resort to the other possibility, namely in vitro fertilisation. PMID- 3805614 TI - [Restoration of fertility following excision of an intracranial hydatid cyst]. AB - An unusual case of a 31 year-old Bedouin women, with secondary infertility of 13 years' duration who conceived twice spontaneously after removal of a hydatic cyst from her frontal lobe is reported. The reproductive function was restored probably by releasing the hypothalamic-pituitary axis from the pressure exerted by the cyst. PMID- 3805615 TI - [Incidence of pulmonary tuberculosis in a population of pregnant women at risk]. AB - So long as the diagnosis is made early and treatment is prolonged adequately pulmonary tuberculosis in pregnant women has been shown to have a much better prognosis than formerly. 13 new pregnant women were found to have tuberculosis in 18 months, which gave an incidence of 32 per 10,000 population. This is 5 times more than the mean incidence in France; and makes it worth while screening for the condition, particularly among immigrant. PMID- 3805616 TI - [Autoimmune thrombopenia and pregnancy. Value of counting scalp platelets]. AB - Fetuses of mothers who have auto-immune thrombocytopenia are at risk in utero of having transitory thrombocytopenia. There is no maternal biological test that can predict the numbers of platelets in the fetus. This count of platelet numbers can be estimated from taking fetal blood from the scalp at the onset of labour, and if the count is less than 50 X 10(9) per litre a caesarean operation is indicated. The authors report a series of 23 pregnancies where the mother had auto-immune thrombocytopenia and where fetal scalp blood sampling was indicated. This series has been compared with a previous series of 14 pregnancies where scalp sampling was not carried out. There was no case of severe fetal thrombocytopenia after scalp sampling was carried out and where the best way of delivery could be predicted early enough in each case. The ease of taking the sample and the safety and reliability of it for estimating the degree of thrombocytopenia in the fetus and thus deciding the method of delivery makes us believe that this method should be used more frequently in cases of maternal thrombocytopenia that appear late in pregnancy. PMID- 3805617 TI - [Premature infants delivered by cesarean section before the 32d week of pregnancy]. AB - Sixty-one premature babies delivered by caesarean section (Group C) before the 32nd week of amenorrhoea were compared with 83 control babies (Group T) born by vaginal delivery. The mortality was comparable: 28 and 32.5%, which is statistically more significant in children born before the 28th week of pregnancy (100 and 66% respectively) and weighing less than 1000 g (53 and 57%). Caesarean section improves the prognosis in multiple pregnancies. Morbidity (respiratory troubles, neurological troubles, infections and jaundice) is hardly different in the two groups. Infections in the lungs are less frequent, but broncho-pulmonary dysplasias are more frequent after caesarean section. Sixty-seven per cent of babies in Group C, and 64% in Group T had normal neuro-psychological development. Severe sequellae were found respectively in 9 and 18% of the infants, the difference being due to motor neurone disease of cerebral origin in respectively 0 and 6 cases. Mortality and the sequellae were identical in the two groups in breech presentations. This study does not support extending the indications for caesarean section in pregnancies under 32 weeks. PMID- 3805618 TI - [Orientation of the fetal head at the time of engagement in induced labor]. AB - Out of 104 cases of induced labour, it was found that in 60% of the cases the fetal head presented itself in an occipito-posterior position. This unusually high percentage has not been explained. PMID- 3805619 TI - [Treatment of female stress urinary incontinence. Results and critical analysis based on 78 cases]. AB - This work reviews 78 case histories of urinary incontinence in women treated surgically. There are two series compared with one another: Burch's operation (indirect colpocystopexy) carried out on 37 patients. The placing of an aponevrotic sling under the neck of the bladder by Cukier's method in 41 patients. Urodynamic studies were carried out in each case systematically before and after operation in order to make a diagnosis and indicate the correct treatment to use in each particular patient. The results as far as the incontinence is concerned, clinically and urodynamically, were good, with a cure rate or a great improvement in 94% to 97.5% of cases. The results seem to be better when strips were used; but these increased the numbers of patients who suffered from dysuria. A protocol for treating these cases of stress incontinences in women can be worked out from this study. PMID- 3805620 TI - [Circular amputation of the uterine cervix, a rare complication of a normal delivery. Apropos of a case]. AB - We report a rare case of spontaneous circular amputation of the cervix of the uterus, complicating a "eutocic" delivery of a girl weighing 3,700 g by a seven para. The interest of this case lies in: the difficulty in explaining this lesion where there had never been any obstetric manoeuvre or prolonged labour. as the placenta was complete the diagnosis was made by exploring the state of the cervix. rapid recovery was obtained by the simple surgical suturing of the bleeding vessels to secure haemostasis and by raising the haemoglobin level. PMID- 3805621 TI - Combined radiocarpal arthrodesis and midcarpal (lunocapitate) arthroplasty for treatment of rheumatoid arthritis of the wrist. AB - Arthroplasties for the wrist with rheumatoid arthritis are usually revised for the articulation between radius and carpus. The midcarpal joint is disregarded although it remains structurally better preserved and is therefore better suited for the preservation of stable motion. When the midcarpal surfaces are satisfactory, a radio-scapho-lunate fusion, accompanied by a midcarpal synovectomy, is an excellent procedure. When the midcarpal surfaces, particularly the head of the capitate, are also destroyed, the tendency has been to either perform a pan-arthrodesis, or to insert a wrist endo-prosthesis. For these severely unstable and destroyed wrists, a stabilization of the radiocarpal joint by arthrodesis, combined with preservation of motion at the midcarpal level by resection of the damaged head of the capitate and its replacement with a small implant has been done. This procedure has allowed all patients to retain a functional range of motion and to experience satisfactory relief of pain. PMID- 3805622 TI - Anatomic and clinical studies of the extensor digitorum brevis manus. AB - The extensor digitorum brevis manus muscle (EDBM) was found in 17 (3.0%) out of 559 dissected hands of 286 cadavers. The anatomy of the EDBM was classified into three types. The EDBM frequently arose on the distal margin of the radius, but without direct attachment to the carpal bones. The insertion of the EDBM was the same as that of the extensor indicis proprius. The EDBM and the extensor indicis proprius were often joined and had the same nerve and arterial supply. The EDBM muscle was considered to be a variant of the extensor indicis proprius muscle. Clinically five of 29 patients with an EDBM were treated. PMID- 3805623 TI - Congenital anomaly of the thumb: aplasia of the flexor pollicis longus. AB - A five-year-old boy, with congenital aplasia of the flexor pollicis longus, without other associated anomalies is reported. A two-stage procedure was done using a silicone rubber rod and pulley reconstruction, followed by transfer of the flexor digitorum superficialis tendon from the ring finger to the distal phalanx of the thumb. This resulted in 0/55 degrees active flexion at the interphalangeal joint. PMID- 3805624 TI - Pathologic conditions of the pisiform and pisotriquetral joint. AB - In eight of sixteen patients with symptomatic pisotriquetral joints the pisiform was excised. A detailed study allowed correlation of the etiologic factors with the pathologic diagnosis. In a similar fashion pathologic-etiologic data were retrieved from 216 cases identified from the world literature and organized into the following four pathologic groups: primary OA (2.3%), secondary OA (48.4%), other arthritides (4.7%), and flexor carpi ulnaris enthesopathy (44.6%). The most common causes were acute and chronic trauma and instability. On the basis of these data, we hypothesized that loss of integrity to the surrounding retinacular structures of the pisiform may lead to instability and thus dysfunction of the joint. PMID- 3805625 TI - Dorsal dislocation of the triquetrum with rotary subluxation of the scaphoid. AB - Dislocations of the carpal bones are common, but dorsal dislocation of the triquetrum is rare and has only recently been reported in the English-language literature. This case report describes such an injury associated with rotary subluxation of the scaphoid that was successfully treated with closed reduction and cast immobilization for 8 weeks. PMID- 3805626 TI - Fracture and ischemic necrosis of the immature scaphoid. AB - The progressively ossifying scaphoid of the child is well protected but is not immune to injury. The diagnosis of scaphoid fracture may be difficult when the fracture occurs through the osteochondral interface. Nonunion and ischemic necrosis of the proximal pole fragment--complications more often seen in adults sustaining scaphoid fracture--may occur in children, as shown by the young patient presented here. PMID- 3805627 TI - Osteoid osteoma of the lunate. AB - Osteoid osteoma is a rare lesion in the carpus. This article records the case of an osteoid osteoma occurring in the lunate. PMID- 3805628 TI - Osteochondritis dissecans of the lunate. AB - Osteochondritis dissecans of the lunate has not been previously reported in the English-language literature. A case of osteochondritis dissecans of the lunate and an ulnar positive variance in a 16-year-old girl is presented. Several possible causes of the lesion and its surgical treatment are discussed. PMID- 3805629 TI - An analysis of proximal phalangeal fractures. AB - To attain accurate reduction in the proximal phalanx as opposed to the other phalanges, we have found open reduction and internal fixation to be necessary in a large proportion of cases in our series. The cause of injury in the majority of cases was blunt assault, possibly a unique spectrum in this type of trial and a probable influence on treatment choice. There were 50 fractured proximal phalanges in 40 patients analyzed according to their modes of treatment, immobilization, and functional results. Treatment for proximal phalangeal fractures have been structured according to these results. PMID- 3805631 TI - Hand and finger prostheses. PMID- 3805630 TI - Functional bracing of fractures of the second through fifth metacarpals. AB - A simple new brace aids in the reduction and immobilization of fractures of the second, third, fourth, and fifth metacarpals. This brace incorporates an adjustable strap and pads made of radiolucent materials. It provides 3-point fixation while allowing full range of motion of the wrist and digits. It has been preferred by patients to an ulnar gutter splint, and its use resulted in less residual angulation of the fracture than occurred with other methods. PMID- 3805632 TI - A technique to control hand position for intraoperative radiography. PMID- 3805633 TI - Modified technique for Herbert screw insertion in fractures of the scaphoid. PMID- 3805634 TI - Late rupture of the flexor tendons as a complication of replacement arthroplasty. AB - A case of attritional rupture of the flexor tendons secondary to metacarpophalangeal (MP) replacement arthroplasty for treatment of rheumatoid arthritis is reported. This complication is thought to be the result of resection of the palmar plate during the arthroplasty that was performed 5 1/4 years previously. Although not previously reported, it could be an expected late result if the palmar plate is excised during arthroplasty. PMID- 3805635 TI - Silicone rubber implant arthroplasty of MP joint in rheumatoid arthritis. PMID- 3805636 TI - The repeatability of testing with Semmes-Weinstein monofilaments. AB - Forty-one filament kits were measured for filament application force, single and multitester application force repeatability, and comparison of filament repeatability with that of other hand held instruments. Results of this study show that if their lengths and diameters are correct, the filaments produce application forces that are repeatable within a predictable range. All hand held instruments vary in application force. The Semmes-Weinstein monofilaments vary relatively little and are a controlled reproducible force stimulus for use in clinical testing. PMID- 3805637 TI - Ruptured flexor tendon tenorrhaphies in zone II: repair and rehabilitation. AB - Seven patients with ruptured flexor tenorrhaphies in zone II had surgical repair of the rupture and completed a second rehabilitation program of active flexion and extension exercises identical to that prescribed after the primary repair. The period between the primary repair and the rupture ranged from 14 to 72 days, with an average of 38 days. The period between the rupture and the secondary repair ranged between 1 and 14 days, with an average of 6 days. Four patients (57%) achieved good to excellent active motion at follow-up. These results are comparable to those obtained by patients with uncomplicated primary repairs that were treated early with passive motion exercises. We conclude that prompt repair of ruptured flexor tenorrhaphies and rehabilitation with active motion exercises is effective and that it should be considered before one chooses flexor tendon grafting. PMID- 3805638 TI - Pathologic rupture of flexor tendons due to longstanding Kienbock's disease. AB - A 62-year-old man was seen for rupture of the flexor digitorum superficialis and profundus to the index finger. X-ray films showed longstanding Kienbock's disease with a completely fragmented lunate bone with fragments lying in front of the anterior lip of the radius. Tendon transfer restored active flexion to the index finger. PMID- 3805639 TI - Histology and ultrastructure of the human flexor tendon sheath. AB - Twenty human flexor tendons and their sheaths were studied to determine the gross, microscopic, and ultrastructural morphology of their surfaces. Specimens were obtained at the time of autopsy or at the time of reconstructive and reparative surgery. The flexor tendon sheath consists of a noninterrupted layer of parietal synovium reinforced externally at intervals by dense bands of collagen, the annular and cruciform pulleys, and the palmar plates of the respective finger joints. The sheath contents are independently covered by a second similar layer of visceral synovium. These two layers are continuous at the proximal cul-de-sac, the vincula origins, and the tendon insertions. While the synovial cells lining the pulleys and tendons differ quantitatively from those of the membranous portion of the sheath, they are morphologically identical. The presence of a visceral synovial layer covering each tendon may indicate a key role of the synovial cell in tendon healing. PMID- 3805640 TI - Permissible limits of flexor digitorum profundus tendon advancement--an anatomic study. AB - Lacerations of the profundus tendon distal to the superficialis insertion can be treated by advancement of the proximal cut end of the tendon to its insertion. In the English-language literature, limits cited for the distance a profundus tendon can be safely advanced vary from 0.75 to 2.5 cm and appear to be based on clinical impressions. Our cadaver model suggested the degree of tendon advancement tolerable was 1 cm. A delicate balance exists in the profundus tendon system, and this should be considered when surgical advancement is contemplated. PMID- 3805641 TI - Early postoperative mobilization of flexor tendon injuries using a modification of the Kleinert technique. AB - The results of 99 flexor tendon repairs in all zones of injury in 36 patients are reported. Both superficialis and profundus tendons were repaired in all cases. Postoperatively patients were managed by an immediate active extension program using a modification of the Kleinert technique and physiotherapy. Results of the study are based on the Buck-Gramcko system of evaluation of flexor tendon repair. In the 70 digits that underwent operations, the results were excellent in 31% of the cases, good in 30%, fair in 20%, and poor in 19% of the cases. There were two tendon ruptures. This study corroborates evidence that early mobilization and hand therapy appear to play an important part in the postoperative management of flexor tendon injuries. PMID- 3805643 TI - Patency after repair of forearm arterial injuries in animal models. AB - Repairs of single artery forearm injuries have only a 50% patency rate. The single artery repairs in the forelimbs of the 10 dogs and 42 rabbits studied in this investigation also had patency rates of approximately 50%. The collateral arteries appeared to be a factor causing the low patency rate since ligating them increased the patency of the repaired vessels, and because arteriograms showed dilation of existing collaterals after occlusion of the repaired artery. Pressure and compliance measurements made before the repair were not able to predict patency. Furthermore, attempts to improve the patency rate by temporarily clamping the collateral artery or by denervating the injured artery were not successful. PMID- 3805642 TI - Aneurysms of the upper extremity. AB - Thirty aneurysms in the upper extremity in 28 patients over the last 10 years are reviewed. Analysis showed that false aneurysms develop from penetrating trauma, while true aneurysms tend to arise in parts of the arterial tree exposed to blunt trauma. Penetrating injury to vessels should be thoroughly explored and repaired. Arterial aneurysm should be included in the differential diagnosis of masses in the upper extremity, especially after trauma. Three-phase radionuclide scanning is a useful tool for evaluating lesions of the distal arterial tree. When an aneurysm is suspected, early treatment is advised. Treatment options of resection and ligation versus reconstitution of vessel flow should be based on preoperative and intraoperative evaluation of circulatory status. PMID- 3805644 TI - Warm ischemic damage to the epiphyseal growth plate: a rabbit model. AB - Warm ischemic growth plate damage was produced in the hindlimbs of 33 New Zealand white rabbits, who were 7 weeks old, by isolating the knee joint on a popliteal vascular pedicle. Zero, 3, 7, and 12 hours of warm ischemia were produced by pedicle occlusion. The 0- and 3-hour ischemic groups showed mild growth disturbances related to the surgical model and were not statistically different at 90 days postoperatively. The 7- and 12-hour ischemia groups showed severe growth disturbances and were statistically different from the 0- and 3-hour groups at all periods measured (p less than 0.05). Large central growth plate lesions were apparent by histologic examination. Twelve hours of ischemia produced a histologic picture identical to growth plate infarction. Increased warm ischemic time correlated with more severe growth retardation and evidence of increased damage to the central area of the growth plate histologically. PMID- 3805645 TI - Preoperative and postoperative gait analyses of patients undergoing great toe-to thumb transfer. AB - Microvascular transfer of the great toe is a reliable method of thumb reconstruction for many patients, but the precise deficit incurred by elective amputation of the great toe has not been fully defined. Twelve patients who had this procedure were evaluated with preoperative and postoperative gait analyses and clinical examinations. The mean age was 29.3 years, with a mean clinical follow-up of 30.3 months, and a comparative follow-up gait study at a mean of 21.1 months postoperatively. Only one patient exhibited a significant motion change postoperatively, which was a reduction in ankle plantar-flexion at weight release of the operated foot (push-off). The average velocity, cadence, step length of the foot that had surgery performed, single and double limb stance times of each foot, and step width did not significantly change. There was only a slight average reduction in stride length at 4.6% (p less than 0.05), which resulted from a decrease in step length of the foot that did not have surgery 7.6% (p less than 0.02). Nine patients had no clinical complaints, two had occasional mild discomfort near the second and third metatarsal heads, and one had intolerance to cold. PMID- 3805646 TI - Management of skeletal giant cell tumors of the phalanges of the hand. AB - Five cases of unicentric benign giant cell tumors of the phalanges of the hand are reported. Three patients were initially treated with curettage and bone grafting; two had recurrences that necessitated ray resection as the definitive treatment, and one was free of disease at 16 years' follow-up. The two patients who were primarily treated with ray resection were free of disease at follow-up of 2 and 1 years, respectively. Enneking's surgical staging system and Lodwick's x-ray grading of bone tumors were used to evaluate management methods. PMID- 3805647 TI - Incomplete release of the first dorsal compartment--a diagnostic test. AB - A clinical examination of the thumb that is useful in determining when a separate compartment for the extensor pollicis brevis tendon has not been released after a previous operation for de Quervain's syndrome is described. PMID- 3805648 TI - Stenosing tenosynovitis in Dupuytren's contracture. AB - Patients with symptoms of stenosing tenosynovitis and clinical evidence of overlying Dupuytren's contracture were treated with localized total fasciectomy through multiple Y-V plasties and the excision of the A1 pulley of the affected digit. At operation the stenosing tenosynovitis could be separated into two categories--patients with external compression from contracting vertical septa or patients in whom the tendon constriction appeared unrelated to the overlying fascial disease. PMID- 3805649 TI - Tendon ruptures in the rheumatoid hand: analysis of treatment and functional results in 60 patients. AB - Seventy-six reconstructive procedures were performed to treat tendon rupture in 60 patients with rheumatoid arthritis. Tendon rupture commonly occurred in the extensors to the ring and small fingers. However, ruptures of extensors and several flexor tendons were also encountered. Single or double tendon ruptures responded successfully to a variety of tendon transfers. Reconstruction for multiple tendon ruptures is a salvage procedure that is often associated with extensor lag and impairment of overall function. Early aggressive treatment of distal radioulnar joint derangements in the rheumatoid wrist is recommended to forestall many cases of tendon rupture. PMID- 3805650 TI - Dupuytren's disease as a cause of ulnar tunnel syndrome. AB - Two clinical cases of documented ulnar nerve compression in Guyon's canal caused by Dupuytren's disease are described. Surgical decompression of the canal promptly relieved the symptoms, and histologic studies confirmed the presence of Dupuytren's disease. PMID- 3805651 TI - Carpal tunnel syndrome in patients undergoing hemodialysis. AB - We treated 20 cases of carpal tunnel syndrome is 12 patients who were undergoing hemodialysis therapy for chronic renal failure. In all patients the arm involved had been used for a fistula. There was no correlation with the renal diagnosis and the duration of hemodialysis therapy. The cause of the syndrome has been debated; however, one factor does not give rise to symptoms of carpal tunnel syndrome. All of the factors discussed in this article, acting in concert, may be causes of carpal tunnel compression. Surgical intervention successfully relieved all symptoms. PMID- 3805652 TI - Isolated compression neuropathy of the palmar cutaneous branch of the median nerve. AB - A case of isolated thenar numbness, with an associated painful palmar wrist mass is presented. At operation, a palmar wrist ganglion compressing the palmar cutaneous branch of the median nerve was encountered. After ganglion excision the numbness in the palm was relieved, and there was no recurrence at 6 years follow up. PMID- 3805653 TI - A hepatologist looks at the irritable bowel syndrome. PMID- 3805654 TI - Diet-induced pancreatitis in China. PMID- 3805655 TI - Adenocarcinoma of the lower esophagus. A disease primarily of white men with Barrett's esophagus. AB - Sex and racial predilection, social history, and histology were analyzed in a biopsy-proven adenocarcinoma of the lower esophagus/esophagogastric junction collected over a 5-year period in two teaching institutions with different patient populations. Adenocarcinoma occurred in 11% of patients with biopsy proven esophageal cancer. The disease occurred only in males at one center, and in a 7:1 ratio of males to females at the other center. Clear racial predilection was seen, since 12 of 13 patients with adenocarcinoma of the esophagus were white, whereas less than 20% of patients with squamous carcinoma of the esophagus were white. The finding of Barrett's epithelium in eight of the 13 cases strongly supports the theory that in white males, Barrett's epithelium is a precursor lesion of adenocarcinoma of the esophagus/esophagogastric junction. PMID- 3805656 TI - The supersensitive hypertensive lower esophageal sphincter. Precipitation of pain by small doses of intravenous pentagastrin. AB - The clinical and investigative features of eight patients with attacks of epigastric pain believed due to a hypertensive lower esophageal sphincter (LES) are described. Radionuclide esophageal transit studies were normal in all but one patient. Two patients had positive acid perfusion studies. Only three had an abnormal baseline esophageal manometry, but after small intravenous doses of pentagastrin all subjects experienced their presenting pain coincident with increases in LES pressure ranging from 75 to 140 mmHg. Five patients eventually required surgical myotomy of the LES, but pain relief which was immediate and complete in all proved permanent in only one. Two of the operated patients continued to experience severe attacks of pain refractory to medical therapy. The diagnosis of a hypertensive LES is best made by pentagastrin stimulation of the sphincter, but cutting the sphincter may not cure the patient. PMID- 3805657 TI - Comparison of ranitidine and sucralfate in the long-term treatment of duodenal ulcer. AB - We evaluated long-term treatment with either ranitidine (R) or sucralfate (S) in the prevention of duodenal ulcer recurrences. Fifty-nine patients with healed ulcers were randomly allocated to maintenance treatment with 150 mg R nightly or 2 g/day S. By using a life table analysis, the calculated probable remission rates at 4, 8, and 12 months were 90, 85, and 53% with R, respectively, and 62, 62, and 53% with S, respectively. These differences were not significant at any interval. In both groups ulcer relapse was independent of sex, smoking habit, and alcohol and coffee consumption, whereas a history longer than 5 years was significantly related to a higher probability of recurrence. No relevant clinical or biochemical side effects were encountered with either drug, but compliance rate was higher in the R group. R and S are equally effective in preventing duodenal ulcer relapse over a 1-year period of maintenance treatment, although R proved to be more effective in preventing early relapse. PMID- 3805658 TI - Spiral organisms in the human jejunum. AB - Spiral organisms were found in close apposition to the jejunal mucosa in a patient with idiopathic intestinal pseudoobstruction. Such organisms are generally not found in the jejunum and their presence in this patient was considered to be related to intestinal stasis, and possibly to diarrhea. PMID- 3805659 TI - Rightward shift of colon cancer. A feature of the aging gut. AB - Two hundred twenty-two patients with colon cancer, diagnosed in the past 5 years, were grouped by age into the sixth, seventh, and eighth decades. Examination showed an increased incidence of right-sided colon cancer by decade and a simultaneous fall in the incidence of rectosigmoid lesions. A trend toward a more favorable Dukes' pattern was evident with each rise in decade. We suggest that the shift in site of colon and rectal cancer toward the right is directly related to age and is a feature of the "aging gut." PMID- 3805660 TI - Clinical features of nongangrenous ischemic colitis. A comparison of stricturing and transient forms. AB - Forty cases of nongangrenous ischemic colitis were studied to find the different clinical features between stricturing form and transient form. Clinical and laboratory findings were compared between two groups, 15 cases of stricturing form and 25 of transient form, which were diagnosed by follow-up barium enema radiography. The following four items, of the nine studied, were significantly different between the two groups; namely, patients of stricturing form were older in age, had longer time intervals from the onset of disease to disappearance of subjective symptoms and to normalization of white blood cell count and/or erythrocyte sedimentation rate, and showed an increase in 1-h erythrocyte sedimentation rate on day 5 or earlier of the disease. Our observations indicate that the age and 1-h erythrocyte sedimentation rate might be useful indicators to differentiate the stricturing and transient forms early after the onset of the disease. PMID- 3805661 TI - Recurrence of Crohn's disease after resection. Are there any risk factors? AB - We report two studies on possible risk factors for postoperative recurrence of Crohn's disease and an extensive literature review. In our retrospective study, 90 patients who had undergone curative resection and anastomosis 1 to 22 years (average 9.3 years) previously were examined. The recurrence rate, calculated by actuarial methods, was 62.2% after 10 years and 86.4% after 15 years. The site of recurrence was clearly related to the initial location of disease (p less than 0.001). However, of the various clinical, pathological, and surgical factors studied, only the preoperative history correlated directly with recurrence (p less than 0.05). The prospective study evaluated the influence on recurrence of microscopic lesions at grossly free margins of ileocecal resection. Twenty-two consecutive patients, operated on for Crohn's disease of the terminal ileum from 6 to 34 months previously (average 24 months), were studied. From the histological grading previously established, recurrence was independent of involvement at both proximal and distal section lines. Therefore, we recommend conservative resection to obtain only grossly uninvolved margins. PMID- 3805662 TI - Erythrocytic sedimentation rate as a measure of clinical activity in inflammatory bowel disease. AB - To assess the reliability of the erythrocytic sedimentation rate (ESR) as a measure of clinical activity in inflammatory bowel disease, we analyzed the correlations of ESR with a global assessment of clinical activity in 77 patients with varying extents of Crohn's disease and ulcerative colitis. Analysis of all 141 ESR determinations in all 77 patients showed a highly significant correlation between mean ESR and clinical activity score (r = 0.54, p less than 0.001). Analysis of 133 ESR determinations in these 77 patients when their disease activity was either mild, moderate, or severe showed some significant differences among certain disease categories. The highest mean ESRs were in patients with the most extensive colon involvement (Crohn's colitis 40.7 +/- 3.3, universal ulcerative colitis 31.0 +/- 3.9), whereas the lowest mean ESRs were in patients with the most limited disease (ulcerative proctitis and proctosigmoiditis 19.2 +/ 2.1). The rate of increase in ESR with progressively increasing clinical activity from mild to moderate was the same in all disease categories, with the exception of Crohn's disease limited to the small bowel (ileitis or jejunoileitis), in which the ESR was relatively unchanged in a small sample of patients. By the time clinical activity became severe, however, patients in all disease categories manifested similarly high ESRs, with the exception of ulcerative proctitis in which the ESR remained low in the single patient tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805663 TI - Quantification of disease activity in patients with ulcerative colitis. AB - To develop an efficient index for evaluating ulcerative colitis, we quantitatively assessed disease activity by multiple regression analysis. Thirty two consecutive cases with ulcerative colitis were studied. These cases were divided by degree of severity into three groups: mild, moderate, and severe; this tripartite grouping was used as a dependent variable. As independent variables, 11 predictors were selected from among physical findings and laboratory data. By multiple regression analysis with stepwise deletion, six factors indispensable to the disease activity were selected: temperature, pulse rate, erythrocyte sedimentation rate, red blood cell count, alpha 2-globulin, and number of bowel movements per day. Disease activity is predicted by using the following equation: Y = -12.168 + 0.333X1 + 0.022X2 + 0.018X3 - 0.337X4 + 0.056X5 + 0.033X6, where X1, X2, X3, X4, X5, and X6 denote temperature, pulse rate, erythrocyte sedimentation rate, red blood cell count, alpha 2-globulin, and number of bowel movements per day, respectively. By applying this equation to each case, the range of activity indices is expressed as follows: mild, less than 1.52; moderate, between 1.52 and 2.44; and severe, more than 2.44. PMID- 3805664 TI - The relative risk of inflammatory bowel disease among parents and siblings of Crohn's disease patients. AB - Siblings of patients with Crohn's disease are 17-35 times more likely to develop the disease than members of the general population. Parents of patients with Crohn's disease are 35-70 times more likely to develop Crohn's disease than the general population. The crude risk of siblings or parents of patients with Crohn's disease developing ulcerative colitis may be half that of developing Crohn's disease; their relative risk may be a quarter that of developing Crohn's disease. PMID- 3805665 TI - A prospective comparison of anoscopy and fiberendoscopy in detecting anal lesions. AB - With the increase in rectal and perianal disease, thorough examination of this area is necessary in every patient with colorectal complaints. We compared the current fibersigmoidoscope and colonoscope with routine anoscopy in the detection rate of perianal pathology in 115 consecutive patients. Straight withdrawal and retroflexion in the rectum of the fiberoptic instruments led to lesion detection rates of 78% and 54%, respectively. The anoscope showed 99% of lesions. Anoscopy was easily learned and required less than a minute to perform. We conclude that anoscopy should be performed in every patient undergoing fibersigmoidoscopy or colonoscopy. Instructions in this procedure should be provided in all training programs. PMID- 3805666 TI - Dietary and supplementary intake of nutrients by patients with gastrointestinal diseases. AB - The dietary and supplementary intake of food, energy, and nutrients were examined in 54 patients after various gastrointestinal operations and in 33 patients with gastritis, peptic ulcer, or undefined abdominal pain. Forty-six of the operated and 21 of the nonoperated patients had to avoid certain foods (p less than 0.001, chi 2-test), mainly milk, beans, cabbage and other vegetables, bread, and fried foods. Only a few patients got discomfort from coffee, fatty foods, and meat. The intake of energy was at the level of light physical work. The dietary intake of iron, vitamin A, and niacin did not reach the level of the recommended daily allowance (RDA). One-half of the patients used vitamins and supplements, which increased their intake over the level of RDA. It is important to inform patients before operations about the possibility of persistent abdominal symptoms after the operation. PMID- 3805667 TI - Acute liver failure. Experience with 145 patients. AB - Acute liver failure (ALF) is an uncommon but serious disease still carrying a high mortality. This report describes one of the largest series of cases of acute failure, managed on a simple intensive supportive therapeutic regimen. One hundred fifty-eight patients with ALF were admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences (AIIMS) during the period July 1976 to December 1981. Data from 145 were completed and analyzed for this report. Of the patients, 85.4% were below the age of 40 years. The female-to-male ratio was 1.3:1. Of the 77 women in the reproductive age group, 59.7% were pregnant. All cases of ALF were secondary to viral hepatitis. Cerebral edema, bleeding, infection, and renal failure were seen in 57.2, 57.2, 39.3, and 16.5% of patients, respectively. Overall survival was 28.9% of patients. It was 33% below the age of 40 years and only 4.8% above this age. Pregnancy did not adversely affect the prognosis. Survival was related to grade of coma, being 22.8% for patients in Grade IV coma and 62% for patients in Grade I coma. In fatal cases the immediate complications resulting in death were cerebral edema (63%), bleeding (30%), renal failure (10.6%), and infection (8.7%). Presence of HBsAg, a serum bilirubin of over 20 mg%, and serum sodium less that 119 mEq/liter were indicators of poor prognosis. A simple, intensive, support therapy yielded results comparable to those reported by centers using a variety of complex therapeutic regimens. PMID- 3805668 TI - Painful muscle cramps. A symptom of liver cirrhosis? AB - We found an 88% incidence of painful muscle cramps in 33 patients with cirrhosis, as compared to 21% in a matched population without liver disease. The cramps were characterized by severe pain, occurred in calf muscles several times a week (mainly at rest or during sleep), and lasted for a few minutes. No definite etiological factor could be found and the underlying pathophysiology remains obscure, as in most other types of muscle cramps. However, the strikingly high incidence and uniformity of the phenomenon may justify the inclusion of painful muscle cramps among the recognized symptoms of cirrhosis. PMID- 3805669 TI - Cimetidine hepatitis. AB - A 62-year-old man developed asymptomatic anicteric hepatitis during cimetidine therapy for duodenal ulcer disease. Liver biopsy revealed zonal (centrolobular) necrosis, bile stasis, and mononuclear cell infiltration. Electron microscopy featured mitochondrial hyperplasia, giant mitochondria, and liver cell bile inclusions. The diagnosis of cimetidine-related hepatitis was confirmed by re exposure to cimetidine, which prompted a rapid rise in serum transaminases while under observation in the hospital. Cimetidine hepatitis is rarely reported, and routine monitoring of the patient's liver tests during therapy does not seem cost effective as a general practice. PMID- 3805670 TI - Eosinophilic gastroenteritis with small bowel perforation. PMID- 3805671 TI - Esophageal bezoar in progressive systemic sclerosis. PMID- 3805672 TI - Hemoperitoneum from a ruptured aneurysm of the gastroepiploic artery. PMID- 3805673 TI - Radiographic and endoscopic findings in human whipworm infection (Trichuris trichiura) PMID- 3805674 TI - Methods to encourage screening sigmoidoscopy examination. PMID- 3805675 TI - Cholera outbreak in Manipur. PMID- 3805676 TI - Case finding in tuberculosis in a peripheral hospital of District Shimla. PMID- 3805677 TI - Hydatidosis in animals in and around Delhi. PMID- 3805678 TI - VDRL sero survey in Andaman and Nicobar islands. PMID- 3805679 TI - Extent of yaws problem in India. PMID- 3805680 TI - Sandflies of bird tunnels in earthen mounds from distt. Rohtak (Haryana). PMID- 3805681 TI - Co-agglutination test: a rapid and early method for diagnosis of typhoid fever- preliminary study. PMID- 3805682 TI - Prevalence of different types of viral hepatitis in patients with jaundice. PMID- 3805683 TI - Screening for seroprevalence of HTLV-III/HIV infection in high risk groups in Delhi. PMID- 3805684 TI - Zooprophylaxis as a useful tool for control of A. aconitus transmitted malaria in Central Java, Indonesia. PMID- 3805685 TI - Needle aspiration of breast masses in the emergency department. AB - The discovery of a breast mass is often the source of great concern for a patient. The mass may, however, be no more than a benign cyst that may be treated in the emergency department. This article describes the technique of needle aspiration--a simple, safe procedure that in many cases is both therapeutic and curative. PMID- 3805686 TI - Celery-dependent exercise-induced anaphylaxis. AB - Food-dependent exercise-induced anaphylaxis, first reported in 1983, is a subtype of exercise-induced anaphylaxis. A case of celery-dependent exercise-induced anaphylaxis is reported. The presentation and management of these and other exercise-related physical allergies, including classic and variant cholinergic urticaria, is reviewed. As the prevalence of strenuous physical activity increases, it is important for emergency physicians to recognize unusual, but potentially serious, complications of exercise. PMID- 3805687 TI - Ludwig's angina and pneumococcal sepsis. AB - We present a 75-year-old patient with an unusual bacteriologic cause of Ludwig's angina, Streptococcus pneumoniae. This organism appears more commonly in children. Recognition of Ludwig's angina, its causative organisms, and the necessity for airway management in addition to antibiotic therapy are important to limit its morbidity. PMID- 3805688 TI - Topical cocaine prior to treatment of penile tourniquet syndrome. AB - A case of the penile tourniquet syndrome is reported in a 5-year-old boy. Release of the constricting strands of hair was possible only after topical cocaine achieved adequate local anesthesia. The syndrome is briefly reviewed and emergency care recommendations are made. PMID- 3805689 TI - Turbinate destruction--a rare complication of nasotracheal intubation. AB - Nasotracheal intubation is a procedure used in the emergency department for airway management. Although the procedure has its attendant complications, we report the rare occurrence of an inferior turbinectomy. Other complications of the procedure are discussed. PMID- 3805690 TI - Anaphylaxis: clinical presentation, immunologic mechanisms, and treatment. AB - Anaphylaxis is a devastating allergic catastrophe. It is described as a systemic, immediate-type hypersensitivity reaction induced by exposure to a specific antigen and is immunologically based. The clinical manifestations may be mild but are often rapidly progressive, leading to respiratory distress and cardiovascular collapse. In addition to avoiding exposure to the antigen, treatment includes general supportive measures and specific therapeutic modalities. The purpose of this article is to review the current concepts of anaphylaxis and discuss the etiologic agents, immunologic mechanisms, clinical presentation, and treatment of this true allergic emergency. PMID- 3805691 TI - Combative patient with fever and altered mental status. PMID- 3805692 TI - Breast mass aspiration: the technical imperative revisited. PMID- 3805693 TI - Epidemiology, pathology, and treatment of axillary hidradenitis suppurativa. AB - The epidemiology, pathology, and management of axillary hidradenitis suppurativa were examined in 11 patients with this disease. On the basis of this study, the following predisposing factors were incriminated in the epidemiology of the disease: predilection of the disease for women, obesity, hair removal by a safety razor, antiperspirants and deodorants, and local pyogenic infections distant from the axilla. Because antiperspirants do not effect transepidermal water loss of axillary skin, their potential deleterious effects are probably related to their chemical irritant effects on cut, nicked, or irritated axillary skin. Treatment of this disease will vary according to its severity. Incision and drainage are usually needed to treat the localized disease. Specific measures must also be instituted to prevent progression of the disease (eg, weight reduction, avoidance of safety razor and antiperspirants and deodorants, and control of localized pyogenic infections distant from the axilla). Management of the chronic phase of the disease is primarily excision of infected axillary skin. PMID- 3805694 TI - Congestive heart failure in children. AB - Congestive heart failure in children is unusual as a presenting problem, and the nonspecific nature of the signs and symptoms in the pediatric population makes recognition difficult. Congenital heart disease is most common in the infant whereas older children most commonly develop congestive heart failure due to cardiomyopathy, myocarditis, electrolyte abnormalities, dysrhythmias, and, more rarely, endocarditis, and rheumatic carditis. Management focuses upon stabilization of the airway and ventilation while improving circulatory function. This is achieved by the use of inotropic agents, combined with attention to the volume and pressure overload, pulmonary problems, dysrhythmias, and ongoing follow-up. PMID- 3805695 TI - Absence of a tachycardic response to intraperitoneal hemorrhage. AB - Five cases of intraperitoneal hemorrhage associated with hypotension and the lack of a tachycardic response are presented. All patients were young, previously healthy women without a history of myocardial disease. None of our patients fits into the category of "irreversible shock." Although relative bradycardia associated with hypotension is often considered a preterminal event, each of our patients recovered after laparotomy. In hypovolemic shock due to intraperitoneal bleeding, the lack of a tachycardic response may occur earlier and perhaps more often than has been suggested, and may delay definitive treatment by confusing the clinical picture. Orthostatic vital signs may be helpful in distinguishing those with true hypovolemia. PMID- 3805696 TI - Needle emboli to lung following intravenous drug abuse. AB - Presented is the case of a 36-year-old man using central venous sites for injection of street drugs. X-ray study revealed numerous retained subcutaneous needles as well as a needle that had embolized to the lung periphery. This represents, to the best of our knowledge, a previously unreported complication of central venous injection of street drugs. PMID- 3805697 TI - A nonpuerperal traumatic vulvar hematoma. AB - A case is presented where a nonpuerperal traumatic vulvar hematoma was initially mistaken for a Bartholin's gland duct abscess. Since the treatment may be different, the importance of clinical differentiation between these two entities is stressed. Proper management of the vulvar hematomas involves bed rest, close observation, and early surgical intervention only when absolutely necessary. Patients with significant vulvar hematomas should be hospitalized and closely followed. PMID- 3805698 TI - Gastrointestinal obstruction associated with multiple-dose activated charcoal. AB - The development of a gastrointestinal obstruction associated with multiple doses of activated charcoal is described. A carbamazepine-intoxicated patient received 240 g of activated charcoal and a total of 600 mL magnesium citrate with the development of an ileus and a small-bowel obstruction. The patient also had episodes of emesis associated with charcoal administration. This case suggests that the use of multiple doses of activated charcoal may be associated with gastrointestinal obstruction, a previously unreported adverse effect. Further evaluation of the incidence of adverse effects associated with activated charcoal is needed to determine optimal therapeutic regimens. PMID- 3805699 TI - Time to be a room again? PMID- 3805700 TI - The exploding toilet and other emergency room folklore. PMID- 3805701 TI - On blowing in the ear. PMID- 3805702 TI - Superior vena cava syndrome, re-visited. PMID- 3805703 TI - Obstruction of the superior vena cava and trachea from benign goiters. PMID- 3805704 TI - The epicardial coronary arteries: proper necropsy examination. PMID- 3805705 TI - 79-year-old man with shortness of breath and apical lung mass. PMID- 3805706 TI - Strategies to reduce malpractice claims. PMID- 3805707 TI - Growth and bone maturation in children from two regions of the F.R.G. differing in the degree of air pollution: results of the 1974 and 1984 surveys. AB - Growth and bone maturation criteria were used in this collaborative study to assess the potential health risk posed by excessive air pollutant emission. The study consisted of two surveys carried out 10 years apart. During this decade, a substantial emission reduction through the effective control efforts was achieved in the index area, but not so in the reference area where the situation remained virtually unchanged during this period. In terms of body height and height-weight proportionality, no significant differences were found between areas and years of investigation. In contrast, the bone age retardation encountered in the children from the polluted area was statistically significant, both at 1974 and 1984 surveys, despite the appreciable improvement in this developmental criterion for boys in 1984. This was true for both group mean values and the percentages of individuals exhibiting the bone maturation delay greater than 10 months. PMID- 3805708 TI - Biomonitoring of environmental pollution hazards from a nickel smelter waste dump. AB - Longterm field exposure study was carried out on 10 rabbits placed for 6 months in a bioindication station located about 3 km downwind of a disposal site of nickel smelter waste dump. As revealed by the method of atomic absorption spectrophotometry, all of these animals showed elevated nickel and chromium levels in their body organs and hair. These findings were paralleled by histologic abnormalities in the lungs and liver tissues. Average dustfall values at the site of exposure did not exceed 5.5 g X m-2 X 30 d-1 during the period of observation. Dustfall deposits in this location contained nickel and chromium in amounts that were higher than in control locality. Analogous experiments on Wistar rats were carried out in a laboratory exposure chamber (exposure 4 h/day, 5 days/week, for a period of 6 months). After exposures to 50 mg X m-3 of metallic dust, lung parenchyma of rats was characterized by the presence of dust particles in various phases of phagocytosis as well as the presence of badly damaged or disintegrated alveolar macrophage cells, which pointed to metallic aerosol toxicity for biomembranes. The technique of air pollution biomonitoring on animals, correlated with the data on ambient air concentrations of the suspended particulate matter and its content of trace metals, appears to be a well suitable tool in establishing the potential air pollution hazards to the exposed populations living in the area of concern. PMID- 3805709 TI - Biliary excretion and organ distribution of 14C radioactivity after 14C-2 ethylhexyl acrylate administration in rats. AB - Rats were intravenously administered (14C)-2-ethylhexyl acrylate at the dose 10 mg/kg or 50 mg/kg b. w. Biliary excretion of 14C-radioactivity was followed in 1 3 hour intervals within the first 24 hours after administration. The rats were then sacrificed and distribution of 14C-radioactivity was followed in some organs. Highest radioactivity was found in liver, less in the kidneys and the least in the brain. A significant increase of bile flow was observed. In the 24 hour intervals 2.2% of the dose was eliminated via bile at both dosages, most of it (83%) during the first 3 hours. PMID- 3805710 TI - Indirect mutagen assay in human lymphocyte in the presence of a metabolic activation system. AB - Chromosome aberrations in cultured human lymphocytes were examined after exposures to various concentrations (from 1 X 10(-6) to 1 X 10(-3) mol X l-1) of cyclophosphamide (CP) in the presence or absence of a metabolic activation system (S9 mix). With metabolic activation, increases in the frequency of aberrant cells (AB. C.) produced by CP were significant and dose-dependent. At a concentration of 5 X 10(-4) mol X l-1, activated CP induced 29% AB. C. versus 6% AB. C. detected after exposures to CP without metabolic activation. The freshly prepared S9 mix did not virtually differ in its activation potency from the S9 mix stored for 3 weeks at -20 degrees C. CP preincubated for 100 min with S9 mix caused little or no increase in AB. C. frequency above the control level. PMID- 3805711 TI - Bacterial lysate (I.R.S. 19) applied intranasally in the prevention of acute respiratory diseases in children: a randomized double-blind study. AB - A controlled trial was undertaken to test I.R.S. 19 (a commercial intranasal spray) versus placebo in the prevention of acute respiratory diseases (ARD) in 825 maternity-school children in three cities; another control group of 327 children received neither I.R.S. 19 nor placebo. The spraying was done twice a day for a total of 20 spraying days in each child; sprayings were interrupted on weekends and during absence, the mean spraying period being 34 calendar days. During the 6-month study (1 November to 30 April) the children were monitored for ARD morbidity causing absence from school. A total of 1,585 such ARD cases occurred; their etiology was not investigated. The indices evaluated were: total duration of ARD-associated absence, ARD incidence, and mean duration of one illness. With the administration schedule used, I.R.S. 19 did not, in an overall evaluation, surpass placebo in any of these indices in either normal children or a subgroup of children with presumed enhanced ARD susceptibility. PMID- 3805712 TI - Influenza activity in Czechoslovakia and the USSR, 1980-1985. AB - Between 1980 and 1985, Czechoslovakia had experienced 4 and the USSR 3 major influenza outbreaks. Of the 3 epidemic outbreaks in the USSR, 2 were associated with influenza B virus (in the 1980/81 and 1983/84 seasons) and 1 with influenza A virus of the H3N2 subtype. In the USSR, influenza A (H1N1) virus never predominated as a cause of epidemic during the 5 years period. In Czechoslovakia, 2 epidemics (in the 1980/81 and 1983/84 seasons) were due to influenza A (H1N1) virus. The epidemic in the 1981/82 season had two waves of unequal heights and a mixed type B and subtype A (H3N2) etiology; a two-wave epidemic associated with isolates of influenza A (H1N1) and influenza B viruses was also recorded in the 1983/84 season. The influenza A (H3N2) epidemic in 1983 was of explosive character. All influenza viruses circulating in the two countries between 1980 and 1985 were of the same antigenic profile, but were isolated from the epidemics that occurred in different influenza seasons. The virological surveillance revealed strains of virus closely related to drift variants detected from outbreaks in 1977-1979 and the new variants A/Chile 1/83, A/Philippines 2/82, A/Caen 1/84 and B/USSR 100/83. PMID- 3805713 TI - Water-borne Mycobacterium xenopi--a possible cause of pulmonary mycobacteriosis in man. AB - In the years 1980-1983 M. xenopi was isolated from the sputum of 37 persons, 30 of them living in the agglomeration of the regional town in the region of Northern Bohemia with 1,175,000 inhabitants. Only 7 of these 30 had manifestation of pulmonary disease. M. xenopi was found repeatedly in the sputum in 5 patients out of 7 affected and in 2 out of 23 persons who showed no signs of a disease. The prevalence was in males between the age of 52-67 years. All of them suffered from other diseases, as chronic bronchitis, TB healed after lobectomy, lung cancer, fibrotic lung lesions, diabetes mellitus, gastric ulcer healed by resection, chronic alcoholism. Investigations were made for detection of the source of infection. Bacteriological examinations of cold and warm tap water in flats of 9 persons with M. xenopi in their sputa were carried out, as well as cold and warm tap water from flats of 2 healthy persons. M. xenopi was found in tap water of 5 persons with M. xenopi in their sputum and in one of the two healthy persons. In the water of one household we found M. kansasii. We came to the conclusion, that transmission carried out in susceptible persons is most probably due to aerosol during washing and showering with water, containing these mycobacteria. PMID- 3805714 TI - Experimental infection of Ancylostoma caninum in chickens: immunization through transfer of sensitized bursal cells. AB - An attempt has been made to demonstrate the immune response in chickens to infection by the dog hookworm Ancylostoma caninum following transfer of sensitized bursal cells from infected donor chickens. Recipients were challenged with a dose of 500 larvae each, 1, 3 and 5 days after cell transfer. The immune response was found to be more pronounced in recipients challenged 5 days after cell transfer than in those challenged 1 or 3 days after transfer and those which received non-sensitized bursal cells. PMID- 3805715 TI - Erythrocyte reagents in the study of Erysipelothrix antigens. AB - The activity of species-specific and type-specific antigens in various preparations isolated from the bacterial mass of standard strains of Erysipelothrix, and also in bacterial cells was studied by means of prepared erysipeloid erythrocyte antigen (species-specific and with general type- and species-specificity) and antibody (species-specific, with general type- and species-specificity as also with type-specificity only) diagnosticums. It has been demonstrated that the activity of these antigens differs in preparations from different strains, depending on the method of extraction. An efficient method of serotyping of Erysipelothrix, based on agglutination of erythrocyte antibody diagnosticums, was proposed. PMID- 3805716 TI - Tumor necrosis factors alpha and beta induce osteoblastic cells to stimulate osteoclastic bone resorption. AB - Antigen- or mitogen-stimulated leukocytes release bone-resorbing activity into culture supernatants in vitro. Among the agents likely to be present in such supernatants are monocyte-derived tumor necrosis factor (TNF-alpha) and lymphocyte-derived tumor necrosis factor (TNF-beta) (lymphotoxin), both of which have recently been shown to stimulate bone resorption in organ culture. To identify the mechanism of action of these agents, we compared bone resorption by isolated osteoclasts with bone resorption by osteoclasts cocultured with osteoblastic cells, and with bone resorption by osteoclasts incubated with supernatants from osteoblastic cells, in the presence and absence of recombinant TNF-alpha and TNF-beta. We found that neither TNF-alpha nor TNF-beta had any significant effect on bone resorption by isolated osteoclasts, but in the presence of osteoblasts the agents caused a twofold to threefold stimulation of bone resorption. A similar degree of stimulation was achieved by supernatants from osteoblasts incubated with TNF before addition to osteoclasts, compared with supernatants to which TNF were added after osteoblast incubation. These experiments suggest that TNF-alpha and TNF-beta stimulate bone resorption through a primary effect on osteoblastic cells, which are induced by TNF to produce a factor that stimulates osteoclastic resorption. Half-maximal stimulation of resorption occurred at 1.5 X 10(-10) M and 2.5 X 10(-10) M for TNF-alpha and TNF beta, respectively. This degree of potency is comparable to that of parathyroid hormone, the major physiologic systemic regulator of bone resorption, and suggests that the TNF may exert a significant influence on osteoclastic bone resorption in vivo. PMID- 3805717 TI - A labile antigen complex at the lymphocyte surface: the effect of the substratum on its expression. AB - Human T lymphocytes carry a surface antigen, detectable by a monoclonal antifibronectin antibody, which appears to consist of 150 and 55 kd components as revealed by SDS-PAGE. After in vitro culture of the lymphocytes on a plastic substratum for 48 hr comparatively few cells (40 +/- 18% in separate individuals) express the antigen. In contrast, the vast majority of lymphocytes cultured on a collagen matrix for the same time period maintains surface expression of the antigen (76 +/- 14% in separate individuals). Conditioned media from lymphocytes on plastic contain substantial amounts of antigenicity detectable by the same antibody, whereas conditioned media from lymphocytes on collagen are devoid of such antigenicity. The expression at the cell surface of other T lymphocyte antigens (Leu-4, Leu-3, and OKT8) is identical during culture on plastic and collagen for 48 hr. Collagen does not activate the cells to DNA synthesis or expression of IL 2 receptors, and consequently the potentiation of antigen expression by this substratum cannot be attributed to a mitogenic effect. The composition of subsets of T lymphocytes and the viability of the cells are the same on plastic and collagen, which excludes that the substratum-dependent variations in antigenicity reflect selection or loss of antigen-bearing cells. Thus, substratum-dependent regulation of the expression at the cell surface appears to be a unique property of the 150/55 kd T cell surface antigen. Culture on collagen substrata augments the number of lymphocytes showing motile behavior two to four times compared with culture on plastic. PMID- 3805718 TI - Terminal complement components play a role in the expression of C5a. AB - This study examined the expression of C5a detected antigenically (RIA) and functionally (PMN-myeloperoxidase release) consequent to classical or alternative pathway convertase cleavage. Maximal C5a expression occurred when C5 was cleaved in the presence of the later-acting complement components, C6, C7, and C8. This effect was detected by using both purified components and normal human serum immunochemically depleted of C7 or C8 and reconstituted with the purified component. C6 alone was not sufficient to augment C5a expression. Subsequent incubation of C6 and C7 with C5 cleaved in the absence of the terminal components was not sufficient for C5a release. Repeated freezing and thawing of C5 cleaved in the absence of C6 and C7 produced C5a equivalent to that detected when convertase cleavage occurred in the presence of the terminal components. Mild detergent treatment of convertase-cleaved C5 was not sufficient for C5a release. We believe that these data indicate a role for the terminal complement components in the expression of both C5a antigen and function. The mechanism for this effect is not known, but it may involve conformational changes in the C5 molecule that occur during membrane attack complex formation. PMID- 3805719 TI - Role of NK cells in protection of mice against herpes simplex virus-1 infection. AB - Natural killer (NK) cells have been implicated in the recognition and killing of a variety of virus infected target cells in vitro, yet their role in vivo remains uncertain. In these experiments, the role of NK cells in the regulation of resistance to herpes simplex virus-1 (HSV-1) was studied. Adult C57BL/6 mice are resistant to HSV-1 (HFEM strain), but are rendered highly susceptible by treatment with cyclophosphamide 24 hr prior to infection. In this model, passive transfer of 10(8) normal spleen cells or 10(7) poly I:C-treated spleen cells provided protection for 72% of the recipients. Spleen cells from NK cell deficient beige mice similarly treated failed to engender passive protection. The phenotype of the cells responsible for transferring protection was NK1.1+, and asialo GM1+. Transfer of NK cells resulted in marked reduction of HSV titers in the livers and brains of recipients. These experiments provide direct evidence for a role for NK cells in protection against development of fatal HSV infection in mice. PMID- 3805720 TI - Studies on the anti-tumor efficacy of systemically administered recombinant tumor necrosis factor against several murine tumors in vivo. AB - The anti-tumor activity of recombinant human tumor necrosis factor (rHTNF) was examined against four newly induced murine sarcomas (MCA-101, -102, -105, and 106) and a murine adenocarcinoma (MCA-38) transplanted s.c. into C57BL/6 mice. The serum half-life after a single i.v. injection of rHTNF was determined to be 30 +/- 2 min. Tumor-bearing mice were more susceptible to the toxic side effects of rHTNF than were normal mice. Forty-eight percent (41/86) of tumor bearing animals that received 10 micrograms rHTNF died within 48 hr after treatment compared with no deaths in 28 normal animals receiving this dose. Treatment of mice bearing either the MCA-101, -102, -105, or -106 sarcoma or the MCA-38 adenocarcinoma with rHTNF resulted in a marked necrosis of the central portion of each tumor within 24 hr. Animals bearing the weakly immunogenic tumors MCA-105, 106, and -38 experienced a reduction in average tumor area of 47% +/- 5, 46% +/- 6, and 37% +/- 11, respectively, by 3 to 4 days after treatment with rHTNF compared with pre-treatment values (p less than 0.001); increases of 79% +/- 11, 74% +/- 10, and 41% +/- 6 were seen in excipient-treated control animals over the same period. In contrast, animals bearing the non-immunogenic tumors MCA-101 and 102 experienced little if any decrease in tumor area at the doses of rHTNF used. rHTNF failed to mediate cures in animals bearing MCA-38, -101, or -102. In contrast, 67 and 28% of animals bearing MCA-105 and -106, respectively, which received 6 to 10 micrograms rHTNF were cured. Likewise, animals bearing MCA-105 and -106 sarcomas treated with 6 to 10 micrograms rHTNF had significantly increased survival compared with excipient-treated control animals. In contrast, no significant difference in mean survival was observed between excipient and rHTNF treated animals bearing MCA-38, -101, or -102. Histologically, the necrotic response of immunogenic MCA-106 and non-immunogenic MCA-102 tumors to systemically administered rHTNF was very similar. These two tumors differed morphologically, however, by the greater degree of chronic inflammation that was present at the periphery of the MCA-106 tumor in comparison with the MCA-102. By 72 hr after rHTNF administration, the sites of regressed MCA-106 tumors were replaced by a heterogeneous population of inflammatory cells and tumor cell "ghosts".(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805721 TI - Anaphylaxis-mediated epithelial Cl- secretion and parasite rejection in rat intestine. AB - Immunologically mediated expulsion of Trichinella spiralis infective larvae in the rat was used as a model to test the hypothesis that intestinal anaphylaxis induced by parasite antigen causes ion transport alterations in small intestinal epithelium, and that the small intestinal epithelium, by altering its physiologic state in response to mast cell-derived mediators, functions as an effector tissue in the expulsion process. Experimental results demonstrated that the rapid rejection response and antigen-inducible changes in net intestinal ion transport acquired through active immunization were transferable with serum containing a high titer of anti-trichinella homocytotropic antibody, as measured by the PCA test. Neither response was expressed in nonimmune hosts nor in recipients of serum in which the PCA-detectable antibody was reduced by heat treatment. Net ion transport by jejunal epithelium of both actively and passively immunized rats was measured in Ussing chambers by using the electrical correlate, short circuit current (Isc). Involvement of chloride secretion in antigen-induced alterations in Isc was deduced from the use of chemical agents that effectively and specifically blocked the antigen-induced Cl- secretory response. The results implicate anaphylaxis in both rapid worm rejection and altered epithelial ion transport. PMID- 3805722 TI - Transfer of antibodies directed to paternal major histocompatibility class I antigens from pregnant mice to the developing fetus. AB - The placental transmission of antibodies directed toward paternal MHC Class I antigens to the developing fetus was studied to assess their effect on the expression of MHC antigens during fetal development and on the development of immune function. 125I-monoclonal anti-paternal MHC antibodies injected i.v. into pregnant mice on day 15 of gestation were efficiently transferred to the fetus within 24 hr in a dose-dependent manner. Biochemical studies on the transferred radioactivity showed that intact antibodies accumulated in the fetus for up to 3 days after antibody injection. During the same period, antibodies were eliminated from the maternal system. The transfer and accumulation of anti-MHC antibodies were independent of the MHC haplotype of the fetus. The pathway of antibody transfer and the localization of transmitted antibodies in the fetus were studied by autoradiographic analysis of the entire fetoplacental unit 24 hr after the injection of anti-paternal MHC antibodies. Our results indicate that antibodies are transferred by way of the placenta and yolk sac, and reach the fetus predominantly via the circulation. Within the embryo proper, the highest levels of antibody were found in the order of blood greater than thymus greater than fetal liver. Most other fetal organs, with the exception of brain and cartilage, showed antibody accumulation, but to a lesser extent. This pattern of antibody distribution over different tissues was similar for allogeneic and syngeneic fetuses. These findings demonstrate that various fetal tissues, including developing lymphoid cells can be directly exposed to the maternally transmitted anti-MHC antibodies, with possible functional consequences on the development of the fetal immune system. PMID- 3805723 TI - Uveitogenic potential of lymphocytes sensitized to interphotoreceptor retinoid binding protein. AB - In our previous study rats immunized with bovine retinal interphotoreceptor retinoid-binding protein (IRBP) were found to develop inflammation in the eye and the pineal gland. This inflammatory disease was distinct in several aspects from experimental autoimmune uveoretinitis (EAU) induced by the retinal S-antigen (S Ag). The current study examined the adoptive transfer of IRBP-induced EAU. We established that lymphocytes from IRBP immunized donor rats were capable of transferring EAU after in vitro stimulation with either IRBP (lymph node or spleen cells) or concanavalin A (spleen cells only). Recipients of these cells developed uveoretinitis and pinealitis identical to the actively induced disease. As compared with the S-Ag system, recipients of IRBP sensitized cells developed disease earlier, and smaller numbers of cells were needed to transfer EAU. Development of inflammation was directly related to a cellular response to the specific retinal antigen used for sensitization. Moreover, the unique nature of ocular inflammation was reestablished in the IRBP system: high proportions of polymorphonuclear leukocytes were found in the inflamed tissue of certain recipients despite a lack of a humoral response to the specific antigen. In contrast to the eye, only mononuclear leukocytes comprised the inflammation in the pineal gland. PMID- 3805724 TI - Tumor necrosis factor is chemotactic for monocytes and polymorphonuclear leukocytes. AB - Human recombinant tumor necrosis factor (TNF) induced migration across polycarbonate and nitrocellulose filters of human peripheral blood monocytes and polymorphonuclear leukocytes, TNF was active in inducing migration at concentrations less than 1 U/ml, and maximal responses (observed at greater than 100 U/ml) were comparable to those elicited by standard reference chemoattractants (FMLP, 10 nM; activated human serum, 5%). Checkerboard analysis performed by seeding different concentrations of TNF above and below the filter revealed that maximal induction of migration required a positive concentration gradient between the lower and upper compartments and that TNF elicited an actual chemotactic response in phagocytes. An anti-TNF rabbit antiserum and anti-TNF mouse monoclonal antibody abolished the chemotactic activity of TNF. Recombinant lymphotoxin was also chemotactic for phagocytes, and its activity was blocked by an anti-lymphotoxin antiserum. Human umbilical vein endothelial cells and blood large granular lymphocytes did not respond chemotactically to TNF under conditions in which appropriate reference chemoattractants were active. The chemotactic activity of TNF may serve to recruit phagocytic cells from the blood compartment to amplify resistance against noxious agents. PMID- 3805725 TI - Idiotypic analysis of myeloma proteins: anti-DNA activity of monoclonal immunoglobulins bearing an SLE idiotype is more common in IgG than IgM antibodies. AB - The anti-idiotype 3I which recognizes a determinant on kappa-chains of anti-DNA antibodies in SLE patients also recognizes a determinant on kappa-chains of 82/706 myeloma proteins tested. Twenty-nine of these 82 proteins bind to double stranded DNA, including two monoclonal IgM, one monoclonal IgA, and 26 monoclonal IgG proteins. DNA binding is much more frequent in the IgG than in the IgM myeloma proteins (p less than 0.001), and is also associated with cationic antibody charge. Two-dimensional gel electrophoresis reveals markedly increased charge heterogeneity of both heavy and light chains of the monoclonal IgG as compared with the monoclonal IgM proteins. We postulate that the increased charge heterogeneity of the IgG-associated 3I-reactive kappa-light chains may reflect somatic mutation, and that DNA specificity within the 3I idiotype system arises by somatic mutation of germ-line genes found in normal individuals. DNA binding may be associated with those mutations that give rise to a cationic immunoglobulin charge. PMID- 3805726 TI - Approaches to augmenting the immunogenicity of the ganglioside GM2 in mice: purified GM2 is superior to whole cells. AB - The gangliosides GM2, GD2, and GD3 are differentiation antigens largely restricted to cells of neuroectodermal origin. They are expressed on most melanomas, astrocytomas, and neuroblastomas and have been shown to function as effective targets for monoclonal antibodies. In previous studies, we have immunized melanoma patients and mice with a series of melanoma cell vaccines containing these antigens, but have observed only occasional antibody responses. We report here the results of experiments in which an irradiated whole cell vaccine shown previously to be optimal was compared with a series of vaccines containing purified GM2. Mice were pretreated with low dose cyclophosphamide (Cy), or not, and were immunized twice with syngeneic melanoma cells (JB-RH) known to contain 60 micrograms of GM2 or with vaccines containing 50 micrograms of purified GM2. Serum was obtained at regular intervals and was tested by immune adherence, complement dependent cytotoxicity, and protein A assays on the JB-RH cell line. The whole cell vaccine, GM2 alone, GM2 incorporated into complete Freund's adjuvant, and GM2 attached to E. coli were all minimally immunogenic. GM2 attached to Salmonella minnesota or BCG, and GM2 attached to certain liposome preparations containing monophosphoryl lipid A, were found to be moderately immunogenic. GM2 attached to the R595 mutant of Salmonella minnesota was found to be significantly more immunogenic. Pretreatment with Cy significantly increased the immunogenicity of this vaccine. The specificities of selected sera were tested in inhibition assays and were limited to GM2. Antibodies produced after immunization were generally exclusively IgM and mediated potent complement dependent cytotoxicity on JB-RH cells. These results identify R595 as the most effective adjuvant tested for augmenting the immunogenicity of GM2 and show that with regard to antibody production, purified tumor antigen presented optimally can be more immunogenic than optimally presented whole tumor cells containing the same amount of antigen. PMID- 3805727 TI - Cytostatic and cytolytic effects of human recombinant tumor necrosis factor on human renal cell carcinoma cell lines derived from a single surgical specimen. AB - The purpose of this study was to determine whether human tumor cell lines derived from a single tumor exhibit heterogeneous responses to the anti-tumor effects of human recombinant tumor necrosis factor (h-r-TNF). Several cell lines with different metastatic propensities have been established in culture from a single surgical specimen of a human renal cell carcinoma following different selection procedures in nude mice. The cell lines exhibited significant differences in in vitro susceptibilities to cytotoxic effects of TNF. Kinetic analysis of the interaction of TNF with susceptible renal carcinoma cells demonstrated that a short 30 min interaction of TNF with the cells is sufficient to produce significant lysis 72 hr later. One cycle of exposure of sensitive cells to h-r TNF did not produce cells resistant to it, nor did the degree of sensitivity to h r-TNF vary after one passage of the cells in nude mice. Tumor cell resistance to the effects of TNF did develop spontaneously after prolonged cultivation in culture. We conclude that tumor cells derived from a single human renal cell carcinoma exhibit a heterogeneous response to the cytotoxic effects of h-r-TNF. PMID- 3805728 TI - Natural cytotoxic cells and tumor necrosis factor activate similar lytic mechanisms. AB - The lytic activity of natural cytotoxic (NC) cells has several characteristics which clearly distinguish it from other cell-mediated lytic activities and from most soluble cytolytic factors. An exception is the lytic activity mediated by tumor necrosis factor (TNF). In this paper, we report a detailed comparison of NC and TNF lysis of target cells which are used as prototype NC targets or TNF targets, and show that the two cytolytic activities have very similar, if not identical, lytic mechanisms. We present data showing that target cells which are NC-sensitive are also TNF-sensitive and that target cells which are NC-resistant are also TNF-resistant. Moreover, cells selected either in vivo or in vitro for NC resistance are selected for TNF resistance, and cells selected for TNF resistance are selected for NC resistance. The analysis of the kinetics of 51Cr release mediated by NC cells or by TNF show that both activities affect similar kinetics, in that there is no cell lysis for several hours after targets and effectors first interact. However, NC and TNF lytic activities can be distinguished. By using the cell lines 10ME or B/C-N as targets, it can be shown that whereas NC-mediated lysis is dependent on protein synthesis, TNF-mediated lysis is not. We also show that targets which are resistant to NC-mediated lysis because they express a protein synthesis-dependent resistance mechanism also require protein synthesis to resist TNF-mediated lysis, suggesting that the same resistance mechanism protects cells against both NC cells and TNF. Together, these data strongly support the hypothesis that NC cells and TNF activate the same lytic mechanism within target cells and that TNF may mediate the lytic activity of NC effector cells. PMID- 3805729 TI - Simplified methods for the purification, quantitation, and functional estimation of human complement C-1-inhibitor (C-1-INH) with a monoclonal anti-C-1-INH antibody. AB - New methods have been developed for the isolation, quantitative detection, and functional measurement of human complement C-1-inhibitor (C-1-INH). The two-step purification procedure for C-1-INH from human plasma or serum employs affinity chromatography with a monoclonal anti-C-1-INH antibody coupled to CNBr-activated Sepharose 4B followed by fractionation on a FPLC Mono Q HR 5/5 column. It yields functionally active, homogeneous C-1-INH with about 40% recovery. For quantitative estimation of C-1-INH an ELISA was performed. ELISA plates were coated with a polyclonal anti-C-1-INH antibody, serum or plasma was added and bound C-1-INH was detected with the monoclonal anti-C-1-INH antibody. The method has a sensitivity of 0.4 ng C-1-INH per assay corresponding to 20 ng/ml. For the detection of functionally active C-1-INH an ELISA was developed using C1-s-coated microtiter plates. After incubation with serum or plasma, C1-s-bound C-1-INH was monitored with the monoclonal anti-C-1-INH antibody. With this method it is possible to measure as little as 0.3 ng of functionally active C-1-INH in 20 microliter of a biological sample. All methods described in the present paper are easy to perform, rapid, sensitive, and highly reproducible. PMID- 3805730 TI - Mechanism of separation of polymorphonuclear leukocytes from whole blood by the one-step Hypaque-Ficoll method. AB - After centrifugation of heparinised whole blood on Hypaque-Ficoll medium (s.g. 1.114, Ferrante and Thong, 1980) the specific gravities were measured of the layers of medium above and below the band of polymorphonuclear leukocytes (PMN), as well as of the PMN and sedimented erythrocytes. The erythrocytes and PMN were also examined for evidence of shrinkage. The medium above the PMN layer was found to be less dense than the medium below the PMN layer, which in turn was less dense than the original Hypaque-Ficoll medium. Examination of the cells showed that the sedimented erythrocytes and PMN were shrunken and of increased density. The results are consistent with a separation mechanism dependent upon osmotic loss of water from the sedimenting erythrocytes, forming a density gradient in the medium in which the PMN become buoyant. PMID- 3805731 TI - Production of monoclonal antibodies. The effect of hybridoma concentration on the yield of antibody-producing clones. AB - The relationship between the number of hybrid clones in each well of the primary culture, the yield of antibody-producing wells and the short-term stability of the polyclonal cultures was tested. The results of the study demonstrate that a higher yield of antibody-secreting clones was obtained by employing lower density of hybrids and that instability of antibody secretion by polyclonal cultures is not the result of overgrowth of non-secreting clones. PMID- 3805732 TI - A flow cytofluorometric double staining technique for simultaneous determination of human mononuclear cell surface phenotype and cell cycle phase. AB - A double staining technique for the simultaneous determination by flow cytofluorometry of cell surface phenotype and cell cycle phase is described. Peripheral blood mononuclear cells were stained with fluorescein-conjugated monoclonal antibodies for cell surface phenotype, fixed serially with 2% paraformaldehyde and 71.25% ethanol, and stained with propidium iodide to label cellular DNA. The cells were then analyzed by flow cytofluorometry for both green and red fluorescence. A variety of cells, including T cells and their subsets, B cells, NK cells and monocyte/macrophages, can be identified by this technique with simultaneous determination of cell cycle phase. PMID- 3805733 TI - Detection of IgE antibody-forming cells by passive cutaneous anaphylaxis using cell extract from lymphoid organs. AB - IgE and IgG2a antibody-forming cells in the lymphoid organs of rats were detected by passive cutaneous anaphylaxis (PCA) reaction using the extract from the tissue. The amount of antigen-specific IgE and IgG2a antibodies in the tissue extract could be expressed as PCA titers in which extract from 10(8) cells/ml was used as starting dilution. The total amount of antigen-specific IgE antibody produced in mouse IgE-producing hybridoma cells was calculated by maximum dilution of the extract to the minimal amount of IgE antibody inducing PCA reaction, i.e., 4 ng/ml. In the case of the extract from mouse IgE antibody forming hybridomas, the minimal number of hybridoma cells to be detected by this method proved to be 2-3 X 10(4) cells/ml. PMID- 3805734 TI - Development of a semi-quantitative enzyme-linked immunosorbent assay (ELISA) for detection of human IgG subclass antibodies. AB - We have developed a sensitive enzyme-linked immunosorbent assay (ELISA) which measures antibodies to bee venom phospholipase A2 (PLA2) and hyaluronidase (HYAL), horse IgG, bovine casein, and the bacterium Streptococcus mutans in each of the four human IgG subclasses. For this purpose, we have used mouse monoclonal antibodies (McAb) specific for each subclass and one which showed 'pan-IgG' reactivity. Binding to human IgG was similar for all the McAb and dilution of human IgG resulted in similar dilution curves for each subclass. Results were expressed as arbitrary U ml-1 by comparing the optical density obtained with each subclass-specific McAb to a reference curve for total IgG antibody constructed using the 'pan-IgG' McAb. Close agreement was found between the total amount of IgG antibody and the sum of the antibody in each of the four subclasses (PLA2 r = 0.90, horse IgG r = 0.98, bovine casein r = 0.84, S. mutans r = 0.85), confirming that these assays provide semi-quantitative measurements of the amount of subclass-specific antibody. PMID- 3805735 TI - Production and characterization of monoclonal antibodies to human tumor necrosis factor. AB - Five stable hybridoma cell lines secreting antibodies to recombinant human tumor necrosis factor (TNF) were established. All monoclonal antibodies belong to the IgG1 subclass. One monoclonal antibody (MAB) (designated as 3B10) neutralizes the L929 cytotoxic activity of natural and recombinant human TNF. Other MABs bind to human TNF but do not neutralize cytotoxic activity. A sandwich enzyme immunoassay specific to human TNF molecule has been developed using 3B10. This assay measures only biologically active human TNF molecules and is as sensitive as a bioassay which measures the cytotoxic activity on L929 cells. These results show that 3B10 is quite useful in studying the biological functions of TNF. PMID- 3805736 TI - Use of poligonal windows for physical discrimination among mononuclear subpopulations in flow cytometry. AB - Peripheral blood mononuclear cells from ten healthy normal donors were analyzed by means of monoclonal antibodies and flow cytometry (FACS IV). In order to apply optimal gating for the identification and exclusion of monocytes from lymphocyte populations, mononuclear cells were analyzed on the scattergram using rectangular or poligonal computer-generated windows. Two main windows on lymphoid population were used which mainly differed for the up-right corner, in the border area between lymphocytes and monocytes. While the number of lymphocytes contained either in the regular or in the poligonal windows was the same, the number of contaminating monocytes decreased by two-fold in the poligonal one. Besides, the use of tight lymphocyte gating, in order to reach lower monocyte contamination, leads to a loss of lymphoid cells which does not appear to be random, but seems to affect mainly the Leu11c+ population with natural killer activity. These cells produce forward and perpendicular scatter signals higher than other lymphocyte subsets, and, therefore, are mainly located in the area of the scattergram which divides lymphocytes from monocytes. These data are in accordance with the large granular morphology of natural killer cells. The use of the poligonal windows seems to be useful to reduce monocyte contamination with no selective loss of natural killer lymphocytes, and may be particularly helpful in the analysis of pathological samples. PMID- 3805737 TI - Third component of rat complement. Purification from plasma and radioimmunoassay in culture media from cell lines. AB - A double antibody radioimmunoassay for rat C3 has been developed. The assay required the preparation of C3 from plasma. A new purification procedure using ion exchange high performance liquid chromatography is described. The final product was homogeneous on SDS-PAGE analysis. Rat C3 has an apparent molecular weight of 187,000 and is composed of two polypeptide chains with molecular weights of 125,000 and 73,000, respectively. The purified C3 antigen with high hemolytic reactivity, as assessed by its specific functional activity, was used in preparing anti-C3 sera to perform a specific radioimmunoassay for quantifying C3 in the presence of heterologous sera contained in the cell culture media. All the validating criteria, such as precision, recovery and dilution studies, were investigated. The high sensitivity of the method allowed replicate determination of C3 in small aliquots of the cell culture medium. PMID- 3805738 TI - Computer-aided hybridoma screening. Production of monoclonal antibodies against membrane fractions from mammary tumour tissue. AB - Monoclonal antibodies were raised against membrane fractions from mammary tumour tissue. 746 hybridomas were obtained against the so-called membrane fraction '2a' and 1393 hybridomas against the so-called 'top-region'. These hybridomas were tested with an immunodot assay, cell-binding radioimmunoassay and an immunocytological screening assay using several antigens. In the evaluation of these data we used the common database software (dBASE II) on a personal computer. To facilitate computer handling, even for the non-specialist, we programmed our individual menu-driven software for computer-aided hybridoma screening. PMID- 3805739 TI - Flow cytometric quantitative evaluation of phagocytosis by human mononuclear and polymorphonuclear cells using fluorescent nanoparticles. AB - The use of fluorescent polymethacrylic nanoparticles (0.3 micron) as a flow cytometric reagent in the quantitative evaluation of phagocytosis by human mononuclear and polymorphonuclear cells is described. The preparation of the nanoparticles, by emulsion copolymerization of methacrylic monomers, and their physicochemical properties are briefly summarized. Nanoparticles coupled with a fluorescent agent (ethidium bromide) were used in a flow cytometric assay to study opsonin-independent phagocytosis by human polymorphonuclear cells and by human monocytes. The phagocytosis of nanospheres by monocytes was determined by flow cytometry from the fluorescence distribution and ingestion was visualized by scanning and transmission electron microscopy. One possible application of the fluorescent nanoparticles is the simultaneous analysis of cell surface antigens and cell phagocytic activity. PMID- 3805740 TI - HPLC analysis of the dissociation and recombination of rabbit immunoglobulin G. AB - Rabbit immunoglobulin G (RIgG) was reduced with dithioerythritol and analyzed by high performance liquid chromatography. A quantitative method for determining the percentage of reduced half-molecules in the mixture was developed. An acetic acid concentration-dependent rate of dissociation of reduced half-molecules was observed. The specific optical absorptivity was determined for whole molecules and half-molecules and found to be significantly greater for the half-molecules. Purified half-molecules were reconstituted into RIgG with a yield greater than 90% following a 16 h incubation at pH 8.0 and room temperature. PMID- 3805741 TI - Measurement of membrane fluidity of polymorphonuclear leukocytes by flow cytometry. AB - A method was established for measuring membrane fluidity of polymorphonuclear leukocytes (PMN) by the excimer-forming lipid technique with pyrenedecanoic acid in flow cytometry. When cells were labeled, the use of 2-25 microM of pyrenedecanoic acid provided similar results. Neither the removal of the unincorporated pyrenedecanoic acid nor adjustment of PMN counts exhibited any effect. By the gate analysis method, membrane fluidity of PMN could be measured with 100 microliters of heparinized whole blood in a short time and results with PMN in whole blood was similar to those with purified PMN. Therefore, purification and count adjustment of PMN could be omitted. By this method, membrane fluidity of PMN, which were treated with membrane fluidizer, was measured successfully. This method could be applied to the study of PMN function in various diseases. PMID- 3805742 TI - A simple, non-chromatographic procedure to purify immunoglobulins from serum and ascites fluid. AB - A simple, two-step procedure to purify the immunoglobulin G (IgG) fraction from mammalian sera and ascites fluid is described. In the first step, albumin and other non-IgG proteins are precipitated with caprylic acid (octanoic acid). In the second, the IgG fraction is precipitated with ammonium sulfate. Factors influencing the precipitation of serum proteins by caprylic acid are described, as are procedural modifications to purify the IgG fraction from sera with a high lipid content. The procedure can be used to purify the IgG fraction of serum from rabbit, sheep, goat, horse, rat and mouse, as well as monoclonal antibodies from mouse ascites fluid. Greater than 80% of the IgG in rabbit serum could be isolated by this procedure, with a purity equal to rabbit IgG purified by anion exchange chromatography. In addition to its simplicity and low cost, the procedure described offers several advantages over other methods to purify IgG. PMID- 3805743 TI - Re: Selection of ELISA reagents. PMID- 3805744 TI - Antitumor activity of optical isomers of cyclophosphamide, ifosfamide and trofosfamide as compared to clinically used racemates. AB - The relationship between enantiomeric homogeneity of three oxazaphosphorine drugs: cyclophosphamide, ifosfamide and trofosfamide and their antitumor activity was evaluated by standard screening tests against four in vivo transplantable tumor models: L 1210 and P 388 lymphoid leukemias, Lewis lung carcinoma and 16/C line of mouse mammary adenocarcinoma. It was shown that the stereodifferentiation of anti-tumor effect of enantiomers was not outstanding although quite consistently in favour of levorotatory forms. The only exception was seen for cyclophosphamide enantiomers tested against leukemias where R/+/form was more effective than S/-/or racemate. PMID- 3805745 TI - Activated macrophage hybridomas secreting a cytotoxic factor. AB - Stable activated macrophage hybridomas were generated by somatic cell fusion between Propionibacterium acnes-induced peritoneal exudate cells and NS-1 myeloma cells. Five cell lines were obtained and each was cloned by limiting dilution; 59 clones were obtained. The cells of 2 clones (MP4-4 and MP4-8) which adhered to the culture dishes were selected for further analysis. These hybridomas exhibited non-specific esterase and beta-galactosidase intracellularly, and asialo GM1, Mac 1, Ia antigens and Fc-receptors on their cell surface. They did not, however, show phagocytic activity or secrete lysozyme. These hybridomas (MP4-4 and MP4-8) secreted the cytotoxic factor without any stimulation. Furthermore strong cytotoxic activity was found in ascites and sera from nude mice inoculated with these hybridomas. These activated macrophage hybridomas should be very useful in studies on cancer immunology and the physiology of macrophages. PMID- 3805746 TI - [Nuclear magnetic resonance imaging in the urologic study of the male pelvis. Apropos of 60 examinations]. AB - Theoretical concepts underlying the principle of nuclear magnetic resonance imaging are defined and the technical basis for its use in medical imaging described (sequences, accumulations, contrast media). Results are presented of a spectrometric study of 23 operative specimens from the bladder, prostate and seminal vesicles with analysis in vitro of relaxation time of the various tissues. Findings confirmed the value of NMR imaging for evaluation of macroscopic extension of tumors within the affected organs, as well as the interrelations of the organs, but the impossibility of identifying histologic structure of tumors and organs explored by this technique. Two groups of subjects were studied: a first group of 20 healthy volunteers to define NMR semeiology of male pelvis and a second group of 40 patients with mainly tumoral lesions of vesicles or prostate. Details are provided of the diagnostic value of NMR imaging with respect to the tumor, local and regional invasion and bone metastases. Excellent images of the tumor were obtained, with the possibility of determining its macroscopic stage, but its histologic nature could not be ascertained. Multiplane examination allowed better assessment of local and regional spread than by a CT scan, particularly for prostatic tumors (bladder, prostate bed or seminal vesicle extension). A negative feature of major importance exists, however, in that early glandular involvement is not detected by NMR imaging, which also fails to identify one case in two with bone metastases. Current research should allow progressive correction of present NMR imaging insufficiencies, notably in the field of tissue characterization. PMID- 3805747 TI - [Seminoma of testis. Analysis of failures and development of therapeutic strategies. Apropos of a Lyons series of 117 cases]. AB - From Jan.61 to Dec.81, 117 patients with seminoma of testis were treated in the Leon Berard Centre, Lyon. All had undergone lymphography during investigation of possible extension, 19 were treated with 200 KV up 1966, 64 with Cobalt up to 1978 and 29 with photons x of 18 MV since that date. From 1979 adjuvant chemotherapy has always included cisplatinum. The 5 years survival rate was 95% of stage I (51/54 cases), 72% of stage II (26/36 cases) and 1/7 of stage III. Unsuccessful treatment of neoplasm was noted in 23 patients, in 80% of cases during the first two years and involving mainly pulmonary metastases. Three patients had mediastinal metastases while recovery surgery was possible in 4 cases. Three fatal iatrogenic complications were observed. Since the use of high energies, particularLy x beams of 18 MV there has been almost total absence of radic complications. Therapy now proposed is as follows: stage I: surgery plus radiotherapy; stage II A-B: surgery and irradiation avoiding mediastinum; stage II C and III: primary chemotherapy. PMID- 3805748 TI - [Cancer of kidney with venous invasiveness: prognosis. Apropos of 238 renal excisions with 64 cases of venous invasiveness]. AB - About a series of 238 surgically managed renal cell carcinoma with 64 venous invasion's cases (without no lost of follow-up) the prognosis is bad: post operative mortality: 12,5%. Overall uncorrected five-years actuarial survival: 25%. But 42% of these patients with venous invasion had associated lymph node invasion and-or visceral metastasis. About 37 cases with only venous extension five-years actuarial survival reaches 45,9%. The inferior vena cava (I.V.C.) extension is the worst. Five american data reports some cases (5 to 18 cases) with near half and half surviving patients. In this series about 14 isolated I.V.C. invasion, only 4 patients are surviving with no evidence of disease but 2 have more than six years and fourteen years follow-up. PMID- 3805749 TI - [Parotid metastases of clear-cell adenocarcinoma of kidney. Apropos of 2 cases]. AB - Two patients presented parotid metastases from adenocarcinoma of kidney. These metastases are rare and may reveal or develop during the course of a cancer of kidney. In the former case diagnosis presents certain difficulties. Treatment of single metastases is by parotidectomy and nephrectomy, prognosis being similar to that of the renal adenocarcinoma. PMID- 3805750 TI - [Preventive bilateral pulmonary irradiation in renal neoplasms]. AB - The aim of the study was to evaluate the role of bilateral lung radiotherapy in the prevention of lung metastases from renal cell carcinoma. The preliminary results are presented. Between 1981-1984, 38 patients with renal cell carcinoma with no evident lung metastases and with normal respiratory function (confirmed by gas analysis, spirometry, diffusion test) were submitted to radical nephrectomy with regional lymphadenectomy. The patients were randomly assigned to two groups. 19 patients were treated with lung radiotherapy (1,500 rad in 5 times with overlap on the mediastinum--3,000 rad) two weeks after surgery, 19 patients did not undergo further treatment after surgery. Chest X-rays and functional lung evaluation were performed at 3.6 and 12 months, and then every six months. Results in the first group (lung radiotherapy) showed no cases of lung fibrosis; 15 patients are disease-free (follow-up: 3-36 months); 4 patients died from cancer, only 1 of whom with lung metastases. In the second group (no lung Radiotherapy) 14 patients are disease-free whilst 5 patients died with lung metastases. PMID- 3805751 TI - [Adenocarcinoma of prostate in adolescents and young adults. Apropos of a case in a 20-year-old man]. AB - A new case of adenocarcinoma of the prostate in a 20 years old man is described. Data from the literature and treatment modalities are discussed in this patient who successively received hormonotherapy, radiotherapy and chemotherapy. An exceptionally long survival has observed in this patient who is surviving in good edition 5 years after the diagnosis. PMID- 3805752 TI - Vascular effects of leukotriene D4 in human skin. AB - Leukotriene D4 (LTD4) increased the blood flow rate in human skin, equipotent to histamine in the dose range of 3.1-200 pmol. The vasodilatation lasted for up to 60 min, and no late reactions occurred. Indomethacin did not affect the LTD4 induced blood flow rate. H1 and H2 antagonists reduced the increase in blood flow rate, but did not abolish the response to LTD4. Local nerve block inhibited the axon reflex-mediated flare component of the LTD4-induced blood flow rate, leaving a local red reaction. This local red reaction was not affected by H1 and H2 antagonists. These results indicate histamine as a mediator of the axon reflex, and show that LTD4 causes a direct vasodilatory effect that is not mediated via histamine or cyclooxygenase products. The laser-Doppler flowmeter was applied for dynamic studies of the vasopressor response in the skin during a Valsalva maneuver, and the relative changes in blood flow were confirmed by control estimates of the blood flow rate by a 133xenon washout method. The pressor response to a Valsalva maneuver was reversed by local nerve block, but not affected by LTD4. Therefore LTD4 did not interfere with the sympathetic activity on the cutaneous vessels. Leukotriene D4 caused a dose-dependent wheal reaction, equipotent to histamine in the dose range of 0.2-200 pmol. Only minor whealing occurred when the vasculature to the test arm was occluded before injection of LTD4 and the circulation restored 30 min later. Most of the LTD4 was apparently metabolized within this period. Subsequent injections of LTD4 into the same sites demonstrated the development of tachyphylaxis with respect to whealing. This evidence suggests that LTD4 cannot mediate sustained inflammation. The injections of LTD4 caused neither pain nor itching. In conclusion, the elucidated properties point to LTD4 as a possible mediator of microvascular changes during acute inflammation. PMID- 3805753 TI - Pigment change and melanocyte distribution in guinea pig skin after cutaneous freeze injury. AB - Cryosurgery has been recommended for the treatment of cutaneous neoplasms, including benign and malignant melanocytic tumors. The main side effect of this treatment is pigment disruption which may be prolonged. There are no quantitative studies on melanocyte distribution after freeze injury. In this study the effect of standardized freeze times on melanocytes in guinea pig skin (tricolored) is described at the anatomic level and at the light and electron microscopic level. Melanocytes are quantified in epidermal sheets following dopa staining at 1-, 2-, and 3-month intervals after freezing. All the lesions were initially hypopigmented with a peripheral rim of hyperpigmentation. This was a transient phenomenon associated with an absence of melanocytes. Pigment migrated into the lesions so that after 3 months all the lesions on black skin were diffusely hyperpigmented. Pigment was slower to return to the red skin. Hair follicles were destroyed in the center of the lesion. The epidermal sheets demonstrated that the hyperpigmentation was an epidermal phenomenon and was associated with increased numbers of melanocytes (p less than 0.001). These melanocytes were distributed evenly throughout the lesion in contrast to the irregular distribution in normal skin. PMID- 3805754 TI - UVB-induced collagen changes in the skin of the hairless albino mouse. AB - Biochemical techniques have been used to measure ultraviolet-B (UVB)-induced changes in dermal collagen composition. Hairless albino mice were irradiated dorsally with a daily dose of 62 mJ/cm2 UVB for 12, 24, 30, and 36 weeks. Nonirradiated controls were housed under identical conditions. Additional groups were irradiated for similar periods and kept for a further 6-24 weeks without irradiation. Skin samples were taken from dorsal and ventral (nonirradiated) surfaces and types I and III collagen were quantified densitometrically after cyanogen bromide digestion and polyacrylamide gel electrophoresis. Type III collagen was expressed as a percentage of the total types I and III collagen and the ratio of dorsal/ventral type III (D/V III) was determined for each mouse. The ratio increased significantly in irradiated animals whereas it decreased in the corresponding period in control animals. In irradiated mice withdrawn from UV exposure the ratio D/V III tended to revert to control levels. These data are in agreement with those of our previous human studies, which showed an increase in type III collagen in sun-exposed skin when compared with covered sites. PMID- 3805755 TI - Spontaneous transformation to anchorage-independent growth of a xeroderma pigmentosum fibroblast cell strain. AB - A skin fibroblast cell strain (GM2995) derived from a patient with xeroderma pigmentosum was received at low passage. As the cells were serially passaged (1:4 dilution), their size and growth characteristics changed. By passage 13, approximately 90% of the colonies produced by cells seeded at low density were composed of small, densely packed cells. Cells capable of anchorage-independent growth were observed after passage 7; they formed round, smooth-edged colonies in soft agar. The frequency of cells exhibiting anchorage-independent growth increased rapidly at subsequent passages, reaching 35-50% of the population by passage 20. This phenomenon was accompanied by the appearance of aneuploidy. These cells are still proliferating actively at passage 35. These late-passage GM2995 cells retain the extreme hypersensitivity to the cytotoxic effect of UV radiation characteristic of early-passage GM2995 cells. PMID- 3805756 TI - Identification of a protein in sera of normal humans that inhibits fibroblast chemotactic and random migration in vitro. AB - Normal human serum contains a 230,000 Mr protein that inhibits fibroblast chemotactic and random migration. This serum inhibitor of fibroblast migration (SIFM) is a heat-stable, trypsin-sensitive protein with a pI of 4.8 that reversibly inhibits the random and chemotactic migration of fibroblasts in vitro. Although SIFM effectively inhibits the chemotaxis of fibroblasts to interstitial collagens, fibronectin, lymphocyte-derived chemotactic factor for fibroblasts, and serum-derived chemotactic factor, it does not alter the chemotactic migration of human peripheral blood neutrophils or monocytes, and does not act as a cytotoxin to human dermal fibroblasts. The SIFM appears to act through a cell directed mechanism to alter the fibroblast's ability to migrate. Serum inhibitor of fibroblast migration may function in vivo to modulate fibroblast migration under physiologic and pathologic conditions. PMID- 3805757 TI - Stratum corneum lipid liposomes: calcium-induced transformation into lamellar sheets. AB - The epidermal water barrier in mammalian stratum corneum is formed of broad lamellar sheets of lipids consisting principally of ceramides (40%), cholesterol (25%), cholesteryl sulfate (10%), and free fatty acids (25%). Such lipid mixtures have been shown to form lipid bilayers in the form of small, unilamellar liposomes when sonicated at 80 degrees C in water containing Tris buffer and 100 mM NaCl. In the present study it is shown that such liposomes are slowly transformed into large unilamellar liposomes and then into broad lamellar sheets after the addition of stoichiometric amounts of calcium chloride. The presence of free fatty acids was a necessary condition for this calcium-induced fusion. These observations may provide a useful analogy for the transformation of flattened liposomes into broad lamellar sheets that occurs during transition of epidermal granular cells into corneocytes. PMID- 3805758 TI - Decreased protein kinase C activity in psoriatic versus normal epidermis. AB - To study the possible involvement of protein kinase C in psoriasis, we determined the activity of this enzyme in involved and uninvolved epidermis from psoriasis patients as well as in normal epidermis from controls. Protein kinase C activity was measured in the 100,000 g supernatants and in the detergent-solubilized particulate fractions of tissue homogenates after partial purification by DEAE cellulose chromatography. The total enzyme activities per gram protein for normal, involved, and uninvolved epidermis were 127 +/- 11.9 mU/g, 64.7 +/- 8.6 mU/g, and 88.5 +/- 14.4 mU/g, respectively. The respective values for total enzyme activity per mg DNA were 7.04 +/- 0.48 mU/mg, 4.28 +/- 0.54 mU/mg, and 5.02 +/- 0.66 mU/mg. By both data bases, protein kinase C activity was statistically lower in the psoriatic skin biopsies than in those from control persons, whereas no significant difference was found between involved and uninvolved epidermis from psoriasis patients. We hypothesize that alterations in protein kinase C-mediated processes due to decreased protein kinase C activity may play a significant role in the pathophysiology of psoriasis. PMID- 3805760 TI - Improved clarity of measurement. PMID- 3805759 TI - Necrobiosis lipoidica: ultrastructural and biochemical demonstration of a collagen defect. AB - Ten patients with necrobiosis lipoidica lesions were studied. Five patients had diabetes mellitus. The age of the patients varied from 15 to 73 years and the duration of the skin lesions was from 2 to 20 years. Histologically, the lesions were characterized by degeneration of collagen and elastin. In some lesions elastin fibers could be seen in areas devoid of normal-looking collagen. Electron microscopy revealed loss of cross-striation of collagen fibrils and a marked variation in the diameter of individual collagen fibrils. The concentration of collagen, measured by assay of hydroxy-proline, a collagen-specific amino acid, was markedly decreased in the lesional skin, but the ratio of type I/III collagen was unchanged in the affected skin. Fibroblasts established from affected skin synthesized less collagen than cells derived from healthy-looking skin. The decreased collagen synthesis was due to a decreased amount of messenger RNA for type I procollagen, measured by hybridization with a specific human cDNA clone. The production of collagenase by these fibroblasts was not increased. Our results thus indicate that in necrobiosis lipoidica lesions, collagen fibrils are defective and the amount of collagen is reduced, probably due to decreased synthesis of collagen by affected fibroblasts. PMID- 3805762 TI - Mouse skin damage caused by cytolysin from Vibrio vulnificus and by V. vulnificus infection. AB - Light and electron microscopy of mouse skin damage caused by intradermal infection with a virulent strain of Vibrio vulnificus and by a single intradermal injection of the cytolytic toxin produced by the bacterium revealed similar structural alterations. The epidermis was intact; however, the infection and toxin produced acute cellulitis characterized by extensive extracellular edema; disorganization of collagen bundles; large accumulations of cell debris and plasma proteins; damaged or necrotic fat cells, capillary endothelial cells, and muscle cells; and mild inflammatory cell infiltration. The virulent strain of V. vulnificus produced a capsule and was resistant to phagocytosis in vivo, whereas a weakly virulent strain of the bacterium did not produce a capsule and was readily phagocytized and digested. Factors that may be important in the pathogenesis of V. vulnificus wound infections include a capsule that inhibits phagocytosis and an extracellular cytolytic toxin that is responsible, at least in part, for the severe tissue damage characteristic of such wound infections. PMID- 3805761 TI - Chlamydial infection of subcutaneous fimbrial transplants in cynomolgus and rhesus monkeys. AB - Acute infection with Chlamydia trachomatis serotype E was established in monkey fallopian tube fimbriae by subcutaneous implantation. Depending upon monkey species, from eight to 20 implants could be established in each animal. Animals were given estrogen before percutaneous inoculation of the autografts with Chlamydia. Acute inflammatory changes were found in homografts examined in the first week after infection, with chronic inflammatory changes noted thereafter. Chlamydial inclusions were detected within fimbrial epithelial cells up to seven days postinoculation by fluorescent-antibody staining and immunoperoxidase staining with C. trachomatis-specific monoclonal antibody. Organisms were recovered from autografts up to five days after infection. Analysis of serum antibody by microimmunofluorescence revealed that serotype E-specific antibody of both IgM and IgG classes was produced after infection. We conclude that subcutaneously implanted fallopian tube autografts may provide a useful primate model for kinetic studies of chlamydial infection and immunity. PMID- 3805763 TI - Capsular polysaccharide antigenemia in rats with experimental endocarditis due to Staphylococcus aureus. AB - In vivo expression of the type 8 capsular polysaccharide (CP) of Staphylococcus aureus was studied in the rat model of aortic valve endocarditis. An enzyme linked immunosorbent assay (ELISA) with monoclonal antibodies to type 8 CP was sensitive to 0.16 ng/ml in serum. All (23 of 23) animals infected with the prototype type 8 strain Becker had CP detected in one or more serum samples. Peak CP levels ranged from 0.16 to 240 ng/ml (median, 25 ng/ml). Among the 14 rats alive on day 2, antigenemia and bacteremia were significantly correlated (r = .71, P less than .005). CP was also present in serum of rats infected with three additional type 8 bacteremic isolates. All serum samples from animals infected with the type 5 prototype strain were negative in the type 8 ELISA. These studies document that the type 8 CP of S. aureus, previously identified only in vitro, is produced and released during in vivo infection and can be detected in serum of infected animals. PMID- 3805764 TI - Compartmentalization of cells bearing "rheumatic" cell surface antigens in peripheral blood and tonsils in rheumatic heart disease. AB - Monoclonal antibodies that recognize "rheumatic" antigens of peripheral blood non T cells were used to study the compartmentalization of such cells in peripheral blood and tonsils of individuals with rheumatic heart disease (RHD) and suitable control subjects. The peripheral blood of most (71%) of the 42 individuals with RHD contained cells reacting with monoclonal antibody 83S19.23 or 256S.10, whereas these cells were present in only 17% of the 41 control subjects (P less than .02). However, none of 21 individuals with RHD had such cells in their tonsils, although they were present in the tonsils of 50% of the 40 control subjects (P less than .03). These results may reflect a failure in RHD or organ specific homing of cells with the epitopes recognized by the antibodies. The presence of these cells in tonsils may be important in the immune response to streptococcal pharyngeal infection, and their absence in RHD may be involved in the unusual immune responses characteristic of this disease. PMID- 3805765 TI - Eosinophilia in Southeast Asian refugees: evaluation at a referral center. AB - We determined the cause of persistent eosinophilia in 128 Indochinese refugees for whom initial comprehensive routine screening had failed to yield an explanation. Intestinal parasitism with one or multiple organisms was the cause of eosinophilia in all but six of these patients. Hookworm and Strongyloides stercoralis were among the potentially pathogenic organisms most frequently implicated (55% and 38%, respectively). There was no correlation between the age or sex of the patients and the type of infecting organism. We also confirmed the usefulness of a previously described serological test for diagnosing infection with Strongyloides stercoralis and examined the test's ability to distinguish between infected and noninfected individuals and to determine parasitological cure. PMID- 3805766 TI - An assessment of the need for gram-negative bacterial coverage in antibiotic prophylaxis for oncological head and neck surgery. PMID- 3805767 TI - IDSA--past, present, and future? PMID- 3805768 TI - Systemic cat scratch disease: report of 23 patients with prolonged or recurrent severe bacterial infection. AB - Over a seven-year period, we identified 23 patients who had prolonged or recurrent, severe, systemic, cat-scratch disease (CSD). Compared with the usual, benign course in 1,038 patients with typical CSD, the course in these 23 patients included prolonged (two or more weeks) morbidity (fever, malaise, fatigue, myalgia, arthralgia, skin eruptions, weight loss, and splenomegaly). Five patients with systemic CSD had either neuroretinitis, pleurisy, arthralgia or arthritis, splenic abscesses, and mediastinal masses or enlarged nodes of the head of the pancreas. Recurrent CSD in two of three adults was confirmed by finding typical CSD bacilli in lymph nodes removed during separate episodes. The majority of patients were adult males, and all patients recovered completely without sequelae. Histopathologic studies of five skin and 18 lymph node biopsy specimens were diagnostic. CSD bacilli were detected in lymph nodes from 15 patients and in the primary skin lesions of four patients. CSD bacilli were found in both skin and lymph nodes of three patients. PMID- 3805769 TI - Cell division in staphylococci: a clue to the three-dimensional structure of peptidoglycan. AB - The composition of the monomeric unit of staphylococcal peptidoglycan has been known since the late 1960s. However, the three-dimensional structure of this macromolecule has been unclear. Staphylococci divide with expansion of a central cross wall into a peripheral hemisphere under conditions that suggest that additional monomers are not introduced, but rather that the shape of existing monomers is changed. The monomeric unit can be divided into a glycan chain piece, a connecting peptide, and a peptide chain piece, which define a solid parallelogram. In the proposed model, appropriate change in the angle of the glycan chain with respect to the peptide chain doubles the surface, as required to deform cross wall into peripheral wall. Furthermore, cross wall peptidoglycan is synthesized in a spiral, which becomes deformed into a spiral to form peripheral wall, and the glycan chain is twisted with two disaccharide units per turn. Insights from the model can be applied to other peptidoglycans and can help explain the mechanism for start of cell division, the functions of various penicillin-binding proteins, the method of resistance to methicillin, and the occurrence of osmotically growth-dependent bacteria. PMID- 3805770 TI - Lassa fever--new issues raised by field studies in West Africa. PMID- 3805771 TI - A prospective study of the epidemiology and ecology of Lassa fever. AB - In studies of Lassa fever in Sierra Leone, the prevalence of human antibody to Lassa virus ranged from 8% to 52%. Mastomys natalensis, the reservoir of Lassa virus, constituted 50%-60% of the rodents captured in houses but only 10%-20% of those captured in surrounding agriculture and bush areas (chi 2 = 90.2, P less than 10(-6), df = 1), a finding suggesting that houses are the most-important location for transmission of Lassa virus. Viral infection of Mastomys from houses ranged from 0% to 80%. The incidence of seroconversions in susceptible persons ranged from 5% to 22% per year; the ratio of illness to infection ranged from 9% to 26%, and the proportion of febrile illness associated with seroconversion was 5%-14%. Eightfold rises in titer of antibody occurred in 1%-18% of the antibody positive population, a result suggesting reinfection. We estimate the ratio of fatalities to infection to be 1%-2%, a rate lower than estimates based on hospitalized cases. The high incidence of Lassa fever makes it a major problem in West Africa. PMID- 3805772 TI - A case-control study of the clinical diagnosis and course of Lassa fever. AB - A prospective case-control study of Lassa fever was established in Sierra Leone to measure the frequency and case-fatality ratio of Lassa fever among febrile hospital admissions and to better delineate the clinical diagnosis and course of this disease. Lassa fever was responsible for 10%-16% of all adult medical admissions and for approximately 30% of adult deaths in the two hospitals studied. The case-fatality ratio for 441 hospitalized patients was 16.5%. We found the best predictor of Lassa fever to be the combination of fever, pharyngitis, retrosternal pain, and proteinuria (predictive value together, .81); of outcome, the best predictor was the combination of fever, sore throat, and vomiting (relative risk of death, 5.5). Complications included mucosal bleeding (17%), bilateral or unilateral eighth-nerve deafness (4%), and pleural (3%) or pericardial (2%) effusion. Lassa fever is endemic in this area and is a more common cause of hospital admission and death than has previously been described; this disease must be considered when diagnosing febrile illness in West Africa. PMID- 3805773 TI - Clinical virology of Lassa fever in hospitalized patients. AB - We measured levels of virus in sequential specimens from 137 patients with Lassa fever. The probability of fatal disease increased significantly with the level of viremia measured either on admission or during the course of illness. The odds ratio of death in patients with viremia greater than 10 TCID50/ml was 3.7 (90% confidence interval, 1.9-7.2). The same ratio in patients with viremia greater than 10 TCID50/ml and with levels of aspartate aminotransferase greater than or equal to 150 IU/liter was 21.5 (95% confidence interval, 5.2-99.0). Virus was found in throat cultures from 39% of viremic patients, compared with 14% of nonviremic patients (P less than .002); however, the level of virus was usually less than or equal to TCID50/ml. Fewer than 3% of patients were viruric during acute illness, and virus was isolated from three of three samples of cerebrospinal fluid. On admission, 53% of patients had IgG antibodies, and 67% had IgM antibodies. Recovery was not associated with the presence of either IgG or IgM. Virus was isolated from greater than 100 serum specimens that also contained high titers of IgG. Clinical Lassa fever was shown to be a disseminated systemic, primary viral infection, with an outcome highly associated with viremia but not with development of antibody. PMID- 3805774 TI - Enzyme-linked immunosorbent assay for Campylobacter pyloridis: correlation with presence of C. pyloridis in the gastric mucosa. AB - Antibody to Campylobacter pyloridis was measured by ELISA in the sera of 160 patients from whom gastric biopsy specimens were also obtained. The antigen was an acid-glycine extract of C. pyloridis, and titers ranged from 80 to 22,000 ELISA units (EU). Of 117 patients in whom C. pyloridis was detected microbiologically or histologically, 87 (74%) had a titer greater than or equal to 300 EU, and only one had a titer less than 150 EU. Of 43 patients in whom C. pyloridis was not detected, only two (5%) had a titer greater than 300 EU. Thus, for a titer of 300 EU the ELISA test had a specificity of 97% and a sensitivity of 81%. At 150 EU the specificity was 78%, and the sensitivity was 99%. Histological diagnosis of active chronic gastritis was associated with a high median ELISA titer (485 E), chronic gastritis with a much lower titer (150 EU), and normal histology with a titer of 110 EU. Discriminating use of this serological test could be of assistance to detect C. pyloridis in the gastric mucosa. PMID- 3805775 TI - Therapeutic efficacy of liposome-encapsulated ribavirin and muramyl tripeptide in experimental infection with influenza or herpes simplex virus. AB - Large, negatively charged, multilamellar liposomes were examined for their ability to improve the therapeutic activity of the broad-spectrum antiviral agent ribavirin (RIB) and the synthetic immunostimulant muramyl tripeptide (MTP-PE) in the treatment of viral pneumonitis. Liposome-encapsulated MTP-PE (L-MTP-PE) was superior to free MTP-PE in activating alveolar macrophages and in protecting mice against intranasal challenge with 10 LD50 (50% lethal dose) of herpes simplex virus type 1 (HSV-1). Mice treated with liposome-encapsulated or free MTP-PE had no detectable viremia and had lower pulmonary titers of virus than controls. Liposome-encapsulated RIB (L-RIB; 3 mg per mouse), administered several hours after infection, was more effective than was free RIB (10 mg per mouse) in protecting mice against intranasal challenge with 10 LD50 of influenza virus, but neither L-RIB nor free RIB protected mice against HSV-1 infection. In contrast, combination therapy with both L-RIB and L-MTP-PE was more effective than either agent used alone. PMID- 3805776 TI - Role of bacterial exopolymers and host factors on adherence and phagocytosis of Staphylococcus aureus in foreign body infection. AB - Using a previously developed guinea pig model of foreign body infection, we examined ultrastructural and functional surface alterations of Staphylococcus aureus strain Wood 46 during the early phase of infection. Exopolymer-free bacteria were prepared and inoculated into subcutaneously implanted tissue cages. After three hours, the bacteria showed abundant capsular and intercellular exopolymers, which were visualized by transmission electron microscopy. Exopolymers were also produced by S. aureus exposed in electron microscopy. Exopolymers were also produced by S. aureus exposed in vitro to fluid from the tissue cage. In contrast, human serum albumin prevented exopolymer production by S. aureus. The influence of exopolymers on the susceptibility of S. aureus to ingestion and phagocytic killing by neutrophils was tested in vitro and found to be negligible. Furthermore, adherence of S. aureus to fibronectin-coated surfaces was unaffected by the presence or absence of exopolymers. Thus, in our experimental model, exopolymers are produced early during the onset of infection, but they have little impact on adherence and phagocytosis. PMID- 3805777 TI - Murine model of intracerebral toxoplasmosis. AB - We established a murine model of toxoplasmic encephalitis by using intracerebral inoculation with Toxoplasma gondii tachyzoites. Normal mice survived, but immunosuppressed mice died from progressive disease. In normal mice, necrosis developed at the site of inoculation, surrounded by areas with intense mononuclear inflammation and cyst formation; tachyzoites were not detectable after two weeks. Immunosuppressed mice had even-larger areas of tissue destruction, and tachyzoites were always detectable. Brains from cortisone treated mice had numerous tachyzoites, but scant inflammation. Brains from cyclophosphamide-treated mice revealed cysts and a variable degree of inflammation. Compared with brains from controls, brains from cyclosporine treated mice revealed attenuated inflammation; however, there were fewer tachyzoites and less tissue destruction than in the brains from cortisone-treated mice. The spectrum of histological findings observed in the model is similar to that observed in brains from humans with toxoplasmic encephalitis. PMID- 3805778 TI - Common-source outbreak of blastomycosis in hunters and their dogs. PMID- 3805779 TI - Q fever endocarditis in the south of France. PMID- 3805780 TI - Persistence of an aminoglycoside-resistance determinant at a university hospital for 12 years. PMID- 3805781 TI - Importance of Aeromonas sobria in Aeromonas bacteremia. PMID- 3805782 TI - Polymorphonuclear leukocyte-mediated, antibody-dependent cellular cytotoxicity in patients with AIDS. PMID- 3805783 TI - Candidiasis in heroin abusers. PMID- 3805784 TI - Local interferon induction by bacterial lipopolysaccharide in mice after pretreatment with Corynebacterium parvum. AB - C57BL/6 mice were injected intraperitoneally (i.p.) with Corynebacterium parvum and subsequently, after an interval of 7-10 days, i.p. with lipopolysaccharide (LPS). The peritoneal wash-fluid was recovered at various times after injection of LPS. Marked interferon (IFN) titers were observed between 2 and 10 h after injection of LPS, whereas no IFN was detected in mice injected with either C. parvum or LPS alone. Very low doses of LPS (0.1 microgram/mouse) were sufficient to cause IFN production in the double-stimulation protocol. The IFN produced was neutralized by an antibody against IFN-alpha/beta. In additional experiments, mice were treated by C. parvum alone; the peritoneal exudate cells (PEC) were recovered and stimulated in vitro by LPS. Again substantial titers of IFN were induced by small concentrations of LPS, whereas untreated PEC did not produce IFN. The cell producing IFN in these cultures was not a T lymphocyte, as experiments with a monoclonal anti-thy 1.2 antibody showed. PMID- 3805785 TI - Human interferons active on murine cells induce pulmonary cysts in A2G mice. AB - Suckling A2G mice were injected daily from birth for 8 days with highly purified human lymphoblastoid interferon (IFN) or recombinant interferons-alpha 1 or alpha 2 rIFN-alpha 1, rIFN-alpha 2), or mouse interferon-alpha/beta (IFN alpha/beta), or control preparations. Only mouse IFN inhibited the growth of suckling A2G mice and induced liver cell necrosis. At 56 days the mice were killed and the lungs examined for the presence of pulmonary cysts. Human lymphoblastoid IFN and rIFN-alpha 1 (and mouse IFN-alpha/beta), which exhibited significant biological activity on mouse cells in culture, induced pulmonary cysts in A2G mice. rIFN-alpha 2, which showed little or no activity on mouse cells, did not induce pulmonary cysts. PMID- 3805786 TI - Configuration of clathrin trimers: evidence from electron microscopy. AB - We used a combination of electron microscopic techniques--negative staining, glycerol spraying with rotary shadowing, and quick-freezing followed by deep etching--to study the configuration of clathrin trimers. All three approaches provide images indicating that the molecule is nonplanar and rather puckered at its center. Viewed from the convex (cytoplasmic) side, its arms display a consistent clockwise slew at their proximal/distal hinge. The most flexible part of the heavy chain may be the links between the distal portion of the leg and the terminal domain. PMID- 3805787 TI - Relevance of aggregation properties of tropoelastin to the assembly and structure of elastic fibers. AB - Solutions of tropoelastin incubated under different experimental conditions were examined by electron microscopy after negative staining and after fixation and embedding. Below 37 degrees C only polymorphous structureless elements of variable size could be found. In samples kept for a few minutes at 40 degrees C, flexible, isolated filaments of 5 nm diameter and variable length, together with a few small aggregates of filaments, were seen. No single filaments, but only bundles of filaments were detectable after incubation at 40 degrees C for longer than 5-10 min. Tropoelastin kept at 40 degrees C for longer than 10 hr formed a white precipitate, which, when fixed and embedded as in conventional electron microscopy, consisted of 0.5-2 microns thick, amorphous and branching fibers, identical to those seen in identically processed normal tissues. From these observations a model for the assembly and structure of elastic fibers is proposed. PMID- 3805788 TI - Are the terminal domains in intermediate filaments organized as octameric complexes? Reevaluation of a recent suggestion. AB - Recently L. M. Milam and H. Erickson ((1985) J. Ultrastruc. Res. 90, 251-260) reported the isolation of a particle thought to be an octomeric complex of the terminal domains of desmin. This complex was isolated after trypsin treatment of intact filaments. As the existence of such a complex would place important restrictions on the possible packing modes of subunits within the filament we have repeated their procedure and additionally characterized the particle in question by detailed protein chemical data. We find that the particle is not derived from the terminal domains but instead comprises a portion of the carboxy terminal half of the alpha-helical rod domain. We further show that the terminal domains are very rapidly digested into small peptides during the trypsin treatment of the filaments. No inferences on the structure of intermediate filament are therefore possible from the data in the original report. PMID- 3805789 TI - Control and eradication of leprosy. PMID- 3805790 TI - Thyroglobulin autoantibodies in leprosy. AB - Two hundred and five sera from lepromatous leprosy patients were tested for the presence of thyroglobulin autoantibodies using tanned red cell haemagglutination technique. Six out of 182 sera from LL patients and 5 out of 23 sera from LL patients with ENL gave a positive reaction for thyroglobulin autoantibodies. PMID- 3805791 TI - Antispermatozoal antibodies in leprosy with special reference to their morphological patterns. AB - Sixty two male patients with polar leprosy--38 lepromatous and 24 tuberculoid types were investigated for the presence of antispermatozoal antibodies with special reference to their morphological patterns. Antibodies were detected by three different immunological techniques. Sperm agglutination was found to be the most sensitive. The incidence of antibodies was higher in patients with lepromatous leprosy and was directly proportional to the duration of the disease in both types of leprosy. Morphologically, head-to-head type of agglutination was observed in 50 percent of the patients, mixed in 41.7 percent and tail-to-tail type in 8.3 percent. There was no correlation between the number of ENL attacks and the incidence of anti-bodies. In polar tuberculoid leprosy patients the histological findings of testicular biopsy indicated cell mediated tissue damage occurring in a non-infective form. PMID- 3805792 TI - Studies on serum proteins in leprosy by polyacrylamide gel electrophoresis (page) -I. AB - Serum protein pattern was studied in the leprosy spectrum, their contacts and in normal individuals by employing polyacrylamide gel electrophoresis. Sera from 80% of untreated BL/LL, 70% of untreated TT/BT patients and 67% of contacts have shown dysproteinaemia either for 232 kD or for 175 kD or for both these proteins together. Tendency of these proteins to return to normal levels was observed after treatment. But both these proteins come back to normal levels only after subsidence of the disease. PMID- 3805793 TI - Uveal changes in leprosy. AB - A total of 424 leprosy patients were screened for uveal involvement. Uveal changes were found in 11.2% of these patients. Uveal involvement was more common in patients with greater duration of the disease and in patients on irregular Dapsone therapy. Of the patients with uveal involvement 82% were lepromatous, 16% were borderline and 2% were of tuberculoid leprosy. Uveal changes in form of active iridocyclitis (21.3%), healed iridocyclitis (58.5%), iris atrophy (10.6%), iris pearls (7.4%), small irregular pupil (46.7%), pupil refractory to dilatation (56.3%) were seen. Posterior segment involvement was rare. Lepromatous and borderline leprosy patients with no clinical evidence of uveal involvement had decreased power of accommodation as compared to normal subjects. PMID- 3805794 TI - An attempt to reduce the loss of pain and touch sensations in leprosy patients. AB - An attempt was made to improve the perception of pain and touch sensations at the leprosy lesions. The loss of pain and touch sensations in a lesion was graded using Pain/Touch-Sensation-Testing-and-Grading devices. Application of a solution containing 1 mg of histamine per ml of DMSO, at the affected area decreased the grades of the loss of pain sensation in 11 (31.4%) patients and of touch sensation in 8 (22.8%) patients, out of the 35 patients tested, indicating an improvement in the perception at the lesion. This effect, however, did not persist even for 5 minutes. A higher concentration (2 mg/ml) of histamine produced reduction in the sensory loss in a larger percentage (47% for pain and 35.3% for touch) of patients, though the duration of this effect was still not prolonged. PMID- 3805795 TI - Immunotherapy in leprosy: a new approach. AB - An immunotherapeutic agent prepared from patient's own affected skin was tried in 30 leprosy cases. 53.6% cases of lepromatous and borderline lepromatous group showed lepromin conversion from lepromin negativity to positivity after 12 weeks of immunotherapy. The clinical and bacteriological improvement was also good. 88.1% cases of borderline tuberculoid also showed fair to good clinical recovery following 12 weeks of immunotherapy. PMID- 3805796 TI - The histopathology of type I (lepra) and type II (ENL) reactions in leprosy. AB - The histopathological features in type I (lepra) reaction comprised a loose and disorganised granuloma in the upper and mid-dermis, dermal edema and variable cellular contents, namely, epithelioid cells, lymphocytes, giant cells, and macrophages. While ENL reactions, were characterised by predominant involvement of subcutaneous vessels, vasculitis, and polymorphonuclear infiltration in and around the blood vessels. PMID- 3805797 TI - Experience with multidrug therapy in paucibacillary leprosy. AB - Eighty paucibacillary leprosy cases were randomly put on two different multidrug regimens for 6 months followed by dapsone monotherapy. Regimen I was according to WHO (1982) recommendations consisting of Dapsone and six once a month rifampicin. In regimen II in addition to above two constituents, clofazimine was added 100 mg on alternate days. Dapsone thereafter was continued in both the regimens upto one year. The efficacy, acceptability and side effects of multidrug regimens were observed for a period of one year. Histopathological assessment was done on completion of multidrug therapy in all cases. A comparative evaluation of effect of two multidrug regimens in paucibacillary leprosy patients is reported. Addition of clofazimine over WHO (1982) recommended regimen appears to have no added benefit. The duration of WHO (1982) recommended regimens was found to be inadequate in many cases. PMID- 3805798 TI - An evaluation of palmar flexion creases and dermatoglyphics in leprosy. AB - The palmar flexion creases and dermatoglyphics of 150 male leprosy patients (100 paucibacillary and 50 multibacillary leprosy) were compared with 50 matched controls. Among palmar dermatoglyphics a significantly high frequency (P less than 0.001) of palmar pattern in thenar/1st interdigital area was noticed on left palm of multibacillary leprosy patients. Slight increase in frequency of distal axial triradii (t' and t'') was also seen on palms of leprosy patients. No difference in values of atd angle and C-line types were observed between patients and controls. Among palmar flexion creases a significantly high frequency of Single Radial Base Crease (SRBC) and lower frequency of Double Radial Base Crease (DRBC) was noticed on palms of leprosy patients as compared to controls (P less than 0.001). The difference mainly exist on left palm. A significantly high frequency of Simian Crease was also observed on palms of multibacillary leprosy patients (P less than 0.001) and paucibacillary leprosy patients (P less than 0.05) as compared to controls. PMID- 3805799 TI - Dapsone dependent nodular panniculitis. AB - A patient recorded to be suffering from tuberculoid leprosy since 1973 and on regular Dapsone monotherapy for about nine years developed asymmetrical, erythematous, subcutaneous, nodular swellings restricted chiefly to the extensor aspects of lower limbs two months after discontinuation of Dapsone therapy. During the course of Dapsone treatment, the patient had developed similar swellings twice previously each time when he stopped the drug for about a month. The swellings disappeared on commencement of Dapsone Treatment. This has been reconfirmed under our supervision. The biopsy of one of the lesions revealed panniculitis with vasculitis. The original diagnosis of leprosy was probably invalid. PMID- 3805800 TI - Amniotic band syndrome. AB - A case of amniotic band syndrome is reported in a 12-year-old boy. He had multiple deformities of the limbs which resembled leprosy. Recently, he developed foot-drop due to pressure on the right common peroneal nerve by the constriction ring of the leg. PMID- 3805801 TI - Amyloid goiter--a case report. AB - A rare case of Amyloid Goiter in association with leprosy is reported. PMID- 3805802 TI - Short term WHO advised multiple drug treatment of paucibacillary patients. PMID- 3805803 TI - Results of a phase I regional hyperthermia device evaluation: microwave annular array versus radiofrequency induction coil. AB - The safety and efficacy of two devices in producing elevated temperatures in bulky deep tumours was evaluated in 11 patients with 12 tumours. Nine of 11 patients had pelvic tumours. Each patient was given a separate trial heating with the microwave annular phased microwave array system (APAS) and the radiofrequency concentric magnetic induction coil (MI), and evaluation was based upon paired comparison of power-limiting patient tolerance endpoints as well as intratumoural temperatures achieved. Toxicity was minimal with either device. On average, 66 per cent of intra-tumoural (IT) temperatures reached greater than 41 degrees C with the APAS, and 12 per cent of IT temperatures reached greater than 41 degrees C with the MI (P less than 0.001). Thirty-two per cent of IT temperatures were greater than 42 degrees C with the APAS, compared to 7 per cent with MI (P less than 0.001). Although the annular microwave array is more complex to use, it has a significantly higher likelihood of achieving temperatures in the therapeutic range near 42 degrees C in deep pelvic tumours than does the magnetic induction coil. PMID- 3805804 TI - Effect of hyperthermia on cisplatin pharmacokinetics in normal dogs. AB - In vitro and in vivo cisplatin pharmacokinetic studies were conducted at 37 degrees C and 42-43 degrees C in dogs. Cisplatin at 1, 2, 3, 4 and 5 micrograms/ml was incubated with canine serum at 37 degrees and 43 degrees C. Aliquots were processed immediately for atomic absorption spectrophotometry to determine total as well as free, ultrafilterable cisplatin concentrations. Thirteen healthy, average-sized mongrel dogs received 1 mg/kg cisplatin as an intravenous bolus. Four were maintained unanaesthetized at 37 degrees C, two were anaesthetized and maintained at 37 degrees C and seven were anaesthetized and maintained at a rectal temperature of 42 degrees C for 60 min. Serum samples were obtained and processed for free and total cisplatin. There were no detectable concentration effects present in either in vitro group. The rate constant reflecting the decay of free cisplatin at 37 degrees C was 0.0035 +/- 0.0007 min 1 and increased significantly (P less than 0.0001) to 0.0053 +/- 0.001 min-1 at 43 degrees C. In vivo pharmacokinetic analysis consisted of model-independent parameters (total body clearance, volume of distribution, half-life and mean residence time). A significant increase (P less than or equal to 0.05) in all parameters was observed with free-cisplatin at 42 degrees C. This data would indicate that at the elevated temperatures encountered in whole body hyperthermia, the rate of formation of reactive metabolites from parent cisplatin is increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3805805 TI - Arrhenius analysis of the heat response in vivo and in vitro of human melanoma xenografts. AB - The response to heat treatment in vivo (40.5-44.0 degrees C) and in vitro (40.5 45.5 degrees C) of five human melanoma xenografts was studied. Specific growth delay was used as a measure of response after treatment in vivo. Colony-forming ability was assayed in soft agar after treatment in vitro. Dose-response curves were established and subjected to Arrhenius analysis. The Arrhenius curves were found to have an inflection point at 42.0-43.0 degrees C in vivo and 41.5-42.5 degrees C in vitro. The activation energies were in the ranges 426-771 kJ/mol in vivo and 676-739 kJ/mol in vitro above the inflection point and 774-1661 kJ/mol in vivo and 1118-2190 kJ/mol in vitro below the inflection point. Above the inflection point the activation energies in vivo and in vitro were not significantly different for any of the melanomas, and furthermore were similar to those reported for rodent tumours, normal tissues and cells in culture in the same temperature range. Below the inflection point on the other hand the activation energies were lower in vivo than in vitro. This difference was probably a consequence of differences in the physiological conditions in vivo and in vitro. The activation energies in vitro in this temperature range were comparable to those reported for normal tissues and cells in culture. PMID- 3805806 TI - Heat-induced alterations in cell membrane permeability and cell inactivation of transformed mouse fibroblasts. AB - Hyperthermia, has recently been extended in many permutations as a modality of anticancer treatment, but the mechanisms underlying heat-induced cell inactivation are poorly understood. In this study, the role of the cell permeability barrier in the process of heat cytotoxicity are examined. Changes in cell membrane permeability were determined by following the efflux of normally impermeant metabolites, e.g. nucleotides, in cultures of Swiss mouse 3T3 cells, and their transformed derivatives, 3T6 cells. The increase in cell membrane permeability as a function of temperature and exposure duration was found to be characterized by a sigmoid curve, with a threshold value, above which the permeability markedly increased. A correlation was found between cell membrane permeabilization and cell inactivation. Both heat-induced permeabilization and heat cytotoxicity were more pronounced in the transformed cells, as compared to their untransformed counterparts. The temperature-dependent permeabilization was more effective in the presence of the ionophore amphotericin B. The data suggest that heat-induced lesion in the cell membrane has a major role in hyperthermia cytotoxicity. PMID- 3805807 TI - Hyperthermia, cell proliferation and cancer. PMID- 3805808 TI - [Surgical treatment of WPW syndrome combined with Ebstein's anomaly]. PMID- 3805809 TI - [Expanded application of the intraluminal ringed graft experience of 17 cases]. PMID- 3805810 TI - [A study on the usefulness of continuous monitoring of myocardial pH in myocardial protection]. PMID- 3805811 TI - [Modified Fontan operation in single ventricle with common atrium and common atrioventricular valve]. PMID- 3805812 TI - [Relation between preoperative physical status and prognosis of abdominal or thoracic aortic aneurysm in the aged]. PMID- 3805813 TI - [Estimation of pulmonary to systemic flow ratio in atrial septal defect by echocardiography]. PMID- 3805814 TI - [Weight of risk factor on extracorporeal circulation by multivariate analysis]. PMID- 3805815 TI - [Cava-pulmonary artery shunt--long-term effect and pulmonary hemodynamics]. PMID- 3805816 TI - [Radioaerosol inhalation lung scan in evaluation of mucociliary transport system after tracheobronchoplastic procedures]. PMID- 3805817 TI - [Transaortic excision of multiple left ventricular myxomas--a case report]. PMID- 3805818 TI - [Rupture of the right pulmonary artery aneurysm after shunt operation of tetralogy of Fallot]. PMID- 3805819 TI - [Suprahyoid release in tracheal reconstruction]. PMID- 3805820 TI - [The usefulness of MRI-CT in aortic diseases]. PMID- 3805821 TI - [An operative case of bilateral coronary to pulmonary fistulae associated with multiple large aneurysms]. PMID- 3805822 TI - [A successful arterial switch operation in a neonate with transposition of the great arteries and patent ductus arteriosus]. PMID- 3805823 TI - [A case of bilateral synchronous primary lung cancer treated by two-staged bilateral bronchoplastic procedures]. PMID- 3805824 TI - [One stage operation of pectus excavatum and annulo aortic ectasia associated with Marfan's syndrome]. PMID- 3805825 TI - [A case of Behcet's syndrome with descending aortic aneurysm]. PMID- 3805826 TI - [Psychosocial backgrounds of climacteric symptoms and complaints]. AB - Postal questionnaires about psychosocial factors related to climacteric symptoms and complaints were sent to women subjects with such symptoms, and to volunteers without such symptoms. Controls were selected from among the volunteers. Each of 216 subjects was matched at random with one of 639 volunteers within one year of the subject's age. Thus, 216 matched-pairs were created, each consisting of a subject and a control. Significantly high relative risks of the following factors as estimated by McNemar's test were shown by a case-control study: social: few intimate friends, low educational level, husband engaged in unskilled labor, employed subject; psychic: feeling of poor health, low self-esteem, perception of lack of respect by people surrounding the subject, dissatisfaction with present life, anxiety about the future, feeling of being a burden to family and/or community. Moreover, correlations between various items listed above were examined by means of the chi-square test. Statistically significant correlations were found for the following pairs of items: low educational level, suggesting low socio-economic status, and either dissatisfaction with present life or feeling of poor health, and few intimate friends, suggesting a lack in potential social support, and either low self-esteem or anxiety about the future. The first mentioned pairs were predominantly associated with severe climacteric symptoms and complaints and the latter with mild symptoms and complaints. PMID- 3805827 TI - [Results of mass screening by automobile for cancer of the cervix uteri in Fukui Prefecture in the past ten years]. AB - The total number women examined by the screening car staff from 1974 to 1983 was 120,860. The number of people examined increased from 3.9% in 1974 to 6.2% in 1983, but is still low. The percentage of people requiring detailed examination was 0.77%-2.02%, and the rate of those, actually examined in detail was 86.3% 97.7%. The rate of detection of carcinoma was 0.08-0.3%. The ratio of dysplasia, CIS and invasive carcinoma was 1.3:1.7:1.0 in the first half of the 1974-78 period and changed to 6.1:2.5:1.0 during the 5 years from 1979 to 1983. Regarding the number of examinations required before detecting CIS and invasive carcinoma, all subject with a more advanced than stage Ib carcinoma of the cervix uteri were detected at the time of the initial examination. As to stage Ia of carcinoma of the cervix, 3 out of 31 subjects were detected at the second visit, 28 subjects at the first visit; 126 out of 146 subjects with CIS at the first visit, and 6 at the third visit or later. The results of cytodiagnosis were, in 72 cases of the class IV, dysplasia was found in 8.7%, CIS in 56.9%, invasive carcinoma in 12.1%, false positive in 22.2%, while in 51 cases of class V, dysplasia was found in 1.9%, CIS in 45.1%, invasive carcinoma 47.1% and false positive in 5.8%. CAI in Fukui Prefecture calculated as the sum of clinic and automobile health examinations, was 152 in 1982, 148 in 1983, 177 in 1984. PMID- 3805828 TI - [Changes in enzyme activity associated with polyamine metabolism in the rat fetal liver during the perinatal period]. AB - Changes in ODC, SAMDC and SAT activity, the rate limiting enzymes in the polyamine metabolism, were measured in the liver of developing rats during the perinatal period. The following results were obtained: ODC activity in fetal rat liver at the 15th day of gestation was 120-fold greater than in mature rat liver, but decreased dramatically as pregnancy advanced. ODC activity during the neonatal period fluctuated at a low level compared with that of the fetus, except for a slight increase at day 5 after birth. SAMDC activity in fetal and mature rat liver was high, but was relatively unchanged throughout the period of development compared with ODC activity. It decreased gradually and increased again toward the mature level from day 5 after birth. SAT activity in fetal rat liver at the 15th day of gestation was significantly high (3-fold that in mature liver) and decreased rapidly with continued fetal development until the 21st day of gestation, when the activity attained that found in mature liver. Thereafter its level was almost constant. There was a positive correlation between ODC activity and growth rate (daily percentage increase) in the weight of liver (r = 0.92, p less than 0.001). There was a similar correlation between SAT activity and growth rate (r = 0.95, p less than 0.001). These results suggest that it is important to raise the putrescine level caused by ODC ornithine----putrescine) and SAT (spermidine----putrescine) with continued fetal development from the viewpoint of polyamine metabolism, which are thought to be involved in cellular proliferation and tissue growth. PMID- 3805829 TI - [Ultrastructural study of the intercellular junction and lanthanum penetration in the mouse blastocyst]. AB - Cell junctions in mouse blastocyst were ultrastructurally investigated with or without lanthanum tracer. Tight junctions, gap junctions and desmosomes were observed in the trophectoderm. The tight junction was located near the zona pellucida in all trophoblast interspaces, whereas the gap junction and the desmosome, which were infrequently observed, were localized far from the zona pellucida. However, the desmosomes in the trophectoderm of the expanded blastocyst after culture increased in number and came to be located near the zona pellucida. The trophoblast layer excluded lanthanum whose invasion was interrupted by the tight junction. There were a few intermediate junctions in the interspace between the trophoblast and the inner cell mass cell as well as between the inner cell mass cells. These findings indicate that a substances whose molecular weight exceeds that of lanthanum (138.9) may not flow into the blastocyst through the intercellular space. Moreover, it is speculated that the intercellular connection is strengthened during the expansion of the blastocyst. PMID- 3805830 TI - [Neonatal effects of the delivery interval during cesarean section under spinal anesthesia]. AB - The relationships between I-DI (induction to delivery interval) or U-DI (uterine incision to delivery interval) and fetal acid-base status or neonatal clinical condition were studied in 60 healthy parturients undergoing elective cesarean section under spinal anesthesia. The patients were divided into groups, i.e. group A (U-DI less than 90 sec, I-DI greater than 14 min, 18 cases), group B (U DI less than 90 sec, I-DI greater than 14 min, 12 cases), group C (U-DI greater than 90 sec, I-DI less than 14 min, 15 cases) and group D (U-DI greater than 90 sec, I-DI greater than 14 min, 15 cases). Acid-base values for maternal arterial (MA), umbilical venous (UV) and umbilical arterial blood (UA), and acid-base gradients for (MA-UV) and (UV-UA) in each group were all in the normal range and revealed no significant differences among 4 groups, though U-DI was correlated with UVPCO2, UAPCO2, and (UV-UA) base deficit (r = 0.322, 0.266, -0.256: p less than 0.05). Acid-base states in cases of long and excessively long U-DI (greater than 90 sec and greater than 150 sec, respectively) were more acidotic than those of short U-DI groups (less than 90 sec). Both 1 and 5 minute Apgar scores were 8 or more in all neonates. There was no correlation between I-DI and fetal acid base values or neonatal clinical conditions. It is conceivable that gentle and careful manipulations of the uterus and fetus rather than shortening of U-DI might be important in preventing against fetal or neonatal depression during cesarean section under spinal block. PMID- 3805831 TI - [Mechanisms of the antitumor action of gestagens on endometrial cancer]. AB - An attempt was made to elucidate the relationship between the progestational activities and antitumor effects of various steroid hormones in vitro and in vivo. The established cell line (Ishikawa cells) of a human endometrial adenocarcinoma bearing estrogen and progesterone receptors was used in this study. Sixteen kinds of steroid hormones including progesterone, medroxyprogesterone acetate (MPA) and danazol were used in vitro. Each hormone was administered at 20 micrograms/ml continuously from the 4th day of culture and the growth curve was evaluated. The effects of progesterone, MPA and danazol at a dosage of 24 mg/kg/day for 53 days on the tumor induced in athymic nude mice with Ishikawa cells were also evaluated. Three kinds of hormones, progesterone, 16 alpha-methylprogesterone and danazol revealed cytocidal effects on the cells in vitro. There was no relationship between the progestational activity and cytocidal effect of each steroid hormone. On the other hand, no significant tumor regression was observed in vivo, but progesterone and danazol showed a tendency to suppress the growth of the tumor. These results suggest that the cytotoxic properties of progesterone may play a more important role than progestational action the cytocidal effect in vitro. It has been known that MPA had antitumor effects on DMBA-induced mammary cancer in rat and human endometrial cancer. However, MPA did not show a significant antitumor effect either in vitro or against the transplanted tumor in this study. Therefore, it was suggested that the antitumor effect of MPA is not direct action on the tumor cells, but indirect action through the interstitial cells of the target organ. PMID- 3805833 TI - [Evidence of heterogeneous nature of pituitary LH and urinary LH]. PMID- 3805832 TI - [The combined effect of bromocriptine and clomiphene citrate on normoprolactinemic anovulation; the lack of effectiveness of clomiphene citrate treatment alone]. AB - The purpose of this study is to investigate the combined effect of bromocriptine and clomiphene citrate (Cl) treatment on 35 patients with normoprolactinemic amenorrhea who failed to respond to Cl alone. Ovulation was restored by this treatment in 20 of these patients (57.1%), and the pregnancy rate was 26.7%. This treatment was effective in 11 of 15 women with polycystic ovary like syndrome (73.3%). Resting levels of prolactin, estradiol and testosterone in the effective group were significantly higher than those in the non-effective group. As a result of the treatment, the prolactin and LH levels were significantly decreased, and estradiol and progesterone levels were significantly increased in the effective group. Before the treatment, the responsiveness of LH to LHRH in the effective group was significantly higher, but the responsiveness of prolactin to TRH in this group was not significantly higher than that in the non-effective group. After the treatment, the LH-releasing response following a premarin injection in the effective group was significantly higher than that in the non effective group. The present results indicate that the therapeutic effect of this treatment may be primarily due to the restoration and improvement of the impaired hypothalamo-pituitary system without the suppression of pituitary prolactin secretion. PMID- 3805834 TI - [Electric pulse-induced fusion of zona-free mouse eggs]. PMID- 3805835 TI - [Function test of the anterior pituitary]. PMID- 3805836 TI - [Two cases of primary amenorrhea caused by gonadotropin deficiency]. PMID- 3805837 TI - [Successful pregnancy in a patient treated by long-term hemodialysis]. PMID- 3805838 TI - [Predictors for sudden death in the posthospital period after acute myocardial infarction]. PMID- 3805839 TI - [Noninvasive assessment of cardiac reserve by supine bicycle ergometer exercise testings in patients with coronary artery disease]. PMID- 3805840 TI - [A case of non-insulin-dependent diabetes mellitus associated with diabetic lipemia]. PMID- 3805841 TI - [An autopsy case of systemic lupus erythematosus with a complication of Budd Chiari syndrome caused by inferior vena cava obstruction]. PMID- 3805842 TI - [A case of periodic fever resembling familial Mediterranean fever, suppressed effectively by colchicine]. PMID- 3805843 TI - [A case of hemosiderosis of the liver in myelodysplastic syndrome]. PMID- 3805844 TI - [A case of autoimmune hepatitis associated with Graves' disease]. PMID- 3805845 TI - [A case surviving overwhelming postsplenectomy infection syndrome with pneumococcal meningitis developing 26 years after splenectomy]. PMID- 3805846 TI - [A severe case of drug-induced allergic hepatitis in herbal medicine]. PMID- 3805847 TI - [Anaphylaxis-like shock caused by hydrocortisone and prednisolone sodium succinate in an asthmatic patient]. PMID- 3805848 TI - [A case of Felty's syndrome with disappearance of circulating smooth-muscle antibody following splenectomy]. PMID- 3805849 TI - [A case of cor pulmonale associated with pheochromocytoma]. PMID- 3805850 TI - In vitro fertilization and embryo transfer: the legal status in Europe. PMID- 3805851 TI - The fertilization of human oocytes by spermatozoa from men with antispermatozoal antibodies in semen. AB - Seventy-two couples, including 15 with antispermatozoal antibodies in the male partner's semen, were studied in a program of in vitro fertilization and embryo transfer. Cases were further subclassified as normospermic or oligospermic and antispermatozoal antibodies were assessed with categorization into the respective human immunoglobulin classes as determined using the indirect immunobead test. The study reveals that fertilization is significantly reduced (P less than 0.001) only if both IgA and IgG antibodies are present in semen but there is no reduction if either class is present alone. The fertilization rate of oocytes is significantly reduced (P less than 0.001) by sperm from oligospermic samples, and there is a further reduction in those cases with combined IgA/IgG antispermatozoal antibodies. PMID- 3805852 TI - The effect of pregnant mare serum gonadotropin on mouse embryos fertilized in vivo or in vitro. AB - The effect of increasing doses of exogenous gonadotropin stimulation for ovarian hyperstimulation was studied utilizing mouse embryos fertilized in vivo or in vitro. Increased rates of embryo degeneration, fragmentation, and triploidy, increased sister-chomatid exchange, and decreased fertilization rates were observed in high-dose stimulation groups. It appears, therefore, that oocyte and/or embryo quality may be affected by increased amounts of exogenous gonadotropin stimulation. PMID- 3805853 TI - Differences in the luteal phases after failed or successful in vitro fertilization and embryo replacement. AB - Luteal phases after in vitro fertilization (IVF) and embryo replacement have been studied in 241 cycles. A positive correlation was observed between the follicular estradiol (E2) peak and the progesterone (P) level on day 3 of the luteal phase, but no correlation was found between the E2-peak value and the luteal-phase duration or midluteal P concentration. When the trials were classified in relation to their outcome (i.e., clinical pregnancies, chemical pregnancies, or failures), the mean P level on day 3 of the luteal phase was significantly higher in clinical pregnancies than in chemical pregnancies and in failures. Mean E2 levels on day 3 were not significantly different among the three groups. Values of the E2/P ratio were significantly higher in chemical pregnancies than in the other groups. No significant differences were observed among the three groups on day 8. When comparing trials ending in failure to those leading to clinical pregnancy for the same patients, pregnancies were obtained in cycles in which early luteal P was higher and the early luteal E2/P ratio was lower than in failures cycles. These data suggest that high P levels and a low E2/P ratio in the early luteal phase might have a favorable influence on the implantation process in human IVF. PMID- 3805854 TI - Ultrasonically guided oocyte recovery for in vitro fertilization: an improved method. AB - Ultrasonically guided follicular aspiration is now routinely used for in vitro fertilization (IVF) in many centers. We present an improved method for oocyte recovery. One hundred nine consecutive patients with mechanical infertility submitted for IVF were included in the study. Superovulation was induced with human menopausal gonadotropin (hMG)/human chorionic gonadotropin (hCG). Oocyte recovery was ultrasonically guided, the bladder filled with phosphate-buffered saline (PBS), and a cannula with trocar used for single percutaneous puncture. The aspiration needle was of 1.6 mm in internal diameter. When compared to published data using smaller-bore needles, it seems that this improved needle increased the number of oocytes recovered to a mean of 6.5 and the number of embryos replaced to a mean of 3.9 per patient, with a pregnancy rate of 20% per transfer. PMID- 3805855 TI - Attitudes toward egg donation of thirty-four infertile women who donated during their in vitro fertilization treatment. AB - The attitudes of anonymous infertile egg donors treated on an in vitro fertilization program toward the donation, the recipient, the potential children conceived, and the recording of information were explored by posted questionnaire. All donations were made for altruistic reasons and payment of eggs was not expected or given. The majority of donors (91%) wished to withhold their names from the recipient, but half of the donors would not mind if the child contacted them later. Most donors (94%) had told others of their donation and the keeping of records would appear essential for future possible identification. Some possible differences in attitudes between egg and sperm donors were noted but comparisons are difficult due to basic differences in fertility status and ease of gamete collection. The attitudes and characteristics of a control group of infertile women, who were in a position to donate excess eggs but declined, showed no significant differences from those of the donor group, except that they had a significantly greater number who already had one or more children and were less likely to discuss their possible donation with others. PMID- 3805856 TI - Pregnancy established in an infertile patient after transfer of an embryo fertilized in vitro where the oocyte was donated by the sister of the recipient. AB - A successful pregnancy in a patient suffering from infertility due to severe tubal disease has been achieved following the transfer of embryos fertilized in vitro following the donation of oocytes by the sister of the recipient. Both sisters ovulated irregularly and asynchronously. The donor's menstrual cycle varied from 24 to 30 days and the recipient's cycle varied from 23 to 26 days. Synchronization of ovulation was achieved by matching the onset of their menstrual cycles prior to treatment by in vitro fertilization and by manipulating the follicular phase of both the donor and the recipient during the cycle of treatment. Ten oocytes were collected from the donor and all were inseminated with spermatozoa from the recipient's husband. Nine normal embryos developed and three were transferred to the uterus of the recipient sister, 55 hr after laparoscopic egg collection. A normal singleton pregnancy resulted. PMID- 3805857 TI - The In Vitro Fertilization Program at Scripps Clinic and Research Foundation, La Jolla, California. PMID- 3805858 TI - Ultrasound-assisted embryo transfer. PMID- 3805859 TI - Microcomputer data acquisition and control. AB - In medicine and biology there are many tasks that involve routine well defined procedures. These tasks are ideal candidates for computerized data acquisition and control. As the performance of microcomputers rapidly increases and cost continues to go down the temptation to automate the laboratory becomes great. To the novice computer user the choices of hardware and software are overwhelming and sadly most of the computer sales persons are not at all familiar with real time applications. If you want to bill your patients you have hundreds of packaged systems to choose from; however, if you want to do real-time data acquisition the choices are very limited and confusing. The purpose of this chapter is to provide the novice computer user with the basics needed to set up a real-time data acquisition system with the common microcomputers. This chapter will cover the following issues necessary to establish a real time data acquisition and control system: Analysis of the research problem: Definition of the problem; Description of data and sampling requirements; Cost/benefit analysis. Choice of Microcomputer hardware and software: Choice of microprocessor and bus structure; Choice of operating system; Choice of layered software. Digital Data Acquisition: Parallel Data Transmission; Serial Data Transmission; Hardware and software available. Analog Data Acquisition: Description of amplitude and frequency characteristics of the input signals; Sampling theorem; Specification of the analog to digital converter; Hardware and software available; Interface to the microcomputer. Microcomputer Control: Analog output; Digital output; Closed-Loop Control. Microcomputer data acquisition and control in the 21st Century--What is in the future? High speed digital medical equipment networks; Medical decision making and artificial intelligence. PMID- 3805860 TI - Fundamentals of feedback control applied to microcomputer instrumentation design. AB - Feedback control is widely used in applications which range from simple control of room temperature to very sophisticated control of space flight. This paper describes some fundamentals of feedback control as they apply specifically to microcomputer based medical devices. A classical controller is described in its analog and digital implementations. Reference is made to methods for adjusting or tuning the controller for specific applications. Successful applications of adaptive or self-tuning control are discussed. Examples of feedback control include systems to control arterial blood pressure by the infusion of sodium nitroprusside, systems to control arterial carbon dioxide concentration by mechanical ventilation and systems to control depth of anesthesia by controlled anesthesia delivery. PMID- 3805861 TI - Implementation of an advanced clinical and administrative hospital information system. AB - Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications horizons of University Hospital's Information System. The implications of remote access to PDMS through the IBM PC emulating a Siemens Model 420 Patient Data Management Terminal are being examined. PMID- 3805862 TI - Can platelet fragments induce hemostasis? PMID- 3805863 TI - Beta-adrenergic blockade: augmentation of neutrophil-mediated inflammation. AB - beta-Adrenergic blockade has been clinically associated with vascular occlusion. Because neutrophil activation, either alone or in concert with other blood cells, can induce vaso-occlusion by aggregation, leukoembolization, and inflammatory damage to vascular endothelium, we studied the effect of beta-adrenergic blockade on neutrophil activation in vitro and on microvascular integrity in vivo. beta Adrenergic antagonists, propranolol and alprenolol, could induce dose-related and stereospecific activation of human neutrophils resulting in granulocyte aggregation and migration. Propranolol produced de novo aggregation and also enhanced responses to chemotaxins, N-formyl-methionyl-leucyl-phenylalanine and C5a. Lysosomal exocytosis was unaffected by beta blockers. In partial explanation of the enhancement of granulocyte activation by beta blockade, we observed that propranolol produced enhanced expression and affinity of granulocyte surface receptors for tritiated N-formyl-methionyl-leucyl-phenylalanine. This enhanced activation of human granulocytes by beta blockers was manifest in vivo as augmented inflammatory dermal edema. Enhanced granulocyte activation by beta blockade may induce microvascular disruption and subsequent tissue inflammation. PMID- 3805864 TI - Platelet membrane vesicles reduced microvascular bleeding times in thrombocytopenic rabbits. AB - We investigated the possible role of platelet membrane vesicles on hemostatic function in vivo. Platelet membrane vesicles were prepared from rabbit platelets stored for up to 6 months at -65 degrees C and transfused into thrombocytopenic rabbits. Significant reductions in microvascular bleeding times were observed up to 24 hours after transfusion, with the greatest corrections at 4 hours. Measurements of factor V, factor VIII, fibrin degradation products, and fibrinogen in animals transfused with membrane ruled out intravascular coagulation and suggested a direct effect of platelet membrane vesicles at the bleeding sites. This conclusion was supported morphologically by identification of membrane vesicles in bleeding time lesions and radiologically by accumulation of 111In-labeled vesicles in lesions. Production of platelet membrane vesicles was simple, and freezing allowed long-term storage of a product capable of short term hemostasis. PMID- 3805865 TI - Effects of copper deficiency on carbon tetrachloride-induced lipid peroxidation. AB - To investigate the hypothesis that copper deficiency in the rat could result in increased susceptibility to CCl4-induced lipid peroxidation caused by decreased free radical defenses, we performed a series of experiments administering CCl4 to copper-deficient and control rats. Peroxidation after CCl4 administration was monitored by measuring the evolution of expired ethane in closed metabolic chambers. Rats were fed one of two copper-deficient diets based on either evaporated milk or powdered milk. Compared with control values, liver copper content, liver superoxide dismutase activity, and plasma ceruloplasmin level were significantly decreased in copper-deficient rats fed either of the diets. Liver glutathione peroxidase activity was also decreased in the copper-deficient rats fed the evaporated milk diet. Ethane evolution was markedly increased in both copper-deficient groups as compared with their controls. Copper deficiency was also found to produce increases in hepatic iron concentrations, but normal rats loaded with iron dextran to increase hepatic iron concentrations into a range similar to that found in the copper-deficient rats did not exhibit increased ethane evolution after CCl4 administration. Copper deficiency in the rat results in increased CCl4-induced lipid peroxidation. PMID- 3805866 TI - Interaction of long-term stored platelets with vascular subendothelium. AB - Platelets stored as platelet-rich plasma under mildly alkaline conditions in vitro maintain morphologic integrity and functional capability for 2 to 3 weeks. We used the Baumgartner method to assess the ability of long-term stored platelets to interact with exposed vascular subendothelium. After 3 days in storage the size and number of thrombi on damaged surfaces decreased. However, the percentage of vascular surface covered was not reduced significantly until the cells had been stored for 14 days. Treatment of vascular segments with chymotrypsin to increase thrombogenicity caused platelets stored for 14 days to adhere and form aggregates on denuded surfaces in a manner similar to that of fresh platelets, but the ability to develop thrombi remained depressed. Thus long term storage that maintains physical and functional integrity also preserves a reasonable capacity of platelets to interact with damaged blood vessels. PMID- 3805867 TI - Lithium and boron in human blood. AB - A new method for determination of lithium and boron in biologic material has been developed. It uses neutron irradiation and subsequent measurements of helium 3 and helium 4 in a static mass spectrometer. Concentrations of lithium and boron in blood from seven apparently healthy donors were in rather narrow ranges (Li = 2.64 +/- 0.94 ng/gm dry weight, B = 97 +/- 22 ng/gm dry weight), and these concentrations also appeared to be correlated at the 0.05 level of significance. PMID- 3805868 TI - Putative role for lithium in human hematopoiesis. AB - Ingestion of lithium salts increases production of neutrophil granulocytes from the bone marrow in human subjects when the concentration of the ion in blood is within the range 5 to 10 X 10(-4) mol/L. Results of preliminary dose-response experiments appeared to indicate that nanomolar levels of lithium stimulated clonal proliferation of granulocyte precursors from normal bone marrow in vitro, suggesting the possibility that this element may contribute to the physiologic regulation of blood cell formation in humans. The present studies confirm that the influence of lithium on hematopoiesis is evident in vitro at concentrations equivalent to that demonstrable in normal blood (2 to 4 X 10(-7) mol/L). Furthermore, such effects are not cell lineage specific, being observed also in clonogenic cultures of erythroid and eosinophil granulocyte progenitor cells, and the phenomenon attributed to lithium is a property shared with rubidium and cesium salts. These findings point to a role for lithium and its elemental relatives in the biophysical mechanisms involved with the control of human blood cell production. PMID- 3805869 TI - Role of chemotactic factor inactivator in modulating alveolar macrophage-derived neutrophil chemotactic activity. AB - The stimulated alveolar macrophage is a potent source of neutrophil chemotactic activity. The release of this chemotactic activity can be inhibited by pretreating alveolar macrophages with anti-C5 antibody. We hypothesized that C5a, a fragment cleaved from C5 when C5 is activated, might activate the alveolar macrophage to release neutrophil chemotactic activity and that chemotactic factor inactivator, a serum inhibitor of C5a, could decrease this release. Activated complement components including C5a were found to stimulate guinea pig macrophages to release chemotactic activity into their culture supernatants at levels that were significantly higher than the chemotactic activity of C5a alone (P less than 0.001). Chemotactic factor inactivator was found to cause a marked reduction in the chemotactic activity released by macrophages stimulated with phagocytic and nonphagocytic stimuli (P less than 0.001, all comparisons). These data indicate that C5a can stimulate alveolar macrophages to release chemotactic activity in vitro, and that chemotactic factor inactivator may play a role in modulating this process. PMID- 3805870 TI - Clearance of instilled surfactant lipid from the lungs of unanesthetized sheep: lipids are differentially transported by nonlymphatic pathways. AB - The routes used by the lung to dispose of instilled exogenous surfactant lipid components were examined with the sheep chronic lung lymph fistula preparation. Small vesicles of radiolabeled dipalmitoyl phosphatidylcholine (DPPC) either alone or with radiolabeled cholesterol (CHOL) were instilled intratracheally, and samples of lung lymph and plasma were collected at 60-minute intervals for 12 hours. At any time point, the total amounts of either labeled DPPC or CHOL that appeared in lung lymph were small fractions (less than 0.5%) of their respective amounts in plasma. Labeled DPPC, as DPPC alone or as DPPC/CHOL (2:1 molar ratio), appeared simultaneously in plasma and lymph and displayed the same time course of appearance regardless of vesicle composition. CHOL appearance was also simultaneous in both plasma and lymph, but was distinctly slower than that of DPPC. The time differences noted between the appearance of labeled DPPC and CHOL in lymph and plasma indicate that these two lipid components of the instilled surfactant lipid component vesicles appear to be handled in different fashions during their transport from the lung. Further, the data obtained by sampling lung lymph suggest that the lung interstitial space may not play an active role in the transport of exogenously administered lipid from the lung. PMID- 3805871 TI - Neutrophil-induced K+ leak in human red cells: a potential mechanism for infection-mediated hemolysis. AB - Activated neutrophils (AN) when incubated with red blood cells (RBCs) at a ratio of 1:100 were shown to damage RBCs as reflected by an increase in passive potassium (K+) permeability. Oxygenated sickle cells were more susceptible to this injury than normal (AA) RBCs. In both normal and sickle cells, the degree of K+ leak was found to be linearly related to the amount of AN in the incubation mixture. Pretreatment of AA RBCs with low-dose H2O2 resulted in an increased K+ leak after exposure to AN. Compared with patients with stable sickle cell anemia, those who were observed while infected or in crisis had notably more K+ leak from their RBCs after AN exposure. Addition of activated neutrophils from a patient with chronic granulomatous disease resulted in K+ leak from normal RBCs, despite a deficiency in production of toxic oxygen species. Cell-free supernatants from AN also mediated K+ leak. Sickle cells were, again, leakier after exposure to these preparations. Scavengers of toxic oxygen species inhibited up to 40% of the leak, whereas the maximal inhibition obtained by using protease inhibitors was 60%. Addition of autologous plasma in low concentrations inhibited the leak but also resulted in hemolysis, probably via a different mechanism. These studies demonstrate that measurement of passive K+ loss from RBCs allows discrimination between two separate mechanisms of AN-induced damage, an oxidant mechanism, as has been previously described, and a new pathway that appears to be mediated by granule-associated enzymes released from AN. The increased susceptibility of sickle RBCs, especially during periods of increased physiologic stress, suggests that previous membrane damage in vivo may render these RBCs more sensitive to the action of either oxidants or granules released from neutrophils. PMID- 3805872 TI - Relationship of radionuclide liquid bolus transport and esophageal manometry. AB - Using simultaneous esophageal manometry and radionuclide transit studies, we compared liquid bolus transport with the various parameters of esophageal contractions. Study subjects included seven normal individuals, six patients with the "nutcracker esophagus" (mean distal peristaltic amplitude greater than 180 mm Hg), and three patients with spastic motility disorders. Manometric studies were performed when the subjects were in the basal state and after intravenous administration of edrophonium and atropine. Simultaneous radionuclide studies were done with subjects in the supine position by swallows of 250 mu Ci technetium Tc 99m sulfur colloid in 10 ml water. We found that normal liquid bolus transport (less than 15 seconds) is primarily dependent on the presence of a peristaltic wave front throughout the esophagus. Above a threshold pressure of 30 mm Hg, liquid transport was not affected by amplitude (33 to 500 mm Hg) or duration (3 to 15 seconds) of esophageal contractions. Repetitive wave forms also gave normal transit times as long as the wave front was peristaltic in onset. There was a significant inverse correlation (-0.65; P less than 0.001) between liquid transit time and peristaltic velocity. Prolonged radionuclide transport (30 to less than 50 seconds) was observed only with nonperistaltic contractions and very low amplitude (15 to 30 mm Hg) peristaltic waves. PMID- 3805873 TI - Activation of contact phase of blood coagulation can be induced by the sclerosing agent polidocanol: possible additional mechanism of adverse reaction during sclerotherapy. PMID- 3805874 TI - Ear protection against water-borne infection: an objective evaluation. AB - Eight different ear plug materials were tested, in 5 ears each, in artificial shallow underwater conditions for 30 minutes, in order to determine their efficacy in sealing the ear canals to avoid water-borne infections in ear canals and open middle ears. Most of the plugs tested would meet everyday requirements for protection, but the polymeric foam plugs, treated with petroleum jelly, and moldable plastic materials were most effective in protecting both the middle ear and the ear canal skin. PMID- 3805875 TI - Chlamydia trachomatis as an aetiological agent of 'glue ear' infections in children. PMID- 3805876 TI - Results of preservation of the posterior canal wall in cholesteatoma surgery as related to middle-ear aeration. AB - The last otological generation witnesses a fierce discussion concerning the treatment of choice of cholesteatomatous ears--closed versus open technique being the issue. The reports of the success and failure of these two opposed techniques varied greatly (McCabe, 1977; Sade, 1982a). It is the purpose of this study to clarify this issue further by reviewing the fate of 100 cholesteatomatous ears treated by the closed technique and followed up for as long as 13 years--a length of follow-up which has not hitherto been reported. We will also try and attempt to correlate the success and failure of this method with the ability of these ears to aerate--a clinical status which may be regarded as indicating the 'Eustachian function' of any particular middle ear in question. PMID- 3805877 TI - Early morphological and chemical changes induced by cisplatin in the guinea pig organ of Corti. AB - Guinea pigs were treated with a single dose of Cisplatin (5 mg IP). After 2-4 days the cochleas were prepared for morphological analysis by scanning electron microscopy and chemical analysis by X-ray dispersive microanalysis. Following Cisplatin, the bundles of stereocilia on the hair cells were found to be rough, disarrayed, fused, and finally absorbed. Significant increases were found in the levels of calcium, sulphur, and phosphorus in the abnormal hair cells. It is suggested that the high calcium levels might be due to the inhibition of enzymes which normally keep cytoplasmic calcium low, and that some of the changes in the stereocilia might be secondary to this. PMID- 3805878 TI - Pharyngectomy for post-cricoid carcinoma with preservation of the larynx (a new technique). AB - A technique for resection of post-cricoid carcinoma with preservation of a functioning larynx is described. Two case histories are presented; indications, contraindications and relevant anatomy are discussed. PMID- 3805879 TI - Craniocervical chordomas in the Mersey Region (a ten-year experience). AB - The clinical presentation and management of craniocervical chordomas in the Mersey Region between 1974 and 1984 are presented, and compared to those in previously published series. A review of the current modalities of treatment is also discussed. PMID- 3805880 TI - The role of the paediatric endoscopist. AB - The role of the paediatric endoscopist has been a changing one. When I first commenced at the Royal Alexandra Hospital for Children in Sydney 25 years ago, paediatric endoscopy of the upper respiratory tract and oesophagus was a limited and poorly defined field. Most endoscopic examinations were requested, often reluctantly, by a paediatrician in the investigation of stridor. In fact my first consultation involved instructions to perform a laryngoscopy, but not a bronchoscopy and general anaesthesia was not to be used! How different the situation is now--the paediatric endoscopist is regarded as a true consultant and his opinion is sought in the investigation and management of congenital or acquired airway and intra-thoracic problems. PMID- 3805881 TI - Aural sebaceous adenomas. PMID- 3805882 TI - Fibrosarcoma of the nose and paranasal sinuses. PMID- 3805883 TI - Carcinoid tumour of the larynx (a case report and review of the literature). AB - Carcinoid tumours of the larynx are extremely rare, only 13 cases having previously been reported in the world literature. A case is reported here with the unusual complication of skin metastases. The true diagnosis is seldom made on the original biopsy, which is commonly reported as poorly differentiated carcinoma. A review of the literature is made with a discussion of the histological diagnosis and treatment modalities. PMID- 3805884 TI - Intracranial hypertension following neck dissection. AB - A 51-year-old man developed prolonged papilloedema as a result of increased cerebrospinal fluid pressure following staged bilateral radical neck dissection. The patient recovered completely with no further specific therapy. Although the prognosis for vision is usually good in patients with longstanding papilloedema due to raised cerebrospinal fluid pressure, permanent visual impairment remains a serious complication. In the presence of anatomical variations of the venous pathways by which the blood leaves the brain, a raised intracranial pressure may also develop following unilateral radical neck dissection. Nine cases of increased intracranial pressure following unilateral radical neck dissection reported in the literature until now are briefly reviewed. PMID- 3805885 TI - Neurofibroma of the cervical sympathetic chain presenting with Horner's syndrome. AB - A case of neurofibroma arising from the cervical sympathetic chain and associated with ipsilateral Horner's syndrome in a patient with von Recklinghausen's disease has been presented. The clinical features and the pathology of the lesion have been discussed. PMID- 3805886 TI - Leprosy in ENT. AB - Two cases of leprosy are reported, one of which was admitted as a case of acute tonsillitis and was referred only later to the ENT surgeons with hoarseness after a diagnosis had been made by biopsy of the lymph node; the other was referred with a possible facial paralysis. This is a rare diagnosis but it should still be kept in mind, particularly in the immigrant population of the United Kingdom and Saudi Arabia and particularly of the Saudis from the southern provinces. PMID- 3805887 TI - Information processing abilities and reading. PMID- 3805888 TI - Information processing and elementary mathematics. PMID- 3805889 TI - Information processing theory and learning disabilities: an overview. PMID- 3805890 TI - Information processing approaches to studying spelling deficiencies. PMID- 3805891 TI - Needs of learning disabled adults. PMID- 3805893 TI - Is the learning disabled adult really necessary? PMID- 3805892 TI - Employer attitudes toward hiring the learning disabled. PMID- 3805894 TI - Intelligence, information processing, and specific learning disabilities: a triarchic synthesis. PMID- 3805895 TI - [Preliminary study of the use of low-molecular weight heparin to prevent thrombotic risk]. AB - This study involved two stages: In vitro study. Three LMWHs, CY 216-CY 222 (Choay) and PK 10169 (Pharmuka), were compared to standard heparin, SH (Choay), and to a high-molecular-weight heparin, HAF (Choay), which particularly revealed a dissociation of anti-Xa (++) and anti-IIa (+) activities for the LMWHs: (table: see text) In vivo study. Healthy volunteers. Subcutaneously injections of PK 10169 or CY 222 according to various protocols (rythm of injections, dosage). For both LMWHs, the dissociation of anti-Xa and anti-IIa activities reoccurs in vivo. A peak of anti-Xa effect was observed 3 to 4 hours after the injections. The duration period of this activity is about 12 hours. The importance of the global platelet tests HT and TEG (modified for the highest doses) should be noted. Study of haemorrhagic tendencies in patients with slight thrombotic risk. From this preliminary study, protocols with CY 216, CY 222 and PK 10169 are proposed for the prevention of thrombotic risk in orthopaedic surgery (injections at 12-hour intervals). PMID- 3805896 TI - [Fibrinolytic treatment of 28 thromboses of valve prostheses. A biological study]. AB - We carried out a series of laboratory investigation in 28 patients with prosthetic valve thrombosis (17 mitral and 11 aortic). The diagnosis was confirmed by TM and bidimensional echocardiograms and by cineradiography. The treatment consisted of UK (4,500 IU/kg/hour for 12 hours) and/or SK (initial loading dose of 500,000 IU, then 150,000 IU/hour for 10 hours). We measured fibrinogen, degradation products of fibrinogen-fibrin, plasminogen and antiplasmin. Two dimensional electrophoresis against anti-fibrinogen, anti fragment-D and anti-fragment-E were employed for some samples. After thrombolytic therapy (SK: 18; UK: 7; SK-UK: 2; UK-SK: 1) complete clot removal was obtained in 21 cases (successful: group S), partial removal in 4 cases (improvement: group A) and failure in 3 cases (failure: group E). 3 patients died. Biochemical effects can be seen in group S and in group A. There were no changes in group E. PMID- 3805897 TI - [Finger plethysmography for studying the blood rheological and hemodynamic components of an acrosyndrome]. AB - Digital plethysmography allows investigation of maximum digital pulse (M.D.P.) after immersion of hands at 45 degrees C over three minutes. It is correlated with digital arterial blood flow. Reactivity to cold is determined from the ratio M.D.P./digital pulse after local and body cooling over 3 minutes. Tests were performed on 65 controls, 69 patients with idiopathic Raynaud's syndrome, 12 with scleroderma, 10 with digital arteritis and 15 with Raynaud's phenomenon secondary to hemorheologic affections. Maximum digital pulse was significantly decreased in patients with digital arteritis and scleroderma. The M.D.P. was normal in controls and patients with idiopathic Raynaud's syndrome, and was significantly increased in patients with a rheologic Raynaud's phenomenon. Digital artery reactivity differentiates the populations studied: it was maximum in patients with scleroderma, moderate in controls and patients with isolated digital arteritis and marked in patients with idiopathic Raynaud's disease and those with rheologic Raynaud's phenomena. PMID- 3805898 TI - [Mural thrombosis of the abdominal aorta. A sometimes unrecognized cause of recurrent embolisms]. AB - A 23 year old patient with an infrarenal abdominal aorta mural thrombosis developed recurrent peripheral emboli. This case underlines the etiologic investigation necessary in cases of peripheral emboli unexplained by the conventional cardiac examinations. Filling of total aorta with contrast is essential (assisted if necessary by oblique projections) to detect possible mural thrombi carrying the risk of recurrent emboli. PMID- 3805899 TI - [Medical treatment of trophic disorders of arterial origin]. PMID- 3805900 TI - [Value of capillaroscopy in arteritis in patients in their 50s]. PMID- 3805901 TI - The dynamics of interlocus associations in the three-locus hitchhiking model. 2. The pairwise linkage disequilibrium between two neutral loci. AB - The hitchhiking effects of a selected locus upon the dynamics of the pairwise association, Dnn, between two neutral loci is examined analytically for the special case where at least one of the neutral loci is in linkage equilibrium with the selected locus. The results apply approximately whenever the product of the pairwise associations between the selected locus and each neutral locus is negligible with respect to the three-way linkage disequilibrium. It is shown that precisely four broad classes of trajectories are possible, whether the selected locus is between (nsn) or to one side (snn) of the neutral loci, and whatever the mode of selection operating. Dnn may: decay rapidly to zero, at a rate faster in each generation than that expected for two isolated neutral loci; monotonically decay to zero at a rate which is slower in every generation than under the usual neutral regime; increase initially and/or in intermediate periods before eventually slowly decaying to zero; or exhibit type 1 behavior in the first segment of the trajectory and either type 2 or 3 behavior in the subsequent generations, with the transition marked by a change in sign. The nature of a given trajectory is largely determined by the direction of gene frequency change at the selected locus, and the initial signs of both Dnn and three-way linkage disequilibrium. The single most important consequence of these results is that there is no simple relation between the amount of pairwise association between two neutral markers and the recombination fraction between them. Several factors influencing the magnitude of the hitchhiking effect are also examined. It is shown that, all else being equal, the greater the three-way linkage disequilibrium, the greater the departure of Dnn from the expected neutral dynamic. Increased recombination among the loci reduces the hitchhiking effect on Dnn. The dependence of the behavior upon the exact position of the selected locus is also determined both within and between nsn and snn chromosomal systems. An interesting discovery is that given equivalent nsn and snn systems, with each having the same recombination between their two neutral loci, Dnn will deviate more from the standard neutral dynamic in the snn system if its selected locus is sufficiently tightly linked to the neutral loci. PMID- 3805902 TI - Periodic Lotka-Volterra competition equations. AB - The Lotka-Volterra competition equations with periodic coefficients derived from the MacArthur-Levins theory of a one-dimensional resource niche are studied when the parameters are allowed to oscillate periodically in time. Specifically, niche positions and widths, resource availability and resource consumption rates are allowed small amplitude periodicities around a specified mean value. Two opposite cases are studied both analytically and numerically. First only resource consumption rates are allowed to oscillate while niche dimensions and resource availability are held constant. The resulting oscillations in population densities and the strength of the system stability as they depend upon crucial relative phase and amplitude differences between the species' consumption rates are studied. This leads to a clear notion of "temporal niche" and of the effects that such oscillations can have on competitive coexistence. Secondly, all system parameters are allowed to oscillate, although the oscillatory consumption rates are assumed identical for both species. The effects on the population density oscillations and their averages are studied and the "best" choice of the common, periodic resource consumption rate for these two "identical" species competing for similar (even identical) niches is considered. PMID- 3805904 TI - Relaxation spectra of interactive neural systems. AB - A nonlinear model of spatially localized interactive neural systems is analyzed in the neighborhood of steady state solutions by computing relaxation spectra which govern the long time approach to steady state activity levels. PMID- 3805903 TI - The rate of convergence of a generalized stable population. AB - In an age-structured population that grows exponentially, each age group pi(t) at period t is asymptotically equivalent to x0t for some positive number x0. In this paper we show that the speed at which the ith age group reaches its exponential state of equilibrium can be measured by the rate at which the ratio vi(t) = pi(t)/pi(t-1) converges to x0. The age specific rate of convergence is determined by considering a quantity r satisfying [vi(t)-x0] less than or equal to rt when t is large; Ri = Inf r (over all initial populations, r satisfying the above inequality) is the R-factor used in numerical analysis to measure the rate at which the sequence vi(t) converges to x0; Si = -1n Ri is then defined as the rate of convergence to stability of the ith age group. The case of constant net maternity rates is studied in detail; in this context S0 is compared to the population entropy H, which was proposed by Tuljapurkar (1982) as a measure of the rate of convergence to stability. PMID- 3805906 TI - On a stochastic integral of a branching process. AB - This paper is concerned with the properties of a stochastic integral which arises in the study of a modified Markov branching process. Explicit expressions are found for the mean and the limit distribution of the integral. PMID- 3805905 TI - A three component model of human bioenergetics. AB - The model described in this article is a generalised three component hydraulic model, proposed to represent net whole body bioenergetic processes during human exercise and recovery. During exercise, fluid flows from the three interconnected vessels in the system represent the breakdown of high energy phosphates (phosphagens), oxygen consumption and lactic acid production. During recovery, replenishment of the fluids represents the repayment of oxygen debt. The model is quantified and solved mathematically, and the solution compared with observed experimental data. Since currently known physiological facts are consistent with four configurations of this model, further experimentation is necessary. PMID- 3805907 TI - The hypercycle, traveling waves, and Wright's equation. AB - A formal relation between the hypercycle equation and the delay differential equation of E. M. Wright is exhibited using a traveling waves approach. Several unsolved questions in either problem can be related and interpreted, in particular new motivation for the study of Wright's equation is obtained. PMID- 3805908 TI - Effects of noise on some dynamical models in ecology. AB - We investigate effects of random perturbations on the dynamics of one-dimensional maps (single species difference equations) and of finite dimensional flows (differential equations for n species). In particular, we study the effects of noise on the invariant measure, on the "correlation" dimension of the attractor, and on the possibility of detecting the nonlinear deterministic component by applying reconstruction techniques to the time series of population abundances. We conclude that adding noise to maps with a stable fixed-point obscures the underlying determinism. This turns out not to be the case for systems exhibiting complex periodic or chaotic motion, whose essential properties are more robust. In some cases, adding noise reveals deterministic structure which otherwise could not be observed. Simulations suggest that similar results hold for flows whose attractor is almost two-dimensional. PMID- 3805909 TI - Nonlinear pattern selection in a mechanical model for morphogenesis. AB - We present a numerical study of the nonlinear mechanical model for morphogenesis proposed by Oster et al. (1983) with the aim of establishing the pattern forming capability of the model. We present a technique for mode selection based on linear analysis and show that, in many cases, it is a reliable predictor for nonlinear mode selection. In order to determine the set of model parameters that can generate a particular pattern we develop a technique based on nonlinear least square fitting to a dispersion relation. As an application we present a scenario for sequential pattern formation of dermal aggregations in chick embryos which leads to the hexagonal array of cell aggregations observed in feather germ formation in vivo. PMID- 3805910 TI - Competing species model with behavioral adaptation. AB - This paper studies the properties of a modified Lotka-Volterra model for two competing species, in which the coefficients of the interaction terms are time dependent averages of the level of interaction over the entire past. For this model, it is shown that competitive exclusion does not occur, there are two possible stable equilibrium points, and in a certain region of parameter space numerical simulations suggest the existence of interesting oscillatory solutions. PMID- 3805911 TI - Solution of functional difference equations from behavioral theory. AB - Behavioral models based on Markovian decision processes lead to functional difference equations for quantities such as the mean lifetime of the forager and the probability of reproductive success of the forager. In this paper, asymptotic and iterative methods are developed for the solution of such equations. The asymptotic methods are compared with numerical simulations. The iterative methods can be proved by a simple application of contraction mapping theorems. PMID- 3805912 TI - Demography in stochastic environments. II. Growth and convergence rates. PMID- 3805913 TI - Numerical solution of a nonlinear advance-delay-differential equation from nerve conduction theory. AB - A functional differential equation which is nonlinear and involves forward and backward deviating arguments is solved numerically. The equation models conduction in a myelinated nerve axon in which the myelin completely insulates the membrane, so that the potential change jumps from node to node. The equation is of first order with boundary values given at t = +/- infinity. The problem is approximated via a difference scheme which solves the problem on a finite interval by utilizing an asymptotic representation at the endpoints, cubic interpolation and iterative techniques to approximate the delays, and a continuation method to start the procedure. The procedure is tested on a class of problems which are solvable analytically to access the scheme's accuracy and stability, then applied to the problem that models propagation in a myelinated axon. The solution's dependence on various model parameters of physical interest is studied. This is the first numerical study of myelinated nerve conduction in which the advance and delay terms are treated explicitly. PMID- 3805914 TI - A multivariate time-series descriptive case study of chiropractic care in the treatment of cervical pain. AB - This paper presents a multivariate quantitative description of the temporal course of 13 clinical variables measured before, during and after a multimodal chiropractic treatment package. Clinical measures included total and peak daily cervical pain, unleveling of the pelvis, shoulders and cranium; bilateral grip strength; and cervical ranges of motion. Intervention techniques included heel wedges; cervical, abdominal, and foot exercises; and spinal adjustments (cervical spine and ilium). Data are presented in tabular and graphic formats, and limitations in validity and reliability are reviewed. Interpretive limitations included confounding by multiple and sequential interventions and by lack of experimental control comparisons. However, the study suggests the plausible influence of biomechanical and adjustive care upon mediators and clinical outcomes. Strengths inherent in multivariate time-series research are noted. PMID- 3805915 TI - Inter- and intra-examiner reliability of upper cervical X-ray marking system. PMID- 3805916 TI - Spinal adjusting instrument. PMID- 3805917 TI - Social change and the drinking age. PMID- 3805918 TI - Premedical education: out of balance. PMID- 3805919 TI - You and malpractice stress. II. One physician's story. PMID- 3805921 TI - Knee arthroscopy for the non-orthopaedist. PMID- 3805920 TI - Traffic fatalities and drinking teens: how big is the problem in Fulton County? PMID- 3805922 TI - Adolescent suicide: a geometric increase. PMID- 3805923 TI - Secondary bacterial peritonitis. PMID- 3805924 TI - Pediatric cardiac rehabilitation: exercise training and prescription. PMID- 3805925 TI - The bare facts about going naked. PMID- 3805926 TI - Tumor registries: measureable advantages. PMID- 3805927 TI - From bad to worse. PMID- 3805928 TI - You and malpractice stress: III. Two spouses' views. PMID- 3805930 TI - Release of medical records without patient authorization? PMID- 3805929 TI - Tobacco and health: the role of the physician. PMID- 3805931 TI - Fetal echocardiography: diagnosis and management of fetal arrhythmias. PMID- 3805932 TI - Breast feeding in early neonatal period. PMID- 3805933 TI - Beclomethasone dipropionate aerosols in Thai asthmatic children. PMID- 3805934 TI - Artificial feeding: choice of proprietary formulas. PMID- 3805935 TI - Pycnodysostosis: a case report. PMID- 3805936 TI - Seasonal variation of the prevalences of malnutrition in Thai children. PMID- 3805937 TI - Effects of amount and concentration of a lactose--containing formula on outcome of infantile diarrhoea. PMID- 3805938 TI - Early home oral rehydration therapy (ORT) in primary health care. PMID- 3805939 TI - Integrated health, nutrition, agriculture and rural development projects, Ubon Ratchathani, Thailand (1976-1984). PMID- 3805940 TI - The study of socioeconomic, behavioural and environmental factors related to diarrhoeal diseases in children under 5 in congested areas of Bangkok Metropolis. PMID- 3805941 TI - The role of intensive care in the management of tetanus. PMID- 3805942 TI - Language and diarrheal diseases. PMID- 3805943 TI - Hepatic rickets. PMID- 3805944 TI - Early neonatal mortality at Ramathibodi Hospital 1979-1983. PMID- 3805945 TI - Sustained release theophylline and ephedrine therapy in chronic asthma. PMID- 3805946 TI - Gestational age assessment by the examination of the anterior vascular capsule of the lens. PMID- 3805947 TI - Diarrhoeal diseases in Thailand. PMID- 3805948 TI - Fever without localizing signs in young children. PMID- 3805949 TI - Vitamin K prophylaxis in the neonate by the oral route and its significance in reducing infant mortality and morbidity. PMID- 3805950 TI - Myasthenia gravis: a clinical study in Thai children at Ramathibodi Hospital. PMID- 3805951 TI - Idiopathic thrombocytopenic purpura in childhood. A comparison of the effect of treatment with 1 mg/kg and 2 mg/kg/day of prednisolone. PMID- 3805952 TI - Post-nephrectomy CT appearance in patients with hypernephroma. PMID- 3805953 TI - Effectiveness of diarrhoeal diseases surveillance by village health volunteer. PMID- 3805954 TI - The normal pediatric Frank orthogonal electrocardiogram: variations according to age and sex. AB - Quantitative computerized analysis of QRS and ST-T parameters of the Frank orthogonal electrocardiogram and vectorcardiogram was undertaken in a large series of 1317 normal infants, children and adolescents stratified according to age and sex. This study confirms the influence of these two constitutional variables, age and sex, over the normal VCG in the whole time span between birth and late adolescence. As children mature, the mid-portion of the spatial QRS loop shifts leftward and posteriorly with relatively little change in the initial and terminal vectors. The spatial T loop shifts anteriorly but at a different rate in males and in females. Unidirectional changes in many amplitude parameters are observed until age 19 in males whereas in females these changes stop earlier or even show a reverse trend around puberty, leading to more important differences between adolescent males and females. Sex-related differences are the most marked for parameters representing the repolarization process. Infants under six months of age form a distinct group with larger dispersions and more disparate variations in the values of vectorcardiographic parameters than in older children. In the newborn period larger sample size might be necessary in order to reduce the normal ranges of vectorcardiographic parameters. PMID- 3805955 TI - The normal pediatric Frank orthogonal electrocardiogram: influence of weight, height and chest circumference. AB - The influence of body weight, height and chest circumference on the pediatric Frank vectorcardiogram (VCG) was investigated in a population of 1317 normal infants, children and adolescents. Simple linear regression analysis showed that 94, 96 and 57 VCG variables were significantly correlated with weight, height and chest circumference, respectively. These numbers were reduced to 10, 18 and 6 VCG variables after a stepwise multiple correlation analysis. The relationship between the VCG and the somatic variables was also studied in ten different age/sex subgroups. Simple regression analysis showed a residual significant correlation between the VCG and all three somatic variables in each group. The multiple correlation analysis allowed us to define a minimum set of VCG variables, from one to six, which could explain all the variation produced by the somatic variables. The coefficient of multiple correlation between VCG and weight was the highest in babies 0 to 6 months old (R = 0.73). For height, the strongest correlation was found in females two to five years old (R = 0.76). In subjects older than two years of age, the correlation between chest circumference and VCG (R = 0.30 to 0.69) was weaker than between VCG and pediatric VCG after stratification for age and sex, especially in the youngest groups. PMID- 3805956 TI - Effect of the heart-lung boundary on the magnetocardiogram. AB - Ionic currents flowing during the activation of the heart generate both electric potentials which can be recorded at the body surface as the electrocardiogram or ECG and magnetic fields which can also be recorded at the body surface as what is termed the magnetocardiogram (MCG). In order to apply the MCG to basic research or clinical diagnosis, one must understand the geometric sensitivity of the recorded signals to the cardiac source currents and evaluate the contribution of secondary ohmic body currents relative to the cardiac currents. The present study aims to evaluate the magnitude of the ohmic current contribution by electrically insulating the heart from the body. It is found that volume currents contribute a large part of the MCG signal recorded at distances greater than 10 cm from the heart, but that close to the heart at least one component of the MCG reflects primary cardiac source currents free of interference from volume currents flowing in the body. PMID- 3805957 TI - Electrocardiographic diagnosis of posterior myocardial infarction revisited: a new approach using a multivariate discriminant analysis and thallium-201 myocardial scintigraphy. AB - This study examined the feasibility of using a multivariate discriminant analysis to design a useful electrocardiographic (ECG) model to diagnose posterior myocardial infarction (MI). Thallium-20) scintigraphy was used as a reference standard to identify posterior scar (fixed perfusion defects). The model was derived from 111 patients of whom 37 had fixed posterior defects and 74 had normal images, and its validity was subsequently tested in a separate group of 180 patients. In the initial group of patients, the fixed perfusion defects involved the posterior left ventricular wall alone in 15 patients, and the posterior and inferior walls in 22 patients. Stepwise multivariate discriminant analysis of 26 ECG variables produced a model of two variables (Q-wave duration in a VF and T-wave amplitude in V1) which provided a sensitivity of 78%, a specificity of 89%, and a predictive accuracy of 86% for the diagnosis of posterior MI. This model, when tested in the second group of 180 patients, yielded an overall prediction accuracy of 82% (sensitivity 65%, specificity 85%). Thus, the combination of Q-wave in a VF and upright T wave in V1 is the best ECG predictor of posterior MI. These two variables reflect the frequent association of posterior MI with inferior MI, and the reciprocal repolarization changes in the right precordial leads. PMID- 3805958 TI - Alternation in refractoriness and in conduction delay in the ischemic myocardium associated with the alternation in the ST-T complex during acute coronary occlusion in anesthetized dogs. AB - The effective refractory period (ERP) during the period of the alternation of the ST-T complex (STTA) in the ischemic myocardium was determined using a synchronized system of electrical stimulators and a bipolar epicardial electrode during acute coronary occlusion in anesthetized dogs. Epicardial unipolar electrograms (UP), epicardial bipolar electrograms (BP) and monophasic action potentials (MAP) were also recorded from ischemic areas. ERP in ischemic areas was prolonged, as ischemia progressed, and during the period of STTA ERP also alternately changed. A lower or negative deflection of the ST-T complex was accompanied by a longer ERP, and a higher or monophasic ST-T complex was accompanied by a shorter ERP. A good correlation was observed between the degrees of alternation in ERP and of STTA. MAP also showed an alternation in its duration and its amplitude. The alternation in duration preceded the alternation in amplitude. A lower or negative deflection of the ST-T complex corresponded to a MAP with a longer duration and a larger amplitude. During the period of STTA, a long conduction delay followed the negative deflection of the ST-T complex. A marked conduction delay appeared only during a period of STTA. Diltiazem and nifedipine inhibited STTA and an alternation in ERP. In conclusion, STTA is associated with an alternation in ERP and in conduction delay, and calcium antagonists attenuate both STTA and an alternation in ERP. PMID- 3805959 TI - Triple antegrade nodal pathway in a patient with supraventricular paroxysmal tachycardia. AB - A 69-year-old patient is described in whom programmed atrial extrastimulus testing revealed dual discontinuity of atrioventricular nodal conduction suggesting a triple antegrade nodal pathway. In this patient, programmed right ventricular pacing initiated two types of tachycardia due to intranodal reciprocating rhythms. In both cases, antegrade conduction occurred via the slow nodal pathway, and retrograde conduction by the fast and intermediate pathways, respectively. During ventricular extrastimulus testing, a single echo beat was elicited via a third circuit: the intermediate nodal pathway in a retrograde direction, and the fast pathway in an antegrade direction. PMID- 3805960 TI - Deep inspiration induced sinus arrest. An unusual manifestation in a patient with the sick sinus syndrome. AB - In a patient with the sick sinus syndrome and near syncope a prolonged sinus pause was documented and reproduced thereafter during sustained deep inspiration. Administration of intravenous atropine abolished this phenomenon, most probably indicating a hyperresponsiveness of the sinus node and AV junction to a vagotonic reflex. PMID- 3805961 TI - Left anterior hemiblock masking the diagnosis of right bundle branch block. AB - A case is presented in which left anterior hemiblock obscured totally the diagnosis of right bundle branch block by abolishing the S wave in leads 1 and aVL, and terminal R wave in leads V1 and V2. The presence of right bundle branch block was confirmed by recording high V1 and V2 leads. Subsequently, the ECG revealed how a greater degree of conduction delay in the right bundle branch may uncover the previously concealed right bundle branch block. The electrocardiographic features of these findings are discussed. PMID- 3805962 TI - Glycoconjugate cytochemistry of the rat small intestine using Helix pomatia agglutinin and colloidal gold conjugates. PMID- 3805963 TI - Structural differentiation in the frond and boring hypha of the dermatophyte Microsporum canis invading human hair in vitro. PMID- 3805964 TI - Size increase of dentin crystals in the intertubular matrix due to caries. PMID- 3805965 TI - Regression of redundant lactotrophs in rat pituitary gland after cessation of lactation. AB - Regressive changes occurring in the pituitary gland of the rat after removal of litters were studied. Pituitary glands of lactating rats were characterized by the presence of numerous hypertrophied lactotrophs. Interruption of lactation caused a blockade of prolactin synthesis and secretion, followed by degeneration of lactotrophs. Morphometric analysis of pituitary glands revealed that lactotrophs accounted for about 50% of the total hypophysial cell count in lactating rats. This percentage decreased progressively and reached pre-pregnant levels 7 days after removal of litters; the decrease was inversely correlated with an increase in the number of degenerating lactotrophs which comprised 30% of all lactotrophs 72 h after removal of litters. The morphological changes found in lactotrophs were closely related to changes in the prolactin content of serum and the pituitary gland. Regression of lactotrophs appeared to be the most important cause inducing the reversal of hypophysial lactotrophic activity to pre-pregnant conditions. PMID- 3805966 TI - Effects of thyroid status on brain catecholamine biosynthesis in adult rats: assessment by a steady-state method. AB - Effects of thyroid status on brain catecholamine turnover in adult rats were investigated using a steady-state method. Rats were treated for 3 weeks with s.c. injections of L-thyroxine (0.4 mg/kg), aminotriazole in drinking water (0.1%, w/v) or vehicle. After 2 weeks of treatment rats were implanted chronically with lateral intracerebroventricular (i.c.v.) cannulae. They were injected i.c.v. with [3H]tyrosine 1 week later. Catecholamine and tyrosine content and specific activity were measured in mediobasal hypothalamus, anterior hypothalamus and striatum, using high-performance liquid chromatography with electrochemical detection. Thyroxine treatment resulted in a significant increase in noradrenaline and dopamine synthesis localized to the mediobasal hypothalamus. Conversely, aminotriazole treatment resulted in a significant decrease in noradrenaline synthesis localized to the mediobasal hypothalamus. The localization of these changes in catecholamine turnover to the mediobasal hypothalamus suggests that they may be specific functional effects which are of importance in the overall integrated control of thyroid function. PMID- 3805967 TI - The relationship between perfusion medium flow rate and steroid secretion in the isolated perfused rat adrenal gland in situ. AB - Using the in-situ, isolated, perfused rat adrenal preparation, we have investigated the effects of changes in the rate of perfusate flow through the gland, brought about both mechanically and by the use of vasoactive agents, in the absence of known adrenocortical stimulants. Adenosine caused a significant increase in the rate of perfusate flow through the adrenal, with a concomitant rise in corticosterone, but not aldosterone, secretion. Adrenaline, on the other hand, caused a decrease in the rate of perfusate flow through the gland, accompanied by a decrease in the rate of steroid secretion. Furthermore, increases in the rate of delivery of perfusate to the gland, brought about by increasing the peristaltic pump rate, caused a large increase in corticosterone secretion, although aldosterone was unaffected. Neither adenosine nor a mechanically increased rate of perfusate delivery increased steroid secretion by collagenase-dispersed rat adrenocortical cells superfused on a Sephadex column. These results suggest the existence of hitherto unsuspected intraglandular mechanisms for the control of steroid secretion. PMID- 3805968 TI - Transient increase in prolactin secretion following hypothalamo-pituitary disconnection in ewes during anoestrus and the breeding season. AB - Hypothalamic control of prolactin secretion was studied in ovariectomized ewes by comparing the effects of hypothalamo-pituitary disconnection (HPD) and sham operation (sham-HPD). HPD caused a two-fold increase in plasma prolactin concentrations on days 1 and 7 following surgery during anoestrus and a tenfold increase during the breeding season. Thereafter, concentrations gradually declined to be similar to those in sham-HPD ewes by day 43 (breeding season) and day 145 (anoestrus). The maximum plasma prolactin response to HPD was similar during the two seasons (anoestrus: 128 +/- 15 bs breeding season: 118 +/- 13 micrograms/l). Sham-HPD had no effect on plasma prolactin concentrations. Prolactin pulse frequency was not affected by HPD, but increases in plasma prolactin concentrations were associated with increases in pulse amplitude. At the time of the normal anoestrus, plasma prolactin concentrations rose in both the HPD and sham-HPD ewes, raising the question of extra-hypothalamic regulation of seasonal changes in prolactin secretion. Plasma LH and FSH concentrations became undetectable in HPD ewes but were unaltered in sham-HPD ewes. We conclude that hypothalamic inhibition of pituitary prolactin secretion in the sheep can be demonstrated by HPD but that this effect is not sustained. This transience may indicate the additional requirement of hypothalamic-releasing factors in the control of prolactin release. In addition, the surgically isolated ovine pituitary of the HPD animal has an inherent pulsatile secretion of prolactin. PMID- 3805969 TI - Kinetic measurement of the urinary production rate of cortisol in male piglets: is the prerequisite 'collection until all label has disappeared' necessary? AB - Urinary cortisol production rate (CPR) was calculated by two different methods in five male piglets (about 3 kg bodyweight) injected i.v. with 40-120 kBq tritiated cortisol ([3H]F. After administration of [3H]F, urine was obtained from four consecutive collections for the following 2 days, during which 80-100% of the label was recovered. Total radioactivity in the urine was measured and used to calculate the total rate constant of 0.115 +/- 0.011 h-1 and, from this, the mean biological half-life (t1/2) of 6.0 +/- 0.6 h (S.D.; n = 4). It was found that the mass ratio of the two principal urinary cortisol metabolites tetrahydrocortisone (THE) and tetrahydrocortisol (THF) was strikingly less than 1.0 (0.4 +/- 0.1; n = 14), which is the reverse of that observed in older pigs, neonatal infants and man. To calculate CPR conventionally, the cumulative specific activities of THE and THF were calculated for the 2-day period of urine collection. The apparent mean CPR values on the basis of THE and THF were calculated as 11.5 +/- 1.6 (n = 5) and 12.8 +/- 3.3 (n = 5) mumol/day respectively, and 12.1 +/- 1.4 (n = 5) mumol/day for the average of THE and THF. The second method for calculating CPR consisted of determining the masses of THE and THF (mumol) per fraction of dose (m/fd) (fd refers to the ratio of radioactivity in the metabolite and dose) at different times after administration of [3H]F. The calculated m/fd values, which are synonymous with the dose divided by the specific activities of the metabolites, and the different times of urine collection were analysed by linear regression. The resulting slope is equal to the CPR. The CPR derived by this method for the average of THE and THF, 10.1 +/- 0.91 mumol/day was significantly (P less than 0.014) lower than that derived conventionally, 12.1 +/- 1.40 mumol/day. This second method may be used when CPR is determined in neonatal infants by means of nonradioactive, deuterated or 13C-enriched cortisol, where the extent of negative feedback by the relatively high dose of exogenous steroid on cortisol secretion must be kept as low as possible. This method also allows urine collections to be used at times when the tracer is still being excreted. PMID- 3805970 TI - Activation of sexual behaviour in castrated rats: the role of oestradiol. AB - Sexual behaviour was induced in castrated male rats with oestradiol-17 beta- or testosterone-filled constant-release implants. Testosterone-induced sexual behaviour was unaffected by treatment with the 5 alpha-reductase inhibitor 17 beta-N,N-diethylcarbamoyl-4-aza-5 alpha-androstan-3-one (4-MA; 16.7 mg/day) but treatment with the aromatization inhibitor 1,4,6-androstatriene-3,17-dione (ATD; 10 mg/day) prevented testosterone from inducing the behaviour. Sexual behaviour could be activated in castrated rats treated with testosterone plus ATD by treatment with 4-MA or with implants filled with a low dose of oestradiol. Lordosis behaviour induced in ovariectomized rats with testosterone-filled implants and progesterone was blocked by ATD treatment and could not be activated with 4-MA but oestradiol implants restored the display of lordosis in the testosterone plus ATD-treated females. 4-MA inhibited the in-vitro formation of [14C]5 alpha-dihydrotestosterone from [14C]testosterone by combined preoptic and hypothalamic tissue at all doses tested and a high dose of oestradiol exerted a similar effect. The results suggest that androgen aromatization is required for testosterone-activated female sexual behaviour but not for testosterone-activated male sexual behaviour. It is suggested that oestradiol normally acts to control the sexual behaviour of male rats by modifying neural androgen metabolism. PMID- 3805971 TI - The streaming adrenal cortex: direct evidence of centripetal migration of adrenocytes by estimation of cell turnover rate. AB - Thirty adult male rats were injected with 0.5 microCi [3H]thymidine/g body weight (specific activity 5 Ci/mmol) and killed, in groups of five, 1 h and 14, 30, 60, 90 and 120 days after injection. The displacement of labelled adrenocytes with time was estimated in autoradiograms of adrenal sections. The radial distance of the labelled cell from the capsule was measured with an eyepiece micrometer and expressed in cell location units, i.e. the number of cells separating the labelled cell from the capsule. One hour after labelling, 95% of labelled cells were confined to the outer quarter of the cortex. During the following days, adrenocytes were displaced inwardly, approaching the medulla at a velocity of 0.24 locations/day. They traversed the three cortex zones, reaching the medulla after 104 days. The three adrenal zones represent three differentiation states of the adrenocyte. When young, the adrenocyte secretes aldosterone, after leaving the glomerulosa it produces corticosteroids and on reaching the reticularis it produces sex hormones. The adrenal cortex is a cell renewal system made of two compartments. A progenitor compartment extending between locations 1 and 15, and a functional compartment, covering locations 16-64. The first compartment produces 0.47 cells daily, which enter the second. Half of them die on their way while the rest are eliminated in the reticular zone. The cell stream is nourished by a subcapsular stem cell. PMID- 3805972 TI - Transient increases in progesterone in daily and 2-hourly saliva specimens from adolescent girls. AB - Daily progesterone profiles obtained from saliva specimens from 101 peri- and postmenarcheal girls showed episodic 'spikes' which reached up to 600 pmol/l from baselines of approximately 40 pmol/l. The authenticity of progesterone in the 'spike' specimens was established using gas chromatography-mass spectrometry. 'Spikes' of progesterone occurred in 5.3% of premenarcheal saliva specimens but in only 1-2% of specimens from girls who were 4-6 years postmenarche. Two-hourly specimens from 53 pre- and postmenarcheal girls had 'spike' frequencies similar to those measured in daily specimens. PMID- 3805973 TI - Equivalence class formation in language-able and language-disabled children. AB - Stimulus equivalence seems to have relevance to the study of semantics and of language more generally. If so, there may be a relation between language use and the demonstration of stimulus equivalence. This was examined in three groups of children ranging in chronological age and matched on a conventional measure of mental age: normally developing preschoolers, retarded children who used speech or signs spontaneously and appropriately, and retarded children who did not. All children were taught a series of four related discriminations and were then tested to determine if classes of equivalent stimuli had formed. All of the language-able children (retarded and normal) formed equivalence classes, whereas none of the language-disabled children did so. Although the exact nature of the relation between stimulus equivalence and language remains to be clarified, these results support the view that stimulus equivalence is a phenomenon with relevance to language. PMID- 3805974 TI - Variable-ratio schedules as variable-interval schedules with linear feedback loops. AB - The mathematical theory of linear systems has been used successfully to describe responding on variable-interval (VI) schedules. In the simplest extension of the theory to the variable-ratio (VR) case, VR schedules are treated as if they were VI schedules with linear feedback loops. The assumption entailed by this approach, namely, that VR and VI-plus-linear-feedback schedules are equivalent, was tested by comparing responding on the two types of schedule. Four human subjects' lever pressing produced monetary reinforcers on five VR schedules, and on five VI schedules with linear feedback loops that reproduced the feedback properties of the VR schedules. Pressing was initiated by instructions in 2 subjects, and was shaped by successive approximation in the other 2. The different methods of response initiation did not have differential effects on behavior. For each of the 4 subjects, the VR and the comparable VI-plus-linear feedback schedules generated similar average response rates and similar response patterns. The subjects' behavior on both types of schedule was similar to that of avian and rodent species on VR schedules. These results indicate that the assumption entailed by the VI-plus-linear-feedback approach to the VR case is valid and, consequently, that the approach is worth pursuing. The results also confute interresponse-time theories of schedule performance, which require interval and ratio contingencies to produce different response rates. PMID- 3805975 TI - More on concurrent interval-ratio schedules: a replication and review. AB - It has been suggested that the failure to maximize reinforcement on concurrent variable-interval, variable-ratio schedules may be misleading. Inasmuch as response costs are not directly measured, it is possible that subjects are optimally balancing the benefits of reinforcement against the costs of responding. To evaluate this hypothesis, pigeons were tested in a procedure in which interval and ratio schedules had equal response costs. On a concurrent variable time (VT), variable ratio-time (VRT) schedule, the VT schedule runs throughout the session and the VRT schedule is controlled by responses to a changeover key that switches from one schedule to the other. Reinforcement is presented independent of response. This schedule retains the essential features of concurrent VI VR, but eliminates differential response costs for the two alternatives. It therefore also eliminates at least one significant ambiguity about the reinforcement maximizing performance. Pigeons did not maximize rate of reinforcement on this procedure. Instead, their times spent on the alternative schedules matched the relative rates of reinforcement, even when schedule parameters were such that matching earned the lowest possible overall rate of reinforcement. It was further shown that the observed matching was not a procedural artifact arising from the constraints built into the schedule. PMID- 3805976 TI - A pharmacological examination of the resistance-to-change hypothesis of response strength. AB - The effects of d-amphetamine sulfate, sodium pentobarbital, haloperidol, and cholecystokinin-octapeptide were examined within the context of Nevin's (1974, 1979) resistance-to-change hypothesis of response strength. In three experiments, rats' responding was reinforced by delivery of food under chained random-interval 30-s random-interval 30-s, multiple fixed-interval 30-s fixed-interval 120-s, or multiple random-interval 30-s random-interval 120-s schedules. Each rat received several doses of each drug and changes in response rate were measured. The resistance-to-change hypothesis predicts greater disruption of response rate relative to baseline in the initial component of the chained schedule and in the 120-s component of the multiple schedules. In the chained schedule cholecystokinin-octapeptide produced greater reductions in response rate relative to baseline in the initial component. However, no differences between components were observed with haloperidol or sodium pentobarbital, and high doses of d amphetamine reduced response rate in the terminal component relatively more than in the initial component. In the multiple schedules either no differences were observed between components or response rate was reduced more relative to baseline in the 30-s component. The data fail to support the notion that drugs may be viewed within the same context as other response disruptors such as extinction, satiation, and the presentation of alternative reinforcement. PMID- 3805977 TI - Similarities in the rate-altering effects of white noise and cocaine. AB - The effects of white noise and cocaine on squirrel monkeys' fixed-interval responding were compared to determine whether the presentation of an exteroceptive stimulus could produce rate-altering effects of the type typically observed following drug administration. To investigate the relationship between control response rate and response rate in the presence of drug or noise, the monkeys were trained under a fixed-interval 300-s stimulus-shock termination schedule in order to generate a wide range of local response rates. A light illuminated the experimental chamber during the interval and, after 300 s elapsed, a lever press during a 3-s period terminated the light and precluded the occurrence of a harmless electrical stimulus that otherwise was delivered at the end of the 3-s period. Each interval was followed by a 30-s timeout during which the chamber was darkened and responses had no consequences. Following intramuscular administration of cocaine, different rates of responding characteristic of control performance converged toward a common rate and, at an appropriately high dose, response rate during the fixed interval became more uniform. When white noise was presented continuously during a given session, different response rates also converged toward a common rate and, at an appropriate intensity, response rate became more uniform. Interactions were obtained when cocaine and white noise were presented together, indicating the possibility of a common behavioral mechanism of action. The results suggest that rate-altering drug effects may be, in part, a result of the ability of drugs to produce nonspecific stimulus effects similar to those observed for exteroceptive stimuli. PMID- 3805978 TI - Self-organization of ependyma in regenerating teleost spinal cord: evidence from serial section reconstructions. AB - Multiple ependymal structures have been observed in regenerating spinal cord of the teleost Apteronotus albifrons. Evidence is presented for two modes of formation of the secondary ependymas: budding off from the primary ependyma, and de novo origin of a tube-like ependymal structure within a group of undifferentiated cells. Serial sections of regenerated cord provide evidence that undifferentiated cells not in immediate contact with the main ependymal layer can organize and differentiate into an ependymal structure in the regenerating spinal cord. These findings suggest that a significant amount of morphological organization can take place independent of the normal developmental sequence and environment. PMID- 3805979 TI - Cell distribution during mouse secondary palate closure. II. Mesenchymal cells. AB - The patterns of distribution of both total mesenchymal cells and the ratios of [3H]thymidine-labelled to total cells were mapped during secondary palatal shelf reorientation in vivo and in vitro. Smoothed spatial averaging, a computer assisted method which takes into account the positions of all cells across an entire histological section of the shelf, was employed. Changes in shelf cross sectional area and cell size were also measured. Three shelf regions, anterior and posterior presumptive hard and presumptive soft palate, were studied at developmental stages which were 30, 24 and 18 h prior to expected in vivo elevation, after in vivo reorientation and during the course of in vitro reorientation. Region-specific patterns of cell distribution change with shelf reorientation. These changes were observable within 6 h. Increases in cell number by cell division may enhance some high local cell densities, but cannot account for decreases in cell density. Increase in cell size is not a factor in decreasing cell density, nor is cell death. Displacement of cells by expansion of the extracellular matrix may be involved. PMID- 3805980 TI - Axolotl retina and lens development: mutual tissue stimulation and autonomous failure in the eyeless mutant retina. AB - During eye development in the axolotl (Ambystoma mexicanum Shaw), morphogenetic movements bring together tissues from head epidermis, neuroectoderm and neural crest. The stages 0 to 14 of axolotl eye development were expanded from Rabl's (1898) stages 1 to 10 and correlated with Harrison's (1969) stages. At the onset of neurulation (stage 13 of Harrison), the head epidermis is already determined to form skin, and the neuroectoderm is committed to form brain, because these tissues develop autonomously in 60% Leibovitz L-15 culture medium. However, a sequence of mutual tissue interactions is necessary to stimulate eye development. When head epidermis and neuroectoderm were cocultured, eyes developed, containing retinas with photoreceptors (stage 8) and lenses with secondary lens fibres (stage 8). The first event needed in this case appears to be the secretion of a growth factor from the head epidermis which stimulates retina development from the neuroectoderm. When neuroectoderm cultures were exposed to nondialysable extracts (30 micrograms ml-1) of an adult epidermis derivative, the bovine cornea, pigmented retinas (stage 6) and at higher concentrations (3000 micrograms ml-1) neural retinas developed (stage 6). In turn, lens formation is stimulated in the head epidermis by a retina-derived growth factor. A mutation that causes adult eyelessness (e eyeless, nonlethal, recessive) affects the earliest event in eye development (stage 1a), while a mutation that causes arrest of eye development (mi microphthalmic, lethal, recessive) acts in a later event (stage 8). Two possibilities have been considered in the case of mutation e: either the head epidermis does not secrete sufficient amounts of active growth factor, or the presumptive retina itself is defective. The latter statement turned out to be correct, because mutant e neural plates rarely developed early retina stages (stage 5) in organ culture when combined with wild-type head epidermis. On the other hand, wild-type neural plates formed advanced retinas (stage 8) in all cases when combined with mutant e head epidermis. As expected, no retina or lens developed when both neural plate and head epidermis were from mutant e donors. The heterozygous presence of genes e and r (renal insufficiency, lethal, recessive) produces duplications of the presumptive retina at the optic stalk. This observation is consistent with the notion that the mutation e, assisted by the r locus, causes a primary failure in the presumptive retinal region. PMID- 3805981 TI - The clonal model of vertebral column development: a reinvestigation of vertebral shape using Fourier analysis. AB - Little work has been done on the skeletal system of allophenic mice (chimaeras). In this paper we re-examine the evidence presented for the clonal theory of vertebral development using quantitative methods which take account of variation. We conclude that the clonal theory is either an overly simplistic approximation of the real situation, or that the evidence so far given in its support is unsubstantiated. PMID- 3805982 TI - The histogenetic potential of neural plate cells of early-somite-stage mouse embryos. AB - The mesencephalic neural plate of early-somite-stage mouse embryos differentiated underneath the renal capsule to form mostly neural tissues together with other tissues some of which were probably of neural crest cell origin. The capacity to form non-neural tissues such as skeletal tissues and melanocytes was lost at about the 5-somite stage. The lateral areas of the plate tended to form non neural tissues more than the medial areas. The cephalic neural plate of presomite head-fold-stage embryos differentiated extensively to form both ectodermal and mesodermal tissues. However, upon completion of neurulation, the mesencephalic neuroepithelium of forelimb-bud-stage embryos gave rise to neural tissues only. Therefore there is a progressive restriction in the histogenetic capacity of the mesencephalic neural plate during neurulation and this could be attributed to the cellular commitment for neural differentiation and the loss of the neural crest cells. PMID- 3805983 TI - Neurulation and the cortical tractor model for epithelial folding. AB - We present here a new model for epithelial morphogenesis, which we call the 'cortical tractor model'. This model assumes that the motile activities of epithelial cells are similar to those of mesenchymal cells, with the added constraint that the cells in an epithelial sheet remain attached at their apical circumference. In particular, we assert that there is a time-averaged motion of cortical cytoplasm which flows from the basal and lateral surfaces to the apical region. This cortical flow carries with it membrane and adhesive structures that are inserted basally and resorbed apically. Thus the apical seal that characterizes epithelial sheets is a dynamic structure: it is continuously created by the cortical flow which piles up components near where they are recycled in the apical region. By use of mechanical analyses and computer simulations we demonstrate that the cortical tractor motion can reproduce a variety of epithelial motions, including columnarization (placode formation), invagination and rolling. It also provides a mechanism for driving active cell rearrangements within an epithelial sheet, while maintaining the integrity of the apical seal. Active repacking of epithelial cells appears to drive a number of morphogenetic processes. Neurulation in amphibians provides an example of a process in which all four of the above morphogenetic movements appear to play a role. Here we reexamine the process of neurulation in amphibians in light of the cortical tractor model, and find that it provides an integrated view of this important morphogenetic process. PMID- 3805984 TI - Cell-matrix interactions: influence of noncollagenous proteins from dentin on cultured dental cells. AB - Matrix-mediated epitheliomesenchymal interactions control dental cytodifferentiations. Experiments were performed in order to study the effects of noncollagenous proteins extracted from dentin on cultured enamel organs and dental papillae. Seven noncollagenous protein fractions were prepared from rabbit incisor dentin and used as substrates to coat Millipore filters. Embryonic mouse tooth germs were dissociated and the isolated tissues were cultured for 4 days on these different substrates as well as on noncoated Millipore filters. When compared to control cultures, only two protein fractions affected the behaviour of epithelial cells. A slight elongation of the cell body and a preferential localization of the nuclei at the basal pole of the cells in contact with the filter was observed with protein fractions 5 and 6. When dental papillae were cultured on Millipore filters coated either with protein fraction 2 or fraction 6, the mesenchymal cells in contact with the filter elongated, polarized and demonstrated a high metabolic activity. Such modifications in the cell organization, implying changes in the cytoskeleton organization and, or, activity, never occurred spontaneously or in the presence of isolated collagens (I-V), laminin or fibronectin. PMID- 3805985 TI - Effects of electric field on fusion rate and survival of 2-cell rabbit embryos. AB - Electric-field-induced blastomere fusion was studied in 2-cell rabbit embryos. Field strengths (1 to 3kV cm-1) and durations (35 to 1000 microseconds) were chosen so as to provide the right balance between fusion rate, viability and developmental capacity of embryonic cells. Maximum plasma membrane tolerance of 2 cell rabbit embryos was observed at about 3kV cm-1 for 1000 microseconds. All surviving 'fused' embryos were able to develop in vitro and most of them formed expanded blastocysts. Observation of 'fused' embryos immediately after fusion and during the whole cell cycle showed that 27.7% of the two diploid nuclei remained separated in the hybrid cell. More than one metaphase plate was formed at the onset of mitosis causing direct cleavage into three or four 'cells'. In the remaining embryos the two diploid nuclei seemed to form a common metaphase plate and cleaved into two equal blastomeres. After transfer to recipient does, 54.4% of these tetraploid embryos developed beyond implantation. Between day 11 and 20, ten live and morphologically fully normal embryos were recovered. Nine embryos were uniformly tetraploid and one recovered on day 18 was a diploid/tetraploid mosaic. The remaining implantation sites contained either abnormal, very retarded embryos or indefinable embryo remnants. After transfer of 'nonfused' embryos treated with 3kV cm-1, 49% gave birth to normal live young. These results suggest that the electric field can be applied successfully in a relatively wide strength and duration range without causing any visible teratogenic effect on treated embryos. Thus, tetraploid embryos can develop normally at least until two-thirds of pregnancy, but the question whether they are able to survive till term remains open. PMID- 3805986 TI - Regeneration of mammary glands in vivo from isolated mammary ducts. AB - Rat mammary ducts, free of buds, can alone regenerate complete mammary trees when transplanted into the interscapular fat pads of syngeneic host rats. All the main mammary cell types are identified within such outgrowths. Epithelial cells, which show the presence of milk fat globule membrane antigens and microvilli on their luminal surfaces, line the ducts. Basal cells surrounding the ducts show characteristic features of myoepithelial cells: immunoreactive actin and keratin within the cytoplasm, myofilaments, pinocytotic vesicles and hemidesmosomal attachments to the basement membrane. Cells within the end buds and lateral buds, however, show few if any cytoplasmic myofilaments and are relatively undifferentiated in appearance. Intermediate morphologies between these cells and myoepithelial cells are seen nearer the ducts. In this respect they exactly resemble the cap cells found in terminal end buds (TEBs) of normal mammary glands. Occasional epithelial cells within alveolar buds show the presence of immunoreactive casein, which is a product of secretory alveolar cells in the normal rat mammary gland. Dissected terminal end buds can regenerate similar ductal outgrowths. Thus, ductal tissue alone can generate all the major mammary cell types seen in the normal gland, including the cap cells. PMID- 3805987 TI - Disruption of segmentation in a short germ insect embryo. I. The location of abnormalities induced by heat shock. AB - The effect of heat shock (15 min at 48 degrees C) on segmentation has been investigated in the short germ embryo of the locust (Schistocerca gregaria). Prior to formation of the germ anlage and at the disc stage heat shock considerably reduced the survival of eggs but appeared to have little effect upon segmentation. At later stages heat shock had no effect on survival but resulted in disruptions of the segmental pattern. The location of abnormal segments depended upon the stage at heat shock and the number affected depended on its severity. A constant number of normal segments developed between the last segment visible at the time of heat shock and the first abnormal segment. These results are similar to the disruptions observed in amphibian somites following heat shock. However, different parts of the segment pattern varied in their response; the head segments were very rarely affected, and disrupted regions rarely started in the middle abdomen (segments A5 and A6). The results are discussed in relation to two models (the clock and wavefront and progress zone models) that have been proposed as an explanation for the specification of the somite pattern in amphibians. PMID- 3805988 TI - Disruption of segmentation in a short germ insect embryo. II. The structure of segmental abnormalities induced by heat shock. AB - A heat shock (of 15 min at 48 degrees C) given to early embryos of the locust, Schistocerca gregaria, results in localized abnormalities in the segment pattern subsequently formed. Most defects involve two consecutive segments of the thorax or abdomen, and these are analysed in detail. The abdominal defects fall into three main classes each of which involves the absence of a particular region of the segment pair and, in one class, duplication of the region which remains. The thoracic defects similarly involve absence of parts of the segments and the formation of a single limb base from which one, two, or three limbs develop. Heat shock may result in the absence of parts of segments in two distinct ways. It may interfere with the process of segmentation or it may delete parts of already formed segment primordia. These possibilities are discussed although, at present, neither can be excluded. The duplication observed in some abdominal disruptions and the formation of triple limbs indicates that the absence of parts of embryonic segments is followed by pattern regulation similar to that occurring in regeneration studies on larval segments and appendages of other insects. Two out of the three classes of abnormality can be explained in terms of intercalary regeneration restoring pattern continuity, but it is possible that discontinuities persist in the remaining class. PMID- 3805989 TI - Ciliary band formation in the doliolaria larva of Florometra. I. The development of normal epithelial pattern. AB - The development of ciliary band pattern in the doliolaria larva of Florometra serratissima is described based on scanning and transmission electron microscopy. The uniformly ciliated epithelium of the post-hatching larva develops four regularly spaced bands over a period of approx. 20 h generating an epithelial pattern that is, essentially, a series of stripes. The first visible events of pattern formation progress over the larval surface in a posterior-to-anterior and dorsal-to-ventral sequence, but the initial pattern is not, in fact, striped. It instead consists of a close-packed array of oval interband domains separated and surrounded by belts of band cells. Secondarily the interband domains expand laterally and coalesce to form continuous, broad stripes, while the bands remain as narrow stripes between them. Two possible explanations for this unusual sequence of events are discussed: that it can be understood in evolutionary terms with reference to band pattern in other echinoderm larvae, and that it is a morphogenetic necessity because limitations inherent in the patterning mechanism prevent the direct formation of regular stripes. PMID- 3805990 TI - The postnatal maturation of efferent tubules in the rat: a light and electron microscopy study. AB - The postnatal maturation of the epithelium and tubule wall of efferent tubules in the rat was investigated by light and transmission electron microscopy, from birth to 50 days of age, when sperms were released from the seminiferous tubules and appeared in the genital duct. At the end of the first week of life, an endocytotic apparatus is differentiated in the epithelial cells. During the third week of life, efferent tubules developed specializations for the transport of sperms and fluids, namely the appearance of ciliated elements interspersed among the principal cells of the epithelium, and differentiation of myoid elements in the tubule wall. The appearance of specializations related to endocytosis and fluid transport across the epithelium preceded the canalization of the seminiferous cords which, in fact, is reported to appear at the end of the second week of life in the rat, along with the initial secretion of testicular fluid. This suggested that the maturation of efferent tubules is not triggered by the passage of testicular fluid, as surmised for the postnatal differentiation of caput epididymis. The postnatal maturation of efferent tubules was almost complete 35 days after birth. The appearance of sperms in the genital duct of 50 day-old animals was not associated with any remarkable structural change. PMID- 3805991 TI - Cinemicrographic study of the cell movement in the primitive-streak-stage mouse embryo. AB - Migration of the mesoderm cells in the primitive-streak-stage mouse embryo was directly studied by cinemicrography using whole embryo culture and Nomarski differential interference contrast optics. Relative transparency and small size of the early mouse embryos enabled direct observation of the individual cells and their cell processes. Seven-day-old mouse embryos were isolated and cultured in a small chamber in a medium consisting of 50% rat serum and 50% Dulbecco's modified minimum essential medium. The mesoderm cells move away from the primitive streak in both anterior and antimesometrial (distal) directions at a mean velocity of 46 micron h-1. They extend cell processes and constantly change cell shape. They do not translocate extensively as isolated single cells, but usually maintain attachment to other mesoderm cells. They show frequent cell division preceded by rounding up of the cell bodies, and accompanied by vigorous blebbing before and after cytokinesis. This study shows that it is possible to examine the motility of embryonic cells inside the mammalian embryo by direct observation if the embryo is small and transparent enough for the use of the Nomarski optics. PMID- 3805992 TI - Blood pressure control during exercise in the Atlantic cod, Gadus morhua. AB - Atlantic cod were subjected to 12-15 min swimming exercise at 2/3 body lengths s 1 in a Blazka-type swim tunnel. Pre- and postbranchial blood pressures, cardiac output (ventral aortic blood flow) and heart rate were continuously recorded, and blood samples for measurement of arterial and mixed venous oxygen tension were taken before and at the end of the exercise period. In a second group of fish, subjected to similar exercise regimes, blood samples were taken for analysis of the plasma concentrations of catecholamines. Pre- and postbranchial blood pressures and cardiac output increase during exercise, while the mixed venous oxygen tension decreases. The effect on cardiac output is due to an increase of both heart rate and stroke volume. There are no significant changes in either systemic or branchial vascular resistances, or in the plasma concentrations of catecholamines. Injection of the adrenergic neurone-blocking drug bretylium produces a decrease in postbranchial blood pressure in resting cod, due to a decrease in the systemic vascular resistance. Exercising cod treated with bretylium have a significantly lower pre- and postbranchial blood pressure than exercising control cod. This is due mainly to a dramatic reduction in the systemic vascular resistance. The alpha-adrenoceptor antagonist phentolamine does not further affect the blood pressure in cod treated with bretylium. It is concluded that the exercise hypertension observed in cod depends on the effect of adrenergic vasomotor fibres maintaining the systemic vascular resistance, and also on the increase in cardiac output. An adrenergic innervation of the heart may play some role in the control of cardiac performance both at rest and during exercise, but the main cardioregulatory mechanism is likely to be non-adrenergic, most probably including cardiac control via variation of the cholinergic vagal cardioinhibitory tonus. PMID- 3805993 TI - Motor correlates of learning behaviour: feeding on novel prey by pumpkinseed sunfish (Lepomis gibbosus). AB - The functional basis of learning in prey capture was investigated in the pumpkinseed sunfish (Lepomis gibbosus). Feeding performance of sunfishes was assessed when the fish were first fed a novel, elusive prey (guppies) and compared with their performance after several weeks of experience with capturing guppies. During these feedings electromyographic recordings were made to document the pattern of activity in four jaw muscles at the strike. With experience, the L. gibbosus improved their ability to capture guppies, and several changes in the pattern of muscle activity were associated with this improved performance. Average duration and maximum amplitude of activity in all muscles increased between trials. Previous studies of muscle activity modulation in fishes indicate that these changes could improve feeding performance on an elusive prey. Thus, specific modifications of muscle activity appear to be one functional determinant of feeding success in fishes. PMID- 3805994 TI - Heat loss from deer mice (Peromyscus): evaluation of seasonal limits to thermoregulation. AB - This paper investigates the influence of seasonal adaptations to thermoregulatory heat loss for deer mice (Peromyscus) during summer and winter. A general, mechanistic model of heat transfer through fur was evaluated for the structural properties of the fur of deer mice. The model was validated against heat production determined from mice exposed to a range of radiative (wall) temperatures (tr) at air temperatures (ta) of 15, 27 and 34 degrees C. Calculated heat loss from the appendages was subtracted from the measured heat production to yield heat loss from the furred torso. This calculated torso heat loss agreed closely with the predicted fur heat loss for all conditions, as shown by a regression slope near 1 (0.99). Simulations using models of fur and appendage heat loss reveal that the winter increase in thermogenic (heat production) capacity has a greater effect than changes in fur properties in expanding the limits to thermoregulation. Both wind and a clear night sky increase heat loss and can limit thermoregulation to air temperatures above those found in deer mice habitats during winter (-25 degrees C). Thus, despite seasonal adaptations, these simulations indicate that thermoregulation is not possible under certain winter conditions, thereby restricting deer mice to within the protected environment of the leaf litter or snow tunnels. PMID- 3805995 TI - Effects of flow rate, duration of stimulation and mineralocorticoids on the electrolyte concentrations of mandibular saliva from the red kangaroo (Macropus rufus). AB - Mandibular saliva was collected at eight flow rates ranging between 0.052 +/- 0.0059 (S.E. of mean) and 4.294 +/- 0.0717 ml min-1 from anaesthetized red kangaroos receiving ipsilateral intracarotid infusions of acetylcholine. The concentrations of sodium (4.04 +/- 0.759 to 75.9 +/- 4.64 mmol l-1) and chloride (51.2 +/- 2.46 to 85.0 +/- 6.90 mmol l-1) and the osmolality (99.7 +/- 4.88 to 178.9 +/- 13.50 mosmol kg-1) were positively correlated with salivary flow rate over most or all of the flow range, whereas the concentrations of potassium (50.3 +/- 2.03 to 19.7 +/- 3.16 mmol l-1), calcium (5.43 +/- 1.696 to 1.26 +/- 0.055 mmol l-1), magnesium (259.8 +/- 49.3 to 19.0 +/- 1.88 mumol l-1), hydrogen ions (457.7 +/- 107.3 to 69.3 +/- 5.64 nmol l-1) and phosphate (2.22 +/- 0.171 to 0.27 +/- 0.040 mmol l-1) were negatively correlated with flow rate. Salivary bicarbonate concentration (15.6 +/- 1.76 to 21.9 +/- 1.83 mmol l-1) showed little flow dependency except possibly at high levels of stimulation. Spontaneous secretion was not observed during anaesthesia. During continuous stimulation of flow at two rates (0.5 and 2.0 ml min-1) for periods of 90 min, rest transients were observed for sodium, potassium, calcium, chloride and phosphate in the initial sample and the sodium concentration rose by 17-56% during the first 60 min of steady-state flow and stimulation. Indications that the gland was capable of responding rapidly to changes in endogenous mineralocorticoid levels were confirmed by intracarotid infusion of aldosterone at 80 micrograms h-1. With the mean salivary flow rate lying between 1.3 and 1.4 ml min-1, the salivary Na+/K+ ratio began to fall at 45-60 min of aldosterone infusion and after 4 h of infusion had fallen to 0.62 +/- 0.116. Administration of deoxycorticosterone acetate (DOCA) for 21 days at 0.25 or 0.3 mg kg-1 12 h-1 caused a further lowering of the Na+/K+ ratio to 0.09 +/- 0.013 at similar flow rates. Biopsy showed this increase to be associated with a moderate level of hypertrophy of the intralobular ducts of the gland. Two types of intralobular duct were identified on the basis of glycogen granulation after DOCA administration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3805996 TI - Diving behaviour and heart rate in tufted ducks (Aythya fuligula). AB - Diving behaviour and heart rate were monitored in tufted ducks diving under circumstances which simulated various environmental conditions such as feeding under ice in winter. When distance to food was increased on a covered outdoor pond, dive duration increased proportionately, but it was calculated that time available for feeding was reduced during the longer-distance 'extended' dives. There was a gradual reduction in heart rate to 77.3 +/- 13.8 beats min-1, which is significantly lower than the resting value of 121.1 +/- 14.1 beats min-1, during the course of extended dives, suggesting that the ducks could gradually switch over to a 'classical' oxygen-conserving response during these prolonged voluntary dives. The duration of the pre-dive preparatory period was positively correlated with dive distance. When the ducks were briefly unable to resurface during an otherwise normal feeding dive in an indoor tank, a situation which may occur if they become disoriented under ice, there was an immediate switch to a full bradycardia. Reduction in heart rate during these 'enclosed' dives occurred only when the ducks were apparently aware of the situation and the rate of onset of bradycardia was very similar to that previously observed during involuntary submersion of tufted ducks. Minimum heart rate was the same at 46 beats min-1 after 15 s of enclosed dives and after 30 s of involuntary submersions, despite the differences in levels of activity in the two situations. PMID- 3805997 TI - The absence of an arterial pressure effect on filtration by perfused glomeruli of the hagfish, Eptatretus stouti (Lockington). AB - Single renal corpuscles of hagfish were perfused with a Ringer solution containing Ficoll 70 to simulate the colloid osmotic pressure of hagfish plasma. Simultaneous measurements were made of single glomerulus filtration rate (SGFR), perfusion pressure and the pressure in a vessel of the renal vasculature. The results confirm that SGFR is independent of pressure in the glomerular capillaries (PGC). The results also suggest that flow through glomeruli and SGFR are closely linked. Studies of the pressures in glomerular capillaries during periods when the perfusion rate was varied indicate that PGC reflects the area of the active capillaries and the rate of perfusion. Therefore, in the hagfish, PGC appears to be an effect of factors that cause glomerular filtration, not the main cause of that process. PMID- 3805998 TI - Iron-containing cells in the honey-bee (Apis mellifera). I. Adult morphology and physiology. AB - Particulate iron was found within the trophocytes of the fat body of the adult honey-bee. These iron granules differed in their structure and composition from iron granules found in other biological systems. The granules had an average diameter of 0.32 +/- 0.07 micron and were composed of iron, calcium and phosphorus in a non-crystalline arrangement. The granules were apparently randomly distributed within the cytoplasm of the cells, and were not associated with any particular cellular organelle. Electron microscopy revealed the presence of cell junctions between the trophocytes. In tissues treated with colloidal lanthanum, 20-nm gaps were seen between the outer leaflets of the cells forming the cell junction. Physiological studies showed that these cells are electrically coupled, but the coupling ratio is low, as a result of extensive coupling to many cells. PMID- 3805999 TI - Iron-containing cells in the honey-bee (Apis mellifera). II. accumulation during development. AB - The development of iron granules in honey-bee tissues was investigated using both anatomical and analytical methods. Iron granules are present only in the trophocytes of post-eclosion adults and have the same elemental composition as those in foraging adults. The granules increase in both size and number during ageing. Iron levels in developing worker honey-bees were measured by proton induced X-ray emission spectroscopy. The rate of iron accumulation was directly related to iron levels in the diet, and the iron can be obtained from pollen and honey, both major food sources of the bee. In adults, the iron content of the fat body reached a maximum level (2.4 +/- 0.15 micrograms mg-1 tissue), regardless of the amount of iron available for ingestion. Maximal iron levels are reached at the time when honey-bee workers commence foraging behaviour, suggesting that iron granules may play a role in orientation. Alternatively, accumulation of iron in granules may be a method of maintaining iron homeostasis. PMID- 3806000 TI - Kinematics and aerodynamics of the greater horseshoe bat, Rhinolophus ferrumequinum, in horizontal flight at various flight speeds. AB - The kinematics and aerodynamics of the greater horseshoe bat, Rhinolophus ferrumequinum, in horizontal flight at a range of velocities are described. As flight speed increases there is a gradual change in the bat's wingbeat kinematics, wingbeat frequency decreasing and wingbeat strokeplane angles increasing. Associated with these changes are changes in the wings' incidence angles, particularly during the upstroke. At low speeds these are large and negative, suggesting thrust generation, while at high speeds these are positive and large, indicating that weight support and negative thrust are being generated. The change from one kinematic pattern to the other occurred gradually. The possible energetic and aerodynamic reasons for these changes are discussed. PMID- 3806001 TI - Non-invasive measurement of respiratory tidal volume in aquatic, air-breathing animals. PMID- 3806002 TI - Calcium-dependent action potentials in the prothoracic gland of Manduca sexta. PMID- 3806003 TI - Thermal dependence of contractile properties of skeletal muscle from the lizard Sceloporus occidentalis with comments on methods for fitting and comparing force velocity curves. AB - The isometric and isotonic contractile properties of fast-twitch glycolytic fibres of the iliofibularis muscle (FG-IF) in the lizard Sceloporus occidentalis were measured in vitro at 5 degrees C intervals form 10 to 40 degrees C. The mean isometric parameters at 35 degrees C, the preferred body temperature of this species, were as follows: maximum isometric force (Po), 187 +/- 8 (S.E.M.) kNm-2; ratio of twitch force to tetanic force (PTW/Po), 0.46 +/- 0.02; time to peak twitch tension (tPTW), 7.0 +/- 0.3 ms; and time from peak twitch force to 50% relaxation (t50% ), 8.2 +/- 0.3 ms. From 20 to 35 degrees C Po was almost constant (within 8% of the value at 35 degrees C). At 10 and 15 degrees C C. Po dropped to approximately 80% of the value at 35 degrees C. Po was very unstable at 40 degrees C. PTW/Po was almost constant at all temperatures. The time-related isometric parameters were positively modified by temperature at all temperatures measured (Q10 greater than 1.9). The force-velocity curves of the FG-IF deviated from the simple hyperbolic relation of A. V. Hill's characteristic equation. We present two alternative equations for fitting these data. These equations resulted in residual sums of squares from nonlinear least-squares analysis that were at least seven-fold lower than those from Hill's equation. The equation that best describes our data is a hyperbola modified by the addition of a linear component: V = B(1 - P/Po)/(A + P/Po) + C(1 - P/Po). To describe the curvature of this or any other force-velocity relationship, we propose the power ratio, Wmax/VmaxPo (where Wmax is the maximum power calculated from the force-velocity relationship and Vmax is the predicted maximum velocity of shortening at zero force). Vmax of the FG-IF was 21.9LoS-1 at 35 degrees C (where Lo is muscle length). This parameter was directly related to temperature between 10 and 35 degrees C with Q10 greater than 1.8. The shape of the force-velocity curve is not influenced by temperature (Wmax/VmaxPo = 0.11). PMID- 3806004 TI - Thermal dependence of sprint performance of the lizard Sceloporus occidentalis. AB - Sprint velocity of the lizard Sceloporus occidentalis was maximal at preferred body temperature (Tb, 35 degrees C). Mean running velocity (VR) and stride frequency (f) at this temperature were 3.23 +/- 0.7 (mean +/- S.E.M.) ms-1 and 15.6 +/- 0.3 s-1, respectively. VR and f did not change significantly when Tb was raised to 40 degrees C. At Tb values between 25 and 35 degrees C the thermal dependencies of VR (Q10 = 1.23) and f (Q10 = 1.12) were quite low. At Tb values below 25 degrees C the thermal dependence of these factors increased markedly. Stride length (LS) was independent of Tb from 15 to 40 degrees C. Lizards with a Tb of 10 degrees C were largely incapacitated, and VR, f and LS were all greatly reduced. Comparisons with measurements of the contractile properties of skeletal muscle of this species suggest that stride frequency is limited by the twitch contraction time at temperatures below 23 degrees C. At higher temperatures, sprint performance is nearly independent of the thermal effects on the muscles. PMID- 3806005 TI - Acquisition of potential for sperm motility in rainbow trout and chum salmon. AB - The male reproductive organ of rainbow trout and chum salmon consists of a pair of testes and sperm ducts. Spermatozoa in the distal portion of the sperm ducts exhibit full motility in the K+-free medium. However, spermatozoa from the testis were almost immotile in this medium. This suggests that the spermatozoa acquire a capacity for movement during their passage from the testis along the sperm duct. In chum salmon migrating into a bay, the sperm duct was almost empty. However, after the fish have travelled upstream for 1 km to their spawning ground in the river, the spermatozoa have left the testis, moved into the sperm duct and are capable of becoming motile. Thus it is probable that the process of acquiring the ability to move occurs within a relatively short period in this simple reproductive organ. Additionally, testicular spermatozoa demembranated with Triton X-100 exhibited motility, although the motility was less than that of demembranated spermatozoa from the sperm duct, suggesting that the acquisition of motility may correspond with the development of some function of the plasma membrane. PMID- 3806006 TI - A possible role for protein dissociation in the functioning of embryonic haemoglobins. PMID- 3806007 TI - The influence of facial characteristics on children's age perceptions. AB - To examine the impact of age-related variations in facial characteristics on children's age judgments, two experiments were conducted in which craniofacial shape and facial wrinkling were independently manipulated in stimulus faces as sources of age information. Using a paired-comparisons task, children between the ages of 2 1/2 and 6 were asked to make age category as well as relative age judgments of stimulus faces. Preschool-aged children were able to use variations in craniofacial profile shape, frontal face feature vertical placement, or facial wrinkling to identify the age category of a stimulus person. Children were also able to identify the older, but not the younger, of two faces on the basis of facial wrinkling, a finding consistent with previously demonstrated limitations in young children's use of relative age terms. The results were discussed in the context of research which reveals parallel effects of craniofacial shape and wrinkling on the age judgments of adults. PMID- 3806008 TI - Evidence for a general category of oblique orientations in four-month-old infants. AB - Recent work on orientation perception and memory in infants suggest that oblique stimulus orientations are treated as members of a category. The two studies in this report support this hypothesis and extend previous findings by demonstrating that this category includes obliques on either side of vertical even when infants are previously exposed to obliques on only one side. PMID- 3806009 TI - The impact of extended practice on rate of mental rotation. AB - 9-, 13-, and 20-year-olds were tested on 3840 trials of a mental rotation task in which they judged if pairs of stimuli presented in different orientations were identical or mirror images. Response time increased linearly as a function of the difference in orientation of the stimuli, and the slope of this function was used to estimate rate of mental rotation. At all ages, mental rotation became faster over trials. Age differences in rate of mental rotation were eliminated after approximately 1500 trials. At all ages the influence of practice was well characterized by hyperbolic and power functions. Furthermore, children's and adolescents' data were well fit by hyperbolic and power functions in which most of the parameters of those functions were constrained to adults' values. These results are discussed in terms of possible mechanisms underlying the impact of practice. PMID- 3806010 TI - Comprehension in "hyperlexic" readers. AB - Mentally retarded children who can read aloud written words better than one would expect from their Mental Age are often called hyperlexic. The reading comprehension thought to be impaired in such children was investigated in four experiments. Mentally retarded advanced decoders, including autistic and nonautistic children, were compared with younger nonretarded children matched for Mental Age and Reading Age. Experiment 1 established that mildly mentally retarded readers could match sentences to pictures as well as could be expected from their verbal ability. This was the same whether they read the sentences or heard them. Experiment 2 demonstrated that only the more able retarded subjects, but not the less able ones, used sentence context in a normal way in order to pronounce homographs. Experiments 3 and 4 showed that these same more able children could extract meaning at both sentence and story level, and their performance was indistinguishable from that of normal controls. Hence, it is doubtful whether these advanced decoders should be called hyperlexic. In contrast, the readers of relatively low verbal ability performed much worse than their normal controls. Although they could be induced under certain conditions to read sentence-by-sentence rather than word-by-word, they did not do so spontaneously. Furthermore, they did not make use of already existing general knowledge in order to answer questions about the stories they had read. The ability to comprehend in terms of large units of meaning seems to be specifically impaired in these low verbal ability fluent readers. We suggest that it is this impairment that marks true hyperlexia. Since there were no differences between autistic and nonautistic readers on any of our tasks, we conclude that hyperlexia is not an autism-specific phenomenon. PMID- 3806011 TI - Preventive effects of acute inflammation on liver cell necrosis and inhibition of heparan sulphate synthesis in hepatocytes. AB - The hepatocytoprotective effect of acute, turpentine-induced inflammation on experimental liver injury, caused by thioacetamide and D-galactosamine, respectively, was studied in relation to the synthesis of glycosaminoglycans and of heparan sulphate in hepatocytes isolated from livers of treated rats. As judged from biochemical parameters of liver cell lesion in serum (various cytosolic and mitochondrial enzymes, bile acids) the extent of liver damage caused by either noxious agent was greatly attenuated under acute inflammatory conditions. There was an inverse statistical correlation (r = -0.63 to r = -0.84) between the functional concentration of a proteinase inhibitor protein determined with the chromogenic substrate assay for human alpha 2-macroglobulin and the catalytic concentrations of various cell leakage enzymes in serum from liver injured rats with turpentine-generated inflammation. The strong inhibition of heparan sulphate synthesis in hepatocytes from injured livers (synthesis rate between 0.2 and 0.4 of that in control cell incubations) is abolished in hepatocytes from livers exposed to the noxious agents but with acute inflammation. The latter condition alone caused a 1.8 fold increase in heparan sulphate synthesis of hepatocytes. Heparan sulphate was the only type of glycosaminoglycan synthesized under all conditions. The results are discussed in view of the pathogenetic potential of heparan sulphate for liver cell necrosis. PMID- 3806012 TI - Phosphoglycerate kinase deficiency: biochemical studies on hair follicles. AB - A fluorimetric procedure for the determination of phosphoglycerate kinase in single human hair follicles is described. Enzyme studies on different parts of hair follicles after dissection show that the distribution of glucose-6-phosphate dehydrogenase matches that of phosphoglycerate kinase. Glucose-6-phosphate dehydrogenase can therefore be used as a reference enzyme to compensate for differences in hair follicle sizes. It was shown that the variation in the values found in individual hair follicles is improved by relating phosphoglycerate kinase to glucose-6-phosphate dehydrogenase activity. In areas of the world where glucose-6-phosphate dehydrogenase deficiency occurs frequently, an autosomally inherited reference enzyme may be preferred. It is shown that 6-phosphogluconate dehydrogenase is useful in this respect. Upon storage a gradual drop in the activity of all three enzymes was observed, but the rate of decrease was about equal: the enzyme activity ratio was, therefore, almost unaffected for a period of one week. This allows the determination of phosphoglycerate kinase even in mailed hair follicles. PMID- 3806013 TI - The isoelectric focusing of creatine kinase variants: II. The heterogeneity of creatine kinase in human serum with normal and elevated catalytic concentrations. AB - An effective and reliable method for the quantitative estimation of creatine kinase-MB, creatine kinase-MM variants and mitochondrial forms of creatine kinase in serum is presented. The high resolving power of isoelectric focusing allows the use of tetrazolium salts and meldola blue for the quantitative measurement without interfering non-specific reduction. The addition of thiol compounds to the agarose medium increases the sensitivity of the method, due to the inhibition of sulfhydryl group oxidation, and prevents enzyme degradation, which is a possible cause of an artificial heterogeneity. Depending upon the type of muscle and the degree of cell damage, we found 3-4 creatine kinase-MM sub-bands in sera with activities below 80 U/l. At elevated creatine kinase activities 3-11 creatine kinase-MM sub-bands were found. The appearance of creatine kinase-MB in serum indicates that damage has occurred to certain organs, especially the cardiac muscle. An organ with moderate or massive cell damage could release, in addition to the sarcoplasmatic creatine kinase variants, other forms with more alkaline isoelectric points (mitochondrial creatine kinase). The presence of such bands in serum of patients correlates with poor prognosis. Besides the separation of creatine kinase-MM sub-bands, creatine kinase-MB, creatine kinase-BB and of macroforms 1 and 2, the advantage of this method is the detection of mitochondrial creatine kinase forms, which in cellulose acetate electrophoresis migrate with creatine kinase-MM. PMID- 3806014 TI - Reference values for free amino acids and other biochemical constituents in serum of male rabbits. AB - Reference values for free amino acids in male rabbits (n = 145) were determined by gas chromatography. In addition, reference values for glucose, serum transaminase activities (aspartate aminotransferase, alanine aminotransferase), and serum protein fractions are reported. PMID- 3806015 TI - [Comparative quantitative clinico-chemical analysis of the characteristics of 24 hour urine and morning urine]. AB - Ten clinical chemical parameters were used to investigate the relationship between morning urine and 24-hour urine in 80 healthy probands. During the period of the investigation there were no dietary restrictions. A period of at least 4 hours was required between the previous micturation and the collection of morning urine. The following parameters were determined: sodium, potassium, chloride, creatinine, urea, uric acid, glucose, calcium, inorganic phosphorus and total protein. Every parameter, with the exception of total protein, was determined without prior manual dilution, by a fully mechanized procedure, using a multichannel analyser SMA 12/60 (Technicon) adapted for routine purposes. The data showed: The scatter of the excretory values is generally lower in 24-hour urine than in morning urine, but collectively the reference intervals are relatively wide. Almost without exception, there is a significant correlation between excretion in the 24-hour and morning urines, but the average correlation coefficient is only 0.5. The determined reference intervals (10/90 percentile) for the concentrations of the parameters in 24-hour and morning urines are largely in agreement. It is concluded from the data that the composition of morning urine of apparently healthy probands adequately reflects excretion of 24 hours. It remains to be seen whether this is also true for pathological states. PMID- 3806016 TI - [Methodological aspects of the photometric determination of prothrombin time using chromogenic substrates]. AB - A method for photometric determination of prothrombin time (PT) with a chromogenic peptide as substrate is described. The reagent contains human placental thromboplastin, a chromogenic substrate, calcium, a heparin antagonist and buffer. The new prothrombin time method has been calibrated against international reference preparations for thromboplastin. The reagent is sensitive to deficiency of all coagulation factors of the extrinsic pathway. However, it is not sensitive for heparin up to 1 IU/ml. The precision of this fast and simple method is comparable to that of mechanised assays for clinical chemistry. PMID- 3806017 TI - Multicentre evaluation of an enzymatic method for creatinine determination using a sensitive colour reagent. AB - A new enzymatic colorimetric method for the determination of creatinine in serum and urine (Creatinine PAP, Cat. No. 839434 and 836885, Boehringer Mannheim GmbH, Mannheim, FRG) was evaluated in 16 clinical chemistry laboratories and the manufacturer's testing laboratory. The test is based on the enzymatic degradation of creatinine and its reaction products by creatininase, creatinase and sarcosine oxidase. The H2O2 produced by the oxidation of sarcosine is determined using a modified Trinder reaction. The test can be carried out either manually or in mechanized analysers which enable the pipetting of a starter reagent to be made. The following results were obtained: Depending on the analyte concentration (range 40 to 1240 mumol/l), medians for the coefficients of variation were: 4.6 0.9% within-run and 6.4-2.8% between-day. At 546 nm the linear measuring range extended from 13 mumol/l (detection limit) to 1780 mumol/l, at 510 nm from 9 to 890 mumol/l. Recoveries in aqueous and human serum based standards as well as method comparisons with Fuller's earth methods and an enzymatic UV test indicate a high accuracy of this new enzymatic method in serum and urine. No interference was observed with haemolysed and lipaemic sera. This also applied to anticoagulants and to 36 drugs at therapeutic concentrations, with the exception of calcium dobesilate, which led to decreased values. Icteric samples containing 120-310 mumol/l bilirubin invariably led to decreased creatinine values (10-50 mumol/l lower). In a collaborative study substantially better interlaboratory agreement was observed with the new colorimetric enzymatic test than with the comparison methods (enzymatic UV test and various Jaffe procedures). In conclusion, this new enzymatic colorimetric test permits a precise and specific determination of creatinine in serum and urine. It makes a considerable contribution to improving the interlaboratory comparability of creatinine determinations and is suitable for routine use. PMID- 3806018 TI - Evaluation of a new inhibitor test for isoamylase on Hitachi 705 analyser. AB - We describe a simple and rapid method for measuring pancreatic and salivary type amylases using the Hitachi 705 analyser. The determination is based on the inhibition of salivary amylase using an inhibitor isolated from wheat germ. The precision of the proposed method was very good: within-day precision varied from 0.4 to 2.5% (CV) and day-to-day precision from 2.2 to 3.7% (CV). The new application correlated well with another commercially available inhibition method. As the standardization is very stable and the assay procedure exactly the same as for the total amylase assay, the proposed method is suitable for routine isoamylase determination. Reference values for pancreatic and salivary amylase activities are presented. PMID- 3806019 TI - Perinatal outcomes and family medicine: refocusing the research agenda. PMID- 3806020 TI - Lower genitourinary infections in women. PMID- 3806021 TI - Patient expectations of family physician. PMID- 3806022 TI - Prevalence of hypertension. PMID- 3806023 TI - Chronic factitious disorder with physical symptoms (Munchausen's syndrome): the early presentation. PMID- 3806024 TI - The reevaluation visit for acute otitis media. AB - Seventy children with acute otitis media diagnosed at a suburban, private primary care practice were examined after a ten-day course of antibiotic therapy and were then monitored closely for an additional 20 days. Parents were advised to seek prompt attention if symptoms of earache, fussiness, or fever recurred at any time during the 30-day study period. Of 14 symptomatic recurrences of acute otitis media, eight (57 percent) occurred within one week of discontinuing antibiotic therapy. Four (10 percent) of 41 children with persistent otitis media with effusion on days 10 to 14 developed symptomatic acute otitis media over the next 18 days, as did four (17 percent) of 23 children who had a normal middle ear examination on days 10 to 14. Early follow-up visits immediately following antibiotic therapy commonly detect persistent otitis media with effusion but appear to have limited value in detecting asymptomatic, posttreatment acute otitis media. the optimal timing of reevaluation visits for children with acute otitis media deserves further study. PMID- 3806025 TI - Lower extremity burns related to sensory loss in diabetes mellitus. AB - A chart review of 37 hospitalized patients with diabetes mellitus who received burn therapy showed that ten (27 percent) had preventable lower-extremity burns related to sensory loss. Most of these ten burns occurred from heat applied for self-care of diabetes, namely, from hot tap water, a hot moist compress, or a heating pad. These ten patients, compared with the other 27 diabetic burn patients, were more likely to be men younger than 45 years old, to have insulin dependent diabetes, and to have been burned during self-treatment. These findings underscore the importance of injury-prevention educational efforts by physicians in cautioning their diabetic patients, especially those with lower-extremity sensory losses, about potential burns from heat applied to the lower extremities for self-care. PMID- 3806026 TI - Adverse perinatal outcomes: is physician specialty a risk factor? AB - An investigation was conducted in a community hospital to determine whether physician specialty (obstetrics vs family medicine) is a risk factor for adverse perinatal outcomes. Over a three-year period, there were 6,856 deliveries, of which 713 (10.4 percent) were attended by family physicians. Overall, there were 301 (4.4 percent) cases with adverse outcomes, of which 32 (10.6 percent) were attended by family physicians. The charts of a weighted random sample of 117 cases with adverse outcomes and 468 controls were reviewed to determine potential risk factors, including prenatal risk status, race, insurance, and specialty of the attending physician. The risk ratio for family physician as attending was 0.99 (95 percent confidence interval, 0.69 to 1.42) after multivariate adjustment for the other risk factors. Only high prenatal risk status was found to be an independent predictor (risk ratio 1.75, 95 percent confidence interval, 1.23 to 2.49). A chart review of a random sample of 146 patients (73 each of family physicians and obstetricians) revealed no difference in the proportion of high risk patients in each specialty. It is concluded that in the setting studied, specialty is not a risk factor for adverse perinatal outcomes, and that this finding is not confounded by the patient's prenatal risk status. PMID- 3806027 TI - The quality of obstetric care in family practice: are family physicians as safe as obstetricians? AB - A literature review on the quality of obstetric care in family practice was conducted to determine whether family physicians are as competent in providing obstetric care as obstetricians. Three types of studies were reviewed: case series, historical cohorts, and population-based studies. No conclusion on the quality of obstetric care in family practice can be drawn from the available studies because of research design limitations. Available evidence suggests, however, that family physicians are as safe as obstetricians when delivering babies, particularly when they concentrate their efforts on providing personal prenatal care, refer high-risk pregnant women appropriately, and practice less technologically oriented care on women who deliver normal-weight babies. In addition, no evidence emerged that family physicians provided significantly poorer obstetric care than obstetricians. In fact, the results from population based studies suggest that family physicians may be safer than obstetricians in delivering normal-weight infants because of their hypothesized less use of technological interventions in that low-risk group of patients. Further studies, especially prospective randomized trials in which the outcomes are assessed in a blinded fashion and case mix is rigorously controlled, are needed to provide a definitive answer. As practical, ethical, and economic constraints are likely to preclude such studies, the case-control design may provide a reasonable alternative. PMID- 3806028 TI - A new method for measuring continuity of care in family practice residencies. AB - Continuity of relationship between physician and patient is a fundamental aspect of the health care provided by family physicians. Measurement of continuity has proved difficult, however. Commonly applied measures, usual provider of care (UPC), continuity of care (COC), and the modified continuity index (MCI), either ignore key aspects of continuity or provide misleading results. Consequently, a new measure of continuity, the modified, modified continuity index (MMCI), with a possible range of 0 to 1, was developed to overcome these problems. It was applied to a residency model practice, in which mean MMCI was found to be 0.59 (range 0.3 to 1.0). Mean COC was .41 and a mean MCI was .44. Thus, unlike COC and MCI, MMCI suggests fairly good continuity of care in this practice while still implying possible improvement. The MMCI should be useful for enhancing training and practice of family medicine. PMID- 3806029 TI - Patient education and the physician-patient relationship. AB - Noncompliance is a major problem that patient education aims at resolving. The emphasis in patient education upon didactic strategies, educational content, and materials distracts from perhaps the most important factor in the success of patient education, that is, the quality of the physician-patient relationship. In the context of the physician-patient relationship many of the patient's psychological needs, wishes, and fears will be revealed, and these factors have bearing upon compliance and the ability to make use of patient education. When the physician develops a psychotherapeutic attitude characterized by empathic attunement to the patient and his or her underlying psychological reasons for resistance to medical advice, the likelihood of accepting patient education increases. PMID- 3806030 TI - Smoking counseling practices of recently trained family physicians. PMID- 3806031 TI - Effects of waiting on patient mood and satisfaction. PMID- 3806032 TI - A comparison of patient satisfaction among prepaid and fee-for-service patients. AB - This study compares levels of patient satisfaction (a valid, indirect measurement of quality of care) between prepaid and fee-for-service patients. A chart audit approach was used to determine whether prepaid and fee-for-service patients seen in an academic family health center at the end of the first six months of a new cost-containment program were comparable in terms of demographic characteristics and indirect measures of health and health behavior. Next, using a 26-item patient satisfaction questionnaire, 436 patients from a single group of providers in the same family health center seen six months after the programs began were randomly surveyed. Sociodemographic and health-related characteristics of prepaid and fee-for-service patients were similar for both groups in the chart audit. There was no statistically significant difference between the overall satisfaction levels of prepaid and fee-for-service patients. Individual constructs that comprise general satisfaction were also statistically similar except for an unexpected finding of dissimilar levels of satisfaction with "physician conduct/humaneness" (P less than .05). Assessed from at least one standpoint, cost containment does not seem to affect overall quality of care, but further investigation is needed, especially in the realm of "physician conduct/humaneness." PMID- 3806033 TI - Screening for colorectal cancer. PMID- 3806034 TI - Prevalence of panic attacks. PMID- 3806036 TI - More family physicians needed in Florida. PMID- 3806037 TI - Sovereign immunity. PMID- 3806035 TI - Cocaine and rhabdomyolysis. PMID- 3806038 TI - Treatment of sickle cell disease with danazol. PMID- 3806039 TI - The single-unit transfusion. PMID- 3806040 TI - Barriers to effective medical discipline and some possible solutions. PMID- 3806041 TI - Physicians and the challenge of politics. PMID- 3806042 TI - The drug problem: tilting with windmills. PMID- 3806043 TI - Ocular injuries in sports. PMID- 3806044 TI - Effects of exercise in diabetes mellitus. PMID- 3806045 TI - The benefits and reproductive risks of exercise to women. PMID- 3806046 TI - Overuse syndrome. PMID- 3806047 TI - Athletic injuries caused by the new sport of windsurfing and a proposed set of preventive measures. PMID- 3806048 TI - Prison health care: problems and alternatives in delivery of health care to the incarcerated--Part II. PMID- 3806049 TI - Arginine deiminase of Mycoplasma hominis: cytoplasmic and membrane-associated forms. AB - Membrane and cytoplasmic fractions of Mycoplasma hominis inhibited the multiplication of this mycoplasma. Arginine deiminase (EC 3.5.3.6), isolated from both fractions, reproduced the inhibition. The purified cytoplasmic deiminase had a subunit Mr of 49,000, a specific activity of 53 units (mg protein)-1 and an A280/A260 ratio of 1.76. The membrane-associated enzyme had an identical Mr but lower values for specific activity [39 units (mg protein)-1] and the A280/A260 ratio (1.46). In experiments in vitro, recent clinical isolates of M. hominis produced less arginine deiminase, but grew faster than the laboratory reference strain PG 21. In addition, other growth inhibitory components associated with membrane preparations were detected in recent clinical isolates but were absent from strain PG 21. PMID- 3806050 TI - Analysis of EDTA-soluble cell surface components of gram-positive anaerobic cocci. AB - The protein content of EDTA extracts from 76 strains of Gram-positive anaerobic cocci was examined using SDS-PAGE. Strains of Peptostreptococcus anaerobius produced almost identical profiles; greater heterogeneity was observed within the species Peptococcus magnus, Peptococcus prevotii and Peptococcus asaccharolyticus, but several strains within each biotype produced similar patterns. Serological investigation of these extracts by ELISA revealed numerous cross-reactions among the different biotypes. Immunoblot transfers from polyacrylamide gels demonstrated two common antigens within strains of the species, Ps. anaerobius, but these were not species-specific. PMID- 3806051 TI - Host modification of the adherence properties of Chlamydia trachomatis. AB - The adherence of Chlamydia trachomatis LGV440(L1) to human HeLa 229 and mouse McCoy cells was stimulated by the lectin wheat germ agglutinin (WGA) and inhibited by the sugars N-acetyl-D-glucosamine, N-acetyl-D-galactosamine and chitobiose, but only when the chlamydiae had been passaged several times in HeLa cells. After passage in McCoy cells, the lectin and the sugars elicited little response. The non-LGV serovar UW-31(K), however, differed from LGV440(L1) in that, regardless of passage, the lectin and sugar effects were observed only in HeLa cells. Affinity chromatography on WGA-agarose confirmed that HeLa-grown LGV440(L1) bound to a significantly greater extent relative to McCoy-grown chlamydiae. In addition, participation of heterogeneous chlamydial ligands was suggested by the observation that the adherence of heated (60 degrees C, 5 min) UW-31(K) to HeLa cells at 37 degrees C was not inhibited at all, but at 5 degrees C, the adherence rate was greatly reduced, indicating the participation of heat stable as well as heat-labile ligands. These data are interpreted to indicate that the passage history of C. trachomatis results in the acquisition of altered surface components that participate in the initial interaction of the bacterium with the host. PMID- 3806052 TI - On the aetiology of bovine farcy in the Sudan. AB - Fifteen strains of the agent of bovine farcy were isolated from lymph nodes of affected cattle. Quantitative analyses of mycolic acids revealed values that allowed the assignment of these strains to the genus Mycobacterium. The organisms bore a greater resemblance to Mycobacterium farcinogenes than to Mycobacterium senegalense. PMID- 3806053 TI - Isolation and preliminary taxonomic studies of Thermus strains isolated from Yellowstone National Park, USA. AB - Forty-eight strains of Thermus isolated from hot springs in Yellowstone National Park, Wyoming, USA, and eight reference strains were subjected to a numerical taxonomic analysis using Gower's coefficient (SG) with single and average linkage clustering. Two major groups were distinguished, which could be differentiated by colony morphology, ability to reduce nitrate and proteolytic activity. Cluster 1 contained Thermus aquaticus YT-1, the type strain of the species, and cluster 2 contained authentic strains of 'T. flavus' and 'T. thermophilus'. T. ruber was recovered as a single member cluster. The mol % G + C of DNA from representative strains from each cluster was 64.4 to 66.8 for cluster 1, 62.2 to 67.1 for cluster 2 and 62.5 for T. ruber. PMID- 3806055 TI - The isolation and characterization of bacteriophages infecting obligately thermophilic strains of Bacillus. AB - Twenty-four thermophilic bacteriophages have been isolated from diverse sources such as compost, soil, silage and rotting straw. Although considerable individual host specificity was observed, the phages were able to infect most of the major taxonomic groups of Bacillus thermophiles. The phages varied considerably in morphology and size; the phage heads were either cylindrical or polyhedral with tails varying in length between 15 and 500 nm. Most of the phages were stable at 50 degrees C for 4-5 h but at 70 degrees C the plaque-forming units decreased by between 10(2)- and 10(7)-fold in 2 h. The DNA of morphologically similar phages was examined by restriction enzyme analysis, and some differences in the DNA fragment patterns were found. Efficiency of plating data indicated that 'B. caldotenax' has a restriction and modification system. These phages may be valuable for the study of the genetics of thermophilic bacilli: transduction of 'B. caldotenax' and 'B. caldovelox' by phage JS017 has been observed. PMID- 3806054 TI - Characteristics of the developmental cycle of actinophage phi C31. AB - Some characteristics of the lytic development of the temperate phage phi C31 in Streptomyces coelicolor A3(2) were studied using a thermoinducible lysogen. The physiological state of the host and the culture medium influenced the production of progeny virus after induction. The latent period lasted 45 min and the rise period 20-30 min. RNA synthesis in induced cultures was reduced with respect to controls. This reduction was restricted to cellular transcription as evidenced by: no stable RNA being synthesized in induced cultures, and the proportion of phage specific RNA increasing from 0.5% before induction to more than 30% in induced cultures. Host RNA synthesis proceeded throughout the lytic cycle. Protein synthesis was also reduced in induced cultures, although to a lesser extent than RNA synthesis. Phage DNA synthesis started at around 10 min postinduction, marking the division between the early and late periods of phage development. Host DNA synthesis occurred during the first 20 min after induction, and gradually decreased later. PMID- 3806056 TI - An efficient method for the introduction of viral DNA into Brevibacterium lactofermentum protoplasts. AB - A method for the introduction of a bacteriophage DNA into Brevibacterium lactofermentum protoplasts is described. Frequencies of 10(5) infective centres per micrograms DNA were easily achieved, the relationship between the number of infective centres and the amount of DNA being linear up to 5 micrograms DNA per assay. This method can be used to introduce foreign DNA into these bacteria. PMID- 3806057 TI - A reovirus from the bedbug, Cimex lectularius. AB - Large numbers of virus particles were identified by electron microscopy in the epithelial cells of the ventriculus of the bedbug, Cimex lectularius. The morphology of the virus particles and the presence of a segmented double-stranded RNA genome imply that this isolate should be included in the Reoviridae. PMID- 3806058 TI - Monoclonal antibodies to cowpox virus: polypeptide analysis of several major antigens. AB - Monoclonal antibodies directed against major antigens induced by cowpox virus (CPV) were produced. The specificities of these antibodies were established by immunoprecipitation, immunoblotting and several serological analyses, and from the cross-reactivities of these antibodies with cells infected with various other poxviruses, ectromelia virus (EV), vaccinia virus and Shope fibroma virus. The antibodies defined included ones reacting with each of the known major antigens of poxviruses, i.e. the common antigen of all poxviruses (probably NP antigen), the Orthopoxvirus-specific antigen (probably LS antigen), the haemagglutinin, the cell surface antigen, the common A-type inclusions in CPV and EV, and the antigen involved in neutralization. PMID- 3806059 TI - ECG of the month. Non-specific T wave changes. PMID- 3806060 TI - Vocal cord paralysis. PMID- 3806061 TI - Crack: the new epidemic. PMID- 3806062 TI - The use of 5-FU in treating advanced esophageal carcinoma. PMID- 3806063 TI - Toxoplasmosis presenting as a cerebral mass in an AIDS patient. PMID- 3806064 TI - Clinical experience with Gore-Tex suture. PMID- 3806065 TI - 1985 Clinical Investigative Forum. Part VII: Pancreas and miscellaneous. PMID- 3806066 TI - Panic disorder. Spectrum of severity and somatization. AB - One hundred++ ninety-five primary care patients were screened for panic disorder utilizing the National Institute of Mental Health Diagnostic Interview Schedule (DIS) as well as four additional questions that screened for core autonomic symptoms of panic disorder. A spectrum of severity of panic disorder was found. A subgroup of patients, labeled in the study as having simple panic, was found to have anxiety attacks associated with four or more autonomic symptoms, but they did not meet DSM-III recurrence criteria (three anxiety attacks within a 3-week period). Compared to primary care patients without panic attacks, patients with both simple panic and panic disorder exhibited multiple phobias, avoidance behavior, a high lifetime risk of major depression, and elevated scores on self rating scales of anxiety and depression. The four autonomic screening questions that the authors added to the DIS interview increased the sensitivity of the DIS in identifying patients with panic disorder. Patients with panic disorder who selectively focus on their frightening autonomic symptoms may not be identified by screen questions that only focus on the cognitive awareness of anxiety. PMID- 3806067 TI - Fears, beliefs, and attitudes in DSM-III hypochondriasis. AB - In order to explore fears, beliefs, and attitudes of patients with DSM-III hypochondriasis, the authors administered the self-rated Illness Attitude Scales to 21 patients with hypochondriasis, matched family practice patients, nonpatient employees, and nonhypochondriacal psychiatric patients. Hypochondriacal patients reported more fears of and false beliefs about disease; they attended more to bodily sensations, had more fears about death, and distrusted physicians' judgments more, yet sought more medical care than other subjects. They did not take better precautions about their health. The self-report of overt attitudes suggests a characteristic syndrome, consistent with the DSM-III description of hypochondriasis. Two of the subscales of the Illness Attitude Scales yielded characteristic responses in hypochondriasis. PMID- 3806068 TI - Somatization disorder in the community. A study of diagnostic concordance among three diagnostic systems. AB - Somatization disorder, the presentation of multiple somatic complaints in multiple organ systems, can be diagnosed by three roughly comparable diagnostic systems: the Washington University Feighner criteria, the Research Diagnostic Criteria, and DSM-III criteria. This study evaluates diagnostic concordance for somatization disorder in these three diagnostic systems using data gathered in the National Institute of Mental Health-sponsored Epidemiologic Catchment Area Program at four sites. Data gathered through use of the Diagnostic Interview Schedule at the Duke, Johns Hopkins, Washington, and Yale University sites indicate that each criterion set identifies a somewhat different group of respondents. Feighner criteria identify the fewest number of respondents, followed by DSM-III criteria and the Research Diagnostic Criteria. Demographic, symptomatic, health utilization, and other severity indices indicate that the respondents identified by each group are very similar and that all diagnostic groups are clearly distinguishable from the normal population. PMID- 3806069 TI - The relationships of anhedonia and the process-reactive dimension to season of birth and infectious disease incidence in schizophrenia. AB - This project was designed to test two hypotheses drawn from a new formulation explaining the exaggerated winter birthrate among hospitalized schizophrenics. The first is that the supposed exaggerated winter birthrate among process schizophrenics actually represents a reduction in spring-fall births caused by prenatal exposure to infectious diseases during the preceding winter--i.e., a high prenatal death rate in process preschizophrenic fetuses. The second is that the level of negative symptoms in survivors at risk for schizophrenia who were born after winters with high infectious disease rates is exaggerated. The findings provided some tentative support for this formulation. Compared with counterparts born after low-disease winters, schizophrenics born after winters with high disease incidences tended to show lower (more reactive) scores on a measure of the process-reaction dimension but higher anhedonia scores. PMID- 3806070 TI - Stigma perceived by patients attending modern treatment settings. Some unanticipated effects of community psychiatry reforms. AB - In recent years reforms were instituted in the Federal Republic of Germany that were designed to facilitate the integration of psychiatric services and psychiatric patients into community life. One goal of this reform was to reduce patients' feelings of stigmatization. Because such feelings were thought to arise through patients' tenure at large, isolated state hospitals, we hypothesized that patients sent to such hospitals would feel more stigmatized than would patients assigned to a modern, integrated university hospital. Further, we hypothesized that patients in the two settings would adopt different strategies to cope with the stigma they perceived and that staff members in the two settings would share patients' views concerning these matters. Although we found that the staff in both hospitals shared our prediction that state hospital patients would perceive more stigmatization, our findings showed just the opposite. State hospital patients were significantly less likely than university hospital patients to believe that most people would devalue and discriminate against mental patients. Nor did we find strong evidence of different styles of coping with stigma among patients in the two settings. Taken together, our results suggest that in the realm of stigmatization well-intentioned efforts of reforms may have had undesirable unanticipated consequences. Given this, we suggest approaches for intervening more directly with patients in the form of "Daily Living Groups," which are designed to explicitly discuss actual and feared stigmatization. PMID- 3806071 TI - The role of brief instructions and suggestibility in the elicitation of auditory and visual hallucinations in normal and psychiatric subjects. AB - The present study is an investigation of the elicitation of auditory and visual hallucinations by brief instructions and the relationship of the report of hallucinatory-type experiences to standard measures of suggestibility. Two experiments were carried out. The first used normal subjects predisposed or not predisposed to hallucinate, as assessed by the Launay-Slade Hallucination Scale (LSHS-A). The second used hallucinating and nonhallucinating psychiatric patients. The high LSHS-A scorers and the hallucinating psychiatric patients were significantly more likely to hear suggested sounds than were their respective controls. High LSHS-A scorers were also significantly more likely to see suggested objects than were their respective controls, although this finding was not replicated in the psychiatric subjects. No significant differences on measures of suggestibility were found between the groups, although in the psychiatric group Barber Test Suggestion and Subjective Involvement scores correlated positively with LSHS-A scores. PMID- 3806072 TI - Comparison of social anxiety in patients with social phobia and panic disorder. AB - Differential response patterns to the SCL-90R in patients with social phobia and panic disorder are presented. The differences are discussed in light of Liebowitz's distinction between primary social phobia and the secondary social fears of panic disorder patients. Treatment implications are also discussed. PMID- 3806073 TI - Prevalence of DSM-III-R self-defeating (masochistic) personality disorder in normal and outpatient populations. AB - The prevalence of DSM-III-R self defeating (masochistic) personality disorder was determined on an outpatient population (N = 82) and a normal population (N = 40) using the Personality Diagnostic Questionnaire (PDQ). Fifteen (18.3%) of the outpatients and two (5%) of normals were assessed as having the disorder. Overlap of greater than 50% with borderline, avoidant, and dependent personality disorders was found. Validation of masochistic personality disorder will require it to be of value in research and clinically in ways distinct from the other personality disorders with which it is associated. PMID- 3806074 TI - The use of imagery in the treatment of posttraumatic stress disorder. AB - The role of visual imagery in the symptomatology of posttraumatic stress disorder (PTSD) has not been fully appreciated. The occurrence of intrusive recollections of a traumatic event in the form of flashbacks is very common and may suggest a possible approach to treatment for many individuals with PTSD. A case is presented in which a combat veteran in psychodynamic psychotherapy for PTSD was successfully treated by capitalizing on his tendency to have flashbacks. In this instance, abreaction and subsequent working through of affective reactions to the abreaction resolved his disorder. Technical considerations and patient selection are discussed, and it is suggested that further study of the efficacy of this approach is warranted. PMID- 3806075 TI - Myoclonic seizures after abrupt withdrawal from phenelzine and alprazolam. AB - Monoamine oxidase inhibitors (MAOIs) are being used more frequently in the treatment of various psychiatric and neurological disorders. Although adverse effects of MAOI treatment are widely known, withdrawal symptoms are less well known. They include nausea, sweating, palpitations, nightmares, and psychosis. Withdrawal reactions from combination therapy with an MAOI and another agent are seldom described. Reported here is the occurrence of myoclonic seizures after the abrupt discontinuation of phenelzine and alprazolam. Alterations in the GABA and serotonin neurotransmitter systems as a result of withdrawal of the MAOI and the benzodiazepine may account for the seizures. PMID- 3806076 TI - Severe nortriptyline intoxication due to change from a generic to a trade preparation. AB - Drug toxicity associated with a drastic increase in blood level developed when a trade preparation was inadvertently substituted for generic nortriptyline. There is a good deal of speculation that different preparations of psychotropic medications may differ substantially in bioavailability, but the frequency of variability of clinical and toxic effects is not clear. Bioinequivalence should be considered as a possible cause of otherwise unexplained changes in response to a psychoactive drug, especially if benefits and side effects are correlated with blood levels. PMID- 3806077 TI - Typifications. The first step for clinical diagnosis in psychiatry. AB - Reigning views on psychiatric nosology regard as "too subjective" certain features of diagnosis which respected psychiatrists have reported and several empirical studies have confirmed. We describe two of these persistent "mysteries" of psychiatric nosology: rapid diagnoses and the praecox feeling. We then demystify these mysteries by explicating the workings of "typification" in the diagnostic process. The criteria of disorders which are provided by classification manuals, such as DSM-III, are shown to presuppose such typifications. Psychiatric typification, although a preconceptual skill, can be rendered fully scientific and objective. PMID- 3806078 TI - Coping as an index of illness behavior in panic disorder. AB - Illness behavior in panic disorder was examined by comparing the coping strategies of female primary care patients (34 with panic disorder, 30 with simple panic, and 78 without panic.) Relationships of coping and distress were also examined within each group. The groups differed significantly on the Ways of Coping Checklist, anxiety (SCL-90 and Zung scales), depression (SCL-90 and Beck scales), and number of phobias. The panic disorder group used proportionately less problem-focused and more wishful thinking than the other groups. Within the panic disorder group, anxiety and depression were correlated negatively with problem-focused coping and positively with wishful thinking, and number of phobias was correlated negatively with the seeking of social support and positively with wishful thinking. Most importantly, when an attempt was made to statistically separate panic patients with multiple phobias from those without multiple phobias, coping was a better marker than was distress. These results emphasize the importance of cognitions in illness behavior and anxiety disorder. PMID- 3806079 TI - Evidences of a sympatho-adrenal dysfunction after lesion of the central noradrenergic pathways in rats. AB - The urinary excretion rates of noradrenaline and adrenaline--as an index of sympatho-adrenal activity--were assessed in a group of rats previously treated with the noradrenergic toxic agent DSP-4. The suppressive effects of clonidine (10 micrograms/kg) on urinary NA excretion were also evaluated. Basal noradrenaline and adrenaline excretion rates were higher in DSP-4 treated rats than in controls. Clonidine elicited a marked suppression of urinary noradrenaline excretion rates in control rats but not in those treated with DSP-4 90-120 days before. Endogenous catecholamine level determinations, 120 days after DSP-4 administration, evidenced, on the one hand, an almost complete depletion of noradrenaline levels in spinal cord, cerebral cortex, and hippocampus. On the other hand, a significant increase of noradrenaline in the kidney and of adrenaline in the adrenal gland was found. These results are interpreted as indicating that the lesion of central noradrenergic pathways induces a sympatho adrenal hyperactivity as well as an impaired response to alpha-2 adrenergic receptor agonists. PMID- 3806080 TI - Effect of oestradiol on the responses of regional brain serotonin to stress in the ovariectomized rat. AB - The effect of oestradiol on the response of regional brain 5-hydroxytryptamine (serotonin, 5-HT) to 24 hour electrical footshock was investigated in ovariectomized rats. The stress applied four weeks after ovariectomy induced significant decreases in 5-HT concentrations in the fronto-parietal brain cortex (Bc), hippocampus (Hipp), striatum (CP), medial-basal hypothalamus (MBH) and the preoptic-anterior hypothalamic area (PAHA). Pretreatment with oestradiol prevented the footshock-induced decreases in 5-HT in the Hipp, CP, MBH and the PAHA. It was concluded that oestradiol may prevent stress-induced response of regional brain 5-HT in ovariectomized rats. An interaction between oestradiol and brain 5-HT is proposed in the control of the course of the oestrous cycles in stressful situations. PMID- 3806081 TI - Physostigmine restores 3H-acetylcholine efflux from Alzheimer brain slices to normal level. AB - A technique was developed, which made it possible to study the in vitro release of 3H-acetylcholine (3H-ACh) from human post mortem brain tissue, collected with short post-mortem delay (2,5-22 hours), both from controls and patients with Alzheimer's disease (AD/SDAT). The tritium (3H) release was investigated during potassium stimulation, and AD/SDAT cortical slices were found to release a decreased amount of 3H compared to control brain slices. Physostigmine, 10(-5) and 10(-4) M, has no significant effect on the release of 3H from control slices, while physostigmine 10(-4) M increased the evoked release from AD/SDAT brain slices over threefold, nearly to the control level. PMID- 3806082 TI - Iron, a new aid in the treatment of Parkinson patients. AB - One of the problems in treating Parkinson patients is the so called "off-effect" which occurs after long term treatment with L-DOPA. Off-effects are characterized by severe rigor and akinesia. Increasing dosages of L-DOPA and decarboxylase- or monoaminooxidase-inhibitors do not improve these symptoms. Intravenously applied iron--in form of a ferri-ferro-complex--exhibited a considerable benefit for all patients treated so far. They regained a remarkable mobility. Their disability score dropped from up to 90% down to 30%. The effect of iron is dosage-dependent and lasts 24 to 48 hours. PMID- 3806083 TI - Alterations in cerebral glutamic acid decarboxylase and 3H-flunitrazepam binding during continuous treatment of rats for up to 1 year with haloperidol, sulpiride or clozapine. AB - Rats were treated continuously for 12 months with therapeutically equivalent doses of haloperidol (1.4-1.6 mg/kg/day), sulpiride (102-109 mg/kg/day) or clozapine (24-27 mg/kg/day) and examined for alterations in brain glutamic acid decarboxylase (GAD) and 3H-flunitrazepam binding. Administration of haloperidol, but not sulpiride or clozapine, for 6 or 12 months increased striatal GAD activity. None of the drug treatments altered nigral GAD activity when examined after 1, 3, 6, 9 or 12 months administration. The number of specific 3H flunitrazepam binding sites (Bmax) in striatal membrane preparations were not altered by 12 months administration of haloperidol, sulpiride or clozapine. Surprisingly, Bmax for 3H-flunitrazepam binding to cerebellar membrane preparations was decreased by 12 months administration of all drug treatments. The dissociation constant (Kd) for 3H-flunitrazepam binding in striatal and cerebellar preparations was not altered. The ability of GABA (0.25-100 microM) alone, and in conjunction with sodium chloride (200 mM), to stimulate specific 3H flunitrazepam binding in striatal and cerebellar preparations was unaltered by haloperidol, sulpiride or clozapine administration for 12 months. The selective effect of haloperidol, but not sulpiride or clozapine, treatment on striatal GAD activity parallels the ability of haloperidol, but not sulpiride or clozapine, to induce striatal dopamine receptor supersensitivity in the same animals. The actions of haloperidol may reflect its greater ability to induce tardive dyskinesia compared to sulpiride or clozapine. PMID- 3806084 TI - Morning administration of melatonin antagonizes the antigonadotrophic effect of afternoon injections of melatonin, 5-methoxytryptophol and arginine vasotocin in intact mice. AB - In intact prepubertal mice kept under a long photoperiod subcutaneous afternoon (4:30 p.m.) injections (20 micrograms) but not morning (9:30 a.m.) injections (100 micrograms) of melatonin and 5-methoxytryptophol elicited antigonadotrophic effects. A morning dose (100 micrograms) of methoxytryptophol abolished the antigonadotrophic effects of afternoon injections of methoxytryptophol. Similarly the antigonadotrophic effects of afternoon injections of melatonin, 5 methoxytryptophol and arginine vasotocin could be partially destroyed by 100 micrograms and completely abolished by 1 mg melatonin administered in the morning. PMID- 3806085 TI - In vivo labeling of dopamine receptors: light microscopic localization at the cellular level by means of dipping autoradiography with the agonist (3H)N-n propylnorapomorphine. AB - A convenient method is described for light microscopic autoradiography at the cellular level for the visualization of in vivo labeled dopamine receptors. (3H)N n-propylnorapomorphine [(3H)NPA] is administered to rats under conditions that are known to give specific and saturable accumulation in the striatum. Seventy minutes after intravenous administration, the brain is rapidly frozen and cut on a cryostate microtome. The sections are treated with formaldehyde vapor, defatted for 1 hour in xylene and dipped in liquid nuclear emulsion, exposed for 2 weeks and developed. Autoradiograms obtained in this way show a high silver grain density over the striatum and a low density over adjacent external capsule and neocortex. There was a sharp delineated boundary between striatum and adjacent external capsule. Since low energy radiation can be quantified in liquid emulsion autoradiograms, we counted silver grains in a number of regions. The distribution of silver grains appeared to be identical with the distribution of radioactive label after similar in vivo administration of (3H)NPA in other studies. PMID- 3806086 TI - Homovanillic acid concentrations in brain, CSF and plasma as indicators of central dopamine function in primates. AB - In a large number (91) of vervet monkeys, correlation coefficients were determined between homovanillic acid (HVA) concentrations in four brain areas. Significant correlations existed between dorsal frontal cortex and orbital frontal cortex and between putamen and caudate nucleus. However, no significant correlations existed between either cortical area and the basal ganglia areas. Correlations were tested between CSF and plasma HVA and between these fluids and brain regions. The only significant relationship found was between CSF and dorsal frontal cortex, after possible treatment effects were statistically removed. The assumption that primate CSF HVA concentration necessarily reflects basal ganglia HVA concentration is questioned and furthermore, the results suggest that HVA from cortex contributes significantly to that in cisternal CSF. Raw plasma HVA measurements (even when uninfluenced by diet or anesthetic) appear to be of limited value in gauging central dopamine metabolism and turnover. PMID- 3806087 TI - Stereospecific 3H-QNB binding to human erythrocyte membranes associated with muscarinic cholinergic receptors. AB - Specific binding of the muscarinic antagonist 3H-QNB can be demonstrated on human erythrocyte membranes. Specific 3H-QNB binding is stereospecific and can be inhibited by a variety of cholinergic agonists and antagonist with affinities similar to their affinities for muscarinic cholinergic receptor binding in other tissues. Accordingly, the data indicate the presence of muscarinic cholinergic receptors on human erythrocyte membranes. Their density is very low, varies between healthy persons, but seems to be an individual characteristic. The data reported are consistent with the assumption that the muscarinic cholinergic receptors on human erythrocyte membranes are mainly of the M1 receptor subtype. PMID- 3806088 TI - Molybdenum in enzymatic and heterogeneous catalysis. AB - The chemistry common to molybdenum at the active centers of molybdoenzymes and at the surface of heterogeneous catalysts is described. Oxomolybdenum(VI) compounds catalyze selective oxidation of unsaturated hydrocarbons, e.g., propene to acrolein. Similarly, oxomolybdenum species take part in reactions catalyzed by molybdoenzymes, e.g., xanthine oxidase, sulfite oxidase, nitrate reductase. In these reactions H+, O2- or HO-, and electrons transfer between substrate molecules and molybdenum atoms and groups at the active centres. The chemistry involved is the acid-base and redox chemistry of molybdenum. Molybdenum disulfide catalyzes hydrogenation of unsaturated hydrocarbons, e.g., acetylene. The active site is a coordinately unsaturated molybdenum atom in a sulfur-ligand environment. The enzyme nitrogenase, which is a protein-bound iron-molybdenum sulfide, is also an excellent hydrogenation catalyst. Both catalysts exploit the chemistry of lower-valent molybdenum coordinated by sulfur. The extent to which understanding of the catalysis can be transferred between the two types of catalyst is assessed. PMID- 3806089 TI - Durene-capped porphyrin complexes of iron(II). Binding of imidazoles, and spectroscopic trends within Fe(porp)B(L) species (B = imidazole base; L = RNC, CO, O2). AB - Solution equilibria are presented for in situ reactions of the type FeII(porp) + B----FeII(porp)B, where porp represents the dianion of some durene-capped porphyrins with variable length linking methylene straps, and B is 1-methyl, 1,2 dimethyl, or 1,5-dicyclohexylimidazole. Increasing distortion of the porphyrin skeleton has no effect on coordination of B at the unhindered side of the capped porphyrin. Increasing skeleton distortion gives rise to regular trends within the visible spectra of the free base porphyrins, the hemin (FeIII) chlorides, and six coordinate FeII(porp)B(L) species (L = RNC, CO, O2), while the visible spectra of FeII(porp) and of FeII(porp)B species are independent of the nature of porp and B, which may be related to greater flexibility of the lower coordination number systems. v(CO) data for the FeII(porp)(CO)B species are discussed briefly. PMID- 3806090 TI - Citrate binding of Al3+ and Fe3+. AB - Citrate occurs at about 0.1 mM in blood plasma and is the most likely small molecule plasma binder of both Al3+ and Fe3+. This paper assesses published stability constants for citrate binding to each metal ion. From pH 2 to 5 Al3+ forms a neutral complex with citrate that may be absorbed into the body in the upper regions of the gastrointestinal tract. It is especially dangerous to ingest aluminum-containing antacids with citrus fruit or juices. Ignoring the likely occurrence of a competing 2:1 citrate-Fe3+ complex necessitates adjustments in reported stability constants for Fe3+ binding to transferrin. In the blood, plasma transferrin steals both Fe3+ and Al3+ from citrate. PMID- 3806091 TI - Uptake of nickel(II) by human peripheral mononuclear leukocytes. AB - Dithiocarbamate-mediated nickel(II) uptake by human peripheral mononuclear leukocytes (mostly lymphocytes) was examined. The lipophilic ligands diethyldithiocarbamate (DDC) and ammonium pyrrolidinedithiocarbamate (APDC) enhanced the cellular association of nickel(II), while ammonium dithiocarbamate (AD) had no effect. Sequential incubations (ligand first followed by nickel(II)) and concurrent experiments (simultaneous exposure) yielded similar results. Cell fractionation studies showed that DDC promoted cytosolic accumulation of nickel(II), rather than in the residual cell pellet. The observations reported are interpreted in terms of the "Equilibrium" model of metal-ion uptake by cells proposed by Professor Williams. Although nickel(II) transformed lymphocytes in vitro from an individual with dermal manifestation of nickel sensitivity to lymphoblasts, there was no apparent difference in nickel(II) uptake capacity over lymphocytes from nonsensitized controls. PMID- 3806092 TI - Protein cognitive sites on the surface of actin. A proton NMR study. PMID- 3806093 TI - 1H-NMR study of the removal of methylmercury from intact erythrocytes by sulfhydryl compounds. AB - The effectiveness of penicillamine, N-acetylpenicillamine, meso-2,3 dimercaptosuccinic acid, 2,3-dimercaptopropanesulfonic acid, and dithioerythritol for removing methylmercury (CH3Hg(II) from intact human erythrocytes has been studied by 1H-nuclear magnetic resonance spectroscopy. The removal of CH3Hg(II) was monitored by measuring the chemical shift of the resonance for the proton on the alpha-carbon of the cysteinyl residue of intracellular glutathione in 1H-NMR spectra of intact, CH3Hg(II)-containing erythrocytes in suspensions to which the sulfhydryl ligands were added. Because exchange of intracellular glutathione between its free and CH3Hg(II) complexed forms is fast, the chemical shift of the cysteinyl resonance provides a direct, noninvasive measure of the fraction of intracellular glutathione that is complexed. The sulfhydryl ligands were found to remove CH3Hg(II) from intact erythrocytes in the order 2,3-dimercaptosuccinic acid greater than 2,3-dimercaptopropane sulfonic acid greater than dithioerythritol greater than penicillamine approximately N-acetylpenicillamine, which also is the order of the conditional formation constants of the CH3Hg(II) complexes at pH 7.4. All five ligands removed CH3Hg(II) from intact erythrocytes much more rapidly than can be accounted for by a mechanism in which the ligand crosses the membrane, combines with the CH3Hg(II), and then transports it out of the cell. An alternative mechanism is proposed in which the ligand reacts with CH3Hg(II) which is complexed by sulfhydryl groups of the membrane, which in turn react with the intracellular CH3Hg(II) to bring more CH3Hg(II) into the membrane, where it can react with the added sulfhydryl ligand. PMID- 3806094 TI - Crystal structure of calmodulin. AB - The crystal structure of calmodulin has been determined to 3.6 A resolution. At this resolution the polypeptide chain can be traced. Some of the side chains have tentatively been identified. Refinement of the structure with x-ray diffraction data measured to 1.65 A resolution is continuing. As reported by Babu et al. calmodulin is about 65 A long and 30 A in diameter. Homolog domains 1 and 2 are related by a local twofold axis, as in parvalbumin and in troponin C, and form one end of the molecule. Domains 3 and 4 form the other end. The second alpha helix of domain 2 and a short interdomain region are continuous with the first helix of domain 3, thereby forming a single helix from residues 67-93. The central region, residues 75-84, of this long helix forms a handle connecting the two pairs of homolog domains. Exclusive of the residues, 75-84, in the handle the closet approach of side chains of pair 1, 2 to pair 3, 4 is 12 A. The spatial relationship of pair 1, 2 to pair 3, 4 is similar in calmodulin to the relationship of the corresponding pairs in troponin C. However, in troponin C there are three additional residues in the handle region of the long alpha-helix and the two pairs are about 5.0 A further apart. On the surface of pair 1, 2 in calmodulin there is one extended region with many hydrophobic side chains from both domain 1 and domain 2. This hydrophobic patch is bounded by two distinct clusters of anionic side chains, one from the beginning of the first helix of domain 1 and on the other side of the hydrophobic surface one from the beginning of the first helix of domain 2. Homologously, the hydrophobic patch on the surface of pair 3, 4 is bounded by two clusters of aspartate and glutamate residues. Either or both of these hydrophobic surfaces may be sites to which calmodulin target proteins bind. PMID- 3806095 TI - 1H NMR studies of heme pocket conformation in zinc-substituted leghemoglobin, a diamagnetic analog of deoxyleghemoglobin. AB - Reconstitution of apoleghemoglobin with zinc protoporphyrin IX is reported. NMR spectra show that the reconstitution is orientation specific and that there is no detectable heme isomerism or conformational heterogeneity. Resonances of heme substituents and distal and proximal amino acid protons have been assigned. Only minor differences in porphyrin-protein packing occur between zinc leghemoglobin and the CO complex of ferrous leghemoglobin. The zinc is five-coordinate and is ligated by the proximal histidine. Comparisons with diamagnetic six-coordinate complexes show that the distal His-61 and Leu-65 side chains move away from the binding site upon coordination of exogenous ligands. Conformational changes are minimal when the ligand is O2. PMID- 3806096 TI - 1H and 31P NMR study of the interaction of molybdate with the nucleotides adenosine 5'-diphosphate and adenosine 5'-triphosphate. AB - ADP and ATP form in acidic aqueous solutions strong complexes with Mo(VI) oxocations in different stoichiometries. Complexation occurs predominantly, if not exclusively, through the phosphate groups of the nucleotides. PMID- 3806097 TI - On the nature of boundary-organized biomineralization (BOB). PMID- 3806098 TI - Mapping space by NMR using susceptibility changes at phase boundaries. AB - A technique for differentiating high-resolution NMR signals from different regions of small objects is outlined and some initial results on model systems are given. This method uses inorganic paramagnetic or diamagnetic ions to create magnetic field gradients at phase boundaries. PMID- 3806099 TI - Thioamide substrate probes of metal-substrate interactions in carboxypeptidase A catalysis. AB - Three thioamide peptides in which the oxygen atom of the scissile peptide bond is replaced by sulfur (denoted by (= S)) were synthesized and found to be good, convenient substrates for carboxypeptidase A. The thioamide bond absorbs strongly in the ultraviolet region, and enzymatic hydrolysis is monitored easily using a continuously recording spectrophotometric assay. The reaction follows Michaelis Menten kinetics with kcat values of 68, 9.0, and 3.7 sec-1 and Km values of 0.83, 0.81, and 0.53 mM for Z-Glu-Phe(= S)-Phe, Z-Gly-Ala(= S)-Phe, and Z-Phe(= S)-Phe, respectively. Activities of the thioamides and their oxygen amide analogs were determined with a series of metal-substituted carboxypeptidases. The Cd(II), Mn(II), Co(II), and Ni(II) enzymes exhibit 30%-35%, 60%-85%, 150%-190%, and 40% 55% of the Zn(II) enzyme activity with the amide substrates; this compares with 240%-970%, 0%-15%, 340%-840%, and 30%-140% of the Zn(II) activity, respectively, with the thioamides. The activity of the Cu(II) and Hg(II) enzymes is less than 3% toward all substrates. Cadmium, a thiophilic metal, yields an enzyme which is exceedingly active with the thioamides; the kcat/Km values are 2.4-9.7-fold higher than with Zn(II) carboxypeptidase. In contrast, Mn(II), which has a relatively low affinity for sulfur, yields an enzyme with correspondingly low activity toward the thioamides. The results are consistent with a mechanism for peptide bond hydrolysis in which the metal atom interacts with the substrate carbonyl atom during catalysis. PMID- 3806100 TI - Distribution of putrescine in rat brain measured by gas chromatography-mass spectrometry. AB - We measured putrescine levels in minute sites of single rat brains using a sensitive, specific assay involving gas chromatography-mass spectrometry. The putrescine level was measured in 20 sites of single rat brains: three sites in the cerebral cortex, six sites in the hypothalamus, three sites in the basal ganglia, three sites in the thalamus, three sites in the limbic system, and two sites in the cerebellum. The level of putrescine was very high in the hypothalamus, high in the basal ganglia and limbic system, and low in the thalamus, cerebellum, and two of the three sites in the cerebral cortex. The highest levels were in the anterior hypothalamic area and the lateral hypothalamic area, and the lowest levels were in the vermis and the lobe of the cerebellum. PMID- 3806101 TI - Acetylcholine synthesis at the rat neuromuscular junction. AB - Acetylcholine (ACh) synthesis in homogenates of rat soleus muscles had two components. One component, specifically inhibited by bromoacetylcholine (BrACh), had a Km for choline of 0.26 mM; the other, resistant to BrACh, had a Km for choline of 45 mM. The component with a low Km was absent from denervated muscle, and was identical in kinetic terms to ACh synthesising activity in homogenates of sciatic nerve. It is therefore considered choline acetyltransferase (ChAT) specific. The use of BrACh as a specific inhibitor of ChAT activity allowed the calculation of ACh synthesis at individual motor end-plates in the soleus muscle of the rat: 2.1 X 10(-3) nmol h-1. Since the number of muscle fibres and the number of motor units are known for this muscle, ACh synthesis per motor unit could be calculated: 0.15 nmol h-1. It is concluded that BrACh can be used as a specific inhibitor of ChAT activity in homogenates of skeletal muscle and that its use will obviate the necessity of dividing biopsied muscle or small rodent muscles into neural and aneural segments. PMID- 3806102 TI - Inhibition of monoamine oxidase by N-methylisoquinolinium ion. AB - N-Methylisoquinolinium ion (N-MIQ) has been found to inhibit the biosynthesis of catecholamines; it inhibited tyrosine hydroxylase activity in striatal tissue slices. In this article, the effects of N-MIQ and an analogue, N methylquinolinium ion, on monoamine oxidase (MAO) activity were examined to see their effects on the catabolism of catecholamines. MAO-A in human placental mitochondria was strongly inhibited by N-MIQ in competition with the substrate. The apparent Ki value of N-MIQ was found to be 20.4 +/- 1.1 microM, whereas that of N-methylquinolinium ion was 54.6 +/- 4.5 microM. MAO-B in human brain synaptosomes and liver mitochondria was found to be inhibited by N-MIQ, but the inhibition proved to be noncompetitive. The inhibition of MAO-B by N-MIQ was completely reversible by dialysis of the incubation mixture. MAO-A in human brain and liver mitochondria was more sensitive to the inhibitor than MAO-B. By quantitative analysis of N-MIQ, using HPLC, it was found not to be catabolized by the incubation with mitochondria, suggesting that the inhibition was due to N-MIQ itself and not due to any metabolic product. The inhibition of MAO by N-MIQ is discussed in terms of its possible involvement of the etiology of parkinsonism. PMID- 3806103 TI - Enzyme activities in regions of the hypothalamus. AB - The activities of certain key enzymes have been measured in the ventral medial and ventral lateral areas of the hypothalamus, which are implicated in feeding behaviour, and compared with enzyme activities in the cortex and brainstem. The enzymes measured are concerned with glucose metabolism [hexokinase (EC 2.7.1.1) and glucose-6-phosphate dehydrogenase (EC 1.1.1.49)], ketone body metabolism [3 hydroxybutyrate dehydrogenase (EC 1.1.1.30)], fatty acid utilisation [carnitine palmitoyl transferase (EC 2.3.1.7)], citric acid cycle activity [pyruvate dehydrogenase (EC 1.2.4.2) and citrate synthase (EC 4.1.3.7)] and neurotransmitter synthesis [glutamate dehydrogenase (EC 1.4.1.3)]. PMID- 3806104 TI - Polyamines stimulate mitochondrial calcium transport in rat brain. AB - The effects of the polyamines spermine and spermidine on rat brain mitochondrial calcium transport were examined using a variety of techniques for measuring the kinetics of calcium uptake and the buffering capabilities of isolated mitochondria. Spermine both increased the rate of calcium accumulation and decreased the set-point to which isolated mitochondria buffer free calcium concentration. In the presence of physiological concentrations of sodium and magnesium, spermine lowered the extramitochondrial calcium level to approximately 0.3 microM, a value close to the resting intracellular calcium concentration. The effect of polyamines was concentration dependent, with a half-maximal effect of spermine observed at approximately 0.1-0.4 mM (respiratory substrate dependent), whereas spermidine was approximately 10 times less potent. Calcium transport by hippocampal mitochondria was stimulated markedly more by spermine than was calcium transport by mitochondria isolated from brainstem. The stimulatory effect of spermine was not due to an increase in the transport of respiratory substrates inside the mitochondria nor to an effect on the enzymes using these respiratory substrates. An examination of the effect of spermine on the kinetics of calcium uptake indicated that spermine increased calcium uptake maximally at low calcium concentrations. Beyond that level, the stimulatory effect of spermine decreases, and spermine can even inhibit calcium uptake. These results are in good agreement with previous reports on the effects of polyamines on calcium transport in mitochondria from peripheral tissue. They support the hypothesis that spermine increases the rate of calcium uptake by mitochondria by increasing the affinity of the uniporter for calcium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806105 TI - Modulation of dopamine release from neuron-enriched tissue cultures by cholinergic agents. AB - Modulation of [3H]dopamine release by cholinergic agents (acetylcholine, atropine, d-tubocurarine, oxotremorine, and nicotine) was studied in primary cell cultures derived from whole brains of foetal rats (17 days of gestation). Monolayer and aggregated neuron-enriched cultures were maintained for 17 days in vitro [3H]Dopamine basal outflow was enhanced by acetylcholine, nicotine, and atropine and was unaffected by oxotremorine, hexamethonium, and d-tubocurarine. The action of nicotine was antagonized by d-tubocurarine, and that of atropine was partially blocked by oxotremorine. A similar picture was seen when the influence of cholinergic agents was studied under depolarizing conditions. The action of oxotremorine was dependent on nerve activity. The presence of both muscarinic and nicotinic antagonists was necessary for abolishing the effect of acetylcholine on the dopamine outflow. These results show that dopamine release in both types of neuron-enriched cultures can be influenced by cholinergic agents and that both muscarinic and nicotinic receptors are involved in regulation of the amine's outflow. PMID- 3806106 TI - Uncoupling of cerebral glucose supply and utilization after hexane-2,5-dione intoxication in the rat. AB - Chronic administration of hexane-2,5-dione (2,5-HD) to rats causes an accumulation of neurofilaments within axons that may lead to their degeneration. This occurs in both the CNS and PNS. It has been suggested that one of the effects of 2,5-HD is an impairment of glucose utilization arising from an inhibition of specific glycolytic enzymes. This hypothesis is based principally on evidence obtained in vitro. In the present study, glucose utilization, glucose transport across the blood-brain barrier, and blood flow have been measured in vivo in brain regions of control rats and in three groups of rats treated with 2,5-HD as (a) a single intragastric dose (500 mg/kg of body weight), (b) high chronic doses of 500 mg/kg of body weight for 15 days, or (c) low chronic doses of 250 mg/kg of body weight for 21 days. Group b showed overt signs of neuropathy, whereas groups a and c did not. The results indicate two independent effects of 2,5-HD in the CNS: a dose-dependent inhibition of glucose utilization and an effect on glucose supply and transport across the blood-brain barrier, which is apparent only after chronic treatment. PMID- 3806107 TI - Purification and properties of rubrophilin: a novel brain specific membrane polypeptide. AB - Rubrophilin, a unique brain specific polypeptide, was purified to apparent homogeneity from microsomal fractions of bovine brains. The peptide stains pink with Coomassie Brilliant Blue R-250 (C.I. No. 42660) under specific conditions, has an apparent Mr of 53,000, and is acidic with an apparent pI of 4.9. The purification involves initial solubilization of delipidated microsomes in sodium dodecyl sulfate, followed by ammonium sulfate fractionation, reversed ammonium sulfate gradient elution from diatomaceous earth, gel filtration on polyacrylamide (Biogel P-200), gradient elution chromatography from hydroxylapatite, and reverse-phase chromatography from phenyl-Sepharose. A yield of about 5 mg of rubrophilin was obtained from 9 g of microsomal proteins. Amino acid analysis shows that rubrophilin contains only nine amino acids with residues/mol as follows: alanine (102), glutamic acid (97), lysine (65), proline (55), aspartic acid (48), glycine (44), serine (37), threonine (35), and valine (10). Cysteine, methionine, tryptophan, tyrosine, isoleucine, phenylalanine, histidine, and arginine could not be detected. Relative rubrophilin content of vertebrate brains was as follows: mammals greater than birds greater than reptiles greater than fishes. It is present in mouse retina and human neuroblastoma cell cultures but could not be detected in octopus optic lobe or in cultured C-6 rat glioma cells. PMID- 3806108 TI - Inhibition of norepinephrine transport and reserpine binding by reserpine derivatives. AB - Reserpine, a competitive inhibitor of catecholamine transport into adrenal medullary chromaffin vesicles, consists of a trimethoxybenzoyl group esterified to an alkaloid ring system. Reserpine inhibits norepinephrine transport with a Ki of approximately 1 nM and binds to chromaffin-vesicle membranes with a KD of about the same value. Methyl reserpate and reserpinediol, derivatives that incorporate the alkaloid ring system, also competitively inhibit norepinephrine transport into chromaffin vesicles with Ki values of 38 +/- 10 nM and 440 +/- 240 nM, respectively. Similar concentrations inhibit [3H]reserpine binding to chromaffin-vesicle membranes. 3,4,5-Trimethoxybenzyl alcohol and 3,4,5 trimethoxybenzoic acid, derivatives of the other part of the reserpine molecule, do not inhibit either norepinephrine transport or [3H]reserpine binding at concentrations up to 100 microM. Moreover, trimethoxybenzyl alcohol does not potentiate the inhibitory action of methyl reserpate. Therefore, the amine binding site of the catecholamine transporter appears to bind the alkaloid ring system of reserpine rather than the trimethoxybenzoyl moiety. The more potent inhibitors are more hydrophobic compounds, suggesting that the reserpine binding site is hydrophobic. PMID- 3806109 TI - Magnetic resonance imaging of experimental cerebral oedema. AB - Triethyl tin(TET)-induced cerebral oedema has been studied in cats by magnetic resonance imaging (MRI), and the findings correlated with the histology and fine structure of the cerebrum following perfusion-fixation. MRI is a sensitive technique for detecting cerebral oedema, and the distribution and severity of the changes correlate closely with the morphological abnormalities. The relaxation times, T1 and T2 increase progressively as the oedema develops, and the proportional increase in T2 is approximately twice that in T1. Analysis of the magnetisation decay curves reveals slowly-relaxing and rapidly-relaxing components which probably correspond to oedema fluid and intracellular water respectively. The image appearances taken in conjunction with relaxation data provide a basis for determining the nature of the oedema in vivo. PMID- 3806110 TI - Contribution of traumatic head injury to neuropsychological deficits in alcoholics. AB - The contribution of head injuries to neuropsychological deficits was studied in 157 recently detoxified alcoholics and 400 control subjects consisting of age stratified randomly selected men and women from the same geographical area as the alcoholics. Head injuries had occurred in 41% and 22% of the male and female alcoholics, but only in 15% and 6% of the male and female control subjects. One third of the injured subjects in both groups had been admitted to hospital for treatment of the acute injury. The neuropsychological test results of alcoholics were significantly inferior to those of control subjects. Unexpectedly, alcoholics with head injuries not identified at hospital were significantly inferior in several Halstead-Reitan subtests when compared with uninjured alcoholics with a similar duration of alcoholism and abstinence. By contrast, control subjects who had sustained a head injury not identified at hospital did not show signs of intellectual impairment when compared with uninjured controls. We conclude that traumatic brain injuries that may cause significant intellectual impairment may easily remain unrecognised in alcoholics. PMID- 3806111 TI - Decline of cognition in multiple sclerosis: dissociable deficits. AB - Three female patients (ages 32, 37 and 27 years) developed progressive deficits of cognition in stages of multiple sclerosis in which physical disability ratings were low. Neuropsychological examination revealed severe cognitive impairments in the first two patients. Cognitive functioning was essentially intact in the third patient, although her work pace was significantly slowed. CT scanning of the brain showed cortical atrophy as well as white matter lesions in patients 1 and 2, and multiple lesions and oedema of predominantly white matter in patient 3. The differences of cognitive dysfunction between the third and the first two patients may be related to involvement of different anatomical structures. PMID- 3806112 TI - The in-vitro chemosensitivity of three cell lines derived from the VM/DK spontaneous murine astrocytoma. AB - Three cell lines, VM/Dk P497 P540 and P560 derived from the VM spontaneous murine astrocytoma have previously been fully characterised and found to differ in their degree of astrocytic differentiation. The in vitro chemosensitivity of the three lines has been investigated using the 35S-methionine uptake assay. Differential chemosensitivity was found to exist between the cell lines. The pattern of chemosensitivity in relation to astrocytic differentiation was complex but the least differentiated cell line, P497, tended to be the least chemosensitive. PMID- 3806113 TI - Changes of frequency spectrum of the CSF pulse wave caused by supratentorial epidural brain compression. AB - The frequency spectrum of the CSF pulse wave and amplitude transfer function from arterial to CSF pressure were estimated in the lateral ventricle and cisterna magna during the course of supratentorial epidural compression of brain in anaesthetised ventilated cats. Ventricular fluid pressure, the amplitude of spectral components of the CSF pulse and the amplitude of transfer function in the supratentorial compartment were increased in an exponential manner as epidural compression advanced. A transtentorial pressure gradient developed when epidural compression exceeded a critical level. Conduction of the CSF pulse through the tentorial hiatus decreased in an exponential manner when plotted against the transtentorial pressure gradient. Transtentorial conduction of the CSF pulse may serve as a sensitive indicator of the development of tentorial herniation. PMID- 3806114 TI - Associated postural adjustments in Parkinson's disease. AB - Postural activity in muscles of the back and legs associated with voluntary forward elevation of the arm at the shoulder with the subject standing was examined in 14 patients with Parkinson's disease and nine normal individuals. The time of onset of EMG activity in each of the postural muscles, relative to the onset of activity in the prime mover, was the same for both patient and normal groups and did not depend on load. The amplitude of the EMG bursts and their frequency of occurrence, was less in patients off drug treatment and immobile, than when mobile on therapy. We conclude that the timing of associated postural adjustments is normal in Parkinson's disease, although their size may be decreased. PMID- 3806115 TI - Relation of photosensitivity to epileptic syndromes. AB - Photosensitivity is the most common mode of seizure precipitation. It is age related, more frequent in females, and most often found in generalised epilepsies. Little is known about its relation to individual epileptic syndromes. This study on 1062 epileptic patients who had 4007 split screen video EEG investigations revealed that the relation to generalised epilepsy is even more close than generally believed. Versive seizures with visual hallucinations was the only focal seizure type related to photosensitivity. Of the syndromes of generalised epilepsy, only childhood absence epilepsy, juvenile myoclonic epilepsy, and epilepsy with grand mal on awakening were related to photosensitivity. The closest correlation was with juvenile myoclonic epilepsy. This is confirmed by a relation to the poly-spike wave pattern, and by an increase of myoclonic seizures by intermittent light stimuli. No relation was found with early childhood syndromes of generalised epilepsy, or generalised tonic-clonic seizures in the evening, or, most remarkably, with juvenile absence epilepsy. In generalised epilepsies with onset around puberty, photosensitivity could thus act as a pathoplastic factor. The female preponderance in both childhood absences and photosensitivity could be due to the same unknown factor. PMID- 3806116 TI - Effects of hyperventilation on pattern-reversal visual evoked potentials in patients with demyelination. AB - The effects of hyperventilation on the pattern-reversal visual evoked potential (VEP) were studied in seven normal subjects and 13 multiple sclerosis patients with visual pathway involvement. Significantly greater reductions in P100 latency occurred in the multiple sclerosis patients than in controls and normalisation of the half-field response topography occurred in one patient after hyperventilation. The VEP changes are attributed to improved impulse transmission in demyelinated fibres in the visual pathway as a result of the alkalosis and changes in ionised calcium levels induced by hyperventilation. PMID- 3806117 TI - Somatosensory evoked potentials in syringomyelia. AB - The two types of upper limb somatosensory evoked potential abnormality observed in nine patients with syringomyelia were reduced amplitude or absent cervical potentials and an abnormal central conduction time. Although this pattern of abnormalities resembles that observed in other intrinsic spinal cord lesions, it differs from peripheral nerve diseases and cervical radiculopathy in which the central conduction time is normal. PMID- 3806118 TI - Electrophysiological observations on the human pudendo-anal reflex. AB - A reproducible electrophysiological technique is described to determine the latency of reflex contraction of the external anal sphincter in response to stimulation of the dorsal genital nerve: the pudendo-anal reflex. This was studied in 38 asymptomatic control subjects and 20 women with neurogenic faecal incontinence, supplemented by determination of the mean motor unit potential duration (MUPD) of the external anal sphincter and anorectal manometry. The reflex latency in the control group was 38.5 +/- 5.8 (SD) ms and appeared to be independent of age or sex. Three patients with faecal incontinence had absent reflexes; the remainder showed significant prolongation of latency (56 +/- 12.2 SD ms) and diminution of amplitude. MUPD was prolonged in incontinence and showed significant correlation with the corresponding reflex latency determination (tau = 0.56, p less than 0.001). The latency of this polysynaptic spinal reflex hence provides a reliable index of neuropathy of the external anal sphincter. PMID- 3806120 TI - Familial lethal cardiomyopathy with mental retardation and scapuloperoneal muscular dystrophy. AB - A family is described with a neuromuscular disorder characterised by possible X linked recessive inheritance, a benign, slowly progressive muscular dystrophy with predominant humeroperoneal distribution and lack of contractures or pseudohypertrophy, central nervous system involvement, myopia and lethal cardiomyopathy. The possibility of cardiac transplant as life-saving therapy is suggested. PMID- 3806119 TI - Four cases of late onset metachromatic leucodystrophy in a family: clinical, biochemical and neuropathological studies. AB - Four cases of familial metachromatic leucodystrophy are described: the age of onset ranged from 15 to 21 years. Mental deterioration was the earliest clinical sign to be noted and all progressed to severe dementia. The arylsulphatase activity in peripheral leucocytes of the patients was very low, 5 to 15 nmol/h/mg protein, moderately reduced in the heterozygote, 40 nmol/h/mg protein, compared with control values of 60-160 nmol/h/mg protein. Sural nerve biopsies in two cases showed perivascular macrophages filled with metachromatic material and electron microscopy showed typical inclusions in Schwann cell cytoplasm. Necropsy in one of the cases revealed severe demyelination mainly in the cerebral hemispheres with metachromatic material in macrophages and neurons. PMID- 3806121 TI - Pure dysarthria due to anterior internal capsule and/or corona radiata infarction: a report of five cases. AB - Five cases with a sudden onset of dysarthria in the setting of hypertension are presented. No case had limb weakness or other neurological deficits. Computed tomographic scan demonstrated a small low density lesion in the anterior part of the internal capsule or the adjacent corona radiata. All cases showed a good recovery from dysarthria within two to four weeks. PMID- 3806122 TI - Non-obstructive idiopathic pachymeningitis cervicalis hypertrophica. AB - Two young men had similar nonobstructive idiopathic pachymeningitis cervicalis hypertrophica, causing chronic (13 and 11 years respectively) C8-T1 radiculomyelopathy proved by surgical and pathological findings. The preoperative Queckenstedt tests and myelography showed no evidence of CSF obstruction. These unusual findings contrast with previous reports which all described complete or at least partial, block. The findings on metrizamide computed tomogram have not been described before. In the two patients it revealed diffuse cord atrophy from C7 to T2 and hemiatrophy with lateral beaking from C4 to C7. The patients benefited from multiple transverse durotomies. The main pathogenesis of the cord atrophy was the compromizing of feeding radicular arteries rather than direct compression. PMID- 3806124 TI - Repeated facial palsies after chlorocresol inhalation. AB - A 42-year-old woman who experienced more than 50 attacks of left-sided facial palsies after exposure to chlorocresol was studied. Only muscles around the left side of the mouth were affected. On neurophysiological testing during chlorocresol provocation the only abnormality was a loss of motor units during maximal contraction of the left orbicularis oris muscle. This could be explained by a peripheral as well as a central effect. Extensive electrophysiological examination without chlorocresol provocation excluded a preexisting generalised nerve disorder and other diagnostic procedures did not give evidence of pathology involving the left facial nerve. A hyperreactive mechanism causing a transient block of the left facial nerve is proposed. PMID- 3806123 TI - Phaeochromocytoma as a cause of reversible dementia. AB - The case of a 57 year old man with cognitive impairment, hypertension and insulin dependent diabetes mellitus caused by phaeochromocytoma is reported. One year after removal of the tumour there was a significant improvement with the full scale IQ increasing by 15 points, normotension and minimal glucose intolerance. Possible mechanisms accounting for reversible cognitive impairment in such a situation are discussed. No previous reports of this association have been discovered. PMID- 3806125 TI - Muscle hypoxia in myositis. PMID- 3806126 TI - Dilated tonic pupils in neurosyphilis. PMID- 3806127 TI - Parkinsonism due to corpus callosum astrocytoma: case report. PMID- 3806128 TI - Huge epithelium-lined cyst: report of two cases. PMID- 3806129 TI - Syncope and sudden unexpected death attributed to carbamazepine in a 20-year-old epileptic. PMID- 3806130 TI - Hypothesis relevant to defective position sense in a damaged knee. PMID- 3806131 TI - Alternating unilateral jaw spasm due to metoclopramide. PMID- 3806132 TI - Pseudotumor cerebri with amiodarone. PMID- 3806133 TI - Gas chromatography-electron impact-mass spectrometry (GC-EI-MS) analysis of saturated fatty acid compositions in formalin-fixed human tissues. AB - Applicability of the gas chromatography-electron impact-mass spectrometry and data system (GC-EI-MS) for fatty acid analysis of formalin-fixed human tissues was evaluated by comparison of formalin-fixed and unfixed brain tissues, and the results of GC-EI-MS analyses of the formalin-fixed brain and adrenal cortex from cases with adrenoleukodystrophy (ALD) and the cerebro-hepato-renal syndrome of Zellweger (ZWS) were presented. When formalin-fixed and unfixed materials were compared, a reduction of polyunsaturated fatty acids was observed after formalin fixation, while saturated and monounsaturated fatty acids remained unchanged. The chromatographic patterns of brain tissues fixed in 10% formalin for 3 days or 17 months were basically the same. In ALD, increased C26:0/C22:0 ratios in the cerebral white matter (2.05 in ALD versus 0.74 in control) and in the adrenal gland (15.2 in ALD versus 0.1 in control), and the presence of unusual very long chain fatty acids (VLCFA), longer than C29:0, were demonstrated. In the ZWS brain, all of the VLCFAs were severely depleted. Thus, formalin-fixed tissue may be a reliable subject to fatty acid analysis. PMID- 3806134 TI - Minicore myopathy with dominant inheritance. AB - Minicore disease (multicore disease) is a benign myopathy characterized by segmental muscle fibre degeneration with disruption of myofibrils and loss of mitochondria. The disease is generally thought to occur either sporadically or follow an autosomal recessive mode of inheritance. We describe 2 patients, a mother and her son, with essentially non-progressive weakness of both proximal and distal muscles. Biopsies from both patients showed focal defects of oxidative enzyme activity as well as focal disturbances of cross-striation typical of minicore myopathy. Normal fibre type differentiation was lacking. Three other families reported in the literature suggest dominant inheritance of minicore myopathy or closely related disease. PMID- 3806135 TI - Macromolecular structure of the Schwann cell membrane. Perinodal microvilli. AB - The macromolecular structure of perinodal Schwann cell membrane was examined with freeze-fracture electron microscopy. Perinodal microvillous-like processes of Schwann cells exhibit an asymmetrical partitioning of intramembranous particles (IMPs), with a moderate (approximately 900/microns2) density of particles on P faces and a lower (approximately 300/microns2) density of IMPs on E-faces. The densities of IMPs observed on the fracture faces of perinodal processes are similar to those within the outer membrane of the Schwann cell proper. On both fracture faces of the perinodal processes and the Schwann cell membrane proper, a high (approximately 45%) percentage of the IMPs displayed a large (greater than or equal to 9.6 nm) diameter. Specialized junctions (i.e., gap junctions, tight junctions) between adjacent perinodal Schwann cell processes or between perinodal processes and nodal axolemmal were not observed. PMID- 3806136 TI - A simple test for the random arrangement of muscle fibres. AB - The random arrangement of a given muscle fibre class has been assessed by estimating 'mean cluster size' in transverse sections of skeletal muscle. The method was found to be useful when the proportion of the fibre class of interest was low. The statistical distribution of this measure was investigated by computer simulation using a hexagonal lattice model of muscle fibre arrangement. An approximate significance test was developed by considering the extreme points of the distribution. Minor changes to the hexagonal lattice model were incorporated to give a more realistic representation of fibre arrangement and these were found to give very similar results to the simpler model. PMID- 3806137 TI - Congenital myotonic dystrophy. Changes in muscle pathology with ageing. AB - Undifferentiated type 2C fibers and satellite cells were increased in number in younger patients with congenital myotonic dystrophy (CMD) indicating immaturity in muscle fiber growth. The changes found in a 38-year-old man with CMD were identical to those described in late onset myotonic dystrophy. Type 1 fibers were found to become predominant with age. This suggests that in this disorder fiber type transformation progresses with age, presumably due to abnormal neural influences or aberrant sarcolemmal responses. PMID- 3806138 TI - Calmodulin content in human brain tumors. AB - Using a radioimmunoassay method, the particulate and soluble calmodulin levels were determined in biopsied specimens from normal human brain and from various human brain tumors. Both in normal and pathological tissues the major portion of calmodulin was revealed in the cytosol. The chromatographic elution profiles of calmodulin obtained from soluble and particulate fractions of the same specimen were identical, thus suggesting an identity of the supernatant and particulate form of calmodulin. In all the examined oncotypes, the calmodulin content was lower than in normal extracts and this biochemical feature could not have been correlated with the degree of malignancy of the neoplasia. Furthermore, the translocation of calmodulin from the particles to the cytoplasm, reported in other rapidly growing tumors, lacks in human cerebral ones. Our findings indicate that in human brain oncotypes the calmodulin distribution is quite different from that found in tumors taken from other tissues, where its level is increased and a positive correlation between calmodulin concentration and growth rate of neoplastic tissue has been revealed. PMID- 3806139 TI - NK activity and NK-like non-specific cytolysis after PPD, rubella and measles antigen stimulation in multiple sclerosis. AB - Blood samples were collected from 14 pairs of multiple sclerosis (MS) patients and from age- and sex-matched healthy controls. The cytotoxic activity of peripheral blood mononuclear cells was tested against the K562 cell line on the day of collection and again after 3 days in vitro culture with medium or with purified protein derivative of tuberculin (PPD), inactivated rubella virus or inactivated measles virus antigen. Lymphocytes from MS patients had a lower spontaneous cytotoxic activity compared to the controls both on the day of collection (P less than 0.025) and after 3 days in culture with medium alone (P less than 0.025). The activity decreased during in vitro culture in both groups, but the decrease was greater among MS patients (P less than 0.05). In cultures with antigens, a strong increase of NK-like cell-mediated cytolysis (NK-like CMC) was noted especially in cultures stimulated with PPD. There were no significant differences in the increase of the activity among MS patients and control subjects. A significant correlation between the increase of NK-like CMC and the lymphocyte blast transformation response induced by each antigen was found. PMID- 3806140 TI - Effects of methylcobalamin on vitamin B1- and B-deficient encephalopathy in rats. AB - Vitamin B1- and B-deficient encephalopathy was produced in adult Wistar rats and the effect of methylcobalamin was studied. These experiments were performed in vitamin B1- or B-deficient rats with or without the administration of guanidine, a magnesium antagonist. These encephalopathic rats showed symmetrical lesions in the pontine tegmentum. No pathological changes in the brainstem were seen in guanidine-administered rats. This suggests that guanidine itself doesn't produce these brainstem lesions. Moderate to severe pathological changes occurred in vitamin B-deficient rats with guanidine administration, whereas these pathological changes were milder in vitamin B1-deficient rats with guanidine administration and in vitamin B1- and B-deficient rats with the combination of the guanidine and methylcobalamin administrations. These facts suggest that vitamin B12, methylcobalamin, plays an important preventive role in the development of the pontine lesions in this experiment. PMID- 3806141 TI - Interventional neuroradiology. State of the art and perspectives. PMID- 3806142 TI - Neuropharmacological investigations in the stiff-man syndrome. AB - In a patient with the stiff-man syndrome, abnormal exteroceptive reflexes in hand and arm muscles were used as a tool for investigating the effects of various centrally acting adrenergic drugs by means of acute testing. Clonidine, tizanidine and methamphetamine induced reflex suppression whereas reserpine had a biphasic effect: transient reflex suppression and delayed reflex enhancement. The drug actions on the reflexes paralleled to some degree those on the muscle stiffness. It is concluded that alpha-adrenergic stimulation leads to reflex suppression and muscular relaxation, whereas alpha-adrenergic blockade has the opposite effect. Correspondingly, long-term oral treatment with the alpha stimulator, tizanidine, proved successful. The hypothesis is put forward that a noradrenergic system which exerts a net inhibitory influence on muscle tone and on exteroceptive reflexes plays an important role in the pathogenesis of the stiff-man syndrome. PMID- 3806143 TI - An electron microscopic study of cerebral vasospasm with resultant myonecrosis in cases of subarachnoid haemorrhage, meningitis and trans-sylvian surgery. AB - Electron microscopic data on the development of myonecrosis following cerebral vasospasm associated with subarachnoid haemorrhage, meningitis and trans-sylvian surgery are presented. The basic feature of myonecrosis was dissolution of myofilaments with resultant fine granular or filamentous material. The disintegrating cytoplasm often contained numerous glycogen granules, dense bodies, autophagic vacuoles and myelin-like membranous bodies. A well-developed sarcoplasmic reticulum was preserved despite myofilament dissolution, while mitochondria showed marked swelling. The nuclei showed either dilution of chromatin or pyknotic change. The basal lamina was remarkably thickened and maintained an irregular outline of the necrotic smooth muscle cells. Enlarged intercellular space contained abundant cellular debris, vesicular structures and connective tissue fibres. The pathogenesis of these changes is discussed. PMID- 3806144 TI - The clinical relevance of locally produced carcinoembryonic antigen in cerebrospinal fluid. AB - Sixteen out of eighteen meningeal carcinomas (89%) secreted carcinoembryonic antigen (CEA) into the cerebrospinal fluid, where it could be quantified separately from the portion originating from the circulating blood. The discrimination of both fractions was performed according to an empirical approach analogous to the immunoglobulins. Only 47% of the intraparenchymal carcinomas released CEA into the CSF compartment and it is possible that the extra-cellular space of these tumour sites does not communicate with the free CSF space. Extradural metastases may cause an impairment of the blood-CSF barrier via restrictions of the CSF fluid turnover, but the dura remains impermeable for the tumour marker. Seven out of 54 primary brain tumours (13%) released carcinoembryonic antigen into the cerebrospinal fluid. PMID- 3806145 TI - Cryptococcal meningoencephalitis: intrathecal immunological response. AB - The intrathecal immune response is reported in a patient with cryptococcal meningoencephalitis. CSF IgM and IgG levels were significantly related to the favourable clinical evolution. IgM response was specifically directed against the pathological agent, while IgG were mostly non-specific. The data are discussed and compared with the other chronic infections of the central nervous system. PMID- 3806146 TI - New developments in the diagnosis and therapy of epilepsy. PMID- 3806147 TI - Bilateral ballism induced by oral contraceptives. A case report. PMID- 3806148 TI - Effects of sodium intake on blood pressure and adrenergic vascular reactivity. AB - The effects of dietary sodium restriction (approximately 2 g daily) on blood pressure (BP) and vascular reactivity to norepinephrine (NE) were evaluated in 12 patients with uncomplicated primary hypertension. BP was significantly reduced at the end of the treatment both at rest (153/100 +/- 19/7 vs. 142/93 +/- 19/5 mmHg) and during an exercise test on a bicycle. The pressor response to NE was significantly lower at the end of the low sodium period (reactivity index = 0.0044 vs. 0.0031; p less than 0.05): A twofold dose of NE was needed to increase mean BP by 20 mmHg (PD20) (from 273 +/- 120 to 450 +/- 218 ng/kg/min; p less than 0.05). Twenty-four-hour NE excretion increased significantly on a low-salt diet (40 +/- 14 vs. 49 +/- 16 micrograms/24 hr; p less than 0.05). The decrease in BP was inversely related to changes in PD20 (R = -0.60; less than p0.05). These results provide the evidence that the fall in BP is, at least in part, mediated by decreased end-organ responsiveness to adrenergic stimulation. PMID- 3806149 TI - Cigarette smoking and atherosclerotic renal artery stenosis. AB - The charts of all patients over 30 for whom an adequate smoking history was available and an arteriogram or DIVA was done, specifically looking for renal artery stenosis, were reviewed to evaluate the role of cigarette smoking in contributing to the development of atherosclerotic renovascular hypertension. A patient was considered to be a "case" if the angiographic study demonstrated a typical stenotic lesion and a procedure (surgery or angioplasty) cured or definitely improved the patient's hypertension. If the study was negative, the patient was considered to be a "control." Twenty-one cases and 27 controls were found. The cases were older (57.5 vs. 49.25 years) and all were white (100% vs. 89%). Both groups had severe hypertension, but the cases had disproportionate systolic elevations (premedication BP 226 +/- 32/126 +/- 24 mmHg vs. 193 +/- 30/121 +/- 24 mmHg) and did not respond as well to drug treatment (180 +/- 30/99 +/- 6 vs. 139/85 +/- 10 mmHg) as the controls. There were significantly more smokers (19/21 vs. 16/27, p less than 0.04; odds ratio 6.53) among the cases, and 17 of the 19 were heavy smokers (greater than 25 pack-years). We conclude that cigarette smoking may contribute to the development of atherosclerotic renovascular hypertension. PMID- 3806150 TI - The incidence of diuretic-induced hypokalemia in two distinct clinic settings. AB - We studied the incidence of diuretic-induced hypokalemia (DIH) in two diuretic treated hypertensive populations. Thirty-seven patients with mild hypertension were treated with HCTZ and monitored over 6 months. Group 1 (21 patients) was treated with 25 mg HCTZ q.d. in a public hypertension clinic. Group 2 (16 patients) was treated with 50 mg HCTZ q.d. in a private-practice setting. Group 1 was predominantly nonwhite (76% vs. 31% [p less than 0.002]). Baseline serum potassium levels were lower in group 1 (3.93 vs. 4.42 mEq/L [p less than 0.001]). Equivalent reductions in blood pressure and serum potassium were observed in both groups. Contrary to expectations, DIH (serum potassium less than 3.5 mEq/L) developed in 52% of group 1 and 19% of group 2 (p = 0.037). Black females were especially at risk for DIH. The higher incidence of DIH in group 1 appears to be related to lower baseline serum potassium levels. PMID- 3806151 TI - Initial treatment of hypertension: a questionnaire survey. AB - The "stepped care" (SC) approach to the management of hypertension has been the standard of care for many years. Recently, concerns about safety of diuretics, coupled with the development of a variety of new antihypertensive agents, have led to questions about the continued use of SC. It is unclear what effect this continuing debate has had on the initial selection of drugs to treat mild to moderate hypertension. We developed four vignettes intended to represent typical patients with mild to moderate hypertension and asked three groups of physicians (house staff, faculty physicians, and private practitioners) how they would initially treat the patients represented by the vignettes. Ninety-five physicians responded. Among the physicians who chose a drug therapy for a vignette (85.9% of total responses), 81.2% selected either a diuretic or a beta-blocking agent, the standard SC regimen. Differences among the groups of physicians dealt with decisions to treat rather than choice of drugs, although house officers tended to use slightly more beta blockers and non-SC drugs. In spite of recent criticism of the SC approach, many physicians are comfortable with the use of diuretics or beta-blocking agents as the initial treatment of mild to moderate hypertension. PMID- 3806152 TI - Does a diuretic cause a further fall in blood pressure in hypertensive patients already on nifedipine? AB - The effect of the addition of a diuretic, bendrofluazide, for 1 month was studied in 12 hypertensive patients who were already on treatment with nifedipine tablets (20 mg b.i.d.) When nifedipine was maximally effective, that is, at 2 hours after the last dose, the diuretic had no further blood-pressure-lowering effect. These results suggest that unlike most other blood-pressure-lowering agents, there is little point in giving a diuretic to patients who are already on nifedipine, and if blood pressure is not controlled on nifedipine alone, it may be more effective to add either a beta blocker or a converting enzyme inhibitor. This has the advantage of avoiding the metabolic problems of diuretics. PMID- 3806153 TI - A comparison of the treatment of hypertension with Chinese herbal and Western medication. AB - Forty-five patients with diastolic blood pressure (DBP) greater than or equal to 105 mmHg were randomly assigned to receive Western (group 1, n = 21) or a classical Chinese herbal preparation (group 2, n = 24) to treat their hypertension (HBP). All remained hypertensive after 4 days in the hospital without treatment. Except for baseline Na+ excretion (higher in group 1) and somewhat more evidence of end organ damage in group 1, the patient groups were comparable. Those in group 1 were given a thiazide diuretic and propranolol if needed, and those in group 2, a mixture of 12 herbs. Patients on active therapy in group 1 had a drop in blood pressure (BP) from 172.6 +/- 27.8/107.4 +/- 13.6 to 141.2 +/- 26.2/89.6 +/- 12.0 mmHg, whereas those in group 2 had no change in BP, 168.8 +/- 22.0/107.7 +/- 9.8 mmHg to 165.7 +/- 23.7/106.0 +/- 11.8 mmHg. Although 66% of patients in group 1 had a DBP under 90 mmHg by discharge, only 8% of those in group 2 did. Except for a fall in serum K+ in group 1, there were no significant biochemical or clinical problems in either group. We conclude that standard Western medication is more effective than a classical Chinese herbal preparation used to treat HBP. PMID- 3806154 TI - Malignant melanoma in the elderly. AB - Advancing age is associated with poorer prognosis in malignant melanoma. We studied 3,872 cases of malignant melanoma to evaluate whether the effect of age could be analyzed relative to sex, tumor depth, primary site, and other clinical and pathologic variables. The sex distribution by age shows a slight female predominance in the early and late decades but male predominance in the middle years. The percentage of patients with metastatic disease at initial diagnosis did not vary with age, despite greater diameter and depth of lesions in the older patients. In fact, in the older age groups, initial nodal metastasis occurred slightly less frequently. Trunk primaries decreased in frequency with increasing age, while extremity lesions remained relatively constant, and face, nose, and ear lesions increased. This was in part related to the histopathologic type, as lentigo maligna lesions increased in frequency with age, superficial spreading lesions were somewhat less frequent in the older age group and nodular types were fairly constant. On the basis of both Clark's level and Breslow thickness, there was an increasing proportion of deeper penetrating lesions in the older age group. The mean diameter of these lesions on the skin surface was also greater for the older patients. This would suggest that lesions in the older individual remain confined to the local site longer, penetrate and spread, but do not necessarily metastasize more rapidly. Cox model regression analysis of survival time within stage showed that age was highly significant as a poor prognostic factor. Though the adverse relation of advancing age with survival was partially explained by predominance of other unfavorable factors, such as primary site, depth of lesion, or histologic type, age remained an independent poor prognostic factor (chi 2 = 5.3; P = .02) for death due to melanoma. PMID- 3806155 TI - Superficial bladder cancer: the primacy of grade in the development of invasive disease. AB - Tumor characteristics thought to predict for development of deep muscle invasion after resection of superficial bladder cancer were retrospectively analyzed in 252 patients with transitional cell carcinoma of the bladder at Stanford University Medical Center. Stage 0 patients accounted for 190 of the patient population (75.5%), while stage A and B1 comprised 51 (20%) and 11 (4.5%), respectively. The median follow-up time was 62 months. Forty-three patients subsequently developed deep muscle invasion; these included 24 (12.6%), 14 (27.5%), and 5 (45.5%) of stage 0, A, and B1 patients (P = .002), or 15 (10%), 15 (9%), and 13 (33%) of grade 1, 2, and 3 tumors (P = .001), respectively. When analyzed by univariate logistic regression, grade (P = .0001) and stage (P = .0118) were significant predictors for invasive disease. Site of tumor and number of tumors at presentation were not significant factors for invasion deep into the bladder wall. When multiple logistic regression was performed, only grade remained as a significant tumor variable to predict for invasive disease (P less than .0091). Risk of invasive disease did not appear to increase with increasing number of recurrences, remaining at approximately an 11% invasion rate through 12 recurrences. In this analysis, grade was the most significant tumor variable in superficial bladder cancer predicting for the development of invasive carcinoma. Future clinical trials for definitive or adjuvant therapy of this disease must stratify for this variable. PMID- 3806156 TI - A totally implanted venous access system used in pediatric patients with cancer. AB - A safe and effective method of venous access is important in the care and treatment of patients with malignancies. A recently available totally implantable venous access system offers advantages over traditional central vein catheters (Broviac and Hickman, Houston). We report our experience with the implanted venous access system used in 31 pediatric patients with malignancies. The mean age of the patients was 7 years (range, 6 months to 17 years), and the mean indwelling time of the catheters was 232 days (range, 14 to 607 days; total patient days, 7,198). The catheters were used to administer chemotherapy, drugs, blood products, and parenteral nutrition, as well as to draw blood. Clotting occurred in the catheters on four occasions, requiring removal of two catheters. Fever occurred in eight patients; one developed a local infection at the site of implantation and four developed bacteremia. Our use of the implanted venous access system in children resulted in a lower rate of infection compared with that when the traditional Broviac and Hickman catheters were used, and simplified patient management. PMID- 3806157 TI - Early results of the monoclonal antibody OVTL3 in specific detection of ovarian cancer. PMID- 3806158 TI - Radiation therapy salvage of Hodgkin's disease following chemotherapy failure. AB - Between 1972 and 1984, 17 patients with advanced Hodgkin's disease failing intensive combination chemotherapy in previously unirradiated nodal and/or pulmonary sites were treated with salvage radiotherapy. Treatment consisted of comprehensive wide field radiotherapy to all known areas of disease. Doses administered to these fields ranged from 1,700 to 5,000 rad, with only three patients (18%) receiving less than 3,000 rad to any field. With a median follow up of over 4 years, 88% achieved a complete response, with median actuarial disease-free survival (DFS) of 19 months (range, 4 to 61+). Actuarial median survival was 64 months, with a range of 4 to 134+ months. Nine patients (53%) are currently alive with three (18%) in continuous complete remission (CR) for 24, 30, and 61 months. In addition, four patients relapsing after salvage radiotherapy are now in CR following additional therapy. Patients younger than 35 years of age had a significantly increased overall survival when compared with older patients (P less than .005). An initial complete response to chemotherapy lasting 12 or more months appeared to be a favorable prognostic factor, although small patient numbers preclude statistical significance. Comprehensive salvage radiotherapy is of significant benefit in patients with advanced Hodgkin's disease relapsing after combination chemotherapy in nodal and/or pulmonary sites. PMID- 3806159 TI - Survival from first recurrence: relative importance of prognostic factors in 1,015 breast cancer patients. AB - Univariate and multivariate analyses of potential prognostic factors for 1,015 women with recurrent breast cancer confirmed that the site of initial recurrence is an important determinant for predicting survival from the time of initial recurrence. However, both estrogen receptor (ER) status and axillary lymph node status at diagnosis, as well as the length of the disease-free interval, provide additional independent information for predicting patient survival after disease recurrence. Involved axillary lymph nodes at the time of initial diagnosis and/or lack of ERs may indicate a highly malignant tumor or a weak host defense, either of which might be related to short survival after relapse. Patients with ER negative tumors recurred more often in visceral and soft-tissue sites, while patients with ER-positive tumors were more likely to recur in bony sites. However, for each metastatic site, receptor-positive patients had longer survival PMID- 3806160 TI - Screening for recurrent breast cancer--its effectiveness and prognostic value. AB - Performance of periodic follow-up examinations after mastectomy for breast cancer is standard practice, primarily for early detection and treatment of recurrence. This study was designed to determine whether this routine screening resulted in significant survival benefit for the patient. The medical records of 1,230 women treated for cure of invasive carcinoma of the breast were reviewed, and 248 cases of recurrence were identified for analysis. Only 36% of recurrences were discovered asymptomatically. Asymptomatic recurrence was associated with favorable biologic factors, ie, more frequent estrogen receptor (ER) positivity and initial node negative status, and survival was superior to that of others. This was particularly true for occult local recurrence. However, compliance with a present schedule of examinations did not confer superior survival. It was concluded that (1) routine screening after mastectomy detects few recurrences that are not already symptomatic, and (2) the superior survival associated with discovery of occult recurrence may result from the influences of lead time and length bias. PMID- 3806161 TI - Factors influencing options in primary breast cancer treatment. AB - Primary breast cancer treatment is determined by tumor factors and by patient preference. Breast cancer treatments that preserve the cosmetic appearance of the breast are appealing and effective for appropriately selected patients; long-term survival following tumor excision and breast irradiation appears to be comparable to that for mastectomy. Since April 1981, when a protocol was developed and treatment options were offered, factors influencing treatment selection have been analyzed in 206 consecutive primary breast cancer patients. Mastectomy was dictated by tumor-related factors in 96 patients (47%); 110 patients (53%) had the option of mastectomy or conservation--tumor excision plus radiotherapy to the breast. Among these 110 eligible patients, 54 chose conservation (49%) and 56 chose mastectomy (51%). Intraoperative findings for ten patients electing conservation necessitated mastectomy, so conservation was accomplished for 44 (21%) of those treated for breast cancer. Beginning in July 1982, breast cancer patients took a battery of psychosexual assessments before any operation (Profile of Mood States [POMS], Health Locus of Control Scale [HLCS] Locke-Wallace Marital Adjustment Test [MAT], Psychosocial Adjustment to Illness Scale [PAIS], Derogatis Sexual Function Inventory [DSFI], Millon Clinical Multiaxial Inventory [MCMI], and a Breast Cancer Information Test [BCIT]). Comparisons of psychologic and demographic variables were made between patients who chose mastectomy and those who chose conservation. No demographic variable was statistically significantly related to choice, although older women tended to select mastectomy more than younger women. Compared with those who elected conservation, women who elected mastectomy were more tense and anxious (P less than .01), more introverted (P less than .01), felt more depressed and dejected (P less than .05), and reported more sexual problems (P less than .05). Those who elected conservation valued their physical appearance more highly (P less than .01) and were generally more self-interested (P less than .05). Mastectomy was dictated by medical considerations for approximately half of patients with breast cancer. Among candidates for breast conservation, the importance of retaining the breast appeared to be determined to a significant degree by measurable psychological factors. PMID- 3806162 TI - High-dose cytosine arabinoside as the initial treatment of poor-risk patients with acute nonlymphocytic leukemia: a Leukemia Intergroup Study. AB - Sixty-seven patients with newly diagnosed acute nonlymphocytic leukemia (ANLL) who were considered to be poor candidates for treatment with cytosine arabinoside (ara-C)/anthracycline antibiotic therapy were treated with high-dose ara-C (HDara C) remission induction therapy. Thirty-four of the 67 patients had a hematologic disorder before developing acute leukemia or had a history of exposure to marrow toxins, 23 patients were greater than 70 years old, and 10 patients had medical problems that were felt to be a contraindication to therapy with an anthracycline antibiotic. Forty-two percent of patients entered complete remission (CR), whereas 22% failed to enter remission because of persistent leukemia. Treatment was associated with substantial toxicity varying from nausea and vomiting to irreversible cerebellar toxicity. Thirty-four percent of patients died during therapy. Poor performance status, a low serum albumin, and a low platelet count were associated with death during remission induction therapy, whereas a high pretherapy leukemic cell mass and a large number of residual leukemic cells in the marrow after six days of therapy were associated with treatment failure due to persistent leukemia. PMID- 3806163 TI - Clinical staging in rhabdomyosarcoma: current limitations and future prospects. PMID- 3806164 TI - High-dose chemotherapy for breast cancer. PMID- 3806165 TI - A phase I-II study of intensive-dose adriamycin for advanced breast cancer. AB - Twenty-six women with metastatic breast cancer were treated with intensive Adriamycin (Adria Laboratories, Columbus, OH) as a single agent administered for three successive days once a month. Dosing started at 25 or 30 mg/m2/d three times, and was escalated by 5 mg/m2/d monthly to maximal tolerance based on hematologic, mucosal, or cardiac toxicities. Four patients (15%) had complete remissions (CRs) pathologically proven, and six others (23%) sustained complete CRs, but were found to have microscopic residual tumor (three) or refused biopsy (three). Twelve patients (46%) attained partial remission (PR). The overall response (85%) and CR rates (38%) were approximately double those reported with conventional Adriamycin doses. Median unmaintained remission duration for the ten patients in CR was 11 months. Cardiotoxicity, determined by radionuclide physiologic studies, occurred in 16 patients at a mean dose of 459 mg/m2; three patients developed reversible congestive failure. There were no toxic deaths. The median overall survival was 18 months. These data suggest that there is steep dose responsiveness to Adriamycin in metastatic breast cancer, and that more effective techniques for using Adriamycin may exist than those conventionally used. PMID- 3806166 TI - Differences in cerebrospinal fluid penetration of corticosteroids: possible relationship to the prevention of meningeal leukemia. AB - The disposition of the synthetic corticosteroids, dexamethasone and prednisolone, in CSF was evaluated following bolus intravenous (IV) and intrathecal (IT) injection in a nonhuman primate model. Steroid concentration in plasma and CSF was measured with a radioimmunoassay following celite column chromatography. The CSF to plasma ratios of dexamethasone and prednisolone following IV bolus administration were 0.15 +/- 0.02 and 0.08 +/- 0.03, respectively. Although peak levels of the two steroids in the CSF reached equally potent levels when administered systemically in equipotent doses, the half-life of prednisolone in the CSF was shorter. In addition, there was a significant difference in the plasma protein binding of the two steroids, which may account for the differences in their CSF pharmacokinetics. Dexamethasone was 70% protein bound over a wide concentration range, while the protein binding of prednisolone was concentration dependent, ranging from 60% at 10 mumol/L to 95% at 0.5 mumol/L and below. After the initial distribution phase in plasma, CSF concentrations of dexamethasone and prednisolone approximated free plasma concentrations, indicating that penetration into the CSF was limited primarily by protein binding. At the plasma concentrations achieved following oral administration of standard doses of prednisone in children, the prednisolone (the active metabolite) is greater than 90% protein bound. The proportionally higher free plasma levels of dexamethasone result in greater penetration into the CSF. These findings may explain the lower rates of meningeal leukemia observed in children receiving dexamethasone instead of prednisone for the treatment of acute lymphoblastic leukemia (ALL). PMID- 3806167 TI - The detection of bone marrow involvement by lymphoma using magnetic resonance imaging. AB - We used magnetic resonance (MR) to image the bone marrow of 31 patients with lymphoma. Images were obtained of the femoral, pelvic, and vertebral marrow with a 0.15 tesla imaging system using a T1-weighted spin echo sequence (TR600/TE 40). With this pulse sequence, normal marrow produces a high intensity signal that reflects the presence of marrow fat (short T1 relaxation time). We previously reported MR imaging of patients with leukemia in relapse and found a diffusely and symmetrically decreased marrow signal intensity due to the replacement of normal marrow fat by cellular material with a long T1. Unlike leukemia, patients with lymphomatous marrow involvement often had patchy, often discrete, areas of low signal intensity, representing focal marrow infiltration. Five of six patients in this study with lymphoma detected by histologic examination also had marrow lesions seen on MR. An additional four patients had marrow lesions detected by MR that were not detected on initial marrow biopsies; two of these had marrow involvement proven on subsequent biopsies, one had disease isolated to the vertebrae that was never pathologically documented, and one had progression of disease in the marrow documented by MR without biopsy confirmation. These results indicate that marrow involvement with lymphoma can be detected by MR imaging and that MR can complement bone marrow biopsy. PMID- 3806168 TI - Semen cryopreservation and artificial insemination for Hodgkin's disease. AB - Seventy-nine men with Hodgkin's disease were treated with chemotherapy protocols at Memorial Sloan-Kettering Cancer Center and had pretreatment semen analysis performed at the area semen bank. The patients were evaluated to determine: the quality of pretreatment semen, the effect of treatment on spermatogenesis, and the success rate of artificial insemination after semen cryopreservation. Pretreatment sperm concentration, fresh motility, fresh progression, postthaw motility and postthaw progression were all significantly decreased in men with Hodgkin's disease compared with normal controls. Posttreatment semen analysis in 44 men showed azoospermia in 80%, sperm concentration, less than or equal to 10 X 10(6)/mL in 11%, and sperm concentration greater than 10 X 10(6)/mL in 9%. Eleven couples attempted artificial insemination using cryopreserved semen, thus far resulting in three pregnancies. Semen cryopreservation and artificial insemination offer a partial solution to posttreatment azoospermia in this population, but further methods are needed to minimize gonadal toxicity without compromising therapy for Hodgkin's disease. PMID- 3806169 TI - Adjuvant methotrexate escalated to toxicity for resectable stage III and IV squamous head and neck carcinomas--a prospective, randomized study. AB - To determine if adjuvant methotrexate (MTX), escalated weekly to toxicity, could improve disease-free survival (DFS) and overall survival by preventing recurrent disease, 60 patients with potentially resectable stage III or IV squamous head and neck carcinomas were stratified by primary site, stage, and nutritional status, then randomized by pairs to receive or not receive adjuvant MTX. All received standard surgery and postoperative radiation therapy. Five patients were taken off study because of unresectability at the time of surgery, leaving 55 evaluable patients. There were no statistically significant imbalances in known prognostic factors between the two treatment arms. MTX was begun at 40 mg/m2 and escalated 10 mg/m2 weekly (four doses preoperatively; four doses postoperatively, preradiation therapy; eight doses postradiation therapy) to mucosal or hematologic toxicity. The median peak MTX dose achieved was 80 mg/m2. Although three patients were hospitalized with MTX toxicity, none died of MTX toxicity. No patient receiving MTX had disease progression during treatment, and there was no increase in postoperative complications. Thirty-two patients died (median survival, 19 months); 23 patients are alive with median follow-up of 43 months. There was no statistically significant difference in actuarial DFS (P = 1.0) or overall survival (P = .61). Although patients on the MTX arm appeared to have less local and regional recurrences at first recurrence (thus more distant metastases), this did not reach statistical significance (P = .06). There was no significant difference between the sites of recurrence at death or last follow-up (P = .38). PMID- 3806170 TI - Gallium nitrate inhibits accelerated bone turnover in patients with bone metastases. AB - Bone metastases are a major source of morbidity in patients with cancer. Previously, we found that gallium nitrate was a highly effective treatment for cancer-related hypercalcemia. Laboratory studies have shown that this drug inhibits bone resorption in vitro and that short-term treatment in vivo increases the calcium content of bone. We evaluated the clinical effects of gallium nitrate on biochemical parameters of increased bone turnover in 22 patients with bone metastases. Treatment with gallium nitrate for five to seven days caused a median reduction in 24-hour urinary calcium excretion of 66% relative to baseline measurements (P less than .01). Hydroxyproline (OHP) excretion was also significantly reduced (P less than .01). The greatest reduction in hydroxyprolinuria occurred in patients with high baseline excretion. Ionized serum calcium and serum phosphorous declined significantly after treatment (P less than .01 for each). Serum immunoreactive parathyroid hormone (PTH) increased significantly (P less than .01), as did serum levels of 1,25 (OH)2-vitamin D3 (P less than .05). Urinary phosphorous excretion and serum levels of 25-OH-vitamin D3 were not significantly changed. No major toxic reactions occurred as a result of this treatment. These results indicate that gallium nitrate significantly reduces biochemical parameters associated with accelerated bone turnover and that this agent may be useful for preventing pathologic conditions associated with bone metastases. PMID- 3806171 TI - Creatinine clearance as a predictor of ultrafilterable platinum disposition in cancer patients treated with cisplatin: relationship between peak ultrafilterable platinum plasma levels and nephrotoxicity. AB - Ultrafilterable platinum (UP) disposition was studied in 22 cancer patients receiving their first course of cisplatin (50 to 140 mg/m2) by two-hour infusion. UP plasma and urinary platinum levels were quantitated using a high-performance liquid chromatographic (HPLC) assay, which was selective for cisplatin and active platinum metabolites. Creatinine clearance was determined in all patients at the time of the pharmacokinetic studies and ranged from 58 to 214 mL/min. Creatinine clearance was a poor predictor of UP disposition in patients, probably as a consequence of the complex renal clearance mechanism for UP in the human kidney, which involves both tubular secretion and reabsorption. However, the peak plasma level of UP was closely related to the area under curve (AUC) of UP (r2 = .831), P less than .0001) and was significantly correlated with the decline in creatinine clearance observed after four courses of cisplatin therapy to 12 of the patients (r2 = .727, P less than .005). Cisplatin dose and the AUC of UP were less satisfactory predictors of the change in creatinine clearance with four courses of therapy (r2 = .488, P less than .025 and r2 = .623, P less than .005). The large interpatient variability in all the parameters of cisplatin disposition measured in this study suggested that there may be a role for individualization of cisplatin dosage based on a peak level obtained in the first course of therapy. Longer term infusion of cisplatin could also be justified. PMID- 3806172 TI - Treatment of hepatosplenic candidiasis with liposomal-amphotericin B. AB - Nine patients with hematologic malignancies developed fungal infections, predominantly involving the liver and spleen. Eight patients had biopsy documented progressive candidiasis and one had an unclassified fungus. The patients were treated with liposomal-amphotericin B (L-AmpB) after their fungal infection progressed during treatment with standard intravenous (IV) AmpB (Fungizone; E. R. Squibb & Son, Princeton, NJ) and/or other antifungals. Eight patients (88.8%) were cured of their fungal infection, and one showed improvement after treatment. Minor acute toxicity and no chronic toxicity were associated with the administration of L-AmpB. L-AmpB is a safe and effective therapeutic method for treating fungal infections that have invaded the liver and spleen even when they are refractory to conventional anti-fungal therapy. PMID- 3806173 TI - Chromosomal translocations in secondary leukemias. PMID- 3806174 TI - Randomized concurrent control groups. PMID- 3806175 TI - Cisplatin-induced hepatic toxicity. PMID- 3806176 TI - Psychotoxicity from antineoplastic agents. PMID- 3806177 TI - MOPP after two decades. PMID- 3806178 TI - Soft-tissue sarcomas of the extremities. PMID- 3806179 TI - Progression sites of metastatic breast cancer under chemotherapy. PMID- 3806180 TI - The ventroposterior inferior nucleus in the thalamus of cats: a relay nucleus in the Pacinian pathway to somatosensory cortex. AB - The ventroposterior region of the thalamus of mongrel cats was searched to locate zones activated by somatic stimuli. By using stimuli that selectively excited Pacinian corpuscles, areas activated by this class of afferent fibers were differentiated from regions activated by other classes of cutaneous mechanoreceptors. The results showed that Pacinian inputs excite neurons in the ventroposterior inferior nucleus (VPI) of the thalamus, whereas other more dorsal zones within the ventroposterior thalamus receive inputs from other mechanoreceptor classes. This definition of the VPI tended to be larger and to extend further lateral than some published descriptions. Horseradish peroxidase (HRP) was injected into ventroposterior zones shown by electrophysiological recordings to receive inputs from Pacinian afferents. Subsequently, labeled cell bodies were observed in the caudal poles of the dorsal column nuclei, a region previously shown to be activated by Pacinian afferents. Very few labeled cells were found in the central region of these nuclei, a region previously shown to be activated by other classes of cutaneous mechanoreceptors. Electrophysiological recordings were used to locate a small portion of the second somatosensory cortex driven by Pacinian stimuli. When HRP was injected into this region cell bodies in the VPI and the lateral part of the posterior group were labeled, but few or no labeled cells were found in ventroposterior lateral nucleus. We hypothesize that the VPI receives Pacinian information from a cytoarchitecturally distinct region in the caudal poles of the dorsal column nuclei. Further, we suggest that a major cortical target for the VPI is a subdivision of the second somatosensory cortex. These studies do not exclude the possibility that Pacinian inputs have other thalamic and cortical targets. PMID- 3806181 TI - Combined eye-head gaze shifts in the primate. I. Metrics. AB - Gaze (eye-in-space) velocity-duration and velocity-amplitude curves were prepared for head-fixed and head-free gaze shifts in the rhesus monkey with an emphasis on large amplitudes. These plots revealed the presence of two distinct gaze reorientation mechanisms, one used when the gaze shift was small (less than 20 degrees) and the other utilized for large coordinated gaze shifts when the head was free. When head-free and head-fixed saccadic gaze shifts were compared in the same animal, no differences in the metrics were found for amplitudes less than 20 degrees. However, for large gaze shifts where contribution of the head to the change in gaze angle was considerable, head-free saccades were found to exhibit lower peak gaze velocities and greater durations than those recorded with the head-fixed paradigm. In order to differentiate between the eye saccades and combined saccadic eye-head gaze shifts, the latter have been termed gaze saccades. Change in head position and change in eye position were both measured during the actual gaze shift and were plotted against the gaze-shift amplitude to determine whether the head movement contributed significantly to the change in gaze angle. The results indicate that below 20 degrees the gaze shift is accomplished almost exclusively with the eyes and the head moves very little; however, for larger saccades, the head contributes approximately 80% of the total change in gaze angle with the eyes contributing only approximately 20%. Large saccadic eye-head gaze shifts do not exhibit 'bell-shaped' velocity profiles as do smaller head-fixed saccades; instead, gaze accelerates to reach a peak velocity after approximately 30-40 ms. This velocity is then maintained for the duration of the gaze shift. Close scrutiny of the fine structure of the velocity profiles of the eye, head, and gaze channels indicates that during gaze saccades, the eye and head movement motor programs interact to maintain gaze velocity nearly constant, unaffected by changes in head velocity. Previous authors had stated that when velocity-duration plots are obtained for oblique saccades of constant amplitude, the resulting points could be fitted with a hyperbolic function. These results were confirmed for head-free gaze saccades and extended to larger amplitudes. When an oblique saccade is made, the smaller component is stretched in duration to match the duration of the larger component. However, as the gaze shift becomes large (greater than 40 degrees), the relationship becomes more complex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806182 TI - Combined eye-head gaze shifts in the primate. II. Interactions between saccades and the vestibuloocular reflex. AB - The mechanisms of eye-head coordination were studied in two alert juvenile rhesus monkeys. Animals were trained to follow a target light to obtain a water reward and the combined eye-head gaze shifts in response to target steps with a variably sized horizontal components were studied. During a certain random portion of the gaze shifts, a torque motor was used to perturb the head to investigate the operational state of the vestibuloocular reflex (VOR) during the saccadic gaze shift. The effects of perturbing the head were assessed during five different conditions: horizontal target steps ranging from 10 to 80 degrees in amplitude; oblique target steps where the vertical component was larger than the horizontal component; purely vertical target steps 10-40 degrees in amplitude; both horizontal and oblique target steps delivered while the animals' saccades had been slowed by the use of diazepam; and large spontaneous gaze shifts in response to both sounds and visual stimuli. Comparison of perturbed and unperturbed large amplitude (greater than 40 degrees) gaze shifts indicate that the VOR is turned off for most of the duration of the movement. Nonetheless, there is an apparent interaction between the saccadic eye movement and the head movement, thus, as the head velocity increases, the eye velocity decreases so that gaze velocity remains nearly constant throughout the gaze shift. Since the VOR is turned off when this interaction occurs, it must represent an interaction between the actual eye and head movement motor programs themselves. Although the results were not quite as clear for small saccades (less than 20 degrees), experiments on animals whose saccades had been slowed either by the use of diazepam or by combining a small horizontal component with a large vertical component indicate that the VOR is left on during these smaller gaze shifts. During quite small gaze shifts (less than 10 degrees), the VOR is clearly functioning; however, as the size of the gaze shift is increased, this becomes less clear, and there appears to be a region where the VOR operates with a gain substantially less than normal before it enters the large gaze shift region where the VOR is turned off entirely.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806183 TI - Olfactory bulb responses to odor stimulation: analysis of response pattern and intensity relationships. AB - Extracellular recordings were made from mitral cells, tufted cells, and presumed glomerular layer and external plexiform layer interneurons of the olfactory bulb of anesthetized rats during odor stimulation. Intensity responses of these cells were studied by presenting a series of six or seven concentrations, spanning a range greater than two log units, in a cyclic artificial sniff paradigm, which produced repeated response measures at each concentration. Experiments focused on obtaining a complete intensity series, including interspersed unstimulated spontaneous activity records, for a single odorant (usually amyl acetate), but concentration responses to other odorants were tested when possible. Odor responses of 46 cells were studied with two approaches. Response form was examined in an attempt to define response classes based on qualitative characteristics of the temporal pattern of response. Assessment of response magnitude was attempted, in order to construct stimulus-response functions for each cell, independent of response form. As previously reported for olfactory bulb cells, the cells in our sample responded to odor stimulation with spike trains of a variety of temporal patterns, consisting of excitatory and inhibitory components that were frequently recognizable in the responses of a cell across a range of concentrations. However, response patterns usually changed significantly with concentration, such that response form across the concentration range could not be predicted from the response at any one concentration. Responses of different cells were sometimes similar to each other in form at one concentration and quite different from each other in the rest of their concentration-response profiles. Classification of response profiles into discrete types, based on consistency of response form throughout the profile, was therefore not feasible. In agreement with other reports, response of a single cell to different odorants sometimes showed similar forms and sometimes showed very different forms across the concentration-response profiles. Since the response form depends on the stimulus intensity as well as the stimulus quality, characterization of response magnitude and of the pattern of response to different odors require testing with a series of stimulus concentrations. Because odor responses consisted of temporally patterned spike trains, whose components changed in complex ways with stimulus intensity, it was not possible to quantify response magnitude by measuring characteristics of particular response components or counting mean frequency.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806185 TI - Tooth pulp deafferentation is associated with functional alterations in the properties of neurons in the trigeminal spinal tract nucleus. AB - The effects of deafferentation of the tooth pulps of mandibular or maxillary teeth were investigated on the functional properties of single neurons recorded in the subnucleus oralis of the trigeminal (V) spinal tract nucleus of adult cats. Deafferentation was produced by endodontic removal, under sterile conditions, of the coronal pulp of the canine, premolar, and molar teeth. The subnucleus oralis of each animal was then studied electrophysiologically in a series of microelectrode penetrations of the subnucleus at a single postoperative time that varied between 3 days and 2 yr. Data from deafferented cats were compared with those obtained from control (unoperated) animals. The study was based on an examination of over 2,000 single units recorded on the side ipsilateral to the pulp deafferentation. In animals deafferented 7-15 days prior to brain stem neuron recording, tooth pulp deafferentation was associated with a statistically significant decrease compared with control animals in the incidence of neurons having a mechanoreceptive field localized within the mandibular or maxillary division; this decrease in incidence was coincident with a significant increase in the occurrence of neurons having a mechanoreceptive field involving two or three V divisions. Linear trend analysis indicated a progressive return to control values from the 7- to 15-day postoperative period. In deafferented cats there were also statistically significant increases in the incidence of neurons having spontaneous activity or showing rapidly habituating responses to brisk tap stimuli applied to the orofacial region; neurons having a receptive field consisting of discontinuous zones of mechanosensitivity were also encountered. The mean impulse frequency of spontaneous activity was not, however, significantly different between control and deafferented animals. The responsiveness of the habituating tap-sensitive neurons was further quantified and compared with neurons showing normal rapidly adapting (RA) features of their responses to mechanical orofacial stimuli. Whereas most (85%) of the RA neurons could faithfully follow stimuli applied by a mechanical stimulator at a mean maximal following frequency of 6.6 Hz and showed entrainment and 'turning curve' profiles comparable to those previously described for oralis neurons in normal animals, most of the habituating tap-sensitive neurons could not follow mechanical stimulus frequencies greater than 1 Hz (mean maximal following frequency 0.3 Hz) and none could be entrained sufficiently to allow for a determination of their tuning curve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806184 TI - Effect of unilateral cerebral cortical lesions on ocular motor behavior in monkeys: saccades and quick phases. AB - Saccades and quick phases of vestibular and optokinetic nystagmus were quantitated using the magnetic-field search coil technique before and during 1 yr after unilateral decortication in three rhesus monkeys. Saccades were examined during several different behavioral conditions: spontaneous saccades made in the light and in the dark; intentional saccades including visually guided saccades to a target light, predictive saccades to a target light stepped to a predictable location, and target-searching saccades when the monkey was rewarded to find and fixate the target light located in the defective visual hemifield; and reflexive saccades made to novel visual, auditory, and tactile stimuli. Quick phases of nystagmus and spontaneous saccades could be initiated immediately postoperatively, although those initiated away from the side of the lesion were reduced in amplitude and rarely moved the eyes into contralateral craniotopic space. Intentional and reflexive saccades could not be initiated away from the side of the lesion during the first postoperative week. Visually guided saccades and reflexive saccades to stationary or moving visual stimuli in the defective visual hemifield never recovered. Target-searching and predictive saccades directed away from the lesioned side recovered but were generated in a staircase pattern; those saccades from orbital positions further into craniotopic space on the side opposite the lesion had progressively higher latencies and smaller amplitudes. The amplitudes of visually guided saccades to targets stepped into the normal visual hemifield were increased in amplitude by approximately 15% but slowly returned to near preoperative values by 20 wk. Pure vertical visually guided saccades to targets stepped or moved in the vertical direction were not generated throughout the postoperative period. Instead, the animals generated oblique saccades, tilted 10-15 degrees toward the side of the lesion. Velocities of saccades and quick phases were significantly reduced at all amplitudes both away from (approximately 37%) and toward (approximately 22%) the side of the lesion. This deficit diminished with time but velocities were still low one yr postoperatively. Our results suggest that cortical areas in one hemisphere are involved in the initiation of contralaterally directed intentional and reflexive saccades but not in the initiation of spontaneous saccades or quick phases. In time, other structures can initiate contralaterally directed intentional and reflexive saccades, except those guided by vision.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806186 TI - Changes in neuronal activity of the monkey precentral cortex during preparation for movement. AB - The aim of this study was to analyze the changes in neuronal activity of the motor cortex associated with preparation for movement. Monkeys were trained to perform a between-hands choice-reaction time (RT) task. They pressed upon two levers with both hands and, after a preparatory period of 1-s duration initiated by a warning tone, they must point at either a left- or right-located target, when illuminated as a response signal, with either the left or right hand. The level of preparation for performing either sided movement was changed by manipulating, across block of trials, the relative probabilities for the left and right hands to point at the corresponding target. When considering behavioral data averaged over daily sessions, it was found that RT significantly decreased as response probability increased, whereas movement time (MT) was not affected. However, large changes in this rule were observed when data collected within a single session were considered. Response probability manipulation was acting on RT alone in 27% of sessions, on MT alone in 19% of sessions, and on both RT and MT in 17% of sessions. Statistically significant trial-by-trial correlations between RT and MT were found; of positive sign for 34% of sessions and of negative sign for 12% of sessions. Electromyographic recordings from the biceps and triceps brachii showed that muscle activity remained stable during the preparatory period, both muscles of the performing arm began to be coactivated about 70-130 ms before the lever release, biceps activation being progressively larger than that of the triceps, and the rising slope of biceps activation was steeper for short than for long RTs. Single-cell recording techniques were used to study the neuronal activity of primary motor cortex during the performance of the task. One hundred and fifteen units in area 4, whose activity was recorded during a whole experimental session, were selected for further analysis. Disregarding 4% of units which did not exhibit any movement-related change in activity, it was found that twenty-one percent of units were related to contralateral movements only, 2% to ipsilateral movements only, and 73% to both sided movements. Among this last subset, 27% of units exhibited reciprocal movement-related changes in activity, the most often an excitation for contralateral movements and an inhibition for ipsilateral movements, and 50% of units exhibited a movement-related change in activity in the same direction for both movements, the most often an excitation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806187 TI - Neural mechanisms of tone-on-tone masking: patterns of discharge rate and discharge synchrony related to rates of spontaneous discharge in the chinchilla auditory nerve. AB - Responses of chinchilla auditory nerve fibers to brief probe tones in the presence of a fixed tonal masker were obtained. The stimulus conditions were analogous to those that have been used in many psychophysical experiments. The relation between previously described response properties of auditory nerve fibers and features of psychophysical tone-on-tone masking was examined. In psychophysical studies, a fixed narrowband masker produces a characteristic pattern of masked thresholds, which becomes broad and asymmetrical at high masker levels. In the present experiment 1, a 5,000-Hz masker was presented at 30, 50, and 70 dB SPL. Masked thresholds based on the average rate of response to probe tones were estimated for single auditory nerve fibers. The lowest of these masked thresholds formed a pattern similar to the psychophysical masking pattern, becoming broader and more asymmetrical as the masker was increased to 70 dB SPL. The masked thresholds of fibers with low and medium rates of spontaneous discharge (SR) were as low as or lower than the masked thresholds of fibers with high SRs. In certain frequency regions, masked thresholds based on responses to cochlear distortion products were lower than the masked thresholds of any fiber responding to the probe tone; this result is also similar to previous psychophysical observations. In experiment 2, responses of chinchilla auditory nerve fibers to probe tones in the presence of a masker at 1,000 Hz and 50 dB SPL were studied. Probe tone thresholds in the presence of this masker have been measured psychophysically in chinchillas. Thus the relation between behavioral and neural masked thresholds in the same species could be examined. Masked thresholds were estimated from average discharge rate responses and also from discharge synchrony. Good quantitative agreement was observed between the probe tone levels at which changes in average discharge rate were observed and the chinchilla's behavioral masked thresholds. For fibers matched for characteristic frequency, the masked thresholds based on average discharge rate of high-SR fibers tended to be elevated compared with the thresholds of medium-SR fibers. Changes in discharge rate synchronized to the probe tone occurred at levels lower than the chinchilla's behavioral masked thresholds. If discharge synchrony can be used for detection, the code would appear to be based on the relative synchrony to the probe tone and to the masking tone. Low synchrony masked thresholds were obtained from fibers with all SRs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806188 TI - Selective growth of rat Schwann cells in neuron- and serum-free primary culture. AB - A serum-free medium, designated S4 [consisting of Eagle's Minimum Essential Medium supplemented with the following components (mg/liter): endothelial mitogen, 100; vitamin C, 1; insulin, 5; cholera toxin, 0.01; putrescine, 8; sodium selenite, 0.0043; MgCl2 X 6H2O, 40; and albumin, fatty acids, amino acids, vitamins, and trace elements], has been established to select for the growth of Schwann cells from primary cultures of dissociated neonatal rat sciatic nerve in the absence of neurons and without exposure of the cells to serum or antimitotic agents. By immunological criteria, confluent primary cultures, grown on a substrate of extracellular matrix derived from cultured bovine aorta endothelial cells, consist of approximately 90% Schwann cells after maintenance in this serum free medium. Secondary cultures of at least 99% purity may be established after treatment of primary cultures maintained in S4 with antiserum against a fibroblast surface antigen, Thy 1.1, in conjunction with complement. Such secondary Schwann cells continue to proliferate in S4, with no decrease in purity, through at least 4 passages. PMID- 3806189 TI - Development of learning and memory in Aplysia. I. Functional assembly of gill and siphon withdrawal. AB - The marine mollusc Aplysia californica provides an excellent preparation with which to examine the development of the neuronal control of behavior for 2 reasons: first, adult Aplysia exhibit a variety of behaviors that are well understood in cellular terms; and second, the development of Aplysia from embryo to adult has been studied in considerable detail. Among the best understood behaviors in Aplysia are the withdrawal responses of the mantle organs (the gill, siphon, and mantle shelf), which exhibit 2 different kinds of behaviors: "spontaneous" contractions that are part of a fixed action pattern, a respiratory pumping sequence of the mantle organs, and reflex contractions in response to tactile stimuli. We have examined the development of both of these withdrawal behaviors in juvenile stages 9-12 and found that they are functionally assembled according to different ontogenetic timetables. Spontaneous contractions. As soon as the siphon and gill emerge, in stages 9 and 10, respectively, they each show a high rate of spontaneous contraction that gradually diminishes throughout subsequent stages until it reaches the low rate typical of adults (stage 13). Since the siphon emerges first, it already exhibits a significant decline in its spontaneous activity (e.g., in stage 11) when the gill's spontaneous activity is at its highest. In addition to a developmental trend in the rate of contractions, there was also a clear developmental progression in the degree of cocontraction of the siphon and gill during spontaneous contractions. In adults, the siphon and gill show a very high degree of cocontraction during spontaneous pumping. However, in juvenile animals, there was a very low degree. Thus, it appears that the siphon and gill withdrawal components of the fixed action pattern become progressively more functionally coupled during juvenile development. Reflex contractions. As soon as the siphon and gill emerge in their respective developmental stages, they exhibit a brisk withdrawal reflex to tactile stimulation of the siphon. Moreover, at each developmental stage, reflex siphon contractions were graded as a function of stimulus intensity, as they are in the adult. Finally, throughout development tactile stimulation of the siphon invariably evoked coincident contractions of both the siphon and the gill, which is characteristic of the adult reflex. Thus, unlike the fixed action pattern that takes several weeks to mature, the defensive withdrawal reflex closely resembles the adult form as soon as the effector organs emerge during juvenile development.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806190 TI - Development of learning and memory in Aplysia. II. Habituation and dishabituation. AB - The defensive withdrawal reflex of the mantle organs of Aplysia californica exhibits a variety of forms of both nonassociative and associative learning, which can exist in both short- and long-term forms. In addition, the reflex can be readily elicited and quantified as soon as the effector organs (siphon and gill) emerge at their respective developmental stages. Thus, this reflex system provides a useful preparation in which to study the development of learning and memory. In the present series of experiments we investigated the development of 2 forms of nonassociative learning, habituation and dishabituation, in the siphon withdrawal component of the reflex. This reflex response could be examined throughout the juvenile life of the animal (stages 9-12) since the reflex is functionally intact as soon as the siphon emerges in stage 9 (Rankin et al., 1987). We studied the development of habituation in stages 9-12 using tactile stimuli to the siphon delivered at interstimulus intervals (ISIs) of 1, 5, 10, and 30 sec. Habituation of siphon withdrawal was evident as early as juvenile stage 9. However, it existed in an immature form: Significant habituation was produced only with a very short (1 sec) ISI. No significant habituation occurred in response to 5 or 10 sec ISIs. Approximately 4 d later, in stage 10, significant habituation occurred to both 1 and 5 sec ISIs but not to a 10 sec ISI. Finally, approximately 1-2 weeks later, in stage 11, significant habituation occurred to 1, 5, and 10 sec ISIs but not to a 30 sec ISI, whereas stage 12 juveniles and adults (stage 13) readily habituated to a 30 sec ISI. Thus, there was a systematic developmental trend in the ability of the animals to habituate: Progressively older animals were capable of habituation to stimuli presented at progressively longer intervals. The systematic development of habituation was also evident by examining the amount of habituation exhibited to comparable ISIs by animals at different developmental stages. For all 4 ISIs examined, older animals showed significantly greater habituation than younger animals. Thus, our results show that habituation is present as soon as the siphon response system emerges and that it develops progressively throughout the juvenile life of the animal. Whereas habituation was present in the earliest developmental stage we examined (stage 9), dishabituation (in response to tail shock) did not emerge until 4-7 d later, in stage 10.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806191 TI - Development of learning and memory in Aplysia. III. Central neuronal correlates. AB - The defensive withdrawal reflex of the mantle organs of Aplysia californica has 2 major components, siphon withdrawal and gill withdrawal. In the previous paper of this series (Rankin and Carew, 1987), the development of 2 forms of nonassociative learning, habituation and dishabituation, was examined in the siphon withdrawal component of the reflex. In the present study we examined these same forms of learning in the gill withdrawal component of the reflex. The purpose of these experiments was 2-fold: to examine the development of learning in the other major component of the reflex; and to establish preparations in which it is possible to carry out a cellular analysis of the development of learning in the CNS. We first established that the gill withdrawal reflex in intact animals exhibited significant habituation in response to repeated tactile stimulation of the siphon and significant dishabituation in response to tail shock. We next determined the contribution of the CNS to the gill withdrawal reflex by surgically removing the abdominal ganglion from intact animals. Using the same stimulus intensity (4 mg) that produced habituation in the previous experiments, we found that the CNS accounted for approximately 95% of the reflex. Finally, we developed 2 preparations that allowed us to relate behavioral observations of learning directly to neural plasticity exhibited in the CNS. In a semi-intact preparation gill withdrawal was behaviorally measured as in the intact animal, but tactile stimulation of the siphon (to produce habituation) and shock to the tail (to produce dishabituation) were replaced by electrical stimulation of the siphon nerve and left connective, respectively. Stimulation parameters were matched to produce behavioral responses comparable with those in the intact animal. In an isolated CNS preparation the same nerve stimuli were used as in the semi-intact preparation, but the response measure used was the evoked neural discharge recorded in an efferent nerve innervating the gill. Both preparations exhibited response decrement and facilitation that was quantitatively as well as qualitatively similar to that observed in intact animals, indicating that 2 simple forms of learning exhibited by the gill withdrawal reflex in juvenile Aplysia can be localized to neural circuits within the abdominal ganglion. PMID- 3806192 TI - Functional properties of parietal visual neurons: mechanisms of directionality along a single axis. AB - The directional properties of parietal visual neurons (PVNs) were examined using the method of single-neuron analysis in waking monkeys. PVN properties were determined with passive visual stimuli as the animal executed a simple detection task. Parietal area PG was studied in 10 hemispheres of 6 male Macaca mulatta. Each class of parietal neurons was identified in PG: the fixation, projection, visual, and oculomotor neurons; 613 PVNs were identified, 323 were studied quantitatively, and 188 were studied with one or more of the protocols described. The receptive fields of PVNs are commonly large and bilateral, and at the limit some may fill the visual field; for many, the central zone of the visual field is spared when the fields are determined by stimuli that enter from the periphery and transit meridians. The receptive fields vary with the behavioral state, the angle of gaze, and the parameters of the stimuli used to determine them. PVNs are sensitive to stimulus movement but relatively insensitive to stimulus speed; many respond over a speed range of 5 degrees-500 degrees/sec. Stimulus-response relations may be incremental or decremental with increasing speed or show maxima or minima in the midrange of speed, but the response variation over the full range is rarely greater than 2:1. The directional preferences of PVNs with bilateral receptive fields are opponently organized; the preferred directions point either inward toward or outward away from the central line of gaze along the 4 meridians tested, which were equally spaced in the circular dimension of the visual field. The mechanism of the axis directionality of PVNs was studied using conditioning-test paradigms. They revealed a feed-forward inhibition preceding a stimulus, an effect that extends from the leading edge of the stimulus for 10 degrees-20 degrees in front of the moving stimulus and lasts for several hundred milliseconds. A double-Gaussian model of superimposed but unequal excitatory and inhibitory effects suffices to explain the present observations. It places demand upon the projection of functional properties from the contralateral hemisphere or from the ipsilateral prestriate areas that project upon PG over multistaged pathways and minimal demands upon intracortical processing mechanisms. PMID- 3806193 TI - Functional properties of parietal visual neurons: radial organization of directionalities within the visual field. AB - Parietal visual neurons (PVNs) were studied in waking monkeys as they executed a simple fixation-detection task. Test visual stimuli of varied direction, speed, and extent were presented during the fixation period; these stimuli did not control behavior. Most PVNs subtend large, bilateral receptive fields and are exquisitely sensitive to stimulus motion and direction but insensitive to stimulus speed. The directional preferences of PVNs along meridians are opponently organized, with the preferred directions pointing either inward toward or outward away from the fixation point. Evidence presented in the preceding paper (Motter et al., 1987) indicates that opponent directionality along a single meridian is produced by a feed-forward inhibition of 20 degrees-30 degrees spatial extent. The observations fit a double-Gaussian model of superimposed but unequal excitatory and inhibitory receptive fields: When the former is larger, inward directionality results; when smaller, outward directionality results. We examine here the distribution of the meridional directional preferences in the visual field. Tests showed that opponent organization is not produced by differences in local directional properties in different parts of the receptive field. The distribution of response intensities from one meridian to another is adequately described by a sine wave function. These data indicate a best radial direction for each neuron with a broad distribution of response intensities over successive meridians. Thus, any single PVN, with rare exceptions, cannot signal radial stimulus direction precisely. We then determined how accurately the population response predicted radial stimulus direction by the application of a linear vector summation model. The resulting population vector varied from stimulus direction by an average of 9 degrees. Whether or not the perception of the direction of motion depends upon a population vector remains uncertain. PVNs are especially sensitive to object movement in the visual surround, particularly in the periphery of the visual field. This, combined with their large receptive fields and their wide but flat sensitivity to stimulus speed, makes them especially sensitive to optic flow. This is discussed in relation to the role of the parietal visual system in the visual guidance of projected movements of the arm and hand, in the guidance of locomotion, and in evoking the illusion of vection. PMID- 3806194 TI - Neuronal control of bird song production. AB - Bird song represents a powerful model system for many of the important problems in behavioral neurobiology, offering both easily measured sensory and motor patterns and a discrete neural effector system. Methods were developed to record the discharge of neurons in singing birds to examine the functions of nuclei in the song control pathway previously implicated anatomically. In several cases, lesions and other techniques were employed to test predictions derived from electrode recordings. Four major findings emerge from these studies. Single-unit recordings from telencephalic nucleus hyperstriatum ventrale, pars caudale (HVc) show several classes of neurons with apparently specialized roles in song production and/or sensorimotor interaction. The nucleus interfacialis (Nlf; Nottebohm, 1980), which provides an input to HVc and is anatomically the "highest" nucleus in the descending motor pathway, is uniquely placed among vocal control nuclei to be a generator of timing cues for song. Consistent with the unidirectional connections between nuclei of the descending pathway, Nlf, HVc, and nucleus robustus archistriatalis (RA) are activated sequentially prior to sound onset. Three other nuclei with connections to or from the descending tract do not show song-related activity in the adult. Bilateral HVc recordings and peripheral disruptions of the vocal apparatus suggest that both hemispheres and syringeal halves normally make similar contributions to most if not all song syllables. The latter finding casts doubt on the analogy between neural lateralization in bird song and in human speech. PMID- 3806195 TI - Ultrastructural evidence related to presynaptic inhibition of primary muscle afferents in Clarke's column of the cat. AB - As part of an investigation on excitatory synaptic transmission in the mammalian CNS, we have examined ultrastructural details of the synaptic connection between primary afferent fibers and dorsal spinocerebellar tract (DSCT) neurons in Clarke's column of the cat spinal cord. Single primary muscle afferents (group Ia and Ib) and DSCT neurons were identified and stained intracellularly with HRP. The terminations of these afferent fibers were examined in serial sections under the EM. Five of 6 Ib boutons and 1 of 14 Ia boutons were contacted by small presynaptic boutons. An example was illustrated in which only 1 out of 7 boutons arising from the same Ia fiber and contacting the same postsynaptic DSCT neuron was contacted by a presynaptic bouton. It is likely that the presynaptic contacts are responsible for presynaptic inhibition of synaptic transmission between primary afferents and DSCT neurons. We have proposed that the observed differences in presynaptic contacts from bouton to bouton may be one of the causes of a nonuniformity in the probability of transmitter release between release sites at this connection. PMID- 3806196 TI - Increased beta-nerve growth factor messenger RNA and protein levels in neonatal rat hippocampus following specific cholinergic lesions. AB - High levels of NGF have recently been detected in cerebral cortex and hippocampus, and it was suggested that NGF supports cholinergic, basal forebrain neurons. The present study directly examined whether NGF levels are altered in the neonatal hippocampus following cholinergic denervation by transection of the fimbria. Ten days after transection, hippocampal cholinergic innervation, as assessed by AChE histochemistry and CAT immunohistochemistry, was decreased, and both hippocampal NGF mRNA and protein were elevated about 50%. This indicates possible lesion-induced transcriptional control of neonatal hippocampal NGF levels. This increase was specific to lesions of cholinergic systems, as entorhinal cortex ablation, which removes other afferent fibers to the hippocampus, did not cause a similar increase. At 30 d after fimbria transection, hippocampal NGF mRNA and protein did not differ from control levels, but the decrease in AChE and CAT staining persisted. Peripheral sympathectomy carried out in the adult rat resulted in 2- to 5-fold increases in NGF protein levels in heart atrium and ventricle, as well as submandibular gland, with no concomitant increase in NGF mRNA. Therefore, the control of NGF levels in the adult PNS is probably posttranscriptional. Our results strongly suggest that NGF is involved in the regulation of central cholinergic neurons and is transiently elevated in the neonatal hippocampus following cholinergic lesion. PMID- 3806197 TI - Preservation of motoneuron electrotonic characteristics during postembryonic growth. AB - The postembryonic developmental period of the nervous system involves, among other processes, an increase in the dimensions of individual neurons. In the present study we examine whether the characteristic electronic parameters that underlie the integrative properties of the neuron (L, the electrotonic length; rho, dendritic to somatic conductance ratio; and tau m, the membrane time constant) are established before, during, or after the neurons reach their final adult size. A second aspect that we analyze are the mechanisms by which the neurons adjust their electrotonic parameters during the growth period. The dimensions of the soma and dendrites of the phallic motoneurons (Ph.m.n.) of the cockroach, Periplaneta americana, increase during the last postembryonic developmental stages and metamorphosis to adult by a factor of 1.75 and 1.5, respectively. This increase is not associated with major changes in the morphological outline of the neuron but is associated with a significant decrease in the input resistance (Rin) by a factor of 6 (from 120 to 20 M omega). The dendritic to somatic conductance ratio (rho) is maintained constant. Morphological analysis of cobalt-filled neurons reveals that the neurons can be represented by an equivalent cylinder (Rall, 1969). Calculations of the electrotonic length (L) of the equivalent cylinder from measurements of the time constants tau m and tau 1 (Rall, 1969) revealed that L is constant throughout the period of neuronal growth (1.29 +/- 0.24 lambda in adult, and 1.13 +/- 0.28 lambda in nymph). The mechanism by which the electrotonic parameters are maintained in spite of growth is continuous adjustment of the diameter and length of the various neuronal segments, rather than by changes in the biophysical properties of the neuron. Several implications in relation to mechanisms of integration and input-output relations during growth and development of neurons are discussed in view of our findings. PMID- 3806198 TI - Evidence for two classes of nociceptive modulating neurons in the periaqueductal gray. AB - The midbrain periaqueductal gray (PAG) and the rostral ventromedial medulla (RVM) are important links in a neuronal network that modulates nociceptive transmission. In the RVM, 2 classes of cells have been identified that show changes in activity at the time of the tail-flick response (TF) elicited by noxious heat (Fields et al., 1983a). We now report that neurons in the PAG region also show changes in activity related to TF. Extracellular recordings were made from the PAG and the ventrally adjacent tegmentum at sites from which it was possible to inhibit TF using stimulating currents of 10 microA or less. Cell activity, time of TF occurrence, and tail temperature were recorded during 5 repetitions of the heat stimulus. Periresponse and peristimulus histograms were plotted with reference to the TF and tail temperature, respectively. A significant number of neurons in the PAG region showed changes in activity that preceded the TF. "Midbrain On-cells" (13.6% of the sample) displayed an abrupt increase in firing just prior to the TF. "Midbrain Off-cells" (4.4%) paused just prior to the TF. The remaining neurons (241 of 294, or 82%) did not exhibit changes in firing prior to the TF. Thus, cells with changes in activity related to the TF are present in the PAG region as well as in the RVM. The PAG has a large projection to the RVM, and microinjection of morphine in the PAG increases activity of RVM Off-cells and decreases that of RVM On-cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806199 TI - Principles of preparation of vein bypass grafts to maximize patency. AB - Experience in cardiovascular and peripheral vascular surgery with saphenous vein bypass conduits is reviewed. It is clear that meticulous technique and graft preparation are crucial to short-term and long-term patency. The risk of early thrombosis is related to damage to the graft's native intima, graft flow, and coagulability of the patient's blood. Attention to atraumatic harvesting techniques and perfection of anastomoses are crucial to minimizing intimal damage. Graft inflow and outflow are fundamental principles. The use of vitamin K antagonists and platelet inhibitors may improve graft survival. Subacute occlusion is related to structural alterations in the grafts themselves. These include intimal hyperplasia and medial fibrosis as the grafts become "arterialized," valve fibrosis, aneurysmal dilatation, clamp stenosis, and suture stenosis. Long-term patency is threatened primarily by atherosclerosis in the graft itself. There is some evidence that care in vein harvesting and implantation as well as the use of anticoagulant agents affect the development of this complication. A technique for graft preparation is presented that is based on the experience of the authors in harvesting grafts for both cerebral and coronary bypass conduits. PMID- 3806200 TI - Long-term intrathecal baclofen infusion for treatment of spasticity. AB - Seven patients with spasticity of spinal cord origin have been maintained for up to 2 years with continuous spinal intrathecal infusion of baclofen. Prior to treatment, all of the patients had severe rigidity in their lower limbs and most had frequent and extensive spontaneous spasms, all of which greatly interfered with their activities of daily living. Oral antispasmodic medications were ineffective or caused central side effects. The patients underwent implantation of a programmable drug pump connected to a lumbar subarachnoid catheter. Within days of beginning continuous intrathecal baclofen infusion, the muscle tone was reduced to normal levels and spasms were eliminated. Over the ensuing months, muscle tone remained normal, but short-duration spasms could be induced by some activities. The greatest benefits to the patients were improvement in activities of daily living and better sleep due to reduced spasms. The baclofen doses were increased over the first few months but then were stabilized or only increased slightly, with the maximum dose being 650 micrograms/day. The most serious complications were two drug overdoses which took several days to clear up and were due to malfunctions of an earlier pump model. Baclofen clearance from the cerebrospinal fluid occurs with a half-life of 5 hours. The most serious concern in maintaining patients indefinitely on intrathecal baclofen is whether drug tolerance will eventually occur. PMID- 3806201 TI - Intracranial carotid artery injury in closed head trauma. AB - Six patients with trauma to the intracranial internal carotid artery are reported. One patient died and two are permanently disabled due to ischemic sequelae. The incidence of this complication of trauma is unknown because of the infrequent use of angiography in head-injured patients. The pathology, clinical course, and management of this condition are discussed with reference to the 25 previously reported cases in addition to the six in this series. PMID- 3806202 TI - Giant intracranial varices secondary to high-flow arteriovenous fistulae. AB - An intracranial varix is rare and has been associated mostly with vein of Galen fistulae or arteriovenous (AV) malformations. The authors present eight cases of intracranial, pial or subpial AV fistulae with concomitant giant varices. Six were supratentorial and two were infratentorial. Only one case involved the vein of Galen. In six cases successful surgical and/or endovascular occlusion of the intracranial AV fistula was obtained, and one case was treated conservatively. Staging of surgery and postoperative hypotension were considered to be important in avoiding edema and hemorrhage following obliteration of a large AV shunt. One patient died from delayed postoperative intracerebral bleeding. PMID- 3806203 TI - Surgical treatment of Cushing's disease. AB - The endocrinological, radiological, surgical, and pathological experience with 34 consecutive patients operated on for Cushing's disease is presented. Preoperative endocrine evaluation demonstrated that 19 patients had "typical" endocrine patterns for pituitary adrenocorticotropic hormone (ACTH)-dependent hypercortisolism and 11 had "atypical" testing. Pituitary pathology was found in 95% of the patients with typical preoperative endocrine testing but in only 55% of those with atypical testing. Eight of 34 preoperative computerized tomography scans demonstrated tumors, which correlated in all instances with the surgical findings. Microadenomas were removed from 25 patients, 22 of whom achieved postoperative remission of endocrine symptoms. Macroadenomas were found in three patients, only one of whom achieved remission after surgery. One patient had removal of an adenoma in the pharyngeal pituitary, and in another an ectopic lung carcinoid was excised; both of these patients were in postoperative remission. Four patients underwent transsphenoidal exploration but no definitive explanation was found for their hypercortisolism; these patients were not in remission. Immunohistochemical staining was performed on every specimen and all tumors showed excessive ACTH-secreting cells. A new rapid stain of the fibrovascular stroma is described. PMID- 3806204 TI - Brain-stem tumors in childhood: a prospective randomized trial of irradiation with and without adjuvant CCNU, VCR, and prednisone. A report of the Childrens Cancer Study Group. AB - Seventy-four children with a brain-stem tumor diagnosed between 1977 and 1980 were entered into a prospective study in which exploration and assessment for resection were optional, radiation treatment using standard methods was required, and randomization occurred with regard to the use of adjuvant chemotherapy (1-(2 chloroethyl)-1-nitrosourea, vincristine, and prednisone) or no further treatment. The overall 5-year survival rate was 20% and was not improved by the adjuvant chemotherapy program. An increased risk of infection was associated with the adjuvant therapy. PMID- 3806206 TI - Effect of dexamethasone on experimental brain abscess. AB - Dexamethasone has been used to manage brain edema in patients with intracranial abscess. However, its administration has often been delayed or avoided for fear of adverse effects upon normal host responses to infection. An experimental model of brain abscess in the rat was developed to determine if dexamethasone produced adverse effects on immune competence and collagen deposition in the region of the abscess. Sprague-Dawley rats were inoculated with Staphylococcus aureus and treated intraperitoneally each day with either dexamethasone (0.25 mg/kg) or saline solution. Surviving animals were sacrificed at 4, 8, 12, or 18 days after treatment. The brains were examined grossly for abscess formation and microscopically for intensity of the inflammatory response, abscess diameter, and wall thickness. There were no differences in mortality rates, abscess production rates, or abscess diameters when groups were compared. The intensity of inflammatory response was similar in both groups. In the group sacrificed 8 days after inoculation, a delay in collagen deposition was apparent, manifested as a thinner abscess wall in the experimental group (mean: 17.8 mu in dexamethasone treated animals and 85 mu in saline-treated control animals: p = 1.0041). At 12 and 18 days after inoculation, there was no difference in abscess wall thickness between the control and experimental groups. Therapeutic doses of dexamethasone had little effect on mortality rates, incidence of abscess production, or intensity of inflammatory response in the experimental animals. Thus, dexamethasone did cause a delay in collagen deposition in the walls of experimental brain abscesses, but wall thickness 18 days after inoculation was not affected. PMID- 3806205 TI - Neurobehavioral outcome following minor head injury: a three-center study. AB - The majority of hospital admissions for head trauma are due to minor injuries; that is, no or only transient loss of consciousness without major complications and not requiring intracranial surgery. Despite the low mortality rate following minor head injury, there is controversy surrounding the extent of morbidity and the long-term sequelae. The authors postulated that consecutively admitted patients who fulfilled research diagnostic criteria for minor head injury and who were carefully screened for antecedent neuropsychiatric disorder and prior head injury would exhibit subacute cognitive and memory deficits that would resolve over a period of 1 to 3 months postinjury. To evaluate this hypothesis, the neurobehavioral functioning of 57 patients was compared within 1 week after minor head injury (baseline) and at 1 month postinjury with that of 56 selected control subjects at three medical centers. Quantified tests of memory, attention, and information-processing speed revealed that neurobehavioral impairment demonstrated at baseline by all means of measurement generally resolved during the first 3 months after minor head injury. Although nearly all patients initially reported cognitive problems, somatic complaints, and emotional malaise, these postconcussion symptoms had substantially resolved by the 3-month follow-up examination. The data suggest that a single uncomplicated minor head injury produces no permanent disabling neurobehavioral impairment in the great majority of patients who are free of preexisting neuropsychiatric disorder and substance abuse. PMID- 3806207 TI - Monitoring retraction pressure on the brain. An experimental and clinical study. AB - The problem of minimizing tissue damage during brain retraction was studied both experimentally in dogs and clinically with the aid of newly designed strain-gauge retractor. The pressure required to obtain a specific exposure decreased gradually with time. The average time for a 50% reduction in retraction pressure was 6.6 minutes in the earlier trials of repeated retraction. The attenuation rate of retraction pressure gradually decreased when retraction of the same area was repeated. The lower the head position of the dog, the larger was the amplitude of brain retraction pressure. Clinical studies demonstrated that: 1) cerebrospinal fluid drainage was effective in decreasing the retraction pressure required; 2) use of multiple retractors reduced the pressure applied by each retractor; and 3) retraction pressure could be monitored when the strain-gauge retractors were applied to arteries and cranial nerves. PMID- 3806208 TI - Feasibility of intracranial surgery in the primate fetus. Model and surgical principles. AB - A research model for intracranial surgery in the primate fetus was developed and tested in 10 timed-pregnant rhesus monkeys. With general anesthesia and sterile surgical technique, a laparotomy followed by a lower uterine segment hysterotomy was performed at a site avoiding the placenta. The amnion was opened carefully by use of the operative microscope and the fetal head was exposed. A scalp incision was made over the frontal region and a small craniectomy and cortical incision were carried out. In three of the fetuses, ventricular shunts were also placed. A layered closure was performed and the uterus was returned to the peritoneal cavity. Placental integrity and fetal viability were assessed before surgery and 1 week postoperatively by ultrasonography. The survival rates were 100% for the mothers and 80% for the fetuses. One fetus died in utero after an overdose of a sedative to the mother, and another was stillborn. Postmortem examination revealed no intracranial or systemic abnormalities in either case, and the cause of death was attributed to drug overdose and a naturally occurring stillbirth, respectively. Newborns were maintained either with their mothers or in a nursery, where they were observed and evaluated for 3 weeks. Weight, crown-rump length, and occipitofrontal head circumference were measured. General patterns of behavior and neurological assessments were recorded weekly. The eight surviving neonates were normal with respect to all parameters evaluated. Several principles of fetal intracranial surgery are emphasized as important: uterine relaxation by prostaglandin inhibition; low-dose halothane anesthesia supplemented by nitrous oxide in oxygen; perioperative ultrasonography and intraoperative transillumination of the uterus for placental localization; lower uterine segment opening; controlled exposure of the fetal cranium; minimization of amniotic fluid loss; enhancement of fetal anesthesia by injection of a local anesthetic agent at the fetal operative site; and multilayered watertight closure. PMID- 3806209 TI - Magnetic resonance images of brain-stem encephalitis. Case report. AB - The clinical and radiological findings in a case of brain-stem encephalitis are described with special emphasis on the serial magnetic resonance imaging. This pathological condition should be differentiated from brain-stem tumors, which may present with similar symptoms. PMID- 3806210 TI - Atlanto-axial dislocation in acute rheumatic fever. Case report. AB - A 10-year-old boy had a sore throat, followed in 4 weeks by acute rheumatic fever and in 6 weeks by atlanto-axial dislocation. Reduction of the dislocation by means of a halo vest relieved his pain, but the cervical spine remained unstable after 3 months of immobilization and required an occiput-C1-2 fusion and rib graft to stabilize the atlanto-axial joint. This is the eighth reported case of atlanto-axial dislocation associated with acute rheumatic fever. The features of previous cases are summarized and the clinical aspects, mechanisms, diagnosis, and treatment of atlanto-axial dislocation are reviewed. PMID- 3806211 TI - Multiple thoracic disc herniations. Case report. AB - A patient with herniated thoracic discs in tandem is reported. The previous literature is reviewed. Difficulties with the preoperative diagnosis and the surgical approach to these lesions are discussed. PMID- 3806212 TI - A posttraumatic lumbar spinal synovial cyst. Case report. AB - A patient with posttraumatic lumbar radicular paresthesias is presented. The preoperative diagnosis of an epidural synovial cyst was considered. At surgery, an epidural synovial microcystic mass was found emanating from a distracted L4-5 facet joint and dissecting into the layers of the ligamentum flavum. A brief review of the condition is presented. PMID- 3806213 TI - Vertebral arteriovenous fistula following anterior cervical spine surgery. Report of two cases. AB - Fistulous communication between the vertebral artery and its surrounding venous plexus is rare. Two cases of vertebral arteriovenous fistula following anterior cervical spine surgery are reported. The anatomic relationships of the vertebral vessels, the radiographic findings, and the various therapeutic approaches to these lesions are discussed. PMID- 3806214 TI - Clipping of an AVM arterial feeder through a burr hole prior to radical surgery. Technical note. AB - If the main feeder of an arteriovenous malformation (AVM) is a branch of the middle cerebral artery, one segment of which lies on the brain surface, it is advisable to clip it through a burr hole placed at an angiographically preselected point. The technical details of the procedure are described. This simple maneuver performed directly prior to radical surgery decreases the risk of possible rupture of an AVM during craniotomy and facilitates radical AVM excision. PMID- 3806215 TI - Aneurysm clip reliability. PMID- 3806216 TI - Carcinoembryonic antigen in epidermoid cyst fluid and plasma. PMID- 3806217 TI - Investigators review potential of antibodies in cancer detection and therapy. PMID- 3806218 TI - NRC simplifies regulations for medical use of byproduct material (10 CFR Part 35) PMID- 3806219 TI - Diagnostic significance of indium-111 granulocyte scintigraphy in febrile patients. AB - Sixty-eight patients with fever of unknown origin, 32 patients with postoperative fever, and 26 patients with therapy-resistant fever after bacteremia were investigated with [111In] granulocyte scintigraphy for the detection of abscesses. The results showed that the value of [111In]granulocyte scintigraphy in the detection of infectious foci vary in these three types of febrile conditions. The overall sensitivity and specificity were 86.5% and 87.8%, respectively. We observed, however, a relatively low predictive value of a positive result in the fever of unknown origin group (73.1%), and also a low predictive value of a negative result in the bacteremia group (66.7%). The C reactive protein (CRP) levels in patients with a true-positive scintigram were significantly (p less than 0.001) higher than in patients with a true-negative scintigram. There was also a significant positive correlation (p less than 0.01) between the serum CRP concentration and the intensity of the granulocyte accumulations. There was no correlation between the peripheral leukocyte count or the erythrocyte sedimentation rate (ESR) and the intensity of the granulocyte uptake. Therefore CRP, but not the leukocyte count or ESR, appears useful for selecting the patients who benefit most from granulocyte scintigraphy. PMID- 3806220 TI - Scintigraphic monitoring of mucociliary tracheo-bronchial clearance of technetium 99m macroaggregated albumin aerosol. AB - A simple method for in vivo monitoring mucociliary tracheo-bronchial clearance is described. Eighteen healthy subjects and 13 patients with various chronic lung diseases were studied by this method. The principle of using an aerosol administration system similar to the system used for routine ventilation lung studies is stressed. Proximal large airway deposition of the radioaerosol was obtained by using relatively large particles (average diameter 2 microM) of [99mTc]MAA aerosol. Monitoring was performed by visual inspection of the tracheo bronchial cinescintigraphic ascendence of the accumulated radioactive boli and by assessing their rate of clearance via automated computer analysis of the time activity curves, following the movement of each bolus. The normal mean +/- s.d. clearance rate thus obtained was 4.7 +/- 1.3 mm/min. This rate appears to be more precise as compared with the range of results obtained by other radioisotopic methods. Significantly faster rates, mean 8.2 +/- 1.4 mm/min (p less than 0.001) were obtained in bronchiectatic patients while slower rates (2.8 mm/min) were seen in a patient with ciliary dyskinesia. PMID- 3806221 TI - Effects of spontaneous respiration on right and left ventricular function: evaluation by respiratory and ECG gated radionuclide ventriculography. AB - To clarify the mechanism of inspiratory reduction of left ventricular (LV) stroke volume (SV) during spontaneous respiration, we measured right and left ventricular volume changes from expiration to inspiration using radionuclide ventriculography with respiratory gating technique. In this method, scintigraphic data were acquired in a list mode with ECG R wave triggers and respiratory volume curve derived from respiratory flowmeter. Cardiac cycles occurring during the second halves of inspiratory and expiratory phases were separately selected and used to produce multigated images for the respective phases. Twelve patients with normal LV ejection fraction (EF) (greater than 50%) and right ventricular (RV) EF (greater than 40%) and without pulmonary diseases were studied. LV end-diastolic volume (EDV) decreased during inspiration in all subjects (by 11 +/- 5%), whereas LV end-systolic volume (ESV) was insignificantly changed. Accordingly, LVSV decreased during inspiration in all subjects (by 17 +/- 7%). LVEF decreased from 64 +/- 6% during expiration to 60 +/- 6% during inspiration (p less than 0.001). In contrast to the left ventricle, RVEDV and RVSV increased during inspiration by 13 +/- 11% and 22 +/- 18%, respectively. RVESV did not change significantly. RVEF increased from 48 +/- 6% during expiration to 52 +/- 5% during inspiration (p less than 0.05). These results indicate that inspiratory reduction of LVSV during spontaneous respiration is due to a decrease in LVEDV which may be derived from an increase in RVEDV during inspiration through the mechanism of ventricular interdependence. PMID- 3806222 TI - Detecting bone marrow metastases at the time of examining the liver with radiocolloid. AB - In a prospective study of 200 different consecutive patients with cancer, the bone marrow of the lumbar spine and pelvis has been examined at the time of obtaining a radiocolloid examination of liver and spleen. The images were examined "blind" by three observers who all agreed about the findings in 177 (89%) of the patients. Agreement by any two was considered to be definitive. The radiocolloid marrow examinations in this selected population had an accuracy of 0.97, sensitivity of 0.80, and specificity of 0.98 in diagnosing metastatic disease when validated by all other available evidence, or follow-up. Of the patients thus examined, 16 (8%) had abnormal marrow scan findings reflecting metastatic disease, eight (4%) at the time radiographs were normal, and two at the time bone scintigraphy was normal. Excluding patients with bowel cancer, in whom the detection rate was zero, 16 (12.4%) marrow examinations were abnormal. As a result we now obtain "saturated" images of the marrow incidental to radiocolloid examinations of the liver and spleen in patients with cancer other than that of the bowel. PMID- 3806223 TI - Colloid shift following blunt trauma. AB - Thirty-three patients who underwent spleen imaging with [99mTc]sulfur colloid following blunt trauma to the left chest and/or left upper abdominal quadrant were evaluated. Nineteen of these patients were found to have reversed liver spleen activity ratios (colloid shift). The incidence of this finding was surprising in view of the absence of any predisposing factors in these patients. Colloid shift was seen as early as 2 hr after trauma and was found to persist as long as 188 days after the traumatic event. The explanation for colloid shift in this group of patients is unknown, but the results suggest that it is secondary to reticuloendothelial system stimulation. PMID- 3806224 TI - Evaluation of [iodine-125]N,N,N'-trimethyl-N'-[2-hydroxy-3-methyl-5-iodobenzyl] 1,3- propanediamine lung uptake using an isolated-perfused lung model. AB - Lung uptake of N,N,N'-trimethyl-N'-[2-Hydroxy-3-methyl-5-iodobenzyl]-1,3- propanediamine (HIPDM) has been reported, but the mechanism of this process has not yet been established. Thus, single-pass [125I]HIPDM accumulation was studied in rat lungs perfused with a Krebs-Ringer bicarbonate buffer containing 4.5% bovine albumin. Iodine-125 HIPDM lung accumulation was monitored by the percent of extraction per gram of lung tissue. Iodine-125 HIPDM lung uptake did not appear to occur by simple diffusion. As the time of perfusion was increased from 2 to 15 min, the rate of uptake of 2 microM [125I]HIPDM decreased by 40%. During a 2-min perfusion, 98.6% +/- 6.7 (n = 8) extraction was observed with 2 microM [125I]HIPDM, but only 38% +/- 2.0 (n = 3) was extracted when the [125I]HIPDM concentration was 1 mM. The addition of 1 mM chlorpromazine, propranolol or imipramine also decreased [125I]HIPDM lung uptake to 43.0% +/- 1.5, 51.4% +/- 2.2, and 49.8% +/- 0.8, respectively, (each n = 4 - 6, p less than 0.001). Cold (4 degrees C) had little effect on pulmonary accumulation (77.7% +/- 7.4, n = 5, p less than 0.01), and the addition of ouabain or the use of sodium-free medium had no effect. Thus, pulmonary [125I]HIPDM accumulation does not appear to occur by sodium-dependent active transport. Rather, its uptake appears to be similar to the uptake of other basic amines, such as propranolol and imipramine, which are known to bind by physico-chemical interactions to pulmonary endothelial cell membranes and reflect pulmonary vascular surface area. PMID- 3806225 TI - Digital autoradiography: design, development, and evaluation of a solid-state image analyzer. AB - A digital image analyzer was developed for high spatial resolution analysis of autoradiograms. The system uses a linear array of charge-coupled devices operating under microcomputer control to scan and digitize autoradiograms into matrices of up to 1,500 X 2,000 pixels with 256 gray levels. The digitized images can be converted from gray scale to pseudo-color and displayed on a high resolution color monitor. Software was developed to facilitate quantitative analysis of autoradiograms produced in single and multiple tracer studies. Because of the high output linearity and accuracy of the solid-state detectors, the system was found to digitize autoradiograms significantly more precisely and accurately than previously described autoradiographic analyzers. PMID- 3806226 TI - Toxicity of indium-111 on the radiolabeled lymphocyte. AB - The radiolabeling of lymphocytes with 111In has resulted in detectable toxic changes in the cells. The mechanisms of toxicity for lymphocytes have been related to the label's radioactivity and to the chelator used to mediate the intracellular localization. These mechanisms were examined by assessing cellular function with mitogen-mediated blastogenesis after labeling lymphocytes with either the chelator (tropolone) alone, 111In complexed with tropolone, or cadmium (the decay product of 111In) complexed with tropolone. Successful lymphocyte labeling with 111In was shown to be dependent upon the concentration of the chelator (tropolone). Increasing concentrations of tropolone inhibited lymphocyte function to a variable degree. Further reduction in cellular function was detected after incorporation of a constant amount of 111In or 111In's decay product, cadmium. Lymphocyte function was decreased by these two labels in a parallel linear manner. This same toxic effect was seen after labeling with small constant amounts of tropolone and increasing quantities of 111In or cadmium. Thus, although both the required chelator and the radiobiologic exposure have a deleterious effect on the lymphocyte, significant lymphocyte toxicity appears to result from the metal-to-cell interaction as a result of the metal decay product (cadmium). PMID- 3806227 TI - Ribbing's disease: radiographic-scintigraphic correlation and comparative analysis with Engelmann's disease. AB - Engelmann's disease is an uncommon condition characterized radiographically by symmetric diaphyseal sclerosis involving predominantly the tubular bones. Ribbing described an entity with similar but less extensive or severe changes which he thought differed sufficiently to constitute a distinct process. We present two cases of Ribbing's disease and one of Engelmann's disease, emphasizing the differences between the two. Radiographic-scintigraphic correlation is provided to demonstrate the value of skeletal scintigraphy in cases of Ribbing's disease and progressive diaphyseal dysplasia. PMID- 3806228 TI - Scintigraphic manifestations of infraction of the second metatarsal (Freiberg's disease). AB - Two patients with Freiberg's infraction of the second metatarsal are presented. The scintigraphic pattern of a photopenic defect with hyperactive collar is demonstrated as evidence of the existence of avascular necrosis or infarction in this entity. The photopenia was appreciated only on pinhole collimator images in our first patient. The later revascularization phase of avascular necrosis with diffuse increase in uptake is demonstrated scintigraphically in the second patient. PMID- 3806229 TI - Subclavian vein obstruction demonstrated with thallium-201. PMID- 3806230 TI - Anterior view on bone scan for the early diagnosis of bacterial lumbar spondylitis. PMID- 3806231 TI - Indium-111 chloride imaging of infected prostheses. PMID- 3806232 TI - Problem with mouse neuroblastoma for iodine-131 MIBG studies. PMID- 3806233 TI - Summary of the conference on the health effects of polyunsaturated fatty acids in seafoods. PMID- 3806234 TI - Effect of marginal zinc deficiency on the lymphatic absorption of [14C]cholesterol. AB - The effect of zinc deficiency on intestinal absorption of cholesterol was investigated in adult male rats fed 3.6 ppm of dietary zinc (ZD) and compared with pair-fed (PF) and ad-libitum (CT) controls fed 30.6 ppm of zinc for 10 to 12 wk. The intestinal absorption of cholesterol was measured by collecting the mesenteric lymph at hourly intervals for 8 h after infusing a dose of [14C]cholesterol in a lipid emulsion through an indwelling duodenal catheter. Data on the hourly lymphatic output of [14C]cholesterol showed that the absorption of [14C]cholesterol plateaued at 4 h postdosing in all groups. The rate of the appearance of [14C]cholesterol in the mesenteric lymph significantly decreased in ZD rats at 5 h and thereafter. The cumulative absorption of [14C]cholesterol by ZD rats for the 8-h period was 4.4 +/- 1.0% of the dose, compared with 11.8 +/- 1.1% by PF and 10.7 +/- 1.4% by CT rats. There were no differences in percent distribution of esterified [14C]cholesterol among the three groups. Also, no significant change in mucosal cholesterol esterase activity was observed due to zinc deficiency. The present data and previous findings taken together suggest that the primary mechanism responsible for the impaired absorption of cholesterol may be associated with defective formation of chylomicrons in the intestinal mucosa. PMID- 3806236 TI - Ammonia production and its contribution to urinary nitrogenous compounds in chickens fed low or high protein diet. AB - The rates of total ammonia production and of ammonia retention and contribution of endogenous ammonia to urinary nitrogenous compounds were assessed using a constant intravenous infusion method with [15N]ammonia for 6 h in adult cockerels fed 7.00 or 1.75 g of protein per kilogram body weight per day for 5 d. At the 7.00-g protein intake level the mean total body ammonia production rate was 47.1 mumol/kg per min, with total excretion and retention rates being 10.1 mumol/kg per min and 37.0 mumol/kg per min, respectively. In birds with 1.75 g protein intake the mean total body ammonia production rate was 27.9 mumol/kg per min, with total excretion and retention rates being 3.1 mumol/kg per min and 24.8 mumol/kg per min, respectively. These values were significantly different between the two dietary groups (P less than 0.05-0.01). Ammonia N produced at low and high levels of dietary protein intake, contributed 33% and 84% of urinary uric acid N and 27% and 58% of urinary total N, respectively. With the above protein intake levels, 88% of urinary ammonia N and 6-9% of urinary nitrogenous compounds other than ammonia and uric acid were donated by ammonia N produced in the body. It is concluded that ammonia N produced in the body is the main source of uric acid N, which entirely explains the increase in urinary total N caused by feeding a high protein diet. PMID- 3806235 TI - Pancreatic enzyme and plasma cholesterol response to chronic ingestion of a nonabsorbable lipid in rats. AB - Pancreatic enzyme activity and plasma and high density lipoprotein (HDL) cholesterol levels were measured in rats chronically fed a nonabsorbable lipid, sucrose polyester (SPE), to determine if the rat pancreas responds to SPE as a dietary lipid or a nonnutritive ingredient. Adult male rats were fed for 28 d a diet containing either 5% or 20% corn oil, 5% SPE, 16% and 4% hydrogenated palm oil (HPO), or 16% corn oil and 4% HPO. HPO is used to prevent anal leakage of unabsorbed oil when SPE is fed at high dietary levels. Since HPO and SPE are not absorbed, rats fed SPE derive their energy from protein and carbohydrate in the diet. The tissue levels of pancreatic enzymes in rats consuming high levels of SPE in the diet resemble those of rats eating a low fat diet in which energy is derived from carbohydrate and protein. Plasma and HDL cholesterol levels were lowest in the group consuming high levels of SPE, an observation that is consistent with previous reports. These data indicate that the pancreas responds to SPE as a nonnutritive ingredient rather than a digestible dietary lipid. PMID- 3806237 TI - Effect of diets containing dry beans (Phaseolus vulgaris, L.) on the rat excretion of endogenous nitrogen. AB - Wistar rats of 60.5 +/- 5.0 g fasted for 24 h were injected intraperitoneally with 10 microCi of [14C]glycine. One to two hours after injection the rats were fed a diet containing 10.53 +/- 0.75% protein provided by dry beans or casein, or a protein-free diet and submitted to a 4-d nitrogen balance. Radioactivity in the feces of rats fed casein, cooked beans and raw beans was roughly 2, 5 and 10 times greater, respectively, than in the feces of those fed the protein-free diet. Apparent protein digestibility showed a strong negative linear correlation (r = -0.9805, P less than or equal to 0.01) with radioactivity in the feces. Positive correlation (P less than or equal to 0.01) was demonstrated between radioactivity and either total carbon or total nitrogen in the feces of rats injected with [14C]glycine. Mean value for the radioactivity in the urine of rats fed the different diets did not differ significantly (P less than or equal to 0.05). Endogenous nitrogen excretion of rats on bean diets was estimated by the ratio of total endogenous N to marker N, based on the protein-free diet. The results indicated that rats fed bean-containing diets excreted significantly more endogenous nitrogen than those fed the casein diet, even though the casein diet had stimulated twice as much endogenous excretion than the protein-free diet. As a consequence, apparent digestibility and biological value of bean protein are generally underestimated, although the "real" biological value was not affected by the endogenous nitrogen excretion of the rat. PMID- 3806238 TI - Creatine metabolism in the pyridoxine-deficient rat. AB - Creatine metabolism was studied in rats fed a pyridoxine-deficient diet for 6-7 wk. Indirect evidence had suggested that creatine levels may be low in these animals, since their livers accumulate a competitive inhibitor of creatine biosynthesis (S-adenosylhomocysteine), and they develop muscle signs suggestive of abnormal creatine metabolism. In contrast, however, the concentration of creatine in both liver and skeletal muscle of pyridoxine-deficient rats was higher than in pair-fed control rats. Pair-fed control rats also had higher creatine levels in liver and skeletal muscle than ad libitum-fed control rats, whose feed intake was about double that of the pair-fed control rats. Thus, feed restriction also increased the tissue creatine levels, and this effect was augmented slightly by pyridoxine deficiency. These changes could not be explained by the results of in vitro measurement of the enzymes of creatine biosynthesis. The activity of guanidoacetate methyltransferase in liver did not differ significantly among the three groups of animals. Kidney arginine-glycine transamidinase activity was noticeably lower in the pyridoxine-deficient rats than in pair-fed control rats and lower in pair-fed control rats than in ad libitum-fed control rats. Since creatinine excretion did not differ significantly among the three animal groups, the results suggest that decreased turnover of creatine may occur during pyridoxine deficiency above and beyond that of an apparent feed restriction alone. PMID- 3806239 TI - Effects of whole rat embryos cultured on serum from zinc- and copper-deficient rats. AB - Whole rat embryos of 9.5 gestational days were cultured for 2 d on sera taken from rats fed diets deficient in zinc (0.5 micrograms Zn/g diet) or copper (0.6 micrograms Cu/g diet), or fed a control diet (100 micrograms Zn and 10 micrograms Cu per g diet). Head malformations were observed in embryos cultured on 12 of 16 zinc-deficient and 11 of 12 copper-deficient serum samples. The protein contents, crown-rump lengths (CRL) and percentages of head to CRL in these embryos were significantly smaller than those of embryos cultured on control serum. Copper and zinc were then added directly to 8 zinc- and 7 copper-deficient serum samples that had grown abnormal embryos. All subsequent cultured embryos had a normal appearance and protein content, CRL and head-to-CRL percentages comparable to controls, except one zinc embryo. These findings suggest that zinc and copper can act directly on embryonic development, and that whole rat embryo cultures can be used to detect deficiencies of these elements. PMID- 3806240 TI - Effect of selenium and molybdenum on methylbenzylnitrosamine-induced esophageal lesions and tissue trace metals in the rat. AB - Thirty-six weanling male Sprague-Dawley rats were randomly assigned to one of four treatment groups: SE rats received 4.0 ppm selenium as sodium selenite in drinking water containing 1% sucrose; 15MO rats received 15 ppm molybdenum as sodium molybdate in the drinking water; 45MO rats received 45 ppm molybdenum in their water; and CON rats received distilled-deionized water containing only 1% sucrose. The esophageal carcinogen methylbenzylnitrosamine (MBN) was administered intragastrically in 10% ethanol twice per week for 5 wk at a dose of 2.5 mg/kg. MBN dosing was followed by a 12-wk period for tumor promotion. After this, heart, lungs, liver, spleen, kidneys, testes, tibia, muscle, brain and esophagus were excised. The esophagus was examined for MBN-induced lesions using dissecting and light microscopes and a portion was analyzed for Se. All other tissues were analyzed for Cu, Zn, Fe and Mn; some were also analyzed for Se and Mo. Most rats had precancerous lesions, and all rats had papillomas. There were no significant differences among the four treatment groups in the incidence and number per rat of precancerous lesions or gross papillomas. The SE group had significantly fewer carcinomas per rat than the other groups. The SE rats exhibited a number of significant differences in tissue trace element concentrations; in particular, they had higher Fe concentrations in heart, kidney and spleen than the other rats. The SE rats also had significantly greater urinary excretion of Mn and Fe, and excretion of the latter elements was significantly correlated with that of selenium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806241 TI - Influence of sucrose and starch on the development of anemia in copper- and iron deficient rats. AB - The purpose of this investigation was to compare the effects of sucrose and starch on the development of copper and iron deficiency. Male Sprague-Dawley rats (n = 48) were fed one of eight diets in a 2 X 2 X 2 factorial design for 24 d. Two levels of copper (deficient, 0.7 microgram/g, or adequate, 8.3 micrograms/g) and iron (deficient, 8.3 micrograms/g, or adequate, 50 micrograms/g), and two types of carbohydrate (sucrose or starch, 62% of the diet) were fed. Copper deficient rats had significantly lower hematocrit, hemoglobin and tibia iron levels and depressed copper and iron absorption when fed sucrose instead of starch. The apparent absorption of copper, but not iron, was significantly lower when rats deficient in both copper and iron were fed sucrose rather than starch. Iron-deficient rats fed sucrose apparently absorbed significantly more iron than those fed starch; however, sucrose did not significantly improve hematocrit and hemoglobin levels. The metabolism of copper and iron by rats fed diets adequate in these nutrients was not affected by the type of dietary carbohydrate. These data indicate that the type of dietary carbohydrate alters both copper and iron metabolism, particularly in copper-deficient rats. PMID- 3806242 TI - Effect of selenium deficiency on the chronic toxicity of adriamycin in rats. AB - The effect of selenium deficiency on the chronic toxicity of adriamycin was examined in rats fed diets adequate in vitamin E. Selenium-deficient and selenium supplemented diets were fed to rats for 10 wk, after which groups of 10 rats fed each diet were given weekly intravenous injections of adriamycin in saline at doses of 0, 0.5 or 1.0 mg/kg body weight for 12 wk. All rats were killed at 24 wk. Even though the cardiac glutathione peroxidase activity in the selenium deficient group was less than 1% of that of the selenium-supplemented group, the severity of the adriamycin-induced cardiomyopathy was similar in both groups. However, the selenium-deficient rats were more sensitive to the growth-inhibiting effect of the higher dose of adriamycin than the selenium-supplemented rats. Moreover, the lower dose of adriamycin caused a mild nephropathy in 70% of the deficient rats but affected only 10% of the supplemented rats. Selenium status may have to be considered when adriamycin is used as a chemotherapeutic agent. PMID- 3806243 TI - Beneficial effect of moderate protein restriction on growth, renal function and survival in young rats with chronic renal failure. AB - We used the model of one-stage uninephrectomy and contralateral heminephrectomy to study the effect of protein restriction on growth and renal function in young (starting age 21 d) female rats. Normal, sham-operated, pair-fed, and chronic renal insufficiency (CRI) rats were fed a 6, 14 or 22% protein (casein) diet. Diets were otherwise isoenergetic and equivalent in sodium, potassium, chloride, phosphate and calcium. Weight, length, urinary protein and creatinine clearances were measured up to 6 mo of age. Regardless of group (normal, sham or CRI), animals fed a 6% protein diet weighed less and were shorter than animals fed 14 or 22% protein diets. No difference in growth could be found between 14 and 22% protein intake. However, animals with CRI fed 22% protein diet had a shorter survival time than animals fed 14 or 6% protein diets. Six percent protein intake led to a lower growth rate over the first 10-12 wk of age than 14 or 22% protein intake. We conclude that 14% protein intake in rats with CRI maintains normal growth and improves survival over 22% protein intake. Rats with CRI fed a 6% protein diet have improved survival compared to rats fed a 22% protein diet but suffer growth retardation. PMID- 3806244 TI - Metabolism at thermoneutrality and in the cold is reduced in the neonatal preobese Zucker fatty (fa/fa) rat. AB - Minimum and maximum rates of oxygen consumption (VO2) were determined in 2-, 6- and 8-d-old lean (Fa/?) and preobese (fa/fa or "fatty") Zucker rats. On each study day, three or four naive littermate male pups were placed in individual respiration chambers submerged in a water bath and studied simultaneously over a range of ambient temperatures (24-35 degrees C). The purpose of the cold exposure was to elicit maximal oxygen consumption and to determine the ability of the rat to maintain body temperature during cold stress. Minimum rates of oxygen consumption were observed at 33-34 degrees C in both groups. As ambient temperature was reduced, VO2 increased and rectal temperature decreased. Regression analysis revealed a significantly reduced oxygen consumption in the preobese pups within the thermoneutral zone and during cold exposure. A defect in energy expenditure for heat production was evident in the preobese (fa/fa) pups as indicated by their attenuated cold-induced rate of oxygen consumption and decreased ability to maintain body temperature during cold stress relative to their lean (Fa/?) littermates. Their lower VO2 within the thermoneutral zone implies that the preobese (fa/fa) pups have a decreased metabolic rate even under conditions in which cold-induced thermogenic mechanisms are turned off. PMID- 3806245 TI - Effect of protein malnutrition on glycoprotein synthesis in rat cerebral cortex slices during the period of brain growth spurt. AB - Wistar rats were fed a normal protein (25% casein) or low protein (8% casein) diet from the day of birth to the day when they were used in the study. Diets were isoenergetic and contained appropriate amounts of salts and vitamins. As early as d 2 of postnatal life, the rats fed the low protein diet had lower body weights than those fed the normal protein diet, but differences in brain weight between the two groups were observed only at 15 d of postnatal life. Eye opening was delayed by 2 d in the animals fed the low protein diet. Malnutrition had no effect on protein concentration in the cerebral cortex of the rats, which increased with age in both groups. [2-3H]Mannose incorporation into cerebral cortex proteins markedly decreased with age in rats fed the two diets. Cerebral cortex slices of 20-d-old rats fed the low protein diet incorporated more [2 3H]mannose than slices from rats of the same age fed the normal protein diet. PMID- 3806246 TI - Influence of plane of nutrition on body composition, organ size and energy utilization of Sprague-Dawley rats. AB - Male (61) and female (53) Sprague-Dawley rats (31 d of age, 85 g) were used to evaluate the influence of plane of nutrition on body composition, internal organ size and energy utilization. Six male and nine female rats were sacrificed initially. The remaining animals were randomly assigned, within sex, and fed to gain either 105 g (H) or 40 g (M) or lose 25 g (L) during a 21-d period. Nine rats each from the H and M groups and six from the L group were then sacrificed. The remaining rats from the H (27) and M (27) groups were fed to gain at the H, M or L rate and rats from the L (12) group were fed to gain at the H or M level during a second 21-d period. All rats were sacrificed at the end of the second period. Body composition and weights of internal organs were determined and relationships between energy intake and energy gain were evaluated. Results indicated that at the end of period 2, body composition at equal age and body weight was influenced by nutritional treatment. At equal body weight, body protein weights were lower (P less than 0.05) and body fat, liver and gut weights higher (P less than 0.05) for rats on higher planes of nutrition. Feed required for maintenance of rats during period 2 tended to be lower and efficiencies of gain tended to be higher for rats fed the low level than for those fed the high level during period 1. Rats fed the medium level during period 1 had similar maintenance requirements but higher efficiencies of gain during period 2 than rats fed the high level during period 1. These results suggest that previous nutrition influenced energy utilization through adaptation of high energy expending internal organs as well as through alterations in body composition and composition of body weight gain. PMID- 3806247 TI - Peritoneal macrophages from mice fed dietary (n-3) polyunsaturated fatty acids secrete low levels of prostaglandins. AB - Peritoneal macrophages from mice fed diets containing 10% menhaden oil incorporated significant amounts of n-3 polyunsaturated fatty acids (n-3 PUFA) into cellular lipids, and this lowered arachidonic acid in these lipid classes compared to those from mice fed diets containing 10% coconut oil. The n-3 PUFA enriched macrophages secreted significantly smaller amounts of prostaglandin E, thromboxane B and 6-keto-prostaglandin F1 alpha when stimulated with opsonized zymosan or phorbol myristate acetate. These studies demonstrated that menhaden oil-enriched diets influence fatty acid composition and prostaglandin synthesis in macrophages. PMID- 3806248 TI - Epidemiologic studies in nutrition: utility and limitations. PMID- 3806249 TI - Protein and amino acid requirements in the adult human. PMID- 3806250 TI - Effect of graded doses of erythorbic acid on ascorbic acid content of tissues of guinea pigs. AB - The effect of graded doses of erythorbic acid (ErA) on the content of ascorbic acid (AsA) in the tissues of guinea pigs administered AsA was studied. The guinea pigs were administered 5 mg AsA and 1, 5, 20, and 100 mg ErA; or 1 mg AsA and 1 and 20 mg ErA; or 20 mg AsA and 20 mg ErA for 16 days. The animals were then sacrificed, and the liver, adrenal glands, spleen, and kidneys were removed to determine the contents of AsA and ErA by using HPLC. The content of AsA in the tissues of the animals administered less than 5 mg ErA together with 5 mg AsA was not significantly different from that of the animals administered 5 mg AsA. The administration of 100 mg ErA together with 5 mg AsA caused a decrease in the amount of AsA in the tissues. The content of AsA in the tissues of the animals administered ErA together with 1 mg AsA was not significantly different from that of the animals administered 1 mg AsA. In the case of animals administered an equal amount of both AsA and ErA, the AsA tissue content was consistently much higher than that of ErA. These results indicated that the administration of relatively small amounts of ErA did not appear to reduce the availability of AsA. PMID- 3806251 TI - Cholesterol, phytosterol and polyunsaturated fatty acid levels in 1982 and 1957 Japanese diets. AB - The dietary intake of cholesterol, phytosterol and PUFA in Japanese was investigated to obtain information on dietary parameters related to coronary artery disease. Three daily menus for both 1957 and 1982 were prepared based on the daily per capita consumption of foods and nutrient intakes from national surveys. From 1957 to 1982, the average daily intake of cholesterol rose 2.1-fold from 183 to 376 mg while that of phytosterol remained at about 373 mg. Daily intakes of total fatty acid (19.2 g), PUFA (7.3 g), MUFA (5.8 g) and SFA (6.1 g) in 1957 increased in 1982 to 48.7 g, 11.9 g, 19.5 g and 17.3 g, respectively. The ratio of PUFA/SFA decreased to 56% from 1.23 in 1957 to 0.69 in 1982 and the PUFA/MUFA ratio also decreased to 48%. The PUFA/cholesterol ratio was lower in 1982 (31.8) than in 1957 (42.6), and the decrease in the phytosterol/cholesterol ratio to 46% was greater than that in the PUFA/cholesterol ratio (which only fell to 75% of the 1957 value). Thus, comparison of the 1982 and 1957 intakes indicated the increase in risk factors, cholesterol and SFA intake, and the decrease in the ratio of PUFA/SFA in the Japanese population during the past few decades. PMID- 3806252 TI - Age-related changes in nitrogen balance and related variables in later life of aging male Wistar rats. AB - Age-related changes in nitrogen balance and related variables in later life of male Wistar rats fed 14.0 g/day (group C) or 8.7 g/day (group R) of 20% casein diet throughout life were examined at intervals of 50 days from day 650 of age. In both groups, body weight decreased from about day 600, and the body weight at the final examinations (on day 1,000 in group C and 1,100 in group R) were 18% and 13%, respectively, less than those on day 600, although the animals consumed more than 98% of their food throughout. Their nitrogen balance fluctuated throughout later life in both groups, but the overall changes did not show a consistent negative or positive pattern. Consequently, the mean nitrogen balance after 650 days of age was calculated as -11.5 +/- 45.3 mg N/day in group C and 1.3 +/- 11.6 mg N/day in group R. On the other hand, protein digestibility increased steadily after 650 days of age in both groups. As a whole, nitrogen metabolism at the whole body level did not change consistently even in later life. PMID- 3806253 TI - Effects of lipophilic derivatives of L-ascorbic acid and dehydro-L-ascorbic acid on the peroxidation of linoleic acid in neutral phosphate buffer containing alcohol. AB - 6-O-Palmitoyl-AsA (AP) and -DHA (DHAP) suppressed LA peroxidation considerably in both 10% and 20% EtOH solutions. The duration of the suppression of LA peroxidation was longer with AP than with DHAP. But after the initial suppression of LA peroxidation, both derivatives showed an accelerating effect. 6-O-Acetyl AsA (Ac-AsA) and -DHA (Ac-DHA) accelerated LA peroxidation from the start of the reaction in 10% EtOH, but suppressed it notably in 20% EtOH. 4-Phenyl-2,3 dihydroxy-2-buten-4-olide (PDHB) and 4-phenyl-2,3-dioxo-4-butenolide (PDOB) accelerated LA peroxidation in 10% EtOH. With 20% EtOH solution, PDHB suppressed LA peroxidation notably, as did AP, but PDOB showed only a short duration (about 1 h) of suppression. These results suggest the complexity of LA peroxidation catalyzed by lipophilic AsA or DHA in aqueous solution containing alcohol. PMID- 3806254 TI - Morphological and cell proliferative study on the growth of visceral organs in monosodium L-glutamate-treated obese mice. AB - The growth pattern of visceral organs was investigated in monosodium L-glutamate (MSG)-treated obese mice with hypothalamic lesions. Male Jcl-ICR strain mice were subcutaneously injected with MSG, 2 mg/g of body weight daily, for five days after birth. The MSG-treated mice became obese after 4 weeks of age. According to patterns of weight gain compared with those in the control mice, the visceral organs in the MSG-treated mice were classified into three groups as follows: The first group of organs (heart, lungs, spleen, pancreas, kidneys, testes, brain and submandibular glands) remained absolutely lower in weight throughout their growth. The second group of organs (liver and stomach) was low in weight until 12 weeks of age, but became identical to that of the control mice after 16 weeks of age. The third group of organs (epididymal fat, small intestine and colon) showed lower weight until 4 weeks of age and were significantly heavier than those in the control mice after 8 weeks of age. The heart in the first group of organs apparently had hypertrophic muscle cells after 8 weeks of age and became significantly hypoplastic due to decreased cell production as was revealed by the continuous suppression of mitotic activity and DNA synthesis by [3H]thymidine autoradiography. The liver in the second group of organs became significantly hypoplastic due to decreased cell production and showed the same weight with the control mice due to the development of fatty liver. The small intestine in the third group of organs became hypoplastic due to decreased cell production in the crypts until 4 weeks of age, and became hypertrophic and hyperplastic by the acceleration of cell production in the crypts from 4 to 8 weeks of age. From these findings, in the MSG-treated mice with specific growth patterns of visceral organs, it is suggested that low energy expenditure results in a relatively excessive energy supply and leads to obesity, because most of the important organs with major physiological functions became hypoplastic. Moreover, it seems that hypertrophy and hyperplasia of the intestine suggest a possible acceleration of the absorptive function. PMID- 3806255 TI - Relationship between amino acid composition of diet and plasma cholesterol level in growing rats fed a high cholesterol diet. AB - The effects of dietary sulfur-containing amino acids and glycine on plasma cholesterol level were studied in rats fed amino acid mixture diets containing cholesterol. The relationship between the amino acid composition of dietary proteins and plasma cholesterol levels was also investigated in rats fed diets containing various kinds of protein such as casein, egg albumin, pork protein, fish protein, corn gluten, wheat gluten and soy protein. Feeding the amino acid mixture corresponding to casein led to an approximately two-fold level of plasma total cholesterol as compared with feeding the amino acid mixture corresponding to wheat gluten. It was possible to reduce the plasma cholesterol of rats fed the amino acid mixture of the casein type by increasing the proportion of cystine in the total sulfur amino acids. Inversely, the deprivation of cystine resulted in an enhancement of the plasma cholesterol of rats fed the gluten type amino acid mixture. Glycine had a tendency to resist increases in the plasma cholesterol level. A significant negative correlation was noted between plasma cholesterol levels and the content of cystine in intact dietary proteins. The results suggest that the differential effect of dietary proteins on plasma cholesterol level is mainly associated with sulfur-containing amino acids included in the protein, regardless of whether it is of animal or plant origin. PMID- 3806256 TI - The influence of rat endogenous nitrogen excretion on the assessment of bean protein quality. AB - The main objective of the present work was to study the interference of rat endogenous nitrogen excretion with the assessment of digestibility and biological value of dry bean (Phaseolus vulgaris, L.) protein. Dry bean plants were cultivated under (15NH4)2SO4 fertilization and at harvest dry beans had 1.080 atoms % of 15N-excess. Nitrogen balance studies indicated that bean protein digestibility and biological value were higher when N-balance was based on 15N excess as compared to total nitrogen, both for undenaturated and heat-denaturated protein. The 15N-balance also showed that heat treatment significantly improved (p less than or equal to 0.05) the digestibility of bean protein in the integral flour and in protein isolate while the biological value decreased for both materials. The results permitted the conclusion that the conventional methods employed for calculation of bean protein digestibility and biological value, based on total nitrogen balance and protein-free diet, underestimate these indices of protein quality. PMID- 3806258 TI - Radium luminizers. PMID- 3806257 TI - Effect of ascorbic acid on calcium elimination in humans. AB - The long-term and short-term influence of large oral doses of ascorbic acid on the urinary excretion of calcium has been investigated. In the first experiment, daily doses of a total of 10 g of ascorbic acid were administered to healthy human subjects. Daily urinary samples of these subjects were collected before and during the treatment, and calcium contents of these samples were measured. Among the 22 subjects, 19 experienced no significant changes in urinary calcium levels during the ingestion of ascorbic acid, one subject experienced an increase, two had a decline. These changes in urinary calcium levels were relatively small and were within the changes from consuming normal diets. In the second experiment, urinary samples of 46 healthy subjects were collected during a period of 8 hours after the ingestion of 2 g of ascorbic acid (33 times the U.S. RDA). A significant increase in mean urinary calcium excretion from 48.2 +/- 25.1 mg to 58.3 +/- 28.0 mg in the 8-h time period was observed. Mean urinary volume and phosphorus were unchanged. Calcium levels of the initially low excretors were significantly elevated while the change in urinary calcium levels of the initially high excretors was not statistically significant following the administration of ascorbic acid. The results suggest that ascorbic acid has a short-term effect on the regulation of the absorption and metabolism of calcium in humans. PMID- 3806259 TI - Guidelines for Employee Health Services in Health Care Institutions. PMID- 3806260 TI - Soft tissue sarcomas and military service in Vietnam: a case comparison group analysis of hospital patients. AB - The possibility that exposure to Agent Orange or phenoxy herbicides may have increased the risk of soft tissue sarcomas has been of genuine concern to Vietnam veterans and their families. A hospital-based case comparison group study was undertaken to examine, through a comprehensive review of medical records and military personnel records, the association between previous military service in Vietnam and soft tissue sarcomas. The case group comprised 234 Vietnam-era veteran patients who served in the US military between 1964 and 1975 and were treated in one of the 172 VA hospitals between 1969 and 1983 with a diagnosis of soft tissue sarcomas. The comparison group consisted of 13,496 patients who were systematically sampled from the same Vietnam-era veteran patient population from which the cases were drawn. Military service information, in particular Vietnam service status, for each case and control patient was obtained from a review of the patient's military personnel records archived at the National Personnel Records Center in St Louis, Missouri. No significant association of soft tissue sarcomas and previous military service in Vietnam was observed: odds ratio was 0.83 with a 95% confidence interval of 0.63 to 1.09. PMID- 3806261 TI - Effect of spirometer temperature on measurement of FEV1 shift changes. AB - Spirometric parameters are generally obtained at ambient (spirometer) temperature pressure saturated (ATPS) and then converted to body temperature pressure saturated (BTPS) by multiplying each observed value by a BTPS correction factor. At ambient temperatures of 23 degrees C or higher, the accepted practice of using a constant BTPS factor introduces a relatively small error in forced expiratory volume in one second (FEV1), but as the temperature decreases below 23 degrees C the error in FEV1 increases. A dynamic BTPS correction factor model has recently been developed to reduce this error. Analysis of across-shift spirometry data from a recent survey indicates that, with an increase in temperature over a work shift of greater than 3 degrees C, 27.1% of 302 subjects were classified as having a greater than or equal to 5% FEV1 drop over the shift using the dynamic BTPS factor model, compared with 41.4% when the standard BTPS correction factor was used (P less than .005). These results indicate the importance of correcting for ambient temperature differences when analyzing for shift changes in spirometric parameters. PMID- 3806263 TI - Spontaneous abortion and occupation. AB - Occupational factors in spontaneous abortion were studied in the current and previous pregnancies of 56,012 women interviewed in 11 Montreal maternity departments, 1982 to 1984. Ratios of observed to expected abortions (RR), after allowance for nonoccupational confounders, were significantly increased (P less than .05) among nursing assistants and attendants (RR 1.24 in current and 1.13 in previous pregnancies), food and beverage servers (RR 1.31 in current and 1.11 in previous pregnancies) and sales persons (RR 1.18 in current and 1.12 in previous pregnancies). Women whose work entailed heavy lifting, other physical effort, long hours, exposure to noise, and exposure to cold had also significantly increased risk ratios. However, when occupational groups were ranked according to work demands, thus avoiding potential bias from prior knowledge of outcome, increased risks were associated consistently only with heavy lifting and other physical effort. PMID- 3806262 TI - Visual display units and pregnancy: evidence from the Montreal survey. AB - Data on 56,012 current and 48,608 previous pregnancies were obtained by interview in 11 Montreal hospitals, 1982 to 1984, after delivery or spontaneous abortion. In 17,632 pregnancies in occupations with substantial use of visual display units (VDUs), users and nonusers had similar rates of congenital defects in both current and previous pregnancies and of abortions in previous pregnancies. In current pregnancies there was an excess of abortions in users which could have been due to biased recall. In a further analysis of all 42 occupational groups ranked according to percentage use of VDUs, the risk of spontaneous abortion in both current and previous pregnancies was the same irrespective of the amount of VDU use. Thus, the study does not support the suggestion that work with a VDU in pregnancy increases the risk of congenital defect or spontaneous abortion. PMID- 3806264 TI - Drug screening in industry. PMID- 3806265 TI - Drug screening in the workplace: ethical guidelines. Committee on Ethical Practice in Occupational Medicine of the American Medical Association. PMID- 3806266 TI - "Catalyst" symptoms in malignant melanoma. AB - Despite efforts to identify and cure early melanoma, mortality from this potentially curable disease continues to increase. In a retrospective analysis of the charts of 568 patients treated for superficial spreading melanomas during a ten-year period, the authors studied the relations between type of symptom, symptom duration, and thickness of the lesion. "Catalyst" symptoms, the particular events that preceded diagnosis, were identified. Patients described 75 different catalyst symptoms or symptom combinations. Bleeding precipitated prompt medical attention but was associated with the deepest lesions (mean thickness 1.77 mm); ulceration, itching and tenderness were associated with delays of several months and lesions of intermediate thickness (1.13 to 1.28 mm); and changes in size, color, or elevation eventuated in diagnosis an average of a year after patients' observations of these changes, with mean lesion thickness of .80 mm to 1.33 mm. Patients react slowly to signs and symptoms of early melanoma. PMID- 3806267 TI - Hospital-based group practice: does it change clinic patterns of care? AB - Initiation of a hospital-based faculty group practice to replace part of a general medical clinic was evaluated in a quasi-experimental design. Practice setting (where patients received their primary care) was the independent variable. The group practice, unlike the traditional clinic, emphasized primary care by providing 24-hour, seven day/week access by telephone; continuity between inpatient and ambulatory care (all patients admitted as private patients of group practice attending physicians) and coordination of care. Resource use, including visits to the primary care site, the emergency room and specialty clinics, and tests ordered at each site were tracked for one year by chart review. Multivariate analysis showed that, contrary to expectations, group practice patients had no fewer emergency room or specialty clinic visits, although they did make more visits to the practice. With respect to tests, practice patients had almost two more tests ordered in the primary care site than clinic patients, although there was no concomitant reduction in tests ordered at other sites. The authors conclude that ambulatory care resource use is an insufficient measure of the effect of a change in practice setting. PMID- 3806268 TI - Risk preference and laboratory test selection. AB - The risk preferences in situations of potential gain, and of potential loss, expressed by 67 physicians were correlated with the numbers of laboratory tests they selected after review of identical copies of two outpatient charts. Physicians who chose a 50/50 gamble of losing ten or no years of life expectancy over an equivalent certain loss of five years selected twice as many tests as those who chose the loss (p less than 0.025). Risk preferences may provide some insight into why some physicians order more laboratory tests than do others. PMID- 3806269 TI - Zlinkoff honor lecture: basic research, clinical research, clinical epidemiology, and general internal medicine. PMID- 3806270 TI - Writer's block. PMID- 3806271 TI - Measuring change in primary care. PMID- 3806272 TI - Protocols in the emergency room evaluation of chest pain: do they fail to diagnose lateral wall myocardial infarction. PMID- 3806273 TI - Electrocardiograms and decision aids in coronary care triage: the truth, but not the whole truth. PMID- 3806274 TI - Evaluation and treatment of hypercholesterolemia--another step. PMID- 3806275 TI - Spectral luminous-efficiency functions obtained by direct heterochromatic brightness matching for point sources and for 2 degrees and 10 degrees fields. AB - Brightness luminous-efficiency functions for point sources and for 2 degrees and 10 degrees fields are based on 6, 63, and 76 subjects, respectively. The function for point sources can be approximated by Judd's 1951 modification of the CIE V(lambda) function. The 2 degrees and 10 degrees functions differ greatly from V(lambda). The two functions differ from each other only at wavelengths from 410 through 520 nm, where the differences are attributed to absorption by the macular pigment. PMID- 3806276 TI - Temporal integration of chromatic double pulses for detection of equal-luminance wavelength changes. AB - Detection probabilities for wavelength changes were measured as functions of stimulus onset asynchrony (SOA) with the chromatic double-pulse method. Two test stimuli of a wavelength lambda t were successively exchanged with a reference stimulus of a wavelength lambda r in equal luminance for a short duration with a SOA. Durations were 5 and 50 msec, and the SOA varied between 5 or 50 and 2000 msec. Lambda r's were 571 and 518 nm, chosen from wavelengths near unique yellow and unique green so that wavelength difference delta lambda = lambda t - lambda r was perceived mainly as redness and greeness for lambda r = 571 nm and yellowness and blueness for lambda r = 518 nm. The results showed that temporal integration characteristics for these equal-luminance wavelength changes were quite consistent: complete integration with SOA up to 20 msec, partial integration with SOA between 20 and 200 msec, and probability integration with SOA greater than 200 msec. They did not show any inhibitory integration that was found for luminance changes. PMID- 3806277 TI - Ganzfield light distribution on the retina of human and rabbit eyes: calculations and in vitro measurements. AB - Retinal illumination was measured in 3 excised human eyes and 14 excised rabbit eyes. The eyes were exposed to Ganzfeld illumination. Illumination was measured at three or four peripheral points at eccentricities up to 60 deg (human) or 90 deg (rabbit). Theoretical light-distribution curves were calculated from eye model data. Theoretical and experimental results for rabbit eyes agree within experimental errors. The experimental curve for human eyes shows a slightly steeper descent toward the periphery than the theoretical curve. Retinal illumination decreases only gradually toward the periphery in both human and rabbit eyes. PMID- 3806278 TI - Hypothalamic dysfunction in periodic catatonia. PMID- 3806279 TI - Hypothalamic dysfunction related to third ventricular size. PMID- 3806280 TI - Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. AB - The sequence of events in haematogenous metastasis from colonic carcinoma was analysed, using 1541 necropsy reports from 16 centres. The findings are consistent with the cascade hypothesis that metastases develop in discrete steps, first in the liver, next in the lungs and finally, in other sites. Deviations of necropsy findings from the cascade model are largely explained on the basis of false negative reports. In only 216 of 1194 cases was there suggestive evidence that metastatic patterns (excluding lymph nodes) were causally related to lymphatic or non-haematogenous pathways. The incidence of metastatic involvement in 'other' (quaternary) sites correlated with target organ blood-flow (ml min-) per g, only when bone marrow and thyroid were excluded. In the thyroid the incidence was lower than expected on the basis of blood flow per g tissue; this may indicate that the thyroid is an unfavourable site for metastatic growth of colonic carcinoma. In the bone marrow it is higher; the latter may be due to delivery of cancer cells via both arterial blood and the vertebral venous plexus. Recognition of this pattern of metastases in the bone marrow could be important with respect of diagnosis and therapy, in patients with colonic carcinoma. PMID- 3806281 TI - Impaired adaptation of pulmonary circulation to extrauterine life in newborn pigs exposed to hypoxia: an ultrastructural study. AB - Twelve Large White pigs aged less than 1 min, and 3, 5.5, and 14 days were exposed to hypoxia (380 torr) for 2.5-3 days. The wall structure of terminal bronchiolar (resistance arteries) and elastic arteries was assessed by light and electron microscopy using quantitative morphometric techniques. In animals exposed from birth, mean terminal bronchiolar arterial medial thickness was increased (p less than 0.05) because endothelial and smooth muscle cells (SMCs) retained their fetal shape, position, overlap, interdigitation and the low surface/volume ratio characteristic of fetal life. In all older animals, the cells had a normal postnatal shape and surface/volume ratio. In the elastic vessels hypoxia did not prevent the normal postnatal reduction in mean SMC diameter of animals exposed from birth. SMC hypertrophy did not occur in any age group, but all animals save those first exposed at 14 days, showed an increase in SMC myofilament volume density (p less than 0.01). Connective tissue volume density also increased (p less than 0.01), mainly due to an increase in elastin and ground substance. Thus a short period of neonatal hypoxia impaired adaptation and appeared to potentiate contractile capacity in stiff-walled arteries but elicited a less marked response from animals first exposed at 14 days. PMID- 3806282 TI - Osteoclasts contain macrophage and megakaryocyte antigens. AB - The origin and mechanism of formation of the osteoclast remains controversial. Although it is known to be derived from a circulating mononuclear percursor, the identity of this cell is unknown. Using a panel of monoclonal antibodies raised against macrophage and other marrow-derived cells, we determined the immunocytochemical staining of human osteoclasts in both fetal bone metaphyseal imprints and frozen sections. Osteoclasts and marrow mononuclear cells were stained by three broad spectrum antimacrophage antibodies, EBM-11, Y182a and BM2. T310, an antibody which stains macrophages and T helper cells, and C17, an antimegakaryocyte antibody, also stained osteoclasts. EBM-11, Y182a and BM2 also stained megakaryocytes in bone imprints as well as normal bone marrow smears. The presence of macrophage-associated antigens in osteoclasts, megakaryocytes and bone marrow mononuclear cells indicates that they are phenotypically similar to macrophages. PMID- 3806283 TI - The pathogenesis of acute systemic candidiasis in a susceptible inbred mouse strain. AB - The histopathological features of the acute infection by Candida albicans in susceptible CBA/H mice, as well as its dissemination in various organs has been examined. The brain, in which the localization of blastospores is minimal, is the organ most severely affected. A significant deposition of blastospores occurs in lungs, liver, spleen and kidney, but of these organs, only in the kidneys is infection established. A transient myocarditis follows the minor blastospore deposition that occurs in the heart. Infection in the affected organs is characterized by abscess formation while in the brain the process is complicated by the development of hydrocephalus and a pachymeningitis that erodes the petrous temporal and involves the vestibular apparatus. There is also infection of the retinae with an accompanying endophthalmitis. PMID- 3806284 TI - Basement membrane charge in human glomerular disease. AB - Fixed anionic charges in the mammalian glomerulus, on both the basement membrane and the epithelial cell foot processes, are believed to form an important part of the glomerular filtration barrier. There is good evidence that their loss causes proteinuria. The charges can be visualized ultrastructurally using cationic dyes, but the requirement of these techniques for perfusion or immersion of fresh tissue has largely confined such studies to experimental models. We have extended the widely used polyethyleneimine technique, to study the charge of glomerular basement membranes in human tissue reprocessed out of paraffin blocks up to 10 years old. We studied selected cases of glomerular disease, where the diagnosis was not in any doubt. In the majority of diseases studied, a continuous charge layer persisted despite severe abnormalities of the basement membrane. Two exceptions were found. In amyloidosis, accumulation of fibrils was associated with a considerable decrease or loss of stainable basement membrane charge. In S.L.E., numerous small defects in the charge layer were noted. The persistence of charge is contrary to reported findings in several animal models of glomerular disease, including puromycin nephrosis, Heymann nephritis and streptozotocin diabetes. Although this method is not subject to precise quantitative analysis, we conclude that in the majority of cases, proteinuria in man is not caused by an extensive loss of glomerular basement membrane anionic charge. PMID- 3806285 TI - Presence of apocrine epithelial antigen (AEA) in type II pneumocytes and in hyaline membranes of neonatal RDS. AB - We have investigated the distribution of an apocrine membrane antigen (AEA) in pulmonary tissue using a rabbit antiserum raised against fat globule glycoproteins isolated from human milk. In indirect immunostaining (PAP, IF) of sections from normal lung tissue, the membranes facing the alveolar lumen of cells corresponding to the type II pneumocytes in the alveolar walls were decorated. The selective distribution of AEA to the membranes of type II pneumocytes was confirmed in double immunostaining by identification of these cells with rat antibodies against surfactant apoprotein. In fetal lung tissue, the AEA antigen was detected by the 9th week of gestation. In lung samples from newborns which had died of respiratory distress syndrome (RDS) the intra-alveolar hyaline membranes stained for the AEA antigen. SDS-PAGE of the immunoprecipitate obtained with anti-AEA serum from radiolabelled glycoprotein fraction of normal lung tissue revealed a single band of 79,000 dalton apparent molecular weight. These findings indicate that the AEA constitutes a membrane marker of the type II pneumocytes and might be involved in the secretory process of surfactant. Immunohistological evidence for the presence of AEA in the hyaline membranes of neonatal RDS is also presented. PMID- 3806286 TI - Organ transplantation in children: ethical issues. PMID- 3806287 TI - Thickening of infant feedings for therapy of gastroesophageal reflux. AB - To assess the effect of thickening of feedings on gastroesophageal reflux and gastric emptying, 20 infants were examined with technetium scintigraphy and detailed behavioral observation after each of a pair of feedings, one with radiolabeled infant formula alone and the other with radiolabeled formula thickened with dry rice cereal. The thickened and unthickened meals were followed by similar amounts of scintigraphically demonstrated gastroesophageal reflux. However, the number of episodes of emesis (1.2 +/- 0.7 vs 3.9 +/- 0.9 per 90 minutes postprandial), the percent of gastric emptying at 30 minutes (17.8% +/- 2.7% vs 22.4% +/- 2.4%), the time spent crying (11.7 +/- 3.1 minutes vs 17.6 +/- 3.8 minutes per 90 minutes), and the total time spent awake (45.2 +/- 5.9 minutes vs 53.1 +/- 4.9 minutes per 90 minutes) were significantly less after the thickened feedings. Because thickening of infant feedings increases the caloric density, decreases emesis, decreases crying time, and increases sleep time in the postprandial period, it is likely to be beneficial in the treatment of infants with gastroesophageal reflux associated with failure to thrive. PMID- 3806288 TI - Lack of efficacy of thickened feeding as treatment for gastroesophageal reflux. AB - The efficacy of thickened feedings for the treatment of gastroesophageal reflux in infancy was evaluated. Fifty-two infants were examined with prolonged pH monitoring of the distal esophagus after feedings of apple juice or apple juice thickened with rice cereal. All infants had a minimum of three feedings of both thickened and unthickened juice. The recordings of distal esophageal pH were analyzed for the percent of time the pH was less than 4 in the first 2 hours after each feeding. The infants were maintained in the following positions after feeding: prone (n = 29), prone-board with the head elevated 30 degrees from horizontal (n = 29), supine (n = 7), and unrestricted (n = 21). We found no significant difference in the percent of time with reflux with thickened versus unthickened feedings except in those infants maintained in the 30-degree prone position. In the first 2 hours after eating thickened juice, infants maintained in this position had increased esophageal reflux time (P less than 0.006). Further analysis revealed that 33% of the infants had a greater than 30% increase in esophageal reflux time after thickened feedings. Our study suggests that the immediate effect of thickened feedings on gastroesophageal reflux in infants is unpredictable. PMID- 3806289 TI - Association of lipid-laden alveolar macrophages and gastroesophageal reflux in children. AB - The association of lipid-laden alveolar macrophages (LLAM) and gastroesophageal reflux (GER) was investigated prospectively in 115 patients in two groups. Group 1 included 74 children with chronic respiratory tract disorders and documented GER by prolonged esophageal pH monitoring, barium esophagram, and esophagoscopy; group 2 included 41 children with chronic respiratory tract disorders without GER. LLAM were present in 63 (85%) and eight (19%) children from groups 1 and 2, respectively (P less than 0.0001). Thus a strong association between the presence of LLAM and GER in children with chronic respiratory tract disorders was established. We suggest that LLAM from bronchial lavage may be a useful marker for tracheal aspiration in children with GER in whom chronic lung disease may subsequently develop. PMID- 3806290 TI - Syndromic paucity of interlobular bile ducts (Alagille syndrome or arteriohepatic dysplasia): review of 80 cases. AB - We have observed two types of paucity of interlobular bile ducts (PILBD) in children with chronic cholestasis: the syndromic type, which is more frequent (80 cases), and the nonsyndromic type (31 cases). Study of patients with syndromic PILBD has enabled us to recognize five major features: peculiar facies (95%), chronic cholestasis (91%), posterior embryotoxon (88%), butterfly-like vertebral arch defects (87%), and peripheral pulmonary artery hypoplasia or stenosis, either isolated or associated with complex cardiovascular abnormalities (85%). By observing these major features, it is possible to differentiate the "complete" syndrome, in which all five features are present (26 cases), from the "partial" syndrome, in which only four (42 cases) or three (12 cases) major features are present. Other less frequent features were observed in patients with complete or partial syndrome: growth retardation (50%), mental retardation (16%), renal disturbances, other vascular malformations, bone abnormalities, high-pitched voice, and delayed puberty. Death occurred in 21 (26%) patients with syndromic PILBD. Therapy consisted of supplementation of medium-chain triglycerides and fat soluble vitamins and administration of cholestyramine or phenobarbital. An autosomal dominant mode of transmission, with variable penetrance, seems likely. PMID- 3806291 TI - Distribution of serum bilirubin conjugates in pediatric hepatobiliary diseases. AB - We used a highly specific method, alkaline methanolysis-high performance liquid chromatography, for determining the concentration and patterns of the unconjugated and esterified bilirubin fractions in the sera of pediatric patients with hepatobiliary disease. Bilirubin-protein conjugates were assayed using a new method that selectively removes bilirubin reversibly bound to protein, allowing measurement of the tightly bound bilirubin-protein conjugates by use of a diazo method. Fifty-two serum samples from children with varying bilirubin concentrations and diagnoses were studied. Whereas no conjugated pigment was detectable in the serum samples of healthy children or in individuals with Gilbert syndrome or Crigler-Najjar syndrome, bilirubin monoester and diester conjugates and bilirubin-protein conjugates were present in the sera of children with cholestatic liver disease, and accounted for 69% +/- 15% of the total bilirubin in these samples. Bilirubin fractional analysis was incapable of differentiating extrahepatic biliary obstruction from hepatocellular disease, because of overlap between the groups. The presence of bilirubin-protein conjugates in serum always coincided with detection of bilirubin monoester and diester conjugates. The distribution of bilirubin and its conjugates in sera provides a sensitive, although nonspecific, measure of hepatic disease. PMID- 3806292 TI - Endoscopic retrograde cholangiopancreatography in children. AB - Endoscopic retrograde cholangiopancreatography (ERCP) is a universally used diagnostic and therapeutic modality in adults with pancreaticobiliary tract disease; its use in children with similar problems has been limited. We have performed ERCP procedures in 39 children and adolescents (aged 6 months to 18 years; mean 12.5 years), using the standard adult and pediatric side-viewing endoscopes. In selected cases, ERCP manometric study of the sphincter of Oddi, endoscopic sphincterotomy, or balloon extraction of common bile duct stones was performed. Nineteen patients had significant or abnormal structural findings, including pancreas divisum (four patients); sclerosing cholangitis (three); and choledochal cyst, chronic pancreatitis, choledochocele, pancreatic pseudocyst, common bile duct stone, and sphincter of Oddi motor dysfunction (two each). In all instances in which patients required operation, ERCP examination provided specific anatomic detail that was useful for planning appropriate intervention. The only significant complication after ERCP was mild pancreatitis, which occurred in four patients and responded to supportive, short-term measures. PMID- 3806293 TI - Dumping syndrome in children. AB - Dumping syndrome developed in seven children after gastric surgery, (Nissen fundoplication in six, Whipple procedure in one). The patients ranged from age 10 months to 13 years, and four of the seven were neurologically impaired. The diagnosis was made by demonstrating an abnormal response to an orally administered glucose challenge. The pediatric literature records only eight cases, but we believe that dumping syndrome is more common in children than once believed. Dietary management can often dramatically diminish the associated symptoms. PMID- 3806294 TI - Increased serum concentrations of 1,25(OH)2 vitamin D in children with fasting hypercalciuria. AB - Inappropriately elevated concentrations of 1,25(OH)2 vitamin D in serum appear to be responsible for excessive gastrointestinal absorption of dietary calcium in patients with absorptive hypercalciuria. We have examined serum 1,25(OH)2 vitamin D concentrations in another group of children with hypercalciuria in whom urinary calcium excretion was excessive after an overnight fast. Eleven children with idiopathic fasting hypercalciuria (IH) (urinary calcium excretion greater than 4 mg/kg/24 hr and fasting urinary calcium/urinary creatinine ratio greater than 0.21) and seven healthy children were observed while they were eating a diet containing 1 gm calcium per day. Fasting serum 1,25(OH)2 vitamin D concentrations were elevated in children with IH compared with control values (35.3 +/- 3.2 vs 21 +/- 2 pg/ml, P = 0.003), whereas fasting serum parathyroid hormone, 25-OH vitamin D, phosphorus, and ionized calcium concentrations were similar in the two groups. These data suggest that disordered 1,25(OH)2 vitamin D metabolism occurs in children with fasting IH. Absorptive and fasting IH may represent a spectrum of a single disorder characterized by excessive urinary calcium excretion and inappropriately elevated serum concentrations of 1,25(OH)2 vitamin D. PMID- 3806295 TI - Idiopathic hypercalciuria in children: pathophysiologic considerations of renal and absorptive subtypes. AB - Sixteen children with idiopathic hypercalciuria and seven control children were observed. Patients were classified into two groups by means of an orally administered calcium loading test. Individuals with renal hypercalciuria (five children) had a high fasting urinary calcium/creatinine concentration ratio (0.27 +/- 0.05), a mild increase of this value after calcium administration (0.29 +/- 0.07, P less than 0.05), and elevated mean serum parathyroid hormone (PTH) concentrations (0.95 +/- 1.14 ng/ml). Patients with absorptive hypercalciuria (11 children) had fasting urinary calcium/creatinine concentration ratio of 0.11 +/- 0.04, a large increase of this index after calcium loading (0.25 +/- 0.06, P less than 0.0005), and normal levels of serum PTH (0.29 +/- 0.10 ng/ml). Next, we examined the effects of two different calcium intakes on urinary calcium excretion, serum calcium, PTH, and 1,25-dihydroxyvitamin D3 concentrations. In patients with absorptive hypercalciuria, the increased calcium intake resulted in significant increments of calciuria (P less than 0.0005), mild elevation of serum calcium concentration (P less than 0.05), and reduction of serum 1,25 dihydroxyvitamin D3 concentrations (P less than 0.005). By contrast, these values were not modified in children with renal hypercalciuria. Serum PTH did not change within each group. After dietary calcium supplementation, serum ratios of 1,25 dihydroxyvitamin D3 to calcium, phosphate, and PTH concentrations decreased significantly only in the group of children with absorptive hypercalciuria. Our data support the contention that 1,25-dihydroxyvitamin D3 metabolism is different in the two groups of patients with hypercalciuria. PMID- 3806296 TI - Familial 46,XX males coexisting with familial 46,XX true hermaphrodites in same pedigree. AB - Reported here is a family with which 46,XX males and 46,XX true hermaphrodites coexist. The propositus was a paternal uncle with 46,XX true hermaphroditism. One of his brothers fathered a 46,XX daughter with true hermaphroditism; a second brother fathered two 46,XX males. Both fathers have normal male karyotypes and phenotypes. No evidence for chromosomal mosaicism or any additional chromosomal abnormalities was obtained. We conclude that inheritance of the abnormality is most likely via paternal transmission of an autosomal testis-determining factor. This family provides evidence to support the hypothesis that 46,XX true hermaphrodites and 46,XX males represent alternative manifestations of the same genetic defect. PMID- 3806297 TI - Aerosol inhalation teaching device. AB - To facilitate teaching of inhalation technique to children, we have developed an aerosol inhalation teaching device by modifying the jacket of a canister nebulizer so that inhalation is accompanied by a horn sound and a flashlight is turned on when the canister is actuated. The device was evaluated in 33 children with asthma who had either never used a canister nebulizer (13 patients) or used incorrect technique (20 patients). The inhalation technique was first taught with conventionally, that is, verbal directions and demonstration with a canister nebulizer for 10 minutes. Only 10 (30%) of 33 children learned the technique. The remaining 23 were then taught with the special device. Twenty of 23 learned the technique within 10 minutes, but three others took longer. In a second study, 22 children, 11 of whom were beginners and 11 incorrect users, were instructed with the teaching device from the beginning. Seventeen (77%) learned the technique within 10 minutes; five others took longer. Most children can be taught the aerosol inhalation technique with this easily constructed device. PMID- 3806298 TI - Developmental assessment: caveats and a cry for quality control. PMID- 3806299 TI - Treatment of gastroesophageal reflux: is nothing sacred? PMID- 3806300 TI - Genetic disorders of mitochondrial function. PMID- 3806301 TI - Audiometer and AudioScope hearing screening compared with threshold test in young children. PMID- 3806302 TI - Rapid determination of C-reactive protein levels: semiquantitative versus quantitative. PMID- 3806303 TI - Pediatric acquired immune deficiency syndrome with panhypogammaglobulinemia. PMID- 3806304 TI - Effect of amniotic fluid on platelet thromboxane production. AB - We have studied the effect of amniotic fluid on thromboxane A2 (TXA2) production as an initial step in an evaluation of the role of this metabolite as the mediator of the pulmonary hypertension that accompanies perinatal aspiration. Term amniotic fluid enhanced platelet thromboxane B2 (TXB2) production in the presence of the aggregating agents thrombin and arachidonic acid, activity being confined to the lipid fraction. Compared with a baseline production of 1.4 +/- 0.45 pmol TXB2/10(6) platelets in response to thrombin (1 U/ml), unfractionated amniotic fluid or its lipid fraction enhanced TXB2 production to 2.87 +/- 0.53 and 2.81 +/- 0.62 pmol, respectively (P less than 0.01). Values for the aqueous extract were no different from buffer control values (1.14 +/- 0.5). No enhancement of platelet TXB2 production was observed in amniotic fluid obtained at 15 to 17 weeks. Similar activity was observed with either adult or neonatal platelets. This thromboxane enhancing property of amniotic fluid appears to be distinct from its thrombin generating property. Following perinatal aspiration, in situ production of thrombin and proaggregatory TXA2 could recruit more platelets, enhance local TXA2 production, and be responsible for the platelet thrombi that have been documented at autopsy in the pulmonary microcirculation in infants with perinatal aspiration syndrome. PMID- 3806305 TI - Dopamine pharmacokinetics in critically ill newborn infants. AB - To compare clinical responses with plasma concentrations of dopamine and to compare dopamine pharmacokinetics in infants of different gestational age or clinical condition, dopamine was administered under carefully controlled conditions of dose and rate of infusion. The dose was increased stepwise from 1 to 2, to 2 to 4, and 4 to 8 micrograms/kg/min. Plasma concentrations of catecholamines, including dopamine, were compared with blood pressure, heart rate, and Doppler cardiac output. The data were analyzed to determine the threshold or minimal plasma concentration of dopamine necessary to produce discernible effects. Plasma clearance rate was calculated from steady-state plasma concentrations. The average threshold for increases in mean arterial pressure was 50% below that for increases in heart rate. Improvements in arterial pressure were noted before and at lower thresholds than for increases in heart rate. Serial echocardiographic data showed dose-dependent increases in cardiac output and stroke volume without significant change in heart rate or systemic vascular resistance. Thresholds and plasma clearance values were similar in infants of gestational age 27 to 42 weeks and birth weights 900 to 4300 g. Administration of dopamine at initial dosages lower than commonly recommended, followed by incremental increase in dose, may be associated with improved left ventricular performance with avoidance of undesirable tachycardia and arrhythmias. PMID- 3806306 TI - Serum concentrations of penicillin after intramuscular administration of procaine, benzyl, and benethamine penicillin in children with pneumonia. AB - Serum concentrations of penicillin were measured in 37 children with pneumonia. The mean serum concentration of penicillin was greater than 1.0 microgram/mL for 11 hours after intramuscular administration of 48,000 U/kg benethamine penicillin compound (nine children), for 26 hours after 48,000 U/kg aqueous procaine penicillin (10 children), and for 40 hours after 79,000 U/kg aqueous procaine penicillin (seven children). After intramuscular administration of 35,000 U/kg benzyl penicillin in 11 children, the serum concentration was 13.3 +/- 7.4 micrograms/mL (mean +/- SD) 30 minutes after the injection, and 4.9 +/- 3.2 micrograms/mL after 3 hours. Our findings lend support to the World Health Organization recommendation that children with mild pneumonia in developing countries be given daily intramuscular injections of 50,000 U/kg aqueous procaine penicillin. PMID- 3806307 TI - Individualizing gentamicin dosage in patients with cystic fibrosis: limitations to pharmacokinetic approach. AB - Gentamicin serum concentrations were measured in 15 children and seven adults with cystic fibrosis and in eight children with other diseases. Potentially toxic trough concentrations occurred in three of the first nine patients studied, in whom the dose and a 4-hour dosing interval were prescribed on the basis of one compartment pharmacokinetic calculations (Sawchuck-Zaske method). In contrast, final concentrations were within the accepted target ranges for the remaining 13 patients with cystic fibrosis, in whom the dose and interval were adjusted empirically on the basis of a single pair of "peak" and trough values. The mean +/- SD final dosage required to achieve target concentrations was 13.8 +/- 2.9 mg/kg/d for children and 11.8 +/- 1.1 mg/kg/d for adults (P greater than 0.05), generally divided into four doses at 6-hour intervals. Mean half-life and incremental increase in serum concentration from previous trough to subsequent "peak," an indirect measurement of volume of distribution, were not significantly different between children or adults with cystic fibrosis and pediatric control subjects; there was little interpatient variability in these values. Thus the high dosage requirements were related more to the higher target concentrations than to altered pharmacokinetic disposition in patients with cystic fibrosis. We conclude that the initial dose of gentamicin to achieve a peak of 8 to 12 micrograms/mL and a trough of less than 2.0 micrograms/mL in patients with cystic fibrosis should be 3 mg/kg administered every 6 hours in children and every eight hours in adults. Subsequent dosage adjustment should be made on the basis of a pair of peak and trough serum concentration measurements obtained after the fifth dose. Dosing intervals in this patient population generally should be no shorter than every 6 hours, even if the initial trough concentration is less than 1 microgram/mL. PMID- 3806308 TI - Short-course amphotericin B therapy for isolated candiduria in children. PMID- 3806309 TI - Use of phencyclidine among adolescents attending a suburban drug treatment facility. PMID- 3806310 TI - Changes in theophylline clearance during aminophylline infusion. PMID- 3806311 TI - New clinical findings in breast milk jaundice. PMID- 3806312 TI - Staphylococcus epidermidis-associated enterocolitis. PMID- 3806313 TI - Chronic Q fever endocarditis. PMID- 3806314 TI - Treatment of children at risk for bacteremia. PMID- 3806315 TI - Life history and population biology of larval Acanthocephalus lucii (Acanthocephala: Echinorhynchidae) in the isopod Asellus aquaticus. AB - Hemocoels of 8,731 Asellus aquaticus collected from the Forth and Clyde canal in Glasgow, Scotland, from January 1980 to March 1981 were examined for larvae of Acanthocephalus lucii. Prevalence and mean intensity were generally low (1.5-8.3% and 1.0-1.6, respectively), but there was a slight seasonal infection pattern with fewer infected isopods during summer, reflecting the appearance of a new isopod generation. Although there were no distinct seasonal trends in the proportions of each larval stage, recruitment of larvae probably occurred mainly during summer and autumn. Some larvae reached the cystacanth stage by late summer or autumn; others overwintered as acanthors or acanthellae and completed development the following spring. The maximum life span of larvae was limited to 1 yr by annual turnover of the isopod population. The distribution of larval A. lucii among isopods was slightly aggregated. There was a peaked pattern in the relationship between isopod length and the prevalence, abundance, and degree of parasite aggregation. The rate of parasite development in laboratory-infected isopods was linearly related to temperature between 9 and 22 C; the temperature threshold was 5.7 C, and the larval parasite required 598 degree-days above threshold to complete development. Among laboratory-infected isopods, 2 mechanisms that could regulate the larval parasite population were detected: intraspecific competition and direct, parasite-induced isopod mortality. However, the intensity of infection in the natural habitat was consistently low and may have remained below the level at which these mechanisms operated. PMID- 3806316 TI - Long-term population dynamics of pinworms (Syphacia obvelata and Aspiculuris tetraptera) in mice. AB - The population dynamics of concurrent infections of Syphacia obvelata and Aspiculuris tetraptera (Nematoda) in laboratory mice were investigated under conditions of constant re-exposure over periods of 56 and 115 days. The results indicate that A. tetraptera burdens equilibrate at a higher level than S. obvelata burdens and that both parasites become aggregated in the mouse population. Parasite burdens were higher following short-term (7 day) exposure of uninfected tracer mice to both parasites when compared with parasite burdens attained over long-term exposure, indicating probable development of immunity. A significant positive correlation was detected between numbers of immature S. obvelata and immature A. tetraptera for both experimental and tracer mice. PMID- 3806317 TI - Development of infections of Gyrodactylus colemanensis Mizelle and Kritsky, 1967 (Monogenea) and the effect on fry of Salmo gairdneri Richardson. AB - The development of infections of Gyrodactylus colemanensis Mizelle and Kritsky, 1967 (Monogenea) and their effect on fry of Salmo gairdneri Richardson are examined experimentally. Starting with initial infections of 1 to 10 worms per fry, intensity in 2 replicate groups increased to peaks of 55 and 65 on day 22 post-infection and declined to 0 by days 67 and 85 post-infection. The parasites were numerically aggregated within the host groups and there was a negative correlation between intensity and fish size. Infections did not influence growth or survival of the host and produced no clinical signs of disease. PMID- 3806318 TI - Utilization of the heme moiety of hemoglobin by Schistosoma mansoni schistosomules in vitro. AB - The hemoglobin in mouse reticulocytes was labeled in vitro with either [3H], [14C] aminolevulinic acid (ALA), or [3H] leucine. Specific labeling of the globin moiety with labeled leucine, and the heme moiety with labeled ALA, was confirmed by carboxymethylcellulose chromatography and cyclohexanone extraction. Most of the leucine label recovered from reticulocytes that were incubated for 4 hr was incorporated in hemoglobin. However, 2 hr incubation of reticulocytes in the presence of labeled ALA followed by 4 hr in cell incubation medium in the absence of ALA was required for sufficient incorporation of the radionuclide into reticulocyte hemoglobin. In all reticulocyte labeling experiments, regardless of the radionuclide used, label was also observed in non-hemoglobin heme-containing molecules. Schistosoma mansoni schistosomules fed reticulocytes in vitro in which the heme moiety of hemoglobin was labeled displayed radioactivity in the protein fraction of the organisms, as determined by TCA precipitation, and in the ethanol soluble component. In comparison, schistosomules fed reticulocytes containing globin-labeled hemoglobin displayed radioactivity only in the protein component. Pre-incubation of the schistosomules in puromycin prior to exposure to lyophilized, [14C] ALA-labeled hemoglobin partially inhibited incorporation of label. These results suggest that the organism utilizes not only the globin moiety of hemoglobin in its nutritional requirements, but the heme moiety as well. PMID- 3806319 TI - Growth and feeding of Echinostoma revolutum on the chick chorioallantois and in the domestic chick. AB - Chemically excysted metacercariae of Echinostoma revolutum cultivated on the chick chorioallantois grew slowly until day 5, more rapidly between 5 and 7 days, and slowly between 7 and 10 days. Worms did not become ovigerous in this site by 12 days, at which time studies were terminated. In contrast, chemically excysted metacercariae reared in the domestic chick were ovigerous by day 9, at which time their mean body area was about 4 times greater than the largest chorioallantoic worms. Histochemical studies, solubility tests for hematin, and X-ray microanalysis of cecal contents showed that chorioallantoic-worms fed on blood from the vascular membrane, whereas chick-worms fed on host intestinal mucosa. PMID- 3806320 TI - The effects of Plagiorchis noblei metacercariae on the development and survival of Aedes aegypti larvae in the laboratory. AB - Plagiorchis noblei infections impair the survival and development of fourth instar Aedes aegypti larvae. Mortality during the larval and pupal stages reached 92%, and 60% of the emerging adults were malformed. The metacercariae interfere with pupation and the emergence of adults. Larvae and pupae that fail to transform to the next developmental stage within the normal time characteristically persist for extended periods, but invariably die without transforming. Whereas 82% of the control larvae gave rise to functional adults, only 4% of infected larvae managed to do so. Such effects may facilitate the transmission of the parasite. PMID- 3806321 TI - Microfilarial perforation of the midgut of a mosquito. AB - To determine whether the midgut envelope of mosquitoes is disrupted by the passage of microfilariae, ultrastructural changes induced by microfilariae of Brugia malayi were observed in midguts of Aedes aegypti mosquitoes. Basal and apical plasma membranes were destroyed, disrupting the full depth of the midgut wall. Ingested ferritin lay against the gut wall, suggesting absence of the peritrophic membrane during penetration. Exsheathment of microfilariae appears to be enhanced by movement against the constricting midgut wall. It was concluded that particles present in the lumen of the gut may be disseminated passively to the hemocoel. PMID- 3806322 TI - Cytogenetics of Dictyocaulus arnfieldi (Cobbod, 1884) Railliet and Henry, 1907. AB - A cytogenetic study of Dictyocaulus arnfieldi was made for the first time. The diploid chromosome number was 2n = 11 for males and 2n = 12 for females; there was an XO/XX sex determinism mechanism. Diplotene stage showed bivalents with 3, 2 or 1 chiasmata. The possible differences in the evolution of D. arnfieldi and Dictyocaulus filaria are discussed. PMID- 3806323 TI - Eulimdana rauschorum n. sp., a filarioid nematode (Lemdaninae) from Larus dominicanus in Antarctica, with comments on evolution and biogeography. AB - Eulimdana rauschorum n. sp. is described from southern black-backed gulls, Larus dominicanus Lichtenstein in Antarctica. The species is most similar to Eulimdana lari (Yamaguti, 1935) from Charadriiformes in the Holarctic. Males have spicules equal in length that are asymmetric in structure distally. There are 4-5 and 3-5 caudal papillae in rows to the right and left of the anus, and 2 small genital papillae at the posterolateral margin of the anus. Females have a variable number of prominent caudal papillae and large microfilariae (365 micron in length). The morphological similarities and host distribution of E. rauschorum and E. lari suggest they are sister taxa in which cladogenesis of the former accompanied the isolation and subsequent speciation of Larus dominicanus in the Southern Hemisphere. PMID- 3806324 TI - Caryospora uptoni n. sp. (Apicomplexa: Eimeriidae) from red-tailed hawks (Buteo jamaicensis borealis). AB - Oocysts of Caryospora uptoni n. sp. were described from the feces of red-tailed hawks, Buteo jamaicensis borealis. Sporulated oocysts were spherical or subspherical and measured 28.1 by 26.4 micron. The oocyst wall was composed of a yellowish outer layer and brownish inner layer and was about 1.5 micron thick. Neither micropyle, polar granules, nor oocyst residuum were present. A single, spherical sporocyst 18.2 by 17.9 micron was present; a Stieda body was absent. A spherical eccentrically located sporocyst residuum was present in many sporocysts, but it degenerated to form a dispersed granular residuum in other sporocysts. Eight randomly arranged sporozoites, 12.6 by 4.2 micron, were present in each sporocyst; they contained a centrally or slightly posteriorly located nucleus. PMID- 3806325 TI - Effects of sugars on the anthelmintic activity of kalafungin. PMID- 3806326 TI - Survival and viability of Dirofilaria immitis microfilariae in defined and undefined culture media. PMID- 3806327 TI - Paragonimus mexicanus (Trematoda) in Costa Rica in two new intermediate hosts: Ptychophallus richmondi and Ptychophallus tumimanus (Crustacea: Decapoda). PMID- 3806328 TI - Factors in developmental delay of Paragonimus kellicotti miracidia. PMID- 3806329 TI - Enzyme-linked immunosorbent assay to detect antibody response against Eimeria bovis and Eimeria zurnii in calves. PMID- 3806330 TI - Resistance of Helisoma trivolvis from the Dominican Republic to infection by the trematode Schistosoma mansoni. PMID- 3806331 TI - Prevalence and intensity of helminth infections in southwest Puerto Rico. PMID- 3806332 TI - Concentration of 125globulins in intestinal tissues of immunized and non immunized chickens infected with Eimeria acervulina. PMID- 3806333 TI - Parasites of white sturgeon, Acipenser transmontanus, from the Fraser River, British Columbia. PMID- 3806334 TI - Infection dynamics of Cryptosporidium parvum (Apicomplexa: Cryptosporiidae) in neonatal mice (Mus musculus). PMID- 3806335 TI - Thiabendazole uptake, metabolism and excretion in thiabendazole resistant and susceptible Trichostrongylus colubriformis. PMID- 3806336 TI - Trichinella from rats in central Italy. PMID- 3806337 TI - Complement and 5-HT increase phosphatidylcholine incorporation into the outer bilayers of Schistosoma mansoni. PMID- 3806338 TI - Helminths of collared lizards (Crotaphytus collaris) from the Pedro Armendariz lava field, New Mexico. PMID- 3806339 TI - Chromosomes of Heterobilharzia americana (Digenea: Schistosomatidae) from Texas. PMID- 3806340 TI - Parasitism of larval Ixodes ticks by chigger mites and fed female Ornithodoros ticks by Ornithodoros males. PMID- 3806341 TI - Prediction and clinical inference: forty years later. AB - The earlier controversy between clinical and statistical prediction has faded into the shadows. Few people today challenge the necessity for both approaches in seeking to develop and apply knowledge. In more contemporary terms, the issue of which prediction method should be preferred involves choosing between a quest for historical truth (i.e., correspondence demonstrated by statistical methods) and a quest for narrative truth (i.e., coherence achieved by clinical formulations). PMID- 3806342 TI - Causes and effects of my disturbing little book. AB - Review and reflection indicate that no more than 5% of what was written in the 1954 book entitled, Clinical Versus Statistical Prediction (Meehl, 1984), needs to be retracted 30 years later. If anything, these retractions would result in the book's being more actuarial than it was. Seven factors appear to account for the failure of mental health professionals to apply in practice the strong and clearly supported empirical generalizations demonstrating the superiority of actuarial over clinical prediction. PMID- 3806343 TI - Accepting error to make less error. AB - In this article I argue that the clinical and statistical approaches rest on different assumptions about the nature of random error and the appropriate level of accuracy to be expected in prediction. To examine this, a case is made for each approach. The clinical approach is characterized as being deterministic, causal, and less concerned with prediction than with diagnosis and treatment. The statistical approach accepts error as inevitable and in so doing makes less error in prediction. This is illustrated using examples from probability learning and equal weighting in linear models. Thereafter, a decision analysis of the two approaches is proposed. Of particular importance are the errors that characterize each approach: myths, magic, and illusions of control in the clinical; lost opportunities and illusions of the lack of control in the statistical. Each approach represents a gamble with corresponding risks and benefits. PMID- 3806344 TI - The schizophrenic diathesis and the kibbutz. AB - In this article, the National Institute of Mental Health (NIMH) "Israeli High Risk Study," which extended over two decades and compared the relative effects of kibbutz and city environments on the diathesis of schizophrenia, is critically examined. Comparison data on personality and cognitive functions of groups of 11- to 16-year-olds and adults are reviewed in the light of previously published material. The apparent shifts in level of adjustment of kibbutz and city subjects, as well as the allegedly greater incidence of pathology in the kibbutz index group, are questioned on methodological grounds. PMID- 3806345 TI - Some Rorschach data comparing schizophrenics with borderline and schizotypal personality disorders. AB - The Rorschach data from 84 borderline personality disorders and 76 schizotypal personality disorders, both groups diagnosed using DSM-III criteria, were compared with each other and with two sets of Rorschach protocols collected from 80 first admission schizophrenics, one being administered shortly after admission and the second taken shortly before discharge. The data indicate that the borderline group is markedly different in both organization and functioning from both other groups; however, there are many similarities between the records of the schizotypals and schizophrenics. It is suggested that nomenclatures such as borderline schizophrenia or latent schizophrenia might be more appropriate to designate the schizotypal group and that the once used, but now discarded, nomenclature of inadequate personality offers a more fitting description of the borderlines. PMID- 3806346 TI - Conceptual and empirical perspectives on the Rorschach assessment of psychopathology. AB - Conceptual and empirical perspectives on the Rorschach assessment of psychopathology are described and placed in a complementary perspective that stresses the value of conceptual formulations and the necessity of empirical data. Empiricism without concepts fails to explain adequately why Rorschach assessment yields useful information; conceptualization without empirical support fails to document adequately the psychometric soundness of Rorschach inferences. Used in tandem, explanatory concepts and supportive data enhance the scientific stature and professional utility of Rorschach assessment. PMID- 3806347 TI - An exploration of separation-individuation themes in the borderline personality disorder. AB - In an attempt to test hypotheses derived from Mahler's theory of borderline development, Rorschach protocols of borderline and schizophrenic patients were studied for the presence of themes related to the separation-individuation process. A specially constructed Separation-Individuation Theme Scale was used with a 96% reliability of agreement between two raters. The borderline group attained more separation-individuation themes than the schizophrenic group, whereas the schizophrenics showed more preseparation-individuation themes. The results were interpreted as a validation of Mahler's theory. In addition, the results tended to confirm a developmental model for the understanding of psychopathology. PMID- 3806348 TI - On the synthesis, cytostatic and antitumour properties of new platinum (II) complexes with 1,2-diaminocyclopentane. PMID- 3806349 TI - [Potentiometric titrations of drugs containing piperazine, piperidine or pyrrolidine groups using modified polymeric electrodes]. PMID- 3806350 TI - [Stabilization of emulsions with hydrophilic polymers]. PMID- 3806351 TI - Dissolution behaviour of tolazamide in the presence of certain non-ionic surfactants. PMID- 3806352 TI - Utility of the charge-transfer complex formation for the spectrophotometric determination of some antimalarials. PMID- 3806353 TI - Differences in conceptualizing self versus conceptualizing other people as manifested in contrasting verb types used in natural speech. AB - Predicted differences in modes of thinking about self versus thinking about other people, derived from assumptions regarding one's privileged information about the self, were tested by comparing the types of verbs used in free descriptions of self versus the types of verbs used in free descriptions of other people. Three minute responses to "Tell us about your family" and "Tell us about school" probes were divided into individual subject/verb/qualifier thought segments, from among which those with myself as subject versus those with other person(s) as subject were selected as the independent variable for testing six predicted self-other differences. It was found, as predicted, that the self more than other people is thought of concretely in terms of what one does (verbs of action) rather than abstractly in terms of what one is (verbs of state). Among state verbs, the self, more than others is described in terms of dynamic becoming rather than in terms of static being states; among action verbs, the self more than others is described as covertly reacting rather than as overtly acting. As regards overt actions, the self more than others is thought of as physically acting rather than as socially interacting; as regards covert reactions, the self more than others is thought of as having affective rather than cognitive reactions. Finally, the self more than others is described in terms of what one is not rather than what one is. The interaction effects on these six verb-ratio differences between self conceptualizing versus other conceptualizing and age, gender, stimulus context, and response modality are described. PMID- 3806354 TI - The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. AB - In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. PMID- 3806355 TI - Enhancing the prediction of self-handicapping. AB - Levels of test anxiety, Type A and Type B coronary-prone behavior, fear of failure, and covert self-esteem were studied as predictors of self-handicapping performance attributions for college women who were placed in either a high- (N = 49) or low- (N = 49) evaluative test or task situation. We hypothesized that test anxiety. Type A or Type B level, and their interaction would account for reliable variance in the prediction of self-handicapping. However, we also theorized that underlying high fear of failure and low covert self-esteem would explain the self handicapping claims of test-anxious and Type A subjects. The results indicated that only high levels of test anxiety and high levels of covert self-esteem were related to women's self-handicapping attributions. PMID- 3806356 TI - Social roles and social perception: individual differences in attribution and error. AB - In a replication of the social roles experiment by Ross, Amabile, and Steinmetz (1977), 103 male and female 14-year-olds viewed a brief videotape that showed a randomly assigned "questioner" asking general knowledge questions of a "contestant," who answered most of them incorrectly. Subjects subsequently manifested the role-based attribution error of attributing significantly more knowledge and ability to the arbitrarily designated questioner than to the arbitrarily designated contestant, and this effect was stronger among girls than boys. Personality data were available on the subjects for when they were in nursery school and again at age 14 in the form of independent Q-sort ratings. Personality correlates of the role effect were stronger among boys but manifested a basically similar pattern among girls and suggested that those most prone to make this attribution error, far from being disadvantaged in social judgment, tended to be more socially engaged and competent as well as emotionally well adjusted. The role effect was also positively associated with self-esteem. Personality correlates of attributional generosity and the tendency to attribute high ability to stimulus persons were associated with generally positive interpersonal qualities and attitudes. Results were interpreted in terms of usually appropriate heuristic social competencies that, in special circumstances, may sometimes underlie attribution errors. The general usefulness of examining individual differences in research on social cognition was noted. PMID- 3806357 TI - Defensive pessimism: harnessing anxiety as motivation. AB - In this article we discuss the strategies that people may use to cope with situations that are risky in that they present the possibility for failure and potential threats to self-esteem. Previous research has indicated that anxiety (Sarason, 1980) and explicitly set low expectations (Sherman, Skov, Hervitz, & Stock, 1981) may lead to performance deficits in these situations. Experiment 1 indicates, in contrast, that with a strategy called defensive pessimism (Norem & Cantor, 1986), individuals may sometimes use low expectations to cope with their anxiety so that it does not become debilitating. A second experiment further supports the contention that low expectations may help individuals negotiate risky situations by showing that interference with the defensive-pessimism strategy impairs performance. Subjects whose strategic construction of the situation was not interfered with do not show impaired performance. These data are interpreted as evidence that the effects of low expectations and high anxiety on performance may be mediated by the strategies individuals use when approaching risky situations. PMID- 3806358 TI - Hardiness, type A behavior, and the stress-illness relation in working women. AB - Hardiness has been proposed as a stress-resistance resource in maintaining health. This construct has been shown to act in conjunction with the Type A behavior pattern in affecting illness. In this study, we examined this relation in women (N = 82) with the use of the Structured Interview and the Jenkins Activity Survey to assess Type A behavior. As expected, there was a strong stress illness association. However, there were no hardiness main effects nor interactions between stress, Type A behavior, and hardiness. Hardiness was significantly associated with age, education level, and marital status. No differences in hardiness composition were found between high stress/high illness and high stress/low illness groups. Only the Powerlessness scale of hardiness was related to illness. These results are discussed in comparison with other hardiness studies. Particular attention is focused on possible sex differences, and implications for future research are suggested. PMID- 3806359 TI - Multiple roles, social networks, and women's well-being. AB - In contrast to earlier approaches to the study of multiple roles, our research was concerned with the frequency and conditions under which both positive and negative outcomes occur. Using data from a random sample of 235 married female nurses, we focused on marital and job satisfaction as important criteria of success in managing multiple roles. In the first phase of the research, a cluster analysis identified five different profiles of marital and job satisfaction. Of the two most positive profiles, one was defined by high scores in both areas, the other by high job satisfaction but only moderate marital satisfaction. In two other profiles, women were very dissatisfied with one role and at best moderately satisfied with the other. In the second phase, the profiles were found to be meaningfully associated with measures of psychological symptomatology and overall life satisfaction. The third phase considered how the profiles were linked to measures of social support and social rejection provided by five key network members. The strongest univariate profile discriminator was the level of work rejection from the spouse. A discriminant function analysis revealed that the level of spouse's work rejection was even more powerful when it was compared to the level of work rejection received from the next closest family member (typically the mother). PMID- 3806360 TI - Attributional processes in the learned helplessness paradigm: behavioral effects of global attributions. AB - Following the learned helplessness paradigm, I assessed in this study the effects of global and specific attributions for failure on the generalization of performance deficits in a dissimilar situation. Helplessness training consisted of experience with noncontingent failures on four cognitive discrimination problems attributed to either global or specific causes. Experiment 1 found that performance in a dissimilar situation was impaired following exposure to globally attributed failure. Experiment 2 examined the behavioral effects of the interaction between stable and global attributions of failure. Exposure to unsolvable problems resulted in reduced performance in a dissimilar situation only when failure was attributed to global and stable causes. Finally, Experiment 3 found that learned helplessness deficits were a product of the interaction of global and internal attribution. Performance deficits following unsolvable problems were recorded when failure was attributed to global and internal causes. Results were discussed in terms of the reformulated learned helplessness model. PMID- 3806361 TI - Coping with stress: divergent strategies of optimists and pessimists. AB - Previous research has shown that dispositional optimism is a prospective predictor of successful adaptation to stressful encounters. In this research we attempted to identify possible mechanisms underlying these effects by examining how optimists differ from pessimists in the kinds of coping strategies that they use. The results of two separate studies revealed modest but reliable positive correlations between optimism and problem-focused coping, seeking of social support, and emphasizing positive aspects of the stressful situation. Pessimism was associated with denial and distancing (Study 1), with focusing on stressful feelings, and with disengagement from the goal with which the stressor was interfering (Study 2). Study 1 also found a positive association between optimism and acceptance/resignation, but only when the event was construed as uncontrollable. Discussion centers on the implications of these findings for understanding the meaning of people's coping efforts in stressful circumstances. PMID- 3806362 TI - Effects of social support and battle intensity on loneliness and breakdown during combat. AB - A sample of 382 Israeli soldiers who developed combat stress reactions (CSR) during the 1982 Israel-Lebanon War were compared with groups of carefully matched controls who did not develop CSR. Lack of social support from officers was found to be related to greater feelings of loneliness and greater likelihood of CSR in soldiers. Lack of social support from buddies was found to be related to greater loneliness. Intensity of battle was also found to be related to greater feelings of loneliness and increased likelihood of CSR. A path model was tested and supported. The model suggests that battle intensity and officer support lead to CSR directly and indirectly by causing increased feelings of loneliness. Possible cognitive and psychodynamic explanations for the findings are offered. The limitations of making causal statements from retrospective perceptions is discussed. PMID- 3806363 TI - Coping in stressful episodes: the role of individual differences, environmental factors, and situational characteristics. AB - Theoretical models emphasize the importance of person and environmental variables in stress and coping processes. This article examines individual differences (extraversion and neuroticism), environmental factors (social support and work demand), and situational characteristics (type of stressful episode and its perceived importance) as predictors of three self-report measures of coping (general coping, direct coping, and suppression) derived from the Ways of Coping Questionnaire. The data analyzed were collected from 135 first-year female student nurses. Individual differences were assessed prior to exposure to the ward environment, and information about stressful episodes was obtained during the initial period of nursing practice. Multiple regression analyses showed that individual differences and environmental and situational factors were significant predictors of the coping scores and that patterns of main and interactive effects were different for each type of coping. For direct coping and suppression, predicted interactions across person, environmental, and situational variables contributed significantly to the explained variance. Curvilinear interactions between work demand and neuroticism were significant for both direct coping and suppression; interactions of social support and extraversion with perceived importance predicted direct coping; and interactions between neuroticism and extraversion and between work demand and importance predicted suppression. These findings are discussed in relation to current substantive and methodological issues in the study of coping and adaptation. PMID- 3806364 TI - [Toxicological studies on biological effects of the herbal drug extracts in rats and mice. II. Moutan bark, Glycyrrhiza and Bupleurum root]. PMID- 3806365 TI - [Determination of O-phosphoethanolamine in male and female mouse tissues by high performance liquid chromatography]. PMID- 3806366 TI - [Reduction of nicardipine, calcium antagonist, with enteric bacteria]. PMID- 3806367 TI - [Pharmacokinetics of the two major metabolites of ethyl loflazepate (CM6912) in dogs and humans. Simulation by a digital computer]. PMID- 3806368 TI - [Experimental production of various types of cholestasis and the effect of cysteamine]. PMID- 3806369 TI - [Synthesis and reaction of dihydrofuro[3,4-b][1,5]benzodiazepinones and dihydropyrrolo[3,4-b][1,5]benzodiazepinones]. PMID- 3806370 TI - Alcohol oxidation by Acinetobacter calcoaceticus EB 104--a n-alkane-utilizing and cytochrome P-450-producing strain. AB - A soluble, NADP+-dependent alcohol dehydrogenase (ADH) with a pH optimum at 8.7 was found in A. calcoaceticus EB 104 after growth on different carbon sources. n Alkanols with short and medium chain length were employed as test substrates. The Km values decreased with increasing chain length. The Vmax values remained nearly unchanged. The activities determined were independent of the carbon source. Furthermore, a n-alkanol-dependent reduction of DCPIP was measured in membrane fractions of cells grown on different carbon sources. The optimum pH for this reaction was at 7.5. Further proof for the presence of a pyridine nucleotide independent ADH was derived from the oxidation of 14C-decanol in the absence of NADP+ or NAD+. PMID- 3806371 TI - Dose-dependent pharmacokinetics of prednisolone in normal and adrenalectomized rats. AB - The pharmacokinetics of prednisolone after 5- and 50-mg/kg doses given as the sodium succinate salt was examined in normal and adrenalectomized rats. Prednisolone, prednisone, and corticosterone concentrations in plasma were determined by HPLC and free prednisolone measured by equilibrium dialysis. Prednisolone sodium succinate was rapidly and completely hydrolyzed to prednisolone as indicated by the absence of the ester from plasma within 5 min after intravenous injection. Prednisolone was rapidly metabolized to prednisone, while corticosterone concentrations in normal rats declined rapidly and were undetectable by 1 hr. Adrenalectomy had no effect on the disposition and protein binding of prednisolone. Dose, however, had a marked effect on prednisolone pharmacokinetics, with mean plasma clearance decreasing from 6.18 to 3.07 L/h per kg and mean steady-state volume of distribution decreasing from 2.14 to 1.05 L/kg from the lower to higher steroid dose. Half-life (0.50 hr) and mean residence time (0.35 hr) were unaffected by dose. Prednisolone plasma protein binding was nonlinear due to saturation of transcortin binding. Changes in pharmacokinetic parameters were not related to the nonlinear plasma binding, but were more likely caused by saturation of elimination pathways and tissue binding sites. PMID- 3806372 TI - Effects of the rate and composition of fluid replacement on the pharmacokinetics and pharmacodynamics of intravenous furosemide. AB - Effects of differences in the rate and composition of intravenous fluid replacement for urine loss on the pharmacokinetics and pharmacodynamics of furosemide were evaluated using the dog as a model animal. Each of six dogs received 8-hr constant intravenous infusion of 20 mg (15 mg used in one dog) of furosemide with 0% replacement (treatment I), 50% replacement (treatment II), and 100% replacement (treatment III) with lactated Ringer's solution, as well as with 100% replacement with 5% dextrose in water (treatment IV). Most pharmacokinetic parameters, such as plasma clearance, steady-state volume of distribution, mean residence time, and terminal half-life, were essentially the same in all four treatments. Renal clearances and urinary excretion rates of the drug in treatments II-IV were essentially the same, but about 20% higher than those in treatment I. In spite of the similarities in kinetic properties, diuretic and/or natriuretic effects from furosemide were markedly different among the four treatments. For example, mean 10-hr urine outputs were 646, 1046, 3156, and 1976 ml and mean 10-hr sodium excretions were 87.0, 142, 383, and 97.2 mmole for treatments I-IV, respectively. Except for treatment III, diuresis and/or natriuresis were found to be time-dependent, generally decreasing with time until reaching a low plateau during later hours of infusion. The present findings also showed that no fluid replacement and 100% replacement with 5% dextrose solution both produced the same degree of severe acute tolerance in natriuresis, indicating the insignificance of water compensation in tolerance development; in treatment II, where neutral sodium balance was achieved, the development of acute tolerance in diuresis and natriuresis can mainly be attributed to negative water balance under this special condition; at steady state the hourly diuresis and natriuresis could differ up to about ten times between treatments. Some implications for the kinetic/dynamic relationship or modeling, in the clinical use, and in the bioequivalence evaluation of dosage forms are discussed. PMID- 3806373 TI - Pharmacokinetic transfer functions and generalized clearances. AB - A generalized steady-state clearance coefficient is defined to relate drug or metabolite mass transfer rates into one area of the body (area II) to the constant drug concentration in another area (area I). It is demonstrated that this clearance coefficient may be used in the transient case to calculate total mass transfer into area II when the drug AUC in area I is known. This generalizes the well-known "clearance formula" CL = Ae/AUC to cases in which several compartments separate areas I and II, as well as to cases where distributed models are preferred. Several applications are discussed, including a noninvasive means of determining the fraction absorbed of topically administered drugs. PMID- 3806375 TI - Analysis of pharmacokinetic data using parametric models. III. Hypothesis tests and confidence intervals. AB - This is the third in a series of tutorial articles discussing the analysis of pharmacokinetic data using parametric models. In this article the concern is how to test hypotheses about, and assign confidence intervals to, the values of the parameters of such models. The basic approach to both tasks involves determining the goodness of fit of the model to the data for alternative values of the parameters and using the change in goodness of fit to assess the plausibility of the alternative values. The goodness of fit is measured by the value of a (least squares-type) objective function. An approximation to the dependence of the latter on the parameter values yields an estimate of the familiar asymptotic covariance matrix of the estimates. The latter can also be used to test hypotheses about, and assign confidence intervals to, functions of parameters. PMID- 3806374 TI - Implementation and evaluation of control strategies for individualizing dosage regimens, with application to the aminoglycoside antibiotics. AB - Three strategies are implemented for controlling serum concentrations by determining individualized dosage regimens. The methods incorporate, respectively, nonlinear least squares parameter estimation, Bayesian maximum a posteriori probability estimation, and a stochastic control procedure that minimizes the expected value of an appropriate therapeutic cost. The performance of the three dose regimen calculation strategies was evaluated using Monte Carlo simulations of a typical therapeutic protocol for tobramycin. PMID- 3806376 TI - Necrotizing fasciitis. PMID- 3806377 TI - The triplane wedge. An adjunctive treatment modality in pediatric biomechanics. PMID- 3806378 TI - Ainhum (dactylolysis spontanea). Report of a bilateral case and literature review. PMID- 3806379 TI - A modified partial chemical matricectomy. PMID- 3806380 TI - Current techniques in diagnostic pathology. Fine needle aspiration biopsy. PMID- 3806381 TI - Treatment of cutaneous myiasis of lower extremity ulcerations with ethyl chloride. PMID- 3806382 TI - Venous ulcer in a sickle cell patient. Case report. PMID- 3806383 TI - Effect of inhibition of glutathione reductase by carmustine on central nervous system oxygen toxicity. AB - Exposure of animals to O2 at increased partial pressures above 2.5 atmospheres absolute results in seizures. The endogenous intracellular antioxidant defense mechanisms are thought to play a protective role in mitigating such seizures. Investigations were carried out to determine if inhibiting brain glutathione reductase with carmustine would result in an alteration in time to seizures of rats exposed to high pressure O2. Treatment of air-breathing rats with carmustine (12.5, 25 and 50 mg/kg i.v.) resulted in a dose-dependent decrease (P less than .001) in whole-brain glutathione reductase activity without affecting the activities of the other components of the antioxidant defense mechanisms determined. This treatment also resulted in a dose-dependent decrease (P less than .001) in time to seizure of rats exposed to four atmospheres absolute O2. Conversely, treatment of rats with lomustine (30 mg/kg i.v.), a nitrosourea compound related to carmustine, failed to affect the activity of brain glutathione reductase or any other component of the antioxidant defense mechanism determined, or did it influence the seizure time of rats exposed to four atmospheres absolute O2. These results suggest that glutathione reductase is an integral component of the antioxidant defense mechanisms. Inhibition of this enzyme results in an alteration in sensitivity of the organism to the toxic effects of O2. PMID- 3806384 TI - Pharmacologic characterization and functional role of muscarinic autoreceptors in the rabbit striatum. AB - The objectives of the present studies were 1) to pharmacologically characterize the muscarinic autoreceptors in the striatum and 2) to examine their role in the regulation of physiologic acetylcholine (ACh) release. Schild plots were generated for atropine and pirenzepine against oxotremorine-induced inhibition of [3H]ACh release. Atropine, a nonselective antagonist, yielded a pA2 of 8.92. The pA2 for pirenzepine, a purported M1-selective antagonist, was 7.14. Both Schild plots had slopes not significantly different from one. Four agonists [oxotremorine, carbachol (CARB), McN-A-343 and pilocarpine] were tested for their effectiveness in inhibiting [3H]ACh release. McN-A-343 and pilocarpine have been reported to be selective for M1 receptors. Oxotremorine and carbachol were effective and potent inhibitors of [3H] ACh release, whereas McN-A-343 and pilocarpine were weak. Although the existence of muscarinic receptor subtypes remains an open question, these data are consistent with the "low" pirenzepine affinity (M2) subtype. Chronic treatments (14 days) with several agents were carried out (in vivo) to assess the role of muscarinic autoreceptors in the regulation of physiologic ACh release. Scatchard analyses of binding studies with [3H]quinuclidinyl benzilate were also performed to assess changes in the muscarinic receptor population in the striatum. Chronic treatment with scopolamine caused a 100% increase in the Bmax for [3H]quinuclidinyl benzilate binding but had no effect on the sensitivity of [3H]ACh release to inhibition by CARB. Fourteen-day treatment with physostigmine (3 mg/kg) produced a decrease in the sensitivity of [3H]ACh release to CARB plus a 42% decrease in Bmax and a 48% decrease in Kd for [3H]quinuclidinyl benzilate binding. Chronic haloperidol treatment caused an increase in the sensitivity of [3H]ACh release to CARB accompanied by a 46% increase in Bmax for 3H quinuclidinyl benzilate binding. These data suggest that muscarinic autoreceptors in the striatum do not regulate physiologic ACh release in the presence of intact acetylcholinesterase and that the interaction of dopaminergic and cholinergic neurons in the striatum may not be simple trans-synaptic inhibition. PMID- 3806385 TI - Neuroeffector function in mesenteric arteries isolated from beagles of different ages. AB - In helical strips of mesenteric arteries from 30-day (28-35 day), 3-month (80-110 day), 2-year (10-40 month) and 12-year (135-161 month)-old beagles, contractile responses to vasoconstrictors were compared. The responses to transmural stimulation and norepinephrine, relative to those caused by 30 mM K+, were greater in the infant beagle arteries than in those from the older beagles. Equipotent concentrations of the amine for producing the same magnitude of contraction as that evoked by 5 or 20 Hz stimulation in beagles of different ages did not differ. Treatment with 10(-9) M prazosin or 10(-8) M yohimbine attenuated the response to norepinephrine in 30-day and 12-year-old beagles to a similar extent. Contractions induced by transmural stimulation in the infant beagle arteries were potentiated slightly by 10(-9) M yohimbine and, in contrast, attenuated at 10(-8) M. On the other hand, the stimulation-evoked contraction in the senile beagle arteries was potentiated by these concentrations of yohimbine in a dose-dependent manner. Angiotensin II potentiated responses to electrical stimulation in 30-day and 12-year-old beagles to a similar extent. Contractions by angiotensin II and serotonin did not alter with age. It may be concluded that alpha adrenoceptor function reduces during an early postnatal period, but does not decline further through senescence. It appears that prejunctional, but not postjunctional, alpha-2 receptor function develops after birth, whereas pre- and postjunctional angiotensin receptors already mature in beagles until the age of 30 days. PMID- 3806386 TI - Coupling of muscarinic receptors to adenylate cyclase in the rabbit myocardium: effects of receptor inactivation. AB - The relationship between muscarinic receptor occupancy and adenylate cyclase inhibition was investigated in homogenates of the rabbit myocardium. The highly efficacious muscarinic agonist oxotremorine-M caused half-maximal inhibition of adenylate cyclase activity at a concentration (Ki) that was 10-fold smaller than that required for half-maximal receptor occupancy in the presence of 0.1 mM GTP (D50-GTP) as measured by competitive displacement of the binding [3H]N methylscopolamine. In contrast, there was much closer agreement between the Ki and D50-GTP of the less efficacious oxotremorine analog BM5 [N-methyl-N-(1-methyl 4-pyrrolidino-2-butynyl)acetamide]. By comparing equal levels of adenylate cyclase inhibition before and after partial inactivation of muscarinic receptors with benzilycholine mustard, it was possible to estimate the dissociation constants (KA) of the oxotremorine analogs. There was good agreement between KA and D50-GTP and also between the degree of receptor inactivation determined pharmacologyically and that estimated by measurements of the binding of [3H]N methylscopolamine. PMID- 3806387 TI - An investigation of the relationship between the hepatotoxicity and the metabolism of N-alkylformamides. AB - The hepatotoxicity and metabolism of the following close analogs of the hepatotoxic antitumor agent N-methylformamide (NMF) were investigated in CBA/CA mice: N-ethylformamide (NEF), dimethylformamide (DMF), formamide and N methylacetamide (NMA). Apart from NMF only NEF was potently hepatotoxic as measured by the elevation of plasma activities of the enzymes sorbitol dehydrogenase and alanine and aspartate aminotransferases 24 hr after drug administration. In freeze-dried urine samples of mice which had received NEF or NMF, but not in the case of DMF, formamide or NMA, thioesters were detected by thin-layer chromatography. Evidence based on high-pressure liquid chromatography analysis and 400 MHz 1H-NMR and mass spectrometry suggests that the thioester metabolite of NEF is S-(N-ethylcarbamoyl)-N-acetylcysteine. It has been shown previously that NMF is metabolized to S-(N-methylcarbamoyl)-N-acetylcysteine. NEF also underwent extensive metabolism to ethylamine; similarly NMF was biotransformed to methylamine. In contrast, the urine of mice which had received DMF contained only very small amounts of dimethylamine and methylamine could not be detected as a metabolite of NMA. Instead, the major metabolite of NMA was identified by 400 MHz 1H-NMR spectrometry as N-(hydroxymethyl)acetamide. DMF is known to undergo extensive metabolism to its N-hydroxymethyl derivative. The results suggest that two metabolic pathways of N-alkylformamides can be distinguished: Hydroxylation at the alpha-carbon of the N-alkyl group and oxidation of the formyl moiety. The former pathway presumably constitutes a detoxification route, and the latter may well be associated with hepatotoxicity, and affords a glutathione conjugate, excreted in the urine as a mercapturate. PMID- 3806388 TI - Altered liver function in diabetes: model experiments with aminopyrine in the rat. AB - The aminopyrine breath test is a valuable quantitative liver function test. However, it may be influenced by factors not related primarily to liver disease. For instance, it has been published that diabetes affects microsomal demethylation of aminopyrine in vitro. The relevance of these findings for the in vivo situation, however, is ill defined. Aminopyrine disposition was evaluated, therefore, by performing an in vivo-in vitro comparison of its kinetics in control, diabetic and insulin-treated diabetic rats. Diabetes was induced by streptozotocin (75 mg/kg i.v.). A tracer dose of [14C]aminopyrine was injected i.p. (40 mu Ci/kg, 0.7 mg/kg) and the kinetics of 14CO2 in breath as well as disappearance of aminopyrine in blood were followed simultaneously for 2 hr. Diabetes increased the 14CO2 elimination rate constant in breath by 90%, whereas total recovery of 14CO2 in breath was decreased by 30% (P less than .001). Aminopyrine clearance in blood was doubled in diabetic rats compared to control (48.9 +/- 11.3 vs. 21.4 +/- 3.3 ml/min X kg, P less than .001). This was due to an increased volume of distribution (1.99 +/- 0.31 in diabetic rats vs. 0.96 +/- 0.11 liters/kg in control). In vitro aminopyrine kinetics in hepatic microsomal preparations showed a 52% higher Vmax of aminopyrine demethylase in D (P less than .001), whereas Km remained unchanged. The diabetes-induced changes were reversible by insulin. It is concluded that diabetes alters the aminopyrine breath test by interfering with demethylation rate and distribution of aminopyrine, and by changing the fate of the cleaved C1-fragments. PMID- 3806389 TI - Resultant pharmacological actions of verapamil: quantification of competitive 5 hydroxytryptamine antagonism in combination with calcium antagonism. AB - According to previous reports, the effect of verapamil on 5-hydroxytryptamine (5 HT) responses in the rabbit aorta is likely to represent a resultant of 5-HT2 receptor antagonism and Ca++-channel blockade. In practice, verapamil produced rightward displacement and depression of 5-HT-concentration-effect curves in this tissue. Under these conditions, verapamil's competitive property may not be justifiably quantified by analyzing curve displacements. In order to detect and quantify this property, a recently developed concentration-ratios method was applied. This method depends on the effect of the test substance, verapamil here, on the expression of competition by a standard antagonist, spiperone in this study. Analysis of the concentration-ratios produced by spiperone in the presence of verapamil permitted receptor competition by verapamil to be detected. Quantification of this property indicated a pKB of 5.73. This estimate of affinity did not account for the total rightward displacement of 5-HT concentration-effect curves that verapamil produced, indicating, presumably, that concomitant Ca++-antagonism contributed to these displacements. Also, this estimate of verapamil's 5-HT2-receptor affinity is lower than that derived elsewhere from an analysis of the overall antagonistic effect of verapamil on 5 HT responses in the rabbit aorta. These results illustrate the potentially general utility of the concentration-ratios methods in elucidating resultant pharmacological actions. PMID- 3806390 TI - Effects of pergolide on the cardiovascular responses to sinoaortic deafferentation in dogs with intact or surgically decentralized adrenal glands. AB - In pentobarbital-anesthetized dogs with decentralized adrenal glands, sinoaortic baroreceptor deafferentation produced an increase in mean aortic blood pressure which reached a maximum (42 +/- 5 mm Hg, n = 6) within 5 min and then waned entirely within the subsequent 25 min. In contrast, in sham-operated dogs, the maximal pressor response due to deafferentation was of greater magnitude (63 +/- 6 mm Hg, n = 8) and of much longer duration (44 +/- 4 mm Hg, 60 min after deafferentation). Heart rate was only augmented slightly in both preparations. A marked elevation of epinephrine plasma concentration occurred 5 min after deafferentation and the magnitude of this effect was 8 times greater in dogs with innervated than denervated adrenal glands. Norepinephrine plasma concentration increased moderately and similarly in the two preparations. Administration of pergolide (30.0 micrograms/kg i.v.) 15 min before undertaking the deafferentation procedure induced a small, short-lasting increase in blood pressure and a small fall in heart rate in dogs in which the innervation to the adrenal glands was left either intact (sham-operated) or removed surgically. In dogs with adrenal gland denervated, pergolide blocked entirely the pressor response and the small elevation in plasma concentration of catecholamines evoked by sinoaortic deafferentation in the matched, saline-pretreated group. However, in sham operated dogs (intact adrenal innervation), pergolide reduced partially (by 41%) the increase in blood pressure and plasma epinephrine concentration caused by deafferentation. The decrease in heart rate, produced by pergolide, was abolished by deafferentation in sham-operated and adrenal decentralized dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806391 TI - Presence of a gamma-aminobutyric acid (GABA) uptake system on cholinergic terminals of rat hippocampus: evidence for neuronal coexistence of acetylcholine and GABA? AB - The effect of gamma-aminobutyric acid (GABA) on the basal release of [3H]acetylcholine ([3H]ACh) was investigated using synaptosomes prepared from rat hippocampus and superfused after prelabeling with [3H]choline. Exogenous GABA added to the superfusion medium caused a long-lasting and concentration-dependent enhancement of the basal efflux of [3H]ACh. The effect of GABA was not antagonized by bicuculline or picrotoxin. Muscimol increased slightly but not significantly the release of [3H]ACh, whereas (+/-)-baclofen or (-)-baclofen were ineffective. The effect of GABA was counteracted by SK&F 89976A [N-(4,4-diphenyl 3-butenyl)-nipecotic acid], SK&F 100330A [N-(4,4-diphenyl-3-butenyl)-guvacine] and SK&F 100561 [N-(4,4-diphenyl-3-butenyl)-homo-beta-proline], three novel inhibitors of GABA uptake, but was unaffected by hemicholinium-3 or by beta alanine. Nipecotic acid, a substrate-inhibitor of the GABA transporter, mimicked GABA and enhanced [3H]ACh release. The results indicate that a GABA transport system is present on cholinergic terminals. PMID- 3806392 TI - Norepinephrine: a potential modulator of the hepatic transport of taurocholate. a study in the isolated perfused rat liver. AB - The effects of norepinephrine on portal blood flow hepatic extraction and intrinsic clearance of taurocholate were studied in the isolated perfused rat liver. Livers were perfused at a constant pressure. [14C]Taurocholate was infused continuously at a rate of 0.6 mumol/min. Then, three increasing doses of norepinephrine were added to the perfusate. Norepinephrine induced a significant dose-dependent reduction in portal blood flow. In spite of this reduction, taurocholate extraction did not increase and intrinsic clearance decreased significantly. When portal blood flow was decreased mechanically, intrinsic clearance was, as expected, flow-independent. The effects of norepinephrine on portal blood flow and intrinsic clearance were antagonised by phentolamine but not by propanolol. Norepinephrine decreases independently both portal blood flow and the vectorial transport of taurocholate. These effects are mediated by alpha adrenergic receptors. PMID- 3806393 TI - Tetraethylammonium transport in renal brush border membrane vesicles of the rabbit. AB - The mechanisms involved in the transport of tetraethylammonium (TEA) in the rabbit renal brush border were investigated by using membrane vesicles. Transport of [14C]TEA (0.2 mM) was measured by a rapid filtration method. We have reported previously that an imposed pH gradient (pHi = 6, pHo = 7.4) stimulates the uptake of TEA markedly, yielding a transient overshoot of 200% above the equilibrium value. Here we demonstrate that an overshoot of similar magnitude can also be obtained in the presence of indirectly induced proton gradients, via the naturally occurring Na+/H+ exchanger or via the artificial K+/H+ exchanger nigericin. The TEA exchange mechanism is shown to be electroneutral, temperature dependent and saturable [Km, 0.328 (CL for P less than .05: 0.250-0.425) mM; Vmax, 2.13 (CL for P less than .05: 1.98-2.32) nmole/mg of protein X 15 sec]. Other organic cations interact with this exchange mechanism: mepiperphenidol and morphine both cis-inhibited and trans-stimulated TEA uptake. Quinine, which was the most potent inhibitor of TEA uptake (57% inhibition at 10(-5) M), did not trans-stimulate. The mechanism appears to be specific for organic cations inasmuch as the organic anion p-aminohippurate did not cis-inhibit or trans stimulate TEA uptake. These results demonstrate the presence of a H+/TEA exchange mechanism in the rabbit renal brush border membrane showing many similarities with that shown to be present in the rat. PMID- 3806394 TI - Effects of centrally administered naloxone on gastrointestinal myoelectrical activity in morphine-dependent rats. AB - The gastrointestinal myoelectrical alterations associated with morphine tolerance and subsequent withdrawal with naloxone were studied before and after treatment with adrenergic blockers, atropine, indomethacin and methysergide administered either i.c.v. or s.c. The rats were prepared chronically with electrodes implanted on the stomach, duodeno-jejunum and colon and two small polyethylene catheters were inserted into the lateral ventricles of the brain. They were rendered physically dependent on morphine by the s.c. administration of a slow release emulsion containing morphine (75 mg over 48 hr). Morphine treatment was associated with an immediate (15-30 min) inhibition of gastric and colonic spiking activity and intestinal migrating myoelectric complex lasting 6 to 8 hr, followed by a partial recovery of gastric spiking activity while a permanent disorganized motility pattern persisted on the intestine. After 48 hr of morphine treatment the i.c.v. and s.c. administrations of naloxone at doses of 0.03 and 3 mg X kg-1, respectively, promoted typical electrical activity lasting 2 to 3 hr, characterized by the presence of five to seven grouped spike bursts and termed "minute rhythm." Previous central but not peripheral administration of either tolazoline or phentolamine at a dose of 0.3 mg X kg-1 inhibited the i.c.v. naloxone precipitated withdrawal. Neither atropine i.c.v. (30 micrograms X kg-1) nor methysergide i.c.v. (20 micrograms X kg-1) and s.c. (0.2 mg X kg-1) nor indomethacin s.c. (4 mg X kg-1) were found to have any effect on i.c.v. naloxone induced minute rhythm pattern.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806395 TI - Electrophysiological actions of cocaine on noradrenergic neurons in rat locus ceruleus. AB - Extracellular microelectrode experiments were conducted to study the effects of cocaine HCl on the activity of spontaneously firing single locus ceruleus (LC) noradrenergic neurons in vivo. The responses of single identified noradrenergic LC neurons to the systemic (i.v.) administration of cocaine were observed over a wide range of doses (0.0625-2.0 mg/kg). The spontaneous activity of all LC neurons receiving doses greater than the threshold dose (0.0625 mg/kg) was inhibited in a dose-dependent manner. The local anesthetics, procaine and mepivacaine, did not affect LC neuronal activity, action potential amplitude or slope. The inhibitory effects of cocaine on spontaneous LC neuron activity was reversed by the subsequent i.v. administration of the specific alpha-2 adrenoceptor antagonist, piperoxone, but not the opiate receptor antagonist, naloxone. Pretreatment with another alpha-2 adrenoceptor antagonist, yohimbine (5 mg/kg i.p.), attenuated significantly the inhibition of spontaneous LC activity elicited by i.v. cocaine. Intravenous cocaine produced a brief increase in mean arterial pressure which did not appear to be correlated with the more sustained inhibition of LC neurons. Reserpine pretreatment (10 mg/kg i.p.) attenuated significantly the inhibitory effects of cocaine on LC activity. These results suggest that the inhibition of spontaneous LC neuron activity by i.v. cocaine is most likely mediated by an augmented action of catecholamines at central alpha-2 adrenoceptors and not by the local anesthetic effects of cocaine. PMID- 3806396 TI - Activation of cholinergic mechanisms in the medulla oblongata reverse intravenous opioid-induced respiratory depression. AB - The role of cholinergic mechanisms in opioid-induced respiratory depression was investigated in isoflurane-anesthetized rats. In these animals, the i.v. administration of fentanyl, a clinically useful potent opioid analgesic/anesthetic, induced a prolonged period of apnea and subsequent rise in the end-tidal CO2, hypotension and bradycardia. The centrally acting anticholinesterase, physostigmine, significantly decreased fentanyl-induced respiratory and circulatory depression. The beneficial respiratory and circulatory effects of physostigmine could be abolished by the administration of muscarinic antagonists, e.g., scopolamine hydrobromide or atropine sulfate. Inhibition of inspiratory phrenic nerve activity by fentanyl and restoration of this activity by the subsequent i.v. administration of physostigmine indicates that the origin of this opioid-cholinergic interaction is the central nervous system. Similar effects on phrenic nerve discharge were observed when the systemic administration of fentanyl was followed by microinjection of physostigmine or carbachol in the rostral ventrolateral medulla. In conclusion, opioid-induced respiratory depression after systemic administration is obtunded greatly by facilitation of muscarinic mechanisms in the ventrolateral medulla. Inhibition of a cholinergic link in the central chemosensor may underlie opioid induced respiratory depression. Manipulation of this cholinergic link could lead to the use and development of analgesics devoid of respiratory depression. PMID- 3806397 TI - Characterization of high affinity [3H]pirenzepine and (-)-[3H] quinuclidinyl benzilate binding to muscarinic cholinergic receptors in rabbit peripheral lung. AB - We have characterized the binding of the selective muscarinic antagonist [3H]pirenzepine ([3H])PZ) and the classical muscarinic antagonist (-) [3H]quinuclidinyl benzilate ((-)-[3H]QNB) to muscarinic cholinergic sites in rabbit peripheral lung membranes. For both radioligands, high affinity binding with pharmacologic specificity was demonstrated. The high affinity Kd for [3H]PZ binding determined from saturation isotherms was 4.5 nM and the Kd for (-) [3H]QNB binding was 6.2 pM. Comparison of the total binding capacity values determined by saturation experiments with [3H] PZ and (-)-[3H]QNB demonstrates that approximately 78% of the total muscarinic binding sites in rabbit peripheral lung bind [3H]PZ with high affinity. There was no significant effect of the guanine nucleotide, guanyl-5'-yl imidodiphosphate, on the inhibition of (-) [3H]QNB binding by the muscarinic agonist carbachol in peripheral lung membranes. If the pulmonary muscarinic receptor with high affinity for PZ proves to have an important role in bronchoconstriction, its characterization could result in the development of more selective bronchodilators. PMID- 3806398 TI - Stimulus control and the development of behavioral tolerance to daily injections of d-amphetamine in the rat. AB - We examined whether daily d-amphetamine administration affected behavior under the control of external stimuli differently than behavior not under such control. Two variants of a fixed-consecutive-number reinforcement schedule were combined in a multiple schedule. An external discriminative stimulus indicated when the schedule requirement for reinforcement had been satisfied in one component, no such stimulus was used in the other component. Reinforcement frequency was roughly equated between the components by reducing the probability of reinforcement in the added stimulus component. Two groups of animals were given daily i.p. injections with equivalent doses of drug. Tolerance to the drug's behavioral effects developed when injections occurred before behavioral evaluation but did so only to a limited extent when injections were given only after the sessions. This indicated that behaving in the presence of the drug facilitated the development of such tolerance. It developed under both stimulus control conditions at both doses; at 3.0 mg/kg, it developed predominantly in those aspects of behavior that were under the control of external discriminative stimuli. Although drug-related decreases in reinforcement frequency in some animals were correlated with behavioral tolerance development, differential tolerance development was not associated consistently with such reductions. Establishing discriminative control of behavior by external stimuli can both reduce sensitivity to repeated d-amphetamine administration and facilitate the development of tolerance to its behavioral effects. PMID- 3806399 TI - Effects of mixed agonist-antagonist opioids on the acquisition of conditional discriminations in monkeys. AB - Responding in patas monkeys was maintained under a multiple schedule of food presentation. One component of the multiple schedule was a repeated-acquisition task in which the discriminative stimuli for left- and right-key responses changed each session (learning). In the other component, the discriminative stimuli were the same each session (performance). The mixed agonist-antagonists dezocine, GPA 1657 and nalbuphine each produced dose-related decreases in the overall rate of responding in each component of the multiple schedule. In general each drug produced greater rate-decreasing effects in the learning than in the performance component, although this differential effect between components was less apparent with dezocine. In the learning component low doses of nalbuphine and GPA 1657 produced small increases in percentage of errors but had little or no effect on response rate. A similar effect was obtained with dezocine in only one of four subjects tested. At doses which produced comparable rate-decreasing effects dezocine also exerted the least disruptive effect on the within-session pattern of acquisition. High doses of each drug disrupted accuracy in each component of the multiple schedule. In contrast to the other drugs tested, buprenorphine had virtually no effect on response rate or percentage of errors in either component of the multiple schedule across a wide range of doses (0.01-3.2 mg/kg). The results suggest that, among the mixed agonist-antagonist, buprenorphine is unique in that it does not disrupt the acquisition or performance of complex discrimination in patas monkeys. PMID- 3806400 TI - Discriminative stimulus properties of buspirone in the pigeon. AB - The novel anxiolytic buspirone was administered to pigeons in a two-key drug discrimination task in an effort to characterize the stimulus properties of the drug and thereby aid in isolating the pharmacologic basis for its anticonflict effect. Key pecking was maintained by a schedule of reinforcement in which every 30th injection-appropriate response was reinforced by the presentation of food. Subjects were first trained to discriminate buspirone (1.0 mg/kg) from saline, and then generalization tests were conducted using a cumulative dosing procedure. Cumulative doses of buspirone (1.0-3.0 mg/kg), the buspirone analog MJ 13805 (1.0 mg/kg) and the 5-hydroxytryptamine-1A ligand 8-hydroxy-2-(di-n propylamino)tetralin (8-OH-DPAT) (0.3-1.0 mg/kg) produced in excess of 90% buspirone-appropriate responding, whereas midazolam (0.03-1.0 mg/kg), haloperidol (0.03-1.7 mg/kg), apomorphine (0.03-1.0 mg/kg), clozapine (0.1-3.0 mg/kg), methysergide (0.1-3.0 mg/kg) and the 5-hydroxytryptamine-1B ligand 1-[3 chlorophenyl]piperazine (0.3-10.0 mg/kg) produced little or no buspirone appropriate responding up to those doses that markedly decreased response rate. These findings support recent behavioral and receptor binding studies suggesting that serotonin receptors, and 5-hydroxytryptamine-1A receptors in particular, may be responsible for mediating the anticonflict effects of buspirone and other atypical anxiolytics. The results also corroborate other behavioral work showing that the anxiolytic effects of buspirone are most likely not mediated by the dopaminergic system. PMID- 3806401 TI - Muscarinic actions of an N-methyl-N-2-bromoethylamino analog of oxotremorine (BR 401) in the mouse. AB - The pharmacological effects of N-[4-(2-bromoethylmethylamino)-2-butynyl]-2 pyrrolidone (BR 401) were compared in the mouse with those of N-[4-(2 chloroethylmethylamino)-2-butynl]-2-pyrrolidone (BM 123) and oxotremorine. BR 401 was more toxic than oxotremorine and BM 123 when administered i.v. (LD50, 0.7 mumol kg-1), but less toxic than oxotremorine when given i.p. (LD50, 39 mumol kg 1). Atropine and methylatropine (10 mumol kg-1 i.p.) increased the LD50 value of BR 401, given i.v., 75- to 100-fold. Upon i.v. administration, BR 401 was 2- to 3 fold more potent than oxotremorine and 10 to 20 times more potent than BM 123 in producing central (tremor and analgesia) and peripheral (salivation) muscarinic effects. However, after i.p. administration BR 401 was 3-fold less potent than oxotremorine in eliciting tremor and analgesia. The aziridinium ion (BR 401A), formed by cyclization of BR 401, produced salivation but no tremor. These observations suggest that BR 401 when given i.v. penetrates effectively into the central nervous system where it cyclizes rapidly to the pharmacologically active aziridinium ion. In contrast, after i.p. administration a large proportion of BR 401 will cyclize before it can reach the central nervous system. BM 123, because of its slower cyclization, enters the central nervous system effectively also by the i.p. route. Thus, central potency of 2-haloethylamines such as BR 401 and BM 123 is critically dependent not only on the rate of cyclization, but also on the route of administration. The duration of tremor induced by BR 401 and BM 123 was considerably shorter than that induced by oxotremorine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806402 TI - Glutathione biosynthesis from sulfur-containing amino acids in enriched populations of Clara and type II cells and macrophages freshly isolated from rabbit lung. AB - The glutathione content of freshly isolated rabbit alveolar type II cells, Clara cells and macrophages was depleted by incubating with diethyl maleate and the ability of these cell types to resynthesize glutathione from the sulfur containing amino acids, cysteine, cystine and methionine was determined. Cysteine and methionine were taken up at a similar rate into each of the cell types, with cystine uptake occurring at a 10- to 14-fold lower rate. The cells were best able to utilize cysteine for glutathione resynthesis and the rates of both uptake and synthesis were fastest in macrophages and slowest in type II cells. There was no evidence for participation of a cystathionine pathway for glutathione synthesis in any of the cell types. PMID- 3806403 TI - Effect of dextromethorphan and levomethorphan on gastric emptying and intestinal transit in the rat. AB - Dextromethorphan and levomethorphan were evaluated using 51Cr as a marker for their effects on gastric emptying and intestinal transit in the rat. Levomethorphan at 10 mg/kg i.p. and 10 and 50 mg/kg p.o. significantly (P less than or equal to .05) inhibited gastric emptying; dextromethorphan did not inhibit gastric emptying at p.o. doses up to 100 mg/kg or i.p. doses up to 10 mg/kg. Naloxone (1 mg/kg i.p.) significantly antagonized the effect of p.o. levomethorphan (50 mg/kg). Levomethorphan (10 and 50 mg/kg p.o. and 1 and 10 mg/kg i.p.) significantly inhibited intestinal transit. Dextromethorphan significantly inhibited intestinal transit after p.o. (10, 50, 100, 200 mg/kg) and i.p. (50 mg/kg) administration. As in the case of gastric emptying, naloxone inhibited the effect of levomethorphan but did not alter the effect of dextromethorphan. Naloxone itself (1 mg/kg i.p.) did not affect gastric emptying or intestinal transit. The results suggest that levomethorphan exerts inhibitory effects on intestinal transit and gastric emptying that are probably mediated partly through an opiate mechanism whereas the effects of dextromethorphan may be mediated through a nonopiate mechanism of action. PMID- 3806404 TI - Effects of atropine upon various components mediating postprandial gastric acid secretion in dogs. AB - Dose-response curves in chronic gastric fistula dogs were first obtained to chemical stimulants of the three accepted physiological excitatory components regulating postprandial gastric acid secretion. These were: 2-deoxy-D-glucose, a central vagal stimulant; gastrin, a hormone; and histamine, a paracrine factor. Using equiactive doses of each, a dose of atropine just maximal for suppressing all of the anatomical phases of food-induced acid secretion in vagally innervated pouch dogs was found to inhibit substantially the responses to all three of the above stimulants. The above results argue in favor of an interdependent model among the above factors for regulating postprandial gastric acid secretion in the dog. PMID- 3806405 TI - Estimation of apparent agonist affinity constants using desensitization of the ileal muscarinic receptor. AB - The effects of short-term desensitization of muscarinic receptors and decreasing the extracellular calcium concentration have been studied using the isolated guinea pig ileum. Desensitization required stimulation of the receptor and was more marked against agonists of low intrinsic efficacy. The process was non specific in that the responses to histamine were also affected. Application of null methods of analysis to pre- and postdesensitization concentration-response curves enabled an affinity constant to be derived. The values were consistently higher than those estimated using the irreversible antagonist, phenoxybenzamine. In contrast application of null methods to concentration-response curves in normal and low calcium concentrations enabled an affinity constant for pilocarpine to be calculated, which was very similar to that obtained using the irreversible antagonist. It is concluded that desensitization cannot be used to determine agonist affinity constants inasmuch as it results in overestimations. PMID- 3806406 TI - Pulmonary extraction of [3H]bupivacaine: modification by dose, propranolol and interaction with [14C]5-hydroxytryptamine. AB - The authors studied the single-pass pulmonary extraction of the potent local anesthetic, bupivacaine, in 21 anesthetized rabbits. Pulmonary extraction of [3H]bupivacaine and [14C]5-hydroxytryptamine (5-HT) was quantified from multiple indicator-dilution outflow curves using indocyanine green as the intravascular reference substance. Pulmonary extraction at control (n = 15; mean +/- S.D.) was 81 +/- 6 and 78 +/- 9% for [3H]bupivacaine and [14C]5-HT, respectively. The apparent volume of distribution of bupivacaine was 38 +/- 9 ml/kg compared with 12 +/- 4 ml/kg for indocyanine green. Simultaneous administration of up to 300 micrograms/kg of bupivacaine did not affect the disposition of either radiolabeled amine; however, injection of 1000 micrograms/kg of bupivacaine significantly (P less than .01) depressed pulmonary extraction of both [3H]bupivacaine and [14C]5-HT. In the presence of 1000 micrograms/kg bupivacaine, the apparent volume of distribution of [3H]bupivacaine decreased to 24 +/- 9 ml/kg (P less than .01). Fifteen minutes after administration of propranolol (100 250 micrograms/kg i.v.), [14C]5-HT removal was unchanged, but the pulmonary extraction of [3H]bupivacaine was significantly decreased to 70 +/- 12% (n = 6; P less than .01). These data suggest that bupivacaine is extensively removed as it enters the lung and that the removal process is a combination of passive diffusion and a small component of saturable specific binding. The interaction of bupivacaine with 5-HT may be part of this specific binding (i.e., endothelial cell uptake) or may have been secondary to direct effects of large concentrations of bupivacaine on membrane function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806407 TI - Antagonism of the cardiovascular effects of adenosine by caffeine or 8-(p sulfophenyl)theophylline. AB - We compared the abilities of the adenosine antagonists caffeine and 8-(p sulfophenyl)theophylline (8-SPT) to block adenosine receptor-mediated hypotension and bradycardia in anesthetized rats. Few quantitative data exist concerning the amounts of caffeine needed to prevent the cardiovascular effects of physiologic plasma adenosine concentrations or concerning the site of action (central or peripheral) of such blockade. Thus, dose-response curves were constructed for the antagonism by caffeine or 8-SPT of the hypotension and bradycardia caused by infusing adenosine i.v. or by giving bolus i.v. injections of the adenosine analogs 2-chloroadenosine, R-phenylisopropyladenosine or N ethylcarboxamidoadenosine. We also quantitated the suppression by caffeine or 8 SPT of the ability of adenosine to potentiate nicotine-induced hypertension and tachycardia. Caffeine (EC50 = 92 microM) and 8-SPT (EC50 = 48 microM) blocked the hypotension produced by elevating plasma adenosine levels from 1.22 to 1.74 microM. Similar drug doses were needed to inhibit the potentiation by adenosine of pressor and chronotropic responses to nicotine or to antagonize the hypotensive and negative chronotropic effects of 2-chloroadenosine, R phenylisopropyladenosine and N-ethylcarboxamidoadenosine. As expected, neither caffeine nor 8-SPT demonstrated selectivity for A1 (predominating at the heart) vs. A2 (predominating at blood vessels) receptor subtypes. Administration of as much as 50 mg/kg i.p. of 8-SPT failed to produce detectable brain levels of the drug, demonstrating its failure to gain access to the central nervous system and indicating that the site at which the drug antagonizes the cardiovascular effects of adenosine is peripheral.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806408 TI - Characterization of the class I antiarrhythmic activity of cibenzoline succinate in guinea pig papillary muscle. AB - The effects of cibenzoline on transmembrane action potentials were examined in guinea pig papillary muscle. Cibenzoline (1-128 microM) did not alter the action potential durations at 50 and 90% of repolarization, the effective refractory period or the ratio of effective refractory period to action potential duration at 90% of repolarization. Likewise, the maximum diastolic potential was virtually unaffected. Cibenzoline depressed the maximum rate of rise of phase 0 (dV/dtmax). This effect was dependent on the rate of stimulation and occurred at a relatively low concentration (2 microM). The onset of use-dependent depression was monoexponential and dependent on the drug concentration, as well as the rate of stimulation. The rate of recovery from use-dependent depression also followed a single exponential time course but was independent of drug concentration and stimulation rate. When cibenzoline and lidocaine were combined in the tissue bath, dV/dtmax recovered with a double exponential time course. The first and second components of this recovery corresponded to the time course observed with lidocaine (first) and cibenzoline (second) alone. Also, the magnitude of the second component was less with the combination than with cibenzoline alone, indicating an interaction between the two drugs. In addition, cibenzoline shifted the curve relating normalized dV/dtmax to membrane potential in the hyperpolarizing direction. Finally, cibenzoline did not alter slow-response action potentials induced by elevated [K]o and isoproterenol. The authors conclude that cibenzoline acts as a class la antiarrhythmic agent in guinea pig papillary muscle. PMID- 3806409 TI - Pharmacologic modulation of ATP release from isolated rat hearts in response to vasoconstrictor stimuli using a continuous flow technique. AB - A new method is described for continuously recording ATP release in isolated perfused hearts by a bioluminescence technique that makes possible the study of the dynamics of ATP release in terms of coronary vascular regulation. Infusion of exogenous ATP in isolated perfused rat hearts resulted in a clearance of 97.8 +/- 0.5% in one pass through the heart. Short-term infusion of either leukotriene (LT) D4 (0.02-0.5 nmol) or norepinephrine (NE; 0.06-0.6 mumol) released significant quantities of ATP from isolated rat hearts in a dose-dependent manner. In contrast, equipotent vasoconstrictor doses of arginine vasopressin (AVP; 20 and 60 microU) failed to release ATP. The amount of ATP released by LTD4 and NE declined by 50 to 60% with each consecutive challenge. LTD4-induced vasoconstriction and ATP release were totally abolished by the LT receptor antagonist FPL-55,712, whereas the NE-induced coronary vasoconstriction and ATP release were totally blocked by the alpha adrenergic blocking agent phentolamine. The coronary vasoconstriction induced by NE was followed by a slight coronary vasodilation, which was inhibited by the beta adrenergic blocking agent timolol without influencing ATP release. The LTD4- and NE-induced release of ATP appears to be receptor mediated and may play a role in the regulation of coronary vascular tone. PMID- 3806411 TI - Human cigarette smoking: effects of puff and inhalation parameters on smoke exposure. AB - This study determined effects of three smoking behavior components: puff volume, inhalation volume and lung exposure duration on biological measures of smoke exposure. A microcomputer-based auditory feedback system allowed subjects (N = 9 or 10 per experiment) to control puff and inhalation parameters as they smoked usual brand cigarettes. In each of four experiments, one smoking parameter was manipulated across sessions while two other parameters were held constant. Biological samples were obtained before and after each 8-puff smoking session conducted under a given set of behavioral parameters for analysis of plasma nicotine and expired air carbon monoxide (CO) levels. In Experiment I, both nicotine and CO levels were influenced systematically as puff volume was varied from 15 to 60 ml (inhalation volume = 50% of vital capacity, lung exposure time = about 9 sec). Nicotine boost (post- minus presession levels) increased 4-fold and CO boost increased 9-fold over this range of puff volume values. In Experiment II, nicotine levels were unaffected when average lung exposure times varied from 5 to 21 sec (puff volume = 50 ml, inhalation volume = 50% of vital capacity), suggesting that all the nicotine available may be absorbed during a normal smoking inhalation cycle with no breathholding. CO levels increased systematically with longer breathholds. In Experiments III and IV, inhalation volumes from 10% and 20% to 60% of vital capacity had no effect on either nicotine or CO levels, and this was true whether lung exposure time was about 8 sec (Experiment III) or about 4 sec (Experiment IV). This series of studies has shown that puff volume is an important determinant of tobacco smoke exposure, but that inhalation components of smoking behavior, at least within the range of parameters tested, have no effect on nicotine exposure levels. PMID- 3806410 TI - Increase in serum digoxin concentration produced by quinidine does not increase the potential for digoxin-induced ventricular arrhythmias in dogs. AB - Chronic treatment of dogs with digoxin alone, quinidine alone and digoxin in combination with quinidine was initiated in dogs to assess changes in arrhythmogenic potential associated with the quinidine-induced increase in serum digoxin concentration observed during combined digoxin and quinidine treatment. The arrhythmogenic potential of digoxin was evaluated through the use of the acetylstrophanthidin (AcS) tolerance test. AcS was infused at a rate of 5 micrograms/kg/min until ventricular arrhythmias occurred during a drug-free period and during chronic treatment with digoxin, quinidine and digoxin plus quinidine. The dose of AcS required to initiate ventricular arrhythmias is inversely related to the arrhythmogenic potential of digoxin present at the time of AcS infusion. Administration of quinidine alone in two different dosage regimens produced serum quinidine concentrations of 5.99 +/- 1.18 and 2.99 +/- 0.43 micrograms/ml and significantly increased AcS tolerance, whereas digoxin alone, over a wide range of serum digoxin concentrations, significantly decreased AcS tolerance. This decrease in AcS tolerance was linearly related to the serum digoxin concentration. The addition of quinidine treatment to animals receiving digoxin resulted in a significant elevation in the steady-state serum digoxin concentration. However, the AcS tolerance determined during the elevated serum digoxin concentration induced by quinidine was greater than that determined during treatment with the same dose of digoxin alone. Thus, quinidine administration to animals receiving digoxin resulted in a significant increase in the steady-state serum digoxin concentration but did not increase the arrhythmogenic potential of digoxin over that observed during treatment with the same dose of digoxin alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806412 TI - A novel mechanism for the enhancement of acetaminophen hepatotoxicity by phenobarbital. AB - Pretreatment of mice with multiple doses of phenobarbital (PB) potentiates N acetyl-para-aminophenol (APAP) hepatotoxicity through induction of cytochrome P 450, thus increasing the formation of APAP-reactive metabolites. The objective of this report is to investigate the effect of a single oral dose of PB on APAP hepatotoxicity in mice. PB was administered (150 mg/kg) 1 hr before oral administration of APAP (400 mg/kg). Blood, liver and urine were collected from mice at 2, 4, 8, 12 and 24 hr after APAP treatment. Mortality rate and incidence of gross hepatic lesions were significantly higher in mice pretreated with PB than in mice treated with APAP alone. At 8, 12 and 24 hr post-APAP treatment, serum glutamic oxalacetic transaminase activity was significantly higher in mice receiving the combination treatment. Hepatic glutathione levels were significantly lower at 1 and 2 hr in mice pretreated with PB. Urinary excretion of APAP mercapturate, APAP sulfate and free APAP increased, whereas APAP glucuronide decreased, in mice pretreated with PB compared with mice treated with APAP alone. Covalent binding of [3H]APAP to hepatic microsomes was markedly increased after PB pretreatment. PB pretreatment was found to deplete uridine diphosphate glucuronic acid in livers of mice at 1 and 2 hr post-APAP treatment. These results indicate that the biochemical mechanism by which a single dose of PB enhances APAP hepatotoxicity does not involve cytochrome P-450 induction; interference with APAP glucuronidation may occur. PMID- 3806413 TI - Kinetics of drug action in disease states. XVIII. Effect of experimental renal failure on the pharmacodynamics of theophylline-induced seizures in rats. AB - Theophylline, the bronchodilating agent, can cause life-threatening, generalized seizures when plasma concentrations exceed the usual therapeutic concentration range. However, the plasma concentrations of theophylline associated with this neurotoxic effect vary widely between patients. To determine the reasons for the wide variation, and thereby to facilitate prevention or early treatment of theophylline-induced neurotoxicity, an animal model of theophylline-induced seizures was developed and has now been used to determine the effect of experimental renal failure on the concentrations of theophylline that cause convulsions. Adult female rats were subjected to bilateral ureteral ligation or injected with uranyl nitrate to produce renal failure or dysfunction. Sham operated and saline-injected rats, respectively, served as controls. Theophylline was infused i.v. at either 1.03 or 2.06 mg/min until the onset of maximal seizures. Renal failure due to ureter ligation was associated with a substantial reduction of the dose of drug required to produce seizures, the concentrations of total and free (unbound) theophylline in serum and the concentrations of theophylline in the brain and cerebrospinal fluid at onset of seizures. The concentrations of theophylline metabolites were very low and did not account for the enhanced neurotoxicity. No apparent change in the neurotoxicity of theophylline was observed in rats with uranyl nitrate-induced renal dysfunction. The results of the investigation on ureter-ligated rats are consistent with recent clinical findings of a higher incidence of theophylline-induced neurotoxicity in azotemic patients. The experimental methodology may therefore be suitable for the prospective identification of other potential clinical risk factors for theophylline neurotoxicity. PMID- 3806414 TI - Mouse antithrombotic assay: the effects of Ca++ channel blockers are platelet independent. AB - In the Mouse Antithrombotic Assay aspirin (30-300 mg/kg) protected mice from death by 15 and 42%, respectively. Four Ca++ channel blockers (nitrendipine, nicardipine, nifedipine and verapamil) were effective in reducing the mortality. At the dose of 100 mg/kg nitrendipine and nicardipine gave 80 and 85% protection respectively. Whereas aspirin almost suppressed completely thromboxane (Tx)B2 and platelet factor-4 release after collagen-epinephrine infusion, neither nitrendipine nor nicardipine modified TxB2 release and only reduced slightly platelet factor-4 release. The treatment with aspirin, nitrendipine or nicardipine did not counteract the fall in circulating platelets counted 1 min after the aggregation challenge, but at 3 min platelet count was significantly higher in aspirin-treated mice than in animals given either Ca++ channel blocker. Mouse platelet aggregation induced in vitro by the combination of collagen and epinephrine was inhibited in samples obtained from mice pretreated with aspirin but was unaffected by the treatment with nitrendipine or nicardipine. The i.v. injection of a 12.5% suspension of hardened red blood cells resulted in death of about 80% of mice within 1 to 2 min. Neither circulating platelet count nor plasma TxB2 level were modified significantly by red cell injection. Aspirin was ineffective whereas both Ca++ channel blockers lowered mortality to 50%. These data suggest that Ca++ channel blockers reduce the mortality in the Mouse Antithrombotic Assay by influencing factors other than platelet aggregation and/or Tx production. These factors might be important in mediating mortality occurring after infusion of hardened red cells. PMID- 3806415 TI - SKF 525A displaces drugs from serum alpha 1-acid glycoprotein binding sites. AB - In vivo treatment of rats with beta-diethylaminoethyl-diphenylpropylacetate hydrochloride (SKF 525A), an inhibitor of hepatic monooxygenases, decreases the serum binding of oxprenolol and propranolol, which bind mainly to alpha 1-acid glycoprotein, but not that of phenytoin, which is bound to albumin. The effect was maximal 40 min after treatment and had disappeared after 6 hr, when enzyme inhibition was still present. A displacing effect was also observed when SKF 525A was added in vitro to serum of rats, dogs and humans and to human alpha 1-acid glycoprotein, whereas binding to human serum albumin was not affected. SKF 525A was found to be equipotent with tris(2-butoxyethyl)phosphate, a known displacer of binding of drugs from alpha 1-acid glycoprotein. When studying the pharmacokinetics or the effects of drugs after SKF 525A pretreatment, the possibility that altered protein binding may influence the findings should be considered. PMID- 3806416 TI - Enantioselective disposition of 2-arylpropionic acid nonsteroidal anti inflammatory drugs. III. Fenoprofen disposition. AB - The disposition of fenoprofen enantiomers has been studied in nine healthy rabbits. A mean (S.E.M.) of 0.73 (0.07) of R-fenoprofen was inverted to S fenoprofen and the distribution volumes for bound plus unbound R-fenoprofen and S fenoprofen were 50.3 (4.5) and 98.5 (5.9) ml/kg, respectively. A model was developed which predicted the area under the S-fenoprofen plasma concentration time curve after bolus administration of racemic fenoprofen. The mean (S.E.M.) predicted area, 2.1 (0.2) mg X min/ml/kg, was within 94% of the observed area 2.2 (0.2) mg X min/ml/kg. The effect of phenobarbital on the disposition of fenoprofen enantiomers was examined in an additional eight rabbits. During the control study the glucuronidation of R-fenoprofen exceeded the corresponding clearance term for the S-enantiomer by 2.1-fold. The clearances of individual enantiomers to their respective glucuronides increased after phenobarbital pretreatment by a mean 1.6-fold for R- and 2.3-fold for S-fenoprofen. The clearance of S-fenoprofen by processes other than glucuronidation and elimination of unchanged drug in urine was increased by a mean of 2.1-fold after phenobarbital pretreatment but the fractional inversion and the inversion clearance of R- to S-fenoprofen were not affected. These data indicate that on racemic fenoprofen administration the area under the curve for the pharmacologically active S-enantiomer would be reduced by phenobarbital pretreatment. PMID- 3806417 TI - Enantioselective disposition of 2-arylpropionic acid nonsteroidal anti inflammatory drugs. IV. Ketoprofen disposition. AB - The disposition of ketoprofen enantiomers has been studied in 12 rabbits with normal renal function (control) and in 6 of these rabbits with renal dysfunction. In control animals a mean (S.E.M.) of 0.09 (0.01) of R-ketoprofen was inverted to its S-enantiomer. The mean distribution volumes for R- and S-ketoprofen were 114 (7.4) and 294 (76) ml/kg, respectively. The mean clearance of the R-enantiomer from plasma was 292 (40) ml/kg/hr compared to 36 (3.2) ml/kg/hr for the S enantiomer. This high degree of enantioselectivity was not due to inversion, renal clearance or clearance by glucuronidation, but was the result of an unknown clearance process(es). Comparing the mean parameters of ketoprofen disposition in renal dysfunction with those in the same animals during the control study, the mean fraction of the R-dose inverted increased by 290%, but this effect was not due to decreased clearance of R-ketoprofen renally or by glucuronidation. The distribution volumes of R- and S-ketoprofen were increased by 200 and 183% by renal dysfunction, consistent with an implied decrease in plasma protein binding. The clearances of bound plus unbound R- and S-ketoprofen from plasma remained unaltered by renal dysfunction. PMID- 3806418 TI - Hepatic disposition of cationic drugs bound to asialoorosomucoid: lack of coendocytosis and evidence for intrahepatic dissociation. AB - A combination of protein binding, liver clearance, subcellular distribution and cell separation experiments was employed to investigate the influence of binding of cationic drugs to asialoorosomucoid (ASOR) on their hepatic uptake and intrahepatic distribution. Two quaternary ammonium drugs, d-tubocurarine and N methyldeptropine, were selected because of their marked differences in hepatic processing and binding to ASOR. In spite of an increase in protein binding of 560% for d-tubocurarine and 380% for N-methyldeptropine, perfusate clearance of both drugs in isolated perfused rat livers was not influenced by addition of 75 mg of ASOR. Absence of coendocytosis was indicated by subcellular distribution studies revealing no extra enrichment of quaternary ammonium drugs in lysosomal fractions compared with control studies. Isolation of parenchymal and sinusoidal liver cells demonstrated d-tubocurarine to be present solely in hepatocytes; binding to ASOR did not affect the relative distribution in the various cell types. It is concluded that binding of cationic drugs to ASOR does not result in endocytosis of a drug-protein-receptor complex by the liver. This result rather suggests that dissociation of the organic cations from the asialoglycoprotein occurs within the liver before endocytosis of the glycoprotein. PMID- 3806419 TI - Effects of the serotonin antagonists, cyproheptadine, ketanserin and mianserin, on cyclic flow reductions in stenosed canine coronary arteries. AB - We compared the abilities of three pharmacologically and structurally dissimilar 5-hydroxytryptamine (5-HT2) antagonists, cyproheptadine, ketanserin, and mianserin, to interrupt cyclic flow reductions (CFRs) in stenosed coronary arteries of open-chest dogs. All three drugs decreased the frequency and severity of CFRs, but differed in the doses required for total abolition. Cyproheptadine and ketanserin both reduced by approximately 50% the frequency of CFRs at 10 micrograms/kg i.v. Mianserin appeared to be less potent; an approximately 50% reduction of the frequency of CFRs required 100 micrograms/kg. These in vivo results correlated well with their abilities to inhibit epinephrine plus 5-HT induced aggregation of canine platelet-rich plasma in vitro. The IC50 values for inhibition of aggregation stimulated by this combination of agonists were 2.21, 2.84 and 7.38 microM, respectively. Ketanserin also inhibited amplification by 5 HT of ADP-induced aggregation of canine platelets much more potently than mianserin (IC50 = 0.07 vs. 3.18 microM). Mianserin and RX 781094, a selective alpha-2 adrenoceptor antagonist, inhibited epinephrine-stimulated aggregation of human platelets more potently than ketanserin (IC50 values = 6.10, 0.19 and greater than 10 microM, respectively). Thus, the abilities of three 5-HT2 antagonists with diverse chemical structures and pharmacologic profiles (5-HT2 antagonism notwithstanding) to abolish CFRs suggests that amplification by 5-HT of other mediators, e.g. epinephrine and/or ADP, influences coronary blood flow importantly in this model. PMID- 3806420 TI - Heterogeneity of nicotine actions in the rat cerebellum: an in vivo electrophysiologic study. AB - Much controversy surrounds the actions of nicotine on mammalian central neurons, especially with respect to the question of presence of multiple nicotine receptors and with respect to similarities of responses to those induced by acetylcholine (ACh). To resolve some of these complexities, the authors determined the effects of pressure-ejected nicotine on identified neurons in the cerebellar cortex of Sprague-Dawley rats under urethane anesthesia. Purkinje cells and interneurons were identified by their anatomical localization, discharge characteristics and responses to electrical stimulation of superficial parallel fibers. Locally applied nicotine altered single-unit activity in a manner strictly dependent on cell type. Pressure-ejected nicotine inhibited Purkinje cells (50/51) and excited cerebellar interneurons (22/22). The effects of nicotine on cell discharge rate were probably receptor mediated because "classical" nondepolarizing nicotinic antagonists selectively blocked the agonistic actions of nicotine. A curare-sensitive site (neuromuscular type) was found to mediate the excitatory effects of nicotine, and a hexamethonium sensitive site (ganglionic type) was found to mediate the inhibitory effects of nicotine. ACh mimicked the effects of nicotine on both cell classes although muscarinic interactions were also observed. The inhibitory effects of ACh on Purkinje cells were antagonized by the ganglionic blocker hexamethonium only if muscarinic receptors were simultaneously blocked via systemic administration of scopolamine. The excitatory effects of ACh on interneurons, on the other hand, were antagonized by the neuromuscular blocker curare even in the absence of a muscarinic antagonist. No interactions of curare and hexamethonium were observed with the amino acid transmitters gamma-aminobutyric acid (Purkinje cells) and glutamate (interneurons). PMID- 3806421 TI - Tyramine-conjugation deficit as a trait-marker in endogenous depressive illness. AB - Patients with endogenous unipolar depressive illness show a highly significant decrease in ability to metabolize an oral load of tyramine to its sulphate conjugate compared with controls and neurotic depressives. As this biochemical lesion persists after clinical recovery and is present in about half the non depressed first degree relatives of endogenously depressed probands, it is likely that the abnormality is a trait marker for depressive illness. It may thus be useful in practice as a predictor of vulnerability to depressive illness. The tyramine test is superior to the dexamethasone suppression test in both sensitivity to, and specificity for, endogenous depression. PMID- 3806422 TI - A family study of patients with attention deficit disorder and normal controls. AB - In a family study of Attention Deficit Disorder (ADD), we collected data on first degree relatives of 22 children with ADD and 20 normal children. The morbidity risk for ADD was 31.5% in the first group. This was significantly higher than the rate of 5.7% in the control group. Relatives of ADD probands were also shown to be at higher risk for Oppositional Disorders and Major Depressive Disorder (MDD). The findings indicate that ADD is a familial disorder associated with increased familial risk of other psychiatric disorders. PMID- 3806423 TI - Assessing the role of X-linked inheritance in bipolar-related major affective disorder. AB - Data from a family study of bipolar affective illness in New York (1968-1972) are reexamined from the vantage point of X-linked dominant inheritance and genetic heterogeneity. For comparison, published data from a similar study in Bethesda (1974-1979) and from a literature summary are also re-analyzed. The New York data support the presence of a change in rates of affective illness over time (secular trend), with a substantial increase in risk at early ages for individuals born after 1920. Hence, risk ratios by sex of proband (male vs female) are calculated for each type of relative, thereby controlling simultaneously for generation and sex of relative. The risk ratios for all three studies are in the direction predicted by X-linkage. In addition, logistic regression is performed, incorporating the effects of generation, sex of relative, sex of proband, and X linkage. In all three samples, the largest effect is due to X-linkage, which reaches statistical significance in the New York and literature summary samples. The results also suggest genetic heterogeneity, in that only a subgroup of bipolars carry the X-linked gene. Crude estimates predict that perhaps one-third of bipolars carry the X-linked gene. Analysis of the New York material also indicates that an X-linked subgroup may be associated with early onset (before 30 years old). These results are consistent with those from linkage analysis with markers on the long arm of the X chromosome. PMID- 3806424 TI - Construct validity of the DSM-III and RDC classification of melancholia (endogenous depression). AB - Diagnostic schedules for any psychiatric disorder should represent a coherent concept and demonstrate adequate construct (internal) validity and transferability. Testing fit to latent class models (e.g. by Rasch model fitting test), correspondence to these requirements can be assessed. Based on data from a sample of 173 depressed in-patients, diagnostic schedules for endogenous depression (melancholia) according to DSM-III and RDC are evaluated for their ability to fit the requirements listed above. According to the data presented, the set of DSM-III-criteria for melancholia represents a coherent concept; on the contrary, this is not the case for RDC-criteria. Furthermore, application of the diagnostic algorithm applied to the defining criteria according to DSM-III has been justified; again, this was not the case for the diagnostic algorithm according to RDC. However, a simple linear diagnostic algorithm emerges from our data. PMID- 3806425 TI - Physiological and psychological differences between good and poor sleepers. AB - Eighteen poor sleepers and 18 good sleepers of mean age 52 yr, selected on the basis of their stated opinions about their sleep, were studied as pairs matched for sex, age, height and weight, on five consecutive nights and two consecutive days. Using EEG measures, the poor sleepers woke more often in the early hours of sleep and achieved half an hour less sleep. They had higher body temperatures by day and night and were more anxious. They tended to have higher urinary cortisol and adrenaline excretion. The groups did not differ in reaction time nor in excretion of urinary 3-methylhistidine. The poor sleepers over-estimated their sleep latency and both groups under-estimated their total sleep, the poor sleepers being significantly more inaccurate. It is concluded that those who complain of poor sleep have also metabolic differences from good sleepers. PMID- 3806426 TI - Schedule for Affective Disorders and Schizophrenia--Lifetime Version modified for the study of anxiety disorders (SADS-LA): rationale and conceptual development. AB - The SADS-LA, a modification of the Lifetime Version of the Schedule for Affective Disorders and Schizophrenia, was designed specifically for studies requiring detailed lifetime information on anxiety disorders, symptoms and traits. This article focuses on current difficulties in assessing and conceptualizing anxiety disorders, as addressed in the SADS-LA. The following topics are discussed: conceptual differentiation of certain anxiety disorders; sub-threshold symptoms and syndromes; the relationship between affective and anxiety syndromes; the residual category, Generalized Anxiety Disorder. We emphasize a lifetime sequential approach to diagnostic assessment for a comprehensive understanding of the interrelationships between mental disorders. PMID- 3806427 TI - A study of depression in nursing homes. AB - The Geriatric Depression Scale (GDS) was used to screen for depression among residents of six nursing homes in Sydney. Of the 61% who could answer the questionnaire, more than one third were depressed. Those who were physically disabled, and those admitted in the previous 3 months scored higher on the GDS. Many of the severely demented patients could be tested with the GDS. PMID- 3806428 TI - Developing a screening index for community studies of somatization disorder. AB - Despite the low prevalence of somatization disorder in the community, the section of the Diagnostic Interview Schedule used to make the diagnosis--as well as previous diagnostic interviews for the related diagnoses of hysteria, and Briquet's syndrome--is quite lengthy. This study evaluates a somatization disorder screening index derived from completed interviews from the NIMH sponsored Epidemiologic Catchment Area program. A screening index comprised of 11 symptoms of somatization was derived at the Duke ECA site and replicated across the Johns Hopkins, Yale, and Washington University sites. Across ECA sites a screening threshold of five of 11 symptoms correctly identified 41 of 42 respondents with DIS/DSM-III somatization disorder (97.6%) while correctly classifying 14,600 of 14,750 (99.0%) without the disorder. The screening index offers promise as a screening device for clinical and community studies of somatization disorder. PMID- 3806429 TI - Variations in platelet 5-hydroxytryptamine in control and depressed populations. AB - Platelet 5-hydroxytryptamine uptake was measured in a group of 28 endogenously depressed patients at three points during the day, before, during and after treatment and in 20 controls at the same three times. Uptake rates varied in control subjects in a manner consistent with the presence of a circadian rhythm in uptake. This variation was absent in depressed subjects. Normal variation was restored in those patients showing a clinical response, irrespective of the effects of treatment on the affinity of the uptake system. This restoration was not found in nonresponders or acutely after treatment was commenced. These findings suggest that depression is associated with a disruption of circadian rhythms, that abnormalities of platelet 5-hydroxytryptamine uptake are secondary to such a disruption and that antidepressants may act to correct this disruption. PMID- 3806430 TI - Frequency of bulimic behaviors and associated social maladjustment in female graduate students. AB - A questionnaire survey of 550 female medical, business and law students revealed that 12% met criteria for bulimia. The bulimic students reported significantly more social maladjustment than their non-eating disordered peers. Frequency of binging and purging was associated with the degree of social impairment, with significant social dysfunction being noted on the overall scale at a minimum binging/purging frequency of once weekly. This finding suggests that the proposed DSM-III frequency criterion may be too restrictive. PMID- 3806431 TI - Personality, functioning and symptomatology. AB - A random sample of 200 people selected from urban and rural communities was assessed using structured interview schedules to measure the prevalence of personality disorder and psychiatric illness and their relation to social functioning. Explosive personality disorder was the most prevalent type of abnormal personality. Social functioning was significantly worse in those with personality disorder than those with normal personality but there was no difference between the various diagnostic categories of abnormal personality. Social functioning differed between some PSE diagnostic categories. An assessment was made of the variables contributing to mean social functioning score, of the interactions between them, and of the correlation between social functioning symptomatology. PMID- 3806432 TI - Neurophysiological properties of magnetic cells in the pigeon's visual system. AB - Single unit electrical activity was recorded extracellularly in the nucleus of the basal optic root (nBOR) and in the optic tectum under earth-strength magnetic stimulation. Units in the nBOR which were stimulated while the eyes were illuminated by light of different wavelengths exhibited peaks of magnetic responsiveness at 503 nm and 582 nm. Magnetically directional selective cells were found in the stratum griseum et fibrosum superficiale of the optic tectum. They also showed directional selectivity to dynamic photic stimuli. Response peaks varied with the orientation of the pigeon in the horizontal plane. This confirmed that the magnetic responses contained directional information. The results suggest that the receptor and neural organisation of the pigeon's visual system provides an adequate substrate for the detection and elaboration of magnetic compass information. PMID- 3806433 TI - Identification of thoracic interneurons that mediate giant interneuron-to-motor pathways in the cockroach. AB - Paired intracellular recordings were made to identify thoracic interneurons that receive stable short latency excitation from giant interneurons (GIs). Eight metathoracic interneurons were identified in which EPSPs were correlated with GI activity which was evoked either by wind or intracellular electrical stimulation or occurred spontaneously. In all cases EPSPs in the thoracic interneurons followed GI action potentials faithfully at short latencies. EPSPs associated with GI action potentials consistently represented the upper range of amplitudes of a large sample of EPSPs recorded in the thoracic interneurons. Seven of the interneurons were correlated with activity in ventral GIs but were not correlated with activity in dorsal GIs. Four of these interneurons were part of a discrete population of interneurons whose somata are located in the dorsal posterior region of the ganglion. The eighth interneuron (designated the T cell) was positively correlated with activity in dorsal GIs. The four dorsal posterior group interneurons and the T cell were depolarized intracellularly to establish their potential for generating motor activity. In all cases evoked activity was stronger in leg motor neurons (primarily Ds and the common inhibitor) located on the side contralateral to the interneuron's soma. The results indicate that significant polysynaptic pathways exist by which GI activity can evoke motor activity. The implications of this conclusion to investigations on the cockroach escape system are discussed. PMID- 3806434 TI - Control of echolocation pulses by neurons of the nucleus ambiguus in the rufous horseshoe bat, Rhinolophus rouxi. II. Afferent and efferent connections of the motor nucleus of the laryngeal nerves. AB - Horseradish peroxidase was applied by inotophoretic injections to physiologically identified regions of the laryngeal motor nucleus, the nucleus ambiguus in the CF/FM bat Rhinolophus rouxi. The connections of the nucleus ambiguus were analysed with regards to their possible functional significance in the vocal control system, in the respiration control system, and in mediating information from the central auditory system. The nucleus ambiguus is reciprocally interconnected with nuclei involved in the generation of the vocal motor pattern, i.e., the homonomous contralateral nucleus and the area of the lateral reticular formation. Similarly, reciprocal connections are found with the nuclei controlling the rhythm of respiration, i.e., medial parts of the medulla oblongata and the parabrachial nuclei. Afferents to the nucleus ambiguus derive from nuclei of the 'descending vocalization system' (periaqueductal gray and cuneiform nuclei) and from motor control centers (red nucleus and frontal cortex). Afferents to the nucleus ambiguus, possibly mediating auditory influence to the motor control of vocalization, come from the superior colliculus and from the pontine nuclei. The efferents from the pontine nuclei are restricted to rostral parts of the nucleus ambiguus, which hosts the motoneurons of the cricothyroid muscle controlling the call frequency. PMID- 3806435 TI - On the discrimination of spatial intervals by the blind cave fish (Anoptichthys jordani). AB - The performance of the blind cave fish in discriminating spatial intervals was investigated. The fish had to discriminate between pairs of grids consisting of equidistant vertical bars. The intervals between the bars on the grid to be chosen were kept constant while the intervals between the bars on the other grid were altered in steps so as to become gradually closer to the interval between the bars on the grid to be chosen. It was found that the fish were still able to discriminate between the two grids when the difference between the bar intervals amounted to at least 1.5 mm. In interpreting the results it was concluded that the phase information in the stimulus on the skin of the fish must be significant for it. PMID- 3806436 TI - Motion detection in the presence and absence of background motion in an Anolis lizard. AB - Anolis lizards respond to a moving object viewed in the periphery of their visual field by turning their eye to fixate the object with their central fovea. This paper describes the relative effectiveness of different patterns of motion of a small black lure in eliciting these eye movements and the way motion of a backdrop of vegetation affects the response. The stimulus was positioned 45 degrees from the animal's line of gaze and oscillated in the vertical axis at different frequencies between 0.5 and 10 Hz. At each frequency, the amplitude of the oscillation was increased until the lizard flicked its eye towards the stimulus. The minimum amplitude needed for response (0.22 degrees of visual angle) was independent of frequency and waveform. The probability of any response occurring was, however, lower at higher frequencies (7 and 10 Hz) and a 1.5 Hz square wave evoked the greatest proportion of responses. Sinusoidal oscillation of a background of vegetation at 1.6 Hz during or before motion of the stimulus lure reduced the probability of an eye flick but did not raise the minimum amplitude needed for a response. The suppressive effect was greatest when the lure was oscillated at frequencies close to that of the background. It is concluded that Anolis, which rely upon motion to detect objects in the periphery of the visual field, filter out irrelevant motion such as that of windblown vegetation by responding preferentially to particular patterns of motion and short term habituation to commonly present patterns of motion. PMID- 3806437 TI - Patterns of pigmentation in the eye lens of the deep-sea hatchetfish, Argyropelecus affinis Garman. AB - The present study is a morphological, biochemical and spectrophotometric characterization of the eye lens pigmentation in 45 specimens (11-88 mm in standard length) of the deep-sea hatchetfish, Argyropelecus affinis (Stomiiformes: Sternoptychidae). For comparison, we also examined available lenses of other members of the family Sternoptychidae, including three other species of the genus Argyropelecus, and two species of the genus Sternoptyx. Lens pigmentation was observed in all specimens of Argyropelecus spp. larger than about 36 mm in standard length, but was absent in all Argyropelecus spp. individuals less than 36 mm. However, lens pigmentation was not observed in Sternoptyx specimens of any size. Detailed studies of A. affinis indicated that at 36 mm the nascent lens fiber cells, which are continually laid down over preexisting, unpigmented cells, begin incorporating pigment, and the pigment concentration increases steadily as pigmented cells are added during lens growth. Spectrophotometric and biochemical data suggested that the pigment is a carotenoprotein complex, the carotenoid-like chromophore being strongly associated with a specific soluble lens protein, alpha crystallin. While the lens coloration in these fishes is age-related, analyses of the retinal visual pigment revealed no concomitant age-related change in the peak wavelength of retinal sensitivity in these fishes. Our data on the spectral absorbance of the lens and visual pigment of these fishes suggest that the lens pigmentation acts as a short wave filter to improve acuity of the visual system. PMID- 3806438 TI - Limits of phase and amplitude sensitivity in the torus semicircularis of Eigenmannia. AB - Eigenmannia can detect modulations in the time disparity of signals received by different regions of the body surface as small as several hundred nanoseconds. This study presents recordings of single units in the torus semicircularis that are sensitive to time disparities (differential-phase) between a sinusoidal signal received by the head region and a similar signal received by the body surface caudal to the fish's pectoral fins. The sensitivity of units to differential phase, measured by the change in spike rate per unit change in time disparity, was greatest when small phase modulations, rather than stationary phase differences, were presented. Thresholds of differential-phase coders ranged from 6.5 microseconds to several hundred microseconds, with approximately 20% of the units having thresholds in the 5-10 microseconds range. For most cells, sensitivity to small modulations of differential-phase was relatively unaffected by time disparity 'offsets' within a range of several hundred microseconds. A threshold of 5-10 microseconds is still an order of magnitude higher than that measured in the Jamming Avoidance Response (JAR). Neurons that were sensitive to amplitude modulations (AMs) had thresholds as low as 0.05%. This value is comparable to that observed at the behavioral level. PMID- 3806439 TI - Stress and changes in the blood of newts, Notophthalmus viridescens, during early regeneration. AB - During the summers of 1984 and 1985, adult red-spotted newts, Notophthalmus viridescens, were maintained in the laboratory at 23 degrees +/- 0.5 degrees C under natural photoperiods. From each of the experimental animals, the right forelimb was amputated just proximal to the elbow. Control newts were not manipulated surgically. Eight, 15, and 22 days after the time of amputation, equal numbers of regenerating and control animals were sacrificed, and blood smears of each individual were prepared with Wright's stain. Mean differential counts of leukocytes of the two groups of newts indicated that the relative number of neutrophils increased and the relative number of lymphocytes decreased in the regenerating animals as compared to their controls (Fig. 1 and Fig. 2). Earlier studies had shown that lymphopenia and neutrophilia occur in red-spotted newts treated with hydrocortisone or with ACTH or subjected to environmental stress (Bennett and Daigle 1983). Consequently, it is suggested that amputation and/or early regeneration may stimulate the increased production of hormones associated with stress in vertebrates, which may, in turn, influence regeneration, itself, and that the detailed study of the distribution of leukocytes in Notophthalmus viridescens may provide an assay with which to study the regulation of regeneration in this species. PMID- 3806440 TI - Directionally selective cells in the locust medulla. AB - Intracellular recordings of a distinctive class of directionally selective cell from the medulla of the locust, Locusta migratoria, optic lobe are described. Dye marking shows that these cells arborize in the distal part of the medulla, and project through the lobula complex. The cells are excited by upward movement and have receptive fields of about 20 degrees in diameter. They are sensitive to a wide range of angular velocities from 0.02 degrees/s to over 200 degrees/s. The cells are sensitive to stationary flicker and have different latencies to dimming and brightening. Evidence is presented which suggests that directional computation depends, at least in part, on an inhibitory interaction between flicker sensitive channels. PMID- 3806441 TI - Control of hindlimb posture by wind-sensitive hairs and antennae during locust flight. AB - Steering movements of tethered, flying locusts, Schistocerca gregaria, subjected to simulated yaw were examined under open-loop conditions. Lateral movements of hindlimbs or curling of the abdomen were monitored with a capacitive movement transducer and were interpreted as indicating the tendency of the animal to turn. Three responses to simulated yaw were noted: Yaw-correcting upwind turning tendencies (Figs. 1, 2, 3). Downwind turning tendencies (Figs. 2, 3, 4, 5), and transient adjustments of hindlimb position consistent with an upwind turning tendency occurred in animals that made either no sustained postural adjustments of hindlimbs, or that exhibited sustained downwind turning tendencies (Figs. 4, 5). Ablations of certain mechanoreceptors tested their roles in wind detection and wind angle determination. The expression of upwind turning tendencies, whether sustained or transient, depends on inputs from cephalic mechanosensory hairplates (Figs. 2, 3, 4, 5). With hairplates occluded, all locusts exhibited downwind turning tendencies. All downwind turning tendencies depend on inputs from the antennae (Figs. 2, 3). Antennae and hairplates operate in an apparent antagonism in the steering responses they produce, which may provide the control flexibility required for complex flight maneuvering. PMID- 3806442 TI - The development of the static vestibulo-ocular reflex in the southern clawed toad, Xenopus laevis. I. Intact animals. AB - In the clawed toad, Xenopus laevis, the static vestibulo-ocular reflex appears in 3 days old tadpoles (developmental stage 42) (Fig. 2). The amplitude and gain of this reflex increase up to stage 52, and then decrease to an almost constant value at stage 60 and older tadpoles (Fig. 3). The most effective roll angle gradually increases during development (Fig. 4). The size of the sensory epithelia reaches the final value at the end of the premetamorphic period (stage 56) (Fig. 5). The small-cellular medial ventral vestibular nucleus (VVN) reaches its maximal number of neurons before the large-cellular lateral VVN. Cell death is more pronounced in the medial than in the lateral part of the VVN. In the dorsal vestibular nucleus (DVN), the numerical development of the small and large neurons is similar to that in the small-cellular medial and large-cellular lateral portion of the VVN (Fig. 7). The results demonstrate that labyrinth and oculomotor centres are anatomically connected before the labyrinth and the vestibular nuclei are fully developed. We discuss the possibility that the ciliary polarity pattern of the sensory epithelium is radial during the first period of life, and changes to the vertebrate fan-type pattern during the second week of life. According to the increase of gain during the first three weeks of life, an increase of the spontaneous activity of vestibular neurons may occur during this period. PMID- 3806443 TI - The development of the static vestibulo-ocular reflex in the southern clawed toad, Xenopus laevis. III. Chronic hemilabyrinthectomized tadpoles. AB - The static vestibulo-ocular reflex was investigated in tadpoles at different times following unilateral destruction of the labyrinth during the period of early organogenesis and premetamorphosis. Balance compensation is completed after a few weeks, while gain compensation only occurs partially (Figs. 2-4). Tadpoles hemilabyrinthectomized in the age of 2.5 days (stage 38) develop no vestibular nuclei on their lesioned side, while tadpoles operated later in their life, possess these nuclei (Figs. 5, 6) even if they were not detectable at the operation day (Fig. 7). For their dorsal vestibular nucleus (DVN), the number of neurons is usually larger on the intact than on the lesioned side; while for the ventral vestibular nucleus (VVN), there is either numerical symmetry or a transient decrease of cell number on the intact side (Fig. 5). The results demonstrate that vestibular compensation occurs even if vestibular nuclei have developed only on one side, i.e. the vestibular commissure is not a prerequisite for a successful compensation process. It is discussed whether the use of extra vestibular error signals for balance but not for gain compensation may cause the differences in time courses of both compensation processes. PMID- 3806444 TI - Type A behaviour, education and psychosocial work characteristics in relation to ischemic heart disease--a case control study of young survivors of myocardial infarction. AB - The interaction of Type A behaviour, psychosocial work environment and education in relation to medical risk factors for IHD was analyzed in a case-control study of male and female post-MI-patients under age 45. In multivariate analysis LDL/HDL-cholesterol ratio and smoking (explaining 27 and 6% of the variance) emerged as the two most important discriminators of patients from control subjects. The third factor, variety of work tasks, explained 5% of the variance. Type A behaviour ranked as factor no. 7, explaining only 2% of the variance and educational level did not reach statistical significance as an independent explanatory factor. When the sample was divided into men and women with high and low education, most of the patient-control difference in Type A and psychosocial work characteristics was found among highly educated men on one hand and women with a low level of education on the other. Thus Type A behaviour seems to be less important and psychosocial work environment more important in adding psychosocial risk to the medically established risk of IHD. PMID- 3806445 TI - Prevalence and correlates of posttreatment and anticipatory nausea and vomiting in cancer chemotherapy. AB - Prevalence and correlates of posttreatment and anticipatory nausea and vomiting (NV) were examined in 149 cancer patients receiving chemotherapy at four treatment centres. Results of multiple regression analyses indicated that posttreatment NV was associated with treatment centre, diagnosis, drug toxicity, and frequency of antiemetic premedication. Anticipatory NV was found to be associated with age, treatment centre, drug toxicity and frequency of posttreatment NV. Eight predictor variables accounted for 49% of the variance in anticipatory NV. Variables showing significant unique effects included age, treatment centre, posttreatment NV and the age by posttreatment NV interaction. Results suggest the importance of examining environmental, psychosocial, and treatment-related variables that may differentiate treatment centres and strongly support the role of classical conditioning in the development of anticipatory NV. PMID- 3806446 TI - The accuracy of dating childhood life events on a parental questionnaire. AB - The accuracy in dating events by parents on the Coddington childhood life-event self-report inventory was assessed, by examining the concordance between events reported on the inventory and at a subsequent life-events interview. Seventy per cent of all the events reported on the inventory were dated at interview within the stated three month period. On group comparisons of all events reported, concordance in dating was not significantly related to the nature of the events classified according to desirability, specificity or direction (exit/entrance). Nor was it related to psychological deviance in the mother or in the child. However, when statements in the questionnaire were examined individually for concordance, there was full concordance for desirable events and for hospitalizations. In contrast, there was no concordance when marital separation, remarriage and birth of a sib were reported. The reasons for this are explored. PMID- 3806447 TI - Type A behaviour and the experience of affective discomfort. AB - Early views of the Type A behaviour pattern (TABP) sought to disengage it from either neuroticism or emotional distress. Recent evidence challenging these views has, however, recommended a reevaluation of the area. Data arising from the present study indicate the TABP to be statistically related to measures of both neuroticism and emotional distress, though whether this association extends to a conceptional similarity, particularly with the former, is a matter for further discussion. PMID- 3806448 TI - Determinants of beliefs about illness: a study of parents of children with diabetes, asthma, epilepsy, and no chronic illness. AB - Social psychological models of health care behaviour frequently take as their starting point perception of the illness. This paper seeks to examine factors that may influence these perceptions. Beliefs about the seriousness of eleven childhood illnesses are compared in four groups of parents. Significant differences were evident between the groups of parents depending upon their experiences with illness. For three conditions (diabetes, asthma and epilepsy) the lowest rating of seriousness was made by parents with a child with that condition. For parents of children with diabetes, having a relative with diabetes in good health was associated with a perception of the illness as significantly less serious than those with a relative in average or poor health, or those with no relatives with diabetes. These results are interpreted within an information processing model. Implications of the findings for social psychological models of health care behaviour are discussed. PMID- 3806449 TI - The factor structure of the Cognitive-Somatic Anxiety Questionnaire. AB - The factor structure of the Cognitive-Somatic Anxiety Questionnaire (CSAQ) was examined in a sample of 227 students. Results from factor-analytic procedures indicated that the main dimensions of the test are a cognitive factor and a somatic factor, although the items do not fall as cleanly into these factors as was predicted a priori. The results are discussed in terms of the importance of differentiating cognitive and somatic anxiety at a theoretical and measurement level. It was concluded, however, that a better scale for these purposes could be constructed. PMID- 3806450 TI - Predictors of long term outcome following a bladder re-training programme. AB - A total of fifty-three female patients suffering from urinary urgency and urge incontinence completed a bladder re-training programme which comprised behavioural and biofeedback treatment components. The psychological status of patients prior to treatment and at eighteen-month follow-up was compared. The role of clinical and psychological factors was examined in relation to treatment outcome (immediately following treatment and at eighteen-month follow-up). Compared to pre-treatment, patients at the eighteen-month follow-up were experiencing fewer psychological symptoms and were more internal with respect to their locus of control, irrespective of urological response to the programme. Poor treatment compliance predicted a poor treatment response both in the short- and long-term. Excessive worrying about, and preoccupation with, the urinary symptoms, previous surgery, and chronic urinary symptoms were all good predictors of a poor treatment response in the long term. PMID- 3806451 TI - Type A, test performance and salivary cortisol. AB - Forty first year medical students, previously screened for the presence or absence of the Type A behavior pattern, collected saliva samples for four days leading up to the first major examination of their medical school course. It was observed that the day of the examination produced substantially different patterns of salivary cortisol concentrations for Type A and non-A subjects, depending on their level of performance. The Type A subjects who scored above the median on the examination showed higher concentrations of salivary cortisol than Type A subjects who scored below the median. The reverse of this pattern was found for non-A subjects. Visual analog scale ratings of subjective stress showed no behavior pattern effects and a very low correlation with the salivary cortisol concentrations. The results support the view that the occurrence of physiological arousal associated with the Type A behaviour pattern is intermittent and dependent on situational factors such as expectation of success and actual success. This is consistent with conceptualizing the Type A pattern as a strategy for resource allocation which may be elective, rather then the behavioural manifestation of an automatic physical response to stress. PMID- 3806452 TI - Hemiarthroplasty: a progression in treatment? PMID- 3806453 TI - Fractures of the distal radius with anterior displacement: Smith's and Barton's fractures. PMID- 3806454 TI - Soft tissue recurrence in giant cell tumour of bone. PMID- 3806455 TI - Tracheostomy in childhood. PMID- 3806456 TI - Squamous cell carcinoma of kidney. PMID- 3806457 TI - Surgeon's workshop: economic suction drainage in the third world. A simple technique for closed suction drainage. PMID- 3806458 TI - Surgeon's workshop: economic suction drainage in the third world. The Unical drain. PMID- 3806459 TI - Adenomatous polyp of the sigmoid colon with focal squamous metaplasia. PMID- 3806460 TI - Re: External vascular trauma. PMID- 3806461 TI - [Interventional radiology]. PMID- 3806462 TI - [Superimposition of images obtained by x-ray computed tomography and MRI]. PMID- 3806463 TI - [Value of x-ray computed tomography in the monitoring of cancer of the ovary. Apropos of 69 cases]. AB - The authors have studied retrospectively, a group of 69 patients with primitive carcinoma of the ovary who underwent at most one CT examination following the first surgical treatment. In 26 out of these, CT was done within the three months following a second surgical operation. Peritoneal metastases were inconsistently seen (5 true positive, 9 true negative, 0 false positive, 9 false negative). The sensitivity is 36%, the specificity 100% and the accuracy 65%. The score is better in the detection of lymphatic, hepatic and intestinal metastases. PMID- 3806464 TI - [Radiology in renovascular hypertension from i.v. urography to digital subtraction angiography. A critical evaluation]. AB - For the last 20 years, the value of radiology in renovascular hypertension (RVH) is well established from diagnostic and therapeutic points of view. However things are changing now due to a better appraisal of the incidence of RVH, new antihypertensive drugs, and new radiological procedures (digital angiography, percutaneous transluminal angioplasty). The approach now takes in account the mode of imaging for a better evaluation of the renal artery stenosis and costs of the procedures as well. Finally a new strategy has been set up for RVH patients management. PMID- 3806465 TI - [Radiologic diagnosis of leiomyosarcomas of the renal vein: the role of angiography. A review of the literature apropos of 2 new cases]. AB - Leiomyosarcoma of the renal vein is a very unusual type of malignant tumor. Two new cases are reported and the nine cases previously documented are reviewed. Through this review the role of radiological investigation and above all of angiography are emphasized. PMID- 3806466 TI - [Radiographic aspects of galactoceles]. AB - The authors report two cases of galactoceles with unusual radiographic patterns, different from those ordinarily described either (opacity or radiocrescent); that is an aspect with a clear superior crescent related to a level between milk and fat, included in a localized galactophoric dilatation. PMID- 3806467 TI - [Collective irradiation caused by radio-diagnostic procedures in France in 1982. Results (2)]. AB - This paper gives the most important results of the collective dose received by patients who undergoing diagnostic radiology examinations in France in 1982. It details, per each X-ray examination type, the collective organ dose associated with, and highlights the importance of the radiological procedures (number of X ray films, fluoroscopy screening time) on the received patient doses. If one takes into account organs for which dosimetric measurements have been carried out, the collective effective dose equivalent per 10(6) inhabitants is 442 man Sievert; the genetically significant dose reaches 0.295 mSv and finally the collective red bone marrow dose due to 45 million X-ray exams practiced in France (1982) is 40,300 man-Sievert i.e. 0.742 mSv. per inhabitant. PMID- 3806468 TI - [Compression of the right pulmonary artery by a dissecting aneurysm of the ascending aorta. Value of x-ray computed tomography]. AB - Right pulmonary artery compression by a dissecting aortic aneurysm-value of computed tomography. The authors relate a case of dissecting aortic aneurysm occurring as a late complication of aortic valve replacement and causing right pulmonary artery compression. Computed tomography appears to be performing technique for the exploration of this unusual case. PMID- 3806469 TI - [Sciatic artery or persistent axial artery. Apropos of 2 rare variants]. AB - Arteriography in two patients showed a persistent sciatic artery, in one case complete and the other case incomplete, associated with a persistent superficial femoral artery. One case was complicated by the presence of an aneurysm. Embryology, pathology, clinical aspects and surgical repercussions are discussed, and emphasis placed on the need for preoperative angiography to detect this embryologic variant requiring another surgical attitude. PMID- 3806470 TI - [Extradural hematoma after the surgical treatment of kyphosis]. AB - Two patients developed paraplegia during the course of surgical reduction and fixation of kyphosis: one of congenital origin and the other related to Marfan's disease. Myelography with contrast showed an extramedullary hematoma, treated surgically. PMID- 3806471 TI - [Suprascapular and axillary subcutaneous emphysema after perforation of a pharyngolaryngeal cancer]. AB - A case is reported of a laryngeal cancer recurrence that had invaded and then eroded the pharynx. The fistula produced was the cause of a thrombophlebitis of upper limb, and subcutaneous emphysema limited to the right shoulder region due to radiosclerosis of soft tissues of neck. PMID- 3806472 TI - [The appendix, a little known organ]. PMID- 3806473 TI - [The heuristics of expert systems in radiodiagnosis]. AB - In the practice of creating expert systems, the radiologist and his team are considered as "the expert" who leads the job of the "cognitian or cognitician". Different kinds of expert systems can be imagined. The author describes the main characteristics of heuristics in redefining semiology, semantics and rules of picture reading. Finally it is the experience of the couple "expert and cognitician" which will in the future grant for the success of expert systems in radiology. PMID- 3806474 TI - [Evaluation of elementary radiologic images of Crohn's ileitis. Retrospective study of a homogeneous series of 238 double-contrast transits in the small intestine]. AB - An homogeneous series of 238 double contrast examinations of the small bowel were reviewed. In this study, 32 regional enteritis (RE) were encountered. Statement of different semiologic signs of RE was established. This study exhibited various signs in RE; some of them were observed in various other enteritis (mainly tumors, ischemia and variation enteritis). Sensitivity varies between 6 and 84%. Highest values are noted with ulcerations, nodules, narrowing of the lumen wall. Specificity and predictive values vary from 64% to 100%. The best results are obtained with graduate lesions, fistulae, skipped area and cobblestone. Only graduate lesions are really pathognomonical but uncommon lesions. Analysis of double contrast small bowel examination has to be compared with the whole medical report in order to improve diagnosis accuracy. PMID- 3806475 TI - [X-ray computed tomography and synovial chondrometaplasia]. AB - Scanography allows diagnosis of radiotransparent intra-articular foreign bodies and establishment of their synovial origin, sometimes even in the absence of joint opacification. It provides an overall assessment of the joint that can be improved by arthrography. Clinical and standard radiologic pictures of primary synovial chondrometaplasia (synovial osteochondromatosis) and intra-articular foreign bodies can cause confusion if the latter are modified by secondary chondrometaplasia. Scanographic analysis of islets of chondrometaplasia suggests their primary nature in the presence of plaques of calcification of a small size, of low density and diffused throughout the image while peripheral, lamellar, dense calcifications are suggestive of secondary lesions. PMID- 3806476 TI - [Direct measurement of cotyloid anteversion of a total hip prosthesis. Value of Arcelin's surgical lateral image]. AB - Measurement of anteversion of cotyle of total hip prosthesis generally involves projection of equatorial guide included in cotyloid piece. Direct measurement of cotyloid anteversion on Arcelin's surgical lateral image showed this method to be a simple, reliable, direct procedure for determination of cotyloid anteversion of total hip prosthesis. PMID- 3806477 TI - [Vertebral osteoid osteoma. Diagnostic value of x-ray computed tomography]. AB - An update review of diagnosis of vertebral osteoid osteoma based on findings in four cases and the documented data accords a predominant place to scan imaging. Computed tomography guided by scintigraphy is the only examination able to determine the site of the lesion with precision. PMID- 3806478 TI - [Leiomyosarcomas of the inferior vena cava]. AB - Leiomyosarcoma of the inferior vena cava in a rare tumor which is predominantly seen in women. The symptomatology is non specific and depends mostly of the segment of the vessel which is involved. Radiologic approach for correct preoperative diagnosis is based on ultrasonography, computed tomography and inferior vena cavography. The best treatment is en bloc resection of the mass associated with pre and post-operative chemotherapy. Although the tumor is slow growing, the prognosis is poor and the average survival is less than two years, due to local recurrence and metastases. PMID- 3806479 TI - [Spontaneous rupture of intracranial dermoid cyst. Clinical and radiological study]. AB - A 22 year old woman had a seizure, and the skull X-ray showed an intracranial arched calcification. CT scan permitted diagnosis of dermoid cyst. Rupture of the cyst was testified by low density areas disseminated on the cortical surface and intra-ventricular fat level. Surgical removal confirmed dermoid cyst with rupture and fat fluid inside. Authors underline infrequency of such intra-ventricular fat level. CT scan, with low density of lipidic origin promote considerably such diagnosis both of the real nature of the cyst and of its rupture. PMID- 3806480 TI - [Grawitz's tumor with arterial hypertension in children. Apropos of a case]. AB - A boy of two years has an hematuria which was first related with an hypertensive acute glomerulonephritis. However because of recurrency of the hematuria radiological investigations were performed and a solid tumor of the right kidney was discovered. The arterial hypertension regressed after the right nephrectomy. Pathology demonstrated a tumor of Grawitz which is rare in children and which is seldom associated with an arterial hypertension. We found only five similar cases in the literature. Arterial hypertension can be related either with a compression of the renal artery of with an inadequate secretion of renin by the tumor. PMID- 3806481 TI - Quality in general practice: a focus on inner cities. PMID- 3806482 TI - Alcohol--finding solutions. PMID- 3806483 TI - Health for all, primary health care and general practitioners. PMID- 3806484 TI - Workload in a general practice 1950-85. AB - Annual patient consultation rates have been recorded continuously for 36 years in a stable National Health Service practice in a south-east London suburb. Four phases in consultation rates were noted: rising rates from 1950 to 1956; peak rates from 1957 to 1963; falling rates from 1964 to 1970 and low stable rates from 1971 to 1985. Thus workload fell by almost 50%, from a peak of 3.81 to a low of 1.93 consultations per patient per year. The reduction of 91% in home visits was much greater than the 43% reduction in surgery (office) consultations.CERTAIN QUESTIONS ARE RAISED BY THE STUDY: why are the consultation rates of this practice so low (one half the national rates); why have consultation rates in the practice fallen; and how many general practitioners are needed by the NHS? More studies are needed which compare practices, their processes and outcomes, and which analyse cost benefits in the health service. PMID- 3806485 TI - How bad are medical records? A review of the notes received by a practice. AB - One hundred and fifty-five medical records received by a practice as a result of transfer of care were examined. It was found that the marital status was recorded for 30% of patients aged over 16 years and the occupation noted for only 15% of patients of working age. Twentythree per cent of the notes included a summary of the patient's history and 39% contained an immunization record. Of the notes for women aged between 16 and 60 years 48% contained a recent cervical smear report. This percentage increased to 61% for women aged 35-60 years. Of the entries examined 86.2% were legible. It is concluded that either doctors do not know as much about their patients as they should or they attempt to carry too much information in their heads. PMID- 3806487 TI - Use of the Michigan alcoholism screening test in general practice. AB - The Michigan alcoholism screening test was used to assess the prevalence of alcohol problems in 142 patients aged between 18 and 60 years consulting a general practitioner. Previous and/or current alcohol problems were identified in 33% of men and 4% of women. Unemployment was found to be significantly associated with alcohol problems in the men of the study group. The higher proportion of patients with alcohol problems requesting consultation compared with those without such problems did not appear to be associated with a specific presenting complaint.Screening for alcohol problems should be undertaken in all patients consulting a general practitioner if early detection and intervention are to be achieved. PMID- 3806486 TI - Assessment of drinking patterns in general practice. AB - A study was undertaken in a north London general practice to see which questions and investigations were useful in assessing the drinking patterns of patients. In a 10-month period in 1984, 855 patients were interviewed by means of a questionnaire about quantity and frequency of drinking and the CAGE questionnaire to determine their drinking habits. They were also asked to blow into an alcolmeter. A blood sample was taken from 119 patients who said they drank more than 20 units of alcohol weekly or who scored more than two on the CAGE questionnaire or who had a positive alcolmeter reading, and gamma glutamyl transpeptidase levels and mean corpuscular volume were determined.The study showed that questions about quantity and frequency of drinking, taking under two minutes to administer in the consultation, are sufficient to raise suspicions about drinking problems. Detailed investigation can then be undertaken in patients who say they drink more than 20 units of alcohol weekly. PMID- 3806488 TI - Treatment for hypertension interrupted by placebo: the response of patients with high and low general health questionnaire scores. AB - A study is described in which established treatment for hypertension was interrupted by placebo as part of a change to an alternative treatment.The patients involved were divided into two groups according to their score on the general health questionnaire. All the patients showed an increase in diastolic pressure after the placebo phase of the change-over but the increase was greater for patients with a high score on the general health questionnaire than it was for patients with a low score. For the patients with a high score the diastolic pressure approximated to the level recorded when the diagnosis was first made, but for patients with a low score it was considerably lower than this initial reading.The implication of this finding for the design of ;changeover' studies is discussed. PMID- 3806489 TI - The outcome of hidden neurotic illness treated in general practice. AB - One thousand patients attending a general practice surgery were asked to complete the general health questionnaire as the first stage of screening for hidden minor psychiatric disorders. Those who had an unexpectedly high score of 20 or more were randomly allocated to doctors or health visitors for treatment. After one year, these two groups were reinterviewed by the doctors and health visitors respectively and comparable rates of recovery were found. After five years, they were interviewed again and a second general health questionnaire completed. It was found that both groups had improved significantly, and that there was no significant difference between them.Poor outcome was associated with problems with children, household or neighbours and with a previous history of psychiatric illness. Improvement was associated with physical treatment of the original disorder, resolution of the original problem and job satisfaction.The implication of these findings for the comparative management of minor psychiatric disorders by general practitioners and non-medical health workers in primary care are discussed. PMID- 3806490 TI - Once in a lifetime: a case of a pineal tumour. AB - This paper describes the case of a 14-year-old boy who presented to his general practitioner with a history of headaches and visual problems. Investigations subsequently revealed that he had a pineal tumour. The management of the patient is described and this rare condition discussed. PMID- 3806491 TI - Reye's syndrome and aspirin. PMID- 3806492 TI - A model to describe social performance levels in elderly people. AB - In elderly patients illness clearly affects both their social activity and their ability to care for themselves. It is important in general practice to recognize this effect when managing old people with acute and chronic illness. A model is described which aims to facilitate estimations of social performance at various levels. By carrying out this estimation the type of ;social' help needed can be better assessed. The model's usefulness in anticipatory care is also described. PMID- 3806493 TI - Marriage guidance counselling in general practice. AB - This paper discusses the results of a survey of all general practitioners and counsellors involved in attachments in the area covered by the London Marriage Guidance Council. The replies of both counsellors and doctors were generally enthusiastic and few problems with attachments were encountered. However, while subjective accounts are positive, it seems essential that more objective research into effectiveness should be conducted if counsellors are to argue their case for being paid. PMID- 3806494 TI - Do women bother about their cervical smear results? PMID- 3806495 TI - Acute febrile mucocutaneous lymph node syndrome (Kawasaki disease) PMID- 3806496 TI - Identification and characterization of muscarinic cholinergic receptors in the isolated plasma membranes and intact tissue of the urinary bladder. AB - The binding characteristics of 3H-quinuclidinyl benzilate (QNB) to strips of intact tissue and to isolated plasma membrane fraction (PM) from rabbit urinary bladder were studied. QNB binding to both preparations was of high affinity and low capacity. The equilibrium dissociation constants (KD) for binding to tissue strips and PM were 2.2 and 0.045 nM respectively. Muscarinic antagonists inhibited QNB binding more effectively than agonists. Ca-antagonist D-600, but not nifedipine caused an inhibition of QNB binding to PM. Vanadate, ouabain or N ethylmelaimide had no significant effect on QNB binding. In contrast to the binding in PM, binding in the intact tissue was reduced by K-depolarization. PMID- 3806497 TI - Heterogeneity of binding of chemotactic formyl peptides to their receptors on rabbit neutrophils: methodological and analytical considerations in the study of complex receptor-binding patterns. AB - The pattern of binding of chemotactic formyl peptides to their receptors on intact rabbit neutrophils was investigated using three different radiolabeled formyl peptides. The purpose of the study was both to establish suitable procedures for the analysis of complex receptor-binding data and to evaluate the heterogeneity of binding of the chemotactic formyl peptides. Radiolabeled formylmethionyl-leucyl-phenylalanine was found to require repurification by thin layer chromatography before it was of sufficient purity for use in these studies. All three radioligands were essentially stable during the binding assay. The 'LIGAND' computer program proved suitable for a detailed and rigorous analysis of the binding data. Each of the three formyl peptides showed significant heterogeneity in its binding pattern and all appeared to interact with the same receptor sites. The degree of heterogeneity, however, was greater with formylnorleucyl-leucyl-phenylalanine than with the other two formyl peptides. The heterogeneity was close to the theoretical limit of discernibility; thus individual binding studies with one formyl peptide did not always show statistical evidence of the heterogeneity. The study also highlighted the severe uncertainty in estimates of the proportions of each type of binding site when such data are analyzed on the basis of the 'two binding site' model. PMID- 3806498 TI - Reconstitution of solubilized serotonin-S2 receptors into phospholipid vesicles. AB - Serotonin-S2 receptors from rat frontal cortex were solubilized using CHAPS/sodium chloride. Reconstitution of the solubilized receptors was achieved by dilution of the soluble preparation, followed by centrifugation to remove the detergent. The receptors were truly reconstituted as judged by sedimentation, increased thermostability and electron microscopy. The reconstituted preparation showed high-affinity binding of [3H]7-aminoketanserin. The binding characteristics resembled those obtained for membrane-bound receptors. PMID- 3806499 TI - Two saturable recognition sites for (-) [125I]iodo-N6-(4-hydroxyphenyl-isopropyl) adenosine binding on purified cardiac sarcolemma. AB - Analysis of (-) [125]iodo-N6-(4-hydroxyphenylisopropyl)-adenosine [( 125I]HPIA) binding to purified sarcolemmal preparations of guinea pig and bovine hearts revealed two classes of binding sites when unlabeled iodo-HPIA (100 mumol/l) was used as non-specific binding marker. In the presence of 1 mmol/l theophylline, however, only the high affinity component was detected. Adenosine receptor agonists caused biphasic displacement of [125I]HPIA binding, with a high affinity potency rank order typical of interaction with A1-adenosine receptors. Biphasic competition curves were also observed with 8-phenyltheophylline and isobutylmethylxanthine, whereas the theophylline curve was monophasic up to 1 mmol/l. In brain membranes, specific binding of [125I]HPIA as well as of [3H]PIA was further reduced when unlabeled iodo-HPIA replaces theophylline as the non specific binding marker. These results suggest the presence of two [125I]HPIA binding sites on cardiac sarcolemma and brain membranes, but receptor function can only be ascribed to the high affinity sites. The low affinity site probably represents an artefact, which is often observed when non-specific binding is defined with the unlabeled counterpart or a structurally related ligand of the radioligand used. PMID- 3806500 TI - Surface transformation of ram spermatozoa in uterine, oviduct and cauda epididymal fluids in vitro. AB - Genital tract fluids were collected continuously from conscious ewes through catheters inserted surgically into the uterus and oviducts. Cauda epididymal spermatozoa and fluid were obtained through catheters inserted into the transected vas deferens. The washed spermatozoa were labelled using the surface specific chloroglycoluril-Na125I procedure. High-resolution electrophoretic analysis of sperm plasma membrane preparations revealed a partial loss of a major surface component (i.e. Mr 97,000) during incubation in uterine and oviduct fluids. This specific loss resulted in a shift in radioactivity distribution toward an Mr 24,000 component which had been previously identified as a sialoglycoprotein. No significant changes in the distribution of radiolabelled surface components were detectable when the spermatozoa were incubated in synthetic medium. Incubation of unlabelled spermatozoa in 125I-labelled uterine fluid showed that adsorption of exogenous fluid components was highly selective; an Mr 16,000 polypeptide was greatly enriched on the sperm surface although it was only a minor component in the incubation fluid. Adsorption of labelled oviduct fluid components was also selective and involved predominantly high molecular weight components (i.e. Mr 140,000, 95,000, 78,000, 53,000). When spermatozoa were incubated in labelled cauda epididymal fluid after exposure to unlabelled uterine and oviduct fluids, several fluid components were incorporated by the plasma membrane, indicating that surface renovation of 'capacitated' spermatozoa may be a more general process rather than a specific event. These results suggest that capacitation of ram spermatozoa involves loss of specific surface proteins as well as selective adsorption of exogenous fluid components and point to a polypeptide in uterine fluid as an active constituent. PMID- 3806501 TI - Effect of cold and hot ambient temperatures on plasma progesterone concentrations in ewes with intact and denervated ovaries containing experimentally maintained corpora lutea. AB - Twenty ewes in which maintained corpora lutea had been established were subject to 1 of 3 treatments: denervation of the ovaries by freezing, denervation of the ovaries using the chemical 6-hydroxydopamine, or control. The animals were exposed sequentially to normal (24.5 degrees C), cold (10.7 degrees C), normal (23.8 degrees C), hot (39.4 degrees C) and normal (24.6 degrees C) temperatures, each for 1 week. On the final 3 days of exposure rectal temperatures and heart rates were measured, and on the final day the body weights, respiratory rates, and blood glucose concentrations were measured and a series of 5 blood samples was collected from each ewe for determination of the progesterone concentrations. The progesterone concentration was greatest during the hot period in 8 of the 12 animals, particularly in the ewes with denervated ovaries (6 of the 7 animals). This suggests that high ambient temperatures increase progesterone concentrations non-specifically, and that denervated ovaries are more sensitive to the circulating catecholamines that presumably mediate this effect. The progesterone concentrations were lower (P less than 0.001) in the groups with freezing or chemically denervated ovaries (2.86 and 2.73 ng/ml respectively) than in the control group (3.38 ng/ml), suggesting that the ovarian innervation plays a physiological role in regulating progesterone secretion. PMID- 3806502 TI - Adenylate cyclase activity of the corpus luteum during the oestrous cycle of the pig. AB - Basal adenylate cyclase values for corpora lutea (CL) removed from cyclic gilts on Days 3, 8, 13 and 18 were 178 +/- 61, 450 +/- 46, 220 +/- 25 and 208 +/- 18 pmol cAMP formed/min/mg protein, respectively. Basal activity was significantly elevated on Day 8 (P less than 0.001). LH-stimulatable adenylate cyclase values for CL from Days 3, 8, 13 and 18 were 242 +/- 83, 598 +/- 84, 261 +/- 27 and 205 +/- 17 pmol cAMP formed/min/mg protein respectively. Serum progesterone concentrations of 12 gilts bled every 2 days through one complete oestrous cycle ranged from 1.1 to 26.9 ng/ml with highest values between Days 8 and 12. The decline in serum progesterone concentrations was coincident with the decrease in basal adenylate cyclase activity. There was no LH-stimulatable adenylate cyclase activity present in the CL at the specific times of the oestrous cycle examined. We conclude that progesterone secretion by the pig CL is apparently dependent on basal activity of adenylate cyclase. PMID- 3806503 TI - Germinal vesicle breakdown in oocytes of human atretic follicles during the menstrual cycle. AB - Histological examination was performed on 975 antral follicles (1-12 mm) from 17 large ovarian resections and 79 whole ovaries collected from 63 women with normal ovarian function at different stages during the menstrual cycle. The meiotic stage of the oocyte was examined in relation to the degree of atresia and size of follicles throughout the menstrual cycle. In healthy follicles the oocytes were in the dictyate stage. In atretic follicles 10% of the oocytes exhibited germinal vesicle breakdown (GVBD) and 20% were necrotic. The percentage of GVBD oocytes in atretic follicles was closely related to the degree of follicular atresia and to the follicle diameter. GVBD percentage rose sharply in the periovulatory period although there was no change of mean follicle size or quality during this period. Such a cyclic evolution in GVBD percentages indicates that the removal of inhibition (due to atresia) exerted by the follicle itself on the germinal vesicle is insufficient to induce the resumption of meiosis in the human oocyte; specific induction seems to be necessary, at least to produce complete nuclear maturation. PMID- 3806504 TI - Steroid production and hCG binding by ram-induced ovarian follicles in seasonally anoestrous ewes. AB - The introduction of rams to a group of previously isolated anoestrous ewes has been shown to stimulate ovarian follicular development and ovulation. The present experiment was carried out to determine the ability of follicles arising from this ram stimulus to produce steroids and bind hCG. Seasonally anoestrous Southdown ewes were exposed to rams for 24 h, 40 h, 3 days, 10 days or 20 days before ovariectomy. Steroid production and the concentration of hCG binding sites in follicles dissected from the ovaries were measured in vitro. The presence of a ram caused ovulation and enhanced oestradiol production by follicles, but had little effect on total androgen production or the number of hCG binding sites present in the follicles when compared to follicles from anoestrous ewes. The oestradiol concentrations in large follicles were not as high as in preovulatory follicles from cyclic ewes reported in other studies. Follicles continued to develop through the ram contact period and when incubated after 40 h and 10 days of ram contact produced high levels of progesterone, indicating partial luteinization, although the corpora lutea (CL) resulting from the induced ovulations regressed prematurely. We suggest that the lack of hCG binding sites in ram-induced follicles may be the cause of poor luteinization and suboptimal development of luteal tissue after induced ovulation in ewes during seasonal anoestrus. PMID- 3806505 TI - Seasonal changes in plasma testosterone concentrations and Leydig cell and accessory gland activity in the Cape horseshoe bat (Rhinolophus capensis). AB - Male Cape horseshoe bats were studied in the Cape Province of South Africa (33 degrees 17'S, 26 degrees 25'E) between January 1983 and June 1985. The reproductive cycle is characterized by reactivation of the seminiferous tubules in early summer (October) after a 4-month (June to September) period of winter inactivity. Spermiogenesis occurred between January and April, and spermatozoa were released to the epididymides in April and May. Spermiogenesis was associated with Leydig cell activity and increasing plasma testosterone concentrations. At this time components of the reproductive accessory glands became secretorily active or showed increasing secretory activity. During winter Leydig cells were secretorily inactive and plasma testosterone concentrations dropped, but components of the accessory complex remained active. There was a second period of Leydig cell secretory activity and increasing and peak plasma testosterone values in late winter/early summer which may be associated with copulation or the initiation of a new cycle of spermatogenesis. PMID- 3806506 TI - Fertilization and early embryonic development in androstenedione-immunized Merino ewes. AB - Ewes were immunized against androstenedione (Fecundin) and assigned to be mated 14 days (179 ewes Group C) or 25 days (174 ewes Group B) after a booster immunization with Fecundin. The anti-androstenedione titres at these times were 6790 and 3240 respectively (P less than 0.01). The remaining 169 ewes were untreated controls (Group A). Ewes were mated to entire rams (12 rams to 180 ewes) at their second oestrus after synchronization of oestrus. Immunization against androstenedione caused a shortening of the time from sponge removal to mating (Day 0) and a decrease in the percentage of ewes mated by the rams. Also, ovulation rate was increased after immunization (P less than 0.01), being 1.42, 2.16 and 1.93 for Groups A, C and B respectively. Egg recovery rates on Day 2 were lower in immunized ewes and there was some indication that fertilization rates were lowered. On Day 13 after mating a higher proportion of blastocysts was recovered from ewes in Group A than from those in Groups B and C. Immunization resulted in lower fertilization rates and smaller blastocysts with lower mitotic indexes (P less than 0.01). At Days 24-32 of pregnancy fetal weight was lower in the immunized ewes. At all sampling stages, the proportion of ewes pregnant (fertility) was lowered in immunized ewes. The results of the present study show that significant reproductive wastage occurs in androstenedione-immunized Merino ewes, with lower rates of embryo recovery and delayed embryonic development being found in comparison to controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806507 TI - Frequency of chromosomal abnormalities in embryos from superovulated merino ewes. AB - Chromosomal analysis was carried out on 48 Day 2-7 embryos collected from superovulated Merino ewes. Three embryos had abnormal chromosome complements (1 X 1N, 1 X 1N/2N, 1 X 3N), yielding an incidence of 6.25% abnormal embryos. It is concluded that superovulation does not cause an increase in the incidence of chromosomal abnormalities in embryos of Merino sheep. PMID- 3806508 TI - Polyploid cells in blastocysts and early fetuses from Australian Merino sheep. AB - Cytogenetic examination was made of 103 13-14-day-old blastocysts and 116 24-32 day-old fetuses from untreated and androstenedione-7-HSA-immunized Merino ewes. There were no differences in the chromosome composition of blastocysts or fetuses from treated or untreated ewes and so the data were combined. At Days 13-14 a 1N/2N mosaic and a 2N - 1/2N/4N mosaic embryo were observed. In addition, 52 of the blastocysts were 2N/4N mosaics, with 8 of these also containing 8N cells, and one blastocyst was a 2N/8N mosaic. No aneuploid fetuses were observed, but 80 of the 116 fetuses contained polyploid cells, including 4N, 6N and 8N cells. The polyploid cells observed in the blastocysts and fetuses should not be considered as abnormal cells as they appear to be a normal part of the developmental processes leading to trophoblast formation and fetal differentiation. PMID- 3806509 TI - Ovarian activities of the West African dwarf goat (Capra hircus) during oestrus. AB - Ovarian activity was studied by laparotomy of 9 adult nulliparous goats in which oestrus was synchronized. Ovulation occurred in animals operated on 20-48 h from the onset of sexual receptivity. There was a mean ovulation rate of 1.57 ova per doe and the right and left ovaries had similar follicular activity in relation to sizes of follicles and ovulations. PMID- 3806510 TI - Liquid nitrogen vapour freezing of mouse embryos. AB - Mouse morulae were frozen rapidly to -196 degrees C in the presence of glycerol by a two-step procedure; the embryos were transferred directly from -7 degrees C after seeding into liquid nitrogen vapour at -170 to -180 degrees C and then into liquid nitrogen 10-15 min later. Suitable conditions for the survival of embryos frozen with liquid nitrogen vapour were found to be: 2 M-glycerol, 2 M-propylene glycol, 2 M-ethylene glycol; 5-30 min equilibration time at 0 degrees C; 3-60 min holding time in liquid nitrogen vapour; dilution of glycerol with sucrose out of the frozen-thawed embryos; morula and early blastocyst stage embryos. Relatively high survival rates (69-74%) were obtained after rapid freezing by liquid nitrogen vapour. Morulae frozen in this fashion, cultured and transferred to recipients developed into normal young. PMID- 3806511 TI - Hormonal changes around oestrus of farmed fallow deer, Dama dama. AB - Concentrations of LH, progesterone, oestradiol-17 beta and androstenedione were measured in serum from blood samples collected from 6 fallow does every hour for 46 h during a spontaneous oestrus. Four does had similar serum hormone profiles, with a pronounced preovulatory LH surge (approximately 20 ng/ml) occurring within 4 h of the onset of oestrus, a small elevation (from 0.1 to 0.3 ng/ml) of progesterone at the onset of oestrus, a gradual but non-significant increase (up to 25 pg/ml) of oestradiol-17 beta and a marked 2-fold increase of serum androstenedione concentrations occurring immediately at the onset of oestrus. The remaining 2 does showed pronounced increases in serum progesterone concentrations at the onset of oestrus and a reduction in the initial LH surge. One of these does exhibited a second preovulatory LH surge within the sampling period. PMID- 3806512 TI - The influence of body temperature and castration on the protein composition of fluid in the rat cauda epididymidis. AB - Polyacrylamide gel electrophoresis under reducing and non-reducing conditions, and immunoelectrophoretic analysis, revealed that several characteristic proteins disappear from the luminal fluid of the rat cauda epididymidis when it is maintained at body temperature. On SDS-PAGE gels prepared under reducing conditions, one Coomassie-blue staining band of Mr 18,000 disappeared and another of 52,000 was significantly reduced after only 6 days; bands of Mr 23,000, several in the Mr 34-38,000 range, one of Mr 48,000, and others of Mr 100-200,000 were eliminated or markedly reduced after 15 days at body temperature. Some were glycoprotein, as judged by their affinity for FITC-ConA. At 15 days after castration there was a broadly similar but rather more extensive disappearance of macromolecules, and of glycoproteins in particular, from caudal fluid. The fact that several similar proteins are diminished in or disappear from fluid or the cauda epididymidis maintained at body temperature, or after androgen withdrawal, raises the possibility that one or more such proteins play a role in sperm storage there. PMID- 3806513 TI - Transformation of endometrium and fertility in late stages of pseudopregnancy in the rabbit. AB - Ovulation was induced in rabbits between Days 14 and 18 of pseudopregnancy by an intravenous injection of hCG. Induction of ovulation from Day 16 onwards led to normal progestational endometrial transformation. In rabbits injected on Day 14 or 15, a normal preimplantation endometrial morphology developed, but not earlier than 7 days after hCG (Day 14/15 + 7). Uteroglobin secretion was advanced during the second pseudopregnancy. After mating or artificial insemination, fertility was greatest on Day 18 of pseudopregnancy. Conception failed on Day 14 and embryo transfers were unsuccessful on Day 14 + 1. Transfers performed on Day 14 + 3, however, led to implantation and offspring, even though endometrial morphology did not correspond to the normal Day 3 preimplantational morphology at the time of transfer. We conclude that endometrial transformation typical of normal pseudopregnancy can be induced by ovulation during the regeneration phase of pseudopregnancy from Day 16 onwards; fertilization and implantation can be achieved as early as Day 15 of pseudopregnancy; an oestrous period with high mating activity and fertility occurs about 3 days later; and Day 14 after hCG represents a limited time of functional change from pseudopregnancy to a fertile uterine cycle in the rabbit. PMID- 3806514 TI - Inhibition of androgen and oestrogen production by clomiphene citrate in avian theca cells. AB - Isolated theca cells (2 X 10(5)/ml) were pre-incubated for 1 h in the presence or absence of clomiphene citrate (10(-12)-10(-4) M). Ovine LH (50 ng/ml) was added and cells were incubated for an additional 3 h. A 50% inhibition of LH-stimulated androstenedione and oestrogen production was obtained with doses of 10(-8) M and 2 X 10(-7) M clomiphene, respectively. Furthermore, the effect of clomiphene on LH-stimulated androstenedione production was reversed by washing clomiphene from the cells before stimulation with LH. In subsequent experiments, the effects of clomiphene on C17-20-lyase and aromatase activities were examined. Conversion of [3H]17-hydroxyprogesterone to androstenedione was inhibited by 50% when theca cells were pretreated with 10(-5) M-clomiphene. In addition, conversion of testosterone to oestrogen by theca cells was inhibited in a dose-dependent manner by clomiphene, with 50% inhibition occurring at a dose of 5 X 10(-6) M. The results show that clomiphene treatment in vitro inhibits androgen and oestrogen production in theca cells by inhibitory effects on the activities of C17-20-lyase and aromatase. In addition to the widely-accepted effects of clomiphene on the hypothalamic-pituitary axis, the present findings add further support to the suggestion that clomiphene exerts direct effects on ovarian steroidogenesis. PMID- 3806515 TI - Platelet-activating factor induces the expression of early pregnancy factor activity in female mice. AB - When synthetic platelet-activating factor (PAF, 1-0-alkyl-2-acetyl-sn-glycero-3 phosphocholine) was injected into mature female mice during dioestrus, pro oestrus or oestrus, it induced the expression of early pregnancy factor (EPF) activity in the sera of these animals within 1 h of injection. The sera of similarly injected males, metoestrous or immature females did not display any EPF activity. The results suggest that embryo-derived PAF may be the ovum factor responsible for triggering the generation of serum EPF activity during the preimplantation stages of pregnancy. PMID- 3806516 TI - Variations in patterns of follicle development in prolific breeds of sheep. AB - Prolific breeds of sheep (Romanov, Finn and Booroola Romanov crosses heterozygous for the Booroola gene (F+) were compared with breeds of lower prolificacy (Ile-de France, Finn X Scottish Blackface, Merino X Blackface and Booroola X Romanov not carrying a copy of Booroola gene (++] by in-vivo monitoring of follicular kinetics by ink labelling during the late luteal phase and follicular phase of the oestrous cycle followed by histological examination of the ovaries or follicle dissection. At each of 3 successive laparotomies, the 3 largest follicles of each ovary were measured and ink labelled. At the final laparotomy, around the beginning of oestrus, all ewes were ovariectomized. High ovulation rate was not associated with the total number of antral follicles in any of the breeds. However, there were more follicles greater than 2 mm in diameter in Romanov and Booroola X Romanov crosses (F+) compared to their respective controls. Such a feature was not observed in Finnish Landrace compared to Finn X Blackface and Merino X Blackface ewes. A more numerous population of recruitable follicles, together with a similar incidence of selection through atresia, were the features associated with the high ovulation rate of Romanov compared to Ile de-France ewes. The high ovulatory potential of the Finn ewes resulted from a markedly reduced incidence of selection through atresia. Booroola X Romanov ewes carrying a copy of the Booroola gene (F+) appeared to possess features of both parental breeds, including high numbers of recruitable follicles, smaller follicular size when recruitment occurs and an extended time for recruitment. Booroola X Romanov (++) ewes, not carrying the gene, appeared to have lost part of the 'Romanov characteristics' of a more numerous population of recruitable follicles. The variability in the kinetics of preovulatory enlargement, seen in these breeds of sheep, demonstrates that there are a number of pathways through which high ovulation rate can be achieved and hence through which ovulation rate might be manipulated. PMID- 3806517 TI - Food availability and secondary sex ratio variation in wild and laboratory house mice (Mus musculus). AB - Female house mice deprived of food intermittently for 1 week before mating gave birth to fewer male young, but litters of females deprived of food for 2 weeks did not differ from control litters. Since mean weights of females did not differ between the two treatments, our results suggest that females were initially stressed by food deprivation, but recovered in the second week. PMID- 3806518 TI - Segmental distribution and gestational changes of GABA-transaminase activity in the rat oviduct. AB - The occurrence and the localization of 4-aminobutyrate:2-oxoglutarate transaminase (GABA-transaminase) in the non-pregnant and pregnant rat oviduct were examined using biochemical and enzyme histochemical techniques. Specific GABA-transaminase activity was detected in the ampullary and isthmic portions of the oviduct as well as in the utero-tubal junction. The enzymic activity was lower in the ampullary than in the isthmic or intramural segments of the oviduct. Pregnancy induced a significant increase of GABA-transaminase activity in each portion of the oviduct. Enzyme histochemistry showed the highest GABA transaminase reactivity at the level of the epithelial cells of the oviduct irrespective of the portion of the tube examined. A faint specific activity was demonstrated in the smooth muscle of the oviduct while the serosa did not show specific staining. Our findings indicate that: the observed increase of GABA transaminase activity in the oviduct of the pregnant rat may be responsible for the reduced GABA levels in the oviduct during gestation; and the extraneuronal localization of GABA-transaminase activity does not seem to support the suggestion of a possible GABAergic innervation of the oviduct. PMID- 3806519 TI - Changes in the organization of surface antigens during in-vitro capacitation of boar spermatozoa as detected by monoclonal antibodies. AB - Monoclonal antibodies specific for three major plasma membrane (PM) proteins, previously referenced as PM protein 2.0, 4.85 and 5.0, and one specific for an unreferenced PM protein (Mr 80,000) were used with indirect fluorescence microscopy to detect the effects of capacitation on the localization of these PM proteins. In ejaculated or cauda spermatozoa, incubation in the capacitating medium caused the appearance of fluorescence in the flagellum and either a loss of fluorescence on the PM overlying the sperm head (PM proteins of 5.0 and Mr 80,000) or a delocalization of fluorescence on the head PM (PM proteins 2.0 and 4.85). Labelling spermatozoa with divalent antibody and then capacitating them indicated the PM protein 5.0 and that of Mr 80,000 migrated out of the head plasma membrane into the flagellar PM during capacitation. These antigens re entered the head PM when fresh seminal plasma was added after the capacitation period or when energy metabolism was inhibited by azide. Cytochalasin D, an inhibitor of the polymerization of actin, prevented movement of PM protein 5.0 and that of Mr 80,000 of the head PM into the flagellum during incubation in the capacitation medium and prevented re-entry of these antigens from the flagellum into the head PM after incubation in this medium. Localization changes occurring with capacitation were time-dependent but independent of the method of preparing samples for microscopy. For the major PM proteins 4.85 and 5.0, a much smaller percentage of caput spermatozoa (approximately 20%) showed specific localization changes compared to those of the cauda (approximately 80%). Chelation of Ca2+ inhibited these changes in ejaculated spermatozoa and fresh seminal plasma, added to capacitated spermatozoa, restored the localization pattern characteristic of uncapacitated spermatozoa. These observations suggest that the organization of major proteins in the plasma membrane overlying the sperm head is altered during capacitation. These changes are reversible, are dependent on sperm maturation and also appear to involve actin filament interactions with the plasma membrane. PMID- 3806520 TI - Ultrastructure of in-vitro oocyte maturation in cattle. AB - Cumulus-oocyte complexes were collected from cows at an abattoir by aspiration from small (1-6 mm) antral follicles. After different periods of culture the complexes were processed for electron microscopy. Cumulus expansion occurred at 12-18 h of culture and concomitantly enlargement of cumulus cell projections in the perivitelline space was seen. At 48 h the innermost cumulus cells flattened and adhered tightly to the zona pellucida. In the oocyte the following changes occurred: at 0-3 h of culture the perivitelline space developed; at 3-12 h disconnection of the junctions between cumulus cell projections and the oolemma, and the concomitant breakdown of the nucleus was observed; at 12-18 h the mitochondria moved from a peripheral location to a more even spatial distribution and the Golgi complexes decreased in size; at approximately 18 h the smooth endoplasmic reticulum formed large aggregates surrounded by mitochondria; at 18 21 h the first polar body was abstricted; at 24-40 h the cortical granules spread; at 30-40 h the polar body degenerated in some specimens; at 40-48 h the perivitelline space decreased in size; and at 48 h one oocyte was in the process of fragmentation. It is concluded that nuclear and cytoplasmic oocyte maturation is simulated in vitro. However, certain deviations were noticed compared to in vivo maturation. PMID- 3806521 TI - Chromosomal analysis of unfertilized human oocytes. AB - Unfertilized human oocytes were obtained from women in an in-vitro fertilization programme. The women had a mean age of 29.4 years (range 24-35 years). Chromosomal complements could be analysed in 50 oocytes. Q-banding of the chromosomes facilitated identification of individual chromosomes: 34 oocytes (68%) had the normal haploid chromosomal complement, 14 complements were hypohaploid (28%), 1 complement was hyperhaploid (2%) and 2 had structural abnormalities (4%). (One oocyte had numerical and structural abnormalities). The 16 abnormal oocytes were obtained from 15 different women. A conservative estimate of aneuploidy in this sample is 4%; however, the frequency of aneuploidy may be higher if there is a predisposition to chromosome loss during oogenesis. This study provides information on the largest series of karyotyped unfertilized human oocytes published to date. PMID- 3806522 TI - Cycloheximide inhibition of ovulation, prostaglandin biosynthesis and steroidogenesis in rabbit ovarian follicles. AB - Cycloheximide (5 mg/kg, i.v.) significantly inhibited ovulation in the rabbit when it was administered as early as 20 h before the ovulation process was initiated by hCG, and as late as 1 h after hCG. The ovulation rate was significantly reduced, but follicular biosynthesis of prostaglandins E and F was only partly inhibited. The biosynthesis of progesterone and oestradiol in follicles during the early stages of the ovulation process was also inhibited. Cycloheximide may therefore inhibit ovulation by a mechanism which is different from the action of indomethacin, and this mechanism may involve the suppression of ovarian steroidogenesis. PMID- 3806523 TI - Role of equilibration before rapid freezing of mouse embryos. AB - The time requirements for permeation by glycerol and dehydration by sucrose before rapid freezing of Day-3 mouse embryos by direct transfer to -180 degrees C were studied. When the embryos were equilibrated in 2.0, 3.0, or 4.0 M-glycerol + 0.25 M-sucrose for 2.5 to 40 min, the post-thaw viability increased (P less than 0.001) with the length of equilibration period at 4 degrees C. At 20 degrees C the volume of embryos increased with the duration of equilibration up to 20 min (P less than 0.001), but the post-thaw viability was not affected. The effect of equilibration in glycerol-sucrose was determined at 20 degrees C for embryos which were previously permeated by glycerol, dehydrated by sucrose or left in PBS + 5% FCS. The survival of previously permeated embryos was not affected by equilibration for 1-16 min in glycerol-sucrose. The maximum survival rate was attained after shorter equilibration in glycerol-sucrose for embryos without pretreatment (4 min) than for those previously dehydrated (8 min). It is concluded that increases in the intracellular glycerol level are beneficial for the viability of rapidly frozen mouse embryos and previous or concomitant exposure to sucrose unfavourably affects glycerol permeation. PMID- 3806524 TI - Melatonin directly stimulates the secretion of progesterone by human and bovine granulosa cells in vitro. AB - Melatonin, at concentrations and periods of exposure reflecting those present during the circadian cycle, was investigated for its influence on steroid production by granulosa cells cultured in serum-supplemented medium. At high (200 pg/ml) but not low (20 pg/ml) physiological concentrations, melatonin significantly stimulated progesterone production by human granulosa cells. This response was independent of the overall level of cell activity and was seen under the different culture conditions associated with different culture media. Exposure to melatonin for 8 h significantly stimulated progesterone secretion to a level similar to that achieved under continuous exposure, and the effect was reduced to control levels during subsequent periods in which no melatonin was added. Melatonin had no consistent effect on aromatase activity in the conversion of stored or serum-available androgen to oestradiol. Melatonin significantly stimulated progesterone production by bovine granulosa cells in vitro, at concentrations similar to those present during the endogenous nocturnal rise (100 400 pg/ml). This response to physiological conditions by human and bovine cells suggests a role for melatonin in the regulation of progesterone production by the ovary. PMID- 3806525 TI - Dissociated centriole development as a cause of spermatid malformation in man. AB - Ultrastructural study of a testicular biopsy from an infertile man with decapitated spermatozoa revealed a hitherto undescribed type of malformation. It was caused by a dissociation between the proximal and distal centrioles during the first steps of spermatid differentiation. The disconnection probably occurred because of the lack of striated columns in the connecting piece. Up to 40% of the separately developed and released tails showed a normal motility in the ejaculate. PMID- 3806526 TI - Reduction of fertility in female rabbits and mice actively immunized with a germ cell antigen (GA-1) from the rabbit. AB - Female rabbits and mice were actively immunized against germ cell antigen (GA-1) of 63 kDa molecular mass isolated from rabbit sperm and testis. There was a significant (P less than 0.05) reduction of fertility in rabbits actively immunized with GA-1 as compared to controls, as seen by the percentage of 9-day implants/corpora lutea ratio (GA-1, 36.3%; controls, 85.7%). In mice, there was again a significant (P less than 0.01) reduction in fertility as seen by mean 7-9 day implants +/- S.D. per mated mouse actively immunized with GA-1 whether through the intraperitoneal route (GA-1, 1.2 +/- 1.6; controls, 8.0 +/- 3.4) or through the subcutaneous/intramuscular route (GA-1, 3.8 +/- 3.4; controls, 10.1 +/- 3.9). The antisera from these actively immunized animals were negative for sperm agglutinating and immobilizing antibodies. In the Western blot enzyme immunobinding procedure, the antisera showed specific binding to a single protein of 63 kDa. The incidence of fertilization of eggs recovered from rabbits inseminated with anti-GA-1 antibodies-treated sperm was not significantly different from control rabbits. The percentage of fertilized eggs obtained from rabbits inseminated with anti-GA-1 antibodies-treated sperm that reached the blastocyst stage upon in vitro incubation, however, was significantly less than that for embryos obtained from rabbits inseminated with control serum-treated sperm. Incubation of normal fertilized eggs in vitro with the antibodies did not affect development. Neither antiserum nor immune uterine fluid reacted with 4-day blastocysts in the indirect immunofluorescence technique. It is concluded that active immunization with GA-1 results in post-fertilization reduction of fertility in rabbits and mice by inhibiting early embryonic development. PMID- 3806527 TI - Assessment of immune responses to H-Y antigen in naturally inseminated and sperm injected mice using cell-mediated cytotoxicity assays. AB - An in vitro cell-mediated cytotoxicity assay has been used to assess immunity to the male-specific H-Y antigen in female mice after either insemination with male cells at syngeneic natural mating or after injection with syngeneic sperm cell suspensions. Lymphocytes showing specific cytotoxicity for the H-Y antigen could be recovered from both spleen and lymph nodes of female mice injected with sperm. However, insemination of male cells at natural mating did not apparently prime cytotoxic cells against the H-Y antigen in either the spleen or para-aortic lymph nodes draining the uterus of female mice mated once or repeatedly (3-10 X) in the absence of pregnancy. These results are discussed in relation to the factors regulating the immune responsiveness of the female to inseminated antigens. PMID- 3806528 TI - Natural killer cell activity and antibody dependent cell-mediated cytotoxicity in preeclampsia. AB - Natural killer cell activity and antibody dependent cell-mediated cytotoxicity (NK and ADCC) of peripheral blood lymphocytes were measured against K-562 and antibody coated HSB target cells with a 4-h chromium release assay in 19 primigravidas with preeclampsia. Nineteen primigravidas with an uncomplicated pregnancy and 19 nonpregnant women served as controls. Lymphocyte NK and ADCC activities are significantly lower in primigravidas than in nonpregnant women. Primigravidas with preeclampsia have similar cell-mediated cytotoxic activities to primigravidas with an uncomplicated pregnancy. These findings support the hypothesis that maternal acceptance of the fetal-allograft is due to suppression of cell-mediated cytotoxicity. Altered cellular cytotoxicity appears unlikely as a cause of preeclampsia. Our results, however, do not preclude local changes in cellular immune activities that may occur at the implantation site. PMID- 3806529 TI - Immunological relationships between murine surrogate mothers and transplanted embryos, as studied by local GVH reactivity. AB - C57BL/Ks (H-2d) female mice were transplanted with early (stage 2) embryos of the A/J (H-2a) strain. Spleens from mice exhibiting successful pregnancies were tested at days 16 to 19 of gestation in a local graft versus host (LGVH) assay using (C57BL/Ks X A/J)F1 recipients and proved to be significantly more reactive than virgin controls or mice carrying transplanted syngeneic fetuses. This increased reactivity was specific for the transplanted embryo's strain. Other controls included donors with semi-allogeneic (F1) transplanted fetuses and females naturally pregnant by allogeneic males which did not give reactions significantly different from virgin control spleen cells. Para-aortic lymph node cells (PALN) obtained from the same A/J embryo-transplanted females showed a strong T suppressive activity both on their own spleen cell (SC) reaction as well as on the reaction obtained with virgin SC. This suppressive activity also appeared to be embryo-strain specific. Serological tests revealed the presence of mast cell-degranulating (anaphylactic) antibodies but not of hemagglutinating or complement-fixing cytotoxic activities. The A/J offspring obtained after embryo transfer to C57BL/Ks females presented at the age of two months significantly lower LGVH reactivity against the surrogate mother's strain. The differences in the responsiveness of the mice transplanted with allogeneic embryos compared with those with conventional pregnancies are discussed. PMID- 3806530 TI - Isolation and partial characterization of early pregnancy factor (EPF) from human pregnancy serum. AB - The isolation and partial characterization of an immunosuppressive early pregnancy factor (EPF) present in the serum of pregnant women, between 3 and 8 weeks of gestation, is described. EPF was purified using ion-exchange chromatography, affinity chromatography and HPLC gel permeation techniques. A homogeneous, active fraction containing a single polypeptide of Mr 21,000 was obtained. This 21 kDa polypeptide appears to represent the major form of rosette inhibiting active material present in maternal serum during early human gestation. PMID- 3806531 TI - Presterilization counseling and women's regret about having been sterilized. AB - A study was designed to assess satisfaction with presterilization counseling, contentment with being sterilized and the effect of variables, such as age, number of children at the time of surgery and ethnic background, on the level of contentment with being sterilized. A total of 1,716 questionnaires were distributed at various hospitals and clinics. Questionnaires were collected from 492 women, who had ranged from 17 to 46 years of age at the time of sterilization. The majority of the women were married, and their average number of children was two. Of 487 women who replied, 30% did not receive any presterilization counseling from a physician; 15% of 480 women received their counseling from a nurse. Of 487 women, 2% fully regretted their sterilization, and the majority of them wanted more children. A positive correlation was found between the degree of satisfaction with presterilization counseling and the level of contentment with being sterilized. It was also found that 6 of the 53 women who were under 25 years of age at the time of surgery fully regretted their sterilization. The ethnic backgrounds of the women and their number of children at the time of surgery had no significant effect on their contentment with sterilization. PMID- 3806532 TI - Management of the third stage of labor with nipple stimulation. AB - Nipple stimulation was found to be a safe alternative to oxytocin in the management of the third stage of labor. PMID- 3806533 TI - Adnexal surgery in pregnancy. AB - Adnexal pathology is a rare event in pregnancy, occurring once in 556 deliveries in this study period, during which 23 patients underwent surgery for it. Eleven patients in the first two trimesters received perioperative prophylactic progesterone without a pregnancy loss. Two of three patients beyond 20 weeks required tocolytic therapy for apparent premature labor. Dermoid cysts and torsion of a corpus luteum cyst were the most common pathologic findings. The type of incision employed was based on uterine size and expected location of the adnexal pathology. It appears that the risk to the pregnant patient undergoing adnexal surgery can be minimized with judicious timing of the operation, preoperative incision planning and modern anesthetic techniques. The use of prophylactic progesterone is unproven, and further studies of this therapeutic modality should be undertaken. PMID- 3806534 TI - Ethical considerations in the management of infertility. AB - Ethical issues arising in the day-to-day practice of infertility treatment are important and sometimes difficult. A couple's infertility problem usually has affective and social dimensions, sometimes disrupting their lives. Responsible care involves dealing with these psychosocial factors, including counseling and striving for informed patient decision making. The ethical problem of whether to provide treatment when the probability of success is low is sometimes complicated by a couple's desperate desire for fertility. In such cases the physician weighs various factors, including the risks of the procedure, the harm that might result from continuing infertility and the degree of the couple's understanding of the pros and cons. Issues of truth telling are raised by a lack of third-party reimbursement for infertility workup and treatment. Also, questions about when to refer or terminate the workup and therapy involve ethical reflection about potential conflicts of interest. PMID- 3806535 TI - Genital injury and implied consent to alleged rape. AB - A review of 440 cases of reported rape was undertaken to see if sustaining injury to the genital area was an inevitable consequence of being raped. Injuries to areas other than the genital were taken as objective evidence that the victim did not consent to the encounter, while sperm found in her vagina that could not be accounted for by voluntary coitus was taken as objective evidence that penile penetration of the vagina had occurred. Of the 75 victims with objective evidence of both noncompliance and vaginal penetration, 28% sustained genital injury. The absence of genital injury does not imply consent by the victim or the absence of vaginal penetration by the assailant. PMID- 3806536 TI - Placenta percreta as a cause of uterine perforation during abortion. A case report. AB - Uterine perforation occurred during abortion in a patient with placenta percreta. The predisposing factor in the invasive placenta in this case was a uterine scar from a cesarean section. PMID- 3806537 TI - Halley's Comet and others: the bacterial star shells. PMID- 3806538 TI - Psychopaths and their treatment. PMID- 3806539 TI - Achalasia: dilatation or operation? PMID- 3806540 TI - Orthopaedic manholes and rabbit holes: some thoughts on medical negligence. PMID- 3806541 TI - Audit of surgical and pneumatic/hydrostatic treatment of achalasia in a defined population. AB - A retrospective survey was made of all the patients resident in the Nottingham area who presented with achalasia between 1959 and 1983. Initial treatment consisted of pneumatic bag dilatation in 26, hydrostatic bag dilatation in one and surgical cardiomyotomy in 22. Those treated by dilatation were older (mean age 52 years) than those treated by cardiomyotomy (mean age 42 years). Seven patients died without receiving active treatment because of old age and infirmity and in 6 this occurred before the introduction of endoscopic dilatation to the area. Initial treatment by cardiomyotomy was associated with a lower recurrence rate than treatment by bag dilatation but with a longer stay in hospital and a higher incidence of complications including empyema, chest infections and oesophageal stricture. PMID- 3806542 TI - Symptomatic and incidental mammary duct ectasia. AB - The histology obtained from 1256 female patients undergoing breast surgery was reviewed. Mammary duct ectasia was noted in 51 (4.2%) patients who had associated symptoms and in 103 (8.1%) patients where duct ectasia was recognized as an incidental finding. The syndrome is defined by primary (nipple change or sepsis) and secondary (pain and lump) symptoms. Formal duct excision gives good results for symptomatic duct ectasia. It is postulated that many women have nonsymptomatic mammary duct ectasia. Secondary infection gives rise to nipple change, lump and pain. In the severe form abscess and fistula formation occurs which necessitates repeated surgical treatment, and rarely mastectomy. PMID- 3806543 TI - Emotional distress in terminal cancer: discussion paper. PMID- 3806544 TI - Sociotherapy and psychotherapy in the treatment of personality disorder: discussion paper. PMID- 3806545 TI - Child psychiatric/paediatric liaison: discussion paper. PMID- 3806546 TI - Not the James Mackenzie lecture--a concept of disease to educate the new type of doctor: discussion paper. PMID- 3806547 TI - Renal arteriovenous malformation demonstrated angiographically in hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease). PMID- 3806548 TI - Pasturella multocida meningitis in a dog lover (or don't kiss pets!). PMID- 3806549 TI - Poverty and human development. PMID- 3806550 TI - Pathogenesis of Alzheimer's disease. PMID- 3806551 TI - Effects of human feeding habits on domestic animals. PMID- 3806552 TI - Cysts of the seminal vesicle. PMID- 3806553 TI - Technology transfer. PMID- 3806554 TI - South African Veterinary Association policy statement on laboratory animals. PMID- 3806555 TI - Traumatic avulsion of the proximal femoral articular cartilage as a cause of hip dislocation in broiler chickens. AB - Review of the normal anatomy of the coxofemoral joint in broiler chickens aged seven weeks and comparison with cases of so-called "hip-dislocation" revealed that the lesion is essentially an avulsion of the articular cartilage of the femoral head, traumatically caused by the manner of catching and handling of birds. No direct relationship to dyschondroplasia (osteochondrosis) was established. PMID- 3806556 TI - Pathogenesis of subclinical bovine mastitis: a comparison of the dynamic balances of various subclinical udder health states monitored by means of single-, double- and triple-parameter laboratory techniques. AB - This comparison of results from parallel investigations, conducted on the small herd model already discussed, has made it abundantly clear that during lactation, udder health as such depends on the 3 major determinants of intramammary epithelial integrity, somatic cellular defence and bacterial challenge. Different subclinical health states and related dynamic fluctuations indicate that each of these conditions and changes depends on the type of major determinant of udder health as well as on the nature and magnitude of factors challenging that determinant, either singly or in combination with another of the main determinants. Because of the involvement of 3 important determinants, diagnostic techniques must of necessity facilitate the concurrent monitoring of each of the determinants and the integrated interpretation of results generated. Such an approach to investigations into subclinical mastitis is not feasible by means of either single- or double-parameter techniques. In contrast, triple-parameter determinations capable of monitoring each of the 3 major determinants of udder health and performed during this investigation by means of the IDF/BSA (International Dairy Federation/bovine serum albumin) criteria, clearly have facilitated the interpretation of results at unprecedented levels of diagnostic differentiations. In the light of this clearer insight into a comparatively extensive range of udder health states at the subclinical level and corresponding dynamic balances and pathogenetic developments, it is apparent that appropriately designed and standardized triple-parameter techniques of high diagnostic sensitivity and reliability, would make the diagnosis of udder health states far more specific, and the control and prevention of subclinical mastitis far more cost-effective, than generally thought possible under present conditions. Further progress in research and practical work on subclinical mastitis may well depend on efficient triple-parameter techniques for determinations on persisting, deteriorating and improving states of bovine udder health. PMID- 3806557 TI - [The role of the veterinarian at the loss of a companion animal]. AB - The loss of a companion animal can be of intense importance to the owner of such an animal. The attitude of the veterinarian who often finds himself in the centre of the emotions experienced by the owner therefore becomes critical. His respectful and responsible handling of the animal, his empathy with the owner, and the realisation of his own sensitive position, are discussed. The veterinarian is led along practical guidelines to expand his professional role and enhance his image as caregiver. PMID- 3806558 TI - The influence of high level feeding on the duration of parturition and the incidence of dystocia in dairy cows. AB - Dairy cows on high and controlled feed levels were observed to determine the duration of the parturition process and the incidence of dystocia. Maternal and foetal mass ratio at calving were recorded. The duration of parturition in cows on high level feeding was significantly prolonged to 5.2 +/- 2.8 hours as compared to 1.34 +/- 0.89 hours in cows on controlled feeding. The incidence of dystocia was significantly higher in over-fed cows. While maternal mass on high level feeding increased by 27.3%, foetal mass increased by only 5.4%. PMID- 3806559 TI - [The significance of the symmetry of the ridge pattern of the hard palate in dogs]. AB - In order to find a parameter that could be used to differentiate between a pedigreed dog and a mongrel the symmetry of the hard palate ridge pattern was examined in 239 pedigreed dogs representing 30 breeds and 334 mongrels. A symmetrical pattern was found in 148 pedigreed dogs and in 15 mongrels. This difference according to the Chi-square test is very highly significant. Thus the symmetry of the pattern is a valuable parameter to be used to distinguish between pedigreed dogs and mongrels. PMID- 3806560 TI - Pathology of canine lentiginosis profusa. AB - Lentiginosis profusa was diagnosed in 3 pedigree Pugs namely two unrelated parents and their female offspring. Macroscopically the lentigines appeared as black macules up to 10 mm in diameter and occurred especially in the skin of the ventral parts of the body. Skin biopsies revealed localised acanthosis and hyperkeratosis with prominent rete ridges and epidermal hyperpigmentation in the absence of any other significant dermal pathology. PMID- 3806561 TI - Dourine in Southern Africa 1981-1984: serological findings from the Veterinary Research Institute, Onderstepoort. AB - The distribution of positive dourine cases found on the complement fixation test at the Veterinary Research Institute, Onderstepoort from 1981 to 1984, is recorded. Within the Republic of South Africa, foci of infection occurred in the Johannesburg, Pretoria, Potchefstroom, Rustenburg, Upington, Lichtenburg, Kroonstad, Louis Trichardt, Middelburg (Cape) and Mossel Bay state veterinary districts. In Bophuthatswana, Transkei, Lesotho, South West Africa and Swaziland, positive cases were also recorded. Anti-complementary activity of horse sera does not present a problem. In donkey and mule sera, however, sera show anticomplementary activity in approximately 50% of cases. This can be reduced by diluting the sera 1/2 before inactivating at 63 degrees C for 1 h. PMID- 3806562 TI - Osteomalacia in young captive crocodiles (Crocodylus niloticus). AB - The clinical signs of osteomalacia in year old crocodiles were kyphoscoliosis, "glassy teath", "rubber jaws" and extreme weakness. Treatment with high oral doses of calcium led to slow improvement. After six months the surviving animal could walk again, but the vertebral column remained deformed after two years. PMID- 3806563 TI - Veterinary education and research in South Africa. PMID- 3806564 TI - Split palate in a litter of pups. PMID- 3806565 TI - 9-(2-Fluorobenzyl)-6-(methylamino)-9H-purine hydrochloride. Synthesis and anticonvulsant activity. PMID- 3806566 TI - Novel 1,3-bis(aryloxy)propanes as leukotriene D4 antagonists. AB - The synthesis and structure-activity relationships of a number of 1,3 bis(aryloxy)propanes, which are in vivo antagonists of LTD4 in the guinea pig, are described. One of these compounds, 4 (Wy-44,329), was not only approximately equipotent with the standard 1 (FPL 55712) in the LTC4 (ID50 = 0.17 and 0.23 mg/kg iv, respectively) and LTD4 (ID50 = 0.11 and 0.15 mg/kg iv, respectively) challenge models but also possessed greater potency in the ovalbumin challenge model (ID50 = 0.47 mg/kg and 4.1 mg/kg iv, respectively) and a longer duration of action. This compound was a competitive LTD4 antagonist on guinea pig ileum (pA2 = 9.4) and possessed mediator release (rat PCA, ID50 = 0.26 mg/kg iv) and 5 lipoxygenase (IC50 = 32 microM vs. 5-HETE) inhibitory activities. PMID- 3806567 TI - New antiarrhythmic agents. 2,2,5,5-Tetramethyl-3-pyrroline-3-carboxamides and 2,2,5,5-tetramethylpyrrolidine-3-carboxamindes. AB - N-(omega-Aminoalkyl)-2,2,5,5-tetramethyl-3-pyrroline- or -pyrrolidine-3 carboxamides were acylated on the primary amino group of the side chain by means of reactive acid derivatives (acid chlorides, activated esters, phthalic anhydrides, phthalimide, 2-alkyl-4H-3,1-benzoxazin-4-ones) or they were alkylated by forming the Schiff bases and subsequent sodium borohydride reduction. Other tetramethyl-3-pyrrolinecarboxamide compounds were synthesized by acylating the aminoalkyl compounds with 2,2,6,6-tetramethyl-3,5-dibromo-4-piperidinone in a reaction involving Favorskii rearrangement. Saturation of the double bond of some pyrroline derivatives furnished the pyrrolidinecarboxamides. The new compounds of each type were active against aconitine-induced arrhythmia and several of them had higher activity and better chemotherapeutic index than quinidine. A few selected examples from each type of the active new compounds showed strong activity against ouabain-induced arrhythmia; for comparison known drugs such as lidocaine, mexiletine, and tocainide were selected. The most potent compounds were oxidized to the paramagnetic nitroxides and the latter were reduced to the N hydroxy derivatives; these products had no or only decreased antiarrhythmic effect. PMID- 3806568 TI - Structure-activity study of 6-substituted 2-pyranones as inactivators of alpha chymotrypsin. AB - A series of 2-pyranones, bearing halogens or electron-withdrawing groups at the 6 position and alkyl, aryl, or aralkyl groups at positions 3, 4, and 5, were synthesized to investigate their binding to and inactivation of chymotrypsin. Both binding and inactivation by 2-pyranones are sensitive to substitutions on positions 3, 4, 5, and 6. Binding was poorest with alkyl substituents on position 3 and best with phenyl substitution, with benzyl or benzyl-like substitution falling in between. The sequence of binding of 6-substituted pyrones is Cl greater than Br greater than H greater than CF3. 6-Chloro-2-pyranones bearing 4 phenyl or 3-(2-naphthylmethyl) substituents effected rapid inactivation of chymotrypsin, while those having 3-benzyl or 3-(1-naphthylmethyl) substituents gave slow inactivation and those with 3-phenyl or 3-alkyl substituents gave no inactivation. Only the 6-halopyrones demonstrated inactivation, with chloro substituted ones acting faster than bromo-substituted ones. PMID- 3806569 TI - Synthesis and pharmacological evaluation of some new tetrahydroisoquinoline derivatives inhibiting dopamine uptake and/or possessing a dopaminomimetic property. AB - As shown by structure-activity relationship studies in 8-(substituted-amino)-4 aryl-2-methyl-1,2,3,4-tetrahydroisoquinolines, the most important structural requirement for a marked antidepressant action is the presence of an ureido, (alkoxycarbonyl)amino, or [(alkylamino)acyl]amino group attached to the isoquinoline skeleton in position 8. In one of the biological tests a significant difference was found between 8-amino-4-phenyl-2-methyl-1,2,3,4 tetrahydroisoquinoline (nomifensine) and the new compounds synthesized. Nearly all compounds substituted in the amino group either decrease the spontaneous motility in mice or exert no effect on it. Two syntheses have been elaborated for the preparation of the compounds represented by the general formulas II-V where R1 = hydrogen, halogen, or methyl; Y = CONHR, OCOR, or CO(CH2)nNHR, in which R = alkyl or aralkyl or NHR = cyclic amine and n = 1-2. The syntheses start either from the corresponding 8-amino-4-aryl-2-methyl-1,2,3,4-tetrahydroisoquinolines or from the corresponding noncyclized amino alcohols. Of the compounds, 4-(p chlorophenyl)-8-[(ethoxy-carbonyl)amino]-2-methyl-1,2,3,4- tetrahydroisoquinoline was found to possess the highest activity. PMID- 3806570 TI - Synthesis and antitumor activity of tropolone derivatives. 3. AB - As part of a study on the antitumor activities of tropolone derivatives prepared from hinokitiol, which naturally occurs in the plants of Chamaecyparis species, effects of aromatic substituents of alpha,alpha-bis(7-hydroxy-5-isopropyltropon-2 yl)toluenes on the activity were examined. Several of the compounds showed high potency in the P388 leukemia assay. 4-Hydroxy analogue 4d showed the most potent activity (T/C = 195%) at a 5 mg/kg dose. The introduction of large-size substituents, of which the steric influence prevents coplanarity of the substituted aromatic function, resulted in a remarkable decrease in the potency. X-ray structural analysis of highly potent 4-methoxy analogue 4b was undertaken. PMID- 3806571 TI - 7-Deoxydaunomycinone quinone methide reactivity with thiol nucleophiles. AB - Under anaerobic conditions and with NADPH as a reducing agent, daunomycin is reduced in the presence of spinach ferredoxin: NADP+ oxidoreductase as the enzyme catalyst to its hydroquinone, from which intramolecular elimination of the C-7 glycoside proceeds to provide a quinone methide intermediate. This quinone methide is capable of bimolecular reaction with the thiolate nucleophiles N acetyl-L-cysteine, N-(tert-butoxycarbonyl)-L-cysteine, and 1-thio-beta-D-glucose, providing a pair of C-7 diastereomers, when the reaction is carried out under the autocatalytic conditions offered by substoichiometric quantities of NADPH. With 0.4 equiv of NADPH, optimal yields of the adducts are obtained of approximately 65%. In each case, the 7S adduct is the major product, with the observed stereoselectivities (7S to 7R) ranging from 2.6 to 1 for N-acetyl-L-cysteine to 4 to 1 for both the N-(tert-butoxycarbonyl)-L-cysteine and 1-thio-beta-D-glucose as nucleophiles. By standard blocking and deblocking procedures, the complete set of complementary functionalized (7S)- and (7R)-N-acetyl and O-methyl 7-L-cysteinyl-7 deoxydaunomycinones is prepared. All efforts to extend this quinone methide trapping reaction to additional nucleophiles (such as I- or N3-), including the use of Fe(III) chelation, are unsuccessful. The Fe(III) chelate of daunomycin is however reduced by ferredoxin reductase and NADPH to the Fe(III) chelate of 7 deoxydaunomycinone, suggesting that quinone reduction of the chelate to the quinone methide has occurred. Of the new compounds prepared, only (7R)-7-S-(beta D-glucopyranosyl)-7-thio-7-deoxydaunomycinone has biological activity. As an in vitro inhibitor of P388 cell growth, it has a 50% inhibitory concentration 25 times greater than that of daunomycin. PMID- 3806572 TI - New cyanomorpholinyl byproduct of doxorubicin reductive alkylation. AB - Previously we reported that reductive alkylation of doxorubicin with 2,2' oxybis[acetaldehyde] and NaBH3CN to form the 4''-morpholinyl derivative also gave the intensely potent 3''-cyano-4''-morpholinyl as a byproduct, by addition of CN- to an iminium intermediate in place of hydride. We now find that sugar 4'-OH is a third nucleophile that can add to the iminium intermediate in this reaction. Bridging of the 4'-OH to the morpholine ring at C.5'' formed a novel byproduct with an oxazolidino ring fused to the sugar and morpholine. The new product was minor at neutral pH but predominant at an acidic pH. When tested against tumors in mice it was 4-6 times more potent than doxorubicin. Hence, in comparison with the 3''-cyano-4''-morpholinyl, potency was reduced up to 100-fold by the O bridge. Analytical HPLC showed the presence of three of the four possible diastereoisomers, and two were isolated. The diastereoisomers appeared to differ in stability. In vitro tests suggested that biological potency varied inversely with stability. PMID- 3806573 TI - Esters and lactones of phenolic amino carboxylic acids: prodrugs for iron chelation. AB - The new iron chelator N,N'-bis(2-hydroxyphenyl)ethylenediamine-N,N'-diacetic acid (1), its dilactone 2, N,N'-bis(2-hydroxybenzyl)-2-hydroxypropylene-1,3-diamine N,N'- diacetic acid (3), and its methyl ester lactone 4 and a series of esters of N,N'-bis(2-hydroxybenzyl)ethylenediamine-N,N'-diacetic acid (5) were prepared and their iron chelating efficacy and toxicity determined by using the hypertransfused mouse model of iron overload. The biological activities were compared with results obtained with use of the hypertransfused rat. Esterification enhanced the oral iron chelating activity but also increased toxicity. The diisopropyl ester of 5 exhibited the highest therapeutic index. In vitro measurements showed that the rate of ester hydrolysis at pH 7.5 increased by a factor of 10(4) in the presence of 5 X 10(-4) M ferric ion, which may account for the utility of esters and lactones as prodrugs. Seventeen other chelating agents were screened but showed no intraperitoneal or oral activity. PMID- 3806574 TI - In the search for new anticancer drugs. 17. Linear and cyclic polyether analogues of N,N:N',N':N'',N''-tri-1,2-ethanediylphosphoric triamide and N,N:N',N':N'',N'' tri-1,2-ethanediylphosphorothioic triamide. AB - Linear and cyclic polyether derivatives of N,N:N',N':N'',N''-tri-1, 2 ethanediylphosphoric triamide (TEPA) and N,N:N',N':N'',N''-tri-1,2 ethanediylphosphorothioic triamide (thio-TEPA) are synthesized and evaluated for their antineoplastic activity against the murine lymphocytic leukemia P388. All compounds, except for 7d, were active ranging from 42% to 287% increase in life span (% ILS). All CD2F1 male mice treated with the most active compound (7a) at 90 mg/kg per day for 9 days were alive after 30 days, whereas all mice treated with the clinical drug thio-TEPA were dead. The % ILS for compound 7a on day 60 was 525. A correlation is presented between the structural features of compounds and their lipophilicities and antineoplastic activities. PMID- 3806575 TI - Adriamycin analogues. Preparation and biological evaluation of some thio ester analogues of adriamycin and N-(trifluoroacetyl)adriamycin 14-valerate. AB - On the consideration that the highly active DNA-nonbinding adriamycin analogues N (trifluoroacetyl)adriamycin 14-valerate and N-(trifluoroacetyl)adriamycin 14-O hemiadipate undergo initial metabolic conversion to N-(trifluoroacetyl)adriamycin by the action of nonspecific serum and tissue esterases, a number of N (trifluoroacetyl)adriamycin 14-thio esters have been prepared and studied for in vitro growth inhibition, vs. human-derived CCRF-CEM leukemic lymphocytes, and in vivo antitumor activity, vs. murine P388 leukemia, relative to the rate of thio ester deacylation induced by esterases present in mouse serum. Products were obtained by reaction of N-(trifluoroacetyl)-14-bromodaunorubicin with thioacetic, thiopropionic, thiobutyric, thiovaleric, and thiobenzoic acids in ethanol, in the presence of potassium carbonate. Because little is known about similar thio ester derivatives of adriamycin itself, the corresponding adriamycin 14-thio esters were also prepared and evaluated for antitumor activity; with these products, determination of their extent of interaction with calf thymus DNA was also performed. For the adriamycin thio ester products, significant in vivo anti-P388 activity was seen with the thioacetate, thiovalerate, and thiobenzoate derivatives, although no compound matched the curative effects of N (trifluoroacetyl)adriamycin 14-valerate in this system. With respect to the N (trifluoroacetyl)adriamycin 14-thio ester products, although the corresponding oxo ester analogues are all significantly biologically active, none of the thio ester derivatives showed activity in vitro or in vivo. PMID- 3806576 TI - Adriamycin analogues. Preparation and biological evaluation of some N (trifluoroacetyl)-14-O-[(N-acetylamino)acyl]adriamycin derivatives. AB - In connection with structure-activity studies related to the novel DNA-nonbinding adriamycin analogues N-(trifluoroacetyl)adriamycin 14-valerate (AD 32) and N (trifluoroacetyl)adriamycin 14-O-hemiadipate (AD 143), we have now prepared a series of N-(trifluoroacetyl)adriamycin derivatives with N-acylamino acid esters at the 14-carbinol position. Target compounds were made by reaction of N (trifluoroacetyl)-14-iododaunorubicin with the sodium salts of N-acylamino acids generally in dimethylformamide-ethylene glycol solvent. Products were evaluated for in vitro growth-inhibitory activity and, to a limited extent, in vivo antitumor activity in the murine P388 leukemia system. ID50 values for the target compounds vs. cultured CCRF-CEM cells were generally in the same range as those for the above-mentioned DNA nonbinding adriamycin analogues. Of the four compounds tested for in vivo activity, although none was as effective as N (trifluoroacetyl)adriamycin 14-valerate, all showed significant activity in the P388 assay system, with three of the compounds, at the doses used, being essentially equiactive with an optimal dose of adriamycin. Studies on the rate of esterase-mediated deacylation of the products, in a defined system containing unfractionated mouse serum as the source of enzyme, showed no relationship between the in vitro and in vivo activities of these compounds and the relative ease at which the side-chain ester substituents were hydrolyzed. PMID- 3806577 TI - Total chemical synthesis and antitumor evaluation of the 9-aza analogue of N (trifluoroacetyl)-4-demethoxydaunomycin. AB - The 9-aza analogue of N-(trifluoroacetyl)-4-demethoxydaunomycin has been synthesized from 2,5-dimethoxybenzaldehyde. Pomeranz-Fritsch condensation followed by borohydride reduction and acid-catalyzed cyclization led smoothly to 4-hydroxy-5,8-dimethoxy-1,2,3,4-tetrahydroisoquinoline. Selective N-acetylation and subsequent Friedel-Crafts acylation with phthalic anhydride produced 2-acetyl 5,12-dihydroxy-1,2-dihydro-2-azanaphthacene-6,11-dione, which was protected as its dimethyl ether and epoxidized to an acylated aza Brigl's anhydride. This was converted to (+/-)-2-acetyl-4-hydroxy-5,12-dimethoxy-1,2,3,4-tetrahydro-2- azanaphthacene-6,11-dione by dehydration to the 4-keto analogue followed by cyanoborohydride reduction either stepwise or in situ. The protecting groups were removed with boron trichloride and the resulting aglycone glycosidated with optically active N,O-bis(trifluoroacetyl)daunosamine bromide and silver trifluoromethanesulfonate. The resulting diastereoisomers were separated by column chromatography and their structures established by CD and NMR spectroscopy. Unexpectedly it was not possible to remove the N-trifluoroacetyl blocking group without aromatization to the azanaphthaquinone. Both (R)- and (S) acetyl-4-O-[N-(trifluoroacetyl)daunosaminyl]-5,12-dihydroxy-2- azanaphthacene 6,11-dione were inactive ip in mice carrying the P388 tumor. Drugs were given at various concentrations on days 0, 5, and 9. PMID- 3806578 TI - (S)-3-[(benzyloxy)methyl]morpholine hydrochloride: a nonstimulant appetite suppressant without conventional neurotransmitter releasing properties. AB - The synthesis and appetite-suppressant activity of (S)-3 [(benzyloxy)methyl]morpholine hydrochloride in dogs are reported. The oral ED50 for appetite suppression in dogs of 3 was 12 mg/kg, and it was tolerated up to 200 mg/kg. 3 had no inhibitory effect on the release or uptake of noradrenaline, dopamine, or serotonin at 10(-5) M. The (R) enantiomer of 3 was not anorexiant. PMID- 3806579 TI - Hydrolysis of Pro-Ala dipeptides by lysosomal hydrolases. Models for the study of lysosomotropic amino acid prodrugs of penicillins. AB - Peptidic lysosomotropic prodrugs of antibiotics and antitumoral agents could be of advantage in chemotherapy, providing that free, active drug is released at, or close to, the desired site of action. Thus, aminoacyl derivatives of doxorubicin, e.g., where the drug is attached to the amino acid by a primary amino function, are sensitive to lysosomal hydrolases. We have examined whether a similar approach can be used for drugs carrying a carboxyl group such as beta-lactam antibiotics. Because the C adjacent to the carboxyl group in beta-lactams has the D configuration, we have examined and report here the synthesis and susceptibility of model peptides, namely Boc-D-Pro-L-Ala and Boc-L-Pro-L-Ala to lysosomal hydrolases. Hydrolysis of the D isomer proceeds considerably more slowly than that of the L isomer. Lysosomal carboxypeptidase(s) and/or amidases appear therefore to have a much narrower specificity than aminopeptidase(s), which will severely limit the applicability of the concept of peptidic lysosomotropic prodrugs. PMID- 3806580 TI - Synthesis and evaluation of 2-substituted 1-methyl-1-(4-tolylsulfonyl)hydrazines as antineoplastic agents. AB - Several N-2 substituted 1-methyl-1-(4-tolylsulfonyl)hydrazines were synthesized and evaluated for antineoplastic activity against the L1210 leukemia and the B16 melanoma. The most active compound to emerge from this study, 2-(methylsulfonyl) 1-methyl-1-(4-tolylsulfonyl)hydrazine, produced maximum percent T/C values with L1210 leukemia and B16 melanoma tumor bearing mice of 207 and 209, respectively. While the attachment of an aryl-, aralkyl-, or alkylsulfonyl moiety to N-2 resulted in retention of activity against both tumor systems, the corresponding benzoyl, 4-nitrobenzoyl, and (2-nitrophenyl)sulfenyl analogues only displayed activity against the L1210 leukemia. PMID- 3806581 TI - Analogues of caffeine and theophylline: effect of structural alterations on affinity at adenosine receptors. AB - A variety of analogues of caffeine and theophylline in which the 1-,3-, and 7 methyl substituents have been replaced with n-propyl, allyl, propargyl, and isobutyl and, in a few cases, with chloroethyl, hydroxyethyl, or benzyl were assessed for potency and selectivity as antagonists at A1- and A2-adenosine receptors in brain tissue. Caffeine and theophylline are nonselective for these receptors. Nearly all of the 22 analogues of caffeine are more potent than caffeine itself at adenosine receptors. Replacement of the 1-methyl moiety with n propyl, allyl, or propargyl substituent has little effect on potency at the A1 receptor while enhancing potency about 7- to 10-fold at the A2 receptor. 3,7-Di methyl-1-propylxanthine is only slightly (1.4-fold) more potent than caffeine at the A1 receptor while being 10-fold more potent at the A2 receptor. 1,3-Di-n propyl-7-methylxanthine is also selective for the A2 receptor, being 8-fold more potent than caffeine at the A1 receptor and 40-fold more potent at the A2 receptor. A number of other caffeine analogues including 3,7-dimethyl-1-n propylxanthine, 7-allyl-1,3-dimethylxanthine, and 1,3-dimethyl-7 propargylxanthine are also somewhat selective for the A2 receptor. The most potent caffeine analogue was 1,3-di-n-propyl-7-propargylxanthine, which was about 100-fold more potent than caffeine at both A1 and A2 receptors. The 10 theophylline analogues were relatively nonselective except for the 1-ethyl analogue and the 1,3-diallyl analogue, which were selective for the A2 receptor, and the 1,3-di-n-propyl, 1,3-diisobutyl, and 1,3-dibenzyl analogues, which were somewhat selective for the A1 receptor. 1,3-Di-n-propylxanthine was 20-fold more potent than theophylline at the A1 receptor and 5-fold more potent at the A2 receptor. PMID- 3806582 TI - Muscarinic ganglionic stimulants: conformationally restrained analogues related to [4-[[N-(3-chlorophenyl)carbamoyl]oxy]-2-butynyl]trimethylammonium chloride. AB - The synthesis of a series of tertiary and quaternary cyclic analogues (isoarecolinol, dihydroisoarecolinol, arecolinol, and 3-pyrroline-3-carbinol derivatives) of [4-[[N-(3-chlorophenyl)carbamoyl]oxy]-2-butynyl]trimethylammonium chloride (McN-A-343) (1), a selective stimulant of muscarinic receptors in sympathetic ganglia (so-called M1 receptors), is reported. The compounds 3-10 were tested for muscarinic ganglion-stimulating activity by recording blood pressure responses in pithed rats. All tertiary compounds tested had no ganglion stimulating activity. Among the series of quaternary derivatives, only the isoarecolinol analogues 4a and 4b showed considerable ganglion-stimulating effects, whereas the dihydroisoarecolinol (8), the arecolinol (6a, 6b), and the 3 pyrroline-3-carbinol derivatives (10) were much less potent. Our experiments therefore demonstrate that in this series a quaternary nitrogen atom, unsaturation at C2 of the ammonium side chain, and a certain spatial arrangement of the ammonium and the phenylcarbamate groups are essential for potent M1 receptor stimulating activity. PMID- 3806583 TI - Analogues of platelet activating factor. 5. Multiple oxygen substitution of the alkoxy chain. AB - Racemic analogues of platelet activating factor (PAF) in which the alkoxy chain (R = -O(CH2)15CH3) has been replaced with a chain containing multiple ether linkages near the end (17, R = -O(CH2)8O(CH2)2O(CH2)2OCH3) or at the beginning (18, R = -O(CH2)2O(CH2)2O(CH2)9CH3) of the chain have been prepared. Both compounds exhibit reduced hypotensive and platelet aggregation responses compared to racemic C16-PAF (1a). This reduction in the biological activities is more apparent when the new oxygen atoms are located near the end of the chain. This substitution of additional oxygen atoms into the alkoxy chain does not result in any dramatic gains in selectivity of the biological responses. PMID- 3806584 TI - Basically substituted ellipticine analogues as potential antitumor agents. AB - Installation of a basic side chain on the ring nitrogen of ellipticine did, as expected, improve the DNA binding properties of these molecules as measured by an ethidium displacement assay. In vivo antitumor activity was not, however, improved. PMID- 3806585 TI - 1,2-bis(arylsulfonyl)hydrazines. 2. The influence of arylsulfonyl and aralkylsulfonyl substituents on antitumor and alkylating activity. AB - Several 1,2-bis(arylsulfonyl)-1-methylhydrazines were synthesized and evaluated for antineoplastic activity against the L1210 leukemia. The most active compound to emerge from this study, 2-[(4-chlorophenyl)sulfonyl]-1-methyl-1-(4 tolylsulfonyl)hydrazine , increased the survival time of tumor-bearing mice by 88%. The alkylating activity of the synthesized analogues and several compounds reported earlier was determined by measuring the absorbance at 540 nm of the alkylated product of 4-(4-nitrobenzyl)pyridine. The results obtained support the concept that the ability to alkylate is a necessary but not a sufficient condition for the expression of antitumor activity by agents of this class. PMID- 3806586 TI - Synthesis of N-(3,6-dihydro-1(2H)-pyridinyl)benzamides with hyperglycemic hypoglycemic activity. AB - A group of N-(3,6-dihydro-1(2H)-pyridinyl)benzamides 7 were synthesized to determine the effect that the position and physicochemical properties of substituents attached to the heterocyclic ring have on blood glucose levels. 5 Methyl-N-(3,6-dihydro-1(2H)-pyridinyl)benzamide 7b was the most active hyperglycemic agent, elevating blood glucose 124% and 116% at 2 and 4 h, respectively, after a 100 mg/kg po dose. The most active hypoglycemic agent was the 4-acetyl analogue 7o, which was about 50% as active as chlorpropamide, lowering blood glucose 19% at 4 h after a 100 mg/kg po dose. A correlation between blood glucose levels and the partition coefficient P was not observed. PMID- 3806587 TI - Synthesis, cell growth inhibition, and antitumor screening of 2-(p-n butylanilino)purines and their nucleoside analogues. AB - Derivatives of N2-(p-n-butylphenyl)guanine (BuPG) and 2-(p-n-butylanilino)adenine (BuAA) were synthesized and tested as inhibitors of mammalian DNA polymerase alpha, cell growth, and macromolecule synthesis. 2-(p-n-Butylanilino)-6 chloropurine (BuACl) served as a useful intermediate to prepare a series of 6 substituted analogues. BuACl, as its sodium salt, reacted with 2-deoxy-3,5-di-p toluoyl-beta-D-ribofuranosyl chloride in acetonitrile to give 64% of the corresponding 9-beta nucleoside (blocked BuAdCl) and only 14% of the 7-beta isomer. Deblocking and substitution of chlorine in BuAdCl generated a series of 2 (p-n-butylanilino)-9-(2-deoxy-beta-D-ribofuranosyl)purine derivatives. Reaction of the sodium salt of BuACl with (2-acetoxyethoxy)methyl bromide also afforded, after deblocking and substitution of the 6-chloro group, a series of 2-(p-n butylanilino)-9-[(2-hydroxyethoxy)methyl]purines. The bases synthesized were inhibitors of DNA polymerase alpha isolated from Chinese hamster ovary cells, the most potent compounds being 6-methoxy and 6-methylthio derivatives of 2-(p-n butylanilino)purine. When tested for their ability to inhibit [3H]thymidine incorporation into DNA in HeLa cell cultures and the growth of exponentially growing HeLa cells, 9-(2-deoxy-beta-D-ribofuranosyl) derivatives had greater potency than their base counterparts, but "adenine" analogues, such as 2-(p-n butylanilino)-2'-deoxyadenosine (BuAdA, IC50 = 1 microM), were considerably more potent than N2-(p-n-butylphenyl)-2'-deoxyguanosine (BuPdG, IC50 = 25 microM). Derivatives bearing the 9-[(2-hydroxyethoxy)methyl] group were nearly as potent inhibitors of [3H]thymidine incorporation in these experiments as the corresponding deoxyribonucleosides. Base and deoxynucleoside derivatives also inhibited cellular RNA synthesis, and several compounds, at high concentrations, inhibited protein synthesis. BuPG, BuAA, and four deoxyribonucleoside derivatives of 2-(p-n-butylanilino)purines were tested against P-388 lymphocytic leukemia in mice. None of the compounds increased the survival time of test animals, but two of them, BuAdA and its 6-desamino derivative BuAdP, were lethal at the highest concentration used (400 mg/kg). PMID- 3806588 TI - Synthesis and antitumor activity of tropolone derivatives. 4. AB - Modifications of monotropolone 2 having poor potency against P388 in mice were studied. The alpha-ethoxy group of 2, prepared from hinokitiol and benzaldehyde diethyl acetal, was replaced with a phenolic or heteroaromatic compound by heating 2 with the appropriate nucleophile. Structure-activity relationships indicated that an acidic hydroxyl and a proton-accepting group situated in the neighboring position, which permits the formation of a chelate with a metal ion, contributed to enhanced activity. Among the compounds studied, the 8 hydroxyquinoline analogue 10f was the most favorable compound. PMID- 3806590 TI - 2-Phenylindoles. Effect of N-benzylation on estrogen receptor affinity, estrogenic properties, and mammary tumor inhibiting activity. AB - Hydroxy-2-phenylindoles carrying substituted benzyl groups and similar substituents at the nitrogen were synthesized and tested for their ability to displace estradiol from its receptor. All of the derivatives tested exhibited high binding affinities for the calf uterine estrogen receptor, with RBA values ranging from 0.55 to 16 (estradiol 100). The mouse uterine weight tested revealed only low estrogenicity for this class of compounds. Several derivatives showed antiestrogenic activity with a maximum inhibition of estrone-stimulated uterine growth of 40%. Two of the compounds (6c, 21c) were tested for antitumor activity in dimethylbenanthracene- (DMBA-) induced estrogen-dependent rat mammary tumors. Only the 4-cyanobenzyl derivative 21c was active. After 4 weeks of treatment with 12 mg/kg (6 times/week), the average tumor area was decreased by 57% (control +204%). In vitro, an inhibitory effect of 21b was only observed with hormone sensitive MCF-7 breast cancer cells but not with hormone-independent MDA-MB 231 cells. These results make a mode of action involving the estrogen receptor system likely. PMID- 3806589 TI - Anthrapyrazole anticancer agents. Synthesis and structure-activity relationships against murine leukemias. AB - Chromophore modification of the anthracenediones related to mitoxantrone in an attempt to provide agents with diminished or no cardiotoxicity has resulted in a novel class of DNA binders, the anthrapyrazoles. Their synthesis was carried out by a two-stage condensation sequence starting from requisite 1,4- or 1,5-dichloro 9,10-anthracenedione precursors. Reaction with a monoalkylhydrazine gave a chloroanthrapyrazole intermediate whose subsequent condensation with primary or secondary alkylamines provided the target "two-armed" anthrapyrazoles. A-ring 7,10-dihydroxy anthrapyrazoles were derived from amine condensation with intermediate 5-chloro-7,10-dihydroxyanthrapyrazoles or, alternatively, from intermediate 5-chloro-7,10-bis(benzyloxy)anthrapyrazoles followed by hydrogenolysis of the benzyl protecting groups to provide the target compounds. Potent in vitro activity was demonstrated against murine L1210 leukemia in vitro (IC50 = 10(-7)-10(-8) M) as well as against P388 leukemia in vivo over a wide range of structural variants. In general, activity against the P388 line was maximized by basic side chains at N-2 and C-5, two to three carbon spacers between proximal and distal nitrogens of the side chain, and A-ring hydroxylation. Besides having curative activity against the P388 line, the more active compounds were curative against murine B-16 melanoma in vivo. On the basis of their exceptional in vivo anticancer activity, A-ring dihydroxy compounds 71 and 74 reported in this study have been selected for development toward clinical trials. PMID- 3806591 TI - Indolizidine and quinolizidine derivatives of the dopamine autoreceptor agonist 3 (3-hydroxyphenyl)-N-n-propylpiperidine (3-PPP). AB - Eight indolizidine and quinolizidine derivatives of 3-PPP were synthesized and tested for possible dopamine (DA) autoreceptor activity. The equatorial indolizidine derivative 19e had the profile of a selective autoreceptor agonist and was half as active as 3-PPP. However, resolution of the compound revealed that the 8R enantiomer was an unselective DA agonist with a profile similar to (+)-3-PPP, while the 8S enantiomer was a weak DA antagonist without any DA agonist activity. The unsaturated quinolizidine derivative 21 also had the profile of a DA antagonist while the axial quinolizidine derivative 18a had an amphetamine-like profile in 6-OHDA-lesioned rats. All other derivatives were inactive. The observed structure-activity relationships were in agreement with existing DA receptor models, although these models are not apparently detailed enough to explain why the 8S enantiomer of 19e is inactive as a DA agonist. PMID- 3806592 TI - Double-headed haptens with pyrocatechol (poison ivy like) and methylene lactone functional groups: a search for skin-tolerance inducers. AB - In order to develop new theories for desensitization, a potential skin sensitizer, 1, with two different haptenic ends, a pyrocatechol group and an alpha-methylene-gamma-butyrolactone moiety, separated by a straight nine-carbon atom chain has been prepared and used to sensitize guinea pigs. A "monohapten" 8 containing an electrophylic alpha-methylene-gamma-butyrolactone, connected to a dimethoxybenzene group, has also been prepared. Both the "bihapten" 1 and the "monohapten" 8 were shown to be sensitizers. Bihapten 1 sensitized animals recognized only bihapten 1 (and not the lactone 8) while monohapten 8 sensitized guinea pigs reacted to both 8 and 1. Bihapten 1 treated animals were further sensitized to monohapten 8 and challenged to the latter: the skin intensity reaction was significantly lower than the test to 8 in 8-sensitized animals. Bihapten 1 seems therefore to "tolerize" against the alpha-methylene-gamma butyrolactone end. PMID- 3806593 TI - Preparation and antitumor activity of new mitomycin A analogues. AB - A series of 26 mitomycin A analogues including 23 new ones was prepared by a variety of methods. The most useful methods were alkoxide exchange on mitomycin A and treatment of 7-hydroxymitosane with 3-substituted 1-phenyltriazenes. Many of the new analogues were superior to mitomycin C in the P388 leukemia assay and the more stringent subcutaneous B16 melanoma assay both in mice. Four of them gave long-term survivors in the latter assay. Quantitative correlations between log P and antitumor activity were not possible, but some guidelines for future analogue development are proposed. PMID- 3806594 TI - Differential blockade of muscarinic receptor subtypes by polymethylene tetraamines. Novel class of selective antagonists of cardiac M-2 muscarinic receptors. AB - Several N,N'-bis[6-[(2-methoxybenzyl)amino]hexyl]-1, omega-alkanediamine tetrahydrochlorides were synthesized and evaluated for their blocking activity on muscarinic receptors in guinea pig atria and rat ileum and bladder. The results were compared with those obtained for the classical nonselective muscarinic antagonist atropine. It was discovered that optimum activity is associated with an eight-carbon chain (compound 4) in guinea pig atria whereas, in both rat ileum and bladder, the 12-carbon analogue 7 had the highest activity. In addition, polymethylene tetraamines 1-6 displayed high selectivity toward guinea pig atria muscarinic receptors. The discriminatory power of 1-6 was not shared by 7. All the tetraamines were shown to be competitive antagonists of muscarinic receptors. N,N'-Bis[6-[(2-methoxybenzyl)amino]hexyl]-1,8-octanediamine was the most potent and selective toward muscarinic receptors in atria, with a pA2 value of 8.13 and a selectivity ratio (atria vs. ileum or bladder) of ca. 270. At a concentration of 10 microM, tetraamine 4 did not affect histamine and 5-hydroxytryptamine receptors of guinea pig ileum or alpha-adrenoreceptors of guinea pig atria whereas it inhibited postsynaptic alpha-adrenoreceptors of rat vas deferens with a -log K value of 5.23 and nicotinic receptors of frog rectus abdominis with an IC50 value of 0.23 microM. It is concluded that 4 is a novel, powerful, and selective tool in the characterization of muscarinic receptor subtypes. PMID- 3806595 TI - Substituted 2-(2-hydroxyphenyl)benzimidazoles as potential agents for the control of periodontal diseases. AB - A series of 16 substituted 2-(2-hydroxphenyl)benzimidazoles was synthesized and evaluated in vitro for antibacterial activity against bacteria associated with periodontal diseases. Several compounds demonstrated a high level of activity, in tube dilution assay, against Actinomycetes viscosus and Bacteriodes gingivalis. These results indicate that several of these compounds may serve as topical antibacterial agents for the control of acute marginal inflammatory gingivitis and periodontitis. PMID- 3806596 TI - Studies on the active molecular species of the H2 receptor antagonists cimetidine and mifentidine. AB - The N'-(4-1H-imidazol-4-ylphenyl)formamidines were recently introduced as a new class of active H2 antagonists; the authors of the compounds (Donetti et al. of de Angeli, Italy) have suggested that these compounds interact with the H2 receptor through their monocations. This is at variance with the model proposed for cimetidine by the SK&F (Smith Kline & French, UK) group who proposed the neutral molecule as the species active at the H2 receptor. In the present study we have investigated the issue whether the neutral or charged species is the active one by measuring the pA2 values of mifentidine and cimetidine at different pH values. Changing the pH will influence the species equilibria of both compounds and thereby affect their activity. The activity changes measured for both compounds are consistent with the proposition that cimetidine as well as mifentidine elicit their activity through their neutral species. PMID- 3806597 TI - Xanthine functionalized congeners as potent ligands at A2-adenosine receptors. AB - Amide derivatives of a carboxylic acid congener of 1,3-dialkylxanthine, having a 4-[(carboxymethyl)oxy]phenyl substituent at the 8-position, have been synthesized in order to identify potent antagonists at A2-adenosine receptors stimulatory to adenylate cyclase in platelets. Distal structural features of amide-linked chains and the size of the 1,3-dialkyl groups have been varied. 1,3-Diethyl groups, more than 1,3-dimethyl or 1,3-dipropyl groups, favor A2 potency, even in the presence of extended chains attached at the 8-(p-substituted-phenyl) position. Polar groups, such as amines, on the chain simultaneously enhance water solubility and A2 potency. Among the most potent A2 ligands are an amine congener, 8-[4-[[[[(2 aminoethyl)amino]carbonyl]methyl]oxy]phenyl]- 1,3-diethylxanthine, and its D lysyl conjugate, which have KB values of 21 and 23 nM, respectively, for the antagonism of N-ethyl-adenosine-5'-uronamide-stimulated adenylate cyclase activity in human platelet membranes. Strategies for the selection and tritiation of new radioligands for use in competitive binding assays at A2-adenosine receptors have been considered. PMID- 3806598 TI - Dopamine agonists: effects of charged and uncharged analogues of dopamine. AB - Dopamine, at physiological pH, may exist as either an uncharged amine or a charged ammonium species. In order to gain insight as to which species is better suited for interaction with the dopamine receptor, we have synthesized dopamine analogues in which the nitrogen atom is replaced with a neutral methyl sulfide, a neutral methyl selenide, a charged dimethylsulfonium iodide, and a charged dimethylselenonium iodide. These analogues were tested for their ability to inhibit the K+-stimulated release of [3H]acetylcholine from striatal slices. At 30 microM concentration, the charged sulfonium and selenonium salts possessed significant agonist activity while the corresponding neutral species were inactive, suggesting that a charged species is optimal for dopamine agonist activity. In addition, the methyl sulfide was converted into the corresponding sulfoxide and sulfone; however, neither of these oxidation products possessed significant activity as dopaminergic agonists. PMID- 3806599 TI - 3-[(2-ethoxyphenoxy)methyl]piperidine derivatives. Synthesis and antidepressant activity. AB - The 3-[(2-ethoxyphenoxy)methyl]piperidine derivatives 3-5 were synthesized and screened as potential antidepressant agents by the reserpine interaction test in mice and the evaluation of reuptake inhibition of biogenic amines in pig brain synaptosomal fractions. In addition, their anticonvulsant activity, tested by pentyleneetrazole antagonism, and approximate acute toxicity were evaluated. In vivo and in vitro tests showed that compounds 3 and 5 possess a biological activity comparable to that of the antidepressant drug viloxazine. PMID- 3806600 TI - Synthesis and antisecretory and antiulcer activities of derivatives and analogues of 2-(2-pyridyl)tetrahydrothiophene-2-carbothioamide. AB - New thioamide derivatives of 2-(2-pyridyl)tetrahydrothiophene-2-carbothioamide (29) and related compounds (in which the tetrahydrothiophene ring was replaced by tetrahydrothiopyran, tetrahydrofuran, 1,3-dithiane, or 1,3-oxathiane and where the pyridine ring was replaced by other nitrogen heterocycles) were synthesized and tested for their antisecretory and antiulcer activities. These thioamides were prepared according to one of the following methods: reaction of an isothiocyanate with the carbanion of the corresponding cyclic precursor (for secondary thioamides); reaction of ammonia or an amine with the dithio ester prepared from the same precursor (for primary, secondary, and tertiary thioamides). These thioamides were evaluated by the Shay method to measure their antisecretory activity and by the stress-induced-ulcer method to test their antiulcer activity. Structure-activity relationships are discussed. N-Methyl-2-(2 pyridyl)tetrahydrothiophene-2-carbothioamide (R.P. 40749, 30) exhibited activities that were at least 10 times higher than those reported for cimetidine. PMID- 3806601 TI - Phenylpiperazine-based radiopharmaceuticals for brain imaging. 3. Synthesis and evaluation of radioiodinated 1-alkyl-4-phenylpiperazines. AB - As part of our program in radiopharmaceutical chemistry we have prepared and evaluated a series of radioiodinated 1-alkyl-4-phenylpiperazines as potential brain-imaging agents. The compounds were chosen on the basis of their synthetic versatility, activation toward electrophilic substitution, and ease of purification. The intermediates 1-6 were readily obtained and converted to the corresponding radioiodinated products 7-12 in 76-91% isolated radiochemical yields. The tissue distribution in rats indicated that the 1-N-butyl derivative 9 possesses the best combination of brain uptake (0.28-0.35% ID X kg/g), retention, and selectivity (brain/blood greater than 20) over the 4-h evaluation period. A subsequent imaging and tissue distribution study in the dog using 131I-labeled 9 supported the results observed in the rat and suggested the potential of this agent as a brain-imaging agent. PMID- 3806602 TI - Dopamine agonists related to 3-allyl-6-chloro-2,3,4,5-tetrahydro-1-(4 hydroxyphenyl)-1H-3-benzaz epi ne-7, 8-diol. 6-Position modifications. AB - The N-allyl derivative (SK&F 85174) of 6-chloro-2,3,4,5-tetrahydro-1-(4 hydroxyphenyl)-1H-3-benzazepine-7,8-diol (SK&F 82526) retains the DA-1 agonist potency of the latter compound but unlike the parent also shows substantial DA-2 agonist activity. In a previous study of N-substituted benzazepines these combined agonist effects were shown to be uniquely associated with the N-allyl group. A continuation of this research has examined dependency of combined DA 2/DA-1 agonist activities on 6-position modification with the specific objective of developing an agonist with maximum effectiveness and potency at the DA-2 receptor subtype. DA-2 agonist activity was measured in a rabbit ear artery assay, and DA-1 agonist activity was determined in an adenylate cyclase assay. Replacing chloro with bromo retains the activity pattern and the potency of the chloro compound; replacement with a hydrogen causes a decrease of both DA-1 and DA-2 receptor activating potency. Introduction of a 6-methyl group causes loss of DA-2 agonist activity and reduction in DA-1 agonist potency. Substitution with a 6-fluoro provides the best balance of DA-2 and DA-1 agonist activities; this compound was moderately potent in both assays. PMID- 3806603 TI - Cluster significance analysis contrasted with three other quantitative structure activity relationship methods. AB - Cluster significance analysis (CSA), a new statistical method to analyze structure-activity relationships in graphically displayed data, is contrasted with linear discriminant analysis, SIMCA, and the method of "relative odds". The data sets evaluated are as follows: antibacterial lasalocid derivatives, antimalarial naphthoquinones, and carcinogenic polycyclic aromatic hydrocarbons. CSA gives results comparable to these other methods, involves fewer assumptions, can be more reliable, and in general is easier to understand. PMID- 3806604 TI - Synthesis and antilipolytic activities of quinolyl carbanilates and related analogues. AB - A series of quinolyl carbanilates was prepared and tested as antilipolytic agents. These compounds inhibited production of glycerol from rat adipocytes and inhibited liberation of free fatty acids from triolein by canine cardiac triglyceride lipases. An extensive structure-activity relationship study indicated that 8-quinolyl 4-methoxycarbanilate (1) contained features necessary for maximum potency in vitro. Substituting a benzofuranyl group for the quinolyl group of 1 provided the most interesting compound on the basis of both potency and structural novelty. 7-Benzofuranyl 4-methoxycarbanilate (44) has IC50's of 16 and 0.3 microM in the myocardial lipase and rat adipocyte assays, respectively. In vivo, compound 44 was orally active as an inhibitor (97% at 25 mg/kg) of lipolysis in the rat. PMID- 3806605 TI - Analogues of the cytostatic and antimitogenic agents chlamydocin and HC-toxin: synthesis and biological activity of chloromethyl ketone and diazomethyl ketone functionalized cyclic tetrapeptides. AB - The synthesis and biological activity of four novel analogues of the cytostatic and antimitogenic agents chlamydocin and HC-toxin are reported in which the natural products' reactive epoxy ketone side-chain moiety is replaced by a chloromethyl or a diazomethyl ketone functionality, but the respective 12 membered cyclic tetrapeptide ring systems are retained. Syntheses of the linear tetrapeptide sequences were, in each case, achieved by conventional methodology and designed such that cyclization would be onto proline. The use of suitably protected L-2-aminosuberic acid (Asu) enabled the ready assimilation of the desired chloromethyl and diazomethyl ketone functionalities after cyclization. Cyclization was accomplished by using bis(2-oxo-3-oxazolidinyl)phosphinic chloride (BOP-Cl). Yields of cyclic product were comparable to or, in the case of the HC-toxin ring system, better than those previously reported. Liberation of the Asu-side-chain acid and manipulation to the required functionalities via mixed anhydride to the diazomethyl ketone and quenching with HCl to yield the chloromethyl ketone was achieved in excellent yield for the HC-toxin analogues but in only moderate yield for the chlamydocin analogue. The antimitogenic activities of HC-toxin chloromethyl ketone (IC50 = 30-40 ng/mL) and chlamydocin chloromethyl ketone (IC50 = 3-10 ng/mL) were found to be 3-4-fold lower than those of the natural products themselves. The diazomethyl ketone analogue of HC toxin was found to be inactive (IC50 greater than 2000 ng/mL). A modification of the HC-toxin peptide ring system, [L-Phe]3-HC-toxin chloromethyl ketone was found not to be a more active analogue (IC50 = 40-100 ng/mL). The nature of the putative target molecule, the binding interactions of the various analogues and the contribution of rate of inhibition toward activity are briefly discussed. The chloromethyl ketones herein reported constitute the most potent synthetic antimitogenic cyclic tetrapeptide analogues yet designed. PMID- 3806606 TI - Synthesis and structure-activity relationships of pyrazolo[4,3-d]pyrimidin-7-ones as adenosine receptor antagonists. AB - A series of 21 1,3-dialkylpyrazolo[4,3-d]pyrimidin-7-ones substituted in the 5 position with various phenyl substituents has been synthesized and found to have affinity for the adenosine A1 receptor. The potency pattern due to substituents of the phenyl ring was found to parallel that found in a previously reported 1,3 dialkyl-8-phenylxanthine series. A quantitative structure-activity relationship was developed between these two series that correctly predicted the potencies of six additional 5-substituted pyrazolo[4,3-d]pyrimidines that were synthesized during the course of the analysis. With use of the correlation as a guide, one additional 5-phenylpyrazolo[4,3-d]pyrimidine containing a 4 [[(dimethylamino)ethyl]amino]sulfonyl substituent to improve aqueous solubility was prepared. On the basis of the high correlation between adenosine binding affinities of analogously substituted xanthines and pyrazolo-[4,3-d]pyrimidines and the close superposition of the heterocyclic rings and substituents that is apparent from molecular models of these two series, it is hypothesized they fit the receptor in an analogous fashion. PMID- 3806608 TI - Stereochemical studies on the cytochrome P-450 catalyzed oxidation of (S) nicotine to the (S)-nicotine delta 1'(5')-iminium species. AB - Mammals metabolize the tobacco alkaloid (S)-nicotine primarily to the lactam (S) cotinine by a pathway involving an initial cytochrome P-450 catalyzed two electron oxidation at the prochiral 5'-carbon atom. The stereochemical course of this oxidation was examined with human microsomal preparations and the E and Z diastereomers of (S)-nicotine-5'd1. The metabolically generated delta 1'(5') iminium ion intermediate was trapped and analyzed as the corresponding diastereomeric 5'-cyano derivatives by a capillary column GC-EIMS selected ion monitoring assay. The results of these studies established that this biotransformation proceeds with the stereoselective abstraction of the 5'-pro-E proton, that is, the C-5' proton trans to the bulky pyridyl group. The observed stereoselectivity was independent of proton vs. deuteron abstraction. Additionally, the extent of (S)-cotinine formation was minor and did not influence the stereochemical composition of the metabolically derived alpha-cyano amines. Studies with male Dutch rabbit liver microsomal preparations gave similar results. These findings suggest that the structure of the complex formed between (S)-nicotine and the active site of cytochrome P-450 is highly ordered and dictates the stereochemical course of the reaction pathway. PMID- 3806607 TI - Substituted arylmethyl phenyl ethers. 1. A novel series of 5-lipoxygenase inhibitors and leukotriene antagonists. AB - A series of new substituted arylmethyl phenyl ethers has been prepared. These compounds were tested as inhibitors of 5-lipoxygenase (5-LO) in rat neutrophils, in vitro antagonists of leukotriene-induced contraction of guinea pig (GP) lung parenchymal strips, and inhibitors of slow reacting substance of anaphylaxis (SRS A) mediated bronchospasm in the GP in vivo. Most representatives of this new class of potential antiallergic/antiinflammatory agents showed potent inhibition of 5-LO activity in rat PMNs. The most potent compound, 2-[[3-(1 hydroxyhexyl)phenoxy]-methyl]quinoline (33), had an I50 of 0.12 microM in the rat PMN 5-LO assay and an I50 of 3.6 microM in the leukotriene-induced contraction of GP lung parenchymal strips, and it also showed 91% inhibition of SRS-A-mediated bronchospasm in the GP in vivo at 10 mg/kg, administered intraduodenally. Some of the compounds in this series were also leukotriene antagonists in vitro, and several of them showed in vivo activity against SRS-A-mediated bronchospasm in the GP. PMID- 3806609 TI - Structural requirements for the inhibition of 5-lipoxygenase by 15-hydroxyeicosa 5,8,11,13-tetraenoic acid analogues. AB - The structural requirements for inhibition of RBL-1 (rat basophilic leukemia) 5 lipoxygenase by 15-hydroxyeicosa-5,8,11,13-tetraenoic acid (15-HETE, 1) were studied by systematic chemical modifications of the molecule at the hydroxyl and carboxyl groups, the double bonds, and the carboxylate and omega side chains. The most potent inhibitors were analogues that contained a 5,8-cis,cis-diene system and acted as alternate substrates for the enzyme. However, several analogues in which the 5,8-diene had been reduced were also found to inhibit the enzyme. Inhibition of 5-lipoxygenase by 15-hydroxyeicosa-11,13-dienoic acid (15-HEDE) analogues was optimal in compounds that generally contained a free carboxyl group, a carboxylate side chain of nine carbons, an omega side chain of five or six carbons, a cis,trans- or trans,cis-11,13-diene or 11,13-diyne system, and a 15-hydroxyl group. Conversion of 15-HEDE to its 16-membered lactone reduced but did not eliminate 5-lipoxygenase inhibitory activity. In contrast, a 3- to 10 fold enhancement of activity occurred when 5,15-diHETE (58) or 5-HETE (56) were cyclized to their respective delta-lactones. Molecular modeling of 15-HEDE analogues, modified in the C11-C15 region, showed that inactive analogues protrude into regions in space not occupied by active analogues. These structural studies indicate that multiple regions are important for 5-lipoxygenase inhibition by both 15-HETE and 15-HEDE analogues and that no single region plays a predominant role in inhibition. PMID- 3806610 TI - 1-[[[5-(substituted phenyl)-2-oxazolyl]methylene]amino]-2,4- imidazolidinediones, a new class of skeletal muscle relaxants. AB - A series of 1-[[[5-(substituted phenyl)-2-oxazolyl]methylene]amino]- 2,4 imidazolidinediones (6a-t) was synthesized, and the compounds were evaluated for direct skeletal muscle inhibition in the pithed rat gastrocnemius muscle preparation. The correctness of structural assignment of the new series was verified by alternate, unequivocal synthesis of one representative structure (6f). The phenyloxazoles 6d, 6g, 6j, 6k, and 6l exhibited significant skeletal muscle relaxant activity when administered intravenously and orally. The skeletal muscle relaxant effect of these five compounds is similar to that of other direct acting skeletal muscle relaxants. The oxazole moiety proved to be an acceptable isosteric replacement for furan, as the biological activity in the oxazole series was retained. The synthesis of this new class of compounds is described, and pharmacologic evaluation data are presented. A discussion of structure-activity relationships is also presented. PMID- 3806611 TI - Synthesis and evaluation of mono-, di-, and trifluoroethenyl-GABA derivatives as GABA-T inhibitors. AB - The syntheses of four derivatives of gamma-vinyl-GABA, in which vinylic hydrogen atoms were replaced by fluorine, are described. With use of 5-ethenyl-2 pyrrolidinone as starting material, the E and Z isomers of 4-amino-6-fluoro-5 hexenoic acid were prepared. The 6,6-difluoro and 5,6,6-trifluoro analogues could be synthesized from 4-oxobutanoic acid tert-butyl ester and (2,2-difluoroethenyl) and (trifluoroethenyl)lithium correspondingly. The compounds were tested as inhibitors of GABA-T, and their in vitro and in vivo biochemistry is reported. The most active derivative was (Z)-4-amino-6-fluoro-5-hexenoic acid; the structure-activity relationship in the series is discussed. PMID- 3806612 TI - Molecular modification of anticholinergics as probes for muscarinic receptors. 1. Amino esters of alpha-substituted phenylacetic acid and related analogues. AB - Two series of compounds having the general structure of C6H5CRR'COOCH2CH2NEt2 were synthesized and examined for their antispasmodic activities. These compounds were selected as structural probes for exploring the nature of muscarinic cholinergic receptor binding sites that interact with atropine-like anticholinergics. These studies indicate a rather strict size limitation for the hydrophobic region of the receptor and suggest intramolecular hydrogen bonding as a possible means to explain the observed stereoselectivity. PMID- 3806613 TI - Molecular modification of anticholinergics as probes for muscarinic receptors. 3. Conformationally restricted analogues of benactyzine. AB - The synthesis and pharmacological evaluation of conformationally restricted analogues of certain anticholinergic agents is a powerful method for probing the topography of the muscarinic receptor. In the present study, clues as to the binding conformation of structurally flexible anticholinergics are provided by approximating certain conformations of benactyzine by synthetic analogues 1-6, which are structurally locked into desired conformations. The pharmacological activity of each analogue is an indication of how well particular conformational models are accommodated by the receptor. The conformation of benactyzine in which an intramolecular hydrogen bond may exist between the hydroxyl group and the carbonyl oxygen of the ester group (conformation I) is approximated by the synthetic analogue 2,2-diphenyl-3-tetrahydrofuranyl (diethylamino)ethyl ether (1) and related analogues. Pharmacological evaluation using dose-response experiments on isolated rat ileum tissue demonstrated that these compounds noncompetitively inhibited acetylcholine-induced ileum contractions. Restriction of the conformational freedom of the amino side chain of 1 by synthesis of the hexahydro[3,4-b]furan derivative 3 provided a weak but competitive inhibitor at low concentration. The conformation of benactyzine in which an intramolecular hydrogen bond may exist between the hydroxyl group and the ether oxygen of the ester group (conformation II) is approximated by 2,2-diphenyl-4-[2 (diethylamino)ethyl]-3-tetrahydrofuranone (4). Pharmacological studies showed that this compound competitively inhibited acetylcholine-induced ileum contractions. These experiments provide evidence that receptor-bound conformation II for benactyzine is preferred over conformation I in providing competitive binding with the muscarinic receptor. PMID- 3806615 TI - Synthesis and antitumor activity of fluorine-substituted 4-amino-2(1H) pyridinones and their nucleosides. 3-Deazacytosines. AB - Novel fluorine-substituted deaza analogues of 5-azacytidine (AZC) and 5-aza-2' deoxycytidine (dAZC) (3-deazacytosines) have been synthesized and tested for antitumor activity. Thus, 4-amino-3,5-difluoro-1-beta-D-ribofuranosyl-2(1H) pyridinone (16), 4-amino-3-fluoro-1-beta-D-ribofuranosyl-2(1H)-pyridinone (17), 4 amino-5-fluoro-1-beta-D-ribofuranosyl-2(1H)-pyridinone (18), 4-amino-1-(2-deoxy beta-D-erythro-pentofuranosyl)-3,5-difluoro-2 (1H)-pyridinone (25), 4-amino-1-(2 deoxy-beta-D-erythro-pentofuranosyl)-3-fluoro-2(1H)-pyridin one (26) 4-amino-1-(2 deoxy-alpha-D-erythro-pentofuranosyl)-3,5-difluoro-2(1H)-++ +pyridinon e (27), and 4-amino-1-(2-deoxy-alpha-D-erythro-pentofuranosyl)-3-fluoro-2 (1H)-pyridinone (28) were prepared by standard glycosylation procedures. Requisite heterocycle 4 amino-3,5-difluoro-2(1H)-pyridinone (6) was prepared in five steps from pentafluoropyridine (1). Other requisite fluoro heterocycles, 4-amino-3-fluoro 2(1H)-pyridinone (7) and 4-amino-5-fluoro-2(1H)-pyridinone (8), were obtained from a bis-defluorination of 4-amino-3,5,6-trifluoro-2(1H)-pyridinone (3) with hydrazine. Acetylation of 17 provided 4-amino-3-fluoro-1-(2,3,5-tri-O-acetyl-beta D-ribofuranosyl)-2(1H)-pyrid inone (29). Structure proof of target nucleosides and heterocyclic compounds was provided by X-ray diffraction, 19F and 1H NMR, and UV. The ID50 values of fluorine-substituted 3-deazacytosines and 3-deazacytidines were greater than 1 X 10(-5) M in L1210 lymphoid leukemia cells in culture. Nucleoside 17 and its tri- and tetraacetates were the most active compounds with ID50 values of 1.07 X 10(-5), 1.23 X 10(-5), and 1.25 X 10(-5) M, respectively. The target nucleosides and intermediate heterocycles were inactive against P388 and L1210 lymphocytic leukemia in mice, except nucleoside 17 (NSC-378066) and its triacetate 29 (NSC-382021). Nucleoside 17 exhibited confirmed DN2 activity (% T/C 169-230) at five dose levels (25-300 mg/kg). Prodrug 29 exhibited similarly confirmed L1210 in vivo activity. PMID- 3806614 TI - 1-Aryl-2-(aminomethyl)cyclopropanecarboxylic acid derivatives. A new series of potential antidepressants. AB - A series of 1-aryl-2-(aminomethyl)cyclopropanecarboxylic acid derivatives were synthesized and evaluated as potential antidepressants. Compounds with the Z configuration were synthesized from 1-aryl-2-oxo-3-oxabicyclo[3.1.0]hexane and those with the E configuration from (E)-1-phenyl-2 (hydroxymethyl)cyclopropanecarboxylic acid. The compounds were evaluated in animal tests designed to reveal potential antidepressant activity and the existence of undesirable side effects. Several derivatives were more active than imipramine and desipramine. On the basis of its activity in pharmacological animal tests of antidepressant activity and its potential lack of side effects, 1 phenyl-1-[(diethylamino)carbonyl]-2- (aminomethyl)cyclopropane hydrochloride, midalcipran (INN), was selected for further development. This compound is currently in phase III clinical evaluation. PMID- 3806616 TI - Antitumor imidazotetrazines. 14. Synthesis and antitumor activity of 6- and 8 substituted imidazo[5,1-d]-1,2,3,5-tetrazinones and 8-substituted pyrazolo[5,1-d] 1,2,3,5-tetrazinones. AB - The systematic variation of the potent antitumor agent mitozolomide (1) is extended to cover alteration of substituents at positions 6 and 8 and to change the imidazo[5,1-d]-1,2,3,5-tetrazinone (1) skeleton to the isomeric pyrazolo-[5,1 d]-1,2,3,5-tetrazinone (17) skeleton. The series of eight 6-alkyl and 6-aralkyl derivatives of 1 showed optimal antitumor activity when the group was small or linear, but activity diminished as size and branching of this substituent increased. This may reflect altered transport characteristics, or failure of the enlarged derivatives to fit a binding site, or possibly a reduced tendency for the derivatives having bulky groups at position 6 to hydrolytically generate the putatively active triazenes (21). Testing of 14 derivatives of 1 differently substituted at position 8 revealed a complex structure-activity relationship, with good antitumor activity obtained for carbamoyl and sulfamoyl groups bearing small substituents. The 8-methylsulfonyl compound had noteworthy activity, but the 8-cyano, 8-nitro, and 8-phenyl derivatives were devoid of useful antitumor activity in these tests. From the limited number of pyrazolotetrazinones (17) reported here, it is suggested that the same conclusions as regards activity also hold true for this ring system. PMID- 3806617 TI - NMR spectroscopic studies of intermediary metabolites of cyclophosphamide. 2. Direct observation, characterization, and reactivity studies of iminocyclophosphamide and related species. AB - 4-Hydroxy-5,5-dimethylcyclophosphamide (6) was synthesized as a stable (to fragmentation) analogue of 4-hydroxycyclophosphamide (1). In anhydrous Me2SO-d6 (less than or equal to 0.03 mol % water), cis- and trans-6 were observed by multinuclear NMR spectroscopy to equilibrate with alpha, alpha dimethylaldophosphamide (7) and 5,5-dimethyliminocyclophosphamide (8). Identification of 8 was based on 1H, 13C, and 31P chemical shifts, selective INEPT and two-dimensional NMR correlation experiments, and temperature-dependent equilibria data. The interconversion of cis-/trans-6 and -7 was also observed in lutidine buffer; 8 was not detected under the aqueous conditions. In Me2SO-d6, hydroxy metabolite 1 underwent dehydration to give iminocyclophosphamide (5), as evidenced by chemical shift data and a selective INEPT experiment. Concentrations of cis-/trans-1, aldophosphamide (2), and 5 were found to be temperature dependent with higher temperatures favoring 2 and 5 in a reversible manner, thus indicating that 1/2/5 were intercoverting. The addition of small amounts of water to Me2SO-d6 solutions of imine 5 resulted in the immediate disappearance of its NMR signals. The role of imine 5 in the conversion of 1 to C-4 substituted analogues of 1 was elucidated for the formation of 4-cyanocyclophosphamide (3a) from 1 and sodium cyanide in lutidine buffer. PMID- 3806618 TI - Octahydropyrazino[2',3':3,4]pyrido[1,2-a]indoles. A new class of potent antihypertensive agents. AB - Simplifications and modifications of the vincamine molecule led to the discovery of antihypertensive 1,2,3,4,4a,5,6,12b-octahydro-12-methylpyrazino[2',3':3,4]pyr ido[1,2-a] indoles. Stereoselective syntheses of both 4a,12b-cis and 4a,12b-trans isomers represent new annulation strategies for the construction of fused piperazines. Compounds of the trans series were at least 10 times more potent than the corresponding cis isomers. Antihypertensive activity and alpha 1 adrenoceptor blocking properties peaked with a simultaneous introduction of 4 methylethyl and 1-alkyl substituents. Compound 15j (AY-28,228; atiprosin), (4a, 12b-trans)-1-ethyl-1,2,3,4,4a,5,6, 12b-octahydro-12-methyl-4-(1 methylethyl)pyrazino[2',3':3,4]pyrido [1,2-a]indole, was chosen for a detailed preclinical evaluation. PMID- 3806619 TI - Activation mechanisms of mafosfamide and the role of thiols in cyclophosphamide metabolism. AB - cis-Mafosfamide (cis-5) (ASTA Z7557), a stable analogue of cis-4 hydroxycyclophosphamide (cis-2), undergoes rapid decomposition in aqueous phosphate buffer or plasma at pH 7.4 and 37 degrees C. The reaction kinetics of cis-5 are complex, and trans-mafosfamide (trans-5) and cis-2 are produced and subsequently disappear over the course of the reaction. The rates of decomposition of cis-5 as well as cis-2 were much faster in plasma than in buffer. The cis-trans isomerization of cis-5 occurred by a specific-base catalyzed process via iminocyclophosphamide (8) as a transient intermediate. In contrast, formation of cis- and trans-mafosfamide (5) from cis-2 and MESNA (sodium 2-mercaptoethanesulfonate) proceeded by an acid-catalyzed process via the hemithioacetal intermediate (6). The significance of these findings with respect to cyclophosphamide metabolism is discussed. PMID- 3806620 TI - Leukotriene D4 antagonists and 5-lipoxygenase inhibitors. Synthesis of benzoheterocyclic [(methoxyphenyl)amino]oxoalkanoic acid esters. AB - A series of novel benzoheterocyclic [(methoxyphenyl)amino]oxoalkanoic acid esters has been prepared. These compounds were tested as inhibitors of rat polymorphonuclear leukocyte 5-lipoxgenase (LO) in vitro and as inhibitors of leukotriene D4 (LTD4) and ovalbumin (OA) induced bronchospasm in the guinea pig (GP) in vivo. In general, inhibitory activity against 5-LO, LTD4, and OA was broadest for benzthiazole-containing analogues (benzthiazole greater than benzimidazole much greater than benzoxazole, benzofuran). The most potent 5-LO inhibitor, 4-[[3-(2-benzthiazolylmethoxy)-phenyl]hydroxyamino]-4-oxobutanoic acid methyl ester (7), had an IC50 of 0.36 microM. Compound 7, however, was inactive vs. OA. The most potent compound in vivo, 4-[[3-[(1-methyl-2 benzimidazolyl)methoxy]phenyl]-amino] -4-oxobutanoic acid methyl ester 4, inhibited both LTD4- and OA-induced bronchospasm by 83% and 60%, respectively, at 50 mg/kg intraduodenally. Compound 4 was studied in the Ames assay employing five strains of bacteria (TA1535, TA1537, TA1538, TA98, and TA100) with and without S 9 rat liver enzyme metabolic activation, and there was no significant number of reversions noted. PMID- 3806621 TI - Chemical differentiating agents. Differentiation of HL-60 cells by hexamethylenebis[acetamide] analogues. AB - Hexamethylenebis[acetamide] (HMBA) is an agent in clinical trial that induces differentiation of certain types of tumor cells to nonmalignant phenotypes. In an attempt to discover a more potent compound, a number of bis-functionalized amides, imides, and hydrazine derivatives of HMBA were prepared and evaluated in vitro with the HL-60 human promyelocytic leukemia cell line. Among the compounds evaluated, the 5,5-dimethylhydantoin derivative is almost 10 times more potent than HMBA in inducing differentiation. The bis-imide, diacetyl-HMBA, is both more potent and effective than its parent compound. Six of the 16 compounds evaluated cause at least 20% differentiation. An inverse relationship between the degree of differentiation and the percentage of viable cells is described for HMBA and its analogues. PMID- 3806622 TI - The influence of physicochemical parameters on the biliary excretion of a series of nitroimidazoles. AB - The relationship between physicochemical parameters and biliary excretion of nitroimidazoles was investigated. The unmetabolized form of each drug was detected in the bile by means of a UV procedure. A highly significant reversed parabolic relationship was shown between the Rm values and the biliary excretion of the test compounds. In other words, the compounds closer to the optimal Rm value are excreted less than those characterized by higher or lower Rm values. Since the Rm values seem to account for both the lipophilic and polar character of nitroimidazoles, the reversed parabola could be due to plasma protein binding and/or some protein binding within the hepatocyte. In fact, both the lipophilic and polar character seem to play an important role in protein binding of chemicals. PMID- 3806623 TI - Molecular modification of anticholinergics as probes for muscarinic receptors. 2. Amino esters of alpha-methyltropic acid. AB - As a continuation of our goals to study molecular probes for muscarinic cholinergic receptors, a series of 3-substituted 2-methyl-2-phenylpropanoates with the general structure of C6H5C(CH2X)(CH3)COOCH2CH2NEt2 where X = OH, OTs, F, Cl, Br, I, and OAc were prepared and their antispasmodic activities examined on isolated rat ileum preparations. Structure-activity relationship studies with these compounds provide further evidence suggesting that binding of an aromatic moiety in a specific location within the hydrophobic region of the receptor is important for anticholinergic potency. A nucleophilic displacement of chloride by "naked" fluoride under mild conditions is also reported. PMID- 3806624 TI - The mechanism of activation of 4-hydroxycyclophosphamide. AB - 4-Hydroxycyclophosphamide (2/3) of unknown stereochemistry is the initial metabolite formed after administration of cyclophosphamide (1). Ultimate conversion to the cytotoxic metabolite phosphoramide mustard (6) is initiated by ring opening of 4-hydroxycyclophosphamide to produce aldophosphamide (4). The ring-opening reaction and subsequent equilibration of 2-4 are subject to general acid catalysis, and the equilibrium composition is independent of buffer structure and pH. In contrast, formation of 6 from 4 proceeds by general-base catalyzed beta-elimination. trans-4-Hydroxycyclophosphamide undergoes ring opening ca. 4 times faster than the cis isomer, and cyclization of 4 favors the trans isomer by a factor of ca. 3 over the cis isomer. The rapid equilibration of 2-5 and the absence of elimination to give 6 at pH approximately 5 provides a convenient method to prepare a stable equilibrium mixture of activated cyclophosphamide metabolites suitable for in vitro use. PMID- 3806625 TI - Synthesis and biological properties of 9-(trans-4-hydroxy-2-buten-1-yl)adenine and guanine: open-chain analogues of neplanocin A. AB - Alkylation of adenine (5a) or 2-amino-6-chloropurine (5b) with excess trans-1,4 dichloro-2-butene (4), effected by K2CO3 in dimethyl sulfoxide or tetra-n butylammonium fluoride in tetrahydrofuran, led in 90-95% regioselectivity to 9 alkylpurines 6a and 6b. The title compounds 2a and 2b were obtained by refluxing intermediates 6a and 6b in 0.1 M NaOH or HCl. Adenine derivative 2a is a substrate for adenosine deaminase whereas both 2a and 2b exhibit 50% inhibition of the growth of murine leukemia L 1210 cell culture at 1 mM concentration. PMID- 3806626 TI - Synthetic bovine prothrombin precursor 13-29 for studies of vitamin K dependent carboxylase. AB - The synthesis of the amino acid sequence found in bovine prothrombin precursor 13 29 (PTP 13-29) has been achieved by solid-phase synthesis of the bis(acetamidomethyl)-protected linear peptide followed by cyclization to the monomeric disulfide. Synthesis of the disulfide bond was achieved by deprotection with mercuric acetate in acetic acid followed by oxidation with potassium ferricyanide. Experimental conditions for closure of the disulfide bond were identified by obtaining the circular dichroism spectra of the linear precursor in a variety of solvent systems. Cyclization in organic solvent systems was not successful but led to the formation of insoluble polymers. Synthetic PTP 13-29 was tested as a substrate for the vitamin K dependent carboxylase. Neither the linear nor cyclic synthetic 17 amino acid peptides were carboxylated as well as the standard, Boc-Glu-Glu-Leu-OMe, at mM concentrations. The estimated Km of synthetic PTP 13-29 is greater than 1 mM. Thus, bovine prothrombin precursor 13 29 is not an unusually effective substrate for the carboxylase as reported by Soute et al. PMID- 3806627 TI - Do doctors owe a special duty of beneficence to their patients? PMID- 3806628 TI - Health. AB - Many practical issues in medical ethics depend on an understanding of the concept of health. The main question is whether it is a purely descriptive or a partly evaluative or normative concept. After posing some puzzles about the concept, the views of C Boorse, who thinks it is descriptive, are discussed and difficulties are found for them. An evaluative treatment is then suggested, and used to shed light on some problems about mental illness and to compare and contrast it with physical illness and with political and other deviancies which are not illnesses. PMID- 3806629 TI - The Warnock Report and single women: what about the children? AB - The Warnock Committee decided not to sanction artificial insemination by donor (AID) and in vitro fertilisation (IVF) for single heterosexual women or for lesbian women on the grounds that it is better for children to be born into a two parent heterosexual family. From an examination of the effects on children of growing up in fatherless heterosexual and lesbian families, this paper questions that assumption. PMID- 3806630 TI - AIDS legislation--turning up the heat? AB - This paper is not about the medical condition of AIDS. Nor is it about the history of the condition since it was first reported in Atlanta, Georgia in 1981. It looks rather, at the catalogue of legislative and other legal responses to the spread of AIDS. The paper analyses the AIDS condition in its historical context. The hysteria accompanying the outbreak of AIDS is contrasted with the similar hysteria associated with other previous epidemics experienced in Australia over the past two centuries. The paper categorises the responses of lawmakers to the condition, according to the approach taken; from 'full blast', through 'moderate heat' to 'low key' or an attempt to avoid or minimise legal intervention. It is suggested that the appropriate response should depend upon such factors as the present magnitude of the condition, its likely future course, the availability of cures and protections against its spread and objectives being sought by intervention. Unless these factors are taken into account gross over-reaction can occur, causing social disruption and much personal injustice. PMID- 3806631 TI - Priorities in the allocation of scarce resources. AB - The authors report and comment on student reactions to a clinical example of moral choice in the microallocation of scarce resources. Four patients require dialysis simultaneously, but only one kidney machine is available. What moral, as opposed to clinical, criteria are available to determine who should have priority? PMID- 3806633 TI - Moral dilemmas in surgical training: intent and the case for ethical ambiguity. AB - It is often assumed that the central problem in a medical ethics issue is determining which course of action is morally correct. There are some aspects of ethical issues that will yield to such analysis. However, at the core of important medical moral problems is an irreducible dilemma in which all possible courses of action, including inaction, seem ethically unsatisfactory. When facing these issues ethical behaviour depends upon an individual's understanding and acceptance of this painful dilemma without recourse to external moral authority. PMID- 3806632 TI - Research on human embryos--a justification. AB - The philosophical debate surrounding the moral status of the embryo has reached the public arena. The author of this paper examines some of the common arguments against embryo experimentation, including an influential article by Professor Ian Kennedy. He concludes that these arguments do not succeed in demonstrating that the intentional creation of embryos for research purposes is wrong, unless they also succeed in demonstrating that contemporary liberal abortion laws are also wrong. The author also criticises the conclusions of the Warnock Report, and suggests that the reasons for permitting embryo research must be given a wider public audience. PMID- 3806634 TI - Psychoanalysis and analytical psychotherapy in the NHS. PMID- 3806635 TI - Informed dissent. PMID- 3806636 TI - Muscular dystrophy in girls with X;autosome translocations. AB - Twenty known cases of X;autosome translocations with breakpoints at Xp21 associated with Duchenne or Becker muscular dystrophy in girls are reviewed. The variable severity described for different persons may reflect differences in X inactivation or in the nature of the genomic target disrupted. High resolution cytogenetic studies on 12 cases indicate breakpoints on the X chromosome at Xp21.1 or Xp21.2. Translocation chromosomes from several of these cases have been isolated in human/mouse somatic cell hybrids. Molecular heterogeneity in the breakpoint positions has been established by probing DNA from these hybrids with a range of cloned sequences known to be located within, or closely linked to, the Duchenne region. The minimum separation between the most distal and the most proximal breakpoints is 176 kb suggesting that, if a single gene is involved, it must be large. Alternatively, the translocations may affect different genes, or confer alterations to regulatory sequences which operate at a distance. PMID- 3806637 TI - The screening of Duchenne muscular dystrophy patients for submicroscopic deletions. AB - We have probed the DNA of 156 Duchenne muscular dystrophy (DMD) patients, representing 140 kindreds, with cloned DNA sequences derived from Xp21 and known to show deletions in some DMD patients. Sixteen cases showed a deletion, as defined by lack of hybridisation to one or more of the four probes used. However, two of these cases were brothers, so 15 independent deletions (10.7%) are represented. The deletion map is compatible with the suggested order for the sites of the probes used in the study, that is, telomere----pERT87.15----pERT87.8 ---pERT87.1----pX J1.1----754----centromere. Further mapping of these deletions and characterisation of the deletion breakpoints should facilitate more accurate molecular localisation of the gene or genes which, when mutated, are responsible for causing DMD. PMID- 3806638 TI - The population genetics of Duchenne: natural and artificial selection in Duchenne muscular dystrophy. AB - The dynamics of X linkage was derived by Haldane in 1935. It is clear that the majority of mutations to an X linked lethal are new and that methods of control based on relatives of known cases can have limited impact on future incidence. The ability to define and track neighbouring loci allows some carriers who are daughters of carriers to be detected, and possible carriers to be excluded, with high reliability. Fetal diagnosis may also be made in the same way, but not without a substantial casualty rate. The precision of such diagnosis by proxy is limited both by the estimate of the recombination fraction and its variance, and can rarely exceed 1/s where the recombinational data are based on s informative meioses. Bracketing loci provide greater security from failure to diagnose cases but may involve substantial casualty rates. The estimation of both failure rates and casualty rates is discussed. PMID- 3806639 TI - X linked muscular dystrophy with contractures. AB - Another family with X linked muscular dystrophy affecting particularly the humeral and tibial muscles is described. Cardiomyopathy in the eldest male necessitated the insertion of a pacemaker. PMID- 3806640 TI - The fragile X syndrome in a large family. II. Psychological investigations. AB - Intelligence levels and intelligence profiles were investigated in 52 members of a large family with the fragile X syndrome. The mental abilities were evaluated by the three Wechsler intelligence tests (WAIS, WISC-R, and WPPSI). Chromosomal and psychological data were then compared. In 22 non-retarded fra(X) negative family members, a mean IQ of 102 was found (males 97, females 106). Eleven non retarded carrier females had IQs between 70 and 110 (mean 86.8), which is 20 points below the mean of normal women (alpha = 0.01). One non-retarded male with 6% fra(X) positive cells had an IQ of 98. His intelligence profile closely resembled the profile in the non-retarded female carriers. The highest IQ in the group of retarded males was 31. The mentally retarded females scored IQs between 26 and 41. In male and female patients verbal intelligence substantially exceeded performance abilities. There was a considerable gap between the highest IQ in the group of retarded females and the lowest IQ in the group of non-retarded carriers (41 and 71 respectively) and a considerable overlap was found between the IQ levels of the non-retarded carriers and normal women. PMID- 3806641 TI - Trisomy 1 in an eight cell human pre-embryo. AB - The high incidence of chromosome abnormalities in clinically recognised pregnancies is well documented, but experience of these problems at the time of conception is extremely limited. Using donated oocytes from women seeking surgical sterilisation, we have established reliable cytogenetic techniques for chromosome analysis of human pre-embryos. These have resulted in the first report of trisomy 1. The pre-embryo showed no other obvious abnormality in relation to follicular characteristics, embryo morphology, and cleavage kinetics. The usefulness of such data in explaining the high incidence of occult human pregnancy loss and the current poor success following embryo replacement is emphasised. PMID- 3806642 TI - Educational impacts of new care systems. PMID- 3806643 TI - Why the dinosaurs died: extinction or evolution? PMID- 3806644 TI - John A. D. Cooper lecture. Making medicine a more attractive profession. PMID- 3806645 TI - A report on the establishment. PMID- 3806646 TI - A workshop to increase communication competence in medical students. PMID- 3806647 TI - A course in medical research study design and analysis. PMID- 3806648 TI - Leadership in medical education: the challenge of diversity. PMID- 3806649 TI - Leadership in meeting ethical challenges. PMID- 3806650 TI - Complement and immunoglobulin levels in early childhood in homozygous sickle cell disease. AB - Complement levels, tests of complement function, and immunoglobulin levels were studied in 63 children with homozygous sickle cell (SS) disease and in 88 children with a normal haemoglobin (AA) genotype from birth to 2 yr of age. Levels of complement component C3 were consistently lower in SS children, the difference being highly significant (p less than 0.001) by the age of 2 yr and levels of C3d were significantly higher from the age of 6 months. These observations are compatible with increased turnover of C3 in SS disease from early in life. No consistent genotype differences were observed in the levels of C4, factor B, or functional assays. IgA levels in SS disease were significantly higher at age 2 yr but there were no consistent patterns with IgM or IgG. There was no difference in the prevalence of infections between groups with low C3 or low values of alternative pathway activity but the groups were small and only capable of detecting major differences. However, the findings cast some doubt on the role of individual complement deficiencies in the susceptibility to infection in SS children at this age. PMID- 3806651 TI - Spontaneous malignant lymphoma in an African green monkey naturally infected with simian T-lymphotropic virus (STLV). AB - An African green monkey naturally infected with simian T-lymphotropic virus (STLV) developed spontaneous malignant lymphoma of diffuse pleomorphic type. The clinical, hematological and histopathological characteristics were very similar to those of human adult T-cell leukemia. PMID- 3806652 TI - Breeding vervet monkeys in a closed environment. AB - A breeding group of vervet monkeys produced 95 offspring over five years. Fetal wastage for 114 pregnancies was 16.7%. Uterine sizes were recorded for 103 pregnancies in various stages of gestation. This enabled diagnosis of pregnancy, estimation of stage of gestation, and prediction of parturition to within two weeks. Detailed observations were made on dental eruption, pelage development, and growth of 57 infants. PMID- 3806653 TI - Glycosylated haemoglobin (Hb A1) in normal rhesus monkeys (Macaca mulatta). AB - Glycosylated haemoglobins were measured in 23 healthy juvenile rhesus monkeys by the use of commercially available minicolumn chromatography (Quick Sep., Isolab Inc., Ohio, USA) to establish the normal range. Values obtained (mean +/- 1 standard deviation (SD) 1.57 +/- 0.68%) were significantly lower than that of 17 adult healthy human volunteers by the use of the same method of estimation (mean +/- 1 SD of 5.34 +/- 0.78%). PMID- 3806654 TI - Tachyarrhythmia in a baboon: a case report. AB - An adult baboon with multiple organ symptomatology and tachycardia was successfully treated with one-time electrical cardioversion. The case is presented to demonstrate the need to include ECG monitoring in diagnostic assessment of primate animals with nonspecific symptoms. PMID- 3806655 TI - The carrier reorientation step in erythrocyte choline transport: pH effects and the involvement of a carrier ionizing group. AB - Under zero-trans conditions, the facilitated transport of choline across the erythrocyte membrane is limited by the rate of reorientation of the free carrier; as a result the pH dependence of this step can be investigated, independent of other steps in transport. It is found that as the pH declines (between 8.0 and 6.0) the rate of inward movement of the free carrier rises and the rate of outward movements falls, so that the partition of the free carrier increasingly favors the inward-facing form. When the pH of the cell interior and of the medium are varied independently, the partition responds to the internal but not the external pH. The membrane potential, which varies somewhat as the pH is altered, has no effect on the carrier partition. The analysis of the results indicates that the carrier mobility is dependent on an ionizing group of pKa 6.8, which is exposed on the cytoplasmic surface of the membrane in the inward-facing carrier; in the outward-facing carrier the ionizing group appears to be masked, in that its pKa is shifted downward by more than one unit. The observations can be explained by assuming that an ionizing group is located in the wall of a gated channel connecting the substrate site with the cytoplasmic face of the cell membrane. PMID- 3806656 TI - Effects of high hydrostatic pressure on 'passive' monovalent cation transport in human red cells. AB - The effects of high hydrostatic pressure (up to 400 ATA) on the 'passive' (defined as ouabain + bumetanide + EGTA-insensitive) influx and efflux of radiotracer cations (K+ Rb+, Na+, Cs+) has been studied in human red cells suspended at different medium tonicities giving altered cell volumes. Under all conditions studied, cation permeability was raised at pressure, and at least two distinct components were found to comprise this flux. Thus, increasing pressure caused a generalized increase in cation permeability which was unaffected by the anion present, demonstrated linear concentration dependence, and was reduced with cell swelling, and stimulated a specific KCl pathway which was Cl- dependent, demonstrated saturation kinetics with raised [K]0 and was increased with cell swelling. High hydrostatic pressure caused a significant alteration to red cell morphology from the normal biconcave disc to cup-shaped forms and it is proposed that this is associated with the unmasking of the volume-sensitive KCl system. PMID- 3806657 TI - Maintenance of epithelial surface membrane lipid polarity: a role for differing phospholipid translocation rates. AB - Large differences in lipid composition of apical and basolateral membranes from epithelial cells exist. To determine the responsible mechanism(s), rat renal cortical brush border and basolateral membrane phospholipids were labeled using 32P and either [3H]-glycerol or [2-3H] acetate for incorporation and degradation studies, respectively. Brush border and basolateral membrane fractions were isolated simultaneously from the same cortical homogenate. Different phospholipid classes were degraded at variable rates with phosphatidylcholine having the fastest decay rate. Decay rates for individual phospholipid classes were, however, similar in both brush border and basolateral membrane fractions. In phospholipid incorporation studies, again, large variations existed between individual phospholipid classes with phosphatidylcholine and phosphatidylinositol showing the most rapid rates of incorporation. Sphingomyelin and phosphatidylserine showed extremely slow incorporation rates and did not enter into the isotopic decay phase for 48 hr. In contrast to degradation studies, however, the same phospholipid class labeled the two surface membrane domains at highly variable rates. The difference in these rates, with the exception of phosphatidylinositol, were identical to the differences in phospholipid compositions between the two membranes. For example, phosphatidylcholine was incorporated into the basolateral membrane 2.5 X faster than into the brush border membrane and its relative composition was 2.5 X greater in the basolateral membrane. The opposite was true for sphingomyelin. These results indicate incorporation and not degradation rates of individual phospholipids play a major role in regulating the differing phospholipid composition of brush border and basolateral membranes. PMID- 3806658 TI - A method for measuring apical glucose transporter site density in intact intestinal mucosa by means of phlorizin binding. AB - Phlorizin binding has been widely used to estimate the site density of glucose transporters on intestinal and renal brush-border vesicles. Glucose transport measurements in the intact intestinal mucosa show that changes in transport rate postulated to arise from changes in site density occur under many physiological and pathological conditions. Exploring the basis of these regulatory phenomena would be facilitated by comparing changes in transport rate and site density measured in the same preparation. Hence we developed methods for measuring phlorizin binding in everted sleeves of intact mouse intestine. Specific binding of phlorizin to glucose carriers reached an asymptotic value within 120 sec, while nonspecific binding continued to rise thereafter. Hence we used 120-sec incubations. The rate of dissociation of specifically bound phlorizin was accelerated by Na+-free solutions and even more by 50 mM glucose, while the rate of dissociation of nonspecifically bound phlorizin was independent of these solution changes. Hence we chose a 20-sec rinse in Ringer + 50 mM mannitol, because it washes out 30-40% of the nonspecifically bound phlorizin but virtually none of the specifically bound phlorizin. Ligand-binding analysis of specific binding against phlorizin concentration suggested two classes of binding sites, of which the one with stronger affinity for phlorizin probably has the higher capacity for glucose transport in mouse jejunum. The calculated affinity and capacity of this component are independent of whether one estimates the specific component of total binding by adding glucose or by removing Na+. PMID- 3806659 TI - Use of phlorizin binding to demonstrate induction of intestinal glucose transporters. AB - We used specific binding of phlorizin to the intact intestinal mucosa in order to measure glucose transport site density in intestines of mice fed a high carbohydrate or no-carbohydrate diet. Nonspecific binding varied with intestinal position but showed only modest dependence on diet. Specific binding to glucose transporters was 1.9 times greater in jejunum of high-carbohydrate mice than of no-carbohydrate mice; this ratio was the same as the ratio for Vmax values of active D-glucose uptake between the two diet groups. The gradient in specific binding of phlorizin along the intestine paralleled the gradient in Vmax of glucose transport. These results directly demonstrate that the increase in intestinal glucose transport caused by a high-carbohydrate diet is due to induction of glucose transporters. They also indicate that the normal positional gradient in glucose transport along the intestine arises from a gradient in transporters, induced by the normal gradient in luminal glucose concentration. PMID- 3806660 TI - The relationship between chronological age, length of institutionalization and measured intellectual functioning among moderately mentally retarded adults. PMID- 3806661 TI - Psychiatric and behavioural disorders amongst older severely mentally handicapped inpatients. AB - A retrospective survey of psychiatric disorders requiring medication amongst 50 mentally handicapped inpatients aged 60 years or more, revealed a high prevalence of affective disorder which increased with age. Behavioural problems such as aggression and overactivity improved with age in some, but not all, patients. PMID- 3806662 TI - An investigation of the use of high- and low-preference food as a reinforcer for increased activity of individuals with Prader-Willi syndrome. AB - The results of this study provide information that might be used to develop an approach to weight loss management for individuals with Prader-Willi syndrome that emphasizes the increase of output. Specifically, our finding that they do have a definite food preference and, subsequently, that they prefer a lesser amount of the high-preference food than a greater amount of low-preference food is contradictory to several non-empirical reports (Holm, 1981; Pipes & Holm, 1981). Further, the use of food as a reinforcer has been considered taboo by those who use more conventional and restrictive management approaches with Prader Willi syndrome individuals. Our data, however, strongly suggest that a low volume of food can be used as an effective reinforcer for increased activity and exercise. PMID- 3806663 TI - Screening of inherited oligosaccharidurias among mentally retarded patients in northern Finland. AB - Urinary oligosaccharides were screened with thin-layer chromatography among 1058 mentally retarded patients of a geographically defined area with an approximate population of 200,000. Aspartylglucosaminuria was detected in 26 cases and Salla disease in 24 cases. All patients with aspartylglucosaminuria had the correct diagnosis before the screening, whereas two new cases of Salla disease were detected. No other inherited metabolic diseases were found. The results demonstrate the accuracy of the TLC method, and indicate a high gene frequency of those two lysosomal storage diseases in the population of northern Finland. PMID- 3806664 TI - Adults who are mentally handicapped as consumers: issues and guidelines for interviewing. AB - This paper has arisen from an investigation of the lives and circumstances of 88 people who are mentally handicapped and living in their own homes or tenancies. This study is funded by the Economic and Social Research Council. The difficulties inherent in interviewing people who are mentally handicapped are outlined. This is followed by a consideration of the findings of previous research and a listing of guidelines for interviewing. The paper also explores consent procedures and issues pertaining to the measurement of satisfaction. PMID- 3806665 TI - Adults who are mentally handicapped and living with their parents: satisfaction and perceptions regarding their lives and circumstances. AB - This study describes the circumstances of 12 adults who are mentally handicapped who are residing with their parents. The results are derived from a content analysis of interviews. The analysis explores the reliability of a procedure for rating people's satisfaction. It also investigates people's views regarding the following: money, cooking, laundry, shopping, cleaning, home, neighbours, friends, support, interests and the ATC. PMID- 3806666 TI - Tissue-specific mosaicism for the stability of a ring 13 chromosome. AB - A ring 13 chromosome was identified in an infant whose chromosomes were studied because of microcephaly. The ring chromosome was studied over a 3-year-period in lymphocytes, and in both short- and long-term fibroblast cultures. Lymphocyte cultures revealed a consistently stable ring 13 chromosome with minimal loss of genetic material (the distal portion of band q34). Fibroblast cultures contained a ring chromosome a quarter of the size of the original ring and this chromosome was unstable in short- and long-term cultures. The patient's mild dysmorphic features and moderate mental retardation correlate with a stable ring chromosome in which only a small amount of genetic material has been lost rather than with the unstable small ring 13 chromosome observed in fibroblast cultures. The observation of drastic tissue specific differences in ring sizes and stability makes phenotypic karyotypic correlations with ring chromosome patients even more difficult and counselling in cases of prenatal diagnosis questionable. PMID- 3806667 TI - Mohs surgery in the treatment of skin cancer. PMID- 3806668 TI - Management of hypertension in early pregnancy. PMID- 3806669 TI - Multiple sequence alignment. AB - A method has been developed for aligning segments of several sequences at once. The number of search steps depends only polynomially on the number of sequences, instead of exponentially, because most alignments are rejected without being evaluated explicitly. A data structure herein called the "heap" facilitates this process. For a set of n sequence segments, the overall similarity is taken to be the sum of all the constituent segment pair similarities, which are in turn sums of corresponding residue similarity scores from a Table. The statistical models that test alignments for significance make it possible to group sequences objectively, even when most or all of the interrelationships are weak. These tests are very sensitive, while remaining quite conservative, and discourage the addition of "misfit" sequences to an existing set. The new techniques are applied to a set of five DNA-binding proteins, to a group of three enzymes that employ the coenzyme FAD, and to a control set. The alignment previously proposed for the DNA-binding proteins on the basis of structural comparisons and inspection of sequences is supported quite dramatically, and a highly significant alignment is found for the FAD-binding proteins. PMID- 3806670 TI - Control of gene expression in the P2-related template coliphages. III. DNA sequence of the major control region of phage 186. AB - The PstI fragment (65.5% to 77.4%) of coliphage 186, known genetically to encode the major control genes, has been sequenced, and an analysis performed to assess coding capacity, transcription-translation signals, and to identify any other significant features. Our analysis indicates that the region encodes: seven genes, including the int and cI genes, which overlap, the late control gene B, and two genes, named CP75 and CP76, encoding potential DNA-binding proteins; a promoter pB and terminator tB for the rightward transcription of the B gene, and we predict the existence of this transcript in a lysogen; a promoter pL and terminator tL for leftward transcription that encodes the int and cI genes, and represents the presumed lysogenic transcript; a promoter pR for rightward transcription to give the presumed (early) lytic transcript that is overlapping and convergent with the lysogenic transcript; and finally, a potential operator site for repressor binding in the region of the pR promoter. Preliminary evidence is presented to support this analysis. PMID- 3806671 TI - Control of gene expression in the P2-related temperate coliphages. IV. Concerning the late control gene and control of its transcription. AB - In this paper we have sequenced four amber mutants and thereby confirmed the gene D (CP65) and gene B (CP67) assignments made in the accompanying paper (Kalionis et al., 1986). We have also studied, by gel electrophoresis, the transcription patterns of gene B in vivo. In a lysogen, gene B is present on a short transcript under autogenous (negative) control. Upon prophage induction, this transcript is amplified, but later in the cycle gene B is present on a larger transcript that originates in the late region. We have detected two copies of an inverted repeat in the promoter region of the B gene that we predict is recognized by the B protein. One arm of this repeat is associated with three of four P2 late promoters, downstream from the start point of transcription. The repeat is not present in the promoter region of P2 ogr. We describe the considerable homology in amino acid sequence seen with the late control proteins 186 gpB, P4 gp delta and P2 gpOgr, and present a working model for control of late gene transcription. PMID- 3806672 TI - DNA sequence of the tail fiber genes 37, encoding the receptor recognizing part of the fiber, of bacteriophages T2 and K3. AB - The DNA sequences of genes 37 of bacteriophages T2 and K3 are presented and compared with that of phage T4. The corresponding proteins constitute, as dimers, the part of the long tail fibers that recognizes the bacterial receptor. The CO2H termini of the polypeptides are located at the free ends of the fibers. Morphologically, the three phages are essentially identical, but they use different receptors. The genes from phages T4, T2 and K3 encode proteins consisting of 1026, 1341 and 1243 amino acid residues, respectively. DNA-DNA hybridizations had shown earlier that genes 37, in contrast to the gene for the major capsid protein, of a number of T-even type phages are highly polymorphic. The deduced amino acid sequences now show that this polymorphism extends to the protein primary structures. About 50 NH2-terminal residues are conserved and are probably required for binding to the adjacent protein 36. This area is followed by more or less irregularly spaced regions of non-homology, partial homology or complete homology. The heterogeneity is most prominent in a region encompassing about 600 CO2H-terminal residues of the T2 or K3 proteins. Nevertheless, the amino acid compositions of the three proteins are very similar and all are rich in glycine. It has been found that the receptor specificities of phages K3 and T2 are determined by protein 38, a polypeptide required for the efficient dimerization of protein 37 of phage T4. Proteins 38 of phages K3 and T2 are functionally interchangeable, those of T4 and T2 or K3 are not. Proteins 37 of phages K3 and T2 possess a conserved sequence of 160 CO2H-terminal residues. This area is missing in the T4 protein. This region may serve as a binding site for polypeptides 38 of phages K3 and T2. The overall picture of the protein primary structures of the three phages strongly suggests that the evolution of genes 37, which was most likely driven by selection for variations in receptor recognition specificities, has not been a steady process but has involved loss and gain of segments of DNA. PMID- 3806673 TI - Cytoplasmic concentrations of inorganic phosphate affect the critical concentration for assembly of actin in the presence of cytochalasin D or ADP. AB - Skeletal muscle actin labelled with pyrene was used to measure the critical concentration (Cc) for assembly in conditions designed to approximate the ionic environment in the cytoplasm. Under these conditions (0.1 M-KCl, 2 mM-MgCl2, 1.1 mM-ATP, 0.1 mM-CaCl2, 0.5 mM-ethyleneglycol-bis(beta-aminoethylether)N,N' tetraacetic acid, 0.25 mM-2-mercaptoethanol, 20 mM-imidazol X HCl, pH 7.0), the steady-state Cc value was estimated to be 0.07 microM (3.0 micrograms/ml), and, consistent with previous observations, the Cc increased to 0.20 microM (8.7 micrograms/ml) in the presence of 10(-6) M-cytochalasin D, and to 1.10 microM (47 micrograms/ml) after conversion of ATP to ADP using hexokinase and glucose. Addition of inorganic phosphate (Pi) at concentrations up to 20 mM caused only a slight decrease in the steady-state Cc, but at 2 mM-Pi (a reasonable estimate of cytoplasmic concentrations) the increase in Cc due to cytochalasin D was abolished, and at higher Pi concentrations there was even a slight decrease. Increasing Pi concentrations also progressively reduced the steady-state Cc for ADP-actin close to that for ATP-actin. These results are consistent with an increased affinity of ADP-actin for the polymer in the presence of Pi. To determine whether these effects of Pi were simply mass action effects on hydrolysis of bound ATP by polymerized actin, the stoichiometry of ATP hydrolysis during actin assembly was estimated and found to be at unity within the limits of experimental error and to be unaffected by Pi up to 20 mM. In addition, actin depolymerized by removal of ATP using glucose and hexokinase rapidly reassembled after addition of 20 mM-Pi. These results are interpreted by a mechanism involving the formation of ADP-Pi-actin species and are discussed in relation to the phenomenon of treadmilling and the theory of dynamic instability, and the potential for their occurrence in cells. PMID- 3806674 TI - Folding mechanism of porcine ribonuclease. AB - The kinetics of unfolding and refolding of porcine ribonuclease were investigated. The unfolded state of this protein was found to consist of a fast refolding species (UF) and two slow-refolding species (UIS and UIIS). After the rapid collapse of the structure during the N (native)----UF unfolding reaction, UIS and UIIS are produced from UF by two independent slow isomerizations of the unfolded polypeptide chain, leading ultimately to a mixture of about 10% UF, 20% UIIS and 70% UIS molecules at equilibrium. This is at variance with all other ribonucleases investigated to date, which show a distribution of 20% UF, 60 to 70% UIIS and only 10 to 20% UIS. The two isomerizations of the unfolded porcine protein differ strongly in rate. The first process with tau = 250 seconds (10 degrees C) leads to an increase in the fluorescence of Tyr92 and was identified as cis in equilibrium trans isomerization of Pro93. At equilibrium, most unfolded molecules contain an incorrect trans Pro93. The second isomerization is much slower (tau = 1300 s at 10 degrees C) and leads to a predominance of the incorrect isomer as well. Like isomerization of Pro93, it is governed by an activation enthalpy of 22 kcal/mol (92 kJ/mol) and it was tentatively assigned to the Pro114-Pro115 sequence of porcine ribonuclease. Because of the wide separation in rate between the two reactions, molecules with an incorrect isomer only at Pro93 accumulate transiently after unfolding. These are the UIIS molecules. Most of them are finally converted to UIS by the 1300 second process. All molecules that have undergone this isomerization refold very slowly, i.e. the UIS molecules. The major fraction contains two incorrect isomers. A 1300 second isomerization after unfolding and a predominant very slow refolding reaction were observed only for the porcine protein. We suggest that these changes in the folding mechanism may be correlated with the presence of the Pro114-Pro115 sequence, which occurs only in porcine ribonuclease. The refolding pathway of porcine UIIS involves the rapid formation of a native-like intermediate with an incorrect trans Pro93 as was found previously for the bovine ribonuclease, where the UIIS species predominates in the unfolded state. PMID- 3806675 TI - Spectrum of spontaneous frameshift mutations. Sequences of bacteriophage T4 rII gene frameshifts. AB - The DNA sequences of 185 independent spontaneous frameshift mutations in the rIIB gene of bacteriophage T4 are described. Approximately half of the frameshifts, including those at hot spot sites, are fully consistent with classical proposals that frameshift mutations are produced by a mechanism involving the misaligned pairing of repeated DNA sequences. However, the remaining frameshifts are inconsistent with this model. Correlations between the positions of two base-pair frameshifts and the bases of DNA hairpins suggest that local DNA topology might influence frameshift mutation. Warm spots for larger deletions share the property of having endpoints adjacent to DNA sequences whose complementarity to sequences a few base-pairs away suggest that non-classical DNA misalignments may participate in deletion mutation. A model for duplication mutation as a consequence of strand displacement synthesis is discussed. In all, 15 frameshifts were complex combinations of frameshifts and base substitutions. Three of these were identical, and have extended homology to a sequence 256 base-pairs away that is likely to participate in the mutational event; the remainder are unique combinations of frameshifts and transversions. The frequency and diversity of complex mutants suggest a challenge to the assumption that the molecular evolution of DNA must depend primarily upon the accumulation of single nucleotide changes. PMID- 3806676 TI - Structure and assembly of turnip crinkle virus. I. X-ray crystallographic structure analysis at 3.2 A resolution. AB - The structure of turnip crinkle virus has been determined at 3.2 A resolution, using the electron density of tomato bushy stunt virus as a starting point for phase refinement by non-crystallographic symmetry. The structures are very closely related, especially in the subunit arm and S domain, where only small insertions and deletions and small co-ordinate shifts relate one chain to another. The P domains, although quite similar in fold, are oriented somewhat differently with respect to the S domains. Understanding of the structure of turnip crinkle virus has been important for analyzing its assembly, as described in an accompanying paper. PMID- 3806677 TI - Structure and assembly of turnip crinkle virus. II. Mechanism of reassembly in vitro. AB - Dissociation of turnip crinkle virus (TCV) at elevated pH and ionic strength produces free dimers of the coat protein and a ribonucleoprotein complex that contains the viral RNA, six coat-protein subunits, and the minor protein species, p80 (a covalently linked coat-protein dimer). This "rp-complex" is stable for several days in high salt at pH 8.5. Reassembly of TCV can be accomplished under physiological conditions, using isolated coat protein and either rp-complex or protein-free RNA. If rp-complex is used in reassembly, the same subunits remain bound to RNA on subsequent dissociation; if free RNA is used, rp-complex is regenerated. In both cases, the assembly is selective for viral RNA in competition experiments with heterologous RNA. Electron microscopy shows that assembly proceeds by continuous growth of a shell from an initiating structure, rather than by formation of distinct intermediates. We suggest that rp-complex is the initiating structure, suggest a model based on the organization of the TCV particle, and propose a mechanism for TCV assembly. PMID- 3806678 TI - Sequence periodicities in chicken nucleosome core DNA. AB - The rotational positioning of DNA about the histone octamer appears to be determined by certain sequence-dependent modulations of DNA structure. To establish the detailed nature of these interactions, we have analysed the sequences of 177 different DNA molecules from chicken erythrocyte core particles. All variations in the sequence content of these molecules, which may be attributed to sequence-dependent preferences for DNA bending, correlate well with the detailed path of the DNA as it wraps around the histone octamer in the crystal structure of the nucleosome core. The sequence-dependent preferences that correlate most closely with the rotational orientation of the DNA, relative to the surface of the protein, are of two kinds: ApApA/TpTpT and ApApT/ApTpT, the minor grooves of which face predominantly in towards the protein; and also GpGpC/GpCpC and ApGpC/GpCpT, whose minor grooves face outward. Fourier analysis has been used to obtain fractional variations in occurrence for all ten dinucleotide and all 32 trinucleotide arrangements. These sequence preferences should apply generally to many other cases of protein-DNA recognition, where the DNA wraps around a protein. In addition, it is observed that long runs of homopolymer (dA) X (dT) prefer to occupy the ends of core DNA, five to six turns away from the dyad. These same sequences are apparently excluded from the near centre of core DNA, two to three turns from the dyad. Hence, the translational positioning of any single histone octamer along a DNA molecule of defined sequence may be strongly influenced by the placement of (dA) X (dT) sequences. It may also be influenced by any aversion of the protein for sequences in the "linker" region, the sequence content of which remains to be determined. PMID- 3806679 TI - Temperature-dependent molecular dynamics and restrained X-ray refinement simulations of a Z-DNA hexamer. AB - Molecular dynamics simulations of the Z-DNA hexamer 5BrdC-dG-5BrdC-dG-5BrdC-dG were performed at several temperatures between 100 K and 300 K. Above 250 K, a strong sequence-dependent flexibility in the nucleic acid is observed, with the guanine sugar and the phosphate of GpC sequences much more mobile than the cytosine sugar and phosphate of CpG sequences. At 300 K, the hexamer is in dynamic equilibrium between several Z forms, including the crystallographically determined ZI and ZII forms. The local base-pair geometry, however, is not very variable, except for the roll of the base-pairs. The hexamer molecular dynamics trajectories have been used to test the restrained parameter crystallographic refinement model for nucleic acids. X-ray diffraction intensities corresponding to observed diffraction data were computed. The average structures obtained from the simulations were then refined against the calculated intensities, using a restrained least-squares program developed for nucleic acids in order to analyse the effects of the refinement model on the derived quantities. In general, the temperature dependence of the atomic fluctuations determined directly from the refined Debye-Waller factors is in reasonably good agreement with the results obtained by calculating the atomic fluctuations directly from the Z-DNA molecular dynamics trajectories. The agreement is best for refinement of temperature factors without restraints. At the highest temperature studied (300 K), the effect of the refinement on the most mobile atoms (phosphates) is to significantly reduce the mean-square atomic fluctuations estimated from the refined Debye-Waller factors below the actual values (less than (delta r)2 greater than congruent to 0.5 A2). Analysis of the temperature-dependence of the mean-square atomic fluctuations provides information concerning the conformational potential within which the atoms move. The calculated temperature dependence and anharmonicity of the Z-DNA helix are compared with the results observed for proteins. The average structures from the simulations were refined against the experimental X-ray intensities. It is found that low-temperature molecular dynamics simulations provide a useful tool for optimizing the refinement of X-ray structures. PMID- 3806681 TI - Transport of sperm within the cloaca of the female red-spotted newt. AB - The transport of sperm in the cloaca and adjacent regions of the female red spotted newt was examined. It was found that within 1 min after sperm were introduced into the vent, they progressed in a random pattern past the apertures of the spermatheca (the glandular, sperm storage organ that opens from the anterior roof of the cloaca) forward to the anterior end of the cloaca and on into the posterior regions of the hindgut and bladder. Sperm did not enter the dorsal recess of the cloaca into which the oviducts and ureters open. After 1 day, few sperm remained within the cloaca lumen. Sperm were not transported into the cloacae of artificially inseminated, anesthetized females without prior administration of norepinephrine to their cloacal mounds. Treatment of the cloacal mounds of naturally inseminated females with an antagonist of neuromuscular transmission (lidocaine) decreased the numbers of sperm in the anterior cloaca relative to those of saline-injected control specimens. Neither dead newt sperm nor live rabbit sperm entered the spermatheca. Rabbit sperm, however, entered the oviduct. It is argued that passive and active mechanisms of sperm transport work in concert. Contractions of smooth muscle, which may be initiated during courtship, probably serve to draw sperm passively into the cloaca and up to and beyond the apertures of spermathecal tubules, but sperm, once in the vicinity of those apertures, probably swim actively into them. PMID- 3806680 TI - Structure of turnip crinkle virus. III. Identification of a unique coat protein dimer. AB - The minor structural protein (p80), found in about one copy per virion in turnip crinkle virus (TCV), is shown by amino acid analysis and peptide mapping to be a covalent dimer of the major coat protein (p40). The covalent linkage occurs near the N termini of the crosslinked chains. These data suggest that TGV and related viruses contain 178 copies of p40 (89 non-covalent dimers) and one copy of p80 (covalent dimer of two additional p40 chains). The presence of p80 in the salt stable RNA-protein complex formed when TCV dissociates, as described in an accompanying paper, indicates that the covalent modification affects binding to RNA. We suggest that p80 might be the final dimer to be incorporated into the shell and that it might also be the site for initiation of uncoating. PMID- 3806682 TI - Structural and histochemical aspects of perirenal adipose tissue in fetal pigs: relationships between stromal-vascular characteristics and fat cell concentration and enzyme activity. AB - Samples of perirenal adipose tissue were obtained from four fetuses from each of seven crossbred gilts at each of three stages of gestation: 70, 90, and 110 days. Samples were routinely prepared for histochemistry and histology. At each age, the largest fat cell clusters were consistently located near points where large blood vessels entered the loose connective tissue. Cell-cluster size decreased with distance from the entry points of large blood vessels. Fat cells proximal to entry points of large arterioles and fat cells distal to entry points of large arterioles were the same size. Enzyme cytochemistry disclosed that reactions for glucose-6-phosphate dehydrogenase (G6PDH), lipoprotein lipase (LPL) and NADH-TR enzymes were reduced in distal (relative to entry points of large arterioles) adipocytes compared with proximal adipocytes. Reactions for succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) in adipocytes were not influenced by location within the tissue. Small fat cell clusters with sparse capillary beds surround arterioles in distal areas of sections from fetuses at 70, 90, and 110 days of gestation. In the proximal areas of sections from 110-day old fetuses, arterioles were surrounded by large fat cell clusters with dense capillary beds. These characteristics serve to distinguish perirenal depots from subcutaneous depots in the fetus. PMID- 3806683 TI - Comparative study of a new ultrastructural specialization of the mammalian retinal pigment epithelium: basal intracytoplasmic tubules. AB - We recently described basal intracytoplasmic tubules that arise from the basal plasma membrane of rat retinal pigment epithelial cells (RPE). They are a previously undescribed ultrastructural specialization of the basal plasma membrane in addition to the well-known basal folds. This report describes similar tubules in the RPE cells of the rabbit, hamster, and kitten. As in the rat, the tubules in the hamster and kitten ramify singly through the basal cytoplasm and bear no special relationship to any other organelle. In the rabbit, however, stacks of closely apposed tubules frequently abut the large lipid droplets in their RPE cells. Although the function of the tubules is unknown, their occurrence in several different mammals suggests they are involved in the function of RPE cells in general. PMID- 3806684 TI - Morphological studies of the spinal cord in tetraodontiformes fishes. AB - The spinal cord of two tetraodontiform fishes, the Japanese file fish (Navodon modestus) and the panther puffer (Takifugu pardalis), are unusual among vertebrates in having a markedly abbreviated spinal cord with a long and flattened filum terminale. Only the rostral short part of the cord of both species is cylindrical; the greater part of the cord is markedly flat. The majority of the spinal nerve roots leave the short cylindrical part. The flattened part of the cord contains the central canal, myelinated nerve fibers, and a few motoneurons surrounding the cauda equina, and it is histologically similar to the filum terminale of amphibians and mammals. The spinal cords of other teleosts, the sun-fish and angler, also are abbreviated and possess a filum terminale and cauda equina. These orders possess an enormous head and short trunk. However, the correlation between this body form and an abbreviated cord is not causal, since the tetraodontiform species described here show ordinary body proportions. The spinal cord may be abbreviated in tetraodontiform fishes in general. PMID- 3806685 TI - Program and abstracts of the VIth meeting of the Japanese section of the International Society for Heart Research. Nagoya, Japan, 6-7 February 1987. PMID- 3806686 TI - Black-on-black homicide: the National Medical Association's responsibilities. PMID- 3806687 TI - Mann-Cavallo sign. PMID- 3806688 TI - Upgrading an industrial clinic to occupational medicine standards. PMID- 3806689 TI - Drug use patterns: implications for the acquired immunodeficiency syndrome. AB - The acquired immunodeficiency syndrome (AIDS) represents a major public health concern for society. Intravenous drug users continue to be the second largest risk group. While needle sharing has been demonstrated to play a prominent role in the higher risk experienced by illicit drug users, serious evaluations of the inherent immunologic aberrancies attendant to drug abuse have been limited. Partly responsible are the small study sample sizes and inadequate examinations of the role of particular patterns of drug abuse in the development of immunologic dysfunction. The present study represents the preliminary findings of an ongoing investigation to assess the contribution of an array of behaviors on various indicators of immunologic status.The results in 97 patients investigated demonstrate that route of administration and duration of drug use were the factors most significantly associated with a greater prevalence of immunologic abnormalities. There was also a suggestion that abnormal liver function may contribute to altered immune status. PMID- 3806690 TI - Comparison of growth of black and white infants during their first two years of life. AB - Growth data were analyzed on 406 infants (211 black, 195 white) during their first two years of life. Only term children weighing more than 2500 g were included in the study. Prenatal and postnatal care were provided at the same university affiliated health maintenance organization. Mean birth weight of black female newborns was 150 g less than white female newborns with a statistical significance of P = .028. Mean birth weight of black male newborns was 40 g less than white male newborns. The difference was not statistically significant. Black male infants were significantly heavier at 12, 18, and 24 months and significantly taller at 24 months than their white counterparts.Significant differences in velocity of growth were seen between black and white female infants regardless of type of feeding. Black female infants gained more weight between 6 and 12 months and increased their length more rapidly between 18 and 24 months than their white cohorts. These data suggest that black infants demonstrate a somewhat different growth pattern than white infants. PMID- 3806691 TI - Thorotrast-associated anemia and bone marrow hypoplasia. AB - Two patients with chronic anemia and bone marrow hypoplasia secondary to Thorotrast deposition are described. In one case thorium dioxide was identified by histoautoradiography, scanning electron microscopy, and x-ray spectrometry. PMID- 3806692 TI - Management of pancreatic trauma: concepts and controversy. AB - Four cases of pancreatic trauma are critiqued, and an algorithm to guide management is outlined. The key to operative assessment of pancreatic injury is the presence or absence of major ductal disruption. The surgeon's assessment is usually accurate, but when doubt exists, intraoperative pancreatography is advocated. In patients with significant pancreatic head injury with ductal disruption and associated duodenal injury, pancreaticoduodenectomy is recommended. In spite of reports to the contrary, duodenal diverticulization should be reserved for the patient with a repairable duodenal injury in association with a pancreatic head wound without ductal disruption. PMID- 3806693 TI - Syndrome of galactorrhea, amenorrhea, and obesity as possible indicators of prolactinoma: a case study approach. AB - Four female patients were found to have microadenomas and high prolactin levels, but the symptoms of the syndrome varied among the patients. Three of four patients had overt galactorrhea, obesity, and amenorrhea. One patient was postmenopausal, and another showed menstrual irregularities. Two patients sought medical attention for headaches, and one for visual disturbances. Two patients previously had used psychotropic drugs, and two patients used birth control pills. When tested, all patients had high serum prolactin levels, abnormal sellar tomograms, and the presence of microadenoma of the pituitary was confirmed by computerized tomography.Because of the high incidence of pituitary tumor among these four patients, this study suggests that a complete workup should be done for patients having galactorrhea, amenorrhea, and obesity as a syndrome or as separate entities. PMID- 3806695 TI - Tautology or not tautology? AB - It has been suggested that the good correlations found between carcinogenic potency in mice and in rats could be an artifact. The artifact suggested arises because there are four correlations to consider--interspecies correlations of toxicity, interspecies correlations of carcinogenic potency, and two intraspecies correlations between toxicity and carcinogenic potency--and the existence of any three implies the fourth. It was argued that the intraspecies correlations between toxicity and potency were due to criteria for data selection. Here we discuss the correlations in detail and show that they are principally due to the experimental observation that there are few cases where most or all animals in a bioassay get cancer. We conclude that the correlations between carcinogenic potency are valid. PMID- 3806694 TI - Squamous cell carcinoma: complication of chronic skin disorders in black patients. AB - Malignant tumors arising from the skin or from dermal appendages are rare in blacks. The presence of certain predisposing conditions, however, makes the development of cutaneous neoplasia a realistic possibility. A case of hidradenitis suppurativa complicated by squamous cell carcinoma is presented and the relationship between these entities is discussed. PMID- 3806696 TI - Oral and intramuscular toxicity of inorganic and organic mercury chloride to growing quail. AB - The lethal toxicity of inorganic (HgCl2) and organic (CH3HgCl) mercury chloride was compared for Coturnix (Japanese quail, Coturnix japonica) of different ages from hatch through adulthood by single-dose acute oral and intramuscular injections and by a 5-d dietary trial. Sublethal mercury toxicity was studied by evaluation of plasma and brain cholinesterase activity. CH3HgCl was more toxic than HgCl2 in all tests at each age tested. LD50s consistently increased over the first 4 wk for both acute methods and both mercurials and then stabilized. The striking difference between single-dose acute and 5-d dietary tests was that CH3HgCl averaged about twice as toxic as HgCl2 by both acute methods, compared to 100 times as toxic by the dietary method. For example, at 2 wk of age, the oral LD50s for CH3HgCl and HgCl2 were 18 and 42 mg/kg and the dietary LC50s were 47 and 5086 ppm. When birds were fed HgCl2 and developed clinical signs of intoxication, they could recover once treatment was withdrawn; however, on CH3HgCl, clinical signs often commenced after treatment was withdrawn, and then actually intensified for several days and culminated in death. PMID- 3806697 TI - Cytoskeletal perturbation induced by herbicides, 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). AB - To understand the mechanisms of toxicity of 2,4-dichlorophenoxyacetic acid (2,4 D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), we have studied their effects on the cytoskeletal organization, particularly microtubules (MT) and microfilaments (MF), DNA synthesis, and the synthesis and composition of cytoskeletal proteins in mouse 3T3 cells. Exposure of cells to 2,4-D or 2,4,5-T resulted in a dose-dependent inhibition of DNA synthesis; 50% inhibition occurred at 2.21 mM and 0.90 mM for 2,4-D and 2,4,5-T, respectively. Furthermore, a strong synergistic inhibition of DNA synthesis was produced by mixtures (each having a total concentration of 1.25 mM) of 2,4-D with 2,4,5-T. Similarly, 2,4,5-T is more potent than 2,4-D in causing cytoskeletal perturbation as revealed by fluorescence microscopy. Treatment of cells with 2,4-D (2.5 mM) or 2,4,5-T (1.25 mM) for 20 h resulted in severe MT aggregation and the appearance of large bundles, which were organized in a rope-like structure in the former and a dramatic octopus-like pattern in the latter. Further, MT bundling is particularly severe in the cell center. Under these conditions, marked changes in MF organization also occurred as evidenced by clustering and crisscrossing of MF in the perinuclear region. A 1:1 mixture (final = 1.25 mM) of 2,4-D and 2,4,5-T, a formulation equivalent to Agent Orange composition, also induced a dramatic perturbation to the organization of MT and MF, resulting in the formation of ring like structures. MT bundling is still apparent, especially around the outer edge of the "rings." MF are localized predominantly along the cell periphery, where they appear to be aggregated tightly forming patches. Surprisingly, the synthesis and composition of cytoskeletal proteins, which are resistant to detergent extraction but released by CaCl2, are essentially unaffected by 2,4-D or 2,4,5-T. These results suggest that the dramatic perturbation of the cytoskeletal morphology caused by these herbicides probably only results from a structural reorganization and redistribution of MT and MF. PMID- 3806698 TI - Subchronic inhalation toxicity of methanol. AB - The subchronic inhalation toxicity of methanol was evaluated in rats and monkeys. Animals were exposed to 0, 500, 2000, and 5000 ppm methanol vapor for 6 h/d, 5 d/w, for 4 wk. The only treatment-and dose-related effect noted was that of mucoid nasal discharge in rats, which was considered reflective of upper respiratory tract irritation. No consistent treatment-related effects were found for organ or body weights or for histopathologic or ophthalmoscopic examinations. Overall, these findings support the use of the present American Council of Governmental Industrial Hygienists threshold limit value (TLV) of 200 ppm and short-term exposure limit (STEL) of 250 ppm for exposure to methanol vapor. PMID- 3806699 TI - Mucociliary clearance from the lungs of rabbits following single and intermittent exposures to ozone. AB - This study examined the effects of ozone (O3) inhalation on mucociliary clearance from the tracheobronchial tree. Rabbits were exposed for 2 h at 0.1, 0.25, and 0.6 ppm or for 2 h/d for 14 consecutive days at 0.25 and 0.6 ppm. Clearance was assessed by measuring the retention of radioactivity tagged, inert tracer particles inhaled immediately after the single 2-h exposure, or 24 h after 2, 7, or 14 of the daily exposures. Single exposures resulted in a concentration related trend toward retarded particle clearance, with a statistically significant difference occurring after exposure to 0.6 ppm. Intermittent exposures produced no significant change in clearance rate, although there was a suggestion of retarded clearance at early time points at both 0.25 and 0.6 ppm. PMID- 3806700 TI - Enhancement of pulmonary metastasis of murine fibrosarcoma NR-FS by ozone exposure. AB - The effects of ozone exposure on the metastasis of a fibrosarcoma (NR-FS) that arose spontaneously in a C3H/He mouse was studied. Male C3H/He mice were exposed to 0.8, 0.4, 0.2, and 0.1 ppm ozone for 1, 3, 5, 7, and 14 d. After the exposure periods, the mice were infused intravenously with NR-FS cells. At 2 wk postinfusion, the lungs were examined for colony development of metastasis. A significantly higher rate of pulmonary metastasis than that of normal mice was observed in the ozone-exposed mice. The enhancement of metastasis due to ozone exposure varied with length of exposure and concentration of ozone. When 1 X 10(5) cells of NR-FS were injected into the tail veins of mice, the maximal enhancement (459%) of pulmonary metastasis was observed in the mice exposed to 0.8 ppm ozone for 1 d. A longer period of exposure to 0.8 ppm ozone also enhanced pulmonary metastasis, although the prolonged exposure (14 d) gradually suppressed the enhancement (268%). In the mice exposed to the lower concentration of ozone, a lower rate of the lung matastasis was observed; even in the mice exposed to 0.1 ppm ozone for the period of from 1 to 14 d, a significantly higher rate of metastasis than that of nonexposed mice was observed. PMID- 3806701 TI - Sequence of bronchoalveolar lavage and histopathologic findings in rat lungs early in inhalation asbestos exposure. AB - To assess the early cellular inflammatory response of the lungs, 7 rats per group were exposed nose-only to 13 mg/m3 of chrysotile asbestos, 7 h/day for 2, 4, or 6 wk. Lung histopathology and bronchoalveolar lavage (BAL) were analyzed. In exposed animals, dose-related bronchiolitis and fibrosis were found that were not seen in control rats (p less than 0.001). In exposed rats, total BAL cells were increased six-to sevenfold over matched controls, and more cells were retrieved with longer exposure (p less than 0.001). In the BAL, counts of macrophages, lymphocytes, and polymorphonuclear cells (PMNs) were each elevated in the exposed rats (each p less than 0.001). PMNs seen histologically and in the BAL may be related to the time period examined. PMNs and lymphocytes observed throughout this 6-wk study support the idea that these cells may have an important role in the early events of asbestos lung injury. PMID- 3806702 TI - Cell transformation and promoter activity of insulation oils in the Syrian hamster embryo cell and in the C3H/10T1/2 mouse embryo fibroblast test systems. AB - The ability of mineral-oil-based and synthetic cable insulating fluids to transform and promote transformation of mammalian cells in vitro have been studied. In experiments with the Syrian hamster embryo cell transformation assay, it was found that C15-C18 alkylbenzenes were the most potent inducers of transformation, followed by low-viscosity and residual mineral oils. No activity and low cytotoxicity were found for a low-viscosity polyisobutylene-based oil. In the two-stage transformation assay of C3H/10T1/2 cells, promoter activity was obtained with all fluids tested. A blend of residual and low-viscosity mineral oils showed the highest activity. This oil possessed a low cytotoxicity and was tested at a relatively high concentration. The alkylbenzenes were more potent than the polyisobutylene-based fluid. The alkylbenzenes were also found to possess initiating activity in the two-stage assay, when 12-O tetradecanoylphorbol 13-acetate (TPA) was used as promoter. All the fluids showed low potency compared to benzo[a]pyrene and the tumor promoter TPA. PMID- 3806703 TI - Short-term toxicity studies of sanguinarine and of two alkaloid extracts of Sanguinaria canadensis L. AB - The short-term toxicity of sanguinarine, a benzophenanthridine alkaloid, and of two alkaloid extracts of Sanguinaria canadensis L. are presented. The acute oral LD50 in rats of sanguinarine was calculated to be 1658 mg/kg, and of the two alkaloid extracts, 1440 and 1250 mg/kg. The acute iv LD50 in rats of sanguinarine was found to be 29 mg/kg. No toxic effects were observed in rats fed up to 150 ppm sanguinarine in the diet for 14 d and in rats treated by gavage with up to 0.6 mg/kg body weight for 30 d. The acute dermal LD50 in rabbits was found to be greater than 200 mg/kg. PMID- 3806704 TI - Percutaneous absorption of the insecticides fenitrothion and aminocarb in rats and monkeys. AB - The dermal penetration of 14C-ring-labeled fenitrothion and aminocarb was determined in rats and rhesus monkeys. In monkeys, 49 +/- 4% (t1/2 = 14 h) of the fenitrothion and 74 +/- 4% (t1/2 = 25 h) of aminocarb were absorbed from the forehead, while 21 +/- 10% (t1/2 = 17 h) fenitrothion and 37 +/- 14% (t1/2 = 31 h) aminocarb were absorbed from ventral forearm. Monkey forehead was 2.3 times and 2.0 times more permeable than the forearm for fenitrothion and aminocarb, respectively. In rats, 84 +/- 12% (t1/2 = 20 h) of the fenitrothion and 88 +/- 6% (t1/2 = 17 h) aminocarb was absorbed from the middorsal region. These results were corrected for incomplete excretion by intramuscular injections of fenitrothion in money, 95 +/- 7% (t1/2 = 12 h), and rat, 69 +/- 9% (t1/2 = 12 h), and aminocarb in monkey, 95 +/- 14% (t1/2 = 8 h), and rat, 63 +/- 6% (t1/2 = 15 h). These results suggest rapid dermal absorption of these pesticides in rats and monkeys and the use of these animal models for measuring dermal penetration is discussed. PMID- 3806705 TI - Studies on the estrogenic activity of a coffee extract. AB - Ethyl ether extracts derived from coffee were tested for in vitro estrogenic and in vivo uterotropic activities. Coffee extracts, unlike tea and cocoa, were found to actively compete with 17 beta-estradiol for uterine cytosol binding sites. The biologically active fractions possessed an unique ultraviolet absorbance spectrum that excluded them from containing flavonoid, coumestan, or resorcyclic acid lactone constituents. Coffee extracts administered to immature female mice for 3 d in feeding studies displayed significant (p less than 0.05) uterotropic responses, which were similar to results obtained in mice treated with a standard 17 beta-estradiol dose. Additional studies in mice disclosed that coffee extracts did not reduce the uterotropic effect normally induced by 17 beta-estradiol when administered simultaneously with estradiol. The complete estrogenic effects of coffee constituents, coupled with their failure to inhibit a biological response evoked by estradiol, strongly suggest that coffee contains constituent(s) that are weakly estrogenic. PMID- 3806706 TI - Effects of manganese, calcium, magnesium, and zinc on nickel-induced suppression of murine natural killer cell activity. AB - The effects that divalent metals have on nickel-induced suppression of natural killer (NK) cell activity were studied in mice. Male CBA/J mice were given a single intramuscular injection of metal salt on a body weight basis. The metal doses used were the following: nickel chloride, 4.5-36 micrograms/g; manganese chloride, 20-80 micrograms/g. Twenty-four hours after metal injection, splenic NK cell activity was assessed using a 51Cr-release assay. Ni significantly (p less than 0.01) suppressed NK activity, while Mn significantly (p less than 0.01) enhanced NK activity. No alteration in NK activity was observed in mice injected with Mg, Ca, or Zn. Since these divalent metals have been shown to have antagonistic effects on Ni-induced carcinogenicity and toxicity, they were used in combination with Ni to determine if such antagonisms exist for NK cell activity. The injection of Ni and Mn in combination at a single site resulted in the enhancement of NK activity, although this enhancement was at a level below that observed following the injection of Mn alone. Injection of Mg, Zn, or Ca in combination with Ni did not affect NK activity compared to saline controls. In contrast, the injection of Ni in one thigh followed immediately by Mn, Mg, Ca, or Zn into the other thigh resulted in significant suppression of NK activity for all metals compared with saline controls. An interesting finding was that the injection of Ni followed immediately by Mn into the opposite thigh resulted in even greater reductions in NK activity than Ni alone. Suppression of NK activity by Ni and Mn injected at separate sites was not seen when Mn injection preceded Ni injection by 1 h. These data indicate that both the divalent metal and the timing of its injection relative to Ni injection are critical for altering Ni induced suppression of NK cell activity. PMID- 3806707 TI - Diagnostic peritoneal lavage in the management of blunt abdominal trauma: a reassessment. AB - In order to reassess the value of diagnostic peritoneal lavage (DPL) in patients with blunt abdominal trauma, we conducted a prospective study over a 15-month period involving 138 patients. There were 29 (28.3%) patients with positive DPL and 103 (71.7%) with negative DPL in this series. Of the 29 patients with positive DPL, 28 (96.5%) were found to have significant intra-abdominal injuries; 27 by exploratory laparotomy and in one case at autopsy. One patient with a grossly positive DPL had a negative exploratory laparotomy (3.4% false positive rate). All 109 patients with negative DPL were admitted. In only one case a significant intra-abdominal injury was demonstrated (0.9% false negative rate). The overall mortality in this series was 11.6% and there were no complications related to the DPL. Our results suggest that DPL is indeed an accurate indicator of significant intra-abdominal injuries in patients with blunt abdominal trauma. PMID- 3806708 TI - Cardiopulmonary arrest following penetrating trauma: guidelines for emergency hospital management of presumed exsanguination. AB - Exsanguination may be presumed in pale, mottled, unresponsive trauma victims with no palpable pulse nor spontaneous respirations with noncranial penetrating wounds. Under ideal circumstances, those victims initially witnessed to have some signs of life can be successfully revived in 5 to 25% of cases. The chance for a successful outcome influences the decision to initiate resuscitation and depends on the mode of injury, anatomic location of the wound, and elapsed time until presentation as well as the organization of the available facilities and personnel. The resuscitative algorithm for presumed exsanguination is markedly different from the ACLS guidelines for cardiogenic arrest and requires some degree of surgical expertise. After confirming the witnessed cardiopulmonary arrest from presumed exsanguination, the four phases of resuscitation are restoring central oxygenation, controlling internal hemorrhage, re-establishing spontaneous cardiac function, and definitively repairing the injury. Regardless of the type or location of the noncranial penetrating injury, these phases must be accomplished sequentially to minimize the risks of cerebral and cardiac anoxia. PMID- 3806709 TI - Hypertonic sodium chloride solutions: effect on hemodynamics and survival after hemorrhage in swine. AB - We evaluated the hemodynamic response of 12% shed blood replacement with 7.5% sodium chloride after a nonlethal hemorrhage in chronically instrumented swine. Compared to no treatment or Ringer's lactate infusion, the hypertonic salt solution was followed by increased cardiac output. We then evaluated the effect of hypertonic sodium chloride on survival after an otherwise lethal hemorrhage in chronically instrumented and unanesthetized swine. Survival was significantly greater after replacement of 25% of the shed blood with 7.5%, but not with 0.9%, 5.0%, or 10.0% sodium chloride solution. The mechanism appears to be by increased tissue perfusion as indicated by lower lactate values. Resuscitation with low volume hypertonic sodium chloride may be life saving and life supporting during the initial treatment of trauma patients when conventional therapy is not available. PMID- 3806710 TI - Early post-traumatic changes in hemodynamics and pulmonary ventilation in alcohol pretreated pigs. AB - Time relations among trauma, pulmonary and systemic circulation, and lung function were studied in pigs. Eleven animals (b.w. 25-30 kg) were investigated under balanced anesthesia. Ventilation was mechanically controlled. Hemodynamics, pulmonary ventilation, and gas exchange were serially recorded. Seven animals were pretreated with 40% ethanol in saline and four with saline only. Ninety minutes after the ingestion of alcohol or saline, the animals were subjected to a standardized soft-tissue trauma. Cardiac output decreased significantly 2 minutes after trauma and remained low in both groups throughout the observation period of 30 minutes. Pulmonary vascular resistance was significantly increased in the alcohol-pretreated group but was virtually unchanged in the control animals. Systemic vascular resistance was similarly reduced in the two groups. Total compliance was somewhat lower in alcohol-pretreated animals and 10 minutes after the trauma arterial oxygen tension was significantly lower in the alcohol group than in control animals. Carbon dioxide elimination was reduced after trauma in both groups. It is concluded that pulmonary vascular response increased and that total pulmonary compliance is somewhat decreased shortly after trauma in the alcohol group while gas exchange is almost unchanged. The results indicate a negative interaction between alcohol and trauma. PMID- 3806711 TI - Natural course of the human bite wound: incidence of infection and complications in 434 bites and 803 lacerations in the same group of patients. AB - Human bites and common lacerations are frequent in certain residential groups in institutions for the care of developmentally disabled individuals. We screened the records of such an institution and studied the course and outcome of 434 human bite wounds and 803 lacerations in the same group of clients. Infection developed in 13.4% of the lacerations, and 17.7% of the bite wounds (chi 2 = 3.474; p greater than 0.06). Prophylactic antibiotics were administered after 14.0% of the bite wounds, and 3.2% of the lacerations. Infection supervened after prophylactic antibiotics in 29.5% of the bites and 34.6% of the lacerations. No patient with a bite wound required debridement, initial or subsequent surgical intervention other than wound closure, admission to hospital, or intravenous antibiotics. There is no recorded instance of a bite wound complication other than immediate loss of tissue. These data substantiate a higher incidence of infection in human bite wounds, but they are scant support for admonition that such wounds are indication for routine antimicrobial prophylaxis or aggressive surgical intervention. PMID- 3806712 TI - The results of quadricepsplasty on knee motion following femoral fractures. AB - Knee motion following femoral fractures is often less than satisfactory. Surgical procedures to increase knee motion are rarely done. This paper presents a series of nine patients who had severe femoral fractures, primarily in the distal third. Once union was obtained, all patients had knee flexion incompatible with normal gait (average 30.2 degrees). All patients underwent a quadricepsplasty at Rancho Los Amigos Medical Center. Eight of the nine achieved knee flexion allowing normal gait (average 78 degrees). This paper presents our indications, methods, results, and complications in performing quadricepsplasty to achieve knee flexion following femoral fractures. PMID- 3806713 TI - Chronic sepsis following intramedullary nailing of femoral fractures. AB - We reviewed 12 patients with chronic drainage after intramedullary nailing of a femoral shaft fracture. The fractures tended to be the result of high-speed trauma and were frequently comminuted. Six were open fractures and six were closed injuries. All but one had been managed initially with the open nailing technique, exposing the fracture site. In six cases we left the nail in place until bone union occurred, an average of 33 months after injury, removing the hardware thereafter. The remaining six patients, each with bone sequestra at the fracture site, underwent nail removal, debridement of nonviable bone, and external fixation followed by bone grafting; this group took 37 months to heal. There was one persistent nonunion in each group. Drainage did not cease in either group until the nail and all sequestra had been removed. There was an average of 4.3 cm of shortening, but no angulation greater than 10 degrees. Six patients were left with less than 45 degrees of knee flexion and only five had 100 degrees or more of knee flexion. PMID- 3806714 TI - Injuries to a sample of seatbelted children evaluated and treated in a hospital emergency room. AB - This study provides descriptions of the types of injuries sustained by a sample of children (0-14 years of age) who were using a vehicle seatbelt at the time of a motor vehicle accident and who were subsequently evaluated and treated in a hospital emergency room. Data were obtained from a hospital monitoring system established in nine emergency room facilities in a single county in California. The analysis indicates that in some cases injured seatbelted children were injured in circumstances in which the seatbelt could not have been protective, e.g., vehicle deformation into the child, flying glass, etc. The analysis of the remaining cases of seatbelted children suggests that there are significant variations in mechanisms of injury as well as injury patterns for different aged children. In many of the cases of injury observed in this sample, even though the child had been restrained in the adult seatbelt, the anatomic characteristics of the child prevented optional protection. The research provides further evidence for the necessity for utilizing specially designed restraints for children at least up to the age of 10 years. PMID- 3806716 TI - Tibial fractures in head-injured children. AB - Twenty-nine tibia fractures in 28 pediatric patients with head injuries were reviewed for mechanism of injury, age, time to healing, deformity, and functional ability. The most frequent cause was auto versus pedestrian accidents and the average patient age was ten years. Most had major associated injuries. Fractures of the middle third of the tibia comprised 75% of the group and healed after 20 weeks. There were few deformities in this group despite the fact that most were treated by closed methods. PMID- 3806715 TI - Peritoneal lavage in pediatric patients sustaining blunt abdominal trauma: a reappraisal. AB - One hundred twenty-eight patients from 0 to 18 years of age underwent diagnostic peritoneal lavage following blunt abdominal trauma. Seventy-eight had negative lavages and 50 were positive. Forty-one patients underwent exploratory celiotomy after positive lavage results. A review of the operative findings and need for surgical intervention led to the conclusion that 12 of these operations were not necessary. Due to the oversensitivity of peritoneal lavage a strongly positive result mandates further diagnostic evaluation unless the patient's clinical status requires exploratory celiotomy. PMID- 3806717 TI - Fever as a predictor of infection in burned children. AB - Although children with burns often develop fevers, we have found no reports characterizing the course and duration of these fevers. To evaluate the predictive value of fever as an indicator of infection in burned children, we reviewed the hospital charts of all 223 children admitted to a regional burn center in the years 1979 through 1982. The highest temperature reading for each 8 hour period of the child's hospitalization was recorded. The highest mean temperature in burned children occurred at 38 to 96 hours after the burn injury; the peak temperatures appeared at the same time, regardless of whether the child had an infection. All of the 23 children with infections (100%) and 145 of the 200 without infections (73%) had a recorded temperature reading of 38.2 degrees C or higher within 2 weeks after their burn injury. When children less than 4 years, or children with more than 20% total body surface area burns were considered alone, the presence of a temperature greater than 38.2 degrees C was not significant in differentiating those with infections. Fever is not a specific predictor of infection in burned children; in children less than 4 years of age and in children with more than 20% burns, fever has no predictive value for the presence of infection. The physical examination is a reliable source of information about wound infection, sepsis, or other childhood infections, and should be the primary tool used in making the diagnosis of infection in burned children. PMID- 3806718 TI - Fractures after hemialloplastic hip replacement. AB - Forty-four patients sustaining ipsilateral femoral shaft fractures after hemialloplastic hip replacements are evaluated according to risk factors for the fractures, treatment and social costs. The fracture incidence was 0.10, and almost half of the fractures occurred within 1 year after the initial alloplastic operation. Possible factors increasing the risk of secondary fracture included loosening of the prosthesis (eight cases), osteoporosis (14 cases), varus angulation of the femoral stem (28 cases), calcar resorption (nine cases), major capsular calcifications (four cases), and cortical defects at the tip of the stem (three cases). The importance of correct insertion of the prostheses is emphasized. The degree of mobilization after fracture healing was overall reduced and most pronounced with increasing age and not correlated to treatment. The earliest mobilization was obtained in patients treated with long-stem prostheses supplemented with internal fixation, and this method of treatment is advocated. PMID- 3806719 TI - Ocular trauma modelling. AB - Non-ophthalmologists must know how to detect, diagnose, and initially manage acute eye and ocular adnexal injuries in order to minimize their morbidity. Such instruction can be provided medical students in part from dog eyes and lids injured so as to produce models of common forms of ocular trauma. We describe the generation of such models and the format of instruction employed at the Uniformed Services University of the Health Sciences. PMID- 3806720 TI - Lower-extremity compartment syndromes associated with use of pneumatic antishock garments. AB - Pneumatic antishock garments (PASG) are frequently used to initially support and manage traumatic hypovolemic shock. PASG have been implicated in the development of complicating compartment syndromes of the lower extremities, but cause and effect have not been clearly defined. The present report documents the occurrence of bilateral compartment syndromes in uninjured lower extremities after using PASG and reviews similar reported cases. PMID- 3806721 TI - The crowded carpal sign in volar perilunar dislocation. AB - Three cases of volar perilunar dislocation were seen at North Carolina Baptist Hospital over a 6-year period. An important finding on anteroposterior radiographs was the overriding of proximal and distal carpal rows giving rise to the "crowded carpal" appearance. Review of the literature demonstrates this configuration in all illustrations of volar perilunar dislocation. Although some authors have noted its presence, the diagnostic significance of this finding has not, to our knowledge, been emphasized. PMID- 3806722 TI - Proximal row carpectomy for open fracture-dislocation of the carpus. AB - A severe carpal fracture dislocation is described and the alternatives of management are discussed. A method of treatment, that is, proximal row carpectomy, is described based on a review of applicable literature. PMID- 3806723 TI - Treatment of hypothermia by extracorporeal circulation and internal rewarming. AB - The treatment of accidental hypothermia by extracorporeal circulation and internal rewarming can be life saving in patients unconscious from drug overdose or victims of accidental exposure to severe cold. Advantages are the rapidity of treatment, the provision of circulatory support, and a lessened chance of rewarming collapse, since peripheral vasodilation is paralleled by an increase in cardiac output. A premature diagnosis of clinical death was averted in two patients with rectal temperatures of 25 degrees C or below, and their lives were saved by the use of this technique. PMID- 3806724 TI - Fracture-dislocation of manubriosternal joint: an unusual complication of seizures. AB - Musculoskeletal complications from seizures produced by epilepsy, eclampsia, hyponatremia, electroconvulsive therapy, and severe tetanus have been described. We present a case of a fracture-dislocation of the manubriosternal joint as a complication of seizures, which to the best of our knowledge has not previously been reported. PMID- 3806725 TI - Treatment of avulsed clavicle and recurrent subluxations of the ipsilateral shoulder by dynamic fixation. AB - A new operative approach is presented for treatment of fractured distal end of clavicle associated with recurrent anterior shoulder subluxations. One case is presented in which open reduction of the fractured clavicle and stabilizing the anterior shoulder joint were accomplished by transfer of the coracoid process with its attached muscles under the subcapularis muscle onto the clavicle. The operation was followed by complete reduction of the fracture and a stable shoulder joint. PMID- 3806726 TI - Immediate mitral valve replacement following gunshot wound to the heart. AB - Controversy exists in management of cardiac trauma as to whether or not injuries of the cardiac valves or septum should be repaired at initial operation. A patient is presented who required immediate mitral valve replacement for acute disruption of the mitral valve apparatus following a transventricular gunshot injury. The need to consider early repair or replacement of injured cardiac valves when they appear to have hemodynamic significance is emphasized. PMID- 3806727 TI - AIDS and the intravenous drug abuser. PMID- 3806728 TI - Brain chemistry and the addictions. AB - This is a very exciting period for basic discoveries in the field of neuroscience. We can begin to hope for the kinds of understanding that will give us medical insight into the causes and mechanisms of the addictions. Such knowledge may open the way for methods of prevention and treatment by means we can hardly imagine today. Tests for genetic vulnerability to addiction, so that prevention measures can be focused on those who would benefit most? Stimulation of the production of endogenous brain chemicals? Repair of genetic defects in peptide or receptor production? Immunizations? Long-term replacement therapies? Who knows? The next decade or two should see exciting developments leading to practical clinical applications in the field of addiction. PMID- 3806729 TI - The other problems of alcoholics. AB - Today's alcoholism treatment populations are characterized by increasing heterogeneity. Alcoholics vary with regard to other substance use and dependence, psychiatric/psychological problems and neuropsychological functioning. The implications of such heterogeneity are explored with regard to conceptualization of alcoholism, assessment, and individualized treatment planning. PMID- 3806730 TI - Conditioned responses in a methadone population. A comparison of laboratory, clinic, and natural settings. AB - The incidence of conditioned high, craving, and withdrawal in methadone maintained patients was compared across three settings: an artificial laboratory setting, clinic extinction sessions, and in self-reports from the natural home environment. A significant proportion of methadone patients showed increased craving and withdrawal in response to drug-related stimuli, even in the artificial laboratory setting. As stimulus opportunities became more varied (clinic extinction sessions) and closer to those in the patient's own home environment, the proportion of patients experiencing subjective craving and withdrawal increased. These results are discussed in terms of the nature of, and inter-relationships among, the conditioned responses found in opiate abusers and the potential role of these responses in relapse to drug use in the abstinent patient. PMID- 3806731 TI - A 2.5 year follow-up of treatment retention and reentry among opioid addicts. AB - Two-hundred and sixty eight opioid addicts completed a 2.5 year follow-up during which we examined the psychosocial antecedents and consequences of leaving, reentering and remaining in treatment. Compared to those addicts who obtained more sustained treatment, the addicts who were only detoxified had fewer psychological problems and were more often male, black and younger. These baseline differences complicated comparisons between these minimally treated addicts and the rest, but among those who had more than minimal treatment, continuous treatment was better than intermittent treatment in controlling substance abuse and legal problems. Further analyses involved dividing the 30 months of follow-up into 6 month blocks and comparing the 6 months before, during and after leaving or reentering treatment. We found that addicts left treatment at periods of relative abstinence and good psychosocial adjustment, although they increased their alcohol abuse during the period of leaving treatment. During the 6 months after leaving, patients often returned to drug abuse and then rapidly deteriorated in social adjustment. When reentering treatment, the majority (75%) stayed for over 6 months and improved steadily in most areas. At reentry patients also had less criminal activity, less physical disability, and less opiate use suggesting a carry-over of treatment benefits, but they had more problems with their spouse and more alcohol and cocaine use than they had when first entering treatment suggesting new precipitants for reentry into treatment. PMID- 3806732 TI - Efficacy of chemical dependency treatment as a function of combat in Vietnam. AB - Traumatized combat veterans frequently attempt to escape the chronic anxiety, insomnia and nightmares characteristic of post-traumatic stress disorder by self medicating with alcohol and drugs. The elimination of alcohol and drugs through chemical-dependency treatment, therefore, might be expected to precipitate an exacerbation of stress symptoms and predispose veterans to new cycles of abuse. The relationship between combat and post-treatment substance abuse has not been subjected to empirical study. This paper examines treatment-completion and post treatment abstinence rates (treatment efficacy) as a function of level of combat when combat veterans are provided trauma-oriented therapy concurrently with treatment for chemical dependency. The experimental results suggest that, under these conditions, treatment efficacy does not vary with level of combat. The absence of combat-level effects is explained in terms of the interactive dynamics of chemical-dependency and post-traumatic stress disorder. PMID- 3806733 TI - Clinical experiences with 959 opioid-dependent patients treated with levo-alpha acetylmethadol (LAAM). AB - Levo-alpha-acetylmethadol (LAAM) is an orphan drug that will soon be generally available to treatment facilities. We have recently treated 959 opioid addicts with LAAM for periods up to 36 consecutive months. Three times per week dosing of LAAM proved to be a safe and effective treatment agent for the majority of subjects. During LAAM induction there is a delay in opioid activity as LAAM forms its long-acting metabolites, therefore, symptomatic withdrawal medication must usually be administered during the first 96 hours of treatment to adequately suppress opioid withdrawal symptoms and prevent self-administration of drugs by the patient. No long-term hepatic toxicity or tumor formation could be demonstrated by liver function studies and liver-spleen imaging in a subgroup of patients. Some opioid addicts report that they prefer LAAM over methadone, but the reverse was reported by about 40% of our patients which suggests that both drugs are needed for adequate maintenance treatment of the opioid-addicted population. PMID- 3806734 TI - Coming to terms with management. AB - This article postulates that clinicians need to understand the nature of the management role in substance abuse agencies, even if they have no aspirations to occupy a management role, because it profoundly affects their conditions of work as clinicians. The article aims to demystify the management role, breaking it down into three major areas of related functions: clinical management, business management, and agency management. A crucial and much misunderstood aspect of the management role, especially at the agency level, is the dimension of power or the management of organizational politics. Lastly we note several advantages that the former clinician has as a manager. PMID- 3806735 TI - Fairmount Institute. PMID- 3806736 TI - ACI: a therapeutic community. PMID- 3806737 TI - Substance abuse problems in Scotland. AB - In the wake of a recent epidemic of substance abuse in Scotland the governmental and medical response has involved a departure from the longstanding policies in Britain. There has been a shift from the medical model to a more community based, minimal intervention model. There have also been a number of changes in legislation relating to substance abuse. It may take a number of years for the effects of these policy changes to be felt. However, the way has been made clear for new initiatives and Scotland is encouraging its inhabitants to take more responsibility for their own lives. A detailed cost benefit analysis of the policy changes is now indicated. PMID- 3806738 TI - AIDS and the substance abuse treatment clinician. PMID- 3806739 TI - [Effect of strophanthin, digoxin and isoproterenol on heart contractility in hypoxia and hypercapnic acidosis]. PMID- 3806740 TI - [Heart contractility in acute respiratory acidosis and acute hypoxia]. PMID- 3806741 TI - Studies on cellular mechanism of the antishock action of anisodamine in rats- effect of anisodamine on the stability of liver lysosomes and comparison of its membrane-stabilizing action with that of dexamethasone. PMID- 3806742 TI - The role of leukotrienes in acute hypoxic pulmonary vasoconstriction in rats. PMID- 3806743 TI - Scanning electron microscopical study of intrahepatic blood vessels during development of experimental cirrhosis in rats. PMID- 3806744 TI - Medial flap of the shank--anatomical study and clinical application. PMID- 3806745 TI - Spleen transplantation: III. Autotransplantation of splenic slices into omental pouches in adults after trauma. PMID- 3806746 TI - A simplified cytocentrifuge and its clinical application. PMID- 3806747 TI - Gambian cultural preferences in the use of insecticide-impregnated bed nets. AB - In field trials of permethrin-treated bed nets in a large Mandinka village, 95% of people were already sleeping under locally-made nets. They lasted about 6 years and cost about US$9.00 ($1.50 per year). Two permethrin dips per year added a further $0.60 per year (1985 prices). Non-immune children slept in beds shared with adults, and people wanted nets for many reasons, not just malaria protection. Fifty-eight per cent of people preferred opaque sheeting to open netting; sheeting gave more privacy, lasted longer, gave better protection from very small insects, dust, rats, etc. White was the colour preferred by 90% of interviewees. Comparing Mandinka with Wolof and Fula, there were ethnic differences in net owning and the proportion of children sleeping in beds with a mattress. PMID- 3806748 TI - Immunodiagnosis of filariasis. AB - The sensitivity and specificity of the enzyme-linked immunosorbent assay (ELISA), the indirect haemagglutination (IHA) test and the counter-current immuno electrophoresis test (CIEP) were assessed in the diagnosis of filariasis. Positive reactions were observed in 91% and 86% of cases by ELISA and IHA respectively. CIEP detected only 31.5% of cases. Cross-reaction due to intestinal nematodes was observed in 80% of cases by both ELISA and IHA whereas with CIEP cross-reaction was observed in 10% of cases. The microfilaria count was inversely proportional to the antibody titre among asymptomatic carriers. ELISA was the most sensitive test, followed by IHA and then CIEP. CIEP, though it detected only a small number of cases, was observed to be the most specific. PMID- 3806749 TI - Disseminated cutaneous leishmaniasis in a field clinic in Bahia, Brazil: a report of eight cases. AB - Eight Bahian patients with cutaneous leishmaniasis who had 20 or more ulcerative lesions of short duration are described. Of five identifications of isolated parasites, four were Leishmania braziliensis braziliensis and one was L. mexicana amazonensis. All but one had positive Montenegro tests initially, and all did after treatment. All had circulating anti-leishmanial antibodies and five responded well to glucantime therapy suggesting a functioning immune response. This is quite different to the anergic hansenoid leishmaniasis seen with L. mexicana amazonensis infections in Brazil. Possible reasons for the occurrence of this type of leishmaniasis are briefly discussed. PMID- 3806750 TI - The first workshop on national breastfeeding programs in Latin America. PMID- 3806751 TI - Infant feeding in urban Kenya: a pattern of early triple nipple feeding. PMID- 3806752 TI - Immunological studies on liver in Egyptian infants and children. PMID- 3806753 TI - Relationship between maternal serum vitamin A and vitamin A status of the corresponding fetuses. PMID- 3806754 TI - Cryptosporidiosis in Ecuadorian children with acute diarrhoea. PMID- 3806755 TI - Cystic fibrosis in Kuwait. PMID- 3806756 TI - The effects of maternal age, education, and parity on birthweight in a Nigerian community: the comparison of results from bivariate and multivariate analyses. PMID- 3806757 TI - Evaluation of coagglutination test for rapid diagnosis of typhoid. PMID- 3806758 TI - Measles in Ghana: a trial of an alternative means of administration of measles vaccine. PMID- 3806759 TI - Breast feeding among poor Singaporeans. PMID- 3806760 TI - Breast feeding among well-to-do Singaporeans. PMID- 3806761 TI - Prevention of blinding malnutrition in India. Newsletter from India. PMID- 3806762 TI - Acute poisoning in Vietnamese children. PMID- 3806763 TI - A balance for the measurement of birth weights by traditional birth attendants. PMID- 3806764 TI - Otitis media in Greenland children: acute, chronic and secretory otitis media in three- to eight-year-olds. AB - The middle ear status was examined in 142 children aged three to eight years from Sukkertoppen and Kangamiut in Greenland. The investigation is based on social pediatric and otologic histories and on objective examination using otomicroscopy and tympanometry. Three-fourths of the small children had a previous history of otitis, some with repeated instances. Otomicroscopic findings revealed suppurative, chronic otitis in 6% and sequelae of chronic otitis in 13%. Tympanometry disclosed a reduced middle ear pressure in another 26% of the ears examined. Comparison of children with healthy ears with the groups with affections of the middle ear showed a tendency to an increased risk of otitis in families at a low social stratum, whereas the mode of habitation seemed insignificant. Finally, a large milk intake both in connection with breast feeding and later in life seemed to reduce the frequency of otitis. The investigation showed that acute otitis and chronic otitis media in particular are more prominent in Greenland than in Denmark. Attention is drawn to the handicap associated with a high incidence of chronic otitis media and the concomitant hearing loss to a population isolated in point of language. The successful achievements of a health information campaign and an active therapeutic program, which has reduced the prevalence of chronic otitis among the Innuit population native to Alaska and Canada, provides the rationale for an increased otologic effort in Greenland. PMID- 3806765 TI - A paradigm for tympanic epithelial dispersion. AB - It is more than a century since tympanic epithelial dispersion was first noted. This concept has not been analyzed mechanically until now. Serial photography of a circular disc holding 530 2.5 mm diameter ball-bearings, some of which were painted black to represent ink dots, has shown the centrifugal movement, enlargement and fragmentation of these marked areas when ball-bearings are added at random into the monolayer. Ink dots applied to mammalian drumheads move in a similar fashion. The model not only represented all the known tympanic epithelial phenomena faithfully, but could also be used to predict a mitotic index for the human drum. The index derived is consistent with normal human forearm skin if the dispersion of the corneocytes is due to the final shape change and insertion of lower epithelial cells into the lowest corneocyte layer. PMID- 3806766 TI - Evoked electromyography in Bell's palsy: a clinically useful test? AB - One hundred and forty-four patients presenting with a Bell's palsy were seen at Sunnybrook Medical Centre, University of Toronto, between the years 1978 and 1985. Only patients with a complete paralysis and not treated with either steroids or surgical decompression of the facial nerve were included in the study. The results of electrical tests performed on days 8, 9 or 10 after the onset of paralysis in 23 patients were used to predict clinical recovery at 12 weeks, six months and 12 months. There was good statistical correlation for values of conduction latency and amplitude with good clinical recovery after 12 weeks (p = 0.01). Electrical tests could not be used to predict clinical recovery at six months and at 12 months. The rationale for any surgical intervention based on the results of electrical tests is questioned. PMID- 3806767 TI - Automastoidectomy caused by keratosis obturans: a case report. AB - This is a case report of a 25-year-old Oriental woman with persistent and neglected keratosis obturans. The enlarging plug of keratin in the deep meatus produced an "automastoidectomy" in the left ear. The clinical findings are supplemented with a preoperative CT scan, and by pre- and postoperative Hopkins rod photographs of the ear. This case demonstrates dramatically the extensive erosion of bone that can occur in a patient with neglected keratosis obturans. PMID- 3806768 TI - Prolonged endotracheal intubation in neonates with hyaline membrane disease. AB - It is well documented that prolonged endotracheal intubation can lead to subglottic trauma and stenosis. Newborn infants with hyaline membrane disease often require assisted ventilation for prolonged periods of time. We examined 11 such children ranging in age from four months to 4.25 years by endoscopy. Some abnormality was found in every child, and in nine there was minor narrowing of the airway. PMID- 3806769 TI - Tracheobronchial and esophageal foreign bodies in the pediatric population. AB - A foreign body lodged in the aerodigestive tract of a child often poses a difficult medical problem. Experience with the diagnosis and removal of these foreign bodies is presented in this retrospective review. The description by a witness of the actual ingestion frequently provided the key to diagnosis. Rigid endoscopy remains a safe technique for foreign body extraction with a low resultant morbidity and mortality. Organic matter comprises the majority of bronchial foreign bodies (70%) while coins are the predominant finding (80%) in the esophagus. PMID- 3806770 TI - Objective assessment of upper airway resistance in the tracheotomized patient. AB - A test has been devised for measuring upper airway resistance to respiratory airflow in the tracheotomized patient. The test is simple and noninvasive; it utilizes either a body plethysmograph or an oral pneumotach to measure airflow. Pressure is measured through the tracheostomy tube of the stoma below the partial obstruction of the upper airway. The test has many important clinical applications. Its technique, rationale for use, and some clinical applications are briefly discussed in this paper, together with basic concepts of flow dynamics. PMID- 3806771 TI - Radiological evaluation of mid-third facial fractures. AB - Clinical assessment of patients with facial injuries can be difficult, particularly if there is extensive soft tissue swelling. The maxillofacial surgeon frequently must rely on radiographic images to confirm and delineate the presence of fractures. In particular, the mid-third of the face is a notoriously difficult area in which to delineate fracture lines in the severely injured patient. In this study, three radiographic techniques were compared for the evaluation of patients with mid-facial fractures treated in a major trauma center: plain films; panoramic zonography; and computed axial tomography. The results indicate that quality plain films are frequently difficult to obtain in the severely injured patient. In selected cases, panoramic zonography and computed axial tomography are important complementary methods for accurate assessment of mid-third facial fractures. PMID- 3806772 TI - Management of the undescended thyroid. AB - Ectopic thyroid can occur throughout the neck but is found most commonly at the tongue base. Management includes Tc99m radionuclide scanning to confirm the presence and location of the thyroid tissue. Dysfunction should be assessed by T4, TSH, and thyroid antibody testing. Hormonal therapy is the primary treatment but surgery may be necessary in cases of airway obstruction. Six children with undescended thyroid are presented and a management protocol based on the presence or lack of symptomatology is proposed. PMID- 3806773 TI - Extracranial and intracranial meningiomas. AB - Meningiomas constitute about 18% of primary intracranial tumors, and they are rarely observed in patients under 30 years of age. In this study, we present the case of a 17-year-old patient who was first seen for a right cervical mass. Further investigation revealed that a meningioma of the posterior cranial fossa had invaded the temporal bone, the infratemporal fossa and the right parapharyngeal region and was at the origin of that cervical mass. This intra- and extracranial meningioma was completely resected in two stages with very satisfactory results. We have reviewed the literature pertaining to the extracranial extensions of meningiomas originating in the posterior fossa. PMID- 3806774 TI - An unusual complication of polymorphic reticulosis: a case presentation. AB - The authors present a case of polymorphic reticulosis which responded to radiotherapy, but had a fatal complication with the development of a tracheoesophageal fistula. PMID- 3806775 TI - Purple normal-sized turbinate: a sign of enlarged adenoids? PMID- 3806776 TI - The case of the elongated uvula. PMID- 3806777 TI - Radioimmunoassay of the anabolic agent zeranol. V. Residues of zeranol in the edible tissues, urine, faeces and bile of steers treated with Ralgro. AB - Two trials were conducted on steers implanted with zeranol (Ralgro) to determine the edible tissue residues and the secretion pattern in faeces, urine and bile of zeranol residues throughout and beyond the recommended withdrawal period (70 days) for this drug. In the first trial there was considerable variation in the zeranol residue concentration in all edible tissues, the highest concentrations found in the liver being significantly above the control values (P less than 0.05). In the other tissues, only fat sampled 14 days after implanting was significantly above the control value (P less than 0.05). The zeranol concentration in bile samples obtained at slaughter [70 days (18), 90 days (5) and 120 days (2)] were all higher than the apparent concentration in the bile of untreated steers. The mean concentration of zeranol in the faeces and urine varied from day to day and between animals sampled on the same day following implantation. The highest mean concentrations were observed during the first 40 days following implanting, declining steadily to approach the control values 70 days after implantation. The second trial using steers prepared with bile duct re entrant cannulae resulted in a similar pattern of zeranol excretion in bile, faeces and urine. The highest concentrations of zeranol were observed in bile and ranged from 24 to 34 micrograms/l; there was considerable variation between animals and within animals sampled on successive days. Although the concentration declined steadily, zeranol was still readily detectable 120 days after implanting.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806778 TI - Procainamide in the dog: antiarrhythmic plasma concentrations after intravenous administration. AB - Procainamide hydrochloride was administered to ouabain-intoxicated dogs to determine an antiarrhythmic plasma concentration of procainamide. Ventricular arrhythmias were produced in dogs following intravenous injections of ouabain. After a sustained ventricular tachycardia was achieved, procainamide was administered and plasma samples collected for assay. Plasma procainamide was assayed by fluorescence polarization immunoassay. Procainamide was administered at increasingly higher constant rate infusions in order to achieve intermittent, steady-state plasma concentrations. Infusion rates were calculated on the basis of previous pharmacokinetic information. All six dogs that received procainamide converted to a normal sinus cardiac rhythm after attaining a mean plasma concentration of 33.8 micrograms/ml with a range of 48.5 micrograms/ml-25.0 micrograms/ml. It was observed that the computer-generated prediction of plasma concentrations based upon previous pharmacokinetic data produced an underestimate of the actual plasma concentrations. These data may suggest that plasma concentrations of procainamide for controlling some cardiac arrhythmias in dogs may be higher than plasma concentrations cited for human patients. PMID- 3806779 TI - Clinical evaluation of R 51163, a new sedative in cattle. AB - R 51163, a purine alkyl piperidine derivative, has been shown to produce reliable sedation in cattle of varying age and breed in three different types of experiments: transport and regrouping of cattle which had only been handled occasionally; manipulations and minor interventions; minor and major surgery with or without supplementary local anaesthesia. With dose rates of R 51163 at 0.05 mg/kg i.v. and of 0.10-0.15 mg/kg i.m. sedation became prominent within 10-15 min and lasted at least 60 min. Caesarean sections were performed under adequate sedation with R 51163 with dose ranging from 0.018 to 0.05 mg/kg i.v. and from 0.075 to 0.10 mg/kg i.m. The data suggest possible increased responsiveness to the drug at the time of calving. PMID- 3806780 TI - Bioavailability and pharmacokinetics of ampicillin and amoxycillin from tablets, capsules and long-acting preparations in the homing pigeon (Columba livia). AB - Three ampicillin and three amoxycillin formulations (tablets and capsules, administered orally, and oily suspensions, injected intramuscularly (i.m.) and subcutaneously (s.c.] were studied in twenty adult homing pigeons (Columba livia). Bioavailability, pharmacokinetics and recovery were determined for each product and administration route. A standard dose of 50 mg/pigeon or 100 mg/kg was used in each study. The mean availability calculated for each of these preparations was 7% for ampicillin anhydrate tablets, 22% for amoxycillin trihydrate tablets, 17% for ampicillin trihydrate capsules, 67% for amoxycillin trihydrate capsules, 46% for ampicillin oily suspension i.m., 67% for amoxycillin oily suspension i.m. and 43% for amoxycillin oily suspension s.c. The blood concentration-time curves for the tablets were very scattered, which was far less the case for the capsules. The maximum blood concentration (Cmax) for amoxycillin was twice as high as for ampicillin. The Cmax resulting from the oily suspensions administered i.m. were low (4.35 +/- 1.05 and 5.04 +/- 1.36 mg/l, for ampicillin and amoxycillin, respectively). The Tmax for ampicillin was 10 h and for amoxycillin it was 0.9 h after administration. Both curves showed biphasic absorption, the initial peak representing an absorption and a distribution phase and the second part reflecting the 'depot-nature' of the drug. After the s.c. administration of the amoxycillin oily suspension the same pattern was found, but the Cmax, which was found at 2.13 +/- 1.03 h after administration, was low (2.81 +/- 0.68 mg/l).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806781 TI - Oral treatment of polioencephalomalacia and subclinical thiamine deficiency with thiamine propyl disulphide and thiamine hydrochloride. AB - Thiaminase type I production by Bacillus thiaminolyticus and activity in vitro were repressed by the primary substate thiamine and by thiamine monophosphate and thiamine propyl disulphide. At thiamine concentrations of 300-3000 mumol/l production of active enzyme by B. thiaminolyticus, and activity of purified enzyme, were totally repressed. Growth of B. thiaminolyticus was inhibited by thiamine propyl disulphide at 3000 mumol/l. Activity of purified thiaminase was lost when incubated with ruminal fluid from healthy thiaminase free sheep. Enzyme activity was also lost when exposed to mildly alkaline conditions but was stimulated and stabilized against heat denaturation if treated with dithiothreitol. Thiaminase activities in the ruminal fluids of cases of ovine polioencephalomalacia were repressed within 2 h of oral administration of thiamine propyl disulphide. Blood pyruvate levels and transketolase activities were restored to normal following treatment. Treated animals recovered clinically and were returned to pasture. PMID- 3806782 TI - Pharmacokinetics of florfenicol in veal calves. AB - The pharmacokinetic disposition of florfenicol was described in veal calves after administration of a single 22-mg/kg dose intravenously, orally after a 12-h fast and orally 5 min post feeding. Both serum concentrations and urinary excretion were studied. After intravenous administration the median elimination half-life was 171.9 min while the half-life of the distribution phase was 5.9 min. The median body clearance (Cl) and apparent volume of distribution (Vz) were 2.85 ml/kg/min and 0.78 l/kg, respectively. Following oral administration the median bio-availability (f) was 0.88 for calves dosed after a 12-h fast and 0.65 for calves dosed 5 min post feeding. Calves given the oral doses had a complex absorption pattern with delayed absorption. Slightly more than 50% of the administered dose both orally and intravenously was recovered as unchanged florfenicol in the urine by 30 h. PMID- 3806783 TI - The efficacy and plasma disposition of chloramphenicol and spiramycin in tick borne fever-infected dwarf goats. PMID- 3806784 TI - Monitoring of morantel levels in digestive contents by high performance liquid chromatography. PMID- 3806785 TI - Route of administration and uterine response to oxytocin in the ewe. PMID- 3806786 TI - Pharmacokinetics of triclabendazole alone or in combination with fenbendazole in sheep. PMID- 3806787 TI - Pharmacokinetics of trimethoprim/sulfadiazine in neonatal calves: influence of synovitis. AB - The effect of synovitis on the distribution of antibacterial drugs into the joint space was studied in 1-week-old calves. Sodium urate crystals were used to induce inflammation in the tibio-tarsal joint of calves and the antibacterial drug combination, trimethoprim/sulfadiazine (Tribrissen), 30 mg/kg, was administered intravenously 3 h after synovitis was induced. The degree of synovitis was monitored by serial WBC counts in synovial fluid. Trimethoprim (TMP) and sulfadiazine (SDZ) concentrations in serum and synovial fluid were measured and pharmacokinetic parameters were calculated. The results indicated that inflammation had no effect upon the concentrations of TMP/SDZ that reach the joint and that synovial fluid and blood are both representative of the central compartment as shown by the non-significant differences in selected pharmacokinetic parameters for TMP and SDZ in these two body fluids. The distribution and elimination of TMP and SDZ in serum were described by a two compartment model. PMID- 3806788 TI - Detection of asymptomatic herpes simplex virus infections after vaccination. AB - Twenty-two volunteers seronegative for antibodies to herpes simplex virus (HSV) were enrolled in a trial to determine tolerance and immunogenicity of an HSV-2 glycoprotein subunit vaccine. Vaccine was administered at days 0, 28, and 140, and sera were obtained on days 0, 7, 14, 21, 28, 35, 49, 56, 140, 147, and 365 for determination of HSV neutralizing antibody activity and antibody-dependent cell cytotoxicity (ADCC). Sera were also tested by immunoprecipitation of radiolabeled HSV-2-infected cell proteins and polyacrylamide gel electrophoresis to identify the viral proteins which elicited antibody responses in vaccine recipients. After vaccination two male volunteers presented with atypical first episode genital herpes: patient 1 with a culture-negative genital lesion at day 53 and patient 3 with urethritis at day 68. Seroconversion to wild-type viral proteins not present in the vaccine was detectable by radioimmunoprecipitation polyacrylamide gel electrophoresis within 10 days in both patients. Two additional volunteers, one a sex contact of patient 1, seroconverted asymptomatically to nonvaccine proteins during the trial. All four vaccine breakthrough patients were indistinguishable from the other volunteers in the time required to develop neutralizing and ADCC antibodies, in the titer of these antibodies, and the time to seroconversion to gB and gD vaccine proteins. However, only one of the four breakthrough patients had antibodies to g80 (a complex of gC-2 and gE) after vaccination as compared with 15 of the other 18 volunteers (P = 0.05). Neither neutralizing antibody nor ADCC titers consistently identified acquisition of wild-type viral infection; therefore, protein-specific serologies were required to detect wild-type antibodies in these four patients. These data underscore the importance of using serologic assays which will distinguish naturally acquired infection from the immune response to vaccination. PMID- 3806789 TI - Expression of the fusion protein of human respiratory syncytial virus from recombinant vaccinia virus vectors and protection of vaccinated mice. AB - Vaccinia virus (VV) recombinants were constructed that contained full-length cDNA copies of the fusion (F) protein gene of human respiratory syncytial (RS) virus. The F protein gene was placed next to the strong early-late VV 7.5-kilodalton promoter and was located within the VV thymidine kinase (tk) gene. Full-length recombinant transcripts that initiated at both the tk and the 7.5-kilodalton promoters accumulated in cells early in infection, and one or more of these transcripts was translated to yield a glycoprotein which comigrated with Fo, the fusion protein precursor. This precursor was processed by proteolytic cleavage to produce the two disulfide-linked subunits F1 and F2, which were both glycosylated and of the same electrophoretic mobility as authentic F1 and F2. Immunofluorescence studies demonstrated that the mature F protein was transported to and expressed on the surface of recombinant VV-infected cells. Inoculation of rabbits with a recombinant vector expressing F resulted in the production of antiserum specific for the RS virus F protein. This antiserum neutralized virus infectivity and was capable of preventing fusion in RS virus-infected cells. Mice were vaccinated with recombinants expressing the F protein. At 3 weeks postinoculation, these animals had serum antibody against RS virus F protein. At 5 days after intranasal challenge with RS virus, the lungs of the mice previously vaccinated with recombinants expressing F protein were free of detectable RS virus, whereas the lungs of unvaccinated mice contained 10(4.2) PFU of virus per g. PMID- 3806790 TI - Transcriptional activities of mammalian genomes at sites of recombination with foreign DNA. AB - The nucleotide sequences of several sites of recombination between adenovirus DNA and hamster, mouse, or human cell DNAs were determined. These sites of recombination had been cloned from adenovirus type 2 (Ad2)- or type 12 (Ad12) transformed cells, from Ad12-induced tumor cells, or from a symmetric recombinant between Ad12 DNA and human cell DNA. One important precondition for the generation of recombinants between host and foreign DNAs might be the establishment of a chromatin configuration that permits access of foreign DNA and of the recombination machinery to cellular DNA. Such favorable chromatin structures might arise during cellular DNA replication or transcription or both. As a first approach toward investigating these more complex problems of foreign DNA insertion, we determined transcriptional activities of cellular DNA sequences at viral junction sites. The sites of linkage investigated in this study with respect to their transcriptional activities were those previously cloned and sequenced (W. Doerfler, R. Gahlmann, S. Stabel, R. Deuring, U. Lichtenberg, M. Schulz, D. Eick, and R. Leisten, Curr. Top. Microbiol. Immunol. 109:193-228, 1983). In addition, a site from cell line HA12/7 which is described in this paper was also analyzed. The results presented demonstrate that the cellular DNA sequences involved in linkage to viral DNA at five completely different sites in DNA from three different species are transcribed into RNAs even in cells which have not been transformed or infected by adenovirus. Some of these RNAs were cytoplasmic and were not poly(A)+. Human cell DNA sequences at the junction to Ad12 DNA in SYREC2 DNA were transcribed into poly(A)+ cytoplasmic RNA which could be translated in vitro. These results are consistent with the notion that at least some of the cellular DNA sequences at sites of insertion of adenovirus (foreign) DNA are transcriptionally active and thus provide an opportunity for recombination. PMID- 3806791 TI - A 14,000-Mr envelope protein of vaccinia virus is involved in cell fusion and forms covalently linked trimers. AB - A monoclonal antibody, MAbC3, that reacts with a 14,000-molecular-weight envelope protein (14K protein) of vaccinia virus completely inhibited virus-induced cell fusion during infection. Immunoblot and immunofluorescence studies revealed that the 14K protein was synthesized at about 6 to 7 h postinfection and transported from the cytoplasm to the cell surface. Synthesis and transport of the 14K protein during infection occurred in the presence of rifampin, an inhibitor of virus maturation. One- and two-dimensional gel electrophoretic analyses demonstrated that the 14K protein forms largely trimers (42K) that are covalently linked by disulfide bonds. The facts that MAbC3 prevents virus uncoating and blocks virus-induced cell fusion but does not prevent virus attachment to cells and the 14K envelope protein forms trimers all suggest that this protein plays major role in virus penetration. PMID- 3806792 TI - Selective inhibition of translation of the mRNA coding for measles virus membrane protein at elevated temperatures. AB - The elevation of culture temperatures of C6 cells that were persistently infected with the Lec strain of the subacute sclerosing panencephalitis (SSPE) virus (C6/SSPE) resulted in immediate selective inhibition of membrane (M) protein synthesis. This phenomenon was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of total cytoplasmic lysates and immunoprecipitation with monoclonal antibody against the M protein in short-time labeling experiments. The synthesis of various viral mRNAs in the presence of actinomycin D decreased gradually at similar rates after a shift to 39 degrees C. No specific disappearance of the mRNA coding for the M protein was observed when viral RNAs isolated from the infected cells were compared before and after a shift up by Northern blot analysis. Results of pulse-chase experiments did not show any significant difference in M protein stability between 35 and 39 degrees C. This rapid block of M protein synthesis was observed not only in Vero cells that were lytically infected with plaque-purified clones from the Lec strain, clones isolated from C6/SSPE cells and the standard Edmonston strain of measles virus but also in CV1, MA160, and HeLa cells that were lytically infected with the Edmonston strain. Poly(A)+ RNAs that were extracted from C6/SSPE cells before and after a shift to 39 degrees C produced detectable phospho, nucleocapsid, and M proteins in cell-free translation systems at 32 degrees C. Even higher incubation temperatures did not demonstrate the selective depression of M protein synthesis described above in vitro. All these data indicate that M protein synthesis of measles virus is selectively suppressed at elevated temperatures because of an inability of the translation apparatus to interact with the M protein-encoded mRNA. PMID- 3806793 TI - Identification of the gene encoding an RNA polymerase-binding protein of bacteriophage T4. AB - One of five bacteriophage T4-specified proteins that bind to host RNA polymerase core has been purified and partially sequenced. A mixed oligonucleotide, based on the amino acid sequence, was used to probe genomic restriction fragments. The gene for this protein, previously designated the 15K protein, has been located between T4 genes 45 and 46 and designated rpbA. PMID- 3806794 TI - Noncoordinate regulation of a vaccinia virus late gene cluster. AB - Identification of a tightly spaced and tandemly oriented late gene cluster within the central conserved region of the vaccinia virus genome suggested the possibility of coordinate regulation of the genes within this domain (S.L. Weinrich and D.E. Hruby, Nucleic Acids Res. 14:3003-3016, 1986). To test this hypothesis, the steady-state levels of transcripts derived from the individual late genes were examined. Cytoplasmic RNA was isolated from infected cells at hourly intervals throughout infection and was used in concert with 5' S1 nuclease mapping procedures to detect transcripts from specific late genes. Among the set of six closely linked late genes, marked differences were observed in both the levels of transcription and the kinetic patterns of expression, providing direct evidence for the existence of differentially regulated gene subsets within the late gene class. Furthermore, these experiments identified one of the genes (encoding a 33,000-molecular-weight polypeptide) as being expressed both early and late postinfection. Interestingly, although transcripts from the constitutively expressed gene were initiated at the same start sites throughout infection, a discrete terminus for these transcripts was detected only at early times. These data suggest that the lack of cis-acting termination signals is not the reason for the late gene transcript heterogeneity observed in vaccinia virus infected cells. PMID- 3806795 TI - Identification of a transcription factor which interacts with the distal domain of the adenovirus IVa2 promoter. AB - For efficient in vitro transcription from the adenovirus IVa2 promoter, two upstream control regions, one proximal to the RNA initiation site at nucleotide position (np) -39 to -48 and the other a distal domain between np -152 and -179, are necessary. By using the band competition assay of Strauss and Varshavsky (Cell 37:889, 1984), we identified a factor which binds to the IVa2 promoter. Competition studies with various deletion mutants demonstrated that the region present 152 to 160 base pairs upstream of the IVa2 transcription start site was necessary for binding of this factor. DNase I footprinting assays demonstrated directly that this factor interacted with the distal domain of the IVa2 promoter. This factor was necessary for efficient transcription from the IVa2 promoter, as evidenced by the ability of a DNA fragment containing the binding site for this factor to inhibit transcription. Its role in bidirectional activation of transcription from major late and IVa2 promoters is discussed. PMID- 3806796 TI - Unusual transcripts in La Crosse virus-infected cells and the site for nucleocapsid assembly. AB - The La Crosse virus S genome segment is known to code for two plus-strand transcripts, free S-mRNA (nucleotide [nt] -15 to 886) and encapsidated antigenome RNA (nt 1 to 983). Early in infection only these plus-strand transcripts could be detected, but at later times plus-strand RNAs representing nt 1 to 886 in an encapsidated form and nt -15 to 983 as a free RNA could also be seen, as well as S-mRNA in an encapsidated form. The encapsidated S-mRNA became relatively important at later times because the free S-mRNA turned over rapidly after 5 h postinfection. The existence of these unusual RNAs and their presence as either free or encapsidated species suggests that the site for nucleocapsid assembly is located at the 5' ends of the genome and antigenome chains. PMID- 3806797 TI - Influenza virus gene expression: control mechanisms at early and late times of infection and nuclear-cytoplasmic transport of virus-specific RNAs. AB - Single-stranded M13 DNAs specific for various influenza virus genomic segments were used to analyze the synthesis of virus-specific RNAs in infected cells. The results show that influenza virus infection is divided into two distinct phases. During the early phase, the syntheses of specific virion RNAs, viral mRNAs, and viral proteins were coupled. Thus, the NS (nonstructural) virion RNA was preferentially synthesized early, leading to the preferential synthesis of NS1 viral mRNA and NS1 protein; in contrast, M (matrix) RNA synthesis was delayed, leading to the delayed synthesis of M1 viral mRNA and M1 protein. This phase lasted for 2.5 h in BHK-21 cells, the time at which the rate of synthesis of all the viral mRNAs was maximal. During the second phase, the synthesis of all the virion RNAs remained at or near maximum until at least 5.5 h postinfection, whereas the rate of synthesis of all the viral mRNAs declined dramatically. By 4.5 h, the rate of synthesis of all the viral mRNAs was 5% of the maximum rate. Viral mRNA and protein syntheses were also not coupled, as the synthesis of all the viral proteins continued at maximum levels, indicating that protein synthesis during this phase was directed principally by previously synthesized viral mRNAs. Short pulses (3 min) with [3H]uridine and nonaqueous fractionation of cells were used to show that influenza virion RNA synthesis occurred in the nucleus, demonstrating that all virus-specific RNA synthesis was nuclear. Virion RNAs, like viral mRNAs, were efficiently transported to the cytoplasm at both early and late times of infection. In contrast, the full-length transcripts of the virion RNAs, which are the templates for virion RNA synthesis, were sequestered in the nucleus. Thus, the template RNAs, which were synthesized only at early times, remained in the nucleus to direct virion RNA synthesis throughout infection. These results enabled us to present an overall scheme for the control of influenza virus gene expression. PMID- 3806798 TI - Regulation of secretion of the hepatitis B virus major surface antigen by the preS-1 protein. AB - P24, P30, and P39, the three major surface antigens of the envelope of hepatitis B virus, are co-carboxy-terminal proteins with different amino-terminal extensions. We prompted expression of these proteins in Chinese hamster ovary (CHO) cells by placing the appropriate coding sequence(s) under the control of the simian virus 40 early promoter. P24 and P30 formed 22-nm particles which were efficiently secreted. In contrast, P39 accumulated in a perinuclear structure, presumably the Golgi complex, and was not secreted. Coexpressing P39 and P24 resulted in the localization of both in the perinuclear region and restricted the secretion of P24. We found that P39 must be expressed at a relatively low level to allow efficient secretion of P24 in typical spherical particles. We hypothesize that P39, by inhibiting the formation of spherical particles, helps to induce formation of filamentous particles and mature Hepatitis B virus. PMID- 3806799 TI - Replication strategy of human hepatitis B virus. AB - To study the replication strategy of the human hepatitis B virus, the 5' end of the RNA pregenome and the initiation sites of DNA plus and minus strands have been mapped. The RNA pregenome was found to be terminally redundant by 120 nucleotides; it is initiated within the pre-C region and may also function as mRNA for synthesis of the major core protein and the hepatitis B virus reverse transcriptase. The hepatitis B virus DNA minus strand is initiated within the direct repeat sequence DR1, it contains a terminal redundancy of up to eight nucleotides, and its synthesis does not require any template switch. The DNA plus strand is primed by a short oligoribonucleotide probably derived from the 5' end of the RNA pregenome, and its synthesis is initiated close to the direct repeat sequence DR2. For its elongation to pass the discontinuity in the DNA minus strand an intramolecular template switch occurs using the terminal redundancy of this template. Thus, the route of reverse transcription and DNA replication of hepatitis B viruses is fundamentally different from that of retroviruses. PMID- 3806800 TI - Instability of large direct repeats in retrovirus vectors. AB - Retrovirus vectors were constructed with large (0.85- to 1.3-kilobase-pair) direct repeats in their genomes. Deletions involving the direct repeats occurred at a high frequency. Deletions occurred both when the direct repeats were in tandem and when they were separated by additional sequences. These deletions occurred during virus replication. PMID- 3806801 TI - Perinephric abscess: current concepts. PMID- 3806802 TI - The supracostal approach for percutaneous nephrostolithotomy. AB - Sixty-nine patients underwent percutaneous nephrostolithotomy or ultrasonic lithotripsy through a nephrostomy tract placed over the 12th rib. All procedures were accomplished as a single stage in a standard operating room with patients under general anesthesia. With the exception of a single failed access the targeted calculus was removed in all instances. There were no episodes of postoperative pneumothorax or hydrothorax. One patient suffered delayed postoperative pneumonia and another patient had a delayed pleural effusion. The supracostal approach for percutaneous nephrostolithotomy is an important and safe modification of the traditional percutaneous approach to the kidney for an endourological procedure. PMID- 3806803 TI - Preoperative devascularization of advanced renal adenocarcinoma using a sclerosing agent. AB - Sodium tetradecyl sulfate is a sclerosing agent used currently as therapy for varicose veins. Animal experiments have demonstrated this drug to be a useful agent for renal tissue destruction. We have used sodium tetradecyl sulfate with or without steel coils for preoperative renal devascularization in 6 patients with advanced renal adenocarcinoma. In all patients sodium tetradecyl sulfate effectively caused renal infarction and was tolerated well. No complications were associated with the use of this agent. Sodium tetradecyl sulfate is an efficient fluid embolic agent that can be a useful adjunct to nephrectomy in selected cases. PMID- 3806804 TI - Immunotherapy of metastatic renal cell carcinoma with polyinosinic-polycytidylic acid. AB - Polyinosinic-polycytidylic acid, a double-stranded ribonucleic acid that is a potent inducer of interferon production, was used in a stabilized form to treat 11 patients with metastatic renal cell carcinoma. Seven patients completed a full course of 8 infusions at maximum tolerated dosage. All patients experienced transient fever and marked fatigue. Anorexia was mild. Transient leukopenia occurred in 3 patients and reversible elevation in creatinine was observed in 1. All 4 patients with brain metastases became lethargic, and 3 died during or shortly after therapy. Only 2 patients demonstrated measurable total regression of isolated metastases (pleural/pulmonary in 1 and bone in 1) but in both metastases at other sites progressed. No partial regressions were seen. Metastases at all other sites (liver, brain and renal fossa) progressed during therapy. Patients who appeared to respond and who performed best during therapy generally demonstrated a higher performance status initially. Expression of natural cytotoxicity in in vitro testing did not correlate with a demonstrated response to treatment. PMID- 3806805 TI - Computerized tomography in bladder rupture: diagnostic limitations. AB - Because computerized tomography is often the first test performed in patients with blunt abdominal and pelvic trauma we designed a prospective study to determine if it might be as accurate as retrograde cystography in the diagnosis of bladder rupture. Patients who had suffered blunt trauma with gross hematuria or who had pelvic fractures and microhematuria underwent computerized tomography followed by retrograde cystography. A urethral catheter was inserted and clamped during computerized tomography to ensure bladder filling. Of our first 2 patients computerized tomography showed no evidence of opacified urinary extravasation in 1 and only subtle evidence in the other. Cystography revealed gross intraperitoneal extravasation of opacified urine in both patients. Presently, retrograde cystography, including a film of the distended bladder and a drainage film, remains the most reliable test in suspected bladder rupture. PMID- 3806806 TI - Risks and benefits of repeated courses of intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer. AB - An actuarial analysis of the risks and benefits of repeated courses of intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer was performed for 100 consecutive patients treated for carcinoma in situ (29), prophylaxis against recurrent tumor (51) or residual superficial papillary tumor (21). The risk-to-benefit ratio at entry into bacillus Calmette-Guerin therapy (7 per cent risk of invasive cancer developing, 5 per cent risk of metastases and 77 per cent prospect for status free of tumor) and in patients who had failed only 1 course of bacillus Calmette-Guerin therapy (11 per cent invasive cancer, 14 per cent metastases and 58 per cent free of tumor) were highly favorable. However, among patients who had failed 2 or more courses of bacillus Calmette-Guerin therapy the risks of invasive (30 per cent) or metastatic (50 per cent) cancer developing exceeded the prospects for eradicating the superficial tumor present (20 per cent) with further therapy. The results suggest that patients who have failed 2 courses of bacillus Calmette-Guerin therapy (as given in our treatment protocol) should be considered for alternative treatment. PMID- 3806807 TI - Vasectomy and vasovasostomy have no effect on seminal plasma zinc concentrations. AB - Mean zinc concentrations were determined for human seminal plasma obtained from 110 nonvasectomized men (139 micrograms. per ml.), 43 recently vasectomized men (144 micrograms. per ml.), 25 long-term vasectomized men (139 micrograms. per ml.) and 25 men who had undergone vasovasostomy (129 micrograms. per ml.). The results indicate that there is no significant short-term or long-term effect of these surgical procedures on prostatic secretory function as measured by seminal plasma zinc concentration. PMID- 3806808 TI - Urological manifestations of isolated iliac artery aneurysms. AB - Three patients with iliac artery aneurysms were seen at our institution with the chief complaints owing to urological manifestations. Iliac artery aneurysms may present with a transrectally palpable mass, hematuria, bladder outlet obstruction, ureteral obstruction, retroperitoneal fibrosis or renal failure. Any such manifestations may bring the aneurysm to the attention of a urologist before diagnosis. PMID- 3806809 TI - Use of reversed nephroureteral stent as suprapubic cystoureteral catheter. AB - By the reversal of the existing nephroureteral stent system a vesicoureteral stent exiting through the suprapubic site is created. The major advantages of this system include avoidance of side holes along the stent, avoidance of a urethral catheter, ease of access for contrast medium studies to monitor healing, comfort and ease of removal. The major application of the system would be for lower ureteral surgery. Development of a 5F catheter with a shorter kidney-to bladder length would permit use of this system in children. PMID- 3806810 TI - "Turban" scrotal dressing. AB - Edema and hematoma are common complications of scrotal surgery. We describe a new technique of scrotal wrap dressing that diminishes markedly the incidence of these postoperative complications. PMID- 3806811 TI - Vesicoureteral reflux and lower urinary tract dysfunction: evidence for 2 different reflux/dysfunction complexes. AB - We examined retrospectively 458 children 2 to 15 years old without neuropathic conditions or a gross anatomical abnormality to determine whether there was an association between lower urinary tract dysfunction and vesicoureteral reflux. We identified 2 different types of reflux/dysfunction complexes with contrasting urodynamic characteristics. One type included bladder instability with powerful voiding contractions of the bladder and reflux that frequently occurred on 1 side only. Reflux nephropathy or the presence of an upper urinary tract abnormality is rare. In the other type the bladder contracted poorly during voiding and overactivity of the urethral closure mechanism often was observed. The bladder usually was stable and the reflux occurred frequently on both sides. Reflux nephropathy or the presence of an upper urinary tract abnormality is relatively common. Direct videourodynamic observations of reflux in a second group of children confirmed the existence of these 2 types of reflux/dysfunction complexes. PMID- 3806812 TI - Measurement of trigonal sensitivity as a test of bladder function. AB - A method has been developed for the measurement of sensory receptors that respond to pressure at the base of the bladder and posterior urethra. The application of force to a balloon catheter placed at that part of the bladder regularly results in an urge to urinate. People with normal voiding perceive the urge to void when 245 +/- 47 gm. (standard deviation) of force are applied. Patients with irritative symptoms (urinary frequency and urgency) perceive the urge to void when 132 +/- 50 gm. (p equals 0.0003) are applied. After enucleative prostatectomy more force is required to cause the urge to void (344 +/- 48 gm., p equals 0.0003) and even more force is required after radical prostatectomy (469 +/- 54 gm., p equals 0.0002). Patients with acute urinary retention or urinary stress incontinence were not distinguishable from the normal group. Patients with chronic urinary retention may be divided into 2 subgroups: 1 with normal sensory perception and 1 with reduced perception (526 +/- 32 gm., p equals 1.6 X 10(-9)). Three patients with urinary urgency not associated with frequency did not perceive the urge to void until 541 +/- 21 gm. (p equals 6.2 X 10(-7)) had been applied. Some elderly patients could not reproducibly report the urge to void. When lidocaine was applied topically within the bladder sensitivity was reduced by 210 +/- 114 gm. (p equals 0.003). It is suggested that pressure sensitive receptors in the mucosa or submucosa of the bladder base and posterior urethra have a role in micturition, that their activity can be quantitated and that protocols designed to manage them may have impact on the care of patients with voiding disorders. PMID- 3806813 TI - A disposable anal plug electrode for pelvic floor/anal sphincter electromyography. AB - During the last year we developed a disposable anal plug electrode for pelvic floor/external anal sphincter electromyography. The electrode consists of 2 disposable silver chloride surface electrodes mounted on a trochlear-shaped sponge. Testing of the new electrode with simultaneous registration of external anal sphincter electromyography using a coaxial needle electrode showed synchronous electromyographic patterns. In clinical urodynamic studies, including 48 cystometry studies with anal sphincter electromyography and 48 pressure-flow electromyographic studies, the electrode provided technically good and reliable electromyograms. The electrode design secures good contact to the recording surface and a safe fixation of the electrode during recording. The compressibility of the electrode might circumvent the problem of possible detrusor reflex inhibition induced by conventional hard anal plug electrodes. We recommend this technique for anal sphincter electromyography, since it is simple, reliable and without discomfort, and it does not require sterilization of the electrode. PMID- 3806814 TI - Urethral complications following ischiectomy in spinal cord injury patients: a urethral pressure study. AB - Ischial ulcers are the most common pressure sores in spinal cord injury patients and ischiectomy often is used in the over-all management. Because a high percentage of spinal cord injury patients with total ischiectomy had complications of the membranous and proximal bulbous urethra, we evaluated urodynamically 15 ischiectomy patients in the supine and sitting positions to determine if pressure usually borne by the ischial tuberosities was transmitted to the membranous and proximal bulbous urethra. Of the 8 patients with a complete ischiectomy at least on 1 side 5 had problems of the membranous and proximal bulbous urethra, and the average urethral pressure increase from the reclining to the sitting position was 111 cm. water. The increase in urethral pressure was not related to any change in bladder or abdominal pressure. The average urethral pressure increase in the nonischiectomy patients was only 16 cm. water and none had any problems of the membranous and proximal bulbous urethra. Some retrospective clinical studies have implicated ischiectomy in the development of these urethral complications. Our urodynamic data lend some direct evidence that a more complete ischiectomy results in excessive urethral pressure with the patient in the sitting position, thereby predisposing the membranous and proximal bulbous urethra to problems related to ischemia. Five of the 8 patients with more complete ischiectomy and 1 with bilateral partial ischiectomy had high urethral pressures and complications, such as pseudodiverticulum, diverticulum and dilatation. More incomplete ischiectomy should be used to obviate this urethral damage. PMID- 3806815 TI - Symptomatic bilateral renal angiomyolipomas in a child. AB - We report a case of bilateral renal angiomyolipomas in a child with Bourneville's tuberous sclerosis. The case is unusual because of the early age of the patient at which symptoms occurred. The presentation and treatment are discussed, and the literature is reviewed. Renal disease can occur in young patients with tuberous sclerosis and it is of clinical importance to document renal involvement in these children. PMID- 3806816 TI - The importance of a successful initial bladder closure in the surgical management of classical bladder exstrophy: analysis of 144 patients treated at the Johns Hopkins Hospital between 1975 and 1985. AB - The staged functional closure of classical bladder exstrophy has produced improved results for many urologists involved in the surgical management of this congenital anomaly. To determine which factors are most important for achieving a successful outcome (urinary continence with preservation of normal renal function) the 144 patients treated at The Johns Hopkins Hospital between 1975 and 1985 were reviewed. Of these patients 51 were managed entirely at our institution, while 93 had had the initial surgical treatment elsewhere. All patients who had undergone primary bladder closure and bladder neck reconstruction were divided into 2 groups: group 1--patients who had a successful initial bladder closure (an exstrophied bladder that is converted into a complete epispadias without wound infection, dehiscence or any degree of bladder prolapse on the first attempt) and group 2--children whose initial bladder closure was not successful. Both groups were analyzed with respect to bladder capacity at the time of bladder neck reconstruction, time required for the bladder to become sufficiently large for bladder neck reconstruction, urinary continence rate, and interval between bladder neck reconstruction and achievement of urinary continence. Patients in group 1 had the largest bladders at the time of bladder neck reconstruction (mean capacity 79 cc, p equals 0.03), shortest intervals between primary closure and bladder neck reconstruction (mean 3.5 years, p equals 0.006), highest urinary continence rate (92 per cent, p equals 0.002), and the shortest interval between bladder neck reconstruction and achievement of urinary continence (mean 1.5 years, p equals 0.18). These findings suggest that a successful initial bladder closure is an important factor for obtaining a larger bladder more quickly and for achieving a high urinary continence rate in patients with classical bladder exstrophy undergoing the staged functional bladder closure. PMID- 3806817 TI - A new application for the removal of caliceal renal stones with the rigid ureteropyeloscope. AB - Stone migration into the kidney can result in failure to remove a ureteral stone with a ureteroscope. A new application with the rigid ureteropyeloscope was used to remove a ureteral stone that had migrated into a lower renal calix. Under fluoroscopic control a 9F catheter was advanced next to the stone through the emptied sheath of the ureteropyeloscope whose tip was in the upper ureter. Then a basket was placed through the catheter and was used to trap and remove the stone. PMID- 3806818 TI - Esophageal cancer metastatic to kidney: report of 2 cases. AB - We report 2 cases of renal tumor secondary to an esophageal cancer and discovered during an examination for hematuria. Despite the history the existence of a renal tumor with no apparent metastatic spread and hematuria justified nephrectomy, which led to the confirmation of metastasis to the kidney. Metastases of esophageal cancers represent only 4.8 per cent of secondary renal tumors. The kidneys are the fourth most common metastatic site of esophageal cancers, generally associated with several other secondary localizations. Their clinical latency is common. The difficulty in diagnosing these tumors and the frequent failure of complementary examinations result from their character, that is nodular, small diameter, multiple and cortical. PMID- 3806819 TI - Endoscopic management of the obliterated ureteroileal anastomosis. AB - Endoscopic restoration of a totally obstructed ureteroileal anastomosis was accomplished in 3 patients. The combined use of rigid endoscopy of the ileal conduit and flexible nephroureteroscopy provided full visualization of the blind ending segments and allowed location of the shortest segment between the lumina. A guide wire was passed through intervening tissue with fluoroscopic monitoring to re-establish internal drainage. This technique offers an alternative to laparotomy and reimplantation in selected cases of ureteroileal stricture. PMID- 3806820 TI - Vesicovaginal fistulas of uncommon etiology. AB - We report 2 cases of vesicovaginal fistulas sustained during sexual intercourse. In our first case fistula formation was probably the result of physical disparity of the partners and a frightened, unprepared woman. In the second case increased friability caused by hormonal influence during menstruation and a urinary infection probably contributed to fistula formation. Both patients underwent a successful, transabdominal repair with omental interposition. PMID- 3806821 TI - Endourological reconstruction of posterior urethral disruption. AB - While conventional methods of urethroplasty for posterior urethral disruption usually are successful technically, they may be associated with complications and often require the expertise of a specialist. Therefore, the option of an endourological approach to the treatment of the obliterated posterior urethra would be highly desirable if a comparable surgical outcome could be achieved. We describe a closed controlled method of posterior urethral reconstruction following traumatic avulsion of the posterior urethra. Urethral continuity was re established by endoscopic identification of the true prostatic outlet, its fixation with an angiography wire and a Goodwin sound, retrograde visual urethrotomy through the fibrotic segment and balloon dilation of the entire posterior channel. Postoperative anatomical and functional results were excellent, and were achieved with much less risk and cost to the patient than those of a perineal or transpubic urethroplasty. PMID- 3806822 TI - Tubovaginal leakage: an unusual cause of incontinence. AB - Incontinence after hysterectomy may be caused by an abnormal fallopian tube draining into the vaginal cuff. We report 2 cases of this condition, which generally is known as hydrops tubae profluens. One patient also had genuine stress urinary incontinence and the other suffered persistent disease after 2 failed suspension procedures. This rare condition should be considered in the differential diagnosis of unusual causes of incontinence. PMID- 3806823 TI - Chronic balanitis owing to pemphigus vegetans. AB - Pemphigus is an autoimmune bullous dermatosis in which intercellular antibodies are associated with loss of intercellular cohesion. Pemphigus vegetans, a rare variant of pemphigus, is manifested by vegetating plaques, usually in intertriginous areas of patients who probably have an increased resistance to the disease. We report a case of chronic balanitis owing to pemphigus vegetans, and discuss proposed pathogenic mechanisms and treatment. PMID- 3806824 TI - Fibrosis of corpus cavernosum after intracavernous injection of phentolamine/papaverine. AB - Intracavernous self-injection with vasoactive drugs is a new treatment for impotence. Although few reports of side effects have been published complications such as priapism and fibrosis of the spongy tissue are of concern. We report a case of penile fibrosis after intracavernous self-injection of a combination of phentolamine and papaverine. PMID- 3806825 TI - Erosion of an inflatable penile prosthesis reservoir into an ileal conduit. AB - We report an unusual complication of an inflatable penile prosthesis. The penile prosthesis reservoir had been placed intra-abdominally and it eroded into an ileal conduit. The reservoir was removed endoscopically but the patient ultimately required creation of a new ileal conduit. Placement of reservoirs intraperitoneally risks erosion into the bowel. PMID- 3806826 TI - Thrombosis of the inferior vena cava by seminoma. AB - We report a case of metastatic seminoma that caused thrombosis and obstruction of the inferior vena cava. The pathogenesis of this rare clinical entity is discussed. The diagnostic studies for detection of vena caval thrombosis and clinical management strategies are reviewed. PMID- 3806827 TI - Spermatic cord liposarcoma in a young boy. AB - We report on a spermatic cord liposarcoma arising in a 16-year-old boy. Treatment consisted of radical orchiectomy without retroperitoneal lymph node dissection, and adjuvant radiation and chemotherapy. The patient has survived 14 months without evidence of recurrence. Paratesticular localization of liposarcoma in patients less than 20 years old is rare. The tumor has no particular characteristic. Treatment consists of radical orchiectomy and the role of retroperitoneal lymphadenectomy is controversial. PMID- 3806828 TI - Hypercalcemia in carcinoma of the prostate: case report and review of the literature. AB - Hypercalcemia developed in a man with recurrent adenocarcinoma of the prostate. Serum calcium became normal soon after bilateral orchiectomy and the patient was free of disease 18 months later. The absence of radiographically detectable bone metastases in this patient suggested a humoral mechanism for the hypercalcemia. Orchiectomy may be an effective treatment for hypercalcemia complicating prostatic carcinoma. PMID- 3806829 TI - 2,8-Dihydroxyadenine urolithiasis: report of an adult case in the United States. AB - 2,8-Dihydroxyadeninuria is a rare purine metabolic disorder that has been reported to have caused urolithiasis in 14 cases, mostly children. Excretion of the hydroxylated metabolites of adenine results from a deficiency of adenine phosphoribosyltransferase. The insoluble calculi have a similar chemical structure to uric acid and frequently are misdiagnosed as uric acid calculi. Management differs from that of uric acid urolithiasis. We report on an adult with 2,8-dihydroxyadenine urolithiasis in the United States. PMID- 3806830 TI - Re: Intravesical bacillus Calmette-Guerin therapy and associated granulomatous renal masses. PMID- 3806831 TI - Re: The ureteral folding technique for megaureter surgery. PMID- 3806832 TI - Re: Dynamic cavernosography: venous outflow studies of cavernous bodies. PMID- 3806833 TI - Self-adhesive wrap. PMID- 3806834 TI - Re: Failure of the Jonas prosthesis. PMID- 3806835 TI - Re: Bilateral granulomatous orchitis: manifestation of idiopathic systemic granulomatosis. PMID- 3806836 TI - Re: Testicular function in 12 cases of penile agenesis. PMID- 3806837 TI - Urinary calculi. PMID- 3806838 TI - Re: Metabolic factors in urolithiasis: a study in Brazil. PMID- 3806839 TI - Thermography as a diagnostic measure of vasculogenic impotence. AB - There is no correlation between penile-brachial index (PBI) and thermography. While it has been shown to be of significant value in other areas of medicine, thermography is non-contributory to the diagnosis of vasculogenic impotence. PMID- 3806840 TI - Histopathologic and ultrastructural correlates of tumor growth suppression by high energy shock waves. AB - High energy shock waves (HESW) are cytotoxic to tumor cells as determined by vital staining and impaired ability of viable cells to form colonies in a clonogenic assay. In addition, direct exposure of tumor nodules to HESW results in suppression of tumor growth rate. In order to identify histopathologic and ultrastructural correlates of these observations, R3327AT-3 prostatic tumor cells were exposed to HESW in vitro and in vivo. Damage to cells in suspension was manifested by fragmentation of cells to form debris. At the ultrastructural level, mitochondria were swollen and contained distorted cristae following exposure of tumor cells to HESW. In vivo exposure of tumor nodules to HESW did not cause a distinct histopathologic or ultrastructural effect that could be qualitatively distinguished from spontaneously occurring cell death. Hemorrhage and necrosis were observed in muscle and fibroadipose tissue adjacent to tumor. The mechanism of HESW-induced cytotoxicity is not clear from our studies. Evidence of damage of normal tissues exposed in vivo and tumor cells in vitro is reflected in histomorphological changes. PMID- 3806841 TI - Potential therapeutic effect of adriamycin-monoclonal anti-prostatic acid phosphatase antibody conjugate on human prostate tumor. AB - Adriamycin was conjugated to an IgG1 monoclonal antibody specific for human prostatic acid phosphatase via a dextran bridge. The adriamycin-monoclonal antibody conjugate retained substantially the original immunological activity of the antibody. Antitumor effect of the conjugate in vitro was studied by its inhibition on RNA synthesis in human prostate tumor cells (LNCaP), which exhibited a higher inhibition than that by an identically prepared adriamycin normal mouse IgG conjugate but was less than that by free adriamycin. The loss in pharmacological activity of the conjugate in vitro was proportional to the extent of dextran oxidation. Antitumor effect in vivo demonstrated that adriamycin monoclonal antibody conjugate greatly inhibited the growth of xenografted prostate tumor, as compared with control groups, only in the early phase of experiment. These results suggested that although adriamycin conjugated to monoclonal anti-PAP antibody via a dextran bridge may be a potential reagent for experimental immunochemotherapy of prostate tumor, caution must be exercised at this stage of development. PMID- 3806843 TI - AMA writes prescription for treating growing drug-diversion problem. PMID- 3806842 TI - Superiority of intravesical immunotherapy with Corynebacterium parvum and Allium sativum in control of murine bladder cancer. AB - Intravesical immunotherapy with bacillus Calmette-Guerin (BCG), Corynebacterium parvum (CP), keyhole limpet hemocyanin (KLH), and an extract of Allium sativum (AS) was studied in mice transplanted intravesically with mouse bladder tumor cells (MBT-2). Female C3H/He mice were anesthetized with sodium pentobarbital. Two X 10(5) MBT-2 cells were delivered into the bladder transurethrally using a small catheter, immediately after the posterior wall of the bladder had been electrocauterized. Bladder tumor became palpable or demonstrable microscopically in two weeks. Immunotherapy with BCG (2 X 10(6) CFU), CP (250 micrograms), KLH (50 micrograms), or AS (25 mg) was administered directly into the bladder via urethral catheter on day 1, day 6, or days 1 and 6. On day 21 the bladders and spleens were excised and weighed, and the bladders were examined macroscopically and microscopically for evidence of tumor. The results of the study showed that two treatments given one and six days after tumor transplant yielded the lowest tumor incidence and that CP and AS appeared equally effective or even slightly more effective than BCG in this model. These results suggest that clinical evaluation of CP or AS may be worthwhile. PMID- 3806844 TI - Treating a societal malignancy--rape. PMID- 3806845 TI - Leads from the MMWR. Drinking and driving and binge drinking in selected states, 1982 and 1985--the Behavioral Risk Factor Surveys. PMID- 3806846 TI - Leads from the MMWR. Multi-drug-resistant tuberculosis--North Carolina. PMID- 3806847 TI - It's an insurance problem, not a liability crisis. PMID- 3806848 TI - Managing liability risk in the office laboratory. PMID- 3806849 TI - Liability for transfusion-acquired disease. PMID- 3806850 TI - A case of high-altitude pulmonary edema treated with nifedipine. PMID- 3806851 TI - Radiation retinopathy. PMID- 3806852 TI - Pseudopneumothorax: a migratory mirage. PMID- 3806853 TI - Health effects of smokeless tobacco. PMID- 3806854 TI - Joystick digit. PMID- 3806855 TI - Colorectal cancer at a public health center. PMID- 3806856 TI - Correlation between biochemical indicators of lead exposure and semen quality in a lead-poisoned firearms instructor. PMID- 3806857 TI - Radioepidemiological tables. Council on Scientific Affairs. AB - In 1983, the Federal Orphan Drug Act was passed. This act included a rider intended as a foundation for compensating individuals with cancers allegedly caused by radiation exposures during certain nuclear events. In response, a National Institutes of Health working group was established that prepared the National Institutes of Health Radioepidemiological Tables. The tables permit computation of a "probability of causation" (otherwise known as "assigned share") that an individual's cancer was caused by earlier estimated exposure to radiation. However, several limitations have been noted in the accuracy of the computations and in the conditions under which the computations are applicable. These limitations have caused the Council on Scientific Affairs of the American Medical Association to recommend that the probability of causation approach not be applied to occupational radiation exposures or to diagnostic or therapeutic exposures in medicine. PMID- 3806858 TI - Report of the Special Task Force on Professional Liability and Insurance and the Advisory Panel on Professional Liability. PMID- 3806859 TI - Congressional testimony on Senate Bill S. 1804. PMID- 3806860 TI - An overview of state medical discipline. AB - The Office of Inspector General's responsibility for financially penalizing and excluding health care professionals from Medicare and Medicaid participation led to an interest in examining the state medical boards' licensure and discipline processes. This article discusses the results of the subsequent study and focuses only on medical discipline issues. We found that the rate of disciplinary actions taken by boards has been increasing. However, revocations and suspensions, the most serious category of actions, have remained relatively constant. Additionally, consumers and law enforcement agencies are the most active sources of possible violations. Individual health care professionals, hospitals, peer review organizations, and medical societies provide strikingly few reports. To rectify these problems, we encourage states to increase physician license renewal fees to fund expansion and improvement of boards' enforcement activities and to consider ways to limit the legal liability of those making good-faith referrals. PMID- 3806862 TI - State medical discipline: defects and hindrances. PMID- 3806861 TI - Beyond tort reform. PMID- 3806863 TI - Paler is better, say skin cancer fighters. PMID- 3806864 TI - Unusual moles play leading role in new strategies for predicting and preventing malignant melanoma. PMID- 3806865 TI - Rape victim advises report attack, get help. PMID- 3806866 TI - Motivations studied and treatments devised in attempt to change rapists' behavior. PMID- 3806867 TI - Leads from the MMWR. Occupational asthma from inhaled egg protein--Iowa. PMID- 3806868 TI - Leads from the MMWR. Measles transmitted in a medical office building--New Mexico, 1986. PMID- 3806869 TI - Leads from the MMWR. Hepatitis--1984. PMID- 3806871 TI - Controlled drinking and the treatment of alcoholism. PMID- 3806870 TI - Leads from the MMWR. Trichinosis--Hawaii. PMID- 3806872 TI - Autologous blood transfusion. PMID- 3806873 TI - Pill-induced intramural esophageal hematoma. PMID- 3806874 TI - Association of diltiazem therapy with increased insulin resistance in a patient with type I diabetes mellitus. PMID- 3806875 TI - Trends in serum cholesterol levels among US adults aged 20 to 74 years. Data from the National Health and Nutrition Examination Surveys, 1960 to 1980. National Center for Health Statistics-National Heart, Lung, and Blood Institute Collaborative Lipid Group. AB - From 1960 to 1980, serum cholesterol levels were determined for three different national surveys of the US noninstitutionalized population aged 20 to 74 years conducted by the National Center for Health Statistics, Hyattsville, Md. Serum cholesterol determinations for each of the three surveys were standardized to the Abell-Kendall laboratory method. Age-adjusted mean serum cholesterol levels decreased by 6 to 8 mg/dL (0.16 to 0.21 mmol/L), or 3% to 4%, between the 1960 to 1962 and the 1976 to 1980 surveys. For men, this represented a decrease from 217 mg/dL (5.61 mmol/L) to 211 mg/dL (5.46 mmol/L) and for women, a decrease from 223 mg/dL (5.77 mmol/L) to 215 mg/dL (5.56 mmol/L). Both declines were statistically significant. Mean serum cholesterol level decreased significantly in whites but not in blacks, and in all education subgroups for whites except men with less than nine years of education. In addition, the percentage of men and women with high-risk and moderate-risk cholesterol levels decreased during this period. PMID- 3806876 TI - Serum cholesterol levels and cancer mortality in 361,662 men screened for the Multiple Risk Factor Intervention Trial. AB - Several prospective studies have demonstrated an association between low serum cholesterol level and subsequent mortality from cancer. This finding was explored in the large cohort (361,662) of men aged 35 to 57 years who were screened for possible randomization to the Multiple Risk Factor Intervention Trial. Mortality follow-up revealed a significant excess of cancer in the lowest decile of serum cholesterol level during the early years of follow-up, which attenuated over time. In contrast, the association between high serum cholesterol and coronary heart disease did not diminish during the average of seven years of follow-up. These findings are consistent with the inference that the association between low serum cholesterol level and cancer is at least in part due to an effect of preclinical cancer on serum cholesterol level. A subset of the cohort (12,866 men) participated in the randomized Multiple Risk Factor Intervention Trial protocol, which called for annual measurements of serum cholesterol level. Among the 150 of these men who died of cancer during the trial, cholesterol level fell 22.7 mg/dL (0.59 mmol/L) more than in the survivors over an equivalent period. These data are consistent with the foregoing inference. PMID- 3806877 TI - Diabetes and the risk of stroke. The Honolulu Heart Program. AB - From 1965 to 1968, the Honolulu Heart Program began following up a cohort of men in a prospective study of cardiovascular disease. For this report, we examined the 12-year risk of stroke in 690 diabetic and 6908 nondiabetic subjects free of coronary heart disease and a history of stroke at study entry. In 12 years of follow-up, 62.3 per 1000 diabetic men and 32.7 per 1000 nondiabetic men experienced a stroke. The relative risk of thromboembolic stroke for those with diabetes compared with those without diabetes was 2.0 (95% confidence limits, 1.4 to 3.0). Although diabetes was usually associated with an atherogenic risk profile, control of hypertension, complicating myocardial infarction, and other risk factors failed to diminish the effect of diabetes on stroke. Among those without diabetes, the relative risk of thromboembolic stroke for those at the 80th percentile of serum glucose level compared with those at the 20th percentile (199 vs 115 mg/dL [11.0 vs 6.4 mmol/L]) was 1.4 (95% confidence limits, 1.1 to 1.8). In the nondiabetic sample, the relative risk of thromboembolic stroke for those with glucosuria compared with those without glucosuria was 2.7 (95% confidence limits, 1.6 to 4.5). There was no association between diabetes, or measures of glucose intolerance, and hemorrhagic stroke. We conclude that diabetes, even in a possibly undiagnosed subset of hyperglycemic individuals, imparts an additional independent risk of stroke unexplained by clinically measured risk factors. PMID- 3806878 TI - Albumin lung/heart ratio change. A simple clinical means of documenting increased pulmonary endothelial permeability to protein. AB - We investigated a simple method that can be used at the bedside for documenting the net accumulation of albumin in the lung. The technique employs measurement with a computer-linked gamma camera of the activity ratio in an area of the right lung compared with the same-sized area in the heart at 20 minutes and three hours following intravenous injection of technetium Tc 99m albumin. We applied this measurement to three groups of patients: a control group and patients with roentgenographic evidence of edema classified according to clinically available criteria as either hydrostatic edema or permeability edema to see if we could document differences among these groups. In control patients this ratio did not increase by more than seven units between the 20-minute and three-hour measurements. Of 18 patients classified by other routine clinical means as having hydrostatic pulmonary edema, 89% showed no increase in lung albumin accumulation. In 29 patients with permeability edema associated with the so-called adult respiratory distress syndrome, 31% showed evidence of net pulmonary albumin accumulation. These findings suggest that some patients otherwise classified as having hydrostatic edema have concomitant permeability changes in the microvasculature and that permeability edema represents a spectrum of endothelial damage. PMID- 3806879 TI - Effect of cocaine on uterine blood flow and fetal oxygenation. AB - Five pregnant ewes and their singleton fetuses were instrumented at 115 to 120 days' gestation (term, 145 days) for heart rate, blood pressure, uterine blood flow, and arterial blood gas sampling. In separate studies, cocaine was given to the ewe or fetus as a 0.5-, 1.0-, or 2.0-mg/kg intravenous bolus, and cardiovascular and arterial blood gas values were obtained for 60 minutes after the injection. The results showed that maternal administration of cocaine produced dose-dependent increases in maternal blood pressure and decreases in uterine blood flow. Uterine vascular resistance increased by 52%, 96%, and 168%, respectively. These responses were accompanied by marked fetal hypoxemia, hypertension, and tachycardia. Direct cocaine administration to the fetus produced smaller increases in fetal heart rate and blood pressure than those observed following maternal cocaine injection, and no significant changes in fetal arterial blood gas values. The conclusions are cocaine alters fetal oxygenation by reducing uterine blood flow and impairing oxygen transfer to the fetus; and fetal cardiovascular changes to maternal administration of cocaine may reflect fetal hypoxemia, increased fetal levels of cocaine or fetal catecholamines, or a combination of these events. PMID- 3806880 TI - Elder abuse and neglect. Council on Scientific Affairs. AB - Estimates of elder abuse approximate 10% of Americans over 65 years of age; obtaining accurate incidence and prevalence figures is complicated by factors including denial by both the victim and perpetrator and minimization of complaints by health professionals. Broad agreement exists in categorizing elder abuse as physical, psychological, and financial and/or material, despite lack of uniformity in definitions. Systematic scientific investigation provides limited knowledge about the causes of elder abuse. Most experts, however, believe that family problems and conflict are a major precipitating factor. Preliminary hypotheses for elder abuse include dependency, lack of close family ties, family violence, lack of financial resources, psychopathology in the abuser, lack of community support, and certain factors that may precipitate abuse in institutional settings. This report presents potential indicators of physical and psychological abuse, along with classification of elderly individuals at high risk, to assist the health professional in identification and prevention of elder abuse. PMID- 3806881 TI - The hospital 'surgical signature'. A quality-assessment tool. PMID- 3806882 TI - Ophthalmologists discuss methods to help physicians see what patients can't see. PMID- 3806883 TI - Simple techniques aid eye drop penetration. PMID- 3806884 TI - Leads from the MMWR. Measles--Dade County, Florida. PMID- 3806885 TI - Leads from the MMWR. Rabies prevention: supplementary statement on the preexposure use of human diploid cell rabies vaccine by the intradermal route. PMID- 3806886 TI - Multi-infarct dementia. PMID- 3806887 TI - Primary Sjogren's syndrome after infectious mononucleosis. PMID- 3806888 TI - Blood lead levels. PMID- 3806889 TI - Chest boxing. PMID- 3806890 TI - The Angelchik antireflux prosthesis. PMID- 3806891 TI - Caring for the patient with Alzheimer's disease. PMID- 3806892 TI - Who should test the testers? PMID- 3806893 TI - Toxic shock syndrome. A newly recognized complication of influenza and influenzalike illness. AB - Nine cases of severe hypotension or death compatible with toxic shock syndrome (TSS) as a complication of influenza and influenzalike illness were identified in Minnesota with onsets between Jan 2, 1986, and Feb 23, 1986, in which five of the patients died. During this time, an influenza outbreak was occurring in the state. Cultures of respiratory secretions were performed in eight patients; Staphylococcus aureus was isolated from all of them. Seven S aureus isolates were available for determination of exotoxin production; five isolates produced toxic shock syndrome toxin-1, one produced enterotoxin B, and one produced both. Acute influenza B infection was confirmed in three of four patients for whom throat cultures or acute and convalescent serum samples were available. Two patients fulfilled the Centers for Disease Control-confirmed case definition for TSS. Four additional patients fulfilled the CDC criteria for a probable case of TSS, and TSS was a likely diagnosis in the remaining three patients. The initial presentation was suggestive of nonsuppurative tracheitis or viral pneumonia in eight patients. In the remaining patient, the initial clinical presentation was compatible with staphylococcal pneumonia. This report demonstrates that TSS can occur as a complication of influenza and influenzalike illness. PMID- 3806894 TI - Preexposure immunization with intradermal human diploid cell rabies vaccine. Risks and benefits of primary and booster vaccination. AB - Intradermal human diploid cell rabies vaccine (ID HDCV) was licensed for preexposure use in the United States on May 30, 1986. We studied the safety and efficacy of this newly approved route and dose of administration. Serologic results were available from 112 (90%) of the 124 persons who participated in an HDCV low-dose preexposure study in which five different ID, intramuscular (IM), and subcutaneous primary immunization regimens were administered. Three 1.0-mL IM doses of vaccine resulted in titers similar to those from three 0.1-mL ID doses when compared 49 days, one year, and two years after primary immunization. Uniformly high postbooster titers occurred in all five groups when ID boosters were administered at one year or two years. Adverse reactions were similar following both ID and IM vaccination. Although ID HDCV can be a cost-effective substitute for IM vaccine, excessive use of unnecessary preexposure booster doses by any route may be inadvisable because of systemic allergic reactions. In addition, poor immune responses to HDCV have been documented in persons vaccinated in some developing countries. This may limit the use of low-dose regimens in some places. PMID- 3806895 TI - Impact of cataract surgery with lens implantation on vision and physical function in elderly patients. AB - We conducted a prospective study of 293 elderly patients undergoing cataract surgery with intraocular lens implantation to determine the impact of the surgery on vision and on subjective and objective measures of patient function. Visual acuity in the surgical eye improved from a mean of 20/100 before surgery to 20/40 four months after surgery; improvement was maintained at one year. Positive changes occurred in some subjective measures of patient function, such as reported activities of daily living and patient report of vision-dependent activities, but these changes were modest. The most marked changes in patient function occurred in objective measures of function. Mental status had improved not quite significantly at four months but significantly at one year. Timed manual performance improved dramatically and significantly at four months and one year. Cataract surgery was associated with improved vision and improved objective function in most patients by four months after surgery, and these improvements were maintained at one year. PMID- 3806896 TI - Therapy vs no therapy for bacteriuria in elderly ambulatory nonhospitalized women. AB - This prospective randomized study was undertaken to determine the efficacy of antimicrobial therapy compared with no therapy for bacteriuria in elderly ambulatory nonhospitalized women. Sixty-one women (mean age, 85.8 years) with bacteriuria were in the no therapy control group and 63 women (mean age, 85.8 years) with bacteriuria were in the therapy group; none had symptoms of urinary tract infection. One short course of antimicrobial therapy achieved a cure rate of 68.3% (43 of 63 women cured) two weeks after treatment. During the six-month follow-up period, ten (16.4%) of 61 women in the no therapy group and five (7.9%) of 63 women in the therapy group developed symptomatic urinary tract infection. At the time of six-month follow-up, 19 (34.5%) of 55 women in the no therapy group and 35 (63.6%) of 55 women in the therapy group did not have bacteriuria. We conclude that for asymptomatic bacteriuria in elderly ambulatory nonhospitalized women, short-course antimicrobial therapy is effective at two week follow-up and that antimicrobial therapy can eliminate bacteriuria in most of these women for at least a six-month period. PMID- 3806897 TI - An attitudinal assessment of faculty practice plans. AB - An awareness of potential conflict between medical schools and private practice prompted an attitudinal assessment of faculty practice plans (FPPs). A representative sample of eight medical school FPPs in seven different communities was selected for study. For each FPP, a sample of health care leaders, stratified at different levels of administrative responsibility, was selected from academic medical centers and from community settings. Topics for FPP assessment were chosen for their relevance to physician and lay administrators involved with academic and community practice. Questions were answered on a yes-no basis and were graded by intensity of response. Although only two of the questions revealed statistical disparity on a simple yes-no basis, the intensity of response differed significantly in eight of the 14 questions asked. This study gives consideration to the strategic implications of FPPs for universities, medical schools, and organized medicine. PMID- 3806898 TI - Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. AB - The bronchodilating effect of magnesium sulfate (MgSO4) was studied in ten asthmatic patients with mild attacks. In five patients, 0.5 mmol/min of MgSO4 was administered intravenously for 20 minutes, and the time courses of respiratory resistance, forced vital capacity, and forced expiratory volume at 1 s were studied. In another five patients, MgSO4 dose-response curves were obtained. Soon after administration began, MgSO4 relieved bronchoconstriction in a dose dependent manner. Maximum responses (mean +/- SE) of respiratory resistance, forced vital capacity, and forced expiratory volume were 71% +/- 3%, 117% +/- 5%, and 118% +/- 1% of initial values, respectively, and were similar to the effects of additional albuterol inhalation. The infusion of MgSO4 also improved dyspnea and piping rales in three other asthmatic patients with a severe attack. We conclude that intravenous infusion of MgSO4 produces a rapid and marked bronchodilation in both mild and severe asthma and may be a unique bronchodilating agent. PMID- 3806899 TI - Transmission of hepatitis B virus by artificial insemination. AB - Although the capacity for transmission of hepatitis B infection by semen is well recognized, the potential for transmission by artificial insemination remains theoretical. Currently, screening of semen donors for hepatitis B virus infection is not standard practice. We saw a case of acute viral hepatitis B in a woman following artificial insemination with semen from a donor subsequently found to be positive for hepatitis B surface antigen (HBsAg). Both the donor serum and semen contained HBsAg and hepatitis B e antigen, and the HBsAg subtype was identical to that of the patient. Documentation of hepatitis B virus transmission by artificial insemination indicates that HBsAg screening of semen donors should be routine practice. PMID- 3806900 TI - Iron deficiency occurs frequently in patients with pernicious anemia. AB - We assessed iron status in patients with pernicious anemia. Iron deficiency coexisted as a presenting finding in 25 (20.7%) of 121 patients for whom data could be evaluated. Another 27 patients (22.3%) developed iron deficiency one month to 14 years later (median, two years). It was impossible to predict such a development in these 27 patients from any of their initial findings. The cause of the iron deficiency was identified in 17 of the 52 iron-deficient patients and suspected in another four. These findings show that patients with pernicious anemia are at high risk for iron deficiency, both at initial presentation and subsequently. Although the cause of the iron deficiency is often not identifiable, clinically important entities are detected often enough to warrant routine investigation for iron deficiency in such patients. PMID- 3806901 TI - Reversible orthostatic hypotension of pernicious anemia. PMID- 3806902 TI - Toxic shock syndrome during an influenza outbreak. PMID- 3806903 TI - Management of malignant pericardial effusion and tamponade. PMID- 3806904 TI - Semen donors as the source of sexually transmitted diseases in artificially inseminated women: the saga unfolds. PMID- 3806905 TI - Liposomes embark on rescue mission to make highly toxic drugs more useful. PMID- 3806906 TI - On the horizon: a pharmacopeia of targeted drugs? PMID- 3806907 TI - Search begins for 'silent' endocrine infections; molecular probes seek evidence of viruses. PMID- 3806909 TI - Leads from the MMWR. Changes in premature mortality--United States, 1984-1985. PMID- 3806908 TI - Leads from the MMWR. Sex- and age-specific prevalence of heavier drinking in selected states in 1985--the Behavioral Risk Factor Surveys. PMID- 3806911 TI - Are British physicians agents of the state? PMID- 3806910 TI - Intracranial hemorrhage after cocaine abuse. PMID- 3806912 TI - Vacuum toilet evisceration. PMID- 3806914 TI - Polycythemia vera among participants of a nuclear weapons test. PMID- 3806913 TI - Bowel infarction in dialysis patients. PMID- 3806915 TI - How do physicians adapt when the coronary care unit is full? A prospective multicenter study. AB - Reducing the numbers of coronary care unit (CCU) beds would decrease expensive unnecessary admissions, but might also block appropriate admissions. To study how physicians adapt to limited CCU beds, we compared their decisions to admit patients to the CCU when the CCU was full with those made when the CCU was not full. We studied 4479 patients who presented with symptoms suggesting acute cardiac ischemia to six New England hospital emergency rooms over 16 months. Of the 2931 patients found on follow-up not to have acute ischemia, 33% of those presenting when the CCU was not full were admitted to the CCU vs 24% of such patients presenting when the CCU was full (P = .0005), a 27% drop. Of the 725 patients proving to have angina pectoris, 74% of those presenting when the CCU was not full were admitted to the CCU vs 62% of such patients presenting when the CCU was full (P = .007), a 16% reduction. Of the 823 patients found to have myocardial infarction, 90% were admitted to the CCU both when the CCU was not full and when it was full. Importantly, for no group did mortality increase when the CCU was full. These data suggest that physicians can safely adapt to substantial reductions in the availability of CCU beds. PMID- 3806916 TI - Blood donation by the elderly. Clinical and policy considerations. AB - At present, healthy potential blood donors older than the age of 66 years often leave the donor pool for reasons of age alone, despite the fact that this demographic group is growing, is a potentially willing source of blood products, and constitutes the cohort with highest per capita use of blood and its derivatives. There is no clinical or physiological rationale for this. We performed a controlled study to measure the feasibility and safety of blood donation by healthy elderly donors aged 66 years and older, compared with a younger cohort aged 55 to 65 years of age. A study group of prior donors aged 66 years and older and a control group of prior donors between the ages of 50 and 65 were sent letters inviting them to donate blood. The volume donated did not differ between the two groups. In the older group, there were eight immediate reactions, seven mild and one moderate. The control population experienced seven immediate reactions, six mild and one severe. We conclude that it is both clinically feasible and efficient to recruit healthy prior donors older than the age of 66 years for blood donation. As a group, this population is potentially able to donate large volumes of blood and do so without any difference in immediate or short-term reactions. Further study of hemodynamic variables as more objective markers of safety is needed. PMID- 3806917 TI - Low birth weight, prematurity, and postpartum endometritis. Association with prenatal cervical Mycoplasma hominis and Chlamydia trachomatis infections. AB - We studied associations of Mycoplasma hominis, Ureaplasma urealyticum, and Chlamydia trachomatis genital infections with pregnancy outcomes, controlling by logistic and multiple linear regression for known risk factors and for the presence of the other two infections. A sample of 1204 Navajo women enrolling for prenatal care had endocervical C trachomatis, M hominis, and U urealyticum cultures and serum samples taken at enrollment and when possible after 30 weeks. Low birth weight (less than 2500 g) was associated with M hominis infection among women with a history of spontaneous abortion. Mycoplasma hominis infection was also associated with postpartum endometritis, but only among women undergoing a cesarean section (odds ratio, 4.7; 95% confidence intervals, 1.22 to 18.3). Although women with recent C trachomatis infection (IgM titer greater than 1:32 on either sample or IgG seroconversion) were at greater risk of low birth weight (19% [3/16]) than women with chronic infection (4.5% [6/133]; relative risk, 4.2), this subgroup at risk was small (11% of women with classifiable C trachomatis infection). Mycoplasma hominis and C trachomatis infections may be important preventable causes of adverse pregnancy outcomes in identifiable subgroups of women. PMID- 3806918 TI - High-dose megestrol acetate. A possible treatment for cachexia. AB - Weight loss and anorexia are significant complications of a variety of disorders and add morbidity to the underlying process. We observed marked weight gain (median, 5.1 kg; range, 0.9 to 20.1 kg) and appetite enhancement in 27 of the 28 patients with breast cancer receiving treatment consisting of high doses of oral megestrol acetate (480 to 1600 mg/d). Weight gain occurred regardless of pretreatment weight, extent of metastases, or response to therapy. Our results suggest a possible role for megestrol acetate in reversing anorexia and weight loss, thereby improving the quality of life of patients with cachexia. Further research is needed to establish the mechanism of weight gain and potential clinical applications. PMID- 3806919 TI - Health policy agenda for the American people. PMID- 3806920 TI - A large-scale autologous blood program in a community hospital. A contribution to the community's blood supply. AB - In an attempt to eliminate the hazards of homologous blood transfusions during major orthopedic surgical procedures, 1672 patients donated 6615 units of autologous blood in a ten-year period. Most of the blood components were stored frozen. The autologous units were later used in 1938 surgical procedures. Intraoperative blood salvage yielded 125,105 mL of blood with an average hematocrit of 80% (0.80), which was reinfused into 934 patients. Autologous blood components accounted for 95% of the transfusion requirements. Thus, the risks of homologous transfusions were avoided in the vast majority of the procedures. Ninety-one percent of the donors were older than 50 years of age and 8.4% were between 80 and 91 years of age. The large-scale use of autologous blood has been feasible, practical, and cost efficient, has contributed to the community's blood supply, and provides the patient with the safest blood available--his own blood. PMID- 3806921 TI - Carcinoma in a mediastinal fifth parathyroid gland. PMID- 3806922 TI - 'Just once in a lifetime . . .' The Health Policy Agenda. PMID- 3806923 TI - Autologous and aged blood donors. PMID- 3806924 TI - Legionella in water: what should be done? PMID- 3806925 TI - Diagnostic and therapeutic technology assessment. Bacillus Calmette-Guerin immunotherapy in bladder cancer. PMID- 3806926 TI - Age-associated myocardial changes in various heart diseases. A clinicopathologic analysis in biopsied and autopsied myocardium. AB - Age-associated changes in histopathologic and ultrastructural aspects of cardiac myocytes were systematically compared with clinical problems. The study material consisted of 1,515 endomyocardial biopsies; 150 normal and 50 diseased cardiac myocytes from pediatric autopsy specimens; 34 intraoperative endomyocardial biopsy specimens from the left ventricle and 28 surgical biopsy specimens from the right or left atrium. The following results were obtained: The myocytes developed to adult size by the age of 15 years. Thereafter, the size did not change up to the age of 59. Short-term hemodynamic overloading to the ventricle caused reactive hyperfunction and hypertrophy of myocytes. Stable hypertrophy resulted in long-term overloading. In cardiomyopathy, compensated or stable hypertrophy occurred, but progression to decompensated or gradual exhaustion and progressive cardiosclerosis (Meerson) took place. Progress of endocardial thickening was often observed during the course of the disease. In the right and left atrial myocardium, extremely advanced pathology was observed and changes were related to the duration of the disease rather than to the severity of the hemodynamics. PMID- 3806927 TI - Age-related changes in right and left ventricular function in tetralogy of Fallot. AB - Age-related changes in right (RV) and left (LV) ventricular myocardium in tetralogy of Fallot (TF) are analyzed with regard to pre- and postoperative ventricular function. In RV, preoperative function was better in patients under 4 years of age in terms of ejection fraction and compliance, but no significant change was seen in LV function. Postoperatively, patients who underwent corrective surgery at age less than 4 years showed no significant difference compared to those at operative age above 4 years in terms of RV and LV functions at rest. However, stress tests for RV by isoproterenol and LV using methoxamine revealed some masked ventricular dysfunction in both ventricles in the older groups. The relationships between these functional abnormalities and previously described histological changes of right and left ventricular myocardium in TF are discussed. PMID- 3806928 TI - Expression of myosin isozymes during the developmental stage and their redistribution induced by pressure overload. AB - Cardiac muscles contain at least two isozymes--referred to as alpha(HC alpha) and beta(HC beta)--of the myosin heavy chain. The proportional ratio of these isozymes varies depending upon the developmental stage and the physiological and/or the hormonal milieu of the cell. Using monoclonal antibodies (MoAb) specific for human cardiac HC alpha and HC beta, we have examined the expression of these isozymes in fetal through adult cardiac tissues and investigated whether isozymic redistribution occurs in pressure overloaded human ventricles. We found that although HC alpha was expressed in the atrium from the early embryonic stage, in embryonic ventricular myofibers, only HC beta was expressed without expression of HC alpha, but some myofibers replace HC beta by HC alpha after birth, and these HC alpha containing ventricular myofibers were found to be decreased by pressure overload, which suggested that isozymic redistribution from HC alpha to HC beta also occurred in the ventricles, as well as the atrium. In addition, we also found two subtypes of HC beta (beta 1, beta 2) in the human heart. In the ventricle, both beta 1 and beta 2 was present in all myofibers; in contrast, some myofibers contained beta 1 or beta 2 or both with or without expression of HC alpha in the atrium. beta 1 and beta 2 were distinctive in their expression during the developmental stage, since beta 1 was present in the embryonic heart from the early developmental stage, whereas beta 2 was not present in the early embryonic heart, but began to be expressed in the late embryonic stage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806929 TI - Pathogenetic mechanism of stenosis in the intramural coronary artery. AB - In order to clarify the pathogenetic mechanism of stenosis in the intramural coronary branch, morphological changes were examined by postmortem coronary angiography and determination of the Coronary Stenosis Index of the Myocardium (CSIM) were made in hearts obtained by autopsy from 10 patients with hypertension, 15 with normotensive myocardial infarction, 25 with hypertensive myocardial infarction, 6 with mitral valvular disease, 7 with aortic stenosis and 14 control subjects. CSIM was significantly higher in patients with hypertension, infarction with hypertension and aortic stenosis than in other three groups, indicating higher incidence of stenosis in those with a left ventricular pressure load. There was no specific correlation between the degree of stenosis of the epicardial coronary artery and that of the intramural coronary branches supplied by the former in any groups examined. Major pathological changes of the intramural coronary branches were muscular hypertrophy of media and proliferation of internal elastic lamella, both observed with a high incidence in vessels with high CSIM values. These findings suggest that intramural pressure which exerted extravascular pressure played an important role in the pathogenetic mechanisms of stenotic changes in the intramural coronary branches. PMID- 3806930 TI - Quantitative analysis of global and regional cardiac performance in normal subjects and patients with coronary artery disease by rest/exercise radionuclide blood-pool study. AB - This study was undertaken to assess regional and diastolic left ventricular (LV) function in relation to LV asynchronous contraction during exercise (Ex). Rest and serial Ex (25w-75w) gated blood-pool study (Tc-99m-RBC) of 6 normal subjects (N), 12 patients with stable angina pectoris (AP) and 8 with LV aneurysm (LVan) were evaluated in regional LV ejection fraction (EF) and Fourier analysis using higher-order harmonics. In the patients with Ex and regional EF showed various responses to Ex. Global LVEF in the patients with AP indicated almost no change during Ex and regional EF declined apparently in anteroseptal segment, corresponding to stenotic left anterior descending artery. Diastolic indices of regional and global cardiac performance, PFR (peak filling rate), TPF (time to PFR) and standard deviation (SD) of TPF histogram, were obtained by Fourier analysis using two-order harmonics. Patients with coronary artery disease (CAD) showed significantly lower PFR, longer TPF and higher SD of TPF than normal group, suggesting asynchronous relaxation. We conclude that regional EF response and diastolic indices of cardiac performance to exercise provide useful and sensitive information detecting the severity of CAD. PMID- 3806931 TI - Usefulness of intravenous dipyridamole combined with pacing stress for detection of myocardial ischemia in coronary artery disease. AB - In order to establish a more clinically useful diagnostic method to detect myocardial ischemia, a stress test of 0.56 mg/kg of intravenous dipyridamole (D), an atrial pacing (P) and the combination of both (D + P) were administered to 14 patients with significant coronary stenosis and 8 patients with normal coronary arteriogram. The effects on regional coronary hemodynamics and myocardial metabolism were subsequently studied. Treadmill exercise tests in 15 patients and thallium-201 exercise myocardial scintigraphy in 14 patients were also performed at another time. When the uptake ratio of myocardial lactate less than 0% was used as an indicator of myocardial ischemia, 100% (12/12) of sensitivity and 100% (6/6) of specificity were obtained with (D + P)-test in diagnosis of significant coronary stenosis and its sensitivity was significantly higher than that with P test (43%) or with D-test (31%). Even though sensitivity and specificity of exercise electrocardiogram (70% and 50%) or thallium-201 exercise myocardial scintigram (88% and 80%) in diagnosis of coronary stenosis were not significantly lower than those of (D + P)-test respectively, myocardial ischemia could also be detected with (D + P)-test in two patients at the region perfused by the infarct related artery, which had not been detected by thallium-201 exercise myocardial imaging. We conclude, (D + P)-test combined with investigation of myocardial lactate metabolism is quite useful to detect myocardial ischemia. PMID- 3806932 TI - Effects of four antiarrhythmic drugs on the induction and termination of paroxysmal supraventricular tachycardia. AB - The electrophysiological effects of antiarrhythmic drugs were tested in 36 patients with recurrent paroxysmal supraventricular tachycardia (PSVT), 25 of whom had accessory pathway reentrant tachycardia (APRT) and 11 A-V nodal reentrant tachycardia (AVNRT; 10 of the slow-fast type one of the fast-slow type). The test drugs were procainamide (used in 19 patients), verapamil (in 27), disopyramide (in 31), and propranolol (in 15). The drugs were tested for their ability to terminate episodes of PSVT as well as to inhibit their induction. Procainamide had an inhibitory effect on APRT in nine of 12 patients (75%) and terminated episodes of APRT in seven of 11 patients (63.6%); in all of them V-A block was responsible for the termination. In four of six patients (66.7%) with slow-fast AVNRT and in one patient with fast-slow AVNRT, inhibition of the induction of tachycardia attacks was noted after procainamide. Termination of AVNRT was seen in the same number of patients. Verapamil inhibited the induction of APRT in 12 of 18 patients (66.7%) and terminated episodes of APRT in 10 of 16 patients (62.5%), all by A-V block. In six of eight patients (75%) with slow-fast AVNRT, inhibition of the induction as well as termination of tachycardia were noted after verapamil. Disopyramide had an inhibitory effect on APRT in seven of 23 patients (30.4%) and terminated APRT in five of 21 patients (23.8%) by V-A block, while AVNRT (all slow-fast type) was terminated in only one of eight patients (12.5%) by disopyramide. Disopyramide was less effective than previously reported. This could be attributed to a relatively low dosage and slow infusion speed. Propranolol inhibited the induction of APRT and terminated episodes of APRT in only one of 10 patients (10%). In two of four patients (50%) with slow fast AVNRT, an inhibitory effect by propranolol was noted, but termination was seen in only one patients. PMID- 3806933 TI - Response to isoproterenol infusion in pediatric patients following atrial repair of transposition of the great arteries. AB - The postoperative function of the right (systemic) ventricle (SV) was evaluated in eight pediatric patients who had undergone intra-atrial switching for simple transposition of the great arteries (TGA). SV function was evaluated at rest and during isoproterenol (ISP) infusion and compared with left ventricular function in the control group. The control group consisted of five patients including two with postoperative pulmonary stenosis, two with mild pulmonary stenosis and one with postoperative partial anomalous pulmonary venous drainage. SV-graphy was performed at rest. During ISP infusion, the TGA group showed a significant increase in cardiac index (3.50 +/- 0.68 (mean +/- SD) L/min/m2 to 4.94 +/- 1.53 L/min/m2, p less than 0.05) and no significant changes in stroke volume index (SVI). Similar changes were observed in the control group. Resting SV ejection fraction was 0.37 +/- 0.05 in the TGA group. In regard to the relationship between SV end-diastolic pressure and SVI, all but one of the TGA patients showed normal response to the stress. These results indicated that the right ventricle in TGA showed an acceptable response to ISP stress and acted as a systemic ventricle for at least two years after surgery. PMID- 3806934 TI - The effects of mechanical vibration on cardiac morphogenesis in the stage 14 chick embryo. AB - The primitive cardiac loop of the stage 14 (Hamburger and Hamilton) chick embryo was subjected to brief vibratory stimuli that resulted in a broad spectrum of cardiovascular malformations. During the 17th day of incubation, both survival and anomaly rates were evaluated. Compared with control embryos (92%), vibration elicited mortality (75%) that was statistically highly significant (p less than 0.001). In addition, the anomaly rate (94%) among surviving embryos was also highly significant (p less than 0.001) relative to controls. Defects included straddling AV valves, variable sizes of VSD and DORV. Several possible explanations are presented concerning the etiology of these vibration-induced malformations. PMID- 3806935 TI - Continuous, low dose of hydralazine, reduces acute hypoxic pulmonary hypertension without a corresponding fall in systemic arterial pressure. AB - Administration of hydralazine in patients with pulmonary hypertension has been reported to cause excessive systemic vasodilatation, limiting its clinical utility (N Engl J Med 1982; 306: 1326). We studied the effects of hydralazine on hypoxic pulmonary vasoconstriction (HPV) in chronically instrumented sheep and evaluated whether different methods of intravenous administration could prevent severe systemic hypotension. Mean left atrial, pulmonary and systemic arterial pressures (Pla, Ppa and Psa mmHg), cardiac output (CO, l/min, electromagnetic flowmeter) and heart rate were measured continuously. Systemic (SVR) and pulmonary vascular resistances (PVR) were calculated by Psa/CO and (Ppa-Pla)/CO, respectively. Following a 30 min baseline period, we initiated hypoxia with mixture of 10% oxygen in nitrogen. After 20 min of hypoxia we then performed the following two experiments: Group A-Hydralazine (10 micrograms/kg/min) was infused continuously for a further 20 min of hypoxia (n = 6); Group B-Hydralazine (400 micrograms/kg) was administered as a single bolus, followed by an additional 20 min of hypoxia (n = 6). In both Groups A and B, hypoxia produced a prominent pulmonary hypertensive response. Continuous infusion of hydralazine (Group A) significantly decreased the hypoxic values of Ppa and PVR from 25.1 +/- 1.1 to 21.7 +/- 1.6 mmHg (p less than 0.01) and from 4.82 +/- 0.50 to 4.17 +/- 0.40 mmHg/l/min (p less than 0.05), respectively. In Group B, hydralazine as a bolus also significantly decreased HPV, with Ppa dropping from 20.9 +/- 0.9 to 18.3 +/- 1.5 mmHg (p less than 0.05) and PVR falling from 4.98 +/- 0.55 to 4.34 +/- 0.53 mmHg/l/min (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806936 TI - [A study on the safety of anesthetic machines (2)--Examination of the oxygen supply circuit]. PMID- 3806937 TI - [Enflurane reduces the inhibition of dorsal horn lamina V type neuronal activity induced by bradykinin injection into the femoral artery contralateral to the recording site]. PMID- 3806938 TI - [Celiac plexus block; multivariate analysis of the distance from the skin to the celiac plexus and splanchnic nerve]. PMID- 3806939 TI - [Effect of blocking bilateral jugular venous outflow on intracranial pressure, compliance and CSF outflow resistance with thiamylal and ketamine in cats]. PMID- 3806940 TI - [Effects of urinastatin on hepatic energy metabolism of the rat in acute hemorrhagic shock]. PMID- 3806941 TI - [Hemodynamic effects of dobutamine and adenosine triphosphate in the ischemic canine heart]. PMID- 3806942 TI - [A model study of velocity profiles during high frequency ventilation]. PMID- 3806943 TI - [Concentration of oxygen for an artificial membrane lung and the safety of prolonged extracorporeal membrane oxygenation]. PMID- 3806945 TI - [The Laerdal mask is much better than the Rendell-Baker Soucek mask for the resuscitation of children]. PMID- 3806944 TI - [Changes in oxygen uptake during open heart surgery]. PMID- 3806946 TI - [Continuous epidural infusion of bupivacaine in postoperative pain relief]. PMID- 3806947 TI - [V-A bypass combined with IABP in acute heart failure following open heart surgery]. PMID- 3806948 TI - [Bronchospasm caused by intravenous methylprednisolone administration]. PMID- 3806949 TI - [Pharmacokinetic and clinical studies on cefuzonam in the pediatric field]. AB - A multi-center open study was conducted to investigate cefuzonam (L-105, CZON), a newly developed cephalosporin from pharmacokinetic, bacteriological and clinical aspects, in the pediatric field with the participation of 17 institutions and their related facilities. The results are summarized as follows. Serum concentrations and urinary excretion. The pharmacokinetics in pediatric patients was investigated with a dose of 20 mg/kg, via one shot intravenous injection or intravenous drip infusion over 1 hour. The results were nearly the same as those in adult patients. Mean serum concentrations 5 minutes after one shot intravenous injections were: 52.8 micrograms/ml with the dosage of 10 mg/kg, 135 micrograms/ml with 20 mg/kg, and 317 micrograms/ml with 40 mg/kg, and T1/2 beta's for the 3 dosages were 1.07 hours, 0.91 hour, and 1.01 hours, respectively. With 1-hour intravenous drip infusion, mean serum concentrations at the end of infusion were: 22.4 micrograms/ml with 10 mg/kg, 46.3 micrograms/ml with 20 mg/kg, 72.5 micrograms/ml with 40 mg/kg, and 69.2 micrograms/ml with 50 mg/kg, and T1/2 beta's for these dosages were 1.31 hours, 1.45 hours, 0.84 hour, and 0.66 hour, respectively. In 6 hours after administration of CZON, urinary excretion rates were 43.5-51.4% for one shot intravenous injections of 10-40 mg/kg, and 42.7-58.6% for 10-50 mg/kg drip infusions. Concentrations in cerebrospinal fluid Penetrations into cerebrospinal fluids in patients with purulent meningitis achieved levels of 2.80-6.40 micrograms/ml with the administration of CZON at 100 mg/kg in acute cases of within 6 days after onset. When the administration of the drug was done at the earlier stage, the greater penetration occurred. However, rates of penetration were 3.10% to 5.03% within 4 days after a drug administration, thus, the penetration was not thought to be as good as other beta-lactam agents which achieve higher penetration rates. Clinical results Of 407 cases treated with CZON, 18 cases were excluded from the statistical analysis. The remaining 389 cases plus 8 cases each of which had 2 complicated diseases, with a total of 397, were statistically analyzed for the clinical effectiveness of this drug against various infections. The efficacy was evaluated as "good" or "excellent" in 248 out of 266 cases from which pathogens were isolated, for an efficacy rate of 93.2%. The efficacy rate was 88.5% for 131 cases for which pathogens were unidentified, thus no statistically significant difference was noted between the 2 groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3806950 TI - [A study on the clinical efficacy and safety of cefuzonam with long-term administration in chronic complicated urinary tract infections]. AB - A new member of injectable cephem antibiotics, cefuzonam (L-105, CZON) was administered in the treatment of 11 chronic complicated urinary tract infections (CC-UTI) which were considered to be for indications of long-term chemotherapy. The results obtained are summarized as follows. Responses in 6 cases out of 9, 66.7%, were evaluated as excellent or moderate by the criteria of the Japan UTI committee at fifth day's judgement. At the end of the treatment, however, only 3 out of 8, 37.5% were determined to be effective. The apparent decrease in the efficacy of the drug after the longer treatment period was caused by replacements of susceptible bacteria with resistant strains. Side reactions were observed in 2 cases, one was diarrhea and the other was chill and fever. In these cases, the administration of the drug was discontinued, and the conditions returned to normal within a few days. In laboratory tests, a slight decrease of thrombocyte was observed in 1 case. The CZON was very effective against infections caused by susceptible bacteria. No differences between CZON and other related compounds were found with regard to safety, hence it was estimated that the drug was highly useful for a long-term treatment on infections caused by susceptible strains to CZON. PMID- 3806951 TI - [Pharmacokinetic studies on aztreonam in late pregnancy in sheep and humans]. AB - The transplacental passage of single intravenous doses of aztreonam (AZT), 1 g or 2 g, was examined in 7 sheep and 14 women in late pregnancy, respectively and the obtained data were analyzed by a two-compartment model. The obtained results were summarized as follows. After single 2 g intravenous doses were given to pregnant sheep, the mean peak level of AZT in maternal blood was 83.79 micrograms/ml and the half-life of the beta-phase was 1.525 hours. After single 1 g intravenous doses were administered to pregnant women, the mean peak level of AZT in blood was 102.62 micrograms/ml and the half-life of beta-phase was 2.128 hours. The peak levels in umbilical venous blood and amniotic fluid were 14.43 micrograms/ml and 11.86 micrograms/ml, respectively. PMID- 3806952 TI - [Studies of aztreonam transfer into the fetus and amniotic fluid in early pregnancy]. AB - The materno-fetal transfer of aztreonam by a single intravenous dose of 1 g was examined in 7 volunteer women undergoing induced abortion in early pregnancy and the following results were obtained. After administration of the drug, maternal blood levels at 15, 30, 60 and 120 minutes were 77.24 +/- 6.09 micrograms/ml (Mean +/- S.E.), 37.84 +/- 5.85 micrograms/ml, 25.62 +/- 3.15 micrograms/ml and 18.10 +/- 2.22 micrograms/ml, respectively. Amniotic fluid level of the drug was low in 3 cases, of which amniotic fluid levels were determined; 0.74 microgram/ml after 229 minutes, 0.83 microgram/ml after 280 minutes and 0.74 microgram/ml after 328 minutes. Fetal tissue concentration of the drug was below our detection limit at 120 minutes. Tissue levels of villus and decidua in 6 cases were also too low to be detectable between 89 and 328 minutes after injection. PMID- 3806953 TI - [Human and animal studies on the pharmacokinetics of norfloxacin in renal failure]. AB - The pharmacokinetics of norfloxacin (NFLX) was studied in 5 patients with chronic renal failure and rats with renal obstruction. The drug was orally given to patients on on- and off-dialysis days in a crossover fashion. Serum levels of NFLX showed a similar profile during both on- and off-dialysis days, and the hemodialysis treatment did not affect the elimination of the drug from the serum. The mean serum elimination half-life was 8.8 +/- 1.2 hours (standard error) for on- dialysis day and it was 7.0 +/- 0.8 hours for off-dialysis day. The urinary recovery of NFLX for 24 hours was less than 0.1% of administered doses in these patients. Rats with renal obstruction exhibited higher drug levels in serum for longer periods of time and elevated biliary excretion ratios in comparison to sham-operated rats, and no significant change in the fraction of biliary metabolites was observed. The biliary excretion of NFLX was likely to be enhanced in patients with renal failure. PMID- 3806954 TI - [Clinical evaluation of ciprofloxacin on biliary tract infection following oral administration]. AB - A newly synthesized antibiotic of quinoline carboxylic acid group, ciprofloxacin (BAY o 9867, CPFX) for oral administration, has a broad spectrum and high antibacterial activity against various bacterial species including aerobic and anaerobic bacteria such as P. aeruginosa and B. fragilis. The CPFX was administered orally in a dose of 200 mg 3 times daily for 5 to 8 days (6.3 +/- 1.0 days) to 12 patients with biliary tract infection consisting of 2 males and 10 females. Two of them were outpatients and 10 were hospitalized. Ages ranged from 27 to 72 years (mean 51.8 +/- 14.8 years), weights from 48.5 to 73.5 kg (mean 60.5 +/- 7.7 kg). All cases were complicated with cholecystolithiasis, with 4 acute and 8 subacute cases. Organisms isolated before the initiation of the CPFX treatment included 3 strains of E. coli from ERCP bile of 3 cases. Infected bacteria were eradicated in 3 cases but results were unknown in the other 9 cases. Clinical responses were excellent in 2 cases, good in 8 cases, fair in 1 case and poor in 1 case. No adverse effect was recognized. Therefore, CPFX appears to be a very useful drug when used for chemotherapy of biliary tract infectious diseases. PMID- 3806955 TI - [Pharmacokinetic studies of a new oral cephem T-2588. Pharmacokinetics in gastrectomized volunteers and the renal excretory system in healthy volunteers]. AB - According to the result of the pharmacokinetic examination of T-2588 (esterified prodrug of T-2525) administered to adult male volunteers who have undergone gastrectomy, it appears that the absorption of T-2588 is delayed in the hypoacidity or the anacidity and also the excretion ratio of T-2525A (an inactive metabolite of T-2525) showed a tendency to become higher in these subjects. Again, according to the result of the pharmacokinetic examination of T-2588 when it was administered together with probenecid to normal healthy volunteers, it appears that the T-2525 is excreted from the kidneys not only into the glomerular filtration but also partly through renal tubules. PMID- 3806956 TI - [Clinical studies on T-2588 in the field of otorhinolaryngology]. AB - From clinical studies on T-2588, an oral ester type cephem, the following results were obtained. Ten patients with acute tonsillitis, 3 with acute pharyngolaryngitis, 2 with acute sinusitis, 1 with acute exacerbation of chronic sinusitis and 2 with acute exacerbation of chronic otitis media were treated with T-2588 at a daily dose of 300 or 600 mg. Clinical responses were excellent in 12, good in 4, fair in 1 and poor in 1. Clinical efficacy was 88.9%. Bacteriologically, all isolates except one strain of S. aureus were eliminated. Clinical efficacies classified by clinical isolates correlated well with bacteriological efficacies. The MICs of T-2525 against clinical isolates were determined and compared with those of cephalexin, cefaclor and amoxicillin. The T 2525 showed potent antibacterial activity against Gram-positive and Gram-negative bacteria including S. pneumoniae, H. influenzae and beta-Streptococcus, but the activity of T-2525 against S. aureus was similar to that of the other antibiotics examined. Neither side effect nor abnormal laboratory finding was observed. PMID- 3806957 TI - [Pharmacokinetics of cefixime in patients with impaired renal function]. AB - Cefixime (CFIX) was given orally in a single dose of 100 mg to 7 patients with varying degrees of impaired renal function (Ccr 12.0-56.7 ml/min) and serum concentrations and urinary excretion rates were measured with time for the first 24 hours by the bioassay method to investigate in vivo pharmacokinetics of the drug. The results obtained are summarized as follows. The mean peak serum concentration of CFIX in 3 patients with moderately impaired renal function (group I: Ccr greater than or equal to 30-less than 60 ml/min) was 2.04 micrograms/ml at 6 hours after dosing and gradually declined to 0.10 microgram/ml at 24 hours after dosing. The half-life was 4.15 hours. The mean peak serum concentration of CFIX achieved was 2.27 micrograms/ml at 8 hours after dosing in 4 patients with severely impaired renal function (group II: Ccr greater than or equal to 10-less than 30 ml/min) and the concentration of CFIX was 0.99 microgram/ml even after 24 hours. The half-life was prolonged to 11.05 hours. There was no great difference between groups I and II in the first 24-hour urinary excretion rates. However, the first 4-hour urinary excretion accounted for 2.14% of the administered dose of CFIX in group I but only 0.47% in group II. Urinary concentrations of CFIX peaked at 4-6 hours after dosing in both groups, and thereafter gradually decreased in group I. Whereas, they did not decline much in group II until 24 hours after dosing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806958 TI - [Clinical studies on te concentration of cefaclor in sera and lung tissues of patients with respiratory diseases]. AB - A 500 mg dose of cefaclor (CCL) was administered orally before surgery to each of patients with respiratory diseases and in fasting. Average concentrations of CCL in sera were 4.04 micrograms/ml at 1.5 hours, 3.03 micrograms/ml at 2 hours, 1.68 microgram/ml at 3 hours and 0.45 microgram/ml at 5 hours after administration. Average concentrations in lung tissues during operation were 0.120 microgram/g at 3 hours, 0.272 microgram/g at 4 hours and 0.297 microgram/g at 5 hours after administration. Ratios of concentrations of CCL in lung tissues to that in sera were from 7.1 to 66.0 percent. The CCL was considered to be a useful antibiotic for the treatment of patients with respiratory diseases. PMID- 3806959 TI - [The penetration of cefotaxime into the cerebrospinal fluid. Comparison between acute and chronic stages in intracranial diseases]. AB - Two grams of cefotaxime (CTX) were administrated by drip infusion to 10 patients (11 material) with acute or chronic stage of intracranial diseases. Concentrations of CTX in the serum and the cerebrospinal fluid (CSF) were determined at 15, 30, 60, 120, 240 and 300 minutes after injection. The results obtained were summarized as follows: Serum levels: Peak levels of CTX in sera were 66.2 +/- 10.23 (S.E.) micrograms/ml in the acute stage group (ASG), and 75.7 +/- 31.39 (S.E.) micrograms/ml at 15 minutes after injection in the chronic stage group (CSG). There were no significant difference between the 2 groups. CSF levels: Peak levels of the drug in CSF were 1.35-4.32 micrograms/ml in ASG and 0.18-0.7 microgram/ml in CSG. Average concentration at 60 minutes after injection was 1.11 +/- 0.09 (S.E.) micrograms/ml in ASG and 0.30 +/- 0.08 (S.E.) micrograms/ml in CSG. The value in ASG was significantly higher than the value in CSG by t-test. The ratio between CSF and serum levels: The levels increased as time passed in both groups and the values in ASG were higher than those in CSG at all time points. Average ratios at 60 minutes after injection were 3.85 +/- 0.29 (S.E.)% in ASG and 1.12 +/- 0.50 (S.E.)% in CSG. The value in ASG was significantly higher than that in CSG by t-test. From the above results, it is considered that CTX is useful for the prophylaxis of postoperative infections in intracranial diseases. PMID- 3806960 TI - [Pharmacokinetics of cefoperazone in end-stage renal failure patients on peritoneal dialysis]. AB - Pharmacokinetics of cefoperazone (CPZ) was examined in 5 patients with end-stage renal failure on maintenance intermittent peritoneal dialysis. Blood levels of CPZ given as a 1 g intravenous bolus injection were not different whether a patient was on or off peritoneal dialysis. Peritoneal clearance of CPZ was 1.6 1.9 ml/min. Blood CPZ levels reached the therapeutic level within 30-120 minutes after an intraperitoneal administration of 1 g CPZ, and remained at the level at least for 3-5 hours. Side effects of CPZ were not observed in any patient. These data indicate that the peritoneal dialysis does not affect blood CPZ levels given intravenously and that effective blood levels of CPZ can be maintained for several hours after an intraperitoneal injection of the drug. Thus, CPZ is considered useful in renal failure patients on peritoneal dialysis. PMID- 3806961 TI - [Clinical investigation of the biliary excretion of cefoperazone in obstructive jaundice]. AB - In the present study, we investigated the biliary excretion of cefoperazone (CPZ) in patients with complete obstruction in the lower bile duct governing PTC drainage, i.e., patients with completely blocked enterohepatic circulation. The blockage was observed to cause a delay in the excretion of CPZ due to hepatic dysfunction and the half-life of CPZ levels in serum was as long as 4.9 hours on the average. This is approximately the same as the half-life of 4.8 hours in hepatic dysfunction reported by Belaieff. Biliary concentration of CPZ reached their peak levels within the first 2 to 6 hours. The time to peak in cases with hepatic dysfunction was similar to that reported by observed in patients without hepatic dysfunction Yura et al. In our cases, however, peak biliary concentrations of CPZ were observed to be between 28 to 954 micrograms/ml with a mean of 320.5 micrograms/ml. These peak levels were lower than those reported by several investigators, but sufficiently effective concentrations seem to have been achieved in the bile even in jaundice because MIC80 values of CPZ are reported to be 6 to 10 micrograms/ml against E. coli, Klebsiella, and Enterobacter and 50 micrograms/ml against the most resistant Serratia. As mentioned above, the lowest peak biliary concentration was found to be 28 micrograms/ml and peak levels reached at least 50 micrograms/ml in 8 out of the 10 patients. Urinary concentrations of CPZ reached their peak levels within the first 30 minutes to 2 hours and CPZ urinary recovery ratio in 24 hours was 24.2 to 93.1% with a mean of 64.1%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3806962 TI - [A study of serum levels of cefoperazone sodium and its movement to myocardial tissue]. AB - After introduction of anesthesia to 19 patients requiring cardiac surgery, cefoperazone sodium (CPZ) 1 g was administered intravenously and its movement to serum, pericardial fluid and tissue of the right auricle was studied. The serum CPZ level was 75.68 micrograms/ml and 59.77 micrograms/ml at 60 and 120 minutes after administration, respectively, and the biological half-life time was 2.54 hours. Lengths of time to achieve peak concentrations of CPZ in pericardial fluid and right auricle tissue after administration were both approximately 1 hour. The drug level in myocardial tissue was 14.52 micrograms/g after 240 minutes. Level of CPZ in myocardial tissue was maintained, even after 240 minutes, sufficiently higher than MIC80 of the drug against Gram-negative bacilli which may be responsible for many infections. No side effects were observed in any case examined. PMID- 3806963 TI - [Late results of operative removal of esophageal cancer with special reference to blunt dissection]. AB - From 1973 to 1985, 185 patients with squamous cell carcinoma of the esophagus were admitted. For such advanced cases as those with penetration into the adventitia, multidisciplinary treatment with bypass surgery, irradiation, hyperthermia and immunochemotherapy was preferably performed. For those with limited invasion not beyond the adventitia, esophagectomy was performed as a first choice. For carcinoma of the lower thoracic and abdominal esophagus, blunt dissection of the thoracic esophagus was undertaken associated with reconstruction of the alimentary tract using a gastric tube via the posterior mediastinum. Of the 185 patients 90 (48.6%) underwent esophagectomy and 77 (41.6%) bypass surgery. Five-year survival rates after operative removal were 69.2% in stage 0, 40.1% in stages I + II, 38.9% in stage III, 4.5% in stage IV and 30.4% overall. PMID- 3806964 TI - [Quantitative variations of lymphocyte subsets in various kinds of cancer patients in the terminal stage]. AB - Immunological studies of the peripheral blood were made in terminal breast cancer and terminal abdominal cancer patients. Two immunological parameters were studied: (1) lymphocyte subsets and (2) proliferative response to PHA. A decrease in the number of OKT-3(+) cells and an increase in that of OKT-8(+) cells were observed in abdominal cancer. It was suggested that the immunological status in abdominal cancer is more suppressive than in breast cancer. Increases in the number of OK-M1(+) cells and Leu-7(+) cells were observed in breast cancer. It is suggested that cytotoxic lymphocytes increase in number in breast cancer more than in abdominal cancer. PMID- 3806965 TI - [Relation between fibrin/fibrinogen degradation products in malignant fluids and the fibrinolytic activity of the peritoneum]. AB - The mechanism of production of fibrin/fibrinogen degradation products (FDP) in malignant fluid was investigated. Levels of FDP in three malignant fluids were high (1200-3000 mcg/ml), but they declined to about 500 mcg/ml after anti cancer treatment. The average levels of FDP in 12 malignant fluids were almost the same as those in nine benign fluids. In a vitro experiment, the fibrinolytic activity of the peritoneum was found to be much higher than that of the tumor. In conclusion, production of FDP in fluid is more closely related to the fibrinolytic activity of the peritoneum than that of the tumor. Intracavitary administration of antifibrinolytic agents is thought to be effect for malignant effusion. PMID- 3806966 TI - [Advanced thyroid carcinoma--possible induction of the host's antitumor immunological response by 131I therapy]. AB - The patient was a 76-year-old man. When he was 31, he had undergone right lobectomy for thyroid cancer. Following this, had repeated recurrences, and finally reached total-thyroidectomized status. Consequently, he was given thyroxin and PS-K thereafter. When he was 75, 131I therapy was undertaken for lung metastases. The changes of serum anti-microsomal antibody (AMA), immunosuppressive substance (ISS) and thyroglobulin (TG) were as follows: three months after the therapy, AMA was 40(2), although it had always been negative before. Nine months later, ISS and TG markedly decreased. CONCLUSION: Under the administration of immunomodulating agents, 131I therapy might induce antitumor immunological responses by the effect of enhancement of cancer cell antigenicity. PMID- 3806967 TI - [Adenosquamous carcinoma originating from the thyroid gland--report of a case and review of the literature]. AB - Adenosquamous cell carcinoma originating from the thyroid gland is extremely rare. Only a few cases have been reported by light-microscopic observations. Like pure squamous cell carcinoma of the thyroid gland, it is generally thought to originate from the thyroid follicular epithelium and to be concerned with squamous metaplasia of the follicular epithelium. In our case, papillary adenocarcinoma was found in the thyroid gland, with the transition to squamous cell carcinoma. Immunohistochemical study for thyroglobulin and keratin further implied he transition of adenosquamous cell carcinoma in the thyroid gland. The origins of squamous cells in thyroid carcinoma are briefly discussed. PMID- 3806968 TI - [An autopsy case of lung cancer in a young adult dwarf]. AB - A 31-year-old man with peripheral squamous cell carcinoma is reported. By nature he was very small. On admission he was 140 cm tall, weighed 28 kg, and was complaining of chest pain of five years duration. A giant tumor in the right lung was found to be moderately differentiated squamous cell carcinoma. He also had congenital anomalies, such as crossed ectopic kidney with fusion, cafe-au-lait spots, inguinal hernia, simian line, etc. He had never been exposed to cancer causing agents. In conclusion, genetic factors related to intrauterine growth retardation might have been linked to his oncodevelopmental mechanisms. PMID- 3806969 TI - [Choriocarcinoma of the stomach]. AB - A 55-year-old Japanese man was admitted to our hospital in January 1985 complaining of epigastralgia. Radiologic and endoscopic examinations showed gastric carcinoma, but biopsy specimens taken by surgery showed the histologic pattern of choriocarcinoma. On autopsy, multiple metastatic sites wer observed, and histological examination of the primary and metastatic sites revealed choriocarcinoma. Primary gastric choriocarcinoma may develop from gastric cancer by retrodifferentiation. PMID- 3806970 TI - [Sclerosing stromal tumor of the ovary]. AB - A 20-year-old woman had the complaints of a tumor in the lower abdominal region and irregular menstruation. A spherical tumor measuring 7 X 6 X 3.5 cm in the great dimension was removed from the left ovary. The cut surface showed a lobular pattern and cystic degeneration in some areas. Histological examination revealed edematous areas and highly cellular areas. The cells were variable in size and shape. Round cells resembled signet-ring cells in places. By PAS reaction and alcian blue stain, these cells were found to be negative, but by Sudan III stain, positive. Postoperatively, the patient complained of genital bleeding for five days. Subsequently, her menstrual pattern returned to normal. PMID- 3806971 TI - [Leukemic cell kill kinetics in bone marrow]. PMID- 3806972 TI - [Quantitation of red blood cell-bound IgG by enzyme linked immunosorbent assay]. PMID- 3806973 TI - [A pyruvate kinase (PK) variant (PK Matsumoto): case report]. PMID- 3806974 TI - [A case of unstable hemoglobin (Hb Koln)]. PMID- 3806975 TI - [A case of Kasabach-Merritt syndrome with giant liver hemangioma]. PMID- 3806976 TI - [Diminished bone marrow fibrosis on autopsy in a patient with acute myelofibrosis following chemotherapy]. PMID- 3806977 TI - [An inhibitor to factor VIII interacting with its activated catalytic subunit]. PMID- 3806978 TI - [A case of transient erythroblastopenia of childhood: serum inhibitor of BFU-E development]. PMID- 3806979 TI - [Evaluation of steroid therapy in idiopathic thrombocytopenic purpura]. PMID- 3806980 TI - [Indication and prognosis of splenectomy in idiopathic thrombocytopenic purpura (ITP)]. PMID- 3806981 TI - [Practical aspects of intractable nature of idiopathic thrombocytopenic purpura]. PMID- 3806982 TI - [Long-term prognosis and prediction of therapeutic effect of idiopathic thrombocytopenic purpura]. PMID- 3806983 TI - [Refractory anemias in Japan]. PMID- 3806984 TI - [Myelodysplastic syndrome: morphological aspects of dysmyelopoiesis]. PMID- 3806985 TI - [Cytogenetic studies in patients with myelodysplastic syndrome]. PMID- 3806986 TI - [Clinicopathological study of myelodysplastic syndrome]. PMID- 3806987 TI - [Ferritin levels of the serum and red blood cells in patients with myelodysplastic syndrome (MDS)]. PMID- 3806988 TI - [Immune complexes]. PMID- 3806989 TI - [Quality control in the analysis of immune complexes]. PMID- 3806990 TI - [Determination of the immune complex level--with special reference to the complement consumption test]. PMID- 3806991 TI - [Detection of immune complexes using the rheumatoid factor]. PMID- 3806992 TI - [Determination of circulating immune complex levels by ELISA using F(ab')2 anti C3 antibody]. PMID- 3806994 TI - [Immunobiological significance of immune complexes]. PMID- 3806993 TI - [Determination of immune complex levels using the Fc receptor of bovine spermatozoa]. PMID- 3806995 TI - [Immune complexes in rheumatoid diseases, with special reference to plasma exchange therapy]. PMID- 3806996 TI - [Evaluation of cardiovascular function using the supine exercise test in the aged]. PMID- 3806997 TI - [Changes in hemodynamics during exercise in patients with ischemic heart disease]. PMID- 3806998 TI - [Evaluation of ischemic ST-T changes in Holter ECG recording]. PMID- 3806999 TI - [Diagnosis of coronary artery disease by intravenous administration of dipyridamole]. PMID- 3807000 TI - [Plasma levels of protein C antigen from healthy subjects]. PMID- 3807001 TI - [Isolation of size-dependent human platelet subpopulations. I. The method for isolation of size-dependent platelet subpopulations by counterflow centrifugal elutriation]. PMID- 3807002 TI - [Application of Friedewald's LDL-c-estimation formula to heterozygotes of familial hypercholesterolemia]. PMID- 3807003 TI - [Clinical role of the periodic measurement of urinary polyamine in hematological malignancies]. PMID- 3807004 TI - [Fluctuation of urinary polyamines in childhood]. PMID- 3807005 TI - [Latex turbidimetric immunoassay for urinary albumin. Fundamental studies and evaluation of normal range]. PMID- 3807006 TI - [A study on precordial vibration. II. Stability]. PMID- 3807007 TI - [Changes in the electroencephalogram, cerebral visual evoked potential and plasma NH3 levels in adult type citrullinemia]. PMID- 3807008 TI - [Blood gas auto-analyser--comparison between the JBA-3 (Jookoo) and ABL3 (radiometor)]. PMID- 3807009 TI - [The variations in epidermal cell kinetics of guinea pig skin after a single irradiation with middle-wavelength ultraviolet light]. PMID- 3807010 TI - [An approach for the surgical treatment of sydactylia in recessive dystrophic epidermolysis bullosa]. PMID- 3807011 TI - [Two cases of malignant angioendothelioma possibly succeeded in treatments]. PMID- 3807012 TI - [A case of staphylococcal scalded skin syndrome in an adult]. PMID- 3807013 TI - [A case of dysplastic nevi associated with cutaneous malignant melanoma. I. Case report]. PMID- 3807014 TI - [A case of dysplastic nevi associated with nodular melanoma. II. Electron microscopic observations]. PMID- 3807015 TI - Macrophage cell line, J774, producing a tumor necrosis factor. AB - Cytotoxic factor was produced from murine macrophage-like cell line, J774, after stimulation with 12-o-tetradecanoyl phorbol-13-acetate (TPA) and lipopolysaccharide (LPS). J774-derived cytotoxic factor is a glycoprotein with a molecular weight of 39,000 by gel filtration and 18,000 by SDS-PAGE, and with an isoelectric point of below 4.3. J774-derived cytotoxic factor exhibited cytotoxicity to L(S) cells, not cytotoxic to L(R) cells, and a necrotizing action against transplanted Meth A sarcoma. J774-derived cytotoxic factor and murine serum tumor necrosis factor (TNF) were identical as regards properties. PMID- 3807016 TI - Role of hydrocortisone, chloroquine and prednisolone in neutrophil mediated cytotoxicity. AB - Human polymorphonuclear leukocytes (PMNs) obtained from normal donors kill tumor cells in vitro. This system was utilized to study the role of lysosomal enzyme release in the cytotoxicity of human neutrophils. When the neutrophils were incubated with hydrocortisone, chloroquine and prednisolone, which are drugs known to stabilize lysosomal membranes, hydrocortisone and chloroquine were unable to inhibit cytotoxicity whereas treatment with prednisolone inhibited cytotoxicity. Recovery in cytotoxicity was observed as the dose of prednisolone utilized was decreased. Cytotoxicity equivalent to that observed with no added drug was found 5 X 10(-7) M for prednisolone. Pretreatment of neutrophils with a dose of prednisolone known to inhibit cytotoxicity (5 X 10(-6) M) resulted in decreased release of the lysosomal enzyme, acid phosphatase, in comparison to untreated neutrophils. PMID- 3807017 TI - Multiple form of L-phenylalanine sensitive alkaline phosphatase in rat fecal extracts. AB - Alkaline phosphatase activity was detected in fecal extracts of male rats. 58% of the total enzyme activity was inhibited by 30 mM L-phenylalanine, which is an inhibitor specific for intestinal alkaline phosphatase. L-Phenylalanine sensitive alkaline phosphatase in the fecal extracts revealed multiple peaks on DEAE Sephadex A-25 ion exchange column with a linear gradient of NaCl. It is discussed that a part of the fecal alkaline phosphatase might be a set of catabolites of the intestinal enzyme. PMID- 3807018 TI - [Characterization of the groundwater around Saga City]. PMID- 3807019 TI - [Effects of sodium nitrite on the action potential responses of the ventricular muscles of mice]. PMID- 3807020 TI - [A species profile of skin Staphylococci and the distribution of drug-resistant strains among five antibacterial agents in staphylococcal species]. PMID- 3807021 TI - Ecological risk factors for mortality from major malignant neoplasms by age and sex. PMID- 3807022 TI - [Measurement of K vitamins in the human placenta by high-performance liquid chromatography with fluorometric detection]. PMID- 3807023 TI - Mitochondrial effect of orally administered dibutyl phthalate in rats. PMID- 3807024 TI - Toxicity of dibutyl phthalate and its metabolites in rats. PMID- 3807025 TI - [Incidence of parkinsonism after treatment with metoclopramide]. PMID- 3807026 TI - [Pseudogout simulating systemic disease in the elderly--its significance in diagnostic considerations in fever]. PMID- 3807027 TI - [The value of the bone scintigram in elderly subjects]. PMID- 3807028 TI - [Report of 6 cases with polymyalgia rheumatica and a review of the literature]. PMID- 3807029 TI - [Relationship between nutrient intake and serum total and HDL cholesterol in the aged]. PMID- 3807030 TI - [Clinical symptoms of gastric ulcer in the aged]. PMID- 3807031 TI - [The effects of physiologic alterations, disease states and drugs on serum uric acid levels in an elderly population]. PMID- 3807032 TI - [Effects of age on cerebral blood flow--a study using the Xe-133 inhalation method]. PMID- 3807033 TI - Human plasminogen polymorphism in Japanese: a new variant and relative activities of plasminogen among phenotypes. PMID- 3807034 TI - [Mechanism of pulmonary congestion in ligature strangulation (II)]. PMID- 3807035 TI - [Comparative studies of human and animal hemoglobins by ELISA method--forensic immunological studies on human specificity. Report-XVIII]. PMID- 3807036 TI - [Differentiation of group ABSe semen from mixtures of group ASe and BSe semens by enzyme-linked immunosorbent assay (ELISA)]. PMID- 3807037 TI - [Medico-legal studies on the mechanism of the pink coloration of the teeth]. PMID- 3807038 TI - [Four cases of fatal poisoning by hydrogen sulfide. A study of greenish discoloration of the skin and formation of sulfhemoglobin]. PMID- 3807039 TI - [Formation of sulfhemoglobin in the blood and skin caused by hydrogen sulfide poisoning and putrefaction of the cadaver]. PMID- 3807040 TI - [Intracranial pressure induced by "blow" and "fall"--an experimental study with a physical model of the head and neck]. PMID- 3807041 TI - Properties of Caucasian type red cell acid phosphatase phenotypes CA and CB found in Japanese. PMID- 3807042 TI - [Experimental autoimmune Heymann nephritis induced by immunization with rabbit anti-brush border antibody associated glomeruli]. PMID- 3807043 TI - [Detection of uremic peaks by high performance liquid chromatography and their behavior]. PMID- 3807044 TI - [Dialysis capacity of peritoneum in CAPD]. PMID- 3807045 TI - [The effects of estrogen on renal osteodystrophy in the female patients undergoing maintenance hemodialysis]. PMID- 3807046 TI - [Urinary crosslinked fibrin degradation products in various renal diseases]. PMID- 3807047 TI - [Changes in renal blood distribution and catecholamine content in the kidney after clamping renal artery]. PMID- 3807048 TI - [Cardiovascular and respiratory reflexes resulting from capsaicin-stimulated renal afferent receptors in dogs]. PMID- 3807049 TI - Effects of trimoprostil on healing and recurrence of acetic acid-induced gastric ulcer in rats. AB - Chronic gastric ulcers were produced by injection of 20% acetic acid (0.05 ml) into the submucosal layer of the rat stomach in order to determine the effects of the prostanoid trimoprostil on the healing and recurrence of ulcers. Local injection of acetic acid solution produced large demarcated ulcers in all animals on day 5, which rapidly decreased to reach low levels on days 40-80 and then became exacerbated on day 100. The exacerbation of the ulcer is probably recurrence. Trimoprostil was administered ad libitum in drinking water containing 0.1, 0.3 and 1.0 microgram/ml (average dose 12.4, 37 and 124 micrograms/kg/day) for a period of 14 days (day 1-15) to assess its effect on healing and for a period of 40 days (day 60-100) to assess its ability to prevent recurrence. The higher two doses of trimoprostil accelerated the spontaneous healing of the ulcers. Furthermore, trimoprostil, at both doses, prevented the observed recurrence of this type of ulcer. Trimoprostil dose-dependently (30-300 micrograms/kg, p.o.) inhibited gastric secretion in pylorus-ligated rats. Cimetidine at the antisecretory dose (1 mg/ml, 132 mg/kg/day) failed to affect the healing process of gastric ulcers, but tended to prevent the recurrence of gastric ulcers. Our present study suggests that trimoprostil is a promising antiulcer drug for the treatment of chronic gastric ulcer. PMID- 3807050 TI - Inhibitory effect of clomiphene citrate on the conversion of 13,14-dihydro-15 keto-prostaglandin F2 alpha to 13,14-dihydro-prostaglandin F2 alpha in rat ovary. AB - The effects of clomiphene citrate (clomiphene) on the in vitro conversion of 13,14-dihydro-15-keto-prostaglandin F2 alpha (15KD-PGF2 alpha) to 13,14-dihydro prostaglandin F2 alpha (13,14H2-PGF2 alpha) in the presence of rat ovarian homogenate, and the relationship between clomiphene and gonadotropin or estrogen in the conversion were investigated. Although clomiphene inhibited the increased conversion of 15KD-PGF2 alpha to 13,14H2-PGF2 alpha by pregnant mare serum gonadotropin (PMS) in rat ovary, the drug did not inhibit the decreased conversion of 15KD-PGF2 alpha by estradiol. The 3-day administration of clomiphene reduced the conversion of 15KD-PGF2 alpha to 13,14H2-PGF2 alpha dose dependently. A single administration of clomiphene also decreased the conversion, and this decreasing effect was similar to that of estradiol. On the other hand, the repeated administration of clomiphene decreased the ovarian and uterine weights and also inhibited the increase of the uterine weight by PMS or estradiol. These results suggest that clomiphene affects the ovarian enzyme catalyzing the conversion of 15KD-PGF2 alpha to 13,14H2-PGF2 alpha. PMID- 3807051 TI - Beta-carbolines selectively antagonize the cholecystokinin action in isolated guinea-pig gallbladder muscle. AB - Two beta-carbolines, methyl beta-carboline-3-carboxylate (beta-CCM) and ethyl beta-carboline-3-carboxylate (beta-CCE), caused the parallel shift of the dose response curve for cholecystokinin (CCK) in isolated guinea-pig gallbladder muscle. The Schild plot regarding the parallel shift in the dose-response curves had a regression line with a slope of 1.03 and a pA2 value of 5.17 for beta-CCE, while the method of van Rossum gave a pA2 value of 5.24 for beta-CCE and 5.53 for beta-CCM. Both the beta-carbolines protected CCK receptors in the gallbladder muscle from alkylation by dibenamine, but beta-CCM did not protect acetylcholine receptors from dibenamine alkylation. These results suggest that beta-CCM and beta-CCE, so-called inverse agonists of benzodiazepines (BZP), antagonize the CCK action in the gallbladder muscle in a competitive manner, and the antagonism takes place at CCK receptor sites. No spare receptors for CCK were found in the guinea-pig gallbladder muscle. PMID- 3807052 TI - Antidiuretic effects of methionine-enkephalin and 2-D-alanine-5-methionine enkephalinamide microinjected into the hypothalamic supraoptic and paraventricular nuclei in a water-loaded and ethanol-anesthetized rat. AB - Effects of methionine-enkephalin (ME) and 2-D-alanine-5-methionine enkephalinamide (DAMEA) microinjected into the hypothalamic supraoptic (SON) and paraventricular (PVN) nuclei, which contain neurons synthesizing and releasing antidiuretic hormone, upon the outflow and the osmotic pressure of urine and the other visceral functions were studied in a rat which was loaded with water and anesthetized with ethanol. These opioid peptides when microinjected into the SON or PVN induced potent antidiuretic effects in dose-dependent and time-dependent manners with no significant effects on the other visceral functions. The approx. ED50 values for DAMEA were 1.3 (in the SON) and 0.7 (in the PVN) nmol, and the values for ME were 110 (in the SON) and 60 (in the PVN) nmol. The antidiuretic effects showed slow onset and long duration, with a minimal urine outflow at approx. 0.5 hr after microinjection and an approx. 2 hr-duration. The effects induced by the opioid peptides were inhibited by pretreatment with naloxone or atropine, without effects of pretreatment with alpha- or beta-adrenoceptor antagonists, suggesting that the antidiuretic effects were mediated through an opioid receptor having low sensitivity to naloxone and also possibly mediated through a muscarinic receptor which was stimulated probably by the ACh released by the opioid peptides. PMID- 3807053 TI - Mechanism of the inhibition of cholesterol absorption by DL-melinamide: inhibition of cholesterol esterification. AB - In order to elucidate the mechanism of action of DL-melinamide [DL-MA, N-(alpha methylbenzyl)linoleamide], an inhibitor of cholesterol absorption, the effect of DL-MA on esterification of cholesterol in the mucosa of rabbit small intestine was studied. DL-MA inhibited acyl CoA:cholesterol acyltransferase (ACAT, EC 2.3.1.26) activity in the mucosal microsomes, with 50% inhibition occurring at approximately 0.5 microM. On the other hand, DL-MA had no effect on the cholesterol esterase (EC 3.1.1.13) activity in the mucosal cytosol. Kinetic studies indicate that DL-MA is an uncompetitive inhibitor of ACAT. D-MA, one of the two optical isomers of DL-MA, was found to be a more effective inhibitor of ACAT than L-MA, another isomer. This finding indicates that the inhibition of cholesterol absorption by DL-MA depends on the inhibition of ACAT by this compound, in view of the fact that D-MA is a more effective inhibitor of cholesterol absorption than L-MA. PMID- 3807054 TI - Activation of mitochondrial functions by malotilate in relation to accelerated liver regeneration in partially hepatectomized rats. AB - Malotilate was orally administered to rats at a dose of 100 mg/kg 2 hr after partial hepatectomy. Mitochondrial state 3 respiration of the liver increased significantly from 23.4 nmol/min/mg protein in the control rats to 29.3 nmol/min/mg protein in the rats administered with malotilate at 3 hr after the hepatectomy (1 hr after the administration). The administration also resulted in higher tendencies in the respiratory control ratio after 3, 6 or 20 hr (1, 4 or 18 hr after the administration) than in the control rats. Although partial hepatectomy made hepatic ATP concentration remarkably low, it gradually increased (from 1.53 mumol/g liver after 3 hr) to a level of 2.03 mumol/g liver after 20 hr in the rats administered with malotilate. No increase in ATP concentration was observed in the control rats. Correspondingly, the adenylate energy charge also showed higher tendencies in the malotilate administered rats. From these result, it is supposed that malotilate activates the mitochondrial functions which results in the increases of ATP concentration and adenylate energy charge. These changes in energy metabolism can be associated with accelerated regeneration of the liver by malotilate. PMID- 3807055 TI - Functional and morphological alterations in the rat stomach following exposure to hypertonic NaCl solution. AB - We examined the effects of 1 M NaCl as a mild irritant on gastric potential difference (PD), acid secretion, mucosal blood flow (MBF), and DNA synthetic activity in anesthetized rat stomachs and compared these effects with those of 4 M NaCl as a strong irritant. Both 1 M and 4 M NaCl produced a PD reduction (mucosal injury), but the reduced PD recovered faster in the mucosa exposed to 1 M NaCl as compared to 4 M NaCl. Acid secretion ceased after exposure to these hypertonic NaCl solutions, but histamine infusion (8 mg/kg/hr) stimulated acid secretion only in the mucosa exposed to 1 M NaCl. The MBF was significantly increased in response to 1 M NaCl, while exposure to 4 M NaCl had no effect on the MBF. These changes in acid secretion and MBF induced by 1 M NaCl were significantly antagonized by pretreatment with indomethacin (5 mg/kg, s.c.). The levels of PGE2 and 6-keto PGF1 alpha in the corpus mucosa were significantly increased in the stomach exposed to both 1 M and 4 M NaCl, and these increases disappeared in the presence of indomethacin. The rate of [3H]-thymidine incorporation was significantly reduced in the mucosa after exposure to 4 M NaCl, but remained unaltered in the stomach exposed to 1 M NaCl. These results suggest that although both 1 M and 4 M NaCl produced mucosal injury (PD reduction) and enhanced PGs formation, a variety of functional alterations mediated by PGs occurred in response to injury in the stomach exposed to 1 M NaCl. The presence or absence of these functional responses may be associated with the biphasic actions on the gastric mucosa of these hypertonic NaCl solutions as mild and strong irritants. PMID- 3807056 TI - Demonstration of endogenous inhibitors of monoamine oxidase in dog cerebrospinal fluid. AB - Cerebrospinal fluid (CSF) from dogs competitively inhibited A-form MAO, but was non-competitive with B-form MAO. Heat treatment of CSF (90 degrees C, 20 min) had no effect on the inhibition. Digestion with trypsin and chymotrypsin reduced the MAO inhibitory activity. After ultrafiltration of the CSF through a membrane to remove substances of greater than 5,000 M.W., significant inhibitory activity persisted. These results suggest that CSF contains endogenous substances that act like MAO inhibitor to inhibit A and B-form MAO, and these substances are peptides of less than 5,000 M.W. PMID- 3807057 TI - Inhibitory effects of a novel synthetic protease inhibitor, FUT-175, on the paw edema in rats and zymosan-induced complement activation in vitro. AB - FUT-175 inhibited the zymosan-induced rat paw edema in a dose-dependent manner, while indomethacin exhibited no significant activities in this model. FUT-175 also inhibited the decrease in hemolytic complement (CH50) induced by zymosan in vitro, and indomethacin was inactive. These results suggest that FUT-175 has potent in vitro and in vivo inhibitory activity against the activation of the complement system induced by zymosan. PMID- 3807058 TI - [Tactile point identification]. AB - The ability to identify spatially tactile point stimuli was examined, under simultaneous or sequential presentation, using a 3 X 3 matrix of vibrotactile stimulators placed against the abdomen. The first experiment showed that the performance of tactile point identification deteriorated with the increase of the number of tactile point stimuli, especially under the simultaneous presentation. The obtained memory span was about two stimulus positions in the simultaneous presentation and about 4.5 in the sequential presentation. In the second experiment, a tactile version of the Hogben-Di Lollo paradigm (1974) was employed to investigate processing rate of tactile point identification. The ability in identifying the missing tactile stimulus position was found to be an increasing function of SOA, reaching asymptote at about 600 ms SOA. A subsidiary task of counting backwards by threes made performance poorer. The analysis of errors indicated the existence of a short-term tactile memory. PMID- 3807059 TI - [82 drawings and their most common names, image agreement, adequacy of complexity, and familiarity]. AB - For use in experiments investigating semantic processing of nonverbal materials, 82 drawings of familiar objects are presented, along with their most common names, the mean ratings of image agreement, adequacy of complexity, and familiarity. Most concepts were exemplars from one of 10 familiar categories (animals, insects, vehicles etc.). Names and ratings were obtained from 81 undergraduates and graduate students. The moderate correlation (r = .40) was found between percentage of the most common name and image-agreement rating, but the other correlations were negligible. The mean ratings of three variables except adequacy of complexity were compared with those of Matsukawa (1983), obtained from Japanese subjects using Snodgrass and Vanderwart's (1980) drawings. The high correlation between familiarity of both studies (r = .88) indicates that this variable is not affected by visual characteristics of the particular stimulus set. The possible uses of the present stimulus set were suggested. PMID- 3807060 TI - [A study of itch intensity in relation to two-point tactual discrimination]. AB - This study was designed to investigate whether or not the areas of the human body most sensitive to itch stimuli are identical with the body parts least sensitive to tactual discrimination, a hypothesis which arouse from our previous studies of itching. Subjects were 12 college students (six males and six females). The itching was induced by grated Japanese yam. The body areas were the upper arm (with large two-point thresholds), the lower leg (with intermediate two-point thresholds), and the middle finger (with small two-point thresholds). An experimental session consisted of a stimulus-application period (200 s), and a post-application period (600 s) during which the itching increases markedly. (After wiping off the grated yam, itching is increased because of the needle crystals of calcium oxalate contained in the yam peel which penetrate slightly into the skin in the process of wiping.) Self-ratings on itching and the volume of dermal blood flow were recorded during two periods. The results support our hypothesis and suggest that tactile sensation has some interaction with itching. PMID- 3807061 TI - [A case of pulmonary alveolar proteinosis complicated by hypercholesteremia]. PMID- 3807062 TI - [A case of hypersensitivity pneumonitis probably due to isocyanate in a polyurethane paint sprayer]. PMID- 3807063 TI - [Five cases of psittacosis]. PMID- 3807064 TI - [An adult case of proximal interruption of the right pulmonary artery]. PMID- 3807065 TI - [A case of hydrocortisone sodium succinate (Saxizon)-induced asthma]. PMID- 3807066 TI - [A case of lung cancer accompanying sarcoidosis]. PMID- 3807067 TI - [Effects of oxygen and nifedipine on hemodynamics in secondary pulmonary hypertension--chronic pulmonary emphysema and chronic lung tuberculosis]. PMID- 3807068 TI - [A monoclonal antibody, AMH-1, reactive with human alveolar macrophages]. PMID- 3807069 TI - [Effect of oxygen on the regional distribution of ventilation-perfusion in the lung and the right ventricular ejection fraction--assessment using Xe-133 and Kr 81m]. PMID- 3807070 TI - [The role of fibronectin in the lower respiratory tract of patients with idiopathic insterstitial pneumonia]. PMID- 3807071 TI - [Reconstruction of the segmental bronchi]. PMID- 3807072 TI - [Problems of supportive systems during perioperative periods in reoperations in valvular heart disease]. PMID- 3807073 TI - [Heart failure related to hypovolemia after cardiac surgery]. PMID- 3807074 TI - [Macroscopic analysis of mediastinal lymph node metastasis in lung cancer]. PMID- 3807075 TI - [Postoperative respiratory care in congenital heart disease with pulmonary hypertension--continuous muscle relaxation therapy]. PMID- 3807076 TI - [Invasive thymoma showing distant postoperative metastasis]. PMID- 3807077 TI - [A case of immediate traumatic pulmonary pseudocyst]. PMID- 3807078 TI - [Successful conservative treatment of spontaneous rupture of the esophagus after late diagnosis]. PMID- 3807079 TI - [A case report of posterior mediastinal bronchial cyst]. PMID- 3807080 TI - [A case report of right ventricular pseudoaneurysm after extracardiac valved conduit surgery]. PMID- 3807081 TI - Phospholipid composition and Ca2+ uptake properties of plasma membrane isolated from canine stomach smooth muscle. AB - The Ca2+ uptake and phospholipids influencing it in plasma membrane isolated from canine stomach smooth muscle was investigated. The major phospholipids in plasma membrane were phosphatidylethanolamine (PE, 26%), phosphatidylcholine (PC, 20%) and phosphatidylserine + phosphatidylinositol (PS + PI, 15%). The cholesterol/phospholipid ratio in the membrane was 0.64. ATP-dependent Ca2+ uptake was inhibited by exogenous PE, PC and PS, but increased by PI. Saponin and phospholipase C inhibited ATP-dependent Ca2+ uptake and accelerated release of Ca2+ from actively loaded plasma membrane vesicles. In the absence of ATP, PE slightly and PI significantly increased Ca2+ uptake, but PC and PS did not affect the Ca2+ uptake. Release of Ca2+ from actively loaded vesicles was 5 times greater in the presence of PI than in its absence. Results suggest PI to be the most active of the tested phospholipids in influencing Ca2+ movement across plasma membrane. PMID- 3807082 TI - [Effects of esophageal distension on canine pancreatic exocrine secretion]. AB - The pancreatic exocrine secretion responses to distension of the thoracic oesophagus were studied in chloralose anesthetized dogs and decerebrated dogs occluded the pyloric sphincter with submucosal ligature. In 79 of 149 distensions, the pancreatic outflow was increased by 70.6% of control value before the distension with latencies of one to five minutes. This response was accompanied by the increased protein and bicarbonate outputs of 83.1% and 303.0% of control value, respectively. In 68 of 149 distensions, the pancreatic outflow, protein and bicarbonate outputs were decreased by 23.2%, 17.1% and 29.1% of control value, respectively. After transthoracic vagotomy immediately above the diaphragm or administration of atropine, the increased response was abolished, but the decreased one was not. The decreased response was markedly reduced by guanethidine, and completely abolished after following adrenalectomy. Furthermore, it was completely abolished after splanchnicotomy, too. There was no relationship between the pancreatic exocrine secretion and the serum gastrin concentration before and after distension of the oesophagus. These results provide an evidence for the existence of the oesophago-pancreatic excitatory and inhibitory responses. The excitatory one is due to the vago-vagal reflex and the inhibitory one is due to the vago-splanchnic reflex. PMID- 3807084 TI - [Abstracts. 28th annual meeting of the Japan Society of Smooth Muscle Research. (I)]. PMID- 3807083 TI - [Effects of highly concentrated estrogen and progesterone on the contractile mechanism of the uterine smooth muscles]. AB - The effects of a high concentrated estrogen and progesterone were studied on the contractile activities in isolated myometrial strips from humans and rats by recording isometric tension development. The contractions were reduced by 10(-5) 3 X 10(-5) M estrone (E1), estradiol (E2), estriol (E3), and progesterone (P) in non pregnant human uterus. The contractions were reduced by 10(-6)-10(-4) M E1, E2, E3 and P in non pregnant rat uterus. The contractions induced by 10(-8)-10( 5) M PGE2 and PGF2 alpha were reduced by 10(-5) M E2 and P in non pregnant rat uterus. The contractions induced by 10(-10)-3 X 10(-8) M oxytocin were reduced by 10(-5) M E2 and P in non pregnant rat uterus. The contractures induced by 10(-4) 10(-2) M Ca2+ were reduced by 10(-5) M E2 and P in non pregnant rat uterus. The effects of a high concentrated estrogen and progesterone were studied on Ca2+ influx and Ca2+ release from intracellular Ca store in the depolarized uterine smooth muscle cells from non pregnant rats. The inhibitory effects on the contractility by 3 X 10(-6)-3 X 10(-5) M E2, E3 and P supported the suggestion that estrogen and progesterone have an inhibitory action on Ca2+ influx and Ca2+ release from intracellular Ca store. PMID- 3807086 TI - [The treatment of staghorn calculi with an extracorporeal shock wave lithotripter, a percutaneous nephrolithotripter and chemolysis]. PMID- 3807085 TI - [Lectin binding studies of the human nephron and renal cell carcinoma]. PMID- 3807087 TI - [Examination of impotence by recording the physiological reaction to sexual stimulation]. PMID- 3807088 TI - [Histopathological investigation of specimens from radical total cystoprostatectomy of carcinoma of the prostate]. PMID- 3807089 TI - [Diagnostic methods in primary hyperparathyroidism]. PMID- 3807090 TI - [A study of micturitional function at attack, acute and recovery phases of cerebrovascular attacks]. PMID- 3807091 TI - [Quantitative analysis of calcium oxalate stones by infrared spectroscopy]. PMID- 3807092 TI - [Prevalence of urinary incontinence in working women]. PMID- 3807093 TI - [First report on studies of normal testicular weight and size in the Japanese]. PMID- 3807094 TI - [Isoantigens ABH in bladder tumors as an indicator of malignant potential. IV. Correlation with Thomsen-Friedenreich antigen and CEA]. PMID- 3807095 TI - [Adrenocortical adenoma associated with congenital adrenal hyperplasia]. PMID- 3807096 TI - Abdominal aortic surgery & horseshoe kidney. PMID- 3807097 TI - Postoperative fever after hemorrhoidectomy. PMID- 3807098 TI - Pulmonary lymphangioleiomyomatosis complicated by pregnancy. PMID- 3807099 TI - Bacteriuria screening. PMID- 3807101 TI - Current treatment of breast cancer in the United States. PMID- 3807100 TI - Critique of CME. PMID- 3807102 TI - Correlation by sex difference between maternal fostering attitudes and children's personalities. PMID- 3807103 TI - Relationship between plasma level and therapeutic effect of sulpiride. PMID- 3807104 TI - Dexamethasone suppression test and negative symptoms of schizophrenics. PMID- 3807105 TI - [Bronchial tuberculosis--a review of 5 treated cases]. PMID- 3807106 TI - [Effect of dilatation on stricture of the distal trachea involving the carina caused by tuberculosis. A case report]. PMID- 3807107 TI - [A case of generalized disseminated atypical mycobacteriosis caused by M. avium complex with manifestation of fever and multiple osteal lesions]. PMID- 3807108 TI - [How should tuberculosis be taught in medical education?]. PMID- 3807109 TI - [Immunological activity of the components of tubercle bacilli]. PMID- 3807110 TI - [The chest X-ray findings in untreated pulmonary tuberculosis patients]. PMID- 3807111 TI - [Relation between roentgenographic features and the clinical course of lung disease caused by the Mycobacterium avium complex]. PMID- 3807112 TI - [A case of miliary tuberculosis with cerebral tuberculoma revealed by computed tomography]. PMID- 3807113 TI - [The difference in tuberculosis situations and achievement of control programs by area and the means of its solution]. PMID- 3807114 TI - [Mechanisms of granulomatous inflammation in tuberculosis]. PMID- 3807115 TI - [Clinical significance of pathologic left axis deviation in patients with left bundle branch block]. PMID- 3807116 TI - [Alterations in the functioning of the adrenergic system in people with coronary artery disease and a normal resting electrocardiogram during exercise testing on a bicycle ergometer]. PMID- 3807117 TI - [Polycardiographic estimation of left heart ventricle function in physically trained men between 30 and 60 years of age]. PMID- 3807118 TI - [Evaluation of circulatory hemodynamics and vascular wall elasticity based on physical analysis of the circulatory system in children with simple obesity]. PMID- 3807119 TI - [In search of causes for coronary artery spasm]. PMID- 3807120 TI - [Pulmonary valve fluttering in persistent ductus arteriosus]. PMID- 3807121 TI - [Heart rhythm disorders in the early ventricular polarization syndrome]. PMID- 3807122 TI - [Simultaneous appearance of encephalographic and electrocardiographic changes in a patient with vasospastic stenocardia]. PMID- 3807123 TI - [5 consecutive operations on the heart over 20 years]. PMID- 3807124 TI - [Automated mapping of the heart electrical potentials in myocardial infarct patients]. AB - A method is developed for automated cartography of the heart's electric potentials from 90 points on the chest surface. The input data program determines characteristic QRS profiles on the basis of change in the value of the first derivative, labelling the identifiable characteristic outlines, computes the gradients for Q/R, R/S amplitude ratios for every element of the field and estimates zone area for each gradient and mean Q, R, S wave amplitudes for all points within the field. PMID- 3807125 TI - [Hemodynamic aspects of the transvenous electrodestruction of the atrioventricular junction]. AB - Transvenous electrodestruction of the atrioventricular junction is an effective method of surgical treatment for supraventricular arrhythmias (paroxysmal tachysystoles) refractory to medication. However, it is central hemodynamic status alone that can be an objective indicator of favorable clinical effect. Major central hemodynamic parameters were examined in 52 patients before and after the operation. Considerable late postoperative improvement of the general condition and normalization of major central hemodynamic parameters were noted in most cases. PMID- 3807126 TI - [Transesophageal electrostimulation of the atria in assessing the degree of the coronary bed lesion in ischemic heart disease patients]. AB - Electrocardiographic changes in response to esophageal atrial electrostimulation were examined in relation to the severity of coronary-bed affection in 99 patients with suspected coronary heart disease. Esophageal atrial electrostimulation was equal, in terms of specificity and sensitivity (73 and 78%, respectively), to bicycle ergometry (77 and 74%), and was superior to it by far in terms of adjustment to diagnostic electrocardiographic criteria. A direct relationship was demonstrated between total ST depression induced by esophageal atrial electrostimulation and the extent of coronary-bed affection expressed as the number of affected coronary arteries or the impaired blood supply area. PMID- 3807127 TI - [Use of transesophageal electrical stimulation of the left atrium for assessing the anti-ischemic effect of nitrosorbide]. AB - Anti-ischemic effect of sorbide nitrate was assessed by means of esophageal left atrial electric stimulation in 26 coronary patients. This method is shown to be useful for objective assessment of the efficiency of antianginal drugs by acute tests in coronary patients. Repeated stimulation in the presence of sorbide nitrate treatment showed smaller ischemic ECG changes. PMID- 3807128 TI - [Differential drug therapy and prevention of different types of atrial fibrillation in ischemic heart disease patients]. AB - Clinical and instrumental examination using enhanced atrial VCG and ECG in 140 patients with coronary heart disease complicated by frequent atrial fibrillation paroxysms (AFP) identified 3 types of atrial myocardial change: the "hemodynamic" or secondary atrial fibrillation, "arrhythmic", or primary atrial fibrillation, and "ischemic" ones, the former 2 types being particularly common. These pathogenetic differences taken into account, long-term differential therapy and prevention of AFP became possible where cordaron proved the most effective agent (74% response rate). Its effectiveness approached 83% in primary AFP and was somewhat lower (42%) in secondary AFP, while digoxin proved more efficient in the latter group (52%). Cordaron treatment was associated with a 9.2% side effects rate; low doses of the drug produced no side effects. PMID- 3807129 TI - [Clinico-instrumental parallels in ischemic heart disease]. AB - Correlations between coronary angiographic findings and the results of some noninvasive functional tests (electro- and echocardiography, bicycle ergometry, etc.) were examined in 50 patients. A relationship was established between the quantity of essentially (over 50% of the lumen) stenosed major coronary arteries and stress tolerance or the double product. PMID- 3807130 TI - [Evolution of the shape of the left ventricular cavity at different phases of the cardiac cycle in healthy persons and ischemic heart disease patients]. AB - Cineventriculo- and echocardiographic studies of left-ventricular cavity demonstrated an increase in the deep diameter and the thinning and outward displacement of the posterior wall during the isovolumic systole in normal subjects. This change of shape was however uncommon and, if present, less pronounced in 19 patients with marked coronary heart disease (CHD). In normal subjects, posterior wall movement amplitude was always greater than that of the anterior wall, whereas in coronary patients left-ventricular wall movement amplitudes were always similar. It is assumed that the lateral posterior wall displacement is due to a later myocardial activation in this area, while the absence of such movements is attributed to increased volume of ventricular cavity. The ratio of left-ventricular diameter to posterior wall thickness was actually below 3 in all normal subjects and above 3 in most of the coronary patients. PMID- 3807131 TI - [Diagnostic value of changes in Q wave amplitude in left thoracic leads during physical loading]. AB - The informative value of stress-induced changes in Q wave amplitude and ST segment for the diagnosis of coronary heart disease was compared in records from left chest leads. Bicycle ergometry was conducted in 74 patients with coronary angiographically documented stenosis (more than 70% of the lumen) of one or more coronary arteries, and 28 subjects showing no apparent coronary arterial changes. The lack of increment in Q wave amplitude was shown to be a fairly sensitive sign of myocardial ischemia. Yet, its specificity is relatively low, much inferior to that of ST changes. The predictive value of changes in ST segment is significantly higher, as compared to that of changes in Q wave amplitude during exercise. Simultaneous assessment of ST and Q wave changes in response to stress failed to improve the predictive accuracy, as compared to the interpretation of ST changes alone. PMID- 3807132 TI - [Importance of cardiac functional indices based on echocardiographic and bicycle ergometric data in the postinfarct period for long-term prognosis]. AB - Myocardial echocardiographic contractility and the extent of coronary arterial involvement, as evidenced by bicycle ergometry (the double product, stress tolerance, myocardial reserve expenditure coefficient and causes of discontinuation) were shown to be of primary importance among other functional cardiac parameters for the prognosis of late outcomes of myocardial infarction in patients examined within the 3d year after the coronary. The risk of sudden death from coronary heart disease was 4.2 times as high in alcohol abusers, as compared to the group average in the examined postinfarction cardiosclerosis patients. PMID- 3807133 TI - [Rehabilitation of patients who have had a myocardial infarct. The cytochemical approaches]. PMID- 3807134 TI - [Changes in the blood plasma lipoprotein system of patients in the acute and recovery periods of myocardial infarct]. AB - Repeated assessments of changes in plasma lipoprotein spectrum in 160 patients with large-focal myocardial infarction, and the aggregation of high-density lipoproteins (HDLP) in 26 of those demonstrated specific quantitative and qualitative shifts that differed in acute infarction and convalescence. Total cholesterol, HDLP cholesterol and triglyceride levels on day 60 after the attack evidenced that atherogenic disturbances of lipid metabolism were virtually similar to those seen in chronic coronary patients. Lipoprotein disorders are more marked in patients with anginal episodes punctuating their convalescence as compared to those whose convalescence is uneventful. PMID- 3807135 TI - [Use of functional electrocardiographic tests for detecting and evaluating disorders of cardiac rhythm in young people]. AB - Ten-minute-long resting electrocardiograms and functional tests (respiratory arrest, hyperventilation, orthostatic and exercise tests) under continuous cardiac rhythm monitoring were conducted in 239 young subjects between 10 and 35 years of age (153 skilled athletes, 62 apparently normal individuals and 24 young unskilled athletes). Arrthythmias were detected in 124 (51.9%) of those. Complex arrthythmias were particularly common in skilled athletes, as compared to normal subjects and young unskilled athletes (58.2, 45.2 and 29.2%, respectively). Cardiovascular abnormalities were found in 30.7% of skilled athletes and 9.7% of normal subjects. Electrocardiographic functional tests allow timely identification of athletes with cardiovascular abnormalities and the choice of correct therapeutic strategy in terms of stress exposure. PMID- 3807136 TI - [Sinus node function of ischemic heart disease patients with chronotropic incompetence]. AB - Forty-five (17.6%) of 256 coronary patients showed inadequately small heart rate augmentation in response to rationed exercise ("chronotropic incompetence"). To assess their sinoatrial node function, esophageal atrial stimulation was done in all patients before and after drug-induced vegetative block, and the adjusted sinoatrial node function time and sinoatrial conduction time were determined. Electrophysiological evidence suggests that "chronotropic incompetence" is in most cases determined by abnormal sinoatrial rhythm. Rationed exercise testing can be used as a screening test for latent weak sinoatrial node syndrome in coronary patients. PMID- 3807137 TI - [Orthostatic ECG changes in hypertension]. AB - During an orthostatic test, most patients with first-stage essential hypertension showed unfavorable ECG changes that were more common in cases of marked orthostatic tachycardia. As the disease progressed, the incidence of unfavorable orthostatic ECG changes declined, apparently due to depressed sympathoadrenal activity common to stable hypertension. PMID- 3807138 TI - [Calcium transport in erythrocytes loaded with a highly selective Ca2+ chelator. The characteristics associated with primary hypertension]. AB - The kinetics of 45Ca accumulation was studied in erythrocytes loaded with highly selective Ca2+ chelator quin-2. Ca2+ erythrocyte penetration rate was increased by 20-30%, and free intracellular calcium (Ca2+ in), by 40-50%, in hypertensive patients, as compared to normotensive controls. Spontaneously hypertensive rats showed no differences in this respect. The addition of valinomycin and quinidine produced a tenfold increase in Ca2+ penetration rate in human erythrocytes and a 1.5-2-fold increase in rat erythrocytes. Under these conditions, the erythrocyte Ca2+ penetration rate and Ca2+ in concentration were increased by 40 and 60%, respectively, in spontaneously hypertensive rats. Hypertensive patients showed no differences. After incubation with the Ca-ATPase inhibitor orthovanadate, erythrocyte calcium level in the absence of quin-2 was 2-3 times as high in spontaneously hypertensive rats as it was in control animals. PMID- 3807139 TI - [New parameter for assessing sinus node function--the sinus node refractory period]. PMID- 3807140 TI - [Use of endomyocardial biopsy for determining the etiology of atrioventricular conduction disorders]. PMID- 3807141 TI - [Current aspects of mucoviscidosis screening in East Germany]. PMID- 3807142 TI - [Hypoglycemia in childhood. 2: Diagnosis and therapy of hyperinsulinemia]. PMID- 3807143 TI - [Emergencies in childhood. 7. Unclear disorders of consciousness in pediatrics]. PMID- 3807144 TI - [Developmental prognosis of children with neonatal convulsions--a psychological follow-up study]. PMID- 3807145 TI - [Pulmonary vascular loop--respiratory disorders caused by vascular abnormality]. PMID- 3807146 TI - [Iatrogenic perforation of the esophagus in newborn infants]. PMID- 3807147 TI - [Pediatric rheumatology in Finland]. PMID- 3807148 TI - [Classification of chronic pancreatitis]. PMID- 3807149 TI - [Acute biliary cholecystopancreatitis]. PMID- 3807151 TI - [Drug occlusion of the pancreatic ducts in experimental pancreonecrosis]. PMID- 3807150 TI - [Endogenous intoxication in acute pancreatitis (classification principles and screening methods)]. PMID- 3807152 TI - [Method for the early assessment of pancreatic tissue viability in acute experimental pancreatitis]. PMID- 3807153 TI - [Planned pancreatic duct occlusion as prophylaxis and treatment in postoperative pancreatitis]. PMID- 3807154 TI - [Pancreatic lesions in acute poisonings]. PMID- 3807155 TI - [Clinico-morphological characteristics of chronic pancreatitis in pancreatic duct occlusion using KL-3 glue]. PMID- 3807156 TI - [Computed tomography in the differential diagnosis of pancreatic cysts]. PMID- 3807157 TI - [Choice of the method of surgical intervention in pancreonecrosis]. PMID- 3807158 TI - [Experience in treating functional paralytic intestinal obstruction in acute pancreatitis]. PMID- 3807159 TI - [Medical secrecy]. PMID- 3807161 TI - [Histodil in the combined therapy of acute destructive pancreatitis]. PMID- 3807160 TI - [Subtotal pancreatic resection in chronic posttraumatic pancreatitis with rupture of the cyst into the pleural cavity]. PMID- 3807162 TI - [Novocaine block of the round ligament of the liver in treating acute pancreatitis]. PMID- 3807163 TI - [Hemosorption in preventing the endogenous intoxication syndrome in acute pancreatitis]. PMID- 3807164 TI - [Complications of pancreatic pseudocysts]. PMID- 3807165 TI - [Asymptomatic pancreatic cyst in a pregnant woman]. PMID- 3807166 TI - [Duodenal necrosis as a complication of acute pancreatitis]. PMID- 3807167 TI - [Acute gastric obstruction caused by a pancreatic cyst]. PMID- 3807168 TI - [Long-term course of a pancreatic tumor]. PMID- 3807169 TI - [Diagnosis and treatment of acute calculous cholecystitis complicated by obstructive jaundice]. PMID- 3807170 TI - [Comparative evaluation of extended and limited selective proximal vagotomy in treating uncomplicated duodenal ulcer]. PMID- 3807171 TI - [Gastric motor function and bioelectrical activity before and after selective proximal vagotomy]. PMID- 3807172 TI - [Gastric phytobezoars and small intestine obturation in the late period after vagotomy]. PMID- 3807173 TI - [Use of the low-energy laser in the combined treatment of gastric and duodenal peptic ulcer]. PMID- 3807174 TI - [Rare combination of duodenal ulcer complications]. PMID- 3807175 TI - [Combined duodenal peptic ulcer and annular pancreas]. PMID- 3807176 TI - [Combined peptic ulcer and gallstones]. PMID- 3807177 TI - [Decompression measures in Billroth-II gastric resection for low duodenal ulcer]. PMID- 3807178 TI - [Surgical correction of the short bowel syndrome in the growing body]. PMID- 3807179 TI - [Evaluation of pancreatic function by rheography using an electrode probe]. PMID- 3807180 TI - [Changes in the activity of the blood serum glycolytic enzymes of patients with the edematous form of acute pancreatitis and cholecystopancreatitis]. PMID- 3807181 TI - [Tactics in paronychia]. PMID- 3807182 TI - [Classification of surgical procedures for acute cholecystitis]. PMID- 3807183 TI - [Errors in the diagnosis and treatment of patients with injuries of the abdominal organs and musculoskeletal system]. PMID- 3807184 TI - [Effect of various factors on the development of infectious complications in open fractures of the bones of the extremities]. PMID- 3807185 TI - [Osteosynthesis using metal plates in the treatment of the sequelae of para- and intra-articular fractures of the femur and tibia]. PMID- 3807186 TI - [Osteomyelitis of the spine following an abdominal wound]. PMID- 3807187 TI - [Treatment of closed fracture-dislocations of the hip joint]. PMID- 3807188 TI - [Diagnosis and prevention of postoperative thromboembolic complications]. PMID- 3807189 TI - [Surgical treatment of ununited fractures and pseudarthroses of the femoral neck]. PMID- 3807190 TI - [Sparing method of treating ingrown nails]. PMID- 3807191 TI - [Reconstruction of the congenitally absent thumb]. PMID- 3807192 TI - [Penetrating wound of the chest cavity and subclavian neurovascular bundle]. PMID- 3807193 TI - [Penetrating wound of the chest cavity]. PMID- 3807194 TI - [Subtotal resection of the small intestine and right-sided hemicolectomy after closed injury of the abdomen]. PMID- 3807195 TI - [Angiographic diagnosis of combined injuries of the spleen and left kidney]. PMID- 3807196 TI - [Rupture of the spleen in a patient with hemophilia A]. PMID- 3807197 TI - [Method of surgical treatment of closed fractures of the tubular bones (an experimental and clinical study)]. PMID- 3807198 TI - [Primary simultaneous surgery in combined and multiple fractures of the long tubular bones]. PMID- 3807199 TI - [Treatment of diaphyseal fractures of the leg bones]. PMID- 3807200 TI - [Arthrosis of the 1st metatarsophalangeal joint]. PMID- 3807201 TI - [Various arguments in favor of the surgical treatment of fractures of the spine]. PMID- 3807202 TI - [Prognostic value of arteriography in the treatment of patients with delayed union of the bones of the lower extremities]. PMID- 3807203 TI - [Local cooling and tissue blood flow of the hand following surgery]. PMID- 3807204 TI - [Reconstructive-rehabilitative treatment of defects and contractures of the hand and forearm]. PMID- 3807205 TI - [Local iodine-novocaine block in the treatment of interspinal ligamentoses]. PMID- 3807206 TI - [Chronic osteomyelitis of the pelvis]. PMID- 3807207 TI - [Closed craniocerebral injuries associated with injuries of the internal organs of the abdomen]. PMID- 3807208 TI - [Selection of a graft for plastic surgery of defects in the soft tissues of the foot]. PMID- 3807209 TI - [Anatomic basis for levels of duodenal injury in closed abdominal injuries]. PMID- 3807210 TI - [Ultrasonic therapy of wounds]. PMID- 3807211 TI - [Sequelae of chronic lesions of the extremities as a result of cold]. PMID- 3807212 TI - [Post-traumatic retroperitoneal hematomas]. PMID- 3807213 TI - [Tactics of the surgeon in combined injuries of the pelvic bones and urinary bladder]. PMID- 3807214 TI - [Treatment of patients with chemical burns of the esophagus and stomach]. PMID- 3807215 TI - [Plasmapheresis combined with hemosorption in the treatment of burns]. PMID- 3807216 TI - [Pancreatic surgery in chronic pancreatitis]. PMID- 3807217 TI - [Individually consistent (tolerable) intraocular pressure in glaucoma]. AB - The author has devised a technique for determining tolerable intraocular pressure; after the intake of hypotensive drugs the intraocular pressure and the optic functions (size of the blind spot, visual fields, visual acuity) are periodically checked. The lowered tonometric value which coincides with the maximum improvement in visual function is considered the individually compatible level of intraocular pressure. Determination of the individually tolerable pressure is important for diagnosis, prognosis, and treatment. Actual intraocular pressure must not exceed the tolerable pressure by more than 5 mm Hg, otherwise the prognosis will be poor. Differential diagnosis between glaucoma, ocular hypertension, and low-tension glaucoma can be established by determining the tolerable pressure. PMID- 3807218 TI - [Computer program controlled perimetry, its advantages and disadvantages]. AB - Following a short historical introduction and a description of basic methods of perimetry, computerized perimetry is described (taking the Octopus computerized perimeter as an example). The hardware-software concept and the three parts of the automatic perimeter, i.e., the controller, the measuring section, and the program section, are described. The technique of threshold determination, the programs (including the new Octopus programs), and the modes of representation of the results are explained. It is shown how one tries top take subjective criteria of the patient, such as attention, intelligence, and ability to concentrate into account during the measurements. The advantages and disadvantages of computerized perimetry are pointed out. It is emphasized that on average the range of scatter of measurements made with the automatic perimeter is smaller than when traditional manual methods are employed. In addition to the accuracy (scatter), the reproducibility (correlation) of the results is also better. Pathologic visual field defects are detected in greater detail and earlier by the automatic static perimeter than by manual perimetry. This applies in particular to early stages of retrobulbar neuritis and glaucoma. PMID- 3807219 TI - [Current results of nitrogen cryotherapy in eyelid basaliomas]. AB - By means of long-term follow-ups of large numbers of patients it has been established that nitrogen cryotherapy for lid basaliomas produces very good results with regard to the cure rate, as well as having considerable advantages over other treatment methods. In contrast to other authors we did not employ the spray method, but a very high-performance nitrogen cryo unit with a closed probe. Experimental measurements showed that this unit is capable of generating at least the same temperatures as with the spray method. The cryoapplication technique is described. The cure rate and causes of recurrence in the first series in the total of 84 patients treated from 1979 to 1983 were evaluated by long-term follow up. If cryobiological principles are observed and the recommended application technique is adhered to, the same cure rate can be achieved as with the spray method and other forms of treatment. There are considerable functional and cosmetic advantages, also as regards the patency of the lacrimal ducts. PMID- 3807220 TI - [Blepharospasm treatment with botulinum toxin (follow-up)]. AB - Within a period of 14 months 73 patients with idiopathic blepharospasm which could not be treated satisfactorily by any other form of therapy were treated by injections of botulin toxin. In 55 cases the follow-up period was sufficiently long to permit an evaluation. Thirty-five patients were temporarily completely free of complaints; in one patient there was no improvement. In the remaining cases there was a slight to distinct reduction in symptoms, which often cause severe suffering. The full effect of the drug lasted between 1 and 27 weeks (average 7.5 weeks). No systemic side-effects were observed; local side-effects (subcutaneous bleeding during injection, slight ptosis, intermittent diplopia) seen in 6 cases were of very minor significance. PMID- 3807221 TI - [Pseudoexfoliation syndrome as a cause of chronic glaucoma]. AB - A clinical study of 70 ambulant and stationary patients showed that of 104 eyes with pseudoexfoliation (PE) syndrome there were 62 eyes (60%) with confirmed chronic glaucoma and 8 (8%) with suspected chronic glaucoma. This is a considerably higher percentage than would normally be expected in a comparable group with an average age of 75 years (between 50 and 95 years). The biomicroscopic picture reveals symptoms of dispersion glaucoma with pigment participation. Provoked through diagnostic mydriasis by means of 0.5% tropicamide HCl and 10% phenylephrine HCl, 44 (52%) of the 84 eyes tested showed a significant increase in intraocular pressure by greater than or equal to 4 mm Hg and 20 (24%) by greater than or equal to 10 mm Hg. A possible cause of the pressure increase, in each case with open chamber angle, is the observed dispersion of the PE material and the adhering pigment fragments. From this observation and from a comparison with existing literature, it is inferred that the PE layers are the result of a sedimentation which also takes place in the chamber angle and in the trabecular meshwork, causing, in a first stage, chronic secondary open-angle glaucoma. In a second stage, the sediments may become detached from their base and cause pressure peaks through acute obliteration of the trabecular meshwork. The lack of proof of an inflammatory, immunological, or hereditary origin of this disease where it frequently occurs in certain areas, leads to the hypothesis of an alimentary or toxic disorder.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807223 TI - [Cavitation bubble dynamics and shock wave generation in eye surgery using the pulsed neodymium:YAG laser]. AB - In a model experiment using polyethylene membrane in balanced salt solution the processes which take place during posterior capsulotomy with pulsed Nd:YAG lasers were investigated by means of high-speed photography and hydrophone measurements. It was found that cavitation bubbles with a maximum diameter of 1.5 to 2.3 mm develop at the focal point even with a pulse energy of 5 mJ; i.e., their spatial extent is much greater than that of the ruptures observed. Furthermore, during optical breakthrough and when the bubble collapses shock waves are generated with a pressure amplitude of 9 to 16 bat at a distance of 18 mm or 162 to 288 bar at 1 mm. Previous estimates ranged from more than 0.1 bat at 15 mm to several kilobar at 1 mm. Above a certain threshold value the energy of the cavitation bubble and of the shock waves is approximately proportional to the energy of the laser pulses with which they are generated. At the same time pulse energy the diameter of the bubbles generated by Q-switched lasers is around 1.5 times as large as those generated by model-locked lasers--the bubble energies are more than three times as great. The shock wave amplitudes after O-switched pulses are likewise 1.5 times as great as after mode-locked pulses and the energy of the shock waves is approximately double. Nevertheless, the size of the holes caused in a polyethylene membrane with a pulse energy of 2 mJ to 5 mJ does not depend on the laser operating mode. Thus, with the polyethylene membrane, no great correlation was found between the mechanical energy acting on it and the size of the holes thus created.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807222 TI - [Eye changes in stenoses of the internal carotid artery--histologic and clinical findings]. AB - From a group of 26 patients with proven stenosis or occlusion of the internal carotid artery, 8 were selected who had typically developing chronic ischemia of the globe. Four eyes had to be enucleated due to painful secondary glaucoma. The results of histological examination correlated with the clinical findings, showing fibrovascular occlusion of the chamber angle with incipient endothelialization, pronounced hyalinization of the ciliary body, venous stasis of the choroidal and retinal circulation, and a predominantly perivenous lymphocytic infiltration of the optic nerve. The causal mechanisms are discussed. Particular attention is given to blood flow factors in the orbital area (in 5 of the 8 patients Doppler sonography showed a reversal of flow in the supratrochlear artery on the same side as the globe ischemia). Diagnosis and therapy require an interdisciplinary approach, since besides treating the ophthalmological complications it is vital to ensure stroke prophylaxis by improving cerebral circulation. PMID- 3807224 TI - [Visual disorders as key symptoms of ocular migraine]. AB - Vascular disturbance of the anterior visual pathways characterized by monocular visual experiences are sometimes caused by migraine. Retinal or ophthalmic migraine, a variant of complicated migraine, is distinctly rare. Two cases of female patients with ophthalmic migraine are reported. The relationships between the use of oral contraceptives and pregnancy are discussed. PMID- 3807225 TI - [Implantation of UV-absorbing posterior chamber lenses]. AB - The authors report on their experience with UV-absorbent posterior chamber IOLs (ORC) implanted between April 1, 1984 and April 1, 1985 (n = 125). Short-term complications and in particular post-operative sterile uveitis, corresponded to those in a group (n = 135) who had had regular PMMA lenses implanted. While no significant lowering of glare perception could be proved after implantation of the UV-block-lenses, color perception seemed to be more correct with these lenses. Because of the short observation time no significant statements can be made regarding the frequency of cystoid macular edema. PMID- 3807226 TI - [Surgical treatment of traumatic amaurosis]. AB - Exploration of the optic canal was performed in 5 patients with traumatic amaurosis. Fractures of the optical canal were found in 4 cases. One case in which the canal was intact was interpreted as evulsion of the optic nerve. Vision improved in one of the cases with a fractured optical canal. Exploration of the optic nerve is recommended in cases of traumatic amaurosis, always provided that the indication is correct. PMID- 3807227 TI - [A holder for the binocular Zeiss prismatic magnifying lens system for distance and/or closeness used in conjunction with the Visutest C or D]. AB - The author describes a simple, practical holder for demonstrating different prismatic magnifying binoculars (Zeiss system). PMID- 3807228 TI - [20 years' experience at a special department for diabetic retinopathy at the 1st University Eye Clinic in Vienna. A status determination]. AB - This survey summarizes the results of almost 20 years of scientific research into diabetic retinopathy. On the basis of examinations and experience in the treatment of 5734 diabetics suffering from retinopathy, present knowledge with regard to the epidemiology, pathogenesis, prophylaxis, and treatment of diabetic retinopathy is communicated and discussed. PMID- 3807229 TI - [Papilledema in insulin-dependent patients]. AB - The acute edematous capillaropathy of epipapillary and peripapillary radial vascolarization is an uncommon complication of type I Diabetes. Fluorescein angiography allows a reliable diagnosis to be made, because it provides good vision of the papilla and of the peripapillary posterior pole. The authors underline the importance of differential diagnosis because of the different therapeutic approach. PMID- 3807230 TI - [Laser treatment of diabetic maculopathy]. AB - The authors report on the techniques of laser treatment of diabetic maculopathy: focal direct laser coagulation of I.R.M.A. in exudative maculopathy; laser grid photocoagulation in edematous maculopathy. PMID- 3807231 TI - [Metabolic disorders in diabetic retinopathy]. AB - The results of the analysis of quantitative and qualitative lipoprotein metabolic disturbances in subjects with diabetic retinopathy are evaluated. The author discusses the role of the high level of various lipids in the pathophysiology of diabetic microangiopathy. PMID- 3807232 TI - [Long-term follow up of the lenses of diabetic patients using Scheimpflug photography linear densitometry]. AB - This article reports on changes in lenses of diabetics, detected by means of Scheimpflug photos. Diabetics aged between 20 and 70 have been undergoing regular ophthalmogical check-ups for 26 months. Linear densitometry of negatives revealed an increase in light scatter at the anterior adjacent clear zone of disjunction (areas 1,2) and the anterior cortex (areas 3,4) in clinically clear lenses over the 26-month period. This change in light scatter is not related to the age of the patients; it is correlated to the duration of diabetes and fasting blood sugar. PMID- 3807233 TI - [Effect of normoglycemic metabolic status in pregnancy on the course of diabetic retinopathy]. AB - Seventy-nine pregnant diabetic women were put under intensified obstetric observation during pregnancy with the aim of achieving normoglycemia. The prevalence and development of diabetic retinopathy were evaluated in 28 of these diabetic women and compared with a control group of 26 diabetic men. The present paper communicates the fundus changes, classified according to the stages of diabetic retinopathy, and their development in the two groups. PMID- 3807234 TI - [Retinal pseudothrombosis]. AB - As opposed to florid diabetic retinopathy, pseudothrombosis in type I diabetics has a favorable prognosis and responds well to panretinal photocoagulation therapy. In the past decade eight cases of retinal pseudothrombosis were evaluated, treated and kept under observation at the department for diabetic eye complications of the 1st University Eye Clinic, Vienna. Photocoagulation therapy repeated at brief intervals halted progression in all cases and improved visual acuity. In the follow-up period (2-10 years) no further episodes of progression were seen. PMID- 3807235 TI - [Oscillatory potentials as an indicator of functional changes in diabetic retinopathy]. AB - In diabetics it can be shown that after successful coagulation of the retina an increase in the amplitude of the oscillatory potentials (OP) takes place, indicating stabilization of retinal function. In Type I diabetics hypernormal and hyponormal OP amplitudes are seen prior to decompensation of the retina. Optimal regulation of diabetic metabolism can bring these pathologic OPs back into the normal range. PMID- 3807236 TI - [Pan-fundus photocoagulation (PRP)--prognostic aspects]. AB - Retinitis proliferans in the diabetic that can not be prevented by PRP can be attributed to insufficient treatment. Examination by means of fundus microscopy, stereochronoscopy of the macula, and computerized perimetry are of prognostic value. Increased PRP should be performed prior to any decision for vitrectomy. PMID- 3807237 TI - [Acute vitreous hemorrhage in diabetes--clinical aspects and follow-up]. AB - Diabetic retinopathy is the most important causative factor of all vitreous hemorrhages. Early vitrectomies improve the prognosis with regard to function and enable panretinal coagulation to be completed. PMID- 3807238 TI - [Fundus changes in hyperlipidemia]. AB - Of a total of 26 patients with hyperlipidemia, 4 developed flat yellow patches of varying size and shape in the macular area. In a different study a total of 9 subjects with similar flat yellow patches were examined; 6 had increased levels of serum cholesterol and triglycerides. The likelihood that such patients have hyperlipidemia is well over 50%. PMID- 3807239 TI - [Long-term study in goniotrepanation with various trephine diameters]. AB - Over a mean observation period of 3 1/2 years. 45 eyes operated on with the trephine diameter of 1.0 mm and 43 eyes operated on with the trephine diameter of 1.5 mm showed the same results with regard to the regulation of IOP, postoperative complications, the number of failures and the period of time elapsing between the operation and its failure. PMID- 3807240 TI - [Histologic and ultrastructural findings in the ciliary ganglion in normal eyes and in patients with glaucoma]. AB - The histological and ultrastructural findings in the ciliary ganglion of glaucomatous patients show proliferation of the satellite cells, vacuolate degeneration of the cytoplasma with loss of the mitochondria and ergastoplasma, and necrosis of the nucleus with decrease of chromatin. PMID- 3807241 TI - [Is YAG laser iridotomy suitable for the prevention of glaucoma attacks?]. AB - In a prospective clinical trial comprising 41 eyes with narrow-angle glaucoma, the patency of YAG laser iridotomy was checked using a rapidly-acting parasympatholytic drug. YAG laser iridotomy was performed after an acute attack of angle-closure glaucoma, in either the affected or the fellow eye. Tropicamide mydriasis had no effect on IOP either in the patient group or in the control group of ten normotensive eyes. PMID- 3807242 TI - [YAG laser iris hole at 6 o'clock in the periphery in the treatment or prevention of closed angle glaucoma and plateau iris and in pupillary block (posterior iris surface-blocking mechanism)]. AB - A shunt between the anterior and the posterior chamber, achieved by shooting an iris hole with a YAG Laser, is presumed to prevent angle closure in eyes with narrow angle glaucoma. Because of their thickening effect on all types of eye tissue, it is advisable to reduce pilocarpine and other miotics once the peripheral iris hole has been created. This is best made at 6 o'clock, since any hemorrhaging caused beneath this point will cease of its own accord. The shunt brings about deepening of the peripheral chamber, and almost always widens the angle in narrow angle glaucoma. PMID- 3807243 TI - [Limbus-based flap versus fornix-based flap in goniotrepanation]. AB - In a prospective, randomized study 61 eyes in which goniotrepanation had been performed using fornix-based or limbus-based conjunctival flaps were followed up for 4 to 18 months. No differences were found in the results of filtration, nor in the form and frequency of filtering blebs or the frequency of complications. In view of the easier technique and better visualization, the present authors prefer the fornix-based flap. PMID- 3807244 TI - [The blind spot: a critical review of the value of scanning perimetry in scotoma of known size]. AB - Using programs 33 and 34 of the Octopus 2000 automated perimeter the field within 30 degrees was examined in 20 normal eyes: The blind spot was rarely missed (2 X), quite often interpreted as a relative scotoma (21 X), less frequently as a small absolute scotoma (7 X) or as an absolute plus relative scotoma (10 X). These findings are also valid for all scotomas of equal or of smaller size located elsewhere within the examined field. PMID- 3807245 TI - [Visual fixation tonometry as an aid in the early diagnosis of endocrine ophthalmopathy]. AB - In some cases of autoimmunogenic hyperthyroidism an endocrine ophthalmopathy is found, but it is difficult to diagnose Graves' disease in early stages. Even before the occurrence of measurable morphological changes (measured by sonography and computed tomography of the orbit and eye muscles) short positional intraocular pressure changes are found in 64.5% of cases with autoimmunogenic dysthyreosis. These pressure changes are detected by positional applanation tonometry. These findings admit the conclusion that with the method described not only early detection of ocular signs associated with thyroid disease is possible, but also early differentiation between autoimmunogenic and nonimmunogenic thyroid disorders. PMID- 3807246 TI - [Incidence of conjunctival and corneal changes in dialysis patients]. AB - Deposits of calcium salts in the conjunctivas and corneas of 72 patients showed a statistically significant correlation to the duration of hemodialysis. The deposition of calcium salts is not influenced by other signs of disturbed calcium metabolism (Ca-PO4 product, alkalic phosphatase) or the patient's age. PMID- 3807247 TI - [Results of surgically and conservatively treated cases of traumatic optic nerve lesions]. AB - The problems of therapy are demonstrated by comparing a retrospective study and a prospective study of 29 cases with lesion of the optic nerve. Intensive cooperation between specialists and a quick diagnostic procedure facilitate therapeutic decision-making and lead to better results. PMID- 3807248 TI - [Regionalization of perinatal medicine. Where does neonatology belong?]. PMID- 3807249 TI - [Indications for studying evoked potentials in childhood. Methods--indications- value]. AB - Evoked potentials (EP) represent a valuable addition to currently applied diagnostic methods in neuropediatrics. Profound knowledge of the neurophysiological conditions producing EP-alterations allows basic conclusions, that cannot be gained or replaced by other investigations. EP-investigation demonstrate the existence but not the nature of a lesion in the CNS. Further diagnostic work-up usually will be necessary. Proved EP-alterations produce reproducible diagnostic results and give clues regarding its localization. Evoked potentials can be used as a screening-method for neuropediatric diseases. By follow-up examinations it is possible to show, wether there is progression or not. Testing for evoked potentials is indicated in suspected cerebral palsy in infants, in all cases of psychomotor retardation of unknown origin, impairment of vision or hearing, in cases of brain trauma or in suspected brainstem process, lesions of N. opticus or visual projective systems, neurometabolic or degenerative CNS disease, phacomatosis, progressive myoclonic epilepsy, ceroidlipofuscinosis Jansky-Bielschowski, benign partial epilepsy with extreme somatosensory evoked potentials, Ramsey-Hunt-Syndrome and aplasia of the corpus callosum. PMID- 3807250 TI - [Experience using transcutaneous pO2 measurement (tcpO2 measurement) during the transport of premature and newborn infants with artificial respiration]. AB - In 55 high-risk neonates of different birth-weight and gestational age, transcutaneous pO2 (tcpO2) was continuously monitored during transports from the Obstetric Units to the Neonatal Intensive Care Units. We were able to demonstrate that the need for oxygen was overestimated in most of the children and thus FiO2 could be reduced in nearly all cases. In this way, FiO2 can be adapted to the real need of the children and hypoxemias can be avoided as far as possible frequency and duration of hyperoxemias can be reduced. Moreover, valuable knowledge about further management of mechanical ventilation may be obtained. Complications, as e.g. obstruction of endotracheal tube, are more rapidly recognized than by ECG-monitoring alone. PMID- 3807251 TI - [Nutritional iron status of infants fed according to current recommendations]. AB - We examined the iron nutritional status of healthy term infants in a longitudinal study from 15 through 365 days of age. All infants were fed according to the present austrian recommendations. Serum hemoglobin (Hb) decreased from 15 through 122 days of age and remained constant thereafter. At 365 days of age, only 4.7% of the infants had hemoglobin levels below 11 g/dl, which is considered the borderline value for anemia. Mean corpuscular volume (MCV) of erythrocytes was changing during infancy. Free erythrocyte protoporphyrin (FEP) was constant from 122 days through 365 days of age. The upper normal value of 3 micrograms/gHb for infants older than 122 days of age corresponded to that for children older than one year and adults. Serum ferritin (SF) decreased from 15 through 183 days of age and remained constant thereafter. At 365 days of age, only 9.3% of the infants had SF below 10 micrograms/l, which is considered the borderline concentration for depletion of iron stores. We found no differences of iron nutritional status between infants who were breastfed longer than 122 days and infants who were breastfed shorter than 122 days or were fed formula. Our findings indicate that the prevalence of iron deficiency anemia and depletion of the iron stores is lower than in previous studies. Changes in infant nutrition during the last years resulted in higher iron intake and lower prevalence of iron deficiency. PMID- 3807252 TI - Orbital venous congestion in childhood. Diagnostic and therapeutical implications. AB - A case study of 2 patients with venous congestion of the orbit due to different etiologies is presented. Both the children demonstrated orbital pain, proptosis, chemosis and conjunctival injection. In one case early diagnosis left to complete recovery by conservative treatment in a patient with a pyogenic cavernous sinus thrombosis. In the other case a traumatic carotid sinus cavernous fistula could be treated successfully using transvasculary navigated detachable balloons. PMID- 3807254 TI - [Epidural hematoma as the initial manifestation of moderately severe hemophilia A]. AB - Epidural haematomas are rarely found in children; diagnosis can be difficult, as their symptoms are often atypic in the first years of life. Very few epidural haematomas were seen as the first manifestation of haemophilia. Ekchymoses of the skin, bleedings in the mouth and after trauma are usually observed here. As a consequence of the case reported here, we want to emphasize the importance of routine preoperative coagulation tests to discover a disorder of haemostasis unknown up to this point. Also the indication to hospitalize a child in order to survey him on the ward should be decided more often after head trauma, even if the symptoms the patient presents are not typical for epidural haematoma. PMID- 3807253 TI - [Acute heart failure in pheochromocytoma in childhood. Case report and demonstration of therapeutic possibilities]. AB - A noradrenaline-secreting phaeochromocytoma of extra-adrenal origin was found as cause of acute cardiac insufficiency in a 12-year-old child. After i.v. treatment with diuretics, digitalis and oral alpha-sympathicolysis with phenoxybenzamine the tumor was surgically removed several days later without further complications. PMID- 3807255 TI - Na+-Li+ countertransport and electrolyte composition in erythrocytes of patients with essential hypertension before and after antihypertensive treatment. AB - The effect of antihypertensive treatment with 6-12 mg of the loop diuretic piretanide over 12 weeks on Na+-Li+ countertransport, and on extra- and intracellular electrolyte composition was studied in 10 previously untreated patients with essential hypertension. These data were compared with 10 sex- and age-matched controls. Blood pressure fell from 180 +/- 18.3/110.5 +/- 9.8 to 154.7 +/- 9.7/92.5 +/- 10.9 mmHg during treatment. Na+-Li+ countertransport was significantly higher in hypertensives (0.36 +/- 0.13 mmol X l-1 rbc X h-1) compared with controls (0.25 +/- 0.05; P less than 0.05). Na+-Li+ countertransport and intracellular electrolyte composition remained unchanged whereas the extracellular potassium concentration fell from 4.28 +/- 0.51 to 3.98 +/- 0.36 mmol/l (P less than 0.05). No increase in the intracellular Na+ content as compared with normotensive controls was found. It is concluded that the intracellular Na+ concentration is not a marker for essential hypertension. The Na+-Li+ countertransport does not seem to be directly related to elevated blood pressure but seems to be a general marker for diseases associated with an increased risk for the development of hypertension. PMID- 3807256 TI - [Empirical study of the assessment of diagnostic procedures as exemplified by the Hemoccult test]. AB - We offered a questionnaire to 52 physicians in order to study the appreciation of the fecal occult blood test as an example of a diagnostic procedure. We asked for an indication of the overall appreciation of the test, and for an estimation of the probabilities of colorectal cancer before the test and with a positive or a negative test result--each of them for three situations with different a priori probabilities. The answers demonstrated that the estimated value of the test, representing the personal experience of the physicians is very low (predictive factor between 0.61 and 0.78). About half of the physicians' estimations showed no improvement of probability by using Haemoccult. This contrasts with the expressed very positive general opinion about Haemoccult testing, including its use in symptomatic patients. This result underlines the necessity of careful evaluation of diagnostic tests. PMID- 3807257 TI - [Increase in liver circulation with nifedipine]. AB - The hepatic hemodynamic effect of 20 mg sublingual nifedipine was evaluated in 15 patients (13 men, 2 women) during heart catheterization. The liver blood flow was measured 10 min after administration of nifedipine by continuous thermodilution (Baim coronary sinus flow analyzer). Nifedipine was associated with a decrease in systolic blood pressure (from 156 +/- 14 to 138 +/-13 mmHg), an increase in heart rate (from 73 +/- 13 to 81 +/- 8.6 beats/min), and increase in cardiac output (from 6.0 +/- 1.6 to 6.5 +/- 1.3 l/min). In 2/15 patients no significant change was derived. The liver blood flow increased in 13/15 patients from 218 +/- 171.7 to 336.7 +/- 247.7 ml/min (22%-194%, P less than 0.01). The study demonstrates that the vasodilation of nifedipine involves the hepatic circulation. If the hepatic clearance of drugs is high and flow dependent, nifedipine-induced increase of hepatic blood flow may impair drug clearance. PMID- 3807258 TI - Transferrin receptors on tumor and bone marrow cells: lack of involvement as target structure for natural killer cells. AB - Two different experimental approaches based on the specificity of monoclonal antibodies (mAbs) have been taken to verify the hypothesis that the transferrin receptor (TfR) on proliferating cells serves as a common target structure for natural killer (NK) cells. Thus, by the lysostrip technique the TfR was removed from the surface of K562 and Molt4 tumor cells by incubation with two different anti-TfR mAbs. The effect of removal of the TfR was controlled by uptake of radiolabeled transferrin, and by binding of non-cross-reacting monoclonal anti TfR receptor antibodies. Though the modulation of TfR on the membrane of viable cells was nearly complete, the cells remained fully susceptible to NK lysis. The second approach consisted in removal of TfR-bearing cells from bone marrow cell suspensions by an indirect rosetting technique. Using mAbs bound to ox erythrocytes the rosetted TfR-bearing cells could be removed from bone marrow cell suspension by density centrifugation with an efficiency of greater than 99%. It could be shown that both fractions, TfR+ and TfR- cells, could be lysed to the same degree by NK cells. Thus, the evidence obtained speaks against a role of TfR as a recognition structure for NK cells. PMID- 3807259 TI - Thrombotic thrombocytopenic purpura without anemia. AB - A patient is described who presented with fever, fluctuating neurological abnormalities, renal dysfunction, and thrombocytopenia. The necropsy revealed the classic histological findings of thrombotic thrombocytopenic purpura (TTP). Hemolytic anemia and fragmented red cells, hallmarks of TTP, were absent in our patient; this does not fit into the classic description of this syndrome. PMID- 3807260 TI - [Hemangiosarcoma of the heart]. AB - The clinical appearance, typical localization, diagnostic procedure and the treatment of hemangiosarcoma--the most frequent malignant tumor of the heart are reported by the case of a 27 years old woman. The patient suffered from dyspnea, congestion of the superior caval vein and paroxysmal tachycardia. X-ray showed cardiac enlargement due to pericardial effusion. Echocardiography revealed a large tumor in the right atrium. Computertomography and angiocardiography showed tumor masses at the orifice of the superior caval vein and a bypass of the blood flow via the azygos vein. Thoracotomy yielded an inoperable hemangiosarcoma. By the combined treatment of irradiation and chemotherapy the cardiac tumor completely disappeared, the patient was temporary symptomless. Later metastases occurred and the patient died 13 months after diagnosis. PMID- 3807262 TI - [5th meeting of the German Society for Clinical Hemorrheology. 7-8 November 1986, Marburg/Lahn. Abstracts]. PMID- 3807261 TI - [Granulomatous gastritis of the antrum in generalized sarcoidosis]. AB - A 42-year-old man had a 4 year history of sarcoidosis stage II (lung). In biopsied specimens of the antrum we found epithelioid granulomas caused by gastric involvement in sarcoidosis. Coincidentally we found a gastric ulcer which was later the source of gastric bleeding. The granulomas were located around this ulcer and also under intact mucosa. Therefore, in our opinion it was not the case that granulomatous gastritis caused the ulceration in a direct way. We saw a connection between hypercalcemia--often found in patients with sarcoidosis, as in our patient--and the gastric ulcer. Therapy was thus aimed at lowering the blood calcium concentration. Steroids were avoided at this time. The ulceration healed, although granulomatous gastritis continued. PMID- 3807263 TI - [Neutralization of low molecular weight heparin Kabi 2165 by protamine chloride]. AB - Low molecular weight (LMW) heparin Kabi 2165 possesses improved pharmacodynamic properties compared with conventional heparin. It is currently investigated in the prophylaxis of thromboembolism. The neutralization of Kabi 2165 by protamine chloride was analysed after i.v. injection of both the agent and the antidot in healthy persons. The anticoagulant effects of the LMW heparin on the activated partial thromboplastin time, thrombin, and thromboelastography are completely and immediately suppressed by protamine chloride. The inhibition of factor Xa is antagonized up to 50%-60%. The bleeding time remained unaffected. The data indicate that protamine chloride may be used in clinical situations as an antidot to the LMW heparin Kabi 2165. A rebound phenomenon of the anticoagulant effect does not occur. PMID- 3807264 TI - Weight reduction and salt restriction in hypertension: effects on blood pressure and intracellular electrolytes. AB - In 16 essential hypertensives on a program of energy restriction (800 kcal/day) with and without simultaneous salt restriction, the effects on blood pressure and intracellular Na+ and Ca2+ in red blood cells were studied. A decrease in blood pressure and intracellular free Na+ and Ca2+ was only observed in the cases of simultaneous energy and salt restriction. The beneficial effect of weight reduction in hypertension thus depends on a diminished salt intake and is probably mediated by changes in intracellular free Ca2+. PMID- 3807265 TI - Posttransfusion purpura. A survey of 13 cases. AB - Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977-1985 are described. All patients were women with a mean age of 58.6 years (range, 36-77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10 X 10(9)/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy. PMID- 3807266 TI - Meningopolyneuritis Bannwarth with focal nodular myositis. A new aspect in Lyme borreliosis. AB - A patient with serologically confirmed infection by Borrelia burgdorferi presenting with painful paresis and atrophy of the proximal muscles of both upper extremities and bilateral facial paresis is described. Electromyography showed a neurogenic and myopathic pattern, and creatine kinase was raised. Muscle biopsy revealed the typical signs of focal myositis. Treatment with i.v. penicillin led to dramatic clinical and serological improvement. Muscle biopsy was repeated 2 months later; neurogenic changes were still present, but no inflammatory signs could be seen anymore. Thus, the presented case may be the first reported of meningopolyneuritis accompanied by focal nodular myositis, in the second stage of Lyme borreliosis. PMID- 3807267 TI - Successful therapy of sarcoidosis-associated thrombocytopenia refractory to corticosteroids by a single course of human gammaglobulins. AB - Thrombocytopenia developed in a 21-year-old patient with sarcoidosis when corticosteroid therapy was discontinued. Platelet-associated IgGs were elevated. High-dose cortisone did not affect the thrombocytopenia. However, platelet counts remained normal for more than 1.5 years following intravenous treatment with a single course of human gammaglobulins. PMID- 3807268 TI - Pancreolauryl test in chronic pancreatitis. AB - The pancreolauryl test was performed in 30 subjects with chronic pancreatitis, in order to evaluate its behavior in relation to the duration of the clinical history and the presence of pancreatic calcifications, diabetes mellitus, jaundice, and pancreatic pseudocysts. A significant inverse linear correlation was found between the onset of symptoms and FDL test values. While calcifications and diabetes were present in patients with both normal and abnormal test results, those with pseudocysts or jaundice always had pathological results. PMID- 3807269 TI - Tyrosine loading in patients with hepatic cirrhosis: lack of effect on plasma catecholamines. AB - Plasma norepinephrine concentrations are often elevated in patients with hepatic cirrhosis in relation to the stage of disease and possibly in response to a decrease in "effective" arterial blood volume. Since tyrosine, the precursor for catecholamines, is said to influence the rate of catecholamine biosynthesis within the central nervous system and peripheral sympathetic structures, we tested whether basal hypertyrosinemia and increased plasma tyrosine levels after oral loading with l-tyrosine are associated with elevated plasma catecholamine concentrations. Baseline norepinephrine (NE) and epinephrine (E) were significantly higher in 17 patients with decompensated cirrhosis, as compared with 11 healthy controls (NE: 809 +/- 108 pg/ml vs 295 +/- 16 pg/ml; E: 69 +/- 9 pg/ml vs 36 +/- 8 pg/ml). No significant correlation between the basal plasma tyrosine and norepinephrine level could be demonstrated in patients with cirrhosis (r = 0.04). Oral tyrosine loading (100 mg/kg b.w.) administered in six equal doses did not change the level of catecholamines, whereas plasma tyrosine increased two- to three-fold. Even a large single dose (14 g l-tyrosine) failed to alter plasma catecholamines in six cirrhotic patients with marked ascites. We therefore conclude that the enhanced availability of tyrosine in cirrhotics does not influence catecholamine biosynthesis in peripheral sympathetic neurons. PMID- 3807270 TI - [Concentration of thiobarbituric acid reactive substances (TBARS) in serum following myocardial infarct]. AB - The serum concentration of thiobarbituric acid reactive substances (TBARS), which can be used in the characterization of O2-radical metabolism, was analyzed in patients with myocardial infarction in the acute phase, 10-14 days, 1 month, and 6 months after infarction, and compared with the TBARS concentration of a healthy group and a group with atherosclerosis. After myocardial infarction we found increased TBARS concentration at all moments of investigation in comparison with the healthy and atherosclerosis groups. Maximum concentration was found 10-14 days after infarction, afterwards the TBARS concentration decreased, without however attaining the values which we found in the comparison groups. The increased TBARS concentration 6 months after myocardial infarction demonstrates a manifestation of disturbances in the O2-radical metabolism. Such disturbances may be regarded as a high-risk factor to the cardiovascular system. PMID- 3807271 TI - Serum laminin--its concentration increases with portal hypertension in cirrhotic liver disease. AB - The concentrations in serum of the high molecular weight glycoprotein laminin and of the N-terminal propeptide of type III procollagen were determined in various histologically proven fibrotic liver diseases (n = 33), of which the portal venous pressure has been measured indirectly. The concentrations of both biomatrix proteins were related to the portal venous pressure. Laminin in serum of normal persons (n = 146) ranged from 0.81 to 1.43 U/ml. Compared with the mean normal concentration (1.04 U/ml) the glycoprotein is increased in fibrotic liver lesions in parallel with the severity of the fibrotic organ transformation reaching the highest values (2.58 +/- 0.87 U/ml, P less than 0.001) in liver cirrhosis (n = 12). The level of N-terminal propeptide of type III procollagen increased similarly, but the concentrations of both matrix proteins exhibit only weak statistical correlations (r = 0.6680). The level of laminin is correlated strongly with the elevation of the portal venous pressure in cirrhotic (r = 0.9206) and fibrotic (r = 0.7157) subjects. For the propeptide of procollagen the respective correlation is r = 0.4808. Molecular sieve chromatography reveals a heterogeneous composition of laminin-related antigens in serum with two main molecular weight fractions of 700 and 300 kD, respectively. PMID- 3807272 TI - [Further comment on the diagnosis of appendicitis and surgical procedures]. PMID- 3807273 TI - [Experience in treating diffuse suppurative peritonitis]. PMID- 3807274 TI - [Gastric mucosal function in the late period following selective proximal vagotomy with pyloroplasty]. PMID- 3807275 TI - [Postural compression syndrome complicated by acute kidney failure]. PMID- 3807276 TI - [Pancreatic function in patients with chronic alcoholic pancreatitis]. PMID- 3807277 TI - [Orthostatic changes in the circulatory system in chronic alcoholism]. PMID- 3807278 TI - [Strangulation of the appendix in a femoral hernia]. PMID- 3807279 TI - [Adrenal pheochromocytoma]. PMID- 3807280 TI - [Guillain-Barre syndrome in chronic active viral (HBsAg-positive) hepatitis]. PMID- 3807281 TI - [Causes of chronic constipation in adults]. PMID- 3807282 TI - [Anaerobic nonclostridial infection in suppurative surgery]. PMID- 3807283 TI - [Diagnostic significance of tryptophan in the protein-free fraction of blood serum in suppurative surgical infection]. PMID- 3807284 TI - [Surgical treatment of adrenal arterial hypertension]. PMID- 3807285 TI - [Diagnosis and treatment of intestinal obstruction due to biliary calculi]. PMID- 3807286 TI - [Intestinal infarct in occlusive lesions of the inferior mesenteric artery]. PMID- 3807287 TI - [Effectiveness of glucocorticoid-saturated endocardial electrodes]. PMID- 3807288 TI - [Effect of heart valve prosthesis on immunity in rheumatism patients]. PMID- 3807290 TI - [Indications for hemosorption and its effectiveness following embolectomy of the major arteries of the extremities]. PMID- 3807289 TI - [Surgical correction of microcirculatory disorders in patients with varicose veins and post-thrombophlebitic syndrome]. PMID- 3807291 TI - [Surgical results in patients with ulcerative duodenal stenosis]. PMID- 3807292 TI - [Principles of the therapy of emergency states]. PMID- 3807293 TI - [Computed x-ray tomography and angiography in the diagnosis of pancreatic cancer]. PMID- 3807294 TI - [Disseminated intravascular coagulation syndrome in acute pancreatitis]. PMID- 3807295 TI - [Evaluation of the functional status of pilots by the indices of interhemispheric asymmetry]. AB - The stability of the functional asymmetry of brain hemispheres (with respect to the right ear coefficient - REC) of pilots was investigated during their exposure to extreme flight factors. It was found that the functional asymmetry of brain hemispheres was sufficiently stable in the subjects whose initial REC was not less than 10%. After exposure the decline of the REC in some subjects was accompanied by deterioration of their health status and quality of their operational work. PMID- 3807296 TI - [Bioelectrical activity of the heart and blood electrolytes in virtually healthy subjects during 120-day head-down tilt hypokinesia]. AB - Electrocardiographic parameters and serum concentrations of potassium, sodium, calcium (total and ionized) and magnesium in 6 essentially healthy men, aged 30 45 years, were measured before, during and after 120-day head-down tilt at -4.5 degrees. A close correlation was demonstrated between T-wave depression and serum concentrations of potassium (direct correlation) and calcium and magnesium (inverse correlation). No consistent changes in the sodium content during the 120 day test were seen. In spite of electrolyte changes in blood induced by head-down tilt, ECG variations showed minor hypokalemia that was not followed by any clinical symptoms. These data can be used to evaluate the status of healthy people exposed to prolonged hypokinesia and to develop adequate prophylactic measures. PMID- 3807297 TI - [Effect of immersion hypokinesia on the parameters of human muscle potentials]. AB - During 3-day immersion hypokinesia stimulation muscle potentials and averaged potentials of total EMG of m. biceps brachii were investigated in six test subjects. Stimulation potentials were obtained by exciting n. cutaneous with a train of square impulses. Potentials were recorded using a combined multi + electrode. Averaged potentials of total EMG were recorded by means of the same electrode. The propagation rate of the potentials, duration of their negative and end-positive phases as well as the length of their negative phase in space were measured. In addition, vector-electromyographic images of the potentials were recorded. After immersion hypokinesia the propagation rate decreased significantly, the duration of the end-positive phase increased and the length of the depolarized zone of potentials in space shortened. The decrease of the rate of propagation of stimulation potentials was 28% and that of averaged potentials of total EMG was 31% per group. These changes developed rapidly enough, indicating shifts in the properties of potentials of action of myofibers during immersion. Factors responsible for these changes are discussed. PMID- 3807298 TI - [Changes in the content of bile acids and lipids in human bile during head-down tilt hypokinesia and their correction]. AB - The spectrum of bile acids and bile lipids in men exposed to 120-day head-down tilt was investigated. The test subjects were subdivided in to four groups: group 1-bed rest per se, group 2-bed rest + exercise, group 3-bed rest + drugs normalizing calcium metabolism, and group 4-bed rest + exercise + drugs. It was anticipated that biliary concrements would primarily be formed in group 1 and 2 subjects. They showed a low level of bile acids and a high content of total Ca and cholesterol in the bile, which was more pronounced in the C portion (decrease of the cholate/cholesterol coefficient). Group 2 subjects displayed a modified synthetic function of the liver: prevalence of tauroconjugates in the bile (decrease of the ratio of glucoconjugates to tauroconjugates). Group 3 and 4 subjects showed a faster synthesis of bile acids in the liver and a lower content of total calcium and cholesterol in the bile, the latter being more distinct in group 4 subjects. Positive dynamics of these parameters is a factor responsible for a reduced lithogeny of the bile. However, the test subjects of these groups exhibited hazardous changes that may be responsible for concrement formation. This is indicated by a lower concentration of the lipid complex in the bile, possibly at the expense of a lower content of phospholipids. This emphasizes the necessity of further search for prophylactic procedures aimed at normalizing the synthetic function of the liver under hypokinetic conditions. PMID- 3807299 TI - [Quantitative study of the osteoblasts and osteoclasts in the bones of rats during the simulation of weightlessness]. AB - Tibia and vertebrae of rats exposed to hypokinesia or head-down suspension were investigated by quantitative histomorphometry. It was found that 35- and 60-day hypokinesia as well as 35-day suspension caused osteoporosis in the tibial and vertebral spongiosa. The development of osteoporosis was accompanied by a significant reduction in the number of osteoblasts in the primary spongiosa of tibia and vertebrae whereas no noticeable changes in osteoclasts were observed either in hypokinetic or suspended rats. The only exception was lumbar vertebrae in which the amount of osteoclasts decreased as a result of 60-day hypokinesia. It is assumed that the reduction in the number and activity of osteoblasts plays the major part in the development of osteoporosis during hypokinesia and suspension. PMID- 3807300 TI - [Possibilities for pharmacological correction of regional osteoporosis in an unsupported extremity]. AB - In 20- and 40-day rat studies the prophylactic effect of retabolil and calcitrin (calcitonin) against hypodynamics-induced osteoporosis was investigated. Hypodynamics was produced by surgical amputation of the lower third of the leg and hence by loss of the support function of the limb. Retabolil was injected intramuscularly at a dose of 0.2 ml once a day for 10 days and calcitrin was injected subcutaneously at a dose of 2 units MRC in 0.5 ml distilled water once a day. The results indicate that osteoporosis in the supportless bone of the experimental animals and that seen during space flight developed in a similar way. In the experiment retabolil and calcitrin inhibited the progressive development of osteoporosis but the strongest effect was obtained upon a combined application of the two drugs. PMID- 3807301 TI - [Thresholds of long-latency evoked potentials and of the sensations of motion occurring during human exposure to linear accelerations]. AB - Forty-seven healthy test subjects were exposed several times each to linear acceleration of varying value. Depending on the acceleration value, they reported subjectively three types of sensations at the threshold level: nondiscriminated in terms of direction (P1, a = 8.0 +/- 2.5 cm/sec2), inverted (P2, a = 12.4 +/- 2.5 cm/sec2) and discriminated (P3, a = 16.1 +/- 3.5 cm/sec2). The acceleration value at which P2 was recorded caused most typical responses in different test subjects whereas that at which P3 was recorded induced greatest individual variations. Evoked potentials in response to linear acceleration were recorded in such a manner which excluded potential instrumental artefacts or possible contribution of eye movements, excitation of the hearing organ and muscle tone changes. The data obtained indicate that acceleration-induced evoked potentials are predominantly of vestibular origin and consist of three peaks, viz. P1, N1, and P2, the latencies of which are equal to 31.3 +/- 7.2, 69.1 +/- 9.1 and 157.6 +/- 10.5 msec at the threshold where they emerge. The peak P1 is most variable, the peak N1 is most stable and the peak P2 is characterized by the largest ratio of the interindividual variation to the individual variation. PMID- 3807302 TI - [Mathematical model of the otolith]. AB - This paper describes a mathematical model of the otolith of mammals represented as a system with parameters of distribution. Two versions of the model are analyzed and the lowest frequencies of natural oscillations of the system are evaluated. PMID- 3807303 TI - [Reactivity of the sympathetic-adrenal system and physical loading tolerance in multiple exposures to a permanent magnetic field]. AB - For 30 days rats were exposed daily 3 hrs a day to a constant magnetic field of 1.6 T. The time within which the rats were swimming with a load until they were fatigued was measured and the concentration of catecholamines in blood and adrenals was determined. Two stages of the response to the magnetic field were identified. During the first stage (1-15 days) physical work capacity increased and the reactivity and reserve ability of the sympatho-adrenal system (SAS) grew. During the second stage (30th day and early recovery period) work capacity returned to normal and the SAS reactivity decreased, although the catecholamines stored in the adrenals remained unchanged. These findings indicate that the SAS is involved in mechanisms underlying changes in work capacity and adaptation processes during exposure to a constant magnetic field. PMID- 3807304 TI - [Calculation of the equilibrium concentrations of the components of a CO2-CO-H2O H2-N2 gas mixture for the cathode space of an electrolyzer with solid electrolyte and the corresponding values of the theoretical decomposition voltage]. PMID- 3807305 TI - [Pathological phenomena in the organs of the lesser pelvis following exposure to +Gz loads of high value and duration]. PMID- 3807306 TI - [Group dynamics and work efficiency under extreme conditions]. PMID- 3807307 TI - [Mechanism of action of local negative pressure applied to the human body on central circulatory dynamics]. PMID- 3807308 TI - [Polyamine level in the brain of rats during long-term hypokinesia]. PMID- 3807310 TI - The sequence of events in gallstone formation. PMID- 3807309 TI - [Radiation-protective effect of insoluble polyanion in prolonged gamma irradiation]. PMID- 3807311 TI - Experimental cholelithiasis in the ground squirrel. AB - Richardson's ground squirrels of both sexes were fed a 2% cholesterol-enriched rat chow diet for various intervals from 6 hours through 20 weeks. Bile was withdrawn from the organs and analyzed biochemically to obtain a lithogenic index. The remaining luminal contents were rinsed from the resected organs and examined by light and scanning electron microscopy. Gallbladder tissue was fixed and examined in a similar fashion to observe the luminal aspect of the epithelial sheet. Scanning electron microscopy revealed increased mucus secretion before precipitation of rhomboidal cholesterol monohydrate crystals from the lithogenic bile. The crystals grew by appositional layering into microliths and then by aggregation into mulberry-shaped stones. Mucus hypersecretion continued to be a common epithelial observation throughout the study. Five days after introduction of the diet, a thick discontinuous sludge-like layer was observed overlying large regions of the epithelial sheet. In later stages, this material was observed embedding cholesterol crystals into the surface aspect of the stone. By 20 weeks many stones were approximately 2 mm in diameter and were accompanied by large numbers of various sized concrements. The nature of the cholesterol crystals and stone formation pattern closely resembled that reported for humans. The ground squirrel fulfills all criteria required to be regarded as an excellent animal model and is well suited for continued study into the role of the epithelial cell during cholesterol cholelithiasis. PMID- 3807312 TI - Microscopic fluorometric analysis of Na-fluorescein transport in the smallest secretory unit (couplet hepatocytes) and the effects of cytochalasin B. AB - The uptake and secretion of sodium fluorescein by couplet hepatocytes was examined in primary culture. When sodium fluorescein was added at an early stage of primary couplet hepatocytes culture, this resulted in a rapid uptake of the dye and its subsequent accumulation in bile canaliculi. From microscopic fluorometry observations, cytochalasin B pretreatment of the couplet hepatocytes caused much more rapid uptake and secretion of the dye in bile canaliculi. The present study indicates that the cholestatic agent cytochalasin B causes choleresis at the bile canalicular level of cultured couplet hepatocytes and also indicates that a defect in canalicular secretion plays no role in the cytochalasin B-induced impairment of bile flow. PMID- 3807313 TI - Manganese-bilirubin cholestasis. Further studies in pathogenesis. AB - To further delineate the mechanism of manganese-bilirubin cholestasis, studies were done to determine: the structural status of the canalicular tight junctions in the model, and the effect of the lack of bilirubin conjugation. The results indicate that canalicular tight junction alterations characteristic of many types of cholestasis develop in this model and that bilirubin conjugation is not a requisite for the cholestatic effect of bilirubin to occur. It is unclear whether the tight junction alterations are the cause of the cholestasis or either secondary effects of the cholestasis or associated noncausal occurrences. The fact that bilirubin does not need to be conjugated in order to effect cholestasis confirms that the cholestasis is due to intrahepatocytic (as opposed to intracanalicular) effects, and may be useful in determining the precise locus and nature of these effects. PMID- 3807314 TI - Quantitation and characterization of glomerular procoagulant activity in experimental glomerulonephritis. AB - Glomerular procoagulant activity (PCA) was studied in four different models of experimental glomerulonephritis (GN) in rabbits. These models included 3 macrophage-dependent models: active autologous phase anti-glomerular basement membrane (GBM) antibody induced GN (active anti-GBMGN); passively induced autologous phase anti-GBMGN, and acute serum sickness; and a macrophage independent model of injury, heterologous phase anti-GBMGN was included also. PCA in glomerular lysates was significantly augmented in the three macrophage dependent models, but not elevated significantly in heterologous anti-GBMGN when compared to glomerular lysates from normal rabbits. The greatest augmentation of PCA was found in glomeruli from rabbits with active anti-GBMGN which also contained the greatest numbers of macrophages. The functional characteristics of the glomerular PCA were similar in each of the models studied. Initiation of coagulation in vitro by these lysates was shown to be dependent on the presence of coagulation Factors VII and V, and largely independent of Factors XII and VIII, suggesting that glomerular PCA activates the extrinsic coagulation pathway. Inhibition studies using concanavalin A and phospholipase C demonstrated that glycoside residues and phospholipids are important chemical moieties for the coagulant activity of PCA. After sonication and ultracentrifugation PCA was found in the cell membrane fraction but not in the cell cytosol of glomerular lysates. These studies provide further evidence that glomerular PCA is markedly augmented in the presence of infiltrating glomerular macrophages and demonstrate that glomerular PCA has the functional characteristics of 'tissue factor', the procoagulant expressed by macrophages on their cell surface membrane. The quantitative association of glomerular PCA with glomerular macrophages, together with the shared functional characteristics of glomerular PCA and macrophage PCA, together suggests that the augmented glomerular PCA in experimental GN is due to tissue factor from infiltrating macrophages (macrophage PCA). PMID- 3807315 TI - Effect of beta-D-xyloside on the renal glomerular cells. II. Morphological studies. AB - The effect of p-nitrophenyl-beta-D-xylopyranoside on the renal glomerulus was studied. Rat kidneys were labeled with [35S]sulfate in the presence or absence of beta-xyloside by using an isolated organ perfusion system and were processed subsequently for morphological studies. By using electron microscopy, preferential intracytoplasmic vesiculation of the visceral epithelium was observed in the beta-xyloside-treated kidneys. The vesicles were distributed throughout the cytoplasm, particularly in the vicinity of Golgi apparatus. They were acid-phosphatase negative, devoid of clathrin-coat, and contained osmium impregnated reaction products. The visceral epithelial foot processes remained firmly attached to the glomerular basement membrane. No loss of cell-surface associated sialoglycoproteins, as evidenced by colloidal iron staining, was observed. No significant change in the morphological features of glomerular endothelial or mesangial cells was noted. By using electron microscopy autoradiography, a significant increase in the number of silver grains over the epithelium, and a decrease in the number over the extracellular matrices was observed. The majority of the grains were either associated with intracytoplasmic vesicles or Golgi apparatus. The mean grain densities (concentration of radiation) increased by 3.6-fold for the epithelium, and decreased by 2.4- and 1.6-fold for the basement membrane and mesangial matrix, respectively. The grain densities over the endothelial and mesangial cells were similar in control and experimental groups. These data indicate that xyloside induces selective alterations in Golgi apparatus of the visceral epithelium and a dramatic imbalance in the de novo synthesized sulfated macromolecules of cellular and extracellular compartments. PMID- 3807316 TI - Polycation binding to glomerular basement membrane. Effect of biochemical modification. AB - The polycation hexadimethrine (HDM) binds to anionic sites in the glomerular basement membrane (GBM) and causes heavy proteinuria when infused in vivo. An in vitro assay of 3H-HDM binding to isolated dog GBM was developed, to permit further analysis of the GBM components binding HDM. 3H-HDM binding to isolated GBM was saturable, reversible in dose-dependent fashion by competing polycations, and inhibited by increasing salt concentration and low pH. The pH dependence of binding suggested that most of the HDM binds to carboxyl groups rather than to the sulfate groups of proteoglycans. Removal of heparan sulfate by heparinase or purified heparatinase had no detectable effect on HDM binding. Treatment of GBM with neuraminidase, hyaluronidase, or chondroitinase reduced binding of HDM by a maximum of 20 to 38%. However, substitution of carboxyl anions with nonionizable glycine methyl ester residues resulted in complete elimination of HDM binding. Parallel results were obtained in studies of glomerular localization of cationized ferritin (CatF), pI 8.5. After carboxyl substitution, GBM did not bind CatF; heparinase-treated GBM bound CatF in a distribution not demonstrably different from normal. Cellulose acetate electrophoresis of glycosaminoglycan fractions prepared from treated GBM confirmed that carboxyl modification did not alter the content or charge of the heparan sulfate of GBM, but heparinase treatment removed at least 90% of heparan sulfate. The results indicate that carboxyl groups are quantitatively more important than heparan sulfate for binding of HDM in vitro. Since HDM causes proteinuria in vivo, carboxyl groups may be important for maintenance of normal permselectivity. PMID- 3807317 TI - Low molecular weight proteinuria exacerbates experimental ischemic renal injury. AB - To determine whether tubular reabsorption of low molecular weight proteins (LMWPs) alters ischemic tubular injury, rats were infused with 25 mg of lysozyme (isoelectric point (pI) 11.3), cytochrome C (pI 10.6), ribonuclease (pI 8.7), or myoglobin (pI 7.0), and during this time 25 minutes of bilateral renal artery occlusion (RAO) was induced. RAO control rats received either saline or 25 mg of albumin. Renal injury was assessed 24 hours later by blood urea nitrogen, creatinine, and histology. Lysozyme, ribonuclease, and myoglobin each exacerbated ischemic damage (increased tubular necrosis, cast formation, azotemia), but to comparable degrees (e.g., blood urea nitrogen range 75 +/- 8 to 100 +/- 5 mg/dl versus controls, 29 +/- 2 to 36 +/- 7; p less than 0.01). Rendering lysozyme anionic (pI 4.5) by succinylation did not diminish its acute renal failure potentiating effect. Cytochrome C which is freely filtered but poorly reabsorbed had a minimal impact on the ischemic process. Infusion of LMWPs did not alter blood pressure, renal blood flow, or induce renal injury in the absence of RAO. During a sublethal ischemic event (10 minutes of RAO) LMWP infusion exacerbated proximal tubular luminal membrane damage before an adverse effect on other critical determinants of cell integrity were apparent (adenine nucleotide pools, oxidant stress). We conclude that endocytic LMWP reabsorption by proximal tubules can exacerbate superimposed ischemic tubular necrosis independent of any direct nephrotoxic protein effect. This action is not influenced by protein isoelectric point and appears to be mediated by a primary intensification of ischemic luminal membrane damage. PMID- 3807318 TI - Myocardial cell growth and blood pressure development in neonatal spontaneously hypertensive rats. AB - We evaluated the changing morphologic features of cardiac muscle cells (myocytes) and nuclei from neonatal spontaneously hypertensive rats (SHR) and their parent, normotensive strain Wistar Kyoto rats (WKY) and compared these with increasing heart weight and blood pressure development to determine if alterations in cell growth were present at this early stage of development. Femoral artery blood pressures were obtained from rats at 2 to 5-day intervals from birth to 21 days of age by using a micropipette servo-null pressure recording system. Tritiated thymidine autoradiography was used to study myocyte nuclear development, and isolated myocytes were prepared to evaluate cell-size changes by using a Coulter Counter system (Coulter Electronics, Hialeah, Florida). Heart weight and blood pressure were elevated in SHR when compared to WKY at birth. Myocytes were all mononucleated at birth in both strains and were of equal size, demonstrating that the larger heart mass in SHR was due to an increased number of cells. Heart weight relative to body weight remained greater in SHR when compared to WKY throughout the 28-day study period, but cell numbers became equal in the two strains by the 2nd week. A this time (6 to 9 days postpartum) blood pressure was also similar in both strains, but increased significantly again in SHR by 15 and 21 days of age. Cell maturation occurred earlier in SHR than in WKY as indicated by an earlier development of binucleate myocytes and there was an earlier initiation of hypertrophic myocyte growth in SHR. Increase in SHR cell size occurred at a time when blood pressures were not different, suggesting that greater cell size in SHR than in WKY was not due to differences in blood pressure. Therefore, when compared to the WKY, the SHR had three phases of altered cell growth: a first phase of accelerated hyperplastic growth during the fetal period, and a second phase (6 to 12 days of age) of earlier initiation of hypertrophic cell growth and increased myocyte size. The SHR myocyte changes in the second phase occurred while the SHR and the WKY blood pressures were not significantly different. Finally, in a third phase (at 15 days of age and over), SHR had a sustained increase in myocyte size as well as elevated blood pressure. PMID- 3807319 TI - Pulmonary fibroblasts: a model system for studying elastin synthesis. AB - Pulmonary interstitial fibroblasts were isolated from 4-day neonatal rat lung and cultured for varying periods of time after first passage. The ability of the cells to synthesize both soluble and insoluble elastin was examined by biochemical, immunological, and ultrastructural techniques. The cells synthesize a tropoelastin of 75,000 daltons which is cross-linked in the extracellular matrix to form sufficient amounts of insoluble elastin to be characterized directly by amino acid analysis. Although the cells produce a soluble form of elastin immediately after confluency and the deposition in the matrix begins shortly thereafter, the actual chemical definition of alkali-resistant elastin does not occur until 4 weeks after confluency. The apparent molecular weight of tropoelastin synthesized by the cells agrees with the molecular size of tropoelastin found in organ culture of neonatal lungs. The pulmonary fibroblast cultures provide an important model system for examining the regulation and response of elastin synthesis in lung interstitium. PMID- 3807320 TI - Quantitative analysis of benzene by selected ion monitoring/gas chromatography/mass spectrometry. AB - A selected ion monitoring gas chromatographic/mass spectrometric method for the quantitative determination of benzene in air, breath, and blood was developed utilizing a headspace assay with benzene-d3 as an internal standard. Limits of detection for 2 ng/mL in blood and 0.1 ppb in a 5-L sample of air or breath were attained. The influence of contamination by background benzene on the analytical process was studied carefully. For cases where background contamination could not be adequately controlled, the assay was modified for the quantitative determination of labelled benzenes six mass units heavier than natural benzene (benzene-d6 or benzene-13C6). Use of the method for the analysis of natural benzene was illustrated for the measurement of background levels in urban smokers and nonsmokers. PMID- 3807321 TI - Determination of trazodone and its metabolite, m-CPP, in serum and urine by HPLC. AB - A sensitive and rapid method for the analysis of trazodone (TZD) and its metabolite, 1-(m-chlorophenyl)piperazine (m-CPP), in the serum and urine of rabbits treated with the drug was developed. The assay requires extraction from the biological fluids with adequately buffered organic solvents followed by HPLC. The assay allows good reproducibility, fair recovery, and excellent linearity in the range of 0.6 to 10 micrograms/mL for TZD and 1.2 to 20 micrograms/mL for m CPP. PMID- 3807323 TI - The quantitation of triazolam in postmortem blood by gas chromatography/negative ion chemical ionization mass spectrometry. AB - A specific and sensitive assay has been developed to quantitate triazolam in postmortem blood using 2H6-triazolam as an internal standard. Triazolam is isolated from whole blood by adsorption on an Amberlite XAD-2 resin and subsequent elution with an organic solvent. The extract is analyzed by gas chromatography/mass spectometry using selected ion monitoring (GC/MS/SIM) in the negative chemical ionization mode (Cl-). The procedure is presently being used in case work and the results from 36 cases are presented. PMID- 3807322 TI - Analytical methods for determination of neat and microencapsulated trichloroethylene in dosing vehicles and whole blood. AB - Gas chromatographic methodologies were developed for the analysis of microencapsulated trichloroethylene (TRI) in corn oil and feed dosage formulations as well as neat TRI in corn oil and whole blood. Recovery, precision, linearity, and the appropriateness of a linear regression model were evaluated for each method. In all cases recovery was greater than 96% and linearity of the standard curves was confirmed. Good precision and chromatographic resolution were obtained for all samples analyzed. PMID- 3807325 TI - Simplified method for determination of plasma nifedipine by gas chromatography. AB - The gas chromatographic assay for nifedipine was simplified by mixing 1 mL of plasma, 50 microL internal standard, and 950 microL of ethyl ether. After vortexing and centrifugation, the organic layer was transferred and evaporated, then reconstituted with 100 microL of ether. A 10-microL sample was injected into the GC. Several steps as well as the use of special lighting and columns are eliminated in the procedure. This method is determined to be linear, specific, sensitive, precise, and accurate. PMID- 3807324 TI - Influence of biological matrix on retention behaviour and identification possibilities of selected neutral and acidic drugs in thin layer chromatography. An interlaboratory investigation. AB - Samples of autopsy blood and liver were spiked individually with aminophenazone, p-aminosalicylic acid, clordiazepoxide, clonazepam, cyclobarbital, furosemide, medazepam, phenacetin, phenazone, and phenobarbital and extracted with diethyl ether at pH 5. The extracts, as well as solutions of pure drugs, were developed in three thin layer chromatographic systems: chloroform:acetone (80:20), ethyl acetate:methanol:ammonia (85:10:5) and chloroform:methanol (90:10). The investigations performed in parallel in two laboratories showed that the intra- and inter-laboratory variability of RF values is larger for drugs extracted from liver. The biological matrix affected both precision and accuracy of results. The number of analysts involved in TLC procedures also affected the intra-laboratory precision. PMID- 3807326 TI - Determination of thallium in urine with Zeeman effect graphite furnace atomic absorption. AB - Thallium is determined in urine with a simple dilution as the only sample pretreatment. Zeeman effect background correction provides adequate accommodation for non-atomic absorption such that sufficient diluted urine can be introduced into the furnace to achieve a detection limit of 0.5 ng/mL. Precision and accuracy were evaluated with Environmental Protection Agency water samples and in vitro spiked urine pools; precision of 15% at the 6 ng/mL level was observed. Diluted urine was used in calibration, with only 4 to 5% difference in slope observed within run among randomly selected urine specimens. PMID- 3807327 TI - Coca tea and urinalysis for cocaine metabolites. PMID- 3807328 TI - Reduced paraquat does not exhibit MPTP-like neurotoxicity. PMID- 3807329 TI - Cyclobenzaprine overdose: the importance of a clinical history in analytical toxicology. PMID- 3807330 TI - Medical surveillance of civil engineering contractors on an ex-gasworks site. PMID- 3807331 TI - Chronic ethylene oxide poisoning in a factory manufacturing medical appliances. PMID- 3807332 TI - School years completed and 5-year changes in pulmonary function and respiratory symptoms in U.S. white male coal miners. PMID- 3807333 TI - The distance learning course in occupational medicine. PMID- 3807334 TI - Sharing occupational health services--four years' experience. PMID- 3807335 TI - Glomerulonephritis associated with hydrocarbon solvents. PMID- 3807336 TI - Alienation and its psychological correlates. PMID- 3807337 TI - The factorial structure of American attitudes toward male nurses. PMID- 3807339 TI - Intrinsic religious orientation: implications in the study of religiosity and personal adjustment in the aged. PMID- 3807338 TI - Somatosensory theory and personal violence (suicide and homicide). PMID- 3807340 TI - Age stereotypes as a function of profession. PMID- 3807341 TI - Symbolic play and social participation abilities of language-impaired and normally developing children. AB - The symbolic play and social participation behaviors of 6 language-impaired and 8 normal language-learning children were compared on three measures of play: (a) the Symbolic Play Test (Lowe & Costello, 1976), (b) the Brown-Lunzer Scale (Brown, Redmond, Bass, Liebergott, & Swope, 1975), and (c) the Scale of Social Participation in Play (Tizard, Philps, & Plewis, 1976). Subject groups were equated for MLU (Brown, 1973), Developmental Sentence Scoring (Lee, 1974), and performance on the Test of Auditory Comprehension of Language (Carrow, 1973). Results indicated that the language-impaired subjects demonstrated significant deficits in symbolic, adaptive, and integrative play behaviors in comparison with the linguistically equivalent normal subjects. The language-impaired group also evidenced significantly more nonplay and significantly less solitary and parallel play than their normal peers. Findings are discussed with respect to the developmental relationship between language and cognition. PMID- 3807342 TI - Developing assertiveness during employment interviews with young adults who stutter. AB - Assertiveness training procedures have been demonstrated to be effective in working with a variety of clinical populations. Persons who stutter represent a group for whom assertiveness skills may be particularly useful. The present study evaluated the effectiveness of an assertiveness training program that included instruction, modeling, behavior rehearsal, feedback, social reinforcement, and homework. Dependent variables included putting the employer at ease, corrective feedback for interrupting, responding to pejorative statements, and acknowledging positive employer behaviors. The results indicated substantial increases in the target behaviors as well as improvements in subjective ratings of baseline and posttraining interviews. A collateral benefit was a sizable posttraining decrease in the amount of stuttering. These results are discussed with reference to future research isolating the influence of assertiveness skills on stuttering. PMID- 3807343 TI - Cognitive strengths and weaknesses in language-impaired children: one more look. AB - The hypothesis-testing abilities of 15 language-impaired and 15 normally developing children matched for mental age were investigated using discrimination learning tasks. The subjects in both groups were presented with two sets of discrimination-learning problems. One set of problems featured explicit input concerning the correct response choice. The other set of problems featured nonexplicit input. The results revealed both differences in the performance of the MA-matched and language-impaired children and differences in performance on the two types of problems. The children in both groups solved more of the explicit input problems than the nonexplicit input problems. In addition, the MA matched children performed significantly better than the language-impaired children, particularly on the nonexplicit problems. The findings suggested that the language-impaired children exhibited deficits in solving discrimination learning problems. The deficits exhibited by the language-impaired children seemed related to deficits in their ability to encode information. PMID- 3807344 TI - Assessing communicative intents in young children: low structured observation or elicitation tasks? AB - This longitudinal study examines the effectiveness of two different assessment methodologies, low structured observation and structured elicitation tasks, to obtain communicative intents from 35 sensorimotor children. The subjects, 9 months of age at the onset of the study, were observed under the two experimental conditions every 3 months, for a 15-month period. The results reveal differences between the two approaches that vary according to the age of the child and eliciting context. The implications of the findings are examined. PMID- 3807345 TI - Story recall and inferencing skills in language/learning-disabled and nondisabled children. AB - Children's ability to recall information and draw inferences from orally presented narratives was examined in sixteen 9- to 10-year-old language/learning disabled (LLD) children and two groups of normally developing children (sixteen 9 to 10-year-olds and sixteen 6- to 7-year-olds). Short fable-like stories were presented to the children, followed by a series of premise and inference questions (half true and half false). The children were also asked to retell each story in their own words either before or after the question sets. Significant overall differences in performance (p less than .05) were seen between the LLD group and the age-matched control group and between the two control groups. The LLD children did not differ significantly from the younger aged control group. Additionally the LLD group exhibited significantly more disparity between the true and false questions than the age-matched controls. For all the groups, inference questions were significantly more difficult than premise questions. Recall of the story prior to answering questions had no effect on question answering. PMID- 3807346 TI - Examination of two issues concerning functional gain measurements. AB - The test-retest variability of aided sound-field thresholds and the feasibility of using corrected 2-cm3 coupler gain values to predict individual functional gain were examined. Test-retest data were used to generate critical differences (in dB) for statistical significance between two aided sound-field thresholds. To be significantly different at the .05 level, two aided thresholds would have to differ by greater than 15 dB. Functional gain and 2-cm3 coupler gain were compared for 20 subjects using careful measurement procedures. Individual variability in the difference between functional gain and 2-cm3 coupler gain was reduced substantially from previous studies and indicates that corrected coupler gain measurements may have some clinical utility. PMID- 3807347 TI - Phonetic development in identical twins differing in auditory function. AB - The subjects of this report are identical (monozygotic) twin boys who differ in auditory function. One has normal hearing; the other has a profound hearing loss bilaterally. These boys offered a rare opportunity to study the effects of hearing loss on vocal development with reasonable control over environmental and genetic factors. This initial report focuses on their vocal development over the sampled ages of 8, 12, and 15 months. Acoustic-phonetic differences in the babbling of the two boys were evident in the 8-month sample (the first recording opportunity), and some differences between them became greater over the succeeding samples at 12 and 15 months. The major differences were in the formant patterns of vocalic elements; the frequency of occurrence of fricatives, affricates, and trills; histograms of syllable type; and variation in vowel usage. The data hold implications for the early identification of infants at risk for communication disorder and for the understanding of auditory-motor processes in phonetic development during infancy. PMID- 3807348 TI - Matching commercial hearing aids to prescriptive gain and maximum output requirements. AB - Insertion gain and saturation sound pressure level (SSPL) characteristics of 71 behind-the-ear hearing aids were evaluated in a computer-assisted analysis as acceptable matches to prescriptive insertion gain and SSPL values derived by a variation of the Prescription of Gain and Output, or POGO, technique (McCandless & Lyregaard, 1983). Stringency criteria in a primary analysis varied from +/- 6 to +/- 16 dB and +/- 2 to +/- 8 dB for gain and SSPL, respectively. Three audiometric contours and associated loudness discomfort levels were used in the simulation. Findings indicated that the relationship between tolerances and the number of aids selected as optimally appropriate varied substantially as a function of audiometric configuration. Minimum gain and SSPL tolerance values of +/- 12 dB and +/- 4 dB, respectively, were required to provide a reasonable choice of instruments for a variety of such configurations. Further analyses shed light on the feasibility of using alternative stringency criteria and on the clinical utility of hearing aid selection using small clinic samples. PMID- 3807349 TI - Predicting spoken language acquisition of profoundly hearing-impaired children. AB - The Spoken Language Predictor (SLP) Index is a proposed guide for making recommendations regarding the most appropriate communication mode to be used in educating a given hearing-impaired child. The SLP Index is the sum of points obtained on five predictor factors that have been weighted according to their contribution to successful spoken language acquisition. The point values assigned for each factor as well as assignment of points to particular test scores within each factor was accomplished by subjective clinical judgment followed by trial application to actual clinic cases. Three ranges of SLP indexes are associated with three educational recommendations: speech emphasis (SLP = 80-100), provisional speech instruction (SLP = 60-75), and sign language emphasis (SLP = 0 55). The purpose of this article is to describe the development and application of the SLP and preliminary evidence for its stability and validity. PMID- 3807350 TI - Immunization with heat-killed pneumococci, but not pneumococcal capsular polysaccharides, improves survival in splenectomized mice. AB - Immunization with pneumococcal capsular polysaccharides (pn PS) is advocated after splenectomy to decrease the risk of overwhelming sepsis. The clinical and experimental evidence for the benefit of immunization after splenectomy is controversial. Various reports in the literature have claimed a benefit of immunization after splenectomy, but careful review of methodologies reveals that heat-killed pneumococci (pn) were used to immunize the experimental animals. Since we have not been able to protect splenectomized (splx) mice by immunization with pn PS, we compared survival after live pneumococcal aerosol challenge and antibody (Ab) responses in splx and sham splx mice immunized with either pn PS or heat-killed pn. Immunization with either heat-killed type 3 pn or pn type 3 PS improved survival in sham-splx mice compared to saline controls (p less than 0.001). Only immunization with heat-killed type 3 pn improved survival in splx mice (p less than 0.001), while pn PS had no effect on survival compared to saline splx controls. Ab responses to pn type 3 PS measured by enzyme linked immunosorbent assay were depressed in splx mice compared to sham-splx mice regardless of the method of immunization. Sham-splx mice immunized with heat killed pn had higher Ab levels compared to mice vaccinated with pn PS (p less than 0.001) suggesting an adjuvant effect in sham-splx mice. The data suggest that immunization with pn PS may not be beneficial to a splx host. Improved survival after immunization with heat-killed bacteria in splx mice may be related to Ab responses to antigens other than the capsular polysaccharide. PMID- 3807352 TI - Effective hepatic blood flow and hepatic bioenergy status in murine peritonitis. AB - To assess the effects of sepsis on effective hepatic blood flow (EHBF) and hepatic tissue bioenergy status 250-350 g rats underwent either sham laparotomy or cecal ligation and perforation (CLP). At 5-, 10-, and 20-hr intervals cardiac output (CO), EHBF, and tissue adenine nucleotide levels were measured. CLP rats showed a hyperdynamic response to sepsis at 20 hr, with CO increased by 25% over sham rats. At all time intervals studied EHBF was decreased and at 20 hr it was maximally decreased by 35%. Hepatic energy charge (HEC) was calculated from tissue adenine nucleotide measurements. HEC was not statistically different in sham and CLP rats at 5 hr and was 11 and 9% reduced from sham levels in CLP rats at 10 and 20 hr, respectively. Thus, EHBF is decreased very early in sepsis; before any changes in hepatic bioenergy status are noted. In this hyperdynamic model of sepsis EHBF is decreased early and decreases progressively with time which may contribute to the significant decrease in HEC that is demonstrated. PMID- 3807351 TI - Effect of superoxide dismutase plus catalase on Ca2+ transport in ischemic and reperfused skeletal muscle. AB - Cytotoxic oxygen metabolites may contribute to skeletal muscle damage associated with ischemia and reperfusion. This study utilized a rat hindlimb ischemia model to investigate the effect of pretreatment with oxygen free radical scavengers superoxide dismutase (SOD) and catalase (CAT) on skeletal muscle Ca2+ uptake by sarcoplasmic reticulum (SR) in limbs subjected to periods of ischemia and reperfusion. SOD and CAT were conjugated to polyethylene glycol to prolong their half lives. Anesthetized rats (ca. 350 g) received an iv injection of either conjugated SOD (2 mg/kg) plus CAT (3.5 mg/kg) (n = 6, Treated Group) or 0.9 saline (4 ml/kg) (n = 6, Control Group) 5 min before unilateral hindlimb tourniquet ischemia of 3 hr duration. After 19 hr of reperfusion, muscle from each lower leg was excised and homogenized. Skeletal muscle SR was isolated by differential centrifugation. ATP-dependent Ca2+ uptake by the SR was then measured with dual wavelength spectrophotometry and used as an index of muscle function. Pretreatment with SOD and CAT maintained higher rates of Ca2+ uptake by SR of skeletal muscle from postischemic reperfused limbs (Treated Group 2.29 +/- 0.21 vs Control Group, 1.61 +/- 0.06 mumole Ca2+/mg protein/min). These results implicate cytotoxic oxygen metabolites in the pathogenesis of ischemic reperfusion skeletal muscle injury. PMID- 3807353 TI - Valvular obstruction of blood flow through saphenous veins. AB - To measure effects of vein valves upon blood flow through venous bypass conduits, 15 human saphenous veins (mean length 40.6 cm, 5.3 valves/vein) were perfused with normal saline at constant pressure (100 mm Hg). Flow through vein was measured before and after valve bisection. Vein valves were bisected using Leather's techniques. After valve bisection, flow in antegrade and retrograde directions was measured in seven veins. These data were analyzed using paired t tests. Antegrade flow through seven veins with intact valves averaged 317.1 cc/min. With valve bisection this increased significantly (P less than 0.001) to 474.3 cc/min. Retrograde flow through veins with valves bisected increased significantly (P less than 0.0001) to 428.3 cc/min. Eleven veins (mean length 42.2 cm, 5.6 valves/vein) perfused simulated capillary beds with banked blood using pulsatile flow (mean pressure 92 mm Hg). Flow, again, was measured before and after valve bisection. Data were analyzed using the paired t test. Antegrade flow increased from 124.4 cc/min in veins with valves intact to 142.5 cc/min once valves were bisected (P = 0.02). These data demonstrate that saphenous vein valves cause significant obstruction to blood flow under conditions similar to those in the arterial system. Bisection of vein valves significantly increases flow through vein. Improved patency of vein grafts using valve bisection techniques may be explained by increased blood flow alone. PMID- 3807354 TI - Calcium-accentuated ischemic damage during reperfusion: the time course of the reperfusion injury in the isolated working rat heart model. AB - The purpose of this study was to determine the time course of calcium-induced postischemic reperfusion injury to the myocardium, using an initial short-term calcium-enriched reperfusion solution. The isolated rat heart model was subjected to 30 min of normothermic potassium cardioplegia-induced ischemic arrest. Control hearts received normal calcium Krebs-Henseliet buffer (KHB) reperfusion. Experimental hearts were challenged with 10 min of calcium-enriched (KHB) reperfusion starting at 0, 1, 2, 5, 15, and 30 min after the beginning of reperfusion. Aortic flow recovery 60 min after reperfusion was used to determine functional recovery. Control hearts recovered 82 +/- 3% of preischemic aortic flow. Hearts which received calcium challenge at 0 and 1 min after the start of reperfusion recovered 43 +/- 4 and 69 +/- 3% of preischemic aortic flow, respectively (P less than 0.01 and P less than 0.05, respectively). Hearts which received calcium challenge 2, 5, 15, and 30 min after reperfusion recovered 75 +/ 2, 80 +/- 2, 85 +/- 2, and 83 +/- 2% of preischemic aortic flow, respectively. Our results indicate that the postischemic myocardium is very susceptible to calcium-accentuated ischemic damage during the initial period of reperfusion. The postischemic heart, however, quickly recovers its ability to withstand a calcium challenge. Five minutes after the start of reperfusion the heart is not influenced by calcium challenge. PMID- 3807355 TI - A comparison of ornithine decarboxylase and S-adenosylmethionine decarboxylase activity in human large bowel mucosa, polyps, and colorectal adenocarcinoma. PMID- 3807356 TI - Effects of portacaval shunt and hepatic artery ligation on liver surface oxygen tension and effective hepatic blood flow. AB - Liver surface oxygen tension (LSOT) and nutrient hepatic blood flow (NHBF) were measured in rats 1 hr and 1 week after sham operation, portacaval shunt (PCS), and hepatic artery ligation (HAL). LSOT was measured using a heated Clark electrode (37 deg) and was expressed as percentage of rectus muscle O2 tension to correct for changes in systemic oxygenation. Nutrient hepatic blood flow (NHBF) was measured using steady-state, low-dose galactose clearance pharmacokinetics. Acutely, we found a close correlation between LSOT and nutrient hepatic blood flow after both hepatic artery ligation and portacaval shunt. At one week after hepatic artery ligation, LSOT and nutrient hepatic blood flow made parallel increases. However, 1 week after portacaval shunt, LSOT increased while nutrient hepatic blood flow remained reduced. The divergence in these results between the two methods of producing hepatic hypoperfusion, implies that LSOT recovers via a different mechanism after portacaval shunt. Recovery of LSOT at one week probably reflects normalization of hepatic O2 delivery after hepatic artery ligation and impaired oxygen utilization after portacaval shunt. PMID- 3807357 TI - Phagocytic function of polymorphonuclear leukocytes and the RES in endotoxemia. AB - The reticuloendothelial system (RES) and the polymorphonuclear leukocytes (PMNs) are thought to play a major role in defense against sepsis. Disturbances in the function of these two phagocytic systems during a septic event is associated with the development of lung capillary injury. Endotoxemia is said to lead to similar changes. Our study examined the function of the RES and PMNs after bolus injection of endotoxin (2 micrograms/kg BW) in a standardized sheep model. For up to 24 hr after endotoxin, blood samples were drawn and PMN function was followed by chemiluminescence, chemotaxis, and adherence as well as the phagocytosis and killing of bacteria. RES function was determined by the blood clearance of a labeled Tc99 colloid. We found an increase of RES clearance directly after endotoxin. Chemotaxis, phagocytosis, and killing were reduced. Adherence was increased. Chemiluminescence peak maximum (CLPM), representing the metabolic activity of the PMNs, was initially increased but shortly thereafter showed a significant decline (at 1 hr: 0.52 +/- 0.13 X 10(6) cpm with P less than 0.05 compared to baseline). The chemiluminescence peak time (CLPT), a measure of membrane receptor function, was significantly reduced (10.0 +/- 2.2 min with P less than 0.001 compared to baseline). Endotoxin led to a reduction of intracellular PMN functions (phagocytosis, killing, CLPM) within 1 hr. Membrane localized functions (adherence, CLPT) were increased. The changes in PMN function might be the reason for the development of lung capillary injury, in spite of undisturbed RES clearance. PMID- 3807358 TI - A reproducible model of acute hepatic failure by transient ischemia in the pig. AB - A model of transient acute hepatic failure has been developed in the pig. Three days after a functional end-to-side portacaval shunt was introduced, 15 ambulant animals underwent total liver ischemia for 4 to 6 h by the closure of a mechanical clamp surrounding the hepatic artery. Four of the eight animals subjected to 4 hr of ischemia survived. All but one of the animals undergoing 6 hr of hepatic ischemia developed grade 4 encephalopathy after 24 to 30 hr and died within 50 hr. Quantitative estimation of liver cell necrosis revealed less than 40% necrosis in the survivors, and approximately 62% (range 49-75%) in animals who died of hepatic coma. As far as the putative toxins are concerned, significant differences were found between animals undergoing 4 and those undergoing 6 hr of ischemia, especially in the plasma ammonia levels and the plasma ratios for tyrosine and phenylalanine. Plasma arginine levels had fallen to zero in both groups at 24 hr and only rose to preischemic values in animals who survived. This large animal model fulfills the accepted criteria of potential reversibility, reproducibility, and death due to hepatic failure. PMID- 3807359 TI - Proceedings of the XII meeting of the International Study Group for Steroid Hormones. Rome, Italy, 2-4 December 1985. PMID- 3807360 TI - Autoradiographic localization of glucocorticosteroid and progesterone binding sites in the human post-mortem brain. AB - The presence of glucocorticosteroid and progesterone binding sites in the human brain has been investigated with an in vitro autoradiographic approach using [3H]RU 38486. The present data revealed that the hippocampus, the entorhinal cortex, the subiculum, the fimbria and the amygdala showed a different pattern of [3H]RU 38486 labeling using various unlabeled steroids (RU 38486, RU 28362, cortisol, RU 27987 and dexamethasone). RU 38486 is the best competitor in all these structures. The hippocampus seems to possess mainly glucocorticosteroid binding sites whereas the entorhinal cortex and the subiculum reveal the presence of both glucocorticosteroid and progesterone binding sites. Furthermore, the amygdaloid complex and the fimbria show a high density of glucocorticosteroid binding sites. PMID- 3807361 TI - Function and plasticity of brain corticosteroid receptor systems: action of neuropeptides. AB - Two types of corticosteroid receptors may be distinguished in rat brain. Type 1 resembles the kidney mineralocorticoid receptor and Type 2 is similar to the liver glucocorticoid receptor (GR). Type 1 receptor system displays two functional expressions, i.e. Type 1 corticosterone (CORT)-preferring sites (CR) and Type 1 mineralocorticoid receptors (MR). MR occurs in circumventricular organs and mediates behaviors such as salt appetite. CR has its principal localization in neurons of the hippocampus, and mediates tonic influences of CORT on hippocampus-associated functions. CR responds with stringent specificity to CORT. Differentiation between CR and MR is due to a different accessibility of the receptor by CORT and ALDO, which seems dependent on the presence of extravascular corticosteroid binding globulin (CBG). GR has a wide distribution in brain, occurs in neurons and glial cells and has its principal localization in such regions as the paraventricular nucleus and the n. tractus solitarii (site of CRF synthesis and of blood pressure regulation, respectively). GR mediates the feedback action of CORT on stress-activated brain processes. GR is subject to autoregulation by CORT. Chronic stress, senescence, and chronic CORT administration reduce receptor number, while GR capacity is increased after adrenalectomy. Reduced GR receptor number results in a less-efficient feedback action. The CORT signal via CR probably can only be altered via changes in CR density evoked rather by neural factors than by autoregulation. CR density is reduced at senescence, but is increased to receptor number of young control animals after chronic treatment with a behaviorally potent ACTH-(4-9) analogue, Org 2766. CR plasticity is prominent for the hippocampus, which is a structure involved in cognition, emotional state and subtle regulation of pituitary-adrenal function. PMID- 3807363 TI - Effects of estradiol on proliferation of endometrial adenocarcinoma cells (Ishikawa line). AB - Estradiol (E2) stimulates the proliferation of human endometrial adenocarcinoma cells of the Ishikawa line, which had been previously shown to respond to estrogen by increasing their levels of progesterone receptor and the specific activities of DNA polymerase alpha and alkaline phosphatase. Although E2 (10(-8) M) did not increase rates of proliferation during the initial logarithmic growth period of the cultures under the chosen experimental conditions (MEM with 15% charcoal-treated fetal bovine serum renewed every 2-3 days), it sustained cell proliferation after about day 10, when parallel control cultures had reached plateau cell densities. Cell proliferation in control cultures at plateau levels was resumed when the hormone was added. Growth rates of cultures containing E2 from the time of seeding and the proportion of quiescent cells, estimated by using a simple cell kinetic model, decreased steadily with time. Ornithine decarboxylase and DNA polymerase alpha activities, as well as estrogen receptor levels, also decreased with time in culture. Ishikawa cells formed colonies in soft agar; colony formation efficiencies were higher as the number of cells seeded was increased from 10,000 to 100,000 cells/6 cm dish, were not influenced by the addition of E2 to the medium (10(-9) to 10(-5) M) and were markedly reduced by difluoromethylornithine (10(-2) M), an effect that was counteracted by putrescine (25 X 10(-6) M). PMID- 3807362 TI - Measurement of testosterone and its 5-alfa-reduced metabolites in human prostatic tissue using isotope dilution mass spectrometry. AB - 5 alpha-Dihydrotestosterone (DHT) has been widely measured in human prostatic tissue using RIA since it is found to be involved in pathogenesis of human prostatic hyperplasia (BHP) and to be the best index for the follow-up of patients affected by prostatic cancer under endocrine treatment. A GC/MS method for the simultaneous determination of testosterone (T), dihydrotestosterone (DHT), 5 alpha-androstan-3 alpha,17 beta-diol (3 alpha-diol) and 5 alpha androstan-3 beta-17 beta-diol (3 beta-diol) in prostatic tissue was developed based on the isotopic dilution technique. Trideuterated internal standards of each compound were previously synthesized in our laboratory. After previous extraction and purification on Sep-Pak C-18 cartridges and Lipidex DEAP columns, T and its metabolites were measured as heptafluorobutyric esters (HFB). Quantitative analysis was performed on a VG 7070 EQ mass spectrometer equipped with a fused silica capillary column using the Selected Ion Monitoring technique. Steroid values (means +/- SD; ng/g tissue) found in 9 human hypertrophic prostates were: T, 0.71 +/- 0.43; DHT, 4.46 +/- 1.41; 3 alpha-diol, 0.34 +/- 0.23; 3 beta-diol, 0.14 +/- 0.32. PMID- 3807364 TI - The role of tissue steroids in regulating aromatase and oestradiol 17 beta hydroxysteroid dehydrogenase activities in breast and endometrial cancer. AB - We have observed that oestradiol concentrations in breast and endometrial tumours are relatively higher than oestrone, in contrast to peripheral tissues. Infusion of radiolabelled oestrogen also suggested there was a difference in metabolism between normal and tumour tissue. We have therefore looked for factors which could modulate tissue steroid metabolism and conclude that progesterone may influence aromatase, and that the adrenal androgens can inhibit oestradiol dehydrogenase activity. The latter mechanism, in particular, may be important in increasing tissue exposure to oestradiol. PMID- 3807365 TI - Estrone conversion rates by human endometrial cancer cell lines. AB - Studies on estrone metabolism by long term human endometrial cancer HEC-1A and Ishikawa cell lines are reported. These cell lines grow well in epithelial mono or plurilayer form, as previously reported. Ishikawa cells appear to be estrogen responsive whereas HEC-1A appear non responsive. In our experience Ishikawa cells show high affinity--low capacity estrogen binding sites in both soluble and nuclear fractions of the same range of ZR 75-1 and of MCF7, but HEC-1A cytosols gave Kd values in the order of 10(-8)-10(-9). These values are probably more representative of estrogen receptors of low affinity-high capacity (site II) and this is in agreement with previous results regarding their poor response to estrogens. These two different endometrial cancer cell lines exhibit at the same time, common and quite dissimilar metabolic patterns of estrogens. In fact, metabolic conversion studies carried out after 24th incubation at not far from physiological concentrations by using high pressure liquid chromatography in reverse phase mode plus "on line" radioactive detection showed: Both these well established cell lines are fast growing in culture with sufficient morphological or biochemical stability, at least during a limited number of passages and appear a useful material for studies on steroid metabolism. In both, estradiol (E2) and estrone (E1) were most part of converted products (more than 95%); negligible amounts of other radio-metabolites were observed. Quite different conversion rates of E1 to E2 have been shown by HEC-1A cells (6 times or more), with respect to Ishikawa. PMID- 3807366 TI - Fertility control in women: results with RU 486 by the end of 1985. AB - RU 486 is the first antiprogesterone to be used clinically. It inhibits the action of the hormone at the receptor level in target tissues. Its action is particularly significant in the endometrium where it prevents the initiation and progression of pregnancy in the first weeks (contragestive effects). The data indicate that the compound can be used for: voluntary interruption of pregnancy between 6 and 10 weeks, induction of menstruation during the fifth week of amenorrhea, and post-coital contraception. Current trials include its use as a once-a-month menses inducer. It can also be utilized for therapeutic interruption at a late stage of pregnancy, and tried as adjuvant treatment in some case of breast cases. The data on RU 486 have been obtained through studies in physio pharmacological endocrinology and biochemistry. The development of this antihormone represents a concerted research effort between biology and medicine. PMID- 3807367 TI - Aromatase inhibitors and their potential clinical significance. AB - Estrogen biosynthesis occurs not only in reproductive tissues of the female but also in such diverse sites as testes, adipose and muscle. Our rationale for the clinical use of aromatase inhibitors is that compounds interacting with aromatase in all tissues could provide both selective and effective inhibition of estrogen production. The most potent inhibitor identified by us to date is 4 hydroxyandrostene-3,17-dione (4-OHA). This compound causes rapid competitive inhibition followed by irreversible inactivation of aromatase. Treatment of rats with 4-OHA results in inhibition of ovarian aromatase and estrogen secretion, accompanied by marked regression of carcinogen induced mammary tumors. Using rhesus monkeys, marked inhibition of peripheral aromatization by 4-OHA was also demonstrated. The first clinical study with a selective aromatase inhibitor was recently carried out using once weekly injections of 500 mg 4-OHA in 60 postmenopausal patients with advanced metastatic breast cancer and unselected for the presence of estrogen receptors. The mean serum estradiol level reduced to 36% of pretreatment values for at least 4 months. No effect of treatment on gonadotropin levels occurred indicating that the reduction in estrogen levels was due to inhibition of peripheral aromatization. In spite of the fact that all patients had relapsed from previous therapy, complete or partial tumor regression occurred in 30% of patients while 15% had static disease. Although the optimum dose of 4-OHA has not yet been established, this aromatase inhibitor appears to be of value in treating postmenopausal breast cancer and may be beneficial in other diseases associated with estrogens. PMID- 3807368 TI - In vitro metabolism of testosterone in the rat prostate: influence of aging. AB - The in vitro metabolism of labelled testosterone has been studied in the ventral prostate of young (2 months) and old (15 and 22 months) male rats. It has been found that the prostate of 2-month old animals converts testosterone into dihydrotestosterone (5-alpha-androstane-17-beta-ol-3-one, DHT) and into the diols (5-alpha-androstane-3-alpha,-17-beta-diol and 5-alpha-androstane-3-beta,17-beta diol) with considerable yields. The prostate of young animals is also able to convert testosterone into delta-4-androstenedione (delta-4-A), 5-alpha androstanedione (5-alpha-A) and androsterone (A); however, the amount of these metabolites are lower than those of DHT and the diols. Aging induces major alterations in the prostatic metabolism of testosterone. In particular, a progressive and significant decrease in the formation of DHT and of the diols has been found in animals of 15 and 22 months of age. Advancing age induces, on the contrary, a progressive and significant increase of the formation of delta-4-A. The total amounts of 5-alpha-reduced metabolites of the 17-keto series (5-alpha-A + A) are higher at 15 and 22 months than at 2 months of age. This increase appears to result from an enhanced formation of 5-alpha-A at 15 months, and of A at 22 months. The present data show that aging exerts important effects on the metabolism of testosterone in the ventral prostate of the rat. The results may help explaining why the old rat does not develop spontaneously the syndrome of benign prostatic hypertrophy (BPH), as it occurs in other species (dogs and humans). PMID- 3807369 TI - What is the value of the computer for the physician? AB - Computer technology is advancing at an increasingly rapid rate. Although the computer's former role in the health care field was primarily limited to the financial and marketing departments of health care facilities, the computer is moving beyond the managerial departments and into the realm of the practicing physician. Much of this change in the use of computers in this field is due to the pressures of cost containment, DRG requirements, the availability of microcomputers, and the desire for improved health care. In the areas of clinical care, medical research, and medical education, the computer is rapidly becoming an indispensable tool through its technological adaptation. The computer is an obvious adjunct to the problem of improving cost efficiency without compromising the efforts toward better health care. PMID- 3807370 TI - Gallbladder adenocarcinoma: the prognostic significance of histologic grade. AB - Gallbladder adenocarcinoma (GBA) postresection 5-year survival rates are less than 5%, but when histologically confined to the mucosa or submucosa, survival rates of 64% (5 years) and 44% (10 years) have been reported. Whether any other histologic features of GBA have prognostic significance is unknown. This investigation was conducted to determine if GBA histologic grade correlates with survival. Thirty patients with advanced stage GBA participating in Eastern Cooperative Oncology Group (ECOG) treatment protocol EST-2273 served as the study material. Using glandular tumor grade criteria recommended by others, a panel of 7 ECOG pathologists categorized the GBA as either predominantly low or high histologic grade. Each patient's GBA histologic section measured no less than 1.0 X 1.0 cm. Predominant grade was defined as being that grade present in greater than 75% of the histologic section. Patient survival times by grade were calculated from date of initiation of chemotherapy until date of death. The 13 week low grade GBA patient survival was significantly longer than the 7-week high grade GBA patient survival (p less than 0.01). Stratification of patients by either high or low predominant histologic grade is recommended in future GBA treatment studies. PMID- 3807371 TI - Lung cancer in men aged 75 or older. AB - Sixty-seven cases of lung cancer occurring in men aged 75 or older were examined at autopsy. There is a similar incidence of epidermoid and small cell carcinoma, but a lower incidence of adenocarcinoma and a slightly higher incidence of large cell carcinoma in this elderly group of patients compared to the incidence of various histologic types occurring in patients of all ages. The various organs involved by metastatic tumor are similar to those seen in lung cancer in general; the overall metastatic disease is less widespread in the older group. PMID- 3807372 TI - Recurrent olfactory neuroblastoma treated by radiation, surgery, and chemotherapy: "a case report". AB - Olfactory neuroblastoma is a rare tumor. The role of CT Scan, morphological details and the electron microscopic findings have been highlighted in the diagnosis of the lesion. The present patient, in which the tumor had recurred following surgical excision, was treated successfully with a combination of radiation, further surgery, and maintenance chemotherapy. We also feel that such a planned multidisciplinary approach is justified as the initial treatment for all advanced lesions in view of high recurrence rates reported following use of radiotherapy or surgery alone. PMID- 3807373 TI - An alternative method for repair of a leaking arterial chemotherapy infusion catheter. AB - Regional chemotherapy infusion via selective arterial catheterization is frequently complicated by the development of cracks or leaks within the catheter. This frequently necessitates a catheter exchange. Herein, we report an alternative, simpler method for dealing with a defect within an infusion catheter. PMID- 3807374 TI - Renal cell carcinoma in a patient with situs inversus totalis. AB - Situs inversus occurs with a frequency of about 1 in 8,000. We present a case of renal cell carcinoma in a patient with situs inversus totalis treated with nephrectomy. Uneventful operative management was attained by adequate preoperative radiologic evaluation. PMID- 3807375 TI - Radiation after pelvic lymphadenectomy: effect on morbidity. AB - The role of a staging pelvic lymph node dissection has been questioned because of its associated morbidity, especially when followed by definitive radiation therapy. Forty-nine patients with clinically localized adenocarcinoma of the prostate underwent a staging pelvic lymphadenectomy. Clinically suspected lymph nodes were submitted for frozen section analysis. A unilateral dissection was performed on 7 patients (14%), none of whom developed intraoperative or postoperative complications. The remaining 42 patients underwent bilateral pelvic lymphadenectomy, after which 26 were treated with definitive radiation therapy using the four-field box technique, and 16 received other forms of therapy (delayed androgen deprivation or hormonal manipulation). The complication rate of 19% was identical for both groups of patients. Complications consisted of 3 seromas, 1 atelectasis, 1 prolonged ileus, 1 wound infection, and 2 transient penile or scrotal edemas. Radiation therapy, therefore, did not increase postoperative morbidity. PMID- 3807376 TI - Primary leiomyosarcoma of the inferior vena cava: a case report and review of the literature. AB - Sixty-six cases of leiomyosarcoma of the inferior vena cava (IVC) have been reported. We present another case and review the characteristics and treatment of this rare tumor. IVC leiomyosarcomas spread by extension into adjacent tissue planes. Direct extension into the heart is known, but not into the kidneys, adrenals, or bowel. IVC leiomyosarcomas arising below the renal vein cause pain in the right-lower quadrant, back, and flank, and varying degrees of lower extremity edema; those arising in the middle caval segment cause right-upper quadrant pain and sometimes renovascular hypertension; those arising above the hepatic vein cause varying manifestations of the Budd-Chiari syndrome. A reasonable approach to early diagnosis involves oral and intravenous contrast studies followed by computed tomography, angiography, and vena cavography. Aggressive surgical treatment is optimal in light of the tumor's slow growth pattern and relatively low malignant potential. (Metastases have been reported in fewer than 50% of cases). Tumors involving the lower IVC are most amenable to surgery; extensive collateral venous drainage of the left kidney preserves renal function during resection of middle caval tumors. Upper caval leiomyosarcomas are the least amenable to complete removal. Postoperative survival of all patients has ranged from a few weeks to eight years. PMID- 3807377 TI - Shoulder flap for head and neck reconstruction: an alternative when everything else fails. AB - The use of axial and free flaps made the use of delayed random flaps for the reconstruction of the head and neck almost obsolete. Immediate reconstruction of intraoral defects using the pectoralis major musculocutaneous flap primarily, as well as other axial or free flaps, has become a common practice. However, in some selected cases due to failure of previous operations or complications of radiation and recurrence, the reconstructive surgeon is left with very little choice. The purpose of this paper is not to advocate the use of the shoulder flap as a primary reconstructive procedure, but to call attention to its availability for certain complicated cases and briefly described the details of the technique. PMID- 3807378 TI - Uterine sarcoma: a retrospective study. AB - From 1965 to 1982, 86 analyzable patients with uterine sarcoma were treated. Nineteen patients (22%) presented with advanced disease. For the patients with curable diseases (67 patients), the disease-free survivals with a median follow up of 4.5 years are 40% (surgery only), 53% (surgery + chemotherapy), 46% (surgery + radiation +/- chemotherapy). The local failure rates are 43%: 32%: 33%, respectively. There is no statistical significance. The most important prognostic factor is the clinical extent of the tumor. The role of radiation therapy and chemotherapy will be discussed. PMID- 3807379 TI - Merkle cell carcinoma report of a case and possible role for adjuvant radiotherapy. AB - A case of neuroendocrine (Merkle cell) carcinoma of the skin is described. This uncommon tumor occurred in a 76-year-old female and presented as a small exophytic nodule on the right anterior chest wall. Following primary excision, it was thought to be a basal cell carcinoma. The diagnosis of Merkle cell carcinoma was established only after the tumor had recurred locally and involved ipsilateral axillary lymph nodes. Although local control was achieved with surgery and radiotherapy, the patient died of probable hepatic metastases 18 months after presentation. The Merkle cell tumor is an undifferentiated small cell carcinoma originating in the skin and has distinct ultrastructural characteristics that help to differentiate it from other small cell tumors. The clinicopathologic characteristics of these potentially aggressive neoplasms are reviewed, and treatment is briefly discussed. PMID- 3807380 TI - The surgeon's future role in the conquest of cancer. AB - This article is a brief review alluding to the multidisciplinary modalities including basic science technologies that are available in the treatment of today's cancer victim. The roles are discussed of the general surgeon and of the surgical fellow, later a surgical oncologist, as they merge into their respective positions to practice their art. The necessity of limiting the number of surgical oncologists with helpful hints on how they can survive in a nonacademic atmosphere are presented. The multidisciplinary approach to treatment of cancer is stressed. PMID- 3807381 TI - Comparison of primary and secondary treatment in squamous oral cancer. AB - A popular rule of thumb has often prevailed in treating oral cancer: Try one modality first; if it fails, try the other--the chance for cure will still be good. To study this dogma, a group of 160 consecutive patients with oral cavity squamous carcinoma were reviewed. A hypothesis was formed: secondary treatment for recurrent cancer, whether surgery after radiation failure or vice versa, would salvage essentially as many patients as primary treatment, say within 15%. Results show a large difference in success rates between first and second treatments when all stages are considered together, a difference well over 15 percentage points. Regarding each stage separately, the largest difference occurs in stage II (28 percentage points); other stages exceed 15 point differences. No significant differences in successful salvage occur between "home" failures and "elsewhere" failures. Local recurrence was a major cause of failure in both groups (55%). We conclude that recurrence of oral squamous cancer after first treatment markedly reduces patients' chance for cure. PMID- 3807382 TI - Pulmonary blastoma in childhood. AB - Pulmonary blastoma (PB) has been considered a very rare primary lung malignant neoplasm. In children, it is one of the rarest cancers reported. To my knowledge, there are only 24 pediatric cases of PB in patients ranging from 2 months to 15 years of age, representing one-fourth of all reported cases in the literature. The association of PB with an underlying abnormal pulmonary morphogenesis, characterized by "cystic lesions," suggests that there is a teratogenic-oncogenic relationship. Review of the literature and the clinical and pathologic features of PB in a 2-1/2-year-old white female are discussed. PMID- 3807383 TI - Mucoepidermoid carcinoma of the stomach. AB - A rare case of mucoepidermoid carcinoma of the stomach in a 70-year-old man is reported. The protruded mass with central depression resembled a submucosal tumor, located on the posterior wall of a part of the cardia, fornix, and upper corpus. Histologically, submucosal ectopic glands composed of columnar cells, mucus-producing cells that closely resemble gastric epithelium, and ciliated epithelium were observed. The tumor consisted of an admixture of cuboidal, columnar cells, mucus-producing cells, singled or pseudostratified ciliated epithelium, and squamous metaplastic cells. The tumor cells were intimately continuous with the submucosal ectopic glands. Gradual transition between tumor cells and epithelium of submucosal ectopic glands was recognized. It is supposed that mucoepidermoid carcinoma of the stomach in this case derived from preexisting submucosal ectopic mucous glands of the stomach. PMID- 3807384 TI - Investigation of Grewia bicolor Juss. AB - Grewia bicolor is a small tree, parts of which are used in Sudanese traditional medicine for treating pustulent skin lesions, internally on indication of a delayed afterbirth and sometimes as a tranquilizer. A phytochemical investigation of Grewia bicolor gave the following results: the petroleum ether extract afforded beta-sitosterol and beta-sitosterol- and triterpene esters, and the triterpenes lupeol and betulin. The methanol extract afforded: beta-sitosterol glucoside and three alkaloids, harman, 6-methoxyharman and 6-hydroxyharman. The latter is the main alkaloid. The methanol extract shows activity against gram positive and gram-negative organisms and causes a strong contraction of the isolated rat uterus which can be blocked by methysergide. PMID- 3807385 TI - Effects of crude drugs on experimental hypercholesterolemia. I. Tea and its active principles. AB - The effect of methanol extractives from tea leaves on hypercholesterolemia was examined in animal models. It was found that orally administered (-)-epicatechin gallate and (-)-epigallocatechin gallate from tea leaves lowered the serum cholesterol level in mice fed a high fat emulsion. Quantitation of tissue cholesterol and examination of liver tissues in mice fed a high cholesterol diet revealed that these constituents also significantly lowered the amount of cholesterol crystallization. These results support the reputed effectiveness of tea use in hypercholesterolemia. PMID- 3807386 TI - Studies on brain structure and neurological function in alcoholic rats controlled by an Indian medicinal formula (SKV). AB - An Indian herbal brew known in Ayurvedic pharmacy as asavam (SKV) was tested for its effectiveness in controlling addiction to ethanol in rats. Rats on SKV therapy with free access to 15% ethanol showed a marked reduction in voluntary ethanol intake. Their performance in simple neurological tests improved and a reversal of ethanol-induced changes in the electroencephalogram and electrocardiogram were also recorded. SKV treatment appeared to correct the fatty changes in liver and the signs of haemorrhage, demyelination and spongiosis seen in the brain of ethanol-fed rats. PMID- 3807388 TI - Effects of Salvadora persica extracts on mice exploratory locomotion activities. AB - The effects of Salvadora persica extracts on mice exploratory locomotor activities and stereotype movements have been determined. Mice injected with Salvadora persica extracts showed significantly low exploratory locomotor activity. The total distance travelled by naive mice injected with saline, during the first 5 min of introduction into an activity cage (Session 1) was 1007 +/- 105 cm/5 min, in contrast to 800 +/- 75, 540 +/- 100 and 330 +/- 55 cm/5 min for naive mice injected i.p. with 5.7, 14.3 and 28.6 ml/kg Salvadora persica extract. The exploratory locomotion of Salvadora persica treated mice declined faster than that of the controls. Mice injected with Salvadora persica extract also showed a significantly lower number of stereotype movements (P less than 0.05). The stereotype movements of the control was 175 +/- 5 movements/5 min and 90 +/- 10, 118 +/- 15 and 35 +/- 11 for mice injected with 5.7, 14.3 and 28.6 ml/kg, Salvadora persica extract, respectively. PMID- 3807387 TI - Extra-pancreatic effects of Momordica charantia in rats. AB - The extra pancreatic effects of the oral hypoglycaemic plant Momordica charantia have been investigated in rats. It was found that the fruit juice of this plant caused an increased glucose uptake by tissues in vitro without concomitant increase of tissue respiration. Oral treatment with the juice prior to a glucose load was found to increase the glycogen content of liver and muscle while it had no effect on the triglyceride content of adipose tissue. Pretreatment of fasted rats with M. charantia fruit juice had no significant effect on the gluconeogenic capacity of kidney slices. Similar results were obtained with kidney slices pre incubated with M. charantia fruit juice. PMID- 3807389 TI - Active principles of Tetradenia riparia. I. Antimicrobial activity of 8(14),15 sandaracopimaradiene-7 alpha,18-diol. AB - Tetradenia riparia is one of the most popular medicinal plants in Rwanda. Previously, several new substances have been isolated from the leaves of this plant, including a new diterpene diol, i.e. 8(14),15-sandaracopimaradiene-7 alpha,18-diol. This new diterpene diol exhibits significant antimicrobial activity against several bacteria and fungi. The minimum inhibitory concentration (MIC) of the substance for microorganisms which were inhibited ranged from 6.25 to 100 micrograms/ml. PMID- 3807390 TI - Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. AB - Investigations were carried out to evaluate the effect of Momordica charantia on the glucose tolerance of maturity onset diabetic patients. The fruit juice of M. charantia was found to significantly improve the glucose tolerance of 73% of the patients investigated while the other 27% failed to respond. PMID- 3807391 TI - Screening of some Somalian medicinal plants for antimicrobial activity. PMID- 3807392 TI - Mucilage in seeds of Plantago ovata and its wild allies. PMID- 3807393 TI - Myocardial protection in the neonatal heart. A comparison of topical hypothermia and crystalloid and blood cardioplegic solutions. AB - Myocardial protection achieved during 2 hours of ischemic arrest was evaluated in 45 isolated, blood perfused, neonatal (1 to 5 days) piglet hearts. Comparisons were made among five methods of myocardial protection: Group I, topical cooling; Group II, hyperosmolar (450 mOsm) low-calcium (0.5 mmol/L) crystalloid cardioplegia; Group III, St. Thomas' Hospital cardioplegia; Group IV, cold blood cardioplegia with potassium (21 mmol/L), citrate-phosphate-dextrose (calcium level 0.6 mmol/L), and tromethamine; and Group V, cold blood cardioplegia with potassium alone (16 mmol/L) (calcium level 1.2 mmol/L). Hemodynamic recovery (percent of the preischemic stroke work) after 30 and 60 minutes of reperfusion was 82.9% and 86.7% in Group I, 35.7% (p less than 0.0001) and 43.7% (p less than 0.0001) in Group II, 76.1% and 77.7% in Group III, 67.4% (p less than 0.05) and 60.6% (p less than 0.05) in Group IV, and 110.7% and 100.6% in Group V. CONCLUSIONS: Topical cooling is an effective method of myocardial protection in the neonate. Cold blood cardioplegia with potassium alone and a normal calcium level provides optimal functional recovery. The improved protection obtained with both crystalloid and blood cardioplegia with normal calcium levels suggests an increased sensitivity of the neonatal heart to the calcium level of the cardioplegic solution. PMID- 3807394 TI - Biological versus mechanical valves. Analysis of 1,116 valves inserted in 1,012 adult patients with a 4,818 patient-year and a 5,327 valve-year follow-up. AB - All surviving patients between 18 and 88 years of age receiving biological or mechanical prosthetic heart valves at the Yale-New Haven Hospital from January 1974 through January 1985 were analyzed for thromboembolism, anticoagulation related hemorrhage, endocarditis, perivalvular leak, valve failure, need for reoperation, late cardiac death, and valve-related death. The rates of these events were analyzed in linear and actuarial terms over the 11 year period. A total of 533 patients received 606 biological valves (328 aortic, 252 mitral, 24 tricuspid, and two pulmonary, consisting of 482 Carpentier-Edwards, 108 Hancock, 15 Ionescu-Shiley, and one other), with a mean follow-up of 2,571 patient-years and 2,935 valve-years. They were compared with 479 patients with 510 mechanical valves (330 aortic, 175 mitral, and five tricuspid, consisting of 178 Starr Edwards, 166 St. Jude Medical, 164 Bjork-Shiley, and two others), which were implanted for 2,247 patient-years and 2,392 valve-years. We found a significantly increased incidence of thromboembolism (p less than 0.001) and reoperation for perivalvular leak (p less than 0.05) in the mechanical valves compared with the biological valves, but a significantly increased rate of valve failure (p less than 0.001) in the biological valves compared with the mechanical valves. The overall analysis comparing total morbidity and valve-related mortality significantly (p less than 0.01) favored the biological valves in the first 5 years of the study and the mechanical valves (p less than 0.001) in the second 5 years of the study. However, the net 10 year results showed no significant difference between the two types of valves. In summary, we found little direct evidence to strongly support the generalized use of one type of valve over another. PMID- 3807395 TI - Extracorporeal membrane oxygenation for respiratory and cardiac failure in infants and children. AB - Fifty-three neonates and seven pediatric patients were treated with extracorporeal membrane oxygenation from September 1983 until April 1986. Venoarterial bypass was achieved by cannulating the right atrium via the right internal jugular vein and the aortic arch via the right common carotid artery. In the neonatal group, 40 infants with acute respiratory failure were treated, and 36 (90%) survived. Five infants with congenital heart disease were treated and three (60%) survived. Among the eight patients with congenital diaphragmatic hernia, there were three (38%) survivors. In the pediatric group, four patients were treated for ventricular failure after cardiac operations. Two were weaned from bypass, with one long-term survivor. Three patients with acute respiratory failure were treated, with one survivor. salvaging high-risk neonates with minimal morbidity and mortality. It has also been useful in the support of infants with congenital heart disease and congenital diaphragmatic hernia. In pediatric patients one cannot expect to get results that are comparable to those found in neonates. Still, this modality can be useful in salvaging some moribund patients with pulmonary or cardiac failure, or both. PMID- 3807396 TI - Abdominal and right thoracotomy approach as standard procedure for esophagogastrectomy with low morbidity. AB - A series of recent articles advocate that blunt esophagectomy through neck and abdominal incisions has superior perioperative results to esophagogastrectomy via thoracotomy and abdominal approach. This prompted a review of a personal series of 40 consecutive esophagogastrectomies performed between July 1978 and December 1985. Diseases included squamous cell cancer in 15 patients, adenocarcinoma in 22, Barrett's esophagus with cancer in two, and fibromyomatoses in one. The approach was en bloc resection through an abdominal incision and right thoracotomy; a cervical incision and anastomosis was added for proximal lesions. All anastomoses were hand-sewn interrupted suture technique. Perioperative results were superior to those reported for blunt esophagectomy. Mortality was zero, no anastomotic leaks occurred, and no major pulmonary complications were seen. Four of the 40 patients required blood transfusions that totaled 8 units. Average preoperative hematocrit value was 38.9% +/- 5.44% (standard deviation) and postoperative hematocrit value was 35.57% +/- 6.06% (standard deviation). Average operating time was three hours and 26 minutes +/- 41.43 minutes and hospital stay was 11.1 +/- 4.62 days (standard deviation). Three patients required transient anastomotic dilations. It is concluded that esophagogastric en bloc resection which uses an abdominal and right thoracic approach can be accomplished with a low morbidity and mortality. A limited thoracic incision, double-lumen endotracheal tube, and self-retaining retraction on the lung minimized pulmonary trauma and respiratory problems were not a factor. PMID- 3807397 TI - Myoventriculoplasty and neoventricle myograft cardiac augmentation to establish pulmonary blood flow. Preliminary observations and feasibility studies. AB - In 10 dogs, a latissimus dorsi muscle (myograft) was neuroelectrically stimulated at 120 cycles/min for as long as 80 days. The higher thresholds and multiple lead penetrations required of direct muscle stimulation for muscle conditioning were avoided. Vascular delay and protective wrapping of the myograft in four dogs resulted in rapid seroma and fibrous sheath formation, which precluded further study. Of the six other myografts that were stimulated, two were used as functional right ventricular myoventriculoplasties and four were employed as neoventricle myografts with inflow and outflow valved conduits that were used to provide total pulmonary blood flow. Myoventriculoplasty produced functional enlargement of the right ventricle with synchronously contractile muscle. Neoventricles provided hemodynamically stable total pulmonary blood flow for as long as 20 hours, until internal chamber thrombus formed. Transpulmonary blood pressure generation by the neoventricle was found to be programmable up to physiologic systemic pressures by modulation of chamber preload and burst stimulation frequency at 50 msec intervals, delivered 120 times per minute. Synchronization capabilities for implantable burst pulse generators would further improve the efficacy of these myograft techniques designed to augment or supplant ventricular function, particularly to provide transpulmonary blood flow at programmable pressures. PMID- 3807398 TI - Modifications of techniques and early results of pulmonary thromboendarterectomy for chronic pulmonary embolism. AB - In 1980 we described bilateral pulmonary thromboendarterectomy with median sternotomy, cardiopulmonary bypass, deep hypothermia, and circulatory arrest for the relief of pulmonary hypertension caused by chronic pulmonary embolism. In our subsequent experience, which totals 41 patients, we have identified three groups of patients characterized by differences of intraoperative management. In Group A (N = 16) myocardial protection consisted of single-dose crystalloid cardioplegia followed by pericardial irrigation with cold saline. Extrapericardial dissection of the pulmonary arteries was performed. Group B (N = 7) was treated the same as Group A except for the substitution of saline slush contained in a laparotomy pad for iced saline. In Group C (N = 18) myocardial protection was single-dose blood cardioplegia followed by the application of a specially designed cooling jacket to the right and left ventricles. Another modification was that of intrapericardial dissection of the pulmonary arteries with extension of the dissection into the hilar tissues without entrance into the pleural spaces. The hospital mortalities of Groups A, B, and C were 18.7%, 14.3%, and 5.5%, respectively (not statistically significant differences). However, other statistically significant differences (p less than 0.05) among the groups were observed: Phrenic nerve paresis occurred in five of seven (71%) Group B patients but in no Group A or C patients; Group B patients required ventilatory support for 32.2 days compared with 8.4 days for Group A and 6.2 days for Group C; time in the intensive care unit was 36 days for Group B patients versus 13 for Group A and 10.3 for Group C; pulmonary vascular resistance decreased 59% (649 versus 259) intraoperatively in 13 patients in Group C. We believe simultaneous bilateral pulmonary thromboendarterectomy with median sternotomy, cardiopulmonary bypass, deep hypothermia with circulatory arrest, and the modified methods of myocardial preservation and dissection represent current optimal surgical management of this problem. PMID- 3807399 TI - The St. Thomas' Hospital cardioplegic solution. A comparison of the efficacy of two formulations. AB - Two commercially available formulations of St. Thomas' Hospital cardioplegic solutions, known as No. 1 (MacCarthy) and No. 2 (Plegisol, Abbott Laboratories, North Chicago, Ill.), were compared in the isolated working rat heart subjected to a long period (3 hours) of hypothermic ischemic arrest with multidose infusion. Solution No. 2 was found to be superior in nearly all respects. Of the 10 hearts infused with solution No. 1, persistent ventricular fibrillation during postischemic reperfusion occurred in six. Two of the six hearts, still in fibrillation after 15 minutes of reperfusion, were returned to regular rhythm by electrical defibrillation but failed to maintain an output. In contrast, in the 10 hearts infused with solution No. 2, ventricular fibrillation was short lasting (p less than 0.01). In comparing mechanical function in all hearts returning to regular rhythm (either spontaneously or after electrical defibrillation), the mean postischemic recoveries for aortic flow and rate of rise of left ventricular pressure (expressed as a percentage of its preischemic control) were significantly greater with solution No. 2 than with solution No. 1 (74.3% +/- 6.9% compared with 18.7% +/- 8.9%, p less than 0.01, and 98.0% +/- 6.0% compared with 63.0% +/- 9.0%, p less than 0.005, respectively). Creatine kinase leakage tended to be lower in hearts infused with solution No. 2 (19.7 +/- 4.7 IU/15 min/gm dry weight as opposed to 27.5 +/- 4.7 IU/15 min/gm dry weight), although this difference did not achieve a level of statistical significance. Consideration is given to the differences in formulation between solutions, which might account for the improved performance with solution No. 2, and it is concluded that the lower calcium content of solution No. 2 (1.2 as opposed to 2.4 mmol/L) is likely to be the most important factor. PMID- 3807401 TI - Development of neo-coarctation in patients with transposed great arteries and hypoplastic aortic arch after Lecompte modification of anatomical correction. AB - We report on three patients with kinking in the proximal aortic arch that developed after Lecompte modification of the arterial switch operation. Two patients had a previous subclavian patch repair of coarctation of the aorta and had an associated hypoplasia of the transverse aortic arch, and one patient had hemodynamically mild coarctation at the anatomical repair. A severe pressure gradient across the kinked area ("neo-coarctation") necessitating reoperation developed in one patient. The acute arch angulation appears to be due to an excessive posterior displacement of the ascending aorta by the anterior relocation of either the right or left main pulmonary artery branch from underneath the aortic arch. A foreshortened and frequently hypoplastic transverse aortic arch, a common association with coarctation of the aorta, appears to be especially vulnerable to the development of "neo-coarctation" after the Lecompte modification of the anatomical repair of transposed great arteries. PMID- 3807400 TI - Influence of operations with cardiopulmonary bypass on polymorphonuclear leukocyte function in infants. AB - To determine the effect of operations with cardiopulmonary bypass on the immunologic function of polymorphonuclear leukocytes in infants, we studied polymorphonuclear leukocyte function and immunologic profile in 16 infants undergoing repair of congenital heart lesions. An oxygen/air/high-dose fentanyl anesthetic was used for all patients. Absolute neutrophil count increased significantly (p less than 0.05) after bypass and remained increased 48 hours afterward. Chemotaxis, random migration of polymorphonuclear leukocytes, and phagocytic index were unaffected, but bactericidal capacity decreased significantly immediately after cardiopulmonary bypass and remained decreased 48 hours later. Serum opsonizing capacity to bacterial and fungal antigens was variably altered, and complement factors 3 and 4 decreased significantly after cardiopulmonary bypass. Total hemolytic complement decreased significantly immediately after cardiopulmonary bypass and returned to normal by 48 hours. These data suggest that operations with cardiopulmonary bypass in infants significantly affect the immunologic function of polymorphonuclear leukocytes and result in consumption of complement. PMID- 3807402 TI - The behavior of pericardial versus porcine valve xenografts in the growing sheep model. AB - The comparative long-term behavior of the pericardial versus the porcine bioprostheses is not yet known. The need for long follow-up times to answer this question makes the growing sheep model an attractive alternative, given its ability to induce early valve degeneration. Sixty-three sheep, 12 to 16 weeks old, were operated on and received 39 porcine (11 Xenomedica, 10 Carpentier Edwards S, nine Hancock I standard, and nine Hancock I T6-treated) and 24 pericardial (14 Mitroflow and 10 Ionescu-Shiley low profile) prostheses of clinical quality in the tricuspid position. Of the 52 operative survivors (32 received porcine valves and 20 received pericardial bioprostheses), six animals (five pericardial and one porcine) were eliminated because of bioprosthetic infection. Late sudden death before the scheduled killing occurred significantly more often (p less than 0.0001) in the pericardial (8/15 or 53%) than in the porcine group (1/31 or 3%). Calcium content of the explanted valves was significantly correlated with time in the pericardial group and the Xenomedica porcine prostheses (p less than 0.05) but not in the Hancock I and Carpentier Edwards S valves, where it was only marginally significant (0.1 greater than p greater than 0.05). Linear regression analysis of tissue calcium content showed a similar slope for the pericardial group and Xenomedica porcine valves, in comparison with the remaining porcine valves. Comparison between the two lines using covariance analysis demonstrated a statistically significant difference between them, which shows that the pericardial and Xenomedica porcine valves appear to reach higher levels of calcification in a shorter follow-up time than the Hancock I, standard and T6-treated, and the Carpentier-Edwards S valve in this animal model. PMID- 3807403 TI - Clinical and hemodynamic assessment of the Omniscience prosthetic heart valve. AB - From 1980 to 1985, 154 Omniscience valve prostheses were implanted in 132 patients (mitral in 72, aortic in 33, and both in 27), 81 women and 51 men, aged 22 to 72 years. There were 13 early deaths (30 day mortality of 9.8%) and nine late deaths. The actuarial survival rate was 79.1% after 4 years, and survival rates after aortic, mitral, and multiple valve replacement were 71.8%, 80%, and 85.2%, respectively. After a postoperative follow-up period averaging 27 months, 96% of the survivors were in Class I or II. The linearized incidence of thromboembolism, hemorrhagic episodes, and reoperation was 3.8%, 3.4%, and 2.3% per patient-year, respectively. After 4 years, freedom from valve-related mortality, valve-related mortality and reoperation, thromboembolic episodes, and all valve-related complications was 93%, 89%, 88%, and 70%. Moderate hemolysis with increases of reticulocyte count and serum lactic dehydrogenase above normal values was found in 80% of the patients, but only one had hemolytic anemia. In 22 patients, the maximal opening angle of the prosthetic disc averaged 54 +/- 11 degrees. Postoperative hemodynamic evaluation was obtained in five patients with aortic prostheses and in 13 with mitral prostheses. Mean aortic gradient and effective orifice area averaged 17.6 mm Hg and 1.2 cm2 at rest and increased to 18.8 mm Hg and 1.7 cm2 with exercise. With mitral prostheses, these values averaged 6.5 mm Hg and 1.9 cm2 at rest and 15.4 mm Hg and 2.1 cm2 with exercise. Thus excellent clinical improvement is obtained with the Omniscience prosthesis; however, the hemodynamic performance of the valve and opening of the tilting disc are suboptimal, causing the prosthesis to be moderately obstructive to blood flow. PMID- 3807404 TI - Dilatation of bronchial stenosis with Gruentzig balloon. AB - Current treatments for bronchial stenosis include surgical resection, laser photoresections, cryotherapy, and limited experience with balloon dilatation. This article describes the use of the Gruentzig balloon for treatment of an acquired bronchial anastomotic stricture after sleeve resection for carcinoma. PMID- 3807405 TI - Flow capacity of the human internal mammary artery. PMID- 3807406 TI - Flow through the internal mammary artery. PMID- 3807407 TI - Pericardial closure. PMID- 3807408 TI - Acupuncture treatment of early rheumatoid arthritis. PMID- 3807409 TI - Acute myocardial infarction treated with yiqihuoxue mixture. A comparative study of therapeutic effects on 430 patients. PMID- 3807410 TI - Percussopunctator treatment of enuresis on the basis of differential typing of the symptoms. PMID- 3807411 TI - Observation on the result of treatment of female infertility in 343 cases. PMID- 3807412 TI - Clinical and pharmacological study of the hemostatic action of rhizoma paridis by contraction of uterus. PMID- 3807413 TI - [A study on the relation between phlegm-stagnant type coronary heart disease and serum lipid levels]. PMID- 3807414 TI - Treating amenorrhea in vital energy-deficient patients with angelica sinensis astragalus membranaceus menstruation-regulating decoction. PMID- 3807415 TI - Effect of radix Salviae miltiorrhizae on calcium deposition in experimental fracture. PMID- 3807416 TI - Effects on the interdigestive myoelectric complex (IDMEC) of small intestine by zusanli moxibustion. PMID- 3807417 TI - Teaching round. VI. Bronchial asthma. PMID- 3807418 TI - Discussion on semantics. PMID- 3807419 TI - The expression of differentiation antigens by Rauscher virus-induced erythroid, lymphoid and myeloid cell lines. AB - Rauscher murine leukemia virus-induced erythroid, lymphoid and myeloid cell lines were characterized with respect to the expression of differentiation antigens using a panel of monoclonal antibodies. The expression of differentiation antigens was measured in a two-step micro ELISA procedure. The cell lines express a number of early markers and lack a number of mature markers characteristic for the respective cell lineages. Moreover they express a number of surface markers which are not or only rarely found on their normal counterparts. The expression of differentiation antigens indicates that the cell lines investigated are arrested in an immature stage of differentiation. This observation implies that the Rauscher virus preferentially transforms early hemopoietic cells. PMID- 3807420 TI - Dye-mediated photolysis of normal and neoplastic hematopoietic cells. AB - The purpose of this study was to determine the sensitivity to merocyanine 540 (MC 540)-mediated photolysis of normal human hematopoietic progenitor cells and four leukemia cell lines (Daudi, Raji, K562 and HL-60). Late erythroid progenitors were the most sensitive normal cells. Early erythroid progenitors were of intermediate sensitivity. Granulocyte/macrophage progenitors and multipotent progenitors were the least sensitive normal marrow cells. A combination of dye concentration, serum concentration, and illumination that eliminated 50% of multipotent progenitor cells reduced the concentration of leukemic cells by greater than or equal to 4.5 log. It is conceivable that this difference in photosensitivity can be exploited for the extracorporeal purging of autologous remission marrow grafts. PMID- 3807421 TI - TmMg and renal Mg threshold in normal man and in certain pathophysiologic conditions. AB - The TmMg and renal Mg threshold were assessed in normal subjects and in a number of pathological conditions. The TmMg in normal subjects was 1.4 mg/100 ml glomerular filtrate (GF) 1.73 m2 and numerically equalled the renal Mg threshold of 1.4 mg/100 ml. No significant difference was seen in patients with primary hyperparathyroidism or hypoparathyroidism. Patients with familial hypocalciuric hypercalcemia, however, tended to have an elevated renal Mg threshold. Investigation of 3 patients with idiopathic renal Mg wasting demonstrated a normal TmMg but reduced renal Mg threshold. Urinary Mg excretion was also assessed in normomagnesemic alcoholic patients. Retention of a parenterally administered Mg load and renal Mg retention were significantly greater than normal despite normal serum Mg concentrations. These data suggest that determination of TmMg and renal Mg threshold may provide useful information in understanding Mg homeostasis in normal subjects and in disorders which may result in abnormal Mg metabolism. PMID- 3807422 TI - Chronic renal failure and magnesium metabolism. AB - A number of factors affect the concentration and distribution of magnesium in patients with chronic renal failure (CRF). Poor nutritional intake, impaired absorption from the intestine, vomiting, diarrhea, the use of diuretics and acidosis may result in a negative balance. More commonly, accumulation of magnesium may be the consequence of reduced renal excretion. Magnesium concentrations are increased in serum and red cells in CRF patients. Bone concentrations and total body magnesium also appear to be increased; muscle magnesium does not appear to be increased. Use of magnesium hydroxide-containing antacids as phosphate binders in patients with CRF was largely discontinued 2 decades ago after reports described increases in serum magnesium concentrations to toxic levels. More recently, the undesirable effects of aluminum-containing phosphate binders (encephalopathy, osteomalacia) have led several investigators to report favorable experiences using low concentrations of magnesium in dialysate and a combination of magnesium and aluminum-containing antacids, as phosphate binders, while closely monitoring serum magnesium concentrations. PMID- 3807423 TI - Comparison of two methods for determination of magnesium concentration of mononuclear blood cells. AB - We describe and compare two methods for the determination of magnesium concentration in lymphocytes from cell cultures. The magnesium concentration of lymphocytes was 36 +/- 4 mmol/kg dry weight by atomic absorption spectroscopy analysis and 39 +/- 19 mmol/kg dry weight with electron probe X-ray microanalysis. We found no significant difference between the results for the two methods. The coefficient of variation was 30% for magnesium concentration among individual cells with electron probe X-ray microanalysis. PMID- 3807424 TI - Measurement and control of intracellular magnesium ion concentration in guinea pig and ferret ventricular myocardium. AB - Intracellular magnesium and sodium ionic concentrations have been measured in mammalian ventricular myocardium using ion-selective micro-electrodes. The values for [Na+]i and [Mg2+]i are 9.5 +/- 0.3 and 2.4 +/- 0.2 mM, respectively. Increasing extracellular [Mg] or decreasing extracellular [Na] both caused a rise of [Mg2+]i and a fall of [Na+]i. Superfusion with ouabain caused a small rise of [Mg2+]i as well as a rise of [Na+]i. Reduction of extracellular [Mg] or cell depolarisation had no effect on [Mg2+]i. A possible hypothesis to explain these results is proposed, namely that the transmembrane Na+ and Mg2+ gradients are coupled such that an alteration of one gradient will affect the other. However, the relative stability of [Mg2+]i suggests that it is also affected by other factors, such as intracellular buffering of the ion. PMID- 3807426 TI - Biochemical investigation of acute pancreatitis. PMID- 3807425 TI - Methods for the estimation of serum magnesium in clinical laboratories. AB - A variety of methods have been reported for the quantitative analysis of magnesium in serum and other biological fluids. The methods may be classified into the following groups: magnesium ammonium phosphate; 8-hydroxyquinoline; titan yellow; dihydroxyazobenzene using fluorimetry; Schwarzenbach ethylenediaminetetraacetic acid; atomic emission spectrophotometry; atomic absorption spectrophotometry; ion chromatography, and carboxanilide, calmagite and related dye methods. These methods are reviewed with specific emphasis on the limitations for their use in clinical laboratories. PMID- 3807427 TI - Pancreatic phospholipase A2 in human acute pancreatitis. PMID- 3807428 TI - The hepatic lysosomes in acute experimental pancreatitis in dogs. PMID- 3807429 TI - Exocrine pancreatic functions tests. PMID- 3807430 TI - Serum PP-release after hormonal (CCK) and mixed test-meal (MTM) stimulation by children with exocrine pancreatic insufficiency (EPI). PMID- 3807431 TI - When and how should the patients with severe haemorrhagic-necrotic pancreatitis be operated on? PMID- 3807432 TI - Primary pancreatic abscesses. PMID- 3807433 TI - The application of interventional radiology in digestive diseases. PMID- 3807434 TI - Ranitidine effect on gastric mucosa damage in patients with rheumatoid diseases on long-term treatment with non-steroid anti-inflammatory drugs. PMID- 3807435 TI - Transtelephonic monitoring: documentation of transient cardiac rhythm disturbances. AB - Symptoms suggestive of a transient disturbance in cardiac rhythm often prompt a patient to seek medical help. Transtelephonic monitoring (TTM) can document the rhythm at the exact time that the patient is experiencing clinical symptoms. Our experience with TTM from 1979 to 1983 involved 526 patients who had one or more of the following symptoms: near-syncope (in 121), light-headedness (in 248), intermittent palpitations (in 281), and tachycardia (in 321). Patients suspected of having a life-threatening arrhythmia after the initial history, physical examination, and laboratory testing were excluded from this study. Of the 526 patients, 259 transmitted with the TTM device during a typical symptomatic episode; 186 had an arrhythmia identified, and 73 had a normal cardiac rhythm. The mean duration (+/- SD) from receipt of the TTM system until the first transmission was 48 +/- 80 days. The most frequent diagnoses at transmission were supraventricular tachycardia (in 80 patients) and sinus tachycardia (in 46). This study showed that TTM is effective in documenting infrequent arrhythmias and in establishing the temporal relationship between clinical symptoms and the patient's heart rhythm. TTM is a useful, practical, and efficient addition to more conventional means of electrocardiographic monitoring for patients with non life-threatening arrhythmias. PMID- 3807436 TI - Temporal changes in the causes of aortic stenosis: a surgical pathologic study of 646 cases. AB - Among 646 patients with pure aortic stenosis who underwent valve replacement at our institution between 1981 and 1985, the three most frequent causes were calcification of congenitally bicuspid aortic valves (38%), degenerative (senile) calcification of tricuspid aortic valves (33%), and postinflammatory (presumably rheumatic) calcification and fibrosis (24%). Among the 324 patients younger than 70 years of age, calcified bicuspid valves were observed in 50%. In contrast, among 322 patients 70 years of age or older, degenerative calcification accounted for 48% of the stenotic aortic valves. During the 5 years of the study, the relative frequency of postinflammatory disease decreased from 30% to 18%, and that of bicuspid valves decreased from 37% to 33%. In contrast, the relative frequency of degenerative calcification increased from 30% to 46%. Consequently, degenerative (senile) calcification is currently the most common cause of aortic stenosis among patients undergoing valve replacement at our institution. This finding may be related to changes in life expectancy in the general population, alterations in patient referral practices, and an increased willingness of surgeons to operate on older patients. Regardless of cause, the observed temporal changes in etiologic factors for aortic stenosis may indicate a potential source of increasing health-care costs among the elderly population. PMID- 3807437 TI - DDD pacing: clinical considerations. AB - DDD pacemakers offer a physiologic form of pacing for selected patients by incorporating atrioventricular synchrony over a wide range of atrial rates. Selection of a patient for DDD pacing necessitates a thorough knowledge of the individual functions of the DDD pacemaker, the limitations of DDD pacing, and the patient's own electrical and physiologic needs. Continuing developments in cardiac pacing include further reduction of the possibility of pacemaker-mediated tachycardia, increased matching to metabolic needs, and advancement of telemetric technology and electrophysiologic testing. PMID- 3807438 TI - Auranofin-associated colitis and eosinophilia. AB - Gold compounds, often used in the treatment of rheumatoid arthritis, have been associated with gastrointestinal disturbances in some patients. Use of auranofin, an oral gold preparation, in a 50-year-old woman with rheumatoid arthritis resulted in diarrhea, abdominal tenderness, nausea, and vomiting, which persisted despite discontinuation of auranofin therapy. The presumptive diagnosis was gold induced colitis and eosinophilia. Administration of cromolyn sodium provided relief. Although this complication may be rare, evolving bowel symptoms in patients receiving auranofin demand prompt attention. PMID- 3807439 TI - Idiopathic crescentic glomerulonephritis or systemic vasculitis? PMID- 3807440 TI - Improved preservation of facial nerve function with use of electrical monitoring during removal of acoustic neuromas. AB - Continuous spontaneous electromyographic activity and responses to electrical stimulation of the facial nerve in the surgical field were monitored in 48 patients undergoing primary removal of an acoustic neuroma. The operative and postoperative results in these patients were compared with the results in 48 patients who were matched for age and size of tumor and who underwent the same surgical procedure without intraoperative monitoring. Eighty-three percent of the patients had preoperative evidence of facial neuropathy, which was more severe with larger tumors. Postoperative facial nerve function was most accurately predicted on the basis of the extent of facial neuropathy on preoperative electrophysiologic testing. Anatomic preservation of the facial nerve in patients with large tumors was substantially improved in the monitored patients (67%) in comparison with those without monitoring (33%). No difference was noted in facial nerve function in the two groups of patients immediately postoperatively. By 3 months, the degree of improvement in the monitored group exceeded that in those who were not monitored, particularly in patients with medium-sized and large tumors. PMID- 3807441 TI - Acceleration of p-aminohippurate excretion in immature rats by dexamethasone treatment. AB - In 5-, 10- and 15-day-old rats repeated administration of dexamethasone caused a dose-dependent increase of p-aminohippurate (PAH) excretion. Remarkably, dexamethasone has no influence on PAH excretion in adult rats. The effect of treatment in young rats cannot be explained by an increase in the glomerular filtration rate. In 10-day-old rats GFR shows a tendency to increase. In renal cortical slices from 5-day-old rats PAH transport is increased following dexamethasone treatment, whereas in 10- and 15-day-old rats an increase of kidney mass seems to be responsible for acceleration of renal excretion of PAH after administration of dexamethasone. In 5-day-old rats only the protein content is statistically significantly increased after dexamethasone treatment. PMID- 3807442 TI - Intraepidemic heterogeneity of influenza A (H3N2) viruses in 1985: antigenic analysis and sensitivity to non-specific inhibitors. AB - During the influenza outbreak of 1984-85 22 strains of H3N2 viruses were isolated in Finland. An intra-epidemic heterogeneity was demonstrated in an antigenic analysis by haemagglutination inhibition test with antisera produced in rats. The strains could be classified into three groups which corresponded to the following reference strains: group I: A/Hong Kong/1/84, A/Hong Kong/3/84; group II: A/Philippines/2/82; group III: A/Caen/1/84. Seven of the isolates were entirely insensitive to gamma-inhibitors of guinea-pig sera, which is in contrast to the small number of these viruses found among H3N2 strains isolated in the 1970s. The insensitive strains could not be isolated until the second or third passage through the eggs, whereas about half of the sensitive and intermediate strains were already isolated during the first passage. Conversions in reactivity with gamma-inhibitors could be detected only from an intermediate or an insensitive virus to a sensitive virus when several strains were passed serially in ovo and in MDCK cultures. The findings suggest that the gamma-inhibitor-insensitive strains corresponded well to the viruses of the human host or arose from dimorphic virus populations under an arbitrary selection of terminal dilution conditions prevailing during isolation in eggs. The insensitive strains did not differ substantially from the sensitive viruses in their ability to agglutinate erythrocytes of different laboratory animals or in their disagglutination patterns. On the other hand, propagation of viruses in MDCK cultures had an effect on these properties. The results are discussed with respect to Q phase variants and receptor binding properties. PMID- 3807443 TI - The effect of toluene inhalation exposure on catecholamine contents in rat sympathetic neurons. AB - Adult male rats were exposed to toluene in short-term exposure by inhalation for 48 h (2000 ppm, continuously), and in long-term inhalation for 3 months (1000 ppm, 8 h daily). The formaldehyde-induced fluorescence (FIF) technique for histochemical demonstration of catecholamines (CA) was used to detect changes in the catecholamine stores. The concentration of CA in the sympathetic neurons of superior cervical ganglia and adrenal medulla was measured by the FIF technique combined with microfluorimetry. The short-term toluene exposure induced a statistically significant reduction of CA contents in sympathetic neurons. After long-term exposure, no change in the CA level could be demonstrated either in sympathetic ganglion or adrenal medulla. In electron microscopic studies no clear pathological changes were detected after toluene exposure. PMID- 3807444 TI - Plasma vasopressin levels during and after cardiopulmonary bypass in man. AB - The effect of cardiopulmonary bypass (CPB) using high dose fentanyl anaesthesia on the concentrations of plasma arginine vasopressin (pAVP), serum electrolytes and osmolality was studied in 12 patients by repeated sampling up to 4th postoperative day. These values were also followed in another 20 patients for the first postoperative day. Fentanyl abolished the pAVP response often seen in major operations but not that produced by CBP. The pAVP concentration 4.8 +/- 0.8 pg/ml immediately after sternotomy increased to 27.2 +/- 1.5 pg/ml (P less than 0.001) after 5-10 minutes on CPB. By the 4th postoperative day the pAVP levels had reached normal values. The main reason for the elevated pAVP concentrations seems to be the onset of CPB, which provokes a fall in mean arterial pressure leading to pAVP release. PMID- 3807445 TI - Pentazocine and codeine: effects on human performance and mood and interactions with diazepam. AB - Effects of two opioid analgesics on performance and their interactions with diazepam were studied double-blind and cross over in ten healthy students. At two week intervals the subjects received first a single oral dose of placebo, codeine (100 mg) or pentazocine (75 mg). Then, 1 h 30 min later they were all given diazepam (0.25 mg/kg) orally. Lastly, naloxone (0.4 mg) was injected intravenously at 4 h. In addition to this, the subjects on pentazocine received a second 75 mg dose at 3 h. Codeine and pentazocine alone failed to affect performance in objective tests (body sway, digit symbol substitution, flicker fusion, Maddox wing, nystagmus) recorded at 1 h 30 min. Visual analogue scales showed subjective drug effects: pentazocine made the volunteers talkative, contented, interested and energetic, whilst codeine rendered them mentally slow. 75 mg of pentazocine and 100 mg of codeine produced comparable plasma opiate activity (determined in morphine equivalents) according to radioreceptor bioassay with [3H]-dihydromorphine as a ligand. Impaired performance was clear at the tests done 1.5 and 2.5 h after diazepam. No major interactions were found between opiates and diazepam in objective tests with the exception that nystagmus was stronger after the combined treatment than after diazepam alone. Codeine reduced the absorption of diazepam. Subjectively codeine and pentazocine counteracted the effects of diazepam. The subjects overestimated their performance after opiate + diazepam when compared to diazepam alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807446 TI - Do nursing homes reduce hospital use? AB - This study applies data from the Manitoba Longitudinal Study on Aging for two purposes. First examined were the hospital-utilization patterns of elderly nursing home admissions during the 2 years before and 2 years after entrance into a facility. In addition, use of the hospital by these new admissions and by long term nursing home residents was compared with that of the use by the elderly living in the community. When age, sex, and mortality rate are taken into account, the results indicate that, although both new admissions and long-term nursing home residents are sicker than their community counterparts, they are significantly less frequently hospitalized. PMID- 3807447 TI - Pneumonia--the quality of medical records data. AB - The quality of medical records data for patients who were hospitalized with community-acquired pneumonia was assessed by comparing medical records data with data obtained in a prospective study of pneumonia for the period April 1, 1984, to December 31, 1984. One hundred five patients fulfilled the case definition of pneumonia for entry into the prospective study. One hundred twenty-seven patients were identified by medical records data. Seventy-three of the patients appeared in both studies. The positive predictive accuracy of the medical records data was 57%. When the etiologic diagnoses for the 73 patients identified by both studies were compared, there was agreement only 52.6% of the time. Streptococcus pneumoniae was overdiagnosed, and Mycoplasma, specific viral causes, and Haemophilus influenzae were not recorded by the medical records data. The quality of medical records data regarding pneumonia can be improved by changing the current ICD-9-CM coding system for pneumonia and by providing instruction and an algorithm for abstractors to follow in assigning a diagnosis of pneumonia. PMID- 3807448 TI - Effect of an academic group practice on patient show rates: a randomized controlled trial. AB - Ambulatory medical clinics at academic centers are reputed to be expensive, inefficient, and poorly regarded by the medical residents who staff them. In an effort to address these problems, some centers have reorganized their traditional clinics into group practices. These group practices are thought to be more effective for teaching and providing services than are the traditional clinics. This is a report on the results of a study in which the authors reorganized two of four firm clinics into group practices in order to test the influence of the organizational changes on the various aspects of ambulatory care. During this controlled prospective trial of the group practice model, higher show rates were observed for patients in the group practices than in the traditional clinics (70% vs 65%, P less than 0.0005). The possible reasons for the higher rates are discussed. PMID- 3807449 TI - Failure of low-cost audits with feedback to reduce laboratory test utilization. PMID- 3807450 TI - Reducing effort with reminders and a parking pass to improve appointment keeping for patients of pediatric residents. PMID- 3807451 TI - [Complications and risk factors in acute diffuse peritonitis]. PMID- 3807452 TI - [Adult respiratory distress syndrome: 4 years' experience]. PMID- 3807453 TI - [Importance of changes in potassium in the management of patients with acute non lymphoblastic leukemia]. PMID- 3807454 TI - [Zinc or cimetidine]. PMID- 3807455 TI - [Definition and prognosis of adult respiratory distress syndrome]. PMID- 3807456 TI - [Strategy for the prevention of ischemic cardiopathy. European Atherosclerosis Society]. PMID- 3807457 TI - [Pulmonary histoplasmosis associated with osteoarticular manifestations. Apropos of a case and bibliographical review]. PMID- 3807459 TI - [Emphysematous cystitis in a diabetic patient]. PMID- 3807458 TI - [Renal vasculitis, diffuse pulmonary hemorrhage and silicosis. Analysis of 2 cases]. PMID- 3807460 TI - [Arteritis of the temporal artery: loss of vision in steroid treatment]. PMID- 3807461 TI - [Complications of the treatment with steroid pulse therapy in rheumatoid arthritis]. PMID- 3807462 TI - [Intrafamilial transmission of the virus of acquired immunodeficiency syndrome]. PMID- 3807463 TI - [Hepatic amyloidosis and portal hypertension]. PMID- 3807464 TI - The postmenopausal woman. PMID- 3807465 TI - Lower urinary tract disorders in the postmenopausal woman. AB - Lower urinary tract disorders in the postmenopausal woman can be particularly disruptive to a patient's life style. The disorders of interstitial cystitis, urinary tract infection, urinary incontinence, and urethral syndrome are discussed in this chapter. PMID- 3807466 TI - Naloxone prevents hyperthermia induced convulsions in the immature rat. AB - There is increasing evidence suggesting that endogenous opioid peptides play a role both in temperature regulation and in the etiopathology of seizures. We have studied the effects of the opioid antagonist naloxone on hyperthermia-induced seizures in unrestrained 15 day old rat pups. Saline injected control animals exposed to an ambient temperature of 40 degrees C for one hr showed a gradual increase in body temperature reaching a maximum of 42 degrees C at 50 min of exposure; at this time, all animals had convulsions and 86% died. Animals pre treated with 10 mg/kg naloxone reached a maximum core temperature of 41 degrees C after 60 min at 40 degrees C and no convulsions or deaths were observed. When animals were exposed for 60 min to a 27 degrees C environment, saline controls maintained their normal body temperature throughout the experiment, while 5 mg/kg naloxone produced a marked hyperthermic effect. These experiments suggest that endogenous opioids may play a role in both temperature adaptation and hyperthermia-induced seizures in the rat pup. PMID- 3807467 TI - Effects of ATP and VIP on guinea pig airways. AB - The bronchodilator effects of vasoactive intestinal peptide (VIP) and adenosine triphosphate (ATP), putative neurotransmitters of nonadrenergic, noncholinergic innervation, were compared with those of isoproterenol (ISP) in guinea pig airways by in vivo and in vitro techniques. In both studies, the test agents produced dose-dependent relaxations. The response of airway smooth muscle to ISP was significantly greater than the responses to the test agents. In the in vivo studies, the test agents produced statistically equieffective responses. However, in the in vitro studies, VIP produced complete relaxation of the precontracted tissues to the baseline, whereas ATP could not, suggesting VIP as a more effective relaxant than ATP. PMID- 3807468 TI - A contribution to indirect ophthalmotonometry in beagles. AB - A test of suitability of the electroimpression tonometer from Fritz Schwarzer GmbH, Munich, for measuring intraocular pressure in dogs was performed. Intraocular pressure of 63 clinically healthy English beagles was measured in both eyes using the instrument with different plunger weights. Intraocular pressure and volume of corneal depression during measurement were determined as a function of the plunger weight from readings on the tonometer with the aid of Friedenwald's tables (2). Using Friedenwald's law and with knowledge of the rigidity coefficient, an intraocular pressure of 32.7 mmHg was found, with individual variations between 12.8 and 54.2 mmHg. The rigidity coefficient for dogs, which was determined by linear regression, was, on average, 0.0103. Differences between male and female dogs were not significant for either parameter. A conversion table for eyes with a rigidity factor of 0.0103 is attached. Intraocular pressure as a function of plunger weight and the reading of measurement is shown in mmHg. In our measurements the Schwarzer electrotonometer for determination of intraocular pressure provided easily reproducible readings. PMID- 3807470 TI - Studies on gastric bicarbonate secretion in man by means of a two-component method. AB - A method for measurement of gastric bicarbonate secretion in man, based on a two component model of gastric secretion, has been recently described. The results obtained by employing that method for clinical studies are reported and reviewed. PMID- 3807469 TI - Pharmacokinetic evaluation of cefsulodin in children with and without cystic fibrosis treated for infectious diseases. AB - The pharmacokinetic characteristics of cefsulodin have been studied in 7 patients suffering from cystic fibrosis (CF) and compared to the findings in 6 children without CF. They were given intravenous bolus doses (3 min) of 40 mg/kg. The antibiotic concentrations were assayed by high-pressure liquid chromatography. The serum concentrations were lower in the CF group as reflected by the mean total area under the serum concentration curves of 180 vs. 309 mg h/1, and the serum concentrations after 8 hours which were below the detection limit in the CF patients compared to 4.7 mg/l in the non-CF. The patients with cystic fibrosis had a not significantly lower total body clearance (5.8 vs. 7.0 1/h). The serum half-life was slightly shorter in patients with CF (1.2 vs. 1.4 hours). Consequently, given microbes of the same MIC's, patients with CF should receive higher doses than those recommended for patients without cystic fibrosis. PMID- 3807471 TI - Mode of action of cholecystokinin octapeptide on smooth muscles of stomach, ileum and gall bladder. AB - Mechanical activity of preparations isolated from canine and guinea-pig stomach, ileum and gall bladder was recorded. At least 2 strips were cut out from each organ and investigated simultaneously in thermostatically controlled organ baths. Responses to acetylcholine (ACH) were used for comparison. Octapeptide of cholecystokinin (CCK-OP) at concentrations of 5 X 10(-11) M to 10(-8) M produced dose-dependent tonic concentrations in all muscle strips and showed a higher affinity but lower efficacy as compared to ACH. Atropine (10(-7) M 10(-5) M) had no effect on the CCK-OP responses in stomach and gall bladder muscle strips but it significantly decreased the CCK-OP responses in ileum muscle strips. Dibutyryl cyclic GMP (dbc GMP) at concentrations of 10(-5) M-5 X 10(-4) M did not change the ACH dose-response curves but shifted to the right in parallel to the control the dose-response curves for CCK-OP in all muscle preparations with pA2 values 5, 5.3, 7.2, and 6 for canine stomach and guinea-pig stomach, ileum and gall bladder, respectively. Michaelis-Menten's analysis suggested a competitive type of interaction of dbc GMP on CCK-OP contractile responses of guinea-pig ileum and gall bladder; at a higher concentration (5 X 10(-4) M) the antagonistic effect of dbc GMP in canine and guinea-pig stomach appeared to be a mixed or uncompetitive type. The data suggest that the contractile effects of CCK-OP in the iliac smooth muscle are caused by cholinergic and direct mechanisms whereas on the gall bladder and gastric smooth muscles by direct myogenic mechanisms only. PMID- 3807472 TI - Rifampicin concentrations in cerebrospinal fluid and plasma of the rabbit by high performance liquid chromatography. AB - A high performance liquid chromatographic (HPLC) assay has been developed for the measurement of rifampicin in cerebrospinal fluid and plasma samples in the rabbit. The method involved a preliminary organic solvent extraction of the drug and p-dimethylaminobenzoic acid (internal standard) from biological samples and subsequent concentration and analysis by HPLC. An aliquot (25 microliters) of the concentrate was injected into the liquid chromatograph and eluted with acetonitrile-10 mM phosphate buffer of pH 3.5 (48: 52, v/v) on a 30 microns C8 reversed phase column linked to a 5 microns C8 analytical column at ambient temperature (25 +/- 1 degrees C). The eluate was detected at 215 nm. The method has been used to investigate the disposition of rifampicin in plasma and CSF in rabbits. PMID- 3807473 TI - Pharmacokinetics of azlocillin in children with and without cystic fibrosis treated for infectious diseases. AB - The pharmacokinetic characteristics of azlocillin were compared in 7 children with cystic fibrosis (CF) and 6 children without this disease who were all treated for infectious diseases. Azlocillin was administered as intravenous bolus injections in doses of 200 mg/kg. The serum concentrations were somewhat lower in CF than in non-CF as reflected by total areas under the serum concentration curves of 594 and 677 mg h/1, and serum levels after 8 hrs of 10.7 mg/1 in non-CF vs. a concentration below the detection limit in CF. The CF children had a lower serum half-life (1.1 hrs) than the children without this disease (3.3 hrs). The difference is explained by higher total body clearance in CF (12.7 1/h) than the non-CF group (8.4 1/h). The dose interval should either be shorter, or the doses increased, when azlocillin is administered to patients with CF. PMID- 3807474 TI - Kinetics of piretanide absorption from the gastrointestinal tract. AB - In a recent report, it was shown that the loop diuretic piretanide is rapidly absorbed after placement of a piretanide solution in the duodenum, while the rate of absorption is definitely slower when the drug is instilled into the ascending colon (5). When piretanide is instilled into the stomach, the absorption process does not differ significantly from that after placement in the duodenum, neither with respect to amount nor rate (5). However, it was not clear from this study whether piretanide is directly absorbed from the stomach or rapidly released into the duodenum. In a study with five volunteers piretanide was instilled into the stomach via a gastroscope. The volunteers took part in two trial phases in a randomized cross-over design: in one phase the administration of 6 mg piretanide was preceded by intravenous administration of 40 mg hyoscine-N-butylbromide (HNB) to immobilize the stomach while in the alternative phase this coadministration of HNB was omitted. Furthermore, the volunteers were lying on their left side to avoid the gastric fluid leaking out into the intestine by gravity. From the concentration-time-curves monitored it can be concluded that piretanide is absorbed directly from the stomach for almost all subjects but with different rates. The rate of absorption increases clearly when the immobilizing effect of HNB disappears. It is most probable that returning peristaltic waves and succeeding gastric emptying results in enhanced absorption from the upper intestinal tract. Furthermore, a pharmacokinetic model which takes into account the differences in the rate of absorption along the gastrointestinal tract was adjusted to the data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807475 TI - [Continuous peritoneal dialysis--an alternative in chronic renal insufficiency in children]. PMID- 3807476 TI - [Examination of suspected stroke--medical and economical aspects]. PMID- 3807477 TI - [Psychiatric symptoms related to the HIV epidemic. 2 case reports with outbreak psychosis]. PMID- 3807478 TI - [AIDS--even children are affected]. PMID- 3807479 TI - [The first case of cryptococcal meningitis in a Swedish patient with AIDS]. PMID- 3807480 TI - [Crigler-Najjar type II syndrome does not normally demand long-term care]. PMID- 3807481 TI - [8 pregnancies in 2 years--1 spontaneous abortion, 7 miscarriages]. PMID- 3807482 TI - [Significant lack of reports on alcohol-related causes of death on death certificates]. PMID- 3807483 TI - [Diagnosis of Borrelia infections is an all-year-round problem as the serological examination of the cases from 1985 shows]. PMID- 3807484 TI - [Development of a new system for surgical ultrasonic aspiration used in cancer surgery]. PMID- 3807485 TI - [Benign monoclonal gammopathy--a condition in which it is difficult to predict its significance]. PMID- 3807486 TI - [Analysis of HBA1 is necessary in the routine check-up of patients with type 2 diabetes mellitus]. PMID- 3807487 TI - [Improved treatment of obstructive apnea syndrome with palatopharyngoplasty]. PMID- 3807488 TI - [Determination of collagen biosynthesis in liver diseases is possible by a non invasive method]. PMID- 3807489 TI - [Patients with suspected and unverified myocardial infarction--prognosis]. PMID- 3807490 TI - [Methadone treatment in the prevention of AIDS. Heroin-dependent prostitutes are an important target]. PMID- 3807491 TI - [Idiopathic pulmonary hemosiderosis--an unusual cause of anemia in children]. PMID- 3807492 TI - [Reversible pulmonary hypertension--a case report with a 20 year follow-up]. PMID- 3807493 TI - [Intensive care of children with status asthmaticus at the Pediatric Department of St Goran Hospital 1970-1984]. PMID- 3807494 TI - [Hereditary protein C deficiency increases the proneness to thromboembolism]. PMID- 3807495 TI - [Hypertensive crises are rare conditions. Uncritical use of intravenous antihypertensive agents can be more harmful than useful]. PMID- 3807496 TI - [Successful abdominal surgical incision in a man of almost 101 years old]. PMID- 3807497 TI - [Mask anesthesia in anal fissure as the cause of facial paresis]. PMID- 3807498 TI - [Effects and side effects of taurolin in experimental peritonitis in the rat]. AB - Taurolin (2%) was tested in a peritonitis in the rat. In a control group without treatment the mortality was 63% 80 h after infection. Intraperitoneal application of taurolin did not change this mortality rate but delayed the mortality by 8 h. Intravenous administration of taurolin increased mortality to 87%. In a second experimental protocol the dosis of bacteria was increased and 100% of the animals died within 16 h. Gentamicin-Piperacillin therapy reduced the mortality to 50%. With taurolin this effect of antibiotics could not be improved. In both groups taurolin was not able to reduce toxic lung edema. With these results and the knowledge of the literature taurolin cannot be recommended for clinical use. PMID- 3807499 TI - [Development of esophageal cancers in patients following cardiomyotomy]. AB - During a 20 year period we observed that in six patients with carcinoma of the esophagus associated with achalasia, four patients had had a prior Heller operation. Fifty patients with achalasia of the esophagus took part in endoscopic and histologic surveillance 5-15 years after cardiomyotomy. We have found a correlation between the severity of histologic changes and the duration of symptoms before the operation. It seems reasonable to advise early therapy to avoid the development of a dilated, poorly emptying esophagus. Our results suggest that long-term regular surveillance of the patient with achalasia is essential even after surgical treatment. PMID- 3807500 TI - [Functional results following conservative and surgical therapy of pathologic fractures in malignant diseases]. AB - From 1972-1982 149 pathological fractures in 91 patients were treated. 134 of these were caused by malignant disease. With 78% metastases were the most common cause for fractures. 59% of the patients were women. The most frequent fracture localisation was the femur followed by ribs and humerus. 62% of the fractures but 100% of the leg fractures were treated operatively. The best functional results were achieved after compound osteo-synthesis. The mean survival time of the patients was 10.7 months. The one year survival rate was 24.6% and the two year survival rate was 9.2%. The best survival rates were observed in women, patients with breast cancer metastases, femur shaft- or subtrochanteric fractures. The lowest survival rate was found in male patients, patients with unknown primary tumour and femur neck fractures. PMID- 3807501 TI - [Must in every case of thoracic trauma an ECG be prepared immediately or later for clinical control?]. PMID- 3807502 TI - [Proceedings of the German Surgical Society, 103d session, 23-26 April 1986]. PMID- 3807503 TI - [Carotid endarterectomy in vertebrobasilar insufficiency]. AB - In 45 patients with uni- or bilateral stenoses of the internal carotid artery in association with symptomatic vertebro-basilar occlusive disease 61 carotid endarterectomies had been performed. 28 patients had at least one patent posterior communicating artery (PCA) visualized angiographically (group A). Of these, 26 patients (93%) became asymptomatic or improved postoperatively. Of the 17 other patients in whom the PCA did not visualize by preoperative angiography, only 8 (47%) subsequently became asymptomatic or were improved (p less than 0.05). Thus, identification of the PCA (angiographically or by transcranial Dopplersonography) is important in predicting those patients in whom carotid endarterectomy may be strongly recommended. PMID- 3807504 TI - [Indications and surgical results in asymptomatic stenosis of the carotid artery]. AB - In 101 patients 114 asymptomatic carotid stenoses were treated operatively, complicated by one lesion of hypoglossic nerve and one temporary neurologic deficit. During the follow-up period of 6-89 months cardiovascular diseases were seen in 60% of the patients. There were 9 late deaths, 5 due to myocardial infarction and 2 due to contrahemispheric cerebral ischemia. TIA's or cerebral infarctions were not observed in the hemisphere corresponding to the operated carotid artery. Interdisciplinary patient selection, non-invasive diagnostics and selective shunt protection are considered to be essential risk reducing factors. PMID- 3807505 TI - [Stab injuries of the heart--an indication for thoracotomy]. AB - The indication for thoracotomy is undisputed with gaping wounds and massive hemorrhage. Pericardial tamponade, however, can develop with discrete stab wounds. Since valuable time is lost during management of superficial wounds, the success of cardiac wound revision, which is usually possible without a pump oxygenator, is limited due to the tamponade-related reduction of cerebral perfusion and subsequent ischemic brain damage. Exploratory thoracotomy, the risks from which are small compared to those from pericardial tamponade, is generally indicated for stab wounds of the heart. PMID- 3807506 TI - [Blunt heart injuries]. AB - Cardiac injuries were present in 16% of our patients suffering from blunt chest trauma. 25% of these cases had no concomitant rib fractures. Sonography is extremely important for evaluation. In myocardial contusion the electrocardiogram reveals mainly disturbances in repolarisation (66 out of 108 patients) and rhythm disturbances (59 patients). A ratio of CK-MB isoenzyme/total CK of over 8% is highly suggestive of myocardial injury. Continuous monitoring in ICU is mandatory. Prognosis is mainly based on additional injuries. Heart wall rupture and luxation of the heart require operative treatment. Lesions of the aortic valves are the most frequent valve injuries. PMID- 3807507 TI - [Clinical aspects and therapy of blunt heart trauma]. AB - In 10 to 66% blunt chest traumata lead to cardiac traumata. As it is shown in our special collective (n = 12) injuries of the pericardial sac of the myocardium, of the myocardial septum, of the coronary arteries and of the cardiac valves have occurred. Therefore clinical symptoms are various and the diagnosis remains difficult with regard to the causative polytrauma. Bleedings and/or pericardial tamponade caused by rupture of the atrial or ventricular wall, injury of main coronary vessels or cardiac dislocation after pericardial rupture urgently require a surgical intervention. Aneurysms caused by blunt trauma, ventricular septal defects, valve insufficiencies may be mostly treated in the interval. PMID- 3807508 TI - [Indications for surgery of mediastinal tumors]. AB - The indication for operation of mediastinal tumors is based on the variability of this disease. Malignant tumors should be operated as far as possible. Tumors of the thymus should be operated, since there is a considerable risk of malignancy. Primarily benign tumors also should be operated, because growth of the tumor could cause local functional problems and malignant degeneration cannot be excluded. Mediastinal tumors in systemic diseases (e.g. lymphoma) should only be operated in order to enable histological diagnosis or to reduce the size of the tumor. PMID- 3807509 TI - [Hemodynamic cardiovascular effects caused by mediastinal tumors]. AB - From 1972 to 1985 158 patients (pts.) were operated because of a mediastinal tumor at the Dept. of Thoracic and Cardiovascular Surgery at Dusseldorf. The tumor led to hemodynamic effects in 11 pts. (8 female, 3 male). In 6 pts. occurred a passive congestion of the upper caval vein (malignant teratoma 2 X, malignant thymoma 2 X, Boeck's disease 1 X, Non Hodgkin's disease 1 X), 4 pts. had a functional stenosis of pulmonary artery (dermoid 2 X, benign thymoma 2 X) and 1 pt. had pericardial effusion by a neurinoma. Being operated all pts. with 'pulmonary stenosis' were free of complaints, while all other pts. had infaust prognoses. PMID- 3807510 TI - [Value of noninvasive and intraoperative diagnosis of malignant mediastinal tumors]. AB - Among malignant tumors of the mediastinum lymphomas are no indication for operation. In our experience, however, fine needle puncture, computed tomography (CT), nuclear magnetic resonance, mediastinoscopic biopsy of lymph nodes and intraoperative freeze section histology can only rarely differentiate between lymphomas and other tumors of the mediastinum. Only CT-guided or direct parasternal biopsy including immunhistochemistry can yield a reliable preoperative diagnosis and prevent unnecessary operation of lymphomas. PMID- 3807511 TI - [Clinical course following thymoma extirpation]. AB - The authors report on 48 thymomas operated on between 1968 and 1985. The survival curve of the 37 (77.1%) totally resected patients showed a marked decrease during the first year postoperatively to 85.8%. The 5-year-survival-rate was 78.5%. Predominantly epithelial thymomas had a significantly worse prognosis than those with lymphocytic predominance. Associated myasthenia gravis (21 of the totally resected patients) as well as invasion beyond the capsule proved to be of negative prognostic significance. Even in cases of gross invasion into neighbouring organs a curative resection was followed by a markedly better prognosis than a mere biopsy or partial resection plus radiotherapy. PMID- 3807512 TI - [Simultaneous interventions of the bile ducts and intra-abdominal organs: what is indicated and when?]. AB - 405 surgical interventions had been carried out simultaneously on the biliary tract and other intraperitoneal organs from 1960 to 1984. The patients were divided into three groups. Concerning group A and B (58 patients) the indication for that double-operation was absolute. The range of postoperative wound infections was 10.3%, complications were noted in 24.1%. Lethality rate was 6.8%, hospitalisation took place for 17.7 days. Concerning group C (347 patients) without absolute indication for surgical treatment on the biliary tract and another intraperitoneal organ wound infections subsequent to operating occurred in 5.7%, lethality rate was 2.3%. Complications could be seen in 12.1% and hospital treatment continued for 15.5 days. Principally occasional operations and surgical treatment carried out simultaneously should be avoided. PMID- 3807513 TI - [When is a simultaneous operation of Meckel's diverticulum indicated: (always- never--or only in special circumstances?)]. AB - Meckel's diverticulum causes in complications 4-16%. These appear, however, only in adolescents. Thus the simultaneous removal of a diverticulum without symptoms is only justified in adolescents. One should renounce to a search and removal in adults. In case of appendectomy indicated by suspected appendicitis with the appendix found to be normal and absent exudation in the abdomen, the search for a Meckel's diverticulum is superfluous. One should also renounce to a search and removal if there is a septic abdominal disease, because a removal in peritonitis is more complicated than the risk of complications a not-removed diverticulum will cause. PMID- 3807514 TI - [Preventive and simultaneous appendectomy]. AB - 75 patients underwent simultaneous appendectomy, when gall bladder, stomach or large bowel were chiefly operated. Complications of incision marks were observed in six cases, but only one of them being possibly due to appendectomy. Six common complications could not be explained by additional operation. Postoperative treatment was not extended. 5 patients died due to the severity of their main disease. Prophylactic or simultaneous appendectomy were conditionally recommended and subjected to a decision by a fully experienced surgeon. PMID- 3807515 TI - [Appendicitis in a personal 10-year patient sample]. AB - 862 patients underwent appendectomy for suspected acute appendicitis at the 3rd Surgical Department of the Semmelweis University, Budapest during the period from 1976-1985. In 111 cases neither the histologic examination nor the macroscopic finding at operation confirmed the inflammation. We considered these cases as "chronic appendicitis". The postoperative mortality rate was 0.8%. Surgical complications arose in altogether 10 patients. In the remaining 751 patients the mortality rate was 0.5% with 20 complications. The incidence of surgical complications was not significantly decreased in cases with "acute appendicitis" therefore we do not emphasize prophylactic appendectomy. PMID- 3807517 TI - [The cold thyroid nodule]. AB - A "cold" thyroid nodule basically always carries the risk of being "malignant". Scintigraphy and sonography can not differentiate between benign and malignant. The best means to discriminate the risk of "cold nodules" is by way of fine needle aspiration biopsy. In general the operative indication for "cold" nodules can be generous. In high suspicion the best surgical strategy is "hemithyroidectomy" as primary operation. PMID- 3807516 TI - [Chronic appendicitis]. AB - From the clinical point of view the so-called "chronic appendicitis" is not existent. In 2/3 of our patients with so-called clinical appendicitis-like symptoms the clinical picture did not correlate with pathological-anatomical findings. There is a strong indication for an operation and only in such recurrent cases where other diseases are excluded. PMID- 3807518 TI - [The cold adenoma as a surgical indication in an endemic area: over- or underestimated?]. AB - The retrospective analysis of 7016 operations of the thyroid (1978-1985) showed an increase of operations of cold nodules from 23% to 52%. The rate of malignancy of cold nodules decreased from 7.2% to 6.3%. But, the intensive operative management of cold nodules resulted in an increase of operations of low stage tumors. Therefore radical operation of thyroid tumors was possible in 68.3% of cases. An elevated rate of malignancy is observed, if a cold nodule is associated with the following criteria: solitary, solid, male patients, younger than 30 and older than 60 years. PMID- 3807519 TI - [Indications status and surgical strategy in cold struma nodule]. AB - Scintigraphy, sonography and fine needle cytology have the best accuracy in the evaluation of a cold nodular goitre. In 2,100 investigations on nodular goitre, it could be found that the incidence of the prophylactic operation for histological diagnosis decreased more than half. On the other hand, with the precise diagnosis the surgeon was able to perform thyroidectomy for thyroid cancer in the first operation. Thus complications of thyroidectomy (paralysis of the recurrent laryngeal nerve, tetany, residual thyroid tissue) could be reduced. PMID- 3807520 TI - [Cold struma nodule--an absolute surgical indication?]. AB - From 1969 to 1984 3,972 operations of the thyroid gland were performed. 3,540 scintigraphic findings were evaluated retrospectively. In 2,013 (57%) cases one or more so-called cold thyroid nodules were found. The malignancy rate in these nodules was 5.6%. The fine needle biopsy and cytology gave in 17.9% false negative results. Based on a malignancy rate of 5.6%, rather high false-negative results of fine needle biopsy and acceptable postoperative complication rate we estimate strict operative indication. PMID- 3807521 TI - [Cold struma nodule--enucleation or resection]. AB - During 1969-1984 2,408 patients underwent thyroid surgery at the Dept. of General Surgery, Giessen University. In 72.5% cold nodules have been diagnosed. However, a cold nodule has been in less than 50% of all cases with cold nodules the causal indication for operation. Inspecting closely the whole thyroid gland, the operating surgeon removes the nodule with a segmental resection if there are no further regressions or suspicion of malignancy. This technique facilitates the histological detection of a possible highly differentiated carcinoma because of its invasion into the capsule. PMID- 3807522 TI - [Intraoperative rapid biopsy of thyroid neoplasms and surgical procedures in atypical adenoma]. AB - For a differential diagnosis of atypical adenoma and highly differentiated follicular carcinoma cryosections are of value only if findings are positive. Between 1977 and 1982 we observed 85 thyroid carcinomas and 47 atypical adenomas. In 5 cases the diagnosis on the basis of a cryosection had failed to detect a carcinoma. In patients with atypical adenoma we performed a subtotal resection; a primary lobectomy was not carried out as it would have meant exposing an unnecessarily high percentage of patients to an increased risk of complications. 3-8 years postoperatively the patients show no pathological findings. PMID- 3807523 TI - [Barrett esophagus as a precancerous condition]. AB - Barrett's esophagus is a precancerous stage as a malign degeneration occurs in about 15%. According to prospective studies the risk of development of cancer is 30 to 42 times higher than in the normal population. Risk factors for malign degeneration, which mostly concerns white males, are abuse of alcohol or nicotine and chronic gastroesophageal reflux. Antireflux surgery is only indicated in Barrett's esophagus in combination with active reflux esophagitis. The uncomplicated Barrett's esophagus should be controlled by endoscopy. The adenocarcinoma in Barrett's esophagus has to be considered as an esophageal carcinoma. Due to its metastatic spread in mostly aboral direction it can be treated by blunt dissection of the esophagus. PMID- 3807524 TI - [Principles of preventing esophageal cancer in corrosive strictures]. AB - In the treatment of corrosive strictures of the esophagus the subsequent development of carcinoma in the cicatrixed esophagus should be taken into consideration. Prophylactic measures should be undertaken. In case of severe persistent stenosis surgery is the most adequate management. PMID- 3807525 TI - [Differential indications in perforation of gastroduodenal ulcer]. AB - The differential indication of perforated peptic gastroduodenal ulcer is presented giving emergency surgical intervention preference. Simple closure after radical excision with a mortality rate of 12.1% as demonstrated in our clinical material is generally performed and in some selected cases the so-called primary definitive therapy excision, SPV or distal gastric resection. In cases of doubt simple closure is performed. An absolute acute indication for simple closure is also valid for the atypical perforation. PMID- 3807526 TI - [Functional anatomy of the human spleen]. AB - For surgery of the spleen the variability of the splenic artery and the lack of major intrasplenic anastomoses are important. The latter enables segmental resections. Lymphocyte subsets, macrophages and dendritic cells, which are necessary for immune responses of the spleen, show a specific localisation in the splenic compartments. The spleen is the most important organ for lymphocyte recirculation. Intracellular particles and membrane defects of red cells are removed from the erythrocytes as they pass through the pulp cords of the red pulp. A knowledge of the functional anatomy of the spleen helps to interpret the effects of splenectomy and splenic transplantation. PMID- 3807527 TI - [Indications for splenectomy in non-malignant systemic diseases]. AB - The benign systemic disorders with involvement of the spleen are divided into haematologic diseases, thesaurismosis, collagenosis, morbus Boeck, infectious diseases, parasitosis and others. 4/5 of the cases are haematologic diseases of the erythrocytic, the thrombocytic and lymphatic system as well as myeloproliferative and aplastic syndromes. 227 of 1214 splenectomies of the last 20 years were done in benign systemic diseases. The functional and mechanical hypersplenism as a rule is the cause for operation. The specific indications, the medical pretreatment and the combination of surgery and non-surgical measures are discussed. PMID- 3807528 TI - [Splenectomy: surgical indications in malignant hematologic diseases]. AB - Indications for splenectomy in malignant hematological diseases are discussed for relief of symptoms (splenomegaly, cytopenias), for staging (M. Hodgkin) or improvement of survival (hairy cell leukemia). The role of splenectomies is also evaluated for Non-Hodgkin lymphomas, chronic lymphatic leukemia, myelofibrosis and for chronic myeloic leukemia. PMID- 3807529 TI - [Complications following splenectomy]. AB - In a retrospective (n = 570) and prospective study (n = 86) early complications following splenectomy were registered in 127/570 (22.3%) resp. 33/86 (38.4%). The mortality rate was 6.6% resp. 6.9%. Recurrent hemorrhage was the most dangerous, infections (pleuropulmonary, wound healing, subphrenic abscess) were the most frequent complications. Their rate is related only to the underlying disease or operative indication (elective splenectomy with hematological diseases; ruptured spleen; incidental splenectomy). PMID- 3807530 TI - [Long-term sequelae of splenic loss]. AB - Beside the increased risk of infection there are further long lasting consequences of splenectomy. The hematologic changes include morphological alterations of red cells, lymphocytosis, monocytosis and increased blood viscosity. There are complaints about general disturbances like physical weakness, abdominal pain or intolerance of alcohol. The response to certain vaccinations is impaired especially in the early postoperative period. Findings concerning the influence on the growth of cancer are controversial. There seems to be an increased risk of disturbed wound healing. PMID- 3807531 TI - [Risk of infection and surgical consequences of splenic loss in childhood]. AB - Among 1882 splenectomized children with a mean follow-up period of more than 5 years the incidence of sepsis was 3.2% with a mortality of 1.4%. As expected the lowest risk (1.6%) was found in case of trauma. Susceptibility to sepsis increases after splenectomy caused by severe disease. It was highest (9.8%) in case of M. Hodgkin, portal hypertension and thalassemia. The younger the patient the higher the risk of PSI. 55% of the affected patients suffered from sepsis within the first two years, 35% after three up to six years. Vaccination and antibiotic prophylaxis are recommended including information about the risk of sepsis. Preservation of orthotopic splenic tissue, if indicated, should be the surgical consequence in childhood. PMID- 3807532 TI - [Risk of infection following splenectomy]. AB - The problem of a reduced resistance against infections in splenectomized patients is again described on the occasion of one patient who died within a very short time after the beginning of a severe infection. A retrospective study of 150 patients without spleen showed that 2.6% died in a consequence of a severe infection. From the surviving patients 20% complained of very frequent infections. Immunological laboratory data as well as the reaction against recall antigens were reduced in those patients. So not all patients without spleen bear a high risk with regard to severe infections. In spite of this fact surgeons should try to preserve the spleen even in adults. PMID- 3807533 TI - [Late results of 1,046 breast reduction-plasties]. AB - Between 1971 and 1985 1046 reduction mammaplasties were performed using the Strombeck technique with personal modifications and also subtotal amputations with free nipple grafting were carried out in 162 cases. Late results of these patients show in detail the age, the amount of weight resected, the histology and the complications. PMID- 3807534 TI - [Clinical and mammographic late results following Strombeck breast reduction plasties]. AB - Report about 197 breast reductions on 100 patients which were operated by the method of Strombeck. Indication was mostly macromasty and excessive ptosis. In the mean 740 g were removed on each side, in 18.2% there was removed more than 1000 g on one side. The more tissue was removed, the higher were local complications. The cosmetic result was good to excellent in 80%. The behaviour to the husband was in most cases not changed after the operation. Mammographic studies showed a good interpretation in 80%. After the operation all patients lost their preoperative complaints. PMID- 3807535 TI - [Results of comparative studies of Strombeck and Skoog breast reduction-plasty]. AB - Long-term results in reduction mammaplasty can be evaluated at the earliest after one year. Criticism about the result induced us to apply more often the technique of Skoog beside the procedure of Strombeck. A follow-up study of 110 patients could be done. Objective parameters were considered as well as subjective factors. Special attention was paid to diagnosis of cancer after mammaplasty. PMID- 3807536 TI - [Late results of McKissock breast reduction-plasty]. AB - 162 patients had a McKissock's reduction mammaplasty between 12.78 and 4.85. The areola is transposed thereby on a cranio-caudal flap. A questionnaire and a checkup was performed 3 1/2 years postop., 57% found the results very good and good, 31% satisfactory, 3% adequate, 6% imperfect and 3% bad. The sensibility of the nipple was almost unchanged in 40%. Erectibility of the nipple was in most cases present. The measures of the breast changed only little after 3 1/2 years. PMID- 3807537 TI - [Do the results of reduction-plasties of the breast justify indications for operation?]. AB - From 1961-1985 we have made by cause of hyperplasia 226 mammaplasties. By continuous follow-up examinations we found out that more than 90% of our patients were quite satisfied with the result and its remarkable that in some cases the women were more happy than the doctor. At all times we have seen a medical indication in order to do a mammaplasty. But before such an operation it seems necessary to analyse the structure of personality. For sake of the surgeon and the surgical method psychopathic personalities should be refused. PMID- 3807538 TI - [Mastopexy with few scars]. AB - Conventional techniques of reduction mammaplasty result in obvious and sometimes unpleasant scars. G. Peixoto (1980, 1984, 1985) has developed a technique of mastopexy and reduction mammaplasty which leaves only minimal scars. Good results are to be achieved in younger females with contractile skin with breast asymmetry and moderate mammary hypertrophy and ptosis. Typical examples are demonstrated resulting only in a periareolar scar. PMID- 3807539 TI - [Corrective interventions of the breast]. AB - The shape, size and location of the nipple and areola are the points that distinguish and ideal-looking breast. Tuberous deformity, inverted nipple and excess of areola tissue are congenital anomalies of the breast. Surgical correction is indicated especially in a case of asymmetry. Acquired malformations of the nipple-areola complex can be the result of injuries or surgical treatment like breast reduction. In this cases a surgical correction improves the result. Some representative cases are demonstrated. PMID- 3807540 TI - [Measuring the sensitivity before and following breast reduction-plasty in 2 competitive surgical procedures]. AB - All non-operated breasts have an irregular pattern of sensibility. The areola is distinctly more sensitive than its periphery; the nipple has a very low grade of sensitivity. The postoperative sensitivity increases for about 2 years without reaching the former level. The loss of sensitivity is unrelated to the method of operation (Stromberg, Pitanguy). The loss of sensitivity is proportional to the reduction of tissue. Most important is to keep the ability for breast-feeding (sympathetic innervation by the arterior branch of the 4th ramus cutaneous lateralis). PMID- 3807541 TI - [Capsule fibrosis in silicone implants]. AB - The contracture of soft tissue capsule, appearing after implantation of all types of breast prosthesis, is the central problem of interest in the augmented breast. Clinical results were graduated in the Baker classification according to the degree of severity. Frequency rate depends on time lapse between implantation and post-examination, definition of capsular contracture, number of all patients and type of augmentation. Various factors are assumed to be causes of capsular contracture; i.e. haematoma, foreign body reaction, subclinical infections and physical-geometrical characteristics of prosthesis. It is possible to influence fibrosis with steroids and antibiotics. PMID- 3807542 TI - [Age as a risk factor]. AB - Risk factors like myocardial infarction, hypertension, and diabetes are increasing with age and cause higher perioperative mortality and morbidity. Advanced and complicated stages of various malignant and benign diseases of colon, gall bladder and bile ducts, stomach and great vessels are also more common in the aged population and therefore enlarge the risks of surgery. There is no dependency between age and frequency of intraoperative complications. No difference could be proven in regard to the malignancy of colorectal cancer in patients younger than 50 and older than 80 years. PMID- 3807543 TI - [Surgical indications in abdominal aortic aneurysm in advanced age]. AB - The operative mortality of abdominal aortic aneurysms (AAA) increases with the age of life (0.0% below 65 y., 11.8% above 75 y.). This fact is mainly caused by an increasing number of concomitant diseases. Therefore indication for surgery needs a critical assessment of the risk caused by concomitant diseases vs. risk of rupture of the aneurysm. Recent progress in operative technique and anaesthesia justifies surgery also in high risk patients with impending rupture (large aneurysms, especially with eccentric aortic dilatation). The best approach to reduce emergency interventions for ruptured AAAs (mortality rate: 50%) is an ultrasound screening program for arteriosclerotic patients at risk. PMID- 3807544 TI - [Infrarenal aneurysm of the abdominal aorta in the elderly--surgical risk vs. danger of rupture]. AB - 426 consecutive patients who underwent operation for the resection of abdominal aortic aneurysm (AAA) between 1982 and 1985 were reviewed. The rate of the over 75-years old patients was 16.2%. In patients over 75 years, operated on electively, mortality was 4.2% but 47.6% in emergency cases. Compared with the younger patients the incidence of risk factors affecting mortality was only higher for myocardial insufficiency. AAA-rupture is more frequent in women. For asymptomatic AAA in the elderly an unstable angina pectoris, myocard insufficiency or incurable cancer limit operative approach because life-time will not benefit. PMID- 3807545 TI - [Replacement of the infrarenal aorta in advanced age]. AB - Between 1975 and 1986, infrarenal aortic replacement, due to aneurysm, was performed on 80 patients (mean age 78.4 +/- 3.2 years, 63 men, 17 women). From 28 electively operated patients one died (3.6%), and from 26 urgently operated symptomatic patients, 23.1% (n = 6). Following emergency operations due to rupture, the lethality rate was 50% (13/26). The figures for patients under 75 years of age were: 4.3% (12/277), 10.6% (7/66) and 40.9% (47/125). An analysis of patients, operated in an emergency, on account of ruptured aneurysm or with symptoms, showed that significant cardiovascular and pulmonary risk factors existed. The risk of electively operated patients older than 75 years is not higher than for younger patients. In our opinion, limitation of indication for operation, due to higher age, is not justified. PMID- 3807546 TI - [Morbidity and mortality following resection of an aortic aneurysm in the aged]. AB - From August 1984-August 1985 118 abdominal aortic aneurysms were treated surgically in the City Hospital Nuremberg. The mean age was 68.9 years, with 26.3% being over 75 y.; and there was a notable decline of elective procedures in this group, which was particularly jeopardized by cardial arrhythmias and renal insufficiency. The lethality was 0 in elective procedures, but reached 50% for symptomatic and over 50% for perforated aneurysms in the old age group. The high lethality of ruptured aortic aneurysms justify elective operation of aortic aneurysms in high age. PMID- 3807547 TI - [Significance of the personality of the surgeon in determining surgical indications]. PMID- 3807548 TI - [Indications for ligation of ductus arteriosus Botalli persistens in premature infants]. AB - Ligation of patent ductus arteriosus can be safely performed even in the smallest prematures and may be life-saving. Medical treatment with prostaglandin inhibitors may be substituted in selected cases. From 1976-1985 a total of 215 prematures was treated. 52 of those experienced spontaneous closure. In 68 infants closure occurred following indomethacin-treatment. 48 had operation after failure of medical therapy and 53 with contraindications to indomethacin were primarily operated. The overall mortality reached 20% and was highest among those with combined medical and surgical treatment. PMID- 3807549 TI - [Surgical indications in isolated splenic diseases]. AB - In clinical routine isolated diseases of spleen are rare manifestations. Absolute criteria for splenectomy are massive bleeding, malignancy, hypertrophic cysts and signs of perforation. Most other cases are relative indications for total splenectomy. Awareness of the spleen's immunological function prompted a search for other methods of management. Therefore an individual consideration on further medical treatment is necessary. Total splenectomy should withdraw from nonoperative or partial operative management of spleen diseases. By a correct preoperative diagnosis criteria should be established for selection of patients most likely to derive benefit from splenectomy. PMID- 3807550 TI - [Radiologic alternatives of splenectomy]. AB - Partial peripheral splenic embolization can be performed in case of incurable thrombocytopenia due to hypersplenism without following splenectomy. A combined proximal and peripheral splenic embolization should only be carried out immediately prior to splenectomy if complications of hemorrhage due to extreme splenomegaly are to be expected. An only proximally performed occlusion can be by bassed by collaterals. Anatomic blood vessel variations, techniques and complications are discussed in 6 cases. PMID- 3807551 TI - [Indications for the implantation of a vena cava filter]. AB - Intracaval filter implantation is an alternative to surgical removement of the sources of pulmonary emboli. The indication for implantation of a Greenfield vena cava filter, which is the far advanced type, has to be a very narrow one, however. The two main indications are: recurrent emboli despite adequate anticoagulant therapy and contraindications to anticoagulation and no possibility for venous thrombectomy or thrombolytic therapy. Venous disobliteration by surgical (thrombectomy) or medical (streptokinase) means remains the therapy of choice. PMID- 3807552 TI - [Autotransplantation of the spleen]. AB - No clinical parameter can prove that the autotransplantation of splenic tissue will restore all splenic functions especially in the immune reaction. Therefore this method is not an alternative to other methods of preservation of the ruptured spleen. Autotransplantation should be used only, when splenic rupture makes splenectomy necessary. PMID- 3807553 TI - [Immunologic capacity and blood circulation of splenic autotransplants- experimental results in swine]. AB - The study deals with the immunological capacity and perfusion rate of splenic grafts in pigs after autologous transplantation into the omentum majus. 12 months after operation the weight and relative blood flow of the regenerated splenic tissue were clearly reduced. The number of antibody forming cells in the grafts was only slightly decreased compared to the normal spleen, whereas the autotransplants could balance a serum-IgM-deficiency, observed due to splenectomy, 4 months after grafting. Furthermore the mitogenic stimulation of T- and B-lymphocytes showed different proliferation rates for the autotransplants compared to the spleen. PMID- 3807554 TI - [Functional performance of spleen transplants]. AB - Splenic autotransplants maintain the maturation of erythrocytes. They also sustain the clearance function qualitatively, but from quantitative aspects, they do not work sufficiently. Animal studies concerning the defence of bacterial infections, are divergent. From clinical examinations, a return of various defects by autotransplants is missed, even more, negative results are reported. So, the prevention of OPSI by splenic replantation is questionnable. PMID- 3807555 TI - [Assessment following total or partial splenic loss]. AB - Expert opinion after splenectomy: In splenectomized patients after trauma the risk of infection is up to 60 times increased. The incidence of sepsis amounts to 1.05, mortality to 0.5%. Spleen-preserving surgery guarantees an immunocompetence only if at least 30% of the spleen is preserved. The professional performance of people having undergone splenectomy is restricted by 30% during the first year ("MdE" of 30%), later by 10% if additional complications occur. PMID- 3807556 TI - [When is a breast-preserving operation permitted?]. AB - Breast preserving operations in cases of breast cancer are permitted only under following conditions: Tumor extension should not exceed stage pT1. Axillary lymph nodes have to be removed completely. Histological examination requires a competent pathologist. Carefully planned and consequently applied radiotherapy with a dosage of at least 60 Gy (6000 rad) is mandatory. PMID- 3807557 TI - [Morphologic criteria in breast-saving surgery]. AB - Efficiency of radiation therapy is dependent on the tumor mass on the one hand and on "radiosensitivity" on the other hand. Thus the locoregional acribic surgery is an urgently required presupposition regarding therapeutic success. In cases of early breast cancer (pT 1 N0 M0) unfavorable prognostic factors may initiate a discussion on adjuvant therapy. From the curative point of view at present breast preserving surgery referring tumors bigger that 2 cm (pT2) should be performed in cases with more advantageous prognostic parameters (low grade malignancy up to grade II a, low degree of tumor cell dissociation, favorable subtype, no relevant lymphangiosis carcinomatosa detectable, etc.). Additional immunohistochemical analysis of the receptor status and the proliferative compartment can be helpful for later therapeutic decisions. The possibility of breast preservation in only palliatively treated cases must be discussed separately. PMID- 3807558 TI - [Effect of the patient's risk factors on surgical indications]. AB - Surgical decision making includes the objective and quantitative estimation of the patient's risk for each individual case in his given situation. For classification of risk checklists should be established to serve as basis of the decision on indication. Intraoperatively the risk should be related to the extent of operation (extension, limitation, two stages). In the postoperative period complications can occur on the basis of general and local risks, who might also newly develop. Perioperative morbidity and mortality are valuable parameters for evaluation of risk and of indication as well as the operative procedure itself. PMID- 3807559 TI - [Tarsal tunnel syndrome]. AB - The tarsal tunnel syndrome shall be discussed in view of the available literature as well as experience derived from 58 operative procedures. A compression syndrome of the tibial nerve should always be considered in cases of pain of the foot after trauma to the lower extremity and foot. The etiology, clinical presentation and treatment shall be described. Conservative therapy is indicated in mild cases with no accompanying EMG alterations, whereas operative treatment and perineural decompression is required for those cases resistant to conservative measures or those with EMG alterations. PMID- 3807560 TI - [Do pathologico-anatomic parameters modify the incidence of recurrence following conservative breast surgery and radiotherapy?]. AB - 201 breast cancer patients (pT1-2, pN0-1) were treated with conservative breast surgery and radiation therapy. 28 (13.9%) treatment failures, -13 (6.5%) local recurrences, 4 (2.0%) axillary - and 11 (5.5%) distant metastases -, were found overall after a mean follow-up of 47 months. The differences between pT2 and pT1 tumors (20.6% vs 10.5%) and nodal positive versus nodal negative patients (28.1% vs 6.8%) are statistically significant. No differences were seen regarding histological features. PMID- 3807561 TI - [Local recurrence following surgery for breast cancer and its relation to the primary intervention]. AB - 32 cases of local recurrence following curative mastectomy were operated between 1975 and 1984. The primary operation was: radical mastectomy n = 20, simple mastectomy n = 6, lumpectomy with axillary dissection n = 6. The rate of local recurrence amounted to: 4.8% (20 patients out of 416) after radical mastectomy; 6 out of 15 patients after simple mastectomy (2 were N1-cases); 6 out of 15 patients after lumpectomy (one case: N1). CONCLUSION: With regard to local recurrence radical mastectomy showed significant better results when compared with less radical operations. PMID- 3807562 TI - [Breast-saving therapy--a safe alternative in primary treatment of breast cancer?]. AB - Since Fisher's publication in March 1985 conservative breast cancer treatment is viewed ever more uncritically. In order to avoid local recurrence this therapeutic modality can only be justified in connection with radiotherapy the negative effects of which are often neglected. Thoroughly competent surgical technique, careful pathological work-up of the tumor material and a computerized radiation planning as a prerequisite for a homogeneous radiotherapy of the breast are necessary to perform conservative breast cancer therapy. Legal-ethical aspects make it imperative to inform the patient about the advantages and disadvantages of conservative versus radical therapy. The realization of conservative breast cancer treatment on a broad basis is, at present, only justifiable under study conditions. PMID- 3807563 TI - [Principles of drug prevention of thrombosis]. AB - The most important reasons of venous thrombosis are injuries of the vessel wall, hypocirculation (stasis) and hypercoagulability of the blood (Virchow-Trias). The prophylaxis of thrombosis is based on the inhibition of the plasmatic coagulation system and on the improvement of circulation. In general surgery the onset of venous thrombosis can be reduced from 28% to about 9% by low-dose heparin prophylaxis. PMID- 3807564 TI - [Intermittent mechanical massage for the prevention of thromboembolism]. AB - Since 1977 we treated more than 7,000 out of 20,000 patients with risk of thromboembolic complications with intermittent pneumatic compression of the legs. Complications due to prophylaxis with heparin can so be avoided. Our statistical analysis makes it reasonable to use this physical method routinely for surgical in-patients. It is as effective as prophylaxis with heparin. The intermittent pneumatic compression is accepted by the patients and is more economical. PMID- 3807565 TI - [Prevention of thromboembolism with low-dose heparin]. AB - With an amidolytic assay plasma heparin activity is measured in patients undergoing elective abdominal surgery and general surgery under LDH-prophylaxis. The data obtained suggest that the response of the hemostatic system to 3 X 5000 U. heparin is individual and unpredictable. In 82 patients undergoing hip fracture surgery it could be demonstrated that there is a correlation between anticoagulant heparin activity and the incidence of DVT. PMID- 3807566 TI - [Indications and results of caval filter operation using the Kimray-Greenfield filter]. AB - Recurrent pulmonary embolism is a permanent risk. The caval filter is able to prevent embolism. The implantation can be done even in seriously ill patients under local anesthesia. In our patients no complication or recurrent embolism were observed. Only one case developed a thrombotic occlusion of the Kimray Greenfield filter as a result of retroperitoneal carcinosis. The relapse of embolism was prevented by the filter. All other implants were seen patent in the digital subtraction angiography. PMID- 3807567 TI - [Prevention of pulmonary embolism using a vena cava filter and cava clip]. AB - Surgical prophylaxis of pulmonary embolism by implantation of Vena-cava-filter (Greenfield) or Vena cava clip (Adams de Weese) was performed in 24 patients. The following indications were used: Recurrent pulmonary embolism under adequate anticoagulation, Pulmonary embolism in cases of contraindications to anticoagulation, Floating thrombus occurring late following deep vein thrombosis, After pulmonary embolectomy. In a retrospective study we recognized 0% recurrent pulmonary embolism, a vena cava occlusion rate of 4% and no clinically relevant signs of bilateral venous stasis in the lower limbs. PMID- 3807568 TI - [Value of transvenous caval occlusion surgery in view of the complications]. AB - 180 vena cava filters (9 23 mm and 120 28 mm Mobin-Uddin and 51 Kimray-Greenfield filters) were implanted from 1970 till December 1985. Technical problems prevented insertion in 5 cases with each filter. With the Mobin-Uddin filter misplacement occurred in 5 cases (3.8%); in two patients embolisation of the 23 mm filter into the pulmonary artery, once with lethal outcome, developed. One perforation of the right ventricle during insertion was successfully treated. Recurrent embolism was found in 3.8% with Mobin-Uddin (M-U) filters, none with Greenfield (K-G) filters. Filter-related operative mortality rate was 3.1% and 0% respectively. PMID- 3807569 TI - [Necessary diagnostic measures for determining indications for pulmonary embolectomy]. AB - Pulmonary angiography is the most reliable diagnostic procedure to establish the diagnosis of pulmonary embolism (high sensitivity and specificity). Therefore it should be performed routinely in the presence of any clinical suspicion of pulmonary embolism (PE) unless PE was excluded by perfusion lung scan or the patient needs urgent operative treatment because of hemodynamical instability. Hemodynamic parameters, blood gas measurements and right ventricular pressures as well are only useful in the therapeutic management and are of limited value in the diagnosis of PE. PMID- 3807570 TI - [Prerequisites of personnel and material resources in determining surgical indications]. PMID- 3807571 TI - [Indications for pulmonary embolectomy]. AB - Acute massive pulmonary embolism continues to be a major problem even though thrombolysis and surgical management have become well established methods of treatment. Our experiences demonstrate that the need for pulmonary embolectomy is rare, today embolectomy must be considered, when thrombolytics are contraindicated or ineffective, as emergency operation in moribund patients with sudden massive pulmonary embolism, in carefully selected cases with chronic post embolic obstruction of pulmonary arteries. PMID- 3807572 TI - [Drug therapy of pulmonary embolism]. AB - Heparin is indicated in pulmonary embolism suspicion, in minor and a part of submassive embolism. The dose is 15,000-20,000 U (acute) and 40,000 U/day subsequently. Fibrinolytic therapy with streptokinase or urokinase is indicated in massive embolism. Submassive embolism is treated by fibrinolysis if no contraindications against fibrinolysis are to be registered. PMID- 3807573 TI - [Isolated soft tissue trauma and combination injuries]. AB - The special problem in severe soft tissue injuries of the lower limb are the thin soft tissue coverage and the diminished blood supply of the distal lower limb and foot. For this reason there is a big difficulty in estimating the severity of the injury. We developed a classification for severe lower limb and foot injuries and classified: soft tissue damage. concomitant local injuries. fracture type. classification of multiple injuries. time of treatment. This classification resulted in 4 groups, which have a prognostic value especially towards amputation or preservation of the limb. PMID- 3807574 TI - [Compartment syndrome]. AB - Among the 4 compartments of the lower leg, the anterior and the deep dorsal compartment show the following significances: both contain important vessels and nerves, both are limited by tense osteofibrous walls. We report on 153 cases of treated compartmental syndrome of the lower leg - in 82 per cent caused by fractures - and 8 cases of CS of the foot. The frequency of irreversible late sequalae such as infection, functional loss or amputation strictly depends upon the time between injury and surgical decompression. The lowest frequency was found in those cases where decompression took place in the phase of impending compartmental syndrome. PMID- 3807575 TI - [Principles of surgical indications: aids in decision making]. AB - Several types of clinical studies provide important decision aids for surgical indications. They include quantitative data on outcomes and utility analysis, graphic illustration of the various possibilities for decisions by decision trees, controlled clinical trials with data used in decision trees and--if these trials fail for several reasons--carefully conducted and documented prospective and retrospective trials. Items for defining the term "surgical indication" were illustrated by constructing a decision tree for treatment of chronic duodenal ulcer. PMID- 3807576 TI - [Monitoring drug therapy in venous thrombosis]. AB - Minimal prerequisites for the follow-up of thrombolytic therapies are determinations of partial thromboplastin time, thrombin time and fibrinogen concentration. With help of these tests it is possible to lower the risk of rethromboses and haemorrhages. By including additional tests some patients may benefit in respect of safety and better knowledge of the underlying mechanisms. However, until now there exists no laboratory tests that is able to give information about success or failure of the therapy independent of phlebography. For the gentechnological products like tPA and prourokinase final conclusions can be drawn only after having established dose-response curves for patients suffering from thromboses. PMID- 3807577 TI - [Surgical therapy of thrombosis of pelvic and leg veins]. AB - The late results of venous thrombectomy could be remarkably improved by routine use of intraoperative vascular endoscopy and additional temporary a.v.-fistula. Long-term follow-up (mean 8 y.) of 119 patients (Ulm 1970-1983) showed full patency in 75% (phlebography) and very good function in 63% (phlebodynamometrie). With improved surgical technique the preservation of values is possible. Mortality was 1,8% and the incidence of clinically relevant postoperative pulmonary embolism was lower than 2%. PMID- 3807578 TI - [Indications for surgery in acute thrombosis of the leg and pelvic veins]. AB - We present 817 patients treated for acute venous thrombosis in pelvis and legs during the years 1957 to 1986. 312 patients underwent surgery, 157 received thrombolytic and 348 conservative treatment. Neither surgery nor thrombolysis can prevent fatal pulmonary embolism. The incidence of PTS increases, if the crural veins and the popliteal confluence can not be opened. We recommend early thrombectomy of thrombosis in the sapheno-popliteal confluence, supported by 32 total recanalisations in 36 patients. PMID- 3807579 TI - [Thrombectomy with AV fistula in embolizing deep venous thrombosis--better therapeutic concepts]. AB - From 1977 to March 1986 69 patients with embolizing deep vein thrombosis underwent thrombectomy plus av-fistula. The perioperative mortality rate was 7.2%, the rate of recurrent pulmonary embolism during follow up (28 +/- 24 months) 4.7% - all minor non-significant emboly-including those with an embolizing thrombosis of the contralateral deep venous system. In 62% preservation of valve competence was successful. As intracaval filter devices for prevention of recurrent pulmonary embolism have many severe complications, out of which the embolisation by the filter itself seems to be the most problematic, the first step of surgical management must be the removal of the embolizing source- thrombectomy plus routine av-fistula. PMID- 3807580 TI - [Possibilities for vascular reconstruction in the post-thrombotic syndrome]. AB - Reconstructive surgery of deep vein thrombosis is technically established. Results, however, are limited by the evolutive character of thrombotic processes and by the permanently impaired hemodynamics in veins with a postthrombotic condition. Long-term patency and functionally satisfactory reflux are not regularly achieved. Best suited are locally limited interventions in the main confluent venous trunks of the pelvic area, the groin and the popliteal groove. It ought to be kept in mind that every deep vein thrombosis simultaneously impairs the deep and superficial lymphatics. Surgical procedures in deep vein thrombosis should therefore try to prevent any further damage to lymph vessels. PMID- 3807581 TI - [Peri- and postoperative preventive use of antibiotics in accident surgery]. AB - To systematize the application of prophylactic antibiotics the classification of wounds into 4 groups is recommended corresponding to the risk of infection. Wounds without bacterial contamination, type 1: Prophylactic antibiotics are not indicated. Wounds type 2: Surgical and chemical decontamination have priority over antibiotics. Wounds type 3: Early antibiotic treatment is indicated if a sufficient debridement is not possible because of anatomical or cosmetical reasons. Wounds type 4: Delayed treatment of open fractures, treatment of infected fractures and fractures with faecal contamination require antibiotic therapy. PMID- 3807582 TI - [Can legal aspects modify surgical indications?]. AB - Surgical indication is determined exclusively by medical points of view. It is the task of the law to make sure that the surgeon makes his decision with the necessary diligence. The surgeon is only liable for diagnostic and therapeutic errors leading to failures in treatment if those are due to malpractice. It is important to carefully consider benefits and risks from the patients view; the forensic risks for the surgeon must not be included in his decision to operate. PMID- 3807583 TI - [Which acute abdominal diseases must have urgent surgery?]. AB - To answer this question, a prospective study of 342 patients was carried out. 18% could be discharged after exclusion of any serious disease; 63% were admitted for observation and in some cases delayed operation; in 19% of cases an emergency operation was performed (mostly for appendicitis and obstruction). The decision for early operation depended largely on the simple methods of history and repeated examination. More complicated diagnostic methods were helpful in a few cases only. PMID- 3807584 TI - [Non-abdominally-induced abdominal pain]. AB - In 5 percent of adult patients with symptoms of acute abdominal illness ("Akutes Abdomen") several extraabdominal diseases can be responsible: pulmonary; cardiovascular; retroperitoneal, metabolic diseases; exogenous intoxications; varia. It often is difficult to look through the pathophysiological ways of abdominal pain perception. Besides direct stimulation of receptors by toxines and/or metabolic products, transmission of pain ("ubertragener Schmerz") is as known for pain perception as emotional factors are. The decision not to operate is difficult and requires safe and immediate differential diagnosis, which mostly is achieved by a precise patient's history, clinical features like localisation and quality of pain as well as technical and laboratory studies. PMID- 3807585 TI - [Abdominal pain in metabolic diseases]. AB - Metabolic disorders which may mimicry a surgical abdomen are ketoacidosis, acute intermittent porphyria, hyperparathyroid crises, Addisons crises, hyperchylomicronemia, hemolytic crises, abdominal crises in hemochromatosis. Abdominal pain of non-surgical and non-inflammatory origin may be also found in abdominal allergic crises, intestinal wall bleeding due to anticoagulants, thrombocytopenia or acute poisoning. The symptoms may be very similar to those in surgical peritonitis. A careful work-up leads to the right diagnosis. PMID- 3807586 TI - [Acute abdominal pain in childhood]. AB - According to the difficulties in communication with babies and very young children there often are problems in the early diagnosis of abdominal pain or symptoms. This is demonstrated in the example of appendicitis in children and meconium peritonitis in the newborns. The possibilities of pain measuring in newborn or preterm babies are shortly discussed. PMID- 3807587 TI - [Procedures in fulminant courses of necrotizing enterocolitis]. AB - 14/42 neonates suffering from N.E.C. developed the clinical stage III (intestinal necrosis, septicemia) and/or IV (intestinal perforation, peritonitis) within 24 48 h ("fulminant" course). 2/14 deteriorated dramatically and died before operation. In 12/14 cases, the general condition could be improved and immediate laparotomy was performed (2/12 died). Management and factors affecting prognosis are discussed. Following surgery, there was no significant difference in survival rates between "fulminant" and protracted course N.E.C. PMID- 3807588 TI - [Surgical indications in acute pancreatitis]. AB - The indication for surgery in acute hemorrhagic necrotizing pancreatitis (AHNP) depends on the severity of the disease and the clinical course. Both factors must be determined daily, based on clinical and laboratory data. CAT-scan does not contribute much to indication. An early operation is necessary if despite an optimal intensive care septic symptoms and signs persist and renal and respiratory failure occur. Surgery is indicated 2-3 weeks after onset of AHNP if septic complications (re)-occur. A close follow up is mandatory. PMID- 3807589 TI - [Bacterial peritonitis]. AB - In bacterial peritonitis the cause, the time of occurrence--independent of surgery or postoperative-and the duration are relevant factors for therapeutic results. The multiplicity of possible combinations makes judgement difficult about different therapeutic concepts. Accepted general principles are: Antibiotics against aerobics and anaerobics. Pre- and postoperative intensive care (fluid replacement!). Treatment of source by the most secure method. Management of peritonitis by intraoperative cleansing and postoperative lavage, scheduled reoperations or open package. PMID- 3807590 TI - [Indications for conservative or surgical treatment of fresh ruptures of the outer ligament]. AB - The significance of the outer ligament lesion of the ankle joint derives from its frequency. Inadequate diagnostics lead to poor treatment results. It is imperative to make held images with the supporting apparatus in 2 planes. The guidelines for treatment are obtained from the measured values. We thus achieve our therapeutic aims: ligament stability with freedom from symptoms, perfect mobility and load capacity and the avoidance of arthrosis. PMID- 3807591 TI - [The social environment and consequences in patients with posttraumatic osteomyelitis]. AB - As soon as the extent of damage--especially in infected nonunion with substantial bone defect--becomes clinically apparent, the patient should be fully informed about the possibilities of treatment, which functional result can be expected in an attempt to salvage the extremity and the implications of long-term hospitalization with the necessity for multiple operations on the patient's social and professional rehabilitation. The patient may then decide for himself that early amputation will give him much better chances in his future life. PMID- 3807592 TI - [Esophageal function following sclerotherapy of esophageal varices]. AB - Functional disorders of the esophagus were evaluated in 24 patients 4 +/- 2 months after sclerotherapy following the first hemorrhage. The mean volume of polidocanol required per patient was 181 +/- 111 ml. 9 patients complained of dysphagia and/or reflux symptoms; strictures were found in two cases; 4 patients had esophagitis. Manometrically the lower esophageal sphincter was completely insufficient in 14 patients; only 7 patients still had a competent cardia. The first group had received significantly more polidocanol than the latter. Tubular motility was disturbed by nonpropulsive (18%) and repetitive (7%) contractions. By longterm-pH-metry the percentage of oesophageal reflux was elevated in all patients. PMID- 3807593 TI - [The asymptomatic gallstone]. AB - There are several sound arguments to operate on "silent" gallstones: The operative mortality following simple cholecystectomy in patients under 40 is zero. 50% of all patients with silent gallstones will be operated upon or develop symptoms within 10-20 years after the initial diagnosis. Carcinoma of the gallbladder is very rarely diagnosed in time and in most cases is incurable at the time of operation. The number of deaths in the FRG due to a carcinoma of the gallbladder has been consistently high in the last decade. Risk factors for cholecystectomy increase with the patients age. Therefore early cholecystectomy is recommended. Nevertheless indication for cholecystectomy is an individual decision. PMID- 3807594 TI - [Surgical indications in the asymptomatic gallstone]. AB - As long as long-term observations of operated and nonoperated patients with silent gallstones are missing, the question of general, differentiated or absent indication for operation in such cases cannot be answered by facts. To day only by 20% of people with gallstones are operated. 50-70% of those with silent gallstones probably remain free of complaints and symptoms during life. Each case of symptomatic cholelithiasis must be operated as soon as possible, but a general indication for operation of really silent gallstones cannot be advocated. PMID- 3807595 TI - [Asymptomatic carotid artery stenosis: when should one--when must one--when should one not operate]. AB - More differentiation than in the past is necessary for the indication of surgery in asymptomatic carotid stenosis. Surgery is indicated in the case of high-degree stenosis (above 80%) before major surgery, rapidly increasing stenosis- especially filiform stenosis--and if non-characteristic complaints are associated with cerebrovascular insufficiency or suspicious CT. Symptomatic carotid stenosis, however, requires surgical treatment. Unilateral asymptomatic stenosis below 70% requires careful observation and no surgery, particularly if the patient is older than 70 years. Surgical experience as well as collaboration with other disciplines are basic requirements. PMID- 3807596 TI - [Neurophysiologic correlates in rhythm perception: early auditory evoked potential responses as indicators of a rhythm detection system]. AB - The results of this experimental study on human subjects indicate that the "far field recorded auditory evoked wave VI potential" is correlated with auditory information processing of "rhythms" ("rhythm recognition", "rhythm experience"). Topography and functional mechanisms of a "neuronal system for rhythm detection" which is a prerequisite of "rhythmic experience" are discussed. The results cannot be interpreted as motor or attention effects. PMID- 3807597 TI - [Central localization of motor components in the internal branch of the superior laryngeal nerve: a horseradish peroxidase study in the rat]. AB - The central organisation of the internal branch of the superior laryngeal nerve was examined in the rat using the technique of intraaxonal transport of horseradish peroxidase (HRP). Application of HRP to the internal branch resulted in anterograde labelling of afferent nerve fibres as well as in retrograde labelling of perikarya within both motor nuclei of the vagus, i.e. the nucleus ambiguus and the dorsal motor nucleus. The location of retrogradely labelled neurons is confined to an area of 700 microns length near the rostral extremities of both nuclei. The internal laryngeal branch, therefore, is not entirely sensory, but contains general and special visceral efferent fibres arising in the dorsal motor nucleus and in the nucleus ambiguus, respectively. Dorsal motor neurons of the internal branch represent preganglionic parasympathetic neurons projecting to the mucous glands of the larynx, whereas efferents from the nucleus ambiguus supply striated muscle fibres of the larynx. The arytenoid and aryepiglotticus are discussed as potential targets of the internal branch of the superior laryngeal nerve. PMID- 3807599 TI - [A method for puncturing the deep neck muscles in humans]. AB - The authors developed a method to puncture neck muscles by means of computer tomographic control, enabling the introduction of an electrode into the obliquus capitis inferior muscle, to investigate the particular role of neck muscles in posture and head movement. PMID- 3807598 TI - [Functional electrostimulation of the denervated posticus muscle in an animal experiment: histo- and biochemical results]. AB - Histochemical and biochemical investigations have been carried out in 2 sheep following unilateral recurrent laryngeal nerve paralysis and direct electrical stimulation of the denervated posticus muscles. The stimulation effect was determined histochemically (standard ATP-ase staining) and compared with the fibre pattern of normal posticus muscles. In addition, one-dimensional gel electrophoresis of myosin heavy-chain isoforms was carried out and correlated with the histochemical results. A dramatic increase of type I fibres could be seen after long-term low-frequency direct electrical stimulation of denervated posticus muscles of the sheep. Biochemically the amount of slow myosin heavy chain isoforms was higher than in normal muscles. PMID- 3807601 TI - [The cartilaginous crooked nose in the no-man's land between specialty disciplines (thoughts and observations from a rhinosurgical practice)]. AB - The surgery of the cartilaginous twisted nose as an extension of septal surgery into the external nose is not as generally integrated in the teaching programme of rhinology as daily practice would require. On the other hand, plastic surgery- considering itself as a speciality of its own--has not yet entered into the full complexity of inner nose surgery, a major component of twisted nose correction. PMID- 3807600 TI - [Value of free, microvascular anastomosis of a small intestine transplant in reconstructive surgery following resection of T4 tumors of the upper aerodigestive tract]. AB - The jejunal graft with microsurgical vascular anastomoses is now recognised as one of the most reliable methods for reconstructing large and various defects of the upper aero-digestive tract. After resection of T4-tumours and reconstruction of phonation, deglutition and aesthetics 50% of our patients could be resocialized within the first postoperative month. PMID- 3807602 TI - [Voice quality following CO2 laser cordectomy]. AB - The voice of patients after CO2 laser cordectomy was evaluated by subjective assessment, registration of voice parameters and sonegraphic classification. The results proved to be closely concordant, the main result being a slight or medium degree of dysphonia. Severe dysphonia or aphonia occurred in about one fifth of patients. This result is somewhat inferior to radiotherapy, but superior to standard translaryngeal cordectomy. Yanagihara's sonegraphic classification of dysphonia is recommendable for future comparative studies. PMID- 3807603 TI - [Parosmias--definition and clinical picture]. AB - The paper proposes the definition and technical terms with greater precision for the description of qualitative smelling disturbances. Thereafter, parosmias are relevant only for the ENT specialist. Their further classification seems to be unnecessary or even false. These parosmias are always described to be troublesome for the patient since he feels the abnormality of the olfactory sensation. Thus, a clear distinction against phantosmias (olfactory hallucinations) and pseudoosmias (olfactory illusions) is given. The cause of parosmias is frequently speculative. Most frequently there occur traumas and influenza. Their treatment is equally the same as in postinfluenza hyposmias. Additionally, the dripping of 4% novocaine or 10% cocaine on the olfactory mucosa is performed. The parosmia is defined to be an independent entity of disorder, not only accompanying hyposmia. The parosmia may occur separately, too, and it does not necessarily recede together with hyposmia and anosmia. PMID- 3807604 TI - [Olfactory neuroblastoma. 3 case reports as a contribution to the clinical aspects, morphology and prognosis]. AB - The leading symptom in all patients was a nasal obstruction. At first all three cases of olfactory neuroblastoma were mistaken for polyposis nasi. The tumour can be diagnosed solely by histologic examination. The light microscopic as well as the ultrastructural findings demonstrated the great morphological variability of this carcinoma. In nearly all cases a definite diagnosis is possible if besides the light microscopic picture also clinical data, ultrastructural and, if necessary, immunohistochemical findings are considered. At the time of diagnosis one tumour was Kadish-stage A and two were stage C. Lokal and metastatic tumour extension, recurrence of disease after treatment, patient age and radical tumour resection at initial presentation, are prognostic important criteria. The discriminant function by Homzie and Elkon permits the oncologist to predict the patient's outcome accurately. PMID- 3807605 TI - [Is endonasal surgery of malignant ethmoid tumors in old age a feasible treatment method?]. AB - Basing on the advantageous long time results after endonasal operation in 2 cases of malign ethmoid tumours in the higher age of life the question is discussed, whether such a procedure could be admissible. According to the principles of tumour surgery it is fundamental denied. Nevertheless it is regarded as a therapy chance in exceptional cases on conditions mentioned by Kummel. PMID- 3807606 TI - [Therapeutic limits of endonasal fenestration of the maxillary sinus]. AB - The endoscopical examination of the diseased maxillary sinus is a common procedure. In cases with obstruction of the ostium the intranasal antrostomy is carried out. 117 operations were followed up 1-7 years postoperatively. In 25.6% of the cases the windows into the inferior meatus were closed. The operation did not yield any improvement of the clinical features in 37% of the cases. There was no correlation to a open or closed window. In these patients the endoscopical and radiological examinations now revealed a diseased ethmoid. Instead of intranasal antrostomy, endoscopical endonasal surgery of the anterior ethmoid (technique of Messerklinger) is recommended. With this procedure, reestablishment of free ventilation of the maxillary sinus is combined with the diagnosis and the therapy of the diseased anterior ethmoid. PMID- 3807607 TI - [Septumplasty. Histologic changes in resected and reimplanted autologous septal cartilage and bone following crush injury]. AB - The histological findings of the crushed deviated septal cartilage and bone are described directly after reimplantation between the mucoperichondrium periostium in septoplasty, and after 11, 16, 24 and 26 months as well as after 6 and 6.5 years. Immediately after crushing, multiple fractures different in width and damage of single cartilage cells and bone cells are visible. The crushed reimplanted material shows partial absorption and partial regeneration especially near the fracture lines over a period of several years. Months and years after reimplantation, the following can be observed: vascularised connective tissue grows into the fractures, metaplastic bone production and a new growth of cartilage-like plates are visible at the crushed cartilage, primary and secondary bone production are visible at the crushed bone. Clinically, a stable plate of bone and cartilage is seen after septoplasty in the reimplantation zone. The importance of reimplantation of crushed material in septoplasty is emphasised. PMID- 3807608 TI - [The mastoid cavity and auditory canal meatoplasty. Relations between corresponding indications]. AB - The indications for conservation of the posterior wall of the auditory canal versus mastoid cavity are described. For a dry cavity the relation of volume of cavity to entrance of meatus is of considerable importance. The necessity of meatoplasty is pointed out. Classical techniques described 100 years ago can still be used today with only slight modifications. PMID- 3807609 TI - [Malformation of the inner ear. Cerebrospinal otorrhea in stapedectomy]. AB - Otoliquorrhoea occurred during stapedectomy (gusher) and signified a case of inner ear malformation which was not apparent on preoperative tomograms but could be demonstrated on postoperative CT scans. There was no bony separation between the irregularly dilated inner auditory canal and the vestibulum. The cochlea was not fully rotated. Intraoperative problems in such malformations may lead to further postoperative hearing impairment. Hence, we report on the clinical, operative and CT findings in order to avoid an operation in patients with similar signs and symptoms. PMID- 3807610 TI - [Macroglossia in plasmacytoma. A case report]. AB - A case of macroglossia is presented the underlying cause of which was a generalized amyloidosis due to a plasmacytoma. Differential diagnosis of macroglossia comprises acromegaly, myxoedema, tumours, allergic reactions, inflammatory diseases, congenital muscular hypertrophy, glycogen storage defects and amyloidosis. PMID- 3807611 TI - [Severe complications following the intrathecal administration of a methylene blue solution]. AB - Very serious complications are reported following intrathecal injection of methylene blue. The clinical indication was to assess spontaneous rhinoliquorrhoe. It is now generally agreed that intrathecal application of dyestuff solutions, especially of methylene blue, is no longer permissible. PMID- 3807612 TI - [Redon drainage in the pharynx or esophagus for the prevention of reoperation in postoperative fistulas]. PMID- 3807613 TI - [Control of pulmonary hemorrhage using an embolectomy catheter]. PMID- 3807614 TI - Acoustic tumor management in senior citizens. AB - We reviewed records of 116 consecutive acoustic tumor surgery patients aged 65 and older during the 10 years ending in 1984. One hundred six had total removal. Ninety-four (81%) had no intraoperative complications and 66 (57%) had no postoperative complications. Only one patient, who had previously undergone partial removal elsewhere, died. Because tumors grow at 2 mm per year, and because elderly patients can expect to live up to 18 more years, we recommend planned total removal of an acoustic tumor as the management of choice for senior citizens in good health. We feel that the advantages of immediate surgery outweigh the risks of delayed surgery when age is advanced, the tumor is enlarged, and general health may be declining. PMID- 3807615 TI - Ectopic gastric mucosa in the cervical esophagus. AB - Ectopic gastric mucosa is a known entity of the mid and lower esophagus which was initially described by Schmidt in 1805. The presence of ectopic gastric mucosa in the cervical esophagus, however, was not described. A review of the literature reveals that ectopic gastric mucosa of the cervical esophagus is not uncommon, but symptoms rarely have been attributed to its presence. This paper reports five patients with isolated inflamed ectopic gastric mucosa in the cervical esophagus who presented with odynophagia and/or dysphagia. Physical examination was unremarkable in each case, and an acid barium esophagram was negative in four of five patients. Factors that distinguish these patients from other cases of odynophagia and dysphagia, as well as detailed clinical findings and treatment, are described. Debate exists as to whether the origin of ectopic gastric mucosa is congenital or acquired. The embryology, gross and microscopic anatomy, and pathologic features are outlined. Patients with persistent dysphagia should have flexible fiberoptic esophagoscopy with an index of suspicion to the existence of ectopic gastric mucosa. Inflamed or ulcerated ectopic gastric mucosa in the cervical esophagus should be treated to relieve symptoms and because of the potential for complications. PMID- 3807616 TI - First branchial cleft cysts: clinical update. AB - First branchial cleft cysts develop as a result of incomplete fusion of the cleft between the first and second branchial arches and give rise to two distinct anomalies, termed type I and type II anomalies. Type I anomalies are purely ectodermal while type II anomalies exhibit ectodermal and mesodermal elements. The type II anomaly incorporates some portion of the first and second arch as well as the cleft. Type I lesions are extremely rare. They appear histologically as cysts lined by squamous epithelium. Clinically, they present as a cystic mass or fistula posterior to the pinna and concha. The cyst is usually superior to the main trunk of the facial nerve and ends in a cul-de-sac on or near a bony plate at the level of the mesotympanum. Type II lesions are more numerous and represent a duplication of both membranous and cartilaginous portions of the external auditory canal. They contain skin as well as adnexal structures and cartilage and may be associated with the parotid gland. Most frequently they are associated with fistulae in the concha or external auditory canal as well as fistulous openings in the neck. PMID- 3807617 TI - A middle ear implantable hearing device for controlled amplification of sound in the human: a preliminary report. AB - Millions of people in the United States suffer from hearing impairment that is not benefited or poorly benefited by surgery or conventional hearing aids. Recently, we introduced an implantable Temporal Bone Stimulator (TBS) designed for those patients having a hearing loss due to external canal conditions; such as, external canal atresia or disease, inoperable ossicular problems, atelectasis or eustachian tube malfunction, and chronic open-cavity mastoid disease. This device requires relatively good cochlear function. However, the electromagnetic application of this device has led to the development of a new device we call the Implantable Hearing Device (IHD). This device stimulates, by an electromagnetic field, an independent electromagnetic sensitive prosthesis attached to the ossicular chain. This direct energy transfer to the ossicular chain provides a high degree of sound amplification and fidelity, thus providing benefit for those with various degrees of sensorineural hearing impairment. Preliminary disclosure of the device design, the animal experimental results, and the data from human testing will be given. PMID- 3807618 TI - Malignancies of the external ear canal and temporal bone: surgical techniques and results. AB - A combined therapy approach to malignancies of the external auditory canal and middle ear has been developed. A technique of external canal resection and gross tumor removal from the middle ear, parotid gland, and superior cervical lymph nodes is followed by postoperative full-therapy irradiation. This combined approach has been used in 30 patients with malignancies involving the external auditory canal and temporal bone. The preoperative evaluation and surgical technique, including the intraoperative decision-making process, is described. Twenty-four patients had squamous cell carcinoma of the external auditory canal, and two patients had basal cell carcinoma. There was one patient each with adenocystic carcinoma, acinic cell carcinoma, high grade mucoepidermoid carcinoma, and a giant cell tumor of bone. This group of patients was broken down into three groups based on the extent of disease as determined at surgery. Overall control of disease, both locally and distant, for the 30 patients was 66%. There were 12 patients with disease limited to the ear canal. These patients had a 91% survival of this disease process. Seven patients were determined to have limited extension beyond the ear canal. These were treated with combined therapy with an overall control of disease of 72%. Eleven patients had extensive disease outside of middle ear into the carotid jugular spine, stylomastoid foramen, and skull base, with a survival rate of 45%. It is concluded that a step wise removal of all gross tumor, as opposed to an en bloc dissection of the temporal bone and skull base, followed by full-therapy irradiation gives equally as good, or even better, long-term survival for this malignancy of the external auditory canal and middle ear. PMID- 3807619 TI - A comparison of retrosigmoid IAC, retrolabyrinthine, and middle fossa vestibular neurectomy for treatment of vertigo. AB - A new procedure, the retrosigmoid internal auditory canal (IAC) vestibular neurectomy has been developed and presented. It involves a 3-cm retrosigmoid craniotomy removing the posterior wall of the IAC to the singular canal, with transection of the superior vestibular nerve and posterior ampullary nerve. This produces a complete denervation of the vestibular labyrinth and preserves the patient's hearing. All ten patients with Meniere's disease had their vertigo cured. Hearing was preserved to within 11 dB of the preoperative pure tone average in 9 of 10 cases. There were no serious complications, no cases of facial paralysis, and no cases of total hearing loss. These results compare favorably with the MFVN and the RVN. The retrosigmoid IAC vestibular neurectomy is an important improvement in the evolution of vestibular neurectomy for the treatment of vertigo. PMID- 3807620 TI - Computed tomography in the evaluation of choanal atresia in infants and children. AB - While traditional confirmatory clinical tests are helpful in establishing the diagnosis of choanal atresia, they give little useful information concerning the composition, position, and thickness of the atresia plate. Surgeons experienced in the repair of choanal atresia have recognized that detailed anatomic assessment is valuable in the preoperative selection of the method of repair and design of the repair once undertaken. The utilization of high-resolution computerized tomography to provide such information in a group of infants and children with choanal atresia forms the basis for this report. The application of computed tomography in the evaluation of choanal atresia and preoperative surgical planning is discussed. Based on this experience, we feel that the introduction of high-resolution computerized tomography is a significant advance in the diagnostic and therapeutic approach to choanal atresia and should be the single radiographic procedure of choice. PMID- 3807621 TI - Observations on the size of the saccule in laryngectomy specimens. AB - Over 300 instances of the association of laryngocele with laryngeal carcinoma have been reported in Europe, but only seven in North America. In the present study, 353 serially sectioned total laryngectomy specimens were examined and the saccule measured with a steel ruler. Saccules extending superior or posterior to the thyroid cartilage were considered as large. Larynges were classified as "cancer" or "normal", the latter being uninvaded organs from patients with adjacent disease. Among the 242 cancer larynges, there were 43 specimens where the saccule exceeded thyroid cartilage dimensions, a laryngocele rate of 17.8%. Mean saccule height was significantly greater in cancer than in normal specimens in coronal sections (P = 0.04), and mean saccule length was significantly greater in cancer than in normal specimens in horizontal sections (P = 0.001). The incidence of large saccules showed a difference between cancer and normal larynges which was highly significant (P = 0.0002). PMID- 3807622 TI - Otolaryngologic cases of Munchausen's syndrome. AB - Munchausen syndrome (MS) is now a well recognized and demonstrated entity. This syndrome is characterized by patients who seek hospitalization and present factitious but usually well-rehearsed histories and symptoms. Five cases of MS, genuine by their ear-nose-throat-maxillofacial factitious signs, are presented. Two of the cases are related to the uncommon MS by proxy. In this subentity the parents fabricate pathological signs for their children. The psychodynamics and the clinical symptoms of our cases are described and the differential diagnoses of malingering, conversion disorders, and hypochondriasis are brought to attention. PMID- 3807623 TI - Cochlear action potentials threshold and systemic arterial pO2. AB - A progressive decrease in arterial pO2 was induced in Hartley guinea pigs (GP) by having them rebreathe the air entrapped in a closed circuit from which the CO2 was continuously absorbed. Following this slow-developing hypoxemia, a sequence of events concerning the ear could be observed. Firstly, a fluctuation in cochlear action potentials (CAP) was noted. This appeared only at stimulus intensities near the threshold and was not evident at higher intensities. At a mean arterial pO2 level of 30 mm Hg, this phenomenon was observed in 60% of the GP. At a mean pO2 of 24.66 mm Hg, a shift in threshold occurred in all GP. Finally, when the blood pO2 reached an average of 14.92 mm Hg, no CAP response could be elicited, even at click intensity of 120 dB SPL. The 30 mm Hg oxygen concentration in the arterial blood was considered as a "critical level" at which the cochlear function starts to deteriorate in guinea pigs. PMID- 3807624 TI - Results in resident cholesteatoma surgery: a review of 85 cases. AB - A review of all patients with cholesteatoma operated on by the residents of the New York Eye and Ear Infirmary under the attending supervision of the Otology Service between 1980 and 1984 was done. Of 130 resident cases, 85 had documented follow-up 1 year or longer and were included in the study. Recurrence rates were 18% with canal wall down (CWD) and 43% with canal wall up (CWU) techniques. Considering other forms of failure (such as precholesteatoma, tympanic membrane perforation, and chronic infection), overall failure rates were 33% (CWD) compared with 82% (CWU). Cholesteatoma recurrence failure rates were higher in patients under the age of 20 (33%) than over the age of 20 (19%). Overall failure rates were 61% and 37% for younger and older patients, respectively. Due to the high failure rate with canal wall up techniques in resident hands, it is recommended that resident service cases be treated with canal wall down technique, especially in the younger age group. PMID- 3807625 TI - Parathyroid carcinoma: two new cases--diagnosis, therapy, and treatment. AB - Carcinoma of the parathyroid gland is a disease only rarely encountered in clinical practice. As most of these tumors retain the ability to manufacture active parathyroid hormone, most patients with the disease present with hypercalcemia, many times symptomatic. Since the tumor accounts for only 0.5% to 4.0% of cases of primary hyperparathyroidism, the diagnosis of parathyroid carcinoma may be unsuspected and delayed. The clinical index of suspicion should be elevated if there is a palpable neck mass, an exceptionally high serum calcium level, and/or recurrence of hypercalcemia following surgery. We review two patients with parathyroid carcinoma who presented with hypercalcemia. In both, the diagnosis of malignancy was made only after microscopic examination of the operative specimen. Surgery consisted of wide local excision in both cases; radiation therapy was administered in one. Postoperative disease-free status is now 23 and 37 months. One of the patients had a history of radiation therapy to the larynx 20 years prior to the development of parathyroid carcinoma. Also reviewed in this paper are the clinical and histopathologic criteria for making the diagnosis of parathyroid carcinoma and the therapeutic approaches and prognosis of this unusual tumor. PMID- 3807626 TI - Intraparotid facial nerve neurofibroma. AB - Neurogenic neoplasms of the intraparotid facial nerve are uncommon and are usually diagnosed intraoperatively by tissue biopsy. Fifty-six cases of primary neurogenic neoplasms involving the facial nerve have been reported. The majority of these have been schwannomas. A case of a solitary neurofibroma involving the main trunk of the facial nerve is presented. Schwannomas and neurofibromas have distinct histological features which must be considered prior to the management of these tumors. The management of neurogenic tumors associated with normal facial function is a particularly difficult problem. A new approach for the diagnosis and management of neurogenic neoplasms is described utilizing electroneurography. PMID- 3807627 TI - Voice intensity of prospective cochlear implant candidates and normal hearing adult males. AB - Voice intensity in 19 prospective cochlear implant candidates, all adventitiously profoundly sensorineurally deaf adult males, was investigated. For the first time with objective data, it was shown that such deaf subjects spoke with significantly increased voice intensity and with greater intensity fluctuations than normal hearing male speakers. Neither length of time of profound deafness nor history of hearing aid use significantly affected voice intensity. Based on quantitative data, rehabilitation of voice intensity problems in the adventitiously deaf is indicated. PMID- 3807628 TI - Morphological aspects of the vestibular nerve of the squirrel monkey. AB - A morphological study of the vestibular nerve of a primate, the squirrel monkey, revealed a systematic organization of neurons according to fiber diameter. At the center of the cristae, thick fibers align in two parallel rows along the long axis; in the periphery of the cristae, thin fibers predominate. Within the superior vestibular nerve the thick fibers of the anterior and horizontal semicircular canals and utricle are situated in the anterosuperior area, the thin fibers in the posterior part. A similar segregation occurs with fibers of the posterior ampullary nerve and the saccule within the inferior vestibular nerve. The fibers continue to segregate at the root entry zone where they lose their Schwann's cell ensheathing and begin to divide into secondary central branches. There is a correspondence between the volume of the ganglion cell and the fiber diameter; hence, a segregation of ganglion cells according to their size also takes place in the vestibular nerve. The organization of the primate's vestibular nerve is similar to that found earlier in an anuran. The relevance of the phylogenetic preservation of the vestibular nerve's anatomical organization is discussed in terms of current physiological findings, which support the differential role of fibers of different diameters in vestibular function. PMID- 3807629 TI - Custom cervical splint for use during head and neck surgery. AB - A custom-made plaster cervical/occipital splint was described that was made to immobilize a patient with vertebral metastases during neck surgery. This is a single example of a problem solved by the cooperation between the head and neck surgeon and the maxillofacial prosthodontist. PMID- 3807630 TI - HeNe laser irradiation delivered transcutaneously: its effect on the sciatic nerve of rats. AB - For our study of the effect of low energy laser irradiation (LELI) on living tissue we used HeNe laser on rats. The exponential absorption was reaffirmed in the living tissues overlying the sciatic nerve. An optimal range of energy between 3.5 and 7 J--associated with energy concentration of 4-10 J/cm2 delivered transcutaneously--was found to cause a significant increase in action potential in the sciatic nerve. The effect lasted for more than 8 months after the irradiation session. PMID- 3807631 TI - Pulsed laser damage thresholds and laser treatment energy parameters, in vivo, of human aphakic intraocular membranes. AB - Energy and power density damage thresholds were determined for the perforation of human aphakic pupillary membranes and intraocular lens implants, in vivo, at the focal point of Neodymium-YAG ophthalmic laser systems, at 1,064 nm, which produced Q-switched nanosecond pulses (TEMoo, pulse duration; 20 ns) and mode locked pulse trains (TEMoo, 9-11 pulses, pulse duration; 30 ps, entire pulse train delivered in 50-70 ns). Pulse energies bracketing the damage thresholds and focal diameter were tabulated. The energy density and power density thresholds for perforation of the pupillary membranes (hereafter referred to as perforation threshold) were slightly lower and power density damage thresholds higher for shorter duration pulses, eg--66 J/cm2 (2,200 GW/cm2) with the picosecond pulse trains vs 80 J/cm2 (2.7 GW/cm2) with the nanosecond pulses and were similar in pseudophakics and aphakics; 78 J/cm2 for pseudophakics vs 83 J/cm2 aphakics, both treated with single nanosecond Nd-YAG pulses, and 68 J/cm2 for pseudophakic vs 66 J/cm2 for aphakic patients treated with picosecond Nd-YAG laser pulse trains. The number of laser pulses and pulse energies required for successful discussion of the pupillary membranes depended not only on the pulse parameters but also on the characteristics of the membrane, such as thickness, nonuniformity, capsular haze, or capsular haze combined with fibrosis. PMID- 3807632 TI - Neodymium (Nd):YAG laser surgery in the equine larynx: a pilot study. AB - Laryngeal surgery in the equine is customarily and routinely performed by means of a ventral laryngotomy incision. Such procedures are usually performed under deep general anesthesia with the horse in dorsal recumbency. The objective of this work was to determine the efficacy of an endoscopic approach coupled to a Nd:YAG laser fiber in performing arytenoidectomy. Arytenoidectomy is commonly indicated in the treatment of arytenoid chondritis and in the failure of prosthetic implantation for left laryngeal hemiplegia. This preliminary study was undertaken to determine the feasibility of the endoscopic laser approach to ablate the most difficult of the structures of the larynx, considering tissue structure and density. This procedure was accomplished by using heavy sedation and local anesthesia and was performed in the standing position. This approach appears to be feasible and makes other adjacent structures accessible via the endoscope coupled to a surgical laser. Indications for future pilot applications of laser surgery in the equine larynx are entrapment of the epiglottis, dorsal soft palate displacement, and the ablation of laryngeal cysts and polyps. This pilot study appears to offer a new modality for discrete surgical ablation of this structure, with minimal postoperative complications and a reduced or equivalent convalescent period in this valuable species of animal. PMID- 3807633 TI - [Do anticholinergic drugs still have significance in the therapy of ulcer?]. PMID- 3807635 TI - [Differential diagnosis in chyloperitoneum]. PMID- 3807634 TI - [Principles of cholesterol and bile acid metabolism in the liver and small intestine (II)]. PMID- 3807636 TI - [Is detection of occult blood in stool overemphasized?]. PMID- 3807637 TI - Naloxone reversal of morphine elicited hyperactivity. AB - When naloxone is administered during morphine elicited hyperactivity, hyperactivity is reversed and hypoactivity occurs in its place. The present experiment tested the hypothesis that this effect is the result of morphine induced supersensitivity to naloxone. Two groups of hamsters received equivalent pretreatment with 15 mg/kg morphine (Groups M/M and M/S) for three days while a third group received saline (Group S/S). During subsequent testing one group received a morphine injection (Group M/M) while the others received saline (Groups M/S and S/S) before being placed in running wheels for a three hour session. Two hours later half the animals in each group received an injection of 0.4 mg/kg naloxone and half received saline. Naloxone produced hypoactivity in animals running under the influence of morphine (Group M/M), but neither in those with an equivalent history of morphine pre-treatment (Group M/S), nor in saline controls (Group S/S). These results are inconsistent with the hypothesis under test, but congruent with a modified dual-action hypothesis. PMID- 3807638 TI - The organ distribution and circulation time of intravenously injected colloidal carriers sterically stabilized with a block copolymer--poloxamine 908. AB - Colloidal carriers injected intravenously are normally removed rapidly and efficiently by the liver and this represents a major barrier to drug targeting. By coating model microspheres and emulsions with a block co-polymer (poloxamine) it has been possible to keep the carrier circulating in the vascular compartment with little or no uptake by the reticuloendothelial system. PMID- 3807639 TI - In vivo electrochemical recording of acetaminophen in non human primate brain. AB - In vivo electrochemical recordings were obtained from the caudate nucleus of three young adult pigtail monkeys (M. nemestrina) following the oral administration of acetaminophen (APAP) (75 mg/kg). Using linear sweep voltammetry, electrodes in the right and left caudate were scanned alternately every five minutes. The electrochemical peak resulting from the APAP was monitored for at least 140 minutes following drug administration. Maximum APAP levels were detected in the monkey caudate 40 minutes following drug administration. Both right and left caudate displayed an identical time course, with oxidation potentials (Eox) similar on both sides of the brain. Blood samples were collected from one monkey by means of an intravenous catheter. Samples were obtained at approximately 5-minute intervals and over a period of 140 minutes following oral administration of APAP. Concentration of APAP in serum peaked 25 minutes after administration. In this animal the maximum electrochemical peak height was detected 40 minutes following APAP administration. These findings demonstrate the ability to measure APAP in the caudate nucleus of awake monkeys by means of electrochemical detection. This method may be useful for calibrating electrochemical electrodes in vivo, and it also provides a model system for studying drug kinetics in the brain. PMID- 3807640 TI - Discriminative stimulus effects of caffeine: tolerance and cross-tolerance with methylphenidate. AB - Twice daily injection of caffeine (30 mg/kg) for 3-1/2 days shifted the caffeine stimulus generalization curve to the right by 3-fold in rats trained to discriminate saline from 30 mg/kg of caffeine, and by 4-fold in rats trained to discriminate saline from 10 mg/kg of caffeine. The latter group was also tested for cross-tolerance with methylphenidate, a drug that generalizes completely with caffeine. Twice daily injection of caffeine (30 mg/kg) for 3-1/2 days increased the ED50 of methylphenidate for caffeine-appropriate responding from 1.5 to 5.5 mg/kg. Conversely, injections of methylphenidate (3.0 mg/kg) increased the ED50 of caffeine from 5.2 to 15 mg/kg. The development of symmetrical cross-tolerance to the discriminative effects of caffeine and to the caffeine-like discriminative effects of methylphenidate supports previous observations suggesting commonalities in the cellular bases of the stimulus properties of these drugs. PMID- 3807641 TI - Sex-related difference of kinin level in rat pituitary gland. AB - The kinin level in the pituitary glands was compared in adult male and female rats. A sex-related difference in the bradykinin (BK)-like immunoreactivity was found in the posterior lobe. The posterior pituitaries of female rats contained a higher concentration of the immunoreactive kinin than those of males. Ovariectomy of female rats resulted in the disappearance of a sex difference in the posterior kinin level and about a 3-fold increase in the anterior one. Orchidectomy of adult male rats failed to alter the kinin levels in both lobes. Moreover, the constitution of pituitary kinins was determined using HPLC. The pituitary kinins consisted of BK, Lys-BK (L-BK) and Met-Lys-BK (ML-BK) in different proportions in both lobes of male and female rats. The gonadectomy altered the proportions of these kinins. These results suggest that the pituitary kinin system may be regulated by circulating gonadal steroid hormones. PMID- 3807642 TI - Solubilization of human platelet vasopressin receptors. AB - The human platelet membrane receptor for vasopressin (AVP) has been solubilized with the cholic acid derivative detergent 3-( [3-cholamidopropyl) dimethylammonio]-1-propane sulfonate. Rapid and simple separation of free tritiated AVP ( [3H]AVP) from the solubilized receptor-hormone complex was done by filtration through polyethylenimine-treated filters. [3H]AVP binds to this soluble receptor with an equilibrium dissociation constant of 11.03 +/- 1.86 nM and a maximal number of binding sites = 288 +/- 66 fmol/mg protein while the corresponding values of the membrane-bound receptor are 1.62 +/- 0.21 nM and 237 +/- 38 fmol/mg of protein, respectively. The Ki value for native AVP derived from competition experiments is 11.02 +/- 2.05 nM for the soluble receptor. Competition experiments with specific vascular and renal antagonists confirm that the solubilized receptor belongs to the V1-vascular subtype. PMID- 3807643 TI - Electrical stimulation of the hypothalamic nucleus paraventricularis mimics the effects of light on pineal melatonin synthesis. AB - In an attempt to clarify further the role of the hypothalamic paraventricular nuclei (PVN) in the control of pineal function, the effects of 2 min electrical stimulation of these nuclei were investigated in acutely blinded, adult, male Sprague-Dawley rats. Pineal serotonin-N-acetyltransferase (NAT) activity, melatonin content and catecholamine levels were measured by means of radio enzymatic, radioimmunoassay and high-performance liquid-chromatography methods, respectively. All three pineal parameters underwent significant declines following brief PVN stimulation during the night time. These observations lend credence to the view that the neural pathways transmitting light information to the sympathetic innervation controlling pineal melatonin synthesis. PMID- 3807644 TI - Studies on the effect of inflammation on the synthesis of glucosylated intermediates of glycoprotein biosynthesis in rat liver microsomes. AB - Glycoprotein biosynthesis is substantially increased in liver during experimental inflammation. This study describes the effect of inflammation on the incorporation of labelled Glc from UDP-Glc into glucosylated lipid-linked intermediates of glycoprotein biosynthesis in liver microsomes. Maximum incorporation of Glc into lipid sugar and lipid oligosaccharide fractions occurred using microsome fractions from rats suffering from inflammation for 48 72 hr. Incorporation of Glc into lipid-sugar fractions was increased about three fold over controls and incorporation into lipid-oligosaccharide fractions was increased about four-fold compared to controls. Maximum incorporation of Glc into lipid-sugar and lipid-oligosaccharide occurred at pH 6.0 and pH 5.2, respectively. PMID- 3807645 TI - Phenylethylamine metabolism to tyramine by postmortem human brain preparations. AB - Human brain preparations obtained from either the putamen, thalamus, hippocampus or lateral occipital gyrus p-hydroxylate phenylethylamine to tyramine, a reaction carried out by a microsomal (100,000 xg pellet) membrane bound, NADPH-requiring enzyme. This is a minor metabolic pathway occurring in chronic psychiatric patients, as well as in age-comparable controls. PMID- 3807646 TI - Characteristics of the transport of ascorbic acid into leucocytes. AB - The degree and the mode of association of [14C]-ascorbic acid with leucocytes are examined. The degree of association of ascorbic acid with polymorphonuclear leucocytes (1-3%) is dependent on cell type, extracellular concentration of ascorbic acid, incubation temperature, intactness of the cells and the extracellular pH. All experiments are performed according to strict protocols as these compounds are labile in aqueous solutions. Further it is noticed that in all experiments an outward gradient of leucocyte endogenic ascorbic acid exists. The results suggest that the association process comprises at least one saturable pathway. The activation of polymorphonuclear leucocytes by phorbol myristate acetate increases the accumulation of ascorbic acid threefold. PMID- 3807647 TI - An initial screening of serum lipids and fatty acid profiles of hypertensive and normotensive subjects. AB - Serum lipids and their acyl group profiles from a group of hypertensive patients with elevated systolic and diastolic pressure were compared with normotensive subjects of matched age, body weight and dietary habits. The level of serum triacylglycerols was elevated in the hypertensive subjects, but the cholesterol level remained normal. The acyl groups of serum triacylglycerols and cholesterylesters from hypertensive subjects indicated a higher proportion of the saturated fatty acids (16:0 and 18:0) and a lower proportion of linoleic acid (18:2) as compared to normal controls. There was no obvious change in the level and acyl group composition of serum phosphatidylcholine between the two groups. Since the hypertensive and normotensive subjects indicated similar dietary habits, the resulting differences in serum lipids reflected an abnormality in the lipolytic process in the hypertensive subjects. PMID- 3807648 TI - PD 116,948, a highly selective A1 adenosine receptor antagonist. AB - (R)-N-(1-Methyl-2-phenylethyl) adenosine (R-PIA), an adenosine receptor agonist has both negative chronotropic activity and coronary vasodilator activity. These actions of R-PIA are proposed to be mediated by subtypes (A1 and A2) of adenosine receptors. PD 116,948 is a xanthine derivative which is a highly selective A1 adenosine receptor ligand. In this study PD 116,948 selectively antagonized the negative chronotropic activity of R-PIA in the isolated rat heart. These results are consistent with, and add further support to the hypothesis that adenosine receptor agonists mediate their negative chronotropic activity via A1 receptors and their vasodilator activity via A2 receptors. PMID- 3807649 TI - Renal artery stenosis: an example of how the periphery can modulate voluntary alcohol drinking. AB - Voluntary alcohol drinking, using a free-access procedure, was studied in rats three weeks after unilateral renal artery stenosis was produced by applying a 0.20 mm solid silver clip to the left renal artery (Two-Kidney, One-Clip, Hypertension). The group of animals with the arterial clip drank significantly less alcohol and more water than a sham-operated group. The two groups, however, drank similar amounts of a palatable glucose solution, suggesting that they did not differ in taste sensitivity. Blood alcohol levels measured for six hours following a 2.5 g/kg intraperitoneal injection of alcohol indicated that the difference in alcohol consumption between the two groups could not be accounted for in terms of differences in drug disposition or metabolism. These findings provide an example of a previously unknown type of control which originates in the periphery and contributes to the regulation of voluntary alcohol drinking. PMID- 3807650 TI - Effect of monofluoromethyldopa (MFMD) on trace amine levels. AB - The concentrations of the trace amines, m-tyramine, p-tyramine, phenylethylamine and tryptamine, were measured in the striatum of the brain and in the kidney of adult rats treated with alpha-monofluoromethyldopa (MFMD), an inhibitor of aromatic amino acid decarboxylase. While MFMD decreased the levels of all four amines in the kidney, only phenylethylamine and tryptamine levels were decreased in the striatum compared to control. Striatal p-tyramine levels were not affected, while striatal m-tyramine levels were increased by MFMD. When the rats were injected with a monoamine oxidase (MAO) inhibitor before MFMD administration, similar changes in striatal and kidney trace amine levels were observed compared to MFMD alone. PMID- 3807651 TI - Oxime-induced decarbamylation and atropine/oxime therapy of guinea pigs intoxicated with pyridostigmine. AB - The generally accepted explanation for the effects of oximes in countering organophosphorus (OP) anticholinesterase is reactivation of the inhibited acetylcholinesterase (AChE). With soman, the inhibited AChE rapidly becomes resistant to oxime reactivation due to a phenomenon called aging. Thus, pretreatment with pyridostigmine (Py) or physostigmine (Ph) followed by atropine sulfate therapy is required to achieve significant protection against soman; the effectiveness of a pretreatment/therapy (P/T) regimen can be further increased against certain OPs (e.g. sarin and VX) by including an oxime in the therapy regimen. The P/T regimen is clouded by a controversy concerning the use of oximes in the treatment of carbamate intoxication, because 2-PAM has been reported to exacerbate intoxication by some carbamates and to have no effect on decarbamylation rates. To better understand the role of oxime therapy in the theory of pretreatment of OP intoxication we examined the effects of 2-PAM and HI 6 on the rate of decarbamylation of Py-inhibited erythrocyte AChE in vitro and in vivo, and studied the effects of atropine plus 2-PAM or HI-6 on Py toxicity. In decarbamylation experiments, Py-inhibited guinea pig erythrocytes were washed free of excess Py and incubated with vehicle or oxime (2 X 10(-4) M, pH 7.3 and 37 degrees C). Aliquots were assayed for AChE activity at various times during a 60 min incubation period. Rate constants were calculated and compared to determine whether the presence of oxime affected decarbamylation. The data from in vitro and in vivo experiments revealed that oximes accelerated the decarbamylation (p less than 0.05) of inhibited AChE. Lethality data for Py treated guinea pigs showed that treatment with atropine (23 mumoles/kg, im) plus 2-PAM or HI-6 (145 mumoles/kg, im) at one min after injection of Py increased the protective ratio from 4.2 (atropine only) to 5.1 and 12.2, respectively. It is suggested that the enhanced therapeutic efficacy of atropine by oximes against Py intoxication is related to oxime-induced reactivation. PMID- 3807652 TI - The effects of the cholecystokinin antagonist, proglumide, on prolactin secretion in the rat. AB - Since cholecystokinin produced important effects on prolactin secretion following its intraventricular injection in ovariectomized rats, we have evaluated the effects of the cholecystokinin antagonist, proglumide, to assess the physiologic significance of CCK in the control of prolactin release. Conscious rats of either sex were used following implantation of third ventricular and/or intravenous cannulae for the administration of proglumide. Blood samples were drawn from conscious animals at various times after injection of the compound. Intraventricular injection of 1 or 10 micrograms of proglumide produced a dramatic decline in plasma prolactin levels in either castrate or intact male rats. Similar results were found following the intravenous injection of 10 or 100 micrograms of the drug. These results contrasted sharply with the findings in ovariectomized females in which the intraventricular injection of the same two doses of proglumide used in males produced a dose-related elevation of prolactin which was opposite to the delayed lowering of prolactin following the intravenous injection of the same doses of the compound used in males. These results indicate that proglumide can lower prolactin in male rats and suggests a physiologically significant role of CCK in the control of prolactin secretion in the male. There appears to be a sex difference in the response since the results contrasted sharply in ovariectomized female rats. The results in the females are puzzling and it is apparent that further studies are needed to determine whether or not CCK has a physiologically significant role to play in prolactin secretion in the female. Since previous results have shown that CCK has no effect on the release of prolactin by the pituitary directly these interactions are presumably taking place in the hypothalamus. PMID- 3807653 TI - Modulation of vascular tonus by the endothelium in experimental diabetes. AB - The role of the vascular endothelium in the contractile response of aortas from streptozotocin-induced diabetic rats was investigated using selected agents. Contractile response to KCl was not affected by removal of the endothelium in both diabetic and control groups, but was diminished in the diabetic rats compared to the control rats. Contractile response to clonidine markedly increased after removal of the endothelium in the control group, with the increment being less in the diabetic group. After removal of the endothelium, contractile response to clonidine was poorer in the diabetic group than the control group. Vascular relaxation induced by acetylcholine disappeared when the endothelium was removed in both diabetic and control groups. The degree of reaction to acetylcholine did not significantly differ between the two groups. These results suggest that in diabetic rats, abnormality of the endothelium dependent vascular relaxation is specific for alpha 2 receptor while that of the vascular smooth muscle reactivity is not receptor-specific. PMID- 3807654 TI - Opioid involvement in the control of feeding in an insect, the American cockroach. AB - Administration of the kappa opiate agonist, U-50,488H (0.10-10 mg/kg), produced over three hours a significant dose-dependent increase in the ingestive responses of free feeding American cockroaches, Periplaneta americana. These effects could be decreased by the opiate antagonist, naloxone (1.0 mg/kg), with naloxone by itself blocking the augmented feeding responses of food-deprived cockroaches. The mu opiate agonist, morphine (1.0-20 mg/kg) caused a significant dose-dependent and naloxone-reversible increase in the locomotory activity of cockroaches. These results suggest that opioid systems may be involved in the control of the feeding in cockroaches in a manner analogous to that proposed for vertebrates. PMID- 3807655 TI - Comparison of informed consent in English and German law. PMID- 3807656 TI - Problems of proof resulting from brachial plexus lesions discovered during the postanaesthetic period: review of the Belgian law claims. PMID- 3807658 TI - Public health professionals and legal liability: from police officer to policed. PMID- 3807657 TI - Italy's law 180--problems and hopes. PMID- 3807660 TI - Criminal court proceedings in England: the contribution of the psychologist as an expert witness. PMID- 3807659 TI - Institutional Review Boards: have they achieved their goal? PMID- 3807661 TI - Use of law as a treatment instrument. PMID- 3807662 TI - Psychotherapy of mentally disturbed criminals: illusion or reality? PMID- 3807663 TI - Aged living alone: health and resources. PMID- 3807664 TI - Life-care institutions. PMID- 3807665 TI - Alcohol and the elderly. PMID- 3807666 TI - Depression and suspiciousness in the elderly. PMID- 3807667 TI - Alzheimer's disease and related disorders: a growing challenge in Maryland. PMID- 3807668 TI - Ethical and legal issues in geriatrics: competence and patient choice. PMID- 3807669 TI - Psychotropic medication for elderly patients: use with caution. PMID- 3807670 TI - The prognostic and therapeutic value of steroid hormone receptors in breast cancer. PMID- 3807671 TI - Lyme disease: a mimicker of juvenile arthritis. PMID- 3807672 TI - Systemic diseases with retinitis pigmentosa-like changes. PMID- 3807673 TI - Overcoming barriers in initiating psychiatric care for the elderly. PMID- 3807674 TI - Overprotecting children with health problems. PMID- 3807675 TI - Management of local skin recurrences. PMID- 3807676 TI - As others see us. PMID- 3807677 TI - Preparation of factor VII-depleted plasma by immunoaffinity chromatography of insolubilized anti-factor VII. PMID- 3807678 TI - Intrinsic factor antibodies in relation to disease. PMID- 3807679 TI - Effects of selected enzymes and monosaccharides on the binding of five bacterial strains to human lymphocytes. PMID- 3807680 TI - Antimicrobial susceptibility determination by an automated conductance technique. PMID- 3807681 TI - Rapid analysis of polyamines in cell culture by high performance liquid chromatography. PMID- 3807682 TI - Automated counting of cells in peritoneal dialysis effluent. PMID- 3807683 TI - Routine screening of catheter urine specimens for chlorhexidine resistant organisms. PMID- 3807684 TI - Thyroid stimulating hormone (TSH) measurements in dementing patients. PMID- 3807685 TI - Analysis of creatinine. PMID- 3807686 TI - HYDRA: a knowledge acquisition tool for expert systems that critique medical workup. AB - HYDRA is a computer-based knowledge acquisition tool under development to assist in the creation of expert systems which critique medical workup. To use HYDRA, a domain expert first outlines the recommended approaches to the workup of a chosen medical problem, using the Augmented Transition Network formalism. From this model, HYDRA produces a list of the various conditions for which critiquing comments may be required to react to all possible approaches that might be proposed by the user of the critiquing system. Domain-specific constraints can be used to restrict the number of conditions suggested. In this way, HYDRA assists the domain expert by providing a model for structuring the problem, and by breaking down the domain expert's work into a set of small, easily understood tasks. PMID- 3807687 TI - Choice and explanation in medical management: a multiattribute model of artificial intelligence approaches. AB - This paper explores a model of choice and explanation in medical management and makes clear its advantages and limitations. The model is based on multiattribute decision making (MADM) and consists of four distinct strategies for choice and explanation, plus combinations of these four. Each strategy is a restricted form of the general MADM approach, and each makes restrictive assumptions about the nature of the domain. The advantage of tailoring a restricted form of a general technique to a particular domain is that such efforts may better capture the character of the domain and allow choice and explanation to be more naturally modelled. The uses of the strategies for both choice and explanation are illustrated with analyses of several existing medical management artificial intelligence (AI) systems, and also with examples from the management of primary breast cancer. Using the model it is possible to identify common underlying features of these AI systems, since each employs portions of this model in different ways. Thus the model enables better understanding and characterization of the seemingly ad hoc decision making of previous systems. PMID- 3807688 TI - Artificial intelligence: a topic for MDM? PMID- 3807689 TI - Sequential analysis for diagnosing diabetes. AB - The authors use a truncated sequential probability ratio test (SPRT) to diagnose diabetes. It is hypothesized that, for a given oral glucose tolerance test (OGTT), the differences between successive observations are more diagnostic than the observations alone. Using such differences in a SPRT, OGTT test data for 950 subjects are analyzed and thresholds for classifying diabetes and normal values are established. This sequential approach provides the same diagnosticity as that obtained by using the National Diabetic Data Group criteria, but it is more efficient. In particular, the procedure significantly reduces the sampling cost and average patient waiting time. PMID- 3807690 TI - Sequential likelihood ratios. PMID- 3807691 TI - The timing of radical cystectomy after recent myocardial infarction: waiting for Godot. PMID- 3807692 TI - Knowledge acquisition and verification tools for medical expert systems. AB - Expert systems require large amounts of domain knowledge for non-trivial problem solving. Experience in developing such systems has shown that the processes of acquiring domain knowledge (knowledge acquisition) and of determining whether the knowledge is consistent, complete, and correct (knowledge verification) are major problems. This paper discusses various tools developed to assist in these two processes. These tools bring additional knowledge to bear, or provide better interfaces between a knowledge engineer and the expert system's knowledge. PMID- 3807693 TI - [1st All-Union Symposium on the Use of Hyperthermia in Oncology. 28-29 May 1986, Moscow]. PMID- 3807694 TI - [Results and prospects for the clinical use of hyperthermia in oncology]. AB - Artificial controlled local and total hyperthermia combined with radio- and/or chemotherapy was used for the treatment of 1211 patients with malignant tumors of different sites. A study of the long-term results of 750 patients showed that the incorporation of hyperthermia in the schemes of combined and multimodality therapy resulted in a significant increase in the 5-year survival of the patients with melanoma, soft tissue sarcoma, breast and rectal cancer. PMID- 3807695 TI - [Use of local hyperthermia in treating cancer patients]. AB - Basic research in thermobiology made it possible to substantiate the advisability of incorporation of local hyperthermia in schemes of radiotherapy of patients with tumors of different sites. Positive experience of thermoradiotherapy of 301 patients with laryngeal, head and neck, uterine and rectal tumors and osteogenic sarcoma using the Soviet equipment indicated the advisability of wider employment of local hyperthermia in various schemes of radio- and combined therapy. PMID- 3807696 TI - [Hyperthermia in the treatment of cancer patients]. PMID- 3807697 TI - [Experience with thermoradiotherapy of malignant tumors]. AB - The authors analyzed immediate, short-term results of thermoradiotherapy of 112 patients and radiotherapy alone of 91 patients (control group). All had tumors of different sites. Local hyperthermia used as an adjuvant to radiotherapy made it possible to increase the frequency of complete tumor regression from 0 to 11% in rectal cancer patients, from 86 to 100% in head and neck cancer patients, from 0 to 14% in the patients with soft tissue sarcomas and from 40 to 71% in children with rhabdomyosarcomas. These results suggest a possibility of raising the efficacy of radiotherapy combined with local electromagnetic hyperthermia. PMID- 3807698 TI - [Preoperative 2-stage thermoradiotherapy of breast cancer]. PMID- 3807699 TI - [Repeated irradiation of recurrent head and neck tumors using hyperthermia]. AB - The authors presented an analysis of immediate and short-term results of therapy of 115 patients on thermoradio- and chemotherapy for recurrent head and neck tumors. Triple irradiation at single focal doses of 10 Gy at one-week intervals between fractions were employed taking into account radioresistance of recurrent tumors. After each session of irradiation the patients received polychemotherapy (cyclophosphamide, vinblastine, methotrexate) for 2 days. Local MWF-hyperthermia was provided before a session of irradiation and during drug administration. Complete or partial tumor regression was noted in 94% of the patients with the resultant improvement in their general status. The 3-year disease-free interval was noted in 41% of the patients. Radiation changes were restricted to atrophy of the skin and mucous membranes and stable disorders of salivation. PMID- 3807700 TI - [Preoperative thermoradio- and thermochemotherapy of breast cancer]. AB - Thermoradio- and thermochemotherapy were employed for the treatment of 85 patients with stage II-III breast cancer. 80 patients of the control group were given either radio- or chemotherapy. In 3 hrs large fractions of irradiation (a single focal dose of 6 Gy and total focal dose of 18 Gy) of the breast, axillary and subclavicular regions or chemotherapy (i.v. injection of vincristine, 5-FU, cyclophosphamide and methotrexate) were followed by local MWF-hyperthermia (915 MHz) to 43 degrees C tumor temperature for 60 min. 3-day treatment was followed by mastectomy on the 4th day. Preoperative thermoradio- and thermochemotherapy made it possible to achieve pronounced pathomorphosis of breast cancer in most of the patients during 3 days, to lower tumor malignancy and the danger of intraoperative metastases. PMID- 3807701 TI - [Evaluation of the effectiveness of preoperative local thermoradio- and thermochemotherapy of breast cancer using thermography]. AB - The efficacy of combined preoperative local MWF-hyperthermia of breast cancer was difficult to assess because within a short period of treatment tumor remained clinically unchanged. At the same time it resulted in the death of cancer cells and blood flow blockade which had to be reflected in the time course of thermography during treatment. Thermography results in the course of thermoradio- and thermochemotherapy were compared in 27 patients. A decrease and blockade of blood flow in a tumor, the death of cancer cells manifested themselves in "colder" zones in a tumor area. The more pronounced the pathomorphological changes were, the lower was the temperature on thermograms in a tumor area as compared to adjacent tissues. Thermography can be used for assessment of the efficacy of hyperthermia of breast cancer. PMID- 3807702 TI - [Local hyperthermia and hyperglycemia in ORL oncology]. AB - Two-year experience of radiotherapy combined with local hyperthermia, hyperglycemia and chemotherapeutic drugs in patients with tumors of the upper respiratory tract showed advantages of this method. The results were compared with those of the control group of patients on radiotherapy only. Three therapeutic schemes were employed. Hyperthermia was performed in 2 temperature regimens. Of chemotherapeutic drugs platidiam, methotrexate, 5-FU and vinblastine were used. PMID- 3807703 TI - [Current problems of thermobiology]. PMID- 3807704 TI - [Effect of the pH of the medium and the nutrient status on the thermosensitivity of tumor cells]. PMID- 3807705 TI - [Effect of blood flow inhibition in tumors on the effectiveness of hyperglycemia and hyperthermia when used following radiation]. AB - The role of tumor blood supply inhibition associated with hyperthermia (HT) and short-term hyperglycemia (SH) combined with HT in enhancement of antitumor action of x-ray radiation was assessed in experiments on solid Ehrlich carcinoma in mice. It was shown that blood flow inhibition assessed by 133Xe clearance, and tumor growth delay were more pronounced after irradiation at a dose of 10 Gy with subsequent SH and HT at 43 degrees C for 30 min as compared to a dose of 15 Gy combined with HT at 44 degrees C for 30 min. Both schemes showed correlation between a degree of blood supply damage in some tumors and the efficacy of their therapy. The authors suggest a significant role of blood flow inhibition in tumors in postradiation HT and especially HT in a background of SH for increasing antitumor effect of irradiation. The assessment of tumor blood supply inhibition is possible to predict the efficacy of SH and HT in radiation therapy. PMID- 3807706 TI - [The microenvironment of tumor cells and the antitumor effect of hyperthermia]. AB - Intravenous infusion of 20% solution of glucose (80 mg/kg of body mass per 1 min) resulted in considerable changes in microenvironment of tumor cells: by the 90th 120th min of infusion there was a decrease in pH, pO2, blood flow inhibition, an increase in the relative number of cells in the S-phase of the mitotic cycle in a tumor. There was no increase in tumor ATP and glucose up to the values at which these substance could enhance thermoresistance, a situation being rather favorable for realizing a damaging effect of hyperthermia. The use of hyperglycemia in the above regimen prior to MWF-hyperthermia enhanced 2-3 times its antitumor effect on the model of subcutaneously transplanted Gueren carcinoma and Pliss lymphosarcoma. Glucose at the concentration of 5-0 mmol enhanced the thermosensitivity of L-1210 cells. The results indicated the efficacy of hyperglycemia combined with hyperthermia. PMID- 3807707 TI - [Metastasis of Lewis carcinoma during local UHF hyperthermia]. AB - The paper is concerned with the results of a study of the relation of a metastatic spreading of mouse Lewis carcinoma to temperature distribution in the area of a tumor and healthy tissue damage. It was shown that a significant metastatic spreading inhibition was observed in selective MWF-hyperthermia (43-46 degrees C, 30 min). In the absence of a selective hyperthermal exposure when both tumors and healthy tissues were damaged (at the same thermal dose), there was a tendency to metastatic spreading enhancement. A considerable metastatic growth was noted after tumor-affected limb amputation without hyperthermal exposure. PMID- 3807708 TI - [Thermosensitivity of clonogenic cells and the induction of thermal tolerance]. AB - Clonogenic cells of some normal tissues (CFU-GM of the bone marrow of mice, CFU-F of the bone marrow of rats, CFU-GM and CFU-F of the bone marrow of dormice) as well as tumor clonogenic cells of the ascitic variant of ascitic Ehrlich carcinoma were characterized by similar thermosensitivity during their heating under in vitro conditions whereas thermosensitivity in clonogenic cells of solid tumors (LLC, solid Ehrlich ascitic carcinoma) turned out twice as high. A possibility of inducing thermotolerance in these cells by various modes was shown. PMID- 3807709 TI - [Microcirculation of tumors and adjacent tissues during combined exposure to metronidazole and hyperthermia]. AB - The results of the study have shown that the proposed temperature-exposure regimen (42-43 degrees C for 30 min.) 30-40 min after metronidazole administration (1 mg per 1 g of the body mass of an animal) influences the vascularization of both normal tissues of the hip and tumors though to a lesser degree. It manifests itself in a elevation of the tone resulting in hypovascularization and a decrease in the total diameter of the vessels. This reaction is more pronounced in the first hours of the first day. The vascular system of ovarian adenocarcinoma turned out to be more reactive as compared to sarcoma 45. PMID- 3807710 TI - [Set of devices for electromagnetic hyperthermia of malignant neoplasms]. PMID- 3807711 TI - [Experimental equipment unit (the Hypertherm-1) for UHF hyperthermia of malignant tumors]. PMID- 3807712 TI - [Radiothermometry in intracavitary hyperthermia]. AB - The potentialities of microwave radiometry application have been considered as an adjuvant to invasive thermometry to control temperature during local MWF hyperthermia. An increasing role of radiometric monitoring in intracavitary hyperthermia has been shown in experiments on heating rectal tumors. Technical aspects of radiometric temperature measurements combined with MWF-hyperthermia are discussed. PMID- 3807713 TI - [Apparatus and technical devices for ultrasonic hyperthermia]. AB - The developed apparatus included ultrasonic generators operating at a frequency of 0.5-3 MHz, piezoceramic radiators of various design providing the heating of an object with convergent, divergent and plane ultrasonic waves, thermoprobes in the form of single or multiple thermocouples with the bends from 5 points at a 5 mm distance from one another, temperature meters and various auxiliaries. The results of measurements of the acoustical fields of the developed radiators were presented. The advantages and shortcomings of the ultrasonic method of tumor hyperthermia were discussed. PMID- 3807714 TI - [Hyperthermia in the system of combined treatment of malignant tumors]. PMID- 3807715 TI - [Acoustic method of determining the temperature of biological tissues during local heating]. AB - The acoustical method of noninvasive control of temperature increment in deep localized heated regions based on a phase or time delay of a probe acoustical signal during its passing through a heated area was discussed. It was shown using a high-intensity focused ultrasonic radiator as a heating device that the sensitivity of the developed experimental apparatus to temperature change was 0.1 degrees C, the size of the heated area being 2 mm, and the spatial resolution in the direction perpendicular to the acoustical axis of the probe system was approximately 1.5 mm. The "non-invasiveness" and high sensitivity of the system was shown to hold promise for its effective clinical application, particularly for a prolonged heating of large tissue areas. In order to realize this potentiality information a priori should be available on such parameters of studied tissue as a sound velocity temperature coefficient, an absorption coefficient, tissue density and thermal heat capacity. PMID- 3807716 TI - [Radiators for electromagnetic hyperthermia of malignant intracavitary neoplasms]. AB - Rod radiators of electromagnetic field designed for electromagnetic hyperthermia of tumors of the body cavities were developed. Their main parameters were investigated in laboratories. Experimental samples of radiators were advanced for clinical trial in the leading cancer institutes of the country. PMID- 3807717 TI - [Effect of hemodialysis on blood hormone and lipid levels in patients with chronic kidney failure]. AB - The task of the study was to investigate the effect of systematic hemodialysis on lipid and hormonal metabolic indices in patients with chronic renal insufficiency (CRI). In 83.3%, patients with CRI at the terminal stage demonstrated lipid disorders noted against a background of noticeable hormonal imbalance and characterized by high levels of insulin, parathormone, cortisol, somatotropin in the blood serum and a low level of triiodothyronine in the blood. Systematic hemodialysis did not result in significant changes in lipid metabolism. Lipid metabolic disorders in patients with CRI at the terminal stage were detected in 91.7% of cases. Changes in the level of hormones under study were characterized by a decrease in thyroxine concentration thus weakening thyroid function in CRI patients. PMID- 3807718 TI - [The microstructural analysis of scintigrams]. AB - A method of assessment of a zone of scintigraphic image based on a textural analysis was proposed. The method was tested by means of an analysis of synthesized images and assessment of 285 scintigrams of various hepatic lesions. The use of the method made it possible to improve the accuracy of differential diagnosis at the expense of defining the structures typical of diffuse and multiple small focal lesions which were undetectable by visualization. PMID- 3807719 TI - [Short-range x-ray therapy of cancer of the lower lip in its early stages]. AB - The paper is concerned with the analysis of the results of brachytherapy of 169 patients with early stages of lower lip vermilion border cancer T1N0M0 in 81 patients, T2N0M0 in 85 and T3N1M0 in 3). Dosimetric planning was performed. The RUM-21 apparatus being at 60-100 kV, a single focal dose was 3.5-3.6 Gy, the total focal dose 55-60 Gy (5 fractions a week). Complete tumor regression in the absence of cosmetic defects or trophic changes was achieved in all the patients. Recurrences developed in 4 patients 1.5-3 yrs. after therapy. A low metastasizing index was noted to the regional lymph nodes. The results obtained indicated a high effectiveness of brachytherapy for early stages of lower lip vermilion border cancer. PMID- 3807720 TI - [Statistical indices of 201Tl distribution in the myocardium]. AB - A study was made of the diagnostic potentialities of a histogram analysis of scintigraphic count distribution on myocardium scans using 201Tl in 9 patients with dilated cardiomyopathy, 12 patients with coronary heart disease and 6 patients with primary pulmonary hypertension. Scans were recorded 10 min., 4 and 24 h after a single administration of 201Tl at rest in the front-forward, 45 degrees left forward oblique and left lateral projections. The heart area on a scan was marked by hand. Count distribution was represented by an intensity histogram. An array of 243 scans was processed independently by 2 operators of different professional skill. A man-machine classification procedure with algorithm teaching was implemented. The author showed a possibility of group distinction by scintillation count distribution in the heart area on myocardium scans using 201Tl, the distinguishing information being within the interval of 41 80% of maximum intensity in this area. Automatic marking of the heart area on a scan was found necessary to have an entirely automated system for distinguishing groups of examinees. PMID- 3807721 TI - [Radiation therapy of esophageal cancer following the correction of metabolic disorders of the body]. AB - The results of radiation therapy of 126 patients with locally spread esophageal cancer and dysphagia of the III and IV degree have been analysed. Irradiation has been carried out after intense correction of metabolic disturbances in 86 patients of the main group as compared with the control group of 50 patients irradiated after gastrostomy. The intense correction therapy has resulted in stabilization of metabolic disturbances of homeostasis, has increased the antitoxic function of the liver and provided the conditions for completion of the radical radiotherapy by the majority of patients. Upon gastrostoma establishment, body mass loss and decrease of blood serum albumin level have continued, causing the discontinuation of the course of radical radiotherapy for half of the patients. Compared to controls, complete and significant responses were observed twice more frequently. Due to this 31% of the main group patients are alive after 3-year follow-up while almost all the patients from the control group died within the first two years of follow-up. PMID- 3807722 TI - [Local use of metronidazole in dimethyl sulfoxide in the radiation therapy of cervical cancer]. AB - A method of the local use of metronidazole dissolved in dimethylsulfoxide (DMSO) for cervix uteri cancer patients was worked out. Applications of 1-2 g of metronidazole were well tolerated by the patients. Metronidazole concentrations in cervical tumors were high (about 1000 micrograms/g), in the blood they did not exceed 16 micrograms/ml. Experiments showed that metronidazole in DMSO diffused in the tissue, its concentrations at a distance of 2-3 cm from the surface were 180-260 micrograms/g. The local use of metronidazole in DMSO caused an increase in the rate of tumor radiation regression. PMID- 3807723 TI - [Effect of the nonspecific prevention of thrombogenic complications on late results in the combined treatment of bladder cancer]. AB - Altogether 106 patients with bladder carcinoma (Stage T3NxMo) after combined treatment were followed-up for 5 yrs. Nicotinic acid and aspirin at common doses were administered to 51 patients (the 1st group) during pre- and post-operative radiation therapy. The other 55 patients (the 2nd group) did not receive these drugs. Relapses were noted in 33.3% of the patients of the 1st group and in 76.3% of the patients of the 2nd group. The 5-year survival in the 1st group was 72.5% and in the 2nd group 27.4%. The administration of nicotinic acid and aspirin to patients during pre- and postoperative gamma-beam therapy was shown to raise the body antitumor resistance. PMID- 3807724 TI - [Comparative biological effectiveness of 125I and 131I]. AB - An experimental study of comparative biological efficacy of 125I and 131I at equal absorbed doses (2.3 and 13 Gy) in the thyroid of rats showed that the blastomogenic effect of both radionuclides was almost the same. Sex differences were found in the development of long-term consequences (20 mos. after drug administration): breast tumors developed in female rats and thyroid tumors in male rats. PMID- 3807725 TI - [Methodological bases for the control of competition in research in medical radiology]. AB - One of the problems of raising the efficacy and acceleration of investigations and developments under the conditions of scientific technical progress is competitive power of products and technologies. The problem is especially acute in international economic cooperation when one must choose an object of license and lines of research promoting its development. The existing mechanisms of control do not ensure reliable solution of this problem and need to be improved. The paper is concerned with the consideration of routine approaches to control of competitive power; new mechanisms based on algorithmic methods using a clustering analysis of patent and scientific medical information have been proposed. The author shows a possibility of building up the functional structure of research pursued in one or several institutions involved in the development of a multipurpose problem, and the choice of directions of research, among them potential objects for license sale and concluding an agreement of international cooperation on a contract basis. PMID- 3807726 TI - [Attachment for interstitial radiation therapy of cancer of the lower lip]. PMID- 3807727 TI - [Topometric preparation of prostatic cancer patients for teleradiotherapy]. PMID- 3807728 TI - A look at laptop computers. PMID- 3807729 TI - Maintaining a general ledger by spreadsheet. PMID- 3807730 TI - Computers in diagnostic radiology. PMID- 3807731 TI - The critical incident technique--a brief guide. PMID- 3807732 TI - I think that I shall never see, a lecture room that's made for me: the lecture arena. PMID- 3807733 TI - Monitoring pre-registration house officer posts. PMID- 3807734 TI - The Community Medicine Game: a flexible learning game with consumer evaluation. PMID- 3807735 TI - Child psychiatry and medical students in small groups. PMID- 3807736 TI - Medical students as adult learners: implications for an innovative short course in the clinical curriculum. PMID- 3807737 TI - Computerised self-assessment made easy. PMID- 3807738 TI - The use of the Objective Structured Clinical Examination (OSCE) in paediatrics. PMID- 3807739 TI - Evaluating medical students' satisfaction with clinical oral assessors. PMID- 3807740 TI - How we teach applied, integrated physiological sciences. PMID- 3807741 TI - Medicine and architecture: a new development in interdisciplinary teaching. PMID- 3807742 TI - Undergraduate ENT teaching--is it relevant? PMID- 3807743 TI - Clinical teaching methods used in undergraduate training in otolaryngology. PMID- 3807744 TI - Constraints in community based undergraduate teaching. PMID- 3807745 TI - [Various information for the differential diagnosis between depression and incipient senile dementia]. PMID- 3807746 TI - [Biological aspects of the treatment of depression]. PMID- 3807747 TI - [Evaluation of prognostic factors in a population of 200 alcoholics admitted to an alcoholic unit]. PMID- 3807748 TI - [The concept of the schizophrenic defect syndrome]. PMID- 3807750 TI - [Psychiatry and abortion. Problems of denial, ambivalence and mourning in the interruption of pregnancy for psychiatric reasons]. PMID- 3807749 TI - [Essential headaches and life events. A prolonged state of stress: an important factor in the etiopathopathogenesis of muscle-tension headache?]. PMID- 3807752 TI - [Typhoid fever in children in Tunisian rural areas. Epidemiologic and clinical study]. AB - Based on 140 cases of typhoid fever observed in the pediatrics service of the Menzel Bourguiba hospital (Tunisia), the authors demonstrate that such an endemic disease still exists in rural areas, with a peak during autumn-winter season. They underline the importance of the contamination due to water. The disease strikes all groups of age. Infants represent 15% of the patients. On its clinical and biological aspect, the disease is significantly different in child or infant. Blood cultures are positive in 2/3 of the cases, while fecal cultures are positive only in 1/3 of the cases. Despite some complications occurring in 1/6 of the cases, evolution is generally favourable. However, infant septicemia is severe, causing death in 1/3 of the cases. PMID- 3807751 TI - [Fantasy and inertia. A group experience with psychotic patients at a halfway facility]. PMID- 3807753 TI - [Evaluation of morbidity, mortality and therapeutic procedures in diarrheal diseases of young children in Cameroon]. AB - The authors report the results of 3 sample surveys carried out in Cameroon and designed to determine the diarrhoeal morbidity, mortality and treatment rates in children under five years of age living in urban and rural areas, under different types of climate. PMID- 3807754 TI - [Complications of measles in adult Africans. Apropos of 95 cases]. AB - 85 cases of measles with complications have been reported in Agades (Niger) from September 1983 to March 1985. The patients were all adults more than 15 years of age. Such complications are more frequent during winter season. The disease is superposable to the one observed in children: same course, same types of complications (superinfection, undernutrition, dehydration, broken compensation of a parasitosis, encephalitis). Mortality rate is next to the one observed in child (18.2%). Death occurs mainly in women (15 women/1 man). The more often fatal complications are: laryngitis, subcutaneous, emphysema, encephalitis, pernicious malaria, pregnancy complications. It appears highly desirable to extend to adults not yet diseased the immunisation campaign carried out for children. PMID- 3807755 TI - [Scleroma of the upper respiratory tract. Apropos of a case of laryngeal localization]. AB - A case of rhinoscleroma with laryngeal localization is reported. Geographic distribution of this granulomatous disease is discussed. Clinical and paraclinical features are explained. Its tumor-like appearance and local spread arouses suspicion of malignancy but differential diagnosis also includes fungal infections and numerous granulomatous diseases. The classic histopathology consists of large Mikulicz's cells. Treatment is essentially based upon antibiotics. PMID- 3807756 TI - [Early exposure to open air of abdominal surgical wounds. Experiences in a general surgery department at a rural hospital in Burkina-Faso]. AB - In one year time, in the surgery department of the Ouahigouya hospital (Burkina Faso, ex Upper Volta), from the 24th. hour after surgery, the authors exposed in the open air 96 out of 219 parietal abdomen sutures. Healing duration and suppuration rate, unfortunately high (24%) were not different whether the sutures were occluded with a dressing or not. According to the authors, clear economical interest, easy monitoring of the suture, absence of influence of precarious hygienic surrounding and of climatic conditions, and mainly satisfaction of patients, are convincing arguments to apply such a practice already largely utilized in some surgery departments in western countries. PMID- 3807757 TI - [Strategy of sleeping sickness control in the Peoples' Republic of Congo: research and perspectives]. AB - The authors review the different strategies applied nowadays in the Popular Republic of Congo to eradicate sleeping sickness. They underline the problems encountered on the field as well as researches carried out to solve them. Recent progress at both levels of screening and trapping opened interesting prospects. Success of the Congo in its fight against sleeping sickness depends now mainly on means made available to apply on a large scale these new methods. PMID- 3807758 TI - [Chiroptera viruses transmitted or not transmitted by arthropods]. AB - The authors make a review of literature on viruses isolated from chiroptera's tissues. They study especially two of these viruses: a true arbovirus, the Japanese B encephalitis virus and a virus of the same genus but not arthropod borne, the Rio Bravo virus. They consider successively for each virus: isolations from bats, serosurveys in bat and in man, and experimental studies with these viruses, allowing to estimate the role of chiroptera in the diffusion and the maintenance of some arboviruses. They also report some personal results of serosurveys in bats from Tunisia and Spain. PMID- 3807759 TI - [A case of hydatid cyst of the mediastinum in the Republic of Niger]. AB - The authors report on an observation made at the Niamey hospital, because of the combined infrequency of both human hydatidosis in western Africa and mediastinal localization of the observed cases. PMID- 3807760 TI - [Scorpionism complicated by transient blindness. Apropos of a case]. AB - A six years old child, string by a Leiurus quinquestriatus scorpion (Buthidae fam), got, 15 hours after having been string, consciousness disorders and convulsions within a feverish context. The general status recovered rapidly, but disorders of upper functions and a total blindness both occurred. The latter disappeared in few weeks time; central disorders improved progressively while a pyramidal syndrome appeared. No satisfactory explanation was given of such phenomena. PMID- 3807761 TI - [Myocardial scintigraphy perfusion with thallium 201 in coronary disease. Importance of the fractional coefficient (K) of segmental washout of the isotope]. PMID- 3807762 TI - [Diffuse interstitial pneumonitis]. PMID- 3807763 TI - [Lack of contractile uniformity of the normal left ventricle]. PMID- 3807764 TI - [Cardiopathy caused by radiation]. PMID- 3807765 TI - [Bronchoalveolar lavage in the diagnosis of miliary tuberculosis]. PMID- 3807766 TI - [Sinus bradycardia in patients with chronic Chagas disease]. PMID- 3807767 TI - [Cytogenetic evaluation of the damage induced by benzimidazoles for therapeutic use in parasitology]. PMID- 3807768 TI - [Epidemiology of cancer in the city of Rosario]. PMID- 3807769 TI - Post-ventricular tachycardia T-wave changes in ambulatory electrocardiogram. PMID- 3807770 TI - [Ambulatory electrocardiography in patients with syncope or dizziness]. PMID- 3807771 TI - [Iron-creatinine ratio in basal urine. Its usefulness as a nutritional status indicator with relation to iron]. PMID- 3807772 TI - [Hyper and hypothyroidism induced by amiodarone]. PMID- 3807773 TI - [A case of extreme ventilation-perfusion irregularity induced by primary mediastinal lymphoma]. PMID- 3807774 TI - [Angioimmunoblastic lymphadenopathy with hypogammaglobulinemia]. PMID- 3807775 TI - [The costal osteolytic image and adenocarcinoma of the prostate]. PMID- 3807776 TI - Congenital bronchial atresia. A report of 4 cases and a review of the literature. AB - The clinical, radiographic, and pathologic findings in 82 patients with congenital bronchial atresia (CBA) have been reviewed, and we have discussed 4 additional cases. Most patients are asymptomatic and come to attention because of abnormal radiographic findings of a round or lobulated perihilar, solid, or cystic mass--the mucoid impaction sign. Typically, the region distal to the mass is hyperinflated. Recently, computed tomography has been shown to be diagnostic and its use obviates the need for other more complex imaging modalities or surgical exploration. Excisional surgery has been performed to preserve lung function in younger patients, because of lack of familiarity with the entity or, as in 2 of our cases, to prevent recurrent infections. Pathologic findings include a cystic, blindly terminating, mucus-filled bronchocele without connection to the main bronchial tree, but with normal subsequent generations of bronchi. Distally there is noncollapsible hyperinflation of the corresponding lung segment or lobe as the result of collateral ventilation from the surrounding lung. The anomaly is the result of an insult to the growing bronchial tree in early development. The differential diagnosis most often includes allergic bronchopulmonary aspergillosis, but cystic bronchiectasis, bronchogenic cysts, and intrapulmonary sequestration should also be considered. Unusual features in our 4 cases included recurrent pulmonary infections in 2 patients and thoracic cage asymmetry in 1. PMID- 3807777 TI - [Evaluation of exposure to fluorine compounds in aluminum metallurgy]. AB - concentrations of hydrogen fluoride and fluorides were determined near pots with a vertical pin Soderberg anodes and near the prototype pot with a prebaked anode. Samples were collected by the stationary method and with personal samplers (Casella) where the membrane filter was connected with the bubbler filled with 0.1 M NaOH. Hydrogen fluoride and fluorides were determined by colorimetric and potentiometric methods. Altogether 300 samples were determined. Fluorides concentrations near pots with Soderberg anodes ranged between 1.42-2.43 mg/m3 (P = 95), geometric mean being 1.86 mg/m3 (with stationary and personal samples). The range of hydrogen fluoride concentrations was 1.28-3.08 mg/m3 (P = 95), whereas geometric mean--1.99 mg/m3 (personal samples). Hydrogen fluoride concentrations in stationary samples were lower (geometric mean--1.47 mg/m3). Fluorides concentrations during the tests with the prototype pot (prebaked anode) were five times lower, as compared to fluorides concentrations near the traditional pots. PMID- 3807778 TI - [Enzymatic activity of superoxide dismutase in lymphocytes and erythrocytes in people of different ages]. AB - The studies were aimed at testing whether or not there is a dependence between the enzymatic activity of superoxide dismutase (SOD) in lymphocytes and erythrocytes of peripheral blood, and the age between 20 and 60 years. Examined were 235 healthy men working in leather plants. Between the ages 41 and 50 years SOD enzymatic activity of lymphocytes was found to show a statistically significant decrease. SOD enzymatic activity of erythrocytes does not undergo significant changes during the occupationally active period of life for men (20 60 years). The predominant values of SOD enzymatic activity of lymphocytes were found within 0-1.0 U/10(6) lymphocytes and within 50-200 U/ml blood in case of SOD activity in erythrocytes. PMID- 3807779 TI - [Energy expenditure and work exertion in clothing industry workers]. AB - The maximum oxygen uptake (VO2max), oxygen consumption compared with VO2max values--percent of VO2max (strenuousness) and energy expenditure in clothing industry workers were investigated. Seventy five subjects took part in those investigations. The effective energy expenditure of weedle women was 2,3 KJ/480 min, store-workers--3,3 KJ/480 min, cutters 4,8 KJ/480 min, layers--5,1 KJ/480 min, and ironers from 3,7 KJ/480 min, to 4,7 KJ/480 min, respectively. PMID- 3807780 TI - [Mental evaluation after chronic exposure to tetrachloroethylene]. AB - With the aim of determining the effects of chronic occupational exposure to Per upon the selected intellectual and psychomotor functions two groups of workers have been examined. The proper group was that of chemical laundry workers exposed to Per (concentrations within TLVs and above). The control group was composed of knitting plant workers nonexposed to chemical substances. The findings point to significant differences between the test groups, consisting in an extension of the time of response to homogeneous and complex light stimuli (psychomotor function) and in a decrease in the ability to see and reflect the visual material (intellectual function) in the Per-exposed group. PMID- 3807781 TI - [The value of thermographic tests in the diagnosis of the vascular vibration syndrome]. AB - With the aim of testing the usefulness of static thermography for the diagnosis of the vibration syndrome with the AGA-680 Medical apparatus, 111 patients treated in the clinic for suspected vibration syndrome and 25 patients with the idiopathic Raynaud's syndrome have been examined. The vibration syndrome was found in 70 patients, basing on complex multispecialist examinations with no thermovisual evaluation. Ischaemic symptoms were found thermographically in 63 subjects (56%), the rates being the same for the vibration syndrome and non diagnosed occupational disease groups. The highest sensitivity was that of the isotonic capillary test (100%) and pallesthesiometry (88.2%), whereas thermometry and capillaroscopy exhibited lower sensitivity (78.1% and 71.5%, respectively), the lowest sensitivities being those of static thermography (56%) and coolness test (31.8%). The highest correlation between the thermographic pathology and the results of the other tests was that relating to pallesthesiometry and isotopic capillary test. No temperature range characteristic for the vibration syndrome or parallelism of clinical and thermovisual evaluations has been found. PMID- 3807782 TI - [The influence of individual and total lifted objects on the equilibrium of the uterus]. AB - Analysed were the dependencies between the single and total weight of lifted objects and disturbed equilibrium of working women's uterus. The examined population covered 167 women working in standing position, lifting objects of different single and total mass during their workday. The analysis involved: workers' age, type of menstruation, childbirth, urine incontinence and equilibrium of the uterus and vagina. The percentage of women with the descent of uterus and vagina, uterus displacement and effort urine incontinence was found to increase with age, length of employment and number of deliveries, particularly high percentage being the one relating to women lifting, just once, heavy objects. No correlation was found between the incidence rate of the health disturbances and the total weight of the objects lifted during the workday. PMID- 3807783 TI - The nonenzymatic oxidation of glutathione in the presence of plasmalike concentrations of disulfides and copper ions. AB - The oxidation of glutathione catalyzed by a combination of low concentrations of disulfides and copper and iron ions (as they occur in the blood plasma) was investigated and compared with data obtained in vivo studies. At pH 7.4 and 37 degrees C oxidation of glutathione (3 mmol/L) in a solution saturated with oxygen could be induced from 0 to 3, 5, 10, and 21 nmol/min and mL by the addition of 0.1, 1.0, 10, and 100 mumol/L CuCl2, respectively. The presence of 50 mumol/L cystinylbisglycine as an additional component increased the rate of oxidation by a factor between two and three. Cystine was only about one third as active as cystinylbisglycine, and trans-4,5-dihydroxy-1,2-dithiane, the disulfide derivative of dithiothreitol, was even less effective in propagating glutathione oxidation. FeCl2 in combination with the disulfides was 30 times less active than copper as a catalyst. With plasmalike concentrations of the reactants, a rate of glutathione oxidation of 0.2 to 0.8 nmol/min and mL, depending on the availability of free plasma copper, could be approximated. This rate corresponds to 8% to 30% of total plasma glutathione oxidation. PMID- 3807785 TI - Stimulation of thermogenesis and brown fat activity in rats fed medium chain triglyceride. AB - Gastric intubation of young male rats with 100 kJ/d of medium chain (C8 and C10) triglyceride (MCT) reduced their voluntary intake of stock diet such that total metabolizable energy intake was similar to that of rats intubated with water, and 41% of their energy intake was derived from MCT. Body weight, energy gain, and energetic efficiency were all markedly suppressed in MCT-fed rats, but energy expenditure over the 14-day experiment was significantly increased. Resting oxygen consumption, measured at thermoneutrality, was also enhanced in MCT-fed rats, but this difference was abolished by injection of the animals with the beta adrenergic antagonist, propranolol. Brown adipose tissue mass was similar for both groups, but the activity of the mitochondrial proton conductance pathway, assessed from the binding of purine nucleotides, was increased by over 70%. These data indicate that the reduced weight gains of animals fed MCT are due to elevated rates of energy expenditure, possibly resulting from sympathetic activation of brown fat thermogenesis. PMID- 3807784 TI - The effect of pantothenate deficiency in mice on their metabolic response to fast and exercise. AB - The changes in fuel metabolism during fast and exercise were compared to the tissue total CoA levels in mice maintained on pantothenate-deficient and pantothenate-supplemented (control) diets. In nonexercised mice maintained on a pantothenate-deficient diet for 65 to 105 days, the total CoA levels of many tissues were significantly lower than in controls (liver 18%, kidney 23%, spleen 21%, heart 38%, and leg skeletal muscle 66%). However, no differences in total CoA levels in brain or epididymal fat pads were observed. During a 48-hour fast, the total CoA levels increased in the heart and liver of both pantothenate deficient and control mice (heart 32 and 19%, respectively; liver 39 and 45%, respectively), but the level of total CoA remained lower in the deficient mice. Liver glycogen levels were 17% lower in deficient mice than in controls and liver ketone bodies were 17% higher in pantothenate deficient mice than in controls. Separate groups of mice on deficient and supplemented diets were trained to run to exhaustion. Compared to trained mice on pantothenate-supplemented diets, the trained pantothenate-deficient mice had lower running times until exhaustion, lower body weights, lower liver and muscle glycogen content (even after rest), and elevated liver ketone bodies both during rest and after running. In summary, the pantothenate-deficient mice were unable to maintain normal glycogen stores, but had a normal ketogenic response to fast and exercise in spite of the lower levels of liver total CoA. PMID- 3807787 TI - Parathyroid hormone secretion: effect of estradiol and progesterone. AB - Previous studies have shown that estrogen therapy in postmenopausal women results in an increase in serum immunoreactive parathyroid hormone (iPTH) levels. It has been assumed that this effect of estrogen on PTH secretion is indirect, being mediated via mild hypocalcemia resulting from an inhibition of bone resorption. We evaluated the direct effect of 17 beta-estradiol (E2) and of progesterone (Prog) on secretion of PTH from bovine parathyroid tissue in vitro. Both E2 and Prog caused a significant stimulation of PTH secretion within one hour, which was progressive for the three-hour observation period. The responses were dose related from 10(-7) to 5 X 10(-10) mol/L. There was no PTH response to 10(-7) mol/L alpha-E2, 3-methoxy estriol, estrone, testosterone, or 20-alpha-hydroxy progesterone, indicating specificity of the responses to E2 and Prog. There was a minimal PTH secretory response to 10(-6) mol/L cortisol and 10(-6) mol/L estrone. The E2 receptor antagonist tamoxifen did not inhibit the E2 effect on PTH secretion. This observation plus the rapid PTH response suggests that this hormonal effect may not be via the conventional intracellular E2 receptor. Therefore, E2 and Prog can stimulate PTH secretion by rapid, direct, and specific effects on parathyroid cells. These gonadal hormones may, therefore, be important in calcium homeostasis via their direct stimulatory effect on PTH secretion. PMID- 3807786 TI - Peripheral lactate and oxygen metabolism in man: the influence of oral glucose loading. AB - We investigated the influence of oral glucose loading (100 g) on glucose, lactate, and oxygen metabolism by deep (mainly muscle) and superficial (mainly skin and adipose tissue) forearm tissues. In normal men aged 19 to 32 years (mean +/- SE, 24 +/- 1), basal arterialized venous-deep venous (A-DV) and arterialized venous-superficial venous (A-SV) plasma glucose concentration differences were 4.1 +/- 1.0 (P less than 0.001) and 4.7 +/- 1.0 (P less than 0.005) mg/dL, respectively, but increased markedly following glucose loading. During the first, second, and third hours after glucose ingestion, A-DV differences were 54 +/- 6,43 +/- 3, and 20 +/- 4 mg/dL, respectively, while the corresponding A-SV differences were 39 +/- 4, 17 +/- 2, and 8 +/- 2 mg/dL, respectively. Forearm glucose uptake by deep (FGU-D) and superficial (FGU-S) tissues basally was 0.057 +/- 0.010 and 0.012 +/- 0.002 mg/100 mL forearm/min respectively. From 15 to 180 minutes after glucose loading, mean FGU-D and FGU-S rose to 0.524 +/- 0.083 and 0.056 +/- 0.006 mg/100 mL forearm/min, respectively. Basal A, SV, and DV lactate concentrations were 0.55 +/- 0.04, 0.78 +/- 0.03, and 0.57 +/- 0.04 mmol/L, respectively (A-SV, P less than 0.001; SV-DV, P less than 0.001; A-DV, NS). Lactate production by superficial tissues (0.079 +/- 0.015 mumol/100 mL forearm/min) accounted for 62% of concurrent FGU-S.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807788 TI - Slower catabolism of apo B48 than of apo B100 in triglyceride-rich lipoproteins during heparin infusions in type 5 hyperlipoproteinemic subjects. AB - The catabolism of chylomicrons plus remnants and of VLDL was studied in four subjects with type 5 hyperlipoproteinemia. Large triglyceride-rich lipoproteins Sf greater than 60 were labeled with 125I, reinjected, and the removal of radioactivity in apo B48 and in apo B100 was measured before and during intravenous heparin. The constant infusion of heparin stimulated lipolytic activity and accelerated the disappearance of apo B100 radioactivity (VLDL and their remnants) from the Svedberg flotation unit (Sf) greater than 60 fraction by 27%, 33%, 51%, and 55% in the four subjects. However, the removal rate of radioactivity in apo B48 (chylomicrons and their remnants) was unaffected by heparin in three subjects; in the fourth the fall in radioactivity was less in apo B48 than in apo B100. There were corresponding rises with heparin in Sf 12 to 60 apo B48 radioactivity in only one subject. Thus, increased plasma lipolytic activity accelerated chylomicron (remnant) catabolism very much less than of VLDL (remnant) removal of type 5 hyperlipoproteinemic subjects. It suggests that a major defect leading to type 5 hyperlipoproteinemia is failure of chylomicrons to become degraded to the point where the particles can interact optimally with the hepatic chylomicron remnant receptor. PMID- 3807789 TI - Hypercalciuria and altered intestinal calcium absorption occurring independently of vitamin D in incomplete distal renal tubular acidosis. AB - Negative calcium balance and calcium nephrolithiasis are two sequelae of chronic metabolic acidosis. To establish the effects of acidosis on calcium and vitamin D metabolism, we have examined a group of nine patients with incomplete distal renal tubular acidosis. Patients were studied during a control phase and after eight months of potassium citrate treatment, 60 to 80 meq daily. Potassium citrate caused a significant decrease in urinary calcium. The fractional intestinal calcium absorption increased significantly, yet no change was observed in serum vitamin D levels. The estimated calcium balance increased significantly from -70.2 +/- 63.8 to +66.7 +/- 48.7 mg/d (P less than 0.01). Thus, potassium citrate treatment improved the estimated calcium balance by lowering urinary calcium while increasing the fractional intestinal calcium absorption. The original hypercalciuric state, its correction to normocalciuria, and the augmentation of intestinal calcium absorption seen in these patients are probably independent of vitamin D control since there was no change noted in serum 1,25 dihydroxyvitamin D levels. PMID- 3807790 TI - Exercise acutely increases high density lipoprotein-cholesterol and lipoprotein lipase activity in trained and untrained men. AB - We studied the effects of a single exercise session on lipid and lipoprotein concentrations and on postheparin plasma lipoprotein lipase (LPLA) and hepatic triglyceride hydrolase activities (HTGLA) in 11 trained (T) and ten untrained (UT) men. Subjects exercised on a bicycle ergometer at 80% of their maximal heart rate for one (UT) or two hours (T). Blood samples were drawn 24 hours before and at ten minutes and 24, 48, and 72 hours after exercise. Values were analyzed before and after adjustment for estimated changes in plasma volume (PV). High density lipoprotein cholesterol (HDL-C) increased 2 +/- 4 mg/dL in T (P less than 0.05) and 1 +/- 2 mg/dL in UT subjects beginning 48 hours after exercise. This increase was magnified by adjusting for the 5% to 8% postexercise expansion of PV. The increase in HDL in the T subjects was produced by increases in the HDL2-C subfraction (+3 +/- 4 mg/dL, P less than 0.05) whereas HDL3 increased in the UT men (+2 +/- 3 mg/dL, P less than 0.05). LPLA did not change in either subject group when estimated PV changes were ignored but increased 11% (P less than 0.05) at 24 hours after exercise when PV was considered. HTGLA was 11% below baseline in the UT men 24 to 72 hours after exercise (P less than 0.05) but showed no change in either subject group after adjustment for PV. These results demonstrate that exercise acutely increases HDL levels by raising the HDL2 subfraction in T and the HDL3 subfraction in UT men.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807791 TI - Non-insulin-dependent diabetes mellitus, abnormal lipoprotein metabolism, and atherosclerosis. AB - Although diabetes mellitus is, by definition, a state of abnormal carbohydrate metabolism, defects in lipoprotein metabolism are a prominent feature of the diabetic syndrome. This is particularly true of patients with non-insulin dependent diabetes mellitus (NIDDM), and it is quite likely that the abnormal lipid metabolism contributes significantly to the increased morbidity and mortality from macrovascular diseases that characterize NIDDM. In this presentation, an attempt will be made to develop a coherent picture as to the pathogenesis of the defects in lipoprotein metabolism seen in patients with NIDDM, as well as to discuss some new information as to possible links between abnormal lipoprotein metabolism and the development of coronary artery disease (CAD). PMID- 3807792 TI - The diabetes education team in the management of non-insulin-dependent diabetes mellitus. AB - Non-insulin-dependent diabetes mellitus (NIDDM) is a complex disease that lasts a lifetime. It can be controlled but not cured. Treatment involves extensive changes in the patient's lifestyle, particularly in the areas of diet and exercise, which can often result in noncompliance with treatment regimens. Efforts to bring about these lifestyle changes usually require an enormous amount of time and attention on the part of the physician, and thus, are best carried out with the help of a diabetes education team. An ideal team would consist not only of the physician, patient, and family, but also a diabetes educator, a nutritionist or dietitian, an exercise therapist, a psychologist or social worker, a podiatrist, and an ophthalmologist or retinologist. A smaller number of team participants can offer a viable alternative by doubling up discipline areas, and by using interested members of the community as a referral source. PMID- 3807793 TI - Evaluation of the efficacy of split-product trivalent A(H1N1), A(H3N2), and B influenza vaccines: reactogenicity, immunogenicity and persistence of antibodies following two doses of vaccines. AB - The reactogenicity and immunogenicity of Tween-ether split trivalent A(H1N1), A(H3N2), and B influenza vaccine in primary school children aged seven to 12 years, and the persistence of antibodies following two doses of vaccine were studied during 1980-1984. Adverse reactions were infrequent, and, even when reported, were chiefly local ones, mild in nature and of short duration. Most of the reactions were less frequent after the second dose than after the first dose. Most of the systemic reactions occurred during the intervaccination period with almost equal frequency, indicating that careful consideration is required to judge whether they were induced by vaccination or not. This vaccine had induced adequate hemagglutination inhibiting (HAI) antibody because the geometric mean titers (GMTs) of the vaccinees were two- to eightfold higher than those of the nonvaccinees to any of the vaccine antigens following two doses of vaccine. In general, the responses to A(H3N2) virus were the best among the vaccine antigens through the four vaccination seasons, but there was a tendency to show a poorer response to the same type (or subtype) of virus antigen as the causative one during a protracted epidemic. The antibodies induced by either vaccination or natural infection were shown to persist for less than a year, supporting the recommendation for annual vaccination. PMID- 3807795 TI - User views on standards for defibrillators. AB - User views on the need for defibrillator standards were surveyed as part of a multifaceted study of defibrillator use in Canadian hospitals. The majority of users favor standardization of performance, labeling, and use characteristics. They also prefer that all defibrillators incorporate cardioversion capability. Most users prefer that the defibrillator automatically switch to the emergency mode after delivery of a cardioversion shock, but almost one half of the physicians preferred the unit to remain in the synchronized mode as set. Most users are in favor of all equipment operating in the same fashion, but paramedics are not. Only a minority believes that cardioversion features are a cause of confusion, yet conversations with biomedical engineers indicate that this confusion is a common problem among the users. Virtually all users prefer that necessary standards for safety and efficacy should be mandatory for both manufacturers and hospitals. PMID- 3807794 TI - Experimental pulmonary cavity formation by mycobacterial components and synthetic adjuvants. AB - An investigation was undertaken to determine the components of mycobacteria responsible for pulmonary cavity formation in tuberculosis. Rabbits received an intrapulmonary injection through the chest wall, of mycobacterial protein, II-p, mixed with either mycobacterial lipids, synthetic adjuvants or Nocardia cell wall skeleton as adjuvant. Six weeks later, they were killed and the lung lesions were examined. Cavities and necrosis were produced by the injection of II-p mixed with cord factor, Nocardia cell wall skeleton or N-acetylmuramyl dipeptide conjugated with long-chain branched fatty acids. Cavities were not produced by either the injection of II-p together with phospholipid, N-acetylmuramyl dipeptide (MDP), MDP-derivatives having no long-chain branched fatty acid, or by the injection of individual components of the mixtures. The results suggest that in tuberculosis a mycobacterial component with a long-chain branched fatty acid such as mycolic acid plays an important role in pulmonary cavity formation by enhancing the antigenicity of mycobacterial protein and helping it induce cell-mediated immunity at the site of the lesion. Passive transfer with sera from rabbits highly sensitized with tubercle bacilli failed to enhance cavity formation in the recipient animals. PMID- 3807796 TI - How to avoid surface burns during electrosurgery. AB - Electrosurgical burns are said to be the most common electrical hazards in operating rooms. Characteristic of all burns is that the user is not sufficiently familiar with electrosurgery, its power, and possible dangers. The simplest way to avoid burns is to educate those engaged in electrosurgery. There always will remain a risk that should lead to technical solution of the problem. From the physics of electrosurgery and heat production, it can be shown that a residual voltage across the neutral electrode plays a dominant role. To monitor this voltage and process it in an appropriate way will open new possibilities in avoiding burns. PMID- 3807797 TI - A proposed standard for evaluating the thermal performance of pediatric dispersive electrodes. AB - The authors have collected and analyzed 1,418 data points of current and duration of all electrosurgical unit activations from 23 surgical procedures on infants and children. The maximum radiofrequency current used was 550 mA and the duration was 4 sec. The maximum heating factor of 3.04 A2--sec was recorded at 225 mA for 60 sec. However, most data points lay between currents of 50-200 mA and durations of 1-5 sec. Using a three-dimensional computer model for a child thigh, the authors solved numerically first for the current density distribution, and then second the temperature elevation around pediatric dispersive electrodes. Derived curves showed that the maximum temperature under the electrode is proportional to the applied power and inversely proportional to the conducting area of the electrode. Analyzing results from pediatric current-duration experiments as well as computer simulation studies should assist in the design of new and improved pediatric dispersive electrodes. Finally, the authors propose a new standard for evaluating the thermal performance of pediatric dispersive electrodes. PMID- 3807798 TI - The significance of a reference in the direct measurement of blood pressure. PMID- 3807799 TI - Clinical engineering participation in problem-reporting programs. PMID- 3807800 TI - The cause of stimulation with electrosurgical current. PMID- 3807802 TI - [Retinal diseases]. PMID- 3807801 TI - Standards: often an inappropriate response. PMID- 3807803 TI - [Drug-induced kidney diseases. I. Analgesics and non-steroidal antirheumatic drugs]. PMID- 3807805 TI - [Sexually transmitted diseases. Reports from the 2d World Congress on Sexually Transmitted Diseases. Paris, 25-28 June 1986]. PMID- 3807804 TI - [Primary prevention of coronary heart disease. Scientific consensus in Europe]. PMID- 3807806 TI - [Tumor necrosis factor]. PMID- 3807807 TI - [Drug-induced liver diseases]. PMID- 3807810 TI - The government's attitude and response to drugs. PMID- 3807808 TI - [Quinolone: a multiple-acting chemotherapy agent]. PMID- 3807809 TI - [Vitamins--trace elements--sports]. PMID- 3807811 TI - AIDS--the new black death? PMID- 3807812 TI - Drugs for hypertensive emergencies. PMID- 3807814 TI - The world of biomolecules--a new dimension for biomedical engineering. PMID- 3807813 TI - Drugs for rheumatoid arthritis. PMID- 3807815 TI - Characterization of ventricular dynamics in dogs using computerized variables and their statistical treatment. AB - To improve the analysis of mechanical events of the cardiac cycle and the selection of indexes of cardiac function, it is necessary to obtain the most probable time course of a given variable or of the shape of a loop. With this objective, a special program has been devised to obtain mean time tracings of left ventricular pressure (LVP) and posterior wall thickness (PWTH). The time scale can be normalized or beats with small variation in duration can be chosen. Mean loops are obtained in dogs by relating mean LVP and PWTH values. The distribution of pairs of individual values is assumed as normal bivariate with respect to its corresponding mean value, yielding confidence and tolerance ellipses. Results show that for a 95% confidence limit the loop is open in normal conditions. We postulate that this statistical treatment, by giving a more precise course of a mechanical signal allows a more accurate comparison between different experimental or clinical situations in the whole cardiac cycle, as well as the development of cardiac indexes. PMID- 3807816 TI - A new algorithm for individual dialysis prescription based on urea kinetics. AB - Methods for calculating required dialysis time to maintain certain blood urea nitrogen levels predialytically thus far have neglected the influence of ultrafiltration during hemodialysis and of weight changes in the interdialytic period. We therefore have developed a new algorithm for individual dialysis prescription based on urea kinetics which further optimizes accuracy of dialysis prescription by considering these two factors. The accuracy of this new method was proven in a prospective follow-up of 3 patients during some 9 consecutive hemodialysis session. It was found that there was a very close relation between the measured and the predicted values of blood urea nitrogen, the difference being only due to variations in dietary protein intake as the patients were kept on liberal food intake. The new algorithm is easily implemented into a pocket calculator and thus can be used under arbitrary dialysis conditions. PMID- 3807817 TI - [Echocardiography studies of the relevance and intrinsic activity of beta blockers in the human]. PMID- 3807818 TI - [Intravenous fibrinolytic treatment of acute myocardial infarct]. PMID- 3807819 TI - [Management of patients with chronic rheumatic disease]. PMID- 3807820 TI - [Gangrene of the forefoot in disseminated lupus erythematosus with involvement of the large arteries of the extremity]. PMID- 3807821 TI - [Digitalis and non-digitalis-induced atrial tachycardia. Differential electrocardiographic diagnosis]. PMID- 3807822 TI - [Differential diagnosis of cholestasis by anamnesis and findings: modern methods for the analysis of results]. PMID- 3807824 TI - [Iodine-induced hyperthyroidism]. PMID- 3807823 TI - [Intra-arterial infusion treatment of mixed infection gangrene with cefotaxime sodium]. PMID- 3807825 TI - [Foetor ex ore and halitosis. Differential diagnosis and therapy]. PMID- 3807826 TI - [Familial primary ornithine carbamoyltransferase defect]. PMID- 3807827 TI - Dietary calcium deprivation and secondary hyperparathyroidism in patients treated with chronic dialysis. AB - In 33 patients with end-stage renal disease undergoing chronic dialysis, serum parathyroid hormone (PTH) levels were correlated with serum concentrations and dietary intakes of calcium and phosphate. The average dietary calcium intake (549 +/- 54 mg/24 h) was lower than the recommended dietary allowance. There was a weak correlation between serum PTH and serum calcium concentrations (r = 0.39, p less than 0.03). There was also a significant negative exponential relationship between dietary calcium intake and serum PTH (y = 162e-0.0016x, r = 0.61, p less than 0.002). Likewise, when divided into low calcium (less than 500, 304 +/- 27 mg/24 h) and modest calcium (greater than 500, 809 +/- 56 mg/24 h) intake groups, in the low calcium-intake group, serum PTH (128 +/- 20 pg/ml) was more than 2 fold greater than that in the modest calcium-intake group (53 +/- 8 pg/ml, p less than 0.003). These results suggest that low dietary calcium intake may contribute to the occurrence of secondary hyperparathyroidism in patients with chronic renal failure undergoing chronic dialysis. PMID- 3807828 TI - Effect of dopamine on sodium uptake by renal proximal tubule cells of rabbit. AB - Although dopamine is known to be natriuretic, it is not clear if this is due to changes in renal hemodynamics or to a direct tubular effect. Studies on the effect of dopamine on proximal sodium reabsorption have yielded conflicting information, both an increase and a decrease in sodium reabsorption has been reported. The present study examines the direct effect of dopamine on sodium uptake in proximal renal cells and the possible mechanisms involved. Dopamine (10(-7)-10(-4) M) stimulated in a dose-dependent manner sodium uptake by proximal renal cells by 35-92%; 1 mM ouabain and 70 microM cycloheximide did not modify the effect of dopamine. Kinetic analysis of sodium uptake by these cells showed a single saturable component, inhibitable by amiloride, with a Km of 80 +/- 6 mM and Vmax of 68 +/- 9 pmol/mg protein/min. Dopamine (10(-4) M) increased the Vmax of sodium uptake by 54 +/- 10.3% and had no effect on the Km. Metoclopramide abolished the stimulatory effect of dopamine on sodium uptake whereas propranolol had no effect. Epinine (a dopamine agonist) also stimulated sodium uptake by these cells. We conclude that dopamine directly stimulates sodium uptake in proximal renal cells; this suggests the natriuretic effect of dopamine in whole animals is due to changes in renal hemodynamics and distal tubular effects; dopamine increases the Vmax of the sodium transporter and not the Km; the sensitivity of sodium uptake to amiloride suggests that dopamine stimulates Na+ H+ exchanger, and the stimulation of sodium uptake by dopamine is independent of Na+-K+-ATPase and new protein synthesis and occurs via the dopamine receptor. PMID- 3807829 TI - Use of calcium carbonate as a phosphate binder in dialysis patients. AB - Aluminum-containing phosphate (Al-binders) employed to control serum phosphorus in patients with chronic renal failure can be associated with the development of aluminum toxicity. To obviate the need for Al-binders, we examined the effectiveness of CaCO3 as a phosphate binder in 31 hemodialysis and 8 CAPD patients followed for 2 months while receiving Al-binders, and then, for 3-14 months while receiving CaCO3 (5.8 +/- 0.4 g/day). Monthly serum phosphorus averaged 5.4 +/- 0.2 mg/dl with Al-binders and 5.1 +/- 0.3 to 5.7 +/- 0.4 mg/dl with CaCO3 (p = NS). There were 25.2 episodes of hyperphosphatemia (serum phosphorus greater than 6.5 mg/dl) per 100 treatment months with Al-binders and 19.2 episodes/100 treatment months with CaCO3 (p = NS). Plasma aluminum levels, 105 +/- 21 micrograms/l during ingestion of Al-binders, fell to 34 +/- 11 micrograms/l after 8 months of therapy with CaCO3 (p less than 0.01). Monthly serum Ca averaged 9.5 +/- 0.1 mg/dl during Al administration and was 8.9 +/- 0.8 to 10.0 +/- 0.2 mg/dl with CaCO3 (p = NS). Thirty-four episodes of hypercalcemia (serum Ca greater than 11.0 mg/dl) occurred in 14 patients ingesting CaCO3, but hypercalcemia did not occur with ingestion of Al-binders. Al-related bone disease was found on bone biopsy in 11 of 13 patients who developed hypercalcemia, compared to only 5 of the 11 biopsied patients who remained normocalcemic (p less than 0.01 by chi 2 analysis). Other side effects included diarrhea in 1 patient and constipation in 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807830 TI - Oral calcium carbonate as phosphate-binder in infants and children with chronic renal failure. AB - In view of the known toxicity of aluminum, we studied the effects of CaCO3 as an alternative phosphate binder in 12 chronic renal failure (CRF) children during 152 patient-months. Mean (+/- SD) serum creatinine concentration rose during that period from 3.7 +/- 1.8 to 5.1 +/- 3.0 mg/dl. 8 patients received CaCO3 from the start, and 4 were switched from A1(OH)3 after 2 months of interruption. In addition to CaCO3 (0.1-0.3 mg/kg BW) all patients received NaHCO3, and all but two received 1 alpha-hydroxyvitamin D3 [1 alpha(OH)D3] or dihydrotachysterol (DHT). Urine and blood variables were checked every 4-6 weeks and medication dosages were adjusted accordingly, aiming to keep serum Ca at 10.4-10.8 mg/dl, serum Pi at 3.5-5.5 mg/dl, and serum HCO-3 above 18 mEq/l. Bone X-rays were obtained every 6-9 months. With treatment, mean serum Ca increased from 8.9 +/- 0.7 to 10.3 +/- 0.4 mg/dl (p less than 0.01), serum Pi decreased from 6.3 +/- 0.9 to 4.2 +/- 0.5 mg/dl (p less than 0.01), and the mean Ca X P product decreased slightly and insignificantly. Mean serum alkaline phosphatase levels decreased significantly from 486 +/- 251 to 168 +/- 28 IU (p less than 0.01). Bone X-rays at the end of the study showed either healing of renal osteodystrophy or its prevention. Only one episode of mild hypercalcemia (serum Ca 11.7 mg/dl) was observed in 1 patient, but his Ca X P product remained low.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807831 TI - Phenylpyruvate-specific glutamine transaminase and renal ammoniagenesis. AB - The glutaminase II ammoniagenic pathway is composed of two enzymes, glutamine transaminase (GTA) and omega-amidase. Studies herein reported define the basal activity, intrarenal distribution and response to chronic acidosis of the more active renal isoenzyme of GTA. A gradient of diminishing enzyme activity was found in assays of cortical, medullary and papillary sections (GTA activity, cortex 114 +/- 3 mumol/g/h; outer medulla 20 +/- 0.6 mumol/g/h; papilla 3 mumol/g/h). Dog kidney had much less activity while no GTA activity was found in guinea pig kidneys. In vitro acidification enhanced ammonia production by the glutaminase II pathway when studied in cytosolic preparations made from normal rat cortex. Chronic in vivo metabolic acidosis increased rat renal cortical and medullary but not papillary GTA activity by 16 and 12%, respectively. Incubation of cortical cytosolic extracts from chronically acidotic rats at pH 7.4 revealed a 29% increase in ammoniagenesis via glutaminase II, as compared to extracts from non-acidotic control rats. The cortical concentration of the most active substrate of GTA phenylpyruvate, is 343 +/- 12 mumol/kg fresh weight and its level was not influenced by in vivo acidosis. Additional studies are presented which suggest that a functional link may exist between glutaminase II and glutamate oxalacetate transaminase. This linkage could result in the cyclic utilization and reformation of phenylpyruvate while glutamine is progressively deamidated and free ammonia formed. The physiologic implications of these results are discussed. PMID- 3807832 TI - Effect of experimental diabetes on glomerular filtration rate and glomerular prostanoid production in the rat. AB - Glomerular hyperfiltration is an early functional renal lesion seen both in experimental and human diabetes mellitus. This increase in the glomerular filtration rate has been thought to be mediated, in part, by changes in vasoregulatory hormones such as the prostanoids. The present study was designed to measure glomerular prostanoid production in rats with experimental diabetes to determine whether the biochemical changes in prostanoid production could be consistent with the hemodynamic alterations noted. Sprague-Dawley rats were studied either 7 or 28 days after intravenous streptozotocin administration (60 mg/kg). Measurements of the glomerular filtration rate were performed in two groups of diabetic animals 28 days after streptozotocin administration: one group with intact prostanoid production, the other having received a cyclooxygenase inhibitor for the 4-week period. Similar studies were performed in nondiabetic control rats. Measurements of glomerular prostanoid production were performed in control and diabetic animals 7 days after streptozotocin administration. The results of these studies indicate that experimental diabetes mellitus is associated with an increase in the glomerular filtration rate and that this increase can be blocked by the administration of a cyclooxygenase inhibitor. In addition, the determination of levels of various glomerular prostanoids indicated an increased production of prostacyclin and a decreased production of thromboxane during this period of hyperfiltration. Thus, these data support the premise that altered prostanoid biosynthesis may be one of the biochemical mediators of the hyperfiltration seen in early experimental diabetes mellitus. PMID- 3807833 TI - Verapamil improves defective duodenal calcium absorption in experimental chronic renal failure. AB - Experiments were carried out to establish whether abnormalities in cellular calcium metabolism in chronic renal failure contributed to the impaired production of 1,25-dihydroxy vitamin D3 [1,25(OH)2D3]. For this purpose the calcium influx blocker verapamil was administered chronically to 5/6 nephrectomized rats (SNX) and sham-operated rats (sham). SNX and sham-nontreated animals served as controls. Fractional duodenal calcium absorption was severely depressed in SNX rats, compared to sham group. Administration of verapamil to SNX rats caused an improvement in calcium absorption despite similar degrees of renal insufficiency as in the nontreated SNX animals. The effect of verapamil requires residual renal parenchyma, since it was not reproduced in bilaterally nephrectomized rats. 45Ca uptake by renal cortical slices obtained from SNX rats was significantly elevated, as compared to sham group, and was corrected in uremic rats treated with verapamil. Plasma concentrations of 25-hydroxy vitamin D3 (25-OH-D3) were similar in all experimental groups. The 1,25(OH)2D3 plasma level in SNX rats was similar to values obtained in the control group, with an almost 2-fold increase in verapamil-treated animals. Quin-2 measurements of cytoplasmic calcium concentration in cultured proximal tubular cells revealed that verapamil prevents calcium bursts provoked by anoxic insult, by parathyroid hormone and by alpha 1-adrenergic stimuli. We conclude that verapamil treatment of SNX rats improves the duodenal absorption of calcium via augmentation of 1,25(OH)2D3 production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807834 TI - Renal osteodystrophy in patients on hemodialysis for more than 10 years. AB - We performed bone biopsies on 13 patients who had been on dialysis from 11.1 to 17.6 years (mean 14.5 +/- 2.1 years) to evaluate renal osteodystrophy in long term dialysis patients. Seven patients had osteitis fibrosa and 6 had a mineralization defect. Stainable bone aluminum was present in 9 of the patients. Serum phosphorus and parathyroid hormone levels were higher and bone aluminum lower in patients with osteitis fibrosa compared to those with a mineralization defect. Those seriously disabled with decreased mobility due to bone pain (7 of 13) had more bone aluminum than those patients with minimal or no disability (1.55 +/- 1.0 mm/mm2 vs. 0.11 +/- 0.18, respectively, p less than 0.01). A history of fractures during the years on dialysis was also associated with elevated stainable bone aluminum (p = 0.04). We conclude that in long-term dialysis patients aluminum-related osteodystrophy results in greater morbidity than osteitis fibrosa. We recommend that aluminum-containing phosphate binders be used sparingly in patients who are to remain indefinitely on dialysis. PMID- 3807835 TI - [A case of traumatic rupture of the cervical tract of the trachea]. PMID- 3807836 TI - [GH-secreting pituitary neoplasm in the prepuberal period. Study of a clinical case]. PMID- 3807837 TI - [Xibornol in inflammatory involvement of the upper airways in childhood. A comparative clinical investigation]. PMID- 3807838 TI - [Clinical evaluation in pediatric dermatology of a new preparation for topical use (1% isoconazole nitrate-0.75% fluocortin butyl)]. PMID- 3807839 TI - [Hepatic damage in celiac disease in children]. PMID- 3807840 TI - [Neonatal systemic infections caused by Candida albicans]. PMID- 3807842 TI - [Cardiovascular involvement in inborn errors of metabolism]. PMID- 3807841 TI - [Congenital myopathies: possible correlations between the muscular electromyographic and histopathologic pictures. Case contribution]. PMID- 3807843 TI - [Interdisciplinary program for the treatment and recuperation of adolescents with essential adiposity. Preliminary data]. PMID- 3807844 TI - [Quantitative determination of C-reactive protein as a useful indicator of neonatal sepsis]. PMID- 3807845 TI - [Vitamin D status evaluated by the determination of serum 25-hydroxyvitamin D in normal children]. PMID- 3807846 TI - [6-year longitudinal study of children hypertensive at birth]. PMID- 3807848 TI - [Hypospadias today]. PMID- 3807847 TI - [Esophageal transection using a stapler in portal hypertension in children]. PMID- 3807849 TI - [Hba1c and fetal macrosomia. Case contribution]. PMID- 3807850 TI - [Megaesophagus in childhood. Considerations on 4 cases]. PMID- 3807851 TI - [Effects of high-doses cisplatin on the auditory function in children]. PMID- 3807852 TI - [Adapting to the Italian population the methods of predicting the adult body height]. PMID- 3807853 TI - [Age of onset of puberty in Turin females. I]. PMID- 3807854 TI - [Age of onset of puberty in Turin males. II]. PMID- 3807855 TI - Sex education: a physician's responsibility? PMID- 3807856 TI - The HMO as an accountable and public institution. PMID- 3807857 TI - Update on imaging techniques in the evaluation of the female breast. PMID- 3807858 TI - A mobile cancer clinic: an effective, safe, and inexpensive method of delivering anti-tumor therapy. PMID- 3807859 TI - Accidental poisoning in Minnesota. Mortality data. PMID- 3807860 TI - Ultraviolet radiation effects on the human eye. PMID- 3807861 TI - The Minnesota Academy of Family Physicians' Research Network: a vehicle for practice-based research. PMID- 3807862 TI - MMIE malpractice claim review. Family practice. MMIE Risk Management Committee. PMID- 3807863 TI - Morbidity and mortality in patients receiving the esophageal obturator airway and the endotracheal tube in prehospital cardiopulmonary arrest. PMID- 3807864 TI - Intrapleural tetracycline in the treatment of malignant pleural effusions. PMID- 3807865 TI - Cholestatic jaundice associated with methyldopa. PMID- 3807866 TI - Orange ceramicware containing uranium glaze. A source of avoidable radiation exposure. PMID- 3807867 TI - The I-hate-quality-assurance cookbook. PMID- 3807868 TI - MMIE malpractice claim review. Family practice clinic. MMIE Risk Management Committee. PMID- 3807869 TI - The epidemiology of anxiety. PMID- 3807870 TI - Anxiety disorders. PMID- 3807871 TI - Identifying panic disorders. PMID- 3807872 TI - Cognitive therapy for anxiety disorders. PMID- 3807873 TI - Anxiety and anxiety disorder in childhood. PMID- 3807874 TI - The anxiety disorders clinic. PMID- 3807875 TI - [Is it necessary to administer hemostatic medicines after surgical operation? The results of questionnaires about the use of hemostatic medicines in Japan]. AB - In Japan, the various hemostatic medicines have been used after operation. On the contrary, in Europe and U.S.A., the anticoagulants are used both before and after operation because of the high incidence of postoperative deep vein thrombosis. We made inquiries about how they have been used to 566 main surgical clinics in Japan. In the half of these surgical facilities, these medicines still have been used routinely. But in 16.9% of surgery, 9.5% of obstetric & gynecological operation and 29.4% of orthopedic surgery, they have never been used at all. In the field of surgery, in 42% of cardiovascular, 32.1% of respiratory and 10.8% of general surgery, they have not been used absolutely. For the patients with liver cirrhosis, obstructive jaundice and the patients who received the massive blood transfusion during operation, more than 80% of facilities have used the hemostatic medicines. After operation, the blood becomes hypercoagulable and tends to form thrombosis, because of increasing coagulability, decreasing AT-III and protein C, hyper-function of platelet, hypofibrinolytic state and high viscosity. Especially cancer patients have the high risk of deep vein thrombosis. Also we investigated the difference of the incidence of the hemorrhagic complications after operation between in the hemostatic drug group and no drug one. No significant difference was observed. It is concluded that the use of hemostatic medicines after operation is not recommended. PMID- 3807876 TI - [Muscle strength in patients with gastrointestinal carcinoma--an important role of muscle strength as a nutritional parameter]. AB - The relationship between nutritional status and muscle strength was examined in 73 patients with gastrointestinal carcinoma preoperatively. Nutritional status was assessed by measuring various nutritional parameters. Muscle strength was determined by measurements of %grip strength and respiratory muscle strength expressed as %maximal expiratory and inspiratory pressure (%MEP and %MIP). The results were as follows: %GS was significantly low in the patients who showed low values in body weight (%ideal body weight: %IBW), mid-arm muscle circumference (%AMC), serum albumin (Alb), serum prealbumin (PA), total peripheral lymphocyte count (TLC), and/or nutritional surgical risk index (NRI). %MEP was significantly low in the patients who showed low values in %IBW, %AMC, triceps skin fold, Alb, PA, retinol binding protein, NRI, and/or nutritional assessment index (NAI). %MIP was significantly low in the patients who showed low values in %IBW, %AMC, creatinine height index, Alb, PA, NRI, and/or NAI. %MEP and %MIP were significantly correlated with %GS. Preoperative %GS value was significantly low in the esophageal cancer patients with postoperative pulmonary complications. It was suggested that %GS was a simple and useful nutritional parameter for detecting depletion of the muscle mass and visceral proteins, for respiratory muscle strength, and for functional capacity of muscle. PMID- 3807877 TI - [Three-dimensional analysis of colonic adenoma and of carcinoma in adenoma with scanning electron microscope and sequential serial sectioning]. AB - Three-dimensional structures were analyzed on 32 human colonic adenomas, 5 hyperplastic polyps, 4 normal colonic mucosa and 5 advanced colonic carcinomas with Scanning Electron Microscope (SEM) and with sequential serial sectioning. After SEM observation, the samples were softened with 2% NaHCO3 and observed with histological serial sectioning. By combining both techniques, that is combined analysis of outer structures for SEM and inner structures for serial sectioning, three dimensional analysis of the colonic adenoma and carcinoma in adenoma were successfully completed. The colonic adenomas were classified into 6 types based on the surface structure observed by SEM as Type I (circular type), Type II (long elliptical type), Type III (branched type), Type IV (gyral type), Type V (wrinkle type) and Type VI (complicated type). Classified Types I, II, III and IV were observed in tubular adenoma, and grades of atypia seemed to be increased as increasing type numbers. Type V, in tubulo-villous adenoma and villous adenoma, were found out and showed severer atypia than observed in Type IV. Among 32 adenomas, 3 portions of focal cancers were detected, and the surface structures of them had highly complicated patterns as shown with Type VI. PMID- 3807878 TI - [Carcinoembryonic antigen (CEA) levels of peripheral and portal blood and tumor histopathology in colorectal cancer]. AB - Correlation between CEA levels of peripheral and portal blood and 9 histopathologic variables were examined in 66 patients with colorectal cancer. CEA levels of portal blood (mean 26.6ng/ml and positive rate more than 5ng/ml, 59.1%) were significantly higher than those (8.1ng/ml and 33.3%) of peripheral blood. Elevation of CEA levels in portal and peripheral blood were most highly correlated with the grade of vein invasion and its location in the layer of colorectal wall, although the levels were related to the other 8 histopathologic variables such as tumor size, the grade of node metastases, Dukes stage and so on. CEA levels of portal blood elevated from 19.4ng/ml and 40% to 43.6ng/ml and 90.2% respectively following operative stimuli to cancer lesions with vein invasion, but the levels did not elevated in the lesions without its invasion. CEA levels of peripheral blood were as low as 5ng/ml in 3 out of 8 patients with liver metastases. However, the levels in portal blood were much higher than 5ng/ml in all the patients. These results suggested that CEA might be hematogenously drained by portal system from cancer cells in the invasive veins, but not by thoracic duct of lymphatic system, and also that the measurement of CEA in portal blood might be available to predict the vein invasion of cancer lesions and liver metastases in patients with colorectal cancer. PMID- 3807879 TI - [Experimental study on the splenic factor influencing hepatic regeneration]. AB - The splenic factor influencing hepatic regeneration was investigated by using primary cultures of adult rat hepatocytes. The uptake of 3H-thymidine into DNA (DNA synthesis) of primary cultured hepatocytes reached maximum at 48 hours after initiation of incubation both in a splenic-extract added group and in a control solution added group and the former showed significantly lower level (p less than 0.005) of uptake than did the latter. And the 3H-thymidine uptake was lower in a splenic venous serum added group than in an aortic or an inferior vena cava serum added group. This splenic DNA synthesis inhibiting activity was labile against heat and lost activity by trypsinization. Furthermore, when the splenic extract was subjected to gel filtration on a Sephadex G-75 column, DNA synthesis inhibiting activity was observed in a certain fraction alone, and its molecular weight was estimated to be 50,000-60,000 daltons. Although extracts from thymus, lymph node and kidney also inhibited the uptake of 3H-thymidine, these DNA synthesis-inhibiting activities showed lower levels than that was shown in the splenic-extract added group. From these results, it is likely that a protein-like substance inhibiting hepatic regeneration is present in the spleen. PMID- 3807880 TI - [Clinical significance of selective middle hepatic venography]. AB - Selective middle hepatic venography was performed in 86 patients who had been scheduled to undergo liver resection because of hepatobiliary diseases. Special catheters were used of which tips were bended counterclockwise at an angle of 45 degrees. Successful middle hepatic venograms were obtained in 65 cases (76%). Abnormal findings were observed in 27 cases (42%), and it was difficult to diagnose them by ultrasonography or computed tomography. Selective middle hepatic venogram is very useful to understand surgical anatomy of the liver in each case preoperatively. In 5 cases of giant tumor, middle hepatic venography is necessary to identify the exact site of the tumor. Selective middle hepatic venography is considered to be one of the indispensable, examinations for liver resection. PMID- 3807881 TI - [Gastrointestinal complications and their prevention after abdominal aortic reconstruction, especially factors and prevention of paralytic intestinal ileus after a abdominal bifurcated grafting operation]. AB - We experienced 66 cases of abdominal aortic repair, which contained 49 cases of abdominal aortic aneurysm (AAA) and 17 cases of high leveled arteriosclerotic occlusion (high ASO), since March, 1977 till December, 1985. Operative procedures were 44 cases of Y-graft replacement and 5 cases of tube graft interposition for all of AAA, and Y bypass grafting for high ASO. As early gastrointestinal complications after these repairs, paralytic intestinal ileus was found 9 cases in AAA group and no case in high ASO group. Mechanical intestinal ileus needed surgical lysis was found one case in AAA group and one case in high ASO group, upper gastrointestinal bleeding was found 2 cases in both groups, transient ischemic colitis 4 cases in AAA group, and liver dysfunction 4 cases in AAA group. The most frequent complication was paralytic intestinal ileus. In the comparison between 9 cases of paralytic intestinal ileus and others, operative time of the former was significantly longer than that of the latter. But there were no differences in the incidence of other factors. We think that, operative procedure must be chosen in consideration of shortening the operative time. And careful management of gastrointestinal tract and pre-operative correction of general conditions, especially the correction of serum electrolytes and nutrition are the most important. PMID- 3807882 TI - [Experience with the familial occurrence of CIIP and review of the literature in Japan]. AB - Recurrent intestinal obstruction for which no underlying cause can be found has been termed "chronic idiopathic intestinal pseudoobstruction (CIIP)" by Maldonado et al. Some clinical features of CIIP have been pointed out in literatures. More often than not, CIIP often shows hereditary occurrence. The authors have summed up twenty-one cases of CIIP reported till 1984 in Japan, In these cases, only one familial occurrence has been reported excluding our own. Our cases were a young woman and her father and they showed clinical features of CIIP and they might have hereditary factors. PMID- 3807883 TI - [A case of downhill esophageal varices--Behcet disease associated with abdominal aortic aneurysm and occlusions of the superior and inferior vena cava]. AB - A case of Behcet disease which vascular lesions progressed remarkably and had massive gastrointestinal bleeding is reported. A 39 year old man was admitted to the hospital complaining of intractable abdominal pain and angiography revealed impending rupture of a saccular aneurysm just above the bifurcation of the aorta. Aneurysmectomy and patch closure of the defect were performed. Four months later, the patient was admitted again complaining of severe abdominal pain and rerupture of the patch graft was recognized by RI angiography. Aorto-iliac bypass was carried out. Although postoperative course was excellent, the sign of superior vena cava syndrome appeared gradually. Venography revealed occlusion or stenosis of the bilateral subclavian and brachiocephalic veins and the superior vena cava. Femoral venography revealed occlusion of the inferior vena cava, too. Two years and three months later of the first operation, the patient had hematemesis and the extensive varicose vein of the entire esophagus was seen by the upper gastrointestinal examination. Five months later of the examination the patient suddenly had massive gastrointestinal hemorrhage and died in spite of vigorous resuscitative therapy. This esophageal varices was considered as downhill esophageal varices caused by superior vena caval occlusion, not by portal hypertension. Downhill esophageal varices due to mediastinal tumor is seen sporadically, but one due to superior vena caval occlusion secondary to Behcet disease is very rare. PMID- 3807884 TI - [Abdominal arteriovenous fistula due to rupture of aorto-iliac aneurysm with multivarious clinical manifestations. Report of a case with successful repair]. AB - We present a 63-year old man with the arteriovenous fistula caused by the rupture of the aneurysm which extended from the abdominal aorta to the bilateral internal iliac arteries. The clinical manifestations included edema of the left lower extremity, pulmonary embolism, high-output congestive heart failure, origulia, azotemia, liver dysfunction and unstable angina. Because of the variety of the clinical symptoms and the lack of the awareness of this rare complication (arteriovenous fistula), we missed the prompt detection of the entity of the abdominal arteriovenous fistula. We finally succeeded the surgical closure of the fistula and the aortic reconstruction with a woven Dacron bifarcation graft. Problems of diagnosis and operative management are discussed. PMID- 3807885 TI - [Effect of coenzyme Q10 on DNA synthesis of the ischemic lobe after partial hepatectomy in partial liver ischemia]. PMID- 3807886 TI - [Development of the rectal reflex test method by electric stimulation under endoscopy]. PMID- 3807887 TI - Mechanism of the selective toxicity of amphotericin B incorporated into liposomes. AB - Previously, it has been shown that incorporation of the membrane channel-forming polyene antibiotic, amphotericin B (AMB), into liposomes composed of dimyristoyl phosphatidylcholine/dimyristoyl phosphatidylglycerol (7:3 ratio) results in reduced drug toxicity to animals with full retention of therapeutic activity against systemic fungal infections. In this report we explore the cellular and biochemical bases of the enhanced therapeutic index of liposomal amphotericin B (L-AMB). AMB and L-AMB are equally potent and both promptly induce rapid cation efflux from Candida albicans cells. By contrast, AMB, but not L-AMB, induces cation efflux and cell lysis in mammalian erythrocytes, demonstrating the selectivity of L-AMB at the cellular level. The characteristics of the lipid of the erythrocyte membrane seem to be the most important determinant of cellular sensitivity, since AMB, but not L-AMB, induces cation release from large unilamellar liposomes composed of red cell membrane lipids, thus paralleling the observations on intact cells. The ability of L-AMB to induce cation release and cause toxicity to erythrocytes, however, can be modulated by changing the lipid composition of the liposome carrier. Thus, AMB-containing liposomes composed of phospholipids with saturated acyl chains are nontoxic, whereas AMB liposomes composed of phospholipids containing unsaturated acyl chains are almost as toxic as AMB itself. The acyl chain composition rather than the head group composition seems most important, although substitution of anionic phosphatidylglycerols for phosphatidylcholines contributes somewhat to the protective effect. Analysis of several types of liposomes containing AMB at concentrations up to 5 mol %, using electron paramagnetic resonance and freeze fracture electron microscopy, shows that the drug is incorporated in the lipid bilayer but produces only modest disruptive effects on bilayer structure. Current results are interpreted in terms of a selective transfer of AMB from "donor" liposomes to "target" cell membranes. The transfer process probably occurs by diffusion of AMB through the solvent but is regulated by the physical properties of both donor and target membranes. PMID- 3807888 TI - Inhibition of RNA and DNA polymerases by the product of the reaction of selenite with sulfhydryl compounds. AB - Sodium selenite has previously been shown to inhibit DNA and RNA synthesis in both intact cells and isolated nuclei. Nevertheless, DNA and RNA polymerases, the enzymes responsible for this synthesis, are insensitive to inhibition by selenite. Several DNA and RNA polymerases have now been shown to be inhibited by selenite in the presence of sulfhydryl compounds. This inhibition is due to the reaction of selenite with the sulfhydryl compounds to form selenotrisulfide derivatives which inhibit the enzymes. The selenotrisulfides decrease the Vmax of the polymerase reaction and increase the apparent Km for the triphosphates, but do not alter the apparent Km of the enzyme for the DNA template. There are differences in potency between selenotrisulfides formed from similar sulfhydryl compounds such as mercaptoethanol and mercaptoethylamine. There are also differences in the sensitivity of different polymerases to inhibition by the selenotrisulfides. PMID- 3807889 TI - Inhibition of human liver folylpolyglutamate synthetase by non-gamma glutamylatable antifolate analogs. AB - Folylpolyglutamate synthetase (FPGS) catalyzes the gamma-glutamylation of both folates and folate antagonists and has been found to be essential for the survival of mammalian cells. Twelve analogs of the antifolates aminopterin (AMT) and methotrexate (MTX) having the -(CH2)2COOH moiety replaced by -(CH2)nX, where X = SO3H,PO3H2 or NH2, were evaluated as inhibitors of FPGS isolated from human liver. The AMT analogs were consistently found to be better inhibitors than their MTX counterparts, following the order of Km values determined for the parent antifolates as FPGS substrates. For the amino and phosphonate (but not for the sulfonate) compounds, inhibitory efficiencies were markedly dependent on the methylene chain length, with the most effective inhibitors having the groups (CH2)3NH2(Ki = 0.2 microM) and -(CH2)2PO3H2 (Ki = 1.9 microM). Of those compounds exhibiting Ki values less than 200 microM, six were competitive inhibitors whereas three showed mixed inhibition (Ki' = approximately 6 Ki) when analyzed using AMT as the variable substrate. This demonstration of mixed inhibition of FPGS is consistent with the binding of inhibitor to a second site on the enzyme. Very similar Ki values (0.2-0.3 microM) were obtained for the -(CH2)3NH2 analog of AMT when using folic acid, AMT, MTX, and gamma-glutamyl-MTX as variable substrates, suggesting that the same enzymatic site on FPGS is active in the gamma-glutamylation of these four folyl derivatives. These findings serve to identify structural features which are important for inhibition of human liver FPGS and may therefore prove useful for the design of new compounds having potential as chemotherapeutic agents. PMID- 3807890 TI - Induction of metallothionein is correlated with resistance to auranofin, a gold compound, in Chinese hamster ovary cells. AB - Metallothioneins (MTs) are low molecular weight, thiol-rich, metal-binding proteins. Auranofin (AF) is a gold compound active in the treatment of rheumatoid arthritis. The effects of AF on regulation of MT gene expression in Chinese hamster ovary cells were studied. AF-resistant cells accumulated substantial amounts of MT mRNA and protein, whereas no induction was observed in AF-sensitive cells. Cells capable of inducing MT in the presence of AF were much less sensitive to AF-mediated cytotoxicity. Induction of MT by low concentrations of Cd protected cells from subsequently administered doses of AF. The level of protection correlated with the level of induced MT. These findings indicate that MT plays a central role in the mechanisms underlying cellular resistance to gold compounds. PMID- 3807891 TI - Identification of the binding subunit of the D1-dopamine receptor by photoaffinity crosslinking. AB - The D1-dopamine receptor from rat striatum has been successfully identified by photoaffinity crosslinking using a newly synthesized radioiodinated derivative of the selective D1-antagonist SCH-23390. This compound, (R,S)-5-(3'-aminophenyl)-8 chloro-2,3,4,5-tetrahydro-3-methyl-[1H]-3- benzazepin-7-ol(SCH-38548), has been radioiodinated by a chloramine T procedure yielding three radioiodinated products. One of these separated congeners (with Rf = 0.35 on thin layer chromatography; CH2Cl2/MeOH/triethylamine; 82.5:17.5:0.01) binds reversibly to rat striatal membranes with high affinity (KD approximately equal to 200 pM), appropriate stereoselectivity, and D1-dopaminergic specificity. [125I]SCH-38548 can be covalently incorporated into a peptide of Mr approximately equal to 72,000 using the heterobifunctional crosslinking reagent N-succinimidyl-6-(4'-azido-2' nitrophenylamino)hexanoate. Covalent incorporation of [125I]SCH-38548 into the Mr approximately equal to 72,000 peptide can be blocked by dopaminergic agents with D1-dopaminergic specificity (for agonists: SKF-38393 greater than apomorphine greater than dopamine; for antagonists: SCH-23390 much much greater than, SCH 23388 and cis-flupentixol much much greater than trans-flupentixol). The D1 dopaminergic selectivity and specificity of the labeling were further demonstrated by the fact that other antagonists such as domperidone, ketanserin, phentolamine, and alprenolol did not compete for the covalent labeling of the Mr approximately equal to 72,000 peptide. These results indicate that the ligand binding subunit of the D1-dopamine receptor resides on peptide distinct from that of the D2-dopamine receptor (Mr = 94,000). This new radioligand should be useful in the molecular characterization of the D1-dopaminergic receptor from various sources. PMID- 3807892 TI - Inhibition of DNA primase by nucleoside triphosphates and their arabinofuranosyl analogs. AB - DNA primase (EC 2.7.7.6) produces an RNA oligomer of approximately 10 bases, which is required by DNA polymerase alpha (EC 2.7.7.7) for the initiation of DNA synthesis. We partially purified DNA primase from acute lymphocytic leukemia cells from patients using several chromatography columns. Poly(dT) and poly(dC), but not poly(dA) or poly(dG), were good templates for ribonucleoside triphosphate (rNTP)-dependent DNA synthesis (i.e., DNA primase activity), and they were used in the study of the effect of natural and arabinofuranosyl nucleoside triphosphates on DNA primase activity. The Km for GTP in the poly(dC) primase assay was approximately 175 microM. All noncomplementary natural rNTPs and deoxyribonucleoside triphosphates (dNTPs) inhibited poly(dC) primase activity to a similar extent (Ki values of ATP and CTP were 610 and 517 microM, respectively). 1-beta-D-Arabinofuranosylcytosine 5'-triphosphate (araCTP) and 9 beta-D-arabinofuranosyladenine 5'-triphosphate (araATP) were more potent inhibitors of poly(dC) primase activity than were CTP and ATP (Ki values were approximately 125 microM). araCTP, araATP, CTP, and ATP inhibited DNA primase activity in a manner competitive with GTP. The concentration required to inhibit poly(dC) DNA primase activity by 50% was determined for a number of arabinofuranosyl nucleoside triphosphate analogs, and the relative potency of inhibition of DNA primase activity was as follows: rNTP = dNTP = 5-aza-dCTP less than ara-5-azaCTP = araTTP = araATP = araCTP less than 2-fluoro-araATP = 2'-azido 2'-deoxy araCTP less than 2'-fluoro-araTTP = 2'-fluoro-5-iodo-araCTP = 2'-fluoro 5-methyl-araCTP. In the poly(dT) primase assay ATP did not follow classic Michaelis-Menten kinetics (ATP exhibited positive cooperativity with a Hill coefficient of 2.0). However, this assay was very sensitive to araCTP (apparent Ki of 25 microM). In summary, these experiments suggested that DNA primase is controlled by the levels of ribonucleoside triphosphates, and that the perturbation of these pools by any agent could lead to the inhibition of DNA primase and thereby inhibit DNA synthesis. Furthermore, aranucleoside triphosphate analogs directly inhibited DNA primase, and it is possible that this effect may contribute to the cytotoxicity of these compounds. PMID- 3807893 TI - [3H]acetylcholine and [3H](-)nicotine label the same recognition site in rat brain. AB - High affinity binding sites for [3H]acetylcholine and [3H](-)nicotine in rat brain were compared with respect to key characteristics, any one of which should distinguish them if they are different. The density of binding sites for each ligand varied approximately 4-fold in five areas of rat forebrain, but in each of these areas and in human cerebral cortex as well, the densities of [3H]acetylcholine- and [3H](-)nicotine-binding sites were indistinguishable. The affinity of [3H](-)nicotine was higher than that of [3H]acetylcholine, but nicotinic cholinergic drugs competed for the sites labeled by the two ligands with similar affinities; and in each case, the site labeled displayed marked stereoselectivity for the enantiomers of nicotine. The binding of [3H]acetylcholine and [3H](-)nicotine was decreased to the same extent by preincubation of tissues with dithiothreitol, and the binding was restored by subsequent treatment with 5,5'-dithiobis-2-nitrobenzoic acid, indicating that a disulfide bond is required at or near the binding site for each ligand. Treatment of rats with nicotine for 10 days increased the density of binding sites for both ligands, and treatment with the cholinesterase inhibitor soman for 9 days decreased the density of binding sites for both ligands. Taken together, these results indicate that [3H]acetylcholine and [3H](-)nicotine bind to the same nicotinic cholinergic recognition site in rat brain. PMID- 3807894 TI - The levamisole receptor, a cholinergic receptor of the nematode Caenorhabditis elegans. AB - We describe a glass fiber filter binding assay for the levamisole receptor, a putative acetylcholine receptor of the nematode Caenorhabditis elegans, and we show that receptor detected in vitro binds both levamisole derivatives and cholinergic agonists with the pharmacological specificity expected of the physiologically functional nematode receptor. The receptor is detected by the binding of tritiated meta-aminolevamisole ([3H]MAL, 27 Ci/mmol). In extracts of the wild-type nematode, there is a saturable, high affinity binding activity for [3H]MAL (Kd approximately 5-10 nM). Well fed wild-type worms contain as much as 3 fmol of high affinity binding activity per mg of extract protein (0.14 pmol/g of wet weight of worms) and dauer larvae, a special juvenile stage, contain as much as 15 fmol of activity per mg of protein. Specific binding activity per mg of protein is highest in larval stages and decreases severalfold in the adult worm. The rates of formation and dissociation of the [3H]MAL-receptor complex are relatively slow (dissociation half-life, 17 min), in agreement with physiological studies of levamisole on Ascaris muscle strips. Levamisole derivatives and cholinergic agonists have the same relative potencies in inhibiting [3H]MAL binding as they do in causing nematode muscle contraction. Vertebrate cholinergic antagonists do not inhibit [3H]MAL binding, but several antagonists (mecamylamine, alpha-bungarotoxin, and cobra venom) potentiate the binding of [3H]MAL and can be used to demonstrate more clearly the presence of a second, lower affinity binding activity whose ligand-binding affinity is also potentiated by these agents. Both high and low affinity wild-type binding components are missing in the extremely levamisole-resistant mutant unc-74(x19). PMID- 3807895 TI - Alpha-ketoacids stimulate rat renal cysteine conjugate beta-lyase activity and potentiate the cytotoxicity of S-(1,2-dichlorovinyl)-L-cysteine. AB - Renal cysteine conjugate beta-lyase (beta-lyase) catalyzes the bioactivation of nephrotoxic cysteine S-conjugates. beta-Lyase activity is present in both renal cytosolic and mitochondrial fractions, and, although the cytosolic beta-lyase is identical to glutamine transaminase K, the mitochondrial beta-lyase has not been characterized. Because beta-lyase is a pyridoxal phosphate (PLP)-dependent enzyme, pyridoxamine phosphate (PMP) formation may occur during the metabolism of cysteine S-conjugates. In this study, the effects of alpha-ketoacids, which may convert the PMP form of the enzyme to the pyridoxal phosphate form, on the metabolism and cytotoxicity of cysteine S-conjugates were examined; the PMP enzyme is catalytically inactive in beta-elimination reactions, but is catalytically active in transamination reactions. Both alpha-keto-gamma methiolbutyrate (KMB) and alpha-ketobutyrate enhanced the metabolism of S-(2 benzothiazolyl)-L-cysteine (BTC) to 2-mercaptobenzothiazole by rat renal cytosol or mitochondria. KMB and phenylpyruvate potentiated both the cytotoxicity of S (1,2-dichlorovinyl)-L-cysteine (DCVC) in isolated rat renal proximal tubular cells and the inhibition of mitochondrial respiration produced by DCVC. These results are consistent with the formation of PMP during the renal cytosolic or mitochondrial metabolism of cysteine S-conjugates. Mitochondrial beta-lyase was previously localized in the outer membrane. To examine whether beta-lyase activity is present in mitoplasts, but in the PMP form, the effects of KMB on the metabolism of BTC to 2-mercaptobenzothiazole and on the DCVC-induced inhibition of state 3 respiration in mitoplasts were studied. The majority of the mitochondrial beta-lyase activity was present in the outer membrane, and the specific activity of the outer membrane beta-lyase was greater than that of the mitoplast beta-lyase. KMB produced equivalent stimulation of beta-lyase activity in intact mitochondria, in mitochondrial outer membranes, and in mitoplasts and potentiated DCVC-induced inhibition of respiration in intact mitochondria, but not in mitoplasts. These results provide additional evidence for the central role of beta-lyase in the bioactivation of nephrotoxic cysteine S-conjugates. PMID- 3807896 TI - Free radical pathways in the in vitro hepatic metabolism of phenelzine. AB - The in vitro metabolism of phenelzine (2-phenylethylhydrazine) by phenobarbital pretreated rat liver microsomes yields ethylbenzene, 2-phenylethanol, 2 phenylacetaldehyde, benzaldehyde, benzylalcohol, and toluene as metabolites. Isotopic studies demonstrate that the oxygen atom of 2-phenylethanol derives from molecular oxygen and that this alcohol is not produced by reduction of 2 phenylacetaldehyde. The rates of destruction of cytochrome P-450, accumulation of spin-trapped 2-phenylethyl radicals, and formation of ethylbenzene and 2 phenylethanol are the same for [1,1-2H]-2-phenylethylhydrazine as for the undeuterated substrate. Small primary isotope effects are observed, however, for the formation of 2-phenylacetaldehyde (kH/kD greater than 1) and benzaldehyde (kH/kD less than 1). Synthetic 2-phenylethylhydroperoxide is converted by liver microsomes to the same alcohol and aldehyde metabolites. The results indicate that the metabolism of phenelzine by rat liver microsomes proceeds primarily via the 2-phenylethyl radical. PMID- 3807897 TI - Isolation, fractionation and reconstitution of a nuclear extract capable of transcribing ribosomal DNA. AB - A procedure for preparing a nuclear extract that efficiently transcribes rat rDNA in vitro has been developed. This procedure, which is based on the protocol described by Dignam et al. (Nucl Acids Res 11:1475, 1983), allows the preparation of extract from large or small amounts of material and requires neither ultracentrifugation nor column chromatography. These extracts were found to be more efficient than other transcription systems. Extract prepared as described routinely synthesize 1-2 transcripts per linear template, and could synthesize upto 6 transcripts per linear template at an elongation rate of 2.1 nucleotides per second. 0.3 M NaCl extracts of nuclei contained RNA polymerase I, but did not transcribe rat rDNA in vitro, whereas extract prepared with 0.42 M NaCl did. The 0.42 M NaCl extract of nuclei was fractionated by chromatography on DEAE-Sephadex and heparin-Sepharose. Two activities were identified that were required for accurate in vitro transcription by endogenous RNA polymerase I. One of these activities was required for accurate initiation, and the second inhibited non specific transcription. The fraction required for accurate initiation by the endogenous RNA polymerase I is that factor which directs species specific transcription, as it also directed the transcription of rat rDNA by nuclear extracts of HeLa cells. Combining that same chromatographic fraction of the 0.42 M NaCl extract with the 0.3 M NaCl extract resulted in specific transcription. These results suggest that a fraction of the RNA polymerase I molecules may exist in a complex with some, or all, of the factors required for transcription. PMID- 3807898 TI - Coupling of histone mRNA levels to radioresistant DNA synthesis in ataxia telangiectasia cells. AB - Cloned genomic DNA for human histone H1, H3 and H4 genes has been used to determine the effects of gamma-radiation on histone mRNA levels and synthesis in ataxia-telangiectasia cells. Synthesis of histone mRNA was determined in cells synchronized with aphidicolin. Effects of irradiation on DNA synthesis and passage through S phase were also monitored. Irradiation was found to slow the passage of control cells through the cell cycle but had no effect on progression of ataxia-telangiectasia cells. H1 and core histone mRNA synthesis was inhibited by radiation in two control cell lines after release from aphidicolin block. No inhibition was observed in one ataxia-telangiectasia cell line and a small degree of inhibition in a second. An increased level of mRNA was observed in both irradiated control and ataxia-telangiectasia cells at 5-7 h post-irradiation compared to unirradiated cells. Similar results were obtained in log phase cells. These results demonstrate that histone mRNA synthesis is radioresistant in ataxia telangiectasia cells and is coupled to radioresistant DNA synthesis in these cells. PMID- 3807899 TI - A new approach to the biochemical pathology of the vascular system, using time governed laminar elution and bioluminescence analyses. AB - Endothelial cells which cover the inner wall of blood vessels were extracted for bioluminescence analyses of nucleotides and enzymes. The contaminating blood was removed by heparinization and rinsing with ammonium chloride. The content of the endothelial cells of the rat aorta was reached by time governed laminar elution, using a saponin solution to disrupt the cell membranes. Uniformity of extraction was achieved with a Hamilton programmable pump. All the analyses of the eluted fractions showed a characteristic and reproducible peak. The activities of glucose-6-phosphate dehydrogenase and adenylate kinase were significantly higher in the diabetic animals whereas the amount of nucleotides did not differ between diabetic and control rats. The laminar elution technique combined with bioluminescence assay represents a new approach to studies of biochemical alterations in the endothelial cells. The method is also useful for extraction and analyses of other surface layers. PMID- 3807900 TI - Interaction of snake venom cardiotoxin (a membrane-disruptive polypeptide) with human erythrocytes. AB - The action of 7.2 microM cardiotoxin on 0.25% human erythrocytes in a plasma extender solution was studied by the interaction of toxin with intact red blood cells and subsequent hemolysis of the cells. The binding of toxin to cells was completed within 10 min, whereas the membrane rigidity was weakened in a non lytic period for about 25 min. The toxin molecules bound almost exclusively to the membrane. The bound toxin could not be liberated with either 0.5% Triton X 100 or 0.1 N NaOH. The degree of binding was slightly reduced in the presence of 10 mM mono- and divalent inorganic salts. The action of toxin might weaken the in situ association of several proteins that are linked with band 3 protein of the membrane, thus making the cells fragile and altering the shape of the cell to a smooth sphere. PMID- 3807901 TI - Changes in the pattern of histone H1 phosphorylation during Drosophila hydei embryogenesis. AB - Histone H1 phosphorylation was examined during embryonic development of Drosophila hydei. A changing pattern of H1 phosphorylation upon separation on an acid-urea polyacrylamide gel was observed in the course of Drosophila embryogenesis. It is considered to be related to the decrease of the mitotic activity of the cells as development proceeds. PMID- 3807902 TI - Viscosity of chromatin solutions increases with increasing ionic strength. AB - Increasing the ionic strength of rat liver chromatin solutions above 0.4 M causes increasing viscosity. This indicates transformation of the compact chromatin molecules to more elongated forms. In the range of 0.4-0.5 M ionic strength histone H1 is dissociating continuously from the chromatin and the quaternary structure chromatin unravels. At ionic strength higher than 0.5 M the viscosities of chromatin solutions are furthermore increasing due to structural deformation. Near 0.7 M ionic strength the core histones H2A and H2B begin to dissociate from the chromatin, and the opening of the nucleosome cores leads to increasing elongation of the chromatin molecules. PMID- 3807903 TI - Psoriatic hair follicle cells. IV. Calmodulin levels in freshly isolated and cultured human scalp hair follicle cells. AB - Calmodulin levels were measured by radioimmuno-assay in freshly isolated and cultured psoriatic human scalp hair follicle cells. The mean value +/- SEM for calmodulin was 1.97 +/- 0.15 ng calmodulin micrograms-1 protein for 16 control subjects whereas calmodulin levels were significantly increased in psoriatic hair follicles, 2.93 +/- 0.26 ng calmodulin micrograms-1 protein (uninvolved skin) for 18 patients and 3.09 +/- 0.21 ng calmodulin micrograms-1 protein for involved skin derived hair follicles for 17 of these patients. In vitro, 3-week-old cultures of psoriatic keratinocytes contained less DNA and more calmodulin per DNA than their normal counterparts. When 6 week-old cultures of psoriatic and control hair follicle keratinocytes were compared, this difference disappeared. These results are related to the state of differentiation of these cultures. PMID- 3807904 TI - The role of interfacial structured water on the glycoprotein arrangement in liposomes. AB - The effect of perturbing the interfacial water structure in liposomes on the glycoprotein arrangement in the bilayer was investigated. This perturbation was achieved by a series of reagents called structure makers and breakers. The glycoprotein arrangement in the liposomes was determined by fluorescence measurement with 1-anilino-2-naphthalene sulphonate (ANS). A dependence of (n) (number of binding sites for ANS on the glycoprotein molecule) with concentration of structure maker and breaker reagents was observed. The results have been interpreted as a possible new arrangement of membrane-bound glycoprotein, due to the effect of perturbing the interfacial water structure in the liposomes. PMID- 3807905 TI - [Molecular mechanisms of photoreception. V. Isolation of cytoplasmic membranes of rod outer segments from the frog retina]. AB - Cytoplasmic membranes of rod outer segments from frog retina intact rods in retina were stained with fluorescent dye fluoresceinmonomercur acetate. The dye is covalently bound to proteins of cytoplasmic membrane and doesn't penetrate into the cells. Upon isolation of the purified outer segments with the labeled cytoplasmic membranes the cells were disrupted and fractionated in density sucrose gradient. Cytoplasmic membranes possess floating densities different from those of disk membranes and thus providing a mean for separating them from the latter. The main peptides of cytoplasmic membranes are 56, 53, 45, 30 and 28 kDa proteins. PMID- 3807906 TI - [Study of the function of low molecular weight nuclear RNA in the cell-free system of isolated nuclei]. AB - Possible involvement of small nuclear RNAs in transcription was explored. The fraction of small (4-8S) nuclear or cytoplasmic RNAs was isolated by Sepharose 4B gel chromatography and its influence on the RNA synthesis in isolated nuclei was studied. Small nuclear or cytoplasmic RNAs stimulated RNA synthesis in isolated nuclei both in the presence and in the absence of cytosol. On the contrary, the influence of E. coli tRNA or high molecular weight cytoplasmic RNA varied depending on the presence of cytosol. The data indicate that small nuclear RNAs may participate in transcription although the mechanisms of their involvement demand further investigation. PMID- 3807907 TI - [Interaction of immobilized DNA with silver ions]. AB - The interaction of Ag+ with DNA immobilized in polyacrylamide gel was studied by means of the ion-exchange method. Ag+ ions are shown to bind to DNA bases, their charges being neutralized by phosphate groups. The binding sites of Ag+ and H+ are likely to be the same, but the strength of Ag+ binding is greater than that of H+. Ag+ ions like H+ are shown to cause the formation of compact structures in immobilized DNA, the amount of these structures being dependent on subtle differences in DNA samples. DNA samples, not forming compact structures under the influence of H+, do not form them under the influence of Ag+. This fact can indicate the similarity of the mechanisms of the compact structures formation in both cases. The results obtained are compared with the data available for the interaction of Ag+ with DNA in solution. The mechanism of the Ag+-DNA interaction is discussed. PMID- 3807908 TI - [Study of ATP-independent stages of reaction catalyzed by phage T4 RNA-ligase]. AB - The isotope exchange between [5'-32P]pAP and A(5')ppAp catalyzed by enzyme was shown not to take place in the absence of the acceptor; i. e. the necessity of the acceptor presence during the second step of the process was demonstrated. The isotope exchange reaction between [5'32P]pAp and (pA)5p was studied. It was demonstrated that acceptor (pA)4, slightly whereas the acceptor (pU)4 completely inhibits the isotope reaction. The isotope reaction exchange between [5'-32P]pAp and (pU)4pAp does not take place. The question of existence of adenylated donor elimination mechanism in the presence of "poor" acceptors is considered on the basis of the data obtained. PMID- 3807909 TI - [The role of multi-enzyme complexes in the integration of cell metabolism]. AB - General properties of enzymes and structurally ordered multienzyme complexes as controllable systems are discussed: the spatial isolation of working sites and sites of control and the realization of control mechanisms with the participation of "external" factors which provide the optimal functioning of the controllable system in the biological system of higher level of complexity. The basic mechanisms of the control of soluble enzymes are isosteric and allosteric mechanisms which directed to the maintenance of cellular homeostasis. The mechanism of functioning of a multienzyme complex as a whole which is realized with the participation of second messengers is classified as a mechanism for tracing of the signals from higher levels of the control of metabolism (from nervous, hormonal and immune systems). When discussing the control of functioning of the multienzyme complexes, special attention was paid to the complex of glycolytic enzymes formed on the structural proteins of skeletal muscles and on the membranes. An order of assembly of the complex of glycolytic enzymes is proposed. The possible localization of this complex in myofibrils is discussed. PMID- 3807910 TI - [Structural organization of the nucleosomal chromatin fibril under various ionic conditions]. AB - The process of chromatin compactization in nuclei at different concentrations of Mg2+ and/or Na+ ions has been investigated by analysis of chromatin cleavage pattern with DNase II. Nuclei of cells that differ in transcriptional activity and have different nucleosome DNA repeat length such as pigeon erythrocytes, rat cerebellum neurons and pigeon brain cortex neurons were studied. In the presence of 0-3 mM MgCl2 several compactization levels of nucleosomal fiber were revealed in chromatin of pigeon erythrocyte and rat cerebellum nuclei (nucleosome DNA repeat of 210 +/- 3 and 202 +/- 3 nucleotide pairs, respectively). Each of these levels are characterized by different types of periodical DNA fragmentation of chromatin with DNase II, namely formation of nucleosomal, "half-nucleosomal" (fragmentation via a 100 nucleotide pairs interval), and dinucleosomal periodicities. Similar compactization stages were shown also for isolated erythrocyte chromatin. In 0-3 mM MgCl2 chromatin of pigeon brain cortex neuron nuclei having nucleosome DNA repeat size 164 +/- 3 nucleotide pairs is cleaved with DNase II producing only a "half-nucleosomal" periodicity. A pattern of chromatin fragmentation was compared in the presence of Na+ and Mg2+ ions. In the presence of 10-100 mM NaCl or in 0.1-3 mM MgCl2 but in the presence of 50 mM NaCl erythrocyte chromatin condenses in nuclei forming a structure which is characterized only by a "half-nucleosomal" periodicity of fragmentation at DNase II action. Upon higher NaCl concentration (100-400 mM) in the presence of 3 mM MgCl2 a transition from dinucleosomal fragmentation to nucleosomal fragmentation of erythrocyte chromatin in nuclei with DNase I was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807911 TI - [Theoretical conformation analysis of beta-casomorphin-5 molecule]. AB - The spatial structure of beta-casomorphin-5 molecule--H-Tyr-Pro-Phe-Pro-Gly-OH has been investigated by the theoretical conformational analysis method. The results indicate that the conformational properties of the molecule can be represented by a large number of structures having twelve different backbone forms. PMID- 3807912 TI - [Composition, structure and various properties of DNA-protein complexes located at the sites of DNA loop attachment to the nuclear skeleton]. AB - The intimate structure of the complexes located at the sites of DNA loops attachment to the nuclear skeleton was analysed. It is shown that: there are at least three components of the attachment site complex: DNA, protein, RNA; protein moiety consists of 7-8 species with Mr 70-17 kDa. Their association with DNA is resistant to ionic detergents, high salt and urea treatments. The DNA-protein complex is also resistant to the SDS-pronase-phenol deproteinisation procedure; the buoyant density of the complex is the same as DNA density. RNase digestion at low ionic strength reduces density of the complex while the same treatment at 0,4 M NaCl has no effect; DNA-protein complexes isolated with urea-high salt treatment are visualised as globular particles 25-35 nm in diameter with DNA loops attached. These particles were not observed after detergent treatment although protein composition of the complex remained the same. PMID- 3807913 TI - [The structure of small polyadenylated B2-RNA]. AB - Small poly(A)-containing RNA molecules which hybridize to the ubiquitous short repetitive sequence B2 and which are transcribed by RNA polymerase III have been identified in the cytoplasm of mouse cells. Here we describe the structure of this small B2 RNA. A cDNA library was prepared from low-molecular weight cytoplasmic poly(A)+RNA isolated from Ehrlich carcinoma cells and the clones which hybridized to B2 sequence were selected. The clones were sequenced and shown to contain B2 sequences followed by a poly(A) tract. The sequences of the cloned B2 RNAs differ from each other by 3-10%, being similar in this respect to genomic B2 copies. Thus, B2 RNA is transcribed from many different B2 sequences in the genome. The 5'-ends of B2 RNA at least in most molecules coincide with the beginning of B2 genomic sequence. The poly(A) segments located at the 3'-end of small B2 RNA are the same size as in mRNA molecules, suggesting posttranscriptional formation. In some clones additional sequences were detected between the 3'-end of B2 sequence and the poly(A) stretch. They seem to result from a lesion in the RNA polymerase III terminator in the corresponding B2 sequences. A model of B2 RNA secondary structure is suggested. PMID- 3807914 TI - [Enzymatic mechanisms of compensation of deleterious mutations]. AB - Mechanisms of stabilization and compensation, that occur in biochemical systems with enzymes modified by harmful mutations are considered. The compensation of such mutations can result in their evolutionary neutralism. The stabilization is considered due to kinetic signals of metabolites which form the direct and feedback connections with enzymes (temporal stabilization), and also the compensation in enzymatic aggregates determined by the changes of conformation (spatial stabilization). Examples of the stabilization in one or several steady states of enzymatic systems are presented. The neutralism of the distortion of inhibitory and catalytic properties of enzymes is shown in the region of stabilization of these properties. PMID- 3807915 TI - [Nucleotides in rat liver cells: sedimentation and fluorescence analysis; DNA, associated with residual nuclear structures]. AB - Rat hepatocyte nucleoids, obtained at different conditions, have been studied by sedimentation and fluorescence methods. Divalent metal ions have been found to play an important role in the superhelical organization of nuclear DNA. Depending on nucleoid isolation conditions, different DNA fragments become associated with the residual nuclear structure. In rapidly sedimenting nucleoids, where nuclear DNA exhibits greater compaction, two types of DNA fragments, differing is size, are associated. In slowly sedimenting nucleoids, where nuclear DNA is in a more relaxed state, one type of DNA fragments is associated. It is assumed that nuclear DNA compaction is conditioned by the formation of additional DNA binding sites with residual nuclear structures and involves divalent metal ions. It has been shown with the aid of restrictase analysis that both types of DNA fragments contain different repeated nucleotide sequences. PMID- 3807916 TI - [Nucleotides of rat liver cells: electron microscope analysis]. AB - Nucleoids of rat hepatocytes have been studied with the aid of electron microscopy. Proceeding from a morphologic comparison of nucleoids obtained at different conditions, it has been inferred that rosette-like structures are the basic element of nuclear DNA loop organization detected by sedimentation and fluorescent methods. Divalent metal ions play a significant role in stabilizing rosette-like structures. A scheme for DNA organization in the somatic cell interphase nucleus is suggested. PMID- 3807917 TI - [Peculiarities of drug therapy in childhood]. AB - The age of the patient is one of the major determinants of drug efficacy due to certain anatomical, physiological, biochemical and behavioral characteristics of different age groups of the pediatric population. Qualitative and quantitative differences in pharmacokinetics and pharmacodynamics of drugs should be considered before dosage regimens can be established. Differences may occur in each age group, but may be even greater in newborns. Nevertheless, the maturation from the newborn towards adulthood proceeds through a continuum and thus involves also other age groups. Pediatricians are aware of this situation. But only for a small fraction of drugs used in newborns and infants clinical-pharmacological data are available, and drug instructions often contain disclaimer statements against the use in children. In pediatric intensive care units newborns and infants often receive drugs which have not been evaluated before within this age group. According to epidemiological data it has to be assumed that 30% of neonates in neonatal care units develop adverse side effects, which may originate from the drug itself or from drug interactions. Drug trials are completed or underway when new approaches to therapeutic interventions are developed for pediatric disease states. Examples for the development of new therapeutic interventions are for instance the use of theophylline for the prevention of apnoes in prematures, the use of indomethacin for the closure of a patent ductus arteriosus, or the specific advances of cancer chemotherapy in childhood. However, there is no doubt that a complete interplay between clinical, ethical and legal aspects renders the task of studying the effects of drugs in children more difficult than in the case of adults. PMID- 3807918 TI - [Diagnostic procedures in abnormal reactions to foods and food additives]. AB - Allergic and intolerance reactions to food and food additives may occur as a result of antibody-mediated or non-immunological mechanisms. Histories of adverse reactions to food must be confirmed and clarified by means of in-vivo and in vitro tests. Offending substances and clinical manifestations are enumerated. The predictive value and the diagnostic or the threshold sensitivity in provocation tests are demonstrated. There are useful laboratory techniques as the detection of specific antibodies or the estimation of involved mediators. Further procedures for the identification and confirmation of the diagnosis of adverse reactions to food and food additives are suggested. PMID- 3807919 TI - [Specific IgE antibodies to cow's milk and individual cow's milk proteins in children with suspected allergy to cow's milk]. AB - Specific IgE antibodies against whole-milk-antigen mixture and against casein, alpha-lactalbumin and beta-lactoglobulin were determined using the radioallergosorbent test (RAST) in 125 sera of children with an initial diagnosis of suspected cow milk allergy. The results of the RAST were correlated with the clinical diagnosis. No specific IgE antibodies could be demonstrated in 98 children. Of these, 20 (20%) showed clinically intolerance to cow milk presumably on the basis of other immunological mechanisms. Specific IgE antibodies could be demonstrated in the sera of 27 children. Of these, 16 (60%) actually showed allergy to cow milk. A statistically significant association with chi 2 test could be established between positive RAST and clinical diagnosis (p = 0.001). PMID- 3807920 TI - [Clinical picture of partial monosomy of chromosome 11 q]. AB - A ten months old male infant was found to have a de-novo-deletion of the long arm of chromosome 11 (q23----qter). With regard to previous reports the combination of the following signs seems to be pathognomonic for partial monosomy of the long arm of chromosome 11: trigonocephaly, abnormal palpebral fissure, epicanthus, broad and depressed nasal bridge, carp shaped mouth, low-set malformed ears and statomotoric retardation. Cerebral atrophy, BNS-seizures, hypsarrhythmia and persistent leukocytopenia have not yet been described. Three distinct types of severity and probably correlated prognosis seem to exist. PMID- 3807921 TI - [Cavernous hemangioma and disseminated intravascular coagulation (Kasabach Merritt syndrome) in a newborn infant with a large ventricular septal defect]. AB - In a 3170 g newborn with a large cavernous hemangioma at the left thigh, heart failure was evident. Echo- and angiographically a large perimembranous ventricular septal defect was found. An important a-v shunt within the hemangioma could be excluded by hemodynamic investigation and selective arteriographic examination of the vascular tumor. Thrombocytopenia present from the first day of life was only temporarily overcome by corticosteroid therapy but nevertheless consumption coagulopathy (Kasabach-Merritt-Syndrome) developed and additional therapy with heparin was necessary in order to normalize the coagulation factors. However, no regression in size of the tumor occurred over the first 8 weeks of life and a total exstirpation of the hemangioma was performed. Postoperatively no further cortison or heparin therapy was necessary. Despite vigorous medical treatment the congestive heart failure persisted. After surgical closure of the ventricular septal defect at the age of three months the infant thrived and could be discharged without pathological symptoms. PMID- 3807922 TI - [Pulmonary artery loop and dysplastic tracheal stenosis. Case report with pre- and postoperative spirometry and discussion of the value of diagnostic signs]. AB - Since his second week of life a boy, with pulmonary artery sling now 8 3/4 years old suffered from mainly expiratory stridor during exercise and dyspnoe during bronchopulmonary infections, twice in a life-threatening manner. The indirect diagnostic signs were all negative, bronchoscopy revealed a narrow distal trachea and a pulsating stenosis of high degree at the bifurcation. Bronchographic findings were characteristic. Angiocardiographically the retrotracheal run of the left pulmonary artery could only be proved by marking the trachea with a catheter. After operation at the age of 8 1/4 years, the boy had no relevant subjective complaints during a follow-up of 6 months. Spirometric lung function tests before and after corrective operation revealed a considerable obstruction of central intrathoracic airways that persisted after operation, only peak flow improved significantly. According to the bronchological findings the reason therefore is a dysplastic tracheobronchial stenosis, which is seen often in combination with PAS. PMID- 3807923 TI - [Recommendations of the Nutrition Commission of the German Society of Pediatrics for the preventive treatment with vitamin K of newborn infants]. PMID- 3807924 TI - [Conservative therapy of phimosis]. AB - Worldwide in about ten percent of boys general circumcision is performed. The motivations are religious or other rites and ethnic customs, but no scientific medical indication exist for this intervention, even not the small group with inborn phimosis. For these until now only the surgical way is given by circumcision. In 56 cases of boys before puberty with severe phimosis 53 could be completely cured by combined parenteral HCG and local Corticoid treatment within 4-6 weeks. The longtime follow up study did not show any later side effect. The therapeutic scheme is given. PMID- 3807925 TI - [Meningitis following lumbar puncture in bacteremia?]. AB - We report on two infants with bacteremia and the clinical signs of meningitis who developed overt meningitis following an extended period after the first lumbar puncture, in which inconspicuous (cytological and bacteriological) cerebrospinal fluid were found. The causative infective agents of bacteremia and meningitis were identical. The iatrogenic induction of meningitis by the procedure of lumbar puncture in the presence of a bacteremia is imaginable, but has not been proven. Diagnostic consequences are: Every lumbar puncture for bacterial meningitis has to be complemented with a simultaneous blood culture. Lumbar puncture should be repeated when clinical signs of meningitis persists in children, especially in infants with positive blood culture and with inconspicuous cerebrospinal fluid findings in the initial lumbar puncture. Such children should be hospitalized for clinical observation. Therapeutical consequences are presently unclear. Proven recommendations are lacking for the different possible procedures after initial lumbar puncture in children with suspicion of a bacteremia: for instance no therapy or one single antibiotic dose given i.v. immediately following the lumbar puncture or the same treatment as in proven meningitis until microbiological results are obtained. PMID- 3807926 TI - [Psychopathy, sociopathy and dissociability. Differential typology of the personality disorders]. PMID- 3807927 TI - Development of knowledge about the appearance-reality distinction. AB - 7 studies of the acquisition of knowledge about the appearance-reality distinction suggest the following course of development. Many 3-year-olds seem to possess little or no understanding of the distinction. They fail the simplest Appearance-Reality (AR) tasks and are unresponsive to efforts to teach them the distinction. Skill in solving simple AR tasks is highly correlated with skill in solving simple perceptual Perspective-taking (PT) tasks; this suggests the hypothesis that the ability to represent the selfsame stimulus in two different, seemingly incompatible ways may underlie both skills. Children of 6-7 years have acquired both skills but nevertheless find it very difficult to reflect on and talk about such appearance-reality concepts as "looks like," "really and truly," and "looks different from the way it really and truly is." In contrast, children of 11-12 years, and to an even greater degree college students, possess a substantial body of rich, readily accessible, and explicit knowledge in this area. PMID- 3807928 TI - [Activity of virion RNA-polymerase in influenza A and B virus variants with different pathogenicities for mice]. AB - RNA polymerase activities in parental strains of influenza A and B viruses nonpathogenic for mice and their pathogenic variants have been studied. The parental strains are A/seal/Massachusetts 1/80, A/USSR 05/81, A/Philippines 2/82, B/Singapore 222/79. The RNA polymerase activity has been also studied in recombinant strains obtained by crossing various parental strains, one of which is pathogenic for mice (AR/PR 8/34), and having different degrees of pathogenicity. The nonpathogenic viruses had low transcriptase activity. RNA polymerase activity in pathogenic variants is shown to be 1.5-3 times higher than that in the parental strains. All the recombinants, whatever their pathogenicity, had approximately the same transcriptase activities which were 1.5-2 times higher than those registered in parental nonpathogenic strains. PMID- 3807929 TI - [Determination of the accessibility and localization of tryptophan residues in the influenza virus hemagglutinin molecule]. AB - The accessibility and localization of tryptophane residues in the influenza viral hemagglutinin molecule have been determined by measuring specific quenching of tryptophane fluorescence by neutral (acrylamide), anionic (I-) and cationic (Cs+) quenchers. It has been shown that acrylamide quenches 64% of tryptophane fluorescence in H3-hemagglutinin whereas I- and Cs+ quench only 34%. The tryptophanyl residues have been assumed to be located in the hemagglutinin molecule both in the cationic and anionic environments. 64% of tryptophanyls have been shown to be located on the surface of the protein globule. PMID- 3807930 TI - [Antiviral and antiproliferative activity of human fibroblast interferon fractions]. AB - The affinity chromatography of Human crude beta-interferon preparations on Blue Dextran Sepharose columns resulted in isolation of several fractions with different ratio of antiviral to antiproliferative activities. The results of investigation of two of these fractions are described in this report. The first of them was eluted by 1N NaCl in 0.01 M tris buffer at pH 7.8, the second was eluted by 1 M NaCl, 50% methylethylenglycol in 0.01 M tris-HCl buffer at pH 7.8. The first of the fractions possessed presumably antiproliferative and the second presumably antiviral activity. Both fractions induced the increase of 2'5' oligoadenylatesynthetase activity in cells although the inducing activity of the first fraction was about 6-fold higher than that of the second one as compared with their antiviral activities. The obtained results indicate that purification of interferon preparation for interferons main antiviral activity may lead to the loss of the great part of antiproliferative material. PMID- 3807931 TI - Micronucleus induction by low doses of X-rays in Vicia faba root tips. AB - Studies on the micronucleus test in Vicia faba root tips (VM test) were carried out in order to estimate the effects at low doses of X-rays (1, 2, 4, 8 and 12 R). The control value of micronucleus frequency is about 0.44/1000 cells. The dose where the micronucleus frequency is twice that of the control was estimated at 1.384 R. There was a linear kinetic dose response for the low-dose range studied here. PMID- 3807932 TI - A comparison of the radiation-induced mutation at the HGPRT locus in V79 and BHK cells. AB - Mutation response at the HGPRT locus has been compared in two differing cell lines: V79/4, an aneuploid Chinese-hamster fibroblast line with a complement of 20 chromosomes, and BHK21-C13, a diploid Syrian-hamster fibroblast line with a complement of 44 chromosomes. The data presented show that BHK is slightly more radiosensitive than V79/4; however, the toxicity curves and expression times are similar for both cell lines. If radiosensitivity is taken into account, a common line can be drawn for radiation mutagenesis. We conclude from the data that radiation-induced mutagenesis is broadly equivalent in the two cell lines examined, and is not dependent on the chromosome complement. PMID- 3807933 TI - Meiotic non-disjunction induced by fission neutrons relative to X-rays observed in mouse secondary spermatocytes. II. Dose-effect relationships after treatment of pachytene cells. AB - (C57B1/Cne X C3H/Cne)F1 male mice were irradiated with single acute doses of 0.4 MeV neutrons (from 0.11 to 0.72 Gy) or 250 kV X-rays (from 0.25 to 3 Gy) and sacrificed 5 days later. Chromosome preparations of secondary spermatocytes, irradiated at the stage of pachytene, were analysed and the incidence of hyper haploidies and chromosome fragments was recorded. Data on numerical aberrations were fitted by highly significant linear relationships for both types of radiation. A relative biological effectiveness (RBE) value of 5.65 was estimated by the ratio between the slopes of the two regression lines. The same linear fitting was applied to frequencies of cells with fragments, even if in this case other types of functions could not be excluded. An RBE value was estimated in the same way as for numerical aberrations and yielded a comparable figure of 5.23. A significant correlation was also found between the incidence of numerical and structural aberrations, which points to the chromosome itself as the prevalent target for radiation-induced non-disjunction (ND). In addition, the highly significant linearity of the dose-effect relationship observed for the induction of aneuploidies suggests, as the simplest hypothesis, a single-hit mechanism of radiation action, possibly through pre-non-disjunctional damage to the centromeric region, rather than an indirect induction of segregational difficulties after primarily induced chromatid interchanges. PMID- 3807934 TI - Studies on radiation-induced chromosome aberrations in mouse spermatocytes. I. Stage specificity and dose-response relationships of chromosome aberrations induced in mouse primary spermatocytes following X-irradiation. AB - The cytological analysis of chromosome aberrations induced at diplotene, mid pachytene, zygotene and leptotene stages following X-irradiation was performed at diakinesis-metaphase I in mouse spermatocytes. The dose-response relationships fitted well to linear equations for deletion-type aberrations at each stage, and to linear-quadratic equations for exchange-type aberrations at all stages except for leptotene. The radiosensitivity to chromosome aberration induction tended to increase gradually with progression through synaptic and post-synaptic stages, diplotene being the most sensitive. Chromatid exchanges were hardly observed at leptotene, the aberrations being mainly isochromatid fragments. On the contrary, chromatid exchanges and isochromatid deletions were mainly observed at later stages (zygotene-diplotene). The specificity of chromosome aberration induction in primary spermatocytes might be influenced by chromatin organization and chromosomal configuration peculiar to meiotic cells. PMID- 3807935 TI - Studies on radiation-induced chromosome aberrations in mouse spermatocytes. II. Dose-response relationships of chromosome aberrations induced at zygotene stage in mouse primary spermatocytes following fast neutron- and 60Co gamma irradiations. AB - The chromosome aberrations induced at zygotene stage in mouse spermatocytes following exposures to fast neutrons and 60Co gamma-rays were examined at diakinesis-metaphase I. The dose-response relationships were well fitted to linear equation for deletion-type aberrations and to linear-quadratic equation for exchange-type aberrations in 60Co gamma-irradiation group. In fast neutron irradiation group, the dose-response relationships were well fitted to linear equations for deletion- and exchange-type aberrations. The rate of deletion-type aberrations was remarkably high for fast neutrons, about 6 times higher than that after 60Co gamma-irradiation. The main types of chromosome aberrations observed were iso-chromatid breaks or fragments and chromatid exchanges in both irradiation groups as well as X-irradiation. These results indicate that there is a possibility that two double-strand breaks are induced simultaneously at iso locus position in sister chromatids by a single track of radiations. Production of such single-track-induced two double-strand breaks in iso-chromatids may be very frequently expressed as iso-chromatid-type deletions in the high LET fast neutron-irradiation group. On the contrary, in the low LET 60Co gamma- or X irradiation group, the above-mentioned mechanism may not be so effective for contribution to chromosome aberration induction in mouse spermatocytes. This mechanism was discussed in detail. PMID- 3807936 TI - Effects of busulfan on murine spermatogenesis: cytotoxicity, sterility, sperm abnormalities, and dominant lethal mutations. AB - The alkylating agent busulfan (Myleran) adversely affects spermatogenesis in mammals. We treated male mice with single doses of busulfan in order to quantitate its cytotoxic action on spermatogonial cells for comparison with effects of other chemotherapeutic agents, to determine its long-term effects on fertility, and to assess its possible mutagenic action. Both stem cell and differentiating spermatogonia were killed and, at doses above 13 mg/kg, stem cell killing was more complete than that of differentiating spermatogonia. Azoospermia at 56 days after treatment, which is a result of stem cell killing, was achieved at doses of over 30 mg/kg; this dose is below the LD50 for animal survival, which was over 40 mg/kg. Busulfan is the only antineoplastic agent studied thus far that produces such extensive damage to stem, as opposed to differentiating, spermatogonia. The duration of sterility following busulfan treatment depended on the level of stem cell killing and varied according to quantitative predictions based on stem cell killing by other cytotoxic agents. The return of fertility after a sterile period did not occur unless testicular sperm count reached 15% of control levels. Dominant lethal mutations, measured for assessment of possible genetic damage, were not increased, suggesting that stem cells surviving treatment did not propagate a significant number of chromosomal aberrations. Sperm head abnormalities remained significantly increased at 44 weeks after busulfan treatment, however, the genetic implications of this observation are not clear. Thus, we conclude that single doses of busulfan can permanently sterilize mice at nonlethal doses and cause long-term morphological damage to sperm produced by surviving stem spermatogonia. PMID- 3807937 TI - Exposure of female mice to ethylene oxide within hours after mating leads to fetal malformation and death. AB - When previously mated female mice were exposed to inhaled ethylene oxide at the time of fertilization of their eggs or during early pronuclear stage of the zygote (before DNA synthesis), a high incidence of mortality among conceptuses and of congenital abnormalities among both the dead and the surviving fetuses was observed. The developmental stage at which death occurred ranged from near the time of implantation to day 17 of gestation when examination of the uterine contents was performed. In comparison, midgestation and late fetal deaths were absent or minimal when the females were exposed either before mating or when conceptuses were in later zygotic stages (pronuclear DNA synthesis) or had reached the early two-cell stage. The random types of congenital abnormality observed and the remarkable stage-dependent sensitivity suggest a genetic basis for the response. The effects differ, both from genetic damages induced in premating germ cells, which lead only to death near the time of implantation, and from teratogenic damage, which leads to malformations only when exposure of embryos occurs during the period of major organogenesis. PMID- 3807938 TI - Comparison of the continuous rat hepatoma cell line 2sFou with primary rat hepatocyte cultures for the induction of DNA repair synthesis by nitrosamines, benzo[a]pyrene and hydroxyurea. AB - We have examined the suitability of the continuous rat hepatoma cell line 2sFou for testing the genotoxicity of chemicals in comparison with that of primary rat hepatocyte cultures (HPC). The capacity of the cells for metabolic activation was assessed by measuring induction of DNA-repair synthesis and inhibition of replicative DNA synthesis by the test compounds dimethylnitrosamine (DMN), diethylnitrosamine (DEN), hydroxyurea (HU) and benzo[a]pyrene (BaP), which are substrates for major hepatic and extrahepatic forms of cytochrome P-450 dependent monooxygenases. The cellular capacity for DNA-repair synthesis was assessed using UV-light as a DNA-damaging agent. Repair-specific incorporation of [3H]deoxycytidine (3H-dCyd) caused by UV-light was higher in 2sFou cells than in HPC. In contrast, background repair incorporation of 3H-dCyd in 2sFou cells was only 1/3 that found in HPC. All the test agents induced DNA repair and inhibited DNA synthesis in both 2sFou cells and HPC. The two nitrosamines were more effective in HPC than in 2sFou cells. HU and BaP affected DNA repair and DNA synthesis in the two cell systems at a similar range of concentrations. In general, DNA repair in the 2sFou cells increased near linearly with the concentrations of the test compounds. The data indicate that 2sFou cells are capable of activating hepatotropic pro-mutagens/carcinogens such as dialkylnitrosamines, and are sensitive indicators of DNA damage. In contrast, BaP, a non-hepatotoxic compound, caused only little DNA repair in these cells. Thus, continuously growing cells, such as 2sFou, show a qualitatively similar response to genotoxic chemicals as HPC and offer a potential alternative to HPC for genotoxicity testing. PMID- 3807939 TI - Diphenylhydantoin and mitotic spindle abnormalities in cultured mouse and human cells. AB - The present study demonstrates that the antiepileptic drug diphenylhydantoin (DPH) is capable of inducing aneuploidy but not structural aberrations in cultured mouse embryonic fibroblasts. A high concentration of 200 micrograms/ml was found to increase the percentage of hyperdiploidy from 4.8 (control) to 16.0. The treatment was found to increase mitotic indices as a consequence of a mitotic arresting action of the drug. These effects are probably due to the effect of the drug on the structure of the mitotic apparatus. Abnormal cell divisions and mitotic disturbance were found to increase in a dose-dependent manner after DPH treatment. In a parallel study, human amnion cells were found to show similar response to DPH treatment. PMID- 3807940 TI - Mutagenicity of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) in the granuloma pouch assay. AB - The rat granuloma pouch assay was used to assess the in vivo mutagenic potential of 2-amino-3-methyl-imidazo[4,5-f]quinoline (IQ), a heterocyclic aromatic amine which is formed during the frying of meat and broiling of fish. The assay was performed with and without pre-induction by Aroclor. In the initial experiment IQ was injected directly into the pouch of non-induced rats. A 10-fold increase in mutation frequencies was obtained with the 2.0 mg/pouch dose of IQ with uninduced cell populations. In a second study IQ was injected intraperitoneally and into the pouch of rats that had been pre-induced with Aroclor. The dose of IQ administered varied from 0.1 to 2.0 mg/pouch. A 10-fold increase in mutation frequencies was obtained with the 2.0 mg/pouch dose of IQ with uninduced cell populations. Aroclor treatment produced no significant increase in mutation frequencies over uninduced animals. Its mutagenic effect is about 10-fold weaker than that of benzo[a]pyrene or N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). PMID- 3807941 TI - Characterization of lactate dehydrogenase of Plasmodium knowlesi. AB - Some properties of purified lactate dehydrogenase, (EC. 1.1.1.27) from schizonts of Plasmodium knowlesi are described. The plasmodial enzyme migrated as single entity on polyacrylamide gel, and resembled rabbit muscle (M4) lactate dehydrogenase in its electrophoretic mobility. The P. knowlesi enzyme consisted of four identical subunits of 31 kDa. Purified lactate dehydrogenase was inhibited almost completely when incubated with 100 microM p chloromercuribenzoate, Ag+ or Hg+ and such inhibition could be reversed by the addition of beta-mercaptoethanol or L-cysteine. Metal chelators did not show any remarkable effect. Oxalic acid is a competitive inhibitor of pyruvate reduction by this enzyme with apparent Ki of approximately equal to 0.41 mM. PMID- 3807942 TI - Stimulation of Schistosoma mansoni miracidia by a 80 kDa glycoprotein from Biomphalaria glabrata. AB - Soluble extracts of Biomphalaria glabrata stimulate in vitro incorporation of methionine in Schistosoma mansoni miracidia. Evidence is presented that a unique 80 kDa glycoprotein representing less than 0.01% of total snail proteins and uniformly distributed in the snail body, is responsible for the observed stimulation. This protein specifically acts on the miracidia and this observation suggests that this glycoprotein influences snail penetration and development of miracidia. However, the presence of molecules stimulating S. mansoni miracidia was also demonstrated in S. mansoni nonpermissive molluscs. PMID- 3807943 TI - An improved purification of glycosomes from the procyclic trypomastigotes of Trypanosoma brucei. AB - The glycosomes of in vitro grown procyclic trypomastigote forms of Trypanosoma brucei were purified by three different procedures and the results compared by electron microscopy, enzyme assays and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Centrifugation on a self-forming Percoll gradient followed by a sucrose gradient centrifugation resulted in the least enriched glycosomal preparation. Centrifugation on a pre-formed Nycodenz gradient gave an improved preparation but the most homogeneous preparation of intact glycosomes was obtained after centrifugation on two successive sucrose gradients. Glycosomes purified by both the Nycodenz and double sucrose gradient procedures appeared larger than in situ glycosomes presumably due to an osmotic effect resulting from disruption of the granular matrix of the organelles. Nevertheless, there appears to be no loss of cisternal contents due to the swelling of the organelles. The glycosomes of the bloodstream form trypomastigotes purified by the same procedures show, however, no sign of swelling. A comparison of glycosomes purified from procyclic trypomastigotes and bloodstream form trypomastigotes prepared by the same double sucrose procedure demonstrated that in the glycosome of procyclic trypomastigotes: activities of hexokinase, phosphoglucose isomerase, phosphofructose kinase, aldolase and phosphoglycerate kinase and diminished by 80 100%; activities of glyceraldehyde-3-phosphate dehydrogenase, triose phosphate isomerase and glycerol-3-phosphate dehydrogenase remain unchanged or are only slightly reduced; there is an appearance of four major new proteins, among which could be phosphoenol pyruvate carboxykinase and malate dehydrogenase. These observations are in basic agreement with those by Hart et al. (Mol. Biochem. Parasitol. 12, 25-35, 1984). PMID- 3807944 TI - Transcriptional mapping of Leishmania enrietti tubulin mRNAs. AB - We have mapped the mRNAs for alpha- and beta-tubulins of Leishmania enriettii promastigotes and amastigotes and have demonstrated that each RNA contains a 35 nucleotide sequence on its 5' end which is not encoded contiguously with the rest of the message. Sequencing of the 5' end of the alpha- and beta-tubulin mRNAs revealed that this 35 nucleotide leader sequence is identical in both messages and that it is homologous to the spliced leader found on the 5' end of mRNAs in the related parasite Trypanosoma brucei. Additionally, we have sequenced regions of the alpha- and beta-tubulin genomic clones upstream from the mRNA encoding regions and have shown that the leader sequence is not encoded within these regions of DNA. Hence, Leishmania tubulin mRNAs may be synthesized by a discontinuous transcription process that links together the transcription products of two separate gene families, as suggested previously by others for the assembly of T. brucei mRNAs. Homologies between the Leishmania alpha- and beta tubulin genes themselves and between these genes and the T. brucei alpha- and beta-tubulin genes have revealed sequences which may be important in synthesis or processing of Leishmania tubulin mRNAs. PMID- 3807945 TI - The biosynthesis of trypanothione and N1-glutathionylspermidine in Crithidia fasciculata. AB - Studies on the biosynthesis of trypanothione [N1,N8-bis(glutathionyl)-spermidine] in the insect trypanosomatid Crithidia fasciculata have led to the discovery of an additional sulfur-containing peptide conjugated to spermidine. Labelling studies with [3H]spermidine show that 50% of the total intracellular spermidine is incorporated into peptide conjugates, the major component being N1 glutathionylspermidine. This compound has previously been identified in Escherichia coli, as the principal low molecular weight thiol in stationary phase, but not the logarithmic phase of growth. In contrast, in C. fasciculata, this compound is present in all phases of growth. In the presence of glutathione and ATP, extracts of C. fasciculata can catalyse conversion of spermidine to N1 glutathionylspermidine and trypanothione. Both N1- and N8-regioisomers of glutathionylspermidine will replace spermidine in the reaction, suggesting they may be intermediates in the biosynthetic pathway to trypanothione. The antiprotozoal drugs berenil, pentamidine, ethidium bromide, imidocarb, methylglyoxal-bis(guanylhydrazone) and 1,3-diacetylbenzene-bis(guanylhydrazone) had no effect on the synthesis of N1-glutathionylspermidine or trypanothione in vitro. PMID- 3807946 TI - Kinetic correlation of the acquisition of resistance to immune attack in schistosomula of Schistosoma mansoni with a developmental change in membrane potential. AB - When Schistosoma mansoni cercariae penetrate the skin of the mammalian host they rapidly pass from fresh water to a high salt physiologic environment and transform into schistosomula. Following this transition, the parasites migrate from the skin to the lungs during which time they change from being highly susceptible to immune attack to being refractory, as measured by in vitro cytotoxicity assays. In this study, in vivo or in vitro schistosomula of different ages were examined for developmentally linked changes in membrane function which might correlate with the attainment of the resistant state. In particular, alterations in the distribution of tetraphenylphosphonium (TPP+), a synthetic lipophilic cation which shows a potential dependent partition across membranes, were followed. Three-hour-old schistosomula, which are greater than 75% susceptible to antibody-dependent complement-mediated attack or lymphokine activated macrophage-mediated cytotoxicity, acquired TPP+ at a similar rate and steady state level to 5-day-old lung worms, which were completely resistant to both these effector mechanisms. The addition of ouabain, a Na+/K+-ATPase inhibitor, caused a 50% decrease in both the rate and steady state of TPP+ uptake by 3 h parasites but had little effect on these parameters in lung worms. Valinomycin, a K+-ionophore, completely inhibited TPP+ influx in both stages. The characteristics of TPP+ efflux from 3-h and 5-day-old parasites preloaded with the cation were found to be dissimilar. Whereas 30% of acquired TPP+ was lost from lung worms within 2 h, only 10% of acquired cation was released from 3-h schistosomula during the same period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3807947 TI - Discovery of a specific double-stranded RNA virus in Giardia lamblia. AB - Nucleic acid samples purified from trophozoites of Giardia lamblia Portland I strain contain an ethidium-stainable band that comigrates with 7.0 kilobase DNA in agarose gel electrophoresis. The band was degradable by alkali, ribonuclease A and ribonuclease T1, but the susceptibility toward the ribonucleases decreased with increasing ionic strength, suggestive of double-stranded RNA (dsRNA). This identification was confirmed by electron micrographs of the purified samples, which showed linear double-stranded structures with an estimated average length of 1.5 micron. In crude homogenates of G. lamblia, this dsRNA was protected against added ribonuclease A but disappeared upon adding sodium dodecyl sulfate or proteinase K. Differential centrifugations suggested an association of the dsRNA with the nuclear fraction, but it was freed to the 109,000 X g pelletable fraction with increasing homogenization. The dsRNA was purified by CsCl buoyant density gradient centrifugations in a distinct band with a rho value of 1.368 g ml-1. Electron microscopy revealed spherical virus-like particles (VLP) with a diameter of 33 nm. VLP of similar shape and size were also identified in the nuclei of sectioned G. lamblia trophozoites. VLP yield a major protein with an estimated molecular weight of 66,000 in sodium dodecyl sulfate polyacrylamide gel electrophoresis. VLP are abundant in the culture media of stationary-phase G. lamblia Portland I strain and are able to infect the G. lamblia WB strain, which is free of the virus. There is no sequence homology between the dsRNA and the nuclear DNA of G. lamblia and thus no apparent integration of viral genome into host DNA. PMID- 3807948 TI - Distribution of iodinated proteins in Dipetalonema viteae after surface labelling. AB - Adult females of the filarial parasite Dipetalonema viteae were radiolabelled using chloroglycoluril and different concentrations of iodine with and without carrier iodide. A detailed quantitative analysis of the distribution of the labelled proteins were carried out using sodium dodecylsulfate and beta mercaptoethanol to isolate the cuticle after different iodination periods. The highest specific activity was found in the pellet, which comprised the cuticular cortical zone with the highly insoluble epicuticle. However, 50% of the radiolabelled proteins were recovered in the extracts, which contained solubilized material from the somatic compartments and the basal and median zones of the cuticle. The data indicate that the isolation of surface-iodinated antigens of filariae is hampered by the presence of a detergent-insoluble epicuticle. Radiolabelled antigens solubilized by detergents are either proteins from internal somatic or cuticular regions or proteins adsorbed onto the epicuticle. PMID- 3807949 TI - Two high affinity nucleoside transporters in Leishmania donovani. AB - A rapid sampling kinetic technique has been used to evaluate the nucleoside transport functions of Leishmania donovani. The results indicated that L. donovani promastigotes possessed two independent purine nucleoside transporters with nonoverlapping substrate specificity. The first transported inosine, guanosine, and their analogs, while the second carried adenosine, analogs of adenosine, and the pyrimidine nucleosides, uridine, cytidine, and thymidine. The apparent Km values of the two nucleoside permeases for their purine nucleoside substrates were extraordinarily low, in the micromolar range. The organisms were capable of concentrating purine nucleosides from the medium and converting them to the nucleotide level with great efficiency and rapidity. Inosine and adenosine transport could be distinguished by different sensitivities to sulfhydryl reagents, suggesting structural differences between the two transporters. Finally, the two nucleoside transport systems of L. donovani were virtually refractory to inhibition by 4-nitrobenzylthioinosine and dipyridamole, two potent inhibitors of nucleoside entry into mammalian cells. PMID- 3807950 TI - In vivo 31P NMR spectrum of Hymenolepis diminuta and its change on short-term exposure to mebendazole. AB - The 31P NMR spectrum of the adult tapeworm, Hymenolepis diminuta, at 37 degrees C during perfusion with physiological saline was composed of 10 peaks. Based on chemical shifts and analysis of worm extracts, the phosphorus components included glucose-6-phosphate, fructose-6-phosphate, phosphorylcholine, glycerophosphoryl choline and -ethanolamine, nucleotide monophosphate-diphosphate and triphosphate, nicotinamide adenine dinucleotide and uridine diphosphate glucose. The mean level of nucleotide triphosphate was 0.86 nmol (mg fresh weight)-1 and the nucleotide triphosphate/-diphosphate ratio 3.9. Based on the nucleotide triphosphate level, worms were viable for at least 3 h and the intracellular pH was maintained constant at approximately 6.7. Short-term exposure to mebendazole perfused at 11 or 27 microM solubilized in physiological saline containing 0.5% Tween 80 or 0.1% dimethyl sulphoxide had little effect on the nucleotide triphosphate level. Some cytological changes, however, were evident following perfusion of mebendazole. In contrast, exposure to 2,4-dinitrophenol caused a rapid decline in nucleotide triphosphate level. It was concluded that mebendazole does not exert its primary effect on oxidative phosphorylation. PMID- 3807951 TI - Chloramphenicol-resistant Salmonella newport traced through hamburger to dairy farms. A major persisting source of human salmonellosis in California. AB - Animal-to-human transmission of drug-resistant salmonella and the role of antimicrobial use in food animals in the emergence of these bacteria are controversial subjects. Investigation of a 4.9-fold increase in Salmonella newport isolations from Californians in 1985 showed that 87 percent of the isolates had an unusual antimicrobial-resistance pattern (including chloramphenicol resistance) and a single, identical plasmid. Interviews of 45 patients and 89 matched controls in Los Angeles County showed that illness was associated with penicillin or tetracycline use during the month before onset (P less than 0.001) and with eating ground beef during the week before onset (P = 0.052). The epidemic strain was isolated from hamburger products eaten by cases, abattoirs where the animals from which the meat came were slaughtered, dairies that sent cows for slaughter on days when culture-positive products were processed, and ill dairy cows. Isolation of salmonella from beef carcasses in abattoirs correlated with the proportion of dead or moribund animals received for slaughter (r = 0.60, P less than 0.05). Isolation of chloramphenicol-resistant salmonella from dairy farms was associated with the use of chloramphenicol at those dairies. We conclude that food animals are a major source of antimicrobial resistant salmonella infections in humans and that these infections are associated with antimicrobial use on farms. PMID- 3807952 TI - Immune endothelial-cell injury in heparin-associated thrombocytopenia. AB - We studied the possibility that immune injury to endothelial cells may have a role in the development of thrombosis in some patients with heparin-associated thrombocytopenia. Serum samples from each of 27 patients who had this clinical diagnosis contained heparin-dependent platelet antibodies and deposited more than normal amounts of IgG, IgA, or IgM on endothelial cells, stimulating the production of tissue factor. Binding of immunoglobulins to endothelial cells was no longer detected when the patients were studied after heparin was withdrawn, but reappeared within several days upon reexposure to heparin in a patient who experienced a clinical recurrence. Binding of immunoglobulin to endothelial cells was partially reduced by the preadsorption of serum samples with heparin or heparan sulfate bound to Sepharose or by enzymatic cleavage of cell-bound heparan sulfate, and was augmented by the addition of heparan sulfate. Thus, serum from some patients with heparin-associated thrombocytopenia may contain antibodies that react with heparin bound to endothelial cells or with heparan sulfate synthesized by endothelial cells. Immune injury to both platelets and endothelial cells may play a part in the development of thrombosis in some patients after heparin therapy. PMID- 3807953 TI - Treatment of adenosine deaminase deficiency with polyethylene glycol-modified adenosine deaminase. AB - We treated two children who had adenosine deaminase deficiency and severe combined immunodeficiency disease by injecting bovine adenosine deaminase modified by conjugation with polyethylene glycol. The modified enzyme was rapidly absorbed after intramuscular injection and had a half-life in plasma of 48 to 72 hours. Weekly doses of approximately 15 U per kilogram of body weight maintained plasma adenosine deaminase activity at two to three times the level of erythrocyte adenosine deaminase activity in normal subjects. The principal biochemical consequences of adenosine deaminase deficiency were almost completely reversed. In erythrocytes, adenosine nucleotides increased and deoxyadenosine nucleotides decreased to less than 0.5 percent of total adenine nucleotides. The activity of S-adenosylhomocysteine hydrolase, which is inactivated by deoxyadenosine, increased to normal in red cells and nucleated marrow cells. Neither toxic effects nor hypersensitivity reactions were observed. In vitro tests of the cellular immune function of each patient showed marked improvement, along with an increase in circulating T lymphocytes. Clinical improvement was indicated by absence of infection and resumption of weight gain. We conclude that from the standpoints of efficacy, convenience, and safety, polyethylene glycol modified adenosine deaminase is preferable to red-cell transfusion as a treatment for adenosine deaminase deficiency. Patients with other inherited metabolic diseases in which accumulated metabolites equilibrate with plasma could benefit from treatment with the appropriate polyethylene glycol-modified enzyme. PMID- 3807954 TI - Medical peer review of physician competence and performance: legal immunity and the antitrust laws. PMID- 3807955 TI - Gaucher's disease. PMID- 3807956 TI - Therapy of genetic disorders. PMID- 3807957 TI - Risk of stroke in male cigarette smokers. PMID- 3807958 TI - Early hospital discharge for very-low-birth-weight infants. PMID- 3807959 TI - Accelerated loss of antibody to hepatitis B surface antigen among immunodeficient homosexual men infected with HIV. PMID- 3807960 TI - Case 32-1986: pulmonary asbestosis. PMID- 3807961 TI - Early deposition of aluminum in bone in diabetic patients on hemodialysis. AB - Aluminum-associated bone disease is a special problem in uremic patients on hemodialysis. We have observed this disorder in uremic patients with insulin dependent diabetes soon after the start of dialysis treatments. We therefore studied bone biopsy specimens from 18 diabetic patients on hemodialysis to determine whether aluminum accumulates on bone surfaces at an accelerated rate in diabetes. We also measured the rates of bone formation, because lower rates may enhance the accumulation of aluminum on bone surfaces. As compared with 18 nondiabetic controls with uremia who were matched for age and duration of dialysis, the patients with diabetes had a higher rate of aluminum accumulation on bone surfaces (2.1 +/- 0.7 vs. 0.4 +/- 0.2 percent per month, P less than 0.01) and a lower rate of bone formation (117 +/- 50 vs. 396 +/- 81 microns 2 per square millimeter per day, P less than 0.01). Also, the patients with diabetes whose cumulative aluminum intake exceeded 0.5 kg had higher serum aluminum levels after an infusion of deferoxamine, as compared with controls matched for aluminum intake (P less than 0.01). These measurements reflected a higher aluminum content in the whole body in patients with diabetes. We suggest that the enhanced rate of aluminum accumulation on bone surfaces in uremic patients with diabetes occurs as a result of a low rate of bone formation and an increased accumulation of aluminum in the whole body. PMID- 3807962 TI - Delineation of the extent of coronary atherosclerosis by high-frequency epicardial echocardiography. AB - Postmortem studies suggest that coronary angiography does not always accurately delineate the extent of coronary-artery disease. We examined this problem in living human hearts by performing high-frequency epicardial echocardiography at the time of cardiac surgery. The ratio of the diameter of the lumen of the coronary artery to the thickness of its wall was used to quantify the severity of coronary lesions. In 11 patients with no angiographic evidence of coronary disease anywhere in the coronary tree, the mean (+/- SEM) ratio was 5.9 +/- 0.3. In 21 patients with angiographic disease at the site evaluated by echocardiography, the mean ratio was lower (2.3 +/- 0.2, P less than 0.05), reflecting encroachment into the arterial lumen by atherosclerotic plaque. In 15 patients with arterial segments that were angiographically normal but with arterial stenoses elsewhere in the coronary tree, the mean ratio was 4.1 +/- 0.3, with marked overlap with the values in the patients who had angiographic disease at the site of the echocardiographic evaluation. These results demonstrate, in living human hearts, that diffuse coronary atherosclerosis is often present when coronary angiography reveals only discrete stenoses. This finding suggests that coronary angiography may underestimate the severity and extent of coronary disease. PMID- 3807963 TI - Epidemiology as a liberal art. AB - Epidemiology has features that resemble those of the traditional liberal arts. This makes it fit both for inclusion in an undergraduate curriculum and as an example in medical school of the continuing value of a liberal education. As a "low-technology" science, epidemiology is readily accessible to nonspecialists. Because it is useful for taking a first look at a new problem, it is applicable to a broad range of interesting phenomena. Furthermore, it emphasizes method rather than arcane knowledge and illustrates the approaches to problems and the kinds of thinking that a liberal education should cultivate: the scientific method, analogic thinking, deductive reasoning, problem solving within constraints, and concern for aesthetic values. PMID- 3807964 TI - Compulsory drug testing: the legal barriers. PMID- 3807965 TI - The changing climate of medical practice. PMID- 3807966 TI - The changing climate of medical practice. Medical practice in the competitive market. PMID- 3807967 TI - The changing climate of medical practice. The physician rebellion. PMID- 3807968 TI - Postmenopausal estrogen and cardiovascular disease. PMID- 3807969 TI - Condom use and HIV infection among prostitutes in Zaire. PMID- 3807970 TI - Fumarase deficiency. PMID- 3807971 TI - Hyperferritinemia in malignant histiocytosis and virus-associated hemophagocytic syndrome. PMID- 3807972 TI - Liqueur lung. PMID- 3807973 TI - Medicine and health care in South Africa. PMID- 3807974 TI - Impaired proximal duodenal mucosal bicarbonate secretion in patients with duodenal ulcer. AB - The defensive factors that prevent the human duodenal mucosa from acidic and peptic damage have not been fully evaluated. To determine whether duodenal mucosal bicarbonate production was altered in patients with inactive duodenal ulcer, we measured basal and acid-stimulated bicarbonate output from the duodenal bulb and the distal duodenum in healthy subjects and patients with inactive duodenal ulcer. As compared with 16 normal subjects, the 12 patients had significantly less mean (+/- SE) basal proximal duodenal mucosal bicarbonate secretion (185 +/- 13 vs. 107 +/- 18 mumol per centimeter per hour; P less than 0.001). Moreover, in response to a physiologic amount of hydrochloric acid (2 mmol per five minutes) instilled directly into the duodenal bulb, peak proximal duodenal bicarbonate output in the patients was 41 percent of the normal response (263 +/- 65 vs. 642 +/- 77 mumol per centimeter per hour; P less than 0.01). There was little overlap between groups. In contrast, bicarbonate outputs in the distal duodenum were similar in the two groups. We conclude that most patients with duodenal ulcer disease have decreased proximal duodenal mucosal bicarbonate production at rest, in response to hydrochloric acid, and in relation to peak gastric acid secretion. Impaired proximal duodenal mucosal bicarbonate secretion may be an important factor in the development and natural history of duodenal ulcer. PMID- 3807975 TI - Comparisons of national cesarean-section rates. AB - Our study of cesarean rates in 19 industrialized countries of Europe, North America, and the Pacific revealed sharp differences in rates, ranging from a low of 5 (Czechoslovakia) to a high of 18 (United States) per 100 hospital deliveries in 1981. Differences in cesarean rates according to maternal age, parity, and complications of pregnancy and childbirth reflected national differences in obstetrical practice. For example, the percentage of mothers who had a vaginal birth after a previous cesarean section was only 5 in the United States as compared with 43 in Norway, where the cesarean rate was half that in the United States. Despite the wide range of cesarean rates, almost all the countries studied have had consistent increases over the past decade, and the annual rate of increase for all countries appears to be converging. The steady pace of increase in developed countries, combined with comparable or even higher rates of cesarean delivery now being reported in less developed countries, underscores the need for the medical community to consider the appropriateness of this continued rise in the number of cesarean deliveries. PMID- 3807976 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 7-1987. A 46-year-old woman with abdominal pain, ascites, and a pelvic mass. PMID- 3807977 TI - Risk factors for hip fracture. PMID- 3807978 TI - Bicarbonate, acid, and duodenal ulcer. PMID- 3807979 TI - Radioactivity in Austrian milk after the Chernobyl accident. PMID- 3807981 TI - Adult respiratory distress syndrome and neutropenia. PMID- 3807980 TI - More on metoclopramide and tardive dyskinesia. PMID- 3807982 TI - Hip fractures in confused patients. PMID- 3807983 TI - Managing the medical-industrial complex. PMID- 3807984 TI - Resurgence of acute rheumatic fever in the intermountain area of the United States. AB - We describe an outbreak of acute rheumatic fever that occurred in the intermountain area centered in Salt Lake City, Utah. Seventy-four children meeting the modified Jones criteria for the diagnosis of acute rheumatic fever were evaluated by the staff at Primary Children's Medical Center, Salt Lake City, from January 1985 through June 1986. This represents an eightfold increase over the average annual incidence at this hospital during the past decade. Carditis, a dominant feature of the outbreak, was confirmed by auscultation in 53 of the patients (72 percent). An additional 14 patients were found to have mitral regurgitation by Doppler ultrasound examination, raising the total incidence of carditis to 91 percent. The children were predominantly from white (96 percent) middle-class families with above-average incomes and with ready access to medical care. There was no apparent increase in the incidence of streptococcal disease or other explanation for the marked increase in acute rheumatic fever. However, mucoid M type 18 and M type 3 group A streptococcal strains were isolated from several siblings of the patients and from schoolchildren (chosen at random) in the area. We conclude that acute rheumatic fever remains an important health problem in the United States. PMID- 3807985 TI - A study of the molecular pathology of sucrase-isomaltase deficiency. A defect in the intracellular processing of the enzyme. AB - The intestinal brush-border enzyme sucrase-isomaltase splits sucrose into its component monosaccharides, glucose and fructose. A deficiency of the enzyme leads to sucrose intolerance. We studied the synthesis and intracellular processing of sucrase-isomaltase, using human intestinal explants in organ culture. Pulse-chase experiments with [35S]methionine followed by immunoprecipitation, sodium dodecyl sulfate-polyacrylamide-gel electrophoresis, and fluorography of labeled sucrase isomaltase demonstrated that the molecule was initially recognized as a protein with a relative molecular weight (Mr) of 205,000. This was apparently converted to a species of 225,000 Mr within two hours. We studied the glycosylation of the protein using endo-beta-N-acetylglucosaminidase H and peptide-N4-(N-acetyl-beta glucosaminyl)-asparagine amidase digestion of oligosaccharide side chains of the two forms of sucrase-isomaltase. The results showed that the early-appearing 205 kd (kilodalton) molecule contained high-mannose asparagine-linked oligosaccharides, and that the later-appearing, 225-kd molecule contained highly processed (mature) carbohydrate chains. Studies in a patient with primary sucrase isomaltase deficiency demonstrated normal translation and high-mannose glycosylation of the precursor but a failure in further processing of the oligosaccharides, with subsequent intracellular degradation of the glycoprotein and undetectable enzymatic activity of intestinal sucrase. Abnormal intracellular processing of the enzyme was the probable mechanism of enzyme deficiency in this patient. PMID- 3807987 TI - Acute rheumatic fever: forgotten but not gone. PMID- 3807986 TI - Meta-analyses of randomized controlled trials. AB - A new type of research, termed meta-analysis, attempts to analyze and combine the results of previous reports. We found 86 meta-analyses of reports of randomized controlled trials in the English-language literature. We evaluated the quality of these meta-analyses, using a scoring method that considered 23 items in six major areas--study design, combinability, control of bias, statistical analysis, sensitivity analysis, and application of results. Only 24 meta-analyses (28 percent) addressed all six areas, 31 (36 percent) addressed five, 25 (29 percent) addressed four, 5 (6 percent) addressed three, and 1 (1 percent) addressed two. Of the 23 individual items, between 1 and 14 were addressed satisfactorily (mean +/- SD, 7.7 +/- 2.7). We conclude that an urgent need exists for improved methods in literature searching, quality evaluation of trials, and synthesizing of the results. PMID- 3807988 TI - Electronic fetal monitoring and cesarean section. PMID- 3807989 TI - The fragile X chromosome. PMID- 3807990 TI - More on coffee and pancreatic cancer. PMID- 3807991 TI - Improved respiratory function in quadriplegics after pulmonary therapy and arm ergometry. PMID- 3807992 TI - Factors prognostic of unprovoked seizures after febrile convulsions. AB - We evaluated the risk of unprovoked seizures after febrile convulsions and the factors prognostic of them in a cohort of 687 children who had an initial febrile seizure while residing in Rochester, Minnesota. Overall, children with febrile convulsions had a fivefold excess of unprovoked seizures, and the risk until the age of 25 was 7 percent. The risk ranged from 2.4 percent among children with simple febrile convulsions to 6 to 8 percent among children with a single complex feature--i.e., focal or prolonged seizures or repeated episodes of febrile convulsions with the same illness. For children with any two of the complex features, the risk was 17 to 22 percent, and for those with all three features, 49 percent. The occurrence of subsequent partial unprovoked seizures was strongly associated with all three of the complex features, whereas the occurrence of subsequent unprovoked seizures of generalized onset was associated with the number of febrile convulsions and a family history of unprovoked seizures. These results are consistent with the view that the increased risk of generalized-onset unprovoked seizures reflects a predisposition to both simple febrile convulsions and generalized-onset unprovoked seizures. The association between complex febrile convulsions and partial seizures, on the other hand, may reflect either a causal association or the presence of preexisting brain disease that is responsible for both the complex febrile seizures and later partial seizures. PMID- 3807993 TI - Effect of danazol in immune thrombocytopenic purpura. AB - Danazol and vinblastine are effective in many patients with chronic immune thrombocytopenic purpura (ITP). To evaluate the mechanism of action of these drugs, we studied six consecutive patients with chronic ITP treated with danazol and one treated with vinblastine. All the patients responded clinically without a notable change in the level of platelet-associated IgG. Instead, the clinical response to therapy was associated with a decrease in the number of monocyte binding sites for monomeric IgG (Fc receptors). In one patient, clinical relapse was associated with a spontaneous 2.7-fold increase in the number of monocyte Fc (IgG) receptors, without a change in the level of platelet-associated immunoglobulin. A decrease in the number of monocyte Fc (IgG) receptors following vinblastine infusion was associated with a clinical remission. We conclude that the clinical course of ITP may be influenced by the expression of monocyte or macrophage Fc (IgG) receptors. Danazol and vinblastine may mediate their clinical effect, at least in part, by influencing the number of available Fc (IgG) receptors on phagocytic cells. PMID- 3807994 TI - Effects of a circulating factor in patients with essential hypertension on intracellular free calcium in normal platelets. AB - Intracellular free (cytosolic) calcium has been reported to be increased in the platelets of patients with essential hypertension. We investigated the possibility that the high cytosolic calcium concentration may be caused by a circulating plasma factor, by incubating platelets from normotensive subjects with plasma ultrafiltrates from patients with essential hypertension. The cytosolic calcium concentration in normal platelets increased after incubation with plasma from patients with untreated hypertension (80 +/- 15 percent [+/- SEM]) or from patients in whom hypertension was well controlled by calcium-influx blockers (129 +/- 33 percent). In contrast, the cytosolic calcium concentration was unchanged after incubation with plasma from normotensive subjects. When platelets from the patients were incubated with plasma from the controls, cytosolic calcium in platelets decreased by more than 30 percent, into the normal range (P less than 0.01). These data demonstrate that plasma from patients with essential hypertension contains a substance that increases the cytosolic calcium concentration in platelets. Cytosolic calcium is a trigger for vascular smooth muscle-cell contraction, and if the plasma factor acts on these cells as it acts on platelets, it may be responsible for the increased peripheral vascular resistance associated with hypertension. PMID- 3807995 TI - Rates and risks of diethylstilbestrol-related clear-cell adenocarcinoma of the vagina and cervix. An update. AB - We reviewed 519 cases of clear-cell adenocarcinoma of the vagina and cervix identified by the Registry for Research on Hormonal Transplacental Carcinogenesis of the University of Chicago through June 30, 1985. In 60 percent of all cases the patient's mother had received diethylstilbestrol during pregnancy. An additional 12 percent of all mothers had been treated with another hormone or with an unidentified medication. Ninety-one percent of the cases in diethylstilbestrol-exposed women were diagnosed when the patient was between the ages of 15 and 27. The median age at diagnosis was 19.0 years. The risk that clear-cell adenocarcinoma will develop in an exposed female from birth through age 34 is 1 case per 1000 women. The temporal pattern of occurrence of clear-cell adenocarcinoma corresponds closely with that of the use of diethylstilbestrol for pregnancy support in the United States. The rarity of this tumor among exposed women suggests that diethylstilbestrol is not a complete carcinogen and that some other factor is also involved in the pathogenesis of clear-cell adenocarcinoma of the vagina and cervix. PMID- 3807996 TI - Predeposited autologous blood for elective surgery. A national multicenter study. AB - To determine the extent to which autologous blood that has been donated in advance ("predeposited") is used in patients undergoing elective surgery and to assess whether predonation decreases the use of homologous blood and the demand on the blood supply, we studied 4996 patients undergoing elective surgery at 18 tertiary care hospitals. Cross-matched blood was ordered for 1287 patients (26 percent), and of these, 590 (46 percent) were considered eligible for predepositing blood. Only 5 percent (32) of the eligible patients actually predeposited blood, indicating that predonation is not widely used. Of those who predeposited, only 13 percent (4 of 32) subsequently received homologous blood, as compared with 36 percent (199 of 558) of those who did not predeposit (P less than 0.01). Among the 199 patients who did not predeposit but required transfusion, we estimate that predonation could have avoided homologous transfusion in as many as 68 percent. If all eligible patients had predeposited autologous blood, they could have supplied as much as 72 percent of their own transfused red cells. The blood for as much as 10 percent of all red-cell transfusions could have been predonated by and transfused into the patients undergoing elective surgery. Greater use of predonation would not only reduce the demand on the blood supply by decreasing the need for homologous transfusion, but would probably also reduce the risk of hepatitis and other transfusion-associated illnesses. PMID- 3807997 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 9-1987. A 74-year-old man with diffuse pulmonary consolidations after emesis and apparent aspiration. PMID- 3807998 TI - The patient's blood is the safest blood. PMID- 3807999 TI - Rethinking public ambulatory care in America. PMID- 3808000 TI - Treatment of hemodialysis-related porphyria cutanea tarda with deferoxamine. PMID- 3808002 TI - How medical professionals evaluate expressions of probability. PMID- 3808001 TI - Leukopenia in Ethiopian Jews. PMID- 3808003 TI - The case for the use of animals in biomedical research. PMID- 3808004 TI - Reassurance regarding problems on Pennsylvania Avenue. PMID- 3808005 TI - Assault by battery. PMID- 3808006 TI - Microascus cinereus (Emile-Weil & Gaudin) Curzi--a human pathogen? AB - Microascus cinereus is described accompanying Aspergillus fumigatus in human lung tissue. The tissue contained A. fumigatus conidiophores and conidia and M. cinereus perithecia, ascospores, annellophores and conidia. The pathogenicity of M. cinereus is discussed. PMID- 3808007 TI - Increased resistance of splenectomized mice to Sporothrix schenckii infection. AB - The susceptibility of splenectomized mice to Sporothrix schenckii was studied, and the role of the spleen in the host defense is discussed. S. schenckii Sp-1 and ddy male mice were used. The mice were divided into 3 groups consisting of splenectomized, sham-operated and intact mice. Each mouse was inoculated intravenously with 2 X 10(6) yeast cells 7 days after operation and the mice were sacrified at adequate intervals for 30 days. Then histological sections stained with H&E or by PAS were prepared from various visceral organs. Using the liver sections the number of yeast cells in a 40 mm2 was counted. Furthermore, the colony forming unit in 100 mg of the liver tissue was compared to each other. In the sham-operated and intact mice many purulent lesions appeared on the 5th day. On the 8th day mononuclear cells accumulated at the foci, and on the 10th day most of the foci became granulomatous. The number of yeast cells in granulomatous lesions reached a peak on the 10th day and thereafter decreased abruptly. On the other hand, in the splenectomized mice approximately half of foci became granulomatous on the 5th day, and the number of yeast cells in the foci began to decrease after the 5th day. There were definite differences in the colony forming unit between the splenectomized and sham-operated or intact mice sacrificed 9 days after inoculation. The colony forming unit of the former is 9.3 X 10(5) on the average, while that of the latter two is 5.6 X 10(6) and 5.1 X 10(6) on the average, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808008 TI - Fraud, libel and the literature. PMID- 3808009 TI - US courts and legislatures face implications of surrogacy. PMID- 3808010 TI - Abortion-inducing drug alarms the right-to-life lobby. PMID- 3808011 TI - New Australian law on embryos still confuses researchers. PMID- 3808012 TI - NASA mosquito watch threatened. PMID- 3808013 TI - Gene manipulation in Britain. PMID- 3808014 TI - Preventing feticide. PMID- 3808015 TI - Neurobiology. Glia and the blood-brain barrier. PMID- 3808016 TI - Biology of communication. First squeaks of speech? PMID- 3808017 TI - Bone nitrogen isotope composition and climate. PMID- 3808018 TI - Aluminium leaching from cooking utensils. PMID- 3808019 TI - The integrity of the scientific literature. AB - A case of admitted scientific fraud has shed new light on the system that ensures the integrity of the scientific literature. Certain lapses from generally accepted standards of research may be more frequent than is commonly believed. PMID- 3808020 TI - On analyzing scientific fraud. PMID- 3808021 TI - Left hemisphere advantage in the mouse brain for recognizing ultrasonic communication calls. AB - In humans, sound perceived as speech is processed preferentially by the right ear and the left hemisphere of the brain. Among animals, such an advantage of one hemisphere (lateralization) in processing communication sound from other members of the species has so far been demonstrated only in macaque monkeys. I report here that in the house mouse, which has a very much less elaborate forebrain than man or macaque monkey, the ultrasonic calls that are emitted by young mice to evoke maternal caring behavior are preferentially recognized by the left hemisphere. In females with no experience of pups, which have been trained to respond to the same ultrasonic calls by conditioning, no advantage for one hemisphere is detected. The results suggest that lateralization of this function evolved early in mammals and emphasize that an innate predisposition for perceiving communication sounds is connected with a left-hemisphere advantage in processing them. This experimental system is a readily-available animal model for studying lateralized auditory brain functions. PMID- 3808022 TI - Expression of a polypeptide containing a dipeptide repeat is confined to the insect stage of Trypanosoma brucei. AB - The protozoan parasite Trypanosoma brucei is transmitted between mammalian hosts by the tsetse fly (Glossina spp.). Trypanosomes ingested by the fly undergo a number of changes in the insect midgut during differentiation to procyclic forms. These include the loss of the variant specific glycoprotein (VSG) coat and the appearance of a common set of procyclic surface antigens. In order to investigate genes other than VSG genes which are expressed only at certain stages of the life cycle, the first cDNA specific to procyclic culture form trypanosomes (equivalent to the stage found in the insect midgut) has been characterized. The encoded polypeptide shows several characteristics of membrane proteins, but its most striking feature is the presence of a repetitive amino-acid sequence in which there are 22 tandem repeats of the dipeptide-Glu-Pro-. Related genes are also found in other trypanosome species and in leishmania. This gene shows many similarities to a number of surface antigen genes described in malaria and, more recently, Trypanosoma cruzi. This is the first example of a repetitive sequence in a parasite protein which is present only in the insect vector, and which therefore cannot be implicated in the mammalian host immune response. PMID- 3808023 TI - Row in United States over schools AIDS education. PMID- 3808024 TI - Is chromogranin a prohormone? PMID- 3808025 TI - Antibodies with some bite. PMID- 3808026 TI - Chromogranin A and pancreastatin. PMID- 3808027 TI - Data in graphs and tables. PMID- 3808028 TI - Mystery object identified? PMID- 3808029 TI - Novel materials from protein-polymer grafts. AB - Proteins are the most underrated and under-used polymers: their impressive properties include infusibility, great mechanical strength and inherent adhesive capability due to a highly flexible backbone and many functional side chains. The notion of moisture sensitivity of proteins is not universally true. Barnacle cement (which can adhere to Teflon) and mussel and clam byssus, all of which are 99% protein, set in the presence of water and resist enzymatic as well as chemical degradation at ambient temperature. This observation suggests that proteins that are capable of tight three-dimensional cross-linking can overcome sensitivity to moisture and enzymatic attack. It should then be possible to achieve similar resistance by appropriate chemical manipulation of proteins, leading to cross-linking. We have achieved such a result with an ordinary protein, commercially available gelatin, which was chemically modified and then epoxidized. When cured such a material binds to metals and plastics. Any protein that has modifiable amino acids can be used for this purpose. PMID- 3808030 TI - Spontaneous recovery after experimental manipulation of the plane of beat in sperm flagella. AB - It is generally accepted that the oscillatory beating characteristic of sperm flagella is the result of an ATP-induced sliding between the doublet microtubules of the flagellar axoneme, with these longitudinal forces being converted into a lateral bending moment by resistive components of the structure that limit the displacement. However, little is known about the mechanisms that regulate this sliding among the nine doublets of the cylindrical axoneme to produce the coordinated planar bending waves required for efficient sperm propulsion. We have investigated these mechanisms with a new procedure in which the sperm head is held in the tip of a vibrating micropipette. Data obtained by gradually rotating the plane of imposed vibration around the sperm axis indicate that the pattern of active sliding between the outer doublet tubules can rotate relative to the sperm head, and suggest that this active sliding is regulated in part by the central tubule complex. PMID- 3808031 TI - DNA ligase I deficiency in Bloom's syndrome. AB - Certain rare human diseases with autosomal recessive mode of inheritance are associated with a greatly increased cancer frequency which may reflect specific defects in DNA repair or replication. These disorders include xeroderma pigmentosum, ataxia-telangiectasia, Fanconi's anaemia and Bloom's syndrome. Cells from individuals with Bloom's syndrome usually grow slowly in culture and exhibit increased chromosomal breakage and rearrangement, an elevated frequency of sister chromatid exchanges, retarded rates of progression of DNA replication forks, delayed conversion of replication intermediates to high-molecular-weight DNA, and slightly increased sensitivity to DNA-damaging agents. Several of these features are also characteristic of Escherichia coli and yeast mutants with a defective DNA ligase. In this investigation we show that one of the two DNA ligases of human cells, ligase I, is defective in a representative lymphoid cell line of Bloom's syndrome origin. PMID- 3808032 TI - Altered DNA ligase I activity in Bloom's syndrome cells. AB - Cells from patients with Bloom's syndrome, a rare disease associated with increased cancer frequency, exhibit cytological abnormalities. These include increased numbers of homologous chromatid interchange figures and sister chromatid exchanges, together with abnormally slow replicon-fork progression and retarded rate of DNA-chain maturation, and suggest that the primary defect in this recessive disorder affects S-phase DNA replication. DNA ligases and DNA polymerases have long been prime candidates for abnormality in Bloom's syndrome, but various studies of DNA polymerases in Bloom's syndrome cells have disclosed no abnormalities. Evidence is presented here, as in the accompanying paper from a different laboratory, for the existence in Bloom's syndrome of an abnormality of the DNA ligase involved in semi-conservative DNA replication. PMID- 3808034 TI - Layfield gives approval to Sizewell B. PMID- 3808033 TI - Glucocorticoid receptor mutants that are constitutive activators of transcriptional enhancement. AB - Glucocorticoids, a class of steroid hormones, associate specifically with intracellular receptors, facilitating a conformational change that converts the receptor in vitro to a DNA-binding protein and in vivo to a nuclear species that activates a class of transcriptional enhancers termed glucocorticoid response elements (GREs). The DNA sequences recognized specifically by the hormone receptor complex correspond directly to those required for GRE enhancement. The structural transition that accompanies steroid binding, 'receptor transformation', has been monitored by changes in receptor chromatographic properties, accessibility to monoclonal antibodies, association with other receptor subunits or with heterologous proteins, and aqueous two-phase partition coefficient. However, the significance of the structural change for the biological activity of the receptor is not understood. We have used cloned rat glucocorticoid-receptor coding sequences to produce and characterize a novel class of receptor mutants that elicit GRE enhancer function in transfected cells even in the absence of hormone. The constitutive activity of those receptor derivatives, together with mapping studies that distinguish between the DNA- and hormone-binding domains of the receptor, imply that the conformational change corresponding to receptor transformation may simply unmask pre-existing functional domains for DNA binding, enhancer activation, or both. PMID- 3808035 TI - Sizewell inquiry leaves questions unanswered. PMID- 3808036 TI - Multi-million dollar vaccination drive against infant mortality. PMID- 3808037 TI - Host-parasite coevolution. The mite pockets of lizards. PMID- 3808038 TI - Social interaction. Survival in extreme isolation. PMID- 3808039 TI - EMBL database offer. European Molecular Biology Laboratory. PMID- 3808040 TI - Protein structure and the specific heat of water. PMID- 3808042 TI - Testis size comparisons. PMID- 3808041 TI - More clues to gene rearrangements. PMID- 3808043 TI - A land-bridge island perspective on mammalian extinctions in western North American parks. AB - In recent years, a number of authors have suggested several geometric principles for the design of nature reserves based upon the hypothesis that nature reserves are analogous to land-bridge islands. Land-bridge islands are islands that were formerly connected to the mainland and were created by a rise in the level of the ocean. Land-bridge islands are considered supersaturated with species in that the ratio of island to mainland species numbers is higher than expected from the area of the island. As a result, the rate of extinction should exceed the rate of colonization on a land-bridge island, resulting in a loss of species that is suggested to be related to the size and degree of isolation of the island. If nature reserves are considered to be similar to land-bridge islands, because most are slowly becoming isolated from their surroundings by habitat disturbance outside the reserves, several predictions follow. First, the total number of extinctions should exceed the total number of colonizations within a reverse; second, the number of extinctions should be inversely related to reserve size; and third, the number of extinctions should be directly related to reserve age. I report here that the natural post-establishment loss of mammalian species in 14 western North American national parks is consistent with these predictions of the land-bridge island hypothesis and that all but the largest western North American national parks are too small to retain an intact mammalian fauna. PMID- 3808044 TI - TIT FOR TAT in sticklebacks and the evolution of cooperation. AB - The problems of achieving mutual cooperation can be formalized in a game called the Prisoner's Dilemma in which selfish defection is always more rewarding than cooperation. If the two protagonists have a certain minimum probability of meeting again a strategy called TIT FOR TAT is very successful. In TIT FOR TAT the player cooperates on the first move and thereafter does whatever the opponent did on the previous move. I have studied the behaviour of fish when confronting a potential predator, because conflicts can arise within pairs of fish in these circumstances which I argue resemble a series of games of Prisoner's Dilemma. Using a system of mirrors, single three-spined sticklebacks (Gasterosteus aculeatus) approaching a live predator were provided with either a simulated cooperating companion or a simulated defecting one. In both cases the test fish behaved according to TIT FOR TAT supporting the hypothesis that cooperation can evolve among egoists. PMID- 3808045 TI - Spectral sensitivity of human cone photoreceptors. AB - The brain computes visual colour by analysing the relative excitations of three types of retinal cones. Each cone excitation is governed by a spectral sensitivity function which relates the amplitude of the neural response to wavelength at constant light intensity. The spectral sensitivities of human cones are not well characterized. We report measuring the sensitivities by recording electrical responses of human cones to stimuli of different wavelengths. Spectral sensitivities of 'green' and 'red' cones, determined over the entire visible region, show peaks near 530 and 560 nm respectively, and are remarkably similar to those of the old-world monkey Macaca fascicularis. They satisfactorily predict the photopic luminosity function, a measure of the sensitivity of cone-mediated human vision to light of different wavelengths. The kinetics of the light responses of human cones also appeared similar to those of macaque cones: the time to peak response to a dim flash was 50-100 ms and there was a characteristic undershoot during recovery. PMID- 3808046 TI - Digital image processing of intracellular pH in gastric oxyntic and chief cells. AB - Cytosolic pH (pHi) is a critically regulated determinant of intracellular function. Several mechanisms for pHi regulation in different tissues have been found, such as direct proton pumping, Na/H exchange, Cl/HCO3 exchange, NaHCO3 cotransport, and Na/H/Cl/HCO3 obligatorily linked. All these studies have used either single cells or cell populations assumed to be behaving homogeneously. Most tissues consist of more than one cell type, so it would be desirable to examine pHi regulation simultaneously in many identified individual cells, particularly in epithelia where disaggregation and purification of isolated cells destroys the normal distinction between luminal and serosal environments. We have used a pH-sensitive fluorescent dye, BCECF (2',7'-bis(carboxyethyl)-5(6) carboxyfluorescein) and digital image processing to study pHi regulation simultaneously in the oxyntic cells (OC) and chief cells (CC) of gastric glands isolated from rabbit stomach. CCs become markedly more acidic upon removal of external Na (Nao), but pHi is restored rapidly on return to normal Nao, with or without Cl. Oxyntic cell pHi is much less affected by Nao. Conversely, OCs become strongly more alkaline on removal of external Cl (Clo), pHi being restored when Clo is replaced with or without Na, whereas CCs are relatively insensitive to Clo. Therefore, Na/H exchange is dominant over Cl/HCO3 exchange in CCs, but in the neighbouring OCs, Cl/HCO3 outweighs the Na/H mechanism, a heterogeneity that correlates with the functions of the two cell types. PMID- 3808047 TI - Soviets seek Japan's help over Chernobyl accident. PMID- 3808048 TI - World Health Organisation plans better AIDS management. PMID- 3808049 TI - New radon cancer hazard study no cause for alarm in Britain. PMID- 3808050 TI - Chemist expected to head UK Medical Research Council. PMID- 3808051 TI - Us AIDS education. PMID- 3808052 TI - Body temperature and the thermodynamics of water. PMID- 3808053 TI - Is lung surfactant protein a lectin-collagen hybrid? PMID- 3808055 TI - Britain's doctors in legal wrangle over confidentiality of records. PMID- 3808054 TI - Platelets mediate the action of diethylcarbamazine on microfilariae. AB - More than 400 million people in the world are infected by filarial parasites leading to a wide range of pathologies. Although introduced in 1947, the mainstay of the therapy and control of the filariases is diethylcarbamazine (N,N-diethyl-4 methyl-1-piperazine carboxamide; DEC), the mode of action of which still remains unknown despite widespread use and intensive laboratory investigations. The marked contrast between an extremely rapid action in vivo and the absence of any significant activity on microfilariae in vitro is unique among chemotherapeutic agents. DEC has been thought to modify the surface layer of the microfilariae and expose them to immunological cell-mediated lysis. This report provides the first evidence that the effect of DEC is mediated by blood platelets with the additional triggering of a filarial excretory antigen (FEA). The killing mechanism is antibody-independent and involves the participation of free radicals. PMID- 3808057 TI - Rem overdose. PMID- 3808056 TI - 4,000 Chernobyl deaths? PMID- 3808058 TI - Oncogenes in atherosclerosis. PMID- 3808059 TI - X-ray scattering. A new probe of protein dynamics. PMID- 3808060 TI - Neurobiology. Disappearing developing cells. PMID- 3808062 TI - Variations in chickens. PMID- 3808061 TI - Body temperature of homoiothermic animals. PMID- 3808063 TI - Pesticides in fog. AB - The discovery of the very acidic nature of fog and clouds has created much interest in sampling, analysing, and elucidating the chemistry of fog, principally because an understanding of the chemical transformations leading to acid fog may provide important clues to the origin of acid rain. Recently, the knowledge of the chemistry of fog has expanded to include carbonyl compounds, volatile organic acids, and alkyl sulphonates. We have discovered that a variety of pesticides and their toxic alteration products are present in fog, and that they occasionally reach high concentrations relative to reported rainwater concentrations. In our experiments, we were able to measure the air-water distribution coefficients of pesticides between the liquid fog and the interstitial gas phase. These measurements reveal that some chemicals are enriched several thousandfold in the suspended liquid fog droplets compared to equilibrium distributions expected from Henry's Law coefficients for pure aqueous solutions. PMID- 3808064 TI - An endogenous annual clock in the toxic marine dinoflagellate Gonyaulax tamarensis. AB - Blooms of the toxic dinoflagellate Gonyaulax tamarensis (synonyms Protogonyaulax tamarensis and Alexandrium tamarense) cause outbreaks of paralytic shellfish poisoning (PSP) in coastal waters throughout the world. In the Gulf of Maine, episodes occur between April and November, a seasonality due in part to life cycle alternations between motile, vegetative cells and resting cysts which overwinter in bottom sediments. Newly formed cysts have a mandatory 2-6 month dormancy period during which germination is not possible, but once mature, the resting state will continue if temperatures are unfavourable or oxygen is unavailable. We now report another factor controlling germination of cysts of G. tamarensis from deep coastal waters--an endogenous annual clock that can override an otherwise favourable environment for germination. Similar annual variability in germination has not been observed for cysts of this species from shallow estuaries. These results represent the first conclusive demonstration of an endogenous circannual rhythm in a marine plant. They are evolutionarily and ecologically significant because an endogenous annual clock can lead to the release of motile cells into deep and relatively invariant bottom waters at those times when temperature and light at the surface are suitable for growth. In shallow waters where seasonal variability is large and extends to bottom sediments, a strategy similar to that of the seeds of terrestrial plants would be more appropriate, namely a direct coupling between germination and the external environment. PMID- 3808065 TI - Molecular dynamics studied by analysis of the X-ray diffuse scattering from lysozyme crystals. AB - It is now well established that the biological activity of proteins is related not only to their mean molecular structure, but also to their intramolecular mobility. Nearly all techniques sensitive to dynamics have given evidence for intramolecular mobility in proteins: NMR, ESR, Raman spectroscopy, fluorescence quenching, Mossbauer spectroscopy, neutron scattering, measurements of elastic constants and hydrogen-deuterium exchange. The dynamics of proteins has also been approached by theoretical calculations. We report here investigations of the atomic and molecular displacements in hen egg-white lysozyme crystals using a new technique. This technique, based on the X-ray diffuse scattering analysis (scattering out of the Bragg reflections), can yield information on the atomic displacements, provided that they are correlated. Rigid-body molecular displacements, correlated along short rows of aligned molecules in two perpendicular directions, have been detected and analysed (mean square amplitude of the order of 5 X 10(-4) nm2). This technique can be also applied to the detection and analysis of intramolecular displacements. PMID- 3808066 TI - Protein kinase Cs. Coping with a growing family. PMID- 3808067 TI - Biomechanics. The spring in the human foot. PMID- 3808068 TI - Cognitive psychology. Non-verbal thinking by animals? PMID- 3808069 TI - Vagaries of nomenclature and the rigidity of the Code. PMID- 3808070 TI - The spring in the arch of the human foot. AB - Large mammals, including humans, save much of the energy needed for running by means of elastic structures in their legs and feet. Kinetic and potential energy removed from the body in the first half of the stance phase is stored briefly as elastic strain energy and then returned in the second half by elastic recoil. Thus the animal runs in an analogous fashion to a rubber ball bouncing along. Among the elastic structures involved, the tendons of distal leg muscles have been shown to be important. Here we show that the elastic properties of the arch of the human foot are also important. PMID- 3808071 TI - Chunking by a pigeon in a serial learning task. AB - A basic principle of human memory is that lists that can be organized into memorable 'chunks' are easier to remember. Memory span is limited to a roughly constant number of chunks and is to a large extent independent of the amount of informaton contained in each chunk. Depending on the ingenuity of the code used to integrate discrete items into chunks, one can substantially increase the number of items that can be recalled correctly. Newly developed paradigms for studying memory in non-verbal organisms allow comparison of the abilities of human and non-human subjects to memorize lists. Here I present two types of evidence that pigeons 'chunk' 5-element lists whose components (colours and achromatic geometric forms) are clustered into distinct groups. Those lists were learned twice as rapidly as a homogeneous list of colours or heterogeneous lists in which the elements are not clustered. The pigeons were also tested for knowledge of the order of two elements drawn from the 5-element lists. They responded in the correct order only to those subsets that contained a chunk boundary. Thus chunking can be studied profitably in animal subjects; the cognitive processes that allow an organism to form chunks do no presuppose linguistic competence. PMID- 3808072 TI - Dynamic receptive field plasticity in rat spinal cord dorsal horn following C primary afferent input. AB - The central terminals of cutaneous primary afferent neurons are spatially ordered in the dorsal horn in a highly organized fashion such that a point-to-point map represents the body surface. This afferent terminal somatotopic map correlates with the map of the receptive fields of the cells on which they terminate. The location, size and modality of the cutaneous receptive fields of dorsal horn neurons necessarily depend upon the anatomical presence of afferent nerve fibres which deliver information from the periphery, directly or indirectly, to the cells. However the receptive field size and modality of a cell do not depend only on anatomical connections. Excitatory and inhibitory interneurons, descending influences and facilitations or depressions of synaptic contacts can alter receptive field properties. Here we show that prolonged and substantial cutaneous receptive field changes can be produced by brief inputs from peripheral unmyelinated afferent fibres. PMID- 3808073 TI - Tissue-specific expression of three distinct types of rabbit protein kinase C. AB - We examined the structure of protein kinase C in an attempt to understand the molecular events connecting protein kinase C activation with the cellular response. Rabbit complementary DNA clones coding for three distinct types of protein kinase C, named alpha, beta and gamma, have been identified and sequenced. The deduced amino acid sequence for alpha, beta and gamma (673, 671 and 672 amino acids, respectively) are closely related. Kinases alpha and beta share an identical N-terminal sequence of 621 amino acid residues and their messenger RNAs arise from a single gene. The C-terminal halves of alpha, beta and gamma are protein kinase domains and are highly homologous to other protein kinases. The mRNAs for alpha, beta and gamma are expressed in various tissues with strikingly different tissue specificities. The one for gamma is found ubiquitously among various tissues, while those for alpha and beta predominate in the brain. PMID- 3808075 TI - US administration plans budget increases for basic research. PMID- 3808074 TI - Inhibition of phosphorylcholine binding to antibodies using synthetic peptides. AB - The amino-acid sequence Phe-Tyr-Met-Glu is unique to phosphorylcholine (PC) binding antibodies. It occurs in the first complementarity-determining region (CDR1) of the immunoglobulin heavy chains in 89% of all the anti-PC myeloma and hybridoma proteins but is not present in 490 other immunoglobulin heavy chains, 854 light chains or in 2,260 other unrelated proteins. This unique tetrapeptide therefore seems to be involved in PC binding. Here we compare the effectiveness of Phe-Tyr-Met-Glu and other structurally related peptides in inhibiting the binding of PC to PC-binding proteins McPC603 and HOPC8. We also test a surface simulation peptide that was constructed to mimic the combining site of McPC603. Our data suggest that all these peptides inhibit the binding of PC to PC-binding proteins non-specifically and we show by computer modelling that the surface simulation peptide does not duplicate the combining site of McPC603. PMID- 3808076 TI - Dispute over who should do DNA fingerprinting in murder hunt. PMID- 3808077 TI - Biogen in European Patent Office row over interferon. PMID- 3808078 TI - [Lung cancer after irradiation: the radon problem]. AB - The estimation and limitation of lung cancer risk from inhaled 222Rn-daughters in mines and in the home is one of the most important problems in radiation protection. The results of epidemiological studies are summarized. The radiation induced increase in the age-specific lung cancer rate can be interpreted in terms of a proportional hazard model. On the basis of this model, the relative fraction of total lung cancer frequency which might be initiated by the radon-daughter exposure in homes is estimated. PMID- 3808080 TI - Photoreceptors, lightness constancy and color vision. PMID- 3808079 TI - Monoclonal antibodies detect human colon precancer cells. PMID- 3808081 TI - Directional hearing of awake, unrestrained treefrogs. PMID- 3808082 TI - Effect of repeated amiflamine administration on serotonergic and noradrenergic neurotransmission: electrophysiological studies in the rat CNS. AB - Amiflamine is a selective and reversible inhibitor of monoamine oxidase (MAO) type A which exerts a preferential effect on serotonin (5-HT) catabolism. The present studies were undertaken to compare the effects of repeated administration of amiflamine (2 mg/kg, twice daily) on several aspects of the functioning of the 5-HT and norepinephrine (NE) systems in the rat CNS. The activity of MAO-A and B was assessed in forebrain slices and the whole brain contents of the neurotransmitters and their metabolites were determined by HPLC after 2-, 7- and 21-day treatments. MAO-A was inhibited by about 50% 2 h after the last dose and its activity was back to normal in rats sacrificed 12 h after the last dose. The activity of MAO-B was unaffected two or 12 h after the last dose. Whole brain concentration of 5-HT was increased to a greater degree than that of NE following repeated administration of amiflamine. These increases in 5-HT and NE were accompanied by decreased levels of their respective metabolites 5-hydroxy indoleacetic acid and 3-methoxy-4-hydroxyphenylethyleneglycol. The firing activity of dorsal raphe 5-HT neurons, but not that of NE neurons, was markedly decreased 2-6 h after the last dose of a 2-day treatment. However, 2-6 h after a 21-day treatment, the firing activity of 5-HT neurons was back to normal, whereas that of NE neurons was decreased by 30%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808084 TI - Characterization of the antinociceptive effects of some adenosine analogues in the rat. AB - The antinociceptive effects of the stable adenosine analogues N6 phenylisopropyladenosine (L-PIA), N6-cyclohexyladenosine (CHA) and 5'-N ethylcarboxamidoadenosine (NECA) were investigated in conscious rats using cutaneous thermal tests (hot plate and tail flick). Subcutaneous administration of the adenosine analogues induced a dose-dependent antinociceptive response for all agents. However, NECA was approximately 15 times more potent than PIA and CHA. Approximately the same potency order and response was seen when the adenosine analogues were administered intrathecally at the lumbar level. By this route of administration, the adenosine analogues were approximately 10-20 times more potent than after S.C. administration. Intracerebroventricular administration (lateral ventricles), however, induced a variable response, in most cases a slight hyperalgesia. The nonspecific adenosine antagonist theophylline (S.C.) rapidly reduced the antinociceptive effect induced by PIA (S.C.) but enprofylline, a bronchodilating xanthine with low ability to antagonize adenosine did not influence PIA-induced antinociception. It is concluded that stable adenosine analogues and presumably adenosine itself have potent antinociceptive effects via specific adenosine receptors in the rat. The effects seem to be mediated mainly by a spinal mechanism of action. PMID- 3808085 TI - [Depressive symptoms following brain infarct]. PMID- 3808083 TI - Opioid activity and distribution of fentanyl metabolites. AB - Fentanyl, a short-term analgesic frequently used in neuroleptanalgesia, has in a number of cases been reported to cause unexpected, severe postanesthetic respiratory depression which can successfully be treated with naloxone. Several explanations for this rebound effect produced by fentanyl (in combination with other drugs) have been proposed, though so far none has proved completely satisfactory. The possibility that this effect may be due to a secondary accumulation of fentanyl or fentanyl metabolites with opioid activity in the brain has led us to investigate the relative opioid potency of several known or proposed metabolites by measuring their inhibitory action on the contraction of guinea-pig ileum in comparison with that of morphine, pethidine, and fentanyl itself. Two proposed metabolites containing the phenethyl sidechain were found to possess an opioid activity lying between that of morphine and pethidine, whereas metabolites without the side-chain were generally less active than pethidine. Using thin-layer chromatography, it was possible to detect one of these proposed active metabolites in vivo in rats. This result may have some relevance for the understanding of the fentanyl rebound. However, the possibility that multiple doses of fentanyl, such as may be given during neuroleptanalgesia, or interactions with other drugs, e.g. tranquilizers and general anesthetics, may be the cause of fentanyl rebound, remains open. PMID- 3808086 TI - [Glucocorticoids in pregnancy: effects on the fetus and newborn infant]. PMID- 3808087 TI - [Increased infertility within marriage]. PMID- 3808088 TI - [Misunderstood physical symptoms and conversion]. PMID- 3808089 TI - [Heterozygote beta-thalassemia in Dutch families]. PMID- 3808090 TI - [Abdominal pain or acute abdomen?]. PMID- 3808091 TI - [Antegrade lavage during surgery for disorders of the left colon]. PMID- 3808092 TI - [Congenital rubella syndrome; a persistent disease]. PMID- 3808093 TI - [Severe methanol poisoning]. PMID- 3808094 TI - [CARA is not a diagnosis]. PMID- 3808095 TI - [Digoxin in elderly patients]. PMID- 3808096 TI - [The 'pill' and breast cancer]. PMID- 3808097 TI - [Why would physicians smoke?]. PMID- 3808098 TI - [Serous inflammation of the middle ear]. PMID- 3808099 TI - [Review of the guidelines of the Dutch Heart Foundation for the prevention of endocarditis]. PMID- 3808100 TI - [Reflux studies and changing views on the pathogenesis of vesico-ureteral reflux]. PMID- 3808101 TI - [A nomogram for the determination of digoxin dosage for elderly patients with atrial fibrillation]. PMID- 3808102 TI - [Worldwide smoking habits of physicians; a survey of 100 studies of tobacco use among physicians in 31 countries in 1951-1985]. PMID- 3808103 TI - [Malignant disorders of the lymphatic system]. PMID- 3808104 TI - [Non-ketoacedotic, hyperglycemic, hyperosmolar diabetic coma in children]. PMID- 3808105 TI - [Minor complaints in family practice; bartholinitis]. PMID- 3808106 TI - [Furosemide]. PMID- 3808107 TI - [Mammography, a study sometimes liable to error]. PMID- 3808108 TI - [CARA therapy is made to order]. PMID- 3808109 TI - [Guidelines for good nutrition: a landmark for the consumer, physician and industry?]. PMID- 3808110 TI - [The removal or not of hair in the operative field and the prevention of wound infections]. PMID- 3808111 TI - [Diagnosis of the hyperventilation syndrome]. PMID- 3808112 TI - [Chlamydia pneumonia in infants]. PMID- 3808113 TI - [The use of silicon prostheses in comminuted fractures of the radial head]. PMID- 3808114 TI - [Gut-preserving surgery in Crohn's disease: resection or correction of stenosis]. PMID- 3808115 TI - [Electrophysiologic properties of neurons of the ventral tegmentum of the midbrain of the alert rat]. AB - Statistical analysis of firing activity, spike shape and duration of single units in ventral tegmental area and adjacent regions of midbrain was performed in conscious rats. Four cell types were distinguished in this neuronal population which heterogeneity may be related to differences in their neurochemical nature and afferent connections. PMID- 3808116 TI - [Afferent connections of the mesencephalic locomotor area of the cat brain]. AB - Afferent projections to the functionally identified mesencephalic locomotor region were studied in cat by means of the horse-radish peroxidase technique. Quantitative calculation of HRP-labelled neurons in the different brain structures after enzyme injections into mesencephalic locomotor region was made. Apart from the entopeduncular nucleus, different hypothalamic areas and substantia nigra, labelled neurons were found in ventral tegmental area, substantia grisea centralis, raphe and vestibular nuclei, nucleus of tractus solitarius and brainstem reticular formation. Neurons accumulating horse-radish peroxidase were found also in the brainstem sensory nuclei. This fact emphasized the structural heterogeneity of the mesencephalic locomotor region which includes neurons and passing fibers; both of them may be significant during locomotion elicited by the midbrain stimulation. PMID- 3808118 TI - [Neurons with visual receptive fields independent of eye position in the caudal portion of the ventral wall of the cruciate sulcus of the cat cerebral cortex]. AB - Neurons responding to tactile and visual stimulation have been found in alert behaving cats in the caudal part of the ventral bank of cruciate sulcus. Tactile receptive fields were located on the cat face mainly around the mouth. Visual stimuli (especially alimentary ones) were effective being presented near the tactile receptive field. It was found that these bimodal neurons (visual and somatosensory) are located in layer VI of the cortex and their visual responses demonstrate space constancy. The position of the visual receptive field of these neurons did not change after saccadic eyes displacements, but remained in register with the tactile receptive field. PMID- 3808117 TI - [Evoked potentials of the parafascicular complex of the rabbit thalamus during peripheral painful stimulation]. AB - A systematic investigation of evoked potentials in the parafascicular complex of the thalamic nonspecific system has been carried out on rabbits. Two types of the evoked potentials were recorded due to the electrical skin stimulation of the paw. In the lateral part of the complex several fluctuations consisting of early and late positive-negative potentials following one another were recorded, in the medial--a simple positive-negative evoked potential. A more complex organization of the thalamic parafascicular complex of rodents is suggested. PMID- 3808119 TI - ["Timer" neurons and "scanner" neurons in the visual cortex of the cat in response to low-contrast between stimulus and background]. AB - The characteristics of the reactions and the properties of orientation detection in neurons separated formerly into "timers" and "scanners" at a high contrast (100) were studied in experiments on unanesthetized, relaxed cats at a lower contrast level. It was found that all "scanners" preserved their properties and did not pass to the group of "timers". On the other hand, only 40% of the initial number of the "timers" remained in this group. Correlation of the properties of neurons of these groups remained as it was at maximum contrast: in "timers" the reaction began and reached the maximum earlier than in "scanners"; it was of a higher frequency and shorter and its characteristics of the orientation tuning were considerably worse. Neurons which passed from the group of "timers" at the lower contrast possessed characteristics intermediated between those of the "timers" and "scanners", approaching the latter by a number of properties. The obtained data confirm the conclusion about the presence and stability of the activity of the visual cortex neurons--"timers" and "scanners" within a wide range of conditions; the former carry out the function of synchronizers, the latter--the role of orientation filters reforming in time. PMID- 3808120 TI - [Responses of neurons of the embryonal neocortex transplanted into the vibrissa projection area of the somatosensory cortex of the adult rat]. AB - Pieces of embryonic rat neocortex were grafted into the barrel-field of adult rats. Extracellular activity of the grafted neurons was registered 3-4 months later. The background neuronal activity in the grafts did not differ neither in pattern, nor in frequency (3.7 +/- 1.4 spikes per s) from that of the normally developing somatosensory cortex. About 57% of the grafted cells responded to deflexion of the contralateral vibrissae by on-effects, 30%-by phasic increase of discharge frequency and 13%-by initial suppression of spontaneous activity. PMID- 3808121 TI - Antitumor activity of four polymer bound trans-1,2-diaminocyclohexaneplatinum(II) 4-carboxyphtalate complexes tested in different model systems. AB - Four polymer bound Pt-complexes have been tested in in vivo and in in vitro systems. No substantial difference in effectivity against P388 leukemia in vivo was found when free trans-1,2-diaminocyclohexaneplatinum(II)-4-carboxyphtalate (TMA) was compared with the polymer bound complexes. The compound with the highest ID50 value in soft agar assay exhibited low effectivity in in vivo testing. Polymer bound Pt-complexes with faster release of the active molecule exhibited in in vivo and in soft agar assay slightly lower activity, when compared with suspension culture test system. Cross resistance of polymer bound complexes was investigated on three cell lines with induced drug resistance against different Pt-complexes. Cross resistance was found between TMA (free and polymer bound) and trans-1,2-diaminocyclohexaneplatinum(II)citrate (PEX) as well as trans-1,2-diaminocyclohexaneplatinum(II)glucarate (PTU) but there was no cross resistance between TMA and cis-diamminedichloroplatinum(II) (cis-DDP). PMID- 3808122 TI - The "in vivo" effect of protein A on tumor growth. AB - The antitumor effect of two purified preparations of protein A obtained from Staphylococcus aureus strain Cowan 1 or the mutant strain A676 was investigated. This study using different doses of SpA (5 or 10 mg/animal) i.p. administered was performed in lymphosarcoma bearing rats at certain intervals of time after tumor transplantation. The treatment with SpA deriving from A676 strain which was started at the same time with the tumor transplantation led to a significant increase in the latency period of tumor growth and the prolongation of survival time of tumor bearing rats. Attempts to use a higher dose of SpA and also a smaller tumor inoculum did not improve the results with regard to inhibition of lymphosarcoma growth in inbred R rats. PMID- 3808123 TI - Concanavalin A-induced agglutination of Ehrlich ascites carcinoma cells during growth of the tumor in mice. AB - ConA-induced agglutination of Ehrlich ascites carcinoma (EAC) cells during development of the tumor in mice has been studied in vitro. EAC cells were incubated with different concentrations of ConA at 37 degrees C for various intervals of time and the cell aggregates of different sizes were scored under microscope. The older EAC cells (20-day-old) showed a decrease in cytoagglutination with respect to large aggregates formation compared to the younger (10-day-old) ones. The small aggregates formed by the 5-day-old EAC cells are dissociated by competition with alpha-methyl-D-mannoside but the large aggregates are not affected by the sugar treatment. The observed differences in the agglutination patterns are discussed in view of the influence of the lipid content of EAC cells and the ascites fluid on ConA-induced cytoagglutination. PMID- 3808124 TI - Influence of ascorbic acid on the mutagenicity of N-methyl-N-nitrosoguanidine and nitrofurans studied by SOS chromotest. AB - Mutagenicity inhibition of MNNG*, NFAA* as well as of nitrovin by ascorbic acid was observed. The influence of ascorbic acid on these compounds was parallelly studied also by spectroscopy. Mutagenicity inhibition was characterized by SOS chromotest. Inhibition degree was evaluated quantitatively introducing the coefficient of inhibition. The influence of ascorbic acid was expressed most markedly in MNNG. It has been found that the decrease of mutagenicity should be mainly caused by acceleration of MNNG decomposition by ascorbic acid. PMID- 3808125 TI - Comparative chromosome examination of AKR mouse lymphoma after its i.p. transplantation with thymus- or spleen-derived lymphoma cells into hybrid mice. AB - A spontaneous AKR female mouse lymphoma was transplanted with its thymus cell suspension (10(6) cells i.p.) into AKR female mice. Lymph node cell suspension derived from one of the leukemic mice was injected (10(6) cells i.p.) into AKR females. The lymphoma cells "homing" to the thymus of one of the AKR females were suspended in Parker solution and 5 X 10(6) cells were given i.p. 5 (C3H X AKR) F3 hybrid mice (group 1). The lymphoma cells "homing" to the spleen of the same AKR female were also suspended, and 5 X 10(6) cells were injected i.p. into 5 (C3H X AKR) F3 hybrids (group 2). Chromosomes were prepared from the thymus and the spleen of two mice in both groups. The karyotypes derived from the hybrids of group 1 were compared to that of the group 2. It was found that the lymphoma cells "homing" to the thymus could be characterized by the trisomy of chromosome 15, while the lymphoma cells "homing" to the spleen had primarily the trisomy of chromosome 18. The results indicate that the thymus manifestation of the spontaneous AKR lymphoma is heterogeneous, and it contains at least two major subpopulations of the lymphoma cells. PMID- 3808126 TI - Electrophoretic mobility patterns of immunologically phenotyped cells in different hemopoietic malignancies. AB - The electrophoretic mobility distribution along with the immunologic phenotype (rosette tests, surface membrane immunoglobulin determination and mainly the detection of differentiation and leukemia-associated antigens by monoclonal antibodies) have been studied in 120 patients with different hemopoietic cell malignancies and in a group of healthy donors. The aim of our study was to compare the electrophoretic mobility character of malignant cells with that of normal T and B lymphocytes and their immune phenotype. Normal peripheral blood lymphocytes showed the typical bimodal pattern of two clearly distinguishable populations of different electrophoretic mobilities, corresponding to T and B cells. In leukemia and lymphoma cells the sharp unimodal peak has appeared, which was attributed to monoclonal origin of these cells. Moreover, the electrophoretic mobility of cells in different hemopoietic cell malignancies reflected different cell lineages and maturation stages within the given lineage group. Utilizing of the cell electrophoretic mobility as an additional marker to the immunologic data for the characterization of leukemia and lymphoma cells is proposed. PMID- 3808127 TI - The value of the short term predictive assay in the inductive treatment of patients with acute nonlymphoblastic leukemia. AB - Predictive capacity and clinical usefulness of the short term predictive assay (STPA) in the inductive treatment of patients with acute nonlymphoblastic leukemia (ANLL) was studied. Inductive treatment consisted of daunorubicin, arabinoside C and 6-thioguanine (TAD regimen). Leukemic cells of 20 previously untreated patients with ANLL were incubated in vitro with two doses of daunorubicin (1 microgram/ml and 10 micrograms/ml), arabinoside C (10 micrograms/ml and 100 micrograms/ml) and 6-thioguanine (10 micrograms/ml and 100 micrograms/ml). The 3H-thymidine as well as 3H-uridine uptake was measured in the treated and untreated cells. The highest predictive presence of the in vivo drug sensitive disease was adequately reflected by the level of 3H-uridine incorporation suppression 30% of control value in the case of daunorubicin (concentration: 10 micrograms/ml) and 80% in the case of 6-thioguanine (concentration: 100 micrograms/ml). In the case of arabinoside C (concentration: 10 micrograms/ml) the limit of 3H-thymidine uptake depression was 20% of control value. It was rather difficult to define the indicative degree of precursors incorporation inhibition for prediction of the drug-resistant disease, because of low number of patients primary resistant to TAD regimen. No correlation was found between the degree of the pre-treatment DNA synthesis rates and the precursors uptake inhibition by the tested drugs. PMID- 3808128 TI - Prognostic factors in Hodgkin's disease. AB - Between 1978-84 371 patients with HD were treated according to Protocol of LCG. 72.5% achieved complete, 10.8% partial remission and 16.7% were nonresponders. The evaluation of results was performed by PIL program from BMDP 81. The mean survival was 61 and disease-free survival (DFS) 60 months. The cumulative survival and DFS at 5 years were 65% and 68%, resp. Advanced HD, B symptoms, histopathology LD, male sex and age above 40 years influenced survival adversely. DFS decreased with CS III B, in males and age above 60 years significantly and in histopathology MC and LD with lack of significance. However, the size of mediastinal involvement was not a poor prognostic factor for survival, but influenced DFS. The prognostic value of major risk factors in HD was estimated by means of frequencies of their associations. PMID- 3808129 TI - Antiimmunoglobulins of rheumatoid factor (RF) type in prediction of melanoma patients. AB - It was found out the titer of antiimmunoglobulins of the rheumatoid factor (RF) type in the sera of melanoma patients can be used in prediction of the development of the patients' status. High titers of antiimmunoglobulins of the RF type, determined by the latex-fixation test (LFT), indicate an unfavorable prognosis in patients with clinical manifestation of uncontrollable recurrence appearing from 1.5 to 2 years after occurrence of the LFT titer. PMID- 3808130 TI - [Central pontine myelinolysis]. AB - A review is given on symptoms, etiology, pathogenesis and prognosis of central pontine myelinolysis (CPM). Since 1959, 315 cases of CPM have been reported in world literature, 41 per cent of the patients described developed their neurological symptoms in the course of chronic alcoholism. In about 32 per cent CPM was connected with electrolyte disturbance, especially hypo- or hypernatremia. Beside the complications of alcoholism, accompanying diseases were malignancies (9%) infections of the lung (10%) and diseases of the central nervous system (7%). Current theories about etiology and pathogenesis of CPM are reviewed with special reference to the syndrome of inappropriate secretion of the antidiuretic hormone (IADH). Own experiences with clinical diagnosis of CPM are reported. Seven patients with neurological symptoms in hyponatremia have been seen prospectively during one year. In three cases clinically, in one patient neuropathologically the diagnosis of CPM was made. PMID- 3808131 TI - [Early or late onset of L-dopa treatment in Parkinson disease?]. PMID- 3808132 TI - [Invasive meningioma of the anterior cranial fossa. Report of 2 cases]. AB - Two cases of falx-meningiomas are reported. In both cases there was tumor infiltration of the skull base, orbital caves and paranasal sinus at the time of diagnosis. The histological diagnoses were hemangiopericytic meningioma and atypical meningotheliomatous meningioma. Prognosis and therapy are briefly discussed. PMID- 3808133 TI - [Familial polyneuropathy with a disposition to pressure paralyses. A contribution to the differential diagnosis of mononeuropathies]. AB - When a young woman admitted for recurrent peripheral nerve palsies was suspected to suffer from hereditary polyneuropathy with liability to pressure palsies, 8 members of her family were examined diagnostically. Only one of these had a history of a transient mononeuropathy. A neurophysiological examination demonstrated peripheral nerve lesions not only in the patients father but also in 5 of her brothers and sisters. In presenting the data for this family the characteristics of hereditary polyneuropathy with liability to pressure palsies and the most important differential diagnostic aspects are discussed. PMID- 3808134 TI - [Methanol poisoning. Clinical, neuropathologic and computerized tomography findings]. AB - In two case reports, the characteristic clinical, CT-scan and neuropathological findings in acute methanol intoxication are described. The significance of acidosis for the survival rate and development of late sequelae is stressed. After a latency period of several days, one patient developed the rare condition of haemorrhagic leucoencephalopathy with striking CT-scan and morphological findings. The etiology of this complication is discussed. The principle therapeutic procedures including the correction of acidosis, haemodialysis and administration of ethanol and folic acid are outlined. PMID- 3808135 TI - [Anticonvulsants in the therapy of glioblastomas]. PMID- 3808136 TI - Regulation of gastric acid secretion in man: an update. PMID- 3808137 TI - Bronchial hyperreactivity. An overview. PMID- 3808138 TI - On combating hypertension: when and how. PMID- 3808139 TI - Multiple myeloma: current problems and controversies. PMID- 3808140 TI - Systemic amyloidosis: a clinical survey of 144 cases. PMID- 3808141 TI - Raynaud's phenomenon: factors of prognostic significance for the development of connective tissue disease. Relevance of vascular and immunological tests. PMID- 3808142 TI - Acute intermittent porphyria in The Netherlands. Heterogeneity of the enzyme porphobilinogen deaminase. PMID- 3808143 TI - Phosphate-binding properties and electrolyte content of aluminum hydroxide antacids. AB - The phosphate-binding capacities of 19 liquid and solid aluminum hydroxide gel antacids were determined in vitro under varying pH conditions. The resulting data provide a basis explaining the phosphate-binding characteristics observed when patients are treated with long-term aluminum hydroxide therapy. No antacid, liquid or solid, showed significant binding at pH 1.0. Maximum phosphate binding (expressed as phosphorus; P) was observed at pH 2.0 and 3.0 for most antacids and decreased markedly at alkaline pH. The liquid antacids showed a significantly greater phosphate-binding capacity than did tablets or capsules (p less than 0.01). At pH 2.0, the liquid antacids bound a mean of 22.3 mg P/5 ml. At pH 8.0 binding was reduced to a mean of 7.3 mg P/5 ml. Significant interbrand differences were observed. At pH 2.0, the solid antacids bound a mean of 15.3 mg P/tablet or capsule. At pH 8.0, binding was reduced to a mean of 5.8 mg P/tablet or capsule. Interbrand differences, while substantial, were less than those observed among the liquid antacids. Variations in sodium and potassium content were clinically insignificant for most of the antacids in this study, while the differences in phosphate-binding properties were sufficient to warrant attention in the patient with renal failure. PMID- 3808144 TI - Hypertension in primary chronic glomerulonephritis: analysis of 288 biopsied patients. AB - The prevalence of hypertension in 288 patients with primary chronic glomerulonephritis was compared with that observed in a control group of 3,477 subjects from the same geographic area. 23.3% of the patients and 12.8% of the general population were hypertensive (p less than 0.01). However, if only patients with normal renal function were considered, prevalence of hypertension (12.7%) was not higher than in the control group. Hypertension was more frequent in focal segmental sclerosis (30%) and in membranous glomerulonephritis (26%) than in IgA nephropathy (9%), membranoproliferative glomerulonephritis (11%) and IgM mesangial glomerulonephritis (12%). Five years after renal biopsy, 92% of normotensive and 47% of hypertensive patients remained with normal renal function (p less than 0.001). These findings suggest that the high prevalence of hypertension in chronic glomerulonephritis is related to the declining renal function. On the other hand, hypertension appears to represent a bad prognostic sign. PMID- 3808145 TI - Subcutaneous and intranasal administration of 1-deamino-8-d-arginine vasopressin in the assessment of renal concentration capacity. AB - Maximum urine concentration capacity was studied in healthy adults using different routes and doses of administration of 1-deamino-8-d-arginine vasopressin (DDAVP)-desmopressin. Plasma levels of DDAVP showed a dose-dependent increase after the subcutaneous but not after the intranasal administration. The effect on urine osmolality was similar but more prolonged after the subcutaneous as compared to the intranasal route. We conclude that subcutaneous injection is a simple and reliable way of administering DDAVP. A dose of 4 micrograms in adults is optimum diagnostically and it corresponds to 20-40 micrograms administered intranasally. PMID- 3808146 TI - Hypouricemia due to increased tubular urate secretion. AB - A 45-year-old woman had hypouricemia (serum uric acid, 1.0-2.3 mg/dl) with increased uric acid clearance (29.8 +/- 9.3 ml/min/1.73 m2). Uric acid clearance to creatinine clearance ratio (Cua/Ccr) was suppressed markedly by pyrazinamide to 2.3% and surprisingly enhanced by probenecid to 227.8%. No other renal tubular or metabolic abnormalities were detected. This previously unreported high postprobenecid Cua/Ccr suggests that markedly increased urate secretion by the renal tubule is responsible for hypouricemia in this patient. PMID- 3808147 TI - Familial renal hypouricemia with intact reabsorption of uric acid. AB - Three patients with renal hypouricemia in the same family are described. Serum urate levels in the mother were in the low normal range and were below normal in her 2 sons. In all 3 patients, the ratios of renal urate clearance to creatinine clearance were abnormally elevated. Clear responses to either pyrazinamide or probenecid administration were observed in these ratios. These results suggest that these 3 patients had renal hypouricemia with normal reabsorption of urate as judged by the criteria for differentiating abnormalities in renal urate handling. This corresponds to the previously postulated mechanism as renal urate hypersecretion. Possible limitations to the diagnostic use of probenecid and pyrazinamide are also discussed. PMID- 3808148 TI - Inhibited efficiency of kidney mitochondria isolated from rats treated with cyclosporin A. AB - The effect of cyclosporin A (CYA) on the respiration and phosphorylation in rat kidney mitochondria was studied. When CYA (50 mg/kg/day) was subcutaneously administered to rats for 4 days, the state 3 respiration and uncoupled respiration of succinate and glutamate/malate respiration was decreased. The respiratory control index was decreased in glutamate/malate respiration. These ex vivo effects of mitochondrial dysfunction are discussed as CYA effects on kidney mitochondria occurring in the intact cell. The nephrotoxic effect of CYA could be demonstrated by increased excretions of urinary enzymes. PMID- 3808149 TI - Effects of parathyroidectomy on blood pressure in spontaneously hypertensive rats. AB - The long-term effects of parathyroidectomy (PTX) on blood pressure, intravascular volume, pressor hormones, and on acute vascular effects of intravenous parathyroid hormone (PTH) were evaluated in spontaneously hypertensive (SH) and normotensive Wistar-Kyoto (WK) rats. PTX or sham operation (CO) were done at 4-5 weeks of age, and a high calcium diet was offered to PTX rats to study them at eucalcemic calcium levels. The cardiovascular effects of PTX, determined after 11 13 weeks, were qualitatively similar in SH and WK rats: mean arterial blood pressure (conscious unrestrained rats) was lower, intravascular volume was higher, total body sodium was slightly higher, and plasma angiotensin II or norepinephrine levels were not different from CO groups. The acute hypotensive and chronotrophic effect of intravenous PTH was unchanged in PTX groups. When parathyroid intact SH rats and PTX SH rats were both examined on an 1.6% Ca diet, blood pressure was significantly lower in PTX than in parathyroid-intact SH rats. The results are compatible with the hypothesis that PTH has a permissive action on blood pressure maintenance in eucalcemic SH and WK rats by mechanisms unrelated to volume status or circulating pressor hormone concentrations. PMID- 3808150 TI - Increased clearance rate of prednisone in the isolated perfused liver of uremic rats. AB - The effect of uremia upon the hepatic clearance rate of prednisone was studied in isolated perfused livers of normal and uremic female rats. The perfusion rate was kept at a constant flow rate of 25 ml/min. In order to induce uremia, one group of rats was 5/6 nephrectomized 3 weeks prior to the perfusions. The concentrations of prednisone and other steroids were measured by a normal phase HPLC technique. In experiments with an initial prednisone concentration of 500 700 micrograms/l, the hepatic clearance rate of prednisone was significantly (p less than 0.001) increased by 40% in livers obtained from uremic rats (11.1 +/- 0.49 ml/min/liver) as compared to control rats (8.0 +/- 1.17 ml/min/liver). No significant correlation was found between the hepatic clearance rate of prednisone and increasing initial prednisone concentrations from 141 to 1,953 micrograms/l in the perfusate. It is concluded that an adaptive mechanism may exist in uremia which results in an increase of the hepatic clearance rate of prednisone. PMID- 3808151 TI - Effects of sera from uninephrectomized rats on renal slices: PAH and TEA uptake and QO2. AB - We followed the effects of sera from unilaterally nephrectomized (uninephectomized) rats compared to sham-operated rats on 3H-p-aminohippurate (3H PAH) and 14C-tetraethylammonium (14C-TEA) uptake and oxygen consumption (QO2) in incubating rat kidney slices. These studies were based on the assumption that a circulating renotropic substance might also influence various transport mechanisms. Sera were obtained at various times postoperation; the height of renotropic activity occurs 17-24 h after kidney extirpation. Sera removed 17-24 h postuninephrectomy significantly decreased both 3H-PAH and 14C-TEA uptake in incubating kidney slices. Similar to the inability to show significant renotropic activity after 36 h, sera obtained 48, 96, and 168 h postuninephrectomy had no significant influence on 3H-PAH and 14C-TEA uptake. Addition of sera (10% v/v) generally depressed QO2. However, sera obtained from uninephrectomized rats compared to sera from sham-operated rats had relatively more depressive effects on QO2 in renal tissue after 30 min of incubation (p less than 0.01). No significant differences in QO2 were seen when the uninephrectomized and sham operated sera were added to the tissue immediately or after 60 min of incubation in the sera. These serum studies on 3H-PAH and 14C-TEA uptake simulate in many respects ones performed previously with serum from spontaneously hypertensive and salt-loaded rats and suggest the presence of a common circulating factor. PMID- 3808152 TI - Cefazolin-induced encephalopathy in a uraemic patient. PMID- 3808153 TI - Hypoxemia and dialysate temperature. PMID- 3808154 TI - Induction of premature ventricular complexes by hemodialysis? PMID- 3808155 TI - Exophthalmos: rare complication of A-V fistula used for hemodialysis. PMID- 3808156 TI - Inefficacy of vitamin E supplementation on anemia in hemodialysis patients. PMID- 3808157 TI - Timing and factors influencing operative outcome in intracranial aneurysms. AB - The results of operation in 851 intracranial aneurysms were statistically analysed. The influence of 22 factors on operative outcome is shown. The importance of the time of intervention for the prognosis of patients is of special interest. It is striking that the outcome of an operation within 48 hours only depends on the neurological status, whereas at operation in the stage of recovery further factors such as vasospasm, arteriosclerosis, brain oedema, ischaemia and blood in the subarachnoid space are of great importance. They lead to a more unfavourable outcome. PMID- 3808158 TI - Ruptured intracranial aneurysms as a cause of subdural haematoma. Potential diagnostic pitfalls and the surgical management of the acute patient. AB - Seven cases of aneurysms that ruptured into the subdural space and were treated surgically are reviewed. Six out of the seven presented with signs of uncal herniation, three of them for at least for four hours or more. They all died in spite of urgent decompression and drainage. Three others suffered from uncal herniation for less than four hours and they all did well. The seventh patient had a small subdural haematoma with no signs of compression of the underlying neural structures. This last patient also had a good outcome. The authors point out that the aneurysm causing the haematoma might be overlooked should one utilize CT (computerized tomography) scan alone without contrast. However, in most instances the history gives the aneurysm diagnosis despite the CT scan of haematoma only. Intravenous contrast CT scan may occasionally demonstrate the aneurysm, provided modern CT equipment is adequately utilised. Severe neurological deficit and uncal herniation might still be reversible provided decompression can be carried out in less than four hours. If accessible the aneurysm should also be clipped at the same time. PMID- 3808159 TI - [Neuroradiologic study using modern imaging procedures (CT:NMR) in venous, cerebral vascular malformations]. AB - Clinical, neuroradiological and surgical findings were analysed in nine patients with venous cerebral malformations. Special emphasis has been placed on MR findings. Venous angiomas are characterised in MR tomography as low-signal areas whereas cavernous angiomas are characterised by a high incidence of signals due to the blood coagulates. In this manner MR tomography confirmed pathologico anatomical findings to the effect that malformations are often made up of a venous and a cavernous component. Today it is also occasionally possible to clarify the aetiology of so-called "cryptogenic" epilepsies. Modern microsurgery enables the removal of a venous vascular malformation even in the parietal area without the risk of impairment or loss of nerve function. PMID- 3808160 TI - Haemangioblastomas of the brain stem. AB - Six cases of capillary haemangioblastoma involving the brain stem are presented. Some clinical and pathological peculiarities of this series are outlined. Four patients (two operated radically) showed good or excellent outcome, whereas two (one partial and one complete removal) died shortly after the operation. The chances of direct surgical approach in brain stem haemangioblastomas are considered and the pertinent literature summarized. PMID- 3808161 TI - Lumbosacral extradural spinal arteriovenous malformation with blood supply from branches of internal iliac arteries. AB - A case of extradural spinal arteriovenous malformation (AVM) is described. The feeding arteries were branches from both internal iliac arteries. The pre operative diagnosis was confirmed by myelography, selective angiography and plain and enhanced CT. The AVM was demonstrated in the ventrolateral epidural space by CT scan, providing an excellent pre-operative localisation related to dural sac and nerve roots. The clinical signs and symptoms are considered to originate from the venous congestion due to the high venous pressure caused by the AV shunt. The possible predisposing factors are also briefly discussed. PMID- 3808163 TI - Retroclival cysts. Report of two cases. AB - Two cases of retroclival arachnoid cyst are presented. The clinical symptoms, putting aside the hydrocephalus, are dominated by pyramidal signs, oculomotor disorders and ataxia. In both cases, a posterior suprasellar extension was found as in the previous descriptions in the literature. This shows the close pathological relations of these cysts to the more classic suprasellar cysts. PMID- 3808162 TI - [Aneurysms of the auditory artery at the internal acoustic meatus]. AB - Aneurysms of the anterior inferior cerebellar artery at the origin of the internal auditory artery are uncommon. Up to the present time 14 cases have been published, and in twelve of these operative treatment was undertaken. We now present a Fifteenth case which was operated on thirty hours after the subarachnoid haemorrhage had occurred and was treated with the calcium antagonist Nimodipine. The clinical course, the neuroradiological findings and the operative situation are presented. PMID- 3808164 TI - [Is osteosynthesis justified for spinal injuries in children?]. AB - The legitimacy of osteosynthesis for the treatment of spinal injuries in children is analyzed as a function of results in 10 cases, 7 affecting the cervical, 2 the thoracic and one the lumbar region, six of the children being under 10 years of age. Five of these children had serious neurologic disorders, including 4 with high tetraplegia. Technical difficulties of osteosynthesis were not made easier by the poorly adapted nature of the material for infantile statures. Indications for this surgery were not only those cases not improved by orthopedic therapy: instability of lesions, the child's condition and deterioration in the neurologic state can also require initial treatment by osteosynthesis. The principal complication is postoperative cervical kyphosis, but this can be prevented by early active reeducation, the stability of the fixation dispensing with the need for external contention. PMID- 3808165 TI - [Stabilization of thoraco-lumbar spinal fractures using Harrington's equipment. Study of the evolution of spinal curvatures]. AB - The radiographic results of treatment of unstable thoracolumbar spinal injuries by Harrington rods are reviewed. The loss of initial correction of kyphosis is 8 degrees on average. Correlation between good anatomical reduction and lapse of time before operation, level of instrumentation and solid spinal fusion exists. But, in burst fracture with deficient anterior pilar, the incidence of loss of reduction is important. The influence of Harrington rods on the spine is significant. PMID- 3808166 TI - [Myelopathies in a context of generalized infection: myelitis or compression?]. AB - Four patients with rapidly progressive tetraparesis in relation with skin or joint infection and septicemia are reviewed. Clinical signs of medullary compression was present in all cases, confirmed by neuroradiological examinations. However, all surgical approaches failed to demonstrate clear evidence of compression. Within three weeks, the neurological picture of severe tetraparesis had an excellent clinical evolution in all cases. One of the patients died after developing pulmonary complications: necropsy did not show any signs of compression. The difficulty of differential diagnosis between an infectious compressive surgical pathology and an inflammatory disease (acute transverse myelitis type) is emphasized, with review of literature. PMID- 3808167 TI - [Hypercoagulability syndrome associated with cerebral lesions. Prospective study of coagulation during surgery of primary brain tumors (17 cases)]. AB - Variations in hemostatic factors have been studied in 17 patients undergoing neurosurgical operations for intracerebral primary tumors. Clotting time (plastic and glass), recalcification time (Howell), plasma fibrinogen level, fibrin split products, partial thromboplastin time, Quick and platelet count were measured before and after the surgical procedure and several times during the following 24 hours. Hemostasis was significantly disturbed, with maximal hypercoagulability 2 hours after operation. In 3 patients, fundus examination showed occlusion of retinal vessels. In all cases the surgical trauma was relatively minor compared with severe cerebral contusion, but was nevertheless enough to disturb the measured parameters, which appear to be sensitive indicators for assessing the severity of cerebral lesions, especially in cases of contusion. A systematic fundus examination is also of diagnostic interest. The state of blood hypercoagulability may lead to disseminated intravascular clotting (DIC) and therefore prophylactic heparin therapy should be administered. PMID- 3808168 TI - [Should the aneurysms of Osler's disease be investigated and operated on prior to hemorrhage?]. AB - Neurologic accidents are today the first cause of mortality following bacterial endocarditis through ischemia or mycotic aneurysm rupture. Authors propose a protocol management by complete cerebral angiography and CT scan as soon as the least neurologic sign appears. A headache is the most frequent of these signs. 35 patients were explored during 3 years and 10 treated surgically. These authors conclude that: mycotic aneurysm must be detected aneurysm with subarachnoid haemorrhage must be operated on as soon as possible. With unruptured aneurysm, surgical decision is more difficult: sequential angiography after excision of the most dangerous aneurysm, demonstrates that an aneurysm can appear, enlarge, diminish or spontaneously resolve. Carrying on with this protocol should allow an answer to this question. PMID- 3808169 TI - [Early surgery of intracranial aneurysms]. AB - In spite of scientific progress during the last two decades, microsurgery, neuroanesthesiology, and a better knowledge of the pathophysiology of cerebral vasospasm, the outcome of subarachnoid hemorrhage (S.A.H.) patients remains very poor. Each year, 28,000 North Americans are afflicted. Eighteen thousand of these patients will either die or become severely debilitated, a mortality morbidity of 64%. Only one patient out of five may return to the premorbid state. International cooperative studies report that the highest rate of rebleeding occurs during the first 24 hours post S.A.H. There is no rebound phenomenon during the 7th-8th day post S.A.H. Cerebral vasospasm begins during the 2d-4th day post S.A.H. and reaches its peak around the 8th day post bleed. Antifibrinolytics like AMICAR (aminocaproic acid) do not reduce significantly the rebleeding rate. In most of the cases the therapeutic level of these drugs is reached only on the third or fourth day of treatment. Hence antifibrinolytics are inactive during the first crucial seventy two hours. Antifibrinolytics increase the incidence of vasospasm, hydrocephalus, and thromboembolic phenomenon. At Infant Jesus Hospital, Quebec City, S.A.H. patients are operated on early since more than two years. Patients included in this study were admitted between January 1983 and December 1984. One hundred and thirty six patients were operated upon, 22 patients operated on acutely, less than 72 hours post S.A.H. Evaluation of these patients included the Glasgow Coma Scale (G.C.S.), the grade according to Botterell classification, a CT Scan, and angiography. A preoperative evaluation included Botterell classification and G.C.S., a post operative evaluation was performed during the first and seventh post operative days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808170 TI - [Study of the deterioration factors in adult patients with cranio-cerebral injuries who "talk and die"]. AB - Between 1978 and 1984, the University Hospital of Geneva (Hopital Cantonal Universitaire) received 46 head injured patients who "talked and died" after their brain insult. Only 14 of them had associated systemic lesions whilst two thirds of the series had an isolated head injury. Detailed review of the case records shows that death was preventable in a quarter of the cases. For 28 patients (60%), the factors contributing to death are avoidable or, at least, their management should be greatly improved. The diagnosis was confirmed by autopsy in 31 patients (67%). PMID- 3808171 TI - [Pre- and postoperative quantitative measures of facial sensitivity in tic douloureux]. AB - Electrical stimulation was used for quantitative assessment of facial sensibility before, during and after percutaneous electrocoagulation of the Gasserian ganglion in 19 patients with tic douloureux. A portable stimulator was of a constant current type, which generated rectangular monophasic pulses of 0,2 ms in length and 100 Hz in frequency. The bipolar electrode consisted of saline-soaked felt discs with a surface of 1 cm2 and an interpolar distance of 1 cm. The thresholds for perception and pain were measured over six regions of each side of the face. Additionally, maximal pain tolerance was measured in the painful area and its corresponding healthy area. Shortlasting intravenous anesthesia with Brietal was given before each electrocoagulation. As soon as the patient began to react to speech, the threshold for pain was measured in the painful and the corresponding healthy area. Preoperatively, the measurements showed that the average threshold for perception was 2,5 mA and for pain 3,5 mA. The average maximal pain tolerance was 10,8 mA. There were no differences between the painful and the healthy sides. Electrocoagulations were stopped when the thresholds for pain in the trigger area had become twice as high as that on the contralateral side. The postoperative measurements showed that the average thresholds for perception and pain had doubled, measuring 4,8 and 8,0 mA, respectively. The average pain tolerance had risen from 10,8 to 22,5 mA. A marked rise of both thresholds was also seen in the ipsilateral areas adjacent to the trigger zone. There was good correlation between a heavy sensory deficit and a favourable clinical result.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808173 TI - [Non-traumatic rhinorrhea from a latero-sellar fistula of the temporal fossa adjacent to an empty sella turcica. Computed tomography aspects; surgical treatment]. AB - The authors report a case of non traumatic rhinorrhea due to an osteo-dural fistula communicating between the latero-sellar part of the left middle cranial fossa and the sphenoidal sinus. This fistula, probably congenital, was adjacent to an intrasellar arachnoidocele ("empty" sella turcica), but was not responsible for it. This lesion was demonstrated by CT scan associated with the injection of Metrizamide. The surgical treatment (trans-sphenoidal approach) allowed complete cure of the fistula and its associated symptoms. PMID- 3808172 TI - [Exclusion of an arteriovenous malformation of the left olfactory groove using endo-orbital ligation of the ethmoidal arteries]. AB - A case history of a 59 year old male patient having an intra frontal cerebral hematoma due to a ruptured olfactory groove arteriovenous malformation (AVM) is reported. Following the operative removal of the hematoma, the patient improved steadily and the risk of a recurrent bleeding was considered. A total thrombosis of the AVM was achieved by a two step bilateral transorbital ligation of both anterior and posterior ethmoidal arteries, with no further intracranial approach. The simplicity of this technic is pointed out and its application in other pathological conditions-such as basilar meningiomas in which embolization is hazardous--is suggested. The authors more recently experienced the beneficial effect of transorbital ligation of ethmoidal arteries prior to removal of a highly vascular supra-sellar meningioma. PMID- 3808174 TI - [Use of a vertebral body graft in cervical spine injuries]. AB - The authors describe the use of body vertebral graft in post-traumatic cervical spine injuries. They underline its advantages. PMID- 3808175 TI - Behavioral and developmental effects of prenatal exposure to pentazocine and tripelennamine combinations. AB - Long-Evans, hooded rats were intubated with one of four dose combinations of pentazocine and tripelennamine on Days 7-20 of pregnancy: 0:0 (mg/kg pentazocine:tripelennamine), 20:10, 40:0, or 40:20. An additional group had free access to lab chow and water throughout pregnancy. At birth, reduced body weights were evident in all drug-treated offspring. Growth deficits were not noted at 5, 10, 15 or 20 days of age. Three measures of activity were collected at 18 days of age, however, none of these measures were differentially affected as a function of prenatal treatment. At 85 days of age, offspring were tested in a two-way shuttle avoidance paradigm. Although the number of avoidances was not significantly affected by prenatal treatment, offspring exposed to these drugs in combination had shorter response latencies than controls with increased training and made more intertrial crossing responses. Additional offspring were tested for seizure susceptibility at 100 days of age. None of the parameters of seizure activity were significantly affected by prenatal drug treatment. Prenatal exposure to pentazocine and tripelennamine resulted in prenatal growth deficits, increased activity during the intertrial interval and decreased response latencies in a shuttle avoidance learning task, suggesting that this polydrug combination may be associated with some long-term behavioral teratogenic risks. PMID- 3808176 TI - Prenatal ethanol exposure alters rat brain morphology but does not affect amygdaloid kindling. AB - Exposure of the mammalian fetus to ethanol causes a variety of nervous system abnormalities, but the evidence relating to seizure susceptibility is contradictory. Therefore, offspring of rat dams that had consumed a mean of 6.9 g/kg/day of ethanol were compared with pair-fed and free-fed controls on rate of electrical kindling of the amygdala and on open field measures of activity. The Ethanol-exposed males displayed increased ambulation and the Ethanol females displayed increased rearing and defecation in an open field. However, there was no significant difference between the groups in rate of kindling. Although the gross size of the brains measured on a coronal section through the anterior tip of the hippocampus did not differ significantly among the groups, there was a highly significant reduction in percent brain tissue area and a corresponding increase in percent ventricle area in the Ethanol group. PMID- 3808177 TI - Sulfolane effects on audiogenic, pentylenetetrazol and afterdischarge seizure activity. AB - Sulfolane dosages that alter seizure susceptibility were determined using audiogenic (AG), pentylenetetrazol (PTZ) and hippocampal afterdischarge (AD) seizure models. The presence of AG seizures and potentiation of PTZ seizures were investigated in rats injected IP with 0, 200, 400 or 800 mg/kg; AD activity was assessed only at the highest and lowest dosages. The dose-dependent hypothermia associated with sulfolane treatment was controlled in Experiment I and a replication study (Experiment II) by testing under isothermic conditions. The effect of body temperature was measured directly in Experiment III by comparing AG seizure incidence and characteristics exhibited by hypothermic and normothermic animals. Audiogenic seizures were elicited in nearly half of the 800 mg/kg animals in both Experiments I and II. Sulfolane-induced hypothermia, maximal at 3 hours, partially protected against AG seizure characteristics. Potentiation of PTZ seizure severity (800 mg/kg) and duration (800 and 400 mg/kg) also were observed. None of the hippocampal AD parameters was affected significantly by sulfolane treatment. The similarity of the convulsants sulfolane and PTZ is discussed. PMID- 3808178 TI - Triethyl lead attenuates feeding and drinking, and induces a conditioned taste aversion, in adult rats. AB - The effect of triethyl lead (TEL) on ingestive behavior in adult male rats was studied in two experiments. In experiment 1, ad lib food and water intakes were monitored following SC injection of 1, 4, or 7 mg/kg body weight of TEL or vehicle; both were significantly attenuated at 4 and 7 mg/kg doses. In a second experiment, the same doses of TEL were given SC in a conditioned taste aversion (CTA) paradigm. Following a single pairing, a dose-related reduction in intake of a 0.1% saccharin solution was observed at all doses tested. Sensitivity of behavioral measures and potential role of discomfort in TEL-induced feeding/drinking shifts were considered. PMID- 3808179 TI - Side preference behavior in rats exposed to alcohol prenatally. AB - Exploration and side preference in a two-hole nose-poke apparatus were examined in 28 to 31-day-old Long Evans rats from three prenatal treatment groups: prenatal alcohol exposed (35% ethanol-derived calories, 35% EDC), nutritional control (0% ethanol-derived calories, 0% EDC) or standard control (lab chow, LC). Rats prenatally exposed to alcohol had significantly more total pokes than the two control groups, who did not differ, replicating the previous demonstration of increased exploration in this age group. All three groups differed significantly in their side preference behavior over the time course of the test session. However, both control groups maintained their preferred side whereas the 35% EDC group alternated side choice over the test session. The three groups also differed in overall degree of side preference; the LC group had the greatest degree of side preference and the 35% EDC group the lowest, with the 0% EDC group intermediary. These results suggest an altered development of cerebral laterality in offspring exposed to alcohol during gestation, and that the effect of alcohol interacts with nutritional variables. PMID- 3808180 TI - The effects of prenatal retinoic acid on the viability and behavior of the offspring. AB - Three experiments were done in Charles River rats to assess the effects of various doses of retinoic acid given at different periods of pregnancy on the postnatal function of the offspring. In the first study doses of 5 mg/kg of body weight were given on days 8-10, 11-13, or 14-16. In the second study, doses of 2.5 or 5 mg/kg were given on days 11-13 or 14-16. In the third study, doses of 2, 4 or 6 mg/kg were given on days 14-16. Five mg/kg given on days 11-13 resulted in significant postnatal mortality, while the viability at all other doses and periods was not affected. The weights of the pups at birth and weaning were normal except in the first study when the pups from dams given 5 mg/kg on days 14 16 were smaller than controls at weaning. The pups from dams treated with 4, 5 or 6 mg/kg consistently showed a delayed response to negative geotropism and auditory startle was delayed in two of the studies at 6 mg/kg. Hyperactivity in preweaning rats tested in photo-cell cages was seen only in the first study, but open-field hyperactivity occurred in all three studies at doses of 4 mg/kg or above. The M-maze performance of the rats from groups dosed with 4, 5 or 6 mg/kg on days 8-10 or 14-16 and the ones dosed with 2.5 mg/kg on days 11-13 was poorer than controls. No differences were seen in either photo-cell or open-field activity at 42 days, but in the final experiment, the rats from the 6 mg/kg group were hyperactive at 100+ days in running wheels. The rats in the 6 mg/kg group performed more poorly at active avoidance and were hypoactive after an amphetamine challenge. These studies show that retinoic acid given prenatally induced functional deficits in the offspring at doses below the "no-effect" level for producing morphological defects and suggests that retinoic acid may be a good model compound for such studies. PMID- 3808181 TI - The effects of diisopropyl phosphorofluoridate (DFP) on inter-response time and circadian patterns of lever-pressing in rats. AB - Rats were injected with saline, 1.0 mg/kg or 2.6 mg/kg of diisopropyl phosphorofluoridate (DFP). Three days later the animals were placed in cages in which they could press a lever to obtain their entire daily ration of food. The time of day at which responses occurred and the time between successive responses were recorded over a six day period to determine the circadian pattern of lever pressing and the distribution of inter-response times (IRTs). The saline injected rats exhibited a normal nocturnal pattern of feeding, while both DFP treated groups exhibited a significantly greater tendency to eat during the day. Analysis of the IRT distributions of the three groups showed a different pattern of results. The saline and 1.0 mg/kg DFP groups produced nearly identical IRT distributions, while the 2.6 mg/kg group produced an IRT distribution which was marked by significant increases in the interquartile range and median IRT. Since the 1.0 mg/kg dose of DFP produced a circadian disruption but did not affect the IRT distribution, it appears that the disruption of circadian activity by DFP which was reported by Raslear and Kaufman cannot be solely explained by simple changes in the motor response. PMID- 3808182 TI - Effects of triethyltin on responding of mice under a multiple schedule of reinforcement. AB - The lethality and behavioral effects of triethyltin (TET) were determined in adult, male BALB/c mice. Following a single IP dose of TET (10, 12.5 or 15 mg/kg), the lethality was determined at 24-hr intervals. By 144 hr after TET administration, lethality had risen to greater than 90% in the groups receiving the 12.5 and 15 mg/kg and 20% (6/30) in the group which received 10 mg/kg. No additional deaths were observed over the remainder of the two week observation period. The behavioral effects of 5, 7.5 or 10 mg/kg were determined in mice trained to respond under a multiple fixed-ratio 30, fixed-interval 600-sec schedule of milk presentation. At 3 hr after TET administration, the rate of responding was decreased at all three doses. However, by 27 hr after 5 or 7.5 mg/kg TET the rate of responding had returned to pre-injection control values while the responding of the mice in the 10 mg/kg group did not return to pre injection control values until 51 hr after administration. In a separate group of mice, 7.5 mg/kg was administered at 2 week intervals for a total of 5 separate administrations. No evidence for a cumulative or diminished behavioral effect was observed. Neuropathological examination revealed a direct dose and time related pathology in the white matter of the CNS. Maximal edematous vacuolar change was observed 72 hr after TET administration. Such morphological changes, however, were totally absent 12 days after a single 10 mg/kg exposure. Multiple exposure to TET (7.5 mg/kg) at 2 week intervals for 10 weeks showed only minimal morphological alterations in the brain. PMID- 3808183 TI - Behavioral, neurochemical and physiological effects of repeated exposures to subsymptomatic levels of the anticholinesterase, soman. AB - The present experiments were designed to study behavioral, neurochemical and physiological effects of repeated exposure to subsymptomatic levels of the anticholinesterase, soman. Sprague-Dawley rats were placed on a soman regimen of 35 micrograms kg-1 (0.3 log10 units below the LD50) which consisted of daily injections SC for the first three days, followed by the same dose three times per week for a total of 11 injections (22 days). There were no significant differences in pretreatment baselines between soman-treated and saline control animals for any of the variables measured. Some basic physiological processes, i.e., caloric intake and body fluid balance, and behavioral functions associated with aversive reinforcement (e.g., conditioned avoidance response) were not affected by the soman regimen. Core body temperature showed an early hypothermia and later developed tolerance. Nociceptive sensory and perceptual thresholds were elevated (hypoalgesia) and remained so throughout the treatment. Temporal perception (as evidenced in fixed interval responding) was significantly impaired initially, but tolerance developed as the duration of the regimen increased. Tolerance was also evident in measures of general activity and cognitive functions. The process of tolerance development proceeded when brain AChE activity was depressed and stable, indicating that some other process(es) must have been involved. The results of the present series of experiments show quite clearly that exposure to the antiChE, soman, at subsymptomatic levels can produce differential effects on enzymatic, physiological and behavioral functions, i.e., some of these functions may be affected while others are not. Moreover, effects when they do appear may also differ in that some may persist during the duration of the exposure, while others may appear initially and then disappear as tolerance develops. PMID- 3808184 TI - Acute sulfolane exposure produces temperature-independent and dependent changes in visual evoked potentials. AB - Sulfolane (tetrahydrothiophene-1, 1-dioxide) is a commercially important solvent. This report describes the consequences of acute exposure to sulfolane upon the visual system, as measured using flash evoked potentials (FEPs) and pattern reversal evoked potentials (PREPs). A single injection of either 1/2 or 1/4, but not 1/8 the IP LD50 (1600 mg/kg) produced significant changes in both FEPs and PREPs which were apparent within 1 hour and lasted longer than 6 hours. Amplitudes of FEP peaks to the first of a pair of stimuli were generally increased compared to control, an effect which was not temperature-dependent. In addition, sulfolane produced an ambient temperature- and dose-dependent hypothermia. Sulfolane increased latencies of FEP and PREP peaks, but attenuating hypothermia eliminated the effect of sulfolane on latencies. PMID- 3808185 TI - Duration and intensity of behavioral change after sublethal exposure to soman in rats. AB - The behavioral effects produced by acute exposure to sublethal doses of pinacolyl methylphosphonofluoridate (soman) were examined in the Sprague Dawley rat. Two hours after exposure to soman (100-150 micrograms/kg IM), dose-related decreases in spontaneous motor activity (SMA), fore- and hindlimb grip strength, thermal sensitivity, and rectal temperature were observed. In addition, acoustic startle response amplitude decreased, while response latency increased. Soman also depressed the percentage of conditioned avoidance and escape responses and increased response latency. In both the 103 and 116 micrograms/kg dose groups, effects on hindlimb grip strength persisted up to 14 days after exposure, while effects on hot plate response lasted for 7 days. A biphasic change in motor activity was seen in the 103 and 116 mg/kg soman groups: Initial SMA depression during the first 24 hours after exposure was followed by SMA increases which persisted up to 21 days. Animals that showed delayed hyperactivity often exhibited seizures and increased excitability when handled. The results of these studies demonstrate that sublethal doses of soman can cause marked and often long lasting changes in behavior in the rat. PMID- 3808186 TI - Behavioral effects of chronic manganese administration in rats: locomotor activity studies. AB - Manganese (Mn) is an industrially important metal which, when given in excess, produces lesions in the basal ganglia of rats and humans. Humans poisoned with Mn often exhibit an initial hyperactivity ("manganese madness") followed by a parkinsonian-like syndrome. The present studies examined the effects of chronic Mn exposure on locomotor activity in rats maintained on 0.0 or 1.0 mg Mn(Cl)2 X 4H2O/ml drinking water. No differences in mean body weights were observed from 0 65 weeks of treatment. Locomotor activity was tested in 15 min sessions at weekly intervals (Weeks 1-13), then at 4 or 14 week intervals thereafter. Mn treatment produced a significant increase in activity on weeks 5-7 before returning to control values at 8 weeks. Habituation measured within a test session was not affected at any time. At 14 and, to a lesser extent, 29 weeks, Mn animals were found to be more responsive to the effects of 1.25 mg/kg d-amphetamine (d-A) than controls. This increased responsiveness was gone at Weeks 41 and 65. Consistent with clinical reports, these results suggest that Mn may produce a transient increase in dopaminergic function, as measured by both spontaneous and d-A stimulated locomotor activity. PMID- 3808187 TI - Attention, distraction and reaction time at age 7 years and prenatal alcohol exposure. AB - This report is one phase of a longitudinal prospective study on the behavioral teratology of alcohol. The present study evaluated the effect of early prenatal alcohol exposure (assessed during pregnancy) on reaction time, attention and distraction in 475 young school-age children who took a computerized CPT vigilance task. Multiple regression analyses were adjusted for a variety of co variates including other exposures, postnatal conditions and demographics. Prenatal alcohol exposure was most significantly related to CPT errors of commission, reaction time, and the vigilance errors summary score. Error scores on the vigilance task were also significantly correlated with independent behavior ratings of endurance, persistence, organization, distractibility and impulsivity. This study supports and extends earlier reports of alcohol-related attentional deficits observable in the neonatal period and in the preschool years. PMID- 3808188 TI - Effects of single exposure to toluene on shock avoidance and time estimation in rats. AB - Behavioral effects of a single exposure to toluene were investigated on 12 rats by means of a shock avoidance task in a shuttle box. After 10 days of acquisition training, 3 groups of 4 rats were exposed to toluene vapor for 4 hr at concentrations of 8,000, 4,000, and 2,000 ppm. The maintenance of shock avoidance and time estimation was examined immediately after, and at the 3rd and 6th hr after the 4 hr toluene exposure. No avoidance response occurred immediately after 8,000 ppm toluene exposure, but it was recovered by the 3rd hr after exposure. Both 4,000 and 2,000 ppm toluene exposures increased the percentage of avoidance response. The response latencies (RLs) were significantly shortened after toluene exposure and the relative frequency distribution of RLs was shifted toward a shorter RL. The shortening of RLs could be attributed not only to the excitatory effect of toluene but also to the acceleration of response initiation. It is possible that toluene-exposed rats estimated the time interval to be longer than the real time, and that this over-estimation of the time interval hastened the timing of response initiation. PMID- 3808189 TI - [Transthoracic approach and costotransversectomy in thoracic discogenic disease]. AB - The thoracic discogenic disease is the rarest, yet is most devastating of all disc lesions. The clinical manifestations including myelopathy and radiculopathy are not characteristic, therefore accurate radiological diagnosis has to be made by carefully performed myelography and CT, and recently by MRI. Historically conventional laminectomy has been attended with terrible results such as paraplegia. Therefore transthoracic approach and costo-transversectomy have been the procedure of choice in recent years, and these procedures can be performed safely and effectively without serious complications with help of the operating microscope. Transthoracic approach is a more decisive anterolateral operation for the central disc and the spondylotic spur in the midthoracic spine with excellent visualization of the anterior aspect of the spinal cord. On the other hand, costrotransversectomy is a less formidable posterolateral approach and it provides a reasonable exposure to the lateral disc and the enlarged facet in the lower thoracic spine. The details of the both operative procedures were discussed by using illustrations. PMID- 3808190 TI - [Evaluation of the hypertensive intracerebral hematoma based on the study of long term outcome--Part II. A role of surgery in putaminal hemorrhage]. AB - Since CT was introduced, 355 cases of putaminal hemorrhage were experienced and surgical indication was evaluated in relation to long-term outcome (ADL). Among these cases, 198 (55.8%) were from operated group and 237 cases (66.8%) were admitted within 6 hours of onset. Comparison of ADL among operated, operated within 6 hours and non operated group was done. In general, results showed no advantage of surgery, and surgery at super-acute stage (within 6 hours). However it showed some surgical advantage in Moderate type, cases of operated within 6 hours and some Severe type. PMID- 3808191 TI - [Experimental study on brain tissue of microfibrillar collagen hemostat (Avitene)]. AB - Microfibrillar collagen hemostat (Avitene) is a new absorbable topical hemostatic agent, of which hemostatic mechanisms are adhesion to the bleeding site and platelet aggregation. Avitene was used to obtain hemostasis and compared with Gelfoam or Oxycel in the injured cerebral cortex in a rabbit. The animals were killed and the lesions were examined grossly and microscopically to evaluate its biocompatibility in the cerebral cortex. Histopathological examinations revealed that Avitene was biocompatible with cerebral cortex in a rabbit. Electroencephalographies did not show the epileptogenic focus when Avitene was applied on the cerebral cortex in a rabbit. It has been applied for the bleeding during surgery for several years. Its effectiveness of hemostasis has been well known. This study indicated that Avitene is very effective and safe to use as a topical hemostatic agent during craniotomy in a rabbit. Therefore, this agent may be useful in a patient with minor and diffuse bleeding in the neurosurgical field. PMID- 3808192 TI - [Treatment of recurrent chronic subdural hematoma--setting an Ommaya tube]. AB - The rate of postoperative recurrences of chronic subdural hematomas is high. Several methods have been advocated, but each one remains controversial. We proposed a simple method of setting an Ommaya tube after burr-hole evacuation. The reservoir was placed in the subcutaneous space, the tip of the tube was placed in the subdural space. The reservoir was punctured with a needle, thereby allowing aspiration of fluid from the subdural space. Sixty one cases of chronic subdural hematomas were operated by simple burr-hole evacuation. The Ommaya tube was used in 46 selected patients.: 1) the volume of hematoma was more than 100 ml and, or 2) older than 70 years of age. Reaccumulation of subdural effusion was detected in 10 cases. The subdural effusions were drained by percutaneously needling the reservoir of the Ommaya tube. This procedure was curative in 9 of the patients. However 1 patient required a small craniotomy. The patient had two outer membranes therefore inner hematoma could not be removed. The authors propose this technique and discuss about it. PMID- 3808193 TI - Assessment of outcome prediction in severe brain damage patients with brainstem auditory evoked response. AB - Patients with various neurological disease resulting in severe brain damage and having Glasgow Coma Scale (G.C.S.) score of less than ten (mean 5.6) were studied with brainstem auditory evoked response (BAER) during the first few days of onset. Among them were subarachnoid hemorrhage, head injury, intracerebral hemorrhage, pontine hemorrhage, intraventricular hemorrhage and bleeding tumor. BAERs were graded into four levels from one (normal) to four (most abnormal). Outcomes were categorized through the Glasgow Outcome Scale. Comparison of the results between BAER and G.C.S. as predictors of outcome was quite similar. Both were reliable in terms of predicting a correctly pessimistic outcome (90% or more), but not a correctly optimistic outcome (40% or less). PMID- 3808194 TI - [Flow cytometric and karyotypic studies on meningiomas]. AB - Although meningiomas have been regarded as one of the benign brain tumors, cases showing clinically malignant behavior have been reported. For the purpose of detecting the possibility of predicting different biological behavior in meningiomas, eleven meningiomas were studied with the aid of flow cytometric (FMC) and cytogenetic techniques. Morphologically two cases were diagnosed as syncytial meningiomas and nine as transitional meningiomas. The former included one case (#5) of "syncytial poorly structured meningioma" (Zang et al.). In the FCM study seven out of eleven cases showed diploid (2C) or near diploid modal peaks with small amounts of tetraploid DNA (4C) cells. The remaining four cases had larger cell populations at 4C. Cytogenetically cells corresponding to 2C and near 2C peaks were also proved to be composed of diploid or hypodiploid cells in all of the eight cases studied. Chromosomal analyses revealed normal karyotypes in three. The remaining five hypodiploid cases had common chromosomal aberrations in G22, including missing chromosome 22 in four cases and 22 q-deletion in one. Nine cases grown in culture were also studied by FCM and were able to be maintained in culture from 14 days to 5 months. Close to the terminal stage of culture, most of the cases in culture tended to have higher cell population at 4C and the appearance of cells even at 8C (polyploidization). Similar changes were also obtained in cultured human fibroblast and seem not to be specific to this benign tumor. These results are discussed with reference to the previous reports from the point of view of patterns of FCM histograms from surgical specimens, degree of hypodiploidy, morphological behavior. Further studies, especially relating to basic cell kinetics are needed before clinical application can be made. PMID- 3808195 TI - [Superficial temporal to superior cerebellar artery anastomosis for rostral brain stem infarction]. AB - The authors report a case of superficial temporal to superior cerebellar artery anastomosis (STA-SCA anastomosis) for progressing rostral brain stem infarction with an excellent result. Precise operative techniques were also described. A 47 year-old male was admitted to our hospital on November 9, 1984, because of sudden onset of dysarthria and ataxic gait. CT revealed a low density area in the pons. Left vertebral angiogram showed occlusion of the left vertebral artery just distal to the origin of the posterior inferior cerebellar artery (PICA). Arterial branch of the left cerebellar hemisphere were filled via the left PICA to the left SCA and anterior inferior cerebellar artery anastomosis. Right brachial angiogram showed the hypoplastic right vertebral artery which ended at the PICA. The rostral basilar artery, both posterior cerebral arteries (PCA's) and right SCA were filled through anastomosis from the right PICA. The posterior circulation was not filled by either of the carotid arteries. In spite of antiplatelet agglutination therapy, the patient had two more episodes of dysarthria, dysphagia, right hemiparesis and gait disturbance. Because of progressing stroke, STA-SCA anastomosis was carried out on the right side on February 27, 1985. During operation, the blood pressure was maintained above the level of 130 mmHg, and intravenous mannitol injection and spinal drainage were done to preserve the right temporal lobe from intracerebral hematoma and/or edema caused by retraction. Postoperatively, the patient has been free from new ischemic attack. He has only slight hemiparesis now eight months after operation. Right external carotid angiogram showed a patent STA-SCA bypass and good filling of SCA's and PCA's bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808196 TI - [Operated case of cerebral venous angioma with early venous filling on cerebral angiography--case report]. AB - A 34-year-old woman had a generalized convulsion of sudden onset on April 30, 1985. The next day, she suffered a reattack of generalized convulsion. She was admitted to Kokura Memorial Hospital on May 13, 1985, and was found to have intracerebral hemorrhage on CT-scan then, underwent surgical procedure. Based on cerebral angiographic findings and histological examination, the diagnosis of cerebral venous angioma was done. Cerebral venous angioma is a relatively rare vascular malformation. Its characteristic angiographic findings are a normal arterial phase and a local network of small vein that converged centrally into a single large vein. However, this present case of venous angioma in the left frontal lobe with hematoma showed not only characteristically enlarged medurally vein, but also early venous filling. The literature of operated venous angioma with early venous filling of the brain are reviewed and discussed. PMID- 3808197 TI - [Posterior fossa subdural hematoma in neonates: report of two cases and review of the literature]. AB - Posterior fossa subdural hematoma in neonates caused by birth trauma is rare; only 30 clinical cases can be found in the literature so far. Here we experience two similar cases and review that literature. Case #1 is that of a full-term female born in the pelvic position. At 21 hours after birth she developed convulsions and a CT scan revealed a high-density area, mainly in the right posterior fossa. On the fourth day, a right suboccipital craniectomy was performed and about 15 ml of hematoma was removed. At present her mental and somatic development is appropriate for her age (5 months), despite the fact that moderate brain atrophy was seen in the CT scan taken at 4 months. Case #2 is that of a full-term female also born in the pelvic position. At 38 hours she became convulsive and opisthotonic; a CT scan revealed a high-density area in the posterior fossa. No neurological abnormality was seen thereafter, however, and she was treated conservatively. On the 18th day, the high-density area in the CT scan had almost disappeared. In the CT scan taken at 6 months moderate brain atrophy was seen, but at the present age of two she evidences quite normal development both mentally and somatically. These cases lead us to emphasize the importance of prompt diagnosis followed by removal of hematoma, and the usefulness of CT scan as a diagnostic method in clinical manifestations of this sort. PMID- 3808198 TI - [A case of posttraumatic vascular abnormality similar to dural arteriovenous malformation]. AB - A case of posttraumatic vascular abnormality similar to dural arteriovenous malformation is reported. A 21-year-old man was injured in the traffic accident and admitted to our hospital with comatose state. Bilateral carotid angiograms revealed no abnormal findings. Then, he was treated conservatively as a diagnosis of cerebral contusion. Nine years after the initial admission, he was fallen into comatose state suddenly and admitted to a local hospital. On the next day, he was transferred to our hospital. Neurological examination disclosed comatose state, right oculomotor palsy, and left hemiparesis. CT scan showed a crescent shaped high density area in the right subdural space, right temporal intracerebral high density area, and left frontal low density area, suggesting right acute subdural hematoma, right temporal intracerebral hematoma, and left frontal old cerebral contusion respectively. Right carotid angiogram revealed an abnormal vascularity in the right middle fossa, which was fed by the middle meningeal artery and drained into the superior sagittal sinus and the transverse sinus. Surgical treatment was performed immediately. Following the evacuation of intracerebral hematoma, the abnormal vascular mass suggesting a nidus of arteriovenous malformation was removed totally, that was attached to the dura mater. Pathological specimen showed large veins and arteries with thrombus, however, no characteristic feature of arteriovenous malformation. Then, this was thought to be an arteriovenous fistula between the branches of middle meningeal artery and the veins of fibroglial scar following by the cerebral contusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808199 TI - [Tuberous sclerosis with intraventricular tumor: report of 2 cases]. AB - It is well known that intraventricular tumors are occasionally seen in patients with tuberous sclerosis. We have experienced two cases of tuberous sclerosis with intraventricular tumor. Case 1: an 8-year-old girl was admitted to our clinic because of headache and vomiting of one month's duration. She had adenoma sebaceum, mental retardation and seizures clinically, and a large tumor was found in the right lateral ventricle by pneumoventriculography. Partial removal of the tumor was performed by the right frontal transcortical approach, but she later died of pneumonia. Necropsy revealed hamartomatous disease characterized by multiple focal tumor-like malformations in various organs including the brain, kidneys, heart, lungs and liver. The histological diagnosis of the intraventricular tumor was subependymal giant cell astrocytoma. Case 2: a 6-year old boy was admitted to our clinic because of headache of one year's duration. He had also suffered from seizures since 6 months of age. Adenoma sebaceum was noted in the cheeks. CT revealed a medium sized tumor at the right foramen of Monro and the moderately dilated right lateral ventricle and several calcified deposits in the lateral ventricle wall. The tumor was subtotally removed by the right frontal transcortical approach. The pathological examination showed subependymal giant cell astrocytoma. Now 6 years after the operation he is enjoying a normal school life. In our cases, intraventricular tumors associated with tuberous sclerosis were of a typically benign histological appearance, that is subependymal giant cell astrocytoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808200 TI - [Pituitary abscess: report of two cases and a review]. AB - Two cases of pituitary abscesses are reported. The first case was a 22-year-old female who was admitted with 14 months history of intermittent fever and headache followed by amenorrhea and polyuria. Plain craniograms showed no remarkable changes on the sella turcica. Direct coronal CT demonstrated a cystic lesion with a ring-like enhanced capsule in the pituitary complex with the apparent bulging of the pituitary top surface. On dynamic CT, the cystic lesion showed no remarkable increase in density. Transsphenoidal surgery was performed and a purulent materials was drained by cutting the underlying fibrous pituitary tissue. Pathological specimen revealed a marked inflammatory reaction around the degenerative pituitary gland. The second case was a 27-year-old female who underwent transsphenoidal excision of craniopharyngioma on May 12, 1983. Postoperatively she did well with the hormonal replacement therapy until 9 months after surgery when a follow up direct coronal CT revealed a cystic lesion with ring-like enhancement in the pituitary fossa. Purulent material was found at transsphenoidal surgery. Pathological specimen from the hard capsule was a chronic inflammatory fibrous tissue without tumorous component. Over seventy cases of pituitary abscesses have been reported previously, but the majority of them were secondary infections associated with systemic sepsis, chronic sphenoid sinusitis or pituitary tumors. Primary pituitary abscesses were rare and would be difficult to be diagnosed preoperatively without an aid of recent CT technology. Thirty cases in the literature since 1970 are reviewed and its clinical pictures and radiological findings are discussed. PMID- 3808201 TI - [Dural arteriovenous malformation of the anterior fossa with subarachnoid hemorrhage]. AB - Idiopathic dural arteriovenous malformation which occurs in the posterior fossa uses predominantly transverse and sigmoid sinuses. Cavernous sinus comes next and others are rather rare. However, we have recently experienced such a rare case which was operated on and cured completely. The malformation was fed through the anterior ethmoid artery and drained to the cortical vein. The case was a 36-year old male and admitted in our clinic for having headache and nausea as the chief complaints. He was diagnosed subarachnoid hemorrhage due to the following findings: CT scans showed a high density zone localized in the sylvian vallecula. Cerebrospinal fluid obtained by a lumbar puncture was found to be bloody. No neurological abnormality other than neck stiffness and positive Kernig's sign was observed. Under study of right carotid arteriography, dural AVM was evident. The anterior ethmoidal artery which branched out from the ophthalmic artery fed the AVM. The cortical vein which ran on the surface of the frontal base was its drainer via a small nidus. There was no abnormality seen on a left carotid arteriogram. Surgery was proceeded with the right frontal craniectomy in extra- and intradural approach. At first, anterior ethmoidal artery was cut at the cribriform plate extradurally. After dura was incised, both the nidus and drainer were coagulated intradurally. The nidus was located at inner surface of the dura. The arachnoid hemorrhage was thought to be caused by rupture of this drainer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808202 TI - [A case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography]. AB - One case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography is reported. A 44-year-old female slipped and hit her head without loss of consciousness, one month ago. Recently she complained of headaches and visited the department of Neurosurgery, Washokai Sadamoto Hospital on May 21, 1985. There were no physical and neurological signs on examination. Plain CT scans showed a crescent-shaped high density area in the left frontal region with a slight mass sign. She was diagnosed as having a possible chronic subdural hematoma and further examination was recommended. Biplane ultrafast overlapping cerebral computed angiotomograms clearly demonstrated a so-called avascular area delineated by enhanced superficial cerebral vessels with contrast medium. Furthermore, a marked high density mass measuring 8 mm X 10 mm X 6 mm in diameters was simultaneously demonstrated around the right anterior clinoid process on the same image, suggesting a cerebral aneurysm. Right carotid angiograms showed a right internal carotid-posterior communicating junction aneurysm. The irrigation of the left chronic subdural hematoma was carried out on May 24 and the neck clipping of the right IC-PC junction aneurysm was done two weeks later. During the operation, there were no findings suggesting a previous subarachnoid hemorrhage from the aneurysm, but a bleb was found on the aneurysm. The post-operative course was uneventful. Since the introduction of the CT scanner, chronic subdural hematomas are usually operated without cerebral angiograms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808203 TI - [Evaluation of the hypertensive intracerebral hematoma based on the study of long term outcome--Part III. Evaluation of neurological grading and CT classification]. AB - It is very important to have a standard neurological grading system and CT classification for "putaminal hemorrhage" to compare, contrast and discuss the results and the surgical indications of various workers. We evaluated 355 cases of putaminal hemorrhage for their long-term outcome by using neurological grading and CT classification of Kanaya et al and compared it with our new classification based on the mode of hematoma extension. The long-term outcome (ADL) showed a better correlation with our new classification. While by using the earlier method (Kanaya et al), there was no significant statistical difference in the ADL between the patients of neurological grade IVb & grade V and also between the patients of CT class II and IIIa. In this classification, the definition of CT class V is not clear as the putaminal hemorrhage does not penetrate into the thalamus. It also ignores the upward or downward extension of the hematoma. Therefore, we emphasize the need for the modification of the presently existing neurological grading system and the CT classification for a better correlation with the long-term outcome. PMID- 3808204 TI - [Effect of calcium antagonist (diltiazem) on symptomatic cerebral vasospasm--with special reference to CT classification]. AB - CT is important for detecting subarachnoid clots and intracerebral or intraventricular hemorrhage. The presence of subarachnoid clots surrounding the cerebral arteries may be one of the causes of cerebral vasospasm. It is agreed that there is a correspondence between the site of subarachnoid clots and the location of cerebral vasospasm. The authors have already reported that the appearance and severity of symptomatic cerebral vasospasm were not affected by calcium antagonists (Diltiazem), but the prognosis improved significantly for 105 patients (especially Hunt-Hess grade II and III) at the 3-month follow-up examination. In this study, the above 105 patients, each with a ruptured supratentorial aneurysm, were classified preoperatively according to Fisher's CT grading system and the effect of Diltiazem was re-examined. Patients in Hunt-Hess grade V were excluded and the duration of treatment with Diltiazem was 2 weeks following the operation. 105 cases (Diltiazem) were compared as a control group with 100 cases who were operated on before the administration of Diltiazem. The frequency of occurrence of symptomatic cerebral vasospasm tended to decline in patients with a CT grade of 2 or 3, and the prognosis improved significantly for 105 patients including 32 cases with symptomatic cerebral vasospasm. The preliminary results here indicate that Diltiazem might be especially effective for patients of Hunt-Hess grade II and III with CT grades of 2 and 3. PMID- 3808205 TI - [Development of cerebral blood flow measurement using skull impedance plethysmography]. AB - Using skull impedance plethysmography, a developmental approach was made to the measurement of mean cerebral blood flow (mCBF) from brain volume exchanging ratio (delta V) involved in bilateral jugular venous occlusion. An experimental study thereof revealed the following results: Comparative examinations were made between total cerebral blood flow obtained by the superior sagittal sinus hydrogen clearance method and delta V X t obtained by the present approach led to the establishment of a linear correlation there between and also of the following calculating formula: mCBF = k X delta V X t (omega X sec) k: proportional coefficient t: blood flow increasing time (10 sec.) The experimental results revealed that the present approach was valid enough as an index of cerebral blood flow. Some future improvements therein seem to make also its clinical application possible. The theory and method of the present approach are described with an examination of several points raised thereby. PMID- 3808206 TI - [A new superselective balloon catheter--all-silicone catheter with a floppy tip]. AB - We have introduced concept of "chemical" embolization and have tried to develop a new agent which would enable us to embolize the lesion with one-shot injection. Such an agent must be able to occlude diffusely the lesion distal to the catheter. This has made it mandatory to develop a new catheter which can be introduced into the vessel as close to the lesion as possible with fewer risks of clot formation and/or vessel damage. A new superselective balloon catheter for angiography and infusion of liquid embolizing materials has been developed. This catheter consists of a proximal relatively stiff silicone catheter, a short distal thin-walled flexible silicone catheter and silicone balloon. These three silicone components are connected by silicone adhesives. The distal catheter allows us to catheterize fine arteries such as lenticulostriates, while the proximal catheter assures easy manipulation. This balloon catheter can be used for superselective angiography and infusion of liquid embolizing materials. It has been used on nine patients; one with a dural arterio-venous malformation (AVM), four with meningiomas, and four with brain and spinal cord AVMs. In the case of dural AVM and meningiomas, it was possible to easily introduce into the middle meningeal artery distal to the foramen spinosum. In addition, in one of the cases of meningioma, we were able to catheterize one of the main feeding pedicles beyond the pterion. Chemical embolization was carried out in 5 cases with good results. In the case of brain and spinal cord AVM, useful information was obtained from the superselective angiography.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808207 TI - [A case of idiopathic brain stone presenting as psychomotor epilepsy]. AB - A rare case of idiopathic brain stone with psychomotor epilepsy is reported. On December 9, 1982, a 29-year-old man with 18 years' history of psychomotor epilepsy was admitted to our neurosurgical service. He had no history of neonatal asphyxia, trauma or other neurological diseases. No neurological deficit was disclosed. Skull x-ray films and plain CT scan demonstrated a calcified mass in the right temporal lobe. No contrast enhancement was noted. Despite an extensive search, the etiology of the calcified mass was not revealed. Conventional EEG showed focal spike discharges in the right anterior temporal lead and telemetered EEG monitoring for 24 hours disclosed sharp wave burst in the right temporal lobe. In spite of appropriate medication, seizures persisted. At surgery, electrocorticogram and stereo-electrocorticogram showed paroxysmal epileptiform events in the right temporal lobe. Anterior temporal lobectomy with excision of calcified mass was done. Histopathological examination demonstrated thick collagen fibers and gliosis around the stone, and diagnosis of idiopathic brain stone was made. We reviewed five previously reported cases. We also emphasized an epileptogenicity of idiopathic brain stone and indication of surgical excision which may result in an excellent control of epilepsy. PMID- 3808208 TI - [A case of intracranial hypoglossal neurinoma]. AB - A case of intracranial hypoglossal neurinoma is reported. A 32-year-old man with a history of unsteady gait and headache for one and a half years was admitted to our hospital on September 23, 1983. Neurological findings on admission were nystagmus toward the left, left IXth and Xth cranial nerve paresis, left cerebellar signs, paresthesia of the left upper and lower extremities on neck flexion, and left pyramidal signs. Atrophy or fasciculation of the tongue was not noted. Computed tomography demonstrated a large isodensity and partially low density mass in the posterior fossa which was markedly enhanced and sharply margined with contrast medium. The tumor extended 45 mm over the edge of the foramen magnum. The maximum size was 45 mm X 40 mm. The coronal and sagittal reconstruction CT scan clearly demonstrated the attachment and extension of the tumor. Enlargement of the hypoglossal canal was clarified by changing the window level, window width and using 2 mm slice CT scan. Anterior-posterior x-ray view of the skull tomography showed enlargement of the hypoglossal canal, as indicated by the CT scan. The left hypoglossal canal was 7 mm and right was 3 mm in diameter. Vertebral angiography demonstrated that the tumor was located in the left posterior fossa, but no tumor stain appeared. This patient did not have XIIth cranial nerve palsy, but the neuroradiological findings strongly suggested a hypoglossal neurinoma, especially the findings of the CT scan and the anterior posterior x-ray view of the skull tomography. On October 5, suboccipital craniotomy with Cl laminectomy was performed in prone position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808209 TI - [Deep sylvian meningioma: case report and review of the literature]. AB - A case of intrasylvian meningioma is presented with some considerations to the clinical, radiological, and pathological features of the tumor. A 34-year-old Japanese woman, who had experienced several episodes of fainting attacks since 19 years old, was admitted to our hospital on March 22, 1983. Her plain skull roentgenogram showed abnormal calcification in her left fronto-temporal region. CT scan demonstrated clear-marginal high density mass in the left sylvian fissure which was homogeneously enhanced after administration of contrast medium. Left carotid angiogram showed intrasylvian mass with small tumor stain in late arterial phase, but external carotid artery had no concern with this tumor. On March 30, left fronto-temporal craniotomy was performed. The tumor was located in the extra-axial space of the sylvian fissure without any attachment to the dura mater or to the choroid plexus of the ventricles. This hard tumor, 70 grams in its weight, was successfully removed. It was histologically diagnosed fibroblastic meningioma. The patient was discharged without any neurological deficits. Twenty-four cases of meningiomas not attached to the dura mater or to choroid plexus could be reviewed from the literature. This type of meningioma is occasionally called "deep sylvian meningioma", but in some reports the tumors developed far from sylvian fissure. And even in the cases in which the tumors were reported to be located in the sylvian fissure, macroscopic space where tumors developed was various. The clinical features, diagnosis, and surgical management of this tumor were also discussed in the report. PMID- 3808210 TI - [A case of arachnoid cyst in the middle cranial fossa presenting with trigeminal neuralgia]. AB - A 50-year-old man had been suffering from left trigeminal neuralgia for 30 years. CT scan revealed an arachnoid cyst occupying the anterior two-thirds of the left middle cranial fossa. Cerebral angiography showed elevation of the left middle cerebral artery and medial shift of the left posterior cerebral artery. Metrizamide CT showed that the cyst was not communicating with the subarachnoid space. Air CT revealed the root of the left trigeminal nerve in contact with the arachnoid cyst. The patient became completely free from the trigeminal neuralgia 6 months after cystoperitoneal shunt. This case seems to be a very rare case of trigeminal neuralgia caused by an arachnoid cyst. PMID- 3808211 TI - [A case of convexity cavernous hemangioma associated with meningioma]. AB - A case of convexity cavernous hemangioma associated with sellar meningioma with parasellar extension is presented. A 61-year-old female who had complained of left blepharoptosis and diplopia was admitted to our hospital. On admission she showed left oculomotor nerve palsy. Plain CT revealed an isodense mass in the sellar and parasellar region. Computed angiotomography demonstrated that this mass was enhanced heterogeneously and filled the sellar turcica and extended superiorly. And homogeneously enhanced mass in the convexity without mass effect was observed. Angiogram revealed no tumor stain in any phase. With these findings, this case was diagnosed as the multiple meningiomas preoperatively. Left frontotemporal craniotomy was carried out, and subtotal removal of sellar and parasellar tumor and total removal of convexity tumor were performed. Pathologically the sellar and parasellar tumor was diagnosed as meningioma, convexity tumor as cavernous hemangioma derived from dura mater. Convexity cavernous hemangioma derived from dura mater is very rare, only one case was reported previously. Only 2 cases of cavernous hemangioma associated with meningioma have been reported in the literature. Correlation between cavernous hemangioma and meningioma is discussed. It is possible to owe this complication to the developmental abnormality concerning with inner factor like genetic factor and so on, because both tumors are mesodermal origin. However it is proper to regard that this complication occurred by chance. PMID- 3808212 TI - [Kleeblattschadel syndrome--a case report]. AB - The Kleeblattschadel syndrome is a type of craniofacial dysostosis having a trilobar deformity of the skull associated with congenital hydrocephalus. We present here a case of the anomaly which we operated on a patient for cranial correction and orbital decompression. The case is a 2-month-old female who was born after 40 week-gestation by spontaneous vaginal delivery with cephalic presentation and observed no abnormality in her vital signs. She was transferred to a neonatal intensive care unit because of her trilobar deformity of the head and severe proptosis. Plain X-ray films of the skull indicated a number of digital markings at the calvarium. The triobar configuration was formed by symmetrical outward protrusion of the bilateral temporal squama and bulging the vertex which made a high valt. The coronal and lambdoid sutures which were prematurely closed together could not be distinguished individually. Both sides of temporal squama were found to be quite thin. She had severe shallow orbit due to the maxillary hypoplasia. A ventriculomegaly was seen in CT scan. Cranial corrections were took place in two stages. A V-P shunt was also done. The first surgery was conducted at three months old for advancing the bifrontal part and decompression of the orbits. Bilateral frontal bone was removed by craniectomy cutting along with both sides of the prematurely closed coronal suture in the back and to the supraorbital ridge in the front after making bicoronal scalp incision on supine position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808213 TI - [Osteoma of the sphenoid sinus--report of two cases]. AB - Although osteoma of the paranasal sinus is comparatively common, involvement of the sphenoidal sinus region is extremely rare. Lame reported that a total of twelve cases had been described in the European literature since 1800. Mikaelin, Kulczynski and Dolan, since then, described three cases. This paper deals with two surgical cases of sphenoidal sinus osteoma, reviewing literature on paranasal sinus osteoma and differential diagnosis in the sphenoidal sinus lesion. Case 1. A 20-year-old man was referred to us by an ophthalmologist, complaining of left visual disturbance (visual acuity: 0.02). He had a past history of chronic sinusitis. Neurological examination revealed papilledema on the left. Plain skull X-ray film showed marked destruction of the sphenoidal sinus and tomography demonstrated thinning and expanding of the sella floor with cloudiness in the sphenoidal sinus. CT scan showed an irregular high density mass in the sphenoidal sinus. Sublabial-nasoseptal sphenoidotomy was performed. The sinus was occupied by homogeneous osseous tissue surrounded by thin fibrous tissue. The osseous part was removed as much as possible by a high speed air drill. Histopathologic examination confirmed mature osteoma. Postoperative course was uneventful and left visual acuity was improved up to 0.06. He is now doing well without recurrence for six months. Case 2. A 59-year-old woman was admitted to our hospital, complaining of acromegaly for ten years. She had a past history of chronic sinusitis, hypertension, diabetes mellitus and left putaminal hemorrhage which was evacuated five months before. She had typical acromegalic features and serum levels of growth hormone was 65.8 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808214 TI - [Growth hormone-producing pituitary adenoma in an 8-year-old girl: case report]. AB - A rare case of pituitary adenoma in childhood presenting as giantism is reported. A 6-year-old girl came to our attention in 1982 because of excessive growth noted since the age of 3 yr. Her appearance revealed giantism. She also had a 4 year history of genital bleeding, but no development of external genitalia nor mammary gland. Endocrinological studies revealed markedly elevated serum basal levels of both growth hormone (GH) and prolactin (PRL). She had a bromocriptine therapy for 1 year and 8 months, but it was difficult to suppress her excessive growth rate. So she was admitted at the age of 8 years to undergo the operation. Visual fields were intact. X-ray examination of the skull demonstrated a slightly enlarged sella turcica. Computerized tomography revealed an isodense mass at the pituitary fossa without extrasellar extention. Repeated endocrinological studies were carried out. Basal levels of GH and PRL were 43.8 ng/ml and 67 ng/ml. All other pituitary function were normal, except for puberal responses of luteinizing hormone (LH) and follicle stimulating hormone in LH-RH loading test. 50 g oral glucose tolerance test was normal. Transsphenoidal microsurgery was performed in August 1984. The tumor filled up the pituitary fossa with fibrous element. Histological examination disclosed a mixed adenoma, predominantly chromophobe, with a few granulated eosinophils. Immunoperoxidase staining was also performed on the adenoma. Most of the tumor cells stained for GH, and a few of them stained for PRL. Postoperatively hypopituitalism was not complicated. Surgery produced a decrease in serum PRL level under 20 ng/ml, but serum GH level was not enough reduced under 10 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808215 TI - [Cerebral ischemic lesions in children and primary cerebral angiitis: report of two cases]. AB - Case 1. A seven-year-old boy was admitted to our hospital shortly after developing right hemiplegia and motor aphasia during rope-jumping play. Neither cervical trauma nor signs of cervical and pharyngeal inflammation were present. The physical examination was negative. The carotid angiogram on the day of admission gave poor visualization of the middle cerebral artery group, although the computerized tomographic finding was not remarkable. His neurological status gradually got better, while the routine laboratory studies gave only a slight increase of ESR (26 mm/hour) and positive CRP(I+). There were no particular findings of CSF from lumbar tap or of serological studies. The second computerized tomographic scan 42 hours after clinical onset showed a wide low dense area with obscure margin in the left parieto-temporal region, which was enhanced variously with intravenous contrast media. In about ten days his clinical state was remarkably improved. The second carotid angiogram one month after admission showed a poor filling of the middle cerebral artery territory and beaded appearance of the artery. The patient was discharged on the 46th day with a minimum right hemiparesis. Case 2. A ten-year-old boy was admitted with complaint of right hemiparesis and motor aphasia developing at night. The physical examination was negative. The laboratory studies were also negative. The computerized tomographic scan five days after onset showed a low dense area in size of 2 x 1.5 x 2 cm in the region of the left Nucleus lentiformis. No enhancement effect was seen. The left carotid angiogram on the same day revealed stenotic lesions at the M1 and the posterior temporal artery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808216 TI - Peptidergic neurosecretory axons regenerate into sciatic nerve autografts in the rat hypothalamus. AB - Pieces of intact or degenerated sciatic nerves autografted into contact with transected neurosecretory axons within the hypothalamus were invaded by neurophysin-positive axons. With increasing time after grafting, increasing numbers of axons were present in both types of grafts, but grafts of degenerated sciatic nerves always contained more axons. At the fine-structural level typical neurosecretory as well as nonneurosecretory axons were usually associated with basal lamina-enclosed neurolemmocyte processes; occasional axons occurred among collagen fibrils or within basal lamina scaffolds. Profiles with the fine structural characteristics of axon terminals were present by 20 days after transplantation. PMID- 3808217 TI - Differentiation in male ferrets of a sexually dimorphic nucleus of the preoptic/anterior hypothalamic area requires prenatal estrogen. AB - Experiments were conducted to determine when during perinatal development testicular steroids act in ferrets to promote the organization of a bilateral nucleus in a medial position at the border of the preoptic area (POA) and anterior hypothalamus (AH), henceforth referred to as the male nucleus of the POA/AH (MN-POA/AH). The formation of the MN-POA/AH was promoted in female offspring by treating their mothers with testosterone over the last 11 days of the 42-day gestation period, whereas MN-POA/AH formation was not disrupted in males castrated within 1, 2 or 5 days of birth. Additional experiments were conducted to determine whether the active hormone which induces differentiation of the MN-POA/AH in the male ferret is an androgen or an estrogen. MN-POA/AH formation was inhibited in males deprived prenatally of estrogenic stimulation via maternal ovariectomy and subcutaneous implantation of the aromatase inhibitor 1,4,6-androstatriene-3,17-dione (ATD) on gestational day 30. By contrast, MN POA/AH formation was not disrupted in males exposed prenatally to the antiandrogen flutamide. These results imply that estrogen, derived from the neural aromatization of circulating testosterone, acts prenatally to promote the organization of the MN-POA/AH in male ferrets. The development of sex-dependent features of forebrain morphology may depend on the neural action of estrogen in males of diverse mammalian species. PMID- 3808218 TI - Loss of estradiol-positive feedback action on LH release during prepubertal period in rats treated postnatally with an opiate antagonist. AB - The purpose of this study was to determine the role of endogenous opioid peptides in the differentiation of the neuroendocrine brain that leads to estradiol dependent LH release in female but not in male rats. Newborn intact or gonadectomized rats were given an opiate antagonist, naltrexone, with or without an opiate agonist, morphine, or saline alone during the critical period of the sexual differentiation of the brain (days 1-10). These animals were weaned on day 21 and injected with estradiol benzoate (EB) in oil or oil alone twice, 48 h apart, and the action of EB on plasma and pituitary levels of LH was studied. The release of LH during the prepubertal period was increased following EB treatment both in intact females and gonadectomized males and females, but not in intact male rats. Naltrexone treatment during the neonatal period prevented the EB induced LH release in both intact and gonadectomized rats. Morphine blocked the inhibitory effect of naltrexone on LH release. Naltrexone treatment did not directly affect pituitary LH storage, but prevented EB-induced depletion of pituitary LH pools; morphine blocked this action of naltrexone. Hence, the inhibitory effect of naltrexone on LH release appeared to result from an alteration of the central mechanism responsible for EB-induced LH secretion. These results suggest a possible involvement of endogenous opioid peptides in the neuroendocrine brain differentiation that results in LH release after EB treatment during the prepubertal period in rats. PMID- 3808219 TI - Differences in blood levels of androgens in female talapoin monkeys related to their social status. AB - Serum testosterone and androstenedione levels were lower in the subordinate female talapoin monkeys of four social groups than either dominant or intermediate-ranking females. This was found in both intact or ovariectomized (oestrogen-treated) animals, which suggests that androgen from the adrenals contributed to this rank-related endocrine effect. These differences disappeared when the females were housed singly, levels in all animals becoming similar to those in subordinates in the group cage. There were no rank-related differences in progesterone levels during either the follicular or luteal phase of the cycle in intact females, or in those of ovariectomized females of different rank, but cortisol was highest in dominant group-living animals in these experiments. Significant correlations were found between androgen levels in group-living females and the amount of sexual interest shown in them by males; the amount of aggressive interaction involving each female did not correlate with her androgen levels. Social rank is defined according to the direction, not the amount, of aggression. These findings suggest that the social hierarchy regulates androgen levels in these female monkeys; there may also be effects on the ability of females to respond to their own, or to administered, androgen. Similar findings have been made previously in male talapoins. Since androgens fill a critical role in the sexual behaviour of both sexes in primates, this may be a neuroendocrine mechanism of general significance relating behaviour to social rank. PMID- 3808220 TI - Impact of endocrine manipulations on brain-based rat growth hormone. AB - Our laboratory has previously described the widespread distribution of an immunoreactive and bioactive rat growth hormone (rGH)-like protein in rat brain. It has also been demonstrated that regulation of pituitary rGH secretion is at least partly mediated by a short-loop negative feedback system. In such a system, increased levels of rGH, acting at a suprapituitary locus, would decrease pituitary GH secretion. Thus, the present study has dealt with attempts to further investigate the hypothesis that one function of brain-based rGH might be as a mediator of the short-loop negative feedback system controlling pituitary rGH release. If brain-based rGH were to function as a mediator of such a system, then in situations where serum rGH levels are decreased, brain rGH concentrations should increase, indicating activation of a negative feedback loop. In the present communication we report that significantly decreased serum GH levels in oophorectomized and in thyroidectomized rats were coupled with a significant increase in rGH concentrations in the hypothalamus and in the amygdala. By contrast, adrenalectomy, which was not associated with any changes in levels of GH in serum caused no perturbations in levels of rGH in the brain. These discordant changes in serum and brain-based rGH are findings compatible with the hypothesis that one function of brain-based rGH is as a mediator of the short loop negative feedback system regulating the release of pituitary GH. PMID- 3808221 TI - Brattleboro rat hypothalamic neurons transcribe vasopressin gene: evidence from in situ hybridization. AB - In situ hybridization has been used to identify specific hypothalamic magnocellular neurons, in normal and Brattleboro rats, that contain vasopressin (VP) or oxytocin (OT) mRNA. The subnuclear distribution of identified neurons in hypothalamic magnocellular nuclei after hybridization with several probes specific for OT or VP mRNA was in direct agreement with immunocytochemical descriptions of the distribution of cells containing VP or OT hormone. The number of grains per cell suggested that Brattleboro rats contained greater levels of OT mRNA, while hybridization with VP probes produced fewer grains in tissue from Brattleboro rats compared to normal rats. This paper provides the first cell-by cell description of VP gene expression in the Brattleboro rat and demonstrates that VP gene transcription is confined precisely to the magnocellular neurons that normally synthesize VP hormone in normal rats. PMID- 3808222 TI - Adrenal secretion of epinephrine after stimulation of trigeminal nucleus caudalis depends on stimulus pattern. AB - Adrenal catecholamine secretion after stimulation of trigeminal nucleus caudalis (Vc) was compared to that evoked from more ventrolateral brain stem areas (VLM) by sampling adrenal venous blood in anesthetized cats. The effect of stimulus pattern on catecholamine secretion was assessed by presenting an equal number (300 pulses over 15 s) of electrical stimuli (75 microA, 0.2 ms) as a continuous pattern and as a burst pattern pulse train at each electrode site. Epinephrine secretion increased promptly by 1 min after burst pattern stimulation of Vc, whereas continuous pattern stimuli had no consistent effect. Burst pattern stimulation of VLM sites caused a small decrease in epinephrine secretion, whereas continuous pattern stimuli had no significant effect. Adrenal norepinephrine increased equally after Vc or VLM stimulation regardless of stimulus pattern. The adrenal catecholamine secretory responses could not be explained by the transient evoked changes in adrenal venous plasma flow or arterial pressure. The data indicate that stimulation of Vc evokes a pattern dependent increase in epinephrine secretion, whereas the increase in norepinephrine secretion is equal after burst or continuous pattern stimuli. Further, adrenal activation by brief neural stimuli cannot be assessed adequately in the cat by measuring epinephrine secretion alone, since stimulation of many ventrolateral brain stem sites caused a significant increase in norepinephrine secretion with no corresponding increase in epinephrine secretion. PMID- 3808223 TI - A1 noradrenergic input to medial preoptic-medial septal area: an electrophysiological study. AB - The effects of electrical stimulation of the A1 noradrenergic cell group on the extracellular activity of medial preoptic-medial septal (MPO-S) neurons were studied in ovariectomized (OVX) female rats under different hormonal conditions [estrogen and progesterone (E-P)-primed or unprimed] via conventional electrophysiological techniques. In addition, MPO-S neurons responding to the A1 noradrenergic cell group stimulation were characterized by examining their connections with the arcuate nucleus/median eminence (ARC/ME). With respect to stimulation of the A1 noradrenergic cell group, a large proportion of MPO-S neurons exhibited one of the following three types of orthodromic responses: orthodromic excitation (OD+), orthodromic inhibition (OD-), or complex orthodromic response (OD comp). The predominant type of response was OD+. Although E-P-priming did not change the relative proportion of neurons displaying a specific type of orthodromic response, it did increase the overall percentage of MPO-S neurons orthodromically responding to A1 stimulation (39% of MPO-S neurons responded to A1 stimulation in the E-P-primed group whereas only 25% of the neurons did so in the unprimed group). Neurons responsive to A1 stimulation were more likely to respond orthodromically to ARC/ME stimulation than were those neurons which were unresponsive to A1 stimulation. About one fifth of MPO-S neurons identified as projecting to the ARC/ME [putative luteinizing hormone releasing hormone (LHRH) neurons] orthodromically responded to A1 stimulation. The predominant type of response was OD+. The present study indicates that A1 noradrenergic input to MPO-S neurons is predominantly excitatory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808224 TI - Correlation of raised cord-blood CK-BB and the development of peri intraventricular hemorrhage in preterm infants. AB - This study concerns the prognostic value of total cord-blood CK-BB activity measured with a new method in preterm infants at risk of PIVH. Twenty-six patients with gestational age less than 36 weeks were studied. The presence of PIVH was proved by either ultrasound scans or autopsy. Total CK-BB values in cord blood of infants who developed PIVH were significantly higher than those of patients without cerebral bleeding (P less than 0.001). PMID- 3808225 TI - Brainstem auditory evoked potentials in severely malnourished children with kwashiorkor. AB - Brainstem auditory evoked potentials (BAEPs) were recorded in a group of 22 children hospitalized for the treatment of severe malnutrition (kwashiorkor). Recordings were repeated after three weeks of treatment. The control group consisted of age- and sex-matched healthy infants. Abnormal BAEP interpeak latencies (IPLs) were found in 32% of the kwashiorkor group in the initial recording and in 40% of this group in the follow-up recording. Abnormalities were evenly distributed between the I-III, III-V and I-V IPLs and in the majority of cases were unilateral. The influence of increasing stimulus rate was investigated. The findings may reflect defects in myelination of auditory brainstem pathways, however, BAEP abnormalities were not related to several indices of growth retardation or to serum albumin and hemoglobin levels. PMID- 3808226 TI - Influence of sleep state and age on body motility in normal premature and full term neonates. AB - To assess the distribution of body motility according to sleep states and age, we performed polygraphic tracings in 39 normal premature and full-term infants during the neonatal period, grouped according to conceptional age in weeks (wCA): 31-34, 35-36, 37-38, and 39-41 wCA. Movements of the upper and lower limbs (UL, LL) were recorded using piezo-electric crystals. Time passed with movements (TWM) was automatically measured at an accuracy of 0.01 seconds. Sleep states were defined according to EEG and REMs criteria. We did not find any significant difference when TWM was compared between age-groups before the 38 wCA, on both UL and LL. TWM decreases significantly after 39 wCA (p less than 0.01). In all infants studied TWM was significantly higher in active sleep (AS) than in quiet sleep (QS). TWM in indeterminate sleep (IS) was usually similar to that in AS. The prevalence of body motility during AS compared to QS further confirms the observation of differences in the control of physiological variables according to sleep states as early as 31 wCA (the lower limit of our study). PMID- 3808227 TI - Incidence of retinopathy of prematurity in low birth weight infants with peri intraventricular hemorrhage. AB - Data from 80 high-risk low birth infants were analysed to determine whether there is a clinical association between Retinopathy of Prematurity (ROP) and Peri Intraventricular Hemorrhages (PIVH) in preterm newborns. Diagnosis of retinopathy was made by retinal examination at approximately four weeks of age. All infants were routinely and repeatedly scanned by real-time ultrasound to diagnose the presence of Peri-Intraventricular Hemorrhages. PIVH was clearly present in 41 (51.2%) of them, whereas 39 (48.7%) infants had no evidence of intracerebral bleeding. We found no statistically significant association between cicatricial retinopathy and PIVH (P = 0.1). We suppose therefore, that the sensitivity of retinal vasculature and cerebral vasculature to the various factors considered to be important in the development of PIVH is different. PMID- 3808228 TI - AMP deaminase activity of skeletal muscle in neuromuscular disorders in childhood. Histochemical and biochemical studies. AB - We studied the histochemical staining and biochemical activity of AMP deaminase in biopsied muscle in Becker-type muscular dystrophy (BMD), Fukuyama-type congenital muscular dystrophy (FCMD), Duchenne-type muscular dystrophy (DMD), Werdnig-Hoffmann disease (WH) in order to elucidate the change of AMP deaminase activity in muscle with neuromuscular disorders in childhood. The intensity of AMP deaminase staining did not decrease in BMD with mild pathologic change, but in DMD, FCMD and WH it decreased in parallel with the severity of the pathologic change. The biochemical activity of AMP deaminase did not decrease in muscle with mild pathologic change in patients with DMD and tended to decrease according to the progress of the disease. The activity of AMP deaminase in muscle of patients with FCMD and WH which showed severe pathologic change was remarkably low. It was demonstrated that the decrease in the activity of AMP deaminase was related to the intensity of pathologic change rather than diagnosis of a neuromuscular disorder. PMID- 3808229 TI - Hypocarnitinemia in the handicapped individuals who receive a polypharmacy of antiepileptic drugs. AB - Decrease in the serum concentrations of total and free carnitine were found in patients who had received multiple doses of antiepileptic drugs, either including or excluding sodium valproate. These concentrations were more depressed in a former patient group. In all patients there were no abnormal losses of carnitine in urine. Several factors which may be relevant to the hypocarnitinemia were surveyed statistically. The univariate correlation analyses revealed that in all the patients the total and the free carnitine levels were each correlated with the values of arm muscle circumference, and they were inversely correlated with the dosages of sodium valproate. Double regression analyses again revealed that the value of arm muscle circumference is the most critical positive factor, and dosage of sodium valproate is the most critical negative contributor, to both the total and the free serum carnitine concentrations. There was, however, some additional negative contribution by the dosage of phenytoin to the total carnitine concentration. These results indicate that although sodium valproate itself reduces the carnitine concentrations in serum, a poor muscle volume and co administration of phenytoin with sodium valproate enhance hypocarnitinemia. PMID- 3808230 TI - Aneurysms of the posterior cerebral artery: report of ten cases. AB - Ten cases of posterior cerebral artery (PCA) aneurysm are presented. There were 13 aneurysms in the 10 patients: 6 saccular, 5 fusiform, 1 broad-based, and 1 giant fusiform serpentine aneurysm. Eight patients underwent operation: clipping for 2 saccular aneurysms, trapping for 1 saccular and 3 fusiform aneurysms, and coating for 2 fusiform or broad-based aneurysms. Microsurgical cerebral revascularization techniques were attempted in 2 cases: after a fusiform aneurysm had been excised, end-to-end anastomosis of the residual two ends of the PCA was performed and, after a giant serpentine aneurysm had been trapped, the superficial temporal artery was anastomosed transcortically to the distal PCA. Two patients died before operation because of rebleeding and vasospasm. Postoperative neurological deficits include contralateral hemiparesis, homonymous hemianopsia, hemihypesthesia, and ipsilateral 3rd nerve palsy. Our results suggest that, despite the good collateral circulation of the PCA, some ischemic events may occur after trapping procedures and that cerebral revascularization techniques may have some benefit in the treatment of unclippable aneurysms in this region. PMID- 3808231 TI - Subarachnoid hemorrhage with normal cerebral angiography: a prospective study on sellar abnormalities and pituitary function. AB - Ten consecutive patients with subarachnoid hemorrhage (SAH) of unknown cause were examined for sellar abnormalities and pituitary dysfunction. The diagnosis of SAH rested on a typical history and the demonstration of blood in the cerebrospinal fluid (computed tomography (CT), lumbar puncture). Initial CT and four-vessel angiography were performed in all patients, and five had repeat angiography. Endocrinological assessment was done after the initial angiography, and abnormal findings from this first study were reassessed 3 months later. The follow-up study included a high resolution CT scan of the sellar region. One patient had panhypopituitarism. Insufficient growth hormone secretion alone or combined with a low plasma concentration of estradiol or testosterone was found in another seven patients. The sella was ballooned or enlarged in three patients, and four patients had at follow-up a partly empty sella. A spontaneous development of a partly empty sella from an adenoma with suprasellar extension was observed in the patient with panhypopituitarism. This patient had experienced pituitary apoplexy with resulting SAH. Based on sellar enlargement, an empty sella, and pituitary dysfunction, this pathogenesis was suggested in another three patients. Our findings suggest that hemorrhagic necrosis in a pituitary adenoma may be an important cause of SAH with normal angiography. PMID- 3808232 TI - Anaplastic ganglioglioma in an infant: case report and review of the literature. AB - A 6-month-old girl had a gradually increasing head circumference. A preoperative computed tomographic (CT) scan of the head revealed an enhancing calcified partially cystic right frontal mass that was removed through a right frontotemporal craniotomy. On microscopic examination, the tumor was composed of sheets of neurons in a glial background alternating with highly cellular anaplastic areas. The diagnosis of anaplastic ganglioglioma was made. The child has done well for the 20 months since the operation without any evidence of tumor recurrence on subsequent CT scans. Because of the immaturity of the child's developing central nervous system, we have elected not to initiate radiotherapy at this time. The pertinent literature regarding gangliogliomas is reviewed. PMID- 3808233 TI - Unusual posterior fossa dural arteriovenous malformation in a neonate: case report. AB - We report the case of an infant born with an unusual posterior fossa dural arteriovenous malformation that was supplied by the entire intracranial circulation. The lesion caused hydrocephalus and congestive heart failure that led to the infant's death. PMID- 3808234 TI - Unilateral S-1 root compression syndrome caused by fracture of the sacrum. AB - Unilateral S-1 nerve root compression after an S-1 sacral fracture was found in an 18-year-old man after a motor vehicle accident. The positive myelogram, myelogram-computed tomogram, and magnetic resonance studies led to surgical intervention. Marked bony callous formation contiguous with the S-1 alar fracture protruded into the canal and was responsible for tethering the S-1 nerve root. A right L-5 hemilaminectomy, an L-4, L-5 and L-5, S-1 medial facetectomy, and foraminotomy facilitated nerve root decompression. Postoperatively, the patient was markedly improved. The authors suggest a more aggressive attitude in the diagnostic, radiographic, and surgical management of sacral fractures now that more specific technical facilities are available to define the precise character of the lesions involved. PMID- 3808235 TI - Metastasizing meningioma. AB - A very unusual case of metastatic spread of a meningioma is described. The clinical presentation was of extradural spinal cord compression, without evidence of a primary tumor. Computed tomography did not reveal any intracranial meningioma; the histopathology of the extradural spinal tumor was identical with that of two intracranial meningiomas previously excised. PMID- 3808236 TI - Carotid artery occlusion and ocular ischemia: therapy control with evoked potentials. AB - We present a patient with internal carotid artery occlusion and ischemic oculopathy in whom extracranial-intracranial arterial bypass improved vision. Visual evoked potentials were studied to obtain objective criteria for indication and follow-up evaluation and confirmed that the improved vision was due to improved retinal function. PMID- 3808237 TI - Burning hands syndrome revisited. AB - The burning hands syndrome of spinal cord injury was first described in 1977. The syndrome is characterized by burning dysesthesias and paresthesias in the hands and may be associated with either cervical fracture/dislocation or no detectable cervical spine abnormalities. A case of burning hands syndrome without cervical spine injury is presented in which somatosensory evoked potentials and magnetic resonance imaging were used to delineate the pathophysiology of this syndrome. PMID- 3808238 TI - Case-control study of clinical outcome after aneurysmal subarachnoid hemorrhage. AB - The clinical and neuropathological features of 84 nonsurvivors of aneurysmal subarachnoid hemorrhage (consecutive autopsy series) were compared with those of 51 survivors (consecutive clinical series). The groups differed significantly in the type of bleeding: 58% of the nonsurvivors had massive subarachnoid hemorrhage (MSAH) compared to 10% of the survivors (P less than 0.00001); 54% of the nonsurvivors had intraventricular hemorrhage (IVH) compared to 29% of the survivors (P less than 0.008); 45% of the nonsurvivors had intracerebral hematoma (ICH) compared to 8% of the survivors (P less than 0.00001). Only 1 of the 19 patients with both MSAH and ICH survived. The incidence of cerebral infarction was similar in nonsurvivors (31%) and survivors (29%). In the absence of associated MSAH, IVH, or ICH, cerebral infarction was uncommon (11%). Documented in-hospital rebleeding was uncommon in nonsurvivors (13%) and survivors (2%). Admission neurological status did not predict outcome independent of the extent of the initial bleeding. Comparison of the two groups suggests that the type and extent of initial bleeding are the most important determinants of mortality in aneurysmal subarachnoid hemorrhage. PMID- 3808239 TI - Naloxone and experimental spinal cord injury: Part 1. High dose administration in a static load compression model. AB - Previous studies by other investigators using a dynamic weight drop injury model in cats or rats have demonstrated a beneficial effect of naloxone in promoting motor recovery after experimental spinal cord injury. The effective doses ranged from 0.8 mg (total dose) in rats to a high dose of 10 mg/kg in cats. We report here an evaluation of high dose naloxone (10 mg/kg) in a model of cord injury in rats using a static load compression technique. After induction of injury at T 12, naloxone (10 mg/kg) was administered by the intraperitoneal route, followed by five additional bolus injections over the course of the next 2 days. Animals were randomly assigned to this treatment regimen (n = 10) or to a saline control group (n = 10). The animals were observed for 4 weeks, with testing of recovery of hind limb motor function (Tarlov score and on an inclined plane). Although there were slight differences in recovery, the overall evaluation showed no statistically significant difference between the naloxone-treated and control groups. The spinal cords of the sacrificed animals were studied morphometrically; there was no statistically significant difference between the residual gray and white matter at the site of cord injury between the treated and control groups. Naloxone did not seem to promote recovery of motor function in this model of spinal cord injury. PMID- 3808240 TI - Naloxone and experimental spinal cord injury: Part 2. Megadose treatment in a dynamic load injury model. AB - We previously reported that high dose naloxone (10 mg/kg) failed to promote recovery of motor function after a static load injury of the spinal cord in rats. In the present experiments, using the more traditional dynamic weight drop model, we tested megadose naloxone administered by the intraperitoneal route in 23 rats, including saline controls (Experiment 1). Thirty minutes after a cord injury at T 12, naloxone was given i.p. in a bolus of 100 mg/kg, followed by a continuous i.p. infusion of 50 mg/kg/hour for 23 hours. Again, no benefit was observed; this raised a question regarding naloxone and its absorption and serum levels. In another study, reported separately, we found that naloxone administered by the subcutaneous route affords higher and more sustained serum levels than by i.p. administration. Consequently, in 20 rats (Experiment 2), we repeated the protocol, using subcutaneous naloxone in a bolus dose of 150 mg/kg, followed by continuous infusion of 75 mg/kg/hour for 23 hours; the result was again negative. Morphometric determination of the residual (normal) cross sectional areas of gray and white matter at the epicenter of the cord lesion showed no statistically significant difference between treated and control animals in either Experiment 1 or Experiment 2. In view of the negative findings at high dose (10 mg/kg) and megadose naloxone, it seems that a reasonable next step would be an evaluation of lower doses using a factorial research design, incorporating a range of doses of naloxone in relation to a variety of intensities of cord injury. This question will be addressed in future experiments. PMID- 3808241 TI - Electron microscopy of simian cerebral arteries after subarachnoid hemorrhage and after the injection of horseradish peroxidase. AB - A large unilateral subarachnoid hemorrhage (SAH) was created in 21 monkeys, and horseradish peroxidase (HRP) was injected into the cisterna magna or left internal carotid artery in 3 others (normals). Cerebral fixation was performed on Day 14 after SAH or 15 minutes after HRP injection. The major cerebral arteries from both the nonclot (control) and clot sides and the normal animals were examined with scanning and transmission electron microscopy (SEM and TEM). SEM of the adventitial surfaces of control and normal arteries revealed tunnel-like structures along the longitudinal axis. No vasa vasorum were seen, but adventitial rounded openings were observed, 10 to 35 micron in diameter in vessels of the anterior circulation and up to 80 micron in diameter in the basilar arteries. The stomas, numbering 5 to 10/mm of specimen, appeared to connect the subarachnoid and intraadventitial spaces or pathways. In SAH arteries, the tunica adventitia was coated with cellular remnants of hematoma or dense, well-organized blood clots, the removal of which revealed blocked stomas. TEM showed HRP in the vessel walls after injection into the cisterna magna, but not after injection into the carotid artery. TEM of control arteries revealed Virchow-Robin (intraadventitial) spaces lined by simple planar epithelium-like cells; Virchow-Robin spaces contained sparse nerve fiber bundles and connective tissue fibers. In SAH arteries, these spaces were almost filled with strands of connective tissue and fibroblasts; no nerve fibers were detected. Vasogenic substances probably reach smooth muscle cells via the adventitial stomas. SAH occluding the stomas may block the cerebrospinal fluid circulation, disturbing nutrition of the arterial wall or removal of wastes from it, thereby aggravating vasospasm. PMID- 3808242 TI - Intracranial penetration due to BB air rifle injuries. AB - The toy BB gun that was commonly available 20 years ago has been modernized into a weapon with lethal potential. We report four children who had intracranial penetration by BBs. Three were shot by another young child, and the fourth child was injured by an intoxicated adult. Two of the children have permanent, severe neurological sequelae. BB rifles should require the same safety precautions and considerations as more traditional firearms. PMID- 3808243 TI - Spinal cord tumors presenting with neural tube defects. AB - Two primary lumbosacral tumors arising at the site of neural tube defects are presented. One was a teratoma diagnosed in an infant with myelomeningocele. The other was an ependymoma that developed in an adult with meningocele. It is postulated that these cases represent a neoplastic transformation of heterotopic primordial elements that have been incorporated within the defect, supporting the view that overgrowth of neural tissue may be the result rather than the cause of neural tube deformity. Such rare occurrences may be due to interaction between intrauterine teratogenic factors and familial predisposition in affected patients. PMID- 3808244 TI - Operative exposure and management of the petrous and upper cervical internal carotid artery. AB - The exposure and operative management of the petrous and upper cervical internal carotid artery (ICA) in 29 patients is detailed. Twenty-seven of these patients had extensive cranial base neoplasms (benign or malignant), 1 had an inflammatory cholesteatoma, and 1 had an aneurysm of the upper cervical ICA immediately proximal to the carotid canal. Preoperative studies useful in the evaluation of these patients included computed tomography, magnetic resonance imaging, cerebral and cervical angiography, and a balloon occlusion test of the ICA with evaluation of neurological status and of cerebral blood flow. The exposure of the upper cervical and petrous ICA was useful to obtain proximal control of the cavernous ICA, aided in the operative approach to extensive petroclival, intracavernous, and parapharyngeal neoplasms, and enabled the total resection of 23 of 27 such tumors. A subtemporal and preauricular infratemporal fossa approach was most commonly used for the exposure of the artery. Intraoperative arterial management consisted of exposure and decompression only, dissection from encasing neoplasm, resection of the invaded arterial segment and vein graft reconstruction, or intentional arterial occlusion. Vascular complications included 1 stroke due to delayed arterial occlusion, 1 stroke and death due to infection spreading from the nasopharynx with bilateral ICA rupture, and 1 pseudoaneurysm formation secondary to wound infection necessitating postoperative balloon occlusion of the ICA. Nonvascular complications included facial nerve paralysis in 10 patients (usually temporary), glossopharyngeal and vagal paralysis in 13 patients requiring Teflon injection of the vocal cord in 9, temporary difficulties with mastication in 9 patients, and wound infection in 3. The surgical exposure and management of the upper cervical and petrous ICA may permit a total operative resection of extensive cranial base neoplasms and is also an alternative for the management of vascular lesions involving these segments of the artery. With malignant neoplasms extending from the nasopharynx, postoperative infection remains a problem and may best be resolved by the use of a vascularized rectus abdominis muscle flap to reconstruct defects of the nasopharynx. Bilateral ICA encasement by neoplasms is also a major problem to be solved. The value of such an aggressive approach to the management of malignant neoplasms remains to be proven. PMID- 3808245 TI - Inflammatory lesions of the basal ganglia and thalamus: review of twenty-one cases. AB - We report a series of 21 patients with basal ganglia and thalamic granulomas or abscesses treated over 7 years. Among them, 15 were tubercular, 5 were pyogenic, and 1 was fungal. Pyogenic abscesses, usually hematogenous, also occurred secondary to osteomyelitis of the skull and chronic otitis media. The fungal abscess developed in a nonimmunocompromised patient with no intercurrent malignancy. Evidence of tuberculosis elsewhere in the body was detected in only 7 patients with tuberculomas. The computed tomographic (CT) image morphology characterizing an abscess or a tuberculoma was present in all except 2 patients with tuberculomas. The fungal abscess resembled a malignant glioma. The only hospital mortality occurred in a deeply unconscious patient with a thalamic pyogenic abscess. A 12-month or longer follow-up in 16 patients showed that 3 continued to be handicapped neurologically, and 2 died 13 and 16 months later, respectively. We conclude that inflammatory lesions at these sites are not uncommon and that CT scans are diagnostic in the great majority. Doubtful diagnosis merits stereotactic aspiration or biopsy of the lesion. Satisfactory results follow adequate medical therapy. PMID- 3808246 TI - Superficial temporal artery to proximal middle cerebral artery anastomosis: clinical and angiographic long term results. AB - Anastomosis of the superficial temporal artery (STA) with a proximal segment of the middle cerebral artery (MCA) has been proposed as a new cerebral revascularization technique alternative to the conventional bypass on the cortical surface. We introduced this procedure in our surgical practice in 1982 for patients with internal carotid artery (ICA) aneurysms not suitable for direct repair in whom occlusion of the ICA is considered necessary. One patient died because a conventional STA-MCA bypass did not prevent a major stroke caused by a therapeutic ICA occlusion. We are reporting our surgical technique and the immediate and long term clinical and angiographic results in five cases operated on during the period June 19, 1982, through January 19, 1983. The early and late patency rates were good. No neurological complications were observed after the bypass procedure or during a 3-year follow-up period. In our opinion, the use of proximal segments of the MCA as recipient arteries for supratentorial revascularization is a good alternative to the use of cortical surface arteries and, in selected cases, could be the first choice technique. PMID- 3808247 TI - Mural tumors with cysts in the cerebral hemispheres of children. AB - Thirteen infants and children with mural tumors (i.e., cysts with mural nodules) in the cerebral hemisphere are presented. The tumors comprise five benign astrocytomas, three ependymomas, two choroid plexus papillomas, one oncocytoma, one hamartoma, and one primitive neuroectodermal tumor. Computed tomography showed well-enhanced mural nodules. Cyst walls did not enhance in any but one, in which the enhancement was attributed to hemorrhage in the cyst. None of the cyst walls contained neoplastic cells. Cerebral angiography was performed in all patients, and five showed extensive vascularity in the tumor nodule. The importance of preoperative angiography is emphasized. Total extirpation of the mural nodule without excision of the cyst wall led to excellent prognosis for these patients. PMID- 3808248 TI - Contralateral trigeminal neuralgia as a false localizing sign in intracranial tumors. AB - Three cases of contralateral trigeminal neuralgia as a false localizing sign in intracranial tumors are reported. In each patient (meningioma, 2 cases; cholesteatoma, 1 case) the tumor was asymptomatic, so that intracranial tumor had not been suspected preoperatively. In all cases, tumors were large and firm. The tumor was supratentorial in two cases. In one case, a cortically mediated mechanism may have caused the neuralgia, whereas in the remaining two cases distortion and displacement of the brain stem and compression of the contralateral Meckel's cave would explain the trigeminal nerve signs. PMID- 3808249 TI - Magnetic stimulation of the human brain and peripheral nervous system: an introduction and the results of an initial clinical evaluation. AB - This report describes a novel method of stimulating the motor cortex and deep peripheral nerves in humans. The technique, developed in the Department of Medical Physics of Sheffield University, uses a large pulse of magnetic field to induce currents within the body and is painless. The basic principles of magnetic stimulation are described, and the technique is compared with conventional electrical stimulation. Safety aspects are discussed with reference to established clinical electrical and magnetic procedures. The results of the first clinical study using magnetic stimulation are described and show clear central motor pathway slowing in multiple sclerosis patients. PMID- 3808250 TI - Magnetic stimulation of human peripheral nerve and brain: response enhancement by combined magnetoelectrical technique. AB - The authors describe the technique of magnetic stimulation from a pulsed induction coil (4.0 T) and the enhanced (5-fold) electromyogram response from hyperthenar muscles obtained when electric and magnetic stimuli are applied simultaneously. The enhancement results have been confirmed for central brain vertex stimulation using the Sheffield magnet. Results obtained with slow (1 to 6 seconds) depth electrode stimulation and recording in humans are compared and are used to predict probable developments in the magnetic field. Because magnetic and magnetoelectrical techniques are painless, noninvasive, and noninjurious, it is believed that they are an important advance in both research and clinical applications of instrumental modification of brain circuits and behavior. There are many diagnostic and therapeutic uses at peripheral and central levels, and some ethical problems need consideration. PMID- 3808251 TI - Motor evoked potentials in the dog: effects of global ischemia on spinal cord and peripheral nerve signals. AB - Motor evoked potentials (MEPs) in cats, rats, and humans have been reported. They appear promising as a test of central nervous system function, and they are sensitive not only to mechanical injury but also to ischemia. In mechanical trauma, the peripheral nerve response is much more sensitive to damage than the cord response, with a lower threshold and an earlier disappearance. We are reporting that the MEP can also be produced in the dog and that, under conditions of cardiac arrest induced by fibrillation, the peripheral nerve response disappears first at about 30 seconds and then the spinal cord response disappears at about 10 to 13 minutes. The late disappearance of the spinal cord response raises serious questions about its role as an adequate injury monitor. The most useful warning feature of the spinal cord response is an increase in amplitude during the critical first 2 minutes of arrest. Latency changes in the cord and peripheral nerve response did not seem as useful as amplitude changes in terms of providing adequate detection of injury. We also evaluated the peripheral nerve signals to determine whether they are partially volume-conducted weak muscle responses, and evidence substantiates their nonmuscle origin. PMID- 3808252 TI - Motor evoked potentials recorded from normal and spinal cord-injured rats. AB - A need exists for an accurate neurophysiological technique that monitors the motor tracts of the cord in patients with spinal cord injury or other cord lesions and for the evaluation of experimental models of cord injury. We have recorded and characterized the motor evoked potentials (MEPs) from 10 normal rats and from 10 rats with the following cord lesions at C-8: 4 animals with complete cord transection and 6 with clip compression injury: 2 at 56.0 g, 2 at 20.0 g, and 2 at 1.5 g. MEPs were elicited by applying constant current anodal stimuli to the sensorimotor cortex with the responses recorded from microelectrodes in the spinal cord at T-10. The MEP consisted of an initial D wave (mean latency, 1.22 +/- 0.09 ms) and 4 subsequent I waves, I1 to I4. The D wave was elicited at stimulation frequencies exceeding 100 Hz, consistent with the hypothesis that it results from direct pyramidal cell excitation. The 56.0-g clip compression injuries and the cord transections abolished the MEP distal to the lesion, whereas the 20.0- and 1.5-g injuries resulted in a latency shift and amplitude decrement of the MEP peaks. These experiments suggest that the recording of MEPs will be an extremely useful and accurate method of monitoring the functional integrity of the cord, of value in patients with cord injury. PMID- 3808253 TI - Corticomotor evoked potentials in acute and chronic blunt spinal cord injury in the rat: correlation with neurological outcome and histological damage. AB - Somatosensory evoked potentials (SSEPs) and corticomotor evoked potentials (CMEPs) were utilized to study acute and chronic blunt spinal cord trauma. Rats, anesthetized with ketamine hydrochloride, were subjected to parasagittal craniectomies and midthoracic laminectomies. SSEPs were cortically recorded and CMEPs were transcortically produced using epidural ball and disc electrodes. SSEPs were elicited and CMEPs were recorded via hindlimb percutaneous needle electrodes. After control records, animals were subjected to a 50-g/cm impact to the dorsal cord surface using a modified weight drop technique. Evaluation of neurological injury was performed by SSEP and CMEP analysis and was compared with neurological assessments obtained before injury and 1 hour, 1 week, 3 weeks, and 6 weeks after injury. Neurohistopathological verification of each spinal cord lesion was performed at 6 weeks after injury. Animals subjected to a 50-g/cm cord impact showed no change in SSEP wave forms, but all components of the CMEP were greatly attenuated with this injury. Acutely, either very weak movement or no movement to noxious stimulation was present without vocalization. There was a spectrum of clinical recovery that correlated closely with the return and normalization of the amplitude of the CMEP in 100% of the animals tested. The eventual degree of clinical and CMEP improvement correlated well with the degree of histological damage present. The results of this study suggest that the CMEP is a reliable indicator of the initial degree of loss of neurological motor function in acute blunt spinal cord injury in the rat, as well as an accurate measure of the degree and extent of recovery. The rat model as outlined here is a simple and inexpensive system for evaluation both clinically and electrophysiologically of the degree of motor recovery from spinal cord injury. This model should prove useful in the evaluation of promising pharmacological agents for potential use in the treatment of acute spinal cord injury. PMID- 3808254 TI - Motor evoked potential as a predictor of recovery in chronic spinal cord injury. AB - In injury to the spinal cord, motor function is the most critical system affected. The introduction of motor evoked potential (MEP) monitoring techniques over the past 5 years has opened new possibilities for the assessment of motor function. We examined the MEP change in 30 cats that received weight drop injuries to the thoracic spinal cord and correlated it with function. The MEPs were recorded above and below the injury and in the sciatic nerves. In these animals, we found that the peripheral nerve response to the MEP was the most sensitive to injury, disappearing immediately upon weight drop. The MEP at the spinal cord level was somewhat more sensitive to injury than the SSEP at the cord level, and the SSEP at the cortex was the least sensitive to injury. The MEP spinal cord signal below the lesion showed both a latency increase and a substantial amplitude decrease after impact. The latency increase, however, was of relatively small absolute magnitude making the amplitude change easier to monitor. The animals were followed chronically, and 17 of the 30 regained ambulation. In all animals (followed up to 2 months), the peripheral nerve signals returned at or immediately before the time of ambulation. In none of the animals who failed to regain a peripheral nerve response was ambulation attained. This supports a strong correlation of the peripheral nerve response with walking. However, the peripheral nerve response was only a short term predictor. Examination of the spinal cord signal showed that the MEP spinal cord signal below the lesion as a percentage above the lesion was a significant correlate of current ambulation recovery, with a correlation coefficient of 0.55. This suggests that evaluation of the SSEP and MEP spinal cord signals may be able to predict longer term recovery in animals and perhaps humans. PMID- 3808255 TI - Considerations for safety in the use of extracranial stimulation for motor evoked potentials. AB - The possibility of neural damage during extracranial brain stimulation for motor evoked potentials (MEPs) is discussed from the perspective of animal studies in which the stimulating electrodes were in direct contact with the brain. These data indicate that the charge per phase used in most of the extracranial MEP protocols is sufficient to induce neural damage if the stimulation is applied continuously for several hours. However, in most cases dispersion of the stimulus current in the extracranial tissue and skull is probably adequate to attenuate the stimulus charge density at the brain surface to a safe level (less than approximately 40 microC/cm2 X ph). However, the possibility exists that low resistance paths between the stimulating electrode and the brain may give rise to foci of high charge density. The possibility of such focusing may be less with magnetic field than with direct electrical field stimulation. We stress the need for additional animal studies designed to delineate a range of safe stimulus parameters for this particular technique. PMID- 3808256 TI - Human cerebral cortical responses to contralateral transcranial stimulation. AB - We wished to develop a noninvasive electrophysiological measure of functioning of human cerebral cortex. The response chosen was that elicited by a corticocortical afferent input, specifically the transcallosal response (TCR). We used ourselves as subjects. The large shock artifacts associated with passing large currents through the head were reduced by: stimulating percutaneously with a focal anode (5 cm2) situated midway between F4 and C4 (i.e., frontal region, standard 10-20 nomenclature) and a medially located, semicircular grounded cathode (26 cm2) no closer than 3 to 4 cm away; and recording with the focal scalp electrode over homologous left frontal cortex vs. two or more reference electrodes interconnected through variable resistors and at least 6 cm away. Transcranial stimulation with pulses of 80 to 140 mA and lasting 100 microseconds elicited a brief diphasic deflection (latency, 2 to 4 ms), followed by an initially positive, often bifid wave with a latency of 9 to 14 ms, lasting 18 to 44 ms and reaching 5 to 10 microV. The initial diphasic deflection greatly increased when the stimulating anode was moved laterally over temporalis muscle, indicating an electromyographic (EMG) origin. The EMG, but not the positive wave, was elicited when the interpolar distance was reduced to 1 cm, which greatly reduced the fraction of current traversing the cortex (epicranial stimulation); furthermore, occluding the circulation to the scalp for 30 minutes by rubber tubing above the zygomas and brows dulled sensation, reduced the EMG, but did not alter the latency or rising phase of the positive wave. Early somatosensory components, if present, were small compared with the positive wave.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808257 TI - Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. AB - The incidence and clinical aspects of acute hydrocephalus were examined in 200 patients with recently ruptured intracranial aneurysms. The following conclusions were reached: Acute hydrocephalus is an important complication of aneurysmal subarachnoid hemorrhage that occurs in approximately 20% of all cases and exhibits an incidence that tends to parallel clinical grade (Grade I, 3%; Grade II, 5%; "Good" Grade III, 21%; "Bad"Grade III, 40%; Grade IV, 42%; Grade V, 26%). Impaired consciousness leading to a general downgrading of clinical status was the predominant clinical finding (93%), but neither this nor other nonspecific signs of increased intracranial pressure were distinguishable from the effects of the precipitating hemorrhage. The computed tomographic signs of acute hydrocephalus are distinctive and consist of selective ballooning of the frontal horns, rostral-caudal enlargement of the cerebral ventricles, and a halo of periventricular hyperdensity (edema) that evolves in sequence with ventricular changes. The treatment of choice is external ventricular drainage, which results in prompt and often dramatic improvement in approximately two-thirds of the patients. PMID- 3808258 TI - Some experiences of techniques for stimulation of the human cerebral motor cortex through the scalp. AB - Stimulation of the motor cortex transcranially has shown a rough somatotopy of stimulation sites on the scalp corresponding to the homunculus and preferential activation of contralateral hand muscles, as well as very short latencies of signals in the cervical spinal cord. The responses are also facilitated by background activation of the muscles. We are reporting a set of patients studied using electrical and magnetic stimulation transcranially. We observed that the latency of electromyogram activation is much shorter in active than contracting muscles and that the muscle twitch produced by cortical stimulation can exceed the force produced by supramaximal stimulation of the peripheral nerve. Our findings suggest that this may be due to multiple firing of motor neurons. Another observation is that magnetic stimulation is not as subject to a reduction in the response latency with facilitation, and response latencies with magnetic stimulation were 2 ms longer than with electrical stimulation. The implications of these findings are discussed. PMID- 3808259 TI - Clinical experience with motor and cerebellar evoked potential monitoring. AB - We are reporting 98 cases of motor evoked potential (MEP) monitoring performed between 1982 and 1986. These were divided into supratentorial, posterior fossa, and spinal cord categories. We observed in this sample that the peripheral nerve or electromyographic response was substantially more sensitive than the spinal cord response to injury and hypotension during operation and was often present bilaterally. Reversible weakening or loss of the peripheral nerve response was not associated with a deficit. However, weakening of the peripheral nerve response without recovery could warn of a motor defect after operation. The spinal cord responses can change so little in amplitude and latency with injury conditions that their reliable use during operation without accompanying peripheral nerve and muscle response monitoring may be compromised, especially in view of the often difficult recording environment in the operating room. With spinal cord monitoring, the MEP seemed closely correlated with the stresses that we imposed on the cord, as well as with subsequent clinical outcome. In posterior fossa cases, we observed sensitivity of the MEP to manipulation of the nervous system and reliable indication of the outcome in the cases monitored. Supratentorial cases present a more complex environment for monitoring; a potential pitfall is to stimulate an area that produces responses in the peripheral nerves and spinal cord, but that is not being compromised by the injury process. Alternatively, stimulating too large an area of cortex or stimulating with too high a current, which penetrates to white matter below the gray matter, may not show an injury. Although we did not encounter cases where permanent deficits were missed by the motor evoked potential, we were concerned by the appearance of temporary deficits. These may be related to technical limitations of our methods and indicate that monitoring of the supratentorial process requires substantial methodological advance for high reliability. Modulation of the MEP by prior somatosensory evoked potential stimulation seems useful and promising. Cerebellar evoked potential responses were present in humans and were sensitive to injury. Overall, this test is promising. PMID- 3808260 TI - Mechanisms of nervous propagation along central motor pathways: noninvasive evaluation in healthy subjects and in patients with neurological disease. AB - Motor evoked potentials (MEPs) to scalp stimulation have been obtained in 45 control patients and in 70 patients with neurological diseases. Optimal responses were obtained through a pericranial cathode consisting of 6 to 12 regularly spaced, interconnected pericranial cathodal discs whose resistance was carefully balanced with that of a stimulating anodal disc placed on the appropriate scalp region. The foci of maximal response for proximal and distal upper limb muscles as well as for lower limb muscles were localized. The scalp to cervical cord central conduction time (CCT) along motor tracts governing the hand muscles was 5.21 +/- 0.42 ms. This index was highly correlated with the subject's height and stable in time when repeatedly tested. Collision between orthodromically and antidromically propagated motor impulses was obtained. Response facilitation was achieved by means of prestimulus voluntary contraction of the target muscle, continuous vibration of its tendon, or scalp stimulation with paired shocks. The presence of a premovement facilitation of MEPs was also demonstrated, as was the presumed presence of transcallosal facilitation. An efferent volley secondary to scalp stimulation was recorded from the nerve trunk. Abnormalities in MEP characteristics as well as in CCTs were found in patients with multiple sclerosis, amyotrophic lateral sclerosis, cord compression, and degenerative diseases of the central nervous system. PMID- 3808261 TI - Motor evoked potential as a monitor of middle cerebral artery ischemia and stroke. PMID- 3808262 TI - Modulation of cat motor evoked potential by prior cerebellar or somatosensory stimulation. PMID- 3808263 TI - Effects of electrically induced afferent input from limb nerves on the excitability of the human motor cortex. PMID- 3808264 TI - Motor system monitoring during joint replacement operations. PMID- 3808265 TI - Recording technically satisfactory somatosensory evoked potentials during spinal cord operation. PMID- 3808266 TI - Early repair of myelomeningocele and simultaneous insertion of ventriculoperitoneal shunt: technique and results. AB - During the years 1975 to 1985, 10 patients underwent simultaneous repair of myelomeningocele and insertion of a ventriculoperitoneal shunt at the Hospital for Sick Children in Toronto. The technique for carrying out these procedures in the same operative setting will be described. None of the patients developed shunt infections or myelomeningocele repair breakdown in the follow-up period of 1 to 9 years. One patient died 9 days after operation secondary to aspiration. The remaining patients underwent neuropsychological testing during their follow up periods and over 70% were found to have normal or slightly below normal intelligence and psychosocial development. The technique of simultaneous repair of a myelomeningocele and insertion of a ventriculoperitoneal shunt in infants with a myelomeningocele and concomitant hydrocephalus overt at birth is safe and should be carried out to decrease the risk of myelomeningocele repair breakdown and cerebrospinal fluid leak in such patients. PMID- 3808267 TI - Meningioma associated with aneurysm and subarachnoid hemorrhage: case report and review of the literature. AB - A patient presented with spontaneous subarachnoid hemorrhage after a prolonged episode of coughing. A preoperative computed tomographic (CT) scan confirmed subarachnoid hemorrhage, but demonstrated no other lesion. Arteriography revealed an ophthalmic artery aneurysm. Operation revealed the aneurysm to be intracavernous without sign of prior rupture; however, a small hemorrhagic meningioma was removed from the ipsilateral anterior clinoid process. In this case, coincidental meningioma and aneurysm presented as a subarachnoid hemorrhage secondary to tumor hemorrhage. The follow-up of cases of subarachnoid hemorrhage with negative arteriography with sequential CT scans is discussed. PMID- 3808268 TI - Brain abscess complicating the use of a halo orthosis. AB - We report a case of brain abscess complicating the use of a halo orthosis in the treatment of a cervical spine injury suffered during wrestling. Four previous brain abscesses complicating the use of halo orthoses have been reported. All cases of abscess have been associated with overlying infection at the site of pin insertion. Our case and at least one of those previously reported may have been related to tightening of the halo pins after placement. Serious spine injuries occur rarely in wrestlers and are associated with the use of illegal holds and maneuvers in which one athlete is thrown to the mat. The pathophysiology and radiographic appearance of a unilateral facet dislocation are reviewed. PMID- 3808269 TI - Cerebrospinal fluid fistula involving the sphenoid sinus. AB - A case of posttraumatic delayed cerebrospinal fluid fistula from the middle cranial fossa to a lateral extension of the sphenoid sinus is reported. The advantages in demonstrating this unusual set of circumstances by computerized tomography are discussed. PMID- 3808270 TI - Moyamoya disease presenting as intracerebral hemorrhage during pregnancy: case report and review of the literature. AB - Intracranial hemorrhage during pregnancy is rare. The authors present a case of moyamoya disease associated with pregnancy. A 32-year-old woman who was at 32 weeks of gestation experienced sudden severe headache followed by loss of consciousness. Computed tomography revealed an intracerebral hematoma in the left temporal lobe, and left carotid angiograms revealed moyamoya disease. The patient underwent emergency craniotomy, the hematoma was removed, and encephaloduroarteriosynangiosis was performed. The patient showed good recovery and, 2 months later, delivered a child vaginally without any trouble. Most intracranial hemorrhages during pregnancy result from cerebral aneurysms or arteriovenous malformations (AVMs), and few cases due to moyamoya disease have been reported. It is generally believed that subarachnoid hemorrhage due to cerebral aneurysms is likely to occur during the middle trimester of gestation, with the risk increasing progressively toward the third trimester. This may be explained by the fact that the cardiac output increases rather acutely from the first to the middle trimester. There seems to be no significant correlation between the stage of pregnancy and the occurrence of hemorrhage due to AVM. Most authors think that the operative indications for intracranial hemorrhage during pregnancy should be the same as for the nonpregnant state. PMID- 3808271 TI - Intramedullary melanotic schwannoma of the cervicomedullary junction. AB - We report a case of a patient with an intramedullary tumor of the cervicomedullary junction. At operation, the tumor was noted to be highly pigmented, and pathological study demonstrated that the tumor was a melanotic schwannoma. Both intramedullary schwannomas and melanotic schwannomas in any location in the body are exceedingly rare. This is the first reported case of an intramedullary melanotic schwannoma of the central nervous system. The possible origin of this tumor is discussed. PMID- 3808272 TI - Multiple oncotic intracranial aneurysms and cardiac metastasis from choriocarcinoma: case report and review of the literature. AB - Ten cases of oncotic intracranial aneurysms from choriocarcinoma have been reported previously. We report an eleventh case with four aneurysms secondary to metastatic choriocarcinoma. These aneurysms seemed to arise from cephalic embolization of neoplastic tissue from an implant of choriocarcinoma in the left ventricle of the heart. PMID- 3808273 TI - Ectopic pituitary gland simulating a suprasellar tumor. AB - A case report of ectopic pituitary gland in the suprasellar region of a normal 39 year-old woman with persistent headaches is presented. The embryological development of the pituitary gland is briefly reviewed, with a discussion of the relevant literature. No previous report of normal pituitary tissue in a suprasellar location in the absence of tumor could be found. PMID- 3808274 TI - Raeder's syndrome associated with intracranial internal carotid artery aneurysm. AB - Raeder's syndrome consists of oculosympathetic paresis and ipsilateral facial pain, with variable involvement of the trigeminal and oculomotor nerves. A 63 year-old woman experienced severe facial pain, a partial Horner's syndrome, and restriction of ocular movements on the left side. A left carotid angiogram disclosed a giant aneurysm of the cavernous portion of the internal carotid artery. This is the third reported case of Raeder's syndrome due to aneurysm of the intracranial internal carotid artery. Her facial pain was relieved by carotid ligation, and serial computed tomographic scans showed decrease of aneurysmal size. PMID- 3808275 TI - Benign osteoblastoma of the clivus removed by a transoral approach: case report. PMID- 3808276 TI - Pituitary apoplexy, bilateral carotid vasospasm, and cerebral infarction in a 15 year-old boy. AB - The authors report a case of pituitary apoplexy associated with oculomotor defects and focal cerebral signs; the visual pathways were intact. Computed tomography documented a mass of heterogeneous density within an enlarged sella turcica and a right parietal infarct. Angiograms revealed bilateral carotid spasm and occlusion of the right angular artery. Treatment was conservative. Control angiograms showed spontaneous resolution of the vasospasm and recanalization of the cortical artery. The patient made a complete neurological recovery; he needed only treatment with vasopressin due to transient diabetes insipidus. The risk of vasospasm and brain ischemia should be kept in mind when treating pituitary apoplexy. The early occurrence of vasospasm in our case suggests the participation of powerful vasoactive agents liberated from the tumor. PMID- 3808277 TI - Spinal subarachnoid hematoma in Behcet's disease. PMID- 3808279 TI - Hydrogen peroxide for hemostasis. PMID- 3808278 TI - Hemifacial spasm resolution without vascular decompression. PMID- 3808280 TI - Cavernous angiomas. PMID- 3808281 TI - First International Symposium on Motor System Evoked Potential Monitoring. West Lafayette, Indiana, June 16 and 17, 1986. Proceedings. PMID- 3808282 TI - Cisternal drainage after early operation of ruptured intracranial aneurysm. AB - The authors reviewed 22 cases of intracranial aneurysm of the anterior part of the circle of Willis. All patients presented with the signs and symptoms of subarachnoid hemorrhage (SAH) and were in good neurological condition on admission. In all cases, early operation was performed to obliterate aneurysm. Subarachnoid blood clots were extensively removed and cisternal drainage was done. With topical application of povidone-iodine and intravenous administration of antibiotics, cisternal drainage continued for 14 days or more after the onset of SAH in 21 cases. Five patients developed symptomatic vasospasm, which was treated with hypervolemia and hypertension, and three received shunts later for chronic hydrocephalus. The overall result demonstrated that 21 patients were independent and had returned to their previous social lives. Therefore, it was strongly recommended that patients is good neurological condition after SAH secondary to ruptured intracranial aneurysm be treated with early operation, removal of subarachnoid clots, and long term application of cisternal drainage. PMID- 3808283 TI - Optimal stimulus duration for extracranial cortical stimulation. AB - Motor cortex stimulation is a new testing area in which either electrical or magnetic fields are used to produce transcranial stimulation of the underlying brain. The resulting signals, recorded from the spinal cord, peripheral nerves, or muscles, are monitored by electromyographic and evoked potential techniques. This report considers the issues in effective stimulation with minimal noxious sensation. Short duration pulses are optimal for electrical fields, and electrodeless stimulation with magnetic fields also makes use of short duration pulses. PMID- 3808284 TI - Spatial summation across the vertical meridian in hemianopics: a test of blindsight. AB - Twenty hemianopic patients with retrochiasmatic lesions have been tested for spatial summation of pairs of flashes simultaneously presented either to the same hemifield or to opposite hemifields across the vertical meridian. In such a task normal subjects show summation, i.e. a faster reaction time in response to a pair of stimuli than in response to a single stimulus. Such an effect is present both for pairs of stimuli presented within the same hemifield and for pairs of stimuli in which the two flashes are presented one in the right and the other in the left hemifield. In contrast to normals, hemianopics as a group did not show interfield summation although, like normals, showed summation within one hemifield. A single case analysis, however, revealed that in one patient there was a reliable overall interfield summation and that in three others there was evidence of summation in at least one testing session. The presence of interfield spatial summation between the normal and the affected hemifield of hemianopics thus provides further evidence of blindsight in a task paradigm in which guessing strategies and stimulus artefacts can be eliminated. The very small proportion of patients showing blindsight can be in part related to the relatively low stimulus intensity and the very brief stimulus exposure duration used. PMID- 3808285 TI - Deep dysphasia in a case of phonemic deafness: role of the right hemisphere in auditory language comprehension. AB - Deep dysphasia, an analogue of deep dyslexia in the auditory modality is a rare and peculiar pattern of repetition disturbance, which has been used to validate Morton's (Deep Dyslexia, pp. 189-196. Routledge & Kegan Paul, London, 1980) logogen theory. Such a case is reported here in which there was strong evidence of destruction of the left temporal lobe auditory areas. Examination of linguistic performance emphasized levels of auditory speech decoding. It was found that this patient had a profound phonemic discrimination deficit, yet could accomplish many lexical operations. It is argued that this case, in which a left temporal lobe lesion was associated with impaired phonological analysis, provides evidence that deep dysphasia may reflect the right hemisphere's non-phonological mode of speech processing. PMID- 3808286 TI - Interhemispheric communication in a case of total visuo-verbal disconnection. AB - Interhemispheric communication strategies as noted in split-brain subjects may serve a compensatory function in patients with total visuo-verbal disconnection. The results of a case support this expectation. Identification of visual material reflected the perceptual and linguistic limitations of the right hemisphere, and naming was sometimes mediated by the rehearsal of alternatives. Implications for disconnection theory are discussed. PMID- 3808287 TI - The development of tactile transfer of information. AB - A finger localization task was used to investigate interhemispheric transfer of tactile information in children aged 5, 7, 9 and 11 yr. Other-hand responses (cross-localization) were less accurate than same-hand responses for all ages tested. However, the size of the cross-localization deficit was strongly age dependent, and provided evidence for a developmental improvement in interhemispheric transfer which is consistent with the sequence of myelination of the corpus callosum during the first decade of life. Transfer with mirror-imaged finger positions on the opposite hands was more accurate for younger children, whereas older children were more accurate when finger positions were spatially aligned. PMID- 3808288 TI - Musical consonances and dissonances: are they distinguished independently by the right and left hippocampi? AB - Our study sought to determine whether, where and how the consonance or dissonance of musical intervals might be reflected in the electrical activity (depth EEG) of the human brain. Presenting an adequate musical test program to a patient with depth electrodes implanted within the planum temporale (near Heschl's gyrus) and the hippocampal formations of both sides, we found that the reactions shown by the depth EEG of the limbic system correspond in precise and distinctly differing patterns to the consonances and dissonances presented. The main findings are: the EEG of the left hippocampus reflects the consonance-dissonance dichotomy; the activity of the left hippocampus but not the right is affected by a previous sequence of dissonances in responding to a single consonance; the EEG activity of the right Heschl's gyrus (the left Heschl's gyrus was not analyzed), but neither the left nor the right hippocampus, responded differently to a given succession of intervals and its pitch inversion. These results may help to understand the different emotional responses which usually arise in response to consonant or dissonant musical intervals. PMID- 3808289 TI - Response sequence organization and reproduction by stutterers. AB - Male stutterers and fluent speakers were compared on their performance of a task requiring tapping keys as rapidly and as accurately as possible to reproduce different finger movement sequences demonstrated on a visual display panel. Although overall finger tapping rate was the same in the two groups, indicating no difficulty by stutterers in performing simple motor movements, stutterers achieved fewer correct sequences and made more errors than fluent speakers. In addition, their response initiation times were slower. Once a correct response was initiated, however, the time to execute the sequence was similar to that of fluent speakers. Replicating earlier work, the two groups were not found to differ on a repetitive sequential finger tapping task with respect to correct sequences or total presses, although the probability of error was greater for the stutterers. The data were interpreted as indicating that in stutterers sequential response mechanisms are lateralized normally as they are in fluent speakers; these left-hemisphere sequential response mechanisms in stutterers appear unusually susceptible to interference, possibly from on-going right-hemisphere activity; stutterers have special difficulty in organizing and/or initiating new response sequences, but once the sequence is initiated, they can perform the sequence as rapidly (but with greater probability of error) as do fluent speakers; and stuttering reflects not a simple motor problem per se, but a higher level organizational problem of a cognitive nature. PMID- 3808290 TI - The prediction of normal P3 latency and the diagnosis of dementia. AB - The relationship between age and the latency of the P3 (auditory evoked response potential) component was best described in 55 normals aged 15-89 by separate linear regression equations for those younger and those older than 63. Twelve out of 19 patients with dementia had P3 latencies at FZ and CZ which were delayed by more than two standard errors from the normal latency for their age predicted using the above equations, and were thus correctly identified. However, an equation calculated across the entire adult age range provided a better patient identification rate. The potential usefulness of P3 measures in clarifying the nature of cognitive impairment in dementia is discussed. PMID- 3808291 TI - Task effects and individual differences in the study of lateral eye movements. AB - Twenty-nine males and 29 females (all right-handed) participated in this study. The effects of question type (numerical, verbal, spatial) and experimenter position (in front of or behind the subject) on direction of lateral eye movements (LEMs) were tested. Also the relation between dominant LEM direction and other individual traits was investigated. The percentage of LEMs (tonic changes) as well as the first LEM (phasic changes) in the reflective period was scored. Results were identical for both methods; there were no task-specific effects demonstrated, nor was a relation found between dominant LEM direction and imagery, extraversion, neuroticism, sensation seeking, impulsiveness, and amount of somatic and psychic complaints. It appeared that the extent to which subjects gazed away varied with the amount of stress that was induced, while the direction of glance depended on the individual habit of the subject. The conclusion was that LEMs are subject specific rather than task specific and that this individual specificity is strengthened under stress conditions. PMID- 3808292 TI - Leftwards error in bisecting the gap between two points: stimulus quality and hand effects. AB - Subjects attempted to bisect the gap between two LEDs; these differed from each other in brightness, stimulus duration, onset/offset (a) synchronies, and in continuous or flashing mode of presentation. There was a systematic bias to the left, especially with the left hand, indicating a motor contribution to this perceptual task. A brief, faint or flashing LED attracted the subjective midpoint, perhaps because of increased processing demands; indeed the general leftwards bias was attributed to a greater visuospatial processing capacity in the right hemisphere. Leftwards bias was rather greater when central fixation was maintained, indicating that hemispatial mechanisms may be more important than anatomical connectivities. The technique may be useful for understanding and treating unilateral neglect. PMID- 3808293 TI - The influence of gender, handedness and head-turn on auditory asymmetries. AB - Subjects performed dichotic tasks with their heads turned 90 degrees to the left, 90 degrees to the right, and straight ahead. In Experiment 1 the stimuli were digits and the subjects varied in both sex and handedness. Right-handedness males showed a significant right-ear advantage under the head-right and head-straight conditions, while left-handed males and both right- and left-handed females failed to show any consistent ear asymmetries. In Experiment 2 the stimuli were melodies and the subjects were all right-handed. Head-turn had no significant influence on the results, and only the males showed a significant left-ear advantage. Overall, the results confirm previous findings that sex and handedness may influence auditory asymmetries, but fail to reveal systematic effects of head turn. PMID- 3808294 TI - When is between-hemisphere division of labor advantageous? AB - Division of labor between the hemispheres is sometimes advantageous. Merola and Liederman (1985) have shown that adolescents' naming performance is superior when two different kinds of letter input are divided between the hemispheres than when both kinds of letter input are projected to a single hemisphere. We now investigated whether the advantage of between-hemisphere division of inputs increases from adolescence to adulthood; occurs when a secondary, concurrent verbal memory task is added; and corresponds with superior performance on the secondary task. Results indicated that use of the hemispheres as insulated work stations increased from adolescence to adulthood, and did not diminish when memory was stressed. However, between-hemisphere division of labor for the primary task did not facilitate secondary task performance. PMID- 3808295 TI - Criterion-specific reduction of verbal fluency in right brain-damaged right handers. AB - Thirty-five vascular right brain-damaged (RBD) and 20 control (C) subjects were submitted to a verbal fluency task for which acceptability criteria were either semantic or formal. Results showed that subjects with a vascular lesion limited to the right hemisphere do show a statistically significant reduction of verbal fluency as compared to controls, that this reduction in verbal fluency is only present when the criterion is semantic, and that such a reduction is independent from the frontal or non-frontal topography of the lesion. These results tend to agree with the general conception of a--non-exclusive--right-hemisphere contribution to lexico-semantic processing, and more specifically to its semantic aspects. PMID- 3808296 TI - Comprehension of abstract concepts in right and left hemispheres of complete commissurotomy subjects. AB - The left and right hemispheres of three complete commissurotomy subjects were tested for the ability to comprehend abstract concepts. A technique was used which allows prolonged viewing of stimulus material restricted to a single visual hemi-field. Twenty-three trials involving a sample inspection figure and a three choice answer array were presented to each hemi-field with instructions to point to the one picture in the choice array related to the sample. As none of the possible choices matched the sample stimulus on any concrete level, correct responses required an abstract mental association. Both the verbal and non-verbal hemispheres performed the task at a high level of proficiency in all subjects. It was further noted that both commissurotomy and normal subjects experienced difficulty in articulating the involved abstract relationship when asked to do so under a free vision condition. The results demonstrate that the right hemisphere, lacking a highly developed language system, can nevertheless support sophisticated cognitive processing at an abstract level, and further suggest that the associative process is not necessarily language-mediated in either hemisphere. PMID- 3808297 TI - Early diagnosis of herpes simplex encephalitis by MRI. AB - The mortality rate of herpes simplex encephalitis (HSE) may be reduced by antiviral therapy, but early administration of the drug and therefore early diagnosis are essential. In our experience with four cases, MRI is the most sensitive noninvasive test in early diagnosis of HSE due to its high sensitivity to inflammatory increased brain water content, and it is superior to CT in localizing the pathognomonic lesions of the limbic system. PMID- 3808298 TI - Vigabatrin for refractory complex partial seizures: multicenter single-blind study with long-term follow-up. AB - The irreversible GABA transaminase inhibitor vigabatrin (VGB) was given in a single-blind fashion to 89 patients with complex partial seizures (CPS) refractory to conventional drugs. The median number of CPS per month decreased from 11.0 to 5.0 after addition of VGB, and 51% of patients had a 50% or greater decrease in CPS frequency (p less than 0.001). Side effects (principally drowsiness, ataxia, and headache) occurred mainly during the initiation of therapy and decreased during therapy. After 12 weeks on VGB, side effects significantly interfered with functioning in only 13% of patients, and the efficacy:toxicity ratio warranted continued administration in 74% of patients. Coadministration of VGB resulted in a mean decrease of 20% in phenytoin serum concentration (p less than 0.001). Sixty-six patients with a favorable response to VGB during the single-blind study have been followed for a median of 16.7 months on VGB. No serious systemic or neurologic toxicity has been detected, and most patients have retained their initial favorable CPS control. PMID- 3808299 TI - Lorazepam in childhood status epilepticus and serial seizures: effectiveness and tachyphylaxis. AB - We report our experience with 300 consecutive parenteral doses of lorazepam (LOR) for status epilepticus (SE) or serial seizures in 77 children and young adults. The median dose for SE in children less than 12 years old was 0.10 mg/kg. LOR stopped the SE in 79% and diminished the intensity of SE in an additional 4%. Prior acute or chronic anticonvulsant use (excepting chronic benzodiazepines) did not alter effectiveness or increase side effects. Duration of freedom from seizures following acute therapy was independent of LOR dosage. In patients requiring sequential doses, LOR becomes progressively less effective. Side effects were few and, when present, always associated with a single or first dose in a series. LOR is a safe and effective acute anticonvulsant agent for in hospital control of SE in the pediatric age group. Tachyphylaxis of anticonvulsant action occurs when serial doses are used. PMID- 3808300 TI - Global aphasia without hemiparesis: multiple etiologies. AB - Acute global aphasia without hemiparesis has been considered pathognomonic of embolic stroke. During 1 year, we encountered six patients with this syndrome. Two had multiple strokes, probably embolic. One had atrial fibrillation; at autopsy, there were metastases as well as multiple infarcts in the left hemisphere. One had a single large infarct in the territory of an anterior branch of the middle cerebral artery (MCA), one had subarachnoid hemorrhage of unknown origin, and one had a sylvian fissure hematoma with intraparenchymal extension from a ruptured MCA aneurysm. Nonembolic etiologies are therefore also possible and include conditions that bar anticoagulation. PMID- 3808301 TI - Oral yohimbine in human autonomic failure. AB - Yohimbine is an alpha 2-adrenoreceptor antagonist that acts to enhance sympathetic nervous system discharge and potentiate sympathetically mediated cardiovascular reflex responses. We therefore assessed the ability of yohimbine to increase sympathoadrenal discharge and raise blood pressure (BP) in patients with autonomic failure characterized by profound orthostatic hypotension. Yohimbine 5 mg orally in eight seated patients significantly elevated mean systolic BP by 33 mm Hg from 136 +/- 15 (mean +/- SD) to a maximum of 169 +/- 23 mm Hg (p less than 0.01), mean diastolic BP by 16 mm Hg from 77 +/- 9 to a maximum of 93 +/- 15 mm Hg (p less than 0.01), and mean heart rate (HR) by 10 beats per minute (BPM) from 68 +/- 12 to a maximum of 78 +/- 17 BPM (p less than 0.01). Plasma norepinephrine (NE) increased from 104 +/- 71 to a maximum of 196 +/- 182 pg/ml (p less than 0.05), but plasma epinephrine (E) did not increase significantly (31 +/- 18 versus a maximum of 39 +/- 21 pg/ml). In five patients given yohimbine 2.5 mg orally, BP, HR, NE, and E tended to increase, but the changes were not significant. Plasma yohimbine levels correlated significantly with the changes in mean arterial pressure (r = 0.61, p less than 0.01). Yohimbine raises BP and HR in patients with autonomic failure. These effects are dose- and concentration-dependent and mediated through increased sympathetic discharge. Yohimbine may be useful in the treatment of orthostatic hypotension associated with autonomic failure. It is unique among current modes of therapy for this disorder in that it enhances discharge of the patient's own sympathetic system. PMID- 3808302 TI - Prognosis of acute stroke. AB - We evaluated factors affecting mortality and quality of life in 1,013 patients with acute stroke followed for 2 to 8 years. In cerebral infarction, the major determinants for short-term mortality were impaired consciousness, leg weakness, and increasing age. The major determinants for long-term mortality were low level of activity at hospital discharge, advanced age, male sex, heart disease, and hypertension. PMID- 3808303 TI - A case-control study of smoking habits, dementia, and other illnesses in idiopathic Parkinson's disease. AB - From 1967 to 1979, 118 incident cases of idiopathic Parkinson's disease (IPD) and 236 age- and sex-matched controls from Rochester, MN, were identified. Medical records on patients and controls for 40 years preceding the diagnosis of IPD were reviewed. The relative risk (RR) for ever-smoked and IPD was not significantly different from unity (RR = 0.7, 95% confidence interval = 0.4 to 1.2). The mean age at diagnosis of IPD was significantly younger (p = 0.007) in the ever-smokers (68.8 years) compared with never-smokers (73.8 years), although this needs to be interpreted cautiously. It is concluded that smoking had no effect on the development of IPD. Within 5 years after the index date, a new diagnosis of dementia was made more often in cases than in controls (p = 0.01). Relative risk of IPD significantly increased when prior diagnosis of psychoneurosis and psychosomatic illness had been made. PMID- 3808304 TI - Controlled-release levodopa/carbidopa. I. Sinemet CR3 treatment of response fluctuations in Parkinson's disease. AB - Eight Parkinson patients with response fluctuations completed an open-label trial of a controlled-release carbidopa/levodopa preparation (Sinemet CR3). At the end of 6 weeks, percent "on" time and mean interdose interval increased, the number of daily doses and "off" periods was decreased, and the variability of plasma levodopa levels and disability scores was reduced. However, response fluctuations continued to occur, day-to-day consistency was poor, and the bioavailability of levodopa appeared less than that of standard Sinemet. Overall benefit waned over the next 3 to 6 months. Oral controlled-release carbidopa/levodopa is capable of reducing fluctuations in plasma levodopa levels and clinical performance in Parkinson's disease. The response to this particular controlled-release formulation was suboptimal and unsustained. PMID- 3808305 TI - Bioenergetic heterogeneity of human mitochondrial myopathies: phosphorus magnetic resonance spectroscopy study. AB - Twelve adults with mitochondrial myopathies were studied by phosphorus magnetic resonance spectroscopy of muscle. All 12 had abnormal 31P-NMR findings; recovery from exercise was abnormal in 11 patients. At rest, the ratio of phosphocreatine to inorganic phosphate was reduced in 10. Exercise transfer characteristics were abnormal in all five patients who could exercise. Exercise-induced intracellular acidosis was subnormal in nine patients. The range of abnormalities indicates biochemical heterogeneity, with two possible groups: primary defects of energy metabolism with marked 31P-NMR abnormalities, and secondary, less specific 31P NMR abnormalities. PMID- 3808306 TI - Optico-cerebral syndrome: simultaneous hemodynamic infarction of optic nerve and brain. AB - Three (0.5%) of 612 patients with an acute ischemic stroke in the carotid territory also had ipsilateral optic nerve infarction. They had unilateral or bilateral internal carotid artery occlusion and reversed flow in the ophthalmic artery. Hemodynamic infarction was suggested by triggering by a drop in blood pressure, decreased ophthalmic artery flow and perfusion pressure, and cerebral infarction in a watershed area. The "optico-cerebral syndrome" suggests internal carotid artery occlusion with hemodynamic disturbances. In carotid disease, monocular blindness may be due to an optic nerve lesion sparing the retina. PMID- 3808307 TI - Atypical Gerstmann-Straussler syndrome or familial spinocerebellar ataxia and Alzheimer's disease? AB - We report a neuropathologic study of a case with features of Gerstmann-Straussler syndrome (GSS) that is remarkable for the large number of neurofibrillary tangles (NFTs) throughout the neuraxis. The patient had a family history of spinocerebellar ataxia, but without dementia in other affected members. Our case meets the cardinal features of GSS as a rare familial degenerative disease characterized by clinically, spinocerebellar ataxia accompanied by progressive dementia, and pathologically, multiple system atrophy combined with widespread amyloid plaque deposition in the cerebral and cerebellar cortex. However, most pathologic studies stress the absence of NFTs in GSS. The nosology of this case is difficult to resolve because of profuse NFTs and morphologic differences between our and comparison Alzheimer's disease (AD) cases, the most prominent being spongiform changes. This case is remarkable because it combines features of a number of CNS degenerative diseases, including multiple system atrophy, AD, spongiform encephalopathies, and cerebrovascular amyloidosis. PMID- 3808308 TI - Recognizing neurotoxic disease. AB - We review issues that cloud the diagnosis of neurotoxic disease, and stress the importance of a directed history. Since an enormous number of potentially toxic chemicals are now deployed in the environment, workplace, and pharmaceuticals, it is essential that physicians be alert to elementary principles of clinical neurotoxicology in order that they pinpoint genuine instances of neurotoxicity and not alarm the public with spurious cases. PMID- 3808309 TI - Is surgical therapy needed for unruptured arteriovenous malformations? AB - A conservative attitude toward unruptured arteriovenous malformations (AVMs) has been based on the belief that surgical resection is too risky and that their natural history is benign. We have operated on 103 patients with a cerebral AVM. In the 49 patients with unruptured AVMs, there was no mortality, and the morbidity was 14.2%. Similarly, low surgical morbidity has been reported from several centers during the last few years. The chance of hemorrhage for both ruptured and unruptured AVMs is about 3% per year, and the combined morbidity and mortality of each hemorrhage is at least 40%. All patients with an AVM should be individually considered for possible surgical resection, whether or not they have bled. PMID- 3808310 TI - Neurology practice patterns in Colorado. AB - Eighty-one percent (47/58) of private-sector neurologists in Colorado responded to a mail survey of practice patterns. We evaluated patient load, degree of principal versus consultative care, and use of neurodiagnostic tests. Broad areas of neurologic education that were perceived to have been lacking during residency training were also addressed. Eight-four percent (41/49) of responding neurologists agreed to participate in a more comprehensive prospective study of neurology practice patterns. The prospective data will provide information to determine how many neurologists are needed and the applications for neurologic education. PMID- 3808311 TI - Artery-to-artery embolism causing stroke in the posterior circulation. AB - The features of strokes caused by embolism from the vertebral artery (VA) to the posterior cerebral artery (PCA) are reported in 12 patients ("local" or "artery to-artery embolism"). Occipital infarction occurred with prominent, fluctuating brainstem ischemic symptoms in six; with minor, transient brainstem symptoms in five; and with basilar artery occlusion in one. Visual field abnormalities were found on initial examination in eight and several days after the onset of brainstem symptoms in four. Radiographic studies in 11 identified extracranial (5 patients) or intracranial (3 patients) VA disease, or occlusion of both segments (3 patients) as sources of emboli to the PCA. Mural thrombus in the VA or embolic occlusion of distal branches of the PCA was visualized in five. PMID- 3808312 TI - Acquired dysarthria in childhood: an analysis of dysarthric features in relation to neurologic deficits. AB - We analyzed the dysarthria of four children with bilateral supranuclear facial palsy and four with bilateral peripheral facial palsy. The children with peripheral lesions had only moderate dysarthria, characterized mainly by weakened vowels and consonants and by hypernasality. In contrast, children with supranuclear lesions were anarthric at first, followed by severe dysarthria with reduced stress and many pauses. Although there was a relation between severity of dysarthria and neurologic disorders, anarthria can be seen in children with bilateral supranuclear lesions and only slight neurologic disability. Damage to cortical or brainstem control mechanisms may be responsible. PMID- 3808313 TI - Idiopathic hypoparathyroidism with extensive brain calcification and persistent neurologic dysfunction. AB - Idiopathic hypoparathyroidism is an uncommon cause of movement disorders. The following case illustrates the persistence of a parkinsonian gait 2 years after the restoration of normal serum calcium levels. The extensive calcifications in the brain presumably account for this as well as for the persistent mild dementia. The importance of identifying hypoparathyroidism early in the course is graphically illustrated. PMID- 3808314 TI - Myophosphorylase deficiency: the course of an unusual congenital myopathy. AB - A 59-year-old man had proximal weakness and wasting that started in early childhood. EMG was "myopathic," serum CK activity was increased, and muscle biopsy showed accumulations of glycogen. Biochemical studies revealed elevated glycogen concentration and absence of myophosphorylase activity. This unusual presentation of a long-standing, painless, and quite static weakness due to myophosphorylase deficiency represents another example of clinical heterogeneity. PMID- 3808315 TI - Effect of anticonvulsant drugs on glutamate neurotoxicity in cortical cell culture. AB - Pretreatment with anticonvulsants partially protects animals against the brain damage induced by intraparenchymal injection of kainate, an analogue of the neurotransmitter glutamate. In murine cortical cell culture, high concentrations of phenobarbital, diazepam, phenytoin, or GABA itself did not prevent glutamate induced neuronal loss. Addition of a glutamate receptor antagonist (gamma-D glutamyl glycine) did reduce glutamate neurotoxicity. The in vivo protective effect of anticonvulsant drugs against the toxicity of excitatory amino acids must be indirect. PMID- 3808316 TI - Altered striatal dopaminergic metabolism 36 hours after unilateral trauma to the human mesencephalon. AB - Markers of dopaminergic synaptic activity and choline acetyltransferase (CAT) were measured in the putamen and caudate nucleus of a patient who lived 36 hours after a unilateral mechanical lesion of the mesencephalon. After cessation of impulse flow along the nigrostriatal tract, dopamine was elevated, dihydroxyphenylacetic acid was diminished, and CAT and tyrosine hydroxylase activity were enhanced in the putamen ipsilateral to the lesion. [3H]-spiperone binding indicated an increase in D2-dopamine receptor density in the caudate nucleus. These findings indicate that the changes predicted from experimental neurochemical models occur in human nigrostriatal systems. PMID- 3808317 TI - Cervical root stimulation in the diagnosis of radiculopathy. AB - Cervical root stimulation (CRS) was compared with conventional EMG, nerve conduction, and late response studies in 34 patients with possible cervical radiculopathy. Cervical roots were stimulated by monopolar needles inserted into paraspinal muscles, recording compound muscle action potentials in biceps, triceps, and abductor digiti minimi muscles. In 18 patients with clinical evidence of radiculopathy, EMG was abnormal in 11 (61%), but CRS was abnormal in all 18. Of 16 patients with symptoms but no signs of radiculopathy, EMG was abnormal in 5 (31%) and CRS was abnormal in 9 (56%). PMID- 3808318 TI - Legionnaires' disease and brain abscess. AB - Neurologic symptoms are common in Legionnaires' disease, but the pathogenesis of these symptoms is not known. Brain scintigraphy or CT shows no abnormality that can account for the symptoms. We present the first evidence of cerebral abscess in a patient with serologically proven acute infection with Legionella. PMID- 3808319 TI - Motor neuron disease and paraproteinemia. AB - We studied two patients with motor neuron disease and paraproteinemia. One had amyotrophic lateral sclerosis (ALS) and IgG lambda monoclonal gammopathy. The second had slowly progressive muscular atrophy and an IgM kappa paraprotein, followed by a biclonal gammopathy when an IgA kappa paraprotein appeared. Treatment with immunosuppressive agents and plasmapheresis lowered the serum concentration of the paraproteins. The ALS syndrome progressed despite therapy. The other patient improved, was stable for several years, but then deteriorated despite continued therapy. PMID- 3808320 TI - Hemifacial spasm due to contralateral acoustic neuroma: case report. AB - A patient with a large acoustic neuroma had contralateral hemifacial spasm. On CT, the brainstem was markedly displaced and distorted by the tumor. After total removal of the tumor the hemifacial spasm was temporarily worse, but disappeared 14 days after the operation. PMID- 3808321 TI - Physostigmine-induced myoclonus in Alzheimer's disease. AB - Physostigmine caused myoclonus in two patients with Alzheimer's disease during a clinical trial. Neither patient had myoclonus before or after physostigmine treatment. We hypothesize that physostigmine reduced the sensitivity of the remaining muscarinic receptors in these two patients, altering the interaction between cholinergic and either serotoninergic or dopaminergic neurotransmitter systems. PMID- 3808322 TI - Cholinergic modulation of human P3 event-related potentials. AB - A paradigm for studying relations between behavioral, neurochemical, and electrophysiologic processes is presented. Scopolamine, a centrally acting anticholinergic agent, abolished the human auditory P3 event-related potential, but had no measurable effect on the pattern reversal visual evoked potential or alpha rhythm. Recent memory was significantly impaired, but assessment of digit span, reaction time, and distant memory showed no impairment. Physostigmine, an anticholinesterase, restored the P3 and reversed the recent memory impairment. These results strongly suggest a cholinergic role in generation of P3 potential and support the concept that P3 generation is related to memory processes. PMID- 3808323 TI - Magnetic resonance imaging after corpus callosotomy. AB - Magnetic resonance imaging (MRI) can visualize the extent of corpus callosotomy performed for medically intractable epilepsy not amenable to focal surgery. Five patients underwent complete callosotomy and one an anterior callosotomy, aged 19 to 24 years, 21 to 53 months (prior to scanning). T1 images showed complete absence of the callosal shadow in five cases and visualization of the genu and splenium in the sixth case. T2-weighted pulse sequence spin-echo MRI showed intense image throughout the region of the entire callosum in the two cases with the longest postoperative course. The two middle cases showed intense T2 signal from the splenium, and the two latest showed no increase in T2 signal. We believe the increase in T2 signal in the transected callosum may represent an in vivo example of anisomorphic gliosis. T1 images demonstrate the anatomic extent of transection, while T2 images demonstrate the chemical and pathophysiologic sequence of transection. Thus, MRI is the imaging test of choice to evaluate callosotomy patients. PMID- 3808324 TI - Prenatal detection of an inherited Duchenne muscular dystrophy deletion allele. PMID- 3808325 TI - Toluene abuse and neurologic impairment. PMID- 3808326 TI - More on numb cheek syndrome (Roger's sign) PMID- 3808327 TI - Acute "axonal" Guillain-Barre polyneuropathy. PMID- 3808328 TI - [Sudden death during Holter electrocardiographic monitoring. Description of a case]. PMID- 3808329 TI - [Treatment of hypertensive emergencies with sublingual nifedipine]. PMID- 3808330 TI - [Echocardiographic changes in hypertensive patients treated with a fixed combination of metoprolol and chlorthalidone]. PMID- 3808331 TI - [Hemodynamic effects of i.v. diltiazem in primary pulmonary hypertension. Presentation of 2 clinical cases and review of the literature]. PMID- 3808332 TI - [Vectorcardiogram (VCG) in the identification of mild-form ventricular pre excitation]. PMID- 3808333 TI - [Pneumopericardium resulting in cardiac tamponade. Description of an atypical case]. PMID- 3808334 TI - [An unusual cause of progressive anemia: ruptured aneurysm of the abdominal aorta]. PMID- 3808336 TI - [Precordial pain and cardiac amyloidosis]. PMID- 3808335 TI - [Role of HDL cholesterol in the etiology of peripheral vascular diseases in diabetes]. PMID- 3808337 TI - [Comparison of the acute effects of ibopamine with those of dopamine on the echocardiographic parameters of systolic function of the heart in congestive cardiac failure]. PMID- 3808338 TI - [Familial heredity in hypertrophic cardiomyopathy. Review of hypertrophic cardiomyopathy. Review of the literature and presentation of personal case records]. PMID- 3808339 TI - [Infarct of the right ventricle]. PMID- 3808340 TI - [Effects of intravenous metoprolol in the treatment of supraventricular tachyarrhythmias]. PMID- 3808341 TI - [Presentation of a case of idiopathic sick sinus syndrome in childhood]. PMID- 3808342 TI - [Implant of a pacemaker through a persistent left superior vena cava. Description of a clinical case]. PMID- 3808343 TI - [Myocardial infarct in the aged. Analysis of 102 cases observed in a coronary care unit (CCU)]. PMID- 3808344 TI - [Vectorcardiography in ischemic cardiopathy]. PMID- 3808345 TI - [Evaluation by an ergometric test of the effects of diltiazem in patients with stable angina]. PMID- 3808347 TI - [Fracture of a single-wire endocavitary electrode catheter as the cause of the malfunction of a VVI permanent stimulation device. Apropos of a clinical case]. PMID- 3808346 TI - [Angiographic study of isovolumetric relaxation (IVR) in chronic ischemic cardiopathy]. PMID- 3808348 TI - [Double aortic arch with an isthmic interruption in a patient with bronchiectatic dysplasia. Description of a case]. PMID- 3808349 TI - [Indications and results of the argon laser treatment of essential telangiectasis of the lower limbs]. PMID- 3808350 TI - [Auditory evoked potentials in primary and secondary brain stem lesions]. PMID- 3808351 TI - [Atracurium dose-response curve. Clinical study]. PMID- 3808352 TI - [Description of two cases of "crush syndrome" observed after the Stava catastrophe]. PMID- 3808353 TI - [Notes on the operative technic in the implantation of tunnelized peridural catheters]. PMID- 3808354 TI - [Methylmethacrylate hypersensitivity. A clinical case]. PMID- 3808355 TI - [Polyradicular neuritis following Hymenoptera stings. A clinical case with successful outcome]. PMID- 3808356 TI - [Computer software in pediatric anesthesia]. PMID- 3808357 TI - [The emergency plan of a district hospital in case of a disaster. Proposal for the organization of the Health Service]. PMID- 3808358 TI - [Dor's technic in surgical correction of hiatal hernia with gastroesophageal reflux]. PMID- 3808359 TI - [Intrahepatic calculosis: technical problems]. PMID- 3808360 TI - [Acute cholecystitis: when to operate]. PMID- 3808361 TI - [Lithiasic pathology of the choledochus. II. Our experience with the use of external biliary drainage associated with papillosphincterotomy]. PMID- 3808363 TI - [Splenic hydatidosis]. PMID- 3808362 TI - [Splenectomy in lymphoma: surgical considerations]. PMID- 3808364 TI - [Initial approach to injuries of soft tissues of the upper limbs. A statistical epidemiological survey of 4700 cases]. PMID- 3808365 TI - [Physiopathology of calcium metabolism. Several aspects of hypocalcemia secondary to thyroidectomy]. PMID- 3808366 TI - [Non-epithelial neoplasms of the stomach. Case reports]. PMID- 3808367 TI - [Carcinoid tumor of the breast. Report of a clinical case]. PMID- 3808368 TI - [Giant leiomyoma of the parametrium. Presentation of a clinical case]. PMID- 3808369 TI - [Post-traumatic diaphragmatic hernia. Clinical considerations]. PMID- 3808370 TI - [Value of antibiotic prophylaxis in elective surgery of tumors of the digestive tract in patients at risk of infection. Review of our experience]. PMID- 3808371 TI - [Sintropium bromide (VAL 480): a new spasmolytic agent in general surgery]. PMID- 3808372 TI - The Hartmann procedure: its role in acute complicated diverticulitis. AB - A retrospective study of 38 patients with Hartmann procedure for acute complicated diverticulitis. Two patients died. Continuity was restored in 30 patients (30/36). With the present mortality (2/38) and a rather low morbidity, the Hartmann procedure can be recommended in acute complicated diverticulitis. PMID- 3808373 TI - Ectopic gastric mucosa in the lower esophagus, presenting as a sessile polyp. AB - A patient with dysphagia caused by a sessile polyp in the lower esophagus is reported. Histologic examination showed ectopic gastric mucosa. Of the benign tumors of the esophagus, only leiomyoma is seen regularly. The remaining tumors are so rare that the consequences of this diagnosis are unclear. When symptoms make treatment necessary, local excision is preferred. PMID- 3808374 TI - The role of computed tomography in fractures of the acetabulum. AB - To evaluate the role of CT in acetabular fractures, CT findings were compared in 45 patients with the information yielded by conventional radiography. In 16 cases the additional information obtained by CT was of importance; indications for CT in initial assessment of acetabular fractures are discussed. PMID- 3808375 TI - Congenital duodenal diaphragm in an adolescent. PMID- 3808377 TI - Medical anti-shock trousers (MAST): a practical device for easy application. PMID- 3808376 TI - Malignant duodenocolic fistula. PMID- 3808378 TI - Acute pseudo-obstruction of the colon. PMID- 3808379 TI - [Popliteal artery entrapment syndrome]. AB - Trapped popliteal artery syndrome is relatively uncommon: the literature reports some 60 cases. The clinical picture is linked to compression of the popliteal artery by the gastrocnemius as it contracts, thus distorting the arterial route. The result is an interruption in the blood flow distally to the area involved due to stenosis of the blood vessel that is at first functional but becomes organic. PMID- 3808380 TI - [Usefulness of measuring serum ferritin in the diagnosis and staging of non microcytoma bronchial carcinoma]. AB - The value of serum ferritin assays in the diagnosis and staging of non microcytoma bronchial cancer is assessed. It is pointed out that the marker is only minimally specific and sensitive in the diagnostic phase as well as being only slightly indicative in the staging of NSCLC. PMID- 3808381 TI - [Role of echocardiography in the diagnosis of cerebral ischemic attacks of embolic origin]. AB - An echocardiographic study of 50 patients with cerebral infarction confirm the importance of this technique in the diagnosis of cerebral ischaemia originating in a cardiac embolism, an importance that has already been underlined by others. The particular value of this technique in young patients in relation to possible treatment is also pointed out. PMID- 3808382 TI - [Epidemiology of vascular diseases in Italy]. AB - The mortality rate from cardiovascular diseases was analysed for Italy as a whole and for individual regions in a sample year (1975). A distinction was made between cardiac and vascular diseases in order to assess the real incidence of the latter. The absolute number of deaths, the percentage mortality and the specific mortality quotient were studied. Deaths were also divided into age groups. Cardiovascular diseases were found to be the primary cause of death, circulatory disease the second. Among the latter, diseases of the encephalic circulation took first place. The same parameters were applied to the 1965-1983 period. Mortality due to cardiovascular disease remained constant over the period since the decrease in deaths from cardiac conditions was offset by an increase in those due to vascular disease in the strict sense. Finally the specific standardised mortality quotients per age and sex were considered in the 1970-1979 period. Mortality trends in Italy and in the individual regions were identical to those described using non-standardised indices. PMID- 3808383 TI - [Usefulness of magnetic resonance in truncal ischemia. A report of 2 clinical cases]. AB - Two cases of pontine ischaemia located in the distribution area of the perforating paramedian branches are reported. In both cases the lesion was documented by nuclear magnetic resonance whereas the CAT scan was normal in both patients. Clinical symptoms correlated well with the site and extent of the lesion documented by MR. PMID- 3808384 TI - [Methodological aspects of gastric acid examination]. AB - The aim of the present work was to study gastric acid secretion in control subjects and in gastric and duodenal ulcer patients and to evaluate sex, age, body weight, blood group, cigarette smoking and the intake of H2-blockers in the 24 hours preceding gastric acid analysis. The results obtained seem to indicate that 6 micrograms/kg b.w./i.m. Pentagastrin is the best stimulus and that basal secretion may be assessed in thirty minutes, without altering the BAO value. Factors such as cigarette-smoking and H2-blockers intake on the one hand and body weight and male sex on the other influence gastric juice output and should therefore be considered in interpreting the results. PMID- 3808385 TI - [Bile acids in chronic hepatopathies]. AB - The clinical value of measuring biliary acids in various chronic liver disease was investigated. The sample examined included 17 healthy subjects, 16 patients with active chronic hepatitis, 15 with cirrhosis of the liver and 14 with cholestatic cirrhosis. The following parameters were considered in each patient: blood bilirubin, gamma GT, alkaline phosphatase, cholinesterase, blood cholesterol, Quick time. The total pool of biliary acids was assayed by the enzymatic method on samples taken in the morning before breakfast and two hours after intake of 600 mg ursodeoxycholic acid. Total biliary increased with the progression of the pathological condition. Unlike all other indicators biliary acid assays after oral loading with ursodeoxycholic acid makes it possible to distinguish between subjects with active chronic hepatitis and those with cirrhosis of the liver. PMID- 3808386 TI - [The nonadrenergic noncholinergic system in the regulation of bronchial tonus]. AB - Bronchial release appears to be regulated by the nonadrenergic noncholinergic system whose transmitter is very probably VIP. In vivo and in vitro studies were conducted to discover whether peptide modifies basic function and/or bronchial spasm provoked by histamine. The data collected show that VIP failed to cause bronchodilation but protects against histamine induced bronchoconstriction both in vivo and in vitro. PMID- 3808387 TI - [Pathological and clinical aspects of bronchial carcinoid tumor. The authors' own case reports]. AB - Data (radiological, endoscopic, histological, clinical and surgical) are presented on 21 subjects with pulmonary carcinoid tumour encountered in the Turin University Chest Surgery Centre in 1980-1985. All patients were subjected to fibrobronchoscopy which revealed the tumour in 18 cases (14 were given multiple biopsies and in 4 cases samples could not be taken due to the patient's intolerance of the endoscopic manoeuvre). No appreciable bleeding occurred after any biopsy. Surgery was performed on all 21 patients (2 pneumonectomies, 7 bilobectomies, 12 lobectomies). There was 85.71% correspondence between pre and post-operative histological diagnosis. PMID- 3808388 TI - [Rare neoplastic and common pathologies of the thyroid]. AB - Observation of three cases of rare thyroid pathology (medullary carcinoma, thyroid lymphoma, De Quervain's subacute thyroiditis) triggers a discussion of the need to take due account of such rare pathologies in preoperative differential diagnosis in order to avoid giving the wrong treatment. The fact that extemporary histological examination is no help in such situations is also discussed. PMID- 3808389 TI - [Diagnosis of duodenogastric biliary reflux: cholescintigraphy and gastroscopy compared]. AB - A group of 35 patients with biliary lithiasis in whom gastroscopy and/or cholescintigraphy revealed the presence of a duodenogastric reflux are examined. The comparative diagnostic value of gastroscopy and cholescintigraphy is considered. The diagnosis of reflux is only indicated by gastroscopy. PMID- 3808390 TI - [Unilateral pulmonary edema due to rapid re-expansion in pneumothorax]. AB - A case of unilateral pulmonary oedema (UPO) caused by rapid re-expansion after drainage of a spontaneous pneumothorax is reported. If acute respiratory failure is noted at the moment of re-expansion the condition can be brought within safe limits by careful clinical observation and if necessary the use of assisted respiration. PMID- 3808391 TI - [Drug dependence]. PMID- 3808392 TI - [Clinical experience with the use of Amorosa, a low-mineral water, in athletes]. AB - Nine semi-professional football players have been studied during a pre championship retreat in a hilly area with their team. The nine athletes drank "Amorosa" oligo mineral water for three weeks and various haematochemical parameters (such as uricaemia, creatinemia, azotemia, sodium content) both before and after the retreat, have been evaluated. Furthermore, LDH and CPK were monitored before and after an exertion test on an exercise bicycle after hydropinic ingestion. The results obtained fully confirm the diuretic and cathartic properties of the water and its property of mobilization of hydroelectrolytic system which are even more useful in subjects needing a rapid elimination of metabolic wastes accumulated during muscle fatigue. PMID- 3808393 TI - [Research on the psychological view of maternity in women in the puerperium]. AB - The aim of our research was to observe the ways in which the hospital and the social environment react towards delivery and birth and how pregnant women experience this event from the psychological point of view. A questionnaire was submitted to 58 puerperas at their third-fifth day. From the analysis of the results we can observe that the hospital structure tends to treat this experience as a mechanical and routinary event; this particularly jouful moment which should be a time of celebration is often undervalued. As a matter of fact the hospital does not create an atmosphere of joy which should accompany any event connected with birth and which should be transmitted to the child offering him a sense of confidence from the very first moment of his life. Women are generally the victims of a culture of terror, originated by an ideology of "institutionalism" which tends to regard the process of birth as a medical phenomenon and not as a natural one, and so they prefer to hand over all responsibility to the specialist, instead of taking charge of it themselves. We have also noticed that women very rarely undertake psycho-physical training before the delivery; the reasons may be the culture of terror or also because the training techniques are considered inadequate for the psychological aspects. We have observed that most of all, women are frightened by the delivery itself and of giving birth to a deformed child. Women lack an experience of psychological growth which would help them to reach an emotional maturity. This is necessary to help the child to develop his infinite potential and abilities which he already possesses from the moment he is born and which will help him to face whole heartedly the fascinating albeit painful adventure that is life. PMID- 3808394 TI - [Medico-social considerations on a hospital case-load of accidental injuries in the elderly]. AB - The files of the Casualty Ward in a Florentine hospital for 1934-36, 1955-57 and 1976-78 were examined and 5030 cases of accidental injuries in the elderly were extracted for analysis. The subjects were grouped according to age, type and locality of the accident and morphology of the clinical picture. The results obtained from statistical analysis of the data demonstrate an increased percentage of accidents in the home, at work and in the street. Road accidents, the incidence of which varied in the different periods considered, were excluded. The outstanding feature is the notable increase in accidents of every type in the home, an environment traditionally considered safe or at least protected. Some medicolegal remarks on these results are presented with the aim of promoting a greater knowledge of the epidemiology of this phenomen as is essential if preventive measures are to be taken. PMID- 3808395 TI - [Chronic pulmonary tuberculosis in a survey of a suburban health center]. AB - The authors survey the epidemiology of pulmonary tuberculosis in the area of their responsibility. Tendency, frequency and severity of a high number of chronic cases are underlined. PMID- 3808396 TI - [Bacterial meningitis]. AB - After a presentation of purulent and liquoral bacterial meningites with an examination of their pathogenesis, a personal case series is presented. Particular attention is paid to the liquoral transfer of antibiotics and it is considered that the treatment of purulent bacterial meningitis cannot be standardised. In contrast tubercolar meningitis can be subjected to standardised treatment. Currently the results obtained in the treatment of purulent bacterial meningitis are less satisfactory than those obtained in tubercular meningitis though certainly better than in the recent past. PMID- 3808397 TI - [Esophageal lesions caused by oral drugs. Epidemiology, physiopathologic bases, prospectives of prevention]. AB - Esophageal injuries caused by oral medications have recently been recognized as a iatrogenic entity. This pathogenesis is due to the retention in the esophagus of drugs with caustic properties. The main predisposing factor is the practice of taking oral drugs with a small quantity of water of and/or in a recumbent position. Elderly subjects and patients with pre-existing esophageal disorders are at higher risk, so that fluid formulations or different routes of drug administration are strongly recommended. A more widespread education to the correct use of drugs and a better drug formulation are necessary for effective prevention. PMID- 3808398 TI - [Behavior of the turnover of I131-fibrinogen in various diseases of the connective tissue]. AB - It is generally admitted that alteration to the blood coagulation system, particularly the creation of fibrin from fibrinogen may play a pathogenetic role in the complex mechanism that characterises rheumatic diseases of the connective tissue. A study was therefore conducted to see whether accelerated fibrinogen turnover could be demonstrated in such patients. To this end the clearance of fibrinogen marked with I131 was assessed in 25 patients in various stages of connectivitis and 10 controls was measured. The results showed a distinct acceleration in fibrinogen turnover only in patients with highly active rheumatoid arthritis. In contrast patients with rheumatoid arthritis in the regressive phase or with stable progressive systemic sclerosis showed values similar to the control subjects. Finally the possible explanations for this behaviour are examined and the clinical interest of the technique employed is assessed. PMID- 3808399 TI - [Rabies and activity of the antirabies center in the province of Mantua]. AB - After an examination of the aetiological, anatomopathological and clinical aspects of rabies, the latest epidemiological studies are described with emphasis on the ways the virus enters Italy. Particular emphasis is given to prophylaxis with gamma globulin and vaccines with a review of their preparation and use past and present. Details are also given of the latest vaccine prepared from human diploid embryonic cells (HDCV). The general and specific procedures adopted in the case of injuries by an animal belonging to a species capable of contracting and transmitting the infection are then described. The last part of the paper presents a case series covering 5 years' activity in the Antirabbies Centre in the Province of Mantua (1979-83). It is concluded that in order to prevent the spread of the disease we need veterinary vigilance, the presentation of information about the problem in schools and the mass media and local Antirabbies Centres providing a round the clock service of assistance and information. PMID- 3808401 TI - [A case of Hodgkin's disease complicated by Strongyloides stercoralis infestation]. AB - A case of Hodgkin's disease complicated by severe Strongyloides stercoralis infection is reported. Strongyloides is an opportunistic parasite that can produce particularly dangerous clinical pictures by autoinfestation in patients with impaired immunity. The appearance of aspecific gastrointestinal symptoms in such patients should trigger careful examination to discover the presence of parasites as well as the more common pathogenic bacteria. reduced among the elderly. PMID- 3808400 TI - [Thyroid function in the euthyroid elderly subject: evidence of low T3 syndrome]. AB - The presence of a low T3 syndrome was confirmed in elderly euthyroid patients. The condition is characterised by lower circulating total (TT3) and free triiodothyronin (FT3) than in adults with no clinical symptoms of hypothyroidism. A total of 133 subjects over 65 were studied as we used 204 adult controls aged 18-65. Among the indices of thyroid function studied only TT3 and FT3 were founded to be statistically reduced among the elderly. PMID- 3808402 TI - [Diagnostic contribution of carcinoembryonic antigen (CEA) in the pleural fluid and serum of patients with metastatic pleural effusion caused by neoplasm of the breast]. AB - The problem of the diagnosis of pleural exudates in breast cancer is examined. It is pointed out that cytology is very little help and it is suggested that carcinoembryonic antigen could be used for assays of the serum and pleural fluid given its high sensitivity even when the cytological examination is negative. PMID- 3808404 TI - [A case of recurrence of pernicious anemia]. AB - A case of pernicious anaemia recurring after 14 years in a patient who had suspended parenteral vitamin B12 treatment two months after the first hospitalisation is described. The earliest haematological signs of vitamin B12 deficiency are examined and the apparent failure to absorb the vitamin B12 regularly taken with the diet when no longer administered parenterally is discussed. PMID- 3808403 TI - [Insulin therapy with microinfusion devices. Review of the literature]. AB - The aim of the present work is to review the most recent data in the literature about the problems, true advantages and limits of continuous infusion of insulin in the therapy of insulin-dependent diabetes mellitus. After a report on the kinds of microinfusors available today and the possible ways of continuously administering insulin, some aspects of CSII (continuous subcutaneous insulin infusion) are reviewed: indications, side effects, patterns of insulin flow programming and psychological aspects. The need for preliminary selection of the patients who are to undergo instructive courses is emphasized. Then the data from the literature about the effects of continuous infusional therapy in relation to metabolic alterations and the later complications of diabetes are analysed. These important aspects are compared with the results of conventional insulin therapy. Finally, the effects of continuous infusional therapy during pregnancy, on brittle diabetes, on insulin sensitivity and on the "down phenomenon" are analysed. It is concluded that, even if you cannot formulate a definitive opinion about this topic, microinfusors can be a functional means of achieving excellent metabolic control. Nevertheless, their greater efficiency in comparison with the so-called optimized insulin therapy has not been unequivocably demonstrated, and the real need for them at the present time appears to be exceptional. PMID- 3808405 TI - [Hepatic injury in mitral valvular cardiopathy. Clinical and diagnostic aspects]. AB - Liver function was studied in 38 patients with various types of mitral valve disease hospitalised with suspected "cardiac liver". Liver biopsy confirmed the suspicion in 22 cases including 4 with cardiac cirrhosis. The remaining 16 patients had other liver pathologies. No significant differences were noted in the distribution of symptoms, clinical signs and laboratory indices of liver function between the two groups of patients. Among instrumental examinations laparoscopy resulted in a diagnostic accuracy of 89.4% and liver echography of 73% when their results were compared with those of needle biopsy. In other words clinical and laboratory diagnosis of "cardiac liver" was found to be totally unreliable whereas, among instrumental examinations, liver echography proved to be a reasonably efficient alternative to laparoscopy. The diagnostic accuracy of this non-invasive test suggests that it should be used systematically for the screening and follow-up of this type of patients, whereas invasive investigations would be reserved for selected cases. PMID- 3808406 TI - [Hepatic cirrhosis caused by alcohol: normalization of the functional parameters after prolonged abstinence]. AB - It has often been noted that total abstention from alcohol will lead to the normalisation of modest liver lesions. For this reason the possibility of regression of more severe lesions was studied. To this end five patients with clinically diagnosed cirrhosis of the liver (bioptically confirmed in 2 cases) were followed up for a minimum of 1 and a maximum of 5 years, demonstrating the total reversibility of clinical and laboratory signs after total abstention for an average 15 months. PMID- 3808407 TI - [Pseudoaldosteronism caused by licorice. Review of the literature and description of 4 clinical cases]. AB - Metabolic and toxic effects caused by prolonged daily ingestion of Liquorice are well known in the literature. Such acquisition doesn't seem to be known enough by practitioners and by common people. Besides active substances such as Glycyrrhizin , Liquorice contains even steroids similar to the adrenocortical ones; among these the most important is Beta-Glycyrrhetinic acid. This one, in vivo and in vitro, produces salt and water retention by means of a "DOCA-like" mineral-corticoid mechanism, and clear suppression of the Renin-Angiotensin Aldosterone axis. A low plasmatic level of Renin and Aldosterone is a common feature. The clinical picture in many ways is similar to the primary Aldosteronism and for this reason the above mentioned syndrome is usually called "Pseudoaldosteronism". Symptoms and signs can be classified into the following main groups: symptoms linked with water and salt retention: oedemas, hypertension, cardiac involvement. Symptoms linked with serum Potassium depletion: asthenia, paralysis (due to Potassium deficiency), myopathy with myoglobinuria. The diagnosis is essential based on an accurate pharmacological dietetic history, aimed to recognise an excessive use of Liquorice (pure or more often as substitute) in the screening of hypertension with or without hypopotassemia. Finally, the more or less quick normalisation of blood pressure and biochemical signs--as an "ex juvantibus" criterion--is the most important reason for the diagnosis. After a wide survey of the literature, the clinical and biological picture in four patients with chronic Liquorice ingestion and Pseudoaldosteronism syndrome is described. PMID- 3808408 TI - [Prognostic value of the non-stress test in the presence of maternal hypertension in pregnancy]. PMID- 3808409 TI - [Clinical significance of echocardiographic monitoring in pregnancies complicated by maternal hypertension]. PMID- 3808410 TI - [Childbirth in adolescents]. PMID- 3808411 TI - [Childbirth in the older pregnant woman]. PMID- 3808412 TI - [Evaluation of the immune status in patients with breast carcinoma]. PMID- 3808413 TI - [Hormonotherapy of carcinoma of the endometrium]. PMID- 3808414 TI - [The success of cervical cerclage in the prevention of the premature interruption of pregnancy]. PMID- 3808415 TI - [Effectiveness of surgical therapy in stenosis of the vulvar ostium]. PMID- 3808416 TI - [A new concept of complete gynecologic surgery for the cure of female urinary incontinence and vaginal prolapse]. PMID- 3808417 TI - [Critical evaluation of the impact of vaginal mycosis in an ambulatory population. Relation between laboratory results and clinical picture]. PMID- 3808418 TI - [Epidemiology of viral hepatitis B: transmission of the infection from mother to child]. PMID- 3808419 TI - [Immunity response in HBV infection in pregnancy. Results of a prospective study]. PMID- 3808420 TI - [Perinatal transmission of hepatitis B. Results of a longitudinal study]. PMID- 3808421 TI - [Evaluation of iron-deficiency anemia in pregnancy]. PMID- 3808422 TI - [Transverse fetal growth curves. A multicenter study]. PMID- 3808423 TI - [Substance dependence and pregnancy. Experience in care]. PMID- 3808424 TI - [Neonatal thrombocytopenia in infants of mothers with ITP]. PMID- 3808425 TI - [Adenocarcinoma of the uterine cervix]. PMID- 3808426 TI - [Association of breast carcinoma and malignant neoplasms of the female genital tract]. PMID- 3808427 TI - [Endocrine aspects of the empty sella syndrome]. PMID- 3808428 TI - [Atypical uterine blood loss: screening using hysteroscopy]. PMID- 3808429 TI - [Colposcopic investigation of 62,258 subjects. Clinico-statistical considerations]. PMID- 3808430 TI - [Side effects and complications of intrauterine devices with special reference to pelvic infection]. PMID- 3808431 TI - [Version using sternal maneuvers under anesthesia and tocolysis]. PMID- 3808432 TI - [The use of sintropium bromide, a new spasmolytic, in obstetrics and gynecology]. PMID- 3808433 TI - [Correlations between colposcopic and cytologic findings]. PMID- 3808434 TI - [Development of a case of carcinoma in situ in pregnancy]. PMID- 3808435 TI - [Cervical endometriosis: findings on a case secondary to diathermocoagulation]. PMID- 3808436 TI - [Colposcopic terminology]. PMID- 3808437 TI - [The endocervix evaluated by the hysteroscope]. PMID- 3808438 TI - [Colposcopic study in the diagnosis of epithelial changes in the vagina]. PMID- 3808439 TI - [Diagnosis of vulvar dystrophy]. PMID- 3808440 TI - [The colposcopic technic and cyto-oncologic sampling]. PMID- 3808441 TI - [Colposcopic indications for biopsy. Biopsy technic and the pathologist's need for an exhaustive histological interpretation]. PMID- 3808442 TI - [Colposcopy and medico-legal problems]. PMID- 3808443 TI - [Cervical therapy]. PMID- 3808444 TI - [Technical variation of conization. Our case records and results]. PMID- 3808445 TI - [Colposcopic training on the pubic structures]. PMID- 3808446 TI - [Colposcopic training of gynecologists on the pubic structures]. PMID- 3808447 TI - [The role of colposcopy, today]. PMID- 3808448 TI - [Survey on colposcopic terminology]. PMID- 3808449 TI - [Colposcopy in young girls and in puberty]. PMID- 3808451 TI - [Colposcopy in the post-menopausal period. A short outline]. PMID- 3808450 TI - [Colposcopy in teen-agers]. PMID- 3808452 TI - [Study of the blood vessels in colposcopy]. PMID- 3808453 TI - [Interference of non-viral inflammations with colposcopic findings]. PMID- 3808454 TI - Dietary iron supply in meningococcal disease patients and controls. AB - Dietary questions were directed to patients and controls in a follow-up study of incident meningococcal disease cases in Norway, winter 1981-1982. The questions emphasized the main iron sources in the usual diet. The daily intake of iron from some sources was estimated, and the various groups compared. The differences were small. PMID- 3808455 TI - Detection of serum antibody response in patients infected with one strain of Campylobacter jejuni with a DIG-ELISA method. AB - Paired sera from 10 patients and a convalescence sample from one patient suffering from campylobacteriosis were analysed for IgG, IgM and IgA antibodies against the infective organism (Campylobacter jejuni PEN 0:6,7) with a DIG-ELISA system. Either formalinized, ethanol-inactivated or heat-inactivated preparations of the infecting organism were used as antigens. Cross reactivity was tested with human sera having agglutinating antibodies against Yersinia enterocolitica (N = 6) or Salmonella typhi or S. parathyphi b (N = 7). All patients displayed IgA and IgM levels in the convalescence sample above that found in healthy blood donors (N = 55). Using the ethanol-inactivated or formalinized preparations more than 90% of the convalenscence sera showed IgG levels above that found in blood donors whereas the heat-inactivated preparation detected 73% IgG positives in the same group of sera. Serum from one patient infected with S. parathyphi b was positive in the test. This finding was interpreted as most likely due to a double infection. The study suggests that serum IgA may be a valuable marker for infection with this microorganism. Both the formalinized and the ethanol inactivated preparations showed presence of flagella in contrast to the heat inactivated preparation. PMID- 3808456 TI - Measurement of cytoplasmic, free magnesium concentration with entrapped eriochrome blue in nerve endings isolated from the guinea pig brain. AB - Cytoplasmic, free Mg2+ was measured spectrophotometrically using an intrasynaptosomally entrapped Mg2+-indicator, Eriochrome blue (EB). Addition of the ionophore A23187 or disruption of the synaptosomal plasma membrane with digitonin caused an increase in absorbance of entrapped EB with a maximum at 551 nm, which is typical for the Mg2+-EB complex. A conversion of absorbance changes to levels of free Mg2+ concentrations was performed after disruption of synaptosomal plasma membranes by digitonin. The results indicated that the internal, free Mg2+ increased from 0.34 to 2.2 mM when the extracellular Mg2+ concentration was increased from 1 to 5 mM. The low values of cytoplasmic, free Mg2+ concentrations suggest the presence of effective regulatory mechanisms in the nerve endings. PMID- 3808457 TI - Primary retinopathy in scrapie in mice deprived of light. AB - Rodents infected with some strains of scrapie develop a severe retinopathy in which the photoreceptor cells are destroyed. The possibility that this results from light-induced damage as a secondary consequence of the disease was tested by maintaining scrapie-infected albino mice in total darkness. Photoreceptor loss occurred in terminal scrapie-infected mice maintained in both total darkness and in normal lighting conditions establishing that the retinopathy is a primary lesion with this strain of scrapie agent. PMID- 3808458 TI - Reduced number of [3H]nicotine and [3H]acetylcholine binding sites in the frontal cortex of Alzheimer brains. AB - Nicotinic cholinergic receptors were measured in human frontal cortex using [3H]nicotine and [3H]acetylcholine (in the presence of atropine) as receptor ligands. A parallel marked reduction in number of [3H]nicotine (52%; P less than 0.01) and [3H]acetylcholine (-55%; P less than 0.05) binding was found in the frontal cortex of Alzheimer brains (AD/SDAT) when compared to age-matched control brains. As a comparison the number of muscarinic receptors was quantified using [3H]quinuclidinyl benzilate and found to be significantly increased (+23%; less than 0.01) in AD/SDAT compared to controls. PMID- 3808459 TI - Decrease in the density of orthogonal arrays of particles in membranes of cultured rat astroglial cells by the brain fibroblast growth factor. AB - The effect of brain-derived basic fibroblast growth factor (bFGF) on the membrane structure of cultured rat astroglial cells was investigated by quantitative freeze-fracture replica examination. In the presence of bFGF the number of the orthogonal arrays of particles (OAP), which are characteristic compounds of the membrane of mammalian astrocytes, is clearly reduced. This finding is discussed in the framework on current views about neuro-glial interactions and their implications in the process of fiber regeneration in the central nervous system. PMID- 3808460 TI - Course corrections of deflected retinal axons on the tectum of the chick embryo. AB - Recently developed neuroanatomical staining methods utilizing transportable markers have made it possible to visualize individual, growing retinotectal axons in the chick embryo. In the present work, we used such methods to examine the behavior of mechanically deflected axons on the tectum. The deflection of axons was achieved by inserting small teflon barriers into the embryonic tectal tissue shortly before the arrival of retinal axons. All axons are laterally deflected by the teflon barrier from their original anteroposterior direction of growth. At the end of the barrier most of them correct their direction of growth. Not only do they turn again towards the posterior tectal pole, but they also approach the route they would have taken in the absence of the barrier. PMID- 3808461 TI - Three-dimensional visualization of the intraganglionic structures of the rat myenteric plexus: scanning electron microscopy with the connective tissue digestion method. AB - The rat myenteric plexus was chemically microdissected and the internal structures of the ganglia were demonstrated under a scanning electron microscope. The present preparation offers a view of the three-dimensional features of ganglion cells and permits their surface structures and the size and pattern of varicosities to be observed. Numerous finger-like processes were observed on the cell bodies of the studded neurons in close relationship with the varicose axons. The intramuscular branches of the plexus were also microdissected and their running pattern was observed. PMID- 3808462 TI - Alteration of the discharge pattern of rat diencephalic neurones with scrotal skin temperature. AB - Neuronal responses to different scrotal skin temperatures were examined in the hypothalamus of anaesthetised male rats. Mean firing rate and interspike intervals were calculated on-line by microcomputers. Two types of response were observed when the scrotal skin was warmed: an abrupt change in mean firing rate coupled with a change in firing pattern, or a change of pattern unaccompanied by any change in mean rate. These results suggest that hypothalamic cells can convey information independently of their mean firing rate. PMID- 3808463 TI - Arginine sensors in the hepato-portal system and their reflex effects on pancreatic efferents in the rat. AB - To investigate the possible existence of arginine sensors in the liver and their reflex effects, afferent discharges from the hepatic branch of the vagus nerve and efferent discharges from the pancreatic branches of the splanchnic and vagus nerves were recorded. Intraportal injection of arginine increased afferent discharge rate of the hepatic branch of the vagus nerve, slightly depressed the efferent discharge rate of the pancreatic vagal branch, and increased the efferent discharge rate of the pancreatic splanchnic branch. The results suggest the existence of arginine sensors in the hepato-portal system that exert reflex regulation of the pancreatic neuroendocrine system. PMID- 3808464 TI - An abnormal retinal projection to the lateral posterior nucleus in micrencephalic rats. AB - The retinofugal projections of albino rats made micrencephalic by prenatal exposure to the cytotoxic teratogen methylazoxymethanol acetate (MAM Ac) have been examined. The only abnormality noted was an increased projection to the lateral posterior nucleus of the thalamus in rats exposed to MAM Ac on embryonic day 15. The relatively normal retinofugal projections were surprising in view of the extensive damage induced by prenatal exposure to this drug. PMID- 3808465 TI - Synthesis of catalytically active choline acetyltransferase in Xenopus oocytes injected with messenger RNA from rat central nervous system. AB - Choline acetyltransferase (ChAT) mRNA and ChAT enzymatic activity have been compared in different regions of the rat central nervous system. mRNA was assayed by exploiting the Xenopus oocyte system which was first tested by measuring the electrophysiological response to glycine after injection of mRNA derived from the ventral part of the spinal cord (VSC). This tissue was found to contain the highest ChAT mRNA level. The striatum, which yielded the maximal enzymatic activity, contained 10 times less ChAT mRNA than the VSC. These results are discussed in terms of the neuroanatomical differences between the two structures. PMID- 3808466 TI - Major dopamine innervation of the cortical motor areas in the cynomolgus monkey. A radioautographic study with comparative assessment of serotonergic afferents. AB - Dopamine (DA) and serotonin (5-HT) innervations were revealed by radioautography in primary motor, premotor and supplementary motor (SMA) cortex in Cynomolgus monkeys, using uptake of tritiated amines in vibratome sections under specific conditions that were previously established. DA and 5-HT axons were distributed throughout all cortical layers. A denser DA innervation was found in layers I, III and to a lesser extent layer V with a striking cluster-like arrangement in layer III, particularly in the SMA. 5-HT axons appeared less numerous; their lower density in comparison with DA axons was especially apparent in layer III, particularly in the premotor and motor areas. A DA-5-HT complementarity was thus suggested in this layer. These results suggest that in addition to the motor control exerted through the nigrostriatal pathway, the cortical DA projections could directly modulate the neuronal activity in motor areas. This could be of major importance in the pathophysiology of motor disorders such as Parkinson's disease. PMID- 3808467 TI - Relationship of parasagittal bands of acetylcholinesterase activity to the climbing fiber representation. AB - The organization of the somatosensory representation by the climbing fiber system was correlated to parasagittal zones in the vermis, which were demarcated by the parasagittal banding pattern of acetylcholinesterase (AChE) activity. Extracellular recordings were made of climbing fiber responses that were elicited by tactile stimulation in anesthetized cats. After the climbing fiber representation was mapped physiologically, the cerebellum was histologically processed for AChE activity. The lateral edge of the lateral AChE banding coincided with the junction between a medial vermis (zones A and X) where 82% of the units were unresponsive and the lateral vermis (zone B) where 72% of the climbing fiber responses represented areas of the body surface. PMID- 3808468 TI - Effect of phospholipase C on the binding of alpha-bungarotoxin to isolated plasma membranes of rat skeletal muscle. AB - Sarcolemmal membranes were isolated from hindlimb muscles of the rat and the specific binding of [125I]alpha-bungarotoxin to the membranes was determined. Incubation of the membranes with a purified preparation of phospholipase C (ex Clostridium perfringens) increased the specific binding of the toxin (Bmax). The apparent dissociation constant (Kd) for the binding was unchanged by treatment with the enzyme. The possibility that latent acetylcholine receptors exist in muscle sarcolemma, and that these receptors can be activated by the enzyme, is discussed. PMID- 3808469 TI - Non-myelinated afferent fibres do not originate exclusively from the smallest dorsal root ganglion cells in the cat. AB - In chloralose-anaesthetized cats, the somata of cervical dorsal root ganglion cells with non-myelinated peripheral branches (group IV units) were impaled with glass micropipettes containing a 10% solution of horseradish peroxidase (HRP). The units were identified by their conduction velocity in the peripheral nerve (less than 2.5 m/s). After identification, HRP was injected iontophoretically into the soma. No significant correlation was found between the conduction velocity and cross-sectional areas of these somata. The soma sizes were distributed over a great portion of the whole size spectrum of the cells in the ganglia studied (C7 and C8). PMID- 3808470 TI - Magnetic fields abolish nychthemeral rhythmicity of responses of Purkinje cells to the pineal hormone melatonin in the pigeon's cerebellum. AB - The effects of micro-electrophoretically applied melatonin on the electrical activity of Purkinje cells in the cerebellum of anaesthetized pigeons were studied. The proportion of excitatory and inhibitory responses to the pineal indoleamine varied significantly depending on whether the cells were tested during the day or at night. This day/night rhythm of responses was abolished if the birds were exposed to complete inversion of the vertical component of an artificial earth's strength magnetic field for one hour at 21.00 h. The results are in line with the concept that pineal involvement in endogenous central nervous rhythms is influenced by changes in the earth's magnetic field. PMID- 3808471 TI - Octadecaneuropeptide, benzodiazepine ligand, -like immunoreactivity in rat central nervous system, plasma and peripheral tissues. AB - Using a specific radioimmunoassay we have investigated the distribution of octadecaneuropeptide (a putative endogenous ligand at the benzodiazepine receptor)-like immunoreactivity (ODN-IR) in rat brain and peripheral tissues. Highest concentrations in brain were found in the hypothalamus, cerebellum and substantia nigra. Significant concentrations of ODN-IR were found in all peripheral tissues studied and in plasma. Chromatographic analysis revealed several molecular forms; one major form, indistinguishable from the synthetic peptide, was found predominantly in peripheral tissues and in plasma, while another major form, of higher molecular weight, was found in brain, peripheral tissues and plasma. Although ODN-IR was present in the synaptosomal fraction, concentrations in the microsomal fraction were higher than for other neuropeptides studied. PMID- 3808472 TI - An initial analysis of the regional distribution of excitatory sulphur-containing amino acids in the rat brain. AB - Certain sulphur-containing amino acids are putative excitatory transmitters in the mammalian central nervous system. The quantification and a partial regional analysis of these compounds in the rat brain is presented. Our findings show that (S)-(+)-homocysteate, determined for the first time, is the most concentrated of those sulphonic and sulphinic amino acids assayed here. PMID- 3808473 TI - Biphasic actions of L-DOPA on the release of endogenous dopamine via presynaptic receptors in rat striatal slices. AB - In rat striatal slices, 30 nM of L-DOPA increased the impulse (5 Hz)-evoked release of dopamine (DA), without increasing the spontaneous release and tissue content of DA. The minimum dose required to increase spontaneous DA release was 0.1 microM and the dose which led to an accumulation of DA was 100 microM. In the presence of NSD-1055, a DOPA-decarboxylase inhibitor, L-DOPA-induced increases in spontaneous DA release were prevented and L-DOPA produced dual actions on the evoked release of DA, a stereoselective propranolol-sensitive increase at 30 nM and a stereoselective sulpiride-sensitive decrease at 1 microM. L-DOPA produces dual presynaptic regulatory actions on DA release, via facilitatory beta adrenoceptors at 30 nM and inhibitory DA receptors at 1 microM. The primary action of L-DOPA appears to be the facilitation of release of DA rather than the conversion to DA. PMID- 3808474 TI - Effects of Ca antagonists on the action potential and their relationship to the muscarinic ACh actions in isolated sympathetic neurons of rabbits. AB - Muscarinically induced depressions of the shoulder in the falling phase as well as the after-spike-hyperpolarization and -depolarization of the action potential in the isolated sympathetic neurons of rabbits were mimicked by a novel peptide Ca channel blocker, omega-conotoxin (synthetic; 0.1-0.5 microM). Cobalt ions (0.1 2 mM) showed bidirectional effects on the shoulder, an early depression followed by a later prolongation, while they consistently induced depressions of other components. Organic Ca channel blockers, verapamil and D-600 (1-50 microM) and nifedipine (0.1-1 microM) appeared to have other effects as they rather caused a prolongation of the falling phase that was shortened by further application of acetylcholine. PMID- 3808475 TI - Proceedings of the Workshop on Neurobehavioral Effects of Solvents. October 13 16, 1985, Raleigh, North Carolina, U.S.A. PMID- 3808476 TI - The study of solvent effects in animals. PMID- 3808477 TI - Exposure issues in the evaluation of solvent effects. PMID- 3808478 TI - Human aspects of solvent neurobehavioral effects. PMID- 3808479 TI - Interconnections between the subthalamic nucleus and the cerebral cortex of the cat. AB - The corticosubthalamic and subthalamocortical projections were examined in the cat by anterograde and retrograde axonal transport of horseradish peroxidase (HRP). Injections of HRP into the gyrus proreus, gyrus sigmoideus anterior and the part lateral to the sulcus cruciatus gave rise to anterogradely labelled terminals in all parts of the ipsilateral subthalamic nucleus in a topographical manner. Injections of HRP into these cerebral cortices as well as the gyrus sigmoideus posterior, the posterior part of the gyrus coronalis and the middle part of the gyrus ectosylvius produced retrogradely labelled neurons in the medial half of the ipsilateral subthalamic nucleus in a topographical manner. These findings suggest that the subthalamic nucleus acts as a link not only in the pallido-subthalamo-pallidal loop but also in the corticosubthalamo-cortical pathways. PMID- 3808480 TI - Do pontocerebellar mossy fibres give off collaterals to the cerebellar nuclei? An experimental study in the cat with implantation of crystalline HRP-WGA. AB - In 15 cats with implantations of crystalline HRP-WGA in the cerebellar nuclei and tetramethylbenzidine histochemistry, the pontine nuclei were carefully examined for presence of retrogradely labelled cells. Findings in the nucleus reticularis tegmenti pontis and the inferior olive, both known to project to the cerebellar nuclei, served as controls for effectiveness of uptake and transport. After implantations restricted to the lateral cerebellar nucleus in 5 cats altogether two labelled cells were found in the contralateral pontine nuclei in regions receiving afferents from the lateral nucleus. In contrast, many labelled cells occurred in the nucleus reticularis tegmenti pontis and the inferior olive. After implantations in 5 cats restricted to the posterior or anterior interposed nuclei, altogether only one labelled cell was found in the pontine nuclei, while many labelled cells occurred in the inferior olive. The nucleus reticularis tegmenti pontis contained a small number of retrogradely labelled cells after implantations in the anterior interposed nucleus, but none after implantations restricted to the posterior interposed nucleus. After implantations restricted to the medial (fastigial) nucleus, no retrogradely labelled cells were found in the pontine nuclei and nucleus reticularis tegmenti pontis (although many were present in the inferior olive). The present findings support earlier conclusions based on anterograde tracing methods that the cerebellar nuclei receive very few, if any, afferents from the pontine nuclei. PMID- 3808481 TI - Inferior olive lesion induces long-term modifications of cerebellar inhibition on Deiters nuclei. AB - The frequency of discharge of cerebellar Purkinje cells and lateral vestibular nuclear cells were recorded at different intervals of time after injection of 3 acetylpyridine (3AP), which destroys the inferior olivary nucleus. During the first few days, Purkinje cells showed an increase of simple spike firing, while Deiters cells showed a strong depression of their discharge. Recordings up to 3 months demonstrated, for both groups of cells, a recovery, whose time course is faster for Deiters cells than for Purkinje cells. A reduced inhibitory efficacy of Purkinje cells, as a consequence of climbing fibre deprivation, is suggested. PMID- 3808482 TI - Topographic arrangement of the projection from the anterior thalamic nuclei to the cingulate cortex in the cat. AB - After injection of HRP into the cingulate and its adjacent cortical areas, neuronal cells were retrogradely labeled ipsilaterally in the anterior, lateral, ventral, intralaminar and midline thalamic nuclei. Most of them occurred in the anterior nuclei, and a topographic correlation was revealed in the projections from the anterior thalamic nuclei to the cingulate gyrus: the rostral part of the cingulate gyrus receives fibers predominantly from the lateral part of the AM and additionally from the caudomedial part of the AV. The caudal part of the cingulate gyrus receives fibers from the medial part of the anteromedial nucleus (AM) and the rostromedial part of the anteroventral nucleus (AV). The intermediate part of the cingulate gyrus receives fibers from the intermediate part of the AM and the caudal half of the AV. PMID- 3808483 TI - Postnatal mitotic division of endothelial cells in the brain. AB - Ultrastructural details of capillary endothelial cells undergoing mitosis in the central nervous system are reported. These mitotic endothelial cells were seen in the brain of 10-day-old mice treated with 6-aminonicotinamide, an antagonist of niacin. Electron microscopy revealed these cells to be characterized by segregated chromosomal materials and the absence of a nuclear membrane. They possessed well-formed tight junctions with adjacent endothelial cells. Numerous microtubules radiated from a centriole toward the chromosomal material. The basal lamina of these dividing endothelial cells was not always well defined and, in some portions was discontinuous. We believe this to be the first ultrastructural demonstration of mitotic endothelial cells in the postnatal brain. PMID- 3808484 TI - The responsiveness of Clare-Bishop neurons to size cues for motion stereopsis. AB - The responsiveness to the size cue, and a combination of the size and motion cues contained in 3-dimensional motion of a visual stimulus was studied in 118 Clare Bishop (CB) cells, including 37 and 10 cells selectively responsive to approaching (AP) and to recessive motion along the axis through the center of the receptive area and the nose (RC), 40 cells responsive to the frontoparallel motion in the horizontal direction (FP), 23 cells rather non-selectively responsive to the two types of motion (NS) and 8 cells responsive to the size cue but unresponsive to the 3-dimensional motion (SZ). About three quarters of the AP cells (27/37) were responsive to both an increase in the stimulus size and divergent motion of the retinal images in the two eyes, which represents the size and motion cues for the approaching motion along the axis through the center of the receptive area and the nose, and were optimally excited by a combination of the two visual cues. About the same fraction of the RC cells (6/10) was responsive to the motion (convergent motion) and size cues (a decrease in stimulus size), and optimally excited by a combination of the two visual cues. In contrast, only a small fraction of the FP cells (6/40) were sensitive to the size cue, and all FP cells were optimally excited by the single presentation of the motion cue for the frontoparallel motion (either right- or leftward motion in both eyes). Responses were frequently (18/40) smaller for the combined presentation of the two visual cues than for the single presentation of the motion cue. Similarly, a small fraction of the NS cells (7/23) was sensitive to the size cue, but many of them (16/23) were non-selectively responsive to the size cues for the approaching and recessive motion. A similar study in an additional 108 (78 AP and 30 RC) cells which were responsive to approaching or recessive motion vertically or obliquely deviating from the axis through the center of the receptive area and the nose demonstrated that they were also sensitive to both motion and size cues for that approaching or recessive motion, and were optimally excited by a combination of the two visual cues. These findings indicate that the CB cell responsiveness to 3-dimensional motion is based on the integration of the motion and size signals conveyed through the two eyes. A model of neuronal circuitry was constructed to explain the CB cell responsiveness to the motion and size signals. PMID- 3808485 TI - Hippocampal minispindle wave in the cat: the different distribution of two types of waves. AB - Spindle-like waves of 40-85 Hz (minispindle-II) and 85-155 Hz (minispindle-I) were recorded from the cat hippocampus. Minispindle-II, as well as minispindle-I, occurred during drowsy and slow-wave sleep episodes. The minispindle-I type was dominant in the CA1 sector; and, conversely, the minispindle-II type was predominant in the hilus of the dentate gyrus. In addition to the different distribution of minispindle-I and -II, disparity was observed in the concurrency of the minispindles. PMID- 3808486 TI - A microcomputer-based system for detailed analysis of rat behavior. AB - A microcomputer-based system that can measure rotational behavior and moving velocity is described. Infrared photobeams detect the animal behavior. One advantage of this system is that data can be stored on floppy disks and analyzed in arbitrary time intervals. This system may be useful for detailed analysis of rat behavior in physiological or psychopharmacological experiments. PMID- 3808487 TI - The responsiveness of Clare-Bishop neurons to motion cues for motion stereopsis. AB - Under paralysis of eye movement and optical adjustment of visual axes of the two eyes, neuronal responsiveness in cat Clare-Bishop (CB) cortex to the binocular presentation of visual stimuli was studied using two types of visual stimulator which presented: 3-dimensional motion of a visual stimulus; and the motion cues (movement of retinal images in the two eyes) contained in the 3-dimensional motion. On the basis of the responsiveness to 3-dimensional motion presented by the first type of stimulator, the CB cells were classified into approaching (AP) cells which were selectively responsive to the approaching motion of a visual stimulus, recessive (RC) cells responsive to the recessive motion, frontoparallel (FP) cells responsive to the frontoparallel motion and non-selective (NS) cells responsive to more than two types of motion. The investigation of the CB cells with 2-dimensional motion stimulus demonstrated 3 different types of binocular interaction: facilitatory (52/239); antagonistic (33/239) or linear summation (154/239). Cells exhibiting the facilitatory interaction (n = 52) were all FP cells, those exhibiting the antagonistic interaction were either AP (n = 25) or RC cells (n = 8), and those exhibiting the linear summation were comprised of all varieties of cells (49 AP, 17 RC, 31 FP and 57 NS cells). The cells responsive to the approaching (37 AP cells) or recessive motion between the center of the receptive area and the nose (10 RC cells), or frontoparallel motion (42 FP cells) in the horizontal direction exhibited the selective responsiveness to the motion disparity (a combination of horizontal movement of retinal images in the two eyes), and those responsive to the vertically or obliquely deviating approaching (20 AP cells) or recessive motion (14 RC cells), or frontoparallel motion in the vertical or oblique directions (13 FP cells) exhibited that for a combination of the motion disparity and the frontoparallel motion in the vertical or oblique direction. These findings indicate that the CB cell responsiveness to 3 dimensional motion of a visual stimulus is explained by the binocular integration of motion signal viewed by each eye. PMID- 3808489 TI - Judi Buckalew: learning to play political hardball. Interview by Linda J. Pearson. PMID- 3808488 TI - Screening tool for daily fetal movement. AB - Knowledge of the expected pattern of fetal movements is important to both health care providers and childbearing women since altered patterns can signal fetal compromise. The daily fetal movement count (DFMC) chart, a tool that is inexpensive, uncomplicated and non-invasive, is a clinically effective means of screening for fetal well-being after 20 weeks' gestation. The DFMC requires pregnant women to begin a fetal movement count at a selected time each day, count 10 movements and record the elapsed time from the first to the tenth movement. Findings which would indicate possible danger to the fetus, and which should be reported immediately, include less than 10 movements in 12 hours; no perception of movement in an eight-hour period; a change in the usual pattern of fetal movement; or a sudden increase in violent fetal movements followed by complete cessation of movement. Development of fetal movement assessment, fetal movement recording methods, teaching patients the DFMC method and nursing implications are described in this article. Use of the DFMC by nurse practitioners can enhance the physical and emotional well-being of pregnant clients. PMID- 3808490 TI - Future research recommendations for establishing NP effectiveness. AB - An information synthesis was conducted to examine nurse practitioner effectiveness as substantiated in existing literature. After an extensive computerized and manual search of the literature, 248 documents judged by staff to be relevant to the topic were reviewed by a content-area expert (N = 11 members), and a methodology expert (N = 8 members). Experts had been chosen on the basis of multiple nominations from an extensive national survey of professional nurses in leadership positions. Upon completing the respective reviews, experts identified key areas in support of NP effectiveness that had not been established or clarified in existing literature. A summary and discussion of the experts' recommendations for future studies in support of nurse practitioner effectiveness are presented. PMID- 3808491 TI - Schizophrenia in primary care. AB - Schizophrenia affects 1 percent of the general population in the United States. Unfortunately, this common illness is often poorly understood and feared by many health care professionals. Whether nurse practitioners who work in primary care are aware of it or not, they inevitably come into daily or weekly contact with schizophrenics. This article is designed to increase nurse practitioners' understanding of this brain disease and help them realize that they already possess skills that are ideally suited to working with this population. Presented here are current definitions and facts about schizophrenia, as well as practical ideas for history taking, physical exam and the development of a realistic management plan. PMID- 3808492 TI - A neural metric. AB - On the hypothesis that the language of the brain may be reducible to a simple yet general metric, the parameters of neural activity used by the nervous system to represent information are examined. Obviously the elegant specializations in neuron response characteristics and the discoveries of detailed and complex anatomical connections are important. But these appear to divert our attention from some of the equally important but simplest and most obvious aspects of neural organization. Some of these more obvious important parameters include the absolute sizes of various brain areas, amount of activity evoked in the neurons involved, and the time over which integration occurs. Considering both the simpler and more complex factors together leads to a very simple but powerful hypothesis of the natural language and metrics of the brain, the differences in amounts of evoked activity between diverse functions summed over space and time. PMID- 3808493 TI - Oesophageal transit patterns in healthy subjects. AB - Oesophageal transit was studied in 49 healthy volunteers. When a good quality bolus was reached, the tracer passed through the oesophagus leaving no residual activity. The mean time of transit of the total oesophagus was 4.5 +/- 1.3 s. In cases of fragmented bolus, residual activity was found in about 80% of the cases giving rise to a prolonged transit time. When using 81Krm, artefacts due to fragmented bolus can easily be overcome by repeating the test as often as necessary. PMID- 3808494 TI - Scintigraphy in duodeno-gastric reflux: a new method of quantification. AB - A prospective study is undertaken in order to demonstrate the ability of scintigraphy with a non compartmental analysis to quantitate the duodeno-gastric reflux. 24 patients have been examined, sitting in front of a gamma camera: 12 with an endoscopically proved reflux and 12 normal subjects or volunteers. About 15 min after an injection of 148 to 222 MBq 99Tcm-IDA they were given a meal labelled with 37 MBq 113Inm-DTPA. Images were recorded for 2 h. Equal size gastric and duodenal ROIs were selected over the duodenum and stomach, avoiding overlap with neighbouring organs. The reflux index based upon the occupancy principle is calculated from the gastric and duodenal curves. It is the ratio between the gastric and duodenal ROI IDA fluxes. The value of the reflux index is 3 +/- 1.8% in normal subjects and 45 +/- 33% in pathological cases. Our method, which does not require intubation, quantitatively evaluates biliary reflux independently of injected dose and hepatic or gallbladder function. PMID- 3808495 TI - Bone mineral content of the spine with dual photon absorptiometry: normalization of the values. AB - A Novo Industry BMC-LAB 22a densitometer equipped with a 153Gd source was recently implemented for the measurement of bone mineral content (BMC). 70 females (aged 16 to 86 years) and 67 males (aged 20 to 79 years) were selected to form a reference population. Care was taken to exclude patients with an illness or taking a drug that could influence the measurements, made at the lumbar spine level (L2-L4). Normalization procedures using several parameters (age, length, weight, span, lean body mass, an index of obesity, accepted scans) were developed to try and reduce the large interindividual coefficient of variation (CV). Total BMC values were found to yield a larger CV than when expressed as BMC cm-1. The relation of BMC with age showed a significant linear decrease of 0.3% year-1 for the male population. In the female population the BMC was not correlated with age up to the age of 50 years. Thereafter a linear bone loss of 0.76% year-1 was noted. Correcting for length decreased the CV in males and in females younger than 50 years. The use of the other parameters resulted in no or a very slight improvement. Combining parameters in a multiple regression analysis resulted in a significant decrease of the CV in females older than 50 years only. PMID- 3808496 TI - Evaluation of the response of a round hole scintillation camera collimator by the Fourier analysis method. AB - The Fourier analysis method was used to investigate the response of scintillation camera collimators with parallel holes. This method which takes into account the septal penetration was applied to the case of round hole collimators having a hexagonal distribution. Modulation transfer functions, MTF have been determined to verify the accuracy of the computed Fourier coefficients of the collimator function. Comparisons between the geometric and the penetrating plus geometric transfer function are shown for round and hexagonal holes. PMID- 3808497 TI - Bone marrow imaging: a comparison study using a 99Tcm-sulphur colloid versus a new 99Tcm-microaggregated albumin. PMID- 3808498 TI - Imaging of metastatic medullary carcinoma of the thyroid with 131I-meta iodobenzyl guanidine. PMID- 3808499 TI - A time for reason. PMID- 3808500 TI - Variables associated with postoperative deep venous thrombosis: a prospective study of 411 gynecology patients and creation of a prognostic model. AB - Deep venous thrombosis is a major complication following gynecologic surgery. Assessing a patient's risk of developing deep venous thrombosis is important for patient selection and in choosing appropriate prophylactic methods. Four hundred eleven patients undergoing major gynecologic surgery were evaluated prospectively. All known variables associated with deep venous thrombosis were recorded. Deep venous thrombosis was diagnosed by 125I fibrinogen leg counting of all patients. Univariate analysis of all variables identified the following to be significantly related (P less than .05) to postoperative deep venous thrombosis: a prior history of deep venous thrombosis, leg edema or venous stasis changes, venous varicosities, degree of preoperative ambulation, type of surgery, nonwhite race, recurrent malignancy, prior pelvic radiation therapy, age above 45 years, excessive body weight, intraoperative blood loss, and duration of anesthesia. A stepwise logistic regression analysis of these variables was performed. The following preoperative prognostic factors remained significant: type of surgery, age, leg edema, nonwhite patients, severity of venous varicosities, prior radiation therapy, and prior history of deep venous thrombosis. Duration of anesthesia was also important when intraoperative factors were considered in the analysis. Using these factors, a prognostic model was created and tested. The model resulted in a degree of concordance of 0.82 and allows one to evaluate the risks of postoperative deep venous thrombosis for an individual patient. PMID- 3808501 TI - Papanicolaou smear history of patients developing cervical cancer: an assessment of screening protocols. AB - The American Cancer Society recently has suggested changes in the frequency of Papanicolaou smear screening which, if followed, would alter current practice considerably. This study assessed the impact of the Papanicolaou smear screening interval on the prevention of advanced disease. Between July 1, 1980 and June 30, 1984, 264 women were evaluated and treated for primary epithelial carcinoma of the cervix (64% had stage I disease). Ninety-seven women (37%) had had a normal Papanicolaou smear within three years of diagnosis, including 48 women (18%) whose last normal Papanicolaou smear was within a year of diagnosis. The cytologic history was unavailable for 81 women (31%). Patients with a screening interval of greater than six years were more likely to be older, of lower socioeconomic status, and black, as compared with patients in the more frequently screened groups. Patients with a screening interval of 36 months or less were similar to those with a 37- to 72-month interval with respect to age, racial characteristics, and socioeconomic status. In this similar group of patients, a screening interval of 37-72 months was associated with a significantly larger proportion of advanced stage disease than found in more frequently screened patients. A policy of screening more frequently than every three years may therefore lead to increased survival among women who develop cervical cancer despite cytologic screening. PMID- 3808502 TI - End colostomy using the end-to-end anastomosis instrument. AB - Gastrointestinal stapling instruments have achieved wide-spread application in intestinal surgery. Reported advantages of stapled bowel procedures compared to classic hand-sutured procedures include reduced tissue trauma, shorter operating time, and improved blood supply to the stapled bowel segment. A technique for creation of an end colostomy using the end-to-end anastomosis stapler (EEA instrument) is described. This technique was used in 11 gynecologic oncology patients who required colostomy. Postoperative stomal function was normal in all cases. No patient developed stomal necrosis, peristomal hematoma, or abscess. No delayed complications have been observed. Colostomy creation with the EEA instrument is a safe, simple and rapid procedure. Possible advantages of the stapled colostomy are enhanced blood flow to the stomal site, reduced incidence of peristomal infection, and improved appliance fit. PMID- 3808503 TI - Fetal pulmonary artery and aorta: two-dimensional Doppler echocardiography. AB - Two-dimensional and pulsed Doppler ultrasound techniques were used to examine 87 fetuses between 17 and 41 weeks' gestation in order to compare pulmonary artery and aortic outflow diameters, mean and maximal flow velocities, and transvalve flows. For purposes of analysis, fetuses were divided into two groups: those less than 31 weeks, and those of 31 weeks or more. Diameters of the pulmonary artery and aortic outflow region increased with advancing gestational age (P less than .001), while mean and maximal Doppler flow velocities did not change. Transvalve volume flow increased across both regions (pulmonary artery from 381 +/- 12 mL/minute to 530 +/- 13 mL/minute and aortic outflow from 286 +/- 10 mL/minute to 410 +/- 13 mL/minute, P less than .001) with advancing gestation. Pulmonary artery diameters were larger than aortic outflow diameters in both groups (P less than .01), while mean Doppler flow velocities were not significantly different. Maximal Doppler flow velocities were greater in the aorta than in the pulmonary artery (P less than .001), and transvalve flow was greater across the pulmonary artery than the aorta in both groups (P less than .05, ratio 1.3:1). This work demonstrates differences in fetal pulmonary artery and aortic outflow anatomy and physiology that must be considered in evaluating studies of fetal cardiac physiology. PMID- 3808504 TI - Respiratory distress syndrome in infants of diabetic mothers in the 1980s: no direct adverse effect of maternal diabetes with modern management. AB - The purpose of this study was to test the hypothesis that diabetes in pregnancy in the 1980s no longer represents a direct risk factor for the development of respiratory distress syndrome (RDS) independent of gestational age, race, sex, mode of delivery, and neonatal asphyxia. We pair-matched 127 infants of diabetic mothers (diabetic group) with 127 infants of nondiabetic mothers (controls) for the above factors. Diabetic mothers enrolled before nine weeks' gestation were randomly assigned to one of two groups: I. "strict management," to achieve euglycemic (fasting blood glucose less than 80 mg/dL, 1.5-hour-postprandial blood glucose less than 120 mg/dL); II. "customary management," to provide care "as practiced in the community" (fasting blood glucose 100 mg/dL or less, postprandial blood glucose less than 140 mg/dL). A group enrolled after the first trimester (III) was managed identically to group II. Infants of diabetic mothers had a rate of RDS of 13.4%, not significantly different from the rate of 15% in controls (P greater than .05). When analyzed by gestational age groups of less than 36, or 36 or more weeks' gestation, there was also no difference in frequency of RDS between the diabetic group and controls. By logistic regression analysis, the presence of RDS in infants of diabetic mothers significantly correlated with lower gestational age (P less than .0001), and delivery by cesarean section not preceded by labor (P less than .01)(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808505 TI - Preterm premature rupture of the membranes with fetal pulmonary maturity present: a prospective study. AB - Ninety-nine patients with premature rupture of the membranes (PROM) before 36 weeks' gestation and documented fetal pulmonary maturity were studied prospectively. Fifty-two patients in labor were allowed to deliver. The remaining 47 were randomly assigned to either prompt delivery (N = 26) or conservative management (N = 21). The overall corrected perinatal survival was excellent (96%). Only one death in the entire series clearly was due to prematurity. Expectant management prolonged gestation greater than one week in only four of 21 patients (19%), and was associated with a significantly increased risk of maternal infections. There were no failed inductions of labor, and 22 of 24 induced patients (92%) delivered vaginally. Neonatal morbidity was similar in each group. These findings in an indigent, largely black population suggest that when pulmonary maturity is present, the maternal risks of conservative management may exceed the potential benefit to the fetus and newborn. The findings of this study may be specific to the population studied, and extrapolation to dissimilar populations may not be warranted. PMID- 3808506 TI - Detection of serum antibody response to Bacteroides bivius by enzyme-linked immunosorbent assay in women with intraamniotic infection. AB - Amniotic fluid from patients with intraamniotic infection usually reveals multiple organisms, including aerobes, anaerobes, and mycoplasmas. Bacteroides bivius, one of the most common isolates in these fluids, is found in approximately 20% of cases. To provide further information of the role of B bivius in intraamniotic infection, we measured serum immunoglobulin G (IgG) against B bivius by a micro-enzyme linked immunosorbent assay. Antigen was prepared from whole cells of a clinical isolate. Amniotic fluid was collected by aspiration of a transcervical pressure catheter, and was cultured for aerobes, anaerobes, and mycoplasmas. Acute and convalescent sera from 47 infected women and 31 controls were assayed to detect serologic response. Patients with intraamniotic infection and B bivius in amniotic fluid culture had significantly greater serologic responses than did infected women without B bivius in amniotic fluid and asymptomatic controls. These data suggest a pathogenic role of B bivius in intraamniotic infection, and imply that it probably plays a frequent role in other obstetric infections. PMID- 3808507 TI - Placental alkaline phosphatase as a tumor marker in ovarian cancer. AB - The serum levels of placental alkaline phosphatase were determined with a radioimmunoassay using a polyclonal antibody on 1236 samples from 414 patients with ovarian cancer. The frequencies of elevated enzyme levels for patients with or without evidence of disease were 17.7 and 10.9%, respectively. The true positive rate was highest in serous cystadenocarcinoma, undifferentiated carcinoma, and dysgerminoma. A tendency to an inverse correlation with differentiation was found. Measurement of the enzyme did not give a useful index of stage of disease, tumor burden, or prognosis. The value of the enzyme as an index of successful therapy was limited because half of the patients lost this marker during progression. Further studies of the use of this enzyme as a tumor marker should evaluate the modulation of the placental alkaline phosphatase pattern during the course of the disease and should be based on monoclonal antibodies. PMID- 3808508 TI - In vitro sensitivity of human ovarian tumors to chemotherapeutic agents with adjuvant danazol. AB - Human ovarian tumors have been cultured as primary monolayers in vitro. The in vitro chemosensitivity was determined indirectly using [3H]leucine uptake with cisplatinum, adriamycin, bleomycin, thiotepa, and chlorambucil. Chemosensitivity also was determined using these agents in the presence of danazol. The tumor cultures showed a uniform increase in sensitivity to these agents in the presence of danazol, suggesting that this drug might merit testing as an adjuvant in the chemotherapy of ovarian cancer. PMID- 3808509 TI - In vitro growth characteristics and chemosensitivities of endometrial cancer using a soft agar clonogenic assay. AB - A soft agar clonogenic assay was used to analyze 91 fresh human endometrial tumor samples for in vitro growth and chemosensitivities. Overall cloning success was 81%. Of the 75 samples adequate for drug testing (30 or more colonies per plate), histologic analysis demonstrated 36 adenocarcinomas, seven adenoacanthomas, ten adenosquamous carcinomas, nine mixed mesodermal sarcomas, seven carcinosarcomas, three papillary adenocarcinomas, and three clear-cell carcinomas. Mixed mesodermal sarcoma specimens demonstrated the most efficient growth, followed by the adenosquamous adenocarcinoma and adenoacanthoma samples. In vitro chemosensitivities were determined by colony inhibition resulting from continuous exposure of tumor cells to known achievable peak plasma and one-tenth peak plasma concentrations of a particular agent. The plating efficiency reflected the clinical virulence by cell type. Thus, we found that malignant endometrial tumors can be cloned in vitro, and the observed chemosensitivities reflect the relative clinical resistance of the tumors to these agents. Based on the high cloning success, this tumor type may be well suited as a model using in vitro soft agar cloning for new drug screening, evaluation of novel drug combinations, and studies of human tumor biology. PMID- 3808510 TI - Routine pretreatment evaluation of patients with gynecologic cancer. AB - We evaluated the usefulness of the routine pretreatment performance of a chest x ray, intravenous pyelogram (IVP), cystoscopy, barium enema, and sigmoidoscopy in patients presenting with endometrial and cervical carcinoma by reviewing the results of these tests in 231 patients. In no patient with cervical or endometrial carcinoma was tumor involvement of the large bowel mucosa found by the use of sigmoidoscopy and barium enema. Two percent of the cervical patients and none of the endometrial patients had bladder mucosal involvement discovered by using cystoscopy. Ureteral obstruction was seen by the IVP in 9% of the cervical patients and 1% of the endometrial patients. All of the women with cervical carcinoma who had bladder mucosal invasion or ureteral obstruction were already stage III before these tests. The chest x-rays showed a 0.7 and 3% incidence of tumor involvement in cervical and endometrial patients, respectively. The final stage differed from the initial stage in seven of the cervical patients and in two of the endometrial patients, but only in three of these nine were the changes based on the findings of the routine pretreatment evaluation. We conclude that routine cystoscopy, barium enema, and sigmoidoscopy in all patients with early stage cervical or endometrial carcinoma is not necessary, that a routine chest x-ray is still indicated in all patients with these malignancies, and that IVP should be performed routinely in all patients with cervical carcinoma but only if clinically indicated in patients with endometrial carcinoma. PMID- 3808511 TI - Familial hypersecretion of adrenal androgens transmitted as a dominant, non-HLA linked trait. AB - Clinical evidence of adrenal androgen hyperfunction (premature pubarche, hirsutism, amenorrhea) occurred in the studied proband, her mother, maternal aunt (twin sisters), and maternal great-grandmother. The basal levels of androgen in the first three were variably elevated. In all the members of this family who were tested, the response of 17-hydroxyprogesterone and progesterone to adrenocorticotropic hormone stimulation was either normal or of the type seen in heterozygotes for congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Of particular importance is the fact that neither the proband nor her mother or maternal aunt had the type of response seen in homozygotes presenting the attenuated form of congenital adrenal hyperplasia. The disorder appears to be a familial condition resulting in excessive levels of adrenal androgens beginning during childhood years, causing hirsutism and amenorrhea and interfering with normal pubertal and adult ovarian function. Glucocorticoid therapy suppresses adrenal androgen levels; in two individuals, conception occurred twice in each during such treatment in otherwise amenorrheic individuals. The pattern of transmission of the disorder appears to be either autosomal or X-linked dominant, and not linked to the homologous leucocytic antibodies (HLA) region of the sixth chromosome. PMID- 3808512 TI - Ketonuria in normal pregnancy. AB - Nine low-risk, clinically normal pregnant women tested their urine for ketone bodies at three- to four-day intervals throughout gestation. Eight of the women had acetoacetonuria present on two to 15 days each. This finding was not related to length of gestation or time of day. Ketonuria probably occurs sporadically in most normal pregnancies. PMID- 3808513 TI - Incidence and recurrence rate of abruptio placentae in Sweden. PMID- 3808514 TI - Sex differences in the practice patterns of recently trained obstetrician gynecologists. PMID- 3808515 TI - Decreased birth weight and femur length in fetuses of patients with the sickle cell trait. PMID- 3808516 TI - Efficacy of Doppler echocardiography in the evaluation of aortic stenosis during pregnancy. AB - The recently developed technology of Doppler echocardiography was used to evaluate a pregnancy complicated by aortic stenosis. Given the lack of established norms for this test during pregnancy and the known cardiovascular changes during pregnancy, it is difficult to interpret this test. However, in the case presented, this test suggested the need for more conservative management, a plan that was justified postpartum. PMID- 3808518 TI - Idiopathic facial nerve paralysis (Bell's palsy) in late pregnancy and the early puerperium. AB - We describe seven patients with idiopathic facial (VII) nerve palsy commencing primarily in late pregnancy or in the immediate postpartum period. One patient had recurrent Bell's palsy in three consecutive pregnancies. Three women developed bilateral palsy. The occurrence of such otherwise rare manifestations of Bell's palsy supports the suggestion that physiologic changes occurring in late pregnancy or the immediate puerperium predispose to Bell's palsy. PMID- 3808517 TI - A case of sudden retinal artery occlusion and blindness in pregnancy. AB - Central retinal artery occlusion is generally a disease of old age associated with loss of vision in one eye. In older patients, it is usually secondary to emboli from atherosclerotic plaques; in younger patients valvular heart disease is a common precursor. Several other conditions have been associated with central retinal artery occlusion, but to our knowledge, there have been no previously reported cases with pregnancy as the sole associated factor. Such a case is presented. PMID- 3808519 TI - A large meningioma presenting as a neurologic emergency in late pregnancy. AB - A case is described of a large meningioma presenting as an acute neurologic emergency in late pregnancy. The diagnosis was made by a head computed axial tomography scan and an immediate cesarean section was performed, followed by a craniotomy and dissection of the tumor, with excellent outcome both for mother and infant. PMID- 3808520 TI - Anterior sacral meningocele in pregnancy. AB - Anterior sacral meningocele is a rare abnormality. Only 14 cases of it have been reported in association with pregnancy. Of those 14 patients, three died as a result of rupture of the meningocele during labor and postpartum. A new case is presented; the clinical presentation, the diagnosis, and treatment are discussed. The obstetric management of the case is discussed and a plan for management is suggested. PMID- 3808521 TI - Recurrent hematuria during multiple pregnancies. AB - A 33-year-old woman presented left ureteral gross hematuria under two conditions: before the second trimester of her last three gestations, and after therapy with an oral contraceptive. We believe that left renal vein varicosities, influenced by mechanical and hormonal factors, produced the hematuria. PMID- 3808522 TI - Hemolytic uremic syndrome after ectopic pregnancy: postectopic nephrosclerosis. AB - Postpartum nephrosclerosis or hemolytic uremic syndrome of pregnancy has been reported to occur as early as the first trimester of pregnancy. The following is a case report of nephrosclerosis occurring after removal of an ectopic pregnancy. PMID- 3808523 TI - Supraglottic hemangioma during pregnancy. AB - A 37-year-old woman, gravida 10, para 1-0-8-1, presented in her second trimester of pregnancy with complaints of frequent sore throats, change in voice quality, and recumbent dyspnea. These symptoms were noted initially during her previous pregnancy, and resolved after delivery. She was found to have a supraglottic hemangioma which occluded 40% of her upper airway. This lesion was noted to dramatically involute beginning at 36 weeks' gestation. The supraglottic hemangioma is a very rare cause of dyspnea in pregnancy. Its growth during pregnancy and regression postpartum is possibly related to the effects of estrogen and progesterone. PMID- 3808524 TI - Myositis ossificans progressiva and pregnancy. AB - Myositis ossificans progressiva is a rare inherited ossifying condition of the striated muscle tissue. In the English language literature there is no reported association of this disease with an advanced state of pregnancy, nor is there any well-documented scientific data about the effect of pregnancy on this disease or of this disease on pregnancy. This report is about a patient with myositis ossificans progressiva carrying to 30 weeks' gestation and successfully delivering a viable female infant. The antenatal care and management problems of this case are discussed. PMID- 3808525 TI - Ectopic pregnancy in an undescended fallopian tube: an unusual presentation. AB - A case of a ruptured ectopic pregnancy in an undescended fallopian tube is presented. The tube and its ipsilateral ovary were located near the splenic flexure of the colon. The embryology and the differential diagnosis of this potentially fatal condition are discussed. PMID- 3808526 TI - Primary sclerosing cholangitis and pregnancy. AB - Primary sclerosing cholangitis is a chronic, fibrosing, inflammatory disorder of unknown etiology affecting the biliary tree. We describe a case of a pregnancy complicated by this condition. Remarkably, maternal cholestasis improved with advancing gestation. Despite a marked elevation of bile acid levels in cord blood, the patient was delivered of a healthy term infant. The principles of management and potential effects of primary sclerosing cholangitis on pregnancy care are discussed. PMID- 3808527 TI - Unexpected accumulation of acyclovir in breast milk with estimation of infant exposure. AB - Although acyclovir is prescribed to women of reproductive age, no information currently exists regarding the advisability of its use in lactating women. This report documents the first known case of acyclovir transfer to an infant through breast milk. Maternal plasma, milk, and infant urine were collected following a 200-mg oral dose of acyclovir. The drug concentration in breast milk exceeded the corresponding plasma concentration except at the time of peak plasma concentration. This would not be expected on the basis of simple diffusion, and might be caused by a facilitated or active transport mechanism. Such a mechanism has not been described for any drug in human breast milk. Subtherapeutic amounts of acyclovir were documented in the infant, and we discuss the potential effects on neonatal immune function. The use of acyclovir in lactating women remains controversial until further study can clarify pertinent questions. PMID- 3808528 TI - Management of primary herpes in pregnancy complicated by ruptured membranes and extreme prematurity: case report. AB - A case of primary herpes simplex vaginitis during pregnancy became complicated by rupture of membranes at 25.5 weeks' gestation. The patient was treated with intravenous acyclovir shortly after rupture, and managed expectantly. Genital lesions rapidly abated, and the infant was delivered by cesarean section at 26.5 weeks' gestation after labor ensued. Transplacental passage of acyclovir was documented. The infant then was treated with a ten-day course of intravenous acyclovir. The infant has remained culture negative for 12 months after delivery. PMID- 3808529 TI - Spontaneous utero-ovarian vessel rupture during pregnancy: three case reports and a review of the literature. AB - Spontaneous rupture of a utero-ovarian vessel during pregnancy is a rare cause of obstetric shock that has caused high rates of maternal and fetal loss. Extensive literature search has revealed only 117 previously reported cases. Three recently managed cases are presented, and clinical features of this maternal complication are discussed. PMID- 3808530 TI - Placenta accreta: a problem of increasing clinical significance. AB - Placenta accreta in association with placenta previa and previous cesarean delivery is a condition of increasing clinical significance. A case report of a woman with placenta percreta is presented. Risk factors, incidence, and management are discussed. Recommendations for preoperative and intraoperative management are presented. PMID- 3808531 TI - Acute fatty liver of pregnancy: etiology of fetal distress and fetal wastage. AB - Acute fatty liver is a rare complication of pregnancy occurring in approximately one in 13,000 deliveries. This disease has been associated with high maternal and fetal mortality rates in the past. Advances in medical care and early recognition and delivery are credited with recent reductions in the maternal and fetal loss seen with this disease. Maternal death is associated with hypoglycemia, hepatic failure, or coagulopathy. The etiology of fetal mortality is not well delineated. Reported is a patient with histologically proved acute fatty liver who developed fetal distress during therapy for coagulopathy. Review of the fetal monitor tracing in conjunction with examination of the placenta have led us to propose that uteroplacental insufficiency may be the cause for fetal distress and fetal wastage in fatty liver of pregnancy. PMID- 3808532 TI - Syndrome of genital, renal, and middle ear anomalies: a third family and report of a pregnancy. AB - Two sisters with multiple congenital anomalies are described. They are felt to represent the third affected sibship with the rare syndrome of genital, renal, and middle ear anomalies. A term pregnancy is also reported in the younger of the affected sisters. PMID- 3808533 TI - Avoidance of maternal morbidity in acute intrauterine infection following chorionic villus sampling. AB - Serious maternal morbidity has been a feature of the few documented cases of acute intrauterine infection after chorionic villus sampling. A case is described in which infection manifested 14 days after transcervical chorion biopsy. Broad spectrum antibiotics were begun, and ultrasound demonstrated a live fetus. After vacuum curettage was performed, repeat scan showed an empty uterus. Anaerobes isolated from the cervix both before chorionic villus sampling and during the infection were also implicated in published reports of patients developing life threatening complications, but were not treated specifically until after morbid sequelae had occurred. Serious morbidity was avoided in this patient by aggressive management with early anaerobic cover, uterine evacuation despite the presence of a live fetus, and confirmation of complete evacuation by ultrasound. PMID- 3808534 TI - Pulmonary endometriosis: treatment with danazol. AB - Pulmonary endometriosis is a rare clinical problem. There is limited information available regarding management of this disorder. Four cases of successful treatment with danazol have been reported. This is a report of a woman with catamenial hemoptysis who responded successfully to danazol therapy; however, hemoptysis resumed after cessation of therapy. The patient was subsequently treated successfully with a total abdominal hysterectomy and bilateral oophorectomy. PMID- 3808535 TI - Hyperandrogenic state associated with a mucinous cystadenoma. AB - A case of mucinous cystadenoma associated with androgen secretion is presented to add to the growing body of literature concerning hormone secretion by ovarian neoplasms regarded as "nonfunctional." The theorized mechanisms of hormone production in these tumors also are reviewed. PMID- 3808536 TI - Ileal resection in the operative treatment of endometriosis. AB - Endometriosis is a common gynecologic condition in which the small intestine is often involved. Anatomic involvement of the appendix and ileum can be catastrophic, leading, respectively, to intussusception and obstruction with potential perforation. We present a case of subclinical ileal endometriosis and recommend careful examination of the ileocecal region during laparotomy when endometriosis is present. Operative treatment is discussed. PMID- 3808537 TI - Nodular fasciitis of the vulva: a report of two cases. AB - We describe two patients with nodular fasciitis of the vulva, a benign pseudoneoplastic lesion that can histologically mimic sarcoma. PMID- 3808538 TI - A de novo case of vulvar synergistic necrotizing fasciitis. AB - Necrotizing fasciitis is an uncommon but potentially lethal soft tissue infection. Reports of this entity in the obstetric patient exist. We present a case of necrotizing fasciitis arising de novo in the vulva. Early diagnosis and radical surgical debridement are the hallmarks of successful treatment. PMID- 3808539 TI - Vaginal agglutination and hematometra associated with epidermolysis bullosa. AB - A case of genital involvement with epidermolysis bullosa is described. Scarring led to vaginal obstruction and hematometra. The classification and treatment of this rare disorder are discussed. PMID- 3808540 TI - Persistent ectopic syndrome: a case report and literature review. AB - A case report is presented of an ampullary ectopic pregnancy which was treated by salpingostomy. Twenty-six days later, the patient underwent repeat operation due to the persistence of trophoblastic tissue within the fallopian tube. A review of the English literature reveals nine cases including our own that have been reported to date. In eight of nine cases, trophoblastic tissue was recovered at the time of the second operation. In the four cases where human chorionic gonadotropin (hCG) titers were available before and after the second procedure, the titers were positive initially and reverted to negative postoperatively. The disappearance curve for human chorionic gonadotropin after excision of an ectopic gestation is discussed. A recommendation is made for a single determination of beta-hCG two weeks after a conservative procedure for an ectopic gestation to screen for persistence of trophoblastic tissue. PMID- 3808541 TI - Squamous cell carcinoma of the neovagina. AB - Congenital absence of the vagina is very rare, with one method of treatment being the split-thickness skin graft vaginoplasty. This is the ninth reported instance of carcinoma arising in the neovagina and is apparently related to the type of tissue transplanted. The optimal therapy for this malignancy remains to be defined. A review of previously reported patients plus this patient suggests that reliance on radiotherapy as the primary means of treatment may result in a high percentage of failures. PMID- 3808542 TI - Condylomata acuminata arising in a neovagina. AB - A case is reported in which condylomata acuminata arose in a McIndoe neovagina. Histopathologic and virologic evidence are provided to support the characterization of these lesions as benign warty processes secondary to human papillomavirus-6. Factors influencing viral site specificity are discussed. PMID- 3808543 TI - Colo-ovarian fistula: a report of two cases. AB - We report two patients with a colo-ovarian fistula which produced a granulomatous oophoritis. Both patients presented with an adnexal mass and abdominal discomfort; in each case the preoperative diagnosis was a probable neoplasm. The patients underwent total abdominal hysterectomy and bilateral salpingo oophorectomy; the colo-ovarian fistula was not recognized intraoperatively in either case. Both patients required reoperation in the early postoperative period because of the development of a colovaginal and a colocutaneous fistula, respectively. Intraoperative recognition of colo-ovarian fistula is important for the selection of the appropriate surgical procedure. The differential diagnosis of granulomatous oophoritis is discussed. PMID- 3808544 TI - Malacoplakia of the ovary. AB - Malacoplakia is a form of chronic granulomatous inflammation that rarely involves the female genital tract. We report a case of malacoplakia of the ovary that developed in a 50-year-old white woman with a long history of von Recklinghausen's disease and diverticulitis. In the current case, malacoplakia presented as a tumorlike lesion in the left adnexal area. It appeared grossly to invade, through direct extension, surrounding soft tissues and loops of the small and large bowels. This case simulated a malignant ovarian tumor, and presented a significant diagnostic challenge clinically and pathologically. PMID- 3808545 TI - Protection when the mercury plunges. PMID- 3808546 TI - Irrational fear: another AIDS 'infection' pervading and paralyzing the country. PMID- 3808547 TI - OSHA's new asbestos standards tighten exposure levels, controls. PMID- 3808548 TI - Monitoring air filter systems increases efficiency, effectiveness. PMID- 3808550 TI - Comparing the three EAPs: external programs are easiest to use. PMID- 3808549 TI - Audiometric calibration: vital part of hearing conservation program. PMID- 3808551 TI - Marketing of health programs includes financial and promotional considerations. PMID- 3808552 TI - Shift work studies provide clues to industrial accidents. PMID- 3808553 TI - Trenching and elevated work: highs and lows of construction hazards. PMID- 3808554 TI - Stricter respiratory protection is required by new asbestos rules. PMID- 3808555 TI - Policies have been confusing, but asbestos awareness improves. Interview by Sheri Hagen Poore. PMID- 3808556 TI - Selling abatement programs requires honesty, openness. PMID- 3808557 TI - Building owners find alternatives to asbestos removal, replacement. PMID- 3808558 TI - Protective eyewear, proper care help stop injuries, blindness at work. PMID- 3808559 TI - Smoking-reduction programs help businesses snuff out health problems. PMID- 3808560 TI - Preventive maintenance programs help stop shut-downs, accidents. PMID- 3808561 TI - Would improved worker health reverse America's productivity decline? PMID- 3808562 TI - A medical student's thoughts on the future of medicine. PMID- 3808563 TI - Is the time ripe for a doctor's union. PMID- 3808564 TI - Health fraud--when magic replaces medicine. PMID- 3808565 TI - Further studies on the antineoplastic activity of homo-aza-steroidal esters. AB - The modified steroidal alkylating agents, 17 beta-hydroxy-3-aza-A-homo-4 alpha androsten-4- one(p-[bis(2-chloroethyl)amino]phenyl)butyrate(1),3 alpha-hydroxy- 13,17-seco-5 alpha- butyrate(2),3 beta-hydroxy-13,17-seco-5-androsten-17-oic- 13,17-lactam(p-[bis-(2-chloroethyl)amino]phenyl)butyrate(3) and and (p-[bis(2 chloroethyl)amino]phenyl)butyric acid(4) have been tested against L1210, P388, Ehrlich ascites tumors (EAT), Lewis lung (LL) carcinoma and adenocarcinoma CA 755. Of four compounds evaluated in L1210 leukemia, none displayed antileukemic activity. Almost all of the four compounds were more or less active against P388 leukemia. Compound 2 possesses a slight antitumor activity in EAT, while only compound 1 appears to be active in LL carcinoma. The antitumor activity of the three modified steroidal esters on adenocarcinoma CA-755 seems to be interesting. PMID- 3808566 TI - Corticosteroid responsive immune thrombocytopenia in Hodgkin's disease. AB - A 72-year-old female is described in whom immune thrombocytopenia (ITP) and fever were the presenting features of stage IIB Hodgkin's disease (HD) of the nodular sclerosis type. Thrombocytopenia resolved following steroid therapy, and after having received MOPP chemotherapy the patient is in sustained remission and with normal platelet counts 18 months later. Review of the 35 cases published to date with ITP in HD shows that of 20 patients treated with corticosteroids alone, 14 failed to respond, 2 had a partial response and only 4 patients had a good response. In contrast, of 29 splenectomised patients only 7 failed to respond, 2 had a partial response, and 20 had a good response. The state of activity of HD was closely correlated with the response of thrombocytopenia to treatment by either corticosteroids or splenectomy: only 7 of 17 patients with active HD achieved a resolution of thrombocytopenia as compared to 15 of 17 patients with HD in remission. Thus, control of thrombocytopenia is easier in patients in remission than in patients with active HD, and splenectomy is more efficient in controlling thrombocytopenia than corticosteroids. PMID- 3808567 TI - Incidence of hematopoietic malignancies in a well-defined population in France. AB - A registration of hematopoietic malignancies was established on January 1, 1980, in order to determinate accurately the incidence and epidemiological features of these diseases in the department of Cote d'Or (population 477,908). Information was collected from various sources (public and private laboratories, hospitals, general practitioners and death certificates). Over a 3-year period (1980-1982), 401 new cases were diagnosed among residents of the department. The crude incidence rates were 32.9/100,000 for males and 23.0/100,000 for females. The corresponding age standardized rates (using world standard population) were 26.1 and 15.9, respectively. The sex ratio was 1.8:1. In males, chronic lymphocytic leukemias, Hodgkin's and non-Hodgkin's lymphomas are the most common hematopoietic malignancies, followed by acute leukemias and multiple myelomas. In females, lymphomas are more frequent than acute leukemias, chronic lymphocytic leukemias and multiple myelomas. Compared to population based registries in other countries, incidence rates are among the highest reported, and are particularly high for chronic lymphocytic leukemia. PMID- 3808568 TI - Cytogenetic studies in secondary leukemia: statistical analysis. AB - Since the number of long-term survivors following radio- and/or chemotherapy for cancer increases, secondary leukemia is now a threatening complication. Several studies already showed that -5/5q-, -7/7q- and -17 were non-random chromosome changes in secondary leukemia. In this study, a statistical approach was used to better determine the non-randomness of the karyotypic abnormalities and to correlate these aberrations with clinical and demographic parameters. The results showed that these were 16 non-random changes involving chromosomes No. 3, 5, 7, 8, 9, 11, 14, 17 and 21. With the exception of -5/5q-, the chromosome changes were found to be dependent not only on the type of primary disease and previous therapy, but also on the sex and age of the patients. PMID- 3808569 TI - Glial fibrillary acidic protein in brain tumors. AB - Glial fibrillary acidic protein has been widely used in neurobiology and neuropathology as a specific marker for normal and abnormal astrocytes. Here, we report the immunostaining of 107 brain tumors and controls using an antiserum against glial fibrillary acidic protein. Selection of astroglia-derived tumors was easy and of high accuracy. Pattern of staining and usefulness of the method are described. PMID- 3808570 TI - Transforming activity of DNA extracted from BKV-transformed hamster cells after passages in culture. AB - Primary fetal rat fibroblasts (FRF cells) were transfected with DNA extracted from BKV-transformed hamster kidney cells at low passage after transformation (HKBKlp cells) and at high passage after transformation (HKBKhp cells). Two transformed rat cell lines were obtained, FRF-DNA-HKBKlp cells and FRF-DNA-HKBKhp cells, transformed by DNA extracted from HKBKlp cells and HKBKhp cells, respectively. They were characterized by a number of biological properties and by tumorigenicity and metastatic ability in newborn hamsters. The two transformed FRF cell lines exhibited exactly inverted properties in comparison with HKBK cells, in particular FRF-DNA-HKBKlp cells showed a low level of nuclear T antigen and a diffuse appearance of TSTA at the cell surface, whereas FRF-DNA-HKBKhp cells demonstrated a high level of T antigen and the capping of TSTA in the cell membrane. The tumorigencity and the metastatic ability were greater with FRF-DNA HKBKlp cells, while FRF-DNA-HKBKhp cells appeared to be less tumorigenic and metastatic in newborn hamsters. PMID- 3808571 TI - Chemotherapeutic effects of 13 nitrosoureas on the LSA lymphoma ascites tumor of the C57BL mouse. AB - The LSA lymphoma of the C57BL/ym mouse has been used to test 13 nitrosoureas for cure of advanced tumors and for induced tumor resistance (ITR) of surviving animals. Tumors were initiated by intraperitoneal inoculation of 10(6) LSA cells. Controls died in 8-9 days. Five-day old tumors were defined as advanced tumors, and treatment consisted of a single dose of a nitrosourea to groups of 10 male mice, 8-9 weeks old, for each compound. The nitrosoureas used were: BCNU (NSC 40992), CCNU (NSC-79037), MeCCNU (NSC-95441), chlorozotocin (CLZ) (NSC-178248), streptozotocin (STZN) (NSC-85998) CNU (NSC-47547), FCNU (NSC-87974), GANU (NSC 254174), ACNU (NSC-245382), PCNU (NSC-95466), cis-acid (NSC-153174), 153174), NSC 88104, and GCNU (NSC-114460). The major endpoint assessed was tumor cure and was grouped as follows: (1) high (greater than or equal to 80%), achieved with BCNU, MeCCNU, CCNU, CLZ, ACNU, FCNU, PCNU, and cis-acid; (2) medium (40- less than 80%), obtained with GANU, NSC-88104, and GCNU, and (3) low or nil (less than 40%), shown by CNU and STZN. The second endpoint was treatment-induced ITR. Cured mice, i.e., those surviving over 30 days after death of controls were challenged with 10(5) LSA live cells, and survivors from this challenge were challenged with 10(7) LSA cells 1 month later. Survivors from both inocula were considered highly immune (HI). High percentages of HI mice (greater than or equal to 80%) were obtained from mice cured with MeCCNU, CCNU, ACNU, FCNU, PCNU, and NSC-88104. STZN produced 0.0% cures; the other nitrosoureas showed 33.3-75% HI mice. Cure rates and ITR appeared to be agent- and structure-related. Cure alone did not lead to the resistant state. PMID- 3808572 TI - Proliferative activity of human solid tumors evaluated by thymidine labeling index and primer-dependent alpha-DNA polymerase. AB - Proliferating cells, independent of their position in the cell cycle, contain a primer-dependent alpha-DNA polymerase (PDP); we have, therefore, tested the feasibility of the PDP assay in breast, ovarian, and head and neck tumors. Experimental results demonstrate that the PDP labeling index (PDP-LI) is constantly superior to the thymidine labeling index (TLI), which indicates the percentage of S phase cells. The PDP-LI/TLI ratios observed were 5.0 in breast cancer, 3.6 in ovarian cancer, and 2.5 in head and neck tumors. Higher PDP-LI scores have been obtained in metastatic breast tumor samples (PDP-LI = 8.8) compared to nonmetastatic tumors (PDP-LI = 4.9). PMID- 3808574 TI - Botany of European mistletoe (Viscum album L.). AB - European mistletoe (Viscum album L.) is a hemiparasitic plant growing on different host trees. According to host specifity three different races can be distinguished. The plant is dioecious with very reduced male and female flowers. The life cycle of V. album is described starting from seed germination to the development of the leaves. The parasitism affords special adaptation to mineral nutrition. PMID- 3808573 TI - Synthesis of a new nor-aza-steroidal ester of p-N,N-bis-(2 chloroethyl)aminophenylbutyric acid and in vitro study of its mutagenicity and clastogenicity. AB - A new nor-aza-steroidal ester of chlorambucil has been synthesized. The study of the mitotic index in CHO and HeLa cells treated with this compound showed that it may be a cytostatic drug. It was also found that treatment of CHO cells with a dose as low as 5 micrograms/ml induces a large number of sister chromatid exchanges. A great number of abnormal metaphases has been observed when CHO cells were treated with the compound at a dose of 25 micrograms/ml. When the compound was tested in the Ames/Salmonella microsome assay, it was found to be mutagenic in strains TA100 and TA1535, both with and without metabolic activation. PMID- 3808575 TI - Comparison of the effects of fermented and unfermented mistletoe preparations on cultured tumor cells. AB - The bacterially fermented mistletoe preparation Iscador, used in cancer therapy for 30 years, and the recently prepared unfermented preparation, have been tested on rat hepatoma tissue culture (HTC) cells and human leukemia Molt 4 cells. As observed by phase-contrast microscopy, treatment of HTC cells with fermented or unfermented Iscador, at a concentration corresponding to 1 mg of fresh plant per milliliter culture, led to rapid lysis of cellular membranes. At a lower concentration, 0.1 mg/ml, unfermented Iscador led to the formation of polynucleated cells. On Molt 4 cells, fermented Iscador also produced cytolysis but after a longer time of action. Unfermented Iscador showed a much stronger cytotoxic effect on these cells than on HTC cells. Fermented Iscador was slightly more potent than unfermented Iscador in inhibiting the growth of HTC cells, but on Molt 4 cells fermented Iscador was less active than unfermented Iscador. DNA synthesis, measured by [3H]thymidine incorporation in HTC and Molt 4 cells, was inhibited by fermented and unfermented Iscador with the same type of differences of action as on cell growth. Fermented Iscador contained a low amount of lectins, approximately 100 ng/ml, while unfermented Iscador contained about 10 times more. A purified mistletoe lectin produced effects on HTC and Molt 4 cells similar to those of unfermented preparations. HTC cells were 100 times less sensitive to this lectin than Molt 4 cells. These results are discussed in relation to the known biological effects of lectins. PMID- 3808576 TI - Pleura carcinosis. Cytomorphological findings with the mistletoe preparation iscador and other pharmaceuticals. AB - Over 160 cases of pleura carcinosis were treated systematically by local intrapleural instillation of Iscador, and the results were documented by cytomorphological examination of the punctate. The results show that, under these conditions, Iscador has two distinct activities, i.e. cytotoxic activity and immunostimulating activity. PMID- 3808577 TI - Structure and properties of polysaccharides from Viscum album (L.). AB - Polysaccharides are possibly involved in the pharmacological effects of Viscum album (mistletoe) extracts, which are used in cancer therapy. Therefore the water soluble polysaccharides of the fresh plant and the fermented proprietary preparation Iscador were isolated and characterized inter alia by methylation analysis, partial hydrolysis and C-13-NMR spectroscopy. The main polysaccharide of the green parts of Viscum is a highly esterified galacturonan whereas in Viscum 'berries' a complex arabinogalactan is predominant. Both types of these constituents were found in Iscador but with definite changes in molecular weight and structure. An interaction between the arabinogalactan and the galactose specific lectin (ML I) in Viscum could be demonstrated. In three immunological tests (granulocyte, chemiluminescence, carbon clearance test) the polysaccharides failed to increase phagocytic activity of granulocytes and macrophages. PMID- 3808578 TI - Specific protein synthesis in oviduct-progestational responses of hens and oestradiol-primed chicks: immunohistochemical demonstration of simultaneous synthesis of avidin, trypsin inhibitor and ovoinhibitor. PMID- 3808579 TI - The chondro-epitrochlearis, an aberrant slip of the pectoralis major. PMID- 3808580 TI - An autopsy case of the positional anomaly of the gut. PMID- 3808581 TI - The amygdaloid connections with the lower brain stem in the rat: a light and electron microscope study using the horseradish peroxidase method. PMID- 3808582 TI - Sodium hyaluronate (Healon) in glaucoma filtering procedures. AB - Healon (sodium hyaluronate) has been used in a prospective study designed to investigate its possible usefulness in promoting effective bleb formation and preventing cleft closure in trabeculectomy for glaucoma. One hundred fourteen patients with open-angle glaucoma were randomly assigned to one of two groups. In one group (55 patients), filtering surgery was performed without the use of Healon. In the remaining 59 patients, Healon was used to separate the iris from the cleft, the sclera from the sclera and the conjunctiva from the sclera. The surgical procedure used was the Stallard-Worst triangular modification of Cairns' method, combined with removal of the Tenon's capsule. The patients whose operations were performed with the aid of Healon had a higher success rate, as manifested by better and more permanent bleb formation and maintenance, more open clefts, less scarring, less peripheral anterior synechiae formation, and significantly lower long-term intraocular pressure. Moreover, the number of patients requiring supplemental postoperative timolol therapy was significantly smaller in the Healon group (5/59 patients: 8.5%) than in the control group (33/55 patients: 60%). There was a transient delay in the reduction of intraocular pressure following trabeculectomy in the Healon patients which was not observed in control patients. Apart from this, no adverse effects were associated with the use of Healon. PMID- 3808583 TI - Elimination of sodium hyaluronate-induced decrease in outflow facility with hyaluronidase. AB - The use of intraocular sodium hyaluronate is complicated by a postoperative rise in intraocular pressure (IOP). The rise in IOP is thought to stem from a "clogging" at the trabecular meshwork by the large molecules of hyaluronate. This study uses serial tonographic measurements in an animal model to document this change in outflow facility. Furthermore, we investigate the ability of the enzyme hyaluronidase to cleave the hyaluronate into smaller molecular weight fragments, in vivo, and thereby eliminate the change in outflow facility. This report demonstrates the potential usefulness of this enzyme and documents the lack of harmful side effects histopathologically. PMID- 3808584 TI - Sodium hyaluronate (Healon) in the surgical repair of Descemet's membrane detachment. AB - Two cases of Descemet's membrane detachment are presented. In both cases, sodium hyaluronate (Healon) was successfully used to repair the detachment surgically. The viscoelastic property of sodium hyaluronate allows it to move Descemet's membrane easily into proper position and maintain it there post-operatively. Sodium hyaluronate left in the anterior chamber can cause an increase in intraocular pressure and prophylactic measures, such as diamox and timoptic should be used in these cases. PMID- 3808585 TI - Botulinum toxin for the treatment of essential blepharospasm. AB - Twenty-six patients with essential blepharospasm were treated with botulinum toxin by injection. The onset of protractor weakness in all patients ranged from one to five days following treatment. Maximal weakness developed within 12 days. There was a variable and gradual return of protractor strength over eight to 29 weeks in most patients and, with it, a return of spasm. Twenty-five patients received some degree of functional relief following initial injection. In most patients, however, the post-injection result could not be stabilized and repeat injections have been necessary to control recurrent spasms. There was one treatment failure. Three patients treated by injection following previous neurectomy and myectomy appeared to have a reduced requirement for subsequent injections. Complications included transient ptosis in six patients and mild exposure symptoms in four patients. Extraocular muscle paresis did not occur. There were no systemic side effects from the botulinum toxin injections. PMID- 3808586 TI - A suggested role for argon laser iridoplasty in management of pigmentary glaucoma. PMID- 3808587 TI - Peribulbar vs. retrobulbar anesthesia: a real difference? PMID- 3808588 TI - Deficient autoregulation and lengthening of the diffusion distance in the anterior optic nerve circulation in glaucoma: an electro-encephalo-dynamographic investigation. AB - Electro-encephalo-dynamographic investigations taken from 36 glaucoma patients showed that the autoregulative mechanism in the region of the anterior part of the optic nerve (apon) is disturbed and the ciliary perfusion pressure is altered in a characteristic manner. The results lead to the conclusion that glaucomatous ischemia occurring in the apon may mainly be due to the following causes and their combinations: high IOP; low blood pressure in the ciliary arterial circulation; insufficiency of autoregulation, and changes of the local conditions of diffusion of oxygen and nutrients. PMID- 3808589 TI - Relationship between ciliary perfusion pressure and pattern-reversal visual evoked cortical potentials: an electro-encephalo-dynamographic investigation. AB - Pattern-reversal visual evoked cortical potentials (VECP) taken from 25 healthy volunteers before, during and after short-lasting elevation of intraocular pressure proved to be dependent on ciliary perfusion pressure (pp cil) in a characteristic way. Reductions of pp cil to ca. 30 mm Hg did not result in VECP changes. These results point to efficient autoregulation in the retinal circulation and in the circulatory region of the anterior part of the optic nerve. When pp cil was reduced to below 30 mm Hg a marked reduction of VECP amplitudes and prolongation of latencies were observed. An autoregulatory capacity of about 15 mm Hg was found. PMID- 3808590 TI - Effects of antiglaucoma drugs on the blood flow in rabbit eyes. AB - Although it is essential that intraocular pressure (IOP) be reduced in glaucoma treatment, it is also vitally important to provide sufficient blood flow to eye tissues so that healthy visual field is maintained. It is possible for an agent to reduce IOP and blood supply to the eye. In that case, glaucoma appears to be under control since IOP has been reduced to within normal range, yet the disease is actually progressing, causing damage to the retina, optic nerve, and other tissues. The 85Sr-microsphere technique was used to study the effects of several antiglaucoma drugs on blood supply to various eye tissues. It was found that pilocarpine, L-timolol, D-timolol and haloperidol are good drugs to use in treating glaucoma because they do not reduce ocular blood flow. D-timolol is particularly good because it does not cause side effects through beta-adrenergic blockade or cholinergic stimulation. On the other hand, trifluperidol and moperone reduce IOP effectively, but also decrease blood supply. PMID- 3808591 TI - Freezing-thawing hysteresis. I. NMR detection in human lens. AB - Human eye lenses were investigated by 1H-NMR as a function of temperature around freezing. Wide hysteresis in line intensity and relaxation time has been found. The hysteresis behavior of the phase transition presents a useful possibility for investigating the structure of water in these materials. PMID- 3808592 TI - Freezing-thawing hysteresis. II. Investigation of human ocular tissues. AB - The freezing-thawing behavior of cataractous eye lenses and corneas was investigated by 1H-NMR. The corneas have shown hysteresis similarly to the normal lens. No hysteresis could be demonstrated in cataractous lenses. The transparency of lens seems to be correlated with the existence of the freezing-thawing hysteresis. PMID- 3808593 TI - Effects of dexamethasone phosphate on the formation of ester forms of riboflavin in the lens. AB - We investigated the effects of excess administration of dexamethasone phosphate (Dx) on the synthesis of ester forms of riboflavin in the rat lens. The formation of ester forms of riboflavin in the lens was reduced by intraperitoneal administration of Dx. No effects on the synthesis were noted upon the administration of a single dose of Dx. Our results show that phosphorylation of riboflavin in the lens is reduced under the condition of excess administration of Dx. PMID- 3808594 TI - Species survey of glutathione peroxidase and glutathione reductase: search for an animal model of the human lens. AB - Lenses from representative species of eight mammalian orders were assayed for glutathione peroxidase and glutathione reductase activities. Wide variation of glutathione peroxidase activity was noted, the lowest activity being that of the prosimian galago while the highest activities were from three Old World monkey species of the genera Macaca and Papio. The hominoids, including the human, all exhibited lower activities of this enzyme. Glutathione reductase activity was lowest in the dog, the rabbit, and all species of cats. The higher Old World monkeys and hominoids, including the human, exhibited enzyme activities many times greater than any other species except the woodchuck. Since glutathione reductase is the rate-controlling enzyme of the glutathione redox cycle, it may be concluded that the most suitable model for the human lenticular glutathione redox cycle will only be found among the higher primates. PMID- 3808595 TI - Further evidence for the involvement of immunoregulatory processes in corneal alkali burns: effects of immunosuppression and convalescent serum. AB - Alkali burns were produced in one eye of a group of mice. Two, 3 and 4 weeks later the second eye of each mouse was similarly burned. The rate of perforation in the second-burned eyes was significantly higher than in the first eye. This effect was abolished by immunosuppressing the animals before the burning of the first eyes. This potentiation effect of an ocular burn on subsequent ones is transferable to other mice by intraperitoneal administration of convalescent serum prepared from mice that were previously burned. This evidence suggests that ocular alkali burns cause the appearance in the circulation of antigens not previously present there. The antibodies produced against these antigens exacerbate the subsequent burn lesion and perhaps also the condition of the original burn. PMID- 3808596 TI - Perimetric profiles and cortical representation. AB - The nature of the interaction between spatial summation and M-scaling was investigated by means of the Octopus automated perimeter. It was found that M scaling of spatial stimulus parameters, alone, did not result in the expected isosensitivity profile. A clinically flat profile was, however, obtained within the central 30 degrees along the horizontal meridian using a large uniform size target (size 3; projected diameter 0.431 degrees). The eccentricities at which presentation of the standard Goldmann targets would result in an isosensitivity profile across the full extent of the visual field were calculated to further illustrate the over-compensation inherent in the current M-scaling equations. PMID- 3808597 TI - Sorbitol production in the lens: a means of counteracting glucose-derived osmotic stress. AB - Heretofore, the intracellular accumulation of sorbitol has been associated exclusively with deleterious (cataractogenic) changes in the lens. This study demonstrates a beneficial role for the sorbitol pathway in the rabbit lens, namely that of counteracting extracellular, glucose-derived, osmotic stress with the intracellular production of osmotically active sorbitol. Large and sudden increases in the extracellular glucose concentration lead to dehydration of the lens, a response that can be diminished by intracellular sorbitol and fructose production. These results are discussed in light of the impact (beneficial/detrimental) of aldose reductase inhibitors on the lens. Sugar cataract formation appears to result from continuous, rather than cyclical, activity of a pathway which normally may have a protective function in the lens. PMID- 3808598 TI - Acute obstruction of the retinal and choroidal circulations. AB - The cases of eight patients (10 eyes) with the equivalent of an acute ophthalmic artery obstruction (simultaneous impairment of both the retinal and choroidal circulations) are described. Ophthalmoscopic features included intense opacification of the retina in the posterior pole; variable absence of a cherry red spot, and the subsequent development of optic atrophy and pigment epithelial changes. Fluorescein angiographic signs encompassed delayed retinal and choroid filling, as well as leakage at the level of the retinal pigment epithelium (RPE). Electroretinography (ERG) disclosed absence of both the a- and b-waves. The entity carries a grim visual prognosis, as all ten eyes initially had no perception of light; improvement to light perception occurred in one instance. PMID- 3808599 TI - Fundus lesions in malignant hypertension. VI. Hypertensive choroidopathy. AB - Experimental renovascular malignant arterial hypertension was produced, by modified Goldblatt's procedures, in 60 rhesus monkeys, and hypertensive fundus changes were studied in detail (by serial ophthalmoscopy and fluorescein fundus angiography in all monkeys on a long-term follow-up, and pathologically in 29 eyes). In hypertensive choroidopathy, retinal pigment epithelial (RPE) lesions and serous retinal detachment (RD) were the classic ophthalmoscopic lesions, whereas fluorescein fundus angiography and histopathologic studies revealed marked abnormalities in the choroidal vascular bed, in addition to the changes in the RPE. The RPE lesions could be subdivided into initial acute focal lesions (due to focal RPE infarction), and degenerative lesions, which developed later and were progressive in nature, maximally involving the macular and peripheral regions of the fundus. The RD developed most commonly in the posterior pole and infrequently involved the peripheral retina. The choroidal vascular bed showed impaired circulation and extensive occlusive and ischemic changes. These studies revealed that hypertensive choroidopathy is as important a fundus change as hypertensive retinopathy. The pathogenesis of hypertensive choroidopathy is discussed in detail; the evidence indicates that it is due to choroidal ischemia, and that hypertensive choroidopathy and retinopathy are two independent and unrelated manifestations of renovascular malignant hypertension. PMID- 3808600 TI - Suprachoroidal implantation for the treatment of retinal detachment. AB - A temporary apposition of retina and choroid has been created during retinal detachment surgery by injection of sodium hyaluronate into the suprachoroidal space in 14 patients. The iatrogenic choroidal detachment lasts at least seven to ten days, allowing adequate time for retinopexy to permanently seal the retinal hole. Suprachoroidal implantation is compatible with and additive to conventional retinal detachment techniques, or it can be used alone as a primary treatment modality. Further clinical evaluation and development are necessary to establish indications and limitations for this technique. PMID- 3808601 TI - Management of rhegmatogenous retinal detachment with macula detached. Steroids, choroidal detachment, and acuity. AB - One hundred thirty-four consecutive eyes with rhegmatogenous retinal detachment involving the macula were evaluated with reference to the effectiveness of systemic steroids in preventing choroidal detachment after scleral buckling surgery and in facilitating both anatomic and functional success. The occurrence of postoperative choroidal detachment was inversely related to the routine intravenous administration of steroids under antibiotic coverage beginning in the recovery room (P = 0.014). Eyes so treated were free of both clinically significant infection and extrusion. The infrequent but worrisome complication of angle closure sufficient to require choroidal tap did not occur among treated eyes. Routine steroid use may have been associated with increased preservation of acuity at the level of 20/200 or better (P = 0.043). PMID- 3808602 TI - Acute retinal necrosis syndrome following herpes zoster dermatitis. AB - The acute retinal necrosis (ARN) syndrome has been recently linked to intraocular infection with one or more members of the herpesvirus family. The authors report two cases of ARN following herpes zoster skin eruptions, and one case following ipsilateral facial nerve palsy (Ramsay Hunt syndrome). Evaluation of serial serum antibody titers against cytomegalovirus (CMV), herpes simplex virus (HSV) (types 1 and 2), and varicella zoster (VZ) virus revealed diagnostic changes for VZ virus alone following the retinitis. Immune precipitation of radiolabeled VZ proteins by these sera followed by gel fractionation yielded radioimmune precipitation profiles characteristic of a recent zoster reactivation. These cases further implicate a central role for VZ virus infection in the etiology of the ARN syndrome. PMID- 3808603 TI - Long-term results of cryotherapy for active stages of retinopathy of prematurity. AB - Between 1976 and 1980, retinopathy of prematurity (ROP) stage III (moderate) (fibrovascular proliferation) developed in 29 eyes (confluent fibrovascular proliferation of 3 clock hours in extension) of 17 preterm babies. The eyes were treated by cryopexy to the avascular retina. Analysis of the visual function and anatomic results in these eyes, five to eight years postoperatively, revealed very good visual function and only a few anatomic abnormalities. Comparison of these eyes with those of two groups of age- and birth-weight-matched preterms (one with less severe ROP, not treated by cryopexy, and the other with no ROP) showed that the degree of myopia was significantly higher in the cryotreated group. Although not statistically significant, there was a higher incidence and a greater degree of astigmatism in this study group. PMID- 3808604 TI - Peripheral circumferential retinal scatter photocoagulation for the treatment of proliferative sickle retinopathy. An update. AB - Forty-four patients (70 eyes, 220 sea fans) with proliferative sickle retinopathy (PSR) received peripheral circumferential retinal scatter photocoagulation (PCRP) to the peripheral zones of retinal capillary nonperfusion. With an average follow up of 3.3 years, 33% of preexisting sea fans regressed completely, 46% regressed partially, 19% remained stable, and 2% showed progression. De novo neovascularization developed after treatment in only one eye (1.4%). Ninety-five percent of patients treated had a final visual acuity of 20/30 or better and only one patient (2%) developed a nonresolving vitreous hemorrhage requiring vitrectomy surgery. These results confirm the authors' previous report and continue to compare favorably to the natural history of PSR in which de novo lesions developed in 58%, and 12% of eyes ended with a visual acuity of 20/200 or less. PCRP seems preferable to other techniques in reducing the risk of nonresolving vitreous hemorrhage and/or traction retinal detachment, although randomized controlled studies are needed to conclusively assess the safety and efficacy of this strategy in treating PSR. PMID- 3808605 TI - Terson's syndrome. Clinicopathologic correlations. AB - In seven cases of Terson's syndrome, an elevated, dome-shaped, membrane was detected in the posterior pole by ophthalmoscopy, echography, or during pars plana vitrectomy. Light and electron microscopic examination of two additional eyes obtained postmortem from an acute case of Terson's syndrome revealed that the posterior vitreous face was elevated by blood and that the internal limiting membrane of the retina was intact and in its normal position. In two chronic cases, a dome-shaped epiretinal membrane was excised from the macula during vitrectomy. Light and ultrastructural studies demonstrated that the membranes consisted of glial cells and basement membrane material. The dome-shaped structure observed in eyes with Terson's syndrome is due to the formation of a subhyaloid hemorrhage. The partially detached posterior hyaloid face created by this hemorrhage provides a scaffold for cellular proliferation and the development of an elevated epiretinal membrane in long-standing cases. Echographically, this membrane resembles a retinal detachment in B-scans, but can be clearly distinguished from retina with standardized A-scan. PMID- 3808606 TI - Cone-rod dystrophy. A clinical and histopathologic report. AB - Clinical, histopathologic, and electron microscopic findings in two postmortem eyes from a 29-year-old black man and the clinical and electrophysiologic findings of his 33-year-old sister, both of whom had bilateral atrophic macular lesions, confirmed the diagnosis of cone-rod dystrophy in these two patients. Light microscopy revealed a loss of photoreceptor cells primarily in the peripheral retina and macula, with relative preservation of both rod and cone cells in the equatorial area. Electron microscopy showed abundant lipofuscin-like granules aggregated in the basal portion of the retinal pigment epithelial cells. In the macular area, many retinal pigment epithelial cells were atrophic. The phagocytic capacity of the retinal pigment epithelium appeared to remain intact. The accumulation of lipofuscin-like granules in the retinal pigment epithelium may be one of the significant pathologic changes of this dystrophy. PMID- 3808607 TI - Retinal and neurologic findings in the Laurence-Moon-Bardet-Biedl phenotype. AB - The nosology of the Laurence-Moon and Bardet-Biedl syndromes has been controversial. Presented is a patient with polydactyly, retinopathy, ataxia, low average intellectual function, and obesity. These features constitute a composite of both syndromes and reflect the clinical heterogeneity that may be seen. Accordingly, the authors suggest the use of the term "Laurence-Moon-Bardet-Biedl phenotype" until these syndromes can be defined in some other manner. The neuroradiologic studies document atrophy of the cerebellum that accounts for the ataxia. Electroretinograms (ERG) demonstrate the decline in retinal function over a 16-year interval and the delayed cone ERG b-wave implicit time with normal cone amplitudes to 30 Hz white flicker that can exist in the early stage of this disorder. PMID- 3808608 TI - The Jackson cross cylinder. A reappraisal. AB - The Jackson cross cylinder is a frequently used but poorly understood tool for clinical refraction. A critical analysis of the principles of cross cylinder testing reveals several important features which should be understood for the proper use of this device. For example, a rarely discussed shortcoming of the cross cylinder is that it can fail to detect even large amounts of ocular astigmatism in certain situations. A little-known advantage of the cross cylinder, on the other hand, is its use in refining cylinder power at an incorrect axis. This particular property of the cross cylinder is useful when the correcting cylinder axis must be rotated toward 90 degrees, 180 degrees, or toward the old axis. The cross cylinder can be used to determine the optimal cylinder power for this new axis setting. Guidelines are also considered for the appropriate step sizes in axis rotation that should be used in cylinder axis refinement. PMID- 3808609 TI - Prevention of ocular toxicity of carmustine (BCNU) with supraophthalmic intracarotid infusion. AB - Intracarotid administration of carmustine (BCNU) is an increasingly accepted therapeutic modality for primary brain tumors. Its beneficial effect on prolonging survival, however, is countered by its frequent delayed complication of retinal toxicity and severe visual loss, which reportedly occurs in approximately 70% of the patients. Since this complication probably results from increased flow of the drug into the ophthalmic artery, the authors have attempted to infuse BCNU via a small intracarotid catheter advanced beyond the origin of the ophthalmic artery. In a series of nine patients (average follow-ups, 10.7 months), the authors were successful in treating six patients with exclusively supraophthalmic infusions. None of these patients developed any ocular toxicity. From the remaining three patients, two patients received one infraophthalmic infusion with no retinal toxicity. The third patient, however, who received three infraophthalmic infusions, developed ipsilateral retinopathy. These results suggest that retinopathic complications of intracarotid BCNU can be avoided if the infusion catheter is advanced beyond the origin of the ophthalmic artery. PMID- 3808610 TI - Life-threatening complication of retrobulbar block. A hypothesis. AB - After routine retrobulbar injection of a 4-ml 1:1 mixture of 0.75% bupivacaine, and of 2% lidocaine and one ampule of hyaluronidase for cataract extraction, the patient sustained bilateral opthalmoplegia, blindness, central respiratory arrest, and loss of consciousness. Neurologic examination shortly thereafter suggests that this may be a result of accidental subarachnoid injection. Prompt recognition and treatment reversed a life-threatening situation. PMID- 3808611 TI - Histological study of epikeratophakia tissue lenses for myopia removed from two patients. AB - Epikeratophakia tissue lenses for the correction of myopia were removed from two patients as a result of postoperative complications such as stromal folds, complaints of glare, and decreased visual acuity. Light and electron microscopic analysis showed protrusions in Bowman's membrane and the anterior stroma corresponding to corneal folds that had been observed clinically. The epithelial cells in these areas contained many vacuolations and a thickened basement membrane. Hemidesmosomes were decreased in number. The tissue lenses had been cut 1.5 mm larger in diameter than the trephined recipient bed into which they were placed. Excess tissue lens material in the central area may have been thrown into folds by mechanical pressure, resulting in the histological changes, clinical signs, and optical distortion that necessitated removal of these grafts. Recently, the surgical technique has been modified, in an attempt to eliminate this problem. PMID- 3808612 TI - Ptosis following radial keratotomy. Performed using a rigid eyelid speculum. AB - Seven patients with acquired ptosis and normal levator function following anterior radial keratotomy are presented. Five of these patients then elected to undergo radial keratotomy of the opposite eye, and four had symmetrical lid fissures (mild bilateral ptosis) after bilateral surgery. Ptosis is a well-known complication of cataract extraction, but has not been reported following radial keratotomy. Unlike cataract extraction, radial keratotomy does not require anesthetic injections, bridle sutures, or conjunctival flaps. The rigid Knapp eyelid speculum used in these cases remains as the only apparent cause of eyelid trauma and subsequent ptosis. During radial keratotomy, the speculum was opened widely in order to provide good corneal exposure and avoid contact with the diamond knife. Contraction of the orbicularis oculi muscle against the rigid speculum may have traumatized the lid, resulting in a levator aponeurosis disinsertion and subsequent ptosis. PMID- 3808613 TI - The autoimmune nature of aqueous tear deficiency. AB - Twenty-two patients with aqueous tear deficiency (ATD) were examined for the presence of the following autoantibodies: immunofluorescent antinuclear antibody (ANA) and Sjogren's syndrome antibodies A and B (SS-A and SS-B). These autoantibodies were found in 17 (82%) patients but not in control subjects, and they correlated with the severity of symptoms and ocular surface changes. Bacterial keratitis, often recurrent and bilateral, and progressive sterile corneal stromal melting developed in six autoantibody-positive ATD patients. Eight antibody-positive patients had labial salivary or lacrimal gland biopsies, and all showed similar histologic features with marked destruction of the glandular architecture by lymphocytic infiltration. Immunoglobulin and complement were not detected in the glandular tissue. Circumstantial evidence suggests that an abnormal immunologic reaction, possibly related to Epstein-Barr viral (EBV) infection, is the cause of the glandular destruction and tear deficiency. PMID- 3808614 TI - Pseudomelanoma of the iris in herpes simplex keratoiritis. AB - A 37-year-old white man with a long history of recurrent herpetic keratitis presented with a rapidly enlarging pigmented iris lesion. The primary diagnostic concern was that the lesion might be a malignant melanoma. A biopsy of the mass was done and proved it to be a granuloma with granulomatous arteritis and infarction of the iris. In a patient with a history of recurrent ocular inflammation, such a hypersensitivity granuloma should be considered in the differential diagnosis of iris melanoma. PMID- 3808615 TI - Long-term analysis of pigmentary dispersion syndrome and pigmentary glaucoma. AB - A retrospective, longitudinal study of 129 eyes in 65 patients with pigmentary dispersion syndrome and either ocular hypertension of glaucoma was undertaken. The mean follow-up period was 17 years (range, 5-35 years). Visual acuity, intraocular pressure (IOP), visual field loss, pigment grade, Krukenberg spindle, iris transillumination, medications, and surgeries were analyzed for each patient at 5-year intervals from 1960 through 1983. Disc and field changes developed in 35% of patients with pigment dispersion syndrome and ocular hypertension during the study period. The long-term prognosis of the medical and surgical management of pigmentary glaucoma is discussed. PMID- 3808616 TI - Orbital-adnexal lymphangiomas. A spectrum of hemodynamically isolated vascular hamartomas. AB - A retrospective review of 13 cases of lymphangioma has led to a classification of these lesions into categories of superficial, deep, and combined types. The clinical manifestations, prognosis, and management directly correlate with the pathophysiology and the location of the lesions. Superficial lesions consist of isolated multicystic vascular abnormalities of cosmetic significance only. Deep orbital lymphangiomas present as spontaneous, acute proptosis due to retrobulbar hemorrhage. Combined lesions demonstrate both superficial and deep components and are also characterized by spontaneous hemorrhages. Histopathologically, lymphangiomas represent a spectrum of vascular hamartomas with a constellation of features that parallels the clinical progression and histology of similar lesions elsewhere in the head and neck. This may include the presence of diaphanous serous-filled vascular channels, a connective tissue stroma with lymphorrhages, features of old hemorrhage, dysplastic vessels, and random smooth muscle bundles. Both direct and indirect evidence suggests that these lesions are characterized by relative hemodynamic isolation. PMID- 3808617 TI - Drusen measurement from fundus photographs using computer image analysis. AB - Drusen are yellowish deposits at the level of the retinal pigment epithelium and are frequently associated with age-related maculopathy (ARM). Drusen often change in size and number over time and may be followed by atrophic or exudative macular degeneration. A quantitative method to measure the development of drusen is needed for controlled studies of the natural history, prognosis, and treatment of ARM. An objective method is described using computer image analysis of fundus photographs for the detection and measurement of drusen. This technique enables us to measure both the area of drusen in the macula and the changes in the drusen pattern over time. Evaluation of repeated photographs showed reproducibility of 6.1%, whereas the reproducibility of processing photographic duplicates was 2.3%. Digitization with a high-quality linear array solid state camera did not change reproducibility significantly. PMID- 3808618 TI - Myopia associated with retinopathy of prematurity. AB - A complete analysis of the components of refractive error was performed on ten eyes of five patients with myopia and retinopathy of prematurity (ROP). In comparison to an age-matched control group, these eyes exhibited both lenticular and axial myopia. Only the high crystalline lens powers, which ranged from 22.20 to 44.13 diopters (D) (mean value, 31.27 D), were found to be statistically significant. In two patients, only one eye had high myopia. The lens power in these eyes was approximately 11 D more powerful than the lens of the fellow eye. Further investigation into the ocular changes induced by prematurity and abnormal oxygen metabolism is needed to determine the reason for the high degree of lenticular myopia. PMID- 3808619 TI - Automated light- and dark-adapted perimetry for evaluating retinitis pigmentosa. AB - Visual fields and dark-adapted thresholds, essential measurements of visual function in patients with retinitis pigmentosa (RP), are usually performed manually. The authors have modified a computerized perimeter to perform automated light- and dark-adapted static perimetry across the visual field of RP patients. Results permit assessment of the level of visual disability in the light and dark and also help define subtypes of RP. PMID- 3808620 TI - Fluorescein angiography basic science and engineering. AB - Fluorescein angiography is an application of the physical phenomenon of fluorescence, which is phosphorescence in which the quantum mechanical decay curve is so rapid that it appears instantaneous, and it consequently has no afterglow. Sodium fluorescein is excited by light energy between 465 and 490 nm, and it decays into a lower state emitting light energy between 520 and 530 nm as fluorescent radiation. The free electrons available for excitation are reduced by chemical bonding between the fluorescein dye and plasma proteins to which up to 80% of the dye is bound in the bloodstream, thus reducing overall fluorescence. Optimalization of the observed and recorded fluorescence is afforded by providing exciter and barrier filters with as little overlap as possible to reduce or eliminate contrast reducing pseudofluorescence. PMID- 3808621 TI - Ptosis associated with botulinum toxin treatment of strabismus and blepharospasm. AB - The incidence, severity, and duration of ptosis after botulinum neurotoxin type A (BAT) injections into extraocular or orbicularis muscles were reviewed retrospectively. Even though lid droop frequently complicated botulinum toxin treatment in this series, no loss of vision or permanent ptosis was encountered. Sixty-seven injections were completed in 44 patients between September 1982 and December 1983. The records were reviewed to determine the incidence of ptosis after these 67 injections. Information was not adequate to ascertain the presence or absence of ptosis after 10 injections. Some degree of ptosis developed after 30 (53%) of the 57 injections with adequate follow-up history. Marked ptosis occurred after 12 (21%) of the 57 injections. The posttreatment lid droop in these 12 cases was potentially visually significant. All cases of ptosis, which impinged on the visual axis, resolved to a level permitting undisturbed vision by eight weeks after toxin injection. The incidence of ptosis was similar in patients who received injections into their medial rectus muscles and in patients who received injections into their lateral rectus muscles. However, an increased incidence of marked ptosis may be associated with the injection of previously operated muscles. Toxin dosage, patient age, and quality of the electromyogram used to monitor the injection showed no statistically significant relationship to the ptosis. PMID- 3808622 TI - Diffuse choroidal melanocytoma in a child. A lesion extending the spectrum of melanocytic hamartomas. AB - A 10-year-old white boy presented with a diffuse pigmented lesion of the choroid of his right eye that had led to a partial secondary retinal detachment. Because of the fear of a diffuse choroidal melanoma (a lesion never before reported in an individual within the first two decades of life), the eye was enucleated. An incisional P-32 study, compared with an uninvolved region, was positive at 154% uptake. Pigmented tissue was discovered surrounding the distal meninges of the optic nerve, on the posterior surface of the eye, and within the orbital soft tissues adherent to the globe. This led to fear of extraocular extension of a malignant melanoma. Light microscopic examination of the enucleated globe demonstrated that the choroid was diffusely and massively thickened by polygonal, hyperpigmented tumor cells that were also present in compressed spindled forms between the lamellae of scleral collagen, in the scleral emissaries, on the surface of the eyeball, and in the distal optic nerve dura. The choroidal tumor cells had the features of those normally encountered in localized optic nerve head benign melanocytomas. Electron microscopy demonstrated the presence of large, well-melaninized melanosomes (but no macromelanosomes), confirming the diagnosis of a diffuse uveal melanocytoma. The differential diagnosis of this new entity and its relationship to previously reported pigmented lesions of the uvea is discussed. PMID- 3808623 TI - Congenital neurocutaneous melanosis with metastatic orbital malignant melanoma. AB - Proptosis and ptosis, caused by a large orbital mass that was excised and determined to be malignant melanoma, developed in a 4-year-old girl with congenital neurocutaneous melanosis (multiple large or giant cutaneous nevi associated with abnormal leptomeningeal pigmentation). Shortly thereafter, the patient had evidence suggestive of systemic metastases and died. The orbital tumor was likely metastatic from a primary meningeal melanoma. Other possible sources of metastatic tumor are discussed. It is unlikely that this was a primary orbital melanoma because the patient had no clinical or pathologic manifestations of pre-existing oculocutaneous melanosis, orbital melanosis, or orbital blue nevus. PMID- 3808624 TI - The gross examination of eyes removed for choroidal and ciliary body melanomas. AB - Because the traditional gross examination technique used by most ophthalmic pathologists requires cutting into the eye without directly visualizing the tumor, pathologists cannot be certain that the slides generated reflect the areas or dimensions of clinical concern. An alternate laboratory technique permits the pathologist to examine the tumor from the clinician's perspective. If the tumor is confined to the posterior pole, the anterior segment is removed first; if the tumor extends anterior to the equator, the calotte opposite the tumor apex is removed permitting direct observation of the tumor. Sections of the tumor can be obtained corresponding to the largest tumor dimensions and other areas of clinical interest to obtain precise clinicopathologic correlations. All portions of the eye not involved by tumor are also studied to complete the examination. PMID- 3808625 TI - Long-term natural history study of senile retinoschisis with implications for management. AB - This is a long-term natural history study of 123 consecutive, nonselected patients (218 eyes) with senile retinoschisis examined periodically, while deliberately withholding all forms of treatment, for from 1 to 21 years (average, 9.1 years) so that the natural behavior and prognosis of this disease could be learned and reasonable recommendations for management could be formulated. The quadrant of maximal involvement was the inferior temporal and 74% of the lesions had posterior borders which were postequatorial. Senile retinoschisis was found to be primarily asymptomatic and nonprogressive. Current indications for treatment, treatment modalities, and complication rates published in recent literature are analysed. No case of symptomatic progressive retinal detachment occurred, but there were 14 cases of localized, nonprogressive and asymptomatic "schisis-detachment". Current indications for treatment of senile retinoschisis should be seriously reevaluated and reduced to one primary indication for treatment, namely symptomatic progressive retinal detachment. PMID- 3808626 TI - Idiopathic recurrent branch retinal arterial occlusion. AB - Recurrent multiple branch retinal arterial occlusions of unknown cause occurred in nine apparently healthy individuals. With the exception of three patients who developed associated auditory symptoms, none developed other signs or symptoms of systemic vascular disease. Ophthalmoscopic and fluorescein angiographic findings suggested focal arteritis and arteriolitis as the cause of the obstructions. Most patients retained good visual acuity. PMID- 3808627 TI - Progression of nonischemic central retinal vein obstruction to the ischemic variant. AB - The cases of 310 patients with central retinal vein obstruction (CRVO) were reviewed. Included among these were 16 who presented with a nonischemic CRVO on fluorescein angiography that progressed to an ischemic CRVO. This subgroup was compared to a control group of 34 patients with a nonischemic CRVO that did not progress to the ischemic state with at least a one year follow-up. Among the eyes in the group that progressed, there was noted to be a higher incidence of initial visual acuity less than or equal to 6/30 (P = 0.005), severe macular edema (P = 0.021), and progressive intraretinal bleeding (P less than 0.0001) than in the control group. There was no significant difference between the groups in regard to age, sex, increased intraocular pressure, or systemic disease. PMID- 3808628 TI - A comparison of visual function tests in eyes with maculopathy. AB - Several recently developed tests of visual function, including the Potential Acuity Meter (PAM), laser interferometer (LI), white-light interferometer (WLI), blue field entoptic phenomenon, and focal electroretinogram (ERG) were compared in 81 eyes with clear media and known macular disease. The results indicate that the PAM, the LI, and the WLI overread relative to Snellen acuity. Laser interferometric acuity values differed from Snellen acuity by at least 1.5 octaves in approximately 40% of all eyes, regardless of stimulus size (2, 5, or 8 degrees). Similar results were obtained with the WLI. Agreement with Snellen acuity was better for the PAM, with 91% of eyes falling within 1.5 octaves of Snellen acuity. Blue field and focal ERG results were categorized as normal or abnormal. While not producing Snellen equivalents, abnormal results from the blue field and focal ERG corresponded with poor Snellen acuity (less than 20/40) in 65% and 91% of eyes, respectively. Assuming that media opacities do not prevent adequate retinal stimulation, the present results suggest that the PAM and focal ERG are the most reliable for evaluating macular function when maculopathy is present. PMID- 3808629 TI - Treatment of giant retinal tears combined with proliferative vitreoretinopathy. AB - Giant retinal tears with foreshortened and stiffened retina secondary to advanced proliferative vitreoretinopathy (PVR) pose a complex problem for the retinal surgeon. In the past, tractional forces on the retina in these eyes have been counteracted temporarily by retinal sutures, retinal incarceration, or retinal tacks, often combined with fluid-gas exchange in the prone position. These techniques are complex and add multiple additional maneuvers to the surgical procedure. The current report describes the use of a simple, stepwise fluid-gas exchange technique with the patient in the supine position in which the expanding gas bubble traps the edge of the stiffened and foreshortened retina against the pigment epithelium. Long-term counteraction of tractional forces was achieved by the use of intraocular silicone oil. Using this technique, 18 of 19 eyes with giant retinal tears and PVR Grade D1 to D3 could be successfully reattached. Four of these successfully reattached eyes had 360 degrees giant retinal tears. The most common and significant complication in our series was the recurrence of periretinal membranes. All 18 eyes that were initially reattached suffered the recurrence of significant periretinal membranes. Four of those 18 eyes developed recurrent interior traction detachments on to four months postoperatively. PMID- 3808630 TI - Pseudophakic retinal detachments in the presence of various IOL types. AB - A series of 600 pseudophakic retinal detachments in 578 patients undergoing surgical repair between 1974 and 1984 was reviewed. Patients with previous retinal surgery of less than six months follow-up were excluded. The series included 395 iris-fixated (IF) lenses, 130 anterior chamber (AC) lenses, and 75 posterior chamber (PC) lenses. The overall success rate for retinal detachment was 88% but was significantly better in the PC lens group and significantly worse in the AC lens group. Forty-one percent of all cases achieved 20/40 visual acuity or better, although the AC lens group did worse (28%), while the PC lens group did significantly better (48%). Risk factors that were predictive of failure also were identified. Many of these factors occurred more frequently in the AC lens group and probably are related to the overall worse outcome in eyes with AC lens implants. The implications of these results for retinal and cataract surgeons are discussed. PMID- 3808631 TI - The diagnoses most commonly missed by ophthalmologists referring patients for fluorescein angiography. AB - A tally of misdiagnoses in patients referred to a fluorescein angiography service disclosed that three conditions made up the majority of all misdiagnoses. These conditions were chronic branch retinal vein obstruction, old or chronic central serous choroidopathy, and retinal arterial macroaneurysms with subretinal or subhyaloid hemorrhage. These three conditions proved to be talented mimics with a wide variety of presentations. PMID- 3808632 TI - Hepatitis B infection in ophthalmologists. AB - A seroepidemiologic survey of ophthalmologists in Western Pennsylvania was performed to define the hepatitis B virus (HBV) exposure risk for this subspecialty population. Of 70 participating ophthalmologists, only 5 (7.1%) had serologic evidence of prior hepatitis (positive hepatitis B surface antibody and antibody to the core antigen of hepatitis B). No participants were found to be HBsAg (hepatitis B surface antigen) positive. The infection rate for ophthalmologists appears lower than that previously described for physicians involved in surgical and nonsurgical medical specialties. However, caution is still recommended since hands and surgical instruments may become contaminated with HBV from the blood and secretions of hepatitis B patients or carriers. PMID- 3808633 TI - Dermal myiasis of the eyelid. AB - A case report describes the clinical findings of dermal myiasis of the upper eyelid in a 6-year-old girl from South America. Dermal myiasis due to Dermatobia hominis can simulate a common furuncle and is known to occur in world travelers. PMID- 3808634 TI - Orbital myiasis. AB - Invasion of the orbit by dipterous fly larvae is a rarely reported from of myiasis. We present a 65-year-old man with orbital myiasis caused by the tissue obligatory larvae of the Old World screw-worm fly Chrysomyia bezziana Villeneuve. Larvae were found invading the orbital apex and exenteration was carried out to prevent intracranial invasion. In this case of orbital myiasis, CT scanning was used to document the extent of intraorbital invasion. To our knowledge, this is the first reported case of ophthalmomyiasis caused by C. bezziana. PMID- 3808635 TI - Neoplastic angioendotheliomatosis. A variant of malignant lymphoma immunohistochemical and ultrastructural observations of three cases. AB - Neoplastic angioendotheliomatosis (NAE) is a rare, fatal disease characterized by widespread intravascular proliferations of malignant cells of putative endothelial origin. Clinically, dermatologic and bizarre neurological manifestations predominate, but review of the reported cases of NAE reveals ophthalmic involvement to be frequent. To our knowledge, no reports of NAE have appeared in the ophthalmic literature. We describe three cases of NAE with the ocular manifestations of visual loss, cells in the vitreous, retinal artery occlusion, retinal vascular and pigment epithelial alterations, nystagmus, and cortical blindness. Autopsies (including eyes and central nervous system) revealed pancorporal involvement by intravascular anaplastic cells in each patient. In two patients massive extravascular involvement was also present. The tumor cells lacked ultrastructural features of endothelial cells and failed to stain for factor-VIII-related antigen. Common leukocyte antigen, a maker for hematopoietic cells, particularly lymphocytes, was detected on tumor cells in all cases, indicating that NAE is probably an extranodal lymphoma. The dramatic response of the central nervous system lesions to radiotherapy in one case supports this contention. It is suggested that this disorder be treated as a malignant lymphoma. PMID- 3808636 TI - Comparative material on automated and semiautomated perimeters--1986. PMID- 3808637 TI - Ophthalmic photodisruptor systems. PMID- 3808638 TI - Intraocular lens data. PMID- 3808639 TI - Depth distortion during slitlamp biomicroscopy of the fundus. AB - The apparent depth of an optic nerve cup or apparent height of a fundus lesion changes with the optics used by an examiner. With slit-lamp biomicroscopy of the fundus, both the auxiliary fundus lens and the biomicroscope contribute to differences in magnification that produces distortion of the object. It is important to understand these differences so that inaccurate conclusions are not drawn and inappropriate therapy will not be instituted when the examiner uses different instruments for making serial observations or uses an unfamiliar instrument. PMID- 3808640 TI - Modern instruments for subjective refraction. A comparative study. AB - In a comparative study, subjective refractions were carried out on 115 normal subjects and 118 patients with four instruments (Humphrey Vision Analyzer, Moller/CooperVision Visutron, Reichert SR-IV, Rodenstock/Coburn Phoromat). The accuracy of the prescriptions obtained, the visual acuity results and the measurement time required were analyzed. The highest accuracy was obtained with the remote-controlled phoropters Phoromat and Visutron. The fastest instrument was the SR-IV. PMID- 3808641 TI - Photographic slit-lamp biomicroscopes. PMID- 3808642 TI - Nucleus removal in planned extracapsular cataract extraction. A new instrument. AB - A new technique of nucleus delivery is discussed. The plane between nucleus and cortex is defined and expanded under direct visualization using hydraulic dissection via a new instrument. The nucleus is irrigated out of the eye or the instrument can be directed into the already defined cleavage plane to effect mechanical extraction via the barb on its superior surface. This technique ensures minimal trauma to zonules and corneal endothelium and results in concomitant removal of a large quantity of cortical material, which simplifies the process of cortical cleanup. PMID- 3808644 TI - American Academy of Ophthalmology continuing education programs. PMID- 3808643 TI - Ophthalmic rods. New ocular drug delivery devices. AB - Ophthalmic Rods, new drug delivery devices for ophthalmic medications, are 2-inch long plastic rods coated with an ocular diagnostic or therapeutic agent. When the drug-coated tip of the rod is brought into contact with the conjunctiva, the medication dissolves into the tear film. We evaluated the safety, comfort, and ease of use of Ophthalmic Rods coated with fluorescein (30 micrograms) in 28 volunteers. Seventy-nine percent (22 of 28) of the patients rated the device as superior to eyedrops, citing cleanliness, comfort, and ease of application as the primary advantages. Ophthalmic Rods effectively delivered fluorescein to the eye and were found to be safe in patients with various refractive conditions, including those with compromised near vision and accommodation. PMID- 3808645 TI - Results of surgery by the modified extended middle cranial fossa approach in 100 patients with acoustic neuroma. AB - The results of surgery by the middle cranial fossa (MCF) approach or the modified extended MCF approach in 100 patients with acoustic neuroma are reported. The rates of facial nerve preservation, tumor removal, and hearing preservation were reported and discussed. This surgical procedure can be applied to tumors of any size, from tumors confined to the internal auditory canal to those extending into the posterior fossa. PMID- 3808646 TI - Facial nerve function after surgery for removal of acoustic neuroma by the extended middle cranial fossa approach. AB - Postoperative facial nerve function was evaluated in 98 patients operated on by the middle cranial fossa approach or the extended middle cranial fossa approach from June 1976 to April 1985. In this series, the smaller the tumor size at the time of the initial surgery, the better the postoperative facial nerve function was. The facial nerve was preserved in 83.4% of the 79 patients who were subjected only to the initial surgery. However, total removal of the tumor along with facial nerve preservation was achieved only in 70.8%. Anatomical preservation of the facial nerve was possible in 78% of 87 patients. The postoperative functional results among patients in whom facial nerves were anatomically preserved were satisfactory (facial expression score of 75% or higher, i.e., 30 points or more out of a possible 40 points) in 70-80% of the patients with small size or intracanalicular tumors, but, in less than 50% of the patients with tumors of medium size or larger. There is a need to obtain higher rates of functional preservation as well as higher rates of satisfactory functional results. At the present stage, we must strive to achieve earlier diagnosis so that surgery can be performed while the tumor is still medium-sized or small. PMID- 3808647 TI - Efficiency of various methods of identifying cerebrospinal fluid in oto- and rhinorrhea. AB - This paper describes methods of cerebrospinal fluid (CSF) leakage diagnosis which have been used in the post-war period. We have listed advantages and disadvantages and given our opinion as to the value of each method. In the form of comparison we have provided a detailed breakdown of the exact procedure of beta 2-transferrin identification used for the immunological diagnosis of CSF leakage. This method, which was developed further by us, is discussed with regard to the results of all sample analysis which have been carried out so far. The result of the discussion is to emphasize the many advantages of this method. In addition, there is a direct comparison made between the fluorescein method and the use of beta 2-transferrin. PMID- 3808648 TI - Pure-tone audiometry of patients with auditory brainstem response abnormalities. AB - To determine the pure-tone thresholds of patients with brainstem disorders, pure tone audiometry was done on 22 patients with partial auditory brainstem response wave disappearance (including wave I response, wave I-III response, and wave I-IV response). This group of patients was selected since partial wave disappearance indicates pathology of the auditory nerve and/or the brainstem auditory pathway. The pure-tone threshold of these patients was essentially normal or very mildly impaired, except for patients with an acoustic tumor or an other cerebellopontine angle tumor. PMID- 3808649 TI - Ossiculoplasty failure with ceramic ossicular replacement prosthesis. AB - The stability of ceramic ossicular replacement prosthesis (CORP) in the middle ear was evaluated in 162 ears that had been followed for more than 18 months. The CORP extruded from 8 ears (4.9%) and was dislocated in 6 ears (3.7%). These failures were considered to be due mainly to postoperative tubal dysfunction and disease recurrence. CORP should not be used when such conditions can be anticipated. PMID- 3808650 TI - Inhibition of vestibulo-ocular reflex by tonic stimulation of the posterior neck region in man. AB - The effect of posterior neck stimulation on vestibulo-ocular reflex (VOR) was studied in 10 healthy subjects. The experimental situation was designed to minimise all afferent inputs except from the neck; each subject was placed in supine position with body fixed to a tilting table inclinable in a vertical plane. The head was immovably secured at 30 degrees to an independent non inclinable rigid frame. In this situation the body could be mechanically moved upwards in the vertical plane (ventriflexion), producing symmetrical and selective stretch of the posterior neck region. The VOR elicited by caloric monoaural stimulation was evaluated for each of the following static positions: 0 degree and 50 degrees of ventriflexion and vice versa. We observed a significant decrease in the slow-phase angular velocity of induced nystagmus as the body was tilted upwards and a significant opposite effect when the body was returned to the original position. Similar changes in VOR were observed in 4 selected patients with spontaneous 'peripheral nystagmus'. Mechanisms involved in the cervical control of VOR are discussed. PMID- 3808651 TI - Histological and ultrastructural findings on mucocele of maxillary sinus. AB - The authors describe a rare case of mucocele of maxillary sinus and, on the basis of the histological and namely of the ultrastructural findings, they maintain that the mucocele has in all probability a multiple pathogenesis being dependent not only on the inflammatory processes, but also on other local predisposing factors and namely the active participation of the mucosa in the formation of the cavity of mucocele. PMID- 3808652 TI - [Various recommendations for the radical improvement of the quality of the traumatological and orthopedic services]. PMID- 3808653 TI - [Uncomplicated compression fractures of the vertebral body in children]. PMID- 3808654 TI - [Surgical treatment of lumbar osteochondrosis]. PMID- 3808655 TI - [Roentgenological characteristics of the structural changes in the spine in sportsmen]. PMID- 3808656 TI - [Low-frequency magnetic field in the complex treatment of patients with lumbar osteochondrosis]. PMID- 3808657 TI - [Cryotherapy of pain syndromes associated with degenerative-dystrophic diseases of the spine]. PMID- 3808658 TI - [Surgical treatment of spinal deformities in Bechterew's disease]. PMID- 3808659 TI - [Problem of the correction of scoliotic curvatures of the spine]. PMID- 3808661 TI - [Study of the regeneration process in the long bones by the method of forced resonance fluctuations]. PMID- 3808660 TI - [Correction of reflex disorders in the acute period of combined cranio-cerebral injuries]. PMID- 3808662 TI - [Fracture-dislocations of the vertebrae with lengthwise deviation]. PMID- 3808663 TI - [A method of fixation of the spine and the fixation device]. PMID- 3808664 TI - [External fixation after reduction of dislocations of the cervical vertebrae]. PMID- 3808665 TI - [Gradual proportioned crural reduction in the treatment of patients with Little's syndrome]. PMID- 3808666 TI - [Immobilization of the leg during the transportation of patients with femoral fractures]. PMID- 3808667 TI - [Decompression operation in the treatment of Perthes disease in children]. PMID- 3808668 TI - [A method of surgical treatment of crural varus deformity in the initial stages of Blount's disease]. PMID- 3808669 TI - [A device for computerized podography]. PMID- 3808670 TI - [Provision for the safety of operations for funnel chest deformity]. PMID- 3808671 TI - [Early differential diagnosis of aseptic necrosis of the femur head and discogenic radiculitis]. PMID- 3808672 TI - [Criteria for determining the errors, complications and outcome of the treatment of closed fractures in statistical studies]. PMID- 3808673 TI - [Teaching traumatology and orthopedics in medical institutes]. PMID- 3808674 TI - [Substantiation of the methods of surgical treatment of inveterate complicated injuries of the lumbar segment of the spine]. PMID- 3808675 TI - [Comparative evaluation of surgical methods for scoliosis treatment using elastic instrumentation]. PMID- 3808676 TI - [Treatment outcomes following anterior spondylodesis in uncomplicated stable penetrating fractures of the vertebral bodies]. PMID- 3808677 TI - [Treatment of the neurological manifestations of lumbar osteochondrosis]. PMID- 3808678 TI - [Rheoencephalography in the functional diagnosis of patients with pathology of the cervical spinal column]. PMID- 3808679 TI - [Changes in the electrical parameters of the intervertebral disks in an experiment]. PMID- 3808680 TI - [Treatment of patients with bone and vascular injuries of the extremities]. PMID- 3808681 TI - [Dependence of the stable fixation of an artificial hip joint in the bone on its design characteristics]. PMID- 3808682 TI - [Hematogenic osteomyelitis of the cervical spine in burns]. PMID- 3808684 TI - [Method of treating the acute manifestations of cervical osteochondrosis]. PMID- 3808683 TI - [Nature and mechanism of the appearance of the odontoid bone]. PMID- 3808685 TI - [Roentgenometric follow-up after the papain therapy of spinal osteochondrosis patients]. PMID- 3808686 TI - [Morphological changes in the intervertebral disks due to papain administered by a new method]. PMID- 3808687 TI - [Case of a cure in bilateral calcaneal pain--the Hagland-I syndrome]. PMID- 3808688 TI - [Vacuum irrigation treatment in a combination of therapeutic measures in the suppurative necrotic complications of open injuries]. PMID- 3808689 TI - [Treatment of fractures of the cervical spine in ankylosing spondylarthritis patients]. PMID- 3808690 TI - [Use of rods for extrafocal fixation in the Ilizarov apparatus in lengthening the femur]. PMID- 3808691 TI - [Sobriety--a standard for life]. PMID- 3808692 TI - [Treatment of trans- and supracondylar fractures of the humerus in children]. PMID- 3808693 TI - [A universal screw distractor-contractor for the spine]. PMID- 3808694 TI - [Attachment for applying the Ilizarov apparatus and for x-ray follow-up in fractures of the leg bones]. PMID- 3808695 TI - [Classification and classifier of multiple mechanical injury]. PMID- 3808696 TI - [Treatment of multiple uncomplicated fractures of the vertebral bodies]. PMID- 3808697 TI - [Avascular necrosis of the mandibular condyle in systemic lupus erythematosus]. PMID- 3808698 TI - [Glucose-galactose malabsorption]. PMID- 3808699 TI - [Relation between the humoral and cell-mediated immune systems]. PMID- 3808700 TI - [Differentiation between developmental bone diseases in VACTERL abnormalities and in the TAR syndrome]. PMID- 3808701 TI - [Anatomy of the ligaments of the upper ankle joint]. AB - The ankle joint is stabilized by a specialized system of ligaments. These are the medial and lateral collateral ligaments and the anterior and posterior syndesmoses, the arrangement and orientation of which can only be understood in terms of function. In the vast majority of cases, injury involves the fibular capsuloligamentous apparatus which, according to anatomical and intra-operative findings, exhibits considerable anatomical variability, recognition of which is a prerequisite for the correct diagnosis and therapy of such lesions. PMID- 3808702 TI - [Biomechanics of the upper ankle joint]. AB - In most cases the ankle joint represents a simple hinge, the unimpaired function of which is dependent on normal play of the distal tibiofibular joint. During flexion and extension of the ankle joint, bending of the fibula is responsible for a substantial part of the mediolateral translational movement of the distal tibiofibular syndesmosis. In comparison with articular body forms under typical stress conditions, ligamentous restraints are of secondary importance. Tensile behaviour of fibular collateral ligaments seems to allow restricted, functional follow-up treatment. In the injury pattern of the ankle joint, the role of the interosseous membrane needs further evaluation. The clinical problems associated with tibiofibular subluxation and synostosis can be explained naturally by the impaired biomechanics of the ankle joint. PMID- 3808703 TI - [Diagnosis, therapy and results of acute instability of the syndesmosis of the upper ankle joint (isolated anterior rupture of the syndesmosis)]. AB - Instability of the syndesmosis of the ankle is defined as a rupture of the anterior tibiofibular ligament and the interosseus membrane. We discuss two different ways in which the injury can occur: the external rotation mechanism and the supination mechanism. Clinical findings allowing a definite diagnosis are always present. These can be confirmed by arthrography of the ankle. A total of 92 patients have been operatively treated by suture of the ligament and reinforcement of the syndesmosis by a positioning screw. PMID- 3808704 TI - [Clinical aspects and therapy of fibular ligament ruptures in childhood]. AB - Injuries to the lateral ligament of the ankle are frequently encountered in adolescence and require just as much care in diagnosis and management as in adults. There is a strikingly high rate of tears with an avulsion of the bony or cartilaginous insertion of the anterior talo-fibular ligament in younger children. The most likely causes are the higher elasticity and strength of ligaments, as well as the special situation of ligament insertion during growth. Experience has shown operative treatment to be superior to conservative measures. Only a surgical procedure can allow exact adaptation of the ruptured ligaments and especially a reinsertion of cartilaginous or bony fragments after avulsion injury. Old tears often make a reinsertion very difficult if not impossible. In these cases, resection of the fragments and reconstruction of ligaments are suggested if necessary. For more operative and technical details, the recently edited monograph from Zwipp should be consulted; it also contains many interesting points regarding the physiology, pathology and clinical importance of injuries to the lateral ligament of the ankle. PMID- 3808705 TI - [Functional treatment of fresh outer ligament ruptures using an Aircast splint]. AB - Functional treatment with an Aircast splint can reduce pathological inversion of the ankle joint. Now that we have used the splint since 1981, we report our experience with a small group of patient who have been reviewed three times in the last 4 years. The patients reported good-to-excellent results. Objective evaluation was slightly better in the first follow up evaluation with increased laxness in the stress tests in the last control. However only one patient needed ligament reconstruction. The Aircast splint provides good-to-excellent subjective results and good objective results in 75% of cases. The following indications are valid for operative treatment: Laxity with a talar tilt of definitely more than 15 degrees, or with an anterior drawer of the talus of more than 12 mm in a young athlete who is dependent on complete stability. Patients with osteochondral lesions and avulsed fibular fragments. History of pre-existing recurrent subluxations, possibly in combination with a ligament reconstruction. PMID- 3808706 TI - [Combined lateral ligament-plasty and calcaneus osteotomy in recurrent foot dislocation]. AB - The risk of a supination trauma is particularly high in patients with pathological calcaneus varus as opposed to physiological calcaneus valgus. If in these patients only the lateral ligaments are operatively treated after a trauma, there is a high incidence of recurrence, as the abnormal position of the calcaneus means that the supinating forces acting laterally have a stronger effect than in normal cases. We therefore suggest a combination of fibulotalar syndesmoplasty with osteotomy of the calcaneus according to Dwyer in such cases. In the last 7 years we have carried out this operation eight times with no recurrence in any of these patients so far. In four patients, a gait analysis was performed. It was established that the abnormal floor reaction forces seen in the presence of calcaneus varus normalize following the operation. PMID- 3808707 TI - [Post-traumatic arthrosis of the upper ankle joint in chronic insufficiency of the fibular ligament]. AB - X-ray studies of the ankle joints of 209 patients with operatively certified ankle joint instability were examined retrospectively in order to estimate the importance of lateral instability in causing degenerative osteoarthritis of the ankle joint. The patients were distributed into two groups: group A (126 patients with chronic fibular instability; 98 were up to 29 years of age and 28 between 30 and 40 years) and group B (83 patients with a fresh fibular rupture: 70 up to 29 years and 13 between 30 and 40 years). For more subtle differentiation of the grades of osteoarthritis, a new score system was developed. The results were tested statistically. In the patients with chronic instability in the younger group signs of degenerative arthritis could be seen twice as frequently as in the recently injured patients; in particular, higher grades of arthritis were found five times more frequently than in the recently injured. All patients with chronic instability in the older group had signs of degenerative arthritis. Higher grades of degenerative arthritis occurred ten times more frequently than in the recently injured. Regarding the recently injured patients, there was no significant difference between the younger and the older group. It is concluded that chronic fibular instability is an important factor in the development of degenerative arthritis, which shows the importance of early stabilization in order to prevent the development of degenerative arthritis. PMID- 3808708 TI - [Diagnosis and therapy of acute and chronic ligament instability of the lower ankle joint]. AB - At the Casualty Clinic of the University Hospital in Hannover, from 1981 to 1985, a total of 35 patients were treated operatively for chronic instability of the transverse tarsal joint: combined instability of the ankle and transverse tarsal joints (n = 15), isolated instability of the subtalar joint (n = 17), and isolated instability of the pretalar joint (n = 3). A simple technique of radiological positioning permits easy and certain diagnosis of isolated anterolateral rotary instability of the subtalar joint. Modified Elmslie tendosis (n = 32), used as an indirect replacement for the interosseus talocalcaneal ligament, had good and very good results in 25 of 27 cases followed up after 3 years. PMID- 3808709 TI - [Acute ligamentous injuries of the Chopart and Lisfranc joint line]. AB - The foot is a complex structure with numerous articular surfaces. As there are many potential complications (severe edema, compartment syndrome of the intrinsic foot musculature, bone and soft tissue necrosis, joint abnormalities, limitation of movement, deformities, etc.), traumatic surgeons must have a detailed knowledge of the relevant functional anatomy and treatment procedures. If there are multiple injuries, in the context of management, early definitive treatment for the injury is to be stressed. One requirement is an exact clinical and radiological diagnosis. As a rule, closed reduction is therapeutically successful. In a stable injury, immobilization can be achieved with a cast; in open wounds and malalignment of joint surfaces, an operative procedure is indicated. Particular attention must be paid to injuries of the tarsal bones in children to avoid delayed failure of growth, as the results of radiological investigations are often difficult to interpret. The diagnosis, techniques of management, and principles of follow-up are presented. PMID- 3808710 TI - [Preliminary results of the cryosurgical treatment of hyperkeratotic papilloma]. PMID- 3808711 TI - [The problem of secretory otitis in children]. PMID- 3808712 TI - [The problem of closed tympanoplasty in cholesteatoma of the middle ear in children]. PMID- 3808713 TI - [Specific IgE antibodies in the sera of patients with allergic rhinitis]. PMID- 3808714 TI - [Early diagnosis and care of children with hearing disorders in the Magdeburg region 1980-1983]. PMID- 3808715 TI - [Leiomyoma of the nose and paranasal sinuses]. PMID- 3808716 TI - [Giant polysegmented fibrous polyp of the esophagus]. PMID- 3808717 TI - [A case of metastasis of breast cancer to the larynx]. PMID- 3808718 TI - [A device for fixing a flash lamp for oral photography]. PMID- 3808719 TI - Censorship no solution. PMID- 3808720 TI - Genesis of generic drugs. PMID- 3808721 TI - Welcome: The Internal Revenue Code of 1986. Part II: Effects on corporations and other businesses. The Health Care Group. PMID- 3808722 TI - The Medical Practice Act of 1985. Part V--Responsibility of the Medical Board for law enforcement and discipline. PMID- 3808723 TI - [Clinical modification of cerebral palsy of the extrapyramidal type by L-dopa (Dopaflex)--longitudinal pilot study]. PMID- 3808724 TI - [Juvenile form of neuronal ceroid-lipofuscinosis--a case report]. PMID- 3808725 TI - [Use of the Heidelberg Language Development Test in disorders of language development in childhood]. PMID- 3808726 TI - [Partial performance weaknesses from the clinicopsychologic viewpoint and their significance for educational practice]. PMID- 3808727 TI - [Differential diagnosis of psychogenic reactions and organic diseases in childhood]. PMID- 3808728 TI - [Diagnosis of early childhood brain damage. 1. Conventional diagnostic methods- review]. PMID- 3808729 TI - [Diagnosis of early childhood brain damage. 2. Incidence, correlation and value of the conventional criteria of brain damage]. PMID- 3808730 TI - [Bibliotherapy as a possible constituent of the psychotherapeutic treatment concept]. PMID- 3808732 TI - [Epidemiologic study of adolescents following suicide attempts]. PMID- 3808731 TI - [An integrative management model of an adolescent psychiatric station]. PMID- 3808733 TI - [Experiences using electroconvulsive therapy in psychoses in childhood]. PMID- 3808734 TI - Some aspects of infantile spasms. PMID- 3808735 TI - A rooming-in program for mothers and newborns at Gunung Wenang General Hospital Manado. PMID- 3808736 TI - Community practices in managing diarrhoeal diseases in a rural area of South Sumatra, Indonesia. PMID- 3808737 TI - Proteinuria selectivity pattern and its relations to clinical and laboratory characteristics and response to treatment in nephrotic syndrome at the Department of Child Health, Hasan Sadikin General Hospital, Bandung. PMID- 3808738 TI - Phenylketonuria. A case report. PMID- 3808739 TI - Tactual sensitivity of chronic pain patients to non-painful stimuli. AB - Chronic pain research tends to focus on responses to thresholds, tolerance, and discrimination involving painful stimuli. This investigation, however, examines responses of individuals with chronic pain to non-painful stimuli. Two-point thresholds were obtained from 19 chronic pain patients and 17 pain-free individuals. The chronic pain patients had a significantly higher two-point threshold, 40.3 mm (S.D., 15.0 mm) than that of the control group, which had a two-point threshold of 30.8 mm (S.D., 7.4 mm). The results indicate that chronic pain decreases tactual sensitivity to non-painful stimuli. PMID- 3808740 TI - Trigeminal neuralgia and atypical facial pain: use of the McGill Pain Questionnaire for discrimination and diagnosis. AB - Although trigeminal neuralgia and atypical facial pain can usually be distinguished on the basis of several well-established criteria, differential diagnosis is difficult in a small number of patients. The purpose of this study was to determine whether the McGill Pain Questionnaire (MPQ) is capable of discriminating between the two syndromes and might therefore serve as a diagnostic aid. The MPQ was administered to 74 patients in Pittsburgh and the data were analyzed statistically in Montreal. In an analysis of the data of 53 patients, 91% of the patients were correctly classified on the basis of 7 descriptors. To determine whether the key descriptors were able to predict the diagnosis of a second group, the discriminant function derived from the first analysis was applied to a new group of 21 patients. A correct prediction was made for 90% of the patients. The results indicate that, in difficult cases, the MPQ may be a useful tool to aid in differential diagnosis. PMID- 3808741 TI - Effects of nucleus raphe magnus stimulation on jaw-opening reflex and trigeminal brain-stem neurone responses in normal and tooth pulp-deafferented cats. AB - Since we have recently shown that tooth pulp deafferentation results in changes in the receptive field properties and activity of brain-stem neurones in the adult cat's subnucleus oralis of the trigeminal (V) spinal tract nucleus, we wished to determine if these changes are associated with alterations in the powerful inhibitory influence that the nucleus raphe magnus (NRM) normally exerts on these neurones and on the related digastric jaw-opening reflex. In control cats or in cats that had undergone mandibular or maxillary tooth pulp deafferentation 7-140 days previously, the effects of NRM conditioning stimulation were tested on jaw-opening reflex responses or oralis neuronal responses evoked by stimulation of the maxillary or mandibular tooth pulp, facial skin, or oral mucosa. No statistically significant difference was noted between control and deafferented animals (n = 32) in the incidence, threshold or time course of NRM-induced inhibition of the reflex responses. Likewise, no difference was noted between control and deafferented animals in these features of the inhibition of oralis neuronal responses. In 276 neurones tested, the high incidence (92%), low threshold (0.08-0.15 mA) and prolonged time course (approximately 400 msec) of NRM-induced inhibition of responses evoked by electrical stimulation of the tooth pulp or by low-intensity electrical or mechanical stimulation of facial skin and oral mucosa were comparable in both groups of animals. These findings indicate that the alterations in properties or oralis neurones subsequent to tooth pulp deafferentation may not be associated with changes in the modulatory influence emanating from the NRM. PMID- 3808742 TI - Brain-stem areas tonically inhibiting dorsal horn neurones: studies with microinjection of the GABA analogue piperidine-4-sulphonic acid. AB - In barbiturate anaesthetized cats, tonic inhibition of the excitation of lumbar dorsal horn neurones by impulses in unmyelinated primary afferents was measured by reversibly cooling the spinal cord at the thoraco-lumbar junction. Tonic inhibition was reduced by microinjection of the GABA analogue, piperidine-4 sulphonic acid (2.5 nM in 0.5 microliter) mainly at AP -7, L 2-5 and V -8 to -10. This area in the ventrolateral medulla is just ventral to the facial nucleus and has been shown to be important in cardiovascular control, particularly in relation to fear-defence reactions. It is proposed that tonic inhibition of the nociceptive responses of spinal neurones is part of such a reaction in response to the trauma of surgery. Since previous experiments had shown that the ventrolateral medulla was important in spinal inhibition produced by PAG stimulation, these experiments support the proposal that analgesia does not occur in isolation but is part of a complex behavioural response of an animal in a potentially injurious environment. PMID- 3808743 TI - Activation of inhibition from the periaqueductal grey matter mediates central analgesic effect of metamizol (dipyrone). AB - The pyrazolone derivative, metamizol (dipyrone), possesses analgesic, antipyretic, anti-inflammatory and spasmolytic properties. It is often classified as peripherally acting. To test the possibility that a central action of the drug contributes to its antinociceptive and analgesic effects, experiments were carried out in which the tail-flick response to radiant heat, flexor reflex activity in the tibialis anterior muscle and activity in ascending spinal axons evoked by stimulation of afferent C fibres in the sural nerve, and activity of neurones in the periaqueductal grey matter and the substantia nigra were assessed in rats. Metamizol administered by intraperitoneal (i.p.; 10, 20 and 40 mg/kg) or intrathecal (i.t.; 50 to 400 micrograms) injection to intact rats dose dependently prolonged the tail-flick latency. Administration by i.t. injection to spinal rats was without effect. Intravenous (i.v.) injection of metamizol (140 mg/kg) reduced flexor reflex activity in intact animals, while an i.t. injection to spinal rats was ineffective at a low dose (100 micrograms) or enhanced the reflex activity at a higher dose (400 micrograms). Activity in ascending axons responding to afferent C fibre stimulation was mostly depressed by i.t. injection of metamizol (40, 80 and 140 mg/kg) in rats with an intact spinal cord. Ascending activity was increased by i.t. injection of the drug (100 and 200 micrograms) to spinal rats. Metamizol (140 mg/kg) i.v. increased the activity of neurones in the PAG and reduced that of neurones in the substantia nigra. Metamizol administered by microinjection into the PAG prolonged the tail-flick latency (15-100 micrograms) and depressed C fibre-evoked activity in ascending axons (100 micrograms). The results suggest that a central action is involved in the analgesic effect of metamizol and that this central action manifests itself by an activation of inhibition originating in the PAG. PMID- 3808744 TI - Pain assessment with different intensity scales in response to loading of joint structures. AB - The purpose of the present study was to compare intensity levels assessed on Borg's Category Scale for Ratings of Perceived Pain (BRPP) (1982) (a verbal scale using adjectives and adverbs combined with the numbers 0-10), with assessments on the Visual Analogue Scale (VAS) (a 10 cm horizontal line). Eight healthy subjects volunteered in an experimental study, where pain was provoked by load on passive soft tissue elbow joint structures. Each subject participated 4 times on different occasions in the same experimental set-up, which was divided into six 2 min periods; 3 periods with load induced by applied external weights causing load moments of 3.4 Nm, 4.5 Nm and 6.8 Nm plus that induced by the weight of the lower arm and hand (average 2.9 Nm), followed by 3 periods without external weights. Each series consisted of 12 assessments given during the last 10 sec period of each minute on either the BRPP or the VAS. No significant difference was found between the first and second time a scale was used by the same subject, and none between the assessments on the VAS and the BRPP. Intensity levels of pain increased with load and time and decreased after reduction of the load moments. It is concluded that both scales can be used to reliably assess intensity levels of perceived pain elicited by loading joint structures. Intensity levels, as assessed on both scales, are associated with applied external load and time for exposure. PMID- 3808745 TI - Vertebral artery thrombosis after spinal injury: case report. AB - The vertebral artery and the cervical spine are closely related anatomically, but damage to that vessel in cervical spinal injury and subsequent stroke involving the vertebrobasilar distribution has rarely been reported. A case of vertebrobasilar stroke following traumatic injury to the cervical spine is described. The anatomy of the vertebrobasilar system is reviewed and possible mechanisms of injury discussed. A literature review follows. PMID- 3808746 TI - Depression following acute spinal cord injury. AB - Nine patients meeting the DSM-111 criteria for major depressive episode were identified among 84 consecutive admissions to the Spinal Injuries Unit of the Austin Hospital. All were successfully treated with antidepressants. The means of recognition of depression, the differentiation of a depressive illness from grief and the implications for rehabilitation are discussed. PMID- 3808747 TI - Epidural abscess causing tetraparesis: case report. AB - A case is presented of a 26-year-old male with a 8-day history of fever and back pain, and limb weakness beginning 24 hours before admission. An abscess caused by a staphylococcus aureus was localised in the thoracic paravertebral region with penetration in the subarachnoidal space at T1. Myelography appeared to be superior to CAT-scan and NMRI of the cervico-thoracal region in supporting the diagnosis. Treatment by laminectomy of C7-T3 48 hours after admission did not lead to neurological improvement and an incomplete tetraplegia persisted. The importance and difficulty of early diagnosis is stressed. PMID- 3808748 TI - Peripheral nerve grafting in the spinal cord: a histological and electrophysiological study. AB - Excision of the dorsal columns was used to create a lesion in the spinal cord. The defect was bridged using a peripheral nerve graft. Silver staining showed the grafts being invaded by axons. Neuronal tracing by injecting horseradish peroxidase into the graft showed the origin of these fibres to be in dorsal root ganglia and in the grey matter of the lumbar cord. All of the animals studied showed horseradish peroxidase staining of neurones in the grey matter of the lumbar cord caudal to the graft. Five of the animals had staining of the dorsal root ganglion cells. Electro-physiological assessment was performed 5 to 6 months following the grafting procedure. Evoked potentials were recorded from the graft in six animals and from the dorsal columns above the graft in six animals. PMID- 3808749 TI - Unusual neurological complications of lumbar myelography with dimeglumine iocarmate (Dimer X). AB - In this report two unusual and serious neurological complications of dimeglumine iocarmate (Dimer X) myelography is presented. One patient became paraplegic six hours after myelography, and the other was mute for 24 hours after having generalised convulsions. The reasons are discussed. PMID- 3808750 TI - The therapeutic flat as a means of orientation and psychological adaptation for the paraplegic's environment. PMID- 3808751 TI - Extravasation from the unused bladder during cystography: case report. AB - Spontaneous, asymptomatic extravasation during retrograde cystography occurred in a quadraplegic patient who had been maintained on constant Foley catheter drainage for 7 years. This phenomenon has recently been described in a few anuric patients being studied prior to renal transplant and is probably related to the chronic disuse status of the bladder. It is a self-limiting process and, in the absence of a clinical reaction, only observation is warranted. PMID- 3808752 TI - Need for a complete neurological examination after spinal cord injury. PMID- 3808753 TI - Suppression of blood monocyte and neutrophil chemotaxis in acute human malaria. AB - The host response to Plasmodia includes the production of enlarged populations of peripheral blood monocytes and tissue macrophages in the spleen and the liver. Since the hyperplasia of the mononuclear phagocyte system is believed to arise as a consequence of an enhanced blood monocyte influx, we tested monocyte chemotactic responsiveness in 19 patients with acute primary attack malaria. In addition, the neutrophil chemotaxis was measured in 12 patients. Before the initiation of antimalarial treatment a significant depression of monocyte chemotaxis was observed in approximately half of the patients when compared with healthy control subjects. The depression was found in Plasmodium falciparum malaria as well as in P. vivax or P. ovale malaria patients. The defective responsiveness was not receptor specific, since the responses towards casein and zymosan activated serum proved to be equally suppressed. The monocyte chemotaxis was followed in 14 of the patients, during treatment and after complete recovery. After 3 days of treatment the response had improved in most of the patients, and after 7 days all patients had a normal monocyte chemotaxis, which remained normal after one month. No significant differences between P. falciparum and P. vivax/ovale malaria was observed with respect to blood monocyte chemotactic responsiveness. Neutrophil chemotaxis in patients with P. falciparum infections was similarly suppressed before treatment (54% of controls), was still defective after 3 days of treatment, and nearly normalized after 7 days (87% of controls). Furthermore, monocyte phagocytic and candidacidal activities were assessed in the same patients on admission and during the follow-up. In contrast to chemotaxis, these functions were normal in all of the patients whenever measured. In conclusion, not all cell functions were altered in concert, and the previously unreported suppression of chemotactic migration might reflect a change in blood leucocyte subpopulations, deactivation in vivo or a direct suppressive effect of plasmodia induced products. PMID- 3808754 TI - Surface properties of developing stages of Trichuris muris. AB - Surface properties of developing stages of Trichuris muris were investigated by analysis of binding affinities for specific anti-parasite antibodies present in a range of infection sera; in vitro eosinophil adherence studies; and binding of the fluorescent-labelled lectins, Con A, WGA, PNA and RCA. In general, larvae of any one particular stage did not bind anti-parasite antibodies present in serum collected at an earlier stage of the infection, thus indicating a considerable degree of antigenic stage-specificity. Forty day and older parasites displayed similar binding properties and it is suggested that no major changes in surface antigenicity occur after the final moult at day 25-30 after infection. Surface properties were also examined by means of complement and antibody-mediated eosinophil adherence assays. Attachment of eosinophils was maximal with day 5 larvae, although even at this stage not all of the parasite surface was covered with attached cells. Despite adherence, eosinophils were unable to effect parasite killing, even after 48 h of incubation. These studies showed that eosinophil adherence-promoting antibodies were present in immune sera; that the larval parasite surface was able to activate complement by the alternate pathway with subsequent generation of C3b molecules, and that the parasite was able to withstand eosinophil adherence and secretion by an as yet unidentified evasive stratagem. Studies with fluorescent-labelled lectins showed that all larval stages (days 5-25 after infection) were positive for Con A binding. Early larval stages (days 5-10 after infection) also bound PNA and WGA. Interestingly, recently moulted individuals rarely exhibited fluorescence, but cast cuticles fluoresced brightly. PMID- 3808755 TI - [Ultrastructural studies of the surface of pulmonary macrophages of guinea pigs exposed to cigarette smoke]. PMID- 3808756 TI - [Morphologic and histochemical studies of chromolipid cytoplasmic inclusions in the pulmonary macrophages of guinea pigs after inhaling cigarette smoke]. PMID- 3808757 TI - [Experimental studies of the dynamics of morphologic changes in the heart in hypothyroidism]. PMID- 3808758 TI - [Morphologic evaluation of the effect of the combined use of cyclophosphamide and actinomycin D on the regenerating parenchyma of the rat liver]. PMID- 3808759 TI - [Morphologic and clinical evaluation of malignant non-epithelial and mixed neoplasms of the genital organs. I. Heterologous sarcoma, stromal sarcoma, carcinosarcoma and adenocarcinoma]. PMID- 3808760 TI - [Morphologic picture of the urinary sediment in cases of cancer of the urinary bladder]. PMID- 3808761 TI - [A method of managing pathomorphologic examinations in cases of acquired immunodeficiency syndrome]. PMID- 3808762 TI - [Acute fulminant ulcerative colitis. A case report]. PMID- 3808763 TI - Sad children. PMID- 3808764 TI - Clinical aspects of childhood depression. AB - Currently, major depressive episodes in children can be diagnosed using criteria similar to those for adult depression. Although symptoms appear similar to those seen in adult depression, differences in cognitive and language functioning compared to adults must be taken into account when assessing children. Recognition of depression and its presentation in children is essential in making an accurate diagnosis. Increased interest and improved methods of assessment and treatment should result in better care for depressed children and their families. PMID- 3808765 TI - Childhood sibling loss. A family tragedy. AB - The loss of a significant object, the loss of a home (security, personal possessions, familiar space that has emotional meaning), the dislocation from one's home or land as occurs in wars or disasters, gives rise to stress-strain responses that may have short-term or long-term effects, eg, post-traumatic stress disorder. The hidden or neglected victims of such occurrences frequently are children--be they siblings or direct descendants. In childhood sibling loss, the effects of the loss are mediated through different members of the family. The acute stressors can give rise to later adversity unless it is recognized that there is a social context in which life and death events occur. Recognizing these individual responses in the family can lead to interventions that may prevent later difficulty. Understanding the meaning of the events to the child, appreciating the fact that events are not just single occurrences, but interact with what existed before as well as with other concomitant events, helps in our therapeutic recommendations and interventions. Sibling loss, though initially related to the death of a sibling, can now be expanded to include the loss of a sibling through chronic illness (emotional, medical, surgical, long-term hospitalization), birth injuries, disabled children (accidents or illness with body changes), chronic illness with visible as well as non-visible changes that require special parental and nursing care, medication on an ongoing basis, and restrictions in diet and activities. The impacts of these losses without death can have devastating effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808766 TI - Treatment issues in childhood depression. PMID- 3808767 TI - Hospitalization of the young. Rationale and criteria. PMID- 3808768 TI - Severe upper airway obstruction. AB - This article describes management of newborn and older children with severe upper airway obstruction, that is, those needing or likely to need airway support for their intact survival. These children have more to gain from optimal care, and more to lose from any error than most other children requiring admission to a pediatric intensive care unit. PMID- 3808769 TI - Intensive care. PMID- 3808770 TI - Continuous renal prosthetic therapy in acute renal failure: an overview. AB - The technology surrounding the treatment of acute renal failure has been traditionally left in the realm of dialysis. The use of peritoneal dialysis for the neonate or small infant and the often difficult use of hemodialysis in larger children and adolescents have been the mainstay of support. Not infrequently, however, the multisystem nature of the failure demonstrated by these patients made either form of therapy at best inadequate. The morbidity of the procedure would add to the already high morbidity of the disease and the patient would either be unable to receive the needed medications because of necessary fluid restrictions, or be subjected to severe hemodynamic or respiratory embarrassment due to the treatment methods themselves. It is precisely toward this patient population that the continuous forms of renal replacement therapy, reviewed herein, are directed. PMID- 3808772 TI - Extracorporeal membrane oxygenation in pediatric respiratory failure. AB - ECMO is capable of safely supporting respiration and circulation in newborns with severe respiratory failure and a moribund clinical presentation. The results thus far suggest that term infants with respiratory failure are the best candidates for ECMO, with a survival rate of 83 per cent. Infants under 35 weeks' gestation have a very high incidence of intracranial hemorrhage. Consequently, we do not currently accept them for ECMO treatment. The outcome of the survivors is largely determined by the clinical condition before ECMO and by major complications. Research must be directed toward cost effectiveness, timing and earlier use, alternative vascular access, cannula and circuit design, and expanded indications. PMID- 3808771 TI - The pediatric acute care laboratory. AB - The acute care laboratory service is an integral part of the total care required by the critically ill pediatric patient. Successful laboratory support for the intensive care unit requires optimal location, and sample collection, analysis, and reporting. These needs may be met with proper commitment on the part of laboratory staff and by application of the analytical technology now available. Testing support must reflect the special medical needs of pediatric patients in terms of sample size, test menu, instrumentation, and results interpretation. PMID- 3808773 TI - Total respiratory compliance and functional residual capacity in young children. AB - Measurements of total compliance of the respiratory system (CRS) by the weighted spirometer technique and functional residual capacity (FRC) by helium gas dilution were attempted in 63 healthy children (aged 2 to 7 years). Weighted spirometry was well tolerated in all but six children, and FRC measurements were successful in 42. Both measurements were reproducible and not affected by posture. Good correlations were found between CRS and height (r = 0.73) and age (r = 0.83) as well as between FRC and height (r = 0.83) and age (r = 0.74). No differences were found between boys and girls. CRS also correlated significantly with FRC (r = 0.67). In five children with cystic fibrosis, measurements of CRS, FRC and specific compliance correlated with disease severity. Our data suggest these well-tolerated techniques may provide a useful means to distinguish the effects of disease from those of growth. PMID- 3808774 TI - Effect of high-frequency jet ventilation on preterm and rabbit tracheal mechanics. AB - The effect of high-frequency jet ventilation (HFJV) on both tracheal dimensions and mechanics was evaluated in preterm and term rabbit airways. Seven tracheal segments were studied at 27 days (group I) and 31 days (group II) of gestation, respectively. Tracheal dimensions and segmental pressure-volume relationships were determined before and after 60 minutes of HFJV (peak pressure 20 cm H2O; mean airway pressure 6.7 to 6.8 cm H2O at 10 Hz). Both tracheal lengths and diameters increased significantly (p less than 0.01) in each group and resulted in increased tracheal volumes: 109% in group I (p less than 0.01) and 60% in group II (p less than 0.01). The mean specific tracheal compliance decreased in group I, from 0.036 cm H2O-1 to 0.015 cm H2O-1 (p less than 0.01), and in group II from 0.029 cm H2O-1 to 0.021 cm H2O-1 (p less than 0.01). Furthermore, the collapsing transmural pressure (the pressure required for total collapse of tracheal segments) decreased significantly (p less than 0.01) in both groups. These data demonstrate significant dimensional and mechanical deformation of tracheal segments after HFJV. An increased propensity toward collapsibility is also observed following HFJV. These changes are similar to those with tracheomalacia. The influence of such deformation on tracheal gas flow during HFJV needs to be further investigated. PMID- 3808775 TI - Compliance measurement in respiratory distress syndrome: the prediction of outcome. AB - Dynamic compliance (Cdyn) measurements within the first three days of life predicted survival in 60 preterm infants suffering from respiratory distress syndrome. Cdyn was measured in 47 survivors at 2.3 +/- 1.4 days of life and in 13 nonsurvivors on 2.7 +/- 1.7 days. All nonsurvivors died from respiratory failure within the first two weeks of life. Mean Cdyn of the survivors was 0.83 +/- 0.33 ml/cm H2O and of the nonsurvivors 0.35 +/- 0.19 ml/cm H2O (p less than 0.001). Cdyn values below 0.45 ml/cm H2O predicted 11 of 13 deaths in infants, and Cdyn measurements above this value predicted 45 of 47 survivals, with a specificity of 81% and a sensitivity of 89%. Eleven of the survivors, who subsequently developed bronchopulmonary dysplasia (BPD), had a mean Cdyn of 0.56 +/- 0.23 ml/cm H2O. When these infants were matched with infants of comparable weight without evidence of BPD, the BPD group had a significantly lower Cdyn (p less than 0.05). Cdyn measurements during the first three days of life are useful in predicting outcome of respiratory failure secondary to respiratory distress syndrome. PMID- 3808777 TI - Diurnal variation in bronchial responsiveness in asthmatic children. AB - To establish the presence of a diurnal variation in bronchial responsiveness in asthmatic children, the increase of peak expiratory flow rate (PEFR) following sympathomimetic inhalation and the response to bronchial provocation with histamine and hyperventilation of cold dry air (HVCDA) were studied. Twenty-nine patients (20 boys, nine girls, aged 9.3 to 17.8 years) measured PEFR before and after sympathomimetic inhalation three times a day for four weeks. A further 15 patients (eight boys, seven girls, aged 6.9 to 18.0 years) underwent bronchial provocation testing every six hours for 24 hours. A diurnal variation in bronchodilator responsiveness was demonstrated in 55% of the first group. Mean amplitude was 60.8% of patients' mean increase in PEFR following bronchodilators. On grouped data, bronchodilation was greater in the morning than in the afternoon (p less than 0.0005) or in the evening (p less than 0.0005). A diurnal variation in the response to bronchial provocation was also found in the second group, but the timing of the rhythm depended on the stimulus used. On grouped data, airways were most sensitive to histamine at 0400 hours and most sensitive to HVCDA at 1600 hours. The diurnal variation demonstrated in bronchial responsiveness could not be attributed to changes in baseline airway caliber and was present, despite the patients' taking sufficient medication to control their asthmatic symptoms. PMID- 3808776 TI - A study of spirometry in children from Mexico City. AB - A study was conducted in two elementary schools in Mexico City to determine values for pulmonary function tests in school-aged residents of Mexico City. The schools were located in Xalostoc, a highly industrialized area of Mexico City, and San Lorenzo, a suburban area of the city. Although data regarding atmospheric pollution were not available, there is an acknowledged higher level of macroenvironmental air pollution in Xalostoc. Pulmonary function tests were performed on 468 children in San Lorenzo and 405 children in Xalostoc. No differences between residents of the two communities for acute or chronic respiratory conditions were detected by questionnaire. The pulmonary function data demonstrate that boys have larger forced vital capacities (FVC) and forced expiratory flows over the middle half of the FVC (FEF25-75) than girls. Slopes of regression lines for FVC but not for FEF25-75 are greater in boys and girls from Xalostoc than in boys and girls from San Lorenzo. This suggests that young children from Xalostoc may experience ill effects of air pollution but develop catch-up growth later. There were no important community or gender effects on slopes of regression lines for height and weight on age. In general, the regression lines for FVC and FEF25-75 were below regression lines reported for children of Mexican ancestry living at sea level. PMID- 3808778 TI - Modification of nonspecific bronchial reactivity in hypothyroid children under different regimens of substitutive opotherapy. AB - Although it has been experimentally proved that thyroid hormones stimulate beta 2 receptor activity and tissue responsiveness to catecholamines, previous studies have established that asthma and nonspecific bronchial reactivity (NSBR) can worsen if complicated by hyperthyroidism. Our study is an effort toward the analysis of this contradiction. In 20 congenitally hypothyroid children, substitutive opotherapy was completely withdrawn for 1 month, resumed in the original dosage for 2 months, and then increased by 20% from day 91 to day 110. Mean NSBR, expressed in carbachol-related PD20-FEV1 and PD25-V25, was significantly increased by day 30, remained significantly elevated by day 90, and returned to initial values by day 110. These results suggest that thyroid hormones per se in nonasthmatic subjects decrease bronchial reactivity. This observation should be taken into consideration when attempting to explain the worsening condition of asthmatics who became affected with hypothyroidism. Bronchial reactivity appears to be under the control of many factors (including thyroid hormone levels). Once it is altered, a period of time seems necessary to restore the original bronchomotor tone (2 months in our study). PMID- 3808779 TI - Vascular ring: clinical and physiological assessment of pulmonary function following surgical correction. AB - Twelve children were evaluated 7.1 years (mean) after surgical repair of a vascular ring causing tracheal compression. Nine patients complained of persistent respiratory symptoms, mostly cough, dyspnea, and/or wheezing. Functional evaluation revealed abnormal spirometry and/or lung volumes in seven subjects. Analysis of maximal expiratory-inspiratory flow-volume loops suggested the presence of residual upper airway obstruction in three patients and peripheral airway obstruction in three others. Eleven patients demonstrated bronchial hyperreactivity to histamine. PMID- 3808780 TI - [Pancreatic polypeptide and motilin secretion in children with jaundice and chronic diarrhea]. PMID- 3808781 TI - [Evaluation of the nutrition of children with simple obesity with special reference to food components which could promote the development of arteriosclerosis]. PMID- 3808782 TI - [Selected studies of humoral and cellular immunity in children with serous cerebrospinal meningitis and pharyngitis]. PMID- 3808783 TI - [Comparative evaluation of schoolchildren's qualification for mass screening following routine and extended health balance studies]. PMID- 3808784 TI - [Congenital cystic adenomatoid malformation of the lungs in 2 children]. PMID- 3808785 TI - [Acute pancreatitis in a 3-year-old girl]. PMID- 3808786 TI - [Epidermolysis bullosa lethalis in a newborn infant with intrauterine fetal dystrophy syndrome and thymic aplasia]. PMID- 3808787 TI - [Effect of exercise therapy on the development of motor skills and general efficiency in children with diseases of the locomotor system]. PMID- 3808788 TI - [Present-day status and the future of preventing developmental anomalies]. PMID- 3808789 TI - [Effect of incorrect nutrition on the development of dental caries in children]. PMID- 3808790 TI - High-density lipoprotein-cholesterol subfractions in adolescent twins. AB - Data on the levels of high-density lipoprotein-cholesterol (HDL-C) and subfractions in 102 adolescent twin pairs and their parents are presented. Children with a family history of premature cardiovascular death had lower levels of HDL2-C than did those without such a history. White girls reporting a high level of physical activity had higher levels of HDL-C and HDL2-C than did their more sedentary peers. In general, children of mothers who smoked had lower HDL2-C than did children of nonsmoking mothers. These findings suggest that low levels of HDL2-C in children may identify families in which there is an increased risk of coronary heart disease and that parental smoking may contribute to changes in this risk factor in the children of smokers as well as in the smokers themselves. PMID- 3808791 TI - Efficacy comparison of oral rehydration solutions containing either 90 or 75 millimoles of sodium per liter. AB - In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy. PMID- 3808792 TI - Health services use by children enrolled in a hospital-based primary care clinic: a longitudinal perspective. AB - The use of a hospital-based primary care clinic for health maintenance and illness care and use of the emergency room were monitored for 3 years for 293 children who had been enrolled in the clinic as infants. Infrequent users of one facet of care were infrequent users of other facets of care, and they remained so for all 3 years. The same trends were noted for frequent users. Children who used the clinic for health maintenance infrequently were more likely to have registered in the clinic after 2 months of age and to demonstrate consistently infrequent use throughout the 3 years. Children who used the clinic for illness care infrequently were more likely to have at least two siblings and to demonstrate consistently infrequent use. Children who used the emergency room infrequently were likely to have been consistently infrequent users for emergencies and illness throughout the 3 years. Conversely, those who used the clinic frequently for health maintenance were more likely to have registered before 1 month of age, to have multiple chronic conditions, and to demonstrate consistently frequent use for maintenance throughout the 3 years. Frequent users for illness care were more likely to have none or one sibling, multiple chronic conditions, and to demonstrate consistently frequent use for illnesses. Finally, children who used the emergency room frequently were likely to have multiple chronic conditions and to demonstrate sustained frequent use throughout the 3 years. These results suggest that patterns of use are established as early as the first year of life. PMID- 3808793 TI - Three years of experience with random urinary homovanillic and vanillylmandelic acid levels in the diagnosis of neuroblastoma. AB - During the last 3 years, random urine samples from 408 patients were tested for elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels to rule out the diagnosis of neuroblastoma. Thirty-seven of these patients had elevated HVA and/or VMA levels, and neuroblastoma was subsequently diagnosed. In three additional patients with negative test results (normal HVA and VMA levels), tumors were subsequently diagnosed (false-negative rate of 7.5%). Ten percent of the patients with neuroblastoma had normal HVA and 27.5% had normal VMA levels at the time of diagnosis. Only one patient (2.5%) with neuroblastoma had elevated VMA levels in the presence of normal HVA levels. More than 60% of the patients with neuroblastoma had urinary HVA and/or VMA levels higher than twice the upper limit of normal. No false-positive results were encountered. Age and stage distributions of the patients are shown, and the significance of the results is discussed. PMID- 3808794 TI - Familial bathing patterns: implications for cases of alleged molestation and for pediatric practice. AB - In a cross-sectional study of how 576, upper-middle class children were socialized around bathing behaviors, families were found to be variable in their handling of bathing practices. But as a group, children were found to bathe alone more frequently as they grew older, and parents were found to bathe less frequently with the child of the opposite sex, particularly as children grew older. It was uncommon for mothers to bathe or shower with sons older than 8 years of age or for fathers to bathe or shower with daughters older than 9 years of age, although most had stopped before that age. This cross-sex aversion may be a reflection of the incest taboo. Several suggestions are made about the development-related changes in bathing practices identified in the study. PMID- 3808795 TI - Judicial involvement and conduct problems of fathers of infants born to adolescent mothers. AB - Data were obtained from retrospective review of 191 patient records to determine the extent and types of conduct problems among fathers of infants born to adolescent mothers. Ninety-eight fathers (51%) reported having committed a legal offense prior to the pregnancy. This rate appears substantially greater than rates of arrests of adolescents in the general population. When paired data for couples were analyzed, there was great similarity for severity of offense. Fathers, however, had committed more severe crimes than their partners. Male offenders came from families of lower socioeconomic status backgrounds and more single-parent families and were less frequently employed or in school (or graduated) than nonoffenders. They also had been more involved with various other problem behaviors, such as a previous pregnancy, drinking behavior, and behavior problems at school. There was a clustering of problem behaviors among offenders suggesting psychosocial maladjustment prior to the pregnancy. Our results suggest an association between fatherhood and delinquency among partners of adolescent mothers. It appears that these fathers form a heterogeneous group. Although some young fathers may be well adjusted, others have significant psychologic problems. PMID- 3808796 TI - Cystic fibrosis and family stress: effects of age and severity of illness. AB - Stress and adjustment in mothers of children with cystic fibrosis was compared with that in a control group of mothers of healthy children. Mothers of children in four age groups were included: preschool, middle childhood, early adolescence, and late adolescence. Mothers of children with cystic fibrosis did not report significantly higher levels of stress than did the control group mothers; nor did they report greater feelings of inadequacy as parents. However, mothers of children with cystic fibrosis in two age groups, preschool and early adolescence, scored higher on a measure of depression than did mothers of healthy children in the same age groups. The relationship of illness severity to maternal stress and adjustment was examined in the cystic fibrosis group. The mother's subjective rating of the child's illness severity was a better indicator of her reported stress than was the Schwachman clinical rating. It appears that many mothers are able to adapt to the presence of cystic fibrosis in the family, although certain periods in the child's life and perceived increases in illness severity are associated with increased maternal distress. PMID- 3808797 TI - Development of severely malnourished children who received psychosocial stimulation: six-year follow-up. AB - The development of 16 children who were hospitalized for severe malnutrition and participated in a home-visiting program of psychosocial stimulation was compared with that of two other groups who were also hospitalized but received standard medical care only: severely malnourished group (n = 18) and an adequately nourished one (n = 20). All groups were assessed regularly on the Griffiths Mental Development Scales and the Stanford-Binet test. Both groups of malnourished children were markedly behind the adequately nourished group on admission to the hospital and the group that received no intervention showed little sign of catching up. The intervention group caught up to the adequately nourished group in 2 years. This report covers the third year of home-visiting and the 3 years following its cessation. The intervention group showed a decline in three of the five Griffiths subscales. However, they retained a marked advantage over the nonintervention group of malnourished children on the Stanford Binet test until the end of follow-up, showing no further decline in the last year. For height, both malnourished groups failed to catch up to the adequately nourished group. It was concluded that a relatively simple intervention can benefit the development of severely malnourished children. PMID- 3808798 TI - Microwave oven burns to children: an unusual manifestation of child abuse. AB - Two children sustained full-thickness burns as a result of being placed in microwave ovens. Well demarcated burns occurred on the skin surfaces closest to the microwave-emitting devices. Morbidity was limited to complications of direct thermal effects. One of the children sustained a distinctive pattern of relative sparing of tissue layers without electrical burn features, such as nuclear streaming and charring, at the entrance site. In both instances eventual identification of this unusual etiology was initiated by child abuse concerns. PMID- 3808799 TI - Serious head injuries from lawn darts. AB - Serious injuries secondary to lawn darts have not been reported. In this article two cases of penetrating skull injuries are reported. One patient developed a polymicrobial brain abscess necessitating surgical drainage and a prolonged hospitalization. Psychologic function was diminished at discharge. The second child required surgical repair of a depressed skull fracture. Thirteen lawn dart head injuries have been reported to the Consumer Product Safety Commission between 1983 and 1985. These injuries are summarized along with the reported cases to point out the seriousness (neurologic impairment in 5/10 head injuries) of such injuries and warn parents and physicians of the potential dangers of this game. PMID- 3808800 TI - Delay in caffeine elimination in breast-fed infants. AB - Because of a persistently elevated caffeine half-life observed in a breast-fed infant during caffeine maintenance therapy, we conducted this prospective longitudinal study in two groups of infants (five exclusively breast-fed and 12 formula-fed). After 46 weeks' postconceptional age, all five breast-fed infants had a marked delay in caffeine elimination, compared with one infant in the formula-fed group. Four breast-fed infants had measurements of significantly longer caffeine half-lives compared with 12 formula-fed infants (76 +/- 13 hours v 21 +/- 28 hours and 54 +/- 9 hours v 16 +/- 13 hours at 47 to 50 weeks and 51 to 54 weeks postconceptional age, respectively), as well as significantly higher trough blood levels (three- to five-fold) after 46 weeks' postconceptional age. The fifth breast-fed infant accumulated caffeine secondary to a steep increase in caffeine half-life from 102 hours at 44 weeks to 372 hours at 51 weeks. The elevated blood caffeine levels in breast-fed infants was not related to higher daily dosage of caffeine citrate (4.4 mg/kg compared with 8.3 mg/kg in the formula-fed group at 56 weeks' postconceptional age). Daily consumption of caffeine was low or nonexistent in four nursing mothers, and transfer of caffeine to the infant was considered to be trivial. The findings from this study suggest, as does breast milk jaundice due to inhibition of glycuronyl transferase, that some components of human milk (free fatty acid, lipase activity, or other factors) inhibit or repress the postnatal normal maturation process of caffeine metabolism by hepatic cytochrome P-450. PMID- 3808801 TI - Elevated catecholamine levels and abnormal hypoxic arousal in apnea of infancy. AB - Arousal from quiet sleep in response to a hypoxic challenge fails to occur in many patients with apnea of infancy. It was hypothesized that catecholamine mediated responses might be involved in the depressed hypoxic arousal response in apnea of infancy and that these differences would be reflected in serum catecholamine concentrations. Fifteen infants with a median age of 5.5 months and a history of unexplained apnea during sleep were studied. Two hypoxic challenges (PiO2 80 mm Hg) were given for three minutes or until arousal from quiet sleep occurred. Of the 15 patients with apnea of infancy 11 (73%) did not arouse to hypoxia. These infants had serum epinephrine levels that were elevated 4.1-fold while awake (P less than .05), 3.4-fold during quiet sleep (P less than .02), and 3.5-fold during hypoxia (P less than .05). They also had serum norepinephrine levels that were elevated threefold while awake (P less than .05), 5.3-fold during quiet sleep (P less than .001), 3.2-fold during hypoxia (P less than .02), and 12-fold during recovery from hypoxia (P less than .001) in comparison with the corresponding levels in the four (23%) infants who aroused normally to hypoxia. It is speculated that elevated circulating catecholamines are associated with abnormal hypoxic arousal responses in children with apnea of infancy. PMID- 3808802 TI - Animal models for evaluation of drugs for use in the mature and immature newborn. AB - The need for a better defined and controlled approach to new therapies for possible neonatal application appears clear in light of present practice and recent history. At this conference several animal models were discussed that could be used for pharmacokinetic and pharmacodynamic studies and for evaluation of efficacy and safety prior to human newborn testing. This, coupled with a requirement for comprehensive human data collection following preliminary approval of new drugs, would, we believe, significantly improve present practice. It will, however, require pressure from the medical community and patient advocates to encourage change in current government regulations and industry policies. PMID- 3808803 TI - Liver injury after oral and rectal administration of N-acetylcysteine for meconium ileus equivalent in a patient with cystic fibrosis. PMID- 3808804 TI - Transcutaneous oxygen monitors are reliable indicators of arterial oxygen tension (if used correctly). AB - The following recommendations should always be kept in mind: Each new transcutaneous equipment, or modification of equipment, must be adequately tested in vivo as well as in vitro. The users must have basic understanding of the principles and the major requirements for applying the tcPO2 technique. Calibration procedures must be carefully adhered to according to the manufacturer's instruction. The temperature of the electrode must be kept at 44 degrees C for premature infants and at 44 degrees or 45 degrees C for term infants if the clinical aim is to estimate arterial PO2 levels. Resetting of the electrode must then be done every two hours. For sick infants, this may be needed more frequently. Whenever there is cause to compare tcPO2 values with arterial ones, the latter must be obtained from an appropriate vessel. Great care must be taken when drawing and analyzing blood for PO2. The infant should not be crying. Significantly lower transcutaneous PO2 values than arterial PO2 values are due to either one or several of the errors indicated above or to an insufficient circulation under the electrode. In recent years, technical or clinical errors seem to have become more and more common. Thereby the technique has unjustly fallen into disrepute. Insufficient circulation under the electrode rarely occurs in the newborn infant and then only in those who are in overt shock. PMID- 3808805 TI - Can we rediscover the bedside? PMID- 3808806 TI - Ribavirin. PMID- 3808807 TI - National Institutes of Health Consensus Development Conference on Infantile Apnea and Home Monitoring, Sept 29 to Oct 1, 1986. PMID- 3808808 TI - American Academy of Pediatrics Committee on Hospital Care: Medical necessity for the hospitalization of the abused and neglected child. PMID- 3808809 TI - American Academy of Pediatrics Committee on Environmental Hazards: Asbestos exposure in schools. PMID- 3808810 TI - American Academy of Pediatrics Committee on Accident and Poison Prevention: All terrain vehicles: two-, three-, and four-wheeled unlicensed motorized vehicles. PMID- 3808811 TI - Pain--a subject ignored. PMID- 3808813 TI - Residents on the phone. PMID- 3808812 TI - Smoke and ear effusions. PMID- 3808814 TI - Absent hypoxic and hypercapnic arousal responses in children with myelomeningocele and apnea. PMID- 3808815 TI - Lack of statistical power. PMID- 3808816 TI - Neonatal intracranial hemorrhage and phenobarbital. PMID- 3808817 TI - Computerized ventilation. PMID- 3808818 TI - Too many warnings on missing children. PMID- 3808819 TI - [Different therapy variants and the nature of the course of membranoproliferative glomerulonephritis]. PMID- 3808820 TI - [Hepatobiliary scintigraphy of children with the nephrotic form of glomerulonephritis at different stages in immunodepressive therapy]. PMID- 3808821 TI - [Clinico-pathogenetic characteristics of pyelonephritis in children in relation to the nature of the bacteriuria]. PMID- 3808822 TI - [Antibiotic sensitivity of the urinary enterobacteria in children with pyelonephritis]. PMID- 3808823 TI - [Calcium metabolism in kidney diseases in children]. PMID- 3808824 TI - [Diagnosis of gastroduodenal diseases in children]. PMID- 3808825 TI - [Immunoglobulins and lysozyme in the gastric juice, oropharyngeal secretion and blood serum of children with gastroduodenal pathology]. PMID- 3808826 TI - [Nephrology and urology problems in the research program for the 12th Five-Year Plan]. PMID- 3808827 TI - [Disorders of gastric motor and evacuatory functions in children]. PMID- 3808828 TI - [Nonspecific protection factors of the duodenal mucosa in chronic gastroduodenitis in children]. PMID- 3808829 TI - [Functional and immunological indices of the small intestine in childhood Lamblia infection]. PMID- 3808830 TI - [Clinical significance of the leukocyte migration inhibition reaction to human liver lipoprotein in children with chronic hepatitis and liver cirrhosis]. PMID- 3808831 TI - [Mechanisms of the development of pancreatitis in children]. PMID- 3808832 TI - [Survey of the research work in pediatrics completed in 1985]. PMID- 3808833 TI - [Antenatal echocardiographic diagnosis of Ebstein's syndrome]. PMID- 3808834 TI - [Circulating immune complexes in acute glomerulonephritis in children]. PMID- 3808835 TI - [Aortic aneurysm in a 3-year-old child with aortoarteritis]. PMID- 3808836 TI - [Case of chronic pancreatitis in the exacerbation stage in a 9-year-old child]. PMID- 3808837 TI - [Progesterone concentration of the plasma of newborn infants]. PMID- 3808838 TI - [Intermediate neurological development of 60 neonates weighing 1500 grams or less at birth. Predictive value of initial findings (clinical aspects, electroencephalograms and brain imaging)]. AB - 60 low birthweight (less than or equal to 1,500 g) are distributed according to existence or not, and intensity of brain disturbances, during the neonatal period; appreciated by neurological examinations, early EEG and brain imaging during the second month of life. At 18 months, at least, neurological outcome is normal for 46 children (but 6 had transient neuromotor anomalies), 14 have sequelae (7 mild, 7 major). All children with clinical neurological examination carried out during the neonatal period are normal at follow up. It is true also for the children without EEG anomaly and normal brain imaging. The early prediction of neurological outcome can be made easily with consideration of these three data. Standardised test are proposed, during the neonatal period, for these low birth weight infants. PMID- 3808839 TI - [Osteoarthritis and osteomyelitis due to Kingella kingae in children. Apropos of 5 cases and review of the literature]. AB - Bone infection caused by Kingella kingae (Kk) is rare since there are only 15 published cases. We report 5 additional cases with isolation of Kk from fluid or bone aspiration. Kk was sensitive to the most common antibiotics. The outcome was favorable in every case. PMID- 3808840 TI - [Recurrent purulent meningitis and deafness: Mondini's malformation]. AB - A 5-year-old girl with severe deafness (90 dB) had two successive attacks of bacterial meningitis. A vesicular cochlea was found on polytomography, and a bilateral defect in the stapes footplate with cerebrospinal fluid leakage during surgery (Mondini dysplasia). Although rare, the eventuality of this malformation emphasises the utility of polytomography of the inner ear in children with congenital deafness. PMID- 3808841 TI - [Congenital cutaneous candidiasis. 2 case reports]. AB - The authors report two new observations of congenital cutaneous candidiasis (CCC). The antenatal character and modes of infection are reviewed, together with the usual clinical features. Diagnosis is based on clinical observation confirmed by biochemical tests. Evolution is generally favorable with topical antifungal treatment. As systemic pulmonary, meningeal or cerebral infection is possible, systemic antifungal therapy may be advisable. PMID- 3808842 TI - [A new case of glucose-galactose malabsorption]. AB - The authors report a new case of glucose-galactose malabsorption. The particular features of this neonatal life-threatening refractory diarrhea are recalled. The dietetic management which permits a normal growth and psycho-intellectual development is described. The pathophysiological mechanisms of this malabsorption is elucidated from a review of the literature which specifies the autosomal, recessive mode of inheritance. PMID- 3808843 TI - [Cesarean section before the end of 32 weeks' gestation. Apropos of 91 neonatal case reports]. AB - 78 cesarean sections (CS) were performed before 32 weeks of gestation over a period of six years in a obstetric clinic; 91 premature infants were born; the rate of CS at this period of time represented 0,47% of total birth. 84 premature infants were transferred to the neonatal unit located in the same clinic; 3 were dead in utero and 4 just after delivery. 69 infants survived (78%) but 6 had severe sequelae (spastic diplegia, epilepsy and RLF) at one year of age and 7 had minor sequelae. PMID- 3808844 TI - [Evaluation of the protocol for management of the first uncomplicated febrile convulsion]. AB - A protocol of rationalized management of the first non complicated febrile seizure was used in 42 children and the results were compared with those observed in the past without the new protocol. The quality of medical data collected from the parents and those given to the family and their practitioner have been improved; the duration of the hospitalization was shorter, the examinations were fewer and the savings realised per child were 3,175 francs. PMID- 3808845 TI - [Hermansky-Pudlak syndrome. Apropos of a case]. AB - A new case of Hermansky-Pudlak syndrome is reported. Clinical, ophthalmological, hematological and dermatological explorations are all described in detail, with emphasis placed on the risks of non-recognition of the syndrome. The ocular albinism is associated with a cutaneous syndrome of highly variable expression and a thrombopathy generally without frank clinical consequence. The quasi spontaneous meningeal hemorrhage noted in this case is unusual. Literature data on this syndrome is reviewed and its main features are described. PMID- 3808846 TI - [Hypercalcemia in pseudohypoaldosteronism]. AB - The authors report a case of pseudohypoaldosteronism with hypercalcemia. Treatment with sodium chloride supplements normalized both plasma electrolytes and calcium, and allowed normal physical development. PMID- 3808847 TI - [Portacaval anastomosis in 2 cases of homozygote familial hypercholesterolemia]. AB - We report the cases of two siblings, both suffering from familial hypercholesterolemia in homozygotic form, followed up before and after portacaval shunt. A total parenteral nutrition failed to decrease plasma cholesterol levels. However, on the basis of clinical data, a portacaval shunt was performed at the age of seven and five and a half. The two patients showed great effectiveness of the shunt with dramatic regression of clinical signs, reduction of plasma cholesterol, without serious complications over a five to six years period after the shunt. PMID- 3808848 TI - [Importance of the study of allergy and determination of the HLA group in the lipoid nephrosis in children. Study of 8 cases]. AB - Eight children with steroid-response nephrotic syndrome were investigated to study the relation-ship between steroid responsive syndrome, allergy and HLA antigens. Six of them had clinical and/or biological allergic symptoms. The allergen was identified in four out of six cases (grass-pollen 2 cases, house dust 1 case, frullania 1 case). Six children had DR7 HLA-antigen, five had B12 antigen. Three of the four children with cortico-dependent nephrotic syndrome have associated B12-DR7 HLA antigens. Search of an allergen seems to be of interest in children with steroid-responsive nephrotic syndrome, since eviction of the allergen may be proposed as a complement to cortico-therapy. PMID- 3808849 TI - [Mineral composition of the milk of mothers of premature infants during early lactation]. AB - The authors have assessed the concentration of sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), zinc (Zn), copper (Cu), manganese (Mn), lithium (Li), cadmium (Cd) and lead (Pb) in the milk of mothers with premature births, during the first month of lactation. The levels of Na, Cu and Mn were decreased and those of K, Ca, Mg, Zn and Li were unchanged. The needs of Na, Ca and Mn for the premature infants are insufficient. Li, present in all the milk samples at a constant level, seems to be a common component. The incidence of Cd in the milk of 7 mothers and of Pb in 4 milk samples indicates their clearance from the mothers' organism. PMID- 3808850 TI - [Arterial hypertension caused by extrinsic compression of the renal artery of tumor origin in a child]. AB - Stenosis of the renal artery secondary to an extrinsic acquired compression of the renal artery because of a tumor is rare. We report two cases. The first case is a boy of 14 months with a large neurogenic tumor from the right renal plexus with compression of the right renal artery. The second case is a girl of 2 years which had a neuroblastoma displacing the right kidney. The right renal vessels were invaded by very calcified solid masses and the removal was very difficult. Arterial hypertension secondary to an acquired unilateral renal stenosis may be healed definitely thanks to surgery. PMID- 3808851 TI - [Retroperitoneal actinobacteriosis caused by Haemophilus actinomycetemcomitans]. AB - A 15 years old boy was admitted to the hospital for high fever, and a four month history of abdominal pain and weight loss. Clinical examination showed painful swelling of the left lumbar region. A retro peritoneal mass was revealed by tomodensitometry. There was a marked biological inflammatory syndrome without bacteriological evidence of infectious disease. Final diagnosis was performed by surgery showing a big abscess. Bacteriological culture of pus was positive for a Haemophilus actinomycetemcomitans. PMID- 3808852 TI - [What is your diagnosis? A case of osteochondrodysplasia]. PMID- 3808853 TI - Relationships among anxiety, defensiveness, sex, task difficulty, and performance on various neuropsychological tasks. AB - The relationships between sex, personality differences, task difficulty, and the performance on neuropsychological tests were investigated. On the basis of trait anxiety and defensiveness, 120 college students were divided into three groups by coping style: high anxious, true low anxious, and repressor groups. As predicted, women obtained significantly higher scores than men on Digit Symbol and word fluency tests, while the opposite sex difference was found for Block Design and Finger Tapping tests. Performance did not vary with trait anxiety. However, on Block Design and one-word fluency test, rated by subjects as the most difficult tests, high state anxiety was associated with significantly poorer performance. PMID- 3808854 TI - Knowledge of task, ability and strategy in processing letter patterns. PMID- 3808855 TI - Effects of age, education and sex on two tests of immediate memory: a study of normal subjects from 20 to 99 years of age. AB - Spatial span (Corsi's block-tapping test) and verbal span (Wechsler Digits Forward) were measured in 1354 normal subjects, aged from 20 to 99 yr., who were subdivided into seven age groups, into three groups according to education, and according to sex. Analysis of variance showed that the three main factors were significant for the spatial span test. The two spans examined held well up to the 60s, and only after this age did significant differences appear in the other age groups. On both tests there were significant differences between the groups divided according to education. PMID- 3808856 TI - Recognition of form and of orientation by poor and normal readers. AB - Poor and normal readers were tested on two visual recognition tasks (N = 34). In both tasks, subjects were shown a random-dot pattern as a standard stimulus on each trial. After a 0.5-sec. or a 15-sec. interval (i.e., 'perceptual' versus 'memory' delay conditions), subjects were shown four patterns on a test slide and required to identify the one resembling the standard. This comparison was based on form identity in Task I and on form orientation in Task II. Recognition by poor and normal readers did not differ at either delay on Task I or at the 0.5 sec. delay on Task II. No evidence of a generalized perceptual deficit among dyslexics was obtained. In general accordance with the theory of Corballis (1974), poor readers performed significantly worse than normals at the 15-sec. delay on Task II, indicating defective memory for orientation. More specific predictions of Corballis's theory were not borne out, however, with regard to the frequency of different types of error. Furthermore, up-down (rather than left right) rotation errors appeared to be a better predictor of dyslexics' reading performance. PMID- 3808857 TI - Psychophysiological experiments in Prague. PMID- 3808858 TI - Effects of menstrual cycle on spatial information-processes. AB - The present study examined effects of menstrual cycle (i.e., ovulatory vs menstrual phase) on performance on spatial information-processes. Participants included 20 spontaneously cycling women (with regular 28- to 30-day menstrual cycles) who were tested on a reaction-time task developed to assess specific spatial information-processes and the Spatial Relations subtest of the PMA battery. For the spatial information-processing task, women responded faster and applied relatively less stringent criteria in the decision process during the ovulatory phase. No effects of cycle changes were found for accuracy of performance on either of the spatial tasks. It is suggested that studies examining effects of menstrual cycle on spatial ability consider an information processing approach in measuring spatial performance and an application of signal detection theory to separate components (strategy vs aptitude) of problem solving. PMID- 3808859 TI - Organizational effects on recall of a movement series by mildly mentally retarded adolescents. AB - The effect of an experimenter-presented organization on facilitating recall of various movement distances by 20 mentally retarded adolescents and 40 nonretarded individuals of the same mental age or chronological age was investigated. Blindfolded subjects performed linear arm movements and reproduced distances under either organized or random presentation conditions. Results support use of experimenter-presented organization in enhancing recall of movement distances in mildly mentally retarded adolescents. PMID- 3808860 TI - Type A-B status, habitual sleep duration, and perceived level of daily life stress of college students. AB - The differences in perceived levels of average daily stress for four groups (94 college students) formed as the logical combinations of Type A-B status and habitual short- and longer-sleep were evaluated. Both the main effects for Type A B status and habitual sleep duration were significant and these variables had an additive effect on perceived level of stress. PMID- 3808861 TI - Relationship between childhood hyperactivity and accident proneness. AB - Previous research suggested that hyperactive children are especially susceptible to accidents. Two questions remain: is the relationship peculiar to hyperactivity in childhood or for behaviorally disturbed children in general and does the relationship hold for females as well as for males? To answer these questions 189 patients at a child psychiatric clinic were rated on a scale which included measures of hyperactivity and accident proneness. The hyperactive patients were more likely to be described as accident prone than nonhyperactive patients. The relationship between childhood hyperactivity and accident proneness is confirmed and is specific. The relationship holds for both boys and girls. PMID- 3808862 TI - Perceived movement and the Craik-O'Brien and Crovitz illusions. PMID- 3808863 TI - Neuroanatomic and neuropsychologic correlates of digit span performance by brain damaged adults. AB - Digit repetition performance was examined in samples of adult brain-injured patients having confirmed unilateral lesions. The primary purposes of the study were to investigate the sensitivity of forward and backward repetition to the effects of lateralized brain lesions and to assess the differential neuroanatomic and neuropsychologic substrates of the two forms of digit repetition. Digit repetition, especially digits backward and particularly by patients with left hemisphere lesions, was significantly lower than would be predicted on the basis of intelligence. However, impaired repetition was not invariably a consequence of brain damage. Correlational data suggested but could not confirm hypotheses about either the functional or the neuroanatomic substrate in differential performance on digits forward and backward. Problems implicit in using measures having a high intellectual loading in clinical studies are discussed, as are suggestions for further research. PMID- 3808864 TI - Sociometric status and social interaction: are the neglected children socially less active? AB - Previous studies have clearly established that isolated children display less social behaviors than popular ones and that poorly accepted as well as isolated children are at risk for future adjustment problems. These findings prompt the author to predict that children of the various sociometric statuses should display differential rates of social interaction with peers. Predictions were tested by administering during the second term to 99 kindergarten children a sociometric measure and by videotaping each child for 1 hr. during free play. Whether or not the child was in social interaction with peers was subsequently coded at 5-sec. intervals by two observers. Sociometric scores and inter- and intraobserver agreements were high. Popular children were the most socially active, followed by the average, the rejected, and then the neglected children, which confirmed all hypotheses. These results give strong support for the validity of the difference between the neglect and rejected vs the popular and the average children and suggested that such work must include the child's rate of social interaction with peers as a covariable in the analyses to identify differences between statuses. PMID- 3808865 TI - Proactive interference and intertrial interval in short-term retention of temporal visual information. AB - The main purpose was to examine the role of proactive interference in temporal short-term memory when subjects experienced time under a conscious cognitive strategy for time estimation, made without time-aiding techniques. Visual durations of 1, 4, and 8 sec. were estimated by 18 subjects under the method of reproduction. Three retention intervals were used: immediate reproduction, 15, and 30 sec. of rest. The three intertrial intervals were immediate, 15, and 30 sec. Constant error was used as an index of bias. The constant errors provided no indication that proactive interference was operating in temporal short-term memory. The lack of proactive interference was not associated with intertrial intervals; even when the intertrial intervals were shortened to 1 sec. no proactive interference was observed. Variable error was used to evaluate effects of forgetting. The variable errors for the 4- and 8-sec. durations seemed amenable to a trace-decay explanation. PMID- 3808866 TI - Responses of emotionally disturbed children to PPVT-R items of human versus nonhuman content: extension of Shipe, Cromwell, and Dunn. AB - A group of 22 children with diagnoses indicating one of the severe developmental disorders were tested for differential response patterns on the PPVT-R, in an extension of earlier research carried out by Shipe, Cromwell, and Dunn in 1966. Data supported the prediction of the children's greater difficulty with PPVT-R items featuring human content than with those featuring nonhuman content. In addition, children's relative success rates on human-content items correlated positively with a measure of differentiation of the children's drawings. The results suggest that the asociality of certain disturbed children may selectively lower intellectual efficiency and lead to underestimation of their intellectual potential. PMID- 3808867 TI - Effect of dietary supplements on acute mountain sickness. AB - Four fit young men participating in a high altitude mountaineering expedition took part in a 15-day trial of two high-calorie dietary supplements. They ate either a high carbohydrate or a high fat supplement, alternating every 3 days. All dietary intake was recorded. Subjects completed a daily questionnaire assessing the severity of symptoms. Within a single-subject design no statistically significant differences were obtained between the severity of symptoms and dietary carbohydrate or total calories. This suggested that the dietary supplements had no effect on symptoms, a finding that is discrepant with the existing literature. However, we did find that subjects consumed more calories while on the high carbohydrate supplement. PMID- 3808868 TI - Type A behavior pattern and motor vehicle drivers' behavior. AB - 2 major components of the Type A coronary-prone behavior pattern are said to be a chronic sense of time urgency and impatience. The present study was done to determine whether these characteristics are associated with the driving performance of Type A individuals. 38 women and 32 men completed the Jenkins Activity Survey and a questionnaire concerning their driving. Those subjects exhibiting more Type A behavior tended to be more impatient, reported being involved in more accidents, and received more tickets for driving violations than those scoring lower on the Type A scale. PMID- 3808869 TI - Subjective intensity of the lily-of-the-valley scent. AB - 14 blind-folded subjects were requested to give numerical judgments of the perceived intensities of 1/4, 1/2, 1, 2, 4, 8, lily-of-the-valley bunches, according to a naturalistic approach. The psychophysical function conforms to a power law. The exponent, smaller than 1, is in the same range as those commonly found for smell. PMID- 3808870 TI - Regularity, exposure time and perception of numerosity. AB - Two experiments are described. In Exp. 1, subjects compared the apparent numerosity of two kinds of dot patterns, regular vs irregular, with two different exposures (160 vs 2000 msec.). In Exp. 2, the subjects had to estimate the numerosity of the same patterns, presented one at a time. Analysis showed a relative overestimation of the regular patterns in Exp. 1 but not in Exp. 2. In general an overestimation occurred with an increase in exposure. Such results support our hypothesis of two separate processes as the basis of the two kinds of performance (estimating vs comparison). PMID- 3808871 TI - Stability of individual psychophysical functions for perceived distance in natural indoor and outdoor settings. AB - Exp. 1 examined correlations of the power functions exponents for individual observers, for apparent distance in a natural indoor setting, obtained for a group of 9 observers over 5 experimental sessions separated by intersession intervals that varied from 1 day to 9 mo. Stable individual differences in the exponent of the psychophysical power law were shown. Intercorrelations of subjects' exponents were positive and reliable with 1 day between sessions and 9 mo. In Exp. 2 the estimates of apparent distance were made by 5 independent groups of 10 observers each, tested and retested at different intersession intervals. There were 5 intervals of 1 day to 9 mo. Fair temporal stability of psychophysical power function exponents was observed in most groups. In Exp. 3 psychophysical power functions were obtained from magnitude estimates of apparent distance in a natural outdoor setting. The same 10 observers were tested and then retested after 1 day and again after 1 yr. Significant correlations for both intersessions intervals indicated consistent and persisting individual differences. Taken together Exps. 1, 2, and 3, regardless of the environment in which distance estimates were performed, clearly demonstrate that power functions are repeatable, enduring, and characteristic of individuals. In addition, the mean exponents were in reasonable agreement with other reported apparent distance exponents obtained in both settings. PMID- 3808872 TI - Body-image distortion and dissatisfaction in university students. AB - The present study investigated body-image distortion and body-image dissatisfaction for a sample of 75 male and 75 female university students, in relation to personality variables implicated in the literature, such as sex-role orientation, self-esteem, locus of control, and depression. Women perceived their weight deviation from the norm at over 15% above their actual deviation, whereas men distorted less than 1%. In a multiple regression analysis, none of the personality measures correlated significantly with body-image distortion; however, sex of subject accounted for 25% of its variance. Body dissatisfaction was significantly associated with low self-esteem, externality, depression, and distortion. The relationship between body-image distortion and dissatisfaction, although significant, was surprisingly small. Apparently, these two aspects of body-image disturbance represent quite distinct constructs. PMID- 3808873 TI - Recognition of unfamiliar faces and common objects by neurologically impaired learning disabled and normal children. AB - The performances of 29 normal and 29 neurologically impaired-learning disabled children (aged 7.3 to 15.3 yr.) were evaluated on unfamiliar face and common object recognition tasks. Although the normal children performed better, the relative difficulty of face and object recognition was the same for both groups. PMID- 3808874 TI - Psychometric patterns on the Rorschach of healthy elderly persons and patients with suspected dementia. AB - The Rorschachs of two groups of 15 elderly subjects, one normal, the other in the early stages of a suspected dementia process, were compared. Both groups were similar in years of education, IQ, and age. An analysis of variance to test for the existence of group psychometric patterns was applied to 11 Rorschach variables, 10 of them were formed by Rorschach determinants and localization scores; one variable was built considering the level of energy projected in M. The analysis showed a real difference between the two groups' profiles. Movement responses of all types contributed heavily to this difference. Results agree with other findings indicating that low Movement score is characteristic of various types of organic diseases. However, the present study indicates that the weak energy level projected in the movement responses is a promising sign that might help in the diagnosis of a suspected dementia. PMID- 3808875 TI - Can straight-forward information change alcohol-related expectancies? AB - In an experimental setting 40 male subjects were asked about their aggressive expectancies in relation to alcohol. They then drank either an alcohol or a placebo drink while exposed to an attractive film and written material designed to alter their beliefs. Results indicate that increases in aggression are expected when drinking and that such beliefs are stable and not influenced by short and trustworthy information. PMID- 3808876 TI - A pronounced cognitive style improves interhemispheric integration: by hemispheric differentiation or by hemispheric similarity? AB - Under conditions of tachistoscopic stimulation normal subjects were presented visuospatial stimulus pairs which had to be integrated interhemispherically. The presence of a pronounced cognitive style improves the interhemispheric integration of this type of information. Two interpretations are discussed. The first explains the observed improvement with a qualitative division of labour, with one highly specialized and one just transmitting hemisphere, i.e., with hemispheric differentiation. The second emphasizes the relatively high capacity of the "subordinate" hemisphere in information processing, i.e., hemispheric similarity. PMID- 3808877 TI - Physical fitness: a buffer against stress. AB - The purpose of this study was to determine the extent to which physically fit and unfit persons differ regarding levels of stress in their lives. The six Kraus Weber tests were employed to assess minimal muscular function and fitness among 4,628 adult males, and a 10-item Likert-type inventory was administered to measure perceived stress. Analysis of covariance was utilized with age statistically controlled, and the results indicated that the unfit subjects perceived significantly more distress in their lives than did the adequately fit subjects. It was concluded that physical fitness may fortify the body against the demands of life and provide increased strength and hardiness. Physical fitness may act as a buffer against stress. PMID- 3808878 TI - Simultaneous-successive factor structure of the WISC-R: a validation study. AB - It has been suggested that the Wechsler Intelligence Scale for Children--Revised (WISC--R) may usefully be interpreted in terms of a Simultaneous-Successive factor structure. A previous attempt to validate this hypothesis via factor analysis of 8 of the 12 WISC--R subtests was later shown to be an unreliable test of this model. The present study, performed upon 36 children, aged 6 1/2 to 12 1/2 yr., 45% female, 83% black, tested the validity of the two-factor model vis-a vis the Kaufman Assessment Battery for Children (K-ABC), which is reported to have an unambiguous Simultaneous-Sequential (Successive) factor structure. Present results do not support a salient Simultaneous-Successive structure for the WISC--R, and clinicians should be wary of using the proposed two-factor model of the WISC--R for diagnostic or remedial purposes. PMID- 3808879 TI - Perceived speed of time and task affect. AB - Task satisfaction is hypothesized to be a function of the perceived speed of time passage while performing a task. Perceived speed of time passage is manipulated both as an internal state (arousal) and as an environmental context (pattern of background rhythm). The results of an experiment (N = 80) support the hypothesis and are interpreted through an implicit model of task satisfaction, i.e., events that seem to occur quickly are perceived as pleasing. The theoretical implications of the findings are contrasted with other frameworks of explanation of task satisfaction. PMID- 3808880 TI - Judgments about sexual harassment: effects of the power of the harasser. PMID- 3808881 TI - Afterimage color perception for designers. AB - This is a study of perception of negative afterimages. Surface color samples were viewed under Spectralight. Subjects fixated on 11 Munsell hues mounted on white cards and matched their afterimages with chips from the Munsell Book of Color. Samples were drawn from 125 participants in two groups, one practiced, the other unfamiliar with afterimage. No single afterimage or Munsell color chip was reported for any of the stimulus hues. However, most afterimage responses for nine stimulus colors fell within one Munsell hue family. Afterimages reported for the remaining two stimulus colors of purple-blue and yellow-red span two adjacent hue families. Results suggest new alternatives to traditional subtractive color complements. New afterimage opposites are provided. PMID- 3808882 TI - Internal versus external references with respect to perception of stimuli on the body surface. AB - Previous studies on the determinants of locus of perception of stimuli on the body have suggested that the position of the stimulus has a significant effect whether a subject perceives a tactile pattern as seen from inside or outside the body. However, it is possible that previous investigators confounded stimulus location--dorsal or frontal--and experimenter's position--behind or in front of the subject. Using 42 male subjects in a 2 X 2 design, the effects of experimenter's position and stimulus location were studied by a new technique for inferring locus of perception. Experimenter's position, rather than stimulus location, affects subjects' locus of perception. Perception of stimuli on the body involves three independent factors, the demand characteristics of the experiment, the manner in which an individual perceives the boundaries of his own body, and an individual's ability to adopt the experimenter's perceptual standpoint. PMID- 3808883 TI - Lateral brain resources and motor performance. PMID- 3808884 TI - Effect of stimulus pulse duration and interstimulus interval on cross-modal matching of auditory and lingual vibrotactile stimuli. AB - Cross-modal matching functions for eight intensity levels of a 1000-Hz auditory stimulus and a 250-Hz lingual vibrotactile stimulus were obtained for two groups of subjects. Group 1 adjusted the vibrotactile stimulus to match the auditory stimulus, and Group 2 adjusted the auditory stimulus to match the vibrotactile stimulus. Stimulus-pulse durations and interstimulus intervals were varied over six experimental conditions for both groups. The variations in stimulus-pulse durations and interstimulus intervals had no appreciable effect on mean matching function exponents for the two groups. A possible regression effect consistent with data from other psychophysical scaling studies was noted for matching functions of the two stimuli. PMID- 3808885 TI - Sex-role orientation of Caribbean adolescents. AB - A total of 140 Caribbean middle-class 17-yr.-olds (68 boys and 72 girls) completed the Bem Sex-role Inventory. Analyses indicated strong stereotypical behavior in the direction of each group's respective sex-type. PMID- 3808886 TI - Panic-disordered subjects' perceptions of film: a repertory grid study. AB - Clinical research into panic attacks over the past two decades has led to the hypothesis that panic-disordered subjects may have a lower threshold to separation anxiety than normals. This hypothesis was investigated by measuring panic-disordered and normal subjects' reactions to viewing a film of a potentially anxiety-provoking situation. The extent to which individuals construe film through identification with the narrative's characters was also examined. To gauge these reactions a repertory grid was administered to 11 subjects with a history of panic disorder and 12 controls after they had watched a half-hour episode from a feature film in which a divorced couple fight acrimoniously over custody of their 17-yr.-old daughter. Five elements were characters mentioned in the film and two were of 'self,' one in a secure and another in an insecure situation. Ten constructs were elicited by a triadic sorting procedure and four were supplied. Ratings of elements on all constructs were subjected to a principal components analysis (INGRID). While the construals of the two groups were essentially similar, there were differences between them in terms of the perceived salience of the film's characters. Panic-disordered subjects also construed themselves as more insecure than did the normals. The results affirm the use of the repertory grid in the study of panic disorder and in the analysis of the perception of filmed events. PMID- 3808887 TI - Lingual vibrotactile and auditory cross-modal matching: frequency effects. AB - 5 subjects matched pairs of auditory and vibrotactile stimuli on intensity, making judgments of suprathreshold magnitudes. Slope values for the 100-Hz cross modal lingual vibrotactile stimulus-standard frequency condition were steeper than those for 250- or 400-Hz conditions. Slope values became steeper at about 25 to 30-dB SL, so frequency seems an important parameter to control in such research. PMID- 3808888 TI - Relationship between perceived job stress and physical and psychological strain among university administrators. AB - The relations between eight job stresses and symptoms of physical and psychological strain were examined among 56 university administrators. Only three of the 16 stressor-strain correlations were significant, suggesting that stress is weakly related to individual strain in this sample. PMID- 3808889 TI - Perceptions by the aged of crime, criminals, and the criminal justice system. AB - A general fear of crime victimization led to modified activities in the community and feelings of relative safety in their own area for 132 elderly respondents on a 24-item questionnaire. They held sympathetic views of crime perpetrators as disadvantaged victims of society themselves, but came to the unlikely conclusions that more police control and harsher prison sentences are needed. PMID- 3808890 TI - Relative size and spatial separation: effects on the parallel-lines illusion. AB - The parallel-lines illusion provides a prototypical example of visual-size assimilation, where the size of a test element is phenomenally skewed towards (or "averaged with") that of a context element. Most assimilation theories predict that distortion should decrease with spatial separation between context and test lengths. However, there is some disagreement about the nature of the function relating sizes of context and test elements and magnitude of assimilation. The present study tests the limits of assimilation in the parallel-lines configurations by observing the effects of a wide range of context/test size ratios, repeated over two disparate levels of spatial separation. The results replicate and extend 1979 findings by Brigell and Uhlarik, confirming that assimilation rises to a peak at midrange size ratios, only to decrease continuously as the ratios become more extreme. The functions were nonmonotonic and similar in shape for both levels of spatial separation, with an over-all decrease in distortion for configurations with the larger separation. PMID- 3808891 TI - Tactile detection threshold determined with single sinusoidal mechanical pulses in the monkey skin. AB - Tactile detection thresholds for single sinusoidal mechanical pulses increased with decreases in the frequency of the stimulus pulse (from 150 to 20 Hz) in a monkey's skin. The results correspond with those of similar electrophysiological studies. PMID- 3808892 TI - Life-span ontogeny of the parallel-lines illusion. AB - The magnitude of two assimilative and one contrastive version of the parallel lines illusion was measured using 72 observers whose ages ranged in years from the teens to the seventies. Only the overestimated assimilative illusion varied significantly with age, producing smaller misestimations in both youth and old age and a maximal distortion in the 50s. This quadratic trend duplicated the adult-age course of the overestimated Muller-Lyer illusion thereby reinforcing the belief that the two are kindred visual anomalies. As with the Muller-Lyer, the ontogeny of the parallel-lines illusion is best explained by age-induced changes in the vigor of contour interactions. PMID- 3808893 TI - Hypnotherapy: a possible alternative for treating pupils affected with attention deficit disorder. AB - The purpose of this study was to ascertain the effectiveness of hypnotherapy in treating attention-deficit-hyperactivity by certified psychologist and physicians. The 7 boys and 4 girls were enrolled in a Special Day classroom for hyperkinesis and behavior problems and were being given methylphenidate (Ritalin). Three attempts were made to hypnotize these subjects; however, the group had to be reduced from 11 to 3 and finally, from 3 to a single child to be successful. A significant improvement from pre- and post-hypnotic sessions was noted. PMID- 3808894 TI - Age salience in older adults' spontaneous self-concept. AB - Distinctiveness theory predictions were examined by the salience of age in older adults' spontaneous self-concept with variation in age composition of residential setting. The hypothesis that elderly respondents in ordinary housing would mention age more often than those in senior housing apartments or nursing homes was not supported. The findings suggest that developmental contingencies exert a differential influence on trait salience in self-concept less during later adulthood than in earlier years. PMID- 3808895 TI - Effects of auditory masking by white noise on variability of fundamental frequency during highly similar productions of spontaneous speech. AB - Six adults (3 men, 3 women) produced highly similar spontaneous speech utterances during quiet and 90-dB SPL white noise. Although subjects' fundamental frequency (fo) was significantly increased when speaking in noise, their fo variability (coefficients of variation) throughout the utterance was not affected by the auditory disruption. This indicated that their ability to vary fo for linguistic stressing was preserved under short-term disturbed auditory feedback. These findings further supported the hypothesis that fo is under open-loop regulation. PMID- 3808896 TI - Teachers' judgments of preschoolers' creativity. AB - This study investigated the relationship of objective measures of preschoolers' ideational fluency and intelligence to teachers' ratings of creativity and desirability. The sample of 60 4-yr.-olds and 39 teachers were from six classrooms. Teachers' ratings of creativity were related to measures of intelligence (r = .46, p less than .001) but not to ideational fluency (r = .10). These findings are discussed in relation to possible halo effects and the ability to discriminate adequately cognitive abilities among preschool children. PMID- 3808897 TI - Effects of auditory masking by white noise on primary stressing during spontaneous speech. AB - 6 adult subjects (3 men, 3 women) produced highly similar spontaneous speech utterances in quiet and with 90-dB SPL white noise. The frequency of occurrence of perceptual judgments of primary stressing in an utterance was not affected by the masking noise. This finding supplements our previous report that variability for stress production of fundamental frequency (fo) during spontaneous speech was preserved under short-term auditory disruption. Also, it adds further support to the contention that fo is under open-loop regulation. PMID- 3808898 TI - What ever happened to the norms for the Matching Familiar Figures Test? AB - The Matching Familiar Figures Test is used almost exclusively to assess cognitive tempo, e.g., impulsive-reflective, etc., in subjects. Although norms for this test were published by Salkind in 1978, a comprehensive review of the literature on cognitive tempo covering 1979 through 1984 showed only 8% of the reviewed studies used the norms. The problems associated with the failure to use norms, most notably, the inability to generalize findings from one sample to another, are covered. PMID- 3808899 TI - Learning style and intelligence of reading disabled students. AB - This study examined the relationship between elements of the Learning Style Inventory and various scales of the WISC-R for reading disabled students. Previous research generally suggests that reading disabled students have preferences that tap the visual-spatial domain and have higher WISC-R Performance Scale and subtest scores than Verbal Scale and subtest scores. Subjects with IQs of 90 or better on either the Verbal or Performance Scales of the WISC-R and a consistency score of 75 or better on the inventory were selected. Contrary to what might be expected, data generally showed a nonmeaningful pattern of correlations between scales of the Learning Style Inventory and WISC-R Performance-type functioning. However, as an important part of the validation of the inventory, lack of association between the two can be interpreted as support for its construct validity. PMID- 3808900 TI - Hemispheric lateralisation for verbal analysis: do children with reading problems differ from controls? AB - Specialisation for verbal-sequential analysis in 'dyslexics', poor readers and matched adequate readers was investigated. Groups did not differ on degree of right-ear advantage on the dichotic digits task, suggesting that the poor readers processed digits in the left hemisphere in a similar way to children who read normally. The results cast doubt on theories that 'dyslexia' is related to incomplete lateralisation for verbal analysis. PMID- 3808901 TI - Real and virtual features in texture perception. AB - The texton theory of preattentive texture perception was recently adopted over a prior model based on the global computation of dipole statistics. It is shown here that the dipole model remains a necessary adjunct unless the texton theory is modified to distinguish real from virtual features of texture perception. PMID- 3808902 TI - Continuous optical transformations do not elicit unique perceptual descriptions. PMID- 3808903 TI - The multidimensional analysis of asymmetries in alphabetic confusion matrices: evidence for global-to-local and local-to-global processing. PMID- 3808904 TI - Serial processing and the parallel-lines illusion: length contrast through relative spatial separation of contours. PMID- 3808905 TI - The mental representation of faces: spatial and temporal factors. PMID- 3808906 TI - Simultaneous masking effect peculiar to peripheral vision. PMID- 3808907 TI - Word intelligibility decrements and the comprehension of time-compressed speech. PMID- 3808908 TI - Assimilative hue shifts in color gratings depend on bar width. PMID- 3808909 TI - Adaptation of place perception for stops: effects of spectral match between adaptor and test series. PMID- 3808910 TI - Parafoveal word processing during eye fixations in reading: effects of word frequency. PMID- 3808911 TI - Spatial frequency processing and the prediction of reading ability: a preliminary investigation. PMID- 3808912 TI - Influence of salicylate and anaesthesia on the rectal absorption of theophylline in rats. AB - The effect of sodium salicylate and anaesthesia on the rectal absorption of theophylline was evaluated in rats. Theophylline proved to be slowly but completely absorbed on rectal infusion in conscious rats, compared with intravenous infusion. Pentobarbital anaesthesia did not influence absorption. In contrast to literature data, the results with salicylate showed that rectal absorption of theophylline was not enhanced. PMID- 3808913 TI - Screening for antimicrobial activity of some essential oils by the agar overlay technique. AB - Fifty-three essential oils were tested against five micro-organisms (Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans) using the agar overlay technique. The essential oils were randomly selected and not on the basis of a supposed activity. It was found that all oils showed an activity against at least one micro-organism, and that substantial activities against P. aeruginosa were scarce. Combined activities against C. albicans, the Gram-positive bacteria and E. coli, and an activity against C. albicans were most often observed. Secondly a combined activity against C. albicans, B. subtilis and S. aureus was found. The differences between the inhibition zones were too small for a differentiation of the antimicrobial activities of the essential oils. A correlation matrix shows the relationships of the micro-organisms as to the activity patterns of the essential oils. High correlations were found for all the micro-organisms, except for P. aeruginosa. PMID- 3808914 TI - Toxicologic and pharmacokinetic evaluation of a case of vancomycin intoxication during continuous ambulatory peritoneal dialysis. AB - The use of vancomycin is rapidly increasing due to the emergence of strains of staphylococci resistant to betalactam antibiotics. In this communication the pharmacokinetics of an overdose of vancomycin in a patient during continuous ambulatory peritoneal dialysis (CAPD) is reported. Brainstem auditory evoked potentials (BAEPs) are used to assess ototoxicity. It could be shown that by shortening the dwell time, the apparent CAPD flow was increased and the vancomycin clearance was also increased. This may explain in part the differences in the values of vancomycin t1/2 in this patient (21 h) as compared to other studies (60-120 h). The age of the patient (3.5 years) may also have influenced the t1/2. Using brainstem auditory evoked potentials as a parameter to assess ototoxicity, it was shown that this patient suffered no damage from the overdose. PMID- 3808915 TI - Prescription of above-knee and below-knee prostheses. AB - New developments in socket design, materials and fabrication are briefly reviewed. A series of charts is presented which summarize the below-knee and above-knee prescription procedures followed at the Veterans Administration Prosthetics Center. PMID- 3808916 TI - Below-knee amputation in patients with vascular disease and prosthetic fitting problems. AB - A study was made of 544 cases with lower limb deficiencies caused by obliterative diseases; 262 cases were below-knee amputees. Of these, 106 (40%) were amputees transferred from other clinics for prosthetic fitting; in 156 cases (60%) the amputations were performed in the Institute. Amputations were carried out using one of two techniques according to the state of arterial and collateral circulation. The posterior flap below-knee amputation (Burgess, 1969) was employed in 94 cases, the other 62 amputations were carried out using a modification of that technique which was characterized by the formation of a musculo-fascia-cutaneous flap. The stump wound healed by first intention in 127 patients (81.4%), by second intention in 18 (11.5%) and in 11 cases (7.1%) the wounds failed to heal. Successful prosthetic fitting and walking training was achieved in 91.3% of amputees and 67.2% were returned to productive work. PMID- 3808917 TI - Running patterns of transfemoral amputees: a clinical analysis. AB - The challenge of rehabilitating young, healthy transfemoral amputees may extend beyond the boundaries of teaching them to adapt to functional activities of daily living. The goal for several of these amputees is to participate and sometimes even compete in recreational activities, including running. These amputee runners require prosthetic adaptations as well as a comprehensive individualized training programme to ensure that their running is as safe and energy efficient as possible. To help amputees achieve this, clinicians must understand normal and prosthetic locomotion. This paper compares the biomechanical differences between walking and running in normal locomotion and analyses the running modes used by transfemoral amputees. The modified running mode achieved with the Terry Fox Running Prosthesis subjectively "looks" more energy efficient to the observer and "feels" more energy efficient to the user. These assumptions have yet to be confirmed or refuted by a rigorous scientific research study. An outline of the proposed physiotherapy protocol includes the familiarization, treatment, and training phases. Physiotherapists involved in amputation rehabilitation may not be commonly confronted with this level of patient expectation. It is their responsibility to give realistic guidance to these amputees so that they can safely and independently pursue their recreational running activities. This need can best be fulfilled by providing sound clinical advice which has been validated by research findings. PMID- 3808918 TI - A comparison of shoe insole materials in plantar pressure relief. AB - A clinical study was performed to evaluate the effectiveness of seven shoe insole materials and their ability to relieve areas of high plantar pressure. The following materials were tested: Latex foam, Plastazote, Dynafoam, Ortho felt, PPTR, Spenco, and Molo. Twenty-six patients with areas of high plantar pressure were tested using each of these materials. The Harris and Beath footprinting technique was used to measure plantar pressure. It was found that the average pressure of a clinically painful plantar area was 398.15kN/m2. All insole materials tested decreased this pressure, with averages ranging from 186.33kN/m2 to 286.35kN/m2. PPT, Plastazote and Spenco were the most effective products tested. PMID- 3808919 TI - Body sway in below-knee amputees. AB - The purpose of the present study was to test the hypothesis that below-knee amputees have less standing stability than normal persons. Twenty below-knee amputees were tested with the quantified Romberg test. All amputees below 59 years and all women above 59 years had a decreased sway compared with matched control groups of normal persons. Amputated men above 59 years did not show any difference in sway compared with the matched control group. Presuming that small sway excursions can be interpreted as a stable standing position, the study shows that a well fitted PTB-amputee stands at least as safely as a normal person. PMID- 3808921 TI - The effect of water content on the stiffness of seating foams. AB - The chairbound, disabled person requires a supportive cushion to distribute pressure in order to reduce the risk of pressure sores and any alteration to the load carrying capacity of the cushion may have a deleterious effect on its ability to provide adequate support. The National Health Service supplies two basic grades of polyurethane foam for wheelchair cushions and this study investigated the effect of water content on their compressive load carrying capacity. Both foams became less stiff and exhibited greater than 20% increase in deformation when containing 20% water by volume at loads encountered in seating. This decrease in stiffness may result in a dramatic change in the pressure distribution under a patient particularly if only a small section of the cushion becomes wet. This result emphasizes the need to fit waterproof coverings to these foam cushions and to maintain the integrity of the covering. PMID- 3808920 TI - Results of the pilot phase of a clinical evaluation of computer aided design of trans-tibial prosthesis sockets. AB - This study served as a pilot to develop the methodology for a larger number of clinical trials. Ten trans-tibial amputees compared sockets made by conventional methods with sockets made using computer aided socket design (CASD). Prosthetists, paired for experience, fitted each subject with one prosthesis using each method. A preferred socket was selected by the subject on the basis of comfort without knowledge of the method by which the socket was designed. Prosthetists also evaluated the sockets. Three subjects preferred sockets built using CASD and one subject preferred the conventional socket only slightly more than the CASD socket. Six subjects clearly preferred the conventional fitting. PMID- 3808922 TI - [Magnetic resonance imaging and pathological evaluation of a case of false aneurysm of the descending aorta with rupture into the left lung]. PMID- 3808923 TI - [The image and anatomical study of echinococcosis--the typical CT image of experimental echinococcal lesions]. PMID- 3808924 TI - [Computed tomographic diagnosis of pulmonary nodules]. PMID- 3808925 TI - [Biochemical aspects of the adverse reaction of contrast media--sequential changes in the amount of kininogen in dog plasma after injection of various amounts of contrast media]. PMID- 3808926 TI - [The prognosis after radiotherapy in carcinoma of the lung based on the extent of mediastinal lymph node involvement]. PMID- 3808927 TI - [Drug-induced obesity]. PMID- 3808928 TI - [Reduced metabolism and facultative pathogenetic thermogenesis in various types of obesity]. PMID- 3808929 TI - [Liposuction--merely cosmetic surgery?]. PMID- 3808930 TI - [Is jejuno-ileal bypass surgery still indicated in the treatment of severe obesity?]. PMID- 3808931 TI - [Obesity and body weight changes. Comments on a long-term Finnish study]. PMID- 3808932 TI - [Extreme low-calorie diets in the treatment of obesity]. PMID- 3808933 TI - [Behavioral change, the key to weight loss]. PMID- 3808934 TI - [Treatment of dysmenorrhea]. PMID- 3808935 TI - [Premedication--why and how?]. PMID- 3808936 TI - Alterations in thrombopoiesis in patients with thrombocytopenia produced by dengue hemorrhagic fever. AB - The causes of thrombocytopenia, one of the most dangerous symptoms in the course of dengue hemorrhagic fever (DHF), are not yet clear. We studied patients with DHF (dengue virus type 2), grouped according to days of illness, platelet counts, serum thrombopoietin (Tpo) levels, and bone marrow differential counts. During the thrombocytopenic phase of disease (3rd-8th days) the Tpo levels were not increased in spite of low platelet counts. Beginning from the 6th-7th day in some patients, a rapid increase in Tpo levels was observed, followed by a rise in the platelet counts. By the 9th-11th days all patients studied were in this phase of convalescence. The bone marrow specimens obtained on the 6th-10th days of illness showed a megakaryocytic hyperplasia in 60% of cases. It seems that dengue viruses provoke a transitory alteration in the humoral regulation of thrombopoiesis which possibly may be the consequence of the lymphoid tissue damage. This extends the thrombocytopenic state and contributes to the appearance of hemorrhagic complications. PMID- 3808937 TI - Therapeutic effect of danazol on metrorrhagia in patients with idiopathic thrombocytopenic purpura (ITP). AB - Idiopathic thrombocytopenic purpura (ITP) is more frequently seen in young females than in any other age or sex group. Danazol, an impeded androgen with a decreased masculinizing potential, has been described as useful in ITP. A total of 25 women 16 to 41 years of age, with chronic ITP were studied. All patients were refractory to treatments with glucocorticoids and splenectomy; 19 were inadequately controlled by immunosuppressants, vinblastine or vincristine-loaded platelets, the radioimmune method, colchicine, plasmapheresis, or surgery for accessory spleens. Danazol was given at a daily dosage of 600 mg for 4 months. All showed clinical improvement, as indicated by cessation or decrease of bleeding, and 12 (48%) cases obtained a drug-dependent excellent or good response of their ITP. Therapy produced amenorrhea or oligomenorrhea in 21 patients (84%) and 7 cases of chronic metrorrhagia were successfully controlled. The drug was well tolerated. Accordingly, danazol may be an effective treatment for ITP or related conditions, especially in adult females with uncontrollable metrorrhagia. PMID- 3808938 TI - Diagnostic and prognostic value of bone marrow biopsy in aplastic anemia. A study of 119 cases. AB - A retrospective analysis of 119 bone marrow biopsies, performed at the time of aplastic anemia (AA) diagnosis, emphasized the prognostic value of several pathological features. Cellularity was evaluated with a better accuracy from biopsies as compared to aspirates and iron kinetics. Only bone marrow biopsies assessed myeloid "hot spots", which featured as favorable prognostic parameters in addition to the usual prognostic indices. The presence of megakaryocytes provided another positive prognostic influence. In contrast, lymphocytosis, plasmocytosis, and stroma injuries were negative in terms of prognosis. Such histological data should be systematically studied in AA at the time of initial evaluation and taken into account prior to choice of therapy. PMID- 3808939 TI - [Hemophagocytic syndrome associated with herpes simplex virus. Apropos of a case with a fatal outcome]. AB - A male patient, aged 23 years, with no notable previous history, was admitted to hospital because of fever, splenomegaly, and pancytopenia. The bone marrow was infiltrated by mature looking histiocytes displaying erythrophagocytosis. Other findings included polyclonal hypergammaglobulinemia, elevated transaminases, hypofibrinogenemia, and hypertriglyceridemia. A diagnosis of virus-associated hemophagocytic syndrome was made and virology studies attributed it to herpes simplex virus type 1. Therapy with acyclovir, high dose i.v. immunoglobulins, and vinblastine was unsuccessful. With the addition of prednisone, a remission, with disappearance of histiocytic marrow involvement, was obtained but was of short duration, and the outcome was fatal. PMID- 3808940 TI - [Transfusion requirements and mean annual hemoglobin level in thalassemia major]. AB - The blood requirements using packed red cells (C) and the mean annual haemoglobin level (Hb ma), corresponding to the mean of all haemoglobin levels before (Hb pre T) and after (Hb post T) transfusion over 1 year, have been measured in 14 splenectomized and regularly transfused thalassaemia major patients. In these non hypersplenic patients a linear relation was determined between C and Hb ma. The blood consumption C has also been measured in 5 patients with hypersplenism. The comparison of C between these two groups of patients offered the possibility of defining the limit of C, for a given value of Hb ma, above which hypersplenism is indicated. The measurement of Hb ma requires the value of Hb post T, a parameter which is sometimes difficult to obtain in practice. For this reason, a method of calculating Hb post T using Hb pre T, C and the number of transfusions over 1 year (N) is described. The relation between these parameters is: Hb post T = Hb pre T + C/N X 0.23. To use this formula, the conditions must be as follows: the haematocrit of blood units must be between 75% and 85%, and the blood volume of each transfusion in a given patient must be identical throughout the year. PMID- 3808941 TI - [Discovery of hemoglobin J Baltimore in an episode of methemoglobinemia in an infant]. AB - A case of a heterozygote for Hb J Baltimore is reported in a French family. This variant hemoglobin was coincidentally discovered during an episode of methemoglobinemia in a 6-week-old baby. The father and one of the brothers were also carriers of the trait. Hematological findings for all of them were normal. As Hb J Baltimore is a frequently occurring hemoglobin variant, we discuss: its possible role in the appearance of methemoglobin, and whether this mutation in different racial groups (Caucasians of West Europe, Canadians, and American blacks) has a common origin or more probably arises from a number of independent mutations. PMID- 3808942 TI - Hb Kokura alpha 2 47 (CE5) Asp----Gly beta 2 in a French Jewish family. AB - An abnormal hemoglobin was found in a young polycythemic man. Case study showed that the polycythemia was not due to hemoglobinopathy as the blood oxygen affinity was normal. Structural study of this variant permitted the characterization of a Hb Kokura alpha 2 47 (CE5) Asp----Gly beta 2 for the first time in France. PMID- 3808943 TI - Interferon enhanced natural killer function in Hodgkin's disease. AB - Natural killer (NK) cell activity of peripheral blood mononuclear cells from 19 untreated patients with active Hodgkin's disease and 22 age- and sex-matched healthy individuals was evaluated using classical K 562 cells as targets in a 4-h assay. A significant decrease was demonstrated in the patients (P less than 0.01) in accordance with previous data from the literature. Preincubation of effector cells with alpha leucocyte recombinant interferon (500 units/10(6) cells/ml) led to a significant increase in NK function in the patients (P less than 0.001). However, 4 patients still remained below the normal range and some patients were poor responders to interferon indicating that the mechanisms of depressed NK cell activity associated with Hodgkin's disease could not be overcome by interferon at least in some patients. PMID- 3808944 TI - [Recommendations of the Hemostasis and Thrombosis Study Group. For better surveillance of anticoagulant therapy by anti-vitamin K agents]. PMID- 3808945 TI - Compilation and analysis of eukaryotic POL II promoter sequences. AB - A representative set of 168 eukaryotic POL II promoters has been compiled from the EMBL library and subjected to computer signal search analysis. Application of this technique to E. coli promoters as a control ensemble revealed the well known consensus sequences at -35 and -10 which indicates that the methods are adequate to approach problems of this kind. The results obtained from the eukaryotic promoter set can be summarized as follows: Common sequence features are confined to a region between -50 and +10 relative to the transcriptional initiation site. The only well conserved consensus sequence is TATAAA, centered at -28. A weak motif, CA followed preferentially by pyrimidines, surrounds the cap-site. Two pentanucleotides which have been shown by experiments to stimulate transcription of certain genes, GGGCG and CCAAT, are moderately over-represented in the upstream region (between -129 and -50). However, they occur at highly variable distances from the initiation site. PMID- 3808946 TI - Circular dichroism of two conformations of poly[d(G-C)] induced by low pH. AB - Circular dichroism (CD) and UV absorption data showed that poly[d(G-C)] (at 0.09M NaCl, 0.01M Na+ (phosphate), 20 degrees C) underwent two conformational transitions upon lowering of the pH by the addition of HCl. The first transition was complete at about pH 3.0. The second transition was complete upon lowering the pH to 2.6 or upon raising the temperature, at pH 3.0, to about 40 degrees C. There was no indication of denaturation during either transition. The CD spectrum for the second acid conformation had large CD bands including a positive one at 288nm, a characteristic associated with C X C+ base-pairs. Electron microscopy showed no significant formation of condensed supramolecular aggregates corresponding to the first or second acid forms of poly[d(G-C)]. On the basis of spectral data, electron microscopy, and proton-uptake measurements, we propose models for the secondary structures that poly[d(G-C)] adopts in its two acid conformations. PMID- 3808947 TI - Complete nucleotide and deduced amino acid sequences of the Brevibacterium lactofermentum tryptophan operon. PMID- 3808948 TI - Nucleotide sequence of rat liver delta-aminolevulinic acid dehydratase cDNA. PMID- 3808949 TI - Mouse 2-5A synthetase cDNA: nucleotide sequence and comparison to human 2-5A synthetase. PMID- 3808950 TI - HCC ligation: rapid and specific DNA construction with blunt ended DNA fragments. PMID- 3808951 TI - Homology between the splice-point region of mitochondrial group I introns and the viroid central conserved region. PMID- 3808952 TI - A catalogue of splice junction and putative branch point sequences from plant introns. AB - Splice junction and possible branch point sequences have been collected from 177 plant introns. Consensus sequences for the 5' and 3' splice junctions and for possible branch points have been derived. The splice junction consensus sequences were virtually identical to those of animal introns except that the polypyrimidine stretch at the 3' splice junction was less pronounced in the plant introns. A search for possible branch points with sequences related to the yeast, vertebrate and fungal consensus sequences revealed a similar sequence in plant introns. PMID- 3808953 TI - Structure of viroid replicative intermediates: physico-chemical studies on SP6 transcripts of cloned oligomeric potato spindle tuber viroid. AB - The structure and structural transitions of transcripts of cloned oligomeric viroid were studied in physico-chemical experiments and stability calculations. Transcripts of (+) and (-) polarity, from unit up to sixfold length, were synthesized from DNA clones of the potato spindle tuber viroid (PSTV) with the SP6 transcription system. Their structural properties were investigated by optical denaturation curves, high performance liquid chromatography (HPLC), electron microscopy, sedimentation-diffusion equilibrium and velocity sedimentation. Secondary structures of the RNAs and theoretical denaturation curves were calculated using an energy optimization program. The secondary structure of lowest free energy for unit length and oligomeric transcripts is a rod-like structure similar to that of the mature circular viroids. When this structure is used as a model for calculations, there is a large degree of agreement between the theoretical and the experimental denaturation curves. At high temperatures, however, (+) strand transcripts exhibited a transition which was more stable than expected from the calculations or than was known from curves of mature viroids. This transition arises from a rearrangement of the central conserved region of viroids to a helical region of 28 stable base pairs either intermolecularly leading to bimolecular complexes, or intramolecularly giving rise to a branched secondary structure. The rearrangement could be detected by electron microscopy, HPLC, and analytical ultracentrifugation. The helical region serves to divide up the oligomeric (+) strand into structural units which may be recognized by cleavage and ligation enzymes which process the oligomeric intermediates to circular mature viroids. PMID- 3808954 TI - Three-arm nucleic acid junctions are flexible. AB - Nucleic acid junctions are stable analogs of branched DNA structures which occur transiently in living systems. We show here that junctions which contain three double helical arms can be enzymatically oligomerized, using conventional sticky ended ligation procedures, to create larger complexes. The products consist of a series of linked junctions separated by 20 base pairs. Junction dimers are formed that have free termini only, whereas trimers and larger species are found to be both unclosed and cyclized. The formation of a series of macrocyclic products which, surprisingly, begins with trimers and tetramers indicates that this junction is flexible about a bending axis, and perhaps twist-wise as well. We have obtained the same results from three different 3-arm junctions, two in which the junction is flanked by a 3 Watson-Crick base pairs, and one in which a G-G base pair flanks the junction. PMID- 3808955 TI - Tissue-specific DNase I hypersensitive sites in a foreign globin gene in transgenic mice. AB - We have investigated the DNase I hypersensitivity of a hybrid mouse/human beta globin gene in erythroid and non-erythroid cells of transgenic mice, to examine the relationship between the chromatin structure and the expression of an exogenous gene. The hybrid globin gene was previously shown to be expressed specifically in erythroid cells in some transgenic lines. The maximal level of hybrid globin mRNA accumulation was a few percent of the endogenous level, and we show here that this results from a low rate of transcription. In erythroid cells from two transgenic lines in which the hybrid gene is expressed, we detect a set of DNase I hypersensitive sites whose locations are indistinguishable from those in endogenous beta-globin genes. The hybrid globin gene contains no DNase I hypersensitive sites in transgenic mouse brain cells. Thus, the tissue-specific expression of the exogenous globin gene is reflected in, and perhaps mediated by, tissue-specific changes in chromatin structure. PMID- 3808956 TI - Terminal structure of hypovirulence-associated dsRNAs in the chestnut blight fungus Endothia parasitica. AB - The 3'- and 5'-terminal sequences of the five large double-stranded RNA species (L-dsRNA; 4.5-6.0 X 10(6) daltons) of EP713, a hypovirulent strain of Endothia parasitica, were determined by mobility-shift and enzymatic methods. All the L dsRNAs appeared to have identical terminal sequences. A heteropolymer sequence was found at one 3'-terminus and a poly(A) sequence of variable length at the other. It was possible to label only one 5'-terminus using polynucleotide kinase and [gamma-32P]ATP, and this was shown to be a poly(U) sequence of variable length. We propose that the dsRNAs have the following structure, where X represents a blocking group: (Formula: see text). A recombinant plasmid containing dsRNA-related sequences was constructed. Hybridization analysis using the recombinant probe indicated that the sequence homology among the L-dsRNAs extended beyond these terminal regions and was also shared by small dsRNAs (0.3 0.45 X 10(6) daltons). PMID- 3808957 TI - Reverse Southern hybridization. AB - A DNA oligomer 25 nucleotides long which contained an HMT (4'-hydroxymethyl-4,5', 8-trimethylpsoralen) furan side monoadduct to thymidine at a 5'-TpA-3' site was used as a probe for the polylinker sequence present in single-stranded M13 mp19 DNA and in double-stranded pUC 19 DNA. Hybridization and photofixation were carried out simultaneously in solution under conditions approximating the melting temperature of the probe-target hybrid. Use of probe concentrations greater than 10(-8) M permitted hybridization times of a few minutes. Irradiation with near ultraviolet light converted the HMT monoadduct present in hybrid complexes into an interstrand crosslink. Efficient photofixation removed hybrid from the equilibrium distribution and resulted in the formation of additional probe-target complex. After removal of excess probe by centrifugation through a semi-permeable membrane (Centricon-30), samples were electrophoresed through an alkaline agarose gel which was analyzed by autoradiography. When using an HMT-modified 25-mer probe end-labeled with 3,000 Ci/mmole 32P, 0.015 ng (3.8 X 10(6) copies) of M13 DNA could be detected. With this same probe 10 micrograms of denatured human DNA (corresponding to 3.0 X 10(6) copies) did not give a signal. PMID- 3808958 TI - Structure and expression of a second sea urchin U1 RNA gene repeat. AB - There are two tandemly repeated sets of U1 RNA genes in the sea urchin L. variegatus. Each of these genes is present in a 1.4 kb repeat defined by a HindIII site about 450 bases 5' to the gene. The sequences of a member of both repeating units (U1.1 and U1.2) has been determined. The repeats are nearly identical for 550 nucleotides 5' to the gene but show great divergence starting 30 nucleotides 3' to the gene, just after the CAAAGAAAGAAAA sequence thought to be required for 3' end formation. The other boundary between the conserved and non-conserved sequences is a polypyrimidine sequence (on the strand which codes for U1 RNA). Both of these repeats are expressed in blastula stage embryos, as judged by transcription of unique sequences 3' to the gene in nuclei isolated from blastula stage embryos. At least some of the two types of repeats are interspersed, since representatives of both repeat types on a single gamma phage isolated from a gene library. The sequence of the U1 RNA in L. variegatus eggs and embryos corresponds to the sequence of the U1 repeat. PMID- 3808959 TI - In vitro and in vivo tumor models for studies of distribution of radiolabelled monoclonal antibodies and fragments. AB - Colon carcinoma multicellular spheroids were incubated in vitro with radiolabelled MAbs. The more rapid penetration of fragments as compared to intact MAbs was clearly demonstrated. For the study of antibody localization in tumors in vivo, the model of nude mice with ligated kidneys was used. Although very artificial, this model allowed to demonstrate that, without urinary excretion, Fab fragments accumulated more rapidly into the tumor than intact MAbs and disappeared faster from the blood. This difference was less striking for F(ab')2 fragments. In the liver a decreased accumulation of both types of fragments as compared to intact MAbs was observed. Concerning radioimmunotherapy we think that Fab fragments are not useful because of their too short half-life in the circulation and in tumor and because they will probably be too toxic for the kidneys. Intact MAbs and F(ab')2 fragments have each their advantages. Intact MAbs show highest tumor accumulation in mice without ligated kidney, however, they remain mostly on the periphery of tumor nodules, as shown by autoradiography. F(ab')2 fragments have been found to penetrate deeper into the tumor and to accumulate less in the liver. It might be therefore an advantage to combine intact MAbs with F(ab')2 fragments, so that in the tumor two different regions could be attacked whereas in normal tissues toxicity could be distributed to different organs such as to the liver with intact MAbs and to the kidney with F(ab')2 fragments. PMID- 3808960 TI - Specific imaging of human brain tumor xenografts utilizing radiolabelled monoclonal antibodies (MAbs). AB - At the present time, specific imaging and treatment of central nervous system malignancies is not possible. The development of monoclonal hybridoma technology may provide the solution to this problem. We have utilized human glioma-derived cell lines (HGCL) transplanted subcutaneously and intracranially into athymic mice and rats to evaluate the imaging and localizing properties of a panel of MAbs. MAbs 81C6, C12, and D12 and 81C6 Fab have shown significant in vivo localization against HGCL D-54 MG and 81C6 against U-251 MG when compared to equivalent non-specific MAbs. In subcutaneous D-54 MG-induced xenografts, maximal localization indices (LI) of up to 15.0 for 81C6, 6.8 for 81C6 Fab, 6.48 for C12, and 4.47 for D12 have been seen. The tumor-tissue ratios for normal brain have ranged from 235 for 81C6 to 167 for D12. The total percent injected dose for 81C6 was nearly 5% in U-251 MG tumors and 10% of the initial dose in D-54 tumors, while the percent injected dose for control MAb were 1.9% and 2.8%, respectively. Four subcutaneously growing U-251 MG tumors were clearly imaged using 131I-81C6. With intracranially growing D-54 MG, 131I-81C6 provided external imaging of intracranial tumors at sizes as small as 20 mg while 131I-45.6, a non-specific MAb, provided imaging only when tumors achieved sizes greater than 300 mg. These data indicate that operationally specific MAbs and MAb Fab can specifically localize and be used to image human tumors transplanted into immunocompromised animals. The animal models described in this paper provide a sensitive method of evaluating MAbs in pre-human trials. PMID- 3808961 TI - Enhancement of tumor contrast on radioimmunoscans by using mixtures of monoclonal antibody F(ab')2 fragments. AB - F(ab')2 fragments of MAbs GA 73-3 (IgG 2 a) and CO 29.11 (IgG 1), which detect distinct antigenic determinants on adenocarcinoma cells of the gastrointestinal tract, were labeled with 131I using the iodogen method. 41 nude mice bearing SW 948 CRC tumors were injected either with a mixture of 100 microCi (11 micrograms) each (n = 9) of the two 131I-F(ab')2 fragments or with either fragment alone at various doses (each group consisting of 8 mice): GA 73-3, 100 microCi (11 micrograms) and 200 microCi (25 micrograms); CO 29.11, 100 microCi (11 micrograms) and 200 microCi (26 micrograms). Whole-body images of the mice were obtained daily for up to six days after injection. Ratios of cpm/pixel in the tumor to those in the rest of the body (rob), representing tumor contrast, were significantly (p less than 0.05) higher in the group of mice injected with the mixture (3.9 +/- 1.5) as compared to those given 100 or 200 microCi of either fragment separately. The biological half-life (T1/2 biol.) of the mixture (44.7 +/- 14.5 h) in the CRC tumors was significantly (p less than 0.05) longer than T1/2 biol. determined in the groups given either fragment alone. T1/2 biol. in the rob was similar in all groups of mice examined. PMID- 3808962 TI - Radioimmunodetection of malignant melanoma with the 225.28S monoclonal antibody to HMW-MAA. AB - A review of the studies on the use of the antigen-antibody system HMW-MAA 225.28S in melanoma radioimmunodetection is reported. The results obtained in a pilot study (42 patients with 74 lesions), a multicenter trial (254 patients with 553 lesions) and a prospective study still outstanding (29 patients with 38 lesions) allow to consider this system as suitable for clinical application. F(ab')2 labelled with 99mTc gave the best results in terms of positivity. Moreover this radioisotope allows the best dosimetric conditions. The gamma energy emitted by this radionuclide is particularly convenient for conventional scintillation cameras and ECT. Very good results in terms of sensitivity (70%-85%) and especially specificity (about 100%) were achieved. Possible clinical applications of the method are discussed. PMID- 3808963 TI - First experiments on radioimmunodetection with b-12-monoclonal antibody fragments against breast cancer antigen. AB - In 14 patients with breast cancer the results of radioimmunoscintigraphy with 123I-labeled b-12 monoclonal antibody fragments were correct in more than two thirds of the patients. PMID- 3808964 TI - Immunoscintigraphy in medullary thyroid cancer using an 123I- or 111In-labelled monoclonal anti-CEA antibody fragment. AB - The monoclonal anti-CEA F(ab')2 fragment MAb BW 431/31, labelled with 123I or 111In, was used for immunoscintigraphy (IS) in 9 patients with medullary cancer of the thyroid (CCC). The results of 11 studies lead to the following conclusions: When using radioiodine as a label for MAb in IS, potassium iodide is absolutely necessary to block the thyroid which is of special importance in patients with thyroid cancer; Preinjection of "cold" MAb reduces the relatively high unspecific uptake (especially in bone marrow) of MAb BW 431/31, which is of special importance for the antibody labelled with 111In; IS with MAb BW 413/31 in patients with CCC and elevated serum CEA is positive only in cases with large secondaries; and In patients with CCC and several manifestations of secondaries, only a single (large) metastasis may be apparent. PMID- 3808965 TI - Radioimmunoscintigraphy with anti-thyroglobulin monoclonal antibodies. AB - Monoclonal mouse antibodies to human thyroglobulin were conjugated to the cyclic dianhydride of DTPA. After radiolabelling with 111In this compound was injected into nude mice bearing various human thyroid carcinomas. Repeated imaging studies were carried out 15 min to 50 h after tracer administration. In both papillary and undifferentiated thyroid carcinoma no significant uptake of radiolabelled anti-hTG-MAb was observed. PMID- 3808966 TI - Limitations in localising and killing tumours using radiolabelled antibodies. AB - Radiolabelled antibodies against tumours are being studied intensely for their use in tumour detection and tumour destruction. Although a host of different tumour types can be localised, results at present are no better than other scanning techniques. In addition no tumour has been eradicated using labelled antibodies. Dramatic improvements will depend upon a fuller understanding of tumour cell biology and optimising all the parameters involved. PMID- 3808967 TI - The nutritional causes of colorectal cancer: an introduction to the Melbourne study. AB - The Melbourne study has shown that dietary factors and alcohol are important in the cause and prevention of colorectal cancer (CRC). A high intake of fat and beef probably causes CRC, and a high intake of beer possibly causes rectal cancer. The beef and beer effects were both independent of other dietary variables, but further research is indicated to explore the mechanisms of their actions. Foods of plant origin protected against CRC, and the "plant food hypothesis" now replaces the dietary fiber hypothesis. Further study is needed on the interrelationships between various foods of plant origin. Vitamin supplements were protective, and again clarification is needed on the mechanism of action. In high-risk populations, nutritional risk and causal factors are likely to be difficult to find, whereas protective factors are likely to be found with greater ease. Further analysis of the Melbourne data will reveal the importance of diet in CRC causation, relative to the other hypothesized causal and protective factors. PMID- 3808968 TI - The relationship between diet, alcohol, and colorectal cancer. The results of a large-scale, eight-year, population-based, clinicopathological and epidemiological study conducted in Melbourne, Australia. PMID- 3808970 TI - Rehabilitation of patients with chronic obstructive lung disease. PMID- 3808969 TI - Case-control study of alcoholic beverages as etiological factors: the Melbourne Colorectal Cancer Study. AB - As part of a large-scale investigation of colorectal cancer incidence, etiology, and survival, a case-control study was conducted to identify whether diet and alcohol, among other variables, were associated with the risk of colorectal cancer. This study compared 715 cases with 727 age- and sex-matched community controls. Findings from the dietary data are presented in the previous paper (Nutr Cancer 9, 21-42, 1987). The total life intake of specific alcoholic beverages was obtained from each subject. Data were classified by consumption of beer, wine, spirits, and alcohol. There was little evidence of an association of any of the alcohol variables with the risk of colon cancer. However, beer was found to be a risk factor for rectal cancer. This effect was more marked in males than in females, but the relative risks for females were consistent with those for males. Relative risk estimates changed only slightly when adjusted for the other alcohol variables and for the variables in the diet model; this suggests that the beer effect is separate from that of other alcohol variables and also from dietary variables. The age differences among beer consumers were found to be associated with cancer risk. Consumption of spirits was associated with a low risk for male rectal cancer. The risk of rectal cancer appeared to depend on beer drinking patterns in the previous 15-20 years. PMID- 3808971 TI - [Broncho-Vaxom in the treatment of recurrent respiratory tract infections in children]. PMID- 3808972 TI - [Effect of selected antibacterial antibiotics on the course of experimental sarcoma L-1 in mice]. PMID- 3808973 TI - [Effect of administration of various cytostatics on selected indicators of calcium metabolism in healthy rats]. PMID- 3808975 TI - [A case of coexistence of interstitial pulmonary fibrosis and primary biliary cirrhosis]. PMID- 3808974 TI - [New units of measurement of respiratory physiology. I. A graphic method of converting the traditional units of pressure to the units of the SI system]. PMID- 3808976 TI - [Effect of vitamin E on the changes in plasma lipid peroxides and platelet aggregation in patients with hyperlipoproteinemia]. PMID- 3808977 TI - [Changes in the taste threshold in patients with chronic renal failure, non dialysed and treated by peritoneal dialysis and hemodialysis]. PMID- 3808978 TI - [Correlations between the presence of dense deposits in the kidney glomeruli and circulating immune complexes in the sera of patients with glomerulonephritis]. PMID- 3808979 TI - [Calcium absorption in the digestive tract and calcium and phosphorus metabolism in postoperative hypoparathyroidism]. PMID- 3808980 TI - [The rate of pressure rise in the ascending aorta (Ao dP/dt) in mitral stenosis]. PMID- 3808981 TI - [Results of the treatment of acromegaly by pituitary irradiation using a Co-60 source]. PMID- 3808982 TI - [Doppler echocardiography: the physical basis of the method of recording. I]. PMID- 3808983 TI - [Doppler echocardiography. Clinical use. II]. PMID- 3808984 TI - [Serum lipids in patients with hypertension treated with prazosin]. PMID- 3808985 TI - [Effect of infections on the rate of detection of circulating immune complexes in the serum of patients with glomerulonephritis]. PMID- 3808986 TI - [Comparison of the effectiveness of peritoneal dialyses conducted by continuous and intermittent methods]. PMID- 3808987 TI - [Methods of studying the intestinal absorption of calcium and phosphates in humans]. PMID- 3808988 TI - [Still's disease in adults]. PMID- 3808989 TI - [Acquired cystic disease of the kidneys]. PMID- 3808990 TI - [Disorders of carbohydrate metabolism in bronchial asthma]. PMID- 3808991 TI - Spectrum of hearts with one underdeveloped and one dominant ventricle. AB - Hearts with one underdeveloped and one dominant ventricle form a spectrum of anomalies extending from the heart with two clearly adequate chambers to those with a true single ventricle. An angiographic concept of grouping such hearts is presented. 129 patients with unequal ventricles underwent catheterization and cineangiography between 1974 and 1983. The age at first catheterization ranged from one day to 24 years (mean 3.9 years). Male-female ratio was 2:1. Five groups of hearts (with their relative frequencies in the spectrum) were established: dominant left ventricle (53%); dominant right ventricle (20%), each with normally related chambers; dominant left ventricle (20%); dominant right ventricle (3%), each with ventricular inversion; true single ventricle (5%). The incidence of atrial anatomy, venous return, intracardiac connections and associated lesions within each group was assessed. From the standpoint of deranged physiology as well as surgical implications there are more similarities than differences among these hearts. The fact that one ventricle will not generate an adequate stroke volume after repair is overwhelmingly more important than most other considerations. For the diagnostic and surgical approach, we believe that the system offers many advantages. PMID- 3808992 TI - Frank vectorcardiograms during the first year of life: a longitudinal study of 62 healthy children. AB - A longitudinal vectorcardiographic study of 62 healthy children was carried out at the ages of one and six days and 1, 2, 4, 6, 9, and 12 months. Recordings were made using the Frank x, y, and z leads and the equipment developed by Arvedson [2]. In each age group 25 spatial vectors were examined. Planar projections of 13 timed QRS vectors were presented as mean QRS loops in the main planes. The results were in agreement with earlier studies but gave a more accurate representation of cardiac activation. The maximal spatial vectors to the right and to the left, the 0.035 and 0.04, the mean QRS and the partial mean 2/3 QRS vectors clearly reflected a decrease in right ventricular dominance during the first two months and an increase in left ventricular dominance during the first year. Vectorcardiographic development in each child, from the newborn pattern onward, occurred individually. None of the 12 vectors examined on 22 children from whom there were recordings in each age group from one day to nine months by the Spearman rank correlation test revealed any significant correlation. PMID- 3808993 TI - Pulmonary arterial changes in patients with ventricular septal defects and severe pulmonary hypertension. AB - In 25 patients, aged eight months to 31 years, with ventricular septal defect (VSD; isolated in 15, the others with atrial septal defect, PDA, coarctation or patent ductus arteriosus + coarctation), each with severe pulmonary artery hypertension (pulmonary artery systolic pressure [Ppa] at least 75% of systemic and an elevated pulmonary vascular resistance), we related morphologic and morphometric data from open-lung biopsy to hemodynamic measurements obtained at cardiac catheterization during the same hospital admission. Of the hemodynamic features measured, only the ratios of pulmonary-to-systemic flow and pulmonary-to systemic resistance correlated significantly with structure. Neither pulmonary artery pressure (Ppa) nor pulmonary vascular resistance correlated significantly with any structural feature studied. The increased external diameter of respiratory bronchiolar arteries in those with the more advanced Heath-Edwards grades reflects dilatation and suggests that it is in the small arteries of the distal arterial bed that the changes of pulmonary hypertension are most significant. Neither age nor body weight correlated significantly with the degree of structural or hemodynamic abnormality. In the ten patients who underwent VSD closure, Ppa was measured postoperatively. The Heath-Edwards grade (no more than one grade-III lesion) and arterial density (at least one-half that normal for age) were the best correlates of the difference between preoperative Ppa and Ppa immediately after corrective surgery. The presurgical catheterization data, including pulmonary resistance and the resistance ratio, did not correlate significantly with change in Ppa following VSD closure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3808995 TI - Psychiatric perspectives on mental retardation. PMID- 3808994 TI - Unguarded tricuspid orifice with two-chambered right ventricle. AB - Catheterization and anatomical data are presented of an infant with cyanosis due to a most unusual variant of unguarded tricuspid valve orifice in association with a two-chambered right ventricle. The inlet portion of the right ventricle ended blindly and was completely separated from the outlet portion by a muscular wall. The outlet chamber, which supported the pulmonary trunk, received its blood from the left ventricle through an outlet foramen. The condition is considered to be related to imperforate Ebstein's anomaly. PMID- 3808996 TI - Mental retardation. Medical aspects. AB - This article reviews the medical aspects of mental retardation with a focus on classification, types of retardations, evaluation and therapies, and etiology. PMID- 3808997 TI - Psychiatric aspects of assessment of competence of mentally retarded persons. AB - There are some mentally retarded, developmentally handicapped persons who--if given an appropriate, enriched, and stimulating environment--can grow, mature, and develop cognitive abilities, emotional stability, and social skills to such a degree that they may become mentally competent, capable of assuming greater responsibilities, and move away from an institution to a more dignified environment in the community, where they may be treated and have, in many ways, the same rights as any other citizens. The role of the psychiatrist is to participate in this developmental process and to give his or her opinion as to the mentally retarded person's mental capacity to live independently. PMID- 3808998 TI - Neuropsychological variables and mental retardation. AB - Improved measures of adaptive behavior would be greatly helpful in the diagnosis of mental retardation. This article describes an objective measure of adaptive behavior that has the further advantage of having a theoretical basis. PMID- 3808999 TI - The culturally deprived child. Social and educational needs. AB - The authors look at the culturally deprived child in terms of his educational and social needs. They emphasize the important role that the school must play. School administrators and teachers must become more sensitive to the role that school plays in a child becoming "turned off" to school. Teachers and administrators, students, and parents must become involved in a cooperative venture to improve the situation faced by the culturally deprived child. PMID- 3809000 TI - 1986 and beyond. A look into the future. AB - Recent research in the field of mental retardation has pointed to a better defined population with exacting prevalence of the basic pathology and related disabilities. Advances in the areas of prevention and treatment have further reduced the prevalence and incidence of mental retardation. Current legislation and legislative procedures have led to a more equitable and fairer application of human rights to all citizens. However, discrepancies and ambiguities still remain with respect to interpretation of the spirit of the law as related to the retarded. Financial restraints and serious economic hardship have impacted on social and political attitudes and created two-tier systems of the rich and poor with the retarded referred to as "surplus population." This situation has, in turn, influenced the availability of resources, manpower, training, and research in this field. The future could be brighter if sociologic and philosophic changes parallel technologic advances. It is our duty and commitment to continue and further the developments in all spheres relevant to the retarded in order to maximize human potential whenever possible. PMID- 3809001 TI - [Uncertain prognosis in myocardial infarction - four year follow-up]. PMID- 3809002 TI - [Myocardial infarction in women to 45 years of age]. PMID- 3809003 TI - [Diagnostic value of reciprocal ST segment depression in acute myocardial infarction]. PMID- 3809004 TI - [The effect of environmental low temperature on exercise, electrocardiogram and subjective symptoms in patients after myocardial infarction during short walks]. PMID- 3809005 TI - [The effect of one physical exertion on the concentration of selected hormones in blood serum of patients with exercise- induced angina pectoris non-complicated and complicated by a history of myocardial infarction]. PMID- 3809006 TI - [Recurrent tachycardia with variable directional conduction after recurrent stimulation in a patient with Wolff-Parkinson-White syndrome]. PMID- 3809007 TI - [Personal experience with the surgical treatment of aortic aneurysms in the thoracic-abdominal segment]. PMID- 3809008 TI - [Hematological complications of heart surgery]. PMID- 3809009 TI - Regional anesthesia for ambulatory foot and ankle surgery. AB - Regional anesthesia provides significant advantages for the patient and practitioner involved in ambulatory foot and ankle surgery. Reliable techniques for administering regional ankle blocks emphasizing their importance in the practice of ambulatory surgery are presented. PMID- 3809010 TI - Total ankle arthroplasty using biological fixation components compared to ankle arthrodesis. AB - When conservative measures fail to alleviate pain and disability of ankle joint disease, tibiotalar arthrodesis is the present accepted surgical treatment. Unfortunately, ankle arthrodesis also carries a significant rate of complications and the success rate does not parallel the results of hip and knee joint arthroplasties. A large percentage of ankle arthrodeses remain painful, and function is not normal. There is no satisfactory "salvage procedure" to a painful ankle fusion. Patients with primary ankle arthritis tend to develop bilateral ankle involvement as well as involvement of the subtalar and midtarsal joints; bilateral ankle fusion results in a severe handicap to gait and function. Ankle fusion with involvement of the subtalar or midtarsal joints might well result in a painful fusion. Maintenance of tibiotalar motion appears essential in both instances. It is apparent that all ankle problems cannot be dealt with by fusion and a successful long-term ankle arthroplasty is needed. Total ankle arthroplasty using cement fixation remains controversial. Continued use of polymethylmethacrylate and additional design changes do not appear to be the answer to possible ankle joint replacement. Initial success using the PCA concept of biological cementless fixation of the Scholz total ankle prosthetic components appears to offer a new dimension in the success of total ankle arthroplasty. PMID- 3809011 TI - Conservative management of metatarsal and heel pain in the adult foot. AB - The Louisiana State University (LSU) Affiliated Hospitals foot clinic has had good success in the treatment of metatarsal and heel pain using the following five modalities. Muscle strengthening and muscle stretching of the intrinsic muscles and the muscles about the ankle joint, especially the gastrocnemius soleus complex. Contrast baths in the acute condition to decrease the edema and inflammatory process. Nonsteroidal agents with the acute condition to decrease the inflammatory response. Shoe modifications. Orthotic devices. Orthotic devices seem to be the most useful in the treatment of both conditions. It has been found necessary to prescribe orthotics in almost all cases of chronic problems to institute permanent relief. Opposition remains to multiple steroid injections into either area, although there is no great objection to one or possibly two injections into a particular area to decrease the inflammatory process. It has been observed that a general worsening of the condition occurs from multiple injections. After repeated steroid injections one sets the stage for increased atrophy of the fat pad, which results in a more prominent bony surface and increased pain. Cases have been documented on many occasions showing indented areas over the heel or metatarsals or complete loss of the metatarsal fat pad of patients who have received multiple injections of steroids. PMID- 3809012 TI - The diabetic foot. AB - Amputation of the lower extremity is more frequent in diabetic patients than in the general population. Causative factors include foot deformities, neuropathy, dysvascularity, infection, and gangrene. A grading and treatment program is outlined for aid in treating the lesions that develop in these feet. PMID- 3809013 TI - Calcaneus fractures: rationale for the medial approach technique of reduction. AB - The fractured calcaneus is an enigma to many orthopedic surgeons. Because of this they are often not reduced as well as they might be. The majority of these fractures can be adequately reduced by the medial approach. This approach is based on the fact that a definite pattern of fracture occurs on the medial side of the calcaneus, whereas there is no pattern on the lateral side. If one restores the medial wall of the calcaneus, which is most accurately done from the medial side, the height, length, and much of the width is restored. Strong pressure over the lateral bulge is necessary to completely restore normal width. Generally, the tongue or joint depression-type fragments can be reduced from the medial side. If not, a separate, lateral incision is used to insure their reduction. The neurovascular bundle is no longer dissected out, removing a psychological barrier to the medial approach. A strong recommendation is made to use the longitudinal pin method of fixation. It is simple, and extremely strong. A classification of calcaneus fractures is presented, which can help in preoperative planning for reduction of these fractures. PMID- 3809014 TI - Periosteal chondroma. PMID- 3809015 TI - Midas Rex Institute Hands-On Workshop. PMID- 3809016 TI - Gaucher's disease. PMID- 3809017 TI - Radial fracture healing with angular deformity. PMID- 3809018 TI - Evaluation and operative procedures for hallux valgus deformity. AB - The hallux valgus deformity, or bunion deformity, is a common problem. Evaluation of the deformity for surgical intervention requires a knowledge of the basic pathomechanics of the medial displacement of the head out of the sesamoid complex with the associated deformity of the large toe and incompetency of the metatarsal cuneiform joint. The foot's relation to the leg and the body must be evaluated as well as the general condition of the patient, the age of the patient, and the expectations of the patient in regard to footwear and level of activity desired postoperatively. X-rays of the feet must be made in a consistent manner. The deformity should be classified as to the degree of severity. Operative procedures are grouped into the distal soft tissue procedures, metatarsal osteotomies, miscellaneous procedures, arthroplasty operations, and combinations of procedures. Indications and complications are presented. The procedures are discussed to provide an overview of surgical methods of treatment available for the hallux valgus deformity. PMID- 3809019 TI - Problems of the second metatarsophalangeal joint. AB - Diagnosis and treatment of second metatarsophalangeal joint problems are discussed. A new staging for Freiberg's disease is presented with differential treatment for each stage. Subluxation of the second metatarsophalangeal joint occurs commonly but is often unrecognized. A simple test in physical examination, the "positive Lachman" of the metatarsophalangeal joint is illustrated and explained. Although controversial, the etiology of synovitis of the second metatarsophalangeal joint is probably diverse; it can occur idiopathically or because of mechanical instabilities relating to malalignment of the first ray or disproportionate length of the second ray. When conservative treatment fails, surgical debridement of the joint is indicated. The second metatarsophalangeal is the most common chronically dislocated joint in the foot. The surgical goal is a reduced metatarsophalangeal joint and a stable toe. Surgical correction detailed by the authors involves a stepwise approach depending on the severity of the contracture, bony overlap, and deformity. PMID- 3809020 TI - Discoid lupus erythematosus and X-linked chronic granulomatous disease. AB - X-linked chronic granulomatous disease (CGD), a defect of leukocyte bactericidal capacity, was seen in three generations of a large kindred. The association of discoid lupus erythematosus (DLE) with CGD was noted. Recurrent antigenic stimulation leading to autoantibody formation may explain the apparently increased frequency of DLE in female carriers of CGD. A screen for CGD, the nitroblue tetrazolium test, is suggested for females with DLE who have experienced suppurative infections or who have a family history of early childhood deaths or recurrent infections. PMID- 3809021 TI - Developmental and psychosocial considerations in pediatric dermatology practice. AB - The psychologic implications of childhood skin disorders have received too little attention. Viewing these conditions in a broader developmental framework could facilitate practice by improving the doctor-patient relationship, increasing compliance rates, and enhancing professional satisfactions. Several key developmental points and concepts are relevant to pediatric dermatologic practice. PMID- 3809022 TI - Polymorphic light eruption in pediatric patients with American Indian ancestry. AB - Polymorphic (polymorphous) light eruption (PMLE) is a cutaneous reaction to a broad spectrum of light energies that is found in persons of American Indian ancestry. We treated PMLE in 11 pediatric patients of American Indian ancestry. PMID- 3809023 TI - Sun protection in well-child care: results of a survey of Florida pediatricians. AB - Chronic sun exposure has been linked to induction of skin cancers including melanoma and aging changes of the skin, has an adverse effect on certain diseases such as lupus erythematosus and is responsible for drug-induced phototoxic reactions. A majority of an individual's lifetime sun exposure may occur during childhood, and thus early photoprotection is desirable. We conducted a written survey of Florida pediatricians regarding their inclusion of sun protection information as part of routine well-child care. The results indicated that a majority of the pediatricians have awareness of the need for parent and patient education about sun-related issues, and most (65%) requested further information and educational materials. This study suggests that expanded educational efforts concerning sun-related health hazards and sun protection would be desirable for physicians involved in pediatric care, for parents, and for children. PMID- 3809024 TI - Palmoplantar milia: sequelae of early congenital syphilis. AB - A 5-month-old male was examined in our dermatology clinic with numerous palmoplantar milia. The child had early congenital syphilis with palmoplantar desquamation, which was followed by the development of milia. Histologic and electron microscopic features suggested that these secondary milia probably derived from the epidermis. PMID- 3809025 TI - Hay-Wells syndrome. AB - Hay-Wells syndrome is an autosomal dominant constellation of facial clefting, ankyloblepharon filiforme adnatum (fused eyelids), and ectodermal defects. Our patient, a child who had these unusual features at birth, led us to consider possible differential diagnoses based on clinical features and review of the literature. PMID- 3809026 TI - Aplasia cutis congenita in one of monozygotic twins. AB - Aplasia cutis congenita is an uncommon disorder characterized by a patchy defect of the scalp and other areas of the skin of the newborn. Several familial cases have been reported, including a set of identical twin girls. The disease was unique in our patient, one monozygotic twin. PMID- 3809027 TI - Hemifacial mixed appendageal tumor in an infant. AB - We believe this to be the first report of a unilateral mixed appendageal tumor without comedones on the face of an infant. Histologically, the tumor had eccrine, apocrine, and basaloid features. The tumor lobules closely resembled islands of basal cell carcinoma. After reviewing the literature, we speculate that some previous case reports of unilateral basal cell nevus were actually appendageal tumors with basaloid differentiation and not true basal cell carcinomas. PMID- 3809028 TI - A case of xeroderma pigmentosum with clinical appearance of dyschromatosis symmetrica hereditaria. AB - A 9-year-old boy complained of increased freckling on the extremities since very early infancy. Examination showed mottled pigmentation with areas of depigmentation on the backs of the hands and tops of the feet, and less strikingly on the arms and legs. Scattered, small, pigmented freckles on the face were also noticed. The condition was clinically diagnosed as dyschromatosis symmetrica hereditaria (DSH) at first. Unscheduled DNA synthesis was reduced to 66% of the normal value, however, and an ultraviolet sensitivity test by colony formation on fibroblasts revealed moderate sensitivity. Therefore this case was finally diagnosed as xeroderma pigmentosum. It is necessary to study cellular repair capacity to make a precise diagnosis when the distinction is so difficult. PMID- 3809029 TI - Meningococcal meningitis with a benign skin rash. AB - A skin eruption may be one of the early clues to meningococcal meningitis. We treated a boy with meningococcal disease accompanied by an exanthemlike eruption. Although the skin lesions in meningococcal meningitis are traditionally described as petechial, purpuric, or ecchymotic, the absence of these findings should not deter the physician from a clinical suspicion of this potentially fatal infection. PMID- 3809030 TI - Neonatal lupus erythematosus. PMID- 3809031 TI - Asymptomatic carotid bruit. A practical approach to diagnosis and management. PMID- 3809032 TI - The use of physical force. PMID- 3809033 TI - The rabbi and the goat in primary care. PMID- 3809034 TI - The painful thyroid. A three-step diagnostic approach. AB - A three-step diagnostic approach can help to determine whether neck pain is related to a thyroid condition: Thyroid pain is almost always short-lived (less than 3 months); patients with thyroid-related neck pain usually point to the thyroid gland as the site of the most intense discomfort; patients with a painful thyroid always have abnormal findings on palpation. The vast majority of painful thyroid conditions are benign and can be managed with very little medication and a lot of reassurance. PMID- 3809035 TI - Gastroenterology 1947-1987. A PGM retrospective. Postgraduate Medicine. PMID- 3809036 TI - Treatment of acute cholecystitis. Selection of the optimum approach. PMID- 3809037 TI - Percutaneous cholecystostomy in patient at high risk. Treatment of acute acalculous cholecystitis. AB - Percutaneous cholecystostomy can be a useful technique for the ill, elderly, or high-risk patient, since he or she is spared open surgery. We used it successfully in a medically unstable woman with acute acalculous cholecystitis. Her drainage catheter, often the source of complications with the procedure, may have been removed too early: A small asymptomatic subdiaphragmatic fluid collection and ileus developed. However, both resolved in 48 hours. PMID- 3809038 TI - Medical complications of herpes zoster in immunocompetent patients. AB - The vast majority of the more than 300,000 annual cases of herpes zoster in the United States occur among healthy, immunocompetent persons. Most patients recover from reactivated varicella-zoster infection, but some experience complications. The most common of these is postherpetic neuralgia, but other neurologic as well as ocular and dermatologic complications can occur as well. Zoster during pregnancy is not of serious concern. Ongoing trials of antiviral agents are aimed at resolving the infection quickly and decreasing the incidence and severity of postherpetic neuralgia. PMID- 3809039 TI - Comprehensive evaluation of the geriatric patient. PMID- 3809040 TI - Chemosensory dysfunction. Clinical evaluation results from a taste and smell clinic. AB - Findings from 441 patient evaluations performed at the Taste and Smell Clinic of the Connecticut Chemosensory Clinical Research Center are presented. Taste and smell dysfunction was the chief complaint in all patients. The diagnostic approach included tests of taste and smell function; history taking; physical, neurologic, otorhinolaryngologic, and nutritional examinations; and clinical laboratory screening tests. Results indicate that the most common chemosensory dysfunction is probably olfactory: 86% of patients in this series had measurable loss of smell function. The most common cause of olfactory deficit was nasal and/or sinus disease (30% of patients), followed by idiopathic conditions (26%) and prior upper respiratory infection (19%). Assessment of individual components of the evaluation suggests that a total circulating eosinophil count may be useful as a screening test for nasal and/or sinus disease among patients whose chief complaint is chemosensory dysfunction. PMID- 3809041 TI - Unorthodox therapy and your cancer patient. AB - Major differences exist between healthcare professionals and the general public in the way in which they view disease processes. Healthcare professionals use a scientific approach, while many of the middle-class public's perceptions of disease are based on a commonsense model. Today's proponents of unorthodox therapy are well-educated, media-conscious, and effective salespersons. More than 50% of patients receiving cancer therapy also use some form of unorthodox treatment. Of all patients who try unconventional therapy, up to 40% may ultimately give up conventional treatment. This is particularly tragic when patients have a potentially curable form of cancer. Physicians need to be aware of the magnitude of this problem and of the rationale used to promote unorthodox therapy. An informed, available, receptive physician remains one of the best defenses against cancer quackery. PMID- 3809042 TI - Local heat and cold therapy. PMID- 3809043 TI - The homeless person with diabetes. A diagnostic and therapeutic challenge. PMID- 3809044 TI - Key issues in nutrition. From conception through infancy. AB - Pregnant and lactating women and infants are at nutritional risk because of their special needs; both require adequate dietary nutrition and, often, dietary supplementation. For example, the mother's increased requirements for iron, calcium, folic acid, and vitamin D usually must be met with increased milk intake and multivitamin-with-mineral supplements. Since the pregnant and the lactating woman can pass both nutrients and nonnutrients to the child, she should be advised on a well-balanced, high-quality diet that is free of drugs or other additives that may be harmful. Although either breastfeeding or the use of formula may fulfill energy and protein needs, the infant may require supplemental vitamins K and C, fluoride, and iron. PMID- 3809045 TI - When to resume sports after infectious mononucleosis. How soon is safe? AB - Numerous factors must be taken into account in deciding when to allow an athlete to return to sports activities after having infectious mononucleosis. Factors such as length of illness, splenic size, and proper use of diagnostic testing have considerable bearing on this important decision. Splenic rupture is a potentially life-threatening complication of infectious mononucleosis, so extreme exercise and alcohol consumption should be avoided for a month after this infection. PMID- 3809046 TI - Nutrition sense or nonsense? PMID- 3809047 TI - Chemical structure of cibenzoline. PMID- 3809048 TI - Impotence and bicycling. A seldom-reported connection. AB - A man riding a stationary bicycle experienced transient tight sensations around the head of his penis during the exercise and progressive impairment of sexual potency over a period of more than one year. Lowering the bicycle seat terminated the bouts of impaired penile sensation, and one month after the patient discontinued the bicycle exercises, sexual potency returned. The course supported an ischemic mechanism for the abnormal penile sensation and a neural mechanism for impotence. Impotence has been associated with both vascular and neural lesions, and there is evidence for both vascular and neural compression in the perineal area during bicycle riding. A relationship between sexual dysfunction and bicycling may be more common than formerly suspected. PMID- 3809049 TI - The aging eye. A family physician discusses some inevitable changes and suggests methods for dealing with them. AB - The aging eye undergoes a variety of structural and physiologic changes that can impair vision and cause functional disability. Among the changes are backward displacement of the eye into the orbit, thickening and yellowing of the lens, decrease in pupil size, increase in laxity of the lids, and accumulation of waste products in the retina. The specific diseases of the eye that occur with aging include macular degeneration, cataracts, glaucoma, diabetic retinopathy, and sudden vision loss. Preventive care both in old age and earlier in life may help forestall ocular changes and the subsequent morbidity and mortality they cause. Environmental changes to accommodate visual change can be important in accident prevention and in improved functioning and quality of life. PMID- 3809050 TI - The passing of benevolence. PMID- 3809051 TI - Skills training in primary care residency. Problems and solutions from the family practice perspective. PMID- 3809052 TI - Is loss of body water a factor in aging? PMID- 3809053 TI - Male infertility. 1. Patient evaluation. AB - Although the cause of male infertility is often obscure, proper evaluation can reveal physiologic abnormalities on which a concept of management can be based. Evaluation includes history taking, physical examination, laboratory studies, semen analysis, radiographic studies, and occasionally, testicular biopsy and other studies. The history and physical examination are the foundation of evaluation and may provide clues to diagnosis. However, semen analysis is the most informative test in evaluation of male infertility. For optimum results, proper collection techniques must be followed and data must be carefully interpreted. PMID- 3809054 TI - Male infertility. 2. Treatment. PMID- 3809055 TI - Male infertility. 4. Evaluation of the female partner. PMID- 3809056 TI - Male infertility. 5. Psychological correlates. PMID- 3809057 TI - Alternatives to esophagomyotomy. PMID- 3809058 TI - Clarification of lumbar puncture technique. PMID- 3809059 TI - Mitral valve prolapse in children. PMID- 3809060 TI - Telephone 'emergencies'. How to respond appropriately and effectively. AB - While the appropriateness of giving medical advice on the telephone could be debated, this discussion is based on the assumption that few physicians can avoid providing this service to their patients. In fact, most physicians must respond often to telephone requests for advice. A large portion of these "emergency" calls result from the caller's psychological experience of powerlessness and helplessness in a situation that he or she perceives as health-related. An understanding of the dynamics of helplessness is essential for the physician to respond therapeutically. A five-step interviewing strategy--including listening, clarification, exploration of self-help, support, and advice--can then be followed in sequence. These steps are applicable not only to medical situations but to any telephone situation in which crisis and helplessness are major components. PMID- 3809061 TI - Accurate blood pressure measurement. AB - The most critical requirement for obtaining accurate blood pressure measurements is that the Korotkoff sounds be loud. Loudness can be enhanced by various techniques of cuff inflation and chest piece placement. The type of manometer, cuff size, and cuff placement are also important factors in obtaining accurate blood pressure readings. Correct systolic pressure measurement depends on proper inflation and deflation of the cuff. True diastolic pressure is usually closer to the disappearance point of Korotkoff sounds than to the muffling phase. Blood pressure should be recorded to the nearest 5 mm Hg because measurement to the nearest 2 mm Hg is not meaningful and is too difficult and time-consuming. PMID- 3809062 TI - Family practice 1947-1987. A PGM retrospective. PMID- 3809063 TI - Headache caused by serious illness. Evaluation in an emergency setting. AB - Severe headache is a common problem among patients in the emergency facility. Because early therapy reduces deaths from subarachnoid hemorrhage, the physician must use advanced technological and sometimes invasive tests to diagnose this serious condition in patients with equivocal signs and symptoms. In patients with meningitis, the physician must assume there will be only one opportunity to make the correct diagnosis. Because patients often seek emergency care early in the course of meningitis, when accurate detection on clinical grounds is more difficult, a conservative approach and liberal use of all appropriate diagnostic techniques are essential. PMID- 3809064 TI - Emergencies from hazardous materials. An overview. AB - Hazardous materials are ubiquitous in modern society. The weak link in the safety chain is transportation. Despite the remarkable safety record in the United States, the potential for disaster is real, as has been seen in Mexico, India, and the Soviet Union. Careful planning and cooperation between federal and local governments, industry, and healthcare providers will decrease the potential for serious accidents and also lessen the impact in terms of morbidity and mortality if disaster does occur. PMID- 3809065 TI - Liability for generic substitution. PMID- 3809066 TI - Office management of the breast mass. PMID- 3809067 TI - Accidental hypothermia. Giving 'dead' victims the benefit of the doubt. PMID- 3809068 TI - Recurrent urinary tract infections in women. Pathogenesis and management. AB - Greater understanding of the pathogenesis of recurrent urinary tract infection (UTI) in women has led to highly successful management techniques. The primary care physician plays a vital role in evaluation and long-term management of these patients. Careful collection and culture of the urine must be performed to document and classify infections. Almost all recurrent UTIs are reinfections from bacteria in the fecal flora. Such infections can be managed successfully by low dose prophylaxis, self-start intermittent therapy, or postintercourse therapy. Patients with infections at close intervals, particularly when caused repeatedly by the same strain, may have a focus of bacterial persistence within the urinary tract. Careful radiologic and urologic evaluation of these patients is mandatory, and localization and removal or correction of the underlying abnormality can result in a cure. PMID- 3809069 TI - 'I never said that!'. PMID- 3809070 TI - Gastric emptying disorders. Tests and treatments. AB - Tests to measure the volume of gastric contents are necessary to determine the nature of a gastric emptying disorder. The conditions that can affect gastric emptying are as varied as peptic ulcer disease, achlorhydria, viral and bacterial infections of the stomach, diabetes, scleroderma, anorexia nervosa, and CNS lesions; some patients experience gastric emptying problems after surgery for peptic ulcer disease. The future of electrical pacing of the stomach and perhaps the gastrointestinal tract in general is very exciting, as is the future use of antiarrhythmic drugs. PMID- 3809071 TI - Interstitial nephritis in a patient with Legionnaires' disease. AB - Renal involvement in legionnaires' disease is a well-known, yet incompletely understood, complication. Manifestations of renal involvement include proteinuria, hematuria, pyuria, cylindruria, and azotemia. Previous cases of legionnaires' disease with renal involvement have shown pathophysiologic changes consistent with acute tubulointerstitial nephritis or acute tubular necrosis. A toxic metabolite produced by Legionella pneumophila has been theorized to produce a vasoconstrictive effect on the renal microvasculature, leading to ischemia and renal dysfunction. The case reported here is unique in that the patient presented with interstitial nephritis in the absence of pulmonary signs or symptoms. PMID- 3809072 TI - Familial cerebral palsy associated with normal intelligence. AB - We describe two families affected by a recessively transmitted familial cerebral palsy with onset in infancy. Two sisters in the first family have a severe spastic diplegia. The older sister also has mild mental retardation and hypothyroidism whilst the younger sister is of normal intelligence. Two brothers in the second family have a spastic quadriparesis, fifth finger camptodactyly and normal intelligence. PMID- 3809073 TI - Antibodies to the thyroid gland and to the thyrotrophin receptor in African and Indian thyrotoxic patients. AB - Sixty two thyrotoxic patients, 34 African and 28 Indian, were studied in order to assess the prevalence of thyroid antibodies and TSH binding inhibitory activity (TBI): 45 had Graves' disease and 17 had toxic nodular goitres. Microsomal and thyroglobulin antibodies were positive more often in Indian than in African patients with Graves' disease (microsomal 52% vs 37.4%, P less than 0.05; thyroglobulin 38.1% vs 4.2%, P less than 0.001). Patients with toxic nodular goitres had a lower prevalence of positive microsomal antibodies (P less than 0.01), but not of thyroglobulin antibodies (P = 0.1) when compared with patients with Graves' disease. TBI activity measured by a radioreceptor assay was positive in 43 of the 45 (95%) patients with Graves' disease and only 1 of the 17 patients (5.9%) with toxic nodular goitre. It thus appears that TBI activity is a sensitive marker in the diagnosis of Graves' disease and that there is a lower prevalence of thyroglobulin and microsomal antibodies in African patients compared with Indian patients. PMID- 3809074 TI - Primary hypothyroidism with paradoxically elevated plasma thyroxine due to thyroxine-binding antibody. AB - Investigation of an elderly patient with clinical hypothyroidism revealed a low serum triiodothyronine (T3) but markedly raised levels of total thyroxine (TT4) and free thyroxine (fT4) when measured by radio-immunoassay (RIA). Primary hypothyroidism was suggested by an elevated basal thyroid stimulating hormone (TSH) and confirmed by a low fT4 when measured by a commercial microencapsulated antibody method. The paradoxically elevated levels of fT4 and TT4 were due to the presence of an antibody which specifically bound T4 and grossly interfered with the RIA thus complicating the diagnosis and later the assessment of replacement therapy. The sensitive immunoradiometric TSH assay proved of value in resolving these problems. PMID- 3809075 TI - Unilateral thyroid swelling due to actinomycosis. AB - A case of unilateral thyroid swelling due to actinomycosis in a 27 year old farm worker is described. Diagnosis was made by fine needle biopsy under ultrasound control. PMID- 3809076 TI - Papillary carcinoma in a giant lateral thyroglossal cyst. AB - The development of carcinoma in a thyroglossal cyst is rare. This report describes the presence of papillary carcinoma in a giant thyroglossal cyst and reviews the literature regarding the clinico-pathological features of the disease and its management. PMID- 3809077 TI - A patient with bulimia nervosa and profound folate deficiency. AB - A case is reported of a young woman with bulimia nervosa who presented with profound folate deficiency. This association has not been reported before despite the increased theoretical possibility. Initially she has responded well to folic acid therapy and social support. PMID- 3809078 TI - Extracorporeal membrane oxygenation as emergency treatment for life-threatening acute severe asthma. AB - We report a case of acute severe asthma that was resistant to full medical treatment, mechanical ventilation and halothane inhalation. Because a fatal outcome appeared likely extracorporeal membrane oxygenation, involving partial cardiac bypass, using femoral artery and femoral vein cannulation was instituted as an urgent measure. The patient then made a satisfactory recovery. PMID- 3809079 TI - DIDMOAD syndrome with megacystis and megaureter. AB - A case of DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and nerve deafness) is described. There was unusually severe urinary tract dilatation which led to an ileal conduit diversion. Immunohistological study of the bladder wall and ureter revealed a marked diminution in nerve fibres, which may have been primary or secondary to the muscle hypertrophy. The possible pathogenesis of the urinary tract dilatation is discussed in relation to this finding. PMID- 3809080 TI - Gonococcal tysonitis. AB - A case of gonococcal urethritis with bilateral tysonitis is discussed. The patient was treated successfully with oral tetracycline 500 mg 6 hourly for 10 days, with a complete resolution. PMID- 3809081 TI - Primary carcinoma of the gall bladder associated with ulcerative colitis. AB - The report concerns a case of primary carcinoma of the gall bladder in a 53 year old man, who, 13 years previously underwent a pan-proctocolectomy for ulcerative colitis. Previous reports are reviewed, highlighting the difficulty of early diagnosis. PMID- 3809082 TI - Hereditary pancreatitis presenting with ascites. AB - We report a case of an adolescent girl who presented with painless massive ascites secondary to chronic pancreatitis and a ductal fistula. The diagnosis was delayed and an unnecessary laparotomy was performed, as initial evaluation of ascites did not include measurement of serum and ascitic amylase. Evidence of pancreatic abnormalities in asymptomatic relatives suggested an underlying hereditary pancreatitis. Hereditary pancreatitis presenting as pancreatic ascites, to our knowledge, has not been described previously. PMID- 3809083 TI - Multilocular cyst of kidney. AB - We describe a child with a multilocular renal cyst who presented with a renal mass and pain due to haemorrhage into the cyst. This type of presentation has not been reported previously. PMID- 3809084 TI - Obstruction of the third part of the duodenum in tuberculosis. AB - Extrinsic compression by tuberculous mesenteric nodes is the rarest form of duodenal obstruction and one such case is presented. Radiology is helpful in differentiating various duodenal lesions. Ideal surgical treatment is duodeno jejunostomy but in some cases only gastroenterostomy is possible. PMID- 3809085 TI - Nodular fasciitis induced by epidural injection. AB - Nodular fasciitis is a well established clinical entity of unknown pathogenesis. A traumatic aetiology is postulated yet specific examples are not documented. We present a case directly attributable to an epidural injection. PMID- 3809086 TI - Spontaneous spinal epidural haematoma with spontaneous resolution. AB - Spontaneous spinal epidural haematoma is of unknown aetiology, but it has been associated with hypertension. Treatment is surgical decompression but three cases of spontaneous recovery have been reported. We report the fourth such recovery in a 68 year old hypertensive woman. PMID- 3809087 TI - Skin necrosis following Haemaccel. AB - Haemaccel is a plasma substitute in frequent clinical use with a low incidence of side effects. I report a patient who developed necrotic blisters following two Haemaccel-insulin infusions, a previously undescribed complication. The rationale behind carrier solutions for insulin therapy is discussed and some of the problems associated with Haemaccel use are considered. I conclude by urging caution in the use of Haemaccel as a carrier solution for insulin therapy. PMID- 3809089 TI - Identifying families at risk of inherited disease. PMID- 3809088 TI - Genetics old and new. PMID- 3809090 TI - Prenatal screening for fetal abnormalities. PMID- 3809091 TI - Prevention of neural tube defects. PMID- 3809092 TI - Genetic influences in diabetes mellitus. PMID- 3809093 TI - How general practitioners can contribute to genetic services. PMID- 3809094 TI - Women general practitioners: time for change. PMID- 3809095 TI - Recovery from hysterectomy. PMID- 3809096 TI - Idiopathic scrotal oedema. PMID- 3809097 TI - Investigation of endocrine disorders in general practice. PMID- 3809098 TI - Evaluation of short stature in childhood. PMID- 3809099 TI - Infertility--a view from an endocrinologist. PMID- 3809100 TI - Hypercalcaemia--common and treatable causes. PMID- 3809101 TI - Thyroid disease and pregnancy. PMID- 3809102 TI - Pituitary tumours: surgery or medical shrinkage. PMID- 3809103 TI - Corticosteroid therapy. PMID- 3809104 TI - Antibodies to endocrine glands--do they matter? PMID- 3809105 TI - Latest news on metabolic bone disease. PMID- 3809106 TI - Recent advances in thyroid disease. PMID- 3809107 TI - [Heroin-induced lung edema]. PMID- 3809108 TI - [Final florid tuberculosis]. PMID- 3809109 TI - [Relation between pulmonary cholesterol granulomatosis and alveolar proteinosis?]. PMID- 3809110 TI - Prenatal diagnosis of infantile GM 2 gangliosidosis type II (Sandhoff disease) by detection of N-acetylglucosaminyl-oligosaccharides in amniotic fluid with high performance liquid chromatography. AB - Prenatal diagnosis of Sandhoff disease (infantile onset) at 16 weeks gestation has been made by detection and analysis of N-acetylglucosaminyl-oligosaccharides in amniotic fluid using high performance liquid chromatography. The elution profile for the branched chain oligosaccharides was identical with that obtained with neonatal and infantile Sandhoff urine. The concentration of the oligosaccharides in the fluid was 1/100th that of urine but when calculated relative to creatinine the levels were similar. No oligosaccharides were detected in normal control amniotic fluids (10 patients) at a similar gestational age. Based on the levels of the amniotic fluid oligosaccharides and the sensitivity limits of the assay, prenatal diagnosis of patients with the juvenile onset form of the disease may also be possible with this technique. PMID- 3809111 TI - A pipette method for rapid karyotyping in prenatal diagnosis. AB - The "pipette method' is introduced as a method of prenatal diagnosis which is in competition with the "in situ' and the "trypsinization' technique. It is sufficiently standardized for routine diagnosis and the banding techniques currently used in prenatal diagnosis (G, Q, C-banding and NOR) have been adapted for it. In 180 cases from 27 different centres, the "pipette method' was employed for chromosomal harvesting in order to save time. An average of 6 X 6 days was taken to achieve a result. There was a pathological karyotype in 28 cases (16.1 per cent) and this high proportion can be related to cases where ultrasound scan has led to a diagnosis of "suspected chromosomal abnormality.' This technique is also of use in advanced stages of pregnancy. The early recognition of the fetal karyotype can contribute to the future management of the pregnancy. The "pipette method' can also be used in chromosomal harvesting of tumour cells and fibroblast cultures. PMID- 3809112 TI - Modifications of ultradian and circadian rhythms of fetal heart rate after fetal maternal adrenal gland suppression: a double blind study. AB - In order to verify whether fetal and maternal adrenal gland suppression induces effects on fetal behaviour, triamcinolone was administered to five healthy pregnant women at 35 weeks of gestation. Five patients of the same gestational age were used as control. Fetal heart rate (FHR) and fetal movements were recorded continuously over 2-h interval by means of cardiotocography. After 3 weeks (38 weeks of gestation) the recordings were repeated without drug administration. Cortisol, adrenocorticotropin hormone, 17 beta-estradiol and unconjugated estriol were measured at the same time every 2 h in maternal peripheral plasma. At 35 weeks we found a loss of circadian rhythms of the hormones investigated and modifications of ultradian and circadian patterns of FHR in the treated group with respect to the control. No differences in hormonal and biophysical parameters were found between the two groups after the end of treatment (38 weeks). These data suggest that the inhibition of fetal and maternal adrenal glands could cause modifications of FHR patterns. PMID- 3809113 TI - Prenatal diagnosis and confirmation of infantile sialic acid storage disease. AB - Amniocentesis was performed in a pregnancy at risk for infantile sialic acid storage disease. Greatly elevated levels of free sialic acid were found in cell free amniotic fluid as well as in cultured amniotic cells from the fetus at risk. After incubation of the cultured amniocytes with fetuin labelled in its sialic acid moiety, pulse and chase experiments respectively showed accumulation and impaired release of TCA-soluble radioactive material in the amniotic cells at risk. These data thus clearly indicated that the fetus was affected. After pregnancy termination, ultrastructural studies of fetal organs and placenta showed a generalized storage picture characterized by clear membrane-bound inclusions. The diagnosis was further confirmed by the finding of greatly increased amounts of free sialic acid in fetal organs and cultured fibroblasts. PMID- 3809114 TI - Pericentric inversion of chromosome 19. PMID- 3809115 TI - [Histologic inhomogeneity of liposarcomas]. PMID- 3809116 TI - [Metastasized Kaposi sarcoma--oral manifestation in a case of AIDS]. PMID- 3809117 TI - [The gallbladder in metachromatic leukodystrophy]. PMID- 3809118 TI - [Esophageal cancer in Fanconi syndrome]. PMID- 3809119 TI - [Pancreatitic pseudocyst with vena cava erosion, necrotizing panniculitis and polyarthropathy]. PMID- 3809120 TI - [Tubulovillous adenoma of the rectum with metaplasia of the squamous epithelium]. PMID- 3809121 TI - Preparation of agarose with low net negative charge density using an inexpensive anion exchanger. AB - A method of preparing agarose of low net negative charge density by the use of Chromium tanned gelatin is described. Using commercial agarose (agarose c) as standard of comparison the product has a sulphate content approximately 0.1 that of agarose c and its pyruvate content was reduced to zero as shown by NMR in DMSO. The product was still able to adsorb and desorb serum glycoproteins similar to agarose c indicating that charge on the agarose c gel particles played a minor role if any on the binding of the serum glycoproteins. PMID- 3809122 TI - [Effect of vitamin E from by-products of cotton oil processing on the glutathione peroxidase system in rats]. AB - The activities of glucose-6-phosphate dehydrogenase, glutathione reductase and glutathione peroxidase from liver, skeletal muscles and erythrocytes of rats fed a vitamin E-deficient, or supplemented, diet were studied. Vitamin E was added in the diet either as a pure pharmacy form of alpha-tocopherol or as a tocopherol mixture derived from oil wastes. The deficiency of vitamin E caused an increase in the activity of the above mentioned enzymes. Both alpha-tocopherol and the tocopherol mixture were found to influence the glutathione peroxidase system. The dose-dependent response of the glutathione peroxidase system was revealed. Possible mechanisms of the changes in the antioxidizing enzymes induced by vitamin E are discussed. PMID- 3809123 TI - [Plasma level of testosterone-estradiol-binding globulin in women with Itsenko Cushing disease]. AB - A total of 50 patients with Icenko-Cushing's disease were examined for the levels of estradiol, testosterone and testosterone-binding globulin in various stages of the disease. In disease recurrences the levels of testosterone were two-fold higher than those in normal subjects versus the testosterone-estradiol-binding capacity (TEBC) in the blood serum which was decreased in patients with Icenko Cushing's disease. During remission the levels of testosterone decreased, those of the blood TEBC increased, but however failed to achieve their values in health. Normalization of the above mentioned levels followed a total adrenalectomy. The levels of TEBC and testosterone were in a feedback correlation whereas no correlation was recorded between the levels of estradiol and TEBC. The TEBC levels estimation can be used for the assessment of the disease clinical course. PMID- 3809124 TI - [Phosphorus-calcium metabolism and calcium-regulating hormones in endogenous hypercorticism]. AB - The authors presented the results of a study of the indices of phosphorocalcium homeostasis, metabolism of osseous tissue and calcium regulating hormones in 44 patients with Icenko-Cushing's syndrome with regard to severity of disease and expression of osteoporosis. It was shown that disturbances of phosphorocalcium homeostasis and an increase in the level of the parathyroid hormone were characteristic for the active stage of Icenko-Cushing's disease and were most noticeable in a severe course of disease accompanied by sharply marked osteoporosis. Hypocalcemia, hypophosphatemia, hypercalciuria, a decrease in phosphate maximum resorption and an increase in AP activity in the blood serum were revealed in this form of disease. Patients with the average gravity of disease and weakly pronounced osteoporosis were characterized by hypercalcemia and an increase in calcium intestinal absorption. Patients with the active stage of hypercorticism were characterized by hypermagnesemia. Secondary hyperparathyrosis was found in 25% of patients with the active stage of Icenko Cushing's disease. PMID- 3809125 TI - [Computed tomography in the differential diagnosis of hypocorticism]. AB - A comprehensive study of 52 patients with hypocorticism was conducted. Some of them were examined using the method of computerized tomography (CT) which provided important evidence for the diagnosis of hypocorticism, assessment of its etiology and differential diagnosis of the process. 12 of 16 patients demonstrated changes which were characteristic for hypocorticism: in 4 patients (no signs of tuberculous involvement of the adrenals) a decrease in their sizes with the preserved regular shape was noted, in 8 patients (with clinicolaboratory findings of tuberculous involvement) enlarged sizes, bilateral deformity of the contours and the presence of petrificates were detected. The authors presented some differential-diagnostic CT signs of tuberculous and metastatic involvement of the adrenals having some features in common. PMID- 3809126 TI - [Functional morphology of the adrenal cortex and incretory kidney structures in the salt-losing form of adrenogenital syndrome in children]. AB - The adrenals and kidney incretory structures (the juxtaglomerular apparatuses and renomedullary interstitial cells) were studied in 12 cases of a desalinization form of the adrenogenital syndrome in children who died at the age of 1-6 mos of acute water-electrolytic disturbances in order to assess function of the structures involved in the regulation of the water-salt equilibrium. The adrenals and kidneys from 7 children of the same age who died of mechanical asphyxia, were taken as controls. The depth of adrenocortical zones, volumes of nuclei and nucleoli in different cortical zones were determined; the juxtaglomerular index, cell count (including vacuolized cells), the area of the juxtaglomerular apparatus and mesangium were determined in the juxtaglomerular apparatus. The amount of cell lipid granules (the interstitial-cellular index), the mean granule volume and the total granule volume were counted in renomedullary interstitial cells. The results were statistically processed, and a paired correlation analysis of all the studied parameters was performed. In the desalinization form of the adrenogenital syndrome morphometric investigation of the glomerular and fascicular zones revealed compensatory processes, not of hyperplastic nature but mainly of hypertrophic nature; morphological and morphometric characteristics of the kidney incretory structures indicated tension of the renin-angiotensin system and probably a decrease in prostaglandin synthesis in salt and water loss. In the control group parameters of structures related to the regulation of the water salt equilibrium, especially in the adrenal cortex, showed good correlation. In the desalinization form of the adrenogenital syndrome some other relationships between these structures developed. PMID- 3809127 TI - [Plasma levels of sex hormones and their receptors in the endometrium of women with normal menstrual cycle]. AB - Plasma estrogen, progesterone, cortisol and prolactin concentrations were determined by RIA in 20 healthy women on the 7th-10th and 24th-26th days of the menstrual cycle. The content of estrogen and progesterone receptors in the cytosol and nuclei of the endometrium was studied by a method of adsorption on dextran-covered carbon; pathomorphological investigation of the endometrium was performed. Sex hormone concentration was shown to be significantly lower in the middle (proliferative) phase as compared to the late one (secretory). Cortisol and prolactin concentrations in both periods did not change. The content of both sex hormone receptors was significantly higher in the middle (proliferative) phase. On the basis of the content and ratio of plasma sex hormones and receptor content in the endometrium a conclusion was made that the main factor in the regulation of receptor levels by sex hormones was the ratio of their concentrations in the plasma. PMID- 3809128 TI - [Hereditary retinal abiotrophy in monozygotic twins with diabetes mellitus]. PMID- 3809129 TI - [Pathogenesis of autoimmune diseases of the thyroid]. PMID- 3809130 TI - [Receptor binding of estradiol and testosterone in the pituitary of female rats]. PMID- 3809131 TI - [Effect of physical exercise on the level of the non-activated form of glucocorticoid receptor in cytosol and phosphorylation of non-histone proteins of the myocardium]. AB - In accordance with recently published data on the nuclear localization of free steroid receptors in vivo and the role of phosphorylation processes in the hormonal control of cellular activity, an attempt was made to study the effect of physical exercise on the phosphorylation of cytosolic and nuclear proteins and on the proportion of nonactivated and activated forms of the glucocorticoid receptor in the hearts of adrenalectomized rats. According to a generally accepted hypothesis, the receptor in these animals resided mainly in the cytoplasm. The results of DNA- and DEAE-cellulose chromatography showed that physical exercise caused an increase in the amount of the nonactivated receptor. As the amount of the activated form remained approximately the same the best explanation was that some amount of the receptor resided in the nuclei even in adrenalectomized rats and physical exercise decreased the affinity of the receptor to nuclear elements. At the end of exhaustive exercise the in vivo phosphorylation of nuclear nonhistone proteins was decreased, however dexamethasone administration enhanced phosphorylation and also caused the receptor translocation into nuclei. The results obtained suggest that both the binding of the hormone to its receptor (leading to closer association with nuclear elements, probably with nonhistone proteins) and the phosphorylation of nonhistones are biologically related events involved in the regulation of gene transcription. PMID- 3809132 TI - [Changes in the activity of enzymes of cholesterol esters synthesis and hydrolysis in rat adrenals after treatment with 17 alpha-ethinyl estradiol]. AB - A study was made of the effect of hypocholesterolemia induced by 3-day administration of 17 alpha-ethinyl estradiol on the activity of lysosomal and cytoplasmatic cholesterol esterases, acyl-CoA: cholesterol acyltransferase and on the free and esterified cholesterol concentrations in the rat adrenals. A decrease in the content of esterified cholesterol in the adrenal tissue was accompanied by a decrease in the activity of acyl-CoA: cholesterol acyltransferase and by an increase in the activity of lysosomal cholesterol esterase. The activity of cytoplasmatic cholesterol esterase was not changed significantly. The data obtained were discussed with relation to the synthesis of steroid hormones in the rat adrenals. PMID- 3809134 TI - [Clinical value of the expert assessment of roentgenologic changes in the lungs of children with mucoviscidosis]. PMID- 3809133 TI - [Involvement of catecholamine mechanisms in the activation of the mouse hypophyseal-testicular complex induced by the presence of females]. AB - A study was made of the role of the adrenergic and dopamine mechanisms in the activation of endocrine testicular function of CBA/Lac and A/He male mice induced by the presence of a female in estrus without any tactile contact with a male. The alpha-adrenoreceptor blocker phentolamine inhibited an increase in the peripheral blood plasma testosterone level caused by the receptive female challenge. Propranolol blockade of beta-adrenoreceptors sharply increased the stimulating effect of the receptive female presence on the blood testosterone level. The expression of adrenoblocker action on the blood male sex hormone level depended on a male genotype. The dopamine receptor blocker pimozide produced a moderate effect on the blood testosterone but an attempt to separate its influence into the male sex hormone tonic secretion and the blood testosterone level against a background of sex activation failed. It was concluded that the adrenergic mechanisms were involved in the hypothalamo-hypophyseotesticular complex activation induced by the receptive female presence. PMID- 3809135 TI - [Role of age characteristics of the structure of the spine in the surgical treatment of tuberculous spondylitis in children]. PMID- 3809136 TI - [Role of tuberculin tests in the diagnosis of tuberculosis of the female genitalia]. PMID- 3809137 TI - [Nonspecific inflammatory diseases of the lung in active tuberculosis and their sequelae]. PMID- 3809138 TI - [Exogenous and idiopathic alveolitis as the object of a clinico-functional study]. PMID- 3809140 TI - [Morphofunctional evaluation of the effect of ultrasound in inflammation of the lungs]. PMID- 3809139 TI - [Diagnostic value of biochemical studies of bronchoalveolar lavage fluid in nonspecific endobronchitis]. PMID- 3809141 TI - [Comparative evaluation of methods of early detection of tuberculosis in adolescents]. PMID- 3809142 TI - [Principles of the pathogenetic therapy of patients with tuberculosis of the respiratory organs]. PMID- 3809143 TI - [Lyell's syndrome in a pulmonary tuberculosis patient]. PMID- 3809144 TI - [Tuberculosis of the tendons and tendon sheaths of the flexors of the hand]. PMID- 3809145 TI - [Sensitivity to sensitins in persons with postvaccinal and infectious allergy to tuberculin]. PMID- 3809147 TI - African trypanosomiasis: haematogenic brain parasitism early in experimental infection through bypassing the blood-brain barrier, with considerations on brain trypanosomiasis in man. AB - A hematogenic invasion of the brain in suckling NMRI mice infected with Trypanosoma brucei rhodesiense was initiated by means of a mechanical damage of the blood-brain barrier. The brain was punctured after development of a blood infection. Brain infection was found in 31 out of 32 animals examined. Trypanosomes are initially capable of rapid multiplication. The number of parasites was highest during the 1st week. From the middle of the 2nd week the number of parasites decreased continuously, alongside increasing atrophy. In the 3rd and 4th week only rare degenerating or ghost trypanosomes were present. No reactions were detected in the glial and mesenchymal cells. It is presumed that the short phase of trypanosome multiplication is due to the temporary collateral oedema of the brain tissue. The decrease in parasites from the 2nd week onwards is mainly attributed to natural death due to particular anatomical features of the brain tissue. These are also responsible for the absence of defensive inflammatory reactions, based on the hypothesis that contact between trypanosomes and the cells of the brain blood vessels is prevented. PMID- 3809146 TI - Selective lectin reactions of two stocks of Leishmania enriettii with differing pathogenicity. AB - Five days old promastigote culture forms of two stocks of Leishmania enriettii pathogenic and non-infective for Cavia procellus, were tested with the lectins of Canavalia ensiformis, Ricinus communis-120, Soja hispida (Glycine maxima), Arachis hypogaea, Ulex europaeus, Ulex europaeus I, Ulex europaeus II, Laburnum alpinum, Lotus tetragonolobus, Euonymus europaeus and with a monoclonal antibody against blood group H. The pathogenic stock reacted with the anti-H lectin of Lotus tetragonolobus and the monoclonal anti-H and the monoclonal anti-H but not with anti-H of U. europaeus I and E. europaeus. The non-infective stock reacted with none of these anti-H specific agglutinins. They had strong agglutination reactions to C. ensiformis (500 micrograms/ml, 1,000 micrograms/ml, 10 mg/ml) R. communis-120 (1:10), S. hispida (1,000 micrograms/ml) and A. hypogaea (500 micrograms/ml, 1,000 micrograms/ml, 2,000 micrograms/ml). They showed moderate agglutinations to U. europaeus, L. alpinum and U. europaeus II. The non-infective stock showed only moderate reactions to C. ensiformis (10 mg/ml), R. communis-120 (1:10), A. hypogaea (2,000 micrograms/ml) and S. hispida (1,000 micrograms/ml). Neither N-acetylneuraminic acid nor neuraminidase was detected on the cell surface of both stocks. This result demonstrates clearly that both stocks of L. enriettii differ in their cell surface carbohydrates. The agglutination reactions with lectins of the non-infective stock of L. enriettii are very similar to L.t. major. PMID- 3809148 TI - The life history of Pleurogenoides orientalis (Srivastava, 1934) (Trematoda: Lecithodendriidae). AB - The life history of Pleurogenoides orientalis (Srivastava 1934), a lecithodendriid trematode of frogs in India is reported and stages in the life history are described. Natural infections with cercariae, which are virgulate xiphidiocercous type, were found in the prosobranch snail Alocinma travancorica. Metacercarial cysts were found in dragon-fly naiads (Tholymis tillarga and Tramea limbata) and aquatic bugs (Laccotrephes griseus and Ranatra elongata) collected from a stream. Adults occurred in the intestine of the pong frog, Rana cyanophlyctis. Laboratory reared A. travancorica fed with eggs of P. orientalis started shedding cercariae from 30 days post feeding. Development of cercariae into infective metacercariae in dragon-fly naiads took 18 days. Mature flukes were recovered from the intestine of experimentally infected R. cyanophlyctis. The entire life cycle from egg to egg producing adult takes 2 1/2 to 3 months. PMID- 3809149 TI - The nervous system of Diplostomum pseudospathaceum Niewiadomska, 1984 (Trematoda, Diplostomatidae). III. Structure of the nervous system in the adult stage. AB - The nervous system of adult Diplostomum pseudospathaceum Niewiadomska, 1984 was studied using Koelle's (1951) method for revealing cholinesterase activity. The nervous system in the fore body grows but its pattern remains the same as in the metacercaria: three pairs of stems connected by numerous commissures and differentiated innervation of various organs in this part of the body. In the elongated hind body the nervous system develops according to another pattern: two pairs of stems connected by a number of commissures form a loose net surrounding the whole segment. The net is more dense at the body end around the genital opening and copulatory organs. A brief discussion of the development of the nervous system of D. pseudospathaceum from cercaria to adult stage is given. PMID- 3809150 TI - Scanning electron microscopy of rediae, cercariae, metacercariae and adults of Mesorchis denticulatus (Rudolphi, 1802) (Trematoda, Echinostomatidae). AB - A detailed study of the surface topography of the echinostome digenean Mesorchis denticulatus (Rudolphi 1802) Dietz 1909 was carried out using the scanning electron microscope. The surface area of the redia is increased by microvilli, and ciliate sensory structures are common around the mouth. The cannibalistic behaviour of the rediae is demonstrated by rediae which have the posterior end and tail of extraredial cercariae protruding from the mouth. The partly devoured cercariae had occasionally - apparently as a defence reaction - covered their bodies with a thick layer of cystogenous material, which, however, does not protect them from being eaten. The surface area of the tegument of the youngest extraredial cercariae is increased by small microvilli or knobs with a presumed function in nutrient absorption. The knobs disappear when the cercariae are fully developed. Flattened spines occur peripherally in the suckers. Different types of ciliate structures are especially common anteriorly. The infective metacercariae, which occur in the gill filaments of euryhaline fishes, have conspicuous collar spines and smaller pointed spines occur on most of the body surface. The spines continue to grow in the experimental final host, chickens. The flattened spines of the oral sucker remain, whereas those of the ventral sucker disappear. The ventral area between the suckers is spineless. PMID- 3809152 TI - The oogenotop of Amphilina bipunctata (Cestodaria). AB - Amphilina bipunctata Riser, 1948 were collected from the white sturgeon Acipenser transmontanus from the Columbia River, USA. The morphology and histochemistry of the oogenotop of Amphilina as they pertain to egg formation are described. The vitelline gland granules secrete the main part of the egg shell. These shell granules are positive for basic proteins, SS groups, and there is a weak reaction for phenolase. The Mehlis gland granules are positive for PAS. The first-formed egg shell is positive for basic proteins and it is weakly positive for phenolase. These egg shells are negative for SS groups and PAS. Conjectures concerning the significance of these data are made. PMID- 3809151 TI - Alterations in the internal defence system of the pond snail Lymnaea stagnalis induced by infection with the schistosome Trichobilharzia ocellata. AB - In order to investigate whether the schistosome Trichobilharzia ocellata interferes with defence activities in its snail intermediate host Lymnaea stagnalis, aspects of the immune system of infected snails and of non-infected controls were compared. The elimination of injected live Staphylococcus saprophyticus bacteria starts at a lower rate in infected snails 1 and 5 weeks after exposure to the parasite, but then proceeds faster than in control snails. During the first 3 weeks of infection, when only mother sporocysts are present, the haemocytes of the infected snails have an increased capacity to phagocytose rabbit red blood cells in vitro. From 5 weeks onwards, when mother and daughter sporocysts are present but cercariae are not yet mature, the phagocytic activity decreases to below control level. The number of circulating haemocytes is also higher in infected snails than in controls at this time. Moreover, the cells are larger, have more inclusions and an increased surface area with many long, branched, spiked pseudopods. The development of the parasite is retarded in a subpopulation of snails in which the haemolymph plasma agglutinates erythrocytes with high titres, compared to a subpopulation with low haemagglutinating activity. The haemagglutinating activity in infected snails of the first decreases significantly from 6 weeks onwards. PMID- 3809153 TI - Localization of glycoconjugates at the tegument of the tapeworms Hymenolepis nana and H. microstoma with gold labelled lectins. AB - Gold labelled lectins were used for electron microscopic localization of carbohydrate components of the tegument surface of two tapeworm species, Hymenolepis nana and H. microstoma. WGA, succinylated WGA, SBA, APA, PNA and, to a lesser extent, Con A were preferentially bound to the spines of the microtrichs. UEA-I and DBA were not adsorbed. The results indicate that the surface coat of both species has exposed N-acetylglucosamine, galactose and perhaps glucose and/or mannose residues. The location of lectin-binding glycoconjugates within the tegument and parenchyma was found using the light microscope on sections of material embedded in Lowikryl K4M after lectin-gold labelling and silver enhancement of the gold grains. The tegument selectively adsorbs WGA and SBA and strongly; adsorbtion of PNA and Con A is less intense. Strong adsorbtion of DBA and PNA was confined to the basal lamina. The parenchyma adsorbed Con A, PNA and DBA, but little WGA and SBA. The results indicate that many glycoconjugates are present in the tegument. They have similar terminal sugar residues to those of the surface coat. The significance of these carbohydrates for host-parasite interactions is discussed. PMID- 3809154 TI - Studies on in vitro IgE synthesis from lymph node cells of mice during infection with Nippostrongylus brasiliensis. Presence of inhibitory factor(s) in serum. AB - The effect of serum factors on Ig synthesis (IgE, IgG) in vitro was analyzed. Spleen and mesenteric lymph node cells were obtained from Nippostrongylus brasiliensis-infected and non-infected mice. Sera and ammonium sulphate precipitated serum fractions from mice of different genetic origin (Balb/c - H 2d, A.CA - H-2f, B10.G - H-2q) suppressed in vitro IgE synthesis whereas a pronounced enhancement of IgG antibody synthesis was obtained in several experiments. Our results obtained with sera from both high and low IgE responder strains demonstrated that no strain specificity exists as to the inhibitory efficacy of mouse sera for total IgE synthesis in vitro. The suppressive activity of the mouse sera was concentrated in a fraction precipitated with 20%-50% saturated ammonium sulphate. Amicon XM50 ultrafiltration suggested that this fraction had an apparent molecular weight greater than 50,000 daltons. Suppressive activity was removed by immunoadsorption of the 20-50% fraction with anti-IgE Sepharose. After exogenous addition of monoclonal IgE to an inactive fraction in vitro neither the fraction enriched in IgE nor monoclonal IgE alone were able to suppress IgE synthesis in the culture. Our results suggest that one or more serum factors in the presence of IgE are responsible for the suppression of total IgE synthesis in vitro. PMID- 3809155 TI - Ultrastructural characterization of tegumental spines of the adult lung fluke, Paragonimus westermani. PMID- 3809156 TI - A unified biosocial theory of personality and its role in the development of anxiety states. AB - A general theory of heritable personality traits and their neurobiological basis is described. Three independent dimensions of personality are defined and related to heritable variation in patterns of response to specific types of environmental stimuli: 'novelty seeking' is due to a heritable tendency toward frequent exploratory activity and intense excitement in response to novel stimuli; 'harm avoidance' is due to a heritable tendency to respond intensely to aversive stimuli and to learn to avoid punishment, novelty, and non-reward passively; and 'reward dependence' is due to a heritable tendency to respond intensely to reward and succorance and to learn to maintain rewarded behavior. Evidence suggests that variation in each dimension is strongly correlated with activity in a specific central monoaminergic pathway: novelty seeking with low basal dopaminergic activity, harm avoidance with high serotonergic activity, and reward dependence with low basal noradrenergic activity. These neurobiological dimensions interact to give rise to integrated patterns of differential responses to punishment, reward, and novelty. The combination of high novelty seeking, high reward dependence, and low harm avoidance (histrionic personality) or the combination of high harm avoidance, low reward dependence, and low novelty seeking (obsessional personality) are each associated with information-processing patterns that lead to unreliable discrimination of safe and dangerous situations and hence to chronic anxiety. In individuals with high novelty seeking, chronic anxiety is characterized by global uneasiness or alarm without specific premonitory cues, frequent bodily pains due to low pain and sensation thresholds, low sedation threshold, and slow fatigability. In contrast, in individuals with high harm avoidance, chronic anxiety is characterized by frequent anticipatory worries based on specific cues, high pain and sedation thresholds, and easy fatigability. In response to frustrative non-reward, individuals with high reward dependence are susceptible to compensatory noradrenergic hyperactivity and hence acute or recurrent states of agitated dysphoria associated with reward-seeking behaviors such as overeating and increased sexual activity. Specific predictions are made about normal personality development as well as the development and familial aggregation of anxiety, somatoform, depressive and personality disorders. These predictions are compared with available information, and recommendations are made for future research. PMID- 3809157 TI - The importance of separation anxiety in the differentiation of panic disorder from agoraphobia. AB - When patients with panic disorders are divided into two groups, those that are without any signs of phobic avoidance and those that are frankly agoraphobic, we see a differential premorbid history of separation anxiety in childhood with school phobia. The former group we found to be without these problems, while the latter demonstrated a history of school phobia in the majority of cases (60 per cent). This may indicate that uncomplicated panic disorder and agoraphobia with panic attacks are not always differential cross-sections of the same disease process, or different levels of severity of the same psychopathological entity, but may represent illnesses best not conceptualized as lying on a continuum. Further research will be served by separating panic disorder (DSM-III 300.01) into two groups: uncomplicated panic disorder, and panic disorder with limited phobic avoidance, which will exist along with the present agoraphobia with panic attacks, perhaps best renamed panic disorder with extensive phobic avoidance. PMID- 3809158 TI - Problems in setting up an executing large-scale psychiatric epidemiological studies. AB - This paper focuses on problems that can be encountered in conceptualizing, executing and writing up large-scale psychiatric epidemiological studies. It makes no attempt to cover fundamental issues of design and analysis, rather it centers on problems associated with projects of considerable size. In the conceptual area, it discusses the prerequisites to be considered before deciding to launch such a study. It notes the administrative and scientific uses of epidemiological studies and considers the strengths and weaknesses of large-scale studies to address those concerns. Issues in carrying out such studies are discussed including decisions about study design, sampling method and instrumentation. All are dependent on the central purpose of the study but trade offs between feasibility and scientific rigor are always present. Data collection and analysis problems highlighted in large-scale studies are examined. They include the difficulty, in the former, of adequately motivating and supervising field personnel and, in the latter, of dealing with problems that accompany missing data and complicated sampling strategies. Potential problems in data access and use and writing up the results are seen as arising from the presence of a large investigative team with diverse interests. Lastly, the comparative worth of these studies is considered. PMID- 3809159 TI - Head posture and craniofacial morphology in adults from northern Finland. PMID- 3809160 TI - A 10-year follow-up of maxillary canine transplantations. PMID- 3809161 TI - A planimetric evaluation of approximal caries progression during one year of consuming sucrose and xylitol chewing gums. PMID- 3809162 TI - Distinguishing between headaches responsive and irresponsive to treatment of mandibular dysfunction. PMID- 3809163 TI - [Metallurgic structure, corrosion and biological compatibility of Ag-Pd-Cu-(Au) (Zn)-based dental casting alloys]. PMID- 3809164 TI - [Dental enamel defects and dental maturity in children and adolescents with celiac disease]. PMID- 3809165 TI - Caries increment and dental health habits. PMID- 3809166 TI - [Immunoglobulins in human saliva]. PMID- 3809167 TI - [Immunocytochemical diagnosis of cervicofacial actinomycosis with special emphasis on periapical inflammatory lesions]. PMID- 3809168 TI - Aortic ascorbic acid, trace elements, and superoxide dismutase activity in human aneurysmal and occlusive disease. AB - Altered trace elements and ascorbic acid metabolism have been implicated in the pathogenesis of atherosclerotic cardiovascular disease. However, their role in the disease process, or the effect of atherosclerosis on their tissue levels within plaque, is poorly understood. The present study analyzes the concentrations of Fe, Cu, Zn, and Mn, and ascorbic acid and superoxide dismutase (SOD) activity in tissue samples from 29 patients with abdominal aortic aneurysms (AAA) and 14 patients with atherosclerotic occlusive disease (AOD). It was observed that the Fe and Mn concentrations in AAA and AOD tissue were higher than the levels in nondiseased control aorta, whereas Cu and Zn levels in AAA and AOD tissue were similar to the levels in controls. The Zn:Cu ratio was significantly lower in the AAA tissue in comparison to both AOD and control tissue. In addition, AAA and AOD tissue had low ascorbic acid levels and low Cu,Zn-SOD activity with Cu,Zn-SOD:Mn-SOD ratios of 0.27 and 0.19, respectively, compared to a ratio of 3.20 in control aorta. These data indicate that aorta affected by aneurysms and occlusive disease have altered trace element and ascorbic acid concentrations, as well as low Cu,Zn-SOD activity. Although these observations do not directly support the hypothesis that AAA is associated with aortic Cu deficiency they do suggest a role for oxygen radicals or increased lipid peroxidation in occlusive and aneurysmal disease of the aorta. PMID- 3809169 TI - Serum concentrations of thyroid hormones and extrathyroidal thyroxine-5' monodeiodinase activity during lactation in the rat. AB - Serum thyroxine (T4) and triiodothyronine (T3) concentrations and T4-5' monodeiodinase activity in liver and kidney homogenates were studied in Sprague Dawley rats during lactation. Blood and tissue samples were collected from nulliparous and pregnant rats 2 days before delivery and from lactating rats 0, 2, 7, 12, 19, and 26 days after delivery. Litters were removed from half of the mothers immediately after delivery to create a postpartum nonlactating group for study at the same times. Pregnant rats had lower serum T4 and T3 concentrations and higher liver T4-5'-monodeiodinase activity than nulliparous females. Low serum T4 persisted throughout lactation but further decrease in serum T3 was observed. Activity of T4-5'-monodeiodinase in liver and kidney homogenates was significantly reduced during lactation as compared to nonlactating rats. Serum concentration of T4 and T3 and T4-5'-monodeiodinase activity in liver and kidney returned toward control values 5 days after weaning (Postpartum Day 26). Our findings suggest that the relative hypothyroid state observed during lactation in rats is associated with a significant decrease in T4 to T3 conversion in the liver and kidneys. PMID- 3809170 TI - Riboflavin metabolism in the hypothyroid human adult. AB - It had been shown that thyroxine regulates the conversion of riboflavin to riboflavin mononucleotide and flavin adenine dinucleotide (FAD) in laboratory animals. In the hypothyroid rat, the flavin adenine dinucleotide level of the liver decreases to levels observed in riboflavin deficiency. We have shown that in six hypothyroid human adults, the activity of erythrocyte glutathione reductase, an accessible FAD-containing enzyme, is decreased to levels observed during riboflavin deficiency. Thyroxine therapy resulted in normal levels of this enzyme while the subjects were on a controlled dietary regimen. This demonstrates that thyroid hormone regulates the enzymatic conversion of riboflavin to its active coenzyme forms in the human adult. PMID- 3809171 TI - Structural determinants of cationic amphiphilic amines which induce clear cytoplasmic vacuoles in cultured cells. AB - Disobutamide (D), an antiarrhythmic cationic amphiphilic amine (CAA), was withdrawn from clinical testing when clear cytoplasmic vacuoles (CCV) were found in the rat and dog during toxicity studies. To delineate the structural determinants of amines that induce CCV, we exposed cultured rat urinary bladder carcinoma and rabbit aorta muscle cells to numerous cationic drugs and chemicals and examined cells by phase light microscopy. The cationic moiety of these CAA was responsible for the induction of CCV. The very potent inducers were compounds that had two strongly basic amine (cationic) centers. The bis tertiary amines were particularly potent inducers. Aliphatic diamines of minimal lipophilicity induced CCV, thus showing that an "amphiphilic" structural feature, though present in many CAA drugs, is not necessary for CCV induction. The distance between the two cationic centers was irrelevant to the induction of CCV. These results support the concept that CCV are a manifestation of intracellular (e.g., intralysosomal) drug storage. These structural delineations will be useful in future drug design and for further understanding of drug-cell interactions. Based on these findings, we were able to synthesize an antiarrhythmic CAA which did not induce CCV. PMID- 3809172 TI - Purification of a syngeneic cross-reactive autotumorolytic factor. AB - An autotumorolytic fraction (ATF) derived from sera of mice bearing spontaneous mammary adenocarcinoma has been purified by sequential chromatography on Sephacryl 200 SF, DEAE Sephacel, hydroxylapatite, and Sephacryl 200 SF. At each stage of the purification, tumorolytic activity was assessed by the ability of the active material to induce lysis of a 2-week-old mammary tumor, and verified by histopathological analysis. Active fractions obtained during the stages of purification were capable of inducing lysis of tumors in both the original donor mice and the syngeneic tumor-bearing mice. Lytic activity was specific only for tumor tissue. This syngeneic crossreactivity of partially purified materials permitted pooling of serum samples for purification purposes. The resultant final preparation of ATF is an homogenous protein fraction, as verified by gradient SDS polyacrylamide gel electrophoresis (SDS-PAGE) and high-performance liquid chromatography. The molecular weight of active ATF is approximately 50,000 Da, as determined by gradient SDS-PAGE. PMID- 3809173 TI - Immunogenicity and adjuvanticity of lipopolysaccharide from Legionella pneumophila. AB - Lipopolysaccharide isolated from Legionella pneumophila was found to be a potent antigen and inducer of antibody with strong adjuvant activity for related and unrelated antigens such as sheep erythrocytes by in vivo and in vitro systems. The LPS was also a potent stimulator of blastogenic responses by spleen cells from normal mice as well as from mice immunized with inactivated whole cells of Legionella. It strongly stimulated production of interferon and interleukin 1. These results indicate that the LPS of Legionella may be an important immune regulator in the host response. PMID- 3809174 TI - Verification of early pregnancy tests in a multicenter trial. AB - Tests for the diagnosis of early pregnancy have been available since 1974. However, no studies have systematically verified the accuracy of routine clinical laboratories in measuring human chorionic gonadotropin (hCG) prior to the time that pregnancy is clinically evident. We have conducted such a study in association with the NICHD-funded Diabetes in Early Pregnancy Study (DIEP). The purpose of this study was to elucidate the etiology of malformations in pregnancies complicated by diabetes mellitus, which probably occurs within the first few weeks of pregnancy, and therefore uniformity of pregnancy testing was necessary among the five centers to find an association of a teratogen at the time of organogenesis. We confirmed that routine clinical laboratories, in fact, could measure accurately hCG at the time of the missed menses; however, detection was not necessarily possible prior to that time. We conclude that in order to assure accurate diagnosis of early pregnancy, tests should ordinarily be delayed until time of the missed menses. When the test is used at this time, it is a reliable tool for early pregnancy testing and thus can be used to resolve questions relating to early pregnancy pathophysiology. PMID- 3809175 TI - Chicken serum inhibits lectin-induced proliferation of autologous splenic mononuclear cells. AB - Splenic mononuclear cells (SMC) proliferate well in response to phytomitogens in serum-free medium. Low concentrations of corticosterone significantly inhibit both spontaneous (1 ng/ml) and phytohemagglutinin-induced proliferation (12 ng/ml) of chicken SMC. Addition of as little as 3% normal heat-inactivated chicken serum to both autologous and heterologous suspensions of chicken SMC causes a 50% inhibition in lectin-induced proliferation. This suppression by normal chicken serum increases in a dose-dependent manner. Inhibition of DNA synthesis by chicken serum is not due to endogenous corticosterone because charcoal stripping of the serum to deplete glucocorticoids does not remove the immunosuppression. Chicken serum is not cytotoxic to lymphoid cells. These data demonstrate that low, physiologic concentrations of corticosterone inhibit proliferation of chicken SMC. Utilization of a serum-free culture system also permitted the identification of a serum factor that appears to be even more immunosuppressive than corticosterone. Since this factor inhibits the lectin induced proliferation of both autologous and heterologous avian lymphoid cells, it may be a very important naturally occurring immunoregulatory compound. PMID- 3809176 TI - Diminished hepatic growth hormone receptor binding in sex-linked dwarf broiler and leghorn chickens. AB - Hepatic growth hormone (GH) receptor binding was compared in normal and sex linked dwarfs (SLD) from both Hubbard and Cornell strain chickens. At 6, 8, and 20 weeks of age, hepatic GH receptor binding in the Hubbard SLD chickens was significantly lower than that of normal fast-growing birds. At 20 weeks of age, only 2 of 22 SLD chickens in the Hubbard broiler strain showed positive binding at a high enough level to allow for Scatchard analysis. The affinity constants and binding capacities of these two SLD chickens were numerically (but not significantly) lower than those of the normal fast-growing birds. We further examined hepatic GH receptor binding in two closely related White Leghorn strains of chickens that have been maintained as closed breeding populations for many years. We observed no detectable hepatic GH binding in the Cornell SLD chickens (N = 20), as compared to the normal-growing control strain (K strain). In both SLD strains, pretreatment with 4 M MgCl2 did not enhance GH binding, suggesting that there was no endogenous GH binding to the receptor. Based on these data, we suggest that the lack, or greatly reduced number, of GH receptors may be a major contributing factor to the dwarfism observed in these strains. PMID- 3809177 TI - Effect of illness on hormonal response to footshock stress. AB - The corticosterone (CORT) and prolactin (PRL) responses to 1.0 mA of footshock were measured in healthy rats and rats with pneumonia. No differences in basal PRL levels were seen, but basal CORT levels were significantly increased in the sick animals. Healthy rats showed a significant increase in both PRL and CORT after receiving footshock whereas the sick rats showed no changes. The adapative value of the current findings are unclear at this time. PMID- 3809178 TI - Guidelines for radiation therapy in clinical research on bladder cancer. PMID- 3809179 TI - Surgical techniques in the management of patients with superficial bladder cancer. PMID- 3809180 TI - Surgical techniques in invasive bladder cancer. PMID- 3809181 TI - Standardization of format of reporting results. PMID- 3809182 TI - Diagnostic work-up. PMID- 3809183 TI - Prognostic factors in superficial bladder cancer. PMID- 3809184 TI - Clinical follow-up. PMID- 3809185 TI - The TNM classification in clinical research. PMID- 3809186 TI - Standardization of protocol format. PMID- 3809187 TI - Policy on monitoring and reporting results. PMID- 3809188 TI - Statistical analysis techniques and sample size determination for clinical trials of treatments for bladder cancer. PMID- 3809189 TI - Transitional cell carcinoma in situ. PMID- 3809190 TI - The role of cytology in the diagnosis, detection and follow-up of bladder cancer. AB - Cytology is an essential and indispensable procedure in the evaluation of patients suspect of harboring a tumor of the lower urinary tract. The interpretation of the cytologic sample is difficult but, in experienced hands, the value of the procedure is significant to the urologist. PMID- 3809191 TI - Cancer drug resistance. Proceedings of a workshop held at the XIV International Congress of Chemotherapy. Kyoto, Japan, June 23-28, 1985. PMID- 3809192 TI - Variation in growth parameters and their effect on the acquisition of drug resistance. PMID- 3809193 TI - Drug-resistance genes can be spontaneously transferred among malignant cells. PMID- 3809194 TI - Cellular resistance to platinating agents in ovarian carcinoma. PMID- 3809195 TI - Patterns of resistance to alkylating agents. PMID- 3809197 TI - Drug resistance in the clinical situation. PMID- 3809196 TI - Pleiotropic resistance and drug development. PMID- 3809198 TI - Techniques to reverse or circumvent drug-resistance in vitro. AB - In this study, we report that membrane-active agents can reverse or circumvent multidrug resistance in tumor cells through alteration of membrane permeability. Two different cell lines are used to assay the drug-sensitivity: colchicine resistant clone derived from human cancer KB cell line with multidrug resistance and P388 leukemia cells resistant to many anticancer agents such as adriamycin, vincristine and other agents. In the latter system, circumvention effect can be tested with mice bearing drug-sensitive or -resistant P388 leukemia in vivo. Thioridazine (calmodulin inhibitor), N-(p-methylbenzyl)decaprenylamine, N solanesyl-N,N'-bis(3,4-dimethoxybenzyl)ethylenediamine and amphotericin B (a sterol-binding polyene antibiotic) have been screened with these two drug resistant cell systems. They overcome the multidrug resistance in Chr-24 as well as P388 leukemia cells resistant to adriamycin or vincristine. N-solanesyl-N,N' bis(3,4-dimethoxylbenzyl)ethylenediamine can reverse the drug-resistance in vivo against mice bearing resistant leukemia. Mechanism to reverse the drug-resistance is to be discussed in relation with altered membrane permeability of the anticancer agents. PMID- 3809199 TI - Modulation of drug resistance in human ovarian cancer: experimental results and clinical applications. PMID- 3809200 TI - Methotrexate resistance in murine and human continuous tumour cell lines: an examination of the different mechanisms involved depending on the order of resistance expressed. PMID- 3809201 TI - Cytokinetic resistance of Lewis lung carcinoma to cyclophosphamide and the amsacrine derivative CI-921. PMID- 3809202 TI - Experimental studies of tumor metastasis and the drug sensitivity. PMID- 3809203 TI - Cellular endocrinology: Hormonal control of embryonic and cellular differentiation. Proceedings of the First International Symposium on Cellular Endocrinology. Lake Placid, New York, August 12-16, 1985. PMID- 3809204 TI - Evidence for the transmission of dorsoventral information to the ectoderm during the earliest stages of limb development. PMID- 3809205 TI - Cytoplasmic factors regulating cellular differentiation. PMID- 3809206 TI - Purification of mesodermal inducing substance and protein synthesis using this material. PMID- 3809207 TI - Chemical properties-dissolution of nonsteroidal antiinflammatory drugs. II. Factors affecting the release of NSAID from monoliths. PMID- 3809208 TI - Antimicrobial properties of some aromatic alcohols. PMID- 3809209 TI - Increases in dissolution rate of nifedipine by roll mixing with polyvinylpyrrolidone. PMID- 3809210 TI - [Helenine and santonine, the 12-carboxy-eudesma-3,11(13) diene]. PMID- 3809211 TI - [Betel--a popular pleasure-giving substance in South Asia]. PMID- 3809212 TI - [Phenytoin synthesis]. PMID- 3809213 TI - [Spartium and sparteine. Its antiarrhythmia action]. PMID- 3809214 TI - Time-related memory effects of vasopressin analogues in rats. AB - The present study was designed to investigate critical time periods for the memory modulating effect of vasopressin and several analogues in rats using a passive avoidance test as the behavioral paradigm. AVP, AVP-(4-8) and AVP-(5-8) were more effective when given immediately after the learning trial (consolidation), while AVP-(1-8) (DGAVP) and AVP-(5-9) were more active when administered one hour prior to the retention test (retrieval). DDAVP and AVP-(4 9) were highly active both when given immediately after the learning trial or 1 hour before the retention test. The period between 12 and 18 hr after the learning trial appeared to be another sensitive period. Administration, in particular of DGAVP, and AVP-(5-9) at 12, 15, and 18 hr after the learning trial induced marked retention of the avoidance response at the 24 hr retention test. Injection at 6 and 21 hr after the learning trial was the least effective in facilitating passive avoidance latencies. The more stable analogue DDAVP facilitated avoidance latencies irrespective of the time of administration. Vasopressin and related peptides exert a long term effect on avoidance behavior. However, DGAVP and AVP-(5-9) facilitated passive avoidance behavior at the 24, 48, and 72 hr retention test if administered immediately after the learning trial. If injection was postponed till 15 hr after the learning trial, passive avoidance behavior was facilitated at the 24 hr retention test only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3809215 TI - Nicotine's effects on female rats' body weight: caloric intake and physical activity. AB - Caloric intake and physical activity contribute to the inverse relationship between nicotine and body weight in male rats. In contrast, the relative contribution of these behavioral variables to the nicotine/body weight relationship in female rats has has not been investigated. Recent research indicates that males and females respond differently to nicotine. The present study was designed to determine the role of physical activity and food consumption in body weight changes associated with nicotine administration in female rats. Nicotine or saline was administered chronically to 24 female rats for 19 days. Body weight, food consumption, water consumption, and physical activity were measured before, during, and after nicotine administration. Body weight and food consumption decreased during and increased after nicotine administration. However, there were no changes in physical activity that could account for these changes in body weight. These results corroborate the report that males and females respond differently to nicotine. PMID- 3809216 TI - Intra-nucleus accumbens amphetamine: dose-dependent effects on food intake. AB - The effects of microinjections into the nucleus accumbens (N.ACC.) of 0.0, 2.0 or 8.0 micrograms of (+)-amphetamine sulphate (AMPH) on food intake and running wheel activity were examined. The 2.0 micrograms dose of AMPH produced increased food intake while 8.0 micrograms significantly decreased food intake. No effect was found on running wheel activity with the 2.0 micrograms dose, though 8.0 micrograms significantly increased the number of wheel revolutions with respect to the saline group. Results were interpreted to suggest that the N.ACC. may be an important site in the mediation of the increased food intake noted with low doses of psychomotor stimulants. PMID- 3809217 TI - A potential role of saline trials in morphine-induced place-preference conditioning. AB - The necessary conditions to alter rats' initial preferences for two sides of a shuttlebox were investigated, using procedures that are often used in the study of drug reinforcement. In Experiment 1, pairings of morphine sulfate (15 mg/kg, intraperitoneally) and either the nonpreferred side or a holding box was factorially combined with alternate-day pairings of saline and either the preferred side or a holding box. Pairings of saline and the preferred side were necessary and sufficient to increase preferences for the initially nonpreferred side. In Experiment 2, pairings of saline and the nonpreferred side, but not the holding box, strengthened the initial preference, regardless of whether morphine or saline injections preceded alternate-day holding-box placements. In Experiment 3, injection and placement in the preferred side in an unpaired manner, or placement only, decreased preferences for that side more than saline injections alone or no treatment. Paired saline injections and placement produced a greater change in preference than no treatment. PMID- 3809218 TI - Sensitization to amphetamine and tolerance to cocaine and phencyclidine stimulation in mice. AB - Amphetamine (1.0-7.0 mg/kg), cocaine (5.0-40.0 mg/kg) and phencyclidine (1.0-7.0 mg/kg) increased acoustic startle responding in mice. These drugs, however, had varying effects on habituation of the startle response after repeated exposure to the auditory stimulus. The primary effect of phencyclidine was to disrupt the habituation process, whereas increased startle responding after cocaine developed without modification of the habituation curve. Amphetamine facilitated acoustic startle at all doses, and after administration of 3.0 mg/kg a significant response sensitization as a function of repeated stimulus presentation was evident. Consistent with previous reports the excitatory effects of cocaine and amphetamine on acoustic startle were blocked by pretreatment with haloperidol. Haloperidol, which decreased startle responding, attenuated the facilitating effects of PCP on acoustic startle as well. Chronic exposure to amphetamine, cocaine and phencyclidine had differential effects on startle responding. The facilitating effects of amphetamine on startle were further enhanced after long term exposure to the drug and the sensitizing effect of repeated amphetamine exposure was observed only when animals were tested with amphetamine. In contrast, tolerance developed after chronic exposure to both cocaine and phencyclidine, and the response attenuation was evident when animals were tested for acoustic startle after cocaine, amphetamine and phencyclidine. PMID- 3809219 TI - Mouth versus deep airways absorption of nicotine in cigarette smokers. AB - Nicotine from the alkaline smoke of cigars is absorbed through the buccal mucosa, but such absorption from the more acidic smoke of American cigarettes has not been reported. Forty-one male and 52 female smokers were studied under normal ventilation and smoking conditions, and under high ventilation and controlled smoking conditions that restricted intake to the mouth only, with no inhalation. The major finding is that there is virtually no intake of nicotine through the buccal mucosa while smoking American cigarettes. Confirming prior reports, plasma nicotine and expired CO levels showed no correlation with the analytical yields of nicotine and CO of the cigarettes smoked. Fifteen nonsmokers (7 male, 8 female) participated in this study as controls. Data from these subjects provided additional information regarding absorption of nicotine and carbon monoxide during passive smoking. Within the highly ventilated environment, there was no significant change of CO and nicotine levels of nonsmokers. However, within the normally ventilated environment, there was minimal increase in both substances, statistically significant only for nicotine. These results suggest that nicotine may be a better indicator of exposure to second-hand smoke than carbon monoxide. PMID- 3809220 TI - The schedule dependent effects of 3-quinuclidinyl benzilate on operant behavior in the rat. AB - The effects of 3-quinuclidinyl benzilate (QNB) on performance maintained by a fixed-ratio 20 (FR-20) or a differential-reinforcement-of-low-rate 20 sec. (DRL 20) schedule for water reinforcement were studied in rats. Graded doses of QNB (range 0.0125-0.2 mg/kg) were administered IP immediately prior to 30 min test sessions. QNB had a biphasic effect on FR responding: at a low dose (0.0125 mg/kg) it increased, while at higher doses (0.05-0.2 mg/kg) it decreased mean response rate in a linear, dose-dependent, manner. QNB had only a monotonic effect on DRL responding; doses of 0.05-0.2 mg/kg increased the mean response rate and decreased reinforcement rate in a dose-related fashion. The ED50's for loss of reinforcement were identical (0.07 mg/kg) for both schedules. The findings indicate that QNB may exert rate dependent effects. PMID- 3809221 TI - Environmental specificity of tolerance to morphine-induced analgesia in a terrestrial snail: generalization of the behavioral model of tolerance. AB - Terrestrial snails, Cepaea nemoralis, develop tolerance to morphine-induced analgesia, such that after 7-9 days of treatment with morphine (10 mg/kg) their response latencies to an aversive thermal stimuli (38.5 degrees C) are not significantly different from those of untreated control animals. In Experiment A snails were rendered tolerant to morphine using either of two pre-injection cues (light and dark background brightness or color) and then assessed for morphine induced alterations in thermal nociceptive responses in both environments. In Experiment B snails were made tolerant to morphine in the presence of one of two different thermal cues (a stressful temperature of 35 degrees C that is normally avoided or an ambient temperature of 22 degrees C) and then tested for morphine induced alterations in nociceptive responses in both environments. In the two experiments tolerance to morphine-induced analgesia was displayed when snails were exposed to the pre-injection environmental cue normally associated with the administration of morphine, but not when exposed to the alternative pre-injection cue. These results demonstrate that various environmental factors (background colors or brightness as well as temperature cues and potentially thermal stress), can function as environmental specific cues for the development of tolerance to morphine-induced analgesia in molluscs, in a manner consistent with a behavioral mechanism of tolerance. Thus, these results suggest that environmental specificity of tolerance involving either classical (Pavlovian) conditioning or habituation may be a general phenomenon having an early evolutionary development and broad phylogenetic continuity. PMID- 3809222 TI - Further studies on the dose-dependent stimulus properties of 5-methoxy-N,N dimethyltryptamine. AB - Twenty-two rats were trained to discriminate either 1.5 mg/kg of 5-methoxy-N,N dimethyltryptamine (5-OMe DMT) from saline in a standard two-lever operant procedure. Once responding was stable, various doses of several serotonin (5-HT) antagonists, i.e., cyproheptadine (CYP), methysergide (UML), cinanserin (CIN), and methergoline (MCE), were administered in combination with 5-OMe DMT, to assess the ability of each antagonist to attenuate each 5-OMe DMT-stimulus. The 5 OMe DMT-stimulus at 1.5 mg/kg was completely antagonized by CYP, and was partially attenuated by CIN and MCE. UML had negligible effects on 5-OMe DMT appropriate responding. In the 3.0 mg/kg 5-OMe DMT-trained rats, UML and MCE partially blocked the 5-OMe DMT-stimulus; CYP and CIN had no significant effect on 5-OMe DMT-appropriate responding. The results suggest that until the in vivo effects and mechanism of action of 5-OMe DMT and certain 5-HT antagonists are better understood, caution is advised when conclusions are drawn from studies employing these agents. PMID- 3809223 TI - Clonidine-induced sedation is not modified by single or combined neurochemical lesions of the locus coeruleus, the median and dorsal raphe nuclei. AB - Single or combined neurochemical lesions of the locus coeruleus, the dorsal and the median raphe nuclei were performed on different groups of rats. Starting 10 days after the lesion, the locomotor activity of all rats was measured for 5 min every day in an open-field. For the first 21 days all lesioned rats, independently of the lesion site, were significantly less active than controls, but from the 11th to the 16th day the locomotor activity of lesioned animals increased progressively and, thus on days 15 and 16, the mean activity of all lesioned groups was not significantly different from that of the controls. From the 17th day onwards the sedative effect of small doses of clonidine (5-100 micrograms/kg) was measured. Neither single nor combined lesions modified the response to clonidine and the linear decrease of activity produced by increasing doses of clonidine was the same in all groups, lesioned or not. Biochemical assays showed a marked loss of corresponding amines as a result of the lesions in cortex, hippocampus and the brainstem. These results suggest that the alpha 2 receptors involved in clonidine-induced sedation are located neither on noradrenergic fibers coming from the locus coeruleus, nor on serotoninergic fibers originating in the median and dorsal raphe nuclei. PMID- 3809225 TI - A partial reinforcement extinction effect in water-reinforced rats intermittently treated with haloperidol. AB - Thirsty rats were trained to traverse a straight runway for 30 sec access to water reinforcement. The experiment consisted of daily single trials during a 30 day reinforcement phase followed by 21 days of extinction. Animals that experienced no water reward on 33% of the reinforcement trials subsequently demonstrated an increased resistance to extinction of the runway response compared to continuously reinforced (CRF) animals. This "partial reinforcement extinction effect" (PREE) was also observed in CRF animals pretreated with the neuroleptic drug haloperidol (0.075 or 0.15 mg/kg) on 33% of the reinforcement trials. Thus, periodic dopamine receptor antagonism produced behavioral results comparable to those produced by periodic reward omission. These data cannot easily be accounted for by some form of general drug-induced performance deficit since the extinction trials were conducted in undrugged animals. It was concluded that dopaminergic substrates may play a role in mediating the behavioral effects of water reinforcement. PMID- 3809224 TI - Perioral behaviors induced by cholinesterase inhibitors: a controversial animal model. AB - Perioral behaviors induced by neuroleptic drugs have been interpreted as an animal model of tardive dyskinesia. However, these behaviors have also been induced or enhanced by physostigmine, a cholinesterase inhibitor. The latter result is contradictory to the clinical effect of physostigmine in human tardive dyskinesia. In view of this contradiction and other considerations, perioral behaviors have also been interpreted as a model of acute dystonia. The present experiments replicated an earlier failure to observe spontaneous perioral behaviors after long-term neuroleptic treatment in rats as well as the paradoxical effect of physostigmine. The effect of physostigmine was also compared to phenylmethanesulfonyl fluoride and methanesulfonyl fluoride, irreversible CNS active cholinesterase inhibitors. There were significant differences between the effects of the various cholinesterase inhibitors and their interactions with perioral behaviors and neuroleptic treatment. It is concluded that the effects of cholinesterase inhibitors on perioral behaviors in rodents may not be accounted for entirely by cholinesterase inhibition. Further experiments using additional agonists and antagonists will be required to clarify the behavioral effects of these cholinesterase inhibitors. PMID- 3809226 TI - Chlordiazepoxide and tonic immobility: a paradoxical enhancement. AB - Four experiments were conducted with chickens to examine the effects of chlordiazepoxide on tonic immobility, which has been implicated as an innate fear response. Not only did chlordiazepoxide produce a paradoxical dose-dependent increase in the duration of tonic immobility, but birds treated with chlordiazepoxide showed significantly enhanced shock-termination thresholds. Using two separate tolerance paradigms, the enhancement due to chlordiazepoxide was shown to be independent of the sedative and/or muscle relaxant effects of the drug. These findings have interesting implications for the supposed anxiolytic effects of the benzodiazepines and the relationship between fear and serotonin in avian species. PMID- 3809227 TI - Cigarette filter vent blocking: effects on smoking topography and carbon monoxide exposure. AB - Two studies were conducted using smokers of unventilated cigarettes to determine the effects of filter vent blocking on smoke exposure (Experiment 1) and smoking topography (Experiment 2). In both studies, subjects were exposed to ultra low yield cigarettes that had 0%, 50%, and 100% of their filter vents blocked with tape. In Experiment 1, carbon monoxide (CO) exposure from eight 60 ml puffs increased in an orderly fashion as a function of filter vent blocking. By blocking filter vents, smoke was no longer diluted with air as it passed through the filter, and hence, exposure to smoke constituents was increased. In Experiment 2, when puff and inhalation parameters were allowed to vary, subjects took significantly more puffs, and larger puffs from unblocked cigarettes than from completely blocked cigarettes, but CO exposure from the completely blocked cigarette was double that from the unblocked cigarette (8.96 ppm vs. 4.32 ppm). The increased number and volume of puffs taken from ultra low yield cigarettes with unblocked filter vents may be due to changes in physical characteristics of the cigarette, and not to smokers actively compensating for reduced smoke constituent yields. PMID- 3809228 TI - Continuous pontine cholinergic microinfusion via mini-pump induces sustained alterations in rapid eye movement (REM) sleep. AB - Although there is much evidence that single microinjections of cholinomimetics into the pontine reticular formation (PRF) evokes rapid eye movement sleep (REMS), no study has yet demonstrated whether protracted manipulations of PRF cholinergic levels can produce sustained alteration of this sleep state. In this study, in rats, an indwelling, chronically implanted osmotic mini-pump was used to infuse carbachol, scopolamine, or saline solutions into various brainstem regions or the fourth ventricle for a period of five consecutive days. Throughout the period of pump operation, carbachol infusions chiefly in the PRF produced sustained REMS augmentation primarily during the night cycle, whereas scopolamine produced a sustained decrease in REMS primarily during the day cycle. The findings provide considerable support for a PRF cholinergic hypothesis of REMS generation and regulation and suggest that the alterations in REMS result from a muscarinic receptor mediated change in PRF neuronal activity. PMID- 3809229 TI - Changes in response rates and reinforcement thresholds for intracranial self stimulation during morphine withdrawal. AB - Rats were implanted with stimulating electrodes in the medial forebrain bundle lateral hypothalamus and were trained in an auto-titration brain self-stimulation paradigm. When response rates and reinforcement thresholds were stable, the animals were implanted with subcutaneous osmotic minipumps (Alzet, 2ML1) which continually delivered morphine (1.2 mg/kg/hr as the base, n = 16) or saline (10.0 microliter/hr, n = 11). After one week the pumps were removed, and the animals were again tested in the auto-titration paradigm following the daily administration of either saline (spontaneous withdrawal) or 1.0 mg/kg naloxone (precipitated withdrawal). During the eight-day withdrawal phase there was a decrease in the rate of lever-pressing for the morphine dependent animals and this was greatest on the first day. The magnitude of the decrease was greater in the precipitated withdrawal group than in the spontaneous withdrawal group and an increase in the reinforcement threshold occurred only with precipitated withdrawal. Animals in both groups lost weight when measured each morning, but the precipitated group showed greater weight loss during the day. In addition, animals in the precipitated withdrawal group had diarrhea and showed a higher incidence of withdrawal signs than both the non-dependent (control) and spontaneous withdrawal groups. These experiments provide a detailed account of opiate withdrawal following the continuous subcutaneous infusion of a small dose of morphine for one week. PMID- 3809230 TI - Inherent hyporesponsiveness to methylxanthine-induced behavioral changes associated with supersensitivity to 5'-N-ethylcarboxamidoadenosine (NECA). AB - Two inbred mouse strains, SWR and CBA, differed significantly in their susceptibility to acute dose dependent theophylline- and caffeine-induced stimulation of locomotor activity. The efficacy of both methylxanthines was reduced in the SWR strain compared to the CBA strain. When brain levels of theophylline were determined at a dose (32 mg/kg IP) which gave maximal behavioral separation of the two strains, no significant differences were found between them (SWR levels 12.5 +/- 1.9, CBA levels 14.3 +/- 1.7 micrograms/g wet weight brain). The dose dependent ability of several adenosine agonists (N6 cyclohexyladenosine, (-)-N6-phenylisopropyladenosine, 5'-N ethylcarboxamidoadenosine) to depress locomotor activity was investigated. SWR mice were found to be significantly more sensitive to NECA-induced depression of locomotor activity and the NECA-induced hypothermia than were CBA mice (respective ED50 values for inhibition of activity, 11.6 and 30.5 nmoles/kg IP). No differences were found in brain [3H]-NECA levels at doses which produced marked differences in behavioral effects between the two strains. The differences in adenosine agonist sensitivity between the strains were both agonist- and behavior-specific. These data indicate that an inherited alteration in behavioral responsiveness to methylxanthine administration can be inversely associated with inherent alterations in susceptibility to the action of specific adenosine analogs. An adenosine A-2 receptor sub-class may be involved in these changes in in vivo pharmacological susceptibility to the action of both methylxanthines and adenosine agonists on locomotor activity. PMID- 3809231 TI - Radio-frequency analysis of the effect of haloperidol and cyclo (leucyl-glycyl) on apomorphine-induced stereotypy. AB - Our previous studies indicated that the peptide cyclo(leucyl-glycyl) (cLG) prevents the development of supersensitivity to dopamine in several animal models at both biochemical and behavioral levels. We therefore tested cLG in a paradigm more commonly used to model tardive dyskinesia, namely chronic haloperidol administration to rats. We found that cLG administered subcutaneously at a dose of 8 mg/kg, blocked about 50% of the supersensitizing effects of of haloperidol on apomorphine-induced stereotypic behaviors. Further, we used a novel method, radio-frequency analysis, that quantifies sniffing and other stereotypic movements. Unlike methods that rely on visual observation of stereotypy and utilize an ordinal scale, these measurements are rated by an automatic motility monitor and utilize a ratio scale. Unlike other automated motility monitors, this device can distinguish between various forms of stereotypic behaviors. Since parametric statistics can be used, there is a significant improvement in the efficiency of the task of rating and comparing stereotypy scores. PMID- 3809232 TI - Dietary manipulation of ethanol preference in the Syrian golden hamster. AB - Male Golden Syrian hamsters, in which ethanol preference was previously established, were fed a basal diet supplemented with essential fatty acid-rich oils (increased weekly from 10-160 g/kg diet), cholesterol (10 g/kg diet) or retinol palmitate (100 or 200 mg/kg diet), each in an independent study. Within 4 5 weeks, all three supplements were associated with significantly decreased ethanol preference. No consistent change in the fatty acid composition of liver or brain was associated with the decrease in ethanol preference but, in ethanol fed hamsters, each of the supplements was associated with an increase in total cholesterol and the cholesterol/phospholipid ratio in liver. The essential fatty acid-induced reduction in ethanol preference was not associated with a significant change in blood ethanol elimination rate or time. PMID- 3809233 TI - Dissociation of decreased numbers of muscarinic receptors from tolerance to DFP. AB - Several studies have demonstrated that chronic treatment with organophosphates, such as DFP, elicits a decreased number of brain muscarinic receptors (measured by the binding of QNB) which has been presented as an explanation for tolerance to the organophosphates. The purpose of the studies presented here was to assess whether graded changes in QNB binding could be attained following different methods of chronic DFP treatment, and whether tolerance to DFP paralleled these changes. Male DBA mice were injected with DFP every 4 days or 2 days for 30 days or daily for 14 days. The animals were subsequently challenged with DFP or the muscarinic agonist, oxotremorine, and respiratory rate, heart rate, body temperature, Y-maze activity and rearing were recorded. Chronic DFP-treated animals were supersensitive to the effects of DFP on respiratory rate, heart rate, and body temperature whereas a modest tolerance to the effects of oxotremorine on respiratory rate, heart rate, and body temperature was seen. Neither tolerance nor supersensitivity were observed for the effects of DFP and oxotremorine on the Y-maze measures. Chronic DFP treatment elicited reduced binding of QNB in striatum, cortex, and hippocampus with the group that had been treated every other day exhibiting the greatest changes. The changes in drug response did not parallel changes in QNB binding which raises questions as to the cause of the reduction in binding. PMID- 3809234 TI - Effects of betamethasone on theophylline disposition in man. Are saliva values predictive of serum theophylline levels? AB - The pharmacokinetic interaction between betamethasone (5 mg/day for 5 days) and theophylline (3.35 mg/kg orally before and after betamethasone treatment) was studied in 13 female patients evaluating saliva and serum theophylline concentrations by means of an enzyme multiplied immunoassay technique. Betamethasone treatment did not significantly change saliva and serum theophylline levels. As regards the potential usefulness of saliva theophylline levels in predicting the concomitant serum concentrations of the bronchodilator, in spite of the significant correlation found in our study (r = 0.758; P less than 0.001), we think that, using individual saliva values, there is a poor predictive value for serum theophylline concentrations. PMID- 3809235 TI - Synthesis of alpha-methyl-benzamido-alpha'-substituted styryl cyclohexanone thiosemicarbazones as potential antifertility agents. AB - Cyclohexanone was condensed with N-hydroxymethyl benzamide in conc. sulphuric acid to give alpha-methyl-benzamido-cyclohexanone (I). The reaction of (I) with thiosemicarbazide in ethanol resulted in alpha-methyl-benzamido-cyclohexanone thiosemicarbazone (II). Condensation of (II) with various aromatic aldehydes in the presence of ethanol afforded alpha-methyl-benzamido-alpha'-substituted-styryl cyclohexanone thiosemicarbazones (III) in yields ranging from 40 to 50 percent. The compounds exhibited pronounced antiimplantation activity in female albino rats. PMID- 3809236 TI - Cerebral cholinergic control of rat arterial blood pressure in streptozotocin induced diabetes. AB - Rats were made diabetic with a single intravenous injection of streptozotocin (STZ; 40 mg/Kg). Buffer treated animals were used as controls. Experiments were performed 7 and 14 days thereafter. One week diabetic rats (plasma glucose = 3.34 +/- 0.58 mg/ml), compared with control animals (plasma glucose = 0.94 +/- 0.33 mg/ml), showed higher (P less than 0.05), more prolonged and dose-dependent pressor and bradycardic responses to intracerebroventricular (icv) injection of carbachol (125, 250 and 500 ng), together with a significantly lower bradycardia after icv injection of physostigmine (1.25, 2.5 and 5 mcg). The pressor response to icv injection of physostigmine (1.25 mcg) was significantly reduced in diabetic rats. Pressor and bradycardic responses induced by angiotensin II (100 and 200 ng, icv) did not show any differences between control and diabetic animals, thus ruling out an impairment of peripheral nerve conduction. Diabetic rats exhibited higher content of acetylcholine (Ach) in the striatum (123.8 +/- 3.09 nmoles/g) and in the hypothalamus (45.7 +/- 1.31 nmoles/g). Three weeks diabetic animals (plasma glucose = 2.76 +/- 0.23 mg/ml) had neither different cardiovascular responsiveness to icv injection of muscarinic agonists nor changes in hypothalamus and striatum Ach content. Data strongly suggest that STZ-induced diabetes temporarily alters cerebral acetylcholine control of cardiovascular apparatus. PMID- 3809237 TI - The effects of a long term dihydroergotoxine treatment on agonist and antagonist striatal dopamine binding sites are dose and age related. AB - Chronic administration of dihydroergotoxine, at the two doses of 2.5 mg/kg and 5 mg/kg decreases the binding of dopamine 3H-agonists to striatal membranes. By contrast the binding of dopamine 3H-antagonists is decreased in the animals treated with the higher dose and increased in those treated with the lower one. In old rats, in which a partial loss of both 3H-antagonist and 3H-agonist binding sites is observed, the DHT treatment confirms to increase the binding of 3H antagonists, without affecting that of 3H-agonists. Thus, aging and ergot alkaloids seem to discrimate between DA-agonist and DA-antagonist receptor sites suggesting that this receptors are separate entityes. PMID- 3809238 TI - The use of a microcomputer for non-linear optimisation of doses in external radiotherapy. AB - The study presents software for a microcomputer designed to determine the optimum dose distribution in external radiotherapy, either by calculating the doses delivered and the field width (in linear programming) or, in addition, by calculating the beam geometry (non-linear optimisation). Various optimisation criteria can be selected, namely the homogeneity, the concentration on the target and the total dose in a sensitive area. The article outlines an example. PMID- 3809240 TI - Aluminum equivalence of materials used in diagnostic radiology and its dependence on beam quality. AB - A semi-empirical theory has been derived that relates the aluminum equivalence of various materials used in diagnostic radiology to their attenuation coefficients. The dependence of the aluminum hardness (AHE) and attenuation (AAE) equivalent on the beam quality is described in terms of effective energy. This 'aluminum equivalence approach' (ALEAP) gives estimates of the aluminum equivalent, regardless of spectral shape, that are usually within +/- 5% except when absorption edges are involved. A reasonable definition for the AHE of K-edge filters is offered. Suggestions are made for methods of testing for compliance with standards and regulations. PMID- 3809239 TI - Improved determination of spin density, T1 and T2 from a three-parameter fit to multiple-delay-multiple-echo (MDME) NMR images. AB - A method is presented for simultaneously determining values of relative hydrogen spin density Nr, T1 and T2 from a single set of NMR image intensities acquired in a short imaging time. Present methods use separate acquisitions and data sets to determine all three parameters. In the method presented, multiple-echo data are collected at multiple delays in virtually the same imaging time used to obtain T1 and a T2-weighted Nr from a separate saturation recovery (SR) T1 measurement. All three parameters are then determined by a three-parameter fit of a derived signal intensity equation to these multiple-delay-multiple-echo (MDME) data. This provides an inherent correction of Nr for T1 and T2 weighting without the use of sequences with TD greater than 5T1, and without further data collection for a separate T2 measurement. It also provides an effective reduction in the noise of the separate T2 measurement. A three-parameter fit to MDME data appears to be superior to the separate T1 and T2 measurements currently used to determine all three parameters. Calculations performed on CrCl3 solutions produced T1 values from 21 ms to 3.4 s, T2 values from 6 to 714 ms, and standard errors as low as 0.33%, with a net imaging time of the order of that required for routine low noise signal intensity imaging. The method could potentially be used in NMR spectroscopy to give similar benefits. PMID- 3809241 TI - The development of harmonic distortion in pulsed finite-amplitude ultrasound passing through liver. AB - The progressive development of finite-amplitude distortion of ultrasonic pulses has been investigated in excised bovine liver using pulsed focused ultrasonic beams at nominal frequencies of 2.5 and 3.5 MHz. Both the transducers and the powers used were those which may be encountered with clinical imaging equipment. Significant distortion of the waveform was observed to occur, particularly at higher powers. For example, at 2.5 MHz, with a mean input pressure (p0) of 0.58 MPa, the second harmonic in the pulse spectrum showed a maximum value of 10.5 dB below the fundamental and the highest third harmonic component was 19 dB below the fundamental. These particular observations illustrate that finite-amplitude distortion may be of considerable significance in the transmission through tissue of ultrasonic pulses during diagnostic scanning. PMID- 3809242 TI - Reliability and validity of goniometric measurements at the knee. AB - The purposes of this study were to assess the intertester reliability of goniometric measurements at the knee and the validity of the clinical measurements by comparing them to measurements taken from roentgenograms. Thirty healthy subjects between the ages of 20 and 60 years were studied. The subjects were positioned on their right side on a roentgenographic table with their left lower extremity on a stabilizing board that was elevated 15 cm above the table's surface. For standardization of the position, an assistant placed the posterior aspect of the subject's left thigh in contact with two 15-cm pegs, which had been inserted perpendicularly into the stabilizing board. The assistant then moved the left leg to achieve an arbitrary angle of the knee joint and held the limb in that position. Two physical therapists then independently used a standard plastic goniometer to measure the knee joint angle in the sagittal plane using the greater trochanter, the lateral condyle of the femur, the head of the fibula, and the lateral malleolus as bony landmarks. A roentgenogram was taken of the extremity before the subject was moved. Pearson product-moment correlation coefficients (r's) and intraclass correlation coefficients (ICCs) were used to analyze the data. The data analysis revealed that the intertester reliability (r = .98; ICC = .99) and validity (r = .97-.98; ICC = .98-.99) were high. The results of this study indicate that goniometric measurements of the knee joint are both reliable and valid. PMID- 3809243 TI - Static measurement of tibia vara. Reliability and effect of lower extremity position. AB - The purpose of this study was to examine the reliability of tibia vara measurements and to determine the effects of lower extremity position on such measurements. A manual goniometer was used to measure tibia vara in both lower extremities of 20 healthy subjects while they assumed three different positions: double-limb stance (DLS) with subtalar joint position uncontrolled (Condition 1), DLS with subtalar joint positioned in neutral (Condition 2), and single-limb stance with subtalar joint position uncontrolled (Condition 3). Intraclass correlation coefficients (p less than .05) revealed that tibia vara measurements were reliable both within and between raters with mean absolute differences between repeated measures of 2 to 3 degrees. An analysis of variance and a Newman Keuls post-hoc test (p less than .05) showed that Condition 3 produced the greatest value of tibia vara followed by Conditions 1 and 2, respectively. The results of this study suggest that lower extremity position is an important consideration when measuring tibia vara and determining whether treatment intervention is indicated. PMID- 3809244 TI - Effect of L-tryptophan and phenylalanine on burning pain threshold. AB - The purpose of this study was to determine the effects of ingestion of L tryptophan or phenylalanine on burning pain threshold using a double blind, pretest-posttest control group design. Sixty healthy, female student volunteers were assigned randomly to L-tryptophan, phenylalanine, or placebo groups, (Groups 1-3, respectively). The pretest radiant heat tolerance was determined for all subjects. Burning pain tolerance was defined as the amount of time in seconds from the initial exposure of the left fifth distal phalanx to a 250-W infrared lamp until the subject's detection of an "intense burning sensation." The subjects in Groups 1 and 2 ingested four 500-mg tablets of phenylalanine or L tryptophan a day for 14 days. The placebo group ingested four placebo tablets a day for 14 days. Immediately after the 14th day, the radiant heat pain tolerance of all subjects was remeasured. The results of a one-way analysis of covariance showed no significant difference in the posttest pain tolerance values of the three groups. PMID- 3809245 TI - Interrater reliability of a modified Ashworth scale of muscle spasticity. AB - We undertook this investigation to determine the interrater reliability of manual tests of elbow flexor muscle spasticity graded on a modified Ashworth scale. We each independently graded the elbow flexor muscle spasticity of 30 patients with intracranial lesions. We agreed on 86.7% of our ratings. The Kendall's tau correlation between our grades was .847 (p less than .001). Thus, the relationship between the raters' judgments was significant and the reliability was good. Although the results were limited to the elbow flexor muscle group, we believe them to be positive enough to encourage further trials of the modified Ashworth scale for grading spasticity. PMID- 3809246 TI - Effect of pulsed short wave diathermy on skeletal muscle injury in rabbits. AB - The purpose of this study was to determine whether short wave diathermy (SWD) would enhance healing of a skeletal muscle injury. Thirty-two rabbits were divided into the following four groups: Experimental Group 1 (n = 8), which was given SWD twice daily for 8 consecutive days; Control Group 1 (n = 8), which was followed for 8 days but not given treatment; Experimental Group 2 (n = 8), which was given SWD twice daily for 16 consecutive days; and Control Group 2 (n = 8), which was followed for 16 days but not given treatment. The muscle injury was induced by giving all 32 rabbits three local injections of a myotoxic drug into the right gastrocnemius muscle. After the 8 or 16 days, all muscles were removed, then embedded in paraffin or frozen, sectioned, stained with adenosine triphosphatase or hematoxylin and eosin and examined with a light microscope. No statistically significant differences in the degree of muscle healing were found between the animals in Experimental Group 1 and Control Group 1 and those in Experimental Group 2 and Control Group 2. A trend toward faster resolution of the muscle injury was observed among those rabbits in Experimental Group 2 as compared with those rabbits in Control Group 2. Further study is required to determine whether SWD can be more effective for enhancing recovery from skeletal muscle injury. PMID- 3809247 TI - Limited joint mobility in adults with diabetes mellitus. AB - Limited joint mobility (LJM) has been identified as a manifestation of diabetes in some children; this study assessed whether LJM is a phenomenon that also affects persons with adult-onset diabetes mellitus (DM). For the purpose of this study, I defined LJM as limitation in at least two anatomical areas of the right upper extremity. I studied 19 right-handed men (10 without DM, 9 with adult-onset DM) aged 53 to 70 years. The right upper extremity active range of motion of eight motions was evaluated, as was the ability to flatten the hand fully. Intrarater reliability of the results of testing the ROM of six subjects on three occasions was calculated to have an average intraclass correlation coefficient of .98. Student's t-test results showed that the patients with DM had significantly less (p less than .05) ROM in their fingers and in shoulder abduction than the age-matched controls, suggesting that some adults with DM do have LJM. If the limitations are major, progressive, or symptomatic, physical therapy would be indicated to maintain ROM, to minimize pain, and to help the patient to be functionally independent. The results of this study suggest that physical therapists should be aware of the need to address LJM when treating patients with DM. For prophylactic treatment, patients with DM could be instructed routinely in ROM exercises. PMID- 3809248 TI - Thermoplastic Minerva body jacket--a practical alternative to current methods of cervical spine stabilization. A clinical report. AB - The halo body jacket and plaster Minerva body jacket have been the preferred orthoses when maximal stabilization of the cervical spine is required. This report identifies some disadvantages of these orthoses, introduces the thermoplastic Minerva body jacket (TMBJ), and discusses its advantages in the rehabilitation of patients with cervical spine instability. A preliminary roentgenographic study was conducted to evaluate the cervical spine motion of five male subjects wearing the TMBJ. The TMBJ, in addition to providing comparable cervical spine stability, offers several advantages over current methods of stabilization. PMID- 3809249 TI - Changes in students' perceptions of the professional role. AB - The purposes of this study were to determine whether students' perceptions of the role of the physical therapist and of themselves in that role change during a two year entry-level postbaccalaureate degree program in physical therapy, when these changes occur, and the differences between students' perceptions and those of their faculty members. A semantic differential test was completed by 14 entry level postbaccalaureate degree students five times during the two-year program. Sixteen faculty members completed the same test twice. Perceptions relating to five concepts of the professional role of the physical therapist and to five concepts relating to self in that role were assessed. Kendall's coefficient of concordance revealed no significant change in the students' perceptions of the role of the physical therapist, but it did reveal a significant change in one of the five concepts relating to their perceptions of themselves in that role (p less than .05). A Mann-Whitney U test revealed significant differences between the students' and faculty members' perceptions for 5 of the 10 concepts. Results of the study provide information about the professional socialization of physical therapy students. PMID- 3809250 TI - Survey of curriculum content related to geriatrics in physical therapy education programs. AB - We investigated the current status of the education of physical therapy students regarding elderly individuals. Data were collected through a questionnaire mailed to the directors of 101 accredited physical therapy education programs; the rate of return was 79%. Nearly all of the program directors (96%) affirmed a need to focus on the care of elderly individuals in their curricula. Currently, 92% of the programs teach aging-related material in six different course areas. The most frequently cited course area was professional physical therapy practice, followed by the behavioral-social sciences. Content on aging was incorporated primarily as parts of required courses, averaged 3 credits (representing 10-15 clock hours of study), and was taught primarily through didactic methods. The main obstacle to offering aging-related courses was a full curriculum. The results of our survey suggest that selective changes are needed, including additional course content that would enrich current education and provide physical therapy students with expanded capabilities to meet the health care needs of the elderly population. PMID- 3809252 TI - Moire measurements. PMID- 3809251 TI - Cost of clinical instructors' time in clinical education--physical therapy students. AB - The purpose of this study was to estimate the total clinical instructor time required to conduct the clinical education program of our physical therapy school. Clinical instructors in 12 of the 29 regional health care facilities providing clinical education programs described, through questionnaires and interviews, the instructional activities in their programs and the number of hours a week required for each activity. For each activity, the instructors indicated whether it served educational purposes only (a single purpose activity) or patient care and research purposes as well (a joint purpose activity), and they estimated the time that they spent with the student (direct contact time). The sample data were used to estimate the annual requirement for clinical instructor time for the physical therapy clinical program, totaling 10,264 hours. The methodology and the findings of this study can assist governmental agencies, educational institutions, and clinical facilities to define policy and funding agreements for clinical training purposes. PMID- 3809253 TI - The photophysical properties of porphycenes: potential photodynamic therapy agents. PMID- 3809254 TI - Endogenous glutathione protects human skin fibroblasts against the cytotoxic action of UVB, UVA and near-visible radiations. PMID- 3809255 TI - Interactions between DNA and psoralenamines studied with dichroism techniques. PMID- 3809256 TI - The effects of porphyrin structure and aggregation state on photosensitized processes in aqueous and micellar media. PMID- 3809257 TI - Analytical model of phototherapy for neonatal jaundice--I. The initial Z-E transient. PMID- 3809258 TI - Non-invasive technique for obtaining fluorescence excitation and emission spectra in vivo. PMID- 3809259 TI - Noninvasive tumor volume measurement using magnetic resonance (MR) imaging and an open sided saddle coil. AB - A magnetic resonance (MR) imaging scanner operated at 0.5 T with a specially constructed receiving coil was used to measure volumes of primary spontaneous tumors in rats and guinea pigs. The coil was used to improve the signal to noise ratio (S/N) of the MR images of tumors in these small animals. The tumor volume was determined by the summation of the volume of contiguous slices or ellipsoid approximation. The accuracy of the volume measurement was better when the numerical integration was used in calculating the slice volume. The open sided saddle (OSS) coil used as the receiving coil gave better S/N than that of the standard head coil. PMID- 3809260 TI - A new theory of the water contents of living cells in solutions containing different concentrations of permeant solutes. PMID- 3809261 TI - Disruption of the plasma membrane leads to an influx of Na+ and Cl- but not an efflux of K+ in mouse hepatocytes and erythrocytes. AB - To determine what mechanisms might be involved in the maintenance of the known extra-/intracellular concentration gradients of Na+, Cl- and K+, small pieces of mouse liver and heparinized blood were appropriately cryofixed. The tissues were cryosectioned and cryosorbed at -100 degrees C or at -40 degrees C. The former temperature prevented diffusion of all ions as measured by electron probe x-ray microanalysis of the thin (0.1 micron) cryosorbed sections of the cells while the latter temperature allowed significant diffusion of Na+ and Cl- into the hepatocytes and erythrocytes but did not allow diffusion of K+ from the hepatocytes or the erythrocytes. These results indicate that the plasma membrane is involved in maintenance of the extra-/intracellular gradients of Na+ and Cl- but that intracellular association of K+ with macromolecules is the main mechanism responsible for maintenance of the extra-/intracellular K+ concentration gradient. PMID- 3809262 TI - Oxygen-17 relaxation times in the blood sera of rats with various cancers. Can a systemic effect be detected? AB - 17O NMR relaxation times of water in the serum of rats with various cancers were measured. No systemic effect could be detected at 4.7 and 8.4 T. The serum T1(17O) value was 7.6 +/- 0.5 ms at 37 degrees C independent of the magnetic field. T2(17O) was approximately half T1(17O). The 17O relaxation times could be determined at a faster rate than the 1H relaxation times. PMID- 3809263 TI - A critical examination of the bioplasma hypothesis. AB - The hypothesis of Zon (Physiol. Chem. and Physics 11, 501-506 (1979); 12, 357-364 (1980] that regions of semiconduction within living organisms may exhibit plasma behaviour is shown to be most unlikely. Although charge carrier concentrations may be acceptable, calculated Debye lengths are shown to be only marginally acceptable and calculated plasma frequencies are not sufficiently high to ensure that charge carrier motions are governed by electrical and magnetic forces rather than hydrodynamic considerations. For the latter reason, conventional semiconductors do not exhibit plasma behaviour except close to absolute zero and if they are free from impurities and lattice disorder. The experimental evidences presented for the existence of biological plasma (bioplasma) from the areas of Kirlian photography, mitogenetic radiation, acupuncture and studies of biological fields, are largely explainable in conventional terms without invoking the existence of biological plasma. PMID- 3809264 TI - Lymphatic drainage in patients after replantation of extremities. AB - Lymph drainage was studied by means of lymph scintigraphy in eight patients in whom successful replantation of a totally or subtotally amputated extremity had been performed. Scintigrams were made after subcutaneous injection of technetium 99m in the replanted part of the patient and the contralateral, normal extremity. In all scintigrams, axillary or inguinal lymph node activity is seen, implying drainage of lymph by means of the lymph vessels. Retention of colloid in the replanted part (79 to 94 percent) shows no significant difference with the contralateral, normal side (86 to 94 percent). Unquestionable evidence of regeneration of lymphatics in humans is delivered in the three patients, in whom lymph node activity and normal retention percentages are seen on the scintigrams after total amputation of an extremity followed by replantation without anastomosing of interrupted lymph vessels. PMID- 3809265 TI - Primary neoplasms of the facial nerve. AB - A series of 30 primary facial nerve tumors is reviewed. Most of them were benign (n = 26); there were four malignant tumors. Neoplasms originating within the temporal bone were found to have preoperative facial paralysis in 84 percent of cases; the extracranial tumors had a 35 percent incidence of preoperative facial paralysis. All tumors in this series were treated surgically--by means of a middle fossa or transmastoid approach for the intratemporal group of tumors; the extracranial tumors were removed by the technique of parotid tumor surgery with complete facial nerve dissection. All the patients with preoperative facial weakness required facial nerve transection. Facial paralysis was rehabilitated with nerve grafts, hypoglossal crossover, or muscle transfers. Because "normal" facial expression is still not attainable following repair of complete facial nerve transection, an early diagnosis, hopefully prior to total neurotmesis, is essential. All patients with unexplained facial weakness, especially that which is progressive and persistent, should have the entire course of the facial nerve investigated for the possibility of treatable etiology. PMID- 3809266 TI - The office treatment of tattoos: a simple and effective method. AB - A simplified method for the treatment of tattoos is described. The method is based on an older method called the "French method" known to tattoo artists. The treatment consists of superficial dermabrasion of the skin followed by application of a tannic acid solution which is then "rubbed" into the skin by the dermabrasion wheel. The treatment site is then "painted" with a silver nitrate stick. A heavy eschar forms which separates in approximately 2 to 3 weeks. The method incorporates the use of equipment that is present in the usual plastic surgical office. The method has produced excellent improvement in tattoos, with obliteration of the tattoo in the majority of cases. This report covers 85 patients with 207 tattoos treated over an 11-year period. The method is presented as a treatment of tattoos that are too large for simple excision. Details of the treatment are presented. PMID- 3809267 TI - Breast augmentation using the expander mammary prosthesis. AB - The expandable mammary prosthesis that has been successfully used for breast reconstruction has been modified for breast augmentation procedures. A new microreservoir that can be buried subcutaneously for extended periods has been developed. The unique design of this implant allows its size to be adjusted postoperatively as many times as desired, thus eliminating the possibility of a second operation to replace an implant whose size is unsatisfactory. Accurate, aesthetically satisfactory results are possible because the volume adjustments are made after the swelling has decreased and the implant has settled into position. Almost all patients offered this opportunity requested postoperative volume adjustments. The results of 59 patients are reported. The surgery was performed over a 3-year period, with the average follow-up time being 6 months. The incidence of capsular contracture has been less than 10 percent. Leakage was a problem in the original implant design; however, since the introduction of the new valve, there has been no leakage to date. PMID- 3809268 TI - Combined transplantation of free tissues. AB - Combined transplantation of free tissues is a new microsurgical technique by which, with only one set of vessels supplying blood, two or more free tissues can be transplanted simultaneously. Very large soft-tissue defects that are not amenable to conventional transplantation, or defects of two or more tissues, either similar or different in nature, can be repaired in a one-stage operation. It is accomplished by vascular combination; i.e., by means of anastomosing the corresponding vessels of their pedicle, the free tissues to be transplanted are reconstituted into an assembly with only one common vascular pedicle which is then rejoined to the vessels selected to supply blood to the grafts in the recipient site. From December of 1983 to July of 1985, the author has performed 17 combined free-tissue transplantations of seven different clinical types for microsurgical repair and reconstruction of extremities. All the transplanted parts survived, and the extremities regained very good function. Seven patients are reported individually in the paper, each representing a definite clinical type. The concepts and operative technique introduced and the indications and advantages of the newly designed procedure are discussed. PMID- 3809269 TI - Classification of the main tenodesis techniques used in hand surgery. AB - The authors put forward a simple classification of the main types of tenodesis used in hand surgery. This classification is based on the theoretical mechanical effects of different tenodesis techniques. It separates simple tenodesis, which overrides only one joint, from dynamic tenodesis, which crosses two or more joints, and further subdivides "direct" and "crossed" dynamic tenodesis. Direct tenodesis is situated on the same side as the rotation axis of the joints, whereas crossed tenodesis crosses those rotation axes. The concept of "reciprocal" tenodesis effect is also introduced. Many different examples are used to illustrate this classification, with appropriate illustrations. PMID- 3809270 TI - The venous skin graft method for repairing skin defects of the fingers. AB - A venous skin graft for the treatment of skin defects in a finger is described. This procedure involves taking a flap from the forearm together with the subcutaneous vein and anastomosing both ends of this vein to the digital artery and vein, respectively. Thirteen difficult finger wounds were resurfaced with such a venous skin graft. The sizes of the flaps ranged from 1.3 X 3.0 cm to 2 X 5 cm. The lengths of the veins taken were from 6 to 12 cm. Subcutaneous fat is thin, and there is good elasticity in the grafted flap. PMID- 3809271 TI - Treatment of preaxial polydactyly of the foot. AB - Fourteen patients with preaxial polydactyly are classified into four types according to their morphologic configuration: type 1--ray duplication; type 2- completely duplicated phalanges; type 3--incompletely duplicated metatarsals; and type 4--incompletely duplicated phalanges. The surgical treatment and timing thereof appropriate for each group are discussed. Three cases of congenital hallux varus deformity are analyzed, focusing on the pathomechanism of this disorder. Based on our experience, two main factors are noticed in the etiology of congenital hallux varus deformity: inadequacy of the adductor hallucis and tightening of the fibrous band pulling the big toe into the varus. PMID- 3809272 TI - Midfacial duplication: a rare malformation sequence. AB - A child with duplicate maxilla is presented, along with a review of the literature of similar cases. Partial duplications of the maxilla are frequently accompanied by cleft lip and palate, multiple uvulae, hypertelorbitism, and intracranial anomalies with hydrocephalus. Theories of the morphopathogenesis for this malformation sequence are discussed. PMID- 3809273 TI - Epidermal cyst originating from the preauricular sinus. AB - Epidermal cysts are the benign tumors which are found in various regions. We experienced a rare case in which the preauricular sinus was the origin of the epidermal cyst. PMID- 3809274 TI - Cosmetic breast augmentation utilizing autologous fat and liposuction techniques. AB - I have presented a new technique of autologous fat transplantation which utilizes fat obtained by liposuction. I believe that this technique will have wide application in the future of cosmetic and reconstructive surgery. PMID- 3809275 TI - Staged use of soft-tissue expansion and lower thoracic advancement flap in breast reconstruction. AB - A single patient is presented in whom breast reconstruction after mastectomy for breast cancer has been achieved by sequential use of soft-tissue expansion followed by permanent silicone implant placement and thoracic flap advancement to define the inframammary fold. This procedure may play a useful role in patients in whom other, more complex methods of breast reconstruction are not selected or indicated and in particular in patients in whom bilateral silicone implants are utilized. PMID- 3809276 TI - The expert teaching system: a new method for learning rhinoplasty using interactive computer graphics. AB - We have developed software that employs interactive computer graphics to simulate the surgical experience of rhinoplasty by allowing the surgeon to experiment within a model of nasal behavior. For any of three preoperative noses, the surgeon can choose and see the effects of dorsal resection, modification of nasal spine or caudal septum, alar cartilage resection, osteotomy, alar wedge resection, and a variety of nasal grafts. The available choices and views total nearly 3000 images, or approximately 200 different surgical solutions. The surgeon can get textual analysis at any time or see accelerated healing to the projected nasal appearance at 1 year. We believe that the ability to experiment without risk, to safely learn the biological laws governing nasal behavior, should augment the development of surgical judgement in rhinoplasty. PMID- 3809277 TI - A suspensory jacket permitting long-term sitting in paraplegic patients. AB - A thoracic suspensory jacket has been used in four patients with recurring ischial pressure sores to transfer the site of skin pressure from the insensate ischial area to the sensory area over the rib cage. This modality is not an alternative to surgery, but rather an adjunct to prevent an early recurrence after an ischial pressure sore has been repaired with a proper surgical procedure. PMID- 3809278 TI - Arteriovenous malformation following rhinoplasty. PMID- 3809279 TI - The use of intradermal tattoo to enhance the final result of nipple-areola reconstruction. PMID- 3809280 TI - External cranioplasty. PMID- 3809281 TI - Rejection with a vengeance. PMID- 3809282 TI - Continuous irrigation of the breast. PMID- 3809283 TI - Fat transplantation. PMID- 3809284 TI - Wire mesh for cranial vault reconstruction. PMID- 3809285 TI - Need for plastic surgeons in Northern Luzon. PMID- 3809286 TI - Closure of orocutaneous and pharyngocutaneous fistulas. PMID- 3809287 TI - The dream must not fade. PMID- 3809288 TI - Leeches. PMID- 3809289 TI - Temporal vertical flap. PMID- 3809290 TI - Preoperative computerized video imaging. PMID- 3809291 TI - Tendon substitute for psychomotor skill laboratory training. PMID- 3809292 TI - A simple device for dynamic traction in tendon injuries. PMID- 3809293 TI - Abdominoplasty and combined procedure. PMID- 3809294 TI - Reconstructing the columella with nasolabial flaps. PMID- 3809295 TI - [A study on stealing by 6 patients with anorexia nervosa]. PMID- 3809296 TI - [Transplantation of hippocampal anlagen into the cerebella of adult rats]. PMID- 3809297 TI - [Therapeutic aspects of "silence" between therapists and schizophrenics- phenomenological psychotherapy]. PMID- 3809298 TI - [Biographic diagnosis--a critical review]. AB - Within the framework of clinical psychology and stress research biographic diagnosis is becoming more and more important. In addition to classical anamnesis, the virtues and limitations of so-called biographic questionnaires and life-event inventories, the chief methods of biographic diagnosis, have been discussed for several years. Following a brief evaluation of anamnesis and biographic questionnaires, the author derives conclusions, based on a method critical analysis of life-event research, for the arrangement of such life-event inventories. PMID- 3809299 TI - [Aspects of process diagnosis in the psychotherapy of psychosomatic diseases]. AB - 15 patients with psychosomatic diseases and the phenomenon of alexithymia, together with neurotic patients are treated psychotherapeutically in half-open groups. Contrary to the neurotics the patients show some special features regarding the process diagnostics. In assessing the wished and really experienced nearness to the group members there is a deficient ability to differentiate. During the therapeutic process the intrapsychic tension (EMI - Inventory of Emotionalities) is subject to great fluctuations or doesn't change. The occurrence of fluctuations in the EMI and of greater differentiations in the N-D Test (Nearness-Distance-Test) suggest a good prognosis. A therapy of psychosomatic patients together with neurotic patients seems to be more effective than the treatment in homogeneous groups. PMID- 3809300 TI - [Treatment of atypical and neurotic depression]. AB - Hitherto it has not been usual to talk in the German language about the therapy oriented concept of two forms of the progress of atypical depression (Type A and Type V). The characteristic symptom of Type A is angst, together with phobias, physical complaints, etc. In Type V there are vegetative symptoms, often towards evening (Hypersomnia, difficulty in getting to sleep, increased appetite, increased weight, increased libido), accompanied by hysterical extrovert personality traits, and of intermittent occurrence. These clinical pictures are amenable to psychopharmalogical therapy. In conformity with the assumption of "somatic accommodation" treatment with antidepressives is recommended in the case neurotic depression, too, at least in the initial stages of treatment. PMID- 3809301 TI - [Subjective quality of life of surgically treated glioma patients undergoing polychemotherapy]. AB - 25 patients with glioma were questioned as to how they apprehended and appreciated their state of health and their psychosocial situation 1 1/2 years (s = 4 months) after the start of their postoperative polychemotherapy. In their opinion, their health was relatively good, that is, they claimed to suffer little pain, few complaints, little feeling of inadequacy, few fears for the future. They regarded the mode of treatment as being somewhat more inconvenient. Such an unexpectedly positive response, in view of the poor prospect, raises the question as to its provenance. A significant cause is seen in the organic psycho-syndrome, and its significance is made the subject of the concluding discussion, with reference to adaptation mechanisms and specifics of the illness. PMID- 3809302 TI - [Description of neurocutaneous melanoblastosis]. AB - Description of a rare case of neurocutaneous Melanoblastosis. In a 25 year-old man there was an extraordinary massiveness of the tumor in the field of the cerebrospinal soft membranes. Tumor cells, relevant for diagnosis, from lumbal and suboccipital liquor could be shown. Nomenclature and pathogenesis of the disease are discussed. PMID- 3809303 TI - [Use of metoclopramide in the treatment of alcohol withdrawal syndrome]. PMID- 3809304 TI - [Measuring reaction times in healthy probands before and following a single dose of psychotropic drugs]. AB - A single dose of Clomipramin, 50 mg; Amitriptylin, 50 mg; Desipramin, 50 mg; Imipramin, 50 mg; Diazepam, 10 mg; Carbamazepin, 200 mg; Haloperidol, 3 mg; were each administered orally, and Clomipramin, 25 mg was administered intravenously, and reaction times were measured and compared with those obtained after administering a placebo. The statistical examination was conducted using Wilcoxon's test. In the case of Amitriptylin, Diazepam, and Haloperidol, there was a statistically significant reduction in the reaction times. PMID- 3809305 TI - [Schizophrenia-like syndromes in the light of the psychopathologic analysis of 1159 cases of acute schizophrenic psychoses]. PMID- 3809306 TI - [Changes in the plasma chlorpromazine level in relation to drug dosage]. PMID- 3809307 TI - [Clinical and environmental determinants of suicide in affective disorder]. PMID- 3809308 TI - [Use of the MMPI-Wiskad test for the examination of drug-dependent persons: comparative analysis of women and men]. PMID- 3809309 TI - [Intellectual efficiency of alcohol-dependent persons kept in detention]. PMID- 3809311 TI - [A case of narcotic dependence treated by atropine coma]. PMID- 3809310 TI - [Intellectual efficiency of alcohol-dependent adolescents and adults kept in detention]. PMID- 3809312 TI - [Psychiatric emergency care and crisis intervention--concepts, experiences and results]. AB - Psychiatric emergencies and life crises are located at opposite ends of a broad scale of stages requiring acute help: Emergency cases need immediate medical care in order to prevent danger to life. For the same reason, immediate hospital admission and additional treatment of risks of internal medicine have to be provided, if necessary. Crises often have not only mental but also social aspects. The immediate urgency of treatment is determined by the psychiatric (suicidal) or the physical risk. Emergency cases and severe crises require a 24 hour medical service. Social aspects cannot be settled in the night-time, even if they are urgent. Emergency and crisis intervention services with a multidisciplinary staff therefore ascribe different roles to physicians, nurses and social workers. Since 1976, the Central Institute of Mental Health provides a 24-hour crisis intervention and emergency service both at the Institute and at the emergency ward of the Mannheim University General Hospital. Within few years, the number of treated episodes has increased to 1,800-1,900 per year. The distance between the place of work or residence is a decisive factor of service utilization. Over 50% of the users of the emergency and crisis intervention service are mentally ill. Only a small part are contacts for crises without psychiatric disorder. Suicidal attempts or intentions account for about 30% of the service users, marriage crises for about 25% and alcohol problems also for about 25%. The development of complementary care in Mannheim has led to a parallel increase in the proportion of chronically mentally ill living in complementary facilities. This clearly indicates that a 24-hour emergency and crisis intervention service is a compulsory prerequisite for the implementation of an efficient system of complementary care for the mentally ill. PMID- 3809313 TI - [A hospital unit for psychiatric crisis intervention 5 years later]. AB - On 7 January 1981 a special ward for crisis intervention and emergency psychiatric cases went on stream at the Max Planck Institute of Psychiatry in Munich. The article reports on the development of this ward between 1981 and 1985. First of all, a brief outline of the structure of the ward is given explaining indications and contraindications for acceptance and the treatment concept. This is followed by statistical evaluation of 1981 to 1985 data in respect of number of admissions and readmissions, duration of stay, percentage distribution of the referring institutions, age distribution, distribution of diagnosis, rates of attempted and committed suicides and onward referral to other institutions for further treatment. Finally, the article reviews changes in the basis concept of therapy and in the style of communication and behaviour within the therapeutic team, besides commenting on unfavourable conditions. PMID- 3809314 TI - [Comparison of the main diagnostic groups at a crisis intervention center]. AB - With the present investigation of clients (admissions in 1980) of a psychiatric crisis intervention center we intended generally a description of the population and especially a characterization of the diagnostical group "psychogenic reaction" (ICD No. 309/308). That diagnostical group differs in many signs significantly from the group of alcohol and drug addicts (ICD No. 303/304). Differences to other diagnostical groups (like neurosis, personality disorders e.g., ICD-No. 300, 301, 306) we elaborated only for some factors. Predominantly we worked with a self-made open questionnaire and an objectivated test (FAPK = Questionnaire for psychosomatic disorders). As main conflict constellations of the patients we noticed personal and social isolation and relationship disorders. Our results in crisis provoking situations are in accordance with those of the life-event-research. The therapeutical consequences are discussed. PMID- 3809315 TI - [Risk of suicide in the psychiatric clinic in relation to compulsory security guarantees and freedom as adjunct to therapy]. AB - Whereas doctors and nurses in a psychiatric hospital are compelled, on the one hand, to prevent a mental patient from committing suicide (which may entail quite considerable restriction of freedom of movement and action), they may find it necessary on the other hand to grant him a certain amount of freedom as an adjuvant to therapy. It has been said that one may well fear that the compulsion to prevent suicide completely over rules therapy as such, and hence that official legislation is an obstacle to full utilisation of existing chances of cure, since it requires doctors and nurses to prevent suicide as the first and foremost consideration. This fear, however, is unfounded. Rather, the psychiatrist is called upon to weight the suicide risk against the chances of cure under less strict supervision in individual cases that appear suitable for following such a procedure. This conclusion is based on legal theoretical deliberations and is in line with judgements pronounced by Federal German Supreme Courts. PMID- 3809316 TI - [Role of genetic factors in suicide. Discussion based on 4 studies in an epidemiologically closed area (Salzburg Federal District, Austria)]. AB - The question of what role genetic factors have in the transmission of suicidal behaviour, in particular suicide itself, is discussed on the basis of four studies of an epidemiologically clearly defined region (the Bundesland Salzburg). The high percentage of suicide positive family histories as compared to the literature are due to exceptionally good sources of information. It could be shown that in suicide cases which were also suffering from endogenous depression, both endogenous psychoses and suicides appeared to a greater extent in their families. In contrast to current assumptions, however, the suicide disposition is not just found in those with endogenous psychoses, but shows a separate genetic determination. The author concludes, without wanting to generalize prematurely, that the genetic factor in suicide research and in the evaluation of suicidality equally be respected as are psychodynamic and sociodynamic factors. PMID- 3809318 TI - The phenomenology of recovery in a chronic schizophrenic. PMID- 3809317 TI - [How voluntary can treatment of adolescent patients with anorexia nervosa be?]. AB - Patients with anorexia nervosa often refuse therapy and deny their organic and psychological state of disease. In doing so they are often supported by their parents who as well assume an ambivalent attitude towards therapy. If the family still refuses assenting to therapy after having been confronted with the severe consequences of this disease, the therapist has to decide by himself whether he initiates inpatient treatment even against the patient's will - so far as his life is in danger. According to Crisp (1980) anorectic patients have the right to intense and even compulsory treatment, as their refusal has to seen as part of their psychopathology. In 5 out of 85 inpatients we started therapy against the patients' and partly even the parents' will. All these cases had a prehistory of several therapy attempts and dropouts. Despite our compulsory measures it was possible to enter into an alliance with the patient and to initiate a positive course of illness. In any case, compulsory treatment has to be carefully considered. None the less, if the patient is in a life-threatening condition the therapist has to be aware of his responsibility without expecting therapy motivation from patients who are not able to meat this expectation because of their somatic and psychological symptomatology. PMID- 3809319 TI - Hypnotic interview and age regression procedures in the elicitation of multiple personality symptoms: a simulation study. AB - Patients diagnosed as suffering from multiple personality (i.e., multiples) behave as though they possess two or more distinct personal identities. When behaving as one identity, these patients often display signs of amnesia for events that occurred while they were behaving as a different identity (Sutcliffe and Jones 1962; Taylor and Martin 1944). In most theoretical accounts multiples are conceptualized as the passive victims of unconscious psychological processes that are beyond their sphere of control. For instance, patients' secondary identities are typically described as "dissociated" mental entities, as "taking over" behavioral control, as behaving independently of (and often in opposition to) patients' wishes and intentions, and so on (Allison and Schwarz 1980; Gruenewald 1984; Prince 1930; Watkins and Johnson 1982). Our paper criticizes this traditional account and suggests instead that multiple personality may be more usefully conceptualized as a social role enactment. Along these lines we present a study using college student role players as subjects to test the hypothesis that the kinds of clinical interview procedures employed routinely to diagnose multiple personality may instead encourage and legitimate enactments of this syndrome. PMID- 3809320 TI - Psychodynamics of perinatal loss. AB - Medical and mental health professionals have been slow to recognize and treat the often traumatic impact of perinatal death. It has only been within the past ten years that researchers have begun to appreciate that a miscarriage, stillbirth or neonatal death can be a devastating loss to the parent, especially the mother (Berezin 1982; Borg and Lasker 1981; Friedman and Gladstein 1982; Peppers and Knapp 1980a). Bereaved mothers mourn pregnancy loss through the grieving process, which includes denial, yearning and despair, usually followed by recovery. Typical maternal reactions during the first months of grief are shock, disbelief, sleeplessness, irritability, crying, sadness, rage, anxiety, somatic distress and sometimes hallucinatory experience of the dead baby (Dunlop 1979; Giles 1970; Kennell et al. 1970; Kirkley-Best and Kellner 1982; Peppers and Knapp 1980b). This paper will explore the impact of perinatal death on the psychological resolution of pregnancy. In order to evaluate the outcome of maternal bereavement, the meanings of the perinatal death in the context of the revived conflicts and identifications occurring in the pregnancy will be considered. After presenting key concepts in the psychoanalytic interpretation of pregnancy, I will discuss the unique aspects of perinatal loss. A clinical case will then be described in some detail to illustrate an adaptive resolution of perinatal loss. PMID- 3809321 TI - The role of the unit chief: an integrated perspective. AB - The practice of modern hospital psychiatry has led to a dramatic increase in the complexity of the role of the unit chief. Although there is a large literature on leadership functions in general, the specific and unique tasks of this role have not been delineated. In this paper, four interrelated tasks of the unit chief are described: boundary management, generation of resources, the mobilization of consensus, and consultation and evaluation. These tasks are divided into functions that address organizational and human needs and are linked with prerequisite psychological valences which enhance their implementation. Examples are designed to demonstrate functional and dysfunctional consequences of the four tasks. PMID- 3809322 TI - Group psychotherapy in an acute inpatient setting. AB - The literature on inpatient group psychotherapy reveals an emphasis on here-and now structured group activity as opposed to in-depth psychodynamic work. Historical material is rarely accessed and therapeutic strategies are focused on interpersonal work within the group. In this paper, groups currently operating in an acute psychiatric setting are described, and problems and practicalities in establishing inpatient groups are discussed. PMID- 3809323 TI - Relationship of platelet MAO activity to characteristics of major depressive illness. AB - Sixty-seven patients (greater than or equal to 55 years of age) with major depressive disorder had pretreatment assays of platelet monoamine oxidase (MAO) activity. As in previous studies, women had higher MAO activity than men, and MAO activity was positively correlated with age. Patients with melancholia (DSM-III) had significantly higher MAO activity than those without melancholia. This finding may reflect the higher MAO activity associated with the symptoms of anhedonia and mood autonomy. Anxiety also was correlated with higher MAO activity, as was a positive family history of depression. In addition, postdexamethasone cortisol levels were correlated with platelet MAO activity. PMID- 3809324 TI - 3H-imipramine binding in depressed elderly: relationship to family history and clinical response. AB - Platelet 3H-imipramine binding (Bmax) was determined in 34 elderly (mean age 64.8) unipolar depressed outpatients who were being treated with either nortriptyline or interpersonal psychotherapy for 10 to 16 weeks, and in nondepressed elderly controls. Bmax values were decreased in the depressed group. In addition, Bmax values were depressed further in subjects with a history of depression in first degree relatives. Good clinical response with either nortriptyline or psychotherapy was associated with lower Bmax compared to those subjects who had a poorer response to treatment. Treatment nonresponders and those with a negative family history of depression had Bmax values that were somewhat decreased but not significantly different from controls. This study extends to the elderly the potential applicability of platelet 3H-imipramine binding as a marker of depressive illness, and proposes a predictor for treatment response in elderly unipolar depressed patients. PMID- 3809325 TI - A psychophysiological study of insomnia. AB - Ten insomniacs with age- and sex-matched controls had studies of baseline sleep, relation of polygraphically defined sleep to retrospective reports, and arousal thresholds to electronic tones or to a recording of a voice calling out the subject's name. The two groups differed in 10 out of 13 questions about habitual sleep and daytime feelings. In contrast, polygraphic measures of baseline sleep indicated only that insomniacs tended to have slightly less total sleep and had a small but significant increase in early morning awakening time. Unlike the descriptions of habitual sleep, the subjects' retrospective reports of the previous night's sleep differed significantly only for the variable of total sleep time, and there were virtually no differences in the description of their status at a given moment. Auditory arousal thresholds were similar in the two groups, and both went back to sleep and stayed asleep with equal facility. These findings suggest that subjectively poor sleep is not necessarily "light" sleep. For both groups, arousal thresholds differed across the sleep stages, and thresholds to hearing the subject's name were lower than those in response to electronic tones. Although insomniacs had as much polygraphically defined sleep as controls between the forced awakenings of the arousal threshold studies, they perceived their sleep to be only approximately half as long. Insomniacs described themselves as having been awake more frequently than controls in 8 out of 10 forced awakening situations. In one case, insomniacs also overestimated the time between awakenings. In both groups, there was little relationship between reported habitual aspects of sleep and baseline polygraphically defined sleep variables. On questionnaires the following mornings, however, in both groups there was a positive correlation of subjective quality of sleep on the baseline nights with percentage of rapid eye movement sleep, and a negative correlation to various aspects of slow-wave sleep. PMID- 3809326 TI - The stability of diagnosis with an application to bipolar II disorder. AB - A temporal stability study (where independent diagnostic interviews are conducted at widely separated time points) is discussed and compared to a test/retest reliability study. We introduce a new battery of statistics, based on the sensitivity, specificity, and true base rate of a disorder, that quantifies either reliability or stability over time, and provide a table that relates these underlying parameters to the opening characteristics of the battery. We analyze data on 50 relatives who participated in the family study component of the National Institute of Mental Health's collaborative "Psychobiology Depression Program." The subjects received an interview 5 years after their initial evaluation by raters without knowledge of the initial assessment. The stability of mania, hypomania, major depression, and alcoholism is considered. Although the kappa coefficient for hypomania was small (0.09), all diagnoses of hypomania in the relatives occurred in the families of bipolar probands, suggesting that the low value of kappa is due to a low sensitivity rather than to a low specificity. This is compatible with earlier findings and demonstrates the value of multiple independent assessments when studying this disorder. PMID- 3809327 TI - Relationship of awakening and delta sleep in depression. AB - It has been demonstrated that deficiencies in slow-wave sleep occur in the sleep profiles of depressed patients. Recent theories of sleep regulation link a deficiency in the so-called "Process S" to these slow-wave sleep alterations. However, the degree of wakening during sleep has been suggested as the explanation for reduced slow-wave sleep. In the present study, the extent of this relationship was examined in both depressed patients and normal subjects. Only a relatively low level of correlation between the degree of wakening and reduction in slow-wave sleep was noted in depressed patients. This finding on 38 unipolar depressed patients is similar to the findings on a smaller sample of depressed individuals. PMID- 3809328 TI - CSF dopamine levels correlate with extraversion in depressed patients. AB - Cerebrospinal fluid (CSF) dopamine levels were studied in 16 male patients who also were tested for self-reported extraversion using the Eysenck Personality Inventory. Log CSF dopamine was significantly correlated with extraversion as predicted by recent theoretical work integrating mesolimbic dopamine function and active responding to external incentives as psychobiological traits. CSF dopamine levels were uncorrelated with the total score on the Hamilton Rating Scale for Depression, self-reported neuroticism, and age. The results are discussed in relation to other biological models of extraversion such as the construct of sensation-seeking behavior. PMID- 3809329 TI - Fluctuating dermatoglyphic asymmetry and the genetics of liability to schizophrenia. AB - Schizophrenic subjects were compared to normal and psychiatric control subjects for degree of fluctuating asymmetry in two dermatoglyphic traits, a-b ridge count and fingertip pattern. The schizophrenic group exhibited significantly greater fluctuating asymmetry than either control group. Furthermore, indicators of disease severity such as early onset and declining course of illness correlated with degree of asymmetry. Both of these observations are expected if a disorder has a polygenic basis, since fluctuating asymmetry is a marker of polygenic inheritance. PMID- 3809330 TI - Obsessive-compulsive disorder and the DST. PMID- 3809331 TI - Serum DBH activity in psychotic vs. nonpsychotic unipolar and bipolar depression. PMID- 3809332 TI - Reliability of a multidimensional locus of control construct for older adults anticipating transitions in careers. PMID- 3809333 TI - Caregiver compliance and feelings of burden in poststroke home care. PMID- 3809334 TI - Personality and alcohol use: a preliminary study. PMID- 3809335 TI - Psychoanalysis and psychology. PMID- 3809336 TI - Indirect assessment of concern about nuclear war. PMID- 3809337 TI - Comparison of WAIS and WAIS-R factor structure for neuropsychiatric patients. PMID- 3809338 TI - Retirement of emeritus medical professors of the University of Chicago and the University of Wisconsin. PMID- 3809339 TI - Seasonal births, academic achievement and psychopathology (suicide and homicide): a regional analysis. PMID- 3809340 TI - Self-report measure of depression in college students. PMID- 3809341 TI - Discriminant function analysis of the McGill Pain Questionnaire. PMID- 3809342 TI - Utility of the modified Health Belief Model in predicting compliance with treatment by adult patients with advanced cancer. PMID- 3809343 TI - Reliability and concurrent validity of three visual-analogue mood scales. PMID- 3809345 TI - Effects of course in hospice nursing: attitudes and behaviors of baccalaureate school of nursing undergraduates and graduates. PMID- 3809344 TI - Specific and diversive curiosity in mentally retarded adults. PMID- 3809346 TI - Psychosocial epidemiology of rheumatoid arthritis in a rural population. PMID- 3809347 TI - Attitudes toward AIDS, herpes II, and toxic shock syndrome: two years later. PMID- 3809348 TI - Locus of control of advantaged and disadvantaged adolescents. PMID- 3809349 TI - Analysis of the relationship between anxiety about mathematics and performance. PMID- 3809350 TI - MMPI F, 4, and 9 as a measure of aggression in a college sample. PMID- 3809351 TI - Utility of the Mini-Mult in a community mental health setting. PMID- 3809352 TI - Relationships between scores on Stanford-Binet IV and Wechsler Intelligence Scale for Children-Revised. PMID- 3809353 TI - Effects of biofeedback and cognitive therapy on stress in patients with breast cancer. PMID- 3809354 TI - Age-specific alcohol prohibition and college students' drinking problems. PMID- 3809355 TI - Lunar phase and acting-out behavior. PMID- 3809356 TI - Hemispheric asymmetry and human electrodermal conditioning: the dichotic extinction paradigm. PMID- 3809357 TI - Blood pressure discrimination. PMID- 3809358 TI - Bidirectional voluntary heart rate control during static muscular exercise: metabolic and respiratory correlates. PMID- 3809359 TI - Autonomic correlates of sensation seeking and monoamine oxidase activity: using confirmatory factor analysis on psychophysiological data. PMID- 3809360 TI - Interactions of respiratory and cardiovascular adjustments to behavioral stressors. PMID- 3809361 TI - General autonomic components of motion sickness. PMID- 3809362 TI - Greater resistance to extinction of electrodermal responses conditioned to potentially phobic CSs: a noncognitive process? PMID- 3809363 TI - Phasic cardiac reactivity to psychological stress as a function of aerobic fitness level. PMID- 3809364 TI - Guidelines for human electromyographic research. PMID- 3809365 TI - P300 development from auditory stimuli. PMID- 3809366 TI - Psychosocial problems and interventions in a referred sample of cancer patients. AB - Estimates of the psychosocial problems of cancer patients vary widely, depending on the nature of the assessment (e.g., psychologic testing, psychiatric interviews) and on the manner of assessment (prospective screening vs. retrospective chart reviews). This study examines the nature of psychosocial problems when these are referred by primary health care staff to a psychosocial service in a large outpatient cancer centre. Both problems and interventions were assessed for a 1-year period. These indicate a referral rate of approximately 20% of patients seen in the centre. The most frequent problem categories centered around family/significant others and personal concerns, whereas the most frequent interventions were educational, psychotherapy oriented (broadly conceived), and assessment oriented. There were differences in several problem and intervention categories on the basis of sex, age, and diagnosis. These data are discussed in terms of psychosocial assessment strategies for cancer patients. PMID- 3809367 TI - The Rorschach Interaction Scale as a potential predictor of cancer. AB - In a long-term prospective study, medical students who later developed cancer, in contrast to the rest of the cohort, gave Rorschach test responses indicating less satisfactory interpersonal relationships as assessed by the Rorschach Interaction Scale (RIS). The scale remained as a predictor of cancer after adjusting for smoking, serum cholesterol level, and age in medical school, and after taking into account the date of diagnosis and length of follow-up time. An exploration of the relationship between the RIS and specific types of cancer suggested that cancers of the lung may be less influenced by this psychologic factor than are other cancers. The findings were interpreted to suggest that internal self-other representations as measured by the RIS are involved as regulators of biologic systems and manifestations of illness, such as cancer. PMID- 3809368 TI - Demographic correlates of SI assessments of type A behavior. AB - A survey interview and the structured Type A interview (SI) were administered to 903 residents of Washtenaw County, Michigan aged 18 or older selected by a multistage probability sample of households. No bivariate relationship was found between Type A behavior and sex or marital status. Type A behavior was positively related to income and education. The prevalence of Type A behavior was highest among those who were employed in white-collar occupations. There was an inverted U-shaped relationship between age and Type A behavior. A slightly higher prevalence of Type A behavior was noted among whites than among nonwhites. Multivariate analysis showed the seven demographic variables to account for 6.8% of the overall variation in Type A behavior, with family income being the strongest demographic predictor. PMID- 3809369 TI - Type A behavior pattern and alcohol intake in middle-aged men. AB - Eighty-one sedentary but healthy, middle-aged men were studied. Type A behavior pattern (TABP) was determined by "structured interview", and dietary intake was assessed by alcohol questionnaire and 3-day diet record. Type A men reported drinking approximately twice as much alcohol as their non-Type A counterparts (mean +/- SD: 21.7 +/- 18.2 vs. 9.4 +/- 9.1 g of ethanol per day; p = 0.0003), and a strong, positive association between TABP and alcohol intake was found. The TABP-alcohol relationship was not confounded by concomitant differences in income level or years of formal education, and remained highly significant in subsequent analyses of nonsmokers alone. Type As and non-Type As did not differ significantly in their consumption of any other nutrient measured. The association between TABP and alcohol intake may have confounded conclusions from previous studies that focused on one or the other as a risk factor for coronary heart disease. PMID- 3809370 TI - Limiting factors in the use of DSM-III criteria with mentally ill/mentally retarded persons. PMID- 3809371 TI - The nature and types of mental illness in the mentally retarded. PMID- 3809372 TI - Psychometric and demographic characteristics of the psychopathology instrument for mentally retarded adults. PMID- 3809373 TI - Components of the design of psychopharmacology studies. PMID- 3809374 TI - Treatment outcome research for depression in mentally retarded children and youth: methodological issues. PMID- 3809375 TI - Neuropeptides as modulators of immune function. PMID- 3809376 TI - Life events, depression, and natural killer cell activity. PMID- 3809377 TI - Issues in the diagnosis of attention deficit disorder: a cautionary note on the Gordon Diagnostic System. PMID- 3809378 TI - [Weight control and weight regulation: an empirical study of a normal population]. PMID- 3809379 TI - Psychogenic seizures. PMID- 3809380 TI - Panic disorder and medical illness. PMID- 3809381 TI - Psychological responses to the implantable defibrillator: preliminary observations. PMID- 3809382 TI - Obsessive-compulsive disorder successfully treated with trazodone. PMID- 3809383 TI - Catatonia relieved by oral diazepam in a patient with a pituitary microadenoma. PMID- 3809384 TI - Differential effects of radical scavengers on X-ray-induced mutation and cytotoxicity in human cells. AB - The cytotoxic and mutagenic effects of X irradiation on a human lymphoblast cell line were examined in the presence of two radioprotective agents which modulate damage to DNA. The cells were treated with X rays alone or in the presence of either dimethyl sulfoxide or cysteamine. Surviving fraction and mutation to trifluorothymidine resistance (tk locus) and to 6-thioguanine resistance (hgprt locus) were measured. Survival was enhanced when the cells were irradiated in the presence of dimethyl sulfoxide; the D0 rose from 58 to 107 rad. However, at both genetic loci the induced mutant fractions were identical in the presence or absence of dimethyl sulfoxide. Survival was enhanced to a greater degree when the cells were irradiated in the presence of cysteamine; the D0 rose from 58 to 200 rad. Cysteamine also protected the cells from X-ray-induced mutation; the frequencies of X-ray-induced mutation at both the tk and hgprt loci were reduced by 50-75%. No protective effects were observed unless dimethyl sulfoxide or cysteamine was present during irradiation. These findings are discussed in terms of the hypothesis that, unlike for cell killing, radiation-induced mutagenesis in human lymphoblast cells is not mediated by the actions of aqueous free radicals, but rather by the direct effects of ionizing radiation. PMID- 3809385 TI - Saturation of a DNA repair process in dividing and nondividing mammalian cells. AB - We have reported that the half-time (T1/2) for the slow phase of repair of radiation-induced DNA lesions increased with dose from 12.5 to 50.0 Gy in both 9L rat brain tumor cells and cerebellar neurons. In this manuscript these studies have been extended to lower doses to determine at what dose this DNA repair process becomes unsaturated. Our alkaline sucrose sedimentation technique in zonal rotors limits determination of the slow phase T1/2 to doses of greater than or equal to 6 Gy for 9L tumor cells and greater than or equal to 4 Gy for cerebellar neurons. The slow phase T1/2 in cerebellar neurons appears constant at doses less than or equal to 6 Gy and then increases exponentially at higher doses; survival of whole brain irradiated rats does not begin to decrease until doses greater than 6 Gy. The slow phase T1/2 in 9L tumor cells is either saturated or just becoming saturated at 6 Gy; a dose just before the final slope of the 9L survival curve is reached. These data support the hypothesis that the shape of mammalian cell survival curves is related to the saturation of a DNA repair process. PMID- 3809386 TI - Sensitivity to radiation and recovery of hematopoietic stem cells. AB - A function is proposed to approximate the fraction of active hematopoietic stem cells that remain after a time following irradiation by X rays. The parameters in the function are determined by minimizing the root mean square (rms) deviations of the logarithms of the function from the logarithms of the experimentally measured stem cell fractions for mice. The rms deviation obtained is 10%. The zero time limit of the function depends exponentially on the dose decaying with a D0 of 0.43 Gy in contrast to the value 0.9 Gy often quoted. This value 0.43 is shown to be consistent with an LD50 of 5.86 Gy, an average of the values previously reported by Bateman et al. [Radiology 79, 1008-1014 (1962)]. No displacement of the exponential to the right is apparent. PMID- 3809387 TI - Cell-cell matrix interactions in induced lung injury. IV. Quantitative alterations in pulmonary fibronectin and laminin following X irradiation. AB - Male LAF/1 mice were locally irradiated at doses of 5, 9, and 13 Gy and compared with untreated and sham-irradiated animals. Lungs were subsequently examined at times of 1, 4, 13, 28, 41, and 63 weeks postirradiation (PI) for alterations in pulmonary fibronectin (Fbn) and laminin (Lam) as a consequence of the irradiation. Thoroughly perfused lungs dissected clear of major airways were homogenized and fractionated by centrifugation into two fractions, soluble (supernate) and insoluble (pellet). Each fraction was analyzed by nonequilibrium competitive enzyme-linked immunoassay (ELISA) for Fbn and Lam normalized to mg protein. The results show a dose-related increase in soluble Fbn demonstrable at 1 week PI and approaching seven times control values by 28 weeks for doses of 13 Gy. Thereafter amounts decrease steadily to 63 weeks. Insoluble Fbn remains at or near control values through 13 weeks, increases in a dose-related fashion almost fivefold by 41 weeks for doses of 13 Gy, and then decreases by 63 weeks. Soluble Lam increased slightly during the duration of the study, returning to normal by 63 weeks. Insoluble Lam shows a dose-dependent increase demonstrable at 4 weeks PI which continues through 63 weeks. Interactions between these alterations in Fbn and Lam and previously reported changes in basal laminar proteoglycans may, in concert with other cellular and extracellular components, relate to the initiation and/or maintenance of radiation-induced pulmonary fibrosis. PMID- 3809388 TI - Differential repair of gamma-ray-induced DNA strand breaks by various cellular subpopulations of mouse jejunal epithelium and bone marrow in vivo. AB - We have examined the induction and repair of gamma-ray-induced DNA strand breaks in different subpopulations of cells in mouse jejunal epithelium and bone marrow using a modification of the alkaline elution methodology whereby different populations of cells are selectively labeled with radioactive DNA precursors. Mice were labeled by intraperitoneal injection with between 0.5 and 2.0 mu Ci/g of [3H]thymidine at various times prior to irradiation with 10 Gy of gamma rays. In the studies with jejunal epithelium, the timing of the injection of the radiolabel relative to the irradiation was varied between 6 and 72 h, depending on the cell population of interest. The DNA damage and repair characteristics representative of both the total cell population and the radiolabeled fraction of these cells were then measured. Little difference was noted in the amount of initial damage induced in these different populations of cells. However, for both the jejunum and bone marrow, cells that incorporated the radiolabel within 6 h after injection (i.e., rapidly proliferating cells) repaired their strand breaks more rapidly than did the remainder of the population. In the case of jejunum, the repair capacity of the radiolabeled cell population progressively diminished as the cells matured and differentiated so that cells that contained the radiolabel 72 h after injection (i.e., mature villus cells) actually repaired their strand breaks more slowly than did the bulk cells. PMID- 3809389 TI - Effect of amplitude-modulated 147 MHz radiofrequency radiation on calcium ion efflux from avian brain tissue. AB - Cerebral cortex tissue slices and cerebral hemispheres prepared from Gallus domesticus chicks were exposed to 147 MHz radiofrequency radiation, amplitude modulated at 16 Hz and applied at a power density of 0.75 mW/cm2, to determine the effect of such exposure of 45Ca2+ efflux from the avian brain tissue. Statistical analysis of these data demonstrates that such exposure has no significant effect on 45Ca2+ efflux. PMID- 3809390 TI - Calorimetric measurement of the carbon kerma factor for 14.6-MeV neutrons. AB - A spherical graphite calorimeter was used to determine the ratio of kerma to influence (kerma factor) for neutrons whose mean energy was approximately 14.6 MeV. The calorimeter was used to measure carbon kerma, while activation foils of Al and Au were used to determine the neutron fluence. The calorimeter was constructed specifically to measure kerma in neutron fields. The amount of graphite and other materials was kept to a minimum to reduce absorption and scattering of the neutrons. Ionization chambers were used to measure A-150 plastic kerma and to monitor the intensity of the exposures. The value for the carbon kerma factor was determined to be 1.80 +/- 0.16 X 10(-11) Gy X cm2. The relationship of this value to other recent measurements and calculations at similar neutron energies is discussed. PMID- 3809391 TI - Some complexes of cobalt(III) and iron(III) are radiosensitizers of hypoxic EMT6 cells. AB - The radiosensitizing potential in hypoxic EMT6 cells of several complexes of Co(III) and Fe(III) has been examined. The cytotoxicity of each of the agents toward oxygenated and hypoxic EMT6 cells was tested over the concentration range of 1 to 500 micron for 1-h drug exposure. There was no statistically significant difference between the cytotoxicity of these complexes toward oxygenated and hypoxic cells. Based on these findings, 100 micron was selected as the drug concentration for the initial assessment of radiosensitizing potential. The radiation survival of EMT6 cells in the presence of 100 microM drug for a series of Co(III) complexes in which the number of nitro ligands was varied showed that the hexanitro and the triamine-trinitro complexes are very effective radiosensitizers. The trans-tetrammine dinitro complex was a more effective radiosensitizer than the corresponding cis-dinitro complex. The diethylenetriamine and 1,10-phenanthroline complexes were very effective radiosensitizers, producing dose-modifying factors of 2.4. The trans-tetrammine dichloro complex was moderately effective, giving a dose-modifying factor of 1.9. On the other hand, the hexammine and triammine tricyano complexes and the trans dinitro complex with negatively charged acetylacetonate ligands were ineffective as radiosensitizers in this system. Finally, three complexes with cyclopentadienyl ligands were examined. The ferricenium salt itself was a moderately effective radiosensitizer, giving a dose-modifying factor of 2.0. However, both the dimethylferricenium salt and the analogous cobalt complex were ineffective. The FSaIIC fibrosarcoma was used to study radiosensitizing potential in vivo. The trans-tetramminedinitro complex was administered at doses of 100, 200, or 300 mg/kg as a single ip injection 1 h prior to irradiation or as three daily ip injections. There was increasing dose modification with increasing drug dosage. With a fractionated radiation protocol in which five daily fractions of 2, 3, or 4 Gy were administered to the tumor-bearing limb with ip drug injections of 100 or 200 mg/kg given 1 h prior to irradiation, a dose-modifying effect of 1.6 was observed with 5 X 200 mg/kg of the drug. PMID- 3809392 TI - Antitumor and radiosensitizing activity of several platinum-(+) dye complexes. AB - We have prepared several complexes of tetrachloroplatinate with organic molecules bearing diffuse positive charges. A human squamous carcinoma cell line, SCC 25/CP, which is 30-, 10-, and 9-fold resistant to CDDP, carboplatin, and iproplatin, respectively, is as sensitive to the platinum-(+) dye complexes as is the parent SCC-25 cell line. A dose of each platinum-(+) dye complex which produced 50-90% cell kill was selected to assess the radiation sensitizing potential of these agents in vitro. All of the platinum-(+) dye complexes were effective sensitizers of hypoxic cells. Pt(Rh-123)2 (100 microM) produced DMFs of 2.7 and 2.6 in the SCC-25 and SCC-25/CP cells, Pt027 (100 microM) gave DMFs of 2.2 and 2.6 in the SCC-25 and SCC-25/CP cells; PtSA (10 microM) produced DMFs of 2.2 and 2.0 in the SCC-25 and SCC-25/CP cells; and PtDeca (50 microM) gave DMFs of 1.8 and 1.9 in the SCC-25 and SCC-25/CP cells. The antitumor activity of the platinum-(+) dye complexes was assessed in four transplantable mouse tumors and compared with the activity of CDDP. In both intraperitoneal and subcutaneous tumors the platinum-(+) dye complexes had activity comparable to CDDP. In the Lewis lung tumor, increasing doses of Pt(Rh-123)2 produced increasing dose modification when the drug was administered prior to single doses of radiation. A dose of 50 mg/kg of Pt(Rh-123)2, Pt027, or PtDeca produced very similar dose modification in this tumor. Overall, the platinum-(+) dye complexes are effective radiosensitizers both in vitro and in vivo. PMID- 3809393 TI - Kinetics of uptake, retention, and radiotoxicity of 125IUdR in mammalian cells: implications of localized energy deposition by Auger processes. AB - The kinetics of uptake, retention, and radiotoxicity of 125IUdR have been studied in proliferating mammalian cells in culture. The radioactivity incorporated into the DNA is directly proportional to the duration of incubation and to the extracellular concentration of 125I. The rate of proliferation of cells is related to the intracellular radioactive concentration and is markedly reduced at medium concentrations greater than or equal to 0.1 mu Ci/ml. At 37% survival the high LET type cell survival curve is characterized by an uptake of 0.035 pCi/cell, and the cumulated mean lethal dose to the cell nucleus is about 80 rad compared to 580 rad of X-ray dose for this cell line. The strong cytocidal effects of the decay of 125I correlate with localized irradiation of the DNA by the low energy Auger electrons. PMID- 3809394 TI - On Fano's and O'Connor's theorems. AB - Fano's theorem states that the fluence of particles, emitted uniformly per unit mass, is constant throughout an infinite medium of uniform composition but varying density. O'Connor's scaling theorem says that the ratio of the fluence of secondary particles to that of primary particles, caused by an external source irradiating a medium in a collimated beam, is the same in two uniform media of the same composition but different density, provided geometrical distances are scaled inversely to density. These two theorems are proved by one line of reasoning. The scaling theorem is given a more general formulation. PMID- 3809395 TI - Synthesis and phosphorylation of histone H1 and high mobility group proteins in the regenerating rat liver after X irradiation. AB - A rat was irradiated to the upper abdomen including the liver and then partially hepatectomized. The subsequent synthesis and phosphorylation of histone H1 and nonhistone chromosomal high mobility group (HMG) proteins were investigated. Incorporation of [3H]lysine into histone H1 was increased and reached its peak at 27 h after hepatectomy, and 14 Gy of X rays inhibited the increase. Increase in the incorporation of [3H]lysine into HMG (1 + 2), 14, and 17 which occurred around 27 h after hepatectomy was not inhibited by 14 Gy irradiation. Phosphorylation of histone H1, measured with 32Pi incorporation in vivo, was maximal between 21 and 24 h, and it was inhibited by 4.8 Gy of X rays and delayed with 1.9 Gy. Phosphorylation of HMG 14, which was the only HMG protein phosphorylated under present conditions, was not affected by X irradiation. The [3H]thymidine incorporation into nuclear DNA started increasing at 21 h and reached its maximum at 27 h after hepatectomy. X irradiation with 4.8 Gy inhibited the incorporation, and 1.9 Gy lowered it. PMID- 3809396 TI - Influence of protein nutrition on dose-survival relationship following rat kidney irradiation. AB - Immediately following unilateral nephrectomy the remaining kidney of juvenile male Sprague-Dawley rats was sham irradiated or irradiated to doses of 14-30 Gy. Following irradiation the animals were placed on isocaloric diets of either 20 or 4% protein. Median life spans for the animals on the low protein diet were significantly increased compared to the median life spans on the 20% protein diet. Serum urea nitrogen (SUN) levels were periodically measured in rats from each of the experimental groups. SUN levels in the irradiated rats fed the 20% protein diet increased significantly over unirradiated controls as a function of time. In contrast animals fed the 4% protein diet showed no significant changes in SUN levels irrespective of the size of radiation dose and time post irradiation. Renal protective factors calculated as the ratio of 80% survival times for animals fed the 20% protein diet compared to animals fed the 4% protein diet can be calculated to be 2.3 at 18 Gy and 2.8 at 22 Gy. Likewise, a SUN protective factor calculated as the ratio of percentage of nonirradiated control SUN values for the two diets (SUN 20% irradiated) (SUN 20% nonirradiated) (SUN 4% irradiated) (SUN 4% nonirradiated) is 2.4 for 18 Gy and 3.9 for 22 Gy. PMID- 3809397 TI - Concentration of fallout plutonium in tissues of Japanese who died during 1980 1984. AB - The concentrations of fallout 239 + 240Pu in various body tissues of subjects who were born before 1941 and who died in Akita and Niigata Prefectures in Japan during 1980-1984 are reported. The median concentrations in vertebrae, sternum, liver, lung, spleen, and kidney were 0.21, 0.08, 0.62, 0.11, 0.08, 0.03 pCi/kg wet weight, respectively. The concentration levels in vertebrae were approximately three times higher than in the sternum. No significant correlation between the concentration in the various tissues and age at the time of death was observed. No differences in the concentration levels in liver and lung were observed between the sexes. Correlation between the concentration in liver and that in lung was not significant. The concentration in liver was similar to that estimated from the ICRP 30 model. However, the concentration in lung was considerably higher than the estimated value. This difference may be caused by the pulmonary lymph nodes contained in the present lung samples. To obtain the average concentration of plutonium in the entire skeleton, further information regarding the macrodistribution of plutonium is required. PMID- 3809398 TI - Energy metabolism and blood perfusion in a mouse mammary adenocarcinoma during growth and following X irradiation. AB - Biochemical and blood perfusion changes in a mouse tumor system (MDAH MCaIV) were studied relative to normal tissues under conditions of normal blood flow and clamped blood supply. Further studies were performed during tumor growth and after local X irradiation. The biochemical profiles of three untreated human soft tissue sarcomas were also investigated. Animal tumors were irradiated in situ with either a single or fractionated regime to total doses of 20 or 49 Gy. Assays of lactate, pyruvate, AMP, ADP, and ATP were made on freeze-clamped tissue following authentic or sham treatments. Blood perfusion to tumors treated in the same way was measured using iv injection of 201Tl. The human tumors were found to have a lower lactate to pyruvate ratio (L/P) than the MCaIV tumors; their ATP levels were also lower. L/P was much higher in the MCaIV tumors than in normal liver, kidney, and muscle in the mouse. Occlusion of the blood supplies of the normal kidney and the MCaIV tumor caused an increase in the lactate and L/P levels in both cases. However, whereas the ATP level in the kidney fell, the level in the tumor was maintained. There was some evidence that the adenine nucleotides were not in equilibrium via the adenyl kinase catalyzed reaction. In addition, tumors were found to contain the enzyme creatine kinase. These results suggest that energy charge calculations cannot be computed in a meaningful manner because the creatine kinase catalyzed phosphorylation of ADP would maintain a higher than normal ATP level. Lactate and L/P ratio was found to increase during tumor growth and decrease following X irradiation. The total adenine nucleotides (AMP + ADP + ATP) exhibited a trend toward lower values with increasing tumor size. There was no significant change in total adenine nucleotides after a single 20-Gy dose; however, fractionated radiation caused some fall in total nucleotides. It is concluded that, in this tumor system, lactate level is a sensitive index of radiation-induced biochemical changes which are likely to reflect changes in tumor oxygenation. PMID- 3809399 TI - Effect of hyperthermia on the repair of sublethal radiation damage in normal and membrane fatty acid substituted fibroblasts. AB - The interaction of heat and X irradiation was studied in normal and polyunsaturated fatty acid (PUFA) substituted mouse fibroblast LM cells. As a result of the substitution the membranes of the PUFA cells were more fluid than the membranes of the normal cells. Three different heat doses were applied (60 min 42 degrees C, 20 min 43 degrees C, and 10 min 44 degrees C) in combination with single or split doses of X rays. Heat radiosensitization was the largest for the 60 min 42 degrees C treatment. Heat radiosensitization and the heat-induced inhibition of the rate of sublethal damage repair were the same for the normal and the PUFA cells. It is concluded from the experiments reported that the processes of hyperthermic inhibition of SLD repair and hyperthermic radiosensitization are independent of membrane fluidity and membrane fatty acid composition. PMID- 3809400 TI - Heat-induced K+ loss, trypan blue uptake, and cell lysis in different cell lines: effect of serum. AB - Experiments were performed with three different cell lines, mouse fibroblast LM cells, HeLa S3 cells, and Ehrlich Ascites Tumor (EAT) cells, to establish the possible importance of hyperthermic-induced alterations in cellular K+ content in the mechanism of cell killing by heat. At different time points after the hyperthermic treatment, the K+ content in the cells, the uptake of the dye Trypan Blue (TB), and cell lysis were assayed. Heat-induced K+ loss preceded TB uptake which was followed by the heat-induced cell lysis. Lysis was assayed as disappearance of cells by counting the cells at different time points in a hematocytometer. The presence of serum during and after the heat treatment was of considerable importance with respect to K+ loss and TB uptake. K+ loss and TB uptake after the heat treatment were less when serum was present during and after hyperthermia. To protect against cell lysis, however, the serum had to be present during a preincubation period of 24 h. Clonogenic ability was not affected by the presence of serum. It is concluded that the intracellular K+ level of hyperthermic-treated cells is not a direct cause for cell killing and that heat induced alterations in the cell leading to cell lysis are different from the processes decreasing cellular K+ content and permeabilizing the plasma membrane for trypan blue. PMID- 3809401 TI - Influence of caffeine on X-ray-induced killing and mutation in V79 cells. AB - Effects produced by caffeine on X-irradiated Chinese hamster V79 cells depended on the growth conditions of the cells. For exponentially growing cells, nontoxic concentrations of caffeine decreased the shoulder width from the survival curve, but the slope remained unchanged. The yield of mutants under the same conditions also remained unaffected. In case of density-inhibited cells, delaying trypsinization for 24 h after X irradiation increased the survival and decreased the yield of mutants. The presence of caffeine during this incubation period inhibited such recovery and significantly increased the yield of X-ray-induced mutants. PMID- 3809402 TI - Radiation sensitivity of hemopoietic stroma: long-term partial recovery of hemopoietic stromal damage in mice treated during growth. AB - We studied the ability of the hemopoietic organ stroma to recover from damage inflicted by 5 or 7 Gy gamma radiation administered during a period of stromal growth in 4-week-old mice. Irradiation resulted in an immediate depletion of femoral colony-forming fibroblastic progenitors (CFU-F) down to 10-20% of age matched control values. A full recovery to normal numbers occurred between 120 and 240 days after irradiation and was followed by a secondary decrease 1 year after irradiation. This secondary decrease was accompanied by a decrease in the femoral CFU-S and CFU-C content. Femoral CFU-F attained normal numbers and it was demonstrated to occur from surviving CFU-F and could not be enhanced or prolonged following infusion of unirradiated bone marrow cells after irradiation. During the transient CFU-F recovery the hemopoietic stroma remained severely damaged as judged by the regenerative capacity of spleen and femur stroma after subcutaneous implantation, and the ability of the spleen to accumulate CFU-S in response to lipopolysaccharide injection. We have reported earlier that in similarly irradiated adult mice, no restoration of femoral CFU-F was observed. This difference between 4-week-old and adult mice could not be explained by a difference in in vitro radiosensitivity of CFU-F or in their in vivo regeneration kinetics following irradiation and subsequent lipopolysaccharide injection. We conclude from these observations that the recovery kinetics of the CFU-F population is different in young and adult irradiated mice, infused CFU-F do not contribute to CFU-F regeneration in an irradiated femur, CFU-F are not the sole determinants of stromal regeneration in femur and spleen following irradiation. PMID- 3809403 TI - Promotion, dose rate, and repair processes in radiation-induced neoplastic transformation. AB - C3H10T1/2 cells were exposed to low doses of 60Co gamma rays at 100 or 0.10 cGy/min and the incidence of neoplastic transformation was assayed with or without the addition of tetradecanoylphorbol-13-acetate (TPA). As we reported earlier [A. Han, C. K. Hill, and M. M. Elkind, Cancer Res. 40, 3328-3332 (1980); C. K. Hill, A. Han, F. Buonaguro, and M. M. Elkind, Carcinogenesis 5, 193-197 (1984)], the frequency of neoplastic transformation per unit dose following low doses appears to be linear and is reduced 2.3-fold at 0.10 cGy/min compared to 100 cGy/min. We report now that the addition of TPA 24 h after irradiation appreciably enhances the frequency after both low- and high-dose-rate exposures. The enhancement indicates that TPA leads to the expression of potentially effective, preneoplastic damage due to gamma rays. Our data suggest that the enhancement of transformation by TPA is essentially independent of dose rate. Also, our results suggest that the sector of preneoplastic damage which is repaired during protracted exposures becomes unavailable to enhancement by TPA. PMID- 3809404 TI - The radiation response of SCCVII tumor cells in C3H/He mice varies with the irradiation conditions. AB - The radiation response of SCCVII tumor cells in C3H/He mice under various irradiation conditions was studied using an in vivo-in vitro assay. When tumor bearing mice were irradiated without anesthesia or physical restraint, the tumor had a hypoxic fraction of 5.4%. Both anesthesia and immobilization of the tumor bearing leg with adhesive tape produced significant increases in the hypoxic fraction (23 and 28%, respectively). Restraining the mouse in a jig without immobilizing the tumor-bearing leg also increased the hypoxic fraction (13%). PMID- 3809406 TI - [Determination of the radiosensitivity of interphase-dying cells in the thymus, spleen and bone marrow of rats by flow cytometry]. AB - The flow cytofluorometry of cells stained with a DNA-specific probe was used to determine the share of dying cells (containing less than 2C DNA) in thymus, spleen and bone marrow cells of irradiated rats. The cell death curves for spleen and bone marrow had a plateau by the 6th h, and for thymus, by the 10th h following irradiation with different doses. On the basis of the dose-response relationship the share of cells dying in the interphase was determined in each organ under study, and dose-response curves shaped. All the curves had no shoulder. Do was 3.0, 3.0 and 3.7 Gy for thymus, spleen, and bone marrow cells, respectively. PMID- 3809405 TI - [Mechanism of the formation of DNA-protein cross-links during the gamma irradiation of chromatin in aqueous solutions]. AB - The method of gel electrophoresis was used to study DNA-protein cross-link formation in fragmentized chromatin gamma-irradiated in water solutions (0.03%). By introducing changes into irradiation conditions (for instance, the use of different gases saturating the solution and the administration of radical acceptors) and by the subsequent electrophoretic analysis (treatment of the exposed chromatin by dissociating mixtures and enzymes) the authors showed a covalent nature of the cross-links in a radiation-induced DNA-protein complex and found the value of G (a cross-link) to be 0.02. PMID- 3809407 TI - [Activation of the chromatin degradation process by a protein factor from the cytoplasm of the thymocytes of irradiated animals]. AB - A cytoplasmic thymocyte fraction isolated 1 h after irradiation of mice accelerates chromatin degradation in isolated nuclei. Treatment of the cytoplasmic fraction by heat and injection of cycloheximide to mice prevent the acceleration of DNA degradation. The analysis of the chromatin degradation products and the kinetics of this process at acid and alkaline pH shows that activation of DNA degradation in thymocytes by a factor obtained from the irradiated cell cytoplasm is specific for a Ca2+, Mg2+-dependent enzyme. The time and dose-dependent parameters of the appearance in the thymocyte cytoplasm of the factor influencing degradation of chromatin are in a good agreement with both the time of the onset of its postirradiation degradation and the dose dependence of this process. PMID- 3809408 TI - [Thymocytes of irradiated rats studied using naphthalenesulfonic probes]. AB - The fluorescence intensity of 1.8-aniline naphthalene sulfonate (ANS) and 2.6 toluidine naphthalene sulfonate (TNS) introduced into irradiated rat thymocytes reached maximum 15 min and 4 h following irradiation (1-20 Gy). The parameters of 1.8-ANS binding to membranes did not contribute markedly to the effect observed. PMID- 3809409 TI - [Mechanisms of the radiation-induced disorder of DNA synthesis. The correlation of biosynthesis, DNA repair and DNA polymerase alpha and beta activity in the bone marrow of rats exposed to gamma quanta and fast neutrons]. AB - A study was made of DNA biosynthesis and repair and alpha- and beta-DNA polymerase activity in rat bone marrow during the first 24 hours following whole body irradiation with gamma-quanta and fast neutrons (up to 6 Gy). There was a correlation between the post-irradiation inhibition of DNA biosynthesis, a decrease in DNA-polymerase activity and template reparability. The data obtained permitted to consider the radiation-induced disturbance of DNA biosynthesis and the change in beta-polymerase activity as one of the possible mechanisms of formation of high relative biological effectiveness of neutrons. PMID- 3809410 TI - [Sensitivity to exposure to postradiation repair inhibitors and to repeat irradiation in the progeny of irradiated cells]. AB - In experiments on HeLa cells a study was made of the response of near and distant descendants of irradiated cells to repeated irradiation and to the effect of inhibitors of repair and replicative synthesis of DNA, that is, arabinosyl cytosine (Ara-C) and hydroxyurea (HU). Throughout 12-15 postirradiation generations the descendants of preirradiated cells were more sensitive to ionizing radiation and to the effect of Ara-C and HU: the dose-response curves had no shoulder and the Do value decreased by 1.7 times. In generations 18 to 24, the sensitivity to the damaging effect of the agents under study was normalized and the resistance somewhat increased. The data obtained indicate that some DNA lesions persist in many generations of the exposed cells. PMID- 3809411 TI - [Radiosensitizing and toxic action of metronidazole and isometronidazole (1-(2 hydroxyethyl)-2-methyl-4-nitroimidazole) on the cells of Ehrlich ascites cancer and hemoblastosis La in vitro]. AB - A study was made of Ehrlich ascites tumor growth and life span of mice bearing hemoblastosis La after inoculation of tumor cells subjected, in anaerobic conditions, to the effect of gamma-radiation and/or metronidazole and isometronidazole. It was shown that the cytotoxic effect of isometronidazole was less manifest than that of metronidazole the radiosensitizing effect, with a reference to anoxic tumor cells in vitro, being nearly the same. PMID- 3809412 TI - [Genetic action of 131I and 125I on the germ cells of male mice]. AB - A study was made of the genetic effects of iodine radioactive isotopes in male germ cells of (CBA X C57Bl)F1 hybrid mice. After a single intraperitoneal administration of Na131I (1.48 to 740 kBq/g) or Na125I (148 to 7400 kBq/g) to males the occurrence of dominant lethal mutations (DLM), reciprocal translocations (RT), and abnormal sperm heads (ASH) was studied. The radioactive iodine isotopes induced DLM at the postmeiotic spermatogenesis stages only. After the effect of the isotopes, the frequency of RT increased insignificantly with dose. The frequency of ASH was only increased with the highest 131I dose. Relative biological effectiveness of 131I and 125I was less than 1 with a reference to the indices under study. PMID- 3809413 TI - [Action of powerful ultrashort laser impulses on the permeability of the outer membrane of HeLa cells]. AB - It was shown that in HeLa cells, at the stationary growth phase, the permeability of the outer membrane for thymidine increased 1 h after irradiation with two ultrashort impulses (Nd3+: YAG laser, lambda = 266, 532 or 1064 nm, the impulse duration of 3 X 10(-11) s, I = 2 or 20 MW/cm2). The effect was dependent on the time interval between the impulses and virtually independent of the radiation wave-length. The maximum increase in the membrane permeability (by approximately 3 times) was noted after irradiation at 4-6 s intervals between the impulses. PMID- 3809414 TI - [Quantitative analysis of the effect of cysteamine on interphase cell death by flow cytometry]. AB - The method of flow cytofluorometry was used to study the radioprotective effect of cysteamine on cells dying in the interphase. DMF was 1.67, 1.67, and 1.76 for thymus, spleen, and bone marrow, respectively. PMID- 3809415 TI - [DNA synthesis in a stationary HeLa cell culture following gamma irradiation]. AB - Residual incorporation of 3H-thymidine into acid insoluble fraction was inhibited a few hours and stimulated 24 hours following gamma-irradiation (60Co) of a stationary culture of HeLa cells with doses of 5 to 50 Gy. The dose-response curve for the stimulated incorporation reached a maximum at a dose of about 10 Gy. Hydroxyurea (10 mM) was shown to suppress the incorporation. The authors suggest that ionizing radiation induces a transfer of resting cells to the S phase-like state. PMID- 3809416 TI - [Correlation of the membrane and genetic effects of lipid peroxidation]. AB - Linoleic acid hydroperoxides delivered to Ehrlich ascites tumor cells in vitro in a concentration reaching a threshold one (approximately 10(-5) M) sharply decrease their ionic permeability and the value of membrane capacity. With suprathreshold hydroperoxide concentrations (greater than 10(-5) M), the specific yield of chromosome aberrations and the share of aberrant cells increase while the mitotic index decreases. The correlation between general regularities and the equality of the threshold concentrations, with a reference to membrane and genetic effects of hydroperoxides, is thought to be an indication of a close relationship between membrane lesions caused by the development of induced lipid peroxidation and injury to genetic apparatus of the cell. PMID- 3809417 TI - [Modification of the interphase death of thymocytes by using colcemid]. AB - The pretreatment of thymocytes by colcemid (0.02 to 0.5 mu g/ml) induces a change in the plasma membrane state, registered by a pyrene fluorescent probe, and a decrease in the interphase cell death after 4 Gy X-irradiation. The authors discuss the role of the cell surface as a trigger initiating death program in irradiated lymphoid cells. PMID- 3809418 TI - [Radioprotective properties of oxolinic acid]. AB - Oxolinic acid was shown to produce a radioprotective effect on mice and a therapeutic radioprotective action on rats and hamsters. As to radioprotective efficiency, oxolinic acid is inferior to such known sulfur-containing agents as indolylalkylamines and alpha-adrenomimetics. But oxolinic acid has an important advantage over them, that is, the increase in radioresistance it induces persists for several hours. The radioprotective effectiveness of oxolinic acid prompts that it is expedient to search for new radioprotective preparations among specific inhibitors of DNA polymerase of replicative synthesis. PMID- 3809419 TI - [Experience in using cystamine for decreasing radiation disorders in Wistar rat embryogenesis]. AB - In experiments on 340 primigravida Wistar rats and 1557 young rats of the first generation a study was made of toxicity and radioprotective efficiency of single subcutaneous injection of 100 mg/kg cystamine on days 3, 11 and 19 of pregnancy. In the control animals, the preparation caused different changes in the pregnancy course, delivery and postnatal development of posterity. The radioprotective properties of the preparation were only manifested when embryos were exposed to 3 Gy radiation (a lethal dose) during the preimplantation period, and it was less effective during the periods of organogenesis and fetus formation. PMID- 3809420 TI - [Role of injuries to the vascular plexus in the development of a radiation lesion of the skin in swine]. AB - A single action of beta-radiation of different energy on the swine skin was studied. The analysis and comparison of clinical and histological features of radiation injury to the mode of the absorbed dose formation associated with the depth of location of the skin structural elements permitted to consider deep vascular plexus of the dermis to be the second critical structure (in addition to basal layer of the epidermis) responsible for the radiation reaction development and for the rate and completeness of repair processes, in particular. PMID- 3809421 TI - [Alkaline phosphatase and transaminase activity in the liver and blood serum of rats in the late periods following combined exposure to external gamma radiation and alpha radiation from plutonium-239]. AB - A study was made of activity of alkaline phosphatase and alanine- and aspartate aminotransferase in rat liver and blood serum at remote times after external gamma-irradiation combined with internal exposure to 239Pu nitrate delivered in two chronically effective doses. The radionuclide was shown to be mainly responsible for the changes observed in activity of the enzymes under study. The degree to which the changes were manifest depended upon dose of plutonium administered. PMID- 3809422 TI - [Effect of metronidazole on the free thymidine content in the blood serum of irradiated mice]. AB - The influence of a radiosensitizer, metronidazole, on the free thymidine content of blood serum of irradiated mice was studied in aerobic and hypoxic conditions. A heated metronidazole solution (1 mg/g) was administered intraperitoneally 30 min before irradiation of animals with a dose of 3 Gy. Thymidine concentration in blood serum was determined by the radioimmunological technique. The influence of metronidazole on the level of thymidinemia was only noted in the animals exposed under hypoxic conditions. PMID- 3809423 TI - X-ray field collimation in diagnostic radiology. AB - A comprehensive study of radiographic practice within radiodiagnostic departments throughout Wales is currently being carried out under the auspices of the College of Radiographers and the Royal College of Radiologists. This paper reports on collimation practices observed in more than 2000 individual patient radiographs involving seven types of examination. Film dimensions are compared to those of the X-ray field and the unnecessary irradiation of radiosensitive organs consequent upon inappropriate collimation is considered. The suitability of film sizes frequently chosen for particular projections is also examined. PMID- 3809424 TI - Reproducibility in radiotherapy. PMID- 3809425 TI - Care of the psychiatric patient in the radiography department. PMID- 3809426 TI - Magnetic resonance imaging (MRI) of the brain in paediatric practice. PMID- 3809427 TI - Periodontal dentistry. AB - Diagnostic radiographs are an invaluable aid to the diagnosis, treatment and monitoring of periodontal disease. However, their usefulness depends very much on minimised distortion of bone and tooth tissue images in an area of the body where the dental radiographer's knowledge, both of the local anatomy and the needs of the clinician, make a tremendous difference. In conclusion, radiographic bite wings are the most accurate projections to demonstrate periodontal disease of the bone margins relative to the necks of the teeth. However, the roots of the teeth are not demonstrated. The OPG gives the best overall picture of the whole mouth and the film can be shown and explained to the patient. Paralleling projections may be still needed in certain areas of the mouth where greater detail is required. Some periodontologists still prefer full mouth paralleling films for their patients. PMID- 3809428 TI - Connecting-up to computers. AB - Having established that the computer is capable of undertaking a wide range of complex processes in a short period of time, it becomes necessary to examine the range of devices which may be connected to a computer, and the methods of establishing communications between the user and the central processing unit (CPU). PMID- 3809429 TI - The departmental use of the microcomputer. PMID- 3809430 TI - Radiography in Japan. PMID- 3809431 TI - Continuous assessment of radiographic training. PMID- 3809432 TI - Patient information leaflets: what effect? PMID- 3809433 TI - Complications of cardiac catheterisation: a study. AB - Serious complications of radiological examinations are relatively rare but cardiac catheterisation carries an inherent risk factor. The introduction of non ionic contrast media has reduced the incidence and severity of reactions but the procedure of catheterisation itself is not without problems. A study has been made of patients undergoing routine, non-urgent cardiac angiography and coronary arteriography to assess the incidence of untoward effects related to the procedure and the contrast media. A comparison may be made between a conventional contrast medium and two new, low-osmolar contrast media. PMID- 3809434 TI - The professional ethic. PMID- 3809436 TI - Physiotherapy in intensive care. PMID- 3809435 TI - Aspects of patient care: the diagnostic viewpoint. PMID- 3809437 TI - Assessment of inequality in length of the lower limb. AB - Six methods of measuring limb length inequality have been described, each with their own advantages and disadvantages. Scanography is current practice in our department, but the choice is obviously dependent on local conditions. It is an area both in orthopaedic and radiological circles that has been largely ignored in the recent past. This article is an attempt to place the art of measuring limb length inequality firmly back on the map. PMID- 3809438 TI - Arthrography of the temporomandibular joint. PMID- 3809440 TI - Radial head views: an alternative. PMID- 3809439 TI - Computer technology for radiographers. 4. Making the system work. PMID- 3809441 TI - Radiotherapy in Papua New Guinea. PMID- 3809442 TI - Radiology in oral surgery--Part I. PMID- 3809443 TI - Therapeutic results in gingival and buccal carcinoma (a retrospective study). PMID- 3809444 TI - [Retrospective study of the clinical value of diagnostic laparotomy and splenectomy of patients with Hodgkin's disease in a radiotherapy establishment]. PMID- 3809445 TI - [Significance of immunologic parameters in prognosis and therapy control of patients with advanced cancer of the mouth mucosa]. PMID- 3809446 TI - [Neurochemical changes during the early radiogenic syndrome in rats and their modification by vitamins]. PMID- 3809447 TI - Changes of lipogenesis in long term continuously irradiated rats. PMID- 3809448 TI - Aseptic necrosis of the femoral head following treatment of malignant lymphomas. PMID- 3809449 TI - [Prognosis of the therapeutic results of radiotherapeutic procedures using a fuzzy classification algorithm]. PMID- 3809450 TI - [Radiation physics--short scientific communications. 12th Meeting of the Clinical Radiation Physics Section and Radiology Technology Section of the Society for Medical Radiology of East Germany, Halle (S.), 22 October-24 October, 1985]. PMID- 3809451 TI - [Comparison of biplane and monoplane volumetry from angiocardiography in connatal heart defects]. PMID- 3809452 TI - [Possibilities of computerized tomography in the diagnosis of recurrent rectal carcinoma]. PMID- 3809453 TI - [Experiences with therapeutic interventions in percutaneous transhepatic cholangiography (PTC) (experiences with intervention radiology of the bile ducts)]. PMID- 3809454 TI - [The significance of CT follow-up studies in acute craniocerebral trauma including the postoperative course]. PMID- 3809455 TI - [Embolization treatment of varicocele using a radiopaque tissue adhesive- Kunnen's modified method]. PMID- 3809456 TI - [Pulmonary hypertension and regional lung perfusion in congenital heart valve defects with arteriovenous shunting]. PMID- 3809457 TI - [Radiocerebrocardiography for the study of central and cerebral circulation and the hemocirculatory effects of vasoactive agents in an ischemic insult]. PMID- 3809458 TI - [Radioimmunological diagnosis of endocrine disorders in radiotherapy of cervix carcinoma]. PMID- 3809459 TI - [Disorders of electrolyte metabolism in hyperthyroidism]. PMID- 3809460 TI - [Heart phase-triggered serial angiodensitometry of renal and cerebral hemodynamics]. PMID- 3809461 TI - [In-vitro studies for the development of a high-density barium sulfate contrast medium]. PMID- 3809462 TI - [Falibaryt HD--a new barium sulfate contrast medium of high-density quality. Results of a cooperative study for the evaluation of the usefulness of the Falibaryt HD barium sulfate contrast agent]. PMID- 3809463 TI - [Neuroradiologic aspects of aneurysm-induced subarachnoid hemorrhage and its complications]. AB - The distribution of aneurysms in 129 patients with subarachnoidal haemorrhage (SAH) (ACA 42%, MCA 27%, ICA 21%, vertebral and basilar artery 10%) differs from the result of large statistics, where aneurysms of the ICA represent the most frequent group. The difference is considered as a consequence of the small statistical group. No differences were found with respect to complications from SAH (angiospasm 24%, infarction 14%, hydrocephalus 18%, second haemorrhage 23%, mortality 20%). The validity of CT and angiography in search for SAH and aneurysm and temporal aspects, correlated with the examination, are discussed. PMID- 3809464 TI - [Neuroradiologic diagnosis and clinical aspects of giant intracranial aneurysms]. AB - The CT and angiographic findings of 33 patients with intracranial giant aneurysms are reported. In the non-thrombosed giant aneurysms, CT showed a homogeneous, primarily hyperdense space-occupying lesion with strong enhancement. The partially thrombosed giant aneurysms appeared hyperdense with hypodense or isodense portions in the plain CT scan. The completely thrombosed giant aneurysms were isodense to hyperdense. In none of the 33 patients could perifocal edema be proved. A CT diagnosis was possible in every case of partially or non-thrombosed aneurysms. Pre-operative angiography in these cases was necessary only for purposes of vessel topography. Five completely thrombosed giant aneurysms could not be identified in either CT or the angiogram so that the diagnosis was not made until surgery. The clinical findings of these five cases of subarachnoid hemorrhage and 28 patients with signs of intracranial space-occupying lesions were diagnostically misleading, as they suggested an intracranial tumor. PMID- 3809465 TI - [Tumors of the facial nerve canal]. AB - The X-ray tomograms of 13 patients with tumors in the facial nerve canal are discussed. The leading clinical symptom is the peripheral facial nerve palsy without recovery, often combined with deafness and dizziness. The X-ray film shows opacity, widening of the internal auditory canal and/or of the third part of the facial nerve canal, further erosion of the bony structures and destruction of the pyramid. PMID- 3809466 TI - Computed tomography in the evaluation of spinal aneurysmal bone cyst. AB - Computed tomographic findings in three cases of aneurysmal bone cyst (ABC) are reported. Although conventional radiography is usually adequate in the demonstration of an expansile osteolytic cavity, CT may provide additional information about tumour characteristics, localization and extent, show the lesion's relation to the spinal cord and thus be of great help in preoperative planning. PMID- 3809467 TI - [Intolerance reaction following glucagon administration in a double-contrast study]. AB - Whereas intolerance reactions against contrast media are a well-known hazard during radiologic procedures, intolerance reactions to other preparations used in radiology are rare. Glucagon, frequently used to induce gastrointestinal hypotonia, is said to have almost no side-effects. A case of anaphylactic reaction during double-contrast upper gastrointestinal examination is reported. Pseudoallergic reaction to propylparaben, a preservative agent in glucagon, is suspected. IgE-antibodies to glucagon could not be detected by RAST. PMID- 3809468 TI - [Percutaneous sclerotherapy of testicular vein insufficiency in persistent and recurrent varicocele]. AB - Among 1217 retrograde phlebographies of left-sided idiopathic varicoceles 66 patients presented because of persistence or recurrence of varicocele, 34 of them after operation and 32 after sclerotherapy. After operation without success there was always - except for one case - a reflux passing the site of ligature. If persistence or recurrence of varicocele occurred after sclerotherapy, the testicular (internal spermatic) vein was most often found to be obliterated at the junction with the renal vein and the sonographically proven reflux went via collaterals or unidentified veins which prevented a repeat sclerotherapy. In 12 out of 32 patients after sclerotherapy a persistent main stem of the testicular vein allowed a second attempt of sclerotherapy. If sclerotherapy in patients after operation or previous sclerotherapy could be performed, it was an effective, low risk procedure on an outpatient basis just as in primary sclerotherapy of testicular vein insufficiency causing varicocele. PMID- 3809469 TI - The early manifestation of Yersinia colitis demonstrated by the double-contrast barium enema. AB - A 19-year old female with a bloody, diarrheal illness of acute onset where Crohn's disease primarily was suspected is presented. The double - contrast barium enema revealed multiple, diffusely scattered aphthous erosions of the colonic mucosa: the rectum was scarcely affected. Biopsies taken by endoscopy demonstrated nonspecific inflammatory changes of the mucous membrane. However, routinely taken stool cultures revealed an infectious colitis due to Yersinia enterocolitica. Our case demonstrates the necessity to consider Yersinia enterocolitis in the radiographic differential diagnosis when the diagnosis of Crohn's disease or ulcerative colitis seems obvious. PMID- 3809470 TI - [Osteolysis of the ilium]. PMID- 3809471 TI - Safe splenoportography. AB - The records of 37 patients who had undergone splenoportography, including one group of 12 who were studied before 1976 and a second group of 25 who were studied after 1977, were reviewed. The primary difference was that in the second group, the tract in the spleen was occluded with absorbable gelatin sponge (Gelfoam) plugs as the needle was withdrawn. In addition, there were minor changes in technique, such as changes in the needle puncture angle and entry site. When the new technique was used, there was a significant decrease in the complications traditionally associated with splenoportography. This procedure is safe and deserves to be considered the procedure of choice in patients in whom precise anatomic information is needed preoperatively that cannot be obtained with noninvasive procedures such as ultrasound or magnetic resonance imaging. PMID- 3809472 TI - Cardiac function: evaluation with fast-echo MR imaging. AB - Magnetic resonance (MR) imaging of the heart has, to date, been limited in its ability to evaluate cardiac function. The authors have implemented a technique for functional assessment of the heart using shorter echo times than those generally used for conventional spin-echo imaging. With these short echo times, multiple images can be obtained in a multisection mode approximately within the isovolumetric phases of the cardiac cycle. This permits a pair of image stacks to be obtained, one in end systole and the other in end diastole. With the use of a modified Simpson rule, left ventricular volume and ejection fraction were calculated and compared with results obtained from contrast material-enhanced ventriculography. Preliminary results indicate that this method has promise for the evaluation of a variety of functional parameters in the heart. The short acquisition times for this functional study permit it to be combined with a tissue characterization study within the time constraints of a clinical MR imaging session. PMID- 3809473 TI - Incompatibility of Hexabrix and papaverine in peripheral arteriography. AB - A case is reported in which a previously patent artery became temporarily occluded during angiography. The authors believe it happened because of incompatibility of the contrast agent ioxaglate (Hexabrix) and papaverine. Extreme caution is recommended whenever a new low-osmolality contrast agent is used in conjunction with a pharmacoangiographic agent. PMID- 3809474 TI - Blood clot formation in angiographic syringes containing nonionic contrast media. AB - Spontaneous thrombus formation may occur if blood is allowed to mix with a nonionic contrast medium in the injection syringe or angiographic catheter. This is probably due to the absence of significant inhibition of the normal blood coagulation mechanism by currently used nonionic contrast media. Careful angiographic techniques will prevent blood from mixing with the contrast medium before injection. The use of a three-way stopcock and connecting tube between catheter and syringe is suggested. Contrast material should be flushed from the catheter immediately after injection. Systemic anticoagulation is not justified as a means of preventing thrombus formation. The potential prophylactic use of heparin added to the contrast medium during angiography or premedication with aspirin, and the attendant risks of these techniques, are discussed. PMID- 3809475 TI - Lung torsion: radiographic findings in nine cases. AB - Torsion of the lung, although relatively rare, can occur under three sets of circumstances: spontaneously, usually in association with some other pulmonary abnormality; following traumatic pneumothorax; and as a complication of thoracic surgery. Nine cases of pulmonary torsion were analyzed. The radiographic findings are a collapsed or consolidated lobe that occupies an unusual position at plain radiography, at plain or computed tomography, at angiography, or at bronchography; hilar displacement in a direction inappropriate for that lobe; alteration in the normal position and sweep of the pulmonary vasculature; rapid opacification of an ipsilateral lobe following trauma or thoracic surgery; marked change in position of an opacified lobe on sequential radiographs; bronchial cutoff with no evidence of a mass; or lobar air trapping. Mortality is high if the torsion goes unrecognized and surgical fixation is delayed. PMID- 3809476 TI - Differentiation of benign from malignant pulmonary nodules with digitized chest radiographs. AB - To assess whether it is possible to distinguish benign from malignant solitary pulmonary nodules with digital techniques, a retrospective study of 68 patients with proved solitary nodules was performed. The conventional chest radiograph for each patient was digitized to 2,048 X 2,048 X 12 bits, and changes in the optical density within the nodule were analyzed. A number (the corrected gradient number) was then generated that reflected this variation. Striking differences were noted between 26 malignant nodules and 21 calcified granulomas. The technique was then applied to 21 benign nodules that had initially required thoracotomy or further study for diagnosis. In nine of these 21 patients (43%), the corrected gradient number allowed correct classification as a benign lesion. PMID- 3809477 TI - Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT. AB - Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning. PMID- 3809478 TI - Pulmonary aspergillosis: unusual radiographic appearance. AB - Three cases of pulmonary aspergillosis are reported in which a seldom-mentioned radiographic feature was seen, namely, a stable, well-defined nodule or mass. The diagnosis of aspergillosis was based on results of transthoracic needle aspiration biopsy. Computed tomographic scans obtained before biopsy revealed no evidence of underlying cavitary disease. Two patients had hemoptysis. The nodule in the third patient was found on a routine chest radiograph. PMID- 3809479 TI - Ovarian cystic teratomas: MR imaging. AB - Magnetic resonance (MR) imaging characteristics of ovarian cystic teratomas were evaluated in 18 patients with 23 surgically proved tumors. The fat within the tumor demonstrated characteristic intensity similar to that of subcutaneous fat and a pathognomic pattern of chemical shift artifact that helped differentiate ovarian cystic teratomas from endometrial cysts. In addition to fat, MR images of ovarian cystic teratomas had several other characteristics that allowed confident diagnosis, including gravity-dependent layering or floating debris, palm tree like protrusions or rounded nodules (dermoid plugs), and, occasionally fat-fluid levels and globular calcification. MR images were diagnostic in 20 tumors and were able to depict a tumor measuring 2 cm in diameter. MR imaging appears to be valuable in problematic cases in which other modalities are not diagnostic. PMID- 3809480 TI - Vaginal agenesis: classification by MR imaging. AB - Vaginal agenesis was studied by magnetic resonance (MR) imaging lin a 15-year-old girl, a 19-year-old woman, and a 21-year-old woman. In each case MR studies demonstrated the presence or absence of a normal cervix and functioning endometrium. This information was useful in planning surgical management. MR imaging assisted in the classification of the abnormality by noninvasively demonstrating the details of pelvic anatomy-and the uterine morphologic characteristics. PMID- 3809481 TI - Complex and simple renal cysts: comparative evaluation with MR imaging. AB - Magnetic resonance (MR) imaging was performed in two groups of patients to determine its usefulness in evaluating fluid-containing renal masses deemed complex with computed tomography (CT). Twenty-two patients in group 1 had indeterminate renal masses by CT, five of which were also indeterminate by ultrasound (US). The results in this group were compared with histologic findings. Group 2 consisted of 20 patients with simple renal cysts diagnosed according to rigid CT criteria. On MR imaging, 11 of the 23 masses in group 1 and 19 of the 20 in group 2 were diagnosed as benign cysts. Fluid within the cyst had long T1 and T2, resulting in a low signal intensity on T1-weighted images. In the 12 remaining lesions in group 1 and in one lesion in group 2, the fluid content was indeterminate and MR did not permit differentiation of cystic renal carcinoma from old hemorrhage or adenoma. When fluid within the cystic mass did not have the MR characteristics of simple fluid, MR was not helpful in characterizing the mass, but when the fluid intensity was similar to normal urine, the cyst was benign. PMID- 3809482 TI - Renal sinus histiocytosis. AB - A 26-year-old woman had an infiltrative renal lesion accompanied by massive regional lymphadenopathy. Biopsy of the renal mass and a coexistent orbital mass revealed identical histologic evidence of sinus histiocytosis. This unusual benign entity is uncommon in the kidney, but radiographically, it may closely simulate an infiltrative renal neoplasm, especially a lymphoma or leukemia or even renal cell carcinoma. PMID- 3809483 TI - Dental radiography: efficacy in the assessment of intraosseous lesions of the face and jaws in asymptomatic patients. AB - In this investigation the efficacy of dental radiography for the detection of occult intraosseous lesions of the face and jaws was evaluated. An analysis of 30 million health insurance records indicated that the period prevalence of malignant lesions was less than 5 cases/million/year, and for benign lesions approximately 100 cases/million/year. Data from a controlled observer-performance study showed that radiographic sensitivities ranged between 50% and 80%. The cost per true-positive finding was estimated to be +8.6 million per malignant case and +430,000 per benign case. An assessment of the dosimetric literature indicated that the benefits of radiographic screening as a means for early detection of a malignancy appear to be counterbalanced by the risk of causing a radiation induced malignancy. Taken together, these data demonstrate that dental radiography is not efficacious for the purpose of detecting occult lesions. PMID- 3809484 TI - Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. AB - To better correlate the appearance of avascular necrosis (AVN) of the femoral head on magnetic resonance (MR) images with the stage of disease, MR images of 56 proved AVN lesions were compared with staging from corresponding radiographs (n = 56), Tc-99m scans (n = 41), and grade of symptoms (n = 28). Fractures complicating AVN were seen in 28 (50%) of 56 radiographs (radiographic stages III V). With long repetition (TR) and echo delay (TE) times, a characteristic "double line sign" consisting of high signal intensity inside a low-intensity peripheral rim was seen in 45 lesions (80%). The central region within the rim was isointense with marrow fat on both short and long TR and TE images in 20 (71%) of 28 lesions uncomplicated by fracture (stages I-II) but in only four (14%) of 28 stage III-V lesions (P less than .001). Symptoms were least severe in lesions isointense with fat and most severe in lesions with low-signal central regions at short and long TRs and TEs. The peripheral double line sign on long TR/TE images may add specificity to the diagnosis of AVN by MR imaging. A chronologic pattern of central MR signal features is presented which may allow staging of AVN by MR imaging. PMID- 3809485 TI - Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. AB - Thirty-two patients (64 hips) in whom avascular necrosis (AVN) of the femoral heads was highly suspected clinically were studied by magnetic resonance (MR) imaging, radionuclide bone scintigraphy, and conventional radiography. MR studies were positive for AVN in 37 hips, compared with 30 positive scintigraphic studies. In all cases in which scintigraphy and radiography were positive, MR imaging demonstrated decreased signal from the affected femoral heads, indicative of bone marrow disease. Imaging results were confirmed by biopsy or subsequent imaging appearances. In patients with negative initial scintigraphic and radiographic studies, the MR imaging criterion for a positive study was a moderately decreased bone marrow signal displaying segmental patterns within an otherwise normal-appearing femoral head on relatively T1-weighted images. In this series of high-risk patients, radionuclide scintigraphy had a sensitivity of 81%, compared with 100% for MR imaging. MR imaging should be the imaging modality of choice for early evaluation of bone marrow changes indicative of AVN. PMID- 3809486 TI - Arthrographic study of painful total hip arthroplasty: refined criteria. AB - The criteria for a diagnosis of loosening or infection of hip arthroplasties on arthrographic study were further refined by a retrospective review of 178 arthrograms representing 170 patients. The 97 arthroplasties that were surgically evaluated form the basis of this report. With the refined criteria, subtraction arthrography had a sensitivity of 96% and specificity of 92% for demonstrating loosening of the femoral component and a sensitivity of 97% and a specificity of 68% for demonstrating loosening of the acetabular component. Pseudocapsule size and the presence of bursae were important factors influencing arthrographic interpretation. Arthrographic findings of pseudocapsule irregularity and the presence of nonbursal cavities were suggestive of infection but were not sensitive or specific. Laboratory evaluation of aspirated material was a more reliable predictor of infection, although its sensitivity was only 71%. PMID- 3809487 TI - Tendons: high-field-strength, surface coil MR imaging. AB - High-resolution magnetic resonance (MR) images of the tendons of the hands, wrists, feet, and ankles of six healthy volunteers and six cadavers were obtained using receive-only surface coils and reduced-field-of-view imaging. Normal anatomy was identified and compared with gross anatomic sections of the six cadavers. Experimentally produced tears of the calcaneal (Achilles) tendon in domestic swine were identified on MR images. The hands and feet of 11 patients were examined, and a variety of pathologic lesions were identified, including acute posttraumatic rupture, acute tenosynovitis, chronic tendonitis, and postsurgical complications. MR imaging provides inherently greater soft-tissue contrast than any other currently available imaging modality. With the use of surface coils and reduced-field-of-view imaging to enhance spatial resolution, MR imaging has become a valuable tool for imaging tendons. Advantages over other available modalities include excellent depiction of anatomic detail, superior contrast resolution, and the potential for multiplanar imaging. PMID- 3809488 TI - Postamputation neuromas and other symptomatic stump abnormalities: detection with CT. AB - One of the potentially troublesome sequelae of limb amputations is the development of stump neuromas at the severed ends of major nerves. The ability to define them and to distinguish them from other causes of stump pain is of considerable clinical significance. Computed tomography was performed on ten lower limb amputees with stump pain. Five patients had neuromas that were manifest as focal or generalized alteration in the caliber, size, or contour of the nerve trunk in the affected stump. The remaining five patients each had an abnormality detected; these abnormalities included heterotopic bone formation, popliteal artery aneurysm, lipoma, scar tissue, and abscess in the contralateral limb. PMID- 3809489 TI - Hippocampal formation and related structures of the limbic lobe: anatomic-MR correlation. Part I. Surface features and coronal sections. AB - Correlation of magnetic resonance (MR) images with cryomicrotome sections and formalin-fixed sections of human brain documents that spin-echo MR imaging with short repetition time/short echo time pulse sequences can display the surface gyri of the inferomedial temporal lobe, including the temporal pole, the parahippocampal gyrus, the isthmus of the cingulate gyrus, the lateral and medial occipitotemporal gyri, and the inferior temporal gyrus; the associated sulci including the rhinal and collateral sulci, the occipitotemporal sulcus, and the anterior calcarine sulcus; the components and fiber tracts of the hippocampal formation including the pes hippocampi, the hippocampus, the subiculum, the dentate gyrus, the subsplenial gyri, the alveus, the fimbria, and the fornix; the fissures and sulci associated with the hippocampal formation, including the hippocampal fissure, dentatofimbrial fissure, and the choroidal fissure; the continuity between the cingulate gyrus and the parahippocampal gyrus through the isthmus of the cingulate gyrus; and the continuity between the callosal sulcus and the hippocampal fissure. PMID- 3809490 TI - Hippocampal formation and related structures of the limbic lobe: anatomic-MR correlation. Part II. Sagittal sections. AB - Magnetic resonance (MR) images in the sagittal plane display the lengths of the parahippocampal gyrus, subiculum, dentate gyrus, hippocampus, fimbria, fornix, hippocampal fissure, choroidal fissure, and temporal horn, and the anatomic relationships of these structures to the surrounding brain. Correlation of these images with anatomic specimens provides criteria for identifying these structures confidently on routine clinical MR imaging. PMID- 3809491 TI - Use of cerebrospinal fluid gating to improve T2-weighted images. Part I. The spinal cord. AB - Ungated and gated magnetic resonance images of the spinal cord acquired with the use of long repetition times (TRs) and long echo-delay times (TEs) were compared in 21 studies performed on a 1.5-T system. Both normal and abnormal spinal cord conditions were compared. All images were acquired in an identical fashion except that ungated studies had TRs of 2,000 or 2,500 msec, whereas in gated studies, TR was determined by the patient's heart rate. The effective TR of images gated to the cerebrospinal fluid (CSF) fell primarily in the range of 1,500-1,800 msec. Gating was accomplished using a peripheral pulse. Three image parameters were assessed: signal-to-noise ratio, object contrast, and resolving power. For each parameter, in both normal and abnormal spinal cords, the CSF-gated studies proved superior by eliminating spatially mismapped signal intensity from pulsatile CSF. PMID- 3809492 TI - Use of cerebrospinal fluid gating to improve T2-weighted images. Part II. Temporal lobes, basal ganglia, and brain stem. AB - Ungated and gated magnetic resonance images of the temporal lobes, basal ganglia, and brain stem acquired with the use of long repetition times (TRs) and long echo delay times (TEs), were compared quantitatively. Twenty-five pairs of images obtained on a 1.5-T system were evaluated. Ungated images (TR = 2,000 msec, TE = 80 msec) were acquired in the same manner as gated images except for TR, which, for gated studies, was determined by a patient's heart rate and generally fell into the 1,500-1,800-msec range. Three image parameters were assessed: signal-to noise ratio (S/N), object contrast, and resolving power. In both normal and abnormal brain tissue, gated images were superior to ungated images in object contrast and resolving power and equivalent in S/N. More so than in comparable studies of the spinal cord, ungated studies were susceptible to both false positive and false-negative interpretations. As in spinal cord studies, the major benefit of gating was the elimination of phase shift images arising from basal cisterns and the third ventricle. PMID- 3809493 TI - Cushing syndrome: pituitary CT scanning. AB - Proper treatment of patients with Cushing syndrome depends on knowledge of whether the condition derives from a pituitary or adrenal adenoma or an ectopic tumor that secretes adrenocorticotropic hormone (ACTH). Fifty-seven patients with Cushing syndrome were prospectively evaluated to determine whether computed tomography (CT) of the pituitary gland is useful in diagnosing or excluding an ACTH-producing adenoma and in predicting the site of the adenoma within the pituitary gland. Findings on CT scans were normal in 35 of 50 patients with surgically confirmed Cushing disease and in seven patients with ectopic ACTH producing tumors. Of the 15 patients with Cushing disease for whom CT results were abnormal, eight had macroadenomas and seven had microadenomas. This study demonstrates a low sensitivity (30%) and low diagnostic accuracy (39%) of CT in the detection of ACTH-producing pituitary tumors and indicates the need for alternative methods of confirming the pituitary origin of excessive ACTH secretion in most patients. PMID- 3809494 TI - The empty delta sign: frequency and significance in 76 cases of dural sinus thrombosis. AB - The presence of the empty delta sign on contrast material-enhanced computed tomographic (CT) scans of the brain is considered pathognomonic of sagittal sinus thrombosis (SST); however, a valid explanation for its appearance is lacking, despite several hypotheses. To determine the frequency of the sign and its prognostic significance, 76 reported cases (112 CT manifestations) of SST and SST related intracranial sinovenous occlusive disease were reviewed. Ten CT signs related to both disease processes were reported; the empty delta sign was the most frequently reported sign (28.6%) of SST. Patients with hemorrhagic infarction and/or the empty delta sign on CT scans had the poorest prognosis. A case illustrative of the empty delta sign is described in which there was engorgement of endothelial- and nonendothelial-lined spaces in the dura mater with hemorrhagic rupture into the dural leaf. The empty delta sign can probably be explained on the basis of the rich dural venous collateral circulation, consisting primarily of lateral lacunae, a vascular mesh (dural cavernous spaces), and meningeal venous tributaries. PMID- 3809496 TI - Acute cerebral infarction in monkeys: an experimental study using MR imaging. AB - Magnetic resonance (MR) imaging was performed in five monkeys with experimentally induced acute cerebral infarction to define the MR imaging features and correlate these with computed tomographic (CT) findings, laboratory analysis, and histopathologic studies. Acute infarct (2-4 hours after embolization) was generally visible on MR images but not on CT scans. CT at 24 and 48 hours did show the infarcts. In all cases the infarct was more clearly depicted with MR imaging and was visualized as an area of high signal intensity on T2-weighted images. Spectrometric nuclear MR measurements of the postmortem cerebral tissue confirmed prolongation of both T1 and T2 values similar to that calculated from MR images. At postmortem laboratory testing, the area of infarction detected with MR imaging had decreased specific gravity and increased water content, reflecting edema. PMID- 3809495 TI - Carbon monoxide toxicity: MR imaging in the brain. AB - Two cases of magnetic resonance (MR) imaging of intracranial abnormalities resulting from carbon monoxide toxicity are presented. Both cases demonstrate lesions in the globus pallidi of high MR signal intensity that correspond to previously reported abnormalities; the second case illustrates bilateral cortical high signal intensity lesions. The superiority of MR imaging in comparison with computed tomography is demonstrated in one case. The known effects of carbon monoxide toxicity in the brain are correlated with the findings of MR imaging. PMID- 3809497 TI - Pseudarthrosis following lumbar fusion: detection by direct coronal CT scanning. AB - Twenty patients with fusions of the lumbar spine (seven with pseudarthrosis, 11 with solid bony fusions, and two with fusions that appeared solid but assessment was complicated by the presence of surgical hardware) underwent computed tomographic (CT) scanning in the supine position in the axial plane and, employing a specially designed seat, in the coronal plane. Three-millimeter contiguous sections were acquired. The direct coronal images were compared with those reformated from the axial images. The higher-resolution direct coronal images facilitated the diagnosis of pseudarthrosis and increased confidence in interpretation of normal studies. Direct coronal imaging is easy to perform and in many cases requires fewer scans and less radiation than reformations. Because it provides more useful diagnostic information, direct coronal imaging should replace current methods for evaluating fusions of the lumbar spine. PMID- 3809498 TI - Infant ribs: generalized periosteal reaction resulting from vibrator chest physiotherapy. AB - A case is reported of diffuse periosteal new bone formation involving the ribs in an infant who received physiotherapy of the chest performed with a vibrator. The abnormality probably resulted from periosteal trauma caused by prolonged vibrator therapy. Since this form of pulmonary therapy is common in newborn intensive care nurseries, radiologists may encounter this finding occasionally. PMID- 3809499 TI - Neonatal herpes simplex encephalitis: correlation of clinical and CT findings. AB - Review of 31 computed tomographic (CT) scans in 15 neonates with herpes simplex encephalitis (HSE) type 2 revealed the most characteristic early findings to be patchy and widespread areas of low attenuation, primarily in white matter, with minimal contrast material enhancement in a meningeal pattern. The low-attenuation lesions increased rapidly in size and prominence during the course of the disease. This was usually accompanied by increased attenuation of cortical gray matter that persisted for weeks to months. Atrophic changes appeared rapidly, being evident in the 3d week. Late findings consisted of very extensive, diffuse, low attenuation of white matter with cortical atrophy. Calcification assumed a variety of distributions, from punctate to an extensive gyral pattern. The cerebellum was involved in nine patients. Early CT findings were not good predictors of outcome, but later serial CT scans showing progression or stability of findings were more accurate in prognosis. CT serves primarily to confirm the diagnosis of neonatal HSE. PMID- 3809500 TI - Multiphasic examinations of the stomach: efficacy of individual techniques and combinations of techniques in detecting 153 lesions. AB - Multiphasic examinations of 153 gastric abnormalities observed radiologically and endoscopically were reviewed to determine the efficacy of four radiologic techniques and of several common combinations of these techniques for examining the stomach. There were 68 gastric ulcers, 12 ulcer scars, 44 cases of gastritis including 27 with erosions, 24 benign neoplasms, and five malignancies. Double contrast, compression, mucosal relief, and full-column techniques detected 82%, 65%, 62%, and 51%, respectively, of all lesions diagnosed with the complete multiphasic examinations. Results indicate that the greater the number of techniques employed, the more accurate the examination, with biphasic and multiphasic examinations detecting 9%-18% more lesions overall than simple single or double-contrast studies. PMID- 3809501 TI - Interventional colorectal endoscopic procedures: residual lesions on follow-up double-contrast barium enema study. AB - Endoscopic procedures such as deep rectal biopsy, sclerosant injection, or banding of hemorrhoids, and the electrocoagulation of small polyps leave residual abnormalities that will be apparent on double-contrast barium enema examinations performed a short time thereafter. Nine cases are described to illustrate the findings that may be encountered. Their recognition is important to prevent diagnostic confusion, and endoscopists should inform radiologists of any procedure performed. PMID- 3809502 TI - Duodenal neoplasms: role of CT. AB - In a retrospective study of 14 cases of duodenal neoplasms evaluated by computed tomography (CT), there were four primary adenocarcinomas of the duodenum, one lymphoma, five metastatic carcinomas, two duodenal lipomas, one villous adenoma, and one leiomyoma. The CT findings were diagnostic in patients with duodenal lipomas. In 11 cases, a primary origin of the mass was clearly identifiable in the duodenum. Thickening of the bowel wall, tumor necrosis, ulceration, and intraluminal defects were common. The relationship of the masses to adjacent structures was clearly shown on CT scans. Extraluminal extent of the lesion was noted on CT scans in seven patients; however, at surgery only four of six were found to have extramural disease. The presence of adenopathy, liver metastases, and vascular and mesenteric invasion were also demonstrated on CT scans. Twelve patients underwent upper gastrointestinal tract series. A duodenal abnormality was seen in all 12 patients, but the extramural extent and distant metastatic involvement could not be seen on these examinations. CT scans allowed the accurate staging of eight of ten malignant lesions and thus helped in the management of duodenal tumors. PMID- 3809503 TI - Obesity-related nonalcoholic fatty liver: CT features and follow-up studies after low-calorie diet. AB - The features on computed tomographic (CT) scans of nonalcoholic fatty liver were investigated in 24 patients with nonalcoholic fatty liver related to overweight. CT examinations were performed before and after 3 months of a low-calorie diet. The reversibility of fatty infiltration during diet therapy could be monitored by changes in appearance on repeated CT scans. Hepatic steatosis improved, as assessed from increases in attenuation values on CT scans after 3 months of the diet, and the improvement was accompanied by a decrease in the elevated serum glutamic-pyruvic transaminase activity. Hepatic fatty infiltration in these patients was not always uniform, and attenuation values in the right lobe of the liver were significantly lower than those in the left lobe. After the 3-month diet therapy, the mean liver volume was significantly reduced, while the spleen volume was unchanged. Two sequential CT examinations, performed before and after diet therapy, may be useful for evaluating obese patients with elevated serum transaminase activity. PMID- 3809504 TI - Digital gastrointestinal imaging: the effect of pixel size on detection of subtle mucosal abnormalities. AB - Five radiographs of double-contrast colon examinations demonstrating subtle mucosal changes of inflammatory bowel disease and five radiographs of healthy colonic mucosa were selected and digitized to four levels of resolution. Pixel sizes of 0.1 mm, 0.2 mm, 0.4 mm, and 0.8 mm were used. Ten radiologists interpreted the images, which were displayed on laser-printed film. Analysis of variance with repeated measures was performed and receiver operator characteristic curves were determined. The results demonstrate that the sensitivity in detecting subtle mucosal abnormalities improved as the resolution improved, with the best sensitivity at the highest resolution; more experienced readers detected details well even at the poorer levels of resolution; the resolution necessary for successfully evaluating the colonic mucosa was lower than expected; and given low noise levels, the matrix size used in conventional television fluoroscopy would be adequate for mucosal evaluation. PMID- 3809505 TI - Multinuclear MR imaging: a technique for combined anatomic and physiologic studies. AB - With the use of specially designed multiple-tuned probes for magnetic resonance (MR) imaging, data collection schemes can be developed for obtaining images of different nuclei simultaneously. Both phantom and in vivo MR images of two nuclei (either hydrogen-1, phosphorus-31, lithium-7, or fluorine-19) were obtained in the time span necessary to collect the image of the less sensitive nuclei. This technique offers a means by which physiologic and anatomic information can be gathered in a highly efficient fashion. PMID- 3809506 TI - Assessment of testicular metabolic integrity with P-31 MR spectroscopy. AB - To evaluate the reliability of phosphorus-31 magnetic resonance (MR) spectroscopy in the assessment of acute testicular ischemia, vascular integrity, and spermatogenesis, the authors studied in vivo canine and primate testicles grouped as follows: group 1 testes (n = 8), in situ canine controls; group 2 (n = 11), canine testes subjected to warm ischemia; group 3, canine (n = 4) and primate (n = 4) testicles from hormone-treated animals. Group 1 control testicles showed high monophosphoester (MP) levels; low levels of inorganic phosphate (Pi), phosphodiester (PD), and phosphocreatine; and high levels of adenosine triphosphate (ATP). Group 2 testes revealed a time-dependent decay of MP/Pi ratios (from 2.1 to 0.70). Regeneration of ATP was noted in the acute reperfusion period. After 6 weeks of pituitary gonadotropin suppression, group 3 testes showed a significant decrease (P less than .05) in MP/PD ratios from a control level of 2.6 +/- 0.3 and a decrease in the MP/beta-ATP ratio from 2.4 +/- 0.1 to 1.8 +/- 0.3. P-31 MR spectroscopy appears to be a potential method for noninvasively assessing testicular ischemic injury and the metabolic integrity of spermatogenesis. PMID- 3809507 TI - An efficacy lesson for medical radiologists from our dental colleagues. PMID- 3809508 TI - Revised glossary of MR terms. PMID- 3809509 TI - Incompatibilities between contrast media and pharmacologic agents. PMID- 3809510 TI - Peripheral low-density area of hepatic tumors: CT-pathologic correlation. PMID- 3809511 TI - Prognostic value of CT in acute pancreatitis: is the early CT examination indicated? PMID- 3809512 TI - Pulmonary hamartoma: CT findings. PMID- 3809513 TI - Nondilated obstructive uropathy. PMID- 3809514 TI - Mammographic microcalcifications: detection with xerography, screen-film, and digitized film display. PMID- 3809515 TI - A rational approach to NSAID therapy. PMID- 3809517 TI - Serendipity and structured research in drug discovery. PMID- 3809516 TI - Autoregulation of the coronary circulation. AB - Coronary autoregulation appears to be closely coupled to myocardial oxidative metabolism. Recent data suggest that coronary autoregulation depends on the prevailing balance between myocardial oxygen supply and demand. It seems likely that pO2 within a critical range may be the initial metabolic stimulus for coronary autoregulation. Whether adjustments in vascular resistance result from changes in myocardial pO2 directly or indirectly through changes in vasoactive metabolites remains unclear. The observation that intracoronary infusion of adenosine deaminase in concentrations sufficient to attenuate myocardial reactive hyperemia has no effect on coronary autoregulation strongly suggests that adenosine is not essential for autoregulation in the blood-perfused dog heart. This is supported by the recent finding that the interstitial concentration of adenosine (estimated from epicardial exudate) remained unchanged during autoregulation. Prostaglandins may play a role in autoregulation in buffer perfused rabbit hearts but do not appear to be involved in blood-perfused dog hearts. Potassium is probably not involved in autoregulation. It is also unlikely that changes in tissue pressure can account for coronary autoregulation. The role of adenine nucleotides, hydrogen ion, carbon dioxide, and intermediate metabolites of the citric acid cycle, in coronary autoregulation has not been examined. The possibility that a myogenic mechanism contributes to coronary autoregulation has not been directly tested. Finally, it is entirely possible that coronary autoregulation may result from the concerted interaction of several different mediators or mechanisms. In this regard, it should be emphasized that blocking or destroying one mediator could elicit a compensatory increase in the contribution of another. PMID- 3809518 TI - Validation criteria for animal models of human mental disorders: learned helplessness as a paradigm case. AB - Three sets of criteria are proposed for assessing animal models of human mental disorders: predictive validity (performance in the test predicts performance in the condition being modelled), face validity (phenomenological similarity) and construct validity (theoretical rationale). The problems inherent in each of these validation procedures are discussed, and their application to the learned helplessness model of depression is examined. It is concluded that whilst the model has good predictive validity, important questions about face validity remain unanswered, and construct validity has not yet been established. The distinctions between animal models and some related experimental procedures are also discussed. PMID- 3809519 TI - Psychopharmacological profile of salsolinol. AB - SAL is a tetraisoquinolein (T.I.Q.), resulting from the condensation of acetaldehyde and dopamine. SAL, injected intraperitoneally, is active in tests commonly used to screen potential antidepressants. This effect is especially studied by using antagonism of apomorphine, reserpine, oxotremorine-induced hypothermia. The noradrenergic system seems to be involved in the mechanism of action. PMID- 3809520 TI - Effects of chronic alcohol consumption in weanling rats on brain gangliosides. AB - Chronic ingestion of ethyl alcohol in pre-weanling rats can decrease whole-brain levels of sialic acid (SA), an acidic sugar that serves as terminal groups on glycolipids (gangliosides) and glycoproteins. Because SA occurs in both classes of membrane-bound chemicals, the alcohol effect could be on either or both parent compounds. We examined the effects of alcohol on gangliosides by measuring levels of six specific ganglioside species in post-weanling rats that were fed liquid alcohol diet for 35 days. We found no major effect on any of the ganglioside species in the alcohol-fed rats compared with their pair-fed littermates. These data suggest that alcohol may have acute effects on membrane gangliosides, but during chronic exposure in more mature animals, the membrane may adapt and maintain near-normal ganglioside composition. Thus, gangliosides may reflect mechanisms of membrane tolerance; they could also be involved in mediating metabolic dependencies in neuronal membranes, a possibility that needs testing. PMID- 3809522 TI - Mescaline action on "memory decay" and "problem solving" behavior in the rat. AB - The modifications of behavior caused in the rat by a chronic oral administration of mescaline have been studied in three experimental situations. In the staircase maze mescaline accelerated the spontaneous decay on the conditioned reflex (memory decay) during the period without daily training. Only the results observed at 30 mg/kg/day of mescaline were statistically significant. In a T maze two lateral alleys closed by two swinging doors, 30 mg/kg/day of mescaline increased the time spent in opening the first door. When the two doors of the lateral alleys were closed with a latch, mescaline 30 mg/kg/day, caused an increase in the time spent by the rat in opening the doors. Mescaline caused an increase in food consumption. The increase at 30 mg/kg/day is statistically significant. PMID- 3809521 TI - The effect of a putative antidepressant, an O2-substituted derivative of barbitone on apomorphine induced hypomotility. AB - The effects of the chronic administration of barbitone and its O2-substituted isopropyl derivative (O2IB) was studied on the hypomotility induced in rats by the acute administration of a low dose of apomorphine. Neither drug was found to selectively antagonize the hypomotility caused by acute apomorphine administration. No correlation could be found between the behavioural effects of the barbiturates and changes in the concentrations of biogenic amines and GABA in four discrete brain regions. The results of this study do not support the conclusions of previous acute studies in which O2IB has been shown to have an antidepressant profile. PMID- 3809523 TI - The calcium entry blockers: anti-manic drugs? AB - The reported property of calcium antagonists as antimanic drugs has been investigated in three models of hyperactivity in mice. The hyperactivity was induced by amphetamine, oxolinic acid or reserpine after inhibition of monoamine oxydase (MAO). Nicardipine (a dihydropyridine derivative) reduces the three hyperactivities, verapamil (a diphenylalkylamine derivative) reduces only oxolinic acid hyperactivity, and diltiazem (a benzothiazepine derivative) was active except in the MAOI-reserpine test. Levomepromazine used as a reference drug reduced the three hyperactivities. The three calcium entry-blockers reduce the different hyperactivities at doses which already decrease motor activity. And so, it seems that their action was not specific. On the contrary, levomepromazine antagonizes MAOI-reserpine induced hypermotility at a dose which is not sedative. These results do not strengthen the property of calcium antagonists as antimanic drugs. PMID- 3809524 TI - Basal hypersecretion of cortisol in relation to abnormal dexamethasone suppression test response in depression. AB - The activity of the hypothalamus-hypophysis-adrenal axis was evaluated in a group of patients with primary affective disorder by correlation of basal cortisol hypersecretion and abnormal response to dexamethasone suppression test (DST). The increase in basal cortisol was not found to be responsible for suppression failure. Moreover, this biochemical abnormality was common in the groups of psychiatric patients studied, although the physiopathologic mechanisms involved are different. Further research is necessary to clarify the results. PMID- 3809525 TI - Nonlinear pharmacokinetics of chlorimipramine after infusion and oral administration in patients. AB - In this study the pharmacokinetics of 75 mg and 150 mg chlorimipramine after infusion and tablets was followed for four weeks in chronically treated patients. The clearance was found to be dose dependent. From the time course of the metabolite desmethylchlorimipramine in plasma it can be concluded, that chlorimipramine tablets are resorbed totally. No correlation between pharmacokinetic and improvement parameters could be found. Doubling of the dosage leads to 3 fold chlorimipramine and 4 fold desmethylchlorimipramine concentrations. The estimated half lives are higher than known hitherto. Especially for chronic treatment with 150 mg chlorimipramine, plasma concentration monitoring is recommended, because 20% of the patients did not reach steady state for chlorimipramine and 60% for desmethylchlorimipramine, in these 4 weeks. PMID- 3809526 TI - The effects of caerulein on nocturnal sleep. AB - Caerulein, a decapeptide chemically related to cholecystokinin octapeptide, was examined polysomnographically for its effect on nocturnal sleep in healthy volunteers. The subjects were 6 males (20-24 years of age). Either a placebo (saline) or caerulein 0.6 microgram/kg was administered intramuscularly to volunteers at 23:00. Polysomnograms were then recorded from 23:00 till 06:30. Little variation in sleep period time, total sleep time, sleep efficiency index, sleep latency, or REM sleep latency in the drug night were found as compared to the control night values. The percentage of REM stage sleep increased significantly (P less than 0.01) on the drug administered night, whereas the change in the percentages of each of the other stages was not significant. The REM density of the vertical eye movements tended to increase on the drug night, but the density of the horizontal eye movements showed no change. There were no changes in the spontaneous GSRs in either vola or dorsum manus. As caerulein shows alpha-1 adrenergic receptor blocker activity, it is suggested that caerulein may increase REM sleep by affecting the central noradrenergic neurons. PMID- 3809527 TI - Altered locomotor activity in neuropsychiatric patients. AB - Movement was monitored continuously for 24-48 hours in representative neuropsychiatric patients, using a wrist-worn portable piezoelectric activity monitor with solid-state memory. Striking differences were observed in both circadian and more rapid (ultradian) rhythms between these patients and normal controls of a similar age. We found a loss of circadian rhythm following stroke, and a marked 4-hour activity rhythm in patients with dementia and brain tumor. These results may provide insights into the neural substrate of activity rhythms and may lead to better care of neuropsychiatric patients. PMID- 3809528 TI - [Chromosome studies in the past and future]. PMID- 3809529 TI - [Chromosome sorting and the genomic DNA library]. PMID- 3809530 TI - [Mapping of human genes by using cell lines with partial deletion of chromosomes]. PMID- 3809531 TI - [Quality control of cell lines in the JCRB-cell bank]. PMID- 3809532 TI - [Subacute sclerosing panencephalitis (SSPE) in Poland 1977-1983. The second stage of epidemiologic studies]. PMID- 3809533 TI - [The preventive vaccination program in Poland in comparison with the programs in other European countries]. PMID- 3809534 TI - [Comparative analysis of the incidence of lymphocytic cerebrospinal meningitis 1982 and 1983 (data of the Infectious Disease Clinic, Pomeranian Medical Academy)]. PMID- 3809535 TI - [Diarrhea in infants up to 2 years of age--1984]. PMID- 3809536 TI - [Infectious mononucleosis--1984]. PMID- 3809537 TI - [Brucellosis and other zoonoses--1984]. PMID- 3809538 TI - [Scabies--1984]. PMID- 3809539 TI - [Changes in the utilization of the Warsaw health services 1970-1979 in relation to the health status of the population. III. Correlations between the services and health services needs]. PMID- 3809540 TI - [Mortality in Poland in relation to other European countries]. PMID- 3809541 TI - [Vaccination against influenza among elderly persons]. PMID- 3809542 TI - [Outbreaks of viral meningitis in Cracow province 1982]. PMID- 3809543 TI - [Factors affecting decision making with regard to the vaccination of humans against rabies]. PMID- 3809544 TI - [Changes in the utilization of Warsaw health services 1970-1979 in relation to the health status of the population. IV. Changes in the types of service]. PMID- 3809545 TI - [Occurrence of antigenic variants of influenza type A H1N1 and H3N2 in swine]. PMID- 3809546 TI - [Chronic enteropathies in children]. PMID- 3809547 TI - [Symptomatic psychosis in trichinosis--effect of steroids or basic disease?]. PMID- 3809549 TI - Identifying the potential problem drinker--a proposal. PMID- 3809548 TI - [Verification of the theory of the role of synanthropic insects in the transmission of intestinal Protozoa]. PMID- 3809550 TI - The diet-cancer conundrum. PMID- 3809551 TI - Chronic diseases. PMID- 3809552 TI - Accidents: programmes for prevention. PMID- 3809553 TI - Health promotion. A discussion document on the concept and principles. PMID- 3809554 TI - Having a baby in Europe, report on a study. PMID- 3809555 TI - [Identification, new needs and new forms of sexuality]. PMID- 3809556 TI - [Structure and therapy of compulsive neurosis]. PMID- 3809557 TI - [The traumatized therapist. Countertransference in a difficult patient]. PMID- 3809558 TI - [Understanding and not understanding. Some technical questions]. PMID- 3809559 TI - [Achievements in current oncological cytodiagnosis]. PMID- 3809561 TI - [Clinical control studies of the role of dietary habits in the etiology of stomach cancer]. PMID- 3809560 TI - [Radioimmunological analysis of the free alpha subunit of chorionic gonadotropin (alpha-HCG) in sera of women during normal pregnancy]. PMID- 3809562 TI - [Changes in levels of triglycerides, cholesterol, noradrenaline and lactates in the blood of patients with severe coronary insufficiency after long-term physical exertion of low intensity]. PMID- 3809563 TI - [The physician as consultant]. PMID- 3809564 TI - [Immunopathology of hairy cell leukemia, its infectious complications and therapeutic conclusions]. PMID- 3809565 TI - [Dissecting aneurysm of the ascending aorta and the right sinus of Valsalva with aorto-cardiac fistula]. PMID- 3809566 TI - [The "Polish Experiment" with regard to the prevention of coronary disease. I. Effect of the program on the level of risk factors among the general population]. PMID- 3809567 TI - [The "Polish Experiment" with regard to the prevention of coronary disease. II. Effect of the program on the level of risk factors among high-risk persons]. PMID- 3809568 TI - [The "Polish Experiment" with regard to the prevention of coronary disease. III. Effect of the program on morbidity and mortality]. PMID- 3809569 TI - [Immunologic indicators in patients with stomach cancer at various clinical stages]. PMID- 3809570 TI - [Blood serum lipids in the population from an industrial environment]. PMID- 3809571 TI - [Serum lipids in men under 45 years of age with primary hypertriglyceridemia and after myocardial infarction. I. Triglycerides]. PMID- 3809572 TI - [Blood serum lipids in men under 45 years of age with primary hypertriglyceridemia and after myocardial infarction. II. Phospholipids]. PMID- 3809573 TI - [Cellular lipoprotein receptors in atherogenesis. I. LDL receptors in cholesterol metabolism]. PMID- 3809574 TI - Modularity, mass-action and memory. PMID- 3809575 TI - Dementia and working memory. PMID- 3809576 TI - Movement and attention in visual working memory. PMID- 3809577 TI - The uses of short-term memory: a case study. PMID- 3809578 TI - Digit span, reading rate, and linguistic relativity. PMID- 3809579 TI - Animal memory: past, present and future. PMID- 3809580 TI - Allocentric spatial learning by hippocampectomised rats: a further test of the "spatial mapping" and "working memory" theories of hippocampal function. PMID- 3809581 TI - Distinguishing between new and used traces: differential effects of electroconvulsive shock on memories for places presented and places passed. PMID- 3809582 TI - A comparison of visual and auditory short-term memory in monkeys (Cebus apella). PMID- 3809583 TI - Bladder base dosage in patients undergoing intracavitary therapy. AB - The maximum dose rate being delivered to the base of the bladder during intracavitary therapy was assessed in 20 patients by CAT scanning during treatment. This value was compared with the I.C.R.U. bladder reference point dose rate calculated from lateral radiographs taken after insertion. The ratio of the maximum bladder base dose rate to the I.C.R.U. reference dose rate varied from 1.01 to 3.59. In ten patients the maximum bladder dose rate was not in the midline. Re-examination of five patients revealed significant changes in bladder base dose rate in two due to changes in applicator positioning and packing. The bladder base dose rate on the vertical plane through the middle of the vaginal ovoids was within +/- 25% of the maximum bladder base dose rate in 22/25 examinations. PMID- 3809584 TI - Radiotherapy with multiple fractions per day in pancreatic and bile duct cancer. AB - Twenty patients with pancreatic and bile duct cancer have been treated with external radiotherapy with multiple fractions per day (MFD). All patients had localized disease only. Sixteen patients have been treated with a split-course technique, to a dose of 60 to 70 Gy in 7-8 weeks, four patients had a continuous series of 44 Gy in 19 days. The mean survival was 7.9 months for patients with a pancreatic cancer. Four out of nine patients with pancreatic cancer in whom the tumour was evaluable showed a tumour regression, one out of nine reached a partial remission. The mean survival in the responders was 9.5 months. All patients with pancreatic cancer died of their tumour. Four out of eight patients with bile duct cancer died of their tumour, the mean survival was 10 months. Four patients with bile duct cancer are still alive (10+, 10+, 10+, 11+ months). No serious acute toxicity was seen. Six patients showed gastrointestinal toxicity at 1.5 to 9 months after the end of treatment. All of them could be treated in a conservative way. From the results obtained in this feasibility study, radiotherapy with MFD in pancreatic and bile duct cancer appears to achieve similar tumour response as conventionally fractionated radiotherapy and the observed toxicity of MFD can be considered as acceptable. MFD might be a more appropriate treatment scheme for combination with chemotherapy and radiosensitizers. PMID- 3809585 TI - Sequential multi-agent chemotherapy and whole abdominal irradiation for stage III ovarian carcinoma. AB - Modern therapy for stage III ovarian carcinoma patients usually involves one or more laparotomies with maximal resection of tumor, and intensive multi-agent chemotherapy. However, with long-term follow-up only 10-15% of patients remain free of disease. In the hope of improving outcome, we have treated 17 women with sequential multimodality therapy, including initial surgical resection (if possible), cyclophosphamide-adriamycin +/- cis-platinum, second-look surgery, and whole abdominal irradiation. Seven patients are currently alive without disease, with median follow-up of 52 months since initiation of radiation and 60 months since initiation of chemotherapy. Disease-free survival correlated with residual tumor at the start of radiotherapy: none (4/4); microscopic, less than or equal to 5 mm (3/4); greater than 5 mm or no surgery (0/9). Survival also correlated with tumor grade: grade 1 (2/2); grade 2 (2/3); grade 3 (3/11). Hematological tolerance of radiotherapy was dependent upon the number of chemotherapy cycles: ten of 11 patients receiving less than or equal to eight cycles completed radiotherapy without excessive delay, compared with only one of five receiving greater than eight cycles. There were no treatment-related deaths and only one patient required laparotomy for bowel obstruction. We conclude that intensive multimodal treatment may be tolerated moderately well if the amount of chemotherapy is limited, and that further studies are justified. PMID- 3809586 TI - Hematoporphyrin phototherapy of cancer. AB - Hematoporphyrin phototherapy of cancer is a new modality for cancer diagnosis and treatment that is currently undergoing clinical trials worldwide. A variety of tumors have been studied, e.g., breast (mostly recurrent skin), lung, bladder, eye, head and neck, gynecological and brain. The most success to date has been with lung and the gynecological tract. Cell and animal studies are being conducted to elucidate the basic photobiological mechanisms involved, as well as the histopathological events associated with tumor destruction. Although major questions remain to be resolved, hematoporphyrin phototherapy is an exciting new therapeutic modality for the treatment of cancer, especially in sites where the unique features of lasers and fiber optics are advantageous. PMID- 3809587 TI - DNA-flow cytometry of squamous cell carcinomas from the human uterine cervix: the identification of prognostically different subgroups. AB - The relevance of DNA-index, alone and in combination with other parameters, was assessed for patients with squamous cell carcinomas of the uterine cervix by using the method of flow cytometry (FCM). Tumours with a diploid or a tetraploid DNA-content appeared to be associated with a less favourable prognosis than was observed in the group with non-diploid/non-tetraploid tumours. DNA-index in combination with either the age of patients or the histological grade of tumours, enabled the separation of prognostically different subgroups. Particularly, the combination of an age under 51 years with a DNA-index of 1 or 2 appeared to define a group with a low survival rate. Furthermore, within the group of well and moderately differentiated tumours, it was possible to identify prognostically different subgroups by combining this parameter with DNA-index, i.e. a non diploid/non-tetraploid DNA-content of these tumours was associated with a more favourable prognosis. From this study it is concluded that FCM clearly contributes to the recognition of subgroups of patients with different prognosis. PMID- 3809588 TI - Dose-rate effects in the radiation response of four human tumour xenografts. AB - The radiation repair capability of four human tumour xenograft lines, two adenocarcinomas of the pancreas, an adenocarcinoma of the breast and a melanoma, has been investigated by means of a soft agar clonogenic assay. Dose-rate dependence studies at 150, 7.6 and 1.6 cGy/min and split-dose experiments, have been performed. Results indicate a good correlation between split-dose recovery and the dose-sparing achieved by irradiation at 1.6 cGy/min when compared to acute irradiation in 3 of the 4 tumour lines. The HX118 melanoma showed dose sparing at dose-rates of 7.6 and 1.6 cGy/min and a substantial ability to perform recovery between split doses of radiation, whereas HX32, a pancreatic carcinoma, showed little dose-sparing and a correspondingly small degree of split-dose recovery. The HX99 breast carcinoma, was aberrant in showing the greatest split dose recovery of the four lines but only a moderate extent of low dose-rate sparing. Data have been fitted by two recently described models for radiation dose-rate dependence; the incomplete repair model of Thames and the Lethal Potentially-Lethal (LPL) model of Curtis. Curves were fitted better by the Thames model which provided a good fit for data from 3 of the 4 xenografted human tumour lines. HX99 produced dose-rate dependence survival curves that were not well fitted by either model. PMID- 3809589 TI - Quality assurance control in the EORTC cooperative group of radiotherapy. 2. Dosimetric intercomparison. AB - The European Organization for Research on Treatment of Cancer (EORTC) has performed site reviews at 17 institutions participating in clinical trials organized by the Cooperative Group of Radiotherapy. In this paper the dosimetric part of the quality assurance control programme is presented. In a previous paper (part 1) the medical profile of the participating centres was presented. In part 3 an integrated clinical and dosimetric investigation in an anatomical phantom will be presented. The deviations between the absorbed dose values, for specific points along the beam axis in a water phantom, determined by us and reported by the hospitals were within an acceptable level of variation (about +/- 3%) for 85, 70 and 71% of the 60Co gamma, X-ray and electron beams, respectively. In some scanning electron beams, too large deviations were found. The flatness and symmetry of the beams were measured. 73% of the X-ray and 60% of the electron beams were within the acceptable levels of variations. Dosimetric recommendations for institutions participating in EORTC clinical trials are presented. PMID- 3809590 TI - About the rate of temperature changes in a thimble chamber. AB - The rate of temperature changes was studied in a nylon thimble chamber provided with a temperature sensor, when the chamber was inserted in different phantom media. It was found, that the temperature time constant for the changes ranged from 40 s (chamber in water) to 515 s (chamber with build-up cap in air). It was also found, that handling the detector for about 30 s caused a temperature rise of about 1 degree C. This temperature rise was reflected in dose-rate measurements with a graphite ionization chamber, but was not measurable with a nylon chamber. PMID- 3809591 TI - Alpha/beta value and the importance of size of dose per fraction for late complications in the supraglottic larynx. AB - In a group of 155 cases with squamous cell carcinoma of the supraglottic larynx (T3-4N0M0), with 3-year local control after radiotherapy, 21 late complications were noted. Using two different methods, an alpha/beta value of 3.8 Gy was calculated. A strong correlation between the risk of late effect in the larynx and size of dose per fraction was found; there was no influence of overall treatment time. PMID- 3809592 TI - The growth and histological characteristics of a series of human bladder cancer xenografts. AB - Xenografts from human transitional cell carcinoma of the bladder (TCC) have been successfully established in CBA mice which had previously been immune-deprived by thymectomy and whole body irradiation with cytosine arabinoside pre-treatment. Xenografts were established from 3/17 patients with histological grade 2 tumours, 3/19 patients with histological grade 3 tumours, and one from a patient with a mixed transitional cell and squamous cell carcinoma. No xenografts were established from patients with histological grade 1 tumours. All the xenografts maintained the histological characteristics of their parent tumours in early passage, but some developed more prominent squamous features in later generations. Many of the xenografts were cystic. PMID- 3809594 TI - Extension of the reciprocal dose analysis to the case of multiple fractions plus top-up. PMID- 3809593 TI - Influence of timing of cytotoxic drug treatment on the response of murine clonogenic spermatogonia to X-irradiation. AB - The enhancement of radiation-induced stem spermatogonial cell killing by three cytotoxic compounds has been investigated using an in vivo clonogenic assay. Drug doses (carmustine (BCNU), 15 mg/kg; cyclophosphamide (CY), 150 mg/kg; procarbazine (PCB), 200 mg/kg) were chosen to kill a high proportion of differentiated spermatogonia but few stem-cells, as assessed by sperm-head counts (SHC) at 29 and 56 days respectively. Drug doses were administered up to 14 days prior to or after local irradiation with 9 Gy of 230 kVp X-rays. BCNU produced a moderate enhancement of damage that was relatively independent of time. Both CY and PCB produced a considerable enhancement of damage especially when administered 1 to 3 days before irradiation. Enhancement in the case of PCB consisted largely of a vertical displacement of the radiation dose-response curves, but with additional evidence for possible changes in slope. PMID- 3809595 TI - The acute in vitro and in vivo radiosensitivity of human lung tumour lines. AB - Eleven human lung tumour lines have been established in xenograft or tissue culture, and the responses to acute irradiation of the 10 lines which cloned in soft agar were assayed. In vitro radiosensitivity was evaluated using the multitarget and linear quadratic models of cell survival and the surviving fraction at 2 Gy. Significant differences in the response of the different cell types were found, the large-cell phenotype exhibiting radioresistance, and small cell carcinomas and adenocarcinomas being radiosensitive. No differences in the capacity of the different tumour types to repair radiation damage were demonstrated. In vivo and spheroid response was modified by the effects of hypoxia and cell-contact phenomena. The results suggested that hyperfractionation would be useful in the clinical management of adenocarcinoma and small-cell carcinoma. PMID- 3809596 TI - Tumor excision and radiotherapy as primary treatment of breast cancer. Analysis of patient and treatment parameters and local control. AB - From 1966 to 1979, 235 patients with operable breast cancer were treated by tumor excision and radiotherapy. The actuarial survival at 10 years was 94.8% for stage I and 58% for stage II tumors. Local recurrent cancer was seen in 23/235 patients and was related to T stage, N stage, width of surgical excision, radiation dose to the tumor bed and anatomopathological differentiation. Recurrences were seen in 1/7 of T0, 3/57 (5.2%) of T1, 11/102 (10.8%) of T2 and 2/6 of T3 tumors. Local control in the breast decreased significantly in N1b cases (p = 0.005) or when 3 or more axillary lymph nodes were positive (p = 0.0074). Local control after segmentectomy or tumorectomy was identical. However, a poorer local control was found in 20 cases treated with subtotal resection (p less than 0.05). A clear dose-local control relationship was found in this material, with a 100% local control in all T0, T1 tumors which received more than 1800 ret and all T2 tumors which received more than 2000 ret. As 19 of 23 breast recurrences were seen at the primary site in the breast we believe that booster doses should be given in order to maximise local control. PMID- 3809598 TI - Adjuvant irradiation after radical surgery of cancer of the rectum and rectosigmoid. AB - From January 1975 through December 1983, 74 consecutive patients were given adjuvant radiotherapy on the whole pelvis after radical surgery for locally advanced rectal (44 cases) and rectosigmoidal (30 cases) cancer. Most patients received 45 Gy to the whole pelvis in 5-7 weeks through AP, PA opposed fields. Fourteen patients were also given adjuvant chemotherapy. Minimum follow-up time of the series is 24 months and median follow-up is 36 months. First relapse was evaluated. Pelvic failures occurred in 17.5% of patients, while distant metastases rate was 32%; median time to relapse was 18 and 10 months respectively. Thirty patients (40.5%) never relapsed and are alive and well, while five additional patients are alive with disease. Four patients died of treatment toxicity. Thirty-one patients died of cancer (41.9%); 8 of them from pelvic failure only. Actuarial relapse-free survival at 3 and 5 years was 51.7% and 46.8%, while actuarial overall survival was 63% and 49%. PMID- 3809597 TI - Carcinoma of the lip and selected sites of head and neck skin. A clinical study of 896 patients. AB - During a period of over 20 years, 896 patients were treated with radiation in Wadsworth Medical Center, Los Angeles, for carcinoma of the lip and selected sites of skin of the head and neck. Basal cell carcinoma (BCC) was found in 467 (52%) patients, squamous cell carcinoma (SCC) in 362 (40%), and the remaining 67 (8%) had tumors with mixed basal and squamous cell features. BCC was the most common tumor (72%) among the 646 skin cancer patients while SCC predominated (99%) among the 250 lip cancer patients. Tumor control correlated well with the size of the lesion, p less than 0.0001. Histology of the lesion also had a significant (p = 0.021) influence on the tumor control rate, which was the highest among the BCC patients when compared with SCC or mixed cell patients. This study has again demonstrated the effectiveness of radiotherapy in controlling small and intermediate size epithelial tumors of the skin and lip. Additionally, irradiation, if administered properly, results in excellent cosmesis and a low incidence of treatment complications. Severe complications of radiotherapy reported in the literature took place at the beginning of this century and are no longer pertinent in the practice of modern radiation oncology. Larger lesions remain a challenge to radiation or surgical dermato-oncologists. A lack of tumor control in such lesions frequently results in a death of patient. PMID- 3809599 TI - Carcinoma of the nasopharynx: results of radiation treatment and some prognostic factors. AB - Seventy-four patients treated for squamous cell carcinoma (SCC) of the nasopharynx were evaluated for the 5-year survival rate. The influence of stage, age, histological differentiation, total tumour dose and irradiation treatment technique (continuous vs. split-course) upon the survival was evaluated in 64 patients (palliations and histologically unclassified SCC were excluded). The 5 year survival rate in the whole group was 28/74 (38%), and in the group without palliations and unclassified SCC 26/64 (41%). The 5-year survival of patients with T1 carcinoma was better (8/9 = 89%) than of patients with T2 (4/14 = 29%), T3 (7/17 = 41%) and T4 (7/24 = 29%) carcinoma. In the group of 55 patients with T2, T3 and T4 carcinoma, those up to 50 years old had better survival (11/21 = 52%) than patients older than 50 years (7/34 = 21%) (p less than 0.01), patients treated with the tumour dose greater than 65 Gy had better survival (16/38 = 42%) than those treated with 50-65 Gy (2/17 = 12%) (p less than 0.05), and patients older than 50 years, with poorly differentiated carcinoma had better survival (7/20 = 35%) than those of the same age, with well-differentiated carcinoma (0/14 = 0%) (p less than 0.005). The split-course irradiation technique did not improved the 5-year survival rate, although on average the total tumour dose in this type of treatment was for 7.9 Gy higher than in the continuous irradiation. PMID- 3809600 TI - Effect of field irregularities on the dose distribution of 4 MV photon beam. AB - Complex irregular fields are often used for the treatment of tumors in radiation therapy. The dose distribution of irregularly shaped fields depend strongly on the shape of field irregularities. The effect of field irregularities on the uniformity of the dose distribution of a 4 MV photon beam has been studied. The uniformity index of the blocked field which is a measure of the dose uniformity of the field has been compared to its corresponding unblocked field. The measured and computer calculated dose are compared for points within 1 and 2 cm from the edge of the field irregularities at the depth of 10 cm. The discrepancies between the computer calculated dose and the measured dose are discussed. Some suggestions are made to improve the dose uniformity of the irregularly shaped blocked fields. PMID- 3809601 TI - Experimental verification of the air kerma to absorbed dose conversion factor Cw,u. AB - In a recently published code of practice for the dosimetry of high-energy photon beams, the absorbed dose to water is determined using an ionization chamber having an air kerma calibration factor and applying the air kerma to absorbed dose conversion factor Cw,u. The consistency of these Cw,u values has been determined for four commonly employed types of ionization chambers in photon beams with quality varying between 60Co gamma-rays and 25 MV X-rays. Using a graphite calorimeter, Cw,u has been determined for a graphite-walled ionization chamber (NE 2561) for the same qualities. The values of Cw,u determined with the calorimeter are within the experimental uncertainty equal to Cw,u values determined according to any of the recent dosimetry protocols. PMID- 3809602 TI - Early and late damage in the mouse rectum after irradiation and cis diamminedichloroplatinum(II). AB - The effects of radiation and cis-diamminedichloroplatinum(II) (c-DDP) in the mouse rectum were assessed using two functional endpoints (anal discharge/diarrhoea and body weight changes), one lethal endpoint (obstructive rectal stenosis) and a microscopic endpoint (semiquantitative histological scoring). After irradiation, anal discharge, diarrhoea and lethal rectal stenosis were found to be the result of submucosal fibrosis with a secondary mucosal ulcer due to mechanical damage by the faeces. Weight loss at both early and late times after irradiation seemed to be related to epithelial cellular depletion. c-DDP, when given in combination with X-rays, did not enhance the incidence of late anal discharge, diarrhoea or rectal stenosis. Using an arbitrary semiquantitative scale for measuring the degree and extent of late rectal injury, c-DDP sometimes seemed to postpone the expression of radiation damage in the rectum. This effect, however, might also be the result only of interexperimental variation. An increase by c-DDP in the early body weight loss after irradiation was also observed which could be explained by an additive effect in the rectal epithelium. PMID- 3809603 TI - The effect of combined treatment of HeLa cells with cisplatin and irradiation upon survival and recovery from radiation damage. AB - Combined treatment of HeLa cells with cisplatin and irradiation under aerobic conditions leads to no interaction between the two treatment modalities, either when they are given simultaneously or when cisplatin treatment is followed by irradiation. Simultaneous treatment with cisplatin and irradiation under hypoxic conditions leads to radiosensitization of HeLa cells by cisplatin. This sensitization was independent from the surviving fraction with cisplatin only, the dose modifying factor being approximately 1.2. Pretreatment or post-treatment with cisplatin does not influence the recovery from sublethal radiation damage. PMID- 3809604 TI - The effect of small radiation doses per fraction on mouse lip mucosa assessed using the concept of partial tolerance. AB - The acute effect of small radiation doses per fraction on mouse lip mucosa was investigated in the present study. In order to minimize the amount of additional sparing by regeneration during fractionated irradiations in this rapidly proliferating tissue, the overall treatment time had to be limited to at most 4 days, so that the number of irradiations that could be delivered was limited. Therefore, the concept of partial tolerance, established in the rat spinal cord model, was applied. The present experimental data confirm the validity of using this concept for assessing the effect of small radiation doses on tissues. The results of experiments covering a wide range of fraction sizes show that the isoeffective dose for a given mucosal reaction increases when the dose per fraction is progressively decreased to about 2 Gy per fraction. Further reduction of the size of dose per fraction, however, does not result in a detectable extra increase in the total dose to produce the same level of biological effect. It seems that the dose limit of sparing by fractionation in this rapidly proliferating normal tissue might be situated at larger fraction sizes than 0.6 Gy as estimated on basis of the mathematical linear-quadratic model, using an alpha/beta ratio of 6 Gy measured from data with doses per fraction in the range of 2 to 10 Gy. PMID- 3809605 TI - Antibodies to FMRF amide, and the related pentapeptide LPLRF amide, reveal two groups of immunoreactive peptides in chicken brain. AB - A radioimmunoassay has been developed for the chicken brain peptide, Leu-Pro-Leu Arg-Phe-amide (LPLRF amide); this peptide was originally discovered because it reacts with antibodies to the molluscan neuropeptide FMRF amide. The present antibody to LPLRF amide reacts about twenty times less well with FMRF amide compared with LPLRF amide. Using radioimmunoassays employing antibodies raised against LPLRF amide and FMRF amide we have separated by gel filtration and HPLC several different immunoreactive peptides in acid alcohol extracts of chicken brain. When LPLRF amide was used as the assay standard one group of peptides reacted similarly with the two types of antibody; the other group, which was represented by a single major component, reacted at least 50 times better with FMRF amide antibodies compared with LPLRF amide antibodies. It seems, therefore, that in the avian central nervous system, and probably other vertebrates, there are several different groups of peptides immunochemically related to FMRF amide. PMID- 3809606 TI - Renal hyperemia in portal hypertension is not mediated by gastrointestinal peptides. AB - The objectives of this study were to characterize the time course of development of the renal hyperemia induced by chronic portal vein stenosis (PVS) in the rat, and to assess the possibility that vasoactive blood-borne gastrointestinal peptides mediate the renal hyperemia in established portal hypertension. Blood flow to the kidneys was measured with radioactive microspheres over a ten day time course. On day 2, no difference in renal blood flow (RBF) was observed in PVS rats as compared with controls. However, by day 4, RBF significantly increased by 35% in PVS vs. control animals. On day 6, the renal hyperemia in PVS rats reached a maximal value that was 42% higher than controls. A steady state hyperemia (approximately 40%) was maintained thereafter. Radioimmunoassay of plasma from control and established portal hypertensive rats (10 days samples) revealed that vasoactive intestinal polypeptide, substance P, cholecystokinin, gastrin, neurotensin, pancreatic polypeptide, beta-endorphin and peptide histidine-isoleucine amide are not elevated in arterial plasma of portal hypertensive rats. These data suggest that the renal hyperemia induced by chronic portal vein stenosis is apparent within 4 days of the onset of a hypertensive state and attains a steady state by day 8. Furthermore, at least eight blood borne gastrointestinal peptides are not directly involved in the renal hyperemia associated with chronic portal hypertension. PMID- 3809607 TI - Presynaptic effects of neuropeptide Y on [3H]noradrenaline and [3H]acetylcholine release. AB - The electrically evoked release of radioactivity from mouse vas deferens and rat hypothalamic slices preloaded with [3H]noradrenaline was measured. In addition the release of [3H]acetylcholine from longitudinal muscle strip of guinea-pig ileum was also measured. Neurochemical evidence has been obtained that neuropeptide Y (NPY), although it co-exists and is released with (-) noradrenaline (NA), it behaves differently as far as its effect on presynaptic modulation of chemical neurotransmission is concerned. It exerts a frequency dependent presynaptic inhibitory effect on noradrenaline release from mouse vas deferens but has no effect on the electrically evoked release of NA from rat hypothalamus. Unlike NA, NPY does not influence the release of [3H]acetylcholine from the longitudinal muscle strip of guinea-pig ileum and does not potentiate the presynaptic effect of NA. It seems very likely, that the inhibitory effect of NPY is mediated via receptors. Its action is concentration dependent. While exogenous noradrenaline inhibited the release of noradrenaline by 91%, the maximum inhibition reached with NPY was not higher than 60%, indicating that either the intrinsic activity of NPY is lower or much less axon terminals are equipped with NPY receptors. Peptide YY (PYY) also reduced the release of NA from mouse vas deferens. PMID- 3809608 TI - Purification and partial characterization of a mitogenic factor from bovine liver: structural homology with basic fibroblast growth factor. AB - Two mitogenic peptides in bovine liver extract were purified to apparent homogeneity by monitoring the purification steps with two in vitro bioassays; one based on stimulation of adult bovine aortic arch endothelial cell proliferation and the other incorporation of [3H]thymidine to mouse fibroblast 3T3 cells. The purification procedure involved cation-exchange chromatography followed by affinity chromatography on heparin-Sepharose and two steps of reversed-phase HPLC. The purified material showed the same biological activity as pituitary basic fibroblast growth factor (FGF). Amino acid analyses of the purified mitogen yielded a similar, but not identical composition to that of bovine pituitary basic FGF(1-146) reported previously. Gas-phase microsequencing identified two sequences in equal amounts in the purified preparation. Furthermore, the sequencing results are in accord with the theoretical data obtained when two truncated forms of basic FGF, corresponding to FGF(12-146) and (16-146), are being sequenced simultaneously. Basic FGF(12-146) is a novel truncated form of basic FGF which has not been isolated before although the (16-146) fragment has been found previously in kidney, corpus luteum, and adrenal. SDS-PAGE analysis could not separate the two forms and showed that both migrated as a protein of about 15,100 daltons, which is slightly smaller than intact basic FGF(1-146) (16,200 daltons). These results, taken together, indicate that at least some of the mitogenic activity in liver may be derived from basic FGF-related polypeptides. PMID- 3809610 TI - Concentration and particle-size distribution of uranium and some trace elements in airborne dust collected in Tsukuba. AB - Uranium and some other trace elements were determined in the size-separated airborne dust collected in Tsukuba with an Andersen-type high-volume cascade impactor. The fission track method and the instrumental neutron activation method were applied to the determination of uranium and other elements, respectively. Selenium, antimony, arsenic and zinc were found to be rich in particulates of smaller size, while scandium, iron and cobalt showed a reverse trend, depending on their main origins, i.e. whether industrial or terrestrial. Uranium was distributed in both the larger and smaller particles to the same extent, suggesting that it is derived from both the terrestrial and artificial sources. PMID- 3809611 TI - [Serum thyroid-stimulating hormone determination by sensitive immunoradiometric assay (IRMA)]. PMID- 3809609 TI - Distribution of bombesin-like peptides in the alimentary canal of several vertebrate species. AB - The objective of this study was to quantitate and characterize the variants of bombesin-like immunoreactivity in the alimentary canal of the rat, rabbit, hawk, owl, dog, monkey and human. Bombesin-like immunoreactivity was found throughout the entire gastrointestinal tract of all species studied. In the rat, the highest concentration of bombesin-like immunoreactivity was found in the colon. Gel chromatography showed that bombesin-like immunoreactivity corresponded to gastrin releasing peptide (GRP-27) and GRP-10. In the dog, the greatest concentration of bombesin-like immunoreactivity was observed in the mucosal layer of the fundus, whereas the concentration of bombesin-like immunoreactivity in the muscle layer of the dog did not vary significantly from region to region. Gel chromatography showed that bombesin-like immunoreactivity in the dog corresponded to GRP-27, bombesin, GRP-10, and a smaller fragment. In the human, the concentration of bombesin-like immunoreactivity did not vary significantly from region to region in the mucosal and muscular layers. Gel chromatography of human fundal mucosa showed that bombesin-like immunoreactivity peaks occur in the regions of GRP-27, bombesin and GRP-10. These findings substantiate the observation that bombesin like peptides play a variety of roles in the regulation of gut function. PMID- 3809612 TI - [Fundamental and clinical evaluation of the immunoglobulin E radioimmunoassay kit (SD-8568)]. PMID- 3809613 TI - [HBsAg/IgM complex in patients with chronic type-B hepatitis]. PMID- 3809614 TI - [Guidelines for evaluation of safety standards associated with hospital cyclotron produced radiopharmaceuticals. Subcommittee on Medical Application of Cyclotron produced Radionuclides, Medical and Pharmaceutical Committee, Japan Radioisotope Association]. PMID- 3809615 TI - Screening the potential risks of toxic substances using a multimedia compartment model: estimation of human exposure. AB - Managing environmental health risks requires the assessment of environmental fate, exposure, and health risk of an ever-increasing list of contaminants. The magnitude of this list precludes an experimental evaluation of each contaminant. For this reason, computer models are being used more frequently to simulate the transport and transformation of chemicals based on physical and chemical properties. This paper describes a multimedia compartment model that we have developed for screening toxic substances. This model, referred to as GEOTOX, uses a combination of physical, chemical, and landscape properties to establish the partitioning, reaction, and interphase-transport characteristics of a chemical. These properties are used to estimate concentrations in the air, soil, water, and food of a representative or generic environment. We use these concentrations in exposure-pathway models to calculate the quantities absorbed by humans; then dose response data are used to estimate health risks. The capability of GEOTOX as a screening tool is illustrated in a sample ranking of three chemicals (i.e., 2,4,6 trinitrotoluene, hexahydro-1,3,5-trinitro-1,3,5-triazine, and benzene) being continuously added to the upper-soil compartment. We find that ranking based on both toxic potency and environmental fate can enhance the risk-management process when compared to ranking based on toxic potency alone. PMID- 3809616 TI - Codex committee on veterinary drug residues. AB - There has been widespread international concern over residues of veterinary drugs in food. However, until recently, there was little international cooperation in trying to find solutions to the problem. Many nations have taken steps to control the increased use of veterinary drugs, but the rules governing their use vary widely from country to country. Sharing of scientific expertise and other resources between countries would markedly improve this situation. With the need for international cooperation mounting, concerned drug regulators from 20 countries met in 1982 and again in 1984 to discuss international use of veterinary drugs. The group repeatedly called for a Codex committee on veterinary drug residues. At its 1983 meeting in Rome the Codex Alimentarius Commission convened an Expert Consultation to consider the need for a new committee. That international group of experts strongly agreed that a standing committee under the sponsorship of the commission should be established. In July of 1985, the commission unanimously voted to establish a new Committee on Residues of Veterinary Drugs in Food. The United States was chosen as host country. The committee will work closely with several existing Codex committees, but it has a clear mandate of its own. Its responsibilities will include establishing a list of priority drugs for review, recommending maximum residue levels, developing codes of practice, and reviewing analytical methods used to control veterinary drug residues. This fall, a new Codex committee has met for the first time--the Codex Committee on Residues of Veterinary Drugs in Food.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3809617 TI - The weight of evidence: regulatory toxicology in Canada. AB - The legislative application of regulatory toxicology in Canada is reviewed, together with the sources of experimental evidence used for action. Examples are given of the critical toxicological information that led to a regulatory decision. Risk numbers have only been used to a limited extent in Canada. Some possibilities for future research are offered. PMID- 3809619 TI - Teaching psychotherapy in contemporary psychiatric residency training. Committee on Therapy. Group for the Advancement of Psychiatry. PMID- 3809618 TI - Cytogenetic and embryotoxic effects of bromophos and demethylbromophos. AB - The organophosphorus pesticide bromophos and the tetramethylammonium and sodium salts of demethylbromophos were tested for cytogenetic and embryotoxic activity on mice of different strains. Single intraperitoneal (ip) doses of 183.0 mg/kg (0.5 mmol/kg) and 73.2 mg/kg (0.2 mmol/kg) bromophos caused a significant enhancement in the percentage of chromosome aberrations in bone marrow cells of CFLP mice; similar effects were produced by a single dose of 0.2 mmol/kg demethylbromophos tetramethylammonium salt and demethylbromophos sodium salt trihydrate, respectively, indicating that the cytogenetic activity of bromophos is not connected with its alkylating properties. After repeated ip or oral administration to pregnant mice of strains AB Jena/Halle and DBA, none of the tested compounds showed a marked influence on the total implantation losses, although in some cases the postimplantation losses were significantly increased. PMID- 3809620 TI - [Surgical treatment of cardiac arrhythmia refractory to medication in a patient with chronic chagasic cardiopathy]. PMID- 3809621 TI - [Clinico-bacteriological correlation in acute infantile diarrhea]. PMID- 3809622 TI - [A case of neurogenic orthostatic hypotension]. PMID- 3809623 TI - [Automatic injections in hysterosalpingography]. PMID- 3809624 TI - [Cleidocranial dysplasia. Report of 3 new cases]. PMID- 3809625 TI - [Congenital absence of a vertebral peduncle. Observations on 4 cases]. PMID- 3809626 TI - [Congenital double patella. Presentation of a case]. PMID- 3809627 TI - [Percutaneous extraction of retained bile calculi and substitution of a T catheter]. PMID- 3809628 TI - [Magnetic resonance study of a case of hepatic polycystosis]. PMID- 3809629 TI - [Osteoid osteoma and osteoblastoma of the vertebrae]. AB - Five cases of osteoid osteoma and five cases of osteoblastoma of the spine are reported. All the patients underwent surgery and the radiographic diagnosis was always histologically confirmed. Conventional radiographic technique using tomography constantly permitted the diagnosis. Computed tomography was primarily useful for spatial localization of the lesion. The authors evaluate the radiographic findings of the two lesions discussing the symptoms which are suspected for these pathologic conditions. Bone scintigraphy must precede radiological examination. PMID- 3809630 TI - [The Chernobyl accident. Dosimetric evaluation and estimation of the risks]. PMID- 3809631 TI - [Nodular pulmonary lesions. Evaluation of the significance of the radiographic semeiotics correlated with the results of transbronchial fiberscopic pulmonary biopsy and transparietal needle aspiration]. AB - The results obtained in 148 patients affected by nodular lung lesions have been evaluated. Transbronchial pulmonary biopsies (TBPB) and/or transthoracic fine needle biopsies (NB) have been performed. Diagnostic yield of the performed procedures was 61.5% for TBPB and 91.5% for NB. Radiographic findings and their incidence rates in benign and malignant nodular lung lesions have been considered. Accuracy rate of radiographic features, evaluated by discriminant analysis, was 77.4%. Radiographic appearance has been more related to NB (87.6%) than to TBPB (72.5%). PMID- 3809632 TI - [Usefulness and limitations of edema of the small intestine in malabsorption syndromes]. AB - Malabsorption syndrome is a clinical condition that can be determined by several situations which can ensue by many etiopathogenetic mechanisms. While the diagnostic approach is, for this reason, complex and uses a lot of clinical, laboratory and instrumental techniques, the therapeutic approach could be surgical or medical. The aim of our research is to establish the diagnostic utility of the radiologic examination of the small intestine by enteroclysis, on the basis of our personal experience and the data referred in literature. We took particular care of the radiological study of primitive malabsorption. PMID- 3809634 TI - [Morpho-functional radiologic evaluation of ileal reservoirs]. AB - Nine patients (4 males and 5 females) have been treated by proctocolectomy with ileal pouch "reservoir". Defecography has been performed. Five patients have been examined by defecography before and four after closure of a loop ileostomy performed to cover healing of the pouch and ileoanal anastomoses. Pouch's evacuation is often inadequate in "S" shaped reservoir (Parks), but postoperative complications are infrequent. Pouch's evacuation is often total in "J" shaped reservoir (Utsunomiya), but post-operative complications are possible. PMID- 3809633 TI - [Segmental ischemic lesions of the mesenteric small intestine]. AB - Segmental ischemic disease consists of segmental infarctions and ischemic stenoses. Vasculitis (LES, polyarteritis nodosa, Schonlein-Henoch syndrome), thrombosis, arteriosclerotic changes, mechanical obstructions (adhesions, hernia, volvulus, traumas), hemorrhagic disorders are the most common causes of these intestinal lesions. The authors report their experience achieved during three years on 428 small bowel examinations; among these, 197 were double contrast enemas. Ten patients showed roentgenographic features referred to vascular diseases: 1 LES, 1 Schonlein-Henoch syndrome, 3 polyarteritis nodosa, 5 spontaneous hemorrhagic disorders or due to treatment with anticoagulants. The authors, after a review of the radiological findings, emphasize the high sensitivity and low specificity of double contrast small bowel enema. Furthermore they underline the usefulness of this method in demonstrating and monitoring intestinal pathologic changes. PMID- 3809635 TI - [Reservations in the routine use of preoperative urography in colorectal carcinomas]. AB - The diagnostic utility of preoperative intravenous urography (IVU) carried out in patients with carcinoma of the large bowel is still controversial. In the period between 1978 and 1984 only 8 out of the 347 patients undergoing surgery for carcinoma of the large bowel showed urinary tract involvement at operation. IVU had been carried out in 106 patients before surgery. The survey results agreed with histological reports in 103 case records: 101 true negative, 2 true positive. Two false positive cases and one false negative were also found. Among the eight patients who at surgery revealed urinary tract involvement, only in three IVU had been proposed; in the remaining 5 cases it had not been requested. It may be suggested that the early recognition of colon carcinoma does not allow the neoplasia to further develop in the urinary tract, at least not in as high a percentage as in the past. We therefore deem it necessary to use at first less invasive and faster methods, such as echography, limiting IVU to those cases where a well-grounded clinical suspicion or a previously executed echography suggest deeper investigation. PMID- 3809636 TI - [Specificity and sensitivity of ERCP in pancreatic pathology]. AB - Fifty-three patients were examined by endoscopic retrograde cholangiopancreatography (ERCP). Operative and/or instrumental-clinical findings indicated that 38 patients had pancreatic disease, consisting of 17 cases of neoplasia, 10 of chronic pancreatitis with benign stenosis, and 11 of chronic pancreatitis without stenosis. An analysis of Wirsung's duct and of the secondary ducts was carried out employing, in the latter case, linear discriminate analysis (Nix and Schmitz method). With this method, 16 of 17 patients (94%) were correctly assigned to group A (pancreatic neoplasia), thus indicating high sensitivity; 7 of 8 patients (88%) were assigned to group B (chronic pancreatitis with benign stenosis), and finally 7 of 10 patients (70%) were placed in group C (chronic pancreatitis without stenosis). Detection of a sample sign such as sharp and/or irregular stenosis of Wirsung's duct enabled a correct diagnosis of neoplasia in the cases examined; this criterion, however, is very specific but poorly sensitive. When it is absent, analysis of the secondary ducts is determinant. If the two criteria are applied together, an exact diagnosis of all forms of neoplasia is obtained. PMID- 3809637 TI - [Xeroductogalactography. Case reports]. AB - Xerogalactography represents the most important instrumental examination in the diagnosis of the secreting breast. The authors describe the radiological findings in the ductal ectasia, intraductal papillomas and papillomatosis and carcinomas in a personal experience concerning 52 patients with mammary secretion. PMID- 3809638 TI - [Somatic sequelae induced by radiotherapy in bone segments in adults]. AB - The authors, on the basis of reports found in literature and of a personal series, discuss the radiological aspects, the differential diagnosis, the main factors that lead to bone sequelae, and the possible contributory causes and complications. The radiological aspects is characterized by the association of sclerotic and atrophic changes, with a prevalence of the latter in the involvement of the mandible and the cranial bones. Among the main factors there are the radiation dose and its chronological distribution. In fact, the higher the values of the nominal standard dose (NSD), the higher the incidence of such alterations and the more difficult to carry out the efficacy of their treatment. These alterations are found almost exclusively after treatment with administration, in terms of NSD, of more than 1352 rets. Among the contributory causes there are all the factors that may change the physiological condition of the bony tissue. The most common complications are fractures and septic osteitis, the last particularly frequent in the mandible. These alterations and mainly fractures may be solved even spontaneously, even if rather late, so that conservative treatments are indicated. After osteitis it is usually possible to avoid pseudoarthrosis. In cases irradiated with higher doses, osteotomy is often necessary sometime followed by poor results. PMID- 3809639 TI - [Computerized tomography in cochlear otosclerosis]. AB - After a review on osseous labyrinthine modifications in cochlear otosclerosis, the authors report their experience, based on four patients, in CT evaluation of the disease. CT high resolution programs detect demineralization centres, which are distinctive of cochlear otosclerosis, at an early stage. CT must be considered a more informative investigation than multidirectional tomography. PMID- 3809640 TI - [3-dimensional automatic dosimetry in curietherapy]. AB - Isodose curves can be viewed on multiple planes along with the radioactive implant and anatomical structures by projecting them on a video-display. The main options offered are the parallel projection of the implant selecting all the possible rotations, zooming and shifting, calculation of distance between two points of a selected plane, stereoscopic display. PMID- 3809642 TI - [Current medicolegal problems deriving from the practice of radiology]. PMID- 3809641 TI - [Radio-chemotherapy of inoperable malignant brain gliomas]. AB - Numerous studies have proved the benefit of the use of postoperative radiotherapy in the treatment of malignant cerebral gliomas. The data concerning the efficiency of the treatment of unoperated gliomas are rather scarce. The data obtained in 28 cases of malignant cerebral gliomas, defined as inoperable and treated with radio-chemotherapy, are reported. The diagnosis was obtained through radiological and bioptic examination (21 out of 28). Using a proper treatment with cortisone "dexamethasone" at a dose of 8-16 mg/day, with telecobaltotherapy, we have reached in almost all cases (26 out of 28) doses of 60 Gy, without significant side-effects. All patients were given BCNU as chemotherapy at a dose of 80 mg/m2 every 8 weeks. The resulting average survival rate of 36 weeks, verified through CT, confirms the validity of radio-chemotherapeutical treatment. This type of treatment has been proved useful not only for prolonging the life of these patients, but also improving the quality of their life. PMID- 3809643 TI - [Congenital posterior bowing of the leg. 18 cases in children]. AB - The authors have seen 18 cases of congenital posterior bowing of the tibia and fibula associated with valgus deformity and shortening. They have noted that the valgus deformity had a tendency to improve during the first four to five years of life. The recurvatum may also improve, but less so than the valgus. Walking is not frequently impaired significantly by the deformity. When it is, an early osteotomy should be done, associated with lengthening using a Wagner distractor. In most of the cases, the progress of the case cannot be predicted accurately. It is therefore concluded that surgical correction-epiphysiodesis in three cases or progressive lengthening in five cases should be performed as late as possible. PMID- 3809644 TI - [Repair of the acetabulum using a bone homograft preserved at the time of revision of total hip prostheses]. AB - Between 1973 and 1982 the authors have used the preserved femoral head to allograft the affected acetabulum in 80 patients with loose total hip arthroplasties. The problems of reconstruction were various and several techniques were used. 65 cases have been reviewed with more than one year follow up. No complication relating to the graft was found. All patients but 6 had dramatic relief of pain. Four new loosenings were encountered. The quality of the functional result was related to the pre-operative condition of the hip and the adequacy of the repair. PMID- 3809645 TI - [Results of hip arthroplasty using Gerard's coupled, non-cemented cups. Analysis of 92 cases reviewed]. AB - The authors have reviewed 92 cases of uncemented surface hip replacements with a minimum follow-up of 3 years. They were operated on using the Gerard technique which must be very precise to avoid devascularisation of the femoral head. 17 failures had to be operated on again. The main indications were necrosis of the femoral head and degenerative arthritis without excentration in patients aged between 50 and 60 years. In this type of patient, satisfactory results were obtained in more than 80%. It is concluded that this type of hip arthroplasty is valuable, provided there are good indications and a precise technique. It should be avoided in elderly, obese and porotic patients, in whom a total hip prosthesis is a better solution. PMID- 3809646 TI - [10-year follow-up of a homogeneous series of 467 total hip prostheses of the Charnley-Muller type. Study of 167 cases]. AB - Four hundred and sixty-seven hips were operated upon by the authors between 1969 and 1974 using the Charnley-Muller prosthesis. 167 were reviewed with more than a ten-year follow-up. Eighty-one per cent were satisfactory after the initial procedure. In 56 cases an aseptic loosening had to be revised. At the femoral level, a varus position of the stem and the presence of cement between the calcar and the prosthesis appeared to be the responsible factors. At the acetabular level the causes of the loosening were an excess of cement, more than 10p. 100 uncovering of the cup by the acetabulum and, particularly, asymmetrical wear of the cup of more than one mm. A pathological study of 20 cases showed that particles of cement cause granulomata to develop all round the prosthesis. Polyethylene wear increases the frictional torque and produces micro-fractures of the cement at the bone-cement interface. It is concluded that the femoral stem should be as thick as possible and that the collar of the prosthesis is useless. Frictional torque should be as low as possible. The use of a metal mesh appears to be beneficial for the cementing of the acetabular cup. PMID- 3809647 TI - [Computed tomographic study of the anatomical modifications of the wrist brought about by section of the anterior annular ligament]. AB - The authors have analysed the action of sectioning the transverse carpal ligament by computerised tomography in 19 patients (22 wrists) with carpal tunnel syndrome. Three cuts were studied-proximal, middle and distal, the wrist being either straight, flexed or extended. The study was done pre-operatively and three months after division of the ligament. The study demonstrated the reconstruction of a new ligament which was more lax and expanded anteriorly, despite the fact that the patient wore a plaster cast for two weeks after operation, the wrist being maintained straight. The calibre of the carpal tunnel showed an increase of between 7 p. 100 and 44 p. 100 after the operation and this increase was not related to any alteration in bone topography, which was unchanged. Thus, the role of the ligament in the permanency of shape of the anterior concavity of the wrist skeleton is questionable. The flexor tendons could expand anteriorly, thanks to the laxity of the new ligament. PMID- 3809648 TI - [Traumatic atlanto-occipital luxation. Value of new radiologic signs (apropos of 2 cases)]. AB - Two cases atlanto-occipital dislocation with survival are reported. The displacement was anterior. One case was associated only with some pyramidal signs and was diagnosed fourteen months after the injury. The other was associated with immediate tetraplegia. Both cases were treated by occipitocervical fusion with plate fixation. The second case was reduced during operation. A review of the literature has shown that dislocation with anterior displacement is more severe than with posterior displacement. The diagnosis is always difficult. The authors show the importance of certain radiological signs such as the curved anterior line joining the odontoid process to the occiput. The need to reduce the displacement in old lesions is discussed. PMID- 3809649 TI - [Osteitis due to anaerobic Corynebacteria in children. Apropos of 4 cases]. AB - The authors have seen four instances in children of osteitis due to a mycobacterium. The disease was subacute and situated in the tibia, the lumbar spine, the talus and the femur. In two cases the diagnosis was eventually mistakenly oriented towards tuberculosis or a malignant tumour. The correct diagnosis was obtained after a bone biopsy which demonstrated a granulomatous osteitis. In such cases there is an indication for a full biopsy and bacteriological examination with culture in aerobic and anaerobic media. Treatment based on pristinamycin resulted in healing. PMID- 3809650 TI - [Traumatic rupture of the great adductor (adductor magnus). Apropos of a case]. AB - The authors report a case of traumatic rupture of the tendon of the adductor magnus. It was operated on one month after the injury when it had formed a painful contractile tumour in the perineal region. The tendon was re-attached to the femur. The result was satisfactory. The authors have made a review of the literature. PMID- 3809651 TI - [60th annual meeting of the Societe Francaise de Chirurgie Orthopedique et Traumatologique. Paris, November 1985. Proceedings]. PMID- 3809652 TI - [Osteoid osteoma of the upper extremity of the femur]. PMID- 3809653 TI - [Block of the movement of the subastragalar joint by astragalo-scaphoid arthrodesis]. PMID- 3809654 TI - [Intra-articular lesions and their development in old ruptures of the anterior crucuate ligament]. PMID- 3809655 TI - [Instrumental measurement of the anteroposterior laxity of the normal and lax knee]. PMID- 3809656 TI - [Autogenous osteocartilaginous transfer in osteonecrosis of the internal condyloid]. PMID- 3809657 TI - [Repair of the long flexor of the thumb. Comparative results apropos of 85 cases]. PMID- 3809659 TI - [Traumatology and osteosynthesis in children]. PMID- 3809658 TI - [Tendino-nerve wounds of the anterior face of the wrist. Apropos of a series of 62 cases]. PMID- 3809660 TI - [Long-term results of the treatment of fracture-luxations of the upper extremity of the humerus. Apropos of 64 cases]. PMID- 3809661 TI - [Microsurgery in pediatric orthopedics]. PMID- 3809662 TI - [Scoliosis and spinal osteosynthesis]. PMID- 3809663 TI - [Fractures of both bones of the forearm in children. Apropos of 162 cases]. PMID- 3809664 TI - [Growth of defective diaphyseal callus in the forearm of the child. Apropos of 108 fractures treated by orthopedic methods]. PMID- 3809665 TI - [Fractures and severe sprains of the spine and spinal cord lesions in children. Analyse of 95 cases]. PMID- 3809666 TI - [Orthopedic treatment of idiopathic scoliosis by the method of Maguelone. Remote results]. PMID- 3809667 TI - [Severe sprains of the ankle in children and adolescents]. PMID- 3809668 TI - [Surgical treatment of idiopathic congenital talipes equine varus by release of the soft tissues]. PMID- 3809669 TI - [Fracture of the external condyle of the humerus in children. Apropos of a series of 46 cases]. PMID- 3809670 TI - [Recovery after aseptic loosening of cemented total hip arthroplasties with Bousquet's cementless prosthesis. Apropos of 136 cases]. PMID- 3809671 TI - [Phlebography of the femur head following fractures of the neck of the femur]. PMID- 3809672 TI - [Setting of the cotyloid in cemented total prosthesis of the hip. Experimental study]. PMID- 3809673 TI - [New implants for the regeneration of bone (Collapat and Pyost)]. PMID- 3809674 TI - [The Luque instrumentation applied to the spine of the growing dog]. PMID- 3809675 TI - [Posterolateral arthrodesis in the treatment of spondylolisthesis and of lumbosacral disk arthrosis. Long-term results]. PMID- 3809676 TI - [Hypomagnesemia and vitamin D metabolism]. PMID- 3809677 TI - [Acute renal failure caused by obstruction of the renal arteries. Apropos of 2 cases]. PMID- 3809678 TI - [Idiopathic rapidly progressive glomerulonephritis associated with diffuse alveolar hemorrhage: presentation of 2 cases]. PMID- 3809679 TI - [A young female with multiple, painful osteosclerotic lesions, developing over a 3-year period]. PMID- 3809680 TI - [The new world of vitamin D]. PMID- 3809681 TI - [Current status of knowledge of pseudohypoparathyroidism]. PMID- 3809682 TI - [Hospital urinary infection. Epidemiologic aspects. Preventive measures]. PMID- 3809683 TI - [Acute hepatitis and diclofenac sodium]. PMID- 3809684 TI - [Histologic transition in patients with minimal-change nephrotic syndrome to mesangial IgM nephropathy]. PMID- 3809685 TI - [Cerebral infarction and convulsive crises in a forme fruste of tuberous sclerosis]. PMID- 3809686 TI - [Neuroleptic malignant syndrome and pathology of the connective tissue]. PMID- 3809687 TI - [Mixed disease of the connective tissue with polymyositic predominance. Description of a case with a rapid and fatal course]. PMID- 3809688 TI - [Central neurofibromatosis. Study of a case]. PMID- 3809689 TI - [Regional cerebral blood flow in partial complex epilepsy with and without the presence of lesions]. AB - Regional cerebral blood flow (r CBF) was measured by the I.V. 133 Xenon method and use of 27 detectors in 91 patients with complex partial epilepsy in interictal periods (at least 48 h over a complex partial seizure). Some were also examined less than 48 h before or after seizures. All were studied with ictal and interictal electroencephalography (EEG), polysomnography, computed tomography (CT), some had nuclear magnetic resonance scans (MR). The blood flow values were compared with a group of a 20 normal subjects matching for age. A significant decrease of r CBF ranged from 15% to 25% was found in the temporal region in three groups of epileptic patients: with repeated normal CT scans and lateralized EEG abnormalities (N = 46); with cortical atrophy in CT scan (N = 12); with neurosurgical focal lesions on CT and or MR scans glioma, arteriovenous malformation) (N = 10). r CBF was normal or decreased by less than 15% in the other regions of the brain. Patients with repeated normal CT scans and bilateral EEG abnormalities either asynchronous or alternatively observed in the right side or left side on waking EEG or during NREM sleep and REM sleep, did not show reduction in r CBF. In a previous study, r CBF distribution was also found normal during interictal phase in patients with primary generalized epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3809690 TI - [Methodology, limitations and value of mapping in electroencephalography]. AB - Data processing is mandatory for EEG mapping. After having used a correct filter and ADC, spectral analysis is completed by interpolating between the spectral values obtained on each recording point to allow a sufficient number of values to be expressed in a grey or color scale on the skull projection plane. The obtention of valid results implies extreme care in data recording and processing. Transitory events (paroxysmal bursts) cannot be detected by spectral analysis. Nevertheless, EEG spectral data mapping is a very good technique to show abnormal EEG focuses in neurology, to study all sorts of neuropsychological reactivities, to follow the evolution of tracings during normal or abnormal aging, metabolic diseases or drug effects. PMID- 3809691 TI - [Results of EEG mapping in brain tumors. Comparison with imaging methods]. AB - Thirty-nine patients with brain tumors were studied with conventional and Q. EEG mapping (FFT) comparatively to CT-Scan. In 33 cases, Q. EEG provided a precise localization of the tumor site, based on slow waves. Furthermore there was a good correlation between CT-Scan and focal theta activity in 31 patients. Focal delta waves were more frequent in deep tumors involving white matter. In 11 of 13 superficial tumors, alpha rhythm was ipsilaterally located, whereas in deeper lesions, its activity was decreased on the tumor side. The putative mechanism of these results are discussed. PMID- 3809692 TI - [Neonatal administration of 5,7-dihydroxytryptamine induces in the adult rat a decrease in paradoxical sleep restored by an intracisternal injection of fetal raphe cells]. AB - By a method of automatic on-line scoring of sleep-waking stages in the rat, a significant decrease of the mean circadian level of paradoxical sleep and a significant increase of light slow sleep were shown in adult animals after neonatal disruption of serotoninergic system by intracisternal injection of 100 micrograms of 5.7-dihydroxytryptamine, when compared to an aged matched sham group. The level of paradoxical sleep was restored in the neurotoxin-treated rats by an intracisternal injection of a suspension of foetal raphe neurons. PMID- 3809693 TI - [Development of a criterion for the automatic detection of sleep spindles in the infant]. AB - The authors present a model for automatic detection of spindles during the different sleep stages. Baseline spindle-free EEG was modelized on a 10 sec recording using an autoregressive model. Spindles were thereafter detected using the quadratic error from this baseline model on successive 1 sec periods. This automatic detection is in a 95.7% agreement with visual analysis. PMID- 3809694 TI - [Value of mazindol in Gelineau's disease. Apropos of 10 cases]. AB - Ten narcoleptic patients were treated daily with Mazindol 2-6 mg for 42.2 months (31-63 months). The response was excellent on narcoleptic attacks in 6 and on cataplexy in 7 cases. However, the nocturnal sleep disturbance persisted unchanged. The improvement was poor in 1 case and inexistant in 1 subject. Minor side effects (dry mouth) occurred in 3 cases, and urinary retention obliged to stop the medication in 2 cases. PMID- 3809695 TI - [Value of computed tomography in the diagnosis of the intrathoracic extension of bronchial cancer]. AB - In 76 patients the diagnosis of the mediastinal extension of a bronchial cancer, assessed by computed tomography (CT), was compared to histological specimens obtained by mediastinoscopy and surgery (58/76). The extension to mediastinal nodes was present in 26 subjects (34.2%) and yet was not recognised 15 times on CT. There were 15 false negatives (FN) and 3 false positives (FP). Sensitivity 43%, specificity 94%, predictive value for positives (VPP) 70%, predictive value for negatives (VPN) 75%. Extension was present in 18 patients. These were recognised 14 times by CT. There were no false positives. (Sensitivity 70%, specificity 100%, VPP 100%, VPN 94%). We conclude That CT is useful for diagnosing direct mediastinal extension and allows the juxta-hilar extension of the cancer to be assessed. CT has no place in the diagnosis of mediastinal gland involvement. Mediastinoscopy (5.2% FN; no FP) is better than TDM for the diagnosis of extension to the mediastinal nodes both for peripheral and central cancers. PMID- 3809696 TI - [Pulmonary hydatidosis. Comparison of cytology and scanning electron microscopy]. AB - The puncture of a hydatid cyst with a fine needle is not generally recommended as a procedure and may even be contra-indicated in the first instance. Sometimes, however, the cytologist will be surprised to discover some scolices in the aspirate when the radiology is misleading, or not suggestive, and the serology is negative. We report two cases where the diagnosis was made by the cytological examination of the aspirate. The cytological study of the liquids was compared with electron microscopy scanning, enabling the stages of development of the parasite in the tissue of the pulmonary parenchyma to be assessed. PMID- 3809697 TI - [Interaction between asthma and maxillary sinusitis]. AB - We have studied atopic status and respiratory function in 69 asthmatics in relation to possible radiological changes in the sinuses. These alterations were classified under four headings: normal, mucosal thickening (greater than 3 mm), polyp or opaque films. The bronchial obstruction, evaluated by FEV1/FVC ratio was compared in the 4 groups. The reversibility of airflow obstruction by beta-2 sympathomimetics (Fenoterol) was the same with or without changes in the sinuses. The atopic trait (RAST or immediate prick tests) or non-atopic asthma was not associated with any sinus abnormalities. In conclusion, if a close association between asthma and radiological disease of the sinuses exists (60% of cases), it does not seem that chronic sinusitis worsens bronchial obstruction or reduces sensitivity to beta-2-sympathomimetics. The changes in the sinus mucosa may be induced by the same aetiologic agent (allergic or non allergic) as asthma. PMID- 3809698 TI - [Evolution of the resistance of Streptococcus pneumoniae to erythromycin at the Pitie-Salpetriere Hospital (1980-1984)]. AB - From January 1980 to December 1984, 563 swabs for Streptococcus pneumoniae were isolated at the Pitie-Salpetriere hospital in Paris, and of these 63 were resistant to erythromycin. The percentage of swabs resistant to erythromycin rose from 2.7% in 1980 to 19.6% in 1984 and was similar for cultures of blood, serous fluid, bronchial secretions, otolaryngological specimens and smears from the conjunction. For swabs resistant to erythromycin these belonged almost exclusively (57 out of 60 or 90%) to the serotypes 6, 14, 19 and 23; one may ask whether the rise in resistance of S. pneumoniae to erythromycin was due to a rise in the frequency of isolation of these serotypes? Between 1980 and 1984 such rise took place since the frequency of isolation of S. pneumoniae belonging to the serotypes 6, 14, 19 or 23 rose from 38% in 1980 to 50% in 1984, but the rise was not significant (p = 0.1). In fact S. pneumoniae serotypes 6, 14, 19 or 23 have become resistant is significant (p less than 0.05). Two factors should be taken into consideration when interpreting these facts. The first is the increased consumption of macrolide antibiotics which doubled overall between 1979 and 1983, both at the Pitie-Salpetriere hospital and in the Public Assistance hospitals of Paris as well as provincial hospitals throughout France. The second factor is the strictly hospital nature of this study which may have led to an overestimation of the frequency of resistance of S. pneumoniae to erythromycin. PMID- 3809699 TI - [Chronic cryptogenic pneumonia]. AB - We report a case of a 72 year old man with the appropriate criteria for the recently identified chronic cryptogenic pneumonia: dyspnoea, cough, low general state, fever, raised sedimentation rate, localised opacities on the chest x-ray; no cause has been identified; the patient will improve on steroid therapy even though antibiotics are without effect, but relapses on stopping the steroids. A lung biopsy shows a predominant intra-alveolar fibrosis. A definitive cure can be obtained by 12 weeks of steroid therapy. PMID- 3809700 TI - [Opportunistic pneumopathy caused by Torulopsis glabrata]. AB - Yeasts are taking a growing place in the development of opportunistic pneumonias in a hospital environment. We report a case of pneumonia due to Torulopsis glabrata in a patient of 58 years in complete remission from a malignant oesophageal tumour after surgery and radiotherapy, and not given immunosuppressive treatment. PMID- 3809701 TI - [Pneumopericardium complicating bronchial cancer]. AB - We report an observation of pneumopericardium occurring, without iatrogenic trauma in the preceding days, during the course of an epidermoid bronchial carcinoma, treated for a year by radio- and chemotherapy. The pneumopericardium produced a very attenuated clinical picture and was resorbed without incidence. But the patient died a few weeks after an overwhelming haemoptysis. The radiological picture is very characteristic. The differential diagnosis is above all that of a pneumo-mediastinum. But in the latter case, the clear zone exceeds the level of the great vessels and subcutaneous cervical emphysema in generally very clear both clinically and radiologically. PMID- 3809702 TI - [French-language Society of Pneumology and the Tunisian Society of Pneumo phthisiology. Tunis, 13-14 June 1986. Abstracts]. PMID- 3809703 TI - [Platelet aggregation study with the impedance-measurement method in whole blood and in platelet-rich plasma. Results of a study on normal subjects]. PMID- 3809704 TI - [An evaluation of the laboratory parameters useful in the determination of disease activity in Crohn disease]. PMID- 3809705 TI - [Bone marrow involvement in Hodgkin's disease at the onset]. PMID- 3809706 TI - [A case of abdominal sarcoidosis]. PMID- 3809707 TI - [A case of cell-mediated acquired immunodeficiency appearing with a picture of fever of unknown origin]. PMID- 3809708 TI - [Anti-erythrocyte antibodies with and without hemolysis in ulcerative colitis. Presentation of 2 cases]. PMID- 3809709 TI - [Changes in hepatic zinc in cirrhosis and extrahepatic cholestasis]. PMID- 3809710 TI - [Contribution of electron microscopy to the diagnosis of pulmonary carcinoma]. PMID- 3809711 TI - [Pulmonary aspergilloma: intracavitary therapy with intrabronchial instillation of drugs. Presentation of 2 cases]. PMID- 3809712 TI - [Course and prognosis of the rehabilitation of patients following acute polyneuritis]. AB - Presented are 31 patients who had been admitted to our clinic for physical medicine for post-acute rehabilitation treatment. On admission, 25 of them suffered from incomplete tetraparesis. All patients were able to walk at discharge, some still having to rely on aids. 29 patients had achieved full independence in ADL tasks. Further gains in muscular strength and functional capacity were achieved over a period of up to two years of continued treatment on an outpatient basis. PMID- 3809713 TI - [Psychotherapy of patients with hearing impairment]. AB - The need for psychotherapy with hearing impaired persons, and its necessity, are undisputed among professional workers. Yet, hardly any theory-based, field-tested experience exists so far concerning the procedures to be employed. The present contribution delineates both potential and limitations of psychotherapy with this population. Four schools of psychotherapeutic thinking are investigated as to their specific potential for contributing to psychotherapeutic work with hearing impaired clients. The aspect of "communication channel" is picked out from systems theory; from psychoanalysis, the concepts of therapeutic contract and transference appear significant; Humanistic Psychology, with its contributions concerning extraverbal expression and verbalization of feelings, has opened major routes of access to the hearing impaired individual; the broadest range of concepts and intervention strategies is presented by behavioural therapy. Behavioural approaches--cognitive conditioning, self-control techniques, thought stopping, cognitive re-structuring--may be of greatest use in working with deaf clients. Given the cognitive and communicative characteristics of the target population, therapeutic work needs to be performed in an eclectic and synoptical manner. Its prime objective lies in uncovering the "deaf identity", in developing and protecting it. PMID- 3809714 TI - [A computer-controlled telephone exchange for improving the occupational possibilities of blind patients]. AB - Working conditions in telephone exchanges are undergoing major changes with the penetration of computer technology. Although overall telephone utilization continues to grow, more and more jobs are being lost by the impact of rationalization. Operator jobs in private exchanges, at the same time, rank high among the job opportunities for disabled people, specifically for the blind. Workstation adaptations, on the other hand, are a valuable working aid for all blind or visually impaired operators, in that they use blindness-adapted information output via the Braille terminal. Pins (dots) being used to represent written information on a braille keyboard, the device in this application is not used as an input but for output purposes. The information a sighted person reads from an LC (line) display, is literally "put at the fingertips" of a blind operator. Following an overview of technical details of both conventional and adapted exchanges, the present report deals with operator training and employment opportunities for blind persons in private branch exchanges. PMID- 3809715 TI - [Continuing education of professionals in rehabilitation is coordinated]. AB - In its programme of action "Rehabilitation in the Eighties", the Federal Government declared that coordinated further education for professional workers in rehabilitation administrations and rehabilitation facilities was to received increased attention in the future. Efficient rehabilitative work presupposes adequate qualification for these tasks in those entrusted with providing rehabilitation services to persons with disabilities. On-going further education of professional workers is indispensable in achieving this objective, in addition to their initial qualification. Hence, the financially responsible rehabilitation administrations and the Federal Rehabilitation Council, on the initiative of the Federal Minister of Labour and Social Affairs, agreed to carry out inter-agency education seminars. For professional workers employed in rehabilitation facilities, the working groups of rehabilitation facilities have started such inter-facility further education in 1986, in coordination with the Federal Minister of Labour and Social Affairs. PMID- 3809716 TI - [Tasks of the counseling and rehabilitation clinic of the kibbutz movement federation]. PMID- 3809717 TI - Effective hydraulic permeability of the glomerular capillary wall in rats after uninephrectomy. AB - The effective hydraulic permeability (k) of glomerular capillaries was studied in 2-month-old Wistar rats 4 weeks after uninephrectomy in comparison to age-matched control rats. Isolated kidneys were perfused with a cell-free solution containing 5% albumin. In this preparation the rise of colloid osmotic pressure along the glomerular capillaries can be neglected because the filtration fraction is low (3%) due to high perfusion rates at normal filtration rates. Single nephron filtration rates (SNGFR) and effective filtration pressures were estimated by micropuncture to calculate the ultrafiltration coefficient (Kf). Glomerular capillary surface area was measured morphometrically to obtain k (k = Kf/S). We found that the effective hydraulic permeability in uninephrectomized rats was higher than in rats of comparable age (26.0 vs 18.0 nl/mm Hg X s X cm2). This can contribute to the adaptive rise in SNGFR after uninephrectomy. PMID- 3809718 TI - Urinary kinin excretion following alterations of vasopressin levels in man and rat. AB - To investigate the interaction between arginine-vasopressin (AVP) and the renal kallikrein-kinin system (KKS), urinary excretion rates of bradykinin (BK) and lysyl-bradykinin (LBK) were monitored in humans following water-loading, and in conscious diabetes insipidus (DI) rats during the infusion of AVP. In humans, the excretion rate of both BK and LBK decreased markedly 90 min after the water load. There was a close positive correlation between plasma AVP levels and urinary BK excretion, while urine flow was correlated negatively with the excretion rates of both kinins. In DI rats infusion of AVP caused a significant, reversible increase (from 14 +/- 2.8 to 35 +/- 5.1 fmol/min) in BK excretion. These results further implicate AVP in the regulation of the activity of the renal KKS. PMID- 3809720 TI - Transfer of immunity to Ostertagia circumcincta and IgA memory between identical sheep by lymphocytes collected from gastric lymph. AB - Sheep rendered immune to Ostertagia circumcincta were challenged with 50,000 larvae and lymphocytes were collected from the gastric lymph up to eight days after challenge. The cells were transferred intravenously to genetically identical worm-free sheep which, together with controls, were challenged with 50,000 larvae and killed nine days later. Cells obtained during the donors lymphoblast response to challenge transferred partial immunity, measured either as stunting or loss of worms. Significantly less immunity was transferred by cells collected either before or after this response. Thus the responding cells can mediate protective immunity to O circumcincta. On the other hand the donor sheep remained immune to their challenge infection despite being depleted of these functional cells, showing that their presence was not essential for immunity to be maintained. Comparison of the immunoglobulin A (IgA) concentrations in the gastric lymph of recipient and control sheep showed that a local IgA response had also been transferred. Enumeration of mucosal mast cells suggested that a mastocytosis had been transferred to the two recipients which were most immune to challenge. PMID- 3809719 TI - Acute effect of cisplatin on renal hemodynamics and tubular function in dog kidneys. AB - The present study was designed to investigate the early hemodynamic and tubular effects of cisplatin administration on dogs. To localize the nephrotoxic actions of cisplatin, we have taken advantage of the lithium clearance method. After infusion of 5 mg of cisplatin per kg, an immediate and significant increase in urinary flow rate (from 0.39 +/- 0.07 ml/min to 0.73 +/- 0.12 ml/min), sodium clearance (from 0.33 +/- 0.11 ml/min to 0.65 +/- 0.14 ml/min), potassium clearance (from 9.23 +/- 0.48 ml/min to 10.77 +/- 0.95 ml/min), lithium clearance (from 15.55 +/- 2.21 ml/min to 23.76 +/- 4.00 ml/min) and fractional lithium clearance (from 0.31 +/- 0.03 to 0.44 +/- 0.04) was seen. This occurred without measurable changes in glomerular filtration rate and renal blood flow. The calculated fractional as well as absolute rates of proximal reabsorption of sodium decreased significantly from 0.68 +/- 0.03 to 0.56 +/- 0.04 and from 4.76 +/- 0.32 mmol/min to 3.92 +/- 0.23 mmol/min, respectively. The results show that administration of cisplatin causes an acute, mainly proximal tubular impairment in dogs without alterations in renal hemodynamics. PMID- 3809721 TI - Effects of irradiated sow colostrum on some biochemical and haematological measurements in newborn piglets. AB - Some biochemical and haematological variables were measured in piglets during the first 48 hours after birth. The piglets were reared either by the sow, or bottle fed with colostrum (either natural or sterilised by irradiation), or a commercial milk replacer. Mean haemoglobin concentrations, packed cell volumes and erythrocyte counts decreased by approximately 45 per cent in all the groups between birth and 48 hours, but leucocyte counts increased more markedly in the colostrum-fed groups. All the colostrum-fed groups showed rapid increases in serum total protein concentrations which were almost entirely due to increases in gamma globulin concentrations. There was no difference in this respect between natural colostrum and colostrum sterilised by irradiation with 500 Krad of gamma rays. Colostrum sterilised by irradiation can protect piglets against infectious agents and simplify the rearing of piglets under specific pathogen free conditions. PMID- 3809722 TI - Population dynamics of Trichostrongylus colubriformis in sheep following anthelmintic treatment. AB - Three groups of five, three-and-a-half to four-month-old lambs were put to graze on three plots contaminated by Trichostrongylus colubriformis. One group (control) was free of parasites, while the other two were infected just before turning out with 3 X 700 third stage larvae. Depending on whether or not the lambs were treated with 50 mg kg-1 thiabendazole nine days after the first infection, the worm burden and the egg output increased or decreased during the grazing period when compared with the control group. In tracer animals put to graze on the same plots afterwards, it was found that the smaller the number of eggs excreted by the first lambs, the higher were the worm burdens of the tracer lambs. PMID- 3809723 TI - Functional antibody responses in pigs vaccinated with live and inactivated Aujeszky's disease virus. AB - Functional antibody tests, including virus neutralising activity of serum, antibody dependent cellular cytotoxicity and complement mediated lysis, were used to measure the response of pigs given either live or inactivated Aujeszky's disease virus vaccines. Pigs were then challenged with virulent Aujeszky's disease virus and antibody responses were analysed and found not to correlate with protection. Reasons for this lack of correlation are discussed and it is suggested that these results indicate that more emphasis should be placed on measuring the local immune response. PMID- 3809724 TI - Effect of pretreatment with hepatic microsomal enzyme inducers on the toxicity of diazinon in calves. AB - The pretreatment of calves with a single dose of 10 mg kg-1 dieldrin or 21 daily doses of 10 mg kg-1 phenobarbitone increased the toxicity of diazinon as reflected by the development of more severe clinical signs and greater depression in whole blood cholinesterase activity in the pretreated calves. Induction by dieldrin or phenobarbitone of the hepatic microsomal enzyme amidopyrine-N demethylase was also accompanied by a concurrent rise in the liver carboxylesterase activity. PMID- 3809725 TI - Chronic orthopaedic disease in adult male broiler breeding fowls. AB - An assessment has been made of spontaneous orthopaedic disease in 100 male broiler breeding fowls aged between 51 and 62 weeks. Lesions were identified in the pelvic limbs of 92 birds, 85 of which showed total or partial rupture of ligaments or tendons. Total ligament or tendon failure was identified at one or more skeletal sites in 54 birds. In two cases, avulsion of the femoral origin of the cranial tibial muscle had occurred. Other findings included degenerative changes in a number of joints but there was no correlation with ligament derangement. Partial or total detachment of the femoral head occurred in 16 birds. The primary lesion was disturbed endochondral ossification and, once detached, the femoral head normally became necrotic. In the reparative phase, 'creeping substitution' was identified. PMID- 3809726 TI - Concussive methods of pre-slaughter stunning in sheep: assessment of brain function using cortical evoked responses. AB - Averaged cortical evoked responses were used to evaluate brain function in anaesthetised sheep. Effects on both evoked somatosensory responses (SERs) and visual evoked responses (VERs) were examined. Following capitive bolt stunning, SERs and VERs were abolished instantaneously and did not reappear for the duration of the experiment. Similar results were found when animals were shot while conscious. It was concluded that captive bolt stunning in sheep produces an immediate, profound and long lasting brain failure and is therefore an effective preslaughter stunning method. PMID- 3809727 TI - Concussive methods of pre-slaughter stunning in sheep: effects of captive bolt stunning in the poll position on brain function. AB - The effectiveness of captive bolt stunning in the poll position was evaluated in eight anaesthetised sheep. Brain function following shooting was assessed using cortical visual evoked responses (VERs). Immediately following shooting, VERs were abolished in all sheep. However, in five of the sheep, VERs gradually recovered; responses became evident in these animals in a mean (+/- SE) time of 50 +/- 16.7 seconds. These results suggest that captive bolt shooting in the poll position can be associated with rapid recovery of brain function. Because such recovery could be associated with return of sensibility, shooting in the poll position should only be used when essential (ie, in horned animals) and then always followed promptly by sticking. PMID- 3809728 TI - Monoclonal antibodies specific for pig serum and cell surface IgM. AB - Two monoclonal antibodies were prepared which react specifically with pig serum immunoglobulin and with the population of B lymphocyte-bearing surface immunoglobulin. Comparison of our monoclonal antibodies with reagents specific for gamma, mu and alpha immunoglobulin chains in double immunodiffusion and immunoelectrophoresis revealed that the monoclonal antibodies recognise IgM in pig serum and mu chain or mu chain-like molecules on B lymphocytes. The monoclonal antibodies, designated LIG 2 and LIG 4, reacted positively with adult pig sera but not with fetal or precolostral sera or with sera from other animal species. LIG 2 and LIG 4 reacted with 15 per cent of cells from the peripheral blood lymphocyte population, 20.2 per cent of spleen cells and 20 per cent of lymph node cells, but did not react with pig erythrocytes, granulocytes or cells isolated from thymus, or with the lymphocytes of other species. Positive reactions were also found on lymphatic and intestinal tissue sections. No genetic polymorphism was found in the pig population revealed by the monoclonal antibodies. The monoclonal antibodies LIG 2 and LIG 4 may be useful for studying the pig immune system, especially as a standard reagent for measuring pig serum IgM and for the identification of positive B lymphocytes. PMID- 3809729 TI - Secretion of hydrogen peroxide by phagocytic cells from bovine non-lactating mammary glands. AB - Phagocytic cells from non-lactating bovine mammary glands have the capacity to secrete hydrogen peroxide when exposed to the soluble membrane stimulant phorbol myristate acetate (PMA). Unfractionated cell suspensions, containing mainly neutrophils and macrophages, and cell monolayers enriched for macrophages secreted hydrogen peroxide. A correlation was observed between the amount of hydrogen peroxide secreted, the antibacterial activity of the cells and the number of neutrophils present in the cell suspensions. Pre-exposure of cells to PMA significantly impaired their antibacterial activity against Staphylococcus aureus suggesting the importance of oxygen metabolism in the bactericidal capacity of these cells. PMID- 3809730 TI - Neuroma formation following partial beak amputation (beak trimming) in the chicken. AB - Branches of the trigeminal nerve, which innervates the beak in the chicken, were damaged after partial beak amputation (beak trimming) and degeneration in the nerve extended from 2 to 3 mm proximal to the cut stumps. Within 10 days the damaged nerves showed regeneration and axon sprouts had been formed. This neural regeneration was rapid so that by 20 to 30 days bundles of regenerating fibres were present and neuromas formed adjacent to the scar tissue of the stump of the beak. These neuromas became more extensive over the 70 day observation period. PMID- 3809731 TI - Chemotherapy and pharmacokinetics of some antimicrobial agents in healthy dwarf goats and those infected with Ehrlichia phagocytophila (tick-borne fever). AB - The therapeutic efficacy and pharmacokinetics of oxytetracycline (10 mg kg-1), ampicillin (20 mg kg-1) and a combination (TSS) of trimethoprim (20 mg kg-1), sulphadimidine (50 mg kg-1) and sulphamethylphenazole (50 mg kg-1) were investigated in normal dwarf goats and in those infected with Ehrlichia phagocytophila. Goats given oxytetracycline or TSS intravenously showed improvement, whereas ampicillin was ineffective. The infected goats had significantly prolonged elimination half-life values for sulphadimidine and oxytetracycline. The disposition kinetics of ampicillin and sulphamethylphenazole showed no marked differences between the healthy and infected animals. The tick borne fever model used in the present study can be of value in testing the therapeutic efficacy and pharmacokinetics of chemotherapeutic agents in rickettsial infections. PMID- 3809732 TI - Porcine parvovirus: propagation in microcarrier cell culture and immunogenic evaluation in pregnant gilts. AB - Porcine parvovirus was propagated in PK-15 cells cultured in roller bottles or on microcarrier beads. After inactivation, the virus was used as antigen in the preparation of vaccines. The immunogenic potency and safety of the vaccines were evaluated in specific pathogen free pregnant gilts and guinea pigs. Experimental challenge tests determined the efficacy of the vaccine in preventing porcine parvovirus transplacental infection. Neither viral antigens nor specific antibodies were detected in fetuses from vaccinated gilts. In contrast, fetal death and, or, mummification occurred when unvaccinated gilts were infected. Both virus and, or, antibodies were also detected in fetuses from these unvaccinated gilts. Serum conversion after vaccination was assayed by microserum neutralisation using guinea pig erythrocytes as cell indicators and by haemagglutination inhibition tests. Viral antigens in fetal tissues were detected using ELISA, the immunobeads technique, the haemagglutination test and by virus isolation. PMID- 3809733 TI - The gastrocnemius tendon of domestic fowl: histological findings in different strains. AB - Vascular and histological studies were performed on normal gastrocnemius tendons from male birds considered susceptible (broiler breeding) and insusceptible (laying strain) to noninfectious tendon rupture. Structural differences between strains were noted at the site where rupture usually occurs. This site contains a hypovascular region which develops at an earlier age in broiler type fowls. Histological sections revealed that vessel occlusion had occurred in birds with hypovascular tendon segments. Chondrocytes and chondroid cells adjacent to occluded vessels accumulated lipid and died. This finding was particularly apparent in broiler fowls where cartilaginous plaques were larger and thicker than in laying strain fowls. The presence of occluded vessels, cartilage death and chondroid infiltration of collagen bundles in broiler type fowls are interpreted as structural changes which may predispose to noninfectious tendon rupture. Indeed they may also predispose to tendon lesions associated with pathogens. PMID- 3809734 TI - Comparison between the renal clearance of endogenous creatinine and inulin in the sheep. AB - Simultaneous renal clearances of inulin and endogenous creatinine were determined during inulin infusions in sheep. The calculated regression of creatinine on inulin clearance differed significantly from the expected line. Discrepancies might be explained by absorption and secretion of creatinine under differing conditions, but it is suggested that lack of specificity of the method used for creatinine determination is an equally likely cause. As the difference between the two clearances was not great (within the range 14 to 48 ml min-1 it was not significant at P less than 0.05), creatinine clearance remains a useful indicator of glomerular filtration. For greatest accuracy, however, inulin clearance remains the method of choice. PMID- 3809735 TI - Serological response of mice to Fusobacterium necrophorum. AB - Mice immunised with killed or living Fusobacterium necrophorum, by five different regimens, almost invariably failed to produce antibodies demonstrable by a passive haemagglutination test. An enzyme-linked immunosorbent assay (ELISA), however, usually demonstrated a serum antibody response. This suggested that F necrophorum was not in fact immunosuppressive in mice--a possibility that had been entertained to explain the great difficulty in protecting mice immunologically against challenge with F necrophorum. PMID- 3809736 TI - Effects of molybdenum or iron induced copper deficiency on the viability and function of neutrophils from cattle. AB - Neutrophils from cattle with copper deficiency induced by molybdenum (0.052 mmol molybdenum kg-1 diet) or iron (8.95 mmol iron kg-1 diet) had an impaired ability to kill ingested Candida albicans and were less viable than those from copper supplemented cattle in in vitro tests of function. Restricted intake (80 per cent of ad libitum) of a copper-adequate diet by cattle also decreased neutrophil candidacidal activity and viability. Additionally, the ingestion of C albicans by neutrophils was impaired by the molybdenum or iron treatments but not by restricted food intake. The changes in neutrophil function and the severity of copper deficiency, in biochemical terms, induced by the molybdenum or iron treatments were greater than those induced by diets of low copper content. PMID- 3809737 TI - Resistance of Cooperia curticei against fenbendazole. AB - Resistance of Cooperia curticei against fenbendazole was demonstrated in The Netherlands. Experimental infection of lambs followed by intraruminal injection of 5 mg kg-1 showed a 100 per cent survival of the C curticei population. With an in vitro egg development assay LC50 values between 0.23 and 0.38 micrograms ml-1 thiabendazole were found. This is the first record of a Cooperia species resistant against an anthelmintic. PMID- 3809738 TI - Comparison of the external dimensions of capripoxvirus isolates. AB - No significant difference was found between the external dimensions of the M forms of isolates of sheep pox virus from Nigeria, sheep and goat pox virus from Kenya and lumpy skin disease virus from South Africa. Earlier reports that isolates of capripoxvirus can be distinguished by their relative sizes could not be substantiated. PMID- 3809739 TI - Perspectives of antioxidant treatment of emphysema with N-acetylcysteine. Proceedings of a satellite symposium to the 4th congress of the European Society of Pneumology (SEP), Stresa, September 27, 1985. PMID- 3809740 TI - Acetylcysteine: a drug with an interesting past and a fascinating future. AB - N-acetylcysteine (NAC) possesses a free sulfhydryl group that can rupture disulfide bridges. Although it is considered to be a mucolytic, its mucokinetic actions include expectorant, bronchorrheic and mucoregulatory contributions. New uses include the management of acetaminophen poisoning and the scavenging of free radicals liberated by cancer chemotherapy drugs. The antioxidant effects may be of prophylactic value in lungs at risk from smoking, pollution and infection. Other uses proposed for NAC include the therapy of connective tissue diseases and its use as a component in life extension diets. PMID- 3809741 TI - Lung protection by a thiol-containing antioxidant: N-acetylcysteine. AB - N-acetylcysteine (NAC) is a thiol-containing compound which nonenzymatically interacts and detoxifies reactive electrophiles and free radicals. NAC was shown to effectively protect human bronchial fibroblasts against the toxic effects of tobacco smoke condensates and the isolated perfused lung against the glutathione (GSH)-depleting effect of tobacco smoke. NAC was also shown to reduce the reactive oxygen intermediate hydrogen peroxide (H2O2) and protect against the toxic effects of H2O2. In vivo studies, however, demonstrated that NAC when administered orally has very low bioavailability due to rapid metabolism to GSH among other metabolites. Thus, even though NAC is very effective in protecting cells of different origins from the toxicity of reactive components in tobacco smoke and reactive oxygen species, a direct scavenging effect by NAC in vivo, particularly when administered orally, does not seem likely. The bioavailability of NAC itself is very low when given this route. A more relevant mechanism in vivo for any protective effect NAC may exert against toxic species may be due to NAC acting as a precursor of GSH and facilitating its biosynthesis. GSH will then serve as the protective agent and detoxify reactive species both enzymatically and nonenzymatically. PMID- 3809742 TI - Metabolic, desmutagenic and anticarcinogenic effects of N-acetylcysteine. AB - N-acetylcysteine (NAC) is often administered to respiratory patients with histories of exposure to noxious agents (e.g. cigarette smoke and atmospheric pollutants), which are known to act as glutathione (GSH) depletors and as cancer initiators and/or promoters. Since NAC is a precursor of intracellular GSH, we investigated its effects on GSH metabolism and on the biotransformation of carcinogenic and/or mutagenic compounds. In vitro, NAC induced a significant increase in oxidized glutathione (GSSG) reductase activity in rat liver preparations and counteracted the mutagenicity of direct-acting compounds (such as epichlorohydrin, hydrogen peroxide, 4-nitroquinoline-N-oxide and dichromate), as a result of its reducing and scavenging properties. At high concentrations, the drug completely inhibited the mutagenicity of procarcinogens (cigarette smoke condensate, tryptophan pyrolysate, cyclophosphamide, 2-aminofluorene, benzo(a)pyrene and aflatoxin B1) by binding their electrophilic metabolites. In contrast, their metabolic activation was stimulated by decreasing NAC concentrations, especially when liver preparations from enzyme-induced rats were used. Lung and liver subcellular preparations of rats treated in vivo with NAC, in various combinations with enzyme inducers and/or GSH depletors, also affected the mutagenicity of a number of compounds. NAC generally increased intracellular GSH and restored its levels following depletion. It did not affect the levels nor the spectral properties of cytochromes P-450 in pulmonary and hepatic microsomes, whereas it stimulated, especially in Aroclor-pretreated animals, cytosolic enzyme activities involved in NADP or GSSG reduction (G6PD, 6PGD and GSSG reductase) and in the reductive detoxification of xenobiotics (DT diaphorase). When administered with the diet, at a nontoxic posology (120 mg/kg b.w.), NAC markedly inhibited the induction of lung tumors in mice by a potent carcinogen (urethane). PMID- 3809743 TI - [Effect of local epicardial sympathectomy on regional myocardial contraction]. PMID- 3809744 TI - [Effects of excessive norepinephrine on cardiac mitochondria calcium transport and oxidative phosphorylation]. PMID- 3809745 TI - [Non-linear least square method with microcomputer using simplex method]. PMID- 3809746 TI - [Impaired diastolic function and its mechanism in mild hypertension--assessment by exercise echocardiography and calcium antagonist]. PMID- 3809747 TI - [The effect of age on AV nodal properties allowing induction of AV nodal reentrant tachycardia]. PMID- 3809748 TI - [Single Master's two step test and arrhythmias]. PMID- 3809749 TI - [Relation between giant negative T wave-apical hypertrophy and hypertrophic cardiomyopathy: assessment with x-ray computed tomography, echocardiography and left ventriculography]. PMID- 3809750 TI - [Enhanced hypotensive effect of long-acting nifedipine on elder patients with mild or moderate essential hypertension]. PMID- 3809751 TI - [Relation of serum apolipoprotein and lipoprotein and coronary atherosclerosis]. PMID- 3809752 TI - [An adult case of corrected transposition of the great arteries complicated atrio ventricular block treated with A-V sequential pacing using myocardial electrode]. PMID- 3809753 TI - Interpretation of changes in DLCO and pulmonary function after running five miles. AB - The purpose of this study was to evaluate changes in pulmonary function after running five miles. Of particular interest was the reaffirmation of the previously reported 'uncoupling' or dissociation of pulmonary diffusing capacity (DLCO) and cardiac output (Q) after moderate or strenuous exercise. Cardiopulmonary assessments were made on eight runners before and after completing three separate five mile runs. There were significant reductions in vital capacity (5.7%) and volume at closing with increases in residual volume (22.5%) and closing capacity post-run. Although DLCO did not change, significant change in cardiac output occurred during the DLCO 10 sec breathhold maneuver. The pre-run DLCO maneuver produced a fall in stroke volume (SV) with an increase in HR while maintaining Q. The post-run Q fell during the DLCO maneuver due to a fall in SV with HR remaining constant. The primary basis for previous speculation of the development of a transient pulmonary edema during exercise has been the failure of DLCO to increase immediately after exercise when HR and presumably Q is elevated. To avoid any misinterpretation of changes in DLCO produced by exercise, Q should be measured at the time of the DLCO determination. Our findings suggest that values for DLCO post-exercise are entirely appropriate for the pulmonary blood flow at the time of the DLCO maneuver. PMID- 3809754 TI - Effects of dystrophy and age on hamster tracheal smooth muscle function. AB - Pharmacological and morphometric evaluations of airway smooth muscle were performed on tracheal segments from control and dystrophic hamsters at 50, 145 and 315 days of age. An age-related change in muscle volume index (a measure of the total smooth muscle per tracheal segment) was not observed in the control group but decreased with age in the dystrophic strain. In the control strain, correlations were not observed between age and maximum pharmacological response to the drugs tested, but a change in sensitivity to carbachol and KCl was noted at 145 days. In contrast, tracheal segments of dystrophic hamsters exhibited decreased maximum responses to carbachol, KCl, histamine, and isoproterenol at 315 days of age. When maximal contractile responses were normalized by muscle volume index, only the KCl maximum tension at 315 days was less than at 50 days of age. Changes in sensitivity to carbachol and KCl were also seen in tracheal smooth muscle of the dystrophic hamster at 145 days of age. At 315 days, histamine and isoproterenol-induced relaxation was less in dystrophic than in control tracheal smooth muscle. It is not possible to ascertain whether the decreased responses of the tracheal segments from the oldest dystrophic hamsters are due to dystrophy alone, or to a combination of dystrophy and aging. PMID- 3809755 TI - Oxygen sensitive afferent information arising from the first gill arch of yellowfin tuna. AB - Single nerve fiber discharge was recorded from O2 sensitive receptors in the first gill arch of the yellowfin tuna, Thunnus albacares, in vitro. These receptors were innervated by the vagus nerve and increased their discharge in response to decreasing perfusion rate, decreasing perfusion PO2 and, in most fibers, to decreasing external PO2. Fibers responding to environmental hypoxia exhibited an exponential increase in discharge to decreasing external PO2 with a sensitivity similar to that exhibited by cat carotid body chemoreceptors. Indirect evidence suggests that these receptors are located near the gill vasculature and are more sensitive to changes in arterial PO2 than water PO2. Their response characteristics and hypoxic sensitivity strongly implicate them as the afferent limb in the cardiac responses and perhaps also the ventilatory responses exhibited by tuna to environmental hypoxia. PMID- 3809756 TI - Effects of airway cooling on tracheal stretch receptors. AB - We studied the effect of cold air on tracheal slowly adapting stretch receptors (SAR) in 6 anesthetized, spontaneously breathing dogs. Air at constant flow and two different temperatures was passed through an isolated segment of the extrathoracic trachea. We recorded SAR action potentials, esophageal pressure, tracheal pressure and temperature. With a reduction in tracheal temperature of approximately 10 degrees C the steady state response of 30 SARs to a distending pressure of 1.0 kPa decreased to 75% of control (P less than 0.001). At lower distending pressure the inhibitory effect of tracheal cooling decreased: 87% of control at 0.5 kPa (P less than 0.05, n = 8) and 96% of control at 0.2 kPa (P greater than 0.05, n = 8). The response of 13 tracheal SARs to sinusoidal pressure oscillations (0.15 kPa) superimposed on a bias pressure (0.5 kPa) was reduced (P less than 0.01) by local cooling to the same extent at the 2 pressure extremes ('peak' value = 71% of control; 'valley' = 67% of control), resulting in a similar change in receptor discharge within the oscillatory cycle. The inhibitory effect of airway cooling on stretch receptors may play a role in cold induced bronchoconstriction. PMID- 3809757 TI - Effects of hypothalamic lesions on the cardiorespiratory responses to muscular contraction. AB - Recent studies have suggested that descending central command from a hypothalamic site (subthalamic locomotor region) is involved in the control of the respiratory and cardiovascular systems during exercise. The purposes of this study were to determine if this hypothalamic area provides tonic drive to the cardiorespiratory systems and modulates the cardiorespiratory responses to static muscular contraction. Anesthetized cats were studied before and after bilateral electrolytic lesioning of the subthalamic locomotor region. Muscular contraction was evoked by stimulation of the L7-S1 ventral roots. Bilateral hypothalamic lesions produced a fall in resting levels for respiratory frequency, minute ventilation, heart rate and arterial pressure. The lesions did not alter the significant increases in arterial pressure and minute ventilation produced by muscular contraction. However, larger heart rate and respiratory frequency responses to muscular contraction occurred post-lesion. We conclude that this area of the hypothalamus provides tonic drive to the cardiorespiratory systems. Furthermore, the subthalamic locomotor region may participate in the modulation of some cardiorespiratory responses to neural feedback from contracting muscles. PMID- 3809758 TI - The hypoxic ventilatory response of rats with increased blood oxygen affinity. AB - Experimental work has established an interspecific relationship between the threshold for the hypoxic ventilatory response and the 'knee' of the Hb-O2 dissociation curve. However, whether this relationship exists intraspecifically remains unclear. To examine the problem further rats were treated with sodium cyanate (NaOCN) to lower P50 and their hypoxic ventilatory response was measured. NaOCN treated rats had a lower PaO2 and higher Hct than control rats. There was no difference between the control and lowered P50 condition in the ventilatory response to hypoxia when % delta VI was plotted against PaO2. The results are consistent with PaO2 sensing chemoreceptors. PMID- 3809759 TI - Effect of graded anesthesia on laryngeal-induced central apnea. AB - To examine the interaction between laryngeal reflex-induced central apnea and anesthesia, we stimulated the superior laryngeal nerves (SLNs) bilaterally in chronically instrumented piglets (N = 18, age 5-17 days) in the presence of various anesthetic dosages. The SLNs were placed in cuff electrodes and wires were exteriorized in the neck for stimulation. A cannula placed in the aorta was used for blood pressure recording and arterial blood sampling. During each experiment, 1-2 days following surgery, ventilation was recorded using whole body plethysmography, and EEG and ECG were recorded using acutely placed subcutaneous electrodes. Following baseline recordings and before administration of anesthesia, the SLNs were electrically stimulated for 15 min. Following recovery from stimulation, pentobarbital (5-15 mg/kg) was infused and the SLN was stimulated with the same variables for 5 min. Before anesthesia, SLN stimulation caused respiratory frequency (Rf) to fall from 44 +/- 5 (mean +/- SEM) to 16 +/- 2 breaths/min; under anesthesia Rf fell from 33 +/- 7 to 9 +/- 1 (pentobarbital dose a = 16 mg/kg) or from 36 +/- 4 to 3 +/- 1 breaths/min (pentobarbital dose b = 28 mg/kg). PaO2 decreased from 110 +/- 4 to 74 +/- 4 mmHg during stimulation before anesthesia and fell from 100 +/- 6 to 40 +/- 4 with dose a or from 98 +/- 10 to 19 +/- 4 mmHg with dose b under pentobarbital anesthesia. Similarly, choloralose/urethane and ketamine anesthesia enhanced SLN-induced respiratory depression. These results suggest that anesthesia impairs the mechanism responsible for initiating breathing during laryngeal reflex activation. PMID- 3809760 TI - [Stories and their organizing function]. PMID- 3809761 TI - [The story in a one-to-one relation]. PMID- 3809762 TI - [Telling stories to deaf children]. PMID- 3809763 TI - [The parents of a deaf baby and the speech therapist. The passage from the medical field to educational guidance]. PMID- 3809764 TI - [Parents of deaf children: hope and preoccupations today]. PMID- 3809765 TI - [Around the deaf child: parents, audiometry specialists, audiologists, speech therapists, hearing aid specialists, psychologists]. PMID- 3809766 TI - [The vocal record]. PMID- 3809767 TI - [The quality of the voice]. PMID- 3809769 TI - [Vocal dysfunction]. PMID- 3809768 TI - An acoustical study of erigmophonic voices and the voices of cordectomized patients. PMID- 3809770 TI - [Reflections of a hospital nurse team on information to give to future laryngectomized patients]. PMID- 3809771 TI - [Extracochlear implantation. Surgical placement of the Prelco prosthesis]. PMID- 3809772 TI - [Aid to totally deaf patients by a unichannel extracochlear implant]. PMID- 3809773 TI - [Our experience with a unichannel extracochlear implant in the rehabilitation of total bilateral deafness]. PMID- 3809774 TI - [Unichannel extracochlear implant in children]. PMID- 3809775 TI - [Good clinical practices. Point of view of the university hospital]. AB - For clinical investigators, usually on the staff of university hospitals, the setting up in France of a good clinical practices system will no doubt improve the quality of clinical trials in that country. It remains that the investigator's responsibility is involved before, during and after the clinical trial period and that the demand on his time is considerable. Close co-operation between the pharmaceutical firm (as promotor and monitor) and the clinical investigator is necessary to conduct a clinical trial. PMID- 3809776 TI - [Good clinical practices. Point of view of the drug manufacturers]. AB - For the drug manufacturer the introduction in France of a good clinical practices system will encourage the development of the pharmaceutical industry, provided a number of precautions are observed. These precautions, which include the need for one set of regulations applicable to the whole of Europe and for the training of clinical investigators, are detailed and discussed. PMID- 3809777 TI - [Industrial drug-surveillance]. AB - Drug surveillance is a fundamental stake for the pharmaceutical industry. Drug manufacturers are responsible, both legally and morally, for the marketing of new products, and this represents very important investments. It is the duty and to the benefit of the pharmaceutical industry to set up a structure devised to collect and evaluate undesirable side-effects. In addition, drug surveillance may give rise to fruitful exchanges between scientific, teaching and industrial communities. PMID- 3809778 TI - [Industrial drug-surveillance. Spontaneous notification: data collection, survey]. AB - The importance of post-marketing drug surveillance has often been stressed. To detect new undesirable side-effects it seems more appropriate to improve spontaneous reporting of such effects. The main stages of spontaneous reporting are listed, with detailed information on his first and second stages: data recording and validation. PMID- 3809779 TI - [Presentation of data in drug surveillance and bases for a decision]. AB - Data presentation is a fundamental step in drug surveillance, for it makes it possible, after methodical analysis of the information obtained, to draw conclusions which may lead to a final decision concerning the product. Several items providing the basis for such decisions are discussed. PMID- 3809780 TI - [Problems of the number of cases in drug surveillance]. AB - The purpose of drug surveillance studies is to ascribe the adverse event observed to a pharmacological cause and to try to evaluate its frequency in order to draw reliable conclusions. The present study shows that epidemiological investigations of the cohort or case-control type not only are of poor warning value but also require so many patients that the information required is obtained very slowly and at a very high cost. Despite its imperfections, spontaneous reporting seems to be the most effective method of post-marketing drug surveillance. PMID- 3809781 TI - [Drug surveillance throughout the world]. AB - There are several systems of international drug surveillance, such as the W.H.O. system, the "Boston University drug epidemiology unit" in the U.S.A. and a similar system used in Switzerland, or the "drug surveillance research unit" in Great Britain. These different centres are described, and the problems of international drug surveillance are discussed. PMID- 3809782 TI - [Quality assurance of clinical trials]. AB - A quality assurance system for clinical trials entails the definition, prior to the trial, of a number of procedures (the "good clinical practices") ensuring that it will be correctly conducted and the verification that these procedures have been respected. Setting up a clinical trial quality assurance system involving the manufacturer, university staff and public authorities should result in trials that are better performed. The role and responsibilities of each party are discussed, together with the consequences to be expected from the introduction of good clinical practices in France. PMID- 3809783 TI - [Gougerot-Sjogren syndrome. Revision of a problem...]. PMID- 3809784 TI - [HB virus infection and delta surinfection in Sahelian Africa]. AB - 78 hospitalized patients were selected when presenting with at least one of these signs: hepatomegaly, jaundice, ascites, oesophageal varices, abdominal venous pattern, splenomegaly. All had radioimmunoassays for hepatitis B surface antigen (HBsAg) and antidelta antibody (78/78). Acute or chronic hepatic disease was diagnosed in 56 patients: 7 acute viral hepatitis, 13 chronic hepatitis, 23 non alcoholic hepatic cirrhosis, and 13 hepatocellular carcinoma. Twenty-two patients with other diagnoses served as controls. Serum antidelta was present in each group: acute viral hepatitis (2/7), chronic hepatitis (2/13), non alcoholic hepatic cirrhosis (9/23), hepatocellular carcinoma (3/13), controls (2/22). Every patient with acute or chronic hepatic disease and positive serum anti-delta was positive for serum HBsAg. Amony controls, 2 patients with positive serum antidelta were negative for serum HBsAg but positive for antiHBs. Delta superinfection is present in the sahelian region; Patients with acute viral hepatitis, chronic hepatitis, non alcoholic hepatic cirrhosis, and hepatocellular carcinoma are electively infected. Patients with acute or chronic hepatitis and positive serum antidelta have hepatitis B virus evolutive infection (positive serum HBsAg). PMID- 3809785 TI - [Tobacco detoxication by acupuncture and group psychotherapy]. AB - In the out-patient tobacco detoxication unit created, in 1977, within the pneumology department of the Hotel-Dieu hospital, Paris, the method used is a combination of acupuncture and group psychotherapy. Its effectiveness has been evaluated, over a 2-year period, by means of a questionnaire mailed to each patient and followed, if necessary, by up to 3 reminders. A computer-assisted assessment of the data thus collected provided a follow-up of varying duration of the 555 patients concerned; 488 patients were treated, then contacted, and 371 (76 p. 100) answered the questionnaire. Weaning--defined here as complete detoxication with a 2 to 28 months follow-up when the questionnaire was filled- was obtained in 24 p. 100 of the patients who answered. Other evaluation criteria would have given figures ranging from 18 p. 100 to 58.6 p. 100. The main reason for failure mentioned by the patients was lack of will. An exhaustive study of 84 publications concerning more than 10,000 candidates to weaning showed that similar results are obtained with several types of psychotherapy, acupuncture and auriculotherapy: a success rate of about 60 p. 100 at the end of treatment, 40 p. 100 at 3 months and 30 p. 100 at 6 months and one year. The results obtained with drugs are not as good, perhaps because their use betrays a lesser desire to give up smoking. PMID- 3809787 TI - [Anterior pituitary insufficiency disclosing an empty sella turcica]. PMID- 3809786 TI - [Sicca syndrome with severe renal insufficiency]. AB - The interstitial nephritis associated with sicca syndrome is usually symptomless or responsible for mild renal impairment. The authors report five cases in which renal failure was severe, requiring haemodialysis in two patients. The physiopathological mechanisms and the treatment of interstitial nephritis in sicca syndrome are discussed. Corticosteroids improved renal function in three of these five patients. PMID- 3809788 TI - [Suppurative thyroiditis. Apropos of a case]. PMID- 3809789 TI - [Immunological changes in chronic alcoholic patients in relation to their hepatic involvement]. PMID- 3809790 TI - [Interstitial nephropathy with nephrotic syndrome induced by pirprofen]. PMID- 3809791 TI - [Treatment of obesity: the staged method]. PMID- 3809792 TI - [Epidemiological characteristics of peptic ulcer in workers of Chuquicamata]. PMID- 3809793 TI - [Bioavailability of a thyroxine preparation and its use in primary hypothyroidism]. PMID- 3809794 TI - [Hypergastrinemia in patients with renal insufficiency in chronic hemodialysis]. PMID- 3809795 TI - [Carpal tunnel syndrome in patients under chronic hemodialysis]. PMID- 3809796 TI - [Immune hemolytic anemia caused by penicillin]. PMID- 3809798 TI - [Verbal behavior in clinical practice]. PMID- 3809797 TI - [A single left superior vena cava. Pacemaker implantation]. PMID- 3809799 TI - [Who is a good cardiologist?]. PMID- 3809800 TI - [Smoking survey in the general population of Santiago]. PMID- 3809801 TI - [Pulmonary function in cardiac diseases]. PMID- 3809802 TI - [Occult alcoholism: prevalence of problem drinkers in patients hospitalized in a general hospital]. PMID- 3809803 TI - [Differential diagnosis of various porphyrias. Experience with 28 cases]. PMID- 3809804 TI - [Behcet's disease]. PMID- 3809805 TI - [Echocardiogram in moderately hypertensive patients]. PMID- 3809806 TI - [Evaluation of the precision and accuracy of clinical laboratories in determinations of clinical chemistry]. PMID- 3809807 TI - [Absence of fetal hypothyroidism despite the therapeutic use of 131I during pregnancy]. PMID- 3809808 TI - [Weil's syndrome caused by Leptospira interrogans serogroup australis serotype bratislava]. PMID- 3809809 TI - [Allergy to insect stings]. PMID- 3809810 TI - [Deaths due to undefined causes in health services of Chile]. PMID- 3809811 TI - [Epidemiology of human hydatidosis in the 11th Region of Aysen]. PMID- 3809812 TI - [Differential diagnosis of dyspnea]. PMID- 3809813 TI - [Functional evaluation of the patient with dyspnea]. PMID- 3809814 TI - Effects of listening to music with headphones on hearing--especially under noisy conditions. AB - The purpose of this experiment was to clarify the effects of exposure to music using headphones under noisy conditions on hearing. The most comfortable loudness (MCL) for three kinds of music (Rock, Popular, Japanese songs) decided by two normal hearing subjects was measured under 6 noisy conditions (Train, Subway, Tram, Bus, Underground, Street) in a soundproof room. In the same manner, the MCL of favorite tunes of five subjects were measured. Temporary threshold shift 2 min after exposure (TTS2) to music for 30 min at the highest MCL was obtained. Furthermore, the characteristics such as spectral structures in one-third octave band or level fluctuations (coefficient of variation) were obtained for noise and music and compared. Statistical analysis revealed that MCL in Street was significantly higher than under other conditions and there was no significant differences in MCL among the various types of music. However, the highest MCL was found for Rock. About 20 dB of TTS was observed in one ear and the hazardous of headphones use in noisy conditions was suggested. PMID- 3809815 TI - A morphological comparison of the foramen magnum of the male Middle Kyushuites with that of other ethnological groups. AB - The foramen magnum of the male Middle Kyushuites was examined by both osteoscopic and osteometric methods. In the osteoscopic study, the two-semicircular shape was the most numerous as in the case of the adult Germans. The breadth and the index of the foramen magnum did not show any significant differences between the male Middle Kyushuites and the other ethnological groups, while the length of the foramen magnum was shorter than that of the others with a statistical significance. The mean length of the foramen magnum of the Kikai-islanders was the longest among the Japanese. PMID- 3809816 TI - Brachycephalization in the head form of school girls in North Kyushu. AB - The maximum head-length and head-breadth of school girls in Kitakyushu city were measured. The purpose of this study is to prove the recent brachycephalic incidence of Japanese. The mean of cephalic index (the percentage ratio of maximum head-breadth to maximum head-length) of these girls is 87.0 indicating hyperbrachycephalic incidence. Since the cephalic indexes of the female farm workers in North Kyushu about 30 years ago were 81.0 and 81.1, the remarkable increase of the cephalic index in the present study may represent an example of the rapid brachycephalization of the present people. PMID- 3809817 TI - [A population survey on mass screening program for gastric cancer. Part 2. Why don't they receive mass screening examination?]. AB - The attitude of non-examined residents to a mass screening program for gastric cancer has been surveyed by a self-administered questionnaire among 3660 residents in a small town near Kitakyushu City. Among 1159 subjects who had not received any type of examination during the past 3 years, the answers of 638 subjects who completed the questionnaire were analyzed in this study. Reasons for not being examined were classified into 4 types; "unnecessary", "rejected", "inconvenient" and "others". The most frequent reason for not taking part in the screening program was "inconvenient" which means that there were some difficulties for them to participate in the program even if they wanted to. This reason was followed by "unnecessary" and "rejected". "Inconvenient" was the main reason for not being examined among people in their forties and fifties and/or among those who have jobs. Among elderly people, "unnecessary" had the highest frequency. "Rejected" was the least important reason in all age groups. In each age group "rejected" was found more frequently among females than males. As the type of reason for not being examined was different among groups, it is essential to work out different countermeasures for each group in order to raise the participating rate. PMID- 3809818 TI - [Isolation of Legionella pneumophila from the UOEH cooling tower]. AB - Twelve samples of water taken from the cooling tower of UOEH were examined for the presence of microorganisms belonging to the genus Legionella by using a new selective medium, Wadowsky-Yee-Okuda (WYO) medium. Three samples contained this organism and they were identified as Legionella pneumophila from their biochemical properties. Among the three contaminated samples, two yielded L. pneumophila serogroup 1 and 3, and the other contained only L. pneumophila serogroup 1. One of the samples of the contaminated cooling tower water was treated with sodium hypochlorite as a disinfectant, indicating that this agent is probably not effective in eliminating L. pneumophila from cooling tower water at that concentration. An effective method of disinfection for Legionella spp. in the cooling tower must be developed to prevent infection in the hospital. PMID- 3809819 TI - [Inhibition of vasopressin secreting neurons of the paraventricular nucleus by gastric distension in rats]. AB - The effects of gastric distension on the neural activity of vasopressin (AVP) secreting neurons of the paraventricular nucleus (PVN) were examined in rats anesthetized with urethane alpha - chloralose. Sixteen putative AVP neurons were identified on the basis of phasically firing patterns. About half of the putative AVP neurons (7/16) were inhibited by gastric distension, while distension of the intraperitoneal balloon had no effect. Severing of the left cervical vagus trunk greatly reduced the inhibitory response. In contrast, the gastric distension had no effect on most non-phasically firing neurons (55/66). These data indicate that sensory information originating from the gastric mechanoreceptors selectively inhibits the activity of PVN AVP secreting neurons and suggest that gastric afferent information is important in the rapid inhibition of AVP release after drinking. PMID- 3809820 TI - [CT diagnosis of malignant thymoma]. AB - Computed tomography (CT) findings of six cases of malignant thymoma were analyzed with eight cases of benign thymoma as a control and the usefulness of CT in their differential diagnosis was evaluated. 1) Three of the malignant thymomas showed a flat shape, while none of the benign ones showed such a configuration. All of the latter were round or oval. 2) The margin of the tumor was irregular and lobulated with evidence of invasion in 4 of the malignant thymomas. All of the benign tumors showed a smooth margin. 3) Intrathoracic metastasis was noted in 2 of the malignant thymomas. 4) CT numbers of the tumors overlapped in both benign and malignant thymomas. 5) Thus the CT observation of the shape, margin, and invasiveness of a tumor as well as evidence of intrathoracic metastasis makes the differential diagnosis between benign and malignant thymomas possible in most cases. PMID- 3809821 TI - [Comparison of bioassay methods of gastrin by means of a pH meter and anti-log amplifier]. AB - For the study of gastric acid secretion, pH lowering of gastric juice has been used. In this study, an anti-log amplifier was used to measure the amount of acid secreted in rats in response to a pentagastrin injection and the accuracy was compared with the conventional method. PMID- 3809822 TI - Sisters with mercury exposure. AB - The same iron pot in which their father had boiled lead with mercury (from a glass thermometer) for the purpose of alchemy, was also used for cooking in the kitchen. Although his wife had died of mercury poisoning, and his 14-year-old and 11-year-old daughters were found to excrete 322 and 455 micrograms/l mercury in the urine, respectively, (1-10 micrograms/l in controls), he stubbornly refused to give permission for them to be examined further. Nine months later, the daughters were permitted to be sent to our clinical ward. While the blood level of mercury had already come down to near normal, its excessive deposition in hair, kidneys and other parts of the body as well as its excessive urinary excretion, were still persistent (beyond tenfold the normal). According to our measurement values, mercury ranged from 14 to 49 micrograms/g in every 1-cm-piece of 10 cm hair of the elder sister, and ranged from 21 to 85 micrograms/g in 14 cm hair from the younger sister. About a 75% decrease in mercury deposition was estimated during these 9 months, based on the speculation of 1.5 cm/month hair lengthening. PMID- 3809823 TI - [Sex-linked agammaglobulinemia. 2 years' intravenous administration of 7S sulfonated gamma globulins to a patient presenting with giardiasis, hepatitis B and arthritis as chronic complications]. PMID- 3809824 TI - [Adult eosinophilic granuloma accompanied by skin manifestations]. PMID- 3809825 TI - [Fatal drug interactions]. PMID- 3809826 TI - [Clinical measurement of psychopathology: the AMDP system]. PMID- 3809827 TI - [Physiopathological significance of the therapeutic action of placebos]. PMID- 3809828 TI - [Spinal cord compressions]. PMID- 3809829 TI - [Duodenal injuries]. PMID- 3809830 TI - [Chemotherapy of cancer. At what hour?]. PMID- 3809831 TI - [Strongyloidiasis (anguilluliasis) imported into Belgium: incidence, symptoms, diagnosis and treatment]. PMID- 3809832 TI - Relations between stimulus force, skin displacement, and discharge characteristics of slowly adapting type I cutaneous mechanoreceptors in glabrous skin of squirrel monkey hand. AB - The contributions of viscoelastic properties of squirrel monkey glabrous skin to slowly adapting Type I (SAI) mechanoreceptive afferent fiber discharge were examined in the present study. Individual fibers of the median and ulnar nerves were isolated by microdissection in six monkeys anesthetized with pentobarbital sodium. Utilizing mechanical stimulation and data analysis techniques identical to those of a previous study of raccoon glabrous skin and its mechanoreceptors (Pubols, 1982a; Pubols and Maliniak, 1984), we studied and compared responses to punctate mechanical stimuli controlled with respect to force or displacement. Squirrel monkey glabrous skin was found to be more compliant than raccoon glabrous skin, in that a given force applied to either a digital or a palmar skin pad produced a greater displacement of squirrel monkey skin. Skin displacement increased approximately linearly with increasing forces at the beginning of static stimulation, but over time (at least up to 20 sec), the relationship became negatively accelerated. Absolute-force thresholds of individual SAI units were significantly lower in squirrel monkey (mean = 122 mg, range = 48-340 mg) than in raccoon (mean = 484 mg, range = 70-1,290 mg). However, absolute displacement thresholds were insignificantly lower (squirrel monkey: mean = 17.24 microns, range = 5-30 microns; raccoon: mean = 30 microns, range = 5-185 microns). Application of suprathreshold forces (range = 1-20 g) and displacements (range = 500-1,000 microns) revealed greater interunit variability in response to maintained stimulation than previously found in raccoon. In 8 out of 15 fibers, the rate of adaptation was significantly greater during constant-displacement than during constant-force stimulation; in 4 cases there was no significant difference; and in 3 cases the rate of adaptation was significantly greater during constant-force stimulation. Potential sources of interunit variability include surface topography of the hand, properties of cutaneous and subcutaneous tissues in the vicinity of the receptor, and experimental variables such as stimulus amplitude and rate of stimulus onset. It is suggested that both regional and species differences in functional properties of cutaneous mechanoreceptors are more likely attributable to differences in mechanical properties of skin and subjacent tissues than to any inherent differences in receptor properties. PMID- 3809833 TI - An ultrastructural study of the marginal nucleus, the intrinsic mechanoreceptor of the snake's spinal cord. AB - Previously reported anatomical and electrophysiological studies have shown that there are neurons in the lamprey's spinal cord that respond to stretching of the spinal cord. Neurons in similar locations are especially prominent in reptiles, where they form the marginal nuclei. These nuclei have been examined in snakes, and it has become apparent that the denticulate ligament is both structurally and functionally closely related to the marginal nuclei. The ligament loses collagen in a short segment of every intervertebral area, and the marginal nuclei are located only in this area. The marginal nuclei consist of a group of medium-sized neurons along the edge of the spinal cord, with a strip of neuropil separating them from the ligament; the neurons extend dendritic processes into this lateral neuropil area and give rise to long finger-like processes. In the present study, these processes were found to be longer than the ones that have been described for peripheral mechanoreceptors; they are thought to be important in sensory transduction. Closely associated with these processes were axon-like structures. They did not make any type of contact with the finger-like processes; however, an occasional synaptic-like contact, consisting of membrane specialization and a congregation of vesicles, was made with dendritic processes. The conclusion is that these finger-like processes are similar to those of peripheral mechanoreceptors, but that there is no equivalent process to the axon-like structure. PMID- 3809834 TI - Telencephalic bill projections in the Landes goose. AB - Electrical activity of trigeminal central projection areas was recorded in anesthetized and chronic awake geese. Evoked potentials of telencephalic structures were studied after stimulation of the bill, quintofrontal tract (QF), and several telencephalic structures (nucleus basalis [Bas], neostriatum frontale [NF], paleostriatum augmentatum [PA], and neostriatum caudale [NC]). Short latency evoked potentials were recorded in Bas after stimulation of the bill or QF; this finding is consistent with a direct connection between the main sensory trigeminal nucleus and Bas. Short- and long-latency evoked potentials were recorded in PA and NC after stimulation of the posterior QF. These potentials are concluded to be due to two different pathways: The shorter-latency response is produced by fibers leaving QF posteriorly, while the longer-latency response is derived from fibers traveling along QF, relaying first in Bas and then in NF. From Bas and NF, two pathways convey impulses to NC; only one is relayed in PA. PMID- 3809835 TI - Loss of spinothalamic tract neurons following neonatal treatment of rats with the neurotoxin capsaicin. AB - The purpose of the present experiments was to determine whether the organization of spinothalamic tract (STT) cells of adult rats was altered following the loss of most of their small-diameter peripheral afferent fibers, resulting from the neonatal administration of capsaicin. Rat pups were randomly assigned to serve as normal controls, to serve as vehicle controls, or to receive subcutaneous injections of capsaicin (50 mg/kg) on postnatal day (PND) 1, 2, 7, or 15; or an injection on PND 1, 3, and 5. When 60 days old, they were anesthetized and received 0.1-microliter thalamic injections of wheatgerm agglutinin conjugated to horseradish peroxidase (WGA:HRP) in the area of the central lateral nucleus (CL), the posterior group (PO), and the ventrobasal complex (VB), or the area of CL or VB. Following a survival time of 48 hr, the animals were perfused, and neuronal HRP reaction product was visualized with tetramethylbenzidine. The number and distribution of WGA:HRP-labeled STT neurons varied in treated animals with the time of capsaicin injection. Rats injected with capsaicin on or before PND 7 demonstrated a significant reduction of labeled STT neurons from the superficial laminae of the spinal cord. Additionally, lamina I neurons were unlabeled in animals treated before PND 7 even with large thalamic injections. Differences in the distribution of labeled STT neurons could not be demonstrated for animals injected with capsaicin on PND 7 or PND 15, though there was a decrement in the number of labeled neurons in PND 7 animals. In order to make certain that absence of labeled STT neurons was not due to some technical error or to insufficient spread of WGA:HRP at the site of injection, six injections of WGA:HRP were placed in the thalamus of PND 1 and normal adult animals. Where the dense core of reaction product did not extend caudal to the posterior commissure, WGA:HRP positive neurons were located and distributed similarly to those cases described for large thalamic injections. Neurons in superficial laminae of the nucleus proprius and lamina I of the contralateral spinal cord were labeled where the dense core of the thalamic injection extended into the mesencephalon of PND 1 animals. These studies indicate that the number and distribution of the cells of origin of the STT are altered in adult rats following their neonatal treatment with the neurotoxin capsaicin, and that this effect is limited to a critical postnatal period. PMID- 3809836 TI - Morphology and synaptic connections of small myelinated primary trigeminal axons arborizing among neurons in the border zone of rat trigeminal nucleus oralis. AB - The anterograde transport of horseradish peroxidase (HRP) was used to examine the morphology and synaptic connections of a morphologically distinct group of small diameter primary trigeminal axons that arborize throughout the border zone (BZ) of rat trigeminal nucleus oralis. Thinly myelinated parent branches (0.75-1.5 micron in diameter) descending in the spinal V tract (SVT) were seen to issue medially directed collaterals that entered BZ, where they branched and eventually terminated by giving rise to thin terminal strands characterized by several relatively widely spaced axonal endings. Based on the size and morphology of the parent branches in SVT, in the root entry zone, and in the sensory root of the trigeminal nerve, these primary axonal (P) endings are considered to be derived from small-diameter myelinated primary trigeminal axons (SDMA). The P endings measured 1-2 micron in diameter and contained numerous agranular spherical (40-60 nm) synaptic vesicles. In the BZ neuropil, most P endings lay in glomeruli, where each formed at least one asymmetrical axodendritic synapse on a dendritic shaft. It is at these synapses that this group of primary axons is thought to transfer its input directly to the dendritic arbors of BZ neurons. A small (0.5-1.5 micron) axonal (F) ending filled with flattened synaptic vesicles (29 X 60 nm) was observed to form at least one symmetrical to intermediate axoaxonic synapse on the P ending, as well as at least one axodendritic synapse on the same dendritic shaft receiving the primary input. Some F endings only contacted dendritic shafts. In view of their symmetrical to intermediate synaptic contacts, F endings are thought to belong to axons derived from at least one source that can inhibit or diminish the firing rate of BZ neurons in response to SDMA input. This would be accomplished either postsynaptically through the axodendritic synapses on the dendritic shafts, and/or presynaptically through the axoaxonic synapses on the P endings. PMID- 3809837 TI - [A case of cutaneous furunculous myiasis originating in Brazil]. PMID- 3809838 TI - [A case from practice (69). Female patient: E.-M., U., born 1955, restaurant kitchen helper (basilar migraine)]. PMID- 3809839 TI - ["Normal" alcohol consumption--one of the causes of high blood pressure, obesity and atherosclerosis]. PMID- 3809840 TI - [Clinical experience with the spiral xenograft as an approach to chronic hemodialysis]. PMID- 3809841 TI - [Phosphorus-calcium metabolism, osteopenia and diabetes mellitus]. PMID- 3809842 TI - [Joint pain, fever]. PMID- 3809843 TI - [A case from practice (70). Patient: M. W., born 3 October 1945, saleswoman]. PMID- 3809844 TI - [Multidisciplinary approach to male impotence due to erectile dysfunction]. PMID- 3809845 TI - [Multidisciplinary consultation on pain at the University Hospital Center of the Canton of Vaud]. PMID- 3809846 TI - [Chronic pain and physician-patient relations (the function of the pain symptom)]. PMID- 3809847 TI - [Somatic aspect of chronic pain]. PMID- 3809848 TI - [Multiple paradoxical embolisms and patent foramen ovale. Intravital diagnosis]. PMID- 3809849 TI - [Infectiousness in general surgery. The bacteria found and the use of antibiotics]. PMID- 3809850 TI - [Postoperative noninfectious febrile states]. PMID- 3809851 TI - [The urethral syndrome and the unstable bladder in women]. PMID- 3809852 TI - Tumours of the small intestine. AB - Tumours of the small intestine are a relatively unusual group of benign and malignant tumours of both epithelial and supporting tissue origin. Their pathology, associated syndromes, clinical features, diagnosis, and management are discussed. PMID- 3809853 TI - Clinical experience in breast cancer--20 years after radical mastectomy. AB - From 1958 to 1982, 1,035 radical mastectomies have been performed in our institute in cases of breast cancer. A total of 804 cases have been followed up for 5 years or more after the operation, the follow-up rate being 100%. Routine radical operations were performed in 695 cases, whereas the other 109 cases were treated with simple mastectomy, modified radical mastectomy, and extended radical mastectomy. The 5-, 10-, 15-, and 20-year survival rates of these 804 cases were 71.8%, 58.2%, 48.8%, and 41.8%, respectively. According to the tumor-node metastases (TNM) classification, the 5-, 10-, 15-, and 20-year survival rates for stage I were 85.4%, 77.0%, 58.3%, and 75.0%; for stage II, 72.8%, 57.4%, 53.5%, and 58.8%; and for stage III, 55.3%, 44.7%, 36.5%, and 8.0%, respectively. PMID- 3809854 TI - [Analysis of the cerebrospinal fluid by isoelectrofocusing on agarose in multiple sclerosis]. AB - Intrathecal synthesis of immunoglobulins can be proved by means of two methods: quantitatively by immunoglobulins titration in CSF, the results expressed with several ratios; qualitatively by demonstration of oligoclonal distribution of gammaglobulins. IEF is the most sensitive of the qualitative methods. From a technical point of view Agarose Isoelectrofocusing seems to be a better method than polyacrylamide isoelectrofocusing and permits, when the interpretation is difficult, immunofixation into the gel. The authors report the results of a comparative study between the evaluation of the IgG Index and agarose isoelectrofocusing of 281 CSF divided into 113 CSF from patients with Multiple Sclerosis (MS) and 168 CSF from patients with other neurological diseases (OND). Sensitivity of IEF was higher than IgG index to prove intrathecal IgG synthesis: in the group of patients with MS, 91 p. 100 of CSF were abnormal instead of 72 p. 100 of IgG Index. In the group of patients with OND, abnormalities in IEF were low (5 p. 100) but the number of inflammatory diseases was poor. These results were similar with the findings of many authors using the same methods. In our opinion, IEF is the best technique which a specialized laboratory can use in routine to prove an immunoglobulin intrathecal synthesis. PMID- 3809855 TI - [Rapid modification of the symptomatology of progressive forms of multiple sclerosis by plasma exchange]. AB - Twelve consecutive patients with a progressive form of multiple sclerosis were submitted to 6 sessions of plasma exchange as single therapy. Results were evaluated by Mac Alpine's, Kurtzke's, a simplified semi-quantitative neurologic validity scale and by determination of 4 totally objective quantitative parameters. A decrease in the disability score, according to Kurtzke, was noted in 4 patients, and comparison of scores of neurologic validity before and after plasma exchange showed a highly significant difference (p less than 0.0001). A significant effect was noted also for two of the quantitative parameters. The effect was predominant on pyramidal and cerebellar disorders. Improvement was rapid but transient and did not persist after 2 months. Theoretically, this improvement after plasma exchange implies the existence of circulating neuro inhibitory factors and that multiple sclerosis is a disease not limited to the central nervous system. Indications for plasma exchange in the progressive form of multiple sclerosis are discussed. PMID- 3809856 TI - [Prolonged absence states in aged patients without epileptic antecedents]. AB - Eight cases of [absence status] are reported, occurring in old patients (7 females, 1 male), mean age 75 years, without any known history of epilepsy. The main clinical feature was a fluctuating state of consciousness, during which the EEG showed diffuse spikes and polyspikes with a frontal predominance. These abnormalities disappeared after intravenous benzodiazepine administration, resulting in most cases in a spectacular clinical improvement. Five of our patients had a depressive history and were taking antidepressive or psychotropic drugs. Hyponatremia or hypokalemia probably secondary to diuretic medications, was present in 4 cases. No recurrence occurred with or without long-term anti epileptic medication. PMID- 3809857 TI - [Marfan's disease and familial neuropathy with sausage-shaped swelling. A case of fortuitous association]. AB - A 25-year-old patient and his sister had Marfan's syndrome and recurrent pressure neuropathy. Marfan's syndrome was inherited from their father while the neuropathy was inherited from their mother. Thus, the association of both disorders in the same patient was fortuitous. However it is suggested that the ligamentous hyperlaxity related to Marfan's syndrome may favour the occurrence of the neuropathy due to pressure. PMID- 3809858 TI - [Ocular bobbing. A new hypothesis]. AB - Three of 4 patients with ocular bobbing were typical cases while in the last case the ocular disorder was asymmetric. A neuropathologic study was conducted in 2 cases. In both use, findings included variable degrees of pontine destruction without lesion of the medulla, with extension of the lesion into the mesencephalon in 1 case. The various physiopathogenic hypotheses put forward are reviewed but none appears satisfactory. A new hypothesis is proposed, based on available clinico-pathologic data (35 published and 2 personal cases) and recent experimental studies. Two centers, one mesencephalic, the other in the medulla, could exist that would generate saccadic movements downwards, and in the pons a center would provoke inhibition of saccadic movements. Destruction of the latter could activate spontaneous saccadic movements downwards (the only possible ones remaining) with the condition that the mesencephalic generating center and its pathways are intact. PMID- 3809859 TI - [Intraventricular hemorrhage after carotid endarterectomy. Role of moyamoya-type collateral circulation]. AB - Stenotic lesions of the cervical arteries due to atherosclerosis or irradiation may provoke the development of a Moya-Moya type collateral network. Rupture of a vessel participating in this collateral circulation may be the cause of a hemorrhagic accident. The hemorrhage may be subarachnoid, intracerebral or more usually intraventricular. Intraventricular hemorrhage occurred in a patient who had developed a Moya-Moya type collateral circulation secondary to atherosclerotic stenosis of a carotid artery. The hemorrhagic incident occurred during carotid endarterectomy, suggesting a predisposing role for hemodynamic modifications resulting from the operation. PMID- 3809860 TI - Obstructive sleep apneic patients have craniomandibular abnormalities. AB - One hundred fifty-five unselected obstructive sleep apneic patients seen in succession had cephalometric roentgenograms and polygraphic recordings performed. These patients were compared to a group of 41 subjects who had consulted orthodontists for malocclusion and had no clinical indication of sleep apnea. The cephalometric landmarks were also compared to those published as normative data in the literature. The limits of "normalcy" were conservatively defined as mean +/- 2 standard deviations. Only two obstructive sleep apneic patients had normal cephalometric landmarks and 150 of the 155 patients had at least two significantly different landmarks from the normative data in the literature. The common findings were a retroposition of the mandible, a different cranial base flexure with a nasion-sella-basion angle more acute than expected, and a displacement of the hyoid bone to a lower position than expected. These combined changes reduced the space occupied by soft tissues anchored on the skull and mandible, and the length of the soft palate was increased. PMID- 3809861 TI - Sleep-disordered breathing and its concomitants in a subclinical population. AB - In order to evaluate possible deficits accompanying sleep-disordered breathing (SDB) in a subclinical population, the nocturnal respiration, health status, and sleep/wake cycle of 46 healthy, heavy-snoring men were measured. Sixty-two percent of these subjects had at least one episode of apnea/hypopnea, while 13% had high levels of apnea/hypopnea [apnea/hypopnea index (AHI) greater than or equal to 5]. Most events occurred in stages 1 or 2 or in REM sleep. Strong relationships between weight and SDB were observed, as were more modest relationships between age and SDB. Correlational procedures indicated relationships between SDB and higher blood pressure, subjective sleepiness, and napping. Because similar, but stronger, relationships involving these variables are observed in patients with a sleep apnea syndrome (SAS), it appears that a continuum exists between heavy-snoring men and patients with SAS. When these subjects were grouped by level of SDB, subjects with high levels of SDB (AHI greater than or equal to 5) had significantly lower nocturnal oxygenation parameters than the remaining subjects. However, there were no between-group differences in health or sleep/wake variables. It is concluded that while apnea/hypopnea events in subclinical populations may not be completely benign events, the level at which they may be considered frankly pathological is presently unclear. PMID- 3809862 TI - Body position changes and periodic movements in sleep. AB - What triggers episodes of periodic movements in sleep (PMS) remains unknown. Despite the uncertainties, there is no doubt of the widespread prevalence of PMS, particularly in elderly populations. This study explored possible consistent temporal relationships between body position and PMS episodes. Eleven subjects, monitored by polygraph and videotape, averaged 299 leg jerks in nine episodes, and 13 body position changes of greater than or equal to 90 degrees. Leg jerk episodes had a significant tendency to terminate soon before body position changes, and likewise there was a trend for leg jerk episodes to begin soon after position changes. It is hypothesized that adverse body positioning, via an influence upon the spinal cord or peripheral tissue perfusion, triggers PMS episodes, which persist until the adverse positions are changed. In this small sample, "adverse" positions could not be elucidated. PMID- 3809863 TI - Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery. AB - Elderly women had better recovery sleep than elderly men following 36-h sleep deprivation, as evidenced by higher sleep maintenance/efficiency and more slow wave sleep (particularly in the amount of stage 4 sleep). During recovery sleep, both groups showed REM latency reduction (two men and three women had seven sleep onset REM periods out of a total of 40 recovery nights), decrease in percentage of early REM sleep and increase in whole-night REM sleep time. Total Mood Disturbance scores on the Profile of Mood States increased in both men and women following sleep deprivation (reflecting a decrease in vigor and increase in fatigue and tension). While the increase tended to be greater in women, in both groups self-ratings of mood returned to baseline after 1 night of recovery sleep. These observations underscore the importance of gender in determining late-life sleep structure and suggest that the ability of older women to achieve slow wave sleep and to have long uninterrupted sleep in greater than that of men. PMID- 3809864 TI - Internal structure of sleep cycles in a healthy population. AB - A large body of data has been gathered on the sleep characteristics of normal subjects. The evolution of each sleep stage within each NREM/REM cycle is presented in detail, showing stage intensities minute by minute. There is a three phase pattern in each stage intensity diagram: an initial phase of rapid change; a central phase of relative stability; and a terminating phase, again, of rapid change. The details of this pattern change progressively during the night. Throughout all cycles, there is a complementary relationship between the intensities of stage 2 sleep and the other stages that underlines the central role of stage 2 sleep in all stage transitions. Stage intensity diagrams for two groups, one group with and one group without stage 4 sleep, were compared. Subjects without stage 4 sleep tended to have a shorter duration and greater latency of stage 3 sleep. Surprisingly, cycles interrupted by abnormally long periods of continuous wake showed a negative correlation between the intensities of wake and slow wave sleep, and these interruptions did not appear to reset the cycle clock to zero. Sleep stage intensity diagrams may be useful to study the sleep patterns of populations of insomniac and depressive patients, as well as the effect of drugs on sleep. PMID- 3809865 TI - Cephalometric roentgenograms and computerized tomographic scans in obstructive sleep apnea. PMID- 3809866 TI - Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. PMID- 3809867 TI - [Thoracic actinomycosis. Apropos of 5 cases]. AB - Described for the first time by Bradshaw in 1846, actinomycosis is a rare, slowly progressing disease associated with the development of anaerobic bacteria of the Actinomyces genus. It predominates in males and is actively encouraged by poor buccal and dental hygiene and by overall decline of defence mechanisms. Thoracic lesions constitute 15 to 20% of the cases and seem to be relatively increasing. Apart from fistulization to the skin, physical examination usually does not show much; only the presence of yellow grains suggests the diagnosis. Radiography is often misleading, suggesting tuberculosis or cancer. Ultrasonography and, chiefly, computerized tomography are the best methods to evaluate the extension of the disease to the pleura, the chest wall and the mediastinum. The final diagnosis is more often supplied by pathological examination than by bacteriology, which is frequently negative. Treatment is facilitated by the fact that Actinomyces is sensitive to antibiotics, notably to penicillin which still is the first choice drug. A well-conducted treatment will give satisfactory results, but sequelae of retractile fibrosis may be disabling. PMID- 3809868 TI - [Transparietal pulmonary puncture in the diagnosis of excavated pulmonary masses. Apropos of 18 cases]. AB - The aetiological diagnosis of excavated pulmonary opacities is sometimes uneasy, hovering between squamous cell carcinoma and abscess. Normal results at bronchoscopy and two weeks of antibiotic therapy do not always provide a definite answer. The authors report 18 cases of such excavated masses and conclude that transparietal needle aspiration can establish the diagnosis provided some technical procedures are followed and the samples obtained are examined by skilled cytologists. PMID- 3809869 TI - [Endobronchial metastases of cancer. Apropos of 29 cases]. AB - In a retrospective study covering a 3-year period, 29 cases were reviewed. All concerned patients with endoscopic abnormalities resembling those of a primary carcinoma and histologically of the same type as a previously known tumour affecting areas as diverse as the E.N.T. region (31%), the colorectal region (20.6%), the mammary gland (13.7%) or the bladder (10.3%). There was nothing particular in the clinical, radiological or endoscopic signs. In the vast majority of cases (27/29) the histological diagnosis was provided by bronchofibroscopy. Thus, not only does endoscopy frequently visualizes abnormalities in obviously secondary carcinomas, but it also diagnoses cancers with clinical, radiological and endoscopic features of primary cancers from which they are sometimes almost undistinguishable. PMID- 3809870 TI - [Treatment by electrocoagulation in malignant tracheobronchial pathology]. AB - The author reports his experience of electrocoagulation used to remove tumoral obstruction of the trachea and primary bronchi. Endoscopic electrocoagulation using a fibrobronchoscope is a useful method. Its results and its cost are of interest, as confirmed by experience in 17 patients. PMID- 3809871 TI - Acid-base balance and blood lactate and pyruvate levels in albino rats bred under normobaric hypoxia or normoxia, after muscular work in a hypoxic or hypoxic hypercapnic environment. AB - Albino rats, Wistar family, have been raised since birth in normobaric hypoxic environment (10-12% O2). This hypoxic animal group and a normoxic animal group were subjected to muscular fatigue by forced march within revolving room. Normoxic animals were subjected to 3 spaced trials: in normoxic environment; in hypoxic normobaric environment; in the same hypoxic normobaric environment with about 2% CO2 added. Hypoxic animals were subjected to 2 spaced trials: in hypoxic normobaric environment; in the same hypoxic environment with about 2% CO2 added. At the end of every single trial, lactatemia, blood pyruvate, acid-base balance and the erythrocytic number were examined. Albino rats raised in hypoxic environment since birth, subjected to muscular work in hypoxic environment showed a smaller increase of lactatemia and a moderate variation of the acid-base balance, compared to normoxic animals in the same conditions. CO2 added to the respired hypoxic mixture during muscular work, attenuated in both animal groups, the observed modifications. Finally we found that the erythrocytes per mm3 of blood increased from the second drawing of blood. PMID- 3809872 TI - [Bioclinical conference in pneumology. Hopital Laennec. Case no. 3--January 1985. Pulmonary opacity and infectious syndrome resistant to non-specific antibiotic treatment]. PMID- 3809873 TI - [Esophagopulmonary fistulas. Description of a case and review of the literature]. AB - We report the case of a 30-year old male patient who presented with chronic right lung purulence of 10 years' duration and of undetermined origin. At pneumonectomy a fistula joining the oesophagus to the cavities in the right lower lobe was discovered. Non tumoral oesophago-bronchial or oesophago-tracheal fistulae are rare, but oesophago-pulmonary fistulae are truly exceptional, since only 3 cases were found in the literature. The possible causes of this pathology in our patient are discussed. PMID- 3809874 TI - [Value of a daily dose of theophylline in the treatment of nocturnal asthma]. AB - The authors report the results obtained with one single daily dose of 10 mg/kg of a long-acting theophylline preparation administered in the evening to asthmatic patients previously treated with the same dose twice a day. Twenty-seven patients presenting with airway obstruction reversible by beta-stimulants entered the study; their mean FEV1 value was 57% of the expected value, and diffuse sibilances were present; paroxysmal attacks occasionally occurred, particularly at night. No significant difference was found between the two dosage regimens with regard to symptomatic improvement, adjuvant drug consumption, and plasma theophylline levels 12 hours after the evening dose. The classical side-effects of theophylline therapy were not increased by the once-a-day regimen. It is concluded that one dose of theophylline per day is effective in the treatment of nocturnal asthma. PMID- 3809875 TI - [Control and prevention of syphilis. Analysis of the program at the Clinical Hospital of the Ribeirao Preto School of Medicine of the University of Sao Paulo]. PMID- 3809876 TI - [A rare complication of nasogastric intubation]. PMID- 3809877 TI - [Epidermoid carcinoma of the skin caused by prolonged tracheostomy]. PMID- 3809878 TI - [Reactivation of the schizophrenic state caused by pseudo-AIDS or fear of AIDS]. PMID- 3809879 TI - [Neonatal transmission by transfusion of HTLV-III/LAV virus]. PMID- 3809880 TI - [Dexamethasone in the treatment of meningococcal meningitis]. PMID- 3809881 TI - [Psoitis: report of 100 cases]. PMID- 3809882 TI - [Stress urinary incontinence. Review]. PMID- 3809883 TI - [Bacteremias in immunosuppressed patients]. PMID- 3809884 TI - Association of the human Lewis blood group Le(a-b-c-d-) with the failure of expression of alpha-3-L fucosyltransferase. AB - Two unrelated individuals are reported who lack alpha-3-L-fucosyltransferase activity in their serum and saliva. Both were blacks, one from the United States and the other from South Africa. No other of the tested members of their families lacked this enzyme. A survey of more than 2000 serum samples from both black and white South African blood donors, black United States donors and white United Kingdom donors failed to disclose another example of a serum deficient in alpha-3 L-fucosyltransferase activity. The two individuals lacking in alpha-3-L fucosyltransferase activity both had the Lewis blood group phenotype Le(a-b-c-d ). No other persons with this phenotype have been reported. The absence of Lec activity in the two individuals who are deficient in alpha-3-L-fucosyltransferase is consistent with the interpretation that alpha-3-linked L-fucose is an essential part of the antigenic determinant recognised by the anti-Lec reagent used in this investigation. PMID- 3809885 TI - Molecular biological study of the structure and expression of human glycophorin A. PMID- 3809886 TI - The role of cartilage canals in the pathogenesis of experimentally induced polyarthritis. AB - Porcine articular cartilage from cases of experimentally induced Erysipelas polyarthritis, a comparative model of rheumatoid arthritis (RA) in man, was examined with different histological and immunohistochemical techniques. The preexisting canals in articular cartilage played a crucial role during the flooding and deposition of arthritogenic microorganisms deep into the cartilage matrix. Subsequently this vascularized tissue mediated the same inflammatory reactions in hyaline cartilage of young animals as seen in other connective tissues. However, these stereotypical responses to injury were modulated by the unique composition and structure of articular cartilage. PMID- 3809887 TI - Serum and synovial fluid histidine: a comparison in rheumatoid arthritis and osteoarthritis. AB - The serum and synovial fluid (SF) histidine, sulphydryl, and protein concentrations were compared in simultaneous samples from 84 patients with rheumatoid arthritis (RA) and a control group comprising 29 patients with osteoarthritis (OA). The SF levels of histidine were higher than the serum levels in the RA patients but significantly lower than corresponding results in patients with OA (P less than 0.001). The latter had levels of serum and SF histidine which were equivalent and within the normal range. Greater quantities of protein were found in the SF of the patients with RA compared with the OA group. The serum and SF sulphydryl concentrations expressed as mumol/g protein were low but in equilibrium in patients with RA. However the SF sulphydryl (mumol/g protein) was depressed relative to serum levels in patients with OA. PMID- 3809888 TI - Quantitation of glycosaminoglycan metabolism in anatomically intact articular cartilage of the mouse patella: in vitro and in vivo studies with 35S-sulfate, 3H glucosamine, and 3H-acetate. AB - We investigated the usefulness of the whole mouse patella to quantitate the synthesis of the glycosaminoglycan (GAG) backbone and its sulfation by intact murine articular cartilage, both in vitro and in vivo. Using 35S-sulfate, 3H glucosamine, or 3H-acetate as precursors of GAG synthesis, it was found that more than 90% of the incorporated radioactivity was confined to the patellar cartilage layer compared to the whole patella. Overnight papain digestion was enough to liberate more than 95% of the incorporated radiolabels, except for 3H-acetate for which 15-25% was not digestible. Comparison of radioactivity in the patella and that in quantitatively isolated GAGs revealed that for 35S-sulfate incorporation studies the whole patella can be used as a reliable measure for sulfated GAG synthesis. The situation was different for the GAG backbone precursors 3H glucosamine and 3H-acetate; more than 50% of the 3H labels were incorporated into compounds other than GAGs or non-covalently associated with matrix components. Hence, in studying GAG-backbone metabolism, polysaccharides must be isolated quantitatively from cartilage. In vivo studies made it clear that both 35S sulfate and 3H-glucosamine are incorporated into patellar GAGs in amounts high enough to enable proper quantitation and that the route of administration (intraperitoneally or intravenously) is of minor importance. Due to its low specificity for cartilage GAGs, 3H-acetate is not suitable for such studies. PMID- 3809889 TI - Role of target and effector cell structures in natural killer-mediated cytotoxicity. AB - An analysis of target and effector cell structures involved in the in vitro natural killer (NK)-mediated cytotoxicity has been performed. The degree of surface expression of transferrin receptor (TR) was only in part correlated with that of cell lysis. Moreover, the lysis could not be blocked by treating target cells with two anti-TR monoclonal antibodies. Finally, cell lines poorly affected by NK cells express TR only at the cytoplasmic level. As to the effector cells, the integrity of cytoskeleton components (especially microtubules) was found to be essential for the occurrence of cell lysis. In fact, vinblastine, an anti microtubule agent, was able to significantly reduce the percentage cell lysis. This effect was not due to a selective depletion in NK cells induced by the drug. It is concluded that the mechanisms underlying NK activity are complex and involve both target and effector cell structures. PMID- 3809890 TI - Interrelationships between body mass and lipid and lipoprotein triglycerides and cholesterol in obese women. AB - In 72 obese women body mass index positively correlated with age and both showed multiple correlations with serum lipids and lipoprotein lipids. After adjustment for age (partial correlation procedure), body mass index resulted to be positively correlated with serum triglycerides, VLDL lipids, HDL-triglycerides and negatively correlated with HDL-cholesterol. The decrease in HDL-cholesterol concentration along with the increase in body weight was due to the reduction of cholesterol in HDL2 subfraction, while HDL3-cholesterol did not show any significant correlation with body mass index. The negative correlation between HDL2-cholesterol and body mass index was independent of other lipoprotein variables and in particular of VLDL lipid levels that were, as expected, inversely related to HDL2-cholesterol. HDL2-cholesterol is believed to be a strong protective factor against atherosclerosis, while doubts exist on the meaning of VLDL lipids as risk factors. Thus, the decrease in HDL2-cholesterol concentration, rather than the increase in VLDL lipids, might give a rational basis to the high incidence rate of vascular disease in obese subjects. PMID- 3809891 TI - Comparison of central and peripheral nervous system lesions caused by high-dose short-term and low-dose subchronic acrylamide treatment in rats. AB - The effects of high-dose subacute acrylamide treatment of up to 50 mg/kg/day for 4 or 10 d were compared to those of subchronic exposure, up to 12 mg/kg/day for 90 d. In the subacute study, Purkinje cells, long ascending tracts of the spinal cord, optic tract terminal or preterminal regions in superior colliculus, sensory ganglion cells, and distal large-caliber peripheral axons were severely affected. Purkinje cells and fasciculus gracilis changes were the earliest lesions. In the subchronic study, the dominant lesion was confined to the distal peripheral axon, with only minor changes occurring in spinal cord and medulla. Paranodal swellings with the characteristic appearance of neurofilament aggregations were not seen. This morphological study suggests a significant difference between high- and low dose acrylamide-induced lesions. If there is a reduced tendency for long-term low dose acrylamide exposure to produce CNS lesions, the risk of irreversible nervous system damage would be less than that predicted from subacute studies. PMID- 3809894 TI - Agents and processes in chemical carcinogenesis. Third Sardinian International Symposium. Cagliari, Italy, October 6-9, 1985. Symposium papers. PMID- 3809892 TI - Comparison of the acute toxicity of N-nitrosocimetidine with three structurally related carcinogens in the rat. AB - The acute toxicity of N-nitrosocimetidine, the nitrosated derivative of the histamine H2-receptor blocking agent cimetidine, was compared with the toxicities of three structurally related nitroso compounds known to be potent carcinogens, namely N-methyl-N'-nitro-N-nitrosoguanidine, N-methyl-N-nitrosourea, and N-methyl N-nitrosourethane, and also with the parent drug cimetidine. The acute toxicity of each compound was investigated in 6-week-old female Fischer-344 rats by estimating the median lethal doses via three different routes of administration, and by assessing the sequence of histopathological alterations induced. According to median lethalities, all three known carcinogens were substantially more toxic than nitrosocimetidine whether administered by the intravenous, intraperitoneal, or oral routes. The widest margin of difference was represented by orally administered N-methyl-N-nitrosourea, the median lethal dose being 59 times greater than oral N-nitrosocimetidine. By this method, the acute toxicities of N nitrosocimetidine and the parent drug cimetidine were virtually identical for each of the three routes of administration. Sequential histological assessment indicated that the three known carcinogens induced specific pathological alterations mainly in organs which were also known to be targets for their carcinogenic activity. In contrast, no tissue lesions of a specific nature were associated with N-nitrosocimetidine or cimetidine in this study. The comparable results with N-nitrosocimetidine and the parent drug provide biological support for previously obtained biochemical data which suggested that N-nitrosocimetidine is rapidly denitrosated to cimetidine in the rat. PMID- 3809893 TI - New data on kinetics of lipid peroxidation in experimental hepatomas and preneoplastic nodules. AB - Lipid peroxidation has been found decreased in several hepatomas. The decline has been shown already at the level of preneoplastic nodules obtained after DEN treatment of rats. A substantial exception is represented by the hepatoma cell line MH1C1, deriving from a slightly deviated Morris tumor. Most of the described experiments estimated lipid peroxidation levels in terms of malonaldehyde production by the thiobarbituric acid test. It is now clear that this test does not account for several other aldehydes produced during lipid peroxidation. We now investigated by high performance liquid chromatography (HPLC) the whole range of non-polar aldehydes produced by tumor homogenates and by preneoplastic nodules both in basal conditions and after stimulation with ADP-iron or ascorbate. It was reduced in the preneoplastic nodules as well as in the DEN-induced hepatoma. The susceptibility to the prooxidant effect of ADP-iron or ascorbate was strongly decreased in all hepatomas as well as in preneoplastic nodules. It has been recently published that hepatoma cells are more susceptible than normal liver to the toxic action of aldehydes. This was attributed at least in part to the decreased activity of aldehyde dehydrogenases, as well as to their different distribution in tumor cells. A deeper study on aldehyde metabolism in hepatomas has shown that alcohol dehydrogenase and NADPH-aldehyde reductase also are markedly decreased in Yoshida hepatoma cells and the MH1C1 cell line. However, glutathione transferase, that can use hydroxynonenal as a substrate, is strongly decreased in Yoshida hepatoma cells but not in MH1C1 cells. PMID- 3809895 TI - Glutathione synthesis in normal liver and in Yoshida AH-130 hepatoma. AB - The amount of reduced glutathione in transplantable hepatomas and in a primary DEN-induced hepatoma is lower than in normal liver. In all tumors examined, the glutathione decrease is not due to an increase of oxidized glutathione. In this paper the in vitro activities of two enzymes involved in glutathione synthesis, gamma-glutamylcysteine synthetase and glutathione synthetase, are studied in normal adult rat liver, in regenerating rat liver and in highly anaplastic Yoshida AH-130 hepatoma cells. The activity of these enzymes was determined in the postmicrosomal supernatant fraction as nmoles of [U-14C]-glutamate incorporated into product per mg of soluble protein. In Yoshida AH-130 hepatoma, the gamma-glutamylcysteine synthetase and glutathione synthetase activities are lower in respect to normal liver. This is in agreement with the low glutathione content observed in the hepatoma cells. On the other hand, in regenerating liver, there are minimal differences in comparison with normal liver. PMID- 3809896 TI - Regulatory aspects of cholesterol metabolism in cells with different degrees of replication. AB - This study explored cholesterol biosynthesis and its possible involvement in cell proliferation and cancer development. Normal proliferating cells and cancer cells were used to study the regulation of the cholesterol biosynthetic pathway. Evidence is presented that shows a positive correlation between the activity of the HMP pathway, DNA synthesis, and cholesterol biosynthesis; this evidence also shows a negative correlation between circulating cholesterol levels and/or cholesterol influx from serum to rates of cell proliferation. It is suggested that since cell proliferation is a prerequisite for the development of cancer, altering the HMP pathway, circulating cholesterol levels, and cholesterol influx from serum alters rates of cell proliferation and development of cancer. PMID- 3809897 TI - 4-Hydroxynonenal and other aldehydes produced in the liver in vivo after bromobenzene intoxication. AB - 4-Hydroxynonenal (4-HNE) has been identified as one of the most reactive products in a series of toxic aldehydes originating from lipid peroxidation of cellular membranes. The possibility that this aldehyde plays a role as one of the mediators of the cellular injury induced by pro-oxidants is currently investigated. Mice intoxicated with bromobenzene showed levels of lipid peroxidation in the liver that exceed those induced by hepatotoxic haloalkanes CCl4 and BrCCl3. Hence, we have searched for the presence of 4-HNE and other lipid peroxidation products in the liver of bromobenzene-poisoned mice. We looked for 4-HNE in liver extracts as either free aldehyde or its 2,4 dinitrophenylhydrazone derivative. Using thin-layer chromatography (TLC) and high pressure liquid chromatography (HPLC) we obtained well resolved peaks, corresponding to the standard aldehyde or its 2,4-dinitrophenylhydrazone derivative, respectively. 2,4-dinitrophenylhydrazone derivatization was also used to determine the total carbonyl content in the liver of the intoxicated animals. Three fractions of hydrazones, according to their different polarity ("polar", "non-polar carbonyls, fraction I"; and "non-polar carbonyls, fraction II"), were obtained using TLC. The UV-visible spectra were recorded for quantitative evaluation. Further fractionation of "non-polar carbonyls, fraction II" provided a fraction containing several alkanals and alk-2-enals, which were analyzed and identified by HPLC. Furthermore, protein bound carbonyls were determined in the liver of the intoxicated animals. PMID- 3809898 TI - Endogenous formaldehyde does not produce detectable DNA-protein crosslinks in rat liver. AB - Formaldehyde is an electrophilic molecule able to crosslink DNA and protein. It has been found to induce tumors in the nasal epithelium in rodents. The safety margin between the maximum tolerated FA concentration in the work place and the concentration found to be tumorigenic in animal studies is very small. Because FA is produced endogenously as a result of a variety of oxidative demethylations, the assessment of the tumor risk from exogenous FA exposure has to be related quantitatively to the level of DNA-protein crosslinks induced by endogenous FA generation. It is reported here that the high level of endogenous FA formed in the liver after a large dose of methanol or of aminopyrine did not lead to any observable increase in DNA-protein crosslinks. Using positive and negative control data from in vitro incubations of liver homogenate with FA or methanol it is estimated that the endogenous level of DNA damage in the liver must be more than three orders of magnitude below the damage observed at tumorigenic concentrations for the rat nose. The fact that FA is formed endogenously cannot, therefore, be used to claim that exogenous FA merely leads to a negligible increase in DNA damage. PMID- 3809899 TI - Society of toxicologic pathologists' position paper on blinded slide reading. PMID- 3809900 TI - [N-nitrosamines, nitrites and nitrates in food products for infants and children]. PMID- 3809901 TI - [Determining the residues of antibiotics and other drugs in food products]. PMID- 3809902 TI - [Use of Hill reaction for determining herbicide residues in plant specimens]. PMID- 3809903 TI - [Microbiological aspects of the quality of food products for children]. PMID- 3809904 TI - [Microbiological aspects of the quality of selected cosmetics]. PMID- 3809905 TI - [Kinetics of lead and cadmium migration from porcelain dishes]. PMID- 3809906 TI - [Hygienic evaluation of dentifrices]. PMID- 3809907 TI - [Determining BHT migration from paper/polyethylene laminates]. PMID- 3809908 TI - [Effect of administration of carbendazim in the rat diet on various biological parameters and the activity of selected serum and liver enzyme]. PMID- 3809910 TI - [The sanitary conditions of swimming pools]. PMID- 3809909 TI - [Qualitative and quantitative changes in microscopic organisms in the water from the Central Water Reservoir in Warsaw]. PMID- 3809911 TI - [Changes in body height during the 13-year period in a group of adult residents of Cracow]. PMID- 3809912 TI - [Cecal pole tuberculosis--an often forgotten differential diagnosis? Observations before and following tuberculostatic therapy]. AB - If the barium enema reveals stenosing changes of the terminal ileum and caecum, tuberculosis must be considered in differential diagnosis, even if pulmonary evidence of the illness is lacking. Since, however, radiographically no exclusive typical changes for the tuberculosis of the terminal ileum and caecum can be seen, the diagnosis must be checked histologically and bacteriologically. Under drug therapy an obvious decrease of the inflammation of the mucosa of the colon could be seen. PMID- 3809913 TI - [Tuberculous colitis--Crohn disease--a clinico-radiologic-endoscopic approach]. AB - The authors report on a case of multifocal stenosing tuberculosis of the stomach, pointing out the difficulties in differential diagnosis especially against Crohn's disease. The importance of x-ray examination is discussed. PMID- 3809914 TI - [Risks in roentgen study of the esophagus]. AB - X-ray examination of the oesophagus can lead to contact between the contrast medium and the lungs, connective tissue in the throat, and the mediastinum, pleura and peritoneum. The hyperosmolar iodine-containing contrast media used so far produce short-term displacement of liquid and local irritation. Long-term changes have not been reported. Contrast media containing barium sulphate will hardly produce irritation but may lead to chronic foreign body irritation; they should not be used if they are likely to come into contact with the pleura and peritoneum. Both water-soluble iodine-containing contrast media and barium sulphate-containing contrast media have resulted in deaths due to pulmonary inundation. In case of suspected disturbance of swallowing or perforation, a water-soluble contrast medium should be used at first. If there are no abnormal conditions, examination can be continued with barium sulphate contrast media. The new isoosmolar water-soluble contrast media offer interesting possibilities of detail improvement. Their better tolerance with satisfactory imaging properties should be established by animal experiments and by clinical tests. PMID- 3809915 TI - [Behavior of the blood vessels of the lung on the roentgen image in children with bronchial asthma--determination of the width of the blood vessels]. AB - On x-ray films of 51 children with asthma bronchiale the authors determined the vascular diameter of the right ascending pulmonary artery, the right vein of the upper lobe, and the peripheral vessels in the upper and lower pulmonary fields at an exactly defined distance from the hilus point, and compared these data with those of a control group of 143 healthy children. During the asthma attack the width of the right descending pulmonary artery and of the vein of the upper lobe corresponded to the values of the control group, whereas the vascular diameters in the upper and lower fields were clearly narrowed. Moreover, in most of the asthmatic children the authors found arc-shaped vessels and irregularly occluded vessels in the periphery of the lungs. PMID- 3809916 TI - [Transcatheter embolization of the hypogastric artery in patients with tumors of the bladder and uterus]. AB - In 31 patients (24 with urinary bladder carcinoma and 7 with gynaecological tumors) artificial embolisation of the hypogastric artery was effected using small spongy pieces of Gelaston or Spongostan or haemostyptic sponge. Uncontrollable bleedings supplied the indication for this measure. Bleeding stopped in 24 patients (19 tumours of the bladder and 5 gynaecological tumours) and was considerably reduced in 7 patients (5 bladder and 2 gynaecological tumours). Side effects in a major proportion of the patients consisted of pain or elevated temperature or fever lasting for several days. Our own experience has shown that embolisation of the hypogastric artery is a valuable method that does not expose the patient to the undoubtedly greater stress of an operation. Embolisation should be bilateral as far as possible and should be selective but not superselective. PMID- 3809918 TI - [An unusual CT sign in isodense subdural hematomas]. PMID- 3809917 TI - [Leiomyoma in the B II stomach remnant]. AB - Following Billroth II surgery carcinomas of the stomach stump are the most common tumours. A rare case of a benign mesenchymal tumour is reported. PMID- 3809919 TI - [Agenesis of the inferior vena cava]. AB - A case of agenesia of 3 of the 4 segments the vena cava inferior is presented. The embryogenesis of the v. cava inferior is discussed in so far as is relevant for the malformation in this case. Exact diagnosis and classification can be made via intravenous and intraarterial DSA and computed tomography. PMID- 3809920 TI - [Size determination of abdominal and retroperitoneal organs by means of ultrasound]. AB - Measurements of the liver, spleen and kidneys have shown that the measured size depends on the respiratory phase and on the position of organs in the abdomen or retroperitoneum, respectively. Hence, statements of the size of these organs or organ parts must be accompanied by data on the respiratory phase and positioning of the patient. PMID- 3809921 TI - [Tuberculosis of the female breast: diagnostic clarification]. AB - Modern therapeutic possibilities made tuberculosis of the breast a rare entity which, however, still exists and usually mimicks a malignancy. It represents a secondary organ manifestation and should be considered in differential diagnosis in all cases of primary lung tuberculosis and when fine needle biopsy fails to yield the expected tumour cells. We demonstrate such a case of breast tuberculosis and stress the cytologist's option to restain any cytological slide according to Ziehl-Neelsen. In our case, this renewed staining established the correct diagnosis. PMID- 3809922 TI - [A rare cause of subcutaneous emphysema]. AB - A rare cause of subcutaneous emphysema is described which developed in two patients after epidural anaesthesia. Only two case reports could be found in literature describing similar conditions. The anaesthesia is performed using the "loss of resistance" technique with injection of air for the identification of the epidural space. Possible explanations for the development of the emphysema are discussed. PMID- 3809923 TI - [Experiences with processing control in the radiology department of a large municipal hospital]. AB - Processing control is an important part of quality control in X-ray diagnostics. From 1 July 1984 to 31 December 1985 the processing of 10 of the 11 processors in the Radiology Department at the Augsburg Municipal Hospital was controlled regularly on a total of 304 days. The speed index was at 95.8%, the contrast index at 96.1% within the limits recommended by the Federal German DIN standard. Processing control has proved meaningful and effective in keeping processing on a constant level. It also indicates where to look for the reasons for poor image quality. It takes less than 5 minutes to carry out the processing control of one processor. Processing control is a task of the radiographer. PMID- 3809924 TI - [From anatomical lesions to symptoms. Role of hepatic biopsy in the development of alcoholic disease]. PMID- 3809925 TI - [Physiopathology and treatment of cirrhotic ascites]. PMID- 3809926 TI - [Alcoholic hepatitis]. PMID- 3809927 TI - [The antibacterial defense system and bacterial infections in cirrhotic alcoholics]. PMID- 3809928 TI - [Handling of drugs by cirrhotic patients]. PMID- 3809929 TI - [Preclinical study of anti-arrhythmia agents. Classification]. PMID- 3809930 TI - [Methods for evaluating anti-arrhythmia drugs in man]. PMID- 3809931 TI - [Pharmacology of diuretics]. PMID- 3809932 TI - [Diuretics, potassium and arterial hypertension]. PMID- 3809933 TI - [Hyponatremia induced by diuretics]. PMID- 3809934 TI - [Diuretics in arterial hypertension]. PMID- 3809935 TI - [Use of diuretics in edematous syndromes]. PMID- 3809936 TI - [Calcium and diuretics]. PMID- 3809937 TI - [Abuse of diuretics]. PMID- 3809938 TI - [Diagnosis of rheumatoid polyarthritis at onset]. PMID- 3809939 TI - [Short, middle and long-term surveillance of rheumatoid polyarthritis]. PMID- 3809940 TI - [Non-articular manifestations of rheumatoid arthritis]. PMID- 3809941 TI - [The rheumatoid hand]. PMID- 3809942 TI - [Physiopathology of rheumatoid polyarthritis for today's and tomorrow's therapists]. PMID- 3809943 TI - [Therapeutic strategy in rheumatoid polyarthritis]. PMID- 3809944 TI - [Role of functional rehabilitation during treatment of rheumatoid arthritis]. PMID- 3809945 TI - [Immunoendocrinology. Introduction]. PMID- 3809946 TI - [Hormones and immunity]. PMID- 3809947 TI - [Autoimmune diseases of the thyroid gland]. PMID- 3809949 TI - [Orientation of diagnosis in the pathology of the optic nerve]. PMID- 3809948 TI - [Hypoparathyroidism, ovarian insufficiency and adrenal insufficiency of autoimmune origin]. PMID- 3809950 TI - [Acute optic neuritis]. PMID- 3809951 TI - [Acute ischemic optic neuropathy]. PMID- 3809952 TI - [Tumors and injuries of the optic nerve]. PMID- 3809953 TI - [Toxic, metabolic and hereditary optic neuropathies]. PMID- 3809954 TI - [The optic nerve. Anatomy, physiology, physiopathology]. PMID- 3809955 TI - [Upper genital infection in women. Sequelae and consequences]. PMID- 3809956 TI - [Vulvocervicovaginal infections and their treatment]. PMID- 3809957 TI - [Diagnosis and treatment of nontuberculous utero-adnexal infections]. PMID- 3809958 TI - The evolution of essential hypertension in a primary prophylactic survey. Ten year longitudinal epidemiologic study (1971-1982). AB - The present work presents the evolution over a ten-year period of subjects with essential hypertension (EH) detected in a group of 5,000 men, aged 40-60 years, randomly selected in an urban environment. The prevalence of EH in the group studied was 20.5%, whereas "borderline" hypertension presented a prevalence of 21.4% reported in an earlier study. A proportion of 76.6% of the hypertensive patients were cared for in an outpatient unit; normal blood pressure values were obtained in about one third of the cases. This result is consistent in itself and, all the more so, bearing in mind ageing of the patients in the course of the study. The study had in view the annual incidence of essential hypertension and the evolution of atherogenic risk factors in hypertensive patients. The incidence of cerebrovascular accidents during the follow up period in this group was 6.85%, sudden death 1.7% and myocardial infarction 6.2%. PMID- 3809960 TI - The value of endoscopy in the diagnosis of gastric ulcer. AB - The ever increasing application of digestive endoscopy has provided a new argument for diagnosis in gastroenterology. Based on a personal experience of 300 cases, the authors are revising the diagnosis of gastric ulcer, comparing the data obtained by X-ray, endoscopic, histologic and bioptic investigations. In about two per cent of the cases, the endoscopic diagnosis of benign ulcer was infirmed by examination of the histologic fragments. PMID- 3809959 TI - The evolution of atherosclerotic risk factors in a primary prophylactic survey. Ten-year longitudinal epidemiologic study (1971-1982). AB - The present work is a study of the evolution of atherosclerotic risk factors in the course of ten years, in a group of 5,000 male subjects, aged 40 to 60 years, from an urban district, undergoing a programme of primary prevention against ischemic heart diseases. The general intervention methodology and the results after five years follow-up were published in earlier papers. The present work describes the ten year evolution of the prevalence of the main atherogenic risk factors studied, the yearly rate of prevalences, first appearance and correction potency of the risk factors detected. PMID- 3809961 TI - The renal involvement in scleroderma. A clinical and morphologic study. AB - The main clinical, biologic, immunologic and morphologic changes characteristic of the sclerodermic nephropathy have been investigated during a mean period of 3.8 years in 21 patients with scleroderma, 19 women and 2 men, with a mean age of 36.1 years. The results obtained have revealed the frequent (38.1%) and early renal involvement, with constant arteriolar and glomerular lesions. Proteinuria was the most frequent (28.6%) and early sign of renal damage. The urinary sediment was poor and the immunologic investigations unconclusive. Dosage of urinary proteins by sensitive techniques (immunoquantitation) and renal biopsy have proved to increase the accuracy of studies for the detection of sclerodermic nephropathy in its initial stage. PMID- 3809962 TI - Method-dependent number and topography of coronary narrowings. AB - A comparative gross and light microscopic study of the coronary arterial bed carried out on 95 selected male subjects aged 51-55 years, revealed that the number and topography of narrowings (more than 50% luminal insufficiency) showed wide method-dependent variations. If only routine gross inspection of the major coronary arteries was performed (method 1) 52% of the subjects exhibited narrowings; if gross inspection was extended to the proximal segment of the first diagonal, first septal, left marginal, right marginal and posterior descending vessels, the proportion of subjects with coronary narrowings augmented to 61% (method 2); finally the use of the light microscopy to investigate vessels supplying the conduction system and terminal vessels (method 3) augmented this proportion to 73%. Conversely, we recorded the absence of narrowings encroaching more than 50% in 48% of the subjects with method 1, in 39% with method 2 and in only 27% with method 3. Using the second method we revealed in coronary branches 29 narrowings and with the third method 52 narrowings. From the 95 cases investigated 46 (48%) did not show narrowings in the major coronary arteries. Of these 46 cases, 17 (37%) exhibited narrowings in coronary branches. This would indicate that more than 1/3 of the subjects without greater than 50% narrowings in the major coronary arteries showed such lesions in the branches of these major coronary arteries. The results of this study demonstrated the necessity of gross and light microscopic examination of the whole coronary arterial bed in all attempts to offer a realistic anatomo-clinical correlation in ischemic heart disease: they also demonstrated that the atherosclerotic involvement of the coronary arterial bed is not limited to the segments grossly examined by each pathologist. PMID- 3809963 TI - The nonconscious, conscious and psychosocial higher nervous activity and the neuroses. PMID- 3809964 TI - Alterations of primary VEP components in the cortical blindness induced by a perinatal encephalopathy. PMID- 3809965 TI - Histochemical research into experimental traumatic lesions (cerebral wound). PMID- 3809966 TI - Results of thymectomy in myastenia gravis. PMID- 3809967 TI - Hydrocortisone action on the thiol groups of the thymus. AB - The total (T) proteic (P) and non proteic (NP)-SH groups in the thymus of male Wistar rats were assayed and the P/NP ratio calculated. Hydrocortisone was administered to the experimental groups as follows: 1, 6, 15 and 45 mg/100 g body weight. Up to a dose of 6 mg HC, the thiol groups decrease progressively, especially the NP groups. At higher doses, the first two--SH groups (T and P) continue to decrease quantitatively, whereas the NP thiol groups notably increase. In the author's opinion, this is due to the exacerbating stages encountered during stress. PMID- 3809968 TI - The excretion of noradrenergic metabolites, particularly MHPG, in obese children and adolescents. AB - Eighty obese children and adolescents (41 males) aged 4-18 were screened for urinary adrenergic derivatives (NA, A, AVM, MN, MHPG) and the results compared with age- and sex-matched controls. Significantly higher amounts of A (8.1 +/- 0.38 micrograms/24 h), MN (0.327 +/- 0.032 mg/24 h) and MHPG (2.74 +/- 0.192 mg/24 h) were found and significantly linear regression curves of MHPG were plotted against urinary creatinine and NA but not against age, weight and Quettelet index. A subgroup of 26 obese having urinary MHPG over 3 mg/24 h ("high MHPG excretors") revealed significantly greater means of weight Quettelet index, A and NA than the remaining 54--member subgroup ("low MHPG excretors"). It was concluded that in randomly selected obese children and adolescents there are obvious humoral signs of sympathetic nervous system overactivity and, possibly, of adrenomedullary increased tonus and that these manifestations may be due, at least in part, to increased central (encephalic) noradrenergic activity, especially in more overweight patients. PMID- 3809969 TI - Circannual rhythms of laboratory parameters in serum of elderly subjects. Evaluation by cosinor analysis. AB - A total of 189 elderly subjects 76 +/- 8 years of age were studied in 230 24-hour profiles consisting of six blood samples collected at 4 hour intervals. The sampling sessions were spread over all four seasons. The circadian means were analyzed by single cosinor analysis for the presence of circannual variations. Statistically significant circannual variations were found in men and/or in women in the serum concentrations of: albumin, total bilirubin, calcium, chloride, CPK, glucose, LDH, potassium, sodium, triglycerides, and uric acid. Only in few functions is the extent of the circannual rhythms in the variables presented here large enough to present potential diagnostic problems in today's practice of laboratory medicine. However, the seasonal variations in metabolic functions, or if endogenous in nature, circannual rhythms may be of physiologic and pathobiologic importance. There is a need to quantify certain of these rhythms as a predictable portion of variability in laboratory values, and presumably as an indicator of human health. PMID- 3809970 TI - A critical view on the notions of hormone and endocrine system. PMID- 3809971 TI - [Measurement of phenoxyacid herbicides by gas chromatography in water intended for public consumption]. PMID- 3809972 TI - [Changes due to water purification in several treatment plants]. PMID- 3809973 TI - [Health care reform and autonomy]. PMID- 3809974 TI - [Prevention of juvenile delinquency]. PMID- 3809975 TI - [Temporal aspects of carbon monoxide in Rome]. PMID- 3809976 TI - [Arbovirus antibodies levels in subjects of the region of Ribeirao Preto, SP (Brazil)]. PMID- 3809977 TI - [Epidemiological research on an outbreak of gastroenteritis]. PMID- 3809978 TI - [Risk of dying in the 1st year of life among slum and non-slum residents in the municipality of Porto Alegre, RS (Brazil), in 1980]. PMID- 3809979 TI - [Freshwater mollusks of the State of Rondonia (Brazil), with special reference to the genera Biomphalaria Preston, 1910 (Pulmonata, Planorbidae)]. PMID- 3809980 TI - [An approach to the study of communicable disease outbreaks. A conceptual model based on spatial and functional scales of epidemic progression]. PMID- 3809981 TI - [The discovery of Biomphalaria glabrata (Say, 1818) in 2 municipalities of the State of Sao Paulo, Brazil]. PMID- 3809982 TI - Identification of Aedes (Stegomyia) albopictus (Skuse) in Brazil. PMID- 3809983 TI - [The adolescent and his life plans]. PMID- 3809984 TI - [The "odds ratio": various considerations]. PMID- 3809985 TI - [Excretion of phenoltetrachlorophthalein in rats with experimental liver injury]. PMID- 3809986 TI - [Clinical significance of pancreas divisum]. PMID- 3809987 TI - [Treatment of osteomalacia caused by anticonvulsants with a derivative of vitamin D (case report)]. PMID- 3809988 TI - [Genetics in orthodontics]. PMID- 3809989 TI - [The significance of ergometric examinations in type I diabetics]. PMID- 3809990 TI - [Anthropo-genetic characteristics of patients with chronic juvenile arthritis]. PMID- 3809991 TI - Denver peritoneovenous shunting for malignant or cirrhotic ascites. A prospective consecutive series. AB - A Denver peritoneovenous (PV) shunt was inserted in 54 consecutive patients for relief of malignant (24 patients) or cirrhotic (30) refractory ascites. The median age of both groups was 58 years, and the most frequent diagnoses were gastrointestinal (15) or ovarian (7) cancers and alcoholic cirrhosis (25). Median survival time was 1.7 and 3.5 months (range, 0.1-15.5 and 0.1-50.5), and the 1 month mortality 42% and 27%, respectively. Postoperative 24-h urinary output increased by 2-31, and the 1-week weight reduction was 8 and 11 kg, respectively, compared with before shunting. Complete shunt failure was encountered early in two patients, due to catheter malposition and clotting. Four more patients experienced transient failure, for an early dysfunction rate of 11%. A shunt related operative mortality of 6% was caused by pulmonary oedema (two patients) and sepsis (one patient). Shunt malfunction intervened in almost half (6 of 14) of the cancer patients surviving 1 month but was relieved in all but 1. In 3 of 22 cirrhotic 1-month survivors, the Denver shunt had to be removed owing to clotting or sepsis (2 patients) or revised because of blockage. Seven patients with cirrhosis are alive a median of 18 months (range, 2-51) after PV shunt surgery. Side effects were detected in 22 patients (41%): thromboembolism (9 patients), sepsis (7), initially bleeding oesophageal varices (3), DIC syndrome (2), postoperative hepatic coma (2), ascitic leakage (2), and pulmonary oedema (2). Patients with gastrointestinal cancers or severe cardiac disease did not benefit from the procedure. A history of hepatic encephalopathy or a serum bilirubin level above about 100 mumol/l was a bad prognostic sign. We could confirm the reported considerable morbidity and mortality after PV shunting, but also its efficiency in certain cases. Careful patient selection and follow-up study, timing of operation, and adherence to technical details are mandatory to improve the results. PMID- 3809992 TI - The effect of peritoneal exudate on peritoneal morphology in experimental acute pancreatitis. A histologic and scanning electron microscopic study. AB - Changes in peritoneal morphology were examined histologically and by scanning electron microscopy during porcine acute hemorrhagic (n = 8) and edematous (n = 9) pancreatitis and after intraperitoneal installation of hemorrhagic pancreatitis-associated peritoneal exudate in healthy piglets (n = 3). In all experimental groups peritoneal inflammatory changes with mesothelial damage were evident already 1 h after the induction of the disease, and increased with time. Hemorrhagic pancreatitis caused desquamation of mesothelial cells and denudation of the basal membrane. Intraperitoneal installation of hemorrhagic pancreatitis associated peritoneal exudate in healthy piglets caused similar changes, whereas the changes in edematous pancreatitis were much less extensive. Peritoneal exudate accumulating in the peritoneal cavity during hemorrhagic pancreatitis caused early chemical peritonitis characterized by severe inflammation of the peritoneum with destruction of the mesothelial cell layer, leading to denudation of the underlying connective tissue. The significance of these changes in the pathophysiology of acute fulminant pancreatitis remains to be further studied. PMID- 3809993 TI - Participation in mass screening for colorectal cancer with fecal occult blood test. AB - A Danish, randomized study with Hemoccult-II, including 60,000 persons between 45 and 74 years old, began in 1985. Methods of increasing acceptability are described for the first 8000. The first 1000 refusals are also analyzed. Written invitations including prestamped envelopes for return of the slides resulted in an acceptability of 58.8%. Two reminders increased the figure to 65.6%. Personal attempts to change the mind of those refusing increased the last figure to 68.9%. Incomplete slides were returned by 49 persons, but on request 43 sent a complete set. All 78 persons with positive tests had colonoscopy, which detected carcinomas in 10 and adenomas in 39. The study confirmed that results of trials from different countries are difficult to compare because of major differences among populations and methods. However, the present results were similar to those obtained in a Swedish study including only persons between 60 and 64 years old. PMID- 3809994 TI - Incidence of Crohn's disease in a defined population in northern Sweden, 1974 1981. AB - An epidemiologic study of Crohn's disease, comprising the population of the two most northerly counties of Sweden and covering the 8-year period 1974-1981, was carried out. The basic population was about 510,000, and the area is regarded as rural, with a mean density of 3 inhabitants per km2. In all, 199 patients with a hospital discharge diagnosis of Crohn's disease were identified. A mean annual incidence of 4.9 per 10(5) inhabitants and a peak incidence of 6.7 were found. There was no sex difference and no obvious change in incidence during the time period studied. The highest incidence was observed in young adults, and ileal disease predominated. A significantly higher incidence was observed in the town of Umea than in the rest of northern Sweden. The increase was confined to the ages between 20 and 40 years. The present study concludes that the incidence of Crohn's disease is high in northern Sweden, even though it is a sparsely populated rural area. The incidence figures are similar to those obtained for other parts of Sweden. PMID- 3809995 TI - Oesophagus scintigraphy in patients with diabetes mellitus. AB - Oesophagus scintigraphy with 99mTc was used to evaluate oesophageal motility in 40 patients with insulin-dependent diabetes mellitus. Abnormal oesophageal function was found in one third of the patients, although none reported oesophageal symptoms. The patients with abnormal oesophageal motility had a high frequency of abnormal autonomic nerve function tests compared with controls. PMID- 3809996 TI - Morphologic changes in ileal reservoir mucosa after long-term exposure to urine. A study in patients with continent urostomy (Kock pouch). AB - In patients with supravesical urinary diversion, continent ileal reservoirs utilized for urinary collection were examined by endoscopy at intervals of 1 month to 9 years after surgical construction, and biopsy specimens were obtained for light microscopy and morphometry. The gross appearance of the mucosa showed alterations in the shape of the shorter and broader finger-like villi during the first postoperative month to the subsequent very low ridges and convolutions or, in some instances, flat mucosa devoid of individual villi. Starting between 1 and 3 years after the surgical construction, endoscopically smooth areas were encountered in caudal areas of the reservoir, and the areas were mixed with islands of villous mucosa. Microscopically and morphometrically, the specimens from villous areas confirmed reduction in villous height and increase in crypt depth, whereas no changes were seen in the epithelial mitotic frequency. The number of mucus-storing goblet cells increased already within 1 month after construction. Specimens obtained from smooth areas showed alterations in the intestinal structure, with reduction of crypts, decreased height of epithelial cells, and occasional epithelial denudation. No signs of fibrosis, foreign-body reaction, or dysplasia were encountered. The constant exposure to urine leads to adaptive changes of the reservoir mucosa, resulting in a true atrophy of villi, crypts, and individual epithelial cells. PMID- 3809997 TI - Ultrastructural and histochemical changes in ileal reservoir mucosa after long term exposure to urine. A study in patients with continent urostomy (Kock pouch). AB - Mucosal biopsy specimens were obtained from ileal reservoirs used for urinary collection in patients with continent urostomy. Shortly after construction of the reservoir there was a reduction in villous height and an increase in crypt depth. After 2 to 3 years of observation, avillous areas were noted in the reservoir mucosa, mixed with islets of villous mucosa. Specimens from the avillous areas showed a marked decrease in height of superficially located enterocytes, with loss of microvilli and a reduction in cell organelles. The histochemically demonstrable activity of oxidative enzymes was significantly reduced in the epithelial cells. There was an increase in the number of goblet cells and autonomic nerve fibres in the crypt layer. The constant exposure to urine led to significant alterations of the ileal mucosa resulting in avillous areas mixed with villous remnants in which many of the intestinal characteristics both structurally and functionally disappear. PMID- 3809998 TI - An in vitro test for cows' milk protein intolerance? AB - The clinical features and results of standard laboratory investigations have been studied in children with cows' milk protein intolerance and the results compared with an in vitro test, examining the degranulation of peripheral blood basophils to cows' milk antigen. Of 67 children investigated, 26 had probable intolerance to cows' milk, and maximal basophil degranulation responses in these children were significantly increased (p less than 0.01). The most striking differences were those observed between children with definite cows' milk protein intolerance and control individuals (p less than 0.002). Of 14 children with definite cows' milk intolerance clinically, only 4 had negative responses. The basophil degranulation test may be a valuable, simple and inexpensive investigation in the diagnosis of cows' milk protein intolerance and perhaps also in other conditions in which food sensitivity plays a part. PMID- 3809999 TI - Enzyme activities in human gastric cancer and polyps. AB - Enzyme activities and the protein to DNA ratio in gastric biopsy specimens from patients with gastric cancer and polyps have been measured and compared with values from controls. In uninvolved mucosa in antral gastric cancer increased activities were found for several membrane and lysosomal enzymes, whereas the monoamine oxidase (MAO) activity was decreased (p less than 0.0005). In cancer tissue the MAO was also decreased (p less than 0.0003). In uninvolved mucosa in gastric cancer of the body, most membrane and lysosomal enzyme activities were increased. In the cancer tissue itself an increase in membrane enzyme activities was found for several enzymes, whereas the MAO activity was decreased (p less than 0.0001). Differences between activities in specimens from the gastric mucosa in patients with gastric polyps and those in controls were less pronounced than between gastric cancer and controls. A discriminant analysis, using the enzymes most sensitive to establish correct diagnosis, could identify normal gastric mucosa in 85-95%, atrophic gastritis in 56-63%, and uninvolved mucosa in gastric cancer in 66-78%. PMID- 3810000 TI - Enzyme activities in human gastric mucosa in gastritis and resected stomachs. AB - Biopsy specimens from the antral and body part of the stomach were studied for a range of marker enzymes in 11 patients with superficial gastritis, 9 patients with atrophic gastritis, and 31 Billroth-II-resected patients and compared with activities found in controls with normal gastric mucosa. In the antral part of the stomach increased gamma-glutamyltransferase activity was found in superficial (p less than 0.01) and atrophic gastritis (p less than 0.05), whereas monoamine oxidase activity was decreased in superficial (p less than 0.01) and atrophic gastritis (p less than 0.05). In the body part, increased activity of gamma glutamyltransferase (p less than 0.01) and acid-beta-glucuronidase (p less than 0.01) was found in superficial gastritis. In atrophic gastritis increased activities for lactase (p less than 0.01), alkaline phosphatase (p less than 0.05), leucyl-beta-naphthylamidase (p less than 0.05), gamma-glutamyltransferase (p less than 0.05), 5'-nucleotidase (p less than 0.01), N-acetyl-beta-D glucosaminidase (p less than 0.05), and acid-beta-glucuronidase (p less than 0.01) were found. Specimens from the gastric remnant showed an enzyme activity pattern similar to that seen in the body in atrophic gastritis, apart from a significantly decreased monoamine oxidase activity (p less than 0.004). Specimens with dysplasia in the gastric remnant showed decreased monoamine oxidase activity when compared with specimens without dysplasia (p less than 0.01). PMID- 3810001 TI - Effect of cimetidine on gastric mucosal cell proliferation in man. AB - Seven duodenal ulcer patients were treated for 3 months with cimetidine. Before and after treatment endoscopic biopsy specimens were taken for autoradiographic estimation of cell proliferation in the gastric mucosa in the antral and fundic part of the stomach and from the duodenum. In all three areas the estimated labeling index was increased during medication with cimetidine. The increase in epithelial cell renewal may participate in the ulcer healing effect of cimetidine. PMID- 3810002 TI - Elevated pancreatic secretory trypsin inhibitor levels during severe inflammatory disease, renal insufficiency, and after various surgical procedures. AB - Elevated levels of immunoreactive pancreatic secretory trypsin inhibitor (PSTI) were found in serum from patients with perforated duodenal ulcer, bacterial peritonitis, urosepticemia, pneumonia, acute renal failure, and also after different surgical procedures. The extent of the trauma seemed to determine the maximal level of PSTI. The increase found paralleled the changes seen in the acute-phase protein antichymotrypsin. There was, however, almost no increase in trypsinogen, thought to be produced together with PSTI in the acinar cells of the pancreas. In conclusion, there is evidence that PSTI is probably also produced somewhere outside the pancreas, in agreement with recent immunohistochemical data. This production may be part of a general acute-phase reaction. Thus, PSTI may have a more general inhibitory function against trypsin-like protease release in tissue injury, instead of being a purely local trypsin inhibitor in the pancreatic gland. PMID- 3810003 TI - Lysophosphatidylcholine and taurodeoxycholate increase stomach permeability to different-sized molecules. AB - The influence of lysophosphatidylcholine (LPC), taurocholate (TC), and taurodeoxycholate (TDC) on gastric mucosal permeability was studied in a rat experimental model, with different-sized polyethylene glycols (PEGs) in the 722 1206-dalton range as permeability markers. Gastric mucosal morphology was also studied by transmission electron microscopy. We found that 2.5 mM and 5 mM LPC and TDC, but not TC, caused an increase in the passage of PEGs across the gastric mucosa. LPC altered the permeability significantly more than did TDC. Morphologically damaged intercellular microvillous structures could be seen after LPC treatment, whereas no obvious changes could be seen after TC or TDC treatment. These findings indicate that LPC and TDC may damage the gastric mucosa and enable permeation of molecules in the 722-1206-dalton range. Molecules within this range could potentially be toxic or antigenic, and this therefore represents an aspect of interest in the pathology of enterogastric reflux. Furthermore, the results indicate that dihydroxy secondary bile acids (TDC) have a more pronounced effect on gastric mucosal permeability than trihydroxy primary bile acids (TC). PMID- 3810004 TI - Enzyme activities in biopsy specimens from human gastric mucosa. AB - The distribution of a series of marker enzymes in the gastric mucosa was studied by analysis of homogenized biopsy specimens from the lesser and greater curvature of the body and antrum, respectively, obtained from 11 control patients. The activities varied significantly between the regions for the membrane enzymes lactase (p less than 0.0001), neutral-alpha-glucosidase (p less than 0.005), alkaline phosphatase (p less than 0.01), leucyl-beta-naphthylamidase (p less than 0.005), and 5'-nucleotidase (p less than 0.0001) and the lysosomal enzymes N acetyl-beta-D-glucosaminidase (p less than 0.0001) and acid beta-glucuronidase (p less than 0.0001), using analysis of variance modified for repeated measurements. When paired comparisons between regions were evaluated, the enzyme activities of the antral regions were significantly higher than those of the body stomach. The activities of gamma-glutamyltransferase, acid phosphatase, and the mitochondrial enzyme monoamine oxidase did not alter between regions, nor did the protein to DNA ratio. The demonstrated biochemical distinction between antrum and body of the stomach may be explained by different physiological and histological properties of the two parts. PMID- 3810005 TI - Screening for coeliac disease in adults by simultaneous determination of IgA and IgG gliadin antibodies. AB - On a gluten-containing diet, patients with untreated coeliac disease have circulating IgA and/or IgG antibodies against the gliadin fraction of gluten. In the present study sera from 69 adults with coeliac disease, 93 adults with other gastrointestinal diseases, and 112 blood donors were tested for IgA and IgG gliadin antibodies by means of DIG-ELISA, a solid-phase immunosorbent assay. A predictive value of a positive test of 95% and a diagnostic specificity of 98% indicate that screening for gliadin antibodies can be highly recommended in suspected adult coeliac disease. It may further be used as a diagnostic test when small-bowel biopsy specimens are difficult to obtain. The results also indicate that the method is valuable for monitoring dietary treatment in outpatient control of coeliac patients. PMID- 3810006 TI - The effect of vagal stimulation on the release of cholecystokinin in anaesthetized pigs. AB - The effect of electrical vagal stimulation on the release of cholecystokinin (CCK) was studied in nine anaesthetized pigs. Plasma CCK concentrations were measured radioimmunologically by means of an antiserum specific for the sulphated tyrosine region of CCK. Stimulation of both vagal nerves for 10 min induced an increase in CCK concentrations from 1.9 +/- 0.4 pmol/l to a peak value of 3.6 +/- 0.4 pmol/l in portal vein plasma and from 1.5 +/- 0.3 to 2.7 +/- 0.4 pmol/l in arterial plasma. Mean integrated increments during stimulation were 12.0 +/- 2.5 pmol/l/10 min (p less than 0.01) and 8.3 +/- 1.0 pmol/l/10 min (p less than 0.001), respectively. The results suggest a vagal innervation of the CCK cell in the upper small intestine. PMID- 3810007 TI - Lysolecithin affects the viscosity, permeability, and peptic susceptibility of gastric mucin. AB - The effect of lysolecithin and lecithin on gastric mucin viscosity, permeability to hydrogen ion, and degradation by pepsin was investigated. Preincubation with lysolecithin produced a marked decrease in the glycoprotein viscosity. This decrease was concentration-dependent and at 10 mM lysolecithin reached a value of 74%. A 25% increase in mucin viscosity was obtained with 10 mM lecithin. Permeability measurements showed that 10 mM lecithin increased the retardation ability of the glycoprotein to hydrogen ion by 11%, whereas a 12% decrease in the retardation capacity of the glycoprotein was obtained with 10 mM lysolecithin. The results of peptic activity assay indicated that whereas lecithin had no effect on the rate of mucin proteolysis, the lysolecithin exerted significant (75%) stimulatory effect. The results suggest that lysolecithin in the stomach weakens the integrity of the protective mucus layer by promoting peptic degradation, reducing the ability to resist acid penetration, and decreasing viscosity of its mucin component. PMID- 3810008 TI - The age-, sex-, and site-specific occurrence of adenomas and carcinomas of the large intestine within a defined population. AB - The prevalence of adenomas at autopsy is compared with the incidence of colorectal carcinomas within a defined population in northern Norway. The study shows that females are more inclined to develop adenomas than males at ages up to 55 years, which corresponds with the higher cancer incidence in younger females than males before the age of 65 years. At older ages males have both a higher prevalence of adenomas and a higher incidence of carcinomas than females. When the data are analysed in accordance with anatomical segment and age, a change in predilection site of adenomas from the distal part of the large intestine at younger ages to the proximal part at older ages was found in both sexes. A similar relative change in the subsite distribution was also found for carcinomas, but only in males, and about 10 years later. PMID- 3810009 TI - Mandibular osteomas in ulcerative colitis. AB - Orthopantomography of the mandible in 50 consecutive patients with ulcerative colitis showed mandibular osteomas in 2 patients (4%), which is the same frequency as found in the normal population. Since earlier investigations have shown an increased frequency of mandibular osteomas in familial polyposis coli, the cancer family syndrome, and colorectal cancer without known familial disposition, it is concluded that the etiology of colorectal carcinoma in ulcerative colitis is not, as for these diseases, a combination of the same genetic and environmental factors but probably only a function of the duration and involvement of the disease. PMID- 3810010 TI - Platelet dysfunction and alteration of prostaglandin metabolism after chronic alcohol consumption. AB - To study the effects of chronic alcohol consumption on platelet functions, the rate of arachidonate-induced platelet aggregation, the production of malondialdehyde in platelets, and plasma levels of prostaglandin endoperoxide metabolites were examined in 88 chronic alcoholics and 24 healthy controls. The rate of platelet aggregation and the production of malondialdehyde in platelets were greater in chronic alcoholics both on admission and 1 week after. However, these alterations returned to the level of healthy controls within 4 weeks of abstinence from alcohol and were independent of the number of circulating platelets. Furthermore, on admission, plasma levels of thromboxane B2 were significantly increased in chronic alcoholics when compared with those of healthy controls (400.8 +/- 36.5 versus 241.7 +/- 28.9 pg/ml plasma; p less than 0.025) and were also significantly correlated with malondialdehyde production in washed platelet debris (r = 0.6049; p less than 0.001). In contrast, plasma levels of 6 keto prostaglandin F1 alpha and prostaglandin E were not altered after chronic alcohol consumption. As a result, the ratio of 6-keto prostaglandin F1 alpha to thromboxane B2 was markedly decreased in chronic alcoholics (0.31 +/- 0.03 versus 0.62 +/- 0.13; p less than 0.001). These results strongly suggest that the imbalance in prostaglandin endoperoxide metabolites is produced by chronic alcohol ingestion. Moreover, a significant correlation was observed between platelet aggregation rate and malondialdehyde production during platelet aggregation (r = 0.559; p less than 0.005). Thus, we conclude that chronic alcohol consumption alters platelet thromboxane metabolism, which is likely associated with the increased ability of platelets to aggregate. PMID- 3810011 TI - Haemodynamic effects of intravenous injection of peritoneal exudate in experimental acute pancreatitis. AB - The haemodynamic effects of intravenous injection into the test animals themselves of peritoneal exudate obtained during experimental acute pancreatitis in pigs were studied. The exudate had a distinct but moderate vasodilating effect when injected into the test animal. This decrease in afterload and a slight compensatory increase in heart rate led to a small increase in cardiac output. The profound hypotensive effect of intravenous injection of peritoneal pancreatic exudate observed by others when injecting the exudate into healthy animals could not be reproduced. In an organism severely affected by pancreatitis, the added pharmacological insult of peritoneal exudate intravenously seems to be of little haemodynamic consequence. Some of the effects previously reported may be caused by trypsin added to the fluid injected intraductally to produce the ailment. PMID- 3810012 TI - Impaired activation of the neutrophil oxidative metabolism in chronic inflammatory bowel disease. AB - The oxidative metabolism of circulating neutrophils was studied in patients with Crohn's disease and ulcerative colitis. The production of superoxide anion (02-.) in patients with ulcerative colitis was markedly decreased irrespective of whether soluble or particulate, non-chemotactic or chemotactic stimuli were used. Crohn's disease neutrophils showed a just marginally diminished 02-. production. Disease activity, as defined by the Crohn's disease activity index, was negatively correlated with the neutrophil O2-. production in both diseases. In both Crohn's disease and in ulcerative colitis neutrophil hydrogen peroxide (H2O2) production was normal. It is concluded that the neutrophil function, as assessed by superoxide anion production, is impaired in patients with inflammatory bowel disease. It is therefore suggested that the suboptimal microbicidal function of these cells, as demonstrated in the present study, may contribute to the disease process. PMID- 3810013 TI - Lysophosphatidylcholine potentiates the increase in mucosal permeability after small-intestinal ischaemia. AB - The influence of lysophosphatidylcholine (lysoPC), taurodeoxycholate (TDC), and taurochenodeoxycholate (TCDC) on the permeability properties of the ischaemic small-intestinal mucosa was investigated. We first studied the effect of ischaemia alone, then of lysoPC, TDC, or TCDC alone, and finally of ischaemia together with lysoPC, TDC, or TCDC on the permeability to sodium fluorescein in a ligated loop of the distal ileum in the rat. Longer periods of ischaemia alone (10 min or more) caused increased permeability, as did high concentrations (10 mM) of any of the agents. Low concentrations (1 mM) of lysoPC alone did not alter the gut permeability, but it significantly potentiated the increased permeability caused by 30 min of ischaemia. In contrast, 1 mM TDC or TCDC did not influence the permeability after 30 min of ischaemia. These findings imply that the ischaemic small intestine may be damaged by small amounts of lysoPC, with increased absorption of potentially pathogenic compounds as a possible consequence. They also point to the possibility that endogenously formed lysoPC may play a role in the mucosal damage and the increased permeability that occurs after small-intestinal ischaemia. PMID- 3810014 TI - Excretion, deconjugation, and absorption of bile acids after colectomy for ulcerative colitis. Comparative studies in patients with conventional ileostomy and patients with Kock's reservoir. AB - Bile acid metabolism was studied in 26 patients with a continent ileostomy (Kock's reservoir) and 32 patients with conventional ileostomy. All had been colectomized for ulcerative colitis. In patients with a continent ileostomy the 14C-glycocholic acid breath test showed increased pulmonary 14CO2 excretion as evidence of abnormal bacterial deconjugation of bile acids and increased faecal 14C excretion as evidence of bile acid malabsorption. Faecal bile acid excretion, determined chemically, and, by inference, bile acid synthesis were only moderately increased (median, 1.8 mmol/day). The disturbance of bile acid metabolism was similar to that found in 32 patients with conventional ileostomy, but more pronounced with higher faecal 14C. A significant difference was that no abnormal bacterial deconjugation took place in patients with conventional ileostomy, since their pulmonary 14CO2 excretion was subnormal. Stool mass was almost identical in the two groups, with median values of 665 and 663 g/day, respectively. Faecal fat excretion was normal in most in both groups. Thus bile acid metabolism is slightly more disturbed in patients with a continent ileostomy than in patients with conventional ileostomy. The resulting malabsorption was modest in both groups. PMID- 3810015 TI - Preparation methods for light microscopic and ultrastructural studies of fetal rat bladder. AB - Little is known about in utero urinary bladder embryogenesis and the development of the urothelium of laboratory animals. Previous scanning and transmission electron microscopy studies in rats and mice have indicated that the highly specialized superficial cells of the urothelium complete their differentiation at a very late stage of fetal development or shortly after birth. Limitations in methodology in the past have precluded extensive examination of earlier stages of bladder development. Innovations in preparatory procedures of the bladder of rat fetuses have been developed which make possible detailed scanning and transmission electron microscopic and light microscopic examination of cloaca and urinary bladder as early as day 11 of gestation. PMID- 3810016 TI - Chromatid behavior in late mitosis: a scanning electron microscopy analysis of mammalian cell lines with various chromosome numbers. AB - Chromatid activity during the process of nuclear reformation following metaphase is a period of mitosis where little precise information is available. Nuclear reformation requires that chromosomes, at metaphase and chromatids during anaphase and telophase align, position and associate in a clearly defined sequence to insure the specific design of each nucleus. Four cell lines with chromosome numbers ranging from seven to almost seventy were chosen to determine whether the process of nuclear assembly is the same throughout. Chromosomal alignment at metaphase is found to be radial in all four cell lines. Chromosome positioning is essentially the same in all four, where the smaller chromosomes are located centrally and longer ones are positioned peripherally in a radial alignment. Chromosomal association is directly related to chromosome number. The more chromosomes in a one dimensional plane occupying a given area, the closer the association. In comparing the HeLaS3 and muntjac chromatids, the former has the closer association at metaphase. Since association is the most important aspect of chromatid behavior in nuclear reformation, chromatid positioning becomes a vital process during anaphase movement. Chromatid positions established during anaphase determines later positioning in the interphase nucleus because of the subsequent interconnection of adjacent chromatids by the formation of a fibrous meshwork. This fibrous meshwork, formed in anaphase and early telophase, functions to stabilize chromatids following their positioning and it also serves as a substrate or matrix for the assembly of nuclear envelope. PMID- 3810017 TI - Basal lamina at the epithelial-connective tissue junction in the rat forestomach, esophagus, tongue and palate: scanning electron microscopic study. AB - The squamous epithelium lining the rat foregut was removed by incubating fresh, unfixed specimens in 2N sodium bromide. The surface morphology of the exposed subepithelial basal lamina was examined by scanning electron microscopy. Areas examined included hard and soft palates, oropharynx, tongue, esophagus, and forestomach. The basal lamina was continuous were not present at all sites. The saucer-like defects of lymphocyte migration that are present in the basal lamina beneath the squamous epithelium of the skin were not observed in rat foregut. The epithelial-connective tissue interface of the rat esophagus does not have the coiled and branched papillae seen in esophagi of adult humans. The three dimensional shapes of the connective tissue cores of the various lingual papillae are well-demonstrated by this technique and are distinct. The basal lamina of the hard and soft palates are also distinct. PMID- 3810018 TI - Surface ultrastructure of human megakaryocytes sorted on the basis of DNA content. AB - The relationship of polyploidization (DNA content) to differentiation is not well defined. We have developed centrifugal elutriation and Percoll density gradient centrifugation to obtain large numbers of highly-purified megakaryocytes which subsequently were stained for DNA content with Hoechst 33342 and sorted by FACS into 8C, 16C and 32C ploidy classes for correlated analysis of cell surface structures by scanning electron microscopy. Each ploidy class revealed unique surface characteristics that reflect differentiation occurring in megakaryocytes independent of their DNA content. PMID- 3810019 TI - The microvascular architecture of the vestibule and the endolymphatic duct and sac of the rat in vascular corrosion casts. AB - The blood vessels of the vestibule and the endolymphatic duct and sac (ES) of the rat were reproduced with methacrylate casting medium and observed under a scanning electron microscope. Dense capillary networks of the macula utriculi and the macula sacculi were observed. The collecting venules from the vestibule emptied into the vein of the vestibular aqueduct (VVAQ). The plexus of the vessels in the ES was triangular in shape and had anastomoses with vessels of the bone and dura and drained into the VVAQ. The posterior meningeal artery (PMA) gave off two branches to the ES. These findings supported the similarity of the vascularization of the vestibule and the ES between the human and the rat. PMID- 3810021 TI - Anatomy and morphometry of myocardial capillaries studied with vascular corrosion casting and scanning electron microscopy: a method for rat heart. AB - The present paper describes a procedure for preparing vascular corrosion casts of rat myocardial microvasculature. Essential components of the procedure include: partial "self clearing" of the heart in vitro; cardiac arrest by infusion of KCl; retrograde aortic root infusion of Mercox-Sevriton casting resin; KOH digestion of ventricular tissue; and desiccation and mounting of casts for scanning electron microscopy. About 50% of rats yielded complete casts. Vasculature closely paralleled muscle fiber orientation. Capillary beds characteristically exhibited branching, many intercapillary cross bridges, and occasional coiling. Average capillary cast diameter (5.6 microns) and intercapillary distance (15 microns) are comparable to results from in vivo studies. From preliminary calculations, vascular volume represents about 10% of the ventricular walls. These data indicate that vascular corrosion casts may be useful in the analysis of pathologic states and in determining the role of potential therapeutic interventions. PMID- 3810020 TI - Permanent noise-induced damage to stereocilia: a scanning electron microscopic study of the lizard's cochlea. AB - Alligator lizards were exposed to broadband noise ranging in intensity from 106 to 132 dB SPL for two hours and permitted to recover from 19 to 62 days. Hearing loss was assessed by comparing the auditory nerve component of the cochlear potential recorded at the end of the recovery period with that recorded before the noise exposure. The stereocilia in these ears were examined with a scanning electron microscope. These sensory hairs showed pathological changes similar to those described in mammalian cochleas with noise-induced damage. In decreasing order of severity the damage included completely missing auditory papillas, missing hair cells, missing hairs, hairs fallen over, and hairs that were only moderately splayed apart compared with their normal appearance. Long lasting hearing loss seems to be associated with all of these sensory hair pathologies. PMID- 3810022 TI - The role of marrow architecture and stromal cells in the recovery process of aplastic marrow of lethally irradiated rats parabiosed with healthy litter mates. AB - Bone marrow aplasia was induced in rats by whole body lethal irradiation (1,000 rads by x-ray), and rats died of irradiation injury within 7 days. Correlative studies at light (LM), transmission (TEM) and scanning electron microscopy (SEM) demonstrated swelling of endothelial and reticular cells and hemorrhage due to detachment of sinus endothelial cells on days 1 and 2. With time, structural recovery occurred without hemopoietic recovery. Reticular cells developed small intracytoplasmic lipid droplets on days 3 and 4. This resulted in fatty aplastic marrow within 7 days. On the other hand, in the marrow of irradiated rats parabiosed with healthy mates by aortic anastomosis, hemopoiesis was initiated by adhesion of nucleated blood cells to fine cytoplasmic pseudopods of fat-stored cells on days 1 and 2 after parabiosis. On days 3 to 5, reticular cells with large lipid droplets and fine pseudopods increased, then hemopoietic foci became clear and extensive. On day 8 after parabiosis, the aplastic bone marrow recovered completely both its structure and hemopoietic activity. Thus, hemopoietic recovery in lethally irradiated marrow begins with recovery of vascular endothelial cells, re-establishment of sinusoidal structure, and morphological and functional recoveries of reticular cells from fat-storage cells by releasing intracytoplasmic lipid droplets. Marrow stromal cells, namely reticular, fat-storage and fibroblastoid cells, share a common cellular origin, and regain their structure and function when fat-storage cells and fibroid cells are placed in contact with hemopoietic precursor cells. PMID- 3810023 TI - The capillary bed in the choroid plexus of the lateral ventricles: a study of luminal casts. AB - Micro-angioarchitecture of the choroid plexus of the lateral ventricles is investigated in microcorrosion casts of animal and human preparations studied with the scanning electron microscope. The capillary bed in the diverse regions of the tissue belongs to one of three patterns: (1)-a network of capillary meshes that envelop the larger arteries and veins predominates in the central segment. (2)-in the villous regions a "leaf-like" organization of sinusoids is found together with (3)-fronds of "glomerular" formations. "Glomeruli" are formed when arterial afferents and venous efferents converge in a quasi hilar structure before branching in arterio-venous loops. Nodular thickenings are observed on glomerular capillaries. The preparations studied (rat, dog, human) are remarkably similar and differ mostly in degree of occurrence of common architectural patterns. Arterio-venous communications are found at the hilus of human glomerular formations. PMID- 3810024 TI - Unique scanning electron microscopic features of hairy cells in hairy-cell leukemia. A review and current status. AB - Past scanning electron microscopy (SEM) reports demonstrated cell surface undulations, ridges, folds, and ruffles to support the monocytic/histiocytic nature of hairy-cell leukemia (HCL) cells. On the other hand, SEM studies illustrating spikes, villi, and microvilli on the cell surfaces favored the lymphocytic nature of hairy cells (HCs). The evidence for the 'hybrid' nature of the HCs has emerged from the demonstration of concurrent display of monocytic (ruffles) and lymphocytic (microvilli) surface features on each cell. Utilizing improved methods of sampling, fixation, and drying, the current status is that all HCs display microvilli and ruffles simultaneously. However, two distinct morphological types of HCs are acknowledged: cells showing ruffled areas next to clumps of microvilli (type A), and cells displaying microvilli interspersed among ruffles (type B). Each of the HCL cases reported in our studies had cells with either type A or type B surface features. Amazingly, these unique SEM features correlate well with the prevalent trend to classify HCs as malignant (villous) B lymphocytes imitating (ruffled) monocytes in some functional respects. PMID- 3810025 TI - Phorbol ester (TPA)-induced surface membrane alterations in B-type hairy cell and lymphocytic leukemia cells. AB - This report documents phorbol ester (TPA)-induced changes in cell morphology, and in vitro growth patterns in 9 patients with hairy cell leukemia (HCL), 21 with B type CLL and non-Hodgkin's lymphoma in leukemic phase (NHL), and 10 with acute non lymphoblastic leukemia (ANLL). TPA caused cells from HCL to adhere strongly and produce elongated cytoplasmic extensions. Many of these cells had an appearance resembling fibroblasts, while others showed marked surface ruffling and spreading containing increased dense bodies, and phagolysosomal vacuoles as seen by transmission electron microscopy. This HCL in vitro growth pattern after TPA exposure differed from that seen in B-CLL and NHL cells, which only adhered moderately after 72 hours and readily detached in clumps. CLL and NHL-cells did not show ultrastructural features of macrophages but had either plasmacytic or HCL features. It is suggested that these different growth patterns may aid in distinguishing HCL from other B-cell neoplasias. The expression of surface markers, tartrate resistant acid phosphatase (TRAP) and Ig secretion were studied in some B-CLL, NHL and HCL cells after exposure to different concentrations of TPA for up to 6 days. Results showed that the documented changes were frequently both dose and time dependent and the most striking HCL-features were encountered after 6 days incubation with higher concentrations of TPA. However, individual variation from case to case was noted. Nevertheless, it seems that TPA induces neoplastic B-cells to mature into secreting plasmacytoid lymphocytes, and cells with features of HCL with variable expression of surface markers and TRAP. PMID- 3810026 TI - The interface of cells and their matrices in mineralized tissues: a review. AB - The interface between cells and matrices in mineralized tissues formed in vivo has been studied mainly by looking at the matrix surface, which is easily prepared, and not at the cell surface, which presents problems. Vertebrate calcified tissues range from being acellular to highly cellular, but for all the tissues the formative cells lay down and organise a cell-specific matrix, although this may be deposited initially on a different tissue-type. The formation of hard tissues is a group activity of many cells; resorption is the province of one cell, though it may be controlled by others in the vicinity. Cell matrix interfaces that develop in vitro have also mainly been studied at the matrix side. The main difficulty with in vitro studies of hard tissue interfaces is that the cells do not have the same activity or even cellular functions as they had in vivo under the complex control of physiological regulation. The question of osteoblastic osteoclasis falls into this category. It is possible to provide new substrata for both formative and resorptive hard tissue cells to test for the interaction between the cells and the 'matrix' on to which they are seeded. The changing cell-matrix interface may also be modelled using computer simulation of osteoclastic movement across a substrate based on known patterns exhibited by other cell types in vitro. Comparison with the shapes of complex resorption pits shows a surprising match. This suggests that the track of the osteoclast due to cell motility and the bone resorptive mechanism resulting in pits along that track are likely to be separately controlled phenomena. PMID- 3810027 TI - Variation in the sizes of resorption lacunae made in vitro. AB - The assessment of in vitro osteoclastic activity has, until recently, been dependent on the analysis of organ culture experiments. We have developed a single cell resorption assay so that the resorptive function of individual osteoclasts could be studied. This paper examines the biological variation in the sizes of resorption lacunae produced by bone cell cultures derived from neonate rats and rabbits, and prehatch or hatchling chicks. Cultures were run for 24h for all species; and in addition for 48h for rat, 9 or 12 hours for rabbit and 3-7 hours for chick. The numbers of the nuclei of osteoclasts seeded on to plastic were counted for all three species. SEM stereophotogrammetry was used to measure areas, volumes, and maximum and average depths of the lacunae using specially designed instruments and software. Rat osteoclasts were smallest, and more chick osteoclasts were very large. There was a species difference in the onset of resorption and the sizes of pits produced, the chick osteoclasts being more vigorous resorbers than the rabbit ones, and the rat least so. For a given plan area, chick lacunae were deeper. There was a high correlation between area and volume. The range of maximum depths for a given area was high, however. Thus the mean of a few measurements of depths should not be used to calculate volume from area. At 24 hours, 77% of the rat, 47% of the rabbit and 28% of the chick lacunae were less than 1,000 microns 3 in volume; and 11% of the rat, 17% of the rabbit and 22% of the chick lacunae were between 1,000 and 2,000 microns 3 in volume. The mean values at 24 hours were 981, 2796, and 4582 microns 3 for rat, rabbit and chick lacunae respectively. PMID- 3810028 TI - The enamel ultrastructure of multituberculate mammals: a review. AB - The enamel ultrastructure of multituberculate mammals has been sampled extensively and studied intensively and is better known than for any other group of early mammals. The enamel of the earliest multituberculates, those of the Late Triassic-Early Jurassic suborder Haramiyoidea and the Late Jurassic-early Early Cretaceous suborder Plagiaulacoidea, is "preprismatic." With only two exceptions, all Late Cretaceous and early Tertiary genera of multituberculates examined have prismatic enamel. Prisms are either small with circular (complete) boundaries or large with arc-shaped (incomplete) boundaries. There is a remarkably consistent relationship between enamel ultrastructural type and subordinal taxa in that small, circular prisms are usually found within the suborder Ptilodontoidea and large, arc-shaped prisms are usually found in the suborder Taeniolabidoidea and in six Late Cretaceous-Early Tertiary genera of indeterminate subordinal status. Research currently in progress suggests that both small, circular prisms and large, arc-shaped prisms are homologous in all multituberculates in which they occur, with one exception. Neoliotomus, a taeniolabidoid, appears to have evolved small, circular prisms independently. In addition, it appears that large, arc shaped prisms represent the primitive condition in multituberculates with prismatic enamel, not small, circular prisms as has been proposed previously. PMID- 3810029 TI - Development of the otolith in embryonic fishes with special reference to the toadfish, Opsanus tau. AB - The development of the saccular otolith and the otolithic membrane was studied in the toadfish (Opsanus tau) using scanning and transmission electron microscopy. Development of the saccular otolith and its otolithic membrane in Opsanus begins with the formation of the primordia in embryos of 17-20 somite age. Calcification of the primordia begins shortly afterwards, although increased calcium layering and formation of the otolithic membrane corresponds to the development of a group of cells lying peripheral to the developing sensory epithelium. These cells contain an abundance of rough endoplasmic reticulum. PMID- 3810030 TI - Studies of otoconial development in a "giant-crystal" strain of chicks using scanning electron microscopy, polarized light microscopy, and X-ray crystallography. AB - Otolith formation was studied in a mutant strain of low-fertility Delaware chicks which exhibit an otolithic defect. In all chicks of this strain, otoliths were present as a fused crystal mass which contained abnormally large (giant) otoconia. Studies of the formation of such otoliths during embryonic development revealed that from the very earliest stages the otoconia were much larger than normal, and in the saccular and utricular otoliths formed a fused mass. These results are interpreted as supporting a hypothesis of the de novo formation of giant otoconia in this giant-crystal strain as opposed to the recrystallization hypothesis proposed for other, dissimilar mutant mammals and birds which also produce giant otoconia. PMID- 3810031 TI - Genes, manganese, and zinc in formation of otoconia: labeling, recovery, and maternal effects. AB - Published studies indicate that genes and dietary manganese deficiency cause vestibular defects and ataxic behaviors. Manganese deficiency during development causes otoconial defects in mice, rats, guinea pigs, and chicks. Mutant genes cause otoconial defects in mice, mink, and poultry. Manganese supplementation prevents the otoconial defects in some mutant mice and mink. Manganese is essential, before crystallization of the otoconia, for synthesis of mucopolysaccharides and otoconial matrix. Such defects can be induced, after otoconia are crystallized during fetal development, by dietary zinc deficiency and sulfonamide treatment (inhibits carbonic anhydrase, a zinc-requiring enzyme). Manganese and/or zinc supplementation ameliorates otoconial defects in pallid and lethal-milk (zinc-deficient) mice. Studies herein show that: Developing otoconia can be quantitatively labeled with 45 Ca. This may provide a means for studying calcium metabolism in otoconia over a prolonged period of time and for determining the possible effects of diet, drugs, and other factors on otoconia. Otoconial defects, induced after otoconia form in the fetus, were observed in newborn mice, but disappeared by two days after birth. Conditions of the inner ear may contribute to the calcification of otoconia. Manganese and zinc supplementation of pallid mice via acidified drinking water is more effective than dietary supplementation in preventing otoconial defects. The effectiveness of zinc but not of manganese is related to maternal genotype (+/pa vs. pa/pa). The effect of supplementation of the dams with zinc but not with manganese increases over successive litters. These studies indicate the potential for interaction of genes and trace minerals on otoconial formation and maintenance. PMID- 3810032 TI - Otoconia as test masses in biological accelerometers: what can we learn about their formation from evolutionary studies and from work in microgravity? AB - This paper reviews previous findings and introduces new material about otolith end organs that help us to understand their functioning and development. In particular, we consider the end organs as biological accelerometers. The otoconia are dealt with as test masses whose substructure and evolutionary trend toward calcite may prove significant in understanding formation requirements. Space flight helps illuminate the influence of gravity, while right-left asymmetry is suggested by study of certain rat strains. PMID- 3810033 TI - Analysis of canine urinary stones using infrared spectroscopy and scanning electron microscopy. AB - Infrared spectroscopic analysis of 741 canine urinary calculi revealed that struvite stones, 58% of the total, were the ones most commonly to be found. Cystine stone disease, 21%, is also of great significance for dogs, whereas calcium oxalate, urate and brushite calculi occur only seldom. 3 cases of xanthine stone formation were also noted. SEM examination revealed structures similar to human stones such as bipyramidal weddellite, pseudomorphs from whewellite to weddellite, apatite deposits in cystine stones and characteristic mono-ammonium-urate needles. Other, unknown, structures were also discovered such as closely-knit intergrowths of cystine and brushite strata, mono-Na-urate and mono-K-urate intergrowths and Ca-urate. Of particular interest are the various forms of xanthine from compact spherical to lance-shapes in sheath-like arrangement. PMID- 3810034 TI - Experimental investigation of the genesis of struvite stones in cats. AB - Infrared spectroscopy of feline urinary stones revealed that struvite was the main constituent in 77.6% of all concrements. However, only in 30.8% (16/52) of struvite stone patients were any infections of the urinary tract detected. Scanning electron microscopical comparison of non-infected feline struvite stones and human struvite concrements which had grown in the presence of infection revealed clear differences. All the feline struvite concrements were of coarse crystalline construction with the crystalline form typical of struvite. Traces of partial solution and stratification were frequently detected on the crystalline surfaces. The human struvite stones whose growth had been accompanied by infection did not display these features; the predominant structures in these concrements revealed very little evidence of any ordered growth. Examination of the urine and calculation of the relative supersaturation showed that where physiological pH values and physiological concentrations of lithogenic substances were present sterile urine can become supersaturated with struvite. The morphological peculiarities of the feline concrements and the results of urinary analysis indicate slow crystalline growth rates. Phases of growth alternate with periods of stagnation. This process may be influenced by dietary factors. In contrast to this, struvite stone formation in the presence of infection is characterised by rapid growth in continually supersaturated urine. PMID- 3810035 TI - Phase transitions of calcium oxalate trihydrate and epitaxy in the weddellite whewellite system. AB - The phase changes calcium oxalate trihydrate-weddellite, weddellite-calcium oxalate monohydrate and calcium oxalate trihydrate-whewellite are individually examined at the atomic level from a theoretical point of view; concomitantly the topological requirements necessary for phase stability are clarified for each structure type. In solution a sequential series of phase transitions according to the steps calcium oxalate trihydrate-weddellite-whewellite is not likely to be energetically favoured; direct conversion of calcium oxalate trihydrate to whewellite should be, instead, ordinarily expected. It is formally demonstrated that along two axial directions a set of atoms is in essentially identical positions in both weddellite and whewellite. This notwithstanding, it is concluded that epitactic catalysis cannot and should not be considered a common mechanism for the formation of whewellite from weddellite (and vice versa) or of kidney stones in general. PMID- 3810036 TI - Prognostic significance of a morphometric study of lymph node biopsies in chronic lymphocytic leukaemia. AB - In 18 chronic lymphocytic leukaemia (CLL) and 2 diffuse, well-differentiated lymphoma (DWDL) lymph node biopsies, morphometric results analysing nuclear area distribution curves by the skewness coefficient were compared to histological findings, clinical stage and survival. Lymphocytic proliferation was subclassified according to the number and the distribution of large lymphoid cells. All cases with a component of large lymphoid cells had a right deviation of the nuclear area distribution curve and a positive value of the skewness coefficient in contrast to those where lymphocytic proliferation was monomorphous. Good correlation was observed between histological findings, morphometric analysis and survival: most patients with a right deviation of nuclear area distribution curve and positive skewness coefficient are clinically stage C, or died within 2-44 months, in contrast to patients with a symmetric distribution of nuclear area curve who are clinically stage A or B and still alive. The results indicate that in CCL and DWDL the lymph node biopsy with quantitative analysis has prognostic significance. PMID- 3810037 TI - Radioimmunoassay of erythropoietin in chronic uraemia or anephric patients. AB - The erythropoietin (Ep) plasma titre of 41 anaemic patients with normal renal function or with renal insufficiency (with or without kidney) was measured by RIA and compared to values observed with the polycythaemic mouse assay. A good correlation was found with both methods (r = 0.88). However, about 20% of samples gave higher values with the bioassay. 21 Ep titres measurable by the bioassay ranged from 40 to 4400 mU (mean 717.1 mU) compared to 14.8 to 3788 mU (mean 484.7 mU) measured by the RIA. Low levels of Ep plasma titre have been observed in patients with renal insufficiency and no difference was found between nephric uraemic patients and the anephric group. These results suggest that the increased blood requirements in anephrics are not due to a smaller production of Ep, but ultimately to the presence of an inhibitor of erythropoiesis. The well-known inverse relationship between haematocrit and Ep level was not found in renal insufficiency. However, some humoral regulation of erythropoiesis seems to persist in these patients since the elevation of red blood cells by transfusions was followed by a decrease of the Ep level. PMID- 3810038 TI - Two allotypes of factor IX present in haemophilia B. AB - Factor IX antigen (IX:Ag) was measured with three different immunoradiometric assays (IRMAs) in 30 healthy people and 43 patients with haemophilia B of varying severity. Two of the IRMAs were based on monoclonal antibodies capable of differentiating between two genetically determined molecular variants of normal factor IX. Most patients with severe hemophilia B lacked demonstrable IX:Ag. The factor IX variant that is undetectable with one of the monoclonal antibodies used was present in 2 out of 6 families with moderate haemophilia B and in 1 out of 6 families with mild haemophilia B. The existence of allotypes of factor IX in hemophilia B may have practical implications for carrier detection and prenatal diagnosis. PMID- 3810039 TI - RES phagocytosis in children with homozygous beta-thalassemia in relation to blood transfusion. AB - In order to investigate the effect of blood transfusion on the RE cell function in thalassemia major, 14 children with homozygous beta thalassemia were studied prior to and 7 to 10 d following blood transfusion, when, according to previous studies, spleen reaches its minimum size. The denatured human albumin (DHA) low and large dose clearance techniques were used in order to estimate the maximum RES phagocytic capacity. It is shown that, despite the confirmed post-transfusion high hepatosplenic circulation, the RE cell phagocytic capacity is not significantly affected. Furthermore the RES phagocytic capacity of beta thalassemics is shown to be significantly higher than that of normal controls, and this can probably be attributed to the RES hyperplasia accompanying the disease. PMID- 3810040 TI - The efficacy and toxicity of VAD in the treatment of myeloma and related disorders. AB - Impressive results have recently been reported in 29 cases of advanced refractory myeloma treated with 4-d infusions of Vincristine and Adriamycin (VAD). We report our own experience with this protocol in 13 cases of myeloma and related lymphoproliferative disorders. In 2 of these cases, VAD was used as first line treatment. Objective responses were seen in two-thirds of cases and the major complication of therapy was infection, predominantly bacterial in nature. PMID- 3810041 TI - Role of iron in the proliferation of the established human tumor cell lines U-937 and K-562: effects of suramin and a lipophilic iron chelator (PIH). AB - Suramin was used to analyze the growth-effects of blockade of iron uptake on two established human cell lines, U-937 (monocytoid) and K-562 (erythroleukemic). Suramin suppressed cell surface transferrin (Tf) binding and uptake of iron via inhibition of receptor-mediated endocytosis (RME). As a result, both lines accumulated in the S-phase. DNA synthesis and cell division were inhibited in the suramin-treated U-937, but not in K-562. Iron, supplied by a route alternative to Tf-to suramin-suppressed U-937 cells, reinitiated DNA synthesis and cell division, although at a lower level than in control cells. Multiple effects on iron-dependent enzymes and an inhibition of binding of undefined growth factors necessary for the transition through the cell cycle are suggested to be mechanisms by which suramin affects the U-937 cells. The results imply that clinically observed side effects of suramin may be caused by interference with cellular iron metabolism. PMID- 3810042 TI - Demonstration of species-specific sensitization to major allergens of Dermatophagoides species by solid-phase absorption of human IgE antibodies. AB - Twenty-five mite-allergic patients in the Brussels area were tested with the skin prick test (1, 5 and 10 histamine equivalents by prick test (HEP] and RAST with standardized extracts of Dermatophagoides pteronyssinus (Dp) and D. microceras (Dm). Highly significant correlations (0.69 less than rS less than 0.96) between the two species coincided with marginal, but highly significant (P less than 0.01), greater reactions to Dp in all comparisons. Species-specific IgE antibodies to antigen Dp-42 (= P1) and Dp-X were readily detected by solid-phase serum absorption with heterologous antigen and subsequent crossed radioimmunoelectrophoresis (CRIE). An absorption single radial immunodiffusion (SRID) technique, involving major allergens Dp-42, Dm-6 and Df-6 of Dp, Dm and D. farinae (Df), demonstrated the presence of IgE antibodies reacting with epitopes common to all species, epitopes common to two species, absent on the third, and epitopes strictly specific for Dp. The majority of patients with a strong IgE binding reacted to both common and strictly species-specific epitopes. The serological findings were in good agreement with the exposure situation in the area: by species-specific ELISA for dust allergen content, Dp occurred as the dominating species, 20 out of 24 homes having dust levels of Dp-42 above 30 ng/g. Five and four homes had detectable levels of Dm-6 and Df-6, respectively, in dust. PMID- 3810043 TI - Stages in LAV/HTLV-III lymphadenitis. I. Histological and immunohistological classification. AB - Lymph nodes from 40 homosexuals with persistent, generalized lymphadenopathy were studied for histological and immunohistological changes and classified into histological stages based on the progressive destruction of lymph node follicles in association with progression of the disease. Three patterns were recognized: stage I was characterized by follicular hyperplasia, mantle zone depletion, and follicular fragmentation in the absence of vasculitis, stage II by signs of follicular involution, and stage III by depletion of follicles and dendritic reticulum cells with development of diffuse pattern. The T zone was gradually depleted of CD4-positive lymphocytes, but on further progression, lymphocytic depletion (which also involved the CD8-positive cells) and fibrosis prevailed. The 40 lymph nodes from homosexuals were classified as stage I in 18 cases, stage II in 11, and stage III in 10. One case did not fulfil our histological criteria for LAV/HTLV-III lymphadenitis, although this patient was seropositive. Convincing correlation was found between histological stages and clinical and laboratory data. The triad of follicular hyperplasia, mantle zone depletion, and follicular fragmentation, in the absence of vasculitis, appears pathognomonic for the early disease. The diffuse pattern, however, may be seen in different disease entities. PMID- 3810044 TI - Stages in LAV/HTLV-III lymphadenitis. II. Correlation with clinical and immunological findings. AB - The aim of the present study was to investigate the relation between the histopathological findings in LAV/HTLV-III lymphadenitis and immunological, clinical, and serological variables. The study group included 38 consecutive homosexual men with persistent generalized lymphadenopathy (PGL) in whom lymph node biopsy was performed. The histopathological lymph node changes were grouped into three stages. Opportunistic infections at the time of biopsy and their development during follow-up were significantly associated with stage III histology (follicular depletion). Analysis of blood from 10 patients with stage III histology revealed significantly (P less than 0.01) decreased proliferative responses of lymphocytes to mitogens and reduced absolute number of CD5+ and CD4+ lymphocytes compared with 17 patients with stage I histology (follicular hyperplasia), whereas patients with stage II histology (follicular involution) had intermediate values. The absolute number of CD8+ lymphocytes was increased in all three stages, as was IgG, while increase in IgM and IgA was restricted to stage III. No difference was observed between the different histopathological stages with respect to the specificity of the anti-LAV/HTLV-III antibody as measured by immunoblotting. In conclusion, the defects of lymphocytes from the blood of LAV/HTLV-III infected persons reflect alterations in secondary lymphoid tissue. Further, there is a close correlation between these alterations and the clinical status of the patients. PMID- 3810045 TI - Invasive pneumococcal infection in Israel. Review of 90 cases. AB - 90 cases of invasive pneumococcal infection hospitalized during the period 1975 1984 were reviewed. The organism was recovered from blood, cerebrospinal fluid or other normally sterile body fluids. 40 of the patients were adults, most of whom had pneumonia, and 50 were children who had pneumonia, primary bacteremia or meningitis. 90% of the adults and 14% of the children had underlying conditions. Nosocomial infection was remarkably more common among adults (25%), than among children (2%). Mortality was similar to that reported by others: 37% for adults and 10% for children. The most important predictive factors for fatal outcome were: old age (greater than 80), meningeal infection, presence of malignancy or chronic lung disease, and failure to mount leucocytosis. 13% of the strains were moderately resistant to penicillin. PMID- 3810046 TI - Epidemiological, bacteriological and complicating features of erysipelas. AB - 233 patients with erysipelas, admitted to the Department of Infectious Diseases, Danderyd Hospital, during a 2-year period were analysed for epidemiological, bacteriological and complicating features. Erysipelas was defined clinically as a febrile skin infection with a sudden onset of a red indurated expanding plaque with a distinct border. Common predisposing factors were alcohol abuse, diabetes mellitus and venous insufficiency, and complications were more common among such patients. No seasonal variation was found. 5% of patients with blood culture had streptococcemia (7/149). Erysipelas emerging from an infected ulcer was seen in 52% (122/233) and in 46% of these streptococci were isolated (57/122), 67% of which were of type A (38/57). Staphylococcus aureus was isolated from 59% of ulcerative cases (72/122) and in 3 of them staphylococci were found in the blood. PMID- 3810047 TI - Post-neurosurgical and spontaneous gram-negative bacillary meningitis in adults. AB - In order to evaluate the clinical aspects of gram-negative bacillary meningitis (GNBM) we reviewed the charts of 20 adult patients with the discharge diagnosis of meningitis caused by gram-negative bacilli (bacteriologically proved) seen between 1973 and 1984. Nine patients had post-neurosurgical (post-NS) GNBM and 11 patients spontaneous (S) GNBM; the mean age of the former was 42 +/- 16 years and of the latter 56 +/- 14 years (p less than 0.05). The overall mortality rate was 50% (33% in the post-NS group and 64% in the S group). The glucose levels in CSF were significantly lower in the patients who died. Patients treated with combined aminoglycoside therapy presented a lower mortality rate than those treated with intravenous aminoglycoside only (25% versus 70%). We suggest that if aminoglycoside therapy is employed, these antibiotics must be administered both intravenously and directly into CNS. PMID- 3810048 TI - Carcinoembryonic antigen (CEA) in blood in cases of pneumonia. AB - Serum levels of carcinoembryonic antigen (CEA) were analysed in patients with pneumonia of different etiology. Significant (p less than 0.01) increases in blood CEA levels occurred in all groups of pneumonia of bacterial etiology, i.e., pneumococcal, gram-negative or chlamydial. In viral pneumonia similar increases were observed, but the changes were not statistically significant, probably due to the small number of patients. In pneumonia of unknown etiology CEA behaved as in bacterial pneumonias. Maximal values between 5 and 15 micrograms/l CEA were common in pneumonia, the basal level usually being less than 5 micrograms/l. The severity of pneumonia, as judged by maximal erythrocyte sedimentation rate, correlated weakly with CEA levels in the bacterial group (p less than 0.05). In pneumonias of unknown etiology white blood cell counts and C-reactive protein levels correlated significantly with maximal CEA (p less than 0.01). In conclusion we have demonstrated, that in pneumonias of different etiology strongly but transiently increased blood CEA levels are the rule. The severity of pneumonia is not clearly correlated with CEA levels. PMID- 3810049 TI - A comparison of the clinico-pathological features with stool pathogens in patients hospitalised with the symptom of diarrhoea. AB - The clinico-pathological features of 515 adult patients admitted to a major Regional Infectious Diseases Unit in United Kingdom with the symptom complex of diarrhoea were compared to the pathogens detected in their stool specimens. Routine clinical examination supported by basic pathological and laboratory investigations identified 138 (28%) in whom the cause of diarrhoea was extragastrointestinal or non-infectious gastrointestinal. Of the 351 patients (72%) with infectious gastroenteritis 72 (21%) had campylobacter, 59 (17%) had salmonella (22% bacteraemic) and 16 (5%) shigella. Clostridium difficile toxin accounted for a further 15 (4%)--antibiotics had been the antecedent cause in only one half of these. Routine microscopical examination of the faeces for red and white cells distinguished many with "culture positive" diarrhoea from those with "culture negative" infectious diarrhoea. Although there are no clinico pathological features which are unique to a particular pathogen and unequivocally suggest a particular pathogen, certain features did tend to present more often in association with particular microorganisms, and this knowledge may suggest a bacterial diagnosis whilst awaiting the definitive results of stool microbiology. These features include prior antimicrobial therapy with positive sigmoidoscopical/histological features: Cl. difficile; protracted diarrhoea in elderly severely dehydrated patients: salmonellosis; foreign travel in males with bloody diarrhoea: shigellosis; abdominal pain in younger patients with a small degree of vomiting: campylobacteriosis. Early diagnosis may then prove useful in rationalizing initial therapy, particularly the appropriate use of antimicrobials. PMID- 3810050 TI - The effectiveness of a short perioperative course with pivampicillin/pivmecillinam in transurethral prostatic resection: clinical results. AB - In a randomized control study comprising 261 patients undergoing transurethral prostatic resection (TUR), the effect of a short perioperative course with the oral combination of pivampicillin/pivmecillinam (PAPM) was analysed in 129 patients. The study was divided in 2 parts: the first 60 patients received 450 mg and the following 69 patients, 900 mg every 12 h until removal of catheter but not longer than for 1 week. 132 controls received parenterally 1 g of cefotaxime (CFT) daily throughout the study. During the first part of the study the frequency of bacteriuria in the PAPM group was 43% preoperatively and 30% 10 days postoperatively, during the second part 47% and 12%, respectively (p less than 0.025). In the CFT group the frequency of bacteriuria was reduced from 52% preoperatively to 28% postoperatively. The prophylactic effect (i.e. the protection against acquired bacteriuria) was 96% and 92% in the PAPM and the CFT groups, respectively. Preoperative bacteriuria was eliminated in 40% of the patients during first part and 69% during second part in the PAPM group, while corresponding figures were 48% and 46% in the cefotaxime group. There were 2 cases of septicemia and 5 of upper urinary tract infections throughout the study evenly distributed between the two groups. Oral pivampicillin/pivmecillinam 900 mg every 12 h was found to be a good alternative for perioperative antibiotic prophylaxis at TUR. PMID- 3810051 TI - Cutaneous leishmaniasis in a 3-year-old Finnish visitor to France. AB - A child with non-ulcerating cutaneous leishmaniasis after a 3-week visit to Southern France is reported. Diagnosis was histological. The possibility of the patient having had a visceral infection was taken into account when designing the final treatment. PMID- 3810052 TI - Salbutamol in the treatment of whooping cough. AB - A double blind placebo-controlled study was performed to evaluate the efficacy of salbutamol in the treatment of 25 pertussis patients. The diminishing of paroxysmal cough in the treatment group did not differ significantly from that of the control group. PMID- 3810053 TI - Eight years of clinical experience with inflatable and semirigid penile implants. AB - Penile prosthesis was implanted for erectile impotence of mainly organic origin in 36 patients between 1977 and February 1985. An inflatable penile prosthesis (IPP) was inserted in 24 cases and a "simirigid prosthesis" (SRP) in 12. The overall infection rate was 11%. Revision because of leakage was necessary after 19% of IPP insertions, though in none with the most recent design. The prosthesis is still in situ in 29 patients (19 IPP, 10 SRP), 24 of whom are satisfied with its function. The latter figure will probably increase after planned surgical revision in two cases. Three patients are dissatisfied in spite of functioning prosthesis, in all cases due to intercurrent disease. The study confirmed the view that penile implants give a high degree of satisfaction in the treatment of organic impotence. PMID- 3810054 TI - Etiology of urethral stricture following transurethral prostatectomy. A retrospective study. AB - A retrospective review of 417 transurethral prostatectomies was made regarding the significance of possible etiologies of postoperative urethral stricture. Clinically significant stricture developed in 9% of the patients. Of the studied factors, only indwelling catheter for a short period (1-7 days) within the last preoperative month showed statistically significant correlation with postoperative urethral stricture. PMID- 3810055 TI - Postoperative urinary retention. II. Micturition problems after the first catheterization. AB - 198 out of 5220 surgical patients were catheterized because of unexpected postoperative urinary retention. In 39% of cases micturition succeeded after the first catheterization of the overdistended bladder, but 61% (58% of the males and 66% of the females) developed more copolicated voided problems. The volume of fluids given intravenously during anaesthesia, the volume of primary urinary retention and increasing age were predisposing factors for prolonged micturition difficulties. Hospitalization was protracted because of postoperative urinary retention in 21 patients, and for 20 males prostatic surgery was necessary to relieve persistent retention. PMID- 3810056 TI - The value of CT in detecting pelvic lymph node metastases in cases of bladder and prostate carcinoma. AB - Fifty-one patients, 15 with bladder cancer and 36 with prostatic cancer, were examined by preoperative pelvic CT scanning in order to determine its sensitivity, specificity and accuracy in detecting pelvic lymph node metastases. The poor sensitivity of CT (40%) in detecting lymph node metastases reduces its value for staging lymph nodes. The reason for the low sensitivity is that metastases in nodes which are of normal size cannot be detected by CT. Pelvic lymphadenectomy remains the only accurate method for evaluating the state of pelvic lymph nodes. PMID- 3810057 TI - Combined Boari bladder flap-psoas bladder hitch procedure in ureteral replacement. AB - Uncomplicated injuries to the ureter are commonly treated with end-to-end ureteroureterostomy or reimplantation into the bladder. The Boari bladder flap and the psoas bladder hitch have been used separately when distal ureteral replacement is required. In cases of more extensive ureteral damage extending above the pelvic rim, more complex procedures have been performed. These procedures (transureteroureterostomy, intestinal replacement or renal autotransplantation) often represent a considerable surgical challenge and may be associated with numerous complications. Combining the principles of the psoas bladder hitch and Boari flap affords the clinician a means of traversing extensive ureteral defects with standard surgical techniques. We report herein patients with ureteral damage who have undergone replacement of various lengths of ureter with combined psoas hitch/Boari flap procedures. The technique is suitable for traversing ureteral defects at least to the lower pole of the kidney. An obvious advantage is that the replacement utilizes only normal urinary tract, it does not endanger ipsilateral kidney nor contralateral ureter or kidney and can be employed in patients with decreased renal function. In our experience ureteral replacement with the combination of the psoas bladder hitch and Boari bladder flap is an excellent method which is surgically simpler and safer than the other methods described for more extensive ureteral injuries. PMID- 3810058 TI - Stripping of the distal ureter after nephrectomy for pelvis papilloma. AB - A new technique for removal of the distal ureter using a vein stripper was successfully used in eight patients after nephrectomy for pelvis papilloma. The method described is safe and shortens operating time. PMID- 3810059 TI - DNA content in renal cell carcinoma. A comparison between flow and static cytometric methods. AB - Different flow and static cytometric techniques for analysis of DNA content were compared using imprints, fresh and paraffin-embedded tissues from renal cell carcinomas. All methods discriminated between diploid-/near diploid and aneuploid samples and gave comparable results concerning modal ploidy levels (r = 0.744 0.970). For retrospective investigations of renal cell carcinoma, flow cytometry using paraffin-embedded tissues seemed to be the method of choice in determination of DNA content. PMID- 3810060 TI - Uremic acidosis and intracellular buffering. AB - Skeletal muscle biopsies were performed in 16 controls and 15 non-dialysed end stage chronic renal failure (CRF) patients presenting untreated metabolic acidosis. Intracellular bicarbonate, pH, water compartments and electrolytes were determined. In 8 of 15 patients muscle ATP and lactate were measured. Intracellular bicarbonate (HCO3i) and pH (pHi) were obtained by means of muscle total carbon dioxide method: a significant (p less than 0.001) reduction in both intracellular acid--base indexes was found in all patients (pHi 6.82 +/- 13 vs. 7.04 +/- 0.05; HCO3i 6.28 +/- 2.07 vs. 11.86 +/- 0.87). Total muscle as well as extracellular water was increased. Muscle sodium and chloride contents were also increased, while no change in potassium and magnesium was detected. A significant decrease of both muscle ATP and lactate was found. The data lead to the conclusion that chronic retention of acids in CRF results in a depletion of the muscle buffer pool and consequently in intracellular acidosis: the latter could be the main cause of the cell energy metabolism derangement described in uremia. PMID- 3810061 TI - Occurrence and significance of heart disease in uraemia. An autopsy study. AB - The occurrence of heart disease in uraemic patients was evaluated from study of 94 autopsied cases of chronic renal failure. The most common autopsy-ascertained causes of death were congestive heart failure (37%), acute myocardial infarction (13%) and tamponading pericarditis (8%). Death from congestive heart failure was significantly more common among the patients aged 60 or more than in the younger group. Hypertension was recorded in 59% of the patients, including all those with fatal myocardial infarction. Coronary arteriosclerosis was graded as absent to mild in about 40% of the patients. More severe grades occurred predominantly in the older patients. Tamponading pericarditis almost exclusively affected patients in haemodialysis. The authors conclude that most deaths among patients with end stage renal failure were due to congestive heart failure. Ischaemic heart disease did not seem to be a more common cause of death than in the general population. PMID- 3810062 TI - Huge bladder carcinoma successfully treated with hydrostatic pressure technique. A case report. AB - A 64-year-old man presented with acute urinary retention and anasarca due to noninvasive multiple papillary transitional cell carcinoma filling the whole bladder cavity and obstructing both ureters. He was treated with hydrostatic pressure distension. A dramatic response occurred, with complete disappearance of the tumour within one month of the treatment. PMID- 3810063 TI - Psychiatric rehabilitation of schizophrenia: editor's introduction. AB - Well-planned and conceptualized rehabilitation of psychiatric patients who demonstrate persisting impairments, disabilities, and handicaps begins with assessment of symptoms and psychosocial functioning. Rehabilitation interventions -aimed at building skills and providing supportive and prosthetic environments- are linked to initial and ongoing assessment. The refractoriness of large numbers of psychiatric patients to conventional and customary forms of therapy will fuel the development of psychiatric rehabilitation that is efficacious and empirically based. PMID- 3810064 TI - The practice of psychiatric rehabilitation: historical, conceptual, and research base. AB - With the recognition that most psychiatric disorders are associated with severe and persisting disability and the development of effective procedures for improving the long-term outcome of patients, the term "psychiatric rehabilitation" is becoming routinely used in the mental health field. Psychiatric rehabilitation has begun to take its place as a viable, credible intervention approach, even infiltrating professionals' jargon and administrators' program descriptions. The field of psychiatric rehabilitation has progressed to the stage where its history can be traced; its conceptual base and treatment strategies described; its practice observed, monitored, and replicated; and its future growth anchored in a research foundation. PMID- 3810065 TI - Symptom monitoring in the rehabilitation of schizophrenic patients. AB - Although precise laboratory methods for measuring psychopathology are not available, interviewer-rated instruments developed to assess symptomatology can be used to monitor schizophrenic patients undergoing rehabilitation. By regularly assessing patients, rehabilitation staff can improve the effectiveness of their interventions. Patients can be screened for high levels of symptomatology which might preclude assignment to rehabilitation programs with high levels of social stimulation. Monitoring the prodromal symptoms of relapse can sometimes prevent florid relapses and sustain a rehabilitative trajectory. Standardized instruments for measuring positive symptoms (e.g., hallucinations, delusions, and conceptual disorganization) and negative symptoms (e.g., affective blunting, amotivation, and asociality) are available. Monitoring target symptoms may be particularly cost effective in the rehabilitation milieu. Use of suggested operational criteria for defining clinical states such as relapse would improve outcome studies on rehabilitation interventions. PMID- 3810066 TI - Functional assessment in rehabilitation. AB - The instruments that assess the functional living skills of chronically mentally ill individuals are reviewed. The instruments range from those that provide relatively global assessments of major life roles such as wage earner and student, to those that provide relatively specific assessments of behaviors such as personal hygiene and money management skills. The content, format, psychometric characteristics, advantages, and disadvantages of each instrument are presented in detail so that the reader can select the instrument that best suits the purposes of the assessment. PMID- 3810067 TI - Training skills in the psychiatrically disabled: learning coping and competence. AB - Social skills training methods represent a major strategy for psychiatric rehabilitation. Building skills in patients with schizophrenic and other major mental disorders is based on the assumption that coping and competence can override stress and vulnerability in reducing relapses and improving psychosocial functioning. For maximum efficiency, skills training needs to incorporate procedures and principles of human learning and information processing. Several models for skills training have been designed and evaluated, each of which has proved to be effective in raising the social competence of chronic mental patients. The "basic" model involves role playing by the patient and modeling, prompting, feedback, and reinforcement by the therapist. A "problem-solving" model of training provides general strategies for dealing with a wide variety of social situations. This model uses role playing to enhance behavioral performance but also highlights the patient's abilities to perceive and process incoming social messages and meanings. It is essential that social skills training be imbedded in a comprehensive program of rehabilitation that features continuity of care, supportive community services, therapeutic relationships, and judicious prescription of psychotropic drugs. PMID- 3810068 TI - Family intervention for the rehabilitation of schizophrenia: toward protection and coping. AB - Recent family aftercare intervention programs for schizophrenia have been reported by groups of investigators led by Falloon, Goldstein, Hogarty and Anderson, and Leff. Despite varied methods of intervention with families, all of these programs, when combined with neuroleptic medication, have demonstrated very significant decreases in relapse rates; some have also demonstrated improvements in social and role functioning. These programs share a number of common features: Family interventions are concrete and practical rather than analytical and interpretive; education about schizophrenia is delivered in a straightforward manner; and family members are treated with respect and helped to develop coping strategies. These demonstration programs are all related to vulnerability-stress coping-competence model of schizophrenia. It is argued that future research programs should aim at gaining a better understanding of the crucial family mediating mechanisms which protect the individual from episodes of schizophrenia. PMID- 3810069 TI - Role of the family in case management of the mentally ill. AB - This article provides a systematic discussion and assessment of the actual and potential contributions that families of the chronic mentally ill can make to the case management of their patient-relatives. It examines family members' involvement with six major case management functions including assessment, linkage, monitoring, assistance with daily problems, crisis intervention, and advocacy. For each function, the authors consider the potential of family members to make a contribution, specific activities that are more appropriately assumed by professional staff, and any limitations or caveats about family members' involvement with the given case management activity. The article points out that family members are clearly quite capable of making significant contributions in almost all aspects of managing their patient-relatives and that their potential contributions are too frequently ignored or underused by professionals. The authors recommend that professionals give greater acknowledgment to the case management efforts of family members, work to integrate the contributions of these natural helpers with formal case management systems, and provide family members with the encouragement and support they need to enhance their caring contributions. PMID- 3810070 TI - Training mental health workers in psychiatric rehabilitation. AB - Staff members from nine mental health agencies were trained in psychiatric rehabilitation technology. The trainers then received intensive followup to assist them in implementing the technology in their own agencies. Evaluation of the impact of the "training of trainers" strategy suggested that mental health workers were able to acquire and apply the skills of psychiatric rehabilitation. The training strategy also appeared to be effective in helping the agencies adopt the philosophy, principles, and skills of psychiatric rehabilitation. PMID- 3810071 TI - What does rehabilitation accomplish? AB - It is often assumed that rehabilitation is limited to helping schizophrenic patients compensate for deficits that are either immutable or altered only by specific medical treatment. However, recent advances in knowledge require that this basic, constricting, and poorly founded assumption about the limitations of rehabilitation be challenged. Data now exist to suggest that for severe mental disorders like schizophrenia rehabilitation may not be just palliative or help compensate for deficits, but may contribute in important ways to basic recovery processes. PMID- 3810072 TI - Autism and genetic disorders. AB - The syndrome of autism has been documented as occurring in association with a wide variety of genetic conditions. Autistic patients with a coexistent genetic condition, however, are not behaviorally or developmentally distinct from autistic patients for whom there is no known etiology or associated organic condition. This report reviews the literature linking autistic behavior with genetic conditions. Genetic, neurodevelopmental, and neuropathological findings in three genetic conditions which frequently give rise to autism are presented in detail. On the basis of this review, two hypotheses are supported: autism is a behaviorally defined phenotype which arises from diverse causes of central nervous system (CNS) damage, and the autistic phenotype represents only one point along a continuum of psychological dysfunction resulting from CNS damage. Current theories of genetic influences on brain development are reviewed, with emphasis on the relationships among qualitative, quantitative, and temporal abnormalities of CNS maturation and behavioral dysfunction. A hypothesis of abnormal brain development resulting from dysfunctional myelination is proposed as a potential etiologic factor in autism. PMID- 3810073 TI - Polyuria among patients with psychosis. AB - Using the criterion of early morning urinary specific gravity (SPGR) of 1.008 or less to define the presence of polyuria, we identified 26 of 72 male (36 percent) and 14 of 31 female (45 percent) institutionalized chronically psychotic patients as polyuric during a comprehensive survey of one of the chronic care units at a State mental hospital. Factors including diagnosis, sex, age, weight, and serum sodium did not distinguish the polyuric from the nonpolyuric patients. For men, administration of lithium was associated with polyuria. Urinary creatinine concentration (UCR) correlated well with SPGR, and UCR may provide an alternate index to separate polyuric from nonpolyuric patients. The clinical implications of our findings are discussed. PMID- 3810074 TI - First person account: three generations of schizophrenia. AB - The author gives an account of three generations of schizophrenia from the changing perspective of childhood through adulthood, as niece, sister, and mother. She describes the impact on the family in this 50-year span and discusses changing societal attitudes to mental illness as well as changes in treatment and professional thinking. PMID- 3810075 TI - [Chlorinated hydrocarbons in the environment IV. Chlorbenzol, 1,2,4 trichlorbenzol, chlornitrobenzole, chloraniline, 2-chlorethanol, 1,3 dichlorpropanol (2), epichlorhydrin]. PMID- 3810076 TI - The EMG gradient as a reflection of metamotivational state. PMID- 3810077 TI - Identification with an aggressor or a victim and its relation to creativity. PMID- 3810078 TI - Context-dependent latent inhibition in taste aversion learning. PMID- 3810079 TI - Intellectual Function Training in adults with acquired brain damage. An occupational therapy method. AB - An occupational therapy method termed Intellectual Function Training (IFT) is presented for cognitive retraining of patients with brain damage. Comprehensive training material, comprising about 900 pages, is described. The method is used to remediate intellectual dysfunction and to give intellectual stimulation, particularly concerning the following abilities: visual perception ability, spatial ability, verbal ability, numerical ability, memory ability and logical ability. The material is used for systematic individualized, daily treatment over a period of 2-4 months. The way in which the material is used is based on neuropsychological and pedagogical principles. Examples of training tasks and the training procedure are given. PMID- 3810080 TI - Intellectual Function Training in adults with acquired brain damage. Evaluation. AB - Intellectual Function Training (IFT) is an occupational therapy method for remediating cognitive functions in patients with acquired brain damage and has been presented in a previous paper. It has been evaluated by comparing a group of trained patients (n = 13) using the IFT method with a control group (n = 13) which underwent conventional rehabilitation. The trained group received IFT for 40 min each day, 5 days a week for about three months. Age, education and neurological status did not differ between the groups. The measurement methods of evaluation were Intellectual Function Assessment (IFP) and three psychometric test batteries. At the beginning of the study there was no significant difference in any subtest between the two groups. After the training period there was a significant difference of at least p less than 0.05 between the trained and the control group in the IFP battery, except for the Long-term Memory subtest. The improvement for the trained group was evident six months later at the time of the follow-up measurement, clearly indicating a significant difference between the groups. In one psychometric subtest a significant difference of p less than 0.01 was found. Within the experimental group over the study time there was a slight increase in performance which was notable in seven of the psychometric subtests p less than 0.05-p less than 0.001. The positive effect of IFT is considered to be specific for the type of task in which the patients were trained, while evidence of the effect on general intellectual function is inconclusive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810081 TI - Upper extremity function in hemiplegia. A cross-validation study of two assessment methods. AB - The methods devised by DeSouza et al. and by Fugl-Meyer et al. for description of upper extremity function after stroke were compared by parallel assessments in a consecutive series of 50 patients with hemimotor deficit. Very close positive associations between both methods indicated a high degree of cross-validity. As both methods appear to be externally valid, have good inter-rater reliability and as the time needed for assessing the arm function of a hemiplegic or hemiparetic patient rarely exceeds 10 min, it appears that the two methods possess about equal descriptive power. PMID- 3810082 TI - Quantified electromyography of lower-limb muscles during level walking. AB - The electromyography (EMG) of eleven different lower limb muscles of ten healthy subjects was quantified during normal level walking. The surface EMGs obtained were normalized, in percentage, to the activity obtained during an isometric maximum voluntary test contraction of each subject. The mean peak activities of the gluteus maximus, gluteus medius, rectus femoris, vastus medialis, vastus lateralis, biceps femoris and medial hamstring muscles occurred at heel-strike and were between 5 and 15% of max isometric EMG. The magnitudes of tibialis anterior and triceps surae muscular activity were higher than those of the other muscles investigated. Mean peak activity in tibialis anterior was 27%, in gastrocnemius medialis 42%, in gastrocnemius lateralis 19% and in soleus 40%. The important role of the triceps surae during walking was reflected in comparatively high muscular activity at push-off. PMID- 3810083 TI - Load moments about the hip and knee joints during ergometer cycling. AB - The aim of the study was to calculate the magnitudes of moments of force acting about the bilateral hip and knee joint axes during ergometer cycling. Six healthy subjects pedalled a weight-braked bicycle ergometer at different workloads, pedalling rates, saddle heights and pedal foot position. During cycling at 120 Watts, 60 revolutions per minute with mid-saddle height and anterior pedal foot position, the mean peak flexing and extending hip load moments were 34.3 and 8.9 Nm, respectively. Mean peak flexing knee load moments was 28.8 Nm and extending moment was 11.9 Nm. Hip load moments were significantly increased by increasing the ergometer workload or pedalling rate. For knee load moments, workload was the most important factor. The flexing knee load moment did not change with changes in pedalling rate. Different saddle heights or pedal food positions had a slight but not always statistically significant influence on the hip and knee joint loads. The maximum hip and knee joint load moments induced during cycling were small compared with those obtained during other exercises or normal activities such as level walking, stair climbing, and lifting. PMID- 3810084 TI - Measurement of skin mobility in the upper back. AB - On manual testing for skinfold tenderness greater resistance has been reported in patients with marked skinfold tenderness. On objective measurement of skin mobility, by raising a skinfold with a vacuum pump and by establishing a stress/strain curve, no difference in skin mobility was found between subjects with and without skinfold tenderness. Furthermore, contrary to manual testing, the suction testing causes no pain in subjects with clinical skinfold tenderness. In a second series of suction tests, comparing skin mobility in a subject with relaxed and contracted underlying muscles, it was found that muscular contraction reduces skin mobility by 50%. The conclusion is that resistance felt by manual skinfold testing is not inherent in the structures, but is caused by contraction of underlying muscles because of pain caused by the manual skinfold test. PMID- 3810085 TI - Four-year prognosis of stroke patients with visuospatial inattention. AB - The four-year prognosis of patients with visuospatial inattention in a stroke register (altogether 255 patients) was studied. Sixty-six surviving patients under the age of 65 were examined neurologically and neuropsychologically after 3 months and 1 year from stroke. Fifty-two of these 66 patients were still reexamined after 4 years from onset. Twelve patients with ischaemic brain infarction had visuospatial inattention: 7 had a clear-cut and contralateral neglect and 5 had milder and less lateralized inattention. The recovery of these 12 patients was poorer in ADL than the other 54 patients. Even when hemiparesis was taken into account, the difference still existed in ADL. The recovery of the 7 neglect patients was poorer than that of the 5 inattention patients. During the follow-up the visuospatial neglect persisted in all 7 cases and the visuospatial inattention disappeared in only one case. PMID- 3810086 TI - Surgical treatment of aortic dissection in 60 patients. AB - During the years 1964-82 a total of 60 patients underwent surgery for aortic dissection. Forty of them were males, with a mean age of 48.8 years (22 to 69) and 20 were females, with a mean age of 49.0 years (31 to 65). Forty-five patients were operated in an acute stage of aortic dissection and 15 patients in a chronic stage of this disease. The mortality rate of patients operated on for acute dissections was 51.1% and of patients with a chronic dissection 13.3%, the over-all hospital mortality rate being 41.7%. Cardiac and haemorrhagic complications were the commonest cause of death. Among the 35 operative survivors, there were seven late deaths (11.7%); 4 patients died of cardiovascular causes. The mean follow-up time was 6.1 years (2.7 to 13.4). Twenty-six long-term survivors were re-examined in the hospital. PMID- 3810087 TI - Mediastinal infection following open-heart surgery. Treatment with retrosternal irrigation. AB - A consecutive series of 1083 patients undergoing open-heart surgery was prospectively observed for infectious complications. Postoperative mediastinitis developed in 15 cases (1.4%). Surgical management of the mediastinal complication consisted of careful debridement of the sternal wound and the anterior mediastinum, followed by continuous retrosternal irrigation with an antiseptic or antibiotic solution after sternal refixation. The mean duration of mediastinal irrigation was 12.7 days. This treatment was successful in 13 of the 15 patients. In 2 of the 13, however, secondary refixation became necessary to stabilize the fragmented sternum. Repeated refixation with mediastinal irrigation was effective in one of these patients. The other underwent removal of the fragmented sternum followed by muscle plasty, but died unexpectedly of aortic dissection when signs of infection were subsiding. Two patients (13%) treated with closed chest irrigation died of recalcitrant mediastinal infection. PMID- 3810088 TI - Repair of coarctation of the aorta in the first three months of life. AB - Coarctation of the aorta was surgically treated in 28 infants (16 male, 12 female) aged 2 days-3 months, with 19 younger than 1 month. Body weight at operation was 1.6-4.2 (mean 2.8) kg. 3 infants had coarctation alone, 10 had a wide patent ductus arteriosus as the only associated anomaly and 15 had a variety of other anomalies. Resection with end-to-end anastomosis was performed in only one case, while 21 underwent subclavian flap aortoplasty and six patch graft aortoplasty. Additional procedures were banding of the pulmonary artery in five cases and open aortic commissurotomy in one case. The early mortality was 10.7% (3 infants) and three more died later. Further cardiac surgery was subsequently performed on four of the infants. Of the 22 survivors, two had significant recurrence of coarctation which, however, was successfully corrected in one case. The blood pressure was within normal limits in all survivors, except those with recoarctation. PMID- 3810089 TI - Effects of pentoxifylline on central hemodynamics in patients with congestive heart failure. AB - Pentoxifylline, a xanthine derivative with vasoactive and hemorheologic properties, was studied in regard to effect on central hemodynamics in ten patients with congestive heart failure due to aortic or mitral valve disease, mainly in NYHA group III or IV. The drug was infused intravenously in a dose of 4 mg/kg b.w. during a stable hemodynamic situation after valve replacement. The heart rate, systemic blood pressure, central venous and pulmonary artery pressures and cardiac output were recorded, and the stroke volume, cardiac index and systemic vascular resistance were calculated. Significant increase in cardiac output from the baseline value of 4.92 l/min was found 5-10 min (+22.6%) and 25 30 min (+19.5%) after pentoxifylline infusion. Cardiac index similarly increased from baseline, 2.73 dsc-5 (+22.3 and +18.3, respectively). The systemic vascular resistance showed significant decrease at the same intervals (-20.6 and -15.5%). The heart rate and stroke volume were significantly increased after 5-10 min. The systemic mean blood pressure and the pulmonary artery and central venous pressures showed no significant changes. There were no adverse effects of pentoxifylline. PMID- 3810090 TI - Prognostic factors for survival in surgically treated aortic regurgitation. AB - Aortic valve replacement was performed for 'pure' aortic regurgitation on 118 patients in a 5 1/2-year period ending in January 1983. In an analysis of prognostic factors, 12 variables were considered. The long-term survival rate was significantly greater in men than in women. Other significant factors were the relative heart volume, left ventricular systolic pressure and size of the implanted valve. A multivariate analysis with the Cox regression model, using the pool of variables simultaneously, showed primary predictive factors independently affecting survival to be left ventricular systolic pressure and size of the implanted valve. Based on this model, a patient-specific survival forecast was constructed. PMID- 3810091 TI - Prognostic factors in aortic valve replacement associated with narrow aortic roots. An analysis using the proportional hazard model. AB - In 80 patients who underwent aortic valve replacement with implantation of a small (21 mm) Medtronic-Hall prosthesis over a period of c. 7 1/2 years, beginning in 1977, prognostic factors were evaluated with use of the proportional hazard model. Twelve variables were considered. Four of them entered the regression model in a time-independent mode. These were preoperative NYHA function class, aetiology (endocarditis), diagnosis ("pure" aortic regurgitation) and aortic cross-clamping time. None of the parameters entered the model in time related mode. Another multifactorial approach to the proportional hazard model, using a stepwise regression analysis, showed the variables with prognostic value to be aortic cross-clamp time and preoperative NYHA class. Based on this model, predicted 3-year survival ranged from 92% to 45% from the most to the least favourable combination of these prognostic variables. A patient-specific prediction of 3-year survival was formulated. PMID- 3810092 TI - Transcervical thymectomy in patients with nonthymomatous myasthenia gravis. AB - Transcervical thymectomy was performed during a 13-year period in 21 patients with nonthymomatous myasthenia gravis. Follow-up showed that only eight patients benefited from the operation. These eight were among the younger patients in the series. This observation is discussed, and also the theoretic background for early thymectomy. The transsternal approach is recommended for thymectomy in elderly patients, but the transcervical may be considered for younger patients, although transsternal reexploration is advocated if this first operation should fail. PMID- 3810093 TI - Zinc and copper metabolism during open-heart surgery. AB - Zinc and copper changes were studied in plasma, whole blood, urine and myocardium in 15 patients undergoing valve replacement in hypothermic cardiopulmonary bypass with hemodilution. During the cardiopulmonary bypass, a fall in plasma copper and zinc concentration was related to hemodilution. The zinc concentration also decreased in whole blood, but remained unchanged intracellularly. The urinary concentration of both cations, but not the output, decreased at the end of the operation in relation to the baseline values. The myocardial copper and zinc concentrations increased during the aortic cross-clamping period. The possible causes and significance of these changes are considered. PMID- 3810094 TI - Effect of oxygen free radicals on rabbit and human erythrocytes. Studies on cellular deformability. AB - Changes in deformability of rabbit and human erythrocytes caused by exposure in vitro to the oxygen free radical generator hypoxanthine and xanthine oxidase were studied. The deformability reduction observed after 30 min of exposure to hypoxanthine-xanthine oxidase could be prevented by pretreatment with SOD, while after only 5 min of such exposure allopurinol and catalase also appeared to have a protective effect. Exposure of human erythrocytes to hypoxanthine and xanthine oxidase in Krebs solution prevented an otherwise occurring hemolysis. Exposure to both substances or to xanthine oxidase alone in Dulbeccos phosphate solution produced a reduction in deformability. The results indicate that exposure of erythrocytes to free oxygen radicals reduces deformability and that this effect may contribute to the myocardial dysfunction and the epicardial erythrostasis observed during open-heart surgery. PMID- 3810095 TI - [Thoracoscopy of pleural effusions: methods, indications, results]. AB - Thoracoscopy, which was formerly used in active tuberculosis to divide pleuro pulmonary adhesions and to complete therapeutic pneumothorax, has now become the object of renewed interest. By introducing, after pneumosera and usually into the 4th to 8th intercostal space in the axillary line, a fine trocar into the chest, the whole thoracic cavity, including parietal pleura, diaphragm, lung and fissures, mediastinum and pericardium, can be explored. This technique, performed under local rather than general anaesthesia or under neuroleptanalgesia, is innocuous, inexpensive and effective. In addition, the patient is immobilized for only 4 or 5 days on average and the technique is much less taxing than surgery, which can be avoided in many cases. Thoracoscopy nowadays is mainly used to determine the cause of chronic pleurisy unexplained after 3-4 weeks (positive pleural biopsies are obtained in 92-97% of cancerous or tuberculous patients). Thoracoscopy is half-way between purely medical practice and surgery and deserves to be widely used again by pneumologists, provided they learn to master the technique by regular, assiduous and adequate use. PMID- 3810096 TI - [Importance of ECG and chest x-ray of ambulant patients with chest pain]. AB - 107 consecutive outpatients were examined prospectively to evaluate the contribution of clinical history, ECG and chest X-ray to diagnosis of chest pain. Based on patient history, clinical examination, ECG and chest X-ray, 23 (21.5%) of all patients had chest pain related to organic disease, whereas in 84 (78.5%) patients the symptomatology was of a functional/psychosomatic nature. In chest pain of organic origin ECG and chest X-ray contributed to diagnosis in 1/4 of the cases. In patients with so-called functional chest pain, ECG and chest X-ray were of no diagnostic value but had a psychological and therapeutic effect in a way that facilitated patient management. PMID- 3810097 TI - [Intravenous high-dose short-term fibrinolysis in myocardial infarct. Experiences with 60 patients]. AB - Sixty patients with suspected myocardial infarction were treated in an open study with intravenous high-dose streptokinase (1.5 million U in 70 min). The average delay between onset of pain and fibrinolysis was 270 min. Reperfusion parameters were fast resolution of pain, rapid decline of ST elevation, arrhythmias and early CK peak. 27 patients were judged on the basis of these criteria as successfully reperfused, 13 as questionable and 20 as failures. Adverse events were 6 hypotensive episodes, 3 hypertensive phases, 2 interruptions due to flush, 1 chill, and 7 minor bleeding episodes. During follow-up there were 2 early deaths from cardiogenic shock. 58 patients were followed for 6-41 months, during which 4 died, 17 had a coronary angiogram and 6 were treated by bypass operation. 35 patients were able to work full-time and 7 half-time. Intravenous high-dose fibrinolysis is harmless and can be done in community hospitals. PMID- 3810098 TI - [Vasopressin in acute myocardial infarct: clinical implications]. AB - Since current data on vasopressin (AVP) secretion during the early phase of myocardial infarction is not extensive, plasma AVP was measured in 26 patients with acute myocardial infarction. Twelve had an increased AVP concentration (23.2 +/- 7.0 pg/ml; mean +/- SEM) whereas 14 had an AVP level less than 3 pg/ml (1.96 +/- 0.14 pg/ml). The patients with AVP greater than 3 pg/ml had higher heart rate and plasma osmolality than those with AVP less than 3 pg/ml. Blood pressure values were the same in both groups of patients. There was no difference in peak CPK and iso CPK activities between the two groups. Seven patients with AVP greater than 3 pg/ml died within the next few days, while only 1 patient with AVP less than pg/ml died. It thus appears that increased AVP concentration during acute myocardial infarction is associated with a poor prognosis. Whether it is a cause or a consequence of an unfavourable course of myocardial infarction remains to be determined. PMID- 3810099 TI - [Renal involvement in Legionnaires' disease]. AB - 9 consecutive cases of Legionnaires' disease are presented, all of which involved either a pathological urinary sediment or acute renal insufficiency. Diabetic glomerular sclerosis and terminal septic shock in one patient accounted per se for the urinary findings and terminal oliguric renal failure. In the remaining 8 patients the renal abnormalities are interpreted as manifestations of Legionnaires' disease: these were acute renal insufficiency in 6, requiring dialysis treatment in 4, proteinuria in 7, hematuria in 5, leukocyturia in 5 and cylindruria in 3 patients. One patient died of pneumonia and one patient, without Legionella-related renal involvement, of septic shock. Renal histology of 5 patients showed acute interstitial nephritis in one and diffuse sclerosing interstitial nephritis in a second patient, whose biopsy was obtained after 3 months' hemodialysis treatment. In 3 patients renal biopsy findings were explained by preexisting renal pathology, i.e. diabetic nephropathy, chronic transplant rejection and shock kidney respectively. Renal failure requiring hemodialysis and urinary abnormalities were largely reversible. PMID- 3810100 TI - [Roxithromycin (RU 28965), a new macrolide effective against pulmonary infections]. AB - Roxithromycin, a new macrolide, has favorable pharmacological properties: it is acid stable and well absorbed, and its prolonged half-life allows b.i.d. prescription of 150 mg. In our open prospective study we found an etiologic infectious agent in 16 (80%) of 20 patients presenting with "atypical" pneumonia. Ten of the 16 pneumonias were due to an organism sensitive to roxithromycin (gram+ cocci, gram- rods, mycoplasma and chlamydia), and 6 to a virus. Therapeutic success was obtained in greater than or equal to 90%. The treatment was well tolerated with fewer gastrointestinal disorders than with erythromycin. PMID- 3810101 TI - [Allergic angioedema after local dental anesthesia and a hyaluronidase-containing preanesthetic injection solution]. AB - Two patients are described who developed allergic angioedema following local anesthesia for dental surgery. Skin testing revealed that hyaluronidase from bull testes contained in one of the preparations used for local anesthesia was the responsible allergen. In both patients hyaluronidase-specific serum IgE antibodies were detected by RAST. Mammalian hyaluronidase, also called spreading factor, is believed to improve penetration of tissues by local anesthetics. It is used worldwide for this and other indications. In the presence of allergic reactions to local anesthetics the possibility of sensitization to hyaluronidase should be considered. PMID- 3810102 TI - [Acute myocardial infarct after prophylactic administration of low doses of heparin-ergotamine: coronary artery spasm the cause?]. AB - There have been several recent publications reporting vasospastic complications under heparin-dihydroergotamine prophylaxis. We report on 2 patients without significant coronary artery stenosis who died of acute myocardial infarction. Both patients had been operated on for a lumbar disc protrusion and were treated with 2500 IU heparin + 0.5 mg dihydroergotamine s.c. twice daily. The possibility of coronary arterial spasm as the cause of the myocardial infarctions is discussed. Publications reporting cases with myocardial infarctions, presumably caused by coronary arterial spasm, and other vasospastic complications under ergotamine therapy are briefly reviewed. PMID- 3810103 TI - [Epidermoid cancer of the upper respiratory and digestive tracts]. AB - Early diagnosis of cancer of the upper aerodigestive tract is possible provided that high risk patients are recognized and their symptoms correctly interpreted, screening endoscopy of the whole squamous cell oropharyngo-oesophageal mucosa and of the tracheo-bronchial tree is performed in every high risk patient presenting the slightest symptoms related to the upper aerodigestive tract, the general practitioner is aware of the limits and pitfalls of the various possible investigation methods (barium swallow, CAT, fine needle biopsy of lymph-nodes, and endoscopy). PMID- 3810104 TI - [Hippel-Lindau syndrome: morphology and immunohistochemistry of tumors related to this syndrome]. AB - Hippel Lindau syndrome (HLS), inherited as a simple dominant trait, is characterized by angiomatosis in the brain and retina, and also by cysts and tumours in various abdominal organs. Microscopically there is a striking morphological similarity between some of these tumours and especially between those in the brain (hemangioblastomas) and in the kidneys (renal cell carcinomas). Biopsy and autopsy material from two patients with HLS was examined chiefly by immunohistochemical methods, to investigate further the origin of these tumours. The cerebral hemangioblastomas of both patients showed tumour cells with a positive immunohistochemical reaction for neuron-specific enolase (NSE), suggesting a neural or neuroendocrine origin, while corresponding investigation of the kidney tumours did not produce similar clear results. Systemic immunohistochemical investigation of all tumours related to this syndrome is recommended. PMID- 3810105 TI - [Moral decay, degeneration of law and insurance]. PMID- 3810106 TI - [Exertion-induced anaphylaxis]. AB - The syndrome of exercise induced anaphylaxis represents a distinct form of physical allergy. This syndrome and the features which distinguish it from other forms of physical allergy are discussed in the context of 10 case reports. The symptoms usually start after 5-30 minutes' exercise with cutaneous pruritus, warmth and progress to urticaria and angioedema. In 3 cases signs of laryngeal edema were present; additional manifestations included upper respiratory distress, gastrointestinal tract symptoms and collapse. The syndrome is distinct from exercise induced asthma or cholinergic urticaria. One patient had both cholinergic urticaria induced by stress, heat and exercise, and anaphylactoid symptoms induced by exercise alone. While the symptoms of cholinergic urticaria subsided after 2-4 hours, the anaphylactoid symptoms lasted up to 48 hours. The symptoms are elicited irregularly, which suggests a multifactorial trigger mechanism. The intake of particular foods or acetylsalicylic acid, and certain weather conditions, are possible cofactors. In 8 of 10 patients an atopic diathesis was found but no exposition to a specific allergen, which could explain the symptoms, was observed. Therapy consists of avoidance of cofactors, change of training habits and cessation of exercise as soon as prodromal symptoms develop. If attacks are frequent, antihistamines or ketotifen can be tried. The acute attack should, like other anaphylactoid reactions, be treated by antihistamines, injection of epinephrine (s.c.) and infusions (colloidal solutions). PMID- 3810107 TI - [HbA1/HbA1c determination: current status and practical significance]. PMID- 3810108 TI - [HbA1c determination in capillary blood]. AB - A practical procedure is described for the determination of HbA1c in capillary blood collected in micro-hematocrit-capillaries. These blood samples can be mailed to the analytical laboratory prior to consultation with the physician. The results of such determinations in 23 juvenile diabetic patients obtained during a two-year observation period are presented. PMID- 3810109 TI - [Treatment of arrhythmia by intracardiac electrocoagulation]. AB - Since July 1982, 12 patients have undergone catheter ablation for refractory arrhythmias. The ablated pathway was the His bundle in 8 patients, an accessory pathway in 3 patients and a ventricular reentrant circuit in 1 patient. The 8 patients in whom the His bundle was ablated comprised 3 cases of atrial flutter, 3 cases of atrial fibrillation, 1 case of atrio-ventricular tachycardia and 1 case of junctional reentrant tachycardia. Results were complete heart block in 6 of these cases, right bundle branch block and first degree a-v block in 1 case and first degree a-v block in the last case. A pacemaker was implanted in 7 patients. The total amount of energy used varied from 50 to 400 joules. In none of these 3 patients did tachyarrhythmia recur. The 3 cases with ablation of the accessory pathway comprised one success, one partial success and one failure. The energy used was 60 to 100 joules. The patient treated for ventricular tachycardia has had no new episodes of tachycardia 4 months after the procedure. The energy used was 200 joules. The mean follow-up for the 12 patients is 12 +/- 7 months. Apart from 2 episodes of thrombophlebitis, no serious complication was noted. Catheter ablation technique is a new and effective treatment for refractory supraventricular tachyarrhythmias. Concerning ventricular arrhythmias, our experience is not sufficient to allow conclusions to be drawn. PMID- 3810110 TI - [Toxoplasmosis in cats--occurrence and diagnosis in the small animal clinic]. PMID- 3810111 TI - [The fecundity of mares in rural veterinary practice]. PMID- 3810112 TI - [Amount of training and endurance of 4358 participants in a 16-km running competition. The '84 Berne running study]. PMID- 3810113 TI - [Running for one's health]. PMID- 3810114 TI - [Significance and value of lactate levels in runners during treadmill tests]. PMID- 3810115 TI - [Sport injuries in badminton]. PMID- 3810117 TI - Marriage, motherhood and research performance in science. PMID- 3810118 TI - Hunger in the U.S. PMID- 3810116 TI - [Casualties in the Alps: epidemiology]. PMID- 3810120 TI - Electrophysiological studies on the termination sites of double projection spinal dorsal horn neurons in the cat. AB - Some projection neurons in laminae III, IV and V of the feline lumbar dorsal horn have been found to be antidromically driven from stimulation of both the ipsilateral cervical dorsal and dorsolateral funiculi that are well-dissected and insulated from one another. No detectable responses can be evoked from these neurons when stimulation is applied to sites rostral to the lateral cervical nucleus and the dorsal column nuclei, suggesting that the dorsal and dorsolateral funicular branches of these neuron's axons terminate in the lateral cervical nucleus and the dorsal column nuclei, respectively. The results indicate that these neurons are an intersection set of the spinal cervical tract (SCT) and dorsal column postsynaptic (DCPS) neurons and have been thus named spinal cervical tract-dorsal column postsynaptic (SCT-DCPS) neurons. PMID- 3810119 TI - Origin of monoaminergic innervation of the nucleus raphe magnus--a combined monoamine histochemistry and fluorescent retrograde tracing study in the rat. AB - By the use of the fluorescent retrograde tracer, Fast Blue (FB), in combination with monoamine fluorescence histochemistry, the origin of monoaminergic input to the region of the nucleus raphe magnus (NRM) was investigated in the rat. After microinjection of FB into the NRM, a great number of FB-labeled NA-containing cells were found in the region of the nucleus reticularis lateralis (corresponding to A1 NA areas), the reticular formation just dorsolateral to the nucleus olivaris inferior (corresponding to the A3 NA area), the ventral part of the locus coeruleus (A6 NA area), and the lateral parts of the nucleus raphe dorsalis (B7 area). In the other NA cell groups of the brain stem, FB-labeled cells could not be observed. Serotoninergic input originating from nucleus raphe obscurus (B2), nucleus raphe pallidus (B1) and nucleus raphe pontis (B5-B6) to the NRM was also observed. A large number of cells containing serotonin (5-HT) in the B2 and B6 areas were labeled by FB, while only a few FB-labeled 5-HT cells in B8, B9 were seen. In addition to the FB-labeled monoaminergic (NA and 5-HT) cells, many FB-labeled non-monoamine containing neurons were observed in the nucleus olivaris inferior and various parts of the reticular formation (FR), particularly in the reticular formation of the pons. In conclusion, our study has extended wider the previous HRP finding. It is shown that the NRM receives noradrenergic, serotoninergic and non-monoaminergic innervation from many regions of the brain stem. The afferent projections containing different neurotransmitters provided an important structural basis for studying the function of the NRM. PMID- 3810121 TI - Characterization and quantitation of vasopressin metabolites in the rat brain by specific radioimmunoassay and high-pressure liquid chromatography. AB - The content of endogenous vasopressin (AVP1-9) and its metabolites in rat's various brain areas and pituitary gland was investigated by the combination techniques of high pressure liquid chromatography (HPLC) and radioimmunoassay (RIA). In addition to the AVP1-9, several compounds with C-terminal AVP immunoreactivity were detected in hypothalamus, hippocampus, amygdala, medulla oblongata and septum. The C-terminal AVP1-9 metabolites were virtually absent in the pituitary gland. In view of the highly potent and selective effects on memory processes of AVP metabolites, some endogenous AVP metabolites in the brain may play an important role in the central nervous system (CNS) function. PMID- 3810122 TI - The biphasic effects of some opiates and opioid peptides on the rat vas deferens. AB - It has been found that the effects of opiates and opioid peptides on RVD are of two types. Compounds of the first type such as Etor, Eton, fentanyl and prodine derivatives, Met- and Leu-Enk and DADL are biphasic in nature. At lower concentrations (10(-8)-10(-5) M) they have inhibitory effects and at higher concentrations (10(-5)-10(-4) M) they are excitatory. Compounds of the second type, such as Mor, benzomorphan derivates, Cyc and SKF and the antagonist Nx have virtually no or only weakly inhibitory effects but may antagonize the inhibitory effect produced by the first group of compounds at lower concentrations. MC belongs to the second type, but it cannot antagonize the inhibitory effect of beta-End. The results are discussed in terms of multiple receptors, the high and low affinity binding sites, and the interrelationship between receptors. PMID- 3810123 TI - Concentrations of arsenic in urine of the general population in Sweden. AB - The concentration of the sum of the metabolites of inorganic arsenic (inorganic arsenic, methylarsonic acid and dimethylarsinic acid) as well as the concentration of organic arsenic compounds, mainly in the form of arsenobetaine, in the urine of human subjects from two cities in Sweden have been studied. The median concentration of metabolites of inorganic arsenic was approximately 8 micrograms As/g creatinine, independent of place of residence, sex, smoking and consumption of beer and wine. However, subjects who frequently ate flatfish and crustacea had somewhat higher (1.5 times) concentrations than those who very seldom ate such food. Flatfish, mainly in the form of plaice, and crustacea were found to be the main source of organic arsenic compounds. Subjects eating this type of seafood more than once a week had approximately 40 micrograms organic As/g creatinine (median value), compared with about 12 micrograms organic As/g creatinine in subjects who very seldom ate it. Other types of seafish or freshwater fish did not give rise to elevated concentrations of arsenic in the urine. The total range of organic arsenic compounds in urine was less than 1 to 525 micrograms As/g creatinine. PMID- 3810125 TI - The ratio of lead-210 to polonium-210 in U.K. diet. AB - The levels of the natural radionuclides, 210Pb and 210Po, in U.K. diet have been measured previously. However, in the earlier measurements, the samples were sufficiently aged for 210Pb and 210Po to have attained secular equilibrium. In order to determine the extent of disequilibrium between these radionuclides in fresh food, measurements have been made on recently collected dietary samples. Disequilibrium has been observed in five food groups. The activity per unit mass of 210Pb was found to be greater than that of 210Po in bread, cereals, sugar and preserves, whereas the opposite was found to be true for eggs and beverages. When account is taken of consumption rates, however, the total intakes of 210Pb and 210Po from these food groups are approximately the same. The annual effective dose equivalents from the ingestion of 210Pb and 210Po have been re-estimated at 41 and 12 mu Sv, respectively. PMID- 3810124 TI - Trace metals in scalp hair of children and adults in three Alberta Indian villages. AB - This study examined trace metal levels in scalp hair taken from 122 children and 27 adult residents of three small northern Alberta (Canada) Indian villages, one of which is situated close to the world's first tar sands oil extraction plants. The three communities studied were: Fort McKay (the exposed village), Fort Chipewyan (also in the tar sands ecosystem but distant from the plants), and Garden River (not in the tar sands ecosystem). Inductively coupled argon plasma emission spectroscopy was used to determine hair sample metal content. Nineteen metals were included in data analysis. Children from Fort McKay had the highest average hair lead, cadmium and nickel levels. Chromium levels were approximately equal in hair from Fort McKay and Garden River children, and significantly elevated above levels found in the hair of Fort Chipewyan children. Children from Garden River showed highest hair levels of eight metals: vanadium, aluminum, iron, manganese, barium, zinc, magnesium and calcium. Fort Chipewyan children had the highest hair levels of copper, but the lowest levels of all other metals. Among adults, hair lead, nickel and cadmium levels were highest in Fort McKay residents, while phosphorous and vanadium were highest in hair from Garden River residents. Bioaccumulation of lead, cadmium, nickel and chromium in hair from Fort McKay residents may be related to exposure to extraction plant pollution. Plant stack emissions are known to contain appreciable amounts of lead, nickel and chromium. Spills into the Athabasca River, until recently the source of Fort McKay drinking water, have been reported from plant wastewater holding ponds, known to contain elevated levels of lead, nickel and cadmium. An increased number of significant metal-metal correlations in hair metal levels for Fort McKay children suggests a richer source of multiple metal exposure, relative to children in the other two communities. PMID- 3810126 TI - Cadmium in edible crabs (Cancer pagurus L.) from Scottish coastal waters. AB - Concentrations of cadmium in the hepatopancreas (0.1-61.3 mg kg-1), gonad (0.15 11.0 mg kg-1) and gills (0.2-10.7 mg kg-1) of the edible crab Cancer pagurus L. from 16 sampling sites round the Scottish coast are reported, and compared with published elevated concentrations in crabs from the Orkney Islands. Geographical variations in the distribution of cadmium between organs indicate that the dietary uptake of cadmium is predominant in northern mainland and Orkney crabs, but that uptake from the water is more important in the south of Scotland. Mean dissolved cadmium concentrations in eastern coastal water increase from approximately 10 ng dm-3 in northern waters to approximately 25 ng dm-3 in the south. It seems likely that a regional contamination of the environment by cadium of geological origin occurs in the extreme north coast of Scotland, and in the Orkney and Shetland areas. PMID- 3810127 TI - Chemical qualities of water that contribute to human health in a positive way. AB - The emphasis on harmful substances that may occur in potable waters has almost obscured the fact that important beneficial constituents are commonly present. The chemical substances in water that make positive contributions to human health act mainly in two ways: (i) nutritionally, by supplying essential macro and micro elements that the diet (excluding water) may not provide in adequate amounts (for example, Mg, I and Zn); and (ii) by providing macro and micro elements that inhibit the absorbtion and/or effects of toxic elements such as Hg, Pb and Cd. Specific examples of these beneficial effects will be given, also examples of harmful effects on health that may result from excessive intake of these ordinarily beneficial elements. Because concentrations of the essential macro and micro elements that occur in natural, potable waters vary greatly, depending upon their source, geographic considerations are very important in any studies attempting to relate water quality to health. In this context, the inverse relationship between hard water and cardiovascular disease will be discussed. Specific data relating hardness and Mg and Ca content of potable waters to specific geographic regions of the U.S.A. will be presented. These data show a strong positive correlation between low Mg content and decreased longevity, and between high Ca and Mg content and increased longevity. In the regions considered, increased longevity correlates strongly with decreased cardiovascular mortality, and the decreased longevity with increased cardiovascular mortality. PMID- 3810128 TI - Evaluation of trace elements in human lung tissue. I. Concentration and distribution. AB - The lungs of eight individuals were investigated for 27 elements by neutron activation analysis and atomic absorption spectrometry. Thirteen segments of each lung pair were analyzed, together with hilar lymph nodes. The trace element distribution in the lungs and the inter-individual concentration differences reveal the existence of two groups of elements. A similar situation is observed in the lymph nodes. The elements Br, Cs, Cu, K, Na, Rb, Se and Zn are relatively homogeneously distributed over a lung pair and show little inter-individual concentration differences. On the other hand, Cd, Co, Cr, Pb, Sb, Sc and V are very inhomogeneosly distributed. The inhomogeneity and the concentrations increase with age. The existence of a concentration gradient within the lung and of relatively higher levels in the lymph nodes point to an enrichment in the lung tissue by inhaled atmospheric contaminants. PMID- 3810129 TI - Evaluation of trace elements in human lung tissue. II. Recovery and analysis of inhaled particulates. AB - Inhaled particulate material, deposited in the lungs of eight Belgian individuals, is differentiated from the tissue with a digestion procedure using the enzyme ficin. This method is simple and efficient and yields a small amount of insoluble dust. The total element concentration of the tissue samples was determined by neutron activation analysis. The radioactive residues obtained after the digestion of the tissue were counted and are considered to represent the insoluble dust fraction. A major part of the Co, Cr, Sb and Sc was recovered in the residues, but only small fractions of the Cs, Rb and Zn. These findings confirm the assumption that Co, Cr, Sb and Sc are enriched in the lungs as a result of the accumulation of atmospheric contaminants. Further proof can be derived from the analogy between the elemental composition of the residue and that of atmospheric particulate matter collected in Belgium. PMID- 3810130 TI - Evaluation of trace elements in human lung tissue. III. Correspondence analysis. AB - The concentrations of 22 trace elements in 13 segments of both lungs of eight individuals were subjected to correspondence analysis, a display method based on principal components analysis. Sample groups were isolated which coincide with the age of the individuals. The firmness of the clusters decreased however with aging. The elements Br, Cd, Co, Cr, Cs, Pb, Sc, Se and V had the most important influence on the grouping. It can be assumed that they are enriched in the tissue by inhaled particulate matter, deposited and accumulated in an insoluble form. The correlation between the elements is proof for their similar behaviour in the lungs: Co, Cr, Sb, Sc and V have a long biological half-life in the tissue, whereas Zn and K are easily removed. PMID- 3810131 TI - Lead fragments in tissues from wild birds: a cause of misleading analytical results. AB - Seriously damaged eider ducks (Somateria mollissima) and long-tailed ducks (Clangula hyemalis) were shot in connection with an oil spill in 1974. Liver and kidney tissues were analyzed for environmental pollutants and lead analysis gave irreproducible results. By means of X-ray photographs, X-ray-dense particles could be observed in the tissues. The foreign particles were extracted by dissolution of the organ tissues in Soluene-350 (Packard Instruments Co. Inc) and then washed with toluene. The insoluble particles consisted of lead and bone splinters of varying size. The form of the former ranged from irregular fragments to dust, and arose by disruption of lead pellets upon collision with bone tissue. Birds shot with lead pellets should not be used for lead determination unless careful X-ray investigations are made prior to the chemical analysis. Determinations should be made on at least two different samples of the tissue examined. PMID- 3810133 TI - Man's role in changing the global environment. Papers presented at an international conference. Venice, Italy, 21-26 October 1985. Part A. PMID- 3810132 TI - Interrelationships between the concentration of magnesium, calcium, and strontium in the hair of Japanese school children. AB - Inductively coupled atomic emission spectrometry was used for the determination of magnesium, calcium and strontium in the hair of Japanese school children (7-15 years of age, 158 males and 184 females). Sex-related differences in the levels of the three alkaline earth metals were observed (T-test, p less than 0.001). Geometric means (SD) of the concentrations of magnesium, calcium and strontium were 30.40 (1.42), 326.3 (1.62) and 0.509 (2.04) micrograms g-1 for males and 61.21 (1.73), 643.4 (1.57) and 2.749 (2.14) micrograms g-1 for females. For both sexes, significant positive correlations were observed between all concentration pairs of the three elements. The concentration ratios between any two of the three elements were also determined. The geometric mean of the concentration ratio of calcium to magnesium for males [10.73 (1.54)] is not significantly different from that for females [10.51 (1.40)] (T-test, p greater than 0.05). On the other hand, concentration ratios of magnesium to strontium [59.71 (1.99)] and calcium to strontium [640.9 (1.74)] for males are significantly higher (T-test, p less than 0.01) than those for females [22.27 (1.60) and 235.9 (1.65)]. The logarithmic-transformed ratio of magnesium to strontium has a strong positive correlation with the transformed ratio of calcium to strontium [r = 0.9529 (p less than 0.001) for males and r = 0.7284 (p less than 0.001) for females]. PMID- 3810134 TI - The impact of gasoline lead on man blood lead: first results of the Athens lead experiment. AB - Taking advantage of a prescribed reduction of the lead content of gasoline, the Athens Lead Experiment attempts to derive the fraction of blood lead due to gasoline lead in Athens subjects. The first results of the study, which is planned to continue until Spring 1986, are presented. PMID- 3810135 TI - Pesticide pollution of soil, water and air in Delhi area, India. AB - In India organochlorine insecticides such as DDT and HCH constitute more than 70% of the pesticides used at present. Its continued use has given interest to monitor for the last few years the extent of organochlorine insecticide residues in soil, water, air and rain water in Delhi area. Out of the 50 samples each of soil and earthworms collected from different parts 48 samples showed that soil and earthworms contained 0-2.61 and 0-37.74 mg Kg-1 of total DDT residues respectively. The area near the vicinity of the DDT factory showed high levels of DDT residues. A two-year survey of the Yamuna river in Delhi showed that water contained an average of 0.24 ug L-1 and the bottom sediment had 0.24 mg Kg-1 of total DDT residues. The fishes collected from the Yamuna river showed very high bioaccumulation of DDT residues. The air and rainwater samples monitored from 3 different areas for two years indicated that DDT was more near the DDT factory area while HCH was more near a commercial complex. These results indicate that the overall organochlorine-residue levels in Delhi is not alarming. It probably indicates that DDT and HCH are more rapidly dissipated and degraded in a tropical country like India. PMID- 3810136 TI - Mercury in neonatal scalp hair. AB - Total mercury levels (TML) were determined in 141 samples of maternal head and pubic hair and neonatal scalp hair. The mean mercury contents of maternal head and pubic hair were 1.88 and 1.10 mg kg-1, respectively, while the mean TML of neonatal hair was 0.11 mg kg-1. A statistically significant correlation was found between TMLs in neonatal and maternal hair. Significant inverse correlation was observed between the mercury concentration in the hair of a newborn and its birth weight. Reported findings provide evidence that the neonatal scalp hair mercury level may be a useful indicator of intrauterine exposure to mercury. PMID- 3810137 TI - Lead, mercury, cadmium and selenium in two species of gull feeding on inland dumps, and in marine areas. AB - The influence of the foraging area on the intake of trace elements was evaluated in tissues of two species of gull: the black-headed gull (Larus ridibundus) and the herring gull (Larus argentatus). Mercury levels were higher in birds from the coastal environment than in those caught on inland dumps; birds found at one dump site showed high levels of lead. Interspecific differences in the levels of mercury and cadmium are discussed. PMID- 3810138 TI - The quantities of cadmium, lead, mercury and arsenic entering the U.K. environment from human activities. AB - This paper presents an estimate of the quantities of cadmium, lead, mercury and arsenic entering the U.K. environment from human activities. Discharges are divided into three source categories: the production and use of the elements, inadvertent sources and various waste disposal practices. The major atmospheric sources of cadmium and mercury include refuse incineration, nonferrous metal production, iron and steel production, fossil fuel combustion and, for mercury alone, the chlor-alkali industry. In contrast, lead and arsenic each have only one major atmospheric source: petrol and coal combustion, respectively. The largest inputs of cadmium, lead and mercury to landfill arise from the disposal of municipal wastes; for arsenic, ash disposal from coal combustion is more important. Industrial activities represent the major sources of trace element input to the U.K. sewage system but domestic sources are important for lead and cadmium, while road run-off makes a considerable lead input. In U.K. coastal waters the major sources of cadmium are the direct discharge of sewage and industrial effluents. For the other elements, the dumping of solid wastes is of more significance. The largest inputs of lead, mercury and arsenic to U.K. agricultural land arise from atmospheric deposition; for cadmium the application of phosphate fertilizers is a more important source, while sewage sludge can be of local significance. PMID- 3810139 TI - Selenium in Japanese baby foods. AB - The selenium content of various baby foods was determined by spectrofluorimetry. Mean levels of Se (ng ml-1) decreased in the sequence: pasteurized cow's milk (28.4) greater than raw cow's milk (23.1) greater than mature human milk (22.5) greater than milk-based infant formulae (6.6). The sequence of mean values of Se (ng mg-1 protein) was: human milk (1.57) greater than raw cow's milk (0.96) greater than infant formulae (0.37). Dietary Se intake (microgram day-1) of 3 month old infants fed on infant formula and various milks decreased in the order: human milk (21.0) greater than pasteurized cow's milk (18.9) greater than raw cow's milk (15.0) greater than infant formulae (5.4). There was a significant positive correlation (r = 1.00, p less than 0.001) between the Se content of the infant formula product and that of the pasteurized milk product of three manufacturers. Hot air treatment reduced the Se content of cow's milk with increasing temperature and time of heating: loss of Se amounted to 11.1% at 210 degrees C for 25 min. The Se content of human milk was positively correlated (r = 0.64, p less than 0.001) with its protein content and negatively correlated (r = 0.77, p less than 0.01) with its fat content. These correlations were not found for infant formulae. PMID- 3810140 TI - Ultimate biodegradation of 2-, 3- and 4-nitrotoluene. AB - The biodegradation of 2-, 3- and 4-nitrotoluene was investigated in a simple laboratory test. All three isomers are shown to be biodegradable in a die-away test after adaptation of the inoculum, though different results were obtained with different types of activated sludges used as inoculum in the static test. The adaptation procedure, employed in this study, was a modification of a test method described by Pitter in 1976. It appeared that adaptation in a semi continuous activated sludge system was most successful when a composite sludge was used consisting of activated sludge from a communal sewage plant and an extract of river mud. meta-Nitrotoluene was more resistant to attack by a mixed population of aquatic micro-organisms than the other isomers. The procedure used in this study is proposed as an attractive alternative for those methods which are recommended by the OECD and the EEC, to test the so-called 'inherent biodegradability'. PMID- 3810141 TI - Lead pollution from the external redecoration of old buildings. AB - Lead concentrations before, during and after external redecoration have been measured in seven school playgrounds. All playgrounds showed increases in lead concentration during redecoration but the extent of contamination and duration varied enormously. The geometric mean lead value per school playground, taken on the day of the highest concentration during redecoration, ranged from 370 to 53000 micrograms g-1. The two post-war schools had significantly lower lead in dust concentrations than the other older schools. PMID- 3810142 TI - A study of the persistencies of SO2 concentrations exceeding limit values in the ambient air of an urban area. AB - This study of the persistencies of SO2 concentrations takes the parameters of the SO2 frequency distributions as a basis. A scheme is proposed for their calculation which allows the forecast of SO2 pollution episodes. PMID- 3810143 TI - Seasonal variation of copper and zinc concentrations in the oyster Saccostrea cuccullata from the Dampier Archipelago, Western Australia: implications for pollution monitoring. AB - The intertidal rock oyster Saccostrea cuccullata, sampled at eight sites on eight occasions over a 1-year period, contained mean Cu and Zn concentrations ranging between 34 and 267 and 206 and 4078 mg kg-1 dry weight, respectively. In the study area, Cu and Zn emanate from sewage and boat slips (antifouling paints), while Zn probably also originates from coolant water from an electricity power generating station and iron ore exporting facilities. Highest oyster wet weight, Cu and Zn concentrations and loads occurred in January (spawning period), indicating that metal variation was not reciprocating wet weight. Lowest metal concentrations and loads occurred in October (period of onset of gametogenesis), while lowest wet weight occurred in April (post-spawning period). No significant (P less than 0.001) variation in the wet to dry weight ratio was noted temporally. However, significant, though slight, variation was noted between polluted and unpolluted oysters. Results of this study indicate that pollution control monitoring programs should consider: seasonal variation of metal concentrations; portion of the year during which standards are exceeded; oyster size and availability for human consumption; suitability of standards where shellfish are not consumed as a staple diet; appropriate size indicies which can be used for selecting specimens for intersite comparisons; wet to dry weight calculations: techniques, spatial and temporal variations; and the physical dynamics of sites used. PMID- 3810144 TI - The Chernobyl accident--radionuclide fallout in S.W. England. AB - Initial fallout data from the nuclear reactor accident at Chernobyl is presented for the Plymouth region of Devon S.W. England which received low levels of radioactivity. During the period of maximum fallout the overall gross gamma activity for the Plymouth area was approximately 10% higher than levels recorded prior to the Chernobyl accident. The increase in levels of radioactivity were within the variability of natural background found in local houses. PMID- 3810145 TI - Isolation of mutagenic components by high-performance liquid chromatography from XAD extract of water from the Nishitakase River, Kyoto City, Japan. AB - In order to determine the concentrations of mutagenic pollutants in water samples taken from the Nishitakase river in Kyoto City, Japan, the organic fraction was concentrated by XAD adsorption followed by elution with ethyl ether. Salmonella typhimurium tester strains TA1538 and TA98 were used fro detecting mutagenic activity. Mutagenic fractions, separated by a liquid-liquid fractionation and two consecutive runs with thin layer chromatography (TLC), were analysed using high performance liquid chromatography (HPLC). The results obtained indicated that at least six different frameshift mutagens, all requiring metabolic activation, were present in the river water. Interestingly, all the mutagens isolated showed more pronounced mutagenic activity in TA1538 than in TA98, which is known to be more sensitive for most frameshift type mutagens. PMID- 3810146 TI - Ammonia, hydrogen sulphide and methyl mercaptides in Finnish municipal sewage plants and pumping stations. AB - Ammonia, methane, hydrogen sulphide and methyl mercaptides were analyzed in the atmospheres of 16 Finnish municipal waste water treatment plants and in 18 pumping stations. The sulphides were analyzed on site as it was found that, with the standard 0.5-l laminated plastic bags, significant amounts of the vapours were lost from the gas phase. The relative humidity of the sampled air was the most likely cause. Under normal operating conditions, sulphides varied from less than 0.07 to 53 micrograms l-1, with highest concentrations found at the sludge presses. Pumping stations had sulphide vapours from 0.07 to 0.5 microgram l-1. The presence of ammonia (0.007-3.5 micrograms l-1) and methane (0.7-18 micrograms l-1) confirmed the hypothesis of the anaerobic origin of the offensive gases. Although more effective ventilation without scrubbing the emission gases would reduce the health hazard in the plants it would burden the environment. PMID- 3810147 TI - In search of biomonitors for cadmium: cadmium content of wild Swedish fauna during 1973-1976. AB - Forty-five species of birds and 22 species of mammals of the terrestrial and aquatic fauna, herbivores as well as carnivores, were investigated during the period 1973-1976 for cadmium-accumulating properties in order to find biomonitors for cadmium in the Swedish environment. The herbivores of the terrestrial fauna, birds as well as mammals, are preferred to carnivores, since they demonstrate generally higher renal Cd levels. The moose (Alces alces), roe deer (Capreolus capreolus) and hare (Lepus europeus and Lepus timidus) were found to be suitable as biomonitors because of their common occurrence and uniform geographical distribution. The eider duck (Somateria mollissima), although a short-distance migrating bird whose diet is composed mainly of mussels and crustaceans, and which lives along a great part of the Swedish coastline, is suggested as a biomonitor of cadmium for the aquatic environment. The accumulation rate of cadmium in the kidneys is rapid. Renal levels of cadmium in the parts per million range are reached 10 weeks after hatching. Juvenile birds should be collected for monitoring purposes before leaving their feeding domains at the end of the summer. PMID- 3810148 TI - Atmospheric pollution in the Venice area. II. Iron, manganese, lead, vanadium and cadmium in suspended particulate. AB - The average yearly and semestral concentrations of some metals (Fe, Mn, Pb, V and Cd) contained in the suspended particulate of three different sites in the Venice area, are presented. The 24-h concentrations of the five metals fit a log-normal distribution. The correlation coefficients between metals, and between metals and sulphur dioxide, suspended particles, and sulphates are also reported; they are very high in the insular zone (historical centre of Venice). This is not found for cadmium, which shows a different behaviour with respect to the other metals. Cadmium is the only pollutant studied whose concentration is higher in the insular urban zone than in the industrial and urban zones of the mainland. PMID- 3810149 TI - Daily intake of thorium by an Indian urban population. AB - Thorium intake by an urban group (Bombay) has been estimated using neutron activation followed by simple chemical separation. Daily intake of thorium via all the three sources: food, water and air, is reported in this paper. The major contribution of thorium to intake is through food (2.0 micrograms), followed by water (0.02 microgram) and air (0.02 microgram). The individual food ingredients such as cereals, pulses, vegetables, milk, etc. were also analysed for their thorium content. The cereals were found to contribute most to the daily intake. PMID- 3810150 TI - Genetic selection of homozygote allozyme genotypes in marine gastropods exposed to cadmium pollution. AB - Five species of marine gastropods (Monodonta turbinata, M. turbiformis, Cerithium scabridum, Littorina punctata and L. neritoides) were exposed to cadmium in the laboratory. The enzyme phosphoglucose isomerase (PGI) tested electrophoretically showed for all five species a statistically significant higher proportion of heterozygotes among the dead animals than among the survivors in the range of concentration tested. This pattern seems to have been established by natural selection. Further, it could be used in developing biological monitors of present and past cadmium pollution based on the genetic response of natural populations to this specific pollutant. PMID- 3810151 TI - Mercury vapour levels in a domestic environment following breakage of a clinical thermometer. AB - Following the breakage of a clinical thermometer in the kitchen of the author's own home, mercury vapour was found to be present in most rooms, but not in concentrations which exceeded the current threshold limit value (TLV). However, assuming a more stringent standard of safety, based on continuous exposure to mercury vapour, it was noted that some of the readings could be considered to be excessive, although these were of a freakish and transient nature. In reality the overall time-weighted average exposure of the occupants was within reasonable limits. Lack of ventilation was a major factor in maintaining discernible levels of vapour over a 3-week period. However, the advent of mild weather was instrumental in dispersing the vapour, by allowing the opening of windows. The residual mercury on the floors would seem to have evaporated, so that no long term health risk ensued. Cross contamination of the hallway carpet was noted indicating that mercury had been transported on the soles of feet and shoes. PMID- 3810152 TI - Chemistry of tropical marine ecosystems. Proceedings of the First International Conference. Rio de Janeiro, Brazil, 27-30 August 1985. PMID- 3810153 TI - Psychiatric diagnoses. PMID- 3810154 TI - Oxygen free radicals linked to many diseases. PMID- 3810155 TI - Evaluation of intrinsic binding energy from a hydrogen bonding group in an enzyme inhibitor. AB - This and two accompanying reports describe the intrinsic binding energy derived from a single hydrogen bond between an inhibitor and an enzyme. The results were obtained by comparing matched pairs of inhibitors of the zinc endopeptidase thermolysin that bind to the enzyme in an essentially identical manner but differ in the presence or absence of a specific hydrogen bond. This report describes five phosphorus-containing analogs of the peptides carbobenzoxy-Gly-Leu-X, in which the Gly-Leu peptide linkage is replaced with a phosphonate ester (-PO2(-)-O ). Values for the inhibition constants of these inhibitors show a direct relation with those of the corresponding phosphonamidate analogs (-PO2(-)-NH- in place of the Gly-Leu peptide moiety), which have been characterized previously as transition state analogs. However, each phosphonate ester is bound about 840 times more weakly than the analogous phosphonamidate, reflecting the loss of 4.0 +/- 0.1 kilocalories per mole in binding energy. From these results and the crystallographic analysis in the next report, it can be inferred that the value of 4.0 kilocalories per mole represents the intrinsic binding energy arising from a highly specific hydrogen binding interaction. PMID- 3810156 TI - Structures of two thermolysin-inhibitor complexes that differ by a single hydrogen bond. AB - The mode of binding to thermolysin of the ester analog Cbz-GlyP-(O)-Leu-Leu has been determined by x-ray crystallography and shown to be virtually identical (maximum difference 0.2 angstrom) with the corresponding peptide analog Cbz-GlyP (NH)-Leu-Leu. The two inhibitors provide a matched pair of enzyme-inhibitor complexes that differ by 4.1 kilocalories per mole in intrinsic binding energy but are essentially identical except for the presence or absence of a specific hydrogen bond. PMID- 3810157 TI - Calculation of the relative change in binding free energy of a protein-inhibitor complex. AB - By means of a thermodynamic perturbation method implemented with molecular dynamics, the relative free energy of binding was calculated for the enzyme thermolysin complexed with a pair of phosphonamidate and phosphonate ester inhibitors. The calculated difference in free energy of binding was 4.21 +/- 0.54 kilocalories per mole. This compares well with the experimental value of 4.1 kilocalories per mole. The method is general and can be used to determine a change or "mutation" in any system that can be suitably represented. It is likely to prove useful for protein and drug design. PMID- 3810158 TI - Human neuroelectric patterns predict performance accuracy. AB - In seven right-handed adults, the brain electrical patterns before accurate performance differed from the patterns before inaccurate performance. Activity overlying the left frontal cortex and the motor and parietal cortices contralateral to the performing hand preceded accurate left- or right-hand performance. Additional strong activity overlying midline motor and premotor cortices preceded left-hand performance. These measurements suggest that brief, spatially distributed neural activity patterns, or "preparatory sets," in distinct cognitive, somesthetic-motor, and integrative motor areas of the human brain may be essential precursors of accurate visuomotor performance. PMID- 3810159 TI - A G1 glycoprotein epitope of La Crosse virus: a determinant of infection of Aedes triseriatus. AB - Arthropod-borne viruses (arboviruses) have specific vector-vertebrate host cycles in nature. The molecular basis of restriction of virus replication to a very limited number of vector species is unknown, but the present study suggests that viral attachment proteins are important determinants of vector-virus interactions. The principal vector of La Crosse (LAC) virus is the mosquito Aedes triseriatus, and LAC virus efficiently infects the mosquito when ingested. However, a variant (V22) of LAC virus, which was selected by growing the virus in the presence of a monoclonal antibody, was markedly restricted in its ability to infect Ae. triseriatus when it was ingested. Only 15% of the mosquitoes that ingested V22 became infected and 5% of these developed disseminated infections. In contrast, 89% of the mosquitoes that ingested LAC became infected and 74% developed disseminated infections. When V22 was passed three times in mosquitoes by feeding, a revertant virus, V22M3, was obtained that infected 85% of Ae. triseriatus ingesting this virus. In addition, V22M3 regained the antigenic phenotype and fusion capability of the parent LAC virus. These results suggest that the specificity of LAC virus-vector interactions is markedly influenced by the efficiency of the fusion function of the G1 envelope glycoprotein operating at the midgut level in the arthropod vector. PMID- 3810160 TI - Lake Tahoe mystery disease. PMID- 3810161 TI - Viewing stereo drawings. PMID- 3810162 TI - Epidemics and civil rights. PMID- 3810163 TI - Teacher training. PMID- 3810164 TI - Identification and isolation of a variant surface glycoprotein from Trypanosoma vivax. AB - The protozoan Trypanosoma vivax is one of the most important agents of African trypanosomiasis, a disease that hinders the productive use of livestock in one third of the African continent. Trypanosoma vivax is also present in the Caribbean and in South America, posing a threat to the livestock industries of the tropical and subtropical world. Much less is known of the biology of this trypanosome than of the better studied T. brucei and T. congolense. One of the variant surface glycoproteins (VSGs) of a West African stock of T. vivax was identified, purified, and partially characterized by the use of a combination of highly resolving techniques to maximize information from the relatively small amount of parasite material available. The molecular weight of the isolated protein (46,000) is smaller than that of VSGs from other species. As with T. brucei VSGs the protein from T. vivax is complexed with sugars and incorporates 3H when living trypanosomes are incubated with [3H]myristic acid, but the T. vivax molecule is more hydrophobic than the T. brucei molecule. The small size of the T. vivax VSG may have a bearing on the functional and evolutionary relationships of variant antigens in trypanosomes. PMID- 3810166 TI - Osteoporosis reexamined: complexity of bone biology is a challenge. PMID- 3810165 TI - Avian v-myc replaces chromosomal translocation in murine plasmacytomagenesis. AB - Deregulation of c-myc expression in association with chromosomal translocations occurs in over 95% of murine plasmacytomas, rat immunocytomas, and human Burkitt lymphomas. Infection with a murine retrovirus (J-3) containing an avian v-myc rapidly induced plasmacytomas in pristane-primed BALB/cAn mice. Only 17% of the induced plasmacytomas that were karyotyped showed the characteristic chromosomal translocations involving the c-myc locus. Instead, all of the translocation negative tumors demonstrated characteristic J-3 virus integration sites that were actively transcribed. Thus, the high levels of v-myc expression have replaced the requirement for chromosomal translocation in plasmacytomagenesis and accelerated the process of transformation. PMID- 3810167 TI - Textbook credits bruise psychiatrists' egos. PMID- 3810168 TI - Defect in Alzheimer's is on chromosome 21. PMID- 3810169 TI - Characterization and chromosomal localization of a cDNA encoding brain amyloid of Alzheimer's disease. AB - Four clones were isolated from an adult human brain complementary DNA library with an oligonucleotide probe corresponding to the first 20 amino acids of the beta peptide of brain amyloid from Alzheimer's disease. The open reading frame of the sequenced clone coded for 97 amino acids, including the known amino acid sequence of this polypeptide. The 3.5-kilobase messenger RNA was detected in mammalian brains and human thymus. The gene is highly conserved in evolution and has been mapped to human chromosome 21. PMID- 3810170 TI - 1987 guide to biotechnology products and instruments. Guide to scientific instruments. PMID- 3810171 TI - Gunshot wounds of the skull. PMID- 3810172 TI - Gunshot wounds of the chest and abdomen. PMID- 3810173 TI - Gunshot wounds of vessels. PMID- 3810174 TI - Gunshot fractures. PMID- 3810175 TI - [A rare case of a gunshot injury of the head]. PMID- 3810176 TI - [Value of diagnostic peritoneal lavage in blunt abdominal trauma]. PMID- 3810177 TI - [Osteosynthesis of the spine with individually adapted plate of carbon fiber reinforced polysulfone]. PMID- 3810178 TI - Portal hypertension: circulatory and renal abnormalities. PMID- 3810179 TI - Progressive non-infectious anterior vertebral fusion. AB - Four cases of progressive non-infectious anterior vertebral fusion are described. Three cases remain relatively asymptomatic, but one has developed spinal cord compression secondary to an acute angled kyphosis. The clinical, radiological, and pathological features are reviewed and some comparisons with the spinal changes in thalidomide embryopathy are made. PMID- 3810180 TI - Annulus fibrosus calcification in the cervical spine: radiologic-pathologic correlation. AB - Intervertebral disc calcification can be secondary to a variety of pathologic processes including some of the arthritides, metabolic diseases, and trauma. The annulus fibrosus is the most commonly calcified component and may mimic vertebral body fracture, limbus vertebra, or a persistent ring apophysis. We describe two young patients who developed calcification in the anterior annulus fibrosus and present radiologic-pathologic correlation in this condition in another case. This calcification may actually be secondary to subclinical or chronic stress on the involved intervertebral disc. PMID- 3810181 TI - Periosteal reaction in systemic lupus erythematosus. AB - The authors report three patients with systemic lupus erythematosus and periosteal reaction. Two of the three cases had systemic vasculitis and the third had local ischemia with ischemic necrosis. PMID- 3810182 TI - Computed tomographic anatomy of the buttock. AB - Computed tomography is an ideal method for imaging the buttock. Thorough knowledge of the anatomic structure of the buttock is necessary to accurately evaluate the many pathologic processes that originate from or extend into the buttock. A detailed review of buttock anatomy is presented here, with particular emphasis on cross-sectional anatomy as seen by computed tomography. PMID- 3810183 TI - Magnetic resonance imaging in acute tendon ruptures. AB - The diagnosis of acute tendon ruptures of the extensor mechanism of the knee or the Achilles tendon of the ankle may usually be made by clinical means. Massive soft tissue swelling accompanying these injuries often obscures the findings, however. Magnetic resonance imaging (MRI) can rapidly demonstrate these tendon ruptures. Examples of the use of MRI for quadriceps tendon, and Achilles tendon rupture are presented. PMID- 3810184 TI - Traumatic pseudoaneurysm of the anterior tibial artery simulating soft tissue malignancy. AB - Two patients presenting with false aneurysm of the anterior tibial artery are illustrated. Presentation was remote from the time of trauma and the diagnosis of neoplasm was initially considered in both because of the bony and soft tissue changes. The purpose of this report is to bring attention to the possibility of delayed vascular injury simulating tumor by describing the radiographic features of these two proven cases. PMID- 3810185 TI - Magnification radiography in osteomyelitis. AB - Osteomyelitis often eludes early diagnosis because plain film radiography is too insensitive and radionuclide bone scanning is nonspecific. In this study, 90 diabetic patients were studied with plain film and magnification radiographs of their feet. Among the 24 patients with osteomyelitis, plain radiographs suggested the diagnosis in 14 patients and magnification radiography was diagnostic in 18 of these patients. Thus, magnification radiography offers some diagnostic advantage in patients suspected of having osteomyelitis. PMID- 3810186 TI - Linear growth of the thoracic spine in chest roentgenograms from birth to 16 years. AB - The length of the thoracic spine was measured in chest roentgenograms of 331 children from birth to 16 years and standards for thoracic spine length in this age group were obtained. PMID- 3810187 TI - The development of post-traumatic cyst-like lesions in bone. AB - Cyst-like lesions in the radius and tibia were observed in two children as a post fracture event. The pathogenesis of these lesions is discussed. Cut sections from anatomic specimens display extensive hemorrhage in subperiosteal as well as endosteal and trabecular bone. Cysts arising from hemorrhagic resorption in various locales may explain the occasional atypical appearance of these lesions. PMID- 3810188 TI - Coralline hydroxyapatite bone graft substitutes in a canine metaphyseal defect model: radiographic-biomechanical correlation. AB - Radiographic and biomechanical assessment of a new type of bone graft substitute derived from reef-building sea coral was performed in a canine metaphyseal defect model. Blocks of this material and autogenous iliac crest graft were implanted, respectively, into the right and left proximal tibial metaphyses of eight dogs. Qualitative and quantitative radiographic evaluation was performed in the immediate postoperative period and at 6 months after surgery. Biomechanical testing was carried out on all grafts following harvest at 6 months, as well as on nonimplanted coralline hydroxyapatite and autogenous iliac cancellous bone. In contrast to autografts, incorporation of coralline implants was characterized by predictable osseous growth and apposition with preservation of intrinsic architecture. Greater percent increase in radiographic density, higher ultimate compressive strength, and lower stiffness with incorporation were documented advantages of coralline hydroxyapatite over autogenous graft. Densitometric measurements correlated moderately with strength for both types of graft material (r = -0.65). These promising results have important implications to the clinical application of coralline hydroxyapatite bone graft substitutes as an alternative to autogenous grafting. PMID- 3810189 TI - Coralline hydroxyapatite bone graft substitutes in a canine diaphyseal defect model: radiographic features of failed and successful union. AB - Radiographic and densitometric evaluation of a new type of bone graft substitute derived from reef-building sea coral via a hydrothermal chemical exchange process was undertaken in a canine diaphyseal defect model. Comparably sized blocks of this material and autogenous iliac cortical-cancellous graft were implanted into the respective radial diaphyses of seven dogs. Qualitative and quantitative radiographic assessment was performed during the immediate postoperative period and at 3 months following surgery. Significant complications were observed radiographically in over half of the coralline implanted limbs, including failed union, graft fracture, and loosening of internal fixation hardware. No significant difference was noted in degree of native osseous in-growth between the implants and the autografts, and the latter exhibited a higher success rate. Radiographic film densitometry was found not to be reliably predictive of coralline implant behavior in the individual case. It is concluded that coralline hydroxyapatite bone graft substitutes appear to offer no particular advantage over autogenous grafts in the management of diaphyseal defects, although further investigation is warranted since other factors may be responsible for the unfavorable findings in this study. PMID- 3810190 TI - Bone cortical mass in newborn infants: a comparison between standards in the femur and humerus. AB - The total bone width (T) and medullary width (M) of the humerus and femur of 216 and 138 Nigerian newborn infants, respectively, were measured in order to determine the normal standards for cortical bone mass in the newborn. The cortical width (C), cortical area (CA), and percentage cortical area (PCA) were calculated for each bone and correlated with gestational age and birth weight. In both the femur and humerus, the values of the cortical measurements were higher in males. The strongest correlation coefficients were obtained between T(0.84), C(0.79), and CA(0.84) and birth weight in the humerus. The correlation with gestational age was, however, similar in both bones. The values of humeral cortical width (C) obtained in this study is less than had been reported in North American white newborn infants. Cortical measurements of the humerus, which is invariably included in the newborn chest radiograph, is a more reliable method of evaluating the status of bone mineralisation than the femur. PMID- 3810191 TI - Case report 390: Tuberculous pseudotumor of the proximal end of the right tibia without obvious synovial involvement. PMID- 3810192 TI - Case report 399: Pachydermoperiostosis (primary hypertrophic osteoarthropathy). PMID- 3810193 TI - Case report 400: Unilateral fusion of odontoid to lateral mass of C1 with pseudoarthrosis on left. PMID- 3810194 TI - Case report 401: Idiopathic carpal/tarsal osteolysis (ICTO) associated with nephropathy. PMID- 3810195 TI - Case report 402: Megakaryocytic myelosis with disseminated osteolysis and osteomyelosclerosis. PMID- 3810196 TI - [The good mother: rural and urban practices related to measles in Haalpulareen women in Senegal]. AB - Anthropologists usually describe the village as a place of tradition, and the town as a place of modernity. In order to question this opposition, a study was carried out among 100 Haalpulaaren mothers (Tukulors and Fulas), 50 from a village in the Sahelian area along the Senegal River and 50 from an underprivileged suburb of Dakar. They were asked about their representations and practices related to measles, which is the first cause of mortality under 5 years of age in the urban group, and second in rural group. Although fatality rates were equivalent in both groups and even higher among village children who had been staying in town at the time of the illness, measles seems much more feared in the village where it comes by epidemics than in town where it is endemic. Moreover, causal interpretations seem to be changed by the different environment of the city where the mechanistic explanation by winds has lost its material basis and is changed into the metaphoric and magical interpretation of wind spirits. As for therapeutic practices, the study reveals a more traditional behaviour (judged on use of local remedies and immunization coverage) in the urban group than in the rural group. This paradoxical result can be explained by the existence of a subgroup of migrant women (seen in town more than in the village) who appear to resist to change and reinforce their traditional behaviours. Finally influence of castes seems to disappear in town, where therapeutic practices vary according to the level of integration into urban society (measured by use of the vehicular language).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810197 TI - Coinsurance effects on dental prices. AB - For many Americans the cost of dental services represents a barrier to receiving regular dental care and maintaining proper oral health. The recent growth of the dental insurance industry, however, may partly offset this price barrier among insureds. Our purpose is to examine the relationship between coinsurance and dental prices for 16 dental services among a sample of Pennsylvania Blue Shield (PBS) adult insureds. The dependent price measure is the annual average gross price paid for 16 specific preventive, restorative, periodontic, endodontic, prosthodontic, and surgical dental services. Independent variables in the price model include the insured's age, education, coinsurance rates, time costs, market area, non-wage income, oral health status, area dentist-population ratio and usual source of care. Data sources are 1980 PBS claims and coinsurance rate data and a mail survey of sampled insureds. OLS regression analysis reveals that the model's independent variables explain little dental price variation. No variable is consistently significant across services, but market area, coinsurance rates, and time costs alternately dominate across equations. These results suggest that, among adult insureds, coinsurance and time costs influence dental fees in a minority of dental services. Insurance reduces the patient's sensitivity to money price, and non-price factors correspondingly seem to become more important in patient search. PMID- 3810198 TI - Concern about cancer in women undergoing elective gynaecological surgery. AB - Interviews were conducted with 63 women aged 18-75 shortly after their admission to hospital for routine non-cancer gynaecological surgery. Three groups were studied: major surgery, chiefly hysterectomy, carried out for benign conditions (n = 25); minor surgery such as dilatation and curettage (n = 29); fertility investigations and sterilisations (n = 9). Women were asked whether they worried if they were suffering from seven serious illnesses including heart disease, breast cancer and gynaecological cancer (cancer of the cervix, womb or ovaries). Significantly more women were concerned that they suffered from gynaecological cancer than any other illness. When asked why they were worried, over 85% of those expressing concern believed that their current gynaecological problem stemmed from cancer. Worry about gynaecological cancer was positively associated with psychiatric status and gynaecological knowledge, and negatively with satisfaction with treatment. A link with presenting clinical symptoms was also identified. This study revealed high levels of unwarranted distress in women undergoing routine surgery. Such fears may not be allayed, since surgeons and staff may not consider cancer to be relevant to the patient's clinical condition. PMID- 3810199 TI - Vietnamese refugee children in camps in Hong Kong. AB - Vietnamese refugee children staying in an open camp in Hong Kong were interviewed to find out the nature of their war experience. The effects of war and refugee experience on their fears about being hurt or killed were assessed. Most of the Vietnamese children in the present sample travelled to Hong Kong with their family and had little experience of separation, death or injury of close family members. However, about two-thirds of them had witnessed violence and one-third reported experience of being assaulted. Children exposed to unpleasant war experience were more likely to report a fear of being hurt than those not exposed to similar negative events. However, there was no consistent finding relating other types of fear to war experience. The family and the cohesiveness of the community in which they lived may have protected them against adverse psychological reactions. PMID- 3810200 TI - Attitudes of breast-feeding mothers: a survey of 649 mothers. AB - A consecutive sample of 1525 mothers were interviewed in hospital after delivery and breast-feeders were interviewed again 12 months later at home. This paper examines the attitudes of mothers to their breast-feeding experience in terms of their enjoyment, satisfaction, embarrassment, how they would choose to feed their next baby should they have one and whether they would encourage their friends to breast-feed. Mothers' attitudes to breast-feeding were strongly associated with the number of children they had, how definite they had been during pregnancy about wanting to breast-feed, the problems they encountered whilst establishing breast-feeding and how embarrassing they found breast-feeding. The length of time mothers breast-fed was also closely associated with the views they expressed concerned breast-feeding. PMID- 3810201 TI - An examination of the relationships among interpersonal stress, morale and academic performance in male and female medical students. AB - Conflicts between medical students and persons involved in their clinical training are a common, yet little studied, source of stress for students. The study reported in this paper examined the relationships between interpersonal stress, specific to training, and measures of students' morale and academic performance during the clinical phase of medical education. The results show that although interpersonal stress was inversely related to morale in both male and female students, the relationship was stronger for females. Morale and interpersonal stress variables strongly predicted the academic performance of female students, as measured by the grades they received in clinical clerkships and their scores on the Part II examination of the National Board of Medical Examiners. The results for males were less clear-cut, as the predictor variables were significantly related to only one of the two performance measures. These findings are consistent with the view that non-cognitive factors have particular relevance for the performance of female medical students. PMID- 3810202 TI - Social life factors affecting the mortality of total Japanese population. AB - The effects of a wide variety of social life factors on the mortality of total Japanese population in 46 prefectures were analysed by stepwise regression analysis twice at a 5-year interval. Age-adjusted all-causes mortality and age adjusted cause-specific mortality from 14 major causes of death were examined. The results indicated that rural residence was the key factor affecting the mortality of total male and female populations; low income, together with old and young age groups, was another important factor for the mortality of the male population. International differences in the effects of urbanisation on mortality rates are discussed in the light of these findings. PMID- 3810203 TI - Employment and ill-health among women in Israel. AB - Recent studies carried out in the United States consistently showed employed women to enjoy better health than non-employed women. Various measures were used and a number of explanatory approaches have been advanced. The present study follows previous research and its purpose is two-fold: first, to identify several dimensions of ill-health and examine the role of employment in each; and second, to provide comparative data from Israel and thus assess the generalizability of previous findings. The analyses reported are based on a sample of 416 married women between the ages of 25 and 65 residing in urban communities south of Tel Aviv. While employment status generally had a positive effect on all measures of health, it accounted for variable portions of the differences between employed and non-employed women. Employment accounted for most of the gap in illness behavior, but only for a small portion of the difference in perceived sickness. Employment increased somewhat the likelihood of mild symptoms. These patterns are discussed in light of theoretical approaches that address the relationship between employment and health. PMID- 3810204 TI - Occupational hazards and heart attacks. AB - There has been limited research on occupation health hazards and heart disease. With the exception of the effects of noise, even less research has been conducted on occupational safety hazards, however. This study takes an initial look at interrelationships between safety hazards and heart disease. Fatal injury rates within industries are taken as proxies for safety hazards; fatal heart attack rates are taken as proxies for heart disease. Holding age, race, and gender constant evidence is found which is consistent with the hypothesis that safety hazards, through their effects on stress, either cause or exascerbate heart disease. PMID- 3810206 TI - Primum non nocere. PMID- 3810205 TI - New clinical roles for pharmacists: a study of role expansion. AB - This study assessed the legitimacy of expanded roles for pharmacists with different status audiences. Pharmacy is a profession in transition and is characterized by considerable ambiguity and uncertainty concerning its status as a health care profession. Significant changes have occurred within the profession of pharmacy in the past few decades which have led to loss of function, social power and status. The response of the profession has been a movement toward a patient-oriented, clinical role for pharmacists. Hypotheses concerning level of support for expanded roles were derived from two conflict-based models of professionalization: a power model which focuses on conflict between professions and the central role of power in defining occupational territory; and a process model which focuses on conflict of interest and diversity within a profession and the development of 'segments' which struggle for control of a profession's direction. Data were collected by self-administered questionnaires sent to California pharmacists, physicians and nurses. Respondents were asked to indicate level of support for 20 role activities for pharmacists working in two practice settings (community and hospital). Pharmacy faculty were the most supportive of the clinical role activities, followed by practicing pharmacists, nurses and physicians. Physicians and nurses were more antagonistic toward clinical activities in the community than hospital practice setting, and were most antagonistic toward role activities which require independent judgement or autonomous action relevant to patient care on the part of the pharmacist. Differences were also noted in support for clinical role activities within the pharmacists' group. The effect of experience in working with a clinical pharmacist on support for clinical role activities is also discussed. PMID- 3810207 TI - Immediate breast reconstruction after mastectomy using a permanent tissue expander. AB - We describe a new breast implant that greatly facilitates immediate breast reconstruction after mastectomy. Through a detachable filling reservoir, the implant can be filled with saline by percutaneous injection; this allows the empty implant to be placed in position and filled only after viability of the flaps is assured. Because filling can be controlled, the fear of skin flap necrosis or wound breakdown is eliminated. Furthermore, the chest wall skin can be expanded, thus avoiding the use of distant flaps. PMID- 3810208 TI - Bile reflux gastritis. AB - Bile reflux gastritis is a disabling postgastrectomy condition characterized by abdominal pain, bilious vomiting, and weight loss. The syndrome appears to be caused by free enterogastric reflux of bile and other proximal small bowel constituents. Endoscopic confirmation of bile reflux and documentation of gastritis support the diagnosis but are not specific for it. Results of medical therapy with chelating agents or drugs that promote gastric motility have been disappointing. Diet and antacids frequently aggravate symptoms. The only effective treatment is surgical diversion of bile away from the gastric mucosa. During a recent seven-year period, 15 patients had diversionary operation for bile reflux gastritis diagnosed by history and endoscopic findings. Before operation, medical management had failed to yield improvement in any case. After operation, all patients showed improvement, and pain was relieved in 85%. Based on our experience, we conclude that current medical therapy may alter but not cure symptoms of bile reflux gastritis; Roux-en-Y diversion is the treatment of choice in patients with persistent symptoms; and delayed gastric emptying is a common complication after the Roux-en-Y procedure, but in our series, the incidence was reduced by using the Tanner 19 modification. New cytoprotective agents that may offer an alternative to operation are currently being studied. PMID- 3810209 TI - Normal hearing in patients with acoustic neuroma. AB - We reviewed the cases of 614 patients who had operation for acoustic neuroma. In 38 cases, hearing was either normal or decreased symmetrically. Almost all patients had unilateral otologic complaints. All patients with unilateral otologic complaints should be evaluated for acoustic neuroma even if results of routine audiometry are unremarkable. PMID- 3810210 TI - Cochlear implant: audiometric results with a single-channel device. AB - With the FDA approval of the first cochlear implant device in November 1984, the possibility of the perception of sound became a reality for the profoundly deaf individual. The cochlear implant group of Cincinnati was involved in the coinvestigator study before the approval of the device. This paper presents data from seven patients with cochlear implants and the resulting improvement in their hearing perception, as well as a discussion about which patients can benefit from the cochlear implant. PMID- 3810211 TI - Heat of intramedullary reaming. AB - Cortical ischemia and necrosis after intramedullary reaming are well documented. Numerous authors have described ischemic changes attributed to mechanical disruption of the arterial system of the intramedullary canal. Few have investigated the potential thermal injury during extreme temperatures generated during intramedullary reaming. We reamed the medullary canal of cadaveric tibial and femoral diaphyses using a flexible shaft reaming device and stainless steel intramedullary reamer. The temperatures generated by reaming from 11 mm through 15 mm in 1 mm increments were measured after each pass. In the 17 specimens tested, we observed an incremental rise in temperature with reaming. The mean intramedullary temperature after reaming was 52 C ( +/- 8.3) with a range of 42 to 67 C. The mean extramedullary temperature was 46 C ( +/- 8.3) with a range of 36 to 59 C. There was a direct correlation between temperature increase and reamer size. Our results indicate that temperature elevations generated during intramedullary reaming are sufficient to cause thermal necrosis, and may cause delayed healing in vivo. PMID- 3810212 TI - Carcinoma of the piriform sinus. AB - Carcinoma of the piriform sinus is one of the most aggressive tumors of the head and neck region. Almost 80% to 90% of the patients will be first seen in the advanced stages. No method of treatment is satisfactory. We present results of various methods of treatment, of which the combination of surgery and radiotherapy may be the best. PMID- 3810213 TI - Positive results of endocervical curettage as an indication for conization of the cervix. AB - At University Hospital of Jacksonville (Fla) during the years 1981 through 1984, 37 patients had conization of the uterine cervix for the sole indication of dysplastic cells found on endocervical curettage. Eighteen of the 37 (48.7%) were found to have a more dysplastic lesion than that diagnosed by colposcopic biopsy. In two of the 37 (5.4%) a previously undiagnosed invasive cancer was found. We conclude that dysplastic cells found on endocervical curettage must be further evaluated with cold conization of the cervix. PMID- 3810214 TI - Caustic ingestion and its sequelae in children. AB - Management of caustic ingestion in children remains a difficult challenge, with the outcome ranging from an asymptomatic state to intractable esophageal strictures. We reviewed the cases of 56 children ranging in age from 10 months to 5 years treated from 1973 to 1984 at the University of Florida. For children seen primarily at our institution, initial management consisted of prompt endoscopy and early institution of steroids and antibiotics. Esophageal burns were confirmed in 37 patients, 21 (56.75%) of whom subsequently had esophageal strictures of varying severity. In seven patients, limited esophageal strictures were managed successfully by dilation, but 14 children with multiple strictures required eventual esophageal replacement. Substernal right colonic interposition was tolerated well by these patients, with few complications, and their growth and development have been satisfactory over follow-up periods ranging from nine months to 13 years. A review of these cases suggests that the character of the ingested caustic material is the most important determinant of the severity of esophageal injury, with preparations containing lye being the most injurious; that in the presence of full-thickness esophageal injury, there is a high potential for stricture formation, regardless of the type of initial management, including early use of steroids; and that multiple esophageal strictures are refractory to dilation, and esophageal replacement should be an early consideration. PMID- 3810216 TI - Arteriovenous fistulas of the large vessels of the neck: nonsurgical percutaneous occlusion. AB - We describe the nonsurgical treatment of arteriovenous fistulas of the large vessels in the neck using three different means of endovascular occlusion of these large lesions, which are surgically difficult to approach and treat. PMID- 3810215 TI - Overnight hernia repair: updated considerations. AB - Since 1976 we have repaired 2,325 inguinal or femoral hernias in 1,517 patients; 90% of these patients were admitted on the morning of surgery, and 91% were discharged the day after surgery. To better address the problem of declining strength in repaired tissues, we now use onlay or underlay grafts of synthetic material to enhance each repair. During the past year, 283 cases were done adding Marlex mesh. We have seen no infection or graft rejection in this group, though a few patients had a seroma needing aspiration. Ninety-five percent of these 1,517 patients had returned to their usual work or activity by the end of the first postoperative week. While a sound and lasting repair is the primary concern, patient satisfaction and cost-effectiveness continue to be valuable by-products of this procedure. PMID- 3810217 TI - Testicular seminoma: effectiveness of primary radiation therapy. AB - We retrospectively studied 44 patients with testicular seminoma treated with primary radiation therapy at the Bowman Gray School of Medicine from 1972 through 1982. The 26 patients with stage I disease received infradiaphragmatic irradiation. Eleven of the 12 with stage II disease, the three with stage III disease, and three with retroperitoneal disease received irradiation to the mediastinum and infradiaphragmatic area. The three-year survival rate without evidence of disease was 100% for stage I. For stage II, the rate was 92% with radiation therapy alone and 100% with salvage therapy. In two patients with stage III disease radiation therapy failed, but both had bulky abdominal disease. Only one died of seminoma. One of the patients with retroperitoneal tumor had unsuccessful radiation therapy but was salvaged with chemotherapy. Neither the diagnosis of anaplastic seminoma in nine patients nor elevated preorchiectomy beta-HCG levels in four patients affected their prognosis. In our series, primary radiation therapy with proper salvage therapy yielded 98% survival. PMID- 3810218 TI - Influence of folk medicine on the family practitioner. AB - The practice of folk medicine in the United States is increasing. Awareness by the family practitioner is essential in order to effectively communicate and successfully recommend medical treatment to those patients who hold belief in these traditional practices. Root medicine is particularly thriving in the southeastern United States. The influx of refugees into the southern coastal states has introduced new concepts into traditional medical practices. Interaction with patients who are involved with traditional health care providers and the modern medical community occurs more frequently than may be appreciated by the physicians. This article is intended to increase physicians' knowledge of some of the basic philosophies and practices of folk medicine, particularly root medicine, and to provide some insight into the reasons why the practitioners of folk medicine can be strongly influential in the medical and psychologic concerns of patients who believe in the power of the supernatural. PMID- 3810219 TI - Screening of jaundiced neonates for glucose-6-phosphate dehydrogenase deficiency. AB - Glucose-6-phosphate dehydrogenase (G6PD) deficiency is transmitted as an X-linked recessive disorder, and thus female infants are expected to be only rarely affected. Review of the records of 1,478 jaundiced newborn infants (728 boys and 750 girls) screened for G6PD deficiency at the Foothills Provincial Hospital in Calgary showed 41 (5.6%) boys and 17 (2.2%) girls with this disorder. In view of the unexpected and unexplained high frequency of G6PD deficiency in female infants, I recommend that screening for this disorder be done in selected jaundiced infants regardless of sex. PMID- 3810220 TI - Dealing with AIDS and fear: would you accept cookies from an AIDS patient? AB - Acquired immunodeficiency syndrome (AIDS) has engendered a crisis of fear among the public and health professionals alike. In addition to the myriad anxieties that generally accompany dying and death, AIDS patients must deal with numerous additional fears. In rushing to treat the physiologic aspects of AIDS, health professionals have generally failed to provide adequate support systems to deal with the emotional needs of dying AIDS patients. Health professionals must now move rapidly to develop support systems based on a realistic understanding of the fears and the other powerful emotions confronted by AIDS victims. Such systems must permit AIDS patients to give meaning to their adversity. PMID- 3810221 TI - Culture as a determinant of "humanistic traits" in medical residents. AB - In this cross-cultural study of Puerto Rican and Texas physicians, we have tested the hypothesis that physicians' "humanistic attributes" are culturally related. Differences (P = .05 to .01) were found between mean responses of the two groups of residents to seven of the questions on the Totalitarian-Authoritarian Dogmatism scale. Factor analysis determined that the two principal components of disagreement were medical political and ethical issues (P = .001) but not patients and their problems. Faculty responses provided additional evidence that customs and traditions influence how professional subgroups manifest attitudes: Puerto Rican faculty rated residents highest on "humanistic traits" if they self reported high ethical scores, and lowest if they self-reported high radical scores; Baylor faculty reflected the "age-drag" on changing values by differing (P = .05 to .001) from both groups of residents on 38% of the questions. The difficulty of rating residents with a universal standard of "humanistic traits" is supported by the culture and age-specific differences reported herein. PMID- 3810222 TI - Torulopsis glabrata infection in immunocompromised children. PMID- 3810223 TI - Protein C deficiency. AB - Severe homozygous protein C deficiency is a rare but serious problem in the newborn, with a clinical presentation of purpura fulminans. We have presented such a case in an 1,870 gm female neonate. Salient clinical findings in this case include DIC associated with extensive ecchymosis and subsequent gangrene of the skin, thrombotic complications that began on the third day of life. There was no precipitating infection. The progressive gangrenous necrosis of heel and toes was refractory to heparin therapy, but there was clinical improvement after treatment with fresh frozen plasma. Our patient's level of protein C antigen was less than 3% (normal 70% to 130%). Levels of other vitamin-K-dependent factors, as well as factor V, factor VIIIC, and antithrombin III were normal. A heterozygous protein C deficiency was documented in the mother and father. Presently the child is receiving warfarin sodium (Coumadin) therapy and is clinically stable. PMID- 3810224 TI - Neurologic Munchausen-by-proxy syndrome. AB - Two children had unexplained neurologic disease found to be induced by a parent. The Munchausen-by-proxy syndrome should be considered in children whose neurologic dysfunction is atypical and when there is significant underlying psychopathology in the family. The early recognition of neurologic Munchausen-by proxy syndrome may prevent costly, potentially dangerous, and painful studies. PMID- 3810225 TI - Complete homonymous hemianopsia: reversal with arterial bypass. AB - In the case presented, gradual reversal of a fixed neurologic deficit followed a superficial temporal artery-middle cerebral artery microvascular bypass procedure. This case illustrates well the zone of penumbra concept. Fixed neurologic deficits may be treated in some cases by bypass procedures. PMID- 3810226 TI - Paradoxic vocal cord syndrome with surgical cure. AB - Paradoxic vocal cord motion (PVCM) can cause wheezing, stridor, weak or absent voice, and ineffective cough. We have described a patient who had a posterior fossa arachnoid cyst, which was thought to be causing PVCM by compressing the brain stem. The PVCM and all symptoms resolved after surgical treatment of the arachnoid cyst. PMID- 3810227 TI - Carcinoid tumor arising in a treated primary germ cell tumor of the mediastinum. AB - A 33-year-old man had a locally aggressive anterior mediastinal carcinoid tumor, manifested as an enlarging mass refractory to chemotherapy two years after initially successful treatment of a primary germ cell tumor. Ultrastructurally, the tumor contained dense-core endocrine-type secretory granules. Many mediastinal carcinoid tumors have been reported, but we found no examples of such a tumor arising as a sequel to or as a refractory component of a mediastinal germ cell tumor after initially effective therapy. PMID- 3810228 TI - Abscess cavity extending from the subarachnoid space to the paraspinal area and psoas muscle. PMID- 3810229 TI - Chronic gonococcal osteomyelitis. PMID- 3810230 TI - Churg-Strauss syndrome: determining adequacy of corticosteroid dosage by the eosinophil count. AB - Prednisone therapy induced prompt clinical remission in a 38-year-old woman with hypereosinophilic vasculitis. Smoldering vasculitis accounts for the 38% fatality rate in treated patients with the Churg-Strauss syndrome. Complete suppression of the peripheral hypereosinophilia will reflect the efficacy of therapy more accurately than clinical response. PMID- 3810231 TI - Termination and suppression of multifocal atrial tachycardia with verapamil. AB - Multifocal atrial tachycardia (MAT) is an ectopic atrial tachyarrhythmia most commonly observed in very ill, elderly patients with hypoxia due to chronic pulmonary or cardiac disease. We have described a patient with recurrent MAT whose paroxysms of arrhythmia were promptly terminated with intravenous verapamil and were ultimately prevented by orally administered verapamil. PMID- 3810232 TI - Traumatic transection of the pancreas with subsequent chronic pancreatitis. AB - A 37-year-old man had chronic pancreatitis resulting from trauma sustained during an automobile accident 30 months before admission. This case was unusual because the injury resulted from blunt trauma, no other abdominal organs were involved, and despite pancreatic transection, no pseudocyst was formed. PMID- 3810233 TI - Cefoxitin-induced interstitial nephritis. PMID- 3810234 TI - Monitoring aminoglycoside serum concentrations. PMID- 3810235 TI - Restless leg syndrome: unusual cause of agitation under anesthesia. PMID- 3810236 TI - [Life style and the health of workers]. PMID- 3810237 TI - [Prevention of vascular diseases of the brain during mass dispensarization of workers]. PMID- 3810238 TI - [An automated system for predicting the flow of visitors at a polyclinic]. PMID- 3810239 TI - [Effect of social factors on morbidity with temporary disability among sewing industry workers]. PMID- 3810240 TI - [Rural health--a Party concern]. PMID- 3810241 TI - [Morbidity among naval commanding officers]. PMID- 3810242 TI - [Analysis of the flow of Soviet publications on social hygiene and public health organization]. PMID- 3810243 TI - [Workers' letters as a source of information for the public health organizer]. PMID- 3810244 TI - [Formation and structure of Soviet documentary information flow in medicine and public health]. PMID- 3810245 TI - [Business games--a form of active training of organizers]. PMID- 3810246 TI - [Public opinion concerning the performance of public health institutions]. PMID- 3810247 TI - [Current problems in the propagation of medical and health information]. PMID- 3810248 TI - [Role of the Pneumology Commission in detecting central cancer and other lung diseases]. PMID- 3810249 TI - [Improving the level of anti-alcoholism propaganda]. PMID- 3810250 TI - [Contributions of the scientists of the Medical Institute to the implementation of food programs]. PMID- 3810251 TI - [Urgent problems of social hygiene and public health organization]. PMID- 3810252 TI - [Social and hygienic evaluation of the health status of newborn infants in the perinatal period]. PMID- 3810253 TI - [Qualimetric evaluation of Russian documentary information with regard to medical patents]. PMID- 3810254 TI - [The use of questionnaires as a method of detecting chronic diseases of the respiratory organs in the population]. PMID- 3810255 TI - [The objectives and development of sanitaro-epidemiologic services]. PMID- 3810256 TI - [Metabolism of biologically active substances in diphtheria]. PMID- 3810257 TI - [Iatrogenic injuries of major blood vessels]. PMID- 3810258 TI - [Treatment of chronic gastroduodenal ulcers by local administration of propolis]. PMID- 3810259 TI - [Treatment of nonspecific pyelonephritis in renal tuberculosis]. PMID- 3810260 TI - [Comparative informative value of the methods of diagnosing epilepsy]. PMID- 3810261 TI - [Lipid metabolism in a hypothalamic syndrome]. PMID- 3810262 TI - [Gastric secretion and gastrinemia in duodenal ulcer with hereditary susceptibility]. PMID- 3810263 TI - [Myxoma of the left atrium]. PMID- 3810264 TI - [Bacterial endo-aortitis complicated by aortic rupture]. PMID- 3810265 TI - [Mycotic lesions of the brain]. PMID- 3810266 TI - [Corticosteroids and gastric secretion]. PMID- 3810267 TI - [Thrombocytic component of hemostasis in chronic nonspecific lung diseases]. PMID- 3810268 TI - [Status of autonomic-vascular regulation in syringomyelia]. PMID- 3810269 TI - [Extrafocal fixation of the spine in tuberculous spondylitis]. PMID- 3810270 TI - [Nitroblue tetrazolium reduction test in patients with hypertension]. PMID- 3810271 TI - [Hypermyoglobinemia in bronchial asthma]. PMID- 3810272 TI - [Carcinoembryonic antigen in cancer of the large intestine]. PMID- 3810273 TI - [Diagnosis of steroid-induced lesions of bone tissue by gamma-photon absorptiometry]. PMID- 3810274 TI - [Psychological methods of the quantitative evaluation of pain]. PMID- 3810275 TI - [A method of diagnosing allergy to penicillin]. PMID- 3810276 TI - [Effect of fat loading on indicators of lipid metabolism in hypertension]. PMID- 3810277 TI - [Arterial hypertension in coal miners]. PMID- 3810278 TI - [Development of clinical gastroenterology]. PMID- 3810279 TI - [Effect of digoxin, apressin and nitrosorbide on the hemodynamics in patients after myocardial infarction]. PMID- 3810280 TI - [Sleep disorders in alcoholism]. PMID- 3810281 TI - [Disorders of cerebral circulation in chronic renal failure]. PMID- 3810282 TI - [Interstitial electrophoresis in acute pleuropulmonary suppurations]. PMID- 3810284 TI - [Clinical picture and diagnosis of defects of the tricuspid valve]. PMID- 3810283 TI - [Endomyocardial biopsy and the basophil degranulation test in infectious-allergic myocarditis and myocarditic cardiosclerosis]. PMID- 3810285 TI - [Long-term recording of ECG for the evaluation of cardiac rhythm in patients with ischemic heart disease]. PMID- 3810286 TI - [Prevention of primary ventricular fibrillation in patients with acute myocardial infarction with trimecaine administered parenterally and in the form of suppositories]. PMID- 3810287 TI - [Radiopneumography--a method of detecting the latent side effects in patients with pulmonary tuberculosis]. PMID- 3810288 TI - [Function of the system of external respiration in disorders of pulmonary hemodynamics of different etiologies]. PMID- 3810289 TI - The natural history of idiopathic scoliosis. Scoliosis Research Society. Orlando, Florida, September 18-22, 1984. PMID- 3810290 TI - The natural history of idiopathic scoliosis before skeletal maturity. AB - A retrospective review of 326 female patients with untreated idiopathic scoliosis was performed to determine what factors might be useful in predicting the risk of curve progression. Components such as family history, height-weight ratio, lumbosacral transitional anomalies, kyphosis, lordosis, and trunk balance were not found to be significant. Predictive indicators included gender, curve patterns, and severity and growth potential. PMID- 3810291 TI - Natural history of idiopathic scoliosis in girls and boys. PMID- 3810292 TI - Idiopathic scoliosis. Natural history. AB - This study reviews the prognostic factors in curve progression in untreated idiopathic scoliosis patients followed an average of 40 years. A select group of 54 patients with 67 curves with complete radiographs from initial presentation, skeletal maturity, 30-year follow-up and 40-year follow-up were analyzed for radiographic factors leading to curve progression. Analysis of these patients confirmed that the radiographic factors identified at skeletal maturity leading to curve progression apply to the skeletally immature patient as well. PMID- 3810293 TI - Natural history of untreated idiopathic scoliosis after skeletal maturity. AB - A total of 187 random cases of untreated idiopathic scoliosis, seen from a minimum of 15 to a maximum of 47 years after the end of growth, were reviewed. All curves increased after skeletal maturity (average progression: 0.4 degrees per year). Thoracic curves tend to progress more than lumbar, lumbar more than thoracolumbar, and thoracolumbar more than double major curves. Pain was present in 114 cases (61%) and appeared more frequently in women, after pregnancies, and with fatigue. Cardiopulmonary symptoms were present in 42 patients (22%), especially those with thoracic and thoracolumbar curves greater than 40 degrees. Psychologic disturbances were found in 35 cases (19%), mostly female patients with thoracic curves greater than 40 degrees. The cosmetic appearance of these patients at long-term follow-up was better compared with that at the end of growth, even though the curves progressed. Patients with decompensation of the trunk at the end of growth seemed to improve with time. In an unselected group of patients with severe curves a mortality rate of 17% was found, twice as much as in the Italian general population. PMID- 3810294 TI - The effectiveness of bracing in the nonoperative treatment of idiopathic scoliosis. PMID- 3810295 TI - The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. AB - A total of 295 patients treated with the Boston bracing system with follow-up of at least 1 year after completion of bracing are reviewed. Pre-brace curves ranged from 20-59 degrees Cobb. Mean age at brace initiation was 13.2 years with a mean treatment time of 2.9 years and mean follow-up of 1.4 years. Mean best in-brace correction averaged 50% with correction averaging 23% at the initiation of weaning from the brace. By the time of brace discontinuance, average curve correction was 15%. At follow-up, average correction was 11%. A comparison of follow-up with pre-brace values of major curves showed that 49% were unchanged +/ 5 degree, 39% achieved final correction of 5-15 degrees, 4% achieved final correction of 15 degrees or more, 4% of patients lost 5-15 degrees, and 3% lost more than 15 degrees by the time of follow-up. Eleven percent of patients underwent surgery during the period of bracing; 1% had surgery during follow-up period. Correction and control of major curves with apexes below T8 and above L2 were best. A strong correlation between best, or initial in-brace correction, and follow-up correction was noted. Young age at the initiation of bracing and higher degrees of pre-brace curvature increased the incidence of surgery. Those curves that had corrected most at the end of bracing were most at risk for loss of correction after bracing. Partial compliance with brace wear appeared as effective as full-time wear. Boston braces without superstructure appeared to be as effective as braces with superstructure for curves with apexes below T7. PMID- 3810296 TI - The natural history of idiopathic scoliosis. Late results revisited. PMID- 3810297 TI - Spinal cord injuries associated with cardiopulmonary complications. AB - Twenty-two of 83 consecutive patients with traumatic quadraplegia admitted to a regional spinal injury center had significant bradycardia. These bradycardic patients accounted for 66% of the cervical spinal cord injured patients' mortality. In general, bradycardia in patients with cervical spinal cord injuries appears to be due to unopposed vagal tone. This bradycardia is self-limited within 3-5 weeks after the onset of paraplegia and does not require permanent pacemaker therapy. PMID- 3810298 TI - Somatosensory-evoked potentials in the evaluation of the unstable rheumatoid cervical spine. A preliminary report. AB - Median nerve somatosensory-evoked potential (SEP) examinations were performed in 24 consecutive patients with rheumatoid arthritis who had symptomatic cervical spine instability. Eighteen patients had C1-C2 instability: in ten, the subluxation was completely reducible, and in eight, the subluxation was irreducible, with or without superior migration of the odontoid process. Four patients had superior migration alone, and two had subaxial subluxation alone. Abnormal SEPs were found in seven patients overall. However, 58% of those patients with irreducible atlanto-axial subluxation and/or superior migration of the dens demonstrated abnormal cervical cord conduction latencies. Patients with these radiographic findings may be at a higher risk for the development of overt myelopathy. PMID- 3810299 TI - Causes of neurologic deterioration following surgical treatment of cervical myelopathy. AB - Neurologic deterioration was analyzed in 110 patients with surgically treated cervical myelopathy secondary to soft disc hernia or spondylosis. Follow-up periods ranged from 2 to 14 years, with an average of 6 years. Of 110 patients, 29 suffered neurologic deterioration. In most of the patients, deterioration occurred within the first year after surgery. Causes of deterioration were divided into three categories: direct trauma to neural tissue during surgery (a preventable complication); instability of the spine, progression of spondylotic changes above or below the level of fusion, and non-union (apparently unpreventable but treatable); and nonsurgery-related accidental trauma (unavoidable and often irreversible). Countermeasures for the deterioration are discussed. PMID- 3810300 TI - Chylothorax--a rare complication after anterior and posterior spinal correction. Report on six cases. AB - The authors observed six cases of chylothorax of 2,000 operations for spinal deformities performed in the past 5 years: in one case of VDS, two Harrington operations, and three anterior strut graft operations. Chylothorax resulted from direct injury to the lymphatic system in four cases of anterior spinal surgery. One of the Harrington cases had a previous history of spontaneous chylothorax that had been managed surgically. The other cases of chylothorax observed after a Harrington operation was bilateral and probably caused by the central venous catheter. All cases were treated conservatively, and the duration of the chylothorax varied from 1 to 18 days. PMID- 3810301 TI - Lumbar spine orthosis wearing. I. Restriction of gross body motions. AB - The effects of wearing commonly prescribed low-back braces and corsets on restriction of gross body motions were investigated. A lumbosacral corset, a chairback brace, and a molded plastic thoracolumbosacral orthosis (TLSO) were studied. Four trunk movements (flexion, extension, lateral bending, and twisting) were examined in five healthy adult men when standing and sitting. All three orthoses restricted at least some gross body motion to approximately two thirds to one half of no-orthosis values. All three orthoses failed to provide restrictions of at least 10% in at least one motion. Mean motion restriction across all eight movements studied in all five subjects were largest when wearing the TLSO and least when wearing the corset. Gross body motion restrictions relieve lumbar trunk muscle and spine loads. PMID- 3810302 TI - Lumbar spine orthosis wearing. II. Effect on trunk muscle myoelectric activity. AB - The effects of wearing commonly prescribed low-back braces and corsets on myoelectric signal levels in the erector spinae and oblique abdominal muscles were investigated. A lumbosacral corset, a chairback brace, and a molded thoracolumbosacral orthosis (TLSO) were studied. Nineteen tasks involving sitting and standing were performed by five healthy adult men. Myoelectric signal levels measured when wearing each orthosis were compared with those measured when performing the same task while wearing no orthosis. The changes in mean myoelectric signal levels ranged from a 9% reduction to a 44% increase when the lumbosacral corset was worn, from a 27% reduction to a 25% increase when the chairback brace was worn, and from a 38% reduction to a 19% increase when the TLSO was worn. PMID- 3810303 TI - The differential utility of the Minnesota Multiphasic Personality Inventory. A predictor of outcome in lumbar laminectomy for disc herniation versus spinal stenosis. AB - One hundred six patients with disc herniation who underwent lumbar laminectomy and discectomy and 51 patients with spinal stenosis who underwent decompressive lumbar laminectomy were evaluated for surgical outcome at least 1 year postoperatively (mean: 18 months). All had completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of the preoperative evaluation. The Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) scales were found to be predictive of surgical outcome in the herniation group. However, no MMPI scale was related to outcome in the stenosis group. Analysis of covariance showed this fact to be related to the differences in age between the two groups of patients, rather than a result of the differing diagnoses. The MMPI appears to be more useful in predicting surgical outcome in the young and middle-aged adult patient population with disc herniation and is not of predictive utility in the older stenosis population. PMID- 3810304 TI - Microlumbar discectomy. A 12-year statistical review. PMID- 3810305 TI - Avoiding late complications due to extensive laminectomies. PMID- 3810306 TI - [Carcinoma of the thyroid gland]. PMID- 3810307 TI - [Morphologic characteristics of the central arteries in the spinal cord in man]. PMID- 3810308 TI - [Percutaneous transhepatic cholangiography]. PMID- 3810309 TI - [Local and microbiologic findings in the nose and throat of children with acute inflammatory otitis]. PMID- 3810310 TI - [Proteins in the food in day care centers for preschool children in the Belgrade area]. PMID- 3810311 TI - [Prolonged preleukemic conditions]. PMID- 3810312 TI - [Radiologic diagnosis of ulcer disease in the postbulbar portion of the duodenum]. PMID- 3810313 TI - [Recent developments in diagnostic MR spectroscopy. II. The isotopes 31P, 19F, 23Na, 39K, 7Li]. PMID- 3810314 TI - [Magnetic resonance tomography of non-acute multiple sclerosis before and after use of a contrast medium (Gd-DTPA)]. PMID- 3810315 TI - [Fine structure of the kidney in MR. 1st report on an optimized measurement technic]. PMID- 3810316 TI - [PACS: an image communication system for the radiology department]. PMID- 3810317 TI - [Comparative tests of color markers used for delineating fields on the skin of patients]. PMID- 3810318 TI - [The effect of immediate cooling of burns on the extent of subsequent changes]. PMID- 3810319 TI - [Topical antibacterial agents in the treatment of burns]. PMID- 3810320 TI - [Conditions for transportation to specialized burn units]. PMID- 3810321 TI - [Reconstruction of the breast after severe burns]. PMID- 3810322 TI - [Double vascularized flaps in the reconstruction of combination injuries of the hand]. PMID- 3810323 TI - [Reconstruction of an amputated fingertip using an island flap]. PMID- 3810324 TI - [Fractures of the facial bones in children and their treatment]. PMID- 3810325 TI - [Fibrous dysplasia of the facial bones in children]. PMID- 3810326 TI - [Surgical treatment of infectious endocarditis in children]. PMID- 3810327 TI - [Unusual complications of Crohn disease]. PMID- 3810328 TI - [Lung "cysts"]. PMID- 3810329 TI - [Superficial seromyotomy of the lesser curvature of the stomach in the treatment of duodenal ulcer]. PMID- 3810330 TI - [Rational continence and its correction in borderline tumors of the middle rectum]. PMID- 3810331 TI - [Thymus tumors and their treatment]. PMID- 3810332 TI - [Hepatic echinococcal cyst]. PMID- 3810333 TI - [Operating activity in surgical departments in Czechoslovakia in 1983. I. A new system for evaluating their activity]. PMID- 3810334 TI - [Operating activity in surgical departments in Czechoslovakia in 1983. II. The most frequent surgical diseases]. PMID- 3810335 TI - [Perspectives in Czechoslovak coloproctology]. PMID- 3810336 TI - [Use of the jejunal loop in esophageal resection]. PMID- 3810337 TI - Progressive dyspnoea with pulmonary infiltrates. PMID- 3810338 TI - 'Lacricele'--an unusual case of proptosis. AB - A patient who sustained a penetrating injury to the right upper lid and eyeball presented a year later with a large cystic swelling in the orbit, which had caused proptosis and displacement of the globe. A symblepharon was found to have walled off the upper fornix causing lacrimal secretions to accumulate, thus forming a cystic lesions or lacricele. PMID- 3810339 TI - Varicose anorectal tuberculosis. A case report. AB - Varicose anorectal tuberculosis is rare. A case is reported and the English language literature reviewed. Attention is drawn to the manifold presentations of this condition. PMID- 3810340 TI - 'Pseudonormalisation' of the 'normal variant pattern' on the ECG of black subjects after intermittent acute myocardial ischaemia. A case report. AB - A middle-aged urbanised black man with unstable angina pectoris showed unusual findings on serial resting ECGs recorded during episodes of chest pain, as well as during symptom-free intervals. The 'normal variant pattern', known to occur in blacks, was recorded in the absence of angina; in a white patient with chest pain it would have been considered as being due to a possible hyperacute myocardial infarction. During repeated episodes of severe angina, 'pseudonormalisation' of the 'normal variant pattern' was seen but the pointer to myocardial ischaemia was the simultaneous occurrence of ST-segment depression, Selective coronary arteriography delineated critical lesions in both the left anterior descending and dominant left circumflex coronary arteries. Coronary artery bypass surgery was successful. The importance of recognition of the 'normal variant pattern' in the black population in which the incidence of atherosclerotic coronary artery disease is rising, is emphasised. PMID- 3810341 TI - Mitral subannular left ventricular aneurysm. A case report. AB - A mitral subannular left ventricular aneurysm in an Ovambo man is described. This condition should be suspected in patients of negroid descent presenting with mitral incompetence and a localised bulge on the left heart border on chest radiography. Mitral and aortic subannular aneurysms are discussed, including the diagnostic use of ECG gated cardiac blood pool imaging. PMID- 3810342 TI - Colonic perforation--a complication of benign gastrocolic fistula. A case report. AB - A case of colonic perforation complicating a benign gastrocolic fistula is presented. Only 2 similar cases have been previously reported in the English language literature. Pathophysiology and management are briefly discussed. PMID- 3810343 TI - Ruptured tubo-ovarian abscess late in pregnancy. A case report. AB - A pregnancy complicated in the late second trimester by a tubo-ovarian abscess, generalised peritonitis and a subdiaphragmatic abscess is reported. The fetus did not survive. The English-language literature is reviewed, as well as possible aetiological mechanisms and methods of management. PMID- 3810344 TI - Curiosa Paediatrica XI: Sternal fracture. PMID- 3810345 TI - Paraffin poisoning. PMID- 3810346 TI - Cancer in Israel. PMID- 3810347 TI - Gonococcal ophthalmia neonatorum. PMID- 3810348 TI - Dysphoria, a non-disease. PMID- 3810349 TI - Perinatal mortality in twin pregnancy. A review of 799 twin pregnancies. AB - There were 799 deliveries of twins at Harare Hospital during 1983. Of the 1598 infants 155 died, giving a perinatal mortality rate for twin pregnancy of 97/1,000, 3 times higher than the rate for singleton pregnancies. The most common cause of death was immaturity. The perinatal mortality rate was higher for second twins than for first twins. Factors important in decreasing perinatal mortality in twin pregnancy are discussed with reference to the literature. PMID- 3810350 TI - Rubella--a case for immunising male adolescents. AB - An outbreak of rubella at a training institution for predominantly adolescent males is described. The cost and inconvenience of the outbreak furnish evidence that immunisation in its own right is worth while, and should not be seen only as a means of protecting susceptible females of child-bearing age. PMID- 3810351 TI - Population studies showing cross-reactivity of Toxoplasma gondii antibodies with antibodies to malignant cervical tissue antigens. AB - Antibody inhibition studies have established that ethanol-soluble extracts prepared from a pool of malignant cervical tissues contained substances capable of reacting with antibodies specific for Toxoplasma gondii and malignant tissue factors. Extracts from normal cervical tissue did not possess Toxoplasma or malignant tissue antigens. Antibodies to malignant cervical tissue extract could be detected singly or in combination with Toxoplasma antibodies. The overall incidence of antibodies to malignant tissue extract in over 2,000 samples of blood tested was 4.4%. Of 98 apparently healthy donors with antibodies to malignant tissue extract, 50% also possessed Toxoplasma antibodies. The combined incidence of anti-Toxoplasma activity was 16.5% of all samples tested. Methods for the isolation and determination of IgG antibodies to malignant tissue and Toxoplasma antigen extracts are described, and the possible significance of the findings discussed. PMID- 3810352 TI - Therapeutic drug level monitoring in the management of epilepsy. AB - A selected group of poorly controlled epileptic patients had their drug plasma concentrations measured. Of those on a single drug, 33% were noncompliant, 33% had drug concentrations in the subtherapeutic or toxic ranges and 34% had levels in the therapeutic range, 86% of which were in the low therapeutic range. In only 9% of the group on multiple drugs were both drug levels in the therapeutic range. Twenty-two per cent of patients were non-compliant for both drugs. Patients were followed up over 12 months with drug level monitoring and dosage adjustments; 49% were seizure-free and 36% had a reduction in seizure frequency of at least 50% over an 8-month period. All but 3.9% were put on a single-drug regimen, and 15.6%, which matched well with the number of non-compliant patients, had no change in seizure frequency. Therapeutic drug level monitoring is a most useful aid in rationalising drug therapy and improving seizure control. PMID- 3810353 TI - Facilities for the mentally handicapped in the Western Cape. Some pressing needs. AB - The proper management of mental handicap requires a carefully planned system of interlocking services. To implement such a system, accurate assessment of needs is essential. In 1984 the Western Cape Forum for the Mentally Handicapped undertook a survey incorporating information received from all existing centres (N = 37) within four economic regions of the Western Cape. The most glaring deficiency in services was in the black community with only 5.4% of the estimated needs being met, whereas in the coloured and white communities the figures were 36% and 86% respectively. However, serious deficiencies and imbalances for all three ethnic groups were identified. Certain basic principles which underlie a well-planned system of provision for the mentally handicapped are outlined. A survey to establish needs on a national level is suggested. PMID- 3810354 TI - Tardive dyskinesia in long-term hospitalised Zulu psychiatric patients. A prevalence study. AB - A survey of long-term hospitalised Zulu psychiatric patients at Ekuhlengeni Sanatorium, Umbogintwini, Natal, revealed a 31% incidence of neuroleptic-related abnormal movements. Length of hospitalisation was the only risk factor significantly associated with the development of tardive dyskinesia. Direct comparisons between these findings and those in white South African patients are invalid because of many uncontrolled variables such as diet and the differing therapeutic approaches of individual psychiatrists. The study confirms that black patients are susceptible to the development of tardive dyskinesia with a prevalence rate comparable to those reported in other population groups, and suggests that they may develop the condition sooner and at lower dosages of neuroleptic drugs than whites. PMID- 3810355 TI - The relationship between stress and weight loss in a diet-exercise programme for obese women. AB - Forty-two obese women participated in two successive 3-month diet-exercise programmes. A stress questionnaire was answered on commencement, after 1 1/2 and 3 months (38 subjects), and after 6 months (30 subjects). A discussion group, informal counselling and in-depth interviews (12 subjects) provided reliable additional data. The hypothesis that subjects with juvenile-onset obesity experience greater stress on the programme and are less successful, was unsupported. The semistructured interviews indicated: that stress is inherent in dieting; that the compensatory effect of exercise mediates the loss of eating as a stress-coping mechanism; and that as goal weight is approached, a serious emotional crisis is experienced, due to the loss of the obese state as a defence. Negative findings from the stress questionnaire, and the patterns which emerged from the interviews, are conceptualised in terms of a general model of reactions to weight loss, which is based on a postulated homeostatic mechanism to maintain acceptable stress levels. PMID- 3810356 TI - Doctor no. PMID- 3810357 TI - The Wendy Savage affair. PMID- 3810358 TI - Do we really help smokers to quit? PMID- 3810359 TI - Prevalence of hypercholesterolaemia in young Afrikaners with myocardial infarction. Ischaemic heart disease risk factors. AB - Ischaemic heart disease (IHD) risk factors, with particular reference to familial hypercholesterolaemia (FH), were studied in 39 male and 12 female Afrikaners aged 55 years or under in an intensive care unit immediately after an acute myocardial infarction and in the survivors at about 3 months after the infarct. Two major risk factors were found. Firstly, about three-quarters of both male and female patients smoked more than 15 cigarettes daily. Secondly, 51% of males and 37% of females had serum cholesterol values of greater than or equal to 7.0 mmol/l and about 20% of both men and women had levels of greater than or equal to 8.5 mmol/l. Three male and 2 female patients--1:10 of the whole sample--had FH diagnosed by rigorous criteria, a prevalence similar to the figure of 1:8 predicted from the frequency of FH heterozygotes in the Afrikaans-speaking population. None of the other IHD risk factors such as hypertension, diabetes and hyperuricaemia appeared to be important. The role of obesity appeared to be indirect by virtue of its frequent association with and possible contribution to hypercholesterolaemia. Many of the patients had a history of previous IHD episodes. PMID- 3810361 TI - Evaluation of the integrated 3-hour plasma cortisol concentration as a test for Cushing's syndrome. AB - Twenty-four hour urinary free cortisol and mean and integrated 13h00-16h00 plasma cortisol levels were measured in 9 patients with proven Cushing's syndrome (5 with Cushing's disease, 2 with ectopic adrenocorticotrophic hormone production due to bronchial carcinoma and 2 with adrenal adenomas) and in 21 patients without Cushing's syndrome. The 24-hour urinary free cortisol levels and mean and integrated 13h00-16h00 plasma cortisol estimations clearly distinguished patients with Cushing's syndrome from those without. However, adequate suppression on dexamethasone suppression tests (false negatives) were obtained in 3 of the 9 patients with Cushing's syndrome. Since the integrated 13h00-16h00 plasma cortisol estimation is cheaper and simpler than the mean 13h00-16h00 plasma cortisol estimation, we recommend it as an adjunct in the diagnosis of Cushing's syndrome. PMID- 3810360 TI - Smoking patterns in the coloured population of the Cape Peninsula (CRISIC study). AB - A cross-sectional study of tobacco-smoking habits in a random sample of 976 coloured subjects aged 15-64 years revealed that smoking was common, 57% of men and 41% of women being current smokers and 10.4% of men and 9.6% of women having stopped smoking. Heavy smoking prevailed, indicating by mean daily consumption of 14.2 and 13.1 cigarettes among male and female smokers respectively; only 33.5% of male and 39.6% of female smokers used less than 10 cigarettes per day. Coloured smokers smoked more heavily during the weekend. Both men and women smoked mostly filter cigarettes. Forty-four per cent of male and 49.5% of female smokers stated that they had attempted to stop smoking, mainly for health reasons. More than one-third of the participants had a positive attitude to combating smoking, particularly those with an educational level higher than Standard 7. Former smokers and heavy smokers had a significantly higher prevalence of ischaemic heart disease than the other participants. Smoking was associated with a low body mass index, low high-density lipoprotein cholesterol levels, low socio-economic standing, high alcohol consumption and type A coronary prone behaviour in men. In 1982 the economically active coloured population of the Cape Peninsula spent an estimated R36.2 million on cigarettes. PMID- 3810362 TI - Maternal mortality in southern Africa, 1980-1982. Part I. Pregnancy can be lethal. AB - Statistics regarding the number of births and maternal deaths during the 3-year period 1980-1982, received from 267 hospitals in southern Africa, are presented. Although 812 maternal deaths were recorded, sufficient information for adequate analysis of epidemiological factors (age and parity), cause of death and avoidable factors was available in only 737. The maternal mortality rate was 8.3/10,000. Six hundred and sixty deaths (89.6%) were classified as direct obstetric death. Two hundred and twenty-nine deaths (31%) occurred in women experiencing their first pregnancy. Avoidable factors could be shown to operate in 407 deaths. Important factors identified were that the patient presented very late for antenatal or intrapartum care, that inadequate therapy was administered and that therapy deviated from the accepted norm. Fetal and neonatal loss was high: only 271 infants survived. PMID- 3810363 TI - Maternal mortality in southern Africa, 1980-1982. Part II. Causes of maternal deaths. AB - Of 737 maternal deaths studied in southern Africa between January 1980 and December 1982, 660 were classified as direct obstetric deaths. Hypertensive disorders of pregnancy were the most frequent cause of death (30%). Obstetric haemorrhage and infection were associated with 20% and 19% of maternal deaths respectively. Advancing age and increased parity were strongly associated with death from obstetric haemorrhage. PMID- 3810364 TI - A comparative analysis of grade 1 and grade 2 water in the Tygerberg Hospital in vitro fertilisation programme. AB - There are conflicting reports in the literature about the effect of the water source for growth and insemination media in an in vitro fertilisation (IVF) programme. A controlled trial was carried out in which two-cell mouse embryos were cultured in Ham F10 medium containing either grade 1 water (test group) or grade 2 water (control group). Of the two-cell embryos, 92.0% (69 of 75) in the test group and 91.8% (67 of 73) in the control group cleaved to the blastocyst stage (no statistically significant difference). On the basis of this experiment grade 2 water was used in the Tygerberg Hospital human IVF programme with good results. A continuing pregnancy rate of 23% per embryo transfer over a 1-year period is reported. PMID- 3810365 TI - The effect of an intensive education programme on the glycaemic control of type I diabetic patients. AB - The effect of patient education on glycaemic control in insulin-dependent diabetes mellitus was assessed in 20 patients selected from the Diabetes Clinic, Groote Schuur Hospital. Education in all aspects of self-care was given to small groups of between 5 and 7 patients. Biochemical tests including measurement of fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c), were performed during a 6-week 'control' period before the educational course, and again during a 6-week 'test' period after it. The mean HbA1c fell from 10.05 +/- 0.43% at the end of the control period to 8.47 +/- 0.25% at the end of the test period (P less than 0.001). FBG levels dropped from 13.53 +/- 0.84 mmol/l at the commencement of the study to 10.83 +/- 1.29 mmol/l before the educational course, and to 9.41 +/- 0.72 mmol/l at the completion of the study. We therefore conclude that intensive education of this nature is of benefit in improving glycaemic control, at least in the short term. PMID- 3810366 TI - Geriatric medicine in Grahamstown. AB - A developing interest in improved care of the aged by the authorities of Settlers' Hospital in Grahamstown led to an invitation to the Geriatric Unit of the University of Cape Town in March 1984 to visit the hospital. The impressions gained on this visit indicated a need to expand hospital-based geriatric medicine into total community care of the elderly. Data were gathered concerning 50 acutely ill and 31 long-stay elderly black patients in Settlers' Hospital. These findings and the recommendations of various committees are discussed against the background of a model for the delivery of better geriatric care throughout the country. The most urgent necessity for Grahamstown appeared to be provision of better care for aged black people in the community. PMID- 3810367 TI - Suicide in South African Indians. AB - Biographical and psychiatric factors among South African Indians in Durban and the greater Durban area were investigated in 50 successive suicides so designated by a magistrate at the time of the inquest. Response to a suicide questionnaire and a symptom check-list compiled by the authors were analysed. Information was elicited from the families, relatives and friends of the deceased, or people who had known or treated or had some contact with the deceased. Major depression and alcohol abuse were noted in the vast majority of cases studied. Hanging was the most common method of suicide, closely followed by ingestion of toxic substances. Culturally attributable differences were found between the present sample and those reported in the existing literature. This and other findings are presented and discussed. PMID- 3810368 TI - Iatrogenesis and suicide in South African Indians. AB - Psychological profiles were obtained by careful, structured interviewing of those who had been close to 47 consecutive South African Indian suicide victims who had died within the greater Durban area between 1982 and 1984, and whose deaths had been designated as 'suicide' by the magistrate conducting the inquest. Almost 50% of the subjects had been suffering from significant physical illnesses, and 65% were taking medication with the potential to potentiate depression. All were retrospectively diagnosed as having been depressed, as they had shown clear signs and symptoms of this illness, yet none was being treated for depression at the time of his or her death. Warnings that they were considering suicide were given by 68%, but little notice was taken. The implications for medical practice and training are discussed. PMID- 3810369 TI - Phaeochromocytoma of the bladder. A case report. AB - The presentation, diagnosis and management of a case of phaeochromocytoma of the urinary bladder is reported and the literature briefly reviewed. PMID- 3810370 TI - Treatment for recurrent ovarian cancer. A report of 2 cases. AB - Two cases of recurrent ovarian adenocarcinoma were resistant to standard combination chemotherapy regimens. Complete response was achieved with salvage therapy comprising cis-platinum 120 mg/m2 intravenously every 3 weeks and VP-16 (etoposide; Bristol-Myers) 200 mg per os weekly. PMID- 3810371 TI - Death from electrical arc flash burns. A report of 2 cases. AB - Two cases of fatal accidental electrocution involving high-tension cables are reported in which autopsy revealed the presence of flash burns and, more significantly, multiple circumscribed and cavitated lesions associated with arcing. Attention is drawn to the danger of 'near-contact' with high-tension cables. The autopsy findings of severe internal injuries, which may be associated with the blast of the electrical discharge or occur secondary to a fall are discussed. In the absence of an adequate history, the autopsy findings may help to elucidate more accurately the circumstances of death and the type of electrical injury involved in fatal electrocution. PMID- 3810372 TI - Mitral stenosis with free-floating left atrial thrombus and recurrent systemic embolisation. A case report. AB - A 64-year-old white woman with moderately severe rheumatic mitral stenosis complicated by atrial fibrillation and recurrent systemic embolisation to the brain was found at operation to have a large 'free-floating' left atrial thrombus, as well as multiple left atrial appendage thrombi. These had not been detected by echocardiography. She also had significantly reduced left ventricular contractility on cine angiography, and right coronary artery atherosclerosis. She underwent successful mitral valve replacement and excision of the left atrial appendage. PMID- 3810373 TI - Tuberculosis screening in industry. PMID- 3810374 TI - A new approach to herpes simplex infections. PMID- 3810375 TI - Measles experience in Durban. PMID- 3810376 TI - Dangerous treatment, shock and hypertension. PMID- 3810377 TI - The cutting diathermy and drain tracts. PMID- 3810378 TI - Significance of sialic acid determination. PMID- 3810379 TI - Chronic pancreatitis presenting as protracted abdominal pain in infancy and childhood. PMID- 3810380 TI - Obstructive sleep apnoea persisting after adenoidectomy. PMID- 3810381 TI - Bicycle accident injuries. PMID- 3810382 TI - Donovanosis (granuloma inguinale) in the Orange Free State. PMID- 3810383 TI - The effect of C3 depletion on resistance of hamsters to infection with the yaws spirochete. AB - The role of complement in humoral-mediated resistance to frambesial infection (yaws) needs to be defined. The level of serum C3 was reduced shortly after infection of hamsters with Treponema pallidum subspecies pertenue. Five weeks after frambesial infection, the serum C3 level began to increase and by week 7 no difference was detected between infected and uninfected hamsters. When C3 was depleted in hamsters by injection of 20 units of cobra venom factor (CoVF), two alterations in host resistance to frambesial infection occurred. Depletion of C3 abrogated the ability of immune serum to confer complete protection on normal hamsters against infection with the yaws spirochete. In all hamsters receiving immune serum but not CoVF, lesions failed to develop and lymph nodes weighed significantly less (P less than or equal to 0.1) than those of controls. Furthermore, no treponemes were detected in the lymph nodes of passively immunized animals. Second, depletion of C3 increased the susceptibility of hamsters to frambesial infection. The onset and progression of frambesial lesions were enhanced as compared with frambesial-infected hamsters not treated with CoVF. Finally, CoVF treatment did not reduce the ability of frambesia-immune hamsters cured of disease with penicillin to resist reinfection. These results demonstrate that complement influences the pathogenesis of yaws. PMID- 3810384 TI - [Use of a urease inhibitor, propionohydroxamic acid, in the treatment and prevention of infectious renal lithiasis. A study of 19 patients]. PMID- 3810386 TI - [Plastic penile induration: diagnosis and ionophoretic treatment with orgotein]. PMID- 3810385 TI - [Brief antimicrobial chemoprophylaxis in urology. A randomized clinical study (absence of treatment, cefotaxime, ceftriaxone)]. PMID- 3810387 TI - [Aztreonam in complicated infections of the urinary tract]. PMID- 3810388 TI - [Use of aluminum potassium sulfate in massive bladder hemorrhage. Preliminary notes]. PMID- 3810389 TI - [Clinical evaluation of a new spasmolytic: sintropium bromide (VAL 480) in spastic states of the upper and lower urinary tract]. PMID- 3810390 TI - [Mechanical energy of unstable contractions and passive distension of the bladder]. PMID- 3810391 TI - [Formation of calculi as a complication of a double-J ureteral endoprosthesis. Presentation of 2 cases]. PMID- 3810392 TI - [Tubular changes after urographic examination. A histopathologic study of 52 cases]. PMID- 3810393 TI - [Renal function and water-electrolyte metabolism in elderly subjects]. PMID- 3810394 TI - [Bone densitometry in the evaluation of the mineral content in patients under hemodialysis treatment]. PMID- 3810395 TI - [Xanthogranulomatous pyelonephritis]. PMID- 3810396 TI - [An unusual case of acute postoperative monolateral renal insufficiency]. PMID- 3810397 TI - [Meaning of the category of the quality of medical care]. PMID- 3810398 TI - Essay at working out an information system for the general practice. Morbidity and utilization data of adult health care in G.P. District No 39 in Pecs. Part 3. PMID- 3810399 TI - Sanitary education and primary prophylaxis of virus hepatitis. PMID- 3810400 TI - Medico-social consequences of alcohol addiction and the main lines of the struggle against alcoholism. PMID- 3810401 TI - The role of the psyche in determining health. PMID- 3810403 TI - Preliminary results of the Ormansag research of the national morbidity survey. PMID- 3810402 TI - The organizing of medical attendance to animal breeders under the specific conditions of the Mongolian People's Republic. PMID- 3810404 TI - Conditionings determining use made of medical services by chronically ill Lublin inhabitants. PMID- 3810405 TI - Socio-hygienic complex characteristics of city families with many children. PMID- 3810407 TI - An analysis of three years' casualty statistics record of coal mines plant. PMID- 3810406 TI - [Carcinogenic effect of the nitrosamines in tobacco smoke]. PMID- 3810408 TI - [Cytogenetic diagnosis of patients with Fanconi's anemia using cyclophosphamide metabolites as the clastogenic agent]. PMID- 3810409 TI - [Reference values of analytical parameters used in the diagnosis of iron deficiency]. PMID- 3810410 TI - [Changes in blood and erythrocyte filtrability in various clinical disorders]. PMID- 3810411 TI - [Cytosine arabinoside as a polyvalent drug in the treatment of acute non-lymphoid leukemias]. PMID- 3810412 TI - [A new family with factor X deficiency]. PMID- 3810413 TI - [Late recurrences in non-Hodgkin's lymphomas with unfavorable histology]. PMID- 3810414 TI - [Does the exclusion of unfavorable prognostic groups affect the therapeutic response in acute nonlymphocytic leukemia?]. PMID- 3810415 TI - [Prognostic value of the FAB classification in acute nonlymphocytic leukemia]. PMID- 3810416 TI - [Monoclonal gammopathy associated with marrow fibrosis]. PMID- 3810417 TI - [The frequency of biclonal gammopathies]. PMID- 3810418 TI - [Thalassemic syndromes in Spain. Preliminary epidemiologic data. Study Group for Hemoglobinopathies and Thalassemias]. PMID- 3810419 TI - Characteristics of the longest job for new disabled workers: findings from the New Beneficiary Survey. AB - This article describes the characteristics of the longest job held by new disabled-worker beneficiaries responding to questions in the 1982 New Beneficiary Survey, conducted by the Social Security Administration in October-December 1982. The characteristics include pension coverage, job duration, employer type, occupation, and industry. Many disabled workers (about half the men and two fifths of the women) reported having been covered by a pension plan. Pension coverage, pension receipt, and job tenure all increased with age, and older disabled workers had pension coverage similar to that of retired workers. Disabled and retired workers often differed in other job characteristics, but tended to become more similar with increasing age. Disabled workers were more likely to have had longest jobs with private employers and in operator-laborer occupations. When they were compared with the job characteristics of retired workers, the characteristics of disabled women exhibited less difference than did those of disabled men. PMID- 3810420 TI - Asset holdings of the newly disabled: findings from the New Beneficiary Survey. AB - About 3 out of 4 new disabled-worker beneficiaries or their spouses owned some type of financial asset in 1982, but the median value of these assets was quite small, according to data obtained by the Social Security Administration in its New Beneficiary Survey. A smaller majority reported owning their own homes, and home equity accounted for most of the reported wealth. Barely a tenth reported that they owned farms, businesses, or commercial property. Differences in age and marital status within the newly disabled population were associated with large differences in asset holdings. Married couples and older disabled workers generally were more likely to own each kind of asset, and generally reported higher values for these assets. Older married men--the largest subgroup among the disabled--are also relatively well-off, though their median asset portfolios were worth only +3,600 when home equity was excluded. Younger single men, the third largest subgroup, reported median total assets worth less than +50, however home equity was treated. The asset ownership rates and median values reported by the new disabled-worker beneficiaries are much lower for every type of asset considered than the rates and values reported by a comparable sample of new retired-worker beneficiaries. PMID- 3810421 TI - Burns. PMID- 3810422 TI - Comprehensive rehabilitation after burn injury. AB - Comprehensive rehabilitation of patients after burn injury requires the organized application of sound, recognized principles. The basic concerns are the prevention of loss of joint motion, loss of muscle mass, and the prevention of anatomic deformities. Important considerations are starting the rehabilitative program as early as possible after injury and avoiding techniques that unduly immobilize the patient or parts of the body. The use of early active motion to the patient and all movable joints, along with appropriate positioning while at rest, is crucial to a successful program. Passive exercising along with the use of restraints and splints is necessary in certain patients. PMID- 3810423 TI - Reconstruction of the external carotid artery. AB - The external carotid artery (ECA) is an underestimated but important collateral to the cerebral hemisphere and eye in patients with severe disease of the internal carotid artery. Fifteen symptomatic patients with total occlusion of the internal carotid artery underwent ECA reconstruction. Ipsilateral ECA reconstruction was performed upon all patients with no mortality or neurologic deficits. Contralateral disease of the carotid artery was noted in 11 and required correction in seven patients. Follow-up study of the patients ranged from one to 68 months (a mean of 26.8 months) after operation. Vertebrobasilar symptoms persisted in two patients, both with contralateral disease. One of these patients successfully underwent extracranial-intracranial bypass. One ipsilateral and one contralateral stroke occurred during follow-up study, both in patients with contralateral disease. Eleven patients were alive and asymptomatic at last follow-up examination. Symptomatic selected patients with occlusion of the internal carotid artery and ECA stenosis or cul-de-sac formation should be considered for operation. ECA reconstruction is associated with little morbidity and three-fourths of the patients remain asymptomatic. A high incidence of contralateral disease of the carotid artery is present. Extracranial-intracranial bypass should only be considered when symptoms persist after correction of contralateral disease of the carotid artery and any ECA lesions. PMID- 3810424 TI - Factors influencing the survival of patients with regional melanoma of the extremity treated by perfusion. AB - Patients with regional metastases of malignant melanoma (75 with Stage IIIA soft tissue metastases, 124 with Stage IIIB nodal metastases and 75 with Stage IIIAB soft tissue and nodal metastases) treated by regional perfusion between 1957 and 1982 were retrospectively studied to identify prognostic factors relating to survival. In patients with Stage IIIB disease, the melanoma specific cumulative survival rates at five years was 72 per cent for one, 33 per cent for two to three and 20 per cent for four or more positive lymph nodes. In patients with Stage IIIAB disease, those with one node had a better survival rate at five years than those with multiple nodes (45 versus 25 per cent). In patients with Stage IIIA melanoma, two groups were identified based upon the results of prior treatment--those with and without prophylactic lymph node dissection (PLND) at the time of primary therapy. The factors associated with decreased survival rates in patients with PLND were: 1, increasing age; 2, presence of subcutaneous or both subcutaneous and dermal metastases, and 3, treatment at normothermic temperatures or earlier date of treatment. No significant factors were found in the group without PLND; however, the survival time was similar to that for patients with Stage IIIAB and one positive node (45 per cent at five years). Knowledge of these factors is important in assessing the prognosis and establishing randomization criteria for prospective studies evaluating various forms of therapy. PMID- 3810425 TI - Primary hyperparathyroidism in Northern Sweden. AB - Three hundred and eleven patients with presumed hyperparathyroidism were operated upon between the years 1961 and 1983 at the two surgical clinics in Northern Sweden equipped with pathologic facilities. Eighty per cent were women. All of the patients were hypercalcemic. Parathyroid hormone (PTH) levels were elevated in 66 per cent of the patients. The correlation between serum calcium and PTH levels was only 0.38. Serum creatinine levels were normal in 92 per cent of the patients while renal concentrating ability was depressed in 79 per cent. The main patient symptoms were fatigue, mental disturbances and renal stones. Eighteen per cent were asymptomatic at the time of the operation. Most patients were diagnosed during in-hospital investigations. Many were also found to be hypercalcemic at regular outpatient controls. At operation, adenomas were found in 80 per cent, different kinds of hyperplasia in 15 per cent, normal histologic finding in 4 per cent, while cancer was found in less than 1 per cent of the patients. At follow up study, 79 per cent were normocalcemic while 3 per cent were hypocalcemic and 11 per cent were still hypercalcemic--7.5 per cent were lost to follow-up study. Nine patients had a permanent paralysis of the recurrent laryngeal nerve. PMID- 3810426 TI - Selective operative cholangiography. AB - This is a study of 505 patients who underwent surgical treatment of the gallbladder. Of this group, 343 were operated upon without operative cholangiography with an incidence of retained stones of 0.03 per cent. One hundred and ten underwent operative cholangiography according to five indications. These are: stones in the common duct on ultrasound or roentgenography; obstructive jaundice; dilation of the common duct greater than 1.2 centimeters; previous cholangitis, and preoperative pancreatitis. The advantages of selective operative cholangiography versus routine cholangiography are discussed in detail. We concluded that the selective operative cholangiography should be the preferred procedure. PMID- 3810427 TI - Serum osmolar and electrolyte changes associated with large infusions of hypertonic sodium lactate for intravascular volume expansion of patients undergoing aortic reconstruction. AB - To better define the serum osmolar and compositional changes associated with the infusion of a large volume of hypertonic saline solution (sodium of 250 milliequivalents per liter), we compared resuscitation using a hypertonic crystalloid (HSL) to Ringer's lactate (RL) in 52 patients undergoing aortic reconstruction. There were no differences between the groups in any of the preoperative measurements, the duration of operation, operative blood loss or transfusion requirement. The RL group required 9.5 liters of fluid intraoperatively as compared with 6.3 liters required by the HSL group (p less than 0.01). There was no significant difference between the groups in the amount of sodium infused to achieve resuscitation or in the sodium balance at the end of the study period. Hypernatremia (average maximum serum sodium: 157 milliequivalents per liter) and hyperosmolarity (average maximum serum osmolarity: 320 milliosmoles per liter) resolved in the HSL group within 48 hours. Correction of the hyperosmolar state was thought to be due to the judicious administration of free water and a decrease in renal free water clearance. The HSL group required significantly greater potassium administration during the early postoperative period due to increased kaluresis. HSL is safe and effective for use in the resuscitation of moderate blood volume deficit. Changes in serum sodium values and in osmolarity resolve rapidly. The serum potassium level should be monitored closely and replaced aggressively. PMID- 3810428 TI - Rectourethral fistulas in Crohn's disease. AB - Rectourethral fistula is an uncommon complication of Crohn's disease. When the rectum is apparently spared of active Crohn's disease, repair by an advancement flap of the rectum may be used, with or without temporary fecal diversion. Three such fistulas were reported successfully using this technique. PMID- 3810429 TI - Safety of hemihepatic vascular occlusion during resection of the liver. AB - To minimize both intraoperative bleeding and circulatory and biochemical disturbances due to the interruption of blood flow to the liver, we developed a technique for selective, mostly unilobar, control of the hilar vessels to the liver called hemihepatic vascular occlusion. One hundred and fifty-three patients who underwent hepatic resection were divided into four groups with and without cirrhosis of the liver and with and without hemihepatic vascular occlusion which was limited to 30 minutes followed by five minutes of perfusion, which was repeated if necessary. This technique reduced the intraoperative blood loss and the postoperative hyperbilirubinemia significantly but did not produce larger postoperative change of transaminases or lactic dehydrogenase serum levels when compared with similar resections without vascular control. PMID- 3810430 TI - Different response to preliminary biliary drainage in proximal versus distal malignant biliary obstruction. AB - This study assessed prospectively the results of endoscopic biliary drainage preoperatively in 40 patients with extrahepatic malignant biliary obstruction. The patients were divided into two groups depending upon the location of the obstruction. Those in group 1, n = 20, were patients with proximal malignant obstruction and those in group 2, n = 20, had distal malignant biliary obstruction. Preliminary endoscopic biliary drainage succeeded in lowering the biliary pressure and the incidence of bacteremia in patients in group 2. In contrast, for those in group 1, it failed to reduce the intrabiliary pressure and, thus, in the presence of bile infection led to an increased incidence of bacteremia. From the results of the present study, preliminary endoscopic biliary drainage is recommended for patients with distal malignant biliary obstruction. For those with proximal malignant biliary obstruction, surgical drainage appears to be the method of choice. PMID- 3810431 TI - A new technique for the removal of gallstones from the hepatic duct. PMID- 3810432 TI - Esophagogastric anastomosis. AB - Sixty-one consecutive patients underwent an end to side esophagogastric anastomosis combined with plication of the stomach around the distal part of the esophagus. No instance of free leakage occurred. Heartburn and regurgitation have been uncommon in this series of patients. PMID- 3810433 TI - A simple, inexpensive device for aspiration biopsy. AB - A simple, inexpensive aspiration device for biopsy has been described. It can be assembled quickly from readily available parts. It was primarily intended for fine needle aspiration biopsy of the thyroid gland, but it has been successfully used in our institution for computed tomography guided pulmonary biopsy as well. In addition, it can be conveniently used with a Menghini or Jamshidi needle for aspiration biopsy of other tissues. Finally, since the syringe plunger throw is adjustable, the device can be used in a clinical laboratory for the repeated sampling of identical aliquots of fluid. PMID- 3810434 TI - Calibration of stenosis of the small intestine with marbles. AB - A simple and reliable method for the calibration of stenoses in intestinal Crohn's disease, using a marble, is presented. With this procedure, unnecessary resection or stenoplasty can be avoided and adequate passage of intestinal contents throughout the whole length of the small intestine is secured. PMID- 3810435 TI - Identification of the rectal pouch of Hartmann. PMID- 3810436 TI - Brachial artery injuries associated with posterior elbow dislocation. AB - Posterior elbow dislocation is rarely associated with brachial arterial injury, occurring in two of 23 patients. A cool pulseless hypesthetic arm associated with swelling at the elbow after a history of a fall on an outstretched arm indicates arterial injury associated with posterior elbow dislocation. Concomitant neurologic and bone injury may occur as well. Arterial repair and stabilization of the elbow is the treatment of choice and should result in a functional extremity. PMID- 3810437 TI - Immunopathology of SLE and related diseases. PMID- 3810438 TI - Angiographic evidence of basilar artery constriction in the rabbit: a new model of vasospasm. AB - The main objective of this study was to produce angiographic evidence of basilar artery constriction using the rabbit model. The technique described involves the transdural injection of blood into the cisterna magna on two different days. The results obtained show that vasoconstriction occurs over a time period that is comparable in duration to that seen in patients undergoing vasospasm as a result of subarachnoid hemorrhage. Further investigation should be done to evaluate the usefulness of the rabbit model as a verifiable tool in studying the etiology of vasospasm. PMID- 3810439 TI - Adrenergic innervation of human middle cerebral artery. Ultrastructural observations. AB - The innervation of the human middle cerebral artery is studied with transmission electron microscopy using the chromaffin reaction technique. Adrenergic nerve fibers and related terminals, with granular electrodense neurotransmitter vesicles, are confined to the tunica adventitia-tunica media transitional zone and the outer layers of the media. These findings may indicate the presence of an adrenergic vasoconstrictor system for circulation control in the human middle cerebral artery. PMID- 3810440 TI - Spinal cord compression in Paget's disease of bone with reference to sarcomatous degeneration and calcitonin treatment. AB - Four cases of spinal cord compression stemming from Paget's disease of bone tissue are reported. Sarcomatous degeneration was proved in one case and in another one malignancy was deduced by computed tomography (CT) scanning. Clinical and radiologic manifestations as well as surgical management are discussed. The value of CT scanning of the spine as an aid in the evaluation of structural changes and the size of the soft tissue mass in sarcomatous degeneration of the lesion is stressed. After calcitonin administration, alleviation of pain and improvement in neurological status have occurred in two treated patients. PMID- 3810441 TI - Cerebral arteriovenous malformations in children and adolescents. AB - A series of 19 juveniles with cerebral arteriovenous malformations is reported. The group is composed of 8 children and 11 adolescents, aged 9-18 years, with an average age of 14.5 years. There were 10 males and 9 females. Twelve juveniles were treated by operation. Ten patients were operated upon electively; one of these died as a direct consequence of excision of the arteriovenous malformation- a female patient with an arteriovenous malformation of the corpus callosum. One other patient in this category expired 3.5 months after the removal of the arteriovenous malformation, from unrelated infectious complications arising from a preoperational ventriculo-peritoneal shunting procedure. Two patients were operated upon on an emergency basis because of an associated intraparenchymal hematoma; both of these patients died. All surgical survivors are leading independent lives. The postoperative observation period ranges from 6 months to more than 17.5 years, with an average of 6.6 years. Of the seven patients treated by nonsurgical means, one was hospitalized in a coma after rupture of the arteriovenous malformation and died shortly after admission; another--a girl in the fifth month of her first pregnancy--was admitted in a stupor and expired from a recurrent subarachnoid hemorrhage 3 weeks after the first occurrence. Five nonsurgical patients left the hospital in good condition, but one died at home 2 years later from intractable cardiorespiratory insufficiency associated with an aneurysm of the vein of Galen. PMID- 3810442 TI - Postoperative subdural fluid collections in neurosurgery. AB - After introduction of computed tomography (CT) scanning, subdural fluid collections (SFCs) have been more frequently detected. We encountered 1013 operated cases in which CT scans were performed at an early postoperative stage. Postoperative SFC occurred in 165 of the 1013 operated cases (17%). The incidence of SFC was highest in aneurysm surgery (47%), followed by neurovascular decompression (27%) and brain tumor surgery (22%). In aneurysm surgery, preoperative ventricular dilatation seemed to promote the occurrence of SFC. In tumor surgery, SFC occurred more frequently when the tumor existed in the sellar region. The SFCs decreased or disappeared in most cases on sequential CT scans, but increased in 27 cases. In the latter, maximum thickness of the SFC was seen between 20 and 30 postoperative days. Nineteen of the 27 cases had preoperative ventricular dilatation. Operation for SFC was performed in four cases with clinical symptoms and signs. Three of 169 cases developed into chronic subdural hematomas. PMID- 3810443 TI - Solitary hemangioblastoma within the third ventricle. AB - A case of solitary hemangioblastoma within the third ventricle is presented. This case was not associated with von Hippel-Lindau disease. Only two other cases of hemangioblastoma arising in the third ventricle have been previously reported. PMID- 3810444 TI - Congenital glioblastoma of the cerebellum with cytofluorometric deoxyribonucleic acid analysis. AB - A case of congenital glioblastoma arising from the cerebellum is presented with special reference to microspectrophotometric deoxyribonucleic acid (DNA) analysis of the tumor cells. Seven cases of this condition are already in the literature. The prognosis is poor and most of the reported cases survive no more than 2 months. Cytofluorophotometric DNA studies were helpful in elucidating the extreme heterogeneous distribution of DNA contents of the tumor cells, suggesting a biological aggressiveness probably related to the rate of proliferation. PMID- 3810445 TI - Massive hemorrhage into intracranial neurinomas. AB - Massive bleeding into an intracranial neurinoma is a rare event. The 12th case of this particular occurrence, which was precipitated by weight lifting, is described and a review of the literature is presented. Risk factors for bleeding appear to be tumor size and vascularity. Presenting symptomatology is abrupt and includes headache, nausea, vomiting, and depressed consciousness. Preexisting symptoms referrable to and marked dysfunction of the cranial nerve of origin are present. Deficits of neighboring cranial nerves are frequent. Computed tomography demonstrates the hemorrhages and the tumors. Mild head injury and physical exertion were precipitating factors in two cases. One-fourth of the patients died, while the others made good recoveries. PMID- 3810446 TI - Caudate head hemorrhage caused by asymptomatic occlusion of the middle cerebral artery. AB - Two nonhypertensive adult patients with asymptomatic occlusion of the middle cerebral artery, in whom caudate head hemorrhage occurred ipsilateral to the occlusive lesion, are described. The mechanism of this hemorrhage is surmised to be identical to that of moyamoya disease: a rupture of the dilated, fragile lenticulostriate artery, which evolved as a collateral channel in response to chronic cerebral ischemia. PMID- 3810447 TI - Agenesis of the left internal carotid artery, common carotid artery, and main trunk of the external carotid artery associated with multiple cerebral aneurysms. AB - A case of agenesis of the left internal carotid artery, common carotid artery, and the main trunk of the external carotid artery with multiple cerebral aneurysms is presented. This case was diagnosed by angiography and computed tomography scanning and confirmed by operation. Correlation between the anomaly of the circle of Willis based on the absence of the internal carotid artery and the development of cerebral aneurysm is discussed on the basis of the reported cases. PMID- 3810448 TI - Chondromyxoid fibroma of the petrous-sphenoid junction. AB - A case of primary chondromyxoid fibroma of the petrous and sphenoid bones extending into the posterior clinoid process, sella, and cavernous sinus in a 26 year-old man is reported. The presence of this tumor was heralded solely by the progressive paresis of the abducens nerve. The occurrence of this tumor is exceedingly rare, and to our knowledge, this is the first report of a primary chondromyxoid fibroma in the parasellar region. The natural history of this tumor, its pathologic diagnosis, and its treatment will be discussed with reference to this unusual case. PMID- 3810449 TI - Cerebellar astrocytoma presenting as a syringomyelic syndrome. AB - Cerebellar astrocytomas comprise about 36% of posterior fossa tumors in childhood. Such tumors presenting with hemorrhage have been reported, but in such cases, the location of the lesion was clinically obvious. This 16-year-old boy presented with a syringomyelic syndrome resulting from hemorrhage in the tumor causing compression of the upper cervical spinal cord. Such a case has not been previously recorded. Possible mechanisms leading to this syndrome are discussed and the relevant literature reviewed. PMID- 3810450 TI - Craniopharyngioma of the cranial base and nasopharynx. AB - A rare case of craniopharyngioma extending to the cranial base and nasopharynx is reported and eight other cases in the literature are reviewed. The embryology and the clinical features of these tumors are discussed. Tomograms of the skull and computed tomography are the most useful radiological tools of investigation. A nasoseptal or transpalatal approach to surgery, which has been performed in reported cases of cystic nasopharyngeal craniopharyngiomas, was not performed on our patient because of the hard consistency and the diffusely infiltrating aspect of the tumor. PMID- 3810451 TI - Primary meningioma of paranasal sinuses treated by the transbasal approach. AB - The authors found the transbasal approach very useful for the treatment of a meningioma originating in the paranasal sinus and massively involving the anterior cranial base. By this approach, both total excision of the tumor and reconstruction of the base of the skull were successfully achieved at the same operation. The usefulness of the transbasal approach as well as the clinicopathologic features of the meningiomas arising in the paranasal sinus are described. PMID- 3810452 TI - The isolated lateral ventricle. Experience at the Hospital for Sick Children. AB - Isolation of the lateral ventricle has long been known to occur following ventriculitis. However, in recent years, functional isolation of the lateral ventricle has been seen with increasing frequency. Since 1979, eight patients without evidence of infection have required treatment for an isolated lateral ventricle following insertion of a contralateral ventriculoperitoneal shunt at the Hospital for Sick Children, Toronto, Ontario, Canada. Two of these patients developed their hydrocephalus after intraventricular hemorrhage, and in six patients the hydrocephalus was associated with myelodysplasia. We specifically excluded patients in whom isolation of the lateral ventricle was secondary to ventriculitis. We feel that the isolated lateral ventricle following ventriculoperitoneal shunting may be due to a dynamic situation where overdrainage of the shunted ventricle leads to a functional obliteration of the foramen of Monro and subsequent enlargement of the contralateral lateral ventricle. PMID- 3810453 TI - Usefulness of the bilateral anterolateral approach in operations on the cervical spine. AB - The authors report on their experience with the bilateral anterolateral approach to the cervical spine, emphasizing its advantages and disadvantages and discussing its indications. PMID- 3810454 TI - One-stage meningomyelocele closure and ventriculoperitoneal shunt placement. AB - Thirteen myelodysplastic neonates were observed to have birth head circumferences below the 90th percentile but ventriculomegaly on preoperative computed tomograms. These infants all required later shunting for hydrocephalus. We then began performing a one-stage procedure of meningomyelocele closure and shunt insertion in all neonates with ventriculomegaly on preoperative computed tomograms without regard to head circumference. Seventeen of 24 additional patients have had the one-stage procedure; 4 have required later shunting; 1 shunt infection (6%) was encountered. We conclude that neonatal head circumference does not predict hydrocephalus, and that ventriculomegaly on preoperative computed tomograms identifies neonates who will require shunting. PMID- 3810455 TI - Evaluation of the role hemoglobin in cerebrospinal fluid plays in producing contractions of cerebral arteries. AB - Many investigators have concluded that hemoglobin is the spasmogen responsible for cerebral vasospasm. The present study was designed to ascertain whether the contractile responses of isolated canine basilar arteries to xanthochromic cerebrospinal fluid from subarachnoid hemorrhage patients was associated with hemoglobin concentration as measured spectrophotometrically. The results clearly showed that spasmogenicity and hemoglobin content were not correlated. The magnitude and duration of the arterial responses varied greatly, further indicating that more than a single factor was responsible. The potent antagonistic, vasodilator effect of such proteins as antithrombin III may account for some of the variation, but the results directly complement clinical findings of others indicating that hemoglobin is not the singular cause of cerebral vasospasm. PMID- 3810456 TI - Arachidonic acid metabolism following aneurysm rupture. Evaluation of cerebrospinal fluid and serum concentration of 6-keto-prostaglandin F1 alpha and thromboxane B2 in patients with subarachnoid hemorrhage. AB - Experimental investigations have suggested an important role of arachidonic acid metabolites in the genesis of cerebral vasospasm following subarachnoid hemorrhage. In this clinical study the cerebrospinal fluid (CSF) and serum levels of the two main arachidonic acid metabolites prostacyclin and thromboxane A2 are evaluated by measuring their stable degradation products 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane B2 (TXB2) using radioimmunoassay methods during the pre- and postoperative course in patients after aneurysm rupture. Although the serum levels of both substances do not seem to be important for the clinical course of the patients, the CSF concentrations of 6-keto-PGF1 alpha and TXB2 provide important data. A close correlation between the initial TXB2 level of the individual patient and the amount of blood in the basal cisterns as detected by computed tomography scan can be demonstrated. The predictive value of this additional information for the occurrence of cerebral angiospasm is discussed. Comparing the CSF levels of both metabolites the slight preoperative elevation of 6-keto-PGF1 alpha is significantly surmounted by an extraordinary rise in TXB2 concentration. Postoperatively, after cleavage of the basal cisterns there is a decline in the CSF levels of both substances. The pre- and postoperative clinical course in comparison to the CSF levels of 6-keto-PGF1 alpha and TXB2 is demonstrated in four patients. A nearly normal course of TXB2 and 6-keto-PGF1 alpha seems to be associated with an uneventful clinical course, whereas a high TXB2 level--whether occurring preoperatively or, even more important, as a secondary postoperative rise--seems to be associated with ischemic complications and neurological deterioration. It is suggested that pre- and postoperative monitoring of CSF levels of 6-keto-PGF1 alpha and especially TXB2 may serve as a possible indicator for the detection of patients at risk of developing cerebral vasospasm. PMID- 3810457 TI - Relationship between leukocytosis and ischemic complications following aneurysmal subarachnoid hemorrhage. AB - The prognostic significance of admission leukocytosis with respect to ischemic complications of subarachnoid hemorrhage was retrospectively investigated in a series of patients with recently ruptured intracranial aneurysms. The present study concerned 47 consecutive cases admitted within 72 hours following the last hemorrhage, in the years 1982-1984. There was no difference in the admission WBC counts between patients who subsequently deteriorated due to ischemic complications and those who did not. However, the cell count rose significantly at the time of the clinical manifestations of ischemia, possibly as a result of structural damage of brain tissue and/or increased sympathetic and adrenocortical activity. The possible contribution of leukocytes to the pathogenesis of ischemic damage following subarachnoid hemorrhage--perhaps through the release of leukotrienes--will require further investigation. PMID- 3810458 TI - Thoracic spinal epidural cysts. AB - Two cases of spinal cord compression by thoracic epidural cysts are reported. The first case, associated with a lipoma, is of a congenital type, while the second illustrates a rare mechanism of spinal cord compression caused by a post traumatic cyst after stretching of the brachial plexus and tearing of the meningeal sheaths of nerve roots. Computed tomography of the spine is helpful in disclosing the cyst and associated malformation, particularly in congenital cases. The prognosis is good after removing the cyst and closing the fistula communicating with the subarachnoid space. Further surgical treatment may be required in complex congenital malformations. PMID- 3810459 TI - Spinal artery aneurysm. AB - A case of a spinal artery aneurysm is presented and the relevant literature is reviewed. The pathology of this aneurysm differed from that of standard intracranial aneurysms. The coexistence of a spinal aneurysm and fibromuscular hyperplasia has not been previously reported. PMID- 3810460 TI - Spontaneous arteriovenous fistula of the superficial temporal artery. AB - A case of a nontraumatic arteriovenous fistula of the superficial temporal artery, documented on selective external carotid arteriography, is described in a 42-year-old man who was successfully treated by complete surgical excision. The clinical features, differential diagnosis, and treatment of arteriovenous fistulas of the superficial temporal artery are reviewed. PMID- 3810461 TI - Benign osteoblastoma of the temporal bone of an infant. AB - Benign osteoblastoma is a rare neoplasm of bone tissue most commonly involving the vertebral column and long bones. Occurrence in the calvarium is extremely rare, and no cases in infants have previously been described. We report a case of benign osteoblastoma occurring in the temporal squama of an infant. The clinical features of this type of tumor occurring in the calvarium are briefly discussed. PMID- 3810462 TI - Cervical spinal deformity in craniometaphyseal dysplasia. AB - A child with craniometaphyseal dysplasia had the presenting symptoms of progressive quadriparesis. She exhibited proportionate tall stature, peculiar face with craniomegaly, genu valgum, and 46,XX,t(12;18)(q13;q12) chromosome aberration. Delayed physical development and mild mental retardation were also present. Subluxation of C-2 on C-3 and kyphosis of the cervical spine, and myelographic blockage at this level were noted. Treatment consisted of fusion of the C-2 to C5-6 vertebra following laminectomies of C-3 and C-4 with satisfactory results. Early detection and surgery for cervical spine deformity and cord compression are necessary to prevent profound neurological deficits in this disorder. PMID- 3810463 TI - Hemiatrophy and glioblastoma. AB - There are very few recorded instances of brain tumors with ipsilateral secondary brain atrophy. All 10 cases in the literature are from Japan. We report a case of primary cerebral hemiatrophy with ipsilateral glioblastoma. As far as we are aware, no such case has been described in the literature. PMID- 3810464 TI - Subarachnoid hemorrhage after preoperative embolization of a cystic meningioma. AB - We present a case of cystic meningioma accompanied by hemorrhage in the cyst and adjacent subarachnoid space that occurred while preoperative embolization in feeders of the tumor was being applied. The possible reason for the hemorrhage was the sudden dynamic changes in blood flow triggered by the embolization. The changes could have caused multiple ruptures of pathologic small vessels. We recommend that preoperative embolization should be used cautiously in treating cystic meningiomas because of a possible increase in bleeding from pathologic weak vessels. PMID- 3810465 TI - [Radiotherapy of seminoma: small-volume irradiation at the stage pT1N0M0- prophylactic irradiation of the mediastinum]. AB - 122 patients suffering from seminoma were irradiated between 1971 and 1981 at the Radiotherapy Department of the University of Munich. 113 patients were available for retrospective analysis. The ten year actuarial survival for all patients was 93%. The survival rate in stage pT1N0M0 (UICC classification) was 100%, in stage pT2-4-xN0M0 97%, in stage pT1-4-xN1-3M0 93%, and in stage pT1-xN4M0/pT1-xN1-4M1 69%. Using a stage adapted target volume, the exclusive irradiation of the paraaortic nodes in the stage pT1N0M0 led to a cure-rate of 100%. Because of this result, and due to the improved tolerance and lower exposure to the remaining testis we recommend this method. The effectiveness of radiotherapy, also in advanced seminomas, the benefit of prophylactic mediastinal irradiation and the therapeutic modalities for treatment of extragonadal seminomas are discussed. PMID- 3810466 TI - [Excentric rotation irradiation in ORL tumors]. AB - A risk of dose insufficiency in the regions situated laterally to the spine and diagonally behind the spine is shown for the irradiation schemes applied hitherto in ORL tumors. In every case the fields are arranged in such a way that the myelon is not exposed to radiation. The excentric rotation technique presented guarantees that the exposition of the myelon doses not exceed 50% of the maximum dose. The axis lays within the myelon itself, and the central rays show an excentric deviation of 3 to 4 degrees. Thus a homogeneous dose distribution is achieved for the complete head and neck section. PMID- 3810467 TI - [A patient positioning system in head and neck irradiation]. AB - A holding system is presented which allows a good, easy, and reproducible positioning of the patient in percutaneous head and neck radiotherapy. The patients are lying comfortably on a neck support and are fixed in such a way that they are not able to turn in a lateral or longitudinal direction. The distance chin-jugulum can be easily determined by an integrated measuring tape. Due to the use of UV ink and UV lamps, the field marking of the patient's skin cannot be seen in the spectrum of visible light. PMID- 3810468 TI - [Dose distribution of pendulum fields in the field border plane]. AB - Calculations (program SIDOS-U2) and LiF measurements taken in a cylindric water phantom are used to investigate the isodose distributions of different pendulum irradiation methods in a plane which is parallel to the central ray plane and crosses the field borders at the depth of the axis. The dose values compared to the maximum values of the central ray plane are completely different for each pendulum method. In case of monoaxial pendulum methods around small angles, the maximum dose value found in the border plane is less than 50% of the dose in the central ray plane. The relative maximum of the border plane moves to tissues laying in a greater depth. In case of bi-axial methods, the maximum value of the border plane can be much more than 50% of the maximum dose measured in the central ray plane. PMID- 3810469 TI - [Monitoring of a water phantom and data acquisition in irradiation planning using a portable minicomputer]. AB - A series of dose profiles measured in general in a water phantom with remote control is necessary for irradiation planning systems to calculate the dose distribution in the patient. This study presents a cost effective method using a portable minicomputer for the monitoring of a water phantom and the digital data transmission to the irradiation planning computer. PMID- 3810470 TI - Rectum obstruction in rats after local irradiation. AB - The dependence of radiation damage of the rectum of the rat on single and fractionated doses was studied. Results obtained were analyzed with the linear quadratic model; an alpha/beta dose of 14 Gy could be derived. PMID- 3810471 TI - [Effect of cisplatin on the recovery from sublethal and potentially lethal radiation damage in cell culture]. AB - The effect of Cisplatin upon the recovery from sublethal damage during fractionated irradiation and upon the recovery from potentially lethal damage after a single dose has been investigated. In three mammalian cell lines, Cisplatin did not influence the recovery from sublethal and potentially lethal damage. There were differences among the three cell lines in their ability to recover from radiation damage. However, a significant quantitative difference between the recovery from sublethal and potentially lethal damage in any one cell line could not be found. PMID- 3810472 TI - [Radiotherapy of medulloblastoma]. AB - Between 1970 and 1985, 29 patients were postoperatively irradiated for medulloblastoma. Eight out of them received only a local irradiation and 21 a complete CNS irradiation. The posterior fossa was saturated up to a dose of 45 to 49 Gy in nine patients and 50 to 55 Gy in twelve patients. The patients treated by complete CNS irradiation show a three-year survival rate of 47% and a five year survival rate of 40%. A nonsignificant increase of the three-year survival rate is found in patients whose posterior fossa was exposed to a higher radiation dose. Eleven recurrences were observed, and the posterior fossa was involved in seven out of these cases. Four recurrences confined to the spine were found after a dose of 20 to 30 Gy. Remote metastases, preferentially with a skeletal site, were formed in three out of 29 cases. PMID- 3810473 TI - [Present status of thymoma therapy]. AB - Eight patients with histologically verified thymoma were treated between 1962 and 1985 at the Radiologic Hospital of the University of Munster. All patients were submitted to thoracotomy and subsequent irradiation. A primary irradiation was performed in four cases. The average survival time of the only irradiated patients was 8.5 months. A considerably better average survival time, i.e. 46 months, was reached by surgical procedure with postoperative irradiation. The therapy of choice in the treatment of malignant thymomas is radical operation and subsequent radiotherapy; in case of benign thymomas a postirradiation is not necessary. 25% of our patients showed early recurrences, parathymic syndromes, and hematogenous metastases. Lymphogenic metastases were not observed. Chemotherapy exerted no demonstrable influence on the tumors. PMID- 3810474 TI - A computer program for I-125 seed implant. AB - A computer program, written in FORTRAN, for I-125 permanent interstitial implants has been developed. After implantation, isocentric radiographs are taken using radiotherapy simulator (Siemens) in order to obtain two X-ray images of seeds on the same film. Honeywell DPS8 computer and Hewlett-Packard 7221A plotter are used for the dose calculation. The program calculates the dose distribution at the plane desired using 100 X 100 matrix. PMID- 3810475 TI - [Effect of ozone and ionizing radiation on an in vitro model--a pilot study of 4 gynecologic tumors]. AB - In order to investigate the sensibility of cultured tumor cells to ozone and irradiation primary tissue cultures from one undifferentiated non-classified ovarian carcinoma, two solid adenocarcinomas of the ovary and one endometrial carcinoma were established. Cultivation was performed according to standard techniques involving the stem cell assay in soft agar as well as the monolayer technique in liquid nutrient media. The type of culture system did not influence the sensitivity of the culture cells to ozone and/or irradiation. Ozone treatment was performed with three different Ozone concentrations (0.03 ppm, 0.1 ppm, 0.3 ppm). Irradiation was done with 100 rd Ra226, Ir192 or Co60. A control experiment showed that the proliferative tendency of benign cells (skin fibroblasts) was not inhibited by the three ozone concentrations used in this study. Ra226 and even the combination of ozone and Radium did not influence the proliferative activity of these benign cells. Ir192 and Co60 were cytotoxic to benign as well as to carcinoma cells. Cultivated cells from endometrial carcinoma resisted to ozone treatment as well as to Ra226 (but they were destroyed by Ir119 and Co60). After pretreatment with ozone (0.1 ppm), Ra226 treatment of endometrial carcinoma cells induced a cytostatic effect implying that no cell divisions were observed after irradiation and the cells lysed within two weeks after irradiation. For the three ovarian carcinoma cell lines analysed in this study ozone treatment had a cytostatic effect even at the lowest concentration (0.03 ppm), with the two higher ozone concentrations a cytotoxic effect could be induced in ovarian carcinoma cells. Exclusive treatment with Ra226 induced a cytostatic effect, but it was cytotoxic after combination with ozone treatment of the lowest concentration (Ir192 and Co60 were cytotoxic in all cases). Our investigation confirmed the radiosensitizing effect of ozone treatment. Furthermore it was shown that exclusive ozone treatment even without combined irradiation displayed a selective cytotoxic action at the ovarian carcinoma cells. PMID- 3810476 TI - [Effect of neuraminidase and x-rays (2 Gy and 8 Gy) on microvilli and membrane invaginations of Ehrlich ascites tumor cells in monolayer culture]. AB - A monolayer culture (Eagle basal medium plus 10% of fetal calf serum) of Ehrlich ascites tumor cells was exposed to X-radiation with 2 Gy and 8 Gy and treated with Vibrio cholerae neuraminidase alone or combined with sublethal X-ray irradiation (2 Gy). Pictures of the Ehrlich ascites tumor cells taken with the electron microscope were investigated in order to find out any cell surface modifications due to membrane invaginations and microvilli. The results showed that the rate of microvilli as well as that of membrane invaginations became higher with the increasing X-ray dose (2 Gy; 8 Gy). Following to neuraminidase treatment there was a considerable augmentation of membrane invaginations as compared to control cells, whereas the number of microvilli was slightly reduced. As it has been already described before, the influence of neuraminidase produced an increased endocytosis activity and a strengthening of the cytoskeleton. Combined treatment with neuraminidase and sublethal X-radiation (2 Gy) caused a higher rate of membrane invaginations than each method alone; the number of microvilli was slightly increased by combined treatment. The conclusion is drawn that these structure modifications are due to reparation processes induced by radiation on the one hand and to an enzymic action of neuraminidase on the cell surface on the other hand. PMID- 3810477 TI - The effect of the rat-cyclophosphamide serum on the rat hematopoietic tissue recovery, previously damaged by cyclophosphamide or by gamma-irradiation. AB - The effect of post-cyclophosphamide serum (post-CY serum) humoral activity in vivo, on the rat hematopoietic regeneration after damage either by cyclophosphamide (CY) or by gamma-irradiation was investigated. Three experimental groups of rats were studied. The first group was treated by a single high dose of CY (200 mg/kg), the second group was whole body irradiated by 6.5 Gy, and the third group was whole body irradiated by 3.5 Gy. Each group was subdivided into three subgroups. The first among subgroups received immediately after damage 0.5 cc post-CY serum, the second received 0.5 normal rat sera per animal. The third subgroup of rats was used as control. Post-CY sera were collected from the Wistar rats, 2.5 months old 48 hours after the treatment by high single dose by CY (300 mg/kg). Post-CY serum activity in comparison to normal serum activity was evaluated in vivo conditions. In order to take samples of peripheral blood, spleen and bone marrow, the animals were sacrificed 24 hours, 48 hours, 72 hours and seven days after treatment. The assessment of post CY sera effect is accomplished by measuring of the proliferative capacity of splenic, as well as bone marrow cells, and by means of the RBC and WBC counts. The results obtained indicate substantial stimulative and proliferative activity of the post-CY sera, when compared to normal sera, particularly in the animals previously damaged with CY. PMID- 3810478 TI - Studies on sister chromatid exchange (SCE) induction by gamma-irradiation and protective effect of L-cysteine in HeLa cells. AB - Effect of different doses of gamma-irradiation on SCE induction in unifiliarly 5 bromo 2-deoxyuridine substituted DNA was studied in various phases of cell cycle. Changes in gamma-irradiation induced SCE frequency was measured by post irradiation treatment with antimutagen L-cysteine. Perturbation in cellular proliferation kinetics due to gamma-irradiation and gamma-irradiation plus L cysteine was also studied. It was observed that gamma-irradiation is an efficient inducer of SCE and is most effective in S phase. L-cysteine also causes SCE induction which is slightly higher than the spontaneous level of SCEs found in HeLa cells. However, post-irradiation addition of L-cysteine reduces SCE frequency in gamma-irradiated cultures and this reduction is maximum in G1 phase irradiated cells. gamma-irradiation delayed the mitosis considerably and this delay continued to increase with increasing doses. L-cysteine reduced the delay in cell cycle caused by gamma-irradiation. PMID- 3810479 TI - The effect of body temperature on the hypoxic fraction in mouse tumours. AB - General anaesthesia as well as mechanical restraint of animals, which is necessary to allow precise local irradiation of mouse tumours, is associated with a rapid drop in body temperature if no special precautions are taken to prevent it. This drop in body temperature leads to an increased sensitivity of the tumour to normoxic irradiation which, in the reported case, may be due to a decrease in the hypoxic fraction from about 20% to about 4% as a result of decreased oxygen consumption and increased tumour perfusion. PMID- 3810480 TI - Central serous retinopathy: variants. AB - Idiopathic central serous chorioretinopathy (ICSC) is a localized detachment of the sensory retina in the macula which is commonly seen by the general ophthalmologist. However, ICSC with bullous retinal detachment is a rare disease characterized by extensive sensory retinal detachment of the posterior pole and elsewhere. Thus far it has been reported in only nine Caucasian patients in the American literature. Two case reports are presented, one typifying ICSC, the other typifying ICSC with bullous retinal detachment. Although both entities probably share the same pathophysiologic mechanism, they are distinct in terms of diagnostic features and treatment. While ICSC is usually self-limiting and frequently diagnosed by history alone, ICSC with bullous retinal detachment is frequently misdiagnosed and subsequently treated improperly. PMID- 3810481 TI - Assessment of visual acuity in toddlers. AB - Visual acuity in children 15 to 35 months of age is particularly difficult to measure. Children in this age range become bored with methods used for assessment of infants, but they are often not capable of responding to the tests used with older children and adults. Partially because of these difficulties, there is no widely preferred standard test of visual acuity for the 15 to 35 month age range. Instead, a variety of behavioral techniques have been used, with varying degrees of success. These techniques will be described and evaluated with regard to adequacy of norms, percent testable rates, test times, accuracy and similarity to adult standards of visual acuity assessment. Practical suggestions regarding the use of existing techniques and the development of new visual acuity assessment techniques for 15- to 35-month-olds will be given. PMID- 3810482 TI - Protection from radiation enteritis by an absorbable polyglycolic acid mesh sling. AB - Patients with malignant tumors of the pelvis who cannot be cured surgically often are treated with radiation after surgery. A devastating side effect of this treatment is radiation-associated small bowel injury (RASBI). The purpose of this study was to test the hypothesis that removal of the small bowel from the radiation field would protect it against RASBI. Twenty cebus monkeys underwent low anterior resection. In 10 animals an absorbable polyglycolic acid (PGA) mesh was sewn circumferentially around the interior of the abdominal cavity as a supporting apron, which prevented the small bowel's descent into the pelvis. The other 10 monkeys did not receive the mesh. All animals received 2000 rads by linear acceleration in a single dose. Twenty-four-hour stool fat, serum vitamin B12, and other serum values were obtained during the study. Animals were sacrificed after 1, 2, 3, 6, and 12 months, and the small bowel and rectum were examined histologically in a blind manner. Two monkeys who did not undergo surgery, or exposure to radiation served as controls. At all sacrifice periods, the animals with PGA mesh slings demonstrated normal small bowel function and histologic structure. Animals without mesh slings had abnormal stool and blood values at 1 month, and by 2 months all had died of small bowel necrosis. The animals that received the slings had no evidence of infection or obstruction, and by 6 months all evidence of the mesh was gone. Support of the small bowel out of the pelvis by an absorbable PGA mesh sling protects against RASBI and is without apparent complications. PMID- 3810483 TI - Surgery for chronic pancreatitis. AB - We operated on 102 patients (89 men and 13 women) who had chronic pancreatitis. The mean age at the time of surgery was 45 1/2 years. Of these patients, 77 had resections (57 distal pancreatectomies, 17 duodenopancreatectomies, an three total pancreatectomies) and 25 had diversion procedures (15 Puestow operations and 10 internal drainage of cysts). The indication for surgery was abdominal pain in 88% and the presence of jaundice in 21%. Our patients had severe pancreatic disease: 64% had pseudocysts, 41% had calcifications, and 26% had calculi in the duct of Wirsung. The postoperative mortality rate was low (3%), but morbidity occurred in 18% (mostly after resection procedures). The incidence of diabetes after surgery was high after resection (57%) but it also occurred after diversion procedures (10%). The quality and length of survival was similar after resections and after diversions, although patients with alcoholic pancreatitis had the worst long-term prognosis. Reoperations were performed in 16% of all patients; the incidence was lower after duodenopancreatectomy. PMID- 3810484 TI - Nomenclature of Raynaud's phenomenon: a capillary microscopic and hemorheologic study. AB - Hemorheologic parameters and nailfold capillaries were investigated in 72 patients with ischemic hand phenomena and 25 normal subjects. Red blood cell (RBC) aggregation and plasma viscosity were normal in all groups except in patients with secondary Raynaud's phenomenon; in this group, these parameters were significantly increased (p less than 0.001). The capillary density in the nailfold was significantly lower in patients with secondary Raynaud's phenomenon or acrocyanosis (p less than 0.001). The capillary diameters were slightly increased in patients with primary Raynaud's phenomenon, moderately increased in patients with acrocyanosis (more than twofold), and markedly increased in patients with secondary Raynaud's phenomenon (fourfold to fivefold). Nailfold velocity, before and after cold provocation, was decreased in all patients (p less than 0.001). The findings in this study support the conclusion that patients with primary and secondary Raynaud's phenomenon, acrocyanosis, or asphyxia digitorum can be distinguished by combining hemorheologic observations with morphologic and functional microscopic investigations of the nailfold capillaries. The nomenclature currently employed in our clinic can be used to define these different phenomena. PMID- 3810485 TI - The role of coronary artery disease in complications of abdominal aortic aneurysm surgery. AB - Coronary artery disease (CAD) is a major cause of morbidity and mortality after elective surgical repair of abdominal aortic aneurysm (AAA). The aim of this study was to determine the relationship between the extent of CAD observed in coronary angiograms (more than 50% stenosis) and the frequency of postoperative myocardial ischemic complications in a consecutive series of 84 patients who underwent elective AAA repair. Ninety-four percent of the patients with clinical evidence of CAD had significant disease as observed in coronary angiograms and eight patients had left main CAD. Seventy-two patients underwent AAA repair with a mortality rate of 1.4%; five patients had preliminary myocardial revascularization, and AAA surgery was not recommended for four patients because of severe cardiac disease. Postoperative myocardial ischemic complications occurred in 13.4% of the patients who had undergone surgery--almost exclusively in patients with clinical evidence of CAD. Both myocardial ischemia and preoperative intervention were more frequent in patients with double- or triple vessel disease than in patients with less extensive disease. Patients with symptoms and with double- or triple-vessel CAD have a high risk of developing myocardial ischemia after AAA surgery. Preliminary myocardial revascularization may be beneficial in this group of patients. PMID- 3810486 TI - Reduced anastomotic bleeding using new sutures with a needle-suture diameter ratio of one. AB - Reduction of blood loss from a vascular anastomosis, especially when one is using a polytetrafluoroethylene (PTFE) graft, is of great interest; even when a technically perfect anastomosis has been performed, there can still be significant and often bothersome bleeding from the needle holes. Currently, sutures have a needle-to-suture ratio of 2:1 or 3:1. Two new sutures, one made of PTFE and the other of polypropylene, were designed to have a needle-to-suture diameter ratio of 1:1. Theoretically, this allows the suture to completely fill the graft needle hole and control bleeding. These sutures were evaluated in a heparin-treated canine in vivo model to measure graft needle-hole bleeding. The materials were also tested by an independent laboratory to compare the basic physical characteristics. Twenty centimeters of 6 mm PTFE graft was interposed in an end-to-end fashion to the infrarenal canine aorta. The graft was then transected at its midpoint and a series of end-to-end, graft-to-graft anastomoses were performed with alternate experimental and control sutures. The experimental PTFE suture bled a mean of 12.46 ml per anastomosis. The experimental polypropylene bled 4.32 ml per anastomosis, while a control suture of polypropelene with a needle-to-suture ratio of 1.94 (5-0 prolene with a C-1 needle), produced a mean blood loss of 33.35 ml per anastomosis. These data are based on a total of 82 anastomoses. The results were analyzed with a two-tailed paired t test. As the data indicate, both experimental sutures allowed significantly less bleeding than the controls (p = .05). The testing of physical properties of the suture included diameter, tensile strength, needle pull-off strength, and elongation percent and were performed by an independent laboratory. These findings are included along with subjective evaluations of the sutures' handling qualities. We believe that sutures produced with needle-to-suture ratios of 1:1 greatly reduce graft needle-hole bleeding and will be a useful addition to the vascular surgeon's armamentarium. PMID- 3810487 TI - Successful use of the Denver peritoneovenous shunt in patients with nephrogenic ascites. AB - Tense ascites in patients who require hemodialysis for renal failure (nephrogenic ascites) is a rare but ominous complication. Its appearance is often followed by a rapid physical deterioration. Nonsurgical attempts to control the ascites are often unsuccessful. Four patients with refractory ascites were treated with Denver peritoneovenous shunts (DPVS). These patients suffered from ventilatory failure, anorexia with malnutrition, and hypotension during hemodialysis. Patients were followed for as long as 18 months after DPVS, and all experienced clinical resolution of the ascites. Ventilatory failure, malnutrition, and hypotension either improved or resolved after shunting. Shunt-related morbidity occurred in all patients and consisted of mechanical complications in four patients and bacteremia in one patient. These problems were resolved by either revision or removal of the DPVS. No deaths were directly related to shunting. Peritoneovenous shunting successfully treats nephrogenic ascites and reverses the morbid sequelae usually associated with this syndrome. PMID- 3810488 TI - Simultaneous retrohepatic inferior vena cavoplasty and side-to-side portacaval shunt for recurrent thrombosed mesoatrial shunt in the Budd-Chiari syndrome. AB - The Budd-Chiari syndrome is an unusual and often fatal form of portal hypertension caused by hepatic vein occlusion. It comprises less than 5% of surgically correctable causes of portal hypertension and can be one of the most difficult to treat. Recurrent Budd-Chiari syndrome associated with a thrombosed mesoatrial shunt can be an even more vexing problem because of the patient's debilitated condition, hypercoagulable state, and altered anatomy from the previous thoracic and abdominal operations. Although the literature describes numerous surgical methods of treating the Budd-Chiari syndrome, no report specifically addresses the reoperative management of a recurrent thrombosed mesoatrial shunt. We report a patient with a recurrent thrombosed mesoatrial shunt, tightly stenotic retrohepatic inferior vena cava, and occluded hepatic veins with severe portal hypertension. A simultaneous inferior vena cavoplasty and a side-to-side portacaval shunt have produced excellent results with 26-month follow-up. To the best of our knowledge, this method has not been previously described. Other reported surgical methods of treating the Budd-Chiari syndrome are discussed, with emphasis on their relative applicability to the reoperative management of this condition. We submit that this one-stage patch cavoplasty and side-to-side portacaval shunt are the best direct surgical methods to provide immediate and long-term benefit for patients with this most challenging problem. PMID- 3810489 TI - Surgical operations in the United States: 1979 to 1984. AB - With data from the National Center for Health Statistics, an in-depth analysis of the number of surgical operations performed in the United States from 1979 to 1984 was carried out. During the study period, there was a 9% increase in the total number of surgical procedures. For the same time period, the number of surgeons grew 20%. By 1984 general surgical operations were greatest in number. However, the 5-year increase in the number of general surgical operations was just 7%. Although obstetric and gynecologic operations declined 1%, the most common inpatient surgical operation performed in the United States is cesarean section. Orthopedic surgical operations grew 24% and arthroscopy has become this country's sixteenth most frequent operation. Cataract extraction is the fourth most common operation and represents 60% of all ophthalmologic surgery. Cardiothoracic operations had the largest increase, 34%. This study demonstrates the dynamics of surgical practice in the United States and conveys a dual message. There is reassuring news concerning "unnecessary" surgery due to supplier-induced demand for operations. Despite recent large increases in the number of surgeons, there have not been parallel increases in the number of surgical operations. The belief that more surgeons necessarily means more surgery is not noted. The disturbing news concerns surgical case loads. The prospect of more surgeons performing fewer operations has become a major problem. The surgical community will have to address this growing inbalance. PMID- 3810491 TI - A ten-year review of Candida sepsis and mortality in burn patients. AB - A retrospective analysis of Candida sepsis was carried out in 1722 burn patients admitted to this center from 1975 to 1984. Cultures were positive for Candida in 233 (13.5%) of these patients during their hospitalization. Candidemia was present in 70 (4.0%) of the 1722 patients. Of the 70 patients with candidemia, 38 (54%) died. However, only 11 patients (15.7%) died of Candida sepsis or mixed Candida and bacterial sepsis (less than 1% of the total patient population). The remaining 27 patients who had candidemia died of bacterial septicemia or organ system failure. The low incidence of Candida and the low incidence of mortality due to Candida was attributed to a comprehensive program of prevention, detection, and treatment. Early initiation of treatment with amphotericin B was an important aspect of the program. PMID- 3810490 TI - The secretion of cholecystokinin in the gallstone patient before and after removal of a functioning gallbladder. AB - Cholecystectomy will not always relieve the abdominal symptoms of the patient with gallstones. The functional effects of gallbladder removal in a patient with a patent cystic duct are not known in detail. Studies of the function of the gallbladder and pancreas have suggested feedback mechanisms for the release of cholecystokinin (CCK). A disturbed regulation of CCK release after cholecystectomy might induce pancreaticobiliary and gastrointestinal dysfunctions. In our study the concentrations of CCK in plasma were measured in 17 patients with gallstones. The measurements were taken with gallbladders opacified at cholecystography and with patent cystic ducts at the operation, in the fasting state, and during stimulation before and 17 weeks after the cholecystectomy. The CCK assay used measures sulfated CCK-8, CCK-22, and CCK-33 with equimolar potency but neither nonsulfated CCK nor any gastrins. Emtobil (containing peanut oil and sorbitol) was used for peroral stimulation of the CCK release. The basal concentration of CCK was 4 pmol/L and rose five times during a "test meal." No significant differences were seen in fasting or stimulated concentrations of plasma CCK before and after the cholecystectomy. Thus cholecystectomy in gallstone patients with functioning gallbladders does not seem to influence the regulation of CCK release. PMID- 3810492 TI - Norepinephrine-induced vasoconstriction is increased in intimal hyperplastic arteries of the dog. AB - Norepinephrine-induced arterial contraction in vitro is known to be increased after endothelial denudation and during the subsequent development of intimal hyperplasia. We now report the response to norepinephrine in intimal-thickened iliac vessels in conscious dogs. Seven dogs underwent balloon catheter deendothelialization of the right iliac artery. Three weeks later, ultrasonic transducers were implanted on both iliac arteries to record dynamic vessel dimension. A catheter was inserted into the terminal abdominal aorta for drug infusion and blood pressure monitoring. The dogs were studied unsedated 2 days after instrumentation. Norepinephrine was infused at doses that did not affect blood pressure (0.01 to 0.05 micrograms/kg/min). Control vessel diameter decreased from 5.2 mm +/- 0.3 to 5.1 mm +/- 0.3 (2.4% +/- 1.0% when standardized to baseline diameter) and intimal hyperplastic vessels from 6.2 mm +/- 0.4 to 5.7 mm +/- 0.4 (7.6% +/- 1.7%). The difference between control and intimal hyperplastic vessel vasoconstriction was significant at p less than 0.0025. The calculated reduction in total vessel cross-section area for control vessels was 4.5% +/- 1.9%. In intimal hyperplastic vessels total cross-sectional area was reduced by 14.5% +/- 3.3% by vasoconstriction and the luminal cross-sectional area was reduced by 17.9% +/- 0.7% by the intimal hyperplasia. These data suggest that luminal compromise due to intimal hyperplasia is compounded by increased sensitivity to norepinephrine. This effect, demonstrated in a large elastic artery shortly after endothelial denudation, may be of even greater significance in a smaller vessel with advanced intimal hyperplasia. PMID- 3810493 TI - Early postoperative morbidity after surgical treatment of thyroid carcinoma. AB - The long-term results after operations for malignant thyroid conditions are well known. Less well known are figures on early postoperative morbidity and mortality after resection of malignant thyroid lesions and data on patient satisfaction with the surgical incision. The data presented in this study show that postoperative mortality (0%) and morbidity (2% incidence of recurrent laryngeal nerve damage; 13% temporary and 1% permanent hypocalcemia) rates are extremely low in this group of patients, who express a high degree of satisfaction with the cosmetic aspects of the operation. PMID- 3810494 TI - Effects of tumor bearing and removal on blood levels of lipids, lipolytic activity, and glycerol and on carcass weight in the rat. AB - In this animal model we investigated the effects of sarcoma bearing and complete or incomplete tumor excision on blood levels of lipids, lipolytic activity, and glycerol and on carcass weight. We also sought causes that could account for the apparent increase in lipid mobilization. Tumor-bearing (TB) rats had depleted retroperitoneal fat stores, elevated blood triglycerides and cholesterol, and normal thyroid, hepatic, and renal function during tumor bearing. Catecholamine, growth hormone, and glucagon levels were not different between TB and nontumor bearing (NTB) groups. Serum lipolytic activity and glycerol levels, which were elevated during tumor bearing, returned to NTB levels after complete tumor excision, along with restoration of retroperitoneal fat depots and carcass weight. The elevated serum lipolytic activity of animals that had tumors only incompletely excised rose significantly higher after the tumor regrew; this was accompanied by a failure to regain carcass weight. Previous work has shown that elevated lipolytic activity can also be demonstrated in culture media conditioned by growth of certain animal or human tumor cell lines in cell culture, free of host influences. This suggests that the actual tumor cell and not the host may be at least partly responsible for the lipid derangements seen in this model. PMID- 3810495 TI - Surgical treatment of congenital dilatation of bile duct (choledochal cyst) with technical considerations. AB - Since the concept of an anomalous junction of the pancreaticobiliary ductal system was introduced, there has been rapid progress in the study of the pathophysiology and the surgical treatment of choledochal cyst, or congenital dilatation of the bile duct. Because of its various disadvantages, cystoenterostomy as a routine procedure for treatment of this condition has been superseded by hepaticoenterostomy after removal of the devastated bile ducts with blocking of communication with the pancreatic ducts. This article describes the technical details of the surgical correction of choledochal cyst. PMID- 3810496 TI - Percutaneous diagnosis and drainage of pylephlebitis: a case report. AB - Suppurative pylephlebitis is a rare complication of intra-abdominal inflammatory processes, but it carries a high mortality rate. Even in this modern era, diagnosis and treatment are difficult because of the nonspecificity of clinical signs and symptoms, as well as laboratory tests. We present a case in which the diagnosis of pylephlebitis was made in the radiology department by percutaneous needle aspiration of the portal venous system. Computerized tomography is very helpful in the diagnosis of pylephlebitis but requires that the radiologist be familiar with this rare entity. The computerized tomographic findings in this case are described and discussed. This patient was treated with percutaneous transhepatic drainage of the portal venous system and antibiotics only since we thought he would not survive a surgical procedure. To the best of our knowledge, there have been no previous reports of percutaneous therapy of pylephlebitis. The patient had an uneventful recovery. PMID- 3810497 TI - Cylindrical dilatation of the choledochus. PMID- 3810499 TI - Economic factors influencing the use of folk remedies. PMID- 3810498 TI - Biliary obstruction in acute pancreatitis in the opossum. PMID- 3810500 TI - Management of urolithiasis: an analysis of 1,293 lithotriptor procedures. PMID- 3810501 TI - Coyote branding injury: a case report. PMID- 3810502 TI - Antilymphocyte antibodies and OKT3 in clinical medicine. PMID- 3810504 TI - Informed consent and the "reasonable person" standard. PMID- 3810503 TI - Sunlight and skin cancer. PMID- 3810505 TI - The corporate practice of medicine, revisited. PMID- 3810506 TI - A general reduction principle for genetic modifiers of recombination. PMID- 3810507 TI - A resolution of the ascertainment sampling problem. I. Theory. AB - We consider the "ascertainment problem" arising when families are sampled by a nonrandom sampling process and, for the purpose of estimating genetic parameters, some assumption must be made about the process by which families enter the sample. A resolution of this problem, involving conditioning the likelihood of the sample on that part of the data relevant to ascertainment, is put forward. Numerical examples illustrating the properties of the procedure are provided. PMID- 3810508 TI - [Treatment of pediatric urinary incontinence using an artificial sphincter]. PMID- 3810509 TI - [Operative management of juvenile bone cysts using beta-tricalcium phosphate ceramic]. PMID- 3810510 TI - [New concepts in the treatment of cleft lip and palate]. PMID- 3810511 TI - [Use of intestinal segments for bladder reconstruction in children]. PMID- 3810512 TI - [Limb- and organ-sparing surgery of malignant solid tumors in children]. PMID- 3810513 TI - [Prevention and conservative treatment of burn sequelae]. PMID- 3810514 TI - [1 year's results of the treatment of esophageal stenosis in children using a new balloon dilatation set]. PMID- 3810515 TI - [Craniofacial surgery: advantages of radical transethmoidal ethmoid resection]. PMID- 3810516 TI - [Case report of a probable phencyclidine-induced psychosis]. PMID- 3810517 TI - [Forms of information supplied by regional drug monitoring centers. Assessment of the activity during 1984]. PMID- 3810518 TI - [Seventh French Drug Surveillance Seminar. Caen, 21-22 November 1985]. PMID- 3810519 TI - [Microcomputerized data bank of nephrotoxic drugs at the Paris-Saint Antoine Regional Drug Monitoring Center]. PMID- 3810520 TI - [Renal toxicity of nonsteroidal anti-inflammatory agents and clometacin]. PMID- 3810521 TI - [Immuno-allergic thrombopenia induced by heparin causing left intraventricular thrombosis]. PMID- 3810522 TI - [Drug interactions due to enzymatic inhibition. The predictive value of pharmacokinetic studies]. PMID- 3810523 TI - [Therapeutic drug mishaps in a medical emergency service]. PMID- 3810524 TI - [Skin necrosis following chemical synovectomy with osmium tetroxide]. PMID- 3810525 TI - [Severe sotalol poisoning and chronic glycyrrhizin poisoning. A formidable combination]. PMID- 3810526 TI - [Does optic neuritis due to cimetidine exist? An analysis of 3 cases]. PMID- 3810527 TI - [Comparative organization of drug monitoring in France and 7 European countries]. PMID- 3810528 TI - [Critical analysis of the adverse effects reported to the Paris-Fernand Widal Drug Monitoring Center in a 2-month period]. PMID- 3810529 TI - [Increased information role of a regional drug monitoring center]. PMID- 3810530 TI - [Advantages of a microcomputer system in researching duplicated reports]. PMID- 3810531 TI - [Organization of a clinical information center on psychotropic drugs]. PMID- 3810532 TI - [Probable role of ceftriaxone in the induction of hypoprothrombinemia]. PMID- 3810533 TI - [Mixed hepatitis due to rifamycin SV. Apropos of a case]. PMID- 3810534 TI - [Diffusion of salicylates through the hemato-encephalic barrier in adults]. PMID- 3810535 TI - [Pharmacokinetics of alminoprofen in healthy subjects. Influence of the time of administration]. PMID- 3810536 TI - [Pharmacokinetics of amikacin in burn patients of middle-degree severity]. PMID- 3810537 TI - [Influence of muzolimine on the pharmacokinetics of gentamycin in subjects with normal renal function]. PMID- 3810538 TI - [Local anesthesia of the upper limb by a combination of bupivacaine and lidocaine. General diffusion, kinetics of the 2 anesthetics, alone or in combination]. PMID- 3810539 TI - [Neutralization of a very low molecular weight heparin fraction CY 222 by protamine. In vitro and in vivo study]. PMID- 3810540 TI - [Comparative study of acebutolol and pindolol in computerized electroencephalography. Trial for demonstrating central effects]. PMID- 3810541 TI - [Physiologic compatibility of compartment models used in pharmacokinetics]. PMID- 3810542 TI - [Influence of spiced and tart food on the absorption of theophylline]. PMID- 3810543 TI - [Treatment of cancers of the digestive tract in the general population. Disappointing results]. PMID- 3810544 TI - [Latamoxef in resuscitation in acute renal failure. Measurement of plasma levels]. PMID- 3810545 TI - [Toloxatone, parkinsonism and dopa therapy]. PMID- 3810546 TI - [Antrafenine, urinary calculi and crystalluria]. PMID- 3810547 TI - [Agranulocytosis and aprindine]. PMID- 3810548 TI - [Extensive motor neuropathy after a single dose of vincristine]. PMID- 3810549 TI - [Side-effects of tiratricol. Apropos of 4 cases]. PMID- 3810551 TI - Electrical aggregometry in whole blood from human, pig and rabbit. AB - The objective of this study was to characterize and standardize whole blood electrical aggregometry (WBEA) in the pig and rabbit, animal models extensively used in atherosclerosis research, and to compare their platelet response with that of man. Platelet aggregation was studied in blood (WBEA) and platelet rich plasma (optical aggregometry, OA). Dose response curves were obtained for ADP and collagen. The effect of hematocrit on WBEA was also evaluated. Aggregation with ADP and collagen using WBEA was more extensive with human than with pig or rabbit platelets. OA revealed similar differences among species but the time to reach maximal aggregation was markedly shorter. Using WBEA, the extent of aggregation was inversely related to the hematocrit. We conclude that WBEA is a useful technique that may be of particular importance in situations where hyperlipidemic plasma prevents the use of OA, as occurs in some atherosclerosis research animal models. PMID- 3810550 TI - [Acute fatal pancreatitis following treatment with pentamidine]. PMID- 3810552 TI - The fibrinolytic system in experimental prostate tumor. AB - Hypofibrinogenemia and disseminated intravascular coagulation are common events in patients with metastatic prostate carcinoma. This study tests the hypothesis that prostate tumor growth and metastasis is associated with sustained activation of fibrinolysis secondary to increased release of plasminogen activator. We implanted an androgen-insensitive prostate tumor into an inbred strain of rats and serially measured plasminogen, plasminogen activator, plasmin and fibrinogen. Control groups included animals without tumor and a group implanted with transitional cell bladder carcinoma, a locally infiltrating tumor not usually associated with hemostatic complications. Our results showed a significant and steady rise in plasma plasminogen activator, plasmin and fibrinogen levels in animals implanted with prostate cancer. This, however, is not specific for prostate tumor. Similar, perhaps more profound changes were noted in animals implanted with the transitional cell carcinoma. PMID- 3810553 TI - Studies on production of antithrombin III with special reference to endotoxin induced DIC in dogs. AB - The production of antithrombin III (AT III) was studied using Se-75 selenomethionine as a tracer in dogs with disseminated intravascular coagulation (DIC) experimentally induced by endotoxin infusion. Using canine AT III purified by heparin-Sepharose affinity chromatography, antiserum against canine AT III was raised in rabbit. To study the production of plasma AT III, Se-75 selenomethionine was injected into the dog and thereafter the radioactivity incorporated into plasma AT III immunoprecipitated by anti-AT III rabbit serum was serially measured. In normal control dogs, peak radioactivity incorporated into AT III fraction was 970 +/- 55 (mean +/- SE) cpm/mg of AT III. It was 1196 +/- 51.5 cpm/mg, 2748 +/- 826 cpm/mg and 1057 +/- 74 cpm/mg when Se-75 selenomethionine was injected 6 h, 24 h and 48 h after a single infusion with one mg of endotoxin/kg body weight of dogs, and was 1.2 times, 2.8 times and 1.1 times more than normal control dogs, respectively. Plasma AT III levels decreased to a minimum of 26.7 +/- 4.9 mg/dl within 6 h after endotoxin infusion and returned to normal levels by 2 to 3 days after the infusion. Since the catabolic rate of AT III was evidently accelerated, judging from the more rapid decay of the AT III radioactivity, it is suggested that the production of AT III is markedly increased in dogs with DIC induced by endotoxin infusion even during a period of low plasma level. PMID- 3810554 TI - Adenosine diphosphate (ADP)-induced alpha-granules release from platelets of native whole blood is reduced by ticlopidine but not by aspirin or dipyridamole. AB - A brief contact between native whole blood and ADP promotes a dose-dependent release of platelet alpha-granules without a fall in the platelet number. We assessed the "ex vivo" effect of three widely used antiplatelet drugs, aspirin dipyridamole and ticlopidine, on this system. Aspirin (a single 800 mg dose) and dipyridamole (300 mg/die for four days) had no effect, while ticlopidine (500 mg/die for four days) significantly reduced the alpha-granules release for an ADP stimulation of 0.4 (p less than 0.02), 1.2 (p less than 0.01) and 2 microM (p less than 0.01). No drug, however, completely inhibits this early stage of platelet activation. The platelet release of alpha-granules may be related to platelet shape change of the light transmission aggregometer and may be important "in vivo" by enhancing platelet adhesiveness and by liberating the platelet derived growth factor. PMID- 3810555 TI - Utility of a modified calibration model for reliable conversion of thromboplastin times to international normalized ratios. AB - The combined thromboplastin reagent, Normotest, has been calibrated against the secondary international reference preparation for bovine thromboplastin, OBT/79. Three expert laboratories measured up to 62 patients on stabilized oral anticoagulant therapy and up to 20 normals in order to establish an INR-scale for Normotest. It was found that the model recommended by the WHO was less suited for the calibration of this thromboplastin. This is the first study in which three independent laboratories demonstrate a similar bias of the WHO calibration model. A modified model in which a correction factor is introduced was applied to the problem and proved to give a reliable calculation method for INR on Normotest. The mean coefficient of variation of INR calculated between measurements with Normotest and OBT/79 (scatter of data around calibration line) was 4.2-5.0% as compared to 5.1-5.7% for the WHO-method. A conversion scale for percent activities between Normotest and Thrombotest was established showing that the recommended therapeutic range of 5-10% Thrombotest (INR = 4.8-2.8) corresponds to 10-20% Normotest. PMID- 3810556 TI - Increased procoagulant response of monocytes from patients with familial Mediterranean fever. AB - Familial Mediterranean Fever (FMF) is an inherited disease of unknown etiology characterized by recurrent inflammatory episodes. Circulating fibrin was found in patients with FMF in absence of clinical manifestation of thrombosis and was statistically less frequently observed in patients treated with colchicine. These results suggest a cellular dysfunction. Therefore, we examined the procoagulant activity (PCA) of isolated mononuclear leukocytes and purified monocytes from FMF patients (n = 20). No PCA was detectable on freshly-isolated monocytes. After several hours of culture. FMF monocytes contained more PCA than control cells and the difference was more marked after endotoxin stimulation. Data obtained with coagulation factor-deficient plasma and anti-human apoprotein III antiserum indicated that the enhanced PCA in FMF monocytes is thromboplastin-like. Lysozyme and interleukin 1 production by monocytes were similar in patients and controls. The increased monocyte PCA appears to be due to an intrinsic and selective higher responsiveness of monocytes. PMID- 3810557 TI - Dose response relationships of anticoagulant activities after subcutaneous administration of two low molecular weight heparins in healthy individuals. AB - This study was performed to estimate appropriate dosages of two low molecular weight heparins (LMWH) for clinical trials on subcutaneous perioperative thrombosis prophylaxis. Anticoagulatory activities and platelet function were investigated after single doses of two LMWH and of unfractionated sodium heparin (UFH) in 24 healthy individuals. Twelve subjects received subcutaneous injections of 1000, 1500, and 2500 i.u. (aPTT) of LMHW 1, and the other 12 received LMWH 2 at same dosages. The following parameters were determined before 30 min, 1 h, 90 min, 2 h, 3 h, 4 h, 6 h, 8 h, and 10 h after either LMWH or 5000 i.u. (aPTT) UFH: aPTT, thrombin time, anti-Xa activity (S 2222, Coatest heparin), and anti-IIa activity (Chromozym TH). Bleeding time, platelet count, and adrenalin-, collagen , and ADP-induced platelet aggregation were assessed before and 3 h after administration. After application of 1500 i.u. LMWH 1 and LMWH 2, the anti-Xa and anti-IIa levels were already significantly higher than after 5000 i.u. UFH. 2500 i.u. LMWH 1 and LMWH 2 evoked significantly greater prolongations of aPTT and thrombin time values than did 5000 i.u. UFH. This was not the case after 1000 and 1500 i.u. LMWH. The half-lives of anticoagulatory effects after LMWH were markedly longer than after UFH. Platelet function was not altered by any of the heparins tested. Our results indicate that LMWH cause anticoagulatory effects in vivo that cannot be predicted by in vitro studies and that the appropriate single dosages of LMWH in subcutaneous perioperative thrombosis prophylaxis have to be estimated by dosage determinations in healthy subjects. PMID- 3810558 TI - A simple in vitro model of mechanical injury of confluent cultured endothelial cells to study quantitatively the repair process. AB - A model of in vitro mechanical injury of confluent human endothelial cells (EC) in culture was developed. Human EC were obtained from umbilical veins and grown to confluence. Application on the EC monolayer of a calibrated disk of cellulose polyacetate paper resulted in removal of the EC, leaving a continuous subendothelial extracellular matrix (ECM) on the culture dish. The regeneration time depended on the original size of the lesion. Regeneration was similar with EC grown on different substrates such as human fibronectin, human subendothelial ECM, bovine collagen type I or surfaces coated with Transglutine, a surgical glue containing adhesive proteins. A human brain extract containing growth factor activity accelerated significantly the repair of the lesion, especially at low serum concentration. This simple in vitro model of mechanical injury allows the quantitative study of the effects of matrices, growth factors and pharmacological agents on the repair process. PMID- 3810559 TI - S2-serotonergic receptor inhibition (ketanserin), combined with thromboxane A2/prostaglandin endoperoxide receptor blockade (BM 13.177): enhanced anti platelet effect. PMID- 3810560 TI - Antithrombin III (ATIII) and heparin cofactor II (HCII) in normal human fetuses (21st-27th week) PMID- 3810561 TI - Prothrombin Perija: a new congenital dysprothrombinemia in an Indian family. AB - A Western Venezuelan indigenous Yukpa(Irapa) family with moderate bleeding and discrepancy in the prothrombin values by biological and immunological methods is described. The propositus presented biological activity of 2% by the methods in one-stage including Staphylocoagulase and Echis carinatus. Electrophoretic migration of the prothrombin in plasma was normal, while the serum only showed one precipitation arc instead of the three of normal serum. The propositus appeared to be homozygous for the abnormal prothrombin which we have denominated Prothrombin Perija. PMID- 3810562 TI - Removal of the anticoagulant activities of the low molecular weight heparin fractions and fragments with flavobacterial heparinase. AB - Recently, the development of low molecular weight heparin fractions and fragments (LMHF) as potential antithrombotic agents has gained increased attention. However, the lack of antagonists to neutralize the anticoagulant effects of these drugs may seriously exclude them from possible uses in extracorporeal therapy. This is mainly because of the concern that the high dosage of the drugs employed in extracorporeal therapy could lead to serious bleeding risks. Our earlier work has demonstrated that immobilized heparinase can remove polydisperse heparin both in vitro and in vivo. To examine whether such a system may be used as a novel approach to neutralize the anticoagulant effects of LMHF, different LMHF were tested using heparinase. In vitro data showed that both the APTT and anti-FXa activities of the LMHF including Kabi 2165, PK 10169, Cy 216 and CY 222 were nearly completely eliminated by heparinase in less than 20 min. This study suggests that an immobilized heparinase system may be an useful element for the acceptance of the LMHF for their use in extracorporeal therapy. PMID- 3810563 TI - Competitions between fibrinogen with its degradation products for interactions with the platelet-fibrinogen receptor. AB - Direct binding of 125-I-labelled plasmic and CNBr-derived fibrin (ogen) fragments (pre-X, X, Y, D, Degta, Efg, E1, N-DSK, N-dsk) to gel-filtered platelets was compared to their ability to support or inhibit ADP-induced aggregation, and to compete with fibrinogen for binding to ADP-stimulated platelets. Pre-X was the only fragment that supported aggregation. All fragments tested except for E derived from fibrinogen (Efg) and Degta bound specifically to the platelets and inhibited ADP-induced aggregation in the presence of fibrinogen. Competitive binding studies with fibrinogen and fragments labelled with different isotopes of iodine, or inhibition of binding of labelled fibrinogen with unlabelled fragments showed that all of the fragments except Efg and Degta were able to compete with fibrinogen for binding. When simultaneous binding of N-dsk and fibrinogen was studied, an increased binding of both ligands was observed probably due to complex formation. The results fully agree with previous findings of binding to immunoprecipitated glycoprotein IIb-IIIa after crossed immunoelectrophoresis. We conclude that the fibrinogen molecule contains at least six sequences responsible for platelet interaction, two in the E domain and two in each of the C-terminal parts of the fibrinogen molecule. PMID- 3810564 TI - Anticoagulant and antithrombotic properties of a gamma-carboxyglutamic acid-rich peptide derived from the light chain of blood coagulation factor X. AB - In this report, we describe the anticoagulant and antithrombotic properties of a peptide (residues 1-44) derived from the amino-terminus of the bovine Factor X light chain by limited proteolysis with chymotrypsin, and subsequently purified by QAE-Sephadex chromatography. The effect of Factor X gla-peptide on the activation of human 3H-Factors IX and X was studied using radiometric assays and purified coagulation factors. Factor VIIa-tissue factor catalyzed activation of Factors IX and X was half-maximally inhibited by Factor X gla-peptide at concentrations of 0.8 microM and 0.2 microM, respectively. Factor IXa-VIII catalyzed Factor X activation was half-maximally inhibited at a gla-peptide concentration of 0.5 microM. In addition, thrombin formation by platelets incubated with Factor Xa and prothrombin could be similarly blocked by gla peptide. Studies with bovine aortic endothelial cells indicated that the Factor X gla-peptide blocked in parallel Factor X binding and activation on the cell surface. Decarboxylation of the peptide by acid heat treatment destroyed its anticoagulant activity. The in vivo anticoagulant potential of native gla-peptide was demonstrated by a rapid prolongation of the PT and APTT following intravenous infusion into a rabbit. In addition, gla-peptide prevented thrombus formation in response to Factors IXa and Xa, but not thrombin, in a Wessler venous stasis model. PMID- 3810565 TI - The effect of platelet surface protein phosphorylation on collagen-platelet interaction. AB - Phosphorylation of the surface proteins of human platelets by treatment with human plasma kinase and exogenous ATP enhances their aggregation response to collagen. This effect can be reversed by treatment of the phosphorylated platelets with acid phosphatase. Moreover, acid phosphatase treatment of normal human platelets results in a decreased aggregation response to collagen. The increased responsiveness of phosphorylated platelets to collagen is associated with a concomitant increase in Thromboxane A2 formation. These results suggest that the platelet surface protein phosphorylation/dephosphorylation plays an important role in modulating platelet function. PMID- 3810566 TI - A rapid preparation of human platelet calcium-activated phospholipid-dependent protein kinase. AB - A rapid, high yield and relatively stable preparation of human platelet calcium activated phospholipid-dependent protein kinase (protein kinase C) is described. The method is based on the calcium-dependent and reversible binding of the enzyme to platelet membranes and its success is largely due to the immediate separation of the enzyme from the soluble calcium-dependent protease as well as the platelet endogenous substrate in the first step. Different additions to the platelet lysis medium are examined and the most critical are leupeptin as an inhibitor of the protease and mercapto-ethanol to maintain enzyme activity. This protein kinase C preparation can be done in less than 24 hours and yields an enzyme which is about 90% pure with a 15-fold activation by calcium, diolein and phospholipid, and is devoid of any cAMP-dependent protein kinase or myosin light chain kinase activities. PMID- 3810567 TI - Infusion of emulsified trieicosapentaenoyl-glycerol into rabbits--the effects on platelet aggregation, polymorphonuclear leukocyte adhesion, and fatty acid composition in plasma and platelet phospholipids. AB - Using 90%-pure free eicosapentaenoic acid, we synthesized 1,2,3 trieicosapentaenoyl-glycerol (EPA-TG) and manufactured an emulsion of EPA-TG with purified phosphatidylcholine from krill as an emulsifier. After two intravenous injections of the EPA-TG emulsion into rabbits, the EPA content in plasma and platelet phospholipids increased markedly. ADP- and collagen-induced platelet aggregation and polymorphonuclear leukocyte adhesion to glass beads were depressed significantly. No significant changes were observed in serum lipids and liver function. In control experiments which were performed in exactly the same manner except that soybean oil emulsion was used instead of the EPA-TG emulsion, there were almost no significant changes. Our results suggest that an EPA-TG emulsion is applicable to those patients who need both intravenous alimentation and preventive care of thrombosis, such as postoperative patients. PMID- 3810568 TI - Altered immunoelectrophoretic profiles of fibrinogen in full-term newborns. PMID- 3810569 TI - Are molecular weight and anti-Xa activity sufficient to predict the antithrombotic power of heparin fractions. PMID- 3810570 TI - [Congenital hip dysplasia at a central hospital]. PMID- 3810571 TI - [Congenital hip dysplasia]. PMID- 3810572 TI - [Hip joint luxation in newborn infants. A diagnostic problem]. PMID- 3810573 TI - [Is the examination of the hip joint of newborn infants good enough?]. PMID- 3810574 TI - [Congenital hip dysplasia and a study of high-risk groups]. PMID- 3810575 TI - [Late diagnosis of congenital hip dysplasia. Children born to Oslo women in 1983]. PMID- 3810577 TI - [Determination of spleen weight by scintigraphy]. PMID- 3810576 TI - [Thyroid cancer in Norway 1970-1979. Regional variation of histological types]. PMID- 3810578 TI - [Septicemia caused by Campylobacter jejuni]. PMID- 3810579 TI - [Klinefelter's syndrome. Early diagnosis and therapy]. PMID- 3810580 TI - [Carnitine deficiency syndromes]. PMID- 3810581 TI - [Drugs, agranulocytosis and aplastic anemia]. PMID- 3810582 TI - [Gastrointestinal symptoms induced by the adverse effects of oral potassium preparations]. PMID- 3810583 TI - [Acetylsalicylic acid and Reye's syndrome]. PMID- 3810584 TI - [The Seditainer. Measurement of the erythrocyte sedimentation rate. Evaluation of a vacuum tube system]. PMID- 3810585 TI - [Cataract. Ambulatory treatment--a working model]. PMID- 3810586 TI - [Height-for-weight measurements]. PMID- 3810587 TI - [Health education directed toward the individual. Can consultation be used?]. PMID- 3810588 TI - [Radioactive fallout and thyroid cancer in Norway]. PMID- 3810589 TI - [Risk of spontaneous abortions and abnormalities in laboratory personnel]. PMID- 3810590 TI - [Long-term treatment with digitalis. Is it necessary in elderly patients with sinus rhythm?]. PMID- 3810591 TI - [Pain and disorders caused by mechanical stress]. PMID- 3810592 TI - [Halitosis]. PMID- 3810593 TI - [Alcohol consumption of patients admitted with acute injuries requiring surgery]. PMID- 3810594 TI - [Myocarditis as a cause of sudden death in children and young adults]. PMID- 3810595 TI - [Carbamazepine in manic-depressive disorders]. PMID- 3810596 TI - [Abuse of antiparkinsonian drugs among psychiatric patients]. PMID- 3810597 TI - [Collagenous colitis]. PMID- 3810598 TI - [Kinking of the internal carotid artery]. PMID- 3810599 TI - [Standardized images of sprained ankles]. PMID- 3810600 TI - [Caudal epidural block in pediatric surgery]. PMID- 3810601 TI - [Use of drugs, environment and life style in adolescents]. PMID- 3810602 TI - [EMLA cream used as a local anesthetic before insertion of a peripheral venous catheter (Venflon) in children]. PMID- 3810603 TI - [Sarcoidosis]. PMID- 3810604 TI - [Group psychotherapy. What structure should psychiatric institutions have?]. PMID- 3810605 TI - [Functional constipation with encopresis. Management of children at an outpatient clinic]. PMID- 3810606 TI - [Systemic lupus erythematosus with glomerulonephritis]. PMID- 3810607 TI - [Hereditary fructose intolerance. A differential diagnosis even in adults]. PMID- 3810608 TI - [Cerebral hemorrhage caused by cerebral amyloid angiopathy]. PMID- 3810609 TI - [Gorlin syndrome]. PMID- 3810610 TI - [Thrombotic thrombocytopenic purpura. Treatment with plasmapheresis]. PMID- 3810611 TI - [Endocytosis. Biological and clinical aspects of a general cellular process]. PMID- 3810612 TI - [Child neglect and severe somatic diseases in children]. PMID- 3810613 TI - [Borderline disorders]. PMID- 3810614 TI - [Long-distance bicycle contest. Heart rhythm and serum enzymes]. PMID- 3810615 TI - [The Norwegian Mount Everest expedition 1985. Physiological and physiopathological aspects of going to high altitude]. PMID- 3810616 TI - [The psychology of daring men and women]. PMID- 3810617 TI - [Smoking habits of Norwegian doctors 1952-84]. PMID- 3810618 TI - [Thrombocyte concentrates made from buffy-coats]. PMID- 3810619 TI - [Clostridium difficile infections]. PMID- 3810620 TI - [Clostridium difficile infections]. PMID- 3810621 TI - [Toxic epidermal necrolysis. Improved prognosis with biological dressings]. PMID- 3810622 TI - [Intestinal bypass dermatitis-arthritis syndrome. A rare complication in the surgical treatment of obesity]. PMID- 3810623 TI - [Suturing apparatus using absorbable staples in hysterectomy]. PMID- 3810624 TI - [Chronic rectal fistula after rectal amputation. Treatment with transposition of the gracilis muscle]. PMID- 3810625 TI - [Guidelines for the prevention of intravascular infections]. PMID- 3810626 TI - [Abortions in Norway 1976-83]. PMID- 3810627 TI - [Urography in hypertension. Practical consequences of recent information]. PMID- 3810628 TI - [Intra-articular knee stabilization with synthetic material. A practice-oriented stabilization technic]. AB - An intra-articular method designed to stabilise the knee joint using synthetic material after rupture of the anterior cruciate ligament is described. The results obtained in forty dogs and two cats treated by this method during the period from 1980 to 1985, are reported. The morbid-anatomical findings within fourteen months after surgery are referred to in one case. Rejection of the ligament was not observed in a single case. When habitual or stationary medial dislocation of the patella was present in addition to a lesion of the anterior cruciate ligament, the patella was no longer found to be subject to dislocation following stabilisation of the knee joint. Clinical results ranged from moderate to satisfactory, varying with the degree of arthrosis and the lesions of the meniscus which were present. This technique does not take up much time and consequently saves expenses. PMID- 3810629 TI - [Diagnosis and treatment of sesamoid bone fractures in the dog foot]. AB - Fragmentation could be due to direct injury or the fact that normal sesamoid bones are subjected to repeated stress. Osteochondrosis could also be a factor in aetiology. Multiple primordia of a fragmented sesamoid bone could produce a picture of fragmentation. Combining the results of selective clinical and radiological examination is of importance prior to proceeding to treatment. Both in chronic cases and in the event of failure of a recent fracture to heal after immobilisation, the decision will consist in surgical excision of fragments. The results of surgical treatment in seven out of eleven dogs having one or several fragmented sesamoid bones, which were referred for surgery, are reported Locomotion was fully restored to normal following surgery in every case. When surgical treatment was carried out earlier, recovery was attained more rapidly. PMID- 3810630 TI - [Roentgenologic studies of the spine of small domestic animals. Myelography. II]. AB - The technique and interpretation of myelography in small animals are described in the present paper. The practical use of cervical myelography is discussed in detail, and the more specialist lumbar method is introduced. Myelographic changes, including a differential diagnosis, are reviewed in addition to normal X rays. An extensive collection of radiographic instances is used to illustrate normal and abnormal findings. PMID- 3810631 TI - [The electrospinogram in dogs]. AB - The recording of spinal action potentials following stimulation of peripheral nerves may be as useful in dogs as it was found to be as a diagnostic tool in man. Technique and results of electrospinograms in ten normal dogs are reported. PMID- 3810632 TI - Update of fundamentals on application of the external fixator. PMID- 3810633 TI - [Calcium metabolism in dogs]. AB - Calcium homeostasis is controlled both directly and by hormones. Directly as a result of the fact that the uptake of calcium from the intestine and its excretion by the intestine, kidney and skeleton are well attuned to one another. A process of diffusion of calcium through the intestinal wall occurs in addition to active absorption of calcium, particularly in young animals. The maximum excretion of calcium by the kidneys is one per cent of the amount of circulating calcium. The skeleton acts as a calcium buffer in which 99.5 per cent of the body calcium is present. As regards hormones, the calciotropic hormones (parathormone, calcitonin and vitamin D) are the most important factors, which particularly affect the processes of absorption, resorption and accretion of calcium. The effects on the excretion of calcium are very slight. The system of calcium homeostasis is designed to maintain a normal level of calcium in blood (dog less than twelve months: 2.5-2.9 mmol/l; dog greater than twelve months: 2.2-3.0 mmol/l). A prolonged abnormal calcium intake will result in skeletal changes, particularly in young dogs. Inhibition of remodelling reconstruction of the skeleton and disturbance of enchondral ossification, which became clinically apparent, among other things, in the canine Wobbler syndrome and osteochondritis dissecans, were observed in Great Danes dogs having a high calcium intake. A low calcium intake in Great Danes dogs resulted in osteoporosis and pathological fractures without any impairment of enchondral ossification being observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810634 TI - Patterns of blood-vessel invasion by mammary tumor cells. AB - Rat mammary tumor TMT-081 was employed as a model for blood vessel invasion because its mode of metastasis resembles that of human tumors. The invasive mechanism was studied with two methods of serial transplantation: transfer of enzymatically dispersed solid tumors, and transfer of buffy coat containing circulating tumor cells. The latter method produced greater invasion of blood vessels, including larger veins and occasionally arteries, perhaps by obviating damage to tumor cells during enzyme treatment. The course of migration was traced by three-dimensional examination in the high voltage electron microscope, as well as the light microscope. Two broad patterns were found for the course of invasion of small and large vessels respectively. PMID- 3810635 TI - Structural changes induced in capillary endothelial cells by growth factors: altered distribution of cytoskeletal elements and organelles in cells spreading in the presence of tumor conditioned medium and hypothalamus derived growth factor. AB - Using high-voltage and conventional electron microscopy of cell whole mounts, we have investigated the effects of tumor-conditioned medium and hypothalmus-derived growth factor on the structure of capillary endothelial cells during their attachment and spreading in tissue culture. Cells were cultured in A, Dulbecco's Modified Eagle's Medium (DMEM) and 10% calf serum; B, equal parts of A and 48 hr mouse sarcoma conditioned medium; and C, A containing 10 units of hypothalamus derived growth factor. Cells cultured in all three media were fully spread, and to the same extent, by 4 hr after plating. While spreading, cells cultured in DMEM alone developed prominent stress fibers and contained numerous bundles of microtubules which formed radical tracts along which mitochondria and other organelles rapidly moved to the cell periphery. Stress fibers were thinner and microtubule tracts fewer in number in cells cultured in tumor-conditioned medium. In 4 hr, organelles moved only part of the distance to the cell margin. Stress fibers were rudimentary and microtubules randomly orientated in cells exposed to hypothalamus-derived growth factor. Most organelles remained near the cell nucleus. The dramatic decrease in stress fibers and microtubule tracts in cells grown in tumor-conditioned medium and hypothalamus-derived growth factor and the subsequent decreased capacity of the cells to move organelles toward their periphery could have some functional significance relative to the growth promoting activity of these substances. PMID- 3810636 TI - Lymphocyte and granulocyte migration across the endothelial layer of bovine pulmonary artery intimal explants towards lymphocyte conditioned medium. AB - An intravenous infusion of endotoxin into sheep results in accumulation of equal numbers of lymphocytes and granulocytes in the pulmonary microcirculation. The role of the sequestered lymphocytes in acute lung injury is not known. The present study examines whether lymphocyte migration through pulmonary endothelium contributes to endothelial damage and also examines the effect of lymphokines on granulocyte migration. Bovine pulmonary artery intimal explants were mounted in Boyden chambers and conditioned media, prepared from bovine peripheral blood lymphocytes, was used as the chemoattractant. The rate of 51Cr labelled bovine granulocyte lymphocyte migration into intimal explants was determined over a 3 hr incubation period. Permeability changes were assessed by adding trace amounts of 14C-sucrose and 3H-water to the upper well and following their rate of equilibration with the lower well. 6-Keto-PGF1 alpha was measured in the upper well. Lymphocyte conditioned media was found to be chemotactic for both lymphocytes and granulocytes (lymphocyte migration at 60 min: lymphocyte conditioned media = 18.5 +/- 2.3%, mean +/- s.e. RPMI control = 12.5 +/- 1.5; granulocyte migration at 120 min: conditioned media = 36.1 +/- 5.7, RPMI control = 18.2 +/- 3.0). Ultrastructural examination revealed leukocyte migration followed an orderly sequence during which the leukocytes maintained close contact with the adjacent endothelial cells. No structural evidence of endothelial cell damage was seen at any time examined. Granulocyte migration was associated with an increased rate of 14C-sucrose equilibration after 2 hr of incubation (lower well counts/upper well counts at 2 hr, RPMI control = 0.18 +/- 0.02; lymphocyte conditioned medium = 0.30 +/- 0.04) indicating alteration in the endothelial barrier function. Leukocyte migration, particularly lymphocyte migration, was accompanied by a marked increase in prostacyclin accumulation (3 hr: no leukocytes, 188 +/- 17 ng/ml; lymphocytes, 560 +/- 104). These in vitro findings suggest that lymphocytes and lymphokines may be involved in acute lung injury and also that permeability changes associated with granulocyte migration may depend on the chemoattractant. PMID- 3810637 TI - Characterization of filaments within the subacrosomal space of rat spermatids during spermiogenesis. AB - Two types of filaments were observed within the subacrosomal space of rat spermatids. The first of these types was characterized as actin by demonstration of actin filament affinity for myosin S-1 subfragments. Actin filaments were noted in the subacrosomal space shortly after the acrosomal sac made contact with the nucleus. As the acrosome increased its surface area contact with the spermatid nucleus, the number of layers of subacrosomal filaments increased. Pre treatment with detergent, which in addition to permeablizing cells to allow entry of S-1, also caused the acrosome to vesiculate and the subacrosomal space to widen. In such preparations filaments were more easily visualized and appeared to extend between the nuclear and acrosomal membranes, indicating, but not proving, attachment to these membranes. During spermatid clongation, the number of actin filaments in the subacrosomal space increased greatly, especially over the dorsal convex region of the spermatid head. The polarity of the majority of filaments was not ascertainable since filaments were tightly packed within the narrow subacrosomal space. In late spermiogenesis (steps 18 and 19), actin filaments were no longer detected within the subacrosomal space. A second and much thicker type of filamentous structure was observed in the subacrosomal space of spermatids at steps 14-17 of spermiogenesis. About 14 nm in diameter (10-15 nm measurement range depending on fixation protocol utilized), these filaments did not decorate with myosin S-1 subfragments and were found in subacrosomal regions not containing actin. Fourteen nanometer filaments were seen in parallel array along the ventral folded portion of the nuclear membrane and extended partially around the nucleus. Like actin filaments. 14 nm filaments were not seen in the subacrosomal space during late spermiogenesis. PMID- 3810638 TI - A simple method for the determination of plasma extrinsic coagulant activity. AB - A spectrophotometric study of plasma coagulation is presented with a method for the determination of plasma coagulant activity, via the extrinsic pathway. Dilute citrated plasma was coagulated by recalcification after the addition of a very small amount of thromboplastin. The maximum increase in absorbance per min during coagulation was used as a measure of coagulant activity. The method was applied to normal platelet-rich plasma samples, and the effect of changing the concentration of plasma, thromboplastin, fibrinogen, and heparin was studied. PMID- 3810639 TI - Serotonin uptake at 22 degrees C of stored platelets. AB - In order to ascertain the possibility that platelet serotonin uptake may occur during storage of platelet concentrates (PC) at 22 degrees C with agitation, the high-performance liquid chromatographic procedure was applied to determine serotonin uptake by platelets. Studies at 22 degrees C showed that platelets stored for 4 days exhibited a significant serotonin uptake with a Vmax value of 2.4 X 10(-19) mole/platelet/min and a Km value of 0.62 X 10(-6) M. Incubation of PC with 5 X 10(-6) M serotonin for 1 day at 22 degrees C increased their serotonin contents from 2.2 to 4.2 X 10(-7) mole/10(11) platelets. Thrombin stimulation caused about 80% release of intracellular serotonin from fresh as well as stored platelets, which contained standard serotonin in the same amount as the original amount. These results suggest that a significant serotonin uptake of platelets might occur during in vitro storage at 22 degrees C and stored platelets have retained abilities to sequester extracellular serotonin into dense granules. PMID- 3810640 TI - Surgical management of pulmonary atresia, and critical pulmonary stenosis with intact ventricular septum. AB - Our experience with the surgical management of hypoplastic right ventricle with intact ventricular septum has included 20 patients with pulmonary atresia and 3 patients with critical pulmonary stenosis. Group 1 consisted of 7 infants who were treated by transarterial pulmonary valvotomy. Four of them were lost shortly after surgery. Group 2 included 11 neonates and one infant who were treated by systemic-pulmonary shunt with 2 operative death. Group 3 included 4 infants who underwent primary prosthetic enlargement of the right ventricular outflow tract. Two of the 4 were lost in the early postoperative period. Eight of 13 patients in groups 1 and 2 who survived the initial palliative procedures underwent additional operations to enlarge the right ventricular outflow tract, and 5 patients survived. However, adequate right ventricular and tricuspid valve growth was obtained in only patients in whom the prosthetic enlargement of the right ventricle was performed in early infancy. These findings strongly suggest the necessity to decompress the right ventricle completely, as early as possible. In conclusion, 1) transarterial pulmonary valvotomy seldom provided satisfactory decompression of the right ventricle, and operative risk was high. 2) systemic pulmonary shunt to re-establish pulmonary blood flow improved neonatal survival, although this procedure may not provide a satisfactory long term palliation. 3) primary or secondary operative enlargement of the right ventricle in early infancy provided decompression of the right ventricle and accelerated substantial right ventricular growth. For patients without an infundibulum or for those in whom attempts to induce tricuspid valve growth had failed, a Fontan type procedure seemed to be the procedure of choice. PMID- 3810641 TI - Influence of obstructive jaundice on acute gastric ulcer, intragastric pH and potential difference in rats. AB - To elucidate the influence of obstructive jaundice on the process of acute ulceration of the stomach under stress loading and to investigate the preventative effect of vagotomy, a series of experimental studies were carried out using SD rats. Animals were divided into four groups: Control, jaundice, vagotomy and jaundice with vagotomy. Each group was subjected to the water immersion-restraint stress and changes in the potential difference of gastric mucosa (PD), the intragastric pH (pH) and the score of ulcer index at sacrifice (UI) were measured. The process of acute ulceration under the stress loading was shown to be accelerated by the weakening of defensive factors in the case of obstructive jaundice. To monitor changes of pH and PD was found to be useful to predict the manifestation of gastric lesion. Vagotomy seemed to be partly effective to prevent the ulceration evidenced by lowering aggressive facter (an increase of pH), but it may also decrease the defensive factor because the vagotomy produced a significant lowering of PD. PMID- 3810642 TI - Determination of urinary vanillylmandelic acid and homovanillic acid by high performance liquid chromatography for mass screening of neuroblastoma. AB - In order to develop a mass screening method for the early detection of neuroblastoma, we measured urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) by a high performance liquid chromatography (HPLC) equipped with an electrochemical detector. Urinary samples were collected on a piece of filter paper and then pre-treated by a simple method. Measurement of VMA and HVA was performed within a short period of time, and by about 80 samples per a day could be analyzed by automatic system. The method described herein proved to be reliable, and we thus recommend it as a useful method for measurement of both VMA and HVA, leading to more accurate detection of neuroblastoma in mass screening test. PMID- 3810643 TI - Experimental study on the regulation of testicular function by the cremaster reflex in rats. AB - The present study was performed to clarify the role of the cremaster reflex in regulating the testicular function in rats. The impairment of cremaster reflex by bilateral dissection of the genitofemoral nerves resulted in a decrease of testicular weight and degenerative changes of the semeniferous tubules in the rats kept in a cold room (4 degrees C), but not in the rats kept at room temperature (22 degrees C). The results indicate that the cremaster reflex contributes much to the temperature regulation of the testicle located within the scrotum. PMID- 3810644 TI - Diagnosis of alkaptonuria by NMR urinalysis: rapid qualitative and quantitative analysis of homogentisic acid. AB - Urinalysis of alkaptonuria using NMR spectroscopy revealed the abnormal amount of homogentisic acid. Qualitative and quantitative determination was performed simultaneously with untreated urine sample and within 15 min. PMID- 3810645 TI - The long-term facilitation of neuronal activity produced by repeated pairing of an orthodromic stimulus and antidromic stimuli in the sliced hippocampal formation. AB - Long-term facilitation in extracellularly recorded population spikes was demonstrated by repeated paired stimulation (RPS) in CA1 neurons of the guinea pig hippocampal slices. Paired stimulation, consisting of a single orthodromic "test" stimulus and a train (5 pulses at 200 Hz) of antidromic stimuli with an interstimulus interval (ISI) of 20, 500 msec or 1 sec was repeated every 5 sec over a 250 sec period. The amplitude of the population spike in response to the test stimulus increased gradually after RPS and reached a plateau level 30-50 min after RPS. The plateau value was dependent on ISI; the shorter the ISI the greater the increase of responses. In contrast, no facilitation was observed when either the test stimulus or the antidromic stimuli were applied separately, without pairing. PMID- 3810646 TI - State rate-setting strategies. PMID- 3810647 TI - Entering the HMO arena: options for hospitals. PMID- 3810648 TI - Evaluating pricing for health care service contracts. PMID- 3810649 TI - Antitrust implications of joint negotiations with third party payers. PMID- 3810650 TI - Comparison of the in vivo and in vitro testicular effects produced by methoxy-, ethoxy- and N-butoxy acetic acids in the rat. AB - Methoxy-, ethoxy- and n-butoxy acetic acids, known urinary metabolites of the corresponding alkoxyethanol solvents, were administered by gavage to rats as a single oral dose equimolar with 500, 250 or 100 mg 2-methoxyethanol/kg body weight. Testicular weight and morphology were monitored over a 14-day period post treatment. Methoxyacetic acid (MAA) was the only compound which produced a significant decrease in testicular weight. Histological examination of the testes from treated animals indicated that MAA at all doses and ethoxyacetic acid (EAA) at the highest dose, produced damage specific to spermatocytes undergoing meiotic maturation and division (particularly stages XIII-XIV) within 24 h of treatment. n-Butoxyacetic acid (BAA) had no discernable effect on the testis at any dose level or time, although there was evidence of haematuria produced by the compound. Addition of MAA, EAA and BAA to testicular cell cultures at concentrations approximately equivalent to the steady state plasma levels of MAA determined after a testicular toxic dose (500 mg/kg) of methoxyethanol (5 mM) produced a specific loss of pachytene spermatocytes (the target population in vivo) from the system by MAA and EAA (MAA greater than EAA). BAA did not produce any specific changes to testicular cell populations in vitro. Thus the production of testicular toxicity by alkoxyacetic acids diminishes with increasing chain length, and a good correlation exists between in vivo and the in vitro system. PMID- 3810651 TI - Acute toxicity of T2 toxin in rats, mice, guinea pigs, and pigeons. AB - The acute intravenous, intragastric, subcutaneous, intraperitoneal and intratracheal toxicity of T2 toxin has been studied in rats, mice, guinea-pigs, and pigeons. The acute LD50 values obtained varied between 1.0 and 14 mg X kg-1, there being little difference between the various routes in any given species. T2 caused vomiting in pigeons at doses of one fifth or less the LD50. In rats doses of 3.0 and 5.0 mg X kg-1 T2 produced lymphopenia, reticulocytosis, and in the highest dose groups normoblastaemia. Additionally, changes in plasma alkaline phosphatase and aspartate aminotransferase activities were seen. Histological changes were observed in lymphoid organs and were most severe in the thymus, lymph nodes, and Peyer's patches. The spleen was less severely affected. Gastrointestinal changes consisting of dead and dying lymphoid cells throughout the lamina propria were seen together with, in some cases, mucosal ulceration. The time course of the development and of the reversal of the changes was followed. PMID- 3810652 TI - Critical prenatal periods for chlorambucil-induced functional alterations of the rat kidney. AB - Previous studies have demonstrated that exposure of rats to chlorambucil during the period of metanephric differentiation results in morphological and functional alterations of the kidneys after birth. The present study describes the effects of chlorambucil treatment at various gestational ages on neonatal renal function to determine if critical periods other than day 11 exist for inducing functional developmental toxicity of the kidneys. Groups of pregnant Sprague-Dawley rats were exposed to 4.5 mg/kg of chlorambucil on gestation days 9, 11, 13 or 15 and the offspring were evaluated for neonatal growth and viability, gross malformations of the kidneys, and renal physiology. The results demonstrate that the critical period for the induction of specific renal defects and hypoplasia lies on day 11 of gestation, but functional alterations of the kidneys were observed after exposure on day 15 of gestation. In terms of practical application, a combination of the basal clearance test and the renal concentration test together provide an efficient means for detecting prenatally induced functional alterations of the kidneys. When renal malformations or anomalies are observed in standard teratology bioassays, studies using techniques similar to those described here may be extremely useful in determining the biological significance as well as permanence or transience of effects such as renal hypoplasia, dilated renal pelvis, and dilated ureter. PMID- 3810653 TI - The chances of false negative results in conventional toxicology studies with rats. AB - Data from conventional rat toxicology studies from 2 centres are used to estimate the coefficients of variation of organ weights, haematology and blood chemistry characteristics commonly measured in such studies. Charts, based on simple statistical formulae, are provided which enable this information to be used to indicate the probability of failing to detect a treatment effect of a given magnitude as statistically significant. The results, for a study with 20 rats/treatment group, when the treatment causes a change of 10% in the characteristic, indicate wide variability in the false negative error rate. With some characteristics (e.g. haemoglobin, total protein, brain weight, red blood cell count) the false negative rate is less than 0.1%, but for others (e.g. white blood cell count, glutamic-pyruvic transaminase, pituitary weight, cholesterol) it is in excess of 70%. PMID- 3810654 TI - Guinea pig pulmonary response to sensitization by five preformed monoisocyanate ovalbumin conjugates. AB - The ability of 5 dissimilar monoisocyanates conjugated to ovalbumin (OA) as a carrier protein to induce pulmonary hypersensitivity towards the hapten specific component was assessed by using a previously described method based on the determination of a respiratory index (RI) in the guinea pig. The test chemicals included the commercially available p-tolyl and hexyl monoisocyanates (TMI and HMI), with 4-isocyanoto-4'-diphenylmethane (IDM), 4-isocyanoato-4' methyldiphenylmethane (IMDM) and 1-isocyanato-methyl-1,3,3-trimethylcyclohexane (IMTC) as synthetized monoisocyanates. Guinea pigs were exposed daily to an aerosol of the OA conjugate of each monoisocyanate up to day 15. Increases in respiratory rate and/or respiratory collapse occurred in the guinea pigs exposed to TMI-OA and HMI-OA conjugates by days 9 and 15, with RI values of 155 and 177, respectively, being recorded. The greatest mean RI values in guinea pigs exposed to IDM-OA, IMDM-OA and IMTC-OA conjugates up to day 15 were 20, 25 and 22, respectively, and were not indicative of any pulmonary reaction. Guinea pigs exposed in parallel to each test conjugate did not exhibit any pulmonary reaction when they were exposed to OA on the challenge days. All these findings evidence pulmonary hypersensitivity as the result of exposure to TMI-OA and HMI-OA conjugates and suggest a high degree of conjugation and strong linkage of all the monoisocyanates with OA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810655 TI - The relative importance of N-oxidation and N-demethylation in the metabolism of trimethylamine in man. AB - The metabolism of orally administered trimethylamine has been studied in 4 male volunteers at 2 dose levels. N-Oxidation was the major route of metabolism whilst N-demethylation was negligible and only significant at the higher dose level. PMID- 3810656 TI - Teratogenicity of flubendazole in rats. AB - Flubendazole, the p-fluoroderivative of mebendazole, was suspended in deionized water, and administered by gavage once daily to pregnant rats on days 8 through 15 of pregnancy at 0 (control), 2.5, 10, 40 or 160 mg/kg. Fetuses were removed on day 21 of pregnancy by caesarian section, and examined by routine teratological methods. The highest dose (160 mg/kg) was embryocidal and resulted in a significant increase in the fetal resorption rate. There was a dose-dependent decrease in fetal body weights which was significant at 40 mg/kg or more. The 40 and 160 mg/kg doses induced significant fetal (gross, skeletal and internal) malformations. A variety of gross malformations occurred, i.e. encephalocele, cranial meningocele, omphalocele, ectrodactyly, club foot, defects in tail, anal atresia, shortened backbone and Spina bifida occulta. The skeletal malformations mainly affected the vertebrae and ribs. The most frequently observed internal malformation was hydrocephaly, followed by anophthalmia and/or microphthalmia. PMID- 3810657 TI - Metabolism of 2- and 3-tert-butyl-4-hydroxyanisole (2- and 3-BHA) in the rat (I): Excretion of BHA in urine, feces and expired air and distribution of BHA in the main organs. AB - The mechanism of the carcinogenic or toxic action of BHA on rat forestomach was examined by studies on the excretion and tissue distribution of radioactivity in F344 male rats given tert-butyl- or methoxy-labelled 3-BHA orally. Within 2 days after a single oral dose of labelled BHA at 1 g/kg body wt, 87-96% of the 14C was excreted, mainly in the urine with smaller amounts in the feces and expired air. More 14C was found in the tissues of rats given the methoxy-labelled compounds. The distributions of 14C in the forestomach and the glandular stomach were similar. At 168 h after treatment, more 14C was found in the forestomach of rats given 2-BHA than in that of rats given 3-BHA. These results indicate that excretion of BHA is rapid, that 4-O-methyl demethylation may take place readily and that demethylated methyl group may become distributed non-specifically in tissues. The carcinogenic or toxic action of BHA on the forestomach does not seem to be due accumulation of BHA in the forestomach. PMID- 3810658 TI - Furosemide toxicity in isolated mouse hepatocyte suspensions. AB - Incubation of freshly isolated mouse hepatocytes with 0.5 or 1.0 mM furosemide caused a depletion of cellular acid soluble sulfhydryls to approximately 20-30% of control over the course of 4.5 h. The depletion was accompanied by a reduction in cell viability (indicated by the lactate dehydrogenase latency test) which was significant (P less than 0.05) for 0.5 mM but not for 1.0 mM furosemide at 4.5 h. Ultrastructurally, 0.5 or 1.0 mM furosemide caused cytoplasmic changes including loss of glycogen, disaggregation of polyribosomes, vesiculation of endoplasmic reticulum, and occasional appearance of lamellar bodies consisting of concentric arrays of paired smooth membranes. These concentrations of furosemide also caused cell surface changes, including loss of microvilli, development of an irregular shape compared to the spherical appearance of untreated hepatocytes, and the development of occasional blebs. The appearance of pale staining hydropic cells was indicative of the final stages of cell death. N-Acetylcysteine (6.0 mM) was effective at preventing the depletion of soluble sulfhydryls, the loss of viability, and the ultrastructural effects of 0.5 or 1.0 mM furosemide, suggesting a role for soluble sulfhydryls in the pathogenesis of furosemide hepatotoxicity. PMID- 3810659 TI - Carotid sinus reflexes in rats given small doses of lead. AB - The effect of low level lead poisoning on the carotid sinus reflex in rats was studied. The reflex was evoked by carotid artery clamping, in control and lead poisoned animals. Wistar rats were given lead acetate trihydrate (50 mg/kg) via stomach tube once weekly for 5 weeks; control animals were given equimolar amounts of sodium acetate. Both groups were fed a regular animal food diet. At the end of the 6th week, and under urethane anesthesia, mean arterial blood pressure and heart rate were continuously recorded for both groups, before and after clamping, and after unclamping the left common carotid artery. In other experiments, some animals were pre-treated with dopamine, 0.040 mg/kg; practolol, 3 mg/kg; propranolol, 0.1 mg/kg; or atropine, 0.1 mg/kg. In animals not given drugs, lead produced a less pronounced rise in mean arterial blood pressure after clamping, and a more pronounced decrease in heart rate after unclamping, compared to control animals. Some drugs altered this response pattern. Atropine led to a more pronounced tachycardia in the lead-poisoned rats, whereas practolol led to a more pronounced bradycardia in the lead-poisoned rats. Propranolol pretreatment led to a less pronounced decrease in heart rate for lead-poisoned rats, again as compared to the controls. Atropine and beta-adrenergic receptor blocking agents produced similar carotid sinus reflex responses in control and lead-poisoned animals. PMID- 3810660 TI - The influence of sodium ascorbate, menadione sodium bisulfite or pyridoxal hydrochloride on the toxic and antineoplastic action of N-methylformamide in P 388 leukemia or M 5076 sarcoma in mice. AB - The toxicity of daily subcutaneously applied 500 mg/kg N-methylformamide (NMF) during a period of 8 days in female CD-mice was ameliorated when 100 mg/kg sodium ascorbate, 60 mg/kg menadione bisulfite or 80 mg/kg pyridoxal hydrochloride were applied simultaneously. The comparison of the daily s.c. application of 360 mg/kg NMF with the intermittent s.c. injection of 720 mg/kg NMF with an interval of 48 h in P 388 leukemia showed that the daily application of NMF induced an increase of life span of 82% whereas the intermittent schedule effected a 142% increase of life span. The simultaneous combination of 360 mg/kg NMF with 60 mg/kg sodium ascorbate applied daily caused a 133% increase of life span and the simultaneous combination of 360 mg/kg NMF with 30 mg/kg menadione sodium bisulfite lead to a 126% increase of life span. The combined daily s.c. application of 360 mg/kg NMF with 30 mg/kg pyridoxal hydrochloride induced only a minimal difference compared to the daily application of 360 mg/kg NMF alone. The combination of 720 mg/kg NMF with 120 mg/kg sodium ascorbate applied in intervals of 48 h showed a 164% increase of life span. In advanced M 5076 sarcoma the daily s.c. application of 360 mg/kg NMF effected a 82% increase of life span and the combination of 360 mg/kg NMF with 60 mg/kg sodium ascorbate effected a 135% increase of life span. PMID- 3810661 TI - Identification of the cooked food mutagen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and its N-acetylated and 3-N-demethylated metabolites in rat urine. AB - The extractable unconjugated metabolites of 2-amino-3-methylimidazo-[4,5 f]quinoline (IQ) were identified in the urine of rats which had received a single dose of [3H]IQ by gavage. The dichloromethane and ethylacetate extracts prepared from the alkalinized 0-24 h urines were analyzed by radio-TLC and radio-HPLC. The 3 major HPLC fractions were submitted to DCI-MS analysis. Unchanged IQ, N acetylIQ and 3-N-demethylIQ have been identified. Extractable unconjugated metabolites represent only about 0.85% of the total radioactivity excreted in the urine. PMID- 3810662 TI - Effect of butylated hydroxyanisole on in vitro and in vivo nitrosation of dibutylamine. AB - The effect of the food additive butylated hydroxyanisole on the nitrosation of dibutylamine was studied in vitro and in vivo, in rats. At the highest concentration tested, butylated hydroxyanisole significantly inhibited the in vitro formation of N-nitrosodi-n-butylamine from dibutylamine and nitrite by 35%. This effect was not observed in animals given dibutylamine, NaNO2 and butylated hydroxyanisole by gavage in the same ratio that produced an effect in vitro. The oral administration of butylated hydroxyanisole to rats given 0.5% nitrate in the drinking water and dibutylamine (0.38 mmol/kg 3 times/day p.o.) was also with no effect, although the experimental model used proved suitable for studying the modulating effect on endogenous nitrosation of different chemicals such as ascorbic acid or potassium thiocyanate. The discrepancy between in vitro and in vivo results is discussed. PMID- 3810663 TI - Isolation and partial characterization of a myotoxin from the venom of the snake Bothrops nummifer. AB - A myotoxin from the venom of the snake Bothrops nummifer was purified to homogeneity by ion-exchange chromatography on CM-Sephadex. The toxin is a basic dimer with a subunit molecular weight of 16,000, as estimated by SDS polyacrylamide gel electrophoresis. The toxin lacks phospholipase A2 activity when tested on egg yolk lecithin and skeletal muscle homogenates. It induces skeletal muscle damage both in vivo and in vitro. When injected i.m. it promotes a drastic increase in serum creatine kinase levels; the isozyme CK-MM is responsible for this increment. A rapid release of creatine kinase was observed when mouse gastrocnemius muscle was incubated with the toxin, suggesting that it induces the formation of relatively large 'lesions' in the plasma membrane of muscle cells. Moreover, analysis of the dose-response data indicated that the myotoxin affects muscle sarcolemma by a 'one hit' mechanism. Skeletal muscle cells are affected by the toxin when calcium is eliminated from the medium. The myotoxin has an i.v. LD50 of 3.9 mg/kg body weight in mice, and induces edema when injected in the foot pad. On the other hand, it is not directly hemolytic, anticoagulant, hemorrhagic nor cytotoxic for lymphocytes. The myotoxin shows partial immunologic identity with a myotoxic phospholipase A2 isolated from Bothrops asper venom. The polyvalent antivenom produced in Costa Rica forms a precipitation arc against B. nummifer myotoxin on immunoelectrophoresis. PMID- 3810664 TI - Comparison of immunological, biochemical and biophysical properties of three hemorrhagic factors isolated from the venom of Bothrops jararaca (jararaca). AB - Compared to the crude velonom of Bothrops jararaca, which needs 5000 ng to produce a hemorrhagic spot of 1 cm2 on rabbit skin, the isolated hemorrhagic factors HF1, HF2 and HF3 require 100, 20 and 15 ng of protein, respectively. Although these hemorrhagic factors possess different biochemical and biophysical properties, they are immunologically related proteins. The hemorrhagic, as well as the proteolytic, activities of these factors are destroyed by EDTA, acidic pH or heat treatments. PMID- 3810666 TI - Hornet venoms: lethalities and lethal capacities. AB - The i.v. LD50 values to mice of pure venoms of Vespa mandarinia japonica, V. simillima xanthoptera, V. tropica deusta and V. l. luctuosa were, respectively, 4.1, 3.1, 2.8 and 1.6 mg/kg. The LD50 value of 1.6 mg/kg distinguishes the venom of V. luctuosa as the most lethal known wasp venom. To measure the absolute lethality of a single sting, a new index, called lethal capacity, based on the amount of venom possessed by an individual and its lethality is presented. V. mandarinia and V. tropica are the most venomous known insects, with a lethal capacity of one sting from V. mandarinia delivering an LD50 (i.v.) dosage of venom to 270 g of mouse. The lethal capacity for an entire hornet colony, called colony lethal capacity, for V. tropica is 84 kg of mouse/colony. PMID- 3810665 TI - Nuclear lipid peroxidation induced in rat liver by T-2 mycotoxin. AB - Oral administration to rats of T-2 mycotoxin (1.25 mg/kg) for five days causes an increase in lipid peroxidation (ascorbate-induced as well as NADPH-dependent) in hepatic nuclei, while the activity of liver glutathione-S-transferase (EC. 2.5.1.18) is decreased. The hepatotoxicity could be due to lipid peroxidation induced by depletion of hepatic reduced glutathione and/or production of free radicals. PMID- 3810667 TI - Proceedings of the International Experimental Toxicology Symposium on Passive Smoking. October 23-25, 1986, Essen (F.R.G.). PMID- 3810668 TI - A critical look at N-nitrosamines in environmental tobacco smoke. AB - The amounts of cigarette smoke carcinogens released into the environment as sidestream smoke (SS) constituents are generally twice as high as the levels of the carcinogens that are inhaled as mainstream smoke (MS). However, certain carcinogens in undiluted SS, such as nitrosamines, exceed MS levels up to 50 times. Regardless of the fact that SS is usually substantially diluted before being inhaled, its constituents can be determined in environmental tobacco smoke (ETS) by modern analytical methods and levels of exposure of involuntary smokers can be assessed by the use of specific markers. Currently, the uptake of ETS by nonsmokers is determined by measuring nicotine and its metabolite cotinine in saliva, serum and/or urine. In on-going studies, we are now exploring the determination of the two highly carcinogenic nicotine-derived nitrosamines N' nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), respectively of their metabolites, in physiological fluids of smokers and nonsmokers. PMID- 3810669 TI - Physiological changes in pulmonary development related to passive smoking and its interaction with active smoking. AB - The growth of pulmonary function between ages 5.5 and 25 years was determined in 1502 observations on 362 subjects from a representative population study of non Mexican American whites in Tucson. There was an average of 8.8 years of follow up, with a maximum of 12. The model developed was robust for follow-up of 3-7 observations (3 + years). Respiratory illnesses and smoking had the biggest negative impact on growth of forced expiratory volume in 1 s (FEV1), Vmax 50%/forced vital capacity (FVC) parental smoking and airway obstructive disease (AOD) were important also. Flow measures showed present and more persistent effects of disease and smoking than did FEV1. PMID- 3810670 TI - Extrapolation from rat studies with environmental tobacco smoke (ETS) to humans: comparison of particle mass deposition and of clearance behavior of ETS compounds. AB - The relative deposition of inhaled heterodisperse particles of the size of environmental tobacco smoke (ETS, mass median aerodynamic diameter 0.2 micron, geometric standard deviation 1.5) is about the same in the tracheobronchial tree and is lower in the pulmonary region of the rat than in the same regions of humans. However, model calculations show that per cm2 of surface area the deposition rate of ETS particle mass shows a doubling in rats as compared to humans in the transitional zone of the lung, i.e., airway generations 16-20. Within the human airways, mainstream smoke particles are deposited to a higher degree in generations 2-5 than in the transitional zone, whereas the opposite applies to ETS particles. Significantly higher pulmonary retention in man than in rats of inhaled ETS particles and their constituents (e.g. cadmium) leads to additional differences in the dose accumulating in the lung over time. Such differences in deposition and retention characteristics of inhaled ETS have to be considered when extrapolating results from rat studies to humans. PMID- 3810671 TI - Personal air exposures and breath concentrations of benzene and other volatile hydrocarbons for smokers and nonsmokers. AB - Personal air exposures and exhaled breath concentrations of 20 volatile organic compounds were measured for 198 smokers and 322 non-smokers in 5 U.S. cities (1980-84). Smokers showed significantly increased breath concentrations of six hydrocarbons: benzene, styrene, ethylbenzene, o-xylene, m + p-xylene, and octane. Homes with smokers had higher indoor air concentrations of the same compounds than homes without smokers during fall and winter. Passive smokers exposed at work had significantly higher levels of benzene and other aromatics in their breath than unexposed non-smokers. PMID- 3810672 TI - Gaschromatographic determination of polycyclic aromatic hydrocarbons, aza-arenes, aromatic amines in the particle and vapor phase of mainstream and sidestream smoke of cigarettes. AB - The present arrangement collects particles and semivolatiles of main- and sidestream smoke and allows a recovery of the trapped substances nearly quantitatively and without impurities. The fractionation procedure allows to separate various groups of carcinogens such as PAH, aza-arenes and aromatic amines for analytical and biological studies. Sidestream smoke contains ten times more polycyclic aromatic hydrocarbons (PAH) compared with mainstream smoke. This holds also true for aza-arenes and amines. PAH of the gaseous phases include only 1% of the particle-bound PAH. PMID- 3810673 TI - The measurement of 'environmental tobacco smoke' particulates. AB - An analysis of sidestream smoke particulates in a wide range of study conditions, utilizing a variety of methods of measurement, was undertaken. The conclusion is that the term 'total particulate matter', as defined for mainstream smoke, has little or no meaning in the context of environmental tobacco smoke. Light scattering instruments offer, in terms of portability and short sampling times, the best option for ambient particulate measurement. However, any quantitative interpretation of the results is dependent upon the initial calibration. PMID- 3810674 TI - A study of the atmosphere in London underground trains before and after the ban on smoking. AB - Measurements of the ambient atmosphere in London Underground train compartments were made before and after a ban on smoking. Levels of nicotine and carbon monoxide and estimates of airborne particulates are given. This paper describes the analytical techniques used in measuring constituents of tobacco smoke in the ambient air of public environments. Levels observed were all found to be far lower than recommended OSHA limits for safe exposure. PMID- 3810675 TI - Clastogenic effect of passive smoking on bone marrow polychromatic erythrocytes of NMRI mice. AB - The genotoxic effect of passive inhalation of sidestream cigarette smoke on bone marrow polychromatic erythrocytes was studied using male NMRI mice. The animals were placed in individual 145.2-dm3 glass chambers resembling a room provided with normal air flow. They were exposed to the sidestream smoke of a commercial brand of cigarettes smoked by a smoking machine under standard conditions. Increased formation of micronuclei within polychromatic erythrocytes (PCEs) of femoral bone marrow 30 h after passive smoking was regarded as being due to the clastogenic effect of the smoke. Passive inhalation of the diluted sidestream smoke of a single cigarette resulted in a significant increase (P less than 0.01) in the frequency of micronucleated PCEs. This clastogenic activity was found to be dose-dependent. PMID- 3810676 TI - Lung cancer and passive smoking: association of an artefact due to misclassification of smoking habits? AB - 1775 subjects were asked about their current use of tobacco products or nicotine chewing gum. 1537 provided a sample of saliva for cotinine analysis. Of 808 who claimed not to be users of such products, 20 (2.5%) had cotinine values above 30 ng/ml, suggesting their self-reports were false. In another study, 540 subjects were interviewed on two occasions. 10% of subjects claiming on one occasion never to have smoked made inconsistent statements on the other occasion. A third study showed a strong tendency for smokers to marry smokers. Bias caused by misclassification of smoking habits coupled with between-spouse smoking habit concordance can completely explain reported apparent excesses in lung cancer risk in non-smokers married to smokers. PMID- 3810677 TI - Misclassification of environmental tobacco smoke exposure: its potential influence on studies of environmental tobacco smoke and lung cancer. AB - The effects of selection, confounding, misclassification and bias must be eliminated from case-control studies of 'passive smoking' and lung cancer before a meaningful interpretation can be made. Misclassification includes the misclassification of the subject's non-smoking status, of the disease status or of the spouse's smoking habits. This paper shows that inflation of the amount smoked by the husbands of female lung cancer cases may have accounted for the apparent 'dose-response' relationships in 3 widely referenced case-control studies. PMID- 3810678 TI - Passive smoking and lung cancer: epidemiological evidence and ongoing international collaborative studies. AB - Epidemiological studies which investigated the association between lung cancer in non-smokers and exposure to tobacco smoke are reviewed. Discordant results are discussed in the light of biases and misclassification. Design, materials and methods are presented of an ongoing international collaborative study to explore the relationship between recent exposure to passive smoking (P.S.), as assessed by interview, and cotinine and thiocyanate levels in urine. PMID- 3810679 TI - IARC approaches to monitoring exposure of passive smoking. AB - Existing information on the nature of passive smoking shows many pitfalls in ascertaining carcinogenic exposures. Two current activities of the International Agency for Research on Cancer are described: presentation of standardized monitoring methods for passive smoking; and an international study to explore biochemical measurements in relation to passive smoking history as assessed by interview. PMID- 3810680 TI - Measuring problems in estimating the exposure to passive smoking using the excretion of cotinine. AB - Quality control studies on cotinine measurements following low level environmental tobacco smoke (ETS) exposure are rare. The exposure to ETS was controlled and systematically changed in a series of experiments in a climatic chamber. Healthy nonsmoking volunteers were exposed to ETS simultaneously. The duration and level of exposure varied using high (8, 17 and 25 ppm CO), and low (2 and 5 ppm CO) exposure levels. The variation between radioimmunoassay (RIA) and gas chromatography (GC) was high as was the variation between the results of RIA laboratories. There was also a high within-laboratory-variation. A 1:10 dilution seems to be preferable over a 1:3 dilution. Freezing the urine samples immediately after collection led to the detection of higher cotinine values than freezing the samples 24 h after collection. Highly reliable data for cotinine were obtained when the urine samples were kept frozen immediately after collection and fractionated sampling over 48-72 h was used. Our data show that estimating low-level ETS exposure by measuring urinary cotinine is highly susceptible to uncontrolled variation and errors. Sufficiently reliable estimates of low-level ETS exposure can be made only when fractionated sampling over 48-72 h is used and when the urine samples are kept frozen just after collection. PMID- 3810681 TI - Determination of nicotine and cotinine in human serum and urine: an interlaboratory study. AB - An interlaboratory study aimed at determining nicotine and cotinine in human serum and urine was carried out. 11 laboratories from 6 countries, all experienced in performing nicotine and cotinine determinations in biological fluids by radioimmunoassay (RIA) and/or gas chromatography (GC) were involved. Each of them received 18 serum and 18 urine samples. The specimens were obtained from 8 smokers and 10 non-smokers; 2 samples from non-smokers were spiked with defined amounts of nicotine and cotinine. All the laboratories distinguished perfectly between the smokers and the non-smokers and according to cotinine levels in serum the laboratories ranked the samples with good agreement. There were systematic differences in the absolute values between the laboratories. The ratios of urinary cotinine concentrations between active and passive smokers differed widely from laboratory to laboratory. The reasons for this are not yet known and necessitate further investigation. PMID- 3810682 TI - Mathematical modeling of nicotine and cotinine as biological markers of environmental tobacco smoke exposure. AB - Computer software developed in our laboratory (CMATRIX) was used to design a physiological pharmacokinetic model of nicotine absorption, distribution, metabolism and excretion in man. The model accommodates inhalation of nicotine from various environmental settings and physiological conditions in man. It was also used to predict pharmacokinetic behavior of cotinine arising from nicotine metabolism. Model-predicted variations in body-fluid nicotine levels confirm that nicotine is not an acceptable quantitative marker of environmental tobacco smoke (ETS) exposure. Though cotinine provides a more stable pattern, predicted interindividual variation suggests the need for specific strict sampling and monitoring guidelines for cotinine to be a reliable quantitative marker. PMID- 3810683 TI - Deposition rates of sidestream tobacco smoke particles in an experimental chamber. AB - The natural dissipation rates of sidestream smoke (SS) particles dispersed in a chamber were studied from the standpoint of a static atmosphere and were expressed as half-lives of residence in the air. The half-lives for particles less than 0.3 micron, 0.3-0.5 micron and 0.5-1 micron were found to be 25.5, 12.8 and 4.9 h, respectively. Total particulate matter (TPM) decreases by half after 6.2 h. Other data on diluted SS in the indoor air were also reported. PMID- 3810684 TI - Hydroxy-phenanthrenes in the urine of non-smokers and smokers. AB - Urinary hydroxy-phenanthrene (HO-PHE) excretion in non-smokers exposed to environmental tobacco smoke (ETS) is not increased. There is no significant difference in HO-PHE excretion between smokers (S) and non-smokers (NS), though excretion seems to be slightly elevated in smokers. A diet rich in polycyclic aromatic hydrocarbons leads to a rise in urinary HO-PHE excretion as compared to a diet low in polycyclic aromatic hydrocarbons (PAH), coming close to significance. HO-PHE excretion is not correlated with the mutagenic activity in urine. PMID- 3810685 TI - Smoking and passive smoking during pregnancy and early infancy: effects on birth weight, lactation period, and cotinine concentrations in mother's milk and infant's urine. AB - The extent of smoke exposure via mother's milk and passive smoking was investigated in a prospective, longitudinal matched-pair study by comparison between children, whose mothers smoked substantially throughout pregnancy and nursing period and children whose mothers did not smoke. Our preliminary results show that not only infants of smoking mothers but also those of smoking fathers show reduction of birth weight. Smoking mothers weaned their babies earlier than non-smokers. Cotinine concentrations in breast milk depended on the number of cigarettes smoked. The highest urinary excretion of cotinine (as expressed by ng cotinine/mg creatinine ratios) were observed in infants fully breast-fed by smoking mothers. After weaning the values were in the same range as those of formula-fed infants of smoking mothers (exposed to passive smoking only). In the group of non-smokers only small or undetectable amounts of cotinine were found. Thus it is demonstrated that both nursing and--to a lower degree--passive smoking contribute to the exposure of infants to nicotine and its metabolite cotinine. PMID- 3810686 TI - Uptake of sidestream smoke by Syrian golden hamsters. AB - An inhalation bioassay with Syrian golden hamsters is being conducted to evaluate the toxic and carcinogenic potential of cigarette sidestream smoke (SS) relative to mainstream smoke (MS). A Hamburg II smoking machine is used to deliver MS by nose-only exposure to hamsters and a modification allows for the simultaneous collection of SS for whole-body delivery to a different rack of animals. The tolerated dose of SS was determined by varying the air/smoke dilutions drawn through the animal restrainers. Preliminary data indicated that 20% carboxyhemoglobin (COHb) could be obtained in SS-exposed animals without fatality. Optimum exposure levels were determined. Monthly measurements of COHb, nicotine and cotinine indicate that the SS-exposed animals are absorbing slightly higher amounts of these smoke constituents than the MS-exposed hamsters. Tumor incidence and carcinogenicity data are being collected through complete necropsy and histology protocols and uptake data continue to be collected. These studies should help elucidate the carcinogenic potential of SS which has been suggested from its composition and from recent epidemiological data of cancer incidence in non-smokers. PMID- 3810687 TI - The effect of smoke age and dilution on the cytotoxicity of sidestream (passive) smoke. AB - Decreases in the mortality of monolayer cultures of L-929 cells exposed to sidestream (passive) smoke with increases in smoke age and dilution have been reported. In the current study, the concentration of sidestream smoke (SS) to which cells were exposed was directly correlated with % mortality (r = 0.987) having 0% mortality at a concentration of 1.19% and a calculated mortality of 9562% at a concentration of 100%. The In of % mortality was correlated with increases in smoke age (r = -0.9999) and the regression equation was used to calculate 0 mortality at an age of 30 s and 393% mortality at the time of smoke generation. In addition, when sidestream smoke generated from a low-yield, filtered, modern design experimental cigarette was compared with that generated from a high-tar non-filtered reference cigarette, a lower number of puffs of smoke from the low-yield cigarette than from the high tar cigarette was necessary to yield 50% mortality of cells. PMID- 3810688 TI - Estimation of smoke dosage and mortality of non-smokers from environmental tobacco smoke. AB - This paper shows how biochemical markers can be used to estimate smoke intake from passive smoking to complement epidemiological studies on the health risks and mortality to non-smokers. Using data from slow nicotine infusions given over 1 h, we estimated that the nicotine intake from passive smoking averages about 0.014 mg/h among urban non-smokers leading their usual daily lives. This compares with 0.23 mg/h in a smoke-filled public house, 0.36 mg/h during maximum exposure in an unventilated room, and 1.0 to 1.4 mg nicotine per cigarette taken in by active smokers. Data from several studies on urinary nicotine concentrations and those of cotinine in blood, urine and saliva were collated. The results show that the concentrations in non-smokers averaged about 0.7% (for nicotine) and 0.6% (for cotinine) of the levels found in smokers. From this we estimate that the mortality from passive smoking is about 1000 non-smokers per year in Britain and about 4000 per year in the United States, assuming that the relation of dose to risk is linear. PMID- 3810689 TI - Deposition of sidestream cigarette smoke in the human respiratory tract. II. Deposition of ultrafine smoke particles. AB - Sidestream cigarette smoke was generated into an inhalation chamber from which five normal male volunteers inhaled the smoke. Size distribution of the smoke aerosol was: count median diameter, 0.11 micron, mass median diameter 0.43 micron. Deposition fraction measured as concentration difference for each size fraction between inhaled and exhaled aerosol for each size interval was: 0.075 micron, 0.24 +/- 0.04; 0.13 micron, 0.15 +/- 0.04; 0.24 micron, 0.10 +/- 0.04; and 0.42 micron, 0.07 +/- 0.02. The declining deposition fraction as size approaches 0.5 micron is consistent with previous theoretical and experimental data. PMID- 3810690 TI - A case of acute renal failure associated with type A acute hepatitis responds dramatically to plasmapheresis. AB - A case of acute renal failure (ARF) associated with type A acute hepatitis followed by a dramatic response to plasmapheresis is described. A female patient was transferred to our hospital with a diagnosis of ARF associated with acute hepatitis. Since radioimmunoassay for IgM antibody to hepatitis A virus showed a positive reaction, recent infection with hepatitis A virus was suspected. Hemodialysis immediately performed after admission was not effective. Plasmapheresis was started on the 5th hospital day and there was a dramatic improvement in ARF and hepatitis. It is concluded that plasmapheresis is effective in the treatment of ARF associated with liver disease if it is applied in the early stage. PMID- 3810691 TI - Operative results in vesicoureteral reflux--with special reference to associated urinary tract infections. AB - Thirty cases of vesicoureteral reflux (VUR) seen at our clinic were reviewed and its outcome assessed, with special reference to postoperative urinary tract infection. It was shown that the success of operation for VUR has no effect for prophylaxis of recurrent urinary tract infection, then it appears unreasonable to speak of the cure of VUR only from the viewpoint of urinary tract infection. Even if reflux is unilateral, with the affected kidney badly damaged and other kidney normal, simultaneous repair of both kidneys is indicated. Because about 4.5% developed contralateral reflux. PMID- 3810692 TI - Ultrastructural and enzyme histochemical studies in orotic acid-induced fatty liver. AB - To confirm the relationship between fatty changes and zonal distribution in the hepatic lobules, we studied the ultrastructural and enzyme histochemical alterations in rat hepatocytes of orotic acid which blocks the release of lipoproteins, administered for 7 days, fatty changes were clearly detected in the hepatocytes, but no zonal distribution of fat in the hepatic lobules was detected. The most striking ultrastructural alterations were observed in the rough endoplasmic reticulum and Golgi complexes. The intensity of the staining of non-specific esterase and lipase was markedly decreased. Based on these data, functional aspects of the hepatocytes in orotic acid administration were discussed. PMID- 3810693 TI - Experimental study on the effects of the extracorporeal ultrafiltration method in advanced congestive heart failure. AB - The effects of the extracorporeal ultrafiltration method were studied in an experimental canine model of advanced congestive heart failure with mitral regurgitation, coronary artery occlusion and overhydration. With the application of this technique, cardiac output, stroke work, systemic vascular resistance and left ventricular dp/dt increased significantly associated with reduction in the right atrial and left ventricular filling pressures. Serum electrolytes were stable throughout the procedure, and there were significant elevations in serum protein and hematocrit levels. The composition of the ultrafiltrate indicated that excessive extracellular fluid was removed. Five out of seven cardiogenic shock subjects also benefited. The clinical application of this approach using recently developed dialyzers to treat intractable heart failure with overhydration under close hemodynamic monitoring is warranted. PMID- 3810694 TI - Parameters of altered plasma glucose levels during short intervals in diabetic patients. AB - The percentages of glycosylated proteins or albumin, or glycohemoglobin A1 (HbA1) in sera from patients with noninsulin dependent diabetes mellitus (NIDDM) were measured to elucidate whether such measurements are useful for evaluation of the mean levels of blood glucose during short intervals in these patients. Forty patients with NIDDM and twenty healthy adults were examined. The percentages of glycosylated proteins or albumin were quantitated by a Glyc-Affin system and those of HbA1 were measured by electrophoresis. It was indicated that the percentages of glycosylated proteins or albumin, and HbA1 in sera from patients with NIDDM were significantly higher than those in sera from healthy adults. There was a significant correlation between the percentages of HbA1 in sera and the mean levels of fasting blood sugar (FBS) during short intervals in patients with NIDDM. It was concluded that the measurement of HbA1 is a useful method for evaluation of the mean levels of blood glucose during short intervals in patients with NIDDM compared with those of glycosylated proteins or albumin. PMID- 3810695 TI - 5 Alpha-reductase inhibitory and anti-androgenic activities of some 4-azasteroids in the rat. AB - Inhibition of 5 alpha-reductase and anti-androgenicity were studied in rats treated with various 4-azasteroids. The known inhibitor, N,N-diethyl-4-methyl-3 oxo-4-aza-5 alpha-androstane-17 beta-carboxamide (4-MA) served as a reference compound, and analogs of this basic molecule were assayed. Enhancement of enzyme inhibitory potency was usually seen with delta 1 analogs, whereas reduction in activity was noted with substitutuents such as delta 5, a spirotetrahydrofuran ring at C-17 or 4-deaza groups. Many of the 4-azasteroids had a much greater oral anti-androgenic effect against testosterone propionate (TP) than dihydrotestosterone propionate (DHTP). This difference in activity versus the two androgens is believed to reflect the necessity for TP to undergo reduction to DHT before becoming capable of stimulating prostatic growth. Inhibition of 5 alpha reductase by active compounds prevented the conversion, thereby producing an anti androgenic effect. In this regard, certain delta 1 analogs of 4-MA, particularly those bearing a 17 beta-(N-tert butylcarbamoyl) group, proved very effective against TP but were relatively inactive versus DHTP. PMID- 3810696 TI - Prostatic cytosol binding of 5 alpha-androstane-3 beta, 17 beta-diol and estradiol-17 beta. AB - The goal of the present research was characterization of the interaction of 5 alpha-androstane-3 beta, 17 beta-diol (3 beta-diol) with prostatic estradiol-17 beta(E2) binding sites to address the role of this 5 alpha dihydrotestosterone(DHT)a metabolite in prostatic regulation. Using dextran charcoal assay we demonstrated specific 3 beta-diol and E2 binding sites in rat ventral prostate cytosol (RVPC) and dog prostate cytosol (DPC). In both cytosols, E2 binding is of high affinity (Ka congruent to 10(9) M-1; RVPC:68 fmol/mg protein), DPC:170 fmol/mg protein), and 3 beta-diol binding is of moderate affinity (Ka congruent to 10(8) M-1; RVPC:62 fmol/mg protein, DPC:165 fmol/mg protein). Unlabeled 3 beta-diol competes effectively for cytosolic 3H-E2 binding sites, whereas unlabeled DHT, 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha diol) and testosterone (T) are poor competitors for 3H-E2 binding sites. Using DNA-cellulose column chromatography, we separated prostatic androgen and estrogen binding activities. The E2 binding activity which adhered to DNA-cellulose was displaced by 100-fold excess 3 beta-diol but not by DHT. Thus data from two assay procedures show competition of 3 beta-diol for 3H-E2 binding sites in rat and dog prostate. PMID- 3810697 TI - Topical anti-inflammatory activity of esters of steroid 21-oic acids. AB - Prednisolone derivatives, methyl 20 alpha- and 20 beta-dihydroprednisolonate and methyl 17,20 alpha- and 17,20 beta-acetonidodihydroprednisolonate have been evaluated for their topical anti-inflammatory activity in the croton oil induced ear edema test. The order of anti-inflammatory potency was prednisolone greater than methyl 17,20 alpha-acetonidodihydroprednisolonate greater than methyl 17,20 beta-acetonidodihydroprednisolonate greater than methyl 20 beta dihydroprednisolonate greater than methyl 20 alpha-dihydroprednisolonate. This order was paralleled by the compounds' octanol-aqueous partition coefficients. Furthermore, after two consecutive days topical administration of an equipotent anti-inflammatory dose, only prednisolone significantly decreased plasma corticosterone levels and relative thymus weight, while the new steroid derivatives had no effect on these parameters, indicating their lack of systemic side effects. PMID- 3810698 TI - Novel derivatives of 3 alpha,7 alpha-dihydroxy-5 beta-cholan-24-oic acid (chenodeoxycholic acid) and 3 alpha,7 beta-dihydroxy-5 beta-cholan-24-oic acid (ursodeoxycholic acid). AB - Several 7-acyl cheno- and ursodeoxycholic acids were obtained in good yields starting from the corresponding cheno- and ursodeoxycholic acids, by a diacylation-selective hydrolysis procedure. A superior method for the synthesis of the 7-oleyl derivatives, by a selective acylation procedure, is also presented. PMID- 3810699 TI - A new synthetic route to 2- and 4-methoxyestradiols by nucleophilic substitution. AB - A new snythetic route to 2- and 4-methoxyestradiols is described. Benzo-15-crown 5 with CuI catalyzes the specific nucleophilic substitution at the carbon atom carrying a non-activated halogen on ring A of the estradiol. PMID- 3810700 TI - Synthesis of 18-hydroxy-19-norcorticosterone and 18-deoxy-19-noraldosterone. Structure determination of related 19-nor steroids by means of 2-D 1H nmr. AB - The compounds named in the title have been synthesized from the di-(ethylene ketal) of 21-hydroxy-3,20-dioxo-19-norpregn-5-ene-18, 11 beta-lactone and its 5(10)-ene isomer. Reduction of this mixture 1 with sodium aluminum bis (methoxyethoxy)hydride furnished the 11 beta, 18, 21-triol 2a. Conversion to the 18,21-diacetate 2b, followed by deketalization to the free dione 3 and hydrolysis, afforded 18-hydroxy-19-norcorticosterone 4a which, in the solid state and probably in solution, has the 18,20-hemiacetal structure. Periodate oxidation of 4a gave 11 beta-hydroxy-3-oxo-19-norandrost-4-ene-17 beta, 18-carbolactone 5a, and acid treatment of 4a or its precursor 2a yielded 18-deoxy-19-noraldosterone 6a. The structure of 5a was confirmed by mass spectrometry and 1H nmr, and compared with that of its C-19 methyl homolog 5b and 19-noraldosterone-gamma etiolactone 8. In particular, 2-D nmr COSY 45 experiments, affording full 1H line assignments, have rigorously established the "natural" beta (axial) configuration of the C-10 hydrogen in the 19-nor lactones 5a and 8, and therefore also in the related 4a, 6a and 19-noraldosterone 7. PMID- 3810701 TI - Critique; synthesis of 3 alpha, 17 beta-dihydroxy-5 alpha-androstane-17-yl-beta-D glucuronide. PMID- 3810702 TI - Cerebrovascular research: the opportunity has never been better. PMID- 3810703 TI - Early management of the patient with recent aneurysmal subarachnoid hemorrhage. AB - Despite its efficacy in preventing rebleeding, the anticipated strong trend in favor of early intracranial surgery has not been achieved. Early intracranial operation remains a useful choice in the management of recent SAH in good-risk patients, but patients must be carefully selected on an individual basis. Many patients will undoubtedly benefit from early surgery but it is not a panacea. Further investigation of surgical treatment in combination with improved preoperative and postoperative medical therapy will be required to ameliorate the outcome of SAH. In particular, the prevention and treatment of cerebral infarction deserves attention. The results of the antifibrinolytic and timing of intracranial surgery studies point to the need for an effective prevention treatment regimen for vasospasm. Further studies about the efficacy of calcium channel blocking drugs in prevention of ischemia after SAH are needed among patients given antifibrinolytic drugs or having early operation. All the advances in treatment are predicated on prompt diagnosis of SAH in good-condition patients. The medical community needs to maintain a high degree of vigilance for the diagnosis of SAH in all patients complaining of a new, unusual or severe headache. Early referral to properly equipped and staffed medical facilities remains a keystone to effective treatment of SAH. PMID- 3810704 TI - Hypertension as a risk factor for spontaneous intracerebral hemorrhage. AB - To better define the etiologic importance of hypertension for spontaneous intracerebral hemorrhage, hospital records were studied for all patients sustaining intracerebral hemorrhage during 1982 in the Cincinnati metropolitan area. Hypertension pre-dating the hemorrhage was present in 45% (69 of 154), as determined by history. A more inclusive definition of hypertension, combining those with a positive history with those found to have left ventricular hypertrophy by electrocardiogram or cardiomegaly by chest radiography, applied in 56% (87 of 154). The cases were compared to controls with and without hypertension derived from the NHANES II study of blood pressure (n = 16,204) to determine relative risk. For the presence of hypertension by history, the relative risk of intracerebral hemorrhage was 3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was also determined for hypertension in blacks (= 4.4), age greater than 70 (= 7), prior cerebral infarction (= 22), and diabetes (= 3). We conclude that the term "hypertensive hemorrhage" should be used very selectively, particularly in whites, and propose that hypertension be viewed as one of several important risk factors for spontaneous intracerebral hemorrhage. PMID- 3810705 TI - Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. AB - Patchy subcortical foci of increased signal intensity are frequently identified on magnetic resonance imaging (MRI) in the elderly. The incidence and clinical correlates of these lesions remain unknown. In this report, 240 consecutive MRI scans performed over a 6-month period were reviewed (excluding patients with recent brain trauma or known demyelinating disease). Subcortical incidental lesions (ILs) were identified, which could not be accounted for by the patient's current clinical diagnosis, neurological status, or CT scan. The ILs were graded according to size, multiplicity, and location. The incidence and severity of ILs increased with advancing age (p less than 0.0005). Among patients over 50 years of age, the incidence and severity of ILs were correlated with a previous history of history of ischemic cerebrovascular disease (p less than 0.05) and with hypertension (p less than 0.05). Multivariable regression analysis identified age, prior brain ischemia, and hypertension as the major predictors of ILs in the elderly. Diabetes, coronary artery diseases, and sex did not play a significant role. With the exception of cerebrovascular disease, there was no association between ILs and any particular clinical entity, including dementia. It is concluded that subcortical parenchymal lesions are frequent incidental findings on MRI in the elderly, and may represent an index of chronic cerebrovascular diseases in such patients. PMID- 3810706 TI - Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II. Postmortem pathological correlations. AB - The pathological correlates of subcortical lesions noted on magnetic resonance imaging (MRI) in the elderly are not known. Postmortem in vitro proton MRI was performed on the brains of seven consecutive elderly patients dying of nonneurologic causes. Scans were done in the fresh and fixed states with the specimen immersed in saline and formaldehyde respectively. A 1.5 Tesla superconductive system was used with a multiple spin-echo protocol generating T2 weighted images. Subcortical MRI lesions were localized in three dimensions and identified at brain cutting. In addition, pathological correlations were obtained from an eighth patient who underwent MRI eleven days before death. Histological examinations were performed in a blinded fashion, including control areas from the same brains. Subcortical MRI lesions were found to be associated with arteriosclerosis, dilated perivascular spaces, and vascular ectasia (p less than 0.05). These histological changes were characteristic of "etat crible" which, like subcortical MRI lesions, is associated with age and hypertension. Shrinkage (or atrophy) of the brain parenchyma around ectatic blood vessels would result in an extensive network of tunnels filled with extracellular water. The proton MRI signal from such areas of the brain would be increased. Gliosis and small areas of infarction occasionally coexisted with "etat crible," but these were not present in all areas with MRI lesions and could not be distinguished by MRI signal alone. In conclusion, clinical and pathological correlations lend support to the uniform hypothesis that MRI provides a nonspecific index of brain parenchymal alterations caused by aging and chronic cerebrovascular disease. PMID- 3810707 TI - Cerebral ischemia and asymptomatic coronary artery disease: a prospective study of 83 patients. AB - A prospective cardiologic evaluation was performed in 83 consecutive patients with transient cerebral ischemia or mild stroke and without symptoms or electrocardiographic signs of ischemic heart disease. Patients were studied with an electrocardiographic exercise test; a positive test was followed by exercise Thallium-201 myocardial scintigraphy. Results were compared to those obtained in a group of 83 age and sex-matched healthy subjects submitted to the same study protocol. Asymptomatic coronary artery disease was detected in 28% of cerebrovascular patients with adequate electrocardiographic exercise test. A scintigraphic perfusion defect of variable extension was found in 19 of them. In the control group the electrocardiographic exercise test was positive in only 6% (p less than 0.01). Our results support the concept that: asymptomatic ischemic heart disease is often associated with cerebrovascular disease; therefore cerebral ischemic attacks may be a marker of coronary artery disease, an active investigation of the heart should be considered in cerebrovascular patients in order to plan optimal, comprehensive management. PMID- 3810708 TI - Post-stroke depression: relationships to functional impairment, coping strategies, and rehabilitation outcome. AB - This study examined the phenomenon of post-stroke depression and evaluated its impact on rehabilitation outcome. Sixty-four patients presenting to a rehabilitation program within weeks of first stroke were evaluated for depression through self-report measures and staff ratings. Patients also rated the particular coping strategies which they used in dealing with their illness and hospital stay. Physical and occupational therapists provided measures of functional impairment at admission and discharge. A high (47%) prevalence of depression was found in this population, with no overall differences observed between patients with right or left hemisphere lesions. Depressed patients, in comparison to non-depressed, evidenced greater functional impairment at both admission and discharge. However, both groups showed similar gains over the course of rehabilitation. Coping strategies employed by depressed patients appeared to reflect a lower level of participation in the rehabilitation process. A subgroup of patients evaluated 6 weeks after discharge revealed that depression was associated with a worsening on one measure of functional status. These findings indicate that depression is a frequent companion of stroke, that it is associated with degree of functional impairment, and that it may exert a negative impact on the rehabilitation process and outcome. PMID- 3810709 TI - Trends in mortality from cerebrovascular disease in Taiwan. AB - The rate of decline in the age-adjusted death rate from cerebrovascular disease (CVD) in Taiwan is not as rapid as in the United States and Japan, and the trends of CVD mortalities have not decreased steadily during the period 1972-1983. A low record of hypertension regulation (5.0%-12.7%), a high proportion (47.1%) of stroke due to cerebral hemorrhage (by clinical assessment), and a high fatality rate (40.1%) for cerebral hemorrhage may account partially for the slower declining rate. A geographic difference in the downward trend of CVD death rate was observed in this period. Districts remote from the major cities have had the lowest decline in CVD death rate. PMID- 3810710 TI - Risk factors for spontaneous cerebral hematomas. Case-control study. AB - In a case-control study of 73 cases of cerebral hematoma diagnosed by CT scan, significant risk factors were history of hypertension, chronic alcoholism, evidence of hepatic disease, EKG abnormalities and high hematocrit values. Initial blood pressure was significantly higher in cases, but blood pressure on the third day after admission was not different from controls. Hypertension and alcoholism did not show a clear correlation, but data from other studies explain the role of alcoholism in vascular disease through a relation with high blood pressure. Risk factors were similar in lobar and basal ganglia hematomas. PMID- 3810711 TI - Cell density in the border zone around old small human brain infarcts. AB - Nine brain autopsy cases of small old cerebral infarcts were selected for neuropathological studies. Eight of the patients had cortical infarcts, in two cases with extension into the striate body. In one case the infarct involved the striate body only. The density of neurons and glial cells was measured in the coronal and the horizontal planes at various distances from the margin of the infarct. Corresponding counting points in the contralateral hemisphere served as control. On light microscopy, the infarcted cortex was irregularly shaped, but on serial sections the bulging parts appeared to be cut off from the infarcted tissue ("pseudo-infarct islands"). The zone of transition from infarcted to normal brain tissue was less than a few mm wide. In one patient, tomographic measurements of the cerebral blood flow (CBF) and a CT scan could be compared with the neuropathological findings. In this patient, CBF in the surroundings of the infarct was decreased despite a normal neuronal density. The study supports the traditional view held by pathologists that a sharp transition exists between infarcted and normal brain tissue and suggests that the hypoperfusion zone surrounding the region of complete infarction may be due to mechanisms other than selective loss of neurons. PMID- 3810712 TI - Familial hyperlipidemia in stroke in the young. AB - Serum cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL) and chylomicron levels were studied in 25 young patients (age 40 years or less) of non-embolic ischemic stroke of unknown aetiology. Fifteen patients were males and 10 were females. The prevalence of hyperlipidemia was found to be 60%. Frederickson's type IIb hyperlipoproteinemia was the commonest (32%) abnormal pattern observed, followed by type IIa (12%), type IV (12%) and type V (4%). Family studies were carried out in all the 25 index patients (15 hyperlipidemic and 10 normolipidemic). Familial hyperlipidemia (i.e. 2 or more hyperlipidemic members in the same family) was found in 9 of the 15 hyperlipidemic index patients and in none of the normolipidemic index patients. The common pattern was found to be that of familial combined hyperlipidemia. The study indicates that screening the family members of hyperlipidemic young patients of non-embolic ischemic stroke may delineate a group of high risk individuals for possible primary prevention before they develop the disease. PMID- 3810713 TI - Proton NMR relaxation times in ischemic brain edema. AB - The state of water in cerebral ischemia was studied by using the proton nuclear magnetic resonance (1H-NMR) method. Cerebral ischemia was induced experimentally in Mongolian gerbils by unilateral ligation of the common carotid artery. Longitudinal (T1) and transverse (T2) relaxation times of the ischemic brain were measured with a pulse FT-NMR spectrometer and the water content was determined by the wet/dry method. Quantitative analysis of the relaxation times was performed sequentially during the initial 7 hours following ligation and the data were compared with those of brain edema previously reported by S. Naruse in the rat. Characteristic findings in brain ischemia include prolongation of the slow component of T2 and increase in the water content. A quantitative comparison of relaxation rate and water content demonstrates that ischemic brain edema in Mongolian gerbils is different from cytotoxic and vasogenic types of brain edema. When R2 (1/T2) was plotted against the water content, the slope value of ischemia in the gerbil was between the slope values of the TET intoxication and cold injury induced edemas reported previously. From these results, it might be said that ischemic brain edema includes both the cytotoxic and vasogenic types of brain edema. Glycerol was demonstrated to affect brain ischemia by decreasing the water content and by shortening the slow component of T2. By analysis of the relaxation times and water content, we examined the pathophysiological characteristics of water molecules in ischemic brain tissue. PMID- 3810714 TI - Regional cerebral blood flow changes associated with ethanol intoxication. AB - Regional cerebral blood flow (CBF) was measured via the 133Xenon inhalation technique in 26 healthy volunteers before and 60 minutes after the oral administration of ethyl alcohol or placebo on a double-blind basis. The cerebral blood flow values, corrected for test-retest differences in carbon dioxide showed a significant bilateral increase after ethanol administration. Blood levels of ethanol, estimated with a breath analyser, did not correlate with the CBF changes. PMID- 3810715 TI - Selective vulnerability of hippocampus and disturbances of memory storage after mild unilateral ischemia of gerbil brain. AB - The effect of selective injury of hippocampal neurons on the consolidation of memory traces was studied in gerbils (meriones unguiculatus) after production of mild cerebral ischemia. The right carotid artery was permanently ligated, and animals without gross neurological deficits ("symptom-negative" gerbils) were selected. Eight days and eight weeks after vascular ligation, cell counts of hippocampal neurons were carried out and correlated with regional blood flow and the acquisition of operant behaviour. Eight days after carotid artery occlusion, learning behaviour was significantly impaired although the number of hippocampal neurons had not changed and blood flow had even increased above normal. After eight weeks, learning behaviour and blood flow were normal but now a significant loss of pyramidal neurons was present in the CA1 and CA2 sectors of the hippocampus. Our observations demonstrate that it is possible to detect subtle functional disturbances by appropriate behavioural investigation before manifestation of selective injury of the hippocampus. Recovery of integrative function, despite persistent cellular damage, provides further evidence for central nervous plasticity. PMID- 3810716 TI - Relationship between metabolic recovery and the EEG prolonged ischemia of cat brain. AB - In normothermic cats, cerebral blood flow was arrested for 1 hour followed by blood recirculation for 5-6 hours. Functional recovery was evaluated by qualitative and quantitative EEG analysis, and metabolic recovery by measuring metabolite and electrolyte levels in tissue samples taken from the cerebral cortex. In 5 out of 12 animals EEG activity did not recover after ischemia (group I); in 3 animals, intermittent EEG activity (group II) and in 4 animals continuous EEG activity returned during the observation period (group III). In group I the energy state was severely disturbed and an increase of calcium was detected, in group II this disturbance was much less pronounced, and in group III changes in energy metabolism and ion concentration were absent with the only exception of lower ADP levels. During recovery, the total intensity of EEG correlated positively with ATP (p less than 0.01) and inversely with lactate (p less than 0.05), and the intensity of the delta band inversely with sodium content (p less than 0.05). The results obtained demonstrate that electrophysiological recovery after prolonged ischemia is closely correlated with the restoration of the energy state and of electrolyte homeostasis of the brain. The inverse relationship of EEG intensity with lactate and sodium are interpreted as evidence for the adverse effects of ongoing post-ischemic glycolysis, resulting in the activation of the H+/Na+ antiporter for the regulation of intracellular pH. PMID- 3810717 TI - Effect of the ganglioside GM1, on cerebral metabolism, microcirculation, recovery kinetics of ECoG and histology, during the recovery period following focal ischemia in cats. AB - The effect of the ganglioside GM1 on the recovery of local cerebral glucose metabolism (lCMRgl), recovery kinetics of cerebrocortical electrical activity, cerebral blood flow and redox state as well as histological changes following focal ischemia has been studied in the cat. Ischemia was produced by occlusion of the left middle cerebral artery (MCA), and GM1 (30 mg/kg) was injected intravenously at 30 min after the MCA occlusion or at the time of release of the occlusion, at 120 min. Another group of animals were subjected to the same ischemic insult, but without GM1 treatment, and sham-operated treated and not treated cats were also studied. The animals of both GM1-treated and non-treated stroke groups were classified into 2 groups (severe and moderate) depending on the depression of electrocortical activity in the ischemic hemisphere at 30 min of the ischemia. There was a significant increase in local cerebral blood flow in the ischemic area in the treated animals. Additionally there was a significant treatment effect on the left peripheral MCA territory for lCMRgl in the 30 min treated moderate group, (p less than .05). This group of animals showed decreased lCMRgl accompanied by less severe histological damage suggesting that GM1 may produce metabolic depression so as to maintain a normal flow-metabolism couple and prevent ischemic structural damage. The possible mechanism of metabolic depression induced by GM1 is briefly discussed. PMID- 3810718 TI - Autoregulation of spinal cord blood flow: is the cord a microcosm of the brain? AB - The autoregulatory capability of regional areas of the brain and spinal cord was demonstrated in 18 rats anesthetized with a continuous infusion of intravenous pentothal. Blood flow was measured by the injection of radioactive microspheres (Co57, Sn113, Ru103, Sc46). Blood flow measurements were made at varying levels of mean arterial pressure (MAP) which was altered by neosynephrine to raise MAP or trimethaphan to lower MAP. Autoregulation of the spinal cord mirrored that of the brain, with an autoregulatory range of 60 to 120 mm Hg for both tissues. Within this range, cerebral blood flow (CBF) was 59.2 +/- 3.2 ml/100 g/min (SEM) and spinal cord blood flow (SCBF) was 61.1 +/- 3.6. There was no significant difference in CBF and SCBF in the autoregulatory range. Autoregulation was also demonstrated regionally in the left cortex, right cortex, brainstem, thalamus, cerebellum, hippocampus and cervical, thoracic and lumbar cord. This data provides a coherent reference point in establishing autoregulatory curves under barbiturate anesthesia. Further investigation of the effects of other anesthetic agents on autoregulation of the spinal cord is needed. It is possible that intraspinal cord compliance, like intracranial compliance, might be adversely affected by the effects of anesthetics on autoregulation. PMID- 3810719 TI - Evidence that vasoactive intestinal polypeptide (VIP) mediates neurogenic vasodilation of feline cerebral arteries. AB - In this study the magnitude of non-sympathetic, non-cholinergic neurogenic vasodilation of feline cerebral arteries in vitro was correlated with the extent of innervation by VIP-immunoreactive nerves. Well-innervated arteries underwent nerve-mediated relaxation whereas those that are not supplied with VIP-containing axons did not relax to transmural nerve stimulation. The relaxation of cerebral arteries that are well endowed with VIP-immunoreactive nerves was selectively and reversibly inhibited by VIP-specific antiserum. Substance P-specific antiserum did not affect the dilator responses. We conclude that VIP is a functional neurodilator transmitter in the cerebral circulation. PMID- 3810720 TI - Correlation between somatosensory evoked potentials and neuronal ischemic changes following middle cerebral artery occlusion. AB - In an attempt to determine the usefulness of evoked potentials as a measure of focal cerebral ischemia, we examined somatosensory evoked potentials (SEP's) and morphological neuronal changes in cats following unilateral middle cerebral artery (MCA) occlusion. Fifteen adult cats underwent transorbital occlusion of the MCA under halothane anesthesia. In seven cats the ipsilateral SEP's were abolished after middle cerebral artery occlusion, and did not show any recovery after 6 hours. The same seven cats showed the greatest area of moderate and severe ischemic neuronal changes, ranging from 21 to 64% (mean 39 +/- 14%) of the total ipsilateral cortical area. The remaining eight cats showed a complete flattening or decreased amplitude of the SEP after occlusion, but demonstrated a considerable recovery in the amplitude of the primary cortical potential during the six hours of the study. All these cats had ischemic areas of less than 15% (mean 9 +/- 3%) of the total ipsilateral cortex. These results demonstrate that the disappearance of the SEP and their failure to recover correlate with the extent and degree of histological cerebral ischemia. PMID- 3810721 TI - Influence of anatomic origin on intracranial distribution of micro-emboli in the baboon. AB - The purpose of this study was to investigate whether the anatomic origin of micro emboli influences their intracranial distribution. In twenty-two baboons, we examined the distribution of 99-Technetium labelled albumin aggregates (5 to 40 microns in size) after injection into the circulation at the left atrium (LA), carotid trifurcation (CA), and anterior and posterior common carotid artery (CCI). In a further subgroup, the emboli were introduced at the carotid trifurcation with the contralateral carotid artery ligated (CA + L). The results of this study demonstrated that aggregates introduced at the carotid artery lodged preferentially in the ophthalmic (p = 0.032) and middle cerebral artery territories (p = 0.016). If the contralateral common carotid artery was ligated, however, more aggregates were found in the ipsi- and contralateral anterior cerebral artery territories (p = 0.01, p = 0.003). Aggregates introduced into the cardiac circulation were equally distributed throughout the brain. This experimental model determined patterns of flow that might be analogous to the human situation where unilateral or bilateral carotid stenosis or stenosis with contralateral occlusion has occurred or embolus from cardiac source has occurred. The results do not imply that the 40 micron microaggregates do cause TIA. These experimental findings support clinical observations that cardiac lesions may cause transient ischemic attacks (TIA) anywhere in the brain. In contrast, those of carotid artery origin cause predominantly middle cerebral or ophthalmic artery territory TIAs unless the contralateral carotid artery is severely stenosed or occluded. PMID- 3810722 TI - Angiotensin delays platelet aggregation after injury of cerebral arterioles. AB - Endothelium of cerebral surface vessels (pial arterioles and venules) was injured with a light/dye technique in anesthetized mice. This induced platelet aggregation at the site of injury. The onset of aggregation was monitored through a microscope in mice given angiotensin II acetate, 4 micrograms i.v. 30 minutes earlier. Aggregation latency was compared with that in vehicle treated (saline) mice. Angiotensin II caused a highly significant delay in aggregation within the arterioles which was not related to a change in shear rate of blood. Angiotensin II added to platelet rich plasma, failed to influence the aggregation produced by subsequent addition of 0.5 microM ADP or 0.5 mM sodium arachidonate. Angiotensin is a well known stimulator of prostacyclin synthesis or release, and angiotensin has been reported to inhibit platelet aggregation ex vivo by increasing prostacyclin in the effluent superfusing the mass of aggregating platelets. Our data represent the first report of an antiaggregating effect of angiotensin II in vivo in an intact microvascular bed. The data is consonant with the literature describing increased prostacyclin levels following angiotensin II infusion. The antiaggregating effect of angiotensin in cerebral microvessels may help explain a recent observation describing increased survival of gerbils treated with angiotensin following carotid ligation. PMID- 3810723 TI - Effects of atherosclerosis on cerebral vessels: hemodynamic and morphometric studies. AB - In this study hemodynamic and morphometric consequences of atherosclerosis were examined in cynomolgus monkeys. We tested the hypothesis that atherosclerosis augments cerebral vasoconstrictor responses to serotonin. We studied 8 normal and 8 atherosclerotic monkeys, which were fed an atherogenic diet for 17 months. Morphometric studies indicated marked intimal proliferation of extracranial carotid arteries, with only modest reduction in the vascular lumen, as atherosclerotic lesions were displaced outward. Cerebral blood flow was measured with microspheres and microvascular pressure was measured with a micropipette in pial arteries approximately 350 microns diameter. Intracarotid infusion of serotonin reduced microvascular pressure, which indicates constriction of large arteries upstream, but cerebral blood flow did not decrease. Serotonin produced a 2-fold greater reduction in cerebral microvascular pressure in atherosclerotic monkeys than in normal monkeys. Intracarotid histamine increased flow and hypocapnia reduced flow in both normal and atherosclerotic monkeys, without altering cerebral microvascular pressure. We conclude: First, atherosclerosis potentiates constrictor responses to serotonin in large cerebral arteries. Because platelets release serotonin when they aggregate, augmentation of responses by atherosclerosis may have implications for cerebral vascular responses during aggregation of platelets at carotid lesions. Second, despite marked proliferation of intima, atherosclerotic lesions are displaced outward during a prestenotic phase of the disease, so that the lumen is relatively well preserved. PMID- 3810724 TI - Effect of aspirin and ticlopidine on platelet deposition in carotid atherosclerosis: assessment by indium-111 platelet scintigraphy. AB - The antiplatelet effects of aspirin and ticlopidine were studied by a dual-tracer method, using indium-111 labeled platelets and technetium-99m human serum albumin, in a group of 12 patients with suspected ischemic cerebrovascular disease. The magnitude of platelet accumulation at the carotid bifurcation was expressed as the ratio of radioactivity of indium-111 platelets deposited on the vascular wall to those circulating in the blood-pool (PAI, platelet accumulation index), 48 hr after injection of labeled platelets. PAI values were measured before (baseline studies) and after the antithrombotic therapies (aspirin studies: 325 mg bid for 22.3 +/- 1.3 days, ticlopidine studies: 100 mg tid for 21.8 +/- 2.1 days). At the baseline, the mean PAI value at 24 carotid bifurcations in the patient group was 15.7 +/- 15.3% (mean +/- S.D.) compared to 4.3 +/- 9.1 at 24 carotid bifurcations in 12 normal subjects (p less than 0.01). We defined the upper limit for a normal PAI (%) value to be +13.9, namely the mean PAI plus 2 SD for the carotid bifurcation in normal subjects and used this value for semiquantitative analysis. At the baseline, significant elevation of PAI (more than 13.9%; positive scintigram) was observed at 12 of 24 vessels, while 12 other regions were negative (less than 13.9%). In the lesions with positive scintigraphic results at the baseline, the mean PAI (%) value from the baseline, aspirin and ticlopidine studies was 29.5 +/- 7.0, 11.2 +/- 8.5 (p less than 0.01 versus baseline) and 21.4 +/- 21.3 (not significant from baseline), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810725 TI - Increased cerebral blood flow during hypercapnia is not affected by lesion of the nucleus locus ceruleus. AB - To test the hypothesis that the putative noradrenergic innervation of intraparenchymal cerebral blood vessels from the nucleus locus ceruleus mediates the vasodilatory response to hypercapnia, regional cerebral blood flow was measured by iodo-[14C]antipyrine autoradiography in awake and restrained rats with unilateral 6-hydroxydopamine lesion of the nucleus locus ceruleus and in unlesioned control rats. Hypercapnia, induced by the inhalation of 5% or 8% CO2 in air for 8 minutes caused a 2 to 5-fold increase in regional cerebral blood flow. However, despite a marked reduction of about 90% in cortical norepinephrine levels ipsilateral to the lesion, blood flow to the frontal and parietal cortex, hippocampus, striatum and cerebellum increased to the same extent in ipsilateral and contralateral regions. Thus, lesion of the locus ceruleus and the resultant depletion of endogenous cortical and hippocampal norepinephrine, does not influence the cerebrovascular response to hypercapnia. PMID- 3810726 TI - Aggregation of multiple risk factors for stroke in siblings of patients with brain infarction and transient ischemic attacks. AB - Hypertension, heart disease, and diabetes are not only the major risk factors for stroke, but they tend to cluster in families. It is unknown, however, whether these conditions occur more frequently among relatives of patients with specific types of stroke as compared to non-relatives. The frequencies of stroke and its major risk factors in two groups of subjects were compared. One group consisted of 76 siblings of 41 patients hospitalized with cerebral infarction and transient ischemic attacks in an investigative stroke unit; the other consisted of 55 siblings of the patients' spouses. The occurrence of these conditions in the relatives was determined from a questionnaire completed by the relatives and supported by information from the relatives' family physicians. When considered separately, hypertension, heart disease, and stroke occurred in a small but not statistically significant excess among the relatives in-law. However, various combinations of two or three diseases, (including diabetes), occurred in 20.9% of the patients' siblings as compared to only 3.6% of the relatives in-law (p less than 0.001). These results suggest that living siblings of patients with cerebral infarction and transient ischemic attacks may have an increased risk of stroke and cardiovascular disease as a result of multiple risk factors operating simultaneously. Prevention programs among this high risk population may be particularly worthwhile. PMID- 3810727 TI - Effect of carotid artery ligation and infusion of fluosol FC-43 emulsion on brain surface oxygen tensions. AB - In eight rabbits, the common carotid artery was ligated and multiple estimations of brain surface oxygen tension performed using a seven barrelled mini-electrode. In five rabbits ligation of the carotid artery resulted in impairment of cortical oxygenation. The remaining three rabbits showed no impairment in the supply of oxygen to the cerebral cortex after carotid occlusion. In the five rabbits who displayed a reduction in oxygen supply after carotid ligation, ventilation with 33% oxygen after the infusion of 15 ml/kg of Fluosol FC-43 produced an improvement in cortical oxygenation in only three of the five rabbits. When these animals were ventilated with 100% oxygen after carotid ligation and Fluosol infusion, oxygen supply in all five was commensurate with or greater than that during control conditions. PMID- 3810728 TI - Comparison of the somatosensory evoked potential and the direct cortical response following severe incomplete global ischemia: selective vulnerability of the white matter conduction pathways. AB - Eight cats were subjected to graded hemorrhagic hypotension following bilateral carotid ligation to produce incomplete global cerebral ischemia. Three additional cats served as controls. The somatosensory evoked potential (SEP) and direct cortical response (DCR) were monitored in all animals and in each case, the cortical component of the SEP was abolished during progressive ischemia while the morphology of the DCR was well-preserved but with reduced amplitude. Determinations of adenosine triphosphate (ATP), phosphocreatine (PCr), and lactate levels in cerebral cortex and white matter were made in five experimental cats and the three controls. At the time of failure of the cortical SEP, PCr was dramatically reduced and lactate moderately elevated in the white matter while ATP remained unchanged. Cortical lactate was only mildly elevated and PCr and ATP were unchanged accounting for preservation of the DCR. In this model of global ischemia, abolition of the cortical SEP is due to a block of stimulus conduction in white matter projection pathways. A hypothesis to explain the observed metabolic changes is presented and correlation is made to clinical situations. PMID- 3810729 TI - Carotid endarterectomy: how does it work? A clinical and angiographic evaluation. AB - In a retrospective study, the clinical and angiographic results were evaluated of 100 consecutive carotid endarterectomies, carried out in 90 patients over the period 1977 to 1983. There was no operation-associated mortality; the perioperative morbidity was 5%. Angiography, carried out, on average, 4.2 months postoperatively, revealed complete occlusion of the operated carotid artery in 16 cases (18.5%); in at least 13 cases this was completely asymptomatic. Perioperative findings suggest that microembolism is, but haemodynamic insufficiency is not, an important cause of focal cerebral ischemia. Therefore, treatment for extracranial atherosclerotic cerebrovascular disease should be focused on the elimination of the source of embolism rather than on an improvement of cerebral blood flow. PMID- 3810730 TI - Experimental acute thrombotic stroke in baboons. AB - To study the effects of antithrombotic therapy in experimental stroke, we have characterized a baboon model of acute cerebrovascular thrombosis. In this model an inflatable silastic balloon cuff has been implanted by transorbital approach around the right middle cerebral artery (MCA), proximal to the take-off of the lenticulostriate arteries (LSA). Inflation of the balloon for 3 hours in six animals produced a stereotypic sustained stroke syndrome characterized by contralateral hemiparesis. An infarction volume of 3.2 +/- 1.5 cm3 in the ipsilateral corpus striatum was documented by computerized tomographic (CT) scanning at 10 days following stroke induction and 3.9 +/- 1.9 cm3 (n = 4) at 14 days by morphometric neuropathologic determinations of brain specimens fixed in situ by pressure-perfusion with 10% buffered formalin. Immediate pressure perfusion fixation following deflation of the balloon was performed in 16 additional animals given Evans blue dye intravenously prior to the 3 hour MCA balloon occlusion. Light microscopy and transmission electron microscopy consistently confirmed the presence of thrombotic material occluding microcirculatory branches of the right LSA in the region of Evans blue stain, but not those of the contralateral corpus striatum. When autologous 111In-platelets were infused intravenously in four animals from the above group prior to the transient 3 hour occlusion of the right MCA, gamma scintillation camera imaging of each perfused-fixed whole brain demonstrated the presence of a single residual focus of 111In-platelet activity involving only the Evans blue-stained right corpus striatum. Focal right hemispheric activity was equivalent to 0.55 +/- 0.49 ml of whole blood, and the occlusion score derived from histologic examination of the microcirculation of the Evans blue-stained corpus striatum averaged 34.8 +/- 2.8. Similar 111In-platelet imaging and histologic scoring experiments carried out in four animals pretreated with the antithrombotic combination heparin and ticlopidine showed marked reduction of both 111In-platelet activity (0.01 +/- 0.03 ml vs. 0.55 +/- 0.49 ml; p less than 0.01) and thrombotic occlusion of the microcirculation (10.8 +/- 7.4 units vs. 34.8 +/- 2.8 units; p less than 0.01) in the right corpus striatum following 3 hours of MCA occlusion. In separate control experiments 111In-labeled autologous platelets were infused after the 3 hour period of right MCA occlusion and subsequent balloon deflation in two animals; no focus of 111In-platelet activity was demonstrated in fixed whole brain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3810731 TI - Dolichoectatic basilar artery: a review of 23 cases. AB - The dolichoectatic basilar artery was found in 23 cases during a 10-year period. The 19 males and 4 females ranged in age from 30 to 69 years (mean: 55 years). Hypertension was noted in 17 patients. In seventeen (74%) of the present cases this anomaly could be visualized with CT scan. Seven patients (30%) presented with pontine infarction, which was identified on CT scan in all cases. Vertebro basilar insufficiency was found in four patients. One patient had transient ischemic attacks. There were facial spasms in four patients and impairment of the lower cranial nerves in one. One patient exhibited cerebellar hemorrhage. In two patients this anomaly was found incidentally. Associated intracranial aneurysms were identified in seven patients, including fusiform aneurysms in 4 and saccular aneurysms in 3. Three patients had an accompanying hydrocephalus. The dolichoectatic basilar artery is associated with various consequences especially in relation to the pathogenesis of brainstem infarction. When this anomaly is diagnosed by CT findings, even if it is clinically asymptomatic, it may be better to treat these patients with medical therapy used to prevent ischemic stroke. PMID- 3810732 TI - Appearance and disappearance of empty delta sign in superior sagittal sinus thrombosis. AB - The diagnostic value of the empty delta sign on post-infusion CT films was investigated in five patients with superior sagittal sinus thrombosis subsequently verified angiographically and/or pathologically. The empty delta sign, which has been considered to be unique and reliable in the diagnosis of cerebral venous sinus occlusion, was observed only on CT films taken one to four weeks after onset, and was not seen in the extremes of the acute or the chronic stage of the illness. These observations may explain why this sign has not been apparent in some reports concerning the CT findings of superior sagittal sinus thrombosis. Recanalization within the thrombus may be the reason why this sign was no longer apparent in the chronic stage of the patients with superior sagittal sinus thrombosis. PMID- 3810733 TI - Effects of forskolin on cerebral blood flow: implications for a role of adenylate cyclase. AB - We have studied cerebral vascular effects of forskolin, a drug which stimulates adenylate cyclase and potentiates dilator effects of adenosine in other vascular beds. Our goals were to determine whether forskolin is a cerebral vasodilator and whether it potentiates cerebral vasodilator responses to adenosine. We measured cerebral blood flow with microspheres in anesthetized rabbits. Forskolin (10 micrograms/kg per min) increased blood flow (ml/min per 100 gm) from 39 +/- 5 (mean +/- S.E.) to 56 +/- 9 (p less than 0.05) in cerebrum, and increased flow to myocardium and kidney despite a decrease in mean arterial pressure. Forskolin did not alter cerebral oxygen consumption, which indicates that the increase in cerebral blood flow is a direct vasodilator effect and is not secondary to increased metabolism. We also examined effects of forskolin on the response to infusion of adenosine. Cerebral blood flow was measured during infusion of 1-5 microM/min adenosine into one internal carotid artery, under control conditions and during infusion of forskolin at 3 micrograms/kg per min i.v. Adenosine alone increased ipsilateral cerebral blood flow from 32 +/- 3 to 45 +/- 5 (p less than 0.05). Responses to adenosine were not augmented during infusion of forskolin. We conclude that forskolin is a direct cerebral vasodilator and forskolin does not potentiate cerebral vasodilator responses to adenosine. PMID- 3810734 TI - Cerebral and cerebellar blood flow autoregulations in acutely induced cerebral ischemia in spontaneously hypertensive rats--transtentorial remote effect. AB - Autoregulation of cerebral (CBF) and cerebellar blood flow (CeBF) was studied before, during and after acutely induced cerebral ischemia in spontaneously hypertensive rats. Cerebral ischemia of the supratentorial portion was induced for one hour by bilateral carotid artery ligation (BCL). The animals were artificially ventilated and the blood flow was measured with a hydrogen clearance technique. To test the autoregulation, the blood pressure was stepwise lowered by bleeding and maintained at a new level, i.e. 15% or 30% lower than the baseline values before, during and after cerebral ischemia. At the preischemic state, CBF and CeBF were 52.1 +/- 6.2 and 58.9 +/- 4.6 ml/100 g/min (mean +/- SEM), of which autoregulations were normally preserved. Following BCL, CBF was markedly decreased to about 10% of control value while CeBF was minimally reduced to 46.9 +/- 8.6 ml/100 g/min (80%). At the ischemic state, CBF became almost zero flow during hypotension. CeBF was also reduced to 74% and further to 58% of the resting value by 15% and 30% decrease in the blood pressure, respectively, indicating impaired CeBF autoregulation. At the 30 min post-ischemic state, CBF was recovered to 48.0 +/- 4.9 and CeBF to 53.9 +/- 5.4 ml/100 g/min. Autoregulation of CBF was still abolished, whereas CeBF was kept constant by 15% fall of blood pressure and slightly reduced to 84% by 30% hypotension, indicating almost recovery of CeBF autoregulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810735 TI - Behavioral performance of rats following neonatal hypoxia-ischemia. AB - The behavioral performance of rats subjected in the neonatal period to hypoxia ischemia at either 37 degrees C or 21 degrees C was compared to that of sham ligated animals. Performance on complex motor tests was significantly delayed only in the hypoxic-ischemic 37 degrees C rats. However, cognitive testing disclosed significant delay of spatial learning in animals subjected to hypoxia ischemia at 21 degrees C and those with gross infarction at 37 degrees C. There was enhanced avoidance learning in the animals with gross infarction in the hypoxia-ischemia 37 degrees C group. Hypoxic-ischemic damage in the neonatal rat at 37 degrees C results in transient delay of complex motor skills, but longer lasting cognitive changes. Hypoxia-ischemia during hypothermia produces no motor deficits, although there may be similar alterations in learning. PMID- 3810736 TI - MR imaging of a false carotid aneurysm. AB - Two months after a gunshot wound to the head of a 12-year-old boy, MR imaging outlined an asymptomatic false aneurysm of the carotid artery. The scan's ability to image in multiple planes with noninvasive visualization of pulsatile vessel flow suggests its use for follow-up examinations of traumatic injuries to the head or neck. PMID- 3810737 TI - Painful tonic spasms caused by putaminal infarction. AB - Lacunar infarcts in the basal ganglia are known to cause various movement disorders, such as chorea, focal dystonia, and hemichorea-hemiballismus. We report here a case of putaminal lacunar infarction which presented with "painful tonic spasms" of the contralateral limbs. This consisted of paroxysmal brief, painful, flexor contractures of the upper, and occasionally the lower limb. These were not focal seizures but were controlled with carbamazepine, which has been used for the "painful tonic spasms" well-associated with multiple sclerosis. The putaminal infarct we describe is probably related to a lupus anticoagulant and systemic lupus erythematosus. PMID- 3810738 TI - Ophthalmoplegia with contralateral hemiplegia. Occlusion of the internal carotid artery due to thrombosis of an intracavernous aneurysm. AB - A left ophthalmoplegia and right hemiplegia were due to thrombosis of an intracavernous aneurysm with occlusion of the left internal carotid artery. Ophthalmoplegia with contralateral hemiplegia is probably a rare syndrome. Thrombosis of an intracavernous aneurysm is probably a rare cause of occlusion of the internal carotid artery. PMID- 3810739 TI - Rational therapy in the neurosciences: the role of the randomized trial. AB - How should clinicians select the specific drug, operation, splint, exercise, or conversations that will best achieve the therapeutic goal for a given patient? This essay will examine three strategies for doing so: induction from our own, individual prior experiences; abdication to the authority of our teachers and those who write review articles; and deduction from the reports of randomized clinical trials. By means of examples from the recent past, the fallibility of the first two approaches will be illustrated. Then, strategies for critically appraising the published reports of randomized trials will be described. Finally, the reasons why the results of even the proper trials may not be accepted by frontline clinicians will be introduced. PMID- 3810740 TI - A proposed method for using a reimbursement moratorium to encourage recruitment for a randomized study of carotid endarterectomy. AB - As indicated by Barnett, Plum and Walton, a definitive clinical trial to resolve the issue of the effectiveness of carotid endarterectomy is clearly needed. A proposal to foster such a trial, through a moratorium on third-party reimbursement other than for randomized patients, has herein been presented. PMID- 3810741 TI - Caffeine induced changes in cerebral circulation. PMID- 3810742 TI - Direct evidence of acute, massive striatal dopamine release in gerbils with unilateral strokes. AB - Dopamine release into the extracellular space was measured with in vivo electrochemical detection in the ipsilateral and contralateral striata in Mongolian gerbils that suffered a stroke after acute unilateral carotid artery ligations. A sevenfold increase in the dopamine signal occurred within 15 minutes of carotid ligation in the ischemic side, while the unlesioned side had no significant change. Increased extracellular levels of dopamine persisted throughout the 3-hour recording period. Pretreatment with alpha-methyl-p-tyrosine 6 hours prior to recording significantly attenuated the signal increase. This study is the first direct demonstration of the marked, continuous dopamine release that occurs during acute cerebral ischemia. PMID- 3810743 TI - The effect of ergotamine and dihydroergotamine on cerebral blood flow in man. AB - The effects of ergotamine and dihydroergotamine on cerebral blood flow was investigated 4 hours after i.v. injection as these drugs might be of importance for migraine treatment. Eight normal male volunteers (not suffering from migraine) received 0.5 mg ergotamine and 1 mg dihydroergotamine i.v. Cerebral blood flow was measured by the xenon-133 inhalation method and single-photon emission computerized tomography before and after intravenous acetazolamide administration (1 g). Cerebral blood flow was measured before and 4 hours after ergotamine and dihydroergotamine administration. Strain-gauge measurements of toe arm systolic gradients were used to monitor the effect of the drug on leg arteries. Mean hemispheric and regional cerebral blood flow was unchanged after either drug (mean +/- SEM, ml/100 g/min): for ergotamine, 57 +/- 3 before and 57 +/- 3 at 4 hours; for dihydroergotamine, 54 +/- 2 before and 55 +/- 2 at 4 hours. The acetazolamide response was unchanged as well. Only ergotamine decreased the toe-arm systolic gradient significantly (22 mm Hg at maximum after 240 minutes; p less than 0.02). Thus, our study did not support the belief that ergot alkaloids should be withheld from patients during attacks of classic migraine, but this has to be investigated further. The discrepancy in the peripheral effects of ergotamine and dihydroergotamine might also be of clinical importance. PMID- 3810744 TI - Failure of deferoxamine, an iron chelator, to improve neurologic outcome following complete cerebral ischemia in dogs. AB - Eleven minutes of complete cerebral ischemia was produced in 17 dogs by temporary ligation of the venae cavae and aorta. Immediately prior to the ischemic episode, 7 dogs received deferoxamine, an iron chelator, 50 mg/kg i.v., and 10 dogs received an equivalent volume of saline placebo i.v. Five dogs failed to meet preestablished protocol criteria and were excluded from data analysis. Neurologic recovery was evaluated by an observer blind to the treatment groups in the remaining 12 dogs at 48 hours postischemia. The neurologic effects of complete cerebral ischemia were compared between dogs treated with deferoxamine and those receiving placebo treatment. One of 6 deferoxamine-treated dogs was normal and 5 were moderately to severely damaged. Similarly, 1 of 6 placebo-treated dogs was normal and 5 were moderately to severely damaged. The authors conclude that deferoxamine does not provide cerebral protection in this model of complete cerebral ischemia. PMID- 3810745 TI - Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system. AB - Regional cerebral blood flow was studied by means of the 133Xe inhalation method in 26 untreated and 10 treated patients with essential hypertension. The untreated subjects were divided into newly and previously diagnosed groups to assess the relation between regional cerebral blood flow and the duration of hypertension. The overall flow reduction was more marked in the frontal and temporal regions in the previously diagnosed group, and this was attributed to pathological changes in the district served by the middle cerebral artery. Regional temporal lobe impairment was also noted in the newly diagnosed and treated subjects. A significant correlation was found between regional cerebral blood flow and mean arterial blood pressure. PMID- 3810746 TI - Urinary and gait disturbances as markers for early multi-infarct dementia. AB - In a retrospective study of 84 outpatients with multiinfarct dementia, urinary and gait disturbances were found in 50% and 27%, respectively, and often preceded dementia and discrete stroke-like episodes by more than 5 years. Compared to patients without urinary disturbance, those with urinary dysfunction were predominantly male and more behaviorally impaired, but were similar in age, cognitive score, depression score, computerized tomography findings, and relative survival. Compared to patients without gait disturbance, those with gait abnormality had a higher Hachinski ischemic score and depression score and were more behaviorally impaired. Urinary and gait abnormalities may be markers for cerebrovascular disease and vascular dementia even in the absence of frank stroke. Damage to bifrontal outflow tracts may be the common pathophysiological mechanism underlying the behavioral and motor symptoms characteristic of vascular dementias. PMID- 3810747 TI - Time-dependent effects of prolonged hypercapnia on cerebrovascular parameters in dogs: acid-base chemistry. AB - Prolonged normoxic hypercapnia initially caused an increase in canine cerebral blood flow, as measured by the radioactive microsphere technique, accompanied by a decrease in cerebrovascular resistance. These effects persisted for 3 hours. An adaptive decrease in cerebral blood flow and increase in cerebrovascular resistance were seen when hypercapnia was maintained for an additional 3 hours. Regional variations occurred; those areas with the greatest initial hypercapnic blood flow (cortex, caudate nucleus) showed a greater rate of decay of flow over time. Cerebrospinal fluid pH, initially acidotic during hypercapnia, increased over the subsequent 5 hours from 6.99 +/- 0.02 to 7.13 +/- 0.02. This was accompanied by an increase in the cerebrospinal fluid bicarbonate ion concentration from a normocapnic baseline of 19.6 +/- 0.6 to 26.2 +/- 4 mEq/l. Total and regional cerebral blood flow were linearly related to cerebrospinal fluid pH (R2 = 0.97). Extrapolation of a full adaptive return of flow to baseline indicated a shift in the cerebrovascular sensitivity to extracellular hydrogen ion concentration during prolonged hypercapnia. PMID- 3810748 TI - Transport of sodium from blood to brain in ischemic brain edema. AB - Brain water and sodium increase during ischemia, suggesting that the blood-brain barrier permeability to sodium is increased. To test this hypothesis we measured the permeability-surface area products of 22Na and [3H]sucrose in gerbils following 3 hours of unilateral ischemia. In animals with neurologic symptoms, unilateral carotid occlusion reduced the cerebral blood flow in the ipsilateral cerebral hemisphere to 13 +/- 4 ml/100 g/min (n = 6). The water content of the ischemic hemisphere increased from 79.0 +/- 0.6 to 80.8 +/- 0.2% (n = 7, p less than 0.001) and tissue sodium content increased from 231 +/- 17 to 359 +/- 23 mEq/kg (p less than 0.0001). However, there was a 40% reduction in the sodium permeability-surface area product of the ischemic hemisphere compared with the control side (1.65 +/- 0.44 vs 2.79 +/- 0.29 microliter/g/min, n = 6, p less than 0.001). The sucrose permeability-surface area product, a measure of blood-brain barrier integrity, was unchanged. Although ischemia was less severe in the diencephalon, the tissue water and sodium contents increased significantly on the ischemic side. In contrast to the cerebral hemisphere, however, the permeability surface area products for both sodium and sucrose were unchanged in the ischemic diencephalon. These results suggest that the increase in tissue sodium seen in ischemic edema is not due to enhanced sodium uptake; we speculate that it results, in part, from a reduction in sodium and water clearance from the tissue. PMID- 3810749 TI - Simultaneous in vivo measurement of lumped constant and rate constants in experimental cerebral ischemia using F-18 FDG. AB - Lumped and transfer rate constants in ischemic brain tissue must be measured to estimate accurately cerebral glucose utilization by the deoxyglucose method. We studied the bilateral middle cerebral artery occlusion model in 17 cats, 5 with a 1-hour occlusion, 5 with a 4-hour occlusion, and 7 with a sham operation. The time course of cerebral tissue radioactivity (Ci*(t)) was monitored by external coincidence counting during a programmed infusion of [18F]-2-deoxy-2-fluoro-d glucose (18F-2-FDG). Arterial plasma concentration (Cp*(t)) of the tracer was kept constant during the first 45 minutes. Rate constants were estimated from Ci*(t) and Cp*(t) by a nonlinear least-squares fitting routine. The lumped constant was estimated from the fit of the ratio of extraction fractions of glucose and 18F-2-FDG by nonweighted, nonlinear least-squares fitting. In the 4 hour-occlusion model, the transfer constant k1* was 23% lower, k3* 39% lower, and the lumped constant 78% higher than in the sham-operated animals. In the 1-hour occlusion model, k3* was 26% lower than in the sham-operated animals but the lumped constant was not significantly different. The rate of glucose utilization was significantly different in the 4-hour-occlusion model compared to the sham operated animals (48% decrease, p less than 0.05) but was not significantly different in the 1-hour-occlusion model. PMID- 3810750 TI - Binding of the hypoxia tracer [3H]misonidazole in cerebral ischemia. AB - Radiolabelled misonidazole, a radiosensitizing drug that binds to viable hypoxic tumor cells, may be useful in identifying hypoxic cells in cerebrovascular disease. Its potential was investigated in the gerbil stroke model. Biodistribution of [3H]misonidazole was measured in normal gerbils and animals that had been subjected to right common carotid artery ligation to produce cerebral ischemia. The uptake of [3H]misonidazole in the right cerebral hemisphere and right/left hemispheral uptake ratios correlated positively with the severity of the stroke when measured 6-9 hours after carotid ligation. Histologic studies in symptomatic ligated animals showed ipsilateral widespread but patchy acute ischemic changes as well as areas that showed no morphological changes. Microscopic autoradiography in these animals showed diffuse heavy labelling only in the ipsilateral hemisphere. This was over areas that had histological damage as well as in adjacent areas that appeared intact. Studies comparing blood flow measured with [14C]iodoantipyrine and [3H]misonidazole retention in gerbils with carotid artery ligations indicated that flow is not a major determinant of retention of this hypoxia tracer. We conclude that a misonidazole congener labelled with a gamma- or positron-emitting isotope may be useful in nuclear imaging of the degree and regional distribution of hypoxic tissue in cerebrovascular disease. PMID- 3810751 TI - Water extraction fraction and permeability-surface product after intravenous injection in rats. AB - A quantitative method has been developed to measure the water extraction fraction of rat brain after successive intravenous bolus injections of [15O]water and [11C]butanol based on a mathematical equation developed by the authors. This new method is noninvasive to the brain or craniocervical large vessels and does not require sacrifice of the rats. Arterial concentration curves and total head counts were measured in 8 rats by means of external coincidence detectors. Water extraction fraction in rat brain was 0.67 +/- 0.13 (mean +/- SD) and permeability surface product was 1.75 ml/g min, where cerebral blood flow and arterial carbon dioxide tension were 1.71 +/- 0.86 ml/g min and 44.8 +/- 14.0 mm Hg, respectively. Water extraction fraction was stable with different measurement times from 20 to 80 seconds. PMID- 3810752 TI - Experimental focal ischemia in cats: changes in multimodality evoked potentials as related to local cerebral blood flow and ischemic brain edema. AB - Somatosensory and auditory evoked cortical potentials (SEP's and AEP's), regional cerebral blood flow, regional brain water content, and alteration of the blood brain barrier were investigated in 3 cortical areas during permanent and 1- and 2 hour transient occlusion of the left middle cerebral artery and after restoration of blood flow in cats. During occlusion, blood flow in the auditory cortex was severely suppressed. In the fore limb projection area of the somatosensory cortex, blood flow was moderately reduced while it was nearly unaffected in the hind limb projection area. Despite different degrees of ischemia in the 3 cortical areas, all evoked responses were completely abolished within 10 minutes after occlusion. During permanent occlusion, the pattern of blood flow reduction persisted, and all evoked potentials stayed abolished. Recirculation after occlusion restored blood flow rapidly. AEP's recovered poorly after both 1 and 2 hours of ischemia. SEP's regained normal amplitudes soon after recirculation in the group with 1-hour occlusion. After 2 hours of ischemia, the recovery of SEP's was variable but better than that of the AEP's. Remarkable water accumulation was observed in the auditory cortex of all 3 groups and was accompanied in the 2-hour ischemia group by a disruption of the blood-brain barrier. In the 2-hour group, water accumulation was also found in the subcortical white matter radiation, whereas significant changes in regional water content were not observed in the somatosensory areas. The present study indicates that abolition of SEP's during middle cerebral artery occlusion in cats is caused by lesions in the afferent pathway leading to cortical deafferentation rather than by cortical ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810753 TI - The social and functional consequences of stroke for elderly patients. AB - This study sought to answer questions about the social and functional consequences of stroke for elderly patients (greater than or equal to 65 years of age). Survivors of acute stroke were retrospectively identified, and hospital records were reviewed. One year after discharge, follow-up interviews were conducted with families of surviving patients. Most patients were discharged to home (82%) and remained there. Independent functional status was the single predictor of discharge to home (p less than 0.01). By the time of followup, less than half of the surviving patients were functionally independent (42%). Stroke is an important cause of functional dependence among the elderly. Attention should be focused on minimizing the effects of persisting dysfunction on them and their families. PMID- 3810754 TI - Hemodynamic effect of carotid endarterectomy. AB - Cerebral blood flow was measured by the intravenous xenon-133 technique at rest and during cerebral vasodilation with acetazolamide in 32 patients before and after uncomplicated carotid endarterectomy. The results were compared with the internal carotid artery perfusion pressure measured during surgery. A significant improvement in side-to-side cerebral blood flow asymmetry occurred in 6 patients studied at baseline and in 11 patients during provoked cerebral vasodilation. These patients all belonged to a group of 14 patients who, in addition to a severe stenosis of the internal carotid artery, presented a reduction in cerebral perfusion pressure of at least 20%. No improvements occurred in 18 patients with no or only minor reduction in perfusion pressure, irrespective of the degree of stenosis. These findings indicate an improved perfusion reserve following carotid endarterectomy in most patients with marked reduction in perfusion pressure, whereas only some of these patients will experience an improvement in baseline cerebral blood flow. PMID- 3810755 TI - Failure of nimodipine to prevent ischemic neuronal damage in rats. AB - The efficacy of nimodipine in preventing ischemic brain injury was tested in rats subjected to a 20-minute period of high-grade forebrain ischemia by 4-vessel occlusion. Three minutes after restoration of circulation to the brain, an intravenous bolus of 5 micrograms/kg nimodipine or an equivalent amount of vehicle or saline was given, followed by continuous intravenous infusion of the respective solution at 1 microgram/kg/min for 2 hours. In a second series, a larger bolus (20 micrograms/kg of nimodipine) and longer infusion period (6 hours) were employed. Histopathology of the brain was evaluated blindly 72 hours later and graded on a conventional 3-point scale. There was no significant effect of treatment in either series. In the 6-hour series, the percent of cerebral hemispheres showing damage of Grades 2 or 3 in zone CA1 of the hippocampus and in the striatum, respectively, was 100 and 40% for the nimodipine-treated rats, 100 and 42% for rats receiving vehicle, and 75 and 25% for animals receiving saline. Thus, this study revealed no beneficial effect of nimodipine when given following a 20-minute period of severe forebrain ischemia. PMID- 3810757 TI - Plasma 3-methoxy-4-hydroxyphenylethyleneglycol and homovanillic acid concentrations in patients with subarachnoid hemorrhage. AB - To ask if the determination of central-nervous-system-derived catecholamine metabolites in peripheral circulation could be a useful index of brain dysfunction after subarachnoid hemorrhage, 3-methoxy-4 hydroxyphenylethyleneglycol and homovanillic acid concentrations in plasma, together with those of free catecholamines (noradrenaline, adrenaline, and dopamine), were serially measured for up to 3 weeks after the initiation of symptoms in 23 patients with aneurysmal subarachnoid hemorrhage as compared to 17 healthy and 9 patient controls. Catecholamines and their metabolites were determined by using high-performance liquid chromatography with electrochemical detection. Plasma 3-methoxy-4-hydroxyphenylethyleneglycol concentrations were markedly elevated in subarachnoid hemorrhage patients with coma compared to those without, and the maximal concentrations observed in comatose patients never occurred in normal subjects or in patients with other neurological disorders. The mean maximal plasma concentrations of free catecholamines did not differ significantly between the comatose and noncomatose groups. Combining 3-methoxy-4 hydroxyphenylethyleneglycol with homovanillic acid level data more clearly discriminated between the comatose and noncomatose subarachnoid hemorrhage groups. The results suggest that plasma concentration of 3-methoxy-4 hydroxyphenylethyleneglycol, a major metabolite of brain noradrenaline, can be a prognostic discriminator for patients with subarachnoid hemorrhage and its discriminating power can be strengthened by combining it with homovanillic acid data. PMID- 3810756 TI - Elevated blood ketone and glucagon levels cannot account for 1,3-butanediol induced cerebral protection in the Levine rat. AB - 1,3-Butanediol is an ethanol dimer that induces systemic ketosis. It has previously been shown to increase hypoxic survival time and reduce neurologic deficit in several experimental preparations. The aim of this study was to determine if the mechanism of 1,3-butanediol-induced cerebral protection was elevation of blood ketone levels, blood glucagon levels, or both. Blood beta hydroxybutyrate levels, glucagon levels, or both produced by a previously reported protective dose of 1,3-butanediol (47 mmol/kg) were simulated by direct i.v. infusion of the ketone beta-hydroxybutyrate and glucagon separately and in combination, and the effect on hypoxic survival time in instrumented Levine rats (unilateral carotid ligation and hypoxic exposure) was determined. To test if the mechanism was a direct or osmotic effect of the alcohol, an equimolar dose of ethanol (47 mmol/kg) was administered and the effect on hypoxic survival time was compared with that produced by 1,3-butanediol. As in previous studies, 1,3 butanediol significantly increased hypoxic survival time (241% of control, Scheffe p less than 0.05). Various doses of beta-hydroxybutyrate and glucagon were infused to approximate the blood levels of beta-hydroxybutyrate and glucagon produced by a protective dose of 1,3-butanediol. Although beta-hydroxybutyrate or glucagon infusions produced blood levels of these substances that were comparable with those produced by administering butanediol, they failed to prolong hypoxic survival time as long as 1,3-butanediol. No correlation was detected between hypoxic survival time and blood levels of beta-hydroxybutyrate, glucagon, insulin, or glucose. An equimolar dose of ethanol did not significantly increase hypoxic survival time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810758 TI - Cerebral amyloid angiopathy presenting as a mass lesion. AB - A rare clinical presentation of cerebral amyloid angiopathy is reported. Our patient presented with the clinical and radiological signs of a right frontal mass lesion suggesting a brain tumor, and a biopsy provided the diagnosis of cerebral amyloid angiopathy. A brief review of the pathology and clinical features of cerebral amyloid angiopathy is presented. PMID- 3810759 TI - Ataxic hemiparesis with contralateral trigeminal nerve impairment due to pontine hemorrhage. AB - A most unusual case of right-sided ataxic hemiparesis with left trigeminal involvement is reported. Computerized tomographic scan revealed a small hemorrhage in the basis pontis. PMID- 3810761 TI - Pulsatile tinnitus. AB - Pulse-synchronous tinnitus suggests a vascular etiology and is deemed rare by the otologic literature. During the period 1978-1985 we evaluated 20 patients with the sole or initial complaint of pulsatile tinnitus. Fourteen patients had objective pulsatile tinnitus, perceived by the patient and the examiner alike, and 6 had subjective pulsatile tinnitus, perceived by the patient only. Angiographic findings in patients with objective pulsatile tinnitus included dural or pial arteriovenous malformations, occlusive disease of the intra- or extracranial carotid arteries from atherosclerosis or dissection, panarterial ectasia, and venous sinus thrombosis. Most of the patients with subjective pulsatile tinnitus had normal evaluations, but other possible causes of subjective pulsatile tinnitus included a carotid occlusion and pseudotumor cerebri. Pulsatile tinnitus is an uncommon symptom produced by a variety of causes. Given the abnormalities present in our series, we would recommend intraarterial digital subtraction angiography or conventional angiography in the evaluation of objective pulsatile tinnitus and intravenous digital subtraction angiography for subjective pulsatile tinnitus. Increased intracranial pressure must also be considered. PMID- 3810760 TI - Familial occurrence of spontaneous dissection of the internal carotid artery. AB - Spontaneous dissections of the extracranial internal carotid artery are diagnosed more frequently as their clinical and angiographic features are more widely recognized. Familial occurrence of spontaneous dissection of the internal carotid artery has not been previously reported. We describe the occurrence of this entity in a mother and daughter and also in a father and son. The familial occurrence of spontaneous dissection of the internal carotid artery raised the possibility of an inherited disorder of the blood vessel wall that predisposes the artery to this disorder. Fibromuscular dysplasia is suspected to be the underlying arterial disease, but other unknown arteriopathies cannot be excluded. PMID- 3810762 TI - Can raising cerebral blood flow improve outcome after acute cerebral infarction? AB - Cerebral blood flow correlates poorly with outcome after stroke, and most therapies aimed at increasing cerebral perfusion have not succeeded in predictably reducing neurological deficit. Newer approaches such as hemodilution and thrombolysis may prove to be more effective but might be most advantageous if combined with efforts to correct postischemic disturbances in cellular metabolism. PMID- 3810763 TI - Alcohol and stroke. AB - Alcohol might contribute to stroke in several ways: induction of cardiac arrhythmias and cardiac wall motion abnormalities which predispose to cerebral embolism, induction of hypertension, enhancement of platelet aggregation and activation of the clotting cascade, and reduction of cerebral blood flow by stimulation of cerebral vascular smooth muscle contraction or by altering cerebral metabolism. While these pathophysiological mechanisms have gained enthusiastic experimental and theoretical support, the findings are preliminary and will require further large-scale clinical and epidemiological analyses to substantiate their roles as causal factors or potentiators of stroke. Documentation of measurable platelet and coagulation cascade abnormalities reported in healthy volunteers who have ingested alcohol will need to be confirmed on a broader scale in stroke patients with recent ethanol consumption. The risk of stroke in those with alcohol-induced atrial fibrillation and cardiomyopathy must be ascertained for the general population. While the experimental evidence is exciting and provocative, epidemiological evidence also suggests a link between alcohol consumption and stroke. Regular alcohol ingestion is associated with hypertension, fatal and nonfatal intracranial hemorrhage, cerebral infarction, and increased risk of death from stroke. Recent, less stringently controlled studies suggest that alcohol consumption is a risk factor for cerebral infarction in young adults with occasional ethanol intoxication and middle-aged women and young men with occasional alcohol intoxication and regular heavy drinking. Alcohol may also be a risk factor for subarachnoid hemorrhage. PMID- 3810765 TI - Stroke data banks. PMID- 3810764 TI - Should carotid endarterectomy be condemned? PMID- 3810766 TI - Dichloroacetate after incomplete ischemia. PMID- 3810767 TI - "Locked-in" syndrome. PMID- 3810768 TI - Stroke in the Lehigh Valley: seasonal variation in incidence rates. AB - We investigated the seasonal pattern of stroke using the Lehigh Valley Stroke Register. This register includes all patients hospitalized with stroke or transient ischemic attack (TIA) from among the 600,000 Lehigh Valley residents. Meterological data were obtained from the National Oceanic and Atmospheric Administration. The study, which uses 18 months of data, included 1,944 cases. Using single harmonic regression analysis, the seasonal pattern of TIA and infarction, but not hemorrhage, fit a sine-cosine wavefunction with a 12-month period (R2 = 41% and 36%, respectively). For infarction, the strongest seasonal pattern was exhibited for women of all ages and for both sexes in the age groups 65-74 and 75-84, but only the sine component was significant. The peak months for TIA were June-August, while the peak months for infarcts were February-April. Correlations between ambient temperature and each type of stroke were computed. A significant positive correlation for TIA was found (r = 0.57, p = 0.01). After adjusting for a 2-month lag between the low for infarction and the peak for temperature, a significant negative correlation was found (r = -0.64, p = 0.01). No significant correlation was found for hemorrhage. Possible reasons for the opposite relations of TIA and infarct are discussed. PMID- 3810769 TI - Influence of age on carotid atheroma in patients with reversible ischemic attacks. AB - To evaluate the influence of age on carotid atheroma we reviewed the angiographic findings in 120 patients with reversible ischemic attacks. The prevalence and severity of atherosclerotic lesions increased significantly with age, and this difference persisted after adjusting for hypertension. These results may at least partly explain the poor long term prognosis for elderly subjects with reversible ischemic attacks, and underscore the importance of taking age into account when relating clinical and angiographic findings in patients with cerebrovascular ischemia. PMID- 3810770 TI - Leukocyte rheology in recent stroke. AB - Eighteen patients with recent ischemic stroke were compared with an equal number of matched controls. Standardized suspensions of red cells as well as of red and white cells were filtered in a new filtration apparatus capable of discriminating between cell deformability and filter occlusion. Results show that red cell deformability, although slightly lower than in controls, is not significantly altered in stroke patients. Filter occlusion, however, was significantly higher in patients when red and white cell suspensions were filtered, but not when red cell suspensions were used, suggesting that white cell filterability is impaired after stroke, which could be due to decreased deformability and/or increased adhesiveness of leukocytes. Slowed white cell passage may also occur in the living microcirculation and may present an obstacle to nutritive flow in exchange vessels, possibly contributing to local ischemia and tissue necrosis after stroke. PMID- 3810771 TI - Identification of intracardiac thrombi in stroke patients with indium-111 platelet scintigraphy. AB - Platelet scintigraphy (PSC) with indium-111 labelled platelets has been confirmed as an adequate method for the detection of intracardiac thrombi in patients with heart disease. We performed PSC of the heart and the neck vessels in 27 stroke patients with suspected cardiac embolism and as control on 10 patients with atherosclerotic lesions of the carotid arteries without evidence of heart disease. The carotid PSC was positive in 6 of 10 patients with carotid disease, and twice in the 27 with suspected cardiac embolism. In these 27 the PSC of the heart indicated pathological conditions 13 times. Pathological platelet accumulations could be visualized in 3 cases in the atrial space, in 9 cases in the region of the left ventricle, and once at the aortic valve. Scintigraphy was negative in all 10 patients with atherosclerosis of the neck vessels. The two dimensional echocardiography revealed pathological findings in 8 of the 13 patients with positive heart PSC (3 with intraventricular thrombi, 3 with valvular disease, 2 with decreased ventricular contractility) and was normal in the 10 control patients. Open-heart surgery was performed in 2 patients with pathological PSC and revealed an intracardiac thrombus. Three of 4 patients with positive atrial PSC showed mitral or aortic valve disease. These results suggest that PSC can provide a valuable method for detecting cardiac thrombi in stroke patients. PMID- 3810772 TI - Hemoglobin concentration and prognosis in symptomatic obstructive cerebrovascular disease. AB - A total of 1,377 patients with symptomatic obstructive cerebrovascular disease (most commonly, internal carotid artery occlusion) entered a trial in which they were randomized to either medical or surgical (extracranial-intracranial bypass) therapy. All but 8 had hemoglobin estimations performed at entry. The patients were followed for an average of 55.8 months. In the medical group, the 325 patients with high normal hemoglobin concentration (15 g/l or more) suffered no more ischemic strokes than the 382 patients with lower values (less than 15 g/l). Those strokes that did occur were no more severe in the high than the low hemoglobin group. Hemoglobin concentration did not emerge as a prognostic factor in those patients treated surgically (n = 662). This prospective study counters the hypothesis that high normal hemoglobin concentration is associated with poor outcome in patients with symptomatic obstructive disease of the carotid and cerebral arteries. PMID- 3810773 TI - Evaluation of brain dysfunction in hypertensive putaminal hemorrhage with multimodality evoked potentials. AB - Changes in multimodality evoked potentials (MEP's), consisting of somatosensory evoked potentials (SEP's), visual evoked potentials (VEP's), and auditory evoked brainstem responses (AEBR's), were studied in 36 patients with hypertensive putaminal hemorrhage to ascertain the relation among areas and distribution of brain dysfunction, the size of hemorrhage on computerized tomographic scan, and the clinical outcome. Among MEP's, SEP's were most significantly involved in all patients. Abnormalities in VEP's and AEBR's remained mild or moderate when the hemorrhage did not extend to the diencephalon. If SEP's were normal or mildly abnormal, they improved early the ictus. These patients did well clinically. If SEP's were absent, the patients had poor outcome even when the hemorrhage was small and located outside the internal capsule. In contrast, deterioration or persistence of MEP's indicated secondary insult to the brain and poor patient outcome. Early and serial MEP studies are useful in evaluating primary and secondary brain dysfunction and in predicting patient outcome in hypertensive putaminal hemorrhage. PMID- 3810774 TI - Cerebral blood flows and tissue oxygen levels associated with maintenance of the somatosensory evoked potential and cortical neuronal activity in focal ischemia. AB - The middle cerebral artery was occluded in 18 cats to evaluate the physiological consequences of cerebral blood flow reductions on the somatosensory evoked potential, spontaneous neuronal activity, and oxygen availability in the ipsilateral and contralateral hemispheres. In the ipsilateral ectosylvian gyrus high-grade ischemia was produced as blood flow in the gray matter was reduced from 52.1 +/- 8.6 (mean +/- SE) to 13.3 +/- 9.0 ml/100 g/min and in the white matter from 33.8 +/- 5.6 to 6.1 +/- 6.4 ml/100 g/min. This significant reduction (p less than 0.05) was associated with abolition of the cortical component of the somatosensory evoked potentials. In all animals occlusion resulted in a predictable extended latency change and a variable amplitude response of the cortical component of the contralaterally recorded somatosensory evoked potentials. In 5 animals, oxygen availability was measured and spontaneous neuronal activity in the contralateral hemisphere was recorded. Volume expansion and hemodilution with either dextran or saline infusions elevated cerebral blood flow in the contralateral gray matter significantly (p less than 0.05) compared with the control and clip values. Ipsilateral spontaneous activity stopped within 4-12 minutes of occlusion, while contralateral spike activity persisted at rates at least equal to those recorded immediately following occlusion. PMID- 3810775 TI - Does cerebral vasospasm result from denervation supersensitivity? AB - This study examined the role of denervation supersensitivity in the development of cerebral vasospasm. Adrenergic denervation of cat basilar artery was accomplished by resection of the superior cervical ganglia or by injection of 6 hydroxydopamine into the cisterna magna. In vivo dose-response characteristics were determined for normal and for denervated arteries, and no significant differences were found between topical applications of serotonin, norepinephrine, epinephrine, fresh blood, or incubated blood. In addition, analysis of cat blood incubated in vitro revealed that the levels of serotonin, norepinephrine, and epinephrine diminished over time, whereas levels of hemoglobin and methemoglobin increased up to Day 14. The results of this study indicate that adrenergic denervation is not the cause of cerebral vasospasm and that, whatever the mechanism, hemoglobin is far more likely to play a role than are the other agents. PMID- 3810776 TI - Evidence that intraluminal pressure affects high potassium- and serotonin-induced contractions differently in the bovine middle cerebral artery: an in vitro study. AB - The effects of changing intraluminal pressure on contractions induced by 70 mM potassium (K+) and 10(-7), 10(-6), and 10(-5) M serotonin (5-HT) were studied in vitro in bovine middle cerebral arteries. Changes in vessel outside diameter in whole-mounted cylindrical sections of artery were detected with a photoelectric infrared device. High K+-or 5-HT (10(-5)M)-induced contractions peaked at 25 mm Hg and were significantly correlated with increasing intraluminal pressure between 25 and 175 mm Hg. Contractions induced with lower concentrations of 5-HT (10(-6), 10(-7) M), norepinephrine, and histamine peaked at 75 mm Hg but were not significantly correlated with rising pressure. Phentolamine (2 X 10(-6) M) added to the extraluminal bath had negligible influence on pressure's ability to affect K+- and 5-HT-induced contractions differently. Reducing bath temperature to 27 degrees C reduced the K+ response at each pressure, but similar temperature changes had little affect on the 5-HT-induced contractions. The K+ response became less sensitive to increasing pressure at low temperatures. Nifedipine (10( 7) M) almost totally eliminated K+-induced contractions, while significantly reducing the responses to all concentrations of 5-HT. The 5-HT responses appeared more sensitive to increasing intraluminal pressure in the presence of nifedipine. Maximum Ca++-induced contractions in the presence of 10(-5) M 5-HT and high K+ occurred at 25 mm Hg, while Ca++-induced contractions and Ca++-induced contractions in the presence of 10(-7) 5-HT or K+ plus 5-HT were maximum at 75 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810778 TI - [Geriatrics in the making?]. PMID- 3810777 TI - Thymic involvement in memory responses after primary challenge with TNP-Ficoll in Xenopus laevis, the South African clawed toad. AB - Memory to TNP-Ficoll in Xenopus laevis is demonstrable as a more rapid secondary response rather than an augmented response. While adult thymectomy abrogates ability to respond to both primary and secondary challenge with soluble TNP Ficoll, memory to this antigen can be revealed in thymectomized animals by challenge with TNP-Ficoll on bentonite beads. Memory to TNP-Ficoll cannot be revealed by secondary challenge with TNP-LPS or TNP-RBC, but memory to TNP-LPS is revealed by TNP-Ficoll challenge. These results are consistent with the hypothesis that, whereas B1 cells (capable of responding to TI-2 antigens) can develop from a pool of B1 and B2 memory cells (generated in response to TD or TI 1 antigens), initial challenge with TI-2 antigen does not produce a pool containing both B-cell subsets. PMID- 3810779 TI - [Depressive symptoms and the utilization of professional care by the elderly living at home]. AB - In Geleen, a survey was held among the total population aged 75-84 years on activities of daily living, housekeeping performance and use of professional and lay care. Out of 860 respondents to this postal questionnaire 334 were selected for a semistructured interview. Two groups with the same physical limitations, one using professional care and the other not, were compared on several characteristics. These characteristics were: 1. mental state (depression, dementia); 2. social network; 3. social-economical situation; 4. housing conditions. By means of multivariate analysis, associations between these characteristics and utilisation of professional care were identified. A major finding of the study was a twice as high prevalence of depression among users of professional care compared to non users. If depression is a causative factor in the demand for professional care, early detection and prevention of depression might be important in reducing professional care demand. Recognising depression in applicants for professional care may assist in adjusting the content of care. PMID- 3810780 TI - [Formal and informal assistance in the elderly. A study on the division of tasks among the elderly, informal support persons and homemaker services]. AB - This article deals with the division of tasks between formal and informal networks of the elderly. Research has been done on the kind and degree of participation in the care of elderly by the elderly themselves, the role of the 'most important' persons in their social network as well as on the role of family home service. Sixty-seven clients of the '7 X 24-hours' home help in Velp were involved. The effect of household composition was also investigated. As regards to three different kinds of activities, the results indicate a division of tasks between formal and informal networks; clients themselves perform especially ADL activities, informal caregivers supporting/supervising activities and the home help household activities. Furthermore it appears that of the total number of activities performed by home help nearly three quarters is neither performed by the elderly themselves nor by the 'most important' person in their social network. PMID- 3810781 TI - [Causes of the slowing-down of cognitive processes in aging: the noise hypothesis]. AB - A typical phenomenon accompanying aging is the slowing down of cognitive processes. This slowing down may be considered to affect only specific aspects of information processing or it may be looked upon as a general property. As yet there exists no generally accepted explanation of this phenomenon. There is disagreement about the exact localisation and the physiological basis of the slowing down. However, a number of hypotheses has been formulated. These hypotheses have in common that the slowing down is attributed to a form of 'noise', either at neuronal level or at psychological level. We discuss several of these noise-related theories and their predictions and review the empirical basis for each of them. It is concluded that the different hypotheses do not exclude each other and that slowing down of cognitive processes can be observed at different levels of information processing. PMID- 3810782 TI - [Hypothermia in the aged; case reports from practice]. AB - Hypothermia is a syndrome that often occurs in the elderly. Two case-histories are presented, after which aetiology, pathophysiology, consequences and complications are discussed. Treatment of moderate hypothermia consists of passive external rewarming. Deep hypothermia should be treated with active internal rewarming with heated intravenous infusion fluids, in order to decrease mortality rates. PMID- 3810783 TI - Leishmania in the Old World: 5. Numerical analysis of isoenzyme data. AB - Numerical analysis of 59 zymodemes of Old World Leishmania, based on the enzyme profiles of 280 stocks, revealed several distinct clusters. Some of these clusters corresponded with traditional taxonomic groupings: L. major, L. tropica, L. aethiopica and L. donovani sensu lato, but hitherto unrecognized groups were also indicated. The analysis provided an overview of the interrelationships between the Leishmania zymodemes. PMID- 3810784 TI - The burden of blindness in adult males in the savanna villages of West Africa exposed to onchocerciasis. AB - Cross-sectional surveys for the prevalence of blindness in West African savanna villages misrepresent the actual burden which blindness imposes on communities. High mortality in the blind, resulting in a shorter life expectancy as compared to non-blind, is associated with high incidence rates and with a rapid turn-over in the blind population. Data collected in Burkina Faso indicate that, in hyperendemic villages, 46% of males and 35% of females aged 15 are likely to become blind before they die. Respective rates in mesoendemic villages are 14% in males and 9.8% in females. The results presented in this paper reinforce the conclusion that blindness, especially onchocerciasis associated blindness, is of greater social and economic significance than usually estimated. PMID- 3810785 TI - Percutaneous transhepatic cholangiography: Ibadan experience. AB - Our experience using the teflon method in carrying out transhepatic cholangiography is described. A teflon needle (20 gauge) was used instead of the conventional Chiba needle. The number of successful examinations and their complication rate are comparable with examination carried out with Chiba needle. The ease of the procedure with the teflon needle and its relative cheapness make this technique preferable, although not without risks, especially in the developing countries where inadequate funds are available for health care. PMID- 3810786 TI - A field trial of microencapsulated deltamethrin, a synthetic pyrethroid, for malaria control. AB - The synthetic pyrethroid deltamethrin was evaluated as a 15 mg/m2 residual application of a microencapsulated formulation for efficacy in malaria control in a 50 km2 area of north-eastern Zimbabwe. Results were compared with very large contiguous DDT sprayed (2g/m2) and unsprayed areas. A total of 3544 rooms were sprayed with deltamethrin. No significant side effects of the insecticide on spraymen were noted. Mosquito captures were poor and inconclusive due to drought conditions, but the malaria vectors Anopheles arabiensis and An. gambiae were identified in the area, the former being 14 times more abundant than the latter in bait collections from an unsprayed area. Monthly bioassays using laboratory reared An. arabiensis showed a higher mortality of mosquitoes exposed on roofs for up to eight months after deltamethrin application and indicated a high mortality in deltamethrin sprayed houses than in DDT sprayed houses. Tests indicated that, after eight months, up to 50% of the deltamethrin remained on the roof and 25% on the wall. Malaria transmission, evaluated by blood slide surveys at the beginning and end of the transmission season, was high in the unsprayed area, slightly less in the adjacent and incompletely isolated deltamethrin sprayed area, and absent or very low in the DDT sprayed area. The results were considered to be favourable for the use of deltamethrin in malaria control by means of residual house-spraying with the non-irritant dosage of 15 mg/m2, but require evaluation in larger trials. PMID- 3810787 TI - An increase in water content of mouse erythrocytes infected with Plasmodium yoelii. AB - Mean cell volume and mean cell water content were examined in Plasmodium yoelii infected mouse erythrocytes by gas chromatography and 3H-sucrose. Mean cell volume increased by 16% in infected erythrocytes with late trophozoites and schizonts. Mean cell water content further increased by 23% in the infected erythrocytes. Measurement of the erythrocyte potassium and sodium concentrations by an atomic absorption spectrophotometer revealed that the infected erythrocytes contained highly elevated sodium and slightly reduced potassium levels when calculated per single erythrocyte. It is suggested that membrane transport processes of sodium and potassium are changed in P. yoelii-infected erythrocytes and that a passive inflow of sodium takes place, which results in an increase in intra-erythrocytic water content. PMID- 3810788 TI - Severe megaloblastic anaemia due to vitamin B12 deficiency in The Gambia. AB - Five cases of severe megaloblastic anaemia in Gambians are described. Three of the patients were found to have pernicious anaemia. The difficulties in diagnosis and the various features of pernicious anaemia in Negroes are discussed. A brief review of the literature is included. PMID- 3810789 TI - Extended cryopreservation of Loa loa and Mansonella perstans microfilariae from human peripheral blood. PMID- 3810790 TI - Identification of Naegleria fowleri in fresh isolates of environmental amoebae using a staphylococcal coagglutination technique. AB - A coagglutination test using Staphylococcus aureus Cowan strain 1 sensitized with specific antiserum successfully identified Naegleria fowleri in axenic and monoxenic culture by detection of a heat stable antigen released into the culture medium during growth. Strong coagglutination, visible to the naked eye, occurred within 30 sec when the sensitized reagent was mixed on a slide with medium from N. fowleri cultures. N. lovaniensis gave a weak cross-reaction which developed over one min clearly distinguishable from that of N.fowleri.N.gruberi and N. australiensis gave no reaction. The technique is proposed as part of a rapid and economical scheme for detecting N. fowleri in environmental samples very soon after primary isolation, with distinct advantages over conventional methods. Further development of the technique to detect other Naegleria spp. and the early diagnosis of primary amoebic meningoencephalitis are suggested as future applications. PMID- 3810791 TI - The suitability of East African primates as animal models of visceral leishmaniasis. AB - The susceptibility of four East African primate species to experimental infection with Leishmania donovani was investigated. Vervet monkeys (Cercopithecus aethiops), Sykes monkeys (C. mitis) and baboons (Papio cynocephalus) all supported low grade infections for periods ranging between four and eight months and subsequently showed evidence of self-cure. Greater bushbabies (Galago crassicaudatus) remained completely refractory throughout the course of the experiment. The significance of hepatic histiocytic nodules in the infected primates, similar to those observed in asymptomatic human visceral leishmaniasis, and the susceptibility of Old World primates to experimental infection are discussed. PMID- 3810792 TI - Lassa fever in children in Sierra Leone, West Africa. AB - A systematic study of Lassa fever in febrile children was undertaken over a four year period, from August 1977 to August 1981, in the Eastern Province of Sierra Leone, West Africa. 479 patients were studied; of these, 245 had adequate specimens to confirm or exclude the laboratory diagnosis of Lassa fever. 51 cases of Lassa fever were identified (21% of patients from whom diagnosis was possible). Virus was isolated from 23 patients. All children had fever; cough and vomiting were present in over 60% of cases studied. The five to nine-year age group had the highest prevalence rate (41% of cases). Seasonal clustering occurred in April, May, and August. A significantly higher proportion of females than males had Lassa fever, a finding which remains to be explained. It is concluded that Lassa fever is a disease of significant concern in the paediatric age group. PMID- 3810793 TI - Detection of serum antibodies and circulating antigens in a chimpanzee experimentally infected with Onchocerca volvulus. AB - The course of the humoral immune response was followed in a chimpanzee experimentally infected over 27 weeks with a total of 168 Onchocerca volvulus 3rd stage larvae obtained from naturally infected wild-caught blackflies. Antibodies against an adult worm extract could be detected by ELISA from week 16 onwards (after the inoculation of 44 larvae). Peak antibody levels were observed between weeks 66 and 74 (about one year after the last larval injection). Thereafter, antibody levels markedly decreased but rose again after week 120. First microfilariae could be detected from week 124 onwards. Microfilarial counts remained low (not more than two microfilariae per skin snip) until the end of the observation period. High levels of IgM antibodies against adult O. volvulus antigens were detectable between weeks 26 and 80 by ELISA. Total IgE levels were found to be only marginally elevated during the course of the infection. Circulating parasite antigens were only detectable for a short time (weeks 34 to 44) of the prepatent period by immuno-radiometric assays (IRMAs) using monoclonal antibodies which were raised against O. gibsoni eggs. Competitive radio-immuno assays detected host antibodies inhibiting binding of 125I-labelled monoclonal antibodies to parasite antigens from week 28 onwards. Host antibodies clearly interfere later in infection with the detection of circulating antigens. PMID- 3810794 TI - Tsetse and trypanosomiasis in the Lambwe Valley, Kenya. AB - The Lambwe Valley is shared between wild animals in a national park and adjacent human settlements with domestic livestock. Thicket and woodland in the valley are heavily infested with Glossina pallidipes. Rhodesian sleeping sickness continues to be a major human health hazard and livestock losses from nagana seriously affect the local economy. Epidemiology is characterized by periods of quiescence and flare-up, reflecting intermittent vector control measures to reduce transmission. The situation has been aggravated in recent years by extension of tsetse habitat and encroachment of settlements to the park. In 1981, an attempt at tsetse eradication by insecticidal methods was unsuccessful, due to technical difficulties and for reasons to do with the resilience of a large, entrenched tsetse population living under environmental optimal conditions. The options for dealing with the disease are outlined, and some of the critical assessments which have to be made are elaborated upon. PMID- 3810795 TI - Interaction between Trypanosoma brucei and the ependymal cell of the choroid plexus. AB - The fine structure of the normal choroid plexus of rats and mice and of those infected with Trypanosoma brucei was examined by transmission and scanning electron microscopy: extracellular trypomastigotes in the perivascular stroma predominate but the evidence presented suggests that they are derived both from stages in the blood and from others undergoing division within ependymal cells, a process which results in destruction of a large proportion of ependymal cells in the parts of choroid plexus affected. The choroid plexus maintains its integrity by regeneration of an outer layer of ependymal cells. PMID- 3810796 TI - The ventricular ependyma of mice infected with Trypanosoma brucei. AB - The fine structure of ependymal cells lining the cerebral ventricles of normal mice and of mice infected with Trypanosoma brucei was examined by transmission electron microscopy. Most of the ependymal cells had been stripped from the ventricular surface of the brain in infected animals but some of the remaining ependymal cells contained intracellular trypomastigotes. The same process of stripping had occurred in a single human brain that was included in the series, but intracellular forms were not found. The significance of the intracellular forms and the implication of the stripping of ventricular ependymal cells are discussed in relation to the pathogenesis of sleeping sickness. PMID- 3810797 TI - The trypanocidal effect of drugs in different parts of the brain. AB - Three parts of the brain, cerebral cortex, lining of ventricle and choroid plexus, are cleared of trypanosomes to different extents by different drugs. There appear to be several barriers preventing drugs from acting in different parts of the brain, the concept of a single "blood-brain barrier" does not account for the phenomena observed. The protection of trypanosomes from certain drugs by the choroid plexus and ventricular wall supports the concept of an intracellular stage of Trypanosoma brucei in the ependymal cell; this concept is also supported by differences in parasitaemia resulting from the inoculation of ependymal and of other tissues. Alternative therapies for sleeping sickness are suggested, one of which (suramin/metronidazole) is being advanced for trials in man. PMID- 3810798 TI - Factors affecting selection for multiple resistance in Anopheles nigerrimus in Sri Lanka. AB - Adult resting habits and breeding habits of Anopheles nigerrimus in Sri Lanka were investigated. This species is primarily exophilic, in contrast to endophilic An. culicifacies in the same areas. An. nigerrimus larvae were found in all habitat types sampled, in particular paddy fields where a large quantity of agricultural pesticides is used. This species was shown to be resistant to a range of insecticides including a number of organophosphates and carbamates. The adult resting behaviour precludes selection of resistance from indoor residual insecticide usage for malaria control and suggests selection from agricultural pesticide usage. PMID- 3810799 TI - The common bedbug Cimex lectularius in African huts. AB - The size and life-stage structure of heavy infestations of C. lectularius in Zulu huts were determined. The presence of more than one person in a hut at night, and control measures attempted by hut owners were found not to influence bedbug numbers significantly. PMID- 3810800 TI - A simple method for post-mortem confirmation of the diagnosis of cerebral malaria: transethmoidal puncture of the brain. PMID- 3810801 TI - Cerastes vipera envenoming--a report of seven cases. PMID- 3810802 TI - Use of the weight-for-height (Nabarro) chart to screen young children for wasting. PMID- 3810803 TI - Preliminary serological study on canine leishmaniasis in the Alpes-Martimes Departement, France. PMID- 3810804 TI - Accidental and transfusion malaria in Italy. PMID- 3810805 TI - Blackfly bites, onchocerciasis and leopard skin: a reply. PMID- 3810806 TI - Epidemic cutaneous leishmaniasis in Tunisia: biochemical characterization of parasites. PMID- 3810807 TI - Kala-azar in Egypt and its cause. PMID- 3810808 TI - The impact of computed tomography and magnetic resonance on diagnostic medical imaging. PMID- 3810809 TI - In vitro characteristics and in vivo viability of platelets contained in granulocyte-platelet apheresis concentrate. AB - A paired prospective study was performed to compare the in vitro storage characteristics and in vivo kinetics of platelets stored in granulocyte-platelet concentrates prepared by apheresis with platelets prepared from whole blood. Platelet and granulocyte-platelet concentrates were collected from five healthy volunteer autologous donors and stored for 16 to 18 hours at 20 to 24 degrees C with and without agitation, respectively. After storage, pH, platelet count, percent release of beta-thromboglobulin, morphologic score, and percent osmotic recovery were measured. In addition, the granulocyte-platelet concentrates were assayed for total leukocyte count, release of lysozyme, and by several in vitro tests of granulocyte function. The platelets in both products were labeled with 111In oxine and infused into the donors. The pH of both products was above 6.0 at the end of storage. The units stored as platelet concentrates compared with those stored as granulocyte-platelet concentrates showed a higher percent release of beta-thromboglobulin, 18.4 +/- 4.0 percent versus 5.9 +/- 3.2 percent (mean +/- SD), but significantly better morphologic scores, 676 +/- 21 versus 525 +/- 56, and better osmotic recovery scores, 72 +/- 10 percent versus 40 +/- 7 percent, respectively (all p less than 0.05). The platelet concentrates (compared with the granulocyte-platelet product) had significantly better in vivo recovery, 49.5 +/- 15.8 percent versus 38.9 +/- 11.5 percent, and survival, 6.1 +/- 1.3 days versus 2.4 +/- 0.4 days, respectively (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3810810 TI - Use of modified fluid gelatin for centrifugal leukapheresis. PMID- 3810811 TI - Elliptocytosis in blood donors. PMID- 3810812 TI - Incidence of ABO subgroups in Chinese in Taiwan. PMID- 3810813 TI - Treatment of thrombotic thrombocytopenic purpura with intravenous gammaglobulin. PMID- 3810814 TI - Mushroom poisoning: therapeutic apheresis or forced diuresis. PMID- 3810815 TI - Red cell antigens in Hispanic blood donors. PMID- 3810816 TI - On the inheritance of the Era red cell antigen. PMID- 3810817 TI - Status of the MNSs antigens on human platelets. AB - A sensitive and specific radioimmunoassay was used to determine whether human platelets possess antigens of the MNSs blood group. Mouse monoclonal IgG anti-M and anti-N were purified by Staphylococcus protein A chromatography, labeled with 125I, and incubated with platelet pellets from donors of various MN phenotypes. Human IgG anti-M, -S, and -s were purified by absorption-elution, incubated with platelet pellets from donors of different MNSs phenotypes, washed, and incubated with 125I-labeled mouse monoclonal anti-human IgG. In both assays, the platelet pellets were centrifuged through phthalate ester oils and the radioactivity in the pellets was counted. Dose-response curves and ligand bound per cell indicated no significant difference in the binding of mouse or human anti-M and anti-N to platelets from donors of the MM, MN, or NN phenotype or of human anti-S and anti s to platelets from donors of the Ss or ss phenotype. Contrary to many previous studies, our data indicate that the MNSs antigens are not expressed on the circulating human platelet. Therefore, antibodies to these antigens probably do not play a role in refractoriness to platelet transfusion. PMID- 3810818 TI - Cryopreservation of hematopoietic progenitor cells collected by hemapheresis. AB - Colony-forming units-granulocyte/monocyte (CFU-GM) harvested from normal donors as a byproduct of plateletapheresis can be cryopreserved successfully with 10 percent dimethyl sulfoxide with the use of standard protocols that have been developed for freezing bone marrow. Short-term storage of CFU-GM in polypropylene vials in the liquid phase of liquid nitrogen yielded a recovery rate of 88 +/- 5 percent (mean +/- SEM). Significant loss of committed progenitor cells was not detected until 1 year after freezing (65 +/- 5%). A comparison of CFU-GM recovery with the polyolefin bag technique (107 +/- 13%) was not statistically different from that obtained with polypropylene vials (78 +/- 7%). Although the freezing bags are more expensive and prone to fracture than the vials, they are easier to handle, store, and thaw in the laboratory, and reinfusion to the patient is more convenient. Cryopreservation of CFU-GM harvested from peripheral blood appears feasible in either of two freezing systems. PMID- 3810819 TI - Fatal Salmonella septicemia after platelet transfusion. AB - A thrombocytopenic, leukopenic patient with multiple myeloma who was given 7 units of platelets died 6 days later from complications of Salmonella heidelberg septicemia. A platelet donor who was asymptomatic at the time of donation had group B Salmonella on stool culture. His clinical history and the results of serologic studies and stool culture were consistent with a mild Salmonella gastroenteritis 5 days before donation. Antibiotic sensitivity patterns and plasmid profiles indicated that the organism (S. heidelberg) isolated from the donor's stool was identical to that isolated from the patient's blood and from the platelet bags. It is believed that low-grade, asymptomatic bacteremia in the donor was the source of infection in the recipient. Food and Drug Administration records contain reports of six septic deaths due to platelet transfusions since 1979, compared with none in the preceding 4 years. Increased use of platelet products and the standard practice of storage at room temperature may contribute to the risk of sepsis after platelet transfusion, particularly in immunocompromised patients. PMID- 3810820 TI - Granulocyte transfusion kinetics measured by chemiluminescence, nitroblue tetrazolium reduction, and recovery of indium-111-labeled granulocytes. AB - A 20-year-old man with chronic granulomatous disease (CGD) and who was receiving granulocyte transfusions for a refractory liver abscess was studied to compare the kinetics of 111In-labeled granulocytes with those of two functional granulocyte assays, nitroblue tetrazolium reduction and chemiluminescence. Transfused granulocytes were eliminated in both rapid and slow phases. Peak recovery was noted in the first sample, which was obtained 10 minutes after transfusion for each assay. The elimination kinetics were similar over 24 hours. These results confirm the value of using 111In-labeled granulocytes as a marker of transfused granulocytes. These data also confirm that the oxidative metabolic function of granulocytes prepared by continuous-flow leukapheresis remains intact while in the recipient's circulation. The response of the patient adds support for the use of granulocyte transfusions in certain patients with CGD. PMID- 3810821 TI - K23. A low-incidence antigen in the Kell blood group system identified by biochemical characterization. AB - An antibody in the serum of a gravida 4, para 3 woman reacted with red cells from two of her children, her husband, and his mother, but with none of more than 2100 reference red cell samples and blood samples from donors. The reactive antigen was inactivated by 2-aminoethylisothiouronium bromide or dithiothreitol-papain treatment. The antigen was immunoprecipitated from paternal red cells with maternal antibody and shown to migrate by sodium dodecylsulfate polyacrylamide gel electropheresis as a single protein of approximately 93,000 daltons. After transfer to nitrocellulose paper by Western blotting, the protein reacted with a rabbit antibody specific for Kell protein. The chemical inactivation and electrophoretic findings were characteristic of Kell group antigens. The reaction with the rabbit antibody establishes that the "new" low incidence antigen was an epitope on Kell group protein and must be coded for by the Kell gene. It has been designated K23. PMID- 3810822 TI - B antigen acquired by normal A1 red cells exposed to a patient's serum. AB - The authors report a patient with the acquired B antigen whose serum contained a factor capable of inducing the acquired B phenotype on normal A1 red cells in vitro. The patient's red cells were not, however, agglutinated by a monoclonal anti-B. These findings and the abolition of the acquired B antigen by treatment of the patient's red cells with acetic anhydride support the deacetylation theory of the genesis of the acquired B antigen. PMID- 3810823 TI - Loss of blood group A in acute leukemia. Morphologic and biochemical studies of red cells. AB - A patient with blood type A had acute myelomonocytic leukemia; his red cells (RBCs) typed as O and his serum had anti-B. RBC membranes were isolated from the patient as well as from controls with group A and O red cells. The membranes were incubated with uridine diphosphate (UDP)-N-acetyl-D-14C galactosamine in plasma from the patient and controls with group A and O red cells. RBC membranes from the patient behaved normally in that they incorporated the terminal carbohydrate responsible for blood group A activity. Scanning electron microscopy showed that the patient's RBCs had striking morphologic changes, with marked crenation and numerous knisocytes and dacryocytes. It was concluded that loss of the A antigen in this patient was not due to an abnormality of the enzyme required to convert H substance to A substance. It was postulated that weakening of the A antigen in some patients with leukemia may be related to a steric modification associated with abnormal red cell morphology. PMID- 3810824 TI - Evidence suggesting the occurrence of C3-independent intravascular immune hemolysis. Reactive hemolysis in vivo. AB - The authors present circumstantial evidence for the involvement of reactive hemolysis, i.e., C3-independent binding of the cytolytic C5b-9 complement complex to bystander red cells (RBC), in a case of intravascular immune hemolysis. Fresh serum obtained from a 6-year-old patient during the hemolytic episode, but not obtained thereafter, induced C5b-9-dependent hemolysis of human RBCs but the indirect C3 antiglobulin test remained negative. Particles (presumably RBC ghosts) isolated from the patient's plasma anticoagulated with EDTA at the peak of hemolysis were coated with C5b-9 complexes, whereas the direct antiglobulin test was strongly positive for IgA, only weakly positive for IgG, and negative for C3. Moreover, neither the autoantibodies isolated by elution (IgG plus IgA), nor free serum autoantibodies (IgA alone) activated complement in vitro. Additionally, serum samples collected later during the 12-month period of observation contained normal levels of C3, C4, C8, and C9, but markedly reduced levels of C7. These serums all produced strong reactive lysis in agarose plates, but not in test tubes. These results appear compatible with the working hypothesis that the intravascular hemolytic episode in this patient might have arisen through a local initiation of complement activation with subsequent C3 independent binding of C5b-9 to and hemolysis of bystander RBCs. PMID- 3810825 TI - A Ge-like autoantibody in the serum of a patient receiving gold therapy for rheumatoid arthritis. AB - A 61-year-old nulliparous woman who had never been transfused was admitted to the hospital because of severe anemia. She had been treated with gold salts for 4.5 years for rheumatoid arthritis. Because she had a negative direct antiglobulin test, an anti-Ge found in her serum was believed to be an alloantibody. Subsequent testing of her initial serum sample with autologous red cells drawn 12 months later showed them to be strongly agglutinated, indicating that she had had a transient depression of her Ge antigen and that the anti-Ge was an autoantibody. It was postulated that these transient effects may have been related to the gold therapy. PMID- 3810826 TI - Anti-Jka autoimmune hemolytic anemia in an infant. AB - Anti-Jka was identified in the serum and on the red cells of an 8-month-old infant with anemia, splenomegaly, and symptoms of an upper respiratory infection. The anemia improved after transfusion and treatment with prednisone. PMID- 3810827 TI - Extension of platelet concentrate storage to 7 days in second-generation bags. AB - Platelet concentrates stored for 7 days in 50 ml of plasma in both thin film and enlarged variations of the standard 5-day CLX plastic bags were evaluated for pH maintenance and in vivo viability by two laboratories working independently. 51Cr labeled platelets were reinfused into normal volunteers at the end of storage and recovery and half-life calculated. The pH was maintained well; less than 10 percent of units fell below 6.0 at 7 days. Mean 7-day recovery for both laboratories was 43.6 +/- 11.6 percent in the thin-film bag and 45.4 +/- 8.52 percent in the enlarged bag, compared with 43.6 +/- 8.8 percent at 5 days in the 5-day plastic licensed bag. After 7 days storage the half-life was 3.6 +/- 0.9 days in the thin-film bag and 3.7 +/- 0.6 days in the enlarged bag, compared with 3.6 +/- 0.5 days in the previously licensed CLX plastic bag after 5 days. Thus, platelet viability was maintained well at 7 days of storage in both of the container variations that allowed increased gas exchange. PMID- 3810828 TI - Evidence that the Lub blood group antigen is located on red cell membrane glycoproteins of 85 and 78 kd. AB - A murine monoclonal antibody of specificity anti-Lub was produced. Immunoblotting of the electrophoretically separated components of membranes from Lu(b+) red cells with the monoclonal antibody identified two glycoproteins of relative molecular mass 85 and 78 kd, respectively. The expression of Lub antigenic activity on these glycoprotein components was shown to be dependent on the presence of one or more N-glycosidically linked oligosaccharides and on the presence of disulphide bonding. PMID- 3810829 TI - A second Dr(a-) proposita with anti-Dra and a family with the Dr(a-) phenotype in two generations. AB - An Israeli Jewish woman who originated from the Uzbekskaya SSR in the south of the Soviet Union, had anti-Dra in her serum and her red cells were Dr(a-) as were those of three of her four children. All Dr(a-) red cells had weakened expression of their Cra, Tca, Esa, IFC, and other Cromer-related antigens. It is suggested that the Dr(a-) phenotype may result from inheritance of a dominant inhibitor gene, although a relatively common recessive allele of Dra was not excluded. Anti Dra was inhibited by serums from the Dr(a+), but not the Dr(a-), members of the family. PMID- 3810830 TI - Computerized selection of donors for inclusion in red cell antibody panels. AB - This study evaluated various algorithms for the generation of a red cell antibody identification panel by computer. The algorithms depended on schemes that optimized Fisher's exact p value for each specificity in the panel rather than using predetermined formulations of desired phenotypic combinations. Panels produced by these computer-driven algorithms offered the distinction of a greater number of antibody specificities than manually created panels. They were also evaluated by a group of technologists to be more useful for general serologic work than panels created manually. Although the panels were created from a database of only 252 donors, an objective numeric evaluation showed that the panels were more useful than commercial panels. The computer approach used in this study may offer means of efficiently creating panels for general use as well as creating panels for resolution of particular serologic problems. They may also facilitate and encourage the construction of panels from small donor databases. PMID- 3810831 TI - Carbonyl iron for short-term supplementation in female blood donors. AB - A randomized, double-blind trial of iron replacement after repeated blood donation was conducted in 75 menstruating women; 51 completed the study. Volunteers were assigned randomly to one of three treatment groups: 1) carbonyl iron (nontoxic elemental iron powder), 600 mg; 2) ferrous sulfate, 300 mg (60 mg Fe++); or 3) placebo, each given three times daily for 1 week immediately after blood donation. Blood samples obtained initially and 56 days later were tested for hemoglobin, mean corpuscular volume (MCV), free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity (TIBC), and percent saturation of TIBC. The prevalence of gastrointestinal side effects was similar in both groups taking iron. At the end of the study there was no laboratory evidence of change in iron status in women who received carbonyl iron (n = 15). In those treated with ferrous sulfate (n = 17) the mean TIBC increased (p less than 0.001), and in the placebo group (n = 19) there were decreases in mean MCV (p less than 0.01), serum ferritin (p less than 0.001), and percent saturation (p = 0.027) with an increase in mean TIBC (p = 0.004). Carbonyl iron seems to be effective for short-term iron replacement in repeat blood donors and may have the advantage of decreased or absent risk of poisoning if accidentally ingested by children. PMID- 3810832 TI - Evaluation and comparison of four reticulocyte enrichment procedures. AB - Four reticulocyte enrichment techniques were compared: differential centrifugation, and density gradient centrifugation with phthalate esters, Percoll-Renografin (PR), and silicone oil. The reticulocyte yields were 2.6, 7.4, 13.5, and 13.1 percent, respectively. The differential centrifugation procedure did not separate a statistically significant higher number of reticulocytes than were counted in an unseparated sample. The PR density gradient procedure was the best for our needs because it yielded the highest number of reticulocytes and was the easiest and quickest of the four procedures to perform; however, the method requires a high-speed centrifuge. PMID- 3810833 TI - Sensitization of repeat plasmapheresis donors to ethylene oxide gas. AB - Repeat plasma donors were studied to determine whether there was a relationship between allergic-type reactions during plasmapheresis and IgE-dependent sensitization to ethylene oxide gas used for sterilization of disposable fluid administration sets. Serums from 32 donors with allergic-type reactions and 84 donors who had no reactions but were exposed to the same materials and served as controls were tested for IgE-antibodies to ethylene oxide. The results, expressed as an IgE ethylene oxide index, were greater than 2 in 78 percent of serums from donors with allergic reactions and 12 percent of serums from controls. This association was significant (p less than 0.0001). Reactivity of the antibodies was directed against an ethylene oxide-human serum albumin conjugate and not against human serum albumin carrier protein. IgG antibodies with ethylene oxide specificity also were present in the serums of repeat plasmapheresis donors. Each of seven rabbits immunized with an ethylene oxide-protein conjugate responded with a high serum level of antibody with ethylene oxide specificity. It was concluded that the residual ethylene oxide in fluid administration sets is immunogenic and may cause allergic reactions in plasma donors. PMID- 3810834 TI - Experience with donors matched for minor blood group antigens in patients with sickle cell anemia who are receiving chronic transfusion therapy. AB - Clinically significant alloimmunization to red cell antigens occurred in 28 percent of transfused patients in a sickle cell clinic. Therefore, a prospective study was undertaken to determine whether matching donors carefully for 17 blood group antigens would diminish the risk of further alloimmunization in patients on a chronic transfusion program. Alloantibodies had developed previously in 8 of the 12 patients. After chronic transfusion with selected donors, four new antibodies developed in three patients. Three antibodies were due to errors in phenotyping or matching, and one was due to an antigen that was not tested for in the protocol. The incidence of developing antibodies per unit transfused was diminished tenfold when selected donors were used. Autoantibodies developed in five patients (42%), but these did not seriously interfere with the transfusion therapy. It was concluded that matching for red cell antigens may diminish the incidence of alloimmunization in patients with sickle cell anemia requiring transfusion. PMID- 3810835 TI - Modification of experimental nephrotoxicity with fish oil as the vehicle for cyclosporine. AB - Cyclosporine-associated renal dysfunction is well recognized. While renal vasoconstriction appears to be a major pathogenic factor, the precise mechanism responsible for the altered hemodynamics is unclear. To investigate whether alterations in renal eicosanoid metabolism could be involved, we substituted fish oil rich in eicosapentaenoic acid (EPA), an inhibitor of cyclooxygenase metabolites, for the conventional olive oil cyclosporine vehicle. Male rats were pretreated with 1.0 cc fish oil or olive oil by gavage. After 14 days, cyclosporine (12.5 mg/cc vehicle) was added to the oil and animals received cyclosporine 50 mg/kg for an additional 14 days. Pair-fed control animals received fish oil or olive oil alone. Glomerular filtration rate (GFR) was severely reduced in the cyclosporine-in-olive-oil (CSA + OO) group (0.28 +/- .05 ml/min/100 g) vs. olive oil (OO) controls (0.70 +/- .04) (P less than 0.001). While GFR was reduced in the cyclosporine-in-fish oil group (CSA + FO) vs. fish oil (FO) controls (0.47 +/- .07 vs. 0.74 +/- .04), it was significantly higher than in the CSA + OO group (P less than 0.05). Trough whole-blood cyclosporine levels were not significantly different in the two groups. While CSA + OO appeared to elevate renal cortical content of thromboxane B2 (65.7 +/- 7.3 pg/mg tissue vs. 46.9 +/- 5.3 for OO), both the CSA + FO and FO groups had reduced levels (31.1 +/- 2.7 and 29.5 +/- 2.3, respectively). In addition, there was a striking reduction in proximal tubular vacuolar changes in the CSA +/- FO vs. CSA + OO group. We conclude that the use of EPA-rich fish oil as the vehicle for cyclosporine results in improved renal function and morphology and is associated with depressed renal cortical levels of vasoconstrictor thromboxane B2. PMID- 3810836 TI - Evidence that renal prostaglandin and thromboxane production is stimulated in chronic cyclosporine nephrotoxicity. AB - Previous reports suggest that cyclosporine (CsA) may have direct effects on arachidonic acid (AA) metabolism in several different tissues. However, the effects of CsA on renal eicosanoid production are unclear. Furthermore, the potential role of changes in renal prostaglandin and thromboxane metabolism in mediating CsA nephrotoxicity is not known. Therefore, in this study, we evaluated the effects of CsA toxicity on the production of AA metabolites by the kidney. In a postischemic, denervated rat model, CsA (50 mg/kg/day) administered for 12-14 days resulted in significant nephrotoxicity with marked decreases in both glomerular filtration rate and renal blood flow. This reduction in renal function was associated with an increase in the renal production of TXB2, PGE2, and 6-PGF1 alpha in vitro. Arachidonic acid significantly stimulated renal eicosanoid production above control values. Increased urinary excretion of TXB2, 2,3 dinorTXB2 (a major TXB2 metabolite), and 6-keto-PGF1 alpha also occurred in rats with CsA nephrotoxicity and reflected the increase in renal production of these eicosanoid products. In contrast, urinary PGE2 excretion was not increased in CsA toxic rats. Thus, CsA nephrotoxicity is associated with specific alterations in renal AA metabolism. Furthermore, alterations in AA metabolism may be important in modulating renal hemodynamics and excretory function in this model. These studies suggest that specific inhibition of vasoconstrictor products of AA metabolism might ameliorate the nephrotoxic effects of CsA. PMID- 3810837 TI - Nonspecific immunosuppressive effect of platelet transfusion in rhesus monkeys. PMID- 3810838 TI - Prevalence of respiratory illnesses of school children in the industrial, urban and rural areas of Singapore. AB - An epidemiological survey of 3216 primary school children living in the industrial, urban and rural areas of Singapore revealed a high prevalence of various respiratory symptoms and illnesses, with 13.1% cough, 8.2% wheezy chest, 25.9% blocked/running nose, 4.3% sinusitis, 7.8% asthmatic attacks and 4.1% bronchitis/pneumonia. Differences in the prevalence of respiratory illnesses and lung function tests were observed among children in the three areas, but this could not be accounted for by the varying air pollution levels which have been maintained below the long-term standards set up by WHO. It was probably responsible for the differences noted. PMID- 3810839 TI - Vitamin A status of Thai children with measles. AB - The acute impacts of measles on vitamin A status of children were assessed. Children with measles had significantly lower serum vitamin A, retinol-binding protein (RBP), and carotene concentrations than did controls. Thirty-two percent of the measles patients had serum vitamin A concentrations less than 10 micrograms/dl. Since measles and xerophthalmia have frequently been associated, vitamin A supplementation for measles patients is recommended particularly for malnourished children. PMID- 3810840 TI - Morbidity in preschool Giardia cyst excretors. AB - Preschool children of two villages of Kharar Taluka, Ropar district, Punjab (India) were screened for the prevalence of giardiasis. Cysts of Giardia lamblia were found in 35.1% of the stool samples and other parasites were rarely seen. The incidence of diarrhoea in association with G. lamblia positivity was 16.5% in subjects whose stool examination was positive on one or more than one occasion. No difference in the incidence of giardiasis could be seen in well nourished and undernourished children living in these endemic areas. PMID- 3810841 TI - Haematological investigations in visceral leishmaniasis. AB - Various haematological parameters were followed in a group of 47 Kenyan patients with visceral leishmaniasis during treatment and follow up. The WBC and platelet numbers were normal by the time of cure, the Hb level took longer to become normal. Red cells were microcytic and hypochromic. MCV and MCH increased during follow up but microcytosis persisted up to a year after cure. Low serum iron and transferrin concentration, low total iron binding capacity and normal to high serum ferritin levels were found in 10 patients and are consistent with 'anaemia of chronic inflammation'. Bone marrows of 15 patients before treatment were normo to hypercellular with increased erythropoietic activity. Low haemosiderin content of the bone marrow was consistent with iron deficiency, but normalization of Hb without iron suppletion would argue against a major role of iron deficiency. Coagulation studies did not indicate diffuse intravascular coagulation. Splenomegaly seems the most important factor in the causation of the pancytopenia. Further studies of contributing factors and of the cause and mechanism of 'hypersplenism' are needed. PMID- 3810842 TI - Serum creatinine and uric acid levels in pregnant urban African and Caucasian women. AB - Serum creatinine and uric acid concentrations were determined for 117 pregnant urban African women and 109 pregnant Caucasian women covering the three trimesters of pregnancy. The creatinine levels for Caucasians rose as pregnancy progressed, exceeding the normal adult level, while that for Africans rose only slightly and only during the last trimester of pregnancy. A similar observation was made for uric acid levels except that the rise in Africans commenced earlier than it did for creatinine, commencing from about the second trimester. Also, the levels in both groups of people remained within the normal adult range. The increased levels of these non-protein nitrogen compounds during pregnancy was attributable to increased metabolism associated with the condition. The difference observed between the Caucasians and Africans was attributed to the better protein nutritional status of the former. It is suggested that the creatinine "curve" especially for the Caucasians could be utilized in the monitoring of foetal well-being. PMID- 3810843 TI - Glycosylated haemoglobin and blood glucose levels in Libyan diabetic patients. AB - Glycosylated haemoglobin (HbA1) and fasting blood glucose levels of 178 Libyan diabetic men were determined. The mean levels respectively were 11.5 +/- 0.4% and 236 +/- 7 mg.dl-1. In this study group, there were 78 patients with insulin dependent diabetes and 100 with non-insulin-dependent diabetes. The highest percentage of patients belong to the age group 51-60 with the onset of diabetes between 41 and 50 years of age. The highest number of obese patients were in the age group 51-60 indicating the strong association between diabetes and obesity. A statistically significant correlation was found between fasting blood glucose levels and HbA1 concentrations (r = 0.37; P less than 0.001). Correlations between urinary glucose and HbA1 or fasting blood glucose were highly significant. These diabetic patients have a poorly controlled diabetes as indicated by the correlation between HbA1 and duration of diabetes. There was no significant difference in HbA1 levels of patients undergoing insulin administration and those taking oral hypoglycaemic drugs. Glycosylated haemoglobin levels will be a valuable adjunct to blood glucose determinations in epidemiological studies. PMID- 3810844 TI - Nonpuerperal nipple discharge in Nigerian women. AB - 100 Nigerian women were entered into a prospective study of spontaneous occurring nipple discharge over a seven year period. The patients consisted of 25 study group patients and three groups of 25 patients comprising the controls. In the study group, seven types of nipple discharge were identified, namely: bloody (40%), watery (4%), and milky (4%). Intraductal papilloma and other benign breast disease were the cause of nipple discharge in 23 of 25 (88%) study group patients. Only 28% of breast cancer patients in control group A, 16% of bloody or serosanguineous and 16% of benign breast tumor patients of control group B presented with nipple discharge. Nipple discharge was an incidental finding in 16% of normal control group C patients. Thus Nigerian women are more likely to seek medical intervention for bloody and serosanguineous discharge. Surgical management remains the optimal management for nipple discharge. PMID- 3810845 TI - Leptospirosis in rural Ghana: Part 2, Current leptospirosis. AB - In this second part of our study a search for cases of acute leptospirosis among hospital patients is described. Of 88 suspected cases of acute leptospirosis, four were confirmed serologically. Of 102 patients with jaundice occurring in a period in which maximal transmission of leptospires could be expected, current leptospirosis was confirmed in one and suspected in another patient. The high prevalence of antibodies against leptospires of different serogroups, described in the first part of the study, is in contrast with the low frequency of acute leptospirosis among hospital patients in the same area. This indicates that most cases of acute leptospirosis do not have a reason for seeking hospital care. A new serovar was isolated, for which the name agogo, reference strain Agogo, serogroup Djasiman, is proposed. PMID- 3810846 TI - The time of passage of the first urine and stool by Nigerian neonates. AB - One thousand consecutive full-term healthy Nigerian babies delivered at Ahmadu Bello University Teaching Hospital Zaria, were studied for the time of passage of the first urine and stool. By 6 hours of postnatal age 42%, 12 hours 76%, 24 hours 95% and 48 hours 99.8% of babies had passed their first urine. Similarly 56%, 81%, 96% and 99.8% of babies had passed meconium by 6, 12, 24 and 48 hours respectively. It is suggested that apparently healthy neonates who have not passed urine and meconium by the age of 12 hours should be closely observed and those who have not done so after 24 hours should be investigated for congenital abnormalities of the lower gastrointestinal and urinary tracts. PMID- 3810847 TI - Lower respiratory tract infection due to Branhamella catarrhalis, two case reports. AB - We describe two cases of lower respiratory tract infection due to Branhamella catarrhalis in elderly patients. The diagnosis was confirmed by isolation of the organism from the sputa in pure growth and also by response to treatment with appropriate antibiotics. Both patients had predisposing factors: one had chronic bronchial asthma and was also on corticosteroids during the illness and the other had chronic obstructive lung disease. Previously reported cases are reviewed. PMID- 3810848 TI - Pathological fracture of vertebral column in association with sickle cell anemia in Saudi Arabia. AB - We describe two cases of sickle cell anemia who were admitted in the hospital with the complaint of backache. X-ray examination and bone scan revealed pathological fracture of vertebral column. These cases are of interest since sickle cell anemia in the Eastern part of Saudi Arabia is reported to run a relatively 'benign' course. PMID- 3810849 TI - Intracranial tuberculoma: case report and review of the literature. AB - A case of multiple intracranial tuberculomas with miliary lesions of the lungs is reported. Atypical clinical presentation; non-specific computed tomographic findings showed large intracranial masses producing a midline shift and progressive neurological deficit necessitating excision of the symptomatic mass. Acid fast bacilli were found in the excised lesion and cultured from biopsy specimens. PMID- 3810850 TI - [Study of the chondriome in SPEV cell culture after treatment with actinomycin D]. AB - It is shown that the 12-hour treatment of cell with actinomycin D (AMD) in the concentration of 0.05 microgram/ml disturbs a correlation between the morphological cycle of mitochondria and phases of the mitotic cell cycle which is characteristic of intact cells. An increase in the total number of mitochondria independent of phase is observed in all the cells in comparison with intact cells. At the same time a decrease in the amount of branched organellae and appearance of giant mitochondria are discovered. All mitochondria are in the condense form. These changes, perhaps, are a result of the inhibition of the rRNA synthesis in the nucleus and of the protein synthesis in the cell found with it by AMD. The possibility of the immediate interaction of AMD with membrane components of the cell, which induces changes in the ion concentrations and peroxidation of the membrane lipids is not excluded. PMID- 3810851 TI - [Modifying effect of dioxane on the cytogenetic activity of N-nitroso-N methylurea]. AB - Dry seeds of Crepis capillaris L. were treated with N-nitroso-N-methyl urea (NMU) and with dioxane (DO) an organic solvent, at pH 7.0 and pH 5.7. The treatment with NMU only was used as a positive control. Three concentrations of NMU were applied. The cytogenetic activity of NMU was found to considerably decrease at two values of pH, while NMU was solved in DO. The relationship between different types of chromosome aberrations remained unchanged in this case. PMID- 3810852 TI - [Approaches to genetic control for the use of pesticides]. AB - Analysis of data available in literature has shown that 65% of 400 pesticides studied for their mutagenicity exert a mutagenic effect on any test-object. The number of revealed mutagens approaches 100% when four or more test-objects are used. Recommendations for quantitative estimation of genetic risk worked out under conditions of model experiments with standard mutagens are not available for pesticides since they are slight mutagens. The necessity for genetic stage-by stage monitoring of pesticide use is substantiated. This monitoring should be carried out at the stage of experimental studies by means of classifications by the degree of potential mutagenic danger (the method is described) and at the stage of ecological and genetic investigations--by means of the regulation for application with due regard for the summary mutagenic background. PMID- 3810853 TI - [Cholesterol and phospholipid content of cells sensitive and resistant to ethidium bromide and its alteration in resistant cells as affected by methyltestosterone]. AB - The content of cholesterol (Chl) and phospholipids (Phl) in cell lines L and CHO K1, sensitive and resistant to the toxic action of ethidium bromide, has been studied. EB-resistant cells were shown to have lower amounts of Chl and Phl, and the ratio Chl/Phl in these cells was decreased too. EB-resistant cells, grown in serum-free medium, have dramatically decreased contents of Chl, while compared with the cells growing with serum. Treatment of EB-resistant cells with methyltestosterone in concentration of 3 X 10(-7) M caused the increase in Chl and Phl contents, thus approximating these indices to those of EB-sensitive ones. PMID- 3810854 TI - [Unscheduled DNA synthesis in human peripheral blood lymphocytes undergoing combined exposure to gamma irradiation and methylmethane sulfonate]. AB - The value of the unscheduled DNA synthesis by exposure to combined action of damaging agents--gamma-irradiation and methyl methanesulfonate--does not exceed its value after separate actions of each particular agent in lymphocytes from healthy subjects as well as in those with Xeroderma pigmentosum in form II (XP2LE). This result is due to inhibiting effects of alkylating agents on DNA polymerases. PMID- 3810855 TI - [Chondroclastic properties of the cartilaginous tissue macrophages of developing bone]. AB - By the electron microscopic and cytochemical studies, in the vascular canals of cartilaginous epiphyses and in the zones of endochondral process of the rabbit and rat femoral bones, there were revealed monocytes, macrophages, the cells of the intermediate differentiation stages among the perivascularly located forms. In the lysosomes as well as on the surface of cytoplasmic membrane of mature macrophages the activity of acid phosphatase and non-specific esterase was demonstrable. Phagolysosomes showed accumulation of 35S-sulphate label 2 hours after its injection into an organism. Macrophages cause degradation of non mineralized cartilaginous matrix by secreting hydrolases and other enzymes and then phagocytize the preformed substrate. In the zones of endochondral process, macrophages also penetrate into the "capsules" of hypertrophic chondrocytes and are involved in their destruction. The cells are regarded as tissue--specific macrophages--chondroclasts. PMID- 3810856 TI - Cryopreservation of Theileria-infected lymphoblastoid cells with functional assessment of viability. AB - Bovine lymphoblastoid cell cultures infected with Theileria annulata were frozen to -60 degrees C in a programmable cooling apparatus using continuous cooling rates of 1 degree C/min, 10 degrees C/min and 120 degrees C/min and a two-step cooling rate with an equilibration period of 20 min at -30 degrees C. The cryopreservative was DMSO at concentrations of 5, 10 and 15%. Aliquots of cryopreserved material were stored in the vapour phase of a liquid nitrogen refrigerator and resuscitated by rapid thawing in a 40 degrees C water bath. The efficiency of the freezing methods was compared by assessing the viability and plating efficiency of cells after resuscitation, dilution and equilibration in cell culture medium. A significant correlation was recorded between the results obtained by these two methods which showed that the two-step method yielded cells with viability of 95 to 97% and a plating efficiency equal to that of unfrozen cells. It was concluded that such a freezing method would be ideal for the cryopreservation and storage of banks of Theileria annulata-infected cells for vaccine purposes. PMID- 3810857 TI - Post-weaning coccidiosis in beef calves in the dry tropics: experimental control with continuous monensin supplementation via intra-ruminal devices and concurrent epidemiological observations. AB - Post-weaning Eimeria zuernii coccidiosis in beef calves was treated prophylactically with monensin from intra-ruminal continuous release devices. The evaluation of four treatments during three consecutive years also allowed observations on the epidemiology of this disease to be made. Monensin was an effective prophylactic and the intra-ruminal devices were a convenient method of continuous administration over a one to two month period. The three years of the trial included two characteristically very dry and one unusually wet weaning period. Coccidiosis was more severe in the dry years suggesting that oocyst challenge was less important than the immunodepressive effect of weaning and dietary stress in precipitating disease. Severe disease also occurred in calves subsequent to elimination of oocyst shedding by monensin during the initial treatment trial. The occurrence of disease in conditions inimical to oocyst survival and development and after treatment suggested a role for arrested endogenous stages. PMID- 3810858 TI - Influence of season of birth on weight for age in two genetic groups of cattle. AB - Body weights from birth to 756 days of age for calves of Mpwapwa cattle (12% Bos taurus inheritance) and backcrosses (34% Bos taurus) born in the wet or the dry season were analysed. The calves were weaned at 75 days of age and after that fed entirely on pasture. Backcrosses were heavier than Mpwapwa at birth and at 252 days of age but not at subsequent ages. Calves born in the dry season had slightly larger birth weights than calves born in the wet season. Weight differences were reversed from 252 to 504 days reflecting the seasonal fluctuations in grass growth. The effect of season of birth on long term rate of gain was negligible. No significant interaction between genetic group (Mpwapwa vs backcrosses) and season of birth (wet vs dry) was observed at any of the ages. The study thus did not confirm the hypothesis that backcrosses because of their higher proportion of Bos taurus genes were more sensitive to the nutritional stress of the dry season than were pure Mpwapwa calves. PMID- 3810859 TI - Livestock production in central Mali: ownership, management and productivity of poultry in the traditional sector. AB - A survey of small-scale poultry production in an urban and two agropastoral systems covered 381 households. Less detailed information was also obtained from a small sample in a transhumant pastoral system. More households owned poultry in the rice (89.5%) than in the millet (81.1%) or urban (57.1%) systems. Domestic fowl were commonest in all systems followed by pigeons, Guinea fowl and then ducks, although the last were absent from the millet zone. Most families kept only one species but there was more diversification in the rice system. Flock sizes were largest in the rice system for fowls, Guinea fowl and pigeons while duck flocks averaged more birds in the urban area. Females predominated in all species except pigeons where sex ratios were about equal. Management practices in relation to housing, feeding, health care and consumption and marketing are described. Productivity figures relating to egg production, egg size, hatchability, growth and mortality are provided. PMID- 3810860 TI - Assessment of heat stress in dairy cattle in Papua New Guinea. AB - The effects of breed (Friesian, AIS, Sindi-Sahiwal and Jersey), time of day (am v pm) and season of the year (hot or cool) on rectal temperature, pulse rate and respiratory rate were examined in the Highlands and Lowlands of Papua New Guinea. Two types of variation were investigated. Between-cow variation was the basis for the comparison of sites, seasons and breeds. Between-day variation was used to assess the effect of environmental temperatures on the animal parameters. Respiration rate and rectal temperature appeared more sensitive as indicators of heat stress than pulse rate and using these criteria the highlands climate was suitable for dairy cattle. Jerseys and Sahiwals showed lower respiratory rates compared with Friesians and AIS and their increase in rectal temperature during the day was less than the other two breeds but was not significantly so. The relationships between respiration rate and rectal temperature are discussed. PMID- 3810861 TI - Digestibility and effect of copra cake on rate of gain, feed efficiency and protein retention of fattening pigs. AB - Sixteen barrows and 16 gilts of average liveweight 40 kg were fed on diets containing 0, 10, 20 or 30% copra cake. The copra cake replaced an equal weight of soyabean-maize meal in the diet. The rates of gain were 705, 719, 543 and 438 g/day and the ratios of feed per unit of gain were 3.21, 3.11, 3.83 and 4.91 for 0, 10, 20 and 30% copra cake diets respectively. Feed intake was reduced when 20 and 30% levels of copra cake were included in the diet. Reduced consumption, digestibility and possibly poor lysine availability and protein digestibility of copra cake are advanced as the main contributing factors for decreased rate and efficiency of gain when copra cake was incorporated beyond 10%. In a second experiment 18 female pigs weighing between 40 and 60 kg were put into metabolism cages and fed diets containing five to 30% copra cake. The copra cake replaced an equal weight of wheat bran. Faeces and urine were collected and analysed. The digestibility of copra cake was found to be low especially for protein (56.3% for true protein) Protein retention was reduced by high levels of copra cake inclusion. It is concluded that high levels of copra cake reduce performance of fattening pigs due to reduced feed intake and poor protein digestibility. Ten % seems to be the optimum level of inclusion. PMID- 3810862 TI - Prognostic value of "total tumor mass score" (TTM): a retrospective analysis of 130 patients with chronic lymphocytic leukemia. AB - The validity of the clinical staging of Jaksic and Vitale for chronic lymphocytic leukemia (CLL), designated total tumor mass score (TTM), was tested in 130 consecutive and previously untreated patients followed at our institution over a 15-year period. The analysis, extended to the whole population, confirmed the prognostic value of the TTM score. Patients with a high TTM (greater than 9.0) had an expected median survival (EMS) of 30 months; those with a low TTM (less than 8.9) had an EMS of 129 months (P less than 0.001). The prognostic value of TTM remained even after adjustment was made for age, sex, lymphocyte count, TTM distribution pattern, bone marrow failure, and response to therapy. Taking into account the value of the TTM score, patients of the intermediate risk group (stage II of Rai et al.) could be divided into two subgroups with a different prognosis (EMS 200 vs. 32 months; P less than 0.005). When used as a continuous quantitative parameter the TTM score may help to define response to therapy. In this study TTM response to therapy was significant for prognosis (P less than 0.001), and there seems to be relationship between the degree of response and survival probability. PMID- 3810863 TI - The role of radiation therapy in the management of primary non-Hodgkin lymphomas of the central nervous system: clinical study of 10 cases. AB - A series of 10 patients with a primary non-Hodgkin lymphoma of the central nervous system were observed and treated by the authors. All were diagnosed after a pathologic examination of the surgical material; the lesions were supratentorial in all cases and unifocal in 9. In every case radiation therapy improved clinical conditions and in most cases even radiologic features of the patients. Four patients were alive and without evidence of disease many months after therapy. Four patients died with a relapse in the central nervous system; 3 of them had disseminated disease at the time of death. Two patients died for an unknown cause. Radiation therapy was performed with 60Co source with 2 opposed portals and the whole brain irradiation technique in all cases but 2. Doses ranged from 35 to 54 Gy. The recent literature on this uncommon disease and the most adequate therapeutic possibilities of radiation therapy and chemotherapy, or both, are discussed. PMID- 3810864 TI - Breast tumors: immunoglobulins in axillary lymph nodes. AB - The immunohistochemical determination of immunoglobulins IgA, IgG and IgM in axillary lymph nodes from 50 unselected breast ductal carcinomas disclosed that lymph nodes with IgG-positive lymphoid follicles and/or metastasized lymph nodes with IgM-positive lymphoid cells are statistically related to breast tumors with a high histologic grade and more than 3 lymph node metastases. PMID- 3810865 TI - New trends in the surgical treatment of primary breast cancer in the Florence District: 1979-1985. AB - The authors report on a consecutive series of 1979 TIS-T1A-T2A-T3A breast cancer cases surgically treated from 1979 to 1985. The study investigates the impact of recent reports on conservative surgery and of a national treatment protocol for breast cancer, encouraging the use of modified radical mastectomy (MRM) and quadrantectomy, axillary dissection and breast irradiation (QUART) as alternatives to Halsted's radical mastectomy (RM). RM frequency dropped from 52% to 8% in TIS-T1A and from 82% to 20% in T2A-T3A cases in the study period, in favor of MRM and of QUART, which increased from 10% to 54% in TIS-T1A cases. Although surgical choices differ widely according to individual surgeons, a definite trend towards more conservative surgery is evident, which demonstrates how the national treatment protocol has affected current surgical practice. PMID- 3810866 TI - Psychologic effects and esthetic results of breast reconstruction after mastectomy. AB - A survey was conducted on 84 patients who chose to have breast reconstruction after mastectomy. A self-rating questionnaire was sent to each patient by mail to collect as much information about the patient as possible: individual status, reasons for requesting breast reconstruction, acceptance and advantages of having the new breast, satisfaction with the overall esthetic results, amount of patient information regarding breast reconstruction, and the source of this information. Once the questionnaire was completely filled out, it was returned by mail to the persons conducting this study. Fourty-three patients (51% of sample) replied with a completed questionnaire. When all the data for this survey were collected, an interesting factor emerged: 33 patients (76.7% of those who replied) reported being substantially satisfied with the esthetic results of their operation. When asked about the reasons for requesting breast reconstruction, 16 patients asserted their request was based on the desire to prove to themselves that they had overcome the disease, and 16 to improve body image. When asked about the advantages of breast reconstruction, 17 patients believed the operation would help improve inner feelings about the loss of the breast. Thus breast reconstruction is indeed an element of prime importance to mastectomized women, especially for their physical and psychological rehabilitation. PMID- 3810867 TI - Paranasal sinuses and nasal cavity cancer: different radiotherapeutic options, results and late damages. AB - From 1970 to 1983, 69 patients, affected by malignant epithelial tumors of paranasal cavities and nasal fossae, were treated with radiotherapy at the Radiology Institute of the University and Radiotherapy Hospital Department of Florence. Primary carcinoma of the maxillary sinus occurred in 44 patients, of the nasal cavity in 20, and of the other sinuses in 5. Most of the patients had locally advanced lesions (63 T3-4: 91.5%) according to the adopted TNM system (Lederman-Gadeberg, Sisson-Jesse). Crude survival data showed 35% and 13% of NED patients at 2 and 5 years, respectively. Local progression was the most important cause of death; patients relapsed within 2 years. The actuarial 5-year survival, corrected for causes of death other than disease, was 32% for the overall series, 32% for maxillary sinus, and 41% for the nasal cavity. There was no difference in survival in patients treated with conventional fractionation (CF) vs. multiple daily fractionation (MDF) -30% vs. 33% at 5 years. The late damages of the radiation therapy in 22 patients without local disease, with a minimum follow-up of 2 years, is also analyzed. PMID- 3810868 TI - Ultrastructural analysis of epidermal hyperplasia induced by multiple 12-0 tetradecanoyl-phorbol-13-acetate (TPA) treatment of mouse skin. AB - Stationary epidermal hyperplasia induced by exposure of mouse skin to 1-6 TPA applications was analyzed by electron microscopy and found to be of two types. Intermingled orderly and irregularly stratified hyperplastic regions observed prominently after a single TPA application gave way, on multiple treatment, to epidermal hyperplasia populated by either cuboidal cells with expanded cytoplasm or by highly polar, narrow, tall and pleomorphic cells. Both cell types were poorly differentiated and displayed a paucity of intact desmosomal junctions, resulting in an incohesive tissue structure in which a number of phenotypic variants were expressed. The variants were markedly less mature than the adjacent cells and showed basal cell phenotype, acquisition of secretory activity or a disturbed mitotic process, resulting in the formation of binucleated cells. The observations suggest that the disturbed mitotic process, poor cellular differentiation and induction of metaplasia could be the mode by which an initiated cell may express its tumor phenotype and escape differentiation during the early stage of TPA promotion. PMID- 3810869 TI - [Epidemiology of acute infantile diarrhea (241 cases)]. PMID- 3810870 TI - [Toxoplasmosis and rubella in Sousse: a sero-epidemiologic study in a school environment]. PMID- 3810871 TI - [The adolescent with chronic disease: care and outcome]. PMID- 3810872 TI - [Neonatal purulent meningitis. Apropos of 25 cases]. PMID- 3810873 TI - [Sarcoidosis of the heart (apropos of 14 cases)]. PMID- 3810874 TI - [Significance of the detection of gestational diabetes. Apropos of 27 cases]. PMID- 3810875 TI - [Intra-abdominal migration of IUDs (apropos of 9 cases)]. PMID- 3810876 TI - [Unilateral menstrual retention with renal homolateral agenesis (apropos of 6 cases)]. PMID- 3810877 TI - [7 cases of postpartum peritonitis: commentary on its diagnosis and management]. PMID- 3810878 TI - [Profile of surgical hemorrhagic ulcer (apropos of 80 cases)]. PMID- 3810879 TI - [Management of abdominal injuries caused by side-arms--is it codified?]. PMID- 3810880 TI - [Polyradiculoneuritis in a solitary secreting plasmacytoma]. PMID- 3810881 TI - [Transformation of Fanconi's anemia into acute leukemia: apropos of 2 cases in a series of 21 patients]. PMID- 3810882 TI - [Congenital afibrinogenemia (apropos of a case)]. PMID- 3810883 TI - [Posterior lumbotomy]. PMID- 3810884 TI - [Study of albumin immobilization on synthetic activated charcoal]. AB - The principles of physical and chemical immobilization of 14C-albumin on synthetic carbon sorbents with different physiochemical characteristics and structures are studied with radioisotopic technique. The protein binding to the matrix is shown to occur more tightly in the presence of the activating agent (water soluble carbodiimide). It is marked that the geometric correlation of the protein molecular size and sorbents mezopores dimensions is critical for the effective immobilization. The synthetic spherogranulated CKH carbons are shown to be preferential for biospecific carbon sorbents creation. PMID- 3810885 TI - [Isolation and properties of aminocaprolactam hydrolase from Providencia alcalifaciens]. AB - L-alpha-aminocaprolactam hydrolase possessing the L-lysinamidase activity was isolated and purified from Providencia alcalifaciens. The purification procedure of enzymes included cell destruction on USDL-1, fractionation by ammonium sulfate, gel-chromatography on G-100, ion exchange chromatography on DEAE cellulose. The purification resulted in a homogeneous enzyme which possessed the both activities. The enzyme molecular weight (180 kDa) was estimated by gel chromatography on Sephadex G-200. Km was 3.5 mM in the phosphate buffer (pH 7.2). L-alpha-aminocaprolactam hydrolase and L-lysinamidase may be related to metal dependent enzymes requiring Mg++. PMID- 3810886 TI - [Purification and properties of NADP-dependent isocitrate dehydrogenase from the bovine adrenal cortex]. AB - NADP-dependent isocitrate dehydrogenase (EC 1.1.42) was isolated and 430 times purified from the hyaloplasm fraction of bull adrenal cortex using fractionation by ammonium sulphate and acetone, heat treatment, chromatography on DEAE-Sephadex A-50, gel-filtration on Sephadex G-200 and affinity chromatography on 2',5'-ADP sepharose 4B. The specific activity of homogeneous enzyme is 60 units per 1 mg of protein at 30 degrees C, yield--34%, pH optimum--8.0, molecular weight, determined by gel filtration on Sephadex G-200, is 96 kDa. The preparation electrophoresis in PAAG in the presence of DS-Na reveals one protein fraction with the mobility corresponding to that of protein having molecular weight of 46 kDa. The data obtained evidence for a dimer structure of the isocitrate dehydrogenase molecule from bull adrenals. PMID- 3810887 TI - [Activity of pyruvate- and ketoglutarate dehydrogenase complexes on various regions of the rat brain]. AB - The activity of pyruvate dehydrogenase and ketoglutarate dehydrogenase complexes (PDC; EC 1.2.4.1 and KDC; EC 1.2.4.2, respectively) was studied in extracts and lysates of mitochondria isolated from the cortex, cerebellum and stem of the rat brain. In all the mentioned cerebral areas the PDC activity calculating per 1 mg protein noticeably increased that for KDC. Under conditions of solubilization the activity of KDC lowered to a greater extent than that of PDC. The studied brain areas are arranged according to the activity of PDC and KDC in lysates in the following order: stem much much greater than cortex greater than cerebellum, however, the highest stock of the PDC activity manifesting with activation of endogenous phosphatase and dephosphorylation of the complex is observed in cerebellum. When calculating per mitochondria isolated from 1 g of tissue, the value of the PDC activity/KDC activity ratio in all areas of the brain is more than 1, and in cerebellum allowing for the complete PDC activity it exceeds 3. The data obtained emphasize the biochemical originality of the cerebellum and the presence of specific peculiarities in regulation of the pyruvate dehydrogenase complex activity in this cerebral area. PMID- 3810888 TI - [Factors regulating mono-oxygenase induction by phenobarbital xenobiotics]. AB - The main nongenetic factors are revealed which regulate the catalytic activity and substrate specificity of microsomal monooxygenases preinduced by phenobarbital-type xenobiotics (barbituric acid and pyrazolone derivatives). It is shown that a blockage of the primary microsomal metabolism of an inducer is the obligate condition for its inductive effect on the content and activity of cytochrome P-450. On this basis it is practicable to convert the typical monooxygenase substrates into inducers of the enzyme biosynthesis by the blockage of the molecule site subjected to monooxygenation. A model is suggested which shows the phenobarbital participation in the formation of the specific configuration of the active site of cytochrome P-450 synthesized; the latter catalyzes the oxidation of a number of substrates by the way typical of inducer itself. PMID- 3810889 TI - [Study of the effect of phosphorylation of histones on their interaction with DNA cellulose]. AB - Data about the influence of phosphorylation levels of histones isolated from the prereplicative and replicative phases induced to proliferation by cycloheximide of rat hepatocytes, on their interaction with DNA-cellulose are presented. It is shown that the DNA-cellulose chromatography of histones is a sensitive model for the investigation of the effect of phosphorylation of histones on their electrostatic interaction with DNA. Using this method it is possible to separate high-phosphorylated subtype of rat liver H1 histones from other subtypes and also to show a direct dependence between the phosphorylation levels of histones and stability of their binding with DNA in prereplicative and replicative phases not only under conditions of proliferation induction by cycloheximide, but also under the subsequent influence of X-irradiation and serotonin. PMID- 3810890 TI - [Effect of various thiamine supplies of the body on the enzyme activity in the metabolism of xenobiotics and lipid peroxidation in rat liver microsomes]. AB - The effect of different thiamine supply of the organism on the enzymic activity in metabolism of xenobiotics and the processes of the lipid peroxidation in the liver microsomes with the application of phenobarbital, an inductor of microsomes' enzymes are studied in experiments on Wistar albino male rats. It is established that deficit of vitamin B1 increases the activity in most of processes studied in microsomes and also the intensity of lipids' peroxidation. Phenobarbital enhances the activity of microsomal oxidation irrespectively of vitamin B1 supply, whereas peroxidation of lipids is activated by phenobarbital only in animals fed on physiological doses of vitamin B1. The N-demethylation rate of dimethylaniline in experiments in vitro is inhibited by high doses of thiamine (150 microM), its derivatives inhibited this process in low concentrations (15 microM) as well. PMID- 3810891 TI - [Alkoxylipids from the mammalian heart]. AB - The phospholipid composition of the cardiac muscle was studied in mammals. The quantitative ratio of three forms--acyl, alkyl and alkenyl (plasmalogenic)--was determined in phospholipids of the heart: phosphatidylethanolamine and phosphatidylcholine. The total quantity of alkoxylipids (plasmalogens and alkyl esters) in various animals amounts to 23-42% of total phospholipids. PMID- 3810892 TI - [Interaction of glucocorticoid hormones with mitochondrial membranes]. AB - The mechanism of 3H glucocorticoid binding with the rat liver mitochondria in vitro is investigated. The linear dependence of the amount of bound hormones on the concentration of the free ones is shown and no saturation in the region of the physiological concentrations is observed. A very low specific binding in the presence of a 100-fold excess of an unlabelled hormone is found. The outer mitochondrial membranes binds a considerably higher amount of steroids, than the inner one. The binding of steroids with the intact liver mitochondria is 2-3 times higher as compared to the binding with spheroplasts of Escherichia coli. Delipidization of mitochondria by diverse lipotropic agents differently influences the binding of steroids with the different functional groups. The interaction of steroids with mitochondria depends on the osmolarity of the incubation medium: the binding is 1.5-3 times higher in the isotonic sucrose solution, that in the hypo- or hypertonic ones. A conclusion is made about the nonspecific character of glucocorticoid binding with mitochondria caused by the interaction with hydrophobic compounds of the mitochondrial membranes. The possible chemical mechanisms for such an interaction are discussed. PMID- 3810893 TI - [Interaction of the glycoprotein from the Bacillus pumilis cell wall with liposomes]. AB - The methods of centrifugation and gel-filtration on Sephadexes G-50 and G-150 were used to study the interaction of Bacillus pumilis cell wall glycoprotein component having the molecular weight of 50 kDa (GP-50) with lyposomes from bacterial lipids. GP-50 is shown to sorb on such liposomes and disturb their barrier properties inducing yield of low-molecular label. GP-50 exerts no effect on properties of liposomes from egg lecithin. Electrostatic forces are supposed to play a decisive role in initial acts of GP-50 interactions with lipid phase of microbial envelopes. PMID- 3810894 TI - [The nature of the pyrimidine substrate of 6,7-dimethyl-8-ribityllumazine synthase participating in riboflavin biosynthesis in yeasts]. AB - 2,4-dihydroxy-5-amino-6-ribitylaminopyrimidine and 2,4-dihydroxy-5-amino-6 ribitylaminopyrimidine-5'-phosphate are studied for their effect on the activity of 6,7-dimethyl-8-ribityllumazine synthase of Pichia guilliermondii yeasts. It is shown that when nonphosphorylated form of pyrimidine and ribose-5-phosphate (donor C-4--a fragment) is used as a substrate, the specific activity of 6,7 dimethyl-8-ribityllumazine synthase is high and Be2+ and F- ions, inhibitors of alkaline phosphatases, do not inhibit it. The value of Km for this pyrimidine is 1.1 X 10(-5) M. Phosphorylated pyrimidine being used as a substrate in the presence of Be2+ and F-, the reaction practically does not proceed. Therefore, only 2,4-dihydroxy-5-amino-6-ribitylaminopyrimidine is a pyrimidine substrate of 6,7-dimethyl-8-ribityllumazine synthase of yeast. PMID- 3810895 TI - [Properties of adenylate cyclase from plasma membranes of the rabbit myometrium in different functional states]. AB - Adenylate cyclase of plasma membranes from the nonpregnant rabbit myometrium shows the maximum activity at pH 7.7-7.9, is characterized by apparent Km for ATP amounting to 0.38 +/- 0.09 mM, V--125 +/- 34.4 pmol min/mg protein, is activated at most by 15-20 mM Mg2+ and F-. Adenylate cyclase of plasma membranes from the pregnant rabbit myometrium is characterized by apparent Km for ATP amounting to 0.74 +/- 0.06 mM, V--77.3 +/- 6.0 pmol/min/mg protein, is activated at most by 5 10 mM Mg2+ and 10-15 mM F-; the pH optimum for the adenylate cyclase in this functional state is 7.3. Adenylate cyclase in the state of labour is characterized by apparent Km for ATP amounting to 0.46 +/- 0.11 mM, V--34.8 +/- 4.6 pmol/min/mg protein, is activated at most by 10-15 mM Mg2+ and F-, shows the same activity at pH 7.3-8.5. Adenylate cyclase of myometrium in three investigated states is activated by 2 mM EGTA; 10(-7) M Ca2+ decreases activation caused by EGTA; higher concentrations of Ca2+ decrease the basal activity of the enzyme. PMID- 3810896 TI - [Activity of NAD- and NADP-containing enzymes and catalase in human erythrocytes after sucrose loading]. AB - The dynamics of glucose content and activity of GL-6-FDG, MDG, ICDG and of catalase in the erythrocytes of healthy people under glucose load was investigated. It has been established that maximal increase of the glucose content in blood under glucose load occurs 60 min later and the peak of activity of all the studied enzymes--90 min later. A degree of the activity increase in certain enzymes is not the same. It enhances considerably in GL-6-FDG and catalase and is hardly tracable in MDG and ICDG. A conclusion is made that glucose metabolism in erythrocytes is accompanied by the intensification of synthesis and hydrogen peroxide decomposition processes. PMID- 3810897 TI - [Glutathione-S-transferase activity in tissues of rats with cardiovascular pathology]. AB - The activity and certain properties of glutathione-S-transferases from tissues of rats with cardiovascular pathology are studied. Role of the enzyme in the detoxication processes in the myocardium is shown. PMID- 3810898 TI - [Characteristics of glycogen synthesis from [1-14C]glucose and its labeled precursors in the piglet liver]. AB - The in vivo experiments have established that the rapid decrease in the glycogen content in the liver of piglets during the first 24 hours after birth is associated with the reduction of the degree of label inclusion from [1 14C]glucose into polysaccharide. The level of label inclusion from [1 14C]pyruvate and [1-14C]lactate into the liver glycogen in new-born piglets is higher than from [1-14C]alanine and [1-14C]glutamic acid. During the days immediately after birth the extension of the pool of glucogenic substrates occurs at the expense of alanine and other amino acids during catabolism of which pyruvate is formed. The degree of label inclusion from the investigated substrates into the liver glycogen of piglets of early age decreases in the series: [1-14C]glucose greater than [1-14C]lactate greater than [1-14C]pyruvate greater than [1-14C]alanine. Glutamic acid in the liver of piglets of early age is not a glucogenic substrate. PMID- 3810899 TI - [Characteristics of hexosephosphate transformation regulation in Zajdela hepatoma and the liver of tumor-bearing rats]. AB - Essential differences are established between the activities in enzymes of monophosphohexoses' transformation in the Zajdela hepatoma and liver of tumour bearing rats. So, a very low hexokinase activity is observed in the liver, the activity of phosphoglucomutase and glucose-6-phosphate being high. In hepatoma cells the activity of hexokinase is relatively high and that of phosphoglucomutase, glucose-6-phosphate phosphatase and dehydrogenases--glucose-6 phosphate and 6-phosphogluconate inhibiting the activity of phosphoglucomutase is considerably lower. Significant differences are also found in the ratios of the glucose, glucose-6-phosphate, fructose and fructose-6-phosphate concentrations, that evidences for changes in the regulatory mechanisms in the hepatoma cells. PMID- 3810900 TI - [Effect of exertion on the tropomyosin level in rat skeletal muscles]. AB - It is established that the content of tropomyosin in skeletal muscles of rats increases due to the action of the systematic physical exercises of the speed force direction. Suprareduction of tropomyosin in remote periods of rest after a single load is a biochemical basis of this process. PMID- 3810901 TI - [Pheochromocytoma in Denmark 1977-1981]. PMID- 3810902 TI - [Pheochromocytoma]. PMID- 3810903 TI - [Primary aldosteronism (Conn's syndrome) in Denmark 1977-1981]. PMID- 3810904 TI - [Transcutaneous monitoring of carbon dioxide tension during delivery]. PMID- 3810905 TI - [Chronic middle-ear inflammation and its sequelae in the population of Greenland]. PMID- 3810906 TI - [Otitis media in Greenlandic children. Acute, chronic and secretory otitis media in Greenland children 3-8 years of age]. PMID- 3810907 TI - [Hypercalcemia in manic-depressive patients during maintenance treatment with lithium]. PMID- 3810908 TI - [Side effects of cervical myelography/radiculography with metrizamide (Amipaque)]. PMID- 3810909 TI - [An algorithm for the differential diagnosis of icterus]. PMID- 3810910 TI - [Complicated terminal phalanx epiphysiolysis of the finger. A simple method for reposition and fixation]. PMID- 3810911 TI - [Traumatic conditions of the middle ear. Mechanisms of development and therapeutic results]. PMID- 3810912 TI - [Scintigraphic diagnosis of pheochromocytoma]. PMID- 3810913 TI - [Unexpected findings at autopsy. Can the clinical value of the autopsy be predicted?]. PMID- 3810914 TI - [Renal oncocytoma]. PMID- 3810915 TI - [Lung function in a representative population sample of persons 30-70 years of age residents of Copenhagen who had never smoked. Normal values for interindividual and intraindividual variations]. PMID- 3810916 TI - [Obstructive sleep apnea syndrome treated with a nasopharyngeal tube]. PMID- 3810917 TI - [Secondary prolongation of the QT interval and ventricular arrhythmias. Causes and treatment]. PMID- 3810918 TI - [The idiopathic long QT syndrome. An overlooked diagnosis]. PMID- 3810919 TI - [Blockade of the left stellate ganglion. Treatment of ventricular arrhythmias in secondary QT prolongation]. PMID- 3810920 TI - [Splenic rupture and delayed intra-abdominal hemorrhage after blunt abdominal injury]. PMID- 3810921 TI - [Can thiazides cause impotence?]. PMID- 3810922 TI - [The value of forensic autopsy in cases of fatal traffic accidents]. PMID- 3810923 TI - [Care of dying cancer patients in their own homes. Experiences of 6 years in a general practice with intensive participation in the care of dying patients in their own homes]. PMID- 3810924 TI - [Utilization of casualty departments by primary health services. A prospective study]. PMID- 3810925 TI - [Immunity to diphtheria in the 30-70 year-age group]. PMID- 3810926 TI - [Experience with the employment of telephone interviews for group screening in epidemiological studies]. PMID- 3810927 TI - [Neutrophilic granulocytes. Myelopoiesis, kinetics and function]. PMID- 3810928 TI - [The toxic influence of nitrous oxide on the bone marrow and nervous system]. PMID- 3810929 TI - [The occurrence of asthma and allergic rhinitis, atopic dermatitis and urticaria in Danish children born in the period of one year]. PMID- 3810930 TI - [The Glasgow coma scale. An introduction and evaluation]. PMID- 3810931 TI - [Virus hepatitis in Sisimiut/Holsteinborg 1979-1985]. PMID- 3810932 TI - [Endoscopic mechanical crushing of calculi in the common bile duct]. PMID- 3810933 TI - [Ring avulsions]. PMID- 3810934 TI - [Asbestos in the indoor atmosphere and environment]. PMID- 3810935 TI - [Asbestos-induced cancer in Denmark]. PMID- 3810936 TI - [Risk factors for cerebral aneurysms and rupture]. PMID- 3810937 TI - [Epidemiological evaluation of the risk of hemorrhage from non-ruptured intracranial sacculate aneurysms]. PMID- 3810938 TI - [Risk of hemorrhage from non-ruptured intracranial sacculate aneurysms]. PMID- 3810939 TI - [Extracerebral arachnoid cysts. 12 cases localized in the middle cranial fossa, diagnosed 1981-84]. PMID- 3810940 TI - [Demonstration of Chlamydia trachomatis by means of monoclonal antibodies]. PMID- 3810941 TI - [The distribution of leukocytes according to size used as a form of differential counting]. PMID- 3810942 TI - [Disorders of magnesium/calcium metabolism related to cisplatin therapy]. PMID- 3810943 TI - [Survival after paraquat poisoning]. PMID- 3810944 TI - [Myelomatosis in a patient with normal ESR, serum protein electrophoresis and bone marrow findings]. PMID- 3810945 TI - [Hearing preserving surgery in the treatment of acoustic neurinoma]. PMID- 3810946 TI - [Women's attitudes to antenatal care, delivery and the postpartum period. I. Antenatal care]. PMID- 3810947 TI - [Elderly people's contact with general practitioners. A 3-year study in the municipality of Rodovre]. PMID- 3810948 TI - [Indoor atmosphere pollution in flats. Measurement of absolute indoor humidity and suspended particle dust in retrofitted flats]. PMID- 3810949 TI - [Systolic time intervals]. PMID- 3810950 TI - [Copper poisoning. Clinical picture, physiopathology and treatment]. PMID- 3810952 TI - [Computer centers in medical research. An alternative to the local personal computer]. PMID- 3810951 TI - [Fatal fluor carbon sniffing]. PMID- 3810954 TI - [Amiodarone (Cordarone) induced liver damage]. PMID- 3810953 TI - [V. Statistics on personal computer]. PMID- 3810955 TI - [Papaverine-induced erection in erective dysfunction]. PMID- 3810956 TI - [Cervix cancer. II. Potential non-infectious etiological factors]. PMID- 3810957 TI - [Women's attitudes to antenatal care, delivery and the postpartum period. II. Delivery and the postpartum period]. PMID- 3810958 TI - [Use of EDP by hospital physicians]. PMID- 3810959 TI - [Surgical treatment of Wolff-Parkinson-White syndrome]. PMID- 3810960 TI - [Chronic paroxysmal migraine. A review and presentation of 4 new cases]. PMID- 3810961 TI - [Experience with Multiload Cu 250 intrauterine device in general practice]. PMID- 3810962 TI - [An alternative tracheal cannula for patients with permanent tracheostomies]. PMID- 3810963 TI - [Verapamil poisoning. Report of a case and a review of therapeutic results]. PMID- 3810964 TI - [Sexual, psychological and social aspects of vasectomy]. PMID- 3810965 TI - [Prevention of smoking at a lung clinic. Results of routine advice]. PMID- 3810966 TI - [Occurrence of allergic and irritative symptoms among gardeners]. PMID- 3810967 TI - [Sexual activity and contraceptive habits among young people. A study among pupils of the 9th grade in the municipality of Viborg]. PMID- 3810968 TI - [Intraoral cancer. 100 consecutive cases]. PMID- 3810969 TI - [Alcohol and blood pressure]. PMID- 3810970 TI - [The contact with pesticides and the occurrence of acute symptoms among gardeners]. PMID- 3810971 TI - [Gonorrhea in the Sukkertoppen medical district in Greenland 1984-1985]. PMID- 3810972 TI - [Evaluation of thrombolysis in cerebrovascular disease]. PMID- 3810973 TI - [Cytostatic treatment of metastatic adenocarcinoma and anaplastic carcinoma of unknown primary origin]. PMID- 3810974 TI - [Infusion thrombophlebitis]. PMID- 3810975 TI - [The response to vaccination for hepatitis B in chronic hemodialysis patients and in staff groups exposed to hepatitis B]. PMID- 3810976 TI - [Sudden death in asthma. Can it be prevented?]. PMID- 3810977 TI - [Do we give patients too many particles with infusions? Investigation of infusion pumps and original infusion sets compared with a standard drip set]. PMID- 3810978 TI - [Amiloride and magnesium. Severe interaction between amiloride and over-the counter drugs containing magnesium]. PMID- 3810979 TI - Effects of high intensity ultrasound on inorganic solids. AB - Ultrasonic irradiation dramatically affects the reactivity of a variety of inorganic solids. We have found, for example, large increases in the rates of intercalation of a wide range of compounds into various layered inorganic solids (such as ZrS2, V2O5, TaS2 and MoO3. High intensity ultrasound also enhances the heterogeneous catalysis of alkene hydrogenation by Ni powders. Scanning electron microscopy reveals that ultrasound has multiple effects on the morphology and surface characteristics of inorganic solids, creating substantial surface damage, increasing surface areas significantly and causing increased particle aggregation. PMID- 3810980 TI - Therapeutic ultrasound and the liver in vivo: action and possible mechanisms. AB - This paper reports on the effects of therapeutic ultrasound upon the liver in vivo. Exposure of the liver of rats to therapeutic ultrasound at a frequency of 0.87 MHz results in intravascular haemolysis which is dependent upon the product of the intensity and the exposure duration (energy deposited within the liver). The resulting structural change (noted when a spatial peak intensity of 1.25 W/cm2 was applied for a duration of 10 min) is a lesion which has four zones. The severity of the injury increased across the four zones when scanning towards the ischaemic area. The biochemical changes observed included an increase in aspartate transaminase, alanine transferase, creatinine kinase and cholesterol and a decrease in total protein and albumin. Healing processes reversed the structural changes after 72 h which was also reflected in the plasma biochemical profile. Exposure of the liver to infrared radiation resulted in haemolysis but not the biochemical or structural alterations observed following sonication suggesting a mechanism for ultrasound action other than heating alone. PMID- 3810981 TI - Measurement and use of acoustic nonlinearity and sound speed to estimate composition of excised livers. AB - The acoustic nonlinearity parameter B/A and sound speed c have been determined for excised normal and abnormal human livers at 20-37 degrees C. These values are compared with analytic measurements of fat and water content of tissues. The results show that normal liver containing 71.0% water and 2.9% fat by weight has a B/A value of 6.75 and sound speed of 1592 m/s at 37 degrees C. Both these parameters increase at an average rate of 0.026 degrees C and 1.5 m/s/degrees C, respectively, as the temperature is raised from 20 to 37 degrees C. Fatty liver (24% fat by weight) exhibits highest B/A (9.12) and lowest c (1522 m/s) of all the livers studied. In contrast to normal livers sound speed in such a liver was found to decrease with temperature. Based on the acoustic and composition measurements, quantitative correlations of B/A and c with fat-water composition have been developed. Inversion of these relationships provide a simple method to determine composition of a tissue sample from B/A and c measurements. PMID- 3810983 TI - Sperm maturation associated with subfertility following hyperbaric exposure of mice. AB - Mice exposed to 50 ATA heliox pressure during one spermatogenic cycle subsequently exhibit subfertility which can recover over an 8-wk period. This study was designed to investigate the changes in spermatid and testicular histology associated with these phenomena. Electron microscopy of testicular tissue from hyperbaric-exposed animals revealed a significant effect on spermatogenesis including disorganization and patchy necrosis of the epithelium. Two weeks after exposure to pressure, abnormalities were more difficult to find and tissues taken from animals 8 wk after exposure were indistinguishable from normal. These data directly confirm our earlier hypothesis that chronic hyperbaric exposure has a deleterious effect on sperm maturation, which is subsequently manifest as a failure in fertilizing capacity. PMID- 3810982 TI - Effect of barbituric acid on the high pressure nervous syndrome in the rat. AB - Male Sprague-Dawley rats were compressed in helium-oxygen mixture at a rate of 3 bar/min. Compression ended once the first convulsion was seen. Saline or barbituric acid at 1 or 2% were infused continuously during compression at a rate of 9.49 ml/h (tail vein). With barbituric acid at 1%, coarse tremor and convulsions appeared at higher pressures than in saline controls. No significant change was observed with 2% barbituric acid compared to saline controls. Barbituric acid which is nonanesthetic had some anti-high pressure nervous syndrome (HPNS) activity which is dose dependent. These results suggest that anti HPNS activity of these different compounds involves at least one site which is different from that responsible for anesthetic activity. PMID- 3810984 TI - Hydrogen washout in bone cortex and periosteum. AB - Residence time distributions of hydrogen in bone of anesthetized dogs and rabbits were used to estimate local blood perfusion rates and to characterize the important transport processes taking place. The hydrogen was administered by inhalation, and the concentrations in the bone were measured by embedded platinum microelectrodes. Mean residence times varied significantly both with position and time, and it was found preferable to calculate residence time from moments of the residence time distribution rather than the downslope method. Moreover, the downslope on a semilogarithmic scale continued to decrease with the increase in observation time. For the tissue investigated, simple compartmental models are inadequate even for the small regions characterized by the electrodes. This means that a large number of Haldanian compartments are needed even to characterize local washout behavior. The significance of this finding for the selection of decompression schedules is briefly discussed. PMID- 3810985 TI - Intramuscular diclofenac sodium as adjuvant therapy for type I decompression sickness: a case report. AB - The residual pain of type I decompression sickness (limb bends) occurring despite recompression therapy is due to an acute inflammatory reaction in the soft tissue around the joint. This case history reports an excellent response in resolving residual pain by the use of an intramuscular injection of the nonsteroidal anti inflammatory drug, diclofenac sodium. The theoretical reasons for this are discussed. PMID- 3810986 TI - Pain-only decompression sickness affecting the orbicularis oculi. AB - A case is reported of a diver who experienced the onset of pain in the left orbicularis oculi muscle approximately 20 min after surfacing from an experimental dive. A careful neurologic examination disclosed no abnormality. The response of the orbicularis oculi muscle to stimulation of the facial nerve and the blink reflex were both normal as recorded with a clinical neurophysiologic recording system (Nicolet CA 1000). The pain resolved quickly with recompression, supporting a diagnosis of pain-only decompression sickness in this small facial muscle. PMID- 3810987 TI - Compression pain in a diver with intraosseous pneumatocysts. AB - A 30-yr-old diver experienced pain in the area of the sacroiliac joint during the descent phase of air diving to less than 10 ATA. Computed tomography of the pelvis demonstrated two gas-filled cysts within the ilium. The mechanism by which this lesion causes pain is discussed and reports of gas within bone are reviewed. PMID- 3810988 TI - Effect of hydrostatic pressure on plasma concentrations of norepinephrine during cold water immersion. AB - Head-out immersion of humans in cold water concurrently stimulates low-pressure receptors and cutaneous cold receptors. In theory, the low-pressure receptors inhibit sympathetic nerve activity to the extent of modifying plasma norepinephrine responses to chilling of the skin. Human plasma norepinephrine concentrations ([NE]p's) were measured when low-pressure receptors were stimulated by 6 h of head-out immersion in thermoneutral water (35 degrees C). The experimental protocol was repeated when cold receptors were activated by a separate exposure to 14.8 degrees C air. Furthermore, both types of receptors were activated by 6 h of immersion in cold water (29.8 degrees C). The control exposure maintained [NE]p close to a constant value of 0.34 ng/ml. Thermoneutral water reduced [NE]p to 0.18 ng/ml after 30 min of immersion, but the change was not statistically significant (two-way ANOVA). [NE]p increased to peak values of 1.5 ng/ml in cold air (P less than 0.05) and 1.1 ng/ml in cold water (P less than 0.5), with no significant differences observed between [NE]p's in cold air and cold water. Equal rates of body heat loss occurred during the exposures to cold air and cold water. Since [NE]p's were comparably raised by separate exposures to cold water and cold air, stimulation of low-pressure receptors by immersion did not significantly depress peripheral vasomotor nerve activity during head-out immersion in cold water. PMID- 3810989 TI - High hydrostatic pressure potentiation of the toxic effects of chromate in cell culture. AB - Development of hyperbaric welding has created the need for new occupational health standards. We have used cell cultures to investigate effects of high pressure chromate on the toxicity of the welding-fume component, chromate. The results indicate that pressure caused rounding-up of cells and changes in F-actin filaments, and that these effects were related to the extent of high pressure and independent of exposure duration. When exposing the Flow 5000 cells to chromate (1-5 microM) the amount of disrupted F-actin fibers was found to depend on the concentration applied and the duration of exposure. The amount of cell-associated chromate was the same for 1 h exposure at 1 and 150 bar. The fraction of rounded cells after exposure to 1 microM chromate and 100 bar for 18 h was higher than would be expected if the effects were purely additive. PMID- 3810990 TI - High hydrostatic pressure and chromate-induced effects on cell cycle kinetics. AB - Cell cycle kinetics was studied using the quenching of 33258 Hoechst fluorescence by bromodeoxyuridine incorporation to investigate effects of high pressure on the toxicity of a welding fume component--chromate. When exposing the glioma cells to 1 microM K2Cr2O7 at 1 bar, we observed a prolongation of DNA-synthesis phase, whereas cells exposed to 5 microM K2Cr2O7 did not pass through mitosis. Cells exposed to 1 or 5 microM chromate during the last part of DNA synthesis and during mitosis were not delayed in passing through mitosis. High pressure (100 bar) or pretreatment with pressure did not cause changes of cell cycle parameters. The combined exposure of 1 microM K2Cr2O7 and high pressure caused the same effect as observed for 1 microM K2Cr2O7 at 1 atm. However, an extra delay was observed in passing through mitosis for cells exposed to 100-bar pressure during the early part of their cell cycle. PMID- 3810991 TI - Effects of dietary lipids on frequency and force in atrial muscle at 10 MPa. AB - Spontaneously beating atrial preparations, from rats fed different lipid diets, were compressed to 10 MPa. The following observations were made: Different lipid diets altered the ratio of omega-6/omega-3 polyunsaturated fatty acids of the cardiac phospholipids. Beating frequency and twitch tension at surface pressure was unaffected by the diets. Compression to 10 MPa caused a decrease in spontaneous beating frequency and an increased twitch tension in all preparations. The decrease in beating frequency was inversely related to the omega-6/omega-3 ratio. Pressure induced increase in twitch tension was not affected by the diets. N2O dissolved in the tissue bath solution partly counteracted the pressure-induced changes. PMID- 3810992 TI - Transmission and scanning electron microscopy of N2 microbubble-activated human platelets in vitro. AB - When N2 microbubbles are stirred in platelet-rich plasma, they cause a fall in the number of free platelets. Changes in the platelets ultrastructure during this interaction between gas bubbles and platelets have been studied by transmission and scanning electron microscopy. Platelets, and aggregates of platelets, adhere to the surface of the N2 microbubbles. This adhesion induces ultrastructural changes (shape change, pseudopod formation, granule centralization, fusion, and disappearance) that are similar to "classical" agonists like ADP, collagen, and thrombin. These ultrastructural studies further strengthen our previous contention that N2 microbubbles activate platelets in a way similar to these physiologic agonists, and show that the previously reported fall in the number of free platelets is due to platelet aggregation. Platelet aggregates are also present in the interstices between gas bubbles. Fixed N2 microbubbles have been demonstrated, and these can be broken like cracked eggs by means of the electron beam in the electron microscope. Possible mechanisms for activation of the platelets by the gas bubbles are: through ADP released from some few platelets; by diffusion of gas after bubble-platelet interaction; and through certain fractions of the plasma proteins and lipids in the bubble surface that may act as binding sites for the platelets and promote adhesion and spreading of the platelets over the surface. PMID- 3810993 TI - Decompression after repeated dives. AB - Seventy-six men and 7 women performed a 2nd dive in a pressure chamber under dry conditions after intervals at the surface of 10, 30, 90, or 120 min. Of these, 35 persons performed a 3rd dive after an interval of 20 or 90 min (118 repeated dives). Air was the breathing gas during all phases of the tests. During exposure to overpressure the divers exercised on a bicycle-ergometer. The decompressions for dives 2 and 3 were the same as for the first dive. After the 2nd or 3rd dive, certain symptoms of decompression sickness of the skin occurred in 5 of the 118 exposures, and 1 diver complained of muscular aches. These results suggest that no general sensitization occurred after the 1st dive. We concluded that a slightly more conservative decompression with regard to ascent velocity and profile is feasible for repeated dives. PMID- 3810994 TI - Personality and demographic variables related to individual responsiveness to diving stress. AB - Thirty U.S. Navy divers were tested for 4 personality and 2 demographic variables. They subsequently were exposed to the stress of being pressurized in a small diving chamber for several hours. Stress responsiveness to this condition was assessed using 3 physiologic and 4 subjective emotionality measures before and after the dive. These physiologic and emotionality measures were factor analyzed and correlated with personality and demographic variables. Difference scores among the physiologic and emotionality measures, indicating responsiveness to stress, correlated significantly with education, diving experience, internality-externality, disinhibition, and socialization. These data indicate that measures of achievement (i.e., diving experience and education), perceived control, sensation seeking, and social adjustment are useful in accounting for individual differences in acute emotional and physiologic responsiveness to stressful diving conditions. PMID- 3810995 TI - Mental health of submariners. PMID- 3810996 TI - [The sex of children and breast cancer. Case-control study]. PMID- 3810997 TI - [The adolescent and contraception. 2]. PMID- 3810998 TI - [Anhidrotic ectodermal dysplasia. Case report]. PMID- 3810999 TI - [Aerosol therapy. Official position of the Association of Lung Specialists of Quebec Province]. PMID- 3811000 TI - [Decline in the use of scientific French must cease]. PMID- 3811001 TI - [Profile of the consumption of caffeine, cigarettes and alcohol by women in Quebec during pregnancy]. PMID- 3811002 TI - [Suicide and depression in college students: comments]. PMID- 3811003 TI - [Haemophilus infections at the Hospital Center, University of Sherbrooke since 1976]. PMID- 3811004 TI - [Intensive plasmapheresis in the Guillain-Barre syndrome. Recent experience]. PMID- 3811005 TI - [Continuous ambulatory peritoneal dialysis and peritonitis]. PMID- 3811006 TI - [Diarrhea and soft drinks]. PMID- 3811007 TI - [Q fever in the Eastern Townships 1975-1984]. PMID- 3811008 TI - [Centralization of antineoplastic chemotherapeutic treatments in a hospital milieu: CHUS 1983-1986]. PMID- 3811009 TI - [At the frontiers of the brain--the neurologist and his literature]. PMID- 3811011 TI - Northern Ireland twin study 1983. AB - Two hundred and fifty-three twin deliveries in Northern Ireland during 1983 were studied. A high perinatal mortality rate of 57 per 1000 births was found, over four times greater than the overall perinatal mortality rate for Northern Ireland in that year. The main cause of these losses remains premature delivery which is frequently complicated by fetal growth retardation. Serial ultrasound scanning in the third trimester is considered mandatory in order to reduce the incidence of undiagnosed fetal growth retardation in twins. PMID- 3811010 TI - Subacute sclerosing panencephalitis in Northern Ireland: twenty years' experience. AB - Subacute sclerosing panencephalitis (SSPE) is a rare degenerative disease of the central nervous system that affects primarily children and adolescents. It is a late manifestation of measles virus infection. In a 20-year period (1965-85) there have been 26 cases of SSPE in Northern Ireland, a frequency of approximately one case per 1.2 million population per year. Males were affected more frequently than females. In other parts of the world the incidence of this disease has been dramatically reduced following effective measles immunisation programmes. The vaccination rate in Northern Ireland probably remains too low to have a similar effect. PMID- 3811012 TI - Gastrointestinal hormones in alcoholic patients with and without liver disease. AB - To assess the effects of both alcoholism and liver disease on gastroentero pancreatic hormones, fasting and post-prandial concentrations were analysed in the following four groups: (1) Alcoholic subjects with liver disease; (2) Alcoholic subjects without liver disease; (3) Control subjects with liver disease; (4) Control subjects without liver disease.Liver disease was associated with increased fasting serum glucose, plasma insulin, pancreatic polypeptide, gastrin and vasoactive intestinal polypeptide. Alcoholism in the absence of liver disease did not influence either the fasting or post-prandial concentrations of serum glucose, plasma gastrin, insulin, pancreatic polypeptide, gastric inhibitory polypeptide, N- and C-terminal glucagon or vasoactive intestinal polypeptide. Alcoholism with liver disease depressed plasma gastric inhibitory polypeptide concentrations. The results suggest that the abnormalities in gastroenteropancreatic hormone in alcoholics are likely to be related to liver disease which is often concurrent. PMID- 3811013 TI - Effect of a meal on blood pressure in the elderly. AB - As post-prandial hypotension may be a cause of falls in older people, blood pressure was measured for one hour following a test meal in 22 elderly patients. There was a small fall in both systolic and diastolic blood pressure but no change in heart rate. Although the changes were small and no symptoms occurred, post-prandial hypotension might be important in elderly patients who had other abnormalities in blood pressure regulation. PMID- 3811014 TI - Rates of admission to six Northern Ireland psychiatric hospitals of patients with primary alcohol-related diagnoses. AB - The rate of admissions to psychiatric hospitals of patients with primary alcohol related diagnoses (PARD) has increased from 1971 to 1983 and they now account for 19.7% of all admissions. There is a wide variation in admission rates between hospitals, and the use of the Mental Health (NI) Act 1961 to admit these patients formally varies up to twelvefold. PMID- 3811015 TI - Gliadin antibody detection in gluten enteropathy. AB - Circulating antigliadin antibody has been described in patients with gluten enteropathy although the prevalence varies in different studies. It has been suggested that the investigation for antigliadin antibody might be useful as a screening test. The object of the present study was to evaluate two different techniques for assaying these antibodies - an indirect immunofluorescent method and an enzyme-linked immunosorbent assay (ELISA). Antibodies were assayed in the sera of 102 patients in whom jejunal biopsies were also obtained. The specificity of both tests was greater than 95%, and the correlation between the presence of antibody and histology was significant (p < 0.005), though the sensitivity of each test was less than 70%. PMID- 3811016 TI - Posterior fossa haemangioblastomas in Northern Ireland: a clinico-epidemiological study. AB - A retrospective study of 25 patients who presented with posterior fossa haemangioblastomas to the Northern Ireland Regional Neurosurgical Centre over the past 25 years has been carried out. The epidemiological and clinical features and the results after operative treatment are presented and compared with other series. Posterior fossa haemangioblastomas were more common in female than in male patients and solid tumours accounted for 40% of all cases. While only two patients had associated polycythaemia, five patients (20%) were found to have persistent leucocytosis pre-operatively, while 24% had von Hippel-Lindau complex including two patients who were operated upon for an associated spinal haemangioblastoma. Of particular interest was a patient who had neurofibromatosis. There was no perioperative deaths. Patients with solid tumours fared badly in the long term compared with those who had a cystic type. PMID- 3811017 TI - Intrapericardial bowel hernia with cardiac tamponade. PMID- 3811018 TI - Rumination in adults--a rare cause of gastro-oesophageal regurgitation in two patients. PMID- 3811019 TI - Near death due to inhalation of slurry tank gases. PMID- 3811020 TI - Capgras syndrome. PMID- 3811021 TI - Primary malignant lymphoma of the appendix. PMID- 3811022 TI - Biliary peritonitis due to choledochal cyst presenting in late pregnancy. PMID- 3811024 TI - The technique of whole body autoradiography--some examples of applications. PMID- 3811025 TI - Autoradiography and histochemistry of mineralized tissues by means of the Ullberg freeze-sectioning technique. AB - The present paper is a review of some different applications of whole-body freeze dried sections to illustrate the usefulness for studies on mineralized tissues. Thus the application of autoradiography fluorescence microscopy and enzyme histochemistry and their combinations is described. PMID- 3811023 TI - Nuclear magnetic resonance imaging in medicine. AB - Using the technique of nuclear magnetic resonance (NMR, MR, MRI), the first images displaying pathology in humans were published in 1980.(1) Since then, there has been a rapid extension in the use of the technique, with an estimated 225 machines in use in the USA at the end of 1985.(2) Considerable enthusiasm has been expressed for this new imaging technique,(3) although awareness of its high cost in the present economic climate has led to reservations being expressed in other quarters.(2) The aim of this article is to give an outline of the present state of NMR, and indicate some possible future developments. PMID- 3811026 TI - Large section cryomicrotomy: a basic method for microdissectioning and in vitro autoradiography of human nervous tissue. PMID- 3811027 TI - Surface cryoplaning. A technique for clinical anatomical correlations. PMID- 3811028 TI - Image analysis in whole-body autoradiography (WBA). PMID- 3811029 TI - Boron neutron capture radiography--perspectives in melanoma therapy. PMID- 3811030 TI - Application of whole-body autoradiography to distribution studies of volatile substances. PMID- 3811031 TI - Accumulation of retinoids in embryonic neural and neural crest cells as part of the mechanism of teratogenesis. PMID- 3811032 TI - Reference values for lung function tests in men: regression equations with smoking variables. AB - Prediction formulas for static and dynamic spirometry, gas distribution, static lung mechanics and the transfer test were derived from measurements in healthy men. The measurements included total lung capacity, residual volume, airways resistance, static elastic recoil pressure of the lung, static compliance, closing volume, slope of the alveolar plateau (phase III), flow-volume variables (including mean transit time) during breathing of air or a helium/oxygen mixture, and conventional spirometric indices. The results from 146 smokers and 124 never smokers were evaluated separately and combined. For all lung function tests a single regression equation was obtained. The prediction formulas included time related smoking variables and were valid for both smokers and never-smokers. For many lung function tests, a nonlinear age coefficient resulted in a significant reduction in variance compared with simple linear models. Heavy tobacco smoking influenced most lung function tests less than ageing from 20 to 70 years, but for airways resistance, transfer factor and phase III the opposite was found. PMID- 3811033 TI - Cerebrospinal fluid and plasma concentrations of clonidine in pigs after epidural, intravenous and intramuscular administration. AB - Epidural clonidine is an alternate way to treat severe pain in man. The cerebrospinal fluid (CSF) and plasma concentrations resulting after epidural, intravenous (i.v.) or intramuscular (i.m.) clonidine, 3 ug/kg b.w. have been determined by a sensitive gas chromatographic method. A porcine model was used, where the epidural and intrathecal spaces were cannulated via the atlanto occipital membrane. After epidural administration of clonidine the CSF concentrations were maximal 20 minutes after the injection, 129 +/- 24 ng/ml (mean +/- S.D.). Clonidine was eliminated from CSF with an apparent half-life of 26 +/- 8.2 minutes (mean +/- S.D.). The plasma concentrations stayed below 1 ng/ml. Low plasma and undetectable CSF concentrations resulted after i.v. clonidine. Thus, epidural clonidine readily penetrates the dura mater into the CSF, and there is a marked gradient between CSF and plasma. PMID- 3811034 TI - Critical aspects of urine and stone analysis. Appearance of iatrogenic urinary calculi. AB - In 25% of the samples the often applied qualitative chemical analysis of urinary stones leads to entirely wrong results with severe therapeutic consequences. The appropriate techniques for stone analysis are infrared spectroscopy and X-ray powder diffraction. These techniques make also possible the identification of iatrogenic urinary calculi. Four types of such stones were detected here, caused by modern medication. N4-acetylsulfamethoxazole, N4-acetylsulfadiazine, mefenamic acid and silicon dioxide. It is only the correct preanalytical treatment of urine samples that prevents considerable impairment of analytical results. Without precautions especially, the oxalate concentration in urine may be doubled or tripled during one day of storage. PMID- 3811035 TI - Clinical significance of stone analysis. AB - The bases of a real metaphylaxis in the renal stone diseases are the analysis of stones and the research of metabolism in blood plasma and urine. The greatest part of the stones analyzed may be classified in four groups: oxalate, phosphate, uric acid and cystine. The metaphylaxis by whewellite and weddellite is the same for both species but there is a distinction in growth and recurrence. In the phosphate stones, the section with the most different composition, a postoperative therapy is only possible with the distinction of 'acid' and 'alkaline' stones. The uric acid and cystine stones need a tight supervision and metaphylaxis for the whole life. On the basis of 15,000 analyses with X-ray diffraction the difference of the renal stones is discussed and the deducation for a genuine metaphylaxis is shown. PMID- 3811036 TI - Ureterorenoscopy in the treatment of ureteral stones. AB - Ureterorenoscopy rendered the endoscopic removal of ureteroliths possible. Big distal ureteroliths which do not pass spontaneously and for which ureterolithotomy is unavoidable, are treated by means of ureterorenoscopy which makes ultrasonic disintegration or stone extraction with a Dormia loop possible, and this under optical control too. The different techniques and strategies are presented. In animal experiments alterations of the urothelium after exposure to ultrasound were examined. There is the possibility to combine ureterorenoscopy with the percutaneous method of litholapaxy or ESWL when treating ureteroliths in the upper part of the ureter which do not pass spontaneously. PMID- 3811037 TI - Percutaneous litholapaxy. AB - The technique of puncture and dilatation 'in the hands of one' is described in detail based on almost 800 percutaneous operations on the kidney. All of the steps of the operation were carried out by the urologist himself. The advantages are presented and two new percutaneous instruments are introduced: a percutaneous working sheath and the lumbotome, a wire-guided, double-blade knife for cutting the percutaneous tract. The principle of percutaneous stone operation is explained as well as special complications which can occur. Finally, statistic results are discussed which clearly show a remarkable decrease of the residual and recurrent stone rate in comparison to conventional kidney stone surgery. PMID- 3811038 TI - Surgical therapy. AB - Conventional stone operations have decisively receded into the background due to modern methods of stone removal, e.g., extracorporeal shock-wave lithotripsy and endoscopic stone removal. The disadvantages of these modern methods are discussed. Because there are no complications by the conventional technics, which are still practised, the technical details are also discussed. PMID- 3811040 TI - Outpatient urologic surgery. PMID- 3811039 TI - Mild metabolic hyperoxaluria and its response to pyridoxine. AB - Three cases of mild metabolic hyperoxaluria (with glycollaturia) are described. They showed different types of response to pyridoxine. One responded to low dose, one responded at first to low dose but became resistant, and the third showed temporary response to high dose. One case also had primary hyperparathyroidism and one had medullary sponge kidneys and hypercalciuria. It is important to measure urinary oxalate (and glycollate) in all cases of calcium oxalate urolithiasis. PMID- 3811041 TI - Development and organization of outpatient surgery units: the hospital's perspective. AB - Many indicators suggest continued growth in the ambulatory surgery arena. Economic pressures, technology, and third-party payers are contributing to this trend. Hospital admissions and inpatient stays are declining. The patient base is shifting to more economical settings. The impact of these factors has been considered throughout this discussion. These occurrences have prompted hospitals to diversify and to create organizational structures that provide opportunities for a total health care business approach. The success of ambulatory surgery programs developed by hospitals has been a major contributor to the continuation of these reorganization efforts. Acceptance on the part of patients and physicians is the major contributing factor to the continued growth of outpatient surgery units. Marketing techniques and consumer-oriented programs, coupled with efficiency and reduced costs, also assure that the ambulatory surgery phenomenon is here to stay. PMID- 3811042 TI - Needle aspiration and needle biopsy procedures. AB - Needle biopsy of the prostate, employing large "core" needles and performed via the transperineal or transrectal routes, is a well-established method for diagnosing prostatic malignancy. This procedure can be performed safely under local anesthesia in an outpatient setting. Rectal cleansing and prophylactic antibiotics have minimized infectious complications following transrectal biopsy, and it remains the favored technique in patients with small lesions. Repeat biopsy under anesthesia is indicated when the clinical suspicion of malignancy remains high despite negative biopsies. In contrast to "core" needle biopsy, which obtains a cylinder of tissue for histologic examination, the fine-needle biopsy obtains a specimen for cytologic examination. If cytologic expertise is unavailable locally, the specimen may be fixed in the office and shipped to a major medical center for interpretation. Fine-needle aspiration may be safely employed to biopsy the prostate, pelvic masses, and inguinal and pelvic lymph nodes. Biopsy of palpable masses can be done simply and safely with morbidity akin to venipuncture. Nonpalpable tissues may be biopsied under radiographic guidance. Fine-needle aspiration biopsy is safe and cost-effective, has resulted in a significant improvement in the accuracy of our clinical staging, and has spared many patients unnecessary surgical procedures. PMID- 3811043 TI - Accreditation of ambulatory surgery centers. AB - Accreditation is required for outpatient surgery facilities not only to assure quality patient care but also to obtain a facility fee reimbursement from many insurance companies. General guidelines concerning subjects considered by the JCAH and the AAAHC in the accreditation process have been reviewed. Because actual physical construction features may affect accreditation, those planning office-based and other types of outpatient surgery facilities should be aware of accreditation requirements before construction is begun. PMID- 3811044 TI - Transurethral resection of prostate and bladder tumors. AB - Endoscopic surgery of the prostate and bladder can be accomplished safely, efficiently, and economically, using outpatient or abbreviated-stay procedures. Local anesthetics rather than more traditional spinal or general techniques may also be used. Guidelines and techniques are described. PMID- 3811045 TI - Laser treatment of bladder carcinoma and genital condylomata. AB - The lasers most amenable to urologic surgery are the CO2, argon, and neodymium:YAG lasers. An understanding of the characteristics of these lasers is essential to the choice of the proper laser for the individual urologic condition to be treated. The relative advantages and disadvantages of all modes of therapy for bladder carcinoma and condylomata are discussed. PMID- 3811046 TI - Varicocele and its surgical management. AB - A discussion of the present role of varicocele in the management of the subfertile couple is presented, with emphasis on detection techniques and the increasing awareness of the presence of bilateral varicocele. The indications and techniques of surgical management are discussed, with particular emphasis on the use of the operating microscope to dissect the spermatic cord at the level of the external inguinal ring under local anesthesia on an outpatient basis with significant cost savings to the patient. PMID- 3811047 TI - Outpatient embolotherapy of varicocele. AB - A detectable balloon technique for precise embolotherapy of varicocele has been developed. Results in 334 patients whose internal spermatic veins were occluded between 1979 and 1985 indicate satisfactory restoration of fertility with minimal morbidity and cost. PMID- 3811048 TI - Surgery of scrotal contents. AB - Almost every scrotal operation may be done with local anesthesia. Occasionally general anesthesia may be elected, but the basic orientation to scrotal surgery should be with local anesthesia as long as the operation can be completed within 3 hours. The only scrotal operation for which I routinely elect general anesthesia is bilateral vasoepididymostomy because this is the only scrotal procedure that takes over 3 hours. Very rarely a scrotal hernia or a huge hydrocele obscures the cord, preventing administration of local anesthesia. Aside from these rare exceptions, I perform all scrotal surgery with local anesthesia. The use of preoperative sedation makes it possible for all patients to tolerate the small amount of discomfort associated with injection of a local anesthesic. Once the anesthetic is injected, scrotal surgery is painless. Regardless of the choice of local or general anesthesia, virtually all patients are discharged to home on the day of surgery. All scrotal surgery should be considered to be ambulatory surgery. PMID- 3811049 TI - Vasectomy. AB - Vasectomy is an excellent method of permanent contraception for the couple whose family is complete, who are mature and fully informed, and who will accept permanent sterility. It is also valuable in preventing bacterial epididymitis. Vasectomy is customarily performed in the office or clinic setting under local anesthesia. Many techniques may be used, but the cut-fulgurate-and-cover technique has never failed in my experience. Postoperative testing is mandatory, and negative results on two samples, collected one month apart, will ensure that delayed spontaneous recanalization has not occurred. The specific complications of vasectomy are spermatic granulomas of vas or epididymis, congestive epididymitis, and antisperm antibodies. Numerous studies have shown no deleterious effects upon the patient's general health. Manhood, pleasure, and sensation are unchanged, and the woman need no longer fear the possibility of an unwanted pregnancy. PMID- 3811050 TI - Vasectomy reversal. AB - A vasovasostomy may be performed on an outpatient basis with local anesthesia, but also may be performed on an outpatient basis with epidural or general anesthesia. Local anesthesia is preferred by most of my patients, the majority of whom choose this technique. With proper preoperative and intraoperative sedation, patients sleep lightly through most of the procedure. Because of the length of time often required for bilateral microsurgical vasoepididymostomy, epidural or general anesthesia and overnight hospitalization are usually necessary. Factors influencing the preoperative choice for vasovasostomy or vasoepididymostomy in patients undergoing vasectomy reversal are considered. The preoperative planned choice of vasovasostomy or vasoepididymostomy for patients having vasectomy reversal described herein does not have the support of all urologists who regularly perform these procedures. My present approach has evolved as the data reported in Tables 1 and 2 have become available, but it may change as new information is evaluated. However, it offers a logical method for planning choices of anesthesia and inpatient or outpatient status for patients undergoing vasectomy reversal procedures. PMID- 3811051 TI - Testicular biopsy and vasography in the evaluation of male infertility. AB - Testicular biopsy is performed mainly to differentiate primary testicular failure from obstructive ductal lesions (usually occurring in the epididymis in azoospermic patients who have normal serum gonadotropins). Testicular biopsy may be performed easily on an outpatient basis with excision of a small piece of seminiferous tissue using a "no-touch" technique. Needle core biopsy and needle aspiration biopsy may become more widely used in the future. The role of flow cytometry for purposes of interpreting testicular specimens may be expanded in the future. Vasography should be performed only at the time of planned definitive correction of obstructive lesions of the genital duct system. Various techniques of performing vasography are discussed. Emphasis is placed on deferring vasography until the time that definitive surgery is performed to correct the patient's ductal obstruction. In that regard, vasography therefore generally is not performed as an isolated outpatient procedure. PMID- 3811052 TI - Semirigid and malleable penile implants. AB - Unless complications such as infection, erosion, or excessive bleeding develop and unless an inordinate number of malpractice suits ensue, I believe that the outpatient setting for implantation of a penile prosthesis will become increasingly utilized. As emphasized at the beginning of this article, the essential basis for success is thorough evaluation of the candidates for implantation, detailed and documented informed consent, and the elimination as outpatient candidates of poor-risk patients such as certain insulin-dependent diabetics. Patients who are good surgical and postsurgical risks are totally acceptable for outpatient operation. The cost to the patient and insurance carriers is drastically reduced. There is every reason to believe that, in the hands of the highly qualified surgeon, this type of intervention is safe, reliable, and cost-effective. PMID- 3811053 TI - Outpatient pediatric urologic procedures. AB - Outpatient pediatric urologic surgery is not a new concept. However, it has recently become extremely popular. The general experience nationwide and particularly the experience at Children's Hospital of Philadelphia and the University of Virginia Hospital indicate that outpatient surgery can be very safe and satisfactory for patients. The outpatient approach requires close cooperation among anesthesiologists, surgeons, and outpatient personnel. Excellent communication with the patient and family is essential. This includes extensive educational printed material and 24-hour availability by telephone. Once the infrastructure is in place, outpatient pediatric urologic surgery results in efficient use of facilities and a more pleasant surgical experience for the patient. The psychological, social, and economic benefits of outpatient surgery make it imperative that a large percentage of pediatric procedures be done on an ambulatory basis. We do not, however, intend to suggest that all minor procedures can be done on an outpatient basis, as certain special situations will mandate hospitalization. PMID- 3811054 TI - Bladder neck suspension for stress incontinence as an outpatient procedure. AB - Simplified but effective operative techniques have made surgery for stress incontinence less hazardous and traumatic and more acceptable to these patients. Transvaginal needle vesical neck suspensions, by avoiding splitting of the fascia of the abdominal wall, decrease postoperative discomfort and convalescence. Various modifications of the original Pereyra needle vesical neck suspension are currently in use. Probably the simplest and most effective is a technique reported by Raz, which the authors employ as an outpatient procedure and describe here. PMID- 3811055 TI - Nursing aspects of outpatient surgery. AB - The increase in outpatient care presents a unique opportunity for health team members and particularly nursing practitioners to participate in cost-saving practices. The ambulatory surgery setting requires participation in all aspects of patient care, from admission through discharge and provides a comprehensive environment for the practice of perioperative nursing. It also presents a unique challenge to encourage the patient to become a more active participant in the regimen of care, encouraging activities that will assist in goal setting and evaluation of care. PMID- 3811056 TI - Complicated implantations of inflatable penile prostheses. AB - In conclusion, implantation of an inflatable penile prosthesis into a normal penis is usually a relatively uncomplicated procedure, but the urologist should be aware of the possibility of complications described in this article. He must be familiar with the advantages and disadvantages of the various prostheses and the surgical techniques required to deal with the problems encountered in complicated as well as in routine prosthetic penile implants. PMID- 3811057 TI - Office ambulatory surgery in urology. AB - Because of the developments in urologic instruments and procedures and the new medications used in intravenously assisted local anesthesia, most urologic operations and procedures can be performed in an appropriate office surgical suite. In-office surgery costs are lower, physician time is optimized, patients are happier, and excellent quality care can be assured. Accreditation by the Accreditation Association for Ambulatory Health Care and Medicare licensure both make facility fee reimbursement adequate for maintenance of a high-quality surgical facility. PMID- 3811058 TI - Outpatient general and spinal anesthesia. AB - By the year 1990, it is projected that 50 per cent of all surgery in the United States will be performed on an outpatient basis. Both surgeons and anesthesiologists must understand patient and procedure prerequisites for outpatient surgery. The surgeon, prior to scheduling the operation, must evaluate the patient as to acceptability and provide that patient with complete information about the proposed outpatient experience. Anesthesia techniques (premedication, intravenous, inhalational, regional) must be modified and adapted to accomplish early patient ambulation and discharge to home on the same day as surgery. Patients must meet established clinical criteria prior to discharge and must be examined by a physician at the time these criteria have been met. The physician's clinical judgment is the single most important factor in determining the patient's home readiness. PMID- 3811059 TI - Regional anesthesia for urologic procedures. AB - Most urologic procedures can be performed under regional blockade anesthesia. These techniques present specific advantages, including the avoidance of the consequences of general anesthesia. The employment of regional anesthesia is a skill requiring knowledge of anatomy and of the desirable and undesirable actions of local anesthetic agents. Sedation of patients undergoing regional blockade offers specific advantages that may contribute to the patient's comfort and safety. PMID- 3811060 TI - Pediatric outpatient anesthesia. AB - Successful anesthetic management of children undergoing outpatient surgery requires that the surgeon and anesthesiologist be actively involved in all aspects of management. Guidelines should be established in consultation with the surgeons, nurses, and administrators to ensure proper selection and preoperative preparation of patients. The psychological evaluation and preparation of children, and the use of pharmacologic premedication when indicated, will ensure a pleasant experience for all involved. The anesthesiologist should choose a specific anesthetic agent and a technique that are appropriate for each individual child. Use of "routine" induction techniques is rarely, if ever, appropriate. Early ambulation and discharge are very desirable in outpatients. Long-acting drugs and techniques that are associated with excessive drowsiness or nausea and vomiting should not be utilized. Special attention must be paid to the analgesic requirements of the child. Regional blocks should be used whenever possible to supplement "light" general anesthesia and to limit the need for narcotics during recovery. Specific criteria for discharge ensure the safety and protection of the child and staff. PMID- 3811061 TI - Extracorporeal shock-wave lithotripsy. AB - Analysis of our data clearly demonstrates that morbidity, secondary treatment, post-treatment manipulations, and failure of treatment increase as the stone size increases because of the increased stone fragment burden. Patients whose stone burden was less than 2 cm clearly had less morbidity. Composition of the stone may also alter the success of treatment (with cystine, calcium oxalate monohydrate, and brushite stones being resistant to treatment). However, post treatment morbidity and complications were observed in all categories. Perirenal hematomas are unpredictable by current preoperative testing. Obstruction with pain can occur any time after treatment but usually occurs within the first 48 hours in the majority of patients. Only 1 per cent of our patients required hospitalization in another institution after discharge. Ambulatory ESWL requires that staff at the facility or a urologist be able to observe and appropriately follow the patient for 24 to 48 hours after treatment. PMID- 3811063 TI - Outpatient endourologic procedures. AB - Many endourologic procedures can be performed routinely on an outpatient basis, including flexible cystoscopy, ureterorenoscopy, and percutaneous nephroscopy through a mature tract. Others, such as percutaneous nephrostomy, nephrostolithotomy, and antegrade ureteral stent placement, can sometimes be done on an outpatient basis. This article describes the indications, techniques, postoperative care, and results of these procedures. PMID- 3811062 TI - Practical aspects of outpatient extracorporeal shock-wave lithotripsy. AB - Outpatient ESWL is practical for the majority of patients undergoing treatment. However, careful preoperative evaluation and patient selection are necessary. Approximately 15 per cent of patients treated require a secondary procedure. We believe that pretreatment placement of a ureteral stent aids in the passage of stone fragments. PMID- 3811064 TI - [Valves of the posterior urethra and reflux megaloureter in children]. PMID- 3811065 TI - [Internal drainage of the kidney in treating cavernous nephrotuberculosis complicated by a ureteral lesion]. PMID- 3811066 TI - [Simultaneous operations on the female urinary and genital organs]. PMID- 3811067 TI - [Treatment of chronic urethritis in women by ultrasonic phonophoresis]. PMID- 3811068 TI - [Role of the thyroid in the pathogenesis of the renal form of primary hyperparathyroidism]. PMID- 3811069 TI - [Clinico-diagnostic parallels in ovarian varicocele]. PMID- 3811070 TI - [Diagnostic significance of determining 3-hydroxyanthranilic acid in patients with precancerous diseases and cancer of the bladder]. PMID- 3811071 TI - [Effectiveness of the combined action of renal artery embolization and large fraction radiation therapy in kidney cancer kidneys]. PMID- 3811072 TI - [Radiation therapy in the combined treatment of prostatic cancer patients]. PMID- 3811073 TI - [Conservative pathogenetic treatment of fibroplastic induration of the penis]. PMID- 3811074 TI - [Method for the objective recording of the bulbocavernosus reflex in men]. PMID- 3811075 TI - [Multilocular cyst of the kidney]. PMID- 3811076 TI - [Experimental study of the electrical activity of the ureter]. PMID- 3811077 TI - Crystalluria in marathon runners. 1. Standard marathon--males. AB - Epidemiological evidence suggests that marathon runners have a higher incidence of renal stone formation than occurs in the general population. Since crystalluria and stone disease are thought to be related, we subjected urine samples from a group of marathon runners to particle counting and sizing in a Coulter Counter equipped with a population accessory unit. The volume-size distribution curves so obtained were bimodal with one peak occurring in the 2-5 micron diameter range and a second in the 15-32 micron diameter range - a pattern that is remarkably similar to the distributions reported for recurrent idiopathic stone formers and distinctly different to those recorded for control subjects. Analyses by scanning electron microscopy and X-ray powder diffraction revealed other features which are regarded as typical of stone formers' crystalluria. These physicochemical data indicate that marathon runners may be at increased risk of urinary stone formation. PMID- 3811078 TI - The effects of extracorporeal shock wave lithotripsy on urological prostheses and endoprostheses. AB - The combination of ESWL and Endourology (EU) enables a wider range of stones to be treated without open surgery than either modality alone. EU frequently involves the maintenance of a plastic prosthesis in or near the area of maximal shock wave concentration during ESWL. Prostheses subjected to a standard test treatment by ESWL and others removed from patients after ESWL were examined visually, microscopically and biochemically by electron microscopy (SEM) and X ray emission spectroscopy (XES) to investigate the effects of ESWL on the prosthesis itself. Foley catheter balloons leaked. Previously smooth surfaces were disrupted and possibly toxic additives may be released. Care should be taken in selecting indwelling EU prostheses if ESWL treatment is likely to follow. PMID- 3811079 TI - Ammonium urate urinary stones. AB - Until the last century, ammonium urate stones were quite common in preindustrial Europe. In contemporary practice these stones are found in developing countries, and are associated with uric acid and ammonium-enriched urine. Such conditions may occur with urealytic infection, resulting in mixed ammonium urate/magnesium ammonium phosphate precipitates and urinary phosphate deficiency of alimentary origin, resulting in precipitates free of magnesium ammonium phosphate, in sterile urine. The latter situation is closely related to a diet poor in phosphate and to a low fluid intake common in endemic lithiasis areas. Ammonium urate and uric acid have different solubility patterns dependent on pH, and consequently treatment will be different in each case. PMID- 3811080 TI - Ammonium urate urolithiasis in the rat with portocaval shunt--some aspects of mineral metabolism and urine composition. AB - In the male rat the effects of portocaval shunt (PCS) on mineral metabolism (fractional intestinal absorption, minerals in serum, in bone, in kidney, and in urine) and the effects on urinary constituents were studied. PCS induced a degree of hyperparathyroidism and the formation of ammonium acid urate urinary tract stones. These phenomena were associated with elevated uric acid, ammonium, urinary pH, as well as with elevated supersaturation of urine with struvite, and to a lesser degree with ammonium acid urate. It is suggested that in the rat PCS interferes with both parathyroid gland function and urinary nucleation of ammonium acid urate. PMID- 3811081 TI - Persistent hypercalcemia after neck exploration--an analysis of 34 cases. AB - A retrospective analysis of 34 patients undergoing 45 re-explorations for persistent hypercalcemia is presented. Thirteen out of the 20 enlarged parathyroid glands were found at reoperation to be normally located, indicating that the initial exploration had been incomplete. A follow-up study of the reoperated patients showed that 25 (74%) were normocalcaemic. Three patients had permanent unilateral recurrent laryngeal nerve damage and 2 patients required calcium and/or vitamin D therapy. Ultrasonography was effective in the diagnosis and localisation of residual parathyroid adenoma in patients with persistent postoperative hyperparathyroidism. PMID- 3811082 TI - Activity of phagocytic granulocytes in patients with prostatic cancer. AB - Chemilumenescence (CL) occurs due to the phagocytosis of bacteria and of tumor cells by polymorphonuclear neutrophils (PMN). Levels of CL were measured in patients with prostatic cancer and from normal subjects. Patients with advanced disease (stage C, D) showed no elevated CL levels as compared to healthy individuals or patients with minimal disease (stage A, B). Following external radiation therapy in patients with stage A-C prostatic carcinoma high levels of CL were recorded. Estrogen medication also resulted in increased CL levels, while estramustine did not affect phagocytic activity. Intradermal BCG vaccination caused increased PMN activity. Progressive prostatic cancer in hormone treated patients was associated with increased CL as compared to patients with stable or regressive disease. PMID- 3811083 TI - [Transurethral ureterolithotripsy in the treatment of ureteral calculi]. AB - We report our experiences with transurethral ureterolithotripsy for treatment of ureteral calculi in 68 patients. 67% of the ureteral stones were extracted successfully. Failures and complications occur often by higher localisation of concrements. Only in 2 patients major complications occurred. Late complications (Ureter Manipulation Syndrome-UMS) were not observed in our patients. In cases with ureteral perforations or mucous membrane lesions ureteral stent must be used. PMID- 3811084 TI - [Spontaneous adrenal gland hemorrhage in adults]. AB - Three cases of the very rare spontaneous unilateral adrenal hemorrhage in adults are described. The main symptoms are hemorrhagic shock, flank pain and fever in some cases. Most important for diagnosis are ultrasound, i.v. pyelogram and computed tomography. In case of emergency computed tomography is the most decisive diagnostic step before removing the adrenal gland. The preferred operative approach is through the 10th intercostal space. No Postoperative corticoid hormone substitution is necessary. PMID- 3811085 TI - [Ureteral injuries in intervertebral lumbar disk surgery]. AB - In lumbar disc surgery ureteral transection is a rare complication and only nine such cases have been reported so far. They are analyzed and two more cases are described. The complication in the first case was recognized immediately and the patient was treated successfully by end-to-end anastomosis of the ureter. The diagnosis in the second case was delayed and this lead to a septic course and finally required nephrectomy. PMID- 3811086 TI - [Vesico-uterine fistula]. AB - The incidence of vesico-uterine fistulas is very low; they can develop from normal delivery, malignant tumors, inflammations and iatrogenic lesions. The increased number of cesarean sections during the past years should also be considered. Two patients are presented. Symptoms, diagnostic and therapy are discussed. PMID- 3811087 TI - [Indications and results of Politano-Leadbetter antireflux-plasty in 565 cases of ureterorenal surgery]. AB - The Politano-Leadbetter antireflux procedure is a standardized and safe method for the treatment of primary and secondary reflux persisting after successful therapy of infravesical obstruction. Indications for antireflux surgery depend on reflux classification, age, urethral calibration and evaluation of position and shape of the ureteral orifice, associated malformations and successful antimicrobial therapy. Reflux was cured in 90.4 per cent of 565 ureterorenal units in 361 children and 103 adults. A persisting reflux occurred in 5.1 per cent and a stenosis of the terminal ureter requiring reimplantation occurred in 0.7 per cent. The overall rate of reinterventions was 8.1 per cent. This low complication rate makes surgical correction advisable if urinary tract infection and primary reflux cannot be eradicated by continuous antimicrobial therapy. PMID- 3811088 TI - Outpatient extracorporeal shock-wave lithotripsy. AB - Extracorporeal shock-wave lithotripsy (ESWL) is a new procedure for which patient management guidelines are still being established. We retrospectively reviewed the first 246 patients treated with ESWL at our facility. Nearly 50 per cent were treated as outpatients, and more than 70 per cent of patients admitted to the hospital were discharged on the first day after ESWL. We conclude that outpatient ESWL is feasible, but that further study is necessary to improve selection of patients for this procedure. PMID- 3811089 TI - Computerized tomography and acute pyelonephritis in children. A clinical correlation. AB - The clinical records and computerized tomography (CT) scans of 14 patients who presented with pyelonephritis to the Children's Hospital of Buffalo between 1976 1985 have been reviewed. The CT findings were as follows: multifocal pyelonephritis (6), lobar nephronia (6), focal pyelonephritis (2). All patients were treated with intravenous antibiotics, and none was surgically drained. Significant underlying diseases were present in 8 patients: diabetes (6), von Gierke disease (1), hepatorenal syndrome (1). The diabetic children tended to have focal disease. Ten voiding cystourethrograms were performed and only four demonstrated reflux. All children became afebrile within a few days. Lobar nephronia was as clinically responsive as pyelonephritis to antibiotic therapy. Urine cultures were most often positive, although there was 1 patient in each category with negative cultures. Blood cultures were rarely positive in any group. Gram negative organisms predominated. CT scanning in children with clinical acute pyelonephritis reveals three major imaging patterns. While distinct radiographically, they behave in a similar clinical manner. Lobar nephronia does not imply a worse clinical prognosis. Intravenous antibiotic therapy alone was adequate for all patients. PMID- 3811090 TI - Some guidelines in use of lasers in renal surgery. AB - Some guidelines for the use of lasers in renal surgery are presented. The carbon dioxide laser was successfully used in 9 patients with diverse renal pathology (staghorn calculus, 4 patients; renal tumor, 3 patients; congenital arteriovenous (A-V) fistula, 1 patient; segmental chronic atrophic pyelonephritis, 1 patient) as an excisional tool, allowing us to reduce intraoperative blood loss, decrease operating time, and preserve the functional integrity on the remaining renal segment. This modality appears to be a safe addition to the urologic armamentarium, when used as an excisional tool in renal surgery. PMID- 3811091 TI - Role of spongiosography in study of penile veins. AB - Spongiosography can help visualize the same venous system seen in cavernosography during erection with papaverine. In 4 cases where the deep dorsal vein was ligated, spongiosography was used to demonstrate why improvement was not sustained. These ligations were not successful because the deep dorsal vein can rechannel through small veins at the site of excision. Furthermore, the external pudendal vein may divert the blood into the femoral vein after dorsal vein ligation. The distribution of the circumflex veins at the level of the spongiosal bodies represents a formidable anastomotic network of veins that bypass all attempts to restrict deep dorsal vein outflow. PMID- 3811092 TI - Penile prosthesis: review of current models, mechanical reliability, and product cost. AB - A fifty-year experience with the modern penile implant has led urologists to conclusions as to the reliability, applicability, and cost of these devices. Product evolution has led to a more physiologic erection. However, with increased sophistication, further potential for failure must be considered. Each modification must undergo the test of clinical experience in addition to classic bench testing in order to predict reliability accurately. PMID- 3811093 TI - Yield of cancer tissue from prostatic needle biopsy. AB - This study concerns the quality of human prostatic cancer needle biopsy specimens for routine diagnosis and for bioassay. We examined routine hematoxylin and eosin stained microscopic sections from 20 prostatic cancer patients, 159 needle cores in all, 71 positive for tumor. Linear core measurements were made with a calibrated ocular micrometer, each segment counted positive if it contained any tumor. Among all subjects there were 35.5 cm of tumor-bearing core length, 26 per cent of the total core length but 60 per cent of the length if completely negative cores were excluded. From these data we calculate a 91 per cent probability of detecting any cancer present if at least 4 cores are taken. PMID- 3811094 TI - Effect of urinary extravasation on renal wound healing in dogs. AB - It is frequently stated that extravasation of urine after intrarenal surgery is deleterious to renal wound healing causing fibrosis or granulation tissue. A study using dogs was designed to test the hypothesis that the contact of urine with incised renal parenchyma may cause altered wound healing. This study showed that exposure of the renal parenchyma to extravasated urine from open collecting structures did not alter renal healing. PMID- 3811095 TI - Ureteral endoscopy with passively deflectable, irrigating flexible ureteroscopes. AB - Flexible, passively deflectable fiberoptic ureteroscopes were used in 18 selected patients. The flexible endoscope must be stabilized with a cystoscope, flexible introducer sheath, or guide wire for placement through the urethra and bladder into the ureter. Irrigation through the instrument is beneficial in clearing the visual field and distending the lumen. These instruments can visualize the lumen of the ureter, and the medial and superior portion of the renal pelvis and intrarenal collecting systems. Their diagnostic value is limited to selected clinical situations. PMID- 3811096 TI - Modification of and expanded indications of MAGPI procedure in hypospadias. AB - Experience with the MAGPI (meatoplasty and glanuloplasty) procedure in hypospadias repair, a modification of the procedure, and expanded indications for its use are presented. The excellent cosmetic results attained warrant more widespread use of this procedure. PMID- 3811097 TI - Videoprostatectomy. AB - Videoprostatectomy is discussed. A few cases have been performed, but many more need to be done to determine the safety of this procedure. PMID- 3811098 TI - Pathologic effects of ESWL on canine renal tissue. AB - The introduction of extracorporeal shock wave lithotripsy (ESWL) has provided an avenue for dealing with many urinary stones noninvasively. The margin of safety for the kidney during shock wave administration is largely undefined. A pilot study was performed where six kidneys in five female mongrel dogs were shocked. Group A kidneys were given 1,776, 4,500, 6,000, or 8,000 shocks, respectively, at 18-24 kV. Group B kidneys received 1,600 and 8,000 shocks (18-24 kV). The number of shocks per electrode ranged from 500 to 4,538 and averaged 2,490. The dogs were sacrificed forty-eight to seventy-two hours (Group A) or twenty-eight to thirty-two days (Group B) post-treatment. Modest damage (hematoma and/or interstitial hemorrhage) was noted in all kidneys. Evidence of permanent change (fibrosis) was noted in both Group B kidneys. Complete necrosis of the kidney was not seen after administration of 8,000 shocks. These preliminary data indicate that lithotripsy can, in some circumstances, produce renal damage in the canine model. PMID- 3811099 TI - Hypogonadism in Prader-Willi syndrome. AB - Prader-Willi syndrome is characterized by eating abnormalities, infantile hypotonia, obesity, mental retardation, and hypogonadism. The causation of hypogonadism varies. We describe a patient with Prader-Willi syndrome whose hypogonadism is secondary to a hypothalamic defect. Individualization of patients with this syndrome is suggested. Based on the particular hormonal abnormality identified, a treatment plan can be constructed. Cryptorchidism should be approached in the usual fashion. PMID- 3811100 TI - Transitional cell carcinoma in ureteral stump after radical nephrectomy for renal cell carcinoma. AB - In a seventy-five-year-old white man gross total painless hematuria developed one year after right radical nephrectomy for renal cell carcinoma. Results of physical examination, laboratory studies, intravenous pyelography, and cystoscopy were normal at that time. One year later, the patient had another episode of gross hematuria. Once again, physical examination, laboratory values, intravenous pyelogram, and cystogram were normal. A right retrograde ureterogram revealed a midureteral filling defect. Total ureterectomy and bladder cuff excision ensued. Pathologic examination revealed well-differentiated transitional cell carcinoma without muscle invasion. PMID- 3811101 TI - Removal of pheochromocytoma by enucleation. AB - In 6 cases pheochromocytomas were removed by enucleation. A typical case is reported in detail illustrating that it might be a procedure of choice in avoiding the risk of injuring the great vessels during operation. PMID- 3811102 TI - Skin metastases from transitional cell bladder cancer. AB - Three cases of transitional cell bladder cancer metastatic to skin are described. This manifestation of transitional cell uroepithelial malignancy was previously believed to be quite uncommon. The authors' experience suggests that this occurrence is not that rare and that it may reflect increased longevity in successfully treated patients, allowing previously unusual manifestations of metastatic disease to become evident. The role of aspiration skin biopsy is discussed. PMID- 3811103 TI - Flow cytometry based on heterogeneity index score compared with urine cytology to evaluate their diagnostic efficacy in bladder tumor. AB - Flow cytometric (FCM) examination of DNA distribution based on heterogeneity index score (HIS) and ploidy pattern and of bladder irrigation specimens were compared with conventional urine cytologic examinations to evaluate the diagnostic efficacy of each method. Of 56 patients with histologically proved bladder tumors, 24 (43%) had positive urine cytology, 41 (73%) had positive FCM, and 45 (80%) had positive urine cytology and/or positive FCM. When bladder tumors were graded histologically, 8 of 11 patients (73%) with grade I bladder carcinoma, 22 of 28 patients (79%) with grade II, and 15 of 17 patients (88%) with grade III had positive urine cytology and/or positive FCM. Of the 28 patients with grade II, 12 with positive urine cytologic results had higher mean HIS (117.5) when compared with 16 (61.1) in whom urine cytology was negative. Of those who continued to have positive FCM in the face of negative findings on cystoscopic and urine cytologic examinations during follow-up, 3 patients eventually were found to have tumors (2 distal ureter, 1 bladder). These results indicate that FCM examinations for DNA distribution of bladder irrigation specimens are as useful as conventional urine cytology in the management of bladder tumors, can be more sensitive for detection and monitoring of the disease, and can contribute further to accurate diagnosis of the disease when combined with conventional urine cytology. PMID- 3811104 TI - Micturition pattern in hyperthyroidism and hypothyroidism. AB - Micturition pattern was investigated in 61 consecutive patients with thyroid disease. The patients were divided into three groups: hyperthyroid, hypothyroid, and euthyroid. Micturition pattern was examined after the first visit to the hospital and again six months later, when thyroid function had been restored to normal. Hyperthyroid patients had significantly increased micturition frequency as well as nocturia compared with their own control group when euthyroid (p less than 0.01). Hypothyroid patients had reduced micturition frequency compared with their own control group (p = 0.05). No significant changes were found in the euthyroid group. Which mechanisms might be responsible for the relationship between thyroid function and micturition pattern is debatable, and calls for further urodynamic and electrophysiologic studies. One conclusion is that thyroid disease should be borne in mind when patients present with unexplained urinary frequency or retention. PMID- 3811105 TI - Intravaginal pressure recording as alternative to intrarectal pressure monitoring. PMID- 3811106 TI - Calcified mesenteric cyst mimicking obstructing ureteral calculus. PMID- 3811107 TI - Importance of prone-position film during intravenous urography in detection of bladder tumors. AB - Three patients with neoplasms on the anterior wall or dome of the urinary bladder underwent intravenous urography (IVU). In each case, the lesion was detected only on the prone-position radiograph. Contrast medium layers in the dependent part of the bladder. If all filming is performed with the patient in supine position, lesions on the anterior wall may be undetected. We advocate routine inclusion of one prone-position film during IVU. PMID- 3811108 TI - [Mass transfer and resonance as the basis of the common theory on hearing and the origin of neurosensory deafness]. PMID- 3811109 TI - [Reaction of the acoustic analyzer to endaural phonophoresis in patients with toxic cochlear neuritis]. PMID- 3811110 TI - [Cochlear implantation in chronic experiments]. PMID- 3811111 TI - [Measuring the frequency resolution capacity of hearing in the normal state and in neurosensory hearing loss]. PMID- 3811112 TI - [Comparative evaluation of various methods of treating patients with otogenic brain abscess]. PMID- 3811113 TI - [Growth of cicatricial membranes to replace missing tympanic membrane]. PMID- 3811114 TI - [Hearing disorders in patients with acute neurosensory hearing loss of viral and vascular etiologies]. PMID- 3811115 TI - [Cerebral hemodynamics in Meniere's disease]. PMID- 3811116 TI - [Exudative otitis media in children]. PMID- 3811117 TI - [Laryngofibroscopy in reconstructive-plastic surgery of the larynx with endoprosthesis]. PMID- 3811118 TI - [Effect of antikinin drugs on the function of the ciliary epithelium of the trachea]. PMID- 3811119 TI - [Use of corundum ceramics in surgical interventions on the maxillary and frontal sinuses (clinico-experimental study)]. PMID- 3811120 TI - [Microcirculation in patients with vasomotor rhinitis and its dynamics before and after the therapeutic use of laser irradiation]. PMID- 3811121 TI - [A laser coagulator in otorhinolaryngology]. PMID- 3811122 TI - [Current methods of diagnosing intracranial abscesses in otorhinolaryngologic practice]. PMID- 3811123 TI - [Differential medical rehabilitation of industrial workers with diseases of the upper respiratory tract]. PMID- 3811124 TI - [Characteristics of immunologic disorders in patients with precancerous conditions and cancer of the larynx]. PMID- 3811125 TI - [Lipoma of the trachea]. PMID- 3811126 TI - [Superficial abscess of the root of the tongue complicated by parapharyngeal phlegmon]. PMID- 3811127 TI - [Orbital complications in children with sinusitis]. PMID- 3811128 TI - [Nasopharyngeal teratoma in a 5-year-old child]. PMID- 3811129 TI - Cytologic differentiation of benign from malignant canine mammary tumors. AB - Cytologic and histologic examination of 91 canine mammary masses was performed by two cytologists and two histopathologists. Ten important cytologic criteria of malignancy for canine mammary tumors were identified. A cytologic grading system for differentiation of benign from malignant mammary tumors was proposed using these criteria. With this system, approximately one fourth of the malignant mammary tumors were given a concordant cytologic diagnosis. Approximately one half of the benign masses were given a concordant cytologic diagnosis by the two cytologists. One-half of all the tumors examined were given inconclusive cytologic diagnoses by both cytologists. The cytologic identification of spindle cells did not differentiate complex and mixed mammary tumors from simple tumors. Only five of the animals studied died of mammary cancer, precluding a critical analysis of the cytologic criteria for prediction of cancer mortality. PMID- 3811130 TI - Electronic measurement of erythrocyte volume and volume heterogeneity in horses during erythrocyte regeneration associated with experimental anemias. AB - Anemia was induced in three groups of horses by moderate or severe acute hemorrhage, or by acetyl phenylhydrazine-induced hemolysis (Groups I, II, and III, respectively). Serial hemograms were done on a multichannel automated blood cell counter with histogram capability. Changes in hematocrit, mean cell volume, erythrocyte number, red cell distribution width (RDW), and standard deviation of erythrocyte volume were examined over time. Significant increases in mean cell volume were first detectable by days 17, 20, and 14 and reached maximum by days 43, 41, and 29, in Groups I, II, and III, respectively (P less than 0.05). Increased mean cell volume was interpreted as reflecting accelerated erythrocyte regeneration; however, not all horses with accelerated regeneration had changes in mean cell volume. Estimated erythrocyte production rate correlated poorly with hematocrit nadir and change in mean cell volume (r = 0.37 and r = 0.36, respectively, P greater than 0.05). In some horses effective regeneration occurs without development of macrocytosis. Mean cell volume remained increased after other parameters returned to control values, suggesting that mean cell volume values may provide retrospective evidence of altered erythrocyte turnover. Anisocytosis as indicated by significant increases in the standard deviation was greatest during the early part of the regenerative response, reaching maximum values on days 30, 28, and 21 in Groups I, II, and III, respectively, and began to decrease as homogeneous repopulation with macrocytes occurred. Red cell distribution width increased significantly only in severe hemorrhage and hemolysis groups, reaching mean maximum values of 24.3 on day 20 and of 26.4 on day 21 in Groups II and III, respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3811131 TI - Lesions and saliva-specific antibody responses in rabbits with immediate and delayed hypersensitivity reactions to the bites of Glossina morsitans centralis. AB - Rabbits exposed to feeding tsetse flies developed cutaneous hypersensitivity responses to fly bites. These responses had characteristics of immediate and delayed type hypersensitivity. Saliva components from the tsetse fly Glossina morsitans centralis were electrophoretically separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Major salivary proteins of 160, 92, 66, 64, 55, 42, 33, 28, and 15 kilodaltons were identified. Separated salivary components were transferred to nitrocellulose filters and probed with lectins and with whole sera and purified IgG from rabbits which had been exposed, via fly feeding, to tsetse antigens for variable periods. Many of the salivary proteins were identified as glycoproteins. Several major salivary proteins were recognized by antibodies from sensitized rabbits. PMID- 3811132 TI - The pathology of experimental Schistosoma curassoni infections in mice and hamsters. AB - The histopathology of experimental Schistosoma curassoni infections in white mice and hamsters was studied. In mice, hepatic lesions were severe with characteristic extensive perilobular fibrosis and large perilobular granulomas throughout the parenchyma. Only a few granulomas were detected in the lung, small intestine, and rectum of mice. In hamsters, lesions in the liver were limited. Few granulomas were found but the giant cell reaction was pronounced. Lesions in the lung and small intestine were minimal. Many subserosal and submucosal epithelioid cell granulomas were in the colon and rectum of hamsters. Parasites were not detected in the bladder of either mice or hamsters. PMID- 3811133 TI - Volume-controlled bronchopulmonary lavage of normal and pneumonic calves. AB - Saline bronchopulmonary lavage of the right lung of 16 anesthetized calves was performed using a single-lumen cuffed endotracheal tube. The initial volume of saline introduced was based on the functional residual capacity (FRC) of the right lung lobes as determined from the proportional weights of the right (58% of total FRC) and left (42% of total FRC) lung lobes. Calves were divided into "pneumonic" and "normal" groups based on clinical signs. Five sequential washes were done on each calf. There was no difference in the percentage of total lavage fluid volume recoverable between normal (83.8 +/- 4.2%) and pneumonic (81.1 +/- 8.2%) calves. Cell yield in the initial wash was consistently greater than in subsequent washes for both normal (12.7 +/- 6.6 X 10(6) cells/kg body weight) and pneumonic (58.1 +/- 37.6 X 10(6) cells/kg body weight) calves, and constituted 62.0% (normal) and 75.4% (pneumonic) of the total recoverable cell yield. Total cell yields were higher (P less than 0.05) in pneumonic calves, primarily due to neutrophil leukocytes (PMN). Neutrophils constituted 53.7 +/- 25% of the total cell yield in the pneumonic calves, but only 12.3 +/- 9.5% in the normal calves. The pulmonary alveolar macrophage (PAM) was the major recoverable cell in normal calves (85.7 +/- 8.7% of total lavage cells). Macrophages constituted a smaller (42.9 +/- 23.5) percentage of the total lavage cells in the pneumonic group due to increased PMN numbers. Viability of recovered cells from the pneumonic calves (91.5 +/- 4.8%) was lower than for the normal calves (94.1 +/- 2.5%), but the difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3811134 TI - Intravascular macrophages in lungs of pigs infected with Haemophilus pleuropneumoniae. AB - Pigs were inoculated intratracheally with a virulent or an avirulent isolate of Haemophilus pleuropneumoniae serotype 5 and sacrificed during the first 24 hours post-inoculation. Intravascular macrophages were examined by electron microscopic and morphometric techniques. Samples of lung were taken from regions with no macroscopic lesions (Zone 0), 2.5 to 3.0 cm from lesions (Zone 1), and from the immediate edge of lesions (Zone 2). Those pigs inoculated with the avirulent isolate did not develop lesions. Pigs given the virulent isolate consistently developed necrohemorrhagic lesions in the dorsolateral aspect of the caudal and middle lung lobes. Relative volumes of intravascular macrophages in Zones 1 and 2 increased with increased time post-inoculation; in pigs given the avirulent isolate, intravascular macrophage volume decreased with increased time post inoculation. Cytoplasmic volume to nuclear volume ratios for macrophages in Zone 2 from pigs with necrohemorrhagic lesions progressively increased with increased time post-inoculation. Enlarged intravascular macrophages had large nuclei, prominent nucleoli, and abundant cytoplasm. Increased cytoplasmic volume was the result of increased numbers of lysosomes, phagosomes, rough and smooth endoplasmic reticulum, and large Golgi complexes. Pigs inoculated with the virulent bacteria had IV macrophages with large phagosomes that contained necrotic cell debris and fibrin. Macrophages with phagosomes were more frequent in the 6-, 9-, and 24-hour sample periods of pigs with lesions than in any other group. Intercellular adhesion plaques (ICAP) were present between IV macrophages and subjacent endothelial cells. ICAP's increased in length with increased time post-inoculation in Zones 1 and 2 from pigs with necrohemorrhagic lesions. In later sample periods, multiple closely associated and interlacing IV macrophages formed a discontinuous layer over endothelial cells in Zone 2 samples near necrohemorrhagic lesions. These results suggest that the intravascular macrophage population changes from immature macrophages to mature macrophages or immature epithelioid cells within 24 hours after inhalation of a virulent Haemophilus pleuropneumoniae. Furthermore, intravascular macrophages likely function to clear cellular and acellular debris from the blood in pneumonic conditions. PMID- 3811135 TI - Muscle lesions in beige (Chediak-Higashi syndrome) and heterozygous C57BL/6J mice. AB - Muscles from male and female C57BL/6J Chediak-Higashi syndrome (CHS) and phenotypically normal mice with the bgJ allele were studied microscopically and histochemically for the presence of basophilic cytoplasmic structures seen by other investigators in muscles of CHS mice of the SB/Le strain. Triceps brachii, gastrocnemius, quadriceps femoris, and biceps femoris muscles were examined. Multiple basophilic cylindrical lesions were present in hematoxylin and eosin stained muscle from all groups. Lesions were positive for esterase, Sudan black, and periodic acid-Schiff. Lesions were only seen in type II muscle fibers. Type I muscle cells comprised less than an estimated 5% of the total muscle fibers in the four muscles examined. Scores were assigned based on the presence or absence of lesions in each muscle. Male mice of both phenotypes had significantly more lesions (P less than 0.05) than female mice. When sexes were combined, lesions were significantly (P less than 0.05) more numerous in normal mice than CHS mice for all muscles except the gastrocnemius. Lesions were significantly (P less than 0.05) more numerous in the phenotypically normal male than the CHS male mice for the triceps and quadriceps muscles. There was no significant difference (P greater than 0.05) between lesions of phenotypically normal female and female CHS mice. Basophilic cytoplasmic structures did not prove to be a manifestation of the CHS trait. PMID- 3811136 TI - Distribution and form of uranium-containing deposits in chickens treated with uranyl nitrate. AB - The kidneys of chicks treated with uranyl nitrate were examined by electron microscopy. Most deposits of electron-dense material containing uranium were found in the lumina of distal tubules and collecting ducts of kidneys collected 12-24 hours post-treatment. Some deposits were present in extracellular spaces between adjacent cells. Only occasionally were deposits found intracellularly where they were associated with localized cellular degeneration. A generalized cellular degeneration over the whole kidney was seen 72-96 hours post-treatment, but this was not directly associated with the deposits of electron-dense material. PMID- 3811137 TI - Membranous nephropathy in the dog. AB - Membranous nephropathy, a disease syndrome characterized by severe proteinuria and often accompanied by the nephrotic syndrome, was identified in 29% of a population of 46 proteinuric dogs. Renal lesions were characterized by the presence of subepithelial immunoglobulin deposits distributed diffusely along the glomerular capillary wall. Advanced stages were associated with progressive thickening of capillary basement membranes and incorporation of the immune deposits. These changes were followed by either glomerulosclerosis or recovery. Characteristic morphologic stages were correlated with clinical pathologic findings which showed that the level of proteinuria, hypoalbuminemia, and consequent nephrotic syndrome was most severe in the initial stages of membranous nephropathy while the level of azotemia increased in the more advanced stages of the syndrome. PMID- 3811138 TI - Crooked calf disease: a histological and histochemical examination of eight affected calves. AB - Macroscopic, histopathologic, and histochemical investigations were made on a group of eight neonatal Angus X Hereford calves, selected from an ongoing outbreak of crooked calf disease among calving heifers. Arthrogryposis of the forelimbs was seen to varying degrees in all eight animals, and torticollis was present in six calves. Histopathology, using hematoxylin and eosin stain, did not reveal any striking or consistent lesion in the affected animals; the majority of the tissues sampled were normal. Muscle samples were processed for adenosine triphosphatase (ATPase) and NADH-tetrazolium reductase (NADH-tr) histochemistry, and the data suggest that a primary myopathy is not responsible for the congenital anomalies in the affected calves. PMID- 3811139 TI - Mammary tumors in a colony of beagle dogs. AB - In a lifetime study, female beagle dogs in a closed colony were administered 226radium and 90strontium. An unirradiated control group was included in the study. A total of 223 of 356 dogs at risk developed 1,112 mammary proliferative growths (hyperplastic nodules and neoplasms). There was no correlation between occurrence and types of lesions in radiation and control groups. The age range for first occurrence of lesions was 10.4 to 13.9 years; hyperplastic nodule and benign mixed tumor occurred 1 to 2 years earlier than other lesions. A multiplicity of growths of similar or different morphological type were common throughout the lifetime of the dog. The female beagles, collectively, developed 244 hyperplastic nodules, 78 adenomas, 694 benign mixed tumors, 78 carcinomas, 14 malignant mixed tumors, and four myoepitheliomas. Proliferations occurred with increasing frequency from the cranial to caudal mammary glands. Metastasis was found in 77% of the dogs with carcinoma. The median time from diagnosis to metastasis was 10 months, but was shorter in dogs with infiltrative carcinoma. PMID- 3811140 TI - A retrospective study of proliferative interstitial lung disease of horses in Florida. AB - Proliferative and fibrosing interstitial lung disease was diagnosed in 20 horses submitted for necropsy between 1982 and 1985. Most of the horses were foals ranging from 3 days to 6 months in age. Six adult horses were affected. The macroscopic and microscopic characteristics of the lesions consisted of proliferative interstitial pneumonia and were similar to those of atypical interstitial pneumonia of ruminants. Based on morphologic features of the lesions, a toxic etiology is suspected for the induction of this naturally acquired primary equine lung disorder, but could not be specifically discovered by historical information. PMID- 3811141 TI - Characterization of cytoplasmic lysozyme immunoreactivity as a histiocytic marker in normal canine tissues. AB - The immunoreactive lysozyme distribution in normal canine tissues was determined to assess the value of lysozyme as a marker of histiocytic differentiation. Lysozyme was largely confined to monocytes, neutrophils, macrophages, serous cells in mucosal associated exocrine glands, and renal proximal tubular epithelium. Macrophages in the majority of tissues stained intensely for lysozyme, although in lymphoid tissues not all acid phosphatase and nonspecific esterase positive cells contained lysozyme. In particular, dendritic antigen presenting cells, including Langerhans cells, follicular dendritic cells, and interdigitating reticulum cells, lacked immunoreactive lysozyme; hence lysozyme appeared to represent a discriminatory marker with respect to these cells. Also, a small proportion of non-dendritic macrophages appeared to lack lysozyme. It was concluded that the demonstration of immunoreactive lysozyme was a useful adjunct to conventional morphological techniques for the identification of tissue macrophages provided that due caution was exercised in the interpretation of the results of lysozyme staining. PMID- 3811142 TI - Pathology of the canine and feline uterine tube. AB - Lesions of the uterine tube were described in 37 dogs and nine cats. Of the 52 lesions noted, 18 were developmental abnormalities; four paramesonephric remnants, and 14 mesonephric remnants. Uterine tube cysts were seen in 16 animals, and seven animals had salpingitis. One dog had hyperplastic changes of the infundibular mucosa, and one cat and one dog demonstrated adenomyosis. There were three primary benign uterine tube neoplasms, one adenocarcinoma, two metastatic neoplasms in the uterine tube, and two bursal lipomas, all in dogs. With the exception of neoplasia of the uterine tube, most lesions were unlikely to affect the reproductive performance of these animals and/or were incidental or secondary to disorders elsewhere in the reproductive tract. PMID- 3811143 TI - Ovarian yolk sac carcinoma in mice. PMID- 3811144 TI - Ectopic thyroid tumor in a dog: thyroglobulin, calcitonin, and neuron-specific enolase immunocytochemical studies. PMID- 3811146 TI - Photomicrography comes of age--or does it? PMID- 3811145 TI - Experimental porcine infective endocarditis: description of a clinical model. PMID- 3811147 TI - The Ionising Radiations Regulations 1985: what they mean in practice. PMID- 3811148 TI - Toxoplasmosis in a flock of sheep: some investigations into its source and control. AB - Toxoplasmosis was thought to be a minor problem on a lowland sheep farm purchasing some 200 ewe lambs annually. Serological investigations and production records suggested a more substantial problem with most of the ewe lambs seroconverting during their first pregnancy, many while still at grass and receiving no supplementary food. Only 60 live lambs were produced per 100 ewe lambs tupped. It was known that cats occasionally inhabited the sheep houses, from which straw bedding was spread onto the pastures after lambing. Trials over two years with ewe lambs grazing either 'clean' or 'dirty' pastures indicated that the straw bedding was the most likely source of infection. Serial serological studies not only defined the time of infection but also showed that the ewe lambs could be kept free of infection and produce more live lambs; 58 live births came from 81 'clean' ewe lambs compared with 21 from 50 'dirty' ewe lambs. PMID- 3811149 TI - Eight years' experience with a register of pig herds monitored for Aujeszky's disease. AB - The Pig Health Control Association launched a control scheme for Aujeszky's disease in Britain in January 1978. Participating herds must not show clinical signs suggestive of Aujeszky's disease and must be serum-sampled every six months for the absence of antibodies. Importations are allowed only from listed herds, or through hysterectomy or hysterotomy, embryo transfer, or artificial insemination (the donor animals in each case having been serologically screened beforehand). During the subsequent eight years, 103 herds have qualified, and at the end of 1985, 49 herds (average size 249 sows) were listed. Despite a high degree of inter-herd stock movements, no clinical or serological evidence of Aujeszky's disease has occurred, and the disease has not arisen in any herd established from the listed herds. During the same period, Aujeszky's disease was spreading in Britain and an eradication programme began in March 1983. By the end of 1985, 502 herds not on the Pig Health Control Association's scheme comprising 421,825 pigs had been slaughtered, together with 259 serologically positive animals in 69 other herds. The Pig Health Control Association's register has provided a safe source of stock. PMID- 3811150 TI - The influence of dietary protein and antimicrobial feed additives on salmonella carriage by broiler chickens. AB - Salmonella carriage in broiler chickens was not apparently influenced by the protein concentration of the ration, pelleting or by the coccidiostat monensin. The inclusion of penicillin in the diet was associated with an increase in salmonella shedding, particularly in the first half of the rearing period, but did not influence the lactobacillary count in the crop or the pH of the contents of the crop, gizzard and caecum. Furazolidone medication (150 mg/kg food) for the first 10 days had no effect on salmonella carriage at the time of slaughter (seven weeks) and studies into the influence of growth promoting antibiotics (avoparcin, bacitracin and virginiamycin) on salmonella shedding were inconclusive. Circumstantial evidence indicated that the food was the most probable source of infection for the birds studied in these experiments. PMID- 3811151 TI - Surgical treatment of lead poisoning in a mute swan (Cygnus olor). PMID- 3811152 TI - An amplifying oesophageal stethoscope. PMID- 3811153 TI - Chairs in veterinary clinical studies. PMID- 3811154 TI - Hormone growth promoter ban. PMID- 3811155 TI - Patelllar subluxation in a keeshond. PMID- 3811157 TI - Doped dobermann. PMID- 3811156 TI - Anaesthetic control for metaldehyde poisoning. PMID- 3811158 TI - Copper deficiency in ruminants; recent developments. AB - The aetiology of copper deficiency in grazing ruminants has been clarified by a number of recent discoveries: the low availability of copper in lush grazed pasture compared with conserved forage; the inhibitory effects on absorption of small increases in herbage molybdenum and sulphur and the antagonism from iron ingested in soil; and the wide genetic variation in copper absorption between different breeds of sheep. The economic importance of copper deficiency has been emphasised by the discovery of unsuspected causes of loss: increased susceptibility to infection and growth retardation in lambs and infertility in cattle. The diagnosis of functional copper deficiency has been improved by the addition of erythrocyte superoxide dismutase to the assays of copper status. PMID- 3811159 TI - An evaluation of an oral glucose-glycine-electrolyte solution for the treatment of experimentally induced dehydration in the horse. AB - Five standardbred geldings were given 1 mg/kg bodyweight of frusemide by intramuscular injection to induce mild dehydration. After food and water deprivation overnight, the mean weight loss was 24.4 +/- 1.8 kg (5.5 per cent of bodyweight). The horses were then given an equivalent volume of an oral glucose glycine-electrolyte solution by stomach tube. No more than 10 litres was given every 30 minutes until the calculated bodyweight loss had been replaced. Measurements made before, during and after the fluid administration included bodyweight, arterial blood haematocrit, PCO2, pH, standard bicarbonate, base excess and plasma concentrations of sodium, potassium, chloride, total protein, glucose, urea and creatinine. The final measurement was taken eight hours after the last dose of fluid and no food or water was offered to the horses during this time. Administration of the solution caused a rapid correction of the frusemide induced dehydration and metabolic alkalosis. Absorption of the fluid from the gastrointestinal tract appeared to be very rapid because by 30 minutes after the last dose of the solution, plasma protein values were not significantly different from those before administration of frusemide. Plasma glucose concentrations became significantly increased for up to three hours after the fluid was given and an increase in creatinine and urea concentrations, which was observed after the administration of frusemide, was still evident at eight hours. The glucose glycine-electrolyte solution was well retained, there being a mean bodyweight loss of 2.8 kg at three hours and 6.2 kg at eight hours after the last dose of fluid. PMID- 3811160 TI - Tick-borne fever in dairy herd. PMID- 3811161 TI - Cambridge intake. PMID- 3811162 TI - Use of chlorbutol in greyhounds. PMID- 3811163 TI - Unreliable diagnosis of Haemobartonella felis. PMID- 3811164 TI - Apparent erysipelas vaccination breakdown. PMID- 3811165 TI - BVA Overseas Association. PMID- 3811166 TI - Dipping risk. PMID- 3811167 TI - Hip dysplasia in greyhounds. PMID- 3811168 TI - Testing for antibiotic residues in milk. AB - Milk from dairy farms in England and Wales has been tested regularly for antibiotic residues since 1965. The sensitivity of the test organism was 0.02 iu/ml penicillin or equivalent until the change to 0.01 iu/ml in January 1986. In 1984-85, 99.6 per cent of the 2,000,000 milk samples tested passed the test and there was an average of 695 failures per month. From 7500 on-farm investigations over the two years 1983-85 the most frequent reasons suggested by farmers for their test failures were not withholding milk for the full withdrawal period (19.3 to 16.5 per cent) and accidental transfer of milk (16.3 to 16.7 per cent). Lactating and dry cow intramammary antibiotic preparations were held responsible for rather over 50 per cent and 25 per cent respectively of the failures in both years. PMID- 3811169 TI - Progesterone therapy in mares with abnormal oestrous cycles. AB - In two studies in Holland and France a total of 41 mares found either to be in anoestrus or showing continuous oestrous behaviour during the early part of the covering season were treated with a progesterone releasing intravaginal device. Of the 32 mares in the first study, 24 ovulated after treatment and 11 became pregnant to a covering at the induced oestrus. In the second study all but one of the nine mares showed oestrus, seven ovulated and six became pregnant at the post treatment oestrus. By the end of the covering season 15 of the 21 mares treated for anoestrus and seven of the 11 mares treated for persistent oestrus were found to be in foal. PMID- 3811170 TI - Liver abnormality in broilers. PMID- 3811171 TI - Summer mastitis prevalence in selected herds in the Irish Republic. PMID- 3811172 TI - Binding out clauses. PMID- 3811174 TI - Dealing with farm casualties. PMID- 3811173 TI - Local authority pay. PMID- 3811175 TI - An investigation of bovine serum copper levels in Lincolnshire and South Humberside. AB - Analysis of more than 2000 bovine serum samples showed a large monthly variation in copper levels. There was also a difference in levels between beef and dairy cows although all showed the same monthly pattern. This monthly variation was correlated with rainfall; the higher the rainfall the lower the copper level. The interpretation of single herd blood copper values must be considered carefully in view of this variation. PMID- 3811176 TI - Use of ammonium tetrathiomolybdate in the treatment of copper poisoning in sheep. AB - Intravenous administration of ammonium tetrathiomolybdate (three doses on alternate days) appeared to be an effective means of containing the acute phase of copper toxicity in sheep, whether this arose from continuous ingestion of high copper feeds or by injudicious use of copper preparations for the control of copper deficiency. No adverse effects were recorded on lamb numbers, birth weight or survival of lambs born to ewes of normal to low copper status when the treatment was applied at sensitive periods of the reproductive cycle. Decreases in 'available' plasma copper and in liver damage occurred rapidly in response to intravenous tetrathiomolybdate and it is suggested that all animals at risk be treated. PMID- 3811177 TI - Tracheal mucus transport in the horse following equine influenza vaccination. PMID- 3811178 TI - Oxfendazole resistance in Trichostrongylus axei in cattle in Australia. PMID- 3811179 TI - Further characterisation of a virus associated with turkey rhinotracheitis. PMID- 3811180 TI - Toxoplasmosis in a flock of sheep: further report. PMID- 3811181 TI - Chairs in veterinary clinical studies. PMID- 3811182 TI - Halothane anaesthesia in the dromedary camel. AB - It was shown that the effects of halothane anaesthesia in the dromedary are similar to those of large domestic ruminants. As a general rule the equipment and techniques used for adult cattle may also be used in the dromedary. Endotracheal intubation may be more difficult in camels because of their narrow oral cavities. Involuntary regurgitation is a particular hazard in dromedaries and every effort should be made to avoid this potentially life threatening complication. PMID- 3811183 TI - An investigation into the aetiology of 'wool slip': alopecia in ewes which are housed and shorn in winter. AB - Alopecia in housed ewes which are shorn in winter, 'wool slip', was investigated by taking wool and blood samples, skin scrapings and biopsies from affected and unaffected animals. Epidemiological information was also obtained from farm records, and reports from a local weather station. No pathological lesions were seen and no ectoparasites or forage mites were seen in wool samples or skin scrapings. The plasma zinc and copper concentrations of both groups were within the normal range but the copper concentrations were significantly lower in the unaffected animals. There was no difference between the prevalence of the disease in ewes of different breeds or between those producing single or twin lambs. A comparison of the mean temperatures during years of summer and winter shearing suggested that cold stress alone was not involved. Skin biopsies revealed that the wool follicles of affected animals were in an early growth phase (anagen) whereas those of unaffected animals were in the inactive phase (telogen). The clinical and histological signs of the disease were similar to those seen experimentally when corticosteroids are used as chemical depilatory agents. It is suggested that wool slip is due to the high levels of corticosteroids which occur as a result of the combination of housing and shearing and on this basis methods of control are proposed. PMID- 3811184 TI - Investigation of the effect of Moraxella phenylpyruvica on the genital tract of the sow. PMID- 3811186 TI - Ministry animal health schemes. PMID- 3811185 TI - Rapid detection of toxigenic Pasteurella multocida by an agar overlay method. PMID- 3811187 TI - Possible antibiotic contamination of milk. PMID- 3811188 TI - Response to Chernobyl. PMID- 3811189 TI - Standardisation of blood samplings on 'vettings'. PMID- 3811190 TI - Inherited parakeratosis in Friesian calves. PMID- 3811191 TI - Piperazine toxicity in a kitten. PMID- 3811192 TI - Chemotherapy of Theileria annulata infection with buparvaquone. PMID- 3811193 TI - Anaesthetic control for metaldehyde poisoning. PMID- 3811194 TI - Some effects of water quality on the performance of high yielding cows in an arid climate. AB - The water from wells in Saudi Arabia is often high in mineral content. The cows in this study had been receiving water containing between 4000 and 5000 ppm total dissolved solids. Four groups of 16 cows were calved down and milked under similar conditions in the hot summer months. Two of the groups were given normal well water and the other two groups received water after desalination in a reverse osmosis plant. One group on each type of water also had their water cooled. The groups of cows receiving treated water drank more water, consumed more concentrate and produced significantly more milk than the groups given normal well water. A similar effect on feed intake and milk production was seen when treated water was given to a 1000-cow unit with a similar number of control cows. PMID- 3811195 TI - Guidelines for veterinary surgeons employed in scientific procedure establishments and breeding and supplying establishments. British Veterinary Association and the Royal College of Veterinary Surgeons. PMID- 3811196 TI - Oestrone sulphate for pregnancy diagnosis in sows. PMID- 3811197 TI - The use of a bovine plasma progesterone ELISA kit to measure progesterone in equine, ovine and canine plasmas. AB - A commerical kit designed to measure the concentration of progesterone in bovine plasma using an enzyme-linked immunosorbent assay (ELISA) has been assessed for measuring progesterone in the plasma of horses, sheep and dogs. Without validation, an immunoassay developed for progesterone in one species should not be used to measure progesterone in the plasma of other species. The kit was assessed by using the criteria of parallelism to a standard curve, the recovery of added progesterone, the correlation with an established radioimmunoassay and the detection of physiological change for each of the species tested. The ELISA kit proved to be acceptable for the analysis of progesterone in the plasma of each species, and in particular for the detection of the low concentrations found during the follicular phase and of the subsequent rise during the luteal phase of the oestrous cycle. PMID- 3811198 TI - Effect of halothane on bronchial calibre of anaesthetised cattle. AB - A computer-aided forced oscillation technique was used to examine the effects of halothane on bronchial calibre in three adult cows after anaesthesia had been induced with xylazine and thiopentone. The administration of halothane failed to produce bronchodilatation, possibly owing to low resting bronchomotor tone in the animals. However, an increase in expiratory reserve volume, associated with a small fall in airway resistance, was observed, suggesting that changes in elastic recoil may make a significant contribution to changes in airway resistance during anaesthesia. The results also emphasise the importance of relating airway resistance to lung volume. PMID- 3811199 TI - Homologous and heterologous antibody reactions in sera from cattle naturally infected with bovine ephemeral fever group viruses. AB - Four viruses belonging to the bovine ephemeral fever (BEF) group have been isolated from bovine blood. Infection of cattle with BEF virus was associated with neutralizing antibody responses to BEF, Kimberley (KIM), Berrimah (BRH) and Adelaide River (ADE) viruses, with highest antibody titres to BEF and KIM viruses. Infection of one cow with KIM virus was associated with a homologous neutralizing antibody response and nil or minimal responses to the other three viruses. Infection of a steer with ADE virus was associated with a rise in neutralizing antibody levels to ADE virus and to KIM virus, but not to BEF or BRH viruses. Infection of a steer with BRH virus was associated with marked neutralizing antibody rises to BRH and BEF viruses and small rises to KIM and ADE viruses. An antibody rise to BEF virus did not necessarily indicate recent BEF virus infection, and should be considered of diagnostic value only when taken in conjunction with clinical signs of disease. PMID- 3811200 TI - Correlation between adherence of Erysipelothrix rhusiopathiae strains of serovar 1a to tissue culture cells originated from porcine kidney and their pathogenicity in mice and swine. AB - Adherence of four virulent and four avirulent strains of Erysipelothrix rhusiopathiae, serovar 1a, to porcine kidney cell lines, PK-15 and ESK cells, was examined in an in vitro system. The virulent strains adhered well to the cells (range of means, 9.95 +/- 0.87-36.01 +/- 1.10 per cell). In contrast, the avirulent strains showed negligible adherence to the cells (range of means, 0.11 +/- 0.04-1.41 +/- 0.13 per cell). Pretreatment of bacteria with heat, trypsin, or antiserum resulted in a marked decrease in adherence. Scanning electron microscopic examination revealed that the bacteria attached directly to the microvilli of cells. PMID- 3811201 TI - [Etiopathogenesis and epizootiology of coccidiosis in rabbits]. AB - Studies were carried out on the etiology and epizootiology of rabbit coccidiosis. Three experimental groups of rabbits were infected with intestinal, liver, and mixed intestinal and liver coccidia. The shedding of oocysts and the clinical course of the disease were followed up, with description of the morphologic changes and the results of the biochemical examinations of the blood. A total of eight species of coccidia were established in all cases--Eimeria magna, E. intestinalis, E. piriformis, E. media, E. exigua, E. irresidua, E. perforans, and E. stidae. Predominating were E. magna, E. perforans, and E. irresidua. Results showed that all age groups of rabbits were susceptible to the coccidial infection, mostly the weaned bunnies and young ones aged 2-3 months. It is admitted that under the present conditions of this country's rabbit raising coccidiosis is a disease of a seasonal character. Biochemical investigations of blood taken from experimentally infected rabbits revealed that the changes in the activity of GOT and alkaline phosphatase and in the amount of bilirubin were most pronounced. PMID- 3811202 TI - [Antigenic structure of strains of Pasteurella multocida]. AB - Studied was strain Pasteurella multocida-547 isolated from pigs affected with an acute Pasteurella infection. Serologically and immunologically its antigen was most closely related to the antigen of strain R-473. The main somatic antigen was 0:6, and the antigenic formula was 6:B. Homologous sera were used to demonstrate the presence of subsidiary antigens by which the newly isolated strain differed from strains R-473 (6:B), 1235 (6:E), and 989 (11:B). The immunodiffusion test with proper sera and heat-resistant water-soluble antigens could yield results that correlate with the typing of P. multocida strains by capsule and somatic antigens as established through other methods. PMID- 3811203 TI - [Properties of Bacteroides nodosus isolated from cattle]. AB - A total of five strains of Bacteroides nodosus were isolated from cattle with interdigital dermatitis on a number of farms. With regard to their cultural and morphologic properties and response to carbohydrates these strains did not differ from B. nodosus strains that caused foot rot in sheep. However, their K-antigen was different from the one of the B. nodosus strains isolated from sheep with foot rot as established via the hemagglutination test. No antigenic variations were found with the strains isolated from cattle. The tests with the proteolytic activity of the isolated strains showed that it was considerably lower than the activity of the strains isolated from sheep. PMID- 3811204 TI - [New trends in the control of enzootic bovine leukemia in Bulgaria]. AB - Experimental and literature data as well as personal observations with herds infected with enzootic bovine leukosis have revealed some new aspects that could be made use of in the control of the disease. The more important ones are stated: newborn calves of cows with positive leukosis response can be given untreated colostrum which has been shown to neutralize the virus; in individual regions and Agro-Industrial Complexes where sporadic cases of leukosis have been recorded isolation premises for positively reacting animals could be designed; cows in the last two months of pregnancy do not always give reliable results with the immunodiffusion test, so such animals should not be investigated at that time with this method. PMID- 3811205 TI - [Isolation of the glycoproteins of the Newcastle disease virus (NDV)]. AB - Two NDV glycoproteins--hemagglutinin-neuraminidase and F-protein--were separated from the remaining structural virus proteins through treatment of the virions with a 2 per cent triton-x-100 and chromatography on a Koh A-sepharose 4B column. A subsidiary ion-exchange chromatography on DEAE--Sephadex technique was employed to separate the two products and obtain them in a pure state. Biologically active NDV glycoproteins were obtained through solubilization of the virions with 10 per cent triton-x-100 at high ion strength, and the two glycoproteins were separated on a DEAE-bio gel column with the use of 0.01 M phosphate buffer of pH 7.2, containing 0.5 M NaCl. PMID- 3811206 TI - [An attempt to create a factorial model of the epizootic process in sheep infected with S. abortus ovis]. AB - Experiments were carried out to build up a factorial model with a group of sheep at different age in an infected region. Studied were the aspects of the disease as caused by Salmonella abortus ovis alone and in combination with Chl. ps. var. ovis. It was found that the factorial model can explain sufficiently well (77.22 per cent) the discussed system--the epizootic process with year-old females and sheep affected with pure and mixed infection. The epizootic process with a mixed infection in these animals ran its course at high intensity. In the case of a pure infection the process was more intensive with young females. With lambs it showed higher intensity when a mixed infection was present. PMID- 3811207 TI - [Enzyme activity of the seminal fluid of bulls after deep freezing and incubation at 39 degrees C]. AB - The study of bull semen revealed that the activity of alkaline phosphatase in the semen plasma and spermatozoa did not change, however, upon incubation at 39 degrees C for at least 5 hours the activity of the enzyme dropped nearly 10 times. The activity of GOT in both plasma and spermatozoa rose after deep freezing, but the difference recorded were statistically insignificant. Upon incubation of semen at 39 degrees C in the course of five hours the activity of this enzyme decreased, although insignificantly. The differences were likewise insignificant with the drop of GPT following deep freezing. It was concluded that the changes with all three enzymes cannot be used as reliable markers of the injury of spermatozoa following deep freezing. PMID- 3811209 TI - [Comparative pharmacokinetic research on amoxicillin in agricultural animals]. AB - Described is the pharmacokinetic of amoxycillin following i/v and oral administration to calves, pigs, and rabbits at the rate of 10 mg per kg of body mass and to turkeys at 30 mg/kg body mass. The pharmacokinetic was found to be of first order, whereas a bispatial model was applicable after i/v introduction of the sodium salt and a monospatial model--following the oral administration of amoxycillin trihydrate. Discussed are the differences in the absorption, distribution, and excretion of the antibiotic as affected by the mode of application and the species peculiarities of the animals. PMID- 3811208 TI - [Normal values of the hematological, biochemical and enzymological indices of the donkey]. AB - Studied were a total of 85 (33 male and 52 female) donkeys of the Martina Franca breed of the domestic ass, aged from one to twelve years. Stated are the results for the normal values of hemoglobin, hematocrit, ESR, total erythrocyte and leukocyte counts, leukocyte formula, blood sugar, cholesterin, urea, total protein and protein fractions, some micro- and macroelements, and enzymes as tabulated in four diagrams. No differences have been established with regard to sex. It has been found that with young animals the normal values of hemoglobin and erythrocytes are lower than with adult ones. With aging the total count of leukocytes shows a lowering trend, while the percent of neutrophiles rises. The lymphocyte profile of the white blood picture of this breed animals has been shown to be combined with eosinophilia. The amount of total protein with young donkeys is lower than with older ones, however, the albumin-globulin ratio remains unchanged. It is also stated that the concentration of inorganic phosphorus and calcium is in reverse correlation with the age of the animals- inorganic phosphorus is higher and calcium is lower in young animals, and vice versa. So far as the enzyme activity is concerned the values of the investigated enzymes are generally lower in donkeys than in horses. PMID- 3811210 TI - [Dynamics of calving, dystocia and the organization and effectiveness of obstetrical care for cows on commercial farm complexes]. AB - A study was carried out on the organization of the obstetrical aid with cows on the large cow complexes in order to raise its effectiveness. Determined was the dynamic of calvings, dystocia, retentio secundinarum, and puerperal endometritis as affected by the time of calving and the character of obstetrical aid as practised on the farms. It was found that most of the calvings (62.6 per cent) take place at night, and 37.4 per cent--in daytime, while within the working day as fixed by the Labour Code--24.8 per cent only. Directly proportional to these were the cases of laboured delivery--60.4 per cent at night and 39.6 per cent in daytime. It was also established that at night obstetrical aid is chiefly rendered by the attendants on duty and the watchmen, which meant that it was unqualified, with bad results: higher rate of postnatal deaths, higher morbidity rates resulting from puerperal endometritis, prolonged period from calving to the first physiologic estrus and prolonged service period, lower conception rates, and higher economic losses. The authors suggest that the organization of labour of vets should take into consideration the productional and biologic processes on the industrial cow complexes, with night duty or two-shift work. These problems should be settled financially and by means of additional personnel as provided by the Labour Code and the new economic approach and its mechanisms. PMID- 3811211 TI - [Viral and bacterial shedding in calves raised under commercial conditions]. AB - Etiological, clinical, and epizootiological studies were carried out with newborn calves on two cow complexes of 500 animals each, raised under industrial conditions. Virologic and bacteriologic investigations of a total of 300 fecal samples taken from both calves and dams on the day of calving up to the 10th day as well as on the 20th and 30th day revealed that in 90 per cent of the cases there were rotaviruses. With calves that remained with the cows up to the 72nd hour 30 to 50 per cent of the rotaviruses were found from the second to the tenth day, and with calves that were separated from their dams immediately after calving rotaviruses were found at more advanced age too. Bacteriologically, as many as 92 strains of Escherichia coli were established as isolated from the fecal samples studied. Antigen K99 was demonstrated with 3.26 per cent of the strains. It was concluded that both with regard to the numbers of the E. coli strains isolated and to the period during which these were found the bacterium prevailed in calves that did not suck directly from their dams in the first days following calving. PMID- 3811212 TI - [A new method for determining an infectivity index in assessing the intensity of an epizootic process]. AB - A new method was suggested to determine the index of deadliness in fixing the intensity of the epizootic process as manifested in its two forms--apparent and inapparent. The method is based on the calculus of probability--a most general formula for the sum of any kind of events. The results obtained have been compared with those reached with the already existing two other methods. The model employed consist of theoretically composed examples corresponding to similar ones in the practice as well as of investigations on Salmonella abortions in sheep. The new method can be employed with all kinds of initial data and results in various variants. PMID- 3811213 TI - [Intensity of the epizootic process in sheep infected with S. abortus ovis and Chlamydia psittaci var. ovis]. AB - An attempt was made to analyze comparatively the intensity of the epizootic process in young female sheep, ewes (second pregnancy, with no records of abortions in their first pregnancy) and their lambs either with an infection of Salmonella abortus ovis only or with a mixed infection of S. abortus ovis and Chlamydia psittaci var. ovis. This was reached through following up and studying the parameters morbidity, mortality, lethality, index of infectedness, index of deadlines, and fertility. It was found that the intensity of the apparent epizootic process was highest with young females affected with a mixed infection, and it was lowest with ewes affected with a pure infection (Salmonella abortion). The intensity of the inapparent epizootic process was best manifested in the young females affected with a pure Salmonella abortion. With these animals both the index of infectedness and the index of deadlines had highest values. PMID- 3811214 TI - [Quality and nutritive value of the liver from fattened local geese]. AB - A research-and-economic experiment was carried out with a total of 8,621 geese of local breeds of 3.964 kg average body mass, fattened forcedly with steamed grain maize in the course of 20-30 days. The dynamic of a number of qualities was followed up with special emphasis on the live weight from the beginning to the end of the fattening period, the weight gain, the mass and quality of liver, and the intake of feed per kg of gain and per kg of liver mass. Determined was also the nutritive value of proteins contained in the liver as judged by the index of the amino acid ratio (tryptophan to hydroxyproline). It was found that local geese could be characterized by good fattening capacity, yielding high-quality liver of excellent organoleptic indices and high nutritive value at a comparatively low intake of feed. PMID- 3811215 TI - [Motivation in the choice of profession by students of veterinary medicine]. AB - Elucidated were the motives in choosing the profession with the student in veterinary medicine, stating the sociologic characteristic of the vet students in connection with the choice made. Stated was the effect of some factors that belonged to the social origin (so-called external factors) as well as the effect of the personal reasons for vocational orientation. The education at the Faculty of Veterinary Medicine was also found to be of importance in this respect. It was established that the most effective external factor was the influence of the family circle, although it was not as significant as in other similar studies in terms of value. In most of the students in veterinary medicine the choice of profession was determined mainly by personal motives: the interest the students took in biologic sciences, the affection for animals, etc.,--which spoke of a decision-making of their own. The effect of institutions of the social past, such as education, school, teachers. Studies of professional orientation on the choice of a profession was said to be negligible. Negative deviations as to the stability of decision-making, particularly in the fourth year of education, were also established, and this made it necessary to combine professional training with didactical means in order to make it optimal. PMID- 3811216 TI - [Effect of feed antibiotics on ampicillin pharmacokinetics in chickens]. AB - Experimental studies with broiler birds revealed that medicated feed (flavophospholipol, vitamyacin A, and the A-149 antibiotic in stimulative doses), offered in the course of two weeks, led to changes in the pharmacokinetic parameters of ampicillin administered i/v (in the form of ampicillin-Na) and via the crop (in the form of ampicillin-trihydrate at 30 mg/kg). It was found that the biologic half-life of ampicillin-Na was prolonged by A-149, and was shortened by vitamicin A, and to a certain extent--by flavophospholipol; the seeming volume of distribution was shown to rise by A-149, and to a certain extent--by flavophospholipol, and was lowered by vitamycin A. The biologic half-life of ampicillin-trihydrate was prolonged by all three ergotropic agents. The systematic bioavailability of ampicillin-trihydrate rose with the use of A-149, and dropped with the use of vitamycin A, and to a lower extent--with the use of flavophospholipol. On the base of the changes established in the pharmacokinetic parameters ampicillin-trihydrate was dosed for use via the drinking water as follows: 196 mg/l simultaneously with flavophospholipol in the feed, 156 mg/l- with the use of vitamycin A, 148 mg/l--when used with the A-149 antibiotic, and 216 mg/l--when administered at no medication via the feed. PMID- 3811217 TI - [Microbial contamination of the air in the housing of laying hens]. AB - Studied were buildings of one and the same design, sizing 92/12/3.5 m. Building A of mechanical ventilation through negative pressure housed 9,000 layers of the White Leghorn breed, and building B of ventilation with equated pressure, providing the same debit per kg biomass, housed 20,000 layers. The air in the buildings, in the close surrounding as well as the feed and soil were investigated with regard to the total counts of organisms as cultured in meat and peptone agar and with regard to the individual counts of coli bacteria, microscopic fungi and hemolytic cocci, and Salmonellae. It was found that the microbial contamination of air on the productional premises and of atmospheric air closely surrounding the buildings, was higher in building A. There were differences in the microflora of the air at the level of the individual stories in building B. The differences in the microbial contamination of air between the two buildings was the result of reconstructions concerning the ventilation system as well as of making it more effective. PMID- 3811218 TI - [Embryotoxic and teratogenic action of phenylmercuric acetate (Falisan Nassbeize)]. AB - Tested was the embryotoxic and teratogenic action of the organic mercury compounds (phenyl mercuric acetate), containing 2 per cent mercury, on albino rats. The preparation was introduced orally during pregnancy in the form of a 2 per cent water solution at the following rates: I group--1/8 LD50 (= 4 mg Hg/kg body mass) on the 4th and 5th day of pregnancy; II group--1/3 LD50 (= 10 mg Hg/kg) on the 4th and 5th day too; III group--1/8 LD50 (= 4 mg Hg/kg) from the 3rd to the 19th day; IV group--control animals. The preparation proved to be highly toxic with the animals of the II group, with high mortality rate (42.85 per cent). No teratogenic effect with malformations was produced with the three test groups during embryogenesis. PMID- 3811220 TI - [Etiology and clinical forms of hoof diseases in bulls]. AB - Investigations were carried out to establish the diseases of hooves in breeder bulls raised under the conditions of modern technologies with restricted movements. It was found that hoof diseases were highest in percent (28%) of all non-infectious diseases. Highest was the percent of the typical traumatic ulcer (62 per cent) and of the local and diffuse aseptic and suppurative pododermatitis (34 per cent), whereas the diseases of the hind hooves prevailed--55 per cent as against 45 per cent for the forelimb ones. Higher was the percent of diseases observed in the hooves of the right limbs--63 per cent as against 36 per cent for the cases of diseases observed in the hooves of the left limbs. The higher liveweight of bulls correlated with the frequency at which hoof diseases were recorded. The pigmented hoof horn tissue was found to be more resistant to the effect of external factors and the hoof diseases associated with them. In the months of May, June, and July the cases of diseased hooves were more numerous than in the remaining months of the year due to the lower resistance of the hoof horn over the rainy period. PMID- 3811219 TI - [Pharmaco-physiologic correlations of iron-dextran complexes in laboratory animals]. AB - Investigated were the Bulgarian preparation dextrofer-100 (Pharmachim) and miofer 100 (Farbwerke, Hoechst, West Germany)--iron-dextran preparations with 100 mg Fe3+/cm3 each. Use was made of 62 domestic cats, 8 guinea pigs, and 18 albino rats. tI was found that the venous introduction of iron-dextran complexes into uretane-treated cats at rates of 100 to 500 mg Fe3+/kg body mass lowered the blood pressure by 10 to 65 per cent; the depressive effect was more strongly manifested with the use of miofer-100. At 100 mg Fe3+/kg and higher doses led to alfa-adrenolytic manifestations (an inverse effect of noradrenaline), and did not change the action of acetyl-choline, histamine, and serotonin. At venous injection the iron-dextran complexes diminished the amplitudes of the heart contractions (with cats in situ). With regard to the nervous-and-muscle condition these preparations were found to manifest an action that resembled that of curare (the effect produced by miofer was stronger). Dextrofer-100 in a five-fold application to guinea pigs at the rate of 0.2 cm3+ (= 20 mg Fe3+) blocked the sensibilizing action of horse serum--it gave protection from an aphylactic shock in about 70 per cent of the animals. In muscular application to albino rats with experimentally induced dextran edema this preparation manifested an antiedema action. The iron-dextran complexes lowered the contraction capacity of ileum sections (taken from guinea pigs) that was manifested under the action of serotonin and histamine. PMID- 3811221 TI - [Etiology and chemotherapy of suppurative surgical infection in horses and cattle]. AB - A total of 24 horses and 42 cattle with a variety of local suppurative processes (wounds, abscesses, phlegmons, tendovaginitis, etc.) were studied under conditions of the clinic with regard to the most commonly found microbial species and the opportunity to work out antibioticogrammes in terms of the effectiveness of 11 of the chemotherapeutic agents widely used in the practice. It was found that prevailing in horses were staphylococci and streptococci. In cattle Corynebacterium pyogenes was predominantly established. Besides, there was a rising trend in the part played by representative agents of the occasionally pathogenic microflora (Ps. aeruginosa, Pr. vulgaris, Escherichia coli) as the causative species of local suppurative processes. These organisms were fairly often isolated in association with other species, while they were more rarely found as the only acting ones in a particular case. Best effects of the antibiotics tested could be expectedly produced by gentamycin (82.5 per cent), carbenimycin (74.2 per cent), oxacyllin (72.7 per cent), ampicillin (68.2 per cent), and canamycin (61.8 per cent). At the same time, the effectiveness produced by some of the antibiotics widely employed in the practice, such as chloramphenicol, tetracycline, streptomycin, and penicillin was below 50 per cent. PMID- 3811222 TI - [The mycoflora of corn silage]. AB - Maize silage was sampled to investigate the mycotic flora in it, the material for testing being taken at the time of preparing the silage as well 4 to 5 months later. It was found that richest mycoflora developed in the superficial layers of the silage mass, chiefly constituted by fungus species of the Aspergillus, Penicillium, Alternaria, and Mucor genera. It was also established that Aspergillus fumigatus was the most frequently isolated species. It is believed that the development of the mould fungi in maize silage was dependent on the quality of compaction and air-tight pressing of the ensiled mass. PMID- 3811223 TI - [Role of rams in the epizootiology of salmonellal abortion in sheep]. AB - Studied was the susceptibility of rams to a Salmonella abortus ovis infection. It was found that the animals could resist the oral experimental infection when the causative agent was introduced in the form of 20 ml broth culture or when the environment was contaminated with it. The Salmonella abortus ovis infection was found to be transmitted from infected rams to normal ewes and vice versa, chiefly through sexual route. PMID- 3811224 TI - [Effect of various temperature regimens for thawing on the quality of bull spermatozoa]. AB - Investigations were carried out to test the effect of various temperature regimes of thawing (40 degrees, 50 degrees, 60 degrees, 70 degrees C) of bull semen frozen after the method of Nagase-Niwa (1964) in the form of pellets sizing 0.15 to 0.20 cm3. It was found that with the rise of water bath temperature the number of restored spermatozoa after thawing also rose. The higher temperatures of thawing led to a reliable shortening of the time of exposure needed for the thawing of individual pellets. Tested was a method and a device for the more effective and safe thawing of semen at higher temperatures. Artificial insemination carried out with semen thawing after the new method--55 degrees C- made it possible to raise the conception rate of the first service by 5.39 per cent as compared to the traditionally employed technology of thawing--38 degrees- 40 degrees C--in cattle breeding practice. PMID- 3811225 TI - [Survivability and penetration capacity of bull spermatozoa frozen by 3 technics]. AB - Studied was the survival and penetration capacity of bull spermatozoa frozen after the following technologies--pellet, straw, and minitube--and the results obtained were compared via biologic experiments. The minitube technology of freezing the semen led to higher thermal resistance of the spermatozoa as against freezing in the form of straws and pallets (363.5 +/- 8.02 min, 356.25 +/- 7.79 min, and 339.00 +/- 8.44 min, respectively). The differences established were statistically highly significant (P less than 0.001). The penetration capacity of spermatozoa in an estral secretion of cows was highest at freezing in the form of minitubes (1.70 +/- 0.54 mm/min). The same was lower with straws (1.53 +/- 0.02 mm/min), and lowest--with pellets (1.52 +/- 0.04 mm/min). The differences were statistically significant (P less than 0.01). The fertilization capacity of spermatozoa frozen with the employment of the three technologies was best with the use of minitubes and straws--50.20, resp., 49.67 per cent, and lowest with the use of pellets--45.22 per cent. PMID- 3811226 TI - [Electrocardiographic research on broilers and hens following treatment with 1 phenyl-2,3-dimethyl-4-naphthalan morpholinomethylpyrazolinone-5]. AB - ECG investigations were carried out with the 1-phenyl-2,3-dimethyl-4-naphthalan morpholino methylpyrazolinon-5 compound on broiler birds and hens at single and manifold s/c injection and oral administration. In therapeutic tranquillizing amounts the compound did not lead to ECG changes. It was not until applying several times higher extratherapeutic doses that shortening of the R--R interval occurred along with broadening of the T wave and appearing of sporadic extrasystolic contractions of the chamber No changes in the voltage of the individual ECG peaks were found. Such effects were observed up to the eighth day following treatment. From the 9th up to the 20th day these phenomena gradually disappeared. The frequency of contractions, resp., the contraction capacity of the heart showed no essential changes. On the 21st day after the compound was applied the heart activity came back to normal. PMID- 3811227 TI - Mutants of an influenza A reassortant which are cold-sensitive (cs) as well as temperature-sensitive (ts): on the role of the neuraminidase activity for influenza virus infection. AB - Temperature-sensitive (ts) mutants were obtained by undiluted passage of the cold sensitive (cs) influenza A reassortant 113/Ho. This reassortant produces normal yields of infectious virus with negligible neuraminidase (NA) at 40 degrees. The mutants obtained from it had a narrow temperature optimum for plaque formation in chick embryo cells, since they were cs as well as ts. Such cs/ts mutants have not been described before. In contrast to mutants derived from FPV, most of the mutants derived from 113/Ho carried a ts defect in the NA gene. NA activity was not detectable after infection with these mutants at 40 degrees. The results are interpreted to mean that, although NA activity is not completely dispensible for influenza A virus replication in tissue cultures, the viruses possess a surplus of NA activity. The normally high activity of NA of influenza viruses seems to be necessary only for the natural infection of the respiratory tract. PMID- 3811228 TI - Analysis of disulfides present in the membrane proteins of the West Nile flavivirus. AB - Recently the primary structure of the structural proteins of the flaviviruses West Nile (WN) virus (Castle et al., 1985; Wengler et al., 1985) and yellow fever (YF) virus (Rice et al., 1985) have been determined. As a first step in a further characterization of the organization of the structural proteins we have now studied the disulfide bridges present in the WN virus membrane proteins. All three membrane proteins, pre M, M, and E, were analyzed. The results obtained can be summarized as follows: The pre M proteins of both WN and YF virus each contain 6 cysteine residues and the position of all of these residues is strictly conserved between both viruses. The M proteins of both viruses do not contain cysteine residues. The E proteins of these viruses contain 12 cysteines and the position of all of these residues is strictly conserved between both viruses. All cysteine residues of the WN virus-derived membrane proteins are present as intramolecular disulfides. The six disulfide bridges generated from the 12 cysteine residues in the WN virus-derived E protein have been identified as follows: Cys 1-Cys 2; Cys 3-Cys 8; Cys 4-Cys 6; Cys 5-Cys 7; Cys 9-Cys 10; Cys 11 Cys 12. The analyses of the amino acid sequence conservation between the E proteins of YF and WN virus and the characterization of the disulfides have been used to develop a description of the E protein in which the molecule is assumed to be composed of the segments R1, L1, R2, L2, and R3 followed by a membrane anchor region at the carboxy-terminal region of the molecule. Computer analyses of the hydrophilicity and of the secondary structure indicate that the R1 region might contain a cluster of viral epitopes. PMID- 3811230 TI - Synthesis in vitro of infectious RNA copies of the virulent satellite of turnip crinkle virus. AB - RNA copies, synthesized in vitro, of the virulent satellite (RNA C) of turnip crinkle virus (TCV) infect plants when coinoculated with helper virus RNA. RNA C is a small linear RNA of about 355 bases which intensifies TCV symptoms in infected plants. Full-length cDNA copies of the satellite were inserted in an expression vector (for RNA synthesis in vitro) in such a way that RNA synthesized in vitro had the same 5'-end as the native satellite. Plus-strand RNA copies of the satellite in near-monomer and multimer form infected plants, while minus strand RNA copies and DNA copies of the satellite RNA did not do so under the conditions tested. When plants were inoculated with RNAs synthesized in vitro from two independently cloned satellite cDNAs with base sequence and length differences, the products of infection corresponded in sequence to the different cRNAs used in the inocula. Satellite RNAs synthesized in vitro from either cDNA produced the same symptoms as the native satellite RNA. PMID- 3811229 TI - Resistance of vaccinia virus to rifampicin conferred by a single nucleotide substitution near the predicted NH2 terminus of a gene encoding an Mr 62,000 polypeptide. AB - Marker transfer procedures were used to locate the site of mutation in the genome of a previously characterized (B. Moss, E. N. Rosenblum, and P. Grimley, 1971), Virology 45, 135-148) rifampicin-resistant (RifR) vaccinia virus isolate. Starting with a cosmid library prepared from the mutant genome, recombination with successively smaller DNA fragments was shown to transfer drug resistance to wild-type vaccinia virus. In this manner, the mutation was mapped within a 485-bp DNA segment in the central region of the genome at the extreme right end of the HindIII D fragment. Nucleotide sequencing indicated that this DNA segment differed from the homologous region of wild-type DNA by a single C/G----A/T substitution. Sequencing of the flanking 2195 bp revealed two tandem nonoverlapping open reading frames (ORFs) encoding putative polypeptides of Mr 16,908 and 61,840. The RifR mutation resulted in a predicted glutamine----lysine change only 27 amino acids from the NH2 terminus of the longer ORF. A predicted asparagine to aspartic acid substitution, found in another RifR vaccinia virus mutant by J. Tartaglia and E. Paoletti (Virology 147, 394-404, 1985), mapped near the carboxyl terminus of the same ORF. These data suggest a model in which head to-tail interaction between Mr 61,840 polypeptides occurs and in which rifampicin blocks virus assembly by preventing this association. PMID- 3811231 TI - Functional interactions of the domains of the adenovirus DNA binding protein. AB - The 34-kDa fragment of the carboxyl end of the adenovirus (Ad) DNA binding protein (DBP) binds to single-stranded (ss) DNA and is able to replace the intact 72-kDa DBP needed for Ad DNA replication in vitro. A similar fragment prepared from the temperature-sensitive (ts) mutant, H5ts107, which has a single amino acid change in the carboxyl end of the DBP, is temperature sensitive for DNA replication and defective in binding to ssDNA. However, in 20 mM NaCl which is the salt concentration during Ad DNA replication in vitro, the intact 72-kDa H5ts107 DBP is defective only in replication but not binding to DNA at nonpermissive temperatures. These observations indicate that the amino domain of the H5ts107 DBP can stabilize the binding of its carboxyl end to DNA. PMID- 3811232 TI - Crystals of antibodies complexed with influenza virus neuraminidase show isosteric binding of antibody to wild-type and variant antigens. AB - We describe here, for the first time, crystals of antibodies bound to a viral antigen which diffract X-rays to beyond 3 A. Crystals have been grown of Fab fragments of monoclonal antibody NC41, complexed with influenza virus neuraminidase (NA) of the N9 subtype and with a variant of N9 NA having a sequence change of Asn to Asp at position 331. This reduces, but does not abolish, the binding of NC41 antibody (in the case of another variant, Ser 371 to Leu, binding of NC41 antibody appears to be abolished). We are presenting data on the three-dimensional structure of these two complexes which indicates that NC41 antibody binds isosterically to the wild type and variant neuraminidase molecules. PMID- 3811233 TI - Nonproductive, cell-associated virus exists before the appearance of antiviral antibodies in experimental measles encephalitis. AB - The ability of measles virus to induce a cell-associated state of infection in the central nervous system (CNS) plays an important role in the pathogenesis of subacute sclerosing panencephalitis (SSPE), a fatal disease of children and young adults. The mechanism by which such an infection state is established is unknown, but several hypotheses have been proposed. One of these suggests that antiviral antibodies induce the nonproductive infection state by a process termed antigenic modulation. Results presented here demonstrate that antigenic modulation is not involved in the induction of a cell-associated CNS infection in newborn hamsters by the LEC strain of SSPE derived measles virus. This follows from the finding that nonproductive, cell-associated virus can be isolated from infected CNS tissues prior to the appearance of antiviral antibodies. PMID- 3811234 TI - The c4 gene of phage P1. AB - The c4 gene of phage P1 has been localized to 335 bp of the P1EcoRI-9 fragment, within 50 bp of the EcoRI-9/14 junction. DNA sequence analysis of this fragment reveals a single open reading frame of 66 amino acids. The location of two c4 mutations, both of which produce changes in the predicted amino acid sequence in this reading frame, suggests that the reading frame codes for the c4 repressor. A region with high homology to the E. coli promoter consensus sequence is located approximately 50 bp upstream from the reading frame. Deletion of this potential promoter region abolishes expression of c4, as indicated by the loss of complementation of c4 mutants for lysogeny. Complementation is restored by the introduction of a heterologous promoter (the T7 phi 10 promoter), indicating that c4 expression is absolutely dependent on transcription of the 66-amino acid reading frame. PMID- 3811235 TI - Infectious influenza A and B virus variants with long carboxyl terminal deletions in the NS1 polypeptides. AB - An influenza A virus, A/turkey/Oregon/71, was shown by protein gel analysis to code for an NS1 protein approximately half the size of those of other influenza A viruses. Sequence analysis of the NS gene of this virus revealed a 10 nucleotide deletion resulting in an NS1 protein of only 124 amino acids. This truncated NS1 polypeptide retained its karyophilic pattern as detected by indirect immunofluorescence analysis of virus infected cells. Also, A/turkey/Oregon/71 virus grew to high titer in embryonated chicken eggs comparable to other influenza A viruses. We also identified a laboratory variant of an influenza B virus, clone 201, which codes for a truncated NS1 protein. Sequence analysis revealed a 13 nucleotide deletion resulting in a shortened NS1 protein of only 127 amino acids as compared to other influenza B virus NS1 proteins possessing a length of 281 amino acids. Again as shown for the NS1 proteins of other influenza B viruses the NS1 polypeptide of B virus clone 201 was found to localize in the nucleus of infected cells. It appears that large deletions in the carboxyl terminus of the NS1 proteins of influenza A and B viruses can be tolerated without affecting the functional integrity of the NS1 polypeptide. PMID- 3811237 TI - Effects of site-specific mutation on structure and activity of influenza virus B/Lee/40 neuraminidase. AB - A cDNA copy of the neuraminidase (NA) gene of a high-growing reassortant influenza virus which has the hemagglutinin of B/Hong Kong/8/73 and the NA of B/Lee/40 was cloned into plasmid pUC 9 and subcloned into a late-replacement SV40 vector so that the NA gene could be expressed in eukaryotic cells. The expressed protein was antigenically and enzymatically active. To study structure-function relationships in the B/Lee NA, particularly in comparison to the known structure of influenza A (N2) NA, specific mutations were introduced using synthetic oligonucleotides. Mutation of an apparently unpaired cysteine residue to serine at position 251 had no effect on protein transport or folding as judged by cell surface reactivity with monoclonal antibodies, and the NA retained enzyme activity, confirming that this Cys is not essential for correct folding of the polypeptide. Mutation of Trp 364 to Leu abolished detectable enzyme activity, while mutation of Thr 368 to Val reduced enzyme activity to less than 25% of wild type levels. Neither mutation affected antigenic properties. Therefore it is likely that both these side chains extend into the NA active site pocket. The results of these experiments are in accord with similarities in the structure of the B/Lee NA compared with that of influenza A (N2) NA. Although there is about 70% amino acid sequence difference between influenza A and B NAs, residues in the active site are highly conserved. Our in vitro mutagenesis experiments help to confirm the tentative alignment of sequences and have identified conserved amino acid side chains involved in enzyme activity. PMID- 3811236 TI - Perturbation of differentiated functions in vivo during persistent viral infection. III. Decreased growth hormone mRNA. AB - Lymphocytic choriomeningitis virus (LCMV) persistent infection that results from the inoculation of C3H/St newborn mice causes growth hormone (GH) deficiency and associated disease characterized by both reduced weight and serum glucose levels. Molecular analysis of pituitary nucleic acids shows GH deficient mice have, on average, fivefold reduced levels of GH mRNA although the histopathology of such GH producing cells is normal. Northern blots indicate that the length of GH mRNA is comparable in the GH deficient, virus infected mice and the GH normal, uninfected age-matched controls. Hence, truncated GH mRNA cannot account for hormonal defect. Mice infected congenitally through mating of persistently infected parents have normal growth and blood glucose levels. GH mRNA levels in pituitaries of these mice are equivalent to those of uninfected age-matched controls but significantly greater than those seen in neonatally infected GH deficient mice. Although infectious virus titers in the sera are equivalent in congenitally and neonatally infected age- and sex-matched mice, virus titers are significantly lower in pituitaries and brains of the congenitally infected mice when compared to neonatally inoculated mice. Additionally, the number of GH producing pituitary cells expressing viral proteins is less in congenitally infected mice relative to those in neonatally inoculated mice. Hence there is a direct association between viral replication in GH-producing cells, lowered GH mRNA, and GH deficiency. PMID- 3811238 TI - Purification and characterization of the reovirus cell attachment protein sigma 1. AB - It has previously been shown that of all the soluble reovirus-specified proteins present in the infected cell lysate, protein sigma 1 alone possesses the capacity to bind to host cells (P.W.K. Lee, E.C. Hayes, and W.K. Joklik, 1981, Virology 108, 156-163). We found that sigma 1 from urea-disrupted reovirus particles was also capable of such specific binding. Reovirions were therefore used as a source of functional sigma 1. Accordingly, a simple procedure has been developed to purify sigma 1 by subjecting urea-disrupted reovirions to DEAE ion-exchange chromatography. Protein sigma 1 thus isolated was electrophoretically homogeneous and the recovery was estimated to be 50 to 60% of the theoretical yield. The purified protein presumably maintained its native conformation since it was recognized by a panel of monoclonal anti-sigma 1 antibodies previously isolated, and was capable of specifically binding to host cell receptors, agglutinating human erythrocytes and inducing neutralization and hemagglutination-inhibition antibodies. Subsequent chemical crosslinking studies revealed the presence of oligomeric (mostly dimeric) sigma 1 forms in the preparation. The amino acid composition of the purified sigma 1 was found to closely match that inferred from the S1 gene sequence. However, attempts to determine its amino-terminal sequence have not been successful. The p/ of the purified protein was determined to be 6.8. Circular dichroic measurements of the purified sigma 1 indicated that 54 and 19% of its residues were arranged in alpha-helical and beta-sheet secondary structures, respectively. PMID- 3811239 TI - Host cell-mediated variation in H3N2 influenza viruses. AB - The influence of the host cell on the selection of antigenic variants of influenza A H3N2 viruses and the relevance of host cell selection to the induction of immunity by these viruses have been investigated. Influenza viruses were isolated from human clinical samples during a single epidemic, were passaged in mammalian Madin-Darby Canine Kidney (MDCK) cells or in embryonated hens eggs, and were tested for antigenic variability in the hemagglutinin (HA) molecule with a panel of monoclonal antibodies. In many cases, the HA of virus cultivated in eggs was antigenically distinct from the HA of virus from the same individual grown in mammalian cells. Viruses recovered from different individuals were antigenically similar to each other when grown in mammalian cell lines yet were antigenically heterogeneous when cultivated in eggs. The HA genes of viruses isolated from different individuals during the epidemic were shown, by sequence analysis, to differ from each other by five or six amino acid residues. Sequence analyses of the HA genes of MDCK cell-grown and egg-grown virus obtained from the same individual demonstrated that the molecular changes between antigenically distinct HAs of MDCK cell- and egg-grown A/Mem/12/85 virus involved a single amino acid substitution at residue 156 in HA1, which lies at the tip of the HA molecule and immediately adjacent to the receptor-binding site. However, the amino acid sequences of HAs from MDCK-grown and egg-grown viruses (A/Mem/2/85) isolated from a second individual were identical although these viruses exhibited antigenic differences when examined with anti-HA monoclonal antibodies. Therefore, single amino acid changes in the HA molecule may not be the sole cause of antigenic changes in the HA observed between pairs of MDCK cell-grown and egg grown viruses and genes other than that encoding the HA may contribute to the host cell-mediated antigenic variation of these viruses. Nevertheless, antigenic differences between viruses grown in eggs and MDCK cells did not influence their ability to protect, since ferrets infected with either live egg-grown or MDCK grown virus were protected equally well from challenge with virus grown in either host cell type. PMID- 3811240 TI - Assembly of influenza ribonucleoprotein in vitro using recombinant nucleoprotein. AB - The influenza A virus nucleoprotein previously expressed in Escherichia coli after fusion to 32 heterologous amino acids has now been purified and tested for its ability to form complexes with RNA in vitro. By using a simple filter binding assay, we show that ribonucleoprotein (RNP) complexes form readily with single stranded RNA of viral or nonviral origin but not with double-stranded RNA. The RNP complexes formed were similar to authentic influenza virus RNPs in appearance under the electron microscope, in buoyant density in gradients of cesium chloride, and in sensitivities to pancreatic ribonuclease, to chaotropic reagents, and to high salt. We conclude that nucleoprotein synthesized in E. coli has all the properties required for correct assembly into ribonucleoprotein. PMID- 3811241 TI - Interaction of the P1c1 repressor with P1 DNA: localization of repressor binding sites near the c1 gene. AB - The c1 repressor of phage P1 was previously shown (B.R. Baumstark and J.R. Scott, 1980, J. Mol. Biol. 140, 471-480) to bind specifically to P1BamHI-9, a 1.4-kb fragment that is closely linked to the c1 structural gene and spans the ends of the P1 genetic map. The position of the repressor binding site(s) relative to the ends of the genetic map and the c1 gene was investigated by testing cloned fragments of EcoRI-7 and BamHI-9 for c1 expression and repressor binding. Although sequences in both BamHI-9 and the adjacent 2.7-kb EcoRI/BamHI fragment were found to be required for the production of the c1 protein, c1 expression could be restored to the 2.7-kb fragment by the addition of a heterologous promoter (ptac). These observations are consistent with the localization of the c1 reading frame to the 2.7-kb fragment and at least part of the c1 promoter region to BamHI-9. The c1 repressor was shown to bind in vitro to two distinct cloned fragments of BamHI-9 derived from the far right side of the P1 map, indicating the presence of at least two recognition sites in this region. DNA sequence analysis revealed that these two fragments share a 23-bp region of homology. A synthetic DNA containing an 11-bp sequence from this region acts as an effective competitor for repressor binding in vitro, suggesting that at least part of the sequence shared by the fragments is involved in repressor-DNA recognition. PMID- 3811242 TI - Nucleotide sequence of the adenovirus type 40 inverted terminal repeat: close relation to that of adenovirus type 5. AB - Human adenovirus type 40 (Ad40) is a pathogen that causes acute infantile gastroenteritis. Ad40 has the distinct characteristic of being difficult to propagate in conventional cultured human cells. The nucleotide sequence of the inverted terminal repeat (ITR) of Ad40, which includes the origin of adenoviral DNA replication, was determined using recombinant plasmid DNA. By using our newly developed program to express the ITR homologies simply, we found that the ITR of Ad40, which is 163 nucleotides long, was related most closely to that of adenovirus type 5, which replicates efficiently. PMID- 3811244 TI - [Methodological recommendations for the military medical advanced training of reserve officers]. PMID- 3811243 TI - Current estimates from the National Health Interview Survey. United States, 1985. PMID- 3811245 TI - [Pathogenetic treatment of frostbite]. PMID- 3811246 TI - [Military training of medical personnel: ready reserves]. PMID- 3811247 TI - [Internal regulation of the epidemic process and the problems of military epidemiology]. PMID- 3811248 TI - [Current status and problems of the occupational selection of servicemen]. PMID- 3811249 TI - [Body function in exposure to the volatile components of turbine oils]. PMID- 3811250 TI - [Blocks in a system of combined treatment of thoracic and spinal injuries (3)]. PMID- 3811251 TI - [Through a course of initiative and rebuilding]. PMID- 3811252 TI - [The place and role of radiology in the care of injuries and diseases during war]. PMID- 3811253 TI - [Computer tomography in the diagnosis of closed abdominal injuries]. PMID- 3811254 TI - [Diagnostic value of roentgenographic and radionuclide examinations in the detection of bone metastases]. PMID- 3811255 TI - [Evaluation of endoscopic retrograde cholangiopancreatography in diseases of the biliary tract and pancreas]. PMID- 3811256 TI - [Diagnosis of lymphoma of the small intestine]. PMID- 3811257 TI - [Local regional metastases of breast carcinoma after mastectomy]. PMID- 3811258 TI - [Effect of health resort therapy on the morphological composition of the peripheral blood leukocytes in patients with chronic diseases of the gastrointestinal tract]. PMID- 3811259 TI - [Changes in the reparative regeneration processes in the stomach of rats orally given boron-containing waters]. PMID- 3811260 TI - [Effect of mineral waters of different chemical compositions on the pH of the stomach and duodenum]. PMID- 3811261 TI - [Effect of physical exercises on the rate of gastric emptying of food in duodenal peptic ulcer patients]. PMID- 3811262 TI - [Manual therapy of thoracalgia with autonomic-visceral manifestations]. PMID- 3811263 TI - [Importance of the health resort stage in the long-term combined therapy of rheumatoid arthritis patients in different age groups]. PMID- 3811264 TI - [Indices of glycosaminoglycan metabolism in assessing the effectiveness of the sanatorium and health resort treatment of children with rheumatoid arthritis]. PMID- 3811265 TI - [Therapeutic and prophylactic importance of mud applications in a complex of sanatorium and health resort factors for treating pyelonephritis in children]. PMID- 3811266 TI - [The health and nonspecific resistance of preschool children who engage in swimming]. PMID- 3811267 TI - [Early endocrine reactions to mineral water intake]. PMID- 3811268 TI - [Effect of Morshin mineral water on chronic gastroduodenitis patients]. PMID- 3811269 TI - [Antibiotic activity of the molds and actinomycetes in the therapeutic muds of Krasnoyarsk Territory and Tuva]. PMID- 3811270 TI - [Classification of potable therapeutic and medicinal table mineraL waters]. PMID- 3811271 TI - [Individual classification of physical exercises--a basis for developing differentiated methods of therapeutic physical exercise]. PMID- 3811272 TI - [Carbohydrate composition of non-collagen proteins and methods for their determination in mineralized tissues]. AB - Qualitative and quantitative composition of carbohydrates was studied in non collagenous proteins of human and animal mineralized tissues. Species- and tissue specific properties, dependence on the rate of mineralization and on the functional characteristics of solid tissues were studied. Role of protein-bound carbohydrates in osteogenesis and physiology of solid tissues are discussed. PMID- 3811273 TI - [The role of carnitine in the energy metabolism of mitochondria and myocardial cells during ischemia and post-ischemic reperfusion]. AB - L-Carnitine was shown to activate similarly or quite similarly the pyruvate + malate oxidation in control and ischemic mitochondria of rabbit heart at the third state. Carnitine did not alter effect of ischemia but decreased respiration at the fourth state. D, L-carnitine did not affect the total content of adenine nucleotides and ATP, the impairment of cell membranes in isolated rat heart under conditions of postischemic reperfusion as well as the coronary flow of perfusate, except of the control aerobic perfusion, where D,L-carnitine increased the coronary flow. PMID- 3811274 TI - [Characteristics of an experimental model of alcoholic cardiomyopathy by diagnostic enzyme tests]. AB - Experimental alcoholic cardiomyopathy was simulated by aminotriazole administration (1 g/kg) into chronically ethanol intoxicated rats. Activity and isozyme spectra of organospecific enzymes and bilirubin concentration were determined in blood plasma. Activity of catalase was assayed in liver and heart homogenates. The data obtained suggest that not only myocardium but also skeletal muscles were impaired in the experimental group of animals. This phenomenon appears to elucidate the similar pathological effect of ethyl alcohol on myocardium and skeletal muscles. PMID- 3811275 TI - [Mechanism of action of remantadine hydrochloride on Sindbis virus reproduction: inhibition of virus penetration into the cell]. AB - The effect of rimantadine and ammonium chloride on the RNA synthesis of Sindbis virus, added in different times of infection cycle, was studied. When compounds were presented in period of adsorption and first hour post-infection, the maximal inhibitory effect was found. The step blocked by rimantadine was identified as uncoating process (deprotainization). This connection was confirmed by the finding that rimantadine markedly reduced the change of the virus RNA into the nuclease-sensitive form. PMID- 3811276 TI - [Effect of vitamin E deficiency on creatine phosphokinase activity and creatine phosphate levels in the heart muscle]. AB - Vitamin E deficient diet of rats developed impairments in energy metabolism of myocardium, involving a decrease in content of creatine phosphate and in the activity of creatine phosphokinase by 20-35%. Concentration of adenine nucleotides was not altered in myocardium and the content of glycogen was only slightly changed. The impairments in activity of creatine phosphokinase and in the content of creatine phosphate might be among the factors responsible for deterioration of the heart muscle contractile functions in avitaminosis E. PMID- 3811277 TI - [Polarographic method for determining activity of dehydrogenases of the pentosephosphate pathway of carbohydrate metabolism]. AB - A procedure is developed for estimation of glucose-6-phosphate and 6 phosphogluconate dehydrogenases activity in human erythrocytes. The procedure involved polarographic registration of oxygen consumption, which is directly related to content of NADPH formed, in a coupled enzymatic system containing peroxidase and Mn2+. PMID- 3811278 TI - [Direct testing of the antioxidant activity of lipids by a kinetic method]. AB - A procedure for direct evaluation of the antioxidative activity of lipids is developed and optimal conditions are characterized. The procedure was used for estimation of the lipid antioxidative activity in blood plasma and erythrocytes of healthy donors. Alterations in the lipid antioxidative activity were shown in various tissues of a dead body. PMID- 3811279 TI - [A modified highly sensitive spectrophotometric method for determining acid phosphatase activity in the animal liver]. AB - A modified spectrophotometric procedure is described for estimation of acid phosphatase activity in rabbit liver tissue. Coefficient of instrumental sensitivity (SA/C = 0.029), apparent molar absorption (epsilon 820 = 30,500), relative sensitivity of measurement (Cmin = 0.18 mM) were calculated as well as main metrological patterns were evaluated, which showed that the procedure was highly sensitive, accurate and reproducible. Standard error did not exceed 1% and standard deviation was not above 5%. PMID- 3811280 TI - [Comparative study of the activity of arginase isoenzymes in brain tumors of humans and experimental animals]. AB - Isoenzyme spectrum and total activity of arginase were studied in rat brain during growth of transplanted neurinoma and glioma as well as in malignant tissues of human brain. After transplantation of the tumors two peaks of arginase activation were observed within 2-4 days in rat brain tissues and within 16 days in tumoral tissue. Positively charged isoenzyme I of arginase was mainly activated but activity of neutral isoenzyme II was unaltered or slightly decreased. In human brain tumors activity of isoenzyme I was also prevailed, while activity of isoenzyme II was increased in some cases. Regulation of the arginase activity appears to occur by a complex mechanism and the enzyme plays a key role in development of nervous tissue neoplasms. PMID- 3811281 TI - [The state of the microsomal oxidative system of the rat liver in the postoperative period]. AB - A functional state of microsomal enzymatic system was studied in liver tissue of rats within 24, 48 and 72 hrs after surgical operation. Factors of operational treatment and of postoperational period were shown to inhibit distinctly amidopyrine demethylase as well as to decrease the content of cytochromes P-450 and b5 and the glycogen concentration in liver tissue. Content of lactic and pyruvic acids was increased in blood. Depression of the functional state of liver microsomes, occurred as a result of hypoxia, appears to be responsible for the phenomenon of elevated drug toxicity during postoperational period. PMID- 3811282 TI - [Characteristic effect of local anesthetics on the phospholipid composition of mitochondria]. AB - Effect of local anesthetics on phospholipid composition was studied in rat liver mitochondria incubated in hypotonic solution of sucrose. Administration of trimecaine hydrochloride caused active hydrolysis of cardiolipin (CL), while destruction of phosphatidyl choline (PC), phosphatidyl ethanolamine (PEA), lysophosphatidyl choline (LPC), lysophosphatidyl ethanolamine (LPE) and lysocardiolipin (LCL) was inhibited. In the mixture containing tetracaine hydrochloride hydrolysis of PEA, LPC and LCL was decreased; dibucaine hydrochloride caused hydrolysis of CL and LPC, whereas PC was not hydrolyzed. The data obtained suggest that local anesthetics, dissimilar in their physico chemical properties, exhibited specific effect on phospholipid spectrum of mitochondrial membranes. PMID- 3811283 TI - [Characteristics of carbohydrate-protein metabolism in rats of different ages after administration of ulcerogenic doses of aspirin]. AB - Distinct age differences in content of carbohydrate-protein substances were found in rat gastric and pre-gastric walls, liver tissue and blood during experimental ulcer caused by acetyl salicylic acid. These results may be applied to the procedures of aspirin administration depending on age as well as they should be considered during stomach impairments followed the drug treatment using the carbohydrate-protein patterns of blood. PMID- 3811284 TI - [Bilirubin binding to glycosylated human serum albumin]. AB - Glycosylation of human blood serum albumin was carried out by means of prolonged incubation of the protein with an excess of D-glucose or D-glucose-6-phosphate. The amount of glucose covalently bound to the protein was determined using thiobarbituric acid or pyridoxal-5-phosphate. The binding of bilirubin to glycosylated albumin was decreased with an increase in amount of glucose incorporated into the macro-molecule. PMID- 3811285 TI - [Effect of electric stimulation of the hypothalamus on the transcription activity of chromatin in the rat liver during aging]. AB - Age-dependent peculiarities of electric stimulation of hypothalamus were studied by means of estimation of active/inactive liver chromatin fractions, protein/DNA ratio in the latters, level of incorporation of 14C-orotic acid in total RNA and in chromatin RNA fractions. Electric stimulation of hypothalamus in adult rats led to an increase in the relative content of active chromatin fraction and in the rate of the labelled precursor incorporation into both chromatin fractions. In old animals the stimulation did not cause any redistribution of chromatin fractions and did not affect the rate of the labelled precursor incorporation into RNA. These data showed that hypothalamic control of the chromatin status was altered during ageing. PMID- 3811286 TI - [Age-related characteristics of thymidine metabolism in healthy subjects and in patients with stomach ulcer and cancer]. AB - Biosynthesis of pyrimidine nucleotides was intensified in proliferating tissues. Age-dependent alterations in activities of thymidine kinase and thymidine phosphorylase were found in healthy persons of 17-70 years old. Distinct increase in activity of thymidine kinase was observed in patients with gastric ulcer but the activity was decreased with ageing. Alterations in the ratio between anabolic and catabolic reactions involving thymidine were studied also in patients with gastric tumor depending on age. PMID- 3811287 TI - [Chloroquine metabolism in the mono-oxygenase system of mouse liver microsomes]. AB - Metabolism of chloroquine in microsomes of mice liver tissue was studied in vitro by means of thin-layer and microcolumn liquid chromatographies. Chloroquine was metabolized in the system with liver microsomal monooxygenases. The products of its oxidation, involving side chain and aminoquinoline nucleus, were studied. As the enzymatic system is principally similar in various species, analogous metabolites of chloroquine appear to be produced after oxidation of the substance in the plasmodium microsomal monooxygenase system. Thus, this metabolic pathway is responsible for chloroquine resistance of the malarial parasite. PMID- 3811288 TI - [The role of free radical oxidation processes in the morphogenesis of axons of regenerating nerves]. AB - Patterns of lipid peroxidation as well as morphogenesis and differentiation of newly formed axons in regenerating nerve were studied in guinea pigs with experimental syndrome of peroxidation which developed after local gamma irradiation of right hind legs of the animals maintained on the diet containing no antioxidants. The diet without antioxidants increased the inhibitory and impairing effects of the radiation on differentiation of the regenerating nerve and also caused similar effects in control experiments without the irradiation. PMID- 3811289 TI - [Aspartate aminotransferase activity as dependent on the degree of serum dilution]. AB - Dependence of the enzymatic reaction rate V. catalyzed by aspartate aminotransferase, on concentration of standard human blood serum Moni-trol I ("Dade", Switzerland) was studied. In the range of moderate dilutions, which did not exceed 1.3-times, the V value altered in accordance with the blood serum concentration C. Under conditions of extensive dilutions dependence of V on blood serum concentration became complicated. The non-linear type of V dependence on blood serum concentration appears to be due to deaggregation of the enzyme molecules with formation of more active fragments as a result of blood serum dilution. Two parameters should be used for characteristics of blood serum aspartate aminotransferase activity: the enzymatic activity of undiluted blood serum as well as the ratio between specific activities of the enzyme in an associated from and the products of its dissociation, i.e. when C-1 and C-0, respectively. PMID- 3811290 TI - [A method of separate determination of enzymuria associated with impairment of glomerular filtration in kidney tissue]. AB - Possibility of separate estimation of urinary enzymes after impairment of glomerular system and kidney tissue was considered theoretically. Activities of lactate dehydrogenase, alkaline phosphatase, aminopeptidase and gamma-glutamyl transferase were studied in blood serum and urine of II patients with nephrotic syndrome (4 patients with nephrotic form of glomerulonephritis and 7 patients with mixed form of glomerulonephritis). Urinary enzymes derived from blood serum constituted 20-30% of total enzymatic activity in urine of the patients with mixed form of glomerulonephritis and it was related only to the blood serum enzymes with relatively low molecular mass and high activity (alkaline phosphatase and LDH). The results obtained are consistent with the published data showing that kidney tissue is mainly responsible for appearance of the enzymes in urine. PMID- 3811291 TI - [The state of the microsomal oxidative system and liver mitochondria in rats after splenectomy]. AB - Activity of main microsomal enzymes and the functional state of liver mitochondria were studied in male rats within 4, 7, 10 and 30 days after splenectomy. Within early periods after the operation content of cytochromes P 450 and b5, activities of amidopyrine N-demethylase, aniline hydroxylase and NADPH cytochrome c reductase were decreased, while the functional state of rat liver mitochondria was impaired. Administration of splenine into the animals within 6 days normalized distinctly the microsomal oxidation and reduced completely the liver mitochondria functional state in the systems involving both substrates of oxidation. PMID- 3811292 TI - [Effect of the modification of low density lipoproteins by thrombin on their interaction with fibronectin]. AB - Interaction of native and thrombin-modified human low density lipoproteins (LDL) with immobilized homologous fibronectin (either covalently bound to Sepharose or adsorbed from blood serum on collagen-Sepharose) was studied. Treatment of LDL with thrombin at pH 7.5 and 37 degrees within 60 min (thrombin/apo B ratio 1:20 w/w) led to formation in LDL preparations of 3 new fragments of apoprotein B which were detected by polyacrylamide gel electrophoresis in presence of sodium dodecylsulfate. Chromatography of native and thrombinmodified LDL on fibronectin Sepharose showed that 30% of the modified LDL and 2% of native LDL were bound to fibronectin-Sepharose at physiological pH values and NaCl concentrations. Study of the interaction of LDL with fibronectin adsorbed on collagen-Sepharose showed that thrombin-treated LDL partially released fibronectin from the sorbent due to the formation of a modified LDL-fibronectin complex. Native LDL did not act in a similar manner. Complexes of modified, LDL with fibronectin were detected under conditions of both electrophoresis in 3% polyacrylamide gel and immunoelectrophoresis. Interaction of LDL with fibronectin may promote accumulation of lipoproteins in the vascular wall and thus may serve as a model system for evaluation of the extent of atherogeneity of LDL and detection of the modified LDL in vivo. PMID- 3811293 TI - [A limiting factor of glycolysis in bone and callus]. AB - Phosphofructokinase reaction was shown to be a key step of glycolysis after addition of various substrates to postmitochondrial fraction of bone and callus in vitro. Administration of fructose-1,6-diphosphate into the animals with femur fracture within a first week of the fracture consolidation led to activation of glycolysis in regenerate as a result of which more mature callus was formed within 10 weeks. PMID- 3811294 TI - [Human lactoferrin: isolation of highly purified preparations from human milk, various physico-chemical properties and distribution in normal and tumor tissues]. AB - Two procedures for isolation of lactoferrin are described using ion exchange and immunoaffinity chromatography. Electrophoretic mobility, molecular mass, isoelectric point and other physico-chemical properties of the antigen were studied. Immunodiffusion and immunoperoxidase techniques exhibited presence of the antigen in some tissues containing glandular epithelium as well as a decrease in lactoferrin content in malignization. PMID- 3811295 TI - [The role of lipid peroxidation in the process of thermal inactivation of tissue thromboplastin]. AB - Thermic inactivation of tissue thromboplastin in air led to an increase in concentration of malonic dialdehyde and to decrease in activity of thromboplastin. Thromboplastin, treated with ionol, exhibited a less distinct loss of the hemocoagulation activity on heating. Inactivation of the tissue thromboplastin in air during thermic treatment involved at least three steps: thermic denaturation of apoprotein III, lipid peroxidation of the lipid component, observed in the experiment, oxidation of apoprotein III and destruction of its lipid moiety. PMID- 3811296 TI - [Age-related characteristics of urinary excretion of oxyproline]. AB - Age-dependent alterations in excretion of hydroxyproline were studied in 62 healthy persons (3-78 years old) by means of analysis of the morning portion of urine after gel filtration on Sephadex G-10. With ageing the following patterns were decreased: content of total hydroxyproline (r = -0.78; P less than 0.001), the ratio hydroxyproline/creatinine (r = -0.80, P less than 0.001) and content of hydroxyproline in peptide fraction with MW greater than 700-1000 (r = -0.50; P less than 0.001). The reverse correlation was found between the contents of total and free hydroxyproline (r = -0.45; P less than 0.001) but total content of hydroxyproline correlated directly with its content in the peptide fraction (r = 0.92; P less than 0.001). At the same time, reverse correlation was observed between the contents of free hydroxyproline and of the peptide-bound amino acid (r = -0.58; P less than 0.001). Approximate ranges of normal excretion of hydroxyproline with urine were calculated in various age groups. PMID- 3811297 TI - [Modification of the mitochondrial membrane from the rat liver by synthetic phospholipids]. AB - Reconstruction of rat liver mitochondrial membrane by means of synthetic phospholipids enabled to improve the conception on the role of lipids in formation of monoamine oxidase multiple forms as well as elucidated the functions of mitochondrial membrane itself, which contains a tightly-mounted MAO, in regulation of biogenic amines enzymatic oxidation. The data obtained excluded the deciding importance of phospholipids in formation of two types of monoamine oxidases and corroborated the hypothesis on the active role of mitochondrial membrane in enzymatic reactions of tightly-mounted MAO as well as these data suggest that alterations in conformational mobility of the membrane hydrophobic sites shifted distinctly the kinetics of the enzymatic reaction. PMID- 3811298 TI - [Antithrombotic effect of salivary gland secretion and other preparations from the leech Hirudo medicinalis after intravenous and peroral administration to rats]. AB - Antithrombotic effect of leech salivary gland secretion was maximal after intravenous administration into rats and was slightly decreased in cases of peroral administration. Blood from leech intestinal tract and leech homogenate exhibited less distinct antithrombotic action. Effect of these preparations was maintained after peroral administration. The antithrombotic effect of the leech preparations did not depend on their antithrombic activity caused by hirudin. These leech preparations appear to elongate a period of blood plasma recalcification caused by kallikrein inhibitors as well as apparently due to their capacity to inhibit aggregation of the thrombocytes. Relatively low molecular mass substances, penetrating through pores of cellophan membrane during dialysis, were responsible for the antithrombotic effect of the preparations studied. PMID- 3811299 TI - [Calcium metabolism and 3',5'-AMP levels in various organs in emotional-pain stress]. AB - Emotional stress caused distinct alterations in calcium metabolism and hypocalcemia development was observed. At the same time, negative balance of calcium, redistribution of calcium in tissues as well as alteration of the 3; 5' AMP content in the tissues were noted. PMID- 3811300 TI - [Competitive inhibition by carbohydrates of reactions between phytohemagglutinin II and plasma glycoproteins]. AB - Competitive reactions between free carbohydrates and the carbohydrates of blood plasma glycoproteins for receptors of phytohemagglutinin II were studied by means of modified cross affinity immunoelectrophoresis. These reactions exhibited both specific and unspecific properties. Possible mechanisms of these reactions are discussed as well as their possible use in studies of properties of carbohydrate containing biopolymers. PMID- 3811301 TI - [Effect of different supplies of vitamin E on biochemical changes in T-2 mycotoxicosis in rats]. AB - Maintainance of rats within 3 months on a ration with low content of vitamin E (6 mg/kg as compared with 100 mg/kg in control) did not alter distinctly the enzymatic activity in mitochondria, lysosomes and the activity of the enzymes, metabolizing xenobiotics as well as did not affect the permeability of lysosomal and plasmatic membranes. In subacute T-2 mycotoxicosis of rats kept on control ration the following alterations were noted: decrease in activity of lysosomal enzymes, aniline hydroxylase, carboxyl esterase and in content of cytochrome P 450 in liver tissue simultaneously with two-fold activation of epoxide hydrolase and UDP-glucuronosyl transferase; decrease in non-sedimented activity of lysosomal enzymes; decrease in activity of alkaline phosphatase and of lysosomal enzymes in blood serum. After administration of the toxin into vitamin E deficient rats, its effect was increased, hemorrhagic syndrome was distinctly developed, permeability of lysosomal and plasmatic membranes was increased. Subnormal consumption of vitamin E appears to cause destabilization of biological membranes structure, which is manifested under conditions of stress. PMID- 3811302 TI - [Successful cure of rectal cancer by conservative methods (a case report)]. PMID- 3811303 TI - [Computed tomography in the precise diagnosis of intracranial neoplasms]. AB - Out of 687 patients examined with Soviet-made CPT-1000M computed tomograph, 37 were found to have brain neoplasia. The x-ray morphologic pattern of tumors was closely studied as well as densitometric indexes before and after contrast intensification. The said complex of data allowed differential diagnosis of brain pathology. In some cases, histologic pattern of tumor was suggested before it was actually identified. PMID- 3811304 TI - [Latent intracranial tumors as a cause of sudden death]. AB - An analysis of the clinico-morphological data on 8 cases of undiagnosed intracranial tumors showed these neoplasms to be the cause of sudden death as a result of cerebral circulation disorders or an acute swelling of the brain. PMID- 3811305 TI - [Prognostic significance of the glucocorticoid receptor level in the bone marrow blast cells of children with leukemias]. AB - Glucocorticoid receptor (GR) levels of bone marrow blast cells were measured in 29 pediatric patients suffering different forms of acute leukemia. A decrease in GR level was registered immediately after prednisolone treatment. Differences in cell GR levels in patients with lymphoblastic and myeloblastic leukemia were not significant. The level of GR of bone marrow blast cells was found to be of prognostic significance in acute lymphoblastic leukemia: 4 out of 5 patients with GR levels under 3,000 sights per cell relapsed within 5-7 months of follow-up whereas all 7 cases with higher levels continue in remission. No correlation between GR level and prognosis was established in 5 patients with various forms of acute myeloblastic leukemia. PMID- 3811306 TI - [Benign tumors of the peripheral nerve trunks]. AB - Seventy-nine cases of benign neurinoma and neurofibroma of the nerve trunk in the extremities were studied. Tumors were radically removed in all cases. Due to application of microsurgical procedure, tumor can be reliably exposed and radically removed, leaving the intact segment of the nerve tissue. In most such cases, prognosis is favorable. PMID- 3811307 TI - [Cytoplasmic receptors of steroid sex hormones in malignant tumors amd precancerous processes of the human oral mucosa]. AB - The ability of receptor cytoplasmic proteins to bind estrogens and androgens was studied in 25 biopsies obtained from cases of squamous-cell carcinoma and leukoplakia of oral cavity mucosa. Androgen receptors were more frequently identified in cancer than in leukoplakia whereas the estrogen receptor situation was reverse. PMID- 3811309 TI - [The Lukes-Collins classification and the Kiel classification of non-Hodgkin's lymphomas]. AB - 280 cases of non-Hodgkin lymphoma were studied histologically according to the criteria of Lukes-Collins as well as Lennert's classifications. Nodularity was predominantly related to the SC and LC types according to the Lukes-Collins classification. Nodularity is indicative of better survival. The Burkitt and convoluted types were found to be predominantly related to childhood or to younger patients and the non-Burkitt type most frequently to the older groups. The Lukes-Collins classification separates well two clear prognostic groups--the favorable and the unfavorable one with overall median survivals of 44 and 11 months, respectively. Within the Kiel classification, nodularity was found mainly in the CB-CC type, but also in 27% of the CC cases. The relationship of the subtypes according to the Kiel classification and age resembles the same relation found with the Lukes-Collins classification, where according to the Kiel classification the Burkitt, convoluted and lymphoblastic types were related to children and adults. Three prognostic groups were identified with overall median survivals of 80, 38 and 13 months, respectively. PMID- 3811308 TI - [Long-term selective infusion of cis-diamminedichloroplatinum into the internal iliac arteries in the treatment of bladder cancer]. AB - Long-term selective infusion of 70-120 mg/m2 cis-diamminedichloroplatinum into internal iliac arteries was used in 20 cases of advanced bladder cancer (T2-3, T3a-5, T3b-4 and T4-4 patients). X-ray endovascular catheterization of arteries was performed in 16 and surgical chronic one--in 4 cases. Complete remission was recorded in 1, partial remission--10 and stabilization--in 9 patients. Pronounced symptomatic effect was observed. No serious complications were registered. The procedure requires further study. PMID- 3811310 TI - [Reproducibility of a non-Hodgkin's lymphoma classification]. AB - In a retrospective reclassification of 148 non-Hodgkin's lymphomas the reproducibility of the Lukes--Collins classification used was tested by comparing a joint diagnosis with that of each author separately. The cases of disagreement were usually proved to have happened within lymphoma groups with an equivalent prognosis. An exception was the relatively high disagreement rate between the subclasses of small lymphocytic and small non-cleaved lymphomas, and this represents the most important finding clinicopathologically. PMID- 3811311 TI - [Effect of thymalin and epithalamin on the metastasis of experimental tumors irradiated with pulsed laser radiation]. AB - The effect of thymalin and epithalamin on dissemination of tumors treated by pulsed laser radiation was studied in C57B1 female mice bearing subcutaneously transplanted melanoma B16 and Lewis carcinoma. Radiation was delivered from TOC 1001 neodymium laser, wave-length of 1,060 nm, pulse duration--1 msec and fluence -350-400 J/cm2. Drug dosage was 1 mg. Thymalin and epithalamin treatment potentiated the preventive effect of laser radiation on tumor dissemination. Application of the said agents was followed by an increase in antibody-producing cells (as measured by Jerne's procedure) in the spleen of irradiated melanoma B16 -bearing mice. PMID- 3811312 TI - [Carcinogenic activity of hexachlorophene]. AB - Albino noninbred rats were exposed to hexachlorophene (chronic inhalation of 0.1 CL50 for 12 months). The tumors detected occurred mostly in the lungs. Increased incidence of lung tumors as well as their histomorphologic pattern (not typical of spontaneous neoplasms of these animals) suggested carcinogenicity of hexachlorophene under the said conditions. PMID- 3811313 TI - [Dependence of the carcinogenic effect of N-nitrosomethylurea on its dosage and the age of female rats]. AB - Female rats aged 3 and 15 months received single intravenous injections of 10, 20 or 50 mg/kg of N-nitrosomethylurea (NMU). The rate of 14-month survival (duration of experiment) in younger animals was 90, 61 and 42%, respectively, while in the older age group it was 15, 0 and 0%. In 3-month-old rats, a direct correlation was established between NMU dosage, on the one hand, and overall incidence of tumors as well as that of breast adenocarcinoma, renal, ovarian and colonic neoplasms, on the other. No dose-incidence correlation was found for any tumor site in 15-month-old animals. The incidence of NMU-induced uterine and cervical neoplasia was higher in the older age group while mammary, intestinal, ovarian and renal tumors were more frequent in younger rats. The results were evaluated versus the data on DNA alkylation, O6-methylguanine repair and DNA synthesis obtained from the same model. A key-role of age-related changes of proliferative activity of target tissues in the modifying effect of aging on NMU-induced carcinogenesis in rats was suggested. PMID- 3811314 TI - [Effect of bile on the development of tumors of the stomach and small intestine induced in rats by N-methyl-N-nitro-N-nitrosoguanidine]. AB - The study of the influence of long-term injection of whole bile into rat's stomach on N-methyl-N-nitro-N-nitrosoguanidine-induced tumors revealed an increased frequency of stomach malignancies matched by a lower frequency of those in the small intestine as well as slower rates of growth of gastrointestinal tumors. PMID- 3811315 TI - [Surgical treatment of a pancreatic tumor with complete obturation of a part of the portal vein (a case report)]. PMID- 3811316 TI - An unusual case of post-transfusion purpura: good transient response to high-dose immunoglobulin. AB - A 62-year-old woman with an unusually protracted post-transfusion purpura failed to respond to three 3-litre plasma exchanges and prednisolone (50 mg/day) for 10 days but then had a good though transient response to two courses of high-dose immunoglobulin infusions with cessation of bleeding. The subsequent recurrent thrombocytopenia was mild and asymptomatic and only partially controlled by corticosteroids but finally resolved completely after 5 months. PMID- 3811317 TI - Continuous monitoring of platelet morphology during small-scale in vitro storage. AB - A commercially available aggregometer was mechanically and electronically modified to enable automatic repeated measurements of platelet morphology for platelet suspensions undergoing prolonged storage within a sealed perspex cuvette, at any temperature. The modifications are described in sufficient detail to enable others to readily produce the same or similar apparatus. Representative experiments with such apparatus are described, and indicate its potential usefulness in defining the rate of change of platelet morphology occurring during storage at any given temperature, e.g. progressive alteration of shear-induced light transmission change values. PMID- 3811318 TI - Generation and degradation of fibrinopeptide A in stored platelet concentrate. AB - The levels of fibrinopeptide A (FPA) were measured in samples from stored platelet concentrates (PC) by radioimmunoassay. In 27 standard, citrated PC, the mean FPA was 13.6 ng/ml, which is elevated 5-6X over background levels. This value did not change significantly over a 7-day storage period. Addition of PGE-1 and theophylline resulted in higher initial levels of FPA (18.0 ng/ml) and a pronounced rise during the storage period (to 43.4 ng/ml by day 10). In contrast, addition of a thrombin inhibitor, D-phenylalanyl-L-prolyl-L-arginine chloromethyl ketone-2 HCl (PPACK) or hirudin, resulted in lower initial levels of FPA relative to standard, citrated PC and a slow increase over time. Introduction of exogenous FPA into citrated PC resulted in a predicted elevation of FPA levels followed by a rapid loss of immunoreactivity (t1/2 = 18 h). Addition of PPACK did not affect this fall-off. However, PC prepared and stored in the presence of PGE-1 and theophylline showed a much slower fall-off of exogenous FPA (t1/2 = 38 h). These data indicate that FPA levels in samples from citrated PC represent a dynamic balance between generation and degradation processes and, thus, the data above underestimate the amount of thrombin activity present in stored, citrated PC. PMID- 3811319 TI - Reactions of murine monoclonal antibodies to blood group MN antigens. AB - BALB/c mice were immunized by intraperitoneal injections with human blood group substances; 4 mice with M and 4 with N. Immune spleen cells were fused with murine myeloma cells X63-Ag-8.653. Two clones secreting monoclonal anti-M and seven secreting monoclonal anti-N were identified. All antibodies were of IgG1 subclass and had kappa light chains. Three clones have been maintained that produced antibodies useful for typing purposes: anti-M, A09 originating from a mouse injected with M, anti-N, AH7 originating from a mouse injected with N, and anti-N BO10 originated from a mouse injected with M substance. In typing 370 erythrocyte samples, monoclonal reagents gave identical results with commercial anti-M or anti-N typing sera of rabbit origin. Significantly, anti-N reagent AH7 obtained by immunization with N substance showed serological differences from anti-N reagent BO10 obtained by immunization with M substance in that AH7 had apparently higher avidity to N specificity on glycophorin A of N erythrocytes than BO10, whereas BO10 showed higher avidity for 'N' specificity on glycophorin B of M and N erythrocytes than AH7. These two reagents showed also somewhat different patterns of reaction with enzymatically digested erythrocytes. This apparent serologic difference between N and 'N' specificities is at variance with current immunochemical data. PMID- 3811320 TI - Proposal for the nomenclature of human plasminogen (PLG) polymorphism. AB - Since its discovery, human plasminogen (PLG) polymorphism has received widespread acceptance in population genetics and forensic haematology. Due to the large number of variant alleles described, a PLG reference typing and Plasminogen Symposium was held, at which a nomenclature proposal was inaugurated. The technology of comparing PLG variants was based on isoelectric focusing and subsequent detection by caseinolytic overlay and 'Western' blotting. Typing results permitted comparison of so far described variant designations and resulted in a new nomenclature proposal for PLG polymorphism. It is recommended that the two most common alleles found in all investigated races be called: PLG*A (previously also PLG*1) and PLG*B (previously also PLG*2), the known variants with acidic pI: PLG*A1 to *A3, intermediate variants: PLG*M1 to *M5, PLG*M5 being functionally inactive, and basic variants: PLG*B1 to *B3. For future classification of newly discovered variants, samples should be compared at any of the laboratories participating in the reference typing. PMID- 3811321 TI - [Status and prospects of the development of gastroenterology in Bulgaria]. PMID- 3811322 TI - [Endoscopic retrograde cholangiography in the diagnosis of mechanical jaundice]. PMID- 3811323 TI - [Duodenal and antral influences on acid formation in the stomach in peptic ulcer]. PMID- 3811324 TI - [Laboratory methods of diagnosis in peptic ulcer and pancreatitis]. PMID- 3811325 TI - [Epidemiologic characteristics of chronic gastritis. Studies of the iris in mass screening of the population]. PMID- 3811326 TI - [Laser therapy in the combined treatment of peptic ulcer patients]. PMID- 3811327 TI - [Treatment of duodenal ulcer with psychotropic agents to prevent relapse]. PMID- 3811328 TI - [Our experience with 3000 upper gastrointestinal fiber endoscopies]. PMID- 3811329 TI - [Gastroesophageal reflux and reflux esophagitis in young people with gastroduodenal diseases]. PMID- 3811330 TI - [Immediate and late results following gastroscopic polypectomy]. PMID- 3811331 TI - [Comparative endoscopic, histomorphologic and cytologic studies in stomach tumors]. PMID- 3811332 TI - [Comparison between the cytologic, biopsy and endoscopic findings in diseases of the upper gastrointestinal tract]. PMID- 3811333 TI - [Transendoscopic treatment of stomach ulcer]. PMID- 3811334 TI - [Intestinal malabsorption syndrome in chronic enteritis]. PMID- 3811335 TI - [Rectoromanoscopic findings during prophylactic examination of peptic ulcer patients]. PMID- 3811336 TI - [Functional and morphological changes in the small intestine of patients with alcoholic liver cirrhosis]. PMID- 3811337 TI - [Hepatitis viral antigens and antibodies against them in chronic liver diseases]. PMID- 3811338 TI - [Ultrastructural characteristics and clinico-laboratory correlations in chronic active hepatitis]. PMID- 3811339 TI - [Serum level of vitamin B12 and folic acid in patients with diffuse liver diseases]. PMID- 3811340 TI - [Serum protein changes in chronic inflammatory liver diseases]. PMID- 3811341 TI - [Clinico-epidemiologic characteristics of 200 cases of primary liver cancer in Burgas Province]. PMID- 3811342 TI - [Present-day diagnosis of primary liver cancer]. PMID- 3811343 TI - A WHO training package aimed at improving the use of radiology for underserved populations. PMID- 3811344 TI - Mental health in old age. A model for concerted action by WHO and university hospitals. PMID- 3811345 TI - Pharmaceutical preparations of psychotropic drugs: the role of WHO. PMID- 3811346 TI - What is medical informatics? PMID- 3811347 TI - Clinical information systems--a review. AB - TWO HYPOTHESES ARE OFFERED IN THIS REVIEW OF CLINICAL INFORMATION SYSTEMS: that the technology is mature, and that benefits to patient care can be shown. More than ten years of operational experience exist with each general class of clinical information systems, and these systems favorably affect staff, reduce errors, improve accessibility to medical information and provide alerts and reminders. To reinforce the maturity hypothesis, most cited studies are also a decade old. Clinically oriented systems are practical and can improve the health care process-a key goal in this era of prepaid or prospective payment for services. PMID- 3811348 TI - The Medical Gopher--a microcomputer system to help find, organize and decide about patient data. AB - We have developed a microcomputer-based medical workstation that does some of physicians' "gopher" work of fetching, organizing, reviewing and recording. For two years physicians have used the first version of this system to order all diagnostic tests in a general medicine clinic. They are about to use a newer version to write prescriptions and office visit notes and to find general medical and patient-specific information. Users can enter data into this system by "pointing" with a "mouse" to menu items displayed on a video terminal. In the course of a computer activity, a physician can obtain information about drugs, tests and different diagnoses, as well as about the patient. The microcomputer workstations are linked to each other and to a central hospital information system through a high-speed network link. Our physicians have accepted the initial order-entry system, and early experience suggests they prefer this faster and more sophisticated system. PMID- 3811349 TI - Medical expert systems--knowledge tools for physicians. AB - Recent advances in the field of artificial intelligence have led to the emergence of expert systems, computational tools designed to capture and make available the knowledge of experts in a field. Although much of the underlying technology available today is derived from basic research on biomedical advice systems during the 1970s, medical application packages are thus far generally unavailable from the young artificial intelligence industry. Medical expert systems will begin to appear, however, as researchers in medical artificial intelligence continue to make progress in key areas such as knowledge acquisition, model-based reasoning and system integration for clinical environments. It is accordingly important for physicians to understand the current state of such research and the theoretic and logistic barriers that remain before useful systems can be made available. One experimental system, ONCOCIN, provides a glimpse of the kinds of knowledge-based tools that will someday be available to physicians. PMID- 3811350 TI - Laboratory medicine in the age of information. AB - Information systems in laboratory medicine reflect and respond to the major changes now taking place in health care. This fruitful and practical area for medical information science encompasses problems in medical information science, shop floor control and issues in clinical behavior. PMID- 3811351 TI - The case for using computers in the operating room. AB - The largest cost center and revenue generator in most hospitals, the operating room is subject to demands for increased cost accountability and quality assurance. Information technology tools can be incorporated into the operating room and have the potential to positively affect practices there through addressing nursing, administrative/financial and medical needs. Microcomputer based operating room systems now on the market can provide functions from scheduling and case costing to medical records and market analysis. Of 21 functions identified, 10 can be characterized as mandatory and the remaining as optional. Individual systems offer varied configurations, providing from 0 to 21 functions. These enhanced capabilities for data collection, monitoring and analysis enable health care professionals to provide both better and more cost effective care for surgical patients. PMID- 3811352 TI - Radiology systems of the 1990s--meeting the challenge of change. AB - Digital imaging technology, particularly reconstructed images such as computed tomography and magnetic resonance imaging, has fueled the increased demand for radiologic services but has intensified storage and communications problems. Today more than 25% of radiologic examinations are digital in origin and, with progressive replacing of film images by digital images likely through the introduction of imaging plate technology, the radiology profession is undertaking the massive effort of evolving a new system where digital images will be transmitted, stored, retrieved and displayed by a multicomponent system connected by a local area network. Through this system, images will be nearly instantly accessible to anyone who needs them.A leading hypothesis is that when the volume of digital examinations reaches 50% of the whole, cost and efficiency considerations will lead to a massive conversion to the digital image management system, which will progress spontaneously. This conversion, unless planned for in today's equipment acquisitions, could lead to great economic stress in hospitals. The 50% point may be reached by the early 1990s. PMID- 3811353 TI - Medical libraries and computers. The role of medical libraries in medical informatics. AB - The classic function of health sciences libraries is to build and maintain a knowledge base and to provide timely access to that collective memory for the purpose of learning, teaching, caring for patients, conducting research or managing an organization. The formats and representation of that knowledge base are changing rapidly, as are the methods and techniques for gaining access to information. Medical libraries have long used computers for cataloging and controlling records but are now shifting to acquiring, managing and distributing bibliographic and full-text information to local library "networks." PMID- 3811354 TI - Learning resources for medical computing. AB - For medical professionals to acquire computer literacy can be an arduous task. Resources for learning medical computing fall into four major categories: learning technical microcomputer use, computerizing an office practice, tracking patient care experience and integrating medical information systems. Both microcomputer use and tracking patient care experience are technical skills similar to learning any medical procedure with which physicians are already familiar. These skills can be acquired by consulting general, commercial resources such as computer stores, popular computer magazines or software manuals. Computerizing an office practice involves diagnosing office information problems by thoroughly analyzing how data flow during outpatient care. Medical information system design and management is a cognitive specialty in which principles of computer science and medical information management are applied to patient care experience. PMID- 3811355 TI - The computer and the future of continuing medical education. AB - Traditional continuing medical education-general reading, attending courses and conferences and having discussions with colleagues-helps physicians review fundamental concepts and learn new developments in medicine. This type of continuing education is well established and will not change dramatically. Beyond this, physicians learn from specific problems that arise in practice. A computer can enhance practice-related continuing medical education by providing information when a physician is developing diagnostic and therapeutic plans. Computer mail and telephone voice mail improve communication among physicians. Computers, by storing practice data, enable physicians to study their practices and profit from experience. Hospitals, specialty societies and medical schools should investigate using computers to help physicians profit maximally from experience. PMID- 3811356 TI - [Results of the treatment of hemorrhage from the upper segment of the digestive system]. PMID- 3811357 TI - [Abdominal injuries in children as an anesthesiologic and surgical problem]. PMID- 3811358 TI - [Treatment of auricular hematomas]. PMID- 3811359 TI - [The wisdom teeth]. PMID- 3811360 TI - [Changes in the serum levels of seromucoid and sialic acid in women with cervical cancer after brachytherapy]. PMID- 3811361 TI - [Heterotopic tumor-like focus of pancreatic tissue in the stomach]. PMID- 3811362 TI - [Diagnostic difficulties in a case of gluten-dependent malabsorption syndrome manifesting itself in the puerperium]. PMID- 3811363 TI - [Oculomotor nerve paralysis in myelofibrosis]. PMID- 3811364 TI - [Various aspects of the etiopathogenesis of spontaneous abortion]. PMID- 3811365 TI - [Pathophysiology of non-cardiogenic pulmonary hypertension]. AB - The pathophysiology of non cardiogenic pulmonary hypertension consists mainly of pulmonary vascular changes and alveolar hypoxia. Pulmonary vascular changes might have different etiologies. First the vessel itself with local thrombosis, embolic obstruction, vasoconstriction and endothelial cell dysfunction with intimal proliferation. Secondly parenchymal changes with secondary vascular affection could contribute to pulmonary hypertension. The mechanism of hypoxic pulmonary vasoconstriction is unknown, a direct interaction of oxygen with the smooth muscle cell is possible. The interaction of activated circulating cells - i.e. platelets or leukocytes - and - possibly predamaged - endothelial cells could be the initiating mechanism for several forms of pulmonary hypertension. This could be especially true for the so called primary forms or for dietary pulmonary hypertension e.g. after ingestion of toxic oil. PMID- 3811366 TI - [Sports fitness in pulmonary hypertension]. AB - In patients with pulmonary hypertension caused by a large ventricular septal defect, the cardiopulmonary performance capacity (CPC) depends on the relation of pulmonary to systemic vascular resistances. Changes in this relation occurring on exercise are mainly due to an exercise - induced fall of the systemic vascular resistance. If the ratio of pulmonary to systemic resistance is below 1 at maximal exercise, the CPC is reduced as a result of the left to right shunt. In case of a pulmonary to systemic resistance ratio of higher than 1 at maximal exercise hypoxemia will be a limiting factor. Only in cases of a moderate degree of pulmonary vascular changes, resulting in a relation of resistances at maximal exercise in the range of 1, will the CPC be normal. Patients with primary pulmonary hypertension always present with reduced CPC as a main symptom. Cardiac output cannot be adequately increased during exercise. Only by excessive peripheral oxygen desaturation can a certain adaptation to the oxygen demand of the exercising organism be possible to a certain degree, though only at low work rates. Uneven perfusion and the corresponding ventilation-perfusion inequality are only moderate. However, due to the widened arterial-venous oxygen difference, ventilation-perfusion inequality with its distinct alveolar-arterial oxygen pressure difference can result in a considerable degree of venous admixture. In adolescents, pulmonary hypertension caused by obstructive lung disease is seen almost only in patients with advanced stages of cystic fibrosis. It is then combined with increased venous admixture, and often with CO2-retention.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3811367 TI - [Doppler echocardiographic evaluation of pressure in the pulmonary artery in children with congenital heart defects]. AB - In children with congenital heart disease serial noninvasive assessment of the pulmonary vascular bed is desirable in order to determine the appropriate timing of cardiac catheterization and corrective surgery. To assess the value of pulmonary Doppler echocardiography for the estimation of pulmonary arterial pressure we correlated the rightsided systolic time intervals (preejection period, acceleration period, ejection period) derived from pulmonary artery Doppler traces with catheterization data (systolic, mean and diastolic pulmonary arterial pressure, total and vascular pulmonary resistances). 62 children aged from 1 month to 15 years suffering from congenital heart disease (n = 52), from rheumatic heart disease (n = 4), from cardiomyopathy (n = 5) or from primary pulmonary hypertension (n = 1) were investigated. The major finding was a highly significant correlation between the acceleration period and the systolic pulmonary arterial pressure (r = 0.79; p less than or equal to 0.0001). However the acceleration period could not be used for prediction of pulmonary arterial pressure in children with poor myocardial contractility. PMID- 3811368 TI - [Etiology and pathogenesis of Crohn disease and ulcerative colitis]. AB - The aetiology and pathogenesis of Crohn's disease and ulcerative colitis have not yet been clarified. None of the many investigations on the involvement of genetic, microbial, psychological, immunological and environmental factors have been able to identify a single aetiological agent. Nevertheless, all of these factors could play a role in a multifactorial model of the aetiology and pathogenesis of inflammatory bowel disease. PMID- 3811369 TI - [New aspects of Crohn disease and ulcerative colitis: current diagnosis]. AB - Differential diagnosis of inflammatory bowel disease includes careful history taking, microbiological stool tests and endoscopy. Radiological procedures are required only in patients with Crohn's disease in order to demonstrate small bowel lesions or fistulae. The clinical relevance of recent scintigraphic techniques (67-gallium-citrate, 111-indium granulocytes, 99m-technetium sucralfate) needs further exploration. Careful follow-up of patients with ulcerative colitis and Crohn's disease is mandatory once the duration of symptoms exceeds 10 years, in view of the high risk of development of carcinoma. The search for severe dysplasia is difficult and time consuming. Certain additional tests promise to be of value in detecting early malignancy, but these are not yet suited for routine clinical follow up. PMID- 3811370 TI - [Value of postoperative irradiation of cases of cervix cancer of histologic stage I/b with extensive infiltration (stage I/c)]. AB - The separation of FIGO stage I b cervical carcinoma into a new histological stage I b1 and a stage I c (deep infiltration confined to the cervix) leads to an essential difference in therapeutic results. 5-year survival of 152 cases consigned to the new stage I b1 was 92%, whereas that of 95 cases of the new stage I c was only 77%. Hence, 5-year survival of stage I c patients is lower than of FIGO stage II a (83%). Contrary to our earlier practice, since 1976 all stage I c cases have received postoperative irradiation (Cobalt60). 5-year survival of 75 stage I c cases without lymph node metastasis was 83% when treated by surgery alone; 5-year survival of 22 similar cases treated by surgery and postoperative irradiation was 82%. There is no benefit of postoperative irradiation in cases of stage I c cervical carcinoma when the lymph nodes are not affected. PMID- 3811371 TI - On the relevance of "second-line" cytotoxic chemotherapy in patients with metastatic breast cancer resistant to standard combinations. AB - 85 clinical studies concerning second-line chemotherapy of metastatic breast cancer have been analyzed. With minor exceptions, the mean remission rates ranged between 0-10% (complete remission) and 20-40% (partial remission) for the most commonly used second-line chemotherapy modalities. The mean duration of response was 6 months, the average survival time 10 months. No significant differences in effectiveness and side effects were found when comparing the different second line treatment programmes. PMID- 3811372 TI - [Obstetric aspects of radiation exposure following the Chernobyl accident]. AB - Radioactivity was determined in the milk from 39 patients and in amniotic fluid, urine and placentas from 17 patients shortly after the Chernobyl disaster by means of a beta and gamma-scintillation counter. Elevated radioactivity (7.6 nCi/l beta activity and 7.4 nCi/l gamma activity) was found only in one sample of breast milk. PMID- 3811373 TI - [Value of anamnesis and the clinical stress test in the diagnosis of incontinence before gynecologic operations]. AB - In a study comprising 471 patients the clinical value of a standardized questionnaire (Gaudenz questionnaire) and the standing clinical stress test were determined in the diagnosis of urinary incontinence. The sensitivity, specificity and predictive value of the positive and negative test of both methods were ascertained. As opposed to the final urodynamic result the clinical stress test alone showed a sensitivity of 48% (specificity 70%) in the diagnosis of genuine stress incontinence. 82% of all patients with stress incontinence were ascertained by the questionnaire, but only 54% were classified correctly as negative. The specificity of both methods combined was 94% and the predictive value 89%. On the other hand the questionnaire's predictive value in the diagnosis of urge incontinence was 9% (specificity 58%). However, the predictive value of both questionnaire and standing clinical stress test, combined, rose to 15%. Our results statistically demonstrate that the use of both methods together provides more significant information than the use of either separately. PMID- 3811374 TI - [What does psychotherapy accomplish in the treatment of psychosomatic disorders?]. AB - Psychosomatic disorders are epidemiologically so frequent as often accompanied by psychic (anxiety), vegetative, and psychiatric (depression) symptoms. Efficient psychotherapy of psychosomatic disorders must therefore influence vegetative (peripheric) and central arousal as well as deficient coping strategies. The latter trigger pathologic psychosomatic reaction patterns in (mostly) specific distressfull situations. Psychotherapy of psychosomatic disorders effects: Relaxation of the overactivated and stimulation of the desactivated, a shift of the patient's exclusively somatic attribution of the disease to a psychosomatic one, more efficient coping strategies, a break-up of the pattern "conflict - emotion - vegetative irritation - physiologic reaction". PMID- 3811375 TI - [Crisis intervention]. AB - The main aspects of crisis intervention are an immediate onset without time consuming referrals, activities of the helper always keeping in mind the biopycho social context, and assistance for selfhelp. Helping people in crises minds to find out and develop the possibilities of the afflicted person aiming that he can overcome his crisis by himself, gaining maturity and reaching a less crisis-prone life style. PMID- 3811376 TI - [Strategies of behavioral medicine in physically severely ill patients]. AB - With physically seriously handicapped patients very often vital functions break down or threaten to break down so that they have to be in intensive care units. They need an elaborate therapy and care that is primarily determined by technical monitoring. The severe illness, the situation of the in-patient treatment and the patients' personality determine the psychotherapy. Behavioral strategies are effective for the reduction of unwanted behavior patterns and the condition of desired behavior patterns. The systematic desensibilization to disaccustom to an apparatus once vital to the patient, the psychological-behavior directed approach in the research of depression as well as several conditioning methods for the organization of operant behavior patterns are to be mentioned here. PMID- 3811377 TI - [Behavior medicine intervention strategies in nursing home patients with manifestations of dementia of multiple origins]. AB - The present study is an attempt to throw light on the possibilities and scope of different therapeutic applications concerning geriatric patients. Guide-lines are presented for the absolving of general animation programmes as well as also a specific "training in realism, orientation and memory" to modify the symptoms of chronic brain syndromes. First results show that with both intervention strategies a better integration of demented patients is possible in the department. Furthermore some improvements in the cognitive area can be attained by means of selective training. PMID- 3811378 TI - [Behavioral medicine aspects of juvenile diabetes]. AB - Childhood or insulin-dependent diabetes is a life-long illness, placing complex and daily demands on the patient and the family. Some studies were carried out in order to investigate the relationship between health status, behavioral and psychological variables. The Hemoglobin A1 was used to index glycemic control. A newly developed diabetes knowledge test and a questionnaire on diabetic related beliefs were administered. The results indicate that diabetic control improves with age. General knowledge of diabetes increases with age, but relates not to diabetic control. But considering age and the particular subtests of knowledge as predictors 59.44% of the variance in diabetic control can be estimated. Perceived barriers to implementing self-care and feelings of disruptiveness culminate in the age of 12 to 13 years. Feelings of stigmatization and the affection by the disease loose weight as disturbing factors with increasing age and knowledge. Increased attention to the child's cognitive developmental level is suggested and methods for improving the effectiveness of patient intervention programs are discussed. PMID- 3811379 TI - Tuberculous mastitis: a continuing problem. PMID- 3811380 TI - The hyperfunctioning intrathyroidal parathyroid gland: a potential pitfall in parathyroid surgery. PMID- 3811381 TI - Identification and antibiotic prophylaxis of high-risk patients in elective colorectal surgery. PMID- 3811382 TI - The use of blood components in the treatment of congenital coagulation disorders. PMID- 3811384 TI - Immune hemolytic transfusion reactions. PMID- 3811383 TI - The use of blood components in surgical transfusion therapy. PMID- 3811385 TI - Autologous blood predeposit for elective surgery: an Italian experience. PMID- 3811386 TI - The appropriate role of frozen-stored red blood cells in transfusion practice. PMID- 3811387 TI - Worldwide supply of blood and blood products. PMID- 3811388 TI - Vagal regeneration after parietal cell vagotomy: an experimental study in dogs. PMID- 3811389 TI - WIPRO/HCFA futility. PMID- 3811391 TI - Patient perceptions during cancer chemotherapy. PMID- 3811390 TI - Aeromedical transportation in Wisconsin. PMID- 3811392 TI - Wisconsin initiative for improving cancer pain management. PMID- 3811393 TI - Strategies for smoking withdrawal. PMID- 3811394 TI - Smokeless tobacco: a public health challenge. PMID- 3811395 TI - Histologic confirmation of recurrent Hodgkin's disease by percutaneous pleural biopsy. PMID- 3811396 TI - [Infant nutrition in East Germany]. PMID- 3811397 TI - [Status of children with frequent infections from an immunologic viewpoint]. PMID- 3811398 TI - [Results of maxillary sinus irrigation in childhood]. PMID- 3811399 TI - [Headache in childhood--problems in diagnosis]. PMID- 3811400 TI - [Hyperosmolar nonketotic diabetic coma in childhood]. PMID- 3811401 TI - [Familial disorders of lipid metabolism in childhood]. PMID- 3811402 TI - [Pain in the thorax in children: references for differential diagnosis]. PMID- 3811403 TI - [Incidence of symptoms at a pediatric polyclinic]. PMID- 3811404 TI - [Exponential escalation of diagnosis and therapy in general medicine]. PMID- 3811405 TI - [Clinical signs and diagnostic procedures in chronic cor pulmonale]. PMID- 3811406 TI - [Lyme disease--a "new" disease (or: diseases also have a history)]. PMID- 3811407 TI - [Anal fissure]. PMID- 3811408 TI - [Knowledge of sickle cell disease--with special reference to differential diagnostic considerations]. PMID- 3811409 TI - [Neuroradiologic study of patients with spinal injuries]. PMID- 3811410 TI - [Osteomyelitis of the iliac crest--a rare complication following perforated appendicitis]. PMID- 3811411 TI - [The use of occupational law in solving problems at obstetric-gynecologic facilities]. PMID- 3811412 TI - [Intensification and rationalization--principles for stable and dynamic growth of the political economy and social progress]. PMID- 3811413 TI - [Work schedule in ambulatory consultation]. PMID- 3811414 TI - [Genetic risks of children of incestuous and consanguineous unions]. PMID- 3811415 TI - [Local anesthesia and the mind]. PMID- 3811416 TI - [Incidence of faulty catheter position in the quantitative analysis of gastric juice]. PMID- 3811417 TI - [Invagination ileus as an acute disease picture--also in the adult]. PMID- 3811418 TI - [Malaria and abdominal typhus--a differential diagnostic problem. Case report]. PMID- 3811419 TI - [Seckel syndrome (the bird-headed dwarf)]. PMID- 3811420 TI - [Alcohol, drugs and traffic laws. 2: Studies of the assessment of significant disability in automobile driving fitness caused by psychotropic drugs or alcohol and psychotropic drug combinations]. PMID- 3811421 TI - [Peace--the ideal and the reality]. PMID- 3811422 TI - [Zoonoses]. PMID- 3811423 TI - [Psychological aspects of managing patients with asthma from the internal medicine viewpoint]. PMID- 3811424 TI - [Current problems in pediatric endocrinology]. PMID- 3811425 TI - [Roentgen study of the large intestine]. PMID- 3811426 TI - [The course of pregnancy and labor in young females with reference to morphometric studies of the placenta]. PMID- 3811427 TI - [Causes, clinical forms and forensic assessment of pedophilia]. PMID- 3811428 TI - [A test system for evaluating touch perception in fitness studies]. PMID- 3811429 TI - [Medical testimony in assessing the legal responsibility of a physician in medical malpractice from the viewpoint of the lawyer]. PMID- 3811430 TI - [Marxist-Leninist positions on the sense and value of human life]. PMID- 3811431 TI - [Caloric value as a concept of the status of the nutritional intake system--body weight]. PMID- 3811432 TI - [Korsakoff amnesia and memory: activation, elaboration and distribution effect]. PMID- 3811433 TI - [Sinus arrhythmia as an indicator of mental stress: quantification by time]. PMID- 3811434 TI - [Lithium-induced changes in interval personality in monopolar and bipolar depressed subgroups]. PMID- 3811435 TI - [Development of a cell culture model of the adherence of staphylococci]. PMID- 3811436 TI - [Effectiveness of mouth irrigation as a preliminary treatment method in stomatology]. PMID- 3811437 TI - [Procedures for preparing hemagglutinin for routine serologic diagnosis]. PMID- 3811438 TI - [Prolactinoma in the male]. AB - In a retrospective study the medical records of 13 male patients with macroprolactinomas were evaluated concerning anamnestic data, clinical, endocrinological and localisation-diagnostic findings as well as therapeutic measures. The main symptoms were disturbances of vision and impaired potency and impaired libido, respectively. The ophthalmological complaints nearly exclusively caused the patients to see the doctor. Clinically the signs of hypogonadism were found. The diagnosis was ascertained by increased serum prolactin levels, ophthalmological findings, X-ray of the sella, cranial computed tomography as well as angiography of the carotid. The operative treatment did not show any normalization of the serum prolactin levels. The rate of recidivations after exclusive operative treatment was high. An additional medicamentous therapy with dopamine agonists is nearly always necessary after operation. Whether or not bromocriptine shall be used as primary therapy, must be decided on in the individual case. PMID- 3811439 TI - [Clinical aspects and prognosis of highly malignant non-Hodgkin's lymphomas]. AB - Clinical data and courses of the disease of 56 patients with non-Hodgkin lymphomas of high malignancy were demonstrated. The age-depending summit of the frequency was between the 51st and 60th year of age, the age median was about 48 years. The initial remission rate three months after the beginning of the therapy was 66%. Out of the responders in 44% relapsed, in which cases 70% of the relapses developed in the first year after the beginning of treatment. After twelve months the survival rate was 0.52 and after 48 months 0.32. Patients with initial remission, with localized stages I and II (Ann Arbor) as well as with primarily extranodal manifestation and with histology of centroblastoma had a clear prognostic advantage. Initial B-symptomas, an advanced stage of the disease and a histology of immunoblastoma and lymphoblastoma as well were negatively correlated to the prognosis. PMID- 3811440 TI - [Hemorheologic studies for evaluating microcirculation in patients with peripheral arterial circulatory disorders and diabetes mellitus]. AB - Haemorheological investigations in 73 male patients with chronic disturbances of the arterial blood supply of the lower extremities and 54 male non-insulin requiring (type-II-) diabetics with and without micro- and macroangiopathy resulted in significant changes of the flow properties of the blood in contrast to 20 comparable clinically healthy males. In all groups of patients a clear increase of the aggregation of erythrocytes and the viscosity of plasma as well as a decrease of the deformability of erythrocytes were to be proved. The size of the deviations of all three parameters from the normal correlated with the degree of severity of the arterial obstructive disease and in diabetics with the occurrence of vascular complications (macroangiopathy, retinopathy) as well as with the situation of metabolism. The decreased fluidity of blood may lead to the development of further enlargement of disturbances of microcirculation. Therefore, haemorheological viewpoints should be included into the total diagnostic and therapeutic concept of the arterial obstructive disease and the diabetes mellitus. PMID- 3811441 TI - [Specialized and interdisciplinary team work in rheumatology]. AB - The large number of rheumatic diseases demands a clear differentiation between the individual forms of diseases. For this purpose are at first necessary knowledge concerning clinical criteria and in the second place knowledge about serological and radiological examinations. The serological programme shall be relevant to practice, consist of a basis diagnostics and for particular differential-diagnostic problems shall include specialized laboratory investigations. Necessary X-ray pictures must be performed with a special aim and comparison of the sides. For therapy the interdisciplinary team work, consisting in the cooperation of rheumatologists, orthopedic surgeons, specialized surgeons and physiotherapists stood the test. An important prerequisite is also the cooperation of the outpatient and inpatient rheumatological institution. For a complex rehabilitation programme apart from the physicians experienced coworkers for tasks of welfare, ergotherapy and physiotherapy are necessary. PMID- 3811442 TI - [Kasabach-Merritt syndrome]. AB - The Kasabach-Merritt syndrome is a rare, congenital disease, characterized by giant haemangiomatosis and disseminated intravasal coagulation. It is reported on an at present 34-year-old patient with such a disease and the long-term course is described. Complications with haemorrhages can be prevented by means of anticoagulants. PMID- 3811443 TI - [Intraoperative imaging of the small intestine for the endoscopic removal of small intestine polyps in Peutz-Jeghers syndrome]. AB - The hamartomas in Peutz-Jeghers syndrome lead to various complications that are frequently followed by small-bowel resections and the development of a short bowel syndrome. In order to prevent such complications an intraoperative endoscopic exploration of the entire small bowel with multiple polypectomies of hamartomas was carried out. Although a further growth of presently unrecognisable hamartomas is possible, such a procedure permits total polypectomy in Peutz Jeghers syndrome, and complications are thus put off to a later time. PMID- 3811444 TI - [pH-metry of the digestive tract--problems in data analysis]. PMID- 3811445 TI - [Fetal shock syndrome]. AB - Fetal hypoxia before and during delivery occurs if a critical limit of uterine and umbilical blood flow is achieved or subsided below that border. As a result of the increased catecholamine secretion a redistribution of blood flow to the different organs of the fetus takes place. The brain, lungs and adrenals are the preferentially perfused organs, whereas the tissues of the kidneys, the skin and other areas have a reduced blood supply. There is, however, no unlimited protective mechanism of the relatively well perfused organs during fetal shock. Brain injuries are dependent on glucose concentration and the arterial blood pressure. The irreversibility of fetal shock is introduced by the development of coagulation disorders and fibrin deposits in the fetal organs, the fall of blood pressure, fetal acidosis and an increased permeability of the blood vessels. Before this state is reached, cardiovascular alterations, changes in acid base status and the continuously measured PO2 take place. These signs should be used to prevent fetal injuries by application of the right measures at the right time. PMID- 3811446 TI - [Effect of infusion acidosis on the condition of the fetus--animal experiment studies]. AB - In order to assess the effect of acid infusion on fetal cardiovascular functions, oxygenation, glucose and electrolyte concentrations, 8 experiments were performed on chronically instrumented ewes. A severe metabolic acidosis (pH less than 7.10, BDECF = 13.5 mmol/l) was induced by intravenous infusion of L(+) lactate into the fetus. There was no significant alteration of baseline fetal heart rate and oscillation amplitude. The blood pressure exhibited a slight increase, probably due to the administration of volume (87-204 ml in 90-210 min). PO2 remained constant while SO2 showed a decrease in the order of 10%, due to the change in oxygen affinity of the fetal blood produced by the Bohr effect. Levels of glucose increased significantly, whereas electrolyte concentrations remained unchanged. After the end of infusion, pH-values returned to the normal range within 110 min. Lactate and BDECF decreased with a half life time of 95 and 48 min, respectively (mean SO2 = 28%). We conclude that a severe metabolic acidosis in the extracellular space does not affect the normal fetal heart rate pattern (baseline, oscillation amplitude) and has no acute deleterious effects on the fetus. Hence, when the actual fetal pH during labor is found to be low, a maternogenic infusion acidosis should be excluded by a simultaneous feto-maternal blood gas analysis. PMID- 3811447 TI - [Histometric studies of placentones of the human placenta]. AB - Regionally different structures of placental terminal villi in the placentones have been shown in earlier publications. In this study the earlier results should be tested by means of histometry. The earlier results could be proved. It was shown that the villi in the centers of the circulation units are less differentiated than those in the peripherie of the placentones. The results were statistically significant. The reasons for the regionally different architecture of the placental villi are discussed with respect to the results of other authors working in the same field. PMID- 3811448 TI - [The uterine contraction stress test with oxytocin nasal spray in the diagnosis of hypoxemia]. AB - Deceleration of the fetal heart rate are indications of fetal distress, which are commonly seen in connection with uterine contractions. The aim of the investigation was, whether nasal application of oxytocin (Syntocinon, Sandoz AG) is sufficient for the induction of contractions for an oxytocin-challenge-test. 232 oxytocin-challenge-tests in 85 risk patients between 29th-42nd week of gestation were analyzed in a retrospective and prospective way. The amounts of oxytocin nasal spray necessary for stimulating contractions were compared to the gestational age and maternal body weight (1 spray snuff = 4 IU Oxytocin). 20 pregnant women were given 8 IU oxytocin nasal spray after 10 minutes CTG registration without any contractions. The incidence of induced contractions per ten minutes period were calculated. The amount of oxytocin nasal spray necessary for the stimulation of contractions decreased in relation to the increased gestational age and maternal body weight (oxytocin spray = 2.751-0.051 X (gestational age)-0.014 X (body weight), p less than 0.01). After a single application of 8 IU oxytocin nasal spray at least one contraction occurred in 13 out of 20 cases within the first 10 minutes. Between the 20th-30th minute the induced uterine contractions reached a maximum of 3 contractions per 10 minutes. No persisting contractions were observed. The application of 8 IU of oxytocin nasal spray is sufficient to induce in about 95% of the cases an oxytocin challenge-test which gives information concerning the actual state of the fetus at risk. PMID- 3811449 TI - [Perinatal medical possibilities and limitations of the obstetrical center--an analysis of the causes of perinatal mortality 1982-1985]. AB - Based on the analysis of 4,881 deliveries during 1982-1985 the perinatal statistical data of a regional perinatal center (level 3) are presented. There is high percentage of pregnancies at risk (57%), preterm deliveries (11%), and increasing incidence of multiple pregnancies (3%). The rate of spontaneous deliveries amounts to more than 70%, the frequency of cesarean sections reached a maximum of 19%. As causes of 82 perinatal deaths (16.8% mortality rate) were found above all fetal malformations (42%), multiple pregnancy (18%), severe intrauterine growth retardation (17%), and premature rupture of membranes with septic complications (10%). Further causes of perinatal death were severe umbilical cord complications (5%), diabetic pregnancy (5%), abruptio placentae and maternal high risks. After detailed analysis 55% of all perinatal deaths proved to be unavoidable, 18% possibly avoidable, and 27% avoidable. The presentation of the avoidable perinatal deaths demonstrates the shortcomings and possible improvements of the obstetrical management and organization. The possibly avoidable cases could be solved in future. According to the purged perinatal mortality rate there are 4 remaining avoidable cases for which the perinatal center proved to be responsible. The perinatal mortality risk in the regional center is therefore less than 1%o. PMID- 3811450 TI - [Is the determination of glycosylated hemoglobins in neonatal macrosomia useful?]. AB - 170 blood samples of mother and child of patients with and without risk of diabetes as well as of mothers with macrosomic newborns have been examined immediately after delivery. The procentual rate of glycosylated hemoglobin (GHb) was determined by an affinity chromatographic method. The mean of the GHb values of the children was 37% lower compared to the values of their mothers and in this showed a linear correlation. A dependence on the deviation of weight of the mothers from the Broca normal weight was found but not a dependence on the gain of weight during pregnancy, on height and age. In the GHb values of mothers and children a significant dependence on the weight of the mother before pregnancy was seen. There was no relation of the glycosylated hemoglobins to the birth weight of the newborn in regard to the age of pregnancy and the sex of the children. To our opinion the GHb measurement can therefore not be used for the diagnosis of latent diabetes in pregnancy in the case of newborn macrosomia. PMID- 3811451 TI - [Infantile papular acrodermatitis (Gianotti-Crosti syndrome]. PMID- 3811452 TI - [Radiologic findings in Bourneville-Pringle syndrome]. AB - Aside from the classical trias of symptoms, Bourneville-Pringle's syndrome shows a lot of other alterations concerning the inner organs. These changes being much more important for the further prognosis are illustrated, and the diagnostic procedure is demonstrated. PMID- 3811453 TI - [Macrophotographic correlates of the histology of precursor nevi and SSM in relation to the McGovern model]. AB - Structures within pigmented skin tumors, which are beyond the dissolving powers of the eye, may be analysed in vivo by macroscopy using incident lighting. Benign melanocytic nevi have a symmetric and distinct horizontal pattern of pigmentation, whereas in melanoma, intraepidermal tumor growth may show coexistence of net- and/or cluster-like and non-structural forms of pigmentation. PMID- 3811454 TI - [Anetoderma]. AB - We report on a 17-year-old girl having suffered from Jadassohn's anetoderma since five years. Administration of Plaquenil resulted in marked improvement: The inflammation disappeared, and there did not occur any new symptoms. The presence of IgA in the capillary endothelium implies an immunological process. PMID- 3811455 TI - [Acute generalized miliary tuberculosis of the skin]. AB - We report on a 32-year-old man suffering from generalized papulonecrotic and haemorrhagic eruption of the skin and oral mucosa. The histologic feature showed leucocytoclastic vasculitis with mononuclear concentration around the deep vessels. Pathologic-anatomical investigation revealed hematogenously disseminated tuberculosis of the lungs. PMID- 3811456 TI - [Disorders of potency in the male--recent etiologic and diagnostic aspects]. AB - Sexual function is impaired by organic, iatrogenic, or psychic causes. The results of numerous studies recently undertaken revealed that organic, especially vascular causes are more common than thought of before. It may be assumed that sexual dysfunction is caused by arteriosclerosis of the penile arteries alone in about 40% of the patients over 40. In addition, other organic (local, endocrine, neurogenic, a.o.) as well as iatrogenic causes (abdominal or pelvic surgery, side effects of drugs) have been observed. Consequently, the number of cases due to psychic factors is considerably below 50%. PMID- 3811457 TI - [Sclerodermiform porphyria]. AB - We give a retrospective survey on the clinical, histological, biochemical, and pathogenetical aspects of sclerodermiform changes rarely accompanying porphyria cutanea tarda (PCT). Sclerodermiform changes were seen in 12 patients (2% of all our PCT cases). In these patients, no correlation was found between the severity of the dermatological signs and symptoms and the degree of disturbance in the porphyrin metabolism. Biochemical remission was not accompanied by improvement of the sclerodermiform changes. The proportion of porphyrins with 4 or 5 COOH-groups was higher than that of PCT patients without sclerosis. The findings are consistent with the view that the development of sclerodermiform changes cannot be merely explained by phototoxic reactions, but the "dark-effect" of the porphyrins may also play an important role in the pathogenesis. PMID- 3811458 TI - [Adenoma seboparum sive sebaceum--a histologic diagnosis]. AB - Adenoma seboparum is a rare tumor without typical clinical features. Therefore, diagnosis is usually made only by histological examination. PMID- 3811459 TI - [Oral acyclovir therapy in recurrent herpes simplex]. AB - 25 patients suffering from recurrent herpes simplex infection were orally treated with acyclovir 5 X 200 mg daily for 5 days. Control examinations were carried out on the 1st, 3rd, 5th, and sometimes on the 7th day of treatment. All patients treated showed a significantly shortened course of the disease and quick decrease of the symptoms. If acyclovir was applied during the prodromal phase, we additionally found inhibited vesicular eruption. There were not observed any dangerous side effects. PMID- 3811460 TI - [A case report of Jadassohn anetoderma]. AB - Itchy pink plaques have been developing on the trunk of a 29-year-old patient for two years. After a few weeks, these plaques usually change into atropic scars. Both types of efflorescence occur simultaneously. Histological examination of a fresh lesion showed leucocytoclastic vasculitis. These micromorphological changes are no longer visible in the atrophic scars. The clinical picture and histological findings are identical with those seen in Jadassohn's anetoderma. The histological changes correspond with the degenerative-inflammatory process first described by Cramer in 1963. PMID- 3811461 TI - [Long-term studies following heart valve replacement]. AB - Heart valve replacement has become a routine procedure in the treatment of patients suffering from valvular lesions. The results of long-term follow-up studies after valve replacement are still important and help to choose the optimal time for surgical intervention and the type of prosthesis. In order to ensure comparability of publications a consent must be found with regard to the demands these publications should fulfill concerning the selection and presentation of data. Generally, retrospective analyses are inappropriate to prove the influence of preoperative or perioperative parameters (e.g. the type of prosthesis) on the late outcome. They may be useful for raising hypotheses. Survival or event-free rates can only be determined reproducibly if adequate follow-up methods are used. By questionnaires at long time intervals important informations are often lost. The duration of the follow-up period depends on whether the event in question occurs with a constant incidence (e.g. bleeding complications due to anticoagulant therapy) or has an inconstant hazard-rate (e.g. primary failure of tissue valves). Increasing hazard-rates in the late postoperative course necessitate adequate follow-up periods. The number of patients followed up has to be determined prospectively so that differences between patient groups may be sufficiently proven after an adequate follow-up period. PMID- 3811462 TI - [Determinants of long-term prognosis following prosthetic mitral valve replacement]. AB - Data of 235 patients with chronic mitral valve disease (NYHA class III or IV) were analyzed retrospectively. Mitral valve replacement was performed in all patients between 1974 and 1983, 46 patients underwent additional tricuspid valve repair during the same operation. Preoperatively, right and left heart catheterization as well as coronary angiography were carried out in all patients. Operative mortality was 8%. For all patients 5 year survival rate was 76% and 10 year survival rate was 72%. Patients with pure mitral insufficiency had a poorer long-term prognosis than patients with mitral stenosis or patients with mixed mitral valve disease (5 year survival rate 54 versus 79%, p less than 0.0014). Patients with previous closed mitral commissurotomy had a poorer long-term prognosis than patients without previous surgery (5 year survival rate 62 versus 81%, p less than 0.0019). Age, NYHA class, associated tricuspid valve repair, pulmonary vascular resistance and mean right atrial pressure had no effect on survival. CONCLUSION: Long-term survival is generally good after mitral valve replacement, but pure mitral insufficiency and previous closed mitral commissurotomy are risk factors for long-term prognosis. PMID- 3811463 TI - [18 years after a penetrating heart injury: follow-up]. AB - This report presents a case of penetrating chest trauma leading to pericardial tamponade and ventricular septum defect successfully resuscitated by surgery in 1968 in an 11-year-old boy. 10 years later a first-size calcified hematoma was removed. However the 30% left to right intracardiac shunt flow as established by complete heart catheterization prior to surgery was not corrected. Non-invasive methods were used to assess cardiac function 18 years after the initial event including physical examination, chest X-ray, thoracic computer tomography, ECG, 24 h Holter monitoring and exercise testing, combined with myocardial scintigraphy and radionuclide angiography and echocardiographic techniques using the transthoracic and the transoesophageal approach. The diagnostic value of echocardiographic examinations is emphasized with special reference to contrast- and Doppler-echocardiography including the color-coded Doppler-flow-imaging technique. PMID- 3811464 TI - [Complete AV block in a heart catheter study using a Swan-Ganz catheter]. AB - A case of complete heart block during right heart Swan-Ganz balloon-tipped flow directed catheterization in a patient with intermittent left bundle branch block after aortic valve replacement is reported. After entrance into the right ventricle with the catheter tip as well as after insertion of a temporary balloon floated pacemaker electrode symptomatic complete heart block occurred. This case demonstrates that in a patient with intermittent left bundle branch block a complete AV block may occur and therefore the possibility of cardiopulmonary resuscitation and temporary pacing has to be taken in account. PMID- 3811466 TI - [Training-induced changes in performance self concept and cognitive abilities in the aged]. AB - 204 healthy elderly subjects (age range 65-85) participated in a training and retest programme leading to marked performance increases in two types of fluid intelligence tests (figural relations and inductive thinking). Effects of testing and training on self-perceived abilities and competence beliefs were measured on a battery of more and less situation-specific, task-related self-report instruments. The strongest and most consistent positive changes in self-concept of abilities attributable to training were found on judgements of task-related self-efficacy and beliefs in personal utility of acquired competence. Judgements of ability as causes for success and failure in future tests were also affected. The results support the view that fluid ability training is a valuable instrument to increase subjective as well as objective efficacy in thinking related to fluid intelligence. Training can therefore be considered helpful in supporting compensatory efforts to counteract age-related losses in perceived as well as actual ability. PMID- 3811465 TI - [Cognitive performance and performance concepts of the elderly. A contribution to basic gerontologic research]. AB - Three self-concepts of competence are investigated with a new instrument measuring different aspects of achievement in a total of 1983 subjects. Empirical data of 430 subjects aged 50 to 95 are presented pertaining to three self concepts of competence and achievement in total and arranged into 4 chronological age groups. The new instrument employed for measuring self-concepts--FSKN- permits a priori the definition of marginal values for "positive" and "negative" concepts of achievement. Results of the cross-sectional study have failed to falsify the hypothesis (1): Elderly people (including those in retirement) have "positive" or "favourable" self-concepts of achievement--i.e. self-concepts characterized by socially desirable attributes. The three concepts of competence of elderly persons investigated (including individuals aged 80 to 95) show a favourability similar to those of 568 schoolchildren, 504 students and 481 persons aged 18 to 50. Correlation studies investigating the relationship of on the one hand elderly persons' cognitive capacity determined by nine different instruments and on the other hand the subjective self-concepts of competence and achievement failed to falsify the hypothesis (2): The higher the objectively measured degree of elderly persons' cognitive capacity, the more "favourable" or "positive" are also the subjective concepts of achievement. In the light of empirical data we may postulate an influence of the current objectively determined cognitive capacity of elderly persons on their subjective (positive) self-concepts of competence and achievement. PMID- 3811467 TI - [Relations between grandparents and their grandchildren in the preschool age]. AB - In a pilot study 23 grandchildren in preschool age (9 boys, 14 girls) and 24 grandparents from the same families (8 grandfathers, 16 grandmothers) were interviewed in detail about the relations to each other. The informations were analyzed with a comprehensive system of categories. Most grandchildren and all grandparents considered the respective other person to be important in their life. The subjects were the more satisfied with their relation, the more often they were together without other relatives. The results are compared with previous findings, and practical consequences are drawn. PMID- 3811468 TI - [Home life of the aged--psychological aspects]. AB - With increasing age the social and physical environment of elderly persons becomes increasingly focussed upon the home and its immediate surroundings, whilst life within the home ("Wohnen") expands to take in a wider variety of activities. Critical life events and transitions in old age often induce changes both in the way of life within the home and also in housing. The way of life of elderly people in the home ("Alterswohnen") can be defined as the totality of goal-directed activities within the social-physical context of their home and its immediate surroundings. This includes as central elements physical and psychological regeneration, communication, recreation, and the emergence of an emotional relationship to the home. From a stress and coping paradigm, difficulties in home life can be interpreted as the result of transactions between individual and environment. These transactions are influenced by the cognitive appraisal of the living situation and by the efforts of the individual to cope with the stressful aspects of home life. PMID- 3811469 TI - [Care taking experiences and social relations of the elderly]. AB - This is a qualitative study based on interviews with 18 former caregivers in Vienna. It can be found that caregiving is not restricted to close family members but covers a rather wide range of related and non-related persons. Caregivers usually start their career as middle-aged persons (around 55); due to the length of caregiving, most caregivers have gone past the age of 60 at the end of the caregiving period. Women without competing social responsibilities dominate among caregivers. Three mechanisms of reciprocity seem to be able to generate positive feelings toward the caregiving experience: gratitude from those cared for, balanced interaction, and financial compensations. Only in a very few cases are shared functions between different caregivers or between caregiver and formal services observed. Efforts towards formal services prove to be of little success in supporting the primary caregiver. In the final stage, almost all supported old people enter an institutional environment. PMID- 3811470 TI - [Status of the elderly among gypsies]. AB - An overview of the relevant literature shows that on one side the chronological age is important in the frame of the social position of an old man or woman in a gypsy society, but much more important is the individual itself and its social situation. Only by reaching a very old age no old gypsy can reach an important position in his society. PMID- 3811471 TI - [Treatment of topics concerning the aged in the German federal parliament 1976 1983]. AB - An analysis of statements concerning old age by members of the German federal parliament from 1976 to 1983 was undertaken on the basis of parliamantary records. It was found that there was no difference between the average of all members and those speaking about old age with regard to political orientation, sex, and age. None of the oldest members spoke about the problems of the old population group. Results of gerontological research were discussed in parliament but mostly the debates were concerned with financial arguments and unemployment policy. In general there was no reinforcement of negative stereotypes towards the aged by politicians. PMID- 3811472 TI - [Group relations outside the family of elderly females--some theses and reflections exemplified by 3 groups]. AB - This article deals with the importance of non-familial group relations for older women. Regarding the background of the specific old age problems of women and their life-long development, it demonstrates the specific function of participation in non-familial groups for older women. These groups give the older women important support in overcoming the problems of old age, with, for instance, female discussion groups, and voluntary groups, and initiatives of older people. These three groups can be seen as a tool to solve the problems of aging. However, the number and quality of these groups is not sufficient in regard to the older women, particularly the underprivileged. For this reason we conclude by mailing proposals for the promotion and enlargement of these groups and the elimination of the barriers hindering the participation of older women. PMID- 3811473 TI - [What information facilitates a laboratory diagnosis-based program for cardiovascular disease in longitudinal analysis? Results of an epidemiologic study]. PMID- 3811474 TI - Dual precipitation method: distribution of cholesterol and triglycerides in diagnosis of hyperlipoproteinemia. PMID- 3811475 TI - [Nephelometric determination of protein concentrations with apparatus of the Spekol series of the Carl Zeiss plant in Jena. 1. Total protein determination]. PMID- 3811476 TI - [Agar electrophoretic determination of HbA1]. PMID- 3811477 TI - [Characterization and preservation of NADH for the determination of the catalytic activity of lactate dehydrogenase]. PMID- 3811478 TI - Comparison of different procedures for the isolation of non-parenchymal rat liver cells. PMID- 3811479 TI - [Miniaturization of mixed agglutination reactions for the detection of non complement dependent antibodies]. PMID- 3811480 TI - [Alterations in the activity of BAEE in the saliva in relation to blood pressure and intensity of inflammatory periodontopathies]. PMID- 3811481 TI - Handedness and dermatoglyphic directional and fluctuating asymmetry. PMID- 3811482 TI - Sib-pair correlations for morphological traits in a Punjabi population. PMID- 3811483 TI - [Life expectancy deficit (LED). A criterion for evaluating the course of malignant tumors. A statistical survey based on 70,231 malignant diseases with special reference to cases with spinal metastases]. AB - The deficiency of life expectancy (DLE), calculated as the difference between the statistical life expectancy at a given age and the survival time with the tumor disease, is a useful measure to extend the concept of tumor malignancy. Both the evaluation of the success of the tumor treatment and the prognosis of the metastatic spread in the vertebral column can be determined with the DLE. For the 9 most frequent tumor localizations the DLE is calculated with the material of the register of cancer in the Saarland/W. Germany (N = 70,128). In an extra part, the DLE for 50 metastases of the spine is compared to the whole cases. PMID- 3811484 TI - [Experimental studies of the optimal plate pre-bending angle in compression osteosynthesis with reference to the plastic-elastic behavior of the osteosynthesis plate]. AB - In order to achieve uniform pressure distribution in the osteotomy crack, the plate used in plate osteosynthesis has to be over-bent prior to fixation. To determine experimentally the extent to which the plate is usually pre-bent "intuitively", the bone axis was measured with narrow autocompression plates pre bent at various angles on bones of cadavers, using a laser-optic system. The optimal pre-bending angle for the six-hole plate was found to be 3-5 degrees, for the eight-hole plate 5-6.5 degrees. The importance of the sliding-hole screw with regard to stability is pointed out. Both elastic and plastic deformation are affected when the plate bends back. However, the strength of the osteosynthesis is only affected by the plastic portion. An examination of the plate after osteosynthesis revealed the 20-30% of the original pre-bending had been lost; this corresponds approximately to the plastic portion. PMID- 3811486 TI - [Comparison of the effects of lordosis on the thoracic spine using the Milwaukee and Gschwend brace in scoliosis and kyphosis]. AB - 64 patients in Milwaukee-Brace and 32 patients in Gschwend-Brace have been assessed for creating lordosis of the thoracic spine. In both types of braces induction of lordosis can be observed although there did not seem to exist a directly proportionate relationship towards the period of treatment. The degree of correction in the thoracic spine depends on the kyphosis at the onset of treatment. In marked kyphosis exceeding 60 degrees or corresponding kyphotic components in scoliosis the Milwaukee-Brace is preferred over against the Gschwend-Brace. In a pure kyphosis with minimal scoliotic curve the Gschwend Brace remains the treatment of choice. PMID- 3811485 TI - [Laceration of the vessels of the kidney hilus. A complication not previously described in halo extension treatment]. AB - During the last years the halo traction proved to be an appropriate preoperative procedure to provide the spinal region with corrective forces, although several complications became known. As a complication unknown as yet a laceration of the renal hilus vessels is described, and the possible causes are discussed. Consequently, in case of abdominal symptoms and signs, a possible intraabdominal or retroperitoneal vascular lesion must be taken into consideration besides the well-known spinal-traction/spinal-cord-traction-syndrome. PMID- 3811487 TI - [Modification of hip rotation plasty in malignant femoral tumors of the middle/distal third]. AB - Described is a modification of the hip rotation plasty in a 22 years old man with a high grade chondrosarcoma of the middle and distal part of the right femur. With exception of the sciatic nerve the whole thigh was resected. After rotation of the lower limb 180 degrees an endoprosthesis fixed in the tibia was used for the new hip joint. PMID- 3811488 TI - [Initial experiences with the cementless PM endoprosthesis]. AB - A follow up of 40 cementless fixed endoprostheses type PM showed good results, similar to cement fixed prostheses. In cementless fixation seem to be more early complications and less late complications, so these results are encouraging what concerns cementless fixation. PMID- 3811489 TI - [Postoperative pain in cement-free femur shaft prosthesis]. AB - With practically all hip endoprosthesis systems the femoral components of which are implanted cement-free irritations in the femoral region persisting for up to two years p.o. have been reported significantly more frequently than with cemented shafts. The discussion of this observation is based on the fact that stems inserted cement-free are mostly press-fitted into the surrounding bone, thus, creating a completely different stress and strain field as compared to cemented shafts. The usually spontaneous disappearance of these initial irritations is attributed to remodelling reactions which, controlled by the load distribution in the surrounding bony tissue which, in turn, is mainly controlled by the shape of the prosthesis, results in the formation of well load bearing bony structures along steps and other surface undulations along the proximal part of the prosthesis. PMID- 3811490 TI - [Value of passive postoperative mobilization treatment following knee joint synovectomy in chronic polyarthritis]. AB - One group of 17 Knee joints was treated postoperatively with continuous passive motion, while the control group received cyclical changes of the Knee's position in flexion and extension. In the postoperative period the CPM-treated patients suffered less pain than the control group. Furthermore the patients of the CPM group reached free extension and 90 degrees of flexion earlier than the control group. The amount of liquid in the suction drainage was higher in the CPM-group than in the control group. Based on the results of our examination continuous passive motion is considered to be a useful contribution to the postoperative treatment of synovectomy of the knee joint in rheumatoid arthritis. PMID- 3811491 TI - [Etiology and pathogenesis of osteochondrosis dissecans of the knee joint]. AB - We report a clinical examination series on 72 knees with osteochondritis dissecans. The O.D. very often affected men employed in construction. An illness on both knees was usually found in younger patients. In those cases the osteochondritis was more often located in an area of lighter bearing. In cases involving only one knee the illness was confined to the area of heavy bearing. In patients seeking therapy up to 10 years after initiation of symptoms we found 50% to have a corpus librum. This rate rises significantly after 10 years to over 90%. In 7 of 10 cases we found a hyperlipoproteinaemia. PMID- 3811492 TI - [Unilateral knee joint endoprosthesis for treatment of varus or valgus gonarthrosis (indications--technic--late results]. AB - In the treatment of varus- and valgus-gonarthrosis the unilateral joint replacement has a definite indication. Good longterm results underline the importance of this method amongst all possible and useful procedures. PMID- 3811493 TI - [Dorsal patellar defect]. AB - A case report of a dorsal defect of patella is presented and discussed in comparison with the Osteochondrosis dissecans of the patella. PMID- 3811494 TI - Progress in viral hepatitis: a review. PMID- 3811495 TI - Endoscopic treatment of biliary tract disease. PMID- 3811497 TI - [Education for physicians]. PMID- 3811496 TI - Endoscopic laser therapy for GI diseases. PMID- 3811498 TI - [Monoclonal antibodies in tumor diagnosis and tumor therapy]. PMID- 3811499 TI - [Heart diseases]. PMID- 3811500 TI - [Value of increased urinary excretion of modified nucleosides as tumor markers in colon cancer]. PMID- 3811501 TI - [Activation of protein C on the surface of cultivated endothelial cells--role of antithrombin III]. PMID- 3811502 TI - [Preservation of tissues--cryopreservation and culture]. PMID- 3811503 TI - [Significance of cell biologic basic research for clinical practice, exemplified by the biosynthesis and transport of thyroglobulin]. PMID- 3811504 TI - [Possibilities and limits of the laser]. PMID- 3811505 TI - [Shock wave lithotripsy of the kidney and gallbladder]. PMID- 3811506 TI - [Endocrine hypertension]. PMID- 3811507 TI - [Angiology from the viewpoint of the surgeon]. PMID- 3811508 TI - [Angiology from the viewpoint of the internist]. PMID- 3811509 TI - [Chronic glomerulonephritis and chronic interstitial nephritis]. PMID- 3811510 TI - [Combined internal medicine-surgical treatment of malignant tumors--from the viewpoint of the internal medicine oncologist]. PMID- 3811511 TI - [Psycho-organic changes]. PMID- 3811513 TI - [Rheumatology]. PMID- 3811512 TI - [Rheumatology]. PMID- 3811514 TI - [Protection of nutrition]. PMID- 3811515 TI - [Poisons in food?]. PMID- 3811516 TI - [Preventive use of iodine]. PMID- 3811517 TI - [Nutrition and drugs--current problems]. PMID- 3811518 TI - [Therapy of obesity--successes and risks]. PMID- 3811519 TI - [Hypertension and nutrition]. PMID- 3811520 TI - [Dietary prevention of coronary heart disease]. PMID- 3811521 TI - [Nutrition and bone metabolism]. PMID- 3811523 TI - [Risk of coronary disease. Hypertension]. PMID- 3811522 TI - [Risk of coronary disease]. PMID- 3811524 TI - [Risk of coronary disease. Diabetes mellitus]. PMID- 3811526 TI - [Risk of coronary disease. Smoking as a factor?]. PMID- 3811525 TI - [Risk of coronary disease. Role of lipid metabolism disorders]. PMID- 3811527 TI - [Clinical aspects and treatment of Kaposi sarcoma in acquired immunodeficiency syndrome (AIDS)]. PMID- 3811528 TI - [Clinical aspects and therapy of malignant lymphomas in AIDS--symptomatology of AIDS encephalopathy]. PMID- 3811529 TI - [Political public health measures and aspects in the control of HTLV-III infection]. PMID- 3811530 TI - [Diseases of the esophagus]. PMID- 3811531 TI - [Early symptoms and possibilities for preventing chronic lung diseases]. PMID- 3811532 TI - [Ulcer disease--the viewpoint of the internist]. PMID- 3811533 TI - [Ulcer disease--the viewpoint of the surgeon]. PMID- 3811534 TI - [Inflammatory and neoplastic diseases of the large intestine]. PMID- 3811535 TI - [Inflammatory and neoplastic diseases of the large intestine]. PMID- 3811536 TI - [Internal medicine aspects of diseases of the bile ducts and pancreas]. PMID- 3811537 TI - [ERCP and endoscopic sphincterotomy in acute pancreatitis]. PMID- 3811538 TI - [New experimental aspects of the pathogenesis of arteriosclerosis in familial hypercholesterolemia]. PMID- 3811539 TI - DNA deletions and DNA polymorphisms of the low density lipoprotein (LDL) receptor gene--their use in diagnosis. PMID- 3811540 TI - [Genetically-induced functional disorders of lipolytic enzymes and their effect on plasma lipoproteins]. PMID- 3811541 TI - Mutants of apolipoproteins A and C. PMID- 3811542 TI - Hyperlipidaemia: screening and therapy. PMID- 3811543 TI - [Plasma exchange and related forms of therapy in severe familial hypercholesterolemia]. PMID- 3811544 TI - [When and in which patients should heart valve defects be surgically corrected?]. PMID- 3811545 TI - [Emotional status in the decision process]. PMID- 3811546 TI - [Metabolic aspects of the pathogenesis of hyperuricemia]. PMID- 3811547 TI - [Renal aspects of the pathogenesis of hyperuricemia]. PMID- 3811548 TI - HGPRT-deficiency--the molecular basis of the clinical syndromes. PMID- 3811549 TI - [Clinical picture and diagnosis of gout]. PMID- 3811550 TI - [Diet therapy of hyperuricemia--scientific principles and practical consequences]. PMID- 3811551 TI - [Drug therapy of hyperuricemia]. PMID- 3811552 TI - When to treat hyperuricaemia. PMID- 3811553 TI - [Myopathy in AMP deaminase deficiency]. PMID- 3811554 TI - [Disorders of pyrimidine metabolism]. PMID- 3811555 TI - [Type II diabetes]. PMID- 3811556 TI - [Classification and heredity in diabetes mellitus]. PMID- 3811557 TI - [Lipid metabolism in type II diabetes mellitus]. PMID- 3811558 TI - [Angiopathies of type II diabetes]. PMID- 3811559 TI - [Structure and administration of polyene fatty acids]. PMID- 3811560 TI - [Dietary fats and serum lipoproteins]. PMID- 3811561 TI - [Arterial hypertension--insidious risk factor for the heart and blood vessels]. PMID- 3811562 TI - [Polyene fatty acids and prostaglandin biosynthesis]. PMID- 3811563 TI - [Early detection of the insidious forms of hyperthyroidism]. PMID- 3811564 TI - [Eicosanoids and essential fatty acids of the cardiovascular system]. PMID- 3811565 TI - [Eicosanoids and the gastrointestinal tract]. PMID- 3811566 TI - Some aspects of in vivo human protein and amino acid metabolism, with particular reference to nutritional modulation. PMID- 3811567 TI - [Paraneoplastic syndrome--an aid in the early detection of malignant tumors?]. PMID- 3811568 TI - Are there atherogenic dietary proteins? PMID- 3811569 TI - [Dietary protein and kidney diseases]. PMID- 3811570 TI - [Dietary protein and resorption of minerals and trace elements, especially iron]. PMID- 3811571 TI - [Disorders of water and electrolyte balance--indicators of neoplastic processes]. PMID- 3811572 TI - [Preliminary and early stages of malignant lymphomas]. PMID- 3811573 TI - [Criteria for assessing the differential use of diet therapy]. PMID- 3811574 TI - [Scientific tasks in the field of nutrition and the development of an agricultural-industrial complex]. PMID- 3811575 TI - [Role of the alimentary factor in the development of morphological changes in the blood vessels in an experiment]. PMID- 3811576 TI - [Biomedical criteria for evaluating the quality of food products obtained by using new feedstuffs with the application of biotechnology]. PMID- 3811577 TI - [Natural killer cell activity in patients with focal scleroderma]. PMID- 3811578 TI - [Neutral lipid spectrum in the blood plasma and erythrocytes of patients with psoriasis]. PMID- 3811579 TI - [Effect of organophosphate pesticides on the fatty acid composition of rat erythrocyte membranes]. PMID- 3811580 TI - [Ultrastructural organization of HEp-2 cells in an experimental model of rubromycosis]. PMID- 3811581 TI - [Analysis of means of detecting sources of infection of patients with syphilis]. PMID- 3811582 TI - [Efficacy of PUVA therapy of patients with psoriasis]. PMID- 3811583 TI - [Blood monoamine oxidase activity and erythrocyte membrane permeability in patients with allergic dermatoses]. PMID- 3811584 TI - [Role of foci of chronic infection of ORL organs in the pathogenesis of neurodermatitis]. PMID- 3811585 TI - [Jadassohn-Lewandowski syndrome]. PMID- 3811586 TI - [Fulminating gangrene of the external sex organs]. PMID- 3811587 TI - [Atypical manifestations of Kaposi's sarcoma]. PMID- 3811588 TI - [Importance of outpatient follow-up in the treatment of patients with rubromycosis]. PMID- 3811589 TI - [Phytodermatitis due to fir tree needles]. PMID- 3811590 TI - [Errors in the diagnosis of syphilis]. PMID- 3811591 TI - [Case of a foreign body in the vagina of an 8-year-old girl]. PMID- 3811592 TI - [Analysis of decay curves with biphasic kinetics]. AB - Medication of trout and carps with chloramphenicol and sulfadimidine results in tissue residues which best fit by a biexponential decay curve. The analysis of residues does not reveal any systematic deviations of the data from the model. On the basis of this model half lives for the fast and slow drug elimination phases can be estimated. For the assessment of withdrawal times it is necessary to compute confidence limits for the decay curves. A withdrawal time may be defined by the intersection of recommended maximal concentrations with the upper confidence limit. This analysis does not include any metabolites. This model is also suited for monitoring purposes. It is recommended to apply the procedure to all chemicals exhibiting biexponential decay kinetics. PMID- 3811593 TI - [Determination of indole and skatole in seafood using high performance liquid chromatography (HPLC)]. AB - A rapid and specific high-performance liquid chromatographic (HPLC) method for the determination of indole and 3-methylindole (skatole) is described. The detection limit of the two compounds is approx. 0.02 mg/kg. Gas chromatographic mass spectrometric (GC-MS) confirmation of the identity has been carried out in shrimps. About 95% of added indole was recovered. The indole formation in shrimps, herring, and turbot, held under different storage conditions, is compared with other common quality indices such as TBA-value and alpha-tocopherol content. PMID- 3811594 TI - [Reduction of lead content and other elements in wine using pectic acid]. AB - A procedure for reducing the Pb content in wines containing high levels of Pb is described. The reduction of Pb by means of pectic acid (PA) depends on the quality grade of the wine. In "Auslese" (wine A) 6250 mg PA/l diminished Pb content in 24 h from 0.88 mg/l to 0.28 mg/l; in "Spatlese" (wine B) from 0.83 mg/l to 0.06 mg/l. Under the same conditions the content of Fe, Zn, Cu decreased in wine A from 8.85 mg/l to 7.05 mg/l, from 4.75 mg/l to 1.25 mg/l, from 0.67 mg/l to 0.57 mg/l and in wine B from 6.70 mg/l to 5.41 mg/l, from 1.17 mg/l to 0.28 mg, 0.46 mg/l to 0.28 mg/l, respectively. PA is removed almost quantitatively by filtration. Sensory properties of treated wines were unchanged with concentrations of PA of 750 mg and 1500 mg/l. A slight effect on taste at 6250 mg PA/l wine cannot be excluded. On account of its high affinity to Pb, PA will probably remove Pb from other liquid foods as well. PMID- 3811595 TI - The fate of ethylenebis(dithiocarbamate) fungicides during processing of contaminated apples. AB - A spectrophotometric method based on the liberation of carbon disulfide is suitable for the determination of ethylenebis(dithiocarbamate) (EBDC) residues on apples. Homogenization of samples before analysis initiates rapid breakdown of EBDC, resulting in low recoveries. Thermal conversion of mancozeb to ethylenethiourea (ETU) in the course of apple processing was investigated. The formation of ETU from EBDC could be reduced by lowering the pH value. The presence of an antioxidant (ascorbic acid or cysteine) significantly diminished the yields of ETU after heating, but they inhibited its subsequent decomposition. The rate of ETU formation did not correspond to a relatively rapid disappearance of the parent compound. The levels of ETU residues in the canned baby food originating from contaminated apples were evaluated after a 9-months storage period: the reduction of ETU amounts varied from 26 to 70%. PMID- 3811596 TI - Arsenic, cadmium, lead and mercury in meat, livers, and kidneys of swine slaughtered in The Netherlands during the period 1980-1985. AB - The results obtained between 1980 and 1985 in a Dutch monitoring programme on the presence of arsenic, cadmium, lead and mercury in meat and organs of swine are presented. For meat, livers and kidneys the median values were, respectively, 0.001, 0.001, and 0.003 mg/kg (fresh weight) for arsenic, 0.002, 0.044, and 0.260 mg/kg for cadmium, 0.01, 0.03, and 0.08 mg/kg for lead and 0.001, 0.002, and 0.005 mg/kg for mercury. No significant changes were observed in the tissue arsenic and mercury levels during the investigated period. A decrease was observed in the cadmium and lead concentrations in livers and kidneys. The provisional Dutch legal limits were exceeded only for lead in one kidney sample. A significant recti linear relation was found between the cadmium concentrations in livers and kidneys. In general the cadmium and lead levels found are comparable with published data, reported from other countries. Compared with data from the literature, the arsenic and mercury concentrations found in the present study are low. PMID- 3811597 TI - [Cadmium contents in cereal samples in the past--a comparison with the present]. AB - Samples of wheat, rye and barley from previous harvests, some of them dating back even to the past century and placed at the authors' disposal by a number of seed growers and governmental research institutions, were examined for their cadmium content by AAS or ICP-AES. Although no statistically valid data could be obtained owing to the low number of samples, it should nevertheless be stressed that the cadmium content found in cereal samples from harvests of the past were within the range of present-day wheat samples. Thus, the variation in wheat samples from former harvests was 20-100 micrograms/kg which is coincident with an average cadmium content of 50-60 micrograms/kg measured in 2000 what samples from the harvests of the last 10 years as determined in a special survey by the Federal Ministry of Food, Agriculture and Forestry. Comparison of the results for cereals samples from harvests of the past and the samples of the survey conducted by the Ministry does not indicate a trend towards a continuously rising cadmium contents of bread cereals. PMID- 3811598 TI - Gas chromatographic determination of deoxynivalenol in cereals. AB - Samples of barley, wheat and maize were analysed for deoxynivalenol (DON). Samples were extracted with aqueous chloroform-ethanol. The extract was purified by column chromatography on silica gel. DON was derivatised with heptafluorobutyric (HFB) acid anhydride. The glassware was silylated to prevent deterioration of the HFB derivative, which stabilised the samples for at least 11 weeks. Quantitation was done by capillary gas chromatography using electron capture detection. Confirmation was obtained by gas chromatography-mass spectrometry. The limit of determination was 0.02 mg/kg. Recoveries of DON averaged 99% with a coefficient of variation of 10.8%. PMID- 3811599 TI - [Organic acids of various kinds of vegetables. IV. Changes in the acids and sugar in tomatoes, sweet peppers and cucumbers during development and ripening]. AB - Concentrations of organic acids and sugars in tomatoes and sweet peppers change notably during ripening. The concentration of malic acid decreases while that of citric acid increases considerably and in redripe fruits clearly exceeds the content of malic acid. Several maxima and minima in acid concentrations occur during development. Both species show constant proportions of citric and isocitric acid (200:1 and 30:1 respectively). In sweet pepper, quinic and ascorbic acid can be found in noticeably higher amounts than in tomatoes. Additionally, succinic acid was detected in tomatoes and fumaric and shikimic acid in sweet pepper. Glucose and fructose, in approximately equal amounts, are the main sugar components; their concentrations are increased during ripening, especially in sweet peppers. The leaves of tomatoes and sweet pepper contain more malic acid and less citric acid than redripe fruits, though here as well citric acid predominates. There is considerably less glucose and fructose present in the leaves of sweet pepper than in the fruits while sucrose is increased. Sucrose is the main sugar component in the leaves. Compared to tomatoes and sweet peppers, egg-plants contain more amounts. - Potatoes contain citric, malic, quinic, succinic, fumaric, and soluble oxalic acid (in order of decreasing amounts). - In cucumbers malic acid notably exceeds citric acid. Both acids hardly change in concentration during ripening. Sugar content decreases during ripening. PMID- 3811600 TI - [Occupation-related socioeconomic groups in Switzerland: social scientific bases and validity studies]. AB - A system of 15 socio-economic groups (SOEG) based on occupation and position within occupation is proposed and discussed as a basis for statistical analyses of mortality data. In order to check the validity of this classification, a random sample of 3058 male death certificates is compared with the information obtained from the corresponding 1980 census records. The comparison reveals that most of the SOEGs have satisfactory validity. The same is true for a model emulating the widely used English system of Social Classes (SC). Estimates of the differences in mortality between SOEGs or SCs can be improved significantly applying correction factors derived from the sample of linked death certificates and census records. PMID- 3811601 TI - [Determinants of preventive health behavior of the Swiss population. Results of the SOMIPOPS study]. AB - In the context of the first Swiss National Health Survey preventive health behaviour was tested in 3419 Swiss citizens aged over 20 years. A health behaviour index including favourable health attitudes and good utilization of preventive health services was correlated with different social indicators. Age, sex and a good self-rated health were the most important factors associated with a high preventive health behaviour score. Education showed a less strong but also significant influence on positive health behaviour. Overall utilization of health services decreased with high preventive health behavior index. PMID- 3811602 TI - [Health personnel in Switzerland: concept, sources and results]. AB - Data concerning health manpower are recorded, in Switzerland, at different levels and in connection with various applications: at the national level, on the occasion of the Federal Census of Population; at the cantonal level, from the cantonal health authorities, which are recording data in connection with professional licences. Both of these main surveys are complementary, because the Federal Census is decennial, whereas cantonal data are continuously recorded. The present article makes by the way of examples some suggestions about how to use the professional data, describes a method for an interpretation of cantonal data and comments results at the national level. Health manpower constitutes a most important part of healths statistics. For instance many questions about controlling health costs and health planning cannot be treated without extensive knowledge of the structure and the development of the medical and paramedical professions. PMID- 3811603 TI - [Care of adult mentally retarded patients in institutions. Comparative study of homes and cantonal psychiatric clinics in the city and environs of Basle]. AB - Mentally retarded adults frequently live in psychatric hospitals because no other place could be found for them. Analysis of data of all mentally handicapped residents in psychatric clinics and special homes in two swiss cantons showed that in no case permanent hospitalisation was justified by severity of additional handicaps nor by behavioural disturbances. The main reason for permanent hospitalisation is practically always the lack of other possibilities of permanent care. PMID- 3811604 TI - [Mortality of schizophrenic patients--a study of 170 cases]. AB - 170 schizophrenic patients, who were treated, between 1971 and 1973, in a mental hospital, in 2 night clinics and a social psychiatric outpatient clinic, were examined, 12 to 13 years later, with regard to rate of death. 7 of the 46 night clinic patients, 1.4% per year, and 2 of the 46 hospital patients, 0.4% per year, had died, all of them by suicide or a psychotic motivated self-destructive act. 16 of the 78 outpatients had died, 1.5% per year, whereby 10 committed suicide (0.99% per year). In comparison with the Swiss mortality tables and accounting for sex and age factors, the death rate by the examined schizophrenics is significantly higher. PMID- 3811605 TI - [Social and preventive medicine developments in the next 15 years]. AB - At the present instant we are evolving in the withdrawing of a lot of traditions. Alas one shouldn't live in the illusion that probably nothing will basically change nor be suspicious of either mass-media histrionics or political opportunism towards fashion phenomena; these will probably be the caricatured reflections of what shall perhaps become our society. They will however refer to their futility in the form of the wave which will mark an evolution we shall try to anticipate. In some degree it will allow to stimulate the thought or to modify structure of our medical institutions or our patients, the social and preventive technics that risk to begin won't be simple improvements of what we have now, but they'll open a qualitative universe and extremely different from those, that were born in the 19th century. This study should above all permit us to understand that our rapport with another reality perhaps, or perhaps a new way of life, 'culture' in the broadest sense, will be upset or simply brought into question. Here we see the importance that will be played by social and preventive medicine and evidently social and preventive psychiatry in the year 2000. PMID- 3811606 TI - [Does selective intervention affect other areas of primary health care? Evaluation of a vaccination program in Somali refugee camps]. AB - The discussion, whether poor countries of the third world should work towards comprehensive or selective primary health care has been based on political and economical arguments. The present study examines how far a selective strategy with one target problem influences other areas of primary health care. The study is based on the experiences with a vaccination program in the Somalia refugee camps. The program produced for the first time a reliable census of the refugee population which produced much smaller figures than had been reported previously. Data on the nutritional status of all children under 5 was collected at the vaccination places. These data provided a new basis for the general food distribution. At the same time the data served to evaluate the supplementary feeding program for vulnerable groups. The study also showed that general food distribution was more important for the reduction of malnutrition than other interventions, such as curative health care, community water supplies, sanitation, supplementary feeding program and vaccination program. Furthermore it illustrates the conditions in which sectorial actions can become a useful asset to community oriented health programmes. PMID- 3811608 TI - [Jogging is accompanied by low absenteeism (the Berne runner study '84)]. AB - 4358 male runners over age 16, competitors of the 16 km race 'Grand-prix of Berne' 1984, represent the study population of a cross-sectional survey. As a part of it, relationships between jogging and absenteeism were investigated. 16 km running time was positively associated with the number of missed work days (p less than 0.001); training activity (kilometers run per week, one-year's average) and absenteeism were related in an inverse way, but only up to a training distance of not more than 50 km/wk. Runners who smoked cigarettes missed over 50% more work days than nonsmokers (p less than 0.001). The relative importance of the motive for jogging 'as a balance to work' was associated with decreased absenteeism (p less than 0.001), whereas relative importance of competition orientated motives was associated with increased absenteeism (p less than 0.001). A multiple regression analysis involving 8 factors was not able to explain more than 11% of the observed variance in missed work days, which underlines the complexity of this dependent variable. The question concerning a possible causal relationship between active, regular, moderate jogging and reduced absenteeism remains unanswered. PMID- 3811607 TI - Social factors and professional attitudes as determinants of the frequency of small surgical procedures among children in Greece. AB - Data concerning histories of Adenoidectomy (Ad), Tonsillectomy (T) and Appendectomy (Ap) were collected from the escorts (mainly mothers) of 2296 children 3-12 years-old. The children were admitted as outpatients at the First Department of Paediatrics of the University of Athens or the Polyclinic of the Children's Welfare Center of PIKPA in Pireaus, during the last six months of 1983. Among children with median age of about six years, 12 percent had already had at least one operation (Ad, T or Ap); this proportion increased to about 25 percent among children with median age of about 10 years. The cumulative incidence of Ad and/or T was higher among boys, whereas the cumulative incidence of Ap was higher among girls. The age adjusted cumulative incidence of Ap was significantly higher in the lower social class, whereas there was no social gradient with respect to Ad or T. There were strong intra-individual correlations among the three studied operations; in particular the age adjusted cumulative incidence of Ap was 2.9 times higher among children with Ad and/or T than among children without any of these operations. Since there are no apparent biomedical reasons to account for the observed intra-individual associations, it appears likely, that these associations reflect parental or physician's attitudes leading to unjustifiable operations in some of the children. PMID- 3811609 TI - [Aerobic capacity estimated from heart rate under submaximal load: an indicator of complaints, personality, personal activity and social status]. AB - In 34 young females (mean: 21 years, range 18-30), working with VDTs, maximum aerobic capacity (MAC) was estimated by use of a cycle ergometer and Astrand's nomogram. MAC correlated with musculoskeletal complaints (-.29, p less than .05), eye complaints (-.36, p less than .05), personal activity (.38, p less than .05), personality dimensions: "Imperturbability" (.41, p less than .01), "Wellbeing" (.31, p less than .05), "Traditionalism" (-.45, p less than .01) and "Psychophysic constitution" (all evaluated by questionnaires), a body weight index (-.51, p less than .01) and systolic blood pressure after performance ( .51, p less than .01). MAC also distinguished significantly between a priori classified subgroups with seldom or frequent musculoskeletal complaints, the latter scoring higher (31 vs. 25 ml O2/kg X min), and subgroups with high or low EMG values of the trapezius muscle, measured at the workplace (25 vs. 33 ml O2/kg X min). A similarly ascertained MAC separated a comparable group of 55 young female university students (mean: 21 years, range 19 to 27) from the VDT users (38 vs. 27 ml O2/kg X min). It is concluded that the indirect estimation of MAC using Astrands nomogram is sensitive enough for certain practical uses and that MAC shows significantly plausible relations to a set of personality factors, social status, complaints and physiological variables to serve as a reliable indicator for personal fitness. PMID- 3811610 TI - [Risk factors of coronary disease among foreign workers in Switzerland]. AB - In a study covering the state of health and nutrition, 255 single Italian and Spanish seasonal workers were examined for the risk factors of coronary heart disease. The prevalences of hypertension (31.7%), hypertriglyceridaemia (38.8%) and adiposity (41.4%) were clearly above the frequencies of comparable Swiss groups. In the prevalences of hypercholesterolemia (13.8%) and smoking (51.7%), no major differences were apparent between the foreign workers and the Swiss population. PMID- 3811611 TI - [Elimination of measles, mumps and rubella in Switzerland]. AB - The combined measles, mumps and rubella live vaccine nowadays available is very well tolerated and confers lifelong immunity. A complete immunization coverage among toddlers, schoolchildren and adolescents should nearly eliminate these three childhood diseases in a given population. The cost/benefit ratio of the immunization is for all three diseases rewarding in Switzerland. Reactions expected to the combined vaccine are mild and complications negligible in comparison to the diseases prevented. Starting in 1987 a nationwide campaign will begin in Switzerland; the aim is to vaccinate next to toddlers all so far non vaccinated 6-7 years old and 14-15 years old schoolchildren respectively for a period of 8 years. PMID- 3811612 TI - [AIDS: each and every one's responsibility]. AB - AIDS is posing challenges at various public health related levels, epidemiological, clinical, social, ethical, legal. In the current absence of possibilities of curative treatment or of vaccine, it is essential to provide sufficient information on the available preventive measures. Given the increase in the numbers of seropositive persons, and the recognition that heterosexual relations area significant transmission route in case of multiple, illknown partners, the need is to actively promote the sale and use of condoms (male preservatives), in risk situations in general (and not only to homosexuals and drug addicts). Among others, a proportion of youth have dangerous behaviors in this regard. Public health leaders as well as those in the social, educational and political fields must adopt a clear stance encouraging the practice of this preventive measure which, literally, can save one's life. PMID- 3811613 TI - Furosemide lowers intracranial pressure by inhibiting CSF production. AB - Furosemide administration effectively lowers intracranial pressure in newborn preterm and term rabbit pups. This effect may be due to the diuretic action of the drug, its ability to inhibit cerebrospinal fluid production or to a combination of both. To test these possibilities newborn rabbits were either injected with furosemide and left unmolested for 6 hours, or anaesthetized and subjected to ventriculocisternal perfusions. During the 6 hour postnatal period the decrease in body weight was 8 times greater in furosemide than in saline treated pups. However, no difference was noted between the average brain weights of these two groups. Secondary effects of the diuretic were noted in blood (12.5% increase in the haematocrit over control value) and in muscle in which tissue water content and NA+ concentration were decreased while K+ concentration was increased. The fact that these parameters remained unchanged in brain suggests that the lowering of intracranial pressure was not attributable to the secondary effects of the diuretic agent. However, the marked reduction in cerebrospinal production noted following furosemide administration indicates that in newborn rabbits this may represent the primary mechanism by which furosemide lowers intracranial pressure. PMID- 3811614 TI - Progressive neurological deficit in children with spina bifida aperta. AB - The results of re-operation of 15 patients with spina bifida aperta are reported. The operation was necessary because of neurological deterioration with increasing motor and bladder dysfunction. In all patients a tethered cord syndrome was present (CT-myelography). The myelum was adherent to the scar of the myelomeningocele repair. At operation the myelum is released from the adherent scar and in this way untethered. The early complications were mild except for one patient with decompensation of hydrocephalus. The aim of the operation was to stop further progression. The results of the operation were satisfactory with stabilisation of motor function in four patients and improvement of motor dysfunction in ten patients. Backache or fixation, bladder dysfunction and abnormal foot shape improved in some of the patients. In our experience the operative untethering procedure was useful. Intensive neurological control of operated spina bifida aperta patients is mandatory especially in those patients who can walk. PMID- 3811615 TI - Status of a group of spina bifida children not managed by early surgery. AB - At Our Lady's Hospital for Sick Children, Crumlin, the policy towards neonates with Spina Bifida is one of individualised care. This means that those children who, experience has shown, will not be long term survivors are not subjected to procedures that are distressing and traumatic to the infant and parents. They are given full nursery care. A small number of children treated on this basis thrive. The question arises whether or not they have been further handicapped by this approach. Since this is a problem which causes concern to both parents and clinicians, this study reviews the present state of these survivors. In the five year period 1979-1983, there was a total of 192 infants admitted to Our Lady's Hospital with open myelomeningocoele. 66 were treated with early surgical intervention. 75 died without any surgical procedure at a mean of 46 days. 51 children underwent late intervention, despite which 29 died. A group of 22 are alive, aged 3-7 years. The mean first admission of these 22 patients was 77 days and was uneventful. However, all 22 are severely handicapped; all are paraplegic, doubly incontinent and have some degree of mental handicap. All have hydrocephalus graded moderate to gross and 17 have been shunted. Amongst these 22 surviving patients, we have been unable to identify, in the initial period, specific events or developments which have clearly caused additional damage to the infant's intellectual or physical well-being. PMID- 3811616 TI - Surgery of arachnoid pouches. AB - An anecdotal presentation of some features of subarachnoid pouches stresses the variable clinical and morphological features. Hydrocephalus is commonly associated but is not always a cause nor a result of the pouches. The nature of the valvular action is unclear but most probably usually takes the form of plugs of nervous tissue, compression of perivascular spaces in the depths of sulci or else meningeal flaps forming slits in the CSF pathways. The nature of the filling force is almost certainly pulsatile and dependent upon venous impulses generated within the thoraco-abdominal cavities. Treatment may need to be directed against the pouch, or the hydrocephalus. Treatment of the valvular mechanism alone by dissection is frequently sufficient. Opening the pouch widely to the ventricular system may also be of value. Post-operative surveillance is necessary. PMID- 3811617 TI - On a free autologous graft of the greater omentum for spinal CSF drainage. AB - A pedicular flap of the greater omentum can after transposition through the posterior abdominal wall to the lumbar subarachnoid space resorb cerebrospinal fluid (CSF), according to earlier studies. The present study investigates the basic prerequisites in rats and cats for a simplification of the method, utilizing a free omental graft transplanted to the lumbar or cervical region, in contact with neighbouring sacrospinal muscles. It is concluded from long term studies that the free omental graft "survives" and preserves its histological characteristics by revascularization between muscle and omentum, indicating a useful resorptive function. PMID- 3811618 TI - The silastic urethral ligature: an aid to catheter management. AB - A technique is described for improving catheter control in patients with neuropathic bladder who have inadequate sphincter tone to retain an indwelling catheter without leaking or to remain dry with a regime of intermittent catheterisation. The urethra or bladder neck is narrowed by one or more ligatures of silastic tubing. 24 patients were operated upon. Results were excellent in 6, satisfactory in 5 and a failure in 13. Successful results are easier to achieve in males than females. In the latter, an alternative method of narrowing the bladder outlet would be preferable. The operation does not spoil the operative field for a possible future artificial sphincter insertion. PMID- 3811619 TI - Os calcis osteotomy in the management of deformities of the hindfoot in spinal dysraphism. AB - The results of 52 primary os calcis osteotomies in 44 patients with spinal dysraphism are reviewed. There were 42 varus hindfoot deformities and ten valgus hindfoot deformities. The results indicate that the operation is simple and uncomplicated, but over a mean 5.8 year follow-up for the varus feet and 6.5 years for the valgus feet, over 50% of the feet developed either a moderate or severe recurrence of deformity. Os calcis osteotomy appeared from this series to be a moderately successful interim operation for the equinus varus foot, delaying the need for premature triple arthrodesis, but the long-term results in cavo varus feet with claw toes were uniformly poor. Furthermore, it appeared to be unsatisfactory in the mobile flail valgus foot unless the subtalar joint had been stabilised by fusion. Correction of proximal joint or bone deformity and muscle imbalance is considered necessary if satisfactory results are to be achieved from the osteotomy. PMID- 3811620 TI - Computer-tomographical appearances of the Chiari malformations of the posterior fossa. AB - The computer-tomography appearances of the Chiari I-III malformations are reviewed. The study is based on a series of 35 cases of Chiari I malformation, 116 cases of Chiari II malformation, and one case of Chiari III malformation. In our experience, a reliable diagnosis of all three types of malformation is possible on computer tomography. However, nuclear magnetic resonance imaging does reveal more detail and may become more important in the diagnosis of malformations of the posterior fossa structures. PMID- 3811621 TI - The incidence of seizure disorder in children with acquired and congenital hydrocephalus. AB - 202 cases of children with shunted hydrocephalus of congenital or acquired origin were studied and the incidence of seizure disorder was found to be 39%. However in only 17% of cases was the seizure disorder found to be persistent. Focal seizures were rarer than expected. If focal seizures were present they did not appear to be related to shunt site. 9.4% of children suffered an episode of status epilepticus. A large number of incidents of seizures could be shown to have a specific precipitant, usually CSF infection or shunt related problems. No aspect of birth history or development or treatment of the hydrocephalus was related to the occurrence or seizure disorder or type of fit experienced. Children with persistent seizure disorder were found to be more likely to be of low IQ, physically handicapped and at Special School. PMID- 3811622 TI - Should the tradition of right cerebral hemisphere shunting still prevail? AB - A review of the literature suggests that the right hemisphere compared with the left may be more sensitive to, and take longer to recover from, cerebral trauma. As there are also grounds for suggesting that shunting may be associated with limited cerebral insult, it is possible to conclude that, theoretically, left hemisphere shunting may be a preferable policy. PMID- 3811623 TI - [Effects of repeated administration of bromocriptine on ambulatory activity in mice, and changes in methamphetamine sensitivity in bromocriptine-experienced mice]. AB - Effects of repeated administration of bromocriptine, a long-acting dopamine agonist, as well as interaction between bromocriptine and methamphetamine were investigated by mean of ambulatory activity in mice. The ambulatory activity of each mouse was measured by a tilting-type activity cage for 6 and 3 hr after administration of bromocriptine and methamphetamine, respectively. The repeated 5 times administration of bromocriptine and of methamphetamine was at intervals of 7 days and of 3-4 days, respectively. Bromocriptine tended to suppress the activity at low doses (1 and 2mg/kg, ip), but increased the activity at high doses (8 and 16 mg/kg, ip), showing biphasic effects depending on the doses administered. Both the ambulation-suppressing and -increasing effects of bromocriptine were enhanced when the drug was repeatedly administered. The mice that experienced the repeated administration of low doses and high doses of bromocriptine exhibited a decrease and an increase, respectively, in the sensitivity to the ambulation-increasing effect of methamphetamine (2 mg/kg, sc). Repeated administration of methamphetamine (2 mg/kg, sc) elicited an increase in sensitivity not only to methamphetamine itself, showing reverse tolerance, but also to high doses of bromocriptine, showing cross reverse tolerance. However, the reverse tolerance to methamphetamine, once produced, was not affected by the repeated administration of low doses of bromocriptine. PMID- 3811624 TI - [Effects of maternal alcohol exposure during gestation and/or lactation periods on radial-maze learning in offspring rats]. AB - The present study was designed to investigate the effects of maternal alcohol (15%) exposure during the gestation and/or lactation periods on learning of an 8 arm radial maze by rat offspring. Acquisition of the maze learning was found to be profoundly retarded only in the offspring of mothers treated with alcohol during gestation. This result could not be explained by a secondary effect of malnutrition produced by the alcohol treatment, because body weight increase in the offspring was suppressed by the alcohol treatment during lactation but not during gestation. The possibility of involvement of deficits in brain development (especially of the hippocampus) in the learning impairment was discussed. PMID- 3811625 TI - [Effect of haloperidol decanoate on the dopaminergic system in the rat brain]. AB - The effect of haloperidol decanoate and haloperidol on the dopaminergic system in the rat brain was studied. Each rat was treated with either once daily ip injection of haloperidol (5 mg/kg) for 4 weeks or a single sc injection of haloperidol decanoate followed by once daily ip injection of saline for 4 weeks. Three weeks after cessations of injections, the levels of dopamine (DA) and its metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), were determined in the striatum, limbic area and frontal cortex 4 hours after a single ip injection of haloperidol (1 mg/kg). The haloperidol decanoate-treated rats showed lower levels of DOPAC and/or HVA than the rats of the other two groups. The DA level was higher only in the limbic area of the rats treated with haloperidol decanoate than that of the rats treated with saline. There was no difference of the levels of DA and its metabolites between the saline and haloperidol-treated rats. These results indicate that the haloperidol decanoate treated rats developed a tolerance to an acute effect of haloperidol on stimulation of DA turnover in the three areas examined, while the haloperidol treated rats developed no tolerance under these experimental conditions. A single sc injection of haloperidol decanoate to rat is expected to produce a long lasting blocking of the central DAergic system for at least 7 weeks. Such a property of this drug appears favourable for the maintenance therapy of schizophrenia. PMID- 3811626 TI - [Rapid establishment of nicotine intravenous self-administration behavior in rats]. AB - The reinforcing effect of nicotine was investigated using the intravenous self administration method in rats. After forced iv injection of nicotine (3, 10 and 30 micrograms/kg/inj) at 1-hr intervals for 3 days in 3 dose-level groups, self administration sessions under the continuous reinforcement schedule were carried out for 15 days. Rats initiated self-administration of nicotine rapidly in 10 and 30 micrograms/kg/inj groups. Daily self-administration responses by nicotine (30 micrograms/kg/inj) were 3-10 times the control levels. Total self-administration responses for 15 days increased in a dose dependent manner. When the fixed ratio was increased from 1 to 4 and 8 after the 15 days self-administration session in the nicotine (10 and 30 micrograms/kg/inj) groups, lever press responses increased only about 2 times, and self-administration responses decreased in the both groups. These findings suggest that nicotine becomes a reinforcer rapidly, but the magnitude of reinforcing effect is relatively week after the acquisition of nicotine for a short period. PMID- 3811627 TI - [Putrefaction-induced changes in the concentration and temporal detectibility of carbon monoxide in cadaveric blood samples]. AB - Eighty-five blood samples with COHb concentrations of 40% and 70% were allowed to putrefy in order to measure the time-dependent changes in COHb values. The samples not hermetically closed had been stored at 6 degrees C and 20 degrees C. GC and photometric methods were applied. Two graphs show that after 15 days (40% COHb) and after 30 days (70% COHb), the COHb concentrations decreased to half at 20 degrees C. Corresponding decreases at a storage at 6 degrees C could be observed after 1 year. Further investigations excluded the formation of new CO. PMID- 3811628 TI - [Quantity of weapon oils at the target as a function of shooting sequence and firing distance]. AB - Five widely used gun oils were tested to see if they could be identified by gas chromatography. All oils in the test produced characteristic gas chromatograms and the test was highly sensitive in tracing the oils. Seven different weapons and various types of ammunition were used to perform firing tests involving an oil sold under the brand name of "Gun pro." The weapons were oiled and wiped dry and subsequently discharged at a cotton cloth target. Series of shots were fired from a maximal distance of 3 m, and the weapon was not cleaned between shots. Grease marks and powder-burn traces were extracted separately and the extracts, after adding an internal standard, were investigated by means of gas chromatography (gas chromatography unit by Perkin and Elmer). The largest quantities of oil were transmitted by indoor ammunition fired from a small-bore rifle. At a firing range of 20 cm, a decrease in the oil quantity could be observed up to the fourth discharge. When the firing range was varied there was a decrease in the oil quantity up to a distance of 80 cm. The first and the second discharge could be distinguished up to a firing range of 60 cm. With increasing force of the projectile and a decrease in the interior length of the gun barrel, the quantity of oil conveyed to the target also decreased. Additionally, the identifiability of the oil was investigated after firing at several layers of cloth and after storage of the samples (no losses occurred after a 1-month storage period).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3811629 TI - [Intravital acellular hemolysis of extravascular erythrocytes. An experimental contribution to the determination of wound age]. AB - The time-dependent acellular, destructive changes in erythrocytes was investigated in rabbits by subcutaneous, intraperitoneal, and subdural implantation of blood-filled diffusion chambers with 0.45 micron pores. The animals were killed at various intervals after implantation (7-24 h), and the erythrocytes in the capsules were examined by light and electron microscopy. The findings were quantified by counting 100 cells per preparation under the light microscope; changes in both matrix and membrane structure were recorded. Matrix changes and membrane variants were specified by electron microscopy. Time dependent changes in erythrocyte matrix and membrane were established, which occurred at the various localizations in an identical sequence, but with different time intervals. The destructive changes were: an increase in loss of matrix, increase in membrane permeability, and decrease in membrane stability. The physiologic bases of and the conclusions for wound timing were discussed. PMID- 3811630 TI - Alcohol involvement in violence. A study from a Danish community. AB - All cases of assaults with violence (n = 1639) from a well defined area were registered for 1 year. A positive alcolmeter test (% greater than 0.2) was registered in 488 cases (29%). A further 216 patients (13%) were found under the influence of alcohol according to a simple clinical judgement. In nine of ten manslaughter and murder cases alcohol was involved. Young men, 19-29 years of age, comprised the majority of victims. Of the episodes of violence 66% took place during the weekend. In 250 cases the alcohol concentration surpassed 1.5%. Almost 50% of the violence episoded took place in or around restaurants. Blunt violence was concerned in 73% of the episodes. Gunshot was registered in five cases, stabbings in two cases. PMID- 3811631 TI - [Cleavage of 2-phenylpropan-1-ol and 2-phenylpropan-2-ol-glucuronide, 2 metabolites of isopropylbenzol (Cumol)]. AB - The behaviour of 2-phenyl-1-propanol (I) and 2-phenyl-2-propanol (II) and their glucuronides with HCl has been investigated. While I shows a high acidic constancy, II undergoes a partial conversion into 2-phenylpropane (III) which itself yields numerous products. The glucosidic bond of glucuronide I is quantitatively split by 10.0% HCl, whereby an aglucone yield of nearly 100% is obtained. The second glucuronide behaves otherwise: the recovery of II is very low (only 40% to 45%) with HCl concentrations of 1.0%-20.0%, although with 1.0% HCl 100% of the glucuronide is hydrolysed. PMID- 3811632 TI - Differentiation between human and chimpanzee in bloodstains by enzyme-linked immunosorbent assay (ELISA) using antihuman serum. AB - An enzyme-linked immunosorbent assay (ELISA) for species identification of human bloodstains using two commercially available antisera against human serum is described. Human bloodstains were to be distinguished from those of chimpanzees and other animals using raw antisera, and the differentiation between human and chimpanzee became more evident when those antisera were absorbed with a small amount of chimpanzee plasma. Human bloodstains could clearly be identified by the present method even after 4 weeks of aging at room temperature. PMID- 3811633 TI - [Enthetic reactions of the hand in progressive scleroderma]. AB - Frequent bone changes in progressive systemic sclerosis are the marginal osteolysis, the arthritic erosions and also the reactions at the numerous entheses of the hand, where the resorptive reactions predominate the osteoproliferative ones. The most frequent resorptions occur at the proximal corners of the tufts. At the margin of the tufts there are also enthesitic reactions, but they do not mark the beginning of an acroosteolysis. PMID- 3811634 TI - [Early detection of fibrosing alveolitis in collagenoses]. AB - Lung function tests during a five-year follow-up were performed on 29 patients with various collagen diseases. At the beginning of the study none of the patients had signs of any pulmonary dysfunction. The onset of fibrosing alveolitis was accompanied by a marked reduction of the diffusing capacity for CO and a more minor alteration of the static specific compliance. The vital capacity and the pO2 at rest changed only in cases of advanced pulmonary fibrosis. PMID- 3811635 TI - [Synovial tissue levels in comparison with synovial fluid and serum concentrations following a single daily administration of 20 mg piroxicam (Felden)]. AB - Serum, synovial fluid and synovial tissue was taken from a total of 25 patients of both sexes on whom a synovectomy had been performed, after a 1, 3, 5, 6 or 7 day treatment with a daily administration of 20 mg Piroxicam (5 patients in each group) and the concentration of Piroxicam (Felden) determined. Parallel to this a part of the synovial tissue taken was histologically examined and classified. The analytical results presented here show that in the mean appr. 33% of the Piroxicam passed from the serum into the synovia, appr. 26% into the non or partially florid synovial tissue and appr. 32% into the florid or highly florid synovial tissue. Felden 20 (Piroxicam) thus fulfills the requirement of a good acting, non-steroidal, antiinflammatory substance (NSAID), namely of being available at the location of the inflammatory process. PMID- 3811636 TI - Decreased supportive function of platelets from patients with SLE on human endothelial cells. AB - Platelets show a supportive effect on human endothelial cells in culture. Platelets of patients with systemic lupus erythematosus showed a significantly reduced growth stimulation as demonstrated by reduced DNA synthesis of the endothelial cells. PMID- 3811637 TI - [Differentiation of colitis and Crohn disease patients based on psychosocial variables]. AB - Two groups of twenty-two patients each, one group suffering from morbus Crohn and the other from colitis ulcerosa, both groups receiving treatment in a medical institution, were compared on the basis of social data, standardized psychological testing techniques, experimental psychologic examinations, and data concerning their disorders. Generally there were hardly any differences between the patients in either group. Merely the results obtained in the experimental procedure differed slightly in that a more pronounced cognitive suppression of affects occurred with the colitis group. Furthermore, a stronger affinity to taking advantage of an offer for psychotherapeutic treatment could be observed in this group. PMID- 3811638 TI - [Secret self mutilation, a psychosomatic disease]. AB - The present article contains initial results form systematic psychoanalytic work with patients practicing secret self-mutilation (our term for these is "mimicry patients"). The group we examined was treated on an in-patient basis in a hospital for psychosomatic disorders. The article may be considered as a preliminary report. Up until now the international range of experience is rather limited. We have therefore, made use of this occasion also for developing an applicable clinical definition of the different forms of self-mutilation. This definition is based upon psychological criteria rather than, as has hitherto been the custom, upon the techniques and the morphology of the self-inflicted injuries. Clandestine self-mutilation, in our understanding, is a psychosomatic illness. The self-manipulation has the character of a psychosomatic symptom which, although self-inflicted, is beyond the control of the afflicted individual and is accompanied by extremely reduced consciousness. So far, the experience gained in therapy points to a variety of subconscious conflicts at the back of this symptom, most frequently a severe guilt problem which is not only manifest intrapsychically but also within the family milieu of the patient. On the whole therapeutic results correspond to those observed with other grave psychosomatic disorders accompanied by organic lesions, that is to say improvement sets in slowly after a therapy extending over periods of several months to several years. Initially, a long time before any treatment of the subconscious conflict may be attempted, such therapy must employ supportive ego-consolidating methods and establish a therapeutic alliance. Even so we see no reason for resignation with regard to therapeutic success. PMID- 3811639 TI - [Psychosocial adjustment of paraplegics]. AB - The present article is concerned with the description and discussion of the results from an investigation on 34 paraspastic of paraplegic male patients. Data on the quality and intensity of functional impairment of the bladder and the intestine and on disorders with regard to the sexual sphere as well as on their psychosocial compensation were obtained in a semi-structured interview of up to four hours duration. Subsequently the data were evaluated with the aid of descriptive statistics. Predominant were two modes of coping with the handicap: Young paraplegics and paraspastics suffering from a traumatic lesion overcame their functional deficits by means of instrumental compensation and almost all of them--after passing through a course of institutionally prescribed developmental steps--achieved a readjustment both with regard to their relationship with the opposite sex and to their professional career. Older handicapped whose lesions were caused by disease persisted in resignation or hypochondriac concentration upon their state of health and were socially isolated. PMID- 3811641 TI - [Schizoid versus hysterical personality structure. II: Social behavior of precipitating events]. AB - 38 schizoid and 70 hysterical patients with neurotic disturbances are compared with regard to social data, intelligence and triggering situation. Schizoids are more frequently single, childless and live alone, while hysterics are married, remarried or divorced, have one child and live with their partner and the child. With nearly the same education and intelligence, schizoid patients are more often workers/skilled workers, pupils/apprentices/students or have no profession; hysterically structured individuals, being predominantly women, are more frequently housewives. Nearly half of the most frequent triggering events are equally distributed in both structure groups; these are particularly events signalling a change during development, which, in degree of severity, can just as well be minor threshold situations as serious reverses. With an earlier age of onset, schizoids decompensate significantly more often in "developmental stages", whereas hysterical patients are more likely to do so in connection with events of "love-sexuality" and those which provoke hysterical anxieties. Of the 15 most frequent events, only 6 each occur in either the schizoids (starting school, puberty, moving away from home, entering into a heterosexual relationship in terms of a casual encounter, beginning an apprenticeship or studies, failure in a test) or the hysterically structured individuals (vacation, marriage, pregnancy/delivery, marital disharmony, extra-marital relationship and severe illness of the patient). PMID- 3811640 TI - [Inhibition of expression as a component of psychosomatic disorders]. AB - This short and far from comprehensive survey on the role of inhibitory mechanisms in psychosomatic disorders is intended to draw attention to the fact that there is a large scientific interest in this issue which surpasses the classical psychodynamic aspects of deficient emotionality. From the point of view of behavioral medicine, social psychology, emotional psychology, and psychophysiology this problem is an imminent topic for scientific research. Inhibition considered as an active process in the individual must be included among those mechanisms of auto- and behavioral regulation where psychic and somatic processes are of mutual influence upon one another. It is suggested that a better understanding of this mutual influence might lead to an improvement of intervention techniques in behavioral therapy. It might, e.g., help to decide to what extent the training of an adequate expression of emotions is indicated in psychosomatic disorders, the kind of training incorporated for instance in concordance therapy (Gerber, 1982). Specific attention might be given to processes of socialization since research findings suggest that conditions of socialization characterized by a hyperactive system of behavioral inhibition make children particularly susceptible to psychosomatic disorders (Buck, 1984). PMID- 3811642 TI - [Psychosomatic findings in orofacial pain dysfunction syndrome]. AB - Patients with orofacial pain dysfunction syndrome cannot be treated in a satisfactory manner by looking at them with a monocausal, linear analytical point of view in the sense of aristotelian logic. In this interdisciplinary study 10 patients were investigated by dental and functional diagnostic procedures, by psychological testing and by psychoanalytically oriented interview technique. It became evident that only the consideration of psychosomatic aspects during dental practice can bring relief for these patients. PMID- 3811643 TI - [Single needle hemodiafiltration]. AB - The haemodiafiltration is a valuable alternative to the conventional dialysis in the cases of both clinical and/or allergic intolerance in conventional dialysis. Moreover, it is suitable for the treatment of therapy-resistant hypertension as well as in all situations, where an insufficient elimination of solved substances is supposed. Up to now the higher expenses prevent the routine use of haemodiafiltration in all dialysis patients. PMID- 3811644 TI - [Morphometric and histochemical studies of the skeletal muscles of patients with chronic renal failure and dialysis patients]. AB - In 19 patients with chronic renal insufficiency in the stage of compensated retention, 20 patients undergoing dialysis and 24 patients with normal renal function muscle tissue was taken by an open biopsy and investigated histologically, histochemically as well as morphometrically. A neurogenic atrophy stood in the foreground of the histologic changes of the striated musculature in uraemia, a pure type II atrophy was found more infrequently. In the patients undergoing dialysis frequency and size of these disturbances were more distinct. Except for a possible influence of a disturbed calcium metabolism other pathogenetic factors supposed in literature could not be found. PMID- 3811645 TI - [Desferal treatment of aluminum poisoning; effect on serum concentrations of aluminum (Al), iron (Fe) and copper (Cu)]. AB - In 2 patients with a progressive dialysis encephalopathy and increased serum aluminium concentrations a Desferal-treatment with 500 mg per week was performed and in these cases the kinetics of Al, Fe, Cu was investigated. After the application of Desferal an increase of the serum levels, the ultrafiltrable proportion, the dialysance and the eliminated quantity of aluminium developed. In the course of the treatment in the two patients the aluminium level could be reduced to approximately normal values. Nevertheless one patient died of a severe course of a progressive dialysis encephalopathy. An increase of the copper concentration independent of Desferal-treatment after the dialysator passage remained without influence on the course of concentration of the serum copper in the examination period. A remarkable effect of the Desferal-therapy on the iron metabolism could not be established. Since in the dosage used there did not appear any side effects the Desferal-application is to characterized as a distinct and effective technique for the decrease of the serum-aluminium concentration in patients undergoing dialysis. PMID- 3811646 TI - [Histochemical localization of aluminum deposits in bones and their relation to the clinical and histomorphometric findings in patients with chronic renal failure]. AB - In 60 patients with chronic renal insufficiency and 36 dialysis patients an iliac crest biopsy was performed, on the undecalcified bone morphometric determinations were carried out as well as the aluminium deposition was investigated histochemically. Histologically were found in 3 patients normal findings, in 11 patients a fibroosteoclasia, in 23 patients an osteoidosis and in 59 patients a combination fibroosteoclasia and osteoidosis. 3 oft the 60 patients with a chronic renal insufficiency had aluminium depositions in the polyblasts. Of the 36 dialysis patients 19 (55.4%) had a positive aluminium histology: 30.7% of the patients with osteoidosis and 23.7% with a mixed form. There was a positive correlation to the bone and osteoid volume, to the osteoid surface and a negative relation to the activity of osteoblasts, the absorption surface and the activity of osteoclasts. Aluminium depositions on the mineralisation border might be of importance for the changes. PMID- 3811647 TI - [Renal osteodystrophy]. PMID- 3811648 TI - Antimicrobial activities of some flavonoid compounds. AB - 6 flavonoid compounds, namely kaempferol, quercetin, myricetin, rutin, naringin, and formononetin were separated from different plant materials. They were identified using column and paper chromatography techniques, and physicochemical methods were applied to determine their structure. Isolated flavonoids were tested for their antimicrobial property against different bacterial and fungal strains as test organisms. PMID- 3811649 TI - [Surgical treatment of benign liver tumors]. AB - We reviewed the records of 105 patients treated for benign hepatic disease at the Department of Surgery of the Charite since 1979. Treatment has to be tailored to the different pathological processes. Modern imaging techniques are of utmost importance for diagnosis and follow up of all patients regardless if they underwent operative therapy or were treated conservatively. Indications and contraindications in the treatment of benign liver tumours are developed on the basis of 44 liver resections with special reference to adenomas and hemangiomas. In all cases a hemihepatectomy seemed justified inspite of the benign disease process. Postoperative complications were mostly related to the surgical incision and caused by abnormalities of protein synthesis and coagulation, frequently observed after major hepatic surgery. Close monitoring and immediate correction of all clinical and biochemical parameters are essential in the postoperative period. PMID- 3811650 TI - [Postoperative coma caused by liver failure]. AB - Reported are 135 cases of hepatectomy. Eight patients died, including seven who died of coma due to liver failure. Preoperative misjudgement of the functional reserve of the liver is, admittedly, an unsolved problem. A two-session approach, following chemotherapeutic tumour reduction, might be an alternative, when it comes to large liver tumours with reduced liver function. PMID- 3811651 TI - [CT findings in gastrointestinal tumors]. AB - Any suspicion of lumino-abdominal tumour growth should be confirmed or invalidated by contrast medium examination. The authors of this paper, deviating from the generally accepted diagnostic strategies, used computed tomography and succeeded in recording gastrointestinal tumours from 25 patients. High-accuracy organ localisation of palpable intestinal tumours proved to be possible by means of computed tomography. Hence, primary diagnostic use of CT appears to be justified in exceptional cases. PMID- 3811652 TI - [Ileus of the large intestine caused by endometriosis. Report of 2 cases and review of the literature]. AB - Two cases of distal colonic obstruction due to endometriosis prompted the authors to elaborate on problems implied in diagnosis and therapy of this rare cause of ileus. Accurate preoperative diagnosis was usually not obtainable from case histories, endoscopy, and X-ray checks. Only emergency operations should be performed on ileus cases (colostomy, Hartmann's operation). Hormonal and surgical treatment should then be continued in consultation with the gynaecologist. Resections should be minimised and mutilating interventions (rectal amputation) avoided. PMID- 3811653 TI - [Endometriosis of the umbilicus]. PMID- 3811654 TI - [Metastasizing hemangiopericytoma]. PMID- 3811655 TI - [Choledochus obstruction by a spreading giant cell tumor of the intrahepatic bile ducts. A rare cause of obstructive jaundice]. PMID- 3811656 TI - [Use of the EEA stapler in esophageal anastomoses]. PMID- 3811657 TI - [Epiphyseal fractures]. AB - The distal humerus and distal tibia are the most common sites of epiphyseal fractures. Epiphyseal detachment was found to occur more often in the region of upper extremities. Treatment of children for epiphyseal fractures is inevitably accompanied by growth disorders. Articular and diaphyseal malpositions are controllable. Fractures in childhood and, consequently, epiphyseal fractures should be grouped by diaphyseal and articular fractures. Epiphyseal detachment should then be associated with diaphyseal fractures, and epiphyseal fractures should be grouped under articular fractures. PMID- 3811658 TI - [Percutaneous reconstruction and fixation of closed fractures of the tibial head. Results of a follow-up study]. AB - A retrospective study was undertaken into 105 cases of closed fractures of the tibial head which had been treated by percutaneous elevation and fixation at the Surgical Casualty Ward of Dortmund, between 1973 and 1983. Follow-up check made 24 months from surgery, on average, revealed functional results which were in all respects comparable to those recorded from cases of open reduction and fixation. The approach was found to be applicable to closed reduction and impression fractures with first-grade and second-grade damage to soft tissue. Stability in exercise is claimed together with low surgical risk and trauma and with minimum demand for osteosynthesis implant. Good long-term results were found to depend strongly on early, intensive, and active exercise treatment. PMID- 3811659 TI - [Ligament rupture of the lateral Chopart joint]. AB - Rupture of the dorsal calcaneo-cuboid ligament has to be expected in about five per cent of all cases of supination trauma in the ankle joint and foot. The injury can be safely verified by standardised holden radiographs, with the other side involved for comparison. Surgical treatment does not appear to be necessary. Four-week immobilisation by cast was found to be sufficient for elimination of complaints and restoration of adequate functionality. PMID- 3811660 TI - [Results of the surgical treatment of ankle joint fractures]. AB - Surgical treatment was applied to 74 cases of ankle joint fractures at the author's hospital, between 1979 and 1984. Follow-up checks were made on 59 patients, within one to seven years from surgery. Luxation fractures accounted for 39 per cent. The rates of wound edge necrosis and bone infection were three per cent each. Results were evaluated by stringent and precisely defined criteria. The worst findings, according to expectation, were recorded from the cases of luxation fractures. Sixty-four per cent of all results were rated good to very good, and 17 per cent were rated poor. The patients' individual assessment was much better, since only three per cent felt that results were inadequate. PMID- 3811661 TI - [Longitudinal fracture of the patella]. PMID- 3811662 TI - [Optical tension studies of lifting osteotomy of the tibial tuberosity]. AB - Optical tension experiments for model statistics were conducted for more elucidation of lifting osteotomy of tibial tuberosity and mechanisms of its impact upon the femoropatellar joint. The following two qualitative conclusions were primarily drawn: Growing pre-displacement caused reduction in the maximum number of isochromates. Stepwise pre-displacement caused dislocation of the contact point. While full translation of the above results to natural conditions is considered impermissible, displacement of femoropatellar pressures is felt to be an important mechanism of action. PMID- 3811663 TI - [Heparin and the prevention of thromboembolism in surgery]. AB - Heparin was introduced to medical prophylaxis against postoperative thromboembolic complications 50 years ago, following its discovery, structural elucidation, and first clinical use. Isolated subcutaneous application with and without control of coagulative data was followed by additional administration of dihydroergotamine. Results were thus substantially improved. The principle has now been scrutinised for the first time at the Surgical Hospital of Kiel University by computerised monitoring of large-scale application to more than 3,000 patients. PMID- 3811664 TI - [Brain protection in the surgical reconstruction of the supra-aortic arteries]. AB - The importance of brain protection in surgical handling of supra-aortic arteries may be derived from the specific nature of cerebral blood flow and from the pathophysiology of damaged cerebral vessels. There is a wide range of special protective methods which have proved to be effective, including strict observance of established rules on surgical indication and tactics, maintenance of circulatory homoeostasis, heparinisation, and use of an intra-luminal shunt. Results obtained from operations on 486 patients for occlusion of supra-aortic arteries are discussed, with particular emphasis being laid on the need for intra operative EEG monitoring. Reference is also made to measures of brain protection in the postoperative phase. PMID- 3811665 TI - [DNA content and prognosis in atypical cervix epithelium]. AB - At 76 patients an atypical epithelium of the uterine cervix was verified colposcopically, cytologically and by biopsy. The mean content and the distribution of DNA was measured by single cell-photometry of Feulgen-stained smears. These findings were compared with the spontaneous follow up of these cases. No correlation could be registered between DNA-characteristics and the fate of atypical epithelium, which was suitable for a clinical therapeutic resolution. PMID- 3811666 TI - [Modern treatment of hydatidiform mole]. AB - Authors describe their experiences in forty seven cases of molar pregnancy. Modern techniques (hCG beta-subunit radioimmunoassay, computerized tomography, pelvic angiography, ultrasonography, prophylactic chemotherapy) are described with regard to diagnosis and treatment of hydatidiform mole. The advantages of trophoblastic disease centers are emphasized. PMID- 3811667 TI - [Usefulness of cytologic studies on abdominal fluid in the control of patients with ovarian cancer]. AB - A report is given about the efficacy of cytology which is gathered by trans vaginal punction and lavage of the abdominal cavity in 95 patients with ovarian cancer treated before. The cytological findings were the following: Cytological examinations were negative (no tumour cells) in 61/95 cases (64.2%). Examinations were ambiguous in 16/95 cases (16.8%) and tumour cells could be proved in 18/95 cases (18.9%). Relapses appeared in the average time of 25 months after finishing of therapy in 17 cases (30%) with negative cytological examinations. We observed 3 relapses among the patients with ambiguous and 3 ones with positive tumour cells. The cytology of abdominal fluid seems to be a capable method in spite of its incompleteness for following up the patients suffering from ovarian cancer. The failure rate is calculated around 30%. Sonography and computerized tomography can complete the diagnostic spectrum. PMID- 3811668 TI - [Ovarian metastasis of cancer of the small intestine with simultaneous ovarian pregnancy]. AB - Report about a case of an ovarian metastasis of a small intestinal adenocarcinoma in a 25 year old woman. Diagnosis was difficult because of a simultaneous ovarian pregnancy on the same ovary. This is very seldom. PMID- 3811669 TI - [Rare late metastasis of a successfully treated advanced ovarian cancer]. AB - A case of a 64 year old woman is reported suffering from bilateral inoperable ovarian carcinoma. Seven years before death the carcinoma was histologically confirmed by an explorative laparotomy. At this time even a diffuse peritoneal carcinosis was found. The polychemotherapy yielded to a reduction of tumor mass. This allowed a surgical radical operation two years later. During continued chemotherapy the patient was clinically and cytologically free of tumor. The death was caused by diffuse late metastases in the brain. PMID- 3811670 TI - [Tubal cancer with cervix metastasis]. AB - A case of tubal carcinoma is presented, which was initially misdiagnosed as an endometrial carcinoma. This was due to a superficial metastasis yielding material during the curettage which simulated an anaplastic adenocarcinoma. The difficulty of correctly diagnosing tubal carcinoma preoperatively has been discussed. PMID- 3811671 TI - [Bilateral benign enlarged ovarian tumors, ascites and hydrops of the gallbladder -a rare combination]. AB - In this case the unusual combination of an enlarged twisted ovarian cyst, a parovarian cyst, ascites and gall-bladder hydrops is being reported. Literature references regarding the clinical relevance of this problems are given. PMID- 3811672 TI - [Relation between corpus luteum function and serum prolactin concentration in early pregnancy]. AB - In 20 patients between the 6.-8. week of pregnancy serum prolactin concentration could be decreased successful by administration of a single dose bromocriptine. Coincidentally the steroid secretion of the corpus luteum has been monitored by measurement the serum concentration of progesterone and estradiol. There are no prolactin related changes in the corpus luteum function under these conditions. PMID- 3811673 TI - [Morbidity status, causes for work disability and social factors influencing work disability in pregnancy. 2. Causes for work disability]. AB - The higher level of patients of pregnant woman in comparison with non-pregnant ones results from a higher unfitness for work which nearly corresponds to the increase of sicknesses depending on gestation. From all causes of unfitness for work more than 60% were depending on gestation. Causes for the half of the release from work depending on gestation were the three diagnoses threatening abortion, threatening premature birth and bleedings. On the total level of patients of 11.66% they had a share of 5.70% points. Infections of the ureter, the diagnosis' 'Other complications in pregnancy', hyperemesis and gestoses followed. Infections of the upper respiratory tract and influenza were the causes of all releases from work which were not depending on gestation. Their share on the level of patients amounted to 0.9% points. Releases from work because of sicknesses of circulation and of the digestive tract followed in their frequency. A number of further causes of unfitness for work had only a small share on the happenings of unfitness for work. PMID- 3811674 TI - [Effect of modified obstetrical neuroleptanalgesia on the duration of labor and uterine contractions]. AB - The literature concerning the value of the "small neuroleptanalgesia" for obstetrical pain-relieve is in dispute. Our experiences are based on the single application of 0.05 mg Fentanyl and 2.5 mg Droperidol on the presupposition of a well--proportionate labour activity with a cervix dilatation of at least 2-4 cm. Sporadically we reinject Fentanyl once more or exceptionally Droperidol, too. Among 308 primigravidae and 189 multigravidae with continuously directed application of Oxytocine the duration of the delivery was shortened distinctly compared with the control group without "small neuroleptanalgesia" but with the same tocergic treatment. After the application of the "small neuroleptanalgesia" the labour--intensity is unchanged, exceptionally a very short lessening in the immediate phase after injection. The method is innocuous for the mother, for the fetus and for the new-born. It is effective and practicable under all circumstances. The method of the "small neuroleptanalgesia" is recommended. PMID- 3811675 TI - [A rare case of symmetrical double abnormality]. AB - A rare case of symmetric incomplete too headed four-handed conjoined twins which was delivered in the Sixth gestational month spontaneously has been demonstrated. These malformations are very seldom with a frequency of one to 65,000 up to 100,000 newborn. Questions about teratogenicity are discussed. PMID- 3811676 TI - [New aspects of therapy with standard immunoglobulin preparations]. AB - Both, in vitro and in vivo studies have shown that intravenous immunoglobulin administration in high doses is of usefulness in the therapy of bacterial infections because of synergistic effects with antibiotics. Unmodified, polyvalent immunoglobulin for intravenous administration is actually used for therapy in patients with severe generalized infections, in patients with autoimmune diseases such as idiopathic thrombocytopenic purpura (ITP). ITP patients were treated with IgG i.v. 400 mg/kg KG. One can hope for practical purposes that IgG preparations administrated prophylactically decrease infectious complications in myelosuppressive phases during aggressive tumor therapy. PMID- 3811677 TI - [Immunologic aspects of pregnancy]. AB - Immunological studies of normal pregnancies as well as of recurrent spontaneous abortions serve as indicators that certain immune responses are linked to reproductive success or failure. Some of the observed often contradictory phenomena concerning intraspecies mammalian pregnancies will be discussed in this review. PMID- 3811678 TI - [Morbidity, causes of work disability and social factors influencing work disability in pregnancy. 1. Morbidity]. AB - The level of patients was analysed on 1,100 pregnant women. The average duration of unfitness for work amounted to 25.7 days. Up to the end of the 34th week of pregnancy 65.4% of the working pregnant women were one or several times unfit for work. Two thirds of all releases from work happened between the 17th and 34th weeks. Pregnant women with risk factors had a significantly higher average frequency and duration of unfitness for work. The indications for intensive care of pregnant women are to be set more severely. The professional expositions of pregnant women have to be more organised by labor rights. Individual behavioural patterns from the view of the doctor and of the pregnant women influence on the occurrence of unfitness for work. PMID- 3811679 TI - [Effect of lumbar peridural analgesia on the evolution of the number of delivery associated operations]. AB - The authors analyse the obstetric material of ten years of their institute in terms of the rate of delivery-completing operations. Lumbar peridural analgesia was introduced in the fourth year of the period under scrutiny. In the course of ten years we delivered 16,582 patients. 2,797 parturients of them were given peridural analgesia. In spite of the widespread use of this method of pain control during labor, the rate of vaginal operative deliveries in percentage terms did not change. The result corroborates the authors' assumption that an increase in the number of obstetric vaginal operations is not a necessary concomitant of lumbar peridural analgesia. PMID- 3811680 TI - [Relation between corpus luteum function and serum prolactin concentration early in pregnancy]. AB - In 23 patients between the 6.-8. week of pregnancy the serum prolactin concentration excessively increased by bolus injection of 10 mg metoclopramide. Coincidentally the steroid secretion of the corpus luteum has been monitored by measurement the serum concentration of progesterone and estradiol. There are no changes in the corpus luteum function caused by hyperprolactinaemia under these conditions. PMID- 3811681 TI - Hemangiopericytoma of meninges. I. Histopathological variability and differential diagnosis. AB - A report on morphological variability of meningeal hemangiopericytomas (HP) is presented. 17 cases of HP (12 with intracranial, 5 with spinal localisation) were examined histologically. In 7 cases the tumor recurred, in 2 repeatedly. Metastases were found in 3 cases. As with peripheral HP, a surprising histological diversity is found with meningeal HP. Differential diagnosis can be difficult: Variants of meningioma, fibrous histiocytoma, paraganglioma and other rare richly vascular tumors have to be considered. Although hitherto little known, some additional signs as mucoid change and focal or diffuse fibrosis are helpful for diagnosis. HP of the meninges is considered a well defined entity apart from meningiomas. PMID- 3811682 TI - Hemangiopericytoma of meninges. II. General and clinical data. AB - Meningeal hemangiopericytoma (HP) has mostly been viewed as a variant of meningioma. There is more and more evidence, however, that HP constitutes a separate entity among tumors of the central nervous system. The data of intracranial and spinal HP of 17 of our patients and from a review of the literature is compared to meningioma and to peripheral HP. Meningeal and peripheral HP present with a similar sex ratio, age distribution, tendency to metastasize and are almost never multiple. This is fundamentally different from meningioma. Other data of meningeal HP like interval between first operation and manifestation of a recurrence or metastasis and survival time cannot be compared to peripheral HP due to its special location. Prognosis of meningeal HP is distinctly worse than of meningioma, placing HP between malignancy grade I and II as specified by WHO. PMID- 3811683 TI - [Neurosurgical aspects of the treatment of esthesioneuroblastoma]. AB - On the basis of the example of two observations by the author the diagnostic and therapeutical problems of the esthesioneuroblastoma are discussed. Neurosurgical problems result from the growing of the tumor into the inner space of the skull or the destruction of the anterior base of the skull with subsequent inflammatory consequences. PMID- 3811684 TI - [Pathologico-anatomic studies in the area of the vertebral artery with special reference to perivascular connective tissue]. AB - On the basis of pathological-anatomical examinations of 25 human cervical vertebral columns a report is given on changes of the perivascular tissue in the region of the Aa. vertebralis. The possible influence of degenerative changes in the skeleton of the cervical vertebral column on this connective tissue reaction is discussed. For a verification of the findings obtained comparative clinical anatomical examinations are necessary. PMID- 3811685 TI - [Subdural hematoma following rupture of an aneurysm]. AB - Subdural hematomas are to be expected in about 3% of ruptured intracranial aneurysms. One third of these bleedings causes rapid deterioration as do subdural hematomas of traumatic origin. Otherwise they will show a prolonged or asymptomatic course. On hand of 8 own cases and 51 comparable cases of literature the symptomatology, diagnostic difficulties and the indication for surgery are pointed out. We could show that in more than 70% subdural hematomas in association with bleeding aneurysm are due to aneurysms of the internal carotid artery or the middle cerebral artery. ICA aneurysms are mostly right-sided in these cases and there is a clearly increased susceptibility of women. The possible mechanisms of occurrence of this kind of subdural hemorrhage are discussed. PMID- 3811686 TI - [Recurrent aneurysmal hemorrhage following establishment of an extra-intracranial microanastomosis]. AB - A report is given on the recurrent haemorrhage of a cerebral arterial aneurysm occurring three days after the establishment of an extra-intracranial microanastomosis by means of a venous transplant. The carotid ligature should be carried out in a second session. The short time interval after the haemorrhage and also the larger flow via the venous bypass is discussed as a possible cause. PMID- 3811687 TI - [Fracture of the occipital condyle. Case description and review of the literature]. AB - The case of an 18 year old young man with an occipital condyle fracture following a motorcycle accident is reported. Guided by this observation and 10 additional case reports of the literature the mechanism of injury, symptoms and diagnostic procedures of this very rare fracture are discussed in detail. PMID- 3811688 TI - Natural and experimental Aujeszky's disease virus hepatitis in the neonatal calf. PMID- 3811689 TI - Allergic skin reactions in the horse: response to intradermal challenge with fractionated Culicoides. PMID- 3811690 TI - Ovine suppurative epididymo-orchitis caused by Histophilus ovis. PMID- 3811691 TI - Infectious pancreatic necrosis: detection of virus and antibodies in rainbow trout IPNV-carrier (Salmo gairdneri). PMID- 3811692 TI - [Prospective and retrospective analysis of prognosis in perinatal hypoxic lesions of the brain]. AB - The article presents data on the prospective and retrospective analysis of the dynamic structure of neurological syndromes in 211 children with perinatal hypoxic lesions of the brain in the preschool period. The complex of examinations included electroencephalography, echoencephalography, psychological examination, as well as measurement of lipid peroxidation products and immunoglobulin levels in the cerebrospinal fluid. It has been demonstrated that transformation of neurological symptom complexes at the most important stages of postnatal ontogenesis plays the decisive diagnostic and prognostic role. On the basis of the findings the authors consider optimal terms for screening children with a history of perinatal hypoxic impairment of the nervous system. PMID- 3811693 TI - [Characteristics of the neurotoxic syndrome in children with perinatal pathology of the nervous system]. AB - Comprehensive examinations of 100 children aged under 1 year with perinatal pathology of the central nervous system have helped to detect clinical, biochemical, and immunologic features in the course of the neurotoxic syndrome that developed in the presence of vitamins A and E inadequate supply. The efficacy of parenteral aevit in correction of the detected disorders was studied. PMID- 3811694 TI - [Current problems of alcoholic embryo- and fetopathy]. AB - The authors consider the least studied questions of alcoholic embryo- and fetopathy in the mechanism of the teratogenic action of alcohol on the development of the embryo and fetus and emphasize the importance of the time of damage, genotype, and additional effects of the environment. On the basis of analysis of the literature and their own data the authors have identified the most important manifestations of the fetal alcohol syndrome at different stages of the child development. The questions of the differential diagnosis are also discussed. PMID- 3811695 TI - [Hyperexcitability syndrome in infants (clinico-electroencephalographic study)]. AB - A total of 236 infants aged under 1 year with the syndrome of hyperexcitability were examined. The awakening EEG was analyzed in 26 children aged 5-6 months. A computerized classification (a discriminant analysis) of such visually ascertained EEG parameters as frequency and amplitude revealed connection between some EEG signs and the presence of hyperexcitability. It is concluded that combined clinico-electroencephalographic examination may be highly informative in the investigation of the pathogenetic mechanisms of this syndrome. PMID- 3811696 TI - [Cryotherapy in the complex restorative treatment of children with infantile cerebral palsy]. AB - Children with spastic diplegia, hemiparetic and hyperkinetic forms of infantile cerebral paralysis were treated with local cryoapplications onto the hands. During the course of cryotherapy the authors studied interference and needle EMGs of the forearm muscles. Local cryotherapy induced a reduction in the muscle tone by gradual switching off the activity of individual motor units. Cryotherapy diminished the intensity of hyperkineses and increased the functional possibilities of the hand so that writing became possible. A conclusion is made that a decrease in the level of afferentation alters the functional activity of some links of the motor analyzer. PMID- 3811697 TI - [A variant of pathogenetic therapy in the acute period of perinatal hypoxic traumatic brain lesions in premature infants]. AB - The restorative potential of reparative cellular processes was studied in 39 immature infants born in hypoxia and receiving a pathogenetic treatment. In addition to the conventional treatment the test group of 24 infants received intravenously 20% piracetam solution, 1% riboflavin-mononucleotide solution, and 0.5% lipoic acid solution beginning from the first days of life. To correct the cellular metabolic processes in a control group of 15 infants, they were given 10% glucose solution, 5% ascorbic acid solution and cocarboxylase. The activity of dehydrogenases in the peripheral blood remained virtually unaltered in the control group but increased by an average of 1.5-2 times in the test group. An 18 month follow-up ascertained that the incidence of neurological complications in the infants receiving the proposed treatment was significantly lower as against the control patients. PMID- 3811698 TI - [Variants of Gerstmann's syndrome in children]. AB - Neuropsychological study of backward schoolchildren with normal intellect revealed the cause of their school disadaptation, namely, a combined cortical disorder expressed in the form of discalculia and disgraphy (Gerstmann's syndrome). Histories of 3 children with this abnormality are described. The authors consider the clinical heterogeneity of the syndrome, its origin, and the use of intact intellectual abilities for adequate medico-pedagogical correction. PMID- 3811699 TI - [Autonomic disorders in children with hyperthermic and affective-respiratory convulsions]. AB - The vegetative tone, vegetative reactivity in the Dagnini-Aschner parasympathic test, and vegetative provision of functions in the orthoclinostatic test as described by Vien et al. were determined on the basis of cardiovascular parameters (blood pressure, heart rate) in a group of 5-year-old children with hyperthermal (n = 44) or affective-respiratory (n = 21) convulsions. The children with hyperthermal convulsions showed an increase in the sympathic tone and hyperfunctional manifestations. Elevated vegetative reactivity was observed in these patients. In contrast, the children with affective-respiratory convulsions presented instability of both systolic and diastolic pressure and a higher pulse rate in head-down tilt test, as compared to normal subjects. This indicates insufficient development of the vegetative regulation mechanisms. PMID- 3811700 TI - [Basal levels of thyroxine, somatotropin and cortisol in children with epilepsy]. AB - The results of radioimmunoassay for basal levels of total thyroxin, somatotropin, and cortisol in the blood serum of epileptic children are presented. Basal levels of total thyroxin and somatotropin were significantly reduced. A decrease in hormone concentrations was more pronounced in an unfavourable versus favourable course of the disease. PMID- 3811701 TI - [Electroencephalographic correlates of positive emotional reactions in children in the first year of life]. AB - The authors investigated electroencephalographic correlates of positive emotional reactions in 28 infants aged from 3 to 10 months. An analysis of the space organization of the hypersynchronous 4 Hz frequency theta-rhythm attending emotional reactions has shown that depending on the type of impact, neural elements in the anterior or posterior cerebral cortex synchronously come into play. It is assumed that the arrangement of the above type of activity is due to both nonspecific activation of the cortex through the influence of the subcortical structures and due to the mechanisms of local activation becoming involved in the realization of the response depending on the biological quality of the irritant and the nature of the activity induced by it. PMID- 3811702 TI - [Correlations between the indicators of EEG and REG in children with serous meningitis]. AB - Investigation of the bioelectrical activity and cerebral blood content has shown different changes in the baseline EEGs and REGs in children with acute serous meningitis. The visual assessment of the EEGs revealed in 52% of cases paroxysmal activity, diminished regularity of the dominant rhythm, etc. The findings of the cross-correlation analysis indicated impairment of the space-time organization of the potentials: there was a reduction in the functional activity of the anterior associative structures, particularly in the left hemisphere, and lagging of the electrical processes in the frontal zones of the right hemisphere from potentials of other centres. Changes in the cross-correlational functions of biopotentials were attended by alterations in the REG parameters, in particular by a decreased amplitude of the pulse wave, elevated vascular tone and increased interhemispherical asymmetry. The role of intracranial hypertension in the genesis of identified disorders is discussed. PMID- 3811703 TI - [Electrical activity of the brain of children with cerebral palsy and the formation of motor skills using methods of functional bioregulation]. AB - The authors consider the results of a quantitative and qualitative analysis of the bioelectrical brain activity in 175 children aged 5 to 14 years with motor disturbances due to various causes who received a rehabilitative treatment in a specialized child sanatorium. In addition to the traditional methods the authors employed some functional bioregulation techniques. A clinico-physiological analysis was conducted with the help of original evaluation scales. The use of the proposed method for the assessment of clinical efficacy and the employment of mathematical processing of EEG showed a high efficiency of techniques of the purposeful correction of motor disorders and contributed to a better understanding of the mechanisms of readjustments occurring in the CNS in the process of the formation of new motor skills. It was found that alpha-rhythm played the main role in the development of new motor skills. PMID- 3811704 TI - [Evaluation of age-related characteristics of the adaptive reactions of a healthy child using a method of analyzing transient processes]. AB - Examination with the use of transient analysis is an objective method helping to assess the quality of vegetative regulation in children and its age-specific characteristics. The data obtained from studying the transient processes in clinically healthy children of different age groups may be used as the reference criteria in clinical studies of vegetative disorders, for establishing scientifically-based age-differentiated regimens for children with regard to adaptive potentialities of the body, as well as for the development of age periodization. PMID- 3811705 TI - [A method of differentiated evaluation of the rehabilitative potential of patients with hypertension in the recovery period after stroke]. AB - The authors have identified 5 groups of patients with essential hypertension in the recovery period of ischemic stroke. Clinical and social characteristics of patients inside each group were assessed by the proposed evaluation scale which has made it possible to differentiated the selected groups and allowed a more objective determination of their clinicofunctional status and rehabilitative potential. The use of the proposed method of a score evaluation in expert medical examination of working capacity will make it possible already at the recovery period of stroke to predict clinical and social outcomes of the disease for each patient as well as his or her rehabilitative and occupational potential. PMID- 3811706 TI - [Behavior disorders in children with mental retardation (data of an epidemiologic study)]. AB - An epidemiological examination of mentally retarded children aged 8-14 years revealed behavioural deviations hindering the patients' adaptation in 31.8%. Behavioural disorders were due to the psychopathy-like syndrome of organic genesis in one group of patients and psychogenic pathological formation of the personality in another. Apart from this, hyperdynamic syndrome (other than psychopathy-like) and neurosis-like disturbances were also attended by behavioural disorders. Among children who had been left without parents from early childhood behavioural difficulties were observed two times more frequently than among children brought up in families, including the so-called difficult families. A total of 66% of mentally-retarded children were either once or repeatedly hospitalized in psychiatric institutions, mainly, in connection with an insufficient correction of behavioural deviations at auxiliary and boarding schools. PMID- 3811707 TI - [Possibilities of preventing childhood schizophrenia]. AB - The authors consider poorly studied questions of childhood schizophrenia prophylaxis (primary, secondary, individual, and social). At present it is virtually impossible to speak about primary and individual prophylaxis of childhood schizophrenia as an endogenic disease. Preventive measures of reduction of birth rates in groups of patients and individuals at a high risk of the disease should be considered as social prophylaxis aimed at decreasing the prevalence of this disease in the population and complicated by relevant deontological problems. Secondary (therapeutic) prophylaxis of infantile schizophrenia holds promise, due to the fact that the predictions of its outcome are not altogether gloomy and prophylactic treatment runs a favourable course in more than half the cases. Prospects of secondary (therapeutic) prophylaxis of childhood schizophrenia are steadily improving due to the breakthroughs of modern therapy. PMID- 3811709 TI - [Follow-up of patients with a history of early childhood schizophrenia (its unfavorable variant)]. AB - The article presents the results of a follow-up of 113 patients suffering from infantile schizophrenia with an unfavourable course. The mean duration of the follow-up in 84 patients was over 11-15 years. In the follow-up period 84% of the patients were characterized by productive predominantly catatonic disturbances with features of pseudooligophrenic dementia, autistic behaviour and apathic manifestations. In the remaining 16% of the patients the state could be assessed as residual with the predominant oligophrenic defect and apatho-autistic behaviour. The author discusses infantile schizophrenia running an unfavourable course at delayed stages of its development, the formation of the defect and also the therapy and care for such children. PMID- 3811708 TI - [Prognosis of the onset of latent pseudopsychopathic and pseudoneurotic schizophrenia in male adolescents (data of a long-term follow-up)]. AB - The authors followed up (for 5-15 years) 256 male patients in whom disease first manifested in adolescence. They identified prognostic signs in the period of manifestations. Stable (over 4 years) remission correlated with an onset characterized by a depressive background, a syndrome of metaphysical intoxication and a correlation between the type of accentuation of the character as determined with help of the Pathocharacterological Diagnostic Questionnaire for adolescents and the clinically-determined premorbid type. Unfavourable prognostic signs included an early onset (at the age of 10-13 years), hereditary aggravation by endogenic psychoses through only the maternal line, untidiness, shamelessness, purposeful malice and sadism directed against the mother, and also characteristic delirious behaviour without formed delirium. PMID- 3811710 TI - [Clinico-catamnestic study of patients with paroxysmal-progressive schizophrenia with a history of affective, anxiety-affective and affective-hallucinatory attacks in childhood/and full-blown hallucinatory-delusional attacks in adolescence]. AB - Clinical follow-up covered 40 patients with paroxysmal progressive schizophrenia with a history of 52 affective, anxiety-affective and affective-hallucinatory attacks at the age of 0-10 years and of 70 hallucinatory-delusional attacks at the age of 11-17 years and older. Over one-third of the examined patients were under the authors' personal observation in early childhood. The follow-up lasted for 5 to 22 years. The authors have established a definite stereotype of the development of anxiety-affective, affective-hallucinatory and hallucinatory delusional attacks. Remissions in this group of patients are characterized by atypical affective disturbances and changes of the personality. The authors have specified clinical characteristics of so-called "premanifest" episodes, attacks, and "premorbid" pseudopsychopathic conditions with manifestations of retardation of personality development and atypical affective disorders. PMID- 3811711 TI - [Characteristics of the course of cyclothymia-like schizophrenia in puberty]. AB - Slowly progressive schizophrenia with subclinical affective attacks in adolescence is characterized by undoubtful differences in the premorbid characteristics of patients, clinical picture and peculiarities of the course of the endogenic process. Different variants of the course are related to structurally and phenomenologically different variants of affective attacks. The more similar is the course of cyclothymia-like schizophrenia to protracted non remission one, the more atypical are affective attacks (adynamic depressions and nonproductive hypomania); the more paroxysmal is the course, the more marked and diverse is the clinical picture of depression (dysphoric attacks) and the more typical are hypomanias. Patients with cyclothymia-like schizophrenia, besides therapy, are in need of the earliest possible rehabilitative treatment aimed at the continuation of education under easier conditions which expedites post-attack readaptation and improves social prognosis. PMID- 3811712 TI - [Pseudoneurologic symptoms of latent depression in children with schizophrenia]. AB - The article describes the clinical picture of diagnostically difficult cases (22 children aged from 6 to 14 years) of depression, masked by marked vegetative disturbances, headaches, dizziness and paroxysmal states simulating a neurological diseases, unconfirmed by objective data. Nosological appurtenance of depression is verified by the presence of negative and productive symptoms of schizophrenia. Clinical picture is determined by both manifestations of depression and the presence of a residual organic background. PMID- 3811713 TI - [Comparative age-related study of anxiety depression in adolescents and young adults]. AB - In adolescents and youths with torpid and paroxysmal progressive schizophrenia the authors analyzed in relation to age the syndrome of anxiety depression without heteronomic inclusions. Age-specific characteristics of anxiety depression of a schizophrenic nature were established. Also elucidated were general structural characteristics of the anxiety-depressive syndrome in adolescents and youths. PMID- 3811714 TI - [Clinico-psychological examination of children with protracted hypomanic conditions in schizophrenia]. AB - A clinico-psychological study covered 28 children aged 4-13 years with protracted hypomanic states (2-8 years) in 3-10-year-long schizophrenia. The authors investigated peculiarities of the development of cognitive activity (thought and perception). Comparison was made between groups of schizophrenics and control groups (the syndrome of motor disinhibition, schizoid psychopathy). The findings of a clinico-psychological examination have helped to elucidate differences in the development of cognitive activity in the above groups of children which may be used for the differential diagnosis and prognosis of the disease course. PMID- 3811715 TI - [Psychopathologic structure of reactive depression in young children]. AB - Thirty-four children, aged 1 to 3.5 years, with a reactive depressive state were examined. Using the ontogenetic approach, the authors analyze affective as well as somatovegetative, psychomotor and behavioural disorders in the structure of the abnormal state. The authors have identified stages of disease development, as well as productive and negative dysontogenetic disturbances secondary to protracted reactive depressions in young children. PMID- 3811716 TI - [System of dynamic observation of children with mental disorders at a psychoneurologic department at a pediatric polyclinic]. AB - On the basis of analysis of the characteristics of patients registered in child psychoneurological rooms and in view of the necessity to ensure continuity in the work of children's and adolescents' psychiatrists the authors propose a system of follow-up of children with mental disorders which helps to ensure consecutive provision of the entire complex of therapeutic and roborant measures to such patients. PMID- 3811717 TI - [Changes in the aggregative properties of the erythrocytes in chronic alcoholism]. AB - On the basis of examination of 50 alcoholics the authors have established that alcoholism is associated with impairments of the aggregational properties of blood erythrocytes expressed in a persistent and marked increase of aggregation and the appearance of enlarged massive aggregates. The severity of aggregation disturbances depends not only on the presence of the abstinence syndrome but is also closely related to the stage of alcoholism, becoming more gross in the progressive course with signs of encephalopathy, and directly correlates with severity of psychotic symptoms. PMID- 3811718 TI - [Complex system of predicting, planning and coordinating scientific research in neurology and its management]. AB - Acceleration of scientific and technological progress calls for further improvement in the system of regulation of neurologic research in the USSR. Recently the role of the Scientific Council, Task commissions and leading institutions in shaping research policy, in active planning and coordination of research work, and in its methodological and organizational regulation has increased significantly. The most important task facing neurologists today is increase in the efficacy of investigations and the introduction of the obtained results into health practice. PMID- 3811719 TI - [Risk factors and the prevention of early organic brain lesions]. AB - The article deals with those risk factors which play the most significant role in the development of early organic lesions of the brain. Particular attention was paid to teratogenic influence on the fetus in the intrauterine period and during parturition. The authors have outlined the main measures for preventing intrauterine and intrapartal lesions to the nervous system and formulated the priority tasks facing researchers in this area. These are as follows: limitation of pathological impacts on the fetus, improvement in antenatal diagnosis and obstetrical methods, and the development of the differential methods of intensive care of newborns and of the diagnosis and treatment of nervous system impairments at early stages of their development. Development of a comprehensive programme involving representatives from different branches of medical science is considered necessary. PMID- 3811720 TI - [Neuromuscular diseases in man (features of their course and types of inheritance)]. AB - A large number of observations of neuromuscular diseases in humans have been analyzed. The clinical course and nature of inheritance of pathological forms differentiated according to the predominant localization of muscle damage have been found to differ within a wide range. The authors have demonstrated the possibility of significant intrafamilial variability of clinical manifestations which should be considered in medicogenetic counselling. PMID- 3811721 TI - [Automatic analysis of needle EMG in the differential diagnosis of neuromuscular diseases]. AB - A total of 112 muscles were studied in 68 patients with different neuromuscular diseases (7 nosological forms). The study was performed using an original programme of an automatic analysis of needle real-time electromyography and a specially designed automatic system on the basis of Soviet microcomputer "Electronika-60". On the basis of an automatic analysis of 17,834 potentials the authors identified 1,619 individual potentials of motor units. Measurement of all parameters (amplitude, duration, the number of phases in the potential and area) and calculation of correlations between individual parameters revealed significant differences of the mean values of the above parameters for each group of patients. PMID- 3811722 TI - [Pathogenesis and treatment of neural amyotrophy]. AB - Examination of 214 patients with Charcot-Marie-Tooth muscular atrophy involved the use of thermography, rheovasography, electrothermometry, capillaroscopy, EEG and vegetative tests. The authors identified the most informative methods of early diagnosis and proposed a new method of therapy (electrophoresis with benzohexamethonium on the vegetative ganglia in combination with trental administration). PMID- 3811723 TI - [Features of the clinical picture, course and treatment of myasthenia in late middle-aged and aged persons]. AB - On the basis of many-year observation of 345 patients with myasthenia (M) developing in elderly and old age (from 50 to 82 years) the authors analyzed the characteristics of the clinical picture of myasthenia in this age group and determined changes in the ratio between males and females first presenting M at this age. The effect of different types of treatment and their combinations employed in these patients was determined. The authors recommend the use of pathogenetic methods of M treatment (thymectomy, X-ray therapy, and prednisolone therapy) in this age group. The most effective method is a combination of thymectomy and X-ray therapy with prednisolone administration. PMID- 3811724 TI - [Course of Duchenne muscular dystrophy and its treatment]. AB - The results of a 12 month follow-up of 3 groups of age-matched children (7 boys in each group) with an identically malignant course of Duchenne's myodystrophy determined by means of a genealogical analysis are presented. The fastest progression of the disease was observed in children receiving conventional treatment. Untreated children showed slower progression of the disease. In patients on allopurinol treatment the process was somewhat checked or there was some regression of symptomatology. PMID- 3811725 TI - [The stiff man syndrome]. AB - A 41-year-old patient with the rigidity syndrome was observed. The disease was expressed in marked rigidity of the long muscles of the back forming a picture of persistent hyperlordosis which led to a considerable disablement of the patient. Another complaint was spasms of the femoral muscles. A four-year follow-up of the patient revealed periodically recurring ataxia, nystagmus, and dysarthria. The patient benefited by relanium (diazepam) administration. On the basis of the literature data and a clinical analysis of this case the authors review clinical, differential-diagnostic, pathogenetic and etiological aspects of the rigidity syndrome. PMID- 3811726 TI - [Destruction of muscle tissue and purine compound metabolism in hereditary muscular dystrophy]. AB - The distribution of purine compounds in the skeletal muscles of the anterior and posterior limbs of 129/Re mice with hereditary muscular dystrophy (HMD) was investigated in a comparative study. The results revealed unidirectional metabolic disorders in both groups of muscles which was manifested in a quantitative redistribution of phosphorus-containing purine components and a decrease in the pool of adenylates in muscle tissue. Elevated concentrations of purine metabolites (inosine, hypoxanthine, xanthine, and uric acid) indicated an augmented metabolism of purines in this abnormality. Impairment of metabolic transformations of purines in the muscle tissue in HMD may be one of the factors responsible for the development of the pathological process in the muscle in the given disease. PMID- 3811727 TI - [Syndrome of excessive growth of the cutaneous integument in spinal cord hernias]. AB - Combination of clinical manifestations of skin hyperplasia in spinal hernias with signs of connective tissue lesion (articular hypermobility, skin hyperelasticity, trophic disorders) indicates involvement of the spinal cord and its radicles which is confirmed by electromyographic findings. Early surgical treatment of spinal hernias prevents the development of irreversible changes in the nervous system and progression of neurological manifestations. It is also important that such patients find occupation which would not be associated with excessive strain on the vertebral column and overextension of the limb ligaments. PMID- 3811728 TI - [Psychogenic pathologic personality development in advanced age]. AB - A study of 51 patients with psychogenic abnormalities developed in old age has shown that the development of such disorders is a comparatively frequent outcome of neuroses and reactive psychoses with the onset in the presenile period and only as an exception takes place in patients with the onset of psychogenic disturbances in old age. Depressive development has proved most typical for advanced age. Such manifestations as chronic subdepression, diffuse hypochondria, egocentrism and rent orientations are universal for all clinical variants of senile pathological development of personality. According to a regression analysis the development of psychogenic disturbances in the second half of life is facilitated by the objective significance and persistence of traumatic situations, a low professional level of patients and a number of other socio psychological and biological characteristics of the person. PMID- 3811729 TI - [Pathocharacterologic reactions in adolescence]. AB - Pathocharacterological reactions have been studied in a long-term follow-up (9-12 years) of 58 youths aged 14-18 years. These reactions were observed more frequently (P less than 0.05) in teenagers with a premorbid accentuation of the character of the epileptoid, unstable, hyperthymic, or hysteroid types. The studied reactions are classified in accordance with the characterological principle. Recommendations on rehabilitation of the above group of patients are presented. The questions of the differential diagnosis are considered. On the whole a stable social adaptation was observed in 72.4% of patients despite a considerable duration of pathocharacterological reactions in some of them. PMID- 3811730 TI - [Dynamics of the main forms of neurosis]. AB - A total of 162 patients (55 with neurasthenia, 53 with hysteric neuroses, 54 with neurosis of obsessive states) have been followed up with emphasis on the evolutional and age-specific characteristics. The authors have established a peculiar nature of the predisposing and pathogenetic factors in the genesis of neuroses and their subsequent dynamics in relation to age (infantile-adolescent, mature, late). The obtained data have made it possible to develop the principles of the pathogenetic therapy of the main forms of neuroses. These principles are based on the mandatory consideration of age-specific features. PMID- 3811731 TI - [Features of the development and clinical picture of hysterical neurosis and hysterical neurotic personality development]. AB - The characteristics of the formation and structure of hysterical symptomatology in hysterical neurosis and hysterical neurotic development of personality are described. The author shows the pathomorphosis of modern hysterical neurotic disturbances and emphasizes a tendency toward imitation of common somatic diseases and the predominance in the clinical picture of neurosis of somato vegetative and asthenic manifestations. Factors affecting the pathological process (characteristics of the premorbid adjustment and psychotraumatic situation) are analyzed. Hysterical neurosis was largely associated with vegetative manifestations while the hysterical neurotic development was more often related to affective ideatory manifestations. The authors have also identified two clinical variants of the hysterical neurotic development whose common characteristics included excessively affective reactions, lability to vehement non-differentiated emotional responses to any stimulus, and behavioural disturbances according to the hysterical type. PMID- 3811732 TI - [Differential diagnosis of the anxiety syndrome]. AB - An attempt is made at the differential-diagnostic interpretation of the anxiety syndrome in different nosological entities. Three variants of the syndrome are identified: neurotic, psychotic, and somatogenic. Clinical characteristics of each variant are described in detail. In the course of a detailed differential diagnostic interpretation the author analyzes the complex of symptoms forming the anxiety syndrome, their different combinations in relation to severity, the leading role of "axial" symptoms and their peculiarities, which makes the diagnostic process far easier and accurate. PMID- 3811733 TI - [Genetic factor in reactive psychoses (concerning their possible hereditary heterogeneity)]. AB - The authors analyzed clinical and genealogical findings about the psychopathological aggravation of heredity in patients with reactive psychoses. The data were collected by studying a familial history in an epidemiological forensic-psychiatric sample of psychogenic psychoses. A conclusion is made about genetic heterogeneity of psychogenic paranoids and psychogenic depressions as well as hysterical and endoformic psychogenic psychoses on the whole. PMID- 3811734 TI - [Dynamics of neuropsychiatric disorders while engaged in occupational activities]. AB - The authors performed a comprehensive study of neuropsychic disorders developing under conditions of occupational activity during a long (up to 6 months) voyage (n = 149). The disorders were shown to change with time and get more complicated from asthenic to unmarked affective ones (of hypothymic nature). A number of biochemical, vegetative and psychological parameters were found to change over time. The disturbances showed a rapid reversibility at rest. PMID- 3811735 TI - [Clinical features of acute phobias with somatovegetative disorders in neuroses and slowly progressive schizophrenia]. AB - Comparison of the clinical characteristics of acute phobic states involving marked vegetosomatic disorders in schizophrenic and neurotic patients have shown that these conditions present two clinically different syndromes--true phobias of the neurotic genesis and vital depersonalization of the endogenic nature. Severity of vegetosomatic disorders is associated with the predominant impairment of the vital levels of psyche. PMID- 3811736 TI - [A peculiar variant of drive pathology in schizophrenia with the anorexia nervosa syndrome]. AB - Detailed clinical and psychological experimental study of 103 schizophrenia patients with anorexia nervosa revealed its most characteristic correlations with a specific variant of the pathology of drive--bulimia bouts and induced vomiting. This variant of the pathology of drive appeared to be similar to narcomania. PMID- 3811737 TI - [Neurophysiologic analysis of disorders of the functional activity of projection systems of the brain in patients with neuroses]. AB - To study the neurophysiological mechanisms of neurasthenia, hysterical neurosis and obsession neurosis with a view to the practical employment of the results, the authors examined 100 patients and 40 normal subjects using the method of evoked potentials (EP). EP changes indicated an neurasthenia-related decrease in the functional activity of the cortex, weakening of its inhibitive functions and an increase in the reactivity of the system of negative-emotional support. Patients with hysterical neurosis displayed the greatest excitability of the structures of the projective pathways and insufficiency of programme-integrating effects of the higher portions of the brain. Neurosis of obsessive states was characterized by an increase in the activity of specific cortical zones and, to a larger degree, of the centres of negative-emotional reactivity. The time-course of EP during treatment is outlined. The findings obtained may serve as additional criteria in the diagnosis and treatment of neurosis. PMID- 3811738 TI - [Psychosomatic balancing]. PMID- 3811739 TI - [Approach to tumors of the chiasm-sellar region with preservation of the olfactory tracts]. AB - Mobilization of the olfactory tract in mono- and bifrontal approach to the chiasmal-sellar region with preservation of its own vascular network down to the olfactory trigone on the side of the approach and for a distance of 20 mm from the other side creates adequate conditions for the operation. According to the EEG values, the degree of the operative trauma does not increase essentially and the prognosis of vision restoration is no worse. The olfactory function is restored immediately after surgery in most cases. PMID- 3811740 TI - [Pathologo-anatomic characteristics of acute cerebral circulatory disorders in craniopharyngioma]. AB - Acute ischemic disorders of cerebral circulation in craniopharyngioma occur mostly in the presence of chronic destructive changes in the vessels of the brain, mainly in the arteries of its base. Long-term spasm of the arteries is the most frequent cause of ischemic circulatory disorders, while the degree of brain affection is determined by the number and caliber of vessels involved in the pathological process. PMID- 3811741 TI - [Geometry and algebra of branches of the middle cerebral artery]. AB - A classification of the cortical branches of the middle cerebral artery (MCA) is suggested by means of which each branch in any hemisphere can be qualified and identified in any variant of MCA branching. The principle of the classification consists in grouping the branches into arteries and trunks of the second, third, etc. order. Branches supplying blood to a certain sector of the lateral surface of the hemisphere are designated arteries. Their number and zone of branching are constant. Branches giving rise to 2 and more arteries are named trunks. Branching of the trunks, the number of trunks of the second, third, etc. order, and the site and type of origin of the arteries are extremely variable. Each trunk can be designated by a formula stating its order and the name of the artery supplied by this trunk. The arrangement of the MCA branches on the surface of the gyri and deep in the sulci, represented on the map of the lateral surface of the hemisphere, is designated conditionally as geometry of MCA branches. The order of branching of the trunks and the type of origin of the arteries, represented on abstract maps of the lateral surface of the hemisphere, are designated conditionally as algebra of the MCA branches. The variability of the geometry and algebra of the MCA branches must be taken into consideration in operations for extra-intracranial microanastomosis and in endovasal intervention on the MCA. PMID- 3811742 TI - [Principles of the diagnosis and surgical treatment of giant gliomas of the chiasm and optic nerve of children]. AB - The clinical picture, diagnosis, and microsurgical treatment of giant gliomas of the chiasm and optic nerves in 22 children are discussed. The use of the microsurgical method for removal of the tumors made it possible to expand the range of indications for the operation and increase the radical character of interventions in tumors which were considered inoperable previously. The preoperative lethality markedly reduced: among 14 patients who underwent operation one died. PMID- 3811743 TI - [Pathogenesis of traumatic subdural hydroma]. AB - Pathogenetic factors leading to the formation of traumatic subdural hygromas (TSH) are identified from analysis of the results of complex examination of 156 patients. Comparative biochemical tests of CSF, blood serum and the hygroma fluid in 15 patients showed the hygroma to contain CSF. The formation of TSH was always a consequence of brain contusion, usually of a severe degree, and rupture of the basal CSF cisterns. As the result of critical analysis of the existing theories of TSH pathogenesis a new conception is formulated. PMID- 3811744 TI - [Ultrastructural changes in the cerebral cortex, cerebellum and ventro-oral nuclei of the optic thalamus in infantile cerebral palsy]. AB - The authors describe 3-, 5-, 7- and 9-layer linear and concentric structures discovered in brain bioptates of patients with cerebral infantile paralysis. They were found to be specific to this disease. The assumptions on the origin and role of these ultrastructures in the pathogenesis of cerebral infantile paralysis are formulated. PMID- 3811745 TI - [Complex electrophysiologic diagnosis of traumatic lesions of the brachial plexus at the preganglionic level]. AB - In 20 patients with preganglionic injuries to the brachial plexus the authors recorded short-latent somatosensory evoked potentials (EP) and sensory EP in response to stimulation of the musculocutaneous, radial, median, and ulnar nerves on both sides. The preganglionic level of brachial plexus injury was characterized by the absence of short-latent somatosensory EP, which reflected disturbance of the connection of the neuromuscular apparatus with the spinal cord, and the presence of sensory EP which bore evidence of maintained connection of the sensory fibers with the spinal ganglia. The electrophysiological data corresponded completely to the operative findings in 11 and partly in 7 cases. PMID- 3811746 TI - [Diagnosis and microsurgical treatment of discogenic lumbosacral radiculitis]. AB - The literature data and the authors' experience in the treatment of 50 patients showed that the level and character of damage inflicted to the spinal cord roots by Schmorl's body can be determined with the precision necessary for performing a microsurgical intervention only on the basis of a diagnostic complex including scrupulous neurological, X-ray, and electrophysiological examination. The authors show the diagnostic value of studying the somatosensory evoked potentials in stimulation of the corresponding dermatomes (L4, L5 or S1), which reflect the primary side of the affection and, to a lesser degree, the level of Schmorl's body. The microsurgical techniques of exposing the spinal cord root compressed by Schmorl's body was carefully developed and described. Attention is focused on the necessity of using the appropriate microsurgical instruments and placing the patient in an adequate position on the operating table. PMID- 3811747 TI - [Elastic properties of the cerebrospinal system and cerebrospinal fluid dynamics in intracranial hypertension and normotensive hydrocephalus in adults]. AB - Time course of changes of the CSF and the elastic properties of the cerebrospinal system were studied in 25 patients with normotensive hydrocephalus and in 26 patients suffering from benign intracranial hypertension. In 66% of cases with the normotensive hydrocephalus syndrome and in 60% of those with benign intracranial hypertension CSF resorption resistance and the elasticity gradient increased. Shunting operations proved effective in such cases. PMID- 3811748 TI - Structural organization of copper(II) ions in complexes with DNA. AB - The interaction of Cu(II) ions with native and denatured DNA as a function of ionic strength of the solution was studied by the equilibrium dialysis method. Graphical analysis of binding isotherms confirmed the occurrence of interstrand and intrastrand binding of Cu(II) with DNA and made possible determination of the respective binding constants. To facilitate interpretation of the data, a new molecular model of Cu(II)-DNA binding has been proposed, assuming interstrand intercalation of one Cu(II) ion between two GC pairs both in the successive even and odd groups of GC pairs, and interstrand binding of Cu(II) to the isolated GC pairs, with the exception of T-C-T and T-G-T sequences. In agreement with this model, the DNA-Cu(II) complex is most stable under the equilibrium with free Cu(II) ions at 4 degrees C, pH 6 when the molar ratio of GC pairs to Cu(II) ions bound interstrandially attains GC/Cuinter = 2 +/- 0.1. PMID- 3811749 TI - Metabolism of cysteine in Ehrlich ascites tumour, mouse skeletal muscles and liver. AB - The cell membrane of intact Ehrlich ascites tumour (EAT) cells limits the penetration and thus the utilization of exogenous cysteine in vitro. In homogenates the uptake of cysteine is the greatest in skeletal muscle, smaller in EAT and the smallest in liver. 2-Oxoglutarate, initiating the pyruvate pathway of cysteine catabolism, raises cysteine utilization only in liver homogenates. Although it also raises taurine formation, it shifts the equilibrium from the oxidative toward the anaerobic pyruvate pathway of cysteine metabolism. 2 Oxoglutarate has no effect on cysteine metabolism in EAT and only a small effect on this process in muscle homogenates. Limitation of cysteine metabolism in the pyruvate pathway in tumour cells is not compensated by increased cysteine oxidation. The greatest increase in protein thiol groups was observed in EAT homogenates; it was markedly reduced in the presence of 2-oxoglutarate. PMID- 3811750 TI - [Modern views on the composition and physiology of bone tissue (review)]. PMID- 3811751 TI - [Intramedullary nailing using safety screws]. PMID- 3811752 TI - [Long-term results of plastic surgery of the tectum using the Bosworth technic]. PMID- 3811753 TI - [Indications for and technic in the correction of deformity by removal of a hemivertebra]. PMID- 3811754 TI - [Surgical wound infection after spondylodesis with instrumentation]. PMID- 3811755 TI - [Use of external fixators in the treatment of supracondylar fractures of the humerus in children]. PMID- 3811756 TI - [Treatment of Bennet fractures using the Lars Thoren method of oblique skeletal traction]. PMID- 3811757 TI - [Ensuring thorough asepsis in the orthopedic-traumatology operating room]. PMID- 3811758 TI - [New, lightweight types of school briefcases for the prevention of postural defects]. PMID- 3811759 TI - Adrenal gland surgery. Preoperative location of lesions, histologic findings and outcome of surgery. AB - The accuracy of various techniques for preoperative location of adrenal lesions was studied in 55 consecutive cases, and the perioperative course and outcome of surgery were analyzed. CT correctly located 94% of all adrenal tumours, was less accurate (42%) in hyperplasia and gave no false-positive results. Selective angiography revealed 75% of the tumours, but was likewise diagnostically inadequate in adrenal hyperplasia. Adrenal venous sampling correctly located 80% of tumours and of hyperplasia. In hyperplasia it was the single most successful procedure for detecting the site of adrenal hyperfunction. Phlebography gave misleading information in almost 45% of cases. The perioperative complications included splenic rupture necessitating splenectomy (3 cases), superficial wound infection (2), pneumonia (4) and subphrenic abscess (1). There were no perioperative deaths. The study indicated CT to be the principal procedure for preoperative location of adrenal disorders. In some cases with adrenal hyperfunction, venous sampling should be added. Adrenal surgery can be performed with low morbidity and no mortality and with favourable long-term outlook in cases of benign lesion. PMID- 3811760 TI - Changes in extracellular sodium content after elective abdominal vascular surgery. AB - To investigate the possible occurrence of extra- to intracellular sodium shift in elective surgery, whole-body extracellular sodium mass/1.73 m2 was determined as the product of plasma sodium concentration and the volume of distribution of polyfructosan-S/1.73 m2 in 53 patients before abdominal aortic surgery and on the first and fourth postoperative days. The patients were divided into four groups, receiving stepwise increasing amounts of sodium. After surgery the extracellular sodium mass was lower than expected from the sum of preoperative value and cumulative sodium balance/1.73 m2. This deficit in extracellular sodium mass showed linear correlation with the sodium balance on postoperative day 1. On day 4 the mean deficits in extracellular sodium mass ranged from 227 to 291 mmol/1.73 m2 in the four groups, and the corresponding cumulative sodium balances from 179 to 528 mmol/1.73 m2. Net shift of sodium into the cells may explain the extracellular sodium deficit. PMID- 3811761 TI - Peritoneal lavage for the evaluation of patients with equivocal signs after abdominal trauma. AB - The value of peritoneal lavage (PL) in the evaluation of 82 patients with equivocal signs after abdominal trauma was studied. The closed technique using an Intracatch (R) was employed. Fifty-four patients had blunt trauma, the predictive value of a positive PL was 86% and the predictive value of a negative PL was 94%, accuracy 94%. Twenty-eight patients had stab wounds, the figures in this group were 100%, 92% and 93%. No complications were seen. There were no retrieval of lavage fluid in 10% of the cases. PL with the closed Intracath (R) technique has the same diagnostic certainty as other methods, but is much quicker to perform and has no complications. PMID- 3811762 TI - An experimental study on the role of gallbladder mucosal fluid secretion and intraluminal pressure in cholecystitis. AB - The cystic duct was ligated and gallstones were implanted into the gallbladder in cats. Five to eighteen weeks later the hydrostatic pressure in the gallbladder lumen was measured after laparotomy, and fluid transport across the gallbladder epithelium was studied and compared to the microscopic gallbladder morphology. Instead of the normal absorption many of these gallbladders continuously secreted fluid to the lumen and had raised intraluminal hydrostatic pressure (61 +/- 8 SEM, mmHg). Morphological signs of acute gallbladder inflammation were common (47%) in gallbladders with mucosal fluid secretion, but were never seen in those that absorbed fluid (p less than 0.05). Gallbladder mucosal fluid transport correlated with a histological score of the inflammation (r = +0.68, p less than 0.01). Gallbladder fluid secretion decreased when the intraluminal pressure was experimentally raised to the initially observed level, demonstrating mechanisms counteracting the secretion in this situation. An increased intraluminal pressure is suggested to be involved in the pathophysiology of acute cholecystitis. PMID- 3811763 TI - The prognostic significance of radiologically determined gastric emptying time before proximal gastric vagotomy. AB - The importance of undisturbed pyloric function is known among surgeons applying proximal gastric vagotomy (PGV) for duodenal ulcer disease. On the other hand, the prognostic significance of subclinically impaired antroduodenal motility is unknown after this operation. Therefore, in the present study 43 PGV patients with normal gastric emptying were compared with 24 PGV patients with prolonged gastric emptying as to the postoperative incidence of ulcer recurrence and symptomatology. Prior to surgery gastric emptying time was determined radiologically in all patients, none of whom had symptoms or signs of gastric outlet obstruction. The duration of postoperative follow-up in the series was 8 to 11 years. The incidence of ulcer recurrence during follow-up was 16% in the whole series, being significantly higher among patients with the primary ulcer in the pyloric or prepyloric area than among those with the lesion in the duodenal bulb. Furthermore, in the patient group with a primary ulcer in the duodenum an excellent operation result was achieved significantly more frequently in the case of preoperatively normal gastric emptying than in the case of delayed emptying. The incidence of ulcer recurrence tended also to be higher among the duodenal ulcer patients with prolonged emptying than among those with normal emptying through the difference between the groups did not reach statistical significance. This study emphasizes the prognostic significance of unimpaired gastric emptying and of even minor subclinical motor dysfunction when electing PGV as the surgical treatment and also that radiologic determination of gastric emptying time before PGV is of value in all patients undergoing the operation, irrespective of the location of the primary ulcer. PMID- 3811764 TI - Mechanical compliance of the small intestine related to long-standing obstruction. An experimental study in rats. AB - Mechanical compliance was studied in rat small intestine subjected to 48 hours of simple obstruction. The values were compared with those obtained in a corresponding section of normal gut. A closed system was used, constructed for continuous measurement of volume-pressure relationships within a hollow organ. The pressure-raising velocity was regulated by programming a steering unit connected to the system. The findings accorded with the hypothesis of an increase in compliance of the obstructed small intestine. The experiments further demonstrated that repeated artificial increases in intraluminal pressure cause change in intestinal compliance. PMID- 3811766 TI - Ranitidine therapy of Barrett's ulcer. Case report. AB - A Barrett's ulcer in a 58-year-old man was healed by 8 weeks of ranitidine therapy, as was an episode of erosive esophagitis a year later. Pharmacotherapy combined with antireflux measures can be an alternative to surgery for Barrett's esophagus, at any rate in patients who are unfit for surgery. PMID- 3811765 TI - The continuing challenge of the negative appendix. AB - A 15-20% negative appendix rate at emergency appendectomy is considered compatible with appropriate aggressiveness of approach for avoidance of perforation and heightened morbidity rate. But the morbidity rate after negative exploration has been estimated as high as 15%. We compared the morbidity rate after emergency appendectomy among patients with acute appendicitis with that in patients with nonacute appendiceal pathology or with normal appendix. Local septic complications (wound infection and/or intraabdominal abscess) were significantly more common in perforative appendicitis than in nonperforative or in cases without appendicitis. Excluding perforative appendicitis, the incidence of such complications did not differ significantly between the other diagnostic groups. The incidence of other complications was evenly distributed among all groups. A scoring system--possibly computer-aided--taking into account predictive factors in appendicitis, combined with careful in-hospital observation, would probably reduce the negative exploration rate in suspected acute appendicitis without increasing the perforation and morbidity rates. PMID- 3811767 TI - Jejunogastric intussusception through the enteroanastomosis after gastric resection. Case report. AB - A case of mechanical obstruction due to retrograde jejunogastric intussusception through the enteroanastomosis after a Billroth II gastric resection is reported. The literature is reviewed with special attention to the operative procedure performed. Reduction of the enteroanastomosis is proposed as the method of choice in these cases. PMID- 3811768 TI - Insulin-like growth factor I and II in 14 animal species and man as determined by three radioligand assays and two bioassays. AB - Insulin-like growth factor I and II (IGF I and II) were determined by five different assays in human serum, in the sera of ten mammalian species and in chicken, turtle, and frog serum. Sera of all tested mammals contain two different IGFs corresponding to human immunoreactive IGF I and receptor reactive IGF II. Receptor reactive IGF II of most animal species does not show significant cross reactivity in the RIA for human IGF II. IGF activity was also detected in sera of non-mammals, such as chicken and turtles, but not in frog serum. The IGF values obtained with the different assay system corresponded rather well: there is a good correlation between the values obtained in the protein binding and the fat cell assay, and between the results of the latter assays and the sum of immunoreactive IGF I and receptor reactive IGF II. The results suggest that those regions in the IGF I and II molecules which are responsible for reactivity with the type I IGF and the insulin receptor have not essentially changed during evolution. Similarly, the C-region, which mainly determines the immunological properties of IGFs, appears to have remained relatively constant in the IGF I, but not in the IGF II molecule. PMID- 3811769 TI - Comparison of the pharmacological properties of pituitary and biosynthetic human growth hormone. Demonstration of antinatriuretic/antidiuretic and barbital sleep effects of human growth hormone in rats. AB - Biosynthetic human growth hormone was compared with pituitary human growth hormone and pituitary 22 K in the weight gain and the tibia test. The three preparations were found to be equipotent. Furthermore, the growth hormones were compared in various pharmacological test systems. All three preparations were found to have a marked antidiuretic and antinatriuretic effect in the rat and to cause a significant shortening of the hexobarbital sleeping time in mice. Biosynthetic and pituitary preparations had the same diabetogenic activity in obese mice, and the growth hormones did not differ with respect to pharmacological profiles in the test systems applied. PMID- 3811770 TI - The role of androstenedione and testosterone in the reproduction and antler growth of a male white-tailed deer. AB - Seasonal levels of androstenedione and testosterone were investigated in plasma of mature intact and castrated male white-tailed deer. In four intact bucks, androstenedione concentrations were low in February and March (around 1 nmol/l) and then increased significantly (P less than 0.05) from April to November (peak 2.34 nmol/l). Testosterone remained low (below 3.5 nmol/l) from February to August and then rose significantly (P less than 0.01) till November (peak 36.78 nmol/l). Both hormones declined from November to February. In three castrates, androstenedione levels remained virtually unchanged (averaging around 0.5 nmol/l) between January and September. After a rapid significant increase (P less than 0.05) till November (peak value 2.45 nmol/l), androstenedione concentrations declined quickly to a baseline level. Testosterone in castrates remained around 0.3 to 0.7 nmol/l for most of the year with a non-significant peak (1.45 nmol/l) in October. These data indicate that the spring and summer increase in androstenedione in the intact deer is of testicular origin; the fall peak, however, may be a result of increased production in the adrenal glands. It can be speculated that the increase in androstenedione in the blood of the male deer during the spring may be responsible for the seasonal initiation and support of antler growth as well as being supportive to the re-activation of the reproductive system. PMID- 3811772 TI - [Radiotherapy and chemotherapy of solid tumors of the digestive tract]. PMID- 3811771 TI - Circulating forms of human foetal somatomedin. AB - Two forms of somatomedin, which crossreact in a radioreceptor-assay using foetal brain membranes as matrix, have been partially purified from the serum of human foetuses aged 16-28 weeks of gestation. The purification scheme consisted of acid precipitation, Sephadex G-50 chromatography, affinity chromatography and cation exchange fast protein liquid chromatography. The two peaks of activity had apparent molecular weights of approximately 7000 and different isoelectric points. The elution positions of these peaks corresponded to the elution positions of the truncated IGF-1 variant and intact IGF-2, respectively. PMID- 3811773 TI - [Role of radiotherapy and chemotherapy in the treatment of epidermoid cancer of the esophagus]. PMID- 3811774 TI - [Role of radiotherapy and chemotherapy in cancers of the stomach, colon and rectum]. PMID- 3811776 TI - [Diabetes and gastroenterology; autonomic diabetic neuropathy]. PMID- 3811775 TI - [Cancer of the anal canal. Experience with 218 cases treated at the Curie Institute]. PMID- 3811777 TI - [Diagnostic aspects of the coexistence of diabetes and cancer of the pancreas]. PMID- 3811779 TI - [Control of diabetes in the peroperative period using continuous intravenous insulin infusion with a pump]. PMID- 3811778 TI - [Liver diseases and glycoregulation]. PMID- 3811780 TI - Quantification of hemoglobin content in colonies derived from human early erythroid progenitor cells (BFU-E). PMID- 3811781 TI - Refractory anemia with excess of blasts with major karyotypic abnormalities in childhood: a case report. PMID- 3811782 TI - NADPH-dependent antibacterial activity in subcellular fractions of human neutrophils: interaction with granule constituents. PMID- 3811783 TI - Maturation sequence of macrophage colony-forming cells in mouse bone marrow. PMID- 3811784 TI - Treatment of autoimmune neutropenia with intravenous high-dose gammaglobulin. PMID- 3811785 TI - The blockade of the reticuloendothelial system after the administration of perfluorocarbon artificial blood. PMID- 3811786 TI - Chromosomal and fluorometric DNA analyses of malignant histiocytosis. PMID- 3811787 TI - Pathologic fracture of the femur secondary to amyloid deposition. PMID- 3811788 TI - Purification and properties of fibrin high-affinity urokinase from human urine. PMID- 3811789 TI - Turnover study of prothrombin, antithrombin III and fibrinogen in patients with liver cirrhosis. PMID- 3811790 TI - Hereditary Hageman factor (factor XII) deficiency: report of three families and review of the literature published in Japan. PMID- 3811791 TI - Immunosuppressive therapy in aplastic anemia based on in vitro culture studies. PMID- 3811792 TI - Therapy for aplastic anemia with cyclosporine: a case report. PMID- 3811793 TI - Premedication for day-case surgery: double-blind comparison of ketobemidone + dimethylaminodiphenylbuten (A-29) and morphine + scopolamine. AB - A double-blind comparison of the effect of Ketogan (ketobemidone and A-29, an anticholinergic and spasmolytic agent) and morphine + scopolamine as premedication was performed in 113 women admitted for abortion and in 114 women admitted for gynaecological dilatation and curettage. Anaesthesia was thiopentone and nitrous oxide and oxygen, occasionally supplemented with enflurane. It was found that 1 ml morphine + scopolamine (10 mg + 0.4 mg) was more sedative than 1 ml ketogan (ketobemidone 5 mg + A-29 25 mg). After ketogan there was less nausea and dryness of the mouth before induction of anaesthesia than after morphine + scopolamine. Ketogan had the same tranquillizing effect but less hypnotic effect preoperatively than morphine + scopolamine. During the 3-h postoperative observation period the patients premedicated with ketogan woke up significantly sooner and had more pain than those given morphine + scopolamine. More patients required postoperative antiemetics in the ketogan-premedicated group than in the morphine + scopolamine-premedicated group. PMID- 3811794 TI - Slowing of the heart during hypotension in major abdominal surgery. AB - Heart rate (HR) and mean arterial blood pressure (MBP) were studied during abdomino-perineal resections of the rectum under neurolept anesthesia in order to observe HR deviations due to hypovolemic hypotension. Of the 65 patients followed, 18 developed a systolic BP under 100 mmHg. Their blood loss (37 +/- 9 ml/kg, mean +/- s.e. mean) was higher than that of the normotensive control group (20 +/- 2 ml/kg, P less than 0.01), the urine production lower (8 +/- 1 versus 10 +/- 3 ml/kg, P less than 0.01) and blood transfusions amounted to 40 +/- 8 versus 24 +/- 2 ml/kg (P less than 0.01). In the hypotensive patients a decrease in MBP from 108 +/- 3 to 94 +/- 3 mmHg was accompanied by a simultaneous increase in HR from 81 +/- 3 to 91 +/- 3 beats/min (P less than 0.05). However, during the hypotensive incident where the MBP averaged 69 +/- 4 mmHg, HR decreased temporarily to 75 +/- 3 beats/min (P less than 0.001). After MBP was restored to 94 +/- 3 mmHg using volume repletion, HR increased to 95 +/- 3 beats/min (P less than 0.001). The results demonstrated a temporary slowing of HR in anesthetized, bleeding and hypotensive patients. PMID- 3811795 TI - Bradycardia during hypotension following release of a tourniquet in orthopaedic surgery. AB - Heart rate (HR) and mean arterial blood pressure (MBP) were followed in 39 consecutive patients during orthopaedic surgery with the leg exsanguinated by an inflatable tourniquet around the thigh. The circulation was stable in all patients until release of the tourniquet. Following release of the tourniquet MBP decreased from 94 +/- 5 (s.e. mean) to 45 +/- 12 mmHg (12.5 +/- 0.7 to 6.0 +/- 1.6 kPa) (P less than 0.005) in 10 patients, while it remained stable in the others. At the same time the hypotensive group showed a decrease in HR from 83 +/ 6 to 67 +/- 3 beats min-1 (P less than 0.005) while no significant change in HR was seen in the normotensive group. The hypotensive group was older (57 +/- 8 versus 50 +/- 4 years (P less than 0.05)), had a larger blood loss during surgery (2.9 +/- 1.2 versus 0.7 +/- 0.3 ml kg-1 (P less than 0.005)), and the duration of the operation was longer in this group (120 +/- 14 versus 60 +/- 27 min (P less than 0.001). It is suggested that the characteristic deviation of HR in conjunction with hypotension following release of a tourniquet is bradycardia. PMID- 3811796 TI - Halothane hepatitis in a prospective study of postoperative complications. AB - In a prospective study comprising 2609 consecutive surgical patients, of whom 1166 were anesthetized with halothane, four cases of hepatitis were encountered. The incidence of hepatitis among those who received halothane was 1:292 in our material. The high incidence may be explained by the recognition of milder forms of hepatitis and by the selection of the series (over 40 years). Serum alanine aminotransferase should be investigated in all patients with postoperative pyrexia of unknown origin if mild forms of halothane hepatitis are to be discovered. The patient's history should be carefully examined for previous postoperative pyrexia of unknown origin following halothane anesthesia, in which case other anesthetics should be chosen. PMID- 3811797 TI - Cardiovascular and blood gas responses to inhaled anaesthetics in normoxic and hypoxic dogs. AB - Changes in haemodynamics and blood gases were investigated before and after administration of 0.5, 1 and 1.5 MAC of halothane, enflurane and isoflurane in respectively 7, 7 and 9 dogs ventilated alternatively with a fraction of inspired O2 in N2 (FiO2) of 0.4 and with brief periods (10 min) of FiO2 of 0.1. Anaesthesia was induced with pentobarbital and the animals were paralysed with pancuronium. Acute hypoxic challenges with FiO2 of 0.1 consistently decreased arterial PO2 to 3.5-4.5 kPa and increased pulmonary vascular resistances by 60 100%. At identical inspired concentrations, as expressed in MAC units, all three inhaled anaesthetics induced a broadly comparable dose-related decrease in systemic blood pressures, due to a depression in cardiac performance as well as a reduction in systemic vascular resistances. Enflurane was the most potent myocardial depressor and isoflurane the most potent vasodilator, halothane being intermediate. Oxygen deprivation was associated with some enhancement of the cardiovascular depressant effects of the inhaled anaesthetics but, in spite of this, matching of O2 transport to tissue O2 demand appeared to be improved, probably in relation to a concomitant reduction in metabolic rate. Only isoflurane inhibited the hypoxic pulmonary pressor response, and this was associated with a slight deterioration in arterial oxygenation in both normoxic and hypoxic conditions. PMID- 3811798 TI - Epidural catheters of the multi-orifice type: dangers and complications. AB - A study on epidural catheters of the multi-orifice type, investigating their tendency to epidurovasal (with an intravascularly positioned catheter tip) and epidurosubarachnoid (with the catheter tip inserted in the subarachnoid space) malpositioning, was conducted on 113 patients using clinical and radiological criteria as controls. Of the improperly placed catheters, 13 were in an epidurovasal (11.5%) and one was in an epidurosubarachnoid (0.9%) position. The findings demonstrate the occasional hazardous dual compartmental misplacement of multi-orifice catheters, in which a distal opening can lie intravascularly or within the subarachnoid space, while a proximal orifice simultaneously retains normal access to the epidural space. The insufficiency of controlling or even recognizing such improperly placed catheters which are only partially in the epidural space, as well as the danger of causing a secondary dural or vascular perforation with epidural catheters, is discussed. Since epidural catheters of the multi-orifice type apparently represent an inherent, vital danger due to their construction (regardless of the catheter material and workmanship), they should no longer be used. PMID- 3811799 TI - Splanchnic blood flow during halothane-relaxant anaesthesia in elderly patients. AB - We have previously found that halothane-relaxant anaesthesia in elderly patients causes a change towards a hyperkinetic circulation, with a decrease in the arterial-mixed venous oxygen content difference. This could be attributed to vasodilation. In the present study the splanchnic contribution to these changes was investigated. Nine patients were studied during halothane-relaxant anaesthesia prior to surgery. During anaesthesia splanchnic blood flow was markedly reduced, while splanchnic oxygen uptake decreased only moderately compared with the awake level. This resulted in an increase in splanchnic oxygen extraction. It is concluded that the splanchnic vascular bed does not contribute to the "hyperkinetic" circulation during halothane anaesthesia. PMID- 3811800 TI - Hypertensive response to thiopental in man during cardiopulmonary bypass. AB - We report the effect of 250 mg of sodium thiopental on vascular tone at constant blood flow in 26 patients undergoing cardiopulmonary bypass while the ascending aorta was cross-clamped. Light anaesthesia was effected with fentanyl and enflurane, muscle relaxation with pancuronium. After a latent period of 10.5 +/- 0.7 s there was a hypertensive response of 9.8 +/- 0.5 s duration and of 21.4 +/- 1.7 mmHg (2.8 +/- 0.2 kPa) magnitude; this was followed by hypotension of 39.6 +/ 4.2 s duration and of 18.4 +/- 1.9 mmHg (2.4 +/- 0.3 kPa) magnitude. There was a statistically significant inverse correlation between the hypertension and body temperature (P = 0.005); the time to onset of hypertension correlated directly with pump volume (P = 0.001), weight of the patient (P = 0.03), and cross-clamp time before the drug was given (P = 0.002), and correlated inversely with the serum sodium concentration (P = 0.001). The duration of hypertension was inversely related to the plasma bicarbonate (P = 0.01) and body temperature (P = 0.04). The duration of hypotension was significantly longer in women (P = 0.0001) and was directly related to the duration of cross-clamping (P = 0.0007), to pH (P = 0.0016), and to PCO2 (P = 0.04). We speculate that thiopental induced the hypertensive response due to a potentiation of the vasoconstrictive (local) effect of norepinephrine, and induced the hypotensive response by a central nervous system effect. Thiopental had no apparent effect on venous tone. PMID- 3811801 TI - Correction of metabolic alkalosis by HCl and acetazolamide: effects on extracellular and intracellular acid-base status in rats in vivo. AB - Extracellular plasma pH (pHe) of nephrectomized male or female Sprague-Dawley rats was changed by infusion of either sodium bicarbonate or HCl to predetermined values in the pH range of 7.53-7.14, and then held constant for 2 h. Intracellular pH (pHi) of the liver, heart, brain, and two skeletal muscle groups as calculated from the distribution of 14C-labelled DMO (5.5-dimethyl-2,4 oxazolidinedione) was compared to corresponding tissues of a control group and rats treated with the carbonic anhydrase inhibitor acetazolamide (Diamox). When compared to control, changes of the extracellular pH in male or female rats were followed by similar effects on pHi in the investigated tissues. At the same extracellular pH there were no statistical differences between pHi values of HCl or acetazolamide treated rats, though the arterial PCO2 following acetazolamide administration was significantly increased when compared to control or the corresponding HCl group. This study shows that administration of acetazolamide or HCl results in a dose-dependent decrease of plasma and tissue pH, and that both agents may be used as a logical and safe therapy during severe metabolic alkalosis in rats. PMID- 3811802 TI - 3-in-1 lumbar plexus block for muscle biopsy in malignant hyperthermia patients. Amide local anaesthetics may be used safely. AB - A 3-in-1 lumbar plexus block with the aid of a nerve stimulator was performed in 32 patients and a psoas compartment block was performed in five patients for muscle biopsy of the upper leg for diagnosis of malignant hyperthermia (MH) susceptibility. Twenty-two patients were found to be MH susceptible by the in vitro contracture test. Twenty patients received 40 ml prilocaine 1.5% with epinephrine 1:200,000 and two received 40 ml bupivacaine 0.5% with epinephrine 1:200,000 without any untoward reaction. The 3-in-1 block provides a high success rate and excellent analgesia for muscle biopsy of the upper leg. Amide local anaesthetics are safe in MH-susceptible patients. PMID- 3811803 TI - Anaesthetic temperature and shivering in epidural anaesthesia. AB - The mechanism of shivering during epidural analgesia remains unclear. This study investigates the role of the temperature of the local anaesthetic injected extradurally. Forty patients admitted for elective caesarean section under epidural anaesthesia were studied; 20 were given bupivacaine warmed to 37 degrees C (warm group) and 20 were given bupivacaine stored at 4 degrees C (cold group); the occurrence of shivering in both groups was recorded. The overall incidence of shivering was 27.5%; two patients of the warm group and nine patients of the cold group shivered. This difference was statistically significant (P less than 0.03). The results suggest that there are thermosensory mechanisms in the human spinal canal. In our view, epidural anaesthetic solutions should be warmed to body temperature prior to injection to reduce the incidence of shivering. PMID- 3811804 TI - The influence of fentanyl on the cardiovascular effect of suxamethonium. AB - The influence of fentanyl on the cardiovascular effect of a single dose of suxamethonium was evaluated during thiopentone N2O/O2 anaesthesia. Sixty adult patients were randomly allocated to three groups. In one group (control group) no fentanyl was given. In two groups fentanyl 0.002 mg/kg and 0.004 mg/kg, respectively, was given before induction of anaesthesia. Three minutes after the injection of suxamethonium 1 mg/kg, both heart rate (HR) and mean arterial pressure (MAP) in the two groups receiving fentanyl were significantly lower than in the control group. However, the absolute changes were small and no dose related effect was seen. An estimation of the change in HR following suxamethonium was made using as predictors initial HR before induction of anaesthesia, age, sex, and the injection of fentanyl. The higher the initial HR, the greater was the chance of a decrease in HR following suxamethonium. Injection of fentanyl lowered the threshold HR above which a decrease was to be expected following injection of suxamethonium. This effect was most pronounced among the younger patients. It is concluded that injection of fentanyl potentiates the decrease in HR sometimes seen after a single dose of suxamethonium and that this effect is influenced by HR before induction of anaesthesia and by age of the patient. PMID- 3811805 TI - Effects of repeated bupivacaine administration on sciatic nerve and surrounding muscle tissue in rats. AB - The effects of repeated administration of 0.5% bupivacaine or saline into the sciatic notch of rats were studied by light microscopy, electron microscopy and a neurophysiological technique. Very severe myositis, including local necrosis, developed in six of 12 rats treated twice daily with 1 ml bupivacaine for either 3 or 7 days. A 3-h infusion of 1.5 ml 0.5% bupivacaine resulted in minor injury to muscle tissue. A marked degree of disruption and vacuolization of myelin sheaths was evident in nerves exposed to bupivacaine for 3 days. Lymphocyte accumulation was confined to the area surrounding the nervous tissue in 7 of 10 of the preparations from rats treated for 3 days or by a 3-h infusion. No histological changes were detected in nerve and muscle tissue from the opposite extremity exposed to saline. After a recovery period of 3 weeks, no differences in the nerve or muscle histology were seen between samples from bupivacaine- or saline-treated animals. The amplitude of the compound action potential of sciatic nerves was, however, significantly lower after bupivacaine treatment (7 days, 1 ml twice daily). Thus, impaired function may continue despite the lack of histological intraneural injury. PMID- 3811806 TI - The incidence of cardiac arrhythmias and arterial hypotension subsequent to standardized surgical stimuli in patients undergoing thoracotomy. With reference to enflurane and halothane. AB - A main factor which might cause cardiac arrhythmias and arterial hypotension during thoracic operations is surgical manipulation around the pericardium and the lung hilus. Halothane and enflurane were compared as to the occurrence of arrhythmias and hypotension caused by standardized surgical stimulation. Twenty eight patients scheduled for thoracotomy were studied. The patients were selected in randomized order, and the anaesthetic agent in use was unknown to the surgeon. ECG, intra-arterial blood pressure and central venous pressure were recorded continuously. Six patients in the halothane group (n = 14) and nine patients in the enflurane group (n = 14) developed premature atrial contractions and nodal rhythm, while nine patients in the halothane group and five in the enflurane group developed a fall in systolic blood pressure of more than 20 mmHg (2.7 kPa). No statistically significant difference in the occurrence of cardiac arrhythmias and hypotension was found between the two anaesthetic groups. PMID- 3811807 TI - Work practices relating to intubation and associated procedures in intensive care units in Sweden. AB - A survey into the current usage of tracheal tubes and associated procedures, such as various sedation regimes and antacid therapy, in intensive care units was carried out in Sweden by sending a questionnaire to physicians in charge of intensive care units in 70 acute hospitals which included seven main teaching hospitals. The purpose of the survey was to see how far the recent advances in tube and cuff design and awareness of the problems caused by prolonged therapeutic paralysis in intensive care units have influenced the attitudes and work practices of physicians in Sweden. Forty-nine replies were received (a 70% response rate). All hospitals used polyvinyl chloride tubes of Magill design, with high residual volume, low pressure cuffs. Intensive care units in 85.7% of teaching hospitals and 47.6% of non-teaching hospitals preferred the nasal route for intubation. Most non-teaching hospitals used a size 7 tube in both adult male and female patients for nasal intubation. The majority of units changed from tracheal tubes to tracheostomy after a period of 1-2 weeks. 85% of all hospitals monitored intracuff pressure as a routine, and in most intensive care units the cuff was inflated to no-leak ventilation. The majority of units rarely used muscle relaxants. Phenoperidine and diazepam were the most popular drugs used for the sedation technique. 71.4% of teaching hospitals and 40.9% of non-teaching hospitals used antacids routinely in patients on intermittent positive pressure respiration. The results are discussed. PMID- 3811808 TI - The effects of ornipressin and adrenaline on lignocaine nerve blocks. AB - An electrophysiological method measuring nerve conduction following the electrical stimulation of a sciatic nerve branch in anaesthetised rats was used to evaluate under strictly controlled conditions the effects of 1:100,000 adrenaline and of 0.03 IU X ml-1 ornipressin on the speed of onset, depth and duration of lignocaine anaesthesia. It was shown that compared with plain lignocaine, lignocaine with ornipressin produced shorter onset of anaesthesia and improved its depth and duration. Adding adrenaline to lignocaine merely extended its duration of action. Ornipressin, therefore, even at low concentration, can be considered as a viable alternative vasoconstrictor to adrenaline, the use of which is undesirable in some categories of patients. PMID- 3811809 TI - Halothane-associated liver damage and renal failure in a young child. AB - A case of halothane-associated liver damage and renal failure is described in an 18-month-old girl after her third halothane anaesthetic. There had been two uneventful enflurane anaesthetics. The diagnosis was confirmed by detecting antibodies specific for halothane-associated liver failure using a recently developed enzyme-linked immunosorbent assay. PMID- 3811810 TI - Oxygen analyzers in anaesthesia: performance in a simulated clinical environment. AB - Nine commercial oxygen analyzers were tested in a laboratory model stimulating clinical anaesthesia conditions. Fifteen test situations were used in order to study the effects of nitrous oxide, humidity, positive end-expiratory pressure, halothane, enflurane and isoflurane. Errors exceeding 8 vol% were not uncommon, the dominating source of error being humidity. Analyzers with efficient dehumidification of gases before analysis performed better than analyzers without this property. PMID- 3811811 TI - Postoperative lymphocytopenia and leucocytosis after epidural and general anaesthesia. AB - Few investigations have demonstrated a positive effect of epidural blockade on the leucocytosis and lymphocytopenia secondary to surgery. Thirty elderly patients undergoing total hip replacement were randomly allocated to two groups: epidural analgesia and general anaesthesia. The leucocyte and lymphocyte counts per- and postoperatively were registered. Significant leucocytosis and lymphocytopenia were found in both groups, but no significant difference was found between the groups. PMID- 3811812 TI - Perioperative autonomic hyperreflexia in high spinal cord lesions: a case report. AB - We report the case of a 20-year-old man with serious perioperative attacks of autonomic hyperreflexia starting during urological surgery 14 months after a complete C6-C7 spinal cord injury. The intraoperative attacks were controlled by deepening the level of anaesthesia, while the postoperative attacks were treated with emepronium bromide. A brief discussion of the pathophysiology and treatment is given. PMID- 3811813 TI - Investigation of malignant hyperthermia in Sweden. AB - One hundred and thirty patients from 52 families were investigated for susceptibility to malignant hyperthermia (MH). The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle to halothane and to caffeine, according to the protocol established by the European malignant hyperpyrexia group. In addition, 13 normal control biopsies were obtained from the same muscle and with the same anaesthesia as in the MH patients. These control results agree with and confirm the criteria formulated in the European MH group. The results are compared with our first 85 investigations performed prior to the establishment of the protocol. The main difference compared to the earlier material is the addition of an equivocal group (MHE), whose muscle reacted in vitro to either halothane or caffeine, but not both. All the families referred because of a fulminant MH reaction contained MHS or MHE members. There was a greater incidence of MH-negative families, suggesting an increased suspicion of MH amongst the clinicians. PMID- 3811814 TI - Low-dose ketamine infusion for analgesia during postoperative ventilator treatment. AB - In a randomized, double-blind study with placebo, ketamine was used as an analgesic during ventilator treatment in the period of recovery after major abdominal surgery. Forty patients were orally intubated and ventilated by means of a volume-controlled ventilator. Twenty of them received an i.v. bolus of 30 mg of ketamine followed by an 8-h infusion of 1 mg per minute. End-tidal CO2 concentration was continuously monitored and ventilation was adjusted to metabolic demands prior to assessment of pain. If pain relief was not adequate, the infusion rate was doubled, and if this was still not sufficient, 5 mg injections of ketobemidone were given i.v. If the orotracheal tube was not tolerated, the internal branch of the superior laryngeal nerve was blocked. A total of 30 injections of ketobemidone were administered to 13 control patients, but only five were given to four ketamine patients. Ten control and three ketamine patients required an internal laryngeal nerve block. Dreams and hallucinations were recalled in three patients in the control group and five in the ketamine group. Only one control and two ketamine patients experienced these as unpleasant. In this investigation, ketamine infusion in a low dose appeared to offer satisfactory analgesia and to permit tolerance of the orotracheal tube. PMID- 3811815 TI - Innervation of lymph nodes: a combined silver impregnation and electron microscopic study. AB - Using silver impregnation and electron-microscopic techniques, nerves have been demonstrated in rat axillary, cervical and inguinal lymph nodes, and their distribution was investigated. With the electron microscope, vesicle-containing varicosities or terminals are demonstrated in close proximity to reticulum cells, lymphocytes, plasmablasts and mature plasma cells. Nerves supplying the blood vessels possibly differ from those supplying stromal or lymphocytic elements. PMID- 3811816 TI - Intracellular lipids in rabbit ear cartilage during tissue regeneration. AB - Circular holes 10 mm in diameter were punched in the proximal region of rabbit ears, and the intracellular lipid content of the regenerated cartilage and the neighbouring old cartilage was studied histochemically up to the 32nd week after wounding. Chondroblasts appeared in the peripheral zone of the regenerated tissue towards the end of the 3rd week, but no intracellular lipids were observed until the 8th week. In the following weeks chondrocytes and intracellular lipids appeared in the intermediate and central zones of the regenerated tissue, the production of cartilage and intracellular lipid being particularly vigorous in the central zone during the last weeks of the study. In the old cartilage adjoining the wound, intracellular lipid levels declined considerably except in new cells produced by proliferation of the perichondrium after wounding. Phospholipids were only observed in the youngest cartilage cells and disappeared when deposits of neutral lipids began to be formed. The interpretation of these observations and the function of intracellular lipids in cartilage are discussed. PMID- 3811817 TI - Retinal epithelial fine structure in the grey seal (Halichoerus grypus). AB - The morphology of the retinal epithelium and the closely associated choriocapillaris and Bruch's membrane (complexus basalis) has been investigated in the eye of the grey seal (Halichoerus grypus) by electron microscopy. The retinal epithelium is composed of a single layer of cuboidal cells joined laterally by apically-located junctional complexes. Basally (sclerally) these cells display numerous infoldings while apically (vitreally) abundant processes enclose rod outer segments. Internally the large vesicular nucleus is centrally located. Smooth endoplasmic reticulum, mitochondria and lysosome-like bodies are abundant. Rough endoplasmic reticulum and polysomes while present are not plentiful. Phagosomes of outer-segment discs are only occasionally noted in the light-adapted state. As the entire fundus is overlain with a choroidally located tapetum cellulosum, only at the extreme periphery is an occasional melanosome present in these epithelial cells. The choriocapillaris endothelium is highly fenestrated and the profiles of these capillaries are deeply indented into the epithelial layer. Bruch's membrane (complexus basalis) is reduced to a trilaminate structure rather than the typical pentalaminate membrane seen in most mammalian species and when associated with capillary profiles is further reduced to a single thick basal lamina. PMID- 3811818 TI - Solid cell nests of the human thyroid in early stages of postnatal life. Systematic autopsy study. AB - The anatomical position and prevalence of solid cell nests (SCN) of the thyroid in early stages of postnatal life have not yet been clearly determined. In order to find out about these unsettled questions a systematic search of these ultimobranchial nests from 92 autopsied thyroids from neonates, children and young adults was undertaken. SCN were present in 61% of the patients; they were mainly located in the middle third of the lateral thyroid lobes, and placed along a central to paracentral and slightly dorsal longitudinal axis. These findings, as compared with our previous observations made in older adult thyroids, further demonstrate that there exist a constant anatomical position and prevalence of SCN in postnatal life. The significantly higher frequency of SCN in males (68%) than in females (48%) (p less than 0.01) found in a study that was further extended to 192 thyroids at early and late stages of postnatal life, is a question that requires further investigation. PMID- 3811819 TI - [The geometry of the human trochlea tali]. AB - The geometrical shape of the trochlea tali is responsible for two completely different courses of motion in the ankle joint setting out from the neutral position: dorsiflexion and plantar flexion. Dorsiflexion: The tibia leads the talus, whereas the fibula is pushed laterally by the screw-shaped lateral articular facet of the talus. The malleoli tightly embrace the trochlea tali, whilst an obvious cleft appears dorsally and medially between the superior articular surface of the talus and the tibial roof. Plantar flexion: The fibula leads the talus which withdraws from the medial malleolus by stretching the anterior talofibular ligament. At the same time the superior articular face of the talus closely contacts the tibial roof. PMID- 3811820 TI - Dynamic model of the equine hindlimb during the swing phase. AB - A dynamic model is developed to describe the swing phase of the hindlimb of a normally walking horse. The limb was represented by four rigid segments constrained to move in a sagittal plane only. The mathematical equations of motion of this four-element pendulum were formulated using Lagrange's theorem. The morphometric parameters from the hindlimb segments of 3 horses were determined using high-speed film analysis. Five muscle groups were incorporated in the model. Muscle activity was derived from earlier EMG measurements. Optimization of muscle moments resulted in a simulated swing movement that approximated that in the living animal. PMID- 3811821 TI - Influence of thioacetamide-provoked liver injury on female rat blood and alveolar bone under stress. AB - Experimental liver injury with different stages was induced to adult female test rats with daily injection of thioacetamide (ThAA). The doses administered intraperitoneally were 50 mg/kg body weight. In the liver sections progressive changes of damage, regeneration and fat substitution were noticed. Kidney sections revealed enhanced glomerular atrophy, particularly in the cortical tubules, provoked in the 3-week traumatization period. The influence of ThAA on female rat blood was assayed using standard biochemical methods. The analyses done were: the percentage of blood obtainable and the serum/blood ratio; the serum alanine transferase; serum alkaline phosphatase; serum creatinine; serum hydroxyproline and serum beta-glucuronidase activity in the acute, subacute, chronic and highly chronic stage of liver injury. The biochemical findings show continuously progressing damages when traumatization proceeds. In the 3-week test period the histological findings processed showed an increase in osteoclastic resorption in the alveolar bone around the occlusally stressed tooth simultaneously with a horizontal bone loss. Some indications of recovering incidents were seen, too. Only in the histological findings was no difference seen in the deterioration between both sexes, contrarily to the biochemical results also discussed in this study. PMID- 3811822 TI - Influence of conventionalization on small-intestinal mucosa of germ-free Wistar rats: quantitative light microscopic observations. AB - Germ-free rats were inoculated with microbial flora from feces of conventionally reared rats and the mucosal structure was quantitatively observed at different time intervals after the inoculation and at different regions of the small intestine. In the ileum, desquamation figures were frequently seen on the villus tip, and several parameters of the mucosal elements, i.e., villus and crypt lengths, mitotic figures, goblet cells and thickness of lamina propria were significantly increased after the inoculation. On the other hand, in the duodenum and jejunum, such parameters except for the lamina propria showed no remarkable change during the course of the experiment, though the villus/crypt ratio increased temporarily at half a day after the inoculation. These regional differences of the mucosal response to the inoculation may be due to the different populations of microbial flora which settled in each region of the small intestine. PMID- 3811823 TI - Histomorphometry of masticatory muscles in the muscular dystrophic mouse. AB - Cross sections of normal and dystrophic digastric, masseter and temporalis muscles from 7-week-old mice were studied by histomorphological and histomorphometrical methods in the light microscope. The histomorphological part of the study revealed marked differences in morphology between normal and dystrophic muscles. Mutual differences between the dystrophic muscles were also observed. Comparisons of the parameters chosen for the histomorphometrical part of the study, i.e., cell size and number of centrally positioned nuclei in a given number of fibers, revealed that the digastric muscle seems to be the least affected and the masseter muscle the most affected by the disease. PMID- 3811824 TI - [Anatomical study on the branches of the celiac trunk (III)--Comparison of findings with Adachi's classification]. PMID- 3811825 TI - [Classifications of megakaryopoietic cells on plastic semithin sections: effects of pregnancy and estrogen administration on megakaryopoiesis]. PMID- 3811826 TI - [Variations of the inferior vena cava and their relation to the drainage pattern of gonadal veins]. PMID- 3811827 TI - [A gross anatomical study on the relation between the cuboid bone and the tendon of the peroneus longus muscle in man]. PMID- 3811828 TI - Current state and tendencies of antibiotic resistance in Hungary. AB - This survey is based on data for 245 903 isolates reported by Public Health Network laboratories in 1983. Facultatively pathogenic Gram-negative bacteria comprised two-third of the isolates, and--except Escherichia coli--were resistant in a high percent to the most frequently used antibiotics. Oxacillin and vancomycin were the most effective against Staphylococcus aureus being in 94.7% resistant to penicillin. In contrast to other streptococci, all Streptococcus pyogenes strains were sensitive to penicillin. The majority of the Gram-positive strains were resistant to tetracycline. A comparison to results reported earlier (1974 to 1983) showed an increasing resistance rate mainly to ampicillin, carbenicillin, co-trimoxazole and gentamicin, which were introduced in therapy during this period. Resistance rate of almost all species has increased to gentamicin, e.g. that of Proteus mirabilis has risen tenfold. Emergence of Haemophilus influenzae resistant to ampicillin, and increasing resistance rates of P. mirabilis and Streptococcus pneumoniae to almost all drugs are remarkable findings. The increasing or variable usage of drugs that have been used for a long time did not influence resistance markedly. In some instances the resistance rates even diminished, e.g. the tetracycline resistance of agents associated with enteric diseases. A restricted use of chloramphenicol reflected in a decreased resistance of some species. Multiresistant Gram-negative strains--which are resistant to all drugs frequently used in Hungary--were isolated in 12.7% from a representative clinical material. The frequent occurrence of multiresistant P. mirabilis and Acinetobacter isolates is a new phenomenon. Surprisingly, the percentage of multiresistant E. coli strains was very low. Amikacin and netilmicin were found to be the most effective against multiresistant isolates. PMID- 3811829 TI - [Progressive multifocal leukoencephalopathy mimicking multiple sclerosis as the sole clinical manifestation of acquired immunodeficiency syndrome]. AB - A 38 year-old wife, of belgian origin and residency, suffered from a left retrobulbar optic neuritis in 1973, with as only sequel dyschromatopsia and central scotoma enlargement. In 1985, 12 years later, she complained of a progressive weakness of the right hand, and developed a spastic tetraplegia within four months. The C.T. Scan showed white matter hypodensities, without mass effect or contrast enhancement, first limited to the left centrum semiovale and later on with multifocal character. Somatosensory evoked potentials after stimulation of the right median nerve demonstrated only lemniscus medialis response. Multiple sclerosis was initially suspected. Analysis of lymphocytes subsets however showed a markedly reduced helper population with as a result a very low H/S ratio, and the serology was found positive for HTLV-III-LAV, thus demonstrating the diagnosis of acquired immune deficiency syndrome (AIDS). Visceral autopsy demonstrated only a CMV pneumonia. Autopsy of the brain showed typical lesions of progressive multifocal leukoencephalopathy (PML). This case is compared with 20 previously published observations of PML associated with AIDS and appears rather unusual due to the association of unfrequent clinical peculiarities: previous, probably coincidental, retrobulbar optic neuritis, female patient, lack of risk factor and clinical symptoms of AIDS. The diagnostic difficulties in the present case are emphasized. PMID- 3811830 TI - Abnormal muscle mitochondria in ischemic claudication. AB - The gastrocnemius and quadriceps muscles findings in 18 patients with chronic arterial insufficiency were reviewed with regard to mitochondrial changes. Prominent mitochondrial alterations were present in eight out of 18 patients. The comparison of clinical data between patients with and without mitochondrial changes revealed that in this latter group all patients were at stage IV, whereas the degree of ischemic disease was milder in the other group: the difference in distribution of patients at stage IV between the two groups was statistically significant. This supports the view that mitochondrial changes are expression of adaptive modification rather than damage. PMID- 3811831 TI - Neuropsychological measures in amyotrophic lateral sclerosis and their relationship with CT scan-assessed cerebral atrophy. AB - Twenty-one male patients affected by ALS have been given a short neuropsychological battery and the results have been compared with those obtained by 21 male subjects affected by other non-dementing neurological diseases. Only two ALS patients had definitely low scores on WAIS (performance scale) and on learning tasks, both verbal and spatial, but the ALS group did not differ, on the whole, from the controls. No relationship was observed between cognitive impairment and cerebral atrophy assessed by computerized tomography. The conclusion is suggested that the cognitive impairment in ALS be a discrete, seldom occurring event. PMID- 3811832 TI - Recirculation after cerebral ischemia. Simultaneous measurement of cerebral bloodflow, brain edema, cerebrovascular permeability and cortical EEG in the rat. AB - The 4-vessel occlusion rat model of cerebral ischemia was modified to permit the simultaneous measurement of cerebral blood flow (hydrogen clearance), brain edema (specific gravity), cerebrovascular permeability (14C-AIB) and electrocardiogram. Surgery was performed in one stage in the anesthetised, paralysed and ventilated rat and severe hemispheric ischemia was produced in all animals. Electrode implantation did not alter cortical specific gravity or Ki for 14C-AIB. During 4 vessel occlusion mean cortical CBF was 5.8 +/- 1.4 ml-1 100 g-1 min. and this was associated with an isoelectric ECoG; 15 min of ischemia produced a significant reduction in mean cortical specific gravity (increase in brain edema). Following 15 min ischemia, 180 min of recirculation were permitted. Post-ischemic blood flow showed an immediate hyperemia (CBF = 202 +/- 12 ml-1 100 g-1 min.) followed by hypoperfusion (CBF = 58 +/- 8 ml-1 100 g-1 min). There was an early further decrease in cortical specific gravity. Further recirculation led to a significant increase in cortical specific gravity (resolution of brain edema). The transfer constant (Ki) for 14C-AIB was not altered at any stage in recirculation. This appears to be a model of pure cytotoxic edema until 180 min recirculation after 15 min cerebral ischemia. Recirculation permitted return of cortical electrical activity. PMID- 3811833 TI - The value of EEG in the investigation of postapoplectic epilepsy. AB - During the 5 years 1979-1983 61 patients within the county of Frederiksberg developed postapoplectic seizures after the age of 60. Of these patients EEG was performed on 48. These EEG's were compared to the EEG's from 25 patients of the same age with epilepsy due to cerebral tumors 33 patients with acute stroke and 24 patients with stroke sequelae who had not experienced seizures. Slow wave activity and foci were seen more often among patients with acute stroke than among patients with postapoplectic seizures whereas paroxysmal activity occurred less often in patients with acute stroke than among patients with postapoplectic seizures patients with stroke sequelae and patients with seizures due to cerebral tumours. Patients with stroke sequelae with proven hemispheric localization had focal abnormalities more often than patients with postapoplectic seizures but apart from this EEG difference between patients with postapoplectic seizures and patients with stroke sequelae or seizures due to brain tumours were not found. In 12 of the patients with postapoplectic seizures and in 20 of the patients with stroke sequelae without seizures EEG at the time of the acute stroke was available. Differences between patients with and patients without seizures were not found neither at the time of the acute stroke nor at the time of readmission due to stroke sequelae or due to onset of seizures. It is concluded that a routine EEG is without value in the diagnosis of postapoplectic seizures in the elderly. PMID- 3811834 TI - Anticonvulsant drugs and bone metabolism. AB - The influence of chronic antiepileptic treatment on bone metabolism has been investigated in 52 adult epileptics, who had normal dietary intake, sunlight exposure and daily living activities. None of the patients had symptoms or signs suggestive of osteomalacia. Serum phosphate levels were significantly decreased and serum alkaline phosphatase levels were significantly increased in the patients compared with matched controls. Calcitonin values and bone mineral content, measured by single photon absorptiometry, were significantly lower among anticonvulsant users. Calcium metabolism impairment grossly correlated to the number of drugs concurrently used by the patient but not to the types, to the relative plasma concentrations or to the overall duration of the treatment. Our findings indicate that in ambulatory patients with adequate diet and outdoor activities in Italy present with clinically irrelevant impairment of bone metabolism. PMID- 3811835 TI - Selective regional effect of various neuroactive drugs on bromocriptine concentration in the brain of rats. AB - Bromocriptine (2-Br-alpha-ergocryptine), a partial ergoline derivative, is a dopamine agonist which has been used successfully in the treatment of hyperprolactinemia, acromegaly and Parkinson's disease. The main targets for the action of the drug are the hypothalamic, hypophyseal pathway and the striatum. These regions contain different populations of neurons which interact with each other in a complex way. In order to check the mechanism of these interactions in rats, we administered different neuroactive drugs together with bromocriptine. After a single intraperitoneal injection, bromocriptine concentration in the striatum was 13.1 +/- 2.9 ng/mg protein, and in the hypothalamus 13.9 +/- 0.8 ng/mg protein. The largest increase in the bromocriptine content in the striatum was found after the concomitant administration of naloxone, an opiate receptor blocker (21.2 +/- 2.5 ng/mg protein). The largest increase of the bromocriptine content in the hypothalamus was found after the concomitant injection of methysergide, a serotonin receptor blocker (27.8 +/- 2.6 ng/mg protein). Amantadine, diazepam and haloperidol caused the largest decrease in the two regions. The mechanism of interaction and therapeutic implication of these findings are discussed. PMID- 3811836 TI - Pituitary apoplexy with sterile meningitis. AB - In 255 patients with evidence of a pituitary tumor, 7 patients presented with typical symptoms of meningitis, which all proved to be sterile. In these patients a pituitary adenoma was surgically verified in 4. In one patient the presence of acromegaly indicated a pituitary adenoma. In 2 patients an enlarged, empty sella was found, taken to reflect spontaneous disappearance of an adenoma. It is thought that the cause of the sterile meningeal reaction in the 7 patients was a spontaneous necrosis of the adenoma with expulsion of necrotic material into the suprasellar subarachnoid space. Although this sequence has been described before it has been considered to occur very rarely. Pituitary apoplexy as the underlying cause of meningitis should be suspected in patients with evidence of pituitary endocrine disturbances or lesion of structures adjacent to the fossa. The diagnosis may be established by computer tomography. Therapeutically, it may be of importance that the nature of the meningeal reaction is promptly recognized. Swift neurosurgical decompression of the sella and adequate hormonal substitution therapy may be essential. PMID- 3811837 TI - Zinc, total protein, and albumin in CSF of patients with cerebrovascular diseases. AB - Fifty-seven well-defined acute stroke patients were investigated for cerebrospinal fluid (CSF) concentrations of zinc (Zn), total protein, and albumin, as well as 6 patients with old infarctions. Significantly increased concentrations were found in patients with acute non-embolic and embolic infarctions and haemorrhage compared with patients having old infarctions or with the controls. The CSF-Zn concentrations in acute infarctions correlated significantly with the total protein and albumin concentrations of CSF. There was no significant difference in the CSF concentrations between the first and second lumbar puncture. The size of the infarctions on CT scan did not correlate with the CSF parameters. High CSF concentrations of Zn, total protein and albumin in acute infarctions related to a poor short-term prognosis. This study shows that CSF-Zn determinations in acute cerebrovascular diseases may be of diagnostic and prognostic value. PMID- 3811838 TI - Cerebral ischemic attacks as a complication of heart disease: the value of echocardiography. AB - The association of heart disease and cerebral ischemic attacks, and the usefulness of echocardiography in detecting heart disease and possible embolic source, were studied in 194 patients with transitory cerebral ischemic attack or stroke. The study revealed 95 patients with heart disease, and 63 of them had positive echocardiographic findings. All together, 35 patients had heart disease as a probable source for systemic embolism. An undetected cardiac disorder, not found by clinical examination or electrocardiography, was detected in 25 patients. The cardiac disorder found by echocardiography only, was most frequently aortic and mitral valve disease. Thus, echocardiography is an useful tool in detecting heart disease in these patients. PMID- 3811839 TI - Clinical and electrophysiological recovery from peroneal palsy. AB - Clinical examination, electromyography and conduction studies in motor and sensory fibres were performed in 14 patients with peroneal palsy of compressive or spontaneous origin. After a period of from 5 months - 3 years, the clinical and electrophysiological examinations were repeated. The rate of recovery was not uniformly good, as only 6 of 14 patients had a complete clinical recovery. Most patients had an incomplete electrophysiological recovery which only partly corresponded to the clinical findings. Electromyography and conduction studies in sensory and motor fibres were found to be of value in predicting the outcome of the peroneal palsy. PMID- 3811840 TI - Brush cytology from the uterine cervix. AB - Invasive carcinoma of the uterine cervix is a common neoplasm even in countries with extensive screening programmes of several years. The incidence rate per 100,000 is still around 18 in Denmark. The reasons for these persistently high rates of incidence despite various prophylactic measures are many and have been thoroughly discussed over recent years. It is imperative, however, to avoid sampling errors in screening procedures for precancerous lesions, especially erroneous interpretations arising from insufficient cytological material. To improve cytological sampling from the uterine cervix we decided to compare a recently introduced brush technique with the routine procedure in our hospital. PMID- 3811841 TI - Diagnostic and curative value of uterine curettage. AB - One hundred and eighty-one consecutive patients admitted for curettage because of irregular uterine bleeding were classified preoperatively as having postmenopausal bleeding, intermenstrual bleeding, menorrhagia, or metrorrhagia. They were followed up at 3 and 9 months after curettage with regard to diagnosis and cure. Fifty-seven per cent were cured; the lowest curative effect was found in patients suffering from menorrhagia. An etiological diagnosis was made in 90 patients; in the menorrhagia and postmenopausal groups, the lowest diagnostic value was found. Next to the histological report basal body temperature measurement was the best test to determine the etiology of the irregular uterine bleeding; hormone analyses and coagulation factors revealed the etiology in only a few cases. Intrauterine diseases were not diagnosed in patients below the age of 35 and it is suggested that curettage should not be used as first treatment in these patients. PMID- 3811842 TI - Epidural and paracervical blockades in obstetrics. Catecholamines, arginine vasopressin and analgesic effect. AB - A comparative study of analgesic and endocrinologic effects of obstetrical epidural anesthesia (EA, n = 23) and paracervical block (PCB, n = 39) was performed. Pain intensity was assessed on a horizontal linear scale. Simultaneously, blood samples for the determination of concentrations of norepinephrine (NE), epinephrine (E) and arginine vasopressin (AVP) were obtained. NE and AVP levels did not bear any relationship to pain scores. Instead, the average plasma E profile during labor was practically identical with the profile of pain scores. Plasma levels of E decreased significantly after EA. A similar but short-lived effect was observed also after PCB. When comparable doses of bupivacaine were used (30 mg in the EA group and 25 mg in the PCB group); initial pain relief after EA and PCB was similar, though after 30 min the pain score increased for patients who received the PCB, while patients who received EA had continued pain relief. Faster absorption of bupivacaine was observed after paracervical than epidural injection. Decreased variability was seen in the fetal cardiograms in 25% after EA and in 33% after PCB. Transient bradycardia was observed in 2 cases after paracervical injection. PMID- 3811843 TI - Human term placenta releases placental protein 10 (PP10) in tissue culture. AB - Placenta, decidua, chorion and amnion were studied to determine the tissue concentration of placental protein 10 (PP10). As measured by radio-immunoassay, all tissues studied were found to contain approximately the same concentration of PP10, in both early and late pregnancy. The release of PP10 was studied in tissue culture, first by using explants of placenta, decidua, amnion and chorion in four preliminary studies. Only the placenta released significant amounts of PP10 into the culture medium and, therefore, further studies were carried out with placental explants. In gel filtration, the bulk of PP10 in the culture medium eluted in the same position as purified PP10, and the dose-response curves of the two materials were parallel. The total secretion of PP10 into the culture medium was studied throughout 96 hours of incubation. Cycloheximide, a protein synthesis inhibitor, reduced the release of PP10 into medium by 31.3 +/- 12.5%. In cycloheximide-treated tissue cultures, the secretion of PP10 recovered when cycloheximide was replaced by original culture medium without cycloheximide. There results show that placenta is a major source of PP10. PMID- 3811844 TI - Circulating levels of placental protein 10 (PP10) in diabetic pregnancy. AB - Circulating levels of placental protein 10 (PP10) were measured in 217 heparinized plasma samples from 35 insulin-dependent diabetic patients and 90 samples from apparently healthy pregnant women between 15 and 40 weeks. In diabetic pregnancy between 15 and 40 weeks, the levels were significantly below normal (p less than 0.001). Decreased PP10 levels were seen especially in those cases where diabetic pregnancy was complicated by intra-uterine growth retardation, intra-uterine death, or severe congenital malformation. In 9 healthy pregnant women the PP10 levels were measured both in heparinized plasma and in serum samples. The plasma values were 76% of those in serum, suggesting interaction between PP10 and heparin. PMID- 3811845 TI - An evaluation of automated indirect blood pressure measurement during pregnancy. AB - An automatic microcomputer-assisted instrument (Dinamap) for indirect determination of blood pressure was evaluated in 10 healthy women in the last trimester of pregnancy. Blood pressure determined intra-arterially was significantly (p less than 0.001) higher than indirect blood pressure determined with the Dinamap instrument or by manual sphygmomanometry. However, there was no significant difference in the mean change in blood pressure determined by the three techniques under investigation. A close correlation was recorded between systolic and diastolic blood pressure determined intra-arterially and with the Dinamap instrument (r = 0.92, r = 0.90), and between blood pressure determined intra-arterially and indirectly by auscultation (r = 0.93, r = 0.81). There was no significant difference in the reproducability of individual blood pressure values determined intra-arterially (systolic, 2.4 mmHg, diastolic, 3.7 mmHg) or by the Dinamap instrument (systolic, 2.8 mmHg, diastolic, 3.4 mmHg) or by auscultation (systolic, 5.0 mmHg, diastolic, 4.9 mm Hg). The Dinamap instrument proved reliable for the measurement of changes in blood pressure during late pregnancy. The technique eliminates the problem of inter-observer error which otherwise becomes evident when checking blood pressure antenatally. PMID- 3811846 TI - Simultaneous recording of uterine and tubal motility during utero-tubal insufflation in monkeys. AB - One main cause of female infertility is the tubal factor, and interest in the role and function of the Fallopian tube has increased our knowledge about tubal infertility. In this study in monkeys, Cynomolgus (Macaca fascicularis), the tubal and uterine motility was recorded with a Millar microtransducer. The recordings were made during uterotubal, uterine as well as tubal insufflation with gas. Tubal activity patterns varied with the phase of the menstrual cycle. The kymograms made during gas insufflation did not reflect tubal or uterine activity, as registered by the Millar microtransducer, but rather the resistance to pressure of the intra-uterine part of the tube. An intra-uterine pressure up to 200 mmHg, has previously been regarded as being free from risk of uncontrolled escape of gas outside the uterus and the oviducts. This was not confirmed in the present study. PMID- 3811847 TI - Corpus luteum function after tubal sterilization using endothermic coagulation. AB - Following various methods of tubal sterilization, menstrual disturbance have been reported. One reason for these might be a change in ovarian function caused by interruption of blood supply or nervous supply to the organ. In order to prospectively evaluate the corpus luteum function following tubal sterilization, plasma progesterone determinations were made during one menstrual period 2-3 months and even years after the operation performed by means of endothermic coagulation. The levels of progesterone in plasma during the menstrual period before the operation were used for comparison. When using endothermic coagulation as a method of sterilization there seem to be no signs of changed corpus luteum function either, months or years after the operation. PMID- 3811848 TI - Non-steroid hormones and tissue polypeptide antigen (TPA) in emetic and non emetic pregnancy. AB - In order to investigate further the endocrine and metabolic features of the common condition emesis gravidarum, serum concentrations of some non-steroid hormones and tissue polypeptide antigen (TPA) were determined in 102 healthy pregnant women. 62 complained of nausea and vomiting in early pregnancy. Significantly higher and lower levels of human chorionic gonadotropin were noted in early and late pregnancy, respectively, in women with emesis gravidarum. A significant rise in serum prolactin and TPA was found throughout pregnancy in all subjects, no differences between emetic and non-emetic pregnancies being registered. Serum concentrations of growth hormone (hGH) showed a significant decline as pregnancy advanced. Emetic women demonstrated higher hGH levels in late pregnancy than did asymptomatic subjects. Free T4 concentrations remained stable when comparing early with late pregnancy, no dissimilarities being found between women with and without nausea and vomiting in pregnancy. These data do not support the hypothesis of major metabolic disturbances as an etiologic factor for nausea and vomiting in pregnancy. However, as overt differences between emetic and non-emetic pregnancy were found, hormonal factors may be involved in the pathogenesis of this condition. PMID- 3811850 TI - Vaginal erotic sensitivity by sexological examination. AB - We studied vaginal erotic sensitivity by vaginal sexological examinations as part of the evaluation and treatment process of couples complaining of female coital anorgasmia but readily orgasmic at female self--or partner-performed external genital stimulation. The existence on the anterior vaginal wall of an anatomically clearly definable erotically triggering entity, termed "The G Spot", was refuted by our findings. The entire anterior vaginal wall, including the deeper situated urinary bladder, periurethral tissues and Halban's fascia, rather than one specific spot, were found to be erotically sensitive in most of the women examined, and 64% of them learned how to reach orgasm by direct specific digital and/or coital stimulation of this area. All other parts of the vagina had poor erotic sensitivity. This supports our conceptualization of a 'clitoral/vaginal sensory arm of orgasmic reflex' including the clitoris, the entire anterior vaginal wall as well as the deeper situated tissues. Instead of looking for a 'vaginal (coital) orgasm' distinctly different from a 'clitoral orgasm', this concept speaks towards a 'genital orgasm' potentially achievable by separate or, most effectively, combined stimulation of those different trigger components of the genital sensory arm of the orgasmic reflex. The format and technique of the vaginal sexological examination are described, and its possible applications and limitations are discussed. PMID- 3811849 TI - Subjective recording of fetal movements. III. Screening of a pregnant population; the clinical significance of decreased fetal movement counts. AB - In order to determine the clinical significance of decreased fetal movement counts, pregnancy outcome was compared between women with decreased fetal movement counts on their Fetal Movement Charts (FMC) (n = 161) and women with normal fetal movement counts (n = 1,354). 1,515 women in the third trimester of pregnancy counted fetal movements for 15 min in the evening and noted the count on a FMC. An individual lowest normal limit for the number of fetal movements was calculated from the first five consecutive counts. A decrease in fetal movements was defined as two consecutive counts below the lowest limit (alarm signal). The alarm signal was associated with an increased risk of placental insufficiency (p less than 0.001) and imminent premature labor (p less than 0.001) and thereby indirectly with an increased risk of the birth of a baby with birth weight less than 2,500 g (p less than 0.05), preterm baby (p less than 0.05) or small-for gestational age baby (p less than 0.05). The alarm signal was also associated with an increased risk of the birth of babies with congenital malformations (p less than 0.05), respiratory disturbances (p = 0.01) and hypoglycemia (p less than 0.05). The short-term method of fetal movement counting can be used to preselect a group of pregnant women whose unborn fetus is at particular risk. PMID- 3811851 TI - Degradation of parathyroid hormone by placental homogenate. AB - Degradation of the bovine parathyroid hormone (PTH) fragment (amino acids 35-84) up to 70% was observed during passage through human placenta in an in vitro perfusion model. Fractionation of the subcellular fractions of human placental homogenate revealed the degradation to take place only in the mitochondrial fraction. It is concluded that human placenta, like kidney and liver, has the ability to degrade PTH. PMID- 3811852 TI - The use of magnesium sulfate for tocolysis in preterm labor complicated by twin gestation and betamimetic-induced pulmonary edema. AB - Maternal cardiorespiratory compromise has been reported to occur during the treatment of preterm labor with tocolytic agents. The risk for these complications is increased by the following factors: multiple gestation, the combination of magnesium sulfate and beta-adrenergic agonist, and the use of adrenocortico-steroids to hasten fetal pulmonary maturity. A case is presented of labor at 28 weeks' gestation complicated by pulmonary edema associated with the three risk factors listed above. The beta-agonist was discontinued with resolution of pulmonary edema. Intravenous magnesium sulfate was continued for 11 days. When uterine contractions finally overcame the tocolysis, delivery occurred. It appeared that uterine quiescence was achieved through the continued use of magnesium sulfate despite pulmonary edema in this case. The risk of continued tocolysis seemed to be counterbalanced by the benefits of prolonged intra-uterine existence for the fetuses. PMID- 3811853 TI - Survival of the second twin 37 days after abortion of the first. PMID- 3811854 TI - Didelphic uterus, atretic unilateral vagina communicating with a double vagina, ipsilateral renal hypoplasia and ectopic ureter. AB - A case of didelphic uterus, unilateral atretic vagina with a small communication and a right-sided hypoplastic kidney is presented and illustrated by 'fistulography' and HSG. When a communication between the atretic and the normal vagina is present, the symptoms are often vague, clinically puzzling and can easily be misinterpreted. Because of the close relationship between the development of the urinary and the female genital tract, concomitant malformations are commonly found. PMID- 3811855 TI - Pararectal abscess with pelvic extension simulating gynecological disease. AB - An anal fistula sometimes takes a high intersphincteric course eventually forming a pelvic extension, with abscess formation above the levator plate. Such a case, simulating gynecological disease, is presented and the differential diagnostic procedures are discussed. PMID- 3811856 TI - Pelvic oxyuriasis. PMID- 3811857 TI - Typhoid fever in pregnancy. Case report and review of the literature. AB - The clinical details of two cases of typhoid fever in pregnancy are described. The first patient contracted the disease in the third trimester, with successful outcome for both mother and baby. The second patient became infected in the first trimester, with the complication of underlying cardiac disease. This resulted in typhoid endocarditis contributing to fetal loss. A survey of the literature is presented and treatment recommendations outlined. PMID- 3811858 TI - Extra-uterine mullerian carcinosarcoma. AB - Carcinosarcoma of the Mullerian system is an uncommon tumor. We report here a case of extra-uterine carcinosarcoma from pelvic wall, presenting 11 years after hysterectomy. Accidental surgical implantation of endometrioid cells is suggested as the pathogenic mechanism in this case. PMID- 3811859 TI - Ovarian carcinoma masquerading as ovarian hyperstimulation syndrome. AB - Two patients receiving ovulation-inducing drugs were found to have ovarian carcinoma. Since patients receiving such medication are prone to develop enlarged ovaries with or without the fully developed hyperstimulation syndrome, the diagnosis of ovarian tumors in such patients may be delayed or missed. It is therefore being suggested that an ovarian enlargement persisting for more than 4 weeks, or the finding of ovarian solid masses by sonography in patients receiving ovulation-inducing drugs, should lead to a thorough work-up for neoplasia, sometimes including even laparotomy. PMID- 3811860 TI - Some components affecting the precision of corneal thickness measurement performed by optical pachometry. AB - With the Haag-Streit pachometer attached to a Haag-Streit 900 slit-lamp, 29 normal individuals were examined by repeated measurements on two separate days by the same observer. A statistical variance component model admitted three components of variance to be separated and estimated as SD: The biological day to day variation (0.006 mm), the variation attributed to the slit-lamp adjustment (0.005 mm), and the variation derived from the adjustment of the pachometer (0.013 mm). Knowing these components an optimum practical procedure of examination can be established. PMID- 3811861 TI - Tear film flow and stability in herpes simplex keratitis and chronic blepharitis. AB - Tear film flow and stability studies were carried out in patients suffering from herpes simplex keratitis and chronic blepharitis by performing Schirmer test I and tear film break-up-time (BUT) measurements. In herpes simplex keratitis the values of BUT were within normal limits. Values of Schirmer test I were significantly higher (t-test, P less than 0.001) in these patients and are considered to be due to reflex hypersecretion of tears. Schirmer test I was found to be unaffected, whereas the values of BUT seen were significantly lower (t test, P less than 0.001) in patients suffering from chronic blepharitis. These lower values of BUT can perhaps be attributed to the altered resurfacing of precorneal tear film as a result of changes in the lid margins. PMID- 3811862 TI - The presence of a contact lens induces a very small increase in the anterior corneal surface temperature. AB - The anterior corneal surface temperature beneath a contact lens covering the cornea was determined from measurements of the average heat flow from the cornea to the atmosphere (efflux) in a group of 13 healthy young subjects. The average heat efflux was 1.1 X 10(-2) cal X cm-1 X sec-1. The mean corneal surface temperature of the same group was 34.5 degrees C for the open eye and 36.2 degrees C for the closed eye conditions. The anterior corneal surface temperature beneath a 0.07 mm thick hydrogel contact lens (40% water content) was found to be 34.6 degrees C (rise of 0.1 degree C) and 34.9 degrees C (rise of 0.4 degree C) beneath a 0.3 mm thick hydrogel contact lens (40% water content), using the measurement of corneal heat efflux and taking the contact lens to have a slight insulating effect. Contact lenses of higher water content caused a smaller rise in anterior corneal surface temperature than lenses of lower water content. PMID- 3811863 TI - Acute glucose-derived osmotic stress in rabbit lenses. AB - The morphological changes observed in rabbit lenses incubated without corpus vitreum in medium whose glucose concentration varied cyclically between normoglycaemia and hyperglycaemia were analyzed for the location of light scattering vacuoles. Minimal changes were seen in the epithelial cells, the external bow fibres and the lens nucleus, while maximal changes with vacuolization and damage were seen in the posterior part of the inner bow fibres. It was shown that the exchange of water takes place mainly across the posterior capsule. The susceptibility of this region in part may be due to the low aldose reductase activity in this region of the lens. PMID- 3811864 TI - Complications and visual outcome 4 months after extracapsular cataract extraction with implantation of posterior chamber lenses. A prospective clinical study. AB - Sixty-seven patients were examined 3 to 5 1/2 (mean 4) months after intended extracapsular cataract extraction with implantation of the 3 M, style 83, posterior chamber lens. A visual acuity greater than or equal to 0.5 was recorded in 58 (86.6%) of the patients. The complications were: one (1.5%) case of acute iritis, one case of pupillary capture and two (3.0%) cases of capsulotomy requiring early secondary cataract. There were no posterior segment complications. None of the patients were treated with anti-glaucomatous medication, and none had intraocular pressure above 20 mmHg. Pre-operatively, biometry was performed, and the SRK-formula was employed in estimating the post operative spherical equivalent refraction: The actually measured refraction differed less than 2 diopters from the predicted refraction in 84.5% of the cases. PMID- 3811865 TI - Retinal detachment after intraocular lens implantation. AB - Between August 1982 and July 1985, 19 eyes were operated for pseudophakic retinal detachment (PRD) (Anterior chamber lens in 13 eyes, posterior chamber lens in 3 eyes and iris supported lens in 3 eyes). The characteristics of these pseudophakic retinal detachments were very similar to those following intracapsular cataract extractions. Retina was re-attached in 18 eyes (95%), in 14 eyes, after one buckling procedure. In 4 eyes, altogether 12 surgical procedures were needed to re-attach the retina. Problems to visualize the peripheral retina, made it necessary to remove the IOL in 3 eyes (2 iris fixated and one in the anterior chamber). PMID- 3811866 TI - The intensity of the light reflex on retinal arteries and veins. AB - The intensity profiles of the central light streak on various sized retinal vessels were measured by a computerized high quality scanning microphotometer. From the fundus photographs in 40 young men 240 arteries and 240 veins were analysed, and light streaks were found on 171 arterial and 170 venous sites. Differences in reflected intensities between arteries and veins and between small and large vessels were studied. In the whole range of vessels measured (50-200 microns) significantly higher intensities were found on arteries compared to veins (P less than 0.01). Large vessels (100-200 microns) reflected the light more intensely than small vessels (50-99 microns) (P less than 0.001). Variations in haemodynamics of flow and in physical properties of the streaming erythrocytes might account for the reflectivity differences between arteries and veins. PMID- 3811867 TI - Interindividual variation and additivity of the visual evoked potentials to the local checkerboard stimulation of the central and paracentral retina. AB - Visually evoked cortical potentials to reversing checkerboard stimulation were recorded from normal subjects. Different locations of the central visual field of maximally 8 degrees radius were stimulated. Stimulation of various parts of the central visual field changed the waveform and the amplitude of the responses of different subjects very individually. This makes it impossible to make a universal decision, how large field or which part of the central field contributes most to pattern evoked cortical potentials. The responses to the upper half field stimulation showed greatest variation making the VEP recording worthless in detecting altitudinal visual field defects. The computed sum of the half field responses was of similar waveform and amplitude to the response to the full field stimulation. The good additivity of the responses applied to all parts of the central visual field tested. PMID- 3811868 TI - Contrast sensitivity in amblyopia. II. Changes during pleoptic treatment. AB - Contrast sensitivity at spatial frequencies 1-19 c/deg was measured in 56 children (mean age 10 years), who had received pleoptic treatment. Measurements were done at the beginning and at the end of a pleoptic treatment period as well as at follow-up using vertical gratings. A deficiency was observed in contrast sensitivity of amblyopic eyes at all spatial frequencies, but it was most notable at high spatial frequencies. Both types of CSF presented by Hess & Howell (1977) were found in all groups of amblyopia. A statistically significant improvement in the mean value of contrast sensitivity of the amblyopic eyes was observed at all spatial frequencies during the pleoptic treatment, although in 12 cases fixation and vision did not improve. Correlation with the improvement in visual acuity was poor. In several cases a change was observed in only one of the two parameters in question. Regarding the better eye, there were some signs of 'hidden occlusion amblyopia': in a few cases contrast sensitivity of the dominant eye deteriorated during the treatment period without a changes in visual acuity only to risk back to the previous level at the follow-up. PMID- 3811869 TI - Contrast sensitivity in amblyopia. IV. Assessment of vision using vertical and horizontal gratings and optotypes at different contrast levels. AB - The contrast sensitivity of 49 amblyopic children (mean age 9 years) was measured in the beginning and at the end of a treatment period using both vertical gratings and optotypes (LH-4 contrast test) at 2, 3, 5 and 75% contrast. The contrast sensitivity of 37 patients was also measure using horizontal gratings. The contrast sensitivity of the dominant eyes measured with vertical gratings was generally higher than when measured with horizontal gratings. The difference was statistically significant at spatial frequencies 1 and 6 c/deg. A similar difference was present in the amblyopic eyes only at the spatial frequency 1 c/deg both before and after the treatment. Individual variation was great; in a given patient the relationship between the two measurements varied from one spatial frequency to the next. It has been shown in earlier investigations that contrast sensitivity measurements using gratings reveal important new information in the study of amblyopia. Both tests, used in this investigation, measure visual function in the low contrast domain and improve follow-up of the changes in vision during treatment of amblyopia when used in addition to visual acuity measurements. Low contrast optotype test seems to measure contrast sensitivity in amblyopia closely similarly to the grating test. The slight difference in detecting a 'hidden occlusion amblyopia' at the intermediate spatial frequencies needs further study. PMID- 3811870 TI - Screening of infants for strabismus and refractive errors with two-flash photorefraction with and without cycloplegia. AB - 35 1/2-year-old and 31 1-year-old children were screened by two-flash photorefraction for strabismus and refractive errors with and without cycloplegia. The sensitivity of the method to detect refractive errors was tested with an optical demonstration eye. All the children were examined clinically to compare the sensitivity of the method. Every child co-operated with the photography, but 4 children did not co-operate in the clinical examination and were thus excluded from the refractive material, as were also two cases of esotropias which were found. There were no false positive or negative strabismus cases. The total refractive material consisted of 120 eyes. The method was clearly more sensitive for refractive errors with cycloplegia. Even one hyperopia of +5.25 D(OD) and +6.0 D(OS) was underestimated without cycloplegia. In the material there were no cases of anisometropia of over 1.0 D in spherical equivivalent that would cause a potential risk for amblyopia. A rather good correlation of refractive results existed with the method in cycloplegia. With partial overlapping of emmetropic and moderate hyperopic cases. The screening of children aged 1/2-1 year with two-flash photorefraction is simple to perform. The underestimation of symmetrical hyperopias should be accepted when cycloplegia is not used. Only one successful photograph of each child is necessary for the interpretation. PMID- 3811871 TI - Breakdown of the blood-retinal barrier in multiple sclerosis measured by vitreous fluorophotometry. AB - Periphlebitis retinae in multiple sclerosis appears as transitory cellular infiltrations around veins in an otherwise normal retina. Similar cellular infiltrations have been found around veins in the central nervous system. In the present study the blood-retinal barrier has been investigated by vitreous fluorophotometry. Eight multiple sclerosis patients with actual periphlebitis retinae and 9 patients with previous but not active periphlebitis retinae were included in this study. Abnormal leakage of fluorescein was manifest in the group of multiple sclerosis patients with periphlebitis retinae. Permeability (1.8 +/- 0.2 X 10(-7) cm/sec; mean +/- SEM) but not in the control group as a whole permeability (1.3 +/- 0.1 X 10(-7) cm/sec; mean +/- SEM) compared to 17 normals (permeability 1.1 +/- 0.005). It is thus concluded that breakdown of the blood retinal barrier may be transitory when connected with periphlebitis retinae in multiple sclerosis. PMID- 3811872 TI - Limbal and axial chamber depth variations. A population study in Eskimos. AB - In an unselected population sample of 505 adult Greenland Eskimos limbal chamber depth (LCD) was estimated according to van Herick et al. (1969), and axial chamber depth (ACD) was measured optically using Haag Streit pachymetry. For comparison LCD was estimated in 308 Danes above 40 years. A marked naso-temporal asymmetry in LCD scoring was found indicating a shallower chamber at the temporal limbus. No corresponding gonioscopic asymmetry was observed. Significant age, sex, and ethnic variations were demonstrated, the lower levels of both parameters being found in elderly persons, women and Eskimos, respectively. Danes showed a lower level of LCD scores than reported in Americans. In detection of eyes showing shallow chambers in the Eskimo population (arbitrarily: ACD less than or equal to 2.0 mm) the van Herick slit-lamp test at temporal limbus yielded a sensitivity of 91%, a specificity of 53% and predictive values of a positive and a negative test of 30% and 96%, respectively. At gonioscopy narrow angles were often found among eyes showing LCD less than or equal to 1/4 of corneal thickness, even when ACD was greater than 2.0 mm (in 25%). PMID- 3811873 TI - Prognostic factors in the development of manifest open angle glaucoma. A long term follow-up study of hypertensive and normotensive eyes. AB - Ninety-three patients, who during a mass screening for glaucoma in 1962-63 attended a thorough ophthalmological examination, were re-examined in 1980-82. At the mass screening 42 patients had IOP greater than or equal to 21 mmHg in at least 1 eye, but none of the 93 patients had glaucomatous optic disc excavations or visual field defects. At the re-examination, 28 patients (30.1%) had developed manifest open angle glaucoma in at least 1 eye. This development was significantly correlated to the height of the IOP, both at the mass screening, during the period of observation and at the follow-up study (P less than 0.05-P less than 0.002). A reduced outflow facility measured at the mass screening was also significantly associated with the later development of manifest glaucomatous damage (P less than 0.05-P less than 0.01). In addition, fibrillopathy (pseudoexfoliation), manifest glaucoma in the 'fellow eye' and a positive family history for glaucoma were found to be important risk factors. PMID- 3811874 TI - Timolol and cornea. AB - The influence of timolol on the corneal epithelium and endothelium was studied in organ culture. The cell morphology was not influenced by drug concentrations less than or equal to 690 micrograms/ml. Cell death was observed at 6900 micrograms/ml. Endothelial cell proliferation after an experimental injury was slowed down at a drug concentration of 690 micrograms/ml. Injurious effects were not observed at the drug concentrations found in the aqueous humour by use of ophthalmic eye solution in eyes with a normal cornea. However, it may be indicated to use eye drops with reduced concentration of timolol in conditions facilitating the resorbtion of the drug. PMID- 3811875 TI - Characteristics of corneal endothelial cells in Fuchs' heterochromic cyclitis. AB - We studied the corneal endothelial cells in 14 patients (6 men and 8 women, ranging in age from 15 to 70 years) with unilateral Fuchs' heterochromic cyclitis (FHC) by means of specular microscopy. The healthy fellow eyes of the patients served as control material. Two affected eyes had undergone an intracapsular cataract extraction before specular microscopy. In one patient, the cyclitic eye also had glaucoma. Changes of the endothelium characterized by intra- and intercellular dark bodies, larger dark defects spanning several endothelial cells and bright irregular patchy areas crossing cell borders on the specular reflex were found in all eyes with FHC. Individual cell analysis did not reveal any significant differences in the endothelial cell density, cell area, coefficient of variation for cell area, cell perimeter, cell shape and in the number of endothelial cell apices between unoperated cyclitic and healthy fellow eyes. The mean cell density was 4.9% lower in the unoperated eyes with FHC than in the control eyes. A significant negative correlation was observed between the patients' age and the cell density both in the healthy and the cyclitic eyes. On the other hand, the correlation between follow-up period and cell density was not statistically significant in the cyclitic eyes. Although FHC does not seem to accelerate significantly the age-related cell density reduction, the magnitude of the cell loss found in the two operated eyes (45.5% and 49.8%) and in the eye with glaucoma (45.2%) may indicate altered tolerance against endothelial traumas in this disease. PMID- 3811876 TI - Serum fibrin degradation products in acute idiopathic anterior uveitis. AB - Levels of serum fibrin degradation products were measured by the Staphylococcal clumping test in patients with acute idiopathic anterior uveitis and traumatic anterior uveitis. We found them to be significantly increased (P less than 0.001) in patients with acute idiopathic anterior uveitis (11.0 micrograms/ml). The extent of this increase in the serum levels of fibrin degradation products correlated well with increased severity of the disease. It showed return to normal levels (5.0 micrograms/ml) with the clinical improvement. It increased again with the re-appearance of acute stage of the disease. We found no alteration in the levels of serum fibrin degradation products in patients with traumatic anterior uveitis. We hypothesise that uveal deposition of immune complexes causes secondary platelet damage and intravascular coagulation which results in uveal tissue damage through inflammation. PMID- 3811877 TI - Closed-lid factors influencing human corneal oxygen demand. AB - A micropolarographic system was used to measure the flux of oxygen crossing the tear-epithelial interface of the human cornea just following stabilization of four lid closure conditions. In all, 215 oxygen flux measurements were made on the corneas of 6 young healthy subjects, including 2 reference conditions: the normal open eye and anterior surface oxygen deprivation. When compared with the temperatures associated with certain of those conditions, oxygen demands greater than those predicted by a previous Q10 measurement were found. Proportional contributions of the non-temperature factor are presented, and the nature of its components suggested. PMID- 3811878 TI - Rabbit corneal endothelial physiologic and morphologic characteristics following storage in MK medium and K-Sol. AB - Rabbit corneas were stored for 3, 7, 10 or 14 days in MK medium or K-Sol. Corneas were thinner immediately following removal from K-Sol than following removal from MK medium at all time periods studied. Following 3 days of storage, corneas stored in both solutions showed similar temperature reversal characteristics. Corneas stored for 7 and 10 days in MK medium also temperature reversed, whereas those stored in K-Sol did not. Corneas stored for 14 days in both solutions swelled following mounting in the specular microscope. Endothelial cell morphology was similar following storage in MK medium and K-Sol at all time periods studied. It is postulated that a persistant osmotic gradient is present across the endothelium following storage in K-Sol. This osmotic gradient occurs because of retention of chondroitin sulphate in the corneal stroma thereby preventing early temperature reversal. PMID- 3811879 TI - In vitro and in vivo growth of an intraocular retinoblastoma-like tumour in F-344 rats. AB - Retinoblastoma-like cells grew in colonies on the bottom of tissue culture flasks. The population doubling time was 19 h. Tumour cells from cell cultures had a 39% plating efficiency, and fresh tumour cells from intraocular tumours had a 32% plating efficiency in colony forming assays. Inoculation of 1.5 X 10(4) tumour cells in the vitreous of F-344 rats resulted in a 100% tumour take and regularly growing tumours with a doubling time of 3 days. The tumour take-rate was not changed in wholebody immunosuppressed animals. The tumour volume was assessed under a stereo microscope, and it was possible to divide the tumours into 4 groups according to the number of intraocular tumour cells. Tumour growth caused eye perforation in 89% of the inoculated eyes. Spontaneous tumour regression was not seen in non-perforation groups. Immunosuppression with whole body irradiation and dense traumatic cataract had no significant effect on the growth. It is concluded that this animal retinoblastoma-like tumour is suitable for quantitative therapy studies in vivo and in vitro. PMID- 3811880 TI - Two years' clinical experience with the preferential looking technique for visual acuity determination in infants and young children. AB - Two years' experience with a preferential looking technique for visual acuity determination was evaluated. Ninety-three patients were tested during this period, but selected groups (34 patients) were reported on earlier. In 59 patients aged 2 months to 13.75 years 131 testing procedures were performed. Diagnostic groups included uncomplicated strabismus (n = 26), strabismus combined with neurological disturbances (n = 16), neurological disturbances alone (n = 11) and other ocular diseases (n = 6). In addition, several of the children were mentally retarded. In 52 of the 59 patients in this study valuable results were obtained, while no useful information could be gathered from the remaining 7 patients. The findings influenced therapy strategies in 24 patients, and subsequent testing reflected therapeutic effectiveness. The test was successful in 7 of 8 patients referred from other clinics for estimation of visual function. Although established acuity thresholds should be regarded as conservative estimates, and not directly comparable to Snellen letter acuity notations, the preferential looking technique proved to be quite valuable in a paediatric ophthalmology unit. Main indications were amblyopia detection, control of therapeutic measures in strabismics, including pre-operative evaluation, and estimation of visual capacity in children with psychomotor retardation. PMID- 3811881 TI - Spatial characteristics of the oscillatory potentials of the electroretinogram. AB - The spatial properties of the trans- and intra-retinal oscillatory potentials (OPs), a- and b-waves of the mudpuppy electroretinogram (ERG) were analyzed. A comparison of the intra-retinal potentials was made with the proximal negative response (PNR), an extracellular response, predominantly from amacrine cells. The spatial characteristics of the OPs differed from the a- and b-waves and the PNR. The OPs integrated spatially up to full field illumination. They seem to represent summated neuronal activity over broader areas than that of the PNR and the a- and b-waves. The results indicate that the OPs reflect activity of second order neurons to which visual information converge from the whole retina. These neurons may be the bipolar cells. No evidence that the OPs orginate in the laterally extending amacrines was obtained. The b-wave data further suggested a centre-surround organization for the neurons indirectly involved in the b-wave generation. PMID- 3811882 TI - Objective evaluation of binocular function with pattern reversal VER. III. Effect of stimulus size and localization. AB - The effect of central and peripheral stimulus field on monocular and binocular amplitude and binocular summation of the pattern reversal VER were investigated. When the central stimulus field size was smaller than 2.0 degrees X 2.0 degrees, there was no significant difference between the amplitudes of the monocular and binocular VER, but when it was equal to or larger than 2.4 degrees, the binocular VER amplitude was significantly larger than the monocular. The value of the binocular summation was highest at the central stimulus field size of 4.0 degrees X 4.0 degrees; at larger sizes, there were no significant changes in the value. Use of a central stimulus field size larger than 2.4 degrees X 2.4 degrees was therefore considered a prerequisite for the effective assessment of visual function, especially binocular function using the pattern reversal VER. Regarding the effect of peripheral stimulus field, both the monocular and binocular VER, but particularly the latter, were found to be sensitive to the central scotoma produced by covering the center of the full-field stimulus. The value of the binocular summation showed a significant reduction with the small central scotoma. We concluded that the pattern reversal VER is very sensitive to a central scotoma and that binocular function is mediated mainly through the central part of the stimulus field. PMID- 3811883 TI - Hip arthroplasty for congenital dislocation. AB - From 1974 through 1981, total arthroplasty was performed for arthrosis following congenital dislocation in 25 hips in 17 patients. Pain was the main indication for surgery. Early complications were two dislocations and one deep venous thrombosis. One malpositioned socket and one loosening of the femoral prosthesis and socket were revised. At follow-up 2-9 years postoperatively, 16 hips were excellent, eight good, and one poor. The dysplastic pelvis and femur require implants of special design, and the original acetabulum should be prepared and reinforced at surgery. A radiographic method for calculation of the center position of the hip before and after surgery proved simple and exact. PMID- 3811884 TI - Metal ions in body fluids after arthroplasty. AB - We measured levels of metal ions in urine and plasma of 17 patients 7-15 years after they had a Co-Cr-Mo alloy total hip replacement. They had higher levels of cobalt and chromium than controls. No case of skin sensitivity to the investigated metals was observed. The values of cobalt and chromium in plasma and urine were considerably lower than in professionally exposed groups and do not represent a toxic hazard for the patients. PMID- 3811885 TI - Wear of the Christiansen hip prosthesis. AB - The wear was examined in 39 Christiansen total hip prostheses, which were removed because of mechanical loosening after being used 5 (3-11) years. In the polyacetal acetabular cups, the head had made an eccentric defect, the mean volume of which was 680 (180-3310) mm3. The mean penetration of the head into the wall of the cup was 0.8 (0.1-3.2) mm. In two additional cups the head had penetrated right through the wall of the cup. In three prostheses the polyacetal sleeve of the trunnion was so worn that the head bore directly on the stem. There was a positive correlation between wear and the time the prostheses had been used before symptoms of loosening presented. PMID- 3811886 TI - Epidemiology of diaphyseal femoral fracture. AB - The incidence of diaphyseal femoral fracture in adults, aged 20 years and older, was determined in Stockholm County using hospital admission rates. The validity of the data was investigated by a study of the medical records of a sample of 277 cases and also by determining the incidence in a subpopulation of 139 cases using an alternative method. The incidence decreased from age 20 to middle age after which it increased into old age. The age-related increase was more pronounced in women and in fractures caused by moderate trauma. From 1972 to 1981, the incidence of diaphyseal femoral fracture caused by moderate trauma increased annually by 10 per cent in women aged 75 years and older. PMID- 3811887 TI - Hip fracture frequent in hospital. AB - In the year 1982, 112 hip fractures - cervical and trochanteric - were recorded in residents of Malmo after having been admitted to hospitals. During that same year, a total of 463 hip fractures occurred in the city. The risk of sustanining a hip fracture was 11 times greater in hospital patients aged 50 years or more than in persons of the same age who had not been admitted to hospitals. PMID- 3811888 TI - The second hip fracture. An epidemiologic study. AB - We studied a group of 151 patients who were treated for various types of fractures and who all had a history of a previous hip fracture. A subgroup with new hip fractures had few of their second fractures on the same side as the initial fracture. It appears that a hip fracture reduces the risk of a subsequent hip fracture on the same side to one fourth and that cervical fractures reduce this risk to one sixth. A tendency was found for the hip fracture to be of the same type as the previous one. The time between the first and the second hip fracture was twice as long in those with a previous cervical fracture as in those with a previous trochanteric fracture. PMID- 3811889 TI - Refracture of the hip rare after removal of fixation device. AB - We studied 99 patients who had had the fixation device removed from a healed hip fracture. During a total of 630 patient years 17 second hip fractures were observed, but only two of these were in the previously fractured hip. We conclude that the fixation device may be safely removed from a healed hip fracture. PMID- 3811890 TI - Posterior instability of the shoulder. A cadaver study. AB - In a cadaver study of 15 shoulder specimens, the internal rotation of the joint was measured applying a constant internal torque of 1.5 Nm to the humerus. The specimens were suspended with the medial border of the scapula in vertical position. A lever fixed to the humerus was fitted with strain gauges for measurement of internal torque and sensors for measurement of internal rotation at different degrees of abduction from 0-90 degrees. Cutting the teres minor and infraspinatus muscle tendons increased internal rotation in the first 40 degrees of abduction. Internal rotation was further increased in this range by cutting also the proximal half of the posterior capsule. Lesion to the posterior capsular structures alone increased internal rotation from 40 degrees of abduction. In conclusion, among the posterior structures of the shoulder joint, the teres minor and the infraspinatus muscle tendons stabilize the joint for internal rotation in the first half of abduction, and the lower half of the capsule in the last part. PMID- 3811891 TI - Hematogenous osteomyelitis in children. AB - In a 10-year period, 31 children, including 9 infants, were treated for hematogenous osteomyelitis. Fifteen children were treated closed and 16 open. Thirteen of 14 positive cultures were Staphylococcus aureus. Three recurrences could possibly have been prevented by a more aggressive primary approach. At follow-up after 5 (1-12) years, 3 neonates had developed severe growth disturbances despite optimal initial treatment. Acceptable results were obtained with antibiotic therapy for 6 weeks or more. We recommend ampicillin and a penicillinase-resistant penicillin, unless bacterial resistance patterns indicate a different antibiotic. We operate if pus has formed and if a child with severe symptoms does not improve during adequate antibiotic treatment and immobilization. PMID- 3811892 TI - Internal pressure in soft-tissue tumors. AB - The internal pressure was measured in 25 soft-tissue tumors in 24 patients. High pressure was associated with pain at rest and tumor necrosis. PMID- 3811893 TI - Replantation of a leg in an adult with 6-years' follow-up. AB - After traumatic amputation of the distal half of the leg, a replantation was carried out using microsurgical technique in a 24-year-old lumber mill worker. He returned to his job after 1 year, and 6 years after the accident he had good function and satisfactory sensibility in the sole of his foot. The case shows that even a lower limb replantation may give useful results under favourable conditions. PMID- 3811894 TI - Median nerve entrapment in elbow dislocation. A case report. AB - When the elbow dislocated posteriorly in an 11-year-old boy the median nerve was caught behind the medial epicondyle and in the joint. The condition was diagnosed at 7 months when a total paralysis had developed. Good function was obtained after neurolysis. This rare condition has typical signs and symptoms which should permit an earlier diagnosis. PMID- 3811895 TI - Painful fabella. A case report with review of the literature. AB - Fabellectomy gave immediate and continued relief of symptoms to a patient with pain of long duration in the lateral aspect of both popliteal fossae. Attention should be given to pathologic changes of the fabella in cases with intermittent posterolateral knee pain and normal examination of the knee, except for tenderness on pressure over the fabella. The clinical importance of the fabella is discussed with special regard to chondromalacia. PMID- 3811896 TI - A case of accessory calcaneus. AB - A 5-year-old boy had accessory calcaneus (os trochleare) with pain, shoe pressure, and a varus position of the foot not reported previously. He became free from his symptoms after the abnormal bone had been excised. PMID- 3811897 TI - [Functional subtotal laryngectomy with cricohyodopexy]. PMID- 3811898 TI - [Stromal reaction, tissue eosinophilia and mastocytosis in carcinoma of the larynx]. PMID- 3811899 TI - [Treatment of carcinoma of the tongue: results of a retrospective study]. PMID- 3811900 TI - [Surgical therapy of primary hyperparathyroidism: considerations on 15 operated cases]. PMID- 3811901 TI - [Brain stem auditory evoked potentials in hypnosis]. PMID- 3811902 TI - [Battery of vocal tests in the evaluation of minimal auditory capability: a normative study]. PMID- 3811903 TI - [Role of posturography in vertigo]. PMID- 3811904 TI - [Magnetic resonance in the topodiagnosis of vertiginous syndromes of central origin]. PMID- 3811905 TI - [Bilateral paralysis of the 6th cranial nerve: a rare complication of isolated sphenoid sinusitis]. PMID- 3811906 TI - Infantile digital fibromatosis. An electron microscopic and immunohistochemical study. AB - Three cases of infantile digital fibromatosis were studied by electron microscopy and immunohistochemistry. The tumor was made up equally of myofibroblasts containing long narrow bundles of microfilaments with dense bodies. Another striking feature was the intracytoplasmic electron-dense inclusion. The inclusions were constituted of packed fibrils similar to those of the long bundles. At the periphery of these inclusions were seen prominent felt-like filamentous structures; the diameter varied from 5-12 nm. The 10 nm filaments were seen most abundantly in the cytoplasm surrounding the inclusions, but sometimes they were also found within the inclusions themselves, mainly at their periphery. These findings suggest that the inclusions may represent an abnormal accumulation of cytoskeletal proteins. On the other hand, various kinds of immunohistochemical study showed that actin, actomyosin, myosin, and vimentin were distinctly observed in cytoplasms of tumor cells. They were located fringing the intracytoplasmic inclusions, but the inclusion themselves showed negative findings, thus indicating a hollow-like staining pattern. These data can be synthesized as follows. The inclusion results from an accumulation of cytoskeletal proteins (actin-myosin complex and vimentin, at least), and antigenicity seems to be lost by for a certain mechanism or in the degenerative process. PMID- 3811907 TI - Lymphomatoid granulomatosis-like lesions in malignant lymphoma. AB - Eighty five cases of malignant lymphoma were surveyed for the presence of angioinfiltrative and angiodestructive growth pattern of lymphoid cells with areas of necrosis and granulomatous appearance simulating lymphomatoid granulomatosis (LYG). LYG-like changes were observed in 13 of 85 cases (15%). The most frequent histology was diffuse large cell lymphoma which occurred in 8 cases (4 non-cleaved, 3 cleaved, and one immunoblastic), followed by three diffuse pleomorphic lymphoma, one diffuse medium-sized lymphoma, and one Hodgkin's disease of mixed cellularity. The most frequent involving site was the lung, as well as the soft tissue. Composition of lymphoid infiltrate varied markedly from case to case and from area to area in the same case. One was solely composed of monotonous atypical cells, other pleomorphic cells including benign lymphocytes, plasma cells, leukocytes, and histiocytes with a varied number of atypical reticuloendothelial cells. The latter histologic appearance was just similar to LYG. Veins were more frequently affected than arteries. The present study indicates that, although the angioinfiltrative and angiodestructive growth pattern of atypical lymphoreticular cells with granulomatous appearance is considered necessary for the diagnosis of LYG, it often occurs in malignant lymphoma. Therefore, one should consider the possibility of malignant lymphoma before making the diagnosis of LYG, especially in the specimens taken from the lung and soft tissue. PMID- 3811908 TI - Lymphoid follicles appearing in gastric mucosa, especially in reactive lymphoid hyperplasia and malignant lymphoma. AB - Histopathological analysis of reactive lymphoid hyperplasia (RLH) and malignant lymphoma (ML) of the stomach was made based on the observations of lymphoid follicles appearing in gastric mucosa. The materials used for study consisted of 28 stomachs without RLH or tumor obtained from either operation or autopsy, 18 stomachs with RLH, and 46 stomachs with ML. Lymphoid follicles appeared soon after birth, increased with mucosal atrophy, and decreased in mucosa with intestinal metaplasia. They possessed a sinusoidal structure and appeared in the muscularis mucosae intimately related to the lymphatic flow. Excepting for the significant proliferative nature, the structural evolution of lymphoid follicles in RLH was similar to that in atrophic mucosa. They showed, however, a wide spectrum of changes containing cases with simple reactive changes to those with prelymphomatous changes. As to ML, the large cell type demonstrated a destructive proliferation, while both small and medium-sized cell types showed proliferation and infiltration preserving their original structure. In the superficial type, ML was frequently accompanied by RLH and mucosal atrophy. The histological features of ML consisted of not only the characteristics of tumor cells but also the proper mucosal changes including lymphoid follicles. PMID- 3811909 TI - Morphogenesis of septa in hepatic fibrosis induced by choline deficiency in rats. Correlation between ito cells, pericellular fibrosis, and septa. AB - Examination of hepatic fibrosis induced by choline deficient diet showed the histogenesis of early fibrosis and septa formation. Male rats were fed a choline deficient diet. Groups of three were sacrificed after 1, 2, 3, 6, 8, 12, and 13 weeks. Control groups of three rats were sacrificed after 6, 8, and 12 weeks. All choline deficient rats showed initial steatosis around the portal tracts. The fat droplets were small at first and gave a microvesicular appearance. As they grew, they gathered around the terminal hepatic venule by the 3rd week. Then, reticular fibers developed around the hepatocytes in the centrolobular area and fibroses connected the terminal hepatic venules. The fat droplets became larger and made nodular masses around the portal tract. These compressed the fibroses to the periphery where they formed septa. After 12 weeks, regenerating nodules developed. Electron microscopy showed that fat storing cells helped cause pericellular fibrosis. PMID- 3811910 TI - Cytoplasmic hyalins resembling Mallory's alcoholic hyalins in pulmonary carcinoma cells. AB - Two cases with Mallory body (MB)-like cytoplasmic hyalins in cells, which were quite uncommon as MB-having cells, were presented. The cases were 61-and 59-year old males. MB-like hyalins were found in large cell carcinoma cells of giant cell type of the lung. The cells containing MB-like hyalins frequently showed a hydropic swelling of the cytoplasm with pyknotic, or wrinkled nuclei. Histochemical properties of the hyalins were just similar to those of hepatic MBs in alcoholic liver diseases. Electromicroscopically, the hyalins were composed of granular, or homogeneous electron dense materials with the peripheral meshwork of randomly oriented fibrils measuring about 100A in diameter. These were stained with anticytokeratin antibodies, suggesting the relateness of the hyalins to intermediate-sized filaments of the cytokeratin type. PMID- 3811911 TI - I-cell disease. A case report and review of the literature. AB - I-cell disease has been reported by many authors but the electron microscopic findings have been reported only rarely. The patient under study was a female infant with a normal delivery after 38 weeks' normal intrauterine life. She showed the physical findings characteristic of I-cell disease, and the diagnosis was made by the analyses of lysosomal enzymes. The child died at the age of 2 years and 3 months due to respiratory insufficiency. By electron microscopy, various-shaped membrane-bound vacuoles were observed in the cytoplasm of various cells such as hepatocytes, myocardial muscle cells, epithelial cells of the renal glomeruli, proximal renal tubular cells, fibroblasts, and chondrocytes. By histochemical analyses we found that these intracytoplasmic storage vacuoles contained glycosaminoglycan and proteoglycan. PMID- 3811912 TI - Atrophy and ductopenia of the right hepatic lobe in a patient with choledocholithiasis. AB - An extremely rare case of atrophy and extensive ductopenia of the right hepatic lobe is presented. The surgically resected atrophic right lobe (100 g) did not show cholestasis or cirrhosis. The right hepatic bile duct revealed sclerosis with luminal obliteration and marked diminution of its branches. The extrahepatic bile duct contained a single cholesterol stone. The right portal vein branches showed luminal narrowing. Disturbance of biliary drainage following sclerosing cholangitis and impediment of portal venous flow in the right hepatic lobe were considered responsible for atrophy of the lobe. Although choledocholithiasis presumably played an important part in the pathogenesis of the sclerosing cholangitis and ductopenia, the reason for selective involvement of the right biliary tree remains nuclear. PMID- 3811913 TI - Cerebro-hepato-renal syndrome of Zellweger. Clinical and autopsy findings and a review of previous cases in Japan. AB - An autopsy case of cerebro-hepato-renal syndrome of Zellweger, which occurred in a 14-year-old Japanese girl, is reported. The autopsy revealed widely distributed cystic changes in addition to renal blastema of both kidneys, and the liver was cirrhotic. The case was complicated by anomalies such as high forehead, strabismus, and partial defect of chorioidea. So far there have been only 10 reported cases of cerebro-hepato-renal syndrome of Zellweger in Japan. PMID- 3811914 TI - Malignant clear cell cystadenoma of the ovary. AB - A 50-year-old female had suffered from abdominal distension and a lower abdominal mass for 3 months. Ultrasonographic examination demonstrated a myoma uteri pattern with a large cystic ovarian tumor. Laparotomy was done on August 30, 1983 and simple total hysterectomy with bilateral salpingo-oophorectomy was carried out. FIGO stage IIC ovarian cancer was stated clinically. Histologically, clear cell cystadenoma of right ovary having benign, proliferative and malignant epithelial elements without dense ovarian stroma was found and diagnosed as malignant clear cell cystadenoma. In spite of Cisplatin therapy, the patient expired on April 6, 1984. PMID- 3811915 TI - Prostatic cancer presenting as metastatic adenocarcinoma of sphenoid sinus. AB - Prostatic cancer is commonly manifested by obstructive uropathy, regional lymphatic metastases, and hematogenous metastases to the axial skeleton. It is relatively rare that initial signs begin with the involvement of other sites. Intracranial metastases especially are seldom found and may be unfamiliar to not only pathologists but also to physicians. In this article, we present a case where the metastasis was first manifest as a sphenoid sinus tumor prior to the demonstration of the primary site and the prostate was confirmed to be primary by biopsy specimen with immunoperoxidase method. In addition to discussing the route of the tumor spread, we deal with a prostatic specific antigen efficient for identifying the primary site. PMID- 3811916 TI - Primary gastric lymphoma with intranuclear inclusions. An immunohistochemical and ultrastructural study. AB - Two patients with primary gastric lymphoma, diffuse lymphoma, a plasmacytoid variant of small cell type, with numerous intranuclear inclusions, are reported. In both cases, biopsy and surgical specimens showed diffuse proliferation of lymphoid cells having plasmacytoid features at different steps of maturation in lamina propria and submucosal layer. The cytoplasm of the lymphoma cells was stained with anti-IgM, anti-kappa chain, and anti-J chain antibodies by avidin biotin peroxidase complex technique. A number of intranuclear inclusions in the lymphoma cells were diastase-resistant PAS positive, and also stained with anti IgM, anti-kappa chain, and anti-J chain antibodies, suggesting a monoclonal situation. In an ultrastructural study of the first case, the inclusions were round and composed of amorphous materials surrounded by a single membrane. In many lymphoma cells, the perinuclear cisternal space was dilated and filled with materials similar to those within both inclusions and rough endoplasmic reticulum. A direct communication between the perinuclear space and the inclusion was demonstrated in some cells, suggesting the perinuclear cisternal origin of these inclusions. PMID- 3811917 TI - Ewing's sarcoma of bone. A correlative cytological and histological study of 14 cases. AB - A correlative cytological and histological study of 14 cases of Ewing's sarcoma is presented. All smears from the fine needle aspirates were performed during the diagnostic investigation before treatment of the patients. The smears were very cellular with relatively small, round to oval tumour cells which appeared rather uniform. Two cell types could be distinguished, however. There was a predominance of relatively light, so-called principal or chief cells, but smaller and darker cells, so-called dark cells, were also observed. We found that Ewing's sarcoma has a characteristic appearance in smears and that fine needle aspiration cytology can be used in its primary diagnosis. A conclusive diagnosis may be made when the clinical and radiographic findings are also consistent. PMID- 3811918 TI - Caryometry of benign compound acquired naevi, Spitz epitheloid naevi and malignant melanomas. AB - In order to get basic caryometric data later to be used in a prognostic study for malignant melanomas, caryometry of 7 compound acquired naevi, 8 Spitz epitheloid naevi and 83 cutaneous malignant melanomas was done and showed mean nuclear profile areas 32.9 microns 2, 73.6 microns 2 and 64.7 microns 2, respectively. Only minimal overlapping existed between the compound acquired naevi and the two other tumour types. Similar differences existed concerning mean maximal profile diameter, proportion of large nuclei and width of nuclear histograms. Mean form factor was lower for the malignant melanomas than for the naevi. The nuclei of the superficial layer of the compound naevi and the Spitz naevi were larger than those of the deep layer. A similar consistent pattern did not exist for the malignant melanomas. PMID- 3811919 TI - The prognostic significance of the monoclonal antibody III D 5 to human milk fat globule antigen in breast cancer. AB - The monoclonal antibody III D 5 identifies an antigen in human milk fat globule membrane, found also on breast epithelial cells. Immunohistochemistry with the antibody was used in the staining of formalin-fixed, paraffin-embedded sections of 80 breast carcinomas. The duration of follow-up of patients was from seven to twelve years. The presence or absence of metastases in regional lymph nodes at the time of primary operation, histological grade and necrosis of tumours correlated highly significantly to the survival of patients. The patients whose tumours exhibited positive staining with the antibody III D 5 had an improved survival-rate compared with those with III D 5 negative tumours. In the patients without metastases at the time of primary operation, the histological grade of primary tumour had only a weak correlation with survival, while the same patients with III D 5 positive tumours had significantly better prognosis compared to the III D 5 negative cases. Inclusion of the III D 5 immunoreactivity with other factors in a prognostic index could permit a more accurate estimation of prognosis in patients with mammary carcinoma. PMID- 3811920 TI - Primary parathyroid hyperplasia of water-clear cell type. Transformation of water clear cells into chief cells. AB - An exceptional case of water-clear cell hyperplasia (WCCH) of the parathyroid glands is presented. Parathyroid tissue was excised at three operations during a period of twenty years before the patient eventually became normocalcemic. Microscopic evaluation of the parathyroids from the first operation showed typical WCCH-findings. However, the parathyroid tissue excised at the last operation was composed of chief cells. There were calcifications and even bone formation. A pigment with the staining and electron-microscopic characteristics of lipofuscin was found in abundance. There were also a few oxyphils. This case shows that clear cells, originally derived from chief cells, can transform into chief cells again. PMID- 3811921 TI - Adult polycystic liver disease and biliary microhamartomas (von Meyenburg's complexes). AB - The relationship between adult polycystic liver disease (PLD) and biliary microhamartomas (von Meyenburg's complexes) was studied in a series of ten autopsy cases in which the size of the cysts varied from microscopic to 10 cm. Biliary microhamartomas, found in every case, were the most abundant (p less than 0.001) in livers with cyst size of 1 cm or less and had almost disappeared in cases with the largest cysts. The number of microhamartomas had no significant correlation with age or liver weight. The results indicate that biliary microhamartoma (von Meyenburg's complex) is coupled with adult-type polycystic liver disease, and, probably, is the histopathological lesion that transforms into cysts. The number of microhamartomas is the highest in the early phase of the disease. PMID- 3811922 TI - Interstitial focal fibrosis and reduction in proximal tubular length in adult rats after lithium treatment. AB - Seven adult male and eight adult female rats were treated with lithium for 16 weeks. The kidneys were fixed by vascular perfusion with glutaraldehyde and investigated by morphometric methods. Plasma lithium was in the therapeutic range. All treated animals showed a significant increase in interstitial volume as a result of focal interstitial fibrosis (from 6.6% to 9.8% in males and from 5.2% to 8.4% in females) and a significant reduction in proximal tubular length in male rats (from 292 to 181 m/kidney). Two rats had elevated plasma urea at the end of the experiment. A few animals that were treated for 8 months showed even more significant structural changes. The findings in the present study demonstrate that lithium treatment also in the adult rat leads to focal interstitial fibrosis in the renal cortex. PMID- 3811923 TI - [Studies on the hypoglycemic effect of Coptis chinensis and berberine]. PMID- 3811924 TI - [Comparison of the effects of DL-tetrahydropalmatine with verapamil on the left auricle of the guinea pig]. PMID- 3811925 TI - [Effects of xinchuanling(XC-1) and its derivative XC-2 on cardiac hemodynamics in dogs]. PMID- 3811926 TI - [Studies of neurotoxin fraction IX from Bungarus fasciatus venom]. PMID- 3811927 TI - [Studies on new anthracycline antibodies 80334 B, C and F. II. Fermentation, isolation, physicochemical properties, biological characteristics and structural determination]. PMID- 3811928 TI - [Synthesis of some 3(4)-bromo and 3,4-dialkoxy-5-nitrofuran azomethine derivatives and their antibacterial activities]. PMID- 3811929 TI - [Studies on the constituents of the flavonoids from the pollen of Typha angustfolia L. (puhuang)]. PMID- 3811930 TI - [Chemical studies on the alkaloids isolated from the tuber of Yuanhu (Corydalis turtschaninovii Bees. f. yanhusuo Y. H. Chou et C. C. Hsu)]. PMID- 3811931 TI - [Identification of two major components in Chinese nystatin]. PMID- 3811932 TI - [Analysis of berberine-type alkaloids in rhizoma Coptidis and Chinese patent medicines by micellar chromatography]. PMID- 3811933 TI - [Effects of 3,4-dihydroxyacetophenone (DHAP) on electrical and mechanical activities in the isolated myocardium]. PMID- 3811934 TI - [Determination of the caffeine content in annaka injections using the 1st derivative dual-wave-length method]. PMID- 3811935 TI - [The pharmacokinetics and disposition of tetramethylpyrazine phosphate in dogs and rats]. PMID- 3811936 TI - [Effects of acetylcarnitine and carnitine on experimental heart failure]. PMID- 3811937 TI - [Inhibitory effect of hydroxycamptothecin on colony formation of KB cells and DNA damage]. PMID- 3811938 TI - [Antithrombotic effect of daphnetin in the rat]. PMID- 3811939 TI - [Sulfur-containing nitrosoureas]. PMID- 3811940 TI - [Studies on the saponins from the root of Glycyrrhiza uralensis Fisch]. PMID- 3811941 TI - [Studies on the chemical constituents of Aquilaria sinensis (Lour.) Gilg. II. Isolation and structure of baimuxinol and dehydrobaimuxinol]. PMID- 3811942 TI - [Quantitative analysis of a three-component mixture--compound tablets of acetaminophen using signal multiplier spectrophotometry]. PMID- 3811943 TI - [Chemical studies on the alkaloids from yuanhu (Corydalis turtschaninovii Bess. F. Yanhusuo Y. H. Chou et C.C. Hsu). VI. Separation and determination of 6 tertiary alkaloids in yuanhu by RP-HPLC]. PMID- 3811944 TI - [Analytical studies on compound preparations containing ethinylestradiol]. PMID- 3811945 TI - [Antispasmodic effect of acetagastrodine on vascular smooth muscle]. PMID- 3811946 TI - [Structure-anticonvulsant activity relationships of some cinnamamides of substituted aromatic ring]. PMID- 3811947 TI - [Studies on chemical constituents of hubeibeimu (Fritillaria hupehensis Hsiao et K. C. Hsia). V. Isolation and identification of hupehenisine]. PMID- 3811948 TI - [The comparison of some properties of gossypol recrystallized from different solvents]. PMID- 3811949 TI - [Pharmacokinetics of clozapine in rabbits]. PMID- 3811950 TI - [Studies on the pharmacokinetics of 3H-neriifolin in rats]. PMID- 3811951 TI - [Quantitative structure-anticonvulsant activity relationships of cinnamamides]. PMID- 3811952 TI - [The relationship between structure and anticancer activity of platinum complexes]. PMID- 3811953 TI - [Studies on triterpenoids of Tripterygium wilfordii Hood-F]. PMID- 3811954 TI - [Studies on the coumarins from the zou-ma-qin (Heracleum moellendorffii Hance var. Paucivitatum)]. PMID- 3811955 TI - [Determination of organic-iodine compounds with a gold-coated quartz piezoelectric crystal]. PMID- 3811956 TI - [Studies on the purity of Chinese megestrol acetate: separation and identification of epimeric isomers of 6-hydroxy-6-methyl-17 alpha-acetoxy progesterone]. PMID- 3811957 TI - [Studies on the physical properties of the injection of polyphase liposome of homoharringtonine]. PMID- 3811958 TI - [Prophylacticly antimetastatic effects of aryltriazene methoxypyrimidine on Lewis lung carcinoma and its histological and ultrastructural observation]. PMID- 3811959 TI - [Influence of sodium selenite on the spontaneous electric activity of the guinea pig and rabbit heart]. PMID- 3811960 TI - [A biogenetic synthesis of prostaglandin E1 methyl ester]. PMID- 3811961 TI - [Determination of carbamazepine in serum by the thin-layer fluorescence scanner]. PMID- 3811962 TI - Metabolism of tobacco specific carcinogens in cultured rat buccal mucosa epithelial cells. AB - The metabolism of tobacco carcinogens was studied in a potential target for their carcinogenic effects. Rat buccal mucosa cells metabolized several polycyclic aromatic hydrocarbons, e.g., benzo(a)pyrene, benz(b)- and benz(j)-fluoranthene, dibenz(a,j)acridine, N,N-diethylnitrosamine and protein pyrolysate products, 2 amino-3-methylimidazo(4,5-f)quinoline, and 2-amino-3,4-dimethylimidazo(4,5 f)quinoline, as measured by binding of the carcinogens to cellular DNA. The highest level of binding was seen with the nitrosamine followed by the protein pyrolysate products. There was no significant difference in the binding levels between the different polycyclic aromatic hydrocarbons. Cells treated with a non cytotoxic dose of the non-volatile condensate fraction of regular tobacco smoke increased metabolism as measured by binding to DNA of the protein pyrolysate products, whereas the pretreatment did not have any effect on the metabolism of benzo(a)pyrene, and N,N-diethylnitrosamine. However, the profile of benzo(a)pyrene metabolites released into the media changed. The results indicate that rat buccal mucosa cells metabolize several classes of tobacco specific carcinogens, and that the metabolism is modified by continued exposure to tobacco smoke components. PMID- 3811963 TI - Effects of manganese chloride on the rat developing nervous system. AB - Sprague-Dawley rats were exposed to sublethal doses of manganese chloride during their postnatal development period up to 44 days of age. They showed transient clinical signs of disease and a decreased homovanillic acid (HVA) content in the striatum and hypothalamus between 15 and 22 days of age. The manganese content in the brain was increased 20-40 times during this period as determined with neutron activation analyses. In spite of this no structural damage or signs of maturation disturbances in the nervous system were found. Interruption of manganese exposure reversed the changes in HVA content. PMID- 3811964 TI - Uptake, distribution and elimination of 3H-gentamicin in different organs of the rat as determined by scintillation counting. AB - Radioactivity attained in different tissues at different times after a single intraperitoneal injection of 3H-gentamicin into male rats was determined using scintillation counting. After about 30 min. kidney cortex demonstrated 3- to several hundred-fold greater radioactivity than other tissues. Gentamicin was released from kidney medulla and the urinary bladder relatively rapidly, whereas the radioactivity in kidney cortex and thoracal cartilage was maintained for at least 6 hrs. PMID- 3811965 TI - Distribution of halothane and the metabolites trifluoroacetic acid and bromide in the conceptus after halothane inhalation by pregnant mice. AB - Mice in late stage of gestation were exposed to halothane at various concentrations for 1 hr, and were killed at different time intervals after discontinuance of inhalation. The concentration of halothane in maternal plasma decreased rapidly, and in the amniotic fluid the halothane never reached more than 20% of maternal plasma levels. Trifluoroacetic acid (TFA) and bromide, formed mainly by maternal metabolism of halothane, accumulated in foetus and amniotic fluid with time, and reached plateau levels in amniotic fluid between 4 and 24 hrs. TFA infused intravenously to the mother reached higher levels in amniotic fluid after long survival times, than in maternal plasma. Equilibrium dialysis experiments showed that TFA and trichloroacetic acid (TCA) (previously shown to accumulate in amniotic fluid) were bound to amniotic fluid macromolecules only to approximately 20-30 percent. This was at the same magnitude (or lower) as compared to binding in maternal plasma, suggesting that such binding did not contribute to the observed retention in the amniotic fluid. Other possible explanations for the slow accumulation and long-term retention in amniotic fluid are transport by bulk flow via foetus, excretion via foetal urine, or paraplacentally through endometrium and foetal membranes, followed by trapping in the amniotic fluid. The significance of this accumulation of metabolites of halogenated organic solvents and halothane for their foetotoxicity is not clear. PMID- 3811966 TI - Rapid HPLC-determination of ibuprofen and flurbiprofen in plasma for therapeutic drug control and pharmacokinetic applications. AB - Ibuprofen has wide applications in the treatment of rheumatoid arthritis and osteoarthroses as an effective non-steroidal antiinflammatory drug. The drug is still being investigated regarding its possible ability to reduce myocardial infarct size. The more potent biphenyl propionic analogue, flurbiprofen, has recently been introduced. Both drugs are strong inhibitors of cyclooxygenase. The specific HPLC-method described requires plasma samples of 100 microliter which are deproteinized and simultaneously extracted with acetonitrile containing either of the drugs as internal standard. Aliquots of 25 microliter of this primary extract were directly injected on a mu Bondapack C18 column. For elution was used a mixture of 60% methanol and 40% 50 mM phosphate buffer adjusted to pH 4.6. The detection limit (at 214 nm) for both drugs corresponded to plasma concentrations of about 0.2 micrograms X ml-1. The applicability of the method was demonstrated in a pharmacokinetic ibuprofen experiment in an adult person. PMID- 3811967 TI - Tissue distribution and fate of budesonide in the mouse. AB - The tissue distribution and pharmacokinetics of 3H-budesonide were studied in the mouse after intravenous administration. The drug was rapidly (t1/2 alpha = 0.062 hrs) and extensively distributed into tissues and organs (V beta = 20.3 l/kg and Vss = 9.4 l/kg). The short elimination half-life (t1/2 beta = 1.55 hrs) and high blood clearance (Cl = 9.04 l/hr/kg) demonstrated a rapid elimination of budesonide from the body. Whole-body autoradiography showed very high amounts of radioactivity in the excretory organs liver and kidney. Also in the lung and lymphatic tissues high amounts of radioactivity were noted. The adrenal cortex but not the medulla was heavily labelled. Radioactivity passed the blood-placenta barrier and to some extent the blood-brain barrier. The identity of the radioactivity in some organs was analysed by liquid chromatography. At all times after dosing (up to 4 hours), the dominating part of the lung, spleen and brain radioactivity was attributable to unchanged budesonide. After 60 min., the dominating part of the kidney radioactivity was identified as polar metabolites of budesonide. The liver radioactivity was at all observation times found to consist mainly of polar metabolites, reflecting the efficient liver biotransformation of budesonide. PMID- 3811968 TI - Phenobarbital enhances the aldehyde dehydrogenase activity of rat hepatocytes in vitro and in vivo. AB - Aldehyde dehydrogenase (ALDH) was measured in primary cultures of hepatocytes obtained with collagenase perfusion from livers of Long-Evans rats. After seven days in culture, basal ALDH activity, protein content and DNA content are significantly decreased. Exposure of the cultures to phenobarbital (PB, 3 mM in the media) does not prevent the decrease of DNA content, although it keeps protein at relatively higher levels. The activity of ALDH is not only preserved, but also significantly enhanced, when propionaldehyde, phenylacetaldehyde, benzaldehyde and D-glucuronolactone are used as substrates and NAD as the coenzyme. A relative increase of activity is also noted when ALDH is measured with benzaldehyde and NADP. Treatment of Long-Evans animals with PB (1 mg/ml, in drinking water for 2 weeks) leads to similar relative increases of the ALDH activity. In absolute values, however, enzyme activities found after in vivo treatment with PB are higher, compared to those obtained after in vitro exposure. These results show that ALDH activity can be greatly enhanced by PB in primary hepatocyte cultures, free from any indirect endogenous influences. PMID- 3811969 TI - 3H-adrenaline release from rabbit isolated aorta by electrical-field stimulation. AB - The aim of the present work was to study the release of 3H-adrenaline (3H-A) from rabbit isolated aorta. This release was compared with that of 3H-noradrenaline (3H-NA). The stimulation-evoked 3H-overflow from aorta preloaded with 3H-A decreased with repeated stimulation (S1-S3). In contrast, prestimulation enhanced subsequent stimulation-evoked 3H-overflows. For both 3H-amines, the 3H-overflow increased concomitantly to the same degree with the number of pulses (30-1000) at 3 Hz. The time course of 3H-overflows with either 3H-A or 3H-NA was compared. In the case of 3H-A, the 3H-overflow increased with time, while for 3H-NA the 3H overflow remained unchanged both at 3 and 10 Hz. The stimulation-evoked 3H overflow from rings preloaded with either 3H-amine was the same at frequencies from 1 to 10 Hz, whereas at 30 Hz the 3H-overflow derived from 3H-A was higher than that using 3H-NA. An analysis of the quantitative aspects of individual stimulation-evoked 3H-overflows showed that the fractional profile did not differ using either amine. In both cases, at least 96% of the 3H-overflow evoked by stimulation at 3 or 10 Hz was contained in the initial four 2-min. fractions. The ratio between stimulation-evoked 3H-overflow and spontaneous 3H-outflow was the same for both amines at 3 Hz, while the ratio was higher for 3H-NA at 10 Hz. Rauwolscine (10(-6) M) enhanced the 3H-overflow 6-fold, while (-)-propranolol (10(-7) M) had no effect at 3 Hz.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3811970 TI - The effect of intrarenal nickel subsulfide injections upon the activity of selected erythrocyte and bone marrow enzymes in rats. AB - The experiments were carried out on Wistar rats. The animals were divided into five groups: Group 1: control group; Group 2: the animals received a single intrarenal dose of nickel subsulfide (Ni3S2) in saline; Group 3: the animals receiving a single intrarenal dose of saline; Group 4: the animals receiving a single intrarenal dose of Ag2S in saline; Group 5: the animals receiving a single intrarenal dose of activated charcoal in saline. Prior to the procedure peripheral blood indices were determined. The experiments included animals manifesting polycythemia. Samples of blood and bone marrow were collected and the activities of AchE, GR and G6PD were determined. An increase in the activity of the three studied enzymes was detected in Groups no. 2 and 5. PMID- 3811971 TI - Pharmacokinetics of pivmecillinam hydrochloride in pregnant and non-pregnant women. PMID- 3811972 TI - Effect of N-aminomethylpiperazine-3,3-diethyl-2,4-pyridinedione on the aggressive behaviour and avoidance training of rats with isolation syndrome. AB - The article investigates the effect of N-aminomethylpiperazine-3,3-diethyl-2,4 pyridinedione (DKMP), a newly-synthesized compound with a clearly manifested anticonvulsant action, on the aggressive behaviour and on the training for active two-way avoidance by using a shuttle-box. The effects of DKMP were compared with the effects of Diazepam on mouse killing behaviour and avoidance training both of isolated aggressive rats and of rats reared in groups. It was found that DKMP (100 mg/kg, subcutaneously) inhibited the aggressiveness in 88 per cent of the aggressive rats, whereas Diazepam (1 mg/kg, i. p.)--in 75 per cent for 4 hours. DKMP manifested a more substantial positive effect on learning (higher number of avoidances) in the aggressive rats, whereas Diazepam had a better effect on the group-reared rats. Both compounds shortened the latencies of the avoidances of aggressive rats, inducing no changes in the grouped rats. The results obtained show that with respect to the effects studied there is similarity in the pharmacological activities of DKMP and Diazepam, indicating only some not very essential quantitative differences. PMID- 3811973 TI - Changes in the reactivity of the intrinsic nervous system of the stomach to hexamethonium after transthoracic vagotomy. AB - Experiments were carried out on seven breedless dogs with chronically implanted electrodes in the stomach. The effect of hexamethonium (in doses of 0.2, 0.3, 0.5, 1, 2, 3, 5, 7 and 10 mg/kg, i. v.) on the migrating myoelectrical complex (MMC) was studied before and after transthoracic vagotomy. Injected on the background of the first MMC phase, hexamethonium in doses of up to 2 mg/kg induces the appearance of spike potentials (SP). Applied on the background of spike activity, hexamethonium induces the appearance of spike activity of the type of the 3rd MMC phase. In a dose exceeding 2 mg/kg, introduced during SP activity, hexamethonium interrupts for different periods of time the SP generation and shortens the duration of the active MMC phases. On the background of increased spike activity characteristic of the stomach after vagotomy, 3 mg/kg hexamethonium have almost no effect on the electrical activity, whereas 10 mg/kg only reduce the percentage of slow waves accompanied by SP. It is probably that after vagotomy the excitability of the intrinsic nerve cells is increased, therefore even the high doses of the ganglionic blocker hexamethonium cannot inhibit entirely the active phases of MMC. PMID- 3811974 TI - Picrotoxin effects on the frog electroretinogram under different background illumination. AB - The effect of blockade of the GABA-ergic synapses in the frog retina by picrotoxin (PT) on ERG was studied under two conditions of background illumination (Ib): scotopic Ib with illumination level below 0.01 lx and mesopic Ib with illumination level of 2 lx. Under scotopic Ib PT produced a greater relative increase in the d-wave amplitude as compared to the b-wave. The substitution of scotopic Ib by mesopic one in untreated retinas produced a greater decrease in the b-wave amplitude than in the d-wave amplitude. The presentation of the mesopic Ib in PT treated retinas potentiated to nearly the same extent the PT effect on both b- and d-wave. So the initial shift between the amplitudes of the b- and d-wave produced by the mesopic Ib was not significantly altered by PT. The results obtained show that the GABA-ergic neurons in the mixed frog retina participate in the gain control of the ON and OFF channels in a wider range of background illumination. Their relative significance in this control seems to be greater under mesopic Ib than under scotopic Ib. We suggest that the effect of mesopic Ib on the sensitivity of the ERG b- and d-wave is complex and involves some other mechanisms in addition to the GABA-ergic one. PMID- 3811975 TI - Reaction time and critical duration for lines' detection and identification of their orientation. AB - Reaction time (RT) and duration of complete temporal summation (tc) were studied for both detection of lines and identification of their orientation. The RT was studied as a function of stimulus intensity, number of orientations and angular difference between them. The temporal summation was studied for detection and identification at several angular differences. It was found that the intensity dependent part of RT for identification at angular difference of 22 degrees equaled that for detection but considerably lengthened at smaller angular differences (10 degrees). The intensity-independent part of RT was minimal for detection and maximal for identification with eight alternatives. The tc increased from 30 msec for detection and identification with the accuracy of 22 degrees to 100 msec for identification with the accuracy of 5 degrees. The results support the conclusion that detection and coarse identification differ only in their later stages and that accurate identification involves additional processes with longer time-constants compared to coarse identification. PMID- 3811976 TI - Inhibition of phospholipid hydrolysis by soluble phospholipase A2 in biological membranes of different origin after lipid peroxidation. AB - In peroxidized rat liver microsomal membranes phospholipid hydrolysis catalyzed by porcine pancreas phospholipase A2 was found to be inhibited. The extent of inhibition depended on the amount of lipid peroxidation products (MDA) accumulated in the membrane. This effect was not due to the direct action of lipid peroxidation products on the enzyme but to membrane modification. The same inhibitory effect was also found with other membranes--rabbit skeletal muscle sarcoplasmic reticulum, bovine retina rod outer segments and rat brain synaptosomes--differing in phospholipid and fatty acid composition. The inhibition of phospholipase reaction by lipid peroxidation depended at least on three factors: decrease in the amount of phosphatidylethanolamine; decrease in the level of phospholipids, containing polyunsaturated fatty acid residues and occurrence of membrane structural rearrangements resulting in unavailability of phospholipid substrates for phospholipase A2 attack. Membrane destruction with anionic detergent--sodium cholate--led to a sharp increase of phospholipase hydrolysis rate. PMID- 3811977 TI - Studying the stability of clear vision using microcomputer "Pravets-82". AB - The method of Ferree and Rand assesses the efficiency of the eye and is very sensitive to fatigue in the visual system. A modification of the method is developed using microcomputer "Pravetz-82". The proposed algorithm is realised in Extended Basic. The features of the modified method include: display of the stimulus on the monitor of the microcomputer, option for interactive change of the parameters of the stimulus from test to test, storage of the data on a diskette, measuring of the time intervals by a programme clock, statistical evaluation of the results with graphic display. The modification makes the method more versatile, precise, and easy to perform. PMID- 3811978 TI - Role of arginine-vasopressin for the development of hypertension following aortic constriction. AB - This study concerns the role of arginine-vasopressin (AVP) for the development of hypertension after constriction of the abdominal aorta proximal to the renal arteries (PAC). The PAC was applied in AVP-deficient Brattleboro (Bb) rats and the blood pressure was recorded 3 weeks later. In untreated rats, PAC did not cause hypertension. When the rats were given AVP 0.6 or 6 nmol day-1 for 2 weeks using mini-pumps, hypertension developed both proximal and distal to the constriction. The level of the hypertension was independent of the AVP dose. When the rats were given I-deamino-4-valine-8-D-arginine-vasopressin (dVDAVP) a specific antidiuretic agonist without effect on the vascular AVP receptors, hypertension did not develop. Sham-operated rats given AVP did not develop hypertension. The PAC rats treated with AVP but not with dVDAVP had an enhanced pressor response to an i.v. bolus dose of angiotensin II. It is concluded that AVP plays an important role in the development of hypertension following aortic constriction and that the action is mediated via the vascular AVP-receptors. We suggest that the presence of AVP permits the expression of other hypertensive factors, such as angiotensin II. PMID- 3811979 TI - Carbonic anhydrase inhibition and cell volume regulation in Necturus gallbladder. AB - Gallbladder epithelial cells transport salt and water isotonically as the renal proximal tubule. The cells also have the property of regulating their cell volume in response to osmotic stress (Fisher et al. 1981, Persson & Spring 1982, Fisher & Spring 1984, Foskett & Spring 1985). The volume-regulating phenomenon is the result of a balance between cell uptake of salt and water at the luminal membrane and exit at the basolateral membrane. Different properties regarding volume regulatory increase and decrease have been found (Eriksson & Spring 1982 and Larson & Spring 1983). The present study links fluid transport and volume regulatory increase of the cell. First we concluded from histological techniques that carbonic anhydrase is present in the cell membrane or in the vicinity of the epithelial cells. Then we measured a decreased net fluid transport in the presence of increasing concentrations of the carbonic anhydrase inhibitor acetazolamide. We showed that the volume regulatory increase is substantially slowed down and that the steady-state volume of the cells changed when carbonic anhydrase was inhibited. Our conclusion is that the rate of CO2 hydration was a limiting step, at carbonic anhydrase inhibition, in both the net transfer of salt and water and also in the ability of the cells to efficiently regulate their volume. PMID- 3811981 TI - Ammonium chloride induced acidosis and aldosterone secretion in the goat. AB - Responses to 30-min intraduodenal infusion of NH4Cl (total amount 75 mmol) were studied in conscious goats. The infusion caused an immediate, transient rise in plasma aldosterone concentration (PA) from a mean of 78 to 221 pmo l-1. As expected, the NH4Cl administration also induced metabolic acidosis, initially subjected to partial respiratory compensation. The acidosis did not become fully developed until 1 h after cessation of the infusion, when PA had almost returned to its initial level. Renal compensation of the acidosis was shown by acidification of the urine and reduced Na excretion being most pronounced 1-2 h post-infusion. During the infusion blood haemoglobin concentration and the haematocrit increased by 25 and 13%, respectively, without simultaneous increase in plasma protein concentration and with persisting ear vasodilatation, indicating a mobilization of stored erythrocytes in the absence of a general increase in sympathetic tone. The results suggest that the reduction of blood pH is not the cause of the increase in PA occurring in association with NH4Cl induced metabolic acidosis, but leave open the possibility that this increase may be due to some centrally mediated or direct adrenal influence of NH+4. As regards the apparent NH4Cl-induced mobilization of stored erythrocytes, it is suggested that such a response may play a role in the defence against acidosis by increasing the buffering capacity of the circulating blood. PMID- 3811980 TI - Rate of oxidative and glycolytic metabolism in the guinea-pig oviduct in relation to contractility and hormonal cycle. AB - The rates of oxygen consumption and lactate production in the guinea-pig oviduct were measured together with registration of contractile activity during three phases of the hormonal cycle. In pro-oestrus (high oestrogen, low progesterone levels) and oestrus (time of ovulation, high oestrogen and progesterone) the rate of O2 consumption was higher than in dioestrus (low oestrogen, high progesterone). The frequency of spontaneous contractions was higher in oestrus than in the other phases. No significant differences in the proportion of the cross-sectional area occupied by smooth muscle were found between oviducts in di- and pro-oestrus. Stimulation by phenylephrine caused decreased frequency and increased amplitude of contractions in dioestrus but not in pro-oestrus, suggesting hormonal modulation of adrenergic mechanisms. The rate of relaxation of high-K+ contractures was higher in pro- than dioestrus. Lactate production and contents of ATP, ADP and phosphocreatine showed no significant variation with hormonal state. The increased rate of oxidative metabolism under oestrogenic dominance could in part reflect changes in ionic transport mechanisms, such as intracellular Ca2+ handling. PMID- 3811982 TI - Sympatho-adrenergic inhibition of vagally induced gastric motility and gastroduodenal HCO-3 secretion in the cat. AB - Chloralosed cats were acutely vagotomized and their adrenal glands were ligated. The gastric lumen was perfused with isotonic NaCl and gastric motility was recorded as change in hydrostatic pressure within the perfusion circuit. Gastric secretions of H+ and HCO3- were calculated from continuous measurements of pH and pCO2 in the perfusate. Mucosal HCO3- secretion in the distal duodenum was titrated in situ by pH-stat equipment. The experiments were divided into three different groups dependent on the state of sympathetic splanchnic nervous supply: intact; cut on a preganglionic level; blocked with the adrenolytic agent guanethidine. Basal levels for gastric motility, gastric H+ and HCO3- secretions and duodenal HCO3- secretion were more or less similar in all groups. Gastric motility, gastric HCO3- and duodenal HCO3- secretory responses to bilateral vagal stimulation were significantly enhanced in splanchnicotomized or guanethidine treated animals as compared to controls with intact sympathetic supply. However, no clear differences in gastric H+ secretory responses to vagal stimulation were demonstrated between animals with an intact or disrupted sympathetic innervation. These results suggest a sympatho-adrenergic inhibitory action on vagally induced mucosa-protective HCO3- secretion in the stomach and the duodenum. Furthermore, vagal stimulation in animals with intact splanchnic nerves induced a guanethidine resistant delayed increase in duodenal HCO3- secretion. The nature of this response was not further analysed. PMID- 3811983 TI - Secretin potentiates cholinergically induced glucagon secretion in the mouse. AB - Glucagon secretion is stimulated by cholinergic activation, and it is known that the polypeptides VIP (vasoactive intestinal polypeptide) and GIP (gastric inhibitory polypeptide) both potentiate this cholinergically induced glucagon secretion. In this study, we investigated whether secretin, which shows structural similarities to both VIP and GIP, affects basal and cholinergically induced glucagon secretion in the mouse. Secretin was injected i.v. to mice at dose levels varying from 0.53 to 17 nmol kg-1, and plasma samples were taken at 2, 6 and 10 min following injection. It was found that secretin in this wide dose range did not affect basal glucagon concentrations. When the cholinergic agonist carbachol was injected i.v. at 0.16 mumol kg-1, plasma glucagon levels were elevated; at 2 min at 0.84 +/- 0.04 ng ml-1 compared to 0.31 +/- 0.02 ng ml-1 in controls (P less than 0.001). A combination of carbachol and secretin (4.25 nmol kg-1) enhanced plasma glucagon levels to 1.22 +/- 0.07 ng ml-1. Thus, secretin potentiated carbachol-induced glucagon secretion by 70% (P less than 0.001). Concomitantly, plasma glucose levels were elevated: 10.8 +/- 0.4 mmol l-1, compared to 9.2 +/- 0.4 mmol l-1 in controls (P less than 0.001). We conclude that secretin, while being without effect on basal glucagon secretion, markedly potentiates cholinergically induced glucagon secretion in the mouse, resulting in increased plasma glucose levels. PMID- 3811984 TI - Somatosensory units in the cat's intercollicular region. AB - Sampling of unitary, neural activity was made with tungsten electrodes in the mesencephalon of cats anaesthetized with chloralose. Possible activation was studied with adequate somatosensory, visual and acoustic stimuli as well as electrical nerve stimulation via electrodes embedded in each forelimb and the contralateral hindlimb. Fifty units or about 10% of the total population were found in clusters of strictly somatosensory units which were activated by light tactile stimulation and with short latency from the contralateral body half. Some of these units had small receptive fields, but others showed convergence of information from large receptive fields which sometimes included parts of the ipsilateral body half. The different clusters appeared to constitute parts of a coherent structure which is located between 3-5 mm lateral to the midline at the anterior/posterior level of the trochlear nucleus, and with slanted dorsal ventral distribution with the caudal parts above and the rostral parts below the Sylvian aqueduct. A somatotopical arrangement was found with the forelimb rostral to the hindlimb, and the suggested structure may be the somatosensory intercollicular nucleus which has been described by others. PMID- 3811985 TI - The effects of naloxone on cerebral function in spontaneously hypertensive rats during hypotensive haemorrhage. AB - The purpose of this study was to examine the effects of naloxone on signs of relative cerebral ischaemia induced by hypotensive haemorrhage. Mean arterial blood pressure (MAP), heart rate (HR), renal sympathetic nerve activity (rSNA) and somatosensory evoked potentials (SEP) were recorded in chloralose anaesthetized spontaneously hypertensive rats exposed to graded bleeding. Hypotensive haemorrhage resulted, after a very brief sympathetic excitation, in marked sympathetic inhibition and bradycardia and a considerable reduction of SEP, indicating relative cerebral ischaemia. However, after 25-30 min this sympatho-inhibitory response was reversed to pronounced sympathetic excitation and tachycardia, which was accompanied by a further attenuation of SEP. A single bolus of naloxone (10 mg kg-1) caused transient sympathetic inhibition and bradycardia, which was accompanied by an improvement of SEP. A bolus injection (5 10 mg kg-1) followed by a 30 min infusion of naloxone (25-35 mg kg-1 h-1) caused a sustained SEP improvement despite the fact that MAP was kept constant during naloxone administration. We conclude that naloxone can have beneficial effects on brain function during cerebral ischaemia, effects that are probably due to blockade of opioid receptors. Our model of relative cerebral ischaemia might be useful for evaluating the mechanisms behind the naloxone effects during this condition. PMID- 3811986 TI - Isoflurane effects in rat hippocampal cortex: a quantitative evaluation of different cellular sites of action. AB - In order to evaluate quantitatively the effects of an inhalation anaesthetic on neuronal excitability and on synaptic transmission in the central nervous system, we have examined the action of isoflurane on slices from rat hippocampal cortex. Isoflurane 1.5% (1.38% anaesthetize 50% of tested rats (MAC)) reduced orthodromically evoked activity in pyramidal cells by 62%. This was due to the combined effects on afferent fibres, excitatory synapses and pyramidal cells. The effect on the postsynaptic neurones was almost as strong as the effect on the excitatory synapses: the population spike evoked by a given synaptic current was reduced by 24%, and the field-EPSP in response to a given afferent fibre volley by 27%. The presynaptic fibre volley was reduced by 17%. PMID- 3811988 TI - Release of immunoreactive vasoactive intestinal peptide (VIP) from the gallbladder in response to vagal stimulation. AB - Immunoreactive VIP was detected in the gallbladder lumen and in the arterial blood and venous effluent from the gallbladder in fasting cats. During perfusion of the gallbladder in vivo there was a constant basal intraluminal secretion of VIP. The VIP concentration in the luminal effluent exceeded that in plasma supporting the notion that there was a release from the gallbladder tissue. The rate of secretion was significantly increased during efferent electrical stimulation of the peripheral cut end of the cervical vagal nerves, after blockade with atropine. A similar increase in concentration of VIP was seen in the venous effluent from the gallbladder. The results suggest a local release of VIP from intrinsic neurons within the gallbladder wall. This release is increased in response to activation of non-cholinergic fibres in the vagus nerves, suggesting a role for VIP in regulation of gallbladder functions. PMID- 3811987 TI - Uptake of dehydroascorbic acid and ascorbic acid to isolated nerve terminals and secretory granules from ox neurohypophyses. AB - When uptake of L-[14C]ascorbic acid ([14C]AA) to various organs in guinea-pigs was studied after intracardiac injection, the adenohypophysis, pars intermedia, and the neurohypophysis had an uptake per milligramme protein which was about half of the uptake to the adrenals. Adrenal uptake was 20 +/- 2.8 pmol mg-1 protein microCi-1 injected. The uptake to the different parts of the hypophysis was considerably higher than the uptake to pancreas, liver, kidney, spleen and other organs. When isolated nerve endings (neurosecretosomes) from ox neurohypophyses were incubated with a medium containing labelled dehydroascorbic acid ([14C]DHA), the uptake was much slower than when the medium contained labelled ascorbic acid. The uptake of [14C]DHA showed a linear dependence on concentration, and was not influenced by addition of Mg2+ and ATP. Addition of Mg2+ + ATP, omission of Ca2+ and Mg2+ or exchange of Na+ in the medium with K+ had no effect on the uptake of ascorbic acid. When isolated secretory granules from ox neurohypophyses were incubated with a medium containing [14C]DHA, uptake was considerably faster than the uptake when they were incubated in a medium containing [14C]AA. The uptake of dehydroascorbic acid was linear with the concentration in the medium and was not changed by addition of Mg2+ ATP. Addition of 10 mM NH4Cl or exchange of 120 mM K+ in the incubation medium with Na+ did not change the uptake of dehydroascorbic acid. The contents of copper, zinc, iron and cobalt were determined in isolated nerve endings (A) and membranes (B) as well as in lysate (C) from isolated neurosecretory granules. The results (in nmol mg-1 protein) were for Cu: (A): 0.25 +/- 0.01 (SEM), (B): 0.67 +/- 0.16, (C): 0.22 +/- 0.06; for Zn: (A): 0.53 +/- 0.13, (B): 6.97 +/- 0.75, (C): 1.8 +/- 0.53; and for Fe: (A): 15.6 +/- 1.9, (B): 6.92 +/- 0.32, (C): 3.15 +/- 0.43. In all preparations the cobalt content was below the detection limit (less than 5 pmol mg-1 protein). PMID- 3811989 TI - Glucocorticoids and tri-iodothyronine inhibit uptake of ascorbic acid to isolated nerve terminals from ox neurohypophyses. PMID- 3811990 TI - Reinnervation of hind limb muscles after ventral root avulsion and implantation in the lumbar spinal cord of the adult rat. PMID- 3811991 TI - Decrease in skeletal muscle myoglobin with intensive training in man. PMID- 3811992 TI - Anti-asthma drugs attenuate inflammatory leakage of plasma into airway lumen. PMID- 3811993 TI - Influence of intensity of bone marrow erythropoietic activity on radiosensitivity of mice. II. Effects of carbon monoxide induced hypererythropoiesis and polycythemia on ability of bone marrow to restitute erythropoiesis in irradiated recipients. PMID- 3811994 TI - Clinical methods in psychiatric genetics. III. Environmental stratification may simulate a genetic effect in adoption studies. AB - In adoption studies, the possibility of inadvertent matching between biological and adoptive parents for some environmental variable (known or unknown) correlated with illness must be considered. We examine such bias quantitatively and show how a genetic effect can be simulated. Existence of a genetic effect which is independent of environmental correlation can be accepted, when the frequency of a disease in adoptees who have a biological parent affected and no adoptive parents affected is significantly greater than the frequency of the disease in adoptees who have an adopted parent affected and no biological parents affected. The published data on schizophrenia, alcoholism, and criminality do not exclude the possibility of undetected environmental correlations simulating a genetic effect, according to this direct criterion. PMID- 3811995 TI - Effectiveness and application of partial hospitalization. AB - Especially during the past 15 years, partial hospitalization (PHP) has been studied extensively. This article reviews the effectiveness and applicability of PHP. To clarify where PHP might fit into the overall mental health care system, the results of empirical research are evaluated with special attention to topics such as treated population, program evaluation, comparison of PHP with inpatient treatment, PHP as alternative to outpatient treatment, comparison of different PHP's, cost effectiveness and burden on the family. The general conclusion is that PHP can be a reasonable alternative to inpatient as well as to outpatient treatment, taking into account factors such as symptomatology, cost and family burden. PHP seems in particular to enhance social role functioning, which might be attributed to the fact that contact between patient and environment is not disturbed by hospitalization. Suggestions for further research are presented. Furthermore it is recommended in order to improve generalizability of results to differentiate the different functions PHP can fulfil in the mental health care system. PMID- 3811996 TI - Positive and negative subtypes of schizophrenia. A study from India. AB - Ninety-eight schizophrenic patients were studied to examine the concept of positive and negative subtyping. Using a cross-sectional phenomenological approach, the relationship of this subtyping with six definitions of schizophrenia was also investigated. The study provides support for this subtyping. Principal components analysis of the data and correlational structure of positive and negative symptom complexes lend further support to this notion. PMID- 3811997 TI - Stability of treatment outcome in short-term psychiatric care. A six-month follow up of a controlled study of patient involvement. AB - The general trend of avoiding and shortening in-patient treatment raises the question of the stability of treatment gains made during hospitalization. A 6 month follow-up was made for patients treated on a short-term psychiatric ward. The origin was a controlled study of two models of patient involvement in treatment planning. Patients benefiting most from a cooperation procedure during hospitalization were those with socio-psychological treatment objectives and those treated in a Basic Activation Group on the ward. The superior outcome for these patients was not stable during the period of follow-up, resulting in an incongruence between in-hospital and post-hospital adjustment. Furthermore, these patients at time of follow-up showed an increased confidence in the staff of the ward and a decrease in the rated importance of their social network. It is suggested that this is the result of dependency reactions and a separation process from the therapeutic milieu of the ward which were not resolved at time of discharge. Greater concern should be invested in formulating the treatment contract in an out-patient context in order to place the emphasis on the real life situation of the patient. PMID- 3811998 TI - Introducing community mental health services. The effects on a suburban patient population. AB - By means of a computerised psychiatric case register, the effects on a defined population with 71,371 inhabitants were studied when the mainly hospital-based psychiatric services in the area were changed to community mental health units with substantial outpatient resources. Diagnostic, social and demographic variables and care utilisation rates were compared. A 29% increase in patients under the new system was observed. Most of the newcomers had acute crisis reactions, were younger, on average, than previous patients and registered alcohol abuse and somatic diseases. Outpatient utilisation increased (170%) and hospital admissions decreased (22%). Compulsory admissions increased (43%), as did sick-leave registrations (21%). These trends are discussed in light of the new organization. PMID- 3811999 TI - Personality traits predicting weight loss outcome in obese patients. AB - A personality inventory, the Karolinska Scales of Personality (KSP), was administered to a group of 28 severely obese patients before treatment with jaw fixation. Several items significantly predicted incapacity to maintain the achieved weight loss 1 year after treatment: anxiety, monotony avoidance, suspiciousness and a low degree of socialization. These personality traits constitute a syndrome of ego weakness or impulsivity which warrants further study. PMID- 3812000 TI - Phobias in India and the United Kingdom. A trans-cultural study. AB - Thirty-nine phobic patients from India were compared with 39 similarly diagnosed age and sex matched patients from the United Kingdom. The British sample contained significantly more patients with agoraphobia and social phobia compared to the Indian group. Sudden death and illness phobias were more frequent in the Indian group. The Indian phobic patients also had more somatic and depressive symptoms. The influence of culture on the presentation of different phobias is discussed. PMID- 3812001 TI - Social factors and depression in Nigerian women. AB - A sample of 30 depressed patients was matched for age and social class with an equal number of non-psychiatrically disturbed subjects. The two groups were similar with regard to the vulnerability model of Brown and his colleagues. However, more depressed patients reported job dissatisfaction than controls. Depressed patients had experienced excess of life events prior to the onset of depression. They were also distinguished from the controls by categories of events involving losses and those related to work. PMID- 3812002 TI - Schizophrenic patients and their parents. A multimethod design and the findings from an illustrative empirical study of cognitive disorders and communication deviances. AB - The research design and main findings from a multimethod research project, in which cognitive disorders in schizophrenic patients and communication deviances in their parents were examined, are presented. Non-paranoid schizophrenics manifested cognitive disturbances on a majority of the variables examined, while paranoid schizophrenics did not. Likewise, parents of non-paranoid schizophrenics revealed significantly more communication deviance than parents of paranoid schizophrenics as well as the control groups (normal and "neurotics"). Egocentrism appeared to be a prominent characteristic of the communication of non paranoid schizophrenics' parents. Conspicuous among the cognitive deficits in their offspring were attentional disturbances. Support for the existence of a link between the parents' communication and the offsprings' cognitive functioning was found by correlation- and regression analyses. PMID- 3812003 TI - Research on the effects of psychodrugs on human interaction. A theoretical/experimental approach. AB - An original method of testing which can measure interactional patterns is presented. This method is based on a relational model, which describes the relational behaviour as a sequence of elementary interactions, in which a "single bit of information" is exchanged. The model and the testing method are applied to monitoring treatment of patients with psychodrugs. PMID- 3812004 TI - Relation between suicide and homicide in Portugal from 1970 to 1982. AB - To evaluate to what extent a suicide can be considered a hetero-aggression converted into self-aggression, this study analyses whether the increase in suicides corresponds to a decrease in homicides and vice-versa. Rates of suicide and homicide from 1970 to 1982 have been analysed in Portugal, Azores and Maderia, and the district and city of Lisbon; age and sex groups have also been compared. There is no inverse variation between suicides and homicides either globally or for males or females. There is also a difference in age distribution for suicides and homicides - suicides being mainly over 50 years, homicides mainly under. This suggests that it is not very plausible that self- and hetero aggressive behaviours alternate in the same individual, although it is possible that, with increasing age, he may move from hetero- or potential hetero aggression to self-aggression. PMID- 3812005 TI - Suicide in southwestern Greece 1979-1984. AB - Study of suicide in a province of southwestern Greece (population 295,000) from 1979 through 1984 demonstrated: mean suicide rate 0.48/10,000 population/year; significant increase of the suicide rate in men after the age of 65, but not in women; significantly higher suicide rate in men from rural than from urban areas; significantly higher suicide rate in men than in women from rural areas, no difference in urban areas; differences in suicide frequency or age at suicide were observed between subjects of different marital status; violent methods of suicide were most frequently used; and psychological disorders were the most frequent causes of suicide. Many of these findings are observed for the first time. Some may be related to the characteristics of the population studied, whereas others may also be present in other populations. PMID- 3812006 TI - Non-regressive schizophrenia: prediction of regressive course. AB - Regressive course during a 14-17 year follow-up in 54 non-regressive (pseudoneurotic, borderline, latent) schizophrenic subjects was predicted from about 100 variables studied on first admission. A significant prediction could not be achieved. This finding lends additional support to our previous interpretation that patients with a non-regressive syndrome are schizophrenics. A large number of them will run a typical schizophrenic course, but we are unable to predict from initial data who will do so. The few possibly predictive variables seemed to be of an unspecific, quantitative and longitudinal nature. They may act in a cumulative manner to increase the vulnerability to psychotic decompensation. PMID- 3812007 TI - Epidemiology of suicide in a Swedish county (Vasterbotten) 1961-1980. AB - As the initial part of the development of a suicide prevention program in a county in northern Sweden, an epidemiologic study on all suicides in the Vasterbotten county 1961-1980 was performed. The study confirms other studies which differentiate between an urban-alienated pattern and a rural-traditional. There is a considerable increase in the suicide rate during the 1970's in the county alongside the development of a marked difference between different socio economic regions. The highest suicide rates are now found in the most sparsely populated mountainous areas in the western part and in the most rapidly expanding urban area. PMID- 3812008 TI - Characteristics of a good ward atmosphere. AB - Thirty-five short term wards were evaluated with the WAS and a good milieu index. The results indicated that psychotic and non-psychotic patients need different types of atmosphere. Psychotic patients seem to benefit primarily from a milieu with a high level of Support, Practical orientation and Order and organization, and a low level of Anger and aggression, whereas non-psychotic patients seem to benefit mostly from a milieu with a high level of all subscales except for two: the level of Staff control ought to be low and the level of Anger and aggression ought probably to be intermediate. PMID- 3812009 TI - Experiences from a marital-sex therapy clinic in Nairobi. AB - Out of 100 first referrals to a newly started family/marital - sex therapy clinic in Nairobi, 52 cases were studied for sociodemographic characteristics, help seeking pattern for their sexual problems, presentation of the sexual problems, factors that might sustain the sexual problems, types of sexual problems and the treatment approaches. There was a male preponderance. Both married and non married patients were seen. The problems tended to occur in relatively young people, and for those who were married in relatively early years of their marriage. The patients attributed the causes of the sexual problems to physical rather than psychological factors, although objective assessment found relatively very few possible physical causes. Elementary rather than subtle psychological causes were frequent. These formed fertile grounds for intervention. The findings are discussed in the light of the social-cultural context in which they were obtained. PMID- 3812010 TI - Detection of physical disorder in newly admitted psychiatric patients. AB - Screening tests for the detection of physical illness in 650 newly admitted psychiatric patients were examined critically. Almost 17% of these investigations were found to be abnormal and certain high risk groups were identified. These included patients suffering from significant weight loss, substance abuse, disorientation and self-neglect in addition to the elderly and patients with clinical evidence of physical disorder on examination. The young and physically fit had the least number of abnormalities, and it is suggested that more clinical common sense should determine the screening procedure and that no test is rightly "routine". PMID- 3812011 TI - Parapartum mental illness: timing of illness onset and its relation to symptoms and sociodemographic characteristics. AB - Clinical pictures and certain sociodemographic factors were studied retrospectively in all women in the county of Stockholm who had a baby during 1976-77 and also had been admitted to a psychiatric department after the 20th week of pregnancy or during the first postpartum year. The sample was classified according to the Research Diagnostic Criteria. A significant rise in the incidence of mental illness was found within the first 3 months postpartum and particularly so within 1 month postpartum as compared with during pregnancy and the following 9 months. This peak in incidence was due to a rise in the number of women classified as Unspecified Functional Psychosis. The nosology of postpartum psychosis is discussed. An increased frequency of neurotic or minor psychiatric disorders was noted during pregnancy as compared with the first 3 months postpartum and the following 9 months. No associations were found between the sociodemographic factors considered and the time of illness onset, although marital discord tended to be more frequent in women with onset of illness during pregnancy. PMID- 3812012 TI - Psychosocial outcome in schizophrenia and psychotherapeutic orientation. AB - The purpose was to compare the psychosocial outcome in two groups of schizophrenic patients who were treated by different methods but were in other respects unselected, and to consider factors predictive of the outcome. The first sample, consisting of a total of 100 patients, had received hospital and outpatient care, here called traditional; only 12 of them had received sustained psychotherapy. Of the second sample, comprising 75 patients, 66 were treated in a psychotherapeutic community and 25 also received sustained psychotherapy. All patients were interviewed by the author on an average of 8 years after the first hospitalization. The patients treated in the psychotherapeutic community had remained longer under hospital care, particularly at first, and at the end of follow-up their functional capacity was lower, but they were more satisfied with the treatment received compared with the patients treated traditionally. The samples did not differ in terms of clinical status. The severity of the schizophrenic disorder, including diagnostic category, and a tendency toward grandiose thinking emerged as the most important factors predictive of psychosocial outcome. Premorbid psychosocial development and social support were also relevant to the outcome. After taking the predictor variables into account, extensive hospital care was still associated with a poor outcome. This may in part explain why, despite the greater amount of psychotherapy provided, the functional capacity of the patients who received psychotherapeutic community treatment had poorer outcome than those treated traditionally. PMID- 3812013 TI - Neuropsychological functioning in schizoaffective disorder, depressed type. AB - Neuropsychological functioning in schizoaffective disorder, depressed type, was tested by two parallel studies. In Study 1, the Luria-Nebraska Neuropsychological Battery (LNNB) was administered to samples of patients meeting Research Diagnostic Criteria (RDC) for schizodepressive disorder, major depressive disorder or schizophrenia, and to a normal control group. In Study 2, the same test battery was used in patients with a former RDC diagnosis of schizodepressive or major depressive disorder, examined from 2 to 4 years after the index episode, during a phase of remission. Study 1 showed that the performance of schizodepressives on LNNB is, on average, intermediate between those of depressives and schizophrenics, which finding is compatible with the view that RDC schizoaffective depression encompasses a heterogeneous group of syndromes, some of which are related to major depression and some to schizophrenia. Study 2 showed that the mean scores on the LNNB scales Memory and Intellectual processes are significantly higher in patients with a former diagnosis of schizodepressive disorder, which supports the idea that the outcome of these patients is worse, on average, than that of "pure" depressives. PMID- 3812014 TI - Space orientation of total hip prosthesis. A method for three-dimensional determination. AB - A method for in vivo determination of orientation and relation in space of components of total hip prosthesis is described. The method allows for determination of the orientation of the prosthetic components in well defined anatomic planes of the body. Furthermore the range of free motion from neutral position to the point of contact between the edge of the acetabular opening and the neck of the femoral component can be determined in various directions. To assess the accuracy of the calculations a phantom prosthesis was studied in nine different positions and the measurements of the space oriented parameters according to the present method correlated to measurements of the same parameters according to Selvik's stereophotogrammetric method. Good correlation was found. The role of prosthetic malpositioning and component interaction evaluated with the present method in the development of prosthetic loosening and displacement is discussed. PMID- 3812015 TI - The subarcuate fossa and channel. A radioanatomic investigation. AB - The subarcuate channel conveys the blood supply to the otic capsule of the semicircular canals, to part of the vestibule and to other neighbouring structures. It is often observed in conventional radiographs of the temporal bone and is reproduced to advantage by conventional multidirectional and computed tomography. The purpose of this report is to draw the attention of otoradiologists to this anatomic structure and to report on some results concerning the radioanatomy of the channel. Plastic casts of 100 radiographed and subsequently macerated temporal bones were evaluated. Fourteen temporal bone specimens were submitted to automatic serial cryomicrotomy. The radioanatomic variations of the channel were demonstrated. The radiographic reproducibility of the channel, length and width, were found to be dependent on the degree of perilabyrinthine and mastoid pneumatization of the temporal bone. PMID- 3812016 TI - Computed tomography of temporal bone specimens. A test of the resolution capability. AB - Ten deep-frozen temporal bone specimens were subjected to computed tomography (CT) in five different projections. The possibility of identifying small structures, such as the ossicles and aqueductal lumina, was assessed. In addition, the semicircular canals were measured. Subsequently corresponding measurements were carried out on plastic casts of these specimens for comparison. A temporal bone specimen is well suited as a test object for evaluating the detectability of small and dense natural structures by CT. PMID- 3812017 TI - Balloon dilatation of alimentary tract strictures. AB - From a series of balloon dilatations of alimentary tract strictures 11 patients with different types of gastric and oesophagogastric anastomotic stenoses are reported. The dilatation of gastric outflow tract obstructions was highly effective in the treatment of retention. In 7 out of 8 cases with gastric outflow stenosis surgery could be entirely avoided and replaced by balloon dilatation. The importance of eliminating retention in the healing of gastric ulcer is discussed. Fistulation in oesophagogastric anastomoses due to stenosis of the outflow portion was successfully treated. The importance of achieving a free outflow tract in order to prevent insufficiency of the anastomosis and formation of a fistula is stressed. PMID- 3812018 TI - Posture of the head and pharyngeal swallowing. AB - Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defective closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In four other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards. PMID- 3812019 TI - Pharyngeal swallowing in patients with paresis of the recurrent nerve. AB - Pharyngolaryngeal function during swallowing was investigated cineradiographically in 22 patients with paresis of the recurrent nerve. Nineteen of these patients (86%) had defective closure of the laryngeal vestibule: 10 patients had defective apposition of the corniculate cartilages, (paresis of the oblique cricoarytenoid muscle), 9 patients had defective apposition of the arytenoid cartilages, (paresis of the interarytenoid muscle), 13 patients had defective movement of the epiglottis (paresis of, i.a. the thyrohyoid muscle), 1 patient had defective closure of the subepiglottic portion of the vestibule (paresis of the thyroepiglottic muscle), 2 patients had defective closure of the supraglottic portion of the vestibule (paresis of the superior ventricular segment of the thyroarytenoid muscle). Five patients with immobility of the epiglottis also had paresis of the pharyngeal constrictor musculature indicating paresis of the superior laryngeal nerve. Our investigation has shown that patients with paresis of the recurrent nerve who present with dysphagia with or without aspiration should be examined cineradiographically for pharyngolaryngeal function during swallowing. PMID- 3812021 TI - Inadvertently performed hysterosalpingography during early pregnancy. AB - A review of 6,225 hysterosalpingographies disclosed four cases of inadvertently performed examinations during early pregnancy. These radiologic misadventures were in three cases performed because of oligomenorrhoea and in one case because of a misjudged decidual bleeding. The radiologic findings and the outcome of these pregnancies are presented. Precautions to avoid this radiographic error are discussed. PMID- 3812020 TI - Barium and meat. A comparison between pharyngeal swallow of fluid and solid boluses. AB - The influence of bolus consistency on pharyngeal swallow was radiologically studied in 24 individuals by comparing liquid barium and solid meat after chewing. Pharyngeal function was apparently performed synchronously and symmetrically on both boluses. No definite conclusion about the influence on epiglottic mobility, closure of the laryngeal vestibule and relaxation of the cricopharyngeal muscle could be drawn from this study. There was no difference in the elevation of the pharynx and larynx. The transit time for a solid bolus was shorter compared with that of a fluid bolus. The transit time for the apex of the bolus was shorter than for the tail. A more marked elevation of the pharynx and larynx was followed by a shorter transit time. The width of the pharyngo esophageal segment was larger in the transverse than in the sagittal diameter during the passage of the bolus and larger on solid compared with fluid swallow. Our results reflect the ability of pharyngeal swallow to be executed with precision and with few alterations due to variable bolus consistency. PMID- 3812022 TI - Value of bone scan in the McCune-Albright syndrome. Report of a case. AB - Bone scintigraphy proved valuable in diagnosing McCune-Albright's syndrome in a 6 year-old girl by detecting multiple, non-symptomatic foci in the skull, axial skeleton and in the extremities. Subsequent roentgen examination showed abnormal bone structure in the affected areas, consistent with fibrous dysplasia. PMID- 3812023 TI - Computed chest tomography in rats with pulmonary damage due to microembolism. AB - Computed chest tomography was performed in 13 rats with pulmonary damage due to microembolism, caused by injection of thrombin (500 NIH/kg body weight) and tranexamic acid, a fibrinolytic inhibitor (200 mg/kg body weight), and in 9 control rats. The purpose of the investigation was to perform attenuation measurements at two levels of the right lung, each with three regions of interest (anterior, mid and posterior). Alterations in attenuation, compared with controls, were correlated with lung weight. Compared with controls, the attenuation was significantly increased in the anterior and posterior regions at both levels in animals with pulmonary damage, but not in the mid regions. There was a statistically significant correlation between increasing attenuation and increasing lung weight. A significant difference was found between damaged and control lungs regarding the microscopic grade of interstitial oedema, alveolar oedema and fibrin. Histograms of attenuation values in computed tomograms might be of value in detecting alveolar oedema. It is concluded that computed chest tomography is a good method for detecting pulmonary oedema at an early stage of experimental microembolism in the rat. PMID- 3812024 TI - Cardiovascular responses to the intracarotid injections of ionic contrast media and iohexol in the dog. AB - Hypotension and bradycardia are the most significant cardiovascular responses resulting from intracarotid injections of hypertonic contrast media (CM). We have assessed both local and systemic vascular responses to the selective intracarotid injections of ionic and non-ionic CM in twelve pentobarbital anesthetized dogs. Alterations in blood pressure, heart rate, and femoral, renal and carotid blood flows were monitored following right common carotid artery injections of ionic contrast media (282-288 mg I/ml), isotonic saline, and iohexol (300 mg I/ml). Ionic CM led to early (0 to 10 s) decreases in blood pressure, heart rate and femoral vascular resistance. Isotonic saline induced no significant early changes in these same parameters while iohexol caused a decrease in heart rate. Our observations suggest that the early (0 to 10 s) decreases in femoral vascular resistance, heart rate and pressure that occur with the intracarotid injection of hypertonic CM are mediated via the autonomic nervous system and initiated from a site in the carotid circulation. During the 15 to 40 s period when the CM has reached the systemic circulation, iohexol produced smaller effects on systemic blood pressure and peripheral vascular resistances than did the ionic CM. During this 15 to 40 s period there were decreased vascular resistances in the carotid and renal vascular beds that probably result from local effects of the CM, however, the femoral resistance was actually increased. This later increase in femoral resistance probably represents the results of increased sympathetic nervous system activity working to offset the decrease in renal and carotid resistances and thus maintain pressure at baseline values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812025 TI - Subspecialization--the dilemma of internal medicine. PMID- 3812026 TI - A study of the association between the prolongation of the QT interval in the resting ECG and myocardial infarction. AB - The relationship between the incidence of myocardial infarction in the 10 year follow-up period and the length of the QT interval and its two components (the time elapsing between the Q wave and the beginning of the T wave, and the duration of the T wave) was investigated in a study of the records of a group of men drawn from a random sample of all 55-year-old men living in Goteborg, Sweden. A significant association was found between the incidence of myocardial infarction and the first component but not with the second component or the QT interval itself. The two components were found to be independent and thus to have the potential to act as confounding factors if the QT interval is examined alone. Further, our results suggest that correcting the QT interval for heart rate needs careful reassessment. PMID- 3812027 TI - Platelet number and volume during myocardial infarction in relation to infarct size. AB - Platelet number and mean platelet volume (MPV) were measured in 100 patients with acute chest pain, 41 with acute myocardial infarction (AMI), 33 with angina pectoris (AP) and 26 with non-coronary event (NCE), and compared with 21 controls. We found no significant difference in platelet count on admission in the patient groups, but it was lower compared with controls. There were no significant differences in MPV between the patient groups nor between patients and controls. Thirty patients with AMI were followed for 10 days and showed an initial 12% fall in platelet count followed by a 36% increase. Initially there was an increase in MPV (2%) followed by a fall (8%). The fall in platelet count and increase in MPV correlated with infarct size (maximum activity of lactate dehydrogenase (LDH)) and might reflect consumption of platelets. The precise role of platelets in the process of infarction is still unknown. PMID- 3812028 TI - Epidemiology of diabetes mellitus in Sweden. Results of the first year of a prospective study in the population age group 15-34 years. AB - All newly diagnosed cases of diabetes mellitus aged 15-34 years in Sweden, where the population in this age interval is about 2.3 million, were registered on standardized forms. During 1983, the first year of the study, there were 311 males and 161 females, excluding 280 with gestational diabetes. The annual incidence of diabetes was 26.2 per 100,000 in males and 14.2 in females. The respective figures for type I were 18.5 and 10.1, and for type II 5.7 and 2.9. The incidence of type I diabetes was similar for the four age groups (15-19, 20 24, 25-29, 30-34 years), while for type II it was highest in the oldest group. Types I and II, but not the sexes, differed as regards the cumulative distribution curves of the maximum blood glucose concentration during the first two weeks after diagnosis. The present incidence of diabetes in Sweden is higher, particularly in males than the rates for similar age groups in Oslo (1925-64) and Denmark (1970-77). PMID- 3812029 TI - Malignant hypercalcemia--a hospital survey. AB - A hypercalcemia frequency of 1.5% was found in patients with malignant disease attending a large oncological center. Eighty per cent of hypercalcemias were of obvious malignant etiology. Hypercalcemia was most frequent in multiple myeloma, renal carcinoma, squamocellular carcinomas of different sites and breast cancer. Most patients had advanced metastasized disease. In 80% of those with solid tumors malignant hypercalcemia was associated with bone metastases. Serum calcium could almost invariably be reduced by treatment, and active treatment was associated with a more favorable prognosis. One year actuarial survival of patients with malignant hypercalcemia was 31%. PMID- 3812030 TI - Long-term corticosteroid treatment in giant cell arteritis. AB - Ninety patients with giant cell arteritis were followed up 9-16 years (median 11.3 years) after diagnosis. The mean duration of corticosteroid therapy was 5.8 years (range 0-12.8 years). Together, the patients had received corticosteroids for 492 patient-years. Five years after diagnosis, 43% of the patients were on corticosteroid therapy. After 9 years, 15 of 60 surviving patients (25%) were still being treated with 1.25-10 mg of prednisolone daily (median dose 5 mg). The relapse rate was about 50%, regardless of the time after diagnosis, when an attempt to withdraw the treatment was made. Forty-six per cent of the relapses occurred within one month and 96% within one year of the end of treatment. Most of the flare-ups occurred during the first year of therapy and in 55% of the patients on a prednisolone dosage of 5 mg or less. We did not find any increase in morbidity in our patients compared to the general population. Nor did we see any significant complications which we could attribute to the steroid treatment. PMID- 3812031 TI - Urinary tract and renal findings in acute Yersinia infections. AB - We studied 71 patients with acute Yersinia infection for the occurrence of pathologic urinary and renal findings. Transient proteinuria and/or microhematuria was found in 17 patients (24%) and slightly elevated serum creatinine in seven patients (10%). Renal biopsy was done in two patients and revealed mild mesangial glomerulonephritis in both cases. One of these patients had IgA glomerulonephritis and Reiter's syndrome. Pyuria occurred in 16 patients (23%) and was frequently associated with Reiter's syndrome. Seventy-three patients with acute intrinsic renal failure were studied for the occurrence of acute Yersinia infection by determining Yersinia antibodies by ELISA. One out of 13 patients with acute glomerulonephritis but none of 60 patients with acute tubulointerstitial renal disease had acute Yersinia infection. Acute Yersinia infection seems to be rarely an etiologic factor in acute intrinsic renal failure. Our results indicate that transient proteinuria, microhematuria, pyuria or impaired renal function are frequent findings in patients with acute Yersinia infections. However, glomerulonephritis seems to be a rather infrequent and mild complication of acute Yersinia infection. PMID- 3812032 TI - Acrodermatitis chronica atrophicans Herxheimer can often mimic a peripheral vascular disorder. AB - During the past few years five patients have been referred to the angiology section at Danderyd Hospital under the diagnosis of chronic venous insufficiency but who were instead suffering from acrodermatitis chronica atrophicans (ACA). The typical case of ACA starts with a limited inflammatory lesion, which is gradually replaced by atrophy and the skin shows a bluish, red discoloration. Late changes may be subluxation of joints in hands or feet and periosteal thickening. Capillary microscopy often reveals a clear picture of atrophy and a prominent, dilated subpapillary venular plexus. If localized to the leg the blood flow of the foot and lower leg may be increased, skin temperature elevated and venous capacity and return augmented. All these variables can consequently mimic venous insufficiency of the leg. ACA is caused by a Borrelia infection and serological testing will always show a significantly elevated titer to Borrelia. The disease is most often easily cured by 2-3 g of penicillin daily for two to three weeks. PMID- 3812033 TI - Secondary intraventricular haemorrhage in blunt head trauma. AB - Intraventricular haemorrhage (IVH) has been detected by computed tomography (CT) in 225 patients admitted to our clinic from 1977 to 1985. In 9 patients IVH was caused by trauma. We report two cases in whom IVH occurred after a lucid interval of about 10 hours postinjury. The pathogenesis of traumatic IVH is discussed comparing these cases with a review of the literature. PMID- 3812034 TI - Clinical evaluation of a simple epidural pressure sensor. AB - The Plastimed epidural pressure sensor was evaluated in 35 patients, twenty-eight of whom were suffering from head injury. In seven patients simultaneous intraventricular pressure measurements were obtained. The epidural pressure sensor was only functioning satisfactorily in approximately 2/3 of the patients, while it was malfunctioning or not functioning in the remainder. In seven comparable IVP/EDP studies significant differences up to 25 mm Hg were noted. In three patients IVP was greater than EDP. In two patients the opposite was true. No significant complications were observed. These unsatisfactory results have made us abandon the technique and resort to intraventricular or subarachnoidal pressure measurements. PMID- 3812035 TI - Pneumocephalus and tension pneumocephalus after posterior fossa surgery in the sitting position: a prospective study. AB - Thirty patients subjected to posterior fossa surgery in the sitting position were evaluated postoperatively by CT scans in order to assess the true incidence of pneumocephalus and subsequent development, if any, of tension pneumocephalus. This prospective survey shows that the postoperative incidence of intracranial air was 100%, while no progression towards tension pneumocephalus producing severe neurological deterioration was observed. It can thus be claimed that, although the sitting position may favour the development of tension pneumocephalus also other factors contribute to its pathogenesis. Finally, neither nitrous oxide nor temperature play any significant role in the development of this complication. PMID- 3812036 TI - Intracerebral mass lesions in patients affected by AIDS. AB - "Toxoplasma gondii" cerebral abscess is a common opportunistic infection in patients affected by AIDS. Making a reliable diagnosis of acute cerebral toxoplasmosis is difficult in AIDS patients because of the lack of specificity of serological data and neuroradiological findings. Brain biopsy is the only procedure which enables a reliable diagnosis to be made a trial of specific medical therapy for toxoplasmosis in patients affected by AIDS and intracranial mass lesion can be advisable before performing brain biopsy. The authors report the cases of three patients affected by AIDS and cerebral toxoplasmosis. Tissue diagnosis was made in the first patient from autopsy material while a presumptive diagnosis was made in the other two cases since specific medical therapy resulted in a dramatic improvement of the neurological status. Despite the good possibilities in the treatment of this complication AIDS, however, carries a poor prognosis. PMID- 3812037 TI - Leucocyte scanning--a valuable tool in diagnosing cerebral abscess--a survey. AB - Intracerebral abscess is a diagnosis which occasionally can be difficult to establish by using CT scan only. This survey describes the usefulness of a supplementary indium-111 autologous granulocyte scan which may increase the diagnostic specificity in the differential diagnosis between neoplasm and intracranial abscess. Judging from the literature and our own investigations the application of the granulocyte scan is discussed with special reference to the possible pitfalls which can give both false negative and false positive results. PMID- 3812038 TI - The protective effect of experimental subarachnoid haemorrhage on sodium dehydrocholate-induced blood-brain barrier disruption. AB - The potential interactive effects between subarachnoid hemorrhage (SAH) and blood brain barrier (BBB) disruption were studied in a rat model. Experimental subarachnoid hemorrhage was produced in twenty rats (experimental group) by the intracisternal injection of blood. In ten additional rats (control group), saline was administered in place of blood. Analysis of mean blood pressure (MBP), intracranial pressure (ICP) and cerebral perfusion pressure (CPP) demonstrated an increase in ICP and MBP and a drop in CPP in all animals following intracisternal injection. Subsequent infusion of the left internal carotid artery with sodium dehydrocholate resulted in blood-brain barrier (BBB) disruption in both groups as evidenced by Evans blue staining of the infused cortex. The extent of BBB disruption was significantly greater in the control group than the experimental group. Analysis of the experimental group demonstrated that animals with the lowest pre-SAH MBP and the lowest CPP during the maximum blood pressure response to SAH demonstrated the greatest resistance to experimental BBB disruption. The possibility of ischemia as a contributing factor in BBB protection subsequent to SAH is discussed. PMID- 3812039 TI - Determination of the glial fibrillary acidic protein in human cerebrospinal fluid and in cyst fluid of brain tumors. AB - The glial fibrillary acidic protein (GFAP) have been quantitatively determined in over 200 samples of liquid content of brain tumours and in cerebrospinal fluid (CSF) of cases with various tumours of the cerebral nervous system. For establishing the GFAP value, the rocket radioimmunoelectrophoresis was used. The studies were performed in three series of patients. The GFAP value of fluids from 26 cysts of both neoplastic and non-neoplastic type had a wide range of 0.6 microgram/ml to 40 micrograms/ml. Significant elevation of GFAP was usually recorded in fluid from cysts of anaplastic tumour with astroglial differentiation. In this series of 24 cases with various brain tumours, the GFAP value of the CSF ranged from 0.2 microgram/ml to 50 micrograms/ml. In gliomas, as in astrocytoma and glioblastoma, these values were on a higher level, of over 4 micrograms/ml. In other tumours and in cerebral lesions of other aetiology, the GFAP values were lower, below 3 micrograms/ml and 0.3 microgram/ml respectively. In another series of 32 patients with brain tumour treated surgically, a significant increase of GFAP (to 30 micrograms/ml) was noted in the CSF during the first week after operation, and that was always associated with an increase of the total protein of the CSF. During the second and third week after operation, when the total protein of the CSF was reduced to a normal level, the values of GFAP were still elevated, first of all in those cases of astrocytoma and glioblastoma which were not radically excised. These findings suggest that investigation of GFAP in the CSF of patients with brain tumour may be helpful in diagnosis and prognosis. PMID- 3812040 TI - Accidental high voltage electrocution: a rare neurosurgical problem. AB - The authors describe a case of accidental electrocution from a high voltage current in a young worker, who was struck by the electric shock in the mid occipital region. The case is especially interesting due to the improbability of anyone surviving after receiving a shock of more than 1000 V., and to the development of bilateral parieto-occipital haemorrhagic infarction with spastic paraparesis, directly caused by the high voltage current and not indirectly by heat generation or secondary head trauma. PMID- 3812041 TI - An orbital-zygomatic-malar bone flap approach: a technical note. AB - The authors describe an orbito-zygomatic-malar bone flap approach which gives lateral extra-cerebral access to the internal base of the skull. The technique is described, and some of the situations in which it has been used are discussed. PMID- 3812042 TI - Influence of transsphenoidal hypophysectomy on visual deficit due to a pituitary tumour. AB - The effect of transsphenoidal hypophysectomy is presented in 60 patients with visual impairment due to a pituitary adenoma, derived from a total series of 194 patients. The preoperative visual acuity and visual fields were compared with those one year after operation. The visual field loss was estimated using a semi quantitative method. Seventy-two eyes had diminished visual acuity, and this improved in 45 eyes (63%). Visual field loss was present in 102 eyes and this improved in 71 eyes (70%). Improvement of either visual acuity and/or visual field was found in 84 eyes (78%). In 16 patients (27%) vision became normal after operation. Improvement of the visual acuity was usually accompanied by an improvement in the visual fields. PMID- 3812043 TI - Spontaneous intracerebral haematomas. Clinical and computertomographic findings and long-term outcome after surgical treatment. AB - Fifty-four patients, aged 15 to 81 years had a spontaneous intracerebral haematoma surgically removed (51 patients) or had ventricular drainage. One-third had arterial hypertension. Two thirds were alert or drowsy preoperatively and two thirds presented with hemiparesis or decerebrate rigidity. Lobar haematomas constituted 72%, deep supratentorial constituted 21% and cerebellar haematomas 7%. Volume of the haematomas ranged from 10 to 205 ml. 10 patients died in the early postoperative phase and 8 patients died later. Among 36 survivors, 35 were evaluated 15-115 months postoperatively. 10 had resumed part of their earlier occupation. Another 12 were incapacitated and the remaining 13 patients needed nursing care. No patient was neurologically or neuropsychologically intact, but 19 had only slight disabilities. CT-changes at follow-up ranged from no abnormalities at all to low-density lesions, possibly associated with dilatation of a lateral ventricle or porencephaly depending on the size of the haematoma and possible ventricular penetration. Surgical evacuation of ICH is recommended in lobar or deep supratentorial haematomas exceeding 20 ml except in patients older than 60 already unconscious. Smaller haematomas with intraventricular extension may benefit from ventricular drainage or, in the fossa posterior, even from evacuation in case of increasing brain stem compression. PMID- 3812045 TI - Restraint among bulimic women. AB - In the present investigation, the scores of bulimic women on the Restraint, Social Desirability, and Lie scales were compared with the scores of obese dieters, obese nondieters, and nondieters whose weights were within normal limits. Bulimics attained significantly higher restraint scores than obese nondieters and normals. These results are discussed within the context of models of bulimia nervosa. PMID- 3812044 TI - The clinical course of surgically treated posttraumatic subdural hygromas. AB - The clinical course of 11 patients with a subdural hygroma, who underwent neurosurgery, was studied. In the first week after the operation no improvement of the mental status could be detected. We considered therefore that operation hardly contributed to improvement. Thus the need to operate is limited to special cases such as acute or space-occupying subdural hygroma. PMID- 3812046 TI - Treatment effectiveness of hypnosis and behaviour therapy in smoking cessation: a methodological refinement. AB - Studies in smoking cessation have generally failed to adequately control for active treatment effects and have assumed that measures of smoking behaviour (i.e., estimated smoking rate, self-monitoring and chemical analysis) are equally reliable measures. Sixty smokers were randomly assigned to one of four different smoking cessation treatment groups: hypnosis, focussed smoking, attention placebo and a waiting list control. Subjects were asked to estimate and monitor their own smoking behaviour. Blood samples were also taken for thiocyanate analysis before treatment. Smoking rates were similarly measured directly, at 3 months and 6 months after treatment. The results indicate that the three measures of smoking behaviour were all highly correlated. No significant differences were found between treatments, directly after treatment or at the 3- and 6-month follow-ups. These results suggest that active treatment effects may not be responsible for behavioural change in a smoking cessation program. The implications of these findings are discussed. PMID- 3812047 TI - Self-efficacy as a predictor of smoking behavior in young adolescents. AB - This study sought to develop a self-efficacy scale to predict smoking behavior and diagnose the most vulnerable factors associated with its onset. A sample of 800 seventh and eighth grade students received the survey on three separate occasions over an 8-month period. The instrument was comprised of 50 self efficacy items, including social and emotional variables, and a self-report of smoking behavior. The data revealed an association between the total self efficacy score and reported smoking behavior, implying the predictive capacity of the instrument. Factor analysis indicated several recurring item groups: social opportunities to smoke, emotional stress, and peer influences. Discriminant analysis of the subscales provided significant prediction of smoking behavior. Onset smoking behavior was also predictable over 3- and 5-month intervals. Peer influence persisted as the primary determinant of smoking activity. To confirm these results and ascertain the generalizability of this instrument, it is recommended that it be administered in other communities, and in conjunction with biochemical analysis to validate the self-reported smoking behavior. The instrument has potential application as a predictor of smoking behavior, to permit the design of more appropriate prevention programs, and as an effective evaluation measure for such interventions. PMID- 3812048 TI - The effect of waiting for inpatient alcoholism treatment after detoxification. An experimental comparison between inpatient treatment and advice only. AB - Seventeen detoxified alcoholics were randomly assigned to a waiting list group or an inpatient treatment group. The waiting list group members were informed that they had to wait some time until there was a vacant place. By their discharge from the Detoxification Unit they were told to complete a self-report form every day with regards to drinking, working, sleeping home and use of disulfiram orally. Two weeks later they had an outpatient appointment in which the self reports were collected and reviewed. This was repeated once for everybody so that they all had to wait 4 weeks. By discharge from further inpatient treatment, the inpatient treatment group was instructed to record the same four behaviors daily as the waiting list group did, and they, too, got an outpatient appointment with a 2 week interval. No significant differences between the groups were observed in the three main variables of drinking, working and sleeping home, but the waiting list group used significantly more disulfiram than the inpatient treatment group. PMID- 3812049 TI - Characteristics of patients with bulimia only, bulimia with affective disorder, and bulimia with substance abuse problems. AB - Characteristics of patients with a diagnosis of bulimia only (N = 46), bulimia with a history of affective disorder (N = 34), and bulimia with a history of substance abuse (N = 34) were compared. Results showed that compared to patients with bulimia only or with bulimia and affective disorders, patients with bulimia and substance abuse experienced a higher rate of diuretic use to control weight, financial and work problems, stealing before and after the onset of the eating disorder, previous psychiatric inpatient treatment, and greater amount of alcohol use after the onset of the eating disorder. Both the substance abuse group and affective disorder group showed a higher incidence of attempted suicide, more social problems, and greater overall treatment rate than the bulimia only group. There were no significant differences among groups in their family histories. PMID- 3812050 TI - Taste dimensions in cigarette discrimination: a multidimensional scaling approach. AB - This study was designed to uncover the fundamental psychological taste dimensions underlying people's ability to discriminate among commercial cigarettes, determine the roles that nicotine, tar, and carbon monoxide play in such taste dimensions, determine whether subjects can distinguish among cigarettes in general, and determine whether they can choose their own brand from among others. Similarities data were collected in a pairwise comparisons task. A multidimensional scaling analysis of the data revealed two dimensions, flat-sharp and high nicotine-low nicotine. Ratings of cigarette sweetness were highly related to ratings of satisfaction and pleasantness, while nicotine, tar, and carbon monoxide had moderate to low correlations with the flat-sharp dimension, sweetness, satisfaction, and pleasantness. While smokers can make distinctions among cigarettes, they generally were not able to choose their own brand from among others. Implications of the study for therapeutic intervention, for constructing more palatable low nicotine, tar, and carbon monoxide cigarettes, as well as for explaining weight gain upon smoking cessation were discussed. PMID- 3812051 TI - Effects of expanded tobacco on acceptability and reported consumption of low-tar cigarettes. AB - Experimental cigarettes designed for the low-tar band were made from one of two blends of tobacco and either 10% or 25% of expanded tobacco. They were smoked over a 7-day period by 24 habitual smokers of cigarettes in the middle-tar band. Sensory characteristics and acceptability of the cigarettes were assessed at first presentation, after 3 days and again at the end of the trial. The expanded tobacco cigarettes were judged to be weaker than the smokers' own usual brands, and the 25% weaker than the 10% expanded. However, perceived strength increased over the 7-day trial. No effect of blend was detected. Smokers given cigarettes with 10% expanded tobacco smoked considerably more of them than was predicted from their reported normal consumption, but this sign of some compensation for reduced nicotine yield did not appear with 25% expanded tobacco. The implications are discussed for persisting smokers switching to the low-tar band, as officially advised to reduce health risks. PMID- 3812052 TI - The effects of cigarette smoking on human sexual potency. AB - Forty-two male cigarette smokers, age 18 to 44, were randomly assigned to high nicotine, low-nicotine, or control groups in a study relating cigarette smoking to sexual response. Subjects watched erotic film segments while their penile diameters, heart rates, and finger pulse amplitudes were continuously recorded by a polygraph. Subjects in the smoking groups smoked relatively high-nicotine (.9 mg) or very low-nicotine (.002 mg) cigarettes prior to watching the last two films, while control subjects ate candy. Smoking two high-nicotine cigarettes in immediate succession significantly decreased the rate of penile diameter change relative to the other conditions. These effects were not seen after a single cigarette was smoked. High-nicotine cigarettes caused significantly more vasoconstriction and heart rate increase than did low-nicotine cigarettes, which did not differ from control conditions. PMID- 3812053 TI - Individual differences in nicotine sensitivity. AB - It is suggested that individual differences in sensitivity to nicotine may help account for a number of anomalous findings uncovered in research on nicotine regulation. However, an examination of the literature reveals very little pertinent evidence. To demonstrate the existence of such differences, 124 male and female subjects were screened for responsiveness to nicotine by smoking a standard cigarette while their heart rates were continuously monitored for 5 minutes before, during, and after smoking. Puff analyses were also conducted to determine the amount of nicotine subjects obtained from cigarettes. Based on increases in heart rate of more than 10 or less than 8 beats per minute from baseline to smoking periods, subjects were categorized as responsive or nonresponsive. To assess stability of responsiveness over time, 20 responsive and 20 nonresponsive subjects were called back for a second session 1 week to 4 months later. At the second session, heart rates were again monitored before, during, and after smoking a standard cigarette. The data indicate that subjects maintained their relative degree of sensitivity to nicotine over time. The results are discussed in terms of Solomon's opponent process model and it is suggested that not all smokers are addicted to nicotine. PMID- 3812054 TI - Some methodological cautions in the use of the Tolerance Questionnaire. AB - Both factor analysis and internal consistency analyses indicate that the items of the Tolerance Questionnaire do not form a unidimensional measure of an underlying construct. Implications of these findings are discussed. The importance of considering smoking rate, one of the scales' eight items, when interpreting validity correlations is emphasized. PMID- 3812055 TI - Smoking cessation in family practice: the effects of advice and nicotine chewing gum prescription. AB - The efficacy of physician anti-smoking intervention with 289 patients in a family practice setting was assessed. The design included two treatment conditions, physician advice and physician advice plus the offer of nicotine chewing gum (NCG) prescription. A no-advice group permitted assessment of the effects of repeated testing. The NCG group had higher rates of abstinence at all follow-up points, but the difference approached statistical significance at 3 months only (p less than .10). Comparison of those who actually used NCG to all other groups revealed significantly more users were abstinent at 1- and 3-month follow-up. A similar pattern occurred for proportion attempting cessation and smoking reduction. A dose-response relationship of gum use to outcome was identified. Long-term users (greater than 20 days) had 86% abstinence at 3 months versus 18% for short-term users. Thus, NCG does appear to have a role in family practice for promoting short-term cessation. PMID- 3812056 TI - The effects of cigarette smoking on the perception of electrical stimulation and cold pressor pain. AB - Prior research has attempted to delineate the effects of cigarette smoking on pain. However, there has been little consensus among findings. Therefore, the present investigation was designed to provide a more carefully controlled evaluation of the effects of cigarette smoking on pain. Specifically, the effects of cigarette smoking on two pain tasks (electrical stimulation and cold pressor) were assessed via three primary response measures: pain threshold, pain tolerance and McGill Pain Questionnaire scores. The results of this study indicated that cigarette smoking did not affect subsequent ratings on any of the response measures for either cold pressor or electrical stimulation tasks. These data are integrated with those of previous research and hypotheses are proposed regarding specific factors responsible for the conflicting findings of studies. PMID- 3812057 TI - Programming social support for smoking modification: an extension and replication. AB - In an extension and replication of previous work on social support in worksite smoking programs, 29 employees were assigned to either a basic smoking control program or to a basic treatment plus significant other support condition. Within a multiple baseline across behaviors design, all subjects received a 6 week treatment program that focused on achieving sequential reductions in nicotine content of brand smoked, number of cigarettes smoked per day, and percent of the cigarette smoked. Both treatment conditions were equally successful in producing abstinence (verified by biochemical analyses) and in producing reductions in smoking behavior among nonabstinent subjects at both posttest and 6-month follow up assessments. In contrast to previous research with this program, there was considerable relapse in both conditions by follow-up. Consistent with previous findings, supportive social interactions were not related to treatment outcome, but the level of negative (nonsupportive) social interactions was inversely correlated with treatment success. Implications of these findings and directions for future research are discussed. PMID- 3812058 TI - Parental pressure, self-esteem and adolescent reported deviance: bending the twig too far. AB - Questionnaire responses from upper-status junior and senior high school students show the importance of perceived parental pressure in understanding adolescent self-esteem and deviant behavior. Adolescents who feel unduly pressured to achieve and succeed in school also are likely to have low self-esteem, to report deviant activity, and to feel they are incapable of reaching the goals set for them by their families. PMID- 3812059 TI - Parent-child communication about sex and young adolescents' sexual knowledge and attitudes. AB - Previous studies indicate that adolescents whose parents talk to them about sex tend to be less sexually active and more likely to use an effective means of contraception. This study sought to determine the relationship between parent child communication about sex and young adolescents' reproductive and contraceptive knowledge and sexual attitudes. Twenty-two 12- to 14-year-olds and their parents completed sexual-knowledge, sexual-attitude, and contraceptive choice questionnaires. Families were divided into high-communication and low communication groups. There were no significant differences in the sexual knowledge, attitudes, or contraceptive choices of the children in the two groups, but the correlation between parents' and children's sexual attitudes in the high communication group was significantly higher than that of the low-communication group. Although this was a correlational study, it seems likely that the similarity in sexual values was the result of parent-child discussion about sex. PMID- 3812060 TI - Shyness, group dependence and self-concept: attributes of the imaginary audience. AB - The imaginary audience of 328 early and late adolescents was studied from the viewpoint of providing educators and clinicians with insight into its attributes- those which both facilitate and hinder youths' development. Early adolescents (about 14 or 15 years of age) displayed a greater awareness of an imaginary audience which probably contributed to their observed, elevated group dependence. Unexpectedly, the shyness of adolescents highly sensitive to an imaginary audience increased with age, possibly because they are unwilling to provide themselves with the social experiences necessary for decentering. Likewise, those highly sensitive to an imaginary audience projected low self-concepts and thus imply that their audience is relatively critical; thus, they probably validate a self-fulfilling prophecy, oblivious to a possible contradictory external reality. The anticipated fact that females appeared to be less socially bold and more group dependent than males might account, in part, for females' greater responsiveness to an imaginary audience. It is suggested that educators and clinicians encourage youth to validate social hypotheses in order to promote the dissolution of the imaginary audience, especially of those who are shy and display self-deprecatory tendencies. PMID- 3812061 TI - Motivations for adolescents' first visit to a family planning clinic. AB - Although family planning clinics routinely gather data on referral sources and primary reasons for visits, little is known about the "precipitating events" which motivate young women to make an appointment or show up at a clinic on a given day. In this study, 150 new patients at a large urban clinic were interviewed to determine what events or advice specifically led to their decision to approach a family planning clinic for the first time. The roles of pregnancy scares, advice from significant others, and situational factors in motivating service use are presented along with a discussion of the program implications of these findings. PMID- 3812062 TI - Beyond Cinderella: relevant reading for young adolescents about stepfamilies. AB - With the number of stepchildren increasing, it is important that books about stepchildren and stepfamilies be available in schools and other settings. Juvenile fiction is a good medium for exposing children to the complexities of stepfamily living, for reducing stereotypes, and for providing role models. This article examines and reviews adolescent fiction with step themes. By providing titles of recommended stepfamily literature, the teacher or helping professional can facilitate an adolescent's adjustment to stepfamily life and not leave him feeling that being in a stepfamily means living like either Cinderella or the Brady Bunch. A list of recommended books is included. PMID- 3812063 TI - Day hospital treatment for borderline adolescents. AB - Short-term psychiatric hospitalization for acute disturbances in adolescents has little effect on underlying developmental deficits. A day hospital treatment program based on psychoanalytic object relations concepts can provide an alternative to costly long-term inpatient hospital adolescent programs while limiting regressive and destructive behavior. An understanding of the characteristics and dynamics of borderline adolescent patients provided the basis for practical approaches that also were helpful to other patients. A review of the literature on the day treatment of borderline patients precedes a discussion of the diagnosis and dynamics of borderline adolescents. This is followed by a description of the methods utilized in a day hospital program whose goal was to potentiate a successful start of a longer-term psychotherapeutic process that could continue after discharge. Difficulties in prognosis and in designing verifying research are discussed. PMID- 3812064 TI - Desire for thinness among high school cheerleaders: relationship to disordered eating and weight control behaviors. AB - The eating disorders of anorexia nervosa and bulimia are increasing in frequency among adolescent females. These increases have been linked to the cultural ideal in American society of thinness. Attempting to control weight is one behavioral manifestation of the desire for thinness. One particular group of adolescents, female cheerleaders, often experience pressure to attain and maintain weight that is lower than other adolescents of the same height. This study examined cheerleaders' desire for thinness in relationship to disordered eating and weight control behaviors. A Desire for Thinness Scale and selected scales from three eating disorders instruments were administered to 751 high school cheerleaders from the Midwest. Cheerleaders who scored in the upper third on the Desire for Thinness Scale were compared with those who scored in the lower third. Cheerleaders who expressed a strong desire for thinness had significantly higher scores (p less than .0001) on 7 of 8 eating disorders scales. The greater the desire for thinness, the more likely the tendency to report disordered eating and weight control behaviors associated with bulimia. Implications from this study include an awareness of how a cultural ideal of thinness may indirectly increase disordered eating and weight control behaviors by making weight loss a salient goal. A proactive approach to modifying negative aspects of the cultural emphasis on thinness is proposed. PMID- 3812065 TI - Cognitive and learning profiles of delinquent and learning-disabled adolescents. AB - The association between juvenile delinquency and learning disabilities has been a focus of considerable discussion and controversy. Nevertheless, only a limited number of investigators have directly contrasted these two populations. In those studies which have examined the link between antisocial behavior and school problems, research methodology has varied, resulting in conflicting evidence and limited consensus. The present study was designed to address this issue by comparing the cognitive and learning profiles of delinquents and learning disabled adolescents. Specifically, 53 delinquents, 26 learning-disabled adolescents, and 50 average achievers were evaluated with newly developed educational and cognitive inventories. These assessment techniques were used to analyze several functional areas including processing efficiency, problem solving, and response style. Application of discriminant analysis to the cognitive and educational profiles of these adolescents suggested the existence of various subtypes of delinquency. Learning disabilities characterized one of these subgroups. It was concluded that more specific descriptions of the learning profiles of adolescent delinquents holds promise for rehabilitation and, perhaps, prevention of juvenile delinquency. PMID- 3812066 TI - The early adult transition and friendships: mechanisms of support. AB - The early adult transition is a neglected but increasingly important stage in the human life cycle. Research indicates that friends are a primary choice of support for young adults faced with developmental tasks such as choice of careers, consolidation of personal identity, and formation of long-term intimate relationships. This study sought to describe and categorize the specific processes by which friends serve to influence the emerging life structures of early adulthood. Five categories were developed from open-ended interviews of 34 young adults ranging from 20 to 28 years of age. These categories describe friends in the roles of models, active agents for change, reactors, interactors, and passive influences. Further specificity is gained through the descriptions of 13 subcategories. Implications of preliminary findings using these categories are discussed. PMID- 3812067 TI - Sex role orientation, level of cognitive development and mathematics performance in late adolescence. AB - Sex differences in mathematics performance are found in late adolescence. This study investigates the effects of psychological sex role orientation (BSRI: masculine, feminine, undifferentiated, androgynous) and level of cognitive development (concrete, formal) on performance in mathematics. ANOVA analysis (N = 69; 18 males, 51 females) revealed significant effects for level of cognitive development and for masculine by feminine sex role orientation interaction. Subjects whose BSRI masculine and feminine scores were either both low or both high scored significantly lower on the mathematics test than subjects whose scores on either masculine or feminine scales were high. This indicates lower mathematics performance for androgynous and undifferentiated subjects. This result is hypothesized to be a function of the particular age level of these subjects and their concomitant overconcern with appropriate sex role development. PMID- 3812068 TI - Segmental influence: the case of educational and occupational significant others. AB - This research examines the scope of influence exerted by the occupational and educational significant others (SO's) identified by a sample of 142 high school youth in an attempt to determine the extent to which this influence is segmental. The data show that the influence of most significant others is specific to either educational or occupational ambitions suggesting that these are fairly distinct realms for adolescents. Variations by sex of student for ego and relationship of other to ego are noted, and the implications of the pattern of SO influence for female achievement are discussed. PMID- 3812069 TI - Intergenerational occupational inheritance in the military: a reexamination. AB - Recent problems the military services have experienced in retaining sufficient personnel to meet growing manpower requirements are unlikely to diminish in the 1980s. As a consequence, it is vital that military decision makers understand the factors that influence career commitments of service members. Based on a stratified probability sample of Air Force married enlisted personnel and officers, this study reexamines the relationship between the military service patterns of fathers and the career intentions of their sons who enlist in military service. It also expands upon past analysis to include the actual career decisions of military men as a dependent variable. In partial support of past research, the present investigation provides no support for an intergenerational linkage between military service patterns of fathers and the career intentions and decisions of their sons--either enlisted members or officers. Implications for future research are discussed. PMID- 3812070 TI - Four-year results of a youth smoking prevention program using assertiveness training. AB - Assertiveness training and its relationship to smoking behavior and how young adolescent boys and girls differ with respect to assertion was investigated. A total of 161 seventh-grade students from six health education classes participated. Two classes received an innovative smoking education program, two classes received assertiveness training plus an innovative smoking education program, and two classes received only the smoking education program usually offered by the school. Locus of control and levels of assertion and smoking behavior were assessed at pre- and posttest. The results indicate that boys are significantly more assertive than girls at age 12 (p = .0018), and this assertiveness increases equally over the next four years (p less than .0001). There were no significant differences in smoking behavior among the three groups; however, trends in smoking behavior in the desired direction were observed. There is no significant difference in smoking behavior between boys and girls. In this respect the sexes have reached equality, that is, girls are initiating cigarette smoking as frequently as are boys. Finally, there were no significant changes in assertion among the groups. It is concluded that the utility of assertiveness training for young adolescents is questionable. PMID- 3812071 TI - Identifying health-seeking behaviors: a study of adolescents. AB - While it is known that health-seeking behaviors are influenced by information seeking behaviors, reported research on adolescents' information-seeking behaviors is minimal. Available definitive information primarily addresses ways in which peers, parents, and health professionals are used as sources of information concerning sexuality. Research is now needed on how adolescents use the media and other sources of health information to effect changes in their lives. The present study sought to determine how adolescents' health-seeking behaviors, which include self-management and information-seeking behaviors, differ according to age, race, socioeconomic status, gender, and religion. The study was based on two assumptions: Self-management and information-seeking behaviors are fundamental to adolescents' health-seeking behaviors, and subjects answer self-management and information-seeking questions in terms of past behaviors and their behavioral intent. Important findings that emerged from this investigation include confirmation of gender as a differentiating variable for the performance of information-seeking behavior and positive health behaviors among black adolescents. Further, subjects reported an overall positive composite of health-seeking behaviors. PMID- 3812072 TI - The effect of maternal employment on adolescent daughters. AB - This report considers the question of the effects of maternal employment on adolescents. The frequently cited conclusion that there is "no difference between the adolescents of employed and nonemployed mothers" is considered inaccurate. It is argued that failure to find differences between these two groups does not mean that there are no differences. Comparisons of personal relationships within the family context showed that daughters of nonemployed mothers had a closer relationship with their fathers, perceived them as happier and more friendly, and experienced less anger and tension in the home. PMID- 3812073 TI - Adolescents: their special physical, social and metapsychologic needs. AB - This essay reviews the universal physical, sociocultural and metapsychologic needs of human beings as manifested in adolescents, the circumstances that interfere with the satisfaction of their needs, diagnosis of the resulting clinical aberrations, and the ethnic, sociocultural, and other vectors that influence seven vectors of effective therapy. PMID- 3812074 TI - The effects of service activities on adolescent alienation. AB - This research evaluated the effects of involvement of adolescents in community service activities on levels of alienation. It was proposed that alienation could be reduced through the implementation of a model which utilized community service activities to facilitate adolescent access to adult society, development of responsibility, collaborative and cooperative work, and control over planning and outcomes. It is suggested that adolescent involvement in service activities can produce positive benefits, among which are reduced levels of alienation, improved school behavior, improved grade point average, and acceptance by the adult community. These findings also suggest that females respond more positively to school when allowed to problem-solve collectively and collaboratively. PMID- 3812075 TI - Black adolescents: a descriptive study of their self-concepts and academic achievement. AB - This study was designed to determine the relationships among global self-concept, self-concept of academic ability, and academic achievement of black American adolescents. The subjects were 211 tenth-grade students in five public high schools in the Pacific Northwest school district who volunteered to participate in the study. Global self-concept was measured by the Coopersmith Self-Esteem Inventory (SEI), self-concept of academic ability by the Brookover Self-Concept of Ability (General) Scale, and academic achievement by the California Achievement Test (CAT). The major statistical tools were the Pearson product moment correlations and Fisher Z statistic. In all of the tests the decision was made to reject the null hypothesis at the .05 level of significance. No significant relationship was found between global self-concept and academic achievement, although the relationship between self-concept of academic ability and academic achievement reached significance. The relationship between self concept of academic ability and academic achievement correlated more strongly than the relationship between global self-concept and academic achievement. These results suggest that the enhancement of global self-concept might not be a potent intervention for academic improvement for black adolescents. PMID- 3812076 TI - A follow-up study of psychiatrically hospitalized adolescents. AB - The present study analyzes the effects of milieu treatment on 169 teenagers admitted to a midwestern state psychiatric facility. Pre- and post hospitalization data for both males and females indicate improved functioning in all the areas studied. PMID- 3812077 TI - Sexual socialization during early adolescence: the menarche. AB - It has been shown that during adolescence most information about sexual matters, generally colored with misconceptions, comes from the peer group, since cultural inhibitions often prevent discussion with parents or other adults. In addition, there is abundant evidence from anthropological data of diffuse negative beliefs across cultures concerning menstruation. In order to explore the early socialization of beliefs and attitudes toward menarche, 258 adolescents, aged 11 to 14 years, male and female pre- and postmenarcheal, from southern Italy, were interviewed by way of an open questionnaire method. The results showed a consistent lack of accurate information by a high percentage of subjects, both male and female; negative beliefs were held only by girls, pre- and postmenarcheal, while boys were more likely to ignore the subject. Half of the postmenarcheal girls expressed a negative evaluation of their first experiences with menstruation, generally due to lack of advance information. As to sources of information, importance of the peer group was confirmed, especially for boys; the influence of the mother and the cultural environment accounted for the positive acceptance of menarche. Fathers appeared to be uninvolved in the transmission of information about menstruation to either boys or girls. PMID- 3812078 TI - Birth weight, Apgar scores, labor and delivery complications and prenatal characteristics of Southeast Asian adolescents and older mothers. AB - The study population included 337 adolescents and 876 mothers who delivered live born, singleton infants in the Maternity and Infant Care Program at the Minneapolis Health Department between 1980-1982. Whites and blacks on the average experienced menarche 1-2 years earlier than the Southeast Asians although age of first pregnancy was 2 years later for the Southeast Asians. In spite of the significantly later ages of entry into prenatal care, lower weight gains, and hematocrits among the Southeast Asians, compared to the white and black populations, overall height-weight status on admission compared favorably with whites and blacks. The virtual absence of alcohol and tobacco consumption among the Southeast Asians may in fact contribute to the generally favorable Apgar scores, length of gestation, and birth weights. The high frequencies of alcohol and tobacco consumption among white adolescents during pregnancy suggest the need for more intervention to discourage smoking in this population. Further, the potential adoption of these substances needs to be discouraged among the Southeast Asian adolescents. While 2-4% of the whites, blacks and Hmong adolescents experienced eclampsia, 1% of the older Hmong mothers and none of the other Southeast Asians experienced eclampsia. The most frequent complication for all groups was perineal laceration. PMID- 3812079 TI - Assessing child-rearing style in ecological settings: its relation to culture, social class, early age intervention and scholastic achievement. AB - Middle- and lower-class black and white adolescents were observed interacting with their mothers during a discussion of seven child-rearing problems. Maternal references to a range of disciplinary measures were identified, analyzed, and related to the subjects' scholastic performances concurrently. A factor analysis of process measures confirmed earlier findings based on self-report data concerning parental disciplinary style. Low SES mothers who participated in an early-age intervention and upper middle-class mothers tended to be less punitive than those in the low SES untreated group. Black mothers were less permissive than those in the white group. Parental disciplinary style was found to be significantly related to school performance. The results are discussed in terms of the development of methodological procedures for interaction analysis in semi structured, ecological research, for the evaluation of process variables in early age intervention follow-ups and theory relating disciplinary style to intellectual development. PMID- 3812080 TI - Introducing conceptual tempo: an attempt to refocus health decision making in youth. AB - This paper reassesses the current trend toward health decision-making skills for youth. A new field of research for health behavior called conceptual tempo is introduced in an attempt to make health decision-making interventions more effective. The argument is made that decision-making programs may not realize their full potential because of the lack of emphasis placed on the child's rate of response or "conceptual tempo" in making health decisions. Suggestions are made on how best to utilize the conceptual tempo literature to enhance health decision-making program objectives in school health education. PMID- 3812081 TI - Group therapy with friends of an adolescent suicide. AB - This paper describes a group of adolescents who met with a therapist after a friend had committed suicide. The purpose of the group was to discuss the feelings engendered by the suicide. The setting up of the group, an explanation of the victim's difficulties, and issues dealt with by the group are described. PMID- 3812082 TI - Antitumor activity and biochemistry of novel analogs of the antibiotic, CC-1065. PMID- 3812083 TI - Perturbation of thymidine kinase regulation: a novel chemotherapeutic approach. AB - The design of compounds which disrupt the regulation of key enzymes is a new strategy for drug development. 5'-AdThd, which can antagonize the feedback inhibition that normally regulates thymidine kinase, is representative of this novel class of agents. The ability of 5'-AdThd to deinhibit thymidine kinase markedly increases the capacity of some cells to phosphorylate thymidine and IdUrd and, thereby, enhance their cytotoxicity. This effect is evident in three human bladder cancer cell lines, but not in normal human urothelial cells. Thus, 5'-AdThd may be able to increase the therapeutic selectivity of IdUrd. Intracellular dTTP pools are critically involved in mediating the effects of 5' AdThd, but differences in these pools from cell type of cell type may not account for the selective stimulation of IdUrd uptake produced in the cancer cells. PMID- 3812084 TI - Dehydrogenases of alpha-keto acids: essential groups of the active centers. PMID- 3812085 TI - Mechanism of synthesis and localization of mitochondrial and cytosolic fumarases in rat liver. AB - Fumarases in the mitochondrial and cytosolic fractions of rat liver were separately purified and crystallized. These two fumarases were not distinguishable in physicochemical, catalytic, or immunochemical properties. The sequences of seven amino acids in the C-terminal portions of the two fumarases were shown using carboxypeptidase P to be identical, i.e.-Val-Asp-Glu-Thr-Ala-Leu Lys-. The amino acid sequence of the N-terminal portion of the mitochondrial fumarase was determined by the Edman method as Ala-Gln-Gln-Asn-Phe-Glu-Ile-Pro Asp-, but that of the cytosolic fumarase could not be determined by the Edman method, since the N-terminal amino acid was blocked. The N-terminal amino acid of the cytosolic fumarase was identified as N-acetyl-alanine by analysis of the acidic amino acid produced by digestion of the enzyme protein with pronase E, carboxypeptidase A and B. Then the sequence of five amino acids in the N-terminal portion was determined by analyzing the acidic peptide obtained by limited proteolysis of the enzyme protein with carboxypeptidase A as Ac-Ala-Ser-Gln-Asn Ser-. Peptide mapping of the tryptic peptides obtained from the mitochondrial and cytosolic fumarases showed no difference in the amino acid sequences of the two except in their N-terminal portions. The turnover rates of the mitochondrial and cytosolic fumarases were determined by injecting L-[U-14C]leucine into rat and following the decay of specific radioactivity incorporated into immunoprecipitates from the partially purified enzyme. The half-life of the cytosolic fumarase was estimated as 4.8 days from the decay curve of its specific radioactivity. The decay curve of the specific radioactivity of the mitochondrial fumarase, obtained after a single injection of L-[U-14]leucine, was quite unusual: its specific radioactivity remained constant for about 7 days after pulse labeling, and then decreased exponentially with a half-life of 9.7 days. Similar amounts of cytosolic and mitochondrial fumarase were found in the livers of the rat, mouse, rabbit, dog, chicken, snake, frog, and carp, respectively. Similar subcellular distributions of the enzyme were also found in the kidney, heart, and skeletal muscle of rats, and in hepatoma cells (AH-109A). However, in rat brain no fumarase activity was detected in the cytosolic fraction. Two putative precursor polypeptides of rat liver fumarase were synthesized when rat liver RNA was translated in vitro in a rabbit reticulocyte lysate system.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3812086 TI - Independent consumption of high and low molecular weight kininogens in vivo. AB - The levels of high molecular weight (HMW) kininogen and pre-kallikrein in rat plasma were markedly reduced after single injection of bromelain (10 mg/kg, i.v.) and gradually recovered over a 72 hour period. The level of low molecular weight (LMW) kininogen, however, was not changed during this period. Rat pleurisy was induced by intrapleural injection of lambda-carrageenin. The levels of HMW kininogen and prekallikrein, but not of LMW kininogen, in the exudate were markedly decreased, when compared with those in plasma of the same animals. After pretreatment with disulfiram, oral administration of ethanol (2 g/kg) or intravenous injection of acetaldehyde (10 mg/kg) to rats caused significant decrease in the plasma level of LMW kininogen with no significant effect on the plasma HMW kininogen and prekallikrein levels. These results suggest that HMW and LMW kininogens may be consumed separately in vivo and play different roles. PMID- 3812087 TI - Urinary kininogen: a possible regulator of kinin formation in normal individuals and subjects with essential hypertension, end-stage renal and liver disease. AB - Most previous studies have not significantly correlated urinary kallikrein to urinary kinins. We investigated whether urinary kininogen might influence kinin formation within the urine. On an ad-lib diet the 24 hour excretion of total and intact kininogen, kinins and kallikrein was determined in 24 control subjects, 20 untreated essential hypertensives, 12 with end-stage renal disease and 8 subjects with liver disease. Kallikrein and kinins were measured by a direct radioimmunoassay. Total kininogen was determined from the sum of preformed kinins and kinins generated after trypsin (intact kininogen). Cross reactivity between purified human low molecular weight kininogen and bradykinin antiserum was 3%. Total and intact kininogen were significantly correlated with kinins in controls, essential hypertension and liver disease. In essential hypertension, end-stage renal and liver diseases kinins were significantly decreased. This was associated with a reduction in kininogen but not kallikrein in essential hypertension and liver disease, and a reduction in kallikrein but not kininogen in end-stage renal disease. Thus, renal kinin generation in various states may be affected by either or both kininogen and kallikrein. PMID- 3812088 TI - Functional significance of the subunits of carboxypeptidase N (kininase I). AB - Carboxypeptidase N (kininase I; 280K) was purified to homogeneity from human plasma. The inactive 83K and active 48K subunits were separated by gel filtration after treatment of homogeneous 280K with guanidine. The two subunits differ in amino acid composition and immunological reactivity. The activities of the 280K and 48K enzymes with naturally occurring substrates were compared to determine whether the 83K subunit affects enzymatic activity of the 48K. At 60 microM concentration, both the 280K and 48K enzymes cleaved (Lys6)-Met5)-enkephalin fastest followed by (Arg6)-(Met5)-enkephalin, anaphylatoxin C3a, (arg6)-(Leu5) enkephalin, C3a octapeptide and bradykinin. The activity ratios (280K/48K) were: (Arg6)-(Leu5)-enkephalin, 0.9; bradykinin, 1.0; (Lys6)-(Met5)-enkephalin, 1.1; (Arg6)-(Met5)-enkephalin, 1.2; and anaphylatoxin C3a, 1.7. Thus, while most substrates were cleaved at similar rates, assuming 2 active sites per 280K molecule, anaphylatoxin C3a was cleaved significantly faster by 280K than by 48K. The ratio of activity was similar (1.9) when the C-terminal octapeptide of C3a was the substrate. These results indicate that the larger, inactive 83K subunit may increase the efficiency of cleavage of some peptides by 48K. PMID- 3812089 TI - Kininase one-an'-a-half: the newest member of the kininase family. AB - A kininase I-like enzyme (carboxypeptidase) was purified to homogeneity from human urine and compared to the 48,000 mol. wt. (48K) active subunit of carboxypeptidase N. The urinary carboxypeptidase had a mol. wt. of 73,000 in gel filtration and 76,000 in SDS-polyacrylamide gel electrophoresis. It had a pH optimum of 7.0 and differed from the 48K subunit in stability, susceptibility to trypsin, and enzymatic activity. The urinary enzyme did not cross-react with antibody to carboxypeptidase N in "Western blotting". Urine from a patient genetically deficient in plasma carboxypeptidase N (21% of normal) contained normal levels of urinary carboxypeptidase with similar properties to that from pooled human urine. Membrane fractions from several tissues contained a similar carboxypeptidase activity. The activity was highest in a microvillous membrane fraction from human placenta (65 nmol/min/mg with Bz-Gly-Lys as substrate). High specific activities were also found in membrane fractions of human kidney (18 nmol/min/mg) and lung (8 nmol/min/mg). The membrane-bound enzyme was distinguished from lysosomal and catheptic carboxypeptidases as well as "enkephalin convertase" by the use of specific inhibitors. These results show that urine contains a carboxypeptidase capable of cleaving arginine or lysine from the C-terminus of peptides. The enzyme does not arise from plasma carboxypeptidase N, but may be released into the urine from the renal brush border. PMID- 3812090 TI - Synthetic inhibitors of carboxypeptidase N. AB - Further to explore the functions of carboxypeptidase N (CPN) in vivo, we undertook two studies to find CPN inhibitors of high potency and relatively long duration of action. In each study we examined for inhibition of hydrolysis of [3H]benzoyl-Ala-Arg using pure bovine serum CPN or human serum. In the first such study we synthesized a series of acyl amino acids and acyl di - and tripeptides containing arginine, lysine or both. All proved to be weak inhibitors (Ki = 10( 3) to 10(-4) M). N alpha-carbamoyl-Arg was the strongest: Ki = 3.5 X 10(-5) M. In the second study we prepared S-acyl (thio ester) derivatives of the highly potent CPN inhibitor 2-mercaptomethyl-3-guanidinoethylthiopropionic acid (2-MGP), as certain S-acyl groups markedly increase the duration of captopril, another mercapto-containing compound. Acetyl-, Boc-phenylalanyl-, phenylalanyl-, benzoyl alanyl-, alanyl-, and Boc-alanyl-2-MGP retained the high potency of 2-MGP in vitro. Although Ala-2-MGP exerted maximum effects in vivo, like those of 2-MGP, the duration of action of Ala-2-MGP was slightly shorter than that of 2-MGP. These results indicate that the mercapto group of 2-MGP can be taken up in some forms of thioester linkage and still remain virtually the full potency of 2-MGP itself. Thus, it appears that a free mercapto function is not essential for the action of 2-MGP. PMID- 3812091 TI - Bradykinin competitive antagonists for classical kinin systems. AB - The substitution of D-phenylalanine for proline at position 7 of bradykinin (BK) converts BK into a specific antagonist. Additional modifications of the nonapeptide structure, especially the inclusion of beta-2-thienylalanine residues (Thi) for phenylalanine at positions 5 and 8, increase antagonist potency in the classic smooth muscle (isolated rat uterus and guinea pig ileum) and rat blood pressure kinin assays. [Thi5,8,DPhe7]-BK had a pA2 value of 6.5 for inhibition of the BK response on rat uterus, and 6.3 on guinea pig ileum. Addition of Lys-Lys- or a D-Arg- residue to the N-terminal of D-Phe7-substituted antagonists decreases uterine agonist activity, but does not affect inhibitory potency on the ileum. Addition of a D-proline residue in place of proline in position 3 of D-Arg- extended antagonists produces specific uterine inhibitors which show no antagonism on the ileum. The D-Phe7-analogs did not inhibit smooth muscle responses to substance-P or angiotensin-II, and the antagonism of kinin responses was competitive. PMID- 3812092 TI - Smooth muscle selectivity in bradykinin analogs with multiple D-amino acid substitutions. AB - Two novel analogs of bradykinin (BK), [DAla7]-BK and DArg-BK, exhibited a dissociation of smooth muscle activities toward higher potency on the uterus than on the ileum, in spite of increased metabolic stability to pulmonary enzymatic breakdown in the rat blood pressure assay. Analogs having a combination of the substitution of D-alanine in position 7 with a D-aromatic amino acid residue in position 6 show even greater uterus specificity. The addition of a D-arginine residue to the N-terminal greatly enhances this selectivity. Relative to BK, these poly-substituted analogs are up to 17 times as potent on the uterus as on the ileum. Still greater uterus selectivity is found among analogs in which glycine replaces the serine residue at position 6 and a D-hydrophobic amino acid residue (such as D-phenylalanine or D-p-chloro-phenylalanine) is present in position 7. These [Gly6, D-Hydrophobic7]-BK analogs are 20-40 times as potent on uterus as on ileum. [Gly6,DPhe7]-BK is the most uterus-selective analog described. In contrast, [Aib7]-BK is quite ileum-selective, having a uterus/ileum potency ratio of 0.1. PMID- 3812093 TI - T-kinin and T-kininogen--an historical overview. PMID- 3812094 TI - Effects of kinins on the isolated perfused rat kidney and evidence for the presence of renal B1 receptors. AB - The kinins, particularly lysyl-bradykinin (LBK), have a bimodal effect on the vasculature of isolated rat kidney. The vasorelaxant but not the vasoconstrictor effect of LBK seems to be mediated by prostaglandins. The vasoconstrictor action of LBK can be blocked by (L-Leu)8-des-Arg9-BK indicating that the rat kidney vasculature has B1 kinin-receptor which mediates the effects of kinins and/or their C-terminal metabolites. PMID- 3812095 TI - Action and metabolism of des(Arg)kinins in mesenteric arteries. AB - Kallidin and bradykinin can be hydrolyzed at their C-termini to produce des(Arg10)kallidin and des(Arg9)bradykinin respectively. These des(Arg)kinins, previously thought to be biologically inactive, are now known to have potent effects on B1 receptors. Although stimulation of B1 receptors has been reported to produce peripheral vasodepressor responses in certain experimental states, only constriction has been reported in isolated vessels (i.e., rabbit aorta, basilar artery, mesenteric vein). In the present study, we have investigated the biologic activity of des(Arg) kinins on a peripheral resistance vessel (rabbit mesenteric artery). We found that des(Arg)bradykinin relaxes mesenteric arteries, and that its potency relative to kallidin and bradykinin is consistent with the presence of B1 receptors. Further, intact mesenteric arteries, and a plasma membrane fraction purified from these arteries, contained a carboxypeptidase activity which was capable of producing des(Arg)kinins from both kallidin and bradykinin. Thus, these data demonstrate that the vasculature has the enzymatic capacity to form B1 kinins, and that stimulation of B1 receptors in resistance vessels can be associated with peripheral vasodilation. PMID- 3812096 TI - Activation by bradykinin and vasoactive intestinal peptide of adenylate cyclase from immunologically sensitized lung membranes. AB - Bradykinin receptors on normal lung membranes seem to be coupled to adenylate cyclase. Stimulation of the enzyme from sensitized lung membranes by adrenaline and vasoactive intestinal peptide was markedly reduced, whereas the ability of bradykinin and histamine to activate the sensitized adenylate cyclase was unaffected. Additional experiments are necessary in order to delineate the precise molecular events associated with activation of each of the two presently known bradykinin receptor types. PMID- 3812097 TI - Increased plasma level of T-kininogen in rats treated with Freund's adjuvant. AB - Studies have been carried out to clarify which component of plasma kininogen in rats increased in the inflammatory condition induced by an injection of Freund's complete adjuvant. Plasma T-kininogen, which was measured by assaying the amount of T-kinin liberated by trypsin treatment, remarkably increased in parallel with the severity of paw swelling following the intradermal injection of adjuvant into the rat hindpaw. Treatment with indomethacin or dexamethasone following an injection of adjuvant suppressed the increase in T-kininogen level as well as the development of paw swelling in rats. These results indicate that T-kininogen, the newly found precursor of T-kinin, is the main component of plasma kininogen which responds to the inflammatory stimulus in adjuvant arthritis. PMID- 3812098 TI - Amino acid sequence of the light chain of human low molecular mass kininogen. AB - The light chain of human low molecular mass kininogen consists of 38 amino acid residues. The half-cystine residue which forms the disulfide bridge to the heavy chain is located in the position 18. Alignment of the low molecular mass kininogen light chain with corresponding sections of other kininogens revealed that the N-terminal part of it is species specific and the C-terminal part is function specific. Furthermore, some internal homologies between various sections of the total molecule were found. A statistically significant sequence homology between the low molecular mass kininogen light chain and the C-terminal part of the ribonucleases was observed. PMID- 3812099 TI - Bradykinin and the gut cholinergic system. PMID- 3812101 TI - Evidence for new spasmogenic substances released by trypsin from plasma of normotensive and hypertensive rats. AB - We have extended our previous study of increased levels of new spasmogenic substances released by trypsin from the plasma of chronic one-kidney, one-clip hypertensive rats by describing preparative procedures utilizing Sephadex G-25, CM-cellulose and C18 reverse-phase HPLC for their partial purification. We demonstrate the existence of at least 6 HPLC components, distinguishable from bradykinin, bradykinin homologues having Lys before Arg1 of bradykinin and T kinin (Ile-Ser-bradykinin) on the basis of their chromatographic properties. Several of these spasmogenic substances induce a very slow contraction of the isolated guinea pig ileum when compared to bradykinin. PMID- 3812100 TI - Kinins as mediators of human allergic reactions. AB - We have demonstrated that kinins are generated following nasal challenge with allergen of allergic (5.6 +/- 0.17 ng/m-), but not nonallergic (0.04 +/- .02 ng/ml), individuals (n = 8 in each case). The presence of kinin was highly correlated with that of histamine and TAME-esterase activity and with clinical symptoms (p less than 0.001). In a double blind, placebo-controlled study, topical administration of the drug Azatadine, which inhibits mast cell mediator release in vitro, reduced the clinical response to allergen challenge and reduced the concentrations of kinins, histamine, and TAME-esterase activity observed following allergen challenge. In addition to the immediate response to allergen, some individuals experience a recurrence of symptoms some 3-12 hours after challenge; in seven such individuals (13.5 +/- 3.2 ng kinin/ml in the immediate reaction), there was a second increase in nasal kinins (2.95 +/- 1.4 ng/ml) during this late reaction, again correlating with increases in histamine and TAME esterase activity. HPLC analysis revealed that a mixture of bradykinin and lysylbradykinin is produced during both responses. Finally, 12 subjects with a history of nasal symptoms upon exposure to cold, dry air (CDA) were compared to five asymptomatic individuals in a nasal challenge system involving nasal breathing of CDA and warm, moist air (WMA). For the symptomatic group the levels of kinin in nasal lavages were significantly increased after CDA (2.9 +/- 0.8 ng/ml) compared to baseline (0.06 +/- 0.01 ng/ml) or WMA (0.3 +/- 0.07 ng/ml). Kinin generation again correlated with increases in histamine, PGD2 and TAME esterase activity and with onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812102 TI - Urinary kallikrein and kininase activity in normal and complicated by hypertension pregnancy. AB - Kallikrein and kininase activities were determined in urine of 58 hospitalized pregnant patients: 15 with E.P.H. gestosis, 10 with chronic hypertension, 18 with non proteinuric pregnancy induced hypertension, 15 with no hemodynamic disease as controls. All our cases with hypertension were treated with alpha-methyl-dopa. A significant increase in urinary kininase activity was shown by only E.P.H. gestosis group vs. controls. In the same group we found a significant decrease in urinary kallikrein activity vs. controls, in contrast with the results obtained previously, perhaps because of the different measuring method. The kininase/kallikrein ratio, theoretically indicative of kinins activity, increased significantly only in the E.P.H. gestosis group. PMID- 3812103 TI - Studies of fibrinopeptide A, fibrinopeptide B beta 15-42, HMW-kininogen and kinin in cases of caesarean section. PMID- 3812104 TI - Different modes of interaction of bradykinin with prostaglandins in pain and acute inflammation. AB - A mode of interaction of bradykinin with prostaglandins (PGs) in pain were compared with that in acute inflammation. When pain production was measured as an increase in reflex hypertensive response of the lightly anesthetized dogs after intrasplenic injection of bradykinin, the response was dependent to the doses (0.3-5 nmol) of bradykinin and that by the small doses (0.1-1 nmol) was blocked by intrasplenic infusion of indomethacin (0.54 mumol/min). The response to the threshold dose of bradykinin (0.3 nmol), which was suppressed during the indomethacin infusion, was potentiated by simultaneous injection of exogenous PGs. Order of the potency was PGI2 greater than PGH2 greater than PGE2 = TXA2 much greater than PGD2. Thus, it is clear that bradykinin induced pain through the generation of one of prostaglandins. On the other hand, the activity of bradykinin in plasma leakage was potentiated by simultaneous injection of PGE2, when tested in rabbit skin. In rat carrageenin-induced pleurisy, plasma prekallikrein was activated and high molecular weight (HMW) kininogen, not low molecular weight (LMW) kininogen, was consumed in the pleural cavity in the entire course of the pleurisy. Bradykinin played a role in plasma exudation in the pleurisy, because the plasma leakage was markedly inhibited in the rats, in which prekallikrein and HMW kininogen in plasma were depleted by intravenous bromelain. PGE2 was found in the pleural exudate, but the contribution of PGE2 itself to the plasma exudation seems to be only 10%. On the basis of the bradykinin release in the pleural cavity, once the PGE2 release was superimposed, the maximal plasma leakage was observed, indicating that PGE2 was released independently from bradykinin, and potentiated the plasma leakage by bradykinin. PMID- 3812105 TI - Levels of IgA, IgM, IgG and complement components during extracorporal circulation. PMID- 3812106 TI - Studies of fibrinopeptide A, fibrinopeptide B beta 15-42 HMW-kininogen and kinin during normal pregnancy labor and puerperium. PMID- 3812107 TI - Hageman factor dependent pathway in local vascular permeability enhancement. AB - The possibility of an involvement of the kallikrein-kinin system in increasing vascular permeability induced by intradermal injection of the guinea pig activated Hageman factor (beta HFa) was examined. In vitro system, the kinin generation was observed in guinea pig plasma when the plasma was incubated with beta HFa. This kinin generation was dependent upon the dose of beta HFa added and upon the presence of plasma prekallikrein, since 97 percent of the kinin release was diminished by removing the prekallikrein in plasma by treatment with anti prekallikrein antibody. These results suggested that the Hageman factor kallikrein-kinin cascade in guinea pig was similar to those in human and bovine plasma. In the permeability experiment in vivo, a simultaneous injection of soybean trypsin inhibitor (10(-6) M), which is the inhibitor of guinea pig plasma kallikrein, inhibited the permeability response to beta HFa by more than 90 percent. The permeability response to beta HFa was attenuated 5 fold in animals depleted of the circulating plasma prekallikrein by intraarterial antibody administration. These results indicated the participation of plasma prekallikrein in the permeability reaction to beta HFa. A simultaneous injection of a kinin destructive enzyme, carboxypeptidase B, diminished the permeability reaction to beta HFa, without any inhibition of the amidolytic activity of beta HFa or plasma kallikrein. A simultaneous injection of an inhibitor of a kinin destructive enzyme (kininase II), SQ 20,881(Glu-Tyr-Pro-Arg-Pro-Gln-Ile-Pro-Pro-OH), augmented the permeability reaction to beta HFa 10 fold, without any effect on the amidolytic activity of beta HFa or plasma kallikrein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812108 TI - A rapid radioimmunoassay for rat plasma kininogen. AB - The assay of plasma kininogen most often relies on bioassay techniques that measure biological effects of vasopeptides formed by proteolytic action on the substrate. These assays are tedious, time consuming, subject to the variations in tissue response and expensive. In the present report a sensitive and rapid radioimmunoassay for rat plasma kininogen is described. Polyclonal antibodies of high avidity and specificity were produced in rabbits immunized with purified rat plasma kininogen. Optimal conditions for each step of the assay were established from a series of initial experiments. Fifty percent (50%) precipitation of 125I kininogen was obtained with a 1:100,000 dilution of antirat plasma kininogen antibody. Precipitation of the antigen-antibody complex was achieved with 10% polyethylene glycol in 0.05 M phosphate buffer, pH 7.5. Since precipitation with polyethylene glycol requires no incubation, this procedure eliminates lengthy waiting periods and the need for a second antibody. The assay can be completed within one day. A standard curve constructed by plotting the fraction of bound 125I-kininogen against the plasma kininogen in a logit-log mode yielded a straight line for kininogen concentrations between 0.1 and 30 ng. The lowest limit of detection of the rat plasma kininogen was 0.1 ng. PMID- 3812109 TI - Isolation and physiological action of capillary permeability increasing-enzyme from the venom of Agkistrodon caliginosus. AB - A purified capillary permeability increasing-enzyme was obtained from Agkistrodon caliginosus venom by modification of our previous purification method. The purified enzyme, which had arginine esterase activity and strong capillary permeability increasing-activity, did not show caseinolytic, clotting or bradykinin-releasing activities. These properties of the enzyme were almost the same as those of the enzyme obtained by the previous purification method. When a mixture of the purified enzyme and bovine plasma or heated bovine plasma was injected into depilated skin on the back of a rabbit, the capillary permeability increasing-activity was much greater than that induced by injection of the enzyme alone. The substance which increases the capillary permeability was extracted from the incubated mixture of bovine plasma and the enzyme with 50-70% ethanol. Its activity was lost on treatment with carboxypeptidase A. From these results, it is supposed that the increase in capillary permeability induced by the enzyme is due to a low molecular weight peptide released from a protein in bovine plasma by the proteolytic action of the enzyme. PMID- 3812110 TI - Intensive neurodiagnostic monitoring. Terminology. PMID- 3812111 TI - Video recording during long-term EEG monitoring of epileptic patients. PMID- 3812112 TI - Intensive neurodiagnostic monitoring. PMID- 3812113 TI - Intensive video/EEG monitoring of neonates. PMID- 3812114 TI - Ambulatory EEG: telemetered and cassette-recorded. PMID- 3812115 TI - Ambulatory diagnostic monitoring of seizures in children. AB - Considerable scope still exists for more accurate recognition of childhood seizures and the definition of their precise type. Careful clinical observation is generally the most appropriate way of achieving these objectives. However, in a proportion of patients even detailed clinical evaluation will leave this issue unclear. Intensive neurodiagnostic monitoring carries the advantage over conventional EEG recordings in generally increasing the likelihood of recording during the child's attacks. Special consideration has to be given to children in carrying out intensive monitoring, largely because of their limited understanding of investigatory procedures and lessened ability to cooperate compared with adults, including adjustment to hospital admission. Equipment design must acknowledge the smaller size of children and the fact that they are generally more active than adult patients. In order to help interpretation of the EEG findings, great reliance has to be placed on the observation by parents and other observers in achieving adequate behavioral accounts. The comparative acceptance by children of the different recording procedures and their relative diagnostic yield are difficult to evaluate objectively. No systematic comparison has been made on the same group of children undergoing the various procedures. Consequently, comparisons have to be made on different patient groups investigated in different centers where it is likely there will be differences in selection criteria for investigation as well as the details of the procedure followed. Video/EEG, telemetry, and cassette recording are best seen as complementary procedures from which a choice is made depending on the child's problem and circumstances and, in particular, whether admission to hospital for video or telemetry is possible or likely to provide the opportunity for studying the clinical phenomena in question. All are capable of high levels of technical merit and a high degree of diagnostic yield when used with appropriate indications. However, especially for EEG services outside special centers and without extra staff resources, it is likely that cassette recording in its 8 channel form has distinct advantages, both in terms of acceptability to children and of operating costs. PMID- 3812116 TI - Ambulatory diagnostic monitoring of seizures in adults. PMID- 3812117 TI - Ambulatory ECG and EEG monitoring in the differential diagnosis of cardiac and cerebral dysrhythmias. PMID- 3812118 TI - Intensive monitoring of psychogenic seizures, aggression, and dyscontrol syndromes. PMID- 3812119 TI - Intensive monitoring of seizures in evaluating efficacy of antiepileptic drugs. AB - Intensive neurodiagnostic monitoring is needed in the proper use of AEDs for three reasons: to diagnose the seizure correctly, to quantify the number of seizures accurately, and to allow the patient and physician to communicate accurately. The means currently available include video/EEG, radiotelemetry, ambulatory cassette recording, and various permutations of the above. In general, video/EEG is the most accurate for diagnosis but the most costly, and ambulatory cassette recording the least costly and thus most useful for quantifying the number of seizures. An organized approach starting with screening interview and continuing after discharge is recommended as being, in the long-term, the most cost-effective and satisfactory approach. PMID- 3812120 TI - Computer analysis during intensive monitoring of epileptic patients. PMID- 3812121 TI - Data reduction methods for intensive neurodiagnostic monitoring: future directions for development. PMID- 3812122 TI - Intensive neurodiagnostic monitoring: strategy for optimal use. AB - Intensive neurodiagnostic monitoring has proven to be a valuable approach to diagnosis and management of epilepsy and related disorders. Certain specific types of problems can be answered with fairly limited outpatient methods, whereas others require exhaustive, complex, and expensive inpatient methods. With rapid advances in technical quality of cameras, videotape recorders, and utilization of computer assistance, changes in current methods can be expected in the near future. PMID- 3812123 TI - Intensive neurodiagnostic monitoring: summary and recommendations. PMID- 3812124 TI - Intensive monitoring of complex partial seizures: diagnosis and subclassification. PMID- 3812125 TI - Psychoanalytically oriented psychotherapy of substance abuse (with observations on the Penn-VA Study). AB - The Penn-VA psychotherapy project was designed to test the hypothesis that the addition of supportive expressive or cognitive behavioral psychotherapy might add a differential benefit to the usual drug counseling of opiate addicts. The results indeed showed that the patients who had treatment administered by the trained psychotherapists did better than those who had only the regular drug counseling. This author describes his experiences as one of the psychoanalytically oriented psychotherapists. Important aspects of this technique and common themes that emerge in the course of treatment are discussed. It is suggested that this treatment approach can be successfully applied to the treatment of the abuse of other substances including alcohol and outside the research setting. PMID- 3812126 TI - Motivational predictors of alcoholics' responses to inpatient treatment. AB - Motivational patterns of 60 alcoholic inpatients were assessed by use of the Interview Questionnaire (IntQ) and were related to staff judgments regarding patients' success or failure in completing an inpatient treatment program. The IntQ was administered soon after intake, one month later, and at the end of treatment. It elicits patients' idiographic accounts of their current concerns and patients' nomothetic ratings of them on variables related to commitment, active participation in goal striving, and goal valence, value, expectancy, and imminence. Structural variables demonstrated significant stability over the first two IntQ administrations, whereas goal content and affect variables did not. Stepwise discriminant analysis of treatment outcome as well as correlational analyses indicated that successful outcomes were significantly related to smaller size of community, concerns appetitive to treatment, lack of concerns about avoiding alcohol, and expecting goal attainments to occur sooner. Goal orientations toward treatment and alcohol were related to other variables in ways consistent with the view that recovery from alcohol is associated with having emotionally positive alternative goals. PMID- 3812127 TI - Prevalence rates for alcoholism, associated depression and dementia on the Harlem Hospital Medicine and Surgery Services. AB - Current prevalence rates for alcoholism, and associated depression and dementia, were determined on random samples of approximately 200 patients admitted to the Medicine Service, and a similar sample to the Surgery Service, of the Harlem Hospital Center. The Medicine patients averaged 51 years of age, significantly older than the Surgery sample's average age of 44 years. Surgery patients also had a significantly greater proportion of patients (46.8 percent) who had achieved at least a high school education compared to Medicine (32.1 percent). The alcohol prevalence rate of 30.2 percent for Medicine was significantly greater than the 18.3 percent Surgery prevalence. Both Medicine and Surgery patients showed that a progressively serious pattern of drinking was associated with progressively serious depression. Progressive dementia was associated with progressive severity of drinking in the Medicine sample, but this finding was not demonstrated in the Surgery patients. Medicine and Surgery patients demonstrated dissimilar profiles of principal admitting diagnoses. Patient management is seriously handicapped by problems of alcoholism and associated problems of depression and dementia. PMID- 3812128 TI - Alcohol use and antisocial experiences. AB - This study examined patterns of alcohol use and several anti-social experiences from two large national samples. The data used were collected by the National Opinion Research Center in 1980 and 1984. The results indicated that self admitted excessive usage of alcohol was clearly associated with the probability of arrest, traffic citations and victimization by physical and firearm assault. No clear pattern emerged concerning lifetime episodes of divorce and to only a limited extent about unemployment in the past five years. PMID- 3812129 TI - Control groups in routine evaluations of outcomes of alcoholism treatment. AB - The use of no treatment or waiting list controls for the time span of both treatment and follow-up of one year or longer involves ethical and methodological problems such as sample attrition; however, shorter follow-ups would lead to overestimates of long-term outcomes. Other comparison groups such as nonspecific treatment controls do not provide an estimate of what would happen to the clients without treatment and what their recovery chances would be in other treatment centers. Therefore, as an alternative to traditional design for outcome rate evaluations, the present paper suggests comparisons to pooled data from follow ups of treated alcoholics. Until methodologically more acceptable pooled data is available, the data on untreated alcoholics pooled and re-analyzed by Emrick and the data on treated alcoholics presented by Gillies, Laverty, Smart, and Aharan could provide a temporary interpretational background. The most serious drawback of the two criterion samples is insufficient description of basic characteristics of the clients (e.g., in respect to age, education, sex, occupation, and to personality measures). More detailed descriptions in most future evaluation studies would make it possible to create better described criterion samples by pooling the data. This would also allow further analyses of the relationship of client characteristics to outcomes and, thus, would allow for special credit to outcomes with difficult clientele. PMID- 3812130 TI - [Acceleration in the development of ossification centers of the hand]. PMID- 3812131 TI - [Incidence of handedness in preschool children. A comparative study with mono- and dizygotic twins]. PMID- 3812132 TI - [The task of Youth Health Protection in the carrying out of a mass hypertension prevention screening program]. PMID- 3812133 TI - [Current problems in the preparation of scientifically-based recommendations for the hygienic arrangement of all-day educational processes in the lower grades of the polytechnical college]. PMID- 3812134 TI - [Sex education--not only for female students of the Gorlitz Technical School. Observations on a paper by Dr. J. Richter]. PMID- 3812135 TI - [Personal conclusions from the activities of the "Student Protection" study group (1981-1985)]. PMID- 3812136 TI - Geography of the nose: a morphometric study. AB - The noses of 34 attractive young North American Caucasian women were analyzed quantitatively, based on 19 nasal measurements (6 single and 7 paired linear measurements, 3 angles, and 3 inclinations) and 15 craniofacial measurements (10 linear measurements and 5 inclinations) taken directly from the face of the women. The relationship between the nasal measurements was studied in 16 proportion indices and the relationship between the nasal and the other craniofacial measurements in 13 interareal indices. The findings were also compared with those in 21 women with below-average faces. Two types of facial harmony disruption were identified: disharmony, a normal index with a visually apparent failure of proportionality, and disproportion, an index value outside of the normal range. The percentage of disharmonies and disproportions was significantly higher in the group of 21 women with below-average faces. The study revealed a wide variety of "ideal" noses. Only a small portion of the measurements (12%) and proportion indices (7%) were at the mean value. At least two-thirds of the interareal proportion indices were located in the mean +/- 1 standard deviation portion of the normal range. Only about one-fifth of the interareal indices were disharmonious and 2.8% disproportionate. The disproportions were more areal in the attractive faces and more interareal in the below-average faces. The greatest disproportion in the attractive face was the moderately short columella in relation to the tip protrusion and in the below average face the long nasal bridge related to the upper-lip height. Disproportions were associated with combinations of normal and abnormal measurements, or with two normal measurements of unequal quality, which resulted in a slightly smaller disfigurement. Analysis of ethnic and racial differences showed the soft nose as the main feature of the most characteristic differences. The study revealed that the key to restoration of facial harmony is the renewal of the uniformity of proportion index qualities by elimination disharmonies and/or disproportionate relationships. PMID- 3812137 TI - Conclusions after 122 revision rhinoplasties: brief review of cases. AB - Revision rhinoplasty is always more complicated than the primary surgery. A more conservative approach using safer, more reliable techniques in primary surgery should decrease the number of revisions. PMID- 3812138 TI - New data in the correction of twisted noses. AB - Besides the numerous functional difficulties for the patient with a twisted nose, he must also handle its psychological repercussions. These repercussions are the cause of the frequent demands for purely aesthetic surgery. Correcting the twisted nose is difficult. There are the possible cutaneous adhesions. Also, two classical factors are involved: septal, due to the elasticity of the cartilage; and the bone itself, due to ostectomies and/or osteotomies not performed or done incorrectly. Though the elasticity of the septal cartilage is corrected by many surgeons, few of them modify that of the alar cartilage. This is what we discuss in this article. We also discuss another element of major importance, the periosteum and its inextensibility. PMID- 3812139 TI - Securing of the nasal skin under the cast in rhinoplasty. AB - The author suggests a method to protect the skin of the nose from vascular impairment, bruising, necrosis, and other complications by interposing between the nasal skin and the overlying splint or cast a protective layer of a soft delicate material such as Telfa or Scrylin. PMID- 3812140 TI - New options in breast reconstructive surgery: alternatives to the latissimus dorsi musculocutaneous flap. AB - Transposition of the latissimus dorsi musculocutaneous flap is still considered by most authors a first-choice technique for breast reconstruction. However, the aesthetic drawbacks of the technique are significant: In our experience the posterior scar and the "patchlike" skin island are of concern to more than 30% of patients. Recent alternatives have sharply reduced the use of the latissimus dorsi myocutaneous flap as our first-choice technique. The utilization of a latissimus dorsi muscular flap in association with submuscular placement of a tissue expander is now our favorite technique for the majority of patients: Residual scarring is insignificant since the whole muscle can be raised through a 5-7-cm-long, S-shaped incision placed along the anterior border of the latissimus dorsi. The results obtained in a group of 35 patients demonstrate that the final results of the procedure in terms of shape and projection of the reconstructed breasts are absolutely similar to those obtained using the latissimus dorsi musculocutaneous flap. However, in patients with heavy body structure and large contralateral breast, satisfactory symmetry and a natural-looking reconstructed breast are obtained more effectively by transposition of a rectus abdominis myocutaneous flap. The precautions to be taken in order to make the procedure suitable for over-weight patients are described and the results are discussed. PMID- 3812141 TI - Open capsulotomy by the transaxillary approach. AB - The release of capsular contracture through the axillary approach is presented. The technique is used in cases that have previously undergone breast augmentation, through the same approach and using the same blunt instrumentation for dissection. PMID- 3812142 TI - [Epidemiological study on urolithiasis in Mie Prefecture. 1. Present status in 1985]. AB - To determine the present status of urolithiasis in Mie Prefecture, we analyzed the 1,314 patients of urolithiasis at 17 Departments of Urology and 2 Departments of Medicine in 1985. The ratio of male patients to female patients was 2.6 to 1. The most frequent incidence of urolithiasis was observed in Iinan county. The incidence of urolithiasis in the urban area was the same as that in the country. Most of the stones (96.9%) were in the upper urinary tract. The incidence of lower urinary tract calculi tended to be high in southern Mie Prefecture. The ratio of upper urinary tract calculi to lower urinary tract calculi in the urban area was the same as that in the country. The peak incidence in males was in the forties, while that in females was in the fifties. The average age was 44.5 years old. Ureterolithotomy was the most frequent (37.5%) surgical therapy, percutaneous nephrolithotomy and shock wave lithotomy done in 8.0% and 6.3%, respectively. The most frequent component of the urinary tract calculi was calcium oxalate and/or calcium phosphate (84.0%). The incidence increased in summer (April through September). PMID- 3812143 TI - [Changes in leukocyte counts using a cellulose acetate membrane (FB-T) during hemodialysis. A comparison with a cuprophane membrane]. AB - The effect of cellulose acetate as the membrane of dialyzer on changes in white blood cell (WBC), platelet, CH50, C3 and C4 was evaluated in 5 patients with chronic renal failure during hemodialysis. Similarly the effect of cuprophan on these values was also evaluated. Significant changes in WBC (neutrophil and lymphocyte) were observed in all patients with cuprophan, but changes in WBC in those with cellulose acetate were not significant. There were no differences in the platelet count, CH50, C3 and C4 values between the cupro phan and cellulose acetate membrane. PMID- 3812144 TI - [Experimental and clinical studies on calcium lithiasis. II. Prevention of recurrent calcium stones with thiazides and allopurinol]. AB - We evaluated 113 patients with recurrent or multiple calcium urolithiasis at our outpatient stone clinic between 1980 and 1983. Diagnostic categories included hypercalciuria (36 patients), hyperoxaluria (35 patients), and hyperuricosuria (31 patients). Thiazides and/or allopurinol were administered to the hypercalciurics and hyperuricosurics, respectively for prevention of stone recurrence. Patients followed up for more than one year were 23 (male 16, female 7) in the thiazide group, and 15 (male 12, female 3) in the allopurinol group. The mean treatment interval was 2.49 years in the former, and 2.35 years in the latter. The remission rate (percentage of patients without formation of any new stones) was 82.6% in the thiazide group, and 73.3% in the allopurinol group. The group stone formation rate was reduced from 0.85 to 0.35/pt-yr in the thiazide group, and from 0.74 to 0.27/pt-yr in the allopurinol group. Efficacy of these two drugs for the prevention of calcium stone recurrence was observed in this selective therapy, but a careful double blind study should be carried out to draw a definite conclusion. PMID- 3812145 TI - [Clinical investigations on prostatic carcinoma patients who survived for long periods]. AB - A clinical investigation was conducted on 15 prostatic carcinoma patients who survived for more than 3 years (as of October, 1984) since the initial examination. The patient's age at first examination ranged from 56 to 84 years, and survival time was from 3 to 8 years. There was no correlation between age at first examination and survival time. No statistically significant relationship was found between the initial examination stage and survival time. However, the Stage D group showed a wide-ranging survival time from the shortest to the longest survival time. In the relationship between stage and grade, as cited above, group D reflected multiple aspects of prostatic carcinoma in the broad spectrum observed from Grade 1 to Grade 3. The performance status of the 15 prostatic carcinoma patients was either Grade 0 or 1 at the initial examination. The group classified in Grade 0 at the time of the first examination displayed a more favorable performance status than the Grade 1 group now (P less than 0.05). Regarding the stage variation, 1 patient showed improvement, 12 showed none, and 2 reflected advance of the disease. It is important that radical surgery be indicated in any operable case, and in the inoperable cases long-term control therapy is required. PMID- 3812146 TI - [A case of infected urachal cyst--a review of Japanese case reports of urachal cyst]. AB - A 24-year-old female with infected urachal cyst is reported. She was admitted to the hospital with complaints of a lower abdominal mass, abdominal pain and cystitis symptom. Brownish pus discharges from her umbilicus were recognized by manual compression of the lower abdominal mass. Cystoscopy revealed a small orifice at the dome of the bladder, and pus discharges from this orifice. A pooling of contrast medium (8 X 2.5 cm) under the umbilicus was detected by a fistelography from the umbilicus, and a low density mass was detected under the abdominal wall between the umbilicus and the dome of bladder on a CT scan. So she was diagnosed as an infected urachal cyst and operated on. The urachal cyst which was adhered to the peritoneum had penetrated both the umbilicus and bladder at the time of operation. Complete removal of the urachal cyst with partial cystectomy was done. We also reviewed the Japanese case reports of urachal cyst. PMID- 3812147 TI - [Adult neuroblastoma: a case report]. AB - A rare case of adult neuroblastoma is presented. A 20-year-old woman complaining of fever and left abdominal tumor was admitted on July 14, 1984 and diagnosed as left nonhormonal adrenal tumor after DIP, CT scanning, and hormonal assay in serum and urine. Left radical nephrectomy was done and the histological diagnosis was neuroblastoma. The chemotherapy of EDX, 5FU was done in 5 courses, but the patient had multiple metastasis and died on November 30, 1984. Neuroblastoma in the adult is rare and 40 cases (greater than 15-year-old) have been reported in the past 5 years, 20 of which were olfactory neuroblastoma. Particularly in urological sites, only 13 cases (greater than 15-year-old) have been reported for the past 20 years. Thus it is a characteristic of adult neuroblastoma that the occurrence in the retroperitoneal cavity is very low, compared with 60-70% of neuroblastoma in children. PMID- 3812148 TI - [A case of pure choriocarcinoma of the testis in an elderly man]. AB - A case of pure choriocarcinoma of the testis in a 62-year-old male is reported. The patient consulted his family physician with an enlarged but painless right scrotal containment in November, 1980. Initial diagnosis was right hydrocele testis and chronic epididymitis, and he was treated with antibiotics. However, the tumor continued to enlarge. Right high orchiectomy was performed on March, 15, 1981 under the diagnosis of suspected right testicular tumor. The resected specimen was 10 X 7 X 6 cm and elastic hard. The cut surface was dark reddish with hemorrhagic foci. Serial sections of the entire testis were made and their histopathological examinations revealed the tumor to be a classical pure choriocarcinoma of the testis. The plasma beta-HCG level was remarkably elevated, but the alpha-fetoprotein level was normal. Anticancer chemotherapy (CDDP 125 mg, MTX 20 mg, ADM 50 mg, and EDX 500 mg) was performed in eight courses after the operation. Multiple metastatic foci were present in both lungs during the treatment, and his condition gradually deteriorated. Therefore, he was transferred to our hospital. Aggressive anticancer treatment could not be given because of his poor general condition, and he died on May, 16, 1982 of carcinomatosis. The autopsy revealed multiple nodular metastasis of the tumor to bilateral lungs, bilateral adrenal glands and right kidney. There was no metastasis to the lymph nodes. The metastatic lesions, macrospically dark reddish with hemorrhagic foci, were histopathologically pure choriocarcinoma. PMID- 3812149 TI - [A case of primary malignant neoplasms associated with penile cancer and prostatic cancer]. AB - A case of a 79-year-old man with penile cancer and prostate cancer is reported. The pathological study of surgical specimens disclosed well-differentiated squamous cell carcinoma of the penis and poorly differentiated adenocarcinoma of the prostate. This is a rare case of multiple primary malignant neoplasms associated with penile cancer and prostate cancer. PMID- 3812150 TI - [Clinical statistics in the Outpatients Clinic of the Department of Urology, Kyoto University Hospital 1983 and 1984]. PMID- 3812151 TI - [Clinical statistics of the admitted patients at the Department of Urology, Kyoto University Hospital 1983-1984]. PMID- 3812152 TI - Comparative study of the effects of pyruvate and CG-120 in preventing experimental oxalate urolithiasis in rats. AB - Male Wistar-strain rats which had been fed a calcium-oxalate lithogenic diet (a glycolate diet) developed urinary calculi in 4 weeks. Sodium pyruvate or CG-120 (a mixture of citrate salts) had been added to this diet to determine its effect in preventing lithogenicity. Rats in the group fed a pyruvate diet had, however, almost no stones in the urinary system. Rats in the CG-120 group showed results somewhat similar to those in the pyruvate group. Increased urinary citrate excretion was observed in both groups and could be implicated as the main inhibitory factor in stone formation. Therefore, it can be concluded that CG-120 exerts a beneficial effect close to that of pyruvate in preventing calculi formation and that both substances cause a high citrate excretion in urine. PMID- 3812153 TI - Do you want your child to be a doctor? PMID- 3812154 TI - Team management for cleft palate children. PMID- 3812155 TI - Cancer programs in Alabama. PMID- 3812156 TI - Rehabilitation of geriatric patients with Austin-Moore prostheses. PMID- 3812157 TI - The self-interest of bureaucrats. PMID- 3812159 TI - Attitudes toward sign communication mode: a survey of hearing and hearing imparied educators of the deaf. PMID- 3812158 TI - The language-experience approach to facilitating reading and writing for hearing impaired students. PMID- 3812160 TI - Motor planning abilities in deaf and hearing children. PMID- 3812161 TI - Conceptual sign language acquisition by Spanish-speaking parents of hearing impaired children. PMID- 3812162 TI - Diagnostic overshadowing among school psychologists working with hearing-impaired learners. PMID- 3812163 TI - Affiliation with professional organizations by vocational educators of the hearing-impaired. PMID- 3812165 TI - Self-esteem in deaf adolescents. PMID- 3812164 TI - Individual differences in the signed communication of deaf children. PMID- 3812166 TI - Magnetic resonance imaging. PMID- 3812167 TI - Stillbirth. AB - Stillbirth is a professional blind spot for physicians and nurses, who may experience denial in dealing with the bereaved mother and her family. Providing choices and information about the conduct of labor and perinatal decisions, as well as pictures of the infant, a hospital birth certificate and other memory items, may be helpful to the parents in their grief. Hospital perinatal loss teams can provide support both to families and to medical staff. PMID- 3812168 TI - Cutaneous myiasis. AB - Although cutaneous myiasis remains uncommon in North America, any traveler to the tropics may return with this ailment. A history of travel to a tropical country, a persistent pruritic lesion resembling a boil but having a dark central punctum with seropurulent or serosanguineous drainage, and complaints of a crawling sensation in the area of the lesion should lead the physician to consider myiasis. Treatment is directed at prompt removal of the fly maggot by incision and extraction. PMID- 3812169 TI - Hemorrhagic complications of varicella. AB - Although normally a benign illness, varicella can be accompanied by purpuric syndromes. While thrombocytopoiesis is normal, a shortened platelet survival time has been demonstrated with no increase in splenic sequestration. Various mechanisms have been suggested, including an autoimmune mechanism, direct interaction between virus and platelets, and vascular damage resulting in platelet removal on nonendothelialized surfaces. PMID- 3812170 TI - Synovial osteochondromatosis. AB - Synovial osteochondromatosis is a benign disorder in which cartilaginous loose bodies develop about the large joints, usually the knee. It is caused by synovial metaplasia of unknown etiology. Symptoms are due either to mechanical problems caused by the loose bodies or to the degenerative arthritis that usually follows in several years. Surgical or arthroscopic removal of the loose bodies appears to be the only effective treatment. Loose bodies may recur, necessitating synovectomy. PMID- 3812171 TI - Evaluation of the child with growth retardation. AB - Although growth retardation usually has a nonpathologic cause, it can be the primary symptom of a number of underlying organic disease. The family physician can evaluate growth retardation with confidence by using the history and physical examination, screening tests, comparisons of chronologic age, bone age and height age, and prior anthropometric measurements. PMID- 3812172 TI - Recognition and treatment of depression. AB - The astute family physician recognizes that such complaints as fatigue, pain, weight change and insomnia may be manifestations of depression rather than of physical illness. This diagnostic challenge is simplified by a working knowledge of the criteria for depression and mania. In addition to diagnosing depression, family physicians can successfully treat this condition with antidepressant medications. PMID- 3812173 TI - Extracolonic manifestations of inflammatory bowel disease. AB - Patients with inflammatory bowel disease may develop various extracolonic manifestations. Oral and eye complaints are common. Recognition is important because these may be clues to subclinical chronic ulcerative colitis or Crohn's disease. Treatment of the bowel inflammation may improve the extracolonic manifestations, such as peripheral arthritis or erythema nodosum. PMID- 3812174 TI - Drug therapy in the elderly. PMID- 3812175 TI - Generic bioequivalence: a scientific consensus needed. PMID- 3812177 TI - The interplay between endogenous catecholamines and induced ventricular tachycardia during electrophysiologic testing. AB - Plasma epinephrine and norepinephrine concentrations were measured before, during, and shortly after induced ventricular tachycardia (VT) in 22 selected patients. Sustained, unimorphic VT was induced by programmed ventricular stimulation and terminated after 45 to 384 seconds by overdrive pacing in all patients. In no patient did VT result in loss of consciousness. The baseline plasma catecholamine concentrations did not correlate with the baseline right ventricular effective refractory period, the cycle length of induced VT, or the number of extrastimuli required to induce VT. Induced VT was not associated with a significant increase in the mean plasma epinephrine concentration. In contrast, the plasma norepinephrine concentration increased from a mean baseline level of 317 +/- 136 pg/ml (mean +/- standard deviation) to 418 +/- 220 pg/ml during VT (p less than 0.01) and increased further to 569 +/- 387 pg/ml shortly after VT (p less than 0.01). The plasma norepinephrine concentration shortly after VT correlated with the rate and duration of VT and with the magnitude of decrease in mean blood pressure during VT (p less than 0.05 for each). In eight patients the same configuration of VT was induced on two sequential attempts; in five patients the same number of extrastimuli were required for the second induction of VT as for the first, whereas in three patients fewer extrastimuli were required. Plasma catecholamine concentrations were not higher in patients requiring fewer extrastimuli to induce the second episode of VT, either shortly after the first episode of VT or shortly after the second episode of VT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812178 TI - Differentiation of viable and nonviable myocardium after acute reperfusion using serial thallium-201 imaging. AB - This study was performed to determine if differences in regional myocardial thallium clearance rates could differentiate salvaged from nonsalvaged myocardium after reperfusion. Twenty-one dogs underwent 2 hours of left anterior descending coronary artery ligation followed by reperfusion. Thallium was administered 5 minutes later and serial images were acquired over 3 hours. Of the 21 dogs, 15 had infarctions of which nine had initially reduced anterior wall thallium activity (group 1) and six had normal or increased activity (group 2). Six dogs did not have an infarction (group 3). All group 1 dogs demonstrated reduced clearance rates in the anterior wall (T1/2 = 15.0 +/- 4.7 hours, SD) compared to the posterior wall (T1/2 = 9.0 +/- 4.4 hours; p less than 0.001). Group 2 dogs demonstrated increased clearance rates in the anterior wall (T1/2 = 5.7 +/- 2.0 hours) compared to the posterior wall (T1/2 = 10.5 +/- 4.6 hours; p less than 0.001). Group 3 dogs demonstrated no difference in clearance rates. In conclusion, although thallium uptake is frequently reduced in nonsalvaged myocardium, tracer uptake can be normal or increased if perfusion has been completely restored. However, an increased clearance rate from the reperfused zone compared to the normal zone is a reliable indicator of nonsalvaged myocardium, despite normal initial thallium uptake. PMID- 3812176 TI - Preventing venous thrombosis and pulmonary embolism. PMID- 3812179 TI - Ischemic heart disease in the WHHL rabbit: a model for myocardial injury in genetically hyperlipidemic animals. AB - Myocardial lesions were frequently found in homozygous Watanabe heritable hyperlipidemic (WHHL) rabbits. The lesions were of two types. One consisted of a dissolution of muscle cells with inflammatory cell infiltrate. The other consisted of replacement fibrosis. The more the lumens of at least one of the three main coronary arteries were narrowed by atherosclerosis, the more the myocardial lesions occurred. The greater the number of vessels that were occluded, the more the incidence of myocardial lesions increased. From the age distribution of rabbits which died of natural causes, the average life span was estimated to be markedly shorter in homozygous WHHL rabbits than in normal rabbits. These findings suggest that WHHL rabbits suffered from ischemic heart disease, including acute myocardial infarction. Thus, this study shows that WHHL rabbits may be useful not only as a model of familial hypercholesterolemia but also for investigating the mechanisms of various clinical forms of ischemic heart disease. PMID- 3812180 TI - Acute and chronic effects of amiodarone on delayed afterdepolarization and triggered automaticity in rabbit ventricular myocardium. AB - The effects of amiodarone on delayed afterdepolarization (DAD) and triggered automaticity induced by low potassium (0.5 mEq/L) were evaluated on isolated rabbit right ventricular muscles, by means of standard microelectrode techniques. Triggered automaticity was induced in 6 of 10 muscles in the control group, in four of eight in the amiodarone-superfused group, and in three of four in the Tween 80-pretreated group. In contrast, triggered automaticity could be induced in only 2 of 10 of amiodarone-pretreated muscles (n = 10) (20 mg/kg intraperitoneally, daily for 4 weeks; p less than 0.05 compared to control and amiodarone-superfused groups). The amplitude of DAD was significantly lower in muscles isolated from rabbits pretreated with amiodarone compared to those from nontreated control rabbits (n = 17). The degree of reduction was significant during all three cycle lengths of stimulation tested (800, 600, and 400 msec), that is, 2.5 +/- 1.8 vs 5.1 +/- 1.8, 2.4 +/- 2.1 vs 5.5 +/- 2.3, and 3.3 +/- 3.4 vs 9.3 +/- 4.3, respectively (values are in millivolts of mean +/- SD). Superfusion with amiodarone (3 micrograms/ml; n = 8) significantly (p less than 0.05) reduced the amplitude of DAD at 800 msec cycle length, but had no significant effect at cycle lengths of 600 and 400 msec. Tissue concentrations of amiodarone in the pretreated group were significantly (p less than 0.05) lower than those in the superfused group (10 +/- 6.8 vs 21 +/- 3.1 micrograms/gm).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812181 TI - Mechanisms responsible for countershock-induced ventricular tachycardia in the intact canine heart. AB - To determine the mechanism for postcountershock ventricular ectopy, internal and external shocks were delivered to 20 anesthetized dogs. Shock energies of 25 and 50 joules were employed internally while 100 and 200 joules were delivered externally. Experiments were performed in both the presence and absence of a nearly toxic dose of ouabain. All shocks resulted in the occurrence of nonsustained (less than 15 seconds) ventricular tachycardia. When bursts of rapid ventricular pacing were synchronized with a shock, the pacing stimuli invariably captured the ventricles and overdrove the shock-induced ventricular tachycardia. However, the burst pacing never appeared to break a tachycardia, since the termination of pacing was followed immediately by the resumption of the shock induced ventricular tachycardia. The presence of ouabain did not alter the response of the ventricles to postshock burst pacing. Administration of verapamil (0.5 mg/kg) had no effect on the duration of shock-induced ventricular arrhythmia. Elevation of the serum potassium level to 8.5 +/- 0.6 mEq/L drastically reduced the duration of postshock ventricular tachycardia in both the presence and absence of ouabain. The results suggest that postshock ventricular ectopy results from an abnormality of impulse initiation rather than reentry. PMID- 3812182 TI - Total and unbound concentrations of quinidine and 3-hydroxyquinidine at steady state. AB - Recent reports indicate that the metabolite of quinidine, 3-hydroxyquinidine, is pharmacologically active. It was the primary purpose of this study to determine total and unbound concentrations of quinidine and 3-hydroxyquinidine in 25 patients receiving quinidine for therapeutic purposes. At the peak, total quinidine and 3-hydroxyquinidine concentrations were 2.7 +/- 1.2 micrograms/ml and 0.57 +/- 0.33 micrograms/ml, respectively, and at the trough they averaged 2.0 +/- 0.91 micrograms/ml and 0.44 +/- 0.25 micrograms/ml. Interestingly, the unbound 3-hydroxyquinidine concentration frequently exceeded the unbound quinidine concentration, averaging 0.30 +/- 0.28 micrograms/ml at the peak and 0.22 +/- 0.14 micrograms/ml at the trough. Quinidine concentrations averaged 0.24 +/- 0.15 micrograms/ml and 0.18 +/- 0.12 micrograms/ml. The ratio of unbound 3 hydroxyquinidine: quinidine was significantly influenced by the unbound clearance of quinidine (r = 0.66). At low clearance values concentrations of both substances were elevated, with the quinidine concentration consistently exceeding that of 3-hydroxyquinidine. In contrast, at high clearance values 3 hydroxyquinidine concentrations were elevated and consistently exceeded the quinidine concentration. Thus, when quinidine concentrations are used to monitor the pharmacodynamic effect of quinidine, it is most appropriate to evaluate unbound concentrations of both quinidine and 3-hydroxyquinidine. PMID- 3812183 TI - Analysis of high-resolution atrial activation: report on 403 cases. AB - The findings of a study carried out on a sample of 403 P waves, selected over the 50 to 300 Hz frequency range, by a portable microcomputer system capable of averaging 512 P waves, are reported. Detailed analysis of P waves was attempted in healthy subjects and in patients affected by pathologic processes where atrial involvement had been observed. An attempt was made to individualize P wave parameters which may be associated with these pathologic conditions. On each atrial signal a 512-point fast Fourier transform was used. The original sample was divided into 18 classes, and the mean values of some parameters of each class were computed. The results of fast Fourier transform computing and of the mean values of parameters for both patients and healthy subjects show two different behaviors with respect to the amplitude-frequency relationships and mean peak-to peak amplitude, respectively. The present results indicate that this technique may be useful for further detailed analysis of P waves. PMID- 3812184 TI - Pacing in children and young adults with nonsurgical atrioventricular block: comparison of single-rate ventricular and dual-chamber modes. AB - A prospective comparison of physiologic response to single-rate ventricular and dual-chamber atrioventricular pacing was conducted in 14 pediatric patients (age 1 to 24 years, median 14) with symptomatic nonsurgical second- or third-degree atrioventricular block. All patients were studied acutely during cardiac catheterization before and after 1 hour of both pacing modes. Following pacemaker implant, eight patients were reevaluated after 1 month of each mode with symptom questionnaire, resting ECG, resting echocardiogram, and Doppler cardiac output measurement at rest and at peak treadmill exercise. Cardiac outputs (mean +/- standard error) increased acutely (n = 14) with both ventricular (32 +/- 12%) and dual-chamber (39 +/- 10%) pacing over intrinsic rhythm values (p less than 0.01 in both). During chronic pacing (n = 8), symptoms were reported only with the ventricular mode. Dual-chamber synchronous pacing was associated with improved mean resting shortening fraction and cardiac output, slower mean resting sinus rate (89 +/- 5 compared to 73 +/- 4 bpm (p less than 0.02), and a 23% increase in mean excerise cardiac output (4.2 +/- 0.4 compared to 3.4 +/- 0.3 L/min/m2) compared to single-rate ventricular pacing. Exercise-induced dysrhythmias occurred only with ventricular pacing. This study demonstrates that pediatric patients with nonsurgical atrioventricular block can compensate for loss of atrioventricular synchrony at rest but exhibit improved cardiac function with chronic dual-chamber atrioventricular compared to single-rate ventricular pacing. PMID- 3812185 TI - Quantitative validation of cineangiographic biplane axial oblique right ventricular volume measurement. AB - Axial cranial oblique biplane views of the right ventricle (RV) permit unique assessment of the RV outflow tract, relationship of the great vessels, and anatomy of the proximal pulmonary arteries. This view may also be useful in assessment of RV free wall and RV septal wall motion. However, the accuracy of volumes derived from biplane angiocardiography with the use of the axial cranial oblique projection has not been adequately validated or compared to conventional views. Nineteen RV animal casts whose volume was determined by water displacement were filmed in conventional posteroanterior/lateral (PA/Lat), 30-degree right anterior oblique/60-degree left anterior oblique (30 degrees RAO/60 degrees LAO) views and in angulated 35-degree right anterior oblique/55-degree left anterior oblique/30-degree cranial (35 degrees RAO/55 degrees LAO/30 degrees Cr) view. Tracings of biplane cast images were analyzed for RV volume by Simpson's rule. RV cast volume was significantly overestimated by 12.2 +/- 6.8, 6.0 +/- 5.3, and 9.3 +/- 9.5 ml in PA/Lat, 30 degrees RAO/60 degrees LAO, and 35 degrees RAO/55 degrees LAO/30 degrees Cr views, respectively. The correlation coefficient (r) and the standard error of the estimate (SEE) for true vs calculated volume was 0.96, 0.98, and 0.97, and 6.8, 5.2, and 7.3 ml, respectively, for PA/Lat, 30 degrees RAO/60 degrees LAO, and 35 degrees RAO/55 degrees LAO/30 degrees Cr views. Although there was a high correlation of angiographic volumes with true volume in all three views, the 30 degrees RAO/60 degrees LAO projection had the most ideal regression characteristics with highest r value and the lowest SEE.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812186 TI - Quantitative regional curvature analysis: an application of shape determination for the assessment of segmental left ventricular function in man. AB - All traditional techniques of regional ventricular function analysis depend upon one or more assumptions about coordinate, reference, or indexing systems, idealized ventricular geometry, and the uniformity of ventricular contraction. Therefore, a method of shape analysis was developed that allows the quantitation of regional curvature and is independent of the assumptions outlined. This was implemented on a commercial image processing unit and applied to silhouettes of 30-degree right anterior oblique left ventriculograms. Three groups with abnormal wall motion (anterior abnormality, n = 23; inferior abnormality, n = 23; anterior and inferior abnormalities, n = 22) were analyzed and compared to a group with normal regional function (n = 22). Relatively few significant quantitative curvature differences were noted at end diastole among the groups. These few abnormalities described a slight increase in curvature or globularity of the anterior and inferior walls. More marked and extensive aberrations were detected at end systole. The group with anterior wall motion disturbances showed four distinct areas of curvature abnormality. Excessive curvature was present on either side of the apex (anterior and inferoapical regions) and apical curvature was less than normal. The fourth region was in the inferior zone, which showed curvature values that were less than normal, suggesting increased inward motion contralateral to the anterior abnormality. The group with inferior wall motion abnormalities also showed excessive end-systolic curvature on either side of the apex (diaphragmatic and anteroapical zones) and deficient curvature at the apex. A combination of these regional morphologic abnormalities was noted in the group with both anterior and inferior dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812187 TI - A simplified mitral valve method for two-dimensional echo Doppler blood flow calculation: validation in an open-chest canine model and initial clinical studies. AB - Quantitative two-dimensional Doppler echocardiography is increasingly used for the calculation of cardiac blood volumes. This study evaluates a simplified method for measuring volume flow at the mitral valve orifice. In four open-chest dogs the simplified mitral valve method was compared to a previously described mitral orifice method for Doppler volume flow calculation and to data obtained by electromagnetic flow measurement. Cardiac output varied from 1.4 to 7.7 L/min. Correlation for both the Doppler method and the electromagnetic meter volume flows was r = 0.98 to 0.99, and there was no significant difference between the two methods. In a clinical pilot study, 10 children were studied in the catheterization laboratory, and the simplified Doppler flow method was compared to thermodilution cardiac output measurements with good results. The study indicates that the simplified mitral valve method provides acceptable accuracy for Doppler cardiac output measurement. PMID- 3812188 TI - Echocardiographic mitral valve prolapse in ballet dancers: a function of leanness. AB - To determine the prevalence of mitral valve prolapse in ballet dancers by echocardiography and to establish which anthropometric measurements best predict the presence of mitral valve prolapse, we compared 44 professional dancers (22 men and 22 women) with 52 controls (24 men and 28 women). Forty-eight percent (21 of 44) of dancers had echocardiographic mitral valve prolapse compared with 10% (5 of 52) of controls (p less than 0.01). The dancers weighed less than the controls and had significantly smaller bony diameters and body circumferences. However, only ponderal index was predictive of mitral valve prolapse in both dancers and controls. Thus, echocardiographic mitral valve prolapse is associated with low body weight relative to height and neither to ballet dancing nor to a distinct body habitus. Echocardiographic mitral valve prolapse may represent a normal variant in the majority of asymptomatic, thin subjects without auscultatory findings. PMID- 3812189 TI - Cardiac size and motion during water immersion: implications for volume homeostasis. AB - Prior work has shown that head-out water immersion (WI) produces a prompt central hypervolemia, a natriuresis, and a diuresis. To assess if cardiac chamber enlargement modulates these effects, we measured cardiac size, shape, wall motion, and cardiac displacement via serial underwater two-dimensional echocardiography. Six normal volunteers underwent 2.5 hours of WI to the neck, seated, at 34.5 degrees C. Recovery was 30 minutes. The size of both atria increased significantly but transiently during the study (p less than 0.0001 for left atrium, and p = 0.0020 for right atrium). Both atria returned to baseline size during WI. Moreover, for left atrium there was a small overshoot in recovery. Neither left ventricular nor right ventricular dimensions nor ejection fraction changed significantly. Also, no shape changes were detected, although WI was associated with upward and lateral displacement of the acoustic windows. Correlation coefficients (r) for left atrial, or right atrial size vs urinary excretion of sodium or urine volume size ranged from 0.05 to 0.36. These results, in sum, suggest that strong compensatory mechanisms are counteracting the effect of WI on distended cardiac receptors, and that cardiac receptor activation alone does not constitute the afferent limb of the reflex mediating the renal effects of head-out WI. PMID- 3812190 TI - Correlates of resting and maximal exercise systolic blood pressure after repair of coarctation of the aorta: a multivariable analysis. AB - Repair of coarctation of the aorta may not prevent the subsequent development of elevated systemic blood pressure at rest or with exercise. The correlates of late postoperative resting systolic blood pressure and maximal exercise systolic blood pressure levels were investigated in a retrospective study of 42 patients who had graded exercise tests after correction of coarctation of the aorta. The independent variables studied included height, weight, body surface area, age at surgery, age at exercise testing, the time interval between surgery and exercise testing, the highest systolic blood pressure prior to surgery, gradient across the coarctation at preoperative catheterization, and the residual postoperative gradient across the coarctation. The same combination of independent variables provided the best regression model for explanation of the variance of both postoperative resting and maximal exercise systolic blood pressure. The models included height, highest preoperative systolic blood pressure, and residual gradient. None of the other variables added significant explanatory ability to either model. These findings suggest that the preoperative level of systolic blood pressure may be the best determinant of timing the corrective surgery. It may be possible to defer the operation, as long as blood pressure remains normal, until an age when repair is less likely to result in recurrent coarctation. PMID- 3812191 TI - The etiologic spectrum of constrictive pericarditis. AB - Ninety-five consecutive patients with constrictive pericarditis that was documented at the time of surgery during 1970 to 1985 were reviewed. The etiologies included idiopathic (42%), postradiotherapy (31%), post-cardiac surgery (11%), postinfective (6%), connective tissue disease-related (4%), neoplastic (3%) uremic (2%), and sarcoidosis (1%). Post-cardiac surgery etiology was seen only after 1980, but constituted 29% of cases during 1980-1985. Postradiotherapy etiology occurred with equal incidence in 1980-1985 and in 1970 1980, but the interval from radiotherapy to presentation with constrictive pericarditis was longer in the more recent period (11 vs 4.75 years). Effusive constrictive pericarditis occurred in 24% overall with similar prevalence in all of the etiologic groups except the postsurgical cases, which were caused by noneffusive fibrous constrictive pericarditis in all instances. Operative mortality was 12% overall: It was lower in the idiopathic group (8%) and higher in the postradiotherapy group (21%). Thus postradiotherapy constrictive pericarditis continues to occur despite technical changes aimed at reducing its likelihood, but recent cases have a longer latent period: and postsurgical constrictive pericarditis has emerged as an important etiology. PMID- 3812192 TI - Nonspecific electrocardiographic abnormality as a predictor of coronary heart disease: the Framingham Study. AB - The risk of developing overt coronary heart disease is examined in relation to occurrence of non-specific electrocardiographic S-T and T-wave abnormalities (NSA ECG) in the Framingham Study. In the course of follow-up, 14% of the 5127 men and women had or developed NSA-ECG without clinically apparent intervening coronary heart disease. During 30 years of surveillance, 760 men and 578 women developed a first overt clinical manifestation of coronary heart disease. NSA-ECG appears to be a hallmark of a compromised coronary circulation which predicted the occurrence of every clinical manifestation of coronary heart disease independently of known risk factors including hypertension, its chief determinant. Coronary morbidity and mortality was increased twofold in each sex. The more common T-wave abnormality alone carried a significant increased risk, although the combination of S-T and T-wave seemed most hazardous. Persons who develop NSA-ECG without other explanation warrant vigorous preventive management against coronary heart disease. PMID- 3812193 TI - The electrocardiogram in prediction of sudden death: Framingham Study experience. AB - The influence of ECG abnormalities on the incidence of sudden cardiac death is examined in the Framingham Study cohort and is compared with the effect of known cardiovascular risk factors. Although many individual ECG abnormalities are associated with SD, multiple regression analysis, including non-ECG variables, leaves fewer independently related ECG sudden death risk factors: ECG-MI and IVB in those with overt CHD, LVH and tachycardia in all men and in women without CHD, and nonspecific ST-T abnormalities only in men. VPBs appear to be without an independent influence. Inclusion of ECG variables in the predictive model for SD has little effect on identifying those at risk for sudden unexpected death, but it improves substantially the predictive value in persons with known CHD. PMID- 3812194 TI - Coronary vasospasm as a cause of stunned myocardium. PMID- 3812195 TI - Angiographically demonstrated isolated acute right ventricular infarction presenting as ST elevation in leads V1 to V3. PMID- 3812196 TI - Serum sickness-like illness and leukocytoclastic vasculitis following intracoronary arterial streptokinase. PMID- 3812197 TI - Right ventricular obstruction from cervical carcinoma: a rare, single metastatic site. PMID- 3812198 TI - Congenital absence of the noncoronary aortic cusp. PMID- 3812199 TI - Echocardiographic diagnosis of Candida mass of the right atrium in a premature infant. PMID- 3812200 TI - Hemolytic anemia and acute mitral regurgitation caused by a torn cusp of a porcine mitral prosthetic valve 7 years after its implantation. PMID- 3812201 TI - Nifedipine therapy of phenylpropanolamine-induced hypertension. PMID- 3812202 TI - Proceedings of the 11th Sigrid Juselius Symposium on Lipoprotein Metabolism in Relation to Coronary Heart Disease. June 1-5, 1986, Haikko, Finland. PMID- 3812203 TI - Nutrition and biogenesis of plasma lipoproteins in nonhuman primates. AB - In this article we examine the production of very low-density lipoprotein (VLDL) by perfused livers obtained from chow- and cholesterol-fed nonhuman primates. These data illustrate two important features of VLDL production. First, VLDL is secreted from the liver in a form very close to that of its plasma counterpart. Thus for chow-fed animals, plasma VLDL and liver perfusate VLDL have similar lipid compositions. Second, the composition of VLDL can be modified significantly by diet in each of two primate species, the Rhesus monkey and the baboon. Rhesus monkey livers uniformly secrete larger quantities of VLDL and show more dramatic dietary effects than do baboon livers. Nevertheless, perfused livers from both species reveal qualitatively similar responses to dietary peanut oil and to lard fed in combination with cholesterol. Both fat-containing diets induce the livers to secrete VLDL enriched in cholesteryl ester compared with control perfusates yet still cholesteryl ester deficient compared with the animals' plasma VLDL. Peanut oil diet reduces the hepatic output of VLDL-associated apoprotein B and triglyceride, whereas lard increases hepatic secretion of VLDL-associated lipids and apoprotein E. We conclude that the nature of dietary fat plays an important role in determining the profile and composition of lipoproteins formed and secreted by the primate liver. We have also briefly reviewed the production of high-density lipoprotein, which is probably formed in the plasma from many sources, with special emphasis on the possible role of newly secreted lipid-poor apolipoprotein A-I and A-II. PMID- 3812204 TI - Structure and biosynthesis of apolipoprotein B. AB - Apolipoprotein (apo) B100 copy deoxyribonucleic acid (cDNA) has been cloned and sequenced. The total sequence of apo B100 messenger ribonucleic acid has been revealed by the work from our group, as well as other groups. The sequence spans 13,689 nucleotides from the initiation to the stop codon. Thus the messenger has the capacity to code for 4563 amino acids corresponding to a molecular weight of approximately 510,000. Computer analyses revealed the presence of regions with amphipathic alpha-helix and of hydrophobic regions with a high probability of beta-structure. Regions of the molecule are characterized by continuous variations between hydrophillic and hydrophobic sequences, the latter coinciding with a high probability of beta-structure. It is suggested that this beta structure is involved, together with the amphipathic alpha-helix, in the binding of apo B100 to the lipid. Pulse-chase studies in Hep G2 cells showed that apo B100 is synthesized as one protein, with a translation time of 14 minutes. The protein is transferred through the cell and secreted within 30 minutes without undergoing any major change in molecular mass. The residence kinetics in the endoplasmic reticulum (ER) is characterized by an increase during the first 10 to 15 minutes of chase followed by an almost linear decrease with a decay rate of 6%/min. The transfer through the ER to the Golgi apparatus accounts for one third of the time needed for the intracellular transfer of apo B100, whereas two thirds of the time is required for the transfer through the later part of the secretory pathway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812205 TI - Kinetic characteristics and mechanisms of regulation of receptor-dependent and receptor-independent LDL transport in the liver of different animal species and humans. AB - In the normal animal and in humans, low-density lipoproteins (LDL) are removed from the plasma by both receptor-dependent and receptor-independent transport mechanisms. Most of the receptor-dependent transport activity is found in the liver, whereas the receptor-independent transport process is widely distributed in many organs. In the steady state the plasma LDL-cholesterol concentration is determined by the rate of LDL production, relative to the rate of LDL removal from the vascular space. This rate of removal in turn is determined by three transport parameters: Jm, the maximal transport rate for the receptor-dependent process in the whole animal; Km, the concentration of LDL-cholesterol in the plasma at which half Jm is achieved; and P, the proportionality constant for the receptor-independent transport process. The values of these parameters are now known for several species, including humans and provide the basis for understanding how the plasma LDL-cholesterol concentration is altered by environmental factors such as aging and diet. With aging, for example, there appears to be no change in the receptor-dependent transport process, and in those situations in which the plasma LDL-cholesterol level rises, this increase appears to be caused by overproduction of LDL. With cholesterol feeding the plasma LDL cholesterol level rises because of an increase in the LDL production rate coupled with a decrease in the maximal transport rate for the receptor-dependent process. The addition of saturated triglycerides to the diet further suppresses the Jm value, whereas unsaturated lipids enhance the maximal transport rate for LDL and lowers the plasma LDL-cholesterol level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812206 TI - In vitro studies of lipid metabolism in human liver. AB - To study the regulation of lipid metabolism in human liver, we have developed assay systems for three rate-determining microsomal enzymes of hepatic cholesterol metabolism: 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase (regulating cholesterol biosynthesis), cholesterol 7 alpha-hydroxylase (governing bile acid formation), and acyl-CoA:cholesterol acyltransferase (ACAT; rate limiting for cholesterol esterification). In addition, we have obtained an assay for low-density lipoprotein binding to its specific receptor in human liver, and we have studied a possible rate-determining enzymatic step in triglyceride biosynthesis, cytosolic phosphatidic acid phosphatase. These assays allow us to study the effects of metabolic perturbations on hepatic lipid metabolism in humans and thus to evaluate the important role of the liver in lipoprotein synthesis and degradation. PMID- 3812207 TI - Enhanced cholesterol elimination and synthesis related to low-density lipoprotein metabolism. PMID- 3812208 TI - Metabolic heterogeneity in very low-density lipoproteins. PMID- 3812209 TI - Regulation of low-density lipoprotein apolipoprotein B levels. PMID- 3812210 TI - Kinetics of LDL subfractions. AB - After injecting 125I- or 131I-labeled lipoproteins, plasma was subjected to discontinuous density gradient centrifugation, which separates low-density lipoproteins (LDL) into three subfractions. Analysis of changes in apolipoprotein B-specific activity with time showed that light LDL is normally the product of intermediate-density lipoprotein and the precursor of heavy LDL, which is subsequently converted to heavier LDL. In hyperapobetalipoproteinemia these relationships are maintained but there is overproduction of light and heavy LDL secondary to increased synthesis of very low-density lipoprotein. In familial hypercholesterolemia, light LDL is produced normally but its conversion into heavy LDL is reduced and independent synthesis of the latter is apparent. These observations suggest that the LDL receptor normally plays a role in the conversion of light into heavy LDL. They also provide an explanation for previously documented differences in LDL composition between hyperapobetalipoproteinemia, in which there is a relative increase in cholesterol depleted heavy and heavier subfractions, and familial hypercholesterolemia, in which there is a relative increase in the cholesterol-enriched light subfraction. PMID- 3812211 TI - Mechanism of action of lipoprotein lipase and hepatic triglyceride lipase. AB - Lipoprotein lipase (LPL) and hepatic triglyceride lipase (H-TGL) were isolated from human postheparin plasma, and their interfacial properties were examined with mixed monolayers of trioleoylglycerol and phosphatidylcholine. LPL showed a surface pressure optimum between 20 and 22 mN/m, whereas H-TGL activity decreased at lipid packing densities of greater than 20 mN/m. LPL activity toward monolayers containing 2 mol percent trioleoylglycerol was enhanced 2.6-fold by the addition of 5 mol percent cholesteryl oleate; cholesteryl ester had no effect on H-TGL activity. We suggest that differences in interfacial properties account for the lipoprotein specificity of these lipolytic enzymes. PMID- 3812212 TI - Metabolic consequences of genetic heterogeneity of lipoprotein composition (lipoprotein heterogeneity). AB - Lipoprotein composition varies among different genetic forms of hyperlipidemia. An increase in hepatic triglyceride (TG) synthesis in subjects with familial hypertriglyceridemia (FHTG) is associated with secretion of large, TG-enriched, very low-density lipoproteins (VLDL), which have an increased affinity for lipoprotein lipase (LPL) in vivo as compared with VLDL from subjects with familial combined hyperlipidemia (FCHL) or from normal subjects. Elevated levels of plasma low-density lipoprotein (LDL) apoprotein B in FCHL are associated with high apoprotein B production rates. The LDL in FCHL is heterogeneous, with a preponderance of an LDL subfraction, which is denser, smaller, and lipid poor as compared with LDL from normal subjects. The more buoyant LDL subfraction in FCHL seems to be catabolized more rapidly than this dense LDL subfraction. PMID- 3812213 TI - Serum lipids and fatty acids in ischemic strokes. AB - Lipid analysis of different constituents in the blood of patients with stroke revealed that an increased level of total serum cholesterol was infrequently (that of triglycerides more frequently) associated with stroke in middle-aged men, whereas the high-density lipoprotein cholesterol content was low in all but young patients with stroke. High contents of cholestanol and low contents of n-6 polyunsaturated fatty acids predict the development of stroke in middle-aged men and are found in both middle-aged men with stroke and elderly patients with multi infarct dementia. Young patients with unexpected stroke had normal serum sterol, triglyceride, and fatty acid contents but markedly reduced arachidonic acid levels in the platelets, a change that was normalized by treatment with aspirin. The results emphasize that the etiopathogenesis of ischemic brain damage may vary markedly from one age group to another. PMID- 3812215 TI - Biotechnology: an introduction. PMID- 3812214 TI - Counseling patients with sleep disorders. PMID- 3812216 TI - Self-help for the athlete. Part 2. Treating injuries. PMID- 3812217 TI - Mortality and morbidity rates of patients older and younger than 75 years with acute myocardial infarction treated with intravenous streptokinase. AB - The influence of patient age on mortality risk and on the incidence of serious hemorrhagic complications after treatment of acute myocardial infarction (AMI) with intravenous streptokinase (SK) and heparin was examined in 120 consecutive patients. No upper age limit was set for patient inclusion. The mortality rate increased abruptly in patients aged 75 years or older such that the 24 patients in that age group had a 10-fold higher in-hospital mortality rate (33% vs 3%) and 1-year mortality rate (42% vs 4%) than the 96 patients younger than 75 years. This increased mortality rate in the elderly patients was related to a 2-fold higher incidence of major hemorrhagic complications (24% vs 11%) and an increased incidence of anterior AMI, healed prior AMI, multiple-vessel coronary artery disease and extensive myocardial necrosis estimated by peak creatine kinase-MB. Hemorrhagic complications were more frequent in women than in men and in patients with diabetes mellitus or systemic hypertension; all of these conditions were more prevalent in patients aged 75 years and older than in those younger than 75 years. In contrast, the incidence of hemorrhagic complications in nondiabetic elderly men (1 of 12) was similar to the incidence of bleeding in the patients younger than 75 years. Based on our data and those from other studies reporting no reduction in mortality in elderly patients with AMI who are treated with intravenous SK, it is recommended that patients aged 75 years or older should not be routinely treated with intravenous SK.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812218 TI - Static exercise with congestive heart failure and the response to vasodilating drugs. AB - The hemodynamic response to static exercise in 28 patients with congestive heart failure (CHF) was compared with that in 8 control subjects. Static handgrip exercise at 50% of the maximal voluntary contraction was performed to fatigue. In patients with CHF, pulmonary arterial wedge pressure increased from 20 +/- 18 to 31 +/- 10 mm Hg (p less than 0.001) (mean +/- standard deviation) and systemic vascular resistance increased from 1,730 +/- 454 to 2,151 +/- 724 dynes s cm-5 (p less than 0.001). Although cardiac index did not change significantly, stroke volume index and stroke work index decreased from 24 +/- 6 to 20 +/- 6 ml/m2 (p less than 0.001) and 28 +/- 11 to 25 +/- 12 g-m/s2 (p less than 0.05), respectively. In control subjects, pulmonary arterial wedge pressure did not change significantly; cardiac index increased from 3.6 +/- 0.3 to 4.0 +/- 0.4 liters/min/m2 (p less than 0.05) and systemic vascular resistance increased slightly, from 1,011 +/- 186 to 1,106 +/- 180 dynes s cm-5 (p less than 0.05). The effects of arterial dilation with hydralazine on the response to static exercise were assessed in 10 of the patients with CHF. Compared with predrug exercise, cardiac index increased 68% (p less than 0.01), stroke volume index increased 76% (p less than 0.01) and systemic vascular resistance decreased 47% (p less than 0.01) after administration of hydralazine. Thus, static exercise can have adverse effects on cardiac performance in patients with CHF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812219 TI - Risk of infective endocarditis in mitral valve prolapse with and without precordial systolic murmurs. AB - The risk of infective endocarditis (IE) associated with a systolic murmur in patients with mitral valve prolapse (MVP) was investigated in a case-control study. The case group comprised all patients with MVP (n = 19) from a series of 136 consecutive adult admissions for IE. Three matched control subjects were chosen for each case from a series of 144 MVP patients without IE. Seventeen of the 19 cases (89%) had documented evidence of systolic murmurs existing before the IE episode; systolic murmurs were documented in 25 of the 57 control subjects (47%). The data indicate a significant increase in the risk of IE in MVP patients with a systolic murmur (p less than 0.01). The absolute probability of IE developing in a patient with MVP and a murmur was estimated to be approximately 1 in 1,400 per year; this was 35 times greater than the probability in a patient with MVP without a murmur. The results suggest that by restricting prophylaxis to MVP patients with a systolic murmur, cover would be provided for almost 90% of those with MVP in whom IE would be likely to develop. PMID- 3812220 TI - The equilibrium position of the mitral valve: an accurate model of mitral valve motion in humans. AB - A "semiopen" diastolic equilibrium position of the mitral valve that is assumed in the absence of transmitral flow has been demonstrated in instrumented dogs. It has been suggested that the papillary muscles and chordae tendineae play an integral role in returning the valve to this position after initial diastolic opening. To determine whether such a model of mitral valve motion is valid in noninstrumented humans without underlying valvular disease, M-mode and Doppler ultrasound studies were performed in 6 subjects who underwent prolonged periods of ventricular diastole and atrial inactivity. After maximal opening, the mitral valve assumed a stable open position in which mean separation of the anterior and posterior mitral leaflets was 52% of maximal separation. This position was maintained for a mean duration of 585 ms, during which time transmitral flow fell to 0 m/s. Peak mitral valve opening preceded the early transmitral flow peak by an average of 42 ms, suggesting an active closure of the mitral valve as flow continued to accelerate. It is concluded that a semiopen equilibrium position of the mitral valve is assumed during prolonged diastolic periods in the absence of transmitral flow and is an accurate model describing diastolic mitral valve motion in noninstrumented humans. The chordae tendineae and papillary muscles may actively participate in the genesis and maintenance of the equilibrium position. PMID- 3812221 TI - Cross-sectional echocardiographic study of criss-cross hearts and superoinferior ventricles. AB - From August 1982 to October 1985, 8 consecutive patients, aged 4 months to 8 years (mean 2.6), with criss-cross or superoinferior ventricles, or both, were studied. Seven patients had usual atrial arrangement and 1 had mirror-image arrangement. In 5 patients there was atrioventricular (AV) concordance with crossed AV streams, the ventricular septum was horizontal in 4 and sagittal in 1, and the ventriculoarterial connections were discordant in all. The 3 patients with AV discordance had superoinferior ventricles, but a criss-cross AV relation was not present; the ventriculoarterial connections were concordant in 2 and double-outlet right ventricle in 1. The sequential connections and spatial relations of the cardiac chambers, as well as the associated anomalies, were accurately assessed by echocardiography. The diagnosis was confirmed by angiography in all patients, by surgery in 3 and by autopsy in 2. PMID- 3812222 TI - Effects of positional changes on inferior vena caval size and dynamics and correlations with right-sided cardiac pressure. AB - Effects of supine and lateral positions on the size and shape of the inferior vena cava (IVC) were studied in 30 normal persons and in 53 patients with cardiac disease undergoing right-sided cardiac catheterization. In normal subjects, mean values for both IVC diameter and area decreased significantly (p less than 0.01) from the right lateral (22 +/- 3 mm and 3.9 +/- 0.6 cm2, respectively) to the supine position (15 +/- 5 mm; 1.8 +/- 0.9 cm2) to the left lateral position (7 +/ 3 mm; 0.8 +/- 0.4 cm2). IVC shape was round in the right lateral, oval in the supine, and slit-like in left lateral position. In the 53 patients, significant differences in IVC diameter and area were also detected in all 3 positions. However, when separated into 2 groups according to right atrial pressure, patients with normal pressure (8 mm Hg or less) had diameter and area values equivalent to those of normal subjects, whereas patients with elevated right atrial pressure (more than 8 mm Hg) had supine and left lateral IVC diameters and areas that were larger than normal, and approximately equivalent: diameters--23 +/- 3 mm (right), 18 +/- 5 mm (supine) and 17 +/- 7 mm (left); areas--4.1 +/- 0.8 cm2 (right), 3.3 +/- 1.2 cm2 (supine) and 3.1 +/- 1.3 cm2 (left). IVC diameters and areas in all 3 positions correlated with mean right atrial pressure, measured subsequently in the supine position, but the left lateral position provided the strongest correlations (r = 0.85, IVC diameter vs right atrial pressure; r = 0.89, IVC area vs right atrial pressure).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812223 TI - Limits of reproducibility of blood flow measurements by Doppler echocardiography. AB - This study evaluates the variability of a quantitative Doppler echocardiographic method for blood flow calculation at the mitral and tricuspid orifice. Four subjects underwent 2-dimensional Doppler echocardiography during normal respiration and nonrespiration. Doppler recordings were integrated to determine mean temporal velocity (MTV) for each cardiac cycle separately. MTV during inspiration and expiration were compared, as were MTVs of 20 consecutive cycles during nonrespiration. Diameters of mitral and tricuspid orifice and interception angles were measured in 10 consecutive cycles at 4 predetermined moments. All results were averaged to a mean subject situation. MTVs were significantly (p less than 0.001) higher during expiration than during inspiration (12.4 and 11.0 cm-2) for the mitral orifice and lower (9.2 and 11.0 cm-2) for the tricuspid orifice. MTV at both orifices showed a significantly smaller variability (7.7% and 9.0%) during nonrespiration than during respiration (14.5% and 13.2%). Diameters of mitral orifice and tricuspid orifice were significantly (p less than 0.001) larger during diastole than during systole whereas standard error of the mean for both was 5.0%. Interception angles measured at mitral orifice are all close to 0 degrees and show minimal variability, while at the tricuspid orifice the angle varied from 15 degrees in diastole to 25.5 degrees in systole, constituting a significant difference in cosine (0.96 to 0.90). PMID- 3812224 TI - Effect of left ventricular size on early diastolic left ventricular filling in neonates and in adults. AB - Peak early diastolic left ventricular (LV) filling rate has been used as an index of LV diastolic function. However, it is known to be affected by LV size. Peak early diastolic transmitral flow velocity measured by pulsed Doppler echocardiography has also been proposed as a noninvasive method of assessing LV diastolic function. To determine if peak early diastolic mitral flow velocity also is influenced by LV size, 20 normal neonates (age 2 days) and 21 normal adults (mean age 38 years) were studied using pulsed Doppler echocardiography to measure mitral flow velocity and M-mode echocardiography to estimate LV end diastolic volume and mitral valvular area. Peak early diastolic LV filling rate was calculated by multiplying peak early diastolic mitral flow velocity by mitral valvular area. Adults had significantly larger LV end-diastolic volumes (mean +/- standard deviation 108 +/- 25 vs 7 +/- 3 ml) and higher peak early diastolic LV filling rates (305 +/- 75 vs 29 +/- 10 ml/s) than neonates (both p less than 0.001). However, no significant difference was found in peak early diastolic mitral flow velocity between adults and neonates (61 +/- 10 vs 58 +/- 11 cm/s). These data suggest that peak early diastolic mitral flow velocity is independent of LV size. Since peak LV filling rate is equal to the product of peak mitral flow velocity and mitral valvular area, the correlation between peak early diastolic LV filling rate and LV size is probably due to differences in mitral valvular area rather than differences in peak mitral flow velocity. PMID- 3812225 TI - Risk factors for coronary artery disease in families of young men with myocardial infarction. AB - Familial clustering of coronary artery disease (CAD) and familial influences on various clinical and metabolic risk factors were investigated in 85 male survivors of acute myocardial infarction younger than 45 years. The study also involved 85 age-matched men randomly selected from the general population and the first-degree relatives of both patients and control subjects. Presence of CAD was assessed by an angina questionnaire and from rest and exercise electrocardiograms. There was an apparent aggregation of premature CAD in 38% of the case families. A familial clustering of hyperlipoproteinemia was present in 58% of the case families and 15% of the control families. Systemic hypertension and cigarette smoking also were clustered in the case families. Multivariate statistical analyses of clinical and metabolic risk indicators in patients with and without a family history of CAD and in control subjects indicated that familial aggregation of CAD is independently related to MI at a young age. Degree and extent of coronary atheromatosis and number and severity of hemodynamically significant stenoses did not differ between young patients with and without a familial aggregation of CAD. The absence of a relation between the family history and severity of CAD implies that other underlying mechanisms are involved. PMID- 3812226 TI - Left ventricular derived cardiac output. AB - Measurement of cardiac output (CO) requires right-sided cardiac catheterization. However, to save time and reduce costs, only left-sided cardiac catheterization is usually performed in most patients with suspected coronary artery disease. Thus, CO is not measured. To determine if CO can be measured from the left side of the heart, 24 patients undergoing cardiac catheterization had near simultaneous determination of CO after indocyanine green dye was injected into the pulmonary artery and left ventricular (LV) cavity. There was close agreement between pulmonary artery and LV derived cardiac outputs (Pulmonary artery = 0.93 LV + 0.12). The pulmonary artery derived CO was 5.7 +/- 2.0 liters/min and the LV derived CO was 6.1 +/- 2.2 liter/min. Also, there was a close relation between pulmonary artery derived stroke volume (82 +/- 33 ml) and LV derived stroke volume (86 +/- 36 ml). Thus, CO can be accurately measured after injection of indocyanine green dye into the LV cavity. PMID- 3812227 TI - Safety of intravenous dipyridamole for stress testing with thallium imaging. AB - Cardiac and noncardiac side effects were studied in 293 consecutive patients referred for nonexercise stress thallium imaging with intravenous dipyridamole. Six minutes after the initiation of infusion, there was a mean 9-beat/min increase in heart rate and a mean 12-mm Hg decrease in systolic blood pressure. The largest increase in heart rate exceeded 20 beats/min in only 13% of patients and the largest decrease in systolic blood pressure exceeded 20 mm Hg in 31%. Noncardiac side effects were headache (11%), lightheadedness or dizziness (5%) and nausea (4%). Only 9 patients required intravenous aminophylline for relief of noncardiac side effects: severe headache in 7 and nausea in 2. Cardiac side effects included chest pain in 76 patients (26%), of whom 70% were given aminophylline for relief of symptoms. Sixty patients (20%) had ischemic ST segment depression and 56 (19%) had arrhythmias (ventricular in 50 and atrial in 6). There were no deaths, myocardial infarctions or sustained arrhythmias due to dipyridamole administration. Among 62 patients also undergoing cardiac catheterization, side effects except for arrhythmias were unrelated to the number of vessels with coronary artery disease. Intravenous dipyridamole is safe for nonexercise stress testing and has few serious side effects. However, the possibility of ischemia requires careful selection of patients and monitoring of vital signs and the electrocardiogram during the test. PMID- 3812228 TI - Acute myocardial infarction shortly after cocaine inhalation. PMID- 3812229 TI - A modified ajmaline test for prediction of the effective refractory period of the accessory pathway in the Wolff-Parkinson-White syndrome. PMID- 3812230 TI - Amiodarone and digoxin for refractory fetal tachycardia. PMID- 3812231 TI - Effect of erythromycin on ventricular arrhythmias and ventricular repolarization in idiopathic long QT syndrome. PMID- 3812232 TI - Dynamic intracoronary echoes in Kawasaki's disease. PMID- 3812233 TI - Atrioventricular pacemaker placement in Romano-Ward syndrome and recurrent torsades de pointes. PMID- 3812234 TI - Blood hematocrit changes during paroxysmal atrial fibrillation. PMID- 3812235 TI - A low-noise P-wave discriminating electrocardiogram in the diagnosis of complex cardiac arrhythmias. PMID- 3812236 TI - Use of the cryoprobe to facilitate intraoperative electrophysiologic mapping by inhibiting sinus node function in automatic atrial tachycardia. PMID- 3812237 TI - Clinical and echocardiographic correlates of systemic embolization in nonrheumatic atrial fibrillation. PMID- 3812238 TI - Mechanism of percutaneous mitral valvotomy. PMID- 3812239 TI - Extensive calcification of a bioprosthesis in the tricuspid valve position and minimal calcification of a simultaneously implanted bioprosthesis in the mitral valve position. PMID- 3812240 TI - Correlation of murmurs of mitral stenosis and mitral regurgitation with presence or absence of mitral anular calcium in persons older than 62 years in a long-term health care facility. PMID- 3812241 TI - Mitral valve myxoma diagnosed by two-dimensional echocardiography. PMID- 3812242 TI - Prevalence of hypertrophic cardiomyopathy in a population of adult Japanese workers as detected by echocardiographic screening. PMID- 3812243 TI - Cyclic nucleotide analysis of myocardial biopsies in hypertrophic cardiomyopathy. PMID- 3812244 TI - Isolated, non-narrowed, single coronary artery with angina pectoris. PMID- 3812245 TI - Inspiratory augmentation of the intensity of the diastolic murmur in right coronary-left ventricular fistula. PMID- 3812246 TI - Mitral valve prolapse, cardiac hemodynamics and coronary circulation patterns in men with angina pectoris and angiographically normal coronary arteries. PMID- 3812247 TI - Aneurysm of the pulmonary trunk unassociated with intracardiac or great vessel left-to-right shunting. PMID- 3812248 TI - Right-sided cardiac thrombi and pulmonary embolism. PMID- 3812249 TI - Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction. AB - Current coronary care electrocardiographic (ECG) monitoring techniques are aimed at detection of cardiac arrhythmias rather than myocardial ischemia. However, in patients with acute myocardial infarction (AMI) who undergo reperfusion therapy, monitoring ST-segment deviation could provide an early noninvasive indicator of coronary artery reocclusion. In this study, the admission 12-lead ECGs of patients with initial AMI were used to propose optimal lead locations for ST segment monitoring. The study population was selected from consecutive Duke University Medical Center admissions during 1965 to 1981 who met the following inclusion criteria: chest pain for no more than 8 hours, initial AMI documented by ECG and 3 of 4 enzyme criteria, greater than or equal to 0.1 mV (1 mV = 10 mm) of ST elevation in at least 1 of the standard 12 leads (not aVR) on admission ECG, and no ECG evidence of conduction disturbances, ventricular hypertrophy or tachycardia. ST-segment deviation was quantified; AMI location was assigned based on the lead with maximal deviation. Of the 80 patients who had an inferior AMI, lead III was both the most frequent location for ST elevation (94%) and the most common site with maximal ST deviation. Lead V2 had the highest incidence of ST segment depression (60%). In the 68 patients who had an anterior AMI, lead V2 had the highest frequency of ST elevation (99%). Leads V2 and V3 were the most common sites of maximal elevation. Thus, for monitoring ST deviation, leads III and V2 may be superior to leads II and V1, which are commonly used in arrhythmia monitoring.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812250 TI - Assessment of left ventricular wall thickness in healed myocardial infarction by magnetic resonance imaging. AB - The ability of magnetic resonance imaging (MRI) to detect and localize healed myocardial infarction (MI) was assessed. Seventeen consecutive patients with healed MI assessed by biplane contrast ventriculography underwent MRI using oblique imaging planes. Seven normal subjects underwent MRI as controls. In each patient, ventriculography identified regional wall motion abnormalities. MRI, performed with a 0.15-Tesla resistive magnet and oblique imaging planes relating to the left ventricle, detected zones of regional wall thinning conforming to the wall motion abnormalities localized by ventriculography in 16 patients. In these patients, adjacent areas of intact myocardium were identified in areas shown by ventriculography to be normal. The left ventricular wall thickness at the site of MI was significantly less than adjacent noninfarcted myocardium (p less than 0.001) and normal hearts (p less than 10(-6)). The ratio of the thickness of the infarct to adjacent normal wall averaged 0.40 (range 0.22 to 0.62). MRI could differentiate healed MI from adjacent noninfarcted myocardium and normal hearts. PMID- 3812251 TI - Silent myocardial ischemia during daily activities in asymptomatic men with positive exercise test responses. AB - The usefulness of prolonged ambulatory electrocardiographic monitoring (AEM) for detecting ischemia was investigated in 17 asymptomatic men who had ischemic-type ST-segment depression (greater than or equal to 2.0 mm) during treadmill exercise testing. No patient took anti-ischemic medications and all patients underwent coronary angiography. A total of 1,154 hours (range 64 to 72 hours/patient) of high-quality AEM recordings was obtained. Silent ischemia (episodes of asymptomatic ischemic-type ST depression of 60 seconds or longer) occurred in 11 patients during daily activity detected by AEM. In 6 other patients, no myocardial ischemic episodes were found. But 1 of these patients withdrew after only 24 hours of AEM and the remaining 5 had no significant coronary artery disease (CAD). All 11 patients who had silent ischemia had significant CAD (at least 50% stenosis) on angiography. There was wide intrapatient variability in the frequency of silent ischemic episodes. Silent ischemia was identified in 6 of these 11 patients after 24 hours of AEM, in 2 after 48 hours and in 3 after 72 hours. Thus, asymptomatic men with positive exercise test responses and CAD have silent ischemic episodes during daily activity. AEM may be useful in helping to predict which patients with asymptomatic positive exercise test responses have CAD; however, extended AEM periods are required. PMID- 3812252 TI - Exercise thallium scans: patterns of use and impact on management of patients with known or suspected coronary artery disease. AB - Physicians' ordering patterns and subjective assessments of the management impact of 345 exercise thallium studies at a tertiary care hospital were evaluated. Exercise thallium tests were ordered to obtain functional information (60%), to detect myocardial ischemia (29%), for routine follow-up (6%) and for screening for coronary artery disease (CAD) (5%). Exercise thallium testing was ordered instead of exercise electrocardiography alone because of an interest in assessing the size of an ischemic or infarcted area (37%), a belief that the exercise electrocardiogram was likely to be nondiagnostic (35%) or that exercise thallium was a better test (23%). In 20% of cases physicians said that thallium imaging results were helpful or pivotal in major management decisions, such as those regarding catheterization or surgery. In most cases, no further tests were ordered and antianginal therapy or activity prescription was changed after exercise thallium testing. Exercise thallium images also helped to stratify patients into low and high probability of CAD categories better than exercise electrocardiographic results alone did. Our data suggest that physicians are using exercise thallium testing to obtain functional information more often than simply to detect CAD and that physicians consider the test to be of considerable value. PMID- 3812253 TI - Usefulness of Q-wave response to exercise as a predictor of coronary artery disease. AB - In lead CM5, the Q-wave response to exercise has been reported as an effective index in predicting coronary artery disease (CAD) and CAD with left anterior descending (LAD) disease. The purpose of this study was to verify these findings when the Q wave was analyzed in lead CC5 in 135 patients. The sensitivity for abnormal ST depression was 77%, specificity 83% and predictive value 78%. The corresponding values for the abnormal Q-wave response (reduction or no change in Q-wave amplitude) were 70%, 61% and 59%. These differences (except sensitivity) were significant. When either a positive ST or Q-wave response was used, sensitivity, specificity and predictive value did not significantly increase compared with the ST segment alone. In addition, only 45% of normal subjects with false-positive ST depression had a normal Q-wave response (increase) and 57% of patients with false-negative ST responses had an abnormal Q-wave response. When a positive response for CAD with an LAD lesion and for multivessel CAD with LAD narrowing was defined as having a Q-wave reduction, the sensitivities were extremely low (15% and 17%), but both the specificities and the predictive values were 100%. Therefore, the Q-wave analysis in lead CC5 is no more sensitive for detecting CAD than the ST-segment response. However, when a decreased Q-wave amplitude is observed, multivessel CAD and LAD narrowing can be predicted. PMID- 3812254 TI - Frequency of painless myocardial ischemia during exercise tolerance testing in patients with and without diabetes mellitus. AB - To evaluate the frequency of painless myocardial ischemia, all patients with positive exercise tolerance test responses (at least 2 mm of ST depression) from 1983 to 1985 were examined. Of the 211 patients with exercise-induced ischemia, 101 (48%) did not have pain during the ischemic period; 26 (12%) had diabetes mellitus, 24 of whom (92%) had type II diabetes mellitus. Lack of pain was not correlated with age, gender, history of cigarette smoking, systemic hypertension, past acute myocardial infarction, coronary artery bypass grafting, use of beta blocking or calcium-channel blocking drugs, number of narrowed coronary arteries or average calculated ejection fraction at cardiac catheterization. Patients with painless myocardial ischemia were less often taking nitrates (39% vs 55%, p less than 0.05) and reported prior episodes of chest pain less often (50% vs 82%, p less than 0.01) than control subjects. There was no difference in the frequency of painless myocardial ischemia between patients with and without diabetes mellitus (54% vs 47%). Duration of exercise was shorter in patients with diabetes mellitus and in patients who had pain with myocardial ischemia. No significant difference in age, gender, use of nitrates, beta-blocking or calcium-channel blocking drugs, history of myocardial infarction, angina pectoris or cigarette smoking was found between diabetic and nondiabetic patients. Systemic hypertension was more common in diabetic patients. Thus, painless myocardial ischemia is common in our patients with positive exercise tolerance test responses, but its frequency is similar in diabetic and nondiabetic patients. PMID- 3812255 TI - Different degrees of ischemic threshold stratified by the dipyridamole echocardiography test. AB - Dipyridamole-echocardiography (echo) testing, exercise stress testing and coronary arteriography were performed in 141 patients with effort chest pain. Patients were separated into 5 groups according to the dose of dipyridamole needed to induce ischemia (0.56 mg/kg over 4 minutes vs 0.84 mg/kg over 10 minutes) and to the time of onset of the asynergy with the small dose (within vs beyond 3 minutes after the end of dipyridamole administration): group 1--early positive response to a small dose (33 patients); group 2--late positive response to a small dose (29 patients); group 3--negative response to a small dose, positive response to a large dose (17 patients); group 4a--negative response to both large and small doses, with significant coronary artery disease (CAD) (32 patients); and group 4b--negative response to small and large doses, without CAD (30 patients). All patients in groups 1, 2 and 3 had significant CAD. The rate pressure product on exercise stress testing was measured at 0.10 mV of ST-segment shift in patients with a positive response and at peak exercise in patients with a negative response. Rate-pressure product significantly separated group 1 and group 2 from each other (157 +/- 46 and 229 +/- 33 mm Hg X beats/min X 1/100, respectively, mean +/- standard deviation) and from group 3, group 4a and group 4b (284 +/- 40, 290 +/- 51, and 298 +/- 45 mm Hg X beats/min X 1/100); values in the 3 latter groups overlapped.2+ Thus, the dipyridamole-echo test can stratify groups of patients with different levels of ischemia threshold on effort. PMID- 3812256 TI - Intraoperative mapping-guided argon laser ablation of malignant ventricular tachycardia. AB - Intraoperative mapping-guided laser ablation of arrhythmogenic myocardium was performed in 5 patients with refractory sustained ventricular tachycardia (VT). Using a 15-W argon laser coupled to a 300-mu optical fiber, a bloodless laser ventriculotomy was successfully performed in 4 patients with VT. Visually- and mapping-guided endocardial ablation of 7 VT morphologic patterns was performed. Five of the 7 sites of VT origin were unresectable using standard resection techniques. Postoperatively, spontaneous and inducible VT was suppressed in all patients (without antiarrhythmic drugs in 4 patients and with a previously ineffective drug 1 patient). Mean pulmonary capillary wedge pressure, cardiac index and left ventricular ejection fraction were unchanged (p greater than 0.2) from preoperative values. Mean maximal creatinine kinase-MB isoenzyme concentration was 139 +/- 75 IU. All patients were New York Heart Association functional class II at discharge. During follow-up, no spontaneous arrhythmia has recurred in any patient. Thus, intraoperative argon laser ablation is effective for VT ablation alone or in conjunction with standard surgical resection techniques. PMID- 3812258 TI - Chronotropic effect of hydralazine and its mechanism of symptomatic sinus bradycardia. AB - The positive chronotropic effect of hydralazine was studied in 9 patients with symptomatic sinus bradycardia. Hydralazine was given in an intravenous dose of 0.15 mg/kg and heart rate, blood pressure, sinoatrial conduction time (Narula method) and corrected sinus node recovery time were measured. The effect of hydralazine was also studied after total autonomic nervous system blockade using 0.04 mg/kg of atropine and 0.2 mg/kg of propranolol intravenously. In the control state hydralazine produced an increase of 28 +/- 15% (mean +/- standard deviation) in heart rate, and this was essentially due to a decrease in sinoatrial conduction time (by 32 +/- 32%, p less than 0.05). Corrected sinus node recovery time also tended to shorten (decrease of 21 +/- 34%, difference not significant). After total autonomic blockade intrinsic heart rate did not change or increased very little (9 +/- 14%) after administration of hydralazine and there was no consistent change in sinoatrial conduction and corrected sinus node recovery times. The small residual effect of hydralazine on heart rate was related to incomplete autonomic blockade, since the effect of postural change (standing) on heart rate was also not totally abolished. The study showed that the positive chronotropic effect of hydralazine was mainly due to a change in sinoatrial conduction with a smaller change in corrected sinus node recovery time, and the major chronotropic effect of the drug was mediated by the autonomic nervous system. PMID- 3812257 TI - Frequency of hypokalemia after successfully resuscitated out-of-hospital cardiac arrest compared with that in transmural acute myocardial infarction. AB - To evaluate the prevalence of hypokalemia in out-of-hospital cardiac arrest, the initial serum potassium and arterial pH values were reviewed from 138 consecutive patients resuscitated from cardiac arrest. For comparison, the same variables were reviewed for 62 consecutive patients who had transmural acute myocardial infarction (AMI) without cardiac arrest. The mean serum potassium level was lower after resuscitation from cardiac arrest (3.6 +/- 0.6 mEq/liter) than during AMI (3.9 +/- 0.5 mEq/liter) (p less than 0.005). The incidence of hypokalemia (potassium less than 3.5 mEq/liter) was greater in patients sustaining cardiac arrest (41%) than in patients who had AMI without cardiac arrest (11%) (p less than 0.001). Hypokalemia was common after cardiac arrest regardless of the occurrence of AMI at the time of arrest. Hypokalemia after cardiac arrest was independent of arterial pH, epinephrine or bicarbonate therapy during resuscitation, or prior therapy with diuretic drugs, digoxin or propranolol. In 10 patients with marked hypokalemia, the serum potassium level returned to normal rapidly (16 hours) during the hospitalization even though only 29% of the predicted potassium requirement was infused before its normalization. Thus, hypokalemia is prevalent immediately after out-of-hospital cardiac arrest, whereas it is uncommon in AMI in the absence of cardiac arrest. The cause and electrophysiologic consequences of this hypokalemia are unknown; in most cases, it is apparently caused by a shift of potassium from the intravascular compartment rather than a total body depletion of potassium. PMID- 3812259 TI - Application of a frequency definition of ventricular proarrhythmia. AB - To differentiate spontaneous variability from proarrhythmia in patients with benign or potentially lethal ventricular arrhythmias, 495 patients with 2 or more Holter tracings during placebo therapy were evaluated. The Holter session with the highest frequency of ventricular premature complexes (VPCs) and ventricular tachycardia was compared with the first placebo recording. Patients were segregated by their baseline frequency of VPCs. The percent of patients taking placebo in this trial who had the same increase in VPC frequency as has been ascribed to those with proarrhythmia varied from 0 of 470 patients with a baseline frequency of ventricular arrhythmia of 10 to 50 VPCs/hour, 3 of 44 (7%) with 51 to 100 VPCs/hour, 1 of 139 (0.7%) with 101 to 300 VPCs/hour and 1 of 265 (0.04%) with more than 300 VPCs/hour. Overall, 5 of 496 (1%) patients would have been classified as having proarrhythmia using the algorithm although only placebo was given. A 10-fold or greater increase in ventricular tachycardia beats in patients taking placebo occurred in 9 of 274 patients (3%). Thus, a simple algorithm to define proarrhythmia in patients with mixed cardiac disease and chronic ventricular arrhythmias can be defined and differentiated from spontaneous variability. This arbitrary algorithm defines proarrhythmia as an increase of more than 3 times when baseline VPC frequency is more than 100 VPCs/hour and more than 10 times when that frequency is less than 100 VPCs/hour with a false-positive rate of only 1%. PMID- 3812260 TI - Role of calcium ion in maintenance of vascular smooth muscle tone. AB - Recent evidence indicates that vascular smooth muscle tone can be increased either by increasing cytoplasmic calcium ion (Ca++) levels or by increasing the sensitivity of the contractile apparatus to calcium. Data obtained with both luminescent and fluorescent calcium indicators indicate that the amount of force produced at a specific Ca++ is variable in intact vascular smooth muscle. Data obtained with the luminescent calcium indicator aequorin indicate that the calcium force curve is very steep in intact vascular smooth muscle cells; i.e., small changes in Ca++ can cause large changes in vascular tone. Therapeutic agents designed to directly decrease intrinsic myogenic tone could be designed to either decrease Ca++ or to decrease the sensitivity of the contractile apparatus to calcium. Considerable selectivity might be obtained by the latter approach. PMID- 3812262 TI - The expert committee of the World Health Organization on classification of calcium antagonists: the viewpoint of the raporteur. PMID- 3812261 TI - Calcium influx and vascular reactivity in systemic hypertension. AB - Numerous studies have focused on functional vascular changes that characterize the hypertensive state. Recent evidence that suggests that increased vascular reactivity in hypertension is due to changes in the delivery of activator Ca++ through channels in the cell membrane will be reviewed. The primary evidence supporting this hypothesis comes from studies that characterize the effects of Ca++-free solution and calcium channel blockers on contractile properties of isolated vascular smooth muscle. In the present study, experiments were performed to investigate the role of Ca++ influx in vascular contractions produced by interventions that cause membrane depolarization. Isometric tension development in helical strips of carotid arteries from stroke-prone spontaneously hypertensive rats in response to elevated K+ and tetraethylammonium chloride was greater than that in carotid arteries from Wistar-Kyoto normotensive rats. The rate of tension development to K+-free solution in carotid arteries from stroke prone spontaneously hypertensive rats was faster than in Wistar-Kyoto normotensive rat arteries. Contractile responses to all 3 depolarizing interventions were reduced in arterial strips incubated in Ca++-free solution containing the chelator ethylene glycol bis-(beta-aminoethyl ether) N,N,N',N' tetraacetic acid and in arterial strips treated with the Ca++ channel blocker verapamil. These results are consistent with the hypothesis that constrictor stimuli that produce membrane depolarization cause an opening of Ca++ channels in the plasma membrane that are sensitive to the organic channel blockers. Further, a change in Ca++ permeability or membrane depolarizing mechanisms contributes to increased contractile responsiveness in carotid arteries of stroke-prone spontaneously hypertensive rats. PMID- 3812263 TI - The myocardial intracellular renin-angiotensin system. AB - In recent years several tissues have been found to contain the components of the renin-angiotensin system. Locally synthesized renin could conceivably function in an endocrine, paracrine or autocrine manner. Isolated left ventricular cardiac myocytes of the rat were examined in the present study and renin and angiotensin II were detected in these cells. This observation suggests the existence of a functioning renin-angiotensin system in the heart and, more particularly, in the left ventricular cardiac myocyte. Additional evidence, derived from micrococcal nuclease and deoxyribonuclease I treatment of angiotensin II-exposed chromatin, suggests that angiotensin II could subserve an intracellular function in some of its cells of synthesis. PMID- 3812264 TI - Inhibition by diltiazem of pressure-induced afferent vasoconstriction in the isolated perfused rat kidney. AB - The renal hemodynamic response to calcium entry blockade depends on the neural, hormonal and physiologic determinants influencing basal renal vascular tone. The effects of perfusion pressure per se on the renal vascular response of the rat kidney to diltiazem were evaluated using normal kidneys and hydronephrotic kidneys perfused extracorporally. In isolated perfused normal kidneys, diltiazem did not alter perfusate flow or glomerular filtration rate (GFR) when administered at a perfusion pressure of 100 mm Hg. In contrast, when diltiazem was administered at a perfusion pressure of 150 mm Hg, the calcium antagonists caused a striking increase in GFR, which was accompanied by an increase in renal perfusate flow. In the isolated perfused hydronephrotic rat kidney, elevation of perfusion pressure was associated with an increase in renal vascular resistance and a reduction in afferent arteriolar diameter. Diltiazem abolished the pressure induced constriction of afferent arterioles and caused an increase in renal perfusate flow in hydronephrotic kidneys perfused at pressures above 100 mm Hg. These findings suggest that in the setting of increased renal perfusion pressure, diltiazem's effects on GFR are mediated in part by an inhibition of pressure induced constriction of the afferent arteriole. PMID- 3812265 TI - A symposium: Calcium antagonists--emerging clinical opportunities. September 11 12, 1986, Boston, Massachusetts. PMID- 3812266 TI - Calcium antagonist agents in hypertrophic cardiomyopathy. AB - Calcium antagonists have emerged as important adjuncts to pharmacotherapy of hypertrophic cardiomyopathy. Calcium antagonists cause significant symptomatic improvement in both obstructive and nonobstructive forms and even in patients refractory to beta-blocker therapy. Exercise hemodynamics and exercise tolerance improve in the majority of patients during long-term therapy with calcium antagonists. Reduction in left ventricular (LV) outflow pressure gradient is not consistent after short- or long-term therapy. The provokable gradient tends to remain unchanged. The changes in LV outflow gradient do not appear to be contributory to symptomatic improvement. LV ejection fraction, mean normalized systolic ejection rate and end-systolic pressure volume ratio remain unchanged, suggesting that calcium antagonists agents do not alter LV systolic function. LV diastolic function and its relaxation properties, however, improve in many patients, which might be contributory to symptomatic improvement and improved exercise tolerance. PMID- 3812267 TI - Experience with calcium antagonist drugs in congestive heart failure. AB - Several clinical studies have demonstrated beneficial hemodynamic effects of calcium antagonist drugs when used as arterial vasodilators in the treatment of certain patients with moderate to severe congestive heart failure. These drugs usually decrease systemic vascular resistance and improve ejection phase indexes of left ventricular function in such patients. However, calcium antagonists have intrinsic negative inotropic effects and other vasodilators such as nitroprusside, hydralazine and captopril appear to be more beneficial when used in the treatment of severe congestive heart failure. PMID- 3812268 TI - Metabolic and hemodynamic effects of nicardipine during pacing-induced angina pectoris. AB - During repeat exercise testing in 10 patients with stable angina, individual optimal doses of nicardipine were determined. Hemodynamic values and cardiac metabolism were studied during 2 pacing periods carried out before and after this dose (mean 5.3 mg). Postpacing ST-segment depression diminished (1 mm) after nicardipine administration (p less than 0.05), whereas pacing time to onset of angina did not change. Nicardipine administration increased heart rate 16% (p less than 0.005) and reduced systolic (10%) and diastolic (8%) blood pressures (both p less than 0.005). Coronary blood flow increased 16% (p less than 0.05) and coronary vascular resistance decreased 24% (p less than 0.01). Myocardial oxygen consumption was unchanged despite an 11% decrease in rate-pressure product during pacing (p less than 0.02). In the control state before nicardipine administration, metabolic signs of ischemia included release of lactate across the heart in 7 patients, decreased mean free fatty acid and glutamate uptake and alanine release during pacing, together with increased glucose uptake and citrate release during recovery. After nicardipine lactate release decreased in 5 of the 7 patients, pacing no longer changed free fatty acid, glutamate and alanine uptake/release from the level at rest. During recovery glucose uptake was reduced and citrate release was unaffected. The hemodynamic data indicate that nicardipine is a systemic and coronary vasodilator, increasing oxygen supply to the ischemic myocardium. The metabolic results indicate a change in substrate utilization toward that of normal heart, suggesting improved aerobic energy supply. PMID- 3812269 TI - Limitations of dipyridamole-echocardiography in effort angina pectoris. AB - The sensitivity of dipyridamole--2-dimensional (2-D) echocardiography was assessed for detection and localization of ischemia in 21 patients with severe chronic stable angina pectoris, a clearly positive exercise stress test response and multivessel coronary atherosclerosis. Regional wall motion during dipyridamole infusion (0.6 mg/kg intravenously over 4 minutes) was compared with control and recovery by 2 blinded observers in consensus. Transient regional wall motion abnormalities were observed in 11 patients. Angina and ST-segment changes occurred in 9 of these 11 patients with positive responses, but in none of those who showed no transient abnormality of regional wall motion. Localization of regional wall motion abnormalities correlated well with angiographic severity of coronary lesions. Endocardial area contraction, evaluated by a computerized system, was reduced significantly after dipyridamole administration in patients with a positive response (from 51 +/- 10% to 35 +/- 11%, p less than 0.001), whereas it did not change significantly in the others (from 43 +/- 6% to 42 +/- 8%). In the 11 patients with a positive response, coronary reserve assessed by exercise testing (modified Bruce protocol) was more impaired than in those with a negative response (time to 1 mm of ST depression 177 +/- 148 seconds and 472 +/- 179 seconds, respectively, p less than 0.01). In patients with severe angina and multivessel coronary artery disease, dipyridamole--2-D echocardiography appears to identify the vessel in which flow reserve is most limited. Although this information may be valuable, indications for the test are restricted to patients with severely limited exercise capacity. PMID- 3812270 TI - Effects of prolonged intensive versus moderate leg training on the untrained arm exercise response in angina pectoris. AB - To compare the effects of 2 different leg training intensities on the cardiocirculatory exercise response of the untrained arm, 58 patients with angina pectoris were randomized to either an intensive (at least 85% of symptom-limited exercise, n = 28) or a moderate (70 to 85% of symptom-limited exercise, n = 30) training group. Patients trained for 6 months, 2 times per week for 30 minutes each. Results of the 2 groups after training showed similar significant (p less than or equal to 0.001) decreases in heart rate (HR), systolic blood pressure (BP) and HR X BP product for trained legs and untrained arms at matched subanginal workloads and significant (p less than 0.01 to 0.001) increase in anginal threshold HR and HR X BP for the onset of 1 mm or more ST horizontal depression during testing of trained legs as well as of untrained arms. The improvement in exercise capacity at subanginal workloads results from decreased HR X BP product. In contrast, the significant increase in HR X BP product for the onset of ST-segment displacement and precipitation of anginal pain for both the trained and untrained limbs may imply an increase in myocardial blood flow. Thus, prolonged intensive or moderate training may significantly improve coronary blood flow in selected patients with angina pectoris. Patients with the highest anginal threshold HR and HR X BP product before training showed the most improvement at 6 months after training. PMID- 3812271 TI - Spontaneous remission of variant angina documented by Holter monitoring and ergonovine testing in patients treated with calcium antagonists. AB - Twenty-four patients with Prinzmetal's variant angina showing a favorable initial response to calcium antagonist treatment were studied to assess the evolution of the disease and the frequency and time course of spontaneous remission. At 3, 6 and 12 months from the acute phase, patients underwent in-hospital control studies, with 48-hour Holter monitoring and ergonovine testing carried out during treatment and after its interruption. During calcium antagonist therapy complete protection from spontaneous attacks was documented in 22 of 24 patients at 3 months, in 19 of 21 at 6 months and in all 21 at 12 months; ergonovine test results were negative in 16 of 23 patients at 3 months, in 16 of 20 at 6 months and in all 20 studied at 12 months. After stopping treatment spontaneous attacks did not reappear in 7 of 24 patients (29%), 14 of 21 (66%) and 16 of 21 (76%) at 3, 6 and 12 months respectively, while the ergonovine test response remained negative in 6 of 21 (28%), 7 of 18 (39%) and 13 of 20 (65%) of the patients controlled at 3, 6 and 12 months. Thus, complete remission of angina documented by both Holter recording and ergonovine testing occurred in 5 of 24 patients (21%) at 3 months, in 7 of 21 (33%) at 6 months and in 12 of 21 (57%) at 12 months. Patients with remission of angina had a shorter duration of symptoms and more often showed normal or not critically diseased coronary arteries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812272 TI - Role of heparin after intravenous thrombolytic therapy for acute myocardial infarction. AB - The optimal approach to management of patients after thrombolytic therapy for acute myocardial infarction (AMI) is unclear. The role of anticoagulation with heparin was evaluated in 75 consecutive patients who received intravenous streptokinase for AMI. Heparin therapy was titrated to keep the partial thromboplastin time (PTT) between 90 and 120 seconds. Seventeen episodes of definite myocardial ischemia (associated with reversible electrocardiographic changes) were observed in 13 patients. When episodes of probable myocardial ischemia are included (typical chest pain relieved by nitroglycerin or associated with more than a 15-mm Hg change in blood pressure but without electrocardiographic changes), 52 episodes occurred in 28 patients. Four episodes of definite and 4 of probable myocardial ischemia occurred within 24 hours of discontinuation of heparin. Analysis of the level of anticoagulation as assessed by PTT at the time of the ischemic events shows that ischemia occurred more often at lower PTTs. Nine hemorrhagic complications occurred, all within 24 hours of streptokinase infusion. In 4 patients bleeding was believed to be major and heparin administration was discontinued; 2 patients with gastrointestinal bleeding required blood transfusions. Our data suggest that after thrombolytic therapy for AMI, the level of anticoagulation is inversely related to the frequency of recurrent ischemic events; that discontinuation of heparin is frequently associated with ischemia; and that administration of heparin is associated with a low incidence of hemorrhagic complications. PMID- 3812273 TI - Significance of elevated MB isoenzyme with normal creatine kinase in acute myocardial infarction. AB - The significance of elevated levels of the MB isomer of creatine kinase (CK-MB) when creatine kinase (CK) level is normal was studied in 400 patients with suspected acute myocardial infarction (AMI). In 350 patients both CK and CK-MB were elevated (group 1), in 21 only CK-MB was elevated (group 2), in 24 neither enzyme was elevated (group 3) and in 5 only CK was elevated (group 4). In 57% of patients in group 2 the CK level was doubled, with a characteristic enzyme curve, within the normal range, suggesting that an increase in CK had been missed because arbitrary definitions of "normal" were used. The median CK increase (60 IU/liter) in group 2 was greater than that in group 3 (23 IU/liter) (p less than 0.001). Patients in group 1 with small AMIs had a relative increase in CK similar to that in group 2. However, patients in group 2 had a lower baseline CK level so that peak CK did not become abnormally high despite a 5-fold increase in some patients. In patients in group 1 with small AMIs, CK was elevated in fewer samples than CK-MB. If only 2 samples were obtained in all patients, elevation of CK levels would have been missed in 63 group 1 patients, erroneously increasing the number of patients in group 2 fourfold (to 84 of 400, or 21%, instead of 21 of 400, or only 5%). Conversely, if patients in group 2 with a doubling of CK are excluded, the prevalence of elevated CK-MB with normal CK would be only 9 of 400 (2%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812274 TI - Outcome after cardiac arrest during acute myocardial infarction. AB - A community-wide study of acute myocardial infarction (AMI) was conducted in all 16 acute-care general hospitals in the Worcester, Massachusetts, metropolitan area during the years 1975, 1978, 1981 and 1984. The in-hospital and long-term prognoses of 667 patients with AMI complicated by cardiac arrest (CA) was compared with that of 2,596 AMI patients without CA. The incidence of CA complicating AMI was similar (21%) during each of the 4 study years. Among patients with AMI who had CA, 36% had CA within the first day of hospitalization and 48% within the first 2 days. The in-hospital case-fatality rate was much higher for AMI patients with CA (78%) than for those without CA (4%) (p less than 0.001). For patients discharged alive from the hospital, a trend toward a higher mortality rate was seen at 1 and 2 years after hospital discharge for patients with CA; however, long-term survival rates were not significantly different between AMI patients with and without CA. When time of occurrence of CA relative to in-hospital survival was examined, patients with early CA (within 1 day or within 2 days of hospital admission) had a significantly greater in-hospital survival (39% and 34%) than did those with late CA (after 1 day or after 2 days) (13% and 12%). Similarly, patients discharged from the hospital after early CA had a significantly better chance of long-term survival than patients discharged after late CA. PMID- 3812275 TI - Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. AB - A high degree of heart rate (HR) variability is found in compensated hearts with good function, whereas HR variability can be decreased with severe coronary artery disease, congestive heart failure, aging and diabetic neuropathy. To test the hypothesis that HR variability is a predictor of long-term survival after acute myocardial infarction (AMI), the Holter tapes of 808 patients who survived AMI were analyzed. Heart rate variability was defined as the standard deviation of all normal RR intervals in a 24-hour continuous electrocardiogram recording made 11 +/- 3 days after AMI. In all patients demographic, clinical and laboratory variables were measured at baseline. Mean follow-up time was 31 months. Of all Holter variables measured, HR variability had the strongest univariate correlation with mortality. The relative risk of mortality was 5.3 times higher in the group with HR variability of less than 50 ms than the group with HR variability of more than 100 ms. HR variability remained a significant predictor of mortality after adjusting for clinical, demographic, other Holter features and ejection fraction. A hypothesis to explain this finding is that decreased HR variability correlates with increased sympathetic or decreased vagal tone, which may predispose to ventricular fibrillation. PMID- 3812276 TI - Incremental prognostic power of clinical history, exercise electrocardiography and myocardial perfusion scintigraphy in suspected coronary artery disease. AB - The incremental ability of a clinical history, exercise electrocardiography (ECG) and myocardial perfusion scintigraphy to identify coronary events in the year after testing was assessed in 1,659 patients with symptoms suggestive of coronary artery disease (CAD), 74 of whom suffered a coronary event in the year after testing. Prognostic power was quantified in terms of the area under receiver operating characteristic curves derived from logistic regression. In 1,451 patients with normal rest ECG findings, a clinical history alone provided the most prognostic power (area = 72%). This improved significantly (by 5%) only when both tests were analyzed. In contrast, clinical history had significantly less prognostic power in the 208 patients with abnormal rest ECG findings (area = 58%), but each test then provided a significant incremental improvement in these patients (by 14% for each). A strategic model was thereby developed for prognostic assessment that recognizes the incremental power of these tests in specific patient groups as well as their overall accuracy and monetary cost. This strategy stratified individual patient risk for subsequent coronary events over a full order of magnitude (from 2 to 22%) at a 64% reduction in the cost of testing compared to performing both stress tests in all patients. PMID- 3812277 TI - Decline in inducibility of sustained ventricular tachycardia from two to twenty weeks after acute myocardial infarction. AB - To determine temporal evolution of sustained ventricular arrhythmias inducible after acute myocardial infarction (AMI), serial programmed ventricular stimulation (PVS) was performed in 27 patients 15 +/- 4 and 150 +/- 28 days after AMI. These patients did not have worsening of congestive heart failure or angina, coronary artery bypass surgery or spontaneous sustained ventricular tachycardia (VT) in the period between 2 PVS studies. During initial PVS, sustained VT or ventricular fibrillation (VF) was inducible in 17 patients (group I) and was not inducible in 10 (group II). Late PVS in group I induced sustained VT or VF in 8 patients (47%) and nonsustained VT or no VT in 9 (53%). A decrease in late inducibility of sustained VT/VF was greater for arrhythmias induced during initial PVS by triple extrastimuli and burst pacing than for those induced by double extrastimuli (88% vs 25%, p less than 0.04), but appeared to be unrelated to the morphologic characteristics or cycle length of the initially induced sustained VT or VF and to other clinical, hemodynamic or angiographic variables. During late PVS in 10 group II patients, sustained VT or VF remained noninducible in 9 (90% concordance); in 1 patient sustained VT was induced. During a mean follow-up of 14 +/- 5 months since late PVS, none of 27 patients had spontaneous sustained VT and 2 patients in group I died suddenly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812278 TI - Value of the 12-lead electrocardiogram in discriminating atrioventricular nodal reciprocating tachycardia from circus movement atrioventricular tachycardia utilizing a retrograde accessory pathway. AB - The value of the 12-lead electrocardiogram for distinguishing atrioventricular (AV) nodal reciprocating tachycardia from circus movement AV tachycardia utilizing a retrograde accessory pathway was studied in 100 patients with narrow QRS complex tachycardia. Intracardiac electrograms showed AV nodal reciprocating tachycardia in 40 patients and circus movement AV tachycardia in 60. The 12-lead electrocardiograms recorded during tachycardia were randomly sorted and reviewed by 4 experienced cardiac electrophysiologists who were blinded to the diagnosis associated with each tracing, the relative proportion of each arrhythmia and the hypotheses to be tested. Each reviewer was asked to indicate the location of the P wave relative to the QRS complex, electrical axis of the P wave in the frontal and horizontal planes and presence or absence of QRS alternation, and to interpret the most likely mechanism. The performance of published electrocardiographic criteria to differentiate AV nodal reciprocating tachycardia from circus movement AV tachycardia was evaluated. The overall accuracy of the reviewers' interpretations was 75%, similar to the accuracy of the predefined criteria when applied by these observers (71% correct, difference not significant). Interobserver agreement of reviewer interpretations was 76% and the intraobserver agreement was 78%. Features associated with circus movement AV tachycardia by univariable analysis were P waves after the QRS complex, faster tachycardia rates and QRS alternation. Multivariable analysis showed that only the location of the P wave relative to the QRS complex was independently associated with the mechanism of tachycardia (p = 0.002). QRS alternation was found by multivariate analysis to be associated with the rate but not the mechanism of the tachycardia. PMID- 3812279 TI - Efficacy and safety of intravenous and oral diltiazem for Wolff-Parkinson-White syndrome. AB - The electrophysiologic effects and safety of diltiazem administered either intravenously or orally were studied in 14 patients with Wolff-Parkinson-White syndrome during orthodromic reentrant tachycardia and atrial fibrillation (AF). Anterograde and retrograde effective refractory periods of the accessory pathway did not change significantly from baseline during either i.v. or oral administration. Administration by either route prevented induction of sustained reentrant tachycardia in 8 patients. In 6 patients, the reentrant tachycardia was either nonsustained (2 patients) or sustained at much slower rates than the baseline rates (mean +/- standard deviation, baseline, 290 +/- 41 ms; i.v., 355 +/- 40 ms [p less than 0.001]; and oral, 377 +/- 33 ms [p less than 0.001]). In these patients anterograde atrioventricular conduction was prolonged significantly from the mean baseline value of 163 +/- 36 ms to 212 +/- 35 ms with i.v. administration (p less than 0.005) and 225 +/- 33 ms with oral administration (p less than 0.005). Retrograde conduction via the accessory pathway did not change significantly after administration of diltiazem. The shortest preexcited RR intervals during AF were significantly reduced during i.v. but not during oral administration: control, 327 +/- 47 ms; i.v., 270 +/- 28 ms (p less than 0.001); and oral, 323 +/- 44 ms (difference not significant). In 5 patients AF was sustained for a mean of 20 minutes after i.v. and for 12 minutes after oral administration (p less than 0.20), compared with a baseline mean value of 0.83 minute.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812280 TI - Electrophysiologic effects, clinical efficacy and safety of intravenous and oral nadolol in refractory supraventricular tachyarrhythmias. AB - The electrocardiographic and electrophysiologic effects, clinical efficacy and safety of intravenous and oral nadolol therapy were examined in 34 patients with recurrent supraventricular tachyarrhythmias (SVT) undergoing electrophysiologic evaluation. Programmed electrical stimulation was performed in the control (drug free) state, after infusion of intravenous nadolol (mean dose 0.09 +/- 0.03 mg/kg) and after chronic oral nadolol therapy in patients who responded to intravenous nadolol (mean dose 83 +/- 12 mg for 5 days). Intravenous nadolol administration prolonged mean sinus cycle length (p = 0.009), mean PR interval (p = 0.001) and mean AH interval (p = 0.001), with no significant electrophysiologic effects in the atrium, ventricle or accessory bypass tracts. Oral nadolol had similar electrocardiographic and electrophysiologic effects, but of lesser magnitude. Intravenous nadolol resulted in complete suppression of induced SVT in 78% of patients with sinus and atrioventricular nodal reentrant tachycardia and 11% of patients with atrioventricular (AV) reentrant tachycardia (p less than 0.001). Partial responses were frequent in intraatrial or AV reentrant tachycardia (37%). Oral nadolol suppressed induction of SVT in patients who responded to intravenous nadolol. Adverse reactions to intravenous and oral nadolol were infrequent--6% and 8%, respectively--and usually did not require drug withdrawal. Intravenous nadolol is highly effective in sinus and AV nodal reentrant tachycardia, and a successful electrophysiologic response to it predicts efficacy of long-term oral nadolol therapy. It has limited efficacy alone in AV reentrant tachycardia and should be considered in combination with other antiarrhythmic therapy in this type of SVT. PMID- 3812281 TI - Treatment of calcific aortic stenosis by balloon valvuloplasty. AB - Recent reports have established the feasibility of using balloon valvuloplasty to reduce left ventricular outflow tract obstruction due to a calcified aortic valve. The present study summarizes experiences with this technique in 9 patients (7 women, 2 men, mean age 78 years) in whom balloon valvuloplasty was used to treat calcific aortic stenosis. Peak aortic valve gradient (mm Hg) decreased from 68 +/- 8 (mean +/- standard error of the mean) before valvuloplasty to 35 +/- 5 after valvuloplasty (p = 0.003). Mean aortic valve gradient decreased from 57 +/- 7 before valvuloplasty to 30 +/- 5 after valvuloplasty (p = 0.006). Calculated aortic valve area increased from 0.42 +/- 0.04 to 0.81 +/- 0.06 cm2 (p = 0.005). Balloon valvuloplasty failed to diminish aortic valve obstruction in only 1 patient who, at subsequent surgery, had a congenitally bicuspid aortic valve. Significant aortic regurgitation was not observed in any of the 9 patients after valvuloplasty. One patient did have a highly focal, presumably embolic, brain stem infarct during the procedure. Femoral arterial blood loss, related to wire guided exchange of balloon catheters too large for a 12Fr introducer sheath, was minimized by direct arterial exposure in 8 of the 9 patients. Thus, these findings confirm the efficacy of balloon valvuloplasty for the treatment of calcific aortic stenosis. The procedure, however, is not without hazard. PMID- 3812282 TI - In vitro analysis of mechanisms of balloon valvuloplasty of stenotic mitral valves. AB - Preliminary reports indicate that percutaneous balloon valvuloplasty is efficacious for treatment of mitral stenosis. The present study was designed to evaluate whether anatomic features of stenotic mitral valves in older adults affect the efficacy of balloon valvuloplasty and to determine the mechanism by which increased orifice area is accomplished. Fifteen mitral valves excised intact at the time of mitral valve replacement from patients with no more than 2+/4+ mitral a regurgitation were selected for study. Balloon valvuloplasty was performed using a sequence of dilation catheters with balloons 18 to 25 mm in inflated diameter. Mitral valve area, measured with a conical valve sizer, increased from 0.71 +/- 0.06 cm2 (mean +/- standard error of the mean) to 1.77 +/ 0.19 cm2 (p less than 0.0001) after valvuloplasty, resulting in an increase in calculated orifice area of 185 +/- 27% (range 34 to 407%). The increase in calculated orifice area correlated inversely with orifice area before valvuloplasty (r = -0.57; p = 0.026), but was unrelated to extent of calcific deposits on the prevalvuloplasty x-ray of the excised mitral valve. Gross examination together with x-ray analysis after valvuloplasty revealed that the mechanism of balloon valvuloplasty in each case involved commissural splitting, including splits through heavily calcified commissures, without grossly apparent detachment of tissue fragments. These findings suggest that balloon valvuloplasty augments the functional mitral valve orifice area in a manner analogous to standard surgical commissurotomy, and balloon valvuloplasty is likely to be efficacious for a wide spectrum of adult mitral valvular stenosis, including severe stenosis with extensive calcific deposits. PMID- 3812283 TI - Echocardiographic observations of calcium in operatively excised stenotic aortic valves. AB - Qualitative and quantitative 2-dimensional (2-D) echocardiographic methods were developed to define the anatomic and physiologic significance of valvular calcium in aortic stenosis (AS). Qualitative methods assigned etiologic diagnoses by matching patterns of calcium with anatomic criteria. Quantitative techniques measured echodensities from superimposed short-axis views of calcium. Fifty-five pathologic specimens procured from surgery were photographed and radiographed. Etiologic diagnoses were assigned from gross examination and radiodensities were planimetered. Echocardiographic and anatomic diagnoses were compared. Sensitivities for diagnosing the most common etiologies, congenitally bicuspid and degenerative, were 58% and 100% and specificities were 100% and 76%. Calcium tended to be heaviest in congenitally diseased valves and lightest in those with degenerative disease (p less than 0.2) and showed propensity for the right cusp in all etiologies except for those with degenerative disease. Correlation of echodensities to radiodensities was 0.82. The relation of calcific echodensities to orifice area was curvilinear; beyond a level of calcium, further deposits did not reduce the orifice more. A systematic echocardiographic examination of calcium in stenotic aortic valves can give a correct etiologic diagnosis in most patients and identify the severely narrowed orifice. PMID- 3812284 TI - Determination of aortic valve orifice area in aortic valve stenosis by two dimensional transesophageal echocardiography. AB - Two-dimensional transesophageal echocardiography was used to measure aortic valve orifice area in 24 patients with aortic valve stenosis (AS) and 15 patients without aortic valve disease. Using transesophageal echocardiography, orifice area could be measured in 20 of 24 patients with AS. With transthoracic echocardiography, orifice area could be determined in only 2 of 24 patients. In patients with AS, orifice area determined by transesophageal echocardiography was 0.75 +/- 0.34 cm2 and that calculated with Gorlin's formula was 0.75 +/- 0.32 cm2. In normal aortic valves, orifice area was 3.9 +/- 1.2 cm2 by transesophageal echocardiography. A good correlation was demonstrated between aortic valve orifice area determined using transesophageal echocardiography and calculated orifice area using Gorlin's formula in patients with AS: r = 0.92, standard error of estimate = 0.14 cm2. The absolute difference between orifice area measured with both methods ranged from 0.0 to 0.4 cm2 (mean 0.09 +/- 0.1). In 4 patients orifice area could not be determined with transesophageal echocardiography. The orifice could not be identified in 2 patients because an appropriate cross sectional view of the aortic valve could not be achieved and in 2 patients with pinhole stenosis (aortic valve orifice area 0.3 cm2). These data show that aortic valve orifice area can be measured reliably using 2-dimensional transesophageal echocardiography. PMID- 3812285 TI - Detection of coronary artery disease by thallium imaging using a combined intravenous dipyridamole and isometric handgrip test in patients with aortic valve stenosis. AB - Detection of coronary artery disease (CAD) in patients with aortic valve stenosis (AS) is clinically difficult. Thallium-201 images were generated in 27 patients with AS during combined intravenous dipyridamole and handgrip test, which induces a marked acute increase in coronary blood flow. Isolated AS was noted in 21 patients and combined AS and aortic regurgitation in 6. Thirteen patients had more than 50% diameter stenosis in 1 or more coronary arteries on angiography. Eleven of them had reversible perfusion defects on post-stress thallium scans (sensitivity 85%). Two patients had thallium defects without angiographic evidence of significant CAD (specificity 86%). In the other 12 patients with normal coronary angiographic findings, the thallium scans were normal. Two patients had dizziness and hypotension after dipyridamole infusion, which disappeared during the handgrip test; 2 others had chest pain during handgrip. One of them was treated with aminophylline and the other with aminophylline and nitroglycerin. No other adverse effects were reported by the patients and no major complications occurred during stress testing. Thus, thallium imaging during combined intravenous dipyridamole and handgrip test appears to be a promising noninvasive method of revealing CAD in patients with AS. PMID- 3812286 TI - Doppler echocardiographic evaluation of ring mitral valvuloplasty for pure mitral regurgitation. AB - Doppler echocardiographic studies were performed in 21 consecutive patients (mean age 56 +/- 11 years) to evaluate postoperative results of mitral ring anuloplasty. All patients were symptomatic and all had clinically severe isolated mitral regurgitation (MR). The origin of MR was myxomatous degeneration, coronary artery disease, rheumatic heart disease or congestive cardiomyopathy. In 20 patients ring anuloplasty was performed using the Carpentier ring and 1 patient using the Duran ring. Postoperative Doppler echocardiographic studies were performed to detect and semiquantitate residual MR by flow mapping and to identify left ventricular inflow or outflow obstruction. The severity of MR was assessed by flow mapping in the left atrium and graded from I to IV in increasing severity. Blood flow velocity spectra were recorded from the left ventricular outflow tract during systole and from the left ventricle subjacent to the mitral valve during diastole. Pressure half-time, mitral valve area and mitral valve gradient were derived from digitized mitral diastolic flow velocity spectra. After ring valvuloplasty, 9 patients had no MR and 6 had grade I, 3 grade II, 2 grade III and 1 patient grade IV MR. Peak diastolic mitral valve gradient was 8 +/- 4 mm Hg, mean diastolic gradient was 3 +/- 2 mm Hg and pressure half-time was 83 +/- 17 ms, representing a calculated mean mitral valve area of 2.9 +/- 0.8 cm. Peak velocity in the left ventricular outflow tract was 0.9 +/- 0.2 m/s, indicating no obstruction to outflow. Our study confirms that mitral ring valvuloplasty produces a significant reduction in severity of MR, and this is achieved without obstructing left ventricular inflow or outflow. PMID- 3812287 TI - Isolated replacement of a prosthesis or a bioprosthesis in the mitral valve position. AB - The operative results of 249 mitral valvular reoperations performed in 215 patients from 1974 through 1986 were reviewed to identify groups at greater risk. Two to 4 reoperations were performed in 28 patients. The mean interval between the first and second valve procedures was 47 +/- 40 months. The most common indications for reoperation were degeneration of bioprostheses (44%) and thrombosis of mechanical prostheses (26%). Thirty patients (12%) died. This rate was significantly higher (p less than 0.02) than that for primary valve procedures performed during the same period. The mortality rate for elective reoperations was 7%. Mortality rates were higher among patients with prosthetic valve endocarditis (6 of 17 cases, 35%), in those undergoing operation on an emergency basis (19 of 82, 23%) and when tricuspid valve replacement or anuloplasty was also performed (9 of 38, 24%) (p less than 0.02). No significant correlation was found between mortality rates and the age or sex of the patients and the types of prosthesis used originally. PMID- 3812288 TI - Isolated replacement of a prosthesis or a bioprosthesis in the aortic valve position. AB - The operative results of 203 aortic prosthetic valve reoperations performed in 175 patients from 1974 through 1986 were reviewed to identify groups at greater risk. Two to 4 reoperations were performed in 23 patients. The mean interval between the first and second valve procedures was 74 +/- 57 months. The most common indications for reoperation were thrombosis of mechanical prostheses (25%), degeneration of homografts (22%) and mechanical valve dysfunction (19%). Eighteen patients (9%) died. This mortality rate was significantly higher (p less than 0.05) than that of primary valve procedures performed during the same period. Mortality rates were higher among patients with prosthetic valve endocarditis (6 of 26 cases, 23%) and among those who underwent operation on an emergency basis (15 of 20, 25%). No significant correlation was found between mortality rates and the age or gender of the patients and the types of prostheses used originally. PMID- 3812289 TI - Frequency of severe (70% or more) narrowing of the right, left anterior descending, and left circumflex coronary arteries in right dominant circulations with coronary artery disease. PMID- 3812290 TI - Transesophageal echocardiography for diagnosis of rupture of the ventricular septum or left ventricular papillary muscle during acute myocardial infarction. PMID- 3812292 TI - Acute myocardial infarction associated with prolonged sneezing. PMID- 3812291 TI - Relation between use of anti-inflammatory agents and left ventricular free wall rupture during acute myocardial infarction. PMID- 3812293 TI - Clinical and angiographic similarities in twins with coronary artery disease. PMID- 3812294 TI - Echocardiographic detection of perforation of the cardiac ventricular septum by a permanent pacemaker lead. PMID- 3812295 TI - An unusual variant of familial preexcitation. PMID- 3812296 TI - Association of atrial flutter with orthodromic reciprocating fetal tachycardia. PMID- 3812297 TI - Treatment of end-stage congestive heart failure by extracorporeal ultrafiltration. PMID- 3812298 TI - Percutaneous balloon valvuloplasty of mitral stenosis aided by cardiac ultrasound. PMID- 3812299 TI - Correlation of serum lipids, calcium and phosphorus, diabetes mellitus, aortic valve stenosis and history of systemic hypertension with presence or absence of mitral anular calcium in persons older than 62 years in a long-term health care facility. PMID- 3812300 TI - Polyvisceral echinococcosis with cardiac involvement imaged by two-dimensional echocardiography, computed tomography and nuclear magnetic resonance imaging. PMID- 3812301 TI - Comparison of direct Fick and thermodilution cardiac output techniques at high flow rates. PMID- 3812302 TI - Laser recanalization in severe end-stage peripheral vascular disease. PMID- 3812303 TI - Risk factors and progression of coronary narrowing. PMID- 3812304 TI - Outpatient cardiac catheterizations. PMID- 3812305 TI - Chemoprophylaxis for infective endocarditis. PMID- 3812306 TI - Food effects on cardiac function and responses. PMID- 3812307 TI - Sinus venosus interatrial communication and sinus node problems. PMID- 3812308 TI - Diltiazem versus propranolol in essential hypertension: responses of rest and exercise blood pressure and effects on exercise capacity. AB - Both beta-blocking and calcium channel-blocking drugs are being used with increasing frequency as initial therapy for essential hypertension. The present study was designed to compare the antihypertensive effects of a beta-blocking drug, propranolol, with a calcium channel-blocking drug, diltiazem, at rest and during upright bicycle exercise and to determine whether exercise capacity is altered by these therapies. Twenty-one patients with uncomplicated systemic hypertension and a diastolic blood pressure (BP) of 95 to 110 mm Hg without medication were randomly assigned to propranolol or diltiazem therapy in a double blind manner. The total daily dosages were titrated as needed, from 160 to 480 mg of propranolol (mean 371 mg) and 120 to 360 mg of diltiazem (mean 307 mg) over 12 weeks, and the titrated dose was maintained for 4 additional weeks. Both drugs significantly reduced supine BP (from 149 +/- 14/101 +/- 4 to 136 +/- 17/89 +/- 10 mm Hg with propranolol and from 157 +/- 14/103 +/- 4 to 144 +/- 13/93 +/- 8 with diltiazem. Only diltiazem reduced BP during submaximal exercise, but both agents produced significant responses during maximal exercise. Diltiazem had no effect on maximal heart rate, exercise duration or O2 uptake, whereas propranolol reduced maximal VO2 from 27 +/- 6 to 22 +/- 6 ml/min/kg (p less than 0.01) and also shortened duration of exercise. Propranolol, despite its effects on heart rate, maintained the workload VO2 relation at submaximal loads, suggesting an increased oxygen delivery. However, these adaptive mechanisms appear to be insufficient during maximal effort. PMID- 3812309 TI - Left ventricular ejection fraction response during exercise in asymptomatic systemic hypertension. AB - To study the effect of mild-to-moderate elevations in diastolic blood pressure (BP) on systolic left ventricular (LV) function, 28 hypertensive patients and 20 normal subjects underwent upright exercise first-pass radionuclide angiography. All were asymptomatic, had normal rest and exercise electrocardiographic findings and no evidence of LV hypertrophy or coronary artery disease. LV function at rest was similar in the 2 groups, but with exercise hypertensive patients had a greater end-systolic volume (69 +/- 19 vs 51 +/- 19 ml, p less than 0.002) and lower ejection fraction (EF) (0.59 +/- 0.09 vs 0.72 +/- 0.07, p less than 0.0001), stroke volume (101 +/- 28 vs 130 +/- 36 ml, p less than 0.005) and peak oxygen uptake (23 +/- 7 vs 33 +/- 9 ml/kl/min, p less than 0.05). Hypertensive patients were separated into 3 groups: group 1-12 patients with an increase in EF with exercise greater than or equal to 0.05; group 2-7 patients with a change in EF with exercise less than 0.05; and group 3-9 patients with a decrease in EF with exercise greater than or equal to 0.05. Group 3 hypertensive patients were older, had a higher heart rate at rest and lower peak oxygen uptake. Rest LV function was similar in the 3 hypertensive subgroups, but exercise end-systolic volumes were higher in groups 2 and 3. Exercise thallium-201 images was normal in all but 1 of 14 hypertensive group 2 or 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812310 TI - Results of the Senning procedure in infants with simple and complex transposition of the great arteries. AB - Because of interest in the arterial switch operation, recent experience with the Senning operation in patients with simple and complex transposition of the great arteries (TGA) was examined. Between 1982 and 1985, 35 patients with simple TGA (group I) and 10 patients with complex TGA (group II) underwent a Senning operation. Mean duration of follow-up was 14 months for group I and 24 months for group II. In group I, 1 patient died early and no patient died late; infrequently, right ventricular dysfunction, tricuspid regurgitation, baffle obstruction or arrhythmias occurred. In group II, no patient died early and 3 died late. In addition, many patients required prolonged digoxin therapy. Because the arterial switch operation has a high early mortality risk and an undetermined long-term morbidity and mortality risk, the Senning operation (or other venous switch operations) is considered the preferred surgical approach for simple TGA. In contrast, an arterial switch operation is performed in patients with complex TGA (without subpulmonic obstruction). Comparison of the early and late morbidity and mortality of the arterial vs the venous switch operation may be helpful in selecting the appropriate surgical approach to complex TGA. PMID- 3812311 TI - Obstructed pulmonary venous drainage with total anomalous pulmonary venous connection to the coronary sinus. AB - Obstructed pulmonary venous drainage is generally considered extremely rare with total anomalous pulmonary venous connection (TAPVC) to the coronary sinus (CS). A retrospective review of 27 operated patients with TAPVC to CS revealed 6 cases of obstruction (22%). Two of 6 patients who died early had evidence of obstruction at the pulmonary vein confluence at autopsy. Among the 21 hospital survivors, obstruction proximal to the point of CS unroofing developed in 4 (19%), necessitating reoperation and resulting in death in 3. One other patient died late. Mean follow-up of the 17 long-term survivors, who are generally doing well, is 85 months (range 2 to 212). There have been no cases of late obstruction at the site of unroofing among 10 patients who underwent the fenestration procedure suggested by Van Praagh. The incidence of early bradyarrhythmias (60%) does not appear to be decreased by this procedure. Review of 13 autopsy specimens suggests that if the right and left pulmonary veins did not drain directly to the CS but converged to form a short common vertical vein (4 cases), obstruction was likely. When pulmonary artery pressure approaches systemic levels preoperatively, careful echocardiographic and intraoperative assessment of the junction of the pulmonary vein confluence with the CS should be made. If there is evidence of obstruction, consideration should be given to anastomosing the horizontal right and left pulmonary veins directly to the left atrium rather than performing a simple unroofing procedure. PMID- 3812312 TI - Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum. AB - The incidence and severity of abnormalities of the coronary arteries were evaluated in 35 necropsy patients with pulmonary atresia and an intact ventricular septum. Right ventricular to coronary artery fistulous connections were found in more than 60% of the cases. All patients with fistulous connections had histologic abnormalities of the coronary arteries. In 50% the lesions were mild, with medial and intimal thickening producing up to moderate luminal stenosis. In 50% there was loss of normal arterial wall structure and severe narrowing or obliteration of the arterial lumen. The coronary arterial fistulas and histologic abnormalities were prevalent in those with underdevelopment of the tricuspid valve and right ventricular cavity but were not found in patients with a normal or dilated tricuspid valve anulus. The coronary arterial abnormalities were found in more than 80% of patients with a tricuspid valve/mitral valve ratio less than 1. A single coronary artery occurred in 6 patients (17%) of this series. In 80% of those with 1 coronary artery arising from the other, the aberrantly arising coronary artery crossed anteriorly to the pulmonary artery and could be at risk in surgical attempts to reconstruct the right ventricular outflow. Aortography is recommended if the coronary arteries are not clearly delineated on ventricular cineangiocardiography. PMID- 3812313 TI - Anatomy and pathogenesis of aorticopulmonary septal defect. AB - The pathologic anatomic features and associated cardiac anomalies of 13 patients with aorticopulmonary septal defect (APSD) and of 236 previously reported cases were analyzed. Morphologically, 3 types of APSD were distinguished: a defect with a more or less circular border located about halfway between the arterial valves and the bifurcation of the pulmonary trunk; a similarly located defect in which the border represents a helix; and a usually large defect in which there is no posterior (distal) border. The appearance of these 3 types of defects suggests a different developmental mechanism for each. Approximately half of the cases of APSD are not associated with other cardiovascular anomalies. Of the anomalies that do occur, anomalous origin of a coronary artery from the pulmonary trunk and interruption of the aortic arch (IAA) type A or severe preductal coarctation are seen far more often than expected. An association with DiGeorge syndrome, frequently noted with persistent truncus arteriosus (TA) and IAA type B, was not seen. Certain cardiac anomalies often seen with TA are rarely seen with APSD, and defects often seen with APSD are rarely seen with TA. These observations indicate that APSD and TA are pathogenetically unrelated even though located in the same region of the heart and, unlike TA and IAA type B, APSD is probably not due to a developmental error involving the neural crest. PMID- 3812314 TI - Frequency of ventricular late potentials and fractionated right ventricular electrograms after operative repair of tetralogy of Fallot. AB - This study was conducted to assess the incidence of abnormalities of ventricular depolarization in sinus rhythm after repair of tetralogy of Fallot and their relation to spontaneous ventricular arrhythmias. Forty-four patients were studied, 10 before surgery (mean age 6.9 years) and 34 after repair (mean age 8.1 years, mean age at surgery 6.5 years, mean interval between surgery and evaluation 11 months). Evaluation was performed by means of body surface and intracavitary signal-averaging techniques, by recording local right ventricular (RV) electrograms at several sites and by 24-hour Holter monitoring (n = 28). No electrophysiologic abnormality was observed in children before surgery. Ventricular late potentials were detected in 18 patients (53%) after repair. Body surface detection of ventricular late potentials was frequently masked by the postoperative right bundle branch block pattern. Local RV electrograms were fractionated in 11 cases (32%) (mean duration 103 +/- 33 ms), most often in the RV outflow tract (n = 9), but no relation was found between fragmentation of RV electrograms and the presence of ventricular late potentials. Spontaneous ventricular arrhythmias occurred in 12 children after repair (43%), but were complex in only 4 patients (14%). There was no correlation between spontaneous ventricular arrhythmias and the presence of ventricular late potentials, presence of fractionated RV electrograms, presence of a proximal right bundle branch block or postoperative hemodynamic status.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812315 TI - Surgical and medical results of complete atrioventricular canal: a ten year review. AB - The files of 121 patients who presented to Children's Hospital of Michigan over the last 10 years with complete atrioventricular (AV) canal were reviewed to evaluate long-term management and overall outcome. Of 121 patients, 70 underwent corrective surgery, 21 (30%) of whom died perioperatively. The surgical mortality rate was 13% when patients with hypoplastic left or right ventricle (n = 6), double-orifice mitral valve or extreme deficiency of mitral tissue (n = 5), and pulmonary vascular obstructive disease (n = 5) were excluded. Of the 49 patients who survived operation, 36 are in New York Heart Association class I, 1 patient requires a pacemaker and 3 died late. In 34 of the 51 patients (28%) who did not undergo operation, pulmonary vascular obstructive disease developed; it occurred within 12 months in 10 patients (8%). Eight other patients who did not undergo operation died before planned surgery (age 1 to 9 months). Although surgical prognosis in good candidates is acceptable, the overall prognosis for children with complete AV canal is guarded because of the risk of early death or early pulmonary vascular obstructive disease and frequently unfavorable anatomy. PMID- 3812316 TI - Maternal transmission of congenital heart diseases: new recurrence risk figures and the questions of cytoplasmic inheritance and vulnerability to teratogens. AB - A review of 8 studies involving 3,996 offspring of parents who have congenital heart disease revealed that the risk for all defects was substantially higher if the affected parent was the mother rather than the father. The risk ratio ranged from a high of 6.39 for aortic stenosis to a low of 1.48 for patent ductus arteriosus, and the ratio was statistically significant in aortic stenosis (p = 0.025) and ventricular septal defect (p less than 0.001). Despite the relatively large number of cases, there were still too few patients to reveal statistical significance for a malformation such as atrioventricular canal, in which there were 5 affected offspring among 36 children of mothers who had atrioventricular canal and no affected children among 16 offspring of affected fathers (p = 0.12). The possible reasons for the preponderance of affected offspring of mothers with a congenital heart disease was studied in the context of various modes of inheritance and maternal physiology. The preliminary conclusion is that although many familial cases of congenital heart disease are compatible with multifactorial inheritance and vulnerability to teratogens, an important subset of cases, particularly in some high-risk families, may be better explained by cytoplasmic inheritance than by multifactorial or mendelian modes. Current genetic counseling should take into account the differences in risk to offspring of affected mothers while confirmation and further investigation proceeds. PMID- 3812317 TI - Cardiac mechanics and function in obese normotensive persons with normal coronary arteries. AB - Obesity is associated with several cardiac abnormalities, but its effects on cardiac loading conditions and contractile function are controversial. The frequent coexistence of obesity with systemic hypertension and coronary artery disease further complicates evaluation of cardiac function in obese persons. Therefore, cardiac mechanics and contractile function were examined at cardiac catheterization in 14 obese persons (50 +/- 5% overweight) who were free of systemic hypertension and angiographic coronary narrowing. Twelve lean subjects who underwent catheterization for chest pain, found to be free of cardiac abnormalities, served as control subjects. Preload, estimated as end-diastolic stress, was greater in obese persons (48 +/- 5 kdynes/cm2) than in lean persons (32 +/- 3 kdynes/cm2) (p less than 0.01). Afterload, estimated by end-systolic stress, was also greater in obese persons: 124 +/- 15 kdynes/cm2 vs 95 +/- 6 kdynes/cm2 (p less than 0.05). Ejection fraction was similar in obese (0.69 +/- 0.02) and lean persons (0.71 +/- 0.02). Mean velocity of circumferential fiber shortening and the ratio of end-systolic stress to end-systolic volume index were also similar in both groups. The value for stress velocity of fiber shortening relation fell within the range of the normal subjects in all but 1 obese subject. Thus, although abnormalities in loading conditions are present in normotensive persons who are moderately obese, contractile function is usually normal. PMID- 3812318 TI - Spontaneous rupture of mitral chordae tendineae in hyperthyroidism. PMID- 3812319 TI - Aortic valve perforation with calcific aortic valve stenosis and without infective endocarditis or significant aortic regurgitation. PMID- 3812320 TI - Echocardiographic features of nonbacterial thrombotic endocarditis. PMID- 3812321 TI - Magnetic resonance imaging of restrictive cardiomyopathy. PMID- 3812322 TI - Congenital absence of the pulmonic valve and tricuspid valve atresia with intact ventricular septum. PMID- 3812323 TI - Two-dimensional echocardiographic diagnosis of cor triatriatum. PMID- 3812324 TI - Congenital aortic arch thrombosis diagnosed by echocardiography. PMID- 3812325 TI - Doppler echocardiographic assessment of cardiac output in normal children with and without innocent precordial murmurs. PMID- 3812326 TI - Infected acute myocardial infarct with rupture in systemic lupus erythematosus. PMID- 3812327 TI - Cardiovascular features of the Werner syndrome. PMID- 3812328 TI - Evidence of antiatherosclerotic action of verapamil from direct effects on arterial cells. PMID- 3812329 TI - Synthesis and migration of 3H-fucose-labeled glycoproteins in the ciliary epithelium of the eye: effects of microtubule-disrupting drugs. AB - 3H-fucose was injected intravenously or intravitreously into albino rats. After time intervals of 10, 40, and 50 min, 1, 1.5, and 4 hr, 1, 3, and 7 days, and 1, 2, and 4 weeks after injection, the animals were sacrificed by intracardiac perfusion with glutaraldehyde. Samples of the ciliary body were prepared for light and electron microscope radioautography. Light microscope autoradiographs showed that the cells of both the inner and outer layers of ciliary epithelium actively incorporated 3H-fucose label in a reaction that peaked in intensity at 4 hr after injection, and then progressively declined. Electron microscope radioautographs revealed that, at early time intervals, most of the label was localized to the Golgi apparatus. With time, the plasma membrane of both cell types became increasingly labeled, and accounted for 60-70% of the total silver grains at 4 hr after injection. Adjacent to the basal cell surface of the inner layer cells, the fibers of the zonula became increasingly labeled from 1.5 hr onwards, providing strong evidence that these cells secrete glycoproteins to the zonula. When vinblastine was administered 30 min before 3H-fucose injection, followed by sacrifice 1.5 hr later, a much larger proportion of label remained localized to the Golgi apparatus than in controls, and the plasma membrane and zonula were much less labeled. These results suggest that, as documented in other cell types, microtubules may play a role in the intracellular transport of membrane and secretory glycoproteins in these cells. PMID- 3812330 TI - The sexually dimorphic larynx of Xenopus laevis: development and androgen regulation. AB - The aims of this study were to characterize sexual dimorphism in the larynx of adult Xenopus laevis and to determine how sex differences arise during postmetamorphic development. The larger male larynx is a result of greater cell numbers in both cartilage and muscle. The dilator laryngis muscle of the male larynx has 6-7 times more muscle fibers than that of the female. At metamorphosis, the larynx is sexually monomorphic and feminine in phenotype. The DNA content of the male larynx doubles during the first 6 months following metamorphosis; there is no net DNA increase in the female larynx during this time. Both sexes experience a marked increase in laryngeal DNA content and mass between 6 months and adulthood. The number of muscle fibers in the male larynx increases at an average rate of 150 fibers a day during the first 10 months of postmetamorphic development. There is no net change in fiber numbers in the female larynx from metamorphosis to adulthood. Administration of the antiandrogen Flutamide to metamorphic frogs prevents the net addition of laryngeal muscle fibers in males. Thus, we propose that addition of postmetamorphic laryngeal muscle fibers in males is dependent upon the presence of circulating androgens. Exogenous testosterone administration results in an increase in laryngeal mass, DNA content, and cellular proliferation in juvenile frogs. Using [3H]thymidine injections to probe ongoing, as well as testosterone-induced, cell proliferation, we conclude that cellular proliferation is regulated differently in males and females during development. Thus androgen-induced proliferation is one cellular mechanism responsible for the sexual dimorphism observed in adults. PMID- 3812331 TI - Expression of nuclear estrogen-binding sites within developing human fetal vagina and urogenital sinus. AB - An autoradiographic study of nuclear estrogen binding was performed in developing human urogenital sinuses and vaginas derived from first and second trimester specimens. Nuclear estrogen binding was detected in all specimens greater than or equal to 10 weeks of gestation within mesenchymal cells. Nuclear labelling within epithelium was observed only in those specimens whose development and differentiation was advanced. Thus, mesenchyme appears to be the initial estrogen target tissue within the developing human vagina and may play a fundamental role in estrogen-induced teratogenesis of the human genital tract. PMID- 3812332 TI - Internal structure of the postcapillary high-endothelial venules of rodent lymph nodes and Peyer's patches and the transendothelial lymphocyte passage. AB - Scanning electron microscopy (SEM) shows that the postcapillary high-endothelial venules of lymph nodes and Peyer's patches consist of two segments each with a different surface relief: a proximal segment with a cobblestone surface pattern and a distal segment of interlacing cytoplasmic plates. Both segments have deep adluminal crevices in which lymphocytes are lodged. The internal structural configuration of this endothelium has been examined by transmission electron microscopy (TEM) of serial sections of lymph nodes and Peyer's patches of mice, rats, and guinea pigs. The serial sections revealed that the endothelial cell bodies and their cytoplasmic extensions were disposed in a direction generally lateral to the luminal surface and intruded into the intercellular spaces of similarly disposed neighboring endothelial cells, resulting in a complex interlacing cellular pattern. Lymphocytes penetrated the endothelial cell body and secondarily followed an intracellular pathway through which they entered the extravascular compartment. At the exposed surfaces of the adluminal venule wall, recirculating lymphocytes were seen in SEM images to enter the endothelium by penetrating the endothelial cell body. The mode of migration of lymphocytes lodged in the endothelial crevices could be determined by SEM and has been examined by TEM of serial sections. At these locations as at the exposed surfaces, lymphocytes also entered the venule by penetrating the endothelial cell body. At both sites this transcellular pathway was followed by lymphocyte entry into the intercellular spaces from which they migrated into the extravascular compartment. PMID- 3812333 TI - Induction of a specific (LM) protein in the submandibular gland of the rat by repeated amputation of the lower incisor teeth. AB - Chronic administration of the beta-adrenergic agonist isoproterenol (IPR) leads to marked hyperplastic/hypertrophic enlargements of the parotid and submandibular glands in rats and mice with concomitant changes in the composition of both the glands and the saliva. Conspicuous among the alterations of the submandibular saliva is the appearance of a 13,000 Mr protein, termed LM (large mobile) protein. Repeated amputation of the lower incisor teeth also causes enlargements of the major salivary glands in rats. In this study, we have compared the enlargements of submandibular glands of rats produced by IPR administration or teeth amputation with respect to the relative levels of the LM protein in gland extracts and saliva. Administration of IPR-HCl (40 mg/kg) twice daily for 5 days or amputation of the lower incisor teeth 3 times a week for 3 weeks resulted in a 2.2-fold increase in the weight of the submandibular gland. Amputation for one week led to a 1.4-fold increase in gland weight. Double immunodiffusion in agar antibodies against the purified LM protein gave a single precipitin line with gland extracts and saliva of IPR-treated and teeth-amputated rats, indicating immunological identity of the reacting antigens. No precipitin lines were seen with gland extracts or saliva of untreated rats. Immunoblots of pooled saliva obtained from IPR-treated or teeth-amputated rats revealed a single protein band of the same electrophoretic mobility in SDS-polyacrylamide gels when stained using anti-LM antibodies. The relative concentrations of LM protein in gland extracts and saliva were measured by a solid-phase enzyme-linked immunoabsorption assay using antibodies against the purified LM protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812334 TI - The correlation between craniofacial and long bone growth: an experimental investigation in normal rabbits. AB - The present study was undertaken to elucidate the relationships between craniofacial and long-bone growth. Nine male New Zealand white rabbits received spherical tantalum bone markers in the tibial epiphyses and in the nasal, frontal, and parietal bones. The animals were followed from 30 to 143 days of age. Growth changes were calculated with a roentgen stereometric system, and the results statistically evaluated. Except for the final interval when all variables varied at random, high correlations between tibial and frontonasal or coronal sutural growth were demonstrated; and the respective linear regression lines were homogeneously assembled. The relationship between the tibia and the sagittal suture displayed great variations between individual animals as well as between the suture's parts, although growth at the interfrontal suture was clearly correlated to tibial growth upon exclusion of the time factor. The first principal component of the three neurocranial sutures was calculated and seemed accurately correlated to long-bone growth. The present study concluded that growth at the frontonasal and coronal sutures normally seems to parallel general somatic development, while growth at the sagittal suture appears individually displaced in time. Nevertheless, when the principal component of the combination of the coronal suture and the neurocranial section of the sagittal suture was computed, this was highly correlated to body growth. PMID- 3812335 TI - Chondroid bone on the upper pharyngeal jaws and neurocranial base in the adult fish Astatotilapia elegans. AB - Serial cross sections of several adult specimens of the cichlid Astatotilapia elegans were used to investigate the fate and structure of the chondroid bone on the articulation between upper pharyngeal jaws and neurocranial base. The tissue persists in the adult on the three elements on which it previously developed, i.e., infrapharyngobranchial III-IV, parasphenoid, and basioccipital bones. It consists of haphazardly arranged, large vesicular cells without a canalicular system, embedded in a matrix histologically indistinguishable from bone matrix. Except for a narrow zone at the distal side, it is mineralized throughout. As in younger stages, the fibrous covering of the chondroid bone forms the articular tissue proper on each of the three elements. Acellular bone, found at the basal margin of the chondroid bone, it is argued, does not result from endochondral replacement of the latter but rather from dermal ossification projecting from the marrow cavity. Although lacunae may be filled in this way with bone, true obliteration of cells does not occur, so that there is no metaplasia from chondroid bone to bone. The part played by the chondroid bone in the outgrowth of the joint apophyses is discussed. PMID- 3812336 TI - Intraventricular neuronal complex of the lamina terminalis of the mouse. AB - An intraventricular neuronal complex has been identified with scanning and transmission electron microscopy at the base of the lamina terminalis of the mouse. The raspberry-shaped complex protrudes from a thickened bulge on the ependymal surface of the lamina terminalis or adjacent rostral floor of the third ventricle. Neurons and occasional ependymal cells cover the surface of the complex. Its core is made up of neurons, ependymal cells, and neuronal processes, which are usually compactly arranged. The core is continuous, through a breach in the ependymal layers, with the subependymal neuropil of the lamina terminalis. Within the core of the complex are large numbers of axodendritic synapses. Axonal varicosities and synaptic terminals are filled with vesicles and mitochondria. Synaptic endings have one of two populations of vesicles: exclusively clear, small, round or flattened vesicles. In view of the known structural and functional characteristics of the lamina terminalis, it is possible that the neuronal complex may participate in neurohormonal regulatory systems of the hypothalamus and hypophysis or in the network of circumventricular organs mediating angiotensin effects. PMID- 3812337 TI - Effect of a high-protein, very-low-calorie diet on body composition and anthropometric parameters of obese middle-aged women. AB - Effects of a very-low-calorie (420 kcal/day), high-protein diet (70 g/day) and realimentation on weight and body composition of 15 obese, middle-aged women were examined in a 4-6 mo study. Mean weight loss was 20.5 kg (1.1 kg/wk). Fat accounted for 83% and lean body mass (LBM) for 17% of total body weight loss. Multiple regression equations estimated from anthropometric measures were developed to predict the body density of obese individuals both before and after weight loss. Best predictors of body density in obese women before and after weight loss were circumference measurements in the trunk area. Nine previously published population specific and generalized equations for predicting body fat in women were not strongly enough correlated with body fat values obtained by densitometry in this study to be of use clinically. PMID- 3812338 TI - Effect of a high-protein, very-low-calorie diet on resting metabolism, thyroid hormones, and energy expenditure of obese middle-aged women. AB - A 4-6 mo study was conducted to examine effects of a very-low-calorie, high protein diet and realimentation on energy expenditure, resting metabolic rate (RMR), and serum thyroid hormones of obese women aged 30-54 yr. Fifteen healthy women, greater than or equal to 126% ideal body weight, were placed on the diet (420 kcal/day) and lost an average of 1.1 kg/wk until a predetermined goal weight was attained. RMR, triiodothyronine (T3), and reverse T3 decreased significantly (p less than 0.05). Thyroxine remained unchanged. Upon gradual realimentation onto solid foods, all metabolic parameters increased significantly within 5 wk toward pre-diet baseline values, but RMR (kcal/h) and T3 values remained significantly below pre-study values. Estimates of mean energy expenditure, utilizing a technique based on energy intake and body composition changes, averaged 1719 kcal/day during the diet period. PMID- 3812339 TI - Storage of medium-chain triglycerides in adipose tissue of orally fed infants. AB - The effect of the fatty acid content of the diet on that of adipose tissue was studied in 5 newborn infants studied prior to feeding and 30 infants fed ad libitum from birth with either human milk or a commercial formula as the sole nutrient. Significant positive linear correlations of dietary intake on adipose tissue content of fatty acids were found for both long- and medium-chain fatty acids (MCFA). Infants stored up to 12% of MCFAs in their subcutaneous fat. The technique of direct transesterification improved the recovery of the volatile MCFAs and could explain the finding that medium-chain triglyceride storage in adipose tissue is more extensive than in previous reports. This study documents that MCFAs are not used solely as a source of energy: they can be reesterified or serve for chain elongation, before being deposited in fat stores. PMID- 3812340 TI - Effects of a high-protein and low-fat diet vs a low-protein and high-fat diet on blood glucose, serum lipoproteins, and cholesterol metabolism in noninsulin dependent diabetics. AB - Six middle-aged patients with noninsulin-dependent diabetes and six normoglycemic control subjects were fed protein-rich and fat-poor (diet A) or protein-poor and fat-rich food (diet B). The patients were hyperglycemic, VLDL triglycerides levels were higher, and HDL cholesterol levels lower than corresponding findings in control subjects. Bile acid formation and biliary lipid composition did not differ between the two groups, but net steroid balance in the patients was elevated by a factor of approximately 2. A switch from diet A to diet B in control subjects was associated with an increase in HDL cholesterol and decreases in bile acid synthesis and net steroid balance. Lipoprotein pattern in the patients remained unchanged, and effects on total bile acid production and steroid balance were less consistent. It is suggested that the response in the patients reflected diabetes-associated abnormalities in lipid metabolism. PMID- 3812341 TI - Digestion of polysaccharides of potato in the small intestine of man. AB - Digestion and absorption from the small intestine of starch and nonstarch polysaccharides (NSP) (dietary fiber) from potato cooked and treated in various ways have been studied in ileostomy subjects. Test meals (300 g) of potato were fed following 24 h on a plant polysaccharide-free diet. Regardless of the treatment the potato had received, greater than 90% of NSP was recovered in ileostomy effluent. Starch from freshly cooked potato was well digested, only 3% being recovered; however, 12% from cooked and cooled potato escaped digestion in the small intestine. Digestibility of starch made resistant to alpha-amylase by cooling improved on reheating. Overall, 9, 18, and 14% of total carbohydrate fed was recovered from freshly cooked, cooled, and reheated potato, respectively. Digestibility of cooled potato was identical when eaten as large lumps or as finely sieved potato. In vitro studies with pancreatin also demonstrated incomplete digestion of cooled potato. PMID- 3812342 TI - Resection of rat small intestine: calcium, phosphorus, and fat balances and 1,25 dihydroxycholecalciferol. AB - In rat with massive resection of mid-small intestine, calcium transport per segment, measured by in vivo perfusion 10 days after surgery, is decreased in duodenum and ileum but is the same in cecum and colon as compared with controls with transection and reanastomosis of mid-small intestine. To extend these findings, we measured balances of calcium, phosphorus, and fat from the 5th to 10th day after surgery and serum concentration of 1,25-dihydroxycholecalciferol on the 10th day after surgery in this experimental model. We found steatorrhea in the resected group, but balances of calcium and phosphorus and serum levels of 1,25-dihydroxycholecalciferol were the same in resected and control groups. We conclude that decreased transport defined by direct examination of membrane function may be undetectable when net transport is measured by balance. Calcium balance during early post-resection period provides no evidence for future calcium deficiency in this experimental model. PMID- 3812343 TI - Lipid and phospholipid fatty acid composition of plasma, red blood cells, and platelets and how they are affected by dietary lipids: a study of normal subjects from Italy, Finland, and the USA. AB - A pilot study was conducted of males 40-45 years old from rural areas of three countries to study the long-term effects of dietary fats on the lipids of plasma, red blood cells (RBCs), and platelets. Differences were observed in cholesterol and phospholipid levels of plasma. Total phospholipids of RBCs and platelets were similar in all three countries. The pattern of individual phospholipids of RBCs in the Finnish and Italian samples differed from the American samples. In all plasma and RBC glycerolphospholipids, the monounsaturated fatty acids were highest in the Italian and the saturated fatty acids were highest in the Finnish samples; PUFAs were highest in the USA samples. Platelet glycerolphospholipids followed similar fatty acid patterns. We concluded that the fatty acid compositions of the glycerolphospholipids of plasma, RBCs, and platelets reflect the major dietary fatty acids. PMID- 3812344 TI - Employed problem drinkers: a nutritional risk group? AB - Nutritional assessment was made in 26 employed Finnish men drinking excessively and in 49 control men. Because of their greater alcohol consumption, daily intake of energy of case men significantly exceeded that of control men; other dietary differences were negligible. Compared with control men, case men had thicker fatfolds but reduced mean body mass and arm muscle circumference. Mean circulating levels of vitamin C and alpha-tocopherol were normal and equal in case and control men, but serum retinol was raised and beta-carotene was reduced in case men. Serum concentration and 24-h urinary excretion of selenium were significantly lower in case than in control men. Serum levels of magnesium and zinc were similar in both groups, but urinary excretions were higher in case men. Heavy drinking does not result in florid nutritional deficiencies in socially intact men, but its role in subtle nutritional alterations deserves further studies. PMID- 3812345 TI - Serum selenium, vitamin antioxidants, and cardiovascular mortality: a 9-year follow-up study in the Netherlands. AB - The association between low serum selenium, vitamin A, and vitamin E levels and mortality from cardiovascular disease (CVD) was investigated in a case-control study nested in a 9-yr prospective study in the Netherlands. For 10,532 persons aged greater than or equal to 5 yr who participated in a 1975-1978 medical survey, serum was stored at -20 degrees C. For the 84 of 106 subjects aged 37-87 yr who died of CVD after the baseline exam, 168 cohort members alive at the end of 1983 and matched for age and gender were selected as controls. No significant associations between serum selenium. vitamin A, vitamin E, and CVD mortality were observed before and after multivariate analyses. The adjusted risk of death from CVD for subjects in the lowest selenium quintile (less than 105.0 micrograms/L) was 1.6 (95% CI, 0.8-3.2). For coronary and stroke death risk, estimates were 1.1 (95% CI, 0.5-2.6) and 3.2 (95% CI, 0.8-12.1). Our findings do not show a clear CVD risk from low selenium and vitamin levels. Although some of the risk estimates were strong, larger studies are required for definitive conclusions. PMID- 3812346 TI - Relationship of magnesium intake and other dietary factors to blood pressure: the Honolulu heart study. AB - Associations between blood pressure and intakes of 61 dietary variables assessed by 24-h recall method were investigated in 615 men of Japanese ancestry living in Hawaii who had no history of cardiovascular disease or treated hypertension. Magnesium, calcium, phosphorus, potassium, fiber, vegetable protein, starch, vitamin C, and vitamin D intakes were significant variables that showed inverse associations with blood pressure in univariate and a multivariate analyses. Magnesium had the strongest association with blood pressure, which supports recent interest in its relation to blood pressure. Nevertheless, it was not possible to separate the effect of magnesium from that of other variables because of the problem of high intercorrelation among many nutrients. While recommendations based upon cross-sectional studies must be viewed cautiously, these results suggest that foods such as vegetables, fruits, whole grains, and low-fat dairy items are major sources of nutrients that may be protective against hypertension. PMID- 3812347 TI - Determination of iron in stools as a method to monitor consumption of iron fortified products in infants. AB - We describe a quantitative method for determination of iron in stool to monitor consumption of iron-fortified milk in infants. The method is simple, fast, and inexpensive. Stool samples from infants consuming fortified milk or nonfortified milk were ashed, and ashes were diluted in hydrochloric acid and reacted with bathophenantroline disulphonate. Mean iron excretion per subject was obtained. Anemia was present in 25.7% of infants in the nonfortified group (upper level of 95% confidence limit for mean iron excretion was 14.9 mg iron/100 g stool) and in 22.2% of infants from the noncompliant fortified group (mean excretion less than 15 mg iron/100 g stool). In contrast, only 0.8% of infants who had properly consumed the fortified milk had anemia. We conclude that this method for determination of stool iron should be considered for estimating compliance in evaluation of results of field trials of iron-fortified products in infants. PMID- 3812348 TI - Transient neonatal zinc deficiency. PMID- 3812349 TI - Histopathology of myelodysplastic syndromes. The FAB classification (proposals) applied to bone marrow biopsy. AB - Twenty-eight cases of myelodysplastic syndrome (MDS) were reviewed to evaluate whether the morphologic criteria proposed by the French-American-British (FAB) Cooperative Group for marrow smears could be applied to glycol methacrylate embedded trephine biopsies. Bone marrow biopsies and marrow smears were examined separately and then compared for the following parameters: percentage of blasts, dyserythropoiesis, ring sideroblasts, dysmegakaryopoiesis, dysgranulopoiesis, monocytes, cellularity, fibrosis, and "abnormal localization of immature precursors". The results of the histologic (biopsies) and cytologic (marrow smears) examinations were in good agreement in 24 of 28 cases. The authors' results suggest that the five MDS types proposed by the FAB group can be reliably distinguished on bone marrow biopsy with knowledge of the peripheral blood blast and monocyte counts. When the bone marrow aspiration is inadequate, the biopsy can establish diagnosis and type of MDS and rules out aplasia or tumor infiltration as possible alternative causes of cytopenia. PMID- 3812350 TI - Hematologic and iron-related measurements in rheumatoid arthritis. AB - The hematologic status of 265 patients with rheumatoid arthritis was assessed. In the group as a whole, a mild depression in the hemoglobin concentration and mean cell volume (MCV) was associated with an increase in the red blood cell distribution width (RDW), erythrocyte sedimentation rate (ESR), and platelet count. Bone marrow trephine biopsies and further measurements of iron status and disease activity were done in [a further] 38 more anemic patients, and the findings in those with absent marrow iron (iron deficiency) were compared with those having stainable stores (anemia of chronic disorders). The RDW was raised in both, and there was no significant difference between the two groups. The concentrations of nonheme iron in the marrow and of serum ferritin were significantly lower in the iron-deficient group, but the geometric mean serum ferritin of 34 micrograms/L was still a good deal higher than that associated with uncomplicated iron deficiency. This was presumably because of the fact that the serum ferritin, which was significantly correlated with the ESR (r 0.55; P less than 0.0004) and C-reactive protein (CRP) r 0.41; P less than 0.01), was also functioning as an acute phase protein. While there was a weak correlation (r 0.37; P less than 0.04) between the marrow nonheme iron and the serum ferritin concentrations, it disappeared when nonactive patients with normal CRP concentrations were excluded. The absence of a correlation is unlike the findings that have previously been noted in other chronic inflammatory conditions and in neoplasia. This raises the possibility that serum ferritin concentrations in rheumatoid arthritis may reflect, in part at least, another store of iron located in affected joints. PMID- 3812351 TI - Comparison of four leukocyte differential methods with the National Committee for Clinical Laboratory Standards (NCCLS) reference method. AB - The authors compared four leukocyte differential counting methods with the National Committee for Clinical Laboratory Standards Reference Leukocyte Differential Method H20-T to determine the clinical sensitivity of the methods. The three-part differential performed by the Coulter Counter Model S-Plus IV and the Toa E-5000, when combined with instrument flags and defined laboratory checking limits for red blood cell and platelet values, are safe and efficacious screening methods for the presence of morphologic abnormalities. The Geometric Data Hematrak 590 proved comparable in clinical sensitivity to a random 100-cell eye-count differential. PMID- 3812352 TI - Heparin-protamine complexes in the production of heparin rebound and other complications of extracorporeal bypass procedures. AB - Neutralization by protamine of the heparin activation of antithrombin III in plasma, in vitro, represents an equilibrium reaction in which by mass action heparin remains complexed only in the presence of an excess of protamine. Loss of this excess through enzymatic breakdown of the free protamine leads to instability of the complexes with liberation of the heparin, reestablishing antithrombin activity. This "heparin rebound" can also be produced by an increase in heparin levels or increased amounts of antithrombin III. These phenomena could occur after extracorporeal bypass procedures by an increase in heparin from whatever source or by added antithrombin III, through transfusions of fresh frozen plasma. A larger excess of protamine does not itself act as an anticoagulant but produces large heparin-protamine complexes that can still activate antithrombin III. Such large complexes, formed in vivo, could possibly block the pulmonary microcirculation and cause the acute pulmonary hypertension that has been reported after protamine infusions. PMID- 3812353 TI - Effect of hemolysis on apparent values of platelet-associated IgG. AB - Addition of red blood cells hemolyzed in the presence of dilute plasma in quantities equivalent to as little as 0.2% hemolysis of red blood cells in whole blood caused significant elevation in the apparent value of IgG associated with platelets (PAIgG) isolated from the preparation. Addition of hemolysate to plasma containing low concentrations of platelets, simulating that obtained from thrombocytopenic patients, caused more striking elevations in apparent PAIgG. Centrifugation of platelet-rich plasma containing hemolysate through a 30% solution of Percoll restored the value of PAIgG essentially to normal. Additional studies using simulated patient whole blood samples anticoagulated with EDTA yielded similar results. The apparent elevation of PAIgG in these preparations appears to result from IgG-bearing membranous material and microspherocytes that co-isolate with platelets separated from blood by conventional methods. Caution should be used in interpreting the results of PAIgG measurements on platelets isolated from blood samples in which even minimal in vitro hemolysis has occurred. PMID- 3812354 TI - Quantitative solid phase fluorescence immunoassay of rheumatoid factor and C reactive protein in active rheumatoid arthritis. AB - A quantitative, semiautomated, solid-phase fluorescence immunoassay (FIA) has been developed for measuring rheumatoid factor (RF) and C-reactive protein (CRP). The correlation of the FIA measurement of RF and CRP with standard measurements in rheumatoid arthritis (RA) patients is not known. To determine the correlation of FIA with standard assay methods, RF and CRP levels were measured by both methods in 151 patients with active RA. RF levels measured by FIA correlated very closely with charcoal agglutination method (r2 = 0.890, P less than 0.0001). CRP levels by FIA correlated very closely with CRP levels by nephelometric method (r2 = 0.886, P less than 0.0001) and Westergren erythrocyte sedimentation rates (ESR) (r2 = 0.356, P less than 0.0001). A weak statistical correlation of RF, CRP, and ESR with some clinical variables of RA disease activity was demonstrated. Measurement of RF and CRP by FIA is similar to standard methods and offers no specific advantages in evaluating RA patients at a single evaluation. PMID- 3812355 TI - Enzyme-linked immunosorbent urine pregnancy tests. Clinical specificity studies. AB - The performance of six recently introduced highly sensitive enzyme-linked immunosorbent (ELISA) urine pregnancy test reagent kits was evaluated for false positive results using 100 male and 100 postmenopausal female urine specimens and the findings were compared with those of a qualitative radioimmunoassay (RIA) procedure. Based on the findings, the most suitable pregnancy test reagent kit was then selected for doing routine pregnancy testing of urine samples of premenopausal patients. The less sensitive PregnaSTICK ELISA method and Concept RIA procedure did not give any positive results. Positive results for postmenopausal female and male urine samples were obtained as follows: Testpack, 2 and 0 (greater than 50 mIU/mL [IU/L]); Icon, 2 and 0 (greater than 50 mIU/mL [IU/L]); Quest, 4 and 2 (greater than 50 mIU/mL [IU/L]); Nimbus, 17 and 4 (greater than 25 mIU/mL [IU/L]); and Sensi-Chrome, 33 and 19 (greater than 50 mIU/mL [IU/L]), respectively. The medical records of the patients whose urine samples gave positive results were examined for information that would have explained the positive results, but no clear-cut reasons were found. Comparison of the routine urinalysis findings showed that there was a correlation between the mucus content of female (but not of male) urine samples and the incidence of false positive human chorionic gonadotropin results. During 12 months of routine use of the Icon reagents for pregnancy testing of premenopausal urine samples, the University of Texas Medical Branch staff has not reported any suspected false positive findings to the authors. PMID- 3812356 TI - The failure of neonates to form red blood cell alloantibodies in response to multiple transfusions. AB - Red blood cell alloantibody production was studied in 90 neonates who received a mean of 14.1 transfusions (range 2-35) from an average of 8.9 donors during the first three months after birth. Standard antibody detection procedures were done with the use of a selected red blood cell panel. No unexpected alloantibodies were detected. These findings suggest, at a 99% confidence level, that neonates do not make red blood cell alloantibodies in response to transfusion, indicating that repeated compatibility testing is probably unnecessary. Thus, following initial antibody screening and compatibility tests, further compatibility testing can be eliminated. PMID- 3812357 TI - Double failure of the Type and Screen. AB - "Type and Screen" programs have proved effective in reducing time and cost in the crossmatching laboratories, while still assuring safety when transfusion is necessary. However, there remains the possibility that the program will miss a patient with an antibody to a low-incidence donor antigen and that such a patient will receive blood from such a donor. The authors report on the actuality of that possibility happening twice within two months in one hospital. PMID- 3812358 TI - Transfusion reactions in patients with cancer. AB - In general, the true incidence of transfusion reactions is difficult to determine with certainty. In patients with cancer, it becomes even more complex to define. During a four-year study period in which 100,177 units of red blood cell transfusions were given to 25,744 cancer patients, 245 episodes of transfusion reactions were reported. The incidence of overall reaction was 0.3% of all transfused units, which is significantly lower than other studies. Febrile nonhemolytic reactions and allergic urticarial reactions were the most frequently noted, constituting 51.3% and 36.7%, respectively, of total reactions. There were only 17 hemolytic reactions (four immediate and 13 delayed-type). The incidence of delayed hemolytic reactions in cancer patients is significantly lower than that reported for patients in non-oncology hospital settings. This could result from the inability of cancer patients to produce alloantibodies against blood group antigens as frequently and efficiently as can those with non-neoplastic conditions. PMID- 3812359 TI - Lymphocytotoxicity crossmatch proficiency testing among regional transplant centers. AB - During an eight and a half-year period (1976-1984), 408 combinations of different cells and sera involving 12,652 lymphocytotoxicity crossmatch reactions performed by 21-37 histocompatibility laboratories were studied in 20 proficiency tests conducted by the South-Eastern Organ Procurement Foundation. Consensus by 75% or more laboratories were obtained on 336 (82.4%) of these test samples: of the 10,410 reactions examined with the use of these consensus cells and sera, only 649 (6.2%) were discordant. Considering positive and negative reactions separately, the discordant (false) positive and negative rates were similar (6.1%, 6.4%, respectively). Varying specific factors in given tests indicated that discordant results were significantly reduced by (1) dispensing sera in trays centrally rather than locally; (2) using a standard one-wash procedure rather than local or three-wash methods; and (3) using reagent (monospecific) rather than patient (polyspecific) sera. Use of standard versus local rabbit complement did not significantly influence the concordance of results. PMID- 3812360 TI - A new solid phase passive hemagglutination test for IgM antibody to hepatitis B core antigen. AB - There is a need for a simple, sensitive, specific, and inexpensive test for immunoglobulin M antibody to hepatitis B core antigen (anti-HBc IgM). A solid phase passive hemagglutination test (SP-PHA) was developed for this purpose and compared with the enzyme-linked immunosorbent assay (ELISA) test. Hepatitis B core antigen (HBcAg) used in PHA and SP-PHA was synthesized in Escherichia coli. Human IgM was captured to a microtiter plate coated with anti-human IgM, and the presence of anti-HBc IgM was demonstrated by the adherence of HBcAg-sensitized erythrocytes to the bottom of a U-shaped microtiter plate. ELISA and SP-PHA were made at 1:100 and 1:1,000 serum dilution, respectively. Both were positive in 100% of 36 cases of acute hepatitis B, 68.18% of 22 cases of chronic hepatitis B, and 20% of 75 healthy carriers of hepatitis B surface antigen (HBsAg) but none in 65 anti-HBc-positive blood donors that had negative results for HBsAg. Results of both tests were identical but were false positive because rheumatoid factor was found only in ELISA. End-point titration by SP-PHA and PHA was also found useful for the differentiation of acute hepatitis B from chronic hepatitis B and HBsAg carriers. PMID- 3812361 TI - Medical monitoring. What is it, how can it be improved? AB - Little has been published about optimizing medical monitoring protocols, although monitoring accounts for over half of all medical laboratory tests. Monitoring is a form of surveillance consisting of repeated testing intended to detect a specified change in a patient indicating a change in his prognosis, need for treatment or need for a change in treatment. The concept of monitoring overlaps with those of screening and diagnosis. One may monitor a physiologic or pathologic process, a therapeutic or noxious agent, comparing results with the patient's previous results or with a group reference range. Pertinent questions include: what are the indications, what is to be monitored, which tests are to be used, when to start, how frequently to test, when to stop. Preliminary improvement of monitoring protocols may be achieved by applying common sense guidelines for medical decision making; using best estimates of test characteristics, of possible risks and benefits of testing, not testing, treating and not treating. Sensitivity analysis may help determine when further clinical research is needed. PMID- 3812362 TI - Further comment on platelet study. PMID- 3812363 TI - More on RDWs (red cell distribution width). PMID- 3812364 TI - Lectin binding and tissue fixation. PMID- 3812365 TI - No single peripheral blood parameter was predictive of iron status. PMID- 3812366 TI - Calcofluor white stain for fungi. PMID- 3812367 TI - Pediatrics to geriatrics? PMID- 3812368 TI - Retraining pediatricians as geriatricians. PMID- 3812369 TI - Russell-Silver syndrome and pituitary gonadal axis dysfunction. PMID- 3812370 TI - Mercury poisoning and acrodynia. PMID- 3812371 TI - Kawasaki disease and hepatitis B: lack of association. PMID- 3812372 TI - Section to discuss health care and the poor? PMID- 3812373 TI - Are parent-child resemblances in growth sex limited? PMID- 3812374 TI - 'Ode to the circumcised male'. PMID- 3812375 TI - Gastric acid aspiration possible during flexible endoscopy without general anesthesia. PMID- 3812376 TI - Neglect of children of alcoholics. PMID- 3812377 TI - Childhood bicycle injuries. What can we do? PMID- 3812378 TI - Bicycle safety. PMID- 3812379 TI - Pediatrics and intrauterine detection of fetal disorders. PMID- 3812380 TI - Bicycle-related injuries. AB - To obtain epidemiologic data and information on the probable causes and severity of bicycle-related injuries, we interviewed all patients with such trauma. Between April 1 and Oct 1, 1983, 520 children presented to the Emergency Department of The Children's Hospital of Philadelphia with trauma related to two wheeled nonmotorized bicycles. The ages of the patients ranged from 1 to 18 years (mean, 8.7 years), and most (72%) were males. Most accidents (84%) occurred less than five blocks from home, and 49% occurred in the street. Thirty-six percent of the patients admitted to stunt riding or going too fast when the accident occurred, and 36% claimed there was a problem with the surface on which they were riding. The accidents occurred when a patient lost control of the bike (45%), a patient on a bicycle was hit by a car (17%), or a pedestrian was hit by a bicyclist (10%). Only three patients were wearing protective equipment at the time of the accident. Most (54%) had received no specific safety instructions about bicycling. The extremities were injured in 53% of the accidents, but head and neck injuries accounted for 31%. Six percent required hospital admission. Males and children over 12 years of age were more likely to have multiple injuries. Accidents that occurred in the street or involved cars were associated with a greater number of serious and multiple injuries. The infrequent use of protective equipment and minimal safety instructions received by the patients in this study suggest that many bicycle-related injuries are preventable. Education of parents and children is recommended to improve bicycle safety. PMID- 3812381 TI - Parental and physician-related determinants of consent for neonatal autopsy. AB - We undertook a cross-sectional epidemiologic study of potential determinants of parental consent for neonatal autopsy at the Brigham and Women's Hospital, Boston. Data were abstracted from maternal and infant medical records in 184 cases of neonatal death occurring between January 1982 and October 1984. The overall consent rate for neonatal autopsy was 72%. Multivariate analysis by logistic regression found previous fetal loss, gestational age, and cause of death to be significantly different between the groups of consenters and nonconsenters. Parents least likely to consent to autopsy were those who had no history of previous fetal loss, who had pregnancies in which the birth weight of the infant was less than 1000 g or the gestational age was less than 28 weeks, or those who had an infant die of extreme prematurity. Factors not significantly associated with consent were maternal age, race, marital status, transfer status, type of prenatal care, the infant's sex, and the staff position of the requester. A second phase of the study surveyed physicians' attitudes regarding the importance of neonatal autopsy. The staff position and previous experience of the physician-requester, in addition to the presumed cause of the infant's death, were significantly associated with the rating assigned to the importance of the autopsy. These findings suggest that the mother's past and present obstetrical experience, the presence of extreme prematurity, and possibly the attitude and experience of the physician requesting autopsy permission may exert important influences on the likelihood of obtaining consent for a neonatal autopsy. PMID- 3812382 TI - Rotavirus gastroenteritis. Clinical and laboratory features and use of the Rotazyme test. AB - Clinical and laboratory features of 86 infants admitted with diarrhea and dehydration were evaluated prospectively. Human rotavirus (HRV) infection was documented in 35 infants (41%) by the Rotazyme test. Those with HRV gastroenteritis (HRV+ group) had a shorter duration of diarrhea prior to admission, more severe dehydration on presentation, and a longer hospital course than the HRV-negative (HRV-) group. Vomiting, fever, upper respiratory tract symptoms, otitis media, and cough were present in equal numbers of infants in both groups. The HRV+ infants had lower serum bicarbonate and higher serum albumin, alanine aminotransferase, aspartate aminotransferase, and uric acid concentrations than did the HRV- infants. Serum uric acid levels greater than 10 mg/dL (590 mumol/L) were present in 69% of HRV+ vs 29% of HRV- infants. The Rotazyme test was found to be a valuable tool in diagnosis; testing on two days increased the yield from 74% to 97% of all infants finally diagnosed as HRV+. The optimal time for testing was within the first five days of illness. PMID- 3812383 TI - Perinatal events and necrotizing enterocolitis in premature infants. AB - Among 2123 premature infants monitored during a large multicenter study of patent ductus arteriosus, necrotizing enterocolitis (NEC) was diagnosed in 121 (5.7%) of these infants. Rates ranged from 13.5% among infants with a birth-weight (BW) of 500 to 749 g to 2.9% among infants whose BW was between 1500 and 1750 g. The presence of a hemodynamically significant patent ductus arteriosus did not alter the incidence of NEC. Of a large number of perinatal events and conditions considered, only BW and maternal toxemia were found to be associated with the rate of NEC, both relating inversely. Thus, these data do not support a relationship between NEC and a variety of perinatal factors previously postulated as potential determinants of the disorder. PMID- 3812384 TI - Occurrence of strabismus in infants born to drug-dependent women. AB - Maternal drug abuse during pregnancy exposes the fetus to the possibility of toxic or addicting effects. At a methadone hydrochloride maintenance program providing medical care to drug-dependent women and their infants, ophthalmologic examinations of all infants born during a 36-month period were performed. Twenty nine infants prenatally exposed to psychoactive drugs were seen at birth and on follow-up. The 24% prevalence of strabismus found in the drug-exposed infants was significantly greater than that of 2.8% to 5.3% reported in the general population. These data suggest that maternal drug abuse and increased methadone dosage during pregnancy may predispose infants to the development of strabismus. PMID- 3812385 TI - Bone mineral content and growth in very-low-birth-weight premature infants. Does bronchopulmonary dysplasia make a difference? AB - It is reported that very-low-birth-weight (VLBW) infants with the complication of bronchopulmonary dysplasia (BPD) are at high risk for metabolic bone disease and growth retardation. In a prospective study, we compared growth and bone mineral content (BMC) during the first year of life in 16 VLBW infants with BPD and 16 VLBW control infants. The BPD and control groups were matched for gestational age (28.2 +/- 0.8 vs 28.4 +/- 1.2 weeks) and birth weight (986 +/- 158 vs 1037 +/- 147 g). Calcium, phosphorus, vitamin D, and energy intakes did not differ during the initial 60-day period of hospitalization. At 1 year of age, there were no significant differences in BMC (104.4 +/- 21.4 vs 109.7 +/- 19.2 mg/cm), weight (7440 +/- 1090 vs 7420 +/- 826 g), length (66.9 +/- 3.4 vs 67.7 +/- 3.0 cm), or head circumference (45.1 +/- 1.5 vs 44.0 +/- 1.0 cm) between BPD and control groups. In both groups bone mineralization was delayed compared to the intrauterine curve for BMC. Growth was also delayed compared to the growth curves of Babson for premature infants during the first year of life. We conclude that for our study population, factors other than the presence or absence of BPD are responsible for marked delays in bone mineralization and growth in VLBW premature infants. PMID- 3812386 TI - Recurrent otitis media in the fragile X syndrome. AB - Thirty prepubertal boys with fragile X syndrome (fra[X]) were evaluated retrospectively to document the incidence of recurrent otitis media by physician records. The number of documented otitis media infections in the first five years of life was statistically more than those of the normal male siblings and of unrelated, cytogenetically normal controls. Nineteen (63%) of the 30 boys with fra(X) experienced six or more otitis infections. Of the 30 boys with fra(X), 13 (43%) were treated with polyethylene tubes or prophylactic antibiotics for persistent middle ear effusion. Males with fra(X) are at high risk for recurrent ear disease, which may exacerbate the cognitive, language, and behavior problems that exist in this syndrome. PMID- 3812387 TI - Clinical prediction of cervical spine injuries in children. Radiographic abnormalities. AB - During the seven-year period from 1976 through 1982, 2133 cervical spine radiographs were obtained for children less than 18 years of age at two hospitals in Tucson. Twenty-five children (1.2%) had x-ray evidence of a cervical spine injury, with a male to female ratio of 4:1. Vehicular accidents accounted for 36% of cervical spine radiographic abnormalities, and sports or playground accidents accounted for an additional 36%. In an attempt to find clinical predictors that might identify x-ray abnormalities, we reviewed the medical records of these 25 children with abnormalities and 713 randomly selected children without x-ray evidence of cervical spine injuries for the following: method of injury, presenting complaints, physical examination findings, therapy, and complications. No single clinical predictor had a sensitivity of 100% when considered in isolation, but clinical assessment consisting of EITHER a complaint of neck pain OR involvement in a vehicular accident with head trauma would have correctly identified all 25 cases of cervical spine injury. If this information had been used prospectively, the number of cervical spine radiographs ordered would have been reduced by 32%. We conclude that the use of this clinical "marker" would have positively identified all children with cervical spine injuries and would have reduced by one third the cost and radiation exposure associated with cervical spine radiographs. Because of the serious consequences of missing a cervical spine injury, we suggest that other studies confirm these results before this information is accepted as a recommendation. PMID- 3812388 TI - Microbiology of retropharyngeal abscesses in children. AB - Aspiration of retropharyngeal abscesses was performed in 14 children. Cultures were taken from aspirates for aerobic and anaerobic bacteria, and all yielded bacterial growth. Anaerobes were isolated in all patients; they were the only organisms isolated in two patients (14%) and were mixed with aerobes in 12 patients (86%). There were 78 anaerobic isolates (5.6 per specimen). The predominant anaerobes were Bacteroides species, Peptostreptococcus species, and Fusobacterium species. There were 26 aerobic isolates (1.9 per specimen). The predominant aerobes were alpha- and gamma-hemolytic streptococci, Staphylococcus aureus, Haemophilus species, and group A beta-hemolytic streptococci. beta Lactamase production was noted in 16 isolates recovered from ten patients (71%). These included all isolates of S aureus, six of 18 Bacteroides melaninogenicus group (33%), and two of three Bacteroides oralis (67%). These findings demonstrate the major role of anaerobic organisms in retropharyngeal abscesses and the presence of beta-lactamase-producing organisms in two thirds of the patients. PMID- 3812389 TI - Correlates of coronary artery aneurysm formation in patients with Kawasaki disease. AB - Factors potentially associated with the formation or prevention of coronary artery aneurysms were investigated in 77 children with Kawasaki disease. The patients were divided into two groups. Group A consisted of those who developed coronary artery aneurysms and group B consisted of those who did not. The patients who developed aneurysms had a significantly longer duration of fever and a significantly lower minimum hemoglobin concentration than those who did not develop aneurysm. In patients who developed aneurysms, aspirin therapy was begun significantly later in the course of the illness compared with those who did not develop aneurysms. We suggest that the timing of the initiation of aspirin therapy may be important in the prevention of coronary artery aneurysms in patients with Kawasaki disease. We believe that it may be important to establish the diagnosis of Kawasaki disease as early as possible and to institute aspirin therapy at an appropriate dosage. PMID- 3812390 TI - Hemagglutination inhibition antibodies in congenital rubella syndrome. A 17-year follow-up in the Ryukyu Islands. AB - We studied long-term rubella hemagglutination inhibition (HI) antibody titers in 381 children born between 1965 and 1966 with congenital rubella syndrome and in 344 of their mothers, who had had postnatally acquired rubella infection. Serum specimens were obtained 12 times during a 17-year period. The initial geometric mean titer of the rubella HI antibody was higher in the children than in their mothers, but the titer declined more rapidly in the children. After 17 years it was 2(5.4) in the children and 2(6.9) in the mothers. In 13 (3.4%) of the children, the rubella HI antibody titer reverted to negativity after three to 17 years. None of the mothers showed a reversion. PMID- 3812391 TI - Perforated gastric ulcer in a rock eater. PMID- 3812392 TI - Association of Turner syndrome with hypoplastic left-heart syndrome. AB - Three cases of hypoplastic left-heart syndrome (HLH) associated with Turner syndrome (45,X) were seen during an 11-year interval. Several isolated case reports are present in the literature. This association is probably not fortuitous but, rather, may represent the most extreme form of a spectrum of left sided heart anomalies seen in patients with Turner syndrome. The association of Turner syndrome with HLH, as well as other known genetic etiologies of HLH, underscores the need for a detailed genetic evaluation in all patients with HLH and argues for cytogenetic analysis for even nondysmorphic females with HLH. PMID- 3812393 TI - Firearms in the home and child safety. AB - One hundred fifty families who were seen in the pediatric outpatient clinics at The University of Texas Medical Branch, Galveston, were surveyed to learn about firearm possession in the home and its hazards to children. Thirty-eight percent of these families kept at least one gun in their home. Fifty-five percent of this group reported that the gun was loaded at all times, and 10% reported that the gun was kept loaded, unlocked, and within the reach of a child. We identified demographic characteristics of at-risk families and considered national statistics for gun safety. It was concluded that household firearms pose a significant risk to children and that intervention by physicians could help reduce this public health problem. PMID- 3812394 TI - Coma following use of rubbing alcohol for fever control. PMID- 3812395 TI - Growing up in a family 'bent' by alcoholism. PMID- 3812396 TI - Primary care and pediatrics. PMID- 3812397 TI - Unusual presentation of nasal foreign bodies. PMID- 3812398 TI - Use of aspirin and Reye's syndrome. PMID- 3812399 TI - Prolonged breast-feeding and nonorganic failure to thrive. PMID- 3812400 TI - Congenital muscular torticollis: computed tomographic observations. PMID- 3812401 TI - Delay in the diagnosis of leukemia. PMID- 3812402 TI - Joint and pulmonary changes in diabetes. PMID- 3812403 TI - Foreign bodies of the air and food passages in children. PMID- 3812404 TI - Response of the patent ductus arteriosus to indomethacin treatment. PMID- 3812405 TI - Penicillin in sickle cell anemia. A panacea for the lost spleen? PMID- 3812406 TI - Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies. AB - Twenty cases of laryngotracheal foreign bodies were reviewed over an 11-year period to determine features that differentiate these from bronchial foreign bodies. A history of choking or aspiration was obtained in 18 patients (90%). The most common presenting symptoms were stridor, wheezing, sternal retractions, and cough. The chest roentgenogram was most often normal (58% [11/19]). Posteroanterior and lateral neck roentgenograms suggested the diagnosis in 92% (12/13) of the patients. The correct diagnosis was made within the first 24 hours of presentation in 11 patients (55%); 19 patients (95%) were correctly diagnosed within one week. The incidence of major complications was 45% (9/20); however, in patients with a delay in diagnosis of over 24 hours the complication rate was 67% (6/9). For this reason, in children with a diagnosis of croup or reactive airway disease who respond poorly or whose condition deteriorates despite appropriate medical therapy, early endoscopy should be considered. PMID- 3812407 TI - Infections in a pediatric intensive care unit. AB - All infections occurring in a busy pediatric intensive care unit (PICU) from 1982 to 1984 were characterized by site, bacteriology, acquisition status, and outcome. Standard Centers for Disease Control criteria were employed. Nine hundred sixty-five patients were admitted to the PICU. Mortality was 3.4%. Two hundred twenty-one infections occurred in 180 patients. Infection rates were 23% and 6% for total and PICU-acquired infections, respectively. Infections of the central nervous system (n = 56), lower respiratory tract (n = 53), and genitourinary tract (n = 46) made up 70% of all infections. Haemophilus influenzae (n = 39) was the most commonly isolated pathogen. Staphylococcus aureus (20%) and Klebsiella-Enterobacter-Serratia (18.3%) were most commonly noted in PICU-acquired infections. Twenty infected patients (11.1%) died in the PICU. Lower respiratory tract infections (20.5%) were associated with the highest mortality. Both PICU-acquired and community-acquired infections were associated with similar mortalities. Infected patients in a PICU have a mortality approximately 300% higher than that seen in the overall PICU population. The data presented document the importance of infection and provide information against which similar units can gauge their infection status for quality-assurance purposes. PMID- 3812408 TI - King's syndrome with malignant hyperthermia. Potential outpatient risks. AB - King's syndrome is a sporadic genetic syndrome exhibiting characteristic facial features, short stature, and subclinical myopathy. Affected individuals are susceptible to malignant hyperthermia (MH) induced by anesthesia, stress, or trauma. The incidence of King's syndrome is uncertain as all reported cases were first recognized following an episode of MH. We report a case of King's syndrome without the cryptorchidism and pectus carinatum associated with the syndrome. King's syndrome's possible link to Noonan's syndrome is discussed herein, and the diagnosis and management of MH are briefly reviewed. We recommend evaluation for MH susceptibility in all patients with clinical signs consistent with King's syndrome and in their family members prior to anesthesia. PMID- 3812409 TI - The use of theophylline clearance in pediatric status asthmaticus. I. Interpatient and intrapatient theophylline clearance variability. AB - A group of 167 pediatric asthmatics were followed up over four years, and their theophylline clearance values were recorded when they were admitted for status asthmaticus. A slow and gradual decrease of the clearance value was noted in all age groups. The clearance did not change significantly between the ages of 2 and 9 years. Longitudinal intrapatient clearance changes achieved statistical significance after the age of 9 years. When the patient groups were studied according to their initial clearance values, it became evident that only the patients with clearance values of 80 mL/kg/h showed significant changes of this value. In our patient group, obesity did not play a significant role in effecting a change in theophylline clearance. PMID- 3812410 TI - Accidental injuries in children in day-care centers. AB - A telephone survey of all licensed group day-care centers serving 2- to 6-year old children in Maryland was conducted to determine the rate of injuries, their nature, and the circumstances of occurrence. Eighty-two percent of the 523 operating centers were contacted. Two centers declined to participate. Twenty nine injuries were reported. A total of 18,728 children were surveyed (children who attended half a day were given half credit per day) or 92,640 child-days. Yearly injury rates of 7.02% for medically attended injuries, 4.29% for injuries limiting activity, and a total yearly injury rate of 11.30% were calculated. This general injury rate was similar to incidence figures from a non-day-care center injury study. This lack of improvement in injury rates in licensed day care is of concern and deserves increased attention from pediatricians. PMID- 3812411 TI - Response of the patent ductus arteriosus to indomethacin treatment. AB - The purposes of this study were to examine the response of the patent ductus arteriosus (PDA) to indomethacin, using serial two-dimensional and pulsed Doppler echocardiographic studies, and to correlate the response to treatment with serum indomethacin levels. Nineteen preterm infants (gestational age, 26 to 31 weeks [mean, 28 weeks]; weight, 600 to 1680 g [mean, 1060 g]) were treated with indomethacin. Two-dimensional and pulsed Doppler echocardiograms were obtained before administration of indomethacin and daily thereafter until the day after the last dose. Ductal responses to treatment were graded as open, constricted, or closed, and serum indomethacin levels were obtained 24 hours after the last dose. The PDA initially closed in 11 (58%) of 19 infants; however, in four of the 11, PDA reopened and three of four required surgical ligation. In seven (37%) of 19 patients, the PDA initially constricted, but five of seven subsequently reopened and required ligation. In one patient, indomethacin had no effect on the PDA. The mean indomethacin level for the whole group was 622 ng/mL. There was no difference in indomethacin level between the group with initial closure vs those with constriction (580 vs 590 ng/mL), nor between those who eventually required ligation and those who did not. This study demonstrates that the majority of premature infants respond to indomethacin treatment with ductal constriction or closure but that reopening occurs frequently. The initial response does not mean that the ductus will remain constricted or closed, and surgical intervention may still be necessary. A serum indomethacin level of more than 250 ng/mL does not ensure ductal closure. PMID- 3812412 TI - Medical problems of foreign-born adopted children. AB - Over 8000 foreign-born children, almost all from third-world countries, are adopted by citizens of the United States each year. Most primary care practitioners do not have enough experience to evaluate and manage their problems efficiently. We reviewed the medical care of the foreign-born adoptees followed up in a single pediatric group practice. The 128 children arrived from one of eight countries in Asia or Latin America at ages ranging from 1 month to 10 years; 57% were female. The median duration of follow-up was 20 months. The most common problems identified included deficient immunizations (37%), intestinal parasites (29%), emotional or behavioral problems (22%), skin diseases (16%), estimated age (12%), scabies and/or lice (10%), and congenital anomales (10%). Twenty-one other classes of problems were identified, including developmental delay, lactose intolerance, vision and hearing deficits, and chronic hepatitis B carrier status. At arrival or within one month, 49% of the children had acute infectious diseases, including upper respiratory tract infection, otitis media, rubeola, varicella, and mumps. Nineteen percent of the children underwent surgical procedures ranging from circumcision to cleft lip-palate repair; 46% of these children were never screened for hepatitis B. Fourteen percent were hospitalized at least once, 5% within the first month after arrival. We developed a simple protocol to screen foreign-born adopted children, allowing rapid identification of treatable problems at the least cost and inconvenience to the family. Thirty-six percent of the families made at least one preadoption visit, permitting an explanation of the protocol and potential problems before the child's arrival. PMID- 3812413 TI - Radiological case of the month. Non-Hodgkin's lymphoma of the nasopharynx. PMID- 3812414 TI - Genetic factors in nonspecific bronchial hyperreactivity. An epidemiologic study. AB - We tested bronchial reactivity to carbachol in 50 asthmatics, healthy parents of 40 asthmatic children, and 70 healthy subjects with no personal or family history of asthma. Stepped doses of carbachol (0.1%) aerosol were given until a 50% drop in forced expiratory flow rate from 25% to 75% was observed, or until the subject had inhaled 80 of his or her own vital-capacity equivalent volumes of the aerosol. The area under the dose-response curve was computed. Histograms of the carbachol reactivity showed a bimodal distribution: 10% of normal subjects and 50% of nonasthmatic parents had values in the asthmatic range. In 85% of parent couples at least one of the two parents had bronchial reactivity without being asthmatic. Our findings suggest that bronchial reactivity to a cholinergic bronchoconstrictor indicates an autosomal-dominant pattern of inheritance. PMID- 3812415 TI - Pruritus of cholestasis is related to effects of bile salts on the liver, not the skin. PMID- 3812416 TI - Is gastroesophageal reflux a factor in some asthmatics? AB - We performed antireflux surgery on 13 adults with both gastroesophageal reflux (GER) and asthma. The duration of asthma ranged from 7 months to 43 yr. Twelve patients had chronic heartburn, 10 had nocturnal cough and wheezing, eight had chest pain, and one was asymptomatic for GER. GER was determined by a combination of esophagoscopy with biopsy, manometry, and esophageal pH testing. Postoperative follow-up ranged from 13 months to 5 yr. Six patients were completely free of all wheezing episodes, six still had wheezing but the frequency and severity had markedly decreased, and one remained unchanged. Of 11 patients who required chronic bronchodilator therapy, four were able to completely stop and six decreased the dose by more than half; one required the same amount of therapy. Of the seven corticosteroid-dependent patients, two were weaned completely, three were being tapered, one remained unchanged, and one required a smaller dose for nasal polyps although he was free of wheezing and had stopped bronchodilators. Three patients, all of whom dramatically improved after surgery, died during their follow-up course: one died suddenly 8 months postoperatively during a walk after dinner from apparent status asthmaticus; one died 9 months postoperatively of refractory congestive heart failure; and one died 30 months postoperatively of metastatic adenocarcinoma of unknown source. We conclude that surgical correction of GER in selected adults with both asthma and GER may significantly decrease or eliminate pulmonary symptoms and the need for asthmatic medications. PMID- 3812417 TI - Effects of nasopharyngeal cocaine or pharyngeal benzocaine on esophageal motility. AB - The esophageal effect of topical anesthetics applied to the nasopharynx was evaluated. Eight healthy volunteers underwent an esophageal motility study after each of the following: no anesthesia, 5% cocaine solution applied to the nasopharynx, and 20% benzocaine spray applied to the pharynx. Upper esophageal sphincter relaxation was prolonged after use of the 5% cocaine solution. No other significant effects on esophageal motility or pressures were noted. PMID- 3812418 TI - Central signals of gallstones in magnetic resonance imaging. AB - The magnetic resonance imaging of gallstones was studied in 34 patients. Diagnosis of the gallstones using magnetic resonance imaging was possible in 29 patients (85%). The gallstones showed as no-signal areas in all cases, with relatively strong signals being detected from the center of the stones in six cases. Postoperative studies showed the stones with the central signals to be of the so-called mixed stone type, in which the central area consists of cholesterol with a radiating structure. The central signal was thought to originate in water that accumulates in the central cavity of the stone, the cavity not being isolated from the exterior of the stone and there being a passage of fluids. The central signal is a characteristic indication of the stone's structure. PMID- 3812419 TI - Colonoscopic therapy of acute pseudoobstruction of the colon. AB - All patients with the diagnosis of acute colonic pseudoobstruction at the University of California, Davis Medical Center from 1979-1985 were reviewed. These 25 patients were initially treated conservatively (nasogastric tube/rectal tube/enemas) and this was successful in eight of 25 patients (32%). The remaining 17 patients (68%) unresponsive to conservative therapy received endoscopic intervention, either colonoscopic suction decompression (CSD) or colonic suction decompression with proximal colonic tube placement (CDT) for continuous decompression. Of the endoscopic procedures performed, 13/17 (76%) resulted in successful acute decompression. Recurrences occurred in 6/13 (45%) (3/7 in the colonoscopic suction decompression group and three of six in the colonic tube placement group). In the 10 failures, six further procedures were attempted, but only one was successful. These patients were then treated conservatively. There were no instances of colonic perforation. Acute pseudoobstruction in our experience is a benign entity that can be safely and successfully treated nonsurgically. Colonoscopic suction decompression is often initially successful but has a high frequency of recurrence. Newer techniques to prevent recurrence, i.e., colonic tube placement, are of potential benefit but presently have technical problems. PMID- 3812420 TI - Complete chemotherapeutic regression of hepatic metastases with resultant hepar lobatum. AB - An instance of hepar lobatum of unusual etiology is described. Because metastatic gastric adenocarcinoma in our patient involved multiple organs including the liver, chemotherapy was administered. There was total regression of the liver metastases at autopsy with cicatrization of the previous sites of neoplastic involvement. The scarring subdivided the liver into irregular areas resulting in the characteristic gross appearance of hepar lobatum. Evidence of syphilis or Hodgkin's disease was not found. Radioisotopic liver scans taken before and after the administration of chemotherapy are included to correlate the clinical findings with the pathological observations. PMID- 3812421 TI - Propylthiouracil-induced fatal hepatic necrosis. AB - We present a fatal case of acute submassive hepatic necrosis occurring in a 42-yr old black woman treated for hyperthyroidism with propylthiouracil for 1 yr. Alcohol and drug abuse were ruled out and all serological tests for hepatitis A and B, cytomegalovirus, and Epstein-Barr virus infection were negative. At autopsy the liver was shrunken and presented a yellow granular appearance. Microscopy disclosed submassive necrosis with bile stasis and severe chronic inflammation, as well as mild bile duct proliferation. Although non-A, non-B hepatitis cannot be ruled out (there was no transfusion of blood or its products), this is considered to be the third fatal case and ninth instance of propylthiouracil-induced hepatic necrosis. PMID- 3812422 TI - Budd-Chiari and the nephrotic syndromes secondary to massive hepatomegaly. AB - Both the Budd-Chiari and the nephrotic syndrome have previously been reported to occur secondary to occlusion of the vena cava. However, they have never been reported to occur simultaneously, nor have either of these entities been reported to occur secondary to massive hepatomegaly. This is the first report of both the Budd-Chiari and the nephrotic syndromes secondary to massive hepatomegaly with vena caval obstruction due to acute fatty liver from heavy alcohol intake. With shrinkage of the liver, the vena caval obstruction cleared as did the Budd-Chiari and nephrotic syndromes. PMID- 3812423 TI - Bradycardia associated with hiatal hernia and gastroesophageal reflux relieved by surgery. AB - A man known to have familial dysautonomia presented with a cardiac arrhythmia due to development of hiatal hernia and gastroesophageal reflux. Preoperative symptoms and assessment are described including use of power spectrum analysis of heart rate fluctuations which was consistent with enhanced parasympathetic stimulation. After surgical repair of hiatal hernia and fundoplication, bradycardia resolved, gastroesophageal reflux symptoms subsided, and the power spectrum analysis of heart rate confirmed decreased parasympathetic influence. Power spectrum analysis proved to be a useful adjunct in confirming preoperative autonomic imbalance and assessing the postoperative result. It is concluded that in individuals with disorders such as familial dysautonomia that are associated with autonomic dysfunction, cardiac arrhythmias may be a sign of esophageal pathology. Thus, cardiac evaluations should be accompanied by investigation of gastroesophageal structure and function and appropriate treatment may prevent a catastrophic arrhythmia. PMID- 3812424 TI - Cholinergically mediated exaggeration of the colonic motor response to cholecystokinin. PMID- 3812425 TI - Pentoxifylline for mesenteric ischemia. PMID- 3812426 TI - Exposure opportunity in epidemiologic studies. AB - We have shown that consideration of exposure opportunity is crucial to planning epidemiologic investigations because it focuses studies on questions of relevance, it helps to identify links to variables that can distort the assessment of an exposure's effect, and the cost of investigation can be reduced by the use of appropriate eligibility criteria. The reasons given by Poole for ignoring exposure opportunity are based on misleading claims of increased precision, disregard for probable confounding by factors related to exposure opportunity, and failure to consider realistically the cost of obtaining data on persons whose experience is irrelevant to the issues under investigation. PMID- 3812427 TI - A case-control study of breast cancer stratified by estrogen receptor status. AB - A population-based case-control study was conducted to examine whether tumor estrogen receptor status differentiated risk factor patterns for breast cancer. From December 1980 to December 1982, 458 women with newly diagnosed breast cancer and 568 control women, aged 20-54 years, from the Atlanta, Georgia, metropolitan area were interviewed. On the basis of tumor estrogen receptor results, cases were classified as receptor-positive or receptor-negative. Intercase analysis showed that age was positively and significantly associated with estrogen receptor-positive breast cancer (p = 0.001); the relative risk for an estrogen receptor-positive as opposed to an estrogen receptor-negative tumor was elevated threefold among women aged 50-54 years compared with those aged less than 35 years. In the case-control analysis, race was the only individual factor that demonstrated a significant difference in the risk for estrogen receptor-positive versus estrogen receptor-negative cancer (p less than 0.05), with blacks being at a 25% excess risk for estrogen receptor-negative cancer compared with whites. Although a history of benign breast disease was a risk factor for both positive and negative tumors, the association was stronger for the estrogen receptor positive tumors. Postmenopausal women were at a lower risk for both cancer subtypes compared with premenopausal women. Compared with non-users, women who had ever taken oral contraceptives had a 16% decrease in the risk for receptor positive cancer and a 22% increase in the risk for receptor-negative cancer. These results are consistent with the notion that certain exposure variables may relate to hormonal status, possibly by augmentation or suppression of estrogen receptor activity. PMID- 3812428 TI - Is diabetes mellitus a teratogen or a coteratogen? AB - The risk of major and minor congenital malformations was compared in the offspring of diabetic (n = 2,639) and nondiabetic (n = 2,144) women who delivered at the Johns Hopkins Hospital in Baltimore, Maryland, between January 1, 1946 and December 31, 1970. In spite of ample power, there was little evidence of an increased malformation risk in offspring born prior to the onset of overt diabetes in the mother. In offspring born after onset, the overall malformation risk was not increased, but severe multi-organ birth defects occurred at approximately twice the control group rate. It is postulated, therefore, that diabetes may act as a coteratogen enhancing the teratogenic effect of other insults but may not itself cause malformations. That some of its effects may be specific is suggested by the especially high risk of vertebral, lower limb, and urogenital defects, a pattern similar to that reported for the caudal dysgenesis syndrome. To better understand the teratogenic effects associated with diabetes, it may be necessary to consider interactions with other factors and to explore the association between maternal diabetes and caudal dysgenesis. PMID- 3812429 TI - Psychosocial predictors of depression. Prospective evidence from the human population laboratory studies. AB - The association between status attributes, personal resources, life stress, physical health, and occurrence of depressive symptoms nine years later was assessed by the 1965 Human Population Laboratory survey of a random sample of 6,928 adults in Alameda County, California, and by a subsequent follow-up survey in 1974. In multiple logistic analyses, depressive symptoms at baseline, low education, physical disability or presence of chronic conditions, poor perceived health, personal uncertainty, residential move, job loss, money problems, anomy, and social isolation were independently associated with increased risk of depressive symptoms at the nine-year follow-up. Age, low income, ethnicity, marital status, separation or divorce, and health practices at baseline were unrelated to depressive symptoms. These results underscore both the multifactorial nature of depression and the importance of prospective analyses of depressive phenomena. PMID- 3812430 TI - Systolic blood pressure differences in black, colored, and white infants. AB - Systolic blood pressure was measured in a random cluster sample of three-month old black (n = 532), colored (n = 496), and white (n = 637) infants in Johannesburg, South Africa, by means of a Parks Doppler ultrasound device with a random zero sphygmomanometer. The study was conducted during a nine-month period in 1981. Major predictors of systolic pressure measurements were which fieldworker had taken the measurement and whether the child was quiet or agitated. After adjustment for predictors as necessary, the mean systolic blood pressure of black infants was about 2 mmHg higher than that of coloreds, which was statistically significant, with suggestive evidence that coloreds have a systolic pressure about 1 mmHg higher than that of whites. Findings at age three months may represent ethnic differences in blood pressure distributions of genetic origin. PMID- 3812431 TI - Mortality among plutonium and other radiation workers at a plutonium weapons facility. AB - Mortality among 5,413 white males who were employed for at least two years at a plutonium weapons facility was investigated to measure risks from exposures to low levels of plutonium and external radiation. When compared with US death rates, fewer deaths than expected were found for all causes of death, all cancers, and lung cancer. No bone cancer was observed. An excess of brain tumors was found for the cohort in general. Elevated rate ratios for all causes of death and all lymphopoietic neoplasms were found when employees with plutonium body burdens greater than or equal to 2 nCi were compared with those with body burdens less than 2 nCi, while accounting for age, calendar period, and induction time. Increased rate ratios were also found for esophageal, stomach, colon, and prostate cancers, and for lymphosarcomas and reticulum cell sarcomas. No elevated rate ratios were noted for bone and liver cancers. When employees with cumulative exposures greater than or equal to 1 rem were compared with those with exposures less than 1 rem, elevated rate ratios were found for myeloid leukemia, lymphosarcoma and reticulum cell sarcoma, liver neoplasms, and unspecified brain tumors. No overall dose-response relationships were found for plutonium or external radiation exposures. Standardized rate ratios increased, however, as plutonium body burden levels increased for all causes, all cancers, and digestive cancers at five years induction time. Standardized rate ratios also increased as external radiation exposure categories increased for all lymphopoietic cancers and unspecified brain tumors for a two-year induction period. With the exception of analyses of combined categories of death, and perhaps of lung cancer, confidence limits were wide, indicating limited precision. Nevertheless, these findings suggest that increased risks for several types of cancers cannot be ruled out at this time for individuals with plutonium body burdens of greater than or equal to 2 nCi. Plutonium-burdened individuals should continue to be studied in future years. PMID- 3812432 TI - Drinking and mortality. The Albany Study. AB - The relation of alcohol consumption to mortality was examined in a cohort of 1,910 employed men aged 38-55 years, enrolled in the Albany Study, a prospective investigation of factors related to cardiovascular disease. Two follow-up periods were examined, one between 1953-1954 and 1971-1972 and the other after 1971-1972. In both periods, there was a positive relation between the rate of alcohol consumption and noncoronary heart disease death, not assignable to any specific cause. Coronary heart disease death was not associated with drinking during the initial follow-up but was negatively associated with drinking in the later follow up. All-cause mortality was positively associated with alcohol consumption in the earlier follow-up, because of the greater cigarette use among drinkers, but not in the later follow-up. There was a significant positive relation of drinking to deaths from liver cirrhosis and diabetes but not to deaths from motor vehicle accidents. PMID- 3812433 TI - Epidemiology of an outbreak of infectious syphilis in Manitoba. AB - An outbreak of 82 cases of infectious syphilis (primary, secondary, and early latent) which occurred in 1984 in the province of Manitoba was analyzed by age, sex, geographic distribution, and stage of disease. In the preceding four years, from 1980-1983, there were 19, 24, 13, and 32 cases, respectively, of infectious syphilis, of which 89% involved males. Compared with 1983, the overall crude incidence rate in 1984 increased by 259%, from 2.9 to 7.5/100,000 population, with a peak incidence in the 25- to 29-year age group of 25.8/100,000 population. This increase was predominantly due to a striking increase in incidence in females which rose 6.3-fold, from 0.4 to 2.5/100,000 females, compared with a 2.3 fold increase in males. This increase was accompanied by a decline in the male-to female ratio, from 15.0 to 4.9. Of the 68 males, 45 named women as their sexual contacts. Females were 2.4 times more likely to present with early latent disease, whereas males were 7.0 times more likely to present with primary disease (p less than 0.01). There was clustering in suburban locations with regard to clinical presentation (60% primary disease) and overall incidence (46% of all cases). These data suggest the occurrence of a major change in the epidemiology of syphilis in the province of Manitoba, with a shift from homosexual to heterosexual transmission. PMID- 3812434 TI - An educational intervention for altering water-sanitation behaviors to reduce childhood diarrhea in urban Bangladesh. I. Application of the case-control method for development of an intervention. AB - A case-control study was performed to develop an empirically based intervention for improving water-sanitation practices and rates of childhood diarrhea among families residing in urban Bangladesh. For three months fortnightly, histories of diarrhea were taken for all children under six years of age among 1,350 families to estimate age-specific rates of diarrhea in the population. A total of 247 randomly sampled families, termed sentinel families, were visited once during the study for prolonged observations of water-sanitation practices. Behaviors potentially affecting incidence of diarrhea were compared in a case group (n = 45), defined as sentinel families whose children had rates at least 1.7 times the rates expected for similarly aged children, and in a control group (n = 53), defined as sentinel families without any episodes of childhood diarrhea during the period of observation. Three practices differentiated the two groups: more control (82%) than case (53%) mothers who were observed to prepare food washed their hands before beginning the preparation (p less than 0.01); fewer control families (33%) than case families (80%) had ambulatory children who, when observed to defecate, did so in the family's living area (p less than 0.01); and fewer control (30%) than case (47%) families had children who were observed to place garbage or waste products in their mouth (p less than 0.10). Focus on these three empiric associations enabled the design of a community-specific educational intervention which is simple in construction and based upon naturally occurring, financially feasible, salutory practices. PMID- 3812435 TI - An educational intervention for altering water-sanitation behaviors to reduce childhood diarrhea in urban Bangladesh. II. A randomized trial to assess the impact of the intervention on hygienic behaviors and rates of diarrhea. AB - An educational intervention was designed to improve three water-sanitation behaviors empirically shown to be associated with high rates of childhood diarrhea in Dhaka, Bangladesh: lack of handwashing before preparing food, open defecation by children in the family compound, and inattention to proper disposal of garbage and feces, increasing the opportunity for young children to place waste products in their mouth. Fifty-one communities, each comprising 38 families, were randomized either to receive (n = 25) or not to receive (n = 26) the intervention. During the six months after the intervention, the rate of diarrhea (per 100 person-weeks) in children under six years of age was 4.3 in the intervention communities and 5.8 in the control communities (26% protective efficacy; p less than 0.0001). A corresponding improvement in handwashing practices before preparing food was noted, although no improvement was observed for defecation and waste disposal practices. These data suggest that educational interventions for water-sanitation practices can have an important beneficial effect upon childhood diarrhea in developing countries, particularly when the interventions are designed in a simple way to promote naturally occurring salutory behaviors that are empirically associated with lower rates of childhood diarrhea. PMID- 3812436 TI - Risk factors for coronary heart disease in adult female twins. Genetic heritability and shared environmental influences. AB - The contributions of shared genes and shared environments to familial aggregation of coronary heart disease risk factors were investigated by genetic and epidemiologic analysis of 434 adult female twin pairs from the Kaiser-Permanente Twin Registry in Oakland, California, during 1978 and 1979. Initial estimates of genetic heritability were statistically significant for serum levels of high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and Quetelet index, but were only marginally significant for systolic and diastolic blood pressures. These estimates were biased, however, because sisters in the same identical twin pair were more similar than sisters in the same fraternal twin pair not only with respect to shared genes but also with respect to shared environmental and behavioral influences. Heritability was estimated again after adjusting for shared environmental and behavioral effects by multiple regression analysis. Genetic heritability remained significant for HDL cholesterol (0.66), LDL cholesterol (0.88), triglycerides (0.53), and relative weight (0.55) but not for systolic (0.42) and diastolic (0.25) blood pressures. The strong genetic components of the levels of LDL cholesterol, HDL cholesterol, and relative weight may in part explain why some women have high levels of these coronary disease risk factors despite following recommended health behaviors. PMID- 3812437 TI - Coding ordinal independent variables in multiple regression analyses. AB - The authors present a coding scheme for ordinal independent variables which may be used in various forms of regression analysis. The scheme is useful in dose response analyses, when the objective is to identify contrasts in the dependent (or response) variable between successive levels of the independent variable, or to identify critical threshold values of the independent variables at which significant changes occur in the response. An example is given of evaluating the survival of lung cancer patients according to their stage of symptomatology. The authors discuss the interpretation of the regression coefficients when this coding scheme is used with linear regression, logistic regression, or in the proportional hazards regression model. PMID- 3812438 TI - Attributable risk ratio estimation from matched-pairs case-control data. AB - Explicit formulas are provided for estimating the attributable risk ratio among the exposed and the entire target population utilizing matched-pairs data. Large sample standard errors and corresponding confidence intervals are provided. These estimates can be obtained from the cross-classification frequencies of matched pairs by disease and exposure status in the usual 2 X 2 table. The key to the development of these formulas lies in recognizing that attributable risk among the exposed is a direct function of the odds ratio, and population attributable risk is a direct function of the odds ratio and exposure prevalence among only the cases (assuming a rare disease). The formulas presented in this paper require only a calculator for computation. The methodology is illustrated with data from a matched-pairs case-control study of oral conjugated estrogens and endometrial cancer. PMID- 3812439 TI - Difficult-to-recruit respondents and their effect on prevalence estimates in an epidemiologic survey. AB - Generous contact efforts were used to recruit 3,004 respondents into the first wave of the St. Louis Epidemiologic Catchment Area (ECA) project, a psychiatric epidemiologic study of the general population, conducted from 1981-1982. These efforts were analyzed to establish which sociodemographic characteristics or current psychiatric disorders were determinants of difficulty in recruitment. Being young, male, black, a nonrural resident, educated, and full-time employed were the demographic characteristics associated with increased contact efforts. Persons currently meeting criteria for an alcohol disorder required almost 20% more contact attempts than those without the disorder; this difficulty lay both in their being less available for an initial contact and refusing at a higher rate once contacted. An optimal recruitment effort cutoff point is provided, and a method is suggested for detecting that optimal point in the course of ongoing studies. PMID- 3812440 TI - Epidemiologic programs for computers and calculators. Exact binomial confidence intervals for the relative risk in follow-up studies with sparsely stratified incidence density data. AB - The authors present a computer program for hypothesis testing and calculation of exact binomial confidence intervals for the adjusted relative risk in follow-up studies involving multiple strata with incidence density (person-time) denominators and small or zero person-count numerators. The program is an extension to multiple tables of a single-table method by Rothman and Boice (NIH publication no. 79-1649, Washington, DC: US GPO, 1979) and represents a counterpart for person-time denominators to the program of Thomas (Comput Biomed Res 1975;8:423-46) for exact analysis of multiple tables with person-count denominators. Comparisons with asymptotic analyses of real and simulated data are given. Copies of the program are available from the authors on request. PMID- 3812441 TI - Re: Smallest detectable relative risk with multiple controls per case. PMID- 3812442 TI - Re: "A psychiatric epidemiologic study of occupational lead exposure". PMID- 3812443 TI - Re: "The fallacy of employing standardized regression coefficients and correlations as measures of effect". PMID- 3812444 TI - Re: "Immune responses to hepatitis B virus and tuberculosis infections in Southeast Asian refugees". PMID- 3812445 TI - Diet and lung cancer risk: findings from the Western New York Diet Study. AB - This study compares the diets of 450 lung cancer cases (296 males, 154 females) with those of 902 controls (587 males, 315 females). Cases were lung cancer patients diagnosed between August 1980 and July 1984 in three western New York counties, while controls were selected from the general population of these same counties. Usual diet was estimated by detailed interviews using a modified food frequency method. Case-control comparisons were made for dietary fat, protein, fiber, calories, cholesterol, and vitamins A, C, and E according to quartiles of intake, adjusting for age and pack-years of cigarettes by multiple logistic regression. Risk was lower for males in the lowest quartile of total dietary fat intake compared with those in the highest quartile (relative risk = 0.5), although the overall trend in the association with dietary fat was not statistically significant (p = 0.12). Likewise, there was a weak, but not statistically significant, direct association between dietary cholesterol and lung cancer in men (p = 0.17). The intake of vitamin A from fruits and vegetables (carotene) was much more strongly associated with reduced cancer risk. For males, the relative risks by quartiles (lowest intake to highest intake) were 1.8, 1.8, 1.0, 1.0 (p for trend = 0.001). For females, this relation was considerably weaker, and was not statistically significant. These findings are generally in agreement with those of several previous studies. The risk reduction associated with vitamin A from fruits and vegetables (carotene) was most evident for males, for those with squamous cell cancers, for light or ex-smokers, and for those over 60 years of age. PMID- 3812446 TI - Centralized obesity and cardiovascular disease risk in Mexican Americans. AB - The association between body fat distribution patterns and cardiovascular disease risk variables (high density lipoprotein (HDL) cholesterol, total cholesterol, diastolic and systolic blood pressures, and fasting blood glucose levels) was sought in a sample of Mexican American adults who were studied during 1981-1983 in Starr County, Texas. In the sample, all diabetics were excluded to see whether centralized obesity carried any risk for cardiovascular disease independent of diabetes. A component of centralized body fat distribution was identified through the use of principal components analysis of five skinfold measurements, which included the upper and lower extremities and trunk areas. The centralized obese were compared with generalized (peripheral) obese and nonobese controls in four subgroups of the population: younger and older adult males and females. The means of all cardiovascular risk variables were in a direction indicating that the centralized obese were significantly at greater risk than nonobese controls (in particular, HDL cholesterol, total cholesterol, and blood glucose levels). The generalized obese differed from the centralized obese in having significantly lower blood glucose levels, and tended to be intermediate between centralized obese and nonobese controls in the other variables. The data confirm that centralized obesity as defined by a linear combination of skinfold measures works in the same way as the waist-to-hip circumference ratio in describing a body build factor which heightens the risk of cardiovascular disease in the obese independent of the clinical diabetic state. PMID- 3812447 TI - The prevalence and correlates of Rose Questionnaire angina among women and men in the Lipid Research Clinics Program Prevalence Study population. AB - The prevalence and correlates of Rose Questionnaire angina were investigated in a sample of 4,661 white woman and men aged 30 years and above who participated in the Lipid Research Clinics Program Prevalence Study 1972-1976. Among men, the prevalence of Rose angina increased with age from about 1% to 12%, while the prevalence among women ranged from about 3% to 6%. Young women compared with men also had a relatively high prevalence of dyspnea, which was strongly correlated with Rose angina in both sexes. For women and men younger than 50 years, the dyspnea-Rose angina odds ratio was about 6 (p less than 0.001), while older women and men had somewhat lower sand higher odds ratios, respectively. Major and minor resting electrocardiographic abnormalities and self-reported history of a heart attack were not significantly associated with Rose angina among young participants of either sex, but they did show positive associations among older participants with the exception of minor electrocardiographic abnormalities in men. A logistic regression analysis revealed a strong inverse association between high density lipoprotein cholesterol and Rose angina in both sexes. Because mortality studies consistently show an excess of coronary heart disease death among young men compared with women, the female excess of Rose angina at young ages suggests that the grouping of angina and myocardial infarction into a single endpoint in cardiovascular disease studies may be more appropriate for young men than for young women. PMID- 3812448 TI - Long-term risk of hysterectomy after tubal sterilization. AB - Previous studies with only short-term follow-up have produced conflicting results on whether a tubal ligation increases a woman's risk for having a hysterectomy. By use of population-based data from the province of Manitoba's universal health insurance plan, all women aged 25-44 years who had a tubal ligation in 1974 (n = 4,374) were identified. As a comparison group, a random sample of 10,000 Manitoba women who were registered with the insurance plan on July 1, 1974 was chosen. Women undergoing hysterectomy prior to July 1, 1974 or a tubal ligation from 1970 1982 were excluded, leaving 6,835 in the comparison group. All health care utilization for two years before tubal ligation or July 1, 1974 (comparison group) was recorded to identify health characteristics of the women. Information was recorded on rate of hysterectomy, dilatation and curettage, all hospitalization, and hospitalization for menstrual disorders for two years after tubal ligation or July 1, 1974. For the longer term analysis, information on hysterectomy up to December 31, 1982 was recorded. At two years there was no increase in adverse gynecologic outcomes between the two groups. Survival curves (life table method) comparing the two groups for up to nine years found higher hysterectomy rates for women aged 25-29 beginning at two years after tubal ligation and increasing with time. Multivariate analysis (Cox's regression model) confirmed that for women aged 25-29, tubal ligation increased the probability of a hysterectomy 1.6 times (1.2-2.3, 95% confidence interval) after controlling for previous gynecologic history, marital status, number of physician visits, and hospitalizations. For women aged 30 and over, tubal ligation was not a risk factor for subsequent hysterectomy in either the short or long term. PMID- 3812449 TI - Prevalence of Alzheimer's disease in a retirement community. AB - In a white, predominantly middle class southern California retirement community, 817 adults aged 65-99 years were evaluated in 1980-1982 in a study designed to assess prevalence of early Alzheimer-type senile dementia. Based on 162 neurologically diagnosed cases, the age- and sex-adjusted prevalence of Alzheimer's disease in the target population was 15.3% (95% confidence interval = 13.0-17.5) among persons aged 65+ years and 35.8% among persons aged 80+ years. Age-adjusted correction for false negatives not detected by a screening procedure yields an estimated prevalence of 16.4% in persons aged 65+ years. Validity of the diagnostic approach was confirmed by a follow-up study. These rates far exceed past prevalence estimates for this disease. Since prevalence of mid- or later stages of Alzheimer's disease may have been underestimated, the high rates in this study may reflect a considerable community burden of early disease. Observed prevalence of Alzheimer-type senile dementia was higher among men than women after adjustment for age, 19.1% and 13.1%, respectively. The female predominance reported in many past clinical surveys may be peculiar to late disease and reflect care-seeking and care-utilization behaviors, rather than differences in incidence. PMID- 3812450 TI - Nonspecific inflammatory bowel disease and smoking. AB - The authors assessed the relation between cigarette smoking and nonspecific inflammatory bowel disease in a case-control study of 124 cases of ulcerative colitis, 109 cases of Crohn's disease, and 250 age- and sex-matched control subjects in hospital for acute nongastric or intestinal conditions unrelated to smoking. For ulcerative colitis, the risk for current smoking compared with never smoking was 0.5, with a 95% confidence interval (Cl) of 0.3-1.0. They observed decreasing risk with increasing number of cigarettes smoked. The risk for ex smokers, however, was greater than that for never smokers (relative risk = 2.7; 95% Cl = 1.5-4.9). The elevated risk of ulcerative colitis in ex-smoking in the presence of an overall lack of association with ever-smoking may plausibly be attributed to either 1) brief induction time of a protective effect of smoking on ulcerative colitis or 2) selective cessation of smoking due perhaps to very early symptoms of the disease. If time at first onset of bowel symptoms, instead of clinical diagnosis, is considered as the index date, the negative association between ulcerative colitis and current smoking would have weakened in men and disappeared in the overall series. There was clear evidence of a positive association between cigarette smoking and Crohn's disease (relative risk for ever smokers vs. never smokers = 4.0; 95% Cl = 2.2-7.3). The risk estimates increased with the number of cigarettes smoked per day and duration of habit. The association between current smoking and Crohn's disease was even stronger when age at first onset of bowel symptoms was considered as the index date, but the risk for ex-smokers fell below unity. PMID- 3812451 TI - Inbreeding and prereproductive mortality in the Old Order Amish. I. Genealogic epidemiology of inbreeding. AB - Epidemiologic patterns of inbreeding in the Old Order Amish were investigated using a unique genealogic registry of Lancaster County, Pennsylvania, Amish that contains information on 8,163 marriages, dating back to the time of the pioneer migrants in the 1700s and spanning more than 10 generations. The kinship coefficient for each marriage was computed using the path method of tracing common ancestors in the multigenerational pedigrees. Because of extensive genealogic connections, mean kinship coefficients and the proportion of related marriages have increased significantly over time, from 0.004 and 37%, respectively, for marriages before 1850 to 0.012 and 98%, respectively, for marriages after 1950. Demographic factors related to higher kinship levels include young age at marriage, large sibship size for both husband and wife, husband being a farmer, and marriages occurring in the marriage season (November or December). The rise in inbreeding levels in the Amish over time can be uniquely contrasted with the decline in inbreeding in most areas of the world. Furthermore, because some of the demographic factors related to high inbreeding levels may be associated with levels of mortality, such factors have to be taken into account when studying the effects of inbreeding on mortality in the Amish. This study uses an epidemiologic approach to the evaluation of inbreeding patterns in a population over time. PMID- 3812452 TI - Inbreeding and prereproductive mortality in the Old Order Amish. II. Genealogic epidemiology of prereproductive mortality. AB - The effects of offspring and parental inbreeding on prereproductive mortality (death before age 20 years) in the historical population of the Lancaster County, Pennsylvania, Old Order Amish were investigated using the Amish genealogic registry, which contains information on 42,465 births dating to the time of the pioneer migrants in the 1700s. Inbreeding coefficients for offspring and parents were computed using the path method of tracing common ancestors in the multigenerational pedigrees. In this population, prereproductive mortality declined from about 15% in the late 1800s to about 5% after 1930. Offspring inbreeding was found to be an independent predictor of prereproductive mortality after multivariate adjustment for demographic risk factors for mortality. Moreover, the higher the coefficient, the higher the relative risk of prereproductive death, and the higher the risk of multiple deaths in the same sibship. There was no evidence of declining inbreeding effects over 10 generations of continuous inbreeding, nor of any significant parental inbreeding effects. Because of the high levels of inbreeding, it could be shown that inbreeding accounts for about 40% of all prereproductive deaths in the present population. Genetic load analysis showed an average of about 1.7 lethal equivalents and a mostly mutational load. PMID- 3812453 TI - Inbreeding and prereproductive mortality in the Old Order Amish. III. Direct and indirect effects of inbreeding. AB - Direct and indirect (mediated by biologic factors) effects of inbreeding on prereproductive mortality (death before age 20 years) were investigated in a case control study conducted in the Lancaster County, Pennsylvania, Old Order Amish. A total of 211 cases of prereproductive death between 1969 and 1980 and 213 live controls were compared for differences in inbreeding coefficients, congenital malformations, birth weight, gestational age, birth complications, and other demographic factors, obtained by linking cases and controls to vital records and the Amish genealogic registry dating back to the 1700s. Inbreeding coefficients (F) for cases and controls were computed using the path method of tracing common ancestors in the multigenerational pedigrees. Close inbreeding (F greater than or equal to 1/64) was a significant risk factor for prereproductive mortality; odds ratio = 1.55. Using the log-linear model, the effect of close inbreeding on mortality was found to be mediated by three indirect casual mechanisms: Regardless of case-control status, inbreeding was significantly related to congenital malformations (recorded at birth), intrauterine growth retardation (birth weight less than 10th percentile for gestational age), and the occurrence of other deaths in the sibship. In turn, each of these factors was independently related to mortality regardless of inbreeding. No significant direct effect of inbreeding remained after adjustment for these factors. There were no effects of inbreeding on prematurity (less than 37 weeks), or birth complications. This study suggests that inbreeding increases the risk of prereproductive mortality by increasing the risk of intrauterine growth retardation and congenital malformations but not prematurity. The log-linear model provides a useful approach to the analysis of direct and indirect risk factors using biologic mechanisms. PMID- 3812454 TI - Childbirth research data: medical records or women's reports? AB - Medical records and women's reports were compared as sources of data for childbirth research. Three weeks after they had given birth in 1982 at five teaching hospitals in Sydney, Australia, 397 low-risk primiparous women in a random sample were interviewed about their birth experiences. The women's reports were compared with data from their medical records. Error sources in data collection were identified at four points: from the actual event to hospital recording, in the abstraction of data from medical records, in women's memory of the actual events, and in women's reporting of their encoded information. Both corrected data sources were accurate for most major variables. It is concluded that both data sources are subject to variation from the actual events they represent and that the assumption that medical records are always more accurate and acceptable is not supported. PMID- 3812455 TI - Hepatitis B virus transmission in nursery schools. AB - To determine whether transmission of hepatitis B virus occurs among children in nursery schools, from 1979 to 1982, 269 children (mean age 2.9 +/- 1.4 years) attending five nursery schools in which there were hepatitis B surface antigen (HBsAg) carrier children were tested for hepatitis B markers. Fifteen children (5.6%) were positive for HBsAg. Ten were possibly infected with hepatitis B in nursery school by HBsAg carrier children with hepatitis B e antigen (HBeAg). Four became HBsAg carriers and six developed transient antigenemia. Three other children were positive for the immunoglobulin M class of antibody to hepatitis B core antigen but negative for HBsAg. It is possible that they too were infected with hepatitis B in schools. These observations indicate that hepatitis B transmission most probably occurs among children in nursery schools in which there are HBsAg carriers with HBeAg, and therefore vaccination of susceptible children is necessary. PMID- 3812456 TI - Possible association of mycoplasma and viral respiratory infections with bacterial meningitis. AB - The presence of viral infection was evaluated in 160 children older than three months with bacterial meningitis who were admitted to Children's Medical Center or Parkland Memorial Hospital, Dallas, TX, between October 1979 and March 1982. Results were compared with a single serologic specimen in 138 children without meningitis. A recent history of upper respiratory infection was obtained from 60% of patients, including 10/13 with pneumococcal, 9/16 with meningococcal, and 77/131 with Haemophilus influenzae meningitis. Viral infection was documented by serologic response (23.8%) or viral isolation (13.2%) in 63/160 (40%) of patients with meningitis. There were 23 positive cultures (one patient with both adenovirus and respiratory syncytial virus). Picornaviruses, including two rhinoviruses, were isolated from six of the 24 subjects without meningitis who had viral cultures. There were 69 serologic conversions in meningitis patients, with 12 patients converting to two organisms and four patients converting to three organisms. Viral diagnoses included: adenovirus, 32 children; respiratory syncytial virus, 14; influenza A, 8; influenza B, 4; parainfluenza (1, 2, and 3), 12; picornaviruses, 9; herpes simplex virus, 1; and cytomegalovirus, 1. Additionally, 6/15 seroconverted to Mycoplasma pneumoniae. The acute geometric mean serum antibody titers of meningitis patients were lower than those of the comparison group for adenovirus (3.5 vs. 6.6, p less than or equal to 0.001) and influenza B (1.2 vs. 1.6, p less than or equal to 0.05). Twenty nine of 131 patients with H. influenzae had evidence of recent adenovirus infection. Primary infection with adenoviruses and possibly influenza B or mycoplasma precedes development of bacterial meningitis in some patients and may be a predisposing factor. PMID- 3812457 TI - An outbreak of phototoxic dermatitis due to limes. AB - During the week beginning July 29, 1984, 12 children in a day camp in a suburb of Baltimore, Maryland, were noted to have skin eruptions consistent with phototoxic dermatitis. These eruptions were confined to the hands, wrists, and forearms, and appeared as discrete and confluent polymorphous patches and linear streaks. These eruptions were also macular, hyperpigmented, and nonpruritic. Clinical examination revealed that 97 (16%) of 622 children, seven (7%) of 104 counselors, and no adult staff members had a similar rash. Onsets of the rash ranged from July 19-August 11, with peak occurrence on July 25-27. All camp members were white. Sex did not vary significantly between those affected and not affected. The mean age (5.3 years) of affected children was significantly different from the mean age (6.9 years) of unaffected children (p less than 0.001). Attack rates for the eight camp units were highest in two units (57% and 74%, respectively) and ranged between 0-6% for the other six units. Activities involving work with hands by various camp units were investigated. Only exposure to making pomander balls (sachets) in arts and crafts class (when other activities were controlled for) was significantly associated with illness (p less than 0.03). In making pomander balls, children punctured the skin of limes (the principal component) with scissors, releasing oils known to contain photoreactive furocoumarin (psoralen) compounds. These compounds evidently coated the children's skin and, upon exposure to the sun, caused a phototoxic dermatitis. An environmental and botanical survey of the camp did not reveal other phototoxic agents with which campers may have had contact. This is one of the largest reported outbreaks of phototoxic dermatitis and the first in which a citrus fruit was implicated on a large scale. PMID- 3812458 TI - Use of the logistic regression model for the analysis of proportionate mortality data. AB - A new statistical analysis strategy for proportionate mortality data is proposed. It is assumed that the occupational exposure, if it has an effect on mortality, increases the rate of death for some subset of causes by a multiplicative factor while not affecting the rates for the remaining causes of death. The unconditional logistic regression model is shown to provide a structure for the data analysis, with one of the predictors being the logit of the probability in the reference population that death was due to the affected causes. Using this model, one can estimate the effect of exposure while simultaneously controlling for a number of potential confounding and selection variables. Also, this model avoids the problems of comparing standardized proportionate mortality ratios, which are indirectly standardized measures. The model is demonstrated on a set of proportionate mortality data for factory workers from the northeastern United States. PMID- 3812459 TI - Analysis of proportionate mortality data using logistic regression models. AB - When only proportionate mortality data are available to an investigator studying the effect of an exposure on a particular cause of death, controls must be selected from among persons dying of other causes believed to be uninfluenced by the exposure under study. When qualitative or quantitative estimates of exposure history can be obtained for the deceased individuals, it is shown that one can use logistic regression models for the mortality odds to efficiently estimate the effect of exposure while controlling for relevant confounding factors by incorporating a priori information on baseline mortality rates available from US life tables. The proposed method is used to reanalyze data from a cohort of arsenic-exposed workers in a Montana copper smelter. PMID- 3812460 TI - Antibody survey for Inoue-Melnick virus infections in Osaka and Houston. AB - Neutralizing antibodies to the Inoue-Melnick virus were detected in healthy adults in Osaka and in Houston. For adults, the prevalence rate for the cross reacting type 3 virus was 13.8 per cent in Osaka and 29.1 per cent in Houston. Antibodies were also found in immune serum globulin prepared from American adults, but not in sera of Osaka children under 10 years of age. The Inoue Melnick virus isolates so far obtained in Houston could be classified into three antigenic types, but in Japan all have been type 1. Type 3 antibody tests detect all homotypic infections plus about 82 per cent of type 1 infections. Thus, the actual prevalence rates for type 1 infections in Japan are somewhat higher than those found with the type 3 assay, namely, about 14 per cent for young adults and 24 per cent for those over 50 years of age. Further studies are needed to elucidate the natural history of this virus infection. PMID- 3812461 TI - Asthma and cancer. PMID- 3812462 TI - Social factors influencing disease incidence. PMID- 3812463 TI - Re: "Effects of passive smoking on ischemic heart disease mortality of nonsmokers: a prospective study". PMID- 3812464 TI - Re: "Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa". PMID- 3812465 TI - Role of immune stimulation in the etiology of multiple myeloma: a case control study. AB - A hospital-based case-control study of 153 multiple myeloma (MM) cases and 459 controls was conducted to evaluate the hypothesis that chronic or frequent infections or allergic and autoimmune diseases might be of higher prevalence in individuals who develop MM. Information was obtained by direct interviews of subjects. Controls were matched to cases on age, sex, race, and hospital. "Immune stimulating conditions" included chronic infections such as pyelonephritis, urinary tract infections (UTIs), prostatitis, rheumatoid arthritis and other collagen vascular diseases, allergies, bronchitis, tuberculosis, cholecystitis, diverticulitis, and osteomyelitis. The overall odds ratio (OR) (odds of history of immune-stimulating conditions in cases versus controls) was 0.4 (95% confidence interval = 0.3-0.7) which suggested that cases had significantly less immune-stimulating conditions than did controls. The exposure rate for these conditions was high for cases (0.7) as well as for all control groups (0.8). These findings suggest that immune-stimulating conditions alone are not the causative factor in the etiology of MM, though they may play a role in the predisposed individual. PMID- 3812466 TI - Effects of zinc supplementation on linear growth in beta-thalassemia (a new approach). AB - Linear growth was evaluated in 32 patients with beta-thalassemia major. At the beginning of the study of 40.6% of the patients were below the 10th percentile with biochemical evidence of zinc deficiency. Effects of zinc supplementation on growth velocity (height) were assessed in a controlled manner. Twenty-one children received oral zinc sulphate for a period of 1 to 7 years (15 early- and 6 late-supplemented cases), while the remaining 11 thalassemics were maintained only on conventional transfusion therapy. The mean height velocity of early-zinc supplemented children was significantly greater than that of normal children (P less than 0.01). An increase in height was also observed in the patients who received delayed zinc retardation. The present study demonstrated that zinc deficiency is one of the factors responsible for retarded linear growth in beta thalassemia major. Only the patients who received zinc supplementation showed an acceleration of growth in height. Administration of zinc could, therefore, be considered as an effective adjuvant therapy in homozygous beta-thalassemia. PMID- 3812467 TI - Iron status of beta thalassemia carriers. AB - One hundred twenty-four relatives (aged 17-52 years) of 35 children with severe transfusion-dependent beta thalassemia major were investigated for their beta thalassemia carrier status (determined by Hb-A2 level) and iron status (determined by serum ferritin level). Forty-eight males had beta thalassemia trait (BTT) and 18 males did not have BTT (control); 41 females had BTT and 17 females did not have BTT (control). Serum ferritin levels (mean +/- SEM) of male BTT, male control, female BTT, and female control groups were 151.0 +/- 27.4, 59.6 +/- 16.3, 120.6 +/- 36.6, and 17.2 +/- 6.1 mcg/liter respectively; the differences between the two male and the two female groups were statistically significant (p = .05 and p less than .001). Iron deficiency (serum ferritin below 10.0 mcg/liter) was present in 6.3%, 38.9%, 24.4%, and 58.8% of male BTT, male control Female BTT, and female control groups, respectively; the differences between the two male and two female groups were statistically significant (p less than .01 and p less than .01). Serum ferritin was over 1,000 mcg/liter in four individuals with BTT (2 male and 2 female). Thus, the BTT group had better iron nutrition. This may suggest that the BTT group has an advantage in maintaining iron balance. PMID- 3812468 TI - An autoantibody with potent antithrombin activity whose action could be inhibited by toluidine blue or methylene blue. AB - A 41-year-old man with posthepatic liver cirrhosis and bleeding tendency was found to have a circulating anticoagulant with potent antithrombin activity. The thrombin time of the patient's purified fibrinogen was normal. This anticoagulant was residing in the patient's IgG fraction, and his IgG fraction could prolong the thrombin time of purified fibrinogen, suggesting that this circulating anticoagulant was an antibody. No heparin was detected in the patient's plasma. However, the antithrombin activity of this anticoagulant could be neutralized by toluidine blue or methylene blue ex vivo. PMID- 3812469 TI - Chronic sclerosing glomerulopathy (heroin-associated nephropathy) in intravenous T's and Blues abusers. AB - The intravenous (IV) use of pentazocine (Talwin) and tripelennamine (pyribenzamine) has become a major form of drug abuse seen in the midwestern United States. Complications of this abuse have included psychotic reactions, acute pulmonary insufficiency, convulsions, and various infections. We have observed three patients in whom the IV use of these agents was associated with the nephrotic syndrome and renal histopathologic findings similar to that reported in heroin addicts with the so-called "heroin-associated nephropathy." Percutaneous renal biopsy demonstrated focal to diffuse segmental or global glomerulosclerosis by light microscopy. Electron microscopy revealed glomerular visceral epithelial cell foot process effacement and microvillus formation. Immunofluorescent studies were negative in the two patients studied. One patient presented in renal failure, and two others progressed to renal failure within 3 years of diagnosis. We suggest the term opiate nephropathy for this lesion in narcotics users, indicating its potential occurrence in non-heroin-using drug addicts. PMID- 3812470 TI - Histopathologic evaluation of lupus patients with transient renal failure. AB - Patients with lupus nephritis and severe renal failure progress to end-stage renal disease despite aggressive therapy to suppress immunologic function. Within this group is a small subset presenting with rapid progression of renal failure and requiring dialytic support. We reviewed the clinicopathologic data of four such patients who were able to terminate dialysis after acute renal failure due to lupus nephritis. Three of these patients have remained independent of dialysis up to 4 years, and one patient returned to dialysis 1 month following discontinuation. Although glomerular pathology was variable in the four patients, a lesion common to all at presentation was acute tubular necrosis. It is suggested that tubular necrosis may cause reversible renal failure when part of the nephropathy of disseminated lupus treated with corticosteroids. PMID- 3812471 TI - Serum lipoprotein disturbances in primary and secondary hyperparathyroidism and effects of parathyroidectomy. AB - Serum lipoprotein disturbances were studied in 86 patients with primary (I), and 34 hemodialysis patients with severe secondary (II), hyperparathyroidism (HPTH) before and seven to 14 days after parathyroidectomy (PTx). In addition, a subset of patients had repeat studies more than 12 months after PTx. In patients with I as well as with II HPTH, mean +/- SEM fasting serum concentrations of total triglycerides (TG) (1.51 +/- 0.09 and 2.17 +/- 0.19 mmol/L, respectively) were significantly increased when compared with that of 22 age- and sex-matched healthy control subjects (1.01 +/- 0.09 mmol/L, P less than .001). No consistent anomalies of serum total cholesterol and lipoprotein cholesterol content were observed in Io HPTH patients. In uremic II HPTH patients, the cholesterol content of high-density lipoprotein (HDL) was significantly (P less than .01) depressed, compared with normal subjects. In the short term, PTx normalized serum total TGs (P less than .001) in Io HPTH patients from 1.50 +/- 0.11 to 1.19 +/- 0.07 mmol/L seven days after PTx. The surgical correction of II HPTH in dialysis patients was also followed by an improvement of hypertriglyceridemia from 2.22 +/- 0.21 to 1.46 +/- 0.08 mmol/L and 1.46 +/- 0.09 mmol/L seven and 14 days, respectively, after PTx (P less than .01). Long-term follow-up after PTx shows clearly a persistent decrease in serum TG concentration in I HPTH patients (1.17 +/- 0.11 mmol/L), as well as in II HPTH patients (1.61 +/- 0.18 mmol/L), 12 months after PTx by comparison with values determined before PTx.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812472 TI - Renal osteodystrophy in asymptomatic hemodialysis patients: evidence of a sex dependent distribution and predictive value of serum aluminum measurements. AB - Bone histologies and serum concentrations of calcium, phosphate, alkaline phosphatase, iPTH, 25 OHD, 1,25(OH)2D3, and aluminum were obtained from 113 chronically hemodialyzed patients free of symptoms and signs of renal osteodystrophy. All patients had a pathologic bone histology; in 69.0%, a mixed form with predominant osteitis fibrosa and concomitant osteoidosis. In 30.1%, we found pure hyperosteoidosis, nearly half of these cases showing osseous aluminum deposits. Hyperosteoidosis was much more frequent in women (35.7%) than in men (20.9%), although the prescribed intake of aluminum-containing phosphate binders was the same. It is possible that female hemodialysis patients were more prone to aluminum accumulation or that they had a better compliance in taking the aluminum hydroxide. Serum parameters alone were not very helpful in predicting the underlying bone disease. Mean iPTH concentrations tended to be lower in the patients with hyperosteoidosis than in those with the mixed lesion, but there was wide variation. Serum aluminum was only predictive for aluminum deposits in the bone when concentrations exceeded 100 micrograms/L. PMID- 3812473 TI - The influence of peritoneal catheter exit-site infections on peritonitis, tunnel infections, and catheter loss in patients on continuous ambulatory peritoneal dialysis. AB - The importance of exit-site infections (ESIs) as a source of peritonitis and catheter loss in continuous ambulatory peritoneal dialysis (CAPD) patients is unknown. We collected data on 137 CAPD patients over a 5-year period (2,052 cumulative patient months). Patients with a history of ESIs were more likely to have peritonitis and tunnel infections than patients without a history of ESIs. A larger percentage of patients with a history of ESIs lost catheters and transferred to hemodialysis than those without such a history, independent of the effect of peritonitis. These data confirm the importance of reducing the incidence of ESIs. More information is needed to determine the nature of the relationship between ESIs and peritonitis. PMID- 3812474 TI - Acute renal failure due to high-grade obstruction following therapy with epsilon aminocaproic acid. AB - An 18-year-old man with mild factor VIII deficiency developed hematuria and, subsequently, acute renal failure due to high-grade urinary obstruction by clots during therapy with cryoprecipitate, epsilon-aminocaproic acid, and acetazolamide administered for ocular trauma. Discontinuation of therapy with the latter two agents and induction of a brisk diuresis with intravenous (IV) fluid therapy resulted in return of renal function concomitant with spontaneous clot passage. A review of previous literature suggests that hemophiliacs may be more susceptible than nonhemophiliacs to high-grade urinary obstruction due to clot formation when epsilon-aminocaproic acid is administered during episodes of hematuria. Acute flank pain, fever, and delayed dense nephrograms on IV pyelogram are characteristic of the syndrome and distinguish it from other forms of acute renal failure associated with epsilon-aminocaproic acid. PMID- 3812475 TI - Dyazide-induced reversible acute renal failure associated with intracellular crystal deposition. AB - Acute interstitial nephritis due to Dyazide therapy, ie, a combination of hydrochlorothiazide (25 mg) and triamterene (50 mg), has been recently reported in the literature. This had been characterized by nonoliguric renal failure after a long latent period (weeks) following exposure to the drug. Pathologic data have indicated a drug-induced hypersensitivity reaction. We report here one case of oliguric acute renal failure after a massive Dyazide intoxication. Based on the results of the renal biopsy and clinical course, we propose that the oliguria was secondary to a direct toxic effect on the tubules, and intrarenal obstruction was secondary to triamterene crystals and crystal-laden cells. In addition, pathologic findings also suggested a moderate hypersensitivity reaction. After hemodialysis and short-term steroid therapy, the patient achieved complete recovery of renal function within 12 days. Recent knowledge of triamterene induced nephrolithiasis helps to explain the pathogenesis of acute renal failure in this patient, and is briefly reviewed here. PMID- 3812476 TI - Bone oxalate in a long-term hemodialysis patient who ingested high doses of vitamin C. AB - We performed a bone biopsy on a patient who had been receiving hemodialysis for 23 years. The bone had oxalate deposition. Previous bone biopsies had shown osteitis fibrosis without oxalate deposition. The osteoid area was increased (11% of bone area), as was the fibrosis (6.1% of tissue area) and aluminum deposition (38% of surface). Bone formation rate was normal (259 mu 2/mm2/d). We examined bone biopsies of 22 patients who had been receiving hemodialysis for over 10 years, and none had oxalate deposits. We discovered that our patient had been ingesting 2.6 g/d of vitamin C. The bone oxalate deposition may have been caused by the ingestion of high doses of vitamin C. PMID- 3812477 TI - Myocardial mucormycosis with emboli in a hemodialysis patient. AB - A 32-year-old man was found to have disseminated mucormycosis. Echocardiogram demonstrated bilateral ventricular thrombi, but there were no segmental wall motion abnormalities. At autopsy, it was found that these thrombi originated from a myocardial abscess and that death had been caused by septic embolization to the brain. The patient had been on maintenance hemodialysis for 9 years. Two transplants, 7 and 8 years previously, had been unsuccessful and had involved only 3 weeks of immunosuppressive treatment. No factor predisposing to fungal infection could be identified, with the possible exception of chronic uremia. PMID- 3812478 TI - Pseudotumor formation in polytetrafluoroethylene-dialysis fistulae. AB - We report two patients with formation of pseudotumors along a polytetrafluoroethylene (PTFE) graft used for dialysis access in chronic fistulae. We postulate a relationship with seroma formation, a known complication of PTFE vascular grafts used for dialysis purposes, possibly through lipolysis of the surrounding fat by a protein-rich exudate. PMID- 3812479 TI - Membranous nephropathy: a concern for malignancy. AB - Numerous authors have long felt that there is an association between malignancy and membranous glomerulonephritis. Most physicians have not noticed this association since the number of patients that they clinically observe is so low that such a relationship might not be obvious. The present study was undertaken to establish whether the relationship is real and to determine exactly how prevalent. Our results indicate the relationship definitely does exist, confirming studies that have shown a relationship based on positive staining for cancer antigens in kidney biopsy specimens. In addition, the study indicates that malignancy will become detectable within a relatively short period after the diagnosis of membranous glomerulonephritis, and that the malignancy rate is five times greater than the incidence in a baseline population. This risk is also highest in the elderly. PMID- 3812480 TI - Renal epithelial hyperplastic and neoplastic proliferation in autosomal dominant polycystic kidney disease. AB - The early v late occurrence of tubular epithelial hyperplasia and the frequency and malignant potential of renal neoplasms in autosomal dominant polycystic kidney disease (ADPKD) are controversial. The kidneys from 87 patients with documented or presumed ADPKD, removed at autopsy (n = 49) or prior to transplantation (n = 38), were thoroughly sectioned and examined. Hyperplastic polyps were found in 90.8% of the patients, even in the absence of renal insufficiency or marked renal enlargement. However, their number was significantly higher in the patients with advanced stages of the disease, and especially in those with a history of dialysis. Hyperplastic polyps were not detected in eight cases, seven of which had no evidence of epithelial hyperplasia, despite thorough examination of multiple sections. A total of 42 neoplasms were observed in 24.1% of the patients. One patient had bilateral low grade clear cell adenocarcinoma. Another patient had a transitional cell neoplasm. The remaining 39 neoplasms were microscopic adenomas. Neoplasms tended to occur more often in men and older patients. None of these neoplasms had been clinically diagnosed, and no metastasis had occurred. Nonneoplastic mass lesions were observed in two patients: one had malacoplakia and the other had xanthogranulomatous pyelonephritis. PMID- 3812481 TI - Immediate hemodynamic response to furosemide in patients undergoing chronic hemodialysis. AB - To evaluate the effect of furosemide on cardiovascular hemodynamics in patients with end-stage renal failure, we studied ten patients undergoing hemodialysis three times a week. Arterial pressure, heart rate, and cardiac output (indocyanine green dye) were measured in triplicate; total peripheral resistance and central blood volume were calculated by standard formulas. Hemodynamics were determined at baseline and 5, 10, 15, and 30 minutes after intravenous (IV) bolus injection of furosemide 60 mg. Furosemide produced a decrease in central blood volume of -13% +/- 2.2% from pretreatment values (P less than .01) that was most pronounced five minutes after injection, together with a fall in cardiac output (from 6.76 +/- 0.59 to 6.17 +/- 0.52 L/min, P less than .10). Stroke volume decreased with a maximum fall occurring after 15 minutes (from 84 +/- 7 to 79 +/- 7 mL/min, P less than .05), and total peripheral resistance increased (from 15.8 +/- 2.1 to 17.8 +/- 2.3 units, P less than .05) after furosemide. Arterial pressure and heart rate did not change. The decrease in central blood volume reflects a shift of the total blood volume from the cardiopulmonary circulation to the periphery, suggesting dilation of the peripheral venous bed. Thus, even in patients undergoing hemodialysis, furosemide acutely decreases left ventricular preload by venous dilation and should therefore prove to be beneficial in acute volume overload. PMID- 3812482 TI - Antifungal treatment of Candida peritonitis in continuous ambulatory peritoneal dialysis patients. AB - Nine peritonitis episodes caused by Candida sp were diagnosed in eight continuous ambulatory peritoneal dialysis (CAPD) patients. Treatment with intraperitoneal administration of amphotericin B and 5-fluorocytosine while the peritoneal catheter was left in situ was effective in six episodes in five patients. Of the three other patients, two started again with CAPD after peritonitis had been cured, but one patient preferred to stay on hemodialysis. In four episodes, peritoneal white cell counts remained high during treatment despite negative cultures. This was probably the result of irritation of the peritoneal membrane caused by the antifungal treatment, possibly by amphotericin B. Persistently elevated leukocyte counts during antifungal therapy, with or without signs and symptoms of peritonitis, are not necessarily an indication of treatment failure. PMID- 3812483 TI - Peritonitis, pancreatitis, and infected pseudocyst in a continuous ambulatory peritoneal dialysis patient. AB - Peritonitis, pancreatitis, and an infected pseudocyst or a lesser sac abscess occurred concurrently in a continuous ambulatory peritoneal dialysis (CAPD) patient. Lack of localizing signs and laboratory abnormalities and technical difficulties with sonography delayed definitive therapy. This case illustrates the complicated course that peritonitis may sometimes run in a CAPD patient. PMID- 3812484 TI - Gaucher disease: genetic heterogeneity within and among the subtypes detected by immunoblotting. AB - The genetic heterogeneity of Gaucher disease subtypes and variants was investigated by immunoblotting of fibroblast extracts. For these studies polyclonal and monoclonal antibodies were raised to acid beta-glucosidase preparations containing a single N-terminal amino acid sequence that was colinear with that encoded by the beta-Glc cDNAs. Three forms (Mr approximately equal to 67,000, 64,000-61,000, and 58,000) of cross-reacting immunologic material (CRIM) were observed in control individuals. Decreased amounts of the same CRIM forms were detected in most type 1 Gaucher disease patients, but single CRIM forms of variable molecular weight were observed in several non-Jewish type 1 variants. One or two CRIM forms of variable molecular weight were found in neuronopathic (type 2 and type 3) patients. The amount of CRIM was severely decreased in the majority of the type 2 and type 3 patients; one American black type 2 patient was CRIM negative. With this one exception, one CRIM form was detected in the cell free culture media from all normal or Gaucher disease fibroblasts that had an Mr approximately 2,000 greater than the highest respective intracellular molecular weight form. All intra- or extracellular CRIM forms were reduced to a single form after deglycosylation with N-Glycanase. In addition, the radioactivity from [3H]Br-conduritol B epoxide, a specific covalent inhibitor of beta-Glc, localized to the CRIM forms of beta-Glc on immunoblots. These results indicate that all subtypes and variants of Gaucher disease result from mutations that alter the stability and/or processing of beta-Glc. Furthermore, the heterogeneity of the CRIM patterns within and among the variants of Gaucher disease cause the diagnostic usefulness of immunoblotting to be restricted to those families in which the phenotype has been well established. PMID- 3812485 TI - A case of ataxia telangiectasia with unbalanced glucose 6-phosphate dehydrogenase mosaicism in the granulocytic/monocytic lineages. AB - Ataxia telangiectasia is a genetically determined disease with multi-system abnormalities and a high incidence of neoplasia. In order to define the nature of the association between ataxia telangiectasia and malignancy, we investigated a patient with the disease and heterozygote for the Mediterranean variant of the X linked marker glucose 6-phosphate dehydrogenase. Enzymatic mosaicism in hemopoietic and nonhemopoietic cells was evaluated with the 2-deoxy glucose 6 phosphate technique. While erythrocytes, platelets, and lymphocytes expressed the same double-enzyme phenotype as tissues of nonhemopoietic origin, granulocytes and monocytes expressed almost exclusively the Mediterranean-type enzyme. We suggest that, as the result of genetic instability at the hemopoietic stem-cell level, the granulocytic/monocytic progeny enjoyed a proliferative advantage and became the predominant clone. PMID- 3812486 TI - Hepatic methionine adenosyltransferase deficiency in a 31-year-old man. AB - A 31-year-old man with hepatic methionine adenosyltransferase (MAT) deficiency was evaluated for an odd odor to his breath. He had no other symptoms. Plasma methionine was 716 microM (normal, 15-40 microM), and plasma methionine-oxidation products were 460 microM (normal, 0). Hepatic MAT activity was 28% of normal. Unlike the control human enzyme, the patient's residual MAT activity was not stimulated by 10% dimethylsulfoxide and the velocity was not increased by high substrate concentration; at 1.0 mM methionine, the patient's MAT activity was only 7% of normal. These biochemical findings are consistent with a deficiency of the high-Km isoenzyme of MAT. Despite this enzyme deficiency, liver histology and clinical tests of hepatic and other organ function were normal. The patient, who is 25 years older than the oldest reported individual with MAT deficiency, provides evidence that partial MAT deficiency is a benign disorder and that chronic hypermethioninemia (less than 1 mM) is not by itself detrimental to health. PMID- 3812487 TI - Advances in asbestos disease research. A symposium. April 22, 1985, Tel Aviv, Israel. Proceedings. PMID- 3812488 TI - Public awareness of the problem of asbestos use in Israel. AB - Concern for occupational health problems in Israel became manifest in the 1930s with the establishment by Histadrut of a Division of Industrial Medicine. Public awareness of the health problems associated with the use of asbestos gradually increased in the 1970s. The history of the development of current programs is presented. PMID- 3812489 TI - Clinical findings among asbestos workers in U.S.: influence of cigarette smoking. AB - All members of a large union were invited to participate in a study of potentially adverse effects of asbestos exposure. Clinical findings among 1,117 workers (90% of those eligible for examination) are presented in this study. Cough was much less common among those without a history of cigarette smoking, although duration from onset of employment did not appreciably affect the prevalence of cough among the smokers. Rhonchi present among nonsmokers were limited in extent, but were marked and diffuse among cigarette smokers. Although dyspnea was as prevalent among nonsmokers as in smokers forty years and more after onset of exposure, it was relatively uncommon and found only among smokers when examined shortly after onset of exposure. Cigarette smoking had less influence on the prevalence of rales among asbestos workers; both smokers and nonsmokers showed this finding when examined 30 years and more after onset of asbestos exposure. Analysis of powerhouse work experience and mask use as possible confounders indicated no difference in prevalence of these characteristics between the smokers and nonsmokers. PMID- 3812490 TI - Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking. AB - A cohort of 1,117 asbestos insulation workers was established in 1963 and has been prospectively followed since then. Chest X-ray abnormalities detected at the initial medical examination, and interpreted according to the International Labour Office Classification of Radiographs of Pneumoconioses are reported in this paper. The prevalence of all radiographic abnormalities (pleural and pulmonary) increased with duration from onset of asbestos exposure. A positive smoking history was associated with a significantly higher prevalence of small irregular opacities indicating interstitial pulmonary fibrosis. Such an association was not found for pleural fibrosis. The possible mechanisms which underlie the effect of smoking on asbestos-induced interstitial fibrosis seem to be of much less importance in the development of pleural fibrosis. Progression of radiographic changes over the 20-year interval 1963-1983 will be separately reported as will the predictive significance of these changes. PMID- 3812491 TI - Smoking, morbidity, and pulmonary function in a group of ex-asbestos workers: a pilot study. AB - Thirty-three of 184 formerly exposed asbestos textile workers were interviewed to evaluate knowledge, attitudes, and practices concerning smoking and asbestos. Twenty-three subjects in this group also underwent physical examination to determine smoking-symptom/sign-pulmonary function interrelationships. Approximately half of the exworkers smoked, and the majority who had stopped did so mostly because of illness rather than because of knowledge concerning smoking asbestos hazards. All workers welcomed the offer of smoking cessation programs. Smokers and exsmokers, but not nonsmokers, were at risk for obstructive-type impairments, but all three groups contained subjects with impairments interpretable as restrictive. The presence of shortness of breath, cough, rales, or decreased breathing sounds alone or in any combination greatly increased the odds that either obstructive- or possible restrictive- or mixed-type impairments would be found on spirometry. Mass screening techniques required about one hour of person time per examinee to assess health status, provide educational material on smoking, and counsel workers on referral arrangements. The findings suggest that smoking alerts, smoking cessation clinics, and medical follow-up are needed, feasible, and acceptable in Israel. PMID- 3812492 TI - Use of asbestos in the Israeli Defense Forces. AB - The Israeli Defense Forces (IDF) have adopted the current standards for asbestos in the workplace (1 fiber/ml). Although average daily exposure to asbestos is relatively limited, nevertheless, the army personnel concerned are defined as "asbestos workers." Four main areas of asbestos use were monitored, and medical examinations of susceptible personnel were performed. Recommendations were suggested for improving conditions. The IDF is now in the process of eliminating the use of materials containing asbestos, with the aim of eliminating asbestos use in the IDF within a three-to five-year period. PMID- 3812493 TI - Comparative epidemiology of men exposed to asbestos and man-made mineral fibers. AB - Comparative analyses are presented of selected studies of long-term reactions to occupational exposures to asbestos and man-made mineral fibers (MMMF), with emphasis on studies with dose-response information and long enough period of follow-up to observe lung cancer excess, if it occurred. Uniform dose estimates based on average number of fibers per milliliter were derived and tabulated with the corresponding standard mortality (or morbidity) ratio (SMR), crude probability for each unfavorable outcome, and the likelihood that at least as many deaths would have occurred as a result of the expected numbers under Poisson assumptions. A dose-response relationship was said to have been indicated when the crude probability increased monotonically with dose and/or the Poisson probability decreased and reached a value of less than 0.05. Some arbitrary assumptions had to be made in estimation of the dose, and they may need to be corrected. Gravimetric dose estimates may have given different results. Studies selected for analysis included Quebec asbestos miners and asbestos cement workers exposed to asbestos, and pooled U.S. and European studies of MMMF workers, as well as a sample of cigarette-smoking fiberglass workers whose X-ray films were evaluated for fine nodular or irregular opacities. The lowest dose capable of showing either a statistically significant excess (single point criterion--SP) or the median dose in an apparent dose-response relationship with cause of death or radiological results is tabulated. Radiological changes show a dose-response relationship for all types, with a median dose for asbestos of 2.8 fibers/ml. For fiberglass workers, the median dose of electron-microscopically detected fibers was two orders of magnitude less. For asbestos SP, exposures of 1.4 to 22 fibers/ml were associated with increased lung cancer, while for mineral wool, the minimal level with significant SP increase in lung cancer was an order of magnitude less. Based on fiber or particle counts, man-made mineral fibers appear to be more potent than asbestos with regard to chronic pulmonary disease. PMID- 3812494 TI - Common problems in asbestos-related pulmonary diseases. AB - Exposure to asbestos is an important public health hazard in all industrialized societies. Although the pulmonary manifestations of prolonged asbestos fiber exposure are well known, there is considerable disagreement over specific clinical features and employment policies. Three of these controversies are the following: a) Can lung cancer be ascribed to asbestos exposure in subjects who lack evidence of asbestosis? b) Is there any clinical significance to benign asbestos pleural changes? c) Is it advisable to change jobs when evidence of asbestosis or benign pleural changes develop? The purpose of this presentation is to help develop a suitable public policy for Israel. Such a policy would have clinical importance as well as economic, legal, and social consequences for the individual and society as a whole. PMID- 3812495 TI - Advances in asbestos disease research. Common practical problems: panel discussion. PMID- 3812496 TI - A rapid and simple method of extracting asbestos bodies from lung tissue by cytocentrifugation. AB - During analyses of alkali digested lung tissue for asbestos bodies, we observed that the number of asbestos bodies in the discarded waste frequently exceeded the number in the filtered residue, the number reported in the standard diagnostic method. This observation led to the exploration of alternative techniques that would optimize the recovery of asbestos bodies. We describe a new, simple, and rapid method for extracting asbestos bodies from digested lung tissue using a cytocentrifuge, in which the waste extraction and filtration steps are eliminated. Samples of digested lung tissue are ready for light microscopy after 10 minutes of cytocentrifugation directly onto a glass slide. The standard method was compared with the cytocentrifuge technique using lung tissue from four asbestos-exposed workers and four controls with no known history of exposure. The number of asbestos bodies extracted by the centrifuge method was, on average, seven times higher than the number found with the standard method. A detailed quantitative study was made of the case that had the most asbestos bodies (comparison of the number of asbestos bodies counted in both "residue" and "waste", applying the filtration and cytocentrifuge methods). The number of asbestos bodies found in the discarded waste significantly exceeded the number in the "reportable" filtered residue. PMID- 3812497 TI - Bronchocarcinogenic properties of welding and thermal spraying fumes containing chromium in the rat. AB - The possible bronchocarcinogenic effects of fumes released during the shielded metal arc welding of stainless steel and the thermal spraying of chromium oxide (Cr2O3) have been studied on the rat. The fume particles were shown to contain tri- and hexavalent chromium in soluble and low soluble forms; they were collected and implanted as pellets in the bronchi of groups of 100 rats by the method of Laskin et al. A negative control group of 100 rats was included, as well as positive controls receiving pellets containing benz(a)pyrene. The experiment was continued for 34 months; no differences of biological significance were noted between the growth rates, survival times, and terminal organ weights of the test and negative control groups. At autopsy, the macroscopic and microscopic appearance of the organs in the three groups, including the local reaction to the implanted pellet, were similar. No precancerous changes were observed at the implantation sites; one rat, who received a pellet containing welding fumes, showed squamous cell carcinoma remote from the implantation site and not associated with the bronchus. It had the appearance of a metastasis. All three benz(a)pyrene control rats developed cancer at the implantation site. The occupational health implications of these findings are discussed. PMID- 3812498 TI - Chromium content of organs of chromate workers with lung cancer. AB - The content of chromium was measured in organs of six chromate workers who had worked in a chromate chemical manufacturing plant, had been exposed to a considerable amount of chromium for over 10 years, and had died of lung cancer. The chromium in the lungs of workers averaged 51.5 micrograms/g (range 24.8-210 micrograms/g), while levels in the lungs of non-exposed controls were 0.07-1.01 micrograms/g. Organs other than the lungs of the workers also had more chromium than those of the controls. Moreover, it was apparent that the metal remained in the lungs long after exposure to chromate had ceased. PMID- 3812499 TI - A cohort mortality study among cobalt and sodium workers in an electrochemical plant. AB - We have studied the mortality between 1950 and 1980 of a cohort of 1,143 workers in an electrochemical plant producing cobalt and sodium. The mortality of the whole cohort is significantly lower than in the French population for all causes of death (SMR = 0.77), and especially for deaths from circulatory system diseases (SMR = 0.59). However, among cobalt production workers, there is a relative over mortality, especially from lung cancers (SMR = 4.66, 4 cases). The relationship between cobalt production and lung cancer mortality was supported by a case control study nested in the cohort study. The authenticity of the occupational origin of this risk could not be established due to the low number of cases and because the role of tobacco consumption could not be taken into account. Other studies should be carried out in plants producing or using cobalt. PMID- 3812500 TI - Respiratory symptoms associated with the use of azodicarbonamide foaming agent in a plastics injection molding facility. AB - Respiratory health variables were studied cross-sectionally in 227 employees of a plastics molding facility where numerous complaints had been apparently associated with the use of azodicarbonamide foaming agent in injection molding. Pre- and postshift respiratory status measures and azodicarbonamide concentrations were also obtained for 17 employees. Cross-sectional pulmonary function differences by injection molding status were not observed. Modest decrements in pulmonary function measures were observed between start and end of shift but with no dose-effect relationship. A strong association was observed for injection molding workers for eye/nose/throat irritation, cough, and wheezing. Additionally, wheezing, chest tightness, and symptoms of chronic bronchitis were strongly associated with work in injection molding during periods in which azodicarbonamide was in use. These results suggest respiratory symptom causation by some combination of azodicarbonamide itself, reaction products of azodicarbonamide formed during injection molding, or other unidentified agents uniquely associated with the process of injection molding with azodicarbonamide foaming agent. PMID- 3812501 TI - Disguising decreases in prednisone dosage. PMID- 3812502 TI - Storage requirements for metronidazole injection. PMID- 3812503 TI - Antiarrhythmic or antidysrhythmic: which is correct? PMID- 3812504 TI - Availability of diethylcarbamazine citrate. PMID- 3812505 TI - Pharmacy 1986. PMID- 3812506 TI - Application of drug-use review principles to intravenous administration set use: a preliminary study. AB - A quantitative study of the use of intravenous administration sets in a 556-bed hospital was conducted as a first step in establishing a use-review program for administration sets. Central supply and pharmacy distribution points for i.v. administration sets were identified. Patient use of i.v. administration sets was recorded twice daily for seven-day periods on each of six patient-care units; data for all units were collected within a three-month period. Use of six common administration sets was studied. For each patient-care unit studied, the majority of sets used were of two of the six types; the specific set types differed by unit. More sets were used between the hours of 0801 and 2000. The number of sets per i.v. patient day (one patient receiving i.v. therapy on one day) was greatest in the intensive-care units. Through application of components of drug-use review, the numbers and types of i.v. administration sets used in various patient care areas were identified. PMID- 3812507 TI - Effect of use-criteria for intravenous administration sets. AB - Numbers of intravenous administration sets used were studied in a 480-bed hospital before and after criteria for selecting sets were implemented. Criteria for use of eight common administration sets were developed by a committee of nurses and pharmacists. Hospital drug-use review was used as a pattern. Baseline data were collected for seven-day periods on each of five patient-care units; twice daily, one pharmacist recorded the numbers of sets used and determined their compliance with the criteria, which had been established but not disseminated to nurses or implemented. After nurses were instructed on use of the criteria, data were collected for a second seven-day period on each unit. Use of each set type as a percentage of all sets and compliant use of each type as a percentage of all compliant use were calculated. Annual hospitalwide cost savings were predicted from the observed changes in use and the hospital's costs in the six-month period before the study. Significant changes occurred in overall use and in use of individual set types. For each set type, use compliant with the criteria increased. Notable changes included decreased use of volumetric chambers (burettes) and increased relative use of Y maxidrip and Y minidrip sets. Annual savings of more than +20,000 were predicted. Criteria for selection of i.v. administration sets had an effect on set use at this hospital. PMID- 3812508 TI - Effect of pharmacist interventions on drug therapy costs in a surgical intensive care unit. AB - The effect of interventions by a clinical pharmacist on the cost of drug therapy in a 14-bed surgical intensive-care unit (SICU) was evaluated. The SICU pharmacist provides both distributive and clinical services from a modified satellite pharmacy five days each week. During a 13-week study period that comprised 65 days, the pharmacist documented all interventions that resulted in a discontinuation of or change in drug therapy, all nonformulary-drug requests, the detection and avoidance of problems related to drug therapy, and the enrollment of patients in investigational drug studies (for which the pharmacy department received monetary remuneration). The effect of these interventions on the costs of drug therapy was calculated using drug acquisition costs and, for i.v. preparations, the cost of the i.v. fluid and the cost of preparing and checking the product. A total of 332 interventions during the study period represented $18,030 in potential cost avoidance, which would extrapolate to an annual cost avoidance of $72,122. The majority of interventions involved discontinuations of or changes in drug therapy, most often involving antimicrobials. This pharmacist had a positive impact on the cost of drug therapy in the SICU. PMID- 3812509 TI - Stability of intravenous admixtures of doxorubicin and vincristine. AB - The stability of doxorubicin and vincristine in admixtures containing both drugs in 0.9% sodium chloride injection, 0.45% sodium chloride and Ringer's acetate injection, and 0.45% sodium chloride and 2.5% dextrose injection was studied. Doxorubicin hydrochloride was added to 30-mL quantities of each base solution to achieve initial doxorubicin concentrations of 1.40 mg/mL and to 0.9% sodium chloride injection to achieve concentrations of 1.88 and 2.37 mg/mL. Vincristine sulfate was added to each doxorubicin admixture to achieve vincristine concentrations of 0.033 and 0.053 mg/mL. All admixtures were protected from light and stored in polysiloxan bags that are used with portable delivery devices. Admixtures were kept at temperatures of 25, 30, and 37 degrees C. Samples withdrawn immediately after preparation and at 1, 2, 4, 7, 10, and 14 days were analyzed by high-performance liquid chromatography for content of each drug. The stability of doxorubicin was dependent on temperature and composition of the base solution. Analysis of data from the samples containing 0.45% sodium chloride and Ringer's acetate injection showed that doxorubicin concentrations were less than 90% of the initial concentration by 12 hours at 37 degrees C, 35 hours at 30 degrees C, and 62 hours at 25 degrees C, and visual changes occurred in all of these admixtures over the course of the study. Vincristine degradation also was most rapid in 0.45% sodium chloride and Ringer's acetate admixtures. Data analysis showed that concentrations of vincristine were less than 90% of initial after eight days at 25 degrees C, five days at 30 degrees C, and three days at 37 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812510 TI - Stability of aqueous solutions of amoxicillin sodium in the frozen and liquid states. AB - The stability of aqueous admixtures of amoxicillin sodium in both the liquid and frozen (solid) states was studied. Admixtures of amoxicillin sodium were prepared in sterile water for injection to a theoretical concentration of 10 mg/mL. For each experimental run, 2-mL aliquots of the admixture were placed in stoppered glass volumetric flasks and stored at temperatures ranging from 19.5 degrees C to -30 degrees C; 16 flasks were stored at each temperature. After equilibration for approximately 20 minutes, duplicate flasks at each temperature were removed from storage conditions for time-zero assay. Subsequently, duplicate flasks were assayed at various times, depending on the storage temperature, for up to 13 days or until more than 80% of the drug had degraded. All samples were assayed at least in duplicate using high-performance liquid chromatography. When amoxicillin solutions were in the liquid state (at temperatures between 19.5 and 0 degrees C), the time required for the amoxicillin concentration to decrease to 90% of its initial value (t90) increased as temperature decreased. However, between 0 degree C and -7 degrees C, the t90 of frozen solutions decreased from two days to 1.08 hours. As temperature declined further, the rate of degradation decreased until the solution was completely frozen; at -30 degrees C, the t90 had increased to 13 days. Amoxicillin sodium is unstable in aqueous solutions stored between 0 degrees C and -20 degrees C. If admixtures of this drug are to be frozen for later use, the storage temperature should be below -30 degrees C. PMID- 3812511 TI - Supply of physicians. PMID- 3812512 TI - Medical management of cardiovascular, hypertensive, and metabolic diseases in the elderly. Proceedings of a symposium. March 14-16, 1986, Orlando, Florida. PMID- 3812513 TI - Familial dysalbuminemic hyperthyroxinemia associated with primary thyroid disease. AB - This study describes a family with intrinsic thyroid disease in addition to familial dysalbuminemic hyperthyroxinemia, a syndrome associated with euthyroidism and increased binding of thyroxine to serum albumin. The simultaneous occurrence of thyroid disease and elevated serum thyroxine concentrations due to familial dysalbuminemic hyperthyroxinemia may confound the diagnosis of the two concurrent disorders and the subsequent therapy of the thyroid disease. PMID- 3812514 TI - Vitamin D toxicity complicating the treatment of senile, postmenopausal, and glucocorticoid-induced osteoporosis. Four case reports and a critical commentary on the use of vitamin D in these disorders. AB - Hypervitaminosis D developed in four patients with osteoporosis or osteomalacia. All patients were given pharmacologic doses of vitamin D, had reduced baseline levels of renal function, and became hypercalcemic with acute renal failure. Measured 25-hydroxyvitamin D (25-OH D) levels were elevated in three patients; levels were not determined in a fourth patient who became normocalcemic when vitamin D therapy was discontinued. Published data on the use of vitamin D for prophylaxis or treatment of any form of osteoporosis fail to document benefits superior to those of calcium alone or calcium with estrogens and fluoride. Data on the use of 25-OH D show no greater benefit than for vitamin D. The use of 1,25 dihydroxyvitamin D (1,25-OH2 D) plus calcium may be superior to the use of calcium alone in some forms of osteoporosis. Vitamin D toxicity is associated with enhanced resorption of bone in some patients. Morbidity included extended hospitalization, dialysis, and chronic renal failure. Pharmacologic doses of vitamin D cannot be recommended for any form of osteoporosis. PMID- 3812515 TI - Renal cell carcinoma in von Hippel-Lindau syndrome. AB - Thirty-seven cases of von Hippel-Lindau syndrome are reported. The urinary tract was studied in 23 patients; 15 of them had the renal lesions. Eight of these 15 patients had renal cell carcinoma, which was bilateral in six. Because 80 percent of these patients are seen initially by neurologists or ophthalmologists, the potential for the development of renal cell carcinoma in these patients, the familial nature of the disorder, and the need for early urologic investigations and subsequent close follow-up are emphasized. PMID- 3812516 TI - Clinical utility of erythrocyte sedimentation rate and plasma protein analysis in the elderly. AB - The utilization and interpretation of the erythrocyte sedimentation rate in the elderly have been surrounded by controversy and confusion. To improve the understanding of the erythrocyte sedimentation rate and its determinants in the aged, a defined population of 111 ambulatory, retirement-home residents underwent thorough clinical and laboratory evaluation. Westergren erythrocyte sedimentation rate, Wintrobe erythrocyte sedimentation rate, and plasma viscosity measurements were all significantly correlated with one another as well as with plasma proteins, particularly fibrinogen and globulins. Age per se had no influence on the erythrocyte sedimentation rate in the study population. On the basis of standard upper limits of normal for younger populations, the Wintrobe sedimentation rate was most commonly abnormal and plasma viscosity least commonly abnormal. The "normal" upper limit of 20 mm/hour for Westergren sedimentation rate was also the optimal limit of normal by receiver operating characteristic analysis of the study population. Although the sensitivity of the Westergren sedimentation rate for the presence of an inflammatory condition or monoclonal gammopathy was only 0.55, the specificity was 0.96, and the positive predictive value of an elevated erythrocyte sedimentation rate being associated with a clinical disorder was 0.93. The enhanced clinical utility of the erythrocyte sedimentation rate in this population compared with other elderly populations may be due to a low prevalence of anemia and hypoalbuminemia. In such populations, the erythrocyte sedimentation rate may remain a useful clinical test, regardless of patient age. PMID- 3812517 TI - Non-Hodgkin's lymphomas: characteristics of long-term survivors following conservative treatment. AB - A most important set of prognostic factors for survival among 467 patients with non-Hodgkin's lymphoma receiving conservative treatment was determined statistically by the Cox proportional hazards model. Non-Hodgkin's lymphoma was diagnosed in these patients between 1958 and 1969. Initial biopsy material was classified according to the Working Formulation, and the Rappaport, Kiel, and Lukes-Collins systems. The Cox analysis identified a group of 37 patients with a median survival of 150 months. These patients had the following characteristics: small lymphocyte, plasmacytoid lymphocyte, small cleaved, large cleaved or non cleaved follicular center cell histologic subtype (Lukes-Collins); no bulky involvement of mesenteric nodes or critical organs--kidney, urinary tract, or pleura; stages I to III disease (78 percent stage I or IE); no B symptoms; age below 60 years; initial resection as a reflection of localized disease. Patients with advanced-stage non-Hodgkin's lymphoma receiving conservative treatment have a relatively short survival (median, less than five years) regardless of histologic subtype. PMID- 3812518 TI - [sic]kly speaking (with apologies to Edwin Newman). PMID- 3812519 TI - When people die. Cause of death versus time of death. AB - A sample of 4,920 disease-related deaths from New York City for 1979 (8.7 percent of all relevant data from New York City's files) showed a 60 percent rise in death rate beginning at 2 A.M. and reaching a peak at 8 A.M. A smaller peak was also noted at 6 P.M. The rise in human mortality beginning at 2 A.M. and peaking at 8 A.M. might be explained by: artifact of deaths occurring anytime during the night that are discovered after daybreak, effect of less efficient health care between 2 A.M. and 8 A.M., and disease processes that somehow increase risk of death between 2 A.M. and 8 A.M. An attempt was made to differentiate among these possibilities by comparing time of death for various subsamples. The bimodal pattern appeared only in the temporal distribution of deaths of persons over 65 years of age; deaths of persons under 65 did not show significant temporal concentration. There were also prominent differences in the distribution of deaths for different reported causes of death. Ischemic heart disease, which numerically accounted for over 50 percent of the sample, showed peak mortality at 8 A.M. for both males and females. Hypertensive disease showed a significant peak in mortality at 1 A.M. for females only. Cerebrovascular disease peaked significantly at 6 A.M. with a significant peak only for males. The age and disease specificity of the 2 A.M. to 8 A.M. rise in death is consistent with a disease-related explanation for the bimodal circadian pattern in mortality. The quality and efficiency of health care could be improved with more precise information on peak periods of risk for specific morbid conditions. PMID- 3812520 TI - Acute primary hyperparathyroidism. AB - Acute primary hyperparathyroidism is an unusual form of primary hyperparathyroidism characterized by life-threatening hypercalcemia. Forty-three cases reported in the literature since 1974 are reviewed, along with five new cases. The average age of the patients was 55 (27 to 82), with an even distribution between men and women. Marked hypercalcemia (17.5 +/- 2.1 mg/dl) was accompanied by parathyroid hormone levels 20 times normal. Virtually all patients had symptoms. Hyperparathyroid bone disease occurred in 53 percent of patients; even more (69 percent) had nephrolithiasis or nephrocalcinosis. Combined renal and skeletal involvement was seen in 50 percent. Only three deaths were recorded. The pathophysiology of the acute hyperparathyroid state is unknown but appears to consist of uncontrolled parathyroid hormone secretion followed by cycles of hypercalcemia, polyuria, dehydration, reduced renal function, and worsening hypercalcemia. These features of acute primary hyperparathyroidism are compared with the features reported in the literature antedating multichannel screening, and with the features of the common form of primary hyperparathyroidism. Clinical guidelines by which the diagnosis may be suspected are also reviewed. PMID- 3812521 TI - The ethics of randomized clinical trials. AB - Randomized clinical trials pose a number of fundamental ethical problems to which morally sensitive investigators must give careful consideration. The randomized double-blind clinical trial is ethically justified and the preferred method of demonstrating therapeutic effectiveness and safety. Alternate methods such as crossover and self-controlled designs, the use of historical controls, observational methods, and practitioner's clinical trials also exist and have their place in certain circumstances. The use of randomized double-blind clinical trials must assure adequate explanation of the research plan to the patient, the documentation of informed consent, adequate consideration of safety, and an acceptably low risk/benefit ratio. PMID- 3812522 TI - Evaluation of current criteria used to measure vitamin B12 levels. AB - Because of recent improvements in the serum vitamin B12 assay, literature criteria based on prior assay methods used in measuring B12 levels were evaluated. Of 1,708 B12 levels measured at Bellevue Hospital in a six-month period, 137 in 124 patients were below 200 pg/ml. Contrary to expectations, 81.6 percent of patients with low B12 levels had a mean corpuscular volume (MCV) below 95 fl. Literature-derived criteria missed 30 percent of patients with low B12 levels. Only three of 12 patients with megaloblastic bone marrow or an abnormal Schilling result had B12 levels that were low (below 100 pg/ml), and nine had values in an intermediate range (100 to 200 pg/ml). This suggests that the use of an MCV below 95 fl and a B12 level below 100 pg/ml as abnormal values may not detect clinically important B12 deficiency. PMID- 3812523 TI - An interview with Sir William Osler on the GPEP report. Interview by Steven L. Berk. PMID- 3812524 TI - The jaundiced view: riding the fences. PMID- 3812525 TI - Idiopathic fasting hypoglycemia in an adult. AB - A 73-year-old man with documented and persistent fasting hypoglycemia for at least 22 years underwent extensive study including percutaneous liver biopsy for measurement of selected enzymes. No known cause of fasting hypoglycemia could be found. This is believed to be the first reported case of "idiopathic" fasting hypoglycemia in an adult. At the present time, it is not possible to classify the cause of this patient's hypoglycemia due to incomplete understanding of the abnormalities of carbohydrate metabolism. PMID- 3812526 TI - Tumor-induced osteomalacia. Kinetics of calcium, phosphorus, and vitamin D metabolism and characteristics of bone histomorphometry. AB - A patient with a mesenchymal tumor and hypophosphatemic osteomalacia was studied before and after tumor excision. Initial laboratory values included normal serum calcium, decreased serum phosphorus and tubular reabsorption of phosphate, undetectable 1,25-dihydroxyvitamin D, and normal parathyroid hormone. Histomorphometry of a bone biopsy specimen showed evidence of increased osteoclastic bone resorption. By 16 hours after tumor removal, 1,25 dihydroxyvitamin D level had normalized, but serum phosphorus level was unchanged; at 28 hours, both serum phosphorus value and tubular reabsorption of phosphate were within normal limits. It is concluded that tumor removal is associated with rapid correction both of 1,25-dihydroxyvitamin D production and of renal phosphate wasting. Increased bone resorption suggests the production of an osteoclast activator by the tumor and may explain the typically normal serum calcium value in this disorder. PMID- 3812527 TI - Steroid-induced Kaposi's sarcoma in a patient with pre-AIDS. AB - Kaposi's sarcoma is known to occur in a variety of immunosuppressed patients. The course of the disease varies depending on the underlying risk factors. A male homosexual patient in whom Kaposi's sarcoma developed while he was being treated with prednisone for Henoch-Schonlein purpura is described. The resolution of his lesions once the steroid was discontinued places him in the group of patients whose main risk factor is the steroid itself, rather than the acquired immune deficiency syndrome (AIDS) risk group. A review of the literature on steroid treated patients in whom Kaposi's sarcoma developed is presented. PMID- 3812528 TI - Euthyroid pretibial myxedema. AB - Pretibial myxedema is typically associated with clinical hyperthyroidism, diffuse goiter, and ophthalmopathy in patients with Graves' disease. A case of biopsy proved pretibial myxedema was encountered in a clinically euthyroid woman who had neither diffuse goiter nor exophthalmos. Although serum total and free thyroxine hormone concentrations were normal, the thyroid-stimulating hormone response to thyrotropin-releasing hormone was absent. This case illustrates that pretibial myxedema may present without other more common manifestations of Graves' disease. In patients with suspect pretibial skin lesions, the thyrotropin-releasing hormone stimulation test may be required to establish the presence of subtle underlying thyroid gland autonomy and the diagnosis of euthyroid pretibial myxedema. PMID- 3812529 TI - Invasive trichophyton rubrum infection in an immunocompromised host. Case report and review of the literature. AB - Typically confined within the keratinized, epithelial layer of the skin and hence categorized among the dermatophytoses, Trichophyton rubrum infections usually present as superficial, scaling eruptions. In certain clinical settings, however, such as in immunosuppressed hosts, deep local invasion, multivisceral dissemination, and even death due to T. rubrum granulomas have been described. A case of multiple, subcutaneous, neutrophilic abscesses due to T. rubrum in an immunosuppressed renal allograft recipient is described. The pathogenesis, diagnosis, and immunology of invasive T. rubrum infections in immunocompromised hosts are reviewed. PMID- 3812530 TI - Holt-Oram syndrome with high myopia. A hitherto unreported association in a Chinese patient. AB - One member of a Chinese family with Holt-Oram syndrome also had high myopia, which is a hitherto unreported feature. The genetic background of this unusual association is discussed. PMID- 3812531 TI - Spontaneous relapse of naproxen-related nephrotic syndrome. AB - A number of nonsteroidal anti-inflammatory drugs cause nephrotoxicity characterized by nephrotic syndrome, usually with acute renal insufficiency. Remission of proteinuria and renal insufficiency after discontinuation of nonsteroidal anti-inflammatory drug therapy is characteristic. Relapse of nephrotic syndrome in the absence of nonsteroidal anti-inflammatory drug rechallenge has not previously been reported. Nephrotic syndrome developed in an 80-year-old woman taking naproxen, and remitted after discontinuation of the drug. Nephrotic syndrome relapsed four months later without re-exposure to naproxen or other nonsteroidal anti-inflammatory drugs. Renal biopsy at that time revealed minimal-change disease. The relationship between these two episodes of nephrotic syndrome is discussed with regard to possible pathogenetic mechanisms. PMID- 3812532 TI - Diabetes insipidus associated with dysplastic pancytopenia. AB - This case report describes a 60-year-old man who presented with a three-year history of generalized malaise, decreased libido, polyuria, and polydipsia. He had been previously investigated for pancytopenia, and found to have a hypoplastic bone marrow. A diagnosis of central diabetes insipidus was established; the patient was also found to have a number of other defects in his hypothalamic-pituitary function. Hematologic studies again revealed peripheral pancytopenia associated with a hypoplastic megaloblastic bone marrow. Computed axial and nuclear magnetic resonance tomography failed to establish the nature of the morphologic lesion in the hypothalamus. A possible relationship between the hematologic and endocrine disturbance is discussed. PMID- 3812533 TI - Sequential prolactin evaluation of a "cured" patient with recurrence of prolactinoma. AB - Several investigators have suggested that prolactin secretion in some subjects with hyperprolactinemia associated with pituitary macroadenomas may have a resistance to the prolactin inhibitory hormone, dopamine. This report describes a male subject with a prolactinoma whose preoperative evaluation demonstrated a resistance of prolactin release to inhibition by dopamine. Evaluation of prolactin secretion from monolayer culture of his tumor also revealed a resistance to inhibition by dopamine. Four months postoperatively, normal serum prolactin levels and a normal maximal inhibition of prolactin to a dopamine infusion of 0.04 microgram/kg/minute suggested surgical cure. However, a 24-hour prolactin sampling revealed blunted nocturnal augmentation of prolactin release, an early escape of inhibition of prolactin release at 150 minutes from a 0.04 microgram/kg/minute dopamine infusion, and abnormal prolactin response to a low dose (0.004 microgram/kg/minute) dopamine infusion. Hence, persistent abnormalities in prolactin secretory dynamics were noted with more extensive testing in this patient when he was thought to have been cured. One year postoperatively, the hyperprolactinemia recurred, prolactin release was markedly resistant to dopamine, and an abnormal 24-hour prolactin profile of release was present. Thus, resistance of prolactin secretion to inhibition by dopamine was present in this patient with a prolactinoma. Additionally, an abnormal prolactin response to dopamine was noted to precede the development of hyperprolactinemia with tumor recurrence. PMID- 3812534 TI - Polyuria and refractory hypernatremia after cardiopulmonary arrest. AB - A patient exhibited brain damage, polyuria, and refractory hypernatremia after myocardial infarction and cardiopulmonary arrest. Serum vasopressin levels were relatively fixed and inappropriately low for the elevated serum osmolality. Hypernatremia persisted despite administration of vasopressin; after vasopressin was discontinued, serum sodium value was corrected with small doses of furosemide and replacement of free water. In her case, impairment of osmotic homeostasis could not be attributed to either simple resetting or complete destruction of osmoreceptors; metabolic normalization required an unusual therapeutic approach. PMID- 3812535 TI - Use of charcoal hemoperfusion with sequential hemodialysis to reduce serum methotrexate levels in a patient with acute renal insufficiency. AB - Acute renal failure induced by methotrexate can be complicated by prolonged high serum levels of methotrexate, resulting in pancytopenia and severe mucositis. The role of dialysis in these patients has not been well elucidated. Serum methotrexate levels were successfully lowered in a patient with methotrexate induced acute renal failure by charcoal hemoperfusion and sequential hemodialysis. No rebound in serum methotrexate levels was observed after perfusion, a phenomenon previously reported as limiting the usefulness of this procedure. PMID- 3812536 TI - Echocardiographic features of mitral regurgitation due to ankylosing spondylitis. AB - A report of echocardiographic features of an extension of "subaortic bump" producing mitral regurgitation in a patient with ankylosing spondylitis and left sided bivalvular regurgitation is described for the first time. The anatomic and echocardiographic features of "subaortic bump," specifically found in patients with ankylosing spondylitis, have been previously reported. A review of the literature on ankylosing spondylitis and mitral regurgitation is discussed. PMID- 3812537 TI - Idiopathic retroperitoneal and mediastinal fibrosis mimicking connective tissue disease. AB - Combined retroperitoneal and mediastinal fibrosis is a rare manifestation of an idiopathic systemic sclerosing disease. This report describes a multisystem illness that clinically could best be described as polyserositis and progressive renal failure. Pathologically, it was characterized by diffuse infiltration of retroperitoneal and mediastinal tissues with plaquelike fibrofatty connective tissue encasing the kidneys, ureters, adrenal glands, and parietal pericardium. These features are diagnostic of a systemic sclerosing disease. It is important to recognize this unusual disorder to avoid confusion with other systemic connective tissue diseases such as systemic lupus erythematosus. PMID- 3812538 TI - Deferoxamine-enhanced fecal losses of aluminum and iron in a patient undergoing continuous ambulatory peritoneal dialysis. AB - Aluminum-associated osteomalacia and transfusion-induced hemosiderosis developed in an anephric patient receiving long-term maintenance treatment with continuous ambulatory peritoneal dialysis. Intravenous administration of 1.0 g of deferoxamine led to marked increases in the fecal elimination of aluminum and iron. Dialysate removal of these same metals also increased but to a lesser extent. This indicates that the biliary/fecal route of excretion may contribute significantly to deferoxamine-induced losses of aluminum and iron in patients undergoing continuous peritoneal dialysis. PMID- 3812539 TI - Massive hepatomegaly following splenectomy for myeloid metaplasia. Case report and review of the literature. AB - Massive compensatory hepatic myeloid metaplasia occurs infrequently after splenectomy for myeloid metaplasia, and it usually develops gradually over several years if it does occur. In this report, a patient is described in whom massive hepatomegaly and evidence of portal hypertension developed within three months of splenectomy. Early evidence for rapid hepatic growth was present at a second laparotomy three weeks after the first surgery, and probably should have triggered initiation of chemotherapy. Indications for splenectomy in these patients, surgical morbidity, and response to splenectomy are discussed. PMID- 3812540 TI - Conduction abnormalities complicating carbamazepine therapy. PMID- 3812541 TI - Severe salicylate intoxication mimicking septic shock. PMID- 3812542 TI - Reactive arthritis and psittacosis. PMID- 3812543 TI - Cyclosporine therapy of central nervous system sarcoidosis. PMID- 3812544 TI - Cocaine-associated myocardial ischemia. PMID- 3812545 TI - Carcinoma metastatic to the thyroid: prevalence and diagnosis by fine-needle aspiration cytology. AB - Although metastatic involvement of the thyroid is not commonly considered in the differential diagnosis of a patient with a thyroid mass, such involvement may be more frequent than has been previously appreciated. To evaluate the prevalence of this disorder, all patients with thyroid nodules referred in a 12-month period underwent fine-needle aspiration, regardless of history or scan results. Seventy patients were studied, six of whom had a previous history of malignant disease. Two of the latter had coincidental thyroid disease, but four (5.7% of the total series) had carcinoma metastatic to the thyroid gland. Two of these patients had had no evidence of malignancy for years prior to the appearance of the thyroid metastases. In one case, the metastasis was a functioning nodule. Fine-needle aspiration cytology provided prompt and accurate diagnosis in all patients. We conclude that metastatic carcinoma to the thyroid is not rare, its presentation may be confused with primary thyroid disease, and fine-needle aspiration cytology is the procedure of choice in such cases, and should be done early in the evaluation of all patients with thyroid nodules, regardless of the presumed etiology or function by scan. PMID- 3812546 TI - Adverse cardiovascular effects of anticholinesterase medications. AB - Anticholinesterase medications (anti-ChEs) play a significant role in the diagnosis and treatment of myasthenia gravis (MG). The primary effect on the heart produced by a surfeit of ACh is bradyarrhythmias with consequent fall in cardiac output and hypotension; yet, adverse cardiac reactions to these agents have been reported relatively infrequently. The authors describe 12 patients with MG from a pool of more than 1,000 who suffered hypotensive episodes related to use of anti-ChEs. The 12 patients (seven male, five female) had a mean age of 62.6 years; of these, eight adverse reactions occurred after edrophonium, two after neostigmine, and two after pyridostigmine. Seven patients had a recent increase in anti-ChEs and none had a decrease in dosage. Nine patients suffered either from severe sinus bradycardia, (20 beats/min), junctional bradycardia, or complete AV dissociation. Two patients had paradoxic sinus tachycardia and all had syncopal or near-syncopal episodes. Evidence for cholinergic stimulation of other organs was generally lacking. No recurrence appeared with reduction of the dose of anti-ChEs or discontinuation of the drug. The authors believe that these agents should be given with caution to patients with inflammatory, infiltrative, or degenerative disease of the conduction systems, patients being treated with digitalis, calcium-channel antagonists or beta blockers, patients with myocardial ischemia, and elderly patients. Appropriate resuscitative equipment should be readily available. PMID- 3812547 TI - Adult onset diabetes mellitus: glycemic control and family function. AB - To test the hypothesis that family function differs in patients according to their level of diabetes control, family function was assessed using the Family APGAR questionnaire in low-income patients with adult-onset diabetes who were under comprehensive care in five community health centers. From 3,000 active patients, a group of 385 with the following characteristics were randomly selected: mean age, 59.1 (range 25-93); M:F ratio, 1:4; and ethnic distribution (blacks: Hispanics: whites, 48%:31%:21%). Categorizing patients by their extent of diabetes control, good family function was found in 92% of patients in good control of their diabetes mellitus, in 66% of those in fair control, and only in 50% of those in poor control (p less than 0.005, chi 2 = 44.1, df = 2). Since these data point to the association between levels of family functioning and control of diabetes, further studies are needed to ascertain if an improvement in family functioning will lead to better diabetic control. PMID- 3812548 TI - ECG abnormalities in myoglobinuria: review of the literature. AB - Reports of electrocardiographic abnormalities in association with myoglobinuria have been sparse and have included conduction disturbances, ST segment shifts, and T-wave changes. In many instances, these changes were noted in patients with underlying heart disease. We report a case of a 34-year-old woman with ST segment depression and T-wave inversion in the inferolateral leads during the acute episode of myoglobinuria. There was no demonstrable underlying heart disease, and there was parallel resolution of these ECG changes with myoglobinuria. We conclude that these ECG changes were produced by cardiac muscle involvement in a manner similar to that observed in skeletal muscle in myoglobinuria. PMID- 3812549 TI - Diminished blood selenium levels in renal failure patients on dialysis: correlations with nutritional status. AB - Selenium deficiency has been implicated as contributing to the development of cardiovascular disease, skeletal muscle myopathy, anemia, increased cancer risk, and deranged immune function. Since these problems may also be associated with renal failure, and the kidney plays an important role in selenium homeostasis, we measured selenium and compared it with nutritional status in 24 stable hemodialysis patients, 12 chronic intermittent peritoneal dialysis patients, and 29 healthy controls. Whole blood and plasma selenium was determined by a spectrofluorometric method. For whole blood the mean (+/- SD) selenium levels were 0.11 +/- 0.02 micrograms/ml in controls vs. 0.071 +/- 0.01 micrograms/ml in hemodialysis cases and 0.052 +/- 0.006 micrograms/ml in peritoneal dialysis (p less than 0.005). Significant decreases were seen also for plasma and red blood cell selenium in all groups respectively. Pre- and postdialysis plasma and whole blood selenium levels showed no significant changes in both dialysis groups. However, predialysis residual peritoneal fluid did contain selenium (0.029 +/- 0.005 micrograms/ml). Some evidence of protein-energy undernutrition was noted in both dialysis groups compared with controls. However, no significant differences in nutritional parameters were noted between hemodialysis and peritoneal dialysis patients. When all groups were combined, significant correlations were found between whole blood selenium and serum albumin (r = 0.61; p less than 0.001), triceps skin fold in females (r = 0.62; p less than 0.001), and midarm muscle circumference in males (r = 0.71; p less than 0.001). We conclude that low blood selenium is present in renal failure patients undergoing hemodialysis. This abnormality is even greater in peritoneal dialysis cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812550 TI - Deoxyuridine increases folate-sensitive fragile site expression in human lymphocytes. AB - Deoxyuridine (dU) increases chromosome breakage at folic acid (FA)-sensitive common fragile sites (mostly 3p14 and 16q23) in human lymphocytes. This dU related increase can be suppressed by thymidine or FA. These results suggest that the mechanism of fragile site expression in low FA medium involves misincorporation of dU into DNA. PMID- 3812551 TI - Dermatoglyphic traits as possible markers of developmental processes in humans. AB - Here we provide data on the relationship in variability between common anthropometric characters (stature, interocular diameter, mesosternal chest circumference, bi-trochanteric diameter, and palm length) and dermatoglyphic traits in groups of young healthy individuals. Our working hypothesis was that quantitative variables of fluctuating asymmetry, diversity, and variability involving dermatoglyphic traits, will be higher in more homozygous groups than in heterozygous ones. It was found that individuals who were in the center (average +/- 0.67 SD) of the morphological trait distribution (and therefore perhaps more heterozygous at loci determining the aforementioned morphological traits), have reduced fluctuating asymmetry in their ridge counts (RC). These heterozygous individuals tended to have lower values of the RC-diversity-indices and the Shanon information-measures of discrete digital patterns. On the basis of the present results and a large body of literature data, the use of dermatoglyphic traits as "markers" of developmental processes are discussed. PMID- 3812552 TI - A new X-linked mental retardation syndrome. PMID- 3812553 TI - The Johanson-Blizzard syndrome: a second report of full autopsy findings. AB - We report on a second patient with Johanson-Blizzard syndrome with full autopsy. The findings are similar to those of the one other available case, but gross or fine CNS maldevelopment was not present; although small by weight, the brain showed no cytoarchitectural disturbance. Normal intellectual development does occur in this syndrome and may relate to the variable effects of the deleterious gene on the developing CNS. PMID- 3812554 TI - Mosaic trisomy 7 and renal dysplasia. AB - Trisomy 7 was detected in umbilical cord cells cultured from a fetus with renal dysplasia. Skin fibroblasts were diploid. Because of a paucity of liveborn infants with full trisomy 7, the phenotype is not well described; however renal anomalies appear to be common with trisomy 7. PMID- 3812555 TI - Pilodentoungulardysplasia with microcephaly: a new ectodermal dysplasia/malformation syndrome. AB - We report on a 6-year-old Brazilian girl with hypotrichosis, dental alterations, onychodysplasia, microcephaly, mental retardation, precocious puberty, abnormal palmar creases, and other findings. This appears to be the first report of this multiple congenital anomalies/mental retardation (MCA/MR) syndrome which is probably due to an autosomal recessive gene. PMID- 3812556 TI - Paternity testing 3: exclusion probabilities. AB - Blood typing with several blood systems is used in many countries to determine paternity or nonpaternity with respect to an alleged father. Various probabilities are usually presented, in particular: the conditional probability of excluding a random man as father given a particular mother-child phenotype combination, and the expected (unconditional) exclusion probability for all mother-child combinations can be calculated for a given blood system. Because these probabilities are of general interest in paternity studies, explicit formulae for the unconditional probabilities have been derived for some of the systems. Algorithms suitable for a microcomputer are given here for finding the exclusion probabilities for any system. These algorithms avoid the need for developing new formulae whenever a new system is introduced or a current system is extended through the addition of further alleles. PMID- 3812557 TI - Animal model: renal lesions in cats with Chediak-Higashi-Steinbrinck syndrome. AB - In this study designed to characterize the renal lesions in cats with the autosomal recessive Chediak-Higashi-Steinbrinck syndrome (CHS), the renal tubular epithelial cells of CHS cats were examined by light microscopy. Numerous cells of proximal convoluted and straight tubules, thin loop of Henle, distal convoluted and straight tubules, and collecting tubules contained enlarged cytoplasmic granules morphologically consistent with lysosomes. In general, the enlarged lysosomes were larger and more numerous in proximal convoluted and straight tubular cells and were generally more massive in older cats. The lesions observed were similar to those in the renal epithelial cells of other species with CHS and were consistent with those reported previously in other tissues of CHS cats. It is concluded that CHS cats are an appropriate model in which to study the effects of the CHS renal lesions on renal function in this syndrome. PMID- 3812558 TI - Ovarian size in the fragile X mental retardation syndrome. PMID- 3812559 TI - Familial situs inversus and congenital heart defects. AB - The midline is a major determinant in the lateral symmetry of the embryo and represents a developmental field which, if defective, may lead to an abnormal situs determination. A family in which four out of seven children had situs inversus and/or congenital heart defects is presented. This report confirms the autosomal recessive inheritance of this developmental field defect. PMID- 3812560 TI - Autosomal dominant painful plantar callosities. AB - We describe large kindred with an autosomal dominant condition characterized by painful callosities that develop over the pressure points of the soles. These callosities are not congenital; they arise with upright ambulation. PMID- 3812561 TI - Multiple congenital anomalies syndrome with myopathy in chromosome 16 abnormality. AB - An abnormality of chromosome 16 in an eight year-old male was associated with a multiple congenital anomalies syndrome characterized by myopathy, cataracts, blepharophimosis, microcephaly, failure to grow, profound mental retardation, moderate sensorineural hearing loss, grand mal seizures, bilateral inguinal hernia, and thoracolumbar kyphoscoliosis. Magnetic resonance imaging of the head demonstrated absence of the corpus callosum and extensive loss of brain parenchyma in the occipital regions. Chromosome analysis from peripheral blood of the patient showed a recombinant chromosome 16 [46, XY, rec (16), dup (p13.1--- p13.3) del (q22----q24)]. The mother had a pericentric inversion of chromosome 16 [46, XX, inv(16) (p13.1;q22)]. Independent recombinant DNA studies have shown that the breakpoints of these chromosomal rearrangements flank the alpha-globin gene cluster locus. PMID- 3812562 TI - Autosomal suppressor gene for fragile-X: an hypothesis. AB - We suggest the existence of an autosomal suppressor gene, S, which is fairly common in the general population and acts to inhibit expression of the fra(X) gene, F. The suppression is effective in males who are hemizygous for F only if they are homozygous for S, while it is effective in females who are heterozygous for F if they are at least heterozygous for S. Thus, the fra(X) phenotype is not expressed in genotypes F-SS,FfSS, FfSs, while it is expressed in genotypes F-Ss, F-ss, Ffss. With a frequency of SS in the general population of approximately 20%, this hypothesis can explain the observed penetrance of about 80% in F- males and about 30% in Ff females. It can also explain the very low frequency of fra(X) expression in Ff females who are daughters or mothers of non-penetrant F- males, and a lower penetrance in siblings of non-penetrant F- males than in grandsons of these males. The model is in good quantitative agreement with other unique characteristics of fra(X) inheritance. PMID- 3812563 TI - Partial duplication 16p resulting from a 3:1 segregation of a maternal reciprocal translocation. AB - We report on a male infant with a duplication 9p (pter----q13) and duplication 16p (p13----pter) resulting from a 3:1 meiotic disjunction of a maternal reciprocal translocation. In this case, the mode of segregation fits to the Pachytene-Diagram Model of Jalbert et al [1980]. The infant showed clinical features that have been described both in dup(16p) and in dup(9p). To our knowledge, this is the first time that this unbalanced karyotype has been reported. PMID- 3812564 TI - DOOR syndrome (deafness, onycho-osteodystrophy, and mental retardation): elevated plasma and urinary 2-oxoglutarate in three unrelated patients. AB - We describe three further children with the DOOR syndrome (deafness, onycho osteodystrophy and mental retardation). A severe seizure disorder and characteristic facial appearance are part of the syndrome. Fourteen similar cases including the present patients are now on record. Autosomal recessive inheritance is likely. An increased level of 2-oxoglutarate in both plasma and urine has been found in our three patients. It is suggested there may be an inherited metabolic defect in this malformation syndrome. PMID- 3812565 TI - New syndrome: familial proportionate short stature, intrauterine growth retardation, and recurrent locking of the fingers. PMID- 3812566 TI - Mental retardation, spasticity, and transverse limb defects. AB - We report on a mentally retarded boy with spastic paraplegia and a transverse defect of the left foot who was born to consanguineous parents. This association of ectrodactyly, mental retardation, and spastic paraplegia was first reported by Jancar [1967]. PMID- 3812567 TI - Prenatal diagnosis of a dup(3p) with holoprosencephaly. AB - The prenatal diagnosis of dup(3p) was made in a female conceptus, the father being a known carrier of a balanced translocation t(3;10)(p21;q26). Interruption of pregnancy at 19 weeks showed a fetus with a holoprosencephaly field defect. Two other cases of dup(3p) have been observed in the same family. The malformations were different in each of the 3 patients, suggesting a considerable degree of variability of dup(3p). PMID- 3812568 TI - Trisomy 18 mosaicism with few stigmata including macrogenitalia. PMID- 3812569 TI - Dominantly inherited syndrome of microcephaly and congenital lymphedema with normal intelligence. PMID- 3812570 TI - A genetic association between microcephaly and lymphedema. PMID- 3812572 TI - Genetic heterogeneity in Duchenne muscular dystrophy. PMID- 3812571 TI - Genetic heterogeneity in Duchenne muscular dystrophy. PMID- 3812573 TI - A further X-linked isolated nonsyndromic cleft palate family with a nonexpressing obligate affected male. PMID- 3812574 TI - A response: a further X-linked isolated nonsyndromic cleft palate family with a nonexpressing obligate affected male. PMID- 3812575 TI - A new genetic model for the fragile X syndrome involving an autosomal suppressor gene--comments on the paper by M.H. Israel. PMID- 3812576 TI - A counseling guide to the Martin-Bell syndrome. PMID- 3812577 TI - Smith-Lemli-Opitz syndrome-type II: multiple congenital anomalies with male pseudohermaphroditism and frequent early lethality. AB - In 1964, Smith et al described a syndrome of microcephaly, growth and mental retardation, unusual facial appearance, syndactyly of toes 2 and 3, and genital abnormalities. Major structural malformations and early death have been uncommon in the many subsequent literature reports. We report on 19 infants with a phenotype we propose to call Smith-Lemli-Opitz syndrome (SLOS)-Type II, in which major structural abnormalities, male pseudohermaphroditism, and early lethality are common. Of these 19 patients, 18 had postaxial hexadactyly, 16 had congenital heart defect, 13 had cleft palate, and 10 had cataracts. Unusual findings seen in these patients at autopsy included Hirschsprung "disease" in five patients, unilobated lungs in six, large adrenals in four, and pancreatic islet cell hyperplasia in three. Comparison of our cases to 19 similar literature cases suggests the existence of a distinct phenotype that may be separate from SLOS as originally described. It is also inherited as an autosomal recessive, as documented by occurrence in one pair of sibs in this study and recurrence in three reported families. PMID- 3812578 TI - The Gardner-Silengo-Wachtel or genito-palato-cardiac syndrome: male pseudohermaphroditism with micrognathia, cleft palate, and conotruncal cardiac defect. AB - We report on two sib fetuses with similar abnormalities detected prenatally by ultrasound. The first fetus had micrognathia, was without cleft palate, and had low-set ears, double outlet right ventricle with a ventricular septal defect, and 46,XY gonadal dysgenesis. The second sib fetus was born with cleft lip and palate, micrognathia, transposition of the great vessels, ventricular septal defect, a right-sided aorta arch, and bilateral cystic kidneys with hypospadias. We were able to identify 11 additional cases in the literature with similar findings. We think this set of defects is a recognizable syndrome that appears to be inherited either as an autosomal recessive or as an X-linked recessive and may overlap with the Smith-Lemli-Opitz syndrome. PMID- 3812579 TI - Two cases of severe lethal Smith-Lemli-Opitz syndrome. PMID- 3812580 TI - Lincoln vs. Douglas again; comments on the papers by Curry et al, Greenberg et al, and Belmont et al. PMID- 3812581 TI - Central nervous system neoplasm in a young man with Martin-Bell syndrome--fra(X) XLMR. AB - A 17-year-old retarded male developed unilateral leg weakness with foot drop, pain, and incontinence. Workup disclosed a cauda equina tumor which, on surgical exploration, was demonstrated to merge with the conus medullaris. Pathological examination of the subtotally resected tumor led to a diagnosis of malignant ganglioglioma. Further evaluation of the patient documented marginal macro orchidism, and chromosome studies showed fragile X. Since some neoplasms are known to be associated with chromosomal deletions and other abnormalities, we suggest that the occurrence of this tumor in this patient indicates a more than coincidental relationship between the two diagnoses. PMID- 3812582 TI - Progressive form of multiple pterygium syndrome in association with nemalin myopathy: report of a female followed for twelve years. AB - We report on a girl with progressive multiple pterygium syndrome in association with gluteal muscle fibrosis and nemalin-myopathy. This girl has been followed for 12 years. Clinical findings, natural history, and the presence of nemalin myopathy suggest the possibility of a distinct form of multiple pterygium syndrome in this patient. PMID- 3812583 TI - Dominant inheritance of a syndrome similar to Rubinstein-Taybi. AB - Two sibs and their mother were affected with a syndrome like the Rubinstein-Taybi syndrome. All three individuals had broad terminal phalanges of the thumbs and great toes, antimongoloid slant of the palpebral fissures, and characteristic facial appearance with beaked noses. Four sibs of the mother had broad thumbs, suggesting a familial pattern. So far there has been no report of dominant transmission of the Rubinstein-Taybi syndrome. This family bears close resemblance to the Rubinstein-Taybi syndrome, which is transmitted as an autosomal or X-linked dominant trait. Inasmuch as the expressivity of the syndrome may be variable, we propose that a thorough family investigation is indicated in all apparently sporadic cases of Rubinstein-Taybi syndrome. Familial cases may be more common than realized and require appropriate genetic counseling. PMID- 3812584 TI - Chromosomal polymorphisms of 1, 9, 16, and Y in 4 major ethnic groups: a large prenatal study. AB - Using trypsin Giemsa banding (GTG), major polymorphisms of the constitutive heterochromatin regions of chromosome 1, 9, 16, and Y were recorded in a New York City population. Polymorphisms were recorded from amniotic fluid specimens received from 6,250 patients from 4 major population groups, ie, White (European) 2,334 cases, American Black-1,795 cases, Hispanic descent-1,737 cases, and Asian (Oriental and Indian)-384 cases. The major chromosomal polymorphisms were classified as follows: obvious pericentric inversion of the constitutive heterochromatin of the long arm of the chromosome (inv qh); significantly enlarged heterochromatic region of the long arm (qh + is greater than, or equal to, twice the size of the short arm of chromosome 16 [16p]); very small or deficient heterochromatic region in the long arm (qh-); large Y (Yq + greater than size of chromosome 18), small Y (Yq- less than size of a G-group chromosome), and pericentric inversion of Y. Our prenatal study confirmed that the incidence of specific chromosomal variants is different in each population group. The most striking examples of this are the pericentric inversion of chromosome 9 and the different polymorphisms of the Y chromosome. The incidence of inv (9) is highest in the Black population (3.57%); slightly above average in Hispanics (2.42%); and relatively low in Whites (0.73%) and Asians (0.26%). The Y appears to be more variable in Asian (3.37%) and Hispanic (1.82%) than in White or Black groups. The 9qh+ is seen more frequently than 1qh+, or 16qh+. Inv (1), 9qh-, and 16qh- are rare. There were no cases of either 1qh- or inv (16).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812585 TI - A new syndrome with features of the Smith-Lemli-Opitz and Meckel-Gruber syndromes in a sibship with cerebellar defects. AB - The Smith-Lemli-Opitz syndrome (SLOS) and the Meckel syndrome (MS) have been regarded as separate autosomal recessive entities. Recently, overlap of these two syndromes has been discussed. A sibship containing a probable new syndrome with features reminiscent of the SLOS and the MS is presented. The literature is reviewed with regard to the frequency of various malformations in these syndromes. Clinical manifestations and cerebellar abnormalities in these sibs are similar to those described in the Joubert syndrome (JS). These three cases may represent a new syndrome with features in common with SLOS, MS, and JS resulting from the same mutant gene, which exhibits considerable pleiotropy. PMID- 3812586 TI - A clinico-genetic investigation of Leydig cell hypoplasia. AB - We report on a kindred including a patient (46,XY) with typical manifestations of Leydig cell hypoplasia who was born to parents who were first cousins. A sister had secondary amenorrhea possibly due to primary ovarian dysfunction. Analysis of six pedigrees fits to a male-limited autosomal recessive pattern of inheritance; its implication for the mutational dynamics in the populations is evaluated. PMID- 3812587 TI - Autosomal recessive nonsyndromal microcephaly with normal intelligence. AB - Autosomal recessive microcephaly is usually associated with moderate to severe mental retardation. An apparently new autosomal recessive disorder comprising a characteristic facial appearance associated with microcephaly and normal intelligence, immunodeficiency, and increased risk for lymphoreticular malignancies has been described recently. We report on a large Arab kindred with frequent consanguineous marriages and eight cases in five sibships with microcephaly, peculiar facies, and normal intelligence. Of these cases, two died of an acute lymphoreticular malignancy or bronchopneumonia. Immunological and chromosomal studies carried out for the three affected living sibs were normal. The existence of an autosomal recessive nonsyndromal variant of microcephaly with normal intelligence is proposed and discussed. PMID- 3812588 TI - Oculoauriculovertebral dysplasia and variants: phenotypic characteristics of 294 patients. AB - Here we describe the phenotypic characteristics of a single craniofacial clinic population of 294 individuals affected with oculoauriculovertebral dysplasia (OAV) and variants. To our knowledge, this is the largest population so described in the literature. The study population was divided into five subgroups based on the presence of combinations of minimal diagnostic criteria: microtia, mandibular hypoplasia, anomalies of the cervical spine and/or epibulbar or lipodermoids. The following data were recorded: sex (M:F 191:103); race (78% Caucasian); the presence of unilateral or bilateral microtia (193 unilateral, 98 bilateral); the presence of symmetric microtia in bilateral cases (34/98); the presence of mandibular hypoplasia ipsilateral or contralateral to the microtic ear or most severely microtic ear in bilateral cases (135/137 were ipsilateral in unilateral cases, 55/62 were ipsilateral in bilateral cases); the number of individuals with no other congenital anomaly in addition to the minimal diagnostic criteria (154/294), with only one other congenital anomaly (51/294), and with two or more other congenital anomalies (89/294); and the type of other congenital anomalies. Finally, we compared our results with other studies. Findings from our study include: mandibular asymmetry should be expected in patients with unilateral or bilateral microtia; bilateral involvement is frequent in patients with microtia; other malformations are seen frequently in all subgroups; anomalies of the cervical spine are more likely to be associated with other anomalies; and other malformations are seen in all systems and should be searched for to provide optimal management. PMID- 3812589 TI - Vitamin B12 responsive homocystinuria and megaloblastic anemia: heterogeneity in methylcobalamin deficiency. AB - A male infant with methyl-B12 deficiency (cblE) presented at age 6 weeks with lethargy, staring spells, and vomiting. He later became hypotonic and unresponsive to stimuli and required intubation and ventilation. He had homocystinuria and hypomethioninemia with megaloblastic anemia but normal serum folate and vitamin B12 concentrations. No methylmalonic aciduria was detected. Fibroblasts, cultured from the patient, were unable to grow in medium in which homocysteine replaced methionine and incorporated abnormally small amounts of [14C]-methyl-tetrahydrofolate but normal amounts of [14C]-propionate into protein. Methyl-B12 content of fibroblasts was low, while the adenosyl-B12 content was normal. Methionine synthase activity was decreased when the assay was performed under both optimal and suboptimal reducing conditions, suggesting heterogeneity in the cblE disease. The patient responded dramatically to hydroxocobalamin treatment. Homocystinuria disappeared after 10 days of therapy, and methionine was normalized after 3 weeks. Psychometric testing at age 15 months showed a developmental age of 9 months. PMID- 3812590 TI - German syndrome in sibs. AB - We present a male-female sib pair born to Ashkenazi Jewish parents with "arthrogryposis," hypotonia-hypokinesia sequence and lymphedema. Of all the "arthrogryposis" hypotonia syndromes, the condition in these sibs appears to be most like that of the patients of German et al [1975] and the patient of Salmon [1978]. They appear to be the first sib pair with German syndrome, which suggests autosomal recessive inheritance. Three of the four known families with affected children have been Ashkenazi Jews. PMID- 3812591 TI - Renal-hepatic-pancreatic dysplasia: a syndrome reconsidered. AB - Five infants, three dying neonatally and two later in the first year of life, had renal, hepatic, and pancreatic dysplasia, a combination of abnormalities first described by Ivemark et al [1959]. The renal malformation consisted of cystic dysplasia, with abnormally differentiated ducts, deficient nephron differentiation, and glomerular cysts. The hepatic abnormality consisted of enlarged portal areas containing numerous elongated biliary "profiles," with a tendency to perilobular fibrosis. Serial liver biopsies in one child with cholestasis from birth showed a progression from bile duct paucity at 1 1/2 wk to typical biliary "dysgenesis" at 7 mo. Four of the five children had intrahepatic ductal dilatation, diagnosed ante mortem in the two older children as Caroli disease. The pancreatic abnormality consisted of fibrosis and cysts, with a diminution of parenchymal tissue. The clinical and functional reflection of these abnormalities in the two children surviving the newborn period included renal insufficiency, chronic jaundice, and insulin-dependent diabetes mellitus. Similar renal, hepatic, and pancreatic abnormalities occur in other syndromes, including trisomy 9, Meckel syndrome, Jeune, Saldino-Noonan, and Elejalde types of chondrodysplasia, and glutaric aciduria II. After exclusion of identifiable syndromes, the remaining cases of renal-hepatic-pancreatic dysplasia do not necessarily constitute a homogeneous group. PMID- 3812592 TI - Megalocornea and mental retardation syndrome: two new cases. AB - We report on 2 patients with the Neuhauser megalocornea-mental retardation syndrome, a recessively inherited clinical entity of relatively recent description (McKusick 24931). A review of the few previous reported patients and our 2 patients shows that megalocornea and mental retardation are the 2 minimal diagnostic criteria. Short stature, seizures, neurological symptoms, microcephaly or macrocephaly, and minor anomalies are all additional nonobligatory manifestations. The small number of published cases may be due to the fact that the association of these two signs has often escaped attention until now. PMID- 3812593 TI - Agenesis of succedaneous teeth: an expression of the homozygous state of the gene for the pegged or missing maxillary lateral incisor trait. AB - Agenesis of the permanent teeth that replace the primary teeth, the succedaneous teeth, was found in children from two kindreds wherein both parents had pegged maxillary lateral incisor teeth. The trait small-pegged-missing maxillary lateral incisor teeth is inherited in an autosomal dominant manner, as demonstrated in the literature and in these families. Agenesis of succedaneous teeth is most likely an autosomal recessive trait due to the homozygous state of the gene for small-pegged-missing maxillary incisor teeth. PMID- 3812594 TI - Lip pits and deletion 1q32----41. AB - A patient with an interstitial deletion of chromosome 1q[del(1q32----41)] was found to have, among other anomalies, congenital lower-lip pits. Lip pits are rare and are found mainly in association with the van der Woude syndrome and the popliteal pterygium syndrome; we cannot find a report of their association with a chromosome anomaly. To our knowledge, interstitial deletion of the segment 1q32-- -41 has not been reported. This observation raises the possibility that the van der Woude syndrome may be due to a submicroscopic deletion of chromosome 1q. PMID- 3812596 TI - The dynamics of angular homeostasis: I. General principles. AB - A general model is proposed casting aspects of ontogeny in quantitative terms amenable to genetic analysis. Its primordial construct is a chain of cells (termed a "pursuer") growing under the influence of a signal towards a fixed structure termed a "target." There is provision for graduated correction of the direction of growth of the pursuer. The determinants of scale include the size of the cells and the distance from the target. The minimum number of parameters is two: the initial angle of growth; and the force of the correction of errors of direction. Both are potentially of genetic interest. The impact of variation in these factors on the path of growth is studied. These findings are readily translated into biological terms, notably in congenital defects of the heart. Besides the primordial purposes, there are other objectives to the process. Some membranes require free edges, or large curvatures, or circular arrays. These secondary qualities require that the cells never reach the target. The target then becomes simply a construction point: that is, while remaining a center of attraction, it is no longer a true goal. If, because of undercorrection, the cell line misses the target at the first pass, it assumes a permanent orbit about it. The orbit rapidly comes to lie on a circle, with a radius independent of the initial angle of growth but related to the cell size and the restoration constant. From this property, several kinds of structures other than a simple bridge may result, especially when a series of lines of growth together form a tissue: a cusp, a free-floating membrane, or a circular membrane to fill a gap. PMID- 3812595 TI - An anthropometric study of 38 individuals with Prader-Labhart-Willi syndrome. AB - Weight, height, sitting height, and 24 other anthropometric variables (5 body circumferences, skinfolds at 7 sites, 4 head dimensions, and 8 hand and foot measurements) were obtained on 38 Prader-Labhart-Willi syndrome (PLWS) individuals (21 with apparent chromosome 15 deletions and 17 nondeletion cases) with an age range of 2 weeks to 38 1/2 years. More than half of these individuals were measured on more than one occasion. The measurements confirmed the presence of short stature, small hands and feet, obesity, and narrow bi-frontal diameter in PLWS. No differences were found for the anthropometric measurements between the 2 chromosome subgroups. Inverse correlations were produced with linear measurements (eg, height, hand and foot lengths) and age, which indicated a deceleration of linear growth relative to normal individuals with increasing age. PMID- 3812597 TI - Dandy-Walker(like) malformation, atrio-ventricular septal defect and a similar pattern of minor anomalies in 2 sisters: a new syndrome? AB - We report on sisters with similar craniofacial anomalies, a brain malformation in the area of the posterior fossa, and a congenital heart defect. The craniofacial findings include macrocephaly, a prominent forehead and occiput, foramina parietalia, hypertelorism, downslanting palpebral fissures, a depressed nasal bridge, narrow palate, and apparently low-set ears. Patient 1 had a Dandy-Walker malformation with communicating hydrocephalus, aplasia of the posterior portion of the cerebellar vermis, and high insertion of the confluent sinus, while in patient 2, a Dandy-Walker variant was found with aplasia of the cerebellar vermis and hypoplasia of the hemispheres, large cisterna magna, high insertion of the confluent sinus, but no hydrocephalus. Both sibs were moderately mentally retarded. The older sister had a complete atrio-ventricular canal and died after unsuccessful heart operation at 3 1/2 years. The younger had a successful operation on a cleft mitral valve and septum primum defect. Chromosomes were normal. The occurrence of a distinct and similar pattern of congenital anomalies in sisters born to healthy parents points toward a "new" syndrome caused by the homozygous state of an autosomal recessive gene. PMID- 3812598 TI - An additional case of deletion 17p11.2. PMID- 3812599 TI - Aplasia cutis congenita and/or epidermolysis bullosa. PMID- 3812600 TI - Menkes syndrome in a girl with X-autosome translocation. AB - We report on a girl with Menkes syndrome (M.S.) and X-2 reciprocal translocation. We conclude that the probable locus for M.S. gene is at band Xq13. This case and other previous case reports of X-linked disorders in females suggest that chromosome analysis is indicated in all females who present with manifestations of a known X-linked lethal condition in order to detect a possible associated balanced X-autosome translocation. PMID- 3812601 TI - Characteristics of home environment of families with mentally retarded children: comparison across levels of retardation. AB - To help fill the relative void of information about families of severely mentally retarded school children, we described 53 such families comparatively with 54 families of EMR and 50 of TMR children. All children resided in their natural homes; families were selected for study by identical means and interviewed at their home. Selection for comparison was made from larger samples to reduce mean age differences in the samples. Differences in age and SES among groups were controlled with analysis of covariance. The impact of the retarded child on adjustment of families with severely retarded children was greater than that of the other groups, but no differences occurred in the impact of the child on marital adjustment. Families with severely retarded children had the highest mean scores on all four scores of the Home Quality Rating Scale. They scored lower than others on the Cohesion, Independence, Moral-Religious Emphasis, and Organization subscales of the Family Environment Scale. Implications for assisting these families were discussed. PMID- 3812602 TI - From institution to foster care: impact on nutritional status. AB - Eighty-two clients who were transferred from a residential institution to foster care homes were provided nutrition services as part of their Individual Program Plans. Findings of the nutrition assessment and intervention were analyzed to document the impact of deinstitutionalization and nutrition services. Nutrition related problems identified were closely associated to the medical problems. More than half of the clients were diagnosed as having seizures and cerebral palsy and were, therefore, at high nutritional risk because of feeding problems and anticonvulsant-induced malnutrition. Forty-three of the 47 clients who were reassessed showed positive changes in height, weight, triceps skinfold thickness, dietary adequacy, and/or biochemical indices. PMID- 3812603 TI - Treatment strategies for self-injurious behavior in a large service-delivery network. AB - Despite pressures in recent years to discourage reliance upon pharmacological interventions, psychoactive drugs continue to be utilized extensively with institutionalized mentally retarded persons. In the present study the scope and pattern of psychoactive drug use within a state-wide institutional service delivery network were examined, with a focus upon its role in the treatment of self-injurious behavior (SIB) and other aberrant behavior patterns. Correlates to psychoactive drugs and alternative intervention approaches were examined. Lack of treatment, insufficient utilization of behavioral technology, and use of physical and chemical restraints as adjuncts to positive behavioral programs were indicated. PMID- 3812604 TI - Foundation care: a treatment model for nonambulatory profoundly mentally retarded persons. AB - Two treatment models, Intermediate Care Facilities for the Mentally Retarded (ICF/MR) and Foundation Care, were compared with respect to their use in the institutional treatment of nonambulatory profoundly mentally retarded persons. Foundation Care is focused on physical and social environmental components of caregiving through emphases on health, nourishment, nurturance, stimulation, and play, with the goal of habilitation. Subjects were randomly assigned to the treatment models. We hypothesized that when compared to ICF/MR, the Foundation Care unit would use more resident-oriented management practices, have different caregiver resident interaction, and have residents who would exhibit more behavioral complexity. Baseline, 6-month, and 1-year measurements were made. Results supported the first and third hypotheses. Caregiver resident interaction was similar for both groups; however, Foundation Care staff used more tactile modalities and contingent interaction. We conclude that Foundation Care may be an appropriate alternative level of care for the nonambulatory profoundly retarded person. PMID- 3812605 TI - Structure of adaptive behavior: I. Replication across fourteen samples of nonprofoundly mentally retarded people. AB - A two-step procedure was used to investigate the dimensional structure of adaptive behavior of mildly, moderately, and severely mentally retarded people. The first step consisted of item factor analyses of the 66-item Client Development Evaluation Report for two derivation samples, each containing 3,024 subjects; results revealed a high degree of cross-sample similarity. Using the preceding results, we conducted parcel factor analyses for 14 samples of retarded people (average sample size, 676). These analyses resulted in a quite stable six factor structure of adaptive behavior: Motor Development, Independent-Living Skills, Cognitive Competence, Social Competence, Social (or Extrapunitive) Maladaption, and Personal (or Intrapunitive) Maladaption. The implications for research and theory of the highly replicable six-factor structure of adaptive behavior were discussed. PMID- 3812606 TI - Effect of mentally retarded persons' level of stereotypy on their learning. AB - The effect of level of stereotypy on learning a discrimination for 30 mentally retarded persons was examined. A factorial design with high and low levels of stereotypy and three levels of IQ was employed. The number of days to acquire the discrimination differed among the IQ groups, but there was no main effect of stereotypy. An interaction was found indicating that a high level of stereotypy slowed learning only in the lowest IQ group. We concluded that the effects of stereotypy upon learning were different across the IQ levels and that high levels of stereotypy did not uniformly interfere with the acquisition of the discrimination. PMID- 3812607 TI - Comparison of two prompting procedures to facilitate skill acquisition among severely mentally retarded adolescents. AB - Six profoundly mentally retarded subjects were taught two tasks of comparable difficulty using different prompting procedures: an antecedent procedure, where the trainer prompted the learner prior to the subject's response and gradually faded the prompt on subsequent trials, approximating an errorless learning model, and a consequent procedure, where the trainer prompted the learner after an error response and gradually faded the prompt on subsequent corrections. Results show that greater gains were made with the antecedent prompting procedure compared to the consequent prompting procedure. PMID- 3812608 TI - Mentally retarded and nonretarded adults' sensitivity to spatial structure. AB - The sensitivity of mentally retarded and nonretarded adults to changes in the structure of their perspectives when those changes are occluded from view during a walk was examined in two studies. Sensitivity was tested by starting participants at a target object located in one room of an unfamiliar office building, walking them via a circuitous path into a new room from which the target was occluded from view, and then asking them to aim a pointer straight at it. Direction judgments were collected across variations in the number of turns in the walk, spatial arrangements of rooms, amount of the subjects' attention available during the walk, and the availability of visual-environmental cues. Results indicate that retarded and nonretarded persons show similar levels of sensitivity to changes in perspective when they walk without visual-environmental cues (i.e., with eyes closed). In the presence of visual-environmental cues, however, the accuracy of nonretarded subjects increased dramatically whereas the retarded subjects did not improve at all. The similarities and differences in performance are related to differences in the perceptual learning thought to mediate use of proprioceptive cues and the inferential processes thought to mediate use of visual-environmental cues. PMID- 3812609 TI - Mentally retarded and nonretarded adults' memory for spatial location. AB - The claim that memory for spatial location is automatic was evaluated. Mentally retarded and nonretarded adults studied 16 objects on a matrix in front of them under one of two instructional conditions: intentional or incidental. They then tried to recall both the objects and their locations. Results showed that memory for spatial location was above chance under both instructional conditions. Intention to encode spatial location had no effect on recall. Finally, retarded and nonretarded adults differed in recall of the objects but not in recall of spatial locations. The findings support several of the criteria for automaticity proposed by Hasher and Zacks (1979) and suggest that automatic encoding of spatial location is an area of strength for retarded persons. PMID- 3812610 TI - Differences between mentally retarded and nonretarded persons' efficiency of auditory sentence processing. AB - Mentally retarded adolescents and MA-matched nonretarded children participated in three experiments designed to examine differences in language-processing efficiency. A compressed speech technique was used in Experiments 1 and 2. Experiment 3 relied on a sentence-picture verification procedure. Our results suggest that retarded and nonretarded individuals differ in the speed with which they are able to execute the semantic-analytic processes but not necessarily the phonological encoding processes that are involved in auditory language comprehension. In addition, the data suggest a possible group difference in the quality of the semantic representation encoded during sentence processing. PMID- 3812611 TI - Iconic memory deficit of mildly mentally retarded individuals. AB - Ten mildly mentally retarded, 10 equal-CA matched, and 10 equal-MA matched nonretarded subjects were required to recognize both verbal (two-letter words) and nonverbal (polygons) stimuli presented tachistoscopically. A backward visual masking paradigm utilizing both monoptic and dichoptic masking and varying stimulus onset asynchrony (SOA) was employed. The mildly retarded subjects were significantly poorer at the most advantageous (longest) SOAs. The monoptic mask was more effective than was the dichoptic mask, with the three groups demonstrating similar masking functions. PMID- 3812612 TI - Variables influencing stimulus overselectivity and "tunnel vision" in developmentally delayed children. AB - Three variables (diagnosis, location of cues, and MA of learners) influencing stimulus control and stimulus overselectivity in autistic children were assessed. Eight autistic and 8 intellectually average children, matched on MA, were trained on two discrimination tasks; one task contained two "within-stimulus" (i.e., physically connected) cues; the other contained the same two cues presented "extra-stimulus" (i.e., physically separate). Generalization gradients were used following training to measure the degree of stimulus control acquired by each cue. Results showed: autistic subjects tended to respond overselectively only in the extra-stimulus condition; MA was positively correlated with breadth of learning; and when autistic children were overselective to one cue, some stimulus control was also acquired by the second cue. The notion of tunnel vision was discussed, as it may represent a "keystone" deficit interfering with stimulus control and learning by autistic children. PMID- 3812613 TI - Evaluation of a residential behavioral program for behaviorally disturbed, mentally retarded young adults. AB - The Adaptive Behavior Scale (ABS) was used to evaluate a three-level token economy designed to modify some aspects of the behavior of behaviorally disturbed young adults of borderline intelligence. The ABS was administered to all those referred to the program. Those admitted were retested upon discharge and 6 months later. Those not admitted, or rejected, were retested 12 months later. Results showed that initially there were few significant differences in scores between the accepted and rejected groups. Following treatment, however, large improvements occurred in those areas that were logically related to target behaviors within the token economy. These gains were maintained on follow-up. The rejected group showed no improvements over the same period. PMID- 3812614 TI - Problem size and mentally retarded children's judgment of commutativity. AB - The effects of problem size on judgments of commutativity by 51 moderately and mildly mentally retarded students were investigated. The task required subjects to judge whether commuted addition problems (e.g., 5 + 2 and 2 + 5) and noncommuted problems (e.g., 5 + 3 and 5 + 0) would have the same or different sum. Small problems had addends of five or less; large problems had at least one addend greater than five. The subjects' responses to the commutativity task were highly consistent across the two problem sizes. Results indicated that many retarded students who are given computational practice recognize the general principle that addend order does not affect the sum. PMID- 3812615 TI - Changing patterns of uveitis. AB - We conducted a retrospective analysis of 600 patients with uveitis seen at the Estelle Doheny Eye Center to determine the frequency of occurrence of the various forms of uveitis and to see if the causes of uveitis have changed as compared with previous studies. In 402 cases (67.0%) we established a specific diagnosis based on history, physical findings, and laboratory studies: 167 cases (27.8%) involved primarily the anterior segment, 230 (38.4%) the posterior segment, and 111 (18.4%) occurred as panuveitis. Intermediate uveitis (pars planitis) was the single most frequently diagnosed uveitic entity and accounted for 92 cases (15.4%). We compared our findings with those of previously published studies and found that, as new diseases occur and improved diagnostic techniques become available, the differential diagnosis of uveitis continues to change. PMID- 3812616 TI - Intraoperative argon endophotocoagulation for recurrent vitreous hemorrhage after vitrectomy for diabetic retinopathy. AB - We reviewed the medical records of 103 consecutive cases of vitrectomy performed for complications of diabetic retinopathy to determine if the introduction of argon laser endophotocoagulation had reduced the incidence of recurrent vitreous hemorrhage. Twenty-six eyes (48%) treated with endophotocoagulation and 35 (71%) eyes not receiving laser treatment had a recurrent hemorrhage. Follow-up was shorter for the eyes treated with endophotocoagulation, but a log-rank analysis to allow for this variable confirmed the benefit of laser photocoagulation (P less than .05). The proportion of eyes requiring surgical removal of the hemorrhage was also significantly lower in the group receiving endophotocoagulation (P less than .05). The beneficial effect of intraoperative laser treatment was independent of the amount of preoperative laser treatment, aphakia, and indications for the original vitrectomy surgery. PMID- 3812617 TI - Foveal cone pigments and sensitivity in young patients with Usher's syndrome. AB - Psychophysical and reflection retinal densitometric techniques were used to investigate foveal function of three patients (ages 14, 16, and 19 years) with Usher's syndrome who had good central visual acuity and, by ophthalmoscopic examination, normal foveal areas. During dark adaptation foveal sensitivity and its relation to proportion of cone pigment present were normal, but the kinetics of regeneration of the pigments were markedly abnormal. Measurements were made to consider the possibilities that the disorders of regeneration were associated with altered light-catching capacities of the patients' cone pigments, deranged transport of visual cycle substances between the retinal pigment epithelium and photoreceptors, or lingering photoproducts. None of the mechanisms fully accounted for the observed kinetics. The results suggested that abnormal kinetics of regeneration are among the earliest signs of malfunction of the foveal photoreceptor-pigment epithelial complex in some of the retinal degenerative disorders. PMID- 3812618 TI - Grid photocoagulation for macular edema in patients with retinitis pigmentosa. AB - We performed a pilot study of grid laser photocoagulation in 16 patients with fluorescein angiographically demonstrable macular edema associated with retinitis pigmentosa. Six of the treated eyes showed a positive response, while none of the fellow untreated eyes did. Seven of the untreated eyes lost one or more lines of vision, while none of the treated eyes did. Overall, 13 of 16 eyes showed decreased dye accumulation in the macula after treatment. In some eyes, the area showing reduced dye accumulation was more extensive than the area that received treatment directly. PMID- 3812619 TI - Management of fibrin pupillary-block glaucoma after pars plana vitrectomy with intravitreal gas injection. AB - After pars plana vitrectomy and fluid-gas exchange, two patients developed fibrin membranes across the pupillary space resulting in pupillary block and subsequent glaucoma. In one case the angle was closed; in the second case the angle was open because of gas in the anterior chamber. In both cases the argon laser made permanent openings in the fibrin pupillary membrane that relieved the pupillary block. PMID- 3812621 TI - Compliance with topical timolol treatment. AB - To determine if compliance with timolol treatment was better than compliance with pilocarpine treatment (as reported previously), we measured compliance with timolol treatment in a sample of 110 patients using an unobtrusive eyedrop medication monitor, which recorded electronically the date and time of each drug administration over a four- to six-week period. The patients administered a mean +/- S.D. of 82.7% +/- 19.0% of the prescribed timolol doses (range, 20% to 100%). Forty-five patients were treated concurrently with timolol and pilocarpine. These patients administered a mean +/- S.D. of 84.3% +/- 14.0% of the prescribed timolol doses and 77.7% +/- 18.7% of the prescribed pilocarpine doses (P = .012, van der Waerden test). Our results suggest that while compliance is influenced by the drug regimen, defaulting is not eliminated by prescribing a more convenient medication with fewer side effects. PMID- 3812620 TI - Serious corneal complications of glaucoma filtering surgery with postoperative 5 fluorouracil. AB - We studied four patients who, having received postoperative 5-fluorouracil after glaucoma filtering operations, developed serious corneal complications. All four patients had preexisting corneal abnormalities including keratoconjunctivitis sicca, exposure keratopathy, and bullous keratopathy. All of the patients developed epithelial defects in the postoperative period. The complications included bacterial corneal ulceration (two patients), sterile corneal ulceration and corneal perforation (one patient), and a keratinized corneal plaque with underlying sterile stromal infiltrate (one patient). The use of 5-fluorouracil, which is an antimetabolite with considerable corneal epithelial toxicity, after glaucoma filtering surgery frequently causes corneal epithelial defects that may lead to secondary complications. Patients receiving this drug should have their corneal status closely monitored. In patients with corneal epithelial disease, 5 fluorouracil should be used with caution. PMID- 3812622 TI - Ocular signs of cocaine intoxication in neonates. AB - We examined 13 cocaine-intoxicated neonates, proven by urine assay, by slit lamp and found that most had iris blood vessel abnormalities. Using an iris vascularity scale that ranged from Grade 0 with no visible vessels to Grade 4 with dilated and tortuous vessels, we found that the intoxicated infants had increased grades in the iris periphery and collarette (P less than .02) as compared to 36 control newborns who had no cocaine in their urine. Infants with dilated or tortuous iris vessels were more likely to be intoxicated by cocaine (P less than .01). The presence of dilated or tortuous iris vessels in a neonate should signal the physician to rule out cocaine intoxication. PMID- 3812623 TI - Blowout fracture of the orbital floor with entrapment caused by isolated trauma to the orbital rim. AB - There are two main theories on the cause of blowout fractures of the orbit: the "hydraulic" theory and the "buckling force" theory. Although both mechanisms have been shown responsible for experimental blowout fractures, the role of isolated rim trauma in producing clinical blowout fractures with entrapment of orbital soft tissues continues to be questioned. I examined a 69-year-old patient who developed a blowout fracture with clinical evidence of entrapment after isolated trauma to the orbital rim. Five days previously the patient had had a cataract extraction and implantation of an intraocular lens in the ipsilateral eye, which remained undisturbed by the trauma. This case supports the role of a buckling force to the rim in producing orbital blowout fractures. Review of the circumstances of injury in large series of blowout fractures suggests that this mechanism may be operative in the majority of cases. PMID- 3812624 TI - Two cases of downbeat nystagmus and oscillopsia associated with carbamazepine. AB - Downbeat nystagmus is often associated with structural lesions at the craniocervical junction, but has occasionally been reported as a manifestation of metabolic imbalance or drug intoxication. We recorded the eye movements of two patients with reversible downbeat nystagmus related to carbamazepine therapy. The nystagmus of both patients resolved after reduction of the serum carbamazepine levels. Neuroradiologic investigations including magnetic resonance imaging scans in both patients showed no evidence of intracranial abnormality. In patients with downbeat nystagmus who are taking anticonvulsant medications, consideration should be given to reduction in dose before further investigation is undertaken. PMID- 3812625 TI - Subarachnoid injection as a complication of retrobulbar anesthesia. AB - We studied eight cases of apparent subarachnoid injection of local anesthetic through the optic nerve sheath and subsequent spread to the parabrainstem cisterns and the contralateral optic nerve sheath. The patients all experienced bilateral decrease in vision and ophthalmoplegia, and variable degrees of central nervous system symptoms and respiratory depression. The complications occurred with a variety of local anesthetic agents and with sharp disposable needles in six of the eight cases. These cases demonstrated the spectrum of signs and symptoms that may follow optic nerve sheath injection of local anesthetic agents. PMID- 3812626 TI - Pseudophakic malignant glaucoma--is it really pseudo-malignant? PMID- 3812627 TI - International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease. PMID- 3812628 TI - The medical treatment of ciliary block glaucoma after extracapsular cataract extraction. PMID- 3812629 TI - Inexpensive lightweight aspheric plastic indirect ophthalmoscopy lens. PMID- 3812630 TI - Vitreoretinal photography using the 90-diopter lens. PMID- 3812631 TI - Magnetic resonance imaging in neuro-ophthalmic rostral brain-stem syndromes. PMID- 3812632 TI - Lenticular chrysiasis in oral chrysotherapy. PMID- 3812633 TI - Globe rupture from blunt trauma after hexagonal keratotomy. PMID- 3812634 TI - Monocyte adherence to endothelial cells in vitro is increased by beta-VLDL. AB - The adherence of blood monocytes to the arterial endothelium is an early event in the development of atherosclerotic lesions. The possibility was investigated that alterations in the level and composition of plasma lipoproteins may contribute to this phenomenon. The adherence of human mononuclear cells to primary bovine aortic endothelial cells was measured in an in vitro monolayer collection assay. Preincubation of endothelial cells with beta-very low density lipoprotein (beta VLDL) from cholesterol-fed rabbits or with very low density lipoprotein (VLDL) from cholesterol/saturated fat-fed cebus monkeys resulted in a significant increase in the subsequent adherence of monocytes to the endothelial cells. The effect of beta-VLDL was maximal at 100 micrograms protein/ml. The response increased with time when endothelial cells were incubated with beta-VLDL for 0 120 minutes, then remained maximal for up to 4 hours. The adherence of a human monocytic cell line (U937) to endothelial cells was also increased by beta-VLDL. These results suggest that diet-induced alterations in lipoprotein composition may contribute to the development of atherosclerotic lesions by affecting the adherence of monocytes to the arterial endothelium. PMID- 3812635 TI - Dietary fatty acid effects on T-cell-mediated immunity in mice infected with mycoplasma pulmonis or given carcinogens by injection. AB - To test whether or not diets enriched in w-6 polyunsaturated fatty acids are significantly immunosuppressive, B10.D2, DBA/2, and C3B6F1 mice were fed diets enriched for fatty acids: linoleic (POLY), oleic (MONO), palmitic (SAT), or eicosapentanoic (FISH). The B10.D2 and DBA/2 mice were given injected methylcholanthrene several weeks later, and immune studies were performed several months after carcinogen treatment. In conventional quarters, DBA/2 fed the POLY diet survived poorly, and many were infected with Mycoplasma pulmonis, even if given the vehicle, tractinoin, only. B10.D2 mice survived well unless on the POLY diet and given methylcholanthrene. Nevertheless, only mice on the POLY diet were significantly immunosuppressed, and only T-cell-mediated cutaneous sensitivity reactions were affected. Antibody, natural killer cell, and natural cytotoxic cell responses were not influenced by the diets. The C3B6F1 mice were assessed for immune functions prior to carcinogen (ethylnitrosourea) instillation into the trachea, and no immunosuppression was detected. After instillation, mice on the POLY and MONO diets were suppressed for T-cell cutaneous responses. Deliberate infection with Mycoplasma pulmonis resulted in suppressed cutaneous T-cell responses in the POLY group of C3B6F1 mice, and aspirin partially reversed the immunosuppression. Mice on the FISH diet were resistant to immunosuppression. It is tentatively concluded that diets rich in w-6 polyunsaturated diets, while not directly immunosuppressive, do predispose animals to suppression of certain T cell-mediated immune responses. This immunosuppression can be "triggered" by infection and/or by exposure to carcinogens. PMID- 3812636 TI - The role of intraalveolar fibrosis in the process of pulmonary structural remodeling in patients with diffuse alveolar damage. AB - For a study of the processes and mechanisms of pulmonary structural remodeling in fibrotic lungs and metaplastic squamous epithelial cells in fibrotic alveoli, immunohistochemical, ultrastructural, and light-microscopic morphometric observations were made of the lungs in acute and proliferative stages of diffuse alveolar damage (n = 40) obtained from biopsies and autopsies. Morphometry showed that intraalveolar fibrosis developed in the early proliferative stage and was more prominent than interstitial fibrosis. In the early proliferative stage, activated myofibroblasts migrated into intraalveolar spaces through gaps in the epithelial basement membrane. They then attached to the luminal side of epithelial basement membrane and produced intraalveolar fibrosis and coalescence of alveolar walls. This intraalveolar fibrosis was the essential factor in the remodeled lungs. Albumin, fibrinogen, immunoglobulins, and surfactant apoprotein were present throughout the hyaline membrane. Fibronectin was not found in hyaline membrane of the lesions in early acute stage but was demonstrated in later stages in outer layers of hyaline membranes and in the areas of intraalveolar fibrosis. Fibronectin may be responsible for the migration and proliferation of myofibroblasts in intraalveolar spaces. Metaplastic single layered and stratified squamous epithelial cells were keratin-positive and surfactant apoprotein-negative. These metaplastic epithelial cells were frequently found in the alveoli with minimal Type II epithelial cell proliferation and in the grossly scarred alveoli. PMID- 3812637 TI - Clonal mapping of the human aorta. Relationship of monoclonal characteristics, lesion thickness, and age in normal intima and atherosclerotic lesions. AB - The surfaces of 8 aortas from women heterozygous for G-6-PD isoenzymes were mapped for an examination of the relationships of monoclonality, lesion type, lesion thickness, and age of the patient. The percent B isoenzyme value of samples of normal intima (n = 315), fatty steak (n = 68), or fibrous plaque (n = 64) was used to define monoclonality, expressed as the [Z] score, the number of standard deviations from the mean percent B isoenzyme of samples of underlying media. Intimal thickness increased significantly with type of lesion, such that intima less than fatty streak less than fibrous plaque, and with the age of the patient. The percentage of monoclonal portions also increased with lesion type, such that 1% of samples of normal intima were monoclonal, compared with 4.4% of fatty streaks and 12.5% of fibrous plaques (P less than 0.005). Monoclonality increased with intimal thickness when normal intima, fatty streaks, and fibrous plaques were combined (P = 0.0001). When examined separately, normal intima showed a direct correlation between monoclonality and intimal thickness. In contrast, the monoclonality of fatty streaks was inversely associated with thickness (P = 0.016) and the monoclonality of fibrous plaques not related to thickness. When entered into a multiple regression model, lesion type and age, but not lesion thickness, significantly predicted monoclonality. The lack of association of intimal thickness with monoclonality suggests that it is the type of lesion that determines monoclonality and not merely its thickness. This implies that mechanisms other than clonal selection are responsible for the monoclonal characteristics of human atherosclerotic lesions. PMID- 3812638 TI - Characterization of neutrophil and monocyte specific chemotactic factors derived from the cornea in response to hydrogen peroxide injury. AB - To unravel the contributions of corneal tissue in endocular inflammation, we examined the capability of corneal endothelial cells (CECs) to release leukocyte chemotactic factors (LCFs) following injury induced by the leukocyte product hydrogen peroxide. Hydrogen peroxide (H2O2) was chemically generated by the interactions of glucose and glucose oxidase prepared in serum-free minimal essential medium (MEM). For these studies, endothelial surfaces of isolated bovine corneas were incubated with glucose (1 mg/ml) and glucose oxidase (20 U/ml) for 4, 6, and 10 hours at 37 C/in a 5% CO2 atmosphere. Supernatants were then removed and assayed for bovine neutrophil or mononuclear cell chemotactic activity. C5 fragment was our positive control for 100% chemotactic response. Corneas were also fixed in buffered formalin for histopathologic evaluation. Results of these studies indicated that 1) 6-hour interactions of the glucose (G)/glucose oxidase (GO) mixture with endothelial surfaces resulted in both endothelial cell injury (cytoplasmic vacuolization and convoluted nuclei) and production of chemotactic factors (via checkerboard analysis) specific for both neutrophils (58% maximum chemotactic response [MCR]) and mononuclear cells (75% MCR); 2) control corneas treated with either G or GO for 4 and 6 hours produced low levels of LCFs (5-15% MCR); 3) preliminary molecular weight characterization of cornea-derived LCFs obtained from corneas incubated with G/GO for 6 hours revealed the detection of chemotactic activity specific for mononuclear cells in two major fractions, one near the void volume (greater than 130,000 daltons) and one near the elution volume (less than or equal to 10,000-15,000 daltons). Chemotactic activity specific for neutrophils was detected only in one major fraction near the elution volume (less than or equal to 10,000-15,000 daltons); and 4) the production of these LCFs by isolated corneas was significantly inhibited, in a dose-response fashion, when the enzyme catalase (1200-6000 U/ml) was added to corneas incubated with G/GO for 6 hours. To investigate whether isolated CECs were capable of producing LCFs in response to G/GO injury, the authors incubated cultured bovine CECs with G/GO for 3, 6, and 20 hours at 37 C in a 5% CO2 atmosphere. Similar to isolated corneas, cultured CECs incubated with G/GO for 6 hours produced significant levels of LCFs specific for neutrophils (67% MCR) and mononuclear cells (75% MCR). Furthermore, the addition of catalase (3000 U/ml) to corneas incubated with G/GO for 6 hours markedly reduced the production of LCFs. These in vitro studies suggest that corneal cells and/or corneal matrix may play important roles in the initiation and amplification of endocular inflammation in vivo by elaborating factors that control leukocyte influx to the anterior chamber region. PMID- 3812639 TI - Changes in ultrastructure and Ca2+ distribution in the isolated working rabbit heart after ischemia. A time-related study. AB - Ultrastructural changes in cardiac muscle of isolated working rabbit hearts after various periods of ischemia are described and compared with distributional changes in calcium. The effects of reperfusion on these structural parameters were also investigated. The purposes of this study were to relate the role of calcium in the degeneration of cardiac muscle; to determine whether Ca2+ localizations could serve as additional criteria to determine more closely the point of no return; and to investigate the contributory role of reoxygenation to the development of myocardial damage. This study shows the existence of topographic differences in the tolerance to ischemia in the mid area, subendocardium, and subepicardium; that the sequestration of Ca2+ by mitochondria is an energy-requiring (active) process that occurs only during reperfusion; the loss of the sarcolemma's ability to bind Ca2+ during ischemia to coincide with increased Ca2+ entry during postischemic reperfusion (this Ca2+ is scavenged by mitochondria as long as sufficient energy remains available; these changes are interpreted as being at the edge of irreversibility); and the lack of additional damage and and lack of Ca2+ accumulation in mitochondria during reperfusion in cells that are damaged to such an extent that mitochondria possess flocculent densities already at the end of the ischemic insult. PMID- 3812640 TI - An implantable hearing device: osseointegration of a titanium-magnet temporal bone stimulator. AB - The use of bone conduction hearing devices has recently entered the realm of implantable prostheses and solid-state electronics, resulting in improved fidelity and applicability for a wider range of patients. One particular device, a temporal bone stimulator (TBS), consists of an external sound processor and implanted portion to cause vibration under the skin. An implantable temporal bone stimulator screw constructed of titanium alloy with a permanent magnet can be vibrated by inductive transcutaneous coupling. The safety and osseointegration of the TBS bone screw were tested in adult goats that were free-field stimulated at 75 dB with the TBS processor for 4 to 21 weeks. Histologic comparisons of the soft tissue and bone adjacent to active and passive screws revealed no remarkable differences between them with bone growing in the interstices of the threaded portion. Evidence for mild reorganization of bone was shown with Goldner's stain, which differentiated bone that was young and unmineralized from bone that was older and mineralized. Reorganization was evident in both the active and passive sites and there was no remarkable difference between the two in a blind study. Additional evidence for the integrity of the implant was obtained by subjecting a calvarium containing both screws to a 5000 gauss magnetic field for 10 minutes of a nuclear magnetic resonance head scan. The calvarium was first dissected free from overlying skin and connective tissue. The magnet-containing screws were not loosened. We conclude that the implanted screw portion of the TBS implantable hearing device is well-integrated into the temporal bone. Mild stimulation of new bone growth indicates a healthy long-term viable implant for bone conduction amplification of sound. PMID- 3812641 TI - Temporalis muscle flap for the otologist. AB - Part or all of the mastoid cavity, ear canal, middle ear, and inner ear are frequently removed in tumor surgery by the otologist. This creates a cavity that is usually closed off at the level of the external meatus and filled with adipose tissue. When this cavity becomes infected in the postoperative period, the surgeon not only has to deal with the local infected cavity, but also with meningitis. This prohibits one from the standard surgical principles of incision and drainage to the outside. A case of an infected obliterated cavity is presented, as well as its treatment with a temporalis muscle flap. This resulted in closure of the dead space in the temporal bone, as well as a successful outcome for the patient. PMID- 3812642 TI - Experimental cochlear hydrops in cats. AB - An experimental model of cochlear hydrops was created in cats. Ten cats underwent surgical procedures to obliterate the saccule, and their temporal bones were studied by light microscopy after sacrifice at 10 weeks. In one group the saccules were destroyed by maceration and aspiration. However, in these ears the saccular lumens were not obliterated and endolymphatic hydrops did not develop. Obliteration of the saccules was achieved in the second group after fascia was introduced into the area of the injured saccules. Cochlear endolymphatic hydrops was a consistent finding in these ears except when a fistula of the membranous labyrinth was present. However, in addition to fibrosis and new bone formation in the vestibules there were also degenerative changes in the hair cells, tectorial membranes, and striae vasculares of these cochleae. The results supported the longitudinal flow theory of endolymph and are consistent with the reported examples of cochlear endolymphatic hydrops in man. PMID- 3812643 TI - Mechanisms of cholesteatoma formation following stapedectomy. AB - Poststapedectomy cholesteatoma is uncommon. We report a patient with bilateral cholesteatomas, each following an initially successful stapedectomy for conductive hearing loss due to stapedial fixation from otosclerosis. A revision right stapedectomy done in 1972 was complicated 4 years later by prosthesis extrusion and cholesteatoma. An extensive left cholesteatoma occurred 7 years after stapedectomy in 1977 and required a radical mastoidectomy. The etiology of poststapedectomy cholesteatoma in this patient was probably chronic eustachian tube dysfunction and negative middle ear pressures. The initial right cholesteatoma occurred following prosthesis extrusion, which is presumed to have been the portal of entry of squamous epithelium into the middle ear. The later occurring left poststapedectomy cholesteatoma represented progression of an attic retraction pocket. Both of these complications were likely secondary to negative middle ear pressure. In addition to eustachian tube dysfunction, other proposed etiologies for poststapedectomy cholesteatoma formation include prosthesis extrusion independent of negative middle ear pressure, unrecognized presence of squamous epithelium in an oval window fat graft, an inverted tympanomeatal flap due to improper positioning, and a marginal perforation from a disrupted anulus. Poststapedectomy cholesteatoma is a rare phenomenon, but does occur. The preoperative exclusion of patients with eustachian tube dysfunction and proper surgical techniques should reduce this complication. PMID- 3812644 TI - Race difference in susceptibility to noise-induced hearing loss. AB - Pure-tone audiometric thresholds were compared in 28 black and 28 matched white male Emergency Medical Service firefighters exposed to high levels of ambulance siren noise. Groups were matched on the basis of chronologic age, duration of firefighter employment, and prevalence of nonjob-related noise exposure. Results suggested that whites are more susceptible to the damaging effects of high-level noise than blacks. In both the mid- and high-frequency regions of the audiogram, blacks showed significantly better sensitivity than whites on the poorer ear. On the better ear, the sensitivity difference between blacks and whites widened as employment duration and, therefore, duration of noise exposure, increased. PMID- 3812645 TI - Role of air bubbles in the perilymph as a cause of sudden deafness. AB - In the course of exploratory tympanotomies we have several times come across air bubbles leaking with perilymph. The fact prompted the hypothesis that in some cases of perilymphatic fistulas, air bubbles could enter the perilymphatic space from the fistula of the inner ear membrane and cause acute, reversible, profound sensory hearing loss. The experimental study described here was designed to test this hypothesis on guinea pigs. Experiments showed that sudden elevation of middle ear pressure by artificial means caused air bubbles to appear in the scala tympani even at a pressure level of 400 mm H2O. It also proved that air bubbles entered the perilymphatic space through the ruptured round window membrane without damaging Corti's organ or the membranous structure of the cochlea. Sequential recording of the action potential revealed that air bubbles induced acute, reversible, and profound hearing loss of cochlear origin, probably by disturbing the propagation of traveling waves of the perilymph. PMID- 3812646 TI - The eustachian tube lumen in chronic otitis media. AB - The measurements of the size of the eustachian tube lumen, in its various regions, in adults are presented. The material consisted of serially sectioned eustachian tubes of 26 normal temporal bones and four pathologic temporal bones, three of them with simple chronic otitis media and one with cholesteatoma. These measurements reveal: (1) in adults (as in children) that there is a considerable variance of the eustachian tube lumen sizes corresponding to other variations in sizes of other organs; (2) no obstruction of the eustachian tube lumen was encountered in any of the pathologic specimens; and (3) there was no significant statistical difference between the lumen size of the eustachian tube retrieved from normal temporal bones compared with those from temporal bones with chronic otitis media. PMID- 3812647 TI - Verrucous carcinoma in the external auditory canal. AB - The apparent rarity of verrucous carcinomas of the ear is reflected by the fact that only three well-documented cases have previously appeared in the literature. However, in other instances the diagnosis of verrucous carcinoma may have been missed because of the unfamiliarity of many clinicians and pathologists with the morphologic characteristics of these lesions. We describe the first case of a verrucous carcinoma confined to the external auditory canal in which a positive diagnosis was only made histologically after local recurrence of what was initially diagnosed as a senile keratosis. The difficulties inherent in diagnosing this lesion and the necessity of close cooperation between the surgeon and pathologist if a diagnostic error is to be avoided are emphasized. Careful follow-up of all warty lesions of the external auditory canal and middle ear cleft is recommended. PMID- 3812648 TI - Osteoradionecrosis of the ossicular chain. AB - Osteoradionecrosis of the temporal bone is a well-known sequela of radiotherapy for neoplasms at the base of the skull. Presenting symptoms include otalgia, chronic aural drainage, and hearing loss, which can be conductive, sensorineural, or mixed. The conductive component has been hypothesized to be caused by radionecrosis of the ossicular chain. This case report documents the existence of osteoradionecrosis of the ossicular chain in a 10-year-old boy operated on for resection of extensive osteoradionecrosis of the temporal bone. PMID- 3812649 TI - Residency program of the Department of Otolaryngology-Head and Neck Surgery of Northwestern University Medical School. PMID- 3812650 TI - Unusually low sexual dimorphism of endocranial capacity in a Zulu cranial series. AB - The mean cranial capacities of 50 male and 50 female Zulu crania were found to be 1373.3 +/- 107.4 ml for males and 1251.2 +/- 101.1 ml for females (means +/- SD). The male value resembles that of other Negro groups, while the female value is somewhat higher than the value for Negro crania as a whole. The index of sexual dimorphism is 8.9%, which is low when compared with those of other Negroid series and other populations. The possible causes for this form of a low sexual dimorphism are as follows: A negative secular trend, with the assumption that the Zulu crania were larger than those of the reference populations of African Negroids before the start of the secular trend change. This would seem to be the most likely possibility, with some supporting evidence for both parts of the explanation. An absence of secular trend, with a demographic sampling aberration, in which large females and small males of the population are sampled. This possibility cannot be totally excluded. An absence of secular trend, with a genetic difference in sexual dimorphism for cranial capacity between the Zulu and the reference populations. While this possibility cannot be excluded, it would be the least preferable explanation. PMID- 3812651 TI - Gene differentiation among ten endogamous groups of West Bengal, India. AB - Ten endogamous populations of West Bengal, India have been surveyed for genetic variation in 12 systems. These populations encompass all social ranks in the caste hierarchy and cover almost the entire geographic area of the state. Gene diversity analysis suggests that these groups exhibit significant allele frequency variation at all but three loci. The overall genetic difference is not, however, in accord with the classification based on caste. Two low-ranking scheduled caste groups are, in fact, in close proximity with the high-caste ones, suggesting evidence of past generations of gene flow among them. Three different clusters of groups emerge from the present data, providing support for the anthropologic assertion that in Bengal Proto-Australoid, Caucasoid, and Mongoloid racial elements generally coexist. However, these three components are not uniformly present in all groups. Geographic separation of the groups is a strong determinant of the gene differentiation that exists among these populations. PMID- 3812652 TI - Cementum annulation and age determination in Homo sapiens. I. Tooth variability and observer error. AB - In order to test the feasibility of cementum annulations to estimate age in humans, observer error and tooth variability in cementum ring counts were evaluated in a sample of 42 mandibular canine and first premolar pairs. Additionally, two sectioning techniques were evaluated. Demineralized thin sections (7 micron) stained with hematoxylin are the preferred technique since their age related variance is greater than 75% for all tooth types examined. In contrast, less than 50% of the total variance was accounted for among individuals when mineralized sections (80 micron) stained with alizarin red were used. Intertooth variability in ring counts of demineralized sections was large between canines and premolars (43%). Premolars provide counts with lower interobserver error and are the preferred tooth. In an expanded sample (N = 51) of demineralized premolars, intraobserver and interobserver error accounted for 2% and 5% of the total variance, respectively. Evaluation of several experimental designs showed that increasing the number of slides per tooth has the greatest effect on reducing variance followed by increasing the number of observers. Increasing the number of observations has little effect. Cementum ring counts are measurable to a highly repeatable extent and provide a level of repeatability greater than that reported for the pubic symphysis and auricular surface aging techniques. PMID- 3812653 TI - Cementum annulation and age determination in Homo sapiens. II. Estimates and accuracy. AB - The cementum annulation aging technique was evaluated in a sample of 80 clinically extracted premolars (age range 11-70 years). Demineralized thin sections (7 micron) stained with hematoxylin were used. The correlation (r) between age and adjusted count (number of annulations added to age of tooth eruption) was 0.78 for the entire sample (N = 73) and 0.86 for a subsample in which teeth with periodontal disease were excluded (N = 55). Standard error of the estimates ranged from 4.7 to 9.7 years depending on sex and health status of the tooth. The technique provided significantly better estimates for females than for males. The overall inaccuracy (mean absolute error) of the technique was 6.0 years, with a bias (mean error) of 0.26 years. Reduced major axis regression of adjusted count on age produced a slope of 0.797 for the entire sample and 0.889 for the nonperiodontal disease subsample. These slopes are consistent with a hypothesis of annual deposition of cementum rings given a decrease in cementogenesis with increasing age. PMID- 3812654 TI - Correlations between relatives in small populations. AB - Correlations between relatives in small, closed populations can be substantially smaller than predicted by the classical formulas of population genetics. This effect is especially pronounced for relatives whose most recent common ancestor is several generations removed. When the effective population size is small, correlations between even close relatives can be negative. This implies that in small populations conventional estimators of quantitative genetics parameters will be biased and that preferential treatment of close relatives will be less likely to evolve. PMID- 3812655 TI - Familial segregation in the iron age community of Alfedena, Abruzzo, Italy, based on osteodental trait analysis. AB - Numerous authors have studied human cemetery remains with an eye toward identifying different socially stratified ethnic or kinship groups within the same population. The interments of the protohistoric graveyard of Alfedena, Abruzzo, Italy, show recurrent organization in separate structures, suggesting to several involved archaeologists that these structures express family groups and/or differences in social function of the occupants. This has induced us to analyze the possible biological implications of specific models for kinship groups, lineages, or mating forms in graveyards. One hundred ninety-six metric and nonmetric skeletal and dental variables were collected. The analysis of metric features was performed by analysis of variance and by calculating divergences between each pair of individuals. The position parameters of the inter-and intragroup distance distributions were then compared by means of nonparametric tests. The nonmetric features were analyzed by contingency tables. The partition of intercircle variance is twice as frequently significant for males (20 variables) as for females (10). For metric variables in males, 20.9% displayed a probability level less than 5% for the null hypothesis of random distribution of individuals in the circles. Fewer (10.3%, but still more than expected at random) reached this level of significance for the females. In the male groups, 19% of nonmetric features showed significant frequency differences, but this was true in only 4.3% of the females.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812656 TI - The relationship between auditory exostoses and cold water: a latitudinal analysis. AB - The frequency of auditory exostoses was examined by latitude. It was found that discrete bony lesions of the external auditory canal were, with very few exceptions, either absent or in very low frequency (less than 3.0%) in 0-30 degrees N and S latitudes and above 45 degrees N. The highest frequencies of auditory exostoses were found in the middle latitudes (30-45 degrees N and S) among populations who exploit either marine or fresh water resources. Clinical and experimental data are discussed, and these data are found to support strongly the hypothesis that there is a causative relationship between the formation of auditory exostoses and exploitation of resources in cold water, particularly through diving. It is therefore suggested that since auditory exostoses are behavioral rather than genetic in etiology, they should not be included in estimates of population distance based on nonmetric variables. PMID- 3812657 TI - Tubular hand bone growth during the latter half of the prenatal period: an allometric analysis. AB - The growth of the 19 tubular hand bones from fetal months 5 to 9 was studied by the allometric method. The hand bones were carefully dissected under a low power stereoscopic microscope. The length and breadth of all bones was found to be monophasic in relation to crown-rump length. In general, maximum bone and ossified shaft lengths in the same row group demonstrate similar allometric coefficients. The specific growth rate of ossified shaft length for all fetal hand bones is greater than the growth rate of maximum length. The highest allometric coefficients for both maximum length and ossified shaft length were obtained from the middle phalanges. The shape of the metacarpals and distal phalanges becomes thinner, while the other bones become thicker or maintain their length-breadth ratio. The relative growth pattern of the first proximal phalanx differed from the middle phalangeal group of the other digits. This suggests that current nomenclatures for the three bones of the pollex is appropriate. PMID- 3812658 TI - Skeletal stature compared to archival stature in mid-eighteenth century American: Ft. William Henry. AB - Fourteen soldiers buried at Ft. William Henry, New York, between 1755 and 1757 are compared for stature to a sample of 2,232 New York Provincial soldiers measured anthropometrically in 1760. The William Henry stature mean of 177.3 cm is significantly higher than that of the Provincials (169.7 cm), and their variation of stature is significantly lower-suggesting that the cemetery population was a select group. A historical explanation is offered for this unexpected finding. PMID- 3812659 TI - Fluctuating dental asymmetry as a measure of odontogenic canalization in man. AB - Fluctuating odontometric asymmetry was evaluated in 202 Lengua Indians and in 125 contemporary caucasoids using Euclidean map analyses, rescaled asymmetry values, and Naperian logarithmic transformations. Both populations showed bimodal distributions of canalizing ability, with significantly more Lengua Indians being less well canalized. Student t-tests indicated that significant interpopulation differences in rescaled asymmetry values centered around maxillary mesiodistal dimensions. Analyses of variance failed to show significant levels of sexual dimorphism in the magnitude of asymmetry for both populations. It is concluded that even in a relatively stress-free population, there exist some individuals who are less well canalized than others. When a population is subjected to elevated levels of parasitic and nutritional stress, the number of less-well canalized individuals increases significantly. PMID- 3812660 TI - Ecological significance of hypometabolism in nonhuman primates: allometry, adaptation, and deviant diets. AB - The "Kleiber relationship" describes the interspecific allometry between body size and metabolism. Like other allometric relationships, the Kleiber relationship not only summarizes scaling effects across species but also provides a standard by which species can be compared. One well-noted deviation from the Kleiber relationship is "hypometabolism": metabolic rates below that expected for a given size. It has been suggested in the literature that hypometabolism may be a primitive mammalian trait, a thermoregulatory adaptation, an adaptation to arboreal folivory, or an adaptation to a diet that is deviant for body size. Data on primate physiology and behavior are used to evaluate these hypotheses. Only the deviant-diet hypothesis is supported by the data on nonhuman primates. Indeed, the Jarman-Bell relationship, which is the basis for this hypothesis, provides a more coherent explanation of correlated features of animal physiology and behavior than do the alternative models. Hypometabolism may be an energy conserving adaptation to a variety of nutritional stresses. The present analysis underscores the point that metabolic rate, like foraging behavior, should be thought of as evolutionarily labile. PMID- 3812661 TI - Dermatoglyphic studies among the two breeding isolates of Gujjars of northwestern India. AB - Dermatoglyphic studies among two breeding isolates of Gujjars (200 individuals from each population) from northwestern India have been carried out. The distribution of phenotypic frequencies of dermatoglyphic features among the Hindu and Muslim Gujjars provides strong evidence that these populations have become distinct in the course of their history. This could have occurred due to the inflow of genes from Muslim invaders and surrounding populations or from the effects of inbreeding and biosocial and geographical isolation of the Muslim Gujjars from their counterpart, the Hindu Gujjars. However, the frequency distribution of dermatoglyphics of the Hindu Gujjars resembles those of the Rajputs, Jats, and Ahirs, suggesting an infrequent inflow of genes from neighboring populations and probably their recent isolation. Sexual dimorphism for dermatoglyphics has also been observed in both Hindu and Muslim Gujjar populations. PMID- 3812662 TI - Fluctuating asymmetry in fetuses of diabetic rhesus macaques. AB - This study examines dental fluctuating asymmetry (FA) in two samples of fetal rhesus monkeys, one composed of 19 fetuses from diabetic mothers (FDM) and the other of 20 fetuses from nondiabetic mothers. Seventeen measurements were taken on the deciduous dentition of right and left mandibles. The degree of FA was assessed by comparing FDM to fetuses of normal mothers by correlation between right and left sides, and analysis of variation differences between right and left sides. Significant FA was found for three traits based on the correlation between right and left sides and for seven traits by the between-treatment ratio of variance between sides. Distal teeth, both within and outside of a morphologic field, exhibit significantly greater FA than mesial teeth. Our results support the hypothesis that developmental instability is detectable by dental FA. PMID- 3812663 TI - Technical report: the effects of humidity on the Abawerk osteometric board. AB - Calibration of the Abawerk osteometric board was checked in varying conditions of relative humidity. The paper scale of the board expands in high relative humidity. Measuring errors as great as 3.5 mm may result when using the board in humid environments. PMID- 3812664 TI - High affinity L-aspartate transport in chick small intestine. AB - Epithelial cells isolated from chick small intestine were used to study the mechanism of L-aspartate transport. Two kinetically distinct uptake systems of high (Km' = 16 microM) and low (Km'' = 2.7 mM) affinity are observed. This paper examines the cation dependence and membrane potential sensitivity of the high affinity system. Unidirectional influx studies indicate that extracellular Na+ is an absolute requirement for transport function. Flux is optimal when K+ is present intracellularly, however this cation is not required for Na+-dependent L aspartate uptake. In the absence of K+, flux enhancement is observed when the intracellular pH is acidic. In contrast, acidic intracellular pH is inhibitory in cells that are preequilibrated with K+. Sodium ([Na+]o greater than [Na+]i gradients, and potassium ([K+]o less than [K+]i) or proton ([H+]o less than [H+]i) gradients can independently energize the Na+-dependent accumulation of L aspartate above equilibrium levels, suggesting that Na+ and L-aspartate cotransport occurs with concomitant K+ or H+ antiport. L-Aspartate influx is insensitive to membrane potential changes created by inwardly directed anion gradients in the presence or absence of intracellular K+. A model is presented that is consistent with electroneutral Na+-coupled transfer with an ion antiport site of low specificity. PMID- 3812665 TI - 31P nuclear magnetic resonance measurements of intracellular pH in giant barnacle muscle. AB - The accuracy of intracellular pH (pHi) measurements by 31P nuclear magnetic resonance (NMR) spectroscopy was examined in single muscle fibers from the giant barnacle, Balanus nubilis. The pHi was derived from the chemical shifts of 2 deoxy-D-glucose-6-phosphate and inorganic phosphate. In fibers superfused with sea water at pH 7.7, pHi = 7.30 +/- 0.02 at 20 degrees C. Experimentally induced pHi changes were followed with a time resolution of 3 min. Intracellular alkalinization was induced by exposure to NH4Cl and intracellular acidification followed when NH3 was removed. Then acid extrusion was stimulated by exposure to bicarbonate containing sea water. In single muscle fibers 31P NMR results were in excellent agreement with microelectrode studies over the pH range of 6.5 to 8.0. The initial acid extrusion rate was 1.7 +/- 0.3 mmol X l-1 X min-1 at pHi 6.75. Our results showed that 31P NMR is a reliable in vivo pH probe. PMID- 3812666 TI - High cytosolic pH inhibits Ca uptake by Myxicola axon mitochondria. AB - Microliter samples of cytoplasm containing mitochondria were aspirated from giant axons of the marine annelid Myxicola infundibulum into polyethylene tubes. The small molecular constituents within these cytoplasmic samples were controlled by a dialysis capillary with a 6,000 molecular weight cut off. The negative log of the calcium ion activity (pCa) (6.72 +/- 0.03, n = 40) and, in some cases, the pH (7.51 +/- 0.01, n = 7) of the samples were monitored with ion-sensitive microelectrodes. Adding 5 mM succinate or 5 mM ATP at pH 7.5 caused the Ca activity in the cytoplasm to drop from an experimentally elevated value of approximately 10 microM to below 1 microM. This decrease could be inhibited with ruthenium red, suggesting a mitochondrial mechanism. Ca uptake, following the addition of either succinate or ATP, was reversibly slowed when the cytoplasmic pH was elevated to approximately 8.3. When ruthenium red was added after mitochondria had taken up Ca, the Ca activity in the extramitochondrial cytoplasm gradually increased suggesting ongoing release of Ca from storage sites. Increasing the cytoplasmic pH to approximately 8.5 in the presence of ruthenium red did not increase the ongoing release over that found with ruthenium red alone. The apparent washout of Ca from the energy-independent, nonmitochondrial Ca buffers was only slightly affected by pH (pH 7.5-8.5). It is concluded that elevating intracellular pH to 8.3 slows the Ca uptake by mitochondria. Thus cytoplasmic pH may have a function in regulating mitochondrial Ca metabolism and/or extramitochondrial calcium activity. PMID- 3812667 TI - Structural effects of exposure of smooth muscle in sucrose gap apparatus. AB - Structural changes were studied over time of a smooth muscle tissue (opossum esophagus circular muscle) exposed in various compartments of a functioning single sucrose gap. The tissues in the Krebs-perfused compartment were qualitatively normal, possessing nerve profiles with little damage, normal appearing smooth muscle and interstitial cells of Cajal as well as gap junctions between muscle cells and interstitial cells. However, in the sucrose compartment tissues had serious damage to smooth muscle, interstitial cells and nerves, and normal gap junctions disappeared. There was also damage to all these structures in tissues exposed to KCl, but most striking was the disappearance of most interstitial cells. These studies raise serious questions about the assumptions underlying the basis for functioning of multicellular tissues in the sucrose gap. PMID- 3812668 TI - Energy expenditure of longitudinal smooth muscle of rabbit urinary bladder. AB - Heat production, oxygen consumption, and lactate production of longitudinal smooth muscle from rabbit urinary bladder has been measured at 27 degrees C. In isometric contractions (initiated by 1-Hz electrical stimulation) ranging in duration from 2 to 300 s, total energy expenditure correlated linearly with the force-time integral. For any given force-time integral oxygen consumption could account for only approximately 60% of the total energy measured as heat production. A substantial contribution of aerobic lactate production to the total energy flux was observed. This lactate production was also linearly correlated with force-time integral and was of sufficient magnitude to account for the discrepancy between total energy expenditure determined as heat production and oxygen consumption. The suprabasal rate of energy expenditure during the maintenance of force was approximately 2.6 mW/g and remained constant throughout contractions of up to 5-min duration, suggesting that in this muscle there is no change in the energetic cost of force maintenance with increasing duration of contraction. The rate of energy expenditure during the initial period of force development was, however, about twofold greater than that during subsequent force maintenance, indicating that there is an extra energy cost associated with the activation of contraction and development of force above that required for force maintenance. PMID- 3812669 TI - Thermic effects of food and exercise in lean and obese men of similar lean body mass. AB - The thermic effect of food at rest, during 30 min of cycle exercise, and postexercise with two sequences of exercise and meal (before or after exercise) was compared in eight lean (mean +/- SE, 12.8 +/- 0.7% body fat) and eight obese men (29.7 +/- 0.6% fat) to determine whether exercise before or after a meal enhances thermogenesis. The groups were matched for age, height, and lean body mass (LBM) in order to study the relationship between thermogenesis and body fat independent of LBM. Metabolic rate was measured by indirect calorimetry on five mornings, in randomized order, after an overnight fast. Treatments on respective days were 1) 3-h rest, no meal; 2) 3-h rest after a 750-kcal mixed meal (14% protein, 31% fat, 55% carbohydrate); 3) during and 3 h after 30 min of cycling, no meal; 4) during and 3 h after 30 min of cycling, meal 30 min before exercise; and 5) 3 h after 30 min of cycling, meal immediately after exercise. The thermic effect of food, which is the fed minus fasted caloric expenditure, was significantly greater for the lean than the obese men under the resting (mean +/- SE 53 +/- 5 vs. 26 +/- 5 kcal over 3 h for the lean and obese groups, P less than 0.01), exercise (26 +/- 4 vs. 4 +/- 2 kcal over 30 min, P less than 0.01), and both postexercise conditions. However, for the lean men the thermic effect of food was significantly greater for the meal-before-exercise than the resting and the meal-after-exercise conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812670 TI - Clenbuterol, a beta 2-agonist, retards atrophy in denervated muscles. AB - Denervated soleus, anterior tibialis, and gastrocnemius muscles, but not the extensor digitorum longus, contained 95-110% more protein after 2-3 wk of treatment with the adrenergic beta 2-receptor agonist, clenbuterol, than denervated controls. In addition, the twofold difference in the protein content of denervated solei was paralleled by similar changes in contractile strength and muscle fiber cross-sectional area. In contrast, when the innervated contralateral muscles were examined, the extensor digitorum longus and anterior tibialis showed relatively small increases in protein of 32 and 19%, respectively, whereas the soleus and gastrocnemius were unaffected. The magnitude of the effects of clenbuterol in sparing the mass and functional capacity of denervated muscle suggests that this agent may be important in studies of neuromuscular diseases and disuse atrophy. PMID- 3812671 TI - Influence of zinc on growth, somatomedin, and glycosaminoglycan metabolism in rats. AB - Weanling male rats were fed control ad libitum, zinc-deficient (ZD, 1 ppm zinc) or pair-fed (PF) control diets for 13 days. Rats subsequently were refed control diets for up to 8 days and serially killed. ZD and PF diets significantly decreased growth rate, feed intake, and feed efficiency compared to controls. Body weight and feed efficiency, but not feed intake, were significantly less in ZD compared to PF. Bone zinc was 315, 286, and 109 micrograms/g (p less than 0.0001) for control, PF, and ZD at the end of depletion. 35SO4 uptake by glycosaminoglycans (GAG) was significantly less in ZD compared to either control ad libitum or PF rats. Xylosyltransferase activity was decreased significantly below PF and control by ZD, suggesting depressed enzyme activity and/or decreased GAG acceptor sites. Bioassayable somatomedin (Sm) activity was 0.81, 0.42 and 0.33 +/- 0.09 relative activity for control, PF and ZD at the end of depletion. Sm was statistically less in ZD compared to PF at day 2 and 5 of refeeding, but not at the end of depletion. Sm activity and GAG metabolism returned to normal after refeeding for 2-5 days in PF and for 5-8 days in ZD rats. Serum insulin but not glucose was significantly depressed by ZD and PF diets. Thus, zinc deficiency depressed growth and cartilage metabolism and was associated with decreased Sm activity and insulin levels. Some of these changes could be attributed to decreased feed intake as a result of ZD. PMID- 3812672 TI - Effect of exercise intensity and starvation on activation of branched-chain keto acid dehydrogenase by exercise. AB - Branched-chain keto acid (BCKA) dehydrogenase activity was examined in rat skeletal muscle as a function of exercise intensity and nutritional status. The activity of BCKA dehydrogenase increased with increasing exercise intensity, showing increases over resting values of 76, 172, and 245% at 10, 20, and 30 m X min-1. The exercise-induced increase in BCKA dehydrogenase activity was the same in the gastrocnemius and in the quadriceps muscles. Rapid removal of the muscle after death is essential because the activity of BCKA dehydrogenase decreased rapidly after death. Thus the likely reasons Wagenmakers et al. (Biochem. J. 223: 815-821, 1984) found exercise caused a much smaller increase in BCKA dehydrogenase activity than Kasperek et al. [Am. J. Physiol. 248 (Regulatory Integrative Comp. Physiol. 17): R166-R171, 1985] are differences in muscle removal time and the duration of exercise. Starvation for 24 h before exercise increased the exercise-induced activation of BCKA dehydrogenase by 160%, which suggests that the increased BCKA dehydrogenase activity is in response to an increased requirement for citric acid cycle intermediates. PMID- 3812673 TI - Regulation of 25-hydroxyvitamin D3 metabolism in chick embryo. AB - We investigated the time course of the development of renal 25-hydroxyvitamin D-1 hydroxylase and 25-hydroxyvitamin D-24-hydroxylase in chick embryos grown in the presence and absence of the eggshell. In embryos with the eggshell, the specific activity (SA) of 25-hydroxyvitamin D-1-hydroxylase in kidney homogenates increased from 0.68 fmol X min-1 X mg protein-1 at 12 days of gestation to a peak of 2.55 +/- 0.50 fmol X min-1 X mg-1 protein-1 at 17 days. In contrast, the SA of 25-hydroxyvitamin D-24-hydroxylase decreased from 2.5 fmol X min-1 X mg protein-1 to 0.90 +/- 0.25 fmol X min-1 X mg protein-1 during the interval. The total plasma calcium was significantly reduced in embryos without shells at 14 to 15 days of gestation (1.1 +/- 0.1 mM, mean +/- SE) compared with normal embryos of the same gestation (2.3 +/- 0.3 mM, P less than 0.002). In embryos without the eggshell, renal 25-hydroxyvitamin D-1-hydroxylase increased from 6.0 to 8.2 +/- 0.6 fmol X min-1 X mg protein-1 at 17 days of gestation and was from four- to sixfold higher than corresponding enzymatic activities for intact embryos. The increased enzyme activity resulting from loss of the eggshell was due to an increase in Vmax. The findings indicate that renal 25-hydroxyvitamin D-1 hydroxylase and 25-hydroxyvitamin D-24-hydroxylase in the chick embryo exhibit activity and show a large capacity for regulation in response to changes in calcium metabolism. PMID- 3812674 TI - Estrogen effects on angiotensin receptors are modulated by pituitary in female rats. AB - The present studies were designed to test the hypothesis that changes in angiotensin II (ANG II) receptors might modulate the altered target tissue responsiveness accompanying estradiol administration. Estradiol was infused continuously in oophorectomized female rats by employing minipumps to achieve plasma estradiol levels and simulating pregnancy levels in the rat. Aldosterone was also infused in control and experimental animals to avoid estrogen-induced changes in renin and ANG II. ANG II binding constants were determined in radioreceptor assays. Estradiol increased binding site concentration in adrenal glomerulosa by 76% and decreased binding sites of uterine myometrium and glomeruli by 45 and 24%, respectively. There was an accompanying increase in the affinity of ANG II binding to adrenal glomerulosa and uterine myometrium. Because estrogen is a potent stimulus of prolactin release from the pituitary of rodents, studies were also designed to test the hypothesis that prolactin may mediate some or all of the estrogen-induced effects observed. Hypophysectomy abolished estradiol stimulation of prolactin release and most ANG II receptor changes. The only effect that persisted was a 41% decrease in the density of uterine receptors. Prolactin administration to pituitary intact rats was associated with a 50% increase in receptor density of adrenal glomerulosa simulating estradiol administration. However, the changes in glomeruli and uterine myometrium were opposite in that both tissues also increased receptor density, suggesting that prolactin was not the sole mediator of the estrogen-induced receptor changes. In conclusion, regulation of ANG II receptors in a number of diverse target tissues by estradiol is complex with contributions from estrogens and pituitary factors, which include but do not exclusively involve prolactin. PMID- 3812675 TI - Cold-induced increase in brown fat thyroxine 5'-monodeiodinase is attenuated in Zucker obese rat. AB - In this study we examined the possibility that the reduced brown adipose tissue (BAT) thermogenesis in the Zucker obese rat may result from a limited capacity for enzymic conversion of thyroxine (T4) to triiodothyronine (T3) in BAT. A total of 34 lean and obese rats, approximately 4 mo old were divided into three treatment groups: group 1 (5 lean and 6 obese) was fed Purina rat chow for 21 days, and group 2 (5 lean and 6 obese) was fed a cafeteria diet for 21 days, and group 3 (6 lean and 6 obese) was fed Purina rat chow and maintained in the cold (8 +/- 1 degrees C) for 7 days. The lean and obese rats in all three groups of animals were matched closely for age and respective body weight. Activity of T4 5'-deiodinase was determined as the rate of T3 production from added T4 under controlled in vitro conditions. Serum T4 and T3 were determined by radioimmunoassay. The rate of T4-to-T3 conversion in BAT was similar in the lean and obese rats maintained at room temperature, whether fed rat chow or a cafeteria diet (approximately 40-50 pmol T3/scapular BAT depot per h). However, expressed per scapular BAT depot, lean rats exposed to cold displayed about a fivefold increase in BAT T3 production (P less than 0.0001), whereas only a small increase was observed in the cold-exposed obese rats. Serum T3 levels tended to be reduced in the Zucker obese rats. Our data indicate a reduced capacity for T3 production in Zucker rat BAT exposed to cold.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812676 TI - Non-steady-state measurement of glucose turnover in rats by using a one compartment model. AB - One of the tracer methods often employed to measure glucose turnover in the non steady state uses the one compartment model of Steele (Ann. NY Acad Sci 1959). However, this model gives adequate results when it is assumed that only a fraction of the glucose pool takes part in rapid changes of glucose specific activity, thereby being necessary to use a correction factor called the "pool fraction." The aim of this study was to experimentally determine the best pool fraction needed in the rat for the calculation of glucose turnover using a one compartment model. This is important as no data are available so far in this widely used species. For this purpose, glucose turnover was measured in anesthetized lean and genetically obese fa/fa rats, using two different experimental designs. In all conditions, the error in estimating the total rate of glucose appearance was lowest when 0.5 was used as the pool fraction. The error was greater with an increase and a decrease in the pool fraction value. It is concluded that in the rat the one-compartment model measures changes in glucose turnover with reasonable accuracy in non-steady-state conditions and that a pool fraction of 0.5 gives the best results. PMID- 3812677 TI - Uptake of exogenous spermidine by rat lungs perfused in situ. AB - Uptake of the polyamine spermidine (SPD) from the pulmonary circulation was characterized by using ventilated rat lungs perfused in situ with Krebs-Henseleit bicarbonate buffer containing 4.5% bovine serum albumin, 5.6 mM glucose, and 20 amino acids at plasma levels. [14C]SPD was accumulated by the lungs in a time- and concentration-dependent manner. The pathway of SPD uptake exhibited saturation kinetics with an apparent Km in the range of 1 microM and a Vmax of 450-540 pmol/g lung min. SPD uptake was inhibited by the naturally occurring polyamines putrescine and spermine (SPM) and by the inhibitor of polyamine synthesis, methyglyoxal bis(guanylhydrazone) (MGBG). Inhibition of SPD uptake by SPM followed competitive kinetics; although MGBG was also a competitive inhibitor of SPD uptake, MGBG was less effective than SPM. These observations indicate that SPD is taken up from the pulmonary circulation by a carrier-mediated pathway that is inhibited by other natural polyamines and by MGBG and exhibits substrate affinity in the range of plasma SPD concentrations. PMID- 3812678 TI - Ionic regulation of Na absorption in proximal colon: cation inhibition of electroneutral Na absorption. AB - Active Na absorption (JNanet) in rabbit proximal colon in vitro is paradoxically stimulated as [Na] in the bathing media is lowered with constant osmolarity. At 140 mM [Na]o, JNanet is -0.6 +/- 0.4 mueq X cm-2 X h-1, whereas at 50 mM [Na]o JNanet is 5.0 +/- 0.7 mueq X cm-2 X h-1, P less than 0.01. JNas----m is a linear function of [Na]o, suggesting a diffusional flux. JNam----s increases almost linearly from 0 to 50 mM [Na]o but then plateaus and actually decreases from 50 to 140 mM [Na]o, consistent with inhibition of an active transport process. Both lithium and Na are equally effective inhibitors of JNanet, whereas choline and mannitol do not block the high rate of JNanet observed in decreased [Na]o. Either gluconate or proprionate replacement of Cl inhibits JNanet. Removal of K or HCO3 does not alter Na absorption. JNanet at lowered [Na]o is electrically silent and is accompanied by increased Cl absorption; it is inhibited by 10(-3) M amiloride and 10(-3) M theophylline but not by 10(-4) M bumetanide. Epinephrine is equally effective at stimulating Na absorption at 50 and 140 mM [Na]; yohimbine does not inhibit JNanet at 50 mM [Na]o. Na gradient experiments are consistent with a predominantly serosal effect of the decreased [Na]o. These results suggest that Na absorption in rabbit proximal colon in vitro is stimulated by decreased [Na]; the effect is cation specific, both Na and Li blocking the stimulatory effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812679 TI - Modulation of hepatic biotransformation and biliary excretion of bile acid by age and sinusoidal bile acid load. AB - Pericentral hepatocytes excrete bile acids more slowly and biotransform them more than periportal cells. This may reflect adaptation to low pericentral bile acid concentration or may be intrinsic. We studied two models in which pericentral bile acid concentrations are high: the 72-h choledocho-caval shunt (CCS) rat and the 3- to 4-wk-old rat. Livers were perfused forward or backward to assess periportal or pericentral hepatocyte function. Taurodeoxycholate (TDC) was infused at 32 nmol X min-1 X g liver-1, and a bolus of [3H]TDC was given to assess metabolism and excretion of bile acids. In CCS livers perfused backward, pericentral cells resembled periportal cells of controls in that time to excrete 50% of administered [3H]TDC (t50) was reduced by two-thirds and [3H]TDC biotransformation was reduced by about half. In young livers t50 was half that of adult livers when perfused backward. Biotransformation, however, was not reduced. Young livers biotransformed more than adult controls for any given residence time of bile acid in the liver. We conclude that the difference between pericentral and periportal cells as regards bile acid processing is adaptive. Livers from young rats biotransform more bile acid than those from controls under similar conditions. PMID- 3812680 TI - Homologous desensitization to prostaglandins in rabbit ileum. AB - Prostaglandins (PG's) increase short-circuit current (Isc), inhibit NaCl absorption, and stimulate Cl secretion in rabbit ileum. These changes occur with the following PGs; E2, E1, nitrilo-I2 and, to a lesser extent, with A2, D2, and F2 alpha. Arachidonic acid (AA) also stimulates secretion. The PG- or AA stimulated Isc does not persist, however, and on prolonged exposure tachyphylaxis develops. Resensitization of the Isc response to PGE2 is rapid, being essentially complete in 15 min after the PG is removed. Desensitization to AA is not reflected by diminished PG generation. PGE2 release from the mucosa after AA addition is constant, although the AA-stimulated Isc decreases. Isc measurements indicate that PGE2 at slightly below its EC50 partially desensitizes and a near maximal concentration completely desensitizes to PGE2 but does not, however, inhibit the subsequent change in Isc caused by theophylline or vasoactive intestinal peptide (VIP). Adenosine 3',5'-cyclic monophosphate (cAMP) measurements suggest that desensitization applies to cAMP production. PGE2 (10( 5) M) increases mucosal cAMP three- to sevenfold, but this elevation is transient; a second challenge dose, which fails to elicit a Isc change, also fails to increase mucosal cAMP. Adenylate cyclase measurements from untreated and PGE2-treated enterocytes demonstrate a decrease in stimulation by PGE2 but not in stimulation by VIP, fluoride, or 5-guanylylimidodiphosphate. PMID- 3812681 TI - Effect of enkephalins on colonic mechanoreceptor synaptic input to inferior mesenteric ganglion. AB - The effects of leucine-enkephalin (Leu-Enk) on colonic mechanoreceptor input to the inferior mesenteric ganglion (IMG) and on colonic intraluminal pressure of the guinea pig were studied in vitro. Superfusion of the IMG with Leu-Enk decreased colonic, afferent mechanoreceptor synaptic input. In neurons in which mechanoreceptor input caused postsynaptic spikes, Leu-Enk decreased synaptic input and increased the basal intraluminal pressure of the colon. When mechanoreceptor input consisted of singly occurring excitatory postsynaptic potentials (EPSPs), Leu-Enk decreased the frequency of EPSPs but did not cause a change in colonic pressure. The inhibitory effects of Leu-Enk on synaptic transmission were antagonized by naloxone. In the isolated IMG, Leu-Enk converted synchronous action potentials in response to electrical stimulation of intermesenteric nerves to subthreshold EPSPs without a change in the resting membrane potential or input resistance. Action potentials elicited by depolarizing current pulses or by exogenous acetylcholine were unaltered by Leu Enk. These data suggest that Leu-Enk increased colonic intraluminal pressure by acting on the presynaptic terminals of colonic mechanoreceptive neurons to reduce synaptic input to and output from the inhibitory neurons of the IMG. PMID- 3812682 TI - Flow across the canine ileocolonic junction: role of the ileocolonic sphincter. AB - The role of the canine ileocolonic sphincter (ICS) in influencing transit of fluids and absorption of water in the ileum was assessed in loops with or without the ICS. Two sets of four dogs each were equipped with isolated ileal loops 40 cm long, attached to the intact bowel through a neuromuscular bridge. In one set, the loop included the ICS and it terminated in an end colostomy; in the other, the loop ended immediately proximal to the ICS, as an ileostomy. Electrical and mechanical signals were recorded from serosal electrodes and strain gauges, respectively, during perfusion of loops with an isotonic solution at rates from 0.7 to 10.0 ml/min. Loops without an ICS propelled fluid by steady, continuous flow at all rates of perfusion; loops with the ICS in place moved fluids in this way only at 10 ml/min. At greater rates of perfusion, fasting cycles of motility were inhibited in all loops and a random pattern of motility developed; this presumably facilitated more steady flow of fluids. At the slowest rate of perfusion, transit times were longer when the ICS was present, but at faster rates both loops showed similar transit times. Presence of the ICS was associated with increased volumes of fluid in the loop and increased absorption of water, especially when loops were perfused slowly. The canine ICS influences flow of saline and absorption in the terminal ileum, but only when flow rates are low. PMID- 3812683 TI - Coordination of electrical activities in muscle layers of the pig colon. AB - Simultaneous recording of electrical activities from the circular and longitudinal muscle layers of the pig colon was performed in vitro to study possible coordination of activities. The electrical activity of both muscle layers consisted of electrical oscillations with superimposed spikes. The frequency range of the electrical oscillations in the circular muscle was 0.5-3.5 cycles per minute (cpm) and in the longitudinal muscle 24-42 cpm. Coordination of the activities of both muscle layers occurred consistently only after stretch or cholinergic stimulation. Then it occurred in a unique fashion. Each oscillation in the circular muscle layer occurred at the same time as the onset of a burst of oscillations in the longitudinal muscle. In addition, multiple simultaneous recordings of the electrical activities from each muscle layer were obtained showing that within the circular muscle layer electrical oscillations were phase locked in the circumferential direction and along the long axis of the colon. They appeared to propagate in either the oral or aboral direction. In tetrodotoxin (with stretch as stimulus) and also in presence of carbachol, bursts of oscillations in the longitudinal muscle layer were phase locked circumferentially (in the different taeniae) and longitudinally. This study shows that the muscle layers in the colon, which have different myogenic electrical activities, can obtain a high level of coordination. PMID- 3812684 TI - Gastrin receptor characterization: affinity cross-linking of the gastrin receptor on canine gastric parietal cells. AB - We applied affinity cross-linking methods to label the gastrin receptor on isolated canine gastric parietal cells in order to elucidate the nature of its chemical structure. 125I-labeled Leu15-gastrin and 125I-labeled gastrin2(-17) bound to intact parietal cells and their membranes with equal affinity, and half maximal inhibition of binding was obtained at an incubation concentration of 3.2 X 10(-10) M unlabeled gastrin. 125I-gastrin2(-17) was cross-linked to plasma membranes or intact parietal cells by incubation in disuccinimidyl suberate. The membrane pellets were solubilized with or without dithiothreitol and applied to electrophoresis on 7.5% sodium dodecyl sulfate polyacrylamide gels. Autoradiograms revealed a band of labeling at Mr 76,000 and labeling of this band was inhibited in a dose-dependent fashion by addition of unlabeled gastrin to the incubation mixture. Dithiothreitol in concentrations as high as 100 mM did not alter the electrophoretic mobility of the labeled band. After taking into account the molecular weight of 125I-gastrin2(-17), our results suggest that the gastrin receptor on parietal cells is a single protein of Mr 74,000 without disulfide linked subunits. PMID- 3812685 TI - Effects of luminal salt concentration on electrical pathways in Necturus antrum. AB - By use of microelectrode techniques the electrical resistances of the cell membranes and paracellular pathways of surface epithelium in Necturus antrum were determined under control conditions (Ringer solutions containing 106.6 mM Na+, 91.4 mM Cl-) and during exposure to mucosal solutions containing high Na+ and Cl- concentrations. Resistances were determined by briefly exposing tissues to mucosal solutions containing 10(-4) M amiloride, a reversible inhibitor of Na+ conductances. Under control conditions in eight tissues, measurements obtained by exposure to amiloride were not significantly different from those obtained by an independent method, intraepithelial cable analysis, thus indicating the validity of the measurements obtained by the amiloride method. In 10 tissues, high luminal NaCl concentrations (Ringer salts + 125 mM NaCl) increased the apical cell membrane resistance from 5,778 +/- 267 to 7,714 +/- 422 omega X cm2 (P less than 0.01) and the basolateral membrane resistance from 2,973 +/- 186 to 3,869 +/- 335 omega X cm2 (P less than 0.01). The resistance of the paracellular pathway decreased from 625 +/- 13 to 505 +/- 13 omega X cm2 (P less than 0.001). Similar alterations in these resistances were observed when Na+ or Cl- were increased individually, when added as salts of isethionate- and N-methyl-D-glucamine+, respectively. These effects were not attributable to increases in luminal osmolarity, since mucosal solutions made equally hyperosmotic with 250 mM sucrose elicited increases in paracellular pathway resistance and decreases in resistances of the cell membranes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812686 TI - Gastrin is not a physiological regulator of pancreatic exocrine secretion in the dog. AB - The role of gastrin as a regulator of exocrine pancreatic secretion has not been proven adequately. In the present study we therefore compared the relative molar potencies of sulfated and unsulfated gastrin 17 with structurally related CCK peptides (synthetic CCK-8 and natural porcine CCK-33) in stimulating exocrine pancreatic secretion in conscious dogs. Dose response curves were constructed for pancreatic and gastric acid secretion. Plasma gastrin levels after exogenous gastrin 17-I and -II were compared with postprandial gastrin concentrations (meal: ground beef 20 g/kg body wt). The molar potency estimates calculated with synthetic CCK8 as standard (potency = 1.00) for pancreatic protein secretion were natural porcine 50% pure CCK-33 1.60, gastrin 17-I 0.12, and gastrin 17-II 0.16. All four peptides induced a dose-dependent increase in pancreatic bicarbonate output. However, the blood concentrations needed to stimulate pancreatic secretion were above the postprandial gastrin levels. Our data indicate that both gastrin 17 peptides are not physiological regulators of pancreatic enzyme secretion in dogs. PMID- 3812687 TI - Regulation of Na-Cl absorption in rabbit proximal colon in vitro. AB - Ion transport in rabbit proximal colon (PC) in vitro is dominated by a Na-Cl cotransport system stimulated by epinephrine. To further characterize the regulation of Na-Cl transport, we tested the effects of specific adrenergic agonists on ion fluxes under short-circuit conditions. Additionally, we tested the effects of the transport inhibitors bumetanide, furosemide, and 4-acetamido 4'-isothiocyanostilbene-2,2'-disulfonic acid (SITS). Basal Na and Cl absorption were essentially nil [Na net flux (JNanet) = 0.3 +/- 0.4, and Cl net flux (JClnet) = -0.5 +/- 0.5 mu eq X cm-2 X h-1, means +/- SE]. The alpha 2-agonist clonidine significantly increased net Na and Cl absorption (delta JNanet = 3.0 +/ 0.6 mu eq X cm-2 X h-1, delta JClnet = 2.0 +/- 0.4 mu eq X cm-2 X h-1) with a minimal change in short-circuit current (delta Isc = 0.1 +/- 0.1 mu eq X cm-2 X h 1). The alpha 1-agonist phenylephrine and the beta-agonist isoproterenol did not alter ion transport. The alpha 2-blocker yohimbine (YOH) had a complex, concentration-dependent effect. At low concentrations (10(-6)-10(-8) M) YOH effectively inhibited epinephrine-stimulated cotransport. Compared with 10(-8)M YOH, 10(-6) YOH blocked 90% of the epinephrine-induced increases in Na and Cl absorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812688 TI - A carrier-mediated system for transport of biotin in rat intestine in vitro. AB - Transport of biotin was examined in rat intestine using the everted sac technique. Transport of 0.1 microM biotin was linear with time for at least 30 min of incubation and occurred at a rate of 3.7 pmol X g initial tissue wet wt-1 X min-1. Transport of biotin was higher in the jejunum than the ileum and was minimum in the colon (85 +/- 6, 36 +/- 6, and 2.8 +/- 0.6 pmol X g initial tissue wet wt-1 X 25 min-1, respectively). In the jejunum, transport of biotin was saturable at low concentrations (Kt = 3.73, microM, Vmax = 3.11 nmol X g initial tissue wet wt-1 X 25 min-1) but linear at higher concentrations (greater than 10 microM). The transport of low concentrations of biotin was inhibited by structural analogues (desthiobiotin, biotin methyl ester, diaminobiotin, and biocytin), Na+ dependent, energy dependent, temperature dependent, and proceeded against a concentration gradient in the serosal compartment. No metabolic alteration occurs to the biotin molecule during transport. This study demonstrates that biotin transport in rat intestine occurs by a carrier-mediated process at low concentrations and by simple diffusion at high concentrations. Furthermore, the carrier-mediated process is Na+, energy, and temperature dependent. PMID- 3812689 TI - Regulation of transmembrane electrical potential gradient in rat hepatocytes in situ. AB - The transmembrane electrical potential gradient (Em) has been measured in hepatocytes from intact anesthetized rats using conventional intracellular microelectrodes under a variety of conditions. Em measurements in control animals were normally distributed around a mean of -35.5 +/- 4.6 mV (SD) with a coefficient of variation (CV) of 13.1% and a range of -26 to -54 mV. In individual livers, however, measurements of Em at a given point in time exhibited little cell-to-cell variation (cv of 4.5%). The Em was noted to fluctuate spontaneously over time and to change consistently in response to a variety of physiological stimuli including fasting (depolarization to -28.5 +/- 3.8 mV) and infusion of glucagon in physiological amounts (hyperpolarization to -45.0 +/- 1.8 mV). Hepatocyte Em abruptly depolarized (2-5 mV) after an intravenous bolus of taurocholate (3 mumol) or alanine (45 mumol), suggesting that both solutes exhibit electrogenic uptake. The Em returned to or below preinfusion values within 5 min. Continued infusion of alanine (10.8 mumol/min), but not taurocholate (810 nmol/min), caused a sustained and unexpected hyperpolarization of Em of 8.2 +/- 3.1 mV that lasted at least 60 min. In separate studies, alanine administration did not alter the biliary excretion of a taurocholate load. Taken together, these observations demonstrate that rat hepatocytes in situ are tightly coupled electrically and that physiological stimuli, including fasting, glucagon, and sodium-coupled solute uptake can change Em considerably over time. The late hyperpolarization of Em caused by alanine appears to offset the rise in intracellular Na+ associated with alanine uptake and preserve the Na+ electrochemical gradient such that Na+-coupled taurocholate transport is maintained. PMID- 3812690 TI - Pyloric ceca of fish: a "new" absorptive organ. AB - The functions of the blind appendages attached to the proximal intestine of many fish, the pyloric ceca, have been disputed. Hence we recorded morphological parameters and nutrient uptake rates in the ceca and intestine of four fish species (rainbow trout, cod, largemouth bass, and striped bass) with various degrees of cecal development (the ceca contribute 70, 69, 42, and 16% of the total postgastric surface area, respectively). Proline and glucose uptake, measured in vitro, is similar in the ceca and proximal intestine. For these two solutes in these four species, and for 10 other solutes (9 amino acids and 1 dipeptide) in trout, the ceca contribute about the same percentage to uptake as to total gut area. Trout ceca and intestine have similar membrane-bound disaccharidase activity. Separate experiments with trout fed either graded glass beads or a radiopaque marker and then X-rayed show that the ceca fill and empty with particles less than 150 microns and over the same time course as the proximal intestine. Thus ceca are an adaptation for increasing intestinal surface area without increasing the length or thickness of the intestine itself. Fish ceca are entirely different from the distally located ceca of birds and mammals, which have fermentation functions. PMID- 3812691 TI - Liver cell membrane solubilization may control maximum secretory rate of cholic acid in the rat. AB - The factors modulating the maximum secretory rate of cholic acid were investigated. Rats were infused intravenously with cholic acid in measured stepwise increasing doses (1, 2, 3, and 4 mumol X min-1 X 100 g body wt-1). Each dose was infused for 30 min and bile samples were collected every 10 min. Bile flow, bile acid, cholesterol, individual biliary phospholipids, and the fatty acid profiles of the biliary phospholipids were determined. Microsomal and bile canalicular membrane-enriched fractions were isolated from cholic acid-treated rats at the end of the experiment. Membranes were analyzed for cholesterol, phospholipid, and phospholipid fatty acid composition. During cholic acid infusion, the secretion rates of bile acid, cholesterol, phospholipid, and bile flow initially increased and then declined. No evidence of liver cell damage was observed by light or electron microscopy. Maximum phospholipid secretion rate (13.5 nmol X min-1 X g-1) occurred before peak bile flow and bile acid secretory rate maximum (4.72 microliter X min-1 X g-1 and 375 nmol X min-1 X g-1). When phospholipid output declined, the proportion of sphingomyelins and phosphatidylethanolamine relative to phosphatidylcholine increased. This was also reflected in the fatty acid composition. Cholic acid infusion caused a decline in microsomal and bile canalicular membrane phospholipid content without affecting their phospholipid composition. Depletion of membrane phospholipid resulted in an increase in the cholesterol:phospholipid ratio, which is suggested to be the underlying mechanism for modulating cholic acid secretion. PMID- 3812692 TI - Pressure and length adaptations in isolated cat stomach. AB - Correlations were made between the adaptation of gastric pressure and longitudinal muscle tension. Isolated cat stomachs were filled with physiological solution and longitudinal strips marked in five segments over the lesser and the greater curvature (LC and GC). Strip length changed the most in the proximal segments of GC. Volume changes led to triphasic changes in gastric pressure. On filling, there was a pressure peak and pressure accommodation to a new base-line pressure. On emptying there was an initial pressure nadir that was followed by a pressure recovery. When isolated longitudinal strips were stretched and released to their lengths at specific gastric volumes, they generated triphasic tension adaption and recovery. Strips from the proximal greater curvature generated the highest base-line tension, highest peak tension, and largest amplitude of tension adaptations. Addition of KCl, carbachol, or physostigmine increased base-line tension and tension adaptations in parallel, whereas atropine reduced them. Tetrodotoxin had no effect. The base-line tension of the isolated cat stomach is maintained by a tonic cholinergic neurosecretion but its tension adaptations do not require neural control. PMID- 3812693 TI - Flow of water between aqueous and vitreous compartments in the rabbit eye. AB - When fluoresceinated dextran (FD) is injected into the vitreous body of the rabbit, it diffuses out of the eye through the anterior chamber so that the ratio of its concentration in the aqueous to that in the vitreous humor remains constant. The rate of loss of the substance from the eye suggests that the vitreous body is stagnant. After penetrating the vitreous body with a 25-gauge needle through the sclera, the FD fluorescence in the aqueous humor is reduced by a factor of three times on the average. This appears to be because the loss of fluid out of the scleral hole sets up a backward seepage of fluid through the anterior vitreous body, which opposes the diffusion of dextran into the anterior chamber. In contrast, making a needle hole has little effect on the level of sulforhodamine B, a more rapidly diffusing molecule, when it has been injected into the vitreous body, and none at all when it has been introduced into the cornea. The changes in the flow across the aqueous-vitreous interface, as well as the changes in aqueous outflow after an experimental intervention to the eye, may be estimated from a comparison of the changes in fluorescence in the anterior chamber of large and small molecular weight compounds injected into the vitreous body. PMID- 3812694 TI - Glomerular angiotensin II receptor modulation in glycerol-induced acute renal failure. AB - The objective of this study was to examine the relationship between plasma angiotensin II (ANG II) and ANG II receptor binding to the glomerulus following acute renal failure (ARF) induced by an injection of glycerol (50%, 10 ml/kg im). At 2 and 24 h after glycerol injection, ARF was documented by a rise in blood urea nitrogen (BUN) (normal, 18.6 +/- 0.7; 2 h after glycerol 29.3 +/- 2.3; 24 h after glycerol, 103.0 +/- 12.0 mg/dl; P less than 0.002 each experimental vs. normal) and creatinine (normal, 0.41 +/- 0.02; 2 h after glycerol, 0.96 +/- 0.10; 24 h after glycerol, 2.40 +/- 0.30 mg/dl; P less than 0.001, experimental vs. normal groups). Plasma ANG II rose from a control of 15.8 +/- 3.1 to 26.9 +/- 4.4 pg/ml at 2 h and 49.5 +/- 8.6 pg/ml at 24 h after glycerol (P less than 0.05, experimental vs. normal). No changes in affinity or density of glomerular ANG II receptors were detected either at 2 or 24 h after glycerol injection despite the significant rise in plasma ANG II (glomerular ANG II receptors: normal, 1,000 +/- 61; 2 h after glycerol, 896 +/- 120; 24 h after glycerol, 936 +/- 80 fmol/mg). The 24-h infusion of ANG II in normal rats to achieve plasma levels identical to the 24 h ARF group caused ANG II receptor density to fall to 58.1 +/- 8.6% of control values (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812695 TI - Mechanism of bicarbonate exit across basolateral membrane of rabbit proximal straight tubule. AB - To clarify the mechanism(s) of HCO3- (or related base) transport across the basolateral membrane, rabbit proximal straight tubules were perfused in vitro, and intracellular pH (pHi) and Na+ activity (aiNa) were measured by double barreled ion-selective microelectrodes. Lowering bath HCO3- from 25 to 5 mM at constant PCO2 depolarized basolateral membrane potential (Vbl), and reduced pHi. Most of these changes were inhibited by adding 1 mM 4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid (SITS) to the bath. Total replacement of bath Na+ with choline also depolarized Vbl and reduced pHi, and these changes were also inhibited by SITS. Reduction in aiNa was observed when bath HCO3- was lowered. Taken together, these findings suggest that HCO3- exists the basolateral membrane with Na+ and negative charge. Calculation of the electrochemical driving forces suggests that the stoichiometry of HCO3-/Na+ must be larger than two for maintaining HCO3- efflux. Total replacement of bath Cl- with isethionate depolarized Vbl gradually and increased pHi slightly, implying the existence of a Cl(-)-related HCO3- exit mechanism. The rate of decrease in pHi induced by lowering bath HCO3- was slightly reduced (20%) by the absence of bath Cl-. Therefore, the importance of Cl(-)-related HCO3- transport is small relative to total basolateral HCO3- exit. Accordingly, these data suggest that most of HCO3- exits the basolateral membrane through the rheogenic Na+/HCO3- cotransport mechanism with a stoichiometry of HCO3-/Na+ of more than two. PMID- 3812696 TI - Calcium modulates vasopressin effect in rabbit cortical collecting tubule. AB - The calcium ion has been proposed to be an important mediator of the hydroosmotic response to arginine vasopressin (AVP). We examined the effect of reducing basolateral calcium activity on hydraulic conductivity (Lp) in response to AVP in rabbit cortical collecting tubules (CCT) perfused in vitro. Each tubule served as its own control. Reducing bathing fluid calcium from 0.94 mM to 4.6 microM reduced Lp in each tubule (mean decrease from 146 +/- 13 to 106 +/- 7 cm X s-1 X atm X 10(-7), n = 11, P less than 0.025). To determine whether this inhibitory effect was due to a decrease in cellular calcium uptake, we measured the effect of adding 10(-4) M lanthanum to bathing fluid on AVP-stimulated Lp. Lanthanum decreased Lp (from 109 +/- 13 to 80 +/- 10 cm X s-1 X atm X 10(-7), P less than 0.05) in each tubule. To examine the site at which low peritubular calcium activity regulates AVP action, we measured the effect of decreasing bathing fluid calcium on 8-[p-chlorophenylthio]-adenosine 3',5'-cyclic monophosphate (ClPheS cAMP)-stimulated Lp (n = 5). Decreasing bathing fluid calcium significantly decreases (P less than 0.025) Lp response to ClPheS-cAMP. Since these results suggest that cellular calcium uptake can exert a post-cAMP effect to modulate AVP action, we examined the effect of the calcium ionophore A23187 (10(-7) M) on AVP- and ClPheS-cAMP-stimulated Lp A23187 reversibly potentiates (25-30%, P less than 0.025) the Lp response to both AVP and ClPheS-cAMP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812697 TI - Mechanism of potassium depletion during chronic metabolic acidosis in the rat. AB - Pair-fed rats on a normal K diet were given either 1.5% NH4Cl or water for 4 days. The acid-fed animals developed metabolic acidosis, negative K balance, and K depletion. Urinary Na excretion and urinary flow were not different between the groups beyond the first day. After the 4 days, isolated kidneys from animals in each of these groups were perfused at normal pH and bicarbonate concentrations. Urinary K excretion was similar between the groups despite the potassium depletion in the acid-fed animals. In contrast, isolated kidneys from animals with comparable K depletion induced by dietary K restriction readily conserved K (fractional excretion 0.35 +/- 0.04 vs. 0.83 +/- 0.09 by the kidneys from acid fed animals, P less than 0.01). Sodium excretion and urinary flow were similar among the three groups of isolated kidneys. Plasma aldosterone concentrations were greater in the acid-fed rats after the 4 days of NH4Cl ingestion than in the control animals (43 +/- 10 vs. 10 +/- 2 ng/dl, P less than 0.01). Adrenalectomized rats were treated with either normal (4 micrograms/day) or high (22 micrograms/day) aldosterone replacement while ingesting NH4Cl for 4 days. Only in the presence of high aldosterone replacement did the acid-fed adrenalectomized animals develop K depletion. We conclude that chronic metabolic acidosis stimulates aldosterone secretion, and that aldosterone maintains the inappropriately high urinary potassium excretion and K depletion seen in this acid-base disorder. PMID- 3812698 TI - Analysis of renal function in the two-kidney Goldblatt model. AB - We analyzed the renal functional responses in all rats 4-6 wk after application of a clip to one renal artery and maintained on either a normal NaCl-intake or a NaCl-depletion protocol utilizing both clearance methods and micropuncture evaluations of glomerular hemodynamics. Although mean arterial pressure (MAP) rose significantly, the response was quite variable and the frequency and degree of hypertension independent of NaCl dietary protocol (142 +/- 7 vs. 137 +/- 6 mmHg, NS). Glomerular filtration rate (GFR) of the unclipped kidney was well maintained regardless of absolute MAP, however, GFR in the clipped kidney was somewhat MAP dependent. The glomerular ultrafiltration coefficient (LpA) was reduced in all clipped rats independent of MAP and dietary NaCl (0.037 +/- 0.002 vs. 0.063 +/- 0.009 nl X s-1 X mmHg-1, P less than 0.05). Glomerular capillary hydrostatic (PG) and glomerular capillary hydrostatic gradient (delta P) were elevated in all clipped rats, regardless of MAP, and to a greater extent in clipped rats maintained on the NaCl-depletion protocol (PG, 59.6 vs. 53.2, P less than 0.05). Among clipped rats, multiple regression analysis revealed no correlation between PG or delta P and the degree of reduction in LpA. The unclipped kidney of the two-kidney, one-clip model is characterized by uniform reductions in LpA independent of the MAP and awake blood pressure produced. Although the increase in PG and delta P may contribute to the reduction in LpA observed, the degree of LpA reduction is independent of the magnitude of elevation in PG and delta P in clipped rats. PMID- 3812699 TI - Electrochemical analysis of renal Na+-glucose cotransport in salamander proximal tubules. AB - The changes in electrical membrane parameters and intracellular sodium activity associated with the absorption of D-glucose were studied in the isolated perfused proximal tubule of the Ambystoma tigrinum kidney. The addition of 10 mM D-glucose to a substrate-free luminal perfusate depolarized the basolateral and luminal membrane potentials by -16.2 +/- 0.9 mV and +20.4 +/- 0.9 mV, respectively (P less than 0.01), increased intracellular sodium activity (acellNa) by 5.1 +/- 0.8 mM (P less than 0.01) and significantly (P less than 0.01) decreased luminal membrane resistance from 2,859 +/- 454 to 1,483 +/- 120 omega X cm2. Both the electrogenic response and the change in acellNa induced by luminal glucose were a saturating function of luminal glucose and sodium concentrations. The electrogenic response to luminal glucose was sensitive to intracellular glucose concentration and the change in acellNa induced by luminal glucose was sensitive to intracellular sodium concentrations. Within the physiological range of membrane potentials and studied, the sodium-glucose cotransporter is more sensitive to a decrease in a favorable electrical gradient than to an increase in a favourable chemical gradient for sodium across the luminal membrane. PMID- 3812700 TI - ADH increases apical Na+, K+, 2Cl- entry in mouse medullary thick ascending limbs of Henle. AB - These studies were designed to evaluate the mechanism for the ADH-dependent increase in transcellular conductance (Gc, mS X cm-2), which accompanies hormone dependent increases in the spontaneous transepithelial voltage (Ve, mV) and in the net rate of Cl- absorption in single medullary thick ascending limbs of Henle (mTALH) isolated from mouse kidney. The total transepithelial conductance (Ge, mS X cm-2) was measured with perfusing solutions containing 5 mM K+, zero Ba2+; Gc was that component of Ge blocked by luminal 20 mM Ba2+, zero K+. In paired experiments, antidiuretic hormone (ADH) increased Gc from 44.5 +/- 5.6 to 58.9 +/ 8.9 mS X cm-2 (delta = 14.3 +/- 5.5; P less than 0.02); however, in the presence of 10(-4) M luminal furosemide, ADH had no significant effect on Gc (delta = 5.0 +/- 4.3; NS). A set of similarly paired measurements together with paired observations on the effects of bath Cl- deletion, permitted an assessment of the effect of ADH on the magnitude of the fall in Gc on bath Cl- removal (delta GClc, mS X cm-2). delta GClc was clearly larger with ADH, 29.6 +/- 4.3, than without ADH, 19.2 +/- 1.0 (delta = 10.4 +/- 4.9; P less than 0.05). However, with luminal furosemide, ADH had no significant effect on delta GClc (delta = 1.7 +/- 4.5; NS). These results indicate that the ADH-dependent increase in Gc is secondary to increased salt entry across the apical membrane. We computed apical (ga, mS X cm 2) and basolateral (gb, mS X cm-2) membrane conductances from the Gc measurements and apical-to-basolateral membrane resistance ratios (Ra/Rb) obtained from cell impalement: the ADH-dependent Gc increase was due to an increase in gb, which was blocked entirely by luminal furosemide. We propose that ADH increases the number of functioning apical membrane Na+,K+,2Cl- transport units, and that gb increases because cell Cl- activity rises and depolarizes the basolateral membrane. Thus the calculated cellular Cl- activity was 16.3 mM without ADH, and 25 mM with ADH. PMID- 3812701 TI - Chronic effects of vasopressin on fluid volume distribution in conscious dogs. AB - Previous studies have suggested that acute elevations of arginine vasopressin (AVP) may result in an extravascular to intravascular shift of fluid independent of any change in total body H2O (TBW). The present studies examined the chronic influence of elevated AVP on fluid volume distribution in five splenectomized, sodium-deprived conscious dogs (avg body wt = 18.9 +/- 0.7 kg). During 4 days of continuous intravenous AVP infusion (0.36 ng X kg-1 X min-1), the computerized average 24-h total body weight was maintained within 110 g of the control value by means of a sensitive servo-controlled scale device. Urine flow and urine osmolality averaged 335 +/- 52 ml/day and 637 +/- 36 mosmol/kg during the preinfusion period and changed to levels averaging 151 +/- 14 and 1,377 +/- 121 with elevated AVP (P less than 0.05). Chromium-51-labeled red cell volume (51Cr RBC), plasma volume (Evans blue), TBW (3H2O), calculated total blood volume (using 51Cr RBC and Hct), and mean arterial pressure averaged 22 +/- 1 ml/kg, 54 +/- 7 ml/kg, 0.62 +/- 0.04 l/kg, 68 +/- 3 ml/kg, and 99 +/- 3 mmHg, respectively, during the control period and remained unchanged during the AVP infusion period. Plasma protein, sodium, and osmolality averaged 6.4 +/- 0.1 g/dl, 145.7 +/- 0.8 meq/l, and 295.0 +/- 1.5 mosmol/kg during the preinfusion period and also remained unchanged with elevated AVP. We conclude from the present studies that AVP has minimal or no chronic influence on internal volume redistribution. PMID- 3812702 TI - Control of renal hemodynamics in hyperglycemia: possible role of tubuloglomerular feedback. AB - The purpose of this study was to test the hypothesis that hyperglycemia, comparable with that found in uncontrolled diabetes mellitus, increases renal blood flow (RBF) and glomerular filtration rate (GFR) through a tubuloglomerular feedback (TGF) mechanism. We infused glucose intrarenally (0.1-0.3 g/min) into anesthetized dogs with normal kidneys (NK), with nonfiltering kidneys (NFK) in which changes in TGF were blocked, and with normal kidneys in which renal perfusion pressure (RAP) was lowered to the limits of renal autoregulation (LPK). Calculated intrarenal plasma glucose levels rose to 250-400 mg/dl. In NK (n = 6) RBF and GFR increased by 18 +/- 3 and 19 +/- 5%, respectively, and renal vascular resistance fell by 17 +/- 2% after 90 min. The renal hemodynamic responses to glucose were abolished in NFK (n = 8); RBF averaged 96 +/- 4% of control after 60 min of hyperglycemia. RBF and GFR did not change during hyperglycemia in LPK (n = 5), averaging 96 +/- 1 and 100 +/- 8% of control, respectively, after 60 min. Autoregulation of RBF and GFR during reductions in RAP was impaired during hyperglycemia in NK; RBF and GFR were effectively autoregulated between RAP of 126 and 70-85 mmHg during the control period, whereas during glucose infusion RBF and GFR fell by 31 +/- 9 and 47 +/- 10%, respectively, when RAP was reduced in steps to 70 mmHg. These data suggest that hyperglycemia impairs renal autoregulation and may increase renal blood flow and GFR through a tubuloglomerular feedback mechanism. PMID- 3812703 TI - Calcium-activated phospholipase C associated with canine renal basolateral membranes. AB - To determine whether calcium-activated phospholipase C effects breakdown of phospholipids present in the basolateral membrane of the renal proximal tubular cell we incubated proximal tubular basolateral membranes isolated from dog kidney in the absence and presence of deoxycholate, and varied free calcium from 0 to 300 microM. Following incubations, lipids were extracted from membranes and separated using thin-layer chromatography. In the absence of deoxycholate, neither phosphatidylinositol nor diglyceride extractable from basolateral membranes changed significantly as calcium was increased. In the presence of deoxycholate, extractable phosphatidylinositol and diglyceride did not change significantly as free calcium was elevated from 0 to 0.03 microM, but phosphatidylinositol decreased and diglyceride increased progressively as 0.03 300 microM free calcium was included in incubations. Most of the increased extractable diglyceride could be accounted for by hydrolysis of phosphatidylinositol as reflected by decreased extractable phosphatidylinositol. Our findings suggest that calcium-activated phospholipase C effects breakdown of phospholipids present in the basolateral portion of the plasma membrane of the renal proximal tubular cell. It is possible that this enzyme plays a role in stimulating protein kinase c at this site. PMID- 3812704 TI - Modification of tubuloglomerular feedback signal by dietary protein. AB - Compared with the effects of a 6% protein diet, feeding rats a 40% protein diet for 10 days increases glomerular filtration rate and decreases the activity of the tubuloglomerular (TG) feedback control system. The decrease in TG feedback activity results from an increase in the threshold at which the loop of Henle flow rate initiates feedback responses. To determine whether this protein dependent shift in the TG feedback response curve is caused by changes in either the signal or the sensing mechanism in the feedback pathway, we used micropuncture and microperfusion techniques to study the TG feedback system of rats fed high- or low-protein (40 or 6% casein) diets for approximately 7-10 days. Compared with the rats fed the low-protein diet, in the high-protein group distally measured single nephron glomerular filtration rate was 17% higher, and Na and Cl concentrations in early distal tubule fluid were 30-50% lower. Early distal osmolality was not different in the two groups. TG feedback responses assessed by changes in stop-flow pressure during perfusion of the distal nephron with NaCl solutions did not differ between diet groups. We conclude that the sensing mechanism in the TG feedback system is not altered by this manipulation of dietary protein, whereas the signal eliciting the TG feedback response is affected. Because rats fed a high-protein diet have higher rates of Na and Cl absorption between the late proximal and early distal tubules than do rats fed a low-protein diet, early distal Na and Cl concentrations are reduced, and the signal for TG feedback is diminished in rats fed the high-protein diet. PMID- 3812705 TI - Effects of myocardial ischemia on regional function and stiffness in conscious dogs. AB - The extent to which cardiac nerves influence responses of regional ventricular function to acute myocardial ischemia was investigated in conscious dogs with intact cardiac innervation (N) and dogs with chronic cardiac denervation (D). Following coronary artery occlusion (CAO) left ventricular (LV) end-diastolic pressure increased more (P less than 0.01) in D (18 +/- 3.2 mmHg) than in N dogs (3.4 +/- 0.7 mmHg), whereas heart rate increased more in N (32 +/- 4.8 beats/min) than in D dogs (16 +/- 3.0 beats/min). In nonischemic zones of D dogs there were greater increases, P less than 0.05, in end-diastolic segment length, systolic segment shortening, and velocity of shortening than in N dogs. In ischemic zones, significantly greater increases in end-diastolic segment length were also observed in the D group, but similar reductions in segmental shortening occurred in both N (-116 +/- 2.8%) and D (-108 +/- 5.2%) dogs. The time constant of isovolumic relaxation was not different in the two groups. However, in ischemic zones of N dogs myocardial stiffness constant (k) increased by 109 +/- 24 from 33 +/- 4.9 and end-diastolic stiffness (Eed) rose by 1527 +/- 310 from 253 +/- 34 mmHg, whereas k increased significantly less (P less than 0.05) in D dogs. Eed of ischemic zones also rose significantly less (P less than 0.05) in D dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812706 TI - Autoregulatory escape from vasoconstriction of intestinal circulation in developing swine. AB - The capability of the developing intestinal circulation to maintain a vasoconstrictor response during postganglionic adrenergic nerve stimulation or norepinephrine infusion was examined in 34 swine aged 6 h to 2 mo anesthetized with pentobarbital sodium. Aortic and portal venous pressures, electrocardiogram (ECG), and blood flow (F) through the superior mesenteric artery were recorded, and intestinal vascular resistance (MVR) was calculated as mean pressure difference per mean F. Baroreceptor reflex inhibition by bilateral occlusion of the carotid arteries increased MVR, section of the splanchnic nerve and postganglionic fibers decreased MVR, and short-latency F decreases were obtained during mesenteric nerve stimulation (MNS). Latencies for the decreases in F shortened with age and with increasing MNS frequency (5-17 Hz) at any age. Prolonging MNS for 60 s at 10 or 12 Hz led to sustained high MVR in 6-h to 7-day old animals; however, MVR decreased toward control before the end of the 60-s MNS period in animals 1 to 2 mo old. Intra-arterial infusion of norepinephrine (0.5 microgram X kg-1 X min-1) decreased F and increased MVR in all animals; but by 5 min of infusion, F was returning toward control level in all but the youngest. This demonstration that the least mature intestinal circulation was least capable of autoregulatory escape from vasoconstriction provides further evidence of its functional immaturity. PMID- 3812707 TI - Relationship between mitochondrial volume density and capillarity in hamster muscles. AB - Mitochondrial volume density and lipid droplet-volume density were stereologically determined from electron micrographs of muscle fibers from three hamster muscles: retractor, sartorius, and soleus. The number of capillaries around a fiber, length of capillary-fiber contact, and muscle fiber area were also measured. Glycolytic fibers of the retractor and sartorius had larger cross sectional areas, lower mitochondrial-volume densities, fewer subsarcolemmal aggregates of mitochondria, and lower capillary-fiber contact length in comparison to oxidative fibers of the retractor and soleus. Values for mitochondrial volume density in the different muscles correlated well (r = 0.97) with resting O2 consumption. The mitochondrial volume densities for each muscle correlated well (r = 0.99) with O2 diffusion coefficients of these muscles. Our results indicate that an analysis of the adequacy of O2 supply to an individual muscle fiber must take into account an interplay among fiber size, percent of the muscle fiber perimeter in contact with a capillary (capillary-fiber contact), and O2 demand of the fiber estimated by mitochondrial volume density. PMID- 3812708 TI - Atrioventricular nodal activation during periodic premature stimulation of the atrium. AB - To study the intranodal origin of the functional properties of the atrioventricular node, progressive changes in nodal cell activation time and cycle length occurring during complete sequences of periodic premature stimulation of the atrium were determined for 419 nodal cells recorded in 11 isolated rabbit heart preparations. The conduction time in proximal nodal cells including the N cells increased only at very short coupling intervals. Conduction time in the distal node (NH and H cells) first increased and then decreased with increasing prematurity. The major fraction of the basic and premature delays developed between N and NH cell activation, a period devoid of upstrokes. The effective and functional refractory periods were related to the minimum intervals between successive upstrokes at the node entrance and outlet, respectively. These results suggest that the cycle-length dependency of nodal conduction is the result of complex changes in propagation time occurring at three levels in the node, whereas the effective and functional refractory periods reflect reactivation limits of cells located at the node entrance and outlet, respectively. PMID- 3812709 TI - Evaluation of diastolic function with Doppler echocardiography: the PDF formalism. AB - A new parametrized diastolic filling (PDF) formalism for evaluation of holodiastolic (left and right) ventricular function via Doppler echocardiography is presented. It is motivated by the empiric observation that during diastole the heart behaves as a suction pump whose dynamics, in certain respects, are those of a damped harmonic oscillator. An expression for elastic recoil (suction) initiated ventricular diastolic fluid inflow velocity v(t) is obtained by differentiation from the solution x(t) of the linear differential equation that describes the motion of a forced, damped harmonic oscillator. It is solved for "over-damped" motion, for zero initial velocity and initial displacement = xo cm. An explicit forcing term F(t) = Fosin(omega t) is included to account for late diastolic (atrial) filling. The quantitative parameters of the model include inertia (mass; m), viscosity (damping constant; c), source of stored energy for suction (spring constant; k), and its initial displacement xo, the amplitude and frequency of the (atrial) forcing term Fo, omega. The mathematical behavior of the solution v(t) and its dependence on the parameters xo, c, and k, which characterize the contour of the Doppler velocity profile (DVP), is discussed. When clinical examples of normal and abnormal transmitral DVPs are compared with v(t) calculated using the harmonic oscillator model, excellent agreement [DVP v(t)]/v(t) approximately 0.05 is obtained throughout diastole. Thus the model allows accurate qualitative and quantitative characterization of global ventricular diastolic behavior by noninvasive means in a variety of normal and abnormal stiffness-compliance states. In addition, it may serve as a prototype for a class of mathematical models that can encompass the essential dynamic elements of ventricular diastolic function that couple to flow and further enhance the role of the heart as a suction pump. PMID- 3812710 TI - Cerebral vascular responsiveness in deoxycorticosterone acetate-salt hypertensive rats. AB - Alterations in cerebral vascular responsiveness were investigated in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Initial studies on the passive-force response characteristics of strips of basilar artery revealed no difference between control and DOCA-salt rats. No difference in acetylcholine induced relaxation was seen between the two groups. The contractile response to KCl was similar in control and DOCA-salt rats. An increase in both threshold and midrange sensitivities to serotonin (5-HT) was seen in basilar artery from DOCA salt rats. However, extracellular Ca sensitivity in the presence of 10(-6) M 5-HT was not altered. Intracellular Ca release (phasic contraction in response to 10( 6) M 5-HT) was similar in control and DOCA-salt rats. Relaxation in response to Ca (membrane stabilization) was also not different. Whereas sodium nitroprusside (SNP)-induced relaxation was not altered in basilar artery from DOCA-salt rats, a significant decrease in isoproterenol (ISO)-induced relaxation was observed. Relaxation following washout of maximal contractions to KCl and 5-HT was similar in the two groups. These results demonstrate specific alterations in cerebral vascular responsiveness of DOCA-salt rats. Whereas KCl contractile and SNP relaxation responses were not affected, responses to 5-HT and ISO were significantly altered. These changes do not appear to be related to alterations in the endothelium or in the Ca responsiveness of the vascular smooth muscle. PMID- 3812711 TI - Microvascular hematocrit and red cell flux in rat cremaster muscle. AB - The arteriovenous distributions of volumetric flow (Q), microvessel hematocrit (Hctmicro), and estimates of red cell volumetric flux (QRBC) were obtained under control conditions in rat cremaster muscle. The results demonstrate a monotonic fall in the ratio of Hctmicro/Hctsystemic from 0.86 in 70-microns arterioles to 0.48 in capillaries followed by a subsequent rise to 0.79 in 98-microns venules. To assess the roles of Hctmicro and Q in red blood cell delivery following a period of reduced oxygen transport, tissue ischemia was produced by occluding the first order arteriole. During the occlusion, arteriolar and large venular hematocrits fell 15-30%, whereas small venular hematocrits increased 24%. After release of the occlusion, a reactive hyperemia ensued with Q, QRBC, and QHctmicro increasing significantly above control values in arterioles, capillaries, and venules. All Hctmicro returned to their control values within 10 s following resumption of flow. Based on the relationship between blood viscosity and Hctmicro, at low shear rate, these transient alterations in Hctmicro were estimated to have a profound effect on blood viscosity, and hence the resistance to blood flow. Such changes may affect recovery from an ischemic episode, although not adversely affecting the oxygen-carrying capacity of blood and convective transport of oxygen. PMID- 3812712 TI - Cell-to-cell diffusion of fluorescent dyes in paired ventricular cells. AB - The intracellular and cell-to-cell diffusion of fluorescent dyes of various molecular sizes were studied in enzymatically isolated paired ventricular cells of the guinea pig heart. Fluorescein sodium (mol wt 332), 6-carboxyfluorescein (mol wt 376), Lucifer yellow CH (mol wt 457), lissamine rhodamine B-200 (mol wt 559), and tetraglycine-conjugated lissamine rhodamine B-200 (mol wt 859) were all diffused into the single ventricular cell through the patch-clamp pipette. All these dyes were able to diffuse through the gap junction of the paired cells. The diffusion coefficient of 6-carboxyfluorescein in the cytoplasm was 5.8 X 10(-6) cm2/s, Lucifer yellow CH was 3.0 X 10(-6) cm2/s, and lissamine rhodamine B-200 was 8.6 X 10(-7) cm2/s. Permeability of the gap-junctional membrane was 6.8 X 10( 4) cm/s for 6-carboxyfluorescein, 2.8 X 10(-4) cm/s for Lucifer yellow CH and 7.4 X 10(-5) cm/s for lissamine rhodamine B-200. Thus lissamine rhodamine B-200 diffused in the cytoplasm and through the gap junction approximately 10 times slower than 6-carboxyfluorescein. Tetraglycine-conjugated lissamine rhodamine B 200 (mol wt 859) passed through the gap junction, suggesting that the critical pore size of the ventricular gap junction may be somewhat larger than that of the conjugated tetraglycine rhodamine. PMID- 3812713 TI - Left ventricular epicardial deformation in isolated arrested dog heart. AB - We have developed a method for measuring epicardial deformation in the isolated arrested dog heart. A biplane video system was used to record the motion of discrete epicardial markers at midanterior sites (n = 4 hearts) and midposterior sites (n = 1) during quasi-static left ventricular (LV) filling. Experimental procedures, performed at room temperature, were completed within 20 min, and LV pressure-volume curves were repeatable and within the range of data presented by other authors. To obtain a complete description of local deformation, epicardial displacements derived from the video record were analyzed using homogeneous strain theory. Local epicardial strain was nonuniform; the mean ranges of midanterior major and minor extensions were 0-13.9 and 0-7.2%, respectively, for LV filling pressures of 0-20 mmHg. For the midanterior wall, the mean orientation of the major extension was 28-35 degrees below the LV circumference, compared with an orientation of approximately 62 degrees at the midposterior site. The results demonstrate the value of this preparation for studying passive ventricular mechanics and are not consistent with the predictions of mathematical models of ventricular stress and strain, in which it has been assumed that the material properties of the passive myocardium are isotropic. PMID- 3812714 TI - Sympathoadrenal mechanisms in cardiovascular responses to naloxone after hemorrhage. AB - Five rabbits were allotted to each of six treatments on a matched-individual basis. Treatments were none, sham, total adrenalectomy with adrenocorticoid replacement, intravenous guanethidine (15 mg X kg-1 X day-1), adrenalectomy + guanethidine, and adrenal medullectomy. The conscious rabbits were bled 20 ml/kg over 5 min. Naloxone (6 mg/kg) was injected intravenously. The responses of arterial pressure and of plasma epinephrine (E) and norepinephrine (NE) concentrations were measured. Factorial analysis was used to calculate the effects of sympathetic noradrenergic nerves (SYM) and the adrenal medulla (ADR) on the responses. In combination, SYM + ADR fully accounted for the pressor response observed in normal and sham-treated rabbits. SYM and ADR each made independent and approximately equal contributions to the response, but the SYM X ADR interaction was strongly antagonistic. The responses of plasma E and NE were fully accounted for by the adrenal glands and sympathetic nerves, respectively. The pressor responses after total adrenalectomy and adrenal medullectomy were similar. Thus hemorrhage-stimulated adrenal corticosteroid release was not essential to naloxone's action, and adrenal enkephalins were not responsible for naloxone's action on sympathetic pathways. PMID- 3812715 TI - Blood and isoproterenol reduce capillary permeability in cat hindlimb. AB - In an earlier study, plasma was observed to counteract the permeability increasing effects of blood-free perfusion when papaverine was present in the perfusate. To determine if this plasma effect was still present in the absence of papaverine, cat hindlimbs were perfused with a blood-free albumin-electrolyte solution, and capillary filtration coefficient (CFC) was measured. These data were compared with CFC values obtained when blood, plasma, or isoproterenol were present in the albumin perfusate. In separate groups of animals, CFC was observed to be 0.017 +/- 0.006 (SD, n = 26) ml X min-1 X mmHg-1 X 100 g muscle-1 during blood-free albumin perfusion, 0.012 +/- 0.002 (n = 24) when blood was present, 0.014 +/- 0.003 when isoproterenol was present, and 0.010 +/- 0.002 (n = 33) when both blood and isoproterenol were present. In a separate study, it was observed that 1) isoproterenol could reduce CFC by 11% when added to blood-free perfusate, 2) plasma had a similar but smaller and more variable effect than isoproterenol, 3) plasma had no consistent effect on CFC when added to a blood-free albumin perfusate containing isoproterenol, and 4) blood could reduce CFC significantly (P less than 0.005), from 0.014 +/- 0.003 to 0.0094 +/- 0.002 (n = 7), when added to a blood-free albumin perfusate containing isoproterenol. It was concluded that, in the absence of papaverine, the principal CFC-reducing effect of blood lay in the cell fraction and that isoproterenol had a small CFC-reducing effect under blood-free conditions. This result contrasts with the plasma effect reported earlier. PMID- 3812716 TI - Rat cardiac myocyte adenosine transport and metabolism. AB - Based on the importance of myocardial adenosine and adenine nucleotide metabolism, the adenosine salvage pathway in ventricular myocytes was studied. Accurate estimates of transport rates, separate from metabolic flux, were determined. Adenosine influx was constant between 3 and 60 s. Adenosine metabolism maintained intracellular adenosine concentrations less than 10% of the extracellular adenosine concentrations and thus unidirectional influx could be measured. Myocytes transported adenosine via saturable [Michaelis constant = 6.2 +/- 2.1 microM and maximal velocity (Vmax) = 9.58 +/- 0.98 X 10(-1) pmol X mg protein-1 X s-1] and nonsaturable (rate constant = 1.8 X 10(-3)/s) processes. A minimum estimate of the Vmax of myocytic adenosine kinase (2 pmol X mg protein-1 X s-1) indicated the saturable component of adenosine influx was independent of adenosine kinase activity. Saturable transport was inhibited by nitrobenzylthioinosine and verapamil (inhibitor constant = 17 +/- 5 microM). Extracellular adenosine taken up by myocytes was rapidly phosphorylated to adenine nucleotides. Not all extracellular adenosine, though, was phosphorylated on entering myocytes, since free, as opposed to protein-bound, intracellular adenosine was detected after digitonin extraction of cells in the presence of 1 mM ethylene-diaminetetraacetic acid. PMID- 3812717 TI - Regional differences in pleural lymphatic albumin concentration in sheep. AB - We used quantitative reflectance autoradiography to compare the concentration of albumin in visceral pleural lymphatics at the cranial and caudal ends of the sheep's lung in the vertical (60 degrees head-up) and horizontal (supine) positions. Twelve to fourteen hours after injecting 125I-albumin intravenously we placed four anesthetized sheep in the vertical position to establish a microvascular hydrostatic pressure gradient along the vertical height of the lung. We placed two anesthetized sheep in the horizontal position. Four hours later, we fixed the left lung and removed visceral pleural tissue blocks from the cranial and caudal ends, separated by a 15-cm distance, along the costovertebral margin. We measured the silver grain density in the pleural lymphatic autoradiograms by dark-field reflectance microspectrophotometry. In the vertical position, the lymph albumin concentration at the cranial end (top) of the lung averaged 2.5 +/- 0.4 g/dl compared with the caudal end (bottom), which averaged 1.8 +/- 0.3 g/dl. The difference (42% greater at the top than the bottom) is significant (P less than 0.05). The computed gradient in perimicrovascular interstitial albumin osmotic pressure was 0.26 +/- 0.13 cmH2O/cm lung height. There were no differences between the cranial and caudal lymphatic groups in the two horizontal sheep. We conclude that in the sheep lung there is a gradient in perimicrovascular albumin concentration due to the vertical gradient in microvascular hydrostatic pressure. PMID- 3812718 TI - Hemodynamic effects of endurance training on canine left ventricle. AB - To investigate the effects of endurance training on myocardial performance seven beagle dogs (exercise group, EG) were trained by treadmill running for 6-7 wk. Before and after experimental period the EG and control group (CG, n = 7) underwent a standard submaximal exercise test (SMT), and hemodynamic status was checked during anesthesia by catheterization technique exposing the animals to different loadings: pacing, volume loading, and isoproterenol infusion. The increase of heart rate during SMT was about 30 beats/min less in the EG than in the CG. A highly linear relationship between stroke work and end-diastolic volume was observed within the groups (for EG r = 0.953, for CG r = 0.846), but the slope of the regression line obtained for EG appeared to be significantly (P less than 0.001) greater. In EG isoproterenol induced increases in end-diastolic (27%), end-systolic (37%), and stroke volumes (19%), but, on the contrary, decreases of these volumes in CG (19, 15, and 22%, respectively); ejection fraction remained unchanged for both EG and CG. Ventricular stroke work was significantly greater in EG. Systemic vascular resistance decreased in EG in every loading test. The results indicate an improved pump performance, which is related not only to the heterometric autoregulatory adjustments, but also to extracardial adaptations. PMID- 3812719 TI - Albumin and IgG in skin and skeletal muscle after plasmapheresis with saline loading. AB - The acute effect of removing plasma equivalent to 1.7% body wt and replacing it with saline equivalent to 10% body wt on the extravascular distribution of water, albumin, and immunoglobulin G (IgG) in skin and skeletal muscle was studied in anesthetized rabbits. The plasma protein concentration decreased by 43%. Prenodal lymph was collected from hindpaw skin or skeletal muscle. The extracellular and plasma volumes in excised tissue samples were measured using 51Cr-labeled ethylenediaminetetraacetic acid and 125I-labeled albumin, respectively. The protein spaces were calculated from measurements of endogenous albumin and IgG concentrations using immunochemical techniques. Lymph flow from both tissues increased more than twice control, whereas the lymph total protein concentration decreased to less than one-half control. Three to six hours after the saline infusion, the skin interstitial volume was 30% greater than control, whereas the extravascular masses of albumin and IgG were 20% greater than control. For muscle, the interstitial volume was twice the control value, whereas the extravascular masses of albumin and IgG were not significantly altered. There was a large decrease in the lymph protein concentration after acute plasmapheresis. However, there was not an acute decrease in the extravascular albumin or IgG masses from skin or skeletal muscle. This may be due to the presence of the collagen matrix and edema fluid. PMID- 3812720 TI - Effect of inflation on microvascular pressures in lungs of young rabbits. AB - We have examined the effect of positive pressure inflation on the longitudinal distribution of vascular resistance and intravascular pressures in isolated blood perfused lungs of 3- to 4-wk-old rabbits. Lungs were perfused in zone 3 at airway inflation pressures (P airway) of 6, 14, and 19 cmH2O (pleural pressure, atmospheric) corresponding to 60, 80, and 90% of total lung capacity. We measured microvascular pressures by the micropipette servo-nulling technique in 20- to 50 microns diameter subpleural arterioles and venules. Pulmonary arterial and left atrial pressures were also measured. Lung blood flow was kept constant at 145 +/- 18 ml X kg body wt-1 X min-1. We found that at P airway of 6 cmH2O, approximately 55% of the total pressure drop was in arteries, approximately 23% in microvessels, and approximately 22% in veins. With increasing P airway and lung volume, there was a significant decrease in arterial and venous resistance, but an increase in resistance in microvessels. We conclude that lung inflation significantly alters the distribution of segmental vascular resistance, and therefore lung volume is an important variable that should be considered during estimation of capillary filtration pressure. PMID- 3812721 TI - Nonosmotic influences on osmotic stimulation of vasopressin in humans. AB - To study the influence of cardiopulmonary baroreceptor loading and unloading on the osmotic stimulation of arginine vasopressin (AVP) in normal humans, we gave 105-min 5% saline infusions (0.06 ml X kg-1 X min-1) to three groups of subjects under different cardiopulmonary baroreceptor loading conditions. Group A received only the infusion, with a consequent increase in central venous pressure (CVP) of 2.6 +/- 1.7 mmHg; group B had CVP held constant by continuous lower body negative pressure; and group C had CVP decreased by -3.3 +/- 1.4 mmHg, also with lower body negative pressure, for the duration of the infusion. Mean arterial pressure increased in group A by 6.6 +/- 3.7 mmHg, but did not change in groups B and C. On average, osmolality increased by the same amount in each of the three groups (11.6 +/- 3.3, 13.7 +/- 3.2, and 10.9 +/- 2.5 mosmol/kg, P = NS). The changes in AVP in the three groups were 3.6 +/- 2.0, 2.7 +/- 1.9, and 6.2 +/- 3.5 pg/ml, P less than 0.03, with group C different from group B and groups A and B not different by individual pairs testing. An independent effect of prolonged CVP reduction on AVP levels in group C was made unlikely by studies in four additional subjects in whom AVP did not change at constant osmolality during 105 min of CVP reduction comparable with that in group C. Thus modest loading of both cardiopulmonary and sinoaortic baroreceptors does not alter the osmotic stimulation of AVP in normal humans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812722 TI - Pulmonary edema in dogs fails to cause reflex responses. AB - Pulmonary edema has been proposed as a stimulus for pulmonary C-fibers. Stimulation of pulmonary C-fibers causes depression of cardiovascular function and either tachypnea or apnea. Our objective was to determine whether pulmonary edema, induced by either increasing pulmonary vascular permeability with alloxan or hydrostatic challenges, would elicit depression of cardiovascular function or changes in frequency of inspiratory activity. Utilizing a preparation in which the left pulmonary vessels and left airway were isolated, we monitored systemic blood pressure (BP), heart rate (HR), and diaphragm contractions (DC) in 13 anesthetized dogs. Injection of alloxan into the left pulmonary artery (LPA) produced transient decreases in HR, BP, and frequency of DC within 20 s of injection with no subsequent cardiorespiratory changes up to 5 min. These alloxan injections also caused coagulation necrosis. Generation of hydrostatic pulmonary edema in the left lung caused no changes in HR, BP, or in the frequency and amplitude of DC. We conclude that alloxan does stimulate reflex cardiorespiratory depression consistent with C-fiber stimulation, but these reflex responses are probably caused by alloxan's caustic effect and not by the resultant edema. We also conclude that pulmonary edema induced by increased hydrostatic pressure does not evoke any reflex cardiovascular responses or changes in frequency of inspiratory activity. PMID- 3812723 TI - Natriuresis induced by localized perfusion within the third cerebral ventricle of sheep. AB - Push-pull perfusion was performed at four different sites in the third cerebral ventricle of conscious sheep. The recovery of the infused solution was 75-90%, suggesting a localized change in the ionic composition and osmolality restricted to a relatively small area in the cerebrospinal fluid (CSF). Sodium and potassium excretion and urine flow were studied before, during, and after perfusion of 200, 150, and 100 mM Na-CSF. Localized perfusion in the anterior dorsal third ventricle (AD3V) of 200 mM Na-CSF caused an increase in sodium and potassium excretion, in urine flow, and a decrease in free water clearance. Perfusion of 200 mM Na-CSF at the other three perfusion sites, i.e., anterior ventral third ventricle, posterior dorsal third ventricle, and posterior ventral third ventricle, did not influence sodium excretion and urine flow. Perfusions with 150 and 100 mM Na-CSF did not cause any change in sodium, potassium excretion, or urine flow at any of the four perfusion sites. These results suggest that sensors sensitive to changes of sodium concentration are located close to the ventricular surface in the anterior dorsal part of the third cerebral ventricle. When stimulated with increased sodium concentration they will initiate increased sodium excretion. PMID- 3812724 TI - Potassium-induced relaxation in vascular smooth muscle of ground squirrels and rats. AB - This study was designed to assess differences in potassium-induced relaxation in two rodents, the Sprague-Dawley albino rat and the 13-lined ground squirrel, Citellus tridecimlineatus. Femoral arteries from both species were cut into helical strips for isometric force recording. After norepinephrine-induced contraction in potassium-free solution, the arterial strips relaxed in response to the introduction of potassium (0.25-20 mM) into the bath. Potassium-induced relaxation was greater in rat than ground squirrel arteries. The concentrations required to induce half-maximal relaxation were approximately 2.5 mM for both species. Potassium-induced relaxation varied with the duration of incubation in potassium-free solution, and with the contractile magnitude induced by varying norepinephrine concentrations. Ouabain inhibited potassium-induced relaxation, with the ground squirrel showing greater sensitivity to the cardiac glycoside than did the rat. Acute cooling (from 37 to 17 degrees C) caused a reduction of the contractile response to norepinephrine in rat arteries, whereas those taken from ground squirrels maintained contractions at, or above, those attained at 37 degrees C. In addition, potassium-induced relaxation in ground squirrel vessels was more sensitive to inhibition by cold than it was in those from the rat. The results show that the characteristics of potassium-induced relaxation (ouabain and temperature sensitivity, magnitude of response, etc.) are species related (ground squirrel vs. rat). PMID- 3812725 TI - Puberty in female rats: relative effect of exercise and food restriction. AB - Reproductive development in relation to growth and fat deposition was compared in three groups of female rats: a group that was allowed to grow only slowly by requiring them to work hard on a running wheel for their food; a group in which the same slow rate of growth was imposed by restricting their food intake, but without an exercise requirement; and a normally growing, nonexercising, ad libitum-fed, control group. Animals forced to run for their food experienced vaginal opening at a significantly lower body weight than either of the other two groups. The same trend was apparent for the first ovulation, but not significant. Thus the present results suggest that, under some conditions, intense exercise may actually accelerate rather than decelerate reproductive development, at least relative to body weight. With the possible exception of body weight, none of the whole-body parameters measured in this experiment (body weight, growth rate, or amount of fat) were found to be critically related to the first ovulation when all three groups of females were considered as a unit. Thus the present results also argue against some of the current hypotheses, all developed using dietary manipulation, that the onset of fertility is somehow dependent on one of these factors. PMID- 3812726 TI - Augmented pressor response to vasopressin in awake dogs after cardiac denervation. AB - Hemodynamic responses to varying intravenous infusion rates of vasopressin were studied in two groups of dogs; one group was cardiac denervated and the other sham operated. Vasopressin given at 200, 1,000, and 5,000 fmol X kg-1 X min-1 produced increases in aortic pressure that were significantly greater in cardiac denervated dogs than in sham-operated dogs. The augmented pressor response in cardiac-denervated dogs was associated with greater increases in total peripheral resistance in this group; decreases in cardiac output were similar in the two groups of dogs. Vasopressin decreased heart rate significantly in each group, but the magnitude of the decrease was significantly smaller in cardiac-denervated dogs. In contrast to these results, the intravenous infusion of phenylephrine or angiotensin II in other experiments on the same dogs produced comparable increases in aortic pressure in each group. These results are consistent with earlier evidence indicating that vasopressin elicits more effective reflex mechanisms to attenuate the increases in blood pressure caused by its direct vasoconstrictor action than do other vasoconstrictor agents, such as angiotensin II and phenylephrine. Since the infusion of vasopressin produced a greater increase in arterial blood pressure in cardiac-denervated dogs than it did in sham-operated control dogs, it appears that at least part of the unique action of vasopressin may be mediated by the potentiation of a peripheral vasodepressor reflex arising from cardiac receptors. PMID- 3812727 TI - Organic cation secretion by Cancer borealis urinary bladder. AB - In the crab, Cancer borealis, initial clearance studies showed a potent renal excretory system for the model organic cation, tetraethylammonium (TEA). TEA clearance averaged 145 +/- 32 ml/day, which was 18 times the paired polyethylene glycol clearance. TEA uptake by slices of urinary bladder was concentrative, saturable, inhibitable by N1-methylnicotinamide chloride, and dependent on glycolytic, but not oxidative, metabolism. When mounted in flux chambers, bladders exhibited a large net secretory flux. For 0.1 mM TEA, the ratio of secretory to reabsorptive fluxes was 65. Urinary bladders from another crab, Cancer irroratus, and a lobster, Homarus americanus, also exhibited net TEA secretion. In C. borealis bladder, secretory transport was concentrative, saturable, and nearly abolished by addition of 1 mM quinine to the serosal bath. Reabsorptive transport was not concentrative and was not reduced by luminal quinine. The data are consistent with a secretory pathway that is transcellular and mediated by carriers at both the serosal and luminal membranes. PMID- 3812728 TI - Morphology and development of an apoeccrine sweat gland in human axillae. AB - Evidence is presented that in adult human axillae there exists a third type of sweat gland tentatively designated as the apoeccrine sweat gland. This type of gland shows a segmental or diffuse apocrinelike dilatation of its secretory tubule but has a long and thin duct which does not open into a hair follicle. The electron microscopy of its dilated segment is often indistinguishable from that of the classical apocrine gland. The less remarkably dilated segment of the apoeccrine gland tends to retain intercellular canaliculi and/or dark cells. These apoeccrine glands are consistently present in adult human axillae regardless of sex or race. In the axillae of the two 6-yr-old subjects, both classical apocrine and eccrine glands were present but no apoeccrine glands were found. Between 8-14 yr of age, the number of large eccrine glands with or without partial segmental dilatation gradually increased. At 16-18 yr of age, the number of apoeccrine glands increased to as high as 45% of the total axillary glands. The data support the notion that apoeccrine glands develop during puberty in the axillae from eccrine or eccrinelike sweat glands. PMID- 3812729 TI - Stress-induced blood pressure responses in SHR: effect of dietary calcium. AB - To assess the influence of dietary calcium on stress-induced blood pressure responses, spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats were placed on low Ca2+ (0.1%) and Na+ (0.25%), intermediate Ca2+ (1.0%) and Na+ (0.45%), or high Ca2+ (2.0%) and Na+ (1.0%) diets for 13 wk prior to measuring blood pressure (BP) responses in an aversive classical conditioning paradigm. Forty-eight hours prior to testing, catheters were placed in a femoral artery under halothane anesthesia for recording direct pressure. On recovery the rats were classically conditioned to a 10-s tone followed by a brief electric shock using a discrimination paradigm. After 24 reinforced trials, SHRs on a low diet had significantly larger pressor responses to the conditioned tones than rats in the high diet condition. SHRs on the intermediate diet exhibited pressor responses midway between the low and high diet groups. In the WKY strain there was no significant dietary effect on conditioned BP response. In both strains the low diets resulted in significantly elevated base-line blood pressure levels. The data confirm earlier reports of elevated BP in SHRs and WKYs following dietary calcium restriction and provide suggestive evidence that the elevation in base line BP may be related to diet-induced changes in BP reactivity in the SHR. PMID- 3812730 TI - Phase resetting and dysrhythmic responses of the respiratory oscillator. AB - This study explores resetting of respiratory rhythm by facilitatory perturbations. The midbrain reticular formation and periaqueductal gray matter were electrically stimulated to evoke facilitation of phrenic nerve activity in nine anesthetized, vagotomized, and glomectomized adult cats. The animals were paralyzed and servo-ventilated to keep end-tidal PCO2 constant. Brief midbrain stimuli were given at various times in the respiratory cycle and the times of onset of rescheduled breaths after stimulation were measured. A plot of phase resetting as a function of stimulus strength and time of delivery defined a helicoid surface. The axis of this helicoid identified a unique stimulus which, when given at the inspiratory-expiratory transition, resulted in unpredictable resetting of respiratory rhythm. This stimulus had a strength that was intermediate to that which identified types 1 and 0 resetting. In one experiment, the singular stimulus often initiated a breath having prolonged inspiratory activity; resumption of the normal rhythm was delayed significantly (P less than 0.01). We conclude that the dysrhythmias observed in this study represent the respiratory oscillator's phase singularity. PMID- 3812731 TI - Autoregulation of renal blood flow and glomerular filtration rate in the pregnant rabbit. AB - Our purpose was to determine whether renal autoregulatory capability is retained in pregnancy despite the marked renal vasodilation that occurs at this time. Renal blood flow and glomerular filtration rate (GFR) were measured in anesthetized pregnant (22-27 days gestation) and nonpregnant rabbits during step reductions in renal perfusion pressure from control (100 +/- 3 mmHg) to 50 mmHg. Control renal blood flow and GFR were significantly higher in pregnant animals, averaging 65 +/- 5 and 13.1 +/- 1.1 ml/min, respectively, compared with 50 +/- 5 and 9.4 +/- 1.2 ml/min in nonpregnant rabbits. Filtration fraction was also significantly elevated in pregnant animals (0.33 +/- 0.02 vs. 0.27 +/- 0.01 in nonpregnant rabbits). During step reductions in renal perfusion pressure, renal blood flow was well autoregulated down to approximately 70 mmHg in both nonpregnant and pregnant animals, falling by only 9 +/- 4 and 12 +/- 5%, respectively. Likewise, GFR was also well autoregulated, falling by 10 +/- 2 and 8 +/- 3% in nonpregnant and pregnant animals, respectively, when perfusion pressure was reduced from 90 to 70 mmHg. These results suggest that renal autoregulation is preserved in pregnancy despite the fact that the renal circulation is already markedly vasodilated. PMID- 3812732 TI - Peripheral and brain tissue catecholamine content in intact and anti-NGF-treated fetal sheep. AB - Fetal lambs were treated with a single dose of anti-mouse nerve growth factor (anti-NGF) at 80 days gestational age. The catecholamine content of tissues was determined at 135 days gestational age. There was a reduction of either norepinephrine, epinephrine, or both, in the thymus, thyroid, atrium (but not ventricle), lung, liver, kidney, and jejunum when compared with age-matched control fetuses. The spleen, ileum, colon, and the adrenal glands were not affected by anti-NGF. In treated fetuses there was a reduction in catecholamine content of the thalamus, hypothalamus, hippocampus, medulla, cerebellum, and cervical spinal cord. These results show that some tissues are sensitive to, and some are refractory to, the action of anti-NGF at 80 days gestation. Also the results suggest that NGF may play a role in the development of catecholamine containing neurons within the central nervous system. PMID- 3812733 TI - Valine entry into rat brain after diet-induced changes in plasma amino acids. AB - Passage of amino acids across the blood-brain barrier is assumed to be modified by amino acid composition of the blood. To gain a better understanding of the effects of protein intake on brain amino acid uptake, we examined associations among diet, plasma amino acid patterns, and the rate of entry of valine into the brain. Rats were fed (8 h/day for 7-10 days) diets containing 6, 18, or 50% casein before receiving one meal of a diet containing 0, 6, 18, or 50% casein. After 4-7 h, they were anesthetized and infused intravenously with [14C]valine for 5 min before plasma and brain samples were taken for determination of radioactivity and content of individual amino acids. As protein content of the meal was increased from 0 to 50% casein, plasma and brain concentrations of valine and most other large neutral amino acids (LNAA) increased severalfold; also the ratio of [14C]valine in brain to that in plasma decreased by greater than 50%, and the rate of valine entry into the brain increased 3.5-fold. The increase in valine flux slowed as plasma levels of LNAA, competitors for valine transport, increased. The results were far more dependent on protein content of the final meal than on that of the adaptation diet; thus changes in protein intake, as reflected in altered plasma amino acid patterns, markedly altered valine entry into the brain. PMID- 3812734 TI - Sulfate transport by chick renal tubule brush-border and basolateral membranes. AB - Brush-border and basolateral membrane vesicles (BBMV and BLMV, respectively) were prepared from chick kidney by a calcium precipitation method and by centrifugation on an 8% Percoll self-generating gradient, respectively. In BBMV a 100-mM Na gluconate gradient, out greater than in, caused concentrative sulfate uptake approximately fivefold greater at 1 min than at 60 min (equilibrium) whether or not the membranes were short-circuited with 100 mM K gluconate, in = out, plus 20 micrograms valinomycin/mg protein. A 48-mM HCO3- gradient, in greater than out, stimulated a 2.5-fold higher uptake at 1 min than at 60 min, and short circuiting as above had no effect on the magnitude of this response. Imposition of a H+ gradient (pH 5.4 out vs. pH 7.4 in) caused concentrative uptake fourfold higher at 1 min than at equilibrium. Short circuiting as above or addition of 0.1 mM carbonyl cyanide m-chlorophenylhydrazone (CCCP) significantly inhibited the pH gradient effect. Creation of an inside positive electrical potential with 100 mM K gluconate, out greater than in, plus valinomycin, also caused concentrative sulfate uptake. The K gradient in the absence of valinomycin had no effect on sulfate uptake (compared with isosmotic mannitol). Based on inhibitor/competitor effects, these are distinct sulfate transport processes. In chick BLMV, imposition of an HCO3- gradient, in greater than out, produced concentrative sulfate uptake; however, neither Na+ nor H+ gradients had significant effects at 15 s. 4-Acetamido-4'-isothiocyanostilbene 2,2'-disulfonic acid disodium at 0.1 mM was an effective inhibitor of BLMV bicarbonate-sulfate exchange; however, neither Cl-, SCN-, nor CCCP inhibited. PMID- 3812735 TI - Influence of transmembrane potential differences of renal tubular epithelial cell on ANG II binding. AB - Previous studies from this laboratory demonstrated specific high-affinity binding sites of rat renal brush-border membrane vesicles (BBMV). The time course of angiotensin II (ANG II) binding in the presence of a NaCl gradient (medium greater than intravesicular) demonstrated an "overshoot" characteristic of electrogenic sodium-dependent D-glucose uptake. The time course of ANG II binding to membrane vesicles equilibrated with NaCl did not exhibit such "overshoot" and was lower in magnitude. Therefore, studies were designed to test the hypothesis that ANG II binding to BBMV was enhanced by a transmembrane potential difference in a manner similar to sodium-dependent D-glucose uptake. The effects of sodium salts with differing rates of anion equilibration were compared on ANG II binding. Peak binding was achieved most rapidly with NaSCN followed by NaCl and Na2SO4. By contrast, sodium acetate, which is translocated electroneutrally, exhibited no overshoot. ANG II binding in the presence of a KCl gradient was similar to NaCl. The overshoot was abolished in the presence of an inwardly directed KCl gradient plus valinomycin. Magnesium salts with differing rates of anion permeabilities had similar effects on binding, as did sodium salts. Scatchard analysis revealed that the receptor density was fourfold higher in the presence of an electrochemical gradient compared with nongradient conditions. These data are consistent with the conclusion that ANG II binding to BBMV is enhanced by a transmembrane potential difference, and suggest that this may be an important modulator of tubular epithelial responses to ANG II in vivo. PMID- 3812736 TI - Regulation of urea synthesis by acid-base balance in vivo: role of NH3 concentration. AB - The purpose of this study was to clarify how changes in acid-base balance influence the rate of urea synthesis in vivo. Since ureagenesis was increased by an ammonium infusion into rats, regulation seemed to be a function of the blood ammonium concentration. The rate of urea synthesis was constant at a fixed rate of ammonium infusion and independent of the conjugate base infused, chloride or bicarbonate. The steady-state blood ammonium concentration was higher in the rats that developed metabolic acidosis. Thus it appeared that regulation was not directly mediated by this ammonium concentration per se. The rate of urea synthesis was also independent of the blood pH. Accordingly, the rate of urea synthesis was examined as a function of the plasma NH3 concentration. The rate of ureagenesis was found to be directly proportional to the plasma NH3 concentration. Assuming that plasma NH3 levels reflect those in mitochondria, the NH3 concentration yielding half-maximal rates of urea synthesis (close to 2 microM) was in the same range as Km for the rate-limiting step in ureagenesis, carbamoyl phosphate synthetase (EC 6.3.4.16). These results suggest that, at a constant ammonium concentration, the decreased rate of ureagenesis caused by a pH fall in vitro could reflect an acidosis-induced decline in the concentration of true substrate (NH3) for this pathway. PMID- 3812737 TI - Presence of multiple sodium-dependent phosphate transport processes in proximal brush-border membrane. AB - Renal brush-border membrane phosphate transport was studied in early and late segments of the pig proximal tubule. Vesicles were prepared from early proximal tubules (outer cortical tissue) and late proximal tubules (outer medullary tissue). Sodium-dependent phosphate uptake into brush-border membrane vesicles was determined using voltage clamp at 5-6 s, 21 degrees C. Sodium-dependent D glucose uptake was determined to verify the cortical and medullary tissue cuts. At pH 8.0 (pHi = pHo), two sodium-dependent phosphate transport systems were evident in the early proximal tubule: a high-affinity system [Km, 0.06 +/- 0.01 mM; maximal transport activity (Vmax), 3.6 +/- 1.1 nmol X mg protein-1 X min-1] and a low-affinity system (Km, 4.11 +/- 0.02 mM; Vmax, 9.7 +/- 0.7 nmol X mg protein-1 X min-1). In the late proximal tubule at pH 8.0, only a single high affinity transport process (Km, 0.19 +/- 0.7 mM; Vmax, 3.4 +/- 0.5 nmol X mg protein-1 X min-1) was evident. D-Glucose kinetics at pH 7.0 revealed both a high affinity (Km, 0.55 +/- 0.09 mM) and a low-affinity (Km, 20.09 +/- 1.39 mM) system in the early proximal segment and a single high-affinity (Km, 1.27 +/- 0.36 mM) process in the late segment. These data suggest that two systems, distinct in their affinities and capacities, are involved in both D-glucose and phosphate transport across the brush-border membrane of the early proximal tubule, but that only a single high-affinity system is present in the late segment. PMID- 3812738 TI - NH3 and NH4+ transport by rabbit renal proximal straight tubules. AB - Isolated perfused S2 proximal straight tubules from rabbits spontaneously secreted ammonia (-1.34 pmol X mm-1 X min-1) and absorbed bicarbonate (49.3 pmol X mm-1 X min-1) when perfusate and bath solutions contained 1 mM NH4Cl and 25 mM bicarbonate (pH 7.4). The NH3 concentration in the collected fluid was on average 40% lower than that of the bath as a consequence of a lower pH in the lumen. To test whether diffusion of NH3 down the bath-to-lumen NH3 concentration gradient could account for the measured ammonia secretion, we measured the permeabilities to NH3 (1.6 X 10(-2) cm/s) and NH4+ (4.5 X 10(-5) cm/s). From these values, we calculated predicted rates of passive NH3 secretion (-3.6 pmol X mm-1 X min-1) and passive NH4+ absorption (0.9 pmol X mm-1 X min-1). The predicted rate of net ammonia secretion exceeded the measured rate, indicating that passive NH3 secretion can fully account for the measured flux. In additional experiments, 10( 4) M acetazolamide in bath and perfusate inhibited net bicarbonate absorption by approximately 80%, but the rate of ammonia secretion was unaffected. CONCLUSIONS: S2 proximal straight tubules spontaneously secrete ammonia as required for generation of a corticomedullary ammonia concentration gradient by counter current multiplication. Diffusion of NH3 down a concentration gradient created by luminal acidification can account for the ammonia secretion. A substantial passive lumen-to-bath backflux of NH4+ occurs. Acetazolamide does not inhibit ammonia secretion. PMID- 3812739 TI - Increased release of norepinephrine and dopamine from canine kidney during bilateral carotid occlusion. AB - The renal overflow of norepinephrine (NE) and dopamine (DA) to plasma from the innervated kidney was studied at rest and during sympathetic nervous system activation by bilateral carotid artery occlusion (BCO) in vagotomized dogs under barbiturate or barbiturate/nitrous oxide anesthesia. BCO elevated arterial pressure and the arterial plasma concentrations of NE, DA, and epinephrine (Epi). Renal vascular resistance (renal arterial pressure kept constant) increased by 15 +/- 7% (P less than 0.05) and the net renal venous outflows (renal venoarterial concentration difference X renal plasma flow) of NE and DA were enhanced (P less than 0.05). To obtain more correct estimates of the renal contribution to the renal venous catecholamine outflow, we corrected for the renal extraction of arterial catecholamines, assessed as the extractions of [3H]NE, [3H]DA, or endogenous Epi. The [3H]NE corrected renal NE overflow to plasma increased from 144 +/- 40 to 243 +/- 64 pmol X min-1 (P less than 0.05) during BCO, which, when compared with a previous study of the [3H]NE corrected renal NE overflow to plasma evoked by electrical renal nerve stimulation, "corresponds" to a 40% increase in nerve impulse frequency from approximately 0.6 Hz. If the renal catecholamine extraction was not taken into account the effect of BCO was underestimated. The renal DA overflow to plasma was about one-fifth of the NE overflow both at rest and during BCO, indicating that there was no preferential activation of noradrenergic or putative dopaminergic nerves by BCO. PMID- 3812740 TI - Direct toxic effect of the radiocontrast agent diatrizoate on renal proximal tubule cells. AB - The pathophysiology of radiocontrast agent-induced acute renal failure is presently unclear. To test for a possible direct deleterious effect of diatrizoate, a commonly used radiocontrast agent, on renal tubule cells, suspensions enriched in rabbit proximal tubule segments were incubated with sodium diatrizoate. After these manipulations, a variety of well-established metabolic parameters to quantitate the extent of cell injury were measured. Diatrizoate sodium (25 mM) produced significant declines in tubule K+, ATP, and total adenine nucleotide (TAN) contents, significant decreases in tubule basal and uncoupled respiratory rates, and a significant increase in tubule Ca2+ content, demonstrating the development of cell injury induced by diatrizoate. These effects were dose related and were progressive with increasing incubation time from 97.5 to 157.5 min. The effects of N-methylglucosamine (meglumine) on renal tubule cell viability was also evaluated. Meglumine is a low molecular weight amino-substituted cationic compound and is commonly added to radiocontrast dye solutions. Meglumine (25 mM) had significant effects to lower tubule K+ content and to decrease both tubule basal and uncoupled respiratory rates. These alterations were slightly additive to diatrizoate in that meglumine diatrizoate produced greater alterations in tubule-metabolic parameters compared to diatrizoate sodium. A period of 22.5 min of hypoxia also caused deleterious changes in each of these quantitative indices of cell viability, and diatrizoate potentiated the degree of hypoxia-induced cell injury. These results demonstrate that the radiocontrast agent, diatrizoate, is directly toxic to renal proximal tubule cells. Meglumine, a cation added to diatrizoate containing radiocontrast solutions, also had a moderate toxic effect on renal epithelial cells and added to the toxicity of diatrizoate. Diatrizoate also aggravated the degree of cell injury induced by a 22.5-min period of hypoxia. These experiments thus provide evidence for a direct toxic effect of diatrizoate on proximal renal tubule cells which was additive to hypoxic cell injury. PMID- 3812741 TI - Effects of vitamin D-induced chronic hypercalcemia on rat renal cortical plasma membranes and mitochondria. AB - Increases in intracellular and mitochondrial calcium content that accompany ischemic and toxic acute renal failure have been suggested to mediate renal tubular cell injury and dysfunction, but the mechanism(s) are unknown. We studied the effects of in vivo vitamin D-induced chronic hypercalcemia on rat renal cortical brush-border and basolateral membranes and mitochondria. In the brush border membrane, hypercalcemia caused significant decreases in alkaline phosphatase-specific activity, total phospholipid molar content, and phosphatidylserine percent molar composition and increases in the cholesterol-to total phospholipid molar ratio and phosphatidylinositol percent molar composition. In the basolateral membrane, hypercalcemia caused significant decreases in Na+-K+-ATPase-specific activity and total phospholipid molar content and increases in the cholesterol-to-total phospholipid molar ratio and phosphatidylinositol 4,5-bisphosphate percent molar composition. In the mitochondria, hypercalcemia caused a mild increase in the mitochondrial calcium content, but no alterations in succinic dehydrogenase-specific activity, succinate-, ADP-, or uncoupler-induced respiration. Thus hypercalcemia caused alterations in brush-border and basolateral membrane enzyme activity and lipid composition, but no functional changes were detected in mitochondria. These hypercalcemia-induced plasma membrane biochemical alterations may be markers of early cell injury and suggest a role for calcium in causing or predisposing to renal tubular cell injury. PMID- 3812742 TI - Prevention of reflex natriuresis after acute unilateral nephrectomy by neonatal administration of MSG. AB - Acute unilateral nephrectomy (AUN) results in natriuresis from the remaining kidney through reflex pathways involving the central nervous system and requiring an intact pituitary gland. The natriuresis is accompanied by an increase in the plasma concentration of a peptide or peptides derived from the N-terminal fragment (NTF) of proopiomelanocortin. We measured plasma immunoreactive NTF-like material (IR-NTF) before and after AUN in control rats and rats treated neonatally with monosodium glutamate (MSG), a procedure that produces neuroendocrine dysfunction by destroying cell bodies in the hypothalamic arcuate nucleus, median eminence, and other brain regions. In control rats, IR-NTF increased from 85.8 +/- 54.9 (SD) to 207 +/- 98.1 fmol/ml after AUN (P less than 0.02) as sodium excretion (UNaV) doubled. In MSG-treated rats, AUN produced no change in plasma IR-NTF concentration (58.8 +/- 21.3 vs. 68.3 +/- 18.5 fmol/ml (P = NS), nor did UNaV increase. Tissue content of IR-NTF was reduced in the arcuate nucleus and anterior lobe of pituitaries from MSG-treated rats compared with controls, but was no different in the neurointermediate lobe. These results indicate that the hypothalamic lesion produced by neonatal administration of MSG prevents both the increase in plasma IR-NTF concentration and the natriuresis after AUN, and therefore lend further support to the concept of a causal relationship between these two consequences of AUN. PMID- 3812743 TI - Effect of bicarbonate and phosphate on renal phosphate leak in experimental Fanconi syndrome. AB - The role of acidosis in the renal phosphate leak in Fanconi syndrome (FS) was studied in maleate-induced FS in rats. Clearance studies were performed in the following groups: 1) intact rats served as control, 2) rats with maleate-induced FS, 3) rats with FS receiving intravenous bicarbonate (HCO3-), 4) intact rats receiving intravenous 0.03 N HCl (inducing acidosis similar to that of Group 2), 5) rats with FS receiving intravenous phosphate buffer and NaCl, and 6) rats with FS receiving intravenous phosphate buffer and bicarbonate similar to Group 3. In Group 2 serum pH and fractional excretion of phosphate (CP/GFR) averaged 7.31 +/- 0.08 (mean +/- SE) and 1.00 +/- 0.06, respectively, and differed significantly from Group 1, in which the corresponding values were 7.41 +/- 0.01 and 0.12 +/- 0.02, respectively. In Group 3, intravenous HCO3- corrected pH to 7.43 +/- 0.01 and reduced CP/GFR to 0.33 +/- 0.05, both results were different from the corresponding rates in Group 2 (P less than 0.0005). In Group 4, intravenous HCl reduced serum pH to 7.31 +/- 0.02 (P not significant as compared with Group 2) and increased CP/GFR to 0.186 +/- 0.030, the latter was higher than CP/GFR in control rats (P less than 0.01) but was lower than that in HCO3- -treated FS rats. In Group 5 serum pH was 7.31 +/- 0.021, similar to Group 2. CP/GFR was 0.84 +/- 0.031, significantly lower than in Group 2 (P less than 0.05). In Group 6 serum pH was 7.43 +/- 0.013 and CP/GFR was 0.86 +/- 0.044.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812744 TI - Interactions between ADH and prostaglandins in isolated erythrocyte-perfused rat kidney. AB - Interactions between antidiuretic hormone (ADH) and renal prostaglandins in the regulation of sodium reabsorption and urinary concentrating ability were studied in isolated erythrocyte-perfused rat kidneys (IEPK). In this model, hemodynamic characteristics are comparable to those found in vivo, and tubular morphology is preserved throughout the period of perfusion. [Deamino]-D-arginine vasopressin (dDAVP) markedly reduced fractional sodium excretion (FE Na) in the IEPK from 3.5 +/- 0.6 to 0.45 +/- 0.14%. After indomethacin, FE Na fell still further to 0.08 +/- 0.02%. In the absence of dDAVP indomethacin had no effect on sodium excretion; FE Na was 2.4 +/- 0.6% in control and 2.0 +/- 0.4% in indomethacin treated groups. dDAVP increased urine osmolality in the IEPK to 741 +/- 26 mosmol/kg. When prostaglandin synthesis was blocked with indomethacin, urinary osmolality increased further to 1,180 +/- 94 mosmol/kg. In isolated kidneys perfused without erythrocytes (IPK), dDAVP decreased FENa from 14.5 +/- 1.8% to 9.6 +/- 1.2%; addition of indomethacin had no further effect. dDAVP increased urine osmolality only modestly to 350 +/- 12 mosmol/kg in the IPK and indomethacin did not increase concentrating ability further (342 +/- 7 mosmol/kg). Thus the IEPK (unlike the IPK) can excrete a markedly hypertonic urine in response to ADH. ADH also enhances tubular reabsorption of sodium in the IEPK. Prostaglandins inhibit both these actions of ADH but do not directly affect sodium excretion in the absence of the hormone. PMID- 3812745 TI - Sulfate-bicarbonate exchange in brush-border membranes from rat renal cortex. AB - Under Na+-free conditions, SO4(2-) uptake by rat renal brush-border membrane (BBM) vesicles could be driven by imposition of a HCO3- gradient (in greater than out). The initial rate of SO4(2-) uptake was stimulated 10-fold, and peak overshoot exceeded equilibrium uptake by 2-3 times. Cl-, SCN-, NO3-, I-, and OH- were able to substitute for HCO3-. Divalent anions, including SO4(2-) itself, were less effective as counterions. Similarly, in the absence of Na+,SO4(2-) efflux was stimulated most effectively by the monovalent ions. HCO3- -SO4(2-) exchange was cis-inhibited by disulfonic stilbenes [4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid (SITS), 4,4'-diisothiocyanostilbene 2,2'-disulfonic acid (DIDS)], phloretin, Hg, and S2O3(2-). HCO3- driven SO4(2-) uptake was saturable, with an apparent Km of 0.4 mM for SO4(2-). Simultaneous imposition of Na+ (out greater than in) and HCO3- (in greater than out) gradients produced approximately additive stimulation of SO4(2-) uptake. The HCO3- -driven component of SO4(2-) uptake, but not the component driven by Na+, was inhibited by SITS. Finally, Na+-driven SO4(2-) accumulation could be reduced by imposing an out greater than in HCO3- gradient, conditions accelerating exchange driven SO4(2 ) efflux. These findings indicate the presence of separate Na+-SO4(2-) cotransport and SO4(2-)-anion exchange pathways in the same BBM vesicles. PMID- 3812746 TI - Energy production, O2 consumption, and blood flow reserve in experimental aortic valve disease. AB - Left ventricular energy production and its relation to myocardial O2 consumption and blood flow reserve were studied in 11 dogs with surgically produced valvular aortic stenosis (AS, 6 of 11) or combined stenosis and insufficiency (AS + AI, 5 of 11), and 7 dogs undergoing sham operation (S). Two months after operation the combined AS + AI group had the highest left ventricular mass (S, 4.85 +/- 0.53; AS, 6.38 +/- 0.90; AS + AI, 7.23 +/- 0.39 g/kg), left ventricular end-diastolic pressure (S, 2.1 +/- 1.6; AS, 6.3 +/- 1.7; AS + AI, 8.6 +/- 3.1 mmHg), left ventricular end-diastolic volume (S, 61.1 +/- 8.5; AS, 73.0 +/- 7.8; AS + AI, 95.8 +/- 20.9 ml), and stroke work. At rest, total left ventricular myocardial blood flow was increased in AS and AS + AI compared with sham (S, 89 +/- 8; AS, 135 +/- 19; AS + AI, 164 +/- 9 ml/min, P less than 0.05); and coronary resistance was lower in both AS and AS + AI groups. Peak-to-resting flow ratio determined by adenosine vasodilation was reduced in AS and AS + AI despite normal resting function (peak-to-resting flow ratio: S, 6.78 +/- 2.24; AS, 3.19 +/- 0.58, AS + AI, 3.99 +/- 0.84, P less than 0.02). Peak-to-resting flow ratio was inversely proportional to left ventricular mass. In turn the degree of hypertrophy correlated with the total power requirement of the left ventricle, regardless of the type of overload lesion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812747 TI - Low Ba-induced pacemaker current in well-polarized cat papillary muscle. AB - It has previously been reported that superfusion of normally quiescent mammalian ventricular muscle with low concentrations of Ba (less than 0.3 mM) can induce spontaneous activity with maximum diastolic potentials (MDP) that are similar to the normal resting potential (-80 mV or larger). The mechanism for this activity was studied in cat papillary muscle sucrose-gap preparations under current clamp and voltage-clamp conditions. Hyperpolarizing current pulses decreased or abolished the amplitude of the pacemaker potential in a voltage-dependent manner. When Ba concentration was increased to 2 mM the MDP depolarized by approximately 20 mV. Hyperpolarizing steps under these conditions abolished the diastolic depolarization, also in a voltage-dependent manner. Voltage clamping the preparation at the MDP during superfusion of 0.2 mM Ba revealed a time-dependent, inwardly directed current. Hyperpolarizing voltage-clamp steps from a holding potential of -50 mV showed that this current was maximal at approximately -70 mV and frequently reversed at membrane potentials of approximately -95 to -115 mV. The time course of this current was biexponential, and the time constant of the faster component decreased with larger hyperpolarization. When the same voltage clamp protocol was repeated in the presence of 2 mM Ba, no time-dependent current change was detected. In four out of five experiments, Cs (2.5 mM) reduced (but never abolished) the amplitude of the low Ba-induced current. Our results do not support the hypothesis that a hyperpolarization-induced current (iF-like current) is responsible for the automaticity in well-polarized ventricular muscle at low Ba concentrations. Instead, our data suggest that this pacemaker activity is the result of a Ba-induced, time-dependent blockade of the inward rectifier potassium current (iK1). PMID- 3812748 TI - Calcium exchange, structure, and function in cultured adult myocardial cells. AB - Cells digested from adult rat heart and cultured for 14 days demonstrate all the structural elements, in mature form, associated with the process of excitation contraction (EC) coupling. The transverase tubular (TT) system is well developed with an extensive junctional sarcoplasmic reticulum (JSR). In nonphosphate containing buffer contraction of the cells is lost as rapidly as zero extracellular Ca concentration ([Ca]o) solution is applied (less than 10 s) and a negative contraction staircase is produced on increase of stimulation frequency. Structurally and functionally the cells have the characteristics of adult cells in situ. 45Ca exchange and total 45Ca measurement in N-2-hydroxyethylpiperazine N'-2-ethanesulfonic acid (HEPES)-buffered perfusate define three components of cellular Ca: a rapidly exchangeable component (t1/2 less than 25 s) accounting for 36% of total Ca, a slowly exchangeable component (t1/2 53 min) accounting for 7% of total Ca, and the remaining 57% cellular Ca is "inexchangeable" (demonstrates no significant exchange within 60 min). The slowly exchangeable component can be increased 10-fold within 60 min by addition of phosphate to the perfusate. The Ca distribution and exchange characteristics are little different from those of 3-day cultures of neonatal rat heart previously studied [Langer, G. A., J. S. Frank, and L. M. Nudd. Am. J. Physiol. 237 (Heart Circ. Physiol. 6): H239-H246, 1979]. The results suggest that the cells are representative of adult cells in situ and that both sarcolemmal-bound and sarcoplasmic reticular Ca contribute to the component of Ca that is rapidly exchangeable. PMID- 3812749 TI - Prolonged support of working rabbit hearts using Fluosol-43 or erythrocyte media. AB - We compared the perfluorochemical emulsion Fluosol-43 and an erythrocyte-based solution as support media for ex vivo working rabbit hearts functioning with a physiological workload. Both groups of hearts (n = 5/group) exhibited stable function (left ventricular peak systolic pressure, peak rates of left ventricular pressure rise and relaxation, aortic flow, peak aortic flow rate, stroke work, and peak power) for the first 6 h of perfusion. Coronary flow, coronary venous O2 content, and O2 supply-to-demand ratio declined similarly in both groups during the first 6 h. Both groups of hearts preferentially utilized pyruvate to glucose. The Fluosol-43-perfused hearts had higher heart rate, left ventricular peak systolic pressure, peak rate of left ventricular pressure rise, aortic flow, coronary flow, and myocardial O2 consumption compared with the erythrocyte perfused hearts. The Fluosol-43 hearts produced more lactate and released more creatine phosphokinase than did the erythrocyte-perfused hearts, but the rates were low and constant throughout perfusion, indicating that the hearts were not progressively ischemic. After the first 6 h, function of the Fluosol-43 hearts declined, resulting in their earlier failure compared with the erythrocyte perfused hearts. The data indicate that Fluosol-43 had sufficient O2- carrying capacity to support stable function of a rabbit heart at a physiological workload for 6 h, and differences in function and ex vivo longevity of the two groups of hearts suggested that a component or contaminant of Fluosol-43 altered sarcolemmal function and/or that a component needed for membrane integrity was lacking in the Fluosol-43 perfusate. PMID- 3812750 TI - Interaction of brief sympathetic stimuli and heart period on atrial contractile force. AB - We studied the dynamic interaction between the independent effects of sympathetic stimuli and heart period on atrial contractile force with three experiments: 1) we measured the inotropic response to brief sympathetic stimuli when the heart was paced; this represented the pure sympathetic effect on contractile force. 2) We measured the responses to identical stimuli when the heart was not paced; this represented the effect of the combined influences. 3) We measured the contractile responses to the identical sequences of changing cycle lengths that were recorded (expt 2) but in the absence of sympathetic activity; this represented the pure effect of changing cardiac cycle length on contractile force. We subtracted the paced from the unpaced responses. This difference represented the linear elimination of the pure sympathetic effect from the combined responses. We then compared this difference with the responses to changing cycle lengths that were measured in the absence of sympathetic activity (expt 3). The values were not equal from 2.5 through 22.5 s after the stimulus of experiment 1 of the protocol above. We performed a similar comparison after expressing the results in the frequency domain. The values were significantly different for most of the frequency spectrum where the greatest power was concentrated. We therefore conclude that there is a significant interaction between the effects of sympathetic activity and changing heart periods, and this interaction determines the resultant inotropic state on any specific beat. PMID- 3812751 TI - Purine efflux after cardiac ischemia: relevance to allopurinol cardioprotection. AB - Allopurinol is thought to protect hearts against damage due to hypoxia or ischemia by inhibiting xanthine oxidase and oxygen radical generation. We subjected isolated rabbit hearts, equilibrated by perfusion at 37 degrees C, to 1 h of global ischemia at 27 or 37 degrees C with or without brief pretreatment with 100 microM allopurinol. The total absence of xanthine or uric acid in the coronary effluent following ischemia, the presence of hypoxanthine (25 +/- 4 microM peak concentration), and the failure of allopurinol to alter purine washout profiles or postischemic cardiac function suggest that rabbit myocardium lacks xanthine oxidase or dehydrogenase. Data obtained with a similar rat heart preparation showed appreciable formation of xanthine (12 +/- 2 microM peak) and uric acid (10 +/- 3 microM). Allopurinol pretreatment inhibited xanthine and uric acid formation and significantly improved key indicators of postischemic left ventricular function. We conclude that there is species dependency in the myocardial activity of xanthine oxidase or dehydrogenase, that when present it can be inhibited by acute allopurinol pretreatment, and that xanthine oxidase activity and its ability to generate oxygen radicals are not universal contributors to cardiac ischemic damage. PMID- 3812752 TI - Maps of optical action potentials and NADH fluorescence in intact working hearts. AB - Voltage-sensitive dyes were used to stain intact perfused hearts and to simultaneously measure optical action potentials (APs) from 124 sites on the epicardium. Patterns of electrical depolarization (activation) and repolarization (recovery) along the surface of the heart were determined from the upstrokes and repolarization phases of optical APs. Standard surface extracellular techniques can detect electrical activation but not the recovery or the duration of APs. The optical recordings were previously shown to be equivalent to intracellular electrode measurements (Salama and Morad, Science Wash. DC 191: 485-487, 1976) and now reveal that AP durations are heterogeneous throughout the epicardium, with durations increasing from the base to the apex of the ventricles. In hearts beating under normal sinus rhythm, the direction and conduction velocity of the activation waves could be altered by electrical stimulation. The normal heterogeneities in AP durations became more pronounced in the presence of the Ca2+-entry blocker, verapamil. The local metabolic state of the tissue was also monitored optically through its intrinsic NADH fluorescence measured from 124 separate regions on the heart. The time course and extent of metabolic injury caused by general anoxia or by a local ischemia induced by a coronary ligation was monitored through maps of NADH fluorescence. The present technique makes it possible to correlate changes in the metabolic state of the muscle with detailed changes in patterns of electrical activity and thus provides a powerful new tool to study fundamental aspects of normal and abnormal cardiac rhythm. PMID- 3812753 TI - Exacerbation of central baroreflex impairment in Dahl rats by high-salt diets. AB - To determine whether baroreflex impairment progresses in hypertensive Dahl rats, we recorded reflex responses to drug-induced changes in blood pressure in hypertension-sensitive (DS) and hypertension-resistant (DR) rats maintained on low- or high-salt diets for 7 wk. Chronotropic responses, manifested as either bradycardia for phenylephrine or tachycardia for sodium nitroprusside, were always smaller in awake DS rats on high-salt diet than in any others. When the same rats were later anesthetized, related changes in afferent aortic and efferent splanchnic nerve activity were similarly reduced. Regardless of dietary salt intake, reflex bradycardia elicited by electrical stimulation of aortic nerve afferents was also weaker in DS than in DR rats, but attendant decreases in mean aortic pressure and splanchnic nerve activity did not differ significantly. These results are compatible with an impairment of afferent and central components of the reflex arc. Even though exact sites of dysfunction were not identified, our findings suggest that in hypertensive DS rats high-salt diets may aggravate baroreflex impairment, at least in part, by acting centrally. PMID- 3812754 TI - Time-dependent coronary blood flow distribution in left ventricular wall. AB - A mathematical model of the coronary circulation in the left ventricular (LV) wall, which describes the time-dependent local blood perfusion throughout the myocardium and the coronary flow in the epicardial vessels, is presented. The myocardial perfusion is essentially controlled by the intramyocardial resistance and the coronary pressure driving force, whereas the epicardial arterial flow is dominated by the epicardial and intramyocardial arterial capacitance and the local transmural pressure on the vessels. The temporal and spatial intramural pressure [P im(y,t)], calculated based on a nested-shell spheroidal model of the LV, is used to evaluate the local intramural resistance to flow and the corresponding zero flow pressure. The calculation of the instantaneous flow in each layer is based on a local, time-dependent modification of the back-pressure concept. A function representing the local tonus of the small blood vessels [T wf(y)] is used to adjust the average coronary flow rate to the metabolic demand of each layer. The calculated results are compared with experimental data, and the assumptions of the model are examined against a variety of experimental conditions. The model provides a qualitative tool for comprehending the distributed flow phenomenon within the myocardium and its relation to cardiac mechanics and autoregulation. PMID- 3812755 TI - Endothelium-dependent relaxation of human pulmonary arteries. AB - Although endothelial cell (EC)-dependent relaxation has been described in most mammals, there have been no detailed reports of its existence in humans. Consequently, we evaluated human pulmonary artery segments taken from uninvolved regions of resected lung from 11 patients. EC removal did not significantly alter relaxation to vasoactive intestinal peptide (VIP). However, relaxation to acetylcholine (ACh) was observed only in segments with EC. Preincubation with either 1 microM propranolol or 10 microM indomethacin failed to block relaxation, but the addition of either 30 microM quinacrine hydrochloride or 100 microM nordihydroguaiaretic acid prevented it entirely. EC-dependent relaxation to ATP was also demonstrated. These data demonstrate that EC-dependent relaxation occurs in human pulmonary arteries. Neither beta-adrenergic pathways nor prostaglandin intermediaries are utilized. An oxidized breakdown product of arachidonic or some other fatty acid from EC phospholipid appears to be involved. These data suggest that interactions between endothelium and smooth muscle may be important in modulating tone in the vessel wall and that damage to the endothelium may play a role in the development of pulmonary hypertension in humans. PMID- 3812756 TI - Regional sciatic nerve blood flow response to limb movement. AB - The regional blood flow in the sciatic nerves (NBF), biceps femoris muscles (MBF), and hind limb skin (SBF) was measured simultaneously in anesthetized, normal rats, in other rats immediately after 15 min of electrical stimulation of one sciatic trunk (10 shocks/s), and in a group of similarly stimulated but previously curarized rats. These experiments were done to quantitate NBF during direct nerve stimulation in both the presence and absence of associated vigorous limb twitching, as these relationships have not previously been examined. Tissue blood flows were measured by an "indicator-fractionation" technic, using the distribution of [14C]butanol. NBF in normal controls was 11.1 +/- 1.4 ml X min-1 X 100 g-1; MBF was 6.8 +/- 0.6 ml X min-1 X 100 g-1. In the stimulated limb of noncurarized rats, NBF rose to 19.8 +/- 3.5 ml X min-1 X 100 g-1. MBF was elevated approximately tenfold. SBF also rose. In stimulated limbs of curarized rats, NBF was also approximately double the resting normal value, 23.2 +/- 4.8 ml X min-1 X 100 g-1, but MBF was then only slightly increased. We conclude that sciatic NBF increases appreciably when this nerve is stimulated, irrespective, for the most part, of whether limb motor activity is increased. The vascular mechanisms which regulate NBF differ from and are largely independent of those regulating MBF. PMID- 3812757 TI - Myocardial temperature variation: effect on regional function and coronary flow in dogs. AB - Incremental changes in the temperature (28-42.5 degrees C) of the anterior left ventricular wall in a canine, working, beating right heart bypass preparation (constant preload, afterload, and heart rate) were produced to measure the effect of regional temperature on myocardial function and blood flow. Circumferential axis segment lengths were measured with sonomicrometry in both the temperature varied, left-anterior descending coronary artery (LAD)-supplied myocardium and the normothermic (38 degrees C) circumflex-supplied myocardium. Fast thermistors (time constant less than 0.25 s) continuously monitored midmyocardial temperature in both areas. A Silastic loop with heat exchanger, thermistors, strain gauge, and flow probe was inserted into the LAD and allowed precise control of regional myocardial temperature. Nine-micron microspheres injected into left atrium were used to evaluate coronary flow and distribution. In six anesthetized dogs, relative to normothermic control (38 degrees C), regional systolic shortening decreased 42.2 +/- 10% at 41 degrees C and increased 23.3 +/- 6% at 31 degrees C. There was no significant change in coronary blood flow or distribution at the three temperatures. Pressure-length areas varied inversely with myocardial temperature. These data demonstrate that there is a reversible inverse relationship between midwall T and ventricular function when heart rate, preload, and after-load are controlled. PMID- 3812758 TI - Changes in pituitary growth hormone cells prepared from rats flown on Spacelab 3. AB - Anterior pituitaries from "small" (250 g) and "large" (400 g) rats flown on the 7 day Spacelab 3 mission were pooled and trypsinized into two single-cell suspensions. Compared with ground-based controls, flight cells appeared to contain more intracellular growth hormone (GH) but release less GH over a 6-day culture period. After implantation into hypophysectomized rats, both sets of flight cells released only 50% of the GH compared with the control cells. Glands from large flight rats contained 44% somatotrophs compared with 37% for controls; small animals showed no difference. There were no striking differences in somatotroph ultrastructure between cells in the four groups. Western blot analysis indicated that there were no major differences in immunoactive GH variants. High-performance liquid chromatography fractionation of culture media indicated that small flight cells released much less of a high-molecular weight variant rich in GH bioactivity. The results suggest that GH cells from rats exposed to microgravity may experience secretory dysfunction. The possibility that this occurs directly at the pituitary cell level is discussed. PMID- 3812759 TI - Hematological measurements in rats flown on Spacelab shuttle, SL-3. AB - Previous studies have shown that a decrease in red cell mass occurs in astronauts, and some studies indicate a leukocytosis occurs. A life science module housing young and mature rats was flown on shuttle mission Spacelab 3 (SL 3), and the results of hematology studies of flight and control rats are presented. Statistically significant increases in the hematocrit, red blood cell counts, and hemoglobin determinations, together with a mild neutrophilia and lymphopenia, were found in flight animals. No significant changes were found in bone marrow and spleen cell differentials or erythropoietin determinations. Clonal assays demonstrated an increased erythroid colony formation of flight animal bone marrow cells at erythropoietin doses of 0.02 and 1.0 U/ml but not 0.20 U/ml. These results agree with some but vary from other previously published studies. Erythropoietin assays and clonal studies were performed for the first time. PMID- 3812760 TI - Hepatic function in rats after spaceflight: effects on lipids, glycogen, and enzymes. AB - The inclusion of rats aboard Spacelab 3 (SL-3) allowed analyses of liver lipids, glycogen, hepatic enzymes of cholesterol, glycerolipid and sphingolipid biosynthesis, and other enzyme activities. Glycogen content was markedly elevated in livers from the flight animals compared with controls. Cholesterol was 24% (P less than 0.04) lower in livers from the experimental groups, whereas blood cholesterol was 19% higher (P less than 0.05). The activity of 3-hydroxy-3 methylglutaryl-CoA reductase, the rate-limiting enzyme of steroid biosynthesis, was 80% lower (P less than 0.01). Total phospholipids and sphingolipid levels did not differ significantly. The specific activity of fatty acyl-CoA synthetase, which is responsible for activation of fatty acids, was 37% (P less than 0.05) higher in microsomes from the rats on SL-3; however, since these animals had 25% less microsomal protein (P less than 0.02), there was no difference per gram of liver. The initial enzymes of sphingolipid and glycerolipid biosynthesis were assayed; serine palmitoyltransferase was 40% lower (P less than 0.01), and glycerol 3-phosphate acyltransferase did not differ. Hepatic cytochrome P-450 content decreased by 50% after spaceflight. Enzymes that did not differ significantly between the two groups include cytochrome b5, glutathione S transferase, tyrosine aminotransferase, aspartate aminotransferase, and cystathionase. These findings suggest that spaceflight alters hepatic metabolism of several classes of compounds. PMID- 3812761 TI - Fragility and composition of growing rat bone after one week in spaceflight. AB - To gain some insight into the early effects of spaceflight on skeletal metabolism, we quantified the major chemical constituents and a noncollagenous protein, osteocalcin, in the third-lumbar vertebrae and humeri from 8-wk-old rats that were part of the 7-day NASA Spacelab 3 flight experiments. The ratio of calcium to hydroxyproline in the humeral diaphysis increased from 8.5 in preflight to 9.8 in ground simulation control and only to 8.9 in flight bones. There was no demonstrable change in the fraction of nonmineralized collagen. Osteocalcin content was reduced in the humerus and vertebra. Reduced accumulation of mineral and osteocalcin with no associated decrease in collagen in flight animals suggests that both mineralization and collagen metabolism are impaired in growing animals during spaceflight within a few days after launch. Strength tests of the humeri of flight rats showed substantial deficits that appeared to be related, not only to the reduced bone mass, but also to the composition and quality of new bone formed. PMID- 3812762 TI - Nuclear morphometric analysis of osteoblast precursor cells in periodontal ligament, SL-3 rats. AB - Five small (55 days old, 196 +/- 5 g) (mean +/- SE) and five large (83 days old, 382 +/- 4 g) Sprague-Dawley strain, specific pathogen-free rats were exposed to a 7-day spaceflight and 12-h postflight recovery period. As measured in 3-micron sections, periodontal ligament (PDL) fibroblastlike cells were classified according to nuclear size: A + A' (40-79), B (80-119), C (120-169), and D (greater than or equal to 170 microns 3). Since the histogenesis sequence is A--- A'----C----D----osteoblast, the relative incidence of A + A' to C + D is an osteogenic index. No difference in A + A' or C + D cells in small rats may reflect partial recovery of preosteoblast formation (A----C) during the 12-h postflight period. Large flight rats demonstrated increased numbers of A + A', indicating an inhibition of preosteoblast formation (A----C). At least in the older group, a 7-day flight is adequate to reduce PDL osteogenic potential (inhibition in PDL osteoblast differentiation and/or specific attrition of C + D cells) that does not recover by 12-h postflight. PMID- 3812763 TI - Histomorphometric analysis of rat skeleton following spaceflight. AB - Male Sprague-Dawley rats were placed in orbit for 7 days aboard the space shuttle. Bone histomorphometry was performed in the long bones and lumbar vertebrae of flight rats and compared with data derived from ground-based control rats. Trabecular bone mass was not altered during the 1st wk of weightlessness. Strong trends were observed in flight rats for decreased periosteal bone formation in the tibial diaphysis, reduced osteoblast size in the proximal tibia, and decreased osteoblast surface and number in the lumbar vertebra. For the most part, histological indexes of bone resorption were normal in flight rats. The results indicate that 7 days of weightlessness are not of sufficient duration to induce histologically detectable loss of trabecular bone in rats. However, cortical and trabecular bone formation appear to be diminished during the 1st wk of spaceflight. PMID- 3812764 TI - Phase setting of circadian locomotor rhythm of infant rats. AB - Postnatal phase setting of pup circadian rhythm by nursing mother was examined in rats by mother-pup exchange experiments. To know the effect of phase reversal of the nursing mother, pups were exchanged after birth so that a mother rat raised pups, half of which were born to her and the other half which came from a reversed mother, and activity onset and offset of pup locomotor rhythm were measured at weaning. Effects of litter size were also examined. Direct entrainment to light-dark cycles was excluded by blinding pups. In the unexchanged group, a strong positive correlation was detected between the phase of the circadian rhythm at weaning and the free-running period measured after weaning. The area covered by the 99% confidence interval of the regression line was used for the phase reference zone, and the circadian rhythm of an exchanged pup whose phase at weaning was located outside the reference zone was regarded as having been influenced by the nursing mother. The complete phase reversal occurred in two out of seven exchanged pups when litter size was relatively large (n = 5-7) and in 9 out of 11 when litter size was small (n = 2). It is concluded that the nursing mother rat is capable of phase setting the circadian locomotor rhythm of blinded pups. This maternal effect seems to be related to litter size. PMID- 3812765 TI - Restricted daily feeding during nursing period resets circadian locomotor rhythm of infant rats. AB - Phase setting of the circadian rhythm by restricted daily feeding (RF) was examined in rat pups. Feeding of virgin, pregnant, and nursing rats together with pups was restricted to 4 h at a fixed time of the day. Phases of the circadian rhythm developed in neonatally blinded pups were measured on the day of weaning to evaluate the effect of RF on phase setting. The activity onset and offset of the locomotor rhythm were used for the phase reference. In blinded pups born and raised under ad libitum feeding, the phase at weaning was a function of the free running period measured after weaning and located in a narrow range (control zone). When RF was imposed from 2 wk prior to the conception (C) until weaning (3w), the pups phases were located outside the control zone and related to the feeding time. To identify the period in which the phase setting is effective, RF was imposed during 5 different periods (C-0w, C-1w, C-2w, 2-6w, and 3-6w). The circadian rhythm of all pups in the C-2w group and some in the C-1w was phase set, but those in other groups were not affected. It is concluded that RF imposed during the early nursing period is capable of phase setting the circadian system of blinded infant rats. PMID- 3812766 TI - Time course of radiolabeled 2-deoxy-D-glucose 6-phosphate turnover in cerebral cortex of goats. AB - The in vivo dephosphorylation rate of 2-deoxy-D-glucose 6-phosphate (DGP) in the cerebral cortex of goats injected intravenously with radiolabeled 2-deoxy-D glucose (DG) was investigated. Serial rapidly frozen samples of parietal cortical gray tissue were obtained at regular intervals over time periods from 45 min to 3 h in awake goats or in paralyzed and artificially ventilated goats maintained under 70% N2O or pentobarbital sodium anesthesia. The samples were analyzed for glucose content and separate DG and DGP activities. The rate parameters for phosphorylation (k3*) and dephosphorylation (k4*) were estimated in each animal. The glucose phosphorylation rate (PR) was calculated over the intervals 3-5 (or 6), 3-10, 3-20, 3-30, and 3-45 min, assuming k4* = 0. As the evaluation period was extended beyond 10 min, the calculated PR became increasingly less when compared with that calculated over the 3- to 5- (or 6) min interval (PRi). Furthermore, as metabolic activity decreased, the magnitude of the error increased such that at 45 min pentobarbital-anesthetized goats underestimated the PRi by 46.5% compared with only 23.1% in N2O-anesthetized goats. This was also reflected in the greater than twofold higher k4*/k3* ratio in the pentobarbital vs. N2O-anesthetized group. It is concluded that when using the DG method in the goat, DGP dephosphorylation cannot be ignored when employing greater than 10-min evaluation periods. PMID- 3812767 TI - Suppressed serum prolactin in sinoaortic-denervated rats. AB - We investigated the effect of arterial baroreceptor deafferentation on serum and pituitary prolactin (PRL) and on catecholamines in median eminence (ME) and anterior and posterior pituitaries. Male Wistar rats were sinoaortic denervated (SAD) or sham operated (SO). Three days after surgery serum prolactin, measured by radioimmunoassay, was suppressed in SAD rats (-54%, P less than 0.05), and dopamine (DA) and norepinephrine (NE) concentrations, measured by radioenzymatic or high-performance liquid chromatography electron capture methods, were significantly reduced in ME of SAD rats (NE, -54% P less than 0.005 and DA, -56% P less than 0.001). Simultaneously, anterior pituitary of SAD rats had significant increases in both catecholamines, whereas posterior pituitary showed no changes. Four hours after surgery serum PRL was also reduced (-40%, P less than 0.05) in SAD rats, but no changes in ME catecholamines were found. Mean arterial pressure (MAP) and heart rate were measured before and after injection of bromocriptine (0.5 mg/kg ip) in SAD and SO rats 3 days after surgery. Bromocriptine markedly suppressed serum PRL in both groups and reduced MAP from 144 +/- 10 to 84 +/- 5 and from 116 +/- 2 to 99 +/- 3 in SAD and SO rats, respectively; heart rate was reduced in SAD rats. We conclude that the SAD rat is a model of hypertension with suppressed serum PRL and that interruption of arterial baroreceptor nerves suppresses PRL secretion probably by modulating tuberoinfundibular turnover of catecholamines. PMID- 3812768 TI - Sinoaortic denervation in the nonhuman primate. AB - There is considerable controversy as to whether removal of baroreceptor input by sinoaortic deafferentation leads to a sustained hypertension in quadripeds. Because of the importance of the baroreflex during postural changes, the effects of baroreceptor denervation may be even more profound in the primate. In this study, six adult male baboons (Papio anubis) were maintained on a tether system to examine the acute and sustained effects of aortic and combined carotid sinus and aortic baroreceptor deafferentation. Mean arterial pressure (MAP) averaged over 24 h increased from 86 +/- 4.0 to 105 +/- 5.5 mmHg after aortic denervation. One week after sinoaortic deafferentation, arterial pressure rose to 129 +/- 12.9 mmHg and then receded to 97 +/- 4.4 mmHg at 4 wk postdenervation. The lability of arterial pressure (measured as the mean of the standard deviations over 24 h) did not change with aortic denervation but increased at 1 and 4 wk after complete baroreceptor denervation. These studies indicate that baroreceptor deafferentation in the primate results in an acute increase in arterial pressure, the lability of arterial pressure, and heart rate. However, by 4 wk postdenervation, the level and lability of arterial pressure are decreased but remain significantly elevated. PMID- 3812769 TI - Effect of permanent access to operant heating on energy balance of growing pigs. AB - Early-weaned littermate piglets were acclimated to cold for 3 wk and then housed for 6 wk at a room temperature of 10 degrees C in individual cages. Half the littermates (OP) could switch on a heater and thus adjust temperature within a cage; the other half (CP) had access to a source of light only. Food was available ad libitum. It was found that when the room temperature was 10 degrees C OP maintained cage temperature at 17.3 degrees C, whereas that of CP was at 10.4 degrees C (P less than 0.001); rectal temperature of OP was 0.4 degree C (P less than 0.01), and locomotor activity 19.9% (P less than 0.001) higher than in CP. Oxygen consumption measured at 25 degrees C was 12.5% lower (P less than 0.05) in OP than CP, but did not differ when measured at 10 degrees C. There were no differences in food intake and growth rate, but the food conversion ratio was improved by 10.9% (P less than 0.01) in OP in comparison with CP. By the end of the experiment CP had shorter bodies, tails and snouts and smaller heads and ears than CP. No difference in distribution of tissues, size of internal organs, or dry matter and energy content in tissues was observed between the groups. The role of autonomic vs. behavioral thermoregulation in maintaining a mammal's energy balance and thermal homeostasis is discussed. PMID- 3812770 TI - Effect of sympathetic sensitization of baroreceptors on renal nerve activity. AB - The role of sympathetic efferent innervation of the carotid sinus on the regulation of baroreceptor sensitivity was examined in thiopental-sodium anesthetized dogs (5 mg X kg-1 X h-1 infusion). Baroreflex sensitivity was defined as the slope of renal sympathetic efferent nerve activity vs. carotid sinus pressure in an isolated, perfused carotid sinus. Slopes were obtained before and after sinus sympathectomy performed by section of the cervical sympathetic trunk. There was no significant differences between baroreflex decreases in renal sympathetic activity due to increases in carotid sinus pressure before and after sympathectomy, but the responses to decreases in carotid sinus pressure after sympathectomy were significantly greater than control. Base-line level of renal sympathetic activity, obtained at a constant perfusion pressure of 115 mmHg, abruptly increased by 11% in response to sinus sympathectomy. The response of baroreceptors to sympathomimetic stimulation was examined by recording carotid baroreceptor afferent nerve activity during ramp changes in carotid sinus pressure after addition of epinephrine (10(-8) to 10(-6) M) to the perfusate of the sympathetically denervated sinus. The slopes of the sinus nerve activity vs. carotid sinus pressure were used as direct indexes of baroreceptor sensitivity. Lower levels of epinephrine (10(-8), 10(-7) M) increased the sensitivity of the baroreceptors and reduced renal nerve activity back toward presympathectomy levels. A higher dose of epinephrine (10(-6) M) did not significantly increase baroreceptor sensitivity. The results of this study suggest that sinus sympathetic fibers produce a tonic sensitization of the baroreceptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812771 TI - Does myoglobin contribute significantly to diffusion of oxygen in red skeletal muscle? AB - We have examined the role of myoglobin to facilitate O2 diffusion to active mitochondria in skeletal muscle by constructing computer-simulation experiments. Steady-state mitochondrial O2 consumption under different conditions of supply partial pressure of O2 (PO2) in a system with and without myoglobin were examined for a one-dimensional slab of tissue. O2 consumption by mitochondria was saturable with the mitochondria located in bands at uniform intervals throughout the tissue. Under these conditions, myoglobin provides a measurable increase in O2 transport for supply PO2 below 10 Torr and diffusion lengths expected for skeletal muscle fibers. We conclude that under circumstances where hypoxia lowers PO2 below 10 Torr that myoglobin begins to provide a measurable increase in O2 delivery to mitochondria. PMID- 3812772 TI - Proglumide, a cholecystokinin antagonist, increases gastric emptying in rats. AB - Injection of cholecystokinin (CCK) reduces food intake and delays gastric emptying. We have previously shown that endogenous CCK also reduces food intake. This may be achieved by a delay in gastric emptying. We investigated the role of CCK in gastric emptying by inhibiting the actions of CCK released by a meal, using a CCK antagonist, proglumide. We postulated that inhibition of CCK should induce an increase in gastric emptying. Gastric emptying was determined in rats by a marker dilution technique using direct gastric intubation. Proglumide (150 mg/kg) significantly accelerated emptying of liquid food by 12.8% (P less than 0.005, n = 12) when injected intraperitoneally following a food preload. Proglumide injected before feeding was ineffective. Oral proglumide, which inhibited gastrin-stimulated acid secretion, was also ineffective. We concluded that proglumide increased gastric emptying by acting on a factor released by the preload, and since proglumide is a specific antagonist, this factor was probably CCK. Therefore CCK may play a physiological role in the regulation of gastric emptying. PMID- 3812773 TI - Contraction of major artery segments of rat by fish neuropeptide urotensin II. AB - Urotensin II (U II) caused marked concentration-dependent contractions of helical strips from several major arteries of the rat. The thoracic aorta was most sensitive; the apparent concentration of U II producing half-maximal contraction was 6.8 X 10(-10) M. Papaverine, dibutyryl cyclic AMP, forskolin, and nitroprusside antagonized the contractile responses to U II at the apparent concentrations producing 50% inhibition (IC50) of 7.6 X 10(-6), 2.1 X 10(-4), 2.5 X 10(-6), and 1.5 X 10(-8) M, respectively. Verapamil, a calcium channel-blocking agent, partially inhibited the contractile response to U II at IC50 = 6.5 X 10( 6) M. Maximal relaxation, i.e., a complete inhibition, could not be obtained even at a concentration of 3 X 10(-5) M verapamil. Cyproheptadine reduced the U II induced contraction at higher concentrations. Phentolamine (10(-5) M), propranolol (10(-5) M), atropine (10(-4) M), tetrodotoxin (10(-6) M), burimamide (10(-5) M), and indomethacin (10(-5) M) did not change the U II-induced contraction. At higher concentration, U II (10(-8) M) induced a small contraction of aortic strips in Ca2+-free Krebs Henseleit solution similar to that of norepinephrine, but the U II-induced contraction was not inhibited by phentolamine or propranolol. The action of U II did not require the presence of endothelial cells. It is concluded that U II acts on vascular smooth muscle and induces the contraction partly through intracellular Ca2+ mobilization but mainly by stimulating the influx of extracellular Ca2+ via potential dependent and potential independent calcium channels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812774 TI - Mechanosensitive afferents of femoral-saphenous vein. AB - Reflex contraction of cat hindlimb skeletal muscles can be induced by mechanical stimulation of afferents in the femoral-saphenous vein. Afferent fibers innervating this vein have been previously reported. Hence, it is evident that mechanoreceptors must be present in the femoral-saphenous vein, yet there have never been direct recordings of sensory nerves that respond to mechanical stimulation of the vein. This study recorded the activity of these venous mechanoreceptors and tested their response to increased intravenous pressure. The activity of single venous afferents was recorded from thin filaments of the saphenous nerve. The afferent response was recorded during external mechanical probing of the vein wall and increases in intravenous pressure. Their venous pressure threshold and adaptation to static pressures were determined. All the afferents responded to both types of mechanical stimuli. Static increases in venous pressure resulted in two types of afferent discharge behavior: slowly adapting and rapidly adapting. Venous pressure thresholds varied considerably with a range of 22.2-174.7 mmHg. The estimated conduction velocities are 2.8-7.8 m/s, suggesting type III, A-delta-myelinated mechanoreceptors. These results demonstrate the presence and mechanical sensitivity of venous afferents that transduce intravenous pressure. Their role in the reflex responses to vein distension is unclear and awaits further investigation. PMID- 3812775 TI - Pulmonary depressor reflex elicited by capsaicin in conscious intact and lung denervated dogs. AB - A pulmonary depressor reflex has been shown to be elicited in anesthetized cats, dogs, and rats by intravenous injection of capsaicin. The effects observed include apnea, hypotension, and bradycardia with some investigators reporting tachypnea following the apneic period. We investigated the response to a bolus injection of capsaicin (20 micrograms/kg) into the cephalic vein in 11 conscious beagle dogs. Five control dogs underwent sham thoracotomies, and six dogs underwent selective denervation of the lungs. A low dead-space latex rubber mask was used to monitor ventilation, and arterial blood pressure was obtained by catheterizing an exteriorized carotid artery. In four of the five control dogs the observed response was apnea concomitant with hypotension and bradycardia, followed by tachypnea. In five of the six lung-denervated dogs there was a slight tachypnea along with hypertension. It is concluded that the pulmonary depressor reflex can be elicited in conscious dogs by intravenous injection of capsaicin but is absent in lung-denervated dogs. PMID- 3812776 TI - Level of alimentation and line of breeding on oxygen uptake by ovine jejunal mucosa. AB - Targhee rams from a selected and control line of breeding were provided with the same diet at either 100 or 40% of ad libitum feed intake levels for 28 days. The rams were killed in a serial fashion over a 35-day period. A sample of the jejunum mucosa was taken, and O2 consumption rates with and without ouabain were measured. Total O2 consumption and ouabain-sensitive respiration rates of the jejunal mucosa taken from rams of the select line were greater than for samples taken from the control rams. Line of breeding did not influence the percent of the total O2 consumption that was ouabain sensitive and the proportion of the jejunum that was mucosa. Differences in rates of total and ouabain-sensitive O2 consumption attributed to level of feed intake were not detected as significant. Both the percentage of the total respiration rates that was ouabain sensitive and the proportion of the jejunum that was mucosa were greater for rams fed at high intake levels compared with rams fed at low intake levels. Thus both breeding sheep on the basis of improved growth potential and level of alimentation influenced aspects of jejunal mucosa respiration that was Na+-K+ adenosinetriphosphatase dependent. PMID- 3812777 TI - Diet, lighting, and food intake affect norepinephrine turnover in dietary obesity. AB - The effects of dietary fat content, lighting cycle, and feeding time on norepinephrine turnover in interscapular brown adipose tissue, heart, and pancreas, and on blood 3-hydroxybutyrate, serum glucose, insulin, and corticosterone have been studied in two strains of rats that differ in their susceptibility to dietary obesity. S 5B/Pl rats, which are resistant to dietary obesity, have a more rapid turnover of norepinephrine in interscapular brown adipose tissue and heart and a greater increase in the concentration of norepinephrine in brown fat when eating a high-fat diet than do Osborne-Mendel rats, which are sensitive to fat-induced obesity. Light cycle and feeding schedule are important modulators of sympathetic activity in heart and pancreas but not in brown fat. Rats of the resistant strain also have higher blood 3 hydroxybutyrate concentrations and lower insulin and corticosterone levels than do rats of the susceptible strain. A high-fat diet increases 3-hydroxybutyrate concentrations and reduces insulin levels in both strains. These studies show, in rats eating a high-fat diet, that differences in norepinephrine turnover, particularly in brown adipose tissue, may play an important role in whether dietary obesity develops and in the manifestations of resistance to this phenomenon observed in the S 5B/Pl rat. PMID- 3812778 TI - In vivo metabolic activity of hamster suprachiasmatic nuclei: use of anesthesia. AB - In vivo glucose utilization was measured in the suprachiasmatic nuclei (SCN) of Golden hamsters using the 14C-labeled deoxyglucose technique. A circadian rhythm of SCN metabolic activity could be measured in this species, but only during pentobarbital sodium anesthesia when the surrounding background activity of adjacent hypothalamus was suppressed. Both the SCN's metabolic oscillation and its time-keeping ability are resistant to general anesthesia. PMID- 3812779 TI - Inhibition of gastric emptying and feeding by fenfluramine. PMID- 3812780 TI - Levels of emotional awareness: a cognitive-developmental theory and its application to psychopathology. AB - The authors present a cognitive-developmental theory of emotional awareness that creates a bridge between normal and abnormal emotional states. Their primary thesis is that emotional awareness is a type of cognitive processing which undergoes five levels of structural transformation along a cognitive developmental sequence derived from an integration of the theories of Piaget and Werner. The five levels of structural transformation are awareness of bodily sensations, the body in action, individual feelings, blends of feelings, and blends of blends of feelings. The authors suggest applications of this model to current unresolved problems in psychiatric theory, research, and practice. PMID- 3812781 TI - Temperament and intellectual development: a longitudinal study from infancy to four years. AB - Using three temperamentally different subgroups from a large birth cohort, the authors undertook a longitudinal study of the association between temperament measured in children at 4 and 8 months and IQ assessed at 4.7 years. The data suggested a strong effect of extreme temperament traits on IQ development in middle and upper socioeconomic classes and in families with superior functioning in terms of communication. The temperamentally difficult group unexpectedly displayed higher IQs, and the well-replicated effect of socioeconomic status on IQ development was observed mainly in this group. These data support the hypothesis that difficult infants activate special family resources, which stimulates intellectual development over the years. PMID- 3812782 TI - "Doom anxiety" and delirium in lidocaine toxicity. AB - Of 15 patients with psychiatric reactions to lidocaine, 12 (80%) had mood changes, 11 (73%) had "doom anxiety," eight (53%) had overt confusional states, and six (40%) had hallucinations and delusions. The authors contend that morbid fears of impending doom or the belief that death has occurred are specific manifestations of lidocaine toxicity and may be mistakenly attributed to "understandable" fears about death during the course of recovery from a myocardial infarction on the coronary care unit. PMID- 3812783 TI - Psychiatrist-patient sexual contact: results of a national survey, II: Psychiatrists' attitudes. AB - In a national random-sample survey of 1,423 practicing psychiatrists, the overwhelming majority of the respondents (98%) said that therapist-patient sexual contact is always inappropriate and usually harmful to the patient. However, 29.6% said that such contact after termination of therapy might sometimes be acceptable. Psychiatrists who acknowledged having had sexual contact with one or more patients (N = 84) differed markedly from their peers in their attitudes. The majority (74%) of these offenders believed that sexual contact could be appropriate after termination; many apparently rationalized their behavior in this manner. The authors discuss the need for systematic professional education on the subject. PMID- 3812784 TI - State and personality in depressed and panic patients. AB - The authors examined 36 patients with panic disorder, 66 patients with major depression, and 124 control subjects to determine personality differences between them in the ill and the recovered states. The panic and depressed groups did not differ from each other in either state. Both recovered groups had less emotional strength and greater interpersonal dependency than the control subjects. The effect of state on personality measures appears to be similar for anxious and depressed patients. No personality measures that clearly differentiated the recovered panic and depressed patients were found. PMID- 3812785 TI - Effects of the Jamison-Farabee consent decree: due process protection for involuntary psychiatric patients treated with psychoactive medication. AB - The Jamison-Farabee consent decree in California mandates an outside psychiatrist's review of involuntary medication of state hospital patients. Patients' rights advocates presumably hoped the decree would facilitate more frequent medication refusal, while clinicians predicted the procedure would impair patient care. Outside review led to only a 1.1% rate of medication denial; half of the patients involved deteriorated afterward. Examination of a sample of patients subject to the decree and two comparable samples 1 year and 10 years earlier suggests that patients' successful medication refusal was no more frequent after implementation of the decree and that the procedure had negligible effects on patient care or outcome for patients not denied medication. PMID- 3812786 TI - Competency determinations in civil commitment. AB - The authors present a brief overview of competency determinations in criminal justice and civil commitment proceedings and review the American Psychiatric Association's Model Commitment Statute, which gives competency a central role. They present an alternative proposal that involves determining a person's competency to undergo civil commitment before a formal commitment hearing and delineates the responsibilities of legal and medical decision makers in the commitment process. PMID- 3812787 TI - Predictive validity of judgments of dangerousness in emergency civil commitment. AB - The authors investigated the predictive validity of judgments of dangerousness made in the context of emergency civil commitment. The medical charts of 101 consecutive patients involuntarily admitted to a university-based acute inpatient unit were reviewed for evidence of violence within the first 72 hours of hospitalization. More than two-thirds of the patients committed as a danger to others engaged in some type of violence, compared with fewer than one-third of other involuntary patients. The findings suggest that the emergency commitment situation permits judgments of dangerousness with a relatively high degree of short-term predictive validity. PMID- 3812788 TI - Sleep reduction as a final common pathway in the genesis of mania. AB - Diverse psychological, interpersonal, environmental, and pharmacological factors that appear to trigger the onset of mania could act via their capacity to cause sleep deprivation, a mechanism that has been shown in experiments with bipolar patients to induce transient or sustained switches into mania. Since mania in turn causes insomnia, the development of mania is potentially self-reinforcing and could become autonomous after being initiated by precipitating factors. The sleep reduction model is based on experimental evidence and is a parsimonious explanation for the precipitation of manic episodes by a wide variety of factors. Furthermore, this model has clear implications for the prevention and treatment of mania and provides a conceptual focus and an experimental paradigm for psychological investigations of the causes of mania. PMID- 3812789 TI - Prevalence of tobacco dependence and withdrawal. AB - In a sample of 1,006 middle-aged male smokers drawn from the general population, 90% (N = 905) fulfilled DSM-III criteria and 36% (N = 362) fulfilled Fagerstrom's criteria for tobacco dependence. Among the 875 who had stopped smoking in the past for at least 24 hours, 21% (N = 184) fulfilled DSM-III criteria and 46% (N = 403) fulfilled the authors' own criteria for tobacco withdrawal. Concordance of results among the criteria for diagnosing tobacco dependence and withdrawal was low. These results suggest that the DSM-III criteria for tobacco dependence are overinclusive and that there is little consensus among the definitions of tobacco dependence and withdrawal. PMID- 3812790 TI - Psychiatric and medical diagnoses as risk factors for mortality in psychiatric patients: a case-control study. AB - On the basis of a case-control study, the authors conclude that former psychiatric inpatients are more likely than control subjects to die of both natural and unnatural causes within 2 years of discharge. Patients who committed suicide were more likely to have had a diagnosis of affective disorder (unipolar depression) or alcoholism. Those who died of natural causes were more likely to have been admitted with medical diagnoses; no specific psychiatric diagnoses were associated with these deaths. It is doubtful that medical illnesses caused psychiatric syndromes such as depression in these inpatients. Psychiatric and medical illnesses combined may increase a patient's likelihood of seeking psychiatric help and entering the hospital. PMID- 3812791 TI - Prognostic validity of the dexamethasone suppression test: results of a six-month prospective follow-up. AB - In a 6-month prospective follow-up study, the authors located and interviewed 165 (88.2%) of 187 primary unipolar depressed inpatients to whom a 1-mg dexamethasone suppression test (DST) had been given during their first week of hospitalization. Longitudinal ratings of symptoms over the follow-up period and 6-month cross sectional ratings on the Hamilton Rating Scale for Depression, the Beck Depression Inventory, and the Global Assessment Scale were obtained for each patient. The authors also collected information on rehospitalization after discharge from the index episode. Baseline DST results were not associated with any of the outcome variables. PMID- 3812792 TI - Suicide and homicide in the United States: an epidemiologic study of violent death, population changes, and the potential for prediction. AB - The authors found significant positive correlations between the suicide and homicide rates for 15-24-year-olds and the proportion of 15-24-year-olds in the U.S. population from 1933 to 1982. Significant negative correlations were found for most adult age groups (35-64 years). Since future numbers of adolescents and adults can be estimated on the basis of current population data for children and preadolescents, the epidemiologic patterns for suicide and homicide may be predictable for certain age groups. However, methodologic problems are inherent in using national mortality and population data, and many years are necessary to evaluate such epidemiologic propositions. PMID- 3812793 TI - The clinical significance of command hallucinations. AB - Patients with command hallucinations (voices ordering particular acts, often violent or destructive ones) are commonly assumed to be at high risk for dangerous behavior. The authors reviewed 789 consecutive inpatient admissions. Of 151 patients with auditory hallucinations, 58 (38.4%) heard commands. The presence of auditory hallucinations was significantly associated with diagnosis, demographic variables, and use of maximal observation and seclusion. However, patients with command hallucinations were not significantly different from patients without commands on demographic and behavioral variables, including suicidal ideation or behavior and assaultiveness. These findings suggest that command hallucinations alone may not imply greater risk for acute, life threatening behavior. PMID- 3812794 TI - Auditory hallucinations and subvocal speech in schizophrenic patients. AB - Fourteen of 18 hallucinating schizophrenic patients reported that the voices they heard went away when they undertook a maneuver that precluded subvocalization. The same applied to 18 of 21 normal subjects who hallucinated under the influence of hypnotic suggestion. Control maneuvers had no such effect. The authors suggest that auditory hallucinations may be projections of schizophrenic patients' verbal thoughts, subvocalized due to deficient cerebral cortical inhibition. PMID- 3812795 TI - Depression in Chinese medical inpatients. AB - The authors studied depressive symptoms among 251 Chinese medical inpatients through the use of the Beck Depression Inventory. Assessment of 100 healthy Chinese volunteers validated the use of American score norms for Chinese subjects. A total of 47.8% of the 251 medical inpatients (N = 120) met the Beck scale criterion for depression. Beck scale scores varied with the occupation of patients and the severity of medical illness but did not vary with sex, age, marital status, duration of hospitalization, or medical diagnosis. PMID- 3812796 TI - Platelet serotonin concentration in schizophrenic patients. AB - Platelet serotonin (5-HT) concentration did not significantly differ between control subjects (N = 45) and schizophrenic (N = 62) or chronic schizophrenic (N = 39) patients. No clinical feature was associated with hyperserotonemia, but the subgroup receiving benzodiazepines had a significantly higher 5-HT level than other patients. PMID- 3812797 TI - Delirium induced by verapamil. PMID- 3812798 TI - Self-inflicted eye injury. PMID- 3812799 TI - Patient incompetence in legal settings. PMID- 3812800 TI - Heroin-induced vomiting in bulimia. PMID- 3812801 TI - Doses and blood levels of tricyclic antidepressants. PMID- 3812802 TI - Sympathomimetic-induced depression. PMID- 3812803 TI - Classification and diagnosis. PMID- 3812804 TI - More on posttraumatic stress disorder. PMID- 3812805 TI - Borderline personality and DSM-III. PMID- 3812806 TI - Sexual side effects of alprazolam. PMID- 3812807 TI - Nicotine and panic attacks. PMID- 3812808 TI - ECT results and meta-analysis. PMID- 3812809 TI - Comment on the review of The Foundations of Psychoanalysis. PMID- 3812810 TI - Proposed changes in DSM-III substance dependence criteria. PMID- 3812811 TI - Treatment of anorexia nervosa. PMID- 3812812 TI - Keeping the clinician-researcher alive. PMID- 3812813 TI - Cerebral ischemic symptoms in anxiety disorders. PMID- 3812814 TI - Carbamazepine, alprazolam withdrawal, and panic disorder. PMID- 3812816 TI - Improved localization of moving targets with prior knowledge of direction of target motion. AB - In dynamic environments in which many stimulus elements are in motion, visual search may depend upon specific characteristics of target motion that are known in advance. When stimulus elements move in various directions but each element can move in only one direction, prior knowledge of the target's direction of motion reduces search time. PMID- 3812815 TI - Echoic and retrieval accounts of the long-term modality effect tested using the suffix procedure. AB - The long-term modality effect is the advantage in recall of the last of a list of auditory to-be-remembered (TBR) items compared with the last of a list of visual TBR items when the list is followed by a filled retention interval. If the auditory advantage is due to echoic sensory memory mechanisms, then recall of the last auditory TBR item should be substantially reduced when it is followed by a redundant, not-to-be-recalled auditory suffix. Contrary to this prediction, Experiment 1 demonstrated that a redundant auditory suffix does not significantly reduce recall of the last auditory TBR item. In Experiment 2 a nonredundant auditory suffix produced a large reduction in the last auditory item. Redundancy is not the only factor controlling the effectiveness of a suffix, however. Experiment 3 demonstrated that a nonredundant visual suffix does not reduce recall of the last auditory TBR item. These results are discussed in reference to a retrieval account of the long-term modality effect. PMID- 3812817 TI - Eidetic-like imagery in hypnosis: rare but there. AB - The production of eidetic-like imagery during hypnosis in subjects with high but not low hypnotizability was supported in three separate experiments using nonfakable stereograms (Julesz, 1971; Gummerman, Gray, & Wilson, 1972). In Experiment 1, 6 (25%) of 24 stringently chosen, high hypnotizables were able to perceive one of the superimposed stereograms (presented monocularly) during conditions of standard hypnosis or hypnotic age regression, or under both conditions, but not during waking. In Experiments 2 and 3, low and high hypnotizables were presented stereograms in an alternating, monocular fashion (one-half to each eye). In Experiment 2, 10% of the high hypnotizables perceived one or more stereograms in hypnosis or age regression, but not during waking. In Experiment 3, none of the 17 low hypnotizables reported correct stereograms, but 6 of the 23 high hypnotizables (26%) did. Relationships between imagery performance and visuo-spatial abilities were investigated. Results support the general hypothesis that hypnosis enhances imaginal processing of information to be remembered that is a literal or untransformed representation. PMID- 3812818 TI - Use of contextual information in the formation of cognitive maps. AB - To investigate the importance of context and presentation of serial order of information in the formation of cognitive maps, subjects were shown slides of pairwise relationships between items and then asked to construct a map. Two context conditions were used: a spatial condition in which the item pairs appeared in the same location on the screen as they would appear in a slide of the entire map and a nonspatial condition in which all item pairs appeared centered on the screen. Information order was either chain, in which new information could be immediately added to the representation, or nonchain, in which brief storage was required. The results indicated that both spatial context and chain order enhance performance. In addition, spatial information reduces the effect of serial order, perhaps by allowing subjects to relate new information to the context itself if they cannot relate it to previous information. PMID- 3812819 TI - An educational scheme for our future society. PMID- 3812820 TI - Recognizing multiple personality patients. AB - As shown by increased frequency of articles on multiple personality patients, this disorder is seen or recognized more than before. This paper describes the finer points of this syndrome that might help in making a correct diagnosis. PMID- 3812821 TI - The "insolvable problem" as a determinant in the dynamics of suicidal behavior in children. AB - This paper attempts to define the characteristics of the "insolvable problem" in the dynamics of suicidal children. It posits that part of the underlying dynamics of suicidal children is being pressured to solve a problem, in the family milieu, which is beyond the child's--and often anybody else's--ability to resolve. Moreover, the paper outlines the possible relation between the insolvable problem and various determinants involved in suicidal behavior such as depression, helplessness, hopelessness, rigidity, etc. This discussion will be accompanied by case demonstrations. PMID- 3812822 TI - Body-image disturbances among obese adults: evaluation and treatment. AB - This paper describes how to diagnose and treat body-image disturbances by a clinical technique involving direct patient participation. The technique has been effective as a diagnostic barometer uncovering discrepancies between the reality of being fat and some patients' secret belief of being thin. PMID- 3812823 TI - Therapeutic uses of humor. AB - This paper examines psychological aspects of humor, leading into a review of the role of humor in psychotherapy. Constructive and destructive aspects of humor in psychotherapy are listed and brief clinical examples from a case given. PMID- 3812824 TI - Secretiveness and guardedness: a comparison of two incest-survivor samples. AB - This paper represents a retrospective attempt to conceptualize defensive postures observed in treating adult female incest survivors. The sample includes psychiatric inpatients and members of an outpatient self-help group. Dynamics of secretiveness, superficial compliance, and guardedness are reviewed in terms of the theoretical underpinnings from the literature and case material. PMID- 3812825 TI - Integrating paradoxical interventions in the normal course of therapy: a nonspecific approach. AB - Paradoxical interventions are presently not frequently integrated into psychotherapy, because bridging over to straightforward interventions is often problematic. We, therefore, need a formulation of paradoxical interventions in terms easily adaptable to various specific therapies and to the problem at hand. A view of paradoxical interventions as consisting of the paradoxical prescription and modifications in the symptom-context relationship produces such a formulation. The prescription can be adapted to the style of therapy being conducted and the modifications planned according to different theories of psychotherapy and psychopathology. PMID- 3812826 TI - Identity development of black Americans: the role of history and the importance of ethnicity. AB - The historical and cultural forces that have affected the identity development of Black Americans are analyzed. In particular the psychological effect of historical events in shaping the identity of Blacks is examined. Revealed are the critical influences that social, historical, political, and economic movements have had on Black Americans because of their powerless status. Ethnicity and culture are important determinants in the development of a positive and healthy sense of self for Black Americans. PMID- 3812827 TI - Serious assaults by outpatients or former patients. AB - Psychiatrists, clinical psychologists, and family practitioners very rarely receive serious injuries from assaults by their outpatients or former patients. The rate of significant assault is comparable to that for nonpatient assault (e.g., mugging). No relationship between clinical experience and being an assault victim could be established. PMID- 3812828 TI - Restraints in the treatment of a patient with multiple personality. AB - This paper describes a technique of voluntary, intermittent use of restraints to work through a dangerous resistance during the treatment of an angry alter personality in a case of multiple personality. A safe environment for the interpretation of the angry dynamics allowed the progress of psychotherapy. PMID- 3812829 TI - The daughter as the principal "double" in a Capgras' syndrome: psychodynamic correlates. AB - In a case of Capgras' syndrome the primary double is usually the spouse. In the described case, the patient chose as a double her pregnant 15-year-old daughter even though her spouse and four other children lived with her. A psychodynamic explanation for this choice is offered within the mechanism of the "ambivalence theory." PMID- 3812830 TI - Effects of age misstatement on the utility of age-dependent anthropometric indicators of nutritional status in rural Bangladesh. AB - We report the effects of age error on use of weight-for-age and height-for-age for assessing and screening malnutrition, and for identifying factors of malnutrition in 679 children aged 22-59 months in Companiganj, in rural Bangladesh. Overreporting and random error in age and correlation of age error with each of the anthropometric indices are observed. As a result, the proportion of children having less than or equal to 60 per cent of median weight-for-age is overestimated by five percentage points and the proportion having less than 80 per cent of median height-for-age is overestimated by six points. Loss in sensitivity (proportion of malnourished children correctly identified) for the above cutoff points is 20 per cent for weight-for-age and 28 per cent for height for-age, compared to the situation in the absence of age error. Although mother's education is not a significant determinant of weight-for-age and height-for-age, age error makes mother's education appear artifactually significant in the analysis of variance. PMID- 3812831 TI - Mortality after bereavement: a prospective study of 95,647 widowed persons. AB - The mortality of 95,647 persons, widowed during 1972-76 and identified by linking the Finnish Population Register and cause-of-death files, was followed up to the end of 1976. A total of 7,635 deaths during 225,251 person-years of experience were observed. Cause-specific standardized mortality ratios by time after bereavement were computed. The highest relative mortality risk was found immediately after bereavement. For all natural causes, mortality during the first week was over two-fold compared to expected rates. The relative risk was larger for ischemic heart disease (RR = 2.3 for men, and RR = 3.5 for women), an effect found in all age groups. Among men under age 65, excess mortality from IHD was also observed during later years of widowhood. For violent causes, exclusive of accidents simultaneously affecting both spouses, mortality was over two-fold during the first month. Mortality from suicides was greater than expected during the first years of widowhood. While the greatest excess mortality after bereavement seems to be due principally to the acute effects of becoming widowed, there also seems to be some excess mortality in younger persons widowed for a longer time. PMID- 3812832 TI - Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses. AB - We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardless of whether they had participated in the screening program, believed that women are justified in having an abortion in the face of fetal abnormality. There was a sharp increase in the number of screening program participants who said they would have an abortion when the probability of the fetus being affected with a neural tube defect rose from 95 per cent to 100 per cent. PMID- 3812833 TI - Trends in esophageal cancer mortality among US blacks and whites. AB - National age-adjusted rates of mortality from esophageal cancer have increased among Blacks in the United States, while remaining nearly unchanged among Whites. By 1980, esophageal cancer had become one of the leading causes of cancer death among Blacks, with the excess among males under age 55 exceeding six-fold. Inferences about the causes of esophageal cancer cannot be made from this descriptive survey, but the rising trend raises etiologic hypotheses about environmental exposures (e.g., alcohol, tobacco, nutrition) that may differentially affect Blacks. PMID- 3812834 TI - Progress toward meeting the 1990 nutrition objectives for the nation: nutrition services and data collection in state/territorial health agencies. AB - Promoting Health, Preventing Disease, Objectives for the Nation, specifies nutrition as a priority area for improving the health of Americans by 1990. Eleven of the 15 nutrition objectives target adults or the public while four address pregnant and lactating women, infants, and children. To determine progress by states toward achieving the nutrition objectives, the Association of State and Territorial Public Health Nutrition Directors conducted a survey in 1985 to which 54 state and territorial nutrition directors responded. Three fourths of the nutrition personnel focused efforts on maternal and child populations, and were supported largely by federal funds from the Special Supplemental Food Program for Women, Infants, and Children (WIC) and the Maternal and Child Health Block Grant. Only 15 per cent were funded by state and local sources. While most agencies reported using nutrition consultation in adult health programs, only 25 per cent paid for these personnel. Data to monitor progress were commonly available for only five of the 15 objectives. Achievement of the nutrition objectives by states will require a more comprehensive approach to nutrition programming with increased allocation of appropriate resources and expansion of health data systems. PMID- 3812835 TI - Degree of public support for household hazardous waste control alternatives. AB - This paper reports information from Massachusetts on attitudes of householders toward alternative approaches and economic solutions to household hazardous waste (HHW) generation and disposal. Residents appear to be aware of the nature of the HHW problem and clearly support action to address the problem. The majority support a law fining householders for the improper disposal of HHW, endorse paying a sales tax on domestic hazardous products to finance safe disposal, and appear willing to drive up to five miles to dispose of HHW twice yearly. PMID- 3812837 TI - Counseling medical and dental patients about cigarette smoking: the impact of nicotine gum and chart reminders. AB - To investigate methods for improving and expanding the counseling of smokers by physicians and dentists, we assigned 112 physicians and 50 dentists (in separate studies) to one of the following conditions: the control or advice-only group received a one-hour lecture on the consequences and management of smoking and a booklet detailing a four-step protocol for counseling patients about smoking; three other groups received, in addition, either, protocol reminder stickers placed on their patients' charts; nicotine gum made freely available to their patients; or both chart reminders and nicotine gum. Exit interviews of 1,091 medical and 647 dental patients indicated that the presence of chart reminders and/or the availability of nicotine gum increased the time spent counseling and altered the nature of the smoking cessation counseling provided by both physicians and dentists. PMID- 3812836 TI - Mortality among the elderly in the Alameda County Study: behavioral and demographic risk factors. AB - We studied the association between behavioral and demographic risk factors and 17 year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk. PMID- 3812838 TI - Thinness and mortality. AB - The relationship of thinness to mortality was examined in White adult members of the Kaiser Permanente Medical Care Program who had at least three multiphasic health checkups between 1964 and 1972, with mortality follow-up through 1980. A detailed comparison was performed of the mortality patterns of "thin" (decile 1 of Quetelet's index) and "average" weight (deciles 4 and 5) cohort members who were age 40-79 years and free of illness at the beginning of follow-up. Thin male (relative risk 1.6, 95 per cent confidence limits 1.0, 2.6) and female (R.R. 2.1, 95 per cent C.L. 1.1, 3.9) current cigarette smokers were at increased risk of mortality compared with average weight smokers. Unmeasured differences between thin and average weight smokers with respect to quantity of cigarettes smoked may have contributed to the apparent association of thinness with mortality in smokers. Thinness was not associated with increased mortality in never smokers and ex-smokers (R.R. 1.0 in men and women). As association of long-term weight loss with mortality was present in thin and average weight men and in thin women. PMID- 3812839 TI - Formaldehyde-related health complaints of residents living in mobile and conventional homes. AB - This paper explores the dose-response relation between formaldehyde (HCHO) concentration and reported health complaints (eye irritation, nose/throat irritation, headaches and skin rash) of nearly 2,000 residents living in 397 mobile and 494 conventional homes. The study analyzes the effects of HCHO concentration, age and sex of respondent, and smoking behavior on each of the four health effects. The results demonstrate a positive dose-response relation between HCHO concentration and reported health complaints, with reported health complaints demonstrated at HCHO concentrations of 0.1 ppm and above. Concentrations of 0.4 ppm in manufactured homes as targeted by the Department of Housing and Urban Development (HUD), may not be adequate to protect occupants from discomfort and from acute effects of HCHO exposure. PMID- 3812841 TI - An outbreak of Brucella melitensis infection by airborne transmission among laboratory workers. AB - An outbreak of acute brucellosis infection was detected among the employees of a biologicals manufacturing laboratory located in Girona, Spain. The first cases appeared six weeks after a vaccine with attenuated Brucella melitensis, Rev-1 had been produced for one week. A clinical and epidemiologic investigation conducted among the 164 employees found 22 patients with clinical symptoms and positive serology, and six patients detected by serology only (attack rate: 17.1 per cent). Blood cultures were obtained from two patients and Brucella melitensis was isolated. Employees working in areas with open windows above the laboratory air extracting system had an attack rate of 39.5 per cent, substantially higher than those working in other locations. When vaccine was manufactured again, an electric oven reaching 300 degrees C had been installed in the air extracting system just before its exit to the exterior. Appropriate culture medium plates were exposed to the laboratory air before and after passing through the oven. Brucellae were isolated from the plates exposed to the air before passing through the oven but not after doing so. PMID- 3812840 TI - Factors influencing return to work following hospitalization for traumatic injury. AB - This paper describes the employment experience of 266 individuals one year after traumatic injury severe enough to require hospitalization. Of those working full time prior to their injury, 56 per cent were employed full-time at one year; an additional 5 per cent were working part-time. Those sustaining a severe head or spinal cord injury were at highest risk of not returning to work (only 43 per cent and 21 per cent, respectively, had returned within the year). Low one-year employment rates (58 per cent) were also noted for individuals whose most severe injury was to one or more extremities. The extent and rate of return to work was examined in relation to selected socioeconomic and personal characteristics. Findings indicate that after controlling for type and severity of injury, personal income, and educational level of the injured person, as well as the identification of a strong social network as defined by the presence of one or more confidants, were important correlates of post-injury employment status. PMID- 3812842 TI - Spousal veto over family planning services. AB - In many countries a spouse, usually the husband, can veto a partner's use of family planning services. Where spousal veto acts as a barrier to family planning services it represents a serious threat to the lives and health of women and children. Removal of spousal authorization requirements has been shown to increase the use of family planning services. The Family Guidance Association of Ethiopia, for example, removed their requirement in 1982 and clinic utilization increased by 26 per cent within a few months. Courts of several countries have held that spousal veto practices violate principles of personal privacy and autonomy and the right to health care. The effect of such judgements has been to reinforce rights to sexual nondiscrimination found, for example, in national constitutions and the Convention on the Elimination of All Forms of Discrimination against Women. This article discusses the nature and application of spousal veto practices, explains how such requirements can violate certain human rights, and explores possible remedies to this problem, including ministerial, legislative, and judicial initiatives. PMID- 3812843 TI - Intestinal parasites in pet store puppies in Atlanta. AB - We examined 143 pups from 14 Atlanta area pet stores for intestinal parasites and reviewed deworming practices and information given to customers. Seventy-four (52 per cent) of the pups had at least one parasite including Giardia sp. (34 per cent), Toxocara canis (12 per cent), and Isospora sp. (9 per cent). Eighty-eight per cent received some form of anthelminthic treatment while at the store. Only six (43 per cent) of the stores routinely informed clients of the need to continue deworming procedures once the pup left the store. PMID- 3812844 TI - Mortality rates among opioid addicts in a longitudinal study. AB - Mortality rates and survival curves were estimated for a sample of opioid addicts who had survived to an initial six-year follow-up interview. A total of 52 of the 555 addicts died between the six-year and 12-year follow-up interviews, which corresponds to an average of 13.8 deaths/1,000 person years. This rate is 6.9 times greater than the general population, adjusting for age. Approximately 29 per cent of the deaths were due to violence and 48 per cent to drugs. PMID- 3812845 TI - Epidemiology of premenstrual symptoms. AB - We examined the prevalence of selected premenstrual symptoms among 520 Connecticut women in relation to demographic, reproductive, contraceptive, and medical characteristics. The prevalence ranged from 39 per cent for breast swelling to 81 per cent for premenstrual weight gain. Socioeconomic status, race, history of benign breast disease, bra cup size, and history of abortions were some of the factors associated with premenstrual symptoms. PMID- 3812846 TI - A comparison of estrogen and progesterone receptors in black and white breast cancer patients. AB - After standardization for age and menopausal status, the prevalence of estrogen receptor positivity among 88 White breast cancer patients was about .72 compared with a prevalence of about .54 among Black patients. The prevalence of progesterone receptor positivity was also higher among White than among Black patients, although the magnitude of the difference was smaller. These differences were unchanged after adjustment for tumor size and nodal and distant metastases in addition to age and menopausal status. PMID- 3812847 TI - A prospective study of giardiasis and water supplies in Colorado. AB - A prospective study of 484 visitors to Vail and Aspen/Snowmass, Colorado, was conducted to determine the risk of acquiring giardiasis. Of the 259 visitors to Vail, no cases of giardiasis were confirmed and only one of 12 water filtrates were positive for Giardia cysts. Of 225 visitors to Aspen/Snowmass two cases of giardiasis were confirmed and 12 of 20 water filtrates were positive for Giardia cysts. The regular occurrence of Giardia cysts in Aspen and Snowmass water was associated with lower rates of giardiasis acquisition than reported during outbreaks of waterborne giardiasis. PMID- 3812848 TI - Factors related to patient smoking status. AB - To investigate those factors associated with patients' cigarette smoking status, 455 consecutive patients seen in two specialty clinics and one general medicine clinic at a university medical center were studied. Patient's age, sex, health status, and number of previous cessation attempts discriminated current from ex smokers. A strong interaction was observed between sex and disease status with females showing a greater impact of smoking-related disease on smoking behavior than males. PMID- 3812849 TI - The epidemiology of road accidents in childhood. AB - We report the incidence of traffic injuries to children in Montreal: 33.4 per 10,000, 57 per cent pedestrians, 24.5 per cent passengers, and 18.4 per cent bicyclists. Nearly 20 per cent were hospitalized and 1.2 per cent died. One-third had MAIS scores of 2 or more with the highest rate of severe injuries found among pedestrians. Pedestrian and bicycle (but not passenger) injuries in low income areas were four to nine times greater than those in more affluent areas. PMID- 3812850 TI - Ethnicity and hip fracture. PMID- 3812851 TI - Bulimic eating behaviors: association with alcohol and tobacco. PMID- 3812852 TI - Those friendly little tanning beds and the public's health. PMID- 3812853 TI - More on in-home pregnancy tests. PMID- 3812854 TI - Immunotherapy of primary immunological aborters: rationale for the use of pooled cryopreserved purified normal peripheral blood mononuclear cells. AB - Patients with recurrent spontaneous abortions have been successfully treated in many centers with third-party immunization directed to a putative TLX antigen system. This immunotherapy requires the screening of a large number of donors to match the patients' red blood cell (RBC) phenotype and has the potential risks associated with transfusions from 30 to 50 donors. Our modified approach to third party immunization is to use irradiated frozen-stored purified lymphocytes pooled from five normal donors. Mononuclear cells from normal donors are obtained in a cell separator. After sedimentation and Ficoll-Hypaque separation, the cells are stored in liquid N2. The RBC depletion of the final preparation is of the order of 5 to 6 logs, theoretically decreasing the need for RBC phenotyping except for the Rh system. Using a highly sensitive fluorescence-activated cell sorter technique and an ADCC assay, we found that ABH, Rh, Fya Fyb, Jka Jkb, MNS, and Kell antigens are either not expressed by cryopreserved human mononuclear cells, or, if so, they are below the level of detection of these highly sensitive assays. We conclude that the use of pooled frozen mononuclear cells is an adequate alternative for immunotherapy. It decreases the transfusion risks associated with exposure to a large number of donors and the need for RBC phenotyping, making this modality of treatment more accessible. PMID- 3812855 TI - Placental lesions in maternal autoimmune diseases. AB - We have investigated the presence and clinical implications of maternal vascular lesions and chronic villitis of unknown etiology (CVUE) in 18 placentas of 15 mothers with several autoimmune diseases (AD), including, for the first time, idiopathic thrombocytopenic purpura, autoimmune thyroid diseases, and multiple sclerosis. The group with AD had significantly more maternal vascular lesions and CVUE than the control group. We did not find lesions that could be attributed to any of the diseases in particular. The histopathologic picture was similar in these diseases, although there appears to be a spectrum in severity. Placental vascular damage with deposits of IgM, C3, and C1q was more prominent in systemic lupus erythematosus and in a patient with systemic sclerosis. In both of these diseases but not in the other conditions, these lesions were related to poor fetal outcome. Although the precise role of each of these autoimmune diseases in pregnancy and fetal outcome remains to be established, there appears to be at least one link between them represented by the presence of severe acute atherosis and heavy granular vascular deposits of IgM, C3, and C1q associated in some with poor fetal outcome. The role of CVUE remains speculative. PMID- 3812856 TI - Motion characteristics of spermatozoa from men with cytotoxic sperm antibodies. AB - Semen samples from 55 fertile nonautoimmune and 44 infertile sperm autoimmune men were evaluated by computerized sperm cell motion analysis. Sperm counts (mean +/- SEM, 59.6 +/- 10.3 X 10(6) per ml), motility (39.0 +/- 4.6%), mean swimming speed (micron/sec, 26.5 +/- 0.9), mean linearity (straight line distance of the cell track divided by the actual track length and multiplied by 10, 6.5 +/- 0.2), and motility index (% motility X mean speed, 10.7 +/- 1.4) in 23 men with significant titers of cytotoxic sperm antibodies in their serum and seminal plasma were less (p less than 0.0001) than those in the fertile controls. However, these parameters were comparable in 18 men with sperm antibodies in their seminal plasma but not in their serum, and the control group. Infertile men with serum cytotoxic sperm antibodies had more sperm cells swimming at 11-30 micron/sec, and fewer moving at 31 micron or higher; this was in contrast to results obtained from fertile men (p less than 0.05). The percentages of sperm cells moving at 21 30 micron/sec were increased, while those moving at 51-60 microns/sec were decreased in men with seminal plasma sperm antibodies, versus controls. Spermatozoa with low linearities (less than or equal to 6) were higher (p less than 0.05) in men with serum and seminal plasma cytotoxic sperm antibodies than in the fertile group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3812857 TI - Treatment of the medial collateral ligament injury. I: The importance of anterior cruciate ligament on the varus-valgus knee laxity. AB - The purpose of this study was to explain the functional roles of the medial collateral ligament (MCL) and the ACL and how they affect the kinematics of the knee joint after isolated MCL injury. Varus-valgus joint laxity was quantitatively measured using a device which allowed various degrees of freedom (DOF) of joint motion during application of a varus-valgus bending moment to the canine knee joint. When the knee motion was limited to 3 DOF (varus-valgus rotation, proximal-distal, and medial-lateral translation), valgus laxity increased significantly (171%) after sectioning the MCL. Thus, the MCL was the primary restraint to the valgus bending moment in the 3 DOF mode. However, the effect of sectioning the MCL on valgus laxity became minimal (21% increase) when the DOF of knee motion was increased to 5 (by adding axial tibial rotation and anterior-posterior translation). In this situation, external and internal tibial axial rotation were coupled with the varus and valgus rotation of the knee joint, respectively, and the ACL also functioned to restrain the varus-valgus rotation. The results of this study suggest that under normal knee joint motion, the functional deficit of the MCL in valgus rotation was compensated for by the remaining structures, especially by the ACL. PMID- 3812858 TI - Treatment of the medial collateral ligament injury. II: Structure and function of canine knees in response to differing treatment regimens. AB - In order to assess the healing of the medial collateral ligament (MCL) and to detect the various effects of treatment regimens, in vivo animal experiments using a canine model were performed. Thirty-five canine MCLs were surgically transected and treated using three clinically popular regimens, e.g., no repair with cage and farm activities (Group 1), repair with 3 weeks immobilization (Group 2), and repair with 6 weeks immobilization (Group 3). The varus-valgus laxity of the knee joint, structural properties of the femur-MCL-tibia (FMT) complex and the mechanical properties of the MCL substance (healing site) were quantitatively measured at 6, 12, and 48 weeks postoperatively. It was found that Group 1 animals had the best results. The varus-valgus laxity of the knee joint and the structural properties of the FMT complex returned to values comparable with the contralateral control by 12 weeks. The recovery of the mechanical properties of the MCL substance was slower and not complete, even at 48 weeks. In confirmation with previous studies, prolonged immobilization was shown to have deleterious effects on MCL healing. The results of this study indicated that early mobilization is the treatment of choice in cases of isolated MCL injury. Also, this study emphasized the importance and effectiveness of using various biomechanical parameters in addition to the conventional ultimate values at failure to evaluate the progress of soft tissue repair. PMID- 3812859 TI - Ice hockey injuries. AB - Ice hockey is a team sport that has recently grown in popularity not only in the United States but also in Canada and Europe. With this increase in popularity has come a growing concern about the number and severity of injuries. The world literature on the biomechanics and physiology of ice hockey was reviewed in an attempt to evaluate the forces and mechanisms involved in the game. The influence of rule and equipment changes on injury patterns was particularly studied. Several studies on the epidemiology of injuries, providing data on the types of injuries and the mechanisms of those injuries, were analyzed to determine the conclusions that could be supported and those that require further study. Possible changes in the patterns and types of injury are outlined. PMID- 3812860 TI - Stress fractures in athletes. A study of 320 cases. AB - We analyzed cases of 320 athletes with bone scan-positive stress fractures (M = 145, F = 175) seen over 3.5 years and assessed the results of conservative management. The most common bone injured was the tibia (49.1%), followed by the tarsals (25.3%), metatarsals (8.8%), femur (7.2%), fibula (6.6%), pelvis (1.6%), sesamoids (0.9%), and spine (0.6%). Stress fractures were bilateral in 16.6% of cases. A significant age difference among the sites was found, with femoral and tarsal stress fractures occurring in the oldest, and fibular and tibial stress fractures in the youngest. Running was the most common sport at the time of injury but there was no significant difference in weekly running mileage and affected sites. A history of trauma was significantly more common in the tarsal bones. The average time to diagnosis was 13.4 weeks (range, 1 to 78) and the average time to recovery was 12.8 weeks (range, 2 to 96). Tarsal stress fractures took the longest time to diagnose and recover. Varus alignment was found frequently, but there was no significant difference among the fracture sites, and varus alignment did not affect time to diagnosis or recovery. Radiographs were taken in 43.4% of cases at the time of presentation but were abnormal in only 9.8%. A group of bone scan-positive stress fractures of the tibia, fibula, and metatarsals (N = 206) was compared to a group of clinically diagnosed stress fractures of the same bone groups (N = 180), and no significant differences were found. Patterns of stress fractures in athletes are different from those found in military recruits. Using bone scan for diagnosis indicates that tarsal stress fractures are much more common than previously realized. Time to diagnosis and recovery is site-dependent. Technetium99 bone scan is the single most useful diagnostic aid. Conservative treatment of stress fractures in athletes is satisfactory in the majority of cases. PMID- 3812861 TI - Gymnastic injuries: the Virginia experience 1982-1983. AB - Gymnastics has undergone a tremendous increase in popularity largely due to exposure during the Olympics. The injury rate in gymnastics is exceeded only by football, wrestling, and softball. A prospective analysis of club level gymnastic injuries over one season (1982-83) was conducted. Complete responses from 15 clubs (2,558 participants) were obtained. Parameters of clubs followed were: skill level, student, instructor ratio, safety equipment, and conditioning and warm-up exercises. Data obtained from each participant were: injuries sustained, event in which injury occurred, setting of injury, type of injury, and duration of disability. Results were 62 injuries among 542 competitive and 2,016 noncompetitive level athletes (5.3 per 100 competitors and 0.7 per 100 beginners). Of the 62 injuries, 51 were acute and 11 chronic. Twenty-one injuries occurred during floor exercises, 13 on beam, 9 on vault, 6 on uneven parallel bars, and 2 on springboard. Acute injuries included 21 sprains, 16 fractures, 6 contusions, 4 dislocations, and 4 muscle strains. A significant finding was the increased frequency of acute injury seen at dismount. Also there was a positive correlation between duration of frequency of practice (fatigue) and injury rate. We would define a high risk gymnast as one who is performing at an advanced competitive level, performing floor or beam exercises, and practicing more than 20 hours per week. PMID- 3812862 TI - Breaststroker's knee. An analysis of epidemiological and biomechanical factors. AB - Competitive swimmers have a high incidence of breaststroke-related knee injuries. Although previous investigators have implicated the terminal phase of the kick in the injury mechanism, athletes often complain of pain during the initial phase of rearward thrust. Disagreement in the current literature surrounds the precise anatomical derangement(s) constituting "breaststroker's knee." The purpose of this investigation was to delineate the epidemiology, anatomy, and pathobiomechanics of breaststroke knee injuries. Descriptive data were obtained by surveying 391 athletes. An extremely high incidence of knee pain was documented both among breaststroke specialists (73%) and nonbreaststrokers (48%). Age, years of competitive swimming, and specific training characteristics were positively correlated with knee pain. Both the medial collateral ligament and the inferomedial patellar border were involved. A further 21 swimmers were assessed in detail using four methods: interview, physical examination, Cybex II isokinetic quadriceps and hamstring testing, and cinematographic analyses. The interview and physical examination data supported the conclusions derived from the descriptive data, while Cybex testing and kinematic film analyses failed to demonstrate statistical differences between the injured and noninjured groups. Although kinematic film analyses did not demonstrate statistical differences between cases and controls, dramatic differences in the injury rate were noted when hip abduction angles at kick initiation were less than 37 degrees or greater than 42 degrees. This bimodal increase in injury rates suggests that modification of hip abduction at kick initiation, in conjunction with altered training regimens, will lead to a reduction in medial knee joint stress and hence fewer breastroke injuries. PMID- 3812863 TI - Observations on the treatment of lumbar disk disease in college football players. AB - Over a 4 year period, 12 college players were treated for diskogenic injury. The most common position affected was down-lineman. Symptoms consisted of low back and/or radicular pain. No players could recall the onset of symptoms relative to football activity; weightlifting was associated with symptoms in three cases. Tentative clinical diagnosis was herniated disk disease. Method of diagnosis in the athletic population is presented along with results of surgical treatment. Percutaneous diskectomy appears to be successful for disk herniations occurring at the L4-5 space or higher. PMID- 3812864 TI - Recurrent herpes labialis in skiers. Clinical observations and effect of sunscreen. AB - Recurrent orofacial herpes infection may be triggered by high altitude skiing, presumably because of solar ultraviolet radiation exposure. Six (12%) of a group of 51 subjects with a history of skiing-triggered herpes observed during 1 week of high altitude skiing experienced reactivations of orofacial herpes a median of 3 1/2 days after exposure. Within this group, application of a sunscreen with a sun protection factor (SPF) of 15 failed to influence the reactivation rate as compared with a placebo. Reactivation of herpes triggered by skiing is common. As application of a sunscreen with an SPF of 15 did not appear to influence the reactivation rate, alternate approaches to the control of recurrent orofacial herpes are needed. PMID- 3812865 TI - Computerized recording of visits to an outpatient sports clinic. AB - At the Tampere Research Station of Sports Medicine (TRSSM) a continuous coding system of patient visits was started on March 1, 1985. The registration form contained 25 variables including all essential information about the patient's identification, sports, time of and reason for the visit, physician, examinations, diagnosis, treatment, and possible further measures. To classify and number the diagnosis, a specific classification of sports injuries and diseases was drawn up. The data were stored and analyzed using a DEC-2060 computer at the University of Tampere. During 6 months a total of 814 visits were recorded. The three most common sports were soccer, long-distance running, and orienteering. Competitive athletes totalled 337 (62%); 43 of these were top ranking athletes. The most common reasons for visits were problems of the knee (266 visits, 33%), ankle (80, 10%), and low back (71, 9%). Knee sprains accounted for 10% of all visits. Problems related to the musculoskeletal system were the reason for 751 (92%) of all visits. Operative treatment was needed by 49 patients (6%). The continuous coding system of patient visits at an outpatient sports clinic showed great advantages as a basic data bank for scientific research, annual statistics, and patient identification and filing. The system described has been adopted as part of the daily routine at the TRSSM. PMID- 3812866 TI - Functional management of stress fractures in female athletes using a pneumatic leg brace. AB - Thirteen consecutive female athletes complaining of activity-induced lower extremity pain were evaluated. Ten of the 13 athletes had either an x-ray film or bone scan positive for stress fracture of the tibia or fibula. Three athletes with classic signs and symptoms of tibial stress fractures and negative x-ray films refused the bone scan. Three athletes had bilateral tibial stress fractures. The athletes were treated by the application of a pneumatic leg brace to the affected leg or legs. Following this, all 13 athletes were able to return to their sport and participate at a high level of competition with little or no symptoms. PMID- 3812867 TI - Biomechanical and histological evaluation of muscle after controlled strain injury. AB - This study correlates force generation and healing in muscle after controlled strain injury. Right tibialis anterior (TA) muscles from 30 rabbits were strained to approximately 80% of failure while the left TA muscles served as control. Both injured and control muscles were then tested for ability to generate force. Seven animals were sacrificed immediately after testing and the muscles were examined grossly and histologically. Remaining animals were retested at 24 hours (N = 7), 48 hours (N = 8), and 7 days (N = 8). Contractile ability following injury was 70.5% of control immediately, 51.1% at 24 hours, 74.5% at 48 hours, and 92.5% at 7 days. Immediate histology showed limited distal fiber rupture and hemorrhage. By 24 hours, histology showed fiber necrosis, infiltration of inflammatory cells, edema, and hemorrhage. At 48 hours there was complete fiber breakdown and intense inflammatory cell proliferation. At 7 days inflammation was reduced and collagen fibrosis more advanced. Our findings demonstrate that injured muscle begins functional recovery by 48 hours despite inflammation and active healing. This suggests that decreasing muscle function seen clinically between 24 and 48 hours following strain injury may result from pain due to inflammation. Scarring and fibrosis seen at 7 days may explain the frequent recurrence of injury to strained muscles. PMID- 3812868 TI - Entrapment of the common peroneal nerve. PMID- 3812869 TI - Stress fracture of the sternum in a wrestler. AB - We have reported and documented a sternal stress fracture. This possibility should be included in the differential diagnosis of acute chest pain in the athlete, especially if upper body stresses are great and play an integral part in the specific athletic activity. PMID- 3812870 TI - The functional treatment of a third proximal phalanx fracture. AB - Aggressive, cool soaks, and buddy taping with thoughtful frequent followups allowed this patient to return to competition safely with full function in a remarkably short period of time. Similar treatment to some soft tissue injuries of the hand and other stable fractures have been done with equal success. PMID- 3812871 TI - Intestinal adenocarcinomas metastatic to the ovaries. A clinicopathologic evaluation of 22 cases. AB - The most common secondary ovarian neoplasm to mimic an ovarian primary tumor is metastatic large intestinal adenocarcinoma. Even after histologic examination, metastases often are mistaken for primary adenocarcinomas, especially endometrioid carcinoma. We analyzed the clinical and pathologic features of 22 cases of documented large intestinal carcinoma metastatic to the ovary. Patients' ages ranged from 42 to 76 years. None of the intestinal primary tumors were Dukes stage A, 32% were Dukes B, and 68% were Dukes C. In nine patients (41%), the intestinal carcinomas had been resected previously from 4 to 60 months before removal of the ovarian metastases. Both ovaries were involved in 43% of the cases. Histologically, 19 cases were classified as pseudoendometrioid type, two as mucinous type, and one as mixed pseudoendometrioid-mucinous type. The most characteristic microscopic features of the ovarian metastases were garland and cribriform growth patterns, intraluminal "dirty" necrosis, segmental destruction of glands, and absence of squamous metaplasia. Special stains for mucosubstances were variable and not helpful in differential diagnosis. Immunohistochemical staining for carcinoembryonic antigen (CEA) was strongly positive. Recognition of these distinctive histologic features is crucial to proper identification of the intestinal origin of these ovarian tumors. Inappropriate treatment as primary ovarian carcinomas thereby is avoided, and more accurate assessment of prognosis is achieved. PMID- 3812872 TI - Infectious mononucleosis. The spectrum of morphologic changes simulating lymphoma in lymph nodes and tonsils. AB - Lymph-node and tonsillar biopsies occasionally are obtained from patients with the infectious mononucleosis syndrome secondary to Epstein-Barr viral infection, particularly if the clinical presentation is atypical and a viral etiology is not suspected. The presence of Reed-Sternberg-like cells in infectious mononucleosis resulting in confusion with Hodgkin's disease is well-known; however, similar difficulty in excluding a non-Hodgkin's lymphoma can be encountered. Eleven cases of reactive lymphoid hyperplasia with the morphologic features of infectious mononucleosis are reported, nine of which had documented Epstein-Barr viral infection. The spectrum of morphologic changes associated with Epstein-Barr viral infection is discussed, with emphasis on the features that permit their distinction from non-Hodgkin's lymphoma. Morphologic features mimicking lymphoma included extensive immunoblastic proliferations in sheets and nodules and marked cytologic atypia. Hodgkin's disease was simulated by the tendency in some cases for the atypical Reed-Sternberg-like cells to cluster about necrotic foci and to show pronounced cytologic atypia. Features permitting the distinction from non Hodgkin's lymphoma included persistent reactive foci with the classic features of infectious mononucleosis, a polymorphous background of transformed lymphocytes rather than irregular or twisted lymphoid cells as seen in non-Hodgkin's lymphoma, and preservation of underlying reticulin architecture rather than destruction, even in cases with extensive immunoblastic proliferation. Hodgkin's disease was excluded by requiring strict criteria for Reed-Sternberg cells and noting the reactive background as inconsistent with Hodgkin's disease. Immunoperoxidase staining of seven of the cases with anti-Leu-M1 failed to demonstrate immunoreactivity of the Reed-Sternberg-like cells with this monoclonal antibody. PMID- 3812873 TI - Malignant melanoma primary in lymph node. The case of the missing link. AB - When malignant melanoma occurs in a lymph node, it is presumed to be metastatic, and the primary cutaneous/mucosal process is discovered to be either active, spontaneously regressed, previously excised, or occult. Nevus cell aggregates and nodal blue nevi are well-documented morphologic curiosities occurring in lymph nodes. It has been hypothesized that these nevus cell aggregates and blue nevi could be progenitors of lymph nodal malignant melanoma in patients without an obvious extranodal site of origin. We document a prototypical case of primary malignant melanoma evolving from precursor nevus cell aggregates associated with blue nevi in an axillary lymph node. The coexistence of nodal blue nevi and nevus cell aggregates implies a common origin from migratory neural crest cells arrested within mesenchyme. PMID- 3812874 TI - Gastric lymphatics. PMID- 3812875 TI - Acute interstitial pneumonia. PMID- 3812876 TI - Solid and papillary epithelial neoplasm of the pancreas. An ultrastructural and immunocytochemical study of six cases. AB - Solid and papillary epithelial neoplasms of the pancreas from six female patients were studied using immunohistochemistry and electron microscopy to define better their histogenesis. The tumors ranged in diameter from 5 to 15 cm (average: 9 cm), and, on cross section, most had areas of hemorrhage and necrosis, sometimes extensive. Microscopically, there was a solid and pseudopapillary pattern, with tumor cells typically having ovoid nuclei with delicate folding and indistinct nucleoli. Of note were the following: a relatively low mitotic rate (range: 0 6/20 hpf), the presence of hyaline globules (four of six cases), and collections of foam cells (three of six cases). Staining for cytoplasmic argyrophil granules was negative in each case. Ultrastructurally, the solid and papillary epithelial neoplasms of the pancreas showed evidence of acinar or ductular differentiation. Two contained zymogen granules, one had intermediate filaments (probably keratin), and three had abundant rough endoplasmic reticulum and mitochondria. Immunostaining was positive for chymotrypsin (six of six cases), trypsin (four of six), and amylase (three of six). None was positive for alpha-1-antitrypsin, neuron-specific enolase, pancreatic polypeptide, gastrin, glucagon, somatostatin, or insulin. The findings support an origin from exocrine pancreas, and follow-up indicates a low rate of malignancy, with local recurrence in two of the six patients. PMID- 3812877 TI - The histologic features of hyperplastic lymphadenopathy in AIDS-related complex are nonspecific. AB - Follicular hyperplasia is the most common histologic finding in lymph nodes of patients with AIDS-related complex (ARC) and persistent generalized lymphadenopathy. To determine the specificity of the published features considered characteristic of this condition, we compared two sets of lymph-node biopsy specimens with follicular hyperplasia. Thirty-eight specimens were from human immunodeficiency virus (HIV/HTLV3/LAV) positive homosexual men with persistent generalized lymphadenopathy, and 87 specimens were from patients free of AIDS risk. Polykaryocytes, epithelioid histiocytes, and follicle mantle zone effacement were significantly more common in the ARC group. Dermatopathic change and so-called follicle lysis were significantly more common in control, non-ARC nodes. No statistically significant difference between the two groups could be demonstrated for the following features: irregularity of follicles, burnt-out follicles, sinus monocytoid cells, marked plasmacytosis, and the toxoplasmosis triad. Most importantly, no feature was seen exclusively in either of the two groups. Although some features considered characteristic of the hyperplastic form of ARC lymphadenopathy are seen more commonly in this condition than in lymph nodes showing follicular hyperplasia unrelated to ARC, none of these features is specific for ARC and there is no histologic picture diagnostic of this condition. PMID- 3812878 TI - The surgical pathology of human Lyme disease. An enlarging picture. AB - Lyme disease is a multisystems infectious disorder caused by the spirochete, Borrelia burgdorferi. Infection occurs by ticks feeding on mammalian hosts, including humans. The distribution of the tick and spirochete is world-wide and is especially prevalent where there are large deer populations. The disease is seen in three stages. Stage I is a cutaneous rash (erythema chronicum migrans) consisting of lymphoplasmacytic infiltrates around dermal vessels. Stage II is characterized by varying forms of meningopolyradiculitis, with or without Bell's palsy or cardiac involvement (complete or incomplete heart block) and with interstitial endomyocarditis of lymphocytes and plasma cells. Lymphoplasmacellular infiltration is seen in the meninges, ganglia, and peripheral nerves. Chronic and intermittent oligoarthritis is the hallmark of stage III disease, characterized by hypertrophic synovitis, often with fibrinaceous deposits and synovial vascular occlusion. Stage III chronic dermatologic syndromes (lymphadenosis benigna cutis, acrodermatitis chronicum atrophicans) consist of cutaneous lymphoid hyperplasia and vascular changes. Neurologic demyelination syndromes also occur in stage III. Plasma cells occur in all stages, but are more prominent in stages II and III. Spirochetes can be demonstrated by silver impregnation stains in some cases. PMID- 3812879 TI - Effect of temperature on the vector efficiency of Aedes aegypti for dengue 2 virus. AB - The effect of temperature on the ability of Aedes aegypti to transmit dengue (DEN) 2 virus to rhesus monkeys was assessed as a possible explanation for the seasonal variation in the incidence of dengue hemorrhagic fever in Bangkok, Thailand. In two laboratory experiments, a Bangkok strain of Ae. aegypti was allowed to feed upon viremic monkeys infected with DEN-2 virus. Blood-engorged mosquitoes were separated into two groups and retained at constant temperatures. Virus infection and transmission rates were determined for Ae. aegypti at intervals ranging from 4 to 7 days during a 25-day incubation period. Results of the first experiment for mosquitoes infected with a low dose of DEN-2 virus and maintained at 20, 24, 26, and 30 degrees C, indicated that the infection rate ranged from 25% to 75% depending on the incubation period. However, DEN-2 virus was transmitted to monkeys only by Ae. aegypti retained at 30 degrees C for 25 days. In the second experiment, the infection rate for Ae. aegypti that ingested a higher viral dose, and incubated at 26, 30, 32, and 35 degrees C ranged from 67% to 95%. DEN-2 virus was transmitted to monkeys only by mosquitoes maintained at greater than or equal to 30 degrees C. The extrinsic incubation period was 12 days for mosquitoes at 30 degrees C, and was reduced to 7 days for mosquitoes incubated at 32 degrees C and 35 degrees C. These results imply that temperature induced variations in the vector efficiency of Ae. aegypti may be a significant determinant in the annual cyclic pattern of dengue hemorrhagic fever epidemics in Bangkok. PMID- 3812880 TI - Detecting artificial anti-dengue IgM immune complexes using an enzyme-linked immunosorbent assay. AB - A variety of methods have been employed to detect viral immune complexes (IC) in clinical specimens. However, most techniques used were not antigen-specific. We developed a simple, specific double antibody sandwich technique to detect artificial anti-dengue (DEN) IgM immune complex (IgM-IC). Positive reactivity with IgM-ICs prepared with live DEN-1, -2, and -3 viruses was found to be related to IgM titers exceeding 1:20 and to the titer of the viruses. Most IgM-ICs prepared with live DEN-4 virus did not react. In contrast, IgM-ICs prepared with hemagglutination antigens, representing all 4 serotypes, reacted positively with amounts of antigens ranging from 2 to 8 units. These IgM-ICs were not type specific. PMID- 3812881 TI - Early antibody responses to rabies post-exposure vaccine regimens. AB - The aim of post-exposure rabies vaccine treatment is to induce immunity, measured as neutralizing antibody, as fast as possible. This is especially important in the tropical rabies-endemic areas where simultaneous passive prophylaxis with hyperimmune serum is not practicable in the majority of cases. We compared the rate of production of antibody during the first two weeks, by six vaccine regimens in 118 subjects using two tissue culture vaccines, human diploid cell strain vaccine (HDCSV) and purified Vero cell rabies vaccine (PVRV). No antibody was detected on day 5. On day 7, the highest seroconversion rate was seen in subjects given HDCSV intramuscularly at two sites on days 0 and 3 (7 of 15), but this was not significantly different from the group with the lowest rate: the conventional single-site intramuscular regimen. All subjects had antibody by day 14, at which time the highest geometric mean titer was in the group vaccinated with 0.25 ml doses of diploid cell vaccine given subcutaneously at eight sites. This regimen, together with the standard single-site diploid cell vaccine and an eight-site intradermal regimen of the same product gave significantly higher titers than the two-site intramuscular regimens of either product. No single immunization schedule emerges as best, so the speed of antibody response, economy, and the skill needed for intradermal injection should be considered when deciding on the optimum regimen for use in a particular geographic area. PMID- 3812882 TI - Vector competence of Culex (Melanoconion) taeniopus for allopatric and epizootic Venezuelan equine encephalomyelitis viruses. AB - The vector competence of Culex (Melanoconion) taeniopus was examined in the laboratory for "enzootic" allopatric and "epizootic" strains of Venezuelan equine encephalomyelitis viruses of hemagglutination inhibition subtypes I, II, III, and IV. Following bloodmeals from viremic hamsters, and extrinsic incubation of 20-22 days, mosquitoes were allowed to refeed for transmission attempts. Infection rates never exceeded 50% with oral doses of less than 10(4) chick embryo cell culture plaque forming units (CECPFU), and approached 100% only after ingestion of greater than or equal to 10(5.5) PFU. Transmission was achieved for some "epizootic" subtype IABC and "enzootic" subtype ID strains after bloodmeals containing greater than or equal to 10(3.4) CECPFU; subtypes II, III, and IV were never transmitted despite oral doses up to 10(5.0) CECPFU. These data contrast sharply with those reported previously for sympatric "enzootic" subtype IE Middle American Venezuelan encephalitis viruses. PMID- 3812883 TI - Biochemical identities and differences among Leishmania species and subspecies. AB - An analysis was presented for identification of 20 species and subspecies of Leishmania by cellulose acetate electrophoresis data from the enzymes glucose phosphate isomerase, mannose phosphate isomerase, and phosphogluconate dehydrogenase. Most Leishmania could be identified from data of these three enzymes. The CAE data for 20 enzymes from over 300 New and Old World isolates were combined, and an analysis of the data which included calculations of genetic identities and genetic distances was reported. High levels of genetic similarity and low levels of genetic distance were noted among comparisons of local populations of the same Leishmania, and lower levels of similarity and higher levels of distance were noted among intracomplex pairings. The biochemical data suggested that similarities and differences among Leishmania could be quantified as they have been in other organisms. For the most part the data presented were consistent with the taxonomic rankings which were based on morphology, behavior, ecology, and other biochemical data. PMID- 3812884 TI - Cortisone-induced recrudescence of Giardia lamblia infections in gerbils. AB - The course of infection with Giardia lamblia in gerbils was studied after oral inoculation with either cysts isolated from humans or cultured trophozoites. Primary infections occurred in 87% of exposed gerbils; cyst release peaked during the second and third weeks post-infection; cysts and trophozoites were observed for up to 49 and 87 days post-infection, respectively. Gerbils were refractory to challenge infection with infective human source cysts at 5 months post-infection. Overall, 50% of animals given subcutaneous injections of hydrocortisone acetate, during or following the late stages of their primary infection, showed recrudescence of infection as evidenced by passage of cysts; percentages showing recrudescence were: 80% at 50 days post-infection, 55% at 70 days post-infection, 27% at 7 months post-infection, and 50% (2 of 4) in gerbils challenged unsuccessfully at 5 months post-infection and subsequently injected with hydrocortisone acetate at 7 months post-infection. Both infected animals and uninfected controls injected with hydrocortisone acetate were immunocompromised as evidenced by significantly reduced plaque forming cell responses to sheep red blood cells. We conclude that infections with G. lamblia in gerbils can last longer than standard examinations for cysts would indicate, and that long-term immunity to this organism can be nonsterile. PMID- 3812885 TI - Lack of enzyme polymorphism in Trypanosoma rangeli stocks from sylvatic and domiciliary transmission cycles in Colombia. AB - Although Trypanosoma rangeli is biologically and morphologically distinct from Trypanosoma cruzi, these two hemoflagellates are epidemiologically linked. We report the results of enzyme electrophoretic studies of T. rangeli stocks isolated from sylvatic and domiciliary Rhodnius prolixus, and infected humans inhabiting foci in which T. cruzi was sympatrically transmitted. T. rangeli stocks displayed electrophoretically detectable polymorphism for only a single enzyme, isocitrate dehydrogenase (ICD), in contrast with the marked phenotypic heterogeneity previously reported among the T. cruzi stocks. The relatively restricted diversity manifested by stocks from different geographic sites and ecologic habitats may reflect the existence of distinctive biologic or genetic constraints influencing T. cruzi and T. rangeli transmission. PMID- 3812886 TI - Circulating excretory-secretory antigen levels and specific antibody responses in mice infected with Toxocara canis. AB - Circulatory excretory-secretory antigen levels and IgM and IgG responses to larval antigens were monitored in the serum of 20 BALB/c mice that had been given approximately 500 infective eggs of Toxocara canis by stomach tube. Other groups of mice received different doses of infective eggs, ranging from 5 to 1,250 eggs. Excretory-secretory antigens were collected from culture fluid in which mechanically hatched larvae of T. canis were maintained. An indirect enzyme linked immunosorbent assay was used to monitor specific antibody responses. Circulating antigen levels were monitored using a direct ELISA which incorporated an IgG fraction of a rabbit antiserum to the excretory-secretory antigens as a capture antibody and a biotin-conjugated form of the same rabbit IgG as the second antibody. The antigen-specific IgM response was evident the first week of infection and peaked 3 to 6 weeks post-infection. The antigen-specific IgG response first appeared the second week of infection and peaked at 6 to 8 weeks post-infection. Both isotype levels stayed near their peak values for the remainder of the study. In the untreated sera, circulating antigen was initially evident and highest the first week of infection; the antigen concentrations dropped by the third month of infection to low, but significant, levels that persisted for the duration of the study. The administration of greater than 25 eggs produced antigenemias. There appeared to be a positive linear trend between the number of eggs given and the amount of antigen in the circulation. PMID- 3812887 TI - Reservoir competence of white-footed mice for Lyme disease spirochetes. AB - Using the vector tick, Ixodes dammini, we described the reservoir competence of the white-footed mouse, Peromyscus leucopus, for the Lyme disease spirochete, Borrelia burgdorferi. Nymphal I. dammini were used to infect mammals, and larval ticks were used to diagnose infection (a form of xenodiagnosis). One tick was nearly as efficient as more than 1 in transmitting the spirochete to mice. The duration of the prepatent period was about 1 week. Prevalence of infection approached 100% in ticks that fed as larvae on mice infected 2 or 3 weeks previously. Thereafter, infectivity gradually decreased, but duration exceeded 200 days. Hamsters, too, became infectious for larval I. dammini. This report formally demonstrates the life cycle of B. burgdorferi as it seems to occur in nature. We conclude that the white-footed mouse is a competent reservoir for the Lyme disease spirochete. PMID- 3812888 TI - Effect of supplemental vitamin A on colon anastomotic healing in rats given preoperative irradiation. AB - We studied the effect of dietary supplementation with vitamin A on the healing of colon anastomoses in irradiated bowel. Rats were divided into two groups. Those in the first group were fed a standard chow diet and those in the second group were fed the same diet supplemented with 150 IU vitamin A/g of chow. The rats were maintained on their respective diets throughout the experiment. After 7 days, half the rats in each group underwent abdominal irradiation (200 rads). Seven days later, all of the rats underwent distal colon division and anastomosis under pentobarbital anesthesia. All rats were killed 7 days postoperatively, the colons excised, and bursting strength and hydroxyproline determinations performed on both the anastomotic segment and a normal proximal segment of adjacent colon. There was a significant decrease in the bursting strength at the colon anastomosis (p less than 0.02) and in the collagen content (p less than 0.02) after preoperative irradiation. This effect was mitigated by dietary vitamin A supplementation. PMID- 3812889 TI - Determinants of stool frequency after ileal pouch-anal anastomosis. AB - The aim of our study was to determine whether ileal pouch motility and evacuability and the 24 hour fecal output influence stool frequency after ileal pouch-anal anastomosis. In 23 patients, at a mean of 24 months postoperatively (range 22 to 26 months), ileal pouch motility was measured using an intraluminal bag and pressure-sensitive catheters. The pattern and efficiency of ileal pouch emptying was determined scintigraphically. A 24 hour stool collection was made and the stool output and stool frequency recorded. The volume of ileal pouch distention at which large amplitude propulsive waves appeared (the threshold volume) correlated closely with stool frequency. The larger the threshold volume, the fewer the stools per 24 hours (correlation coefficient -0.70; p less than 0.01). Also, the greater the 24 hour stool output, the greater the stool frequency (correlation coefficient 0.79, p less than 0.001). In contrast, the efficiency of ileal pouch evacuation was less strongly related to stool frequency (correlation coefficient -0.41, p = 0.05). We conclude that ileal pouch motility and stool output are major determinants of stool frequency after ileal pouch-anal anastomosis. Inefficient pouch emptying is less commonly associated with frequent bowel movements. PMID- 3812890 TI - Misplaced pancreatic duct orifice as a cause of recurrent acute pancreatitis. AB - Acute recurrent pancreatitis in the absence of alcoholism and gallstones is a frustrating illness for both the patient and the physician. Over a 10 year period, 33 patients were operated on and found to have a duct of Wirsung entering the duodenum through the fibers of the sphincter of Oddi. Recurrent pancreatitis of sufficient intensity to require hospitalization had occurred an average of 4.2 times per patient, and each had experienced numerous episodes of abdominal pain of lesser severity. At least two attacks of pancreatitis that required hospitalization had occurred in all patients. All known causes of pancreatitis, including alcoholism, gallstones, hypercalcemia, hyperlipidemia, drug reactions, and pancreas divisum were excluded. Endoscopic retrograde cholangiopancreatography showed no ductal abnormalities. Twenty-eight of the patients had previously undergone cholecystectomy 8 months to 20 years before operation. A sphinteroplasty of the common bile duct and duct of Wirsung resulted in elimination of attacks of pancreatitis in all except two patients. Follow-up has been more than 5 years in 16 patients, more than 4 years in 10 patients, and more than 1 year in 5 patients. There have been no deaths. It appears that the entrance of the duct of Wirsung into the duodenum through a separate orifice through the fibers of the sphincter of Oddi causes recurrent acute pancreatitis. It seems likely that the problem is one of intermittent pancreatic duct obstruction. Normal pancreatic duct caliber is attributed to the intermittent nature of the obstruction. Enlargement of the orifice of the duct of Wirsung and division of the sphincter of Oddi relieved attacks of recurrent pancreatitis. PMID- 3812891 TI - Hemodynamic basis of the pain of chronic mesenteric ischemia. AB - Tonometry, a new technique to indirectly assess intestinal blood flow, was used to determine the hemodynamic changes produced by a simulated meal in animals with a fixed, decreased splanchnic blood flow. In experiments on 14 dogs, celiac artery and superior mesenteric artery blood flow was maintained at 50 percent of normal flow by occluders and flow probes, and tonometers were placed in the stomach and small bowel to measure intramural pH, a metabolic marker of intestinal perfusion. Intramural pH was determined at 100 percent and 50 percent splanchnic blood flow, at 50 percent flow after instillation of cream into the stomach, and again when cream was placed into the small bowel. Intestinal intramural pH decreased significantly when blood flow was decreased to 50 percent, as expected, but decreased significantly again when cream was placed in the stomach. The hemodynamic explanation of the decrease when cream was placed in the stomach is a steal from the intestinal to the gastric circulation stimulated by food in the stomach. Such a steal could explain the temporal nature of the pain experienced by patients with chronic mesenteric ischemia. PMID- 3812892 TI - Complications and reoperation after Nissen fundoplication in childhood. AB - Over a 10 year period, 429 Nissen fundoplications were performed on children with gastroesophageal reflux. Postoperative complications occurred in 69 children (16 percent), including wrap herniation or breakdown in 29; postoperative bowel obstruction in 18; stricture in 10; intraabdominal abscess and enterocutaneous fistula in 3 patients each; and wound infection, wound dehiscence, and inadvertent splenectomy in 2 patients each. The postoperative mortality rate was 0.9 percent (4 of 429 patients) and was related to sepsis in 1 patient, a metabolic disorder in 1 patient, and underlying pulmonary disease in 2 patients. All four patients were neurologically impaired. Fundoplication successfully controlled symptoms of gastroesophageal reflux in 395 children (92 percent) over a follow-up period ranging from 6 months to 10 years. Thirty-eight patients (8.8 percent) required a second antireflux operation because of recurrent symptoms. Twenty-nine patients had severe neurologic impairment (76 percent), 5 had associated congenital malformations (13 percent), and 3 had significant pulmonary problems (8 percent). Only one child requiring reoperation was considered otherwise normal. Indications for reoperation included wrap breakdown or herniation (28 patients), stricture (6 patients), and inadequate wrap (4 patients). Twenty-four of 28 children with wrap herniation or breakdown had neurologic impairment. A second fundoplication was successful in 35 of 38 patients (92 percent). A second procedure failed in three children, who required subsequent resection and colon interposition. PMID- 3812893 TI - Influence of tumor cell DNA ploidy on the natural history of rectal cancer. AB - We have examined tumor cell DNA content as a possible variable in the behavior of early rectal cancer treated by local excision. Flow cytometry assays of tumor cell DNA content were carried out on specimens of archived, paraffin-embedded tissue specimens from 30 patients (11 male and 19 female) whose early rectal cancers were treated by curative local excision more than 60 months previously. The cancers invaded to the muscularis mucosae in 2 patients (1 with aneuploid disease and 1 with diploid disease), into the submucosa in 15 patients (7 with aneuploid disease and 8 with diploid disease), and the muscularis propria in 13 patients (8 with aneuploid disease and 5 with diploid disease). A total of 16 patients had aneuploid disease and 14 had diploid disease. Local recurrence of cancer developed in 12 patients. Of these 12 patients, 10 (83 percent) had aneuploid disease. By contrast, of the 18 patients who remained free of disease, 12 (67 percent) had diploid disease. Seven of the 12 patients with recurrence died. Six of these seven (86 percent) had aneuploid disease. The aggressive clinical behavior of the tumors with aneuploid DNA content was not otherwise predictable by standard histologic features. Aggressive tumor behavior appears to correlate closely with aneuploidy in locally treated rectal cancers, as opposed to a lack of correlation in our patients treated with major resection. The fact that these cancers are being treated by local excision may allow the prognostic impact of DNA content to reflect the natural history of cancer. PMID- 3812894 TI - Factors affecting the morbidity of elective liver resection. AB - To identify the determinants of morbidity and mortality after hepatic lobectomy, we studied 17 potential risk factors in 58 consecutive patients who had right hepatic lobectomy (39 patients), left hepatic lobectomy (10 patients), extended right hepatic lobectomy (6 patients), and left lateral segmentectomy (3 patients). The lesions were benign neoplasm (11 patients), primary malignancy (12 patients), metastatic neoplasm (28 patients), and inflammatory conditions, namely, stones, ductal strictures, and abscess (7 patients). Two patients died (3.8 percent), one from operative hemorrhage and the other from sepsis. Major complications occurred in 29 patients (50 percent). The presence of diabetes or pulmonary disease correlated with the development of complications. Infection occurred in four of five patients with diabetes. The incision was extended into the thorax in nine patients, all of whom had complications. The mean weight of the resected specimen did not differ between patients who underwent thoracotomy and those who did not, but the two largest specimens (over 2 kg) were removed without thoracotomy. Minor complications developed in two patients with benign tumors. Biliary fistulas developed in three of seven patients with inflammatory conditions. Infectious complications were decreased in the presence of adequate perioperative antibiotics and closed drainage of the subphrenic space. These data show that in fit patients, elective liver resection can be performed with a low morbidity and mortality; diabetes, pulmonary disease, and inflammatory lesions increase the risk of hepatic resections; adequate antibiotics and closed drainage decrease the risk of infection; and thoracotomy markedly increases the chance of complications. Finally, since elective resection can nearly always be performed without thoracotomy, it should be avoided in most patients. PMID- 3812895 TI - Long-term results of pancreatojejunostomy in patients with chronic pancreatitis. AB - During a 10 year period, 69 patients with pancreatic duct dilation of 7 mm or more and intractable pain from chronic pancreatitis underwent Roux-Y drainage either as a lateral pancreatojejunostomy on 48 occasions or as a caudal pancreatojejunostomy in 21 cases. Nine patients (three with caudal pancreatojejunostomy and six with lateral pancreatojejunostomy) were lost to follow-up within the first postoperative year. The residual 60 patients undergoing 64 procedures were followed for an average of 69.3 months (range 10 to 144 months). Four patients with recurrent pain after caudal pancreatojejunostomy were converted to a lateral pancreatojejunostomy, with resolution of pain. Long term pain relief occurred significantly more often in patients undergoing lateral pancreatojejunostomy than in those who received a caudal pancreatojejunostomy (66 versus 34 percent, p less than 0.01). Accordingly, caudal pancreatojejunostomy has little place in the surgical management of these patients. Since no differences existed in the two surgical populations, long-term pain relief in chronic pancreatitis appears more favorably influenced by the choice of an appropriate surgical procedure, rather than resulting solely from progressive destruction of the gland, as has been claimed. Although successful results in patients with lateral pancreatojejunostomy could not be correlated with anastomotic suture technique (one layer versus two layers or capsule versus mucosa-to-mucosa, p greater than 0.05), the creation of a pancreatojejunal anastomosis of more than 6 cm was found to be critical for success (p less than 0.001). Restoration of either exocrine or endocrine function should not be anticipated after otherwise successful lateral pancreatojejunostomy. However, if ductal dilatation can be demonstrated, recurrent pain after lateral pancreatojejunostomy is best managed by repeat lateral pancreatojejunostomy rather than resection. PMID- 3812896 TI - Bad blood: perspective of a country boy. PMID- 3812897 TI - Is an antireflux procedure necessary in conjunction with parietal cell vagotomy in the absence of preoperative reflux? AB - During a 4 year period, we found no objective evidence that parietal cell vagotomy contributes to the production of gastroesophageal reflux. The fact that patients without reflux preoperatively achieved the same satisfactory clinical results whether parietal cell vagotomy was or was not accompanied by an antireflux procedure supports this view. Therefore, in the absence of reflux, we cannot recommend the prophylactic use of an antireflux procedure in combination with parietal cell vagotomy in the treatment of patients with duodenal ulcer. On the other hand, patients with duodenal ulcer should be evaluated for gastroesophageal reflux before operation because it is desirable to combine parietal cell vagotomy with an antireflux procedure if both conditions exist. Patients who have mild reflux preoperatively but no symptoms of reflux after parietal cell vagotomy alone, as in three of the four patients in Group IV, may have such symptoms subsequently. Therefore, we think that the combined procedure does not increase the morbidity over that of parietal cell vagotomy alone and recommend the combination of parietal cell vagotomy and an antireflux procedure for any patient undergoing operation for duodenal ulcer who also demonstrates an abnormal degree of gastroesophageal reflux. PMID- 3812898 TI - Effect of incidental appendectomy on the development of wound infection in patients undergoing staging laparotomy for Hodgkin's disease. AB - Two hundred ten patients were retrospectively studied to evaluate the risk of appendectomy performed during laparotomy for staging of Hodgkin's disease. Seventy-nine patients did not have their appendix removed, and a wound infection developed in 1. One hundred thirty-one patients had an appendectomy, and 7 wound infections occurred in this group. This difference was not statistically significant. No patient died as a consequence of their wound infection, and no intraabdominal infections occurred. Our data suggest that the risk for development of a wound infection after a staging laparotomy for Hodgkin's disease is increased by performing an incidental appendectomy as part of the procedure. Although the differences noted were not statistically significant, this was probably due to the sample size. Based on our data, we do not routinely remove the appendix at the time of staging laparotomy. PMID- 3812899 TI - [Vacuous chewing after haloperidol and GABA-linoleamide administration in the rat]. PMID- 3812900 TI - [Anoxia caused by pure nitrous oxide disclosing French aberrant standards]. PMID- 3812901 TI - [Experimental analog devices for automatic stabilization of intracranial pressure in patients with external drainage]. PMID- 3812902 TI - [Use of etomidate in neuroradioanesthesia. Apropos of 230 cases]. PMID- 3812903 TI - [Evaluation of postoperative complications following esophageal surgery]. PMID- 3812904 TI - [Medical and obstetric complications of pregnancy and the incidence of intrauterine fetal growth retardation (etiologic factors of retardation)]. PMID- 3812905 TI - [Late toxemias of pregnancy (pre-eclampsia) in teenagers. I. Course of pregnancy]. PMID- 3812906 TI - [Late toxemias of pregnancy (pre-eclampsia) in teenagers. II. Course of labor and fate of the newborn child]. PMID- 3812907 TI - [Suppression of unwanted lactation in parturients with estrogens and bromocriptine]. PMID- 3812908 TI - [Genital actinomycosis in the presence of intrauterine pessaries]. PMID- 3812909 TI - [Surgical creation of a cervix and neovagina in congenital malformations with hematometra and hematosalpinx]. PMID- 3812910 TI - [Applications of sigetin in gynecologic practice]. PMID- 3812911 TI - [Changes in the estrous cycle of the rat after irradiation with a helium-neon laser]. PMID- 3812912 TI - [Changes in the specific functions of women engaged in hot-house production]. PMID- 3812913 TI - [Gamma-camera scintigraphy in idiopathic varicocele and infertility]. PMID- 3812914 TI - [Use of testicular prostheses in andrologic practice]. PMID- 3812915 TI - [Antigens of human sperm studied using monoclonal antibodies]. PMID- 3812916 TI - [Acute poisoning and pregnancy]. PMID- 3812917 TI - [Chronic uterine inversion treated by a traditional method of African folk medicine]. PMID- 3812918 TI - [Erosion of a uterine horn by an abdominal pregnancy implanted on the fundus uteri]. PMID- 3812919 TI - Are book reviews in medical journals worthy? PMID- 3812920 TI - Hair follicle-like change over histiocytomas. AB - Epidermal hyperplasia is a common finding overlying histiocytomas. Occasionally, a distinctive type of basaloid hyperplasia occurs, with differentiation into primitive hair follicle tissue. This study attempts to characterize this change and determine whether it is associated with any particular clinical or histological feature. Data from patients with histiocytomas displaying induction of pilar epithelium in the epidermis above the lesions was compared with data from controls who did not show this change. The size, site, and duration of histiocytomas were similar in both groups, as were the predominant cell type and distance of histiocytoma from the epidermis. Serial sectioning of histiocytomas showed that the induction of pilar epithelium was a focal phenomenon, often missed in routine sections. It is suggested that histiocytoma cells may produce a "hair organizing mediator." PMID- 3812921 TI - Aspiration cytology of cutaneous metastatic melanoma and epidermoid carcinoma of the penis. AB - Aspiration biopsy cytology is an accurate, safe, innocuous alternative to excisional biopsy in diagnosing the nature of concomitant superficial nodules or lymphadenopathy in patients with known cutaneous malignancy. In patients with penile cancer, aspiration biopsy cytology may avoid the morbidity (30-50%) and mortality (3%) of groin dissection staging. A positive aspirate is conclusive of Stage III tumor and, in patients with occult nodal metastases, may lead to early curative lymphadenectomy. In the present study of 28 patients with known cutaneous malignant melanoma, the aspiration biopsy cytology of 31 superficial nodules resulted in a cytologic diagnosis of metastasis in 29 nodules from 26 patients. In the management of patients with known melanoma, the positive cytology of superficial nodules is conclusive of metastatic disease and requires an accurate radiologic study to establish or exclude disseminated disease. Surgical removal of a metastatic superficial nodule is indicated when the lesion is considered localized disease and the patient, having been accurately examined, is determined to be apparently free of disease in other sites and organs. When systemic diffuse melanoma is found, the excision of metastatic superficial nodules is unnecessary. Positive aspiration cytology may avoid risk from ill judged surgical procedures and indicate appropriate palliative treatment of the disease. PMID- 3812922 TI - Glycoconjugates in sweat glands and other structures of skin from normal and cystic fibrosis subjects. AB - In this study, glycoconjugates of human skin varied in structure between cell types in an individual and often between individuals for a given cell type. Stored secretory material in dark cells of the sweat gland coil contained complex carbohydrate with terminal alpha-galactose, N-acetylgalactosamine, fucose, or sialic acid. The plasmalemma of clear cells in the secretory coil stained conspicuously for terminal alpha-N-acetylgalactosamine, and the cytosol of clear cells contained lectin-reactive glycogen in the majority of specimens. Superficial and deep cells of the sweat duct evidenced plasmalemmal glycoconjugate with terminal N-acetylgalactosamine. However, only the superficial cell plasmalemma in the duct stained for terminal alpha-N-acetylgalactosamine, fucose, and sialic acid. In several specimens, only the deep cells in the sweat duct revealed plasmalemmal glycoconjugate with terminal beta-galactose. Sebaceous glands alone displayed lectin affinity demonstrative of terminal alpha-galactose and like other sites stained for terminal beta-galactose and alpha-N acetylgalactosamine. The epithelium in epidermis and hair follicles appeared similar, except for epidermis failing to evidence fucose and alpha-N acetylgalactosamine with certain lectins. Both underwent changes in glycoconjugate composition with cell maturation. Skin from control subjects and patients with cystic fibrosis did not differ in lectin-binding properties. Abnormalities observed in cystic fibrosis specimens included decreased volume of sebaceous glands and, in two cases, increased infiltration of macrophages staining for terminal N-acetylgalactosamine. PMID- 3812923 TI - Follicular lymphomatoid papulosis. AB - A patient with follicular lymphomatoid papulosis is reported. Only two cases of this rare variant have been previously reported in the literature. Lesions typical of lymphomatoid papulosis in this case were centered around disrupted hair follicles. They corresponded to the type A "histiocytic" variant of lymphomatoid papulosis. The histologic features and theories regarding histogenesis of this unusual disorder are discussed. PMID- 3812924 TI - Candida albicans septicemia with folliculitis in heroin addicts. AB - Disseminated candidiasis occurring in heroin abusers has been reported in the recent years as a peculiar type of septicemia. Dermatological lesions consist of folliculitis with Candida albicans within hair shafts. PMID- 3812925 TI - Sebaceous carcinoma of the face following irradiation. AB - Malignant neoplasms of sebaceous glands are uncommon but generally occur about the head and neck, where these glands are concentrated. The sites of most frequent occurrence are the ocular adnexae, where sebaceous carcinoma presents as an infiltrating malignancy with a poor prognosis. Cutaneous sebaceous carcinoma is rare at other sites but has a better prognosis. We have located eight cases in the literature of sebaceous carcinoma arising in a previously irradiated field: five in the ocular adnexae and three elsewhere on the face. We here report a fourth case of recurrent sebaceous carcinoma with metastases that occurred on the face of an 82-year-old woman who had received radiation to the area for cosmetic epilation 35 years previously. PMID- 3812926 TI - Multifocal intraepidermal carcinoma in a dog histologically resembling Bowen's disease. AB - A middle-aged, spayed female dog developed multiple cutaneous neoplasms that had clinical and histologic features of Bowen's disease in humans. Although lesions began in sun-exposed, glabrous skin, they progressed to hairy skin and to mucous membranes. Metastasis did not occur, although one lesion eventuated in local invasion of bone. The dog subsequently developed metastatic cutaneous myxosarcoma and euthanasia was requested by the owners. PMID- 3812927 TI - Mental illness in medical students. A problem the profession must face. PMID- 3812928 TI - Effect of respiratory infections on exacerbation of asthma in adult patients. A six-month follow-up. AB - The peak expiratory flow values and asthma symptom scores of 92 adults with extrinsic and intrinsic asthma were recorded daily from September 1981 to April 1982 in order to study the effects of symptomatic respiratory infections (SRI) on the course of asthma. During the follow-up, 253 exacerbations of asthma were observed in 67 patients. 68 subjects had 141 episodes of SRI. 63 of 253 exacerbations (25%) were found in association with SRI. The mean duration of the exacerbations associated with SRI was 11.4 days, significantly different (P less than 0.01) from the mean duration of 8.1 days recorded for the other exacerbations. The results confirm the high incidence of asthmatic exacerbations during respiratory infections and suggest that the recovery from an exacerbation is slower in association with infection. PMID- 3812929 TI - Timothy-specific IgG antibody levels vary with the pollen seasons. AB - Serum samples were collected from eight grass pollen hypersensitive children during a 4-year period. The sera were assayed for contents of timothy-specific IgE antibodies by RAST. Timothy-specific IgG and IgA antibodies were quantified by a refined ELISA in which covalent binding of the antigen to the polystyrene solid phase had been performed. IgG antibodies were also assayed by a Sepharose protein-A technique with radiolabelled timothy allergens as the antigen. It was possible to register clearcut seasonal variations with postseasonally boosted antibody levels not only of timothy-specific IgE but also of IgG antibody. Both IgG1 and IgG4 antibodies specific for timothy showed seasonal variations of a similar degree. It was not possible to register seasonal variations of the same magnitude of timothy-specific IgA antibodies. PMID- 3812930 TI - Antigen-induced bronchial anaphylaxis in actively sensitized SD rats. Effects of local treatment with anti-asthmatic drugs. AB - We studied the effects of anti-asthmatic and anti-inflammatory drugs on antigen induced bronchial anaphylactic reactions (BAR) in Sprague Dawley (SD) rats immunized with ovalbumin (OA) and alum. The animals were treated locally (intratracheal instillation (i.t.) or by aerosol) with terbutaline (TERB), disodium cromoglycate (DSCG), theophylline (THEO), the xanthine derivative 3,7 dihydro-1,8-dimethyl-3-phenyl-1H-purine-2,6-dione (D4026), budesonide (BUD) or dexamethasone (DEX) at various times before intravenous (i.v.) challenge with OA. The BAR was elicited by giving a low dose of OA. When the response to that challenge had levelled an additional high dose of antigen was given. Previous work had shown that TERB, DSCG, and D4026 given systemically (i.v.) at a suboptimal dose, had a better inhibitory efficacy when the animals were challenged with a low antigen dose late (6 weeks) than when challenged early (2-3 weeks) after immunization. We show here that such a difference in efficacy is not recorded after local treatment. Moreover, each of the drugs inhibited BAR to the same extent after i.t. as after i.v. treatment. Potent drugs like TERB and D4026 seemed to show similar efficacy when given either i.t. or by aerosol, whereas less potent drugs like DSCG and THEO were less effective when given by aerosol. In a previous study, we showed that the inhibitory capacity of glucocorticoids (GCS) on the BAR did not vary with sensitization conditions of the rats, BUD and DEX showed the same inhibitory capacity after intraperitoneal (i.p.) treatment as after i.t. treatment. In the present study, DEX showed increased whereas BUD showed decreased inhibitory capacity when given by aerosol 18-24 h before challenge. The duration of the anti-anaphylactic activity after inhalation was longer for DEX than for BUD. PMID- 3812931 TI - [H-H-H syndrome: a rare disease also relevant in anesthesiology]. AB - We report on a 17-year-old boy with H-H-H-syndrome (hyperornithinaemia, hyperammonaemia, homocitrullinuresis), an inborn disorder of the urea cycle, who had to undergo osteo-synthesis of a fractured upper leg. Pathophysiological aspects of this rare syndrome as well as possible recommendations for the anaesthesiological management are discussed. PMID- 3812932 TI - [Computer-assisted regulation of blood pressure by drugs acting on the cardiovascular system. Problems in the development of a closed-loop control system]. AB - This article reports on the problems associated with the development and use of a computer programme for computer-monitored blood pressure control by means of cardio- and/or vasoactive drugs. The computer, a monitoring device routinely used in hospitals, and an infusion pump on the one hand, and the patient on the other, are part of a closed loop control system. Regulation is effected in the manner practised in hospitals, the mean arterial pressure (MAP) serving as an auxiliary controlled variable. The computer programme analyses the directly measured blood pressure curve in two respects: Detection and assessment of external disturbing factors and endogenously conditioned changes in the blood pressure curve and determination of MAP via a special control algorithm. With the help of a prototype of the automatic controller, the programme was subjected to extensive clinical trials in more than 140 patients to date. The programme was particularly successful wherever a residual circadian rhythm leads to variable requirements of vasopressor or cardiovascular drugs. The use of technical control algorithms has proved unsuitable because of the complex nature of blood pressure control. PMID- 3812933 TI - [Knowledge of central pontine myelinolysis]. AB - By a case study, the authors point out the significance of a too rapid correction of hyponatremia for the development of central pontine myelinolysis. The regional anatomy of the lesion is discussed, and reference is made to the differential diagnostic spectrum. PMID- 3812934 TI - [Permeability of the cochlear aqueduct]. PMID- 3812935 TI - [Infectious-allergic diseases in otorhinolaryngology]. PMID- 3812936 TI - [Obliterative otosclerosis (a descriptive epidemiology study]. PMID- 3812937 TI - [Rhinomanometry (III). A simplified method. Diagnostic value]. PMID- 3812938 TI - [Sebaceous elements in the salivary glands. Apropos of a case of sebaceous carcinoma of the submaxillary gland]. PMID- 3812939 TI - [Cholesteatoma of the maxillary sinus. Apropos of a case]. PMID- 3812940 TI - [Phono-surgery of tensor weakness (personal technic)]. PMID- 3812941 TI - [Effectiveness of the use of topical sulfamides in postsurgical nasal packing]. PMID- 3812942 TI - [Tumor of the infraorbital canal]. PMID- 3812943 TI - [A possible function of Hensen cells of the internal ear in the guinea pig]. PMID- 3812944 TI - A career post--with intensive therapy? PMID- 3812945 TI - Glycine and transurethral resection. AB - Fifty patients undergoing transurethral resection of the prostate were studied for evidence of glycine absorption and haemodilution. Plasma glycine levels increased substantially in nine patients and, in five, calculated irrigant fluid absorption ranged from 619-1582 ml; another patient had absorbed 1360 ml fluid with only a small rise in plasma glycine. Two illustrative case histories are presented. The role of glycine as an inhibitory neurotransmitter is discussed and the possibility of toxic mechanisms other than dilutional hyponatraemia is mentioned. Intravenous diuretics, hypertonic saline, and perhaps calcium salts, are recommended for the overt transurethral resection syndrome. PMID- 3812946 TI - Intravenous regional anaesthesia below the knee. A cross-over study with prilocaine in volunteers. AB - The quality of anaesthesia provided by three dosages of prilocaine, 40 ml 0.5%, 20 ml 1%, or 40 ml 1%, administered in random order, for intravenous regional anaesthesia of the lower extremity below the knee was compared in six volunteers. Limited sensory blockade was achieved in the groups with 40 ml 0.5% and 20 ml 1% during the 30-minute test period. One subject was not fully anaesthetised with any of the dosages used. Recovery was rapid (mean 12-13 minutes) in these two groups. In two subjects given 40 ml of 1%, complete recovery took 90 minutes. At 30 minutes, the degree of flexion remaining in the great toe (control 100%) was 4% in the groups who received 40 ml of 0.5% and 1%, but 34% in those who received 20 ml of 1% respectively. Full motor recovery was achieved in 8-9 minutes. Five of six volunteers who received the 400-mg dose experienced subjective signs of central nervous system side effects when the cuff was released. In this group, the mean plasma level of prilocaine at 2 minutes was 1.22 micrograms/ml, maximum 2.12 micrograms/ml. In a radiological examination, no leak of contrast medium under the tourniquet cuff (300 mmHg) was detected. The development of anaesthesia was fastest following the largest dose, but the large number of central side effects makes that dosage less suitable for clinical work. PMID- 3812947 TI - A double-blind comparison of intramuscular pethidine and nalbuphine in labour. AB - A double-blind, between-patient comparison of intramuscular pethidine 100 mg and nalbuphine 20 mg for the relief of pain during labour in 80 patients is described. Severity of pain was assessed before and after treatment by subjective pain scores and visual analogue scales. Neither of these methods showed a significant difference between the treatments. Nalbuphine was associated with less maternal nausea and vomiting than pethidine, but this possible advantage was somewhat offset by a tendency of the drug to produce more maternal sedation and dizziness. The mean umbilical vein/maternal vein ratio was significantly higher for nalbuphine (0.78, SEM 0.03) than for pethidine (0.61, SEM 0.02), which suggests easier placental transfer of the former. This finding was reflected in significantly lower 2-4 hour neurobehavioural scores for the infants of mothers given nalbuphine, but there was no significant difference between these scores at 24 hours. On the basis of this study, nalbuphine does not offer a substantial improvement over pethidine for pain relief in labour. PMID- 3812948 TI - Patient-controlled analgesia. Experience of two new machines. AB - Two modern patient-controlled analgesia pumps have been evaluated in the laboratory and in clinical use. Both machines generally performed satisfactorily and patients achieved good pain relief from self-administered morphine. The relative merits of the two pumps are discussed and although the on demand analgesic computer is preferred, a substantial investment of time on the ward is required to provide continuous patient-controlled analgesia. PMID- 3812949 TI - A disposable device for infusion analgesia. An evaluation of the Travenol infusor. AB - The performance of the Travenol infusor when used to administer an intravenous infusion of analgesic after surgery has been investigated. Mean flow was very similar to the manufacturer's quoted figure of 2 ml/hour, but there was a large interindividual variation. Results from a laboratory study suggest that this was due to variation in the manufacture of the infusor. PMID- 3812950 TI - Halothane hepatitis in a child? PMID- 3812951 TI - Absorption of epidural morphine. PMID- 3812952 TI - Safety hazard with cylinder yoke on a Boyle's machine. PMID- 3812953 TI - Long-term ketamine infusion. PMID- 3812954 TI - Emergency guided blind intubation. PMID- 3812955 TI - Training in fibreoptic intubation. PMID- 3812956 TI - Anaesthesia and gastric carcinoid. PMID- 3812957 TI - Severe hypoxaemia during cardiopulmonary bypass. PMID- 3812958 TI - Intensive care for Legionnaire's disease. PMID- 3812959 TI - Narcotic overdose and acute rhabdomyolysis. PMID- 3812960 TI - Removal of inhaled peanut using a fibreoptic bronchoscope. PMID- 3812961 TI - Equipment malfunction: possible hazard. PMID- 3812962 TI - Herpes simplex after spinal pethidine. PMID- 3812963 TI - Forensic anesthesia. PMID- 3812964 TI - [The pharmacokinetics of continuous peridural morphine infusion]. AB - In patients with cancer pain treated by continuous epidural opiate infusion (4.5 24 mg morphine per day) via implanted or portable pumps (n = 40) plasma levels of morphine were determined during the postoperative period and during regular refill of the pump systems. Concentrations were between 2.6 and 18.8 ng/ml depending on daily dosage and body weight. There were no signs of accumulation. Concentrations in lumbar CSF measured in some of the patients were 15-20 higher but decreased by 10-20% (in relation to daily dosage) in the course of long-term treatment. This may be induced by reduction in permeability of the dura due to fibrosis within the epidural space after chronicle catheterization. Cervical CSF concentrations (during chordotomy) were about 1/6 to 1/7 of the corresponding lumbar CSF levels. It may be assumed that epidural opiate infusion in spite of low blood levels is accompanied by relevant cerebral opiate actions. PMID- 3812965 TI - [Somatosensory evoked potentials under thiopental and etomidate]. AB - The somatosensory evoked potential in response to median nerve stimulation was recorded in 42 patients during infusion of either 15 mg/kgbw thiopentone (TH) or 1 mg/kgbw etomidate (E) within 15 min and before and after injection of 0.3 mg/kgbw etomidate bolus. Cortical and cervical responses were analysed simultaneously and central conduction time (CCT) was calculated. Marked alterations of waveforms and an increase in latency of the primary cortical SEP and of CCT were observed in all patients. Infusion of TH or E was followed by a diminution of middle and long latency components. Amplitude of the cortical N20 was found to be unchanged during and after TH and to be increased after infusion or injection of E, indicating the synchronizing properties of this drug. The cervical SEP (N14) remained entirely unchanged in response to both agents. During hypnotic drug administration a pronounced increase in latencies and CCT as well as a decrease in the number of identifiable peaks has to be considered when SEP monitoring is performed intraoperatively or in intensive care treatment. PMID- 3812966 TI - [The quality of washed autotransfused erythrocytes. The elimination of plasma hemoglobin, osmotic fragility and survival rate of retransfused erythrocytes]. AB - Intraoperative transfusion has until recently been understood to mean full retransfusion of the blood removed by a suction pump without significant changes due to external influences, which considerably limited its utilization. Intraoperative transfusion can only be performed without decisive disadvantages when the blood can be suctionally removed in large amounts and immediately retransfused. In recent years, the Cell Saver has provided a system which can also prepare soiled blood for retransfusion. Extensive orthopedic surgery entails large blood losses due to oozing from expanded wound areas; only rarely does acute bleeding occur. Because of intensive tissue contact, the suctioned blood has been soiled with activated clotting factors, lytic enzymes, free haemoglobin from damaged red cells, cleaning solutions, and other undesired elements. With the Cell Saver system, it is possible to remove the plasma and recover 70-80% of the intact red cells sufficiently freed from stroma and free haemoglobin. The osmotic fragility of these cells served as a measure of integrity and membrane stability. They were compared to red cells withdrawn preoperatively and showed an identical osmotic relationship. Determining the survival rate of the retransfused cells in vivo shows that they provide a high-quality and in most cases, a sufficient replacement of blood loss. Even after 6 days, over 70% were found in the circulating blood. Premature, disproportionate elimination, which could be dangerous for the patient, does not occur. PMID- 3812967 TI - [Emergency ventilation using an Ambu-bag with a new coniotomy set]. AB - A new coniotomy set (Mini-Trach, Portex Ltd) for endotracheal suction was modified with a 4-mm tube adapter and used for ventilation with standard resuscitation bags (Ambu, Laerdal) in two corpses. Minute volumes achieved with open glottis were 36 +/- 1.9 l/min for Ambu, 33 +/- 2.8 l/min for Laerdal, and 16 +/- 1.1 l/min for a standard anaesthesia machine, respiratory frequencies were 51 +/- 5.3/min, 46 +/- 8.9/min, and 30 +/- 3.3/min respectively. Auscultation and inspection showed good ventilation of both lungs. We conclude that this coniotomy set is suitable for emergency ventilation by standard resuscitation bags until a definite airway can be established; it permits higher flow than needle coniotomy and avoids most of its complications. Care must be taken when outflow must also be achieved by the same cannula. PMID- 3812968 TI - Recovery of nanogram quantities of DNA from plasma and quantitative measurement using labeling by nick translation. AB - A method which allows for the quantitative measurement of DNA in plasma is described. After treatment of plasma with phenol, DNA is precipitated by ethanol using gelatin as a coprecipitating agent. DNA is then measured by nick translation labeling. This assay takes a few hours. It is suitable for the measurement of DNA within a range of 0.02 to 20 ng in 10 microliters of plasma. For example, it is applied to the measurement of DNA in plasma from mice injected with bacterial lipopolysaccharide. PMID- 3812969 TI - Wet-chemical postcolumn reaction and fluorescence detection analysis of the reference interval of endogenous serum vitamin K1(20). AB - The reference interval for serum vitamin K1(20) levels was assayed in healthy fasting adults by a method based on high-performance liquid chromatography (HPLC). The isolation procedure involves a solvent extraction of the plasma lipids followed by two chromatographic steps, consisting of a purification of the extract on a semipreparative adsorption column and a final quantitation on a reverse-phase column. Vitamin K1(20) and vitamin K1(25), the internal standard, are monitored by fluorescence detection after postcolumn reduction with a methanolic solution of tetramethylammonium octahydridotriborate. This reaction is performed in an open tubular reaction coil at elevated temperature. The median plasma concentration in 50 healthy fasting adults was 247 pg/ml. The levels showed a skewed distribution with a range of 62 to 980 pg/ml [log x +/- 2 SD (log x)]. The method is linear over the entire physiological range and has a within run precision of 3.6% (n = 5, mean = 311 pg/ml). The minimum detectable amount in serum is 50 pg/ml. Other extraction procedures resulted in lower recoveries or in interferences in the final measurement. The vitamin K1(20) levels as reported by other research groups are also discussed. PMID- 3812970 TI - Application of a nitrocellulose immunoassay for quantitation of proteins secreted in culture media. AB - A macro-dot immunoassay was developed to quantitate proteins (antigens) secreted in the culture media of primary rat hepatocytes. Dilutions of protein standards and undiluted spent culture media were applied to numbered sheets of nitrocellulose (NC) paper by vacuum filtration (in volumes up to 1 ml) through a specially designed macrofiltration apparatus constructed of plexiglass. Sequential incubation of the NC with bovine serum albumin blocking buffer, monospecific antibody, and 125I Protein A enabled quantitation of protein concentration by determination of NC bound radioactivity. Linear and reproducible standard curves were obtained with fibrinogen, albumin, transferrin, and haptoglobin. A high degree of coefficient of correlation between radioactivity (cpm) and protein concentration was found. Intra- and interest reproducibility was excellent (C.V.'s less than 7%). By using monospecific antibodies, single proteins (i.e., fibrinogen), as low as 32 ng/ml, could be quantified in heterogeneous protein mixtures and in spent culture media. The assay was sensitive to the difference of fibrinogen secretion under nonstimulatory (serum free hormonally defined medium, SFHD) and stimulatory (SFHD plus hydrocortisone) culture conditions. The procedure and techniques described are applicable to the quantitation of any protein in a suitable buffer. PMID- 3812971 TI - Spectrophotometric determination of inorganic phosphate in the presence of thiol compounds. AB - A spectrophotometric method for inorganic phosphate determination in the presence of thiol compounds is described. Thiol compounds, which interfere with the measurement of inorganic phosphate by a modification of the method of Gomori, are removed by carboxymethylation by iodoacetate prior to the formation and reduction of phosphomolybdate complex. A linear standard curve is obtained by this method, and the method is suitable for the assay of a phosphate-releasing enzyme when the measurement must be performed in the presence of thiol compounds. PMID- 3812972 TI - Introduction of deoxyribonucleoside triphosphates into intact cells by electroporation. AB - A simple method, employing high-voltage electric discharge (electroporation), was developed to introduce phosphorylated nucleosides into the cytoplasm of viable cells. HL-60 leukemia cells permeabilized by this technique remained viable and incorporated deoxyribonucleoside triphosphates into nuclear DNA. Furthermore, DNA synthesis was depressed for at least 24 h in HL-60 cells made permeable to 1-beta D-arabinosylcytosine 5'-triphosphate by this methodology. Electroporation was found to be applicable to the permeabilization of a wide variety of cell lines in culture to nucleotides, suggesting that this methodology may be useful for the introduction into intact cells of a wide variety of molecules that are not normally transported effectively. PMID- 3812973 TI - Extraction of myosin light chains and actin from bovine cardiac muscle acetone powder. AB - A joint preparation of the two myosin light chains and actin from bovine cardiac muscle acetone powder is described. There is a significant improvement in the ease of purification, while the yield of the myosin light chains equals the best yields obtained from the use of established techniques. The actin yield greatly exceeds that obtained in an earlier published report. PMID- 3812974 TI - Low-cost two-dimensional gel densitometry. AB - A major obstacle to full utilization of the powerful technique of two-dimensional (2-D) gel electrophoresis is the expense and complexity of quantifying the results. Using an analog-to-digital converter already present in the widely available Commodore 64 or Commodore 128 microcomputer, we have developed a 2-D gel densitometer (GELSCAN) which adds only $20.00 to the cost of the Commodore system (currently around $700.00). The system is designed to work with autoradiograms of 2-D gels. Spots of interest are identified visually and then positioned manually over a light source. A pinhole photoelectric sensor mounted in a hand-held, Plexiglas holder, or "mouse," is briefly rubbed over each spot. Maximum density of the spot is determined and its value is converted to counts per minute via an internal calibration curve which corrects for the nonlinear response of film to radiation. Local spot backgrounds can be subtracted and values can be normalized between gels to adjust for variation in amount of radioactivity applied or in exposure time. Reproducibility is excellent and the technique has some practical as well as theoretical advantages over other more complicated approaches to 2-D gel densitometry. In addition, the GELSCAN system can also be used for scanning individual bands in 1-D gels, quantitation of "dot blot" autoradiograms and other tasks involving transmission densitometry. PMID- 3812975 TI - Measurement of free and esterified carnitine in tissue extracts by high performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) method for the determination of L-carnitine in clamped and frozen rat livers is described. L-carnitine + acetyl CoA in equilibrium with acetyl-L-carnitine + CoASH Using the above enzymatic reaction, release of CoASH is stoichiometric with the L-carnitine added. The present method has made possible the determination of carnitine in liver tissues, which is difficult by the conventional enzymatic spectrophotometric method using 5,5'-dithiobis(2-nitrobenzoic acid), owing to acetyl-CoA hydrolysis during prolonged incubations at pH 7.8. PMID- 3812976 TI - Growing calmodulin crystals for X-ray diffraction studies at room temperature in 2 days. AB - Crystals of bovine brain calmodulin have been grown using a novel procedure which utilizes a mixture of alcohols as a precipitant. Crystals were grown by vapor diffusion at room temperature in the presence of 15% ethanol, 25% 2-methyl-2,4 pentanediol, 5.0 mM calcium chloride, and 10.0 mM sodium acetate buffer at pH 4.0. Crystals were visible within 4 h and grew to 0.75 X 0.3 X 0.125 mm in 2 days, without seeding. The crystals of calmodulin are isomorphous with those found by W. J. Cook, J. R. Dedman, A. R. Means, and C. E. Bugg (1980, J. Biol. Chem. 255, 8152-8153). The protein crystallizes in space group P1 with unit cell dimensions a = 29.92 A, b = 55.96 A, c = 24.75 A, alpha = 93.81 degrees, beta = 99.24 degrees, and gamma = 88.40 degrees. PMID- 3812977 TI - In situ autoradiographic detection of folylpolyglutamate synthetase activity. AB - The enzyme folylpolyglutamate synthetase (FPGS) catalyzes the conversion of folate (pteroylmonoglutamate) to the polyglutamate forms (pteroylpolyglutamates) that are required for folate retention by mammalian cells. A rapid in situ autoradiographic assay for FPGS was developed which is based on the folate cofactor requirement of thymidylate synthase. Chinese hamster AUX B1 mutant cells lack FPGS activity and are unable to accumulate folate. As a result, the conversion of [6-3H]deoxyuridine to thymidine via the thymidylate synthase reaction is impaired in AUX B1 cells and no detectable label is incorporated into DNA. In contrast, FPGS in wild-type Chinese hamster CHO cells causes folate retention and enables the incorporation of [6-3H]deoxyuridine into DNA. Incorporation may be detected by autoradiography of monolayer cultures or of colonies replica plated onto polyester discs. Introduction of Escherichia coli FPGS into AUX B1 cells restores the activity of the thymidylate synthase pathway and demonstrates that the E. coli FPGS enzyme can provide pteroylpolyglutamates which function in mammalian cells. PMID- 3812978 TI - Affinity precipitation of lactate dehydrogenase with a triazine dye derivative: selective precipitation of rabbit muscle lactate dehydrogenase with a procion blue H-B analog. AB - A simple methoxylated derivative of the triazine dye, Procion blue H-B, selectively precipitates rabbit muscle lactate dehydrogenase from solution. Optimum protein precipitation occurred at an enzyme subunit:dye ratio of approximately 2:1 and was fully reversible upon addition of competitive ligands such as NADH. With a crude extract of rabbit muscle, affinity precipitation with the dye followed by dissolution with NADH yielded homogeneous lactate dehydrogenase in 97% overall yield. PMID- 3812979 TI - Fluorographic detection of tritiated glycopeptides and oligosaccharides separated on polyacrylamide gels: analysis of glycans from Dictyostelium discoideum glycoproteins. AB - Previous workers have shown that oligosaccharides and glycopeptides can be separated by electrophoresis in buffers containing borate ions. However, normal fluorography of tritium-labeled structures cannot be performed because the glycans are soluble and can diffuse during equilibration with scintillants. This problem has been circumvented by equilibration of the gel with 2,5 diphenyloxazole (PPO) prior to electrophoresis. The presence of PPO in the gel during electrophoresis does not alter mobility of the glycopeptides and oligosaccharides. After electrophoresis, the gel is simply dried and fluorography performed. This allows sensitive and precise comparisons of labeled samples in parallel lanes of a slab gel and, since mobilities are highly reproducible, between different gels. The procedure is preparative in that after fluorography the gel bands can be quantitatively eluted for further study, without any apparent modification by the procedure. In this report, the procedure is illustrated by fractionation of both neutral and anionic glycopeptides produced by the cellular slime mold Dictyostelium discoideum. PMID- 3812980 TI - Purification of hormone-sensitive lipase by high-performance ion exchange chromatography. AB - We have developed an improved method for purification of hormone-sensitive lipase from adipose tissue. The method employs two preparative high-performance ion exchange chromatography steps on Mono Q and Mono S after detergent solubilization and partial fractionation of the enzyme by gradient sievorptive chromatography on QAE-Sephadex. About 0.2 mg of greater than 70% pure enzyme is prepared at 10% yield within 6-7 days from adipose tissue of 500 rats. This protocol is a major improvement over the previously established procedure in terms of accessibility, rapidity, enzyme purity, and yield. PMID- 3812981 TI - The chemical synthesis of high specific-activity [35S]adenosylhomocysteine. AB - The study of the family of transmethylases, critical to normal cellular function and often altered in cancer, can be facilitated by the availability of a high specific-activity S-adenosylhomocysteine. We report the two-step preparation of [35S]adenosylhomocysteine from [35S]methionine at a specific activity of 1420 Ci/mmol in an overall yield of 24% by a procedure involving demethylation of the [35S]methionine to [35S]homocysteine followed by condensation with 5'-chloro-5' deoxyadenosine. The ease of the reactions, ready availability and low cost of the reagents and high specific-activity and stability of the product make the procedure an attractive one with many uses, and superior to current methodology. PMID- 3812982 TI - The influence of radioiodination on the adsorption of IgG and serum albumin to polystyrene. AB - The adsorption of radioiodinated rabbit IgG and bovine serum albumin (BSA) to polystyrene tubes was investigated. Adsorption isotherms where the proportion of the protein bound was relatively constant over a range of intermediate protein concentrations, and where the proportion bound was protein dependent, were obtained. To investigate the effects of radioiodination, proteins labeled to give a wide range of substitution ratios (0.03 to 3.7 125I/protein molecule) were employed. While labeling did not appear to affect BSA adsorption, the kinetics of IgG binding were altered in a number of ways. The proportion bound in the concentration independent region was decreased even at substitution ratios less than or equal to 0.2. In addition, while all preparations of iodinated BSA, and IgG preparations with less than or equal to 1.6 125I/IgG, gave bimodal adsorption isotherms, with more heavily labeled IgG (greater than or equal to 2.5 125I/IgG) the apparent high affinity binding to the plastic surface was abolished. These results indicate that radioiodination substantially alters the kinetics of the binding of IgG to polystyrene. In addition, the results obtained are discussed with respect to previous relevant and often apparently contradictory findings. PMID- 3812983 TI - Histone separation by high-performance liquid chromatography on C4 reverse-phase columns. AB - Previous work in our laboratory (Lindner, H., Helliger, W., and Puschendorf, B. (1986) J. Chromatogr. 357, 301-310) described a rapid separation of H1 and core histones by reverse-phase high-performance liquid chromatography using a Bio-Rad Hi-Pore butyl (C4) silica-based column. Despite the short elution time, a high resolution of the different histone fractions, except H4 and H2A (MHP), could be obtained. In this report we present a method for the separation of H4 and H2A (MHP) as well, while maintaining a similar analysis time. By varying the gradient, trifluoroacetic acid concentration (0.05%), and flow rate (1.3 ml/min) the histones were eluted from the C4 column in the following order: H1 (MHP), H1 (LHP), H2B, H2A (LHP), H4, H2A (MHP), H3 (LHP), and H3 (MHP). LHP and MHP refer to less and more hydrophobic histone variants. The identification of the individual protein fractions was performed by comparison the retention times with pure histone markers as well as by gel electrophoresis. PMID- 3812984 TI - Spectrophotometric determination of tryptophan and tyrosine in peptides and proteins based on new color reactions. AB - A new spectrophotometric method for quantitative determination of tryptophan and tyrosine in peptides and proteins is described. It is based on two specific color reactions, the reaction of tryptophan with formaldehyde and the reaction of tyrosine and tryptophan with hydroxylamine and ceric cations. By combination of these two reactions both tyrosine and tryptophan can be determined simultaneously. Tyrosine and/or tryptophan bound in peptides and/or proteins react independently of the rest of the peptide or protein molecule. The method is simple, accurate, and sensitive. Hydrolysis is not necessary. PMID- 3812985 TI - Sequential volume changes on a small sample by density. AB - A procedure is described for generating a sequence of volume changes by density on the same sample of a solution. The entire volume-change profile over the reactant concentration range of interest can be accomplished with 0.1-0.2 mumol of a protein in 100 microliters of sample. The calcium-binding proteins, calmodulin and skeletal troponin-C, were employed to determine the volume increases attending the sequential addition of calcium ions. Both volume-change profiles exhibited nonlinear increases over the first four equivalents of calcium ion added. PMID- 3812986 TI - A double-label two-dimensional gel electrophoresis procedure specifically designed for serum or plasma protein analysis. AB - A double-label two-dimensional electrophoresis procedure has been developed which is specifically designed for the comparison of serum or plasma proteins in two different samples. Proteins are labeled by reductive methylation with [14C]- or [3H] formaldehyde. The procedure is economical because small quantities of relatively inexpensive isotopes are used and it is at least as sensitive as silver staining in detecting proteins. A fourfold increase in the sensitivity of autoradiography over existing methods was obtained by performing autoradiography before processing the gel for fluorography. A spot in the electrophoretic gel that contains 17-28 ng of labeled protein is detectable. This corresponds to proteins present in serum at a concentration of 5-10 micrograms/ml. Even greater sensitivity can be achieved, at greater expense, by increasing the quantities of the radioisotopes in the labeling reaction. The particular value of the double label approach is that complex mixtures from two different sources are resolved together thus eliminating the possibility of differences arising from the resolving procedure itself. The procedure was applied to a mixture of serum and plasma from a single subject and a number of qualitative and quantitative differences were observed. PMID- 3812987 TI - Normal- and reverse-phase HPLC separations of fluorescent (NBD) lipids. AB - We have developed two high-performance liquid chromatography methods for separating a number of fluorescent 4-nitrobenzo-2-oxa-1,3-diazole (NBD) analogs of glycerolipids and sphingolipids. Samples of fluorescent lipid analogs containing NBD-aminocaproyl (C6-NBD) or NBD-aminododecanoyl (C12-NBD) acyl chains were synthesized and analyzed by the following HPLC methods. An isocratic normal phase method permitted resolution of a mixture of the 1,2-(palmitoyl, C6-NBD) analogs of triacylglycerol, diacylglycerol, phosphatidic acid, phosphatidylethanolamine, and phosphatidylcholine in less than 10 min, while a mixture of the (C6-NBD)-labeled analogs of ceramide, glucocerebroside, and sphingomyelin was separated in approximately 15 min. This method also detected various (C6-NBD)-phosphatidylcholine and -phosphatidylethanolamine molecules which differed only in their nonfluorescent acyl (oleoyl or palmitoyl) chains, and readily separated nonfluorescent dipalmitoylphosphatidylcholine from both (C6 NBD)- and (C12-NBD)-phosphatidylcholine derivatives. An isocratic reverse-phase system permitted separation of isomers of fluorescent phosphatidylcholine, ethanolamine, -glycerol, -inositol, -serine, and phosphatidic acid in which the NBD-fatty acid was present in either the sn-1 or sn-2 position of the glycerol backbone. PMID- 3812988 TI - Determination of cell number in monolayer cultures. AB - Determining the cytostatic or cytotoxic effects of various conditions on monolayer cells requires techniques that are rapid, reproducible, and able to monitor these effects as a function of time. Methods currently used to monitor cytostasis or cytotoxicity are either static or indirect; that is, they are designed to test effects of various treatments either at single time points or on associated cellular processes, such as membrane integrity. Because of these limitations in extant techniques, we undertook this study to improve methods for the rapid determination of cell number in monolayer cultures. We have arrived at conditions of staining cell nuclei with crystal violet under fixed regimens which allow rapid and reproducible quantification of cell number in cultures grown in 24-well miniwells. Quantification is possible by solubilizing the adsorbed dye into a solution of Triton X-100 and determining optical density (O.D.) using spectrophotometry. The present communication documents that O.D. is linearly related to cell number with a sensitivity of ca. 500 cells and that the technique is applicable to study agents which affect cell proliferation. PMID- 3812989 TI - A study of interferences in glucose measurements in blood by hydrogen peroxide based glucose probes. AB - The main blood constituents which could interfere in clinical glucose measurements using a hydrogen peroxide based glucose electrode have been investigated using several different membranes and constant and sweeping potentials. Both diluted and whole undiluted sera were investigated. With a 3500 molecular weight cut-off (MWCO) membrane, acetaminophen, cysteine, and ascorbic acid can interfere. With a 100 MWCO membrane, only acetaminophen interfered. PMID- 3812990 TI - Isolation of ribosomal subunits from an extremely halophilic archaebacterium Halobacterium halobium by hydrophobic interaction chromatography. AB - A new method was developed for a simple, rapid, and effective preparation of ribosomal subunits from the extremely halophilic archaebacterium Halobacterium halobium using hydrophobic interaction chromatography on phenyl-Sepharose CL-4B. One milliliter of swollen gel matrix (total bed volume) bound up to 15 A260 units of 70 S ribosomes. By a stepwise reduction of the ionic strength first 50 S and then 30 S subunits were solubilized and differentially eluted. The pooled fractions containing 50 S and 30 S subunits, respectively, were adjusted to higher ionic strength and concentrated by ultrafiltration. The yield of purified (30 S + 50 S) subunits was up to 60% of the input of 70 S ribosomes. Poly(U) dependent polyphenylalanine synthesis assay demonstrated that the subunits were as active as native 70 S ribosomes. 30 S and 50 S subunits of nonhalophilic Escherichia coli, however, were not isolated separately by the application of this method. PMID- 3812991 TI - Density-based separation of liposomes by glycerol gradient centrifugation. AB - Sonicated liposomes of soybean phospholipids (asolectin) distribute nearly throughout a 19-22% (v/v) glycerol gradient when centrifuged to near equilibrium. Upon recentrifugation on an identical gradient, liposomes selected from several positions in such a gradient migrate as narrow bands to positions close to their original positions, indicating that the liposome distribution in the first gradient is the result of a density-based fractionation. Molecular sieve chromatography, turbidity, and trapped volume measurements indicate that the liposome densities are qualitatively related to their size, with the larger liposomes more dense than the smaller ones. Size estimates obtained by electron microscopy of negatively stained preparations indicate that the fractionation is effective for liposomes with diameters ranging from 200 to 600 A, with maximum efficiency in the range 200-300 A where the majority of the liposomes is found. Interestingly, high concentrations of liposomes improve the efficiency of the fractionation procedure. The size dependence of liposome density is shown not to be due to differential glycerol permeability or lipid composition, and is therefore most likely due to variations in the specific volumes of the individual phospholipid molecules owing to the curvature of the liposomes. Finally, freezing of the glycerol gradient fractions in liquid N2 and storage at -70 degrees C does not modify the size of the isolated liposomes. It is suggested that glycerol density gradient fractionation of liposomes could be a useful general method for obtaining liposomes of reasonably uniform size in large quantities and high concentrations. PMID- 3812992 TI - Cooled sample introduction probe for liquid secondary ionization mass spectrometry. AB - The design and performance of a cooled sample introduction probe for fast atom bombardment or other liquid secondary ionization mass spectrometric studies are described. Cooling relatively volatile matrix materials (sulfolane, thioglycerol, and tetraglyme, for example) in situ in the ion source can increase the duration of the sample spectrum by a factor of 10. Cooling also permits a much wider range of matrix materials to be used. As an example, the spectrum of the carbohydrate, peracetyl [Glu(beta 1----3)]7 Glucitol in tetraglyme matrix, is shown to give an excellent spectrum including cleavage peaks corresponding to losses of the first five sugar residues. The spectrum lasted approximately 10 times longer when the probe tip was cooled to 9 +/- 1 degrees C than when no cooling was used, corresponding to a 10-fold increase in integrated sensitivity. PMID- 3812993 TI - Interference by lipids in the determination of protein using bicinchoninic acid. AB - Bicinchoninic acid forms the basis of an analytical method for the determination of protein. The reagent produces a purple complex with cuprous ion (Cu+) in an alkaline environment and is the basis for the monitoring of cuprous ions produced in the reactions of proteins with alkaline Cu2+. This method of protein determination was reported to have greater tolerance to many commonly encountered interfering compounds, when compared to the Lowry technique. However, we have found the bicinchoninic acid technique to produce erroneously high values for protein when common membrane phospholipids were included in the assay. Phospholipids in the presence of bicinchoninic acid produced an absorbance peak similar to that produced by protein. This absorbance was linear with concentration, however, the slope varied for individual phospholipids. The combined absorption of phospholipid and protein was not strictly additive. The results indicate that the presence of appreciable quantities of lipid in samples can cause significant error in the analysis of protein by the bicinchoninic acid procedure. PMID- 3812994 TI - High-performance ion-exchange chromatographic separation of proteoglycans. AB - Proteoglycans synthesized by cultured human muscle cells were separated by ion exchange high-performance liquid chromatography using a Bio-gel TSK DEAE 5-PW analytical column. The procedure requires only 40 min to complete. The same analytical size column can be used for either analytical or semipreparative scale separations without significant loss of resolution. Proteoglycans elute from the TSK column with a similar recovery and at similar elution ionic strengths when compared to the established cellulose-based chromatographic gel, DEAE-Sephacel. The technique has been applied to the analysis of chondroitinase-digested samples and is particularly useful for rapid screening of large numbers of cultures for both biosynthetic rate studies and analysis of patterns of proteoglycan synthesis. PMID- 3812995 TI - A solid-phase competitive radioimmunoassay for the insulin receptor. AB - A radioimmunoassay for the insulin receptor has been developed. In this assay, unlabeled receptor competes with 125I-labeled receptor for binding to monoclonal anti-receptor antibodies immobilized on microtiter wells coated with affinity purified anti-mouse immunoglobulin G. This assay was highly reproducible and could detect 7 ng (14 fmol) of insulin receptor. By utilizing monoclonal antibodies to various antigenic regions of the receptor, different parts of the receptor molecule could be examined. By utilizing antibodies to the cytoplasmic domain of the receptor, an assay was developed which was not influenced by the presence of insulin and could equally detect the insulin receptor from different species (rat and human) and different tissues (placenta and brain). By utilizing antibodies to an autophosphorylation site of the receptor, the assay was shown capable of detecting the extent of phosphorylation of the receptor. Finally, this assay was utilized to monitor the decrease in insulin receptors in lysates of insulin-treated human lymphocytes. This radioimmunoassay should be useful for monitoring both the number and status of the insulin receptor under a variety of physiological conditions. PMID- 3812996 TI - A rapid method for the isolation of peroxisomes from rat liver. AB - A preparative method for the isolation of peroxisomes from the liver of normal, untreated rats is described. The peroxisome-enriched "light mitochondrial" fraction is layered on a 30% Nycodenz (5-[N-2,3-dihydroxypropylacetamido]-2,4,6 triiodo-N,N'-bis[2, 3-dihydroxypropyl]isophthalamide) solution containing 1 mM tetrasodium EDTA and then centrifuged in an angular rotor for 1 h at 130,000gavg. Peroxisomes are sedimented to the bottom leaving other organelles at the top of the tube. On the basis of morphological and biochemical studies, it is found that the peroxisomes (marker-enzymes catalase and urate oxidase) obtained in this method are not contaminated with lysosomes (marker-enzyme acid phosphatase) and contained very few mitochondria (marker-enzyme succinate-cytochrome c reductase) and microsomal vesicles (marker-enzyme glucose-6-phosphatase). PMID- 3812997 TI - High-performance liquid chromatography and ultraviolet spectrophotometry for quantitation of tryptophan in barytic hydrolysates. AB - A procedure for quantitation of tryptophan in feedstuffs is described. It is based on barytic hydrolysis of material at 125 degrees C for 16 h, acidification of hydrolysate to pH 3 with HCl, high-performance liquid chromatography on Nova Pak C18 (Waters Assoc.), and spectrophotometric determination of tryptophan at 280 nm. The recovery of tryptophan from lysozyme added to samples ranges from 98.7 to 100%. PMID- 3812998 TI - The use of disulfonatonaphthalimide fluorescent dyes for the fluorescence polarization immunoassay of steroids. AB - A series of fluorescent disulfonatonaphthalimide derivatives of testosterone and estriol have been synthesized and their fluorescent properties investigated. The fluorescence lifetimes of these derivatives were higher than that of the unreacted fluorescent dye while the quantum yields were of the same order. The compounds were therefore compared in terms of their utilizability in steroid fluorescence polarization immunoassays. The assay sensitivity and precision with each compound is discussed in terms of the position, type, and length of the chemical "bridge" linking the steroid to the fluorescent dye. It is proposed that these fluorescent labels are highly appropriate to this type of immunoassay. PMID- 3812999 TI - In situ melanin assay for MSH using mouse B16 melanoma cells in culture. AB - A sensitive in situ melanin assay using cultured mouse B16 melanoma cells is described for structure-activity studies with melanocyte-stimulating hormone (MSH) peptides. B16 Cells were seeded at a density of 2500 cells per well in 96 well microtest tissue culture plates; after 24 h the cells were incubated in the presence of serial dilutions of MSH peptides for 3 to 5 days. The melanin released into the medium of each well was then determined spectrophotometrically at a wavelength of 405 nm using an automatic microplate reader calibrated against synthetic melanin. Studies with alpha-MSH, [Nle4, D-Phe7]-alpha-MSH, [3'-iodo Tyr2]-alpha-MSH, adrenocorticotropin (ACTH)(1-24), and ACTH(1-39) showed that the peptides had identical intrinsic activities and that the relative potencies were similar to those obtained with a tyrosinase assay. The EC50 of alpha-MSH was 27 pM, i.e., about five- to sevenfold lower than that in the assays for tyrosinase or intracellular melanin. Thus, the new assay represents the most sensitive melanoma cell assay for MSH available to date. PMID- 3813000 TI - Use of high-performance liquid chromatography for quantitative determination of the native form of the third component C3 of human complement. AB - A high-performance liquid chromatography method is reported for the quantitative determination of the intact C3, the third component of complement, in solutions containing inactivated C3. This method is simple and far more sensitive than a conventional method using 5,5'-dithiobis(2-nitrobenzoic acid). PMID- 3813001 TI - One-lane sequence analysis of oligodeoxyribonucleotides. AB - Treatment of 5'-end 32P-labeled oligodeoxyribonucleotides with 0.4 M aqueous piperidinium formate, pH 2, at 37 degrees C for 6 h, followed by treatment with 1 M aqueous piperidine at 90 degrees C for 6 h, produces, after electrophoresis through 27% polyacrylamide sequencing gels, one-dimensional distributions of radioactivity from which the base sequences can be deduced. The order of intensities for the bands signaling the various bases is G greater than A greater than C greater than T. The spacing from a given band to the next higher band in the ladder was base characteristic, the order of band spacings being G greater than T greater than or equal to A greater than C. In contrast to the one-cleavage one-lane DNA sequencing method reported earlier (B. J. B. Ambrose and R. C. Pless, 1985, Biochemistry 24, 6194-6200), which was based on treatment of end labeled DNA with hot aqueous piperidine in the presence of sodium chloride, the present method produces a salt-free hydrolysate, thus minimizing electrophoretic irregularities in the fastest moving bands. PMID- 3813002 TI - Sodium-sensitive glass microelectrode: modified Thomas recessed-tip configuration. AB - Using a glass-membrane, sodium-sensitive microelectrode, a modified Thomas sodium sensitive electrode has been developed. The modified Thomas electrode possesses a high sensitivity (57.9 mV/log aNa), a high selectivity (KpotNa,K less than 0.005), a relatively low electrical resistance (7.65 X 10(11) ohms), a small sensing chamber (10 microns3), and can be made in the double-barreled configuration. The modified Thomas electrode is designed to directly measure the intracellular sodium concentration of epithelial cells. PMID- 3813003 TI - Determination of amine oxidases in tissues by peroxidation-induced chemiluminescence of phthalazines. AB - A method is proposed for the determination of the activity of amine oxidases in purified samples and tissue homogenates. The method is based on the chemiluminescence of luminol and other cyclic hydrazides elicited by the horseradish peroxidase-catalyzed peroxidation using H2O2 produced in the amine oxidase reaction. Several aspects of the chemiluminescence method for determining enzymatic activity in crude tissue extracts are discussed. PMID- 3813004 TI - An automated method for determining buoyant density of nucleic acids using a preparative ultracentrifuge. AB - We present a technique for analytical buoyant density sedimentation of nucleic acids which is performed in a preparative ultracentrifuge, in contrast to an analytical ultracentrifuge. Following centrifugation in a preparative rotor, small cylindrical quartz tubes are optically scanned; upon completion of the scan the data are processed immediately by a microcomputer and the buoyant density of the nucleic acid is calculated. Experimental data are presented employing several different deoxyribonucleic acids banded in neutral and alkaline cesium sulfate. Results are independent of rotor speed, location of bands within the gradient, and loading density of the cesium sulfate solution. Derived buoyant density values agree within 0.5% of previously published values. PMID- 3813005 TI - Radioimmunoassay of rat apolipoprotein A-IV. AB - We have developed a specific and sensitive radioimmunoassay for rat apolipoprotein A-IV (apoA-IV). The protocol includes treatment of the samples for 1 h at 60 degrees C with 0.7% Tween 20. Under these conditions, linear logit-log plots have been obtained for apoA-IV in lymph and plasma lipoprotein fractions as well as for purified apoA-IV. The sensitivity of the assay is to 20 ng. Absolute mass values obtained with the assay were validated by comparison with values obtained with an independent method of colorimetric reading of apoA-IV separated by polyacrylamide gel electrophoresis from plasma high density lipoproteins. The concentration of apoA-IV in fasting plasma averaged 10.2 mg/dl and in the mesenteric duct lymph 15.8 and 12.6 mg/dl during the fasting and the fat absorption states, respectively. PMID- 3813006 TI - Mass spectrometric methods for protein sequencing. PMID- 3813007 TI - Indirect determination of nitrogenated drugs by atomic absorption spectrometry. PMID- 3813008 TI - Spectrofluorometric method for the determination of N-nitroso compounds. PMID- 3813009 TI - Determination of protein in human serum by high-performance liquid chromatography with semiconductor laser fluorometric detection. PMID- 3813010 TI - Fluorescence determination of streptomycin in serum by reversed-phase ion-pairing liquid chromatography. PMID- 3813011 TI - Study of temperature and mobile-phase effects in reversed-phase high-performance liquid chromatography by the use of the solvatochromic comparison method. PMID- 3813012 TI - Simultaneous determination of phenylephrine hydrochloride and pheniramine maleate in nasal spray by solvent extraction-flow injection analysis using two porous membrane phase separators and one photometric detector. PMID- 3813013 TI - Amperometric flow injection determination of fructose with an immobilized fructose 5-dehydrogenase reactor. PMID- 3813014 TI - Liquid chromatography with electrochemical detection and coulometric investigations of carbamate and urea pesticides. PMID- 3813015 TI - Differentiation of isomeric acylcarnitines using tandem mass spectrometry. PMID- 3813016 TI - Rank annihilation with incomplete information. PMID- 3813017 TI - Capillary gas chromatography/pulsed supersonic jet/fluorescence excitation spectroscopy for the identification of methylanthracenes in a complex environmental sample. PMID- 3813018 TI - Laser videofluorometer system for real-time characterization of high-performance liquid chromatographic eluate. PMID- 3813019 TI - Molecular fluorescence in thin liquid films. PMID- 3813020 TI - Fiber-optic probe for kinetic determination of enzyme activities. PMID- 3813021 TI - Simultaneous determination of free homovanillic acid, (3-methoxy-4 hydroxyphenyl)ethylene glycol, and vanilmandelic acid in human plasma by high performance liquid chromatography coupled with dual-electrode coulometric electrochemical detection. PMID- 3813022 TI - Comparison of Jarrell-Ash, Perkin-Elmer, and modified Perkin-Elmer nebulizers for inductively coupled plasma analysis. PMID- 3813023 TI - Electron capture negative ion chemical ionization mass spectrometry of 1,2,3,4 tetrachlorodibenzo-p-dioxin. PMID- 3813024 TI - Extension of dynamic range in Fourier transform ion cyclotron resonance mass spectrometry via stored waveform inverse Fourier transform excitation. PMID- 3813025 TI - Further studies of the hydration model for ionic activities in unassociated electrolytes. PMID- 3813026 TI - Development of extended X-ray absorption fine structure spectroelectrochemistry and its application to structural studies of transition-metal ions in aqueous solution. PMID- 3813027 TI - Ion chromatographic procedure for bicarbonate determination in biological fluids. PMID- 3813028 TI - Fluorometric determination of nitrite with 4-hydroxycoumarin. PMID- 3813029 TI - Chemical procedure for preparing surface-enhanced Raman scattering active silver films. PMID- 3813030 TI - Identification and colorimetric determination of organic cyanates in nanomolar quantities. PMID- 3813031 TI - Laser-desorption Fourier transform mass spectrometry of synthetic porphyrins. PMID- 3813032 TI - Feedback search of hierarchical trees. PMID- 3813033 TI - Characterization of a diet reference material for 17 elements. PMID- 3813034 TI - Sensitive adsorptive stripping voltammetric measurements of antihypertensive drugs. PMID- 3813035 TI - Simultaneous determination of major and trace elements in urinary calculi by microwave-assisted digestion and inductively coupled plasma atomic emission spectrometric analysis. PMID- 3813036 TI - Quantitative determination of sulphamethazine and carbadox in animal feeds by paired ion high-performance liquid. PMID- 3813037 TI - Direct determination of chlorhexidine in urine by high-performance liquid chromatography. PMID- 3813038 TI - [The central retinal artery of the white laboratory mouse]. AB - The white laboratory mouse has an Arteria centralis retinae which differs from the Arteria centralis retinae of the human in the following points being: The origin of this artery hies in the region where the Arteria bulbi comes through the Sclera and therefore does not enter the Nervus opticus until she is in the wall of the Bulbus oculi. In the retina the Arteria centralis retinae divides into 6 radiating branches. PMID- 3813039 TI - [Craniofacial growth influenced by blood supply. 1. Collaterals and anastomoses following unilateral ligation of the common carotid artery]. AB - The influence of the blood supply on craniofacial growth was investigated in 396 albino rats (Rattus norvegicus Berkenhout). This was done by blocking the right common carotid artery of animals aged 42 d. The rats were slaughtered at previously specified intervals after the operation. The ligature led to dilation of the other major arteries of the neck. Numerous collaterals and anastomoses were also formed. These occurred on the ligature side in the flow region between the proximal and distal stumps of the right common carotid artery, between the flow regions of the right external carotid artery and the right vertebral artery and between the flow regions of the right subclavian artery and the right external carotid artery. Further anastomoses arose between the arteries of the other side, i.e. the rostral thyroid artery, lingual artery, submental artery and labial mandibular artery. PMID- 3813040 TI - The corrected circumference of human pulmonary trunk and arteries in relation to the size of aorta and principal bronchi. AB - The corrected circumference of the pulmonary trunk, its branches and ascending aorta as well as the maximum diameter of the principal bronchi, were measured in 120 human fresh cadavers of subjects (60 males and 60 females) aged between 27 and 91 years, died of natural causes. The statistical analysis of the obtained data yielded the following main results: 1) the corrected circumference of the pulmonary trunk, smaller than that of the aorta, is not statistically correlated with the age of the subjects and does not present significant degrees between the 2 sexes; 2) the right and left pulmonary arteries have a corrected circumference quite similar in the 2 sexes and statistically correlated with that of the vessel of origin; 3) both the right pulmonary artery and the right principal bronchus have sizes greater than the left ones, possibly due to the greatest volume and weight of the right lung; 4) the lackness of a correlation between the size of the pulmonary arteries and those of the respective bronchi shows once more the difficulty of identifying general rules concerning the interrelationship between vascular and ductal human structures. PMID- 3813041 TI - On the cavum septi pellucidi and the cavum Vergae. AB - A cavum septi pellucidi continuous with a cavum Vergae, of the noncommunicating type, was found in a human brain and is described in detail. Out of 89 brains that were examined, a cavum septi pellucidi was present in 16 brains, an incidence of 17.97%; the cavum septi pellucidi and cavum Vergae were both in one brain, an incidence of 1.12%. The cavum Vergae never occurred alone in any of the specimens studied. A review of the literature is made and the following concepts are advanced: 4 types of cava are suggested, including the noncommunicating form which, anatomically, is the typical cavum; these noncommunicating cavities contain cerebrospinal fluid that filters through the septal laminae and is reabsorbed by capillaries and veins of the septa. The main aspects regarding the anatomy, histology and embryology of these cavities is reviewed. The cavum septi pellucidi and the cavum Vergae occur undetected in many instances, and when they are apparent it is because they are part of a wide spectrum of defects in the central nervous system and in other organ systems. At present, the existence and diagnostic significance of these ventricular cavities is becoming recognized by modern procedures, such as computed tomographic scanning. PMID- 3813042 TI - [Electromyography of the trapezius muscle (upper portion) and the levator muscle of the scapula in certain arm movements]. PMID- 3813043 TI - Scanning and transmission electron microscopic study of the ampullary region of the dog vas deferens, with special reference to epithelial phagocytosis of spermatozoa and latex beads. AB - The present SEM and TEM study clearly indicated that the epithelial cells of the ampulla vasis deferentis of the dog are capable of performing phagocytosis of degraded spermatozoa and even inert latex beads as in other animals described previously and further supported our working hypothesis that epithelial phagocytosis may be a common event in the vas deferens of mammals, though its precise significance remains to be clarified. PMID- 3813044 TI - Emissary occipital foramen. AB - 214 skulls were studied for the present study. A small foramen in the squamous part of the occipital bone just behind foramen magnum was noticed for the passage of emissary vein in one skull only, probably connecting occipital sinus with suboccipital venous plexus. PMID- 3813045 TI - The use of ketotifen, a mast cell blocker, for treatment of oligo- and asthenozoospermia. AB - Treatment of idiopathic oligo- and asthenozoospermia by the mast cell blocker Ketotifen leads to a very moderate, but statistical significant improvement of sperm count and sperm motility. However, pregnancy rate was within the range of spontaneous conceptions. To evaluate the possible significance of this new treatment approach further research is mandatory to elucidate the relationship between mast cell proliferation and dysfunction of the blood-testis barrier. PMID- 3813046 TI - Evoked sacral potentials in subjects with true premature ejaculation. AB - Evoked sacral potentials were used to study the bulbo-cavernous reflex in 85 patients with true premature ejaculation (TPE) and in 52 subjects as a control group. In the perineal and perianal recordings the amplitudes of the evoked responses (means +/- SD) were 70 +/- 91.1 microV and 35.6 +/- 36 microV in the TPE patients, and 39.2 +/- 36.8 microV and 26 +/- 21.6 microV in the controls, respectively. Both these differences resulted significant (P less than 0.01 and P congruent to 0.05, respectively). Our results suggest a reflex hyperexcitability, or an impaired "modulation" of the motor neurons of the pudendal nucleus by the regulating upper centers in the TPE patients. PMID- 3813047 TI - [14C]-2-deoxyglucose uptake studies in Leydig cells. AB - The present study examines several aspects of [14C]-2-deoxyglucose uptake by rat Leydig cells: the characteristics of uptake by Leydig cells and type of inhibition by cytochalasin B, the effect of other drugs on [14C]-2-deoxyglucose uptake, the specificity of the glucose transporter for other substrates and the effect of various hormones. The apparent Km and V for [14C]-2-deoxyglucose were 0.4 mM and 0.17 mumol/min/10(6) cells, respectively. The inhibition of [14C]-2 deoxyglucose by cytochalasin B was competitive in nature, with an apparent Ki of 0.28 microM. Both phloretin and phlorizin (1.0-50 microM) inhibited [14C]-2 deoxyglucose uptake in a dose-dependent manner. Although D-glucose inhibited [14C]-2-deoxyglucose uptake by Leydig cells, L-glucose was ineffective, reflecting the stereospecificity of the glucose transporter for the former substrate. Various hormones, including: insulin, LH, 17 beta-estradiol or growth hormone which have been reported to stimulate glucose uptake in cells from other tissues, had no effect on [14C]-2-deoxyglucose uptake in Leydig cells under the current conditions. It remains to be determined how glucose uptake in Leydig cells is regulated. PMID- 3813048 TI - Megalospermatocytes: indicators of disturbed meiosis in man. AB - Megalospermatocytes are degenerating primary spermatocytes which do not develop any further than to leptotene stage of the prophase of meiosis. In histological sections they are prominent because of their size (approximately 24 microns in diameter). The nucleus of a megalospermatocyte presents single strands of chromosomes only. The cytoplasm contains extremely widened vesicles and cisternae of the ER which are filled with a finely granular electron dense material. Megalospermatocytes may appear singular in small groups in the testis tissue of young men with varying fertility disturbances. They are relatively frequent in testis tissue of men older than 65 years. Here they represent a special form of a rest of spermatogenetic activity in the germinal epithelium. PMID- 3813049 TI - Further evidence for an inhibitory effect of L-tryptophan loading on testicular functions of rat. AB - Quantitative analysis of spermatogenesis at stage VII of the cycle of the seminiferous epithelium, radioimmunoassay of plasma testosterone and spectrofluorometric assay of brain 5-hydroxytryptamine (5-HT) levels were performed following administration of L-tryptophan (LT) alone and in Carbidopa pretreated Wistar strain rats. Carbidopa, an inhibitor of peripheral L-aromatic amino acid decarboxylase, was used to prevent the peripheral conversion of LT to 5-HT. The rats were sacrificed in groups on the day after (8th day) and 13 days after (21st day) the cessation of 7 days of treatment. The time duration of 13 days is approximately equivalent to one cycle of the seminiferous epithelium in Wistar strain rats. LT enhanced the brain 5-HT level, the increase being much greater in Carbidopa plus LT treated rats. However, reduction of plasma testosterone was similar in both the treated groups. There was no significant change in count of the germ cells on the day after cessation of treatment. However, marked degeneration of step 7 spermatids was observed when the analysis was performed 13 days after cessation of treatment. Human chorionic gonadotropin (HCG) administration along with Carbidopa plus LT treatment partially prevented the step 7 spermatid degeneration. These findings suggest that the inhibition of spermatogenesis and steroidogenesis following LT administration was secondary to decreased pituitary gonadotropin secretion which is in turn under the influence of brain 5-HT neurones. There is a minimum possibility of a direct action of LT, after conversion to 5-HT, on testicular tissue. PMID- 3813050 TI - Electrophoretic characterization of mouse epididymal esterases in inbred lines and in a natural population. AB - Esterase isozymes were studied in mouse epididymis of two inbred strains (C57BL, DBA/2) and in a natural population (Swiss OF1), by using vertical polyacrylamide gel electrophoresis and staining with alpha or beta-naphthyl acetate as a substrate. Eighteen (C57BL), 17 (DBA/2) or 16 (Swiss OF1) epididymal isozymes were separated; four were common to the testis, and five to both the testis and the serum. The use of different inhibitors showed that carboxylesterase activities account for the greater part of the total epididymis non-specific esterase activity. This comparative study revealed minor interspecies variations since only two isozymes were not expressed in the same manner in the three populations examined. Among the nine isozymes which appeared solely in the epididymis, the profiles varied between tissues and fluids as well as between the proximal part in which sperm maturation occurs and the distal part where sperm storage takes place. The variations proceeded from the relative activity of isozymes and the presence or absence of some of them; two characterized the proximal part and one the distal part in the three species. By comparing testis and epididymal tissues and fluids, it is suggested that the isozymes found in epididymal fluids originated from the testis, the epididymal epithelium or both. In addition to this epididymal secretory function, the lack in the fluid of the distal part of one isozyme identified in the testis, and two in the proximal part may also provide evidence for its reabsorptive function. PMID- 3813051 TI - Kinetic properties of hexokinase of germ cells in rat testis. AB - The Michaelis-Menten constants (Km) of glucose, fructose, galactose, 2-deoxy-D glucose and ATP as substrate for hexokinase of spermatocyte, spermatid and cauda epididymal spermatozoa extracts were measured. The Km value of glucose was very similar for all three germ cells. It was also true for all other substrates. The affinity of glucose for this enzyme was the highest while that of fructose was the lowest. The Km values were in general agreement with characteristics of hexokinase extracted from other tissues of rat. The Vmax values were also determined. The Vmax ratio of fructose to glucose showed the highest values of 1.1. The Vmax ratios of other substrates to glucose were below 1.0. The results suggest that hexokinase in the germ cells is similar to that in other tissues in its kinetic properties. PMID- 3813052 TI - Comparison of the short-term effects of vasoligation and open-ended vasectomy on the reproductive tract of the male rat. AB - Comparison was made between the short term effects of vasoligation and open-ended vasectomy in the rat at 2, 4 and 8 weeks after surgery. Epididymal granulomata were observed in 2/5 and 1/5 rats respectively 2 and 4 weeks after vasoligation. No epididymal granulomata were observed following open-ended vasectomy, providing some support for the suggestion that this procedure may be beneficial in reducing early post operative complications in the epididymis. An unexpected observation in the 2 week open-ended vasectomy group was the finding that in 2 of 5 animals the proximal end of the vas had been temporarily obstructed by overgrowth of a fibromuscular cap. Increased distal cauda epididymidis tubule diameter in these animals suggested an increased intratubular pressure. No sustained differences were seen in the incidence of granulomata or in the response of the testis or epididymis to either vasectomy procedure by 8 weeks. The results suggest, because of the high incidence of granulomata formation following vasoligation in the rat, that by 8 weeks after surgery both vasectomy procedures are equally effective in preventing further damage in the epididymis caused by elevated intraluminal pressures. PMID- 3813053 TI - Examinations of polyvidone-iodine as an irrigation solution for spermatic duct occlusions. AB - In vitro experiments with human sperm as well as animal experiments were carried out to test the applicability of polyvidone-iodine as an irrigation solution for spermatic duct occlusions. The substance polyvidone-iodine was initially chosen on the basis of spermiograms because of its ability to immobilize spermatozoa, and then its spermicidal effect was clearly proven by means of eosin vital staining. The aim of the animal experiments was to examine the substance for possible histotoxic side effects and to ascertain the retention of residual sperm in the ampulla area of the vas deferens. Polyvidone-iodine fulfills all the required criteria as an irrigation solution: it is definitely spermicidal with no long-term histotoxic side effects; in addition, it acts as a disinfectant and is easily obtainable as well as inexpensive. Postoperative azoospermia is attained in animal experiments after four weeks at the most. PMID- 3813054 TI - Cardiovascular function during controlled hypotension induced by adenosine triphosphate or sodium nitroprusside in the anesthetized dog. AB - The present study was undertaken to compare the hemodynamic effects of adenosine triphosphate (ATP) and sodium nitroprusside (NP) given in equieffective doses to induce hypotension during halothane anesthesia. Eight dogs, instrumented with pressure and ultrasonic dimension transducers for assessment of left ventricular (LV) performance, were given both NP and ATP. Regional blood flow was measured by radioactive microspheres. After 20 min of infusion, both drugs decreased systemic arterial pressure by 36% with minimal changes in cardiac index (CI), LV end diastolic pressure, or heart rate. However, hypotension produced by ATP was associated with a greater CI (3.84 +/- 0.32 vs 2.97 +/- 0.35 L X min-1 X m-2) than was NP and also associated with a further decrease in systemic vascular resistance (14.4 +/- 1.4 vs 17.7 +/- 2.2 mm Hg X L-1 X min X m2). Left ventricular global function, measured by the slope of the linear regression line of the LV end-systolic pressure-diameter relation (Ees), did not change significantly after either drug. Blood flow to the coronary bed was significantly greater with ATP than with NP (231.6 +/- 30.6 vs 81.7 +/- 6.1 ml X min-1 X 100 g 1). Except for an increase in hepatic arterial blood flow with NP, neither ATP nor NP significantly altered blood flow to the brain, spinal cord, spleen, kidney, jejunum, muscle, and skin. Controlled hypotension by ATP was stable and rapidly reversible without rebound hypertension. The results of this study indicate that ATP is a rapidly acting, effective hypotensive agent that compares favorably with NP. PMID- 3813055 TI - Effect of pregnancy on bupivacaine-induced conduction blockade in the isolated rabbit vagus nerve. AB - Bupivacaine-induced conduction blockade of A, B, and C fibers of the isolated vagus nerve was compared in fourteen pregnant and fourteen nonpregnant rabbits. After a control period in HEPES-Liley solution, the isolated nerves were exposed to bupivacaine concentrations of 0.1 mM to 1.0 mM. After 30 min exposure, the nerves were stimulated supramaximally and the percent reduction in amplitude of A, B, and C fiber compound action potentials was recorded. Linear regressions were fitted by the least squares method. The A fiber conduction blockade was consistently greater in the nerves from pregnant rabbits (P less than 0.001). The slope of the C fiber dose-response curves was also significantly greater in nerves from pregnant rabbits (P less than 0.01). The results indicate that the response of isolated nerves from pregnant animals to local anesthetic-induced conduction blockade differs from that of nerves from nonpregnant animals. However, it is not certain whether the difference is related simply to a more rapid diffusion and shorter onset of block or an enhanced sensitivity of the nerve membrane during pregnancy. PMID- 3813056 TI - Body mass and spread of spinal anesthesia with bupivacaine. AB - The effect of body mass on spinal anesthesia with isobaric 0.5% bupivacaine was examined in 90 patients. The first 50 patients received 3 ml isobaric 0.5% bupivacaine. Another 40 patients, selected at random to receive 3 ml of either hyperbaric or isobaric bupivacaine 0.5%, were then studied. Levels of pin-prick analgesia and motor block were tested during induction, surgery, and recovery. The effects of high spinal anesthesia on peak expiratory flow (PEF) and arterial blood gas tensions were also examined in the last 40 patients. With isobaric bupivacaine, persons with higher than normal BMI [body mass index = weight (kg) divided by height-squared (m2)], or persons who were shorter than normal had higher cephalad spread of anesthesia. With hyperbaric bupivacaine only shorter individuals developed higher levels of anesthesia. Because of considerable interindividual variability, however, these observations are of only limited clinical value in predicting the spread of bupivacaine spinal analgesia. The higher spread of analgesia was associated with a decrease in PEF, whereas, the blood gas tensions remained undisturbed. PMID- 3813057 TI - Hepatic dysfunction after isoflurane anesthesia. AB - Four members of the Anesthetic and Life Support Advisory Committee of the Food and Drug Administration assessed the contribution of isoflurane (Forane) to 45 instances of hepatic dysfunction after isoflurane anesthesia reported to the FDA for 1981-1984. For 29 (64%) of the cases, at least three members concluded that nonanesthetic causes (e.g., hypoxia, sepsis, viral infection) explained the hepatic injury. For 16 cases (36%), two or more members concluded that isoflurane might be one of several possible causes of the hepatic injury. In the latter cases, patients tended to be younger, had undergone anesthesia of shorter duration for operations outside the chest and abdomen, had developed symptoms later, had higher plasma transaminase values but lower bilirubin values, and had a lower incidence of eosinophilia, anemia, transfusions, and congestive heart failure. The committee concluded that current evidence does not indicate a reasonable likelihood of an association between the use of isoflurane and the occurrence of postoperative hepatic dysfunction. PMID- 3813058 TI - Hypertonic saline as a resuscitation solution in hemorrhagic shock: effects on extravascular lung water and cardiopulmonary function. AB - To determine the effect of resuscitation with hypertonic saline on extravascular lung water, seven adult sheep were endotracheally intubated; mean arterial pressure (MAP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), and central venous pressure (CVP) were monitored. A 5-French, thermistor-tipped catheter was used to measure extravascular lung water (EVLW). Colloid oncotic pressure (COP), serum electrolytes and osmolality, and arterial and mixed venous blood gas tensions were measured. The COP-PCWP gradient and the shunt fraction (Qsp/Qt) were calculated. After baseline measurements, the animals were bled to an MAP of 50 mm Hg (blood volume removed, 16.2 +/- 3.6 ml/kg), which was maintained for 30 min, measurements then being repeated. Three percent sodium chloride solution was infused at 500 ml/15 min until two of three parameters- cardiac output (CO), PCWP, or MAP--were restored to baseline values. Data were recorded again and then 60 min later. No shed blood was reinfused. The total volume of hypertonic saline infused was 39 +/- 19 ml/kg. Pulmonary artery pressure did not vary throughout the study. PCWP, MAP, and CO were significantly lower than baseline (P less than 0.05) 30 min after bleeding but all except MAP returned to baseline with resuscitation. Throughout the study, EVLW did not vary despite a COP-PCWP gradient less than 4 mm Hg. Serum sodium levels and serum osmolality were significantly above baseline values after resuscitation. In this animal model of hemorrhagic shock, infusion of hypertonic saline effected resuscitation without compromising cardiopulmonary function or increasing EVLW. PMID- 3813059 TI - Fundamental properties of local anesthetics. I. The dependence of lidocaine's ionization and octanol:buffer partitioning on solvent and temperature. AB - The protonation equilibrium and hydrophobic character of lidocaine were characterized by its pKa and the octanol:buffer partition coefficients of the charged (P+) and neutral (Po) drug species. These measurements were accomplished by ultraviolet spectrophotometry of pure lidocaine HCl solutions at different temperatures, ionic strengths, and buffer concentrations. Corroboration of the pKa determination by the potentiometric method and of the partition coefficients by gas chromatography validated the general application of the spectrophotometric technique. The pKa increased with decreasing temperature (7.61 +/- 0.06 at 36 degrees C; 7.94 +/- 0.04 at 26 degrees C, in water; mean +/- SD), increasing ionic strength (8.06 +/- 0.02 at 26 degrees C in 0.165 M NaCl) and increasing buffer capacity (8.28 +/- 0.06 at 25 degrees C in 0.15 M NaCl + 20 mM buffer). Octanol:buffer partition coefficients for both the protonated and the neutral species (expressed as mole fractions) increased upon warning: 0.55 +/- 0.04 and 2666 +/- 202, respectively, at 25 degrees C, and 0.75 +/- 0.09 and 3210 +/- 272, respectively, at 36 degrees C. Ionic strength and buffer concentration had no significant effect on either P value. The increase in pKa at lower temperatures coupled with the decreased partition coefficients resulted in a nearly constant concentration of the protonated species in octanol as the system was cooled, whereas the concentration of the neutral species fell by more than 80%. This finding may explain the large increase in the impulse blocking potency of lidocaine observed upon nerve cooling, if the protonated anesthetic species is the more active form of the drug competing with the neutral species for a common binding site. PMID- 3813060 TI - Narcotics decrease heart rate during inhalational anesthesia. AB - We determined the heart rate (HR) response to enflurane, halothane, and isoflurane and the effects of narcotics on this response in 81 healthy patients scheduled for elective surgery. Patients were randomly assigned to one of six treatment groups: one of the three anesthetics (approximately 0.9 MAC) in 60% nitrous oxide, and either 0.15 mg/kg of intramuscular morphine 30-60 min before induction or 1 microgram/kg of IV fentanyl 10 min after skin incision. All patients received diazepam, 10 mg orally, 60-90 min before anesthesia, a rapid sequence intravenous induction, and mechanically controlled ventilation. During inhalational anesthesia and the first 10 min of surgery, no significant change in HR occurred in any group (compared to the preinduction HR), although patients given morphine premedication tended to have a decreased HR and those not given morphine premedication tended to have an increased HR. These trends partially account for significant differences that emerged between groups after induction of anesthesia. Patients given morphine premedication and halothane had lower HR (64 +/- 3 SEM) than patients given isoflurane (80 +/- 3) or enflurane (84 +/- 3) and no morphine premedication. Patients anesthetized with enflurane and morphine premedication had lower HR (71 +/- 3) than patients given enflurane without morphine premedication. Administration of fentanyl 10 min after incision (these patients had received no morphine) significantly decreased HR in the presence of any of the vapors. We conclude that inhalational anesthetics used in the clinical setting we employed do not significantly increase heart rate, and that prior administration of morphine or concurrent administration of fentanyl may significantly decrease HR. PMID- 3813061 TI - Plain or hyperbaric bupivacaine for spinal anesthesia. AB - Three ml of bupivacaine 0.5%, either plain or in 8% glucose, was injected intrathecally in three groups of twenty patients. Group 1 received bupivacaine 0.5% plain; group 2 received bupivacaine 0.5% in 8% glucose. Patients in groups 1 and 2 were kept sitting for 3 min after injection. Patients in group 3 received bupivacaine 0.5% in 8% glucose and were placed in the supine horizontal position immediately after injection. Observations of patients in group 3 were observer blind and in groups 1 and 2 double blind. The differences between segmental levels of sensory and temperature loss between groups 1 and 2 and between groups 2 and 3 were statistically not significant. Motor blockade of the lower extremities was more intense in the patients who were kept sitting for 3 min (groups 1 and 2). It is concluded that both solutions are equally suitable for spinal anesthesia, provided patients receiving the plain solution are kept sitting for at least 2 min. When using hyperbaric bupivacaine, posture seems to have no influence on cephalad spread. PMID- 3813062 TI - The lumbar subdural extraarachnoid space of humans: an anatomical study using spinaloscopy in autopsy cases. AB - The lumbar subdural extraarachnoid space was examined by spinaloscopy in 15 autopsy subjects. Special attention was paid to the ease with which the space opened up and also to the extent of view achieved. In ten cases the space opened up with ease, in four cases with difficulty, and in one case it was not possible to establish the subdural space at all. The bevel of an 18-gauge Tuohy needle introduced into the subdural space could be visualized in eight of 13 cases. An epidural catheter was then passed through the Tuohy needle into the subdural space in eight cases and was visualized in six of them. Although care must be exercised in drawing conclusions for clinical epidural anesthesia from autopsy cases, this study confirms the possibility of placing both the bevel of a Tuohy needle and an epidural catheter in the subdural space. The results reemphasize the need for caution suggested by other reports regarding the possibility of subdural puncture in epidural anesthesia and subsequent injection of anesthetic solution into the subdural space. PMID- 3813063 TI - Effects of 100% oxygen and a mixture of oxygen and air on oxygen saturation in the immediate postoperative period in children. AB - Arterial oxygen saturation during transportation of children from the operating room to the recovery room and in the recovery room was monitored in two groups of patients, one given 100% oxygen at the end of anesthesia, the other given a 50:50 mixture of oxygen and air. The oxygen-air group had a statistically significantly higher incidence of hypoxemic episodes. Preoxygenation with 100% oxygen before transfer from the operating room reduces the incidence of hypoxemia in children. PMID- 3813064 TI - Effect of cimetidine on duration of action of succinylcholine. PMID- 3813065 TI - Status asthmaticus treated with isoflurane and enflurane. PMID- 3813067 TI - Esophageal activity and light anesthesia. PMID- 3813066 TI - A case of difficult neonatal ventilation. PMID- 3813069 TI - A simple way to limit anesthetic pollution during anesthetic induction. PMID- 3813068 TI - Prolonged unilateral mydriasis after nasal septal reconstruction. PMID- 3813070 TI - Difficult airway? PMID- 3813071 TI - Does silent aspiration during endotracheal anesthesia cause pulmonary aspiration syndrome? PMID- 3813072 TI - Abstracts of papers and posters presented at the International Anesthesia Research Society 61st congress. Lake Buena Vista, Florida, March 14-18, 1987. PMID- 3813073 TI - Cardiovascular and electrophysiologic interactions between diltiazem and isoflurane in the dog. AB - The effects of the calcium entry blocker diltiazem (iv loading dose 0.4 mg/kg, iv maintenance dose 0.4 mg/min) and subsequent isoflurane-induced hypotension to mean aortic pressures of 70 and 55 mmHg on global and regional right ventricular (RV) and left ventricular (LV) performance (ultrasonic dimension technique), on coronary (electromagnetic flow probes) and systemic hemodynamics, and on electrophysiologic parameters (PR, QRS, QTc intervals) were studied in eight open chest dogs, anesthetized and paralyzed by continuous infusions of fentanyl and pancuronium. Diltiazem at a plasma concentration of 282 +/- 33 ng/ml (mean +/- SE) caused significant (P less than 0.05) increases in coronary blood flows, and decreases in coronary and systemic vascular resistances with only little effect on global and regional RV and LV function. However, the PR interval increased by 40%, and three animals developed II degrees atrioventricular block type I. At stable diltiazem plasma levels, administration of isoflurane caused dose dependent decreases in myocardial segment shortening and stroke volume with unchanged LV or increased RV preload, and little changed RV or reduced LV afterload indicating myocardial depression. Coronary and systemic vascular resistances remained unaffected. At the higher concentration of isoflurane (mean inspired 1.3 +/- 0.2%), seven animals developed intermittent sinus node arrests with pauses up to 12 s followed by intermittent junctional escape or sinus rhythms. Similar interactions might develop in patients on diltiazem receiving isoflurane. PMID- 3813074 TI - The cardiovascular and adrenergic actions of verapamil or diltiazem in combination with propranolol during halothane anesthesia in the dog. AB - Continuous infusions of verapamil and diltiazem were established in halothane anesthetized dogs (1.15-1.35% end tidal concentration) with or without a concomitant propranolol infusion to investigate changes: in cardiovascular function, in reflex activation as reflected in circulating catecholamine levels, and in the chronotropic response to the exogenously administered beta agonist, isoproterenol. Verapamil plasma levels of approximately 100 and 250 ng X ml-1, diltiazem plasma levels of approximately 140 and 325 ng X ml-1, and propranolol levels of approximately 70 ng X ml-1 were tolerated individually in the presence of halothane, although atrioventricular conduction was prolonged in the verapamil and diltiazem groups. Catecholamine levels were increased in the high verapamil group. However, when propranolol was combined with the lower levels of verapamil or diltiazem, the result was decreased heart rate, blood pressure, left ventricular maximum rate of tension development (dP/dt), and cardiac index with increased systemic vascular resistance. When the attempt was made to proceed to the increased plasma levels of verapamil or diltiazem in the presence of propranolol, 6/6 animals in the verapamil-propranolol group and 4/6 animals in the diltiazem-propranolol group were unable to maintain a mean arterial blood pressure of greater than 50 mmHg, and many developed 2 degrees or higher heart block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813075 TI - Morphine pharmacokinetics in early infancy. AB - The pharmacokinetics of morphine in ten infants less than or equal to 10 weeks of age who were receiving morphine infusions were determined. Infants 1-4 days of age (newborns) showed longer elimination half-lives than the older infants (6.8 vs. 3.9 h). Clearance in the newborns is less than one-half that found in older infants (6.3 vs. 23.8 ml X min-1 X kg-1). The combination of lower clearance and longer elimination half-life in newborns (0-7 days) may well explain a prolonged duration of action for morphine in very young infants, but other etiologies are needed to explain the respiratory sensitivity believed to persist in older infants. PMID- 3813076 TI - Cardiovascular effects of and interaction between calcium blocking drugs and anesthetics in chronically instrumented dogs. IV. Chronically administered oral verapamil and halothane, enflurane, and isoflurane. AB - Dogs were chronically instrumented to measure aortic and left atrial blood pressures, left ventricular maximal rate of tension development (dP/dt), cardiac output, and carotid, coronary and renal blood flows. Measurements were taken with the animals awake and during steady-state low and high concentrations of halothane (1.2%, 2.4%), enflurane (2.4%, 4.0%), and isoflurane (1.6%, 3.0%) with and without at least 2 weeks of oral verapamil, 120 mg, three times per day. Plasma verapamil levels varied widely, with means of 500-700 ng X ml-1 in awake animals and lower (300-400 ng X ml-1) at the time of hemodynamic measurements during anesthesia. Chronic oral verapamil in awake dogs produced predominantly tachycardia. The hemodynamic effects of low-dose halothane and isoflurane before and after oral verapamil were unchanged except for decreased renal blood flow after oral verapamil and no coronary vasodilation nor tachycardia. However, left atrial pressure was increased and cardiac output and coronary blood flow were decreased by low concentrations of enflurane with oral verapamil compared to without. The combination of oral verapamil with low (clinical) doses of enflurane was more depressant to the cardiovascular system of healthy dogs than was the combination of verapamil and halothane or isoflurane. PMID- 3813077 TI - Effects of barbiturate anesthesia on functional residual capacity and ribcage/diaphragm contributions to ventilation. AB - The effect of iv methohexital infusion anesthesia on functional residual capacity (FRC) (helium dilution) in 14 surgical patients (age 23 to 59 years) was determined. Eight subjects were studied wearing an inflatable mask, sealed with surgical lubricant. They showed a mean +/- SD 3.5 +/- 6.4% FRC decrease (no significance). Six subjects studied via mouthpiece awake and via endotracheal tube during anesthesia showed a mean 22 +/- 19% reduction in FRC, significantly greater than face mask studies (P less than 0.05). The greatest FRC decrease occurred in subjects with repetitive or protracted coughing after intubation. The serum methohexital level was 6.6 +/- 3.6 micrograms/ml for intubated patients, and 6.0 +/- 1.1 micrograms/ml in those with face mask (no significance). The depth of anesthesia was sufficient to produce a 50% reduction in ventilatory response to CO2 rebreathing, from 15.8 to 8.7 l/min/% CO2. Respitrace plethysmography indicated a 38 +/- 12% ribcage contribution to tidal volume during quiet breathing, which increased to 47 +/- 14% with CO2 breathing (end tidal FCO2 9-10%). There was no dimunition of ribcage contribution during anesthesia in either group, irrespective of CO2 concentration. The authors interpret their findings to indicate that iv methohexital anesthesia does not produce FRC reduction, in contrast to an inhaled anesthetic such as halothane. It is proposed that this difference may be related to maintenance of coordinated ribcage/diaphragm muscle activity, because ribcage activity is markedly suppressed by halothane. In addition, it is proposed that FRC reduction in intubated subjects was the result of a confounding variable, namely coughing in response to the endotracheal tube. PMID- 3813078 TI - Lung collapse and gas exchange during general anesthesia: effects of spontaneous breathing, muscle paralysis, and positive end-expiratory pressure. AB - Lung densities (atelectasis) and pulmonary gas exchange were studied in 13 supine patients with no apparent lung disease, the former by transverse computerized tomography (CT) and the latter by a multiple inert gas elimination technique for assessment of the distribution of ventilation/perfusion ratios. In the awake state no patient had clear signs of atelectasis on the CT scan. Lung ventilation and perfusion were well matched in most of the patients. Three patients had shunts corresponding to 2-5% of cardiac output, and in one patient there was low perfusion of poorly ventilated regions. CT scans after 15 min of halothane anesthesia and mechanical ventilation showed densities in dependent lung regions in 11 patients. A shunt was present in all patients, ranging from 1% in two patients (unchanged from the awake state) to 17%. Ventilation of poorly perfused regions was noted in nine patients, ranging from 1-19% of total ventilation. The magnitude of the shunt significantly correlated to the size of dependent densities (r = 0.84, P less than 0.001). Five patients studied during spontaneous breathing under anesthesia displayed both densities in dependent regions and a shunt, although of fairly small magnitude (1.8% and 3.7%, respectively). Both the density area and the shunt increased after muscle paralysis. PEEP reduced the density area in all patients but did not consistently alter the shunt. It is concluded that the development of atelectasis in dependent lung regions is a major cause of gas exchange impairment during halothane anesthesia, during both spontaneous breathing and mechanical ventilation, and that PEEP diminishes the atelectasis, but not necessarily the shunt. PMID- 3813079 TI - Effects of halothane on medullary inspiratory neurons of the cat. AB - The effect of halothane on the electrical activity of inspiratory neurons of the nucleus tractus solitarius (NTS) was studied in decerebrate, paralyzed, mechanically ventilated cats. Simultaneous recording of the activity of the neurons of the NTS and the phrenic nerve was done to identify the inspiratory neurons. Cells whose firing activity was synchronous with that of the phrenic nerve were considered inspiratory neurons. Administration of 1% and 1.5% halothane in oxygen induced a dose-dependent depression of the cell activity (spikes/s) with the cervical vagi intact or severed. Five and ten minutes after inhalation of 1% halothane, the cell activity (mean +/- SE) expressed as per cent of the control was 55.3 +/- 9 and 27 +/- 7, respectively (P less than 0.001), before bilateral cervical vagotomy. The corresponding values for 1.5% halothane were 25 +/- 10.1 and 5.6 +/- 3, respectively. Upon termination of halothane administration, the cell activity gradually returned toward the control level. The cell response to halothane was not affected by bilateral cervical vagotomy. Hypercapnia produced by inhalation of 5% CO2 increased the cell activity, but halothane caused profound depression of the cells even in the presence of hypercapnia. Based on these results, it may be concluded that: halothane has inhibitory effects on the activity of the inspiratory neurons of the NTS; and halothane-induced respiratory depression has a central component and that the NTS may serve as a site of action of halothane for its respiratory depressant effect. PMID- 3813080 TI - Effect of nitrous oxide on the oxyhemoglobin dissociation curve and PO2 measurements. AB - Blood from 20 ASA physical status I patients collected before and after induction of anesthesia was used in vitro to reexamine the effects of nitrous oxide on the oxyhemoglobin dissociation curve and the response of the oxygen electrode. The preinduction P50 values with and without 70% N2O were 28.4 +/- 0.1 mmHg and 26.8 +/- 0.1 mmHg, respectively. The postinduction P50 values with and without N2O were unchanged, namely 28.4 +/- 0.1 mmHg and 26.8 +/- 0.1 mmHg, respectively. Our data confirm the observation that N2O causes a small elevation of P50 (P less than 0.001) and that this effect is both rapidly inducible and reversible. Our results also indicate that N2O has no effect on polarographic PO2 measurements. PMID- 3813081 TI - Studies of local anesthetic action on natural spike activity in the aortic nerve of cats. AB - The aortic nerve was used to study the blocking action of procaine and bupivacaine on natural spike activity. In anesthetized cats, a segment of the aortic nerve was placed in a perfusion chamber and exposed to increasing drug concentrations, varying pH, while temperature remained constant. Total nerve activity was recorded continuously, and its change was related to drug concentration. The half-time of recovery following drug wash-out was also determined. At pH 7.4, the minimal blocking concentration was 0.5 X 10(-3) mol/l for procaine and 0.05 X 10(-3) mol/l for bupivacaine, the half-times of recovery 1.4 and 3.0 min, respectively. Procaine and bupivacaine reversibly blocked natural spike activity at the same concentrations as they blocked electrically evoked activity. The aortic nerve, whose physiologic spike traffic can be followed continuously for hours, may be used to advantage for studying the long term effects of local anesthetics in vivo. PMID- 3813082 TI - A jet-stylet endotracheal catheter for difficult airway management. PMID- 3813083 TI - Effects of fluid therapy on serum glucose levels in fasted outpatients. PMID- 3813084 TI - A prospective evaluation of femoral artery monitoring in pediatric patients. PMID- 3813085 TI - A comparison of aperiodic analysis of the EEG with standard EEG and cerebral blood flow for detection of ischemia. PMID- 3813086 TI - The occurrence of obstructive sleep apnea in a recovery room patient. PMID- 3813087 TI - Transient hypoxemia from a transient right-to-left shunt in a child during emergence from anesthesia. PMID- 3813088 TI - Temporary paraplegia following spinal anesthesia in a patient with a spinal cord arteriovenous malformation. PMID- 3813089 TI - Prevention of intraoperative myocardial ischemia during noncardiac surgery with intravenous diltiazem: a randomized trial versus placebo. PMID- 3813090 TI - Hyperkalemia, verapamil, and dantrolene. PMID- 3813091 TI - Inhibition of postanesthetic shivering with radiant heat. PMID- 3813092 TI - Control of endotracheal tube cuff pressure using a simple device. PMID- 3813093 TI - Mini-spike dispensing pin--an efficient way to prepare dantrolene. PMID- 3813095 TI - Bronchial cuff pressure: comparison of carlens and polyvinylchloride (PVC) double lumen tubes. PMID- 3813094 TI - Subarachnoid block: two for the price of one? PMID- 3813096 TI - Carcinogenic potential of nitrous oxide. PMID- 3813097 TI - Detection of contaminated nitrous oxide. PMID- 3813098 TI - [Treatment principles and methods in acute liver and kidney failure]. PMID- 3813099 TI - [Possibilities of correcting the structural and functional changes in the cardiac lymphatic bed in the postresuscitation period using complex infusion therapy]. PMID- 3813100 TI - [Morfilong for long-term postoperative analgesia]. PMID- 3813101 TI - [Extracorporeal membrane oxygenation of the blood in myocardial infarct]. PMID- 3813102 TI - [Gluco- and mineralocorticoid function of the adrenals during prolonged conduction anesthesia in the postoperative period]. PMID- 3813103 TI - [Hexenal anesthesia and immunity]. PMID- 3813104 TI - [Prevention of the postoperative and postnarcotic suppression of humoral immunity]. PMID- 3813105 TI - [Effect of surgery and anesthesia on the body's immune status and the course of the postoperative period]. PMID- 3813106 TI - [Structural changes in the liver and kidneys in traumatic illness with various methods of resuscitation]. PMID- 3813107 TI - [Effect of the respiratory rate on the tidal volume and ventilatory minute volume in high-frequency jet-controlled artificial pulmonary ventilation]. PMID- 3813108 TI - [Effect of N20 and ftorotan on cerebrospinal fluid production and resorption]. PMID- 3813109 TI - [Methodologic aspects of hemosorption in clinical medicine]. PMID- 3813110 TI - [Hemosorption using a SUMS-1 sorbent in staphylococcal septicemia]. PMID- 3813111 TI - [Catheter embolism of the heart and vessels]. PMID- 3813112 TI - [Treatment of the croup syndrome in children at the resuscitation stage]. PMID- 3813113 TI - [The laryngotracheal angle in children and its significance in the practice of the anesthesiologist and of the resuscitation specialist]. PMID- 3813114 TI - [Use of epidural anesthesia in middle-aged and elderly patients for operations in the aortofemoral area]. PMID- 3813115 TI - [Case of combined tetanus and gas gangrene]. PMID- 3813116 TI - [Liver function during etran anesthesia and surgery: clinico-morphologic comparisons]. PMID- 3813117 TI - Clinical experience with a new rate-responsive TX pacemaker. AB - In this report, we describe our initial experience with a new rate-responsive TX pacemaker in 10 patients. This pacemaker system uses a conventional transvenous ventricular electrode, which senses the evoked QT interval after a ventricular paced beat, as an indicator of physiological metabolic demand. Implantation of the TX pacemaker does not differ from that of conventional VVI units, and two special modes are available after implantation: TX and VVI mode. Bicycle ergometer tests showed that significantly higher rate response and exercise ability were achieved during the TX mode compared with the VVI mode (mean maximal heart rate: 115 +/- 13 bpm vs 96 +/- 21 bpm, p less than 0.01, and mean maximal exercise time; 10.7 +/- 3.9 min vs 8.0 +/- 3.8 min, p less than 0.01, respectively). In one patient, cardiac index was measured by a thermodilution method during the bicycle ergometer test, which confirmed that an adequate increase in cardiac index (rest: 3.38 liters/min/m2, vs exercise; 7.34 liters/min/m2) was obtained by an increase of the pacing rate (rest: 72 bpm vs exercise: 128 bpm). Our results show that physiological rate-responsive pacing using the QT interval provides a simple means of increasing the heart rate and cardiac index. PMID- 3813118 TI - Theory and methods of local tissue-pO2 monitoring in experimental angiology. AB - The platinum-multiwire-surface electrode after Kessler and Lubbers gives the opportunity of direct measuring of the local tissue-pO2-pressure; this 8-wire electrode with a Pt-wire-diameter of 15 microns operates on the polarographic principle. Each Pt-wire has a hemispheric collecting area of about 30 microns. Pressure ischemia by compression of capillaries is prevented by proportioning the weight (2.1 g) of the electrode. Data output is done by continuous pO2 measuring; pO2 histograms. During the continuous pO2 measurement the electrode stays on the tissue measuring point thus enabling the direct record of quickly proceeding reactions. The pO2-histogram exhibits the statistical distribution of the local partial oxygen pressures in a studied organ, a quasi sample inquiry is performed in the tissue, based on minimum 100 single values that are obtained by repeated manual repositioning of the electrode. By this, values are obtained on the level and distribution of local pO2 in the tissue so that condition and function of the microcirculation can be objectively assessed. Immediate alterations in the local tissue pO2 suggest regulatory adjustment after hemodynamic changes. Technical problems connected with pO2 measurement in clinical use (sterilization, data acquisition and presentation) are described. The presented technique gives the chance to exactly assess the effects of vasoactive drugs on the microcirculation and to quantify the results of operations, for example after bypass-surgery. PMID- 3813119 TI - The influence of R-wave amplitude on the degree of ST-segment depression in exercise electrocardiography in the individual patient. AB - Many factors have been found to influence the magnitude of ST-segment depression in the exercise electrocardiogram. We investigated whether R-wave amplitude is a significant factor. We studied the exercise electrocardiogram of 20 patients with angiographically documented coronary artery disease, including greater than or equal to 70% stenosis of the left anterior descending artery, who had an ischemic response to exercise but no previous anterior myocardial infarction. Precordial leads V1-6 were taken into account. When all 120 leads were measured, those with ST-segment depression greater than or equal to 2.0mm at peak exercise had a mean resting R-wave amplitude of 19.03 +/- 5.81mm; those with ST-segment depression 2.0-1.0mm, R 11.42 +/- 5.99mm; and those with ST-segment depression less than 1.0mm, R 5.9 +/- 5.21mm (p less than 0.001 between groups). When the R-wave amplitude was correlated with the ST-segment depression in each precordial lead, the correlation was 1.0. In leads V1-6, when 67 tracings with ST-segment depression greater than 0.5mm were measured, the correlation was 0.537 (p less than 0.001). In each precordial lead the t values of R-wave differences correlated very strongly (r less than 0.883) with the differences in ST-segment depression. We conclude that precordial R-wave amplitude significantly influences the magnitude of ST-segment depression. PMID- 3813120 TI - Myocardial ultrastructure in Kearns-Sayre syndrome. AB - Myocardial ultrastructural changes are described in a twenty-five-year-old female with typical Kearns-Sayre syndrome. The electrocardiogram revealed complete atrioventricular block with an occasional torsades de pointes type of ventricular tachycardia. His bundle recording demonstrated HV block with normal AH interval. An endomyocardial biopsy showed "ragged-red fibers" by the modified Gomori trichrome stain, and on electron microscopy there were increased numbers of morphologically abnormal mitochondria: ie, gian mitochondria, a whorled pattern of the cristae, and electron-dense substances, and paracrystalline inclusions in the mitochondria. The patient has been well since pacemaker implantation, but she may develop a clinically overt cardiomyopathy due to progression of myocardial involvement. PMID- 3813121 TI - Kaposi's sarcoma following corticosteroid treatment for temporal arteritis--a case report. AB - After three months of corticosteroid treatment, a sixty-nine-year-old man, suffering from temporal arteritis, developed a Kaposi's sarcoma (KS) initially located on the left ankle and subsequently spread over both feet and hands. Laboratory data showed a deficiency of both humoral and cellular immunity and constant positivity in the tests for cytomegalovirus. The onset of KS during corticosteroid treatment of temporal arteritis is an extremely rare occurrence, this case being only the second one reported in the literature. In our case the development of this neoplasm can be related to an immunodeficiency that led to a deficit in the immunological surveillance, along with an activation of oncogenic viruses. PMID- 3813122 TI - Radiolabeled platelets in detecting the source of recurrent pulmonary emboli--a case report. AB - Multiple pulmonary emboli are recognized to be the cause of progressive pulmonary failure. In these patients, the source of emboli may be difficult to detect, even by venography. The authors describe the use of autologous Indium 111-labeled platelets to locate the origin in a patient with progressing right heart failure. PMID- 3813123 TI - Pulmonary artery agenesis presenting as massive hemoptysis--a case report. AB - Massive hemoptysis is the expectoration of approximately 600 ml of blood in twenty-four hours. Major causes of massive hemoptysis are tuberculosis, bronchiectasis, pulmonary neoplasm, fungus ball, bronchial adenomas, lung abscess, intrabronchial rupture of an aortic aneurysm, cystic fibrosis, pulmonary infarction, and pulmonary trauma. Other, less common causes include Goodpasture's syndrome, broncholiths, pulmonary varix, A-V malformation, and bleeding disorders. Agenesis of the pulmonary artery usually occurs in association with congenital cardiac anomalies, and isolated unilateral absence of the pulmonary artery is uncommon. About 10% of the patients with pulmonary artery agenesis develop inconsequential hemoptysis, but massive hemoptysis is a very rare complication of this anomaly. The following is a case report of a twenty-nine year-old man with agenesis of the left pulmonary artery, who presented with massive hemoptysis requiring embolization and, eventually, pneumonectomy. PMID- 3813124 TI - Early disappearance of lymphatics draining ischemic myocardium in the dog. AB - To assess myocardial lymphatics during the evolution of myocardial infarction we performed lymphangiographic studies thirty and three hundred sixty minutes after occlusion of the left anterior descending coronary artery in 92 dogs. A morphometric index was employed on a coded basis to assess the lymphangiograms. Well before myocardial necrosis was evident, at thirty minutes, a striking reduction was evident in lymphatic filling in the ischemic zone: similar changes were seen three hundred sixty minutes after occlusion. Heparin in doses that rendered blood incoagulable did not prevent the lymphatic occlusion or collapse, but they were prevented by two agents that act as cardiac lymphagogues, hyaluronidase and CLS 2210. Lymph flow from the heart was assessed in another 23 dogs. Lymph flow fell sharply after coronary artery occlusion in placebo-treated dogs but was well maintained in dogs treated with hyaluronidase and with CLS 2210. The reduction in cardiac lymphatic filling and lymph flow occurred too early to be a consequence of myocardial necrosis. To the extent that reduced lymphatic drainage allows the local accumulation of potentially toxic products, it could contribute to the local damage. Treatment with the lymphagogues not only maintained lymphatic patency but also reduced evidence of myocardial damage evident on examination by light and electron microscopy. These studies provide an alternative to commonly held concepts on how hyaluronidase reduces myocardial infarction after coronary artery occlusion and support the concept that lymphatic occlusion or collapse plays a role in myocardial infarction. PMID- 3813125 TI - The slow response to therapy in a patient with multiple admissions for bronchial asthma. PMID- 3813127 TI - Vomiting as a dominant symptom of asthma. AB - These three cases are presented as additional evidence that vomiting can be a dominant symptom of asthma. Coughing and wheezing can be overlooked or ignored. Asthma must be considered in the differential diagnosis of vomiting. PMID- 3813126 TI - Reliability and predictive value of salivary theophylline levels. AB - The reliability and accuracy of salivary theophylline levels as a predictor of serum theophylline levels was investigated in 28 hospitalized chronic asthmatics, free of other chronic diseases, on continuous aminophylline infusion for greater than 24 hours. Twenty paired blood and saliva theophylline levels from 12 patients (group 1) were used to develop a formula for predicting serum theophylline levels from salivary levels. Twenty-one paired blood and saliva theophylline levels from 16 patients (group 2) were used to test the formula obtained. The formula predicted the serum theophylline concentration within 1.51 microgram/mL in 76% of the samples and within 1.88 microgram/mL in 100% of the samples. There was an excellent correlation between the predicted and actual serum theophylline concentrations, r = .93; thus under controlled conditions of steady-state pharmacokinetics in patients free of other diseases, salivary theophylline levels can be used to accurately predict serum levels. PMID- 3813128 TI - Modification of bronchial hyperreactivity during pollen season in children allergic to grass. AB - Ten children, sensitive to grass pollens with seasonal rhinitis and mild asthma, underwent bronchial challenge with carbachol in the pre-seasonal, seasonal, and post-seasonal period. According to pollen count, we observed significant differences between pre-seasonal, seasonal, and post-seasonal values. Also basal FEV1 values varied in the same fashion. Seven of the ten children also participated in a previous similar study in 1984, at which time they did not demonstrate significant variations to bronchial challenge. We wish to emphasize the importance of pollen concentration in the atmosphere as well as the existence of a threshold value of grass pollen necessary for a significant modification in bronchial reactivity to occur. PMID- 3813129 TI - Positive skin tests to fern spore extracts in atopic patients. AB - Thirty-six atopic and eight non-atopic adult volunteers who had been exposed to ferns in their homes, were skin tested with extracts obtained from seven species of house ferns. Out of the 36 atopic patients, 18 had positive skin reactions to at least one out of seven species of the most common house ferns, whereas none of the non-atopic, healthy controls had positive reactions to any of the ferns. PMID- 3813130 TI - Hereditary angioedema associated with selective IgA deficiency. PMID- 3813131 TI - An attempt to prevent anaphylaxis by aerosolized antigen in guinea pigs. AB - In an attempt to provide an alternative and safer technique of specific hyposensitization for those patients for whom the conventional treatment presents a high risk for anaphylaxis, we used a guinea pig model for extracorporeal hyposensitization. We sensitized three groups of guinea pigs with an olive pollen extract. Two of the groups were sensitized before removal of their buffy coat and the third group was sensitized after the removal of their buffy coat. The buffy coat cells were incubated with the same antigen and intracardially reinjected into their respective donors. Subsequent challenges by aerosolized antigen and intracardiac injections were performed. We did a basophil degranulation on random samples of buffy coat of tested and control animals. We skin tested the animals and we examined the histopathology of their lungs. The animals reinjected with the incubated buffy coat prior to sensitization showed a greater protection from aerosolized antigen and the onset of their anaphylactic symptoms was significantly delayed when compared with controls. The results of basophil degranulation studies showed that animals sensitized before removal of their buffy coat had approximately a threefold increase of degranulated basophils as compared with animals that were sensitized after removal of buffy coat and approximately a fourfold increase when compared with controls. This degranulation did not affect the specific skin test. Histopathologic observations did not reveal any characteristics typical of anaphylaxis. PMID- 3813132 TI - Food allergy and adult migraine. PMID- 3813133 TI - The National Coalition on Immune System Disorders. PMID- 3813134 TI - [Determination of choriogonadotropin (hCG). Current problems]. PMID- 3813135 TI - [Comparison of 2 rapid systems for evaluating the sensitivity to antibiotics of 170 strains of Enterobacteriaceae: the Rapid ATB and the Autobac]. AB - Susceptibility of 170 strains of Enterobacteriaceae to 17 antibiotics was determined by 2 rapid automated sensitivity testing systems. The general agreement between the two methods was 95 p. cent. Discrepancies have been compared with the standard method of MIC's determination. PMID- 3813136 TI - [A manual method for the direct determination of serum iron using a new chromogen: chromazurol B]. AB - The authors describe a manual method for the direct assay of iron in human serum using the ammonium salt of Chromazurol B. This new chromogen reacts with ferric or ferrous ions and cetyltrimethylammonium bromide giving a purple ternary complex. Reliability and practicability of the method are studied. The results correlate very well either with those of the SFBC's method or with a direct ferrozine-guanidine kit. The reagents are very cheap, the method is quickly performed; no significant interference could be observed in case of high concentrations of added bilirubin, copper or hemoglobin. PMID- 3813137 TI - [A rapid method for the determination of cyclosporin A in blood by high performance liquid chromatography]. AB - The purpose of this paper is to propose a method for the determination of cyclosporin in whole blood by means of HPLC with UV detection. After a one step extraction into ether, the organic layer is washed NaOH and evaporated to dryness. The residue is reconstituted in a mixture of acetonitrile and water (40/60) (V/V) and injected into the chromatograph. The C8 reversed phase column is warming at 75 degrees C temperature. The mobile phase consists of acetonitrile and water (60/40) (V/V) and the wavelength is set at 210 nm. The technique is rapid, sensitive, reproducible and well suited for therapeutic monitoring and for pharmacokinetic studies. PMID- 3813138 TI - [Rapid determination of serum myoglobin: may the diagnosis of myocardial infarction be disproven during the first 6 hours after typical chest pain?]. PMID- 3813139 TI - Misclassification of a commercially available enzyme as lipoprotein lipase. PMID- 3813140 TI - [Genetic aspects of atherogenic dyslipoproteinemias]. AB - Beyond persistent underestimation of atherogenic dyslipoproteinemias of genetic origin, which account altogether for one out of 50 births, and even more, considerable advances have been done, in the last past years, about molecular and genetic basis of metabolic defects, and possible various mutations--at this level. These major advances include not only the discovery of LDL Apo B100 receptor pathway by M. Brown and J. Goldstein with various mutations about synthesis or cellular processing of these receptors, but also some critical amino acid substitutions in molecular sequence of apoprotein E, as well as apoprotein A1, A2, and perhaps, also apoprotein B. Chromosomal localisation of all these coding genes, and identification of there exons and introns are also available. And practical use of genetic probes could appear promising a very next future. PMID- 3813141 TI - [Oral premedication with diazepam]. AB - A double blind study has been carried out on patients scheduled for appendicectomy. They were divided into two groups who were given diazepam as premedication either orally or intramuscularly. The clinical effects were measured with regard to anxiolysis, gastric contents volume and acidity. Orally premedicated patients were not significantly less anxious. No significant differences between both groups concerning gastric contents (volume and pH) were found. Therefore, oral premedication did not increase the risk of inhalation. Taking into account the previous findings in the literature, the pharmacological advantages of the oral route and the lack of complications, a wider use of oral premedication for elective operations in adults is recommended. PMID- 3813142 TI - [Brachial plexus block in children. Approach through the brachial canal]. AB - This study included 35 children (average age: 8 years) undergoing surgery of the upper limb under brachial plexus block. The brachial plexus was approached by the brachial canal route, which is a simple, rapid and efficient way (34 were successful). The main advantage of this technique was the avoidance, in most children, of general anaesthesia as a complement. In addition, postoperative analgesia was satisfactory in all cases. In spite of large doses and volumes of lidocaine and bupivacaine used with this technique, no complication was observed. PMID- 3813143 TI - [Femoral nerve block as a postoperative analgesia technic in surgery of the knee]. AB - A femoral nerve block was performed as a postoperative analgesic technique in 50 patients after knee surgery; this surgery is a very painful one. The technique used was the inguinal route, as described in the textbooks. Bupivacaine was used: 1.5 mg X kg-1 without exceeding 150 mg. The result was good in 46 patients, with four failures. The average duration of analgesia was 600 min, the shortest being 300 min, the longest being 1,200 min. This technique can be recommended after surgery of the knee as safe and reliable. PMID- 3813144 TI - [Sciatic nerve block by the anterior approach in surgery of the legs]. AB - Forty-four sciatic nerve blocks were performed by the anterior route in combination with forty-four "3-in-1" blocks and seven lateral femoral cutaneous nerve blocks. The use of radioscopy for determining the anatomic injection points made the technique easier and safer. It was preferred for patients in whom general anaesthesia was not desirable for lower limb surgery. PMID- 3813145 TI - [Spinal anesthesia with bupivacaine for surgery of the hip in the elderly]. AB - In 60 elderly patients, spinal anaesthesia for orthopaedic hip surgery was induced randomly with 15 mg bupivacaine 0.375% without glucose (Group I), 2.5% glucose (Group II) or 7.5% glucose (Group III), in 4 ml. The injection was made in the lateral position, and the patients turned supine immediately after. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. The hyperbaric solutions produced a greater cephalad spread of analgesia (T8,9 and T9,8 respectively) than the glucose-free solution (T10,5). The mean duration of analgesia at the L2 level with the isobaric solution was significantly greater: 187 min versus 171 min and 150 min with the hyperbaric solutions. All the patients had complete motor blockade of the lower limb. The mean duration of the motor block was significantly shorter for the 2.5% and 7.5% glucose solutions (137 and 125 min respectively for Bromage's degree 3) versus 170 min for the glucose-free solution. Although the pre-anaesthetic arterial pressures in the three groups did not differ significantly, the systolic, mean and diastolic arterial pressures decreased only by about 20 to 25% in all groups. It was suggested to take into account the more rapid infusion of lactated Ringer's solution (20 ml X kg-1) in Group III. Anaesthesia was satisfactory in 95% of patients in Group I and Group II, and 90% in Group III. Glucose-free bupivacaine produced a long-lasting blockade suitable for hip surgery of long duration. PMID- 3813146 TI - [Drugs used in a medical intensive care unit]. AB - The treatments of 400 consecutive patients admitted in a 22-bed adult medical intensive care unit (ICU) were analysed prospectively. One hundred and thirty-one different drugs were prescribed with a mean of 5 +/- 4 drugs per patient (means +/- SD), during 8 +/- 11 days. The most commonly prescribed drugs were 1) preventive drugs, 2) antibiotics, 3) psychoactive drugs and analgesics. Two thirds of the drugs were administered by a parenteral route. Mean daily cost was low: 57 FF per patient (6.3 US dollars, 1984), most of this being due to the prescription of antibiotics (59.8%). The wide range of drugs prescribed in different ICU precludes the compilation of a restricted list of drugs to be used in ICU. Nevertheless, prescription guidelines are suggested consisting of the discussion, for each patient, of the prescription of any of four types of drugs: those of the organ failure(s), of the underlying disease(s), preventive drugs, and finally comfort drugs. PMID- 3813147 TI - [Acute fatty liver of pregnancy]. AB - A case is reported of acute fatty liver of pregnancy with maternal and foetal survival inspite of jaundice, encephalopathy, renal failure, gastro-intestinal haemorrhage and serious coagulation problems. The acute fatty liver is a rare disease of unknown aetiology which occurs during the third trimester of pregnancy. Early diagnosis based on liver biopsy obtained by the transjugular route, immediate delivery of the foetus and intensive care improve an otherwise fatal prognosis. PMID- 3813148 TI - Tracheobronchomalacia in an adult with metaphyseal chondrodysplasia. AB - Anaesthetic complications such as obstruction of airways by submucosal cartilage bone protuberances, immobility of the neck or instability of the atlanto-axial joint have been described earlier in paediatric patients with congenital osteochondral disorders. This report concerns a case in which tracheal collapse due to tracheobronchial malacia in an adult patient with metaphyseal chondrodysplasia evidently caused severe ventilatory difficulties in the induction of anaesthesia. The management of the patient on three subsequent occasions is described. During the first operation, support of the upper respiratory tract was performed. For this procedure, awake tracheal intubation with local anaesthesia applied to the larynx, vocal cords and trachea was used. After surgical correction of the bronchus of the right upper lobe and the stem bronchus, subsequent anaesthesias for surgical treatment of scoliosis could be conducted safely. The possibility of co-existing tracheobronchial malacia in patients with osteochondrodysplasias should be considered and tracheal intubation under local anaesthesia is recommended. PMID- 3813149 TI - [Pulmonary complications after gastrografin inhalation during radiographic control of esophageal anastomosis]. AB - Tracheal penetration of water soluble contrast media (gastrografin) for X-ray control, after gastro-oesophageal anastomosis, resulted in acute pulmonary oedema in two patients. In this type of surgery, mediastinal dissection was responsible for recurrent nerve injury. Inhalation was due to this recurrent nerve palsy. The pulmonary oedema could be related to gastrografin high osmolarity. Therefore, to prevent this complication, previous laryngeal cavity examination is recommended before carrying out the X-ray investigations. In case of recurrent nerve paralysis, barium sulphate or lipiodol should be preferred because of their lack of effect on the lungs. PMID- 3813150 TI - [Acute parathion poisoning. Value of repeated determination of plasma pseudocholinesterases]. AB - A case is reported of acute massive overdose with parathion in a 48 year old male farmer. Despite an adapted and early treatment, the clinical course was unusually prolonged. The need for repeat titration of plasma pseudocholinesterases, as the best indicator of overdose, is stressed. Recovery without after-effects coincided with the return to normal plasma levels of pseudocholinesterases. PMID- 3813152 TI - [Severe acute intravascular hemolysis in a surgical hemorrhagic context]. AB - A case of severe acute intravascular haemolysis occurring after surgical repair of an abdominal aortic aneurysm in a 60-year old patient is reported. The operative conditions were difficult, requiring three laparotomies within 24 h, with rapid and profuse transfusion: 20 units of red blood cells, 31 of colloids, 11 units of fresh frozen plasma, 31 of diluted albumin and 41 of crystalloid solution. Evolution of the haemolysis became rapidly favourable under symptomatic treatment: forced diuresis (11.91 per 24 h) and alkalinization. None of the classic complications (acute renal failure, disseminated intravascular coagulation) arose. After review of various causes of severe acute intravascular haemolysis, its origin was probably mechanical in this case. PMID- 3813151 TI - [Hemodynamic aspect of adiastole in oxprenolol poisoning]. AB - Self-poisoning with beta-blockers is uncommon but often life-threatening. A 59 year old man was admitted to the ICU after having ingested an estimated dose of 2 g of oxprenolol. Circulatory collapse occurred without pre-existing cardiac failure. Right ventricular haemodynamic data showed adiastole which responded to massive doses of isoprenaline and dopamine. Subsequently the patient recovered normal haemodynamic parameters. This report suggests that right ventricular dysfunction may complicate beta-blocker overdose. PMID- 3813153 TI - [Repair of a suprahepaticocaval injury under extracorporeal circulation]. AB - The case of a 29-year old man who presented with haemorrhage from hepatic veins and the retrohepatic vena cava is reported. On the belief that a conventional technique would be dangerous, total extracorporeal circulation was used as a supportive procedure. The method facilitated anatomic definition of the venous injuries. The repair could then be calmly and precisely carried out because of a practically bloodless operative field. The procedure was well tolerated and the postoperative course was uneventful; the patient was discharged 15 days later. Many surgical techniques have been described for the repair of traumatic injuries of the inferior vena cava and hepatic veins, but all with a high level of peroperative mortality. So, cardiopulmonary bypass and hypothermia seemed to be a useful procedure. However, some points need further consideration: heparin administration may promote bleeding from other lesions and, in the case of associated gastrointestinal injuries, the risk of major septic dissemination is great. PMID- 3813154 TI - [A case of spinal extradural hematoma during the insertion of an epidural catheter]. AB - An epidural haematoma was observed after epidural lumbar puncture in a 75-year old patient receiving 5,000 units calcium heparinate every 12 h as antithrombotic therapy. The diagnosis was suspected by the occurrence of sudden pain and bleeding through the epidural catheter, followed by a complete paraplegia. The diagnosis was confirmed by contrast myelography. Early surgery did not improve the neurological deficit. This case report emphasized that anticoagulant therapy must be discontinued before epidural anaesthesia. PMID- 3813155 TI - [2 cases of anaphylactic shock caused by probable sensitization to a solvent of flunitrazepam]. PMID- 3813156 TI - [Value of ketamine in anesthesia in radial keratotomy]. PMID- 3813157 TI - [Congenital long-QT syndrome and isoflurane]. PMID- 3813159 TI - Interposed abdominal compression-CPR: its effects on parameters of coronary perfusion in human subjects. AB - Recent literature has emphasized the relationship between coronary perfusion during CPR and the success of resuscitation from prolonged arrest. In this study, aortic and right atrial pressures were monitored simultaneously during modifications of CPR. Three parameters associated with survival or coronary blood flow during CPR were measured: diastolic arterial pressure (DAP), diastolic arteriovenous difference (DAVD), and mean AV difference (MAVD). Standard advanced cardiac life support protocol was used although vasopressors were given by continuous infusion. In a series of two-minute trials, standard CPR, interposed abdominal compression (IAC) CPR, high-compression force (HCF) IAC-CPR, and HCF standard CPR were performed, with each patient serving as his own control. The DAP increased from 25 mm Hg during standard CPR to 43 during IAC CPR (P less than .001) and 50 during HC-IAC-CPR (P less than .001). The MAVD increased from 4 to 8 mm Hg during HCF-IAC-CPR (P less than .05). IAC-CPR had inconsistent effects on the DAVD. Three patients had a return of spontaneous circulation during the modifications of CPR after a mean of 43 minutes of asystole with standard CPR. In the seven autopsied patients, no significant abdominal injury was found. All forms of CPR studies produced DAVD in the majority of patients well below the minimum DAVD needed for resuscitation in animal models of prolonged arrest. Although the interposed abdominal compression seems to offer some advantages over standard CPR, these hemodynamic data suggest that it would be unlikely to improve survival rates appreciably. PMID- 3813158 TI - Use of cardiac enzymes identifies patients with acute myocardial infarction otherwise unrecognized in the emergency department. AB - Recognition of an acute myocardial infarction in the patient with chest pain is a frequent challenge to the clinician. Previous studies suggest that cardiac enzymes are of limited value in identifying patients with acute MI in the emergency department. Such studies have not evaluated the use of cardiac enzyme tests to complement decision making in the population of patients clinically designated for ED release. We studied 773 ED visits by patients age greater than or equal to 30 years presenting with chest pain unexplained by thoracic trauma or radiographic abnormalities. Cardiac enzyme levels were not available to the clinicians at the time of the initial visit and disposition of these patients was determined solely by clinical and ECG evaluation. Of the 291 admitted patients, 46 had an MI; 22 of the MI patients had a normal creatine kinase (CK) level. Of the 482 patients released from the ED, 181 patients had an elevated CK level. Among the released patients were five patients with MI. Four released MI patients had a CK level greater than or equal to 200 IU/L and three had an elevated CK-MB fraction (greater than or equal to 12 IU/L). In the population of patients scheduled for release, an elevated CK-MB had sensitivity, specificity, and positive predictive value for MI of 60%, 100%, and 60%, respectively. Although cardiac enzymes cannot be used in isolation to make admission decisions, selective use of CK-MB for final screening of patients otherwise scheduled for ED release may enhance the initial admission of patients with MI at risk for unintentional release. PMID- 3813160 TI - Developing a clinical algorithm for early management of cervical spine injury in child trauma victims. AB - To define a subset of injured children for whom emergency cervical spine radiography may be unnecessary, we performed a retrospective chart and radiologic review. Two entry methods were used: All injured children, from birth through 16 years, who had received cervical spine radiographs at The Children's Memorial Hospital from September 1983, to September 1984, were included. All patients from birth to 16 years with proven or suspected cases of cervical spine injury who had received cervical spine radiographs and who had been treated at either the Children's Memorial Hospital or the Northwestern University Spine Trauma Unit during period 1974 to 1984 also were included. Each child's chart was reviewed, and 84 clinical variables were recorded. All radiographs were reviewed by a pediatric neuroradiologist. Of 206 children studied, 59 had cervical spine injuries. A clinical algorithm was derived using the following eight variables: neck pain; neck tenderness; limitation of neck mobility; history of trauma to the neck; and abnormalities of reflexes, strength, sensation, or mental status. The following decision rule was selected: Positive findings in any of these eight variables mandates cervical spine radiography. This algorithm correctly identified 58 of 59 children with cervical spine injury, yielding a sensitivity of 98% and specificity of 54%. Cervical spine radiographs could have been avoided in 79 children (38% of the entire sample). This algorithm performed better than did models derived from logistic regression analysis of the same data. Validation trials are required prior to the implementation of this or other clinical decision algorithms in practice. PMID- 3813161 TI - Satisfaction with practices: emergency physicians versus internists. AB - No comparison has been made of satisfaction with practices of emergency physicians versus other specialists. We used a previously tested questionnaire that measures differences between current and preferred practice conditions, and with items regarding training and practice, and intention to change positions. It was sent to 250 physicians practicing emergency medicine and 250 practicing internal medicine in a metropolitan area. Both specialty types were defined by type of practice, rather than by specialty training or board certification. Ninety-five (38%) emergency physicians and 79 (32%) internists responded. Factor and correlation analyses identified six satisfaction indexes: resources, professional autonomy, administrative autonomy, patient relationships, professional relationships, and status. Physicians practicing emergency medicine were less satisfied, that is, reported more difference between current and preferred conditions, than physicians practicing internal medicine with professional autonomy, patient relations, and status (by t tests, P less than .01 for each). Emergency physicians were more satisfied with professional relationships (P less than .01). Only 40% of emergency physicians, versus 60% of internists, reported no intention to leave their present position within the next two years (P less than .02). Expectation of position change by physicians practicing emergency medicine was predicted by dissatisfaction with professional autonomy, lack of board certification, recency of graduation from medical school, and belief that monetary compensation would be higher elsewhere (R square, 0.35; P less than .01), while variables such as patient load, hours worked per week, and hospital size proved unimportant. We identified areas of dissatisfaction among emergency physicians that differed from those among internists.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813162 TI - Epidemiology of pediatric prehospital care. AB - Very few studies about prehospital care of pediatric emergencies have been published. With new interest in emergency care of the pediatric population demonstrated by the development of Pediatric Advanced Life Support and Advanced Pediatric Life Support, it is imperative to have data that define the different types of problems encountered in the prehospital care setting and their outcomes. Prehospital assessment forms were reviewed retrospectively over a consecutive 12 month period beginning August 1, 1983. Patients under 19 years of age were studied in a service area with a population of 557,700. A total of 3,184 forms were analyzed, representing approximately 10% of all ambulance runs. This contrasts sharply with the fact that the pediatric age group represents 32% of the population. The major users were the youngest and the oldest of the pediatric population. Of the cases, 54.4% were in the trauma category. The largest trauma group was motor vehicle accidents in the adolescent age group. Male patients predominated in the trauma cases. Medical disorders were the major reason for prehospital care in the very young. The demand for emergency medical services (EMS) occurred mainly during the summer months and on weekends. More than 50 percent of all EMS pediatric cases occurred during the hours of 1:00 PM to 9:00 PM. Advanced life support was associated with prolonged on-scene time and had a relatively low use and success rate in the younger pediatric population. Resuscitation of 23 cases of pediatric prehospital arrest resulted in no survivors to hospital discharge. The appropriateness of prolonged time spent on scene (mean of 18.3 minutes in 1,196 cases) for prehospital pediatric emergencies requires further evaluation. PMID- 3813163 TI - The relationship between total prehospital time and outcome in hypotensive victims of penetrating injuries. AB - Most authorities in the field of trauma recommend that seriously injured patients be transported directly to a regional trauma center, even if it requires bypassing nearby community hospitals. The purpose of our study was to examine the relationship between the survival rates of patients with presumed hemorrhagic shock due to penetrating injuries and the total prehospital time required to manage and deliver those patients to a single regional trauma center in a large urban area. During a 30-month-period, 498 consecutive victims of penetrating injury, presenting in the field with a systolic blood pressure of 90 mm Hg or less and transported to a single regional trauma center, were prospectively evaluated in terms of age; initial prehospital trauma score; injury severity score (ISS); TRISS probability of survival; response, scene, transport, and total prehospital times; and survival (discharge from hospital). All patients were managed and transported by a single urban paramedic service that has a fairly uniform response time (5.3 +/- 3 min) throughout its entire service area. The response area is spread out over an approximately 1,000 square-mile region, and transport times to the regional trauma center can exceed a half hour. The total prehospital time (TPT) was calculated as the time elapsed from the receipt of the emergency call to the time of arrival at the regional trauma center. Patients arbitrarily were categorized into four subsets according to the initial prehospital trauma score (1, 2 to 6, 7 to 11, 12 to 15). Patients also were analyzed in terms of four incremental groups of increasing TPT (0-20, 21-30, 31 40, greater than 40 min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813164 TI - Dichloroacetate treatment of ischemic cerebral lactic acidosis in the fed rat. AB - Despite advances in cardiac resuscitation, ischemic brain injury remains generally untreatable. Animal studies of brain ischemia associate brain lactate levels of more than 18 mumol/g with irreversible neuronal injury. Lowering brain lactate therefore may prevent or minimize ischemic brain necrosis. Earlier studies in our laboratory using fasted rats demonstrated that sodium dichloroacetate (DCA) decreases ischemic brain lactate when given either before or immediately after partial global ischemia (PGI). Other investigators have shown that fed animals have more glucose and generate higher lactate levels by anaerobic metabolism during PGI. We evaluated the ability of DCA to lower brain lactate in fed male Wistar rats subjected to PGI. Four groups (n = 6 each) were studied--PGI and control rats with either placebo or DCA treatment. PGI was induced for 30 minutes by combining bilateral carotid artery occlusion with hemorrhagic hypotension. This was followed by release of carotid occlusion, reinfusion of shed blood, and immediate treatment with either DCA (25 mg/kg, IV) or placebo. Thirty minutes later brains were frozen in situ with liquid nitrogen for extraction and measurement of tissue glucose, glycogen, and lactate. Blood glucose and serum lactate were monitored throughout the experiment. No significant differences were found between the two PGI groups in brain glucose, brain glycogen, or ischemia-induced elevations in blood glucose and serum lactate. However, brain lactate was significantly lower in DCA-treated (12.5 mumol/g) than in untreated (22.8 mumol/g) PGI rats (P less than .001). In addition, all untreated PGI rats had levels of more than 18 mumol/g, and therefore were at high risk for neuronal necrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813165 TI - Intraosseous infusion flow rates in hypovolemic "pediatric" dogs. AB - We tested a 20-gauge, 2 1/2-inch spinal needle and a 13-gauge, 3 1/2-inch bone marrow needle with Ringer's lactate delivered by gravity and 300 mm Hg pressure in vitro and in hypovolemic puppies to ascertain in vivo intraosseous flow rates and to determine the effects of catheter size and anatomic factors on flow rate. In vitro flow was significantly faster than in vivo flow (P = .001). In vivo, mean flow rates were 11 mL/min for the 20-gauge needle and 13 mL/min for the 13 gauge needle by gravity. The mean flows by 300 mm Hg pressure for the same needles were 24 mL/min and 29 mL/min. While the in vivo flow rates were significantly greater for the 13-gauge versus the 20-gauge needle, the differences were not clinically significant (2 mL/min difference by gravity and 5 mL/min difference by pressure). The clinically comparable in vivo rates for the two needles tested indicated that the rates are dependent on flow through the bone marrow rather than the size of the needle. The data suggest that while intraosseous infusion is a rapid technique for gaining vascular access, the flow rates achieved may not be sufficient for the definitive treatment of severe hypovolemic or hemorrhagic shock alone. PMID- 3813166 TI - Endotracheal diazepam: absorption and pulmonary pathologic effects. AB - We conducted a study to evaluate the absorption of endotracheally administered diazepam and the pulmonary pathologic changes induced by its administration. Six cats received diazepam and five cats received saline endotracheally. Serial blood gases and serum diazepam levels were drawn at intervals for 90 minutes after the administration of diazepam. The cats were sacrificed after two days and their lungs were examined by a pathologist. Mean diazepam levels reached a peak two minutes after the administration of diazepam and remained elevated above therapeutic levels for 90 minutes. There was no significant change in pH, PO2, or PCO2 for either group. Histologic examination of the lungs showed a significantly increased incidence of pneumonitis in the diazepam group as compared to the saline group. This study demonstrates that although diazepam is well absorbed when administered endotracheally, it has adverse effects on the lungs that may preclude endotracheal use in the currently available commercial form. PMID- 3813167 TI - Haloperidol for sedation of disruptive emergency patients. AB - Agitated, threatening, or violent behavior often jeopardizes the patient with self-inflicted injury or delays medical evaluation and treatment. Patient cooperation with therapy can be achieved using haloperidol by the IM, IV, or oral route. The safety and efficacy of haloperidol in the emergency department setting was examined. Haloperidol was administered to 136 patients to control behavior. Eighty-eight received the drug in the ED; 18 of these 88 were critical patients receiving the drug during resuscitation. Forty-eight of the 136 were crisis intervention center patients. Ninety patients were acutely intoxicated with ethanol. Twenty-three patients had head trauma; 20 of these also were inebriated. Various other drugs were responsible for the behavior of 15 patients. Acute psychosis was involved in 40 cases. Thirty-one patients were thought to have a personality disorder. The route of administration of haloperidol was intramuscular in 110, IV in 19, and oral in seven patients. Disruptive behavior was alleviated within 30 minutes in 113 of 136 (83%) patients. Effect was judged suboptimal in 20 of 136 (15%), and no effect was noted in three of 136 (2%) patients. Four complications (3%) were noted, three minor and one more serious episode of hypotension in a critical patient. Haloperidol is a safe and efficacious drug for use with disruptive patients in the emergency setting. It is a useful tool for management of agitation of diverse etiologies. PMID- 3813168 TI - Methemoglobin levels following intravenous lidocaine administration. AB - Methemoglobin levels were obtained before and after administration of IV lidocaine in 40 cardiac patients. Patients were given a 1-mg/kg bolus of IV lidocaine hydrochloride, started on a maintenance infusion at 2.0 mg/min, and given a second bolus of lidocaine of 0.5 mg/kg 15 minutes after the initial bolus. The maintenance infusion was adjusted from 1 to 4 mg/min according to clinical needs. Methemoglobin levels were drawn at zero, one, and six hours, and lidocaine levels were drawn at one and six hours after the initial bolus. Elevation of methemoglobin levels after lidocaine administration was statistically significant (P less than .05), but not clinically significant. The highest methemoglobin level obtained was 1.2%. Only one other patient had a level above 1%. No patient developed either signs of lidocaine toxicity or toxic levels of methemoglobin. Routine determination of methemoglobin levels is not clinically indicated following routine lidocaine administration. It may have some as-yet undetermined value in lidocaine-toxic patients. PMID- 3813169 TI - Level of consciousness as a predictor of complications following tricyclic overdose. AB - In order to determine whether patients at low risk for complications following tricyclic antidepressant (TCA) overdose can be identified, we analyzed the records of all admissions for TCA overdose from 1975 to 1985. Of the 92 patients reviewed, 37 had serious complications including hypoventilation, loss of protective airway reflexes, seizures, hypotension, hemodynamically significant arrhythmias, or death. Patients with complications had increased heart rate, depressed level of consciousness, depressed Glasgow Coma Scale, and prolonged QRS interval, as compared to patients without complications. All 37 patients with serious complications required intubation in the emergency department. A Glasgow Coma Scale of less than 8 was the most sensitive predictor of serious complications (sensitivity = .86; specificity = .89). This was significantly better than the QRS interval (QRS greater than or equal to 100 msec; sensitivity = 59; specificity = .76). We conclude that level of consciousness is a better predictor of risk of complications and need for ICU admission than the QRS interval. Patients who are responsive to verbal stimuli on leaving the ED are at very low risk of developing complications. PMID- 3813170 TI - The radiopacity of ingested medications. AB - We investigated prospectively the radiopacity of 312 pills found on a university hospital formulary by first radiographing them through 15 and 25 cm of water to duplicate the radiodensity of the human body. The pills that were radiodense through water were studied in a human cadaver model, and their densities were quantified by computed tomography (CT). Thirty-five of 312 pills were radiopaque in 15 cm or more of water, and 23 of these pills were radiopaque on a plain radiograph when placed in the stomach of a cadaver. Common mnemonics used to identify radiopaque pills were found to be incomplete and inadequate. Chloral hydrate, iron-containing preparations, calcium carbonate, iodinated compounds, acetazolamide, busulfan, and potassium preparations were consistently radiopaque. Antihistamines, phenothiazines, and tricyclic antidepressants demonstrated varying radiopacity. There was varying radiopacity among the same medications made by different manufacturers. The presence of an enteric coating did not assure that the pill would be radiopaque. Merely radiographing a pill that has been placed on a standard radiograph cassette will make pills that are actually radiolucent in the body appear radiopaque. This test cannot be used to predict radiopacity in vivo. Visibility when radiographed through 15 cm or more of water and a CT radiodensity of more than 1,300 Hounsfield units are predictors of the radiopacity of a pill in the stomach of a cadaver model on a standard KUB radiograph. Variables, such as the size of the patient, the arrangement of pills in the stomach, air contrasting a pill, and the specific composition of the enteric coating or the pillmatrix, affect the radiodensity of pills.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813171 TI - A nine-year evaluation of emergency department personnel exposure to ionizing radiation. AB - Emergency department personnel experience potential occupational hazards from exposure to ionizing radiation (x-rays). To assess this risk, ionizing radiation exposure was analyzed during a nine-year period for 128 ED personnel. The group consisted of 21 physicians, 92 nurses, and 15 ancillary personnel. Exposure was measured for both penetrating and nonpenetrating radiation using standard film dosimeter badges. Film badge use compliance was 66.7% for physicians, 86.2% for nurses, and 86.7% for ancillary personnel. Penetrating radiation exposure averaged 0.12 mrem/month for physicians, 0.70 mrem/month for nurses, and 0 mrem/month for ancillary personnel, all less than the average natural background exposure. We concluded that if standard radiation precautions are taken, the occupational risk from ionizing radiation exposure to personnel in the ED is minimal, and that routine monitoring of radiation exposure of ED personnel is unnecessary. PMID- 3813172 TI - Teaching research in the emergency medicine residency curriculum. AB - Research in emergency medicine is a necessary component for the growth and development of the academic discipline. Although the need exists for competent physician investigators, most graduates of emergency medicine residencies have had little structured education in research design or methodology. This is particularly true in community hospital programs with little funding allocated to research, limited facilities, and few staff members actively involved in research. Our purpose is to describe a research curriculum designed to operate within a community-based residency program. This curriculum identifies a detailed set of educational objectives in research techniques with the expectation that on completion of the residency program, the resident will be able to critically evaluate medical literature and independently design a research project. We have developed a specific plan for meeting these objectives with coordinated seminars, readings, journal clubs, research projects or exhibits, and professional conferences. We suggest some practical methods of motivating residents and attending staff to pursue clinical investigation. PMID- 3813173 TI - Disaster medical assistance teams. AB - Five medical care functions are essential in disaster medical care--field rescue and first aid, casualty clearing, medical staging, field surgical intervention, and definitive care. Each of these functions requires substantial augmentation in response to disaster. Three functions, clearing, staging, and field surgical care, are complex functions requiring organized and skilled disaster medical units. We describe two kinds of disaster medical units designed to meet these needs. One unit is designed for casualty clearing and medical staging, the other for field surgical services. We describe how they can be created and used as part of a National Disaster Medical System. PMID- 3813175 TI - Itinerant emergency physicians. PMID- 3813174 TI - Chest pain, shock, and pneumomediastinum in a previously healthy 56-year-old man. AB - It is apparent from this discussion that it may be exceedingly difficult to make the diagnosis of Boerhaave's syndrome. The failure to correctly diagnose this patient was due, in part, to the absence of vomiting in the history. Nevertheless, the presence of pneumomediastinum on the initial chest roentgenogram was a significant finding that was missed and would have suggested this diagnosis. This patient is an example of an "atypical" presentation and demonstrates that vomiting need not be a part of the presentation. Because esophageal rupture is a rare clinical entity, a high index of suspicion and careful examination of the chest roentgenogram are mandatory to establish the correct diagnosis. PMID- 3813176 TI - Shift to the left. PMID- 3813177 TI - Theophylline loading in acute asthma. PMID- 3813178 TI - Effective triage scoring systems. PMID- 3813179 TI - Orotracheal intubation and potential cervical spine injury. PMID- 3813180 TI - Alcohol blood levels. PMID- 3813181 TI - Continuous infusion of intravenous naloxone. PMID- 3813182 TI - Power of the P value. PMID- 3813183 TI - Physical standards for employment and the courts. PMID- 3813184 TI - The advantages of studying psychological phenomena rather than psychiatric diagnoses. PMID- 3813185 TI - Behavioral and psychoanalytic perspectives at therapeutic choice points. PMID- 3813186 TI - Mental health policy. Observations from Europe. PMID- 3813187 TI - Private foundations in health affairs. A case study of the development of a national initiative for the chronically mentally ill. PMID- 3813188 TI - Vasodilators and pulmonary hypertension: where do we go from here? PMID- 3813189 TI - Hemodynamic effects of urapidil in patients with pulmonary hypertension. A comparative study with hydralazine. AB - Vasodilator therapy for pulmonary hypertension ideally should cause a proportionately greater reduction of resistance in the pulmonary vascular bed than in the systemic circulation. This should limit the occurrence of systemic hypotension, which can complicate the use of most vasodilator drugs. Urapidil is a new vasodilator that acts by postsynaptic alpha 1-blockade while inhibiting the aortic pressure baroreceptor reflex and reducing central sympathetic tone. We investigated and compared the short-term effects of Urapidil and hydralazine in 10 patients suffering varying degrees of pulmonary hypertension. Each patient received either 0.35 mg/kg hydralazine or 0.75 mg/kg Urapidil intravenously on 2 sequential days in a randomized order. The main effect of Urapidil was to decrease the mean pulmonary artery pressure in all 10 patients from 44 +/- 4 to 37 +/- 3.5 mm Hg (p less than 0.001). After Urapidil infusion, the mean decrease of resistance in the pulmonary vascular bed (32%) exceeded that in the systemic circulation (25%). In contrast, pulmonary artery pressure remained unchanged with hydralazine, and predominant systemic vasodilation occurred: systemic vascular resistance decreased by 45%, whereas pulmonary vascular resistance decreased by 25%. Hydralazine markedly increased the cardiac index and induced tachycardia. Urapidil maintained the heart rate nearly constant and only slightly increased the cardiac index, thereby fostering the diastolic emptying of the pulmonary circulation. No significant change in arterial oxygenation occurred with either drug, although arterial oxygen partial pressure tended to increase with hydralazine. Urapidil may be a promising drug in the treatment of patients with pulmonary hypertension. PMID- 3813191 TI - Once-daily sustained-release theophylline reduces diurnal variation in spirometry and symptomatology in adult asthmatics. AB - In 22 adult asthmatics (mean age, 55.2 +/- 15.4 yr), we compared Uniphyl given once a day to Theo-Dur given twice a day using a randomized, double-blind, two phase crossover trial. All patients demonstrated acute bronchodilator responsiveness (FEV1 increase greater than 15%) to inhaled salbutamol and were dependent upon both orally administered theophylline and inhaled salbutamol at time of entry. Each phase lasted 9 days, the first 2 days of which were a theophylline washout. Uniphyl was given once a day at 8 P.M. and Theo-Dur was given twice a day at 8 A.M. and at 8 P.M. For each patient, the total daily theophylline dose was the same during both phases. Asthma symptoms, drug side effects, and PEFR were recorded at 8 A.M. and at 4 and 8 P.M. each day. On Days 7, 8, and 9 of each phase, serum theophylline concentrations were measured and spirometry was performed at 8 A.M. and at 4 and 8 P.M. The results demonstrated significant differences in both pharmacokinetic and clinical efficacy between the 2 drugs. Uniphyl produced greater "peak" and lower "trough" theophylline concentrations than did Theo-Dur, although both lower "trough" theophylline concentrations than did Theo-Dur, although both drugs maintained concentrations within the accepted therapeutic range. In contrast to the pharmacokinetic findings, Uniphyl was associated with significantly less fluctuation in pulmonary function throughout the day, and the values at 8 A.M. for FEV1, PEFR, and wheeze demonstrated significant clinical efficacy in favor of Uniphyl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813190 TI - Reduction of chronic hypoxic pulmonary hypertension in the rat by an inhibitor of collagen production. AB - Chronic hypoxic pulmonary hypertension in the rat is associated with increased collagen and elastin in the pulmonary artery. We investigated whether excess vascular collagen contributes to chronic hypoxic pulmonary hypertension by administering the proline analogue cis-4-hydroxy-L-proline (cHyp), an agent relatively specific for inhibiting collagen production, to rats exposed to chronic hypoxia. Sprague-Dawley rats (weighting 200 g) were exposed to air or hypoxia (10% O2-90% N2) for 3 wk. Groups studied were: air-exposed injected with saline, air-exposed injected with cHyp, hypoxic injected with saline, and hypoxic injected with cHyp. At the end of 3 wk, we measured mean right ventricular pressure (RVP) of animals breathing room air and hydroxyproline and desmosine contents of the main pulmonary artery trunk. Hypoxia increased RVP from 13 +/- 1 to 27 +/- 1 mm Hg (p less than 0.05); cHyp partially prevented this increase since RVP was 17 +/- 1 mm Hg (p less than 0.05). There was no effect of cHyp on cardiac output. Hypoxia increased collagen from 0.9 +/- 0.1 to 2.0 +/- 0.3 mg/artery (p less than 0.05); cHyp completely prevented this increase since collagen was 1.0 +/- 0.2 mg/artery (p less than 0.05). Hypoxia increased elastin from 1.1 +/- 0.1 to 2.4 +/- 0.2 mg/artery (p less than 0.05); cHyp had no apparent effect since elastin was 2.1 +/- 0.1 mg/artery. Also, cHyp did not affect RVP or vascular collagen or elastin in air-breathing animals. The cHyp treatment prevented luminal narrowing and thickening of arteriolar walls by hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813192 TI - Theophylline-induced alterations in cardiac electrophysiology in patients with chronic obstructive pulmonary disease. AB - To investigate the effect of theophylline on cardiac electrophysiology, electrophysiologic testing was performed before and during aminophylline (theophylline ethylenediamine) infusions in 10 male patients with stable COPD. This produced a mean plasma theophylline concentration of 15.6 +/- 0.9 micrograms/ml (mean +/- SEM) and increases in plasma catecholamine concentrations consistent with activation of the sympathetic nervous system. Plasma epinephrine increased from 40 +/- 6 to 57 +/- 9 pg/ml (p less than 0.05), and plasma norepinephrine increased from 406 +/- 63 to 522 +/- 90 pg/ml (p less than 0.01) during the aminophylline infusion. Significant reductions were seen in the atrioventricular (81.4 +/- 6.8 to 73.0 +/- 5.6 ms, p less than 0.05) and His Purkinje (40.7 +/- 4.3 to 36.1 +/- 3.8 ms, p less than 0.02) conduction intervals, sinoatrial conduction time (81.3 +/- 10.3 to 65.0 +/- 7.6 ms, p less than 0.05), corrected sinus node recovery time (199.0 +/- 13.4 to 148.2 +/- 22.9 ms, p less than 0.05), shortest atrial pacing interval producing 1:1 atrioventricular conduction (391.0 +/- 25.5 to 325.0 +/- 15.5 ms, p less than 0.001), and atrial effective refractory period (ERP) (224.0 +/- 7.0 to 201.0 +/- 7.2 ms, p less than 0.01), but there was no change in the intraatrial (PA) conduction interval or ventricular ERP. Although no arrhythmias were induced, 5 patients had symptoms (3 presyncope and 2 chest pain) with rapid atrial pacing during but not prior to the aminophylline infusion. These changes could be caused by direct action of theophylline on cardiac conduction tissue or they may be caused at least in part by the associated increase in sympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813193 TI - Gastroesophageal reflux in patients with asthma and chronic bronchitis. AB - To determine the relationship between gastroesophageal (GE) reflux and pulmonary disease, we studied 21 asthmatics, 30 chronic bronchitics, 6 patients with GE reflux and no pulmonary symptoms, and 10 control subjects; GE reflux was diagnosed by pH monitoring and GE scintiscanning. Frequency of GE reflux in the asthmatics was 57%; in the chronic bronchitics it was 56%. Pulmonary function tests did not show any differences between patients with or without reflux. The GE reflux episodes were more numerous but shorter in asthmatics than in chronic bronchitics. Patients with digestive symptoms alone were no different from chronic bronchitics with respect to reflux. The mechanism whereby reflux triggers pulmonary problems was investigated using the following 2 tests: scintiscan for pulmonary aspiration, and esophageal acid infusion (0.1N HCl). Six pulmonary aspirations were detected. Only asthmatics, with or without reflux, showed any significant variations in maximal expiratory flow at 50% and 25% of VC after HCl infusion. Thus, our results show that asthmatics differ from chronic bronchitics by the characteristics of their reflux. PMID- 3813194 TI - Hypotonic and isotonic aerosols increase bronchial reactivity in basenji greyhound dogs. AB - Because basenji-greyhound dogs have greater bronchial reactivity to a range of inhaled stimuli than mongrel dogs do, and because bronchial hyperreactivity to nonspecific stimuli is characteristic of asthma, we asked whether basenji greyhound dogs have greater bronchial reactivity to hypotonic and isotonic aerosols than mongrel dogs do. We assessed bronchial reactivity by measuring both the total pulmonary resistance and the bronchial response to an acetylcholine aerosol, before and after delivery of hypotonic and isotonic aerosols. Bronchial reactivity as measured by a change in total pulmonary resistance increased 9-fold after delivery of hypotonic and 5-fold after delivery of isotonic aerosols in 5 anesthetized basenji-greyhound dogs, but not in 3 similarly challenged mongrel dogs (p less than 0.01). Bronchial reactivity as measured by an increased bronchial response to acetylcholine aerosol increased 3-fold in basenji-greyhound dogs but not in mongrel dogs. Thus, hypotonic and isotonic aerosols increase bronchial reactivity in basenji-greyhound dogs. We also asked whether vagal or nonvagal pathways are involved in the increase in total pulmonary resistance induced by a hypotonic aerosol. Both vagal and nonvagal pathways appear to be involved, since blockade of the vagal pathway by intravenously administered atropine only partially inhibited the bronchoconstriction induced by a hypotonic aerosol (54%). Disodium cromoglycate, which inhibits vagal and nonvagal pathways, partially inhibited the bronchoconstriction (57%), but even in combination with atropine, did not completely inhibit it (68%). Our observations in basenji greyhound dogs are similar to results in asthmatic subjects, suggesting that basenji-greyhound dogs are useful experimental animals in which to study the mechanisms by which hypotonic and isotonic aerosols increase bronchial reactivity. PMID- 3813195 TI - Differing response of asthmatics to sulfur dioxide exposure with continuous and intermittent exercise. AB - Ten subjects with mild asthma were initially exposed in an environmental chamber (26 degrees C 70% relative humidity) to clean air and 1.0 ppm SO2 while performing 3 sets of 10-min treadmill exercises (ventilation, 41 L/min) broken by 15-min rest periods. To evaluate the effects of the pattern and duration of exercise on the response to SO2 exposure, the subjects were then exposed to the same environmental conditions while exercising continuously for 30 min. Specific airway resistance (SRaw) was measured by body plethysmography before each exposure and after each exercise. All SO2 responses were significantly greater than the clean air responses. With intermittent exercise and SO2 exposure, mean SRaw measurements (preexposure and after 10, 20, and 30 min of exercise) were 5.4, 14.7, 12.8, and 11.1 cm H2O/s. After SO2 exposure with continuous exercise, the mean SRaw showed an increase from 5.2 to 17.3 cm H2O/s. This increase was significantly (p = 0.018) greater than the response after the third exercise in the intermittent protocol. It appears that asthmatics show an attenuated response to repetitive exercise in an atmosphere of 1.00 ppm SO2 and that the response to SO2 exposure develops rapidly and is maintained during 30 min of continuous exercise. PMID- 3813196 TI - The response of the nasal airway to exercise. AB - Exercise causes a fall in nasal resistance that may be due to sympathetic vasoconstriction in the nasal mucosa. Other factors potentially involved in the exercise effect on nasal resistance are: increased alae nasi muscle activity, passive redistribution of blood to exercising muscle and away from the nasal mucosa, increased nasal air flow, and hyperventilation. In order to determine the importance of these factors, 6 healthy adults had nasal pressure/flow data collected at rest and after bicycle exercise at 100 to 160 W. Erect exercise with nose breathing, erect exercise with mouth breathing, voluntary isocapnic hyperventilation at the minute volumes achieved during exercise, and supine exercise were performed. The alae nasi muscles were voluntarily activated during pressure/flow measurements. The pressure/flow data were displayed on a logarithmic plot; parallel rightward shifts of this plot indicate falls in nasal resistance mediated by enlargement of the air passage. The position of the plot was defined by the flow rate at which the slope of the logarithmic plot steepens abruptly (Vtr). Erect exercise with nose breathing caused a fall in nasal resistance in all 6 subjects (mean change in Vtr, +14.4 L/min). Exercise mouth breathing and supine exercise caused similar falls in nasal resistance in all subjects (mean change of Vtr, +14.1 and +14.2 L/min, respectively). Voluntary isocapnic hyperventilation had no effect on nasal pressure/flow properties in any subject (mean change in Vtr, -1.3 L/min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813197 TI - Acute upper airway injury in burn patients. Serial changes of flow-volume curves and nasopharyngoscopy. AB - Serial flow-volume curves and fiberoptic nasopharyngoscopy were performed in 36 patients with cutaneous burns and/or smoke inhalation. Baseline flow-volume curve patterns were abnormal in 26 (72.2%) patients, and follow-up studies demonstrated significant reductions (p less than 0.04) in inspiratory and expiratory flow rates in the 6 patients who required endotracheal intubation because of anatomic upper airway obstruction. None of the patients with stable or increased flow rate measurements required intubation. The progression of upper airway edema in 14 patients was characterized by obliteration of the aryepiglottic folds, arytenoid eminences, and interarytenoid areas by boggy, edematous tissue that prolapsed to occlude the airway. These changes correlated with an increased size of cutaneous burns (p less than 0.0001), the presence of burns of the face and neck (p less than 0.05), and more rapid intravenously administered fluid resuscitation (p less than 0.04). Anatomic and physiologic changes consistent with upper airway dysfunction occur frequently in burn victims. Progression of these abnormalities correlates with the severity and distribution of cutaneous injury and is influenced by intravenously administered fluid. PMID- 3813198 TI - Mechanism of the postural dependence of vital capacity in tetraplegic subjects. AB - It is well established that unlike normal subjects patients with cervical cord transection have an increase in VC when changing from the seated to the supine posture. To investigate the mechanism of this paradoxical increase, we measured static lung volumes in both the seated and supine posture in 14 consecutive patients with tetraplegia (C4-C7) and in 4 patients with paraplegia (Th4-Th7). The increase in VC in the supine compared with the seated posture was (mean +/- SE) 0.41 +/- 0.07 L (16.0% of the seated value) in the tetraplegic subjects and 0.40 +/- 0.01 L (11.2% of the seated value) in the paraplegic subjects (p less than 0.001). However, TLC in all subjects was 0.28 +/- 0.05 L smaller in the supine posture (p less than 0.001), thus indicating that the larger VC in this posture is related to a reduction in residual volume (RV) rather than to an increased mechanical advantage of the diaphragm. The reduction in RV in the supine posture was consistent, averaging 0.72 +/- 0.06 L (29.1% of the seated value) in the tetraplegic subjects and 0.62 +/- 0.21 L (37.6 percent of the seated value) in the paraplegic subjects (p less than 0.001). Inflating blood pressure cuffs at the bases of the legs prior to the assumption of the supine posture diminished the reduction in RV with recumbency by only 0.10 +/- 0.02 L. In contrast, the postural dependence of RV was abolished when the abdomen was tightly supported by elastic straps and maintained constant in configuration during postural changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813199 TI - Inspiratory muscle activity as a trigger causing the airways to open in obstructive sleep apnea. AB - This report discusses mechanisms causing the airways to open during obstructive sleep apnea (OSAS). In 4 male patients with OSAS, 92 nonrapid eye movement (NERM) sleep apnea episodes and 37 rapid eye movement (REM) sleep apnea episodes were analyzed breath by breath during a one-night study. We calculated the pressure time index of the diaphragm (the product of inspiratory time/cycle duration (Tl/Ttot) and mean transdiaphragmatic pressure swing), evaluated the sleep stages via EEG, and performed frequency spectrum analysis of the EMG of the diaphragm. It was found that with each occluded inspiratory effort the tension time index of the diaphragm (TTdi) increased progressively to reach or slightly exceed the fatigue threshold, 0.15 to 0.18 (during NREM sleep the TTdi of the last occluded breath was 0.195 +/- 0.045 and during REM sleep the TTdi of the last occluded breath was 0.153 +/- 0.037); that a close time relationship was observed as well between the onset of arousal and the opening of the airways. Our data suggest that the airways may be triggered to open by a protective reflex originating in the larynx or the inspiratory muscles upon reaching a certain degree of contraction. PMID- 3813200 TI - Correlation between genioglossal and diaphragmatic responses to hypercapnia during sleep. AB - Oropharyngeal patency during sleep is dependent on the dilating force of the genioglossus, the main tongue protrusor muscle. We measured the ventilatory (Vl), diaphragmatic (EMGdi), and genioglossal (EMGgg) electromyographic responses to CO2 in awake and sleeping goats; delta Vl/delta PETCO2 decreased from awake (0.85 +/- 0.087 L/min/mm Hg) to NREM sleep (0.69 +/- 0.069) to REM sleep (0.57 +/- 0.078, p less than 0.005 versus awake). There were minimal decreases in delta EMGdi/delta PETCO2 and EMGdi at a PETCO2 of 55 mm Hg from awake to NREM, but a significant decrease in EMGdi at a PETCO2 of 55 mm Hg during REM sleep (p less than 0.025 versus NREM). Inspiratory EMGgg was only present above a PCO2 threshold, which was similar for each state (49.3 +/- 2.3 mm Hg PETCO2 awake, 48.8 +/- 2.4 during NREM, 49.5 +/- 2.5 during REM), and delta EMGgg/delta PETCO2 tended to be less during both sleep states compared with that while awake (p = 0.10). At any PCO2, inspiratory EMGgg was markedly inhibited during REM sleep when rapid eye movements were present (phasic REM). We conclude that there is disproportionate inhibition of the genioglossus relative to the diaphragm at low CO2 tensions and at any PCO2 during phasic REM sleep. This imbalance may predispose the upper airway to inspiratory occlusion during sleep. PMID- 3813201 TI - Respiratory activity of genioglossus. Interaction between alcohol and the menstrual cycle. AB - Alcohol consistently decreases genioglossal electromyographic (EMG) activity in awake men, but in women this response is more variable, possibly because of the menstrual cycle. To assess the interaction between alcohol and the menstrual cycle on genioglossal EMG activity, we measured ventilation and genioglossal EMG activity in 9 normal women before and after they drank 1 ml/kg alcohol. The effect of alcohol on ventilation and genioglossal EMG activity was studied twice in each subject: once during the follicular phase and again during the luteal phase of the menstrual cycle. Measurements were made while the subjects breathed room air and rebreathed a hypercapnic gas mixture. The ventilatory response to CO2 was significantly greater during the luteal phase of the menstrual cycle. Alcohol had no effect on resting ventilation or the ventilatory response to CO2 during either phase of the menstrual cycle. However, alcohol significantly decreased peak integrated genioglossal EMG activity during the follicular (low progesterone) phase but not during the luteal (high progesterone) phase of the cycle. The relative alcohol resistance of genioglossal EMG activity during the luteal phase may explain in part the low incidence of sleep-disordered breathing in premenopausal women and the benefit that some male patients with obstructive sleep apnea have derived from treatment with progesterone. PMID- 3813202 TI - Differences in pharyngeal properties between snorers with predominantly central sleep apnea and those without sleep apnea. AB - The underlying cause of idiopathic central sleep apnea syndrome is not well understood. We therefore examined the possibility that patients with idiopathic central sleep apnea may have abnormalities of upper airway mechanics that might contribute to the pathogenesis of central apneas. The acoustic reflection technique was used to assess pharyngeal size, lung volume dependence, and pharyngeal "compliance" in 8 patients with idiopathic central sleep apnea, all of whom were snorers, and in 8 weight-matched, snoring control subjects with normal sleep studies. Patients with central sleep apnea when compared with control subjects exhibited markedly increased specific pharyngeal "compliance" (0.12 +/- 0.05 versus 0.03 +/- 0.01 cm H2O-1; p less than 0.001), increased change in pharyngeal area from FRC to RV (0.8 +/- 0.5 versus 0.03 +/- 0.3 cm2; p less than 0.05), and a larger pharyngeal area at FRC (4.7 +/- 0.9 versus 3.8 +/- 0.8 cm2; p less than 0.03). We conclude that increased pharyngeal "compliance" and lung volume dependence may play a role in the etiology of central apneas in this syndrome. PMID- 3813203 TI - Airway area by acoustic response measurements and computerized tomography. AB - In order to determine more precisely the accuracy with which the acoustic reflection technique (ART) can infer airway area during spontaneous breathing, we compared acoustic measurements of airway area with equivalent areas measured from computerized tomographic (CT) scans of the neck and chest in 7 patients (mean age, 54 yr; range, 33 to 69 yr) with a history of upper airway abnormalities. At the time of the study, all patients were clinically stable and had no recurrent nerve palsy. Measurements of airway area by ART and CT were performed in the supine posture while patients breathed quietly at FRC. We found that there was considerable intersubject variability in area-distance functions determined by acoustic reflections. None of the subjects had a flat tracheal plateau. Once the acoustic and CT data were aligned, we compared cross-sectional areas at various distances from the glottis. Comparison points were separated by 1 cm, and as many as 13 different CT sections were used in some subjects. Mean values for all data points (n = 83) were 2.45 +/- SD = 0.69 cm2 and 2.56 +/- SD = 0.82 cm2 for the acoustic and CT methods, respectively, Z = 0.93; p greater than 0.05. Linear regression analysis revealed a correlation coefficient (r) of 0.92; p less than 0.0001. On the basis of these findings, we conclude that the acoustic reflection technique may be used reliably for clinical and physiologic studies of the upper airways in humans. PMID- 3813204 TI - Growth inhibition of Blastomyces dermatitidis in alveolar and peripheral macrophages from patients with blastomycosis. AB - Blastomyces dermatitidis evokes a pyogranulomatous disorder with organisms frequently found inside giant cells. Macrophages from bronchoalveolar lavage fluid and peripheral blood in monolayer cell cultures were challenged with live yeast organisms to examine phagocytosis and intracellular growth. A greater number of macrophages from patients recovering from blastomycosis had phagocytized Blastomyces compared with macrophages from healthy control donors. No differences were detected within the groups between alveolar and peripheral macrophages. Intracellular growth of the fungus was reduced in cultures of both cell types from patients compared with those from control subjects. Supernatants from specific Blastomyces antigen-stimulated lymphocyte cultures were collected, and treatment with the supernatant to control donors' macrophages resulted in increased phagocytosis and inhibition of intracellular growth. Antigen-induced lymphocyte stimulation as a correlate of cellular immunity is qualitatively related to alveolar or peripheral macrophage phagocytosis and growth inhibition of this fungus. PMID- 3813205 TI - Response to therapy of pulmonary Mycobacterium avium-intracellulare infection correlates with results of in vitro susceptibility testing. AB - Seventy-five patients with pulmonary infection caused by Mycobacterium avium intracellulare were studied to determine whether results of therapy correlated with in vitro susceptibility testing of mycobacterial isolates. Fifty patients responded to therapy and 25 were nonresponders. The total number of drugs received by responders did not differ significantly from the total number of drugs received by nonresponders. However, responders received significantly more drugs to which their isolate was susceptible in vitro than did nonresponders (2.4 +/- 1.2 versus 1.4 +/- 1.0, p less than 0.001). We conclude that patients with pulmonary M. avium-intracellulare infection should receive chemotherapeutic agents to which their isolate is susceptible in vitro. PMID- 3813206 TI - Value of repeat fiberoptic bronchoscopies and significance of nondiagnostic bronchoscopic results in patients with the acquired immunodeficiency syndrome. AB - Out of 286 patients with the acquired immunodeficiency syndrome (AIDS) who had fiberoptic bronchoscopies performed for the diagnosis of pulmonary disease, 21 (7.3%) patients (Group I) had repeat procedures after 1 to 30 days (mean, 14.8 days) because of persistent pulmonary infiltrates despite therapy, and 46 (15.9%) patients (Group II) had repeat procedures after 2 to 32 months (mean, 7.5 months) because of recurrent pulmonary infiltrates after initial clinical and radiographic improvement. Pneumocystis carinii pneumonia was the most common diagnosis in both groups on initial evaluation, being found in 55% of the patients. Repeat bronchoscopy yielded a new treatable diagnosis in 1 (5%) of 21 patients in Group I and in 27 (59%) of 46 patients in group II. Sixty-two percent of patients in Group I died within 1 month. It appears that in patients with AIDS who have persistent or worsening pulmonary infiltrates despite therapy, repeat bronchoscopy after a short interval (i.e., less than 1 month) is unlikely to have therapeutic implications. In contrast, those patients whose pulmonary involvement resolves initially may benefit from an aggressive diagnostic approach if new pulmonary infiltrates appear. In both groups, nondiagnostic bronchoscopies were common (29% overall). The most commonly missed bronchoscopic diagnoses (proved by open lung biopsy) were cytomegalovirus pneumonia and Kaposi's sarcoma, and neither had much therapeutic implication. Further, 12 patients in Group II with nondiagnostic bronchoscopies improved both radiographically and clinically even though no treatment was given. PMID- 3813207 TI - Damage and repair of lung connective tissue in rats exposed to toxic levels of oxygen. AB - We studied damage and repair of lung connective tissue in rats exposed to toxic amounts of oxygen by measuring lung content of collagen and elastin and the number of collagen fragments in lung lavage fluid after exposure to 98% O2 for 60 h. Lung collagen was decreased 17%, and collagen fragments in lavage fluid were increased 4- to 5-fold in O2-exposed rats compared with those in control rats. No biochemical evidence of elastin degradation was found. Mild emphysematous changes and a leftward shift of fluid-filled, pressure-volume curves were induced within 2 wk after recovery from exposure to O2. Administration of the lathyrogen beta aminopropionitrile worsened the emphysematous lesion produced by hyperoxia, suggesting that replacement of connective tissue during repair limits the extent of emphysema. We conclude that lung collagen is degraded and an emphysematous lesion is produced by relatively short exposure to toxic amounts of oxygen. PMID- 3813208 TI - The role of platelets in the adult respiratory distress syndrome. Culprits or bystanders? PMID- 3813209 TI - Sarcoidlike lung granulomatosis induced by aluminum dusts. AB - Interstitial lung disease developed in a 32-yr-old chemist after working 8 yr in a dusty atmosphere containing aluminum powders. Bronchoalveolar lavage disclosed a helper T-lymphocyte alveolitis, and transbronchial lung biopsies showed sarcoidlike epithelioid granulomas. These granulomas contained dust identified by mineralogic analyses as consisting mainly of aluminum particles. Nasal and liver biopsies and a Kveim test did not reveal extrapulmonary granulomatous infiltration. An extensive immunologic work-up showed none of the abnormalities classically seen in sarcoidosis, but peripheral blood lymphocytes exhibited blastic transformation in the presence of soluble aluminum compounds. About 1 yr after cessation of exposure, a chest radiograph and lung function tests remained essentially unchanged, but signs of alveolitis disappeared. This observation suggests that aluminum may cause granulomatous lung disease accompanied by a helper T-lymphocyte alveolitis, similar to that of berylliosis and sarcoidosis. Further observations would be necessary to show if this constitutes an early stage of aluminum-induced fibrosis (aluminum lung). PMID- 3813210 TI - Myocardial contraction band lesions in patients with fatal asthma: possible neurocardiologic mechanisms. AB - Myocardial contraction band necrosis (MCBN) occurs in catecholamine infusion, central nervous system stimulation, stress, and transient myocardial ischemia with reperfusion. In 4 of 13 children who died with asthma, MCBN was present, suggesting that this cardiac lesion may contribute to the deaths of some asthmatic patients. Two of the 4 patients who had MCBN had not received sympathomimetics intravenously or by an intracardiac route. Therefore, mechanisms other than infusions of large doses of catecholamines are probably involved in production of this cardiac lesion in asthmatics. PMID- 3813211 TI - Histoplasmoma, pleural fibrosis, and slowly enlarging pleural effusion in an asymptomatic patient. AB - A slowly enlarging pleural effusion and significant pleural fibrosis occurred in an asymptomatic patient with a subpleural histoplasmoma. The pleural disease may be a reaction to antigen diffusing into the pleural space from the histoplasmoma. In selected patients, resection of the histoplasmoma may be necessary to prevent impairment of ventilation from pleural fibrosis. PMID- 3813212 TI - NHLBI workshop summary. Pulmonary complications of the acquired immunodeficiency syndrome: an update. Report of the second National Heart, Lung and Blood Institute workshop. PMID- 3813213 TI - Follow-up on tuberculosis treatment in a Cambodian refugee camp. PMID- 3813214 TI - Early reexploration for excessive postoperative bleeding lowers wound complication rates in open heart surgery. AB - Clinical reviews of sternal wound infections following open heart surgery indicate many predisposing factors including diabetes, low cardiac output, use of bilateral internal mammary grafts, and reoperation for excessive postoperative bleeding. This study was undertaken to determine the role of mediastinal re exploration in the development of sternal wound complications. From a series of 2,271 patients undergoing median sternotomy for open-heart surgery between 1979 and 1984, 71 (3.1%) were re-explored for excessive bleeding. Nine of these patients died in the early postoperative period of noninfectious complications. The remaining patients were divided into two groups. Group 1 (54 patients) were re-explored without subsequent problems. Group 2 (8 patients) developed sternal and costochondral wound complications. Comparison of age, intercurrent and pre existing disease, total bypass time, crossclamp time, and postoperative hemodynamic status showed no statistical difference. All patients bled an average rate of 247 ml/hr. However, the average time before re-exploration was 7.6 hours in group 1 compared to 13.8 hours in group 2 (P less than 0.001). Sternal wound complications may be minimized by a policy of early re-exploration for excessive postoperative bleeding (greater than 200 ml/hr for 4 hours). PMID- 3813215 TI - Cardiac tumors in 19 years of private practice. AB - Since 1966 the authors have encountered nine cardiac tumors: eight myxomas and one tumor initially thought to be a sarcoma but histologically a squamous carcinoma. Seven myxomas were left atrial and the other were right atrial in location. The carcinoma was predominantly located in the right ventricle. Eight of the nine patients were female; ages ranged from 32 to 85 years. Of the myxomas, five displayed fever and dyspnea, two congestive heart failure and one transient ischemic episodes. The patient with carcinoma was in right heart failure. All patients underwent cardiac catheterization as well as echocardiography when it became available. Five myxomas were correctly diagnosed preoperatively while three were thought to have mitral stenosis. The patient with carcinoma showed a large right ventricular filling defect and a picture of constriction. All myxoma patients underwent surgery--three via left thoracotomy and five via sternotomy. Seven patients survived; however, the patient with right atrial myxoma was explored via the left chest for mitral stenosis and the myxoma was not discovered. She died of a pulmonary embolism pathologically confirmed as myxoma. All survivors have been followed by yearly echocardiograms and are free of recurrence. The patient with carcinoma died before surgery could be performed. Autopsy revealed almost complete replacement of the right ventricle by tumor and constrictive pericarditis. The terminal event was pulmonary embolus of squamous carcinoma. Although cardiac tumors are a rare entity, a high incidence of suspicion plus modern diagnostic methods can yield the diagnosis and allow a curative operation. PMID- 3813216 TI - Anatomic location of acute diabetic foot infection. Its influence on the outcome of treatment. AB - One hundred ten diabetic foot infections were studied in 76 patients with reference to the effect of the anatomic location of the infection on the treatment outcome. Distal infections were located in the toes or metatarsal phalangeal joints; proximal infections were located along metatarsals, at the heel, or above the ankle. Overall limb salvage was significantly lower in the proximal group (47.8%) than in the distal group (96.6%). A revascularization for healing was required in 12 per cent of hospitalizations. Mortality was significantly higher in the proximal group, but the healing times for open wounds and overall morbidity were not different between the groups. Diabetic foot infections must receive careful and timely treatment by concerned surgeons. The outcome of proximal infections is poor, with major risk of limb loss and mortality, but not hopeless. The treatment of distal infections derives greater limb salvage with nevertheless similar morbidity and healing time. PMID- 3813217 TI - Recurrent carotid stenosis. Incidence and management. AB - The actual incidence of recurrent carotid occlusive disease is not known. From January 1974 through December 1984, fifty-four patients underwent at least one second carotid endarterectomy or reconstructive procedure at St. Thomas Hospital in Nashville. Five patients required a third carotid operation. This retrospective study examines case reports, risk factors, patient presentation, interval of recurrence, and pathology involved. Surgical techniques and results are described. Complications occurred in six patients undergoing a total of 66 operations for an overall incidence of 9 per cent. Thrombosis was minimized by the use of antiplatelet drugs. Follow-up of patients ranged from one to 84 months. Four main causes for restenosis are discussed. PMID- 3813218 TI - Distal bypass for limb salvage in very elderly patients. AB - During the last 3 1/2 years, 40 bypasses to a tibial or peroneal artery (distal bypass) were performed for severe leg ischemia in 34 patients who were 80 years of age or older (range, 80-91; mean, 85). The operative mortality rate was 5 per cent. Cumulative life-table limb salvage rates for the 40 extremities were 91 per cent at 1 year and 81 per cent at 3 years. Graft patency rates at 1 and 3 years were 88 per cent and 56 per cent, respectively. Survival rates for the 36 patients were 91 per cent and 58 per cent at 1 and 3 years, respectively. Among 134 patients younger than 80 years who underwent 142 distal bypasses during the same 3 1/2-year period, no operative deaths occurred. In this younger group, cumulative life-table rates at 1 and 3 years were 89 per cent and 89 per cent, respectively, for limb salvage, 86 per cent and 85 per cent, respectively, for graft patency, and 93 per cent and 78 per cent, respectively, for survival. There were no statistically significant differences in these figures for the younger group when compared with corresponding figures for the older group. Among the 36 very elderly patients who underwent distal bypass for limb salvage, 24 patients (67%) with 25 revascularized limbs are alive and have a salvaged, functional extremity after follow-up as long as 41 months (mean, 21 months). These results suggest that an aggressive approach using distal bypass is warranted for limb salvage in very elderly patients. PMID- 3813219 TI - Differentiation of vascular and neurogenic claudication. AB - Lower extremity pain caused by exercise but relieved by rest is usually a reliable symptom of chronic arterial insufficiency. However, similar discomfort often occurs in patients who have neurospinal compression. Furthermore, both arterial occlusive disease and neurogenic causes of lower extremity discomfort may present simultaneously. Forty patients with symptoms that suggested intermittent claudication comprised our study group. All had non-arterial cause of their complaint. The nonvascular origin of the symptoms was suggested initially by clinical evaluation in 30 patients and by noninvasive evaluation in 25 patients. The neurospinal origin of symptoms was obscured in 15 patients because of the concomitant presence of significant arterial occlusive disease as demonstrated by noninvasive arterial testing. Twelve of these 15 patients underwent arterial reconstruction, which did not relieve their symptoms. Subsequently, the neurospinal origin of their symptoms was proven by appropriate evaluation and therapy. Forms of evaluation that proved helpful in the differential diagnosis were lumbosacral spine x-rays, electromyography, nerve conduction velocity studies, computerized tomography, Doppler noninvasive assessment and, at times arteriography and contrast myelography. PMID- 3813220 TI - The role of complete cerebral angiography in the evaluation of patients with prior stroke. AB - Ninety-eight consecutive patients with clinically resolved prior stroke were evaluated with complete cerebral angiography (CCA) in a prospective protocol. CCA showed the cause in 85 per cent, demonstrated significant intracranial pathology in 22 per cent, and directed medical (20%), surgical (33%), or nonspecific therapy based on a clear delineation of intracranial and carotid bifurcation anatomy and pathology. PMID- 3813221 TI - Risk of pulmonary embolus with inferior vena cava thrombosis. AB - The authors have evaluated the risk of pulmonary embolism both as a primary event or as a secondary embolus despite adequate anticoagulation in 39 patients with phlebographically documented inferior vena caval (IVC) thrombosis. Twenty-six of these patients had thrombi characterized as free floating, and 13 had thrombi that were adherent to the IVC wall without a free-floating component. The incidence of initial pulmonary embolism confirmed by either pulmonary arteriography or high probability ventilation-perfusion lung scanning was 50 per cent (13/26) in those patients with free-floating IVC thrombi, but 15 per cent (2/13) in those with closely adherent mural thrombi (P less than 0.05). Pulmonary embolism despite adequate anticoagulation occurred in 27 per cent (7/26) of patients with free-floating clots, but in only 17 per cent (1/8) of cases with adherent thrombi (P greater than 0.05). These data strongly suggest that patients with documented free-floating inferior vena caval thrombi are at a significant risk for pulmonary embolism as an initial event and perhaps also as a recurrent embolus, even in the presence of adequate anticoagulation. When such thrombi are identified, the overall incidence of pulmonary embolus is high and conventional anticoagulant treatment with heparin may not be sufficient. PMID- 3813222 TI - [Determination of drug plasma levels. Is it clinically profitable?]. PMID- 3813223 TI - [Importance of bacteremia in children less than 2 years old with fever without manifest focus]. AB - Authors studied the importance of occult bacteremia among children, under 24 months of age, presenting fever without localizing signs. 113 patients were studied, six had positive blood cultures (5.4%). Agents identified were: N. meningitidis twice, E. coli, Staphylococcus aureus, Streptococcus viridians and group B Streptococcus. Some clinical and laboratory data (body temperature, WBC count, neutrophil count and band count), were studied as predictors of bacteremia. None of these were statistically related to presence of bacteremia. PMID- 3813224 TI - [Moderate hypercholesterolemia in children. An index of familial pathology?]. AB - Out of 44 children (with 200 mg/dl cholesterol) 22, with constantly high levels of cholesterol were studied. All belong to a children population from Madrid which 95 percentile for cholesterol was 204 mg/dl. Fifty nine subjects, first degree relatives of these 22 children (17 families) plus probands were studied to determine if moderately elevated cholesterol levels during infancy are related to any form of familial lipidic disorder. Serum lipidic levels, anthropometric measurements, dietary habits a history of atherosclerotic cardiovascular disease (ACVD), were evaluated in all these 81 individuals. Hypercholesterolemia was encountered in 13 of the 59 non probands and high triglyceride levels in 6 people. More than one member of the family was to have some form of lipidic disorder in 12 of 17 families (71%) and in 10 the metabolic abnormality was of a type associated with a higher risk to suffer ACVD. Five families had a combined hyperlipidemia of the multiple lipoproteinemic (4 familiar heterozygotic hypercholesterolemia and one hyperlipidemia with a double phenotype II B and V). All family members were apparently healthy and had no knowledge of their underlying lipidic abnormality. In this group of families antecedents of morbi mortality because of atherosclerosis were more frequent that in group control families. Authors conclude that a moderately elevated serum cholesterol level during infancy may be a marker for various familiar lipidic disorders. Detection in infantile population of serum cholesterol levels 200 mg/dl should prompt us to perform a more complete lipidic evaluation both in children as well as in their families. PMID- 3813225 TI - [Mental retardation and X chromosome fragility]. AB - In four families with mental retardation as cardinal sign, authors found 11 cases of fragile chromosome X, 8 males (most with severe mental deficiency), and 3 females (mothers of affected children). Association of behavior perturbation as uneasiness, and hyperkinesia; facial dysmorphism as long or triangular face, big ears and macroorchidism, postpubertal in most of the cases, allow for clinical diagnosis. Autistic behavior is a suspicion sign too. Authors point out the necessity of a precocious diagnosis in order to treat patients with folic acid and to extend genetic counseling to the families. Prenatal identification is possible and inheritance mode in uncertain, debating recessive form linked to chromosome X and autosomic dominant controlled by sex. Incidence of 1.8/1,000 in newborn males, convert this specific form as the most frequent cause of mental retardation in this sex. PMID- 3813226 TI - [Evaluation of the bronchial provocation test with histamine in asthmatic children]. AB - Histamine inhalation challenge was performed in 32 asthmatic children aged 6 through 13, 20 control children aged 8 through 14, and 16 control adults aged 24 through 37 years. Histamine concentration producing a 20% fall in baseline FEV1 (PC20FEV1) was obtained. No control adult had a value below 8 mg/ml unlike 7 (35%) control children, all of them with values between 4 and 8 mg/ml. Asthmatics only on intermittent bronchodilators had higher PC20FEV1 values than those requiring daily medications. A value of 2 mg/ml was roughly the limit between these two subpopulations of asthmatic children. Test showed a high reproducibility in a two hour interval. Histamine inhalation challenge is useful in diagnosis of asthma and in assessment of its, severity. A PC20FEV1 value of less than 8 mg/ml may not be always reliable in indicating bronchial hyperreactivity, depending on the method used and-or the population studied. PMID- 3813227 TI - [Mediastinal teratomas. A clinical and pathologic study of 3 pediatric cases]. AB - Mediastinal teratomas are reported in three children. Two cases: an eighteen month-old female and a twelve-years-old female, were diagnosed of mature cystic teratoma. Third patient was a twelve-year-old male with an immature mediastinal teratoma. All tumors were located in anterior mediastinum. Mediastinal mature cystic teratomas were completely excised and their evolution were favourable. However, immature mediastinal teratoma infiltrated lung parenchyma and great blood vessels; in this case only a biopsy was performed. This patient died a month after surgical procedure. Clinical, radiological and pathological findings of mediastinal teratomas in childhood are commented. Prognostic factors and evolution of different histological types of mediastinal teratomas are evaluated. PMID- 3813228 TI - [Arrhythmia-hyperkalemia in a newborn infant with congenital adrenogenital syndrome. Usefulness of cardioversion]. AB - Cardiac arrhythmias can be life-threatening situations requiring swift action. Disorders of heart beat in pediatric age and, mainly, in neonatal period are very rare out of those occurring after cardiac surgery. Because of this there can be no training in their management on the part of pediatricians. A case of hyperkalemic arrhythmia in a newborn with adrenogenital syndrome in which electrical cardioversion was successful is presented. Furthermore, sequential electrocardiographic changes with hyperkalemia are shown and comments on physiopathology, diagnosis, treatment and etiology are made. PMID- 3813229 TI - [Abnormal movements in children. 2 cases of known etiology but infrequent: Sandifer syndrome and a syndrome caused by neuroleptics]. AB - Authors present two cases of children with abnormal movements. One of them described slow and dystonic movements of neck and head due to an important gastroesophageal reflux. These movements were useful to decrease annoyances that reflux causes in the child. Appearance of these movements and reflux is what is named "Sandifer syndrome". The other case presented stereotyped movements of head, like a negation, continuous and produced by a long intake of neuroleptics, which had caused a blockade of central dopaminergic receivers. Suppression neuroleptics of cured the child. PMID- 3813230 TI - [Psoriasis and chronic vitamin A poisoning]. AB - A case of a five year old girl who during a treatment with high doses of A and D vitamins prescribed for a long time because "psoriasis" is showed. Clinical, radiologic and biochemical symptomatology of chronic poisoning by vitamin A is proved. Authors want to draw attention to dangers of long use of vitamin A. PMID- 3813231 TI - [Treatment of vomiting in childhood]. PMID- 3813232 TI - [Fisher's syndrome: apropos of a case]. PMID- 3813233 TI - [Acute neonatal renal insufficiency associated with myoglobinuria]. PMID- 3813234 TI - [Congenital pulmonary arteriovenous fistula. Usefulness of M-mode contrast echocardiography]. PMID- 3813235 TI - [Acute edema of the lung as onset of the hemolytic-uremic syndrome]. PMID- 3813236 TI - Coccidioidomycosis in the acquired immunodeficiency syndrome. AB - Of 27 patients with the acquired immunodeficiency syndrome (AIDS) in Tucson, Arizona, 7 had concurrent coccidioidomycosis. Early manifestations of infection in 6 patients included diffuse nodular pulmonary infiltrates and Coccidioides immitis in many extrathoracic sites. By comparison, a retrospective review of the cases of 300 patients hospitalized with coccidioidal infection identified only 13 patients without AIDS who had the same extent of infection, and only 3 of these patients had no immunosuppressing conditions. Antibodies for coccidioidal antigens at serum dilutions as high as 1:2048 were detected in 5 of the 7 patients with AIDS. Six had temporary responses to amphotericin B treatment, taken both alone and combined with ketoconazole, but all died within 14 months of their diagnosis of coccidioidomycosis. Because annual rates of coccidioidal infection in the Tucson area are 4% or less, the rate of 27% that we calculated, based on 7 patients having the infection during 26 years of risk for AIDS, suggests frequent reactivation of the infection or enhanced susceptibility to endemic exposure in persons with AIDS. PMID- 3813237 TI - Percutaneous-endoscopic biliary stent placement. A preliminary report. AB - The placement of large-bore endoprostheses for relief of biliary obstruction by the percutaneous-transhepatic route is painful, requires a large hepatic parenchymal tract, and has a fairly high complication rate. The alternative technique of endoscopically placing similar-sized stents requires special instruments and skills, and may fail in passing very tight stenoses. We report a simpler combined percutaneous-endoscopic biliary stent (PEBS) placement technique with a high placement rate used in 11 patients with advanced malignant obstruction. In all 11 patients, 10 and 11.5 French stents were easily placed. Three patients developed sepsis but responded to antibiotics. One clogged stent required replacement. Two stents needed later endoscopic adjustment. Results of liver function test improved in 10 patients, and 8 patients showed improved quality of life. PMID- 3813238 TI - Biochemical profiles. Applications in ambulatory screening and preadmission testing of adults. AB - Evidence bearing on the utility of biochemical profiles for ambulatory care screening and preadmission testing was reviewed, and recommendations were formulated. Certain biostatistical principles relevant to this analysis include the concepts of regression to the mean, the meaning of biochemical "normality" (particularly as it relates to multiple testing), and the effects of disease prevalence on the post-test probability of disease for individual test results. Applying these principles to a typical 12-test battery in asymptomatic adults, one would expect a low yield of unanticipated diagnoses and a high proportion of false-positive results. For the typical test battery, the empirical evidence supports these expectations in ambulatory care screening. In addition, routine preadmission use of biochemical profiles is not supported by studies examining their impact on patient care, hospital costs, or lengths of stay. Whereas components of these profiles can be endorsed for screening or preadmission testing, we recommend that the routine use of the entire profile be abandoned in these settings. PMID- 3813239 TI - Transient regional osteoporosis. A study of 56 cases and review of the literature. AB - We describe the clinical features and course of disease in 56 patients (33 men and 23 women) with transient regional osteoporosis. The median age at hospitalization was 48 years. All patients had monoarticular or oligoarticular joint pain that was aggravated by weight bearing. Eighteen also had pain at rest in the involved joints and 6 had nocturnal pain. The joints of the lower extremities were affected in 54 patients; the hip was the most commonly affected joint. There was little evidence of synovitis. Osteoporosis was diagnosed on the basis of characteristic clinical findings and the results of roentgenograms and bone scans. The osteoporosis resolved spontaneously over several months. Treatment consisted of joint protection, initiation of gradual ambulation, and administration of nonsteroidal anti-inflammatory agents. Although its cause is unknown, osteoporosis appears to be a regional rather than a systemic process. PMID- 3813240 TI - Optimal duration of treatment for kidney infection. PMID- 3813241 TI - What cornerstone is best for physician payment reform? PMID- 3813242 TI - Certification in critical care medicine. PMID- 3813243 TI - The calcium hypothesis on hypertension. PMID- 3813244 TI - Calcium and cardiac arrest. PMID- 3813245 TI - Serum enzyme assays in acute myocardial infarction. PMID- 3813246 TI - Arterial blood gas analysis. PMID- 3813247 TI - Recurrent ventricular tachycardia in a patient with a peritoneovenous catheter. PMID- 3813248 TI - Bronchial carcinoid tumor and hypercalcemia. PMID- 3813249 TI - Thrombocytopenia, eosinophilia, and ranitidine. PMID- 3813250 TI - Spontaneous spinal epidural hematoma, Brown-Sequard syndrome, and factor XI deficiency. PMID- 3813251 TI - Thrombocytopenic purpura and platelet transfusion. PMID- 3813252 TI - Acute intoxication due to topical application of diethylene glycol. PMID- 3813253 TI - Acute febrile cerebrovasculitis. PMID- 3813254 TI - Theophylline toxicity and nifedipine. PMID- 3813255 TI - Keeping up with the medical literature. PMID- 3813256 TI - Medicine in Cambodian refugee camps. PMID- 3813258 TI - The ghost of GPEP yet to be. PMID- 3813257 TI - Cigarette smoking and Nicorette gum. PMID- 3813259 TI - The medical review article: state of the science. AB - Fifty reviews published during June 1985 to June 1986 in four major medical journals were assessed in a study of the methods of current review articles. Assessments were based on eight explicit criteria adapted from published guidelines for information syntheses. Of the 50 articles, 17 satisfied three of the eight criteria; 32 satisfied four or five criteria; and 1 satisfied six criteria. Most reviews had clearly specified purposes (n = 40) and conclusions (n = 37). Only one had clearly specified methods of identifying, selecting, and validating included information. Qualitative synthesis was often used to integrate information included in the review (n = 43); quantitative synthesis was rarely used (n = 3). Future research directives were mentioned in 21. These results indicate that current medical reviews do not routinely use scientific methods to identify, assess, and synthesize information. The methods used in this systematic assessment of reviews are proposed to improve the quality of future review articles. PMID- 3813260 TI - The foodstuffs intolerated and postprandial symptoms experienced by the patients with various gastrointestinal diseases. PMID- 3813261 TI - [Surgery of tumors of the adrenal gland. II--Conn's syndrome]. PMID- 3813262 TI - [Surgery of tumors of the adrenal gland. III--Pheochromocytoma]. PMID- 3813263 TI - [Complete esophago-jejunal-duodenal recanalization after total gastrectomy for early gastric cancer. Technical note and initial results]. PMID- 3813264 TI - [Anatomo-surgical considerations in the treatment of the pancreatic stump in duodeno-cephalo-pancreatectomy]. PMID- 3813265 TI - [Surgery of tumors of the adrenal gland. I--Cushing's syndrome]. PMID- 3813266 TI - [Antibiotic therapy of purulent meningitis]. PMID- 3813267 TI - [Cardiac manifestations of Lyme disease]. AB - Three cases of Lyme's disease with cardiac involvement are reported. One patient had myocarditis complicated by symptomatic complete AV block and two patients had asymptomatic 1st degree AV block. There were no abnormalities on echocardiography. The cardiac changes occurred between the 18th and 40th day after the onset of the disease and persisted 10 days: however these conduction defects may vary within a few hours. A rapid and complete cure was obtained with antibiotic therapy. PMID- 3813268 TI - [Absence of ultra-structural histological lesions of the myocardium in cardiac insufficiency of hyperthyroidism]. AB - Myocardial failure may complicate hyperthyroidism. Some authors consider that preexisting myocardial lesions are necessary for its development. We studied a case of myocardial failure, presenting as a dilated cardiomyopathy, complicating hyperthyroidism in a 57 year old woman. She had a bio-clinical evaluation and a haemodynamic study with endomyocardial biopsy of the left ventricule. No valvular or coronary disease were noted. The light and ultra-microscopic aspects of the myocardium were within normal limits. We conclude that preexisting myocardial lesions are not essential to the development of myocardial failure complicating hyperthyroidism. PMID- 3813269 TI - [Risk factors in the combination of myocardial infarction and carotid atheroma]. AB - This study compares two groups of patients: Group I with 44 patients who suffered recent acute myocardial infarction and Group II: 40 control subjects. In both groups, 2D Doppler echocardiography was performed to detect carotid atheroma, to determine the respective roles of vascular risk factors for two sites of atherosclerosis. Carotid atheroma affected 73 p. 100 of subjects in Group I and 22.5 p. 100 in Group II. Carotid stenosis of more than 40 p. 100 was found mainly in hypertensive patients who presented with acute myocardial infarction, and in patients with left ventricular hypertrophy. Smoking was more frequent in Group I than in Group II (p less than 0.001) irrespective of the frequency of carotid atheroma (p less than 0.05). Hypercholesterolaemia only favoured carotid atherosclerosis after acute myocardial infarction (p = 0.01). We did not find any difference in the incidence of diabetes mellitus in the two groups of patients. Age analysis indicated that carotid atheroma occurred earlier in Group I than in Group II. An association between a dominant risk factor for coronary disease (smoking or hypercholesterolemia) was found in 9 patients, all of whom had severe bipolar atherosclerosis with multivessel coronary lesions and carotid stenosis. PMID- 3813270 TI - [Resistance to vitamin K antagonists. 6 cases]. AB - Haemorrhage is the most frequent complication of oral anticoagulant therapy (OAT) and a resistance to these drugs is rarely reported. The following classification of OAT resistance is proposed: primary or secondary resistance according to the delay of onset (at the initiation of therapy or later); selective or generalized according to the number of drugs involved (only one or several); absolute or relative as judged by the prolongation of the prothrombin time (absent or moderate). Six cases are reported and the mechanisms of resistance are discussed: no intake, variations in the vitamin K availability (diet, intestinal absorption and synthesis of vitamin K), variations in the pharmacokinetics of oral anticoagulants (drug interactions, abnormal hepatic metabolism) and variations in the receptor affinity (hereditary resistance). Resistance is often overcome by progressive increase of the doses of oral coagulant, or by changing drugs, to warfarin or coumadin (long acting drugs). PMID- 3813271 TI - [Acute degenerative mitral insufficiency caused by rupture of the chordae in the elderly patient]. AB - Five cases of degenerative mitral incompetence due to rupture of the chordae tendinae in patients over 70 years of age were reviewed to determine the clinical features of this pathology which is not rare in elderly patients. Chordal rupture usually involves the posterior leaflet and is a sign of generalised disease of the mitral apparatus of two main types: myxoid infiltration or pellucid degeneration. Although the clinical syndrome of rupture is rare (10 p. 100), the mechanism of the mitral regurgitation can be identified by 2D echocardiography with a sensitivity of 92 p. 100, and the consequences of regurgitation on the left ventricle can also be evaluated. Rapid progression to acute cardiac failure is often observed and early surgical cure may be necessary (valvular replacement with a bioprosthesis is more common than mitral valvuloplasty). Further justification for this surgical approach is the improved myocardial protection which has reduced the perioperative mortality rate to less than 10 p. 100. PMID- 3813272 TI - [Primary hypothalamic tumors (excluding craniopharyngioma). Endocrine and post radiotherapy development study. Apropos of 17 cases]. AB - The authors underline a number of features of primary hypothalamic tumours (except craniopharyngioma) based on a study of 17 cases: The vital prognosis is satisfactory; only one death was observed with an average follow-up period of 80 months (range 1 to 17 years). This raises the question of the necessity for systematic biopsy to confirm the tumour histology (although when performed in conditions of stereotaxis there are no serious risks). The site of the tumour makes surgery difficult and complete ablation impossible. As many hypothalamic tumours, including the pilocytic astrocytoma which is the commonest type, are sensitive to radiotherapy, this would seem to be the treatment of choice. Total regression is observed in the majority of cases. From the endocrine point of view, the mediocre prognosis is aggravated by high energy radiotherapy. However, with the present therapeutic methods, it is relatively easy to compensate complete or dissociated deficits. There is an endocrine syndrome suggestive of hypothalamic tumour which consists of anterior pituitary deficiency, diabetes insipidus and moderate hyperprolactinaemia (20 to 100 ng/ml). Close medical surveillance is essential, both of the local (visual field and frontal CT scanning) and endocrine effects. Hormonal deficits may occur as a late complication up to 5 years after radiotherapy. The problems inherent to hypothalamic tumours: neurogenic hypernatraemia which is luckily uncommon, with an unexplained weight gain occurring during substitute therapy for adrenal insufficiency with physiological doses of hydrocortisone. Finally, the overall prognosis is good with a minimum of complications due to radiotherapy, excepting endocrine deficiency, providing a dose of 60 grays in 6 weeks at 2 grays per session is not exceeded. PMID- 3813273 TI - [Congenital hyperparathyroidism. 3 cases]. AB - Hypotonia, neonatal respiratory distress with a chest wall deformity should arouse clinical suspicion to the diagnosis of primary hyperthyroidism. The most common signs at this age are hypercalcaemia, increased alkaline phosphatase, low TRPP and radiological changes especially in the hip. Radio-immunological assay of PTH and plasma concentrations of Vitamin D metabolites are important diagnostic aids but the interpretation of these results should take the clinical and familial context into consideration. Rapid bone structural changes, the resistance of the hypercalcaemia to usual therapeutic measures and the progression to rickets justify urgent surgical treatment. Nearly all cases are due to clear cell hyperplasia. PMID- 3813274 TI - [Amyloidosis in adult Still's disease. Apropos of 2 cases]. AB - Two cases of amyloidosis were observed in a personal series of 42 patients with the adult from of Still's disease. Two other cases have been previously reported in the literature. In the first case, amyloidosis occurred 18 months after the onset of the disease and involved the kidneys and gastrointestinal tract with a fatal outcome in 6 months. In the second case, renal amyloidosis was observed 4 years after the onset of Still's disease and progressed to renal failure in 7 months, necessitating chronic haemodialysis. These cases show that the adult form of Still's disease may rarely be complicated by amyloidosis, the prognosis of which is particularly poor. PMID- 3813275 TI - [Osteomedullary amyloidosis with osteolytic lesions. Apropos of 4 cases]. AB - Amyloidosis of bone and bone marrow is rarely symptomatic and is generally limited to deposits diagnosed by histological examination. Four cases with lytic bone lesions are reported. In 2 cases, amyloidosis was associated with Waldenstroem's Macroglobulinemia, in one case with multiple myeloma and in 1 case with solitary plasmocytoma. These 4 cases are compared to 14 cases already published in the literature, including 2 cases of plasmocytic dyscrasias. The role of amyloidosis in the genesis of bone lesions is discussed. PMID- 3813276 TI - [Intravenous theophylline: adaptation of dosage to blood theophylline levels at admission and to clearance]. AB - Intravenous infusions of aminophylline expose the patient to the risk of overdosage related to the narrow safety margin of the therapeutic concentrations and to the great individual variability of its excretion. The aim of this study was to evaluate a simplified protocol designed to determine the optimal dose of theophylline based on total body clearance. Forty-four patients (average age: 63 years) admitted with decompensation of chronic respiratory failure (N = 33) or with status asthmaticus (N = 11) were studied. Theophylline was administered initially at a constant rate R0 (mg/kg/h) depending on serum theophylline concentrations on admission T0 (mg/l): R0 = 0.75 - 0.75 T0/20. Serum theophylline concentrations were measured at the 6th and 12th hours (T6 and T12) for calculation of clearance (Chiou et al. J. Pharmacokinet. Biopharm., 1978, 6, 135 151) and for adjusting dosage R. After 48 hours of treatment at this infusion rate, serum theophylline was again measured (T48) to check the adjustment of the dosage and recalculate clearance. In 11 patients T0 was greater than 15 mg/l (max = 44) and T12 was 10.5 +/- 6.4 mg/l. Theophylline was withdrawn in 6 patients with initial clearances less than 5 ml/kg/h (zero in 5 cases). T48 was within therapeutic values (10-20 mg/l) in 55 p. 100 of cases (21/38). Twelve patients had T48 less than 10 mg/l due to an increase in theophylline clearance (+ 80 p. 100 on average) related to improved right ventricular function in 7 cases. In 5 patients T48 was greater than 20 mg/l (max = 27.5) due to a fall in clearance (average -47 p. 100) which could have been caused by administration of erythromycin in 1 case and by dose-dependent kinetics in 2 cases. This protocol which is simple to carry out in practice allows early adjustment of dosage to give effective serum theophylline concentrations in over 50 p. 100 of cases. No serious cases of overdosage were observed, even in patients with high T0 and/or low initial clearances. Under-dosage and overdosage are related to large individual variations in theophylline clearance. PMID- 3813277 TI - [Cholestatic and cytolytic hepatitis and acute kidney failure caused by pirprofen]. PMID- 3813278 TI - [Phlebitis of the arm. Apropos of 45 cases]. AB - We report in this retrospective study the data of 45 patients presenting with deep venous thrombosis of the upper extremities. This includes: 22 phlebitis due to strains, 3 traumatic phlebitis, 3 phlebitis combined with an adjacent injury, 7 phlebitis following endovenous therapeutic procedures and 10 spontaneous phlebitis (4 during adjacent medical pathologies), 3 pulmonary embolisms, including a septic one are thus demonstrated. No patient died. The follow-up date of 12 patients out of 32 exhibiting a spontaneous phlebitis or phlebitis due to a thoracic outlet syndrome have been documented: 25 p. 100 of them still presented with severe injuries. All patients underwent heparin therapy, but no fibrinolytic. A surgical procedure of the thoracic outlet syndrome was performed, when liable to the disease. Data of this series was then compared with those of previous reports on the subject. PMID- 3813279 TI - [Caval thromboses and systemic diseases]. AB - Sixty-five patients presenting with a vena cava syndrome have been examined over a 7 years period; incidence of systemic diseases as an etiologic factor has thus been studied. A systemic disease was diagnosed in 17 cases, that is 25 p. 100 of cases. This incidence is higher in inferior vena cava syndromes (15 cases out of 45). Two diseases appear as the main factors: on one hand, Behcet disease, liable for 8 vena cava thrombosis, 7 inferior and 8 superior thrombosis; on the other hand, severe disseminated erythematous lupus liable for 5 cases of inferior vena cava thrombosis. Other etiologies are mentioned such as: Churg and Strauss disease (1 case), Horton disease (1 case) and hemorrhagic rectocolitis (1 case). In the patients presenting with lupus, two died from various pulmonary embolisms; a vena cava clip was required in 3 cases. As for lupus, the immuno-hepatologic exploration did demonstrate a thrombopenia in 5 cases, an hemolytic anemia with a positive Coombs test in 2 cases, and a circulating anti-coagulant (antiprothrombinase type) in one case. Though high frequency of systemic diseases in this series may depend on the patients' recruitment, systemic lupus as well as Behcet diseases are to be researched in case of vena cava thrombosis, above all if diagnosed in a young patient and failing to be explained by a congenital abnormality of hemostasis. PMID- 3813280 TI - [Hereditary deficit of antithrombin III]. AB - Antithrombin III is a well-known coagulation inhibitor. Its heterozygous deficit is demonstrated through concentrations reduced about by 50 p. 100. On a clinical level, about 40 p. 100 to 70 p. 100 patients present with deep venous thrombosis (visceral on the whole) and pulmonary embolisms from puberty. There are both qualitative and quantitative deficits, these appearing to be mostly frequent. Only calculation of activity in the presence of heparin (co-factor of heparin) enables to diagnose these two types of deficits. Treatment performed includes both AT III concentrated agents and heparin in severe cases. Recurrences prevention is performed thanks to antivitamins K. If surgical treatment or delivery, a prevention of any incidents thanks to a vicarious therapy (AT III concentrated agent) is to be used. PMID- 3813281 TI - [Constitutional protein C deficiency in 57 patients from 22 non-related families]. AB - A congenital deficiency in protein C (physiological inhibitor of coagulation) was identified in 57 patients: the deficiency was quantitative (type I) in 20 families, qualitative (type II) in two families. The transmission was autosomal dominant in 21 families but was suspected to be recessive in one family: the 18 years old homozygous propositus has a severe deficiency (protein C = 16 p. 100): both parents are heterozygous (consanguinity was present) and 5 other family members with heterozygous deficiency are asymptomatic. In the 49 patients (25 women, 24 men) belonging to the 21 other families, 9 men and 4 women (27 p.100) are asymptomatic although precipitating factors had existed in 5 patients. In the remaining 36 symptomatic patients, a deep venous thrombosis was observed in 34, a pulmonary embolism in 18. Recurrent arterial thromboses were diagnosed in 3 patients. The first thrombotic episode was observed at the mean age of 27 +/- 11 years and a triggering factor was found in 26 patients (72 p. 100). Thrombosis was recurrent in 21 (60 p. 100). In the patients without oral anticoagulant treatment, mean protein C antigen concentrations were 47 +/- 9 p. 100 and mean protein C activity was 46 +/- 10 p. 100. In 4 patients with type II deficiency, protein C antigen levels were normal (113 +/- 15 p. 100), contrasting with decreased protein C activity (43 +/- 6 p. 100). Thirty-eight patients have been treated with oral anticoagulants and a skin necrosis developed in the homozygous patients only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813282 TI - [Role of erythrocytes in thromboembolism pathology]. AB - The association of erythrocyte disorders and thrombosis in polycythemia vera, paroxysmal nocturnal hemoglobinuria (PNH) and sickle cell anemia suggest that erythrocyte abnormality, could be involved in the genesis of thrombosis. A significant correlation between the hematocrit level and the incidence of thrombosis has been reported indicating the role of blood viscosity, but did to exclude an intrinsic red cell. Thrombotic episodes in sickle cell anemia might be explained by a decreased deformability and an increased adhesion of red cells to endothelium. The incidence of thrombosis is of 40 p. 100 in patient with PNH with a frequent sus-hepatic localization. In addition to abnormal erythrocyte adhesion, abnormal membrane lipid distribution was observed in PNH, suggesting that they could participate in the pathophysiology of thrombosis. PMID- 3813283 TI - [Role of phlebography in the diagnosis of deep venous thromboses of the legs]. AB - Phlebography makes the diagnosis of lower limbs venous thrombosis possible, and points out as well both site and extension. The technique used is the "free flow" technique which is modified so as to visualize the iliac veins as well as inferior vena cava. The presence of lacunar image or cupula-shaped interruption demonstrates a recent thrombosis above all if associated with venous dilatation; absence of a main venous trunk and collateral circulation do demonstrate a previous thrombosis. Phlebography fails to explore easily some veins, especially pelvic and deep femoral veins, as well as to determine the clot initial appearance. Non-invasive methods, such as labelled fibrinogen, Doppler ultrasonography and rheoplethysmography are less sensitive and specific; only Doppler ultrasonography associated with ultrasound can supply quite good results. Despite such efficient methods, especially ultrasound combined with Doppler ultrasonography, phlebography appears as the main examination in the patients presenting with various thrombosis or pulmonary embolism. PMID- 3813284 TI - [Pseudophlebitis of the lower limbs. A critical study from 102 suspected cases of deep venous thrombosis]. AB - Clinical diagnosis of deep venous thrombosis appears as uneasy, because of inconstant and non-specific symptoms. When studying a phlebitis, the risk to diagnose venous thrombosis is over 50 p. 100. This review of 102 patients, supposed to present with phlebitis, confirms such data. The diagnosis reliability depends mainly on the physician's experience. Examination and clinical research, combined with Doppler data make possible to perform a good diagnosis in 4 cases out of 5. However, in 20 p. 100, phlebography is strongly required, appearing as an essential examination. Analysis of epidemiologic and clinical data demonstrates the importance of certain data as for the diagnosis: female sex, age superior to 60 years, existence of two antecedents and/or a cardiopathy, a complex clinical picture might demonstrate a diagnosis of deep venous thrombosis. Post-phlebitic syndrome and skin infectious pathologies are the main pseudophlebitis etiologies. Popliteal cyst (often mentioned in English literature as a pseudophlebitis factor) is diagnosed in 11 p. 100 of cases. PMID- 3813285 TI - [Treatment of deep venous thromboses with heparin. Therapeutic management and biological monitoring]. AB - Heparin may be administered either prophylactically (to prevent postoperative thromboembolic complications) or therapeutically (when thrombosis has occurred) and the dosages are very different. In addition, low molecular weight heparins are now available, and usually reserved only for prevention of thrombosis. The biological monitoring of these different therapies has evolved, and in addition to the classical tests like the recalcified plasma clotting time or the APTT, it is now possible to use more specific tests like the amidolytic activity of anti IIa or anti-Xa. None of the simple tests alone is satisfactory for the verification of the efficacy of the treatment on a formed thrombosis or for detecting patients at high risk of haemorrhage. At this present state of our knowledge, the association of two of the preceding tests is recommended as any discrepancy could lead to the detection of an associated, unrecognised abnormality such as a circulating anticoagulant factor or thrombocytopaenia. The monitoring of classical prophylactic treatment generally only requires a very limited monitoring. PMID- 3813286 TI - [Cerebral vascular accidents in anticoagulant therapy]. AB - Thirty-three patients hospitalized as they presented with cerebral vascular lesions during anticoagulant therapy (25 intracerebral hemorrhages, 7 subdural hematoma, and one ischemia lesion). Frequency of intra-cerebral hemorrhages along with anticoagulant therapy was about 11 p. 100, this of subdural hematoma ranged from 12 to 38 p. 100. Intra-cerebral hemorrhages failed to show any peculiar topography and volume was variable. A predisposing factor thus existed in about 50 p. 100 of cases: high blood pressure or arterial aneurysm. Previous cranial traumatism was only demonstrated in 48 p. 100 patients presenting with a subdural hematoma. Prognosis as for these intracranial hemorrhages might be compared to this of hemorrhagic lesions appearing under other etiologic conditions. Ischemia lesion was secondary to a severe thrombopenia to heparin. PMID- 3813287 TI - [Value of thrombolytic agents in venous thrombotic states]. AB - Fibrinolytic efficiency in the treatment of deep venous thrombosis is superior to heparin efficiency, but appears as more expensive. It must thus been used only if strongly required. Thrombolytic role is then demonstrated on the clot lysis, as far as the latter is recent, near, and not really obstructive. Such a thrombosis can be performed such a treatment, thus reducing sequelae of post-phlebitic disease. However, it increases by 2.9 the hemorrhagic risk, thus requiring extreme caution as for fibrinolysis and by 70 for SK and up to 200 for UK as for the cost. On a practical point of view, using SK (100,000 U/h) UK (4,000 U/kg/h) after an initial dose or UK (2,000 U/kg/h) combined with heparin, the treatment will be performed at least three days and followed up every 6 hours thanks to a fibrinemia, biological control as for therapeutic efficiency, numeration and a TCK. Fibrinolytics are thus prescribed to young patients presenting with a recent phlebitis demonstrated thanks to phlebography. PMID- 3813288 TI - [Venous thrombectomy and caval interruptions]. AB - Authors study the role of surgical treatment in the venous thrombo-embolic disease. At the moment, venous thrombectomy can be performed only in post operative unilateral iliac thrombosis as well as in juxtarenal vena cava thrombosis (so as to enable a sub-nephric cava interruption) and finally to ilio cava thrombosis. Vena cava interruptions can be performed either through a peri cava clip, or by an intra-cava filter (the most efficient appears to be the K.R. Greenfield filter). Various advantages are thus studied. Vena cava interruptions are then discussed, according to clinical and angiographic data. PMID- 3813289 TI - [Surgical treatment of sequelae of phlebitis]. AB - Surgical indications in the post-phlebitic disease are supplied by an accurate physiopathologic analysis of the mentioned syndrome. Fuller research means such as: phlebography, functional explorations enable to demonstrate great pathogenic processes that could require a surgical treatment: venous obstruction can be treated thanks to a derivation treatment Palma-type. Various techniques have been proposed as for deep venous insufficiency. Surgical procedure of superficial venous insufficiency appeared as essential in operative indications. The major problem of such a procedure was the suppression of blood escape due to perforans veins insufficiency. There was no surgical treatment of postphlebitic disease, but rather surgical techniques that could be suited to particular conditions. PMID- 3813290 TI - [Recommendations of the Hemostasis and Thrombosis Study Group. Toward better monitoring of anticoagulant treatment with antivitamins K]. PMID- 3813291 TI - [Chronic capillary hyperpermeability?]. PMID- 3813292 TI - [Role of ornithosis in pneumopathies]. PMID- 3813293 TI - [Arterial hypertension and unilateral small kidney]. AB - Within a 10 years period, 612 patients underwent an autopsy, in a geriatric hospital. Seventeen p. 100 were discovered to have a high blood pressure. Twenty nine patients (that is about 4 p. 100) presented with a small unilateral kidney. The pathogenetic factors of these unilateral nephropathies were various, many causes of which were unilateral pielonephritis. Out of the patients exhibiting a small unilateral kidney, 62 p. 100 had a high blood pressure. Hypertension due to a unilateral nephropathy, when studied on a statistic level, does not induce any atheromatous lesion nor heart ponderal hypertrophy more acute than essential high blood pressure. The unilateral nephropathies hypertension would thus be compared to an hypertension "depending on sodium or volume" and not as an hypertension "depending on renin". PMID- 3813294 TI - [Hospitalization of the elderly in a department of internal medicine. Predictive elements of risk and benefit]. AB - One hundred and thirty patients over 70 years have been examined in a prospective way, so as to determine pernicious and benefic effects of hospitalization in elderly people. Deaths appear to be more frequent in old male patients, with a high cultural level on one hand, and a "reduced" independence, on the other hand (according to the "Sandoz clinical assessment of geriatrics scale"). Benefic effects appear to be essentially dependent on primary diagnosis, and on the entourage, as well as on the previous medical care, though less important. PMID- 3813295 TI - [Multiple extra-bone sites of Kahler's disease]. AB - The authors report the case of an IgA secreting multiple myeloma which, after a rapid initial remission, relapsed with skin, thyroid, testis and lung metastases without bone recurrence. A review of the medical literature on this subject underlines the poorly differentiated microscopic appearance and the low secretion of paraprotein of these extraosseous plasmacytic tumours which have a poor prognosis due to their increased malignancy. PMID- 3813296 TI - [Prognostic value of anti-TSH receptor antibodies in Basedow's disease treated with carbimazole]. AB - In order to precise their prognostic value, the anti-TSH receptor antibodies (TRAK) have been measured in 70 cases of Graves' disease treated with carbimazole. Results (expressed in percentage of inhibition of labeled TSH binding) were grouped into 7 mean values: before treatment, from 15 days to 3 months, from 3 to 12 months, 2nd, 3rd, 4th and 5th years. For all cases together, a progressive decrease was observed: 40, 37, 29, 19, 14, 10, 7 p. 100. In 16 cases with good outcome, the mean values are significantly lower than those of 29 cases with bad outcome, respectively: 33 vs 46, 29 vs 43, 17 vs 30, 12 vs 27, 11 vs 22, 3 vs 15, 1 vs 11 p. 100. The TRAK titers at whatever t time are correlated to the clinical state at t + 2 years: about 30 p. 100 relapses if the TRAK titer is less than 10 p. 100; about 80 p. 100 relapses if it is 80 p. 100. So, the anti TSH receptor antibodies have their place among the prognostic parameters of Graves' disease treated with carbimazole. PMID- 3813297 TI - [Subacute septicemia caused by Meningococcus of serogroup Y and acquired deficiency of complement C3 fraction]. AB - The high frequency of meningococcal infections in patients with congenital deficiency of a component of the complement terminal pathway emphasizes the critical role of this system in host resistance against Neisseriaceae. We report the observation of a subacute septicaemia due to N. meningitidis serogroup Y. This girl had an acquired deficit of the C3 fraction of complement due to a high titre of C3 nephritic factor (C3NeF). There was no evidence of partial lipodystrophy or biological symptoms of glomerular disease. The meningococcal infection revealed this biological abnormality. PMID- 3813298 TI - [Subcapsular hematoma of the liver in an eclamptic crisis]. AB - A patient is described who showed signs of eclampsia in the 31st week of first pregnancy. The cause of shock proved to be a subcapsular hematoma in the liver and it was accompanied by a hematothorax. The diagnosis was made by CT-scanning. The pathogenesis is discussed. PMID- 3813299 TI - [Castelman's angiofollicular hyperplasia of multifocal form Apropos of 2 cases]. AB - Castelman described as angiofollicular hyperplasia (AFH) a benign lymphovascular hyperplasia forming a single tumour, classically situated in the mediastinum. A multifocal lymph node form of AFH was individualised by Leibetseder and Turner about 10 years ago (MAFH). This is a rare syndrome, the clinical and biological characteristics of which are almost identical to angioimmunoblastic lymphadenopathy (AIL). The only difference is in the histology of the ganglia which shows changes of AFH. We report two cases of MAFH. In one patient with histological confirmation of splenic involvement the evolution was subacute. In the second case, the histological features of the lesions were observed to change during successive biopsies: appearances of AFH changed to typical AIL. This observation suggests that MAFH may be a disorder of the immune system. Usually considered as benign lymphatic hyperplasia with a chronic evolution, the long term development of lymphoma poses the problem of the evolutionary potential of this condition, which may be likened to AIL in which lymphomatous transformation is also recognised. PMID- 3813300 TI - [Malignant histiocytosis of pulmonary form]. AB - Malignant histiocytosis beginning by a unique pulmonary location is most unusual. The case reported here has seemed worthy because of its strange clinical aspect, the unexpected diagnosis, and because of the way it answered completely and rapidly to the following chemotherapy: Adriamycin 50 mg/m2, Cyclophosphamide 750 mg/m2, Vincristine 2 mg one day every three weeks associated to Prednisone 100 mg/m2 the five first days. A study of literature has allowed us to review all pleuro-pulmonary location initiating malignant histiocytosis and to stress out the errors of diagnosis that can outcome in this case. PMID- 3813301 TI - [Mutagenicity of urine after ingestion of saccharin in man]. AB - In vitro tests of mutagenicity help detect carcinogenic substances. A variation of the Ames test may be used to study the mutagenicity of urine after exposition of the organism in vivo. Saccharin is a widely used artificial sweetener excreted in the urine which can induce dose-dependent tumours of the bladder in the animal. We studied the mutagenicity of the urine of healthy volunteers after the ingestion of a single dose of saccharin. The results show a mutagenic effect related to the dose ingested in two types of Salmonella typhimurium (TA 98 and TA 38). These results are difficult to interpret as saccharin is not mutagenic in vitro alone or in the presence of control urine which eliminates a direct carcinogenic or cocarcinogenic effect; we were unable to detect impurities or metabolites. This study underlines the difficulty of prophylactic detection of chemical carcinogens. PMID- 3813302 TI - [Abscess of the spleen caused by Salmonella typhi: case report]. PMID- 3813303 TI - [Systemic lupus erythematosus diagnosed after 12 years' treatment with procainamide]. PMID- 3813304 TI - [Unusual metabolic alkalosis in chronic renal failure]. PMID- 3813305 TI - [Recurrent polymyositis and positive Toxoplasma serology]. PMID- 3813306 TI - [Nephrotic syndrome and multivisceral manifestations in a patient treated with amiodarone]. PMID- 3813307 TI - [Tuberculous pyopneumothorax 38 years after collapse therapy]. PMID- 3813308 TI - [Diarrhea and gram-positive intra-enterocytic microorganisms in AIDS?]. PMID- 3813309 TI - [Hypoaldosteronism caused by 18-hydroxydehydrogenase deficiency (or type II corticosterone-methyl-oxidase)]. PMID- 3813310 TI - [Aortic insufficiency and rapidly constrictive pericarditis in juvenile onset rheumatoid arthritis. Apropos of a case and review of the literature]. PMID- 3813311 TI - [The role of corticoid therapy in plasma exchange. Meeting organized by the French Society of Hemapheresis. Paris, 29 January 1986]. PMID- 3813312 TI - [Corticotherapy and plasma exchange in myasthenia and polyradiculoneuritis]. PMID- 3813313 TI - [Analysis of 3 years' activity of recognized plasma exchange centers of the Paris Public Welfare Department]. PMID- 3813314 TI - [Value of methylprednisolone in the treatment of systemic necrotizing vasculitis. Results in 15 patients]. PMID- 3813315 TI - [Efficacy of the injection of corticoids combined with plasma exchange in the treatment of patients with autoimmune thrombopenic purpura]. PMID- 3813316 TI - [Treatment of lupus nephropathies without corticoids]. PMID- 3813317 TI - [Immunopharmacology of glucocorticoids]. PMID- 3813318 TI - [Psychiatry and interdisciplinary research. Value of a systems approach]. AB - Interdisciplinary research is particularly difficult, because of the different frames of reference used in the individual disciplines. Psychiatry by itself show already the complexity of the current methodological situation. A fundamental epistemological problem is posed by the unity and uniqueness of the patient as opposed to the multiple-faceted traits and experiences presented to the observer. The authors show the utility of the systems concept for solution of these difficulties. They depict the characteristics of "the systemal method", the way it is employed and its many applications in the clinic as well as in pharmacology, neurochemistry, neurophysiology and ethology. The systemal approach allows comparison and integration of data and results from various disciplines by means of the concepts "homology" and "isomorphism", and may thus contribute to progress in the study of biological psychiatry. It also makes it possible to regard the organism as an ensemble of sub-systems in interaction with its environment. Finally, because of its logicomathematical foundation, the systemal approach lends itself readily to application of computer techniques. PMID- 3813319 TI - [The simulation of mental disorders. 2. Other psychopathological and psychosociodynamic aspects]. AB - The output and presentation of unauthentic symptoms, or more or less roughly exaggerated, effected intentionally, can only create conceptual and semantic difficulties to the observer when, well informed by the context, he suspects a utilitarian objective from the individual person. The problem of malingering, seed of pathology, refers to questions on the expert's role and his way of collaboration with the petitioning authority. PMID- 3813320 TI - [The psychotic, laws and the Law]. AB - We relate some clinical examples of patients who went to hospital as offenders (murders). They were not condemned because they were mentally ill; we tried to demonstrate that article 64 of the French law is inadequate in reference to modern psychological, phenomenological and psycho-analytical discoveries. We relate cases of patients who harshly punished themselves because they were not convicted by the Law. The last observation induces the transition between the Law, as Lacan says, (the fundamental taboo of incest) and the laws put up by our societies. PMID- 3813321 TI - [Animal experiments in hospitals on the subject of addicting substances]. PMID- 3813322 TI - [Medical responsibility in cases of suicide in hospitals]. AB - The author considers the problem of medical responsibility in case of suicide at the hospital, his study being limited to the psychiatric hospital which is the field of his practice. The notion of medical responsibility is dealt in connection with the functioning of medical units as well as with regards to the medical or care action which are practised therein. The author's conclusions deal with the psychological motivations of the plaintiffs, insisting as well on the reasons due to the very evolution of psychiatry as on the motives due to the evolution of families' mentality. PMID- 3813323 TI - [An alternative to the hospitalization of the demented elderly: the nursing home]. AB - The number of demented old people continues to increase. Their admission to a hospital is dangerous ("Syndrome de Glissement") and tolerated with difficulty by the nursing staff. The solution of home care is interesting but insufficient. The creation of collective homes for demented elderly seems to furnish an effective solution contributing to a decrease in hospital admissions and a better quality of life for these persons. The modalities of creation and functioning are considered and allows one to think that these establishments will appear in France and also, in the world. PMID- 3813324 TI - [Apropos of 40 supervisory home visits in view of a decision for commitment in the department of Gironde]. PMID- 3813325 TI - [Video confrontation and dementia]. PMID- 3813326 TI - [Self mutilation preceding transsexualism]. PMID- 3813327 TI - [Childhood asthma]. PMID- 3813328 TI - [Ekbom's syndrome and delusion of skin infestation. 1. Review of the literature]. PMID- 3813329 TI - [The late-life companion and the inanimate object of the person with senile dementia: an attempt at comprehension through a comparative study with phenomena encountered during childhood]. AB - The thought of this work about the mad senile person's affective life concerns some almost permanent clinical establishments such as: on one hand, the existence of late-life companions and inanimate objects evoking some phenomena met during childhood: fancied companion, fetish objects. On the other hand, the existence of "behaviours" evoking those of the little child during his psycho-affective development. We have been led to study the notion of regression during the dementia process and ask ourselves about psychopathological mechanisms underlying this regression, regarded as a mechanism of narcissistic strengthening underlying the appearance of late-life companion or inanimate object. We underline in the conclusion that: on one hand, for these persons showing a deep disturbance of narcissistic economy, there is need to elaborate a relation with a narcissistic object, according to the somato-psychic deterioration level. On the other hand, the phenomena established during the dementia process, can't be assimilated to opposite distance covered by progressive movement. PMID- 3813330 TI - [Toward a new approach to mania]. AB - After giving a brief summary of the classical psychiatry contribution (taken down a medical pattern of psychiatry diseases) to the knowledge of manic-depressing disorder, the problem of clinical-biological connection to which this classical psychiatry is still confronted is underlined. As a possible answer to this problem, a new approach to mania is possible in a dimensional perspective of the mental disease taking into account the connection model as well as the pathological characteristics within the clinical chart. The notion of integrated behaviour will supply to notion of syndrome (in which all symptoms are equivalents). So, a behaviour dimension, well defined from a clinical analysis connected with a factorial analysis, is proposed as a specific maniac size and as a compartmental aim to the treatments. A dividing of mental pathology in terms of behaviour anomalies should allow a better link between the clinical and the biological. PMID- 3813331 TI - [Childhood antecedents in adult schizophrenics. I) Critical review of retrospective and prospective studies]. PMID- 3813332 TI - [Childhood antecedents in adult schizophrenics. II) Anamnestic study of 35 adult schizophrenics]. PMID- 3813333 TI - [Plasma levels of clomipramine and declomipramine in patients with depression: a study of its correlation with therapeutic efficacy]. AB - Twenty four in-patients with an endogenous or non endogenous depressive syndrome (9 and 15, respectively) were treated in hospital for 21 days with various dosages regimens of clomipramine. Plasma concentrations of clomipramine and demethylclomipramine were determined once a week in blood samples. Therapeutic effects were assessed with Hamilton Rating Scale. At day 21, optimal therapeutic effect was observed when the sum of clomipramine and demethylclomipramine plasma levels was situated between 200-400 ng/ml. PMID- 3813334 TI - [Statistical evaluation of a new depression scale: the relational scale]. PMID- 3813335 TI - [The group of selective antidepressants, serotonin reuptake inhibitors]. PMID- 3813336 TI - [Psychogenic polydipsia with hyponatremia]. PMID- 3813337 TI - [Clinical analysis of the effect of psychotropic agents by a quantitative study of free association and experimental dream arousal]. PMID- 3813338 TI - [Increase in suicide rates in Scandinavian psychiatric hospitals]. PMID- 3813339 TI - [Borderline states]. PMID- 3813340 TI - [The borderline state or the double form of the double]. PMID- 3813342 TI - [Several commentaries on the psychotherapy of borderlines]. PMID- 3813341 TI - [Borderline state: prospective or retrospective diagnosis]. PMID- 3813343 TI - [A general survey of epidemiologic research in Norwegian psychiatry]. PMID- 3813344 TI - [Role of epidemiology in the adaptation of a private psychiatric health system]. PMID- 3813345 TI - [Life events and cancer of the breast]. PMID- 3813346 TI - [Hemodialysis and mental disorders (schizophrenia in particular). Survey of 7746 patients and 153 hemodialysis units]. PMID- 3813347 TI - [Incidence and aspects of the Ekbom syndrome. Study involving French dermatologists (apropos of 150 cases )]. PMID- 3813348 TI - Within-laboratory quality control of asbestos counting. PMID- 3813349 TI - Occupational health hazards from road construction and sealing work. PMID- 3813350 TI - Airborne spores from mouldy citrus fruit--a potential occupational health hazard. PMID- 3813351 TI - Bone and joint changes in the wrists and elbows and their association with hand and arm vibration exposure. PMID- 3813352 TI - Capture efficiency of flanged circular local exhaust hoods. PMID- 3813353 TI - Barium in welding fume. PMID- 3813354 TI - Rationale of ACGIH recommendations for size-selective sampling. American Conference of Governmental Industrial Hygenists. PMID- 3813355 TI - Intralesional corticosteroid treatment of chalazia. AB - Thirty-eight chalazia in 29 patients were treated with intralesional corticosteroid injections; 71% resolved after one injection, and another 15.8% resolved after a second injection. Only two large chalazia required surgery. Intralesional corticosteroid injection offers an easy, quick, and effective way of treating small and medium-size chalazia and does not require special instruments or any additional treatment. The method is convenient for the patient as well as for the ophthalmologist. PMID- 3813356 TI - Sarcoid granuloma simulating amelanotic melanoma of the iris. AB - A 24-year-old black man had a unilateral vascular iris tumor associated with iridocyclitis. Clinically, the iris lesion appeared similar to an amelanotic melanoma. A systemic workup, including an angiotensin-converting enzyme determination, suggested a diagnosis of sarcoidosis. A conjunctival biopsy confirmed that diagnosis. PMID- 3813357 TI - Congenital see-saw nystagmus associated with retinitis pigmentosa. AB - Two sibling patients with see-saw nystagmus associated with advanced retinitis pigmentosa are presented. The see-saw nystagmus was most likely congenital but demonstrated a torsional pattern different from that previously reported for congenital see-saw nystagmus. Anatomic and etiologic factors associated with see saw nystagmus are discussed. PMID- 3813358 TI - Acute frontal sinusitis after lacrimal surgery. AB - Acute frontal sinusitis occurred in four patients who required removal of the anterior portion of the middle turbinate to provide adequate intranasal drainage during lacrimal surgery. Three patients with redness and swelling around the wound were initially thought to have wound infection, but localized tenderness to percussion of the frontal sinus and air fluid levels on x-rays indicated acute frontal sinusitis. Treatment with antibiotics and steroids gave relief. Use of unipolar electrocautery to excise the middle turbinate probably caused acute inflammation of the frontonasal duct. We recommend simple excision without electrocautery in those cases requiring removal of turbinate for successful lacrimal surgery. PMID- 3813359 TI - Foveal diseases. AB - Among the small group of diseases in which the pathology is limited to the fovea are foveal cyst or hole, pseudovitelliform maculopathy, solar maculopathy, and retinal burn induced by the illumination of the operating microscope. A brief discussion of each of the above is presented to provide help in diagnosis, management, and, wherever possible, prophylaxis. PMID- 3813360 TI - The ETHAN syndrome. AB - Two mechanisms by which patients compensate for congenital nystagmus are assumption of a head position that places the eyes in a "null zone" of least nystagmus, known as nystagmus compensation syndrome (NCS), and convergence to dampen nystagmus, known as nystagmus blockage syndrome (NBS). We followed five patients in two groups who combine these mechanisms. The first group presented with spontaneous alternation between nystagmus and a head turn with orthotropia (NCS), and a large-angle esotropia with a variable head position that persisted even when patched (NBS). The second group of patients presented with a constant large-angle esotropia that lessened their nystagmus and variable head posture (NBS). Following recession of both medial rectus muscles with or without placement of posterior fixation sutures, they developed an abnormal head posture with orthotropia (NCS). The presence of mild amblyopia may contribute to the alternation between the two compensatory mechanisms. PMID- 3813361 TI - [Tympanic reconstruction by molded grafts. Value and results. Apropos of experience in 158 cases]. AB - Use of a moulded aponeurotic graft, shapened and then made rigid by heat and formalin, is a seductive method of tympanic reconstruction because of its simplicity and availability. Indications for and results of the application of this method are analyzed based on experience of 158 cases, with sufficient follow up in 90. The principal indication for use is large perforations, when it is possible to exteriorize the whole canal and almost all the tympanic remains, while doubt exists as to its advantages for treatment of small perforations. Its essential advantage is in fact the ease with which the graft can be positioned on external surface of malleus and inside the remains of tympanic membrane. Overall anatomical results were very satisfactory (83.5%) if one includes in failures of treatment the apparent lateralizations of graft. Functional results were poorer, with rarely complete recovery of hearing and a certain number of labyrinthizations possibly due to injury to handle of malleus or even perforation of canal. Secondary degradation of favorable results may develop because of some degree of lateralization of the newly formed tympanic membrane. These could perhaps be avoided by the technical artifices proposed by other authors. PMID- 3813362 TI - [Functional surgery of cancer of the hypopharynx. Hemilaryngopharyngectomy, posterior pharyngectomy by bilateral cervical approach]. AB - The authors report on 48 patients operated by hemi-laryngo-pharyngectomy for spinous carcinoma of the piriform sinus. They try to precise the indications by analysing the factors influencing survival and relapses. They compare surgery to the other methods. In a second part, they report 3 cases of posterior pharyngectomy by bilateral cervical incision. PMID- 3813363 TI - [Choice of the 3d portion of the jejunum for reconstruction of the pharynx in circular pharyngolaryngectomies. Indications and advantages]. AB - Many procedures are used for reconstruction of a pharyngeal gutter after circular pharyngolaryngectomy, interrupter of digestive continuity. The operation chosen was used of third part of jejunum for reconstruction, and its indications and limitations are described. The choice was based on anatomic data from dissection of 100 cadavers and values for different measurements performed (length of transplant, height of mesentery, caliber and length of vessels), and more particularly on constancy and reliability of vascularization of this digestive segment. To these advantages are added bacteriologic, technical, histologic and physiologic reasons. Results are analyzed of 11 operations carried out in the same department, from among a larger group comprising now 45 cases. Postoperative course was usually uncomplicated with rapid restoration of deglutition (a mean of 11.77 days in 9 of the 11 cases). Preoperative radiotherapy is not a contraindication and postoperative radiotherapy should be given routinely as a complement to surgery. It is usually well tolerated and transplant necrosis is not provoked. Nevertheless, the seriousness of this type of lesion is underlined by the high incidence of carcinologic failures, with an elevated risk of local and regional recurrence and of distant metastases. PMID- 3813364 TI - [Functional radical neck excision. Evaluation of 10 years' experience. Apropos of 434 cases]. AB - A total of 434 functional evidements of neck were conducted in 313 patients, taking into account all primary localizations. Details of the procedure used are described while emphasizing the need for an evidement tending towards one as complete as a radical operation. Surgery was usually elective (89% of cases) but in 11% considered as essential. A high proportion of lymph nodes classified as no were, however, found to be invaded (22.8%, including 27.5% of these with capsule rupture). Despite this, glandular recurrence on the side of functional evidement was extremely low (less than 7%) even when recurrence was epithelial or involved a second localization. These findings emphasize the validity of functional evidement and confirm published data, known to be difficult to analyze. Although the value of this operation with respect to the cancer is well established, the actual functional interest, particularly in relation, to external branch of XI th nerve is debatable. PMID- 3813365 TI - [Origin of acoustic neuroma]. AB - Acoustic neurinomas are vestibular schwannomas. Ultramicroscopic examination of the root of these tumors, removed using a petrosal approach (translabyrinthic, suprapetrosal) in 20 cases, investigated the site of origin of the schwannoma. Tumoral capsule was absent between Scarpa's ganglion cells and tumoral cells, these two types of cells being intermingled. The fact that the very small tumors, 3 to 5 mm in diameter, were all derived from Scarpa's ganglion and were separated by a capsule from the other structures of internal auditory canal prove that acoustic neurinoma arises from Scarpa's vestibular ganglion. Other studies have shown the absence of myelin surrounding bodies of Scarpa's ganglion cells in humans, inversely to findings in other vertebrates. Since on the one hand the appearance in humans is similar to that observed during development of Scarpa's ganglion in the rat, and on the other hand acoustic neurinoma has never been demonstrated in the animal, it can be suggested that acoustic neurinoma development in humans corresponds to cellular immaturity of Scarpa's ganglion. PMID- 3813366 TI - [Anesthesia in surgery of acoustic neuroma by the trans-petrous approach]. AB - A combined oto-neurosurgical team has operated upon 86 patients with acoustic tumors larger than 2 cm via translabyrinthine (T.L.) approach over a period of two years. Authors describe anesthetic technic and discuss the advantages of T.L. approach versus sub-occipital approach: supine position, unnecessary invasive monitoring, anesthetic safety, no venous air embolism, quick recovery, no vital pulmonary complications. PMID- 3813367 TI - [Our experience with surgery of neuromas of the 8th nerve]. AB - Before 1982 the suboccipital approach was reserved for neurinomas larger than 2 cm diameter, whereas since that date the translabyrinthine approach has been employed in all cases where no attempt was made to preserve hearing. Of the 85 patients operated upon between 1978 and 1985, 5 were through a supra-petrous approach, 35 a retro-sigmoid approach, 44 a translabyrinthine approach and one by a transotic approach. Translabyrinthine approaches allowed the best postoperative course and conservation of normal facial motility in 22 patients of 33 with stages II and III lesions. An attempt was made to preserve hearing in 9 patients, with one reasonable result by the supra-petrous approach and 2 satisfactory results including one perfect operated upon using a rectosigmoid approach. PMID- 3813368 TI - [Neurinoma of the intratemporal facial nerve. Anatomo-clinical classification of 12 cases]. AB - Neuromas of the intratemporal facial nerve are uncommon benign tumors, mostly schwannomas. An anatomo-clinical classification is proposed in view of the 12 cases reported here: neuromas of the internal auditory canal and of the cerebello pontine angle, presented as a sensorineural hearing loss; neuromas of the geniculate ganglion area, presented as a progressive facial palsy, or mimicking a facial palsy a frigore; tympano-mastoid neuromas, presented as a retro-tympanic mass or a tumor extended into the external auditory canal, associated with a conductive hearing loss. Complete excision of the tumor requires the resection of a segment of the nerve that is immediately restored with end-to-end anastomosis or placement of a cable-graft. In some cases, however, the facial nerve can be preserved. PMID- 3813369 TI - [Our postoperative care and surveillance in surgery of stable sequelae of chronic otitis]. AB - After a brief summary of the technique used for myringoplasty (enlarged endaural approach, large flattened aponeurotic graft applied to deep surface of tympano meatal flap after a "request" for boring) emphasis is given to the need for strict surveillance and postoperative care by the surgeon. Immediate postoperative care starts in the operating room and involves a deep intra-meatal dressing (1 or 2 Popes oto-wicks placed on a thin film of silastic or simply surrounded by Gelfoam) and a superficial dressing. The dressing is renewed on the 3rd day with the patient in bed and involves only the superficial one. Secondary postoperative care extends to the 10th or 15th day and includes exeresis of the deep pope-Gelfoam assemblage under careful binocular microscope control followed by audiometric examination. Hospital stay is a mean of 5 days and medical treatment (antibiotics, vasodilators, corticoids) is given as required. Late postoperative care can be summarized as involving regular surveillance and the application of certain rules that cause little disturbance in the patients life. Various rare and even exceptional incidents, benign in the majority of cases, are reviewed. PMID- 3813370 TI - [Current status of petrositis]. AB - Actual symptomatology of petrositis is often poor; Gradenigo's syndromes are rare. Petrositis can occur as large cystic cholesterol granuloma of the petrous apex. Their C.T. scan, surgical and pathological aspects are different from cholesteatoma of the apex. PMID- 3813371 TI - Hyperbaric oxygen therapy for laryngeal radionecrosis. AB - Radionecrosis of the larynx is a debilitating disease associated with pain, dysphagia, respiratory obstruction, and, in some cases, the need for laryngectomy. Persistent poor wound healing can lead to death. A series of eight patients with advanced (grades III and IV, Chandler classification) radionecrosis of the larynx treated with adjunctive hyperbaric oxygen therapy is presented. Signs and symptoms of radionecrosis were dramatically ameliorated in seven of eight patients, while one patient, despite subjective improvement, eventually required laryngectomy. There were no deaths. These results are compared to previous series on radionecrosis of the larynx in which hyperbaric oxygen was not used. This series indicates that hyperbaric oxygen therapy is a useful and effective adjunctive treatment modality in the management of laryngeal radionecrosis. PMID- 3813372 TI - Subglottic stenosis: retrospective analysis and proposal for standard reporting system. AB - A retrospective analysis was undertaken reviewing management of 67 patients treated for subglottic stenosis (SGS) at the Children's Hospital National Medical Center (CHNMC) between 1980 and 1985. Forty-seven (90%) of the patients were followed for at least 18 months from the time diagnosis was made. Twenty-three (66%) of the patients followed for at least 18 months were successfully decannulated or had an adequate airway without tracheotomy. To compare efficacy of management of SGS at the CHNMC with management outcomes previously reported, a review of medical literature was undertaken and data from the most significant reports on management of SGS were collated and tabulated. Since analysis of published reports did not yield a consensus regarding optimal methods for management, and statistics in many published reports were absent or unclear, authors of the previously published reports were contacted personally by means of a letter and survey questionnaire. Results of the survey show that many authors have not performed a statistical review of their case data to determine relative efficacy of different surgical procedures. Thus, retrospective review of cases managed at the CHNMC as well as information obtained from leading experts in management of SGS indicate that there is no single optimal procedure or technique for management of all cases of SGS. Further, the way in which surgical procedures for management of SGS are being reported makes difficult the process of meaningfully comparing results reported by different surgeons. A reporting system is proposed that uses specific terms and objective parameters. PMID- 3813373 TI - Dysphagia due to cervical spine surgery. AB - Surgery upon the cervical vertebrae may produce prolonged dysphagia due to regional damage, hemorrhage, infection, and denervation. Cases illustrating these problems are presented with attention to the progression of the clinical course and the diagnostic modalities of radiology and endoscopy. Methods of prevention are emphasized and the therapeutic plan is outlined. PMID- 3813374 TI - Pathogenesis of subglottic stenosis from endotracheal intubation. AB - Subglottic stenosis is more likely to develop secondary to endotracheal intubation if one or more trauma-related risk factors are involved. Ulcerations occur most often in the posterior-lateral cricoid ring. They vary in size and may involve the entire circumference of the subglottic area. The ulcerations heal with fibrous scarring which, if extensive enough, results in subglottic stenosis. PMID- 3813375 TI - Developments in pediatric neurolaryngology. AB - Advances in diagnosis through the use of video and still photographs have made the recognition of pediatric laryngeal disorders much more accurate and precise. Open laryngeal surgery in children was felt to possibly impair growth and development. New procedures to correct structural congenital and acquired lesions in children have freed us from many of these reservations. One of the frontiers now being explored is neurogenic abnormalities within the pediatric larynx. At present, no uniform method of evaluation is being used other than observation of laryngeal motion. The use of electromyography in combination with still and motion photography should allow proper evaluation of the results of surgery or observation. PMID- 3813376 TI - Carcinoid tumor of the larynx: the role of conservative therapy. AB - Carcinoid tumors of the larynx are an extremely rare condition, universally malignant, and unresponsive to radiation and chemotherapy. Just over 20 cases have been reported in the literature to date. Treatment is adequate surgical excision. The number of these tumors reported should increase due to the use of electron microscopy and immunohistologic techniques in making the diagnosis. This paper illustrates the role of conservative laryngeal surgery, when appropriate, as an effective form of therapy. The basic pathologic diagnostic criteria are illustrated. PMID- 3813377 TI - Bipolar cautery for the fiberoptic bronchoscope. AB - A bipolar electrocautery probe for use through the fiberbronchoscope has been designed and has proven useful in treating small endobronchial lesions and bleeding sites. PMID- 3813378 TI - Current management of lesions of the pediatric larynx. AB - A variety of congenital and acquired lesions of the larynx are now managed effectively with the use of the carbon dioxide laser. This instrument seems to be the most effective of all available lasers for this type of therapy. Argon and neodymium:yttrium aluminum garnet lasers do not appear appropriate for such lesions for several reasons. On occasion, patients with congenital and acquired subglottic stenosis, as well as those afflicted with rare tumors of the larynx, require open procedures as part of their treatment regimen. The need for appropriate equipment and competent pediatric anesthesia is paramount when undertaking cases of this type. These patients offer unique challenges to a laryngologist, but correction of their problems is effectively managed by appropriate application of current technology. PMID- 3813379 TI - Laryngeal problems in children. AB - Some diseases of the larynx that now are rare were common in 1950, when the author began the practice of pediatric otolaryngology. These include laryngeal tuberculosis, bulbar poliomyelitis, and acute exanthemata. The management of laryngotracheitis and supraglottitis has altered markedly, with the mortality reduced drastically. The advent of the operating microscope and carbon dioxide laser has broadened the efficacy of laryngeal surgery. Subglottic stenosis continues to be a challenge despite new operations. Laryngeal transplant may be the answer to some intractable diseases. PMID- 3813380 TI - Immediate free gastro-omental flap reconstruction of the mouth and throat. AB - A portion of the greater curve of the stomach with its attached omentum was transplanted to reconstruct the pharynx and oral cavity after ablation of upper aerodigestive tract cancer. The tissue characteristics of the transplanted material were similar to those of the removed oropharyngeal tissue. The gastro omental free flap produced a moist mucosal surface that was self-cleaning and distensible. The free gastro-omental flap was successful in five of seven patients. Because of excessive flap secretions during the early postoperative period, all patients had tracheotomies to protect the lower airway from aspiration. PMID- 3813381 TI - Effect of radiotherapy on the outcome of pharyngeal reconstruction using free jejunal transfer. AB - Eighteen patients had free jejunal reconstruction of the pharynx and cervical esophagus following pharyngoesophagectomy for malignant tumors. Four patients had no radiation therapy, four had postoperative radiotherapy, and ten had preoperative radiotherapy. Comparison of complication rates indicated no increased risk of complication in patients receiving 6,100 to 6,400 rad of postoperative radiotherapy. Patients having preoperative radiotherapy had a higher incidence of graft failure due to vessel thrombosis, suggesting that radiation endarteritis may increase the risk of graft failure. PMID- 3813382 TI - Tumor recurrence within myocutaneous flaps. AB - Myocutaneous flaps have become increasingly popular in reconstructive head and neck surgery. As surgeons have gained familiarity with them, many of the advantages, limitations, and complications of these flaps have become apparent. A rare but serious complication of myocutaneous flaps is recurrent tumor within the pedicle. Three cases of squamous cell carcinoma involving three different myocutaneous flaps are presented and the literature is reviewed. Possible mechanisms of tumor metastasis to myocutaneous flap pedicles are discussed. Surgeons must be aware of the possibility of tumor involvement of reconstructive flaps to facilitate early diagnosis and aggressive treatment. PMID- 3813383 TI - Management of difficult airway problems with percutaneous transtracheal ventilation. AB - Percutaneous transtracheal jet ventilation was used in the management of 13 cases of upper airway obstruction. Cases are subdivided according to the nature of the presenting airway problem. The first group had stable upper airway abnormalities; the second group presented as emergencies with rapidly evolving upper airway obstruction. This technique has two major advantages: 1) it provides rapid access to the airway during acute emergencies; and 2) it provides control of the airway where tissue distortion from head and neck trauma or tumor surgery makes standard anesthetic techniques difficult. Complications including catheter displacement, total expiratory obstruction, pneumothorax, and subcutaneous emphysema have been encountered. The authors conclude that percutaneous transtracheal jet ventilation is effective. However, potential problems exist and an in-depth understanding of the technique is necessary for its appropriate application and successful use. PMID- 3813384 TI - Pitfalls to laser correction of choanal atresia. AB - Many methods have been used over the years to correct choanal atresia, a cause of neonatal respiratory distress. The precise, relatively bloodless incisions of the carbon dioxide laser have made it an effective tool for laser surgery using a transnasal approach. In spite of its utility, certain conditions impede laser surgery. These conditions include septal deviation, enlarged inferior turbinates, high arched hard palate, and other craniofacial disorders. Prolonged duration of stenting appears to reduce the success rate. PMID- 3813385 TI - Laser therapy of dysphonia plica ventricularis. AB - Dysphonia plica ventricularis involves the faulty participation of the ventricular folds in the act of phonation. The speech disorder was one of the first to be described with the use of indirect laryngoscopy. This dysphonia can occur as a compensation for anatomic or physiologic alterations within the larynx (vicarious type) or as isolated ventricular fold hypertrophy unaccompanied by other obvious laryngeal disorders (usurpative type). Conservative phoniatric therapy has been the primary modality of treatment for dysphonias resulting from ventricular fold hypertrophy, with surgical intervention being reserved for those patients not responding to speech therapy. We describe the successful use of the carbon dioxide laser in the excision of the hypertrophied false vocal cords in a patient who failed conservative management with speech therapy. PMID- 3813386 TI - Tracheal bronchogenic cyst: a new clinical entity? AB - Bronchogenic cysts arise as congenital anomalies of the primitive foregut. Although bronchogenic cysts arising from and partially occluding the trachea have been reported in adults, this entity has not as yet been documented in children. We report a case of an infant with respiratory distress resulting from an intratracheal bronchogenic cyst. In view of its ability to create airway compromise, the pathogenesis, preoperative evaluation, and surgical management of this rare lesion will be discussed. PMID- 3813387 TI - Congenital bronchoesophageal fistula in the adult. AB - Congenital bronchoesophageal fistulas usually present in infants and may occur with or without esophageal atresia. Twenty cases of congenital bronchoesophageal fistula in adults have been reported in the English literature. Another case of this rare developmental anomaly is presented here. The radiographic, endoscopic, surgical, and pathologic findings are discussed with a review of the literature. PMID- 3813388 TI - Tracheotomy in the preterm infant. AB - Over the last decade, prolonged survival of preterm infants (gestation less than or equal to 36 weeks) who require lengthy periods of mechanical ventilation has necessitated that many of these infants undergo tracheotomy. The complication rate for tracheotomy in these preterm infants has not been reported. We compared 83 full-term (FT) infants who underwent tracheotomy in their first year of life with 41 preterm infants. Twenty-three preterm infants had birth weight greater than or equal to 1,500 g (PT), and 18 of the preterm infants had gestational age less than or equal to 32 weeks and birth weight less than or equal to 1,500 g (PT VLBW). Early complications (day 0 to 7) occurred in over 50% of the PT-VLBW compared to only 24% of the FT infants. Late complication rates were similar for all three groups. This higher early complication rate for PT-VLBW infants may be related to gestational age, low birth weight, and medical condition rather than surgical technique. PMID- 3813389 TI - Deglutition following supraglottic horizontal laryngectomy. AB - In order to determine factors that may contribute to deglutition problems following supraglottic horizontal laryngectomy or its modified techniques, clinical records of 38 patients were studied. Contribution of the following factors was investigated: age; sex; tumor classification; radical neck dissection; extent of and symmetry in removal of the aryepiglottic folds, arytenoid cartilages, and false folds; removal of the base of the tongue, hyoid bone, and a part of the vocal folds; extent of removal of the epiglottis and thyroid cartilage; cricopharyngeal myotomy; and some complications and concomitant diseases. The results suggest that removal of the arytenoid cartilage and asymmetrical removal of the false folds contribute to deglutition problems. We conclude that the standard supraglottic horizontal laryngectomy associated with surgical approximation of the larynx to the base of the tongue and cricopharyngeal myotomy does not usually cause serious deglutition problems. When the arytenoid cartilage is removed, reconstruction of the structure is required for the prevention of severe aspiration. PMID- 3813390 TI - Epiglottoplasty for the treatment of laryngomalacia. AB - Laryngomalacia is the most common congenital laryngeal anomaly. Patients present with different degrees of stridor and feeding problems that usually resolve by 18 months of age. A small number present with severe feeding problems, failure to thrive, stridor with cyanosis, and apnea, which may result in cardiopulmonary disease. These infants require surgical intervention, usually a hyomandibulopexy or tracheotomy. We present a new procedure, epiglottoplasty, that is performed endoscopically and involves excision of redundant mucosa over the lateral edges of the epiglottis, aryepiglottic folds, arytenoids, and corniculate cartilages. Ten patients have undergone this procedure with good results. Epiglottoplasty represents an alternative to tracheotomy in severe laryngomalacia. Indications, techniques, postoperative management, and complications are presented. PMID- 3813391 TI - Synchronous airway lesions in infancy. AB - Stridor in the young infant is evaluated by careful laryngoscopy. When a lesion of the larynx is diagnosed, the necessity and risk of bronchoscopy are challenged. To assess the need for careful examination of both the upper and lower respiratory tract, a 2-year retrospective study was performed at the Children's Hospital of Pittsburgh. Of 103 infants who underwent diagnostic laryngoscopy and bronchoscopy for airway obstruction, stridor, or both, 18 (17.5%) had two or more synchronous airway lesions detected. Laryngoscopy alone, without further workup of the entire respiratory tract (ie, bronchoscopy, radiographic studies) may fail to detect concurrent disorders in infants with airway obstruction. PMID- 3813392 TI - Flexible laryngoscopy in neonates, infants, and young children. AB - Flexible laryngoscopy was performed 453 times on 264 patients 4 years of age or younger. Sixty-five percent were under 6 months of age. Stridor was the indication for laryngoscopy in 60% of the patients. Problems secondary to intubation and poor voice each were indications in 12%. The most common finding was laryngomalacia, followed by laryngeal edema, normal larynges, and vocal cord paralysis or paresis. Subglottic stenosis was diagnosed in 17 patients. Flexible laryngoscopy is a relatively noninvasive, safe, and effective technique for examining the larynx of infants and young children. PMID- 3813393 TI - Bronchial casts in children. AB - Bronchial casts were found in four children during a 2-year period at the Children's Memorial Hospital. These four children represent 0.2% of the 1,943 endoscopic cases during that time. Thirty other cases of bronchial casts have been reported previously in children 9 years of age or younger, only 12 of which were not associated with cystic fibrosis. Casts may be a complication of many diseases; cystic fibrosis, asthma, bronchitis, allergic bronchopulmonary aspergillosis, and bronchocentric granulomatosis are the most common. With the exception of cystic fibrosis, these diseases may all have an allergic pulmonary reaction as the underlying cause. In all four cases reported here, the diagnosis was made at endoscopy because the clinical picture is not dissimilar from that of bronchial foreign bodies. Management includes endoscopic removal of the cast, chest physical therapy with nebulized acetylcysteine, and an evaluation to determine the underlying condition. PMID- 3813394 TI - [Paris Dermatology Seminar, 12-15 March 1986. Papers]. PMID- 3813395 TI - [Demodex and perifollicular inflammation in man: review and report of 69 biopsies]. AB - The activities of several lysosomal hydrolases (beta-galactosidase, beta hexosaminidase, alpha-mannosidase, beta-glycuronidase and acid phosphatase) were determined in serum and blood lymphocytes from patients affected with scleroderma. Statistical comparisons between means of patient and control groups (Student's t test) showed a significant difference in serum beta-galactosidase and acid phosphatase between patients and controls (serum beta-galactosidase: 36.5 +/- 22 nmol/h/ml in the scleroderma group versus 24 +/- 13 nmol/h/ml in the control group; serum acid phosphatase 853 +/- 345 nmol/h/ml in the scleroderma group versus 634 +/- 295 nmol/h/ml in the control group). These differences were significant (p < 0.01). Both enzyme activities were also significantly increased in the group with systemic scleroderma, but the difference was less in the group with localized scleroderma (this is discussed in terms of statistics and pathophysiology). The other enzyme activities determined were not significantly modified. The validity of these results is discussed, together with their diagnostic value and with the pathophysiological hypotheses put forward to explain the high levels found. PMID- 3813397 TI - [Type IV Ehlers-Danlos syndrome of acrogeria type]. AB - A familial case of acrogeria, occurring in a mother and her daughter, is reported. A 12-year old mentally retarded girl was seen with a history of repeated ecchymoses despite normal hemostasis. On clinical examination, the skin was diffusely atrophic with atrophy and wrinkling most pronounced on the extremities. The venous pattern was noticeable on the upper aspect of the anterior trunk and the extremities. The feet were small and the nose was pinched. "Cigarette paper" scars and molluscoid pseudotumors were seen over the elbows and the knees. Some skin hyperextensibility was noted and loose-jointedness of the fingers was demonstrated. The fingernails, hair, dentition, and bone roentgenograms were normal. The mother, a 34-year old woman, presented with the same abnormalities and reported the same condition in her mother. A younger brother was normal and there was no history of consanguinity. In both cases, the skin biopsy specimens showed dermal atrophy with irregular increase of the elastic staining material in the mid dermis. Ultrastructural studies showed a widened endoplasmic reticulum within the fibroblasts. Biochemical studies, performed in the daughter, showed complete lack of collagen III in the dermis. This, together with the visceral complications occurring in the mother and in previously reported patients, suggests that acrogeria represents a clinical variant of Ehlers-Danlos type IV. Its association with phenylketonuria in the daughter is considered to be coincidental. PMID- 3813396 TI - [Serum lysosomal hydrolases in various forms of scleroderma]. AB - The activities of several lysosomal hydrolases (beta-galactosidase, beta hexosaminidase, alpha-mannosidase, beta-glucuronidase and acid phosphatase) were determined in serum and blood lymphocytes from patients affected with scleroderma. Statistical comparisons between means of patient and control groups (Student's t test) showed a significant difference in serum beta-galactosidase and acid phosphatase between patients and controls (serum beta-galactosidase: 36.5 +/- 22 nmol/h/ml in the scleroderma group versus 24 +/- 13 nmol/h/ml in the control group; serum acid phosphatase 853 +/- 345 nmol/h/ml in the scleroderma group versus 634 +/- 295 nmol/h/ml in the control group). These differences were significant (p less than 0.01). Both enzyme activities were also significantly increased in the group with systemic scleroderma, but the difference was less in the group with localized scleroderma (this is discussed in terms of statistics and pathophysiology). The other enzyme activities determined were not significantly modified. The validity of these results is discussed, together with their diagnostic value and with the pathophysiological hypotheses put forward to explain the high levels found. PMID- 3813398 TI - [Erythema annulare centrifugum and Hashimoto's thyroiditis]. PMID- 3813399 TI - [Hydroa vacciniforme]. PMID- 3813400 TI - [Ultrastructure of lichen aureus]. PMID- 3813401 TI - [Therapeutic action of etretinate in amyloid lichen]. PMID- 3813402 TI - [A case for diagnosis: Malherbe's calcifying epithelioma]. PMID- 3813403 TI - [Eosinophilic fasciitis (Shulman's disease)]. PMID- 3813404 TI - [Cutaneous signs of trichinosis. Apropos of the 1985 outbreak]. PMID- 3813405 TI - [Staphylococcal scalded skin syndrome]. PMID- 3813406 TI - [Physicochemical analysis of subcutaneous calcifications in a case of Thibierge Weissenbach syndrome]. AB - A physicochemical study of subcutaneous calcium deposits was performed in a patient with typical Thibierge-Weissenbach syndrome which had begun, ten years previously, with Raynaud's phenomenon and sclerodactylia. Calcium deposits had progressively developed, forming large plates on the arms, flanks and thighs. In the course of the disease they had become ulcerated, exuding a white, chalky material. X-ray films and xerograms demonstrated the extent of these deposits. The calcium-phosphorus balance was normal, and the other clinical and laboratory examinations were concordant with a diagnosis of Thibierge-Weissenbach syndrome (calcinosis). Only systemic corticosteroid therapy slowed down the pathological process; calcium chelating agents (diphosphonate) proved ineffective. The physicochemical study showed that the deposits consisted of carbonated apatite type B with the following formula: Ca8.0(PO4)4.1(CO3)1.2(HPO4)0.8 The mineral substance seemed to be less reactive and more stable than normal bone. This would account for the total lack of effectiveness of all treatments, notably calcium chelating agents, on the course of the deposits. Treatments usually produce bone demineralization before they influence the calcium deposits. This study provides much more detailed information than was hitherto available on calcium deposits and on carbonate ion contents in the apatite phase. The presence of carbonates increases the solubility and reactivity of calcium apatite. PMID- 3813407 TI - [The FLOTCH syndrome. Familial occurrence of total LeukOnychia, Trichilemmal cysts and Ciliary dystrophy with dominant autosomal Heredity]. PMID- 3813408 TI - [A case of cervical actinomycosis developing for 7 years without any treatment]. PMID- 3813409 TI - [Congenital syphilis: a new case with bone lesions]. PMID- 3813410 TI - [A case for diagnosis. Scalp gangrene due to temporal arteritis (Horton's disease)]. PMID- 3813411 TI - [Desensitization to Hymenoptera venoms]. PMID- 3813412 TI - [Ambulatory phlebectomy]. PMID- 3813413 TI - [Effectiveness of an amphoteric surface agent against Schistosoma mansoni miracidia in field-like conditions in Niger]. AB - The laurylamidopropylbetaine, a surface active substance, has been tested in field conditions, in Niger, against Schistosoma mansoni miracidia. Experiments were carried out in artificial ponds of 20 m3, in which conditions were similar, as far as possible, to conditions found in transmission sites. The product showed a satisfactory remanence and the percentage of infected molluscs dropped down to zero with a low (2 ppm) concentration. It is suggested that laurylamidopropylbetaine could be used into soaps in order to renew constantly the product in washing and bathing places and reduce schistosome transmission. PMID- 3813414 TI - [Chaetotaxy of Gastrodiscus aegyptiacus cercaria (Trematoda, Paramphistomoidea) a horse parasite]. AB - Cercarial chaetotaxy of Gastrodiscus aegyptiacus (Paramphistomoidea), parasite of the Horse, is described. Cercariae were shed by experimentally infected Bulinus forskalii. This description is the first one of a Gastrodiscidae. The cercarial chaetotaxy of the Gastrodiscidae is quite different from those of Paramphistomoidea and Diplodiscidae. PMID- 3813415 TI - On first-stage larval resistance under controlled conditions of three species of nematodes of the family Protostrongylidae Leiper, 1926. AB - A study was made on the survival of the first larval-stage of three species of the Family Protostrongylidae (Cystocaulus ocreatus, Muellerius capillaris and Neostrongylus linearis). At every temperature (5, 12, 20, 26 and 36 degrees C) and humidity (100, 70 and 30%) combinations, the species which needed the least time to reach the pre-established (50, 75 and 95%) mortality rates was Neostrongylus linearis. In all cases Muellerius capillaris was the species needing the longest time to reach the same mortality percentages (rates). The direct relationship between the survival capacity of each species and their relative abundance in the grazing zone of the sheep used as a source of larvae studied is also discussed. The comparison of our results with those of other authors is made on the basis of an adaptive relationship between the species of parasites studied and their definitive hosts. PMID- 3813416 TI - [Trematodes of fish from Lebanese coasts. I. Pseudopycnadena fischthali n.g. n.sp. (Trematoda, Opistholebetidae), a parasite of Diplodus (Teleostei) from Lebanese coasts]. AB - Description of a new species of Trematode Opistholebetidae, intestinal parasite of Diplodus sargus and Diplodus vulgaris from Lebanese coasts. Erection of a new genus Pseudopycnadena. PMID- 3813417 TI - [Anatomo-pathologic study of skin and ocular lesions in rodents infested by Monanema spp.: significance for the study of human onchocerciasis]. AB - Skin and ocular lesions were studied in murids Lemniscomys striatus L. infested by 2 isolates of Monanema spp, a rodent filaria with skin-dwelling microfilariae. Histologic examination disclosed microfilariae in lymphatic vessels. Penetration of microfilariae in extra-vascular tissues caused vascular changes, subacute inflammatory cells infiltration, granulomatous nodules and scarring lesions. These alterations corresponded to the successive stages of an inflammatory process. No correlation noted between tissular lesions, delay of filarial infestations and number of microfilariae in the "snip". The presence of lesions in one or several tissular areas demonstrated that extravascular escaping of microfilariae was not synchronous. Symptomatology of filariasis depended on the localization of the lesions. Similarities between the lesions noted in murids Lemniscomys striatus L. and those observed in man showed that the 2 isolates of Monanema spp. used in this study were very close to O. volvulus in the pathological domain. They might be considered as a valuable and reproducible experimental model. PMID- 3813418 TI - [Life cycle of Tetrameres (Microtetrameres) inermis (Linstow, 1879): tetramerid nematode parasite of the weaver Ploceus aurantius in Togo]. AB - The tetramerid nematode Tetrameres (Microtetrameres) inermis (Linstow, 1879), was found in the weaver Ploceus aurantius in Togo. Its larval biology was studied in experimentally infected orthopterans Tylotropidius patagiatus and Locusta migratoria (Acrididae). The length of infective third-stage larvae of T. (M.) inermis (1.5-1.6 mm) was shorter (2.2-2.6 mm) than those of the larvae of T. (M.) corax and T. (M.) helix. In the family Tetrameridae the primitive nature of the sub-genus Microtetrameres in revealed by the presence of developed pseudolabia which resemble the cephalic structures in the Spiruridae, and by the type of encapsulation of the parasite in the adipose tissue of the insect intermediate host. As with Cyrnea eurycerca (Habronematidae) the infective larvae leave their capsule and are found free in the hemocoele. PMID- 3813419 TI - [Studies on ticks (Acarina, Ixodidae), parasites of cattle in West Algeria. I. Systematic survey and seasonal activity]. AB - Tick samples (Acarina, Ixodidae) were collected for two years on bovidae from the whole Oran area which were brought weekly at the Oran open market (Algeria). The 5,500 ticks thus obtained could be divided into six genera and twelve species. From the phenological analysis the following were defined: three spring species (Rhipicephalus bursa, Rh. turanicus and Rh. sanguineus), three summer species (Hyalomma detritum, H. impeltatum and Boophilus annulatus), three winter species (Ixodes ricinus, Haemaphysalis punctata and Dermacentor marginatus) and three species called perennial (H. marginatum, H. excavatum and H. lusitanicum). In fact, the latter are present on cattle all year around, but in winter, the collected specimens (mostly male and a few females) remain fixed on their host without feeding. The parasitic intensity for each species and its relative distribution pattern were studied monthly on cattle from november 1981 to september 1983. The distribution on host of different species was analyzed. Short rostrum ticks were found to have a significant preference for specific habitats (depending on the thickness of the teguments) while long rostrum species are fixed on more varied sites. In the case of plurispecific infestations of the same area, phenomena of competition-exclusion were not observed. Most of the animals are simultaneously infected by two or four different species of ticks. Taking into account this first estimation, it was possible to define two types of associations both related to the rearing methods and geographical source of bovines.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813420 TI - [New or little known fleas (Siphonaptera) from Chile: description of Plocopsylla diana n. sp. (Stephanocircidae)]. AB - Plocopsylla diana n. sp. from the Chiloe and Malleco Provinces is distinguished from all species of this genus by the helmet-comb (18 to 19 teeth) and the genitalic parts of male. The male of Ctenoparia inopinata Rothschild 1909 is described, and for the first time, Ctenoparia jordani Smit 1955 and C. topali Smit 1963 are cited from Chile. PMID- 3813421 TI - [Ceratopogonidae (Diptera) of the Congolese Mayombe. I. Daily pattern of the biting activity of female Culicoides grahamii Austen, 1909]. AB - Owing to appropriate sampling methods, the study of the daily pattern of biting of female "Culicoides grahamii Austen, 1909" was achieved in the Congolese Mayombe. It was discovered that this pattern was rhythmical in close connection with the sunrise and sunset. Many climatic parameters were simultaneously studied (temperature, hygrometry, brightness). This starting factor of this rhythmical pattern seems to be a brightness which agrees to a total shortwave radiation on the ground, equal or inferior to 25 cal x m-2 x h-1. It seems that the temperature does not play any role. PMID- 3813422 TI - The levels of total protein and protein fractions in the serum of rabbits infected with Eimeria stiedai. AB - The total protein levels in rabbits infected with Eimeria stiedai together with the alterations in the different protein fractions over a period of 35 days were studied. It was observed that from the second week of infection onwards a progressive increase took place in total proteins; the electrophoretic study revealed that the hyperproteinemia is mainly due to the increase in gamma globulins accompanied by a decrease in the concentration of albumin and a increase in alpha and beta-globulins. These protein alterations induce an important modification in the albumin/globulin. ratio which decreases considerably. PMID- 3813423 TI - [Discovery of a protist parasite, apparently akin to Acrasiae, in the genital tract and various organs of primates]. AB - Microcysts were first observed in histological sections of the placenta of a gibbon, the uterus of a Microcebus, showing a pyometra, the placenta, spleen and lung of a new born mangabey which died soon after birth from an interstitial pneumonia. Plasmodial forms were also discovered in the sections, either encysted or infiltrating the tissues. Cultures from all the above mentioned pathological material were attempted on a special medium, the composition of which will be given later. All cultures shew myxamoeba-like organisms aggregating and merging into pseudoplasmodial forms that produced microcysts. Attention is drawn to the pathogenic role of this new kind of parasites in order that they should be searched for, in every case of genital troubles not ascribable to other causes. PMID- 3813424 TI - [Description of Hymenolepis cerberensis n. sp. (Cestoda: Hymenolepididae) and first general considerations on the fauna of cestode parasites of the pygmy shrew Suncus etruscus (Savi, 1822) (Insectivora: Soricidae)]. AB - Description and differentiation of the adult stage of Hymenolepis cerberensis n. sp. (Cestoda: Hymenolepididae), an intestinal parasite of the Pygmy white-toothed shrew, Suncus etruscus (Savi, 1822) (Insectivora: Soricidae: Crocidurinae) in the region of Banyuls-sur-Mer and Cerbere (Oriental Pyrenees, France). The new species is characterized by the size of the gravid specimens and by the presence of 18-21 rostellar hooks of 18.5-20 micron and of filaments around the embryophore. The general composition of the fauna of Cyclophyllidea parasitizing S. etruscus is analysed. There are three less specialised Hymenolepis species with a scolex of the same type and one Pseudhymenolepis species, with the absence of unarmed species lacking a rostrum. The oioxenous character of the Cestodes parasitizing Suncus species sustains the validity of the genus Suncus. The resemblance of the Cestodefaunas suggests a narrow phyletic relationship between the genera Suncus and Crocidura. PMID- 3813425 TI - [Experimental approach to the role of the paratenic host in the circulation of the parasite Bothriocephalus claviceps Goeze, 1782 (Cestoda, Pseudophyllidea)]. AB - This article concerns an experimental work monitored in 5 species of fishes in the order to evaluate their value of paratenic hosts, in the cycle of Bothriocephalus claviceps, a parasite of the eel, Anguilla anguilla. The intestinal localisation and the lack of development of parasites are the two principal characters of this parasitism. The second character is sometimes contradicted. The effective evolution has been observed during 20 days. The more important losses of parasites coincide with the invasion of fishes. After that stage, the decrease of effectives is slower. The authors are led to consider that two modes of circulation are required for the parasite: the direct transmission and the transmission with intercalation of paratenic hosts. PMID- 3813426 TI - [A new onchocercal parasite, Onchocerca alcis n. sp., parasite of the moose Alces alces in Sweden]. AB - Among the onchocercids of cervids, Onchocerca alcis n. sp., a parasite of the moose, Alces alces, belongs to that small palearctic group of evolved onchocercids consisting of O. jakutensis, O. garmsi and O. tarsicola. It is distinguished from its most closely related species, O. jakutensis, primarily on the characters of the lateral chord and cuticle, its greater spicule ratio, and the characteristic shapes of the anterior and posterior extremities of female worms. PMID- 3813427 TI - Elaeophora elaphi n. sp. (Filarioidea: Onchocercidae) parasite of the red deer (Cervus elaphus). With a key of species of the genus Elaeophora. AB - We described a new species of nematode filarioid (Onchocercidae) parasiting the hepatic vessels of the red deer Cervus elaphus. This new species is characterized by the number and disposition of the papillae on the genital area of the male, and the presence and characteristics of an "area rugosa" situated just in front of the ventral impair precloacal papilla. We discussed this new species, giving a key to the identification of all the known species of the genus Elaeophora. PMID- 3813428 TI - [A filaria of African Muridae in the wall of the colon: Monanema martini n. sp]. AB - Description of M. martini n. sp. (= M. nilotica El Bihari et al., 1977 sensu Bain et coll., 1985), a parasite of Arvicanthis niloticus from Mali. The natural host is Arvicanthis niloticus from Mali; the description is based on material from experimentally infected laboratory-bred rodents (holotype from A. niloticus; other specimens from Lemniscomys striatus). Like other related species the microfilariae of M. martini are said to be "skin dwelling" (in fact they are in cutaneous lymphatic vessels). The main characteristic feature of this new species is the localization of the adults in the lymphatic vessels of the colon. PMID- 3813429 TI - [Presence in Morocco of Phlebotomus (Paraphlebotomus) kazeruni Theodor and Mesghali, 1964]. AB - A report is made of Phlebotomus kazeruni on southern Marocco (Tata and Ouarzazate Provinces). This sandflies was previously known only from Afghanistan, Iran and Saudi Arabia. PMID- 3813430 TI - [Note on the relations between vectors of leishmaniasis and forest trees in French Guiana]. AB - The study of relationships between Phlebotomine sandflies and different species of trees, 0 to 1.5 m above ground, was carried out in the French Guiana forest. We found that certain forest trees are more propitious than others to the development or maintenance of certain leishmaniasis vectors. Lu. umbratilis, vector of Leishmania braziliensis guyanensis, represents between 28 and 88% of samples collected on trunks. The association of Lu. umbratilis and Lu. rorotaensis represents between 58 and 98% Lu. flaviscutellata, vector of Leishmania mexicana amazonensis, frequently caught on humans, was not found on tree trunks. PMID- 3813431 TI - [A new Phlebotomus from Algeria, Phlebotomus (Paraphlebotomus) kazeruni]. PMID- 3813432 TI - Preliminary SEM observations of the cercaria of a Sanguinicola sp. (Digenea: Sanguinicolidae). AB - Some data concerning the external ultrastructure of the cercariae of a Sanguinicola sp. observed with SEM are offered and the similarities and differences found when these cercariae are compared with those of Aporocotyle simplex are discussed. PMID- 3813433 TI - [Shedding pattern of Schistosoma japonicum cercariae from mainland China by Oncomelania hupensis]. AB - The release of Schistosoma japonicum cercariae from the People's Republic of China shedded by Oncomelania hupensis was observed hourly under laboratory conditions: LD 9 - 15, T degrees = 25 degrees C. Daily periodicity of emergence was recognized during the light period. Peaks emergence occurs between 2 and 5 p.m. Results are compared with other geographical strains of S. japonicum. PMID- 3813434 TI - [Study of schistosome-mollusk vector compatibility by the technic of microsurgical transplantation of sporocysts in two Schistosoma japonicum Oncomelania hupensis combinations originating in mainland China]. AB - The Schistosoma-Mollusc compatibility was tested in two Schistosoma japonicum Oncomelania hupensis combinations originated from mainland China. The first combination is a combination maintained for more than 30 years in laboratory, the second consisted of a laboratory strain of S. japonicum and a strain of O. h. hupensis taken in the field (Jiangxi province). The fully absence of sporocyst throwing out and hemocyte infiltration 24 h. after transplantation suggest a perfect compatibility of the two combinations. Concerning the test carried out on a natural population of O. h. hupensis, the result obtained might reveal that the schistosomiasis transmission area from Jiangxi province represents focuses with high risk. PMID- 3813435 TI - [Two trichostrongyloid nematodes in an African murid. 1. Description of the adults]. AB - Two new trichostrongyloids are described Neoheligmonella dossoi n. sp. and N. tranieri n. sp. concomitant parasites in the intestine of Uranomys ruddi (Rodentia-Muridae) from the Ivory Coast. N. dossoi differs from N. pseudospira and N. houini parasites of Arvicanthis abyssinicus in Ethiopia, by the length of the vestibule (longer than two thirds of the length of the infundibulum). N. tranieri is closely related to N. dossoi but can be differentiated by its longer uncoiled body and a characteristic synlophe. PMID- 3813436 TI - [Parasitism of Mustelidae by Skrjabingylus petrovi: first report in western Europe]. AB - A study of the sinuses parasites was carried out on 206 skulls of small mustelidae: Mustela putorius (52), M. nivalis (17), M. erminea (13), Martes foina (102), and M. martes (11) from Eastern France. Besides Troglotrema acutum two Skrjabingylus species (S. nasicola and and S. petrovi) were observed and S. petrovi described for the first time in France. PMID- 3813437 TI - [Leishmania braziliensis Vianna, 1911 s. st., in French Guiana]. PMID- 3813438 TI - [Conditions required for the systematic study of male schistosomes by scanning electron microscopy]. PMID- 3813439 TI - Locally available plant materials for use as ophthalmic surgical swabs. AB - Four locally available plant materials have been studied and adapted for use as suitable surgical swabs for various ophthalmic surgical procedures. The corn, the millet, the sugar cane stems and the banana leaf frond provide very cheap, easily available and suitable materials for use as alternative surgical swabs to the much used and tested German Spontex swabs. PMID- 3813440 TI - Endoscopic papillotomy without cholecystectomy for bile duct stones. AB - Endoscopic papillotomy without cholecystectomy has been performed in 20 elderly patients with complications of bile duct stones. Good biliary drainage was achieved in 17, and there were no complications. One cholecystectomy was subsequently required. Later deaths have been due to unrelated causes. It is concluded that endoscopic treatment alone may be all that is required to manage bile duct stones in the elderly. PMID- 3813441 TI - The use of Hickman-Broviac catheters for paediatric radiotherapy. AB - We describe the first use of Hickman-Broviac catheters in 20 children under the age of 4 years for repeated daily general anaesthesia for radiotherapy. These children received a total of four hundred and eighty two general anaesthetics. The advantages and disadvantages of using Hickman-Broviac lines are discussed. PMID- 3813442 TI - Inguinal hernia repair: which suture? AB - Two hundred and fifty six consecutive inguinal hernia repairs in one hospital over a 15 month period have been reviewed. There was a significant association (P less than 0.00001) between the length of history and postoperative complication rate. The use of braided suture was associated with an apparent increase in sepsis and recurrence rate (P less than 0.1). Synchronous bilateral repair was not associated with an increase in complications. It is concluded that the use of braided suture material in an inguinal hernia repair may result in an unacceptable level of sepsis and recurrence. It is also concluded that attempts to reduce the interval between the onset of an inguinal hernia and operative repair will result in lower complication rates. PMID- 3813443 TI - Complications of T-tube drainage of the common bile duct. PMID- 3813444 TI - Morbidity study of submandibular gland excision. PMID- 3813445 TI - Primary suture or T-tube drainage after choledochotomy. PMID- 3813446 TI - [Surgical treatment of obstructive cancers of the left colon. Value of lateral cecotomy]. PMID- 3813447 TI - [Osteochondral fractures of the knee in athletic children]. PMID- 3813448 TI - [Bilateral postero-lateral vertebral approach by median incision in spondylolisthesis caused by spondylolysis. 30 cases]. PMID- 3813449 TI - [Complicated iliac aneurysm disclosed by genital hemorrhage: rupture of an iliac aneurysm into the posterior vaginal pouch]. PMID- 3813450 TI - [Crohn's disease localized in the appendix. Apropos of a case and review of the literature]. PMID- 3813451 TI - [Primary leiomyosarcoma of the renal vein]. PMID- 3813452 TI - [TM and bidimensional echocardiography of subvalvular aortic stenoses]. AB - 28 children (age: 7.5 +/- 4.6 years) and five adults with a subvalvular aortic stenosis were evaluated by TM and bidimensional echography. Long axis parasternal and apical two cavities-aorta views seem the most reliable to determine the anatomical varieties (type I in diaphragm: 25 cases; type II fibromuscular: 5 cases; tunnel: 1 case; isolated mitral abnormalities: 2 cases). 24 patients were catheterized. Among the various echocardiographic parameters that were measured, the ratio parietal thickness/left ventricular diameter in telesystole appears best correlated to the hemodynamic gradient (r = 0.65). PMID- 3813453 TI - [Fab fragments of antidigoxin antibodies and acute digitalis poisoning]. AB - Acute digitalis intoxication is infrequent and severe. The mortality rate is between 15 and 20 per cent. Its treatment has been greatly improved with the appearance, in 1976, of a specific serotherapy: Fab fragments of antidigoxin antibodies. The clinical experiment reported in the literature relates to approximately one hundred cases and establishes that this therapy has a practically constant and non dangerous efficacy. The lack of availability of these fragments Fab represents presently the only obstacle to the development of this treatment, but the use of monoclonal antibodies, already available experimentally, should, in the future, circumvent this last hurdle. PMID- 3813454 TI - [Coronarography in the study of myxoma. Apropos of a case diagnosed by this technic]. AB - In a 59 years old woman presenting a rudimentary picture of myocardial infarction, ventriculograms confirm a limited necrosis and coronarography shows an abnormal vascular image, evoking an intracardiac tumor, while the arteries are free of atherosclerosis or thrombosis on angiography. Although auscultation and echography are normal, the diagnosis of myxoma will be confirmed by angiocardiography, then by surgery and pathology. The advantage of selective coronary angiography in myxomas is considered with 24 cases from the literature having undergone this examination, including 20 cases, among which ours, which present an aspect of "tumoral vascularisation". The particularities of coronarography (aneurysms, embolic obstruction, origin and aspect of hypervascularisation) are analyzed. This technique appears very useful, not only to detect a complication of the tumor or an associated coronaritis, but also to help in the diagnosis of myxomas in cases where angiocardiography or mostly echocardiography are deficient. PMID- 3813455 TI - [Residual arterial hypertension after excision of an extra-adrenal pheochromocytoma]. AB - Residual arterial hypertension after excision of a pheochromocytoma of the Zuckerkandl organ, has brought the problem of its etiology. The short term approach consisted in performing, after specific biochemical dosages, a scintigram with IMBG, a scan and a magnetic resonance imaging, to look for a second pheochromocytoma. A negative workup enabled to conclude to an essential arterial hypertension. Nevertheless, this does not exclude the possibility of a long term malignancy, requiring clinical monitoring and IMBG scintigraphy. PMID- 3813456 TI - [Myocardial infarction, an unrecognized complication of Behcet's disease?]. AB - It the vascular complications of Behcet's disease, especially thrombophlebitis, are well known, coronary involvement in seldom described (less than ten cases in the literature). The two cases reported here, of patients under 45, having presented both a myocardial infarction confirmed by coronary arteriography, lead to bring up first the problem of the causal relationship between disease and necrosis (inflammatory syndrome, thrombogenic tendency, vasospastic aspect), to reach a preventive attitude with, firstly, and extended use of anticoagulants in patients severely affected, in evolutive outbreaks, and then with the easier indication of anti-spastic treatments, mostly calcium blockers. PMID- 3813457 TI - [Toward better monitoring of anticoagulant treatment with antivitamins K. Recommendations of the Hemostasis and Thrombosis Study Group]. PMID- 3813458 TI - [Early and late hospital mortality in myocardial infarction. Causes and prognostic factors. Apropos of 140 cases]. AB - The purpose of this work is to study the causes of early and late in-hospital mortality of myocardial infarction, to define elements of prognosis and to attempt to prevent the fatal outcome of the coronary disease. This study concerns 107 men and 33 women, between the ages of 30 and 83 years (mean age 62.8 years). The total mortality is 12% (early: 6.5%, late: 5.5%. 66% of the patients are over 60 and 45% present 3 or more coronary risks factors. The clinical picture is characterized by frequent initial complications (84% of the cases), dominated by hemodynamic failure. The infarction is most of the time located anteriorly (56.6% of the cases). Primary cardiogenic shock represents the main cause of early mortality (55.3%). A recurrent infarction represents 75% of the causes of late deaths. Tri-vessels involvement and alteration of the ventricular function are noted in 9 out of 14 coronary arteriograms. Prognosis factors are proposed to differentiate high risk patients requiring an early coronary arteriogram in view of a specific medical and/or surgical treatment. The best signs of a poor prognosis are: tri-vessels involvement and alteration of the ventricular function. PMID- 3813459 TI - [Changes in amplitude of the R wave in V5 during a computerized exercise test: value in the diagnosis of coronary insufficiency]. AB - In order to determine the real value of the amplitude variations of the R wave V5 during a stress test, in the recognition of coronary insufficiency, the stress tests of 227 patients were reviewed and compared to the results of coronary angiography. This permitted to find 93 patients with healthy coronaries and 134 patients presenting an involvement of the anterior inter-ventricular artery (AIVA); 37 have a one-vessel disease, 38 have a two-vessel disease, 59 a tri vessel disease. Quantitative analysis of the modifications of the R wave in V5 during stress, finds mean values of amplitude variations of 1.46 +/- 2.65 mm (p less than 10(-7)) in the reference group; + 1.36 +/- 3.03 mm (p less than 0.01) in patients with a one-vessel disease; +/- 2.02 +/- 2.73 mm (p less than 10(-5)) in patients with two-vessel disease; +/- 1.77 +/- 2.82 mm (p less than 10(-6)) in patients with three-vessel disease. Mean variations are not significantly different from one group to the other and do not permit to individualize a specific evolutive profile in favor of a coronary disease. Considering the absence of alterations or the increase of the amplitude of R in V5 during stress as a pathological response to a coronary insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813460 TI - [Anesthesia and surveillance in intracavitary fulguration for radical treatment of ventricular tachycardia]. AB - Endocavitary fulguration, is a new technique to ablate the arrhythmogenic substrate of chronic ventricular tachycardias (VT). This method is used in patients with ventricular tachycardias of varied etiologies. 47 fulgurations in 36 patients with 40 hemodynamic and 12 myocardial metabolic studies are presented. In cardiopathies, the cardiac performance is altered with an ejection fraction of less than 50% and a ventricular function curve which is in Braunwald zone II. Ablation of the arrhythmia was obtained in 63% of cases. Severe complications were observed in 13% of cases, i.e.: low cardiac output, pulmonary oedema and myocardial ischemia. Three patients died from cardiac failure. Ventricular tachycardia was induced to localize the arrhythmogenic foci to be fulgurated. Ventricular tachycardia led to hemodynamic changes with a high pulmonary capillary wedge pressure and low cardiac output (-21%) which was further lowered under general anesthesia (-42%) due to poor response to tachycardia. Endocardial fulguration per se induced severe but transient (less than 5 minutes) hemodynamic changes and was sometimes complicated by myocardial ischemia and conduction disorders. General anesthesia is necessary to perform endocardial fulguration but cannot be induced with a poor hemodynamic state and with high rate ventricular tachy-arrhythmias. Three criteria are used concerning the anesthetic agents: 1) maintainance of cardiac contractility and baro-reflex efficiency; 2) respect of myocardial oxygen balance; 3) maintainance of excitability during mapping of arrhythmogenic foci. Hemodynamic monitoring is necessary to understand and manage complications due to this new type of therapy. PMID- 3813461 TI - [Myocardiopathy disclosing a centronuclear myopathy in an adult]. AB - The authors report the case of a primary myocardiopathy of the young adult, related in fact to a rare muscular congenital disease: centro-nuclear myopathy. The case is different from the classic picture in that it is revealed late, by its cardiac manifestations which dominate the clinical picture and lead to an irreducible cardiac insufficiency requiring a heart transplant. Only a muscular biopsy with histological and histo chemical study permits to make the diagnosis, while the lesions of the myocardium are non-specific. PMID- 3813462 TI - [Evaluation of the antihypertensive effect and tolerability of a new delayed action calcium channel blocker: nitrendipine, prescribed as a single daily dose of 20 mg]. AB - The authors have studied the effects of Nitrendipine, orally given in a dose of 20 mg, once a day for 30 days, in patients with mild to moderate hypertension. Twelve patients initially entered the study but four of them discontinued the treatment during the first week, because of unwanted side-effects: headaches, palpitation, sensations of burning skin. The remaining eight patients underwent a comparative evaluation at the end of a placebo period (DO) and at the end of the active treatment (D30), including successively: an automatic blood pressure recording with a Bard-Sentron device for 3 hours, then a determination of plasma renin activity, aldosterone and catecholamines, and finally a measurement of the blood pressure with a mercury manometer, at rest and during a standardized exercise on an ergometric bicycle. At D30, the Nitrendipine tablet was given one hour after the beginning of the automatic recording. The blood pressure measured with the mercury manometer (i.e. approximately 2 hours after the dose of Nitrendipine) significantly decreased from D0 to D30, at rest and during exercise, respectively from 161.5/104.6 to 132.8/82.5 mmHg and from 210.0/116.8 to 190.0/95.6 mmHg. The automatic recording provided, at D0, a mean blood pressure value of 152.4/90.6 mmHg; at D30, this mean value was as high as 142.6/90.7 mmHg during the hour preceding the dose of Nitrendipine (NS) and as high as 129.2/78.6 mmHg during the 2nd hour following the intake of the tablet (p less than 0.01). Plasma aldosterone and plasma renin activity significantly (p less than 0.05) increased from D0 to D30, whereas catecholamines did not change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813463 TI - Ball and spring or slit and core valve for hydrocephalus shunting? AB - Ventriculoperitoneal or ventriculoatrial shunting is the main method used in the management of hydrocephalic children. It is, however, associated with frequent complications. In order to reduce the risk of complications several types of shunts have been developed. In vitro studies have been performed to compare different types of shunts (1), but clinical studies concerning the efficiency of different shunt constructions are scanty (2). In the present study the Hakim Cordis valve and the Pudenz-Heyer valve were compared in a series of 148 patients who had undergone 573 shunt operations for hydrocephalus. No significant differences were observed in the efficiency of these two shunts, though there was an increased rate of catheter rupture for the Pudenz-Heyer valve and an increased tendency for development of slit ventricles for the Hakim-Cordis valve. The patency rate for the Pudenz-Heyer valve proved to be statistically significantly higher (p less than 0.001) than that for the Hakim-Cordis valve, while there was a slight difference in the tolerance for high CSF protein levels favoring the Hakim-Cordis valve. PMID- 3813464 TI - Somatosensory evoked potentials in evaluation of decompressive surgery of cervical spondylosis and herniated disc. AB - Somatosensory evoked potentials (SEPs) were studied in patients with cervical radiculopathy and/or myelopathy caused by spondylosis or herniated disc. SEP recordings were performed before and after operation using an averaging technique by stimulating the median nerve separately at both wrists, with surface electrodes at three different levels: Erb's point, 7th cervical spine and inion. During the follow-up time all patients showed improvement of clinical symptoms. The preoperative SEP recording was abnormal in one or more parameters in all patients. Notable improvement (6-36 months postoperatively) of these abnormalities was observed in 12 out of 14 radiculopathy patients and in 4 out of 9 myelopathy patients. Only in the radiculopathy series could a statistically significant improvement (p less than 0.01) be found in two SEP parameters (amplitude N13 and relative amplitude difference of N13 amplitude). Therefore SEP abnormalities are commonly present in cervical radiculopathy and particularly in cervical myelopathy, and seem to be quite persistent postoperatively, even though clinical improvement especially in the form of pain relief is achieved. PMID- 3813465 TI - The treatment of Moyamoya disease by superficial temporal-middle cerebral artery (STA-MCA) anastomosis. AB - STA-MCA anastomosis was performed in a total of eight patients ranging in age from five to 42 years for treatment of symptomatic Moyamoya disease. All of the patients presented with symptoms of cerebral ischemia. In most cases bilateral procedures were performed at separate operations. No patients have experienced increased neurological deficits as a result of surgery, while the ischemic symptoms have been relieved completely in most cases. The surgical procedure is especially demanding in the treatment of Moyamoya disease, but remains one of the few solutions to the treatment of this disease. PMID- 3813466 TI - Suboccipital removal of vestibular neurinoma with preservation of the labyrinth. AB - Hearing preservation in surgery for vestibular neurinoma depends on several factors, the first of which is, of course, early diagnosis. If a small enough tumor is found in a patient with reasonable hearing, there is a fair chance that it can be removed in toto with preservation of some hearing. We report data from 40 operated patients; the question was whether the identification of the transverse crest and the removal of tumor from the lateral part of the internal auditory meatus could be achieved without opening of perilymph spaces. In most of these ears the angle from the medial edge of a suboccipital craniectomy allowed the surgeon a direct view of the lateral part of the internal auditory meatus with good exposure of the transverse crest without his having to open the labyrinth. So far we believe that loss of hearing caused during these operations is mainly due to the unfavorable location of the cochlear blood supply through the meatus. PMID- 3813467 TI - Outcome of patients after transcranial operation for pituitary adenoma. AB - A retrospective study of 111 craniotomies for pituitary adenomas was analyzed. The follow-up time was 14-33 years. Thirteen patients died from complications of primary or secondary operations, 23 of causes otherwise related to the tumor and 20 of unrelated causes. 40% of patients surviving the primary operation had recurrence of their tumor. Radiotherapy did not prevent recurrences, but postponed their occurrence. Some tumors appeared very late, the last one 18 years after operation. 70% of the surviving patients need hormone substitution, but only 8 patients have severe impairment of vision. PMID- 3813468 TI - Surgery of vertebrobasilar aneurysms and nimodipine. AB - Five patients among 60 consecutive patients suffering from recent subarachnoid hemorrhage were operated for ruptured vertebrobasilar aneurysm. Topical nimodipine treatment was given during the operation after clipping and continued systemically for three weeks. One out of the five patients developed symptoms which could be ascribed to delayed arterial vasospasm. Nimodipine may be advantageous in preventing ischemic complications when used prophylactically. Further investigation is needed to elucidate its efficacy in cases of vertebrobasilar aneurysms and conventional timing of surgery. PMID- 3813469 TI - Comparative retrospective study of patients operated for cervical disc herniation and spondylosis. AB - 173 patients suffering from symptoms of cervical disc herniation or spondylosis were surgically treated during 1975 through 1984 by Cloward's method via the anterior route or by total or hemilaminectomy with Epstein's foraminotomy via the posterior route. Of the 41 patients with disc herniation, 37 had radiculopathy as the main disorder and only 4 myelopathy. Of the 132 spondylosis cases radiculopathy was the main disorder in 92 and myelopathy in 40 cases. The operative route was selected according to the site of the osteophytes or disc herniation. The criteria for operative treatment were persistent radicular pain, motor weakness and progressive muscle atrophy, or evidence of cord compression. All patients underwent myelography preoperatively and sometimes also x-ray computed tomography. A clear correlation between the roentgenographic findings, clinical signs and symptoms served as the prerequisite for operative treatment. Follow-up review an average of 55 months after the operation showed excellent or good results in 80% of the disc herniation cases, but in only 35% of those with spondylosis. However, in the latter group pain relief was obtained in 76% of cases. In the spondylosis series there were significant correlations between the parameters of severity of disease and duration of symptoms and the surgical results, whereas in the disc herniation series no clear correlations were observed. Gait disturbances associated with myelopathy were only minimally relieved. There was no clear correlation after surgery between the degree of the disease and working capacity, but the duration of preoperative disability was significant in this respect. Postoperative complications were infrequent and no severe complications occurred. PMID- 3813470 TI - The Cushing reflex in the absence of intracranial hypertension. AB - A case is presented in which the left frontoparietal scalp, skull and dura were excised during removal of a massive squamous cell carcinoma. The exposed and relaxed brain was protected only with split-thickness skin grafts for 23 days before successful rotation of a full thickness scalp flap. During the first postoperative day following tumor removal, lumbar cerebrospinal fluid drainage by indwelling catheter was instituted. Transient cardiovascular signs of the classical Cushing reflex and an ipsilateral pupillary dilation rapidly ensued. This phenomenon lends further support to one of the theories regarding the pathogenesis of the Cushing reflex being a pressure gradient (not high intracranial pressure per se) causing axial distortion of the brain stem. In addition, this case is an example of brain herniation in the absence of clinical intracranial hypertension. PMID- 3813471 TI - Specific technical note concerning the preparation of distal rectal anastomoses. AB - The present increase of distal conolorectal anastomoses is certainly due to the desire of surgeons to conserve the natural routes of intestinal transit. With the exception of unusual, and in some cases debateable indications, such as haemorrhagic rectocolitis or Crohn's disease, most distal anastomoses involve cancer. At present, the main interest in distal rectal anastomoses is focussed on the choice of operating technique: manual or mechanical. In the opinion of the author, the decisive factor in favour of the use of Staplers was the substantial reduction of the incidence of dehiscence from 16 to 5 percent. PMID- 3813472 TI - [International Course on Medico-Surgical Coloproctology. Paris, January 23-25, 1986]. PMID- 3813473 TI - Contribution of modern imaging in rectosigmoid neoplastic disease (comparison with fiberoptic endoscopy). AB - Double-contrast enema (DCE) remains the primary diagnostic exploration. Its specific method and interpretation require skillful handling. Unlike colonoscopy, DCE results in false-positives, the frequency of which varies widely in function of the skill of the interpretation. False negatives reach a significant level from a threshold of size which can be fixed at 5 mm. Despite these drawbacks, double-contrast enema, which is an exploration involving a two level of invasiveness and which provides a good panoramic image of the colon should remain the primary exploration in routine check-ups. DCE is an essential part of loco regional evaluation. It is important in post-operative check-ups to screen for relapses. Post-operative follow-up should be systematic, involving an initial reference examination after 4 months, a check-up every 6 months for two years and then an annual check-up. PMID- 3813474 TI - Colonic ischemia after aorto-iliac surgery. AB - Post-operative colonic ischemia represents a major complication of aorto-iliac surgery. The cause is a low output with a variable combination of a systemic low output and loco-regional low output secondary to atherosclerotic or surgical lesions of the inferior mesenteric artery. The pre-operative angiographic work up, evaluation of the colonic ischemic risk, per-operatively, revascularization of the inferior mesenteric artery, preservation of the hypogastric flow, control of stable systemic hemodynamics, have significantly diminished the incidence of severe colonic ischemia while systematic colonoscopy at the slightest evocative symptom has permitted an effective treatment. The mortality is therefore greatly reduced. When the colonic ischemia is part of an acute circulatory failure, it is only one factor among other visceral ischemias, and it is the same for pelvic ischemias. In these 2 eventualities, the prognosis remains latent. PMID- 3813475 TI - Ischemic pathology of the colon. AB - Ischemic colitis is a disease with a polymorphic clinical picture, which may be of a formidable gravity in gangrenous forms. Its etiologies are varied and more and more due to a low arterial output. The examinations permitting to establish the diagnosis are barium enema and mostly colonoscopy which should be performed early and repeated often. The treatment vary according to the severity of the disease; prognosis is always reserved. PMID- 3813476 TI - [Useless appendectomy, its diagnostic difficulties]. AB - There are no useless appendectomies. Appendectomy is useful in the treatment of appendicitis. Early appendectomy has enabled us to win the battle against appendicitis. Appendectomy is useful in the diagnosis of appendicular syndromes. Appendicitis isn't the only appendicular disease. Appendectomy is an excision biopsy. Appendectomy is useful in the exploration of pseudo-appendicular syndromes. Appendicites encounter ileo-colic, urologic gynecologic, hepato vesicular, gastro-duodenal or even extra-abdominal disorders at the "space to the right of the iliac fossa". The diagnosis is then non-appendicitis rather than appendicitis. It is based on clinical criteria and the modern minimum useful investigation. Appendectomy is then an exploratory laparotomy. Appendectomy is useful in the prevention of pre-appendicular syndromes: post-surgical appendicites, traveller's appendicites and circuit appendicites, appendectomy does not cost more than appendicitis. PMID- 3813478 TI - Sphincter-saving excision for cancers of the middle and lower parts of the rectum. AB - Currently four methods of sphincter-saving excision are in vogue for carcinomas of the middle and lower rectum--low anterior resection with or without the aid of the circular stapler, abdomino-sacral (or abdomino-transphincteric) resection, abdomino-anal resection with endocavitary sutured colorectal or colo-anal anastomosis, and local excision (or destruction by diathermy or contact irradiation). The relative advantages and--as far as is known--the results of these different methods are examined with special reference to anterior resection using the circular stapler, which is now by far the most popular choice. PMID- 3813477 TI - Epidermoid cancers of the anus. Changes in therapeutic ideas. AB - Under this term, the authors discuss cancers of the anal canal. Cancers of the edge of the anus are skin cancers whose treatment will not be discussed here. Cancers of the anal canal are rare and are much more frequently found in women than in men. They are more or less differentiated epidermoid cancers. The therapeutic problems raised: cure a cancer with a loco-regional evolution beginning in the mucous lining of the anal canal and able to spread throughout the pelvic cavity; treatment should be total (on the tumor and ganglia) and conservative; treatment should avoid major complications such as necroses, fistulas, incontinence; it will often be carried out in elderly patients in poor general condition, poorly supporting lengthy treatments, hospitalization and anaesthesia. The therapeutic possibilities; two major therapeutic techniques possible, radiotherapy and surgery. PMID- 3813479 TI - [Malabsorption in alcoholic cirrhosis]. AB - 21 patients with alcoholic cirrhosis were worked up for malabsorption. In three patients, the fecal weight was over 200 g/24 h; three had a steatorrhea over 6 g/24 h and in four the creatorrhea was over 2 g/24 h. The D-xylose test was abnormal 4 times out of 18, but these 4 patients presented an ascites. Alpha-1 antitrypsin clearance was increased in 1 out of 9 patients. The Lundh test demonstrated in 5 out of 8 cases an external pancreatic insufficiency, but without any relation with the fecal losses. The 4 patients with malabsorption showed signs of malnutrition (anthropometric criteria). In the course of an alcoholic cirrhosis, malabsorption seems therefore infrequent, dissociated, and only observed in patients with signs of malnutrition. PMID- 3813480 TI - [Abdominal actinomycosis: a rare complication of gastric surgery? Apropos of a case]. AB - One case of abdominal actinomycosis is reported which was detected in a diabetic patient three years after surgery for duodenal peptic ulcer. Gastric actinomycosis is very rare and is usually discovered during surgery for gastric mass. The role of surgery as a predisposing condition to infection is discussed. The diagnosis rely on the characterization of the bacteria in cultures from a discharging wall fistula and on histopathologic examination which reveals the characteristic actinomycotic granules. PMID- 3813481 TI - [Isolated traumatic perforations of the gallbladder. 2 case reports]. AB - The first case is a classic perforation, the second case is a sub-serosal rupture with dissection of the gall bladder wall. Cured by cholecystectomy. The heavy ethanol impregnation of both injured patients is emphasized as a contributing factor. Sonogram, peritoneal tap-lavage and eventually a retrograde cholangiogram are recommended for the diagnosis. PMID- 3813482 TI - Immunolymphscintigraphy of axillary lymph node metastases in breast cancer patients using monoclonal antibodies: first clinical findings. AB - The results of preliminary investigations into the immunolymphscintigraphic (ILS) detection of axillary lymph node metastases in nine breast cancer patients by means of the 3C6F9 monoclonal antibody (MAs) are presented. The IgG2a monoclonal antibody detects a 37 KD antigen, consistently found on the surface of primary and metastatic breast tumors. Each patient received 1 mCi of I-123 (specific activity, 2 mCi per mg of antibody) as a subcutaneous injection between the 2nd and the 3rd finger of both hands, i.e., the healthy side serving as a control for the affected side. Clear images of lymph node metastases were visible 4 to 8 hours after injection of the antibody. Seven of the nine patients studied were positive by scanning and six showed positive lymph node involvement by histopathology (6/7; true positive = 86%). Two patients did not show any iodine uptake in the axilla and were subsequently found to be free of metastases (2/2; true negative = 100%). These data give an overall accuracy of ILS of 89% and demonstrate that 3C6F9 localizes preferentially in affected axillary lymph nodes compared to normal lymph nodes. PMID- 3813483 TI - Action mechanisms of anti-invasive agents. AB - An anti-invasive activity has been observed with a number of agents in confronting cultures between invasive cell populations and embryonic chick heart fragments. Cytochalasins, microtubule inhibitors and dipyridamole act via intracellular targets. Inhibition of glycosylation of proteins, low temperature and alkyl lysophospholipids alter the plasma membrane. Flavonoids aim at extracellular targets. In a unifying hypothesis we postulate that invasion is due to lack of responsiveness to stop signals that normally retain cells within their tissue boundaries. Some of the anti-invasive agents act on cellular activities that are necessary for invasion; others might act on the stop signal, the perception of and/or the response to this signal. PMID- 3813484 TI - In vitro and in vivo studies with anionic sulfatide-liposomes containing adriamycin. AB - Neutral and negatively charged liposomes containing Adriamycin (ADM) were examined for efficiency of drug entrapment and stability in serum. The greatest entrapment of ADM was obtained with negatively charged liposomes containing sulfatide. Moreover, these sulfatide-containing liposomes were more stable than other liposomes in the presence of serum. Tissue distribution studies indicated that the levels of ADM were increased several-fold in mouse liver and spleen after i.v. injection of the drug entrapped in sulfatide-liposomes, while levels of the drug were significantly diminished in the heart. Finally, the in vivo antitumor activity of ADM in liposomes containing sulfatides resulted in significantly greater survival rates than free ADM or ADM entrapped in liposomes without sulfatides. PMID- 3813485 TI - Different techniques for drug cytotoxicity evaluation on MCF-7 human breast cancer cell line. AB - Contrasting results have been reported following the use of different in vitro techniques for the evaluation of drug cytotoxicity on cultured cell lines. Our interest focuses on the evaluation of drug cytotoxicity on a ER+ breast cancer cell line (MCF-7). The present study compares the effect of Doxorubicin using the following different techniques: a dye exclusion test; cell growth after treatment, expressed either as slope of cell growth curves or as the number of cells in treated cultures as a percentage of the number of cells in control cultures at different time intervals after treatment; a clonogenic assay in liquid medium. The dye exclusion assay failed to demonstrate drug-related killing of cells. Our data from the present study support the relative superiority of clonogenic assay compared to other methods. However, the occasional use of different methods could by-pass the limitations of this assay, and, depending on the specific experimental conditions, could lead to a better definition of drug cell killing. PMID- 3813486 TI - Doxorubicin cytotoxicity to P388 lymphocytic leukemia as determined by alkaline elution and established assays. AB - Very large variations exist in the response of individual tumors to antineoplastic agents, even when the tumors are apparently very similar from the point of view of stage and histological classification. It has been recognized for a long time that methods capable of revealing the specific chemosensitivity of individual tumors could be useful for an individual optimization of a chemotherapeutic protocol. The Tumor Colony Forming Assay (TCFA) and the Biochemical Antimetabolic Assay (BAA) have been proposed for this purpose. Their main limitation is a consequence of the fact that the capability of in vitro growth is required from cells of a tumor grown in vivo. This is often lacking or very poor in the first in vitro passages. In this work we have investigated the possibility of using a sensitive method for evaluating DNA damage, the Alkaline Elution technique (AE). Cells treated in vivo can be easily tested directly for DNA damage. No cell proliferation in vitro is required. It is not required that the measured effect is the specific cause of cell death. A P388 Doxorubicin sensitive line and a resistant subline were tested. Correct correlations between DNA damage and chemosensitivity were obtained working both in vivo and in vitro. This test could be useful for assessing the chemosensitivity in vivo of alkylating and intercalating agents. PMID- 3813487 TI - Relapse of endometrial carcinoma related to steroid receptor concentration, staging, histologic grading and myometrial invasion. AB - Estradiol and progesterone receptor concentrations were positively correlated to the stage of the disease and to the grade of the tumors, but not to myometrial invasion. Myometrial invasion of more than the inner third and degree of differentiation are both important prognostic factors. By combining low estradiol receptor concentration and the degree of myometrial invasion in poorly differentiated adenocarcinomas, stage I-II, it was possible to identify a group of patients containing a high percentage of relapses. This group consisted of 60% of all patients with poorly differentiated carcinoma stage I-II, who had a relapse rate of almost 50%, and were thus suitable for aggressive initial treatment. PMID- 3813488 TI - Effect of estradiol on proliferation and on cell loss in the MXT mouse mammary tumor. AB - The MXT tumor is an experimental mammary tumor, maintained by transplantation in B6D2F1 mice, which contains significant amounts of estrogen and progesterone receptors. The aim of the present work was to study the effect of estradiol (E2) administration on the cell kinetic parameters (thymidine labeling index: TLI, S phase duration: TS, cell cycle duration: Tc, growth fraction: GF, potential doubling time: T, cell loss factor: luminal diameter) of an MXT anaplastic carcinoma strain. These parameters were analyzed using single-, double- or repetitive-tritiated thymidine (3H-TdR) labeling techniques. Uteri were used as controls for the methodology. Our data clearly demonstrate that E2 exerted a marked stimulatory effect on the tumor cell proliferation. This effect is the net result of a shortening of the mean cell cycle duration (Tc) and of a 3-fold increase of the number of cells produced per time unit in 89% of the total cancer cell population. Beside this stimulatory effect, E2 produces a marked increase of the tumoral cell loss. This loss seems to affect a cell fraction which has reached the quiescent state (Q) for a short time. PMID- 3813489 TI - Influence of inoculation sites and tumor cell culture techniques on the phenotype of a mixed cartilage- and bone-producing mouse mammary tumor. AB - We have previously reported the characterization of an intraperitoneally (IP) transplantable bone-forming MXT tumor. However, the question was unresolved as whether the bone-forming cells originated from either the host animal or from the neoplasm itself. The present work attempts to answer this question by studying the influences of inoculation sites (subcutaneously, SC; intraperitoneally, IP; in the brain, IB; intracranially, ICR) on both the cartilage- and bone-forming tumor phenotypes. Furthermore the influence of cell culture procedures (two- and three- dimensional cultures) on these phenotypes was investigated. SC administered MXT cancer cells never produce bone-forming tumors, suggesting the existence in the dermis of substance(s) inhibitory to the formation of cartilage or bone. On the contrary, our data clearly demonstrate that bone-forming tumors can be obtained by either IP route, in a way which mimics endochondral ossification, or in the brain (IB), a region usually devoid of connective tissue. This observation substantiates the hypothesis according to which the tumor itself is able to produce osseous tissue. Another main finding is the increasing occurrence of skeletal tissues produced by cells proceeding from three dimensional culture. Finally, ICR and IB tumors exerted a bone-lytic action against the host skull suggesting that tumor cells either produce osteolytic substances (prostaglandins, enzymes) and/or that they contain various cell types exhibiting different properties toward osteogenesis. This model offers new perspectives for studying the mechanisms of both normal and pathologic osteogenesis. PMID- 3813490 TI - Cis-platinum (CDDP) plus etoposide (VP-16-213) and treatment of disseminated neuroblastoma. AB - Ten patients with neuroblastoma were treated with a standard pulsed administration schedule of cis-platinum and etoposide (VP16-213). Two patients are experiencing good partial responses lasting over 8 months. One other patient had a partial response. Toxicity was mild and limited to high frequency hearing loss, temporary increase in blood urea nitrogen, and myelosuppression. These data may be useful to compare with data from other more aggressive or different administration schedules of the drug combination. PMID- 3813491 TI - Thyroid hormone receptors in human breast cancer: effect of thyroxine administration. AB - The present study was designed to establish the presence and pharmacological properties of the nuclear triiodothyronine receptors (T3R) (binding capacity, affinity and number of sites) in human breast cancer samples as well as the effects on them of thyroid hormone administration (T4). A computerized Scatchard plot analysis was designed to resolve the exponential curves in order to estimate the real number of T3R. T3R was present in 83% of the patients studied. In the thyroxine treated group, the number of nuclear T3R increased in the postmenopausal women, and may decrease in the premenopausal group, compared with the control group. These results suggest that T3R and thyroid hormone may play a role in breast cancer growth regulation; they also suggest that the T3R could open up the possibility of the classification of patients (as for ER and PgR), and consequently of new therapeutic trials. PMID- 3813492 TI - Specific interactions between quinacrine and self-complementary deoxydinucleotides. PMID- 3813493 TI - Molecular interactions between nucleic acids and antitumor substances by Raman and NMR spectroscopy. AB - 1-Methyladenosine (1-MeAdo) and protonated 1-Methyladenosine (1-MeAdo.H+) were chosen as a model to study the molecular interactions between the carcinogen dimethylsulphate (DMS) and the base adenine, and the interactions between the antitumoral electrophilic cis-diamminedichlorophatinum (II) (cis-Pt) and the methylation product of the base, respectively. Raman and multinuclear NMR studies show the molecular perturbations caused by the carcinogen on the base and those of the antitumoral substance on the reaction product base-carcinogen. PMID- 3813494 TI - Effect of lectins on tumorigenicity of AKR lymphoma cells of varying malignancy. AB - This study represents an attempt to characterize differences in the cell surfaces of cells of high - and low - malignancy by use of lectins. The effect of concanavalin A (con A), Phaseolus vulgaris lectin (PHA) and the galactophilic lectin of Pseudomonas aeruginosa (PA-I) on cell agglutination, viability and tumorigenicity of two variants of malignancy of AKR lymphoma was tested. Cell viability was not affected by the lectins. Agglutination of the two variants was similar with all lectins and was specifically inhibited by the respective sugars. However, the effect on tumorigenicity of the two variants differed markedly: it was strongly reduced by PHA in the less malignant variant, while the more malignant one was hardly affected. The effect of con A was, on the contrary, more accentuated on the high-malignancy variant. The effect of PA-I was in the same direction as con A, but reduction in oncogenicity of both variants was feeble. PMID- 3813495 TI - On the role of aging in cancer incidence: cohort analyses of the lung cancer data. AB - Lung cancer age-specific mortality rates for male and female cohorts born in the United States between 1903 and 1928 increase from age 32 to 52 according to an equation of the form log (mortality rate) = m(age) + b, where m and b are constants. Variation exists among the cohorts in the magnitudes of m and b, but correlation coefficients between age-mortality patterns among all cohorts are highly positive (r greater than 0.98, p less than 0.01), indicating that the form of the equation is similarly appropriate for each cohort. Because cigarette smoking behavior has varied among cohorts and between sexes, we conclude that the form of the equation, i.e., the exponential nature of the lung cancer age mortality pattern, is independent of environmental carcinogenicity and is best attributed to some aspect of the intrinsic aging process. PMID- 3813496 TI - Vasopressin in Alzheimer's disease: a study of postmortem brain concentrations. AB - Vasopressin (AVP) and its analogues are reported to improve learning- and memory related performance in experimental animals, and perhaps also in humans. Memory impairment is a clinical hallmark of the dementing disorder, Alzheimer's disease. We have examined AVP concentrations in postmortem brain tissue from 12 patients with histologically confirmed Alzheimer's disease and 13 control subjects. AVP was measured by a highly specific and sensitive radioimmunoassay, validated by parallel inhibition curves and high-performance liquid chromatography. Alzheimer brains had either normal or slightly increased AVP levels in the neocortex, which does not have AVP cell bodies. Significant reductions in AVP content were found in the hippocampus, nucleus accumbens, and globus pallidus interna. Levels were normal in all other regions studied. Abnormalities of the brain vasopressin system may contribute to the memory deficit associated with Alzheimer's disease. PMID- 3813497 TI - Sickle cell anemia and central nervous system infarction: a neuropathological study. AB - CNS infarcts were demonstrated in 12 of 24 autopsied patients with sickle cell anemia. The infarcts occurred most extensively in the territory supplied by the distal branches of the internal carotid artery, especially the anterior-middle cerebral artery boundary zone. They were regularly associated with organizing and recanalizing thrombi involving the distal cervical and proximal intracranial divisions of the internal carotid system. On the basis of these findings, we infer that the pathogenesis of the infarction involves perfusion failure or intraarterial embolization in addition to intravascular sickling. PMID- 3813498 TI - Structural determinants of electroencephalographic findings in acute hemispheric lesions. AB - We studied electroencephalograms and computed tomographic scans of 54 patients with acute hemispheric strokes. Electrographic parameters evaluated included field, amplitude, frequency, persistence, and reactivity of focal or lateralized slow-wave activity. Ipsilateral and contralateral background activity were also assessed. Structural and clinical features studied were lesion size, density, mass effect, location, tissue involvement, deep structure involvement, level of consciousness, and outcome. The data were analyzed using computer sorting and the chi 2 test. The field, amplitude, and frequency of focal slow-wave abnormalities generally failed to show a specific association with structural details. Continuous focal abnormalities correlated with large lesions (p less than 0.05), mass effect (p less than 0.05), and altered state of consciousness (p less than 0.05). Reactive focal abnormalities were associated with small lesions (p less than 0.05) and the absence of mass effect (p less than 0.02). Ipsilateral background activity abnormalities correlated with lesion size (p less than 0.001) and mass effect (p less than 0.01). Attenuation of ipsilateral background activity was more important than irregularity. Abnormal background activity contralateral to the lesion side was associated with alteration of consciousness (p less than 0.05). PMID- 3813499 TI - Zinc in multiple sclerosis. II: Correlation with disease activity and elevated plasma membrane-bound zinc in erythrocytes from patients with multiple sclerosis. AB - Previous studies have shown that zinc levels in erythrocytes are significantly elevated in patients with multiple sclerosis (MS). To examine the correlation between erythrocyte Zn levels and disease activity, we measured erythrocyte Zn levels longitudinally. Levels were dramatically decreased during a clinically documented exacerbation of MS. To determine the localization of increased Zn levels in MS erythrocytes, we employed standard techniques for the isolation of nonhemoglobin erythrocyte membrane ghosts. Patients with MS had three times more Zn in ghost material than did controls. Chloroform-methanol extraction in erythrocyte ghosts followed by determination of Zn levels indicated that most of the membrane-bound Zn was associated with the lipid-soluble fraction. Non-lipid associated Zn and total membrane protein concentration were similar in MS and control samples. Results suggest that mechanisms which govern cellular availability, compartmentalization of Zn, or the binding of Zn to cell surface membranes may be altered in patients with MS, and that these mechanisms vary with disease activity. PMID- 3813500 TI - Electrophysiological correlates of a paroxysmal movement disorder. AB - Averaged electroencephalographic activity related to rhythmic jerking movements was recorded in a patient with a complex neurological symptomatology. The diagnosis of a functional disorder was strongly suggested by his clinical course, inconsistent findings from physical examination, and negative workup. His abnormal movements were associated with the same electrophysiological correlates as normal willed motion, suggesting that averaged movement potentials may provide useful information in the study of patients with suspected functional movement disorders. PMID- 3813501 TI - Dicarboxylic aciduria in an infant with spinal muscular atrophy. AB - A 1-year-old infant with classic Werdnig-Hoffmann disease was found to excrete abnormally large amounts of dicarboxylic acids in both fed and fasting states, with especially notable increases in the longer-chain (C10 and C12) 3 hydroxydicarboxylic acids. Dicarboxylic aciduria has not previously been associated with Werdnig-Hoffmann disease and suggests a primary or secondary defect of fatty acid metabolism in the disorder. PMID- 3813502 TI - Hemispheric brain damage in unilateral status epilepticus. AB - A 20-year-old woman with psychomotor seizures developed prolonged unilateral status epilepticus followed by coma, right hemiparesis, fever, liver failure, and eventually death. Neuropathological findings included severe neuronal ischemic cell change and massive brain edema, essentially restricted to the left cerebral hemisphere. Massive destruction of the hemisphere involved in epileptic activity with sparing of the contralateral hemisphere provides supportive evidence that in humans prolonged seizure activity can cause permanent brain damage. PMID- 3813503 TI - The pathophysiology of penicillamine-induced myasthenia gravis. AB - The temporal course and pathophysiology of penicillamine-induced myasthenia gravis were studied in detail in a typical case. Our results suggest that this disorder and idiopathic autoimmune myasthenia gravis share the same essential pathophysiological features, including the presence of anti-acetylcholine receptor (AChR) antibody, serum-induced blockade of AChRs, antibody-mediated accelerated degradation of AChRs, and a resultant quantitative reduction in available junctional AChRs. An initial severe reduction in junctional AChRs was reversed and the patient recovered, both within 8 months of stopping penicillamine. Our data suggest that penicillamine probably produced myasthenia gravis by initiating a new autoimmune response rather than by enhancing ongoing autoimmunity. PMID- 3813504 TI - Magnetic resonance imaging of the midbrain in Parkinson's disease. AB - We have analyzed magnetic resonance images of the midbrain in patients with Parkinson's disease, and have found that there is a narrowing of the signal from the pars compacta of the substantia nigra relative to controls. The nature of the histological changes that may be responsible for this effect is discussed. Magnetic resonance imaging has the potential of becoming a useful diagnostic tool in the management of parkinsonism. PMID- 3813505 TI - Sporadic paroxysmal dystonic choreoathetosis associated with basal ganglia calcifications. PMID- 3813506 TI - [Physicochemical properties and structure of the nonmacrolide polyene antibiotic altamycin A]. AB - Altamycin A, an antibiotic described earlier was classified by its physicochemical and biological properties as belonging to the subgroup of polyenic nonmacrolides. Physicochemical properties of altamycin A and other representatives of nitrogen-containing polyenic nonmacrolides are presented. It is shown that the molecule of the antibiotic contains D-digitoxose (a sugar). The structure of the antibiotic aglycone was determined by the mass spectra of the oxidative degradation products of perhydroantibiotic, methyl heptahydroantibiotic and methyl permethylperhydroaglycone. Unlike alpha-lipomycin, altamycin A contains the tetraene system of conjugated methylene bonds. PMID- 3813507 TI - [Changes in the fluorescence in preparations of normal human immunoglobulin during deamidation]. AB - It was shown that self-fluorescence of normal human immunoglobulins prepared with the use of donor and placental raw materials lowered after incubation at 37 degrees C for 28 days and after storage under the standard conditions (4-10 degrees C) for 2 years. Dependence of thermostability of the immunoglobulins on the raw material used for their preparation and the storage period was revealed spectrofluorometrically. Resistance of the proteins to thermal denaturation lowered on storage. However, it was higher in the immunoglobulins prepared with the use of donor serum. Thermostability and lowering of self-fluorescence of the proteins depended on the level of their amidization. PMID- 3813508 TI - [Quantitative determination of the antibiotic doxorubicin by high-performance liquid chromatography]. AB - A new three-component system was developed for separation of a mixture containing 6 components: doxorubicin, rubomycin, dihydrorubomycin, 14-bromrubomycin, doxorubicinone and rubomycinone. The system uses reverse phase high performance liquid chromatography. Separation was performed on a column with Spherisorb C18 (4.6 X 250 mm) with the particle size of 10 microns. Relationships between the capacity factor k1 for the above 6 components and relative arresting alpha for 3 hardly separating components: doxorubicin, rubomycinone and dihydrorubomycin, as well as between the percentage content of the organic component, acetonitrile and the percentage content of the buffer solution were studied. The external standard method was used for determination of purity of doxorubicin standard preparations. The method provides routine quantitative assay of doxorubicin hydrochloride. PMID- 3813509 TI - [Antitumor activity of doxorubicin in respect to solid tumors in mice]. AB - Antitumor activity of doxorubicin, an antibiotic prepared in the USSR was studied with respect to 4 solid tumors of mice: lymphosarcoma LIO-1, sarcoma 180, pregastric cancer OZh5 and melanoma B-16. Doxorubicin showed high antitumor activity against lymphosarcoma and sarcoma 180. However, it was somewhat lower than that of rubomycin and carminomycin. By selective antitumor activity against mouse pregastric cancer doxorubicin was superior to rubomycin and carminomycin. Estimation of antitumor activity of doxorubicin revealed its advantages in inhibition of melanoma B-16 growth, while carminomycin was superior in prolonging the animal life-span. PMID- 3813510 TI - [Pharmacokinetics of cefazolin during hemosorption and hemodialysis]. AB - The influence of hemosorption and hemodialysis on the pharmacokinetics of cefazolin was studied in 20 patients with chronic and acute renal insufficiency. The integral mean value of the antibiotic extraction coefficient in hemosorption was approximately 2 times higher than that in hemodialysis. In the first case the value of this parameter systematically lowered with time (the constant of the process rate amounted to 0.89 h-1), while in the second case it was constant. PMID- 3813511 TI - Penicillins, cephalosporins, and tetracyclines in treatment of hamsters with fatal leptospirosis. AB - A predictable 6- to 7-day course of a fatal Leptospira interrogans serovar bataviae infection in experimentally infected mature 110- to 150-g hamsters was used to evaluate the therapeutic efficacy of conventionally used and newer antibiotics. Active drugs were ampicillin, bacampicillin, cyclacillin, piperacillin, mezlocillin, doxycycline, chlortetracycline, cefotaxime, and moxalactam. Cephalexin, cefadroxil, cefamandole, and cefoperazone showed little or no activity in preliminary studies. In delayed treatment studies, all nine active drugs prevented death of hamsters even when treatment was delayed until 1 to 2.5 days before expected time of death. Leptospires in kidneys of surviving animals could be demonstrated in one or more hamsters treated with doxycycline, chlortetracycline, cyclacillin, and piperacillin, but in none of the animals treated with ampicillin, bacampicillin, mezlocillin, cefotaxime, and moxalactam. The potential usefulness of newer penicillins and cephalosporins, as well as ampicillin, chlortetracycline, and doxycycline, for treatment of severe leptospirosis is reported. PMID- 3813512 TI - Antileishmanial activity of liposome-encapsulated amphotericin B in hamsters and monkeys. AB - Visceral leishmaniasis (kala-azar) results from parasitization of the macrophages of the liver, spleen, and the rest of the visceral reticuloendothelial system with Leishmania donovani. Pentavalent antimony is the drug of choice for leishmaniasis chemotherapy; amphotericin B (AmB) is active but is rarely used, because of drug toxicity. AmB encapsulated within macrophage-directed carriers (liposomes) has been used to treat humans with systemic mycoses complicating neoplastic diseases; dosages of up to 5 mg of encapsulated AmB per kg per day for greater than 14 days are without apparent kidney or liver toxicity. In the present work, greater than 99% of L. donovani parasites were eliminated from the liver and spleen of infected hamsters by one administration of 1.5 to 11 mg of liposome-encapsulated AmB (L-Amb) per kg. A total of 98 to 99% of hepatosplenic parasites were eliminated from squirrel monkeys by three administrations of 4 mg of L-AmB per kg. L-AmB was 170 to 750 times as active as antimony in hamsters, and approximately 60 times as active as antimony in monkeys. The demonstration that apparently nontoxic human dosages of L-AmB eliminate essentially all hepatosplenic parasites in hamster and primate models suggests that this preparation should be considered for clinical trial against kala-azar. PMID- 3813513 TI - Pharmacokinetics of cefoperazone in the parturient. AB - Limited pharmacokinetic data for cefoperazone are available from the parturient. Because cefoperazone has a dual excretory pattern, primarily via the biliary system and secondarily via the kidney, pregnancy-induced physiologic alterations can influence its deposition and clearance. Twelve term parturients receiving cefoperazone prophylaxis after cesarean section were selected for study. After 2 g of cefoperazone was administered for 1 h intravenously, serial blood samples were assayed by high-pressure liquid chromatography. Plasma protein binding of cefoperazone was studied in vitro. The mean peak cefoperazone concentration +/- standard deviation was 169.9 +/- 60.4 micrograms/ml. The mean half-life was 152 min. Total serum clearance was 80.8 +/- 30.8 ml/min. The steady-state volume of distribution was 14.2 +/- 6.0 liters. All subjects had detectable trough levels at the end of the dosage interval, with a mean value of 6.5 +/- 5.2 micrograms/ml. Protein binding of cefoperazone for parturients was 74.3 +/- 10.9%, compared with 87.7 +/- 3.2% in nonpregnant controls (P less than 0.05). These data suggest that cefoperazone deposition can be greatly influenced by pregnancy. However, unlike several other new antimicrobial agents whose excretions are mainly renal, the cefoperazone half-life and thus trough concentration for the parturient more closely resemble that for the nonpregnant subject. PMID- 3813514 TI - Continuous sampling for determination of pharmacokinetics in rat cerebrospinal fluid. AB - A method for determining drug concentration relationships between plasma and cerebrospinal fluid (CSF) in rats is described. Continuous CSF samples were collected directly from the third anterior ventricle with an indwelling cannula inserted through the bregma point, and drug concentrations were determined by high-pressure liquid chromatography and radioimmunoassay micromethods. Three antibiotics with different abilities to cross the blood-CSF barrier (chloramphenicol, piperacillin, and gentamicin) were tested. This method was found to be reproducible for each drug even if the antibiotic levels were low and the sample volumes very small. Peak CSF concentrations occurred between 0.75 and 1.25 h after injection for all three antibiotics. Percent penetration values at 1 h were 50, 1.2, and 5.4% for chloramphenicol, piperacillin, and gentamicin, respectively. PMID- 3813515 TI - Bactericidal activity and killing rate of serum in volunteers receiving ciprofloxacin alone or in combination with vancomycin. AB - Ten healthy volunteers received the following regimen on different days: vancomycin, 500 mg intravenously; ciprofloxacin, 200 mg intravenously; vancomycin plus ciprofloxacin. Concentrations in serum measured microbiologically at the end of infusion and 1 and 6 h after the end of infusion were, respectively (mean [standard deviation] in milligrams per liter): 32.3 (5.5), 14.2 (2.6), and 4 (0.9) for vancomycin and 3.12 (0.86), 0.78 (0.18), and 0.19 (0.05) for ciprofloxacin. Vancomycin concentration was not affected by the simultaneous administration of ciprofloxacin. The serum bacteriostatic and bactericidal (SBA) activities were measured 1 and 6 h after the end of infusion against five strains each of Staphylococcus aureus susceptible and resistant to oxacillin, Staphylococcus epidermidis susceptible and resistant to oxacillin, Corynebacterium strain JK, and Listeria monocytogenes and three strains of Mycobacterum fortuitum. Ciprofloxacin alone provided low SBAs against the tested strains even 1 h after administration. Vancomycin provided adequate SBAs against staphylococci and Corynebacterium strain JK 1 h after administration. None of the regimens tested showed adequate bactericidal activity against L. monocytogenes and M. fortuitum. The combination of vancomycin with ciprofloxacin was indifferent. This was confirmed by studying the rate of killing in serum. Vancomycin plus ciprofloxacin appeared to be promising for the empiric treatment of infection in immunocompromised patients. PMID- 3813516 TI - Protection of mice from lethal influenza virus infection with high dose-short duration ribavirin aerosol. AB - An aerosol generated from a reservoir containing 60 mg of ribavirin per ml given for 2 h twice daily for 4 days afforded the same high level of protection against lethal influenza virus infection of mice as a longer, conventional treatment schedule (20 mg/ml given for 11 h daily for 4 days). Incremental decreases in ribavirin concentration made while maintaining the 2-h intermittent schedule provided progressively less protection of mice. Mice exposed to the 60-mg/ml doses had significantly increased pulmonary and serum drug levels when compared with mice given 20 mg of drug per ml, these increases were transient, and no evidence of pulmonary intolerance was detected. These studies suggest that protective effects of ribavirin against influenza virus infection can be achieved without untoward effects if higher doses and shorter periods of administration are used. PMID- 3813517 TI - Epidemiology of intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime in a hematology-oncology unit. AB - Intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime was surveyed for 3 years in a hematology-oncology unit. Of 416 patients, 66 (15.9%) were colonized, each with a different strain. The incidence of intestinal carriage was not correlated with cefotaxime consumption in the ward but was strongly associated with individual exposure to cefotaxime. PMID- 3813518 TI - Comparative efficacy of ketoconazole and mebendazole in experimental trichinosis. AB - The therapeutic efficacy of ketoconazole and mebendazole was studied in ICR/CD-1 mice infected with Trichinella spiralis for 17 to 20 weeks. Efficacy of both drugs was over 70% when compared with results in control mice. This study indicates that both ketoconazole and mebendazole should be considered in the treatment of trichinosis in humans. PMID- 3813519 TI - Mycobacterium avium-M. intracellulare isolates from patients with or without acquired immunodeficiency syndrome. AB - Susceptibility testing and serotyping were performed on 57 isolates of Mycobacterium avium-M. intracellulare from patients with acquired immunodeficiency syndrome (AIDS) and 75 isolates from patients without AIDS. Susceptibility patterns and serotypes of AIDS isolates were significantly different from those of non-AIDS isolates. These results may partially explain the poor therapeutic response of M. avium-M. intracellulare infections in AIDS patients. PMID- 3813520 TI - Relevance of in vitro antimicrobial susceptibility of Brucella melitensis to relapse rate in human brucellosis. AB - The in vitro susceptibility of Brucella melitensis was examined vis-a-vis the clinical outcome in 75 patients with brucellosis. The initial MICs for Brucella isolates from patients who relapsed and from those who did not were similar. Furthermore, the MICs for isolates from patients whose infections relapsed were no different from those for original isolates. Our results clearly showed that neither initial nor subsequent antibiotic susceptibility plays a role in the likelihood of relapse of patients with brucellosis. PMID- 3813521 TI - Oxidation of carbon sources via the tricarboxylic acid cycle during calcium induced conidiation of Penicillium notatum. AB - The TCA cycle was examined during Ca2+-induced conidiation in Penicillium notatum over the 12-h period after addition of Ca2+ to vegetative cultures. Conidiation was independent of Ca2+ when certain intermediates and derivatives of the TCA cycle served as sole carbon sources. Arsenite and malonate augmented the effect of Ca2+ on conidiation but did not substitute for it. Mitochondria from vegetative cells had low rates of oxidation of TCA cycle intermediates and, with the exception of pyruvate, aconitate and glutamate, these were poorly linked to phosphorylation processes. Calcium ions affected mitochondrial function causing reduced oxidation of oxoglutarate, elimination of pyruvate oxidation and a decline in respiratory control of these substrates with increased oxidation of NADH and NADPH. Radiorespirometric studies and enzyme searches revealed a complete but weakly oxidative TCA cycle in vegetative cells. In Ca2+-induced cells oxoglutarate dehydrogenase activity was deleted within 6.5 h of Ca2+ addition and this was accompanied by establishment of an 'incomplete Krebs cycle'. Calcium-induced conidiation was associated with increased capacity for acetate and glutamate metabolism involving an activated glyoxylate shunt which may be related to enhanced biosynthetic demand. The metabolic basis of the Ca2+ effect on conidiation is discussed in connection with previous findings. PMID- 3813522 TI - Mathematical modelling of lipid production by oleaginous yeasts in continuous cultures. AB - A mathematical model was constructed to describe the influence of the carbon to nitrogen ratio (C/N-ratio) of the growth medium on lipid production by oleaginous yeasts. To test this model and to determine some relevant model parameters, the oleaginous yeast Apiotrichum curvatum ATCC 20509 was grown in continuous cultures at various C/N-ratios and dilution rates. It appeared that when nitrogen is limiting for the formation of biomass, the remaining glucose can be converted to storage carbohydrate and storage lipid. No clear dependence of carbohydrate yield on the C/N-ratio could be demonstrated, but lipid yield increased gradually with increasing C/N-ratios. The maximal dilution rate for lipid producing yeast cells appeared to be optimal at relatively low C/N-ratios. It can be concluded that the experimental results fitted well with the mathematical model. By using this model, lipid yield and lipid production rate can be calculated at any C/N-ratio of the growth medium and optimum operation conditions can be predicted for the production of microbial lipids. PMID- 3813523 TI - Kinetics and energetics of reduced sulfur oxidation by chemostat cultures of Thiobacillus ferrooxidans. AB - Thiobacillus ferrooxidans was grown in chemostat cultures with thiosulfate and tetrathionate as the limiting substrates. The yields at steady state on both substrates at different dilution rates were calculated. In a few experiments the air supply was supplemented with 2% CO2 (v/v). This resulted in a slightly increased yield. Cells from the chemostat cultures were used to study the kinetics of thiosulfate, tetrathionate, sulfite and sulfide oxidation. With all substrates mentioned the Ks values were in the micromolar range. The values for thiosulfate and tetrathionate were 2 orders of magnitude lower that those published previously. PMID- 3813524 TI - The effect of growth temperature on esterase patterns in psychrotrophic Bacillus species and other gram-positive genera. AB - The growth temperature of Bacillus stearothermophilus was previously reported to affect the esterase band pattern obtained after gel electrophoresis. In this study gel electrophoresis of esterases was done on a group of Antarctic bacterial strains cultivated at different temperatures to investigate whether band shift due to a change in growth temperature was a general phenomenon or limited only to select groups. Most strains studied were in the Bacillus genus. Standard strains of known Bacillus species and other Gram-positive genera were examined for comparative purposes. A change in the esterase band pattern was observed as a result of variation in growth temperature. Two major esterase band were dominant in this diverse group of species. PMID- 3813525 TI - Oxidation of amines by yeasts grown on 1-aminoalkanes or putrescine as the sole source of carbon, nitrogen and energy. AB - The maximum growth rate of Trichosporon cutaneum CBS 8111 in chemostat cultures was 0.185 h-1 on ethylamine and 0.21 h-1 on butylamine, that of Candida famata CBS 8109 was 0.32 h-1 on putrescine. The amine oxidation pattern of the ascomycetous strains studied, viz. Candida famata CBS 8109, Stephanoascus ciferrii CBS 4856 and Trichosporon adeninovorans CBS 8244 was independent of the amine that had been used as the growth substrate. It resembled that of benzylamine/putrescine oxidase found in other ascomycetous yeasts. However, differences in pH optimum and substrate specificity were observed between the amine-oxidizing systems of these three species. The amine oxidation pattern of cell-free extracts of Trichosporon cutaneum CBS 8111 varied with the amine that was used as growth substrate. The enzyme system produced by Cryptococcus laurentii CBS 7140 failed to oxidize isobutylamine and benzylamine, and showed a high pH optimum. The synthesis of amine oxidase in the four yeast strains studied was not repressed by ammonium chloride and was weakly repressed by glucose but was strongly repressed if both compounds were present in the growth medium. PMID- 3813526 TI - Bacteroides xylanolyticus sp. nov., a xylanolytic bacterium from methane producing cattle manure. AB - As part of a study of the biogas production from cattle waste, xylanolytic bacteria were isolated from enrichments of fermenting cattle manure. From 34 isolates, mostly Gram-negative rods, a typical strain was investigated in more detail. It was an anaerobic non-sporeforming, Gram-negative rod, which was motile with peritrichous flagella. This organism fermented xylan and many soluble sugars (glucose, cellobiose, mannose, xylose, arabinose). Other hemicelluloses such as gum xanthan, laminaran, locust bean gum, and gum arabic were not utilized. It also could not use cellulose. Fermentation products were carbon dioxide, hydrogen, acetate and ethanol. The bacterium produced carboxymethylcellulase and xylanase, especially when growing on xylan. Growth was optimal between 25 degrees C and 40 degrees C and between pH 6.5 and 7.5. The guanine plus cytosine content of the DNA was 34.8 +/- 0.8%. The isolate was identified as a member of the genus Bacteroides, and a new species is proposed: Bacteroides xylanolyticus (xylan dissolving). The type strain of B. xylanolyticus is strain X5-1 (DSM 3808). PMID- 3813527 TI - FDA inspection of an academic laboratory. PMID- 3813529 TI - Structures of the sugar chains of a major glycoprotein present in the egg jelly coat of a starfish, Asterias amurensis. AB - Sugar chains of a major glycoprotein, obtained from the egg jelly coat of a starfish (Asterias amurensis), were released quantitatively as oligosaccharides by hydrazinolysis. After N-acetylation, they were converted to radioactive oligosaccharides by reduction with NaB3H4. Analysis by paper electrophoresis revealed that all of them were neutral oligosaccharides. Upon Bio-Gel P-4 column chromatography, the radioactive oligosaccharide mixture was separated into four components. Structural study of each component by sequential glycosidase digestion in combination with 1H-NMR spectroscopy revealed that the glycoprotein contains the following oligosaccharides, in which R represents either proton, Glc alpha 1----, Glc alpha 1----3Glc alpha 1----, or Glc alpha 1----2Glc alpha 1--- 3Glc alpha 1----. (Formula: see text) PMID- 3813528 TI - Developmental study of human fetal placental fibronectin: alterations in carbohydrates of tissue fibronectin during gestation. AB - Human term placental tissue fibronectin contains about twice the carbohydrate content of human adult plasma fibronectin or fetal plasma fibronectin. The chief difference is the presence of substantial amounts of large N-linked polylactosamine chains on the placental fibronectin. The large carbohydrate on placental tissue fibronectin weakens the binding of fibronectin to denatured collagen. To examine whether a developmental change takes place in the placental fibronectin during gestation, fibronectin was isolated from placentas of different developmental stages beginning with the first trimester and ending with term. Polylactosamine carbohydrate, as well as total quantity of carbohydrate, increased steadily during gestation, reaching a maximum at term of more than 9% carbohydrate. Weakened binding of fibronectin to collagen occurred near the end of gestation concomitant with an increase in the quantity of larger polylactosamine glycopeptides. Relationships among these developmental changes, the impending birth, and the end of the function of the placenta remain to be investigated. PMID- 3813530 TI - Biosynthesis of 3-hydroxy fatty acids, the pheromone components of female mallard ducks, by cell-free preparations from the uropygial gland. AB - Diesters of 3-hydroxy C8, C10, and C12 acids, the female mallard duck pheromones, were found as the major products of the uropygial glands only during the breeding season. The 3-hydroxy acids were identified by mass spectrometry of the trimethylsilyl ethers of the methyl esters and of the diols derived from LiAlH4 reduction of the hydroxy acids. A cell-free extract from the gland catalyzed conversion of dodecanoic acid to 3-hydroxydodecanoic acid which was identified by radio thin-layer and radio gas chromatographic analysis of the enzymic products as methyl-3-acetoxydodecanoate and as diacetate of the diol generated by LiAlH4 reduction of the enzymic product. The enzymic introduction of the hydroxyl group at C-3 was catalyzed mainly by a 50,000g pellet prepared from a 1000g supernatant obtained from the cell-free extract. This reaction required ATP, CoA, and O2, and the CoA ester of the acid was more efficiently converted than the free acid to the 3-hydroxy acid. KCN at 1 mM and 50% CO did not inhibit the reaction. 3H from 3H2O was incorporated into 3-hydroxydodecanoic acid during the enzymic synthesis of this acid from dodecanoic acid. Mass spectrometry of the 3-hydroxy acid generated by the particulate fraction in the presence of H2 18O showed that 18O was incorporated as expected from hydration of a delta 2 double bond. From the above results it is tentatively concluded that peroxisomal acyl-CoA oxidase converts the acyl-CoA to the 2-enoyl-CoA which is hydrated to generate the 3 hydroxy acid. PMID- 3813531 TI - A regulatory polymorphism for rat hepatic cytochrome P-450g. AB - Rat hepatic cytochrome P-450g is a male-specific hemoprotein found at significant levels only in adult animals. In the present study, two-dimensional gel electrophoretic and immunochemical methods were used to study a polymorphism of this isozyme and its ontogenetic regulation. Inbred ACI/Hsd and WF/Hsd rats were found to express high and low levels of cytochrome P-450g, respectively. F1 hybrids of these strains showed additive inheritance for this trait and the responsible gene was found to be autosomal. Cytochrome P-450g and another male specific form of the enzyme, cytochrome P-450h, were characterized by a similar time-course for their ontogenetic expressions. However, unlike cytochrome P-450g, the level of cytochrome P-450h was indistinguishable in hepatic microsomes from mature ACI/Hsd and WF/Hsd rats. Considering these results, we tentatively conclude that the gene regulating the level of cytochrome P-450g is Cis-acting. PMID- 3813532 TI - Identification of a 42K phosphoprotein of platelets modulated by collagen: the alpha-subunit of pyruvate dehydrogenase. AB - Platelets exposed to collagen sufficient to stimulate the release reaction show an increase in labeling of two intracellular proteins with molecular weights of 20,000 and 42,000. The 20,000 Mr protein has already been identified as the light chain of myosin whereas the identity of the 42,000 Mr protein had not been established. By use of biochemical and immunological techniques, the identify of the 42,000 Mr component of prelabeled platelets found in the 100,000g supernatant of freeze-thawed or sonicated cells appears to be one of the subunits of pyruvate dehydrogenase complex which is translocated from the mitochondria to the 100,000g supernatant during the preparative procedure. Increased phosphorylation of the 42,000 Mr protein occurred after collagen stimulation and was accompanied by diminished pyruvate dehydrogenase activity. PMID- 3813533 TI - The participation of NADP, the transmembrane potential and the energy-linked NAD(P) transhydrogenase in the process of Ca2+ efflux from rat liver mitochondria. AB - The pyridine nucleotide specificity, the participation of delta psi, and the energy-linked transhydrogenase in the process of Ca2+ efflux stimulated by the oxidized state of NAD(P) were examined in rat liver mitochondria energized by ascorbate + TMPD. The following observations were made: The Ca2+ efflux rate is independent of the redox state of mitochondrial NAD, but is at a minimum when mitochondrial NADP is in the reduced state and accelerated several-fold when it is in the oxidized state. When the redox state of NADP is shifted to a more oxidized state, the steady-state level of Ca2+ in the medium increased and delta psi decreased in proportion to the mitochondrial NADP+ level. The activity of the energy-linked NAD(P) transhydrogenase seems to be a key element in determining the redox state of NADP and thus of Ca2+ retention and efflux from mitochondria. PMID- 3813534 TI - Glial-derived neurite-promoting factor is a slow-binding inhibitor of trypsin, thrombin, and urokinase. AB - Glial-derived neurite-promoting factor was found to be a slow-binding inhibitor of trypsin, urokinase, and thrombin. The kinetic mechanism of the inhibition differs among the three proteases. With trypsin and urokinase, an initial protease-factor complex formed which isomerized to a tighter complex. For thrombin, however, no initial complex was kinetically observed. The dissociation constants of the equilibrium complexes of the factor with trypsin, urokinase, and thrombin were 17, 280, and 18 pM, respectively, and the apparent second-order rate constants for the interaction of the factor with these enzymes were, respectively, 4.7 X 10(6), 1.2 X 10(5), and 2.1 X 10(6) M-1S-1. Heparin increased the rate at which the factor reacted with thrombin by over 40-fold to 8.9 X 10(7) M-1S-1 and decreased the dissociation constant of the complex by over 80-fold to 0.3 pM. The values obtained for the apparent second-order rate constants when compared with the kinetics of neurite induction by the factor indicate that the neurite-promoting activity of the factor is not due to the inhibition of urokinase but could be due to the inhibition of an enzyme with a specificity similar to that of thrombin or trypsin. Comparison of the values of the apparent second-order rate constants obtained for the factor with those obtained for protease nexin suggests that these two molecules are very similar in their inhibitory properties. PMID- 3813535 TI - Biochemical characterization and development of DNA polymerases alpha and delta in the neonatal rat heart. AB - The ontogeny of DNA polymerase activity in the neonatal rat heart was studied. The DNA polymerase activities in rat heart extracts were identified as DNA polymerase alpha and DNA polymerase delta activities by their purification and characterization, by the use of a specific inhibitor (BuAdATP), and by a specific monoclonal antibody against DNA polymerase alpha. Using these inhibitors, it was shown that the two activities declined in parallel during the maturation and terminal differentiation of the heart. PMID- 3813536 TI - Anisotropy decay of diphenylhexatriene in melittin-phospholipid complexes by multifrequency phase-modulation fluorometry. AB - Frequency-domain fluorometry was used to investigate the intensity and anisotropy decays of diphenylhexatriene (DPH) in melittin-lipid complexes. Simulated and experimental data indicate that correlation times ranging from 0.3 to 500 ns can be determined using data from 1 to 200 MHz. For the melittin-lipid complexes the hindered rotator model was not adequate to account for the anisotropy decays, especially at temperatures above the transition temperatures. At high protein-to lipid ratios the data revealed the formation of small particles (100 A) of melittin and dipalmitoylphosphatidylcholine and the disruption of membrane order in bilayers of dipalmitoylphosphatidic acid. PMID- 3813537 TI - Distinct temporal relation among oxygen uptake, malondialdehyde formation, and low-level chemiluminescence during microsomal lipid peroxidation. AB - An oxystat system was employed in conjunction with a single-photon counting apparatus for simultaneous monitoring of oxygen uptake, oxidative decomposition of membrane lipids, and occurrence of electronically excited species during microsomal lipid peroxidation. During NADPH/ADP-iron-promoted lipid peroxidation at a steady state oxygen partial pressure (pO2) of 30 mm Hg, complex time relationships among oxygen uptake, malondialdehyde (MDA) formation, and low-level chemiluminescence were observed. While the first two parameters occurred nearly simultaneously, low-level chemiluminescence occurred with a significant delay. A decrease of the steady state pO2 to 3 mm Hg led to significant increases of the lag phases of all three parameters and a further enhancement of the time displacement of low-level chemiluminescence in relation to oxygen uptake and MDA formation. At a pO2 of 0.5 mm Hg, the lowest pO2 maintained during this study, no low-level chemiluminescence was observed while oxygen uptake and MDA formation were still detected. In contrast, during NADPH/CCl4-promoted lipid peroxidation at a pO2 of 0.5 mm Hg a sudden drastic rise of low-level chemiluminescence accompanying oxygen uptake and MDA formation was observed. At pO2 between 0.5 and 3 mm Hg all three parameters occurred nearly concomitantly during the entire incubation. At pO2 levels above 3 mm Hg all three parameters showed principally the same behavior. However, the respective maxima of low-level chemiluminescence were reached with some delay. The present observations support the assumption that the decomposition of membrane lipid peroxyl radicals to MDA and the formation of electronically excited species proceed via different pathways. The time displacement between oxygen uptake and MDA formation, on the one hand, and low-level chemiluminescence, on the other hand, depends on the type of initiating radical system and on the steady state pO2 level. It is suggested that the differences are due to distinct subsets (chemical or spatial) of secondary peroxyl radicals in the membrane. PMID- 3813539 TI - Microtubules bind glyceraldehyde 3-phosphate dehydrogenase and modulate its enzyme activity and quaternary structure. AB - Glyceraldehyde 3-phosphate dehydrogenase, a tetramer of 140,000 Da, interacts with in vitro reconstituted microtubules. It results in a partial inhibition of the activity of the microtubule-bound enzyme. After cold depolymerization of the microtubule-glyceraldehyde 3-phosphate dehydrogenase complexes, a fraction of the enzyme is recovered in an active form in the disassembly supernatant; the other fraction devoid of activity, identified by polyacrylamide gel electrophoresis, remains associated with the undepolymerizable microtubule protein pellet. The inactivation of the microtubule-bound enzyme is related to the concentration of microtubule protein. Higher the concentration of microtubule protein, lower the fraction of inactivated enzyme; consequently, glyceraldehyde 3-phosphate dehydrogenase is able to copolymerize quantitatively with microtubule protein through one assembly-disassembly cycle, provided that the concentration of microtubule protein is high. Monomeric glyceraldehyde 3-phosphate dehydrogenase (molecular weight: 35,000) devoid of enzyme activity, prepared by reversible dissociation of the tetrameric enzyme, also binds to microtubules and is quantitatively recovered in the undepolymerizable microtubule protein fraction after cold treatment. These results indicate that interacting with microtubules, glyceraldehyde 3-phosphate dehydrogenase partly dissociates into inactive monomers, this process is regulated by the concentration of assembled microtubule protein, and active and inactive glyceraldehyde 3-phosphate dehydrogenase bound to microtubules have different fate at the step of microtubule disassembly. These data suggest that an association of glyceraldehyde 3-phosphate dehydrogenase to microtubules could play a role in modulating the activity of the glycolytic enzyme in intact cells. PMID- 3813538 TI - Glucocorticoids change the nucleotide and sugar nucleotide pool sizes in cultured human skin fibroblasts. AB - Fibroblasts in culture were treated with the glucocorticoid budesonide. The nucleotide and sugar nucleotide pools were quantitated after separation by isotachophoresis. Steroid treatment induced a 40% increase of the UDP-N acetylhexosamine pool and a 30% increase of the UDP-glucuronic acid pool whereas the UTP pool was diminished. These effects became apparent after 24 h of incubation and a new steady state was attained after 48 h of incubation. The 3' phosphoadenosine-5'-phosphosulfate pool was probably not influenced by the glucocorticoid treatment. The half-life of the UDP-N-acetylhexosamine pool was considerably longer in treated than in control cells. The efflux from the UDP-N acetylhexosamine pool was also lowered in the treated cells. The changed efflux may be due to a decreased glycoconjugate synthesis induced by glucocorticoid treatment. The rate of equilibration of [14C]glucose and [3H]glucosamine with the UDP-N-acetylhexosamine pool was changed by glucocorticoid treatment; especially that of [3H]glucosamine was decreased. PMID- 3813540 TI - Transformation of an arachidonic acid hydroperoxide into epoxyhydroxy and trihydroxy fatty acids by liver microsomal cytochrome P-450. AB - In the absence of NADPH, the addition of an arachidonic acid hydroperoxide, 15 hydroperoxyeicosa-5,8,11,13-tetraenoic acid, to liver microsomes, prepared from phenobarbital-treated rats, resulted in the formation of two major metabolites and several minor products, some of which have been purified by reverse-phase high-performance liquid chromatography. We propose the structures of the two major products to be 13-hydroxy-14,15-epoxyeicosa-5,8,11-trienoic acid and 11,14,15-trihydroxyeicosa-5,8,12-trienoic acid based on spectral characteristics and mass spectral analysis of derivatives of the compounds. A potential heterolytic cleavage product, 15-hydroxyeicosa-5,8,11,13-tetraenoic acid, was not a product of the reaction. Ferric cytochrome P-450 catalyzed the formation of these products as shown by the inability of boiled microsomes to support the reaction, the inhibition of epoxyhydroxy and trihydroxy fatty acid formation by imidazole derivatives which bind tightly to the ferric heme iron of cytochrome P 450, and the inability of carbon monoxide (which binds to ferrous P-450) and free iron chelators (EDTA and diethylenetriaminepentaacetic acid) to inhibit product formation. These results show that liver microsomal cytochrome P-450, in addition to its role in the NADPH-dependent metabolism of arachidonic acid, can utilize a hydroperoxide to produce an interesting series of potentially important arachidonic acid metabolites. PMID- 3813541 TI - Cell transport in model extracellular matrices. AB - The rapid transport of cells has been shown to occur by ordered countercurrent convection. This convection can be created by mixtures of macromolecules which make up the extracellular matrix and by the degradation and aggregation products of these macromolecules. The ordered countercurrent convection is manifested in the form of structured flows and arises in isothermal systems with small concentration gradients of solutes. The flows are gravity driven but may rapidly move at angles close to the horizontal axis if they are mechanically constrained to do so. These flows have been shown to rapidly transport cells at rates ranging from 1 to 100 mm h-1, depending on the conditions of the experiment. The transport of cells is nonspecific in that various cell types (chondrocytes, fibroblasts, endothelial cells, and red blood cells) as well as inert particles of similar size (latex beads 6-microns diam) are transported at similar rates. Latex bead transport by structured flow has also been demonstrated to occur in confined spaces in the form of Teflon tubing down to 200 microns in diameter and at angles in the range of 45-90 degrees to the horizontal axis. The flows may also occur over relatively long distances for a prolonged period of time. The conditions for flow formation are simple and widespread. It is suggested that it may contribute to the forces involved in the movement of cells in the extracellular matrix in vivo especially during remodeling and embryogenesis. PMID- 3813542 TI - Chloroplast phosphoproteins: phosphorylation of a 12-kDa stromal protein by the redox-controlled kinase of thylakoid membranes. AB - Activation of the redox-controlled protein kinase of thylakoid membranes is detectable in vivo by measuring radioisotope incorporation into the light harvesting Chl a/b protein and four photosystem II proteins (8.3, 32, 34, and 44 kDa). In normal barley leaves, the kinase is active under both aerobic and anaerobic (N2) conditions, but in the Chl b-less chlorina f2 mutant it is active only under anaerobic conditions. The responsiveness of this enzyme in the mutant to changes in the gas phase has been exploited to distinguish its protein substrates from those of other leaf protein kinases. Most of the soluble phosphoproteins of normal and mutant leaves (including a conspicuously labeled 67 kDa polypeptide) are labeled equally under both aerobic and anaerobic conditions, indicating that they are not substrates of the redox-controlled protein kinase. The major exception is a 12-kDa phosphoprotein, which is labeled in the mutant only under anaerobic conditions. The 67- and 12-kDa phosphoproteins are located in the chloroplast and are labeled when isolated organelles are incubated with [32P]orthophosphate in the light. When thylakoids and stroma are prepared from chloroplasts and are incubated with [gamma-32P]ATP in vitro, the 12-kDa protein is phosphorylated in the thylakoid preparation and then released from the membranes into the medium. The electron transport inhibitor diuron blocks activation of the redox-controlled kinase and prevents phosphorylation of the 12 kDa protein, which is thus the first example of a soluble protein to be phosphorylated by the thylakoid-bound protein kinase. The 67-kDa protein is phosphorylated by a distinct stromal kinase whose activity is not sensitive to diuron. PMID- 3813543 TI - Source of the hepatic microsomal trans-2-enoyl CoA hydratase bifunctional protein: endoplasmic reticulum or peroxisomes. AB - The present study was designed to investigate the hepatic localization of the microsomal bifunctional trans-2-enoyl CoA hydratase. Despite the low activity (less than 10%) of peroxisomal marker enzymes in isolated hepatic microsomes (acyl CoA oxidase (this study), catalase, and urate oxidase (L. Cook, M. N. Nagi, J. Piscatelli, T. Joseph, M. R. Prasad, D. Ghesquier, and D. L. Cinti, 1986, Arch. Biochem. Biophys. 245, 24-26), additional evidence in this study suggests that the microsomal enzyme is derived from peroxisomes. For example, the microsomal hydratase activity was associated with the ribosomal fractions but not with the smooth endoplasmic reticulum. In addition, when an extract of the peroxisomal enzyme was incubated with either free ribosomes or membrane-bound ribosomes, marked binding was observed with each of the fractions. Furthermore, the ease of release of the bifunctional enzyme from both free ribosomes and membrane-bound ribosomes by only KCl suggests that the bound enzyme is not a nascent protein. Labeling of liver tissue from DEHP-treated rats with rabbit immune IgG made to the purified microsomal hydratase followed by gold conjugated goat anti-rabbit IgG suggested a single subcellular site for the bifunctional hydratase--the peroxisomal organelle. PMID- 3813544 TI - Further studies on the covalent crosslinking of thyrotropin to its receptor: evidence that both the alpha and beta subunits of thyrotropin are crosslinked to the receptor. AB - Highly purified alpha- and beta-subunits of thyrotropin were individually radioiodinated and, subsequently, recombined with their unlabeled complementary subunits. This procedure resulted in the formation of [125I]thyrotropin(TSH) hybrid molecules which were labeled on only one hormone subunit. Characterization of the binding properties of these two hybrid molecules demonstrated that both yielded nonlinear Scatchard plots with Kd and Bmax values similar to those obtained with radioiodinated native TSH and that both were capable of interaction with the high- and low-affinity binding components of the TSH receptor. The recombined [125I]TSH molecules were then crosslinked to the TSH receptor using disuccinimidyl suberate. Following electrophoresis and autoradiography, two labeled TSH-receptor complexes with Mr of 68,000 and 80,000 were observed. These two complexes exhibited hormone specificity and electrophoretic mobility identical to those previously observed using native [125I]TSH. Crosslinking with increasing concentrations of disuccinimidyl suberate suggested that the formation of the 68,000 and 80,000 complexes was sequential with the 68,000 appearing before the 80,000. Furthermore, the two bands were labeled regardless of which TSH subunit of the hybrid TSH was radioiodinated. These data strongly suggest that the 68,000 and 80,000 TSH-receptor complexes are the result of crosslinking to the TSH alpha-beta dimer and not to one subunit in the case of the 68,000 complex and to the TSH alpha-beta dimer in the case of the 80,000 complex, as had been hypothesized previously. PMID- 3813545 TI - Dehydrodolichyl diphosphate synthetase from rat seminiferous tubules. AB - Homogenates of seminiferous tubules from rat testes catalyzed the incorporation of label from [14C]isopentenyl diphosphate into a variety of polyprenyl products. Long chain polyprenyl mono- and diphosphates were formed as major products when undesirable side reactions were minimized. The long chain polyprenyl diphosphate synthetase was measured as a sum of the mono- and diphosphate derivatives formed and was dependent on the addition of t,t-farnesyl diphosphate, isopentenyl diphosphate, and divalent cation. The highest activity was associated with the membranous fractions, whereas activity was negligible in the cytosolic fraction. The products of this prenyl transferase were labile to acid and yielded petroleum ether soluble products which indicated that the alpha-isoprene unit was unsaturated. Hydrolysis of either the polyprenyl mono-or diphosphates with a testicular phosphatase in the absence of NaF yielded C75, C80, C85, and C90 polyprenols. The chain lengths of the products of the synthetase suggest that this enzyme is responsible for the de novo biosynthesis of dehydrodolichyl diphosphates which are precursors of the dolichyl derivatives found in testes. PMID- 3813546 TI - Disulfide inhibition of copper-catalyzed oxidation of ascorbic acid: spectrophotometric evidence for accumulation of a stable complex. AB - Copper-catalyzed oxidation of ascorbic acid was retarded in the presence of the biological disulfide compounds cystine and oxidized glutathione. The evidence suggested that this effect was due to the formation of a stable complex involving the copper ion, the disulfide compound, and ascorbic acid or a derivative formed during the oxidative process. This indicated that less copper was available for the formation of oxygen complexes which are not as stable as the disulfide complexes. Ellman's reagent (Nbs2) was reduced when it was substituted for the biological disulfides or when added, with EDTA, to solutions in which ascorbic acid, copper ion, and the biological disulfides had been allowed to interact. The complex formed with cystine was detected at 360 nm but the glutathione complex was not detected at this wavelength. It is proposed that disruption of cystine or glutathione complexes by EDTA results in formation of 2,3-diketogulonic acid which acts as a reductant of Ellman's reagent. PMID- 3813547 TI - Photosynthetic carbon metabolism in isolated pea chloroplasts: metabolite levels and enzyme activities. AB - We report here that enzyme activation precedes the rise in metabolite levels, which appear to limit photosynthetic CO2 fixation during induction in pea leaf chloroplasts. Therefore light activation may be required for the build-up of photosynthetic intermediates and hence for photosynthesis in isolated chloroplasts. Analysis of metabolite levels and the known kinetic properties of the chloroplast enzymes indicates that the reductive pentose phosphate cycle is subject to control which fluctuates between several points during induction and when CO2 fixation is maximal. The transketolase-aldolase-catalyzed reactions around sedoheptulose-biphosphatase appear to provide a simple and effective primary control for photosynthetic CO2 fixation. When substrate levels and enzyme active site concentrations are taken into account, there is insufficient glyceraldehyde 3-phosphate dehydrogenase, aldolase, and transketolase activity to support photosynthetic CO2 fixation at observed rates. These results suggest that there may be direct transfer of glyceraldehyde 3-phosphate among these enzymes in the pea chloroplast. PMID- 3813548 TI - Identification of vitamin K1 chromenol--a novel metabolite of vitamin K1 formed in vitro by a component in blood. AB - A newly recognized metabolite of vitamin K1, vitamin K1 chromenol, is produced when the vitamin is added to the plasma or serum of a number of species. The metabolite was identified by comparison of its uv and mass spectra and high performance liquid chromatographic retention times with those of the synthetic vitamin K1 chromenol. In aqueous solution vitamin K chromenol decomposed to a variety of products and reacted with nucleophilic substances. Optimal conditions for its formation and evidence that chromenol formation may be an enzyme catalyzed reaction are presented. PMID- 3813549 TI - Purification and characterization of intracellular galactose oxidase from Dactylium dendroides. AB - The intracellular galactose oxidase from Dactylium dendroides was purified to homogeneity with a 64% yield. The enzyme is a glycoprotein (7.7% neutral sugars, 1.7% aminosugars) with 72,000 Da of molecular mass. The enzyme showed nonlinear double reciprocal plots with O2 and D-galactose, suggesting cooperative binding for both substrates. The intracellular galactose oxidase catalyzes the oxidation of galactose derivatives and dihydroxyacetone but not of glycerol, glycolaldehyde, beta-hydroxipyruvate, and allyl alcohol which are substrates for the extracellular enzyme. Compared with the extracellular galactose oxidase, the intracellular enzyme showed higher carbohydrate content and sensitivity to diethyldithiocarbamate. PMID- 3813550 TI - Cobinding of bilirubin and sulfonamide and of two bilirubin molecules to human serum albumin: a site model. AB - Differential light absorption spectra of the bilirubin-albumin 1:1 complex, obtained on addition of 20 different sulfonamides, differ with respect to shape and amplitude. This finding seems to indicate that the sulfonamide molecule is bound in direct touch with the bilirubin. The light absorption spectrum of bilirubin-albumin 1:1 undergoes changes on cobinding of a fatty acid anion, laurate, and on variation of pH, previously explained by a change of dihedral angle between the two chromophores of the bilirubin molecule. In bilirubin albumin 2:1, binding of laurate and variation of pH cause little change of the spectrum. This is best explained by binding of the two bilirubin molecules in close proximity, preventing conformational changes in the complex. From measurements of fluorescence of the lone tryptophan group in albumin and quenching on binding of bilirubin, we calculated the distance of 22 A from tryptophan to the first bound bilirubin molecule, and of 18 A to the second. Mutual quenching of the bilirubin fluorescence from two bound bilirubin molecules seemed to indicate that the two are bound closely together. A model of bilirubin albumin with a binding site capable of accommodating one bilirubin and one sulfonamide molecule, or two molecules of bilirubin, is compatible with our findings. PMID- 3813551 TI - Accumulation of protoporphyrin-IX by the chlorophyll-less y-y mutant of Chlamydomonas reinhardtii. AB - A pigment accumulating in a Mendelian mutant (y-y) of Chlamydomonas reinhardtii, which has essentially no chlorophyll and lacks inner chloroplast membranes in the light and dark, was isolated and characterized. It was identified as protoporphyrin-IX (PROTO) by spectral analysis using two different methods of extraction and fractionation. The amount of PROTO was estimated to be 10(7) molecules per cell. Since PROTO was the only intermediate of chlorophyll biosynthesis that accumulated, we conclude the y-y lesion in the pathway is after PROTO. PMID- 3813552 TI - The structures of N- and O-glycosidic carbohydrate chains of a chondroitin sulfate proteoglycan isolated from the media of the human aorta. AB - A large Mr chondroitin sulfate proteoglycan was extracted from the media of human aorta under dissociative conditions and purified by density-gradient centrifugation, ion-exchange chromatography, and gel filtration chromatography. Removal of a contaminating dermatan sulfate proteoglycan was accomplished by reduction, alkylation and rechromatography on the gel filtration column. After chondroitinase ABC treatment, the proteoglycan core was separated from a residual heparan sulfate proteoglycan by a third gel filtration chromatography step. As assessed by radioimmunoassay, the isolated proteoglycan core was free of link protein, but possessed epitopes that were recognized by antisera against the hyaluronic acid binding region of bovine cartilage proteoglycan as well as those that were weakly recognized by anti-keratan sulfate antisera. Following beta elimination of the protein core, the liberated low Mr oligosaccharides were partially resolved by Sephadex G-50 chromatography, and their primary structure was determined by 500-MHz1H NMR spectroscopy in combination with compositional sugar analysis. The N-glycosidic carbohydrate chains, which were obtained as glycopeptides, were all biantennary glycans containing NeuAc and Fuc; microheterogeneity in the NeuAc----Gal linkage was detected in one of the branches. The N-glycosidic glycans have the following overall structure: (Formula: see text). The majority of the O-glycosidic carbohydrate chains bound to the protein core were found to be of the mucin type. They were obtained as glycopeptides and oligosaccharide alditols, and possessed the following structures: NeuAc alpha(2----3)Gal beta(1----3)GalNAc-ol, [NeuAc alpha(2----3)Gal beta(1----3)[NeuAc alpha(2----6)]GalNAc-ol, and NeuAc alpha-(2----3) Gal beta(1-- -3)[NeuAc alpha(2----3)Gal beta(1----4)GlcNAc beta(1----6)] GalNAc-ol. The remainder of the O-glycosidic carbohydrate chains bound to the isolated proteoglycan were the hexasaccharide link regions of the chondroitin sulfate chains that remained after chondroitinase ABC treatment of the native molecule. These latter glycans, which were obtained as oligosaccharide alditols, had the following structure (with GalNAc free of sulfate or containing sulfate bound at either C-4 or C-6): delta 4,5GlcUA beta(1----3)GalNAc beta(1----4)GlcUA beta(1--- 3)Gal beta(1----3)Gal beta(1----4)Xyl-ol. PMID- 3813553 TI - Inhibition of papain by nitriles: mechanistic studies using NMR and kinetic measurements. AB - N-(N-acetyl-1-phenylalanyl)aminoacetronitrile is an inhibitor of papain. With 13C NMR spectroscopy we have shown that a reversible covalent adduct is formed with papain. The reversible nature of the covalent-adduct formation was demonstrated with NMR saturation-transfer technique using a DANTE pulse for selective excitation. In addition the covalent adduct was displaced with an aldehyde inhibitor to regenerate the nitrile compound. No hydrolysis of the nitrile was observed. The covalent adduct is most likely a thioimidate formed between the essential thiol and the nitrile. Several p-nitroanilide substrates and their corresponding nitrile inhibitors were examined. A correlation between Ki and kcat/Km was observed. This finding together with the fact that the pH dependence of Ki parallels that of kcat/Km suggests that the interaction of nitriles and papain has considerable transition-state character. In contrast, a nitrile was shown to be an ineffective inhibitor of alpha-chymotrypsin. PMID- 3813554 TI - Characterization of the seed and leaf lipids of high and low linolenic acid flax genotypes. AB - The total seed lipids of four flax (Linum usitatissimum) genotypes, differing markedly in their acyl composition, were extracted and fractionated using column, preparative, and thin-layer chromatography. In the total lipid extract of seeds, the lower linolenate content of the cultivar Glenelg (39.1% compared to that of cv. Croxton (50.5%) was associated with a higher oleate content. Further reductions in linolenate content in the induced mutants of cv. Glenelg, M1722 (17.2%) and "Zero" (1.9%) were accompanied by equivalent increases in linoleate but only minor increases in oleate. Similar changes were observed in the major triacylglycerol fraction of the simple lipids (fatty acid esters of glycerol and sterols), but there was considerable heterogeneity for acyl composition in the minor simple lipid components, including both diacylglycerols and sterol esters, and the complex lipids (glycolipids and phospholipids). The induced mutations substantially reduced linolenate content of all lipid fractions but in no case was it eliminated. Maturation of "Zero" seed at 15/10 degrees C (compared to 24/19 degrees C) increased linoleate and decreased stearate and oleate contents in all lipid fractions. In contrast to seed lipids, the acyl composition of the leaf lipids of the mutant genotypes was the same as those of their parent. PMID- 3813555 TI - Large-scale purification of active cytochrome b6/f complex from spinach chloroplasts. AB - A preparation is described through which large quantities of pure, active cytochrome b6/f complex can be isolated from spinach chloroplasts. The resulting complex is at least 90% pure with respect to the maximum content of redox centers, consists of four polypeptides according to polyacrylamide gel electrophoresis, and lacks both ferredoxin: NADP+ oxidoreductase and the high molecular weight form of cytochrome f seen in some other preparations. The complex contains 2 mol b6 and 2 atoms of nonheme iron per mole of cytochrome f, and possesses a high plastoquinol-plastocyanin oxidoreductase activity (Cyt f turnover no. 20-35 s-1). The present preparation should be helpful in the effort to crystallize the cytochrome b6/f complex. PMID- 3813556 TI - Biosynthesis of four rat liver mitochondrial acyl-CoA dehydrogenases: in vitro synthesis, import into mitochondria, and processing of their precursors in a cell free system and in cultured cells. AB - The synthesis, translocation, processing, and assembly of rat liver short chain acyl-CoA, medium chain acyl-CoA, long chain acyl-CoA, and isovaleryl-CoA dehydrogenases were studied. These four acyl-CoA dehydrogenases are homotetrameric flavoproteins which are located in the mitochondrial matrix. They were synthesized in a cell-free rabbit reticulocyte lysate system, programmed by rat liver polysomal RNA, as precursor polypeptides which are 2-4 kDa larger than their corresponding mature subunits (Mr 41,000-45,000). When the radiolabeled precursors were incubated with intact rat liver mitochondria, they appeared to bind tightly to the mitochondrial outer membrane. At this stage they were completely susceptible to the action of exogenous trypsin. The precursors bound to mitochondria at 0 degrees C were translocated into the mitochondria and processed when the temperature was raised to 30 degrees C. No reaction occurred when the temperature was kept at 0 degrees C, however, suggesting that the binding of the precursors is temperature independent while the subsequent steps of the pathway are energy dependent. Indeed, the translocation reaction was inhibited by compounds such as dinitrophenol and rhodamine 6G which inhibit mitochondrial energy metabolism. The newly imported (mature) enzymes were inaccessible to the proteolytic action of added trypsin. The processing of the precursors to mature subunits was proteolytically carried out in the mitochondrial matrix, and the processed mature subunits mostly assembled to their respective tetrameric forms. Newly synthesized larger precursors of each of the four acyl-CoA dehydrogenases were recovered from intact, cultured Buffalo rat liver cells in the presence of dinitrophenol. When dinitrophenol was removed in a pulse-chase protocol, the accumulated precursors were rapidly (t1/2 3-5 min) converted to their corresponding mature subunits. On the other hand, when the chase was performed in the presence of the inhibitor, the labeled precursors disappeared with t1/2 of greater than 4 h for long chain acyl-CoA dehydrogenase and 1-2 h for the other three enzyme precursors. PMID- 3813557 TI - P-450 binding to substrates camphor and linalool versus pressure. AB - The spin equilibrium of two bacterial cytochrome P-450 enzymes are compared by their visible spectra versus temperature and pressure. P-450 from Pseudomonas linalool shows a much weaker dependence on pressure than P-450 from P. putida which has camphor as substrate. The linalool system denatures at a higher pressure (3 kbar) than the camphor system (1 kbar) and shows a weaker dependence on external solvent conditions. The camphor system shows evidence of the binding of a second substrate molecule which reverses the effect of the first on the spin equilibrium. A model involving two substrate molecules is an alternative explanation of the apparent saturation with camphor of the spin equilibrium. PMID- 3813558 TI - Association of chicken mitochondrial creatine kinase with the inner mitochondrial membrane. AB - The stoichiometry and dissociation constant for the binding of homogeneous chicken heart mitochondrial creatine kinase (MiMi-CK) to mitoplasts was examined under a variety of conditions. Salts and substrates release MiMi-CK from mitoplasts in a manner that suggests an ionic interaction. The binding of MiMi-CK to mitoplasts is competitively inhibited by Adriamycin, suggesting that they compete for the same binding site. Fluorescence measurements also show that Adriamycin binds to MiMi-CK so that the effect of Adriamycin on the binding of MiMi-CK to mitoplasts is not simple. Titrating mitoplasts with homogeneous MiMi CK at different pH values shows a pH-dependent equilibrium involving a group(s) on either the membrane or the enzyme with a pKa = 6. Extrapolating these titrations to infinite MiMi-CK concentration gives 14.6 IU bound/nmol cytochrome aa3 corresponding to 1.12 mol MiMi-CK/mol cytochrome aa3. Chicken heart mitochondria contain, after isolation, 2.86 +/- 0.42 IU/nmol cytochrome aa3. Titrating respiring mitoplasts with carboxyatractyloside gives at saturation 3.3 mol ADP/ATP translocase/mol cytochrome aa3. Therefore, chicken heart mitoplasts can maximally bind about 1 mol of MiMi-CK per 3 mol translocase; in normal chicken heart mitochondria about 1 mol of MiMi-CK is present per 13 mol translocase. PMID- 3813559 TI - Isolation and sequence determination of an active site peptide of rabbit muscle pyruvate kinase. AB - Rabbit muscle pyruvate kinase was inactivated by 2', 3'-dialdehyde ADP with the incorporation of one molecule of reagent per enzyme subunit. The inactivated protein was digested with trypsin after reduction and carboxymethylation. The labeled peptide was isolated by gel filtration and further purified by HPLC. The peptide was sequenced both by liquid-phase and gas-phase automatic Edman degradation. A 34-residue peptide was obtained. This peptide is identical to a tryptic peptide labeled with trinitrobenzenesulfonate, isolated and sequenced by Johnson et al. (Biochem. Biophys. Res. Commun. (1979) 90, 525-530) from bovine muscle pyruvate kinase. Available evidence suggests that dialdehyde ADP labels the enzyme at the same lysine in position 25 of the peptide, as found by Johnson et al. The high homology between the isolated peptide and regions of other pyruvate kinases from low to high eukaryotes supports the idea that this peptide is related to the enzyme active site. PMID- 3813560 TI - Factors underlying significant underestimations of glucokinase activity in crude liver extracts: physiological implications of higher cellular activity. AB - M. Kuwajima, C. B. Newgard, D. W. Foster, and J. D. McGarry (1986, J. Biol. Chem. 261, 8849-8853) have concluded that the reason postprandial hepatic glycogenesis occurs primarily from gluconeogenic precursors rather than glucose is because glucokinase activity is insufficient to support the observed rates of glycogen synthesis. F. L. Alvares and R. C. Nordlie (1977, J. Biol. Chem. 252, 8404-8414) have concluded that the combined activities of glucokinase and hexokinase are less than the apparent rates of hepatic glucose uptake. We have identified several factors in the assays used in these studies which lead to substantial underestimations of glucokinase activity. Glucokinase was assayed either by allowing glucose 6-phosphate to accumulate over 10 min (discontinuous assay) or by coupling the formation of glucose 6-phosphate with its oxidation by Leuconostoc mesenteroides glucose 6-phosphate dehydrogenase and NAD (continuous assay). Accurate determinations of glucokinase at 37 degrees C with subsaturating glucose require both 100 mM KCl and 2.5 mM dithioerythritol in the assay medium; 2-mercaptoethanol will not substitute for dithioerythritol. When both KCl and dithioerythritol are absent (Kuwajima et al.) glucokinase activity is underestimated by 3- to 5-fold. The discontinuous assay as used previously (Alvares and Nordlie) underestimates glucokinase activity in crude extracts by 2- to 2.5-fold, due in part to the hydrolysis of glucose 6-phosphate and its transformation to other hexose monophosphates. Under optimized conditions at 37 degrees C both assays yield similar results in extracts from fed rats, i.e., 2-3 and 4-5 units/g liver at 10 and 100 mM glucose, respectively. Some implications of the finding that total hepatic glucose phosphorylating capacity at physiological concentrations significantly exceeds the observed rates of postprandial glycogen synthesis are discussed. PMID- 3813561 TI - Retention of anomeric form in lysozyme-catalyzed reaction. AB - A lysozyme-catalyzed reaction is initiated by a cleavage of the beta-1, 4 glucosaminide linkage, followed by hydration and transglycosylation. Since all glycosides produced by transglycosylation have beta-glycosidic linkages between the sugar and the acceptor moieties, the lysozyme-catalyzed reaction has been classified as an anomer-retention reaction. However, there is no experimental evidence on the anomer retention of the new reducing residue produced by the hydrolysis of the substrate. In the present study, an attempt was made to determine the anomeric form of the GlcNAc residue at the reducing end in nascent hydrolytic products. The anomeric forms of the enzymatic products were separated and quantitatively analyzed by high-performance liquid chromatography. The amounts of alpha- and beta-anomers in the product were plotted against the reaction time. Computer analysis of the experimental data indicated that the nascent hydrolytic product takes only the beta-anomeric form and that the alpha anomer is formed from beta-anomer by mutarotation. PMID- 3813562 TI - Hydrophobic interactions of brush border alkaline phosphatases: the role of phosphatidyl inositol. AB - Tissue-specific (intestinal) and tissue-nonspecific (kidney) rat alkaline phosphatases are released from their respective brush border membranes by different enzymes. To elucidate the mechanism underlying their membrane attachment, we tested the ability of these enzymes to partition into lipid or aqueous phases both before and after treatment with phospholipases and proteases. Interaction with Triton X-114 micelles was eliminated or decreased by treatment of intestinal enzyme with phospholipase A2 or papain, while only phosphatidylinositol (PI)-specific phospholipase C (PIPLC) and subtilisin were effective with the kidney enzyme. Binding to octyl Sepharose for the intestinal enzyme was decreased by phospholipase A2 more than by PIPLC, whereas the reverse was true for the kidney enzyme. Treatment with phospholipases decreased the apparent mass of the phosphatases by 50-80 kDa, presumably due to loss of bound lipid and detergent. PIPLC treatment of the kidney, but not the intestinal enzyme, prevented binding of the phosphatase to phospholipid vesicles. These results show that both enzymes are bound to respective membranes by hydrophobic anchor peptides to which phospholipids are bound. However, their sensitivity to phospholipases is different. The data are consistent with the hypothesis that, in the kidney enzyme, the PI is bound covalently, while with the intestinal enzyme, binding of PI appears to be tight but not covalent. PMID- 3813563 TI - Is the ubiquinone pool in the respiratory chain of the bacterium Paracoccus denitrificans really unhomogeneous? AB - We have established the participation of a mobile redox pool in the respiratory chain of anaerobically grown bacterium Paracoccus denitrificans. In testing the kinetical homogeneity of the pool it was found that the ratio of fluxes of electron transport toward the terminal acceptors oxygen and nitrate was coincident for the respiratory substrates NADH and succinate; this provides evidence against the preferential link of one dehydrogenase with a distinct terminal enzyme through the separate pool of ubiquinone. The deviation from the expected behavior observed in comparing the titration of NADH oxidase and succinate oxidase with respiratory inhibitors such as mucidin (inhibitor in the bc1 region) or cyanide can be accounted for by the activation of succinate dehydrogenase upon the increase in the reduced state of respiratory components during the titration. PMID- 3813564 TI - Transcriptional control of human cytochrome P1-450 gene expression by 2,3,7,8 tetrachlorodibenzo-p-dioxin in human tissue culture cell lines. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) induces aryl hydrocarbon hydroxylase (AHH) activity and human cytochrome P1-450 mRNA in the human breast carcinoma MCF 7 and hepatoblastoma HepG2 tissue culture cell lines. Although AHH activities induced by 100 nM TCDD are comparable in these cell lines, the EC50 values for TCDD differ: EC50 approximately equal to 1 nM for HepG2; EC50 greater than 20 nM for MCF-7. In order to determine the mechanism responsible for this difference in EC50, we have examined putative regulatory factors such as the intracellular TCDD receptor as well as the kinetics of mRNA transcription and accumulation in these cells. TCDD increases transcription of hP(1)450 mRNA in both MCF-7 and HepG2 cells; however, MCF-7 cells require higher concentrations of TCDD to produce transcriptional activation comparable to that observed for HepG2 cells. These data indicate that the difference in EC50 is determined at an early step in the induction of hP(1)450 mRNA. With the use of a sensitive assay based on high performance anion-exchange liquid chromatography, an intracellular protein which binds TCDD with high affinity was detected in HepG2 cytosolic fractions but not in MCF-7 cells. Thus, the difference in EC50 for TCDD can be correlated to the differences in TCDD binding. We postulate that MCF-7 cells contain a "defective" receptor with decreased affinity for TCDD. PMID- 3813565 TI - Quantitation of ketogenesis in periportal and pericentral regions of the liver lobule. AB - A method has been devised to quantitate rates of ketogenesis (acetoacetate + beta hydroxybutyrate production) in discrete regions of the liver lobule based on changes in NADH fluorescence. In perfused livers from fasted rats, ketogenesis was inhibited nearly completely with either 2-bromoctanoate (600 microM) or 2 tetradecylglycidic acid (25 microM). During inhibition of ketogenesis, a linear relationship (r = 0.90) was observed between decreases in NADH fluorescence detected from the liver surface and decreases in ketone body production. NADH fluorescence was monitored subsequently from individual regions of the liver lobule by placing microlight guides on periportal and pericentral regions of the liver lobule visible on the liver surface. Rates of ketogenesis in sublobular regions were calculated from regional decreases in NADH fluorescence and changes in the rate of ketone body formation by the whole liver during infusion of inhibitors. In the presence of bromoctanoate, ketogenesis was reduced 80% and local rates of ketogenesis were decreased 31 +/- 4 mumol/g/h in periportal areas and 28 +/- 3 mumol/g/h in pericentral regions. Similar results were observed with tetradecylglycidic acid. Therefore, it was concluded that submaximal rates of ketogenesis from endogenous, mainly long-chain fatty acids are nearly equal in periportal and pericentral regions of the liver lobule in liver from fasted rats. Rates of ketogenesis and NADH fluorescence were strongly correlated during fatty acid infusion. Infusion of 250 microM oleate increased NADH fluorescence maximally by 8 +/- 1% over basal values in periportal regions and 17 +/- 4% in pericentral areas. Local rates of ketogenesis, calculated from these changes in fluorescence, increased 35 +/- 6 mumol/g/h in periportal areas and 55 +/- 5 mumol/g/h in pericentral regions. Thus, oleate stimulated ketogenesis nearly 60% more in pericentral than in periportal regions of the liver lobule. PMID- 3813566 TI - Low-temperature fluorescence emission changes in thylakoids induced by acetyl glyceryl ether phosphorylcholine (AGEPC). AB - The electroneutral zwitterionic phosphatidylcholine derivative 1-0-alkyl-2-acetyl sn-glyceryl-3-phosphorylcholine (AGEPC), when added to low-salt chloroplasts (Tricine-washed), induces an enhancement of the F685/F730 ratio in the 77 degrees K fluorescence emission spectrum. The effect depends highly on AGEPC concentration and AGEPC/Chl ratio. Phosphatidylcholine with similar electrical properties is ineffective. AGEPC, when added to low-salt plastids of intermittent light plants, also induces changes in the 77 degrees K emission spectrum (decrease in the long wave length 720-nm band and blue-shift of the 681-nm band). The effect is attributed to modulation of the organization of the photosynthetic units via the AGEPC incorporation in the thylakoid, rather than to charge effects. PMID- 3813567 TI - Kidney zinc-thionein regulation of delta-aminolevulinic acid dehydratase inhibition by lead. AB - This study was undertaken to evaluate the ability of kidney Zn-thionein to regulate Zn availability to the Zn-dependent enzyme, delta-aminolevulinic acid dehydratase (ALAD), and mediate the effect of Pb on this enzyme. Male CD rats were pretreated with 200 mumol Zn/kg, sc, 48 and 24 h prior to assay of renal ALAD, which resulted in activation of renal ALAD and increased the resistance of this enzyme to inhibition by Pb in vitro. To determine the mechanism for this resistance, binding patterns of Zn and Pb in kidney cytosol were assessed. Rats were pretreated with Zn 48 and 24 h prior to injection of 203Pb (170 microCi/kg, ip). Kidneys were removed 4 h later and cytosol was fractionated on a Sephadex G 75 gel filtration column. Both 203Pb and Zn coeluted with the Zn-thionein fraction. Zn-thionein-I and -II, purified previously by DEAE anion-exchange chromatography, bound 203Pb in vitro. In another experiment, addition of purified Zn-thionein to reaction mixtures increased activity of purified bovine liver ALAD twofold and reversed inhibition of ALAD by Pb. Addition of apo-thionein to reaction mixtures partially prevented the inhibition of purified ALAD by Pb, indicating the biological significance of 203Pb chelation. Gel filtration of ALAD assay incubates containing 65Zn-thionein demonstrated that Zn is transferred from Zn-thionein to ALAD. Gel filtration of incubates containing 203Pb demonstrated that the presence of Zn-thionein alters the cytosolic binding pattern of Pb, with less bound to ALAD and more bound to Zn-thionein. The results demonstrate a dual function for Zn-thionein in mediating Pb inhibition of ALAD by a mechanism involving both donation of Zn to this Zn-requiring enzyme and chelation of Pb. These results also suggest that Zn-thionein may serve to regulate ALAD activity in vivo and mediate the inhibition of this enzyme by Pb. PMID- 3813568 TI - Immunological studies of the binding protein for chloroplast ferredoxin-NADP+ reductase. AB - Monospecific rabbit antibodies against the ferredoxin-NADP+ reductase binding protein of spinach thylakoids were obtained and characterized. The immunoglobulin G (IgG) fraction gave single precipitation arcs with the purified antigen or with Triton X-100 extracts of thylakoids or the reductase binding protein complex. Antibodies against the flavoprotein behave similarly. Both antibodies agglutinated thylakoids and precipitated the diaphorase activity of a Triton X 100 extract of these membranes. Isolated Fab fragments of the IgG anti-binding protein inhibited NADP+ photoreduction in a time- and Fab concentration-dependent manner. The presence of ferredoxin diminished the rate of inhibition. In the light, the inactivation rate was higher than in dark and this effect was abolished in the presence of uncouplers. These results suggest that the binding protein is protruding from the thylakoids and could be sensing the proton gradient. PMID- 3813569 TI - Proton NMR studies of the biologically active 1-34 fragment of bovine parathyroid hormone: examination of a structural model. AB - Proton NMR spectra of the biologically active 1-34 fragment of bovine parathyroid hormone (bPTH) were studied as a function of pH over the range of pH 4 to 10, in buffer and in 6 M guanidine DC1. One of the histidine C-2 peaks titrated normally, with a pKa value of 6.8, but the other two histidines in this peptide had pKa values of 6.3. Denatured PTH showed only one histidine C-2 peak with a pKa of 6.7. An aliphatic peak identified as due to either a methionine or a glutamine residue also shifted with pH, and the pKa for this shift was 6.3. Finally, small but significant upfield shifts in the methyl and methylene resonances were observed as a function of pH, and when compared to the denatured peptide. These results indicate that the N-terminal domain of native PTH has considerable structure in solution, and are consistent with a theoretical model for the folding of this peptide. PMID- 3813570 TI - [Ministry of Education Group on Special Comprehensive Cancer Study: Report by the special committee on antineoplastic agent screening]. PMID- 3813571 TI - [Intrahepatic-artery infusion of cis-diamminedichloroplatinum (II) and 5 fluorouracil in primary or metastatic liver cancer]. AB - Eight hepatocellular cancer patients and eighteen metastatic liver cancer patients were treated with intrahepato-arterial infusion of CDDP (cis diamminedichloro-platinum II) plus 5-FU (5-fluorouracil); CDDP (0.8-1.0 mg/kg) was given once every 7 or 10-14 days, while 5-FU (250-100 mg/day) was infused daily. A partial response was obtained in 5 of 8 patients with primary liver cancer and in 9 of 14 evaluable patients with metastatic liver cancer. However, severe complications due to bone marrow suppression were observed in 4 patients, 3 of whom died of septicemia and one of enterocolitis. This combined intra-hepato arterial chemotherapy exerts a synergistic anticancer effect on malignant liver tumors, although the bone marrow suppression associated with it remains to be overcome. PMID- 3813572 TI - [Anticancer drug sensitivity test and its clinical evaluation in 15 cases of acute leukemia and lymphoma]. AB - We carried out in vitro anticancer drug sensitivity tests a total of 24 times in 15 cases of childhood leukemias and lymphomas using the microplate culture and crystal violet staining method. We then compared them with the clinical effects. As a result, the in vitro efficacy rate at onset of cases was 40%, which was less than that for relapsed cases, which was 100%. Especially, cases of ALL at onset all failed. As for the relation between in vitro and in vivo effects, cases for which it was possible to make evaluation both in vitro and in vivo numbered 16. The results for these cases were; true positive rate, 71%; true negative rate, 50%; predictive accuracy, 69%. The true positive rate was higher than the usual rate. As for the efficiency of each anticancer drug, in vitro predictive accuracy for ADR, Ara-C and 4 HCP (CPM) was higher than for other drugs. From these results, it became clear that our method is very useful for the screening of effective anticancer drugs. PMID- 3813573 TI - [Blocking factors in human blood which inhibit the cytotoxicity of lymphocytes]. AB - The cytotoxicity of human peripheral blood lymphocytes against malignant tumor cell lines was significantly inhibited by human plasma or sera. In addition to so called blocking factors such as antigens, antibodies, antigen-antibody complexes, IAP and ferritin, some substances which could be removed by heat or centrifugation were considered to play a significant role. PMID- 3813574 TI - [Inhibitory effect of human plasma on 17-1A-dependent cellular cytotoxicity]. AB - Mouse monoclonal antibody 17-1A-dependent cellular cytotoxicity hardly revealed any killer activity in the presence of human plasma, nor did 17-1A show complement-dependent cytotoxicity. ADCC of 17-1A-armed effector cells was also inhibited by human plasma. These results were caused by the inhibition of 17-1A binding to the Fc receptors of effector cells. PMID- 3813575 TI - [A phase II study of 590-S (1-phthalidyl-5-fluorouracil) in patients with breast cancer--multi-center cooperative study--Cooperative Study Group of 590-S in Breast Cancer]. AB - A phase II clinical study involving 16 institutions was performed for the treatment of breast cancer with 590-S, a new masked fluoropyrimidine derivative. A dose of 900 mg/day was administered orally for more than 4 weeks. Out of 33 cases enrolled, 18 were completely recorded and evaluable. The response rate was 33.3%: 2 CR and 4 PR. It was noteworthy that, out of 12 cases previously treated with other 5-FU derivatives, 5 cases (41.7%) were judged as effective. Of 26 cases, side effects were observed in 8 (30.8%). All of these were gastrointestinal disorders such as nausea, vomiting, and loss of appetite. 590-S is considered to be a useful antitumor agent. However, further investigation will be required. PMID- 3813576 TI - [Therapeutic effects of a combination of intermediate-dose cytosine arabinoside, adriamycin and vincristine in relapsed acute leukemia]. AB - Eleven cases of acute leukemia, 8 relapsed and 3 refractory to a conventional induction chemotherapy, were treated with a combination of intermediate-dose cytosine arabinoside (ara-C), adriamycin (ADM) and vincristine (VCR). They consisted of 9 ANLL and 2 ALL. The therapeutic regimen consisted of 1-hour infusion of ara-C of a dose of 500 mg/m2 every 12 hours for 6 days from days 3 to 8, ADM, 40 mg/m2, on day 1 and VCR, 1.4 mg/m2, on day 2. Among 11 cases in which an evaluation was possible, 7 obtained complete remission (CR). The CR rate was 77.8% in the 9 cases of ANLL. The toxicity of this regimen included the following: conjunctivitis in 4 of 11 cases (36%), nausea and vomiting in 9 of 11 cases (91%) and hair loss in all cases, although no toxicities of the central nervous system of liver were observed. The mean level of serum concentration of ara-C was above 10 microM at 15, 30 and 60 minutes after the initiation of infusion. The therapeutic effect of this regimen consisting of intermediate-dose ara-C is expected to be useful not only in induction of refractory and relapsed acute leukemia, but also in the postremission therapy of CR cases. PMID- 3813577 TI - [Antitumor efficacy of recombinant interferon-beta on human glioma]. AB - The antitumor efficacy of recombinant interferon-beta (rIFN-beta) on human glioblastomas was investigated in vitro and in meningeal gliomatosis(MG) models. A total of 1.5 X 10(5) human glioma (ONS-12 and ONS-20) cells were suspended in 2 ml of RPMI-1640 with 10% fetal calf serum and placed in plastic dishes (Falcon #3001). rIFN-beta 10(2)-10(5) units were then added to each culture dish on days 3, 5 and 7. Both ONS-12 and ONS-20 human glioma cells were suppressed with a low dose of rIFN-beta. As MG models, 5 X 10(7) ONS-12 glioma cells were suspended in saline and transcutaneously inoculated into the cisterna magna of BALB/c nu/nu mice using a 27-gauge needle. The median survival times (MST) of MG models which were treated by intrathecal administration of 10(3) U of rIFN-beta and intraperitoneal injection of 10(4) U of rIFN-beta were 11.0 and 8.0 days, compared with an MST of 7 days for control mice. The rIFN-beta was not effective by intraperitoneal administration but was effective by intrathecal administration in the MG models. The MSTs of MG models which were treated by administration of 10(5) U, 10(3) U of rIFN-beta and 0.1 ml saline were 15.0, 19.0 and 9.0 days, respectively. The therapeutic efficacy in MG models depended on the administration route of rIFN-beta, and as far as could be determined from the MG models, high-dose administration of rIFN-beta was not always useful. PMID- 3813578 TI - [Bladder instillation of verapamil as a means of enhancing the efficacy of chemotherapy in superficial bladder carcinoma: influence of bladder instillation of verapamil on the cardiovascular system]. AB - Although it is well known that calcium antagonists in vitro possess enhancing effects on anti-tumor drugs, their clinical use is limited on account of side effects on the cardiovascular system. In the present study, the authors attempted the instillation of Verapamil (calcium antagonist) combined with anti-tumor drugs into the bladder for the treatment of superficial bladder carcinoma. The dosage of Verapamil necessary for maintaining an effective concentration for enhancement of the anti-tumor drug was determined and the influences of bladder instillation of Verapamil on the cardiovascular system and on the bladder were studied. The results obtained were as follows: the use of 5 mg of Verapamil was able to maintain an effective concentration (10(-5) M) for enhancement of anti-tumor drugs for at least 2 h. Absorption of Verapamil from the bladder to the vascular system was minimal. No influence on the cardiovascular system or on the bladder was observed. The results of the present study encourage us to pursue the clinical use of Verapamil combined with anti-tumor drugs for the treatment of superficial bladder carcinoma. PMID- 3813579 TI - [Discriminant analysis of bone marrow suppression of methyl 6-[3-(2-chloroethyl) 3-nitrosoureido]-6-deoxy-alpha-D-glucopyranoside (MCNU)]. AB - Twenty-five patients with primary or metastatic brain tumor were treated with two administrations of MCNU, 67-125 mg/m2 i.v., at 1-293 day intervals. Thrombocytopenia of less than 10 X 10(4)/mm8 occurred in 9 cases (36.0%) and leukocytopenia of less than 3 X 10(3)/mm3 in 11 cases (44.0%). The factors influencing these two kinds of bone marrow suppression were investigated using discriminant analysis (SPSS software package). The most influential factor for thrombocytopenia was the dose of MCNU and that for leukocytopenia was the interval between the two administrations. These results show that patients should be able to receive this drug without suffering bone marrow suppression if care is taken with regard to their condition with the time interval between doses. PMID- 3813581 TI - [Changes in beta-glucuronidase activity recognized in granulocytes from patients with carcinomas of the gastrointestinal tract]. PMID- 3813580 TI - [Treatment of a case of childhood acute non-lymphocytic leukemia (ANLL) using high-dose cytosine arabinoside for intensification of early therapy]. AB - A 12-year-old girl with acute non-lymphocytic leukemia was treated with a protocol involving high-dose cytosine arabinoside (Ara-C) for intensification of early therapy. The patient, who had been revealed to have CNS infiltration on admission, achieved complete remission after receiving ACMA/BHAC combination and intrathecal MTX. As an early intensification treatment, ID/HD Ara-C was safely and effectively administered; this consisted of ADR (45 mg/m2 iv) Day 1, intermediate-dose Ara-C (0.5 g/m2, 1-h drip, q. 12 h) Days 2-4, and high-dose Ara C (3 g/m2, 3-h drip, q. 12 h) Days 10-11, followed by L-asp (6,000 U/m2, im) on Day 12. Ten months later, the patient has been in continuous complete remission. High-dose Ara-C should be included with caution as an early intensification of treatment to improve the therapeutic results of childhood ANLL. PMID- 3813582 TI - [Primary cultures of various differentiated human cells and their transfer (2). The isolation of target cells from their specimen]. AB - The specimen employed for the culture should be possibly rich of target cells in order to obtain the successful primary culture. When the target cells are located along the inner side of a duct forming tissue, they can be relatively easily isolated as major cell population in their whole dissegregated cells by means digesting the inner wall of ductive tissues. When the specimen supplied for the culture is so small and limited, the explant outgrowth culture method can be better applied for the culture. For the primary cultures of malignant cells, soft agar cell suspension method can be better available for the successful culture. PMID- 3813583 TI - Arachidonic acid metabolites in cutaneous carcinomas. PMID- 3813584 TI - Estrogen receptors in malignant melanoma. PMID- 3813585 TI - Cyclosporin A therapy for mycosis fungoides. PMID- 3813586 TI - Cyclosporine in the treatment of psoriasis. PMID- 3813587 TI - Topical cyclosporine in alopecia areata. PMID- 3813588 TI - Efficacy of low-dose cyclosporine in severe atopic skin disease. PMID- 3813589 TI - Granuloma annulare-like skin lesion due to Fusarium roseum: therapy with ketoconazole. PMID- 3813590 TI - Cutaneous horn arising in cutaneous leishmaniasis. PMID- 3813591 TI - Mast cells and fibrosis. PMID- 3813592 TI - A case-control study of possible causative factors in mycosis fungoides. AB - A detailed case control study was carried out on 53 patients (33 males and 20 females) with histologically proven mycosis fungoides and on an age- and sex matched control population. Possible causative factors investigated included occupation, recreation, and exposure to petrochemicals, pesticides, insecticides, and potential carcinogens. Exposure to plants of the Compositae family, tanning history, and chronic sun exposure were also investigated, as were smoking history, drug ingestion history, and other skin disease. Personal and family histories of other malignancies were also investigated. The only statistically significant difference to emerge was that the patients with mycosis fungoides had significantly more family history of atopic dermatitis. In view of the absence of any significant difference between patients and controls with regard to personal history of atopic dermatitis, this difference may be the result of multiple statistical testing rather than a phenomenon of true biological significance. PMID- 3813593 TI - Mast cell numbers in diffuse scleroderma. AB - Numbers of mast cells were quantitated in the lesions of diffuse scleroderma and morphea. Mast cells increased and then decreased in number in the papillary dermis of diffuse scleroderma. No significant change of mast cell numbers was noted in the reticular dermis. Mast cells increased in the papillary dermis with fine collagen bundles (grade 2 skin of scleroderma) and decreased in the papillary dermis with homogeneous collagen bundles (grade 3 skin of scleroderma). The total number of cells increased in the papillary dermis of grade 1 and 2 skin of scleroderma and decreased in the grade 3 skin of scleroderma. In morphea a reduced number of mast cells was noted in grade 3 lesions. It is suggested that mast cells play an important role in fibrotic process of scleroderma skin. PMID- 3813594 TI - The incidence of bacteremia during skin surgery. AB - The development of transient bacteremia during simple surgical excision of cutaneous neoplasms was studied. Of 35 patients undergoing surgery on eroded, but not clinically infected, cutaneous tumors, one developed a transient bacteremia, whereas none of 15 patients developed bacteremia during surgery on cutaneous neoplasms with intact skin surfaces. The low incidence of bacteremia associated with surgery on eroded skin neoplasms suggests that, for this commonly performed surgery, prophylactic antibiotics be administered perioperatively only to patients with prosthetic heart valves and not to other patients at risk for endocarditis. This recommendation would be in keeping with the American Heart Association guidelines for prophylaxis for other surgical procedures associated with low incidences of transient bacteremia. PMID- 3813595 TI - Malignant melanoma of mucous membranes. A clinicopathologic study of 13 cases in Japanese patients. AB - We found 13 mucosal melanomas (13%) among 103 cases of malignant melanoma at Tohoku University Hospital, Sendai, Japan, a high incidence. Five melanomas were found on the oral mucosa, another five on the genital mucosa, two within the nasal cavity, and one on the esophagus. Three of the melanomas on the oral mucosa occurred on the lip and the other two on the gingiva. A striking prevalence of melanomas was observed in women, the male-to-female ratio being 0.08. Histologic examination revealed that 58% of the melanomas were characterized by lentiginous, 23% by nodular, and 15% by superficial spreading proliferation. Most of the melanomas were Clark's level IV or V at the time of diagnosis. Except for three who have been under observation for a short time, all the patients have died. There appear to be some clinical and histologic similarities between mucosal melanoma and melanoma of the volar skin, but the difference in biological behavior warrants that the two be classified separately. PMID- 3813597 TI - Familial focal alopecia. A new disorder of hair growth clinically resembling pseudopelade. AB - A 14-year-old girl was evaluated for patchy hair loss present from early childhood. Her mother was found to have a similar condition. When studied in transverse section, biopsy specimens from both women showed marked anagen-telogen transformation that circumstantially appears to be irreversible. Preservation of telogen epithelium with absence of inflammation and scarring readily separate focal familial alopecia from the pseudopelade state and from localized alopecia areata. To our knowledge, this is the first description of a new familial disorder causing focal alopecia. PMID- 3813596 TI - Scleredema and paraproteinemia. Enhanced collagen production and elevated type I procollagen messenger RNA level in fibroblasts grown from cultures from the fibrotic skin of a patient. AB - An edematous rash developed on the abdominal skin of a 76-year-old woman who had had diabetes mellitus for ten years. Some months later, the affected skin became thickened and indurated. Histopathologic examination revealed marked dermal fibrosis with excessive deposition of collagen. The patient also had IgA (k-type) paraproteinemia. Fibroblast cultures from the affected and unaffected skin were studied for collagen metabolism. Procollagen synthesis was elevated about sixfold on fibroblasts derived from the affected skin. A similar increase was detected in messenger RNA (mRNA) levels using a complementary DNA clone specific for human pro alpha 1(l) collagen mRNA. The elevated mRNA level could be the result of increased transcriptional activity of collagen genes or decreased degradation of collagen mRNAs. Our findings suggest that increased collagen deposition may account for the marked dermal fibrosis that we observed in this patient. PMID- 3813598 TI - Transient acantholytic dermatosis in immunocompromised febrile patients with cancer. AB - A focal acantholytic dermatosis resembling transient acantholytic dermatosis (TAD) clinically and histologically occurred in four immunocompromised and persistently febrile patients with various malignant neoplasms. No pathologic organism was isolated in cultures from blood or from the actual skin lesions. The rash resolved over several days, coinciding with defervescence. As do authors of other reports of TAD, we believe that the etiology of TAD is related to heat, persistent fever, and/or sweating. PMID- 3813599 TI - The cause of dermatitis herpetiformis. PMID- 3813600 TI - Eruptive vellus hair cyst with singular histologic finding. PMID- 3813601 TI - Recent clinical advances in knowledge of the nonleprous environmental mycobacteria responsible for cutaneous disease. PMID- 3813602 TI - Surgical margins for basal cell carcinoma. AB - Basal cell carcinomas frequently extend beyond their visible borders. Therefore, the goal of surgical therapy must be to eradicate both the clinically apparent tumor and its microscopic extension into the surrounding normal-appearing skin. This entails excising the tumor along with a margin of clinically normal skin. Unfortunately, there is no agreement as to the optimal width of surgical margins. We therefore studied 117 cases of previously untreated, well-demarcated basal cell carcinoma. Prior to excision, the normal-appearing skin surrounding the tumor was marked in 2-mm increments. The tumor was then excised using Mohs micrographic surgery. The extent of the subclinical tumor invasion was calculated from the presurgical skin markings. For tumors with a diameter less than 2 cm, a minimum margin of 4 mm was necessary to totally eradicate the tumor in more than 95% of cases. PMID- 3813603 TI - Skin lesions caused by Mycobacterium scrofulaceum. AB - A 32-year-old man with systemic lupus erythematosus controlled by steroid therapy developed multifocal cutaneous abscesses caused by Mycobacterium scrofulaceum. The distribution and evolution of the lesions suggested hematogenous dissemination, but he exhibited no pulmonary or other visceral manifestations of systemic mycobacterial disease. The patient completed nine months of therapy with isoniazid and rifampin, and the lesions resolved within five months of presentation. PMID- 3813604 TI - Malignant pyoderma or pyoderma gangrenosum of the head and neck? AB - Malignant pyoderma is a rapidly progressive ulcerating process of unknown origin that predominantly affects the head and neck of young adults. Malignant pyoderma has been considered distinct from pyoderma gangrenosum because of the predominant head and neck location of the ulcers and because the ulcers lack undermining and surrounding erythema. A case of a 22-year-old woman with a severe ulcerative process predominantly affecting the head and neck is described. A review of the literature indicates that malignant pyoderma and pyoderma gangrenosum are almost certainly identical disorders. PMID- 3813605 TI - Periorbital basal cell carcinoma requiring ablative craniofacial surgery. AB - Four patients with recurrent, periorbital basal cell carcinoma and who ultimately required craniofacial composite orbitectomies are presented. Common clinical features included medial canthal and eyelid location of tumors, multiple previous surgical procedures, and morphealike clinical appearance of the tumor. Common histologic features included extensive, dense hyaline fibrosis and perineural invasion. Because of the extensive soft-tissue and osseous involvement, all patients required composite resection of the orbit, the ethmoidal sinus, the orbital contents, and the soft tissue of the eyelids, brow, and temporal region. This required an intracranial approach utilizing a frontal craniotomy and distant flap coverage of the resultant defect. Emphasis is placed on the early, aggressive, and complete surgical resection of such lesions, before orbital invasion has occurred, so subsequent mutilating surgery may be avoided. PMID- 3813606 TI - Anaemia and child health surveillance. PMID- 3813607 TI - Sweetness. PMID- 3813608 TI - Maternal compared with infant vitamin D supplementation. AB - Vitamin D metabolites were studied in mother-infant pairs at delivery and eight and 15 weeks after that to evaluate the possibility of vitamin D supplementation of infant through the mother. Healthy mothers (n = 49) delivering in January received daily either 2000 IU (group 1), 1000 IU (group 2), or no (group 3) vitamin D. Their infants were exclusively breast fed, and those in group 3 received 400 IU of vitamin D a day. After eight weeks of lactation the infantile vitamin D concentrations were similar in groups 1 and 3 but significantly lower in group 2. The serum 24,25-dihydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations were also lower in group 2. The mean mineral, parathyroid hormone, and alkaline phosphatase values showed no intergroup differences at any point. No infants showed any clinical or biochemical signs of rickets, and their growth was equal. In conclusion, a daily postpartum maternal supplementation with 2000 IU of vitamin D, but not with 1000 IU, seems to normalise the vitamin D metabolites of breast fed infants in winter. Maternal safety with such supplementation over prolonged periods, however, should be examined. PMID- 3813609 TI - Age at diagnosis and abilities in idiopathic hypercalcaemia. AB - Forty three children aged 6 to 16 years with a documented history of idiopathic infantile hypercalcaemia were assessed on a variety of cognitive and behavioural measures. No relation was found between the age at which hypercalcaemia was diagnosed and subsequent full scale intelligence quotients (IQ) and reading or spelling abilities. Verbal IQ was, however, significantly higher than performance IQ, which had an inverse relation with age at diagnosis. Furthermore, scores for deviant behaviour were found to correlate with age at diagnosis. Thus the characteristic psychological profile of this syndrome may be in part a function of hypercalcaemia during infancy. PMID- 3813610 TI - Effect of tracheobronchial suction on respiratory resistance in intubated preterm babies. AB - Measurements of the resistance, time constant, and compliance of the respiratory system were made in 25 mechanically ventilated, preterm babies on 32 occasions, using the single breath technique. Patients were classified according to the level of respiratory resistance by reference to a population of 36 babies studied over the first two days of life before airway secretions had become apparent. There was a highly significant fall in both the resistance and time constant measurements after tracheobronchial suction or lavage for infants whose pretreatment values of resistance were greater than the reference mean. When tracheobronchial toilet was effective in removing secretions the changes in resistance and time constant values were again significant. No changes in compliance values were noted. Severe but clinically inapparent mucous obstruction of the airways was revealed in two infants by a progressively rising respiratory system resistance during continuous monitoring. The need for and efficacy of tracheobronchial suction and lavage could be determined by such techniques for monitoring the resistance of the respiratory system during mechanical ventilation. PMID- 3813611 TI - Synchronous mechanical ventilation of the neonate. AB - We describe a simple technique of neonatal ventilation that induces the neonate to breathe in synchrony with the ventilator. This preserves the beneficial effects of spontaneous respiration (unlike therapeutic paralysis) and reduces potentially harmful interactions between baby and ventilator. The technique uses measurements of the neonate's own respiratory timing. PMID- 3813612 TI - The metabolic load of stored blood. Implications for major transfusions in infants. AB - Plasma electrolyte, intermediary metabolite, and hormone concentrations were measured in samples of 110 units of citrate phosphate dextrose blood being used for clinical transfusions. The most important changes from the physiological range were in sodium, potassium, glucose, and lactate concentrations. Mean sodium concentrations fell from 170 mmol/l at the beginning of storage to 156 mmol/l at the end and mean potassium concentrations rose from 7 mmol/l to 25 mmol/l. Glucose had a mean concentration of 20 mmol/l at the beginning of storage and had only fallen to 15 mmol/l at the end. Mean lactate concentrations increased from 7 mmol/l at the beginning of storage to 25 mmol/l at the end. Many samples had cortisol, insulin, and growth hormone concentrations within the physiological range. Citrate phosphate dextrose blood contains a large substrate load that changes during storage and that should be taken into account when infants are transfused large volumes of blood. The strong correlation coefficients with duration of storage for sodium, potassium, and lactate (-0.71, 0.91, and 0.90, respectively) indicate that concentrations of these substrates can be predicted within a narrow range if the duration of blood storage is known. PMID- 3813613 TI - Infantile diarrhoea due to water complementation of breast and bottle feeding. AB - This study investigated the prevalence of unusual infant feeding practices among 204 mothers of infants aged 1-12 months, who were admitted with acute diarrhoea to the only two national hospitals in Kuwait. Ninety per cent of the mothers boiled water to prepare a powdered milk formula, but only 15% boiled water for drinking. Thirty nine infants (19%) were admitted more than once. Better family state in terms of socioeconomic class, maternal education, and breast feeding gave some protection against re-admission, though this was not significant. It seems that the condition of drinking water is an important cause of diarrhoea and hence of re-admission. The number of re-admissions was twice as high among infants drinking unboiled (unfiltered or mineral) water than among those drinking boiled or unboiled but filtered water. Breast feeding is protective if no extra water is given. PMID- 3813614 TI - Diabetes insipidus and occult intracranial tumours. AB - We describe four patients with intracranial tumours who presented with diabetes insipidus and subsequently developed an evolving anterior pituitary endocrinopathy. The delay in imaging the tumours varied between 2.1 and 11.2 years (mean 5.4 years). PMID- 3813615 TI - Height in epilepsy. AB - Longitudinal data on the height of prepubertal children with epilepsy are presented. Although both seizures and antiepileptic drugs may affect serum hormone concentrations, linear growth remains normal. PMID- 3813616 TI - Preoperative stabilisation in congenital diaphragmatic hernia. AB - Critically ill infants with congenital diaphragmatic hernia were treated by either early surgery or delayed surgery after preoperative stabilisation. The preoperative stabilisation was aimed at correcting acidosis and hypoxia, thereby reducing the severity of persistent fetal circulation. Survival improved from 12.5% after early surgery to 52.9% after delayed surgery. PMID- 3813617 TI - Neonatal typhoid fever. AB - Three infants of Pakistani immigrant mothers developed typhoid fever in the neonatal period. All three survived, but two became chronic excretors of Salmonella typhi. The risk of an outbreak of typhoid fever in a maternity unit or special care baby unit is emphasized. PMID- 3813618 TI - Fluoride treatment in corticosteroid induced osteoporosis. AB - Severe osteoporosis with multiple vertebral fractures occurred in two girls receiving prolonged high dose corticosteroids for relapsing dermatomyositis. Sodium fluoride, supplemented with calcium and vitamin D, helped control secondary osteoporosis in one case and should be considered as part of the curative treatment of corticoid induced osteoporosis. PMID- 3813619 TI - Neonatal opiate withdrawal. PMID- 3813620 TI - Tracheostomy--a parent's view. PMID- 3813621 TI - Immunoprophylaxis of infants born to hepatitis B virus exposed mothers. PMID- 3813622 TI - Serum albumin concentrations and oedema in the newborn. PMID- 3813623 TI - High plasma urea concentration in babies with lamellar ichthyosis. PMID- 3813624 TI - Vitamin D metabolites in idiopathic infantile hypercalcaemia. PMID- 3813625 TI - Pulse oximetry in neonatal care. PMID- 3813626 TI - Hypermobility of joints. PMID- 3813627 TI - Oedema and the aging prima donna. PMID- 3813628 TI - Cystic fibrosis and diabetes mellitus. PMID- 3813630 TI - Cost of Stycar boxes. PMID- 3813629 TI - Spermatic cord torsion. PMID- 3813631 TI - Vision testing beads. PMID- 3813632 TI - Malignant tumours in the neonate. AB - One hundred and two cases of neonatal cancers, representing 2% of all paediatric malignancies, were seen during a 60 year period at The Hospital for Sick Children, Toronto, Canada. The neonatal cancers included neuroblastoma (47%), retinoblastoma (17%), soft tissue sarcoma (12%), central nervous system tumours (9%), leukaemia (8%), and a few cases of Wilms' tumour, liver tumour, and miscellaneous tumours. The overall mortality from disease was 41%. Patients with retinoblastoma, Wilms' tumour, and neuroblastoma had the best prognosis. Forty three patients (42%) survived their neonatal cancers; all were treated with surgery or radiochemotherapy, or both, but none suffered long term major handicaps as a result of treatment. There was one instance of second malignancy of the thyroid gland induced by radiation. We conclude that although neonatal cancers are difficult management problems, many patients can be cured. Physicians should discuss with parents the possible risks associated with treatment before treatment is begun. PMID- 3813633 TI - Influence of elective preterm delivery on birthweight and head circumference standards. AB - We calculated new birthweight and head circumference centiles for boys and girls between 24 and 42 weeks' gestation from 20,713 singleton live births at our hospital between 1978 and 1984. Among the 803 babies born at or before 34 weeks' gestation, 28% were delivered electively for fetal problems; they were considerably lighter than babies born after spontaneous preterm labour. In contrast, they showed only a small deficit in head circumference, possibly due to a brain sparing effect in growth retarded infants. Electively delivered preterm infants cause a bias in birthweight and head circumference centiles and we recommend that these babies should be excluded when these centiles are calculated. PMID- 3813634 TI - Non-convulsive status epilepticus. AB - Status epilepticus can complicate any type of seizure activity. A group of 13 children with non-convulsive status has been studied. Five presented with chronic fluctuating neurological features, while eight had intermittent episodes of their atypical status, although each of these lasted for several days. The clinical features, treatment, and outcome for these groups of children are described. Most of the children in both groups are mentally retarded after regressing at the time of their status epilepticus. The recognition and aggressive treatment of atypical status is important in reducing the risk of subsequent mental handicap. PMID- 3813635 TI - Scrotal swellings in the under 5s. AB - Scrotal swelling is a common cause of referral to the paediatric surgical services in Edinburgh, constituting 12% of total admissions. Of these, 2818 (65%) were in boys under the age of 5 years, with a wide variety, including inguinal hernias, hydroceles, testicular torsion, tumours, and some interesting but uncommon conditions. A retrospective study was performed over a 12 year period to assess the incidence, aetiology, mode of presentation, disease, and management of scrotal swellings in boys under 5. Although most of the causes of these swellings were easily elucidated from a history and clinical examination, it was apparent that a high level of suspicion was also necessary to ensure that more serious problems did not go undetected. PMID- 3813636 TI - Growth hormone response to a standardised exercise test in relation to puberty and stature. AB - Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9 (1.4) years; mean height SDS 3.0 (0.8], and 30 normal children (group 3: mean age 13.3 (3.2) years; mean bone age 12.8 (3.4) years; mean height SDS -0.4 (0.8]. Results of GH are expressed as mean (SEM). The pre-exercise GH was similar in the three groups (group 1, 8.0 (2.3) mU/l, group 2, 8.5 (2.5) mU/l, and group 3, 8.3 (2.3) mU/l). There was a significant rise in GH after exercise in all three groups. GH after exercise was higher in group 2 (35.1 (2.5) mU/l) compared with groups 1 and 3 (17.8 (3.0) and (20.8 (3.2) mU/l). Post-exercise GH was less than 10 mU/l in 29 children (34% total; 49% group 1, 6% group 2, and 34% group 3). There was a positive relation between post-exercise GH and both bone age and public hair stage. Multiple regression analysis revealed that relevant predictors of a rise in GH with exercise were different for the sexes in these children with varying stature: for boys, bone age and pubic hair stage; for girls, height and height SDS. All the tall girls were in puberty. No statistical relation was observed between post-experience GH and cardiovascular response to exercise, time of day of exercise, time of eating before exercise, and plasma insulin or insulin to glucose ratio at time of exercise. We conclude that the GH response to the physiological stimulus of exercise is higher in puberty compared with childhood. Therefore, although children may be suspected of having GH deficiency after a failure of GH to increase after exercise, a non response may be a normal finding in prepubertal children, independent of stature. PMID- 3813637 TI - Growth and growth factors in diabetes mellitus. AB - Growth of 79 children with diabetes was analysed at diagnosis and again after one to 10.7 years of treatment with insulin. Both sexes were tall at onset, whereas at the last observation boys alone showed significant growth retardation. Height standard deviation score (SDS), however, showed no significant fall either in 32 subjects reassessed after five years of disease or in 18 subjects examined at full stature. Skeletal maturity was not significantly impaired after treatment. Pubertal growth spurt was reduced, especially in girls and in subjects with onset of disease at or around puberty. We found no significant correlation between height and height velocity SDS and glycosylated haemoglobin values or secretion of growth hormone during the arginine test. Somatomedin C values were correlated with height velocity SDS in prepubertal boys. The results of this study suggest that there are interferences in the growth of children with diabetes but that they do not seem to have a significant influence on adult height. PMID- 3813638 TI - Inherited disorders of straight chain fatty acid oxidation. PMID- 3813639 TI - Childhood asthma and growth outcome. AB - To study the ultimate growth variables of children with asthma we analysed the military medical records of 54,041 boys and 38,102 girls at the age of 17 years. History of asthma was found in 2252 boys and 1158 girls, who were then categorised according to three grades of severity. Analysis of their growth was made separately for each sex and for each grade of severity of clinical disease. Boys who suffered from mild asthma that subsided before adolescence were significantly taller, heavier, and fatter than their respective controls. There was a slight decrement in all three growth variables in correlation with increased severity. The most severely affected patients had retarded height and weight in comparison with the mildly affected children, but the differences were not significant. The same tendency was found in the girls. Children with asthma will ultimately reach normal height and weight. Those who are mildly affected tend to be even taller and heavier than adolescents without asthma. The severity of the asthma influences final growth. PMID- 3813640 TI - Preterm blood counts vary with sampling site. AB - In preterm babies both haemoglobin and total neutrophil count values from capillary sites are significantly and variably higher than those from simultaneous arterial samples. Comparing simultaneous venous and arterial samples, the mean haemoglobin was slightly higher but the total neutrophil counts were similar. PMID- 3813641 TI - Chloroquine treatment in desquamative interstitial pneumonia. AB - An infant presented with failure to thrive, tachypnoea, and hypoxia reversed by oxygen. Lung function showed decreased pulmonary compliance; lung biopsy showed desquamative interstitial pneumonitis. Chloroquine 10 mg/kg/day resulted in improvement and relapse when temporarily stopped. The patient was completely asymptomatic during four years' treatment and six months after stopping treatment. PMID- 3813642 TI - Congenital isolated folic acid malabsorption. AB - We report a case of congenital isolated malabsorption of folic acid, the first in a boy. Only seven previous cases have been reported, and we discuss two aspects- namely, the tendency to infection, with evidence of impairment of both cellular and humoral immunity, and the absence of neurological disturbances. PMID- 3813643 TI - The need to screen all retinoblastoma patients for esterase D activity: detection of submicroscopic chromosome deletions. AB - Roughly 5% of all patients with retinoblastoma carry a constitutional chromosome deletion on the long arm of chromosome 13, which confers a prezygotic predisposition to tumour development. As offspring of deletion carriers have a 50% risk of inheriting the predisposition locus it is important to identify deletion carriers. The site of the esterase D gene to the often deleted region offers an objective means of deletion identification. The chromosomes of a patient with unilateral retinoblastoma, previously supposed to have a normal karyotype, were reexamined after the discovery that his red blood cells contained reduced activities of esterase D. A small sub-band deletion was found in chromosome region 13q14. These findings emphasise the importance of measurements of esterase D in all patients with retinoblastoma, even those with an apparently normal karyotype. PMID- 3813644 TI - Tachycardia and heart failure after ritual circumcision. AB - Four newborn babies developed acute heart failure a few hours after circumcision at 8 days. During this procedure, a sponge soaked in epinephrine was applied to the circumcision site and left there for several hours. Treatment was with digoxin and diuretics and signs of heart failure disappeared within 24-72 hours. PMID- 3813645 TI - Treatment of Campylobacter gastroenteritis. AB - Twin boys suffered from recurrent diarrhoea due to Campylobacter jejuni after entering a day nursery. Stool sampling of all 17 children at the nursery revealed C. jejuni in 12. Simultaneous treatment with antibiotics of all children with positive cultures successfully eradicated the infection. PMID- 3813646 TI - Pitfalls in the management of epilepsy. PMID- 3813647 TI - Medical evidence in child abuse. PMID- 3813648 TI - Apnoea monitoring and cot deaths. PMID- 3813649 TI - The school entry medical examination. PMID- 3813650 TI - PUVA therapy damages psoriatic and normal lymphoid cells within milliseconds. AB - Results of previous investigations have indicated that photochemotherapy (PUVA) attacks membranes of target cells. Using the combination of a stopped-flow technique and laser irradiation we were able to prove that the fast PUVA effect is explainable solely by the membrane damage. Lymphoid cells of healthy persons or psoriatics were taken, within 1 ms mixed with 8-methoxy-psoralen (8-MOP) at concentrations of 1.0, 0.1, and 0.5 microgram/ml, and then irradiated by a 337-nm laser pulse (0.5 mJ/cm2) lasting some picoseconds. Approximately 1 ms after administration of 8-MOP to the cell surface at least 10% of the cells were damaged, as could be judged using the standard trypan blue exclusion test. This happened at 8-MOP concentrations of 1.0 or 0.1 microgram/ml plus laser irradiation, but a concentration of 0.05 microgram/ml 8-MOP plus laser exposure did not cause any effect within 8 ms after mixing. There was no difference between using lymphoid cells from healthy persons or from psoriatics. The fact that only a very short time is necessary before cell damage occurs means that, as far as the fast PUVA effect is concerned, a photochemical reaction involving nuclear DNA can be discounted. PMID- 3813651 TI - Comparative morphological and growth kinetics studies of human hair bulb papilla cells and root sheath fibroblasts in vitro. AB - Dermal papillae isolated from anagen hair bulbs obtained from biopsy specimens from five subjects with normal hair pattern, and fibroblasts derived from the mesenchymal root sheaths (RSF) of the same hair follicles were separately grown in culture and the cell-cycle distribution pattern on different days was analyzed by applying DNA flow cytometry (FCM). Papilla cells (PC) exhibited distinctive morphological features by forming cell aggregates differing from RSF with respect to cell shape and growth pattern. They also proliferated remarkably more slowly than RSF. DNA-FCM analysis showed that both PC and RSF demonstrated synchronous fluctuations in the percentage of cells in G1/0, S and G2 + M phases during the period of subculture. PMID- 3813652 TI - Cholesterol sulfate uptake and outflux in cultured human keratinocytes. AB - Cholesterol sulfate-cholesterol homeostasis in the epidermis may be important for normal desquamation. Recent evidence from cell-culture studies indicates that cholesterol sulfate inhibits sterologenesis by inhibiting the activity of 3 hydroxy-3-methylglutaryl coenzyme A reductase, the rate-limiting enzyme in cholesterol synthesis. For cholesterol sulfate in the stratum corneum to function as a feedback regulator of epidermal sterologenesis, it must have the capacity enter cells. In these studies, uptake and outflux of cholesterol sulfate was examined in cultured human foreskin keratinocytes, and compared with uptake and outflux of cholesterol and 25-hydroxycholesterol, as well as with sterol uptake by another cell type, the skin fibroblast. The uptake of the free (not lipoprotein-associated) form of all three sterols was not consistent with a receptor-mediated process. Although the cholesterol sulfate uptake was approximately three-fold less than that of 25-hydroxycholesterol, it was nearly seven-fold greater than that of cholesterol itself. Whereas 25-hydroxycholesterol was rapidly washed out of keratinocytes in outflux experiments, both cholesterol and cholesterol sulfate tended to remain cell-associated. These studies demonstrate that cholesterol sulfate is readily taken up by keratinocytes, in which it may be in a position to modulate cellular lipid metabolism. PMID- 3813653 TI - Effects of 12-o-tetradecanoylphorbol-13-acetate and polyprenoic acid derivative on calcium-activated phospholipid-dependent protein kinase of pig skin. AB - 12-o-Tetradecanoylphorbol-13-acetate (TPA) activates calcium-activated, phospholipid-dependent protein kinase (protein kinase C) partially purified in an ion exchange column from pig epidermis. Protein kinase C was activated by TPA in a concentration-dependent manner with simultaneous addition of Ca2+ and phospholipid. Polyprenoic acid derivative (E5166) which is a newly synthesized retinoic acid derivative, inhibited the TPA activation of protein kinase C. This inhibition may explain the mechanisms by which retinoids inhibit TPA-induced tumor promotion. PMID- 3813654 TI - Active proliferation of telangiectases in skin of patients with progressive systemic sclerosis (PSS). AB - The labeling index of endothelial cells as measured by in vitro autoradiography with 3H-thymidine and the electron microscopic structure of microvessels were studied in telangiectases. The telangiectases of eight patients with progressive systemic sclerosis (PSS) were compared with the cherry angiomas of six healthy controls subjects. The ultrastructural features of telangiectases were similar in the two groups and were characteristic of capillaries and postcapillary venules of the dermis, with multilayering of the vascular basement membrane. However, a significant difference existed between these two groups in an autoradiographic study: in PSS telangiectases, the average labeling index was 5.9%, whereas in cherry angiomas it was around 0.8%. Thus, the telangiectases in PSS are structures with accelerated endothelial proliferation, as are the other endothelial cells of microvessels anywhere in dermis in this disease. However, the great heterogeneity of the labeling index (varying from 0.5% to 27%) must be emphasized in telangiectases. PMID- 3813655 TI - Toxicity of N-methyl-4-methoxynaphthalimide, a fluorescent whitening agent. PMID- 3813656 TI - Improved methodology for a sea urchin sperm cell bioassay for marine waters. PMID- 3813657 TI - Assessment of the biological impact of point source discharges employing Asiatic clams. PMID- 3813658 TI - Worker exposure to, and absorption of, cypermethrin during aerial application of an "ultra low volume" formulation to cotton. PMID- 3813659 TI - Availability and toxicological effects of low levels of biologically bound cadmium. PMID- 3813660 TI - Cadmium kinetics in freshwater clams. III. Effects of zinc on uptake and distribution of cadmium in Anodonta cygnea. PMID- 3813661 TI - [Proceedings of the Swiss Society for Gynecology. Annual meeting, Munsterlingen Wolsberg, 19-21 June 1986]. PMID- 3813662 TI - [Lethality and morbidity of gynecologic interventions. A study of the Professional Society of Swiss Gynecologic Clinics]. PMID- 3813663 TI - [Preventive use of antibiotics in gynecology and obstetrics]. PMID- 3813664 TI - [Para-aortic lymph node excision]. PMID- 3813665 TI - Low dose intravenous 3-amino-1-hydroxypropylidene-1,1-bisphosphonate (APD) for the treatment of Paget's disease of bone. AB - Twenty patients with severe symptomatic Paget's disease were treated with a series of 15 mg intravenous infusions of 3-amino-1-hydroxypropylidene-1,1 bisphosphonate (APD). A regimen of either five consecutive days of treatment (regimen 1) or a course of 12 weekly infusions was administered (regimen 2). In five cases regimen 2 followed regimen 1 after a three month interval. Alkaline phosphatase levels fell in all patients and returned to the normal range in 12. All but one of the patients obtained symptomatic improvement. There was a median fall in alkaline phosphatase activity of 63%. Eight patients observed a transient increase in bone pain starting about 24 hours after the first infusion. Intravenous APD was well tolerated, and we conclude that it is an effective treatment for Paget's disease; this route of administration avoids the problem of poor and unpredictable gastrointestinal absorption seen when a bisphosphonate is given orally. The optimal dose and duration of APD therapy, frequency of relapse, requirement for further courses, and merits relative to other second generation bisphosphonates remain to be established. PMID- 3813666 TI - Vertebral osteomyelitis due to Staphylococcus warneri. AB - We report a case of vertebral osteomyelitis in a diabetic woman. This appears to be the first report of such an infection with the coagulase negative staphylococcus, S warneri. PMID- 3813667 TI - Is pregnancy a risk factor in the causation of rheumatoid arthritis? PMID- 3813668 TI - Measurement of the cross linking compound, pyridinoline, in urine as an index of collagen degradation in joint disease. AB - An enzyme linked immunoassay (ELISA) for the collagen cross link, pyridinoline, has been developed using affinity purified antibodies, with a sensitivity down to about 0.1 ng of cross link. Measurements of urinary pyridinoline were made in patients with rheumatoid arthritis (RA), osteoarthritis (OA), and a control group showing no signs of joint disease. Expressed relative to creatinine values, pyridinoline was significantly increased in both RA and OA groups compared with controls: these differences were much larger than could be attributed to any age related effects or to changes in urinary creatinine concentrations. These findings were confirmed by analysis of a series of 24 h urine collections which showed that the total pyridinoline excretions were significantly higher in both RA and OA groups than in the controls. As pyridinoline is much more prevalent in cartilage than in bone collagen, measurement of this compound in urine may provide an index for monitoring the increased joint destruction that occurs in arthritic disease. PMID- 3813669 TI - Behcet's disease in Iraqi patients. AB - The clinical features of 60 patients (45 male, 15 female) with Behcet's disease (BD) are reported in this prospective study. Ninety seven per cent had mouth ulceration, 83% genital ulceration, 75% skin lesions, 48% ocular involvement, 48% synovitis, 17% thrombophlebitis, and 22% of the male patients had epidiymitis, while constitutional symptoms were reported by 63%. The arthritis was intermittent, self limiting, and non-destructive, involving large joints, mainly the knees and ankles. The pathergy test was positive in 37 of 52 patients with BD, and negative in all 120 healthy controls and in 20 healthy volunteers who possessed the HLA-B51 antigen. HLA-B51 was present in 32 of 52 (62%) patients with BD compared with 51 of 175 (29%) unrelated normal controls. Both the pathergy and HLA-B51 tests were negative in four of 52 patients with BD. Behcet's disease is not uncommon in Iraq. Practising physicians, dermatologists, and ophthalmologists must be more aware of its existence. PMID- 3813670 TI - Anticardiolipin antibodies: isotype distribution and phospholipid specificity. AB - Quantitative isotype specific enzyme linked immunosorbent assay (ELISA) was used to determine the distribution of immunoglobulin isotypes and phospholipid specificities of anticardiolipin (anti-CL) antibodies in 40 patients with one or more of the following 'antiphospholipid (anti-PL) antibody associated clinical complications'--namely, thrombosis, fetal loss, thrombocytopenia. Twelve of 40 patients had IgG, IgM, and IgA anti-CL antibodies. Ten patients had IgG and IgM, five patients had IgG and IgA, and three patients had IgM and IgA anti-CL antibodies. There was no statistical association between any single isotype or any group of isotypes with thrombosis, fetal loss, or thrombocytopenia. The presence of IgG anti-CL antibodies in 36 of the 40 patients suggests that this isotype may be most important in determining clinical complications, but there were four patients without IgG anti-CL antibodies who also appeared susceptible to thrombosis, fetal loss, and thrombocytopenia. IgG, IgM, and IgA anti-CL antibodies bound the negatively charged phospholipids, phosphatidylserine and phosphatidylinositol, but not the zwitterionic phospholipid, phosphatidylcholine. There was no significant difference between binding to cardiolipin and binding to other negatively charged phospholipids, suggesting that the specificity of these antibodies is for negatively charged phospholipids in general rather than for cardiolipin in particular. PMID- 3813671 TI - Pulmonary disease in polymyositis/dermatomyositis: a clinicopathological analysis of 65 autopsy cases. AB - The clinical and autopsy records of 65 patients with either polymyositis (24) or dermatomyositis (41) and pulmonary disease were reviewed. Pulmonary symptoms were recorded in 43 of the cases and included dyspnoea in 31, cough in 23, and chest pain in six. Interstitial lung disease was noted at autopsy in 27 patients; almost half of these had arthritis. Bronchopneumonia was found in 35 patients, 31 of these had received prednisone. Dysphagia was present in a similar proportion of patients with and without pneumonia. Pulmonary vasculitis was seen in five patients; pulmonary symptoms, arthritis, and raised erythrocyte sedimentation rate were present in four of these cases and all five had associated interstitial lung disease. Other pulmonary manifestations included pulmonary oedema, primary pulmonary malignancy, diffuse alveolar damage, fibrinous pleuritis, pulmonary emboli, and diaphragmatic atrophy. The mean survival after disease onset was 29 months but was much less for those with interstitial lung disease and pulmonary vasculitis. PMID- 3813672 TI - Ultrastructural localisation of muramidase in the human synovial membrane. AB - The synovial intimal cell layer comprises two morphological types of cell, A and B, with an intermediate type also postulated. Type A cells show features in common with other cells of the mononuclear phagocyte system, while type B cells appear similar to fibroblasts and are assumed to have synthetic activity. Muramidase is a marker of mononuclear phagocytic cells, and we have investigated the synovial membrane for the presence of this enzyme in cells by an immunogold labelling technique. Muramidase was localised within intracytoplasmic vacuoles in subintimal macrophages and type A synoviocytes. This finding provides further evidence that type A cells are closely related to macrophages. PMID- 3813673 TI - Predictive value of mean platelet volume in gold induced thrombocytopenia. AB - In rheumatoid arthritis the mean platelet volume does not alter with the institution of parenteral gold therapy and with long term gold therapy. It appears to have no value in predicting the onset of thrombocytopenia. It may, however, predict a haemorrhagic diathesis once gold induced thrombocytopenia is established. PMID- 3813674 TI - Uptake of chloroquine and hydroxychloroquine by human blood leucocytes in vitro: relation to cellular concentrations during antirheumatic therapy. AB - The accumulation of chloroquine and hydroxychloroquine in unfractionated mononuclear cells and in purified monocytes, lymphocytes, and neutrophil polymorphonuclear leucocytes (PMN) was measured in vitro. Accumulation of both drugs in leucocytes was time and dose dependent. Cellular levels comparable to those found during antirheumatic therapy were achieved by preincubation for 60 minutes with up to 0.1 mM chloroquine or hydroxychloroquine. PMID- 3813675 TI - Drug induced impairment of polymorphonuclear cell bactericidal ability in rheumatoid arthritis. AB - Thirty three patients with rheumatoid arthritis (RA) treated only with non steroidal anti-inflammatory drugs were divided into two groups according to the drug received (group A: diclofenac, group B: indomethacin or ketoprofen), and their polymorphonuclear (PMN) cell functions were investigated. We found that bactericidal ability was the only function significantly impaired in group A as compared with group B patients and normal controls. This modification correlated well with the reduction of control PMN bactericidal ability when this test was carried out in patient plasma. These differences between drug effects might explain some of the discrepancies between reports of PMN cell functions in RA. PMID- 3813677 TI - Gout in the elderly, a separate entity? AB - To evaluate whether the clinical pattern of gout differed between elderly women and men a retrospective study was performed in all women (22) and men (18) in our rheumatological clinics who developed gout after the age of 60. The diagnosis was made after a mean of 2.6 years of joint complaints in women and after 1.2 years in men. In about half the patients complaints started in more than one joint, often including the big toe. In five women, but none of the men, complaints started in the fingers. No correlation was found between gout and the presence of tophi or Heberden's nodes in the finger joints. The mean uric acid level was higher in women (0.61 mmol/l) than in men (0.53 mmol/l), and almost all the women (95%) used diuretics and only 56% of the men did so. PMID- 3813676 TI - IgM rheumatoid factor (RF), IgA RF, IgE RF, and IgG RF detected by ELISA in rheumatoid arthritis. AB - One hundred patients with rheumatoid arthritis (RA), of whom 73 were seropositive by latex or Waaler-Rose (WR) assays, or both, 100 healthy subjects, and 102 diseased controls (22 patients with systemic lupus erythematosus (SLE) and 80 with bronchial asthma) were evaluated for the presence of IgM rheumatoid factor (RF), IgA RF, IgE RF, and IgG RF by an enzyme linked immunosorbent assay (ELISA). Ninety two per cent, 65%, 68%, and 66% of the patients with RA were found to be positive for IgM, IgA, IgE, and IgG respectively. A positive correlation existed between the levels of IgM RF and IgA RF on the one hand and disease activity on the other, and the levels of IgM RF and IgA RF correlated with the levels of circulating immune complexes as measured by a C1q binding assay. The presence of extra-articular features also correlated positively with the levels of IgA RF and IgE RF. Five out of six patients with Sjogren's syndrome had very high levels of IgA RF. Of 47 patients typed for HLA-DR, DR1 and DR2 were significantly more frequent in those with the highest levels of IgM RF. Conversely, DR3 was associated with low levels or absence of IgA RF and IgE RF. These results suggest that immune response genes may regulate the level of different RF isotypes. The frequencies of IgM, IgA, IgE, and IgG RF were 59%, 36%, 9%, and 27% respectively in SLE and 25%, 2.5%, 70%, and 59% in bronchial asthma. PMID- 3813678 TI - Refractory massive pleural effusion in systemic lupus erythematosus treated by pleurectomy. AB - A 34 year old man is described with systemic lupus erythematosus and recurrent massive pleural effusions. Systemic treatment with corticosteroids and azathioprine controlled all other manifestations of the disease apart from the pleural effusions. These were finally, successfully treated by pleurectomy. PMID- 3813679 TI - Myopathy in Addison's disease. AB - Since the first description of primary adrenocortical insufficiency by Thomas Addison in 1855 several large series of patients with Addison's disease have been published. The common signs and symptoms include: weakness, hyperpigmentation, weight loss, gastrointestinal complaints, and hypotension. It is rare for patients with Addison's disease to present with musculoskeletal symptoms including flexion contractures, hyperkalaemic neuromyopathy, Guillain-Barre syndrome, migratory myalgia, sciatica-like pain, and low back pain. Myopathy has not been previously described in Addison's disease. Herein we report a patient presenting with severe hyponatraemia and myopathy which resolved after steroid replacement therapy. PMID- 3813680 TI - Desensitisation to allopurinol. PMID- 3813681 TI - Idiopathic haemarthrosis with chondrocalcinosis. PMID- 3813682 TI - IgA serum levels and disease activity in ankylosing spondylitis. PMID- 3813683 TI - Connective tissue deposits in MRL/1 mice. PMID- 3813684 TI - Percutaneous endoscopic gastrostomy for gastrointestinal decompression. AB - From September 1980 to April 1986, 185 percutaneous endoscopic gastrostomies were performed at University Hospitals of Cleveland. Of these, nine (5%) were done for chronic gastrointestinal decompression and form the basis of this report. Patients ranged in age from 21-73 years (mean: 51 years) and all had prolonged, complex hospitalizations extending 25-122 days (mean: 63 days). The only complication associated with the procedure was the identification of transhepatic placement of the catheter, which caused no adverse effects. Two of the nine patients died during hospitalization of causes unrelated to the gastrostomy construction. The goals of gastric decompression and elimination of nasogastric intubation were achieved in all patients. In one patient with gastric intestinal disconnection, the percutaneous gastrostomy was effective as the sole means for elimination of swallowed saliva and gastric output. Three patients continued to use the gastrostomies for chronic decompression after discharge for the remainder of their lives (2 months, 6 months, and 2 years, respectively). Percutaneous endoscopic gastrostomy may provide a safe, secure, and comfortable method of long term gastric decompression in a select group of high-risk patients with complex intra-abdominal processes. PMID- 3813685 TI - Common pancreaticobiliary channels and their relationship to gallstone size in gallstone pancreatitis. AB - Bile reflux into the pancreatic duct after impaction of a stone in a common pancreaticobiliary channel has been suggested to be the initiating factor in gallstone pancreatitis. Such reflux would require that the impacted stone be smaller than the length of the common channel. The incidence of common channels was studied and gallstone size was compared with common channel length in patients with gallstone pancreatitis and those with cholelithiasis or choledocholithiasis without pancreatitis. Sixty-seven per cent of patients with gallstone pancreatitis had a common channel present on intraoperative cholangiography versus 32% of patients with cholelithiasis or choledocholithiasis without pancreatitis (p less than 0.005). Common channel length was greater than the diameter of the smallest stone in nine of 27 patients with gallstone pancreatitis and in 13 of 109 patients with cholelithiasis or choledocholithiasis without pancreatitis (p less than 0.025). In conclusion, common channels are more frequent in patients with gallstone pancreatitis than in patients with other biliary tract disease. Furthermore, gallstone pancreatitis is associated with stones that are smaller than the common channel, which favors obstruction of both pancreatic and bile ducts while allowing reflux of contents between them. PMID- 3813686 TI - Indications for operation in abdominal stab wounds. A prospective study of 651 patients. AB - This prospective study comprises 651 patients with knife wounds of the anterior abdomen. Three hundred and forty-five patients (53%) had symptoms of an acute abdomen on admission and were operated on immediately. The remaining 306 patients (47%) were managed conservatively with serial clinical examinations. This group included 26 patients with omental or intestinal evisceration, 18 patients with air under the diaphragm, 12 patients with blood found on abdominal paracentesis, and 18 patients with shock on admission. Only 11 patients (3.6%) needed subsequent operation, and there was no mortality. The overall incidence of unnecessary laparotomies was 5% (completely negative, 3%). Of the 467 patients with proven peritoneal penetration, 27.6% had no significant intra-abdominal injury. It is concluded that many abdominal stab wounds can safely be managed without operation. The decision to operate or observe can be made exclusively on clinical criteria. Peritoneal penetration, air under the diaphragm, evisceration of omentum or bowel, blood found on abdominal paracentesis, and shock on admission are not absolute indications for surgery. Alcohol consumption by the patient does not interfere with the clinical assessment. PMID- 3813687 TI - The evolution of morphologic and biomechanical changes in reversed and in-situ vein grafts. AB - A comparative study of experimental reversed (RV) and in-situ (INS) vein grafts with respect to the evolution of morphologic and compliance characteristics was done in a canine model. In addition, the compliance characteristics in a series of human INS vein grafts were recorded as a function of time after operation. At 6 months after implantation, all experimental grafts displayed well-developed intimal hyperplasia. There was no significant difference in either absolute intimal thickness (INS 0.133 +/- 0.09 mm vs. RV 0.085 +/- 0.06 mm; NS) nor in the percentage of the total wall thickness occupied by the intima when experimental INS grafts were compared with RV grafts after 6 months. Similarly, compliance values of INS and RV vein grafts were similar at all time intervals examined up to 6 months after operation. Thirty-three human INS vein grafts had a mean compliance value of 1.74 +/- 0.72 (percent radial changes per mmHg X 10(-2) at a median postoperative interval of 14 weeks. This value did not differ significantly from those measured in the INS vein grafts. Although all vein grafts examined retained their native viscoelastic properties, this study suggests that functioning human INS vein grafts are less compliant than previously suspected on the basis of prior ex-vivo and clinical studies of RV saphenous vein grafts. The purported clinical superiority of the INS vein graft cannot be explained on the basis of superior biomechanical performance or failure to develop intimal hyperplasia. PMID- 3813688 TI - Hypothermia-induced reversible platelet dysfunction. AB - Baboons that were subjected to systemic hypothermia at 32 C had an arm skin temperature of 27.3 C and bleeding time of 5.8 minutes. With local warming of the arm skin to 34 C, the bleeding time was 2.4 minutes. In normothermic baboons with arm skin temperature of 34.6 C, the bleeding time was 3.1 minutes. Local cooling of the arm skin to 27.6 C produced a bleeding time of 6.9 minutes. Increasing the skin temperature of the arm in hypothermic baboons to 38.9 C and in normothermic baboons to 40.1 C reduced bleeding times to 2.1 and 2.3 minutes, respectively. In both hypothermic and normothermic baboons there was a negative and significant correlation between the bleeding time and the arm skin temperature and the thromboxane B2 level in the shed blood obtained at the template bleeding time site. There was a significant positive correlation between the thromboxane B2 level in the shed blood and the arm skin temperature. Both in-vivo and in-vitro studies have shown that the production of thromboxane B2 by platelets is temperature-dependent, and that a cooling of skin temperature produces a reversible platelet dysfunction. Data also suggest that when a hypothermic patient bleeds without surgical cause, skin and wound temperature should be restored to normal before the administration of blood products that are not only expensive but may also transmit disease. PMID- 3813689 TI - Local recurrences after subtotal esophagectomy for squamous cell carcinoma. AB - From July 1982 to June 1985, 100 patients with squamous cell carcinoma of the thoracic esophagus had esophageal resection and reconstruction using an abdominal and right thoracotomy approach (Lewis-Tanner operation). Five patients died within 30 days. The remaining 95 patients were studied prospectively for evidence of local recurrences. It was found that anastomotic recurrences occurred in eight patients, and mediastinal recurrences involving the intrathoracic stomach occurred in seven patients over a mean follow-up period of 13 months. The total local recurrence rate was 16% (15 of 95 patients). The incidence of anastomotic recurrence was shown to be related only to the length of the proximal resection margin and not related to tumor differentiation or lymph node metastases. A proximal resection margin of less than 5 cm measured at operation had a 20% risk of developing an anastomotic recurrence, and a margin of between 5 to 10 cm had an 8% risk. Mediastinal recurrences that encroached on the intrathoracic stomach were found to be related more to the extent of lateral spread of the primary tumor in the mediastinum than to the length of the resection margins. Postoperative radiotherapy in patients with palliative resections decreased the incidence of local recurrences. To reduce the incidence and consequences of local recurrence after esophagectomy, it is suggested that in patients with tumors in the upper thorax, a more complete esophagectomy is warranted, postoperative radiotherapy should be given to patients with short resection margins, and in patients with extensive mediastinal spread, use of the retrosternal route for reconstruction is preferred. PMID- 3813691 TI - Cognitive learning during surgical residency. A model for curriculum evaluation. AB - The program summary of the American Board of Surgery In-Service Training Exam (ABSITE) can be used to quantitate cognitive learning during a surgical residency and to identify areas of curricular weakness in a residency program. Knowledge on each question is categorized as high (known) or low (unknown) depending on the percentage of residents who answered correctly. Knowledge of Level 1 (entry) residents is then compared with Level 5 (exit) residents. Each ABSITE question can thus be categorized on entry versus exit as known-known, unknown-unknown, unknown-known, and known-unknown. Only about half of unknown knowledge on entry appears to become known on exit. Very little knowledge known on entry becomes unknown on exit. Weaknesses in specific subject areas can be readily identified by ranking questions according to the number of exiting residents who answer incorrectly. Use of this technique to quantitate cognitive learning in a residency program may allow objective assessment of changes in curriculum. PMID- 3813690 TI - Vasodilator prostaglandins (PG) prevent renal damage after ischemia. AB - Thromboxane (Tx) synthase but not cyclo-oxygenase inhibitors prevent acute tubular necrosis (ATN) after renal ischemia, a phenomenon believed to be due to stimulation of the endogenous production of vasodilating prostaglandins (PG). This study directly tests that vasodilating PG protect against the consequences of renal ischemia. Anesthetized, 500-g rats had right nephrectomy and 45 minutes of left renal pedicle clamping or sham clamping. The rats were treated with intravenous (I.V.) saline 1.9 mL/h starting 40 minutes after clamping or sham clamping. All rats except the sham group (N = 8) were pretreated 1 hour before ischemia with ibuprofen (12 mg/kg) to prevent prostanoid synthesis. Beginning 5 minutes before clamp release, the rats were treated intravenously for 2 hours with: saline vehicle (N = 9), PGE1 400 ng/kg/min (N = 6), nitroprusside 4 micrograms/kg/min (N = 8), or dopamine 3 micrograms/kg/min (N = 11). After 24 hours, sham rat creatinine level was 0.5 mg/dL and weight of the left kidney was 86.5% of the previously removed right kidney. Compared with sham rats, ischemia and saline treatment resulted in a rise in creatinine level to 2.7 mg/dL (p less than 0.05) and a rise in kidney weight to 101.9% (p less than 0.05); PGE1 led to a creatinine level of 1.1 mg/dL, a value lower than that of the rats treated with saline (p less than 0.05), and a kidney weight of 92.0%, a value similar to that of sham rats; nitroprusside and dopamine led to a rise in creatinine levels to 3.2 mg/dL (p less than 0.05) and 2.3 mg/dL (p less than 0.05), respectively, as well as a rise in kidney weight to 108.0% (p less than 0.05) and 105.4% (p less than 0.05), respectively. Histologic examination showed ATN in rats treated with saline, nitroprusside, and dopamine, but not in rats treated with PGE1. These results indicate that PGE1 protects the cyclo-oxygenase-treated kidney against ischemia-induced ATN. PMID- 3813692 TI - The Medical Defence Union. How the United Kingdom copes with mishap and malpractice. PMID- 3813693 TI - The Kapandji-Sauve operation. Its techniques and indications in non rheumatoid diseases. AB - The Kapandji-Sauve operation consists in the arthrodesis of the distal radioulnar joint surmounted with a segmentary resection of the lower ulna. This technique may be used not only in rheumatoid dislocations of the distal radioulnar joint instead of the resection of the distal end of the ulna (Moore-Darrach) but also in traumatic diseases such as dislocations, sprains, chronical instabilities of this joint and stiffness secondary to Colles fractures. Two techniques are described, following the original one proposed in 1936. The first one (Technique I) indicated to chronical instabilities secondary to sprains and distal radioulnar dislocations. In this case, the ulnar head is in right situation at the sigmoid notch level and may be blocked at this place with two screws in mid position of prono-supination. The gap between the two extremities of the ulna must be filled by the pronator quadratus to avoid bony reconstruction. The second one (Technique II) is especially designed for the limitations of the prono supination motion after Colles fractures, with shortening of the radius which causes an incongruency of the distal radioulnar joint and a positive ulnar variance. In this case it is necessary to lift up the ulnar head before blocking it in the sigmoid notch. A proceeding doing this automatically is described. Technique I was used in three cases and Technique II in four. In all cases the range of the prono-supination motion was normal in three to six weeks. The pains disappeared except a slight one when holding a load in supination position and when resting the hand unsteadily. The stability of the wrist was recovered allowing to unwind screw caps and to turn door knobs. PMID- 3813694 TI - The cervico-thoracic outlet compression syndrome. Analysis of surgical treatment. AB - Surgical treatment of the thoracic outlet compression syndrome is being presently reconsidered. Until these last few years, there was the choice between two interventions only: scalenotomy, a simple operation entailing no complication, but with a 60% recurrence rate--or the resection of the first rib through an axillary approach, an efficacious intervention which caused, however, serious nervous complications in 14% of treated cases. The follow-up of 75 cases operated for a TOCS reveals to the authors that--all techniques taken into account- results are unsatisfactory in 33% of cases. These failures are due either to technical deficiencies, or to a complication arising in the course of the operation, or to an erroneous diagnosis. The authors resort to surgery only to treat serious vascular syndromes (absolute indication) or invalidating neurological compression syndromes, after failure of physical therapy (relative indication). They propose a cervical approach--the only one enabling a safe dissection of the brachial plexus--a partial scalenectomy, resection of all fibrous bands pressing on nervous trunks, or the resection of a cervical rib. Should the costo-clavicular space appear anatomically too narrow, the first rib, already partially freed by the cervical approach, will be resected through the axillary route. PMID- 3813696 TI - [Round table: Current status of paralysis of the intrinsic muscles of the last four fingers]. PMID- 3813695 TI - Analysis of sequelae secondary to the radial forearm flap. A study of twenty-six cases. AB - The radial forearm flap is used extensively in hand and reconstructive surgery. We have performed 31 radial forearm flaps (15 free and 16 pedicled flaps) in 25 adults and 5 children. This series was analyzed in an attempt to minimize the sequelae of the upper limb and provide more specific indications for this flap. Vascular sequelae were assessed by Doppler and thermography examinations. The functional sequelae were appreciated by wrist motion and grasp strength examinations. Cutaneous sequelae were evaluated according to the time of healing and the quality of the scars. Several technical modifications may be proposed in order to try to minimize sequelae. As shown by our study, cutaneous sequelae are the most important and they must always be considered in the indication of this flap. PMID- 3813697 TI - [Loss of digital tissues and carpal canal syndrome. Apropos of 3 cases]. AB - We have observed three cases of carpal tunnel syndrome (CTS) complicated by cutaneous ulcerations and acroosteolysis. Although our first patient had a mild case of CTS, he had a concomitant amphetamine addition. This led to a mania for gnawing away at the digits in the territory of the median nerve. Our other two patients had severe cases of CTS. One suffered from diabetes and the other from primary amyloidosis. Surgical decompression of the median nerve was carried out in these two cases and led to rapid healing of the cutaneous lesions. The latter patients suffered from the entity known in the french literature as carpal tunnel "ulcero-mutilating" (ulcero-osteolytic CTS). This paper discusses possible mechanisms for its pathogenesis. In one of our cases, for example, we were struck by the role played by the patient's behavioral habits whether it be conscious or subconscious in the self-perpetration of the cutaneous and osseous lesions. PMID- 3813698 TI - [Value of Samii's method in the treatment of digital neuromas]. AB - The treatment of pain after digital amputation consists of surgical treatment if the pain is due to excessive nociception on the nerve. With micro-surgical technique, it is possible, like Samii, to suture some of the fascicles into central direction with the other nerves fascicles, after resection of the nervroma; or to anastomose the nerve with the other nerve, if we have two nevromas on the same digital amputation stump. Results of this technique are generally progressive disappearance of the pain. PMID- 3813699 TI - [Revascularization of digital avulsion injuries caused by rings]. AB - The authors describe an original technique of ring fingers revascularization, avoiding two chief dangers met in the double vein grafts: the one of the joint and tendinous devascularization with its risks of stiffness, and the other one of the devascularization of the skin sheath with secondary necrosis or trophic trouble. The worse artery is resected and the defect is bridged by a long venous graft, the skin of the distal fingers being provided by the backflow. PMID- 3813700 TI - Cryoablation, a versatile tool in arrhythmia surgery. PMID- 3813701 TI - Cryoablative techniques in the treatment of cardiac tachyarrhythmias. AB - Of 175 patients treated surgically for potentially lethal or refractory cardiac tachyarrhythmias, 53 underwent mapping and definitive operation using cryoablative techniques as the primary or adjunctive method. Included were 16 patients with supraventricular tachycardia caused by accessory pathways (Kent bundle) in the right anterior or posterior paraseptal location. Cryoablation was successful in abolishing tachycardia in 93.7% (15 of 16). Six patients (100%) with permanent junctional reciprocating tachycardia were cured by cryoablation. Eighteen of 19 patients with atrial ectopic tachycardia were treated by cryoablation alone or in combination with excision of the atrial appendage, with success in 15 (83.3%). Five of these were left atrial foci cured by cryoablation. Fourteen right atrial foci were treated by excision of the appendage only (1 patient), excision of the appendage and local cryoablation (8 patients), and cryoablation alone (5 patients). Three of these underwent partial (2 patients) or complete (1 patient) atrial disconnection after excisional and cryoablative techniques failed to control the tachycardia. Multiple ectopic atrial foci were common (9 patients), and successful cryoablation was accomplished in 100% of the patients with a single atrial ectopic focus (10 patients) but in only 66% of those with multiple foci. Thirteen of 19 infants with critical ventricular tachycardia were treated by cryoablation at the site of the ectopic focus, either alone or in combination with excision of the area. Elimination of tachycardia was accomplished in 13 patients (100%). Myocardial hamartoma (Purkinje cell tumor) was the histological diagnosis in 11 of the infants with ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813702 TI - Management of infective endocarditis: seventeen years' experience. AB - Infective endocarditis remains a serious illness with a high mortality. In more than 75% of 417 patients, the infection was due to gram-positive microorganisms. The non-drug-addicted patients (33%) were elderly and debilitated with advanced illness that preceded the endocarditis. The drug-addicted patients (67%) were young and were infected with multiple kinds of microorganisms. The blood cultures grew strains of Staphylococcus aureus resistant to methicillin sodium and nafcillin sodium in a majority of patients. Gram-negative microorganisms and fungi were cultured almost exclusively from samples from the drug-addicted patients. The high mortality among the non-drug-addicted patients (28%) was related to their advanced age and debilitating illness. The high mortality among the drug-addicted patients (21%) was related to the complex bacteriology of their infections and the severe anatomical disruption of the valvular complexes of the heart. When cured of their disease after treatment with intravenously administered antibiotics or a valve procedure or both, their long-term survival was related to whether or not they abstained from their habit. If the patient abstained from the use of drugs, the chances of survival were good; if not, death invariably ensued. This experience strongly supports our contention that if a patient returns to the use of drugs and reinfects the valve after initial cure, a second valve operation is contraindicated. PMID- 3813703 TI - Surgical treatment of atrioventricular canal malformations. AB - This study reports our experience with a consecutive series of 106 patients with atrioventricular (AV) canal malformations operated on between March, 1972, and June, 1985. There were 11 ostium primum defects, 90 partial forms of AV canal, and 5 complete forms of AV canal. Associated cardiovascular lesions were found in 26 patients. Operation was performed under total-body perfusion. There were 5 postoperative deaths, and the overall mortality was 4.7%. Eighty-seven patients were followed up. Follow-up averaged 6 years 7 months. The study shows that the long-term results in patients with mild preoperative mitral insufficiency are better than those with severe mitral insufficiency, and suggests that partial approximation of the mitral cleft is probably the method of choice in most patients. PMID- 3813704 TI - Significance of metastatic disease in subaortic lymph nodes. AB - Thirty-five patients underwent resection of primary bronchogenic carcinoma of the left upper lobe or left main bronchus in the presence of metastatic disease in subaortic lymph nodes. No patient had metastatic disease in other mediastinal node stations. There was 1 postoperative death. Complete follow-up is available on 34 patients. Three-year and five-year actuarial survival for the entire group is 44% and 28%, respectively. For 23 patients undergoing complete resection, five year actuarial survival is 42%. Resection of primary bronchogenic carcinoma in the presence of subaortic nodal metastases is associated with improved survival relative to reports of survival following resection of metastatic disease in other mediastinal node stations. Resection should be undertaken in these patients especially when it is judged that the resection is likely to be complete. PMID- 3813705 TI - Management of airway trauma. II: Combined injuries of the trachea and esophagus. AB - Twenty-four consecutive patients with combined injuries of the trachea and esophagus were operated on at the Tulane University Hospital and the Charity Hospital of New Orleans between 1967 and 1983. Only 3 of the injuries resulted from blunt trauma, and 1 of these patients had a total transection of both the trachea and esophagus; the remaining injuries were due to penetrating trauma (20 gunshot wounds; 1 stab wound). The combined lesions involved the cervical region in 20 patients and the thoracic esophagus and trachea or bronchus in 4. All patients underwent bronchoscopy; in recent years all have had esophagoscopy, because our experience indicates that esophagrams, which patients also underwent, have a high rate (12.5%) of false negative results. Operative techniques included a two-layer closure of all esophageal injuries, closure of the trachea with non absorbable monofilament suture, and transthoracic or cervical drainage. Muscle flaps were used for suture line reinforcement. Associated operative procedures included tracheostomy (5), laparotomy (4), vascular procedures (5), neurologic procedures (2), and closed-tube thoracostomy (6). Five patients (21%) died in the perioperative period, 4 of 20 with combined cervical injuries, and 1 of the 4 with combined thoracic injuries. Deaths resulted from missed injuries to the esophagus (2 patients), a missed tracheal injury (1), associated vascular injury (1), and associated thoracoabdominal injury (1). Two patients experienced cervical esophageal suture line leaks, both of which sealed with conservative therapy. Clinical follow-up showed good results in 90% of the patients who survived.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813707 TI - Reoperations for left-sided low-profile mechanical prosthetic obstructions. AB - A series of 2,474 hospital survivors of primary mitral, aortic, and double mitral aortic valve replacement were observed for a cumulative period of 11.945 years (mean, 4.2 years; range, 0.6-14 years). The linearized incidences of reoperations for thrombotic obstructions were 0.33 +/- 0.08% for mitral valve replacement, 0.36 +/- 0.1% for aortic valve replacement, and 0.42 +/- 0.1% for double valve replacement (p = not significant). Forty-one patients (16 mitral, 12 aortic, and 13 double valve replacements) underwent a total of 44 reoperations with a mean interval of 36 +/- 29 months (range, 0.25-85 months) between operations. Diagnosis was established invasively only in 13 patients (30%). Hospital mortality at reoperation was 18% (8 patients); 28 patients (63%) required emergency surgery. The choice surgical procedures were thrombectomy for clotted aortic prostheses (18 of 24) and valve replacement for obstructed mitral valves (22 of 25; p less than .001). Rethrombosis occurred in 3 patients (1 aortic and 2 double valve replacements). At hospital admission 17 patients (38%) had prothrombin times outside therapeutic ranges (between 20 to 30% of the normal value). The incidence of reoperations for thrombosis in low-profile mechanical prostheses was unaffected by valvar position and number of prostheses implanted. Rethrombosis occurred only in previously cleaned valves, although its occurrence was not significant. The present results indicate that, as experience is gained in the diagnosis and surgical management of this complication, hospital mortality can be reduced significantly (from 37% to 4%). PMID- 3813706 TI - Preliminary evaluation of cocarboxylase on myocardial protection of the rat heart. AB - The presence of cocarboxylase (CC) is essential for the oxidation of pyruvate to acetylcoenzyme A (acetyl-CoA) and its subsequent degradation by means of the Krebs cycle. We compared the effects of various concentrations of CC in a cardioplegic solution on the survival and hemodynamic and metabolic recovery of 23 isolated, working rat hearts subjected to 60 minutes of hypothermic (23 degrees C) ischemic arrest. Group 1 (N = 6) consisted of hearts infused with the basic cardioplegic solution (Tyers' solution with glucose), to which no CC was added. In group 2 (N = 6) CC was added at 0.1 ml/L to the cardioplegic solution. In group 3 (N = 5) CC was added at 1 ml/L, and in group 4 (N = 6) CC was added at 10 ml/L. The cardioplegic infusions were performed at a pressure of 40 mm Hg for 2 minutes just before arrest; 30 minutes later they were performed again for 1 minute. Only two hearts (33.3%) recovered in group 1 whereas five recovered in group 2, five (100%) in group 3, and five (83.3%) in group 4. The recovery of hemodynamic performance as a percentage of preischemic control values showed marked improvement in the CC groups, especially group 3, when compared with group 1. The metabolic variables in the CC groups were also markedly improved, with significantly (p less than .05) decreased levels of tissue lactate and increased levels of creatine phosphate compared with those in group 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813708 TI - Long-term results of DeVega tricuspid annuloplasty. AB - DeVega tricuspid annuloplasty was performed in 74 patients undergoing mitral or mitral and aortic valve replacement between January, 1972, and December, 1985. Sixty-two hospital survivors have been followed up for a mean of 85.3 +/- 6.6 months. Actuarial survival at 14 years was 71.5 +/- 8.2%. None of the late deaths was related to the tricuspid annuloplasty. Three patients required tricuspid valve replacement for recurrence of tricuspid regurgitation (0.68% per annum). Eleven asymptomatic patients studied hemodynamically at a mean period of 53 months after the operation showed maintenance of the hemodynamic improvement. We recommend DeVega annuloplasty as the method of choice for moderate to severe tricuspid regurgitation in the absence of an organically diseased or deformed valve. PMID- 3813709 TI - Impalement injuries to the thorax as a result of motor vehicle accidents. AB - We report three cases of thoracic impalement by large-diameter steel pipes as a result of motor vehicle accidents. The steel pipes were removed in all patients in the operating room under general anesthesia and controlled circumstances. Despite the dramatic nature and presentation of these injuries, all 3 patients had nonlethal injuries and have recuperated without sequelae. Orderly care with standard surgical procedures is required and will give good results. PMID- 3813710 TI - Surgical management of infants with complex cardiac anomalies associated with reduced pulmonary blood flow and total anomalous pulmonary venous drainage. AB - Eight infants with complex cardiac anomalies and pulmonary stenosis or atresia were noted to have obstructed total anomalous pulmonary venous drainage (TAPVD) either at the initial cardiac catheterization (Group 1; n = 2) or after creation of systemic-pulmonary artery shunts (Group 2; n = 6). The 2 patients in Group 1 underwent early repair of TAPVD (1 at 7 days, the other at 1 1/2 months of age) before any subsequent operation and are now doing well at 18 months of age. The 6 patients in Group 2 underwent repeat cardiac catheterization because of persistent severe cyanosis with faint or absent continuous murmur and were found to have patent shunts and obstructed TAPVD (1 mild, 5 severe). One patient who underwent repair of TAPVD at 2 1/2 months of age survived and is well at 2 years of age, whereas 4 patients who underwent repair at an average age of 6 months (age range, 3-16 months) subsequently died. The sixth patient, who did not undergo repair, remained severely cyanotic with hypoplastic pulmonary arteries in spite of repeated shunts. We feel that increased awareness of the possible association of TAPVD and reduced pulmonary blood flow in infants with complex cardiac defects, in combination with echocardiography, oxygen saturation studies, and angiography with prostaglandin E1 challenge, should lead to early diagnosis, avoidance of unnecessary systemic-pulmonary artery shunts, and increased survival rates in these infants. PMID- 3813712 TI - Left atrial myxoma: pulmonary infarction caused by pulmonary venous occlusion. AB - Atrial myxomas are the most common primary cardiac tumors. Typical complications include congestive heart failure, systemic emboli, or vasculitic type syndromes. Presented is a case of postpartum congestive heart failure in a 17-year-old girl. Echocardiography revealed a left atrial mass. Intraoperatively this mass was found to be extending into and occluding the left pulmonary veins. Left pulmonary infarction had occurred, and left pneumonectomy was required to completely remove the lesion. This case thus represents an unusual complication of left atrial myxoma. PMID- 3813711 TI - Budd-Chiari syndrome resulting from a membranous web of the inferior vena cava: operative repair using profound hypothermia and circulatory arrest. AB - A 47-year-old man was seen with Budd-Chiari syndrome caused by a congenital membranous web obstructing the inferior vena cava (IVC) above the hepatic veins. Operative repair was accomplished using cardiopulmonary bypass, profound hypothermia (24 degrees C), and 10 minutes of circulatory arrest. This technique permitted accurate resection of the web, thorough removal of thrombus from the IVC and the hepatic veins, and repair of the atriocaval junction with an autologous pericardial patch. Postoperative angiographic study showed unobstructed flow through the IVC with filling of the hepatic veins. We believe this is the first report of use of this technique to treat Budd-Chiari syndrome resulting from a congenital web obstructing the IVC and hepatic veins. PMID- 3813714 TI - Nonoperative removal of entrapped thoracic intracardiac monitoring catheters: a new bedside technique. AB - Flexible guidewires introduced into transthoracic intracardiac monitoring catheters can release entrapped areas of acute angulation caused by fascial closure sutures. This technique has been successfully applied to adult and pediatric patients with various sized guidewires and catheters, thus obviating the need for surgical removal of the entrapped monitoring catheters. Because entrapment with subsequent fracture of these monitoring catheters represents the most common complication of their use, lessening of this risk supports their continued widespread implementation. PMID- 3813713 TI - Coarctation of the aorta: anastomotic enlargement with subclavian artery: two new surgical options. AB - Recoarctation is still observed following surgical treatment of coarctation in small infants. Modifications to conventional surgical techniques are suggested to avoid this serious complication. Coarctectomy is performed. To obtain a much wider noncircumferential anastomosis, the subclavian artery is used to enlarge it either as a flap or by reimplantation. No residual pathological tissue is left behind, and this should help prevent recurrence. PMID- 3813715 TI - Continuous povidone-iodine irrigation. PMID- 3813716 TI - Myocardial preservation. PMID- 3813717 TI - Pitfalls of intermittent aortic cross-clamping for myocardial protection. PMID- 3813718 TI - Disseminated candidiasis in drug abusers. PMID- 3813719 TI - Ventricular tachycardia, or accelerated junctional rhythm? PMID- 3813721 TI - Leukocytosis in infection. PMID- 3813720 TI - Splenectomy for thrombocytopenia in chronic liver disease. PMID- 3813722 TI - Metabolic abnormalities and vertigo? PMID- 3813725 TI - Coronary-prone behavior pattern. PMID- 3813724 TI - Pulmonary arteriography: the gold standard. PMID- 3813723 TI - Diuretics and blood pressure. PMID- 3813726 TI - Ambulatory training of residents. PMID- 3813727 TI - Pseudoxanthoma elasticum and rheumatoid arthritis. PMID- 3813728 TI - Mesothelioma as carcinoma? PMID- 3813729 TI - High-dose intravenous immunoglobulin in the management of myasthenia gravis. PMID- 3813730 TI - Tests for mononucleosis and chronic daytime sleepiness. PMID- 3813731 TI - Empty sella in a case of Werner's syndrome. PMID- 3813732 TI - Questioning the value of esophageal motility testing in chest pain of noncardiac origin. PMID- 3813733 TI - Risk factors for acquiring pneumococcal infections. PMID- 3813734 TI - Approaching an understanding of the genetic basis for autoimmune thyroid disease. PMID- 3813735 TI - The unusual presentations of tularemia. Bacteremia, pneumonia, and rhabdomyolysis. PMID- 3813736 TI - An improved diagnostic approach to ascites. PMID- 3813737 TI - Cancer and venous thromboembolism. PMID- 3813738 TI - Impact of computed tomography on stroke management and outcome. AB - Computed tomographic (CT) scanning is effective to show cerebrovascular lesions causing the symptoms and signs of a stroke. However, CT scanning may not change stroke morbidity or mortality. A retrospective medical chart review compared 93 patients with cerebral infarctions treated before CT scanning was available with 92 patients who had undergone scanning. The two groups showed no difference in type of treatment given or in subsequent severity of disability, mortality, or discharge destination. However, the post-CT group had a significant reduction in the total number of neurodiagnostic procedures, but estimated total charges for all diagnostic procedures were not significantly reduced. Computed tomographic scanning may not be beneficial for stroke patients who have a clear history of acute onset, are alert, and have no findings indicating an intracranial mass. PMID- 3813739 TI - Diabetic renal hypouricemia. AB - In diabetes, the serum uric acid level is low due to increased urate clearance; however, its mechanism remains unknown. We examined seven maturity-onset diabetic patients with rarely reported hypouricemia due to renal tubular abnormality to better understand the renal handling of urate by the diabetic kidney. The results of studies indicate that the increase in urate clearance was entirely accounted for by increased pyrazinamide-suppressible urate clearance. The maximal uricosuric response to probenecid administration was exaggerated. The effects of drugs on urate clearance were similar to those we have previously reported in the syndrome of inappropriate secretion of antidiuretic hormone. In four patients, the family survey did not reveal anyone with hypouricemia. These observations suggest that hypouricemia due to hyperuricosuria, which responds markedly to pyrazinamide and probenecid, is actually an indicator of renal tubular abnormality in diabetics. PMID- 3813740 TI - Early treatment of acute myocardial infarction with intravenous streptokinase. A high-risk syndrome. AB - Fifty-one successive patients treated with intravenous streptokinase 1.7 +/- 0.8 (mean +/- SD) hours after onset of symptoms of acute myocardial infarction were evaluated during a three-month posthospital follow-up period. Coronary angiography was performed four to nine days after the initial hospital admission. Twenty-eight patients had a second late angiogram. Forty-one patients had successful reperfusion but only 25% of all patients were without significant clinical cardiovascular manifestations during this period. Postmyocardial infarction angina pectoris occurred in 21 patients, an abnormal stress test result was present in 28 patients, eight patients developed congestive heart failure, and five patients had reinfarction. An intervention with percutaneous transluminal coronary angioplasty or coronary artery bypass graft was performed in 15 (37%) of 41 reperfused patients. A significantly higher intervention rate was present in patients treated with streptokinase within one hour following the onset of symptoms. Early reocclusion (within three months of the infarct) was noted in patients with 60% or more residual stenosis in their infarct-related coronary artery. These patients also had a significantly greater incidence of angina pectoris. Our findings indicate that early thrombolytic therapy of acute myocardial infarction preserves myocardium, and since the infarct-related artery is patent, but narrowed, the jeopardized area is responsible for a high-risk syndrome with an increased likelihood of ischemic symptoms. An early aggressive approach may be indicated, especially for patients with greater than 60% residual stenosis in their infarct-related coronary artery. PMID- 3813741 TI - Occult malignant neoplasm in patients with deep venous thrombosis. AB - An association between venous thrombosis and cancer was first suggested by Armand Trousseau and subsequently confirmed by multiple postmortem studies. In a previous study, patients with pulmonary embolism, as assessed by pulmonary angiography, were at significantly increased risk of occult cancer with a comparison group of patients without pulmonary embolism. This nonconcurrent prospective epidemiologic study extends these findings by demonstrating a significantly increased risk of occult cancer in patients with deep venous thrombosis (DVT) confirmed by impedance plethysmography as compared with those with suspected DVT in whom the diagnosis was ruled out. Differences in the incidence of malignant neoplasms were greatest within the first two years after the diagnosis of DVT, and patients younger than 50 years with venous thrombosis were at particularly increased risk of occult cancer (relative risk, 19.0). These findings indicate that all patients with DVT or pulmonary embolism should have an appropriate diagnostic workup and careful follow-up, particularly with regard to the risk of occult cancer. PMID- 3813742 TI - Relationship of prior myocardial infarction to false-positive electrocardiographic diagnosis of acute injury in patients with chest pain. AB - Prompt management of patients suffering acute myocardial infarction requires accurate early diagnosis based on the electrocardiogram. To assess the predictive value of ST segment elevation and ST segment depression (both greater than or equal to 0.1 mV) for the diagnosis of evolving myocardial infarction, we studied 100 consecutive patients admitted to the coronary care unit of The New York Hospital with at least 30 minutes of chest pain. Of 31 patients with ST segment elevation, 26 patients (84%) evolved myocardial infarction (positive test results for serum creatine phosphokinase-MB isoenzyme fraction), while only 13 (48%) of 27 patients with ST segment depression had myocardial infarctions. Among patients with ST segment elevations with a history of prior myocardial infarction, only five (50%) of ten evolved myocardial infarction, compared with 21 of 21 with no prior infarction. False-positive diagnoses of acute injury were due to ST elevation in the area of prior Q wave infarction. Prior myocardial infarction did not alter the lower predictive value of ST segment depression for evolving infarction. We conclude that patients presenting with chest pain and ST segment elevation have approximately twice the likelihood of myocardial infarction than patients with ST segment depression; incorporation of historic information regarding prior myocardial infarction can improve the predictive value of ST segment elevations to 100% but does not improve prediction with ST segment depressions. PMID- 3813743 TI - Factors associated with a poor outcome in tularemia. AB - To identify the factors associated with a poor outcome, we reviewed the records of 28 patients with tularemia diagnosed between 1974 and 1984. Most of the patients were men between the ages of 35 and 45 years, who presented with ulceroglandular tularemia. Twelve patients had the anticipated rapid response to therapy, with resolution of their presenting symptoms within one week (group A). Surprisingly, the majority (16 [58%] of 28) had a more prolonged or fatal illness (group B). Group B patients more often had a serious underlying medical disorder, and waited longer before seeking medical attention. Only patients in group B presented with electrolyte or renal function abnormalities (31%), pneumonia and pleural effusions (25%), elevated serum creatine phosphokinase levels (25%), and Francisella tularensis bacteremia (12.5%). Sterile pyuria, however, was an unexpectedly frequent finding in both groups. Group B patients more often experienced a prolonged delay from the time of physician contact to therapy, and were not treated with an aminoglycoside; relapse (12.5%) and death (6.2%) occurred only in group B. Thus, earlier and more appropriate intervention by the physician may have prevented some of the increased morbidity in our patients. These findings suggest that rapid presumptive aminoglycoside therapy (gentamicin sulfate or streptomycin sulfate) should be considered soon after tularemia is suspected, especially for patients with serious underlying medical disorders. PMID- 3813744 TI - Clinical summary and course of idiopathic anaphylaxis in 73 patients. AB - Seventy-three patients with anaphylaxis of unknown cause were studied. Repeated histories and physical examinations were performed by the Northwestern University (Chicago) allergy service in an attempt to find a cause for the anaphylaxis. Documentation of abnormal physical findings during an episode of anaphylaxis was necessary in each patient. Prior to our initial consultation, these 73 patients had required 115 emergency room visits and 37 hospitalizations. No deaths have occurred in 224 patient years of follow-up from initial presentation. Thirty eight (52%) patients have infrequent reactions (defined as one episode only or mild episodes less than six times per year) requiring acute treatment alone. Thirty-five (48%) patients have severe or frequent life-threatening reactions (defined as episodes that include syncope, documented hypotension, and airway compromise as major manifestations) requiring maintenance antihistamines and prednisone. Laboratory studies were not helpful in finding a cause of anaphylaxis in any of the 73 patients. Associated atopic conditions were present in 45 patients. Twenty-three patients had chronic idiopathic angioedema, urticaria, or both prior to developing idiopathic anaphylaxis. Sixteen patients only treated acutely for each episode of anaphylaxis and seven patients previously receiving maintenance medication are now asymptomatic without medication for longer than one year. PMID- 3813745 TI - Hypercalcemia. A complication of advanced chronic liver disease. AB - Hypercalcemia has not previously been recognized as a complication of advanced chronic liver disease without hepatoma. During a five-year period, 16 patients evaluated in the liver transplantation program at the University of Pittsburgh developed hypercalcemia. All had advanced chronic liver disease with mean total bilirubin concentration of 29.5 +/- 4.6 mg/dL (50.1 +/- 78.2 mumol/L) (mean +/- SEM) and prothrombin time 16.8 +/- 0.8s. The highest serum calcium level was 17.2 mg/dL (4.3 mmol/L). The mean serum calcium level was 11.7 +/- 0.3 mg/dL (2.93 +/- 0.075 mmol/L) with an ionized calcium level of 5.41 +/- 0.35 mg/dL (1.35 +/- 0.088 mmol/L) and a phosphorus level of 4.2 +/- 0.4 mg/dL (1.4 +/- 0.1 nmol/L). Mild to moderate renal insufficiency was present in 14 (87%) patients; the mean serum creatinine level was 2.8 +/- 0.4 mg/dL (247 +/- 35 mumol/L). In five (38%) patients parathyroid hormone was completely suppressed and in an additional five (38%) patients, it was in a range most compatible with nonhyperparathyroid hypercalcemia. The 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D levels were normal or low in the 11 patients in whom determinations were made. Hypercalcemia that is not due to hyperparathyroidism or hypervitaminosis D is a potential complication of advanced chronic liver disease. PMID- 3813746 TI - An accurate method to obtain urine for culture in men with external catheters. AB - Results of urine cultures from 26 male nursing home patients wearing external catheters, collected by a simple standardized technique, were compared with culture results from the same patients obtained by sterile in-and-out catheterization. The culture results were the same in 22 (85%) of the matched specimens, and specimens collected by the standardized technique were 100% sensitive and 94% specific in detecting significant growth of pathogenic organisms. In contrast, 13 (57%) of 23 specimens collected from patients with external catheters by the nursing home staff using their routine technique yielded three or more organisms and were considered contaminated. These results suggest that it is possible to obtain a urine specimen that reflects bladder urine in the vast majority of patients with external catheters, and thus potentially avoid the need for in-and-out catheterization when diagnosing and planning treatment for urinary tract infections in this population. PMID- 3813747 TI - Ecthyma gangrenosum without bacteremia. Report of six cases and review of the literature. AB - We encountered six patients with ecthyma gangrenosum due to Pseudomonas aeruginosa who, uncharacteristically, had no evidence of bacteremia prior to the institution of antibiotic therapy. Seven similar cases have previously been reported in the English-language medical literature. These 13 patients resembled those with classic ecthyma gangrenosum accompanied by Pseudomonas septicemia in being immunocompromised and neutropenic and having skin lesions at similar sites. The most striking difference between these two groups of patients was a significantly lower mortality rate for the nonbacteremic patients. These findings suggest that ecthyma gangrenosum can occur as a primary skin lesion in the absence of bacteremia. Patients with this particular subtype of infection appear to have a better prognosis than those having a preceding bacteremia. PMID- 3813748 TI - Subclavian vein stenosis as a complication of subclavian catheterization for hemodialysis. AB - Thirteen patients had placement of a subclavian vein catheter for temporary vascular access for hemodialysis. Peripheral venography was performed within two to six weeks of catheter placement. Forty-six percent (six of 13 patients) developed subclavian vein narrowing, which resolved in two patients. The duration of catheter placement had no impact on the incidence of this complication. Subclavian vein catheterization can frequently lead to subclavian vein stenosis, which often will resolve spontaneously. Consideration should be given to placement of subclavian lines on the contralateral side of a planned permanent vascular access. PMID- 3813749 TI - Fine-needle aspiration. Usefulness for diagnosis and management of metastatic carcinoma to the thyroid. AB - The usefulness of fine-needle aspiration (FNA) for the diagnosis and management of metastatic carcinoma to the thyroid was determined by reviewing the records of 19 patients identified during a six-year period. Fine-needle aspiration was able to document metastatic cancer to the thyroid in 14 patients with, and five patients without a history of prior nonthyroidal cancer. Breast, kidney, and lung were the most frequent carcinomas metastatic to the thyroid. Age range and time from diagnosis of the primary carcinoma to documentation of metastasis were similar to those in prior surgical series from this institution. The finding of metastatic disease on FNA was totally unexpected in four patients. The possibility of metastasis was not mentioned before FNA in six patients with a known history of nonthyroidal cancer. Only six patients underwent a thyroid operation after FNA. Fine-needle aspiration was able to direct appropriate surgical or conservative management without adversely affecting survival among patients. PMID- 3813750 TI - Exercise thallium imaging in patients with diabetes mellitus. Prognostic implications. AB - We used exercise thallium 201 imaging in 123 patients with diabetes mellitus (77 men and 46 women, aged 56 +/- 8 years), 75% of whom had angina pectoris (typical or atypical). During exercise testing, 18 patients (15%) had angina pectoris, 28 (23%) had ischemic ST changes, and 69 (56%) had abnormal thallium images. During follow-up (up to 36 months), there were 12 cardiac events; four patients died of cardiac causes and eight had nonfatal acute myocardial infarction. Univariate and multivariate survival analysis identified two independent predictors of cardiac events: the event rate was significantly less in patients with normal images and exercise heart rate over 120 beats per minute than in patients with abnormal images and exercise heart rate of 120 beats per minute or less (0% vs 22%). The patients with abnormal images or exercise heart rate of 120 beats per minute or less had an intermediate event rate (11.5%). Furthermore, two of the 54 patients with normal images and ten of 69 patients with abnormal images had subsequent cardiac events. Thus, exercise thallium imaging is useful in risk stratification in patients with diabetes mellitus. PMID- 3813751 TI - Efficacy and safety of aztreonam in the treatment of serious gram-negative bacterial infections. AB - Aztreonam was used in the initial treatment of infection of the urinary tract (23 cases), respiratory tract (17 cases), skin and soft tissue (12 cases), abdominal cavity (three cases), endocarditis (two cases), septicemia (eight cases), and osteomyelitis (two cases). In 26 of 60 evaluable infectious episodes, aztreonam was used alone. Clinical cure was observed in 35 of 60, improvement in 24 of 60, and failure in one of 60 cases. Ten patients developed subsequent superinfection. Aztreonam was well tolerated, although one case of exfoliative dermatitis and one of pseudomembranous colitis occurred. However, these cases were complicated by proximal administration of other antibiotics. PMID- 3813752 TI - Treatment of cancer-associated hypercalcemia with cisplatin. AB - Cisplatin (cis-platinum) has been shown to lower cancer-associated humoral hypercalcemia in an animal model and to inhibit bone resorption in vitro. This prospective study was designed to evaluate the efficacy of cisplatin in treating cancer-associated hypercalcemia in humans. Thirteen patients with severe hypercalcemia refractory to rehydration were treated with a 24-hour infusion of cisplatin, 100 mg/m2. Serial measurements of serum calcium and tumor size were made following cisplatin treatment and compared with pretreatment values. Nine patients (69%) achieved normocalcemia after treatment with cisplatin; and mean duration of benefit was 38 days in these patients. No reduction in tumor size was seen. All patients died of progressive cancer. We conclude that cisplatin can control malignant hypercalcemia for relatively long periods, and that its mechanism of action is not due to a reduction in tumor size. PMID- 3813753 TI - The Limulus amebocyte lysate assay. A rapid and sensitive method for diagnosing early gram-negative peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. AB - The Limulus amebocyte lysate (LAL) assay was used in a blinded, prospective fashion to analyze peritoneal fluids from 35 consecutive patients undergoing continuous ambulatory peritoneal dialysis (CAPD), who presented with clinical peritonitis. The results were correlated with standard microbiologic culture results. The LAL assay was positive in all three patients with gram-negative peritonitis, was appropriately negative in 24 of 28 gram-positive infections (sensitivity, 100%; specificity, 86%) and was positive in two of five cases in which there was no microbiologic growth. One of the two patients in this last group yielded a gram-negative organism two days later. It was then demonstrated that therapeutic concentrations of a variety of antibiotics (cefazolin sodium, gentamicin sulfate, tobramycin sulfate, ticarcillin disodium, penicillin G potassium, vancomycin hydrochloride, metronidazole hydrochloride, piperacillin sodium, and trimethoprim/sulfamethoxazole) did not interfere with the LAL assay. Together, these data indicate that the LAL assay is useful for identifying patients at high risk for gram-negative peritonitis and for excluding from possible aminoglycoside exposure the majority of patients with peritonitis undergoing CAPD, most of whom will have gram-positive infections. Furthermore, lack of antibiotic interference allows the possibility of monitoring treatment efficacy. PMID- 3813754 TI - Sheep-associated outbreak of Q fever, Idaho. AB - Between Feb 1 and Aug 31, 1984, an outbreak of 18 symptomatic cases of Q fever occurred in Idaho; these numbers represent an increase over the three cases reported in 1982 and the five reported in 1983. Four of the patients in the outbreak required hospitalization for two to five weeks; there were no fatalities. Eight of the cases had documented Q fever hepatitis, and one had pneumonia. All 18 of the 1984 cases for whom information was available were epidemiologically linked to visiting or working at a sheep research station and/or being exposed to animals from this research station. In this outbreak, patients typically had a hepatitislike illness associated with fever and severe headache. Severity of illness ranged from asymptomatic to life threatening. Cases of pneumonia and hepatitis due to Q fever continue to occur in the United States, especially among persons exposed to livestock. PMID- 3813755 TI - Recognition of alcoholism and substance abuse in primary care patients. AB - Alcohol and other substance abuse are frequently seen in primary medical practice but are underdiagnosed. Forty-two (14%) of 294 adult primary care patients suffered from alcohol or other substance abuse, as diagnosed by a structured psychiatric interview. Primary care physicians identified 17 (40%) of these patients, as well as another patient identified during a six-month follow-up period, as having a substance abuse problem at initial clinical evaluation. Clinically identified substance abusers were older, more likely to be married, and more often used multiple drugs. They more frequently had antisocial personality disorders, while patients not clinically recognized were often depressed. Logistic regression analysis indicated that the presence of antisocial personality, the absence of a coexisting depressive disorder, and better social functioning scores were the factors most strongly associated with clinical recognition. The study suggests clinical judgment issues, which may be useful to physicians in training to improve their recognition and treatment of substance abuse disorders. PMID- 3813756 TI - Diagnosis, staging, and surgical treatment of prostatic carcinoma. PMID- 3813757 TI - Paroxysmal supraventricular tachycardia and bundle branch block. PMID- 3813758 TI - Pulmonary embolism from a venous thrombus located below the knee. AB - A patient with bronchogenic carcinoma developed acute thrombophlebitis below the knee followed by pulmonary embolism. Sequential nuclear venograms, perfusion lung scans, bilateral impedance plethysmography, and the patient's clinical course indicated that the below-knee thrombus had embolized in its entirety, causing clinically significant disease. This case demonstrates that below-knee thrombi are not always benign and, in certain circumstances, merit anticoagulation. PMID- 3813759 TI - Recurrent pulmonary atelectasis as a manifestation of familial Mediterranean fever. AB - Recurrent attacks of pulmonary atelectasis were the leading sign of familial Mediterranean fever in a young man of Jewish-Georgian extraction. His mother suffered from the more common manifestations of the disease. Treatment with colchicine caused a complete disappearance of his attacks. However, when challenged by discontinuing colchicine therapy for eight days, another, documented attack of pulmonary atelectasis occurred. To our knowledge, this is the first case of familial Mediterranean fever presenting with recurrent pulmonary atelectasis. PMID- 3813760 TI - Rebound hypertension following abrupt cessation of clonidine and metoprolol. Treatment with labetalol. AB - Abrupt withdrawal of adrenergic blockers in a hypertensive subject may result in acute hypertensive crisis. This crisis results from marked increase in adrenergic discharge and upregulation of adrenoceptors. In a patient with hypertensive crisis following abrupt cessation of clonidine hydrochloride and metoprolol tartrate, intravenous administration of labetalol hydrochloride rapidly reduced blood pressure and heart rate to precrisis levels. The patient was subsequently maintained in a normotensive state by continued oral use of labetalol. This case study demonstrates that alpha- and beta-blocking activities of labetalol may be particularly beneficial in a hyperadrenergic state following abrupt withdrawal of adrenergic blockers. PMID- 3813761 TI - Myeloproliferative syndrome evolving in a patient with macromolecular lactate dehydrogenase. AB - A myeloproliferative syndrome, masked by severe iron deficiency, evolved in a woman with lactate dehydrogenase (LDH) complexed to IgA. Macromolecular LDH is an uncommon cause of increased serum LDH activity. By observing the patient's course for ten years, we were able to understand the initially puzzling clinical findings. PMID- 3813762 TI - Amniotic fluid cell culture: techniques and results. PMID- 3813763 TI - Ultrastructure of Entamoeba invadens cysts obtained under the effect of emetine, tinidazole and rifampin. PMID- 3813764 TI - Deterioration of intracellular destruction capacity of S. aureus in children with systemic lupus erythematosus. PMID- 3813765 TI - Physiological role of the pigment of the enamel in the rodent incisors. Its importance in experimental biology and medicine. PMID- 3813766 TI - Hormonal study in 100 patients with hypophyseal adenoma treated by surgical means. PMID- 3813767 TI - EEG and clinical patterns of limbic epilepsy induced by kainic acid in cats. PMID- 3813768 TI - The influence of concentration and relaxation on the EEG power spectra during a CNV paradigm. AB - EEG segments of 1 sec duration, beginning 1 sec before the imperative stimulus were analysed by Fast Fourier Transformation in a CNV paradigm with interstimulus intervals (ISI) of different durations (1, 3, 5 sec) and with constant (K1, K3, K5) and randomized (R1, R3, R5) ISI presentation. In the alpha band, there were found differences in the power spectra between the constant and the longer randomized (R3, R5) ISI conditions, the latter having a slower center frequency, a smaller radius of gyration and a higher kurtosis. This describes a sharper alpha line of slower frequency in the R3 and the R5 ISI condition, due to pronounced synchronisation of alpha activity. It is discussed as an expression of increased relaxation and reduced concentration. In the theta band, differences appeared between the short ISI conditions (K1, R1) and the longer ones. PMID- 3813769 TI - Increased efficacy of antidromic and orthodromic activation of cat alpha motoneurons upon arrival of coerulospinal volleys. AB - The present study demonstrates the enhanced efficacy of impulse initiation among the hindlimb alpha motoneurons of flexor and extensor origins (n = 35) upon electrical stimulation of the locus coeruleus (LC) in decerebrate cats. When combined with the LC-evoked excitatory postsynaptic potential (EPSP), intracellular hyperpolarization-induced partial and total blocks of antidromic invasion were overcome, resulting in full-spike generation in all cells (n = 21). In three other cells, partial blocks, representing the motoneuron refractoriness resulting from double stimulation at close intervals, were relieved by the concomitant LC-EPSP. When an antidromic volley occurred at a time when the somadendritic (SD) membrane was near threshold, LC stimulation was shown to increase the probability of full-spike initiation as well as to shorten the initial segment (IS)-SD delay, suggesting a coerulospinal enhancement of the safety factor for IS-SD impulse conduction. When coincident with the LC-EPSPs, group Ia EPSPs of flexor and extensor origins were demonstrated to reach the threshold of discharging the cells (n = 4). In those cells exhibiting prominent depolarizing synaptic noise (n = 10), LC stimulation was sufficient to cause the cell to fire action potentials presumably by interacting with concomitant excitatory synaptic drive. The present results advocate that the descending LC excitatory drive has engaged in the action potential initiation process of the alpha motoneuron, facilitating its reaching the firing threshold during concurrent depressed membrane excitability as well as subthreshold converging inputs. PMID- 3813770 TI - A massive but short lasting forebrain deafferentation during sleep in the rat and cat. AB - The rat and cat show just prior and sometimes after paradoxical sleep a short lasting behavioral stage characterized by: i) frontal cortex high amplitude spindle bursts and low frequency theta activity in the dorsal hippocampus, and ii) the lowest ventrobasal complex transmission level of all sleep-waking stages. The duration of this "intermediate" stage is increased at the expense of paradoxical sleep by low doses of barbiturate. The intercollicular "cerveau isole" preparation shows for hours the electrophysiological patterns of the intermediate stage. It is concluded that the intermediate stage of sleep corresponds to a forebrain massive deafferentation process leading to a functional disconnecting from the brainstem. For the survival of the species it is understandable that this behavioral stage is necessarily short lasting. PMID- 3813771 TI - On the question of nomenclature of homologous subdivisions of the inferior olivary complex. AB - The wide variety of terms, or other designations, that have been applied to the mammalian IO have been described above and are summarized in Tables I-IV. Although divergent in their general character there are some common threads that can be used to weave an acceptable and appropriate set of terms that can be applied to most, if not all, mammals studied to date. Concerning the MAO it is clear that there are six principal subdivisions of this part of IO (Table II A, II B). In addition to individual descriptive terms (such as 'ventral part') they have been designated as "subgroups", "cell groups", or "subnuclei" by various investigators. Since MAO, by its name (medial accessory nucleus) is already identified as a subdivision of IO, we suggest that the term 'subgroup' is appropriate to specify further subdivisions of this nucleus. With this in mind we suggest the following nomenclature for the MAO, subgroups, a, b, c (nucleus beta), and d (dorsal cap), the vlo, and dmcc. This is obviously a combination of styles currently in use yet when used together seem most appropriate for several reasons. First, the terms a-d have gained wide acceptance; acceptable equivalent terms for c and d are nucleus beta and dorsal cap, respectively. Second, this method method will accept present opinions concerning probable subdivisions of each subgroup, or future studies which may show that such further subparts exist. For example, such subdivisions can be designated as a and a1 (as is currently done in certain marsupials), b and b1 and so forth. Such an approach would also accommodate the suggestion that subgroup d (dorsal cap) in certain primates consists of two parts. It has been suggested that nucleus beta and subgroup c are separate entities in rat. However, the overwhelming opinion from studies on a variety of other forms is that these are separate terms for the same cell group. One could argue that nucleus beta in rat is subgroup c and what has been called c could be designated c1. Third, the terms vlo (ventrolateral outgrowth) and dmcc (dorsomedial cell column) have gained wide acceptance and, in our opinion, are preferable to other designations. To date no subdivisions of either of these cell groups have been proposed. In addition, the terms 'cell group g' and 'subnucleus g' have been used to describe parts of DAO and MAO, respectively. Consequently, continued use of this designation may confuse the terminology issue more than clarify it.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3813772 TI - Structural and chemical characterization of S-layers of selected strains of Bacillus stearothermophilus and Desulfotomaculum nigrificans. AB - The structures, amino acid- and neutral sugar compositions of the crystalline surface layers (S-layers) of four selected strains each of Bacillus stearothermophilus and Desulfotomaculum nigrificans were compared. Among the four strains of each species a remarkable diversity in the molecular weights of the S layer subunits and in the geometry and constants of the S-layer lattices was apparent. The crystalline arrays included hexagonal (p6), square (p4) and oblique (p2) lattices. In vitro self-assembly of isolated S-layer subunits (or S-layer fragments) led to the formation of flat sheets or open-ended cylindrical assembly products. The amino acid composition of the S-layers exhibited great similarities and was predominantly acidic. With the exception of the S-layers of two strains of B. stearothermophilus (where only traces of neutral sugars could be detected), all other S-layer proteins seemed to be glycosylated. Among these strains significant differences in the amount and composition of the glycan portions were found. Based on this diversity interesting questions may be asked about the biological significance of the carbohydrate units of glycoproteins in prokaryotic organisms. PMID- 3813773 TI - Analogs of the autoinducer of bioluminescence in Vibrio fischeri. AB - The enzymes for luminescence in Vibrio fischeri are induced only when a sufficient concentration of a metabolic product (autoinducer) specifically produced by this species accumulates. It has previously been shown that the autoinducer is 3-oxohexanoyl homoserine lactone and that it enters the cells by simple diffusion. To further study the mechanism of induction, we have synthesized several analogs of the autoinducer. The analogs were tested with V. fischeri for their inducing activity and for their ability to inhibit the action of the natural autoinducer. The compounds were found to display various combinations of inducing and inhibiting abilities. None of the compounds tested appeared to have any effect on cells of V. harveyi strain MAV or Photobacterium leiognathi strain 721, but several of the compounds decreased light output by P. phosphoreum strain 8265. These studies show that 1) the site of action of the autoinducer is not highly sterically constrained 2) the autoinducers of other species of luminous bacteria are likely to be quite different from that of V. fischeri and 3) a simple mode in which one autoinducer molecule binds to a single receptor protein site and thus initiates luciferase synthesis is inadequate. The analogs should prove useful in the study of the binding site and mode of action of the autoinducer. PMID- 3813775 TI - [Methyl bromide poisoning. II. Contribution of 2 cases]. PMID- 3813774 TI - Fermentation of xylose and hemicellulose hydrolysates by an ethanol-adapted culture of Bacteroides polypragmatus. AB - Bacteroides polypragmatus type strain GP4 was adapted to grow in the presence of 3.5% (w/v) ethanol by successive transfers into 1% (w/v) D-xylose media supplemented with increasing concentrations of ethanol. The maximum specific growth rate of the ethanol-adapted culture (mu = 0.30 h-1) was not affected by up to 2% (w/v) ethanol but that of the non-adapted strain declined by about 50%. The growth rate of both cultures was limited by nutrient(s) contained in yeast extract. The ethanol yield of the adapted culture (1.01 mol/mol xylose) was higher than that (0.80 mol/mol xylose) of the non-adapted strain. The adapted culture retained the ability to simultaneously ferment pentose and hexose sugars, and moreover it was not inhibited by xylose concentrations of 7-9% (w/v). This culture also readily fermented hemicellulose hydrolysates obtained by mild acid hydrolysis of either hydrogen fluoride treated or steam exploded Aspen wood. The ethanol yield from the fermentation of the hydrolysates was comparable to that obtained from xylose. PMID- 3813776 TI - [Trends in cerebrovascular disease mortality in Cuba]. PMID- 3813777 TI - [Factors which affect the prognosis of pneumococcal meningitis]. PMID- 3813778 TI - [Drusen. A cause of pseudopapilledema. Apropos of a case]. PMID- 3813779 TI - [Prevalence of migraine in the southern area of Madrid. Preliminary study]. PMID- 3813780 TI - [Use of ergotropic substances as stabilizers of intestinal flora]. PMID- 3813781 TI - [Middle-term course of craniopharyngiomas in children as a function of initial therapeutic choice]. AB - Despite numerous studies and publications, the treatment of craniopharyngiomas in children remains controversial. The present series of 33 cases, followed for the last 10 years, is analysed according to therapeutic protocols jointly defined, case by case, from each patient's features and in restricting the extent of surgical excisions. In agreement with other recently published series, two options give superior results: complete excision, when the risk is low; in the other cases, partial excision or rather a simple biopsy or decompression, followed by irradiation. Risks of relapse are thus quite reduced and mortality greatly reduced. The unavoidable consequence of hypopituitarism is easily treated. However, the frequency of psychic and/or neurologic sequellae as well as the risk of post-radiation complications should not be disregarded when selecting treatment. PMID- 3813782 TI - [Treatment of neonatal hypothyroidism. Comparative effects of levothyroxine and thyroid extracts]. AB - The authors compare the effects of treatment with thyroid extracts and levothyroxine on T3, T4 and TSH levels in 2 groups of 8 hypothyroid infants. Serum TSH levels were lower in infants receiving thyroid extracts on and after the 15th day. The interest of a treatment associating T4 and T3 and of adapted doses of LT4 is discussed. PMID- 3813783 TI - [Chemotherapy and ovarian function. Retrospective analysis in 17 girls treated for malignant tumor or hematologic disease]. AB - Ovarian function was investigated in 17 patients aged 13 5/12 to 30 years who had received various types of combined chemotherapy without any irradiation. Ovarian insufficiency was found in 6 cases with amenorrhea (n = 5) or irregular menstruations (n = 1). There is a high risk of sterility in these cases although as described in one case, a normal pregnancy occurred in spite of evidence of ovarian failure. Cyclophosphamide seemed to be less harmful when given before puberty. Great variations in individual susceptibility for relatively low doses were observed with this drug. The combination with other drugs in some protocols might play a role in these cases. At variance with results reported in adults, the MOPP chemotherapy used in children with Hodgkin's disease did not induce ovarian dysfunction. PMID- 3813784 TI - [Biosynthetic growth hormone and the opinions of pediatricians. The form of the problem after a regional survey]. AB - An enquiry was undertaken with 35 pediatricians in the area of Bordeaux, concerning the attitudes induced by the future availability of a synthetic growth hormone obtained by genetic engineering and which might allow for treatment of a greater number of children presenting with important growth retardation. Biosynthetic growth hormone is perceived as a innovative technologic advance. However, the pediatricians questioned showed prudence as to the risks of excesses as to indications. PMID- 3813785 TI - [Weight indices during the first 18 months of life in low birthweight infants]. AB - A prospective study was carried out among 190 low birthweight neonates (less than 2,500 g) in order to assess their ratio of total body fat by 2 adiposity indices: Weight/Height3 (W/H3) at birth and Weight/Height2 (W/H2) subsequently. Adequate for gestational age (AGA) girls with weight indices (W/H3) above the 10th percentile (AGA/I+) had a lower height than AGA/I- girls on the 6th (p less than 0.01) and 9th (p less than 0.05) months of corrected chronological ages. Mean weight and height of small for gestational age (SGA) neonates with weight indices (W/H3) lower than the 10th percentile (SGA/I-) were similar to the SGA/I+ as soon as 3 months of corrected chronological age. SGA/I+ infants experienced a progressive increase in low weight indices (W/H2) until 15-18 months without significant differences with SGA/I- at 3, 6, 9 months of corrected chronological age. Meanwhile, low indices (W/H2) were more frequently observed in SGA/I- at 15 18 months. Thus the early characteristics in weight indices disclose a lower ratio of body fat in SGA infants than in normal children, at least up to age 15 18 months. PMID- 3813786 TI - [Cushing's syndrome caused by multinodular adrenocortical dysplasia in a 3-year old child. Association with a neurologic syndrome]. AB - A case of multinodular pigmented adrenocortical hyperplasia occurring in a child aged 4 years is reported. The disease suggested an autonomously functioning lesion with low plasma ACTH. At surgery both adrenals presented with brown or yellow patches on the surface corresponding to multiple nodules. Unilateral adrenalectomy was followed by complete recovery and normal ACTH response to IV lysine vasopressin with a follow-up of 3 years. The patient also presented mild spastic diplegia and retarded mental development of unexplained origin. PMID- 3813787 TI - [Transient neonatal hypothyroidism in a neonate born of a mother with Hashimoto's thyroiditis]. AB - Transient neonatal hypothyroidism was found in a boy whose mother was treated for hypothyroidism due to Hashimoto's thyroiditis. During the neonatal period the infant had antithyroid microsomal and antithyroglobulin antibodies and immunoglobulins inhibiting cyclic AMP production by thyroid cells in vitro. After one year of treatment, all antibodies disappeared. Thyroid scintiscan and fixation in the neonatal period was negative and became positive 2 months after stopping treatment with normal fixation and cervical thyroid picture. The mother's serum contained the same antibodies: they crossed the placental barrier and were responsible for neonatal pathological manifestations. PMID- 3813788 TI - [Iconographic rubric. Pulmonary aspergilloma]. PMID- 3813789 TI - [Frequency and value of autopsy in perinatal death]. AB - In the province of Hainaut (Belgium), a study was undertaken in order to assess a pediatric pathology department, organized at the regional level. The study concerned 182 perinatal deaths, occurring among the 16,071 births in 9 maternity hospitals, in 1982 and 1983. The frequency of autopsies was 51%, both for stillbirths and for early neonatal deaths. It was 76% in the group of deaths related to congenital malformations and 48% in the group of deaths of unknown cause. The lack of an autopsy was explained in 20% of cases by the parents' refusal, in 8% of cases by the state of maceration of the fetus and by the obviousness of the diagnosis in 24%. In 46% of cases, no etiology was found and it appeared that the degree of physician interest was an important factor in the frequency of autopsies. Dissection alone revealed the cause of death in 13 of the 94 autopsies. In children presenting with congenital malformations, the performance of a complete pathologic study almost always led to genetic counseling for the parents. This counseling was almost never given when autopsy was not performed. PMID- 3813790 TI - [Pediatric management in public maternity hospitals. National survey for the year 1983]. AB - The authors report the results of a French national survey concerning the means of pediatric management of neonates in public maternity hospitals, during the year 1983. Answer rate was 56% from the 508 maternity hospitals surveyed and 87% in the Ile-de-France area. An important deficiency in human and technical resources is apparent from the results : there was no nursery nurse in more than two thirds of the maternity hospitals responding; 86% were below the desirable standards for pediatrician attendance (one weekly attendance per 100 labours per year) and 51% had less than half this personnel; 20% had no pediatric on-call system; there was a clear-cut deficiency for care and supervision equipment and for emergency laboratory tests necessary for the preparation before transfer of neonates with severe distress. A major reorganization of this system is necessary in order to improve perinatal mortality and morbidity. PMID- 3813791 TI - [Lupus and pregnancy]. PMID- 3813792 TI - [Kawasaki's syndrome and normal erythrocyte sedimentation]. PMID- 3813793 TI - [C-reactive protein and neonatal infection]. PMID- 3813794 TI - [Acute influenzal myositis]. PMID- 3813795 TI - [Magnetic resonance imaging in pediatrics]. PMID- 3813796 TI - [Respiratory history of children and chronic cough in adolescents]. AB - The purpose of this work was to study the relation between respiratory history during childhood and teenagers' chronic cough and possible abnormalities of pulmonary function. This etiological survey was carried out among 538 pupils with a chronic cough and 1,094 controls (boys and girls), teenagers attending school in Bordeaux and its surroundings (average age, 16.7 years). The data were collected by means of self-administered questionnaires among the teenagers and their parents. Spirometry was performed in a randomised sample of 172 pupils. A significant relation was found between chronic cough and both respiratory history and a decrease of F.E.V.1 (in boys and girls) and F.E.F. 25-75 (in girls only). Moreover this relation was present also among the subjects with incomplete answers and in the group of non-asthmatics. PMID- 3813797 TI - [Cardiac children surgically treated under deep hypothermia in the first months of life. Psychopedagogic evaluation]. AB - A psychometric and behavioral evaluation was undertaken in the first 31 patients surviving after intracardiac repair during circulatory arrest and deep hypothermia in the first months of life. I.Q. in these patients were similar to those in normal children albeit that no extrasurgical pathological condition impaired the cerebral potential (dysmaturity). Graphic and spatial structuration problems were present in half the patients around age 5-6 years. These problems disappeared later on. Functional autonomy was decreased at the beginning of school. There was no school absenteism. Participation in gymnastics was normal. One third of patients participated in sports regularly. PMID- 3813798 TI - [Neonatal testicular torsion]. AB - Twenty-six cases of neonatal torsion of spermatic cord were studied and compared to 171 cases reported in the literature. In a few cases, the torsion was antenatal and this may explain some absent testes. Diagnosis is sometimes difficult to make; symptoms were comparable to those in other disorders: peritoneo-vaginal tunnel, testicular inflammation or testicular tumor. In these cases, surgery can make the exact diagnosis although it cannot save the testis even if it is performed early. PMID- 3813799 TI - [Blood pressure from 0 to 18 months. Use of an automatic measurement method]. AB - A prospective study of blood pressure in 251 neonates and infants aged 0 to 18 months was undertaken with an automatic measurement method. Children of black race (n = 33) were taller (p less than 0.05), heavier (p less than 0.025) and older (p less than 0.001) than the rest of the sample, but had lower systolic (SAP) and diastolic arterial pressures (DAP), especially between 9 and 18 months (p less than 0.01). There was no significant difference according to race [North Africans (n = 50), white (n = 143) and the others (n = 25)], or to sex. For the sample (n = 218) of non black children, SAP and DAP increased with age (p less than 0.001), weight (p less than 0.001) and height (p less than 0.001). Percentiles were determined in each age class for SAP and DAP. Mean pressure figures increased from 86.8 mmHg (0-1 month) to 108 mmHg (9-12 months) for SAP and from 52.5 mmHg (0-1 month) to 65.5 mmHg (9-12 months) for DAP. PMID- 3813800 TI - [Lyme disease. Apropos of a case in children]. AB - A case of Lyme disease with purely neurological manifestations is reported in an 11 year-old girl. Positive blood and cerebrospinal fluid serology allowed for diagnosis. Treatment with Penicillin led to favourable outcome. Atypical manifestations and treatment of Lyme disease are reviewed. PMID- 3813801 TI - [Mediastinal pseudocyst in hereditary pancreatitis]. AB - A 6 year-old child was hospitalized for thoracoabdominal pain. There was a clinical and radiological right pleural effusion. Ultrasonography showed a pseudocyst of the head of the pancreas. CAT scan and operative opacification showed a mediastinal extension of the pseudocyst, with no communication with the pleural effusion. This pseudocyst illustrates an unusual variation of a known complication of this disease. Recovery was obtained via fistulization into the jejunum. PMID- 3813802 TI - [Cutaneous manifestations of periodic disease]. AB - The authors report the case of an 8 year-old girl admitted for an erysipelas-like rash of the lower limbs and an episode of Henoch-Schonlein purpura. These manifestations were subsequently attributed to familial mediterranean fever. This case report illustrates the polymorphism of cutaneous manifestations in this disease. PMID- 3813803 TI - [Pyridoxin-resistant homocystinuria. Apropos of a case with early thromboembolic complications]. AB - The authors report a case of homocystinuria diagnosed in a 2 year-old boy presenting with psychomotor retardation and with widespread cerebral vascular thromboses, unusually severe at that age. The disease was of the pyridoxin resistant type, for which use of remethylation activators led to a good biological result. PMID- 3813804 TI - [Congenital neuro-malaria]. PMID- 3813805 TI - [Severe arterial hypertension and orthopedic operation in children]. PMID- 3813806 TI - [Amnesic ictus after benign skull injury]. PMID- 3813807 TI - [Neonatal spontaneous chylothorax. Antenatal diagnosis]. PMID- 3813808 TI - Schizoaffective psychosis. II. Manic, bipolar, and depressive subtypes. AB - Three schizoaffective subtypes-manic, bipolar, and depressive-were compared across multiple baseline (demographic, premorbid, morbid) and long-term outcome dimensions. Though the subtypes were comparable at baseline, the patients with depressive schizoaffective disorder scored consistently better at follow-up, although none of these differences was statistically significant. Results failed to support the validity of such subtyping in schizoaffective disorder, at least in predominantly chronic populations. PMID- 3813809 TI - Testing DSM-III symptom criteria for schizotypal and borderline personality disorders. AB - Schizotypal and borderline personality disorders (SPD and BPD, respectively) appear to be different at follow-up, yet they are poorly discriminated from each other by current DSM-III symptom criteria. In the Chestnut Lodge Follow-up Study, three axis II study cohorts (pure SPD, n = 10; pure BPD, n = 81; mixed SPD/BPD, n = 18) with distinctive outcomes are defined using current borderline systems. This study compares the relative frequency with which individual symptom criteria from each system discriminate across study cohorts. Findings suggest that for SPD, the most characteristic (core) DSM-III symptoms are odd communication, suspiciousness/paranoid ideation, and social isolation, while the least discriminating symptom is illusions/depersonalization/derealization; the core DSM III symptoms for BPD are unstable relationships, impulsivity, and self-damaging acts, while the least discriminating symptoms are inappropriate anger and intolerance of aloneness; depression as a symptom does not discriminate between SPD and BPD; and transient psychoses and brief paranoid experiences and/or regression in treatment discriminate for SPD but against BPD and therefore fit better as SPD criteria. Results support the retention of some, but the elimination of other, DSM-III symptom criteria for the diagnosis of SPD and BPD. PMID- 3813810 TI - Anxiety and depression in a primary care clinic. Comparison of Diagnostic Interview Schedule, General Health Questionnaire, and practitioner assessments. AB - Over one half of all persons seen in a primary care clinic were identified as having anxiety or depressive disorder by the primary care provider, the General Health Questionnaire (GHQ), or the Diagnostic Interview Schedule (DIS). In only about 5% of all patients were findings positive on all three assessments concurrently. Both the GHQ and the practitioners identified over 30% of all patients as having a disorder, while about 8% had one or more of five DIS anxiety or depressive disorders (major depression, dysthymia, panic disorder, generalized anxiety disorder, or obsessive-compulsive disorder). Of the patients with DIS disorders 83% had positive GHQ scores, and 73% were identified by the practitioner as having a mental disorder. PMID- 3813811 TI - Antidepressant treatment of medical-surgical inpatients by nonpsychiatric physicians. AB - The prescribing of antidepressants by nonpsychiatric physicians on adult medical surgical inpatient services of a university hospital was examined through the review of medical records of patients who received amitriptyline hydrochloride, doxepin hydrochloride, or imipramine hydrochloride during a one-year period. Reasons for antidepressant use were treatment of depression (56%), pain (30%), or other conditions (14%). Regardless of the reason for use, nonpsychiatric physicians were found to use relatively low dosages, rarely plan or effect dosage increases, and rarely discontinue medication. PMID- 3813812 TI - Psychiatric consultations in short-term general hospitals. AB - We investigated the use of psychiatric consultations in short-term general hospitals using a national sample of 327 hospitals and examining the hospital experience of approximately 263,000 patients discharged from these hospitals. We found that the demographic characteristics of patients receiving psychiatric consultations in the national sample were roughly similar to those reported for patients receiving consultations in earlier, single-hospital studies. Rates of consultation were considerably lower, however: 0.9%, compared with a median rate of 3.3% reported in the literature. We also found that patients receiving psychiatric consultations used more hospital resources than other patients. PMID- 3813813 TI - Psychiatric consultation to inpatients with 'early-onset' type I diabetes mellitus in a university hospital. AB - With the use of medical records and the Consultation-Liaison Outcome Evaluation System, we studied psychiatric consultation to 52 hospitalized patients with type I diabetes mellitus having onset of disease by age 25 years. The distribution of psychiatric diagnoses assigned to this sample of patients with "early-onset" diabetes did not differ from those of patients with other medical and surgical illnesses. Three features did distinguish consultation to patients having type I diabetes: the diabetics were referred unusually early in the hospital course; psychotropics were seldom utilized; and consultants' recommendations for diagnostic studies were not followed in more than 90% of cases. The study indicates that the primary medical diagnosis is a critical variable governing consultees' use of and responses to psychiatric consultation. PMID- 3813814 TI - Quantification of agreement in psychiatric diagnosis revisited. PMID- 3813815 TI - Computer simulations of neural information processing and the schizophrenia-mania dichotomy. AB - Recent developments in artificial intelligence use computer simulations of complex neural systems to model associative memory and gestalt-seeking during cognition. Perturbations imposed on such computer simulations caused catastrophic breakdowns of neural functioning. The resulting cognitive disturbances assumed two forms, one "schizophreniclike" and the other "maniclike." The former was induced by memory overload and resulted in misperceptions, loose associations, and also parasitic processing states that pathologically controlled the flow of associations. The latter was caused by increased randomness of neural activity, which induced "jumps" from one gestalt to another. The relationship between this differential model of psychotic disturbances and other studies of schizophrenia and mania were explored. PMID- 3813816 TI - Short-term haloperidol administration acutely elevates human plasma homovanillic acid concentration. PMID- 3813817 TI - Acute psychosis and plasma catecholamine metabolites. PMID- 3813818 TI - Marfan's syndrome and schizophrenia: a case report. PMID- 3813819 TI - Charlie Brown and statistics: an exchange. PMID- 3813820 TI - Assessing therapist success. PMID- 3813821 TI - The structure of the pigment cells in the turtle Trionyx sinensis. AB - A light and transmission electron microscopic study of the pigment cells (chromatophores) revealed the presence of three types of cells, namely: melanophores, xanthophores or erythrophores, and iridophores. The melanophores contained eumelanin containing organelles, the melanosomes and iridophores showed reflecting platelets, whereas, the xanthophores contained pterinosomes. Quantitatively melanophores appeared in large numbers and were widely distributed, ranging from the skin to many internal viscera, whereas iridophores were few and xanthophores very rare. PMID- 3813822 TI - Dynamic behavior of ciliated centrioles in rat incisor ameloblasts during cell differentiation. AB - Centriolar pairs of ameloblasts were examined in relation to cell differentiation at the growing end of rat incisors. In their undifferentiated phase, including many mitotic cells, most of the centrioles in the ameloblasts were located lateral to the nuclei; the pairs were closely associated to each other. During the differentiating phase, the centriolar pairs moved more distally, always accompanied by the Golgi apparatus; they often became separated from each other. In the early secretory phase, and also in the following secretory phase, the pairs were usually observed distally, often away from the nuclei, and were separated from each other more frequently than in the previous differentiating phase. Throughout these phases of the ameloblast differentiation, one centriole of the pair was invariably ciliated and the Golgi apparatus was commonly associated with the centriolar pair. Such movement and separation of the ciliated centrioles is considered to be involved in the morphological and functional differentiation of the cells. PMID- 3813823 TI - The innermost layer of cementum in rat molars: its ultrastructure, development, and calcification. AB - The present study describes the ultrastructure of the innermost layer of cementum (ILC) in the rat molars and discusses its developmental process and calcification mechanisms. The following points are the main results of this study: The ILC is a thin layer, about 2.0 micron thick, intensely stained with hematoxylin but not stained by silver impregnation. Electron microscopically, it is composed of substances stained with ruthenium red and chronic phosphotungstic acid presumed to be proteoglycans and a few thin collagen fibrils. Periodontal fibers penetrate the ILC only a short distance, and do not reach the root dentin surface. The ILC begins to form on the root dentin surface, just after the disintegration of Hertwig's epithelial root sheath. At the same time, matrix vesicles and spherical bodies, which may be derived from the matrix vesicles, appear on the surface of the developing ILC. Dental sac cells show higher cell activities than the epithelial sheath cells. Observations support the view that the dental sac cells secrete the ruthenium red positive material. On the basis of the above findings, the ILC is suggested to be formed by the dental sac cells and calcified by the matrix vesicles derived from these cells. The ILC can be regarded as a specialized cementum between the root dentin and the cementum in the strict sense, serving the connection of the two tissues. PMID- 3813824 TI - Surface morphology of the human yolk sac: endoderm and mesothelium. AB - The yolk sac of human embryos from the 5th to 7th week of gestation was first revealed under the scanning electron microscope (SEM) with complementary observations under the transmission electron microscope (TEM). The inner and outer surfaces of the human yolk sac basically showed profiles similar to those of other mammalian yolk sacs reported by previous workers. The free surface of the endodermal cell measured 10-15 microns in diameter and was only slightly swollen in its earlier stages, possessing microvilli of 100-600 nm in length. On the other hand, the outer surface of mesothelial cells was swollen, but much smaller in size (8-10 microns). The mesothelial microvilli were much longer than those of the endoderm, measuring about 1.5 micron in length. On the endodermal surface, ruffles and various sizes of holes with short microvilli were occasionally found. The latter became larger with development, and seemed to be continuous with the endodermal tubules. PMID- 3813825 TI - Likelihood ratio vs a multivariate model. PMID- 3813826 TI - Likelihood ratio and positive predictive value. PMID- 3813827 TI - Meningeal myelomatosis. PMID- 3813828 TI - The pathologist and congenital malformations. PMID- 3813829 TI - Pathologic findings in adrenoleukodystrophy heterozygotes. AB - Two women, heterozygous for X-linked adrenoleukodystrophy, contained striated adrenocortical cells without inflammation and central nervous system demyelinative lesions. Only one was symptomatic neurologically; neither exhibited hypoadrenalism. These findings further document the variability of adrenoleukodystrophy heterozygotes and provide evidence that the major pathologic differences between hemizygote and heterozygote are quantitative in nature. PMID- 3813830 TI - Obstructive lesions of the lower urinary tract in the prune belly syndrome. AB - The prune belly syndrome is a well-recognized entity consisting of deficient abdominal musculature, cryptorchid testes, and urinary tract abnormalities most consistent with an obstructive phenomenon. However, an obstructive lesion has not been consistently identified in previously reported cases. Retrospective review of the autopsy files of The Johns Hopkins Hospital, Baltimore, identified 18 cases of prune belly syndrome occurring since 1945. In 13 cases, obstructive lesions in the lower urinary tract had been described grossly. A single case, in which the lower urinary tract had been preserved intact and subsequently serially sectioned as 8-micron sections taken at every 120 micron, demonstrated an obstruction consisting of two overriding urethral lumens connected only by a narrow channel. Reconstruction of the sections suggested that this represented a "kink" in a short segment of the prostatic urethra just above the membranous urethra, leading to the obstructive changes of bladder hypertrophy and dilatation, hydroureter, hydronephrosis, and renal dysplasia seen higher in the urinary tract. The results suggest that examination of the lower urinary tract in cases of prune belly syndrome by serial histologic sectioning of the intact unopened prostatic and penile urethra may be required to demonstrate the presence or absence of an obstructive lesion. PMID- 3813831 TI - Exstrophy of the cloacal membrane. A pathologic study of four cases. AB - Exstrophy of the cloaca is a rare congenital anomaly. The authors add the pathologic findings of four distinct cases reported in this article to those reported in the literature. In all cases, common anomalies were recognized. In addition, there were rare anomalies, such as single umbilical artery, vestige of the left superior vena cava, common mesenterium, calcification of the cerebellum, incomplete segmentation of the left lung, abnormal shape of the liver, and knock knee. The embryology of this complex anomaly is difficult. It is considered that this anomalous condition results from breakdown and mesodermal invasion of the cloacal membrane. PMID- 3813832 TI - Ultrastructural localization of acetylcholinesterase activity in Hirschsprung's disease. AB - Localization of acetylcholinesterase activity in congenital megacolon was studied by light and electron microscopy. Acetylcholinesterase activity was strongly positive at the light microscopic level in the Auerbach's plexus of the normal segment and in proliferated nerve fibers of the aganglionic segment. The reaction product observed by electron microscopy was deposited in and between the plasma membranes of the ganglion cells, nerve fibers, and their terminals. The product was also observed in the rough endoplasmic reticulum, nuclear envelope, and Golgi apparatus of the ganglion cells. Acetylcholinesterase activity in the aganglionic segment was observed in and between the plasma membranes of nerve fibers and nerve terminals, which terminated in proximity to smooth muscle cells. Reaction deposits were also observed in the interspace between nerve terminals and smooth muscle cells, suggesting direct innervation of smooth muscles by extrinsic nerve fibers. PMID- 3813833 TI - Is there a pathogenetic role of hepatitis B virus in lupus nephritis? AB - In view of the widely disputed frequency with which hepatitis B surface antigen (HBsAg) is found in the sera and kidney biopsy specimens of patients with systemic lupus erythematosus (SLE), serologic screening of HBsAg and immunofluorescence studies for HBsAg and hepatitis B core antigen in renal biopsy specimens were performed in 45 patients with SLE. Five of the 45 patients with SLE had HBs antigenemia, and the prevalence was not significantly different from that of the general population in Hong Kong. The renal biopsy findings of these five patients showed lupus nephritis in two and features suggestive of hepatitis induced glomerulonephritis in three. Our findings do not support an increased prevalence of HBsAg in sera or kidney of patients with SLE, and hepatitis B virus is unlikely to have a pathogenetic role in SLE in areas where both SLE and HBs antigenemia are common. PMID- 3813834 TI - Intraglomerular tubular epithelial cells. A marker of glomerular hematuria. AB - The occurrence of intraglomerular tubular epithelial cells (ITEC) was investigated in 202 consecutive renal biopsy specimens and were present in 111 (55%). Minimal, focal, or diffuse glomerular diseases were all represented. Of the patients with ITEC 110 (99%) had gross or microscopic hematuria, either alone or associated with proteinuria; however, ITEC were found only in one of 79 proteinuric patients with no documented hematuria. Intraglomerular tubular epithelial cells did not occur in four patients with drug-induced interstitial nephritis and microscopic hematuria, or in 11 normal controls. The pathogenesis of ITEC is not known, but our data indicate that the phenomenon is almost constantly found in association with glomerular hematuria. Identification of ITEC, therefore, should help to confirm the glomerular origin of hematuria when histologic alterations are minimal. PMID- 3813835 TI - Focal pontine leukoencephalopathy in immunosuppressed patients. AB - In three patients who died of immunodeficiency syndromes, including two patients with acquired immunodeficiency syndrome (AIDS), foci of necrotizing leukoencephalopathy were found in the basis pontis. The lesions were identical in location and morphology to those previously described in patients who received chemotherapy and central nervous system radiotherapy for various malignancies, and (except for their restricted anatomic location) resembled the disseminated necrotizing leukoencephalopathy that complicates central nervous system leukemia and lymphoma. The lesions are to be distinguished from central pontine myelinolysis, are confined to pontocerebellar tracts, and are not specific for the immunodeficient state, but may reflect preterminal metabolic derangements, since they seem unrelated in this clinical setting to malignancy and/or its treatment. Alternatively, they may be a consequence of the immunosuppressed state. The presence of this morphologic abnormality in two AIDS patients is especially intriguing, in view of the frequency with which white matter lesions are seen in the AIDS population. PMID- 3813836 TI - Ultrastructural abnormalities of the liver in total lipodystrophy. AB - We present the results of light and electron microscopy studies of the liver in an 8-year-old girl with congenital total lipodystrophy. Liver histology revealed cirrhosis, and ultrastructural study showed mitochondrial abnormalities and an increase in the number of peroxisomes. A potential relationship between the high fatty acid concentration in the serum and the peroxisomal proliferation is considered. PMID- 3813837 TI - Juvenile polyp with intramucosal carcinoma. AB - Intramucosal carcinoma arising in an otherwise typical juvenile polyp is reported. Adenomatous change and carcinoma in situ have been previously documented in patients with the multiple juvenile polyposis syndrome. The syndrome was not present in this case. Although rare, juvenile polyps (both in solitary and multiple forms) are a potential site of malignant change. PMID- 3813838 TI - Statistical techniques reported in pathology journals during 1983-1985. Implications for pathology educators. AB - The increasingly scientific basis of medicine challenges pathology educators to incorporate quantitative skills into a very compressed curriculum. One strategy is to focus training on the statistical techniques pathologists will most commonly encounter in their literature. We identified the reporting of statistical techniques in nearly 5200 original articles published during 1983 1985 in 16 journals important to pathology. Our results suggest that a reader familiar with 12 fundamental statistical concepts can evaluate knowledgeably over 95% of the quantitative findings reported in these journals. With the exception of survival analysis and pharmacologic modeling, these techniques are typically encountered in many introductory statistical texts. In numerous articles, failure to identify the statistical methodology used made it impossible to identify the analytic procedures used and, hence, judge the scientific validity of results. PMID- 3813839 TI - [Analysis of the action of cardio-active drugs]. PMID- 3813840 TI - [In vitro studies of microsomal n-oxidation of various guanidines]. PMID- 3813841 TI - Importance of nitrile substitution for the Ca antagonistic action. PMID- 3813842 TI - Temporary bone tissue ischemia in the hind limb of the rabbit. A vital microscopic study. AB - With in situ bone vital microscopy it was demonstrated that a cuff pressure of 300 mm Hg applied over the rabbit thigh is sufficient to cause a complete vascular standstill in the tibial cortex. Cuff-induced tissue ischemia applied for 30 min did not result in any adverse bone tissue reactions over a follow-up period of 30 days. Locally applied isolated bone ischemia for 3 or 6h resulted in an inflammatory response, and 4-6 weeks after the 6-h ischemia bone resorption was evident. PMID- 3813843 TI - Internal pressure and oxygen tension of bone tumors and tumorous conditions. AB - Internal pressure and oxygen tension were measured in 24 patients with bone tumors and tumorous conditions. High internal pressures were observed in most of the rapidly growing lesions. The internal pressures of slowly growing and non growing lesions were not different from those of normal bone marrow. Oxygen tension was commonly higher in the rapidly growing lesions than in simultaneously obtained peripheral venous samples from the same patients. The oxygen tension of the fluid from simple bone cysts was lower than that in venous samples from the same patients. There is a good correlation between internal pressure and the growth rate of the bone lesions in this study. It is suggested that internal pressure and oxygen tension of the lesions demonstrated the degree of blood supply to the bone tumors and tumorous conditions. PMID- 3813844 TI - The influence of indomethacin on tendon healing. A biomechanical and biochemical study. AB - The influence of indomethacin on the biomechanical and biochemical properties of tendons during their healing was investigated. In 68 New Zealand White rabbits a transverse tenotomy followed by repair with a criss-cross suture was performed in the plantaris longus tendon of the left hind limb. The leg was immobilized for 4 weeks postoperatively in a long-leg plastic splint. Half of the animals were treated with indomethacin, 10 mg/kg/day orally, and the other half with placebo. After 4, 8, and 16 weeks of treatment the animals were killed and biomechanical and biochemical parameters were measured. After 16 weeks there was a significant increase in tensile strength in the indomethacin group. There were only small biochemical differences between the groups. However, there was a slight but significant decrease in the amount of soluble collagen in the indomethacin group. This may indicate a higher degree of cross-linkage following indomethacin treatment, which might explain the increased tensile strength. PMID- 3813845 TI - Outcome of clavicular fracture in 89 patients. AB - During 1982, 118 patients with clavicular fracture were treated in the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital. Eighty nine patients appeared for the follow-up examination in 1984. Eighty-three fractures were treated with immobilization in a sling. Four fractures were treated with plate fixation primarily and two patients were operated on for delayed union. The immobilization averaged 21 days, range 10-42 days. The follow up was 2 years in all cases. The result was good in 65 cases, satisfactory in 20, and poor in 4 cases. Patients with primary dislocation of more than 15 mm or with shortening observed at the follow-up examination had statistically significantly more pain than patients without these findings. PMID- 3813846 TI - Loosening 5 years after total hip replacement--a radiological study of the McKee Farrar and Charnley prostheses. AB - In a prospective study, 138 patients who underwent total hip replacement by the McKee-Farrar or the Charnley technique were monitored yearly for 5 years by X ray. Six variables were measured on anteroposterior and lateral projections to describe the position of the prosthesis. Lateral opening greater than 50 degrees and cover of the acetabular cup less than 1.5 cm correlated with an increased cup loosening rate: 71% (98 of 138) were loose at the 5-year follow-up. However, only about one-third of all cup loosenings in the present series can be explained by nonoptimal position of the prosthesis. No significant difference emerged concerning loosening rate between the McKee-Farrar and the Charnley prostheses. PMID- 3813847 TI - Elastin in the human intervertebral disk. A histological and biochemical study comparing it with elastin in the human yellow ligament. AB - The elastic fiber and elastin in the human yellow ligament and intervertebral disk were studied histologically and biochemically. The elastic fiber in the human intervertebral disk, which until now had not been clearly identified microscopically, was observed clearly. We found the distribution of the elastic fiber in the intervertebral disk to be very sparse and irregular, and its diameter was small, being about one-tenth of that found in the yellow ligament. The elastin contents of the yellow ligament and intervertebral disk were 46.7% +/ 0.9% and 1.7% +/- 0.2% respectively (mean +/- SE) of the total dry weight. The amino acid composition of elastin in the yellow ligament is similar to that of other tissue, as reported in the literature; however, that found in the intervertebral disk is significantly different. It would appear, therefore, that the elastin in the intervertebral disk is of a different type from that found elsewhere. PMID- 3813848 TI - The effect of the radiographic projection on the measured position of the prosthesis at knee arthroplasty. AB - Radiographic pictures with different centerings were taken of a Geomedic prosthesis attached to a knee joint preparation. Moderate rotations and incorrect centerings did not result in significantly different measurements. PMID- 3813849 TI - Long-term follow-up of patients with geomedic prostheses. AB - Of 122 Geomedic arthroplasties performed, 85 were possible to follow up. The mean observation period was 58 months. The original position of the prosthesis was analyzed with respect to its effect on the clinical condition. A score system was used for this purpose. A normal alignment was obtained in 51%. No statistically significant correlation could be shown between a high radiographic score and a high clinical score. A resorption zone of 2mm or more, considered a sign of loosening, arose in 37% and a coexisting change of position in 12%. There is no difference in radiographic score between the prostheses which were judged as loose and the other prostheses. Twelve percent of the patients were reoperated because of loosening. The patients consider their condition to be very good or good in 93% of cases. Pain at rest and pain on weight bearing were totally absent in 87% and 72% of cases respectively. PMID- 3813850 TI - Comminuted fractures of the proximal humerus treated with hook plate. AB - Good results were obtained using a hook plate to fix bone in 18 cases of fracture of the proximal humerus in which the bone was greatly comminuted or dislocated. The hook plate protects the fixed area against rotation, shear stress and flexion much better than other fixation methods. PMID- 3813851 TI - Indications for the application of Wagner's method of external fixation across the knee joint. AB - External fixation with Wagner's apparatus can, because of its mechanical properties, be employed for temporary immobilization of the knee joint. This method is especially suitable for patients for whom immobilization in plaster is problematic or disadvantageous. It can be applied to the following categories of patients: Patients with injuries to the bones or ligaments of the knee which are associated with wounds or injuries of the blood vessels or nerves; Patients with multiple injuries of the leg (e.g., fractures of the tibia and femur) and concomitant intra-articular knee injuries; Patients with a septic arthritis of the knee joint. PMID- 3813852 TI - The gluteal approach to the ischium. AB - This paper describes a gluteal approach to the ischium which facilitates a good exposure of the whole region from the lower part of the ischium to the pubic ramus and allows extensive resections and partial hip reconstruction if necessary. The approach is demonstrated as used in two cases - one benign (desmoplastic fibroma) and one malignant tumor (chondrosarcoma). PMID- 3813853 TI - Concentration of cefuroxime in the bones of albino white rats: a comparative study of femur, humerus, and mandible. AB - The levels of cefuroxime in rat bones with a different morphology, function, blood supply, and proportion between lamellar and cancellous bone were studied, after a 24-h administration of 750mg/kg X 3. The concentrations in the right and left femora, humeri, and mandibles of the same animal were measured 2 h after the last administration. The result indicate statistically significant differences between femur and humerus (P less than 0.001), femur and mandible (P less than 0.05), and humerus and mandible (P less than 0.05). PMID- 3813854 TI - Second femur fracture after hemiarthroplasty of the hip: salvage procedure by Partridge bands and long-stemmed prosthesis. AB - We report on a technique for stabilising a femoral shaft fracture occurring between a cementless hip prosthesis and a distal plate in an elderly patient. We used a long-stemmed Austin-Moore hemiarthroplasty and removed all but the most distal screws, encircling the whole femur with Partridge nylon bands. PMID- 3813855 TI - Myoelectric spectral analysis and strategies for quantifying trunk muscular fatigue. AB - Objective techniques for assessing trunk musculature with respect to fatigue related characteristics do not exist. Based on work that relates frequency spectral shift in myoelectric signals to muscular fatigue at other body sites, a study was carried out to investigate and evaluate strategies for application of these techniques to the lumbar musculature. Through evolution of test administration procedures to reduce test time and discomfort as well as data interpretation methods to account for interindividual variability observed in data, an approach was developed for objective measurement of fatigue rate. While abdominal and lumbar muscle groups were assessed in 40 healthy subjects with results presented for 50% and 100% maximum voluntary contraction load levels, the methodology is discussed with emphasis on erector spinae results. The approach involves a normal function fatigue plot. The plot relates fatigue rate as measured by myoelectric spectral characteristics to muscle load normalized by body weight and is independent of the maximum voluntary contraction concept. This relationship forms the basis of comparison of the measured fatigue rate for a subject with questionable function to expected normal values determined from the plot, given the measured load level. PMID- 3813856 TI - Planning disorder after closed head injury: a case study. AB - Disturbances of executive functioning after traumatic brain injury represent significant obstacles to social and vocational recovery and may require specific remedial intervention. We report the treatment of a client with impaired planning ability and poor self-control after closed head injury. Intervention consisted of a self-instructional procedure that required him to verbalize a plan of behavior before and during execution of the training task and gradually faded overt verbalization. There was systematic reduction of off-task behaviors and problem solving errors over the eight weeks of training. Pre- and postmeasures showed significant changes consistent with increased planning ability. Self-control ratings of everyday behaviors improved with explicit training to promote generalization. Training of plan-ahead and self-verbalization strategies appears effective for remediation of executive functioning after traumatic brain injury. Generalization to real-life situations can be observed with extended training. PMID- 3813857 TI - Ultrasound treatment of reflex sympathetic dystrophy. AB - Three cases of lower extremity reflex sympathetic dystrophy (RSD) responded dramatically to a daily low dose ultrasound (0.5 watts/cm2 X 5 minutes) therapy to the tarsal tunnel and plantar nerve distribution, and the use of a shoe insert. Two of the three cases had been refractory to more standard therapy for RSD, including pharmacologic agents. All three patients preferred a conservative approach to surgical sympathectomy. No complications were observed, and all three cases are now symptom free. Daily ultrasound treatments are time-consuming and costly but are safe and may be useful for patients who refuse surgical sympathectomy. We hypothesize that ultrasound may have affected peripheral sympathetic nerve fibers. However, more indirect effects of ultrasound, such as increased blood flow to the limb, may be part of the action mechanism as well. PMID- 3813858 TI - Tissue compliance meter for objective, quantitative documentation of soft tissue consistency and pathology. AB - A new instrument is described, the tissue compliance meter (TCM), for quantitative and objective recording of soft tissue consistency. This quality is appreciated at present only by the subjective method of palpation. Use of the TCM therefore offers a method to quantify palpation of tissue consistency and to document findings objectively. The handheld instrument allows immediate and simple reading of the depth of penetration of a rubber disc at a known pressure. The relation between the achieved penetration and employed pressure expresses the compliance. The TCM consists of a rubber disc with the surface of 1 cm2 attached to a force gauge. The depth of penetration of the rubber tip is indicated by a disc which slides on the shaft of the force gauge. Normal values were established for men and women over muscles which are frequently affected by spasm. Tissue compliance measurement can document changes in soft tissue consistency which occur in muscle spasm, spasticity, swelling, tumors, lumps, hematomas, etc. Use of the TCM provides the most sensitive and earliest objective indication of either healing and resolution in soft tissue pathology or occurrence of complications. Changes in muscle tone such as reduction of spasm, tension, or spasticity can be recorded. The effects of different types of physical therapy can thus be documented objectively. PMID- 3813859 TI - Marital adjustment following spinal cord injury. AB - The present study examined marital characteristics of couples who are coping successfully with spinal cord injury (SCI) versus those who are not and the relationship of positive marital adjustment in SCI couples as compared with positive adjustment among able-bodied (AB) couples. In a 2 X 2 factorial design the marital relations of 10 nondistressed and 10 distressed SCI couples and 14 nondistressed and 10 distressed AB couples were examined. Assessments were conducted in the couples' homes and included self-report measures of recreational social activities and sexual relations, and observations of marital communication skills. Multivariate analyses revealed significant interaction effect with posthoc comparisons, indicating that spouses in distressed SCI marriages engaged in significantly fewer activities alone and with their spouse and requested the greatest degree of change in the marital relationship in comparison with the other groups. There was a significant main effect for marital satisfaction, with distressed couples expressing more dissatisfaction in sexual relations and more negative communications during conflict resolution tasks. Although the results do not indicate that substantive differences exist in quantitative and qualitative aspects of marital relations between SCI and AB couples, several trends were observed which suggest the need for further research. PMID- 3813860 TI - Swallowing disorders in closed head trauma patients. AB - Fifty-three closed head trauma patients with dysphagia were examined videofluorographically to determine the specific nature of their swallowing disorder. Eighty-one percent of the patients exhibited a delayed or absent swallowing reflex while approximately 50% of the patients suffered from reduced tongue control, and 33% had reduced peristalsis. Laryngeal disorders and cricopharyngeal dysfunction occurred in a small number of patients. The average head trauma patient exhibited more than one swallowing motility problem. Twenty patients aspirated, with delayed or absent swallowing reflex as the most common etiology for the aspiration. Many of these patients did not produce a reflexive cough during or after they had aspirated material into their airway. For this reason, and since the pharyngeal stage of the swallow is extremely difficult to assess with presently available bedside techniques, videofluorographic evaluation becomes an invaluable tool for identification of the precise nature of the swallowing disturbance, the presence of aspiration, and the etiology of the aspiration. PMID- 3813861 TI - Balance and age in the sighted and blind. AB - This study evaluated the usefulness of a balance test with eyes open and closed to index postural control capability. Experiment 1 was a one-year longitudinal study of 225 subjects aged 50 to 82 years. Comparing the two conditions, balance with eyes open had higher reliability, had greater sensitivity to aging effects, correlated stronger with functional age indices (vital capacity and forced expiratory volume), and showed greater sensitivity to the effects of physical fitness training. Experiment 2 included 22 visually impaired subjects aged 19 to 84 years. Minimally sighted subjects balanced for longer than fully blind subjects, but no differences in balance were found between subjects blind from birth versus those with acquired vision loss. The findings demonstrate the importance of vision to balance and indicate that balance with eyes open is a valid and sensitive test for clinical and research purposes. PMID- 3813862 TI - Mobility for persons with spinal cord injury: an evaluation of two systems. AB - Wheelchairs and knee-ankle-foot orthoses (KAFOs) were evaluated by 92 persons with spinal cord injuries resulting in paraplegia to determine reasons for use and to determine their adequacy. While 67% of the sample was prescribed KAFOs, only 16 (26%) persons who were prescribed braces were still using them for any purpose, and only 4% as their sole means of mobility. Reasons for disuse and problems with braces were examined. Wheelchairs were rated significantly higher than long leg braces on value, potency and activity level permitted. A needs assessment revealed that transportation and mobility concerns were more prevalent than other areas of concern. Differences between KAFO users and former users were examined by discriminant analyses. Former users tended to have complete lesions and to be older; current users tended to have incomplete lesions and to be younger. Despite the problems associated with KAFOs, it is clear that this technology will continue to be useful to some degree for about 10% of individuals. PMID- 3813863 TI - Reliability and validity of the Disability Rating Scale and the Levels of Cognitive Functioning Scale in monitoring recovery from severe head injury. AB - The Disability Rating Scale (DRS) and the Levels of Cognitive Functioning Scale (LCFS) are both widely used to monitor recovery from head injury, despite the total lack of published research on the reliability and validity of the LCFS, and the fragmented and incomplete reports on these characteristics of the DRS. Forty head-injured inpatients were evaluated with the DRS and LCFS four times weekly throughout their rehabilitation hospitalization. The DRS and LCFS were compared in terms of how consistently ratings could be made by different raters, how stable those ratings were from day to day, their relative correlation with Stover Zeiger (S-Z) ratings collected concurrently at admission, and with S-Z, Glasgow Outcome Scale (GOS), and Expanded GOS (EGOS) ratings collected concurrently at discharge, and finally in the ability of admission DRS and LCFS scores to predict discharge ratings on the S-Z, GOS, and EGOS. Results suggest that both scales possess significant degrees of test-retest and interrater reliabilities, and of concurrent and predictive validities, but the DRS surpasses the LCFS in nearly every regard. These results offer psychometric justification favoring the use of the DRS for monitoring recovery from head injury. PMID- 3813864 TI - Development of a behavioral test of visuospatial neglect. AB - The Rivermead Behavioral Inattention Test (RBIT), consisting of nine items sampling activities of daily living, was administered to 28 patients after unilateral right (20) or left (8) cerebrovascular accidents, and to 14 non-brain damaged controls. All patients were tested on two parallel forms of the RBIT with order of presentation balanced and on at least two of six conventional tests of visual neglect. Control subjects were tested on either form 1 or form 2 of the RBIT. Interrater reliability of scoring was tested on seven subjects chosen at random. Using control scores to determine the cutoff point between visual inattention and noninattention, 14 patients (50%) showed evidence of visuospatial neglect on the RBIT. Correlation between the two forms of the test was 0.83. The RBIT also correlated well with five of the conventional tests. Interrater reliability was 100%. The RBIT appears to be a valid and reliable test of visuospatial neglect and one which is likely to provide more information about everyday problems than existing measures of neglect. PMID- 3813865 TI - Reducing wound infections. Improved gown and drape barrier performance. AB - A 21-month study involving 2181 clean and clean-contaminated general surgical procedures was performed to evaluate the effectiveness of a commercially available disposable gown and drape system vs a cotton system in reducing wound infection. The series in which the disposable spun-laced fiber system was used had a significantly lower overall infection rate (2.83% vs 6.5%) as well as better rates in clean (1.8% vs 3.8%) and clean-contaminated (4.8% vs 11.4%) procedures. This effect was independent of all other factors. The odds of developing a wound infection was 2 1/2 times higher with a cotton system than with a disposable system. Actual cost analysis from three types of hospitals showed lower costs with utilization of disposable gown and drape systems. Hospital charges were significantly higher for those patients developing wound infections. The results of the study demonstrated not only significant reduction in wound infection rates but also major cost savings when a disposable gown and drape system was used in the operating room. PMID- 3813866 TI - Design and conduct of antibiotic trials. A report of the Scientific Studies Committee of the Surgical Infection Society. AB - Several recent publications have identified important methodologic problems in the design and conduct of antimicrobial trials in surgery. Developed by consensus of the members of the Scientific Studies Committee of the Surgical Infection Society, this report provides broad guidelines for the construction of antimicrobial trials. The central issues identified include pretrial definition of study purpose, entry criteria, assignment device, and statistical analysis. These issues are fundamental in designing studies with an acceptable likelihood of finding differences among those antimicrobial regimens at least risk to the study subjects. The importance of stratifying patients on the basis of background condition, disease, and severity of illness is stressed. The inclusion in a study of variables that enhance the statistical power and, therefore, the believability of this study is stressed as an important means of clarifying substantial differences between therapies. PMID- 3813867 TI - Assessing operative site infection in surgical patients. AB - We evaluated the contribution of altered host defense to the risk of developing an operative site infection. In part 1 of this study, we measured the following variables in 404 preoperative patients: cutaneous delayed-type hypersensitivity, age, serum albumin level, contamination status at the time of surgery, and the duration of surgery. Patients were examined daily postoperatively for the presence of an operative site infection (culture-positive drainage or infected tissue; overall rate, 17.3%). The above variables, plus previously defined risk factors, were examined by logistic regression analysis using the development of an operative site infection as the dependent variable. An equation to calculate the probability of developing a postoperative wound infection was thus derived. In part 2 of the study, a separate, matched group of 404 preoperative patients was used to test the validity of this predictive equation. A good fit of the model was obtained, with 70.3 wound infections predicted and 67 obtained (chi 2 = 0.8; not significant, ie, no difference between expected and observed wound infections at all probability deciles). We conclude that there are three determinants of an operative site infection, host defense (delayed-type hypersensitivity), acute and chronic physiologic derangement (albumin and age) and bacterial contamination risk at surgery (contamination status and duration of surgery). PMID- 3813868 TI - Kupffer cell modulation of the systemic immune response. AB - The effects of global hepatic injury and of Kupffer cell activation on systemic immunity were studied in an in vivo rat model, using the diameters of the delayed type hypersensitivity (DTH) response to keyhole limpet hemocyanin and of a subcutaneous Staphylococcus aureus abscess as measures of systemic immunoresponsiveness. Hepatic injury with carbon tetrachloride resulted in significant suppression of the DTH score (5.5 +/- 0.7 vs 8.8 +/- 0.8 mm). Kupffer cell activation with intraportal Escherichia coli was likewise suppressive (DTH score, 4.4 +/- 0.5 vs 6.1 +/- 0.4 mm for animals receiving systemic E coli); the magnitude of this suppression correlated with the numbers of organisms extracted by the liver. Conversely, Kupffer cell ablation with carrageenan lessened the immunosuppressive effects of anesthesia and surgery (DTH score, 8.5 +/- 0.9 vs 6.8 +/- 0.6 mm for controls; S aureus abscess, 4.1 +/- 0.4 vs 5.7 +/- 0.4 mm for controls). These results indicate that Kupffer cells can modulate the systemic immune response and suggest that gram-negative portal bacteremia with resultant Kupffer cell activation may contribute to the immunologic derangements characteristic of trauma and critical surgical illness. PMID- 3813869 TI - Effect of altered volume of distribution on aminoglycoside levels in patients in surgical intensive care. AB - The apparent volume of distribution (Vd) of aminoglycosides was found to be increased in 100 patients in a surgical intensive care unit who had gram-negative pneumonia or intraabdominal sepsis and acute physiologic scores greater than 12. Following loading or maintenance doses, carefully timed blood samples were collected for measurements of serum concentrations by fluorescence polarization immunoassay. The Vd, determined by linear regression analysis of a one compartment model using the Sawchuk-Zaske method, was 0.34 +/- 0.121 L/kg and was larger than the normal Vd of 0.20 to 0.25 L/kg, suggesting a 36% to 70% increase in extracellular fluid volume. Since there is a predictable increase in aminoglycoside Vd in the septic surgical patient, a proportionately larger aminoglycoside dosage is required initially to achieve desirable peak serum levels. Close monitoring of blood levels during maintenance dosing is suggested since dynamic changes in renal function and aminoglycoside Vd occur in the critically ill. PMID- 3813870 TI - Flow cytometric measurement of rat lymphocyte subpopulations after burn injury and burn injury with infection. AB - Increased infection rates in burned patients may result from a disproportionate increase in the suppressor subpopulations. Measurement of lymphocyte subpopulations is difficult in burned patients because gradient-purified cells are contaminated by nonlymphoid cells. The accuracy of flow cytometric subpopulation analysis was improved by restricting (gating) the analysis to cells with light-scatter intensity typical of lymphocytes. Blood was obtained 48 hours after burn from rats receiving no burns, 30% scald burns, or burns seeded with Pseudomonas aeruginosa to induce infection. Subpopulations were identified by monoclonal antibodies to T-lymphocyte antigens. Gating increased the values obtained for most subpopulations, but the relative differences between groups were unchanged. Burned and infected animals, but not animals burned only, had a decreased ratio of helper to suppressor lymphocytes (HSR) relative to control. A decreased HSR correlated with sepsis, but not with infection susceptibility. This suggests that a decrease in HSR may be a result of infection rather than a cause of susceptibility to infection. PMID- 3813871 TI - Local heat increases blood flow and oxygen tension in wounds. AB - The effect of local hyperthermia on subcutaneous tissue oxygen tension (Psqo2) and perfusion was investigated in eight patients (13 trials) using a subcutaneously implanted oxygen tonometer. Application of heat increased subcutaneous tissue temperature and Psqo2. Mean Psqo2 during oxygen breathing rose by 39.5 mm Hg, an 80% increase over the average baseline Psqo2. The corresponding mean subcutaneous temperature increased 4.0 degrees C. A significant linear correlation was found between the change in Psqo2 and subcutaneous temperature. There was an average threefold increase in local perfusion estimated by using the Fick principle. The data reaffirm the value of local hyperthermia in treating contaminated wounds and suggest a mechanism for its ability to ameliorate infections. The mechanism implies that local heat may have prophylactic value as well. PMID- 3813872 TI - Inhibition of lymphocyte proliferation by fluid-phase C3b as influenced by macrophages. AB - The effect of fluid-phase C3b on mitogen-induced lymphocyte proliferation in the presence and absence of macrophages was studied. In general, C3b inhibited the proliferation of lymphocytes when monocytes (macrophages) were present. The degree of inhibition by C3b was different for B and T lymphocytes and varied for different subpopulations of lymphocyte classes. In the absence of monocytes (macrophages), there was insignificant inhibition by C3b of lymphocyte proliferation, and thus the observed inhibition appeared to be due to the effect of C3b on the monocytes/macrophages present in the mixed lymphocyte preparations. PMID- 3813873 TI - Prevention of major amputations in diabetic patients. PMID- 3813874 TI - Exchanges of magnesium and phosphorus at different sites in the ruminant stomach. AB - Three ruminating calves were each provided with a rumen cannula (from which reticulum samples could be obtained), an abomasal cannula and a sleeve sutured at the omasal-abomasal orifice that permitted digesta flowing from the omasum to be diverted and collected. The calves were each given in turn a high roughage (HR) and high concentrate (HC) diet consisting mainly of dried grass and flaked maize in the proportions by weight of 3:2 and 1:2 respectively. A water soluble non absorbable marker (polyethylene glycol) and a particulate marker (103Ru phenanthroline complex) were also given and the diets were sometimes supplemented with MgSO4. For each diet (HR(O), HR(Mg), HC(O), HC(Mg)) samples were taken from the reticulum and omasal outflow. Magnesium, phosphorus, PEG and 103Ru were measured in the samples as taken and liquid-rich and solid-rich fractions prepared from them. From their distributions relative to the two markers, Mg and P flows into and out of the omasum were estimated. Results were too few to show significant differences in absorption efficiency between diets but overall approximately 10-40% of the Mg entering the omasum was absorbed as a net effect implying that this organ may be the major site of Mg absorption in young cattle. For P also substantial amounts entering the omasum (approximately 10-40%) were absorbed in that organ. PMID- 3813875 TI - [Nutrient dependence of energy preservation requirements in rats. 1. Dependence of energy requirements for preservation in fully-grown rats on the type of nutrient offered as the sole energy source]. AB - In two experiments with fully-grown albino rats (Wistar strain) the energetic utilization of glucose, sunflower oil and casein in the maintenance metabolism was determined under thermoneutral conditions of keeping the animals. The relative requirement of metabolizable energy for maintenance was, with either glucose, sunflower oil or casein being the sole energy source of the feed, in experiment 1 100:105:133 and in experiment 2 100:102:135. The absolute values of the maintenance requirement of metabolizable energy were in experiment 1 347 +/- 26, 364 +/- 61 and 460 +/- 33 resp., and in experiment 2 330 +/- 11, 337 +/- 21 and 446 +/- 27 kJ/kg LW 0.75 resp. The results are discussed in connection with the efficiency of ATP synthesis (metabolizable energy/mol ATP gain) in the oxidative decomposition of nutrients. PMID- 3813876 TI - [Nutrient dependence of energy preservation requirements in rats. 2. Effect of the protein level of feed and the environmental temperature on the energy preservation requirement and heat production in fully-grown rats]. AB - The influence of protein in exchange for carbohydrates on the energy maintenance requirement was studied with nearly fully-grown rats at ambient temperatures between 33 and 21 degrees C. The levels of the crude protein content were 10, 25, 40 and 70%. At an ambient temperature of 33 and 30 degrees C energy maintenance requirement increased with the growing protein content in the feed. At a temperature of 30 degrees C the following values of energy maintenance requirement were measured in the sequence of the protein levels mentioned: 330 +/ 11, 347 +/- 18, 360 +/- 15 and 399 +/- 15 kJ metabolizable energy/kg live weight 0.75 X d. The occurring changes largely coincide with the expected values calculated from the efficiency of the ATP synthesis in the oxidative catabolization of protein and carbohydrates. At ambient temperatures of less than 30 degrees C, thermogenous effects after the exchange of protein versus carbohydrates could only be observed partly or not. 30 degrees C in feeding on the maintenance level and 33 degrees C in the state of hunger are estimated as the lower critical temperatures. Below the critical temperatures down to 24 degrees C heat production increased less per 1 degree C temperature decrease both in hungry and fed rats than in the temperature range between 24 and 21 degrees C. By the decrease of the ambient temperature from 24 to 21 degrees C the heat production of the hungry or fed rats increased by 39 or 33 kJ/degrees C X kg live weight 0.75 X d. PMID- 3813877 TI - Inhalation pharmacokinetics of 1,2-dichloroethane after different dietary pretreatments of male Sprague-Dawley rats. AB - The effect of the pretreatment of male Sprague-Dawley rats with phenobarbital (PB), butylated hydroxyanisole (BHA) and disulfiram (DSF) on the inhalation kinetics of 1,2-dichloroethane [ethylene dichloride (EDC)] was studied by the gas uptake method. A closed recirculating system was constructed and characterized. The rate curves in all the pretreatment regimens showed saturable dependence on EDC concentration. These saturable dependencies (Michaelis-Menten) appeared to be associated with enzymatic metabolism. In general, a two-compartment, steady-state pharmacokinetic model described the uptake data. Data were transformed by Hanes plots to calculate the inhalational Km, the ambient EDC concentration at which uptake proceeded at half maximum rate, and Vmax, the maximum rate of uptake (i.e., maximum rate of metabolism). Although PB and BHA pretreatments did not affect the Km of EDC, PB pretreatment increased the Vmax while DSF pretreatment decreased both the Km and Vmax. PMID- 3813878 TI - Urinary excretion of p-hydroxylated methamphetamine metabolites in man. I. A method for determination by high-performance liquid chromatography electrochemistry. AB - p-Hydroxymethamphetamine and p-hydroxyamphetamine in urine samples from methamphetamine addicts were analyzed by high-performance liquid chromatography electrochemistry (HPLC-EC). The urine samples were hydrolyzed with equal volumes of 12 N HCl at 60 degrees C for 4 h and were then diluted with water and neutralized with NaOH solution. The neutralized urine was passed through a solid phase extraction column, Bond-Elut C18, and after washing, the substances were eluted with acidified acetonitrile. The eluate was evaporated under a stream of nitrogen. The residue was dissolved in 0.1 N PCA and a small volume of the aliquots was injected into the HPLC. This procedure for determination quantitated both free and conjugated forms of the metabolites together. Thereby we could determine concentrations of the metabolites in minute urine samples; i.e., from 2.5 microliters urine. The free form of the metabolites alone was analyzed by the same procedure except for hydrolysis of the conjugates. Concentrations of methamphetamine, p-hydroxymethamphetamine and p-hydroxyamphetamine in the urine samples of addicts collected at arbitrary times were determined by this procedure or by gas chromatography. It was found that there was no correlation between the concentration of methamphetamine and that of the metabolites. This investigation also revealed that various ratios between the concentrations generally were scattered over a wide range of percentages. PMID- 3813879 TI - The effects of ethanol, estrogen, and hexachlorobenzene on the activities of hepatic delta-aminolevulinate synthetase, delta-aminolevulinate dehydratase, and uroporphyrinogen decarboxylase in male rats. AB - To determine if clinically observed disorders in heme biosynthetic enzymes, known as sporadic porphyria cutanea tarda (PCT), could be reproduced in experimental animals, male Fischer rats were treated with ethanol, estrogen and hexachlorobenzene (HCB). A series of heme biosynthetic enzymes were assayed. In the rats given free access to 8% ethanol-drinking water for 15 weeks, delta aminolevulinate (ALA) dehydratase was significantly reduced in erythrocytes. In the liver, ALA synthetase and uroporphyrinogen (UROgen) decarboxylase activities remained unchanged. In bone marrow cells, these activities did not change markedly. In the rats treated with estrogen (1 mg estrioltripropionate/rat/week, IM), no body weight gain was observed during the treatment for 15 weeks and urinary ALA excretion increased to 1.7 fold over normal level. In the liver, a significant increase was observed in the activity of ALA dehydratase, but other enzymes remained within the normal level. In bone marrow cells and erythrocytes, ALA dehydratase was also increased. ALA synthetase increased only in bone marrow cells to 2.1 times higher than the control level. In rats fed 0.3% HCB-diet for 8 weeks, urinary excretion of ALA, coproporphyrin and uroporphyrin increased to 2.4, 3.3 and 3.8 times higher than the controls, respectively. In the liver, an increase was observed in ALA synthetase, while a decrease was observed in ALA dehydratase and UROgen decarboxylase. In bone marrow cells and erythrocytes, ALA dehydratase was reduced and activities of other enzymes did not show any changes. These results indicate that alcohol, estrogen and HCB do not produce phenomena similar to those observed clinically in PCT. PMID- 3813880 TI - Induction of monooxygenases and growth in rat liver by progesterone. AB - Female Wistar rats were treated with various doses of progesterone orally via the diet or via the SC route. Oral treatment resulted in enhanced progesterone levels in the liver as measured by radioimmunoassay. There were up to 3-fold increases in activity of ethylmorphine demethylation by isolated microsomes; metabolism of aminopyrine and benzphetamine was less enhanced, that of aniline and p nitroanisol showed no distinct increases. Progesterone also caused increases in liver size and total liver protein by up to 50%; total liver DNA showed only slight, insignificant increments. These studies suggest that hepatic effects of progesterone are similar to those previously described with synthetic steroids such as pregnenolone-16 alpha-carbonitrile (PCN) and cyproterone acetate. PMID- 3813882 TI - Sex-related differences in NADPH-dependent lipid peroxidation induced by cadmium. AB - Male and female rats were dosed once a day for 2 days with injections of 1.5 mg Cd/kg. Formation of thiobarbituric acid reactive substances (TBA-RS) was significantly increased in male rat liver but not in the females. NADPH-dependent lipid peroxidation in vitro in microsomes derived from untreated rat liver was greater in males than in females. Furthermore, addition of cadmium (Cd) to microsomes isolated from male rat liver produced a dose-dependent potentiation of NADPH-dependent lipid peroxidation from low concentrations of Cd. In microsomes derived from females a significant increase in lipid peroxidation was observed only at high Cd concentrations. NADPH-dependent lipid peroxidation enhanced by Cd was greater in the males than in the females. These data suggest that a sex related difference in the ability of Cd to induce lipid peroxidation in vivo in rat liver appears to be mediated partly through differences in hepatic microsomal NADPH-dependent lipid peroxidation. PMID- 3813881 TI - Oxidative biotransformation in primary cultures of chick embryo hepatocytes: induction of cytochrome P-450 and the metabolism of benzo(a)pyrene. AB - Primary cultures of chick embryo hepatocytes are known to maintain their initial level of cytochrome P-450 for a number of days. To explore the possibilities of chick embryo hepatocyte cultures as a tool in drug metabolism, induction profiles of cytochrome P-450 were determined and the metabolism of benzo(a)pyrene as a model substrate was studied. Maximum induction by phenobarbitone and Aroclor 1254 is reached after 21 h and 18 h, respectively, both in the presence and absence of serum. For beta-naphthoflavone induction is maximal after 31 h in the presence and 43 h in the absence of serum. The levels of P-450 after induction are comparable to those found in vivo in rats: increases of 200% for phenobarbitone, 200% for beta-naphthoflavone and 210% for Aroclor 1254. Ethoxyresorufin-O deethylase activities are induced by beta-naphthoflavone and Aroclor 1254, but as expected only slightly by phenobarbitone. In the absence of serum in the culture medium, for the control as well as the induced cells a plateau of activity is maintained for at least 24 h. In the presence of serum a decline in P-450 levels is observed. Especially in the case of Aroclor, an increase in porphyrin content of 320% of control values is seen at the same time. A number of representative metabolites of benzo(a)pyrene were quantitated during a 4-h incubation. Relative amounts are comparable to those observed with rat liver microsomes. As expected, beta-naphthoflavone and Aroclor induce the rate of metabolism (by 500% and 400%, respectively, in the absence of serum), but phenobarbitone has no or very little effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813883 TI - A comparative study of the acute inhalation toxicity of smoke from TiO2 hexachloroethane and Zn-hexachloroethane pyrotechnic mixtures. AB - Rats was exposed to white smoke generated from mixtures of titanium dioxide hexachloroethane (TiO2-HC) and zinc-hexachloroethane (Zn-HC), respectively, in an inhalation chamber operated in the static mode. The dose was varied by varying the amount of smoke mixture and/or the exposure time. The acute inhalation toxicity of TiO2-HC smoke was much lower than the Zn-HC smoke. Thus, the animals survived exposure to TiO2-HC smoke, even at relatively high smoke concentrations. This smoke was irritating to the animals and minor, acute inflammatory changes were seen in lung tissue. In contrast, Zn-HC smoke was very toxic and caused lethal injuries to the experimental animals, even at relatively low concentrations. Pulmonary injuries were extensive and death was due to blood congestion with pulmonary oedema. Since the TiO2-HC and Zn-HC mixtures form TiCl4 and ZnCl2, respectively, a separate study was performed in which rats were exposed to TiCl4 gas or ZnCl2 aerosol. No animals died from exposure to TiCl4 at concentrations between 370 and 2900 mg/m3 for 10 min. The LC50 of ZnCl2 was found to be around 2000 mg/m3 during a 10-min exposure period. The difference between the two types of smoke is explained by the difference in toxicity between TiCl4 and ZnCl2. PMID- 3813884 TI - Toxicity of sodium arsenite in mouse embryos in vitro and its influence on radiation risk. AB - Mouse embryos at the preimplantation stage were used in vitro for assessing the risk exerted by arsenic on early stages of embryonal development. We studied the effects of sodium arsenite on morphological development, proliferation, and micronucleus formation. A concentration of 100 microM sodium arsenite immediately killed the embryos, and 1 microM almost completely inhibited formation of blastocysts. Micronuclei were induced starting from 0.7 microM arsenite. Concentrations below 0.1 microM (0.1 microM corresponds to 7.5 ppm arsenic) did not show significant effects with respect to any of the end-points examined. Arsenic did not influence radiation risk under various experimental conditions; all the effects after combining moderately toxic doses of sodium arsenite and X rays corresponded to the effect obtained by the addition of the single effects. PMID- 3813885 TI - Toxicological studies with dithranol and its 10-acyl analogues. AB - The oral LD50 values of an antipsoriatic drug, dithranol, were 1542 mg/kg in NMRI mice and 3216 mg/kg in Wistar rats. Three 10-acyl analogues of dithranol (10 acetyl, 10-propionyl and 10-butyryl dithranol or butantrone) were more toxic both in mice and rats. They were mutagenic only in TA1537 of the five Salmonella typhimurium strains tested. None of them were mutagenic in two Escherichia coli strains. Butantrone was least toxic to test bacteria and had the lowest mutagenic activity on TA1537. In metaphase analysis of in vitro treated human lymphocytes, dithranol, 10-acetyl dithranol and 10-propionyl dithranol produced significant increases in the number of chromosome and chromatid gaps but without a clear dose response relationship, and without inducing significant breaks. Butantrone did not cause significant increases in gaps or breaks. In the mouse micronucleus test, dithranol and butantrone caused no increases in micronucleated polychromatic or normochromatic erythrocytes, indicating lack of clastogenic activity in vivo at maximum tolerated doses. Hence, dithranol and its 10-acyl analogues have a weak mutagenic activity in vitro. The mutagenic activity of butantrone is lower than that of the other analogues and dithranol. PMID- 3813886 TI - Early detection of amatoxins in human mushroom poisoning. AB - Amatoxins were detected radioimmunologically as early as 90-120 min after ingestion in the gastric fluid and urine of a 15-year-old boy who tried to commit suicide by ingestion of wild mushrooms. This early detection of amatoxins in the urine is proof of rapid absorption from the intestinal tract and subsequent excretion by the kidneys in man. PMID- 3813887 TI - Biochemical and morphological changes of the rat adrenal medulla induced by peroral xylitol. PMID- 3813888 TI - An electron and immunoelectron microscopic study of dengue-2 virus infection of cultured mosquito cells: maturation events. AB - The maturation process of dengue-2 virus in C6/36 mosquito cells was studied by electron microscopy at 12, 16, 24, 48, and 78 hours postinoculation (p.i.) and by immunoelectron microscopy at 48 and 78 hours p.i. Maturing virions appeared within cytoplasmic vacuoles and on the surface of infected cells from 24 hours p.i. onward in close topographical relationship to the dense particles that occurred concurrently in the cytoplasm. The dense particles measured 25 to 35 nm in diameter; the mature virions measured 50 to 55 nm in diameter, with a dense core measuring 30 to 35 nm in diameter covered by a 10 nm-thick membrane envelope. The morphological observations indicated that the dense particles were dengue nucleocapsids assembled in the cytoplasm and that they apparently budded into the vacuolar lumens and the extracellular space at the vacuolar and plasma membranes, acquiring membrane envelopes and becoming mature virions in the process. The virions that budded into the vacuolar lumens were released extracellularly by exocytosis. In the samples tested with dengue-2 polyclonal antibodies, intense immunostaining occurred at the sites of virus budding on the cell surface; host cell membrane and cytoplasm adjacent to the budding virions stained less intensely. In the samples tested with a dengue-2 monoclonal antibody specific for the envelope glycoprotein, budding virions stained rather exclusively, with no staining occurring in adjacent host membrane or cytoplasm. PMID- 3813889 TI - Nucleotide sequence of the 5'-terminal untranslated part of the genome of the flavivirus West Nile virus. AB - We have determined the nucleotide sequence of the 5'-terminal untranslated region of the 42 S genome RNA of the flavivirus West Nile virus by primer extension. These analyses make our primary structure determination of this genome, which comprises a total number of 10,960 nucleotides, complete. Some implications of our data concerning the structure of flavivirus-specific nucleic acids and the initiation of translation of WN virus-specific RNA are discussed. PMID- 3813890 TI - The structure of the capsid inner layer of reoviruses. Brief report. AB - It is shown that reovirus capsid inner layer consists of 132 capsomeres with a skewed icosahedral pattern of T = 13 (left). 780 structural units composing capsomeres are integrated into trimers. The boundary between capsomeres runs between the structural units forming trimers. PMID- 3813891 TI - Expression of immunity to intravaginal herpes simplex virus type 2 infection in the genital tract and associated lymph nodes. AB - Herpes simplex virus type 2 is a human venereal pathogen which causes lethal neurological illness after intravaginal inoculation into BALB/cJ mice. In the present studies, we demonstrate that intravaginal vaccination with an attenuated strain of this virus, which possesses a partial deletion of the thymidine kinase gene, rapidly induced durable immunity to lethal intravaginal challenge with wild type virus. Such immunity was characterized by a dramatic hyperplasia of genital lymph nodes and a significant reduction in wild-type virus replication and spread from the genital tract following lethal challenge. Of greater importance, immunity to lethal wild-type virus challenge in the genital tract was transferrable to non-immune mice with genital lymph node cells prepared 1 week after intravaginal vaccination but was not transferrable with serum or cells from other lymphoid organs tested at this time. The adoptive transfer of anti-viral immunity to wild-type challenge was also characterized by a diminution in wild type virus replication and spread from the genital tract. These results suggest that an important component of cellular immunity to genital pathogens may be antigenic stimulation of genital lymph nodes. PMID- 3813892 TI - Aggravation of pathogenicity of an avian influenza virus by adaptation to quails. AB - Influenza virus A/turkey/Ontario/7732/66 (H 5 N 9), which is highly pathogenic to chickens, is nonpathogenic to quails. After intratracheal or intramuscular inoculation of quails, virus replication was limited to the respiratory tract, genital organs, and pancreas. However, aggravation of the pathogenicity was achieved through adaptation only by several passages of lung homogenates in quails. The adapted virus caused a fatal generalized infection in quails as well as in chickens. The pathogenic change of the virus could not be explained by a change in the proteolytic cleavability of the hemagglutinin, because no difference was found in the cleavability between the original and the adapted viruses. The adapted virus formed larger plaques and grew a little faster than the original one in both chicken embryo and quail embryo cells. The faster multiplication of the adapted virus at the site of infection might be the reason for its change in pathogenicity. The original virus could circulate among quails by a direct contact transmission without causing disease. The shed virus, however, caused a fatal infection in chickens when they were kept in contact with the infected quails. The epidemiological significance of this observation is discussed. PMID- 3813893 TI - [Effects of improvement in working conditions on occupational asthma]. PMID- 3813894 TI - [A study on childhood pollinosis (2nd report)--an epidemiological examination of pollinosis among junior high school students in Matsukawa town, Nagano Prefecture]. PMID- 3813895 TI - [The children with selective IgA deficiency registered at the All Japan Immunodeficiency Registry]. PMID- 3813896 TI - [Natural killer (NK) cell activity in parents of children with bronchial asthma]. PMID- 3813897 TI - [Ventilatory function in workers in food additive processing]. PMID- 3813898 TI - Cerebral glycolysis and glycogenolysis in diazinon treated animals. PMID- 3813900 TI - [The effect of work on the course and development of ankylosing spondylitis]. PMID- 3813899 TI - The relationship between Trichothecium roseum and Aspergillus parasiticus and the production of aflatoxins. PMID- 3813901 TI - [Localization of acute attacks of gout in relation to patient occupation]. PMID- 3813902 TI - [Use of hemodialysis in the treatment of phenobarbitone and phenytoin poisoning]. PMID- 3813903 TI - [Features of the growth and differentiation of the spinal ganglion of the embryonic rat in diffusion chambers]. AB - Cultivation peculiarities in diffusive chambers on nucleoporous and milliporous filters of the rat embryo spinal ganglia have been investigated on the 18th-20th days of development. Optimal variants have been obtained on the nucleoporous filters. Growth and differentiation of the sensitive neurons and cells of the peripheral glia are realized quicker in the diffusive chambers on the nucleoporous filters, than under in vitro cultivation. In 7-12 days in the diffusive chambers there are already mature pseudounipolar and multipolar neurons, and lemmocyte--axonal interrelations are of definitive character. The disadvantage of the method is its limited time of cultivation, since a connective tissue capsule is formed around the diffusive chamber. PMID- 3813904 TI - [Features of the motor innervation of striated muscle tissue of the esophagus]. AB - By means of neurohistological, histochemical and ultramicroscopical techniques it has been revealed that motor innervation of the oesophageal striated muscle tissue in rats and rabbits is performed by amyelinated nervous fibers, that terminate as nervous-muscle synapses. Ultrastructural peculiarities of these synapses are presented as a large amount of synaptic vesicles in the axonal terminal, as a poor ramification of secondary synaptic folds, as a considerable amount of mitochondria in the adjoining sarcoplasm. Reaction to acetylcholinesterase demonstrates that most of the motor nervous terminals belong to the racemose type. They are situated in the oesophageal musculature chaotically and have less area than synapses of the muscle of the locomotor apparatus. PMID- 3813905 TI - [Succinate dehydrogenase activity in various parts of the rat heart in systole and diastole]. AB - After fixation of the rat heart at the state of systole and diastole, succinate dehydrogenase (SDH) activity has been revealed. In distributions of the muscle fibers according to their optic density, statistic characteristics connected with the first four moments have been taken into consideration. SDH activity is different in five cardiac parts. Individual changeability is more pronounced in the all cardiac parts at diastole. In comparison to the internal one at systole, it is lower in the all parts, and at diastole--in the atria only. The ratio of the internal and individual changeability is in such a state, that it should be taken into account in all statistical calculations, connected with SDH activity determination in cardiomyocytes. PMID- 3813906 TI - [Capillaries of the intrinsic nerves of human skeletal muscles]. AB - Development of blood capillaries in the human intraorganic nerves has been studied. The intramuscular nerves of fetuses, newborns, children and mature persons (88 cases in all) make the object of the investigation. Combination of light optic methods and electron microscopy is used. The development of blood capillaries of the human intraorganic nerves is a complex process, indissolubly connected with development of myelin and amyelin conductors. The capillaries in the nerves appear on the 3d month of the intrauterine development and their structure is the most favourable for intensively proceeding, at this time, the myelinization process. With progress of nervous fibers and stromal elements, differentiation of the blood capillaries takes place. By the 6th month of the interuterine life, the capillaries of the intramuscular nerves are mainly formed. The structural unit in interrelation of the capillaries and nerve elements is the complex: capillary-lemmocyte-nervous fiber. Further changes are of slower character. PMID- 3813907 TI - [Coronary sinus of the heart in various anomalies of the conotruncus]. AB - Thirty-one hearts with anomalous conotruncus (common arterial trunk, hypoplasia of the aorta with transposition, atresia of the pulmonary trunk) have been studied. There are some peculiarities in anatomy and topography of the coronary sinus, concerning its sources, that is veins forming the venous sinus, position and interrelations with the venous sulcus and with the interatrial septum, size and form of the ostium and valve of the coronary sinus. The most amount of the anatomical peculiarities of the sinus are observed in the preparations, where the anomalous conotruncus is combined with absence of one or both cardiac septa. PMID- 3813909 TI - [Neurono-glial ratios in the frontal cortex of the human cerebrum in normal and pathologic aging (Alzheimer's disease)]. AB - Structural organization of the frontal area cortex (fields 8 and 47) in the left and right cerebral hemispheres has been studied cytoarchitectonically in mentally sound and sick persons of various age groups (34-40, 50-60 and 80-90 years). In sections 20 mcm thick, stained with cresyl-violet, in 0.001 mm3 of the cerebral substance (layers III and V) arrangement density is estimated for all pyramidal neurons, for all gliocytes, neurons surrounded with satellite glia and separately for perineuronal gliocytes, as well as per cent ratio of all the parameters obtained. In the process of normal and pathological ageing certain changes, both common for these two processes and specific for each of them, take place in the structural organization of the fields 8 and 47. Under normal ageing the changes are more distinct in the field 8, in the layer III, and at Alzheimer's disease there is a slight prevalence of them in the associative field 47, in the layer V. PMID- 3813908 TI - [Morphologic changes in the thymus and lymphoid nodules of the appendix of the white rat subjected to increasing physical loads]. AB - By means of histological and morphometrical methods the thymus and appendage have been studied in male white rats subjected to a dosed physical loading (swimming). The physical loading is accompanied with essential changes in structure and cell composition of the immunogenic organs. The rate and character of the changes depend on the adaptability level of the animal's organism to the physical loading. At adaptation to the loading, the process of age involution of the thymus decelerates, amount of lymphoid nodules in the appendage increases, comparing the control parameters, contents of lymphocytes noticeably increase in all zones of the lymphoid nodules. When adaptation to the physical loading is not sufficient, the rate of the thymus involution sharply increases, while in the appendage the number of the lymphoid nodules decreases. However, in some animals at a sharp involution of the thymus, the changes in the appendage do not differ from the control ones. PMID- 3813910 TI - [Variants of the position of the jugular trunks]. AB - Topographo-anatomical position of the jugular trunks has been investigated in 30 human corpses. Certain differences in structure of the left and right jugular trunks are revealed, their peculiarities in persons with different habitus type are noted. The peculiarities mentioned are expedient to take into account in surgical practice, when pathways of lymphatic drenage are cut with prophylactic aims in patients suffering from inflammatory processes in the maxillofacial area. PMID- 3813911 TI - [Changes in the anatomic structures and cellular composition of lymph nodes after prenatal exposure to oleandomycin]. AB - Tracheobronchial and mesenteric lymph nodes have been investigated in 120 embryos, fetuses and newborn (5-, 14-, 30-day-old) rats by means of anatomical, histological and electron microscopical methods. Prenatal influence of oleandomycin phosphate on development of lymph nodes has been analysed. Effect of the drug on the mother--fetus system produces certain reactive changes in the anatomical structures responsible for the barrier-filtration and drainage functions of the lymph nodes. The immunocytopoietic function is inhibited, as demonstrates certain decrease of lymphatic line cells. PMID- 3813912 TI - [Embryonic development of the human duodenum]. AB - Epithelial duodenal anlage takes place at the end of the first month of the human embryogenesis in connection with appearance of the pancreatic epithelial germs. It has a form of a short arch with a spindle-like enlargement of the middle ductal part. Formation of the hepato-duodenal ligament and of the duodenal mesentery results in appearance of the given organ anlage with a three-layered wall in 5.5-6-week-old embryos. The anlage makes an arch, protruding to the right and forward with a spindle-like enlargement of the middle ductal part. It is tightly connected with the forming anlage of the pancreatic head, when the pancreatic epithelial anlages are fusing. An intensive growth of the pancreatic head is accompanied with emergence and enlargement of the superior, descending and inferior parts of the duodenum, that acquires a semicircular form in 8-8.5 week-old embryos. Its transitional stage is a curved semicircle having a form of a distended spiral coil; that reflects an uneven growth of the organ in the human embryogenesis. PMID- 3813913 TI - [Transformation of the kidney pelvis and the major and minor calices during their development]. AB - The investigation has been performed in 28 series of histological sections of human embryos and prefetuses (4-20 weeks of the intrauterine development) and in 17 fetal corpses by means of certain histological methods, preparation of graphic reconstructive models, microscopy and fine preparation. The structural form of the definitive organ renal pelvis is demonstrated to depend on the ramification type of the metanephric duct derivatives. This is stipulated by interinductive processes of the ureteral sprout and metanephrogenic tissue. Quantitative and qualitative characteristics of the diverticulum ramification of the mesonephric duct during embryonic period of the prenatal ontogenesis predetermine the number of the calyces renalis majors and minors in the metanephros. PMID- 3813914 TI - [Histochemical demonstration of enzymatic activity in the mucous layer of the internal organs]. PMID- 3813915 TI - [Method of preparing biological objects for precision ultramicrotomy]. PMID- 3813916 TI - [The teaching of human anatomy in departments of universities composed of many schools]. PMID- 3813917 TI - [Studies on age-related morphology during the past 5 years and prospects for their development]. PMID- 3813918 TI - [Advances in the therapeutic approach to hypertension before the recent epidemiological and physiopathological verifications]. PMID- 3813919 TI - [Endomyocardial biopsy of the right ventricle in patients with endomyocardial fibrosis]. PMID- 3813920 TI - [Myocardial infarction at an anterior site. Prognostic value of the Gaasch index]. PMID- 3813921 TI - [Evaluation of subjects with hyperreactive pressure response to physical effort]. PMID- 3813922 TI - Accuracy of two-dimensional echocardiography for measuring right ventricular outflow tract in tetralogy of Fallot. PMID- 3813924 TI - [Acute myocardial infarction in a 5-year old child--mucocutaneous lymph node syndrome (Kawasaki disease). A case report]. PMID- 3813923 TI - [Incidence of obstructive lesions in the coronary artery system among the active population of the city of Sao Paulo]. PMID- 3813926 TI - [Xipamide in the treatment of moderate arterial hypertension]. PMID- 3813925 TI - [Echo- and phonomechanocardiographic evaluation of left ventricular function and total peripheral resistance during treatment of systemic arterial hypertension with pindolol and propranolol. A comparative study]. PMID- 3813927 TI - Controversies in diagnosis and management of pseudotumor cerebri. PMID- 3813928 TI - Subcortical dementia. PMID- 3813929 TI - Cortical vs subcortical dementia: neuropsychological similarities. PMID- 3813930 TI - Spontaneous carotid dissection with acute stroke. AB - Thirty (2.5%) of 1200 consecutive patients with a first stroke had a spontaneous dissection with occlusion of the cervical internal carotid artery (ICA). A suggestive picture with ipsilateral headache and oculosympathetic paresis was uncommon (17%), so that diagnosis was uncertain before angiography. Seven patients died within one week. During follow-up (mean, 3.2 years) with sequential Doppler ultrasonographic testing, 12 survivors had a good recovery and early reopening of the occluded ICA, and 11 had a poor recovery usually without reopening of the ICA. Recurrence of a dissection occurred in only one patient. Large infarcts causing death or a severe disability were associated with an ICA thrombus and distal emboli; the organization of this intraluminal thrombosis may explain the absence of reopening in these cases while resorption of the intramural hematoma developed. Early heparin sodium therapy may help prevent intraluminal clotting without carrying an important risk of extending the dissection, but its clinical benefit remains unproven. Contrary to current opinions, ICA dissection with occlusion causing cerebral infarction may often carry a severe prognosis. PMID- 3813931 TI - Interobserver reliability in the interpretation of computed tomographic scans of stroke patients. AB - Interobserver reliability in interpretation of computed tomographic images was studied by six senior neurologists who independently evaluated on a standardized Stroke Data Bank form the brain lesions of 17 patients. The results analyzed with kappa statistics yielded moderate to substantial agreement on most items of interest including the stroke pathology and anatomy. In general, the levels of agreement were as high as previously reported for the diagnosis of the mechanism of the stroke, and much higher than on many stroke history items and items of neurologic examination. Excellent agreement was obtained for the detection of infarcts and intracerebral hemorrhage, and substantial agreement was obtained on whether the computed tomographic images were normal or indicative of small deep infarcts, superficial and deep infarcts, and aneurysms. The level of agreement on anatomy of the lesions was best for the frontal, parietal, and temporal lobes, putamen, cerebellum, and subarachnoid space. Implications for clinical research and diagnosis are discussed. PMID- 3813932 TI - Ischemia may be the primary cause of the neurologic deficits in classic migraine. AB - This study investigates whether the cerebral blood flow reduction occurring in attacks of classic migraine is sufficient to cause neurologic deficits. Regional cerebral blood flow measured with the xenon 133 intracarotid injection technique was analyzed in 11 patients in whom a low-flow area developed during attacks of classic migraine. When measured with this technique, regional cerebral blood flow in focal low-flow areas will be overestimated because of the effect of scattered radiation (Compton scatter) on the recordings. In this study, this effect was particularly taken into account when evaluating the degree of blood flow reduction. During attacks of classic migraine, cerebral blood flow reductions averaging 52% were observed focally in the 11 patients. Cerebral blood flow levels known to be insufficient for normal cortical function (less than 16 to 23 mL/100 g/min) were measured in seven patients during the attacks. This was probably also the case in the remaining four patients, but the effect of scattered radiation made a reliable evaluation of blood flow impossible. It is concluded that the blood flow reduction that occurs during attacks of classic migraine is sufficient to cause ischemia and neurologic deficits. Hence, this study suggests a vascular origin of the prodromal neurologic deficits that may accompany attacks of classic migraine. PMID- 3813933 TI - Visual loss in pseudotumor cerebri. Incidence and defects related to visual field strategy. AB - Visual field examinations were performed serially on 20 patients with pseudotumor cerebri using a modified Armaly-Drance visual field strategy with a Goldmann perimeter as well as an automated perimeter (Octopus). Visual loss was found in 75% of eyes using the manual strategy and in 77.5% of eyes with automated threshold perimetry. This incidence of visual loss is 50% greater than any previously reported series. All major defects detected were present with both types of perimetry. Both strategies were more sensitive for documenting visual loss than previously described strategies. Since therapy for pseudotumor cerebri is determined by the degree and progression of visual loss, a specific sensitive strategy, rather than routine screening perimetry, should be used for determination of visual loss. PMID- 3813934 TI - Learning deficit in Parkinson's disease. Comparison with Alzheimer's disease and normal aging. AB - The learning ability of 12 patients with Parkinson's disease (PD) was studied using a verbal paired-associate learning task, and was compared with that of ten patients with Alzheimer's Disease (AD) and 12 controls (NC). Overall, the PD patients performed significantly better than the AD patients but significantly worse than the NC subjects. Their performance was not related to their overall level of cognitive functioning as measured by the Mattis' Dementia Rating Scale, but was unequally distributed suggesting that the PD population actually consisted of more than one subgroup. A low error group performed like controls, while a high error group had a learning impairment comparable to that of AD patients. It is concluded that PD patients may have three patterns of neuropsychologic performance: some are unimpaired, some have "focal" abnormalities, and some have a generalized impairment of cognitive function. PMID- 3813935 TI - Temporal lobe involvement in multiple sclerosis patients with psychiatric disorders. AB - Patients with multiple sclerosis (MS) frequently develop psychiatric disturbances. The clinical histories and magnetic resonance imaging results from eight patients with MS and psychiatric disorders were compared with those from eight control MS patients matched for age, sex, duration and severity of illness, and clinical course. Both groups had widespread lesions on the magnetic resonance imaging scans; however, the psychiatric group had more clinically defined sites of MS involvement, possibly indicating a difference in the biologic activity of the lesions in this group. The total lesion area was not different between the groups. However, the distribution of lesions did differ; the psychiatric group had significantly more temporal lobe involvement than the control group. These results indicate a role for the cerebral lesions themselves, particularly those in the temporal lobes, in the genesis of psychiatric disorders in MS. PMID- 3813936 TI - Neurobehavioral outcome after closed head injury in childhood and adolescence. AB - Hospital records of 53 children and adolescents, aged 18 years or less, with closed head injury were reviewed for information on long-term outcome. Computed tomographic scans were used to divide the patients into clinicopathologic groups. Within these groups, duration of coma was the major index of severity. Outcome was assessed using the Glasgow Outcome Scale and by evaluating social behavior, school performance, and vocational functioning. Patients with diffuse injury plus focal lesions fared worse than those with diffuse injury only. Coma lasting more than one month led to a poorer outcome in both groups. Many individuals had limiting emotional disturbances, which may have resulted from disruption of frontal systems modulating arousal and social behavior. PMID- 3813937 TI - Adult metachromatic leukodystrophy. Value of computed tomographic scanning and magnetic resonance imaging of the brain. AB - Patients with adult-onset metachromatic leukodystrophy (MLD) often present with personality changes or deterioration of cognitive functions. Although rare, this form of MLD should be included in the differential diagnosis of psychotic and dementing disorders. The following case report describes a 38-year-old man with adult-onset MLD, who carried the diagnosis of schizophrenia and was treated as a schizophrenic for a number of years. Metachromatic leukodystrophy was initially suspected because of white matter abnormalities detected on computed tomographic scans and magnetic resonance images of the brain. The diagnosis of MLD was confirmed by the discovery of markedly reduced leukocyte arylsulfatase A activity. The computed tomographic and magnetic resonance imaging findings in MLD are reviewed. PMID- 3813938 TI - Neurologic complications of the epidermal nevus syndrome. AB - The epidermal nevus syndrome is a neurocutaneous disorder characterized by distinctive skin lesions and often serious somatic and central nervous system (CNS) abnormalities. We observed four cases of this disorder with epidermal nevi and neurologic manifestations, including mental retardation, seizures, ophthalmologic abnormalities, intracranial aneurysm, and porencephalic cyst. A review of 60 reported cases of the epidermal syndrome and our experience suggest that CNS complications are more likely to be associated with epidermal nevi on the head and that the CNS abnormalities are most often ipsilateral to the skin lesion. PMID- 3813940 TI - Survival of patients with cataract. PMID- 3813939 TI - Cerebral hemiatrophy, hypoplasia of internal carotid artery, and intracranial aneurysm. A rare association occurring in an infant. AB - A 4-month-old child with a very rare association of primary (congenital) left cerebral hypoplasia, hypoplasia of the left internal carotid artery, and giant anterior communicating artery aneurysm was seen. The aneurysm was detected and treated before rupture. We briefly reviewed the literature on agenesis (hypoplasia) of the internal carotid artery, intracranial aneurysms in childhood, and primary cerebral hypoplasia. It is proposed that cerebral arteriography, cranial computed tomography, or magnetic resonance imaging be performed in all children with primary cerebral hemihypoplasia to establish an etiologic diagnosis and, more importantly, to detect and treat possible associated intracranial aneurysms before they become symptomatic. PMID- 3813941 TI - Ophthalmology in the 21st century. PMID- 3813942 TI - Extension of retinal detachments as a complication of pneumatic retinopexy. PMID- 3813943 TI - Fluorouracil and suprachoroidal hemorrhage. PMID- 3813944 TI - Properdin-mediated immune ring formation associated with Pseudomonas keratitis. PMID- 3813945 TI - Radiation therapy for ocular necrobiotic xanthogranuloma. PMID- 3813946 TI - Regression. PMID- 3813947 TI - Medical malpractice litigation in the management of vitreoretinal diseases. PMID- 3813948 TI - Results and prognostic factors in vitrectomy for diabetic vitreous hemorrhage. AB - The final visual acuities and prognostic factors predictive of these results were analyzed in 353 eyes that had pars plana vitrectomy for nonclearing diabetic vitreous hemorrhage. Eighty-one percent of the eyes had improved visual acuities on final examination. The percentage of eyes that achieved a visual acuity of 20/100 or better and the percentage that achieved 5/200 or better increased during the study period. Preoperative factors associated with a favorable visual prognosis included the following: preoperative visual acuity of 5/200 or better, absence of iris neovascularization, absence of neovascular glaucoma, clear lens or minimal cataract, and panretinal photocoagulation of at least one fourth of the fundus. Intraoperative factors associated with a favorable visual prognosis included retaining the crystalline lens and absence of an intraocular gas bubble. PMID- 3813949 TI - Vitrectomy for progressive proliferative diabetic retinopathy. AB - We analyzed the results of 105 diabetic vitrectomy cases. The vitrectomies were performed for progressive fibrovascular proliferation that caused epiretinal membranes, vitreopapillary traction, florid neovascularization, or subhyaloid hemorrhage, with or without substantial preoperative visual loss. Eyes with inactive retinal neovascularization, dense vitreous hemorrhage, traction retinal detachment involving the macula, or combined traction and rhegmatogenous retinal detachment were excluded. Seventy-four eyes (70%) had improved final vision. The final vision was unchanged in eight eyes (8%) and was worse in 23 eyes (22%). Factors associated with a favorable visual prognosis included the following: age of 40 years or less, preoperative visual acuity of 5/200 or better, absence of preoperative iris neovascularization, preoperative panretinal photocoagulation, and absence of an iatrogenic retinal break. PMID- 3813950 TI - Thrombin infusion to control bleeding during vitrectomy for stage V retinopathy of prematurity. AB - We prospectively studied 36 consecutive premature infants with the diagnosis of retinopathy of prematurity stage V with total traction retinal detachment who underwent lensectomy/vitrectomy and epiretinal membrane delamination. The first 26 patients underwent vitrectomy using thrombin mixed with Balanced Salt Solution Plus at a concentration of 100 U/mL and the remaining ten patients had pure Balanced Salt Solution Plus used. Intraoperative and postoperative bleeding were monitored. The overall intraoperative bleeding rate was 92% (33/36). Intraoperative bleeding (19% vs 80%) and bleeding at the time of wound closure (4% vs 30%) were both significantly reduced in the thrombin vs no thrombin group. PMID- 3813952 TI - Epiretinal membranes in sickle cell retinopathy. AB - We examined the hospital records (including fundus photographs) of 769 patients (1486 eyes) with sickle cell disease from June 1978 to July 1985 for evidence of epiretinal membranes in the macula (51 eyes) or extramacular region (four eyes) of the posterior pole. The incidence of epiretinal membranes, seen in the eyes of patients with hemoglobin SC, SS, and SB+ thalassemia, was 3.7%. Most epiretinal membranes were mild, and visual acuity was 20/40 or better in 78.2% of these eyes. Severe macular pucker was occasionally noted following retinal detachment surgery. One patient with SC disease developed a macular epiretinal membrane that led to a macular hole and eventually to macular and extra-macular retinal detachment. Epiretinal membranes are a relatively common cause of maculopathy in patients with sickle cell disease. PMID- 3813951 TI - Aminocaproic acid reduces the risk of secondary hemorrhage in patients with traumatic hyphema. AB - In a prospective, randomized, double-masked study, 34 patients (34 eyes) with nonperforating ocular injury and traumatic hyphema were treated with either aminocaproic acid (Amicar), 100 mg/kg every four hours, up to a maximum of 30 g/d, or placebo for five days. None of 21 patients who were treated with aminocaproic acid rebled, while three (23%) of 13 patients who were treated with placebo rebled. This difference was statistically significant. Of the three patients who rebled, two required surgical intervention, with one patient requiring four surgical procedures. Although complications following aminocaproic acid therapy included light-headedness, nausea and vomiting, and systemic hypotension, only one patient was withdrawn from the study because of drug related adverse reactions. This study strongly confirms that aminocaproic acid therapy significantly reduces the incidence of secondary hemorrhage following traumatic hyphema. PMID- 3813953 TI - Quantification of diabetic macular edema. AB - In a cross-sectional study, 34 diabetic patients with clinically significant macular edema underwent visual acuity testing, stereo fundus photography (graded for retinal thickening and hard exudates), fluorescein angiography (evaluated for macular leakage and the outline of the foveal avascular zone [FAZ]), and vitreous fluorophotometry (whereby posterior penetration ratios were calculated). This last ratio provided the highest single correlation with visual acuity; next highest were patient age and FAZ grading. Multivariate regression confirmed that these three variables together best predicted visual acuity. Lesser correlations with acuity were obtained with angiographic leakage and fundus photography grading. Cross-correlations among all gradings showed that indicators of breakdown of the blood-retinal barrier, ie, fluorophotometry, angiographic leakage, and retinal thickening, were significantly correlated with each other, whereas FAZ grading was independent of all these factors and correlated only with acuity. By performing vitreous fluorophotometry and fluorescein angiography, it is possible to quantitate two major components of diabetic maculopathy: breakdown of the blood-retinal barrier and macular ischemia, both of which are highly correlated with visual acuity. PMID- 3813954 TI - Graphic presentation of computer-analyzed keratoscope photographs. AB - We describe a corneal topography analysis system that creates accurate high resolution graphics of corneal surface power from computer analysis of keratoscope photographs, and we present several examples of corneal shape analyses. The major improvement in the updated version presented here is the development of a contour map of corneal surface power. Improvements in computer algorithms used to analyze the raw data obtained from the keratoscope photographs have also been made, resulting in increased accuracy. This system allows the ophthalmologist to see the patterns of power distribution on the corneal surface more easily than is possible by visual inspection of keratoscope photographs. Improved corneal topography analysis should find wide clinical application in the study of refractive corneal surgery techniques and in the study of corneal disorders that cause irregular astigmatism. PMID- 3813955 TI - Endolaser, cryopexy, and retinal reattachment in the air-filled eye. A clinicopathologic correlation. AB - We report the histopathology of intraocular argon blue-green laser photocoagulation lesions and transscleral cryopexy lesions in the air-filled human eye. Two days after treatment, the cryopexy lesions showed full-thickness retinal involvement, including disruption of the internal limiting lamina. The laser lesions showed full-thickness involvement as well. These observations emphasize the need for caution with thermal treatment modalities in the air filled eye. Ophthalmoscopic examination 48 hours following vitrectomy, internal drainage of subretinal fluid, and gas fill of the vitreous cavity for diabetic macular detachment of several months' duration showed the retina to be attached. However, histopathologic examination revealed a thin layer of persistent subretinal fluid, demonstrating that it may take longer than is clinically apparent for true retinal reattachment to occur following gas tamponade of posterior retinal breaks. Prolonged gas tamponade may be necessary before retinal reattachment, with reestablishment of photoreceptor-pigment epithelial adherence, can be expected to help seal unrecognized or untreated posterior retinal breaks. PMID- 3813957 TI - Argon laser panretinal photocoagulation for diabetic retinopathy. Scanning electron microscopy of human choroidal vascular casts. AB - Plastic casts of the choroid of a 76-year-old diabetic man who received panretinal photocoagulation for proliferative diabetic retinopathy were studied with the scanning electron microscope. Despite a 14-month interval between the last panretinal photocoagulation session and death, numerous choriocapillaris filling defects were present and correlated with photocoagulation lesions present on antemortem fluorescein angiograms. PMID- 3813956 TI - Histopathology of krypton red laser panretinal photocoagulation. A clinicopathologic correlation. AB - The histopathologic appearance of five-day-old and 14-day-old krypton red laser created panretinal photocoagulation lesions in the diabetic human eye is described. The five-day-old lesions were examined near the equator. The 14-day old lesions were near the temporal arcades and optic disc. Both groups of laser lesions showed a similar degree of damage and occlusion in the lamina choriocapillaris and deeper choroidal vessels. The 14-day-old posterior laser lesions showed outer retinal damage, whereas the five-day-old peripheral lesions showed full-thickness retinal involvement, probably because the peripheral retina is approximately half the thickness of the posterior retina. The five-day-old lesions showed no evidence of repair, whereas the 14-day-old lesions showed an adhesion formed with tight junctions binding Muller's fibers to retinal pigment epithelium. PMID- 3813958 TI - Central nervous system and peripheral mechanisms in ocular hypotensive effect of cannabinoids. AB - Systemic administration of cannabinoids decreases intraocular pressure (IOP). To determine whether the mechanism of action originates in the central nervous system, we administered various cannabinoids into the cerebral ventricles of conscious New Zealand albino rabbits. When delta 9-tetrahydrocannabinol (delta 9 THC), delta 8-tetrahydrocannabinol, cannabinol, and cannabidiol were given intravenously, only delta 9-THC produced dose-dependent ocular hypotension and miosis. Bolus administration into the cerebral ventricles or ventriculocisternal perfusion of delta 9-THC did not change IOP or pupil size. In urethane anesthetized rabbits, IOP and blood pressure were lowered by intravenous administration of delta 9-THC but not by bolus cerebral administration. These observations indicate that the action of cannabinoids on IOP does not originate in the central nervous system. Alteration of blood pressure may be involved in the mechanism of ocular hypotension induced by delta 9-THC. PMID- 3813959 TI - Intraocular pressure effects of multiple doses of drugs applied to glaucomatous monkey eyes. AB - The effects of multiple dosing with 0.5% timolol maleate, 2% epinephrine hydrochloride, 4% pilocarpine hydrochloride, 1% vanadate, 1% forskolin (nonproprietary name, colforsin), or 0.5% prostaglandin F2 alpha on intraocular pressure (IOP) were each tested on eight cynomolgus monkey eyes in which glaucoma was induced by photocoagulating the trabecular meshwork with the argon laser. The week prior to drug therapy, baseline IOP measurements were carried out at hourly intervals from 9:30 am to 3:30 pm on three days. One to two days later, therapy was initiated. Each drug was applied topically to both eyes of each monkey twice daily for at least four days. The IOP was measured with a calibrated pneumatonometer at the same hourly intervals on treatment days as on the baseline days. The IOP at each time of day on treatment days was compared with the average baseline IOP measured at the corresponding time of day. Topical application of timolol, epinephrine, pilocarpine, vanadate, and prostaglandin F2 alpha significantly reduced IOP without evidence of tolerance or tachyphylaxis during the course of therapy. Forskolin did not significantly decrease IOP after the second day of treatment. PMID- 3813960 TI - Effect of carbachol on rabbit corneal endothelium. AB - We investigated the current reformulation of the commercially available intraocular preparation of carbachol for its effect on corneal thickness and endothelial cell ultrastructure. A 15-minute perfusion in the specular microscope with 0.01% carbachol caused a significant increase in the corneal swelling rate, which returned to control values after 75 minutes of reperfusion with Krebs Ringer bicarbonate solution. Continued reperfusion with Krebs Ringer bicarbonate solution led to the final average corneal swelling rate being statistically similar to that of controls over the entire 180-minute perfusion period. Transmission and scanning electron microscopy demonstrated no changes in endothelial cell ultrastructure. PMID- 3813961 TI - The effect of perfluoropropane on the cornea in rabbits and cats. AB - The effects of perfluoropropane gas on the cornea were compared with those of sulfur hexafluoride gas following injection into the anterior chamber of rabbits and cats. Injection of 0.15 mL of gas produced a perfluoropropane bubble that lasted 22 days compared with a sulfur hexafluoride bubble that lasted seven days. The sulfur hexafluoride bubble produced corneal edema for as long as the gas was present. With perfluoropropane, corneal edema persisted even after the gas bubble disappeared. In another group of cats, multiple sequential injections of sulfur hexafluoride to maintain a gas bubble of duration comparable with the perfluoropropane bubble also produced edema as long as gas was present. Clinical corneal edema, endothelial fibrin deposition, endothelial opacities, and retrocorneal membrane were observed by slit-lamp and light, scanning, and transmission electron microscopic examinations of the corneas exposed to perfluoropropane but not of those exposed to sulfur hexafluoride. Prolonged corneal endothelial contact by perfluoropropane results in corneal edema due to endothelial dysfunction, which persists in cats probably because feline endothelium is less capable of regeneration than that of rabbit. PMID- 3813962 TI - Systemic tetracycline treatment of alkali-induced corneal ulceration in rabbits. AB - Recent evidence has demonstrated a marked anticollagenolytic effect for the tetracycline antibiotics. We have examined the efficacy of systemic tetracycline hydrochloride in a rabbit model of corneal ulceration. A standard alkali burn (1N sodium hydroxide for 40 s) was delivered to 62 eyes (31 rabbits). Animals were then divided into three groups: group 1 (controls) (ten rabbits [20 eyes]) received no treatment; group 2 (ten rabbits [20 eyes]) received 10 mg/kg/d of tetracycline hydrochloride, given intramuscularly; and group 3 (11 rabbits [22 eyes]) received 50 mg/kg/d. Ulceration occurred in 85% (17/20) of control eyes. The higher dosage of tetracycline was more effective in preventing ulceration than the lower dosage (9.1% vs 55%). Eyes with higher levels of tetracycline in ocular tissues were less likely to ulcerate. PMID- 3813963 TI - Systemic aminocaproic acid reduces fibrinolysis in aqueous humor. AB - Systemically administered aminocaproic acid has been demonstrated to reduce the incidence of secondary hemorrhage in traumatic hyphema. To directly determine the concentration of aminocaproic acid in the aqueous humor, four groups of rabbits were studied following administration of four different regimens of intravenously administered aminocaproic acid. Plasma and aqueous humor samples were assayed for drug content and antifibrinolytic activity. Peak aqueous humor concentrations of aminocaproic acid ranged from 2.5 to 33 mg/dL and varied according to the systemic dose administered. The antifibrinolytic activity paralleled the aminocaproic acid content, with a peak range from 310 to 683 s. These findings indicate a direct relationship between antifibrinolytic activity and the concentration of aminocaproic acid in aqueous humor. PMID- 3813964 TI - Magnetic resonance imaging diagnosis of hepatolenticular degeneration. PMID- 3813965 TI - Surgical instrumentation cart. AB - We describe the design of a surgical equipment/instrumentation cart that provides accessibility, mobility, convenience, conservation of floor space, and efficient use of vertical air space. This multiple-shelf cart allows organization and coordination of multiple pieces of equipment. The attached working shelves replace the multiple Mayo stands and free up needed floor space. This cart provides for easy storage and unnecessary movement of equipment and potential damage. The power strips on the rear of the cart eliminate the multiple electrical cords and potential injury to operating personnel and equipment malfunction. PMID- 3813966 TI - A planimetric study of temporal bone pneumatization. AB - The present study is based on the results of planimetric measurements of temporal bone pneumatization in 60 children. Radiological and clinical follow-up studies show that a myringotomy is sufficient therapy for cases of serous effusions. In contrast, mucous effusion require long-term middle ear ventilation with tympanostomy tubes to get approximately the same increase in temporal bone pneumatization. PMID- 3813968 TI - The cochlea of the spontaneously diabetic mouse. II. Electron microscopic observations of non-obese diabetic mice. AB - We used transmission electron microscopy to examine the cochlea of non-obese diabetic mice as animal models for human type I or non-insulin-dependent diabetes mellitus. Pathological changes were observed in the organ of Corti of the basal turn and in the stria vascularis of each turn. Major findings in the stria vascularis were protrusion or condensation of marginal cells, swelling of intermediate cells, and widening of the intercellular spaces. Principal findings in the organ of Corti involved degenerative changes of the outer and inner hair cells and replacement of hair cells by supporting cells. No prominent pathological changes were observed in the capillaries. The possible mechanism of diabetic involvement in cochlear pathology is discussed. PMID- 3813967 TI - Stimulation of peripheral blood lymphocytes with autologous tumor and serum derived fractions from patients with laryngeal carcinomas. AB - We investigated the in vitro stimulation of peripheral blood lymphocytes with tumor extracts and serum-derived fractions from five patients with laryngeal carcinomas. Lymphocyte cultures were propagated by Interleukin-2 or phytohemagglutinin. Sera of the same patients were fractionated and the amount of circulating immune complexes present was measured by a Raji cell assay. A positive lymphocyte reaction was found in only two of the five cases after stimulation with autologous tumor extract. This response was determined by an increased 3H-thymidine incorporation. The reactive lymphocytes could be restimulated by autologous serum-derived fractions, which contained high or very low levels of circulating immune complexes. A characterization of different lymphocyte subsets revealed an elimination of natural killer cells and a relative enrichment of T-helper cells during in vitro stimulation and cultivation. PMID- 3813969 TI - Ciliary activity in the in vitro tubotympanum. AB - We have introduced a tissue culture technique in which the ciliary activity of the cultured tubotympanum can be studied. We have found that ciliated cells of the eustachian tube and middle ear lining continued a beating activity during 168 h of observation. The mean loss of activity of the ciliated cells from the eustachian tube or mucosal sites proximal to the tube was 20% or less, while that of mucosal sites distal to the tube was about 40% even after 168 h of cultivation in our culture medium of RPMI 1640. Our technique of tissue culture is available for studying the long-term effects of various therapeutic agents or adverse factors on the ciliary activity in the tubotympanum. PMID- 3813970 TI - Teratoma of the soft palate with multifocal cyst formation in the tongue and the brain. AB - We report a case of a solid and cystic teratoma appearing in the soft palate that was associated with a cyst in the tongue and a huge cystic formation in the arachnoid of the brain. Histologically, the tumor of the soft palate contained elements of all three germ layers, with a predominance of mature glial tissues. This typical teratoma and the two other concurrent lesions were all located on the same side of the head, and were thought to have a common embryonic origin. These multifocal tumors may represent an incomplete manifestation of a "teratoma complex". PMID- 3813971 TI - The laryngeal vestibule and voice quality. AB - Most of the literature on voice quality focuses on the vocal folds while six other gestures involving the laryngeal entry and epilaryngeal structures are largely ignored. Whole organ tracer series histograms of the larynx are examined and suggestions are made as to which muscles and/or forces might cause these gestures. An examination of photographs of the larynx indicates that the latter must be described in three dimensions: medio-lateral, antero-posterior, and vestibule cross-sectional area. The article is aimed at laryngologists in general, not surgeons in particular, and has implications for laryngology (being a putative model of diagnostic procedures), physiology (what forces create epilaryngeal configurations?), neuroscience (does the motor cortex control single muscles or whole gestures?), speech pathology (what is the ragbag called "hypertenseness"?), linguistics (how is one to describe lower pharynx phenomena?) and paralinguistics (what is the extrasystemic laryngeal component of voice quality?). PMID- 3813972 TI - Proceedings of the 1986 annual meeting of the German Society for Otorhinolaryngology and Head and Neck Surgery. Summaries. PMID- 3813973 TI - George Lyman Duff memorial lecture. Personality, gender, and coronary artery atherosclerosis of monkeys. PMID- 3813975 TI - Very low density lipoproteins stimulate cholesteryl ester formation in U937 macrophages. Heterogeneity and biologic variation among normal humans. AB - Normolipidemic fasting VLDL stimulated the formation of cholesteryl ester in the human macrophage-like cell line, U937. VLDL from different persons exhibited heterogeneity over a 10-fold range in stimulating cholesterol esterification, and were 7% to 98% as active as human LDL. The effects of VLDL in U937 cells were highly correlated to those in normal human fibroblasts. VLDL did not induce cholesterol esterification in resident mouse peritoneal macrophages, nor in fibroblasts that lacked LDL receptors, suggesting that receptors for LDL, rather than for beta-VLDL, mediate the effects of VLDL. The active VLDL particles were found in the dense VLDL subfraction, Sf20 to 60, but not in Sf60 to 100 or Sf100 to 400. The activity of unfractionated VLDL was correlated directly with % cholesteryl ester in total or Sf20 to 60 VLDL, and inversely with VLDL triglycerides. Biologic variation of fasting VLDL activity in U937 cells was found in 13 normolipidemic ambulatory subjects. As compared to the correlation between the activity of two VLDL samples derived from a single aliquot of blood (r = 0.90), the correlation was lower (r = 0.60) between the activity of samples taken on successive days, and even less (r = 0.05) between VLDL samples obtained 2 weeks apart. Substantial biologic variation also occurred in VLDL composition except for VLDL unesterified cholesterol. These findings suggest an environmental influence on VLDL metabolism by macrophages. PMID- 3813974 TI - Fatty streak expansion and maturation in Watanabe Heritable Hyperlipemic and comparably hypercholesterolemic fat-fed rabbits. AB - This study focuses on the expansion and maturation of the fatty streak in the aorta of Watanabe Heritable Hyperlipemic rabbits and comparably hypercholesterolemic fat-fed rabbits between 2 and 6 months duration of hypercholesterolemia. In both groups of animals, the fatty streaks expanded due to: 1) the formation of multiple layers of a mixed population of macrophage derived foam cells and lipid-containing smooth muscle cells, 2) the hypertrophy of the macrophage-derived foam cells, 3) the continued accumulation of extracellular matrix, 4) the insudation of plasma components. Immunocytochemical studies utilizing macrophage-specific and muscle-actin-specific monoclonal antibodies indicated that the expanding and mature fatty streaks in both the Watanabe and fat-fed rabbits were primarily composed of macrophage-derived foam cells. Hypertrophy of those foam cells situated immediately beneath the endothelium was associated with retraction of the endothelium and exposure of the intimal foam cells to the circulation. Endothelial retraction with exposure of intimal foam cells may facilitate entry of blood cells and lipoproteins into the lesions and formation of mural thrombi on the surfaces of the exposed cells. Biochemical analyses of the cholesterol content of the arteries indicated that both unesterified cholesterol and cholesteryl esters were deposited to a comparable degree in both the Watanabe and fat-fed rabbits. Thus, the absence of the low density lipoprotein receptor in Watanabe rabbits does not appear to directly influence the accumulation of cholesterol in the artery wall. PMID- 3813976 TI - Population-based study of glycosylated hemoglobin, lipids, and lipoproteins in nondiabetic adults. AB - Glycosylated hemoglobin levels reflect glucose homeostasis over the preceding months. Many investigators have reported levels of glycosylated hemoglobin in diabetics and have noted a strong correlation of these levels with lipids and lipoproteins, but not with HDL cholesterol. We report here the first population based study of the predominant fraction of glycosylated hemoglobin, HbA1, and its correlates in nondiabetics. In 558 euglycemic adults (fasting plasma glucose less than 140 mg/dl) aged 40 to 79 years who had no history of diabetes, HbA1 was normally distributed, was unrelated to age, and was correlated with fasting plasma glucose in men and women and with obesity in women. After adjusting for age and obesity, HbA1 was significantly correlated with total plasma cholesterol and LDL cholesterol in both sexes and with total plasma triglyceride and VLDL cholesterol in men. HDL cholesterol was not significantly associated with HbA1 in men or women. These associations are similar, although weaker, than those reported in most studies of diabetics. The finding that the association of glycosylated hemoglobin with lipids and lipoproteins extends throughout the normal range of blood sugar suggests that this association may be relevant to both the excess risk of ischemic heart disease in diabetics and in nondiabetics with higher levels of fasting plasma glucose. PMID- 3813977 TI - Alteration of high density lipoprotein subfractions of nonhuman primates fed fish oil diets. Selective lowering of HDL subfractions of intermediate size and density. AB - Two groups of adult male African green grivet monkeys (12 animals in each group) were fed atherogenic diets containing 40% of total calories as fat with half of the fat calories derived from lard or menhaden oil and 0.8 mg cholesterol/kcal for a period of 10 months to ascertain the effect of such diets on lipoprotein concentrations, composition, and distribution. After 8 months on this diet, the animals' lipoproteins were isolated from their plasma by ultracentrifugation and agarose column chromatography, and these were characterized chemically. Compared with the lard-fed group, the menhaden oil-fed animals had significantly lower total plasma cholesterol (decreases 33%), HDL cholesterol (decreases 33%) and apo A-I (decreases 30%) concentrations and LDL molecular weights (decreases 15%). Although the fish-oil diets resulted in an average similar reduction of LDL cholesterol concentrations (decreases 34%), the decrease was not statistically significant. The lipid and apoprotein compositions of plasma LDL and HDL were similar between the two groups of animals. The distribution of HDL subfractions was determined by gradient gel electrophoresis and density gradient ultracentrifugation. The fish-oil group had a significant reduction in protein (decreases 46%) of HDL subfractions of intermediate size (80 to 88 A) compared to the lard-fed group. By density gradient ultracentrifugation, there was a 35% to 40% lower concentration of protein in the d = 1.10-1.13 g/ml subfraction of fish oil-fed monkeys. Thus, feeding fish oil to nonhuman primates results in a selective decrease in the concentration of HDL subfractions of intermediate size and density compared to lard-fed animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3813978 TI - Effect of nicardipine and verapamil on in vitro albumin transport in rabbit thoracic aorta. AB - Calcium antagonists have been shown to have an antiatherogenic effect. We investigated the effect of nicardipine and verapamil on the albumin transport across the media of excised rabbit thoracic aorta. The effect of nicardipine was also tested in deendothelialized arteries. The vessels were incubated for 90 minutes in oxygenated Krebs or 80 mM KCl solutions at in vivo length and at a transmural pressure of 70 mm Hg. The transmural concentration profiles of 125I albumin across the media were measured by a frozen serial sectioning technique. In deendothelialized arteries, K+ decreased the mean medial uptake of labeled albumin, whereas 10(-7) M nicardipine in Krebs increased the uptake and 10(-9) M nicardipine had no effect. In a K+-rich solution, containing 10(-7) or 10(-9) M nicardipine, the medial uptake was lower than, but not significantly different from, that in Krebs. In intact K+-treated vessels, the wall concentrations near the lumen were increased and concentration gradients across the media were observed, possibly due to an increase in endothelial permeability following K+ induced contraction of the endothelial cells. This effect was reversed by the addition of 10(-7) M nicardipine, but not by 10(-7) M verapamil. Nicardipine and verapamil (10(-7) M) in Krebs solution enhanced the albumin uptake by the media of intact arteries. This effect on the permeability of the media may be related to the antiatherogenic effect of calcium antagonists. PMID- 3813979 TI - Mass transport, atherogenesis, and risk. AB - If the local chemically-active interstitial concentration (chemical activity) of a particular atherogenic molecule (atherogen) is considered to be one of the fundamental driving forces in a system of reactions that produces an associated local atherogenic change, then the chemical activity may be used as a measure of the potential for lesion development or local "risk." A model of steady-state, combined, diffusive and convective transport of an assumed atherogen across a multilayered arterial wall was used to illustrate mechanisms by which transport processes interact with tissue barriers to determine the transmural (x axis) chemical activity distributions [a(x), mol cm-3]. The model was used to evaluate the effects of increased endothelial gap fractional area (increased endothelial permeability), elevated blood pressure, elevated serum concentration of the atherogen, internal elastica fenestration, and preexisting intimal thickening on a(x). It was found that sites along the arterial tree that are characterized by "mild" increases in endothelial gap fractional area and concomitant subjacent interstitial sieving of the atherogen developed high a(x), in some cases much higher than that (a0) of the blood, and therefore were at high risk even in the absence of other risk factors. Moreover, the risk at such sites was dramatically increased with hypertension and/or elevated serum atherogen concentration and/or preexisting intimal thickening. However, if either condition, i.e., opened endothelial intercellular junctions or subjacent interstitial sieving, was absent, these other risk factors were ineffective. Finally, the response of the model was shown to be consistent with a variety of well-known, as well as puzzling, observations suggesting that transport processes may play roles in determining both the architecture of the atherosclerotic lesion and its rate of development. PMID- 3813980 TI - Fatty streak initiation in Watanabe Heritable Hyperlipemic and comparably hypercholesterolemic fat-fed rabbits. AB - Morphologic and immunocytochemical studies were conducted to determine the sequence of cellular interactions that occur during the initiation of the fatty streak in the aorta of Watanabe Heritable Hyperlipemic rabbits and comparably hypercholesterolemic fat-fed rabbits. Watanabe rabbits from 3.5 weeks gestation to 2 months of age and fat-fed rabbits from 1 week to 2 months duration of hypercholesterolemia were compared utilizing light microscopic and scanning and transmission microscopic techniques. In both groups of animals, the earliest detectable events were an increase in monocyte adherence and subendothelial migration followed by formation of a single layer of intimal macrophage-derived foam cells. Immunocytochemical studies using macrophage-specific and muscle-actin specific monoclonal antibodies support the morphologic data which suggests that the early fatty streak in both the Watanabe and fat-fed rabbits is predominantly composed of macrophage-derived foam cells. Thus, the absence of functional low density lipoprotein receptors in the Watanabe rabbit and differences in the distribution of cholesterol among the lipoproteins in the Watanabe and fat-fed rabbits do not appear to alter the initial responses of the cells of the artery wall to chronic hypercholesterolemia. PMID- 3813981 TI - Piriform sinus fistula as a route of infection in acute suppurative thyroiditis. AB - A case of acute suppurative thyroiditis due to a left piriform sinus fistula was reported. A five-year old boy had a acutely painful tumor in the anterior part of the neck. It was a diffuse, firm, warm erythematous tumor, and laboratory, radiologic findings showed the acute inflammation of the left lobe of thyroid. a barium swallow revealed a very thin fistula originating from the apex of the left piriform sinus extending antero-inferiorly. This fistula was considered to be a route of infection in acute suppurative thyroiditis, allowing bacterial infection to begin in the perithyroidal space and spread to the thyroid gland. The complete fistulectomy was required for a permanent cure, but an administration of antibiotics was very effective in this case. PMID- 3813982 TI - Incidence and prognosis of acute profound deafness in Japan. AB - The Acute Profound Deafness Investigation and Research Group of the Japanese Ministry of Health and Welfare conducted nation-wide studies on idiopathic sudden deafness, mumps deafness, and deafness accompanied by perilymphatic leak. In the epidemiological study, data were accumulated from 11 institutions on the incidence and prognosis of patients with idiopathic sudden deafness, especially involving total deafness or near-total deafness; mumps deafness; and deafness accompanied by perilymphatic leak. Out of 1,331 patients with sudden deafness, total deafness was found in 8.6% of the patients, and near-total deafness was found in 10.7% of the patients, with prognosis being less favorable in the former than in the latter. Perilymphatic leak was found in 10(0.7%) of the patients with idiopathic sudden deafness. Among the patients with deafness accompanied by perilymphatic leak, hearing recovery was rated as cured or markedly recovered in 41% of the patients. Hearing recovery was not observed in all the patients with mumps deafness showing total deafness. PMID- 3813983 TI - [Treatment of Meniere's disease. Middle ear infusion with lidocaine and steroid solution]. AB - Before considering the surgical treatment of patients with Meniere disease who would resist to various conservative therapies, including oral drug therapy, the author experimented the inner ear anesthetic therapy or the middle ear infusion therapy with a steroid solution, and each therapeutic result was compared. The results were as follows: 1) The effectiveness of the inner ear anesthetic therapy for vertigo was noted in 42 ears out of the total 47, while the effectiveness of the middle ear steroid infusion therapy for vertigo was found in all treated 21 ears. 2) Although both therapies proved non-effective for hearing disturbance, excluding special cases, the former therapy was found effective for it in 26 ears among 42. 3) For other concomitant symptoms such as the full sensation of ear obturation, head heaviness, and stiff shoulders, both therapies were considerably effective. It was concluded from these results that the first choice of therapy for patients with Meniere disease who should resist to all conservative therapies should be the middle ear steroid infusion therapy at the out-patient clinic, and the second choice would be the inner ear anesthetic therapy, and that both therapies were worth while experimenting before considering surgical treatment. PMID- 3813985 TI - Bacteriolytic activity of lysozyme in the nasal mucosa. AB - During an experiment to study the localization of the lysozyme in the nasal mucosa of humans by the protein A-gold technique, we observed the accumulation of lysozymes around bacteria possibly causing bacteriolysis. The lysozyme, therefore, seems to play a preventive role against some kind of bacterial infection in the nasal mucosa in situ. PMID- 3813984 TI - Congenital Horner's syndrome in otolaryngologic practice. AB - It is well known that Horner's syndrome is characterized by ptosis, miosis, and facial anhydrosis. However, the congenital form of Horner's syndrome is relatively uncommon, and it is scarcely known among otolaryngologists. In this report, two cases of congenital Horner's syndrome are described, both encountered recently in the recent author's practice. In the first case, the patient was seeking unnecessary medical treatment for a facial abnormality, not for his eyes. Thermography performed on this patient confirmed his complaint. Having had the first experience made diagnosis in the second case easier. Thus, although rare, this syndrome may be encountered in an otolaryngologist's daily practice and it is important to recognize its symptoms. It is suggested that some suffering from this disease may go undetected due to physicians' lack of familiarity with it. PMID- 3813986 TI - Laser scanning: a method of retinal imaging. PMID- 3813987 TI - An electrosurgery power output meter. PMID- 3813988 TI - Performance assessment of CT scanners. PMID- 3813989 TI - Evaluation of a generalized template matching procedure. PMID- 3813990 TI - The logical approach to bone tumors. PMID- 3813991 TI - Surgery of musculoskeletal tumours. PMID- 3813992 TI - The role of radiotherapy in the management of sarcomas of soft tissue and bone. PMID- 3813993 TI - Complications of cerebral angiography in a teaching hospital. PMID- 3813994 TI - Odontoma (report of 8 cases). PMID- 3813995 TI - Giant cell tumor of the posterior arch of the atlas. PMID- 3813996 TI - The apparent mid zone pneumatocoele in the intensive care patient. PMID- 3813997 TI - Radiographic features of progressive pseudorheumatoid arthritis. PMID- 3813998 TI - Lumber facet joint block: a simplified technique. PMID- 3813999 TI - Clinical application of pinhole collimator and analog motion correction device in cholescintigram. PMID- 3814001 TI - Workplace exposure and reported health in New Zealand diagnostic radiographers. PMID- 3814000 TI - NMR: principles, applications and recent advances. PMID- 3814002 TI - Distribution and ultrastructure of mast cells in the duck. AB - The distribution and ultrastructure of mast cells in the duck were studied. Carnoy's fluid was found to be the best fixative, and Padawer's method was found to be useful in demonstrating the metachromasia. Mast cells were seen in many of the organs and were most numerous in the proventriculus. Perivascular location was frequently seen. The ultrastructure resembled that of the chicken mast cell. The cell contained different types of membrane-bound granules, some of which were electron-dense and mottled. PMID- 3814003 TI - An enzyme-linked immunosorbent assay for serodiagnosis of coccidiosis in chickens: use of a single serum dilution. AB - A simplified enzyme-linked immunosorbent assay (ELISA) was used to survey broiler chickens for coccidial infection. With an antigen derived from Eimeria tenella oocysts and a single serum dilution of 1:100, the absorbance values were directly used for the evaluation of antibody levels. When the detection level, determined with sera from specific-pathogen-free chickens, was used as the negative standard, randomly selected sera from broiler chickens essentially were negative. Sera were periodically collected from two flocks of commercial broilers reared under medication, and their ELISA titers were compared with their excretion of oocysts. When the oocyst isolation rate indicated that infection was severe, a substantial number of chickens showed high absorbance values in ELISA. These results indicate that coccidial infections in the field can be detected serologically with ELISA. PMID- 3814004 TI - Effects of social stress on the toxicity of malathion in young chickens. AB - Thirty-eight 7-week-old white leghorn chickens of two strains (high and low antibody response to sheep erythrocytes) were divided into groups for exposure to high and low levels of social stress. They were then challenged orally with a toxic dose of the organophosphate insecticide malathion (250 mg/kg body weight) and evaluated 60 min later for muscarinic signs (diarrhea, lacrimation, respiratory secretions), nicotinic signs (muscle weakness), plasma cholinesterase activity, and brain acetylcholinesterase activity. A significant correlation was shown between clinical and biochemical indices of organophosphate toxicity. The correlation between social stress and malathion toxicity was less well defined. Chickens with low antibody response preexposed to high social stress were most resistant to organophosphate toxicity. PMID- 3814005 TI - Response of leukocytes in chickens infected with the avian schistosome Austrobilharzia variglandis (Trematoda). AB - Leukocyte levels were monitored weekly in chickens infected with the avian schistosome Austrobilharzia variglandis. Changes in relative and absolute numbers of leukocytes were recorded over a 7-week period beginning 1 week before exposure. There was a significant increase (P less than 0.001) in total leukocytes, peaking at 5.8 X 10(4) cells/mm3 on day 21 postexposure; controls had 2.4 X 10(4) cells/mm3 on that day. The leukocyte count declined over the next 3 weeks, returning to nearly normal levels by day 42 postexposure. With the exception of eosinophils, which peaked 35 days postexposure, all leukocyte subpopulations peaked in number on day 21. Increases in heterophils and monocytes were related to the schistosome egg burden. PMID- 3814006 TI - Drug-sensitivity of 99 isolates of coccidia from broiler farms. AB - Coccidia were isolated from 99 broiler farms in 12 broiler-producing states and tested for sensitivity to contemporary anticoccidial drugs. The isolates usually comprised two or more species, including 92 Eimeria acervulina, 47 E. maxima, 28 E. tenella, and 10 E. brunetti. Based on intestinal-lesion-score reduction of 30% or more, 38% of isolates were resistant to monensin (110 ppm), 29% to salinomycin (60 ppm), 20% to nicarbazin (125 ppm), and 46% to amprolium + ethopabate (125 + 4 ppm). Isolates with 50% or greater reduction of lesion scores were considered sensitive. Thirty-three percent were sensitive to monensin, 53% to salinomycin, 67% to nicarbazin, and 39% to amprolium + ethopabate. Other isolates had intermediate response to drugs and were considered to have "reduced sensitivity." There was some evidence for incomplete cross resistance to the polyether, ionophorous products. PMID- 3814007 TI - Morphometric and radiographic characteristics of tibial bone of broiler chickens with twisted leg disorders. AB - Tibiae from normal broiler chickens were compared with those from broilers displaying twisted leg in an attempt to develop a pattern recognition for the disorder. Qualitative differences were determined using conventional radiography, and quantitative differences were determined using sequential morphometry. Sequential radiography revealed that twisted leg developed from a slight deviation or torsion of the distal tibiae. Progressive bowing of the tibiae and compensatory thickening of the cortex on the weight-bearing side were characteristic radiographic features of twisted leg and were most likely a functional adaptation to the disorder. Sequential morphometry suggests that the development of twisted leg in broilers may be related to a structural abnormality in the distal tibiae, namely shallow distal condyle grooves. Shallow distal condyle grooves may predispose the distal tibiae to a slight displacement of the gastrocnemius tendon and hence uneven strain on the distal condyles. Other changes in tibial morphology (diameter at midshaft, condylar width, cortical thickness) appeared to be functional adaptations to the deformation rather than the primary cause. PMID- 3814008 TI - Dose-titration of fenbendazole in the treatment of poultry nematodiasis. AB - Broiler chickens were fed ad libitum diets containing fenbendazole at various concentrations and durations for the removal of adult Ascaridia galli, Heterakis gallinarum, and Capillaria obsignata. All regimens were 100% effective against A. galli. Fenbendazole at doses of 80 ppm for 3 days and 48 or 30 ppm for 5 days was 100% effective against H. gallinarum. C. obsignata was not removed completely by any regimen, but greater than or equal to 95% effectiveness was seen in birds given fenbendazole at doses of 80 ppm for 3 days and 48 ppm for 5 days. All medicated rations were readily consumed, and the treated birds exhibited no adverse reactions. PMID- 3814009 TI - Serological profiles of commercial broiler breeders and their progeny. 2. Newcastle disease virus. AB - Newcastle disease virus (NDV) hemagglutination-inhibition (HI) titers were determined for serum samples from eight commercial broiler breeder flocks and their progeny. The chickens sampled had been vaccinated and reared by different producers in different regions of the United States. Breeder flocks had the highest number of NDV-positive HI titers (greater than or equal to 1:10). Eighty percent or more of the samples from six of eight breeder flocks were positive; the geometric mean titers (GMTs) for those six breeder flocks ranged from 19 to 92. Only 3 of 8 broiler flocks had an increased frequency of positive titers and higher GMTs after vaccination. The frequency of positive titers was greater than 80% in only 2 of 8 of the oldest broiler flocks. The number of NDV-negative titers (less than 1:10) increased with age in most broiler flocks, even though all had been vaccinated once or more with live NDV vaccines. PMID- 3814010 TI - Astrovirus: a cause of an enteric disease in turkey poults. AB - Virus particles of 30 nm diameter and star-shaped morphology were detected in intestinal contents of turkey poults and were identified as astroviruses. Seventy six intestinal samples from 65 commercial turkey flocks between 6 and 35 days of age were evaluated for the presence of astroviruses by immune electron microscopy. Astroviruses were frequently detected in intestinal samples from poults that had enteritis and diarrhea of undetermined etiology. Astroviruses were geographically widespread and were present in poults from all six operations evaluated. Astroviruses were inoculated into specific-pathogen-free poults. Changes observed in the gastrointestinal tract were: dilatated ceca containing yellowish frothy contents, gaseous fluid in the intestinal tract, and loss of tone of the intestinal tract (gut thinness). Poults experimentally inoculated with astrovirus gained significantly less body weight and absorbed significantly less D-xylose than uninoculated controls. PMID- 3814011 TI - Survey of the pathologic findings in a large production colony of pigeons, with special reference to pseudomembranous stomatitis and nephritis. AB - Pathologic evaluations of pigeons dying between September 1984 and August 1985 are reported for a production colony of 1200-1800 White Carneau and Show Racer pigeons ranging in age from hatchlings to 12 years. Infectious diseases were the common causes of death in pigeons younger than 1 year; salmonellosis and nephritis were the common causes in pigeons 1-3 years old; and neoplasia and reproductive organ disorders were the common causes in pigeons older than 3 years. Monthly mortality was 2-4% in pigeons fed a cholesterol-containing diet and 0.9% in those fed noncholesterol-containing pellet diets. The increased deaths in the cholesterol-fed birds were attributed primarily to end-stage renal disease and atherosclerosis with secondary complications. The most frequently observed clinical entity in pigeons younger than 6 months was pseudomembrane formation on the oral and pharyngeal mucosa, termed pseudomembranous stomatitis. The definitive etiologic factor was not determined. Although all affected pigeons had similar gross lesions, the cases fell into one of three subsets, suggestive of bacterial, fungal, or viral etiologies. Chronic nephritis occurring as end stage renal disease was more severe in pigeons fed a cholesterol-containing diet. PMID- 3814012 TI - Absence of influence on immune competence by the sex-linked gene (K) determining slow feathering in white leghorn chickens. AB - Males of white leghorn strain crosses heterozygous (Kk) for the sex-linked feathering locus genes were mated to rapid-feathering (k-) females to produce rapid- and slow-feathering chicks of both sexes. K did not influence humoral mediated immunity against challenge with sheep erythrocytes, killed Brucella abortus, or killed infectious bursal disease virus. Chicks challenged at 3 weeks of age had higher primary responses and higher titers of 2-mercaptoethanol resistant antibody (IgG) than those challenged at 1 week of age. K had no influence on levels of cell-mediated immunity based on responses in in vitro phytohemagglutinin tests of donors 2 to 126 days of age, on responses in in vitro one-way mixed-lymphocyte cultures, and on rejection rates of skin grafts on young chicks. Feathering type did not influence viremia or antibody to avian leukosis virus; the level of lymphoid leukosis tumors was higher in rapid-feathering females than in slow-feathering females at 28 weeks of age (53% vs. 72%; P less than or equal to 0.10). We conclude that K does not influence general immune competence. The possibility that it may influence specific immunity to ALV under conditions not met in this study, because of an endogenous virus recently associated with the K locus, is discussed. PMID- 3814013 TI - A heat-stable toxin isolated from the turkey coryza agent, Bordetella avium. AB - A toxin was isolated from Bordetella avium grown in a defined medium. The toxin was active for mice but not for turkey poults or Japanese quail. The extraction procedure is described. The toxin was trypsin-sensitive and heat-stable (85 C for 30 min), and its activity was blocked by B. avium hyperimmune serum. PMID- 3814014 TI - Induction, collection, and partial characterization of induced respiratory macrophages of the turkey. AB - Respiratory macrophages (RM) of the turkey were elicited with a 1:4 (v/v) suspension of incomplete Freund's adjuvant in sterile phosphate-buffered saline injected directly into the abdominal air sacs. RM were purified by passage through a Ficoll-Hypaque gradient resulting in 95.7 +/- 5.9% purity and 94.8 +/- 12.3% viability. On days 7 and 9 postinjection, adequate numbers (7.15 +/- 5.47 X 10(6) macrophages per turkey) of RM for in vitro experiments were obtained. RM of the turkey demonstrated the ability to adhere to glass, phagocytize Zymosan A, and kill Escherichia coli in vitro. PMID- 3814015 TI - Effect of temperature-sensitive Mycoplasma gallisepticum vaccine preparations and routes of inoculation on resistance of white leghorns to challenge. AB - One-week-old chickens were vaccinated with live or formalin-killed temperature sensitive (TS) Mycoplasma gallisepticum (MG) either intranasally (IN) or subcutaneously (SQ). Live TS MG protected chickens against S6 strain challenge directly into the air sacs, regardless of route of vaccination. Killed MG, however, protected chickens only when administered SQ. Antibody to MG was detected in sera and in the tracheal and air-sac washings of only the chickens given live vaccine IN. The antibody present in tracheal and air-sac washings may be one of the mechanisms that play a role in resistance to MG challenge. PMID- 3814016 TI - Ability of ethoxyquin and butylated hydroxytoluene to counteract deleterious effects of dietary aflatoxin in chicks. AB - The antioxidants ethoxyquin and butylated hydroxytoluene (BHT) were added to diets of chicks in concentrations three and eight times above that usually found in poultry feed beginning 15 days after hatch; the chicks had been placed on feed containing 1000 or 3000 ppb aflatoxin on the day of hatch. These diets were continued until chicks were 6 weeks of age. At that time, deleterious effects of aflatoxin on weight gain, feed efficiency, and organ weights (spleen, bursa) were evident. BHT alleviated these effects, but ethoxyquin did not. Pretreatment with ethoxyquin did not protect chicks either. Ethoxyquin was not able to induce the activities of chick liver enzymes that detoxify aflatoxin and other foreign compounds. Lack of effect of ethoxyquin on these enzymes may hinder ability of this antioxidant to protect chicks from aflatoxin. PMID- 3814017 TI - Turkey coryza: selected tests for detection and neutralization of Bordetella avium heat-labile toxin. AB - Bordetella avium heat-labile toxin (HLT) was lethal for poults, mice, and embryonating chicken eggs. It produced hemorrhagic lesions in turkey and guinea pig skin. Antiserum made in turkeys neutralized the lethality of the toxin and its ability to produce hemorrhagic skin lesions. Further, antiserum against HLT of an Ohio strain neutralized lethality of HLT of strains from Iowa, North Carolina, and West Germany. The antiserum did not neutralize lethality of HLT from B. bronchiseptica. Bordetella avium HLT was not ciliostatic for turkey tracheal-ring cultures and did not stimulate adenyl cyclase activity using mouse adrenal cell cultures. PMID- 3814018 TI - Failure to demonstrate viscerotropic velogenic Newcastle disease in psittacine birds in the Republic of the Philippines. AB - Birds on the islands of Luzon, Mindanao, and Palawan in the Republic of the Philippines were surveyed for viscerotropic velogenic Newcastle disease (VVND). Virus isolation was attempted on 728 cloacal samples from native and exotic psittacine birds, non-psittacine birds, and domestic chickens and ducks. A VVND virus isolate was obtained from a single domestic chicken that had exhibited ocular discharge and diarrhea 3 days before sampling. All other birds were negative for VVND. PMID- 3814019 TI - A study of Marek's disease in Japanese quails vaccinated with herpesvirus of turkeys. AB - In a study of outbreaks of Marek's disease in quails, 220 adult quails vaccinated with herpesvirus of turkeys (HVT) were examined pathologically and serologically for Marek's disease (MD). Forty-three of the 220 quails exhibited microscopic lesions similar to those of chickens with MD. MD-virus-specific antigen was found in feather tips of 44 of the 220 birds, and the HVT-specific antibody was found in sera of 56 of the 220 birds by agar gel precipitation. There was a positive correlation between the incidence of lymphomatous changes and the presence of MD virus-specific antigen, and there was a negative correlation between the incidence of lymphomatous changes and the presence of antibody against HVT on a flock basis. PMID- 3814020 TI - Muscovy ducklings, a particularly sensitive avian bioassay for T-2 toxin and diacetoxyscirpenol. AB - Day-old domesticated Muscovy ducklings (Cairina moshata) were given the trichothecene mycotoxins T-2 toxin or diacetoxyscirpenol at 0.25, 0.5, or 1 micrograms/g of feed for 7 days. All concentrations of both toxins caused characteristic dose-related lesions on the roof of the oral cavity of the birds. Muscovy ducklings showed these signs in a shorter time (less than 16 hours in some cases) and at a lower feed concentration of these trichothecenes than did other avian species in similar studies. PMID- 3814021 TI - Characterization of a velogenic Newcastle disease virus isolated from broilers in Saudi Arabia. AB - A highly virulent Newcastle disease virus (SA84) was isolated from a large broiler operation in Saudi Arabia. The mean death time of chicken embryos given the minimum lethal dose, the pathogenicity of the isolate for 8-week-old chickens, the plaque characteristics, and the intracerebral pathogenicity index indicated that the isolate is of the viscerotropic velogenic pathotype. PMID- 3814022 TI - Fowl cholera: influence of Bordetella avium on vaccinal immunity of turkeys to Pasteurella multocida. AB - Turkeys exposed to Bordetella avium were vaccinated against fowl cholera with live Pasteurella multocida vaccine. Previous exposure to B. avium resulted in impairment of systemic immunity conferred by the vaccine: 86% of the vaccinated turkeys exposed to B. avium at 1 day old developed lesions or died of fowl cholera after challenge at 15 weeks old with virulent P. multocida. Of vaccinated turkeys not previously exposed to B. avium, only 26% had lesions or died of fowl cholera. PMID- 3814023 TI - Cysts resembling hydatids in a chicken. AB - Two large cysts recovered from the abdominal cavity of a domestic chicken superficially resembled hydatid cysts of Echinococcus spp. No protoscolices were present. Microscopic examination of the internal lining of one of the cysts revealed a single cuboidal to columnar, ciliated epithelium, leading to a diagnosis of oviduct cysts. Earlier records of hydatids of fowl are reviewed. PMID- 3814024 TI - Salt poisoning in turkey poults. AB - A 4% mortality in 5-to-11-day-old turkey poults was attributed to 1.85% sodium chloride in the feed. The syndrome included peracute respiratory distress, ascites, and sudden death that resembled peracute heart failure. Clinical signs were observed only in the final phase of the toxicity, but progressive histologic lesions were found. Live, apparently unaffected poults showed increases in intracellular glycogen and cytoplasmic granularity, loss of striation, and early mild intercellular myocardial edema; similar but more severe histologic lesions were seen in live, ascites-affected poults. The ascites-affected poults had hydropericardium and hydrothorax which seemed to develop just minutes before death. Ultrastructurally, focal areas of myocardial cells exhibited myofibrillar disarray, lysis of myofilaments, widened Z-bands, and dilation of sarcoplasmic reticulum. PMID- 3814025 TI - Pinealoma in a broiler breeder. AB - An incidental central nervous system tumor was found in a broiler breeder. The cellular mass was histologically similar to the normal pineal gland, but it was characterized by a decreased ratio of follicular/parafollicular cells, a relative increase in mitoses, a size three times greater than a normal pineal gland, and growth and expansion into adjacent cerebellar tissue. These characteristics warranted a diagnosis of pinealoma rather than pineal gland hyperplasia. PMID- 3814026 TI - American Association of Avian Pathologists 1985 summary of disease reports. PMID- 3814027 TI - Glutamic oxalacetic and glutamic pyruvic transaminase activities in different tissues of rats and guinea pigs exposed to varying levels of altitude stress for different periods of time. AB - It was observed that both glutamic oxalacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) activities were significantly increased in different tissues of both rats and guinea pigs, during a short period of altitude exposure, as well as in acclimatized animals. Interestingly, it was found that oral administration of glucose showed no such significant change at either sea level or in a hypoxic condition. Studies on the activity of GOT and GPT in different tissues of normal guinea pigs showed a little change in liver and brain during short periods of exposure. Kidney and heart showed a significant increase in GOT activity without any change in GPT activity. Increased activities were observed in all the tissues of the acclimatized animals. Of both unexposed and acclimatized animals, there was no change in the enzyme of unexposed and acclimatized animals except in heart following injection of thyroxine (16 micrograms X kg-1), but the enzyme activities were most pronounced in scorbutic animals. PMID- 3814028 TI - Cardiovascular responses to moderate facial cooling in men and women. AB - Experiments were conducted on a group of 20 healthy men and women to determine the pattern of cardiovascular response to moderate facial cooling (4.0 degrees C at 5.0 m X s-1) for 10 min. Data were collected each minute during exposure. During the course of exposure, both heart rate and forearm blood flow decreased significantly, 4.9 beats X min-1 (-9.2%) and -1.1 ml X 100 ml-1 X min-1 (-28.9%), respectively, while mean arterial blood pressure increased significantly +3.7 mm Hg (+4.0%) from pre-exposure values (p less than 0.05). There were no significant differences found in cardiovascular responses between men and women. There was considerable within-group variation for each recorded cardiovascular variable, but their ranges of variability remained relatively constant throughout exposure. These results indicate that moderate facial cooling precipitates significant cardiovascular responses in healthy subjects and the range of response may depend, in part, on individual factors. PMID- 3814029 TI - Cardiovascular dynamics during the initial period of head-down tilt. AB - The cardiovascular response to 1 h of 6 degrees head-down tilt was studied in 12 male subjects, ages 30-39 years, to simulate the early effects of weightlessness. Fluid shifts, hemodynamic variables, and indices of myocardial contractility were evaluated by utilizing electrocardiography, systolic time intervals, impedance cardiography, sphygmomanometry, and measurement of calf circumference. Most cardiovascular variables remained stable throughout the initial 30 min of the protocol, even though translocation of fluid from the legs to the thorax commenced immediately with the onset of head-down tilt. In contrast, minutes 30 60 were characterized by reduced stroke volume, cardiac output, mean stroke ejection rate, and Heather Index concomitant with an elevation in mean arterial pressure. Intrathoracic fluid volume continued to increase while leg volume continued to decrease. This latter physiological response suggests intrathoracic sequestration of fluid volume; blood was apparently redistributed to the pulmonary circulation rather than being retained in the great veins. PMID- 3814030 TI - Emotional and physiological effects of nitrous oxide and hyperbaric air narcosis. AB - Measurements of seven self-reported emotional states (happiness, activity, fear, anger, depression, fatigue, and anxiety) and three physiological variables (heart rate, systolic blood pressure, and diastolic blood pressure) were made among 16 subjects under four conditions: all subjects breathing normobaric air; several days later, immediately after half the subjects had breathed 30% nitrous oxide and the other half had breathed nomobaric air; the following day, subsequent to exposure of all subjects to a simulated depth of 57 m on air in a hyperbaric chamber; and several weeks after the hyperbaric chamber exposure, with all subjects breathing nomobaric air. The results showed that the physiological responses of the group that breathed nitrous oxide did not differ significantly from the control group following the hyperbaric chamber exposure, while self reported happiness was lower among the nitrous oxide group than among the control group following hyperbaric chamber exposure. Nitrous oxide does not appear to benefit emotional or physiological adaptation to nitrogen narcosis associated with breathing hyperbaric air, and may even impair emotional adaptation, at least under these experimental conditions. PMID- 3814031 TI - Respiratory response and muscle function during isometric handgrip exercise at high altitude. AB - The purpose of this investigation was to determine if the hyperventilatory response to fatiguing isometric exercise at sea level could predict resting ventilation and acute mountain sickness (AMS) at 4300 m altitude. Exercise consisted of four successive endurance handgrips held to complete fatigue at 40% of maximum isometric handgrip strength (MHS). There was no relationship between the magnitude or pattern of exercise-induced hyperventilation at sea level and the severity of AMS later at altitude. Sea level hyperventilatory response was not predictive of resting ventilation at altitude. Altitude exposure progressively increased both the incidence and magnitude of the hyperventilatory response to exercise and prolonged it for 60-90 s into the recovery period, providing support for the "central command" theory of ventilatory control during isometric exercise. MHS was significantly increased at altitude--by 11% on day 2 and 16% on day 6. Endurance times to fatigue were reduced, but not always significantly so. A follow-up study involving more practice at sea level demonstrated MHS to be significantly increased throughout an entire 18-d stay at 4300 m and for 3, but not 5, days after descent. Significant changes in endurance could not be demonstrated. Neither AMS nor changes in body weight or circulating norepinephrine levels can account for the temporal pattern of increased grip strength, but the respiratory alkalosis occurring at altitude appears to be a likely mechanism. PMID- 3814032 TI - Effects of atropine and 2-PAM chloride on vision and performance in humans. AB - These experiments assessed the time course and severity of effects of atropine and 2-PAM chloride on selected visual functions, physiological measures, and a tracking performance task. Atropine up to 4 mg X 70 kg-1 body weight and 2-PAM Cl in doses up to 1200 mg X 70 kg-1 body weight were administered intramuscularly in a double-blind Latin square design. A long lasting and dose-related increase in pupillary diameter and decrease in accommodative amplitude with accompanying loss of near visual acuity was found following atropine administration. These functions returned to baseline 2 d after injection. Distance acuity, contrast sensitivity, color vision, and intraocular pressure showed no changes after atropine. Tracking performance was significantly decreased by 4 mg of atropine. The changes in vision function cannot readily explain the tracking performance loss, since the tracking involved a distant visual target while the atropine produced degradation of near vision. Most of the physiological tests, tracking performance and all visual functions were unaffected by 2-PAM Cl. PMID- 3814033 TI - The behavioral effects of anticholinesterase insult following exposure to different environmental temperatures. AB - This study evaluates soman toxicity via a number of behavioral tasks after an 8-h exposure to one of five thermal stress conditions (-1,7,15,23, or 31 degrees C at 80 +/- 5% RH). Animals were removed from the environmental chamber, injected with soman (0-160 micrograms X kg-1), and tested 30 min post-injection. The test battery included: motor activity, grip strength, core temperature, sensitivity to heat, effects on memory and learning, and a subjective rating of the animal's state of health. A significant thermal stress/soman interaction was observed for all measures. This interaction was seen as a shift of the soman dose-response functions to the right for the higher temperature groups, i.e., the lower the stress temperature, the greater the susceptibility to soman. For example, the ED50 for the activity measure was 38 micrograms X kg-1 for the -1 degree C exposure group and 94 micrograms X kg-1 for the 31 degrees C group. The thermal stress influence on soman toxicity may be a function of previous motor activity. PMID- 3814034 TI - Efficacy of transdermal scopolamine against seasickness: a 3-day study at sea. AB - Transdermal scopolamine has been reported to provide protection against motion sickness, both while sailing at sea (7-8 h) and under experimental conditions. In this study, we tested the efficacy of transdermal scopolamine and evaluated its side effects during a 72-h cruise at sea. We tested 38 male volunteers, 20-25 years old, who were located on a 3000-ton vessel. The presence of seasickness, defined by Graybiel's diagnostic criteria, was used to calculate percent protection. When sickness was considered as malaise II or more, the drug provided 74, 73, and 39% protection during the three sailing days, respectively. There were no significant differences in the magnitude of the side effects reported by experimental and placebo groups. We conclude that transdermal scopolamine's efficacy against seasickness during a 3-day cruise was not associated with significant side effects and, therefore, we find the drug suitable for long-term use by sailing crews. PMID- 3814035 TI - Skeletal response to simulated weightlessness: a comparison of suspension techniques. AB - The skeletal response to simulated weightlessness was studied in rats subjected to two different methods of suspension. Skeletal unloading of the hind limbs for a two week period was achieved by use of either a back harness or tail traction. In comparison to pair-fed control rats, back-suspended rats failed to gain weight whereas tail-suspended rats exhibited normal weight gain. Quantitative bone histomorphometry revealed marked skeletal abnormalities in the proximal tibial metaphysis of back-suspended rats. Loss of trabecular bone mass in these animals was due to a combination of depressed longitudinal bone growth, decreased bone formation, and increased bone resorption. In contrast, the proximal tibia of tail suspended rats was relatively normal by these histologic criteria. However, a significant reduction in trabecular bone volume occurred during 2 weeks of tail suspension, possibly due to a transient inhibition of bone formation during the early stages of skeletal unloading. Lack of weight gain in back-suspended rats may be indicative of a pronounced stress response during which corticosteroids adversely affected the skeleton. Maintenance of normal weight gain by tail suspended rats provides evidence for the less traumatic nature of this method of suspension. Our findings indicate that tail suspension may be a more appropriate model for evaluating the effects of simulated weightlessness on skeletal homeostasis. PMID- 3814036 TI - Conjunctival oxygen tension at high altitude. AB - Transconjunctival oxygen tension (PcjO2) was studied using a hypobaric chamber and during mountaineering excursions. Measurements obtained during acute chamber exposures (15-20 min) at sea level, 1829 m (6,000 ft), 3048 m (10,000 ft), 4267 m (14,000 ft) and return to sea level were (means +/- SEM): 60.1 +/- 2.7, 49.1 +/- 1.8, 38.3 +/- 2.4, 27.4 +/- 1.5, and 61.1 +/- 2.8 mm Hg, respectively (n = 13). The ratio of PcjO2 to arterial blood oxygen tension (PaO2) did not change in a consistent manner between sea level and 4267 m; PcjO2 was 74 +/- 6.9% of PaO2. The 16 subjects participating in the mountaineering phase of the study revealed similar means at sea level and 1829 m (57.4 +/- 2.4 and 46.3 +/- 1.9 mm Hg respectively), but a smaller decrement was observed at 3048 m (43.0 +/- 1.6 mm Hg). The difference between mountain and chamber values may be accounted for by a partial acclimatization to altitude brought about by longer exposure on the mountain excursions. A comparison between PcjO2 and transcutaneous oxygen tension during the chamber study suggests that a greater precision and sensitivity is obtained with measurement of oxygen tension at the conjunctival site. PcjO2 measurement is a non-invasive reflection of PaO2 which is suitable for continuous monitoring during hypoxia studies. PMID- 3814037 TI - The relationship of hearing loss to airman age and exposure to aircraft noise in Israeli Air Force pilots. PMID- 3814038 TI - Comparison of epidural pressure in live anesthetized and post-mortem primates. AB - The response of the head to impact in the posterior-to-anterior direction was investigated with live anesthetized and post-mortem primates. The study was conducted at the University of Michigan Transportation Research Institute (UMTRI) under the sponsorship of the Motor Vehicle Manufacturers Association. 3-D motion and epidural pressures were experimentally measured. Interpretation of the results by simulating the tests using a 3-D mathematical model of the primate brain was done by Dr. C. Ward. The results of the tests and the simulation are presented to demonstrate the differences found between live and post-mortem primate brains. PMID- 3814039 TI - Reduction in paradoxical sleep after L-dopa administration in rats. AB - The EEG and EMG activity of two groups of rats (N = 8 each) was recorded during one experimental and 5 control days. On the experimental day, one group received 125.0 mg/kg L-dopa preceded by 50.0 mg/kg benserazide hydrochloride. The other group received 1.0 mg/kg haloperidol, immediately before the recording session. After L-dopa plus benserazide administration the total time and the number of episodes of paradoxical sleep and slow wave sleep decreased significantly compared to control sessions. PMID- 3814040 TI - Effect of anosmia on reproduction in male and female wolves (Canis lupus). AB - Anosmia was produced in two female and three male wolves by transection of the olfactory peduncle and was confirmed by their inability to detect meat, urine, feces, anal-gland secretions, and fish emulsion. All operated animals continued to investigate the environment with their noses, to interact normally with other pack members, and to feed at levels which maintained presurgical body weights. No effect was found on reproductive physiology (females: estradiol or progesterone concentrations, ovulation, pregnancy or parturition; males: testosterone, testicular recrudescence or sperm numbers, motility or maturation). One anosmic female became dominant and although she urine-marked with a flexed leg, the rate was lower than typical for dominant females and perhaps contributed to her failure to pair-bond with the dominant male. One anosmic male raised-leg-urinated while competing for pack dominance and when kenneled away from other males. Precopulatory, copulatory, and maternal behavior were observed for one anosmic female and appeared normal. However, neither male that was sexually naive before surgery showed interest in proestrous or estrous females. The possibility that secondary degeneration of brain regions mediating sexual behavior was responsible for the failure of these males to respond was not supported. Not only was the lack of male sexual response the only serious deficit following transection, but the male which was sexually experienced prior to surgery did copulate successfully during his second postoperative breeding season despite continued anosmia. Chemosensory priming from female urine during the protracted proestrous phase, as well as urinary and vaginal odors during estrus, appear to be critical for induction of full sexual potency in sexually naive males. The importance of urine and vaginal secretions in the sexual response of experienced males is uncertain. PMID- 3814041 TI - Social mediation of puberty: an adaptive female strategy? AB - Females of two hamster species with contrasting degrees of gregariousness were tested for social influences on the timing of sexual maturation. When female dwarf hamsters (Phodopus sungorus campbelli), a gregarious species, were housed with an adult male at weaning, they began estrous cycles significantly earlier than when they were housed alone or with their family. Females housed with one or two female siblings at weaning matured significantly later than did all other females. Once mature, females housed with familiar males conceived later than did females housed with unfamiliar males. Rearing conditions also affected body weight; those housed with female siblings grew more slowly and attained a lower weight at 8 weeks of age than did females in all other groups. In contrast, when weanling female golden hamsters (Mesocricetus auratus), a solitary species, were housed with either an adult male, two female siblings, or alone, they did not differ in their rate of sexual maturation or growth. It is suggested that the degree to which social factors can accelerate or delay puberty is an adaptive characteristic and may be correlated with the degree of gregariousness of a species. PMID- 3814042 TI - Effects of social defeat on acute cardiovascular response in salt-sensitive and salt-resistant rats. AB - We studied the effects of social stress (SS) and a high salt diet on systolic blood pressure (SBP) and heart rate (HR): S/JR male rats (which exhibit marked elevations in SBP when placed on a high sodium diet) and R/JR male rats (which are resistant to the BP-elevating effects of a high sodium diet) were maintained on a low sodium diet (0.3% NaCl) or placed on a high sodium diet (8% NaCl). Within each dietary condition independent groups were either exposed to SS, by placement in the cage of a trained fighter male (Long-Evans breed) for 25 min, or exposed to no stress. The dietary regimen was imposed for 10 days with stress exposures on Days 1, 2, 3, 5, 7, and 9, with SBP and HR measured indirectly by tail plethysmography 3 min following exposure to SS. SS produced an acute decrease in SBP (20-30 mm Hg) in S/JR rats on the second and subsequent exposures, but did not affect HR. SS did not affect SBP of R/JR rats, but did produce a significant elevation of HR. Maintenance on the high sodium diet increased SBP in S/JR, but not R/JR, rats when it was measured on the eighth (no stress) day, but SS obscured the effects of diet on SBP on days when rats were stressed. Following exposure to attacks, defeated SS rats displayed an upright submissive posture relatively late during the first stress exposure when no change in SBP was observed after SS in S/JRs, but displayed the submissive posture immediately and with long duration on the second and subsequent exposures when a marked decrement in SBP was seen. PMID- 3814043 TI - The ulcerogenic effect of a rest period after exposure to water-restraint stress in rats. AB - Shock-induced gastric ulceration in rats is exacerbated by allowing animals to rest between the period of stress and sacrifice. Conflicting data have been reported for similar post-stress rest effects using restraint stress. In Experiment 1, rats restrained in water for 2 h and then allowed a 2-h rest period exhibited significantly greater gastric ulceration than rats sacrificed immediately after the 2-h restraint-in-water stress period. The strength of this phenomenon is confirmed by Experiment 2, in which rats challenged with restraint in water for 1.25 h and then allowed a 1.25-h rest period before sacrifice exhibited greater ulceration than animals maintained in the restraint-in-water stress for the full 2 1/2 h. Corticosterone levels for these two treatment groups were similar at the time of sacrifice. Post-stressor rest therefore actively contributes to the ulcerogenic processes initiated by this form of stress challenge. PMID- 3814044 TI - Initial environment influences amphetamine-induced stereotypy: subsequently environment change has little effect. AB - Saline-treated and amphetamine-treated (7 mg/kg, ip, immediate) male rats from a Sprague-Dawley substrain were observed in two test environments designed to elicit different investigative responses in normal rats. Snout contact with the substrate was generated by placing the rat in a small enclosed cage. Absence of snout contact was induced by placement of the rat on a square elevated platform. Detailed ethological records were kept of locomotion, rearing, sitting, grooming, gnawing, and sleeping throughout the 90-min session. Amphetamine-treated rats incorporated environmentally contingent bodily postures into their forms of stereotyped behavior. The postures were characteristic of those evinced initially by the saline-treated rats in the same test environment. The control rats showed appropriate changes in their investigative behavior when the apparatus was changed at 10 and at 30 min postinjection. The amphetamine-treated rats, however, were completely unresponsive to such changes at 30 min and only partially so at 10 min postinjection. It was concluded that there is a temporal gradient of decreasing readiness to modify repetitive behavior after a single, large dose of amphetamine. PMID- 3814045 TI - Functional activity in the brain of socially deprivated rats produced by an active avoidance test after razobazam (Hoe 175) treatment: a 2-deoxyglucose study. AB - The 2-deoxyglucose (2-DG) autoradiographic method was used to map metabolic activity in the brain of socially deprivated rats during an active avoidance test. The method investigated the effects of razobazam during this learning test. The animals were socially deprivated for 5 weeks. On the first experimental day the animals were trained to avoid a footshock by jumping onto a platform. During training and testing, the total number of avoidance responses was scored. On the second day during one 2-DG session of 40 min, razobazam increased the avoidance score by 18% as compared to controls. Autoradiographs were analyzed using a two dimensional densitometric method. The analysis of the brain structures showed a 22% reduction of optical density in the nucleus habenularis lateralis, a 25% increase in the caudal part of the nucleus accumbens, and a 13% increase in the frontal cortex in rats treated with razobazam, but no change in the amygdala. These results provide a preliminary concept to explain how the new compound razobazam produced a better learning performance in socially deprivated rats. PMID- 3814046 TI - Lateralized audiogenic seizure: motor asymmetries exhibited and the effects of interrupted stimulation. AB - Sensitized SJL/J mice were monaurally tested for susceptibility to sound-induced seizure. The acoustic stimulation was interrupted for 15 s at various points during the biphasic pattern of running which these mice characteristically exhibit before seizing. Asymmetries of run directions and side of fall were noted. In addition, a dramatic reduction in seizure incidence was found when the interruption either extended into the period when the later burst of running would have occurred or began during this running burst. Finally, the results indicate that the latencies to the later running burst and the subsequent seizure are determined at or about the time of the onset of the first burst of running. PMID- 3814047 TI - Studies on retrograde and anterograde amnesia of olfactory memory after denervation of the hippocampus by entorhinal cortex lesions. AB - The effect of hippocampal denervation on olfactory memory in rats was tested after interrupting the lateral olfactory tract projections at the level of the entorhinal cortex. When lesioned animals were trained to learn new odors, they showed no evidence of retention 3 h after acquisition. These results confirm earlier data on rapid forgetting in rats after hippocampal deafferentation and are in parallel to the anterograde amnesia typically found in humans with hippocampal damage. On the other hand, preoperatively learned information was minimally impaired after hippocampal deafferentation even if it was acquired within less than 1 h before the lesion. This finding differs from reports on humans as well as monkeys with hippocampal damage where memories formed during a critical time span of months or even years before the lesion are found to be impaired. This may suggest that the consolidation process in humans and rodents has different time scales or that the roles of the human and the rat hippocampal structure in memory formation are somewhat different. PMID- 3814048 TI - Developmental and seasonal changes in canary song and their relation to changes in the anatomy of song-control nuclei. AB - Young male canaries become sexually mature in late winter, 8-12 months after hatching. During the months between hatching and sexual maturity they develop adult song. The successive stages in the development of adult song are subsong, plastic song, and stable or full song. Once stable song is achieved it lasts for the duration of the breeding season. After the end of the breeding season there is a recurrence of song instability during summer and early fall. This plastic song is followed, once more, by stable song. New song syllables are added to the song of adult male canaries and some of the earlier syllables disappear. The song repertoire sung at 2 years of age is substantially larger, and different, from that sung during the first breeding season, when the birds were 1 year old. A comparable change occurs between the second and third breeding seasons. Most of the syllables acquired by adult males are formed during the summer-fall period of song instability. Developmental and seasonal changes in song are accompanied by anatomical changes in two forebrain nuclei known to be involved in song control, the hyperstriatum ventralis, pars caudalis (HVc), and the robust nucleus of the archistriatum (RA). HVc and RA grow during the subsong and plastic song periods of song development. These nuclei reach adult size by the time stable adult song is first produced, and retain this size during the breeding season. However, the size of HVc and RA diminishes by late summer, when it becomes comparable to that of a 3- to 4-month-old bird. This reduction in size is temporary and has been corrected by the following breeding season. It is suggested that these seasonal changes in volume reflect circuit changes which are under hormonal control, and that these changes are related to processes of learning and, possibly, forgetting. Despite earlier reports of left hemispheric dominance in canary song production, we failed to find any evidence of right-left systematic differences in the size of HVc and RA during development or in adulthood. Various hypotheses relating song learning to changes in the underlying anatomy are offered. PMID- 3814049 TI - Unilateral olfactory conditioning in 6-day-old rat pups. AB - The potential that early olfactory learning might be laterally organized in the brain was investigated in 6-day-old rats. This hypothesis is based on the finding that the commissural systems that subserve bilateral olfactory communication do not mature until the second week of postnatal life. Pups were trained with pairings of cedar odor and intraoral infusions of milk while one nostril was occluded. Animals expressed a conditioned orientation towards cedar if tested with the trained nostril open. No such conditioning was observed if the untrained nostril was open during testing. Further, when individual pups received cedar odor/milk pairings with one nostril open and orange odor/milk pairings with the other open, they expressed a conditioned preference for orange when tested with the orange-trained nostril open, and a preference for cedar when tested with the cedar-trained nostril open. Classically conditioned oral responses (mouthing) also appeared to be lateralized. However, no such unilateral conditioning occurred with respect to behavioral activation, which is also conditioned in this paradigm. Increases in activity to the odor CS were observed regardless of whether the trained or untrained nostril was open during testing. These results suggest that in developing rodents, olfactory memories may be partly represented in structures that can be unilaterally accessed during training and testing. They provide a starting point for isolation of neural substrates of the olfactory conditioning process. PMID- 3814050 TI - Sex differences in the effects of gonadectomy on amphetamine-induced rotational behavior in rats. AB - The effects of gonadectomy on amphetamine-induced rotational behavior were studied in male and female rats. Different systemic doses were used to produce equivalent brain concentrations of the drug in each group, thereby controlling for sex differences in the metabolism of amphetamine. Ovariectomy of female rats significantly attenuated amphetamine-induced rotation, whereas castration of males was without effect. The results support the idea that in females, the endogenous gonadal hormones facilitate functional activity in the mesostriatal dopamine system. PMID- 3814051 TI - Continuous measurement of plasma protein content in the alert rat during and after 3 to 5 minutes of moderate activity. AB - A refractometric method was used for the continuous registration of plasma protein concentration in rats during and after 3 and 5 minutes of provoked activity. Simultaneous conductometric measurements of hematocrit (hct) showed that, although both invariably changing in the same direction, the relative change of protein concentration is always less than that of hct: plasma volume changes calculated from the former fall short of those calculated from hct by 34 +/- 23% during the hemoconcentrative period during activity and by 52 +/- 11% during the hemodilutory period after activity. The difference between these figures was significant, thus implying that fluid leaving the circulation during the filtration phase is less rich in protein than that entering it during the absorptive phase of microvascular adjustments. A kinetic analysis of the period after activity was made. The rate constants of fluid- and protein-flux were closely correlated. Both plasma volume and intravascular protein mass increased asymptotically to a new equilibrium 6% above control within 30 min after activity. It is suggested that the excess protein is mobilized from large parenchymatous organs, mainly the liver. PMID- 3814052 TI - The effects of dietary mackerel oil on plasma and cell membrane lipids, on hemodynamics and cardiac arrhythmias during recurrent acute ischemia in the pig. AB - Fish-oil nutrition leads to a change in fatty acid composition of cellular membranes. To investigate whether this affects cardiac responses to acute myocardial ischemia, pigs were fed a 9.1% (w/w) mackerel-oil (n = 8) or 9.1% (w/w) lard-fat diet (n = 8). Eight weeks mackerel-oil feeding reduced plasmacholesterol (51%) and triglyceride (48%), while the n-6 fatty acids of cardiac and platelet membrane phospholipids were partially replaced by n-3 fatty acids. After 8 weeks the animals were anesthetized and the left anterior descending coronary artery was occluded 6 times for a period of 5 min at 15 min intervals. Recovery of cardiac function and the incidence of cardiac arrhythmias were similar for both dietary groups. However, during the last reperfusions, hyperemic responses were less in magnitude and shorter lasting in the lard-fat (81 +/- 17 ml/min) than in the mackerel-oil group (129 +/- 18 ml/min). This may be caused by a difference in thromboxane synthesis, as coronary venous blood thromboxane B2 levels were higher in the lard-fat (77 +/- 6 pg/ml) than in the mackerel-oil group (19 +/- 7 pg/ml, P less than 0.05) during peak hyperemia. The low baseline levels of both thromboxane B2 and 6-keto prostaglandin F1alpha in fish-oil fed animals originate from the reduced content of precursor fatty acid in the membrane phospholipids. In conclusion, despite marked changes in membrane fatty acid composition induced by prolonged feeding with fish oil, no modification of recovery of cardiac function and of incidence of cardiac arrhythmias was found during acute recurrent ischemia. PMID- 3814053 TI - Myocardial protection by micromolar manganese in the calcium paradox and additive effects of verapamil. AB - The aims of the present study were to establish if micromolar manganese (50 mumol) may substitute for calcium during calcium-free perfusion and also to assess if manganese substitution for calcium may ensure tissue protection by verapamil (1.0 mg/l). Two injury levels (minimal and total calcium paradox) caused by different volumes (5 ml and 45 ml) of calcium-free perfusion (5 min) prior to calcium repletion (15 min) were examined in a normothermic isolated rat heart model. The presence of manganese during calcium-free only (5 min) or the presence of manganese prior to (5 min), during (5 min), and following (5 min) calcium-free perfusion conferred considerable protection as assessed by enzymatic, physiological and metabolic parameters in both the total and minimal calcium paradox models. The presence of verapamil prior to (5 min), during (5 min) and following (5 min) calcium-free perfusion combined with the presence of manganese conferred a further protection, particularly in the total paradox. It is concluded from the study that 50 mumol of manganese, although effective in tissue protection, cannot substitute totally for the loss of calcium during calcium-free perfusion and that manganese may substitute for the micromolar calcium needed for tissue protection by verapamil. PMID- 3814054 TI - Does digoxin sensitize left ventricular mechanoreceptors? AB - Afferent nerve fibre activity from left ventricular mechanoreceptors was recorded in 10 anaesthetized cats before and after two intravenous injections of 15 micrograms/kg digoxin at 1 hour interval. These receptors are activated by coronary artery occlusion and induce a depressor cardiovascular reflex resulting in bradycardia and hypotension. Neither the spontaneous activity of the receptor's afferent nerve fibres nor their maximum activity during temporary coronary artery occlusion was affected by digoxin. The results show that digoxin in therapeutic doses has no sensitizing effect on left ventricular mechanoreceptors with vagal afferent fibres. The sensitization of cardiopulmonary baroreflexes by digitalis glycosides shown in previous investigations is thus more likely to be mediated by a central nervous effect of the drug. PMID- 3814055 TI - Further studies on the effects of myosin P-light chain phosphorylation on contractile properties of skinned cardiac fibres. AB - We investigated the influence of myosin P-light chain phosphorylation by Ca2+ calmodulin dependent myosin light chain kinase (MLCK) on the sensitivity of the tension-pCa relation and maximum unloaded shortening velocity (Vmax) of chemically skinned heart fibres of the pig. Submaximum Ca2+ stimulation (pCa 5.5) induced 20 +/- 5% of the isometric tension achieved at maximum Ca2+ activation (pCa 4.3). MLCK-induced myosin P-light chain phosphorylation increased the isometric force development at pCa 5.5 by 40% whereas maximum tension at pCa 4.3 was not affected. Unloaded shortening velocity (Vmax) was not altered by myosin P light chain phosphorylation either at maximum or at submaximum Ca2+ concentration, being c. 1.2 muscle length/s at pCa 5.5 and 2.2 muscle length/s at pCa 4.3. The MLCK-induced increase of the myosin P-light chain phosphorylation level was evaluated by determination of 32P-incorporation. Two phosphorylatable myosin P-light chains could be demonstrated. PMID- 3814057 TI - [Physical therapy management after knee arthrotomies]. PMID- 3814056 TI - Acute myocardial ischaemia in the anaesthetised pig: local catecholamine release and its relation to ventricular fibrillation. AB - In anaesthetised open-chest pigs, sequential myocardial samples were obtained before and after occlusion of the distal half of the LAD. These samples were analysed histofluorimetrically to determine the density of catecholamine containing neurones in each sample (quantified morphometrically), and radioenzymatically for total tissue noradrenaline content. Following coronary artery occlusion, 75% of the animals (24 out of 32) died in ventricular fibrillation in the first 30 min, the other 25% (8/32) survived the first 60 min of myocardial ischaemia. Coronary artery occlusion led to a significant reduction in the density of fluorescing fibres in the ischaemic myocardium of animals which fibrillated (from 1.25 +/- 0.2% to 0.67 +/- 0.10% at 15 min) whereas in the survivors there was no significant change in fluorescing area during the course of the experiment. Animals which fibrillated had a significant reduction in tissue noradrenaline concentration of the ischaemic myocardium (from an initial concentration of 612 +/- 72 to 402 +/- 64 ng/g ww) within the first 5 min of ischaemia. It is concluded that in this model of myocardial ischaemia, the development of ventricular fibrillation in the early phase seems to be related to the release of noradrenaline from the sympathetic neurones after the onset of myocardial ischaemia. PMID- 3814058 TI - [Possibilities for errors in the determination of angles of the coxal end of the femur in hip dislocation with surgical interventions]. PMID- 3814059 TI - [Biometric effectiveness of a plaster cast for functional thigh abduction in the conservative therapy of dislocated hips]. PMID- 3814060 TI - [Damage to the knee joint in ship building]. PMID- 3814061 TI - [Wire osteosynthesis in fractures in the area of the shoulder]. PMID- 3814062 TI - [Catterall classification and prognosis of Perthes disease in a retrospective study]. PMID- 3814063 TI - [Topographic differences in the value of the 2 sec Elastic Modul in the cartilage tissue of the knee joint]. PMID- 3814064 TI - [Problems in measuring and evaluating QRS duration in the ECG of the horse]. PMID- 3814065 TI - [Relation between erythrocyte sedimentation rate and erythrocyte count, fibrinogen content and viscosity of plasma in the individual (long-term study of 3 dogs)]. PMID- 3814066 TI - [Campylobacter jejuni/coli in partridges (Perdix perdix L.) and pheasants (Phasianus colchicus L.)]. PMID- 3814067 TI - [An air gun projectile in the ureter of a cat]. PMID- 3814068 TI - [Responsibility for confidentiality of the veterinarian]. PMID- 3814069 TI - [Behavior of tracer substances in the conjunctival epithelium of the goat. An electron microscopy study]. PMID- 3814070 TI - [Field study on the development of resistance of Chlamydia psittaci to tetracyclines]. PMID- 3814071 TI - [Enzyme serologic studies of the arctic char (Salvelinus alpinus L.) of Lake Konigssee affected by Triaenophorus nodulosus]. PMID- 3814072 TI - Attenuation of the virulent RH strain of Toxoplasma gondii by passages in mice immunized with Toxoplasma lysate antigens. AB - The virulent RH strain of Toxoplasma gondii was attenuated after a few passages or just one long passage in mice immunized twice with a four-week interval between immunizations with an emulsion of Toxoplasma lysate antigens and complete Freund's adjuvant. Three avirulent strains, RH-cyst III, IV and VIII were established from the RH strain. The RH-cyst III strain was effective for vaccination against challenge with the original, virulent RH strain. The attenuation of T. gondii is an expression of the innate attributes of this parasite necessary to maintain its parasitic life cycle in nature. PMID- 3814073 TI - Effect of the composition of reversion medium on change of Staphylococcus aureus lysostaphin protoplasts to coccal forms and L-forms. AB - The experimental conditions under which protoplasts of Staphylococcus aureus strain MS353 (pCp) are converted to the coccal or L-form were investigated. Protoplasts prepared by treating coccal MS353 (pCp) strain with Lysostaphin formed various types of colonies (coccal form, L-form and mixed types) in about 50% yield when they were plated on reversion (R) medium consisting of 2% brain heart infusion, 0.5M sodium succinate, 0.01% bovine serum albumin, 20 mM MgCl2 and 0.6% agar. The L-form type colonies with a typical fried-egg appearance that developed on the R medium at an early stage gradually reverted to the coccal form through a mixed type stage in which a high density area first appeared in the periphery of the colony and then spread throughout the colony. The use of modified R medium without MgCl2 or R medium in which 0.5M sodium succinate as an osmotic stabilizer was replaced by 7.5% NaCl resulted in marked delay in the appearance of reverted cells. R medium without bovine serum albumin yielded atypical L-form type colonies, which contained masses of coccal cells with very irregular margins. On the other hand, R medium without MgCl2 but with penicillin G supported development of L-form type colonies at high rate (13-15%) from the inoculated protoplasts. PMID- 3814074 TI - Urea synthesis in freshly isolated and in cultured periportal and perivenous hepatocytes. AB - Periportal hepatocytes isolated by digitonin/collagenase perfusion produced urea faster than did similarly prepared perivenous hepatocytes, in both the presence and the absence of amino acids and various urea precursors. There was no difference between the two cell types in rates of intracellular proteolysis. The initial difference in urea synthesis persisted for 5 days during primary culture, but then gradually disappeared. Our results demonstrate that the periportal dominance of urea formation is unrelated to the currently existing acinar microenvironment in the intact liver, but probably reflects differences in acinar key enzyme activities only slowly converging during culture. PMID- 3814075 TI - Diurnal variation in the fraction of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in the active form in the mammary gland of the lactating rat. AB - 'Expressed' and 'total' activities of 3-hydroxy-3-methylglutaryl-CoA reductase (HMG-CoA reductase) were measured in freeze-clamped samples of mammary glands from lactating rats at intervals throughout the 24 h light/dark cycle. 'Expressed' activities were measured in microsomal fractions isolated and assayed in the presence of 100 mM-KF. 'Total' activities were determined in microsomal preparations from the same homogenates but washed free of KF and incubated with exogenously added sheep liver phosphoprotein phosphatase before assay. Both 'expressed' and 'total' activities of HMG-CoA reductase underwent a diurnal cycle, which had a major peak 6 h into the light phase and a nadir 15 h later, i.e. 9 h into the dark period. Both activities showed a secondary peak of activity (around 68% of the maximum activity) at the time of changeover from dark to light, with a trough in the value of the 'expressed' activity that was close to the nadir value. 'Expressed' activity was lower than 'total' at all time points, indicating the presence of enzyme molecules inactivated by covalent phosphorylation. Nevertheless the 'expressed'/'total' activity ratio was comparatively constant and varied only between 43% and 75%. Immunotitration of enzyme activity, with antiserum raised in sheep against purified rat liver HMG CoA reductase, confirmed the presence of both active and inactive forms of the enzyme and indicated that at the peak and nadir the variation in 'expressed' HMG CoA reductase activity resulted from changes in the total number of enzyme molecules rather than from covalent modification. The sample obtained after 3 h of the light phase exhibited an anomalously low 'total' HMG-CoA reductase activity, which could be increased when Cl- replaced F- in the homogenization medium. The result suggests that at that time the activity of the enzyme could be regulated by mechanisms other than covalent phosphorylation or degradation. PMID- 3814076 TI - Kinase activator protein mediates longer-term effects of starvation on activity of pyruvate dehydrogenase kinase in rat liver mitochondria. AB - Starvation of rats for 48 h increased the activity of PDH (pyruvate dehydrogenase) kinase 2.2-fold in extracts of liver mitochondria, 2.9-fold in PDH complex partially purified therefrom by fractional precipitation, and 5-fold in PDH complex partially purified by gel filtration on Sephacryl S-300. A protein fraction was separated from PDH complex in extracts of rat liver mitochondria by gel filtration or fractional precipitation, which increased the activity of PDH kinase in rat liver and pig heart PDH complexes. The activity of this protein fraction was increased approx. 2.5-fold by 48 h starvation of rats. With highly purified pig heart PDH complex it was shown that the protein fraction increased the Vmax. of the PDH kinase reaction 35-fold (fraction from fed rats) or 82-fold (fraction from starved rats); starvation had no effect on the concentration of protein fraction required to give 0.5 Vmax. Evidence is given that the increase in PDH kinase activity effected in extracts of liver mitochondria by starvation is due to increased activity of kinase activator protein, which is tightly bound by rat liver PDH complex and not removed by a single gel filtration. With pig heart PDH complex, increased PDH kinase activity was retained after gel filtration of an admixture with kinase activator protein from starved rats, but was restored to the control value by a second gel filtration; the alterations in PDH kinase activity were associated with obvious changes in protein bands in SDS gels. PMID- 3814077 TI - Pyruvate metabolism in castor-bean mitochondria. AB - We report the isolation of mitochondria from the endosperm of castor beans (Ricinus communis). These mitochondria oxidized succinate, external NADH, malate and pyruvate with respiratory-control and ADP/O ratios consistent with those found previously with mitochondria from other plant sources. The mitochondria exhibited considerable sensitivity to the electron-transport-chain inhibitors antimycin A and cyanide when oxidizing succinate and external NADH. Pyruvate dependent O2 uptake was relatively insensitive to these inhibitors, although the residual O2 uptake could be inhibited by salicylhydroxamic acid. We conclude that a cyanide-insensitive alternative terminal oxidase is functional in these mitochondria. However, electrons from the succinate dehydrogenase or external NADH dehydrogenase seem to have no access to this pathway. There is little interconnection between the salicylhydroxamic acid-sensitive and cyanide sensitive pathways of electron transport. alpha-Cyanocinnamate and its analogues, compound UK5099 [alpha-cyano-beta-(1-phenylindol-3-yl)acrylate] and alpha-cyano-4 hydroxycinnamate, were all found to be potent non-competitive inhibitors of pyruvate oxidation in castor-bean mitochondria. The accumulation of pyruvate by castor-bean mitochondria was determined by using a silicone-oil-centrifugation technique. The accumulation was shown to observe Michaelis-Menten kinetics, with a Km for pyruvate of 0.10 mM and a Vmax. of 0.95 nmol/min per mg of mitochondrial protein. However, the observed rates of pyruvate accumulation were insufficient to account for the pyruvate oxidation rates found in the oxygen-electrode studies. We were able to demonstrate that this is due to the immediate export of the accumulated radiolabel in the form of malate and citrate. Compound UK5099 inhibited the accumulation of [2-14C]pyruvate by castor-bean mitochondria at concentrations similar to those required to inhibit pyruvate oxidation. PMID- 3814078 TI - Role of spermidine in the expression of late markers of adipose conversion. Effects of growth hormone. AB - Confluent Ob1771 cells treated with an inhibitor of spermidine and spermine synthesis, methylglyoxyal bis(guanylhydrazone), were dependent on putrescine addition for the expression of glycerol-3-phosphate dehydrogenase and acyl-CoA synthetase, which behaved as late markers of adipose conversion. A similar dependence was observed with drug-treated Ob17MT18 and 3T3-F442A preadipocyte cells, but not with non-differentiating 3T3-C2 cells. Studies in drug-treated Ob1771 cells at the mRNA level showed that the parallel expression of mRNAs encoding for glycerol-3-phosphate dehydrogenase and an homologue of serine proteinases of Mr 28,000 [Cook, Groves, Min & Spiegelman (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 6480-6484] was also dependent on putrescine addition. Double isotope experiments with [14C]putrescine and [3H]spermidine, as well as analysis of the polyamine content in drug-treated Ob1771 cells under various conditions, demonstrate after putrescine addition that the expression of late markers of adipose conversion was highly correlated with a 2-fold increase in the intracellular concentration of spermidine. No correlation was observed with changes in the intracellular concentrations of putrescine and spermine. Long-term exposure of untreated Ob1771 cells to growth hormone, which led to the expression of late markers of adipose conversion [Doglio, Dani, Grimaldi & Ailhaud (1986) Biochem. J. 238, 123-129] was also accompanied by the same increase in spermidine concentration, which attained values identical with those determined in drug treated cells supplemented with putrescine. This observation suggests that the permissive effect of growth hormone on the terminal differentiation of adipose cells might e related to changes in the intracellular concentration of spermidine. PMID- 3814079 TI - Characterization of the binding of the anti-sickling compound, BW12C, to haemoglobin. AB - The anti-sickling agent BW12C [Beddell, Goodford, Kneen, White, Wilkinson & Wootton (1984) Br. J. Pharmacol. 82, 397-407] was designed to left-shift the oxygen saturation curve of haemoglobin (HbA) by preferential binding to the oxy conformation at a single site between the terminal amino groups of the alpha chains through Schiff's base formation, ionic and hydrophobic interactions. In the present work, Schiff's base linkages formed with [14C]BW12C were reduced with NaBH4 and the alpha- and beta-globin chains separated. Under oxy conditions at a molar ratio of 2:1, the covalently bound BW12C is localized almost exclusively on a single alpha-chain; tryptic digestion confirms the terminal amino group (alpha 1-valine) as the reaction site, in accord with the design hypothesis. However, about half the labelled BW12C is released on tetramer disruption, suggesting the presence of additional non-covalent binding. Under deoxy conditions, alpha- and beta-chains are labelled approximately equally, and at higher molar ratios additional binding in both oxy and deoxy conditions is seen. Isoelectric-focusing studies under oxy conditions show a complex pattern of modified bands for both HbA and HbA1c (blocked beta-terminal amino groups) but no modification for HbA carbamylated at both alpha- and beta-terminal amino groups or at the alpha-chains only, again confirming the alpha-terminal amino region as the main interaction site. Equilibrium dialysis measurements under oxy conditions indicate two strong binding sites with a binding constant of less than 10(-6) M and a number of weaker binding sites. The present data thus confirm that BW12C binds at the intended locus but reveal additional non-covalent binding at an undefined site, and weaker binding through Schiff's base formation with other amino groups. PMID- 3814080 TI - Distribution of the integral membrane protein NADH-cytochrome b5 reductase in rat liver cells, studied with a quantitative radioimmunoblotting assay. AB - The intracellular localization of the post-translationally inserted integral membrane protein, NADH-cytochrome b5 reductase, was investigated, using a quantitative radioimmunoblotting method to determine its concentration in rat liver subcellular fractions. Subcellular fractions enriched in rough or smooth microsomes, Golgi, lysosomes, plasma membrane and mitochondrial inner or outer membranes were characterized by marker enzyme analysis and electron microscopy. Reductase levels were determined both with the NADH-cytochrome c reductase activity assay, and by radioimmunoblotting, and the results of the two methods were compared. When measured as antigen, the reductase was relatively less concentrated in microsomal subfractions, and more concentrated in fractions containing outer mitochondrial membranes, lysosomes and plasma membrane than when measured as enzyme activity. Rough and smooth microsomes had 4-5-fold lower concentrations, on a phospholipid basis than did mitochondrial outer membranes. Fractions containing Golgi, lysosomes and plasma membrane had approximately 14-, approximately 16, and approximately 9-fold lower concentrations of antigen than did mitochondrial outer membranes, respectively, and much of the antigen in these fractions could be accounted for by cross-contamination. No enzyme activity or antigen was detected in mitochondrial inner membranes. Our results indicate that the enzyme activity data do not precisely reflect the true enzyme localization, and show an extremely uneven distribution of reductase among different cellular membranes. PMID- 3814081 TI - Possible involvement of the lipid-peroxidation product 4-hydroxynonenal in the formation of fluorescent chromolipids. AB - The effects of the lipid-peroxidation product 4-hydroxynonenal on the formation of fluorescent chromolipids from microsomes, mitochondria and phospholipids were studied. Incubation of freshly prepared rat liver microsomes or mitochondria with 4-hydroxynonenal results in a slow formation of a fluorophore with an excitation maximum at 360 nm and an emission maximum at 430 nm. The rate and extent of the development of the 430 nm fluorescence can be significantly enhanced by ADP-iron (Fe3+). With microsomes, yet not with mitochondria. NADPH has a catalytic effect similar to that of ADP-iron. Fluorescent chromolipids with maximum excitation and emission at 360/430 nm are also formed during the NADPH-linked ADP-iron stimulated lipid peroxidation. Phosphatidylethanolamine and phosphatidylserine react with 4-hydroxynonenal revealing a fluorophore with the same spectral characteristics as that obtained in the microsomal and mitochondrial system. The findings suggest that the fluorescent chromolipids formed by lipid peroxidation are not derived from malonaldehyde, but are formed from 4-hydroxynonenal or similar reactive aldehydes via a NADPH and/or ADP-iron-catalysed reaction with phosphatidylethanolamine and phosphatidylserine contained in the membrane. PMID- 3814082 TI - Na+-H+ exchange in luminal-membrane vesicles from rabbit proximal convoluted and straight tubules in response to metabolic acidosis. AB - Na+-H+-exchanger activity of pars convoluta and pars recta luminal-membrane vesicles prepared from the proximal tubule of acidotic and control rabbits were assayed by a rapid-filtration technique and an Acridine Orange method. Both experimental approaches revealed the existence of an antiporter, sensitive to metabolic acidosis, in pars convoluta membrane vesicles. Kinetic data, obtained with the pH-sensitive dye, showed that the Km for Na+ transport was unchanged by acidosis, whereas Vmax. for exchanger activity was increased, on an average, by 44%. The fluorescence method, in contrast with the rapid-filtration technique, was able to detect exchanger activity in pars recta membrane vesicles. The Km value for the antiporter located in pars recta is comparable with that calculated for pars convoluta membrane vesicles. By contrast, the Vmax. of this exchanger is only about 25% of that found for pars convoluta. Furthermore, metabolic acidosis apparently does not increase Na+-H+-exchanger activity of pars recta luminal membrane vesicles. PMID- 3814083 TI - Molecular-size standards for use in radiation-inactivation studies on proteins. AB - The accuracy of the radiation-inactivation technique for estimating molecular size was investigated with a range of proteins of known molecular mass. With the use of irradiation with a 16 MeV electron beam, inactivation was examined both in frozen samples at 77 K and in freeze-dried samples at room temperature. The effect of the presence of detergents and chloroplast membrane preparations was also measured. It was demonstrated that proteins added as internal standards, including malate dehydrogenase, glucose-6-phosphate dehydrogenase and cytochrome c, can provide an accurate calibration of molecular size. However, a disadvantage of the technique was that the target size of oligomeric enzymes could be that of either the monomers, dimers or higher oligomers. The detergent Triton X-100 increased the rate of inactivation of the proteins investigated. PMID- 3814085 TI - Metabolism of 17-hydroxyprogesterone by a Bacillus species. AB - Fermentation of 17-hydroxyprogesterone with a Bacillus species (IICB-301) in a modified nutrient medium under aerobic conditions yielded androst-4-ene-3,17 dione and 15 alpha,17-dihydroxypregn-4-ene-3,20-dione in addition to a new pregnane analogue, 6 beta,17,20 alpha-trihydroxypregn-4-ene-3-one. Each microbial metabolite was characterized by the application of various spectroscopic techniques. The availability of the new metabolite, 6 beta,17,20 alpha trihydroxypregn-4-ene-3-one, enabled complete elucidation of its 13C-n.m.r. spectrum. PMID- 3814084 TI - Oxygenase properties of the (4-hydroxybenzoyl)methanol-cleavage enzyme from an Alcaligenes sp. AB - Studies using H2(18)O and 18O2 demonstrated that, in the cleavage of (4 hydroxybenzoyl)methanol to 4-hydroxybenzoic and formic acids by an enzyme from an Alicaligenes sp., oxygen is incorporated into both products from dioxygen and not from water. The enzyme is, therefore, an oxygenase. PMID- 3814086 TI - A high-performance-liquid-chromatographic method for the assay of coproporphyrinogen oxidase activity in rat liver. AB - An h.p.l.c. method was developed for the assay of coproporphyrinogen oxidase activity in rat liver. The protoporphyrinogen IX formed is completely oxidized to protoporphyrin IX for separation and quantification by reversed-phase chromatography with mesoporphyrin as the internal standard. The Km of coproporphrinogen oxidase is 1.01 +/- 0.23 microM. The activities are 4.07 +/- 0.40 nmol of protoporphyrin IX/h per mg of mitochondrial protein and 224 +/- 19 nmol of protoporphyrin IX/h per g of liver tissue homogenate. The method is sensitive enough for measuring enzyme activity in small amounts of human tissue from needle biopsy. PMID- 3814087 TI - Restoration of the properties of carnitine palmitoyltransferase I in liver mitochondria during re-feeding of starved rats. AB - The recovery of the parameters of the kinetic properties of carnitine palmitoyltransferase (CPT) I in liver mitochondria of starved rats was studied after re-feeding animals for various periods of time. There were no significant changes either in the activity of the enzyme at high palmitoyl-CoA concentrations or in the affinity of the enzyme for palmitoyl-CoA, or in the sensitivity of CPT I to malonyl-CoA inhibition after 3 h or 6 h re-feeding. After 24 h re-feeding, both the affinity of the enzyme for palmitoyl-CoA and the activity of the enzyme were still not significantly different from those for the enzyme in mitochondria from 24 h-starved animals. By contrast, the sensitivity of CPT I to malonyl-CoA inhibition was largely, but not fully, restored to that observed in mitochondria from fed rats. PMID- 3814088 TI - A difference infrared-spectroscopic study of the interaction of ubiquinone-10 with phospholipid bilayers. AB - The interaction between 1,2-dipalmitoyl phosphatidylcholine and ubiquinone-10 in aqueous systems was studied by difference i.r. spectroscopy. Binary mixtures of the two lipids in proportions of 2, 5 and 15 mol% were investigated in the spectral regions reporting on the hydrocarbon chains of the phospholipid and the polar phosphate group. No spectral shifts or significant broadening of any absorbances due to the phospholipid were detected at temperatures of 20 or 54 degrees C. Changes in the frequency of the maximum of the CH2 antisymmetric C-H stretching vibration with temperature indicated that the gel-to-liquid-crystal line phase-transition temperature of the phospholipid was lowered by about 2 degrees C in the presence of between 2 and 15 mol% ubiquinone-10. Absorbance by the benzoquinone substituent of ubiquinone-10 was detected by spectral subtraction of dispersions of phospholipid alone. Bands due to C = O stretching and ester group vibrations of ubiquinone-10 in co-dispersion with phospholipid were compared with the same spectral region when ubiquinone-10 was dissolved in solvents or as a crystalline solid. Spectral changes could be detected when ubiquinone-10 in phospholipid was compared with solution in dodecane and chloroform. These may indicate that the benzoquinone ring system is located within a hydrocarbon domain in dispersions with dipalmitoyl phosphatidylcholine. It was concluded from the study that when ubiquinone-10 is co-dispersed with dipalmitoyl phosphatidylcholine in water the two lipids phase-separate. There is no evidence that ubiquinone-10 intercalates between phospholipid molecules, which undergo a gel-liquid-crystalline phase transition in only a slightly modified form. The data suggest that the benzoquinone substituent resides in a hydrophobic domain and that aggregates spanning the bilayer are a possible arrangement of the ubiquinone in the structure. PMID- 3814089 TI - A suitable parameterization of the Michaelis-Menten enzyme reaction. AB - It is shown here that a suitable form for estimation and inference using the Michaelis-Menten [(1913) Biochem Z. 49, 333-369] model for simple enzymic reactions is one in which the two parameters appear in the denominator of the equation. In this form, convergence to the least-squares estimates using the Gauss-Newton method [see Kennedy & Gentle (1980) Statistical Computing, Marcel Dekker, New York] is virtually ensured, or, as the model in this form is a member of the class of 'generalized linear models', it may be fitted by packages such as those of Rothamsted Experimental Station [(1977) GENSTAT (A General Statistical Program), Rothamsted Experimental Station, Harpenden] and the Numerical Algorithms Group [(1978) GLIM (Generalised Linear Interactive Modeling), Numerical Algorithms Group, Oxford]. Furthermore, the parameters-in-denominator principle is readily extended to more complicated catalytic models. With all parameters in the denominator, the least-squares estimators are close to being unbiased and normally distributed, whereas severe bias and non-normality may result from use of the standard formulations. PMID- 3814090 TI - Characterization of the liver P2-purinoceptor involved in the activation of glycogen phosphorylase. AB - Evidence has been presented for the existence in rat liver of P2-purinoceptors which are involved in the control of glycogenolysis. Isolated rat hepatocytes and purified liver plasma membranes have been used to study the binding of the ATP analogue adenosine 5'-[alpha- [35S]thio]triphosphate (ATP alpha [35S]) to these postulated P2-purinoceptors. The nucleotide analogue behaves as a full agonist for the activation of glycogen phosphorylase in isolated hepatocytes, 0.3 microM being required for half-maximal activation. Specific binding of ATP alpha [35S] to hepatocytes and plasma membranes occurs within 1 min and is essentially reversible. The analysis of the dose-dependency at equilibrium indicates the presence of binding sites with Kd of 0.23 microM with hepatocytes and Kd of 0.11 microM with plasma membranes. The relative affinities of 10 nucleotide analogues were deduced from competition experiments for ATP alpha [35S] binding to hepatocytes, and these correlated highly with their biological activity (activation of glycogen phosphorylase in hepatocytes). For all the agonists, binding occurs in the same concentration range as the biological effect. These data clearly suggest that the detected binding sites correspond to the physiological P2-purinoceptors involved in the regulation of liver glycogenolysis. The rank order of potency of some ATP analogues suggests that liver possesses the P2Y-subclass of P2-purinoceptors. PMID- 3814091 TI - Purification and properties of an oestrogen-stimulated mouse uterine glycoprotein (approx. 70 kDa). AB - An oestrogen-induced secretory protein from mouse uterine luminal fluid was purified by CM-Affi-Gel Blue chromatography and reverse-phase h.p.l.c. This protein has an apparent molecular mass of approx. 70 kDa both by SDS/polyacrylamide-gel electrophoresis (with or without 2-mercaptoethanol) and by gel-filtration column chromatography, indicating that it exists as a single-chain polypeptide. Further analysis of the protein revealed that it is highly basic (pI greater than or equal to 10) and is a glycoprotein. The N-terminus appears to be blocked to Edman degradation. The partial amino acid sequence of a fragment was obtained by cleavage with CNBr; no sequence homology was apparent between the analysed fragment and other known sequences. The incorporation of [35S]methionine into uterine proteins in vitro revealed that oestrogen treatment of immature mice stimulates both synthesis and secretion of the 70 kDa protein. An enzyme-linked immunosorbent assay with polyclonal antibody was used to determine the tissue distribution of the protein. Tissues such as lung, brain, spleen, muscle, intestine, liver, kidney and ovary of oestrogen-treated mice did not have detectable amounts of the 70 kDa protein. Immunoreactivity was present in uterine and vaginal tissues from oestrogen-treated animals. The 70 kDa protein was not induced by testosterone or progesterone. Although the function of this protein is unknown, it is useful as a marker for the study of oestrogen action in the mammalian uterus as well as regulation of gene expression at the molecular level. PMID- 3814092 TI - Synthesis and degradation rates of collagens in vivo in whole skin of rats, studied with 1802 labelling. AB - Rats of synthesis and degradation in vivo of collagens in 0.5 M-acetic acid soluble and -insoluble extracts from skins of three growing rats were determined by using a labelling procedure involving exposure of the animals to an atmosphere of 18O2 for 36 h. For comparison, rats also received injections of [2H]proline. Serial skin biopsies were taken at frequent intervals over 392 days. Enrichment of 18O and 2H in the hydroxyproline of the collagen fractions was determined by gas chromatography-mass spectrometry. Changes in size of the soluble and insoluble collagen pools were considered in the evaluation of isotope kinetic data. The insoluble collagen fraction showed no degradation. The efflux (mean +/- S.D., expressed as mumol of hydroxyproline) from the soluble collagen pool was estimated to be 59.9 +/- 1.9 per day from the 18O data, and 25.5 +/- 7.5 per day from the 2H results. The finding indicates significant reutilization of 2H radiolabelled proline for hydroxyproline synthesis. From these isotope data and estimates of size of the collagen pools it was determined that 55% of the collagen disappearing from the soluble pool was due to maturation into insoluble collagens and 45% of the disappearance was a result of actual degradation of soluble collagen. These results confirm the utility of 18O2 as a non-reutilizable label for studies of collagen turnover in vivo. PMID- 3814093 TI - Cathepsin S. The cysteine proteinase from bovine lymphoid tissue is distinct from cathepsin L (EC 3.4.22.15). AB - Cathepsin S was purified from bovine spleen by acid autolysis, (NH4)2SO4 fractionation and chromatography on CM-Sephadex C-50, CM-cellulose and activated thiol-Sepharose. Cathepsin L was isolated from lysosomal fractions of rat liver, rat kidney and bovine liver. Generally, cathepsin L was bound tightly to CM Sephadex C-50. Preparations of cathepsin L from rat liver, rat kidney and bovine liver were shown to have kinetic constants for the substrate benzyloxycarbonyl Phe-Arg-7-(4-methyl)coumarylamide in the same range (Km 2-3 microM). Benzyloxycarbonyl-Phe-Phe-diazomethane proved to be a sensitive irreversible inhibitor of cathepsin L from different species. Cathepsin S differed in all these characteristics from cathepsin L. A polyclonal antibody to cathepsin L from rat reacted with bovine cathepsin L but not with bovine cathepsin S. PMID- 3814094 TI - Free-radical-mediated fragmentation of monoamine oxidase in the mitochondrial membrane. Roles for lipid radicals. AB - A flux of hydroxyl radicals generated by gamma-irradiation can fragment monoamine oxidase in the membrane of submitochondrial particles. This fragmentation can be inhibited by mannitol and in addition is more extensive in monoamine oxidase preparations that have been depleted of lipid. This latter observation is consistent with the higher yields of fragmentation induced by hydroxyl radicals in soluble proteins in the absence of added lipids. In the absence of oxygen, gamma-irradiation of submitochondrial particles leads to cross-linking reactions. A flux of hydroperoxyl radicals also causes fragmentation, whereas one of superoxide is virtually inactive in this respect. The irradiation of submitochondrial particles leads in addition to the accumulation of products of lipid peroxidation. When these irradiated preparations are exposed to ferrous or cupric salts a further fragmentation of monoamine oxidase ensues, especially at acid pH. These transition-metal-catalysed reactions do not occur with irradiated preparations depleted of lipid, and the post-irradiation protein modifications are concomitant with further lipid peroxidation. The data indicate roles for lipid radicals in both fragmentation and cross-linking reactions of proteins in biological membranes. These reactions may have an important bearing on control of protein activity and of protein turnover in membranes. PMID- 3814095 TI - NADPH-dependent generation of a cytosolic dithiol which activates hepatic iodothyronine 5'-deiodinase. Demonstration by alkylation with iodoacetamide. AB - We have assessed a previously proposed mechanism mediating 5'-deiodinase activation involving enzymic reduction of disulphides to thiols in non glutathione cytosolic components of Mr approx. 13,000 (Fraction B) catalysed by NADPH in the presence of other cytosolic components of Mr greater than 60,000 (Fraction A). The extent of Fraction B reduction under various experimental conditions was monitored by determining the amount of 14C incorporated into chromatographically isolated Fractions B and A after their alkylation with iodo[14C]acetamide. Incorporation of 14C into B was found to require the simultaneous presence of NADPH and A, to be directly proportional to the concentration of NADPH added, and to be unaffected by either propylthiouracil or iopanoate. Activation of 5'-deiodinase attainable using B after its partial reduction by various concentrations of NADPH and subsequent alkylation with non radioactive iodoacetamide was inversely proportional to the previously added concentration of NADPH. Fraction B was stable at 100 degrees C for 5 min, while similar heat treatment of Fraction A or omission of NADPH resulted in a complete loss of 14C incorporation. A greater than 90% reduction in iodo[14C]acetamide incorporation was revealed when 0.2 mM-sodium arsenite was added after enzymic reduction of B, as well as when NADPH was replaced by NADH. Fraction B could be labelled more extensively after reduction non-specifically, with dithiothreitol or NaBH4, but not by GSH. These observations provide strong evidence for the presence in vivo of a cytosolic disulphide (DFBS2) in Fraction B which can be reduced enzymically to a dithiol [DFB(SH)2] by NADPH and cytosolic components in Fraction A. The degree of activation of hepatic 5'-deiodinase correlated with the amount of available (unalkylated) Fraction B. PMID- 3814096 TI - Affinity purification of seminalplasmin and characterization of its interaction with calmodulin. AB - Bull seminalplasmin antagonizes with high potency and selectivity the activating effect of calmodulin on target enzymes [Gietzen & Galla (1985) Biochem. J. 230, 277-280]. In the present paper we establish that seminalplasmin forms a 1:1, Ca2+ dependent and urea-resistant complex with calmodulin. The dissociation constant equals 1.6 nM. In the absence of Ca2+ a low-affinity complex is formed that is disrupted by 4 M-urea. On the basis of these properties, a fast affinity purification of seminalplasmin was developed. The high specificity of seminalplasmin as a calmodulin antagonist was demonstrated for the multipathway regulated adenylate cyclase of bovine cerebellum. Far-u.v. c.d. properties are consistent with a random form of seminalplasmin in aqueous solution; 23% alpha helix is induced on interaction with calmodulin. The fluorescence properties of the single tryptophan residue of seminalplasmin are markedly changed on formation of the complex. These studies allowed us to locate tentatively the peptide segment that interacts with calmodulin, and to ascertain the structural homology between seminalplasmin and other calmodulin-binding peptides. Additional material, showing the inhibition of calmodulin-mediated activation of bovine brain phosphodiesterase by melittin and seminalplasmin and also the near-u.v. spectrum of affinity-purified seminalplasmin, has been deposited as supplement SUP 50135 (4 pages) at the British Library Lending Division, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies may be obtained on the terms indicated in Biochem. J. (1986) 233, 5. PMID- 3814097 TI - Physical properties of chondroitin sulphate/dermatan sulphate proteoglycans from bovine aorta. AB - Bovine aortic chondroitin sulphate/dermatan sulphate proteoglycans (PG-25, PG-35 and PG-50) were differentially precipitated with ethanol and analysed by a variety of chemical and physical techniques. The glycosaminoglycan chains of PG 25 and PG-35 contained a mixture of glucuronic acid and iduronic acid, whereas the uronic acid component of PG-50 was primarily glucuronic acid. In addition, various amounts of oligosaccharides containing small amounts of mannose, a galactose/hexosamine ratio of 1:1 and an absence of uronic acid were covalently linked to the core protein of all proteoglycans. The weight-average Mr (Mw) values of the proteoglycans determined by light-scattering in 4 M-guanidinium chloride were 1.3 X 10(6) (PG-25), 0.30 X 10(6) (PG-35) and 0.88 X 10(6) (PG-50). The s0 values of the proteoglycans were distributed between 7 and 8 S, and the reduced viscosities, eta sp./c, of all proteoglycans were dependent on the shear rate and polymer concentration. Electron microscopy of spread molecules revealed that PG-25 contained small structural units that appeared to self-associate into large aggregates, whereas PG-35 and PG-50 appeared mainly as monomers consisting of a core with various numbers of side projections. Hyaluronic acid-proteoglycan complexes occurred only with a small proportion of the molecules present in PG 35, and their formation could be inhibited by oligosaccharides. These results suggest the presence in the aorta of subspecies of chondroitin sulphate and dermatan sulphate proteoglycans, which show large variations in their physicochemical and inter- and intra-molecular association properties. PMID- 3814098 TI - The characterization of an acidic calmodulin-binding protein in brain cytoskeleton and membrane fractions. AB - One of the most abundant acidic proteins in rat brain has an Mr of 68,000 and a pI of 5.6 (68K 5.6 protein) when analysed by two-dimensional gel electrophoresis. The 68K 5.6 protein was found in large relative amounts in brain cytoskeleton preparations and in membrane and supernatant fractions. High-salt washing and proteolytic digestion did not remove this protein from the membrane elements. The 68K 5.6 protein was also found in the microtubule-associated protein fraction of purified microtubules and was present in large relative amounts in preparations of intermediate-filament proteins. The 68K 5.6 protein binds to calmodulin in the presence of Ca2+ ions, and we found it to be an abundant acidic calmodulin binding protein in brain tissue. PMID- 3814099 TI - Evidence for the presence of oligophosphoglyceroyl-ATP in rat offney. AB - The inability to account for large systematic variations in total purine nucleotide content of perfused rat hearts led to the demonstration that the soluble adenine nucleotides are in rapid equilibrium with a highly phosphorylated hetero-oligomeric derivative whose structure appears to be 3-phospho[glyceroyl gamma-triphospho-5'-adenosine-3'-3-phosp ho]4glyceroyl- gamma-triphospho-5' adenosine [Hutchinson, Morris & Mowbray (1986) Biochem. J. 234, 623-627]. Analogous techniques to those used with hearts for specifically labelling tissue purine nucleotides followed by extration and purification of nucleotides from the trichloroacetic acid-precipitable fraction show the existence of a corresponding rapid equilibrium between ATP and an oligomeric tetraphosphoadenosine derivative in perfused kidneys. PMID- 3814100 TI - Regulation of lipoprotein lipase synthesis in 3T3-L1 adipocytes by cachectin. Further proof for identity with tumour necrosis factor. AB - We investigated the mechanism by which the endotoxin-induced macrophage secretory protein cachectin is able to suppress the activity of lipoprotein lipase in 3T3 L1 adipocytes. The loss in activity results from an effect on the synthesis of the enzyme, as determined by a decreased incorporation of [35S]methionine into immunoprecipitable lipoprotein lipase. The results were nearly identical whether crude conditioned medium or a highly purified preparation was utilized as a source of cachectin. [35S]Methionine incorporation into acid-precipitable protein was minimally affected by purified cachectin, suggesting that the suppression of the lipoprotein lipase was not due to a general suppression of protein synthesis. These results, taken together with our previous work, provide additional evidence that cachectin and tumour necrosis factor are functionally identical. PMID- 3814101 TI - Olfactory adenylate cyclase of the rat. Stimulation by odorants and inhibition by Ca2+. AB - Membranes prepared from the olfactory mucosa of the rat show a high level of adenylate cyclase activity. The activity increases up to 2-fold in the presence of physiologically relevant concentrations of odorants and is inhibited by Ca2+. The level of cyclase activity found is sufficient to explain the speed of olfactory transduction, which occurs on a time scale of tens of milliseconds. PMID- 3814102 TI - Thermal transitions in rat erythrocyte ghosts. AB - Thermal transitions in rat erythrocyte ghosts have been studied by means of scanning microcalorimetry, intrinsic fluorescence, circular dichroism and infrared spectroscopy. Heating of the suspension of rat erythrocyte ghosts induced at least four thermodynamically irreversible transitions. Each of these transitions is believed to be due to a localized structural transition induced by thermal stress. The influence of pH, papain, phospholipase and other modifications on the thermal transitions in rat erythrocyte ghosts is demonstrated. PMID- 3814103 TI - A trypsin inhibitor isolated from lymphatic leukemia cells. AB - A trypsin inhibitor from murine L 1210 lymphatic leukemia cells was isolated on QAE Sephadex A-50 and Trypsin-Sepharose 4B and purified about 197 times. It is a thermostable peptide, nonsensitive to changes in the pH range 2-10. It inhibits trypsin proteolytic activity against hemoglobin, azocaseine and trypsin esterase activity. PMID- 3814104 TI - [Occurrence of phenylalanine hydroxylase in the human kidney]. AB - Phenylalanine hydroxylase activity, determined by fluorimetric procedure in human kidney (cortex) of 17 patients, who had a kidney operation, was on the average 4.7 nkat tyr/g protein (25 degrees C), which is 28% in comparison to the enzyme activity in human liver. This is in good accordance with the results of AYLING et al. who investigated 15 human kidneys. They found by the spectrophotometric method 22% of the liver enzyme activity. A nonspecific hydroxylation could be excluded by tests with the inhibitors p-Cl-phenylalanine, 3-I-tyrosine and 6-F tryptophan. PMID- 3814105 TI - Central effects of leukotriene C4 and D4 in rats and mice. AB - Leukotrienes (LTs) C4 or D4 in a dose of 12 nmoles were administered into the lateral ventricle (i.c.v.) of the rat brain under urethane anaesthesia, and the changes in the blood pressure, heart and respiratory rate were investigated. In other animals the behaviour was evaluated by means of the open field test, and the rectal body temperature was measured. Besides, the content of noradrenaline, 5-hydroxytryptamine and 5-hydroxyindole acetic acid was estimated in different parts of the brain following i.c.v. application of LTs. In mice the antinociceptive effect of LTs in a dose of 1.5 nmoles was examined in the hot plate test; furthermore, the effect of LTs on chlorpromazine catalepsy was measured. Only LTC4 caused a slight rise of the peripheral blood pressure, a decreased respiratory rate and affected the behaviour of rats. Both LTs decreased the rectal body temperature but did not alter the content of biogenic amines in the brain of rats. In mice both LTs did not change the reactivity to thermic pain stimulus; only LTC4 intensified chlorpromazine catalepsy. The results indicate that both LTs exert slight biological effects upon the central nervous system; however, it should be emphasized that LTC4 has a stronger effect. PMID- 3814106 TI - Lesions in the mesencephalic part of pedunculopontine nuclei modify goal-directed behaviour. AB - Eleven Long-Evans hooded rats were preoperatively tested in an open field (OF), then trained in a Y-maze and thereafter symmetrically lesioned in the mesencephalic part of the pedunculopontine nuclei (MPPN). The OF test on the 11th postoperative day revealed no significant changes in exploratory behaviour, but a significant increase of ambulatory activity during all periods of 10 min exposure. This points to the role of the lesioned structure in response inhibition and habituation. High postoperative retention of preoperatively learnt conditioned avoidance responses (CAR) and of brightness discrimination showed no memory deficit. Reaction times were significantly decreased in the MPPN rats without symptoms of enhanced emotional activation. The escape speed from start to goal box was significantly slowed down after lesion. The formation of a new CAR stereotype in the jump test was impossible after MPPN lesions, because the rats did not find the escape possibility. The results differ from that of other mesencephalic reticular lesions. PMID- 3814107 TI - [Inhibition of several strains of influenza virus type A and B by phenolic polymers]. AB - Ten synthetic polymers of diphenolic compounds (KOP, HYKOP, CHOP, 3,4-DHTOP Na ADROP, NH4-ADROP, Na-NORADROP, NH4-NORADROP, GENOP, and 2,5-DHTOP) as well as two phenolic polymers of natural origin (Na-humate, NH4-humate) were tested for their effectiveness on several strains of influenza virus type A and B. The allantois on-shell system was used for primary screening. Virus multiplication was assessed by means of the infectious titer. All substances tested were found to exert inhibitory effects on influenza virus type A, while 3,4-DHTOP, Na-ADROP, NH4 ADROP as well as GENOP were effective against either type. The highest titer reductions (greater than 4.0 log 10 ID50) were obtained with KOP and HYKOP against influenzavirus A/Brasil/11/78 and with 3,4-DHTOP, KOP and HYKOP against influenzavirus A/Hongkong/1/68. Only GENOP showed antiviral activity against all virus strains tested so far. PMID- 3814108 TI - [Effect of piracetam on passive avoidance learning in ethanol-treated mice]. AB - Mice received pre- and postnatal drinking water containing 20% ethanol. Ethanol treatment significantly impaired learning, reflected by shorter latency to enter the dark compartment of the apparatus. This effect could be antagonized by the administration of twice daily 100 mg/kg piracetam for ten days. The ethanol treatment and the administration of piracetam did not affect the step-through latencies in the training situation. PMID- 3814109 TI - Influence of inhibitors of thrombin on porcine aortic smooth muscle cells in primary culture. AB - Heparin and synthetic inhibitors of thrombin are able to decrease the rate of division of porcine vascular smooth muscle cells in primary culture and to increase their myosin content. These effects are abolished by thrombin. Inhibitors of thrombin may therefore be useful in preventing arteriosclerotic lesions. PMID- 3814110 TI - Characterization of the synaptosomal high-affinity uptake of noradrenaline in the nucleus accumbens of rats. AB - In the nucleus (n.) accumbens, a predominantly dopaminergic innervated brain region, a high-affinity noradrenaline (NA) uptake exists indicating NA termination in this area. The affinity of the uptake carrier (Km) is in the range of that given for other regions. For characterizing the specificity of NA uptake, inhibitory experiments of NA and dopamine (DA) uptake were carried out with nomifensine and desipramine. The experiments with desipramine clearly show that the NA uptake is independent of the DA uptake into dopaminergic terminals occurring predominantly in this nucleus. PMID- 3814111 TI - Is there really a new evolutionary paradigm--or just an uncomfortable gap in the old one? PMID- 3814112 TI - Autoregulation of tubulin synthesis. PMID- 3814113 TI - Testicular Leydig cells: differentiated cells responding to multiple hormonal control and producing varied products. PMID- 3814114 TI - Human tissue fibronectin: expression of different isotypes in the adult and fetal tissues. AB - The isotype of fibronectin present in human adult and fetal lung tissues was studied by limited proteolysis by cathepsin D followed by immunoblot analysis with domain-specific antibodies. The results indicate that the fibronectin in the adult lung tissue is predominantly the plasma-type whereas the fibronectin in the fetal lung tissue is more related to the cellular-type than to the plasma-type. Thus, it appears that the fibronectin isotype in tissue switches from the cellular-type to the plasma-type during ontogenesis. PMID- 3814115 TI - Oxalyl thiolesters and N-oxalylcysteine are normal mammalian metabolites. AB - A method for the quantitative analysis of N-oxalylcysteine and oxalyl thiolesters (RSCOCOO-) in biological samples is described. These compounds were found in all rat tissues examined (kidney, liver, brain, heart, muscle and fat), with the amount of N-oxalylcysteine ranging up to 18 nmoles/g wet weight and that of oxalyl thiolesters up to 65 nmoles/g wet weight. The identification of such compounds in animal tissues adds further credence to the hypothesis that they may be important metabolic effectors. PMID- 3814116 TI - Molecular cloning of the chicken nerve growth factor gene: mRNA distribution in developing and adult tissues. AB - The gene for chicken nerve growth factor was cloned by screening a chicken genomic library with a mouse nerve growth factor cDNA clone. Northern blot analysis indicated the presence of nerve growth factor mRNA throughout the central nervous system of the chick, with the highest levels in retina, midbrain/hindbrain and spinal cord. In embryonic brain, nerve growth factor mRNA was expressed at low levels at day 8, with a progressive increase up to postnatal day 2. Substantial amounts of nerve growth factor mRNA were expressed in embryonic leg tissues at a time when the dorsal root ganglia that project to the limb are maximally responsive to nerve growth factor. PMID- 3814117 TI - Potassium depolarisation markedly enhances muscarinic receptor stimulated inositol tetrakisphosphate accumulation in rat cerebral cortical slices. AB - Rat cerebral cortical slices labelled with [3H]-inositol were incubated with the muscarinic agonist carbachol in media containing normal 5.9 mM or elevated 24 mM K+ ions. Over the first few minutes both carbachol and elevated K+ stimulated the production of [3H]-inositol phosphates. The very rapid formation of [3H]-inositol tetrakis, tris and bisphosphate was followed by accumulation of [3H]-inositol monophosphate. However, elevated K+ resulted in a relatively larger stimulation of [3H]-inositol bisphosphate than muscarinic receptor stimulation. When carbachol effects were examined in media containing elevated K+, production of [3H]-inositol trisphosphate was apparently additive whereas the mono and bisphosphate displayed somewhat synergistic responses after 1-2 minutes. In contrast, [3H]-inositol tetrakisphosphate production was greatly enhanced and marked synergy was observed between the K+ and carbachol responses. The production of the tetrakisphosphate under these conditions was dependent on extracellular Ca2+ and a stimulatory effect of this divalent ion on the 3-kinase is discussed. PMID- 3814118 TI - Changes of membrane fluidity in chemotactic peptide-stimulated polymorphonuclear leukocytes. AB - Although the phenomenon of stimulus-response coupling in polymorphonuclear leukocytes involves a series of membrane events the influence of stimulation on membrane fluidity is to clarify. In our experiments we have used 1-(4 trimethylaminophenyl) 6-phenyl-1,3,5-hexatriene and 1,6-diphenyl-1,3,5-hexatriene fluorescence polarization technique to evaluate membrane fluidity in living polymorphonuclear leukocytes after stimulation with N-formyl-methyonil-leucyl phenylalanine peptide which has a well defined membrane receptor on the plasma membrane. We report that polymorphonuclear leukocytes stimulation increases 1-(4 trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene polarization, only when colcemid, a microtubule disrupting drug, is added to polymorphonuclear leukocytes. This can be viewed as an indirect evidence that microtubules are involved in the control of polymorphonuclear leukocytes membrane fluidity. On the contrary no changes have been observed with 1,6-diphenyl-1,3,5-hexatriene. This study indicates the potential use of 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene to evaluate the involvement of plasma membrane physical state during intact cell activity. PMID- 3814119 TI - Differential inhibition of rat and human glutathione S-transferase isoenzymes by plant phenols. AB - Glutathione S-transferase (GST) isoenzymes isolated from human tissues and rat liver are differentially inhibited by quercetin, alizarin, purpurogallin and ellagic acid. Rat liver GST isoenzymes are far more sensitive to these compounds as compared to the human GST isoenzymes. Among human GST, the anionic isoenzymes containing C type and A' type subunits are inhibited to a greater extent as compared to the cationic isoenzymes containing A and B type subunits. The anionic GST isoenzymes of human erythrocytes and placenta are differentially inhibited by these plant phenols indicating that the placental and erythrocyte isoenzymes may be distinct proteins. PMID- 3814120 TI - Relative spectral response as a function of sequential ligand binding. AB - A unique method is presented for the determination of the critical number of ligands that must bind to a macromolecule to elicit a spectroscopic response. This method is based on analysis of ligand binding data. For example, four Ca2+ and two Mg2+ ions are necessary for mirroring the relative decrease in the intrinsic fluorescence of bovine prothrombin fragment 1. For application of the method, ligand loading and relative spectroscopic response data must be measured over a full range of concentrations. PMID- 3814121 TI - Expression of Agrobacterium tumefaciens T-DNA gene 7 in Xenopus laevis oocytes. AB - The expression of Agrobacterium tumefaciens T-DNA gene 7 was investigated in Xenopus laevis oocytes. Cloned DNA injected into oocytes consisted of T-DNA sequences derived from octopine type Ti plasmid B6-806 and T-DNA attached to plant DNA sequences at the left junction in crown gall tumors. Transcription initiation sites observed in oocytes were similar to those for transcript 7 in crown gall tumors. Quantitative differences in transcription occurred depending on the flanking sequences of the injected clones indicating that sequences upstream of the TATA box of T-DNA gene 7 affect the quantitative expression of this gene in Xenopus oocytes. PMID- 3814122 TI - Tumor cell biotransformation products of prostaglandin A1 with growth inhibitory activity. AB - The growth inhibitory effect and the fate of prostaglandin A1 (10(-6) M) were followed in cultures of rat B104 neuroblastoma and C6 glioma cells. More than 40% and 85% of the drug were neither recognized by a prostaglandin A1 antiserum nor extracted from the acidified medium with ethyl acetate, after 6 h and 24 h incubation, respectively. When the supernatant of cells cultured in the presence of prostaglandin A1 during 24 hours was transferred to other cells and used as culture medium, the same growth inhibitory effect as with prostaglandin A1 was observed even when no prostaglandin A1 was added. After extensive purification and reverse phase HPLC of supernatant, four peaks more polar than prostaglandin A1 were shown; two of them were still active as growth inhibitors. This biotransformation was not observed with normal cells like L 929 or chick embryo fibroblasts, for which prostaglandin A1 had no inhibitory effect. The identification of these metabolites will allow the study of the structure activity relationship. PMID- 3814123 TI - NMR studies of flexible opiate conformations at monoclonal antibody binding sites. I. Transferred nuclear Overhauser effects show bound conformations. AB - 500 MHz H, homonuclear, intra-molecular, transferred Nuclear Overhauser Effect measurements have been performed on the bound forms of a classical opiate antagonist, nalorphine and an agonist, levorphanol at their respective binding sites in two different specific anti-opiate monoclonal antibody fragments. Based upon previous studies of opiate conformations in solution the results clearly show without extensive interpretation that one of these flexible haptens has the opposite (from solution) isomeric conformation in its bound form. For nalorphine the axial isomer of the N-allyl substituent is the bound form whereas in solution the equatorial isomer dominates at a ratio of 5:1. For levorphanol the bound form is that of equatorial N-methyl in accord with the low energy conformation in solution. In this preliminary report we discuss the initial measurements and results and their implications with respect to the conformations of flexible ligands at macromolecular binding sites including opiate receptors. PMID- 3814124 TI - Lectin interactions with the variant surface glycoprotein from Trypanosoma brucei brucei incorporated into liposomes. AB - The variant specific surface glycoprotein from Trypanosoma brucei brucei is incorporated into lipid vesicles using 8M urea as an unfolding reagent. Pronase treatment of these proteoliposomes removes most of the protein, leaving a glycophospholipopeptide which is the membrane attachment site. We show here that lectins, specific for mannose and galactose are able to recognize oligosaccharide residues on these proteoliposomes, using a straightforward aggregation assay. The relevance of these results obtained with the liposome model system to the accessibility of the surface antigens in living trypanosomes is discussed. PMID- 3814125 TI - Estrogenic activity of phenol red in rat anterior pituitary cells in culture. AB - The estrogenic activity of phenol red, a pH indicator widely used in cell culture media, was studied in rat anterior pituitary cells. After 72 hours of incubation with 40 microM phenol red, a 40-50% increase in prolactin cell content and a 100% stimulation of luteinizing hormone-releasing hormone induced luteinizing hormone release was observed. Both effects could be completely reversed by simultaneous incubation with the antiestrogen LY156758. In the rat uterine [3H] estradiol binding assay, phenol red showed a significant displacement at concentrations above 10 microM while its concentration in the commonly used culture media is about 40 microM. From the present results, we conclude that phenol red acts as a weak estrogen in normal tissues and that its estrogenic activity should be taken into account in studies using estrogen-sensitive cell or tissue cultures. PMID- 3814126 TI - Stereoselective product inhibition of glutathione S-transferase. AB - Isozymes 3-3 and 4-4 of rat liver glutathione S-transferase are stereoselectively inhibited by the diastereomers of 9,10-dihydro-9-glutathionyl-10 hydroxyphenanthrene, 1. The conformation of the biphenyl moiety is the same in the enzyme -1 complex as in aqueous solution with the glutathionyl and hydroxy groups in the axial positions. Isozyme 4-4 is also inhibited by the four diastereomers of 1,2-diphenyl-1-(S-glutathionyl)-2-hydroxyethane. The stereoselectivity of inhibition is modest in all cases and is manifest in both the type of inhibition as well as the magnitude of Ki. PMID- 3814127 TI - Effect of removal of the cytolytic factor of Bacillus thuringiensis subsp. israelensis on mosquito toxicity. AB - Solubilized crystal protein of Bacillus thuringiensis subsp. israelensis was fractionated by affinity chromatography using a monoclonal antibody directed against the crystal's 28 kDa peptide. The 28 kDa peptide was found to be relatively nontoxic to mosquito larvae although it does contain the hemolytic activity of the crystals. The crystal protein fraction depleted of the 28 kDa peptide was found to be nonhemolytic and to retain nearly full toxicity to mosquito larvae. These results suggest that the 28 kDa peptide is not required for the toxicity of solubilized crystal protein. PMID- 3814128 TI - Precipitation of the D-galactose specific lectin from Erythrina indica by a triantennary complex type oligosaccharide. AB - We have previously demonstrated that a high mannose type glycopeptide is bivalent for binding Concanavalin A (Con A) and can precipitate the lectin (Bhattacharyya L. and Brewer, C.F. (1986) Biochem. Biophys. Res. Commun. 137, 670-674). The present results show that a triantennary complex type oligosaccharide containing nonreducing terminal galactose residues can precipitate the D-galactose/N-acetyl D-galactosamine specific lectin from Erythrina indica (EIL). The interactions of the oligosaccharide with EIL was investigated by quantitative precipitin analysis. The equivalence point of the precipitin curve indicated that the glycopeptide is trivalent for EIL binding. These results indicate that each arm of the oligosaccharide can independently bind separate lectin molecules leading to precipitation of the complex. These findings are discussed in terms of the possible biological structure-function properties of complex type oligosaccharides. PMID- 3814129 TI - Trypsin induced destabilization of liposomes composed of dioleoylphosphatidylethanolamine and glycophorin. AB - Destabilization of liposomes composed of phosphatidylethanolamine (PE) and purified glycophorin of human erythrocytes was studied with the release of an entrapped fluorescent dye, calcein. Proteolytic cleavage of liposomes by trypsin induced a rapid increase of turbidity and the leakage of calcein from the liposomes. Kinetic experiments indicated that the destabilization was a second order reaction, i.e. it required liposome collision. Using N-(7-nitro-2,1,3 benzoxadiazol-4-yl) PE as a fluorescent probe for the formation of hexagonal phase of PE, tryptic digestion of the liposomes resulted in a higher tendency of the PE bilayer to transform into the hexagonal phase. We propose that hexagonal (or inverted micellar) structures are involved in the trypsin induced liposome destabilization. PMID- 3814130 TI - Regulation of lipoprotein lipase secretion by mouse peritoneal macrophages. AB - Resident mouse peritoneal macrophages in culture spontaneously secrete lipoprotein lipase. Secretion of lipoprotein lipase was 10-fold greater in thioglycollate-elicited and 6-fold greater in mineral oil-elicited macrophages. The increase in enzyme secretion was dependent on protein synthesis and glycosylation of the newly synthesized enzyme. The addition of 1 to 500 ng per ml of lipopolysaccharide to the culture medium resulted in a dose-dependent inhibition of lipoprotein lipase secretion. Thus, secretion of macrophage lipoprotein lipase is a regulated process, and may be increased as part of the response to inflammation. This may have important implications in the atherogenic process in the arterial wall. PMID- 3814131 TI - The gene for human chromogranin A (CgA) is located on chromosome 14. AB - Chromogranin A (CgA) is a protein that is present in most neuroendocrine tissues and is co-secreted with their resident hormones. We have assigned the CgA gene to human chromosome 14 by hybridization of a CgA cDNA probe cloned from a cDNA library of human medullary thyroid carcinoma cells to spots of individual human chromosomes flow-sorted onto nitrocellulose filters. Southern analysis of human genomic DNA with the same probe revealed only 1-3 restriction bands. These studies indicate that the CgA gene is probably single copy and not a member of a dispersed, multigene family. The CgA gene is not co-localized with the genes of any of the CgA-associated hormones. PMID- 3814132 TI - Changes in phosphorylation of nonhistone proteins during differentiation of a lower eukaryote Physarum polycephalum. AB - During starvation-induced differentiation of a slime mold Physarum polycephalum several changes in the phosphorylation of nuclear proteins occur. The overall content of serine- and threonine-bound phosphate drops by 50% and de novo phosphorylation of a number of nonhistone proteins is drastically altered. On the contrary, no selective dephosphorylation of nuclear proteins phosphorylated under normal growth accompanies differentiation. PMID- 3814133 TI - Capsaicin, a pungent principle of hot red pepper, evokes catecholamine secretion from the adrenal medulla of anesthetized rats. AB - Using a direct monitoring system for catecholamine (CA) secretion into the adrenal vein, we have demonstrated that capsaicin (CAP) evokes CA secretion from the adrenal medulla of pentobarbital-anesthetized rats. A significant increase in epinephrine (E) secretion was seen in rats infused with CAP (200 micrograms/kg, i.v.) without a detectable lag after the infusion. Norepinephrine (NE) secretion evoked by CAP was fairly weak compared with E secretion. The secretion of E evoked by CAP was dose-amount dependent. The stimulation of E release by CAP was barely detectable at 20 micrograms/kg, half-maximal at 100 micrograms/kg, and maximal at 600 micrograms/kg. When CAP (200 micrograms/kg) was infused into rats, the weight-ratio of E to NE was significantly higher (47.6) than when acetylcholine (12.5 micrograms/kg) was infused (13.0). These results indicate that CAP can evoke CA secretion from the adrenal medulla of rats. PMID- 3814134 TI - In vitro synthesis of apo-A-IV and apo-C by liver and intestinal mRNAs from lean and obese Zucker rats. AB - The relative content and expression of mRNA coding for apolipoproteins A-IV and C in liver and intestinal cells have been studied in obese hyperlipemic (fa/fa) and lean (Fa/-) Zucker rats. The RNA were translated in a rabbit reticulocyte lysate system using 35S methionine as label. Apo-A IV and apo-C were immunoprecipitated with specific antibodies and characterized by electrophoresis and autoradiography. The content and expression of mRNA specific for apo-A-IV and apo C was much higher and the liver of obese than of lean rats. The apo-A-IV and apo C synthetic capacity of intestinal cells from fa/fa and Fa cells from fa/fa and Fa rats was similar suggesting that the lipoprotein overproduction, already described in obese Zucker rats, is mainly from hepatic origin. PMID- 3814135 TI - Assessment of phospholipid deacylation-reacylation cycles by a stable isotope technique. AB - Incorporation of 18O into glycerophospholipids was determined after incubating mouse peritoneal exudate cells for 1 or 2 h in media containing 40% H(2)18O. Gas chromatography-mass spectrometry of hydrogenated fatty acid methyl esters showed highest amounts of 18O in choline phospholipids and phosphatidylinositol. Acyl groups generally present at the sn-1 position contained at least as much carbonyl 18O as those at the sn-2 position. Considering the route of 18O incorporation via free fatty acid derived through ester hydrolysis in H(2)18O, acyl turnover in certain peritoneal exudate cell phospholipids may equal or exceed 20% per h. PMID- 3814136 TI - Magnetic lipase active in organic solvents. AB - Magnetic lipase (magnetite particles coated with polyethylene glycol-modified lipase) was prepared in two steps: Lipase was coupled with 2,4-bis(O methoxypolyethylene glycol)-6-chloro-s-triazine, activated PEG2, to obtain polyethylene glycol-modified lipase, PEG-lipase. The PEG-lipase was added to the solution of ferrous (Fe2+)- and ferric(Fe3+)-ions with the pH value adjusted to 8.0-8.5 to obtain magnetic lipase. The magnetic lipase was dispersed in organic solvents such as benzene and 1,1,1-trichloroethane with the particle size of 120 +/- 60 nm. The colloidal solution was very stable and no aggregation occurred even after 5 days. A high enzymic activity (11.6 mumol/min/mg protein) for lauryl laurate synthesis was observed in 1,1,1-trichloroethane. The magnetic lipase was readily recovered from the organic solvents in a magnetic field of 6000 Oe without loss of the enzymic activity. PMID- 3814137 TI - Specificity of activated glucocorticoid receptor expression in heart and skeletal muscle types. AB - Muscle metabolic responses to glucocorticoids are specific to fiber type. The present study revealed that a definite pattern exists in the formation of the two thermally activated glucocorticoid receptor complexes among the different types of muscle. Fiber types that enlarge from glucocorticoids (heart) contained the highest relative distribution of binder II and lowest content of binder IB. Fibers that atrophy from glucocorticoids (white muscle) contained negligible content of binder II and the highest appearance of binder IB. The formation of binder IB could not be explained by differences in proteolysis among the cell types. These results are consistent with the hypothesis that specific receptor forms may regulate the glucocorticoid induction of muscle hypertrophy and atrophy. PMID- 3814138 TI - Isolation and characterization of a novel nonheme chloroperoxidase. AB - Chloroperoxidase, purified from the fermentation of Curvularia inaequalis, had a molecular weight of approximately 240,000 and was composed of 4 subunits of identical molecular weight (Mr 66,000). The enzyme was specific for I-, Br- and Cl-, and inactive toward F-. The optimum pH of the enzyme was centered around 5.0. X-ray fluorescence revealed that the enzyme contained 2.2 atoms of zinc and 0.7 atom of Fe per molecule of protein. The enzyme had no heme-like compound as a prosthetic group, making it the first nonheme chloroperoxidase to be reported. Under oxidative conditions that rapidly inactivated other haloperoxidases, this enzyme was remarkably stable. PMID- 3814139 TI - A rapid and sensitive method for the estimation of individual tRNA pools. AB - A rapid and sensitive method is described to quantitatively compare tRNA pools for individual aminoacids in a single experiment. The procedure comprises of: charging of total tRNA with a mixture of radiolabeled aminoacids, deacylation of the esterified tRNA with a volatile base and the recovery of the labeled aminoacid, derivatisation of the aminoacid with phenylisothiocyanate after mixing with excess of nonradioactive aminoacids, baseline separation of the phenylthiocarbamyl aminoacids by reverse phase high performance liquid chromatography monitored by A254nm and quantitation of the radioactivity in individual aminoacid peaks. The radioactivity in the aminoacid peak corresponds to the quantity of the aminoacylated tRNA. The method has been successfully applied to quantitate the individual tRNA pools in the developing silk glands of Bombyx mori, a functionally adapted tissue which undergoes considerable variations in tRNA content. PMID- 3814140 TI - Evidence that O6-alkylguanine-DNA alkyltransferase becomes covalently bound to DNA containing 1,3-bis(2-chloroethyl)-1-nitrosourea-induced precursors of interstrand cross-links. AB - The reaction of partially purified human O6-alkylguanine-DNA alkyltransferase with 1,3-bis(2-chloroethyl)-1-nitrosourea-treated DNA resulted in formation of a DNA-protein covalent complex. Complex formation required active alkyltransferase and brief treatment of DNA with the drug. DNA lost its capacity to form the complex once drug-induced DNA interstrand cross-links were completely formed. These results are consistent with a model in which the transferase catalyzes cleavage at O6-guanine and transfer of the alkyl moiety in a putative O6, N1 ethanoguanine intermediate of cross-link formation. DNA-protein complex formation presumably results when the transferase accepts the N1-ethanoguanine-DNA structure, analogous to its acceptance of simple alkyl groups. PMID- 3814141 TI - Immunochemical characterization of protein kinase C in rat liver nuclei and subnuclear fractions. AB - A doublet of immunoreactive bands has been identified in rat liver nuclei, nuclear matrix and lamina by means of a polyclonal antibody against protein kinase C. The two polypeptides show an apparent molecular weight of 77 and 74 kDa on SDS-polyacrylamide gels, and appear to be tightly bound nuclear components, resistant to detergent and high salt extraction. Given the complexity of the genes encoding for protein kinase C, these two forms of the enzyme might be translational products specifically located in the nucleus, involved in the transduction to the genomic apparatus of regulatory signals generated by growth factors and tumor promoters. PMID- 3814142 TI - Synthesis/secretion of nerve growth factor is associated with cell growth in cultured mouse astroglial cells. AB - Astroglial cells cultured from 8-day-old mouse brain synthesized and secreted nerve growth factor (NGF). An increase in cell density or the withdrawal of serum from the culture medium caused a drastic decrease in the rate of NGF secretion which could be reversed by reculturing at a low cell density or by refeeding with serum-containing culture medium. The cells cultured for two weeks without serum entered the quiescent phase without loss of the activity of an astroglial marker enzyme, glutamine synthetase. These results suggest that NGF secretion by astroglial cells in vitro is regulated in a growth phase-dependent manner. Evidence is also presented to show that NGF secretion is not phase-specific in the cell cycle. PMID- 3814143 TI - Antithrombin III mRNA in adult rat liver and kidney and in rat liver during development. AB - Using Northern blots the size of antithrombin III (AT III) mRNA in rat liver was found to be 1650 nucleotides. Adult rat kidney also contained a slightly smaller mRNA at about 20% the level in liver. The ontogeny of AT III mRNA in the liver was assessed by dot blot hybridization. The mRNA was detectable at the earliest age examined (14th day of gestation) at about 15% of the adult levels. After the 17th day of gestation the levels of antithrombin III mRNA rise reaching 50% of adult levels at birth. After birth the mRNA levels rise to 75% of adult levels by the 5th day and reach adult levels by 40 days after birth. We suggest that foetal AT III is produced by both the foetal liver and by placental transfer of the maternal inhibitor. PMID- 3814144 TI - Transient expression of sialylated glycans during glycoprotein processing by embryonal carcinomas. AB - Embryonal carcinoma and early embryonic cells express unusually large and complex carbohydrates on their surfaces that are lost during differentiation. These carbohydrates are composed of alternating galactose and N-acetylglucosamine residues and have either linear or branched architectures. Compared to the glycans expressed by many differentiated cells these glycans are poorly sialylated. However, metabolic studies reveal that there is a transient expression of sialylated glycans during the processing of glycoproteins by embryonal carcinomas. After a short pulse with mannose the major complex-type glycan is a biantennary glycan with two sialic acids. During subsequent chase periods this glycan species is replaced by unsialylated glycans that have elongated branches composed of alternating galactose and N-acetylglucosamine residues. PMID- 3814145 TI - The effects of ethanol on cellular calcium content in primary myocardial cell cultures from offspring of sedentary and swim-trained pregnant rats. AB - Primary myocardial cell cultures obtained from offspring of swim-trained (T) and sedentary (S) Sprague-Dawley rat mothers (dams) were used to evaluate the influence of exercise training and ethanol on cellular calcium (45Ca) content. The pregnant rats swam in water maintained at 37 degrees C 6 days/week during gestation. The dams swam continuously for 30 min on the first day of gestation. The swimming time was increased by 5 min until the rats swam continuously for 1.5 hr. After the cultures had been in incubation for 4 days, the cells were treated with 600, 800, and 1000 mg% ethanol for 30 min and 1 hr. 45Ca content (nmol/mg protein) of the untreated controls and all but one of the ethanol treated groups from the T cultures (1000 mg%) were significantly elevated over the comparable groups from the S cultures for both 30 min and 1 hr of incubation (p less than or equal to 0.05). The data suggest that exercise during pregnancy induces adaptations in myocardial cell cultures from the offspring such that 45Ca content levels are elevated which may provide protection against ethanol toxicity. PMID- 3814146 TI - Primary structure of human carcinoembryonic antigen (CEA) deduced from cDNA sequence. AB - The cDNAs corresponding to the mRNA encoding a polypeptide which is immunoreactive with the antisera specific to carcinoembryonic antigen (CEA) (1) are cloned. The amino acid sequences deduced from the nucleotide sequences of the cDNAs show that it is synthesized as a precursor with a signal peptide followed by 668 amino acids of the putative mature CEA peptide, whose N-terminal 24 amino acids and amino acids 286 to 295 exactly coincide with those known for N-terminal sequences of CEA (2) and NFA-1 (3), respectively. The first 108 N-terminal residues are followed by three very homologous repetitive domains of 178 residues each and then by 26 mostly hydrophobic residues which probably comprise a membrane anchor. Each repetitive domains contains 4 cysteines at precisely the same positions and as many as 28 possible N-glycosylation sites are found in the CEA peptide region agreeing with high carbohydrate content of purified CEA. PMID- 3814147 TI - Differential expression of fibrillar collagen genes during callus formation. AB - An experimental fracture healing model in the rat tibio-fibular bone was employed to study the appearance of messenger RNAs for types I, II and III collagens during endochondral fracture repair. Total RNA was extracted from normal bone and from callus tissue at various time points. The total RNAs were analyzed in Northern hybridization for their contents of procollagen mRNAs using specific cDNA clones. The results show that during the first week of fracture repair type III collagen mRNA is increased to the greatest extent, followed by type II collagen mRNA during the second week. The 28-day callus resembles bone by containing mainly type I collagen mRNAs and very little type II or III collagen mRNA. PMID- 3814148 TI - Heparin induces specific protein release from human intestinal smooth muscle cells. AB - Human intestinal smooth muscle cells have recently been identified as the major cell type responsible for stricture formation in Crohn's disease. Heparin, a sulfated glycosaminoglycan, has been shown to be a key modulator of vascular smooth muscle cell growth both in vivo and in vitro and to affect the release of proteins from these cells. Heparin has also been shown to affect the growth of human intestinal smooth muscle cells. In this report we demonstrate that heparin, in addition to its effects on proliferation, also has very specific effects on proteins released by these cells in vitro. Examination of the culture medium proteins of heparin-treated human intestinal cells revealed an increase in three proteins of molecular weight between 150-250 kd, an increase in a 37 kd protein and a decrease in synthesis of lower molecular weight (less than 20 kd) proteins. In substrate-attached material a transient effect on a 48 kd protein was observed. No effects on intracellular labeled proteins could be demonstrated. The 35S-methionine labeled protein profile of human intestinal smooth muscle cells exposed to heparin is similar to that observed in rat vascular smooth muscle cells yet distinct differences do exist. Extracellular processing does not account for the released proteins nor is de novo protein synthesis required suggesting that altered intracellular protein processing is the mechanism for the heparin-induced protein pattern. The release of specific proteins following exposure to heparin may reflect a significant influence of this glycosaminoglycan on the metabolism of smooth muscle cells in general and particularly in the human intestine. PMID- 3814149 TI - Irreversible inactivation of lactoperoxidase in the course of iodide oxidation. AB - In the course of lactoperoxidase-catalysed I- oxidation, which is a model for the initial step of thyroid hormone biosynthesis, irreversible enzyme inactivation can occur if free molecular iodine (I2) or other oxidized iodine species accumulate. Evidence is presented that the breakdown of the catalytic activity is the result of the iodination of the peroxidase-apoprotein. This kind of enzyme inactivation, which can be prevented by iodine acceptors' such as thyroglobulin or high concentrations of I-, may well play a role in the regulation of the synthesis of thyroid hormones in vivo. PMID- 3814150 TI - A novel protein kinase activity in rabbit gastric gland cytosol. AB - A novel protein kinase activity was characterized from the cytosolic fraction of isolated rabbit gastric glands. The kinase phosphorylated a major 33,000 Da endogenous protein (pp33) and was stimulated by Zn2+ and Mn2+ with Kact of 1.0 and 7.5 mM, respectively. Mg2+ and Ca2+ failed to stimulate any pp33 kinase activity. The kinase utilized both ATP and GTP as phosphate donors with a Km of 10 microM for both. The pp33 protein displayed an isoelectric point of 7.5 to 7.8 and was phosphorylated predominantly on threonine residues. The kinase activity is clearly differentiable from all reported kinase activities and appeared to be enriched in rabbit gastric fundic mucosa. The results indicate that gastric fundic mucosa contains a novel protein kinase activity. PMID- 3814151 TI - Stimulation of cytosolic free calcium and inositol phosphates by prostaglandins in cultured rat mesangial cells. AB - We studied the effects of four products of arachidonate cyclo-oxygenation on a phospholipase C-dependent signal transduction system in cultured rat glomerular mesangial cells. PGF2 alpha, PGE2 and the thromboxane A2/endoperoxide analogue U 46619 rapidly increased cytosolic free Ca2+, measured in monolayers loaded with the fluorescent intracellular probe fura-2. Peak responses were dose-dependent and unaffected by chelation of extracellular Ca2+, indicating release from internal stores. The thromboxane A2-receptor antagonist SQ 27,427 selectively inhibited responses to U-46619. The PGI2 analogue Iloprost had no effect on cytosolic Ca2+. PGF2 alpha, PGE2 and U-46619 also stimulated accumulation of total inositol phosphates during 15 min incubations. We conclude that phospholipase C activation mediates the effects of certain eicosanoids on the glomerular mesangium. PMID- 3814153 TI - Cloning and sequence analysis of bovine beta-casein cDNA. AB - A bovine beta-casein cDNA clone was isolated from a cDNA library prepared from mammary gland mRNA. Sequence analysis revealed 25 nucleotides (nt) of the 5' noncoding region, 672 nt of the complete sequence coding and a 3' region of approximately 500 nt. When the nucleotide sequence of bovine beta-casein cDNA is compared to rat beta-casein cDNA (5), a high degree of homology is observed in the first 100 nt corresponding to the signal peptide of the pre-beta-caseins. PMID- 3814152 TI - Leupeptin and chymostatin inhibit mammalian protein methylesterase activity. AB - Purified protein methylesterase (PME) from rat kidneys was incubated with ovalbumin-methyl esters and a series of protease inhibitors. All four inhibitors with C-terminal aldehyde, leupeptin, chymostatin, Boc-Gln-Leu-Lys-H and D-Phe-Pro Arg-H completely blocked PME activity. Other inhibitors including, alpha-1 antitrypsin, soybean trypsin inhibitor, antithrombin III, phenylmethylsulfonylfluoride, aprotinin and lima bean trypsin inhibitor had no significant effect whereas pepstatin, at high concentration reduced the enzymatic activity by 25%. The most potent inhibitors, leupeptin and chymostatin, had a Ki of 3.5 X 10(-8) and 5.4 X 10(-7) M, respectively. These inhibitors provide two new tools to study PME function. PMID- 3814154 TI - Formation by bifunctional furocoumarins of DNA crosslinks and their repair in cultured mouse embryo fibroblasts. AB - Formation of crosslinks in DNA by three bifunctional psoralen derivatives plus UVA light in mouse embryo fibroblasts was evaluated by a NaI density gradient centrifugation method. Psoralen was shown to be a more active cross-linking agent than 8-methoxypsoralen. As for 4,5',8-trimethylpsoralen, it needed much lower concentrations and much less 365 nm light fluence to yield high percentages of crosslinked DNA. Repair of adducts formed by these psoralen derivatives was studied by splitting the irradiation dose into two equal parts separated by variously long dark repair periods. It was shown that essentially only monoadducts formed during the first irradiation period were repaired. These mouse embryo fibroblasts seem unable to repair interstrand DNA crosslinks. PMID- 3814155 TI - Cytosolic sialidases of rat tissues with special reference to skeletal muscle enzyme. AB - Using 4-methylumbelliferyl-N-acetylneuraminic acid as substrate, the cytosolic fractions of various rat tissues were assayed for sialidase activity. The activity was about 16 times greater in skeletal muscle than in liver, and the enzymes from the two sources were identical in chromatographic behavior, pH optimum, and substrate specificity. Apparently the same enzyme was found to be distributed in brain, heart, stomach, intestine, and testis, but not in lung and spleen. Sialidase was also present in kidney cytosol at a high level, but the enzyme resembled liver lysosomal sialidase rather than liver cytosolic sialidase in substrate specificity. PMID- 3814156 TI - Purification and characterization of two forms of cytochrome P-450 from rat kidney cortex microsomes. AB - Two forms of cytochrome P-450 (P-450), designated P-450 k-1 and P-450 k-2, have been purified about 100-fold from rat kidney cortex microsomes. P-450 k-1 and P 450 k-2 have monomeric molecular weights of 51,500 and 52,000, respectively, on sodium dodecyl sulfate(SDS)-polyacrylamide gel electrophoresis. Absolute spectra of the oxidized forms indicate that P-450 k-1 is largely in the low-spin state and partly in the high-spin state, and that P-450 k-2 is essentially all in the former. The absorption maxima in reduced carbon monoxide difference spectra are at 450.5 and 451 nm with P-450 k-1 and P-450 k-2, respectively. The two P-450s catalyze the omega- and (omega-1)-hydroxylation of fatty acids such as caprate, laurate, myristate, and palmitate, although P-450 k-1 exhibits a higher specific activity with all fatty acids tested. In addition, P-450 k-1 is capable of hydroxylating prostaglandin (PG) A1 and A2 at the omega-position, whereas P-450 k 2 has no activity toward PGs. These activities are all stimulated by addition of cytochrome b5. The two P-450s give different peptide map patterns when partially digested with Staphylococcus aureus V8 protease or papain. PMID- 3814157 TI - Identification of calmodulin-binding proteins in pure mitochondria by photoaffinity labeling. AB - Calmodulin-binding proteins (CaM-BPs) were identified in the submitochondrial fractions obtained from highly purified rat liver mitochondria. The matrix fraction contained five CaM-BPs with apparent molecular weights (MW) of 27K, 38K, 47K, 76K, and 84K Da in a Ca solution. Electron transfer particles also contained five CaM-BPs, but their MWs were 31K, 35K, 53K, 66K, and 73K in a Ca solution. Nonspecific calcium-independent CaM-BPs were also identified in matrix fractions, having MWs of 10K, 25K, and 49K Da. PMID- 3814158 TI - An ecto-cyclic AMP-independent protein kinase in goat spermatozoa and its change of activity during forward motility. AB - Goat cauda-epididymal intact spermatozoa have been shown to possess an ecto cyclic AMP-independent protein kinase activity on the external surface that causes phosphorylation of the serine and threonine residues of exogenous phosvitin. The enzyme is neither a tyrosine kinase nor a catalytic subunit of the cyclic AMP-dependent protein kinase. It is not activated by Ca2+, calmodulin and phosphatidylserine. The intact-cell enzyme is capable of phosphorylating a variety of proteins including sperm plasma membrane-bound phosphoprotein(s). The enzymic activity of the intact spermatozoa was not due to contamination of broken or "leaky" cells. The kinase activity of the whole cells was strongly inhibited by the non-penetrating surface probes: p-chloromercuriphenylsulphonic acid (10 microM) and proteases (125 micrograms/ml). The specific activity of the ecto kinase increased nearly 100% during vigorous forward progression of spermatozoa. PMID- 3814159 TI - On the NADPH dependent reaction of cytoplasmic sn-glycerol-3-phosphate dehydrogenase. AB - Cytoplasmic sn-glycerol-3-phosphate dehydrogenase (EC. 1.1.1.8.) can reduce dihydroxy acetone phosphate with NADPH as coenzyme under in vitro conditions, in solutions of low ionic strengths, at pH values lower than 7. The reaction is inhibited by phosphoenolpyruvate, NAD, ATP, ADP and Pi. In the cell this reaction can occur apparently only in case of specific metabolic conditions, i.e. when the local pH is low and the enzyme is protected from the inhibition by the above listed metabolites. PMID- 3814160 TI - Prostaglandin synthesizing enzyme activities of hepatocytes and non-hepatocytes in rat liver as a function of age. AB - The developmental profile of prostaglandin (PG)-synthesizing enzymes in liver was investigated in rats from the fetus to 2 years old. In the neonatal period, the activities of PGD2-(2.7 nmol/min/mg protein) and PGE2-(2.2 nmol/min/mg protein) synthesizing enzymes were predominant, whereas PGE2-synthesizing enzyme alone further increased in activity during adult to old ages (5.2-6.1 nmol/min/mg protein). In order to determine the sites of PGs production in rat liver, we prepared hepatocytes and non-hepatocytes by a collagenase digestion method. Regardless of the ages we examined, the major PG produced in the hepatocytes was proved to be PGE2, on the other hand, PGD2 was almost exclusively produced in the non-hepatocytes. These results suggest that each PG may have individual roles in the development of rat liver. PMID- 3814161 TI - Ischaemia and tissue pyruvate dehydrogenase activities in the rat: a comparison of the effects of cervical dislocation and pentobarbital anaesthesia. AB - The work defined the relationship between [long-chain acylcarnitine] and PDHa activities in hearts, kidneys and livers of rats sampled after cervical dislocation or pentobarbital anaesthesia. Although tissue [long-chain acylcarnitine] correlated with fatty acid availability or its mitochondrial oxidation in anaesthetized rats, this was not the case for hearts or kidneys of rats sampled after cervical dislocation. Cardiac [long-chain acylcarnitine] and PDHa activities were higher in rats killed by cervical dislocation. Metabolite changes within the hearts were consistent with tissue hypoxia and the effects of cervical dislocation were mimicked in hearts of pentobarbital-anaesthetized rats by 20s ischaemia. Renal and hepatic PDHa activities were unaffected by this short period of ischaemia. The susceptibility of cardiac PDHa to hypoxia or ischaemia may explain the variability in activities often observed within or between laboratories. PMID- 3814162 TI - Stimulation of glycogen phosphorylase kinase by phospholipids. AB - The acidic phospholipids phosphatidylinositol (PI), phosphatidylserine (PS), phosphatidylinositol 4-phosphate (PIP), phosphatidylinositol 4,5-biphosphate (PIP2) and the neutral phospholipid lysophosphatidylcholine (LPC) were found to stimulate (3 to 8-fold) the activity of nonactivated rabbit skeletal muscle phosphorylase kinase at pH 6.8, without significantly affecting the activity at pH 8.2. In this respect, phosphatidylcholine and phosphatidylethanolamine were ineffective, while the anionic detergent sodium dodecyl sulfate (SDS) and the anionic steroid dehydroisoandrosterone sulfate (DIAS) were able to mimic the action of phospholipids. SDS was also found to be a very efficient activator of the autophosphorylation of phosphorylase kinase (20-fold activation at 200 microM). The activating effect of phospholipids largely depends on the size of lipid vesicles, which is connected with the procedure of their preparation. These results suggest that phosphorylase kinase belongs to the class of Ca2+-dependent enzymes, which are sensitive to stimulation by calmodulin, limited proteolysis and anionic amphiphiles. PMID- 3814163 TI - Mode of L-tryptophan uptake into rat hepatocytes via trypsin-sensitive high affinity transport system. AB - The effect of trypsin treatment on the mode of L-tryptophan uptake (L- and T transport systems) into hepatocytes was investigated in comparison with that of L leucine (L-type system) using isolated rat hepatocytes. L-Tryptophan uptake occurred via at least two saturable (one high-affinity and one low-affinity) and one non-saturable components in intact hepatocytes, while L-leucine was taken up via one saturable and one non-saturable component. Hepatocytes whose surface had been digested with trypsin lost only the high-affinity component of the two saturable L-tryptophan transport systems, while they retained the saturable component for L-leucine transport (Km = 3.3 mM). Km values for the trypsin sensitive (high-affinity) and -insensitive (low-affinity) components of L tryptophan uptake were 14 microM and 2.1 mM, respectively. However, inhibition studies with some substrates of the L-, T- and both transport systems as inhibitor demonstrated that L-tryptophan uptake via these two components could not be classified in terms of the T- and L-systems. The present results indicate the presence of a carrier with a very high affinity for L-tryptophan in rat hepatocytes. PMID- 3814164 TI - Structure and function of the receptor for polymeric immunoglobulins. PMID- 3814165 TI - Immunoglobulin G as a glycoprotein. PMID- 3814166 TI - Studies on the interaction with thymidylate synthase of analogues of 2' deoxyuridine-5'-phosphate and 5-fluoro-2'-deoxyuridine-5'-phosphate with modified phosphate groups. AB - The role of the phosphate moiety of dUMP, and some analogues, in their interaction with mammalian thymidylate synthase, has been investigated. Substrate and inhibitor activities, and the pH-dependence of these activities, of dUMP and 5-FdUMP, as well as analogues with modified phosphate groups, were compared. The methyl ester of dUMP was neither a substrate nor an inhibitor. By contrast, the methyl ester of 5-FdUMP was a slow-binding inhibitor of the enzyme from L1210, Ehrlich ascites carcinoma and CCRF-CEM cells, with Ki values in the micromolar range. Both 5-FdUrd and the newly synthesized 5'-methylphosphonate of 5-FdUrd were also slow-binding inhibitors of the Ehrlich carcinoma enzyme, but with Ki values in the millimolar range. The interaction of dUMP, 5-FdUMP, and the methyl ester of the latter decreased with increase in pH, whereas that of the 5'-methyl phosphonate of 5-FdUrd remained unchanged. The results are discussed in relation to the role of the phosphate hydroxyls of dUMP in binding to the enzyme. 5-FdUMP and its analogues exhibited differing interactions with two binding sites on the enzyme molecule, consistent with cooperativity of binding. A convenient procedure is described for the synthesis of 5-fluoro-2'-deoxyuridine-5'-methylphosphonate, applicable also to the preparation of other 5'-methylphosphonate analogues. PMID- 3814167 TI - Glutathione levels in cultured heart cells. Influence of buthionine sulfoximine, an inhibitor of glutathione synthesis. AB - In primary cultures of heart cells in mid-growth phase, levels of acid-soluble glutathione were 99 nmoles/mg protein and increased to 178 nmoles/mg protein at confluent growth. Glutathione disulfide accounted for less than 9% of the total. Levels of protein-bound mixed disulfide in mid-growth phase cells were 58 nmoles/mg protein and decreased to 36 nmoles/mg protein at confluent growth. Buthionine sulfoximine (BSO, 10(-4) M) depleted the levels of both glutathione and glutathione disulfide with no influence on the levels of protein-bound mixed disulfide. BSO had no influence on the multiplication rate of heart cells in primary culture. In secondary passage cultures, the levels of glutathione were less than half those of the primary cultures. BSO depressed cell growth and soluble glutathione, whereas the levels of protein-bound mixed disulfide were increased. These results showed that BSO depletes heart cells of soluble glutathione, whereas protein-bound thiol remains unchanged or increases. PMID- 3814168 TI - The effect of malaria infection on primaquine elimination in the isolated perfused rat liver. AB - Most antimalarial drugs are eliminated by hepatic metabolism. However, the influence of malaria infection on the hepatic elimination of these drugs has not been examined. In the present study the elimination of the antimalarial primaquine has been examined in isolated perfused rat livers (IPRL) of malaria infected Sprague-Dawley rats (90-110 g) (MI group; N = 6) and age- and weight matched healthy rats (control group; N = 7). IPRL preparations for the MI group were established 12-15 days after rats were infected with merozoites of Plasmodium berghei (150 X 10(6) parasites/ml; 0.2 ml i.p.). At the time of study there was marked variation in the degree of parasitaemia achieved in the rats used in the MI group, from 2 to 27% of erythrocytes being infected. Livers were isolated using standard techniques and perfused at 10 ml/min in a 100 ml recycling system for 4 hr. In the control group, the perfusate disappearance of primaquine was biphasic with a mean t1/2 beta of 0.77 +/- 0.10 hr. This was prolonged in the MI group (mean t1/2 beta = 1.06 +/- 0.09 hr; P less than 0.05). There was no significant difference in the volumes of distribution of primaquine between the MI group (mean = 320 +/- 73 ml) and the control group (mean = 284 +/- 79 ml). Although there was a trend to lowered primaquine clearance in the MI group (mean 217 +/- 26 ml/hr), it was not significantly different from that seen in the control group (mean = 277 +/- 42 ml/hr; 0.10 less than P greater than 0.05). However, there was an inverse linear correlation between primaquine clearance and the percentage parasitaemia (r = 0.722, P less than 0.05). These results suggest that the extent to which primaquine elimination had been compromised was related to the severity of malaria infection, and that in severe infections reduced efficiency of elimination raises the possibility of drug toxicity. PMID- 3814169 TI - The anticoagulant, hepatic lipase-releasing and lipoprotein lipase-releasing activities of several natural and chemically modified heparins differ. AB - Several 'natural' heparins have been found to have different potencies for releasing hepatic lipase and lipoprotein lipase. These differences can also be obtained by treating heparins with physical and chemical methods, which also affect the anticoagulant activity. These differences in potency in hepatic lipase releasing activity are discussed in terms of the role of this lipase in lipoprotein and cholesterol metabolism. PMID- 3814170 TI - Effects of lead acetate on DNA and RNA synthesis by intact HeLa cells, isolated nuclei and purified polymerases. AB - The effects of lead acetate on DNA and RNA synthesis have been investigated with intact HeLa cells, isolated nuclei, and purified DNA and RNA polymerases. No inhibition of DNA or RNA synthesis in intact cells was found even after exposure to 0.5 mM lead acetate for 18 hr. In contrast, both DNA and RNA synthesis in isolated nuclei were inhibited by lead (with 50% inhibition at approximately 150 and 80 microM respectively). Similarly, both HeLa DNA polymerase alpha and RNA polymerase II were inhibited, with 50% inhibition obtained at approximately 150 and 20 microM lead acetate respectively. The inhibition of nucleic acid synthesis in isolated nuclei can thus be accounted for by inhibition of the polymerases. The sensitivity of Escherichia coli DNA polymerase I to lead acetate was found to be significantly greater than the HeLa DNA polymerase alpha (50% inhibition at only 10 microM), but the sensitivity of the E. coli RNA polymerase was the same as that of the HeLa enzyme. PMID- 3814171 TI - Hepatic indices of thyroid status in rats treated with 2,3,7,8-tetrachlorodibenzo p-dioxin. AB - The functional thyroid status of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) treated rats is unknown. Therefore, activities of certain thyroid-responsive enzymes were examined in the livers of adult male Sprague-Dawley rats 1 week after treatment with TCDD (6.25, 25 or 100 micrograms/kg). Activity of the thyroid-responsive flavin L-glycerol-3-phosphate dehydrogenase (per mg mitochondrial protein) was decreased slightly in livers of TCDD-treated rats, while that of succinate dehydrogenase remained unchanged. In contrast, activities (per mg supernatant protein) of three thyroid-responsive NADP-dependent cytosolic enzymes, malic enzyme, glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase, were increased by TCDD treatment in a dose-dependent manner. Lactate dehydrogenase (activity per mg supernatant protein) was also augmented slightly 1 week after TCDD administration. Liver mass was increased by TCDD treatment in a dose-dependent manner, but DNA content per liver was similar at all doses examined. Total hepatic protein, expressed per liver or mg hepatic DNA, was increased in TCDD-treated rats when compared to their pair-fed counterparts. The decreased activity of the mitochondrial L-glycerol-3-phosphate dehydrogenase, in contrast to the increased activities of the supernatant enzymes, malic enzyme, glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase, is not consistent with a shift in functional thyroid status following TCDD treatment. PMID- 3814172 TI - Delivery of 5-aminosalicylate to the guinea pig cecum. PMID- 3814173 TI - Quantitation of translatable (Cu2+,Zn2+)superoxide dismutase messenger-RNA in lungs of endotoxin-treated O2-exposed rats. PMID- 3814174 TI - Metabolic activation of the tricyclic antidepressant amineptine--I. Cytochrome P 450-mediated in vitro covalent binding. AB - Incubation of [14C]amineptine (1 mM) with hamster liver microsomes resulted in the irreversible binding of an amineptine metabolite to microsomal proteins. Covalent binding measured in the presence of various concentrations of amineptine (0.0625-1 mM) followed Michaelis-Menten kinetics. Pretreatment with phenobarbital increased not only the Vmax, but also the Km, for this binding. Covalent binding required NADPH and molecular oxygen and was decreased when the incubation was made in the presence of inhibitors of cytochrome P-450 such as piperonyl butoxide (4 mM), SKF 525-A (4 mM) or carbon monoxide (80:20 CO-O2 atmosphere). In contrast, binding was increased when microsomes from untreated hamsters were incubated in the presence of 0.5 mM 1,1,1-trichloropropene 2,3-oxide, an inhibitor of epoxide hydrolase. Metabolic activation also occurred in kidney microsomes. In vitro covalent binding to kidney microsomal proteins required NADPH and was decreased by piperonyl butoxide (4 mM) but was not increased by pretreatment with phenobarbital. We conclude that amineptine is activated by hamster liver and kidney microsomes into a chemically reactive metabolite that covalently binds to microsomal proteins. PMID- 3814175 TI - Metabolic activation of the tricyclic antidepressant amineptine--II. Protective role of glutathione against in vitro and in vivo covalent binding. AB - Incubation of [11-14C]amineptine (1 mM) with an NADPH-generating system and hamster liver microsomes resulted in the in vitro covalent binding of an amineptine metabolite to microsomal proteins; this binding was decreased by 41 71% in the presence of cysteine, lysine, glycine or glutathione (0.5 mM). An inverse relationship was found between the concentration of glutathione in the incubation mixture (0.25-4 mM) and the extent of covalent binding in vitro, which became undetectable at concentrations of glutathione of 2 mM and higher. Administration of [11-14C]amineptine (300 mg/kg-1 i.p.) to hamsters pretreated with phorone (500 mg/kg i.p.) resulted in the in vivo covalent binding of an amineptine metabolite to hepatic proteins. This binding was increased by phenobarbital-pretreatment and decreased by piperonyl butoxide-pretreatment. After various doses of phorone (150-500 mg/kg), an inverse relationship was found between hepatic glutathione content and in vivo covalent binding. Administration of amineptine alone (300 mg/kg i.p.) depleted hepatic glutathione by 16% only; in these animals, in vivo covalent binding was undetectable from background. Amineptine (300 mg/kg i.p.) did not produce hepatic necrosis, even in hamsters pretreated with phorone and/or phenobarbital. We conclude that physiologic concentrations of glutathione essentially prevent the in vivo covalent binding of an amineptine metabolite to hepatic proteins, and that this binding does not produce liver cell necrosis in hamsters. PMID- 3814176 TI - Oxidative metabolism of carbon disulfide by isolated rat hepatocytes and microsomes. AB - The oxidative metabolism of carbon disulfide (CS2) was investigated in isolated rat hepatocytes and liver microsomes. In microsomes, CS2 metabolism was increased by phenobarbital pretreatment of the rats and decreased with pretreatment of the rats with cobaltous chloride. In both microsomes and hepatocytes, CS2 metabolism was inhibited by SKF-525A. Carbon dioxide (CO2) was the major volatile metabolite of CS2 in hepatocytes, and carbonyl sulfide (COS) was the major volatile metabolite in microsomal incubations. Addition of cytosol to microsomal incubations shifted the predominant volatile metabolite from COS to CO2 but did not change total volatile metabolite formation. Acetazolamide, a carbonic anhydrase inhibitor, significantly decreased COS metabolism but not CS2 metabolism in isolated hepatocytes or microsomes fortified with dialyzed cytosol. When [18O]H2O was included in incubations of microsomes and CS2, a substantial portion of the resulting COS was [18O] enriched, indicating that the oxygen atom was derived from water. These data are consistent with the hypothesis that CS2 is oxidized predominantly by the cytochrome P-450 containing monooxygenase system, and the product of this reaction is an unstable intermediate which reacts with water to form monothiocarbonate and reactive sulfur species. Monothiocarbonate is the hydrated form of COS. In intact hepatocytes, it is metabolized predominantly to CO2 and hydrogen sulfide. Unmetabolized monothiocarbonate can be dehydrated to COS. The majority of the reactive sulfur species and hydrogen sulfide are oxidized to nonvolatile sulfur compounds, including sulfate, but by different mechanisms. PMID- 3814177 TI - Hepatotoxicity of N-methylformamide in mice--I. Relationship to glutathione status. AB - In order to investigate the link between hepatotoxicity caused by N methylformamide (NMF) and its ability to deplete hepatic glutathione experiments were conducted in three strains of mouse which differ in their susceptibility towards NMF-induced liver damage. NMF toxicity was measured by changes in plasma levels of sorbitol dehydrogenase and alanine and aspartate transaminases. In BALB/c mice, the most susceptible strain, a hepatotoxic dose of NMF (200 mg/kg) caused a depletion of hepatic glutathione to 21% of control levels 2 hr after drug administration. In CBA/CA and BDF1 mice the same dose of NMF depleted glutathione to 53% of control levels and did not cause hepatotoxicity. In BALB/c mice depletion of hepatic glutathione by pretreatment with buthionine sulfoximine decreased the hepatotoxic dose threshold of NMF from 150 mg/kg to 100 mg/kg. Conversely, pretreatment of mice with cysteine or N-acetylcysteine protected against both glutathione depletion and NMF-induced hepatotoxicity. The results are in accordance with the suggestion that the hepatotoxicity of NMF is associated with its metabolism to an intermediate which reacts with glutathione. PMID- 3814178 TI - Hepatotoxicity of N-methylformamide in mice--II. Covalent binding of metabolites of [14C]-labelled N-methylformamide to hepatic proteins. AB - Incubation of the hepatotoxin N-methylformamide (NMF) labelled either in the methyl group (OHCNH14CH3) or the formyl group (OH14CNHCH3) with mouse hepatic microsomes in the presence of NADPH, but not in its absence, led to covalent binding of metabolites to microsomal proteins. When [14C]NMF was injected into BALB/c mice radioactivity was found to be associated with liver and, to a much lesser extent, with kidney proteins. Association of radioactivity derived from OHCNH14CH3 with hepatic proteins was higher in BALB/c mice than in CBA/CA mice and in these it was higher than in BDF1 mice. Association of label derived from either isotopomer was significantly reduced but not abolished by pretreatment of mice with cycloheximide suggesting both covalent binding and metabolic incorporation of NMF metabolites. Depletion of hepatic glutathione by pretreatment of mice with buthionine sulfoximine or diethyl maleate prior to administration of OH14CNHCH3 enhanced the association of label with hepatic proteins measured 1 hr after drug injection. Covalent binding of [14C]NMF to hepatic microsomes in vitro was abolished in the presence of glutathione. It is argued that the generation of the toxic lesion and the association of NMF metabolites with hepatic proteins may be causally related even though certain mechanistic and enzymatic details of this link remain obscure. PMID- 3814179 TI - Total cytochrome P-450, but not the major phenobarbitone or 3-methylcholanthrene induced isoenzyme, is differentially induced in the lobes of the rat liver. PMID- 3814180 TI - The effect of electron-affinic radiosensitizers on ATP levels in V79 379A Chinese hamster cells. PMID- 3814181 TI - o,p'-DDT (1,1,1-trichloro-2(p-chlorophenyl) 2-(o-chlorophenyl) ethane is a purely estrogenic agonist in the rat uterus in vivo and in vitro. PMID- 3814182 TI - The inhibitory effect of p-trifluoromethyl substitution on the hepatic microsomal metabolism of benzyl phenyl sulphide. PMID- 3814183 TI - [The structure of Buthus eupeus neurotoxin M9 in a solution studied by 1H-NMR spectroscopy]. AB - Neurotoxin M9 isolated from the venom of Central Asian scorpion Buthus eupeus (66 amino acid residues, 4 disulfide bridges) has two slowly exchangeable conformations at the acidic pH. 2D-1H-NMR spectroscopy has been used to determine the polypeptide backbone foiding in the conformer that dominates under physiological conditions. The conformer contains the right alpha-helix (residues 22-31) and the antiparallel beta-sheet, which consists of the three strands (residues 1-5, 46-52, 35-40). All five Xxx-Pro bonds are in the trans configuration. Comparison of the obtained data with the crystal structure of the homologous scorpion toxin v-3 Centruroides sculpturatus (65 residues) and the solution spatial structure of the "short" type insectotoxin I5A Buthus eupeus (35 residues) shows close similarity in the first case and similarity of the types and mutual disposition of the regular secondary structure elements in the second case. PMID- 3814184 TI - [Interpretation of 1H-NMR spectra of the cyclic analog of kallidin in solutions]. AB - 1H-NMR resonances of [cyclo (10-1 epsilon)]kallidin (cyclo-KL) in (CD3)2SO and H2O have been assigned by combined analysis of two-dimensional phase-sensitive COSY and NOESY spectra. The presence of three slowly interchangeable conformers cyclo-KL I, cyclo-KL II, and cyclo-KL III, has been established, their population in (CD3)2SO being 25, 35 and 40%, respectively. Cyclo-KL I conformer possesses trans-configuration of all peptide bonds, but in the cyclo-KL II and cyclo-KL III conformers the Pro3-Pro4 and Arg2-Pro3 peptide bonds, respectively, have cis configuration. In----solution, the following exchange occurs between the conformers: cyclo-KL II----cyclo-KL I----cyclo-KL III. The assignment of 1H-NMR signals of all the three cyclo-KL conformers has been carried out in H2O by gradual titration with (CO3)2SO. The conformer populations in H2O are 45, 25 and 30%, respectively. PMID- 3814185 TI - [Glycosphingolipids of human aorta]. AB - The structures of the main gangliosides of human aorta (intima and media) were elucidated. The main component (67%) was identified as N-acetylneuraminosyl lactosylceramide (ganglioside GM3). The aorta tissue contained also gangliosides GM1, GD3, GD1a, and GT1. All sialic acid residues in gangliosides were present as N-acetyl-neuraminosyl derivatives. Among neutral glycosphingolipids of human aorta, the main components were identified as glucosylceramide, lactosylceramide, globotriaosylceramide and globotetraosylceramide. The preliminary data suggest that the composition of the investigated glycosphingolipids in tissue might vary upon atherosclerosis lesions of aorta. PMID- 3814187 TI - [Acceptor specificity of mannosyl transferases from Salmonella of serotypes C2 and C3]. AB - Synthetic mono- and disaccharide derivatives of moraprenyl pyrophosphate were studied as mannose acceptors during the assembly of the repeating unit Rha-Man Man-Gal of the Salmonella newport (serogroup C2) and S. kentucky (serogroup C3) O antigens. Mannosyl transferases revealed strict specificity towards the configuration of terminal monosaccharide residue at C1 as well as to the type of linkage between monosaccharide residues in the disaccharide acceptor. The specificity of mannosyl transferases towards the structure of subterminal monosaccharide was not absolute. Alpha-D-Glucose and alpha-D-mannose derivatives were found not to serve as mannosyl residue acceptors, whereas those of alpha-D talose, alpha-D-fucose, 4-deoxy-D-xylo-hexose and Man (alpha 1-3) glucose were substrates in enzymatic mannosylation with formation of polyprenyl pyrophosphate trisaccharides. These derivatives could serve as substrates for two subsequent enzymatic reactions: rhamnosylation and polymerization of the repeating units, yielding 40-60% of the polysaccharides. PMID- 3814186 TI - [Conformation of the dienone system of delta 4,9-19-nor-3-ketosteroids from x-ray analysis data and its relation to reception and hormonal activity]. AB - Basing on the data of the X-ray analysis of 2 beta-methylestr-4,9-dien-3-one-17 beta-ol (C19H26O2) and A-ring unsubstituted steroid 4,9-dien-3-ones, the noncomplanarity and flexibility of the conjugated dienone system in these transformed steroids has been demonstrated. The results have been also confirmed by UV spectroscopy. The ability of the dienone system to assume conformations with the out of- plane C3 = O3 and/or C9 = C10 bonds allows the AB-fragment of the steroid molecule to adopt the conformations required for interacting with various receptors. This property may also account for a simultaneous enhancement of several hormonal activities upon such a modification of steroids. The results of the X-ray analysis of 2 beta-methylestra-4,9-dien-3-one-17 beta-ol (space group P2(1)2(1)2(1), a 8,543(2), b 9,783(2), c 18,690(7) A, R 8,7%) are presented. PMID- 3814188 TI - [Mass-spectrometric determination of the structure of glycopeptides from the bacterial cell wall (illustrated by Lactobacillus bulgaricus)]. AB - Mass spectrometry has been applied to the structural analysis of one of the glycopeptides from blastolysin, antitumor bacterial preparation isolated from the Lactobacillus bulgaricus cell wall. The glycopeptide (MW 10,000) was subjected to partial acid hydrolysis (6 N HCl, 100 degrees C) and the resulting products were dansylated or trifluoroacetylated and methylated or deuteromethylated. The mixture of these derivatives was examined by high-performance liquid chromatography or gas chromatography followed by mass spectrometry using electron impact and ammonia chemical ionization techniques. PMID- 3814189 TI - [Synthesis of polymerizable phospholipid derivatives and creation of polymer monolayers and liposomes with immobilized bacteriorhodopsin]. AB - Polymerizable phospholipid derivatives with N-acryloyl groups have been synthesised; monomeric and polymeric monolayers and liposomes based on these compounds have been prepared and investigated. Bacteriorhodopsin immobilized in the monomeric and polymeric liposomes was shown to retain its native activity. PMID- 3814190 TI - Transient response of bienzyme electrodes. AB - A mathematical model of the transient response of amperometric bienzyme electrodes with a consecutive, cyclic and parallel substrate conversion is developed. At high catalytic activity the kinetic behavior of consecutive and parallel conversion is close to the substance diffusion through the inert membrane, and the kinetics of cyclic conversion are 3.54 times slower. At low substrate conversion rates the electrodes' response is markedly retarded. Mathematical modeling results are compared with the experimental data on the kinetic behavior of amperometric enzyme electrodes in the membranes of which the consecutive and cyclic conversions of glucose and nicotinamide adenine dinucleotide, respectively, take place. PMID- 3814191 TI - Clinical uses of enzyme electrode probes. AB - Clinical applications of enzyme electrochemical sensors are reported; they are based on the coupling of enzymes with potentiometric membrane electrodes (pH, iodide), or potentiometric probes (ammonia, carbon dioxide) or amperometric devices (oxygen, hydrogen peroxide). The most popular and successful immobilization procedures for enzymes are reviewed, namely physical entrapments and chemical methods for binding enzymes to solid support like collagen and nylon net; procedures specifically developed for clinical uses of enzyme probes. The simplicity of the apparatus is evidenced, and it is explained how a single instrument can be useful for all kind of measurements. Practical suggestions for constructing a typical probe are given. Single paragraphs are devoted to the determination of urea, cholesterol, creatinine, amino acids, glucose, lactate, protein, choline and acetylcholine to clarify the sequence of enzymatic and electrochemical reactions in order to elucidate the application range, the sensitivity and the selectivity as well as the relevant interferences for each metabolite either in the enzymatic or in the electrochemical step. The applications performed in vitro, in vivo and ex vivo and the commercial availability of some instruments are reported. PMID- 3814192 TI - Cyclosporin A treatment of refractory rheumatoid arthritis. AB - Ten patients with rheumatoid arthritis were entered into a 24-week pilot study of oral cyclosporin A at a starting dosage of 6 mg/kg/day, followed by a 12-week washout period. Significant improvement in clinical parameters was observed at 12 weeks and 24 weeks (P less than 0.02 versus baseline for joint pain and joint swelling indexes and patient and physician assessments; P less than 0.04 versus baseline in the numbers of painful/tender joints and swollen joints). Adverse reactions were varied: renal impairment occurred in all patients and hypertension occurred in 7. All patients demonstrated an increase in defined disease activity at cessation of treatment and through the washout period. Cyclosporin A is clinically effective in the treatment of patients with refractory rheumatoid arthritis, but its value as an intervention therapy is limited by its toxicity. PMID- 3814193 TI - Pyogenic sacroiliitis caused by group G Streptococcus. PMID- 3814194 TI - Granuloma annulare. PMID- 3814195 TI - Possible contribution of cartilage to fibrous pannus. PMID- 3814196 TI - The assessment of pain in rheumatoid arthritis. Validity of a behavioral observation method. AB - It is difficult to objectively measure pain in rheumatoid arthritis (RA). A behavioral observation method for the assessment of RA pain has been developed. In this study, videotapes were made of 53 RA patients while they performed standardized maneuvers. Trained raters viewed the videotapes and recorded the frequencies of 7 pain behaviors. Clinical and laboratory measures of rheumatoid disease activity also were recorded for each patient. Rheumatology fellows viewed 20 randomly chosen video recordings of the patients and made global estimates of the intensity and unpleasantness of pain. Significant positive correlations were found between total pain behavior scores and measures of disease activity. The fellows' estimates of the intensity and unpleasantness of the patients' pain also were significantly and positively correlated with the total pain behavior scores. The behavioral observation method may be useful in the assessment of RA pain and may be included as an objective outcome measure in clinical trials with RA patients. PMID- 3814197 TI - A common anti-DNA idiotype in sera of patients with active pulmonary tuberculosis. AB - The sera of 57 patients with active, untreated pulmonary tuberculosis were examined for the presence of a common anti-DNA idiotype, 16/6. Thirty-four of the 57 sera (60%) had an increased level of the idiotype, as measured by enzyme linked immunosorbent assay using a specific rabbit anti-16/6 serum. Of 28 matched control sera, only 1 (4%) was found to be positive for the idiotype. The sera of patients with tuberculosis also showed increased activity against a variety of antigens with which lupus autoantibodies are known to crossreact (e.g., single stranded DNA, double-stranded DNA, polynucleotides, and cardiolipin). A correlation was observed between serum IgG and IgM levels and the 16/6 idiotype levels. PMID- 3814198 TI - Protein traffic in human synovial effusions. AB - Concentrations of 5 marker proteins were measured in synovial fluid and serum samples from knee effusions of 11 patients with rheumatoid arthritis and 9 with osteoarthritis. Indirect determinations of synovial plasma flow and lymphatic drainage were obtained by measuring iodide clearance (ml/minute) and radio albumin clearance (ml/minute). Together with protein concentrations, these determinations allowed us to calculate: the flux of each marker protein through synovial tissues (mg/minute); the volume of plasma cleared by synovium per unit time (ml/minute); and the fractional extraction per passage through the synovial microcirculation (protein permeance). These measures differed substantially between rheumatoid arthritis and osteoarthritis patient populations and quantified the severity of the microvascular lesion in rheumatoid synovitis. PMID- 3814199 TI - Immunohistochemical characterization of synovial cells in arthritic MRL-lpr/lpr mice. AB - MRL-lpr/lpr (MRL/l) mice spontaneously develop an autoimmune disease associated with arthritic manifestations. We used a recently developed mild demineralization procedure, followed by immunohistochemical staining of frozen sections, to investigate cell patterns in the hindlimbs of MRL/l mice at various stages of arthritic disease. Large numbers of Mac-1 (Mas 034)-positive, macrophage-like cells were seen both within the thickened synovial lining layer and in the deeper layers of the synovial tissue in all stages of arthritis. Ia-expressing cells were scarce in the lining layer, but occurred in moderate numbers in the deeper layers of synovial tissue. Lymphocytes were totally absent in MRL/l joints in all stages of arthritis, as demonstrated by lack of staining with Ly-1, Lyt-2, GK 1,5, and antiimmunoglobulin antibodies. Our findings are discussed and related to other types of experimental arthritis and to rheumatoid arthritis in humans. PMID- 3814200 TI - An open, controlled, randomized comparison of cyclosporine and azathioprine in the treatment of rheumatoid arthritis: a preliminary report. AB - Cyclosporine (10 mg/kg/day) and azathioprine (2.5-3 mg/kg/day) were compared for 26 weeks in an open, controlled, randomized study of 24 patients with rheumatoid arthritis. Each treatment group consisted of 12 patients. Those patients who took cyclosporine improved significantly in the 50-foot walk time, circumferences of proximal interphalangeal joints, Ritchie articular index, global assessment by investigator, and grip strength, when compared with baseline findings. In the azathioprine group, there was improvement only in grip strength. PMID- 3814201 TI - Evidence of the validity of the Arthritis Impact Measurement Scales. AB - The Arthritis Impact Measurement Scales (AIMS) were administered to 120 patients with rheumatoid arthritis. These patients also rated the importance of various aspects of their treatment. Our findings support the validity of the pain, anxiety, depression, dexterity, and physical activity subscales of the AIMS. The household activity subscale, however, may not be appropriate for use with men, and the activities of daily living subscale may be insensitive to mild impairment. PMID- 3814203 TI - Arthritis Health Professions Association. Scientific abstracts. 1986 regional meetings. PMID- 3814202 TI - Nuclear ribonucleoprotein immune complexes in pericardial fluid of a patient with mixed connective tissue disease. AB - We performed immunopathologic studies of the pericarditis present in a patient with mixed connective tissue disease. A large number of nuclear RNP (nRNP) immune complexes (ICs) were found in the pericardial fluid, but not in the serum. The pericardial small vessels had no deposits of IgG. These results suggest that locally formed nRNP ICs were closely associated with the pathogenesis of pericarditis in this patient. PMID- 3814204 TI - Gas chromatographic evaluation of the antimycotic democonazole for pharmacokinetic and bioavailability studies in man and animals. AB - A new gas chromatographic method for quantitative determination of 1-[2,4 dichloro-beta-[2-(p-chlorophenoxy)ethoxy] styryl]imidazole (demonoconazole), employing an electron capture detector, was developed. All analytical parameters were satisfactory within the range between 5 ng and 1 micrograms per ml of plasma, which means 20 pg-2 ng as absolute sensitivity. This method therefore is specific and sensitive enough for the quantitative determination of the drug in biological samples for pharmacokinetic and bioavailability studies to be performed in animals and human beings. PMID- 3814205 TI - A comparison of some of the pharmacological properties of the new eburnamenine derivative vindeburnol with those of vincamine, vinburnine, dihydroergotoxine mesilate and nicergoline. AB - The effects of a new eburnamenine derivative (3 beta,14 alpha, 16 alpha)-(+/-) 14,15-dihydro-20,21-dinoreburnamenin-14-ol (vindeburnol, RU 24722) on EEG, on brain energy metabolism and on local cerebral blood flow (LCBF) and in different experimental models of cerebral insufficiency were compared with those of vincamine, vinburnine (1-eburnamonine), dihydroergotoxine mesilate and nicergoline. Vindeburnol at 2 mg/kg i.v., increased the EEG resistance time in rats subjected to asphyxia anoxia and at 10 mg/kg s.c., significantly improved the electrocortical recovery of gerbils subjected to a 10-min cerebral ischemia. Vindeburnol (10 mg/kg i.p.) significantly retarded glucose, phosphocreatine and adenosine triphosphate utilization and lactate production in mouse brain during 10 s of decapitation ischemia. The cerebral metabolic rate was 10.34 mmol/kg/min, which was about 50% of the control value. At 10 mg/kg i.p., the product induced a slight and transient increase in LCBF. Vincamine improved the early phase of the postischemic electrocortical recovery in the gerbil, had no effect on cerebral energy substrates and slightly increased the LCBF for 15 min. Dihydroergotoxine mesilate improved the early phase of the electrocortical recovery in gerbils subjected to ischemia, did not significantly modify the energy substrates and rapidly increased the LCBF, which was normal after 30 min. Vinburnine and nicergoline were inactive in the cerebral insufficiency models used and did not significantly modify cerebral energy metabolism. These results show that vindeburnol has a different pharmacological profile from vincamine, vinburnine, dihydroergotoxine mesilate and nicergoline, and suggest that vindeburnol may be therapeutically effective in cerebral insufficiency. PMID- 3814206 TI - Electroencephalographic characteristics of lithium hydroxybutyrate. AB - Lithium hydroxybutyrate influence on excitability, functional mobility and frequency range power of the cortex electrograms, midbrain reticular formation, posterior hypothalamus caudate nucleus, dorsal hippocampus, basolateral amygdala and medial thalamus in rabbits has been investigated. It has been shown that the drug suppresses the non-specific activating systems of the midbrain and posterior hypothalamus, intensifies work of the caudatocortical inhibitory mechanisms and the forebrain limbic formations (the hippocampus and amygdala). PMID- 3814207 TI - Effect of some new cardiotonic agents on synaptosomal sodium uptake. AB - The new positive inotropic agents sulmazole, piroximone, milrinone and 1,5 dihydro-6-chloro-3-methy-limidazo [2,1-b]quinazolone-2 enhance 22Na uptake in rat brain synaptosomes. In comparison, theophylline, a cyclic nucleotide phosphodiesterase inhibitor, has no effect on synaptosomal 22Na uptake. Tetrodotoxin inhibits the stimulation induced by the new inotropic agents. The quinazolone is about three times more potent than protoveratrine B and milrinone and ten times more potent than sulmazole and piroximone. There is a direct correlation between the 22Na uptake and the positive inotropic effect on guinea pig left atria of the new cardioactive drugs. The dose-response curves for synaptosomal 22Na uptake and for the inotropic effect on guinea pig left atria are parallel for sulmazole and the quinazolone drug, with first an increase and then a decrease in activity. PMID- 3814208 TI - Comparative study on acute antihypertensive effects and pharmacokinetics of nisoldipine, nifedipine, nimodipine and nicardipine administered orally to conscious renal hypertensive dogs. AB - The acute antihypertensive effects and pharmacokinetics of orally administered nisoldipine (Bay k 5552) were compared with those of nifedipine, nimodipine and nicardipine in conscious renal hypertensive dogs. The antihypertensive effects of hydralazine were also investigated. Nisoldipine as well as nifedipine, nimodipine and nicardipine dose-dependently lowered mean blood pressure, which was significant 0.5 h and reached its peak effect 1 to 2 h after dosing. Significant antihypertensive effects of hydralazine started 1 h and peaked 3 h after dosing. Of the drugs used, nisoldipine showed the most potent and the longest antihypertensive effects. The fall in mean blood pressure by the drugs was accompanied by a significant increase in heart rate. The tachycardia by nisoldipine and nimodipine, but not by nifedipine and nicardipine, was not dose dependent. The tachycardia by nisoldipine was not significantly different from those by the other four drugs. The plasma nisoldipine concentration was significantly correlated with the fall in mean blood pressure. This was also the case for nifedipine, nimodipine or nicardipine. However, the slope of the regression line for nisoldipine obtained by plotting the antihypertensive effects against plasma concentrations was greater than those for the other 1,4 dihydropyridines examined. Nisoldipine had the lowest maximum plasma concentration and the longest elimination half-life among the four 1,4 dihydropyridines, resulting in no significant difference in the area under the plasma concentration-time curve. These results suggest that of the drugs examined, nisoldipine is the most potent, has the longest duration of action making it useful for long-term treatment of hypertension. PMID- 3814209 TI - Gastric cytoprotection of aceglutamide aluminium in rats. AB - Aceglutamide aluminium (AGA, KW-110, Glumal) at doses of 30-100 mg/kg p.o. prevented the formation of the gastric lesions induced by three noxious compounds, ethanol, HCl and acidified taurocholate, all dose-dependently. The preventive effect of AGA against taurocholate-induced lesions was more marked than that against the other two noxious agents. AGA at the cytoprotective doses caused almost no decrease of the gastric acid secretion in both pylorus-ligated and non-ligated rats. AGA stimulated gastric mucus secretion and prevented the increment of back-diffusion of hydrogen ion into the mucosa significantly. These data indicate that AGA caused a cytoprotective effect not through the suppression of acid secretion but through the augmentation of the defense of the mucosa against autodigestion by gastric juice. In addition, pretreatment with indomethacin diminished the cytoprotective effect of AGA almost completely. This result suggests that the mechanisms of AGA's cytoprotection may be concerned with endogenous prostaglandins. PMID- 3814210 TI - [Separation and pharmaco-toxicological studies of the enantiomers of Ifosfamide]. AB - The enantiomers of ifosfamide were isolated chromatographically by the use of an optically active adsorbent. The biological activities of the racemic product and of the enantiomers (+)- and (-)-ifosfamide were compared as to the acute toxicity after single intraperitoneal administration on mice. Futhermore, the antitumor activity has been compared with regard to the rat leukemia L 5222 and the haematotoxicological effect. Under the conditions given, no biological differences between these 3 ifosfamide preparations were observed. PMID- 3814211 TI - Pharmacokinetics of ciprofloxacin. 1st communication: absorption, concentrations in plasma, metabolism and excretion after a single administration of [14C]ciprofloxacin in albino rats and rhesus monkeys. AB - The absorption, disposition, metabolism and excretion of 1-cyclopropyl-6-fluoro 1,4-dihydro-4-oxo-7-(1-[U-14C]piperazinyl)-3- quinoline carboxylic acid (ciprofloxacin, Bay o 9867; designated tradename: Ciprobay) were studied following a single intraduodenal (rat), oral and intravenous (rat, monkey) administration, respectively, in the dose range 5 to 30 mg/kg body weight. Ciprofloxacin was absorbed partially (30 to 40%) in both species. Peak plasma concentrations of radioactivity were measured approximately 1 h (rat) or 2 h (monkey) after oral dosing. Terminal half-lives ranging from 26 to 44 h were determined for the elimination of radioactivity from the plasma (observation time up to 48 h after dosing). Nearly identical concentrations of the unchanged drug and total radioactivity were found during the first 7 or 8 h for the monkey after intravenous injection and for the rat also after oral administration, respectively. After reaching maximum concentration of 0.25 microgram/ml after administration of 5 mg/kg to rats and 0.88 microgram/ml after dosing with 30 mg/kg to a rhesus monkey, the unchanged drug was eliminated from plasma corresponding to half-lives ranging from 3 h (rat) and 4.4 h (monkey). The radioactivity was rapidly and completely excreted in both species. After intravenous administration about 51% (rat) and 61% (monkey), respectively, was excreted via the kidney. After oral dosing renal excretion amounted to 6-14% (rat) and 30% (monkey), respectively. Maximum residues in the body (exclusive gastrointestinal tract) of 1% of dose occurred in both species. In urine and feces of rats predominantly the unchanged drug and a conjugate were detected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814212 TI - Antibacterial activity and ototoxicity in guinea pigs, and nephrotoxicity in rats of arbekacin. AB - Arbekacin (HBK), 1-N[(S)-4-amino-2-hydroxybutyl]-3',4'-dideoxykanamycin B, showed broad antibacterial spectra against gram-positive and gram-negative bacteria including Pseudomonas aeruginosa. It was also effective against gentamycin- or tobramycin-resistant bacteria. HBK was resistant to various aminoglycoside inactivating enzymes except for AAC (2') and AAC (6')-IV, both of which slowly inactivated it. Even at higher dosages (150 mg/kg i.m. or greater, which resulted in some deaths), HBK never decreased the pinna reflex in guinea pigs, while 150 mg/kg or more of dibekacin (DKB) or amikacin (AMK) caused loss of this reflex. HBK has less ototoxicity than do DKB and AMK. This was confirmed by histopathological examination of the inner ear. The degree of nephrotoxicity of HBK was suggested to be similar to that of DKB as judged from serum biochemical tests, urinalysis, and histopathological findings. PMID- 3814213 TI - Linearity of the pharmacokinetics of phosphomycin in serum and interstitial tissue fluid in rabbits. AB - A study was carried out on the access and residence of (-)(1R,2S)-1,2 epoxypropylphosphonic acid (phosphomycin) in interstitial tissue fluid produced experimentally by subcutaneous implantation of spiral steel cages after administration of doses of 20, 30 and 60 mg/kg of the antibiotic to rabbits. The levels reached by the drug in serum and interstitial tissue fluid (ITF) were determined by a microbiological plate diffusion method. The elimination half lives of phosphomycin ranged between 1.16 and 1.57 h. These values are similar to those found for the disappearance half-lives from ITF. Phosphomycin reached maximum concentrations in ITF between 31.95 and 80.37 micrograms/ml. Linear relationships were established between the (AUC) 0 infinity in serum, the (AUC) 0 infinity in ITF and Cmax in ITF and the doses studied, revealing the non-dose dependent kinetics of phosphomycin. The linearity of phosphomycin kinetics was checked in serum and ITF by applying the superposition principle. PMID- 3814214 TI - Effects of oral nisoldipine in ischemic heart disease. A radioisotopic study. AB - Nisoldipine (Bay k 5552) is the most potent calcium antagonist known; yet, its cardiovascular effects in man are still under investigation. In the present study 10 consecutive male patients with isolated significant lesion on the left anterior descending coronary artery underwent ECG gated nuclear ventriculography at rest and during submaximal bicycle exercise in the supine position. Following the oral administration of 10 mg of nisoldipine the study was repeated at 90 and 180 min, with the patient in the same position and with the same work load. Left ventricular ejection fraction (EF), end-systolic blood volume index (ESBVI), end diastolic blood volume index (EDBVI), stroke volume index (SVI), peak left ventricular ejection rate (PER), peak left ventricular filling rate (PFR), time to PER (TPER) and time to PFR (TPFR), and systemic vascular resistance (SVR) were evaluated, regional wall motion was also judged by three independent observers. At rest, a significant (p less than 0.001) decrease of SVR and systolic blood pressure (SBP) was found; a significant (p less than 0.001) decrease of diastolic blood pressure (DBP) and an increase (p less than 0.05) of heart rate (HR), EDBVI and PFR were also registered, the other indexes resulting unaffected. During exercise the reduction of SVR was confirmed. An improvement of the wall motion was found in 4 out of 11 segments at rest and in 9 out of 17 under stress. CONCLUSIONS: nisoldipine shows a predominant peripheral effect, without impairment of cardiac contractility; the improvement of the wall motion of the ischemic regions achieved at similar levels of double product suggests an increased coronary blood flow and a metabolic amelioration. PMID- 3814215 TI - [Age-dependent differences in the pharmacodynamic effect of topically applied Corticosteroids]. AB - The results of comparative studies with corticosteroid topicals on age-associated differences are presented. In each of the test series 10 to 14 subjects were included, either young adults aged 18-24 years or older adults aged 65-76 years. Tests on vasoconstriction were carried out with alcoholic solutions of amcinonide (the active principle of the dermatic Amciderm), betamethasone 17-valerate and triamcinolone acetonide. Comparative studies with ointments included clobetasol 17-propionate instead of triamcinolone acetonide. Additionally, the kerosene test was performed to evaluate the age-dependency of this non-allergic inflammatory response and also to compare the antiinflammatory activity of the corticosteroids due to the age differences. In the vasoconstriction tests higher potencies were determined in the younger than in the older test subjects. In the kerosene test significant differences could be shown between the age classes with a view to the reaction to the irritant as well as the suppressive activity of the corticosteroids. Since the individual variations in the older groups were greater than those in the younger groups, the differences between the steroids were less distinct in the former ones. In testing and in therapeutic administration of corticosteroid topicals age differences should be regarded in view of skin reaction. PMID- 3814216 TI - Isolation and structural elucidation of urinary metabolites of ciprofloxacin. AB - After oral administration of 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7 piperazine-1-ylquinoline++ +-3-carboxylic acid (ciprofloxacin, Bay o 9867; designated trademark: Ciprobay) four metabolites M1-M4 were isolated from human urine by Craig counter current distribution and semipreparative high-performance liquid chromatography. Their molecular structures were elucidated by nuclear magnetic resonance and mass spectrometry and confirmed by comparing their spectra with those of authentic synthetic reference compounds. PMID- 3814218 TI - [The usefulness of a model of acute hypoxia for the testing of cerebroprotective drugs]. AB - The aim of this study was to find out whether the mouse in acute normobaric hypoxia (3.5% O2) may be appropriate as a screening model for testing cerebroprotective drugs. The survival time of the mice in hypoxia was used to determine drug effects. 39 agents with various pharmacological and toxicological properties were investigated. Cerebroprotective, centrally depressant and stimulating as well as cardiovascular drugs were included. Only 6 out of 16 cerebroprotective drugs used therapeutically prolonged the survival time of mice in acute hypoxia. However, a positive effect was demonstrable especially for those cerebroprotective drugs (extractum Ginkgo bilobae, meclofenoxate, naftidrofuryl, pentoxifylline and pyritinol), which are generally accepted to be active. On the other hand, 12 out of 23 drugs which are therapeutically used as cardiovascular drugs, central stimulants or depressants or have known toxicological effects also prolonged the survival time of mice in hypoxia. Thus, it became clear that the result of this hypoxia test may be influenced by various pharmacological actions. Especially drugs stimulating the cardiovascular system or depressing CNS activity could prolong the survival time of mice in hypoxia, whereas drugs with vasodilating effects could even shorten it. Opposite effects could superpose or neutralize each other. Therefore, the mouse in acute hypoxia seems to be of limited value as a screening model for testing cerebroprotective drugs. PMID- 3814217 TI - [Detection of cutaneously administered flufenamic acid in the inner space of the knee joint]. AB - Ten patients who were scheduled for surgery due to an internal damage of the knee joint, were treated 2 days before operation 3 times daily with an ointment containing flufenamic acid (Mobilisin spezial). At the time of operation, plasma and synovial fluid, tissue samples from the synovial membrane, Hoffa's fat pad and-- as far as possible--meniscus and articular cartilage were taken. Until 72 h after the operation, urine samples were collected. The flufenamic acid level was determined by means of high pressure liquid chromatography associated with fluorometric detection. Flufenamic acid was detected in all tissues of the knee joint and in the synovial fluid. The highest concentration of flufenamic acid was found in the synovial membrane. PMID- 3814219 TI - Sulmazole effects on mechanical performance of hypoxic and reoxygenated isolated mammalian myocardium. AB - The present study intended to investigate the effects of 2-[2-methoxy-4 (methylsulfinyl)phenyl]-3H-imidazo[4,5-b]pyridine (sulmazole, AR-L 115 BS) on mechanical performance of rat myocardial fibers under hypoxia, and subsequent reoxygenation. Because of a possible caffeine-like mechanism of action of sulmazole similar experiments were performed with theophylline and the results compared. 1. Under normoxic conditions, sulmazole and theophylline displayed a positive inotropic action with acceleration of relaxation at small concentrations (sulmazole: 6.4 mumol l-1; theophylline 7.35 mumol l-1). Increasing doses led to a negative inotropic effect with slackened relaxation and loss of its load sensitivity (up to 390 mumol l-1 for sulmazole; up to 350 mumol-1 for theophylline). In agreement with other reports, the dose-effect curve was shifted towards low concentrations. 2. During ischemic crisis, therapeutic doses of sulmazole (6 mumol l-1) and theophylline (7 mumol l-1) induced no additional depression of contractility and protected relaxation. During subsequent reoxygenation, better recovery of contractility was observed without any very significant improvement of relaxation. 3. During reoxygenation beyond 120 mumol l 1, increasing doses of sulmazole depressed contractility. An additional depressive effect on mechanical performance was observed during hypoxia only for the highest dose (390 mumol-1). PMID- 3814220 TI - Immunopharmacological actions of the new antiallergic drug 11-oxo-11H-pyrido[2,1 b]quinazoline-2-carboxylic acid. Effects on immunological reactions in mice and in humans. AB - The effects of 11-oxo-11H-pyrido[2,1-b]quinazoline-2-carboxylic acid (Sm 857), a new antiallergic drug, on immunological reactions in mice and in humans were investigated. The mouse hemolysin formation against sheep erythrocytes was not suppressed by Sm 857 (10-100 mg/kg/d i.p., p.o.) for 3 days either before or after immunization. The formation of anti-dinitrophenyl (DNP) IgE antibodies in mice immunized with dinitrophenyl-conjugated ovalbumin (DNP-OA) and alum, was not suppressed by Sm 857 (10-100 mg/kg i.p., p.o.) for 3 days either before or after immunization, but the formation of anti-DNP IgG antibodies on 7 days after immunization was slightly suppressed in the group of mice treated i.p. with 100 mg/kg/d of Sm 857 for 3 days after immunization. On the other hand, both the proliferation of human peripheral blood lymphocytes (PBL) induced by concanavalin A, phytohemagglutinin-P, pokeweed mitogen (PWM), protein A (Pro A) and Cowan I, and the formation of IgM and IgG plaque forming cells by PBL stimulated with PWM or Pro A, were suppressed significantly only in the presence of Sm 857 (10(-4) g/ml). In addition, Sm 857 hardly affected the nitroblue tetrazolium reduction test, phagocytosis and chemotaxis in human neutrophils. PMID- 3814221 TI - Study of drug interaction between the new antiallergic drug 11-oxo-11H-pyrido[2,1 b]quinazoline-2-carboxylic acid and theophylline. AB - A new chemical compound, 11-oxo-11H-pyrido[2,1-b]quinazoline-2-carboxylic acid (Sm 857), known to inhibit the second stage type I allergy and endowed with antiasthmatic action, was investigated with regard to its effects on theophylline (TP) blood level in comparison with ketotifen and tranilast, antiasthmatics of the same therapeutic category as Sm 857, and tiaramide, an antiinflammatory agent. Sm 857 was administered orally to rats at 50 mg/kg, followed by oral administration of TP at 10 mg/kg or intravenous administration of aminophylline 13 mg/kg 10 min later. The concomitant use of Sm 857 apparently lowered the development of TP blood level during 1-5 h after administration when compared with the control. A similar lowering effect on TP blood level was observed at both single and 3-day prior administration of Sm 857. Ketotifen also reduced TP blood level at a dose of 50 mg/kg, while tranilast proved to have almost no such influence on TP blood level. Unlike the mentioned antiasthmatics, tiaramide tended to delay TP clearance. The determination of TP free fraction produced by addition of testing drugs to TP-containing rat serum in vitro after incubation for a certain period of time revealed a 30% increase in free fraction percent in case of Sm 857 addition, 7% increase in case of tranilast addition and no change at all in case of ketotifen and tiaramide addition. Above results suggest that the concomitant use of Sm 857 and TP might cause drug interaction. Sm 857 is thought to increase the blood free fraction of concomitantly used TP and to accelerate elimination of TP from blood. PMID- 3814222 TI - [The tumor inhibitory effect of valepotriates on transplanted and chemically induced autochthonous tumors in the rat]. AB - The tumor inhibitory effect of a standardized mixture of valepotriates was investigated. The growth of 3 transplanted and 2 chemically induced autochthonous rat tumors was not influenced significantly by intravenous or peroral administration of these compounds. PMID- 3814223 TI - Distribution of [14C]-ciprofloxacin in experimentally induced intramuscular abscesses of rats. AB - Wistar rats were infected by injection of 0.05 ml of a dense oily suspension of Staphylococcus aureus into the posterior thigh muscles of the hind leg. Three days later, solid abscesses had formed which were characterized by a peripheral accumulation of polymorphocytes and incipient central necrosis. At this time, 10 mg/kg of [14C]-ciprofloxacin (1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7 piperazin-1-ylquino line-3-carboxylic acid, Bay o 9867; designated tradename: Ciprobay) were administered intravenously. The animals were sacrificed at various time intervals after treatment and the distribution of radioactivity was examined by whole-body autoradiography. Five min after administration of ciprofloxacin, the radioactivity was found to be differentially distributed among all organs and tissues, but no radioactivity was detectable in the abscess. Beginning from 1 h post appl., increasing relative amounts of radioactivity were seen inside the abscesses. The relative enrichment as compared to the surrounding muscle tissue was most pronounced after 5 h, indicating that the radioactivity was eliminated more rapidly from the muscle than from the abscess. Some radioactivity was still present in the abscess 8 h after treatment of the animals. The comparison of autoradiograms and corresponding histological sections revealed a distinct affinity of [14C]-ciprofloxacin and/or its potential radioactive metabolites to the areas of inflammatory cellular infiltrates. PMID- 3814224 TI - Experimental findings on the estrogenic activity of estradiol enantate. AB - In a first attempt to find out the estrogenic activity of the monthly injectable contraceptive composed of dihydroxyprogesterone acetophenide 150 mg + estradiol enantate 10 mg (Perlutal, Topasel), estradiol enantate (estra-1,3,5(10)-triene-3 ol-17 beta-heptanoat), estradiol benzoate and ethinylestradiol were compared in rats of the Chbb: THOM species. Estradiol benzoate potency was significantly higher than that of estradiol enantate: 20.34 (15.57-26.31) times in the vaginal cornification test in castrated females; 2.21 (1.63-2.98) times in the uterine weight test also in castrated rats and 2.91 (1.86-4.54) times in the vaginal opening test in immature rats. Ethinylestradiol, orally administered in the first two tests, was less active than the other two parenterally given substances; it overcame them in the vaginal opening test, when all substances were perivaginally administered. The duration of action of equivalent doses on the vaginal smear in castrated females resulted higher for estradiol enantate: 2.52 times more than estradiol benzoate and 5.2 times more than ethinylestradiol. Based on these results and on preexistent literature, the estradiol enantate dosis which would be sufficient to obtain the endometrial proliferation in women was extrapolated and compared with those already established of estradiol benzoate and ethinylestradiol. Finally, the possibility that the estrogenic potency of the injectable contraceptive treatment can be similar or lower than the oral one with pills containing ethinylestradiol 0.030-0.050 mg is discussed. PMID- 3814225 TI - Pharmacokinetic studies of estradiol enantate in menopausic women. AB - Healthy menopausic women received 10 mg i.m. of estradiol enantate (estra 1,3,5(10)-triene-3-ol-17 beta-heptanoate, one of the components of Perlutal or Topasel). Their estradiol serum levels were determined by radioimmunoassay (RIA) on days 1, 2, 3, 6, 8, 10, 13, 15, 17, 20, 22, 24, 27, 29 and 31 after the injection. Based on these data, the elimination rate constant (K = 0.12445 d-1), the elimination half-life (t1/2 = 5.57 d), the absorption rate constant (Kabs. = 1.5050 d-1), the absorption half-life (t1/2 abs. = 0.46 d) and the volume of distribution (Vd = 5087 l) were calculated. These results are compared with others not obtained by RIA and discussed from a therapeutic-clinical point of view. PMID- 3814226 TI - Central and autonomic nervous system side effects of ketanserin. AB - A placebo controlled, randomized, double-blind cross-over study was carried out in 7 healthy volunteers in order to study the central and autonomic nervous system side effects of ketanserin in comparison to clonidine. Psychometric performance was assessed as well as electroencephalographic recordings (EEG), saliva production, mean arterial blood pressure (MAP) and pulse rate under placebo conditions (P, 10 ml saline), following 0.15 mg/kg ketanserin or 2 micrograms/kg clonidine i.v. administration. The sedation index as well as the deceleration of EEG frequencies clearly expressed sedation following both, ketanserin and clonidine. Saliva production was significantly decreased by ketanserin (p less than 0.05) and clonidine (p less than 0.01), respectively. MAP was only very slightly reduced by ketanserin, while clonidine caused a small but significant decrease (p less than 0.0001). The pulse rate changes did not reach a clinically important extent. Thus, sedation as main central nervous system side effect and reduction in salivation as autonomic nervous system side effect of ketanserin could be clearly quantified in comparison to placebo and clonidine. PMID- 3814227 TI - Comparison of the suppressive effects of L-aspartic acid and chlorpromazine + diazepam treatments on opiate abstinence syndrome signs in men. AB - According to the hypothesis implying that the main reason of physical dependence on opiate is the inhibition of brain L-asparaginase activity and L-aspartic acid gradually decreases compulsory opiate intake so that physical dependence disappears by itself, 31 opiate addicts were given 8 g L-aspartic acid for 7 days after withdrawal from opiate and appearance of abstinence syndrome signs. The attenuations by L-aspartic acid of the abstinence syndrome signs were statistically compared with those obtained from other 12 opiate addicts received daily 50 mg chlorpromazine + 60 mg diazepam which have long been used to suppress abstinence syndrome because of their multiple receptor blocking and sedative effects. The intensity and duration of 13 signs out of 16 ones were found to be significantly more alleviated and shortened in the addicts treated with L aspartic acid. PMID- 3814228 TI - Effects of the calcium antagonist nifedipine on thromboxane B2 level and platelet aggregation in hypertensive patients. AB - The effects of a calcium antagonist nifedipine (Adalat) on platelet aggregation was examined in vitro and in vivo. In vitro examination: Platelet aggregation induced by adenosine disphosphate (ADP), epinephrine, collagen, arachidonate, and thrombin was all inhibited dose-dependently in the platelet-rich plasma prepared from the blood of healthy individuals by the addition of nifedipine to a final concentration of 5 or 10 micrograms/ml. In vivo examination: 20 patients with essential hypertension were treated with 30 mg/d of nifedipine for 8 weeks. Significant decreases in both systolic and diastolic pressures were observed 2 weeks after the beginning of the administration, and continued throughout the administration period. ADP-induced platelet aggregation decreased by 25% after 2 weeks, 36% after 4 weeks, and 44% after 8 weeks (p less than 0.05 for all decreases). Plasma thromboxane B2 level also decreased markedly from 217.3 +/- 91.7 pg/ml before the administration to 119.0 +/- 29.7 pg/ml (p less than 0.01) 2 weeks after, and 99.1 +/- 25.4 pg/ml (p less than 0.01) 8 weeks after the beginning of the administration, suggesting suppressed thromboxane A2 production. PMID- 3814229 TI - Effect of bezafibrate on low levels of high density lipoprotein cholesterol in normolipidemia. Study in coronary patients and their first degree relatives. AB - A pharmacological study was carried out in a group of 20 subjects composed of 13 coronary patients and 7 normal close relatives (first degree) who were considered at a high risk for coronary heart disease (CHD) because of their low levels of high density lipoprotein cholesterol (HDLch) (mean +/- SD: 34.1 +/- 5.2 mg/dl) and their high total cholesterol/HDLch (Tch/HDLch) ratio (mean +/- SD:6.7 +/- 1.1), despite their normal serum lipid values. With the purpose of normalizing these parameters they were submitted to a 4-month treatment with bezafibrate, a hypolipidemic agent which has a known effect in increasing HDLch and in decreasing the Tch/HDLch ratio. At the end of the study total serum cholesterol and triglycerides decreased significantly by 10 and 30%, respectively (p less than 0.01). HDL increased in its cholesterol content by 33% reaching a value of 45.4 +/- 9.8 mg/dl (mean +/- SD, p less than 0.01) as well as in its apolipoprotein A1 (Apo A1) content (13%, p less than 0.02). HDL2 subfraction also rose in cholesterol and in Apo A1: by 90 and 38%, respectively (p less than 0.01). HDL3 subfraction rised only its cholesterol content by 24% (p less than 0.01). Tch/HDLch ratio was significantly reduced (p less than 0.01) to a value of 4.6 +/- 0.9 (mean +/- SD). Total serum Apo B diminished by 14% (p less than 0.01). No adverse effects were observed during the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814230 TI - Pharmacokinetics of salicylates administered with metoprolol. AB - The widely used acetylsalicylic acid (ASA, Colfarit) was administered in combination with metoprolol (Lopresor) during 7 days. Plasma concentrations of total salicylates (ASA and salicylic acid (SA) and metoprolol were monitored during the treatment period, on day 7 urinary excretion was also investigated. The kinetic data of the compounds were compared to those of the metoprolol and ASA control periods. Metoprolol kinetics remained uninfluenced whereas the maximal plasma concentrations of the salicylates were significantly higher than in the ASA control period. PMID- 3814231 TI - Pharmacokinetics and bioavailability of doxycycline in humans. AB - The bioavailability of a new tablet of 6-deoxy-5-hydroxytetracycline (doxycycline, Doxycline Plantier) was estimated relatively to an oral solution and a commercially available capsule. Each form was administered to 12 healthy volunteers according to a replicated latin square. Statistical analysis of non compartmental pharmacokinetic parameters - maximum concentrations, corresponding time, area under the plasma concentrations curve and unchanged amounts recovered in the urine - failed to show any difference between the tested pharmaceutical forms, although the new tablet allows to reach higher concentrations. PMID- 3814232 TI - [Photoacoustic spectroscopy as a new approach to the determination of the skin penetration of locally applied drugs. Preliminary communication]. AB - Photoacoustic-spectroscopic investigations of the penetration of topically applied drugs into the horny layer of the human skin are reported. By this technique the light absorption of the horny layer and its change due to drug diffusion can be determined in vivo in dependence on depth. Measurements have been performed on a sunscreening agent and on an UVA-absorbing systemic drug after topical application to the forearm. PMID- 3814233 TI - National survey of educational preparation in pediatric audiology. PMID- 3814234 TI - Brainstem audiometry of infants. Committee on Hearing, Bioacoustics, and Biomechanics. Commission on Behavioral and Social Sciences and Education. National Research Council. PMID- 3814235 TI - The dosimetry of 125I seed eye plaques. AB - The ability of a brachytherapy treatment-planning computer program to calculate accurately the dose from 125I seeds at distances relevant to eye plaque therapy was investigated. Thermoluminescent dosimetry measurements were made in a plastic phantom at depths of 0.5, 0.97, and 1.5 cm, and results were corrected for finite dosimeter size and phantom effects. Doses were calculated at the same depths with an 125I seed linear source model that accounted for dose anisotropy. Measurements and calculations were found to agree within their mutual uncertainties. The presence of a gold plaque was found to reduce the dose at all measured depths by 8%. PMID- 3814236 TI - Alimentary malignancies in Arabs in the Eastern Province of Saudi Arabia. AB - A study was made of 89 cases of alimentary malignancies in Arab patients in the Eastern Province of Saudi Arabia. The pattern of alimentary involvement observed was colo-rectum 43%, stomach 34%, oesophagus 19% and small intestine 4.5%. This finding was in contrast to previous studies in Saudi Arabia which had reported the upper alimentary tract, particularly the oesophagus, as the site most frequently affected. Of the patients 80% were Saudis. The male:female ratio was 3.9:1. A striking feature was the youthfulness of several patients, 44% being under fifty years of age. There were only three cases of alimentary lymphoma. Although colo-rectal schistosomiasis was a moderately frequent finding in the population studied, there was no pathological evidence to support an aetiological association between bilharziasis and large bowel malignancy. PMID- 3814237 TI - Experimental studies on the antithrombotic action of a highly effective synthetic thrombin inhibitor. AB - The antithrombotic action of the highly effective synthetic thrombin inhibitor N alpha-(2-naphthylsulfonylglycyl)-4-amidinophenylalanine piperidide was studied in various models of experimental thrombosis in rats. Intravenous infusion of the thrombin inhibitor caused a dose-dependent inhibition or prevention of stasis induced venous thrombosis, of arterial thrombosis after electrically-induced damage of the vessel wall and of thrombotic occlusion of an extracorporeal arterio-venous shunt. PMID- 3814238 TI - Event-related potentials in children at risk for schizophrenia during two versions of the continuous performance test. AB - Event-related potentials (ERPs) were recorded from children of schizophrenic parents, children of parents with affective disorders, and children of parents without a history of psychiatric illness. ERPs were elicited during two versions of the continuous performance test (CPT), which differed in their level of processing complexity. The data were recorded from electrodes located at midline frontal, central, parietal, and occipital scalp sites. Diagnostic assessments of the parents were performed using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version and Research Diagnostic Criteria. Clinical assessments of the children were made with a modified version of the Global Assessment Scale. ERP amplitudes for six electrophysiological events were compared among groups for target and nontarget stimuli using analyses of variance of both factor score and baseline to peak measures. There was one isolated between-group finding: frontal negative slow wave recorded at FZ was of greater magnitude in the high risk (HR) than in either the psychiatric (PC) or normal control (NC) groups. Since only a small percentage of children at risk will eventually develop schizophrenia, ERP amplitude deviance and frequency distribution analyses were also performed and compared among groups. ERP component amplitudes did not distinguish the groups when each component was considered separately. Deviance analyses, using a combination of the amplitudes of the six ERP components, also did not provide evidence of a deviant subgroup within any of the three groups. There appeared to be no relationship between ERP component amplitudes and behavioral adjustment in adolescence. Some evidence of a relationship between deviant attentional functioning and ERP component amplitude was found, but the pattern of findings within the attentionally deviant HR subgroup was opposite to that found for the HR group as a whole and more consistent with the pattern found for the NC group. PMID- 3814239 TI - Functional hallux limitus and its relationship to gait efficiency. PMID- 3814240 TI - [Impressive but still disappointing decline in perinatal mortality in The Netherlands]. PMID- 3814241 TI - [Gallstone ileus]. PMID- 3814242 TI - Disability assessment as a measure of progress in leprosy control. PMID- 3814243 TI - [Treatment of migraine attacks in children with dihydroergotamine Spofa and lysenyl]. PMID- 3814244 TI - Hemolytic anemia in neonatal malaria. PMID- 3814245 TI - Atypical causes of hand pain. AB - The history and physical examination allow early identification of the cause of hand pain in most patients. In some cases, however, the etiology of the pain is not obvious and a diagnostic problem arises. The less common causes of hand pain include atypical mycobacterial infection, occult fractures, bone fragments, incomplete carpal coalitions, carpal ligament injuries and several uncommon forms of tendinitis. PMID- 3814246 TI - Adenosine release into venous plasma during free flow exercise. AB - We measured adenosine release into venous plasma as an index of interstitial adenosine concentration during free flow exercise hyperemia. Isolated, blood perfused dog calf muscles were stimulated at 6 Hz for 10 min at free flow. Plasma samples were collected before, during, and after the exercise period for analysis of plasma adenosine concentration [( ADO]) by HPLC. Adenosine release (Rado) was calculated as plasma flow times venous-arterial [ADO] difference. Rado (nmole/min/100 g) went from -0.1 +/- 0.1 at rest to 6.6 +/- 4.6 during 6-Hz exercise. Isoproterenol infusion, which caused an increase in blood flow equivalent to 6-Hz exercise, did not result in increased Rado. Infusion of the 5' nucleotidase inhibitor, alpha, beta, methylene adenosine 5'-diphosphate (AOPCP) did not prevent the increase in Rado during exercise. These results support the hypothesis that interstitial adenosine concentration increases during sustained free flow twitch exercise and that this results in increased release of adenosine into venous plasma. PMID- 3814247 TI - Crystal and molecular structure of cyclo(L-prolyl-glycyl)3. A cyclic hexapeptide with a cis peptide bond. AB - The crystal structure of cyclo(L-Pro-Gly)3 was solved using X-ray crystallographic techniques. The backbone of the peptide is asymmetric and is made up of five trans peptide units and one cis peptide. There is a hydrogen bonded water bridge that links the carbonyl oxygens, O1 and O4. The molecules exist as dimers in the crystal lattice. The two molecules of the dimer are related by crystallographic twofold symmetry and are linked by two N-H ... O hydrogen bonds. The crystals are trigonal, space group P3(2)12 with a = 11.379(3), c = 32.93(1) and z = 6. The structure was solved by multisolution methods and refined by least squares technique to an R of 0.083. PMID- 3814248 TI - Fluorescence measurements of the binding of cations to high-affinity and low affinity sites on ATP-G-actin. AB - The binding of cations to ATP-G-actin has been assessed by measuring the kinetics of the increase in fluorescence of N-acetyl-N'-(5-sulfo-1-naphthyl) ethylenediamine-labeled actin. Ca2+ and Mg2+ compete for a single high-affinity site on ATP-G-actin with KD values of 1.5-15 nM for Ca2+ and 0.1-1 microM for Mg2+, i.e. with affinities 3-4 orders of magnitude higher than previously reported (Frieden, C., Lieberman, D., and Gilbert, H. R. (1980) J. Biol. Chem. 255, 8991-8993). As proposed by Frieden (Frieden, C. (1982) J. Biol. Chem. 257, 2882-2886), the Mg-actin complex undergoes a slow isomerization (Kis = 0.03-0.1) to a higher affinity state (K'D = 4-40 nM). The replacement of Ca2+ by Mg2+ at this high-affinity site causes a slow 10% increase in fluorescence that is 90% complete in about 200 s at saturating concentrations of Mg2+. Independently, Ca2+, Mg2+, and K+ bind to low-affinity sites (KD values of 0.15 mM for Ca2+ and Mg2+ and 10 mM for K+) which causes a rapid 6-8% increase in fluorescence (complete in less than 5 s). We propose that the activation step that converts Ca G-actin to a polymerizable species upon addition of Mg2+ is the binding of Mg2+ to the low-affinity sites and not the replacement of Ca2+ by Mg2+ at the high affinity site. PMID- 3814249 TI - Studies on zoapatle, II. Leucanthanolide, a novel sesquiterpene lactone from Montanoa leucantha ssp. leucantha. PMID- 3814250 TI - 3,3'-Neotrehalosadiamine (BMY-28251), a new aminosugar antibiotic. PMID- 3814251 TI - Current progress toward the prevention of the Wernicke-Korsakoff syndrome. AB - The Wernicke-Korsakoff syndrome is a rare neurological disorder which strikes primarily alcoholics and is caused, at least in part, by insufficient bioavailability of thiamin. Because of the low cost of preventing this disease by adding thiamin to alcoholic beverages relative to the cost of the long-term care of patients with the chronic phase of the disease, there has been a need to determine the feasibility of this particular preventive strategy. Recent data demonstrating normal levels of erythrocyte transketolase in patients presenting with Wernicke's encephalopathy has led some to question the link between thiamin deficiency, and the development of the syndrome, despite the fact that virtually all patients with Wernicke's encephalopathy will respond favorably to parenteral thiamin, and the evidence that rats deprived of thiamin develop lesions that are characteristic of the disease. Thiamin is nontoxic, is stable in alcoholic beverages, and is undetectable in beer to professional taste-testers at levels theoretically sufficient to guarantee adequate absorption. Although there is much inter-subject variability it appears that thiamin at therapeutic concentrations can be absorbed by the jejunum in the presence of alcohol. Evidence that patients with the Wernicke-Korsakoff syndrome have an altered thiamin-requiring isoenzyme and evidence that six patients with Wernicke's encephalopathy failed to respond to oral thiamin has caused some doubt as to whether the target population would be able to benefit from the measure. Other determinants of thiamin utilization, such as folate and magnesium status, also may figure in the etiology of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814252 TI - Tetrahydro-beta-carbolines in human urine and rat brain--no evidence of formation by alcohol drinking. AB - 1-Methyl-1,2,3,4-tetrahydro-beta-carboline (1-MeTHBC) and 6-methoxy-1-methyl 1,2,3,4-tetrahydro-beta-carboline (6-M-1-MeTHBC) were identified and quantified in the urine of 131 healthy volunteers by gas chromatography/mass spectrometry (GC/MS) with a chemically-bonded glass-capillary column. 1-MeTHBC was present naturally in the human urine, whereas 6-M-1-MeTHBC was observed in only 20% of all subjects at a much lower level. No significant relationship was observed between these substances and alcohol consumption in the subjects. Various foods and alcoholic beverages were found to contain 1-MeTHBC but not 6-M-1-MeTHBC; thus, the urinary 1-MeTHBC detected could be of dietary origin. Salsolinol, on the other hand, was significantly elevated in the urine without increase of THBCs by long-term moderate drinking. 1-MeTHBC and 6-M-1-MeTHBC were also analysed in the brains of rats following inhalation of ethanol and acetaldehyde for four days. No evidence of formation of these compounds was observed in any regions of the brain. PMID- 3814253 TI - Ethanol-induced cytoskeletal dysgenesis with dietary protein manipulations. AB - Ethanol-induced cytoskeletal abnormalities occur in many cell types, affecting structure and function of the respective organs. When affecting the developing myocyte, damage is responsible for the hypotonicity and congestive heart failure of Fetal Alcohol Syndrome (FAS) infants. To test the hypothesis that ethanol damages myocytes in utero, and determine that damage is not affected by dietary protein manipulations, female Sprague-Dawley rats were fed Leiber-DeCarli diets containing either 10% or 25% protein-derived calories, isocalorically balanced with or without 36% of the total calories containing ethanol. Muscle biopsies from rat pups of the ethanol-fed groups showed disorganized myocyte cytoskeleton: sarcomeric dysplasia with Z-band abnormality, actin in disarray, and granulofilamentous debris. Teratogenic effects of ethanol on myocytes occur in rat pups in utero, supporting the use of this model for studying ethanol effects on the developing cytoskeleton. We report ultrastructural evidence which provides a partial explanation of the mechanism of a well-known clinical phenomenon. PMID- 3814254 TI - Patterns of compliance and evasion in treatment programmes which include supervised disulfiram. AB - Examination of the compliance patterns of 84 patients offered supervised disulfiram in aqueous suspension, and for whom adequate supervision by family members, friends or colleagues was possible, showed that 38 took disulfiram regularly and remained abstinent throughout the minimum six-month period for which it was prescribed. Twenty risked drinking alcohol while taking disulfiram, half of whom did not experience a significant reaction on doses of 200-300 mg daily. In nine patients there was a temporary lapse of supervision. Two patients induced vomiting of disulfiram. Four substituted inert medication. Nine dropped out of treatment--usually after separating from their partner--and two refused to start disulfiram. Apart from these 11 patients, attempts to sabotage or evade treatment were not necessarily associated with a poor response. In most cases it was possible to out-manoeuvre the patients by increasing the dosage or modifying the supervision techniques. Awareness of these possible patient responses is essential if the considerable potential of supervised disulfiram is to be maximised. PMID- 3814255 TI - An analysis of context and alcohol consumption in a group of criminal events. AB - The aim of this analysis was to demonstrate the importance of examining the context of alcohol consumption with regard to a criminal event. The paper explores information which was part of a larger study of alcohol use by violent and non-violent offenders. Data were collected by interview from the offenders and correlated with other reports. Earlier findings of the study which have been reported suggested that level of consumption was associated with the type of offence. In this paper a more complex drinking/drinking context and crime relationship is shown to exist. The circumstances at the time of the crime were related more to the level of alcohol consumption than to the violent or non violent nature of the crime. Type of beverage, companionship and time of day were found to be particularly good indicators of the amount of alcohol consumed. PMID- 3814256 TI - Controversial views of the editorial board on the intraoperative management of ruptured saccular aneurysms. PMID- 3814257 TI - AIDS in Indonesia. PMID- 3814258 TI - Syphilis in HTLV-III infected male homosexuals. AB - Out of 100 male homosexual persons screened for AIDS, 54 were found to be HTLV III antibody positive. Of these, 34 (63%) had a positive history of syphilis, as compared to 16 (35%) of the 46 HTLV-III antibody negative persons (P less than 0.01). In the HTLV-III antibody positive group 12 (22%) had had more than three syphilis infections as compared to none in the negative group (P = 0.02). The frequency of a previous primary, secondary, and latent syphilitic infection was different in the two groups. During the 1970s and early 1980s the incidence of syphilis in the U.S.A. and in Denmark was increasing, but from 1982 the incidence decreased markedly, possibly a consequence of the fear of AIDS, which appeared in 1981-82. It is speculated that the high frequency of syphilis among homosexual men might have been a co-factor for the acquisition of the HTLV-III infection. PMID- 3814259 TI - Immune dysfunction in rabbits associated with chronic administration of enemas and rectal insemination. AB - NZ rabbits were treated with various combinations of enemas and intrarectal insemination (1 or 3 ml of semen a week) to investigate the effects of intestinal uptake and immunogenicity of seminal components and of an unrelated antigen, bovine serum albumin (BSA), given simultaneously. For 5 months the treatment was limited to enemas and/or semen, and total immunoglobulins and antisperm and antilymphocyte antibodies were determined. Then, without interruption of the treatments, the animals received two courses of three consecutive daily intrarectal administrations of BSA, and the humoral response was determined 7 days after each course of administration. Only 1 of 18 intrarectally inseminated animals responded with production of antisperm antibodies; none had antilymphocyte antibodies. Total immunoglobulins, however, were significantly increased in animals receiving enemas alone (p less than 0.02) or followed by insemination (p less than 0.05). The humoral response to BSA was significantly (p less than 0.01) enhanced by prior administration of enemas but was moderately reduced by simultaneous administration of semen, in a dose-related fashion. PMID- 3814260 TI - Plasma protein alterations in AIDS and hemophilia A. AB - Plasma proteins of patients with AIDS, ARC, hemophilia A, and some viral infections were studied using various electrophoretic techniques, and compared to healthy control subjects. On isoelectric focusing (IEF) gels the most prominent and consistent finding was a marked increase in a basic protein band (AABP) at pI approximately equal to 9.0 in plasma samples derived from AIDS and hemophilia A patients. Using SDS gels, we noted an increased amount of protein in the 90 KD region in AIDS patients as compared to control subjects. On two dimensional gels (2D gels) basic protein(s) with pI congruent to 8.1-9.0 and molecular weight of approximately 90 KD were noted to be increased. In addition, a basic protein of 27 KD along with two acidic proteins in the low molecular weight region were also elevated in AIDS plasma. Although a limited number of samples were analyzed, it seems probable that a number of proteins are altered in AIDS plasma. AABP stained positive with periodic acid Schiff (PAS) reagent, indicating that it is a glycoprotein. This protein did not bind to an anti-IgG sepharose column, suggesting that it is not an immunoglobulin. The purified protein also did not react with antibody to fibrinogen and hemoglobin beta-chain. There are many changes in the plasma protein pattern of AIDS and hemophilia A patients as compared to normal controls. PMID- 3814262 TI - Autologous rosette forming cells in subjects at risk for the acquired immunodeficiency syndrome. AB - We investigated the distribution of autologous rosette forming cells (ARFC) in the peripheral blood from subjects at risk for the acquired immunodeficiency syndrome (AIDS). The mean percentage of ARFC with autologous plasma from 35 male homosexual individuals was significantly lower than that of 31 normal controls. The mean percentage of ARFC of SARA had a direct linear correlation with the percentage of T4+ cells (p less than 0.01). Within the SARA group, those with antibodies against HTLV-III/LAV had percentages of ARFC significantly lower than SARA with negative antibodies. Plasma from SARA decreased the percentage of ARFC of normal cells when compared to normal homologous plasma (p less than 0.005), whereas normal homologous plasma did not modify the low percentage of ARFC from SARA. These results indicate that SARA possess a depletion of this subpopulation of T cells. This is more pronounced in subjects with anti-HTLV-III/LAV antibodies. The low ARFC is related to a decrease in the number of cells that correlates with the number of T4+ cells. The inhibition of normal ARFC by plasma from SARA suggests the existence of plasma factors that could mask the lymphocyte receptors for their own red blood cells and/or coat erythrocytes preventing lymphocyte-erythrocyte binding. PMID- 3814261 TI - HTLV-III infection among 315 intravenous drug abusers: seroepidemiological, clinical, and pathological findings. AB - Seroepidemiological, clinical, immunological, and pathological features were studied in 315 intravenous drug abusers (IVDA) seen in five centers for drug addicts' assistance in the Friuli Venezia-Giulia region of Italy, close to the borders of Austria and Yugoslavia. No case of AIDS has been observed. Sixty-five (21%) were affected by persistent generalized lymphadenopathy (PGL). HTLV-III seropositivity was noted in 86 (27%) of the overall 315 IVDA, in 50 (77%) of 65 patients with PGL, and in 1 (0.5%) of 205 blood donors tested as a control group. Patients with PGL had a significantly lower OKT4/OKT8 ratio than the rest of the IVDA population and controls. Systemic symptoms were present in 52% of the patients with PGL, the most frequent symptoms being fatigue and night sweats. In 20 patients with PGL, DR typing revealed a significant increase in DR-5 frequency and a significant decrease of DR-2 frequency. The predominant histological features in the lymph nodes taken from 25 patients consisted of an exuberant follicular hyperplasia, capillary vessel proliferation, and plasmacytosis. Nineteen (22%) females reporting occasional prostitution were compared to 10 non IVDA female prostitutes and concomitantly evaluated. HTLV-III seropositivity was noted in 11 (58%) of 19 IVDA female prostitutes and in none of the 10 non-IVDA prostitutes. Thirty-five couples composed of both IVDA were compared to 24 couples composed of an IVDA and a non-IVDA. Among the 24 couples of whom one or both partners were seropositive, concordance in HTLV-III seropositivity was present in 5/11 (45%) couples composed of both IVDA, and in only 1/13 (8%) couples composed of an IVDA and a non-IVDA. This suggests that the sharing of contaminated needles, universally practiced by our IVDA population, plays a more important role in the transmission of HTLV-III than sexual contact. PMID- 3814263 TI - Persistence of high risk sexual activity among homosexual men in an area of low incidence for acquired immunodeficiency syndrome. AB - A survey of 305 homosexual men was performed in an area of relatively low incidence for AIDS and low seroprevalence for antibody to the human immunodeficiency virus (HIV). The objective of the study was to investigate current knowledge and practice of sexual behavior designed to limit transmission of HIV. The results showed that while the majority of the study group believed that they had made changes in their life styles that would reduce the likelihood of transmitting or acquiring the virus, nearly half admitted to persistently engaging in active and passive anal intercourse without condoms. These data suggest the need for more widespread and effective forms of education to help prevent the continuing spread of the AIDS epidemic. PMID- 3814264 TI - [Dynamics of the prolonged and persistent estrogenic endometrium]. AB - Prolonged oestrogenic endometrium and persistent oestrogenic endometrium are frequent pathological states which have in common a variable degree delay or an absence of apparition of histological signs of luteal impregnation. In fact these two main states include several kinds of lesion; in our experience this point of view, which is an artificial division, is a too static one. We have to consider all the possible states to see the evolution of the whole. In this work, we have performed a cautious mounting of the different phases to get a dynamic view of these lesion; with this view one can see with a different lighting luteal insufficiency of the endometrium. In that way numerous secretory dystrophic aspects considered like secretory abnormal endometrium have to be related to prolonged or persistent oestrogenic states of which they are an evolutive variant. This dynamic approach allows to establish clinico-pathological correlations and leads to a best knowledge of hyperplasic endometrium and of treatment and prevention of endometrial hyperplasia. PMID- 3814265 TI - [Ultrastructural study of the lymph nodes in patients at risk for AIDS]. AB - The identification of viral particles in the lymph node germinative centers from patients at risk for AIDS is an important diagnostic factor in the prodromal stages of this illness. Those particles are solely seen between the cytoplasmic extensions of the dendritic reticular cells. They have the same morphology than LAV-HTLV III virus, incriminated retrovirus in the etiology of the disease. They were found in 26 of the 30 lymph nodes studied. PMID- 3814266 TI - [Lymphomas and AIDS]. AB - We report 21 cases of lymphomas associated with AIDS. Sixteen cases are Non Hodgkin's lymphomas of high grade malignancy. Immunoblastic B cell lymphomas are frequent: 11 cases/16, especially with extra nodal localisations. Three cases are Burkitt's lymphoma; 2 cases are large non cleaved cell lymphoma. Five cases of Hodgkin's disease are associated with AIDS related complex syndrome (ARC) showing the interest of lymph node biopsy in such patients. We analyzed 6 cases with lymphoid bone marrow infiltration and discuss the relationship between prelymphomatous states and low grade malignant lymphomas in AIDS or ARC patients. PMID- 3814267 TI - [Digestive system lesions in relation to AIDS. Diagnostic value]. AB - The histopathological study of the digestive mucosae has a great diagnostic value. It appreciates lymphoid tissue; it may suggest AIDS when it discloses rare inflammatory or tumoral lesions; it may disclose an infectious and/or Kaposi sarcoma lesion which may be the first manifestation of AIDS in a seropositive LAV patient or may be an additional lesion in a patient known to have AIDS. The autopsies have shown the spread of the extension and the evolution of these lesions. The discussion of the histopathological lesions must always include the extra-digestive localisations as well as the "non opportunistic" associated infections. PMID- 3814268 TI - [Hepatic, biliary and pancreatic lesions in LAV-HTLV III infection]. AB - We believe it is important to underscore: The frequency and variety of the lesions, mainly within the liver but also of the biliary tract and the pancreas, which may reveal an inaugural complication of AIDS. The interest of the vascular lesions, mainly of the sinusoids as well as the various associated lesions due to pathogens (bacteria, viruses, fungi) and/or to toxic drugs. The physiopathology and histogenesis of the lesions are still obscure. Both the lesions of the hepatocytes and these of the sinusoids are poorly understood, and it is reasonable to discuss the role of various pathogens, such as viruses, peculiarly Epstein Barr and moreover LAV-HTLVIII viruses. PMID- 3814269 TI - [Histopathology of cutaneous lesions]. AB - Kaposi's sarcoma in AIDS syndrome differs in many ways from the typical nodular lesions observed in older patients. Clinical lesions are usually multiple with no predilection for the lower extremities; they usually present as small macules or patches with little or no infiltration, pink rather than deeply violaceous; indeed their clinical recognition may be difficult. Histological features of early patches of Kaposi are subtle: they are not as obvious as in well-developed nodular lesions: however certain precise clues exist which permit a correct diagnosis to be made. PMID- 3814270 TI - [AIDS in children. Histopathologic study of 12 cases]. AB - The anatomo-clinical investigation of a series of 12 cases of AIDS in infants, over two years in Hopital des Enfants Malades (Paris) allows the following observations to be made: the frequency of materno-foetal contaminations (8/12); the relative shortness of the incubation period (3-6 months); the variable degree of the atrophy of the lymphoid tissues; the absence of vascular proliferation; the interest of demonstrating viral proteins associated with LAV virus (p 18) in imprecisely identifiable cells of lymphoid tissue; the severity of the thymic alterations, which are characterized less by a lymphocyte depletion than by a loss of the maturation of the epithelial tissue, which still preserves its hormone secretory properties. PMID- 3814271 TI - [Ultrastructural characteristics of the regression of a Novikoff hepatoma transplanted into immunized rats]. AB - In order to elucidate ultrastructure of tumoral rejection, we have studied the sequential morphological modifications of Novikoff hepatoma transplanted in striated muscle of normal and immunized rats. Specific immunity was induced by the repeated injection of small doses of tumor cells. One month after immunization, a tumorigenous dose was then injected in striated muscle. The animals were sacrificed at 1, 4, 6 or 7 and 14 or 21 days, and tissue samples of the zone of implantation were taken for morphological study. The transplanted tumor regressed in all immunized rats and the sequential ultrastructural examination of these tumors indicated three major phases in their regression: an initial phase (day 1) during which there was an inflammatory infiltrate rich in neutrophils, a reduction of the mitotic activity of tumoral cells and the necrosis of some of them; an intermediary phase (days 4-7) during which the intratumoral infiltrate was composed mainly of lymphocytes and macrophages. These cells surrounded the tumoral cells and eventually formed microgranulomas. Tumoral cells showed cytostasis and/or cytolysis; a final phase (days 14-21) where the tumor had completely disappeared and had been replaced by fibrous tissue and vacuolated macrophages. The morphologic aspect of the intermediary phase is characteristic of a regressive tumor. Our sequential observations clearly showed the sequestration of tumor cells by macrophages and suggest the contact cytolysis of tumor cells. The sequestration of target cells by macrophages might facilitate the concentration of the cytolytic substances in the area of intercellular contacts, and likewise protect these substances from neutralization by serum or tissue inhibitory factors. PMID- 3814272 TI - [Contribution of immunocytochemical marking of benign cells to the diagnosis of serous effusions]. AB - In pleural and peritoneal effusions, the distinction between mesothelial cells and histiocytic cells is fairly often difficult. This distinction is specially important in malignant effusions, where such reactive cells can be confused with tumoral ones. In order to increase the accuracy of cytological diagnosis, the immunocytochemical reactivity with 13 antibodies was studied. Four antibodies (vimentin, lysozyme, monoclonal keratin, OKM1) realise a panel specially useful for the characterization of mesothelial and histiocytic cells in most cases of benign or malignant effusions. PMID- 3814273 TI - [Does Ming's classification of gastric carcinomas have epidemiologic or prognostic value?]. AB - The population based registry of digestive tract tumours of the country of Cote d'Or was used to assess the epidemiological and prognostic value of Ming classification. The 211 gastric carcinomas operated or autopsied between 1976 and 1981 in this population were reviewed on a pathological basis. The expansive type (46.0%) was nearly as frequent as the infiltrative type (47.9%). In 6.2% of the cases it was impossible to classify carcinomas in one of these two types. The male/female ratio was higher in the expansive type (3.0) than in the infiltrative type (2.2) and the mean age of patients at the time of diagnosis was higher in the expansive type (69.5 years) than in the infiltrate type (66.4 years p less than 0,05). Ming classification was difficult to use with superficial carcinomas: 9 out of 12 could not be classified. Among invasive cancers only 1.5% were not classified in one of the two types. Polypoid and fungating carcinomas were more often of the expansive type (70.1%). On the contrary infiltrative carcinomas (ulcerated or not) corresponded to the infiltrative type of Ming in 65.6%. It was not possible to extrapolate the WHO classification to the Ming classification. Infiltrative carcinomas were more often associated with hyperplastic stroma (38.1%) than did expansive carcinomas (5.2%) the proportion of carcinomas limited to the digestive wall was higher in the expansive type (21.7%) than in the infiltrative type (5.0%). The survival rate was better in the expansive type (41.4%) than in the infiltrative type (30.1%) but the difference was not significant. The prognosis depended partly on the time of diagnosis. The results suggest that Ming classification has an epidemiological interest. It allows us to distinguish two types of carcinomas that appear quite different on basis of their growth and penetration capacity. However its prognostic interest appears limited. PMID- 3814274 TI - [Hamartomas of the breast. Apropos of 14 histologically controlled cases]. AB - 14 cases of mammary hamartomas are reported. The WHO describes the mammary hamartoma, as a pseudo-tumor made of ducts and lobules, with fibrosis or adipose connective tissue. The mammogram consists in a well circumscribed tumor generally surrounded by a defined zone of less attenuation. Surgically, the hamartoma can usually be enucleated. Microscopy reveals lobules always but inconstant adipose tissue. Confrontation between gross and histologic features are necessary for the diagnosis. The embryologic development of the mammary gland could help to explain the origin of such a lesion, malformative rather than tumorous. PMID- 3814275 TI - [Recurrence of hyperparathyroidism following a parathyroid autograft. Hyperplasia or carcinoma?]. AB - The authors report a case in which hyperparathyroidism recurred after total parathyroidectomy and autogenous parathyroid graft into the fore-arm musculature, in a patient with chronic renal failure. Light and electron microscopic studies of the grafted tissue show a severe, nodular hyperplasia. This case report illustrates the rapid "tumour-like" growth of the hyperplastic parathyroid grafted tissue; according to some authors, the hyperplastic parathyroid tissue displays an increased propensity to become malignant. PMID- 3814276 TI - Prevention of myocardial injury by pretreatment with verapamil hydrochloride prior to experimental brain death: efficacy in a baboon model. AB - Systemic and pulmonary hemodynamics were studied in two groups of Chacma baboons following the induction of brain death. Group A was a control group of 11 animals who underwent brain death. They showed significant increments of mean systemic arterial, left atrial, and pulmonary arterial pressures; of systemic vascular resistance, heart rate, and pulmonary artery blood flow; and a reduction in aortic blood flow during the induction of brain death. As a result of increased sympathetic nervous system activity, areas of myocardial cell necrosis occurred in 73% of the animals and pulmonary edema in 36%. Group B consisted of five animals that were pretreated with verapamil hydrochloride infused over a period of 30 minutes prior to the induction of brain death (mean dosage, 0.26 mg/kg). Except for a rise in heart rate, no significant changes occurred in systemic or pulmonary hemodynamics, and no myocardial or pulmonary histopathological changes were seen. These findings would indicate that verapamil hydrochloride prevents both the peripheral and central hemodynamic changes that result from increased sympathetic activity associated with the induction of brain death, and thus prevents myocardial structural damage, which may be associated with increased calcium uptake by the myocyte. PMID- 3814277 TI - Brain cortex tissue Ca, Mg, Fe, Na, and K following resuscitation from cardiac arrest in dogs. AB - Recent evidence suggests that ultimate neurologic injury following cardiac arrest and resuscitation may be largely determined by biochemical events occurring during reperfusion. To test this hypothesis and further characterize the time course of some of these events, we examined tissue samples from the parietal cortex for their total content of calcium (Ca), magnesium (Mg), iron (Fe), sodium (Na), and potassium (K) after 10 minutes, two hours, four hours, and eight hours of reperfusion following a 15-minute cardiac arrest in dogs. After 10 minutes of reperfusion, there were relatively small, but significant, increases in the total tissue content of Ca and Na, as compared to nonischemic controls. All values had returned to normal at two hours and remained normal at four hours of reperfusion. However, at eight hours of reperfusion, Ca and Na content approximately doubled and K content was reduced by half. There were no significant changes at any time in the tissue content of Fe or Mg. We conclude that with between four and eight hours of reperfusion following a 15-minute cardiac arrest, a major defect occurs in many cells of the cortex with respect to their ability to control ionic balances of Ca, Na, and K. This might be explained either by failure of the energy-dependent ionic pumps or by more generalized damage to the membrane permeability barrier by a process such as lipid peroxidation. PMID- 3814278 TI - Emergency bypass system: analysis of gas transfer. AB - A portable emergency bypass system using a membrane oxygenator device (CPS) was evaluated. The ability of the CPS to supply the oxygen transfer needs of five anesthetized dogs consistently over six hours and the system's effects on hemoglobin concentration, platelet count, and degree of hemolysis were assessed. The animals maintained spontaneous heart beats, pump flows averaged 100 ml/kg/min; mean arterial pressures were maintained at from 114 to 144 mm Hg. Immediate dilution of hemoglobin and platelet levels occurred in the first 30 minutes. Further hemodilution was limited during the first two hours, although three of the animals required transfusions during the six-hour period to maintain their hematocrits. Plasma free hemoglobin did not significantly increase during the six hours. Baseline oxygen consumption data obtained in three animals ranged from 44.5 to 96 (ml oxygen/min/m2). Oxygen and carbon dioxide transfer measurements during the first hour of bypass were not significantly different from measurements during the last hour of perfusion. The study suggests that optimal use of the CPS could supply much if not all of a patient's basal oxygen transfer requirements for at least six hours. PMID- 3814279 TI - Stabilization of patients prior to interhospital transfer. AB - With regionalization of specialized health care services, some patients must be transferred between hospital to receive needed care. The authors evaluated 100 transfers to their emergency department as to the adequacy of stabilization prior to transport. Problems were identified in the areas of communication (nine cases), oxygenation (two cases), cardiac monitoring (one case), intravenous lines (eight cases), airway (two cases), ventilation (one case), equipment and personnel accompanying the patient (one case), bladder catheterization (four cases), nasogastric suctioning (one case), radiographs (nine cases), and spinal immobilization (seven cases). Because more than one error occurred in some patients, the total number of patients having problems with stabilization was 28. The authors also compared the reimbursement status of transferred patients with that of the region's and emergency department's patient populations. No evidence was found that financially undesirable patients were being preferentially transferred. Thus, even when transfers are not made because of unfavorable reimbursement status, many errors in stabilization occur. A review of the literature shows that inadequacies in stabilization for transfer are widespread. This may be improved through physician education, use of transport teams, and judicious use of interhospital transport. The indications and responsibilities of transfer are discussed. PMID- 3814280 TI - Pneumoparotitis: an unusual manifestation of hay fever. AB - This case concerns bilateral parotitis apparently caused by increased intraoral pressure generated by sneezing and forceful clearing of the nares during an attack of hay fever. This was accompanied by painful anterior cervical lymphadenopathy. The condition responded well to an oral cephalosporin and increased fluid intake along with an analgesic agent. The patient recovered without sequelae. PMID- 3814281 TI - Acute abdominal aortic aneurysm presenting as isolated testicular pain. PMID- 3814282 TI - Correlation of initial amitriptyline concentration reduction with activated charcoal therapy in overdose patients. AB - Plasma amitriptyline concentrations were measured serially in nine overdose patients and correlated with the timing and amount of each patient's initial activated charcoal therapy. A direct correlation was found between the time to initial charcoal therapy (Tc) and the plasma concentration half-life of amitriptyline (T 1/2) calculated for the first seven to 18 hours of hospitalization; T 1/2 = 2.68 + 0.047 Tc (r = 0.78, P less than 0.05). An inverse trend of T 1/2 with the initial amount of charcoal administered was also noted. Nortriptyline, the major metabolite of amitriptyline, decreased in two of three patients who received greater than or equal to 50 gm of activated charcoal within 60 minutes of presentation. These findings support previous in vitro and human volunteer studies advocating the rapid administration of activated charcoal in acute tricyclic antidepressant overdoses. PMID- 3814283 TI - Bedside urinary chloride measurement: assessment in the acute setting. AB - In 100 random urine samples from hospitalized patients, the results of a rapid bedside test for urinary chloride (Quantab chloride titrators) were compared with those of the hospital laboratory. Renal chloride retention (less than or equal to 20 mEq/L) was recognized using the titrator in 25 of 27 samples. There were no falsely low results in samples containing greater than 20 mEq/L by laboratory analysis. The titrator strips should aid in rapid diagnosis of conditions in which the recognition of renal salt retention is important. PMID- 3814284 TI - Methanol intoxication in multiple trauma. AB - Management of inflicted or self-inflicted trauma to accomplish homicide or suicide is no novelty in the practice of medicine. However, it takes an astute clinician to recognize serious poisoning in the midst of life-threatening injuries. We describe two cases where homicide and suicide attempts were accompanied with the ingestion of methanol. Both patients recovered with proper management of the injuries as well as early recognition and treatment of the methanol poisoning. PMID- 3814285 TI - Intravenous epinephrine abuse. AB - A 19-year-old man with a history of intravenous cocaine and amphetamine abuse injected 1.1 mg of epinephrine intravenously from an over-the-counter bronchodilator inhaler. Within seconds, headache, nausea, numbness of hands and feet, precordial chest discomfort, and palpitations developed. The patient was given a sublingual nitroglycerin tablet by a bystander and promptly had a syncopal episode. Hypotension was observed in the emergency department 10 minutes later. Administration of 2 L of Ringer's lactate maintained blood pressure at 80 90 mm Hg systolic. An electrocardiogram showed ischemic changes in the precordial leads. Cardiac enzymes remained normal. Mild hypokalemia and hyperglycemia were observed. This case illustrates an unusual route of abuse of an over-the-counter epinephrine bronchodilator. PMID- 3814286 TI - End organ flow: a prerequisite for resuscitation/reanimation. PMID- 3814287 TI - Interhospital transfer of emergency patients. PMID- 3814288 TI - Is advanced cardiac life support the standard of care? PMID- 3814289 TI - Effect of a simulated saturation dive to 31 ATA on pulmonary function. PMID- 3814290 TI - Evaluation of diving fins on the basis of physiological responses during incremental exercise. PMID- 3814291 TI - Relationship of lactate threshold and onset of blood lactate accumulation as determinants of endurance ability in untrained females. PMID- 3814292 TI - A comparison of lactate threshold and onset of blood lactate accumulation during two kinds of duration of incremental exercises. PMID- 3814293 TI - [An investigation on physique and physical fitness of children in an elementary school of Tokyo]. PMID- 3814294 TI - [Materials of the anaerobic threshold with special reference to nationality, sex, and age]. PMID- 3814295 TI - A quantitative analysis of the human bone marrow granulocytic cell lineage using the SAMBA 200 cell image processor. II. The blast cells in refractory anemia with an excess of blasts. AB - A quantitative image analysis of bone marrow blast cells from eight patients with refractory anemia with an excess of blast cells was performed using the SAMBA 200 cell image analyzer. A total of 33 parameters was computed on 665 cells visually classified as B1 blasts (agranular cells), B2 blasts (cells containing a few azurophilic granules) and B3 blasts (cells with numerous granules). The continuum of variation of some cytoplasmic parameters (area, hue and standard deviation of the luminance, hue and saturation histograms) and some nuclear parameters (area and convexity degree) from the B1 cells to the B3 cells indicated a concomitant cytoplasmic and nuclear maturation, with the B1 cells being the most immature. An attempt to automatically classify these cells using a stepwise linear discriminant analysis resulted in an average of 68% correctly classified cells at the fifth step. Among the B1 and B2 blast cells considered together, an unsupervised classification method distinguished seven subgroups of blasts, which were principally different in cytoplasmic area, cytoplasmic color and nuclear texture. The percentages of cells belonging to two of these subgroups were highly discriminatory with respect to the prognosis. These two cell types had morphologic, textural and color features that put them very near the normal immature myeloidlike progenitor cells and normal myeloblasts, as demonstrated by means of canonical analysis. All patients having a very low percentage of these two cells among their blast cells died from overt leukemia less than one year after the first diagnosis of their disease. PMID- 3814296 TI - Image cytometry in malignancy grading of breast cancer. Results in a prospective study with seven years of follow-up. AB - A fully automated system for image cytometry is presented. In combination with a special tumor sampling procedure, the system proved able to record with high reproducibility a large number of tumor cell population descriptors of high prognostic significance in a prospective study of breast cancer. These included the degree of abnormality of DNA distribution (strongly correlated with the proliferative rate) and some descriptors of shape and texture (strongly correlated with the grading system for breast cancer suggested by the World Health Organization). While the extreme complexity of a true malignancy grading system for breast cancer is underlined, the results of this study indicate that its creation is a possibility, given sufficient effort by interdisciplinary teams using modern sophisticated analytical techniques. PMID- 3814297 TI - The delineation of nuclear boundaries in microscopic images. AB - A semiautomatic procedure for tracking the boundaries of liver nuclei in digitized microscopic images of normally prepared biopsy material is described. The operator selects the nucleus, and a guided sequential search procedure tracks edge segments, which may subsequently be linked to produce a closed or partially open boundary, which is then accepted, completed or rejected by the user. PMID- 3814298 TI - Quantitative analysis of immunoglobulin-containing cells in gastrointestinal pathology. AB - The morphometric quantitative analysis of immunoglobulin-containing cells in gastrointestinal biopsies was explored as a possible additional parameter in making the histologic diagnosis of gastrointestinal diseases. Determination of immunoglobulin-containing cells was useful in the differential diagnosis of small intestinal disorders and may be useful in inflammatory diseases of the colon. However, before its general application in diagnosing inflammatory diseases of the colon can be advocated, prospective studies are necessary to determine the specificity and sensitivity of the quantitative analysis of immunoglobulin containing cells in individual cases of large bowel disease. PMID- 3814299 TI - Variation of surface density and other parameters in remodeling of trabecular bone in various conditions. AB - To appreciate the remodeling of the trabecular bone, the static morphometric parameters of surface density (SV(TRAB/BONE] and volumetric fraction (VV(TRAB/BONE] of cancellous bone were measured and compared to remodeling parameters, i.e., the surface extents of active/inactive resorption, active bone formation and nonmineralized bone. Iliac bone biopsies from 28 subjects with spasmophilia, osteoporosis and primary hyperparathyroidism were studied by means of a Nachet-France NS 2000 automatic image analyzer and a Zeiss ocular integrator; the results obtained in each group showed comparable values for the two methods (r = .8 for each group, with P less than .01). The remodeling parameters measured by means of the ocular integrator were compared with the variation measurements of the trabecular surface density, SV(TRAB/BONE). The correlation between the inactive osteoid surface and the coefficient of variation of the mean (CVM of SV(TRAB/BONE] on sections was significant for the three pathologic groups. The average mean values and standard errors of the mean of this latter parameter for the spasmophilia and hyperparathyroidic groups were, respectively, 0.063 +/- 0.008 and 0.092 +/- 0.012. Analysis of the experimental data shows that the simple global measurement of CVM (SV(TRAB/BONE] by means of an automatic image analyzer supplies information on the skeletal state during tissue remodeling. PMID- 3814300 TI - Morphometric investigation of the human thyroid gland. With special reference to the methods and to nontoxic goiter. AB - A study was carried out to (1) evaluate methods for the quantitative morphologic description of the human thyroid gland and (2) investigate the relationship between the morphology and the functional state of the gland in patients with nontoxic goiter. Analysis of sampling variance showed a high contribution of biologic variation between individuals, a low contribution from the variance within individuals and a negligible contribution from the stereologic procedure itself to the overall variation. The optimal numbers of sections per gland and fields of vision were found to be 2 and 17, respectively. The only constant relationship between the morphology and the functional state, either before or after resection, was a positive correlation between the epithelial cell volume left behind and the se-"free" thyroxine index 12 months postoperatively. It is concluded that quantitative morphologic description of the human thyroid gland is possible without being too time-consuming but that the value of such investigations is clinically doubtful in cases of nontoxic goiter. PMID- 3814301 TI - Morphometric and topologic analysis of freeze-fractured interphase nuclei. AB - Interphase rat liver nuclei were studied by freeze fracturing followed by electron microscopic observations. This method permits information on the native organization of the nuclear components in the hydrated state to be obtained. Morphometric analyses, performed with a Leitz Texture Analysis System, gave precise information on the different nuclear components, based on the histograms of their size distribution in heterochromatin, interchromatin and nucleolar areas. The textural characteristics were analyzed by computer to determine the topologic distribution of the solenoid chromatin fibers, the nucleosome filaments and the ribonucleoproteins in the different nuclear domains. PMID- 3814302 TI - Grading ovarian tumors. Evaluation of decision making by different pathologists. AB - Although grading of ovarian tumors is widely performed, the criteria for each grade are not well defined; as a result, pathologists tend to establish their own criteria without, however, assessing the actual predictive value of the criteria. In order to investigate this relationship, four gynecologic pathologists independently reviewed and carefully graded as benign, borderline or malignant (grade I, II or III) 40 "common" epithelial tumors of the ovary, without reference to clinical, prognostic or other findings. Intermediate grades were allowed. Subsequently, a subjective grading form was completed for each case; the form contained questions regarding the histologic and cytologic features. The sets of features with the biggest correlation with the tumor grades differed among the pathologists. This may indicate that the observers use different features in their grading processes. Moreover, the pathologist with the highest number (five) of significant microscopic features in the multivariate model had the lowest coefficient of correlation between his tumor grade and his feature set. The correlation coefficients for the other pathologists were quite similar, although the features used (no more than two or three) varied. The participants in the study felt that the methodologic approach had an educational value for them. Further investigations are required to evaluate whether the differences in the underlying decision making process also result in frank disagreement in ovarian tumor grading. PMID- 3814303 TI - Interpathologist and intrapathologist disagreement in ovarian tumor grading and typing. AB - In order to evaluate possible differences in the typing and grading of ovarian tumors, four different gynecologic pathologists independently evaluated slides from 198 patients. Histologic typing was done using the WHO recommendations, and the tumors were graded as benign, borderline or malignant (well, moderately or poorly differentiated). All of the slides were assessed twice by each pathologist (with approximately a 12-month time interval) in a "blind" fashion (i.e., without any knowledge about stage, treatment and clinical outcome). In addition to assessing interobserver agreement, the intraobserver consistency was evaluated by comparing the first and second assessments of the same pathologist. Histologic grading showed the best correlation between observers' results; however, the level of agreement was low. Complete agreement was rare, both in the first and second assessments (18.7% and 32.8%, respectively). Complete disagreement was rare, but occurred, both in the first and second assessments. Agreement in histologic typing was rather good after panel discussions; further analysis of the data revealed that the lack of agreement could not be attributed to any one of the pathologists in particular. The intraobserver agreement in grading and typing the same tumor differed. The number of cases with more than one grade difference between the first and second assessments varied from 0.5% to 3.2% between the different pathologists. Complete consistency was also varied: 87%, 78%, 64% and 62%. Histologic typing in general was less consistent, although some pathologists were better than others. The results indicate the need for objective criteria for grading ovarian tumors. PMID- 3814304 TI - Urinary tract morphometry. An overview. AB - An overview is presented of the application of morphometry to conditions in the urinary tract, with the work of a number of researchers briefly summarized. The data discussed show that morphometric techniques are already being successfully applied in the differential diagnosis and grading of some diseases of the prostate, urinary bladder and kidney. In the prostate, nonneoplastic changes can be differentiated from neoplasms and prostatic carcinomas can be more precisely graded. Both cytologic and histologic preparations of bladder carcinomas can be graded by morphometric techniques. Morphometry has found another application in assisting in the distinction between normal kidneys and those with "minimal change" disease. The specific criteria pertaining to the use of morphometric methods in each of these situations are also discussed. PMID- 3814305 TI - Algorithm for DNA-cytophotometric diagnosis and grading of malignancy. PMID- 3814306 TI - [Biophysical studies of blood products within the scope of the development of a blood component therapy program for surgical practice]. PMID- 3814307 TI - [Cardiovascular behavior in anesthesia induction using etomidate (Radenarcon)]. PMID- 3814308 TI - [Anesthesiologic problems in the surgical treatment of scoliosis using the Harrington technic]. PMID- 3814309 TI - [Open injuries of the heart--a case report]. PMID- 3814311 TI - [Causes of arterial hypertension in children and adolescents]. PMID- 3814310 TI - [Horner syndrome following percutaneous puncture of the internal jugular vein--a case report]. PMID- 3814312 TI - [Arterial hypertension in hospitalized children]. PMID- 3814313 TI - [Exchange transfusion in neonatal hyperbilirubinemia: complications and mortality]. PMID- 3814314 TI - [Inappropriate antidiuretic hormone secretion syndrome in children with purulent meningitis]. PMID- 3814315 TI - [Diphtheria outbreak in Yucatan. Preliminary investigation]. PMID- 3814316 TI - [The clinical problem of abnormalities of porphyrin metabolism]. PMID- 3814317 TI - [Laryngeal pseudo-papillomatosis of probable tuberculous origin in a preschool child]. PMID- 3814318 TI - [Norms for the treatment of acute infectious diarrhea]. PMID- 3814319 TI - [Should patients with idiopathic pulmonary hemosiderosis receive treatment or not?]. PMID- 3814320 TI - [New horizons in the diagnosis and prevention of viral hepatitis]. PMID- 3814321 TI - [Seroepidemiology of hepatitis A virus infection in communities of the southern border of the State of Chiapas]. PMID- 3814322 TI - [Does racemic epinephrine prevent post-extubation atelectasis?]. PMID- 3814323 TI - [Oligosaccharides and glycine in a new formulation for oral hydration. Experimental evaluation of absorption of water and sodium]. PMID- 3814324 TI - [Survey on the use of antibiotics in acute respiratory infections in the Mexican rural population]. PMID- 3814325 TI - [Ocular toxoplasmosis in children. Study of 33 cases]. PMID- 3814326 TI - [Somatometric study and psychomotor development of children recuperating from neonatal tetanus]. PMID- 3814327 TI - [Teratoma of the thyroid. First 2 cases studied in Costa Rica]. PMID- 3814328 TI - [Inappropriate antidiuretic hormone secretion syndrome]. PMID- 3814329 TI - [Infantile uncinariasis as a public health problem]. PMID- 3814330 TI - [Sensitivity and specificity of a neurologic screening test]. PMID- 3814331 TI - [Pelger-Huet anomaly. Cases in a Mexican family]. PMID- 3814332 TI - [Initial recovery from malnutrition using 2 different milk formulations]. PMID- 3814333 TI - [Management of the newborn infant with water-electrolyte imbalance using a pure oral rehydration solution]. PMID- 3814334 TI - [Thrombotic thrombocytopenic purpura: report of a case responding to plasma infusion]. PMID- 3814335 TI - [Abdominal angiostrongylosis. Clinical aspects, treatment and review of the literature]. PMID- 3814336 TI - [Psoas abscess in children]. PMID- 3814337 TI - [Molecular biology of Bordetella pertussis]. PMID- 3814338 TI - [Norms for the treatment of acute respiratory infections. Proposal for a protocol based on the syndromic diagnosis]. PMID- 3814339 TI - Lesions of the retrosplenial cortex produce deficits in reversal learning of the rabbit nictitating membrane response: implications for potential interactions between hippocampal and cerebellar brain systems. AB - The effect of bilateral lesions of the retrosplenial cortex on discrimination reversal learning of the rabbit nictitating membrane response was examined. Results showed that animals with such lesions were not impaired in their ability to acquire a cross-modality discrimination, but were severely impaired in their ability to reverse the discrimination once it was learned. All animals failed at the reversal phase of the task because they displayed high levels of conditioned responding to both the CS+ and the CS-. Thus bilateral damage to the retrosplenial cortex results in deficits in reversal learning that are highly similar to those observed after bilateral hippocampectomy. These findings are interpreted within a conceptual framework that characterizes multisynaptic projections from the hippocampus to the retrosplenial cortex, and ultimately to the cerebellum, as responsible for the behavioral expression of learning-related changes in hippocampal pyramidal cell activity. PMID- 3814340 TI - Persistence of visual cortex dendritic alterations induced by postweaning exposure to a "superenriched" environment in rats. AB - To assess the relative permanence of dendritic alterations induced by postweaning housing conditions, dendritic field parameters in the occipital cortex were compared among rats that had spent 30 days, beginning at 23-25 days of age, in a "superenriched" environment, rats that had the same treatment followed by 30 days of housing in individual cages, and rats that spent either 30 or 60 days in individual cages. The superenriched environment consisted of two large toy-filled cages, one containing water and one containing food, which were attached to opposite ends of a maze in which the pattern of barriers was changed daily. Aspinous stellate neurons of layer IV and pyramidal neurons of layer III both exhibited increases in total dendritic length and number of branches in response to superenriched environment exposure. In a factorial analysis of initial experience condition by age of subject, the consistent presence of experience effects combined with the relatively rare appearance of either age effects or interactions indicated that the dominant result was for the dendritic effects of the initial superenriched environment exposure to persist through the subsequent period of individual housing. PMID- 3814341 TI - Characterizing amnesic patients for neurobehavioral study. AB - During the past 100 years, neuropsychological testing of amnesic patients has provided a valuable method for learning about the structure and organization of normal memory. One complicating feature of this work is the fact that amnesic patients differ in terms of the pattern of their lesions and in terms of what damage is present in addition to the lesions that cause amnesia. Accordingly, as the questions asked of amnesic patients have become more sophisticated, it has become increasingly important in every group of study patients to obtain information about both the severity and the selectiveness of memory impairment. The present article considers the suitability of several memory tests and other cognitive tests for the purpose of characterizing amnesic patients. Data from these tests are presented for 10 amnesic patients (6 with Korsakoff's syndrome, 3 with amnesia owing to anoxia or ischemia, and case N.A.), who constitute our standing population of study patients, and for two control groups. Data from most of the tests are also presented for patients who were amnesic following bilateral electroconvulsive therapy. Neuropsychological descriptions of patients, which appear in the Subjects section of experimental articles, need to be expanded and standardized if published findings from one laboratory are to provide a foundation for work in other laboratories with different study patients. PMID- 3814342 TI - Classical conditioning of the rabbit eyelid response with a mossy-fiber stimulation CS: I. Pontine nuclei and middle cerebellar peduncle stimulation. AB - The nictitating membrane/eyelid responses of 18 rabbits were classically conditioned using cerebellar mossy-fiber stimulation as a conditioned stimulus (CS) and air puff as an unconditioned stimulus (US). The dorsolateral, lateral, and medial pontine nuclei and the middle cerebellar peduncle were effective stimulation-CS sites for training. In one group of rabbits, robust conditioned eyelid responses were produced with paired trials and subsequently extinguished with CS-alone and explicitly unpaired presentation of the CS and US. In a second group of rabbits, no conditioned responses were evident for 4 days of unpaired CS and US presentations. Conditioned responses did develop, however, after paired training was begun. Lesions of the interpositus nucleus of the cerebellum completely abolished the conditioned responses of a third group of rabbits overtrained with the mossy-fiber CS and air-puff US. These results support previous studies which have demonstrated that the cerebellum is critically involved in acquisition and retention of simple learned responses. In addition, the present results support previous theories of cerebellar function which have proposed that mossy fibers supply critical "learning" input to the cerebellum for acquisition and retention of motor skills. PMID- 3814343 TI - Effect of alcohol on behavioral and autonomic thermoregulation in mice. AB - Male, BALB/c mice were injected intraperitoneally with ethyl alcohol (ethanol) in dosages of 0, 0.03, 0.1, 0.3, 1.0, or 3.0 g/kg and then placed in a temperature gradient which permitted the measurement of preferred ambient temperature (Ta). The 3 g/kg dosage of ethanol resulted in a slight, but statistically equivocal, lowering of the preferred Ta during the first 30 min of placement in the gradient. A replication of this experiment using a higher sample size indicated that a 3 g/kg dosage of alcohol caused a statistically significant decrease in preferred Ta. In another experiment, BALB/c mice were treated with the aforementioned ethanol dosages while metabolic rate (MR), evaporative water loss (EWL), and colonic temperature were measured 60 min postinjection at Ta's of 20, 30, and 35 degrees C. At a Ta of 20 degrees C a dosage of 3 g/kg caused a significant decrease in MR, EWL, and colonic temperature. At a Ta of 30 degrees C this same dosage caused significant reduction in colonic temperature, however; at a Ta of 35 degrees C ethanol had no effect on these parameters. In conclusion, mice treated with a relatively large dose of ethanol will select a significantly cooler Ta, which is associated with hypothermia. These combined behavioral and autonomic thermoregulatory effects suggest that ethanol led to a decrease in the set-point body temperature. PMID- 3814344 TI - Influence of mouse genotype on responses of central biogenic amines to alcohol intoxication and aging. AB - Dopamine and serotonin responses to various periods of alcohol treatment have been followed in striatum and hippocampus of two inbred strains of mice and related to the effect of aging. A striking strain dependency was noted for chronic alcohol effects and also for senescence. For both neurotransmitters studied the C57Bl strain loses tolerance to prolonged alcohol injury earlier than the Balb/c strain. This loss of tolerance accompanying aging may be indicative of more widespread changes in CNS adaptability in this strain. The unequal capacity to adapt also appears to depend on the nervous structure and the neurotransmitter considered. Alcohol and aging induced changes are not identical. In a given mouse strain, significant effects of either drug or aging induced disturbances are noted. A similar molecular process could operate in both aging and alcohol abuse, but the neurochemical effect might depend on the nervous structure or neurotransmitter involved. Such a phenomenon may be the basis of differences in behavioral changes observed in alcoholics. PMID- 3814345 TI - Hypothalamic and serum catecholamines in ethanol and acetaldehyde treated guinea pigs. Relation to moderate short-term cold exposure. AB - Adult guinea-pigs were treated with ethanol (2.5 g/kg, IP) or acetaldehyde (100 mg/kg, IP) and exposed to moderate cold (+4 degrees C) for 50 minutes. Controls were given 0.9% NaCl solution. The hypothalamic catecholamines norepinephrine (NE) and dopamine (DA) and also norepinephrine and epinephrine (E) in the serum were analyzed by high-performance liquid chromatography with an electrochemical detector. Blood glucose, free fatty acids and glycogen in the liver and skeletal muscle were also measured. Acetaldehyde caused a similar drop in colon temperature as did ethanol, but neither could prevent cold-induced vasoconstriction in the ear lobe. Ethanol significantly reduced the concentration of NE in the hypothalamus compared to the controls. Acetaldehyde had a tendency to lower hypothalamic NE. There was no significant difference between drug treated groups in NE concentration. Neither ethanol nor acetaldehyde had any effect on hypothalamic DA. In the ethanol group serum E and glucose were significantly elevated compared to the acetaldehyde group. Serum glucose was also higher compared to the controls, and the difference in serum E concentration near the level of significance. No significant differences were found between the groups in serum NE, FFA or skeletal muscle and liver glycogen concentration. The results point to a possible central effect of ethanol during a short-term moderate cold exposure. The effects of acetaldehyde on neuronal tissue remain speculative, but a possible effect on noradrenergic neurons cannot be ruled out. Although the hypothermic effect of acetaldehyde corresponded that of ethanol, further experiments are required to elucidate the role of acetaldehyde in ethanol induced hypothermia. PMID- 3814346 TI - Ethanol polydipsic choice: effects of alternative fluid polydipsic history. AB - Two groups of rats drinking either 5% ethanol or 0.9% NaCl solution under a fixed time 1-min schedule of food pellet delivery became polydipsic during daily 3-hr sessions. When both fluids were made available to animals during sessions, strong side preferences typically developed so that neither fluid was preferred in spite of the fact that one group had a mild-to-moderate physical dependence on ethanol. The group that drank 0.9% NaCl solution initially failed to acquire a strong 5% ethanol polydipsia when this became the sole available fluid, and special procedures were required to induce an ethanol polydipsia comparable to that of the other group. Hence, a history of 0.9% NaCl solution polydipsia interfered with the institution of chronic, ethanol overdrinking in this group. Equal ethanol intakes were maintained in the groups when a compound solution consisting of 5% ethanol plus 0.9% NaCl solution was available along with a 5% ethanol choice. Whenever a 0.9% NaCl solution was presented in competition with either 5% ethanol or the compound 5% ethanol plus 0.9% NaCl solution, ethanol intake was reduced. Implications for the prevention and amelioration of human ethanol overdrinking are discussed. PMID- 3814347 TI - 1,4-Butanediol and ethanol compete for degradation in rat brain and liver in vitro. AB - We examined the enzymatic reaction responsible for the conversion of 1,4 butanediol to gamma-hydroxybutyric acid and the interaction of ethanol with this conversion in brain and liver. The enzyme responsible for this reaction in liver appears to be alcohol dehydrogenase. However, in both tissues, there was a competitive inhibition by ethanol of the conversion of 1,4 butanediol to gamma hydroxybutyric acid with an apparent Ki of 6.5 X 10(-3) M in brain and 2.7 X 10( 3) M in liver. These findings may explain the potentiation of the behavioral effects of ethanol by 1,4 butanediol. PMID- 3814348 TI - Individual difference in urinary excretion of salsolinol in alcoholic patients. AB - Urinary excretion of salsolinol (6,7-dihydroxy-1-methyl-1,2,3,4 tetrahydroisoquinoline) in 30 male alcoholic patients during the withdrawal period was determined. They were divided into two groups, i.e., Group A with 14 subjects had a high level of urinary salsolinol (51.9 +/- 40.8 ng/mg creatinine) on admission to a hospital, and Group B with 16 subjects showed a low level of the substance (3.9 +/- 1.9 ng/mg creatinine). Following a sustained drinking bout, urinary salsolinol in Group A declined to a normal level within a few days. We found that the subjects in Group A showed a greater excretion of urinary dopamine and norepinephrine than those in Group B. There were no differences between the two groups in levels of blood ethanol, serum GOT, GPT and gamma-GTP. PMID- 3814350 TI - Antagonism by naltrexone of voluntary alcohol selection in the chronically drinking macaque monkey. AB - An opiate receptor antagonist can reduce excessive alcohol drinking in the rat previously given intracerebroventricular (ICV) infusions of a tetrahydroisoquinoline. Recently, it was found that cerebrospinal fluid (CSF) obtained from volunteers or human patients and subsequently injected ICV in macaque monkeys markedly alters the voluntary consumption of ethyl alcohol in certain of these primates. The purpose of the present study was to determine whether an opioid antagonist would affect the pattern of alcohol intake in selected monkeys which drank excessive amounts of alcohol. Initially, the preferred concentration of alcohol was determined individually for each monkey which consistently drank from 3.0-6.0 g/kg alcohol per day. Subsequently, the single concentration, which ranged from 5-15%, was offered together with water during three consecutive periods as follows: (1) 4-day control baseline period; (2) a 3-day interval during which a saline control vehicle or 0.6 or 1.2 mg/kg naltrexone was administered subcutaneously at 0900 and 1700 hours; and (3) a final 4-day post-injection period during which the alcohol-water preference test was continued. The results showed that both doses of naltrexone significantly attenuated voluntary alcohol drinking up to 60% of the baseline intake during the 3 days of its administration. In two monkeys, alcohol drinking continued to be suppressed up to 50% of basal intake during all or a part of the 4-day post naltrexone interval. These findings suggest that an opiate receptor mechanism in the brain could be partially involved in the action of the chemical constituents of the human's CSF which serve to induce an abnormally high intake of alcohol in the infra-human primate. PMID- 3814349 TI - REM-sleep deprivation-induced increase in ethanol intake: role of brain monoaminergic neurons. AB - The ethanol intake of Long-Evans male rats was recorded before, during and after deprivation of rapid eye movement (REM) sleep produced with the flowerpot technique modified by using a cuff pedestal and electrified grid floor instead of water. Ethanol intake increased significantly during REM-sleep deprivation. A rebound decrease in ethanol drinking was then observed during the REM-rebound phase immediately after the termination of REM-sleep deprivation. Because REM sleep deprivation has been reported to impair the function of central monoamine neuronal systems and because some studies have implicated these systems in the control of voluntary ethanol intake, we studied whether different monoamine uptake blocking agents could antagonize the increase in ethanol intake caused by REM-sleep deprivation. After three days of REM-sleep deprivation, the rats were given uptake blocking agents for serotonin (citalopram, 5, 10 and 20 mg/kg/day, IP), dopamine (GBR 12909, 5 mg/kg/day, IP) and noradrenaline (talsupram, 1, 5 and 10 mg/kg/day, IP). Citalopram and GBR 12909 did not modify the increased level of ethanol intake, but talsupram decreased ethanol intake to the levels seen prior to deprivation, and during the REM-rebound phase amplified the decrease found. These effects of talsupram could be antagonized by blocking mg/kg/day, IP). Prazosin alone tended to increase ethanol consumption. These findings suggest that functional alterations in central noradrenergic neurons during REM-sleep deprivation may contribute to the concurrent increase in ethanol intake. PMID- 3814351 TI - Structure and function of eukaryotic chromosomes. 54th conference of the Gesellschaft fur Biologische Chemie. Tubingen, June 14th-16th, 1986. Abstracts. PMID- 3814352 TI - Molecular biology of the nervous system. Joint meeting of the Neurochemical Group of the Biochemical Society and the Study Group Neurochemistry of the Gesellschaft fur Biologische Chemie. Cambridge, U.K. 3rd-4th July, 1986. Abstracts. PMID- 3814353 TI - On the state of calcium ions in isolated rat liver mitochondria. V. Development of a rapidly dischargeable pool of mitochondrial calcium during calcium-induced transition. AB - Ruthenium red-induced calcium efflux from rat liver mitochondria is accelerated in the course of calcium-mediated mitochondrial transition. Analysis of the efflux patterns reveals biexponential kinetics consisting of the native slow phase preceded by a faster phase developing in the presence of calcium. The data are consistent with a progressive transformation of mitochondrial calcium into a rapidly dischargeable pool prior to spontaneous calcium release. Analysis of the efflux pattern is proposed as a method to discriminate between different mechanisms of modulation of ruthenium red-induced calcium efflux. Thus, it is shown that acetate, in contrast to phosphate, stimulates ruthenium red-induced calcium efflux due to the development of the rapidly dischargeable pool of calcium. PMID- 3814354 TI - The primary structure of the hemoglobin of the European Souslik (Citellus citellus, Rodentia). AB - The complete primary structures of two hemoglobin components of the European Souslik (Citellus citellus) are presented. The two hemoglobins have identical alpha-chains but differ in the amino-acid sequence of their beta-chains. The chain separation was achieved by chromatography on carboxymethyl-cellulose CM-52. Amino-acid sequences were established by automatic liquid-phase and gas-phase Edman degradation of the globin chains, of their tryptic peptides and of a peptide resulting from acidic hydrolysis of an Asp-Pro bond in the alpha-chain. The differences between the two beta-chains are manifested in three amino-acid exchanges. The sequences are compared with those of human and European Marmot hemoglobins. Only few differences were found among hemoglobins of C. citellus and other representatives of Sciuromorpha. PMID- 3814355 TI - Applications of light scattering in microbiology. AB - Applications of the three principal light scattering techniques of turbidimetry, differential light scattering, and quasi-elastic light scattering to systems of microorganisms are reviewed. The relation between the three techniques is demonstrated and it is shown how these techniques can yield basic structural, optical, and even hydrodynamic properties for a wide range of microorganisms, with particular emphasis on changes in such properties. Such applications include antibiotic susceptibility testing, the effects of inhibitors on trypanosome motility, spore structure, virus self-assembly, and bacterial motility on the surface of fermentation reactors. PMID- 3814356 TI - Monoclonal antibody against the catalytic subunit of bovine heart cAMP-dependent protein kinase and the application of enzyme purification. AB - A monoclonal antibody against the catalytic subunit of bovine heart cAMP dependent protein kinase has been prepared. The antibody, M73/PK1, belongs to the heavy-chain subclass IgG3 and has a titer of 20,480. Purified M73/PK1 was obtained by ammonium sulfate precipitation and Protein A-agarose affinity chromatography and was coupled to CNBr-activated Sepharose 6MB. The catalytic subunit was purified by this affinity column. A 75% yield and 4746-fold purification were obtained. These results show that this is a suitable and effective method for the purification of the catalytic subunit of bovine heart cAMP-dependent protein kinase. PMID- 3814357 TI - Characteristics and application of immobilized papain in a continuous-flow reactor. AB - Papain was immobilized on an anion-exchange resin by physical adsorption followed by cross-linking with glutaraldehyde. The activity and rate of heat inactivation of the enzyme was determined at 37 to 95 degrees C. Activity increased with an increase in temperature up to 85 degrees C, then decreased slightly at 95 degrees C. Activation of the enzyme by cysteine in 2 mM EDTA increased proportionally with an increase in concentration from 0.004 to 0.12 M. Levels of dissolved oxygen in solutions of EDTA containing cysteine in a closed system and with nitrogen purging in the absence of cysteine in an open system were monitored at 51 degrees C. Both the presence of cysteine and purging with nitrogen were effective in depleting dissolved oxygen. The final oxygen level was essentially independent of cysteine concentrations of 0.01, 0.02, and 0.10 M, and was reached in 95, 85, and 55 min, respectively. However, final levels of oxygen were dependent upon the flow rate of nitrogen from 1 to 10 SLPM and were reached within 15 min. Immobilized papain in a continuous-flow stirred-tank (300 rpm) reactor with a 4-liter reaction volume accompanied by nitrogen purging of 4 SPLM was used to hydrolyze a 1.5% casein solution in the presence of 0.01 M cysteine in 2 mM EDTA at 51 degrees C. The reaction rate was 1 liter/h and activity was measured based on the content of trichloroacetic acid-soluble protein in the outflow. Papain activity was not observed to decrease during a 30-h reaction period. PMID- 3814358 TI - Stability of membrane pores in hypotonically dialyzed erythrocytes: coencapsulation of different stokes radius probes can occur for at least 21 days in human erythrocytes. AB - Hypotonic dialysis of human erythrocytes results in porous cell stability for several days. Hypotonic cells stored for 1 week are essentially normal with respect to the preparation of carrier erythrocytes. Afterward, cells begin to irreversibly hemolyze resulting in decreased cell recoveries and decreased encapsulation percentages of two probes, sucrose and inulin. The holes generated by controlled hypotonic dialysis (100 mOsm/kg) are unlike the single rupture hole generated by dialysis to 10-20 mOsm/kg. The minimum pore size of resealed, annealed carrier cells is confirmed to be less than 5.2 A. PMID- 3814359 TI - Membrane pores in hypotonically dialyzed sheep erythrocytes remain open after three weeks of storage: entrapment of different stokes radius probes, [14C]sucrose and [3H]inulin. AB - Sheep carrier erythrocytes were prepared from dialyzed cells stored for 3 weeks. The initial pore size in freshly dialyzed cells exceeds the Stokes radius of that for hemoglobin. Hypotonically dialyzed erythrocytes are then very stable in a porous state. Two probes of different Stokes radius were used to determine the relative size of the pores. Sheep erythrocytes entrap inulin to a greater extent than sucrose, a much smaller molecule. With storage, a greater fraction of dialyzed cells become impermeable to inulin than to sucrose indicative of pore size greater than 5.2 less than 20 A. Since hemoglobin content did not change relative to storage, the pore size was less than the Stokes radius of hemoglobin. Pores generated by controlled hypotonic dialysis are unlike the single rupture pore found in erythrocyte ghosts. PMID- 3814360 TI - The cardiolipin antigen: chemistry and composition. AB - Cardiolipin, the primary lipid hapten in the antigen suspension used for the detection of antitreponemal antibodies in the sera of syphilitic patients, was successfully coupled to glucose oxidase, peroxidase, and some other enzymes using different crosslinking agents. These complexes were used to replace the pure uncomplexed cardiolipin for the preparation of the antigen suspension. When these suspensions were allowed to react with serum that contained anticardiolipin antibodies the activity of the enzyme was inhibited. In the absence of antibody, no enzyme inhibition was observed. PMID- 3814361 TI - [Documents and archives of quality control laboratory data in the pharmaceutical industry]. PMID- 3814362 TI - [Experiences with influence of the characteristics of drugs and type of excipient on drug release from suppositories]. PMID- 3814363 TI - [Spectrophotometric analysis of D-penicillamine and mercaptopropionylglycine in pharmaceutical formulations with ammonium tetrachloropalladate]. PMID- 3814364 TI - Plasma levels and metabolism of bendazac lysine salt in man. PMID- 3814365 TI - Bioavailability of amoxapine in experimental animals. PMID- 3814366 TI - Mandibular fractures. Their effect on growth and dentition. AB - Findings in 28 subjects having had childhood mandible fractures with long-term follow-up document asymmetric facial growth and dental abnormality in a high proportion. Facial growth abnormalities, five of which were moderate to severe, were detected by trained medical-dental examiners in 13 of the subjects (47%). Cephalometric abnormalities were detected in 18 (67%) of the 27 subjects so analyzed, with five (18%) meeting multiple roentgenographic criteria for abnormality. Frontal and lateral cephalometric abnormalities were found in nearly equal percentages among condylar-only, condylar-body, and noncondylar fracture groups, but abnormalities were most severe in association with the condylar injuries. The single best screening tool for facial abnormality was clinical examination. Frontal cephalometric roentgenograms correlated with clinical findings better than lateral cephalometric roentgenograms. However, roentgenograms alone had a 35% false-positive incidence of abnormality when correlated with the clinical-dental examination. Abnormalities of occlusion and dentition were seen in ten (36%) of the 28 subjects. Pterygoid muscle exercises following prolonged intermittent, nocturnal, intermaxillary fixation are discussed as a possible means to reduce the incidence of these abnormalities as the child matures. PMID- 3814367 TI - Open treatment of condylar fractures with biphase technique. AB - Most fractures of the condyle of the mandible are managed by closed reduction techniques. Commonly used methods include intermaxillary fixation with a natural dentition or with dentures or splints. Fixation for a variable period of time provides for union of the fragments. In patients in whom the condyle is badly displaced and/or the adjoining mandibular segment is unstable, open techniques are often applied. This article discusses the indications for surgery and presents a method of reducing and maintaining fixation with an external device. Although the approach requires a major surgical procedure and can potentially cause injury to the facial nerve, there is a decided advantage in the direct visualization of the reduction and immobilization of the fracture. Several cases are presented to demonstrate the method and result. PMID- 3814368 TI - Single-point stabilization of zygomatic fractures with the minicompression plate. AB - Unstable zygomatic fractures frequently require stabilization at two points. A new "mini" dynamic compression plating system designed specifically for zygomatic fractures permits single-point stabilization. We used a minicompression plating system with a series of patients at the University of Washington Affiliated Hospitals, Seattle. Satisfactory single-point stabilization of displaced zygomatic fractures was consistently achieved with this method. The plate and screws are substantially smaller than commonly used in mandibular fractures facilitating cosmetic concealment. There are theoretical advantages of this plating system as they apply to the unique geometry of the zygomatic fracture. PMID- 3814369 TI - The trapezius myocutaneous flap. Dependability and limitations. AB - Many reports of the trapezius myocutaneous flap have centered on a single form of the flap. However, three distinct myocutaneous segments, the superior, the lateral island, and the extended island flaps, can be harvested from the trapezius muscle and its overlying skin. Fifty-five patients underwent reconstruction for head and neck defects using 56 trapezius myocutaneous flaps consisting of 28 superior, 24 lateral island, and four extended island flaps. The four vascular supplies of the trapezius muscle are discussed, with emphasis on the variable nature of the transverse cervical and dorsal scapular arteries. Major complications developed in two of 28 superior, five of 24 lateral island, and one of four extended island flaps. The superior flap, although the most dependable, has the most limited range of application. Both the lateral and extended island flaps have a broader range of clinical application, but their usefulness may be limited by previous neck surgery or occult neoplasm in the neck, as well as by the variable vascular supply. Due to the above limitations, 30% of our attempts to utilize the lateral island flap had to be aborted at the time of surgery and an alternate means of reconstruction used. The trapezius myocutaneous flaps are excellent reconstructive tools for selected defects. PMID- 3814370 TI - Wound healing and the Shaw scalpel. AB - The Shaw heated scalpel is now widely used in head and neck surgery because it provides better hemostasis intraoperatively. Concerns persist over the immediate and long-term effects of this instrument on wound healing. This study compares heated and unheated Shaw scalpel incisions in the skin of 7-week-old piglets. Tensile strength measurements and histologic evaluations were made at frequent intervals up to nine weeks after incision. Histologic studies showed no differences in the two groups at any time in the study. Tensile strength of wounds was significantly less two weeks after incision in the Shaw scalpel group, but following that time, the wounds increased in strength, and by seven weeks, the two groups were equal in this respect. Thus, we conclude that the Shaw scalpel wounds in pigs are, ultimately, similar to standard scalpel wounds, although there is a period of diminished tensile strength. PMID- 3814371 TI - The treatment of orbital varicosities. AB - Varicosities or swollen veins of the periorbital temporal and frontal areas are uncommon except when tumor or inflammatory diseases involve the orbit. The recent surge of interest in cosmetic appearance has created a new concern in some patients about dilated veins of the periorbital area that have previously been considered normal. These engorged vessels are considered as cosmetic blemishes and thus present the physician with a problem. A new successful technique of electrothrombosis with an insulated 27-gauage needle is described, and the experience in three cases is discussed. PMID- 3814372 TI - 'Tissue clay'. A new technique for augmentation rhinoplasty. AB - A new technique for dorsal augmentation during rhinoplasty was utilized in 58 patients over a period of four years. Microfibrillar collagen (Avitene) was combined immediately before the operation with autogenous whole blood, forming a "tissue clay," which was then sculpted into the desired dorsal contour. Tissue clay solidifies after one week and becomes palpably similar to bone. Long standing results of four years have documented the ability of the substance to augment the nose up to 1 cm in height. There have been no complications to date, and the average resorption rate over a two- to four-year period was 16%. The esthetic and functional results in 58 cases were deemed excellent, safe, and effective. PMID- 3814373 TI - Management of xeroderma pigmentosum. AB - Xeroderma pigmentosum is an autosomal recessive disease associated with a defect in DNA repair from damage by ultraviolet light. It is characterized by the development of cutaneous malignancies in childhood and by death from the local or systemic complications thereof by the third decade of life. The head and the neck are the most frequently affected areas. Management involves sunlight avoidance and prompt biopsy of any new skin lesion. Due to the chronic nature of the disease, it is necessary to excise the least amount of tissue consistent with tumor removal in order to preserve skin for future procedures. In some patients, radiation therapy and/or certain chemotherapeutic agents are abnormally cytotoxic and must be utilized with caution. PMID- 3814374 TI - Reconstruction of nasal defects with a nasolabial island flap. AB - The superiorly based nasolabial island flap is a versatile method for reconstructing lower, mid, and upper nasal defects. Our technique and successful experience in eight consecutive cases are presented. Cadaver injection studies were performed and demonstrated the important contribution of the infraorbital artery to the blood supply of this flap. PMID- 3814375 TI - Far-advanced otosclerosis. Cochlear implantation vs stapedectomy. AB - In 1981, our group, as part of a Food and Drug Administration investigator team directed by William House, performed Illinois' first cochlear implantation. We have since performed cochlear implantations in ten other persons. Since May 1980, approximately 35 severely to profoundly deaf persons per year have been referred to our clinic for evaluation. A small number of these patients had far-advanced otosclerosis. In these cases, exploratory tympanotomy and stapedectomy followed by rehabilitation with a hearing aid was a more appropriate management than cochlear implantation. Case histories and a temporal bone study of far-advanced otosclerosis are presented. PMID- 3814376 TI - Tick-borne Borrelia infection in patients with Bell's palsy. AB - An enzyme-linked immunosorbent assay was applied to serum samples of 94 patients diagnosed as having Bell's palsy: they were studied throughout two consecutive years in an attempt to establish serologic evidence of a tick-borne spirochetal infection. A strain of Borrelia spirochetes, isolated from Swedish Ixodes ricinus ticks, was used as an antigen, and separate estimations of spirochetal IgG and IgM antibodies were made; serum samples with titers above the 95th-percentile level of 120 healthy individuals were considered positive. Thirteen percent of the patients' serum samples were IgG-positive, 3% were positive for IgM, and 3% were positive for both IgG and IgM. A twofold or greater increase of IgG titers was found in 6%. All the patients who were seropositive experienced the onset of palsy during the period from July to December. PMID- 3814377 TI - Blood transfusion and outcome in stage III head and neck carcinoma. AB - Treatment outcome was correlated retrospectively with blood transfusions received in 179 surgical patients with stage III squamous cell carcinoma of the head and neck. Seventy-three percent of patients requiring no blood transfusion survived three years with no evidence of disease (NED). By comparison, patients receiving 3 or 4 U of transfused blood experienced a 47% three-year NED survival. Patients receiving 5 U or more of blood perioperatively experienced a 40% two-year NED survival. Seventy patients underwent surgery and postoperative radiation therapy. Life-table analysis demonstrated statistically significant differences in survival for patients who received 2 U or fewer of blood when compared with patients who received more than 2 U. These differences were not present in patients having surgery subsequent to previous radiation therapy or surgery alone. Blood transfusion may be detrimental to the management of patients with malignant neoplasms. The mechanisms through which blood transfusion affects malignant neoplasm is unknown. PMID- 3814378 TI - Proximal large-bore jet ventilation for laryngeal laser surgery. AB - The carbon dioxide surgical laser has made many open upper airway operations obsolete. However, new laser-related hazards have been encountered, the most serious of which is fire in the airway. Venturi jet ventilation removes that risk and provides an unobstructed surgical field. Indications and techniques for the use of jet ventilation with carbon dioxide laser surgery remain controversial, particularly whether jet ventilation should be used in papillomatosis or in the severely obstructed airway, and whether proximal and distal catheter techniques are equally safe and effective. We report the successful use of proximal large bore Venturi jet ventilation in 327 consecutive patients undergoing microlaryngeal laser surgery. The technique is ideal for pediatric patients with subglottic stenosis or recurrent respiratory papillomas and has not caused distal seeding in the latter group. We recommend the use of low-pressure ventilation, even in relatively obstructed airways. The experimental evidence reported here corroborates the clinical viewpoint expressed; the technique is safe, simple, and uncomplicated if used with care. PMID- 3814379 TI - The temporal bone anomaly in CHARGE association. AB - Examination of the temporal bones from a patient with the CHARGE association revealed an unusual form of dysplasia. Mondini dysplasia of the pars inferior with complete absence of the pars superior was observed in both temporal bones. A review of the literature revealed four previous descriptions of this unique anomaly in patients whose clinical picture resembled the required components of CHARGE. On this basis, it is suggested that this anomaly represents a specific form of labyrinthine dysplasia which may be called the CHARGE dysplasia of the temporal bone. PMID- 3814380 TI - Migraine and sudden sensorineural hearing loss. AB - A 62-year-old woman developed recurrent episodes of sudden sensorineural hearing loss, occurring with migraine headaches. This is an unusual complication of migraine, which probably arises from a reversible vasoconstriction of the cochlear blood vessels. Pathogenesis of migraine and its variants are reviewed herein, along with the rationale of the modalities in its treatment. In this case, the patient's hearing improved after administration of ergot alkaloids, carbon dioxide/oxygen inhalations, and stellate ganglion blocks; it is not known whether this improvement represented therapeutic effect or spontaneous recovery. PMID- 3814381 TI - Toxicity of oral radiotherapy in patients with acquired immunodeficiency syndrome. AB - Although radiotherapy is a standard form of management of head and neck tumors, treatment of the oral cavity in patients who have the acquired immunodeficiency syndrome has produced unacceptable toxicity. Five such patients are described as a warning of enhanced toxicity of oral radiotherapy in this patient population. PMID- 3814382 TI - Acoustic impedance transformation. PMID- 3814383 TI - Pathologic quiz case 2. Plaque stage of mycosis fungoides. PMID- 3814384 TI - Pathologic quiz case 1. Epithelioid hemangioma (histiocytoid hemangioma, angiolymphoid hyperplasia with eosinophilia). PMID- 3814385 TI - Infection following uncontaminated head and neck surgery. AB - The efficacy of perioperative antibiotic administration during major head and neck surgery in which the wound is contaminated by saliva has been clearly established. This study was undertaken to ascertain the incidence of postoperative wound infection encountered in patients undergoing major head and neck surgery in which no contamination occurred. The records of 438 patients who had undergone parotidectomy, thyroidectomy, or submandibular gland excision were reviewed retrospectively. Eighty percent of the patients had received no perioperative antibiotic therapy. Infections developed in three (0.7%) patients during one month following surgery. One of these patients had received perioperative antibiotic prophylaxis. These data clearly demonstrate the non efficacy of antibiotics administered in patients undergoing parotidectomy, thyroidectomy, or submandibular gland excision when no infection exists prior to surgery. PMID- 3814386 TI - Treatment of scleroma with ceforanide. AB - Three patients with rhinoscleroma who presented with nasal and pharyngeal symptoms are described. Treatment with ceforanide, a new second-generation cephalosporin with high intrinsic activity against Klebsiella, and possessing a long half-life, was used as outpatient treatment. A total of 120 g of ceforanide was administered over a period of two months. All three patients showed signs of clinical improvement, but only two of three became bacteriologically sterile at the end of two months; one patient relapsed bacteriologically but not clinically, once the drug was discontinued. Second- and third-generation cephalosporins appear to have excellent activity against the causative pathogens of rhinoscleroma. Because of the impracticality of administering these agents parenterally over prolonged periods of time, there is a need for the development of an oral cephalosporin with similar intrinsic activity and beta-lactamase stability. Perhaps the novel beta-lactam antibiotics such as the penems and monobactams, some of which can be administered orally, will answer that need. PMID- 3814387 TI - Dynamics of eardrum changes following secretory otitis. A prospective study. AB - Children with secretory otitis who, during the period from 1970 through 1975, had been treated with adenoidectomy and insertion of ventilating tubes were reexamined three to eight years after treatment and, again, ten to 16 years after treatment. The changes of the tympanic membranes were analyzed with regard to the occurrence of attic retractions and changes of the pars tensa of the membranae tympani. At the first follow-up examination, varying degrees of attic retractions were found in 37% of ears and, at the second follow-up examination, in 27% of ears. This general improvement was mainly due to normalization of the slight retractions, whereas the frequency of severe retractions increased. Pathology of the pars tensa of the membranae tympani was found in 57% of ears at the first examination and comprised the following: tympanosclerosis (19%), tympanosclerosis and atrophy (10%), atrophy (22%), atrophy and pexi (3%), and adhesive otitis (3%). At the second follow-up examination, pathology of the pars tensa of the membranae tympani occurred in 58.05% of ears and was distributed as follows: tympanosclerosis (26%), atrophy and tympanosclerosis (11%), atrophy (14%), atrophy and pexi (5%), adhesive otitis (2%), and sinus cholesteatoma (0.5%). PMID- 3814388 TI - Pressures exerted by experimental cholesteatomas. AB - Previous studies have shown that transmitted pressure may be an important factor in the induction of osteoclastic bone resorption by cholesteatoma. However, the ability of cholesteatomas to actually exert pressure on adjacent structures has not been studied. Implantable pressure gauges were used to measure static pressure exerted by induced gerbilline cholesteatomas. Cholesteatomas were found to exert pressures between 1.31 mm Hg and 11.88 mm Hg. Osteoclastic bone resorption was observed in areas where the pressure gauge transmitted these pressures to bone. Thus, pressure exerted by an expanding cholesteatoma may be an important factor in the induction of osteoclastic bone resorption. PMID- 3814389 TI - Stapedial muscle electromyography in various diseases. AB - Stapedial muscle electromyograms (SEMGs), obtained by an averaging technique of electrocochleography, were studied in patients with various diseases. The latency of SEMG was prolonged in incomplete facial palsy (Bell's palsy and cerebellopontine angle tumor), with stapedial reflex (SR) of a small amplitude or without SR. In otitis media with effusion, in which SR could not be obtained, SEMGs were clearly observed and showed normal waveforms and latencies. In Meniere's disease and sensorineural hearing loss, SEMG waves had normal waveforms and latencies. These results indicate that the SEMG shows a normal waveform and latency when facial nerve function is intact, and that its latency is prolonged in incomplete paralysis of the facial nerve. PMID- 3814390 TI - Evidence of persistent viral infection in Meniere's disease. AB - Aspects of humoral and cell-mediated immunity that might characterize the continuation of symptoms in 25 patients with chronic Meniere's disease were examined. We found significant elevations of both humoral and cellular immune responses to viral antigens of herpes simplex I, varicella-zoster, rubella, and cytomegalovirus. Serum immunoglobulins were quantitatively abnormal in 24 of 25 patients, without a consistent pattern. These immune responses may be linked to persistent viral infection in chronic Meniere's disease. PMID- 3814391 TI - Volumetric analysis of the tympanic isthmus in human temporal bones. AB - A volumetric study on the tympanic isthmus and its relationship to temporal bone pneumatization was conducted in 110 serially sectioned temporal bones with and without middle ear pathology. With a microcomputer and digitizing tablet, the area of the tympanic isthmus and the degree of pneumatization in sample sections were calculated. Nonpathologic temporal bones showed a significant correlation between the volume of the tympanic isthmus and the degree of pneumatization. The narrowest area of the tympanic isthmus and the degree of pneumatization were also highly correlated. The result indicated a definite inhibition of pneumatization due to chronic middle ear infection when compared with nonpathologic temporal bones. PMID- 3814392 TI - Effects of size of the nasal airway on nasal airflow rate. AB - The controversy concerning the effects of nasal airway impairment on facial growth has stimulated renewed interest in upper airway respiratory function. We assessed the relationship between nasal airway patency and nasal airflow rate, using the pressure-flow technique to estimate nasal cross-sectional size and nasal airflow rate in 30 normal and 82 nasally impaired adults. Groups were categorized according to otolaryngologic examination results and pressure-flow measurements. The results clearly demonstrate that size of the airway influences airflow rate when the smallest nasal cross-sectional area is under 0.4 cm2. The data suggest that the nose becomes flow-limiting when it is less than 0.18 cm2. These data support our contention that nasal airway impairment in adults occurs when the airway is less than 0.4 cm2 in size. PMID- 3814393 TI - A classification system for maxillary sinus carcinoma. AB - A system of classification that reflects the site of origin within the sinus cavity is proposed for maxillary sinus carcinoma. Careful examination for areas of anesthesia or pain over the distribution of the various branches of the infraorbital nerve may localize the site of origin of the disease within the maxillary sinus. Early treatment can thus be provided, sometimes before the tumor can be identified radiologically. PMID- 3814394 TI - Androgen receptors in normal and neoplastic laryngeal tissue. AB - Androgen cytoplasmic (ARc) and nuclear (ARn) receptors were analyzed in normal and cancerous laryngeal tissue obtained from male and female patients. In men, neither ARc nor ARn were detectable in most of the normal larynx tissue specimens, while either ARc, ARn, or both were present in eight of 16 laryngeal carcinomas. In women, all three normal and two of four malignant laryngeal tissue specimens possessed ARc without ARn. The presence of androgen receptors in some laryngeal carcinomas shows that these tumors are possibly hormone sensitive, and hormonal therapy should be considered in treating these tumors. PMID- 3814395 TI - An experimental study of the circulation of the vocal fold on phonation. AB - The ischemic change of the vocal fold on phonation was studied with an oxygen electrode using the canine vocal fold. Oxygen pressures of a limited area of the vocal fold were measured in the lamina propria and vocal muscle at the middle of the membranous portion. The results are summarized as follows: oxygen pressure in each area decreased on phonation as compared with respiratory movement, an ischemic change of the vocal fold occurred on phonation, and the response in the lamina propria was less than that of the vocal muscle. PMID- 3814396 TI - Midline cervical cysts in children. Thyroglossal anomalies. AB - Deep, midline cervical cysts clinically diagnosed as thyroglossal duct cysts (TDCs), have been pathologically classified as dermoid cysts because of the presence of skin appendages and a squamous epithelial lining. In 75 midline cervical masses preoperatively diagnosed as TDC, we could classify only 54 as TDC, using the preexisting criteria of squamous or ciliated columnar epithelial lining associated with a tract or thyroid follicles. Eleven cysts were reclassified as dermoid, and six were called "mixed" because of features of both dermoid cysts (skin appendages) and TDC (epithelial tract or thyroid follicles). The morphological similarity of all these lesions suggests a common origin, perhaps from totipotential tissue entrapped during the descent of the embryonic thyroglossal duct from the base of the tongue. We conclude that these lesions should be grouped together under the eponym of "thyroglossal anomalies," and that treatment for all should consist of the Sistrunk procedure. PMID- 3814397 TI - Paraganglioma of the temporal bone in infancy. A congenital lesion? AB - Jugulotympanic glomus tumors have been called many things, but "paraganglioma of the temporal bone" is perhaps a more suitable term. This tumor is generally described as benign with a predilection for middle-aged women. Herein we report the case of an 11-month-old female infant with this condition. The extensiveness of the tumor with intracranial involvement at presentation suggests that the lesion might have been present for some time and raises the question of it being congenital in origin. We emphasize the overall importance of including paraganglioma of the temporal bone in the differential diagnosis of a "bleeding polyp" of the ear. PMID- 3814398 TI - The free greater omental flap for treatment of mandibular osteoradionecrosis. AB - Osteoradionecrosis can involve the mandible following radical irradiation for treatment of oral cavity cancer. The radionecrosis of the mandible is often associated with severe intractable pain, local or extensive deformity, including pathologic fracture, orocutaneous fistula formation, and frequent loss of function. Treatment has ranged from analgesia and antibiotics to hyperbaric oxygen treatments to local or extensive sequestrectomies with partial or total mandibulectomy and restoration of tissue losses with unirradiated tissue. To our knowledge, this is the first report of the successful use of a free greater omental flap for immediate treatment of mandibular osteoradionecrosis and concomitant reconstruction. We found the omentum to be an excellent vascular bed that rapidly resolved the osteoradionecrosis and pain, promoted healing, and restored mandibular function with minimal discomfort to the patient. PMID- 3814399 TI - Pathologic quiz case 2. Infected oncocytic cyst. PMID- 3814400 TI - Pathologic quiz case 1. Giant cell arteritis (temporal arteritis, cranial arteritis). PMID- 3814401 TI - Care of tracheoesophageal voice prostheses. PMID- 3814402 TI - Stapedotomy and better hearing results at 4000 Hz. PMID- 3814403 TI - Nasopharyngeal carcinoma and nasal allergy. PMID- 3814404 TI - Closure of septal perforations. PMID- 3814405 TI - Fusiform-shaped cells. PMID- 3814406 TI - In search of closure: subjective contour illusions, Gestalt completion tests, and implications. AB - This study investigates the construct validity of perceptual closure tests (CTs), and isolates a common processing demand from the right-hemisphere. Sixty-seven patients with focal unilateral lesions (34 right side, 33 left side), and 80 control subjects participated. Multivariate analyses indicated that there was substantial age-related variance in all CTs, while sex was variably significant; CTs are not uniform in their discriminating ability, and hence factorially complex; and their specifically right hemisphere-sensitive dimension was subjective contour illusions, and interestingly unrelated to facial discrimination ability. The methodological and theoretical implications are discussed. PMID- 3814407 TI - Hemisphere asymmetries, spelling ability, and classroom seating in fourth graders. AB - Fourth grade children (N = 159) from eight classes who were free to select their seating location in the classroom were tested for spelling ability. On 100 word spelling lists, the children (males and females) seated on the right side of the classroom (facing the teacher) were superior to children on the left. Analysis of spelling errors for reliance on phonological processing in a subsample (N = 28) revealed that right sitters made more phonetically inaccurate misspellings, whereas, on the left, females, but not males, committed more phonetically accurate misspellings. The results support the view that hemispheric information processing is correlated with classroom seating location or preference, but casual inferences regarding the neuropsychological mechanisms underlying these findings are unwarranted pending clarification of several major theoretical issues. PMID- 3814408 TI - Lateralized interference effects: evidence for a processing style by modality interaction. AB - A time-sharing paradigm was used to study potential interference effects of concurrent successive-auditory/vocal, successive-visual/motor, simultaneous auditory/vocal, and simultaneous-visual/motor tasks on right- and left-handed manual-motor behaviors of differential levels of difficulty. Participants were selected from each of three developmental levels from 9 through 20 years of age. Results suggested that processing style (i.e., successive or simultaneous) interacts with modality (i.e., auditory/vocal or visual/motor) in terms of lateralized interference effects; however, potential effects due to age level were obfuscated by differential concurrent-task difficulties. PMID- 3814409 TI - Volumetric asymmetries of the human brain: intellectual correlates. AB - Volumetric measures of the brain and ventricles were derived from CT films and related to intellectual variables from the Wechsler Adult Intelligence Scale (WAIS). Subjects were patients referred for neurological examination for headache or somatic complaints, sometimes accompanied by anxiety or dysphoric affect (N = 41), for whom a comprehensive neurological work-up revealed no evidence of abnormality. The asymmetry of hemispheric volume (left minus right over total, times 100) was correlated (r = .57, p less than .001) with Verbal IQ minus Performance IQ within subjects. No relationship was observed between total brain or hemispheric volumes and IQ scores. Brain and ventricular volumes were larger for the left hemisphere than the right. PMID- 3814410 TI - Dual task performance in children: generalized and lateralized effects of memory encoding upon the rate and variability of concurrent finger tapping. AB - Interference between concurrent tasks was used to investigate the brain basis of capacity limitations apparent when children encode information. Seventy-three right-handed children in Grades 1-4 engaged in speeded unilateral finger tapping while encoding a variable number of faces or numbers for subsequent recognition testing. With both face and number encoding, tapping rate decreased as memory load increased. Encoding numbers was more disruptive than encoding faces. Both encoding tasks slowed right-hand tapping more than left-hand tapping, relative to control tapping performance, but had only a bilateral effect on the variability of tapping. Although overall interference was less than that observed with a comparison task (i.e., speaking), the asymmetry of interference was comparable. The results suggest that cerebral lateralization for memory encoding, as well as for speech, is constant across the age range of 6-10 years. Findings regarding developmental change in overall capacity, however, are task specific: interference from speaking but not from memory encoding decreases with increasing age. PMID- 3814411 TI - The combining of multiple hemispheric resources in learning-disabled and skilled readers' recall of words: a test of three information-processing models. AB - Three theoretical models (additive, independence, maximum rule) that characterize and predict the influence of independent hemispheric resources on learning disabled and skilled readers' simultaneous processing were tested. Predictions related to word recall performance during simultaneous encoding conditions (dichotic listening task) were made from unilateral (dichotic listening task) presentations. The maximum rule model best characterized both ability groups in that simultaneous encoding produced no better recall than unilateral presentations. While the results support the hypothesis that both ability groups use similar processes in the combining of hemispheric resources (i.e., weak/dominant processing), ability group differences do occur in the coordination of such resources. PMID- 3814412 TI - Stimulus categorization by brain-damaged patients. AB - Patients with localized insult to the right hemisphere, or to either the anterior or the posterior portion of the left hemisphere, as well as neurologically intact controls, evaluated stimuli on a seven-point rating scale for their degree of category membership. The stimuli were taken from one of two continua, one composed of fruit and vegetable items, and the other of items differing in hue and shape. Different subsets of stimuli provided different contexts for the judgments of category membership. The two left-hemisphere groups showed anomalies in categorizing the fruit and vegetable items but not the perceptual items, while the reverse was true for the right-hemisphere patients. Moreover, both left hemisphere groups demonstrated context effects in their judgments of the representativeness of the fruit and vegetable items, but differed in the way in which they responded to changing contexts. Left posterior patients demonstrated weak category boundaries and even reclassified items. In contrast, patients with left anterior damage showed highly categorical responses and less differentiation of items within a category. All groups showed striking context effects in judgments of perceptual items in terms of changes in representativeness ratings and the location of a category boundary. Alternative interpretations of the results are offered. PMID- 3814413 TI - Backward masking of lateralized faces by noise, pattern, and spatial frequency. AB - Experiments 1 and 2 measured the critical interstimulus interval at which a face presented to the right or left visual field escaped a trailing noise, pattern, or spatial-frequency mask. The function relating target duration to critical ISI was multiplicative in the noise and spatial-frequency condition, but additive at longer durations in the pattern mask condition. An advantage of about 8 msec for the left visual field and 2 msec for the right field was found in the pattern and spatial-frequency masking condition, respectively. No consistent visual field differences were found in the noise mask condition. Taken together, these results suggest that hemispheric difference in face recognition are either absent or inconsistent at early, peripheral, energy-sensitive stages of processing, but emerge strongly at higher order central stages. The results also suggest that the left and right hemispheres are not differentially sensitive to the output of high and low-spatial-frequency channels, respectively. If it is assumed that the central face processor is functionally localized to the right hemisphere, one can infer from these results that interhemispheric transmission time is not greater than 8 msec, and the output of sensory analysis and/or relational features are transferred across the interhemispheric commissures. PMID- 3814414 TI - Hemispheric visual processing in face recognition. AB - Two experiments tested how facial details are used in recognizing face drawings presented to either the left or right visual field (VF). Subjects used inner and outer features about equally in both the left and right VFs. The major finding was a very strong tendency to recognize the upper facial features more accurately than the lower facial features. The top-to-bottom recognition difference occurred in both VFs, in contrast to an earlier study by J. Sergent (1982, Journal of Experimental Psychology: Human Perception and Performance, 8, 1-14). Methodological differences between the present experiments and Sergent's studies were discussed. It was concluded that both the left and right hemispheres recognize novel faces using top-to-bottom serial processing. PMID- 3814415 TI - The acquired immune deficiency syndrome: ocular findings and infection control guidelines. AB - The acquired immune deficiency syndrome (AIDS) is characterised by a loss of normal cellular immunity in affected individuals which predisposes them to severe opportunistic infections and neoplasms. These pathological processes may affect the eye, and ocular involvement with an opportunistic infection or malignancy may be the first clue to the presence of AIDS. This article reviews the ocular manifestations of AIDS and concludes with infection control guidelines for ophthalmologists treating patients with AIDS and related conditions. PMID- 3814416 TI - Bilateral diffuse melanocytic uveal tumours associated with systemic malignant neoplasm. AB - A case of bilateral diffuse melanocytic uveal tumours in a 34-year-old male in association with a systemic carcinoma is described clinically, by light microscopy and by transmission electron microscopy. Although the reports of such cases are extremely rare, they do not necessarily represent a new syndrome. PMID- 3814417 TI - Investigation and prognosis in the retinal pigment epitheliopathies. AB - Eighty-three patients with retinal pigment epitheliopathy have been identified from the photographic and fluorescein records of the Tennent Institute of Ophthalmology in Glasgow. Many have been brought back for follow-up assessment. Twenty-seven patients had placoid lesions, 22 geographic lesions and 15 a condition which we propose to rename the 'not ocular histoplasmosis' (NOH) syndrome. Patients with placoid lesions could be divided into typical acute multifocal placoid pigment epitheliopathy (AMPPE), where the long-term visual prognosis was poor because of recurrent disease leading to extensive areas of atrophy, and acute diffuse placoid pigment epitheliopathy which seemed to be self limiting. No consistent evidence of viral or immunological abnormality was found in either group of patients. Geographic lesions appeared to result either from a coalescence of focal lesions or from a slow (serpiginous) spread from a single focus. Four patients with helicoid atrophy lost central vision from disciform lesions. Seven patients had pigment epithelial disorder associated with sarcoidosis. The pigment epithelial disease was unresponsive to systemic corticosteroid therapy and tended to be complicated by disciform lesions. Disciform lesions may occur in any type of pigment epitheliopathy, as may serous retinal detachment or pigment epithelial detachment. A technique for the biopsy of choroid and retinal pigment epithelium is described. This may lead to a better understanding of these disorders. PMID- 3814418 TI - Congenital upper lid coloboma. AB - Twenty-two patients with congenital upper lid colobomas were assessed. Strabismus occurred in 13 cases and was associated with bands of fibrous tissue or adhesions, high refractive errors and opacities in the ocular media. A traction test is strongly recommended early in all children with congenital upper lid colobomas. A lateral cantholysis and direct closure was the commonest type of surgery, but unless the coloboma closed easily a lower lid rotation flap gave the best results. PMID- 3814419 TI - Trachoma: 1985 update in Western Australia. AB - Aboriginal preschool and school children were surveyed in the Eastern Goldfields Region and the Eastern Kimberley Region of Western Australia between 1979 and 1985. Statistics from these surveys show that there has been an apparent change in pattern of follicular trachoma since the National Trachoma and Eye Health Programme in some of the communities. The prevalence of follicular trachoma in the 0 to 9 year old age groups had declined from 26.4% in 1977 to 8.8% in 1984/1985 in the Eastern Goldfields and Red Centre combined (0.10 greater than p greater than 0.05). The prevalence reduction occurred in areas where there have been improvements in school hygiene and housing. The prevalence of cicatricial trachoma has also apparently declined from 65% in 1977 to 39% in 1985 in the Red Centre, from 39% in 1977 in the Eastern Goldfields to 21.7% in 1985, and from 58% in 1977 to 24.9% in 1985 in the Eastern Kimberley, Communities at risk were identified and recommendations made for frequency of continued screening, depending on age, distribution and location. PMID- 3814420 TI - Pilocarpine-induced movement of the trabecular mesh. AB - From geometrical considerations of the trabecular meshwork, ciliary muscle contraction has been predicted to produce an inward movement of the mesh. Goniophotographs taken under carefully controlled conditions before and after topical administration of pilocarpine showed a change in angle between cornea and mesh that is consistent with the predicted change. PMID- 3814421 TI - Twenty-two cases of clear cornea trabeculectomy. AB - The essential feature of clear cornea trabeculectomy is the use of a corneal approach, to create an intrascleral cleft communicating freely with the anterior chamber, without disturbing Tenon's tissue and conjunctiva. In this small series the procedure produced diffuse thick walled blebs with normalisation of intraocular pressure without medication in 11 eyes. This relatively poor result may be due to lack of the specialised instruments used by Cairns. The technique deserves further investigation. PMID- 3814422 TI - The vicryl tie technique for inserting a draining implant in the treatment of secondary glaucoma. AB - We have previously described surgical techniques for draining severe cases of secondary glaucoma by means of an artificial implant. Wherever possible these implants have been inserted in two stages. The technique involved suturing the episcleral plates of the implant to the sclera without connecting them to the chamber as the first procedure. Following this procedure the presence of the plates cause the surrounding tissue to form a thin fibrous envelope called a preformed bleb cavity. After a suitable interval of between six and eight weeks the connecting tube of the implant was inserted into the anterio chamber so as to drain aqueous into this preformed bleb cavity. This manoeuvre drastically reduced the incidence of postoperative hypotony and has proved a safe and effective technique. This communication reports an improvement on this technique in which the connecting tube of the implant is occluded by a ligature of 5-0 vicryl before inserting the tube into the anterior chamber through a fine needle puncture, at the same time as the episcleral plates of the implant are sutured to the sclera. The effect of this procedure is thus to prevent any drainage of aqueous until three to five weeks after operation when the vicryl suture material dissolves, allowing aqueous to drain into the preformed bleb system lined by a thin layer of dense fibrous tissue. This technique provides the advantages of the previous two stage technique without the need for a second operation. The surgical technique is described together with the results of treating a series of 20 eyes with severe secondary glaucoma. PMID- 3814423 TI - Congenital absence of the inferior rectus muscle. AB - A case of unilateral congenital absence of the inferior rectus muscle is presented. Absences of extraocular muscles, either singly or in combination, are rare, but isolated reports have been published. The abnormalities have been reported as occurring with increased frequency in craniofacial dysostoses, notably Crouzon's disease. In the case reported here, the abnormality was discovered during planned vertical muscle surgery for a large left hypertropia. Infraplacement of the horizontal recti was performed at a later date. Computerised axial tomography (CAT) scanning confirmed the absence of the inferior rectus. The embryogenesis of the extraocular muscles is briefly discussed. PMID- 3814424 TI - A hospital rental system for low vision aids. AB - Costly low vision aids are rented to patients by the Otago Hospital Board. Occupational therapists see the patients in the Low Vision Clinic and then as necessary in their homes. As a consequence accurate follow-up and analysis of the help provided by these aids is available. Patients with senile macular degeneration use telescopic reading aids for an average of 27 months after they are prescribed. PMID- 3814425 TI - Ten years' experience in low vision practice. AB - The Low Vision Clinic at the Palmerston North Hospital has now been operating for 10 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available. PMID- 3814426 TI - Efficacy of miconazole in experimental keratomycosis. AB - For the first time comparative efficacy of 1% miconazole in ointment base and drops has been evaluated against Candida, Aspergillus and Fusarium organisms in experimental keratomycosis. The findings of the present study reveal that miconazole in ointment drug delivery system has the advantage of being more effective in healing the fungal ulcers and associated lesions. It requires much less frequent application than drops, a parameter of great importance in improving patient compliance. Miconazole ointment was well tolerated by the rabbit eye and produced no ocular or systemic toxicity. The present study confirms that miconazole is a broad-spectrum antifungal agent and it could be a better alternative to presently available drugs to treat human keratomycosis. PMID- 3814427 TI - An unusual case of bull gore injury. AB - An unusual and hitherto unreported presentation of a bull gore injury sustained during harvest festival celebrations is described. The patient was seen with the metal horn cover complete with decorative ribbons impacted in his orbit. The injury had caused a blowout fracture of the orbital floor, and at surgery the globe was retrieved from the maxillary antrum. The development of optic atrophy precluded useful vision in the injured eye. PMID- 3814428 TI - Intravitreal angiostrongyliasis. AB - A case of intravitreal angiostrongyliasis is reported in a Thai female who had eaten raw snails. After immobilising the worm by use of an intravitreal cryoprobe it was successfully removed via the pars plana with vitreous foreign body forceps. PMID- 3814429 TI - A short history of ophthalmic laser. PMID- 3814430 TI - Amiodarone hydrochloride. PMID- 3814431 TI - [A case of dural arteriovenous malformation with bilateral thalamic infarction]. AB - A 59-year-old man was admitted because of frequent vomiting and obtundation in February 1982. Neurological examination on admission revealed only slight impairment of consciousness. Papilledema, meningeal irritation sign and paralysis were not elicited. The plain CT scan was normal, but the CT scan with contrast material showed patchy enhancement in the left temporal lobe and around the third ventricle. Cerebral angiography showed a dural arteriovenous malformation (dural AVM) in the left transverse sinus fed by the left occipital artery, and the retrograde flow into the straight sinus. By the third day following admission, the level of consciousness became alert. The patient did not complain of headache, bruit and visual disturbance. He showed mild disorientation and memory disturbance. But his ordinary daily-living was independent. In August 1982, the patient gradually became inactive and apathetic. At times he lay in bed with moving his eyes, swallowing foods. At other times, he lay in bed with closing his eyes, immobile, and unresponsive except to strong painful stimuli. The patient was incontinent and required nursing care. During three month periods, the patient progressively became somnolent, speechless and immobile. Eventually, he was in a state of akinetic mutism. The patient became unresponsive. The state of consciousness fluctuated within a narrow range. The pupils were isocoric and did not react to light. He sometimes moved his eyes horizontally, but the vertical eye movement was limited. Deep tendon reflexes were hyperactive with Babinski reflex bilaterally. Passive mobilization of extremities revealed hypertonic. The CT scan disclosed the bilateral symmetrical infarction of the thalamus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814432 TI - [The normal range of cerebral atrophy during aging: statistical analysis of 500 normal subjects]. AB - We previously reported the newly developed quantitative measurement of the cerebral atrophy (pixel count method), and advocated the value CCR (CSF-cranial ratio) as the index of the volumetric measurement of the cerebral atrophy. As the pixel count method is somewhat troublesome, we tried to compare the various linear measurement methods with pixel count method by means of multivariant analysis, and reported a single formula to calculate CCR from the linear measurement methods. Now we studied 500 normal subjects using the pixel count method and examined the normal range of the cerebral atrophy during aging by means of the maximum likelihood method. The normal range was estimated as follows; 0.32 less than y less than 5.78 (t less than 48), 0.068 t--2.944 less than y less than 0.368 t--11.884 (t greater than 48). Using these formula and this newly reported normal range, we can easily predict whether the cerebral atrophy is pathological or not. PMID- 3814433 TI - [Auditory evoked brain stem responses in patients with normal pressure hydrocephalus following subarachnoid hemorrhage and elderly dementia]. AB - There have been many reports that had discussed the effectiveness of shunt surgery in dementia patients. But it is not always reliable to predict such effectiveness before the operation. We used auditory evoked brain stem responses (ABR) to investigate the degree of brain damage in normal pressure hydrocephalus (NPH) and predict the effectiveness of shunt surgery. Fifteen patients with subarachnoid hemorrhage were divided into three groups, 5 cases without any symptoms of NPH, 6 cases with one of three symptoms of NPH and 4 cases with full blown symptoms of NPH which improved after shunt surgery, it is NPH. Eleven cases of aged patients were classified into two groups, Elderly normal (6 cases) and Elderly dementia (5 cases) groups, Younger normal group was composed of 8 healthy persons. Interpeak latencies (IPL's) on ABR was used as indexes of evaluating brain stem function, I-V IPL was used as central transmission time (CTT). CTT of Younger normal group and Elderly normal group were not different. It showed that CTT was a reliable parameter of ABR independently of age. There was significant prolongation of CTT in the patients of NPH and Elderly dementia group in comparison with other groups, However between them significant differences were not present. We concluded that there was some degree of brain stem dysfunction in the patients of NPH as well as dementia patients suggesting one aspect of the pathogenesis of NPH. But we could not distinguish the patients of NPH from other dementia patients by the analysis of ABR. PMID- 3814434 TI - [Alexia with agraphia produced by localized infarction in the inferior posterior region of the left temporal lobe]. AB - There have been several reports on alexia with agraphia due to hemorrhage or trauma in the inferior posterior region of the left temporal lobe since Yamadori (1982) first reported a case of cerebral hemorrhage. We presented the first case of alexia with agraphia due to a circumscribed infarct in the inferior posterior region of the left temporal lobe. A 65-year-old right-handed man had an acute onset of inability to read Japanese "kana" letters and to write any letters. He had no difficulty in speaking or understanding. Neurological examination on admission was normal except for homonymous quadrantanopia in the right upper field. Neuropsychological findings: Spontaneous speech was fluent without dysprosody. There were no disturbances in auditory understanding or in repetition. He could read Japanese "kanji" characters correctly, however, he could not read any "kana" letters. Writing was also disturbed severely even as to his address, name or telephone number. Calculation was also difficult. There were no disturbances in naming colors, no ideomotor or constructional apraxia nor visual agnosia. X-ray computed tomography (CT) scan showed a faint low density area with ring enhancement suggesting a cerebral infarct in the inferior posterior region of the left temporal lobe. Patient's hospital course was characterized by a marked improvement of alexia, especially of "kana" letters as compared with that of "kanji" characters. Dissociative improvement of alexia compared with agraphia in this case could be explained by the fact that the lesion was in close contact with the occipital lobe and that he also had pure alexia in the early stage. PMID- 3814435 TI - [Short latency somatosensory evoked potentials in patients with syringomyelia]. AB - Short latency somatosensory evoked potentials (SSEPs) following median nerve and posterior tibial nerve stimulation were studied in six patients with syringomyelia. Three patients had Chiari malformations, two patients experienced fracture of the spine and one patient had a cauda equina ependymoma. SSEPs following median nerve stimulation were abnormal in all patients, of which five patients showed abnormal SSEPs only in the unilateral stimulation on the side of sensory deficits. SSEPs obtained from three out of eight upper extremities which showed no disturbance of deep sensation, were abnormal, so SSEPs were able to detect subclinical abnormality indicating dorsal column dysfunction. Abnormal patterns of SSEPs were classified in three types as follows; Type 1: disappearance of P13, N16 and N18 (3 cases), Type 2: the prolonged interpeak latency P11-P13 (2 cases), and Type 3: abnormal N16 and N18 with preserving P13 (1 case with Chiari malformation). P9 and P11 were present without prolonged latencies in all cases. SSEPs following posterior tibial nerve stimulation were abnormal in two of the three tested patients. Those two patients had disturbance of deep sensations in the lower extremities. All patients underwent surgical treatment, syringo-peritoneal shunt in four patients, foramen magnum decompression with syringo-subarachnoid shunt in one patient, and total removal of an ependymoma of the cauda equina with syringotomy in one patient. Postoperative neurological improvement were found in three patients, of which two cases also showed improvement in SSEPs. On the contrary SSEPs were unchanged in two patients with posttraumatic syringomyelia, whose postoperative neurological condition was also unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814436 TI - [Local cerebral blood flow and glucose metabolism in experimental meningeal carcinomatosis]. AB - Patients with meningeal carcinomatosis often evolve signs of impairment in higher mental function. Yet, common findings of histological observation are only a sheet of tumor cells on the cortical surface, and no intracerebral mass are noted. To elucidate mechanism of mental disturbances in meningeal carcinomatosis, local cerebral blood flow and glucose metabolism were evaluated in a model of experimental meningeal carcinomatosis. Viable cells (1 X 10(4) of Walker 256 tumor were inoculated into cisterna magna of Wistar rats. Animals were used for autoradiographic study at 1 to 12 days after tumor inoculation. Local cerebral glucose utilization (LCGU) and local cerebral blood flow (LCBF) were measured with quantitative autoradiographic technique using 14C-iodoantipyrine and 14C deoxyglucose as a tracer, respectively. In the early stage of tumor growth (1 to 3 days after tumor inoculation), reduction of LCGU was averaged to be 31% in the cerebral cortex and 28% in the deep structures, whereas reduction of LCBF was 28% in cerebral cortex and 19% in deep structures on average. In the late stage of tumor growth (4 to 12 days after tumor inoculation), average reduction of LCGU was 57% in the cerebral cortex and 47% in the deep structures. On the other hand, reduction of LCBF was averaged to be 42% in the cerebral cortex and 38% in the deep structures in the late stage of the disease. Reduction of LCGU and LCBF was especially evident in the sensory cortices such as parietal cortex, visual cortex and auditory cortex, and in the auditory centers of the brain stem such as medial geniculate body and inferior colliculus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814437 TI - [Effects of FO-1561 on postischemic cerebral functional and metabolic recovery in experimental cerebral ischemia]. AB - Effects of S-adenosyl-L-methionine sulfate tosylate (FO-1561) on postischemic cerebral functional and metabolic recovery in experimental cerebral ischemia were investigated. Severe bilateral forebrain ischemia in rats was induced by four vessel occlusion with reducing the mean arterial pressure to 100-110 mmHg. After forebrain ischemia had been maintained for 30 minutes, recirculation was started by removal of the arterial clamps of bilateral common carotid arteries and by increasing systemic arterial pressure to the preischemic level. The EEG was continuously recorded from gold-coated screws inserted bilaterally in the parietal bones with the tips in extradural position, against a reference inserted prefrontal bone. Analysis of power spectrum of EEG activity was done by Berg Fourier Analyser. The brains were frozen in situ with liquid nitrogen before, during and after ischemia and then chiselled out during irrigation with liquid nitrogen. Concentrations of ATP in brain tissue were determined with high performance liquid chromatography. FO-1561, 100 mg/kg, was given intravenously, immediately after recirculation. After recirculation there was a tendency that EEG power spectrum in FO-1561-treated animals contained higher percentage of beta wave compared to that in control animals, while delta wave was lesser in FO-1561 treated animals. At 90 minutes following recirculation, ATP level in control animals was 2.17 +/- 0.05 mumol/g (mean +/- SE) and 2.42 +/- 0.03 mumol/g (mean +/- SE) in FO-1561-treated animals. Thus, recovery of ATP level was significantly better in FO-1561-treated animals than in control animals (p less than 0.01). PMID- 3814438 TI - [The effect of hyperglycemia on ischemic brain damage: relevance to the local cerebral blood flow]. AB - The effect of hyperglycemia on ischemic brain damage in rats was studied by measuring the local cerebral blood flow (LCBF) using a transient middle artery (MCA) occlusion model. Rats, fasted except for water for 12-16 hours, were used. They were anesthetized with halothane and the stem of the left MCA was occluded for 2 hours by a microclip. Reperfusion was performed by removal of the clip. The rats were awaken from anesthesia after removal of the clip. Hyperglycemia was induced by intraperitoneal injection of 50% glucose and same volume of 50% D mannitol or physiological saline were injected intraperitoneally 20 minutes before MCA occlusion in control rats. LCBF was measured by quantitative autoradiography using 14C-iodoantipyrine 2 hours after clipping and 2 hours after reperfusion. Some rats were prepared for neuropathological observation 72 hours after reperfusion. In hyperglycemic rats, plasma glucose concentration rose to over 500 mg/dl at the peak. A hyperglycemic state around 300 mg/dl was maintained during the experiments. Elevation of hematocrit and plasma osmolarity to the same degree were observed in both hyperglycemic and mannitol pretreated rats. On histological study ischemic neuronal cell damage was found to be more extensive in hyperglycemic rats than in the saline pretreated rats. At 2 hours after MCA occlusion, LCBF in the ischemic focus decreased significantly in hyperglycemic rats compared with the control. The reduction of LCBF was observed also in the contralateral non-ischemic side (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814439 TI - [Cerebral amyloid angiopathy in senile dementia--a comparison between senile dementia and Alzheimer disease]. AB - The brain was examined neuropathologically in 16 elderly patients with severe dementia (8 cases of senile dementia, 5 of vascular dementia and 3 of combined senile-vascular dementia), focussing an attention on amyloid angiopathy and and other senile changes. The findings were compared with the results obtained in 10 cases of Alzheimer disease described previously. Amyloid angiopathy was noted in all cases of senile dementia and its distribution was similar to that of Alzheimer disease. The frequency of cerebral amyloid angiopathy in elderly patients with severe dementia was more closely related to disease than to age. One patient each with senile dementia and combined senile-vascular dementia showed markedly advanced amyloid angiopathy. The cases who showed other senile changes (e. g., senile plaque, Alzheimer neurofibrillary tangle, nerve cell deciduation) were frequently seen in patients with Alzheimer disease than in those with senile dementia. Further, there was a tendency that the brain weight was lighter in patients with Alzheimer disease than in those with senile dementia. PMID- 3814440 TI - [Study of cerebral blood flow in patients with cerebral infarction by 133Xe inhalation method--comparison between affected and unaffected hemispheres, and sequential changes]. AB - Cerebral blood flow in both hemispheres was studied by the 133Xe inhalation method in 49 patients with cerebral infarction in the unilateral hemisphere. They were classified into three groups by computed tomographic findings as follows; relatively large low density lesion including the cerebral cortex and subcortex (cortical: C group), relatively large low density lesion including the subcortical white matter and basal ganglia (large subcortical: L group), and small low density lesion including the subcortical white matter (small subcortical: S group), respectively. Mean cerebral blood flow (mCBF) in the affected hemispheres was markedly low in C group, moderately low in L group, and slightly low in S group, in all of the examinations. Several cases in C and L groups revealed remarkable changes of mCBF less than one month after the onset. MCBF in both hemispheres was lower in C group than in L and S groups less than one week after the onset. Seven to twelve weeks after the onset, mCBF in the affected hemisphere was lower in C and L groups than in S group, and than in the unaffected hemisphere of C and L groups. There was no difference between mCBF in the affected hemisphere and that in the unaffected hemisphere in most of S group. Sequential changes of mCBF in both hemispheres were divided into seven types in 27 cases, who were examined first less than one week and repeatedly then. However, the sequential changes were classified roughly into two patterns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814441 TI - [A case of pleomorphic xanthoastrocytoma]. AB - A case of pleomorphic xanthoastrocytoma (Kepes) is reported. This patient was a 12-year-old boy with a history of convulsive seizure. Neurological examination on admission showed no abnormality. Plain CT scan revealed a well defined low density area with calcification in the right frontal lobe. A part of peripheral portion of low density area were well enhanced with contrast media. At operation, there was a cyst containing xanthochromic fluid in the right frontal lobe. A part of cyst well near the cerebral surface was reddish hard. Total removal of nodular tumor and subtotal removal of the cyst wall were performed. He has been doing well for these 3 years following craniotomy and has no deficit without CT evidence of recurrent tumor. Histologically the tumor cells displayed marked pleomorohism. However either necrosis or mitosis were not seen. Frequently these cells had vacuolated or foamy cytoplasm. There were many of the giant cells and multinucleated cells. In some area, these tumor cells were surrounded by a fine network of reticulin fibers. Electron microscopically the tumor cells were occasionally filled with glial filament and lipid granules were seen. Immunoperoxidase technique revealed GFAP in the cytoplasm of the tumor cells. This case was considered to be pleomorphic xanthoastrocytoma first proposed by Kepes. PMID- 3814443 TI - [A case of Pick's disease with long duration--an extraordinary cerebral change in the fore part of cerebrum]. AB - An autopsied case of Pick's disease, having an extraordinary cerebral change in the anterior portion of Lobus frontalis and temporalis, was reported. Our case is a 71 year-old woman at death with a fourteen year history of chronic progressive dementia and mental deterioration, and it may be stressed that the existence lasted 8 years, over the latter half of clinical course, was depended on the tube feeding. The first symptoms suddenly appeared in 1964, 2 months after her husband's death of illness, when she was 57. She prepared the table for breakfast late at night, calculated wrongly in her domestic account book, and stole foods in the grocery. Two years later, her illness was diagnosed as presenile dementia by characteristic personality change and marked dilatation of anterior horn of lateral ventriculus. On admission to National Musashi Sanatorium, three years after the first symptoms' appearance, she presented restless walking, insomnia, memory loss, weakness of concentration, and high degree of disorientation. Particularly, it was noticeable that she behaved with bizzare contact. After 1970, tube feeding was introduced continuously, because of swallowing difficulty. Death occurred in July 1978 from a general weakness and a broncho-pneumonia, 14 years after the onset of the first symptoms. Autopsy revealed small and atrophied brain weighed 820 g. Cerebral cortical atrophy extended to frontal, temporal, insular, and parietal lobes, but right T-1 was relatively well preserved. On section, frontal and temporal ventriculus were remarkably enlarged and caudate nuclei were extremely atrophic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814442 TI - [Treatable ischemic neuronal damage in the gerbil hippocampus]. AB - The Mongolian gerbil is known to develop delayed neuronal death in the hippocampus following brief forebrain ischemia (Brain Res 239: 57-69). Morphological, biochemical, or electrophysiological studies on this neuronal injury have shown that neurons still retain potential reversibility at the earlier period of alteration. To examine this possibility, immediately following 5 min of ischemia in the gerbil, pentobarbital, diazepam, or nizofenone was injected. Seven days following ischemic insult, animals were perfusion fixed and neuronal density in the hippocampal CA1 subfield was counted. Most of the neurons in the CA1 sector survived ischemic insult when a drug was given, whereas most of them were lost without the treatment. The average neuronal density of treated groups showed a statistically significant (p less than 0.01) persistence compared with that of control group. The effective dosage of the drugs were 20-40 mg/kg in pentobarbital, 10-20 mg/kg in diazepam, and 12.5-25 mg/kg in nizofenone. On the other hand, when pentobarbital was injected 1 hr following ischemia, while neurons still remain intact morphologically, it showed no effect. This result indicates that the neuronal damage of "delayed neuronal death" type is reversible if treatment is instituted at an early period of cell change. PMID- 3814444 TI - [Chronic toluene intoxication and hyperkinesie volitionnelle]. AB - Hyperkinesie volitionnelle is one of the involuntary movements discriminated from intention tremor. It occurs idiopathically and with cerebral infarction, head trauma, brain tumors, multiple sclerosis, hepatolenticular degeneration and polyneuropathy. Here, we report a case of toluene intoxication presenting hyperkinesie volitionnelle. A 28-year-old painter noticed a tremor of the upper extremities on December 1979. The tremor occurred both in posture and in voluntary movements. The tremor gradually developed and appeared in the legs in May 1980. Slight titubation of the trunk and head was marked in sitting posture. He showed staggering of gait. On August 1980, he exhibited slurred speech. He was admitted to the Department of Neurology of Chiba University Hospital on January 19th, 1981. Neurological examination revealed slight mental deterioration, pendular nystagmus, bradylalia, 4-5 c/s violent postural tremor of the upper extremities, action myoclonus, head and truncal titubation, mild leg tremor in sitting posture. The tremor increased terminally on finger to nose testing, and showed fast, coarse, convulsive movement (movement oppositionniste). But there was no dysmetria. The involuntary movements, above mentioned, were summarized as hyperkinesie volitionnelle. Muscle tone was hypotonic. Muscle weakness and atrophy were not seen. Deep tendon reflexes were all exaggerated, but there was no pathological reflex. He showed wide-based ataxic gait. Sensory and autonomic functions were normal. Blood, urine and cerebrospinal fluid analysis appeared normal. Electroencephalography showed 40-50 microV, 9-10 c/s alpha waves with a few fast waves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814445 TI - [Central nervous system toxicity of carmofur, an antineoplastic drug]. PMID- 3814446 TI - Increased cardiac electrical instability concomitant with pacing induced repolarisation abnormalities. AB - The relation between the occurrence of repolarisation abnormalities after right ventricular pacing and spontaneous arrhythmias was investigated in 16 patients in whom the sick sinus syndrome was suspected. All patients had normal QRS complexes and T waves in the electrocardiogram before pacing and required atrial stimulation and His bundle recording for diagnostic purposes. Patients were randomised into a study group or a control group. In the eight patients in the study group right ventricular pacing was performed for 12 hours, and was followed by inversion of the T wave in surface leads II, III, aVF, and V2-V5 and lengthening of the QTc interval. The frequency and complexity of ventricular arrhythmias increased after pacing in six patients who had ventricular extrasystoles in the baseline Holter recording. As the configuration of the T wave became normal the frequency of ventricular extrasystoles returned to baseline values. In the control group of eight patients ventricular pacing was not performed after the electrophysiological study and no changes were seen in T wave configuration and in the frequency of spontaneous arrhythmias. These results suggest that the post-pacing repolarisation abnormalities reflect abnormal electrical properties of the ventricle and that in some cases they lead to increased electrical instability. PMID- 3814447 TI - Factors influencing survival and mode of death in severe chronic ischaemic cardiac failure. AB - An evaluation of factors which may influence survival and mode of death was conducted over a three year period in a consecutive series of 50 patients with severe chronic ischaemic cardiac failure for more than three months. At the initial assessment all patients were already receiving intensive medical treatment. During follow up four patients successfully underwent cardiac surgery and medical treatment was modified in most patients, with four patients receiving antiarrhythmic drugs. Twenty six patients died: 17 suddenly within one hour of onset of symptoms and nine of progressive cardiac failure. The mortality by one year was 26% and by two years it was 62%. Comparison of those who survived with those who died within one year of follow up showed that a very low left ventricular ejection fraction, severe ventricular arrhythmias, the presence of gallop rhythm, and New York Heart Association class IV were the variables that predicted mortality. By two years left ventricular ejection fraction, ventricular arrhythmias, and pulmonary capillary wedge pressure were the variables that were significantly different in survivors and patients who died. No differences were found in any of the recorded variables between those who died suddenly and those who did not. Thus in patients with chronic ischaemic cardiac failure determination of the left ventricular ejection fraction and the severity of ventricular arrhythmia on the ambulatory electrocardiogram are the best ways to predict prognosis. The presence of gallop rhythm and New York Heart Association class IV status predict early death. PMID- 3814448 TI - Importance of angina for development of collateral circulation. AB - The extent of collateral circulation in 46 patients who had intracoronary thrombolysis within six hours of the onset of acute myocardial infarction was evaluated. Patients who had had a previous myocardial infarction (4 cases) or who had spontaneously recanalized infarct related coronary arteries (5 cases) were excluded from the analysis. Collateral development was graded during coronary cineangiography according to the extent of opacification of the collateral and epicardial arteries distal to the site of occlusion (collateral index 0 to 3). Angina was considered to be present before myocardial infarction if it had occurred more than one week before acute myocardial infarction. Collateral channels were visible in only two of 19 patients without angina before infarction and nine of the 18 patients with angina before infarction. The prevalence of angina and the collateral index were not significantly influenced by the extent of coronary vessel disease. It is concluded that myocardial ischaemia is important in promoting collateral development in man as well as in laboratory animals. PMID- 3814449 TI - Diurnal variation in left ventricular function: a study of patients with myocardial ischaemia, syndrome X, and of normal controls. AB - Angina can occur in the early morning. The mechanism of this is unclear and both haemodynamic changes and coronary artery spasm may be important. The purpose of this study was to investigate the diurnal variation in pulmonary artery diastolic pressure (an indirect measure of left ventricular filling pressure) in six normal subjects, 18 patients with coronary artery disease, five with variant angina, and six with syndrome X. A transducer tipped catheter and a simple recording system were used to record ambulatory pulmonary artery diastolic pressure for 24 hours. Variation in pulmonary artery diastolic pressure was related to the timing of episodes of ST segment depression and elevation by simultaneously recording a frequency modulated electrocardiogram. Episodes of ST segment change occurred predominantly in the early morning (midnight to 6 am) in variant angina (eight out of 14 episodes) whereas in syndrome X all episodes were recorded during the day. In coronary artery disease both painful and painless episodes were distributed throughout the day, with 10 out of 67 episodes occurring between midnight and 6 am. A similar diurnal variation in pulmonary artery diastolic pressure was seen in the groups--that is, values were low during the day and higher at night, with the maximum values between midnight and 6 am. The 24 hour median pulmonary artery diastolic pressure was higher in patients with coronary artery disease than in the control group and those with syndrome X. The finding that pulmonary artery diastolic pressure, and therefore left ventricular end diastolic pressure, is greatest in the early morning may represent the background haemodynamic state in which other factors lead to myocardial ischaemia during these hours. PMID- 3814451 TI - Pulsed Doppler echocardiographic evaluation of neonatal circulatory changes. AB - Pulsed Doppler echocardiograms were obtained from 42 normal fullterm neonates at less than 12 hours (20 subjects), 4 days (20 subjects), and 33 days (12 subjects). The acceleration time of the flow velocity and ventricular systolic time intervals were measured on recordings obtained at the right and left ventricular outflow tract, and the patency of the ductus arteriosus was evaluated by the flow at the pulmonary end of the ductus. The flow velocity pattern of the right ventricular outflow tract changed from a triangular shape with a peak velocity in early systole in the younger age groups to a dome-like contour with a peak velocity in mid-systole; thus the ratio of mean acceleration time to right ventricular ejection time increased with age. The flow velocity pattern of the left ventricular outflow tract was triangular in all age groups, and the ratio of mean acceleration time to left ventricular ejection time showed no significant change with age. The right ventricular pre-ejection period shortened and the right ventricular ejection time lengthened with age; thus the ratio of mean right ventricular pre-ejection period to right ventricular ejection time decreased with age. The left ventricular systolic time intervals showed no significant change with age. The ductus arteriosus was patent in all subjects who were less than 12 hours old but was closed in the older neonates. Pulsed Doppler echocardiography is a valuable method of evaluating pulmonary vascular bed in the early neonatal period. PMID- 3814450 TI - Left ventricular function at similar heart rates during tachycardia induced by exercise and atrial pacing: an echocardiographic study. AB - M mode echocardiography was used in 10 normal subjects to study left ventricular dimension and function variables at identical heart rates during tachycardia induced by supine bicycle exercise or atrial pacing. Echocardiographic data were analysed independently by two observers. The maximum heart rate reached during atrial pacing was lower (mean (1SD) 148 (17) beats/min) than that reached during exercise (mean (1SD) 167 (14) beats/min). The left ventricular end diastolic dimension was greater before supine exercise than before atrial pacing, probably as a result of leg raising. At each graded exercise step the end diastolic dimension remained greater than during atrial pacing and the differences became progressively greater with increasing heart rates. The left ventricular end systolic dimension was not significantly different at each step during the two stresses. During recovery the end systolic dimension was significantly smaller after exercise than at corresponding heart rates induced by atrial pacing. Left ventricular function indices--fractional shortening and peak rates of left ventricular systolic and diastolic dimensional change--were significantly higher during exercise than during atrial pacing and the differences increased with heart rate. It is concluded that the intervention used to change heart rate has an important effect on M mode echocardiographic left ventricular dimensions; indices of left ventricular performance increase progressively during exercise and differ from those measured at the same heart rate during atrial pacing; it is important to consider heart rate, stroke volume, and loading conditions when reference values are used and when the effects of a particular stress are to be interpreted. PMID- 3814452 TI - Dilated cardiomyopathy associated with haemolytic uraemic syndrome. AB - In two children with the haemolytic uraemic syndrome dilated cardiomyopathy occurred in the absence of hypertension, or fluid or electrolyte disturbance. These cases presented with acute left ventricular failure. Echocardiography showed left ventricular dilatation and reduced contractility. There was also ventricular wall thickening, which persisted. Twelve other children with haemolytic uraemic syndrome had prospective echocardiography. Eleven of them showed no evidence of cardiomyopathy and in one transient dilatation and reduced contractility developed without clinical signs. Dilated cardiomyopathy is a rare but important extrarenal manifestation of the haemolytic uraemic syndrome and is best demonstrated by echocardiography. PMID- 3814453 TI - Reversed offsetting of the septal attachments of the atrioventricular valves and Ebstein's malformation of the morphologically mitral valve. AB - Ebstein's anomaly of the tricuspid valve is characterised by downstream displacement of the tricuspid leaflets. In the case of the septal leaflet, the result is exaggerated offsetting of the atrioventricular valves. Thus it might be supposed that in Ebstein's anomaly of the mitral valve, downstream displacement of the aortic (septal) leaflet of the mitral valve could move its attachment beyond that of the tricuspid valve, resulting in reversed offsetting. To examine this hypothesis three patients each with a concordant atrioventricular connection were studied. The first, with Marfan's syndrome and without an abnormal mitral valve, had reversed offsetting shown by echocardiography. The second, without Marfan's syndrome and with Ebstein's anomaly of the mitral valve, showed echocardiographically normal offsetting but a displaced mural leaflet. The third, in whom Ebstein's anomaly of the mitral valve was confirmed at necropsy, showed all the features of the second case, with normal offsetting of the atrioventricular valves. Thus reversed offsetting is not a feature of Ebstein's anomaly of the mitral valve and in the first case this feature was caused by upward displacement of the tricuspid valve secondary to dilation of the aortic root. PMID- 3814454 TI - The British Cardiac Society Working Group on Coronary Prevention: conclusions and recommendations. PMID- 3814455 TI - Transient shock and myocardial impairment caused by phaeochromocytoma crisis. AB - A patient admitted to hospital after injury to the abdomen was found to have transient hypertension which was followed by profound hypotension. ST elevation developed and extensive myocardial akinesia was seen at echocardiography, but coronary angiograms at this stage were normal. After treatment with intravenous fluids and dopamine he progressively recovered normal cardiac function. A partly necrotic catecholamine secreting tumour was later removed from the abdomen and it is likely that a kick to the abdomen had damaged the tumour and the consequent release of catecholamine had triggered a phaeochromocytoma crisis. PMID- 3814456 TI - Pulmonary regurgitation in transposition of the great arteries. AB - A female infant who presented with cyanosis and tachypnoea was found to have transposition of the great arteries, a ductus arteriosus, and a ventricular septal defect. An aortogram showed evidence of mild pulmonary regurgitation, which persisted after a Senning's operation; this is a hitherto unrecognised clinical finding. PMID- 3814457 TI - A rare variant of common arterial trunk. AB - A 13 day old baby was admitted to hospital with multiple abnormalities, increasing cyanosis, and cardiac failure. Cardiac catheterisation was performed on the day of admission and he died shortly after the procedure. A rare variant of common arterial trunk, in which the pulmonary arteries arose directly from the underside of the aortic arch, was found at necropsy. PMID- 3814458 TI - Atrial fibrillation precipitated by tyramine containing foods. AB - Episodes of atrial fibrillation that occurred after meals developed in a 60 year old man with a history of ischaemic heart disease. The attacks were precipitated by precursors and metabolites of tyramine and tyramine containing foods and drinks, in the absence of monoamine oxidase inhibitors. The patient has remained free of atrial fibrillation for the past twelve months on a diet that does not contain tyramine. PMID- 3814459 TI - Reversibility of primary pulmonary hypertension during six years of treatment with oral diazoxide. AB - A 32 year old woman presented with a syncopal attack and dyspnoea on exertion. A diagnosis of primary pulmonary hypertension was confirmed by clinical examination, cardiac catheterisation, and pulmonary angiography. Her symptoms resolved completely with oral diazoxide and the pulmonary arterial pressure was reduced to normal levels over a period of six years. When diazoxide was discontinued on two separate occasions pulmonary hypertension recurred. This demonstrated the continued presence of the underlying stimulus for vasoconstriction. PMID- 3814460 TI - The disposition of amodiaquine in man after oral administration. AB - A method is described for the simultaneous determination of amodiaquine (AQ) and desethylamodiaquine (AQm) in plasma, urine, whole blood and packed red cells. After oral administration of AQ (600 mg) to seven healthy subjects, absorption of AQ was rapid, reaching peak concentrations in plasma, whole blood, and packed cells at 0.5 +/- 0.03, 0.5 +/- 0.1 and 0.5 +/- 0.1 h respectively (mean +/- s.e. mean). The apparent terminal half-life of AQ was 5.2 +/- 1.7 h. AQ was detectable for no longer than 8 h. AQ underwent rapid conversion to AQm, which reached peak concentrations in plasma, whole blood and packed cells at 3.4 +/- 0.8, 2.3 +/- 0.5 and 3.6 +/- 1.1 h respectively. AQm was still detectable at the end of the sampling period (96 h) when the plasma concentration was 29 +/- 8 ng ml-1. The area under the plasma concentration vs time curve (AUC(0, infinity] for AQ was 154 +/- 38 ng ml-1 h; the corresponding value for AQm was 8037 +/- 1383 ng ml-1 h. There were no significant differences in the values for AUC of AQ between plasma, whole blood, or packed cells. The whole blood to plasma concentration ratio for AQm was 3.1 +/- 0.2, and the AUC (0.24) for AQm in whole blood (6811 +/ 752 ng ml-1 h) was significantly greater than that in plasma (2304 +/- 371 ng ml 1 h), P less than 0.001. The recovery of AQm from urine collected 0-24 h was 6.8 +/- 0.8 mg (n = 6).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814461 TI - Quantitative and qualitative binding characteristics of disopyramide in serum from patients with decreased renal and hepatic function. AB - Protein binding of disopyramide, binding capacities, affinity constants and serum concentrations of alpha 1-acid glycoprotein (AAG) were studied in five groups of patients. A: young healthy volunteers (n = 8); B: elderly patients with minor symptoms of ischaemic heart disease (n = 9); C: patients with cirrhosis of the liver and normal values of coagulation factors (II, VII and X), albumin and immunoglobulin G (n = 8); D: patients with cirrhosis and at least two abnormal of the previously mentioned values (n = 9) and E: eleven patients with severely impaired renal function. Subfractions of AAG (Fr1, Fr2 and Fr3) were determined by affinoimmunoelectrophoresis. AAG concentration was significantly (P less than 0.005) elevated in group E patients and decreased (P less than 0.025) in group D patients. Fr2 is probably associated with the high affinity, first binding site of disopyramide to AAG. Earlier observations of a reduced qualitative binding of disopyramide in patients with cirrhosis can be explained by a significant decrease in Fr2 (P less than 0.001) in group D patients. The protein binding of disopyramide in patients with uraemia was significantly increased due to a significant (P less than 0.005) increase in AAG concentration in spite of a smaller (P less than 0.025) affinity constant. Suggestions for therapeutic drug monitoring based on total serum concentrations are given. PMID- 3814462 TI - Nimodipine disposition and haemodynamic effects in patients with cirrhosis and age-matched controls. AB - Six biopsy proven cirrhotics and five age-matched controls (mean 55.3 vs 52.4 years) were randomly given single 60 mg p.o. and 30 mg s.l. doses of nimodipine. Serum concentrations and blood pressure were measured regularly over the subsequent 24 h period. The clearance of nimodipine was reduced in the patients with cirrhosis. Apparent oral clearance of nimodipine in the cirrhotic group was significantly lower than that observed in the normal group (187 +/- 163 l h-1 vs 469.6 +/- 198.4 l h-1, P less than 0.01). There were no significant changes in mean arterial pressure (MAP) in the normal subjects. There were, however, significant reductions in MAP following oral nimodipine in the cirrhotics. These reductions were significantly related to nimodipine concentrations in individual patients (P less than 0.05). PMID- 3814464 TI - Conclusiveness of rechallenge in the interpretation of adverse drug reactions. AB - We here consider the extent to which the presumed correlation between an adverse event and the administration of a particular drug can be reinforced by rechallenge. At first question of terminology is: what is a rechallenge? Rechallenge is often accepted too readily as proof of a causal relationship and clinical examples give illustrations of common misinterpretations. Definitions are proposed to characterize: the outcome of rechallenge; the conditions under which rechallenge is performed. In discussing causality, a sharp distinction is drawn between the outcome per se and the establishment of a causal relationship. Finally, the simple concepts proposed here should permit to establish a typology of rechallenge and to assess, by further experimental or retrospective research, the conclusiveness of rechallenge in interpreting adverse drug reactions. PMID- 3814463 TI - The effects of naproxen and sulindac on renal function and their interaction with hydrochlorothiazide and piretanide in man. AB - We have studied the effect of a single dose challenge of naproxen (500 mg) and sulindac (200 mg) on renal function in five volunteers, and the effect of a single dose challenge of the thiazide, hydrochlorothiazide (100 mg), and loop diuretic, piretanide (6 mg) on renal function when the diuretics were given alone or when superimposed on chronic therapy of either naproxen or sulindac. None of the nonsteroidal anti-inflammatory drug (NSAID) or diuretic exposures significantly influenced glomerular filtration rate, as measured by creatinine clearance. Over the first 4 h of the study, both naproxen and sulindac reduced fractional excretion of sodium by approximately 50%. Sulindac also caused a significant uricosuria whilst naproxen promoted urate retention. Similar changes were observed over 8 h. Superimposition of either hydrochlorothiazide or piretanide on top of chronic sulindac therapy resulted in a blunting of the natriuresis by approximately 30% compared to when these diuretics were given alone: the action of the diuretics was unchanged by naproxen. Sulindac pretreatment did not alter the urinary excretion of either hydrochlorothiazide or piretanide; naproxen did not alter hydrochlorothiazide excretion. On the basis of these findings, it is concluded that NSAIDs exert direct tubular effects that do not necessarily interfere with the delivery of diuretics to their sites of action within the nephron. PMID- 3814465 TI - Accumulation of caffeine in healthy volunteers treated with furafylline. AB - The pharmacokinetics and tolerance of repeated oral doses of furafylline were investigated in normal volunteers. In accord with predictions from single dose studies, steady state was achieved on the first day following the administration of 90 mg and maintained by subsequent daily doses of 30 mg. When corrected for body weight there were no significant differences in minimum and maximum plateau levels of furafylline between males (1.2-2.0 micrograms ml-1; mean body weight 67.2 kg) and females (1.6-2.6 micrograms ml-1; mean body weight 54.9 kg). The half-life of elimination was less when the plasma concentration was lower than 600 ng ml-1 than during the stationary phase of treatment. Despite constant plasma levels the repeated administration of furafylline appeared to be associated with the onset of adverse xanthine-like side effects, a finding which was subsequently traced to the presence of, and possible synergism with, accumulating serum levels of caffeine in those volunteers drinking caffeine containing beverages. Subsequent studies showed that a single dose (90 mg) of furafylline results in a rapid accumulation of caffeine given orally (100 mg twice daily) and that this is accompanied by an elimination half-life of some 50 h and an abrupt decrease in metabolite levels. The furafylline-induced accumulation of caffeine was not influenced by the smoking habits of the subjects, implying that the metabolite pathway blocked by furafylline is the demethylation of caffeine in position 3, an implication confirmed by the reduced formation of paraxanthine. This demonstration of an unacceptable level of adverse side effects resulting from a potent inhibiting effect of furafylline on the metabolism of a normal dietary constituent has obvious implications in the interpretation of drug-induced toxicity. PMID- 3814466 TI - Estimating the clearance of amylobarbitone from a single plasma measurement. AB - Amylobarbitone sodium (200 mg) was given by intravenous injection to nine healthy, young adults (four males). Subjects were drug-free and nonsmokers. Serial blood samples were drawn for 48 h following the infusion, and multiple sample and single sample estimates of clearance were calculated. The mean (+/- s.d.) values for clearance (CL) and apparent volume of distribution (V) were 0.032 (+/- 0.007) 1 h-1 kg-1 and 1.08 (+/- 0.16) 1 kg-1, respectively. The mean (+/- s.d.) single sample estimate of clearance, CL, based on just the 48 h plasma concentrations of amylobarbitone was 0.033 (+/- 0.006) 1 h-1 kg-1. The 48 h single sample CL value was shown to reliably reflect the value of CL with little bias and good precision. Values of the 48 h CL when compared to CL exhibited a mean prediction error (mpe) of 1.2% with 95% confidence limits of -6.3% to 9.4%, and a root mean squared error (rmse) of 9.4%. It is concluded that amylobarbitone's clearance can be estimated in a single dose, single sample protocol permitting its use as a single dose, single sample probe for studying host factor influences on drug metabolism. PMID- 3814467 TI - Nefopam excretion in human milk. AB - Human milk and plasma samples were obtained from five healthy nursing mothers who were taking nefopam hydrochloride (60 mg four-hourly) for post-episiotomy pain. Concentrations of nefopam were quantified in milk and plasma paired samples, taken daily from birth for 5 days, by a specific paired-ion reverse phase h.p.l.c. method. Although nefopam was present in human milk in an equivalent concentration to plasma (milk: plasma ratio 1.2 +/- 0.7, mean +/- s.d.), the likely infant exposure was less than 0.05 mg kg-1 day-1 which, on a body weight basis, would be less than 3% of the maternal dose. PMID- 3814468 TI - Torsion of the testis: a new risk factor for testicular cancer. PMID- 3814469 TI - DNA flow cytometric study of 5-fluorouracil used to treat end stage non-Hodgkin's lymphoma. PMID- 3814470 TI - Proliferative lesions in the livers of mice treated 18 months previously with cisplatin. PMID- 3814471 TI - Immunity to a syngeneic sarcoma induced in rats by dendritic lymph cells exposed to the tumour either in vivo or in vitro. AB - Rats were prepared surgically so that peripheral intestinal lymph could be collected from them while a syngeneic tumour (the HSN sarcoma) was growing in each major Peyer's patch of the small intestine. Dendritic lymph cells were isolated from the lymph and injected i.p. into naive, syngeneic rats. Each of the 16 recipients received just under 10(6) such cells and was challenged 10 days later with a subcutaneous dose of 10(4) viable HSN cells. Six weeks after this challenge only 7 of the recipients had a tumour and these were small (mean weight 1.8 g), while 17 controls (which had each been treated with 10(6) thoracic duct lymphocytes from the same donors, and given the same challenge) all had large tumours (mean weight 8.8 g). The remaining 9 test rats were still free of tumours when they were killed and autopsied 4 months after challenge. Dendritic lymph cells from normal rats were 'sensitised' by incubating them overnight on a monolayer of HSN cells. They were then transferred to 5 naive recipients which received the usual challenge. Six weeks later they all had tumours (mean weight 1.3 g) but these were much smaller than those in the 5 controls (mean weight 9.3 g). PMID- 3814472 TI - Location of T-cell leukaemia cells in a model rat system by means of a fluorescent probe. AB - Fluorescence probes for the active centre of an enzyme associated with tumour cells have been used to locate leukaemia cells in a model rat system. These fluorescent techniques are inexpensive and rapid to carry out. The leukaemic cells can be located by fluorescence microscopy in frozen sections, wax embedded sections and resin embedded sections. The technique is illustrated with reference to sections of leukaemic rat kidney, epididymis and testis. These studies confirm earlier histological findings employing conventional staining techniques and have the advantage that individual leukaemia cells can be detected in leukaemic animals undergoing drug therapy. The evidence suggests that these techniques will be of value in further studies of the design of drugs directed to leukaemia cells. PMID- 3814473 TI - Characterization of radiation resistant hypoxic cell subpopulations in KHT sarcomas. (I). Centrifugal elutriation. AB - Studies were performed to determine the location, with respect to cell cycle phase, of the radiobiologically hypoxic cells in KHT sarcomas. Cells dispersed from solid KHT tumours were separated into subpopulations at different stages of the cell cycle by centrifugal elutriation. Flow cytometric analysis of the DNA content of these subpopulations indicated that the degree of synchrony that could be achieved was greater than or equal to 95% for G1 cells, 70-75% for S cells and 70-75% for G2M cells. The approach to locate and characterize hypoxic cells was based on the premise that due to their lack of oxygen such cells would preferentially survive radiation treatment. Consequently KHT sarcomas were irradiated in situ either in dead animals or in animals breathing air. Following treatment, the tumours were dissociated, the cells elutriated into the various phases of the cell cycle and clonogenic cell survival was determined. Complete dose-response curves were determined for cells in the G1, S and G2M cell cycle phases. The various cell cycle subpopulations obtained from tumours irradiated while mice breathed air, all demonstrated survival curves with a break and final slope which paralleled that of the corresponding anoxic cell survival curve. From these curves the proportion of hypoxic tumour cells in the G1 phase was calculated to be 10.1 +/- 1.7%. Because the elutriated S and G2M enriched cell fractions were to some extent contaminated by cells from other phases of the cell cycle, the percentage of hypoxic S and G2M tumour cells was estimated to range from 0-7% and 0-5% respectively. However, since G1 cells comprised the majority of all the neoplastic cells in these tumours, the data suggest that hypoxic cells in KHT sarcomas are found primarily in this cell cycle stage. PMID- 3814474 TI - Influence of perinatal nicotine administration on transplacental carcinogenesis in Sprague Dawley rats by N-methylnitrosourea. AB - The administration of nicotine during the perinatal stages of life resulted in a significant decrease in tumours occurring after transplacental induction by N methylnitrosourea (MNU). The overall tumour incidence following p.o. application of MNU to dams was 85% in rats of the F1-generation, the main occurrence being related to the neurogenic system (62% of the animals). Regular injections of nicotine before or after birth resulted in a reduction of malignancies by 17% and 22% (P = 0.08 and 0.0015), respectively. The difference in the incidence of neurogenic tumours proved to be highly significant (P less than 0.002) in rats of either sex, when nicotine was applied over 26 weeks following birth. There was a gender-specific imbalance in rats which received the carcinogen only, in favour of a lower tumour yield in females (P less than 0.04), which became less apparent when nicotine was given additionally. These findings suggest that nicotine is capable of modulating the expression of chemically induced tumours of the neurogenic system in a favourable way. PMID- 3814475 TI - Testosterone-induced DNA synthesis in cultured rat ventral prostate: effects of estracyt and its derivatives. AB - Testosterone-induced DNA synthesis in cultured rat ventral prostate was used to compare the direct effects of Estracyt and Emcyt with that of their metabolite, estramustine, and their carrier-hormone, oestradiol-17 beta on prostatic growth. In serum-supplemented medium (5-20% FCS), all the compounds were equally effective in suppressing testosterone stimulated DNA synthesis which was reduced by between 40-50%, whereas in serum-free medium the estramustine compounds were consistently less effective than oestradiol-17 beta. In the presence of 4 X 10( 9) M testosterone in serum-free medium, stimulated DNA synthesis was reduced by 15-30% following incubation with 4 X 10(-7) M of Estracyt, Emcyt and estramustine and by 60% with 4 X 10(-7) M oestradiol-17 beta. Thus, none of the estramustine compounds appear to offer any selective advantage over that of oestradiol-17 beta in suppressing prostatic DNA synthesis at the target tissue level. PMID- 3814476 TI - The clinical course of bone metastases from breast cancer. AB - All patients with carcinoma of the breast seen in this Unit since 1970 were reviewed to study the incidence, prognosis, morbidity and response to treatment of bone metastases. The biological characteristics of the primary tumour were compared in patients relapsing first in bone or liver. Sixty-nine percent of patients dying with breast cancer had bone metastases and bone was the commonest site of first distant relapse. Bone relapse was more common in receptor positive or well differentiated (grade 1) tumours. The median survival was 24 months in those with disease apparently confined to the skeleton compared with 3 months after first relapse in liver. Ten percent of patients with breast cancer developed hypercalcaemia. All had metastatic disease and 85% had widespread skeletal involvement. Fifteen percent of patients with disease confined to the skeleton developed hypercalcaemia. The response in bone to primary endocrine therapy, and chemotherapy, was apparently less than the overall response achieved. A large proportion had apparently static disease reflecting the insensitivity of the UICC assessment criteria. The duration of survival in these patients was similar to responding patients, suggesting a tumour response may occur in the absence of discernable radiological evidence of healing. PMID- 3814477 TI - Oestrogen receptors in primary and advanced breast cancer: an eight year review of 704 cases. AB - ER content of primary tumour tissue has been examined in 704 patients presenting with operable breast cancer. The median follow-up is now 84 months and no patient has received adjuvant therapy of any kind. ER status is related to histological grade, menopausal status, initial site of metastases and subsequent response to endocrine therapy. A significant advantage in terms of survival is found in ER positive patients which is confined to those lymph node positive at mastectomy. DFI is also significantly related to ER status in lymph node positive patients. Survival after the symptomatic presentation of metastases and the institution of endocrine therapy is prolonged in patients with ER positive tumours. The overall response rate to endocrine therapy in assessable patients with ER positive tumours is 32%. By combining the ER status and histological grade of tumour tissue, a group of patients comprising 28% of those assessable to endocrine therapy can be identified (ER positive, grade I and II) with a response rate of 46%. PMID- 3814478 TI - The in vitro and in vivo anti-tumour activity of N-AcMEL-(Fab')2 conjugates. AB - To increase the accessibility of drug-antibody complexes to tumours and to decrease non-specific binding via Fc receptors N-acetyl-melphalan (N-AcMEL) was conjugated to F(ab')2 fragments. These fragments were synthesised by pepsin degradation of IgG MoAb. Up to 20 molecules of N-AcMEL could be successfully coupled to each F(ab')2 fragment (compared with 25 molecules/intact IgG) with retention of both drug and antibody activity. The N-AcMEL-F(ab')2 conjugates demonstrated specific cytotoxicity in vitro however despite the absence of non specific Fc receptor binding and greater permeability when using F(ab')2 fragments, the N-AcMEL-F(ab')2 and N-AcMEL-IgG conjugates had similar anti-tumour activity in vivo. Conjugates made with whole IgG and F(ab')2 were equally effective in eradicating subcutaneous solid tumours in mice when injected intravenously. The lower immunogenicity of F(ab')2 fragments compared with whole IgG and the similar cytotoxicity of their conjugates, suggests that the F(ab')2 conjugate has greater clinical utility. PMID- 3814479 TI - Lymphocytopenia as an independent predictor of early recurrence in breast cancer. PMID- 3814480 TI - On the age-dependent association between cancer of the breast and of the endometrium. A nationwide cohort study. AB - The association between breast and endometrial cancer was investigated in a cohort consisting of 60,065 subjects (99% of all women in whom a first breast cancer was diagnosed in Sweden in 1960-63 and 1968-81). Complete follow-up until 1981 revealed a total of 260 endometrial cancers, as against an expected number of 151.1 (relative risk (RR) = 1.72; 95% confidence limits (CL) 1.46; 1.87). RR increased steadily from close to unity in women younger than 50 at breast cancer diagnosis to 2.40 (CL 1.97; 2.93) in those 70 years of age and older. The excess number of endometrial cancers occurred primarily during the first five years of follow-up (RR = 2.07; CL 1.79; 2.38). A common causal agency for breast and endometrial cancer is more likely to lie in environmental than in genetic factors and other observations in the same population do not support that such factors are related to characteristics of the women's reproductive histories. PMID- 3814481 TI - Variation in lymphoma incidence within Yorkshire Health Region. AB - The spatial distribution of new cases of lymphoma occurring in Yorkshire between 1978 and 1982 has been studied. Administrative districts were used as the basis for analysis and differences in age standardised incidence rates between districts were determined. Excessive rates for NHL were found to occur in Scarborough, York and Leeds districts. In addition an analysis contrasting broadly urban and rural districts showed an excess of NHL in rural areas, particularly of the follicular subtypes. PMID- 3814482 TI - Hodgkin's disease: case control epidemiological study in Yorkshire. AB - This is the first report of a case-control epidemiological study on lymphomas and leukaemias occurring in Yorkshire during 1979-84. This paper deals with the results of the Hodgkin's disease analysis comprising 248 cases and 489 controls. The results indicate support for previous work with respect to small family size and past history of infectious mononucleosis. Positive observations made in a previous pilot study are also confirmed and extended with respect to associations with certain chronic skin lesions, dental anaesthesia and familial factors. Negative associations are described with respect to X-ray exposures and cigarette smoking. It is proposed that these results fit into a general hypothesis that these conditions are the result of interaction between infectious agents and altered immunity in those persons genetically predisposed. PMID- 3814483 TI - Lung cancer and women: results of a French case-control study. AB - Ninety-six women with histologically confirmed lung cancer and 192 matched controls were involved in an international case-control study conducted from 1976 to 1980. The aim of this study was an examination of the effects of different smoking habits, especially the type of cigarettes smoked (light or dark tobacco and filter or nonfilter use) on the occurrence of lung cancer in French females. All these patients were either nonsmokers or lifetime cigarette smokers. Matched relative risk (RR) of smokers compared to nonsmokers was found to be increased for both Kreyberg I (RR = 6.6) and Kreyberg II (RR = 2.1) categories; however, this increase was significant (P less than 0.0001) only for Kreyberg I lung cancer. A significant increase (P less than 0.0001) in matched RR was found with early age at first cigarette smoked, daily consumption, duration of smoking, frequency of inhalation, use of dark tobacco and use of nonfilter cigarettes. Matched RR associated with smokers not always using dark tobacco and those smoking only dark tobacco as compared to nonsmokers were significantly increased (trend test P less than 0.0001). On the contrary, the increase of RR was not significant when either daily consumption, or duration of smoking, or age at first cigarette was taken into account. Lung cancer appeared to be associated with daily consumption and use of nonfilter cigarettes in a matched logistic regression. PMID- 3814484 TI - Further studies on the response of intestinal crypt cells of different hierarchical status to eighteen different cytotoxic agents. AB - Adult male mice were treated with one or two different doses of each of 18 different cytotoxic agents. They were sampled at various times (3-12h) thereafter, and the spatial distributions of cell death in the small intestinal crypts were studied. Dead or dying cells or cells carrying dead cell fragments were examined histologically, and all of these were recorded (for convenience as apoptotic fragments), relative to the cell position in the crypt. Thus, distributions of apoptotic fragments against cell position were determined. A regression analysis of the data obtained at different times after administration of each agent was undertaken and the position of the median of the spatial distribution of presumptive target cells was deduced for each cytotoxic agent. The accuracy of this median value was determined to be +/- 0.5 cell positions. From these median values, the different cytotoxic agents could be divided roughly into three groups: [3H]thymidine, isopropyl-methane-sulphonate, gamma-rays, bleomycin and adriamycin all have their median values (susceptible cells) at cell positions 4 to 6; bischlorethylnitrosourea, actinomycin D, cyclophosphamide and cycloheximide at cell positions 6-8; mechlorethamine, triethylenethiophosphoramide, vincristine, 5-fluorouracil, hydroxyurea and methotrexate at cell positions 8-11. The position of these medians was considered in relation to the killing of clonogenic cells. Preliminary studies on the distributions of dead cells after myleran, cis-platinum and heat (hyperthermia) were also reported. There is a general tendency for antibiotics and radiation to attack the lower cell positions in the crypt. Alkylating agents on the other hand have a somewhat broad spectrum of action. Antimetabolites and a microtubule dissociating agent act on higher cell positions. No difference could be detected between two different forms (sources) of actinomycin D. The changes in the yields of apoptotic and mitotic cells with time and the migration velocities of cells in the crypts carrying apoptotic fragments after exposure to cytotoxics are also presented. PMID- 3814485 TI - Factors involved in the anti-cancer activity of the investigational agents LM985 (flavone acetic acid ester) and LM975 (flavone acetic acid). AB - LM985 has been shown previously to hydrolyse to flavone acetic acid (LM975) in mouse plasma and to produce significant anti-tumour effects in transplantable mouse colon tumours (MAC). It has undergone Phase I clinical trials and dose limiting toxicity was acute reversible hypotension. Substantially higher doses of LM975 can be given clinically without dose limiting toxicity. We have investigated the activity of LM975 against a panel of MAC tumours and also the in vitro cytotoxicity of both LM985 and LM975 in two cell lines derived from MAC tumours. LM985 is considerably more cytotoxic than LM975 in vitro but increased length of exposure to LM975 results in improved activity. Single in vivo injection of LM975 showed no activity against the ascitic tumour MAC 15A, moderate activity against the s.c. poorly differentiated tumour MAC 13 and produced a significant growth delay in the well differentiated MAC 26. These latter responses were considerably enhanced by repeated injection 7 days later. Pharmacokinetic studies in mice following i.p. injection of LM985 demonstrated rapid degradation of LM985 to LM975 in the peritoneum. Length of exposure as well as drug concentration appear important factors in determining anti-tumour responses. PMID- 3814486 TI - The development of medullary carcinoma of the thyroid does not involve the loss of alleles on the short arm of chromosome 11. PMID- 3814487 TI - Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis. AB - Mortality up to 1 January 1983 has been studied in 14,106 patients with ankylosing spondylitis given a single course of X-ray treatment during 1935-54. For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than that of members of the general population of England and Wales, and this increase is likely to have been a direct consequence of the treatment. The proportional increase reached a maximum of 71% between 10.0 and 12.4 years after irradiation and then declined. There was only a 7% increase in mortality from these tumours more than 25.0 years after irradiation and only for cancer of the oesophagus was the relative risk significantly raised in this period. Neither the magnitude of the relative risk, nor its temporal pattern following treatment, were greatly influenced by the age of the patient at first treatment. For leukaemia there was a threefold increase in mortality that is also likely to have been due to the radiotherapy. The relative risk was at its highest between 2.5 and 4.9 years after the treatment and then declined, but the increase did not disappear completely, and the risk was still nearly twice that of the general population more than 25.0 years after treatment. There was some evidence that the risks of acute myeloid, acute lymphatic, and chronic myeloid leukaemia were all increased, but no evidence of any increase in chronic lymphatic leukaemia. The relative risk appeared to be greatest for acute myeloid leukaemia. For colon cancer, which is associated with spondylitis through a common association with ulcerative colitis, mortality was increased by 30%. For non-neoplastic conditions there was a 51% increase in mortality that was likely to be associated with the disease itself rather than its treatment. The increase was apparent for a wide range of diseases and was not confined to diseases that have been associated clinically with ankylosing spondylitis. PMID- 3814488 TI - Thyroid cancer among young women related to prior thyroid disease and pregnancy history. AB - We conducted an epidemiologic case-control study of thyroid cancer in women aged 40 and under to test the hypothesis that endogenous hormones may relate to the development of this disease, since the only known cause of thyroid cancer, ionizing radiation, does not account for the striking female over male excess. When compared to neighbour controls women with thyroid cancer more often had a history of benign hyperplastic thyroid disease (Relative Risk (RR) = 14.5; P less than 0.01) and more often had ever been pregnant (RR = 2.1; P = 0.04). Both these findings were consistent with findings of previous studies. After eliminating women with a history of hyperplastic thyroid disease from the analysis we found a strong association with miscarriage as the outcome of the first pregnancy (RR = 11.5; P less than 0.01), and we suspect that this factor may be another indicator of thyroid abnormality. An independent and increasing risk was observed with an increase in the total number of pregnancies after excluding women with prior thyroid disease and those whose first pregnancy ended in a miscarriage. The RR for 4 or more pregnancies was 6.3 (P = 0.03). Prior exposure to radiation therapy was not an important factor in our study of young women; this suggests that the emphasis in future studies of thyroid cancer must shift to study other types of risk factors. PMID- 3814489 TI - Serum retinol level in patients with colorectal premalignant and malignant lesions. AB - Serum retinol levels were determined by a fluorometric method in patients with colorectal cancer or polyps and those with inflammatory bowel disease. Serum retinol levels in patients with benign or malignant colorectal polyps and stage B cancer (modified Dukes' classification) were similar to those found in controls. By contrast, serum retinol levels were significantly lower in patients with Dukes' stage C or D. Among cancer patients that were followed after surgical treatment serum retinol levels did not differ significantly from those found in controls. Patients who died of metastases during follow-up possessed very low serum retinol levels. These findings suggest that a decreased serum retinol level in cancer patients is a consequence rather than a precursor of the neoplastic process. Furthermore, this study suggests that the marked decrease in serum retinol level might be an indicator of poor prognosis in colorectal cancer patients after surgery. PMID- 3814490 TI - Breast self examination and breast cancer stage at diagnosis. AB - The relationship between breast self examination (BSE) and breast cancer stage at diagnosis was examined in 616 women aged 15-59 years. Differences in tumour characteristics between those not practising BSE and those practising but not taught were small and inconstant. However, women who had both practised and had been taught BSE had more favourable tumours than the non-practising group. The difference was most marked in terms of tumour size and the involvement of axillary nodes. The proportions of women in the non-BSE and taught-BSE groups with each characteristic were respectively: size less than or equal to 2 cm 33% and 45%, T1 clinical stage 27% and 42%, and N0 pathological stage 37% and 50%. This advantage to taught-BSE women persisted after adjustment for the identified confounding factors of age, social class and oral contraceptive use. The likely impact on breast cancer mortality is difficult to assess, although the potential benefit of the lead time gained must not be ignored when assessing the costs and benefits of BSE. PMID- 3814491 TI - Risk of leukaemia in ovarian tumour and breast cancer patients following treatment by cyclophosphamide. AB - A case-control study was conducted to determine whether the development of leukaemia was associated with chemotherapy for neoplasms of the ovary or breast, in a population where most such chemotherapy consisted of cyclophosphamide alone. Cases and controls were identified from the National Cancer Registry of the German Democratic Republic. Cases were women who had developed leukaemia as a second primary after an initial diagnosis, at least one year before, of an ovarian or breast tumour. Controls were patients with an ovarian tumour or breast cancer who had survived to the year when the case developed a leukaemia but who had not themselves developed a second malignancy. Controls were matched to cases by the site of the first primary and its year of diagnosis, as well as year of birth. The relative risk for acute leukaemia following treatment with cyclophosphamide alone was significantly elevated (P less than 0.05), at 14.6 for ovarian tumour patients and 2.7 for breast cancer patients. Among breast cancer patients the increased risk of leukaemia associated with chemotherapy was confined to women who had been under 50 years of age at the time of diagnosis of the breast cancer (for whom the relative risk was 13.1). No excess risk of leukaemia was observed in association with radiotherapy for either ovarian or breast cancer patients. The present findings strongly suggest that cyclophosphamide as a single chemotherapeutic agent is capable of inducing leukaemia in humans. PMID- 3814492 TI - Mitotic activity in non-Hodgkin's lymphoma. Relation to the Kiel classification and to prognosis. AB - At histopathological diagnosis of non-Hodgkin's lymphoma (NHL) the mean number of mitoses in 10 high power fields (X 40) was determined in thin sections (2 micron) and designated 'mitotic index' (MI). In 38 patients the thymidine labelling index (LI) of the lymphoma cells was also determined. There was a close correlation between MIs and LIs (r = 0.81, P less than 0.001) indicating that MI reflects the proliferative activity in NHL. Among 101 patients with NHL classified according to the Kiel nomenclature MIs were generally lower in lymphomas of low grade malignant type than in the high grade malignant lymphomas. The variation of MIs within morphological subgroups was especially pronounced in high grade lymphomas. Only 18 of 49 patients (37%) with MI greater than or equal to 2 have survived for 2 years in contrast to 37 of 52 patients (77%) with MI less than 2 (P = 0.001). For patients with histologically low grade lymphomas and MI greater than or equal to 2.0 the median survival was 23 months and for those with MI less than 2.0 58 months (P = 0.09). Patients with high grade lymphomas and MI greater than or equal to 2.0 had a median survival of 15 months compared to 57 months for those with MI less than 2.0 (P = 0.04). In a multivariate analysis of 50 patients with centroblastic-centrocytic (CB-CC) or centroblastic (CB) lymphomas the importance of different prognostic factors was analysed. Among the variables age, MI, growth pattern (follicular vs. diffuse), cell type (CB-CC vs. CB), clinical stage (I vs. II-IV), initial chemotherapy (active vs. less active) only age and MI gave significant prognostic information. It is concluded that the assessment of mitoses in NHL gives prognostic information in addition to histopathologic classification. The method is simple and the proliferative activity and histopathological diagnosis can be ascertained routinely on the same occasion. PMID- 3814494 TI - Students' approaches to learning in an innovative medical school: a cross sectional study. PMID- 3814493 TI - Chlorambucil and interferon for low grade non-Hodgkin's lymphoma. PMID- 3814495 TI - Biliary lipid secretion in the regenerating liver of the rat. AB - The effect of two-thirds hepatectomy on biliary lipid secretion was studied in fasted rats. Bile acids, cholesterol and phospholipids were determined in the bile of rats with biliary drainage. Bile acid and phospholipid concentrations were not significantly modified during liver regeneration but there was a significant decrease in cholesterol concentrations in bile at 12 h after hepatectomy, with a gradual return to normal values. The molar percentage of cholesterol and the calculated lithogenic index of bile were also significantly decreased by 12 h. The biliary secretion of bile acids and phospholipids, expressed per gram of liver, showed a tendency to increase regeneration, but cholesterol secretion was significantly decreased from 12 to 48 h following liver resection. Some possibilities to explain the uncoupling between cholesterol secretion and bile acid secretion are discussed. PMID- 3814496 TI - Studies on the pathogenesis of actinomycotic mycetoma in animals injected with fractions isolated from Nocardia brasiliensis. AB - In the present study the participation was evaluated of isolated fractions of Nocardia brasiliensis in the genesis of the inflammatory response observed in actinomycotic mycetoma. Subcutaneous injection in mice of a suspension containing a polysaccharide fraction F1 obtained by treating cell walls with sodium hydroxide induced an inflammatory response at the inoculation site which was characterized by a large influx of polymorphonuclear (PMN) and mononuclear (MN) leucocytes between the 2nd and 4th days. On the 8th day, a typical granulomatous reaction was observed involving large numbers of epithelioid cells. Intravenous injection of the lipid extract adsorbed to charcoal particles into mice induced an inflammatory reaction around the particles embolized in the pulmonary microcirculation which was similar to that described above. The kinetics of the inflammatory cell migration was studied by total and differential counts of leukocytes that migrated to the peritoneal cavity of rats inoculated intraperitoneally with the F1 and lipid fractions. Both fractions initially induced intense PMN migration, which was later reduced, with a simultaneous increase in mononuclear cells. The present results demonstrate that a polysaccharide fraction (F1) and the lipid fraction reproduce the fundamental lesion of actinomycotic mycetoma. PMID- 3814497 TI - The functioning in unanaesthetized sheep of the popliteal lymph node after the surgical removal of its blood supply. AB - Operations were performed to cannulate the efferent duct of the popliteal node of sheep and, at the same time, the blood vascular system was removed surgically from the popliteal fossa so that the node was deprived of it blood supply. Twelve preparations were technically successful in that lymph flowed spontaneously from the unanaesthetised sheep for from 3 to 30 days after the operation. Eight control preparations were established in which the blood supply of the node with the cannulated efferent duct was left intact. In only four of the test preparations was the function of the node decisively impaired so that dendritic macrophages appeared in the lymph, the output of lymphocytes remained very low, and later histological examination showed the nodes to be grossly depleted of lymphocytes. In two of these four preparations the surgical devascularization of the node was aided by arterial embolization. In the remaining eight test preparations the outputs of lymphocytes in the lymph gradually regained normal values, and the nodes then responded normally to antigenic stimuli. PMID- 3814498 TI - Bypass induced liver disease: an experimental study of the effect of post operative protein supplementation and metronidazole therapy in an animal model. AB - An animal model of jejuno-ileal bypass (JIB) with post-operative weight loss and liver dysfunction was established in the rat. The role of a protein supplemented diet and post-operative metronidazole was investigated using this model. The use of a protein supplemented diet alone markedly reduced the detrimental effects of JIB. Although a beneficial effect was also noted with post-operative metronidazole, it was less marked and there appeared to be no additive benefit when both were used together. The results of this study would support the routine use of a protein enriched diet post-operatively in patients undergoing JIB. PMID- 3814499 TI - Organ culture of fetal rat small intestine for testing gluten toxicity: a reappraisal. AB - Jejunal segments from fetal rats of 18 days gestation were maintained in an organ culture system for up to 72 h. During this period, villi developed within the intestinal lumen and the epithelium changed from stratified to simple columnar. Peristaltic activity was observed during in-vitro culture. Alkaline phosphatase specific activity of the bowel segments fell after 48 hours culture, compared with pre-culture values (P less than 0.05), but that of alpha-glucosidase increased. The addition of Frazer's gluten fraction III to the culture medium caused slowing in the rate of morphological maturation of the jejunal explants, but there was no additional effect on enzyme specific activities compared with segments cultured in gluten-free medium. The place of organ culture of fetal rat intestine as an animal model for testing cereal toxicity in the study of coeliac disease remains unclear. PMID- 3814500 TI - Histochemical and ultrastructural study of renal cortical necrosis in rats treated with oestrone + vasopressin, and its prevention with a vasopressin antagonist. AB - Renal cortical necrosis was induced by the administration of vasopressin to oestrogen-pretreated rats. Histochemical (succinic dehydrogenase, trichrome, perjod acid Schiff) and electronmicroscopic methods were applied to examine how the vasopressin antagonist d(CH2)5Tyr(Met)AVP influences the development of this renal cortical necrosis. The experiments revealed that vasopressin did not induce hypoxia or necrosis in the renal tubules if the antagonist was administered simultaneously, even after oestrogen pretreatment. The conclusion is drawn that this pressor antagonist may be of value for the prevention of renal cortical necrosis in rats or in human beings. PMID- 3814501 TI - Ultrastructural pathology of iron-loaded rat myocardial cells in culture. AB - The pathological changes induced by in-vitro iron-loading or cultured rat myocardial cells were studied. Cells were exposed to 59Fe-labelled ferric ammonium citrate for up to 24 h followed by 24-72 h chase experiment. After 24 h exposure 29% of the total cellular radioactivity was found in ferritin, 10% in non-ferritin heat supernatant and 61% in an insoluble heat-precipitable form. Mossbauer spectroscopy showed a gradual shift from intracellular iron particles less than 1.8 nm in diameter, through particles of intermediate size, to ferritin like aggregates over 3.0 nm in diameter, reaching about 20% of total iron by 24 h. Ultrastructural studies showed premature damage such as mitochondrial abnormalities and excessive autophagocytosis. Small, 2.0-5.0 nm electron-dense cytosolic particles were noticed at 3 h of iron loading and reached maximal concentrations at 6 h. This was followed by accumulation of the small particles and of typical iron-rich ferritin cores within siderosomes. Because of the limited duration of iron loading and the high concentrations of non-transferrin inorganic iron employed, the present model is more relevant to acute than chronic iron overload. The efficient incorporation of large amounts of iron within ferritin molecules and its subsequent segregation, together with other smaller particles, within membrane-bound bodies, may represent a defence mechanism limiting iron toxicity in the face of advanced cytosiderosis. PMID- 3814502 TI - Changes in prolinase and prolidase activity during CCl4 administration inducing liver cytolysis and fibrosis in rat. AB - In earlier papers, we reported that the activity of prolidase (EC 3.4.13.9) increased in the plasma of patients with cirrhosis, while that of serum prolinase (EC 3.4.13.8) was normal and was affected only by necrosis. In this work, we investigated prolinase and prolidase activity during short and long-term CCL4 administration in the rat. After a single dose, prolinase activity increased in serum faster than did prolidase activity and it also decreased more slowly. Within the liver, no significant change in these two enzyme activities was observed during the acute phase of necrosis. During chronic CCl4 intoxication, the rises in prolidase and prolinase activity in rat serum were difficult to interpret, because of the liver necrosis present throughout the experiment. However, within the liver, prolinase activity was not affected, unlike that of prolidase which rose at week 3, reached a maximum value at week 6 (reversible fibrosis) and remained elevated at weeks 10 and 12 (irreversible fibrosis). The increase in prolidase activity was specific for liver and was not observed in other tissues. These results are in agreement with those obtained in humans; they highlight the possible physiological significance of enhanced liver prolidase activity during the fibrotic process. PMID- 3814504 TI - Natural killer cell activity of peripheral blood mononuclear cells from patients with various forms of systemic scleroderma. AB - Peripheral blood mononuclear cells from 63 patients with systemic scleroderma, including incipient or prodromal acrosclerosis, and from 20 healthy individuals were tested for natural killer (NK) cell activity and antibody-dependent cell cytotoxicity in a 4 h 51Cr release assay using K562 and L1210 cell lines respectively. In patients with systemic scleroderma natural killer cell activity was significantly decreased compared with the controls. NK cell activity was markedly lowered in patients with diffuse scleroderma and in transitional form acrosclerosis-diffuse scleroderma, and was normal in cases of acrosclerosis and/or CREST syndrome and in cases of prodromal or incipient scleroderma. Antibody-dependent cell cytotoxicity of mononuclear cells from the systemic scleroderma patients was within the normal range. The lowered natural killer cell activity correlated with the severity of systemic scleroderma, in terms of the extent of skin and organ involvement. PMID- 3814503 TI - Antiserum-induced neutropenia in the rat: characterization of a rabbit anti-rat neutrophil serum. AB - A heterologous rabbit anti-rat neutrophil serum (ANS) based on peptone-stimulated peritoneal exudate neutrophils (PMNLs) from Sprague Dawley rats was prepared. Leucoagglutination and indirect immunofluorescence assays revealed high titres of antibodies to rat PMNLs (1/2560), lower titre of antibodies to rat lymphocytes (1/160) and a very low titre against rat platelets (1/20). ANS given intravenously (i.v.) to rats in doses of up to 42 mg of protein/kg b.w. caused transient neutropenia, lasting about 10 min after administration, and thrombocytopenia, lasting about 5 min. Two minutes after an i.v. injection of 21 mg of ANS/kg b.w. there was profound uptake of 51Cr-labelled PMNLs in the lung, increased release of 51Cr to plasma, an increased amount of 51Cr in the spleen and consumption of greater than 98% of total complement (CH50). Two hours later there was high activity of 51Cr in the plasma, spleen and liver, while lung radioactivity had decreased to below baseline and CH50 had recovered to 55% of baseline. An intraperitoneal (i.p.) injection of ANS was followed by prolonged neutropenia with a maximum after 12 h. Simultaneously peripheral mononuclear cells slightly decreased. There was no change in the number of peripheral platelets in the blood or in the plasma concentration of fibrinogen, alpha 2 antiplasmin, plasminogen or plasminogen activators. Intraperitoneal administration of ANS did not affect CH50. It was concluded that the raised ANS had good specificity against rat PMNLs and was able to induce prolonged neutropenia after i.p. injection without affecting the complement of fibrinolytic system. PMID- 3814505 TI - Sensitivity to UV radiation of fibroblasts from a Japanese group A xeroderma pigmentosum patient with mild neurological abnormalities. AB - A 12-year-old girl, suffering from xeroderma pigmentosum (XP), had mild cutaneous and neurological abnormalities. She showed no neurological abnormalities at the age of seven, but areflexia of the patellar tendons at II. She had no malignant tumours. The skin fibroblasts from the patient were about twice as sensitive to the lethal effects of 254 nm ultraviolet (UV) radiation as those of Group C XP patients, and about twice as resistant as those of typical Group A XP patients. The ability of these fibroblasts to reactivate UV-damage adenovirus 5 was intermediate between those of Group C and typical Group A patients. The patient's cells were assigned to genetic complementation Group A by use of the cell-fusion technique. This is the first case in Japan of a Group A XP patient with mild neurological abnormalities. The mild cutaneous manifestations of this patient may be explained by the residual ability of the cells to repair UV-damaged DNA. PMID- 3814506 TI - Oral acyclovir prevents herpes simplex virus-associated erythema multiforme. AB - A young woman suffering from recurrent erythema multiforme associated with relapsing gluteal herpes simplex is presented, in whom long-term treatment with oral acyclovir prevented herpes episodes as well as erythema multiforme. PMID- 3814507 TI - Porokeratosis: immunosuppression and exposure to sunlight. AB - Four cases of disseminated superficial actinic porokeratosis are described, all in patients who had been given immunosuppressive treatment, which might have been a contributing factor in the development of the condition. The possible relationship of immunosuppressive actinic porokeratosis to viral infection is also discussed. PMID- 3814508 TI - 'Tin-tack' sign in localized pemphigus foliaceus. AB - Two patients with localized pemphigus foliaceus are described, in whom a positive 'tin-tack' sign was a significant feature; this is the appearance of small horny plugs attached to the undersurface of the scale removed from the affected site. This report is intended as a reminder that a positive 'tin-tack' sign is not exclusively a feature of discoid lupus erythematosus but is also seen in localized pemphigus foliaceus. PMID- 3814509 TI - Molluscum contagiosum and the acquired immunodeficiency syndrome: clinical and immunological details of two cases. AB - We report here the clinical and immunological findings in two patients with molluscum contagiosum poxvirus infection and the acquired immunodeficiency syndrome (AIDS). These cases support earlier evidence that the molluscum contagiosum virus may act as cases support earlier evidence that the molluscum contagiosum virus may act as an opportunistic pathogen. There is now evidence that members of all five families of double stranded DNA-containing human viruses have been associated with unusual clinical manifestations in AIDS patients, and the significance of DNA virus infections in patients with AIDS is discussed. PMID- 3814510 TI - Treatment of porphyria cutanea tarda. PMID- 3814511 TI - Plasma somatomedin-C levels in psoriasis. AB - We have measured plasma levels of somatomedin-C, one of the principal mediators of growth hormone action, in 25 patients with plaque-type psoriasis of varying severity and compared these levels with those found in healthy controls. Plasma somatomedin-C levels were not elevated in the psoriatic patients regardless of the severity of their disease, suggesting that in these patients growth hormone secretion is within normal limits. PMID- 3814512 TI - Skin mast cells in polycythaemia vera: relationship to the pathogenesis and treatment of pruritus. AB - We have measured skin mast cell numbers, circulating basophils and whole blood histamine in 13 patients with polycythaemia vera. Itching was present in nine cases and correlated well with the numbers of skin mast cells but not with circulating basophils or whole blood histamine. Immediate relief of pruritus was achieved with aspirin, and myelosuppressive therapy was useful for long-term control of symptoms. Neither histamine (H1 or H2) antagonists nor iron replacement therapy were effective forms of treatment. The findings suggest that mast cell prostaglandins are an important factor in the pathogenesis of pruritus and that local vascular responses may trigger mast cell degranulation. PMID- 3814513 TI - The infectious aetiology of tropical ulcer--a study of the role of anaerobic bacteria. AB - We have cultured anaerobic bacteria from patients with tropical ulcers. Fusobacteria were isolated most frequently. Anaerobes were always present, together with aerobes or facultative anaerobes, particularly in early phase ulcers, suggesting that the combination of organisms is important in the pathogenesis of the disease. Spirochaetes were identified in material examined by light and electron microscopy, but were not cultured. PMID- 3814514 TI - Mycosis fungoides--response to therapy and survival patterns in 85 cases. AB - The clinical course and management of 85 cases of mycosis fungoides presenting over a 20-year period are described. The extent of skin involvement and presence of lymphadenopathy were seen to be important prognostic factors. The following survival patterns were observed. In eight cases with limited plaque disease there was prolonged disease-free survival after treatment with kilovoltage X-rays; after a median follow-up of 64 months there was only one case of progression to generalized disease. In 49 cases of generalized skin disease (plaque disease +/- tumours; erythroderma) treated with total skin electron beam therapy there was a 24% 5-year disease-free survival; this potential for long-term survival was seen in cases with generalized plaque disease without lymphadenopathy. The remainder of the cases showed a continuously relapsing course. The extent of skin involvement and presence of lymphadenopathy can both be used as known prognostic factors to adopt a logical plan of treatment. PMID- 3814515 TI - Increased production of fibronectin by fibroblasts from pre-cancerous scars. AB - The detection of those post-burn scars which have become established pre malignant lesions is difficult. I describe a highly sensitive enzyme-linked immunosorbent assay for fibronectin (FN) production by fibroblasts from scar tissue. The amount of FN produced by fibroblasts from scar tissue adjacent to an area of squamous cell carcinoma was found to be 30 times that produced by fibroblasts from normal scar tissue. Thus, this method may be a useful indicator of scars which are pre-malignant. PMID- 3814516 TI - Granulocyte pyruvate kinase in psoriasis vulgaris and psoriasis arthropathica. AB - The activity of granulocyte pyruvate kinase in 46 patients with psoriasis vulgaris and eight patients with psoriasis arthropathica was investigated. It was found that in both groups of patients the activity of pyruvate kinase was significantly higher than in healthy individuals. This suggests that the rate of glycolysis in granulocytes of patients with psoriasis is markedly increased. The activity of granulocyte pyruvate kinase in 11 psoriatic patients with actively spreading lesions was compared with the activity of this enzyme when the patients were in remission. The activity of the enzyme was significantly increased during the active stage of the disease and returned to normal during remission. PMID- 3814517 TI - Systemic sclerosis-like lesions during long-term penicillamine therapy for Wilson's disease. AB - Systemic sclerosis-like lesions developed in a 14-year-old boy with Wilson's disease who had been treated with D-penicillamine for 11 years. Clinical and laboratory manifestations included proximal scleroderma, pulmonary restrictive defects, positive antinuclear antibodies, and the deposition of C3 at the dermal epidermal junction of the lesional skin. This is the first case reported in which long-term administration of penicillamine was followed by the development of systemic sclerosis-like lesions. PMID- 3814518 TI - The role of mucosal transferrin in intestinal iron absorption. PMID- 3814520 TI - Neonatal diagnosis of antithrombin III congenital defect in a premature newborn. PMID- 3814519 TI - Analysis of red cell survival data. PMID- 3814521 TI - Significance of ring sideroblasts in refractory anaemia with excess of blasts. PMID- 3814522 TI - Treatment of primary proliferative polycythaemia by venesection and busulphan. PMID- 3814523 TI - A possible epidemiological association between multiple sclerosis and lymphoma/leukaemia. PMID- 3814524 TI - Multiple myeloma in a pair of twins. PMID- 3814525 TI - The spleen and haemolysis: evaluation of the intrasplenic transit time. AB - The mean intrasplenic red cell transit time (STT) and the slow mixing splenic red cell volume (SSV) have been measured in patients with hereditary spherocytosis (HS), autoimmune haemolytic anaemia (AIHA) and lymphoproliferative disease (LD). There was an inverse relationship between the mean red cell life span (MRCLS) and the STT in HS (r = -0.96, P less than 0.001) and in AIHA (r = -0.90, P less than 0.001). No such relationship existed in LD. The size of the spleen and the SSV were not related to the severity of haemolysis. Our data offer strong evidence for the conditioning effect of the spleen on HS- and AIHA red cells and suggest that the STT is an index of the adverse effect of the spleen on red cells in patients with HS or AIHA. PMID- 3814526 TI - Gerbich reactivity in 4.1 (-) hereditary elliptocytosis and protein 4.1 level in blood group Gerbich deficiency. AB - The membrane polypeptide composition and the blood group Gerbich phenotype of red cells from 4.1 (-) hereditary elliptocytic patients and from Gerbich-negative donors, who display two unrelated genetic abnormalities, were compared. In homozygous 4.1 (-) hereditary elliptocytosis where the primary defect was presumably the absence of the membrane skeletal protein 4.1, there was approximatively a 70% reduction in the minor sialoglycoproteins beta and gamma. This was associated with a severe reduction of blood group Gerbich reactivity as determined with both murine monoclonal and human anti-Gerbich antibodies. In the heterozygous state in the presence of one haploid set of protein 4.1 gene there was only a modest decrease in glycoproteins beta and gamma and the Gerbich serological reactivity was within normal limits. In homozygous Gerbich-negative red cells which lack glycoproteins beta and gamma but do not display elliptocytic red cells, the levels of protein 4.1 was repeatedly found within or just below the lowest values of normal controls. In the heterozygous Gerbich-negative conditions, glycoproteins beta and gamma were present in reduced amounts but the blood group Gerbich reactivity fell within normal limits since the anti-Gerbich reagents used were unable to detect a dosage effect. The amount of protein 4.1 was normal. These results add further support to the view that protein 4.1 and the sialoglycoproteins beta and gamma are physically linked in vivo which in some way serve to maintain red cell shape and integrity. Of interest was the finding that absence of protein 4.1 had a greater influence on the level of membrane glycoproteins beta and gamma than did the absence of beta and gamma glycoproteins on band 4.1. PMID- 3814527 TI - Autoimmune haemolytic anaemia in childhood associated with non-complement binding IgM autoantibodies. AB - Red cell bound IgM autoantibodies free of associated IgG autoantibodies and unable to activate complement have not yet been considered as the cause of autoimmune haemolytic anaemia (AIHA). We report on warm type AIHA resulting from the action of IgM autoantibodies on circulating RBC. Twelve children (eight of whom were infants) with relatively severe haemolytic anaemia were studied. Whereas the clinical findings and courses of all children appeared to be compatible with warm type AIHA, the serological findings during the haemolytic phase were atypical in that the direct antiglobulin test (DAT) was negative in 11, and positive in one case due to C3d only. The use of radiolabelled antihuman globulin antibodies showed, however, that the RBC of all the patients were sensitized with warm IgM antibodies. Elevated values of IgA and/or IgG immunoglobulins on the patients' RBC were found to be present in only two cases. Complement activation by IgM autoantibodies could not be detected in all other cases neither in vivo nor in vitro. Thus, we conclude that non-complement binding IgM autoantibodies were responsible for the AIHA in the majority of these children possibly representing an as yet unrecognized variant of warm type AIHA. PMID- 3814528 TI - Utility of the FAB classification for myelodysplastic syndromes: investigation of prognostic factors in 237 cases. AB - The utility and prognostic significance of the FAB classification was studied in 237 patients with a myelodysplastic syndrome. No significant differences in actuarial survival and probability of transformation to acute leukaemia were found in patients with RA, AISA or CMML. The median survival time for the RA group was 50 months, for the AISA and CMML subclasses more than 60 months. The probability of transformation for the RA, AISA and CMML subgroups showed a linear trend with a probability of 25% for the RA, 16% for the AISA and of 18% for the CMML groups after a 5 year observation period. A uniformly poor prognosis was found for the RAEB and RAEB/t subgroups with median survival times of respectively 9 and 6 months. Chromosomal abnormalities were found in 68 out of 155 patients (44%). Patients with only normal metaphases or with abnormal metaphases together with karyotypic normal cells had a longer median survival time and a lower probability for transformation as compared to those with only abnormal metaphases. The most important factor in prognosis is the number of blast cells in blood and bone marrow. Age and sex, and certain quantitative and qualitative abnormalities in the peripheral blood appear of limited prognostic value for patients with RA, AISA and CMML. The longer life expectancy of 35 patients with CMML as compared to other series seems to be related to the percentage of blast cells at the time of diagnosis. PMID- 3814529 TI - Safety at sea: a forgotten frontier? PMID- 3814530 TI - A neurological evaluation of workers exposed to mixtures of organic solvents. AB - Workers with long term exposure to mixtures of organic solvents below regulatory limits have been reported to experience mild, but clinically detectable, sensory or sensorimotor polyneuropathies. In conjuction with a cross sectional study of behavioural performance a clinical neurological evaluation was conducted among printers and spray painters to examine dose response relations. All 240 subjects completed an occupational history and symptom questionnaire and underwent a clinical neurological examination. On average, subjects had been employed on their current job for six years. Classification of solvent exposure for each subject was based on exposed versus non-exposed job titles and observations during an industrial hygiene walk-through or on the measured concentration of solvents in full shift personal air samples. The average full shift solvent concentration was 302 ppm for printing plant workers and 6-13 ppm for workers at other plants. Isopropanol and hexane were the major constituents. Neurological abnormalities consistent with mild polyneuropathy were found in 16% of subjects; none was clinically significant. Exposed/non-exposed comparisons showed slightly higher frequency of symptoms in the exposed subjects which was not related to solvent level. Subjects categorised as exposed during the walk- through survey also had poorer vibratory sensation measured at the foot and diminished ankle reflexes. In multiple linear regression models, however, controlling for age, sex, alcohol intake, and examiner, no significant (p less than 0.05) relation was found between solvent concentration and poor neurological function except for two point discrimination measured at the foot. This investigation has not provided evidence for dose related adverse neurological effects from exposure to moderately low levels of solvent mixtures for a relatively short duration, although this may be due to the shortness of exposure duration, the type of solvent exposure, or to selection factors. PMID- 3814531 TI - Alveolar sampling and fast kinetics of tetrachloroethene in man. II. Fast kinetics. AB - Fast kinetic phenomena were studied in human subjects exposed to tetrachloroethene (perchloroethylene, PER). The duration of exposure ranged from one to 60 minutes and the concentration of PER in inhaled air ranged from 0.02 to 0.40 mmol/m3. The PER concentration in mixed venous blood (pulmonary artery) was estimated by alveolar concentration (CAlv) measured after a residence time of 10 s. During exposure, stoppage of intake (breath holding up to 50 s) caused a decrease of CAlv down to about 60% of the CAlv at a residence time of 10 s. At the end of exposure, stoppage of intake (breathing fresh air) caused a decrease of CAlv with t1/2 = 15-25 s; after two to four minutes, the decrease slowed down abruptly and the concentration remained more or less constant for about one to three minutes. After this stationary level, the decrease of CAlv continued but at a slower rate. During and after exposure, the decrease of CAlv seems to be caused by large differences in the circulation times of blood flowing through rapid, well perfused tissues and slower, well perfused tissues which may explain the stationary level. From this point of view, the vessel rich group in a compartment model must be split up in order to predict tissue and organ concentrations during peak environmental concentrations. PMID- 3814532 TI - Prevalence of overuse (injury) syndrome in Australian music schools. AB - Overuse (injury) syndrome, common in musicians, is characterised by persisting pain and tenderness in the muscles and joint ligaments of the upper limb due to excessive use and in more advanced instances by weakness and loss of response and control in the affected muscle groups. This occurs typically in tertiary music students when their practice load is raised. In seven Australian performing music schools the minimum prevalence of the condition was found to be 9.3%. In two music schools where the study was more controlled the incidences were 13% and 21%. The factors leading to overuse (injury) syndrome may be identified as follows: the genetic factor of vulnerability which cannot be altered; the student's technique which may be influenced by teaching and application so that it is more "energy efficient"; and the time X intensity of practice which is totally within the student's control. Prevention involves education of staff and students about the overuse process, rationalisation of practice habits and repertoire, abolition or reduction of static loading of the weight of the instruments, and earlier reporting when the problem is most easily corrected. Psychological problems arising in this syndrome appeared to occur as a reaction to the condition rather than as a causal factor. PMID- 3814533 TI - An experimental study of the physiological effects of chain saw operation. AB - This experimental study was designed to determine whether a combination of noise and vibration produced more pronounced changes in temporary shifts of finger skin temperature and temporary threshold shift (TTS) of hearing than those resulting from exposure to either stress alone. Nineteen healthy subjects were exposed to six different combinations of vibration, noise, and handle holding by using a chain saw for a pre-determined time. The mean value of normalised finger skin temperature decreased much more when the subjects operated a chain saw at high speed (exposure 1) than when they operated the chain saw with the noise isolated by double hearing protection (exposure 2). In five of the 14 subjects significantly larger TTS values at 4 kHz were observed in the former condition (exposure 1) compared with the values obtained when they stood beside someone else operating a chain saw (exposure 3). The results of this study suggest that noise may play a part in inducing the constriction of the peripheral vessels seen with local exposure to vibration, and that hand-arm vibration may produce an additive effect on the noise induced TTS. PMID- 3814534 TI - Lysozyme activity in ultrastructurally defined fractions of alveolar macrophages after inhalation exposure to nickel. AB - Rabbits were exposed to 0.6 mg/m3 of nickel as NiCl2 for about one month. After exposure, alveolar macrophages were lavaged from the lung and divided into three fractions by elutriation. Laminated structures in the macrophages were related to fraction number so that the fractions with the largest cells contained the highest number of structures. The lysozyme activity decreased in unfractionated as well as in fractionated macrophages from nickel exposed rabbits. The decrease was most pronounced in the fraction with the smallest macrophages and smallest number of laminated structures. Therefore the pronounced decrease in lysozyme activity seen in this and earlier studies is not caused by the increased amount of surfactant material. Increased amount of surfactant is a hallmark of nickel inhalation exposure and the surfactant material is responsible for the morphological and metabolic effects of the macrophages. The decreased lysozyme activity is probably a direct effect of nickel on the macrophages. PMID- 3814535 TI - Respiratory diseases in wood workers. AB - A survey was carried out on wood workers and on a group of unexposed, healthy controls. One group of wood workers (group A) were asymptomatic and another (group B) had symptoms either of chronic cough and dyspnoea on exertion (B1) or dyspnoea at work and bronchial hyperreactivity (B2). The control group (group C) was randomly selected from among a population of laboratory workers. No significant differences were found among the groups with respect to the frequency of atopy but the prevalence of a positive skin reaction to wood extracts was significantly higher in the asthmatic subjects. The adjusted FVC and FEV1/FVC% were significantly higher in B1 than in the other groups; the FEV1 was lower in B1 than in B2 and in B2 than in the other groups; TLCO and KCO differed significantly in all four groups. A significant negative correlation was observed between FEV1, MEF50, TLCO and KCO and duration of exposure to wood dusts. The alveolar volumes were not significantly different between the groups and were not correlated with duration of exposure. These results confirm the observation that exposure to wood dust or to some bronchoreactive substances linked with wood working can induce chronic obstructive lung disease (COLD). Some cases of wood dust asthma seem to be related to an immediate allergic reaction, but precipitating antibodies appear to be an index of exposure rather than of disease. The decrease in diffusion capacity can be ascribed to a thickening of the alveolar capillary membranes secondary to an alveolitis like, non symptomatic, allergic reaction. PMID- 3814536 TI - Mortality and cancer incidence among workers in an abrasive manufacturing industry. AB - Earlier epidemiological studies have shown that exposure to aluminium oxide and silicon carbide might carry with it an increased risk of lymphomas, stomach cancer, and non-malignant respiratory disease. To elucidate further this possible hazard, the cancer morbidity and the total mortality pattern was studied among 521 men manufacturing abrasive materials who had been exposed to aluminium oxide, silicon carbide, and formaldehyde. Total dust levels were in the range of 0.1-1.0 mg/m3. The cohort was followed up from 1958 until December 1983. No significant increase was found in total mortality, cancer mortality, or incidence of non malignant respiratory diseases. PMID- 3814537 TI - Mortality from non-malignant diseases among women in the meat industry. AB - A mortality follow up study was conducted among 7261 white female members in a local meatcutter's union in Baltimore, Maryland, between July 1949 and December 1980. The group was divided into four main job categories within the meat industry and a control group of non-meat workers belonging to the same union. Mortality in each of these subgroups was compared with that of white women in the United States general population through the determination of cause specific standardised mortality ratios. No increased risk of death from non-malignant causes was observed in any job category within the meat industry. Some caution should, however, be exercised in interpretating this finding, as few workers in chicken slaughtering plants died. PMID- 3814538 TI - Have "formal investigations" into fishing vessel losses ceased? AB - Systematic studies of 618 fishing vessel losses between January 1961 and December 1982 have shown a significantly increased incidence of total losses from 1972 onwards. Comparison of mean pre- and post-1972 rates indicated an increase of 120% from 2.54 to 5.58 losses per 1000 vessels at risk. Parallel examination of the mortality of fishermen from all occupational accidents showed no improvement. For deaths arising from vessel losses alone, the mean crude death rate, for the same periods, increased by 13%. Despite these findings, formal investigations (courts of inquiry) into fishing losses, ordered by the Department of Transport according to specified criteria, decreased in number from about 1975 onwards. The mean number fell by 61% from 3.1 (1961-71) to 1.2 a year (1972-82). Furthermore, the reduction in the rate of formal investigations into fishing vessel losses ( 84%; p less than 0.0001) was greater than the corresponding reduction (-61%; p less than 0.001) in United Kingdom merchant vessel investigations and this difference was statistically significant (p less than 0.01). During 1972-82 there were 61 fewer fishing investigations than predicted from the rate at which these were ordered during 1961-71. The last took place in 1979. None of the 141 fishing vessel losses between January 1980 and December 1982 proceeded to formal investigation. The possibility that the criteria for ordering formal investigations have not been fulfilled by the circumstances of fishing vessel losses from 1975 onwards is assessed as one explanation for this paradoxical finding of an inverse relation between losses and investigations. The accident investigation and public reporting procedures for aviation accidents should be adobted for marine accidents in general and fishing vessel losses in particular. PMID- 3814539 TI - Evaluation of the chelating action of methicillin in prolonged experimental metallic mercury poisoning. PMID- 3814540 TI - Solvents and the brain: explanation of the discrepancy between the number of toxic encephalopathy reported (and compensated) in Denmark and other countries. PMID- 3814541 TI - Sickness absence at the French National Electric and Gas Company. AB - The certified sickness absence of workers in the French National Electric and Gas Company was studied for 12 months and has been described according to the demographic and occupational characteristics of the employees. The results showed that the principal factors affecting absence are sex, job, and salary. The high percentage of absent women was explained by neither the type of occupation nor family status. Respiratory diseases, accidents, and musculoskeletal and psychiatric disorders were the leading diagnostic categories. Indices of severity, duration, and frequency were calculated and compared between groups. The duration of absence increased with the severity of the medical cause of absence and with the patient's age. PMID- 3814542 TI - Effects of 50 Hz electric currents on vigilance and concentration. AB - Seventy six male volunteers were studied in a crossover trial to assess the effect on the central nervous system of 50 Hz electric currents. Currents totalling 500 microamperes were passed through electrodes attached to the head, upper arms, and feet, simulating exposure to a vertical electric field of about 36 kV/m. Exposure and sham exposure sessions were assigned using double blind techniques and current passed for about 5.5 hours during the exposure session. A series of psychological tests comprising self reports of mood and performance tests of memory, attention, and verbal skills were administered. The present paper discusses the effects of those currents on vigilance and sustained concentration and examines the hypothesis that electric fields act as stressors. The results indicate that vigilance and concentration were not influenced by exposure, nor do they support the hypothesis of a stress reaction. Although brief reports of sensations at electrode sites compromised the double blind conditions to some extent, the performance changes associated with these reports were independent of exposure per se. Within the vigilance task there were two possible exposure effects on the time taken to identify non-target numbers. Firstly, the non-targets were identified more slowly during the first hour of exposure. Secondly, for subjects not reporting sensations, non-target latencies on the second day were slower in the exposed group--there were no corresponding differences on the first day. The interpretation of this effect is complicated by its apparent restriction to the second day and may indicate some kind of state dependent transfer phenomenon. PMID- 3814543 TI - Occupational risks for renal cancer in Sweden. AB - A systematic assessment was made of the occurrence of renal cancer among men by industrial and occupational classification using the Cancer-Environment Registry, which links cancer incidence (1961-79) and census data (1960) with industry and occupation for all employed individuals in Sweden. Data were analysed separately for cancers of the renal parenchyma and pelvis. Significantly increased risks for renal cell cancer were observed for several professional and white collar occupations, including physicians and others in the health care industry. By contrast, the risks for renal pelvis cancer tended to be higher among blue collar workers, especially in the machine industry. Deficits of both cancers occurred among farmers. The findings of the survey are considered as aetiological clues that may deserve further study, although some associations support observations in other countries. PMID- 3814544 TI - Leukaemia in benzene workers: a retrospective cohort study. AB - A retrospective cohort study was conducted in 233 benzene factories and 83 control factories in 12 cities in China. The benzene cohort and the control cohort consisted of 28,460 benzene exposed workers (178,556 person-years in 1972 81) and 28,257 control workers (199,201 person-years). Thirty cases of leukaemia (25 dead and 5 alive) were detected in the former and four cases (all dead) in the latter. The leukaemia mortality rate was 14/100,000 person-years in the benzene cohort and 2/100,000 person-years in the control cohort; the standardized mortality ratio was 5.74 (p less than 0.01 by U test). The average latency of benzene leukaemia was 11.4 years. Most (76.6%) cases of benzene leukaemia were of the acute type. The mortality due to benzene leukaemia was high in organic synthesis plants followed by painting and rubber synthesis industries. The concentration of benzene to which patients with a leukaemia were exposed ranged from 10 to 1000 mg/m3 (mostly from 50 to 500 mg/m3). Of the 25 cases of leukaemia, seven had a history of chronic benzene poisoning before the leukaemia developed. PMID- 3814545 TI - Does atopy have any predictive value for laboratory animal allergy? A comparison of different concepts of atopy. AB - Atopy is widely used as a discriminant in selection for employment involving exposure to allergenic substances. The validity of this has been tested in a population with a known burden of what is largely considered to be an IgE mediated disease, laboratory animal allergy. The findings suggest that atopy is insufficiently sensitive and specific for this purpose and that this is probably true for other occupational allergic diseases. The relation between different concepts of atopy--namely, atopy defined by family history, by personal history, and by skin prick tests with common allergens--has also been examined. The subpopulations identified by these criteria differed appreciably. Different concepts of atopy should not be used synonymously as they often are at present. PMID- 3814546 TI - Estimation of long term exposure to mixed solvents from questionnaire data: a tool for epidemiological investigations. AB - Quantifying the exposure of construction painters to mixed organic solvents is difficult in the face of a lack of industrial hygiene data, the heterogeneity of the solvents used, and the variability in work practices which influences the amount of solvents to which a worker is actually exposed. This report describes an attempt to derive an estimate of airborne solvent exposure using questionnaire responses in a population of construction and maintenance painters. This exposure index (EI) is a weighted average of the total number of gallons used a year minus the fraction which would be absorbed by a respirator, where the weights are based on the method of application (spraying, rolling, brushing) and the presence of ventilation (per cent time inside v outside). An analysis performed to determine the sensitivity of the EI to variations in the values chosen for several parameters showed that the index is relatively insensitive to the underlying assumptions that we have used. One component of the EI (self report of hours worked) correlated well with union payroll records. The EI appears to provide a useful relative (not absolute) estimate of airborne exposure to organic solvent mixtures which may be used as a dose surrogate in epidemiological investigations. PMID- 3814547 TI - Epidemiology and the prevention of occupational asthma. PMID- 3814548 TI - Respiratory effects of a single saturation dive to 300 m. AB - Lung function and the response to exercise were monitored in seven diver/welders who took part in a test saturation dive to 300 m for an average duration of 12 days; decompression took an average of nine days. Immediately after the dive the forced vital capacity was increased above base line by on average 0.51, the forced expiratory volume by 0.281 and peak expiratory flow rate by 0.71 s-1. There was no change in flow rate at small lung volumes (FEF 75% FVC). Recovery was complete and appeared to have a half time of 28 days. Transfer factor of the lungs for carbon monoxide (TlCO) was reduced by on average 9.6% after the dive but while partial recovery occurred, the values at one year were on average lower than those observed initially. The reason is unclear. One subject developed transient oxygen toxicity with stiff lungs and increased ventilation and cardiac frequency during submaximal exercise; a second subject developed similar changes but without accompanying symptoms. There is need for detailed physiological surveillance of people undertaking deep dives; this should be undertaken in circumstances that permit accurate measurements and full subject cooperation. PMID- 3814549 TI - Ventilatory function in rubber processing workers: acute changes over the workshift. AB - When considering rubber tyre manufacturing from an occupational health viewpoint, three areas may be identified in which exposure to respirable materials are potentially harmful: the processing, curing, and talc areas. A study of the ventilatory function of the entire work force employed in the processing area in a rubber tyre manufacturing plant was undertaken to determine whether an acute reduction in lung function occurs over the course of their working shift (the plant worked a three shift system) and whether a chronic exposure to the occupational airborne contaminants causes permanent changes in lung function. The ventilatory function was measured at the worksite at the beginning and immediately after the end of the workshift. No evidence of chronic obstructive pulmonary disease was found and in most cases no significant decline in FEV1 was observed. Only one of the 79 individuals showed a moderate obstruction, measured by the ratio FEV1/FVC which gave the value of 0.55, with no variation over the shift. For non-smokers, the FVC, FEV1, and FEF25-75% were lower in those exposed for more than five years than in those exposed for five years or less. A similar pattern was also observed in the FVC and FEV1 of the smokers. None of these differences was statistically significant. Within each exposure group the pulmonary function of the smokers was lower than that of the non-smokers, but the only significant difference was found in the values of FEF25-75%. Only one man showed a decline in the FEV1/FVC ratio over the shift, but during each shift, a decrease in all the lung function tests was observed. The decrease was smallest during the first of the three shifts. These results are thought to support the hypothesis that there are acute adverse effects over an eight hour shift. Further investigations are needed to discover whether these acute changes in lung function result from a chemical stimulation or irritant receptors in the airways. PMID- 3814550 TI - Determinants of respiratory symptoms in insulation workers exposed to asbestos and synthetic mineral fibres. AB - The determinants of respiratory symptoms were studied in an active workforce of insulation workers exposed to asbestos and synthetic mineral fibres. Responses to a mailed respiratory symptom questionnaire from 537 insulation workers without diagnosed asbestosis were analysed using logistic regression. Wheezing complaints and breathlessness were related primarily to current cigarette smoking and to symptoms suggesting an asthmatic predisposition antedating work in the trade. There was also evidence that these complaints were related to occupational exposure (estimated by number of hours worked in the trade) in subjects with prior airways hyperreactivity. An asthmatic predisposition antedating work in the trade was the major determinant of acute respiratory symptoms in the workplace. The effects of workplace exposures on respiratory symptoms may have been underestimated due to selective withdrawal from the active workforce and due to inaccuracies in the measure of exposure used. PMID- 3814551 TI - Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation. AB - This study was undertaken to determine the relation between radiographic and histological manifestations of pulmonary asbestosis (interstitial fibrosis) in insulation workers who had died of lung cancer. Of 450 confirmed deaths from lung cancer a chest radiograph suitable for determining evidence of pneumoconiosis was obtained in 219. Of these cases, 138 also had a tissue specimen submitted that was suitable for histological study to determine the extent of histological fibrosis. There was a significant albeit limited correlation between the radiographic and histological findings (r = 0.27, p less than 0.0013). All 138 cases had histological evidence of parenchymal fibrosis; in 25 (18%), however, there was no radiographic evidence of parenchymal fibrosis. In 10 cases (7%) both parenchymal and pleural disease were undetectable on the radiograph. Thus a negative chest radiograph does not exclude the presence of interstitial fibrosis (asbestosis) in a substantial proportion of insulation workers previously exposed to asbestos who develop lung cancer. PMID- 3814552 TI - Cytology of peritoneal aspirates and washings. PMID- 3814553 TI - Experimental estimation of intrauterine fetal irradiation dosage in computed tomography using a Rando Phantom. AB - A Rando Phantom was used experimentally to estimate the dosage of intrauterine irradiation a fetus would be subjected to if a computed tomographic investigation were to be performed antenatally. Lithium fluoride thermoluminescent dosimetry chips (TLD chips) were placed in the assumed intrauterine fetal position in a Rando Phantom. A scanogram was then used to identify the location of the chips and a computed tomographic scan was performed of the assumed intrauterine fetal position. It was felt that the measurement obtained from the TLD chips would give a more realistic estimate of the total dose that a fetus may be subjected to, both due to the primary and the scattered irradiation of the computed tomographic examination. PMID- 3814554 TI - Does conception before marriage matter? AB - Data from the 1970 British Births survey were used to compare 1380 births conceived before marriage (women who were delivered less than 6 months after marriage) with 13,845 births to women who had been married for at least 6 months before delivery. Infants in the premarital conception group were at increased risk because of maternal youth, primiparity and maternal health behaviour such as smoking. Once these factors had been taken into account there was no residual risk of perinatal death or low birthweight. There was a slight excess of preterm deliveries. PMID- 3814555 TI - Spontaneous abortion following mid-trimester amniocentesis. Clinical significance of placental perforation and blood-stained amniotic fluid. AB - The clinical significance of placental perforation and blood-stained amniotic fluid was studied in a group of 7238 Danish women undergoing mid-trimester amniocentesis for prenatal diagnosis under ultrasound guidance. The risk of spontaneous abortion was significantly increased both in pregnancies where the placenta was perforated and in those with blood-stained amniotic fluid. The risk estimate nearly doubled after placental perforation and more than doubled with a bloody tap. It is concluded that for women at relatively low risk of a fetal genetic abnormality, the indication of the amniocentesis should be reconsidered if a placental perforation is unavoidable. PMID- 3814556 TI - The effect of epidural anaesthesia for caesarean section on maternal uterine and fetal umbilical artery blood flow velocity waveforms. AB - The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diastolic (A/B) ratios, associated with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia. PMID- 3814557 TI - Fear of failure: a place for the trial of instrumental delivery. AB - The safety of performing potentially difficult midcavity forceps or vacuum extractions, as trials of instrumental delivery was assessed retrospectively. Successful vaginal delivery was achieved in 61% of 122 patients with delay in the second stage who had a trial of instrumental delivery performed in an operating theatre with full preparations to proceed to caesarean section. The outcome was compared with that in 42 patients who were delivered for the same indication, by primary caesarean section, without prior instrumentation. Transient fetal trauma occurred only in the trials of instrumental delivery, and there was no significant difference in immediate neonatal or maternal morbidity. In another group of 61 patients instrumental delivery was attempted without full preparations for possible caesarean section and when unexpected difficulty arose, the forceps or vacuum extractor were abandoned in favour of caesarean section. Within this group of unexpected failures of instrumentation there were significantly more babies with low Apgar scores, delayed onset of respirations or needing intubation. A carefully conducted trial of instrumental delivery is an acceptable alternative to caesarean section for delay in the second stage due to a potentially difficult midcavity arrest. PMID- 3814558 TI - Fetal distress and the condition of the newborn using cardiotocography and fetal blood analysis during labour. AB - The efficacy of electronic fetal monitoring combined with fetal blood analysis during labour in identifying fetal distress was investigated in a retrospective study. Operative delivery for fetal distress diagnosed during labour was performed in 9% of 2659 deliveries. All had continuous fetal heart rate monitoring and 22% had a fetal scalp blood analysis. Operative delivery had been performed in 53% of the infants who were acidotic at birth (umbilical artery pH less than 7.20) and in 46% of those with a low modified Apgar score (less than 7). These results show that the use of continuous fetal heart rate monitoring and fetal scalp blood sampling detects fetal distress without resulting in a high rate of operative delivery. PMID- 3814559 TI - Retrograde ejaculation: a systematic approach to non-invasive recovery of spermatozoa from post-ejaculatory urine for artificial insemination. AB - Retrograde ejaculation is an uncommon but treatable form of male infertility. Successful recovery of live spermatozoa from the post-ejaculatory urine for artificial insemination is dependent on careful regulation of pH and osmolarity of the urine into which ejaculation takes place, and separation of the motile spermatozoa from the debris and cells which are found in these samples. Three pregnancies established by artificial insemination of spermatozoa recovered by noninvasive means from the bladders of men suffering from retrograde ejaculation are described. The techniques for preparing the urine for spermatozoal survival, and for removal of cells and debris by sedimentation or buoyant density centrifugation are discussed. PMID- 3814561 TI - Long-term ambulatory anticoagulation by constant subcutaneous heparin infusion in pregnancy. Case report. PMID- 3814560 TI - Nasal absorption of progesterone in women. AB - Absorption profiles were obtained from women following the administration of ointment containing 20, 30 and 40 mg of progesterone to the nasal mucosa. There were no significant differences in area-under-curves between groups receiving the drug in one nostril but when 40 mg doses were divided between two nostrils there was a significantly greater area-under-curve suggesting that the area of mucosa applied with the drug is more important than dosage. PMID- 3814562 TI - The role of second-look laparotomy in the management of patients with Stage II, III and IV ovarian cancers following chemotherapy with cisplatin, adriamycin and cyclophosphamide. PMID- 3814563 TI - Acquired posterior keratoconus. AB - A case of acquired posterior keratoconus is presented. As in developmental cases the vision was moderately reduced and the condition was not progressive. Posterior keratoconus is usually developmental in origin, but trauma has been implicated in some cases. PMID- 3814564 TI - Cyclic variation in onset of central retinal vein occlusion. AB - We studied the seasonal incidence of onset of symptoms of central retinal vein occlusion (CRVO) in 105 patients over a 5-year period. Their onset showed a significant cyclic variation (p less than 0.01), being most frequent in the months September through to February. We believe this seasonal variation may in part reflect seasonal changes in haemostasis and retinal perfusion, though other unidentified factors play a significant role. PMID- 3814565 TI - Low dose fluorescein angiography of the conjunctiva and episclera. AB - By reducing the dose of injected fluorescein its leakage from conjunctival and episcleral capillaries has been minimised. These vessels have been demonstrated with great clarity, and the venous circulation, previously obscured by extravascular fluorescein, has also been revealed. The anatomy of the anterior segment vessels, and the blood flow within them, has been studied in eight normal subjects. The anterior ciliary arteries feed an anterior episcleral arterial circle that has superficial and deep components. This supplies the anterior conjunctival and episcleral circulations, the limbal arcades, and the iris arterioles. Where the superficial arterial circle is deficient, isolated vessels emerge from the deep segments of the circle to supply the episcleral plexus and conjunctival arterioles. Watershed zones between the anterior and posterior territories of the conjunctival and episcleral circulations overlap. They may fluoresce up to 30 seconds after the anterior ciliary arteries. The scope of this technique and the implications of these findings are discussed. PMID- 3814566 TI - Nerve fibre layer loss in diseases of the outer retinal layer. AB - We present examples of nerve fibre layer changes in diseases thought to affect primarily the outer retinal layers. These disease processes include cone-rod dystrophies, rod-cone dystrophies, juvenile macular degeneration (Stargardt's disease) and fundus flavimaculatis, vitelliform macular dystrophy, and Leber's congenital amaurosis. All were associated with alterations in the retinal nerve fibre layer, either diffuse or focal. The presence of these nerve fibre layer changes raises the question of transsynaptic degeneration and of possible primary or associated disease of other retinal cells than the receptors-namely, bipolar, amacrine, Mueller, or ganglion cells--in these disease of the outer retinal layer. Involvement of the nerve fibre layer also indicates the need to examine patients with defects in the nerve fibre layer by electroretinograms and other tests for outer retinal layer disease when no obvious optic nerve disease is present. PMID- 3814567 TI - Viscoelastic evacuation of traumatic hyphaema. AB - A technique for the safe evacuation of traumatic hyphaema is described. The viscoelastic properties of Healonid are used to separate the hyphaema from other ocular tissues and to extrude it through a small corneal incision. Healonid maintains a deep anterior chamber and a stable intraocular pressure. It also protects the lens, cornea, and iris and allows clear observation. PMID- 3814568 TI - A corneal abnormality associated with trisomy 8 mosaicism syndrome. AB - Eye abnormalities are a significant feature of trisomy 8 mosaicism syndrome. This paper gives the first account of the specific histopathology of a corneal opacity which is characteristic of this syndrome. The importance of early recognition is stressed because of potential therapeutic visual improvement. The necessity of including mosaic trisomy 8 in the differential diagnosis of such corneal opacities is illustrated by this case. PMID- 3814569 TI - Primary orbital amyloidosis localised to an extraocular muscle. AB - Primary, localised orbital amyloidosis has been reported previously in only 15 patients. A case with amyloidosis strictly localised to an extraocular muscle is presented. PMID- 3814570 TI - Neurotropic malignant melanoma of right temple with orbital metastasis: a clinicopathological case report. AB - A case is reported of neurotropic melanoma developed from a superficial spreading melanoma with minimal cytological deviation, situated in the right temple. The nine-year course was clinically characterised by local recurrences, involvement of the orbit and the parotid region via neurogenic invasion, and systemic metastases to lung, seventh rib, and the brain. The histopathology was characterised by fascicles of dysplastic spindle cells, neuroid arrangement in loose fibrillary matrix, and peri- and intraneural permeation of the nerve trunks. Despite minimal atypism the neoplasm metastasised and had a fatal outcome. The spindle cell component of the neurotropic melanoma lacked melanogenesis; Fontana stains were negative. As previously demonstrated, the histogenesis of the neurotropic melanoma is possibly a Schwann cell differentiation of the dysplastic atypical melanocytes, as shown by the positive reactions to Bodian's stain. PMID- 3814571 TI - Diagnosis of orbital myositis by nuclear magnetic resonance imaging. AB - Two cases of orbital myositis are reported in which precise identification of the involved muscle was possible with the use of surface coil nuclear magnetic resonance (NMR) imaging. A clinical response to oral steroids in both cases coincided with a marked reduction in the abnormal thickening of the muscles as seen on the NMR images. PMID- 3814573 TI - Bupivacaine and lignocaine for ophthalmic surgery. AB - Bupivacaine 0.5% when used as a local anaesthetic for ocular cataract surgery does not give absolute ocular akinesia but provides adequate and prolonged pain relief. In comparison lignocaine provides good ocular akinesia at operation but pain relief is short lived. The mixture of the two local anaesthetics in equal volumes eliminated the disadvantages of their individual use. PMID- 3814572 TI - Spatial contrast sensitivity and the diagnosis of amblyopia. AB - The relationship was studied between spatial contrast sensitivity function and type of pathology of the visual system. Two characteristics were found to be typical for amblyopia: there is a discrepancy between the high-frequency cut-off ('grating acuity') and the Snellen acuity; the contrast sensitivity is strongly dependent on the width of the stimulus. In optic nerve degeneration a decrease in contrast sensitivity is found at low spatial frequencies. Decreased contrast sensitivity at high spatial frequencies is atypical but occurs in those disorders associated with decreased Snellen visual acuity. From these findings a relationship is defined which enables spatial contrast sensitivity tests to be used to differentiate between amblyopia and optic nerve degeneration. PMID- 3814574 TI - Complete evulsion of the globe and optic nerve. AB - A 17-year-old boy had an evulsion of globe and optic nerve from an automobile accident. Computed tomography showed a severed optic nerve on the injured side. A visual field defect was demonstrated in the other eye. PMID- 3814575 TI - A comparison of cycloplegic and manifest refractions on the NR-1000F (an objective Auto Refractometer). AB - The manifest (dry) and cycloplegic refractions of 50 eyes of 25 patients aged 8 to 28 years were studied on the Nikon Auto Refractometer NR-1000F (AR) and compared with the results of clinical refraction (CR) under homatropine and the final clinical acceptance on postmydriatic testing. Only patients in the younger age groups with low to moderate refractive errors were included in this study; high myopes and hypermetropes and patients with aphakia and mixed astigmatism were excluded. The degree of agreement for spherical equivalents, sphere components, and cylinder components was analysed separately for both cycloplegic and manifest refractions on the AR and CR. The results showed that the fixation target in the NR-1000F induces significant instrument myopia during manifest refraction in the younger patients with lower refractive errors. We recommend that caution should be exercised in interpreting manifest refractions on the AR, especially in younger patients. A cycloplegic automatic refraction would be acceptably accurate. PMID- 3814576 TI - Binding and hydrolysis of ATP by cardiac myosin subfragment 1: effect of solution parameters on transient kinetics. AB - Transient kinetic data of ATP binding and cleavage by cardiac myosin subfragment 1 (S1) were obtained by fluorescence stopped flow and analyzed by using computer modeling based on a consecutive, reversible two-step mechanism: (formula: see text) where M1 and M12 denote myosin species with enhanced fluorescence and K'O = K0/(K0[ATP] + 1). The kinetic constants K0, k12, k23, and k32 and the fractional contributions of M1 and M12 to the total fluorescence are analyzed over a range of systematically varied solution parameters. The initial ATP binding equilibrium (K0), which decreases with increasing pH, is facilitated by a positively charged protein residue with a pK of 7.1. An active-site charge of +1.5 is determined from the ionic strength dependence. The rate constants k12, k23, and k32 also exhibit pK's near neutrality but increase with increasing pH. The majority of the large (-54 kJ/mol) negative free energy of ATP binding occurs upon S1 isomerization, k12, and a large increase in entropy (183 J/kmol at 15 degrees C) is associated with the cleavage step. The equilibrium constant for the cleavage step, K2, is determined as 3.5 at pH 7.0, 15 degrees C, and 200 mM ionic strength. There are no significant changes in fractional contributions to total fluorescence enhancement due to solvent-dependent conformational changes of S1 in these data. When values for the combined rate constants are calculated and compared with those determined by graphical analysis, it is observed that graphical analysis overestimates the binding rate constant (K0k12) by 25% and the hydrolysis rate constant (k23 + k32) by as much as 30%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814577 TI - Purification and characterization of an enkephalin-degrading dipeptidyl aminopeptidase from porcine brain. AB - A porcine brain dipeptidyl-aminopeptidase (DAP) has been purified more than 2400 fold from a crude mitochondrial fraction containing synaptosomes. This enzyme catalyzes the release of free Tyr-Gly from Leu-enkephalin (Km = 2.5 microM) with an optimal activity between pH 6.0 and pH 8.0. The enzyme appears homogeneous as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis devoid of detectable contaminating aminopeptidase activities. The native enzyme is a monomeric protein with a molecular weight of 51,000 +/- 1,000 and an isoelectric point of 4.6 +/- 0.1. This enzyme cosediments with synaptosomes on a Ficoll sucrose gradient and is partially associated with synaptic plasma membranes. Its activity is inhibited by the metal-chelating agents ethylenediaminetetraacetate and o-phenanthroline. It is not inhibited by the OH-reactive agent phenylmethanesulfonyl fluoride and SH-reactive agents such as p (chloromercuri)benzoate and N-ethylmaleimide. Among the various biologically active peptides tested, the purified enzyme releases efficiently the N-terminal dipeptide moiety from enkephalins, Trp-Met-Asp-Phe-NH2 (CCK4), and Gly-Trp-Met Asp-Phe-NH2 (CCK5). At variance, the native peptides CCK8, substance P, neurotensin, and angiotensin II are not cleaved by the DAP. This enzyme is different from other unspecific DAPs, as well as from enkephalin-degrading DAPs previously reported, by its molecular weight and substrate specificity. PMID- 3814578 TI - Decarboxylation of oxalacetate by pyruvate carboxylase. AB - The decarboxylation of oxalacetate by pyruvate carboxylase in the absence of ADP and Pi is stimulated 400-fold by the presence of oxamate, which is an inhibitory analogue of pyruvate. The observation of substrate inhibition when either oxamate or oxalacetate is varied at a fixed concentration of the other indicates that both molecules bind at the same site on the enzyme. The pH profiles for this reaction show no evidence of the involvement of an enzymic acid-base catalyst, suggesting that the proton and CO2 units may be exchanged directly between the reactants (although CO2 sequestered in the active site may be an intermediate in the process). The pH profiles of the full reverse reaction of pyruvate carboxylase in which oxalacetate decarboxylation is coupled to ATP formation and where Pi is the variable substrate do, however, indicate that such an acid-base catalyst is involved in the other partial reaction of the enzyme in proton transfer to and from biotin. The enzyme also displays two oxamate-independent oxalacetate decarboxylating activities, one of which is biotin-dependent and the other is independent of biotin. PMID- 3814579 TI - An experimental test of the discreteness-of-charge effect in positive and negative lipid bilayers. AB - The electrostatic properties of charged bilayers and the bilayer component of biological membranes are often described theoretically by assuming the charge is smeared uniformly over the surface. This is one of the fundamental assumptions in the Gouy-Chapman-Stern (GCS) theory. However, the average distance between the charged phospholipids in a typical biological membrane is 2-3 nm, which is 2-3 times the Debye length in a 0.1 M salt solution. Existing discreteness-of-charge theories predict significant deviations from the GCS theory for the adsorption of ions to such membranes. We considered the predictions of the simplest discreteness-of-charge theory [Nelson, A. P., & McQuarrie, D. A. (1975) J. Theor. Biol. 55, 13-27], in which the charges are assumed to be fixed in a square lattice and the potential is described by the linearized Poisson-Boltzmann relation. This theory predicts deviations that are larger for counterions than for co-ions and much larger for divalent than for monovalent counterions. We tested these predictions by measuring the adsorption of a fluorescent monovalent anion and a paramagnetic divalent cation to both positive and negative membranes, which we demonstrated experimentally had the same average surface potential. All our experimental results with probes, including those obtained on membranes in the gel rather than in the liquid-crystalline state, agreed with the predictions of the GCS theory rather than with the discreteness-of-charge theory. A simple calculation indicates that the agreement between the experimental results and the predictions of the GCS theory could be due to the finite size of the lipids. PMID- 3814580 TI - A test of discreteness-of-charge effects in phospholipid vesicles: measurements using paramagnetic amphiphiles. AB - A new series of negatively charged, paramagnetic alkylsulfonate probes was synthesized and can be used to measure both the internal and the external surface potentials of model membrane systems. We tested for discreteness-of-charge effects in lipid membranes by comparing the surface potentials, estimated by use of these negatively charged amphiphiles, with that of a series of positively charged alkylammonium nitroxides in charged membranes. From the partitioning of these probes, the membrane surface potential was estimated in phosphatidylcholine membranes containing either phosphatidylserine or didodecyldimethylammonium bromide. The surface potentials, estimated with either positive or negative probes, were identical, within experimental error, in either positive or negative membranes, and they were well accounted for by a simple Gouy-Chapman-Stern theory. This symmetry, with respect to the sign of the charge, indicates that discreteness-of-charge effects are not significant in determining the potential sensitive phase partitioning of these probes in model membranes. Thus, despite the fact that charge on membranes is discrete, models that assume a uniform density of charge in the plane of the membrane adequately account for the potentials measured by these amphiphilic probes. PMID- 3814581 TI - Elasticity of synthetic phospholipid vesicles and submitochondrial particles during osmotic swelling. AB - A rapid and accurate method has been developed for measuring the elastic response of vesicle bilayer membranes to an applied osmotic pressure. The technique of dynamic light scattering is used to measure both the elastic constant and the elastic limit of dioleoylphosphatidic acid (DOPA) and DOPA-cholesterol vesicles and of submitochondrial particles derived from the inner membrane of bovine heart mitochondria. The vesicles prepared by the pH-adjustment method are unilamellar and of uniform size between 240 and 460 nm in diameter. The vesicles swell uniformly upon dilution. The observed change in size is not due to any change in the shape of the vesicles. The data also indicate that the vesicles are spherical and not flaccid. The total vesicle swelling in these studies resulted in a 3-4% increase in surface area for vesicles swollen in 0.15 M KCl and a 5-10% increase in surface area for vesicles swollen in 0.25 M sucrose. This maximum represents the elastic limit of the vesicles. Evidence is presented to show that the vesicles release contents after swelling to this maximum, reseal immediately, and reswell according to the osmotic pressure. For DOPA vesicles in a 0.15 M KCl tris(hydroxymethyl)aminomethane hydrochloride (Tris-HCl) buffer (pH 7.55), the observed membrane modulus is found to be in the range of 10(8) dyn/cm2. The modulus was found to be in the order of 10(7) dyn/cm2 for DOPA vesicles in a 0.25 M sucrose-Tris-HCl buffer (pH 7.55). This is comparable to that of submitochondrial particles in the same sucrose-Tris-HCl buffer. The observed membrane modulus also decreases with vesicle size. Its magnitude and its variation with ionic strength indicate that the major component of bilayer elasticity is neither the inherent elasticity of the bilayer nor the bending modulus. The variation of the membrane modulus with respect to curvature suggests that its principal component may be related to surface tension effects including the negative charges on the vesicle surface. There is considerable variation between vesicles swollen in sucrose and those swollen in KCl in the membrane modulus, in the elastic limit at which the vesicles burst, and in the transbilayer pressure difference at bursting. The latter was found to be 4-6 mosM (10(5) dyn/cm2) in sucrose solution and 20-4 mosM (10(6) dyn/cm2) in KCl solution. PMID- 3814582 TI - Absence of detectable ribonucleic acid in the purified, untransformed mouse glucocorticoid receptor. AB - The glucocorticoid receptor (GC-R) isolated from the mouse AtT-20 pituitary tumor cell line exists in three forms. The untransformed (non-DNA-binding), 9.1S species (319K) can be converted into two transformed (DNA-binding) species. One of these (5.2 S, Mr 132K) appears to be composed of one molecule of the hormone binding, monomeric protein (96K) plus a small RNA, while the second transformed species is the monomeric, hormone-binding subunit (3.8 S, 96K) itself. We wished to determine whether the untransformed GC-R contains RNA or if the monomer binds to RNA subsequent to subunit dissociation (which occurs during receptor transformation). Kinetic studies using both the crude and purified untransformed GC-R show that the untransformed, 9.1S GC-R dissociates into 3.8S monomeric subunits, without forming a transient 5.2S complex. The untransformed receptor was then purified with affinity chromatography, gel filtration, and DEAE cellulose chromatography. One major protein band, corresponding in size to the GC R monomer (94K-96K), was observed on sodium dodecyl sulfate-polyacrylamide gels upon silver staining or fluorography of [3H]dexamethasone mesylate covalently labeled receptor. In vivo 32P-labeling of AtT-20 cells, followed by purification of the untransformed GC-R, yielded two major 32P-labeled components (94K-96K and 24K). Both of these bands were protease-sensitive, contained phosphoserine, and were unaffected by ribonuclease treatment. We conclude that the untransformed mouse GC-R is wholly proteinaceous and contains no RNA. Thus, RNA binding occurs subsequent to dissociation of the oligomeric, untransformed GC-R complex into monomers. PMID- 3814583 TI - Design and synthesis of glucagon partial agonists and antagonists. AB - The hyperglycemia and ketosis of diabetes mellitus are generally associated with elevated levels of glucagon in the blood. This suggests that glucagon is a contributing factor in the metabolic abnormalities of diabetes mellitus. A glucagon-receptor antagonist might provide important evidence for glucagons's role in this disease. In this work we describe how we combined structural modifications that led to glucagon analogues with partial agonist activity to give glucagon analogues that can act as competitive antagonists of glucagon stimulated adenylate cyclase activity. Using solid-phase synthesis methodology and preparative reverse-phase high-performance liquid chromatography, we synthesized the following seven glucagon analogues and obtained them in high purity: [D-Phe4,Tyr5,Arg12]glucagon (2); [D-Phe4,Tyr5,Lys17,18]glucagon (3); [Phe1,Glu3,Lys17,18]glucagon (4); [Glu3,Val5,Lys17,18]glucagon (5); [Asp3,D Phe4,Ser5,Lys17,18]glucagon (6); I4-[Asp3,D-Phe4,Ser5,Lys17,18]glucagon (7); [Pro3]glucagon (8). Purity was assessed by enzymatic total hydrolysis, by chymotryptic peptide mapping, and by reverse-phase high-performance liquid chromatography. The new analogues were tested for specific binding, for their effect on the adenylate cyclase activity in rat liver membranes, and for their effect on the blood glucose levels in normal rats relative to glucagon. Analogues showing no adenylate cyclase activity were examined for their ability to act as antagonists by displacing glucagon-stimulated adenylate cyclase dose-response curves to the right (higher concentrations). The binding potencies of the new analogues relative to glucagon (= 100) were respectively 1.0 (2), 1.3 (3), 3.8 (4), 0.4 (5), 1.3 (6), 5.3 (7), and 3 (8). Glucagon analogues 3-5 and 8 were all weak partial agonists with EC50 values of 500 (3), 250 (4), 1600 (5), and 395 nM (8), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814584 TI - Enthalpy changes in microtubule assembly from pure tubulin. AB - The enthalpy changes that occur in the self-assembly of tubulin into microtubules were examined by adiabatic differential heat capacity microcalorimetry and by isothermal batch microcalorimetry. Tubulin solutions at concentrations between 7 and 17 mg/mL were heated from 0 to 40 degrees C at heating rates of 1 or 2 deg/min in pH 6.8 or 7.0 assembly buffers containing 20 mM MES, 100 mM glutamic acid, 5 mM MgCl2, 3.4 M glycerol, and either 0.5 mM GMP-PCP or 1 mM GTP. The assembly reaction in the presence of GTP was characterized by a complex heat uptake pattern consisting of a broad endotherm with a sharper exotherm superimposed on it, similar to assembly in a GTP phosphate buffer [Hinz, H.-J., Gorbunoff, M.J., Price, B., & Timasheff, S.N. (1979) Biochemistry 18,3084]. Replacement of GTP by the nonhydrolyzable analogue resulted in a pattern typical for an endothermic reaction only. These results have permitted the assignment of the endothermic process to microtubule assembly and of the exothermic process to the resultant GTP hydrolysis. In these studies equilibration was found to be slow, several hours of cooling being required for the system to return to its original state. Turbidity scans also revealed hysteresis between consecutive scans and a displacement of the depolymerization transition midpoint to a lower temperature than that of assembly. The disassembly of microtubules was examined in batch calorimetry experiments in pH 7.0 phosphate, 1 mM GTP, 16 mM MgCl2, and 3.4 M glycerol, in which tubulin assembled into microtubules was diluted to below the critical concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814585 TI - GDP state of tubulin: stabilization of double rings. AB - Purified tubulin, with GDP occupying the exchangeable nucleotide binding site, has been examined conformationally and for its ability to self-associate into double rings. The circular dichroism spectrum increased by ca. 10% in negative amplitude between 205 and 225 nm over the spectrum of tubulin in the GTP state, but there were no significant shape changes. This indicates that replacement of GTP by GDP induces tubulin to adopt a more ordered conformation. The sedimentation coefficients of tubulin alpha-beta dimers in the GDP and GTP states were identical, with s20,w = 5.8 S. A sedimentation velocity study of tubulin in the GDP state showed that, in the presence of magnesium ions, this protein undergoes a reversible Gilbert-type self-association. The end product of this reaction was found to be 26 subunit double rings identical with those described by Frigon and Timasheff [(1975) Biochemistry 14, 4567-4599] for a similar polymerization of tubulin in the GTP state. Analysis of the data showed that Tu GDP has a much stronger propensity for the formation of double rings than Tu-GTP, the corresponding equilibrium with constants for the 26Tu in equilibrium Tu26 being 4.2 X 10(119) M-25 and 2.27 X 10(109) M-25 for Tu-GDP and Tu-GTP, respectively. This leads to Tu-GTP being predominantly in the form of alpha-beta dimers and Tu-GDP in the form of double rings under normal experimental conditions used in the study of microtubule assembly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814586 TI - Study of the time-resolved tryptophan fluorescence of crystalline alpha chymotrypsin. AB - The tryptophan environments in crystalline alpha-chymotrypsin were investigated by fluorescence. The heterogeneous emission from this multitryptophan enzyme was resolved by time-correlated fluorescence spectroscopy. The fluorescence decays at 296-nm laser excitation and various emission wavelengths could be characterized by a triple-exponential function with decay times tau 1 = 150 +/- 50 ps, tau 2 = 1.45 +/- 0.25 ns, and tau 3 = 4.2 +/- 0.4 ns. The corresponding decay-associated emission spectra of the three components had maxima at about 325, 332, and 343 nm. The three decay components in this enzyme can be correlated with X-ray crystallographic data [Birktoft, J.J., & Blow, D.M. (1972) J. Mol. Biol. 68, 187 240]. Inter- and intramolecular tryptophan-tryptophan energy-transfer efficiencies in crystalline alpha-chymotrypsin were computed from the accurately known positions and orientations of all tryptophan residues. These calculations indicate that the three fluorescence decay components in crystalline alpha chymotrypsin can be assigned to three distinct classes of tryptophyl residues. Because of the different proximity of tryptophan residues to neighboring internal quenching groups, the decay times of the three classes are different. Decay tau 1 can be assigned to Trp-172 and Trp-215 and tau 2 to Trp-51 and Trp-237, while the tryptophyl residues 27, 29, 141, and 207 all have decay time tau 3. PMID- 3814587 TI - Kinetics of the reconstituted 2-oxoglutarate carrier from bovine heart mitochondria. AB - The 2-oxoglutarate carrier from the inner membrane of bovine heart mitochondria was purified by chromatography on hydroxyapatite/celite and reconstituted with egg yolk phospholipid vesicles by the freeze-thaw-sonication technique. In the reconstituted system the incorporated 2-oxoglutarate carrier catalyzed a first order reaction of 2-oxoglutarate/2-oxoglutarate exchange. The substrate affinity for 2-oxoglutarate was determined to be 65 +/- 18 microM (15 determinations) and the maximum exchange rate at 25 degrees C reaches 4000-22,000 mumol/min per g protein, in dependence of the particular reconstitution conditions. The activation energy of the exchange reaction is 54.3 kJ/mol. The transport is independent of pH in the range between 6 and 8. When the first fraction of the hydroxyapatite/celite column eluate was used for reconstitution, besides the 2 oxoglutarate/2-oxoglutarate exchange, a significant activity of unidirectional uptake was observed. This activity may be due to a population of the carrier protein which is in a different state. PMID- 3814588 TI - Effects of a cytosolic protein on the interaction of rat pancreatic zymogen granules in vitro. AB - Photon correlation spectroscopy has been used to study the kinetics of aggregation of isolated rat pancreatic zymogen granules in vitro by monitoring time-dependent changes in mean particle size derived from the photon count autocorrelation function, g2(tau). Isolated granules were stable in isotonic sucrose (pH 5.4-7.0). At pH 6.0 they maintained a mean diameter of 1225 +/- 18 nm with a polydispersity index of 0.199 +/- 0.007. The mean granule diameter showed a limited decrease (approx. 20%) with increasing pH within the range 5.4-7.0, but the polydispersity index was unaltered. At pH greater than 7.0 granule instability was indicated by a rapid reduction in total photon counts. In solutions of monovalent cations ([M+] greater than 10 mM) and divalent cations ([M2+] greater than 0.5 mM) zymogen granules aggregated at a rate dependent upon both ion and granule concentration. These effects were consistent with the bimolecular nature of the interaction mechanism and were clearly distinguishable from the limited size changes associated with osmolarity. At concentrations of Na+ or K+ salts greater than 50 mM granule aggregation was accompanied by anion dependent solubilisation. A soluble protein fraction separated from the pancreatic acinar cell cytosol by gel filtration reduced the mean diameter and polydispersity index of zymogen granules suspended in isotonic sucrose, inhibited cation-induced aggregation and stabilised granules to solubilisation induced by raising pH greater than 7.0 or exposure to high ionic strength media. The inhibitory effects of this protein were apparent at concentrations less than or equal to 10 micrograms X ml-1 (i.e. at inhibitor: granule protein ratios less than 1:20) and could not be mimicked by bovine serum albumin, the Ca2+-binding proteins calmodulin and troponin C (less than or equal to 100 micrograms X ml-1), nor the highly negatively charged polymer polyglutamate (less than or equal to 10 micrograms X ml-1). Inhibitory activity was also absent from fractions of rat liver cytosol prepared identically to pancreatic acinar cytosol. These observations are consistent with the presence in pancreatic acinar cells of a specific cytosolic granule stabilisation factor (or factors) that normally restricts zymogen granule interaction and may therefore play an important role in the regulation of granule mobility and exocytosis. PMID- 3814589 TI - Temperature-dependent modes for the binding of the polyene antibiotic amphotericin B to human erythrocyte membranes. A circular dichroism study. AB - The interaction of amphotericin B with isolated human erythrocyte ghosts was monitored by circular dichroism at 37 degrees C and 15 degrees C. Although different, these spectra were not concentration dependent over a concentration range covering the inducement of K+ leakage and hemolysis, which suggests the existence of only one bound amphotericin B species. At 15 degrees C, the spectra indicate that amphotericin B is complexed with membrane cholesterol; the complex formation is saturable but not cooperative. At 37 degrees C new spectra are observed, and their existence is conditioned by the presence of membrane proteins. The binding is cooperative but not saturable. The amphotericin B right side-out vesicles complexation is temperature as well as ionic strength dependent: at high ionic strength it is the same as with ghosts, with the same temperature dependence. At low ionic strength it is characteristic of an interaction with cholesterol, regardless of temperature. In the large unilamellar vesicles reconstituted from the total lipid extracts of erythrocyte membranes, amphotericin B is complexed with cholesterol, regardless of temperature and ionic strength. These results indicate that there are two different modes of amphotericin B complexation with erythrocyte membranes, reversible one in the other, depending on the molecular organization of the membrane and the presence of membrane proteins. PMID- 3814590 TI - The molecular organization of the influenza virus surface. Studies using photoreactive and fluorescent labeled phospholipid probes. AB - The membrane structures of remantadin-sensitive and remantadin-resistant influenza virus strains were studied using a photoreactive fatty acid as well as analogues of phosphatidylcholine, phosphatidylethanolamine and sphingomyelin, carrying a fluorescent or photoreactive reporter group at the end of one of the aliphatic chains. The results obtained demonstrated for the first time that the phospholipids of the viral membrane form lateral domains differing by the fluidity of their hydrocarbon chains and, probably, by the head-group composition of the lipids. The hemagglutinin small subunit (HA2) was shown to protrude into the apolar region of the phospholipid bilayer, whereas the M1 protein makes contact only with the inner surface. In the remantadin-sensitive virions the heavy hemagglutinin chain (HA1) appears not to be in contact with the lipid bilayer, whereas in the remantadin-resistant strain HA1 has a hydrophobic segment that proved to be inserted into the bilayer. PMID- 3814591 TI - Isolation of apical plasma membrane in rabbit gallbladder epithelium by Percoll density gradient centrifugation. AB - The apical membranes of rabbit gallbladder epithelial cells were isolated by treating the homogenate with Ca2+ or Mg2+ and centrifuging the suspension in Percoll gradient. In this way brush-border membranes were obtained with enrichment factors ranging between 10 and 20 and yields of 15-30%. A second method is described with which membranes were isolated, without any preliminary treatment, first by differential centrifugation, then with Percoll gradient; the final membrane enrichment was over 15, however the yield was very low (3%). Many possible enzymatic markers of the apical plasma membrane were investigated: L gamma-glutamyltransferase, alkaline phosphatase, leucine aminopeptidase, sucrase. The first appears to be that of choice. Apical membrane fraction could be also evidenced by autofluorescence or by labeling with Lotus tetragonolobus lectin. Preliminary experiments showed that apical plasma membranes isolated in this way form vesicles. PMID- 3814592 TI - In squid axons, ATP modulates Na+-Ca2+ exchange by a Ca2+i-dependent phosphorylation. AB - In squid axons ATP stimulates both the forward and reverse modes of the Na+-Ca2+ exchange by changing the affinity of the carrier towards Na+ and Ca2+ ions. Whether ATP activates the Na+-Ca2+ antiporter allosterically or is hydrolyzed during activation is still debated. The hypothesis that ATP modulates the Na+ Ca2+ exchange through phosphorylation has been tested by means of [gamma-S]ATP, an ATP analog that can act as a substrate for kinases but not for ATPases. Steady state Ca2+ efflux was measured in squid axons dialyzed without ATP and containing either 0.7 or 100 microM Ca2+i. Addition of 1 mM [gamma-S]ATP markedly increases the Na+o-dependent component of the Ca2+ efflux. The activation by [gamma-S]ATP: requires the presence of Mg2+i, is partially reversible upon removing the analog, is greater than that caused by ATP and only operates on the exchange system since no activation of the ATP-dependent uncoupled Ca2+ efflux (Ca2+ pump) can be detected. 22Na+ experiments were used to monitor the Cao-dependent Na+ efflux (reverse Na+-Ca2+ exchange). Without Ca2+i and ATP, Na+ efflux is very small ('leak'). [gamma-S]ATP does not activate the efflux of Na+ in the absence of Ca2+i. In the presence of Ca2+i the ATP analog stimulates both the Cao- and Nao dependent Na+ efflux components. Interestingly, neither the Na+ pump, Ca2+i independent Na+-Na+ exchange, Nai+-Mg2+i exchange or Na+/K+/Cl- cotransport are affected by [gamma-S]ATP. The experiments indicate that a Ca2+i-dependent phosphorylation occurs during the activation of the Na+-Ca2+ exchange by ATP. PMID- 3814593 TI - Solid core liposomes with encapsulated colloidal gold particles. AB - Solid core liposomes with encapsulated colloidal gold particles were prepared through four major steps: Preparation of prevesicles with encapsulated solid cores of agarose-gelatin by emulsification of agarose-gelatin sol in organic solvent containing emulsifiers followed by cooling. Extraction of lipophilic components from prevesicles to obtain microspherules of agarose-gelatin. Introducing colloidal gold particles into microspherules and coating with protein molecules. Encapsulation of colloidal gold-bearing microspherules with the modified organic solvent spherule evaporation method for preparation of liposomes (Kim et al. (1983) Biochim. Biophys. Acta 728, 339-348 and Kim et al. (1984) Biochim. Biophys. Acta 812, 793-801). Electron micrographs showed that if liposomes were prepared by using a lipid mixture containing dioleoylphosphatidylcholine/cholesterol/dioleoylphosphatidylglycerol/tri olein (molar ratio 4.5:4.5:1:1), there was only a single continuous bilayer membrane for each solid core liposome. However, if no triolein was added to the lipid mixture, it would cause the formation of multilamellar liposomes. In both cases, there were hundreds to thousands of colloidal gold particles within each solid core liposome. PMID- 3814594 TI - Nucleoside and nucleobase transport and metabolism in wild type and nucleoside transport-deficient Aedes albopictus cells. AB - Nucleoside and nucleobase transport and metabolism were measured in ATP-depleted and normal Aedes albopictus mosquito cells (line C-7-10) by rapid kinetic techniques. The cells possess a facilitated diffusion system for nucleosides, which in its broad substrate specificity and kinetic properties resembles that present in many types of mammalian cells. The Michaelis-Menten constant for uridine transport at 28 degrees C is about 180 microM. However, the nucleoside transporter of the mosquito cells is resistant to inhibition by nmolar concentrations of nitrobenzylthioinosine and the cells lack high affinity nitrobenzylthioinosine binding sites. The cells also possess an adenine transporter, which is distinct from the nucleoside transporter. They lack, however, a hypoxanthine transport system and are deficient in hypoxanthine phosphoribosyltransferase activity, which explains their failure to efficiently salvage hypoxanthine from the medium. The cells possess uridine and thymidine phosphorylase activities and, in contrast to cultured mammalian cells, efficiently convert uracil to nucleotides. An adenosine-resistant variant (CAE-3 6) of the C-7-10 cell line is devoid of significant nucleoside transport activity but transports adenine normally. Residual entry of various nucleosides into these cells and of hypoxanthine and cytosine into wild type and mutant cells is strictly non-mediated. The rate of permeation of various nucleosides and of hypoxanthine into the CAE-3-6 cells is related to their hydrophobicity. Uridine permeation into CAE-3-6 cells exhibits an activation energy of about 20 kcal/mol. At high uridine concentrations permeation is sufficiently rapid to partly overcome the limitation in nucleoside salvage imposed by the nucleoside transport defect in these cells. PMID- 3814595 TI - 2H-NMR, 31P-NMR and DSC characterization of a novel lipid organization in calcium dioleoylphosphatidate membranes. Implications for the mechanism of the phosphatidate calcium transmembrane shuttle. AB - 2H-NMR, 31P-NMR and DSC investigations are presented on the structure and dynamics of the Ca2+-dioleoylphosphatidate complex which is formed upon addition of calcium to dispersions of pure dioleoylphosphatidate or of dioleoylphosphatidate in mixtures with dioleoylphosphatidylcholine (DOPC). It is concluded that the phosphate region in the polar headgroup of dioleoylphosphatidate is immobilized, while the oleate chains remain liquid and have increased disorder. In mixtures of dioleoylphosphatidate and DOPC in the presence of calcium a dioleoylphosphatidate-rich phase is segregated, in which the molecular behaviour of phosphatidate is rather similar to that of the pure Ca2+-dioleoylphosphatidate complex. A hypothetical model is proposed for the structure of this complex and this is correlated with the dioleoylphosphatidate mediated transmembrane transport of calcium (Smaal, E.B., Mandersloot, J.G., De Kruijff, B. and De Gier, J. (1986) Biochim. Biophys. Acta 860, 99-108). Data indicate that this transmembrane shuttle is an inverted organization of phosphatidate molecules enclosing calcium ions in an anhydrous core. PMID- 3814596 TI - p-Aminohippurate transport in basal-lateral membrane vesicles from rabbit renal cortex: stimulation by pH and sodium gradients. AB - p-Aminohippuric acid (PAH) uptake was studied in basal-lateral membrane vesicles prepared from rabbit renal cortex. An outwardly directed hydroxyl gradient (pHo = 6.0, pHi = 7.6) stimulated PAH uptake slightly over that when the internal and external pH values were equal at 7.6. A 100 mM sodium gluconate gradient directed into the basal-lateral membrane vesicles increased PAH uptake about 2-fold over that when N-methyl-D-glucamine or potassium gluconate gradients were present. When hydroxyl and sodium gradients were simultaneously imposed (pHo = 6.0, pHi = 7.6 and 100 mM sodium gluconate extravesicularly) PAH uptake was stimulated greater than with the pH or Na+ gradient alone. In fact, an 'overshoot' was observed. Countertransport experiments showed that either intravesicular PAH or intravesicular PAH and Na+ could stimulate 3H-PAH uptake. Probenecid, an inhibitor of organic anion transport, inhibited both the hydroxyl-stimulated and Na+ gradient-stimulated PAH uptake but the greatest inhibition by probenecid was seen when the hydroxyl and sodium gradients were both present. Thus, it is proposed that the driving force for PAH accumulation across the basal-lateral membrane of the proximal tubule is a transport system which moves Na+ and PAH into the cell for an hydroxyl ion leaving the cell, i.e. a sodium-dependent anion anion exchange system. PMID- 3814597 TI - Alterations by saponins of passive Ca2+ permeability and Na+-Ca2+ exchange activity of canine cardiac sarcolemmal vesicles. AB - Saponins can both permeabilize cell plasma membranes and cause positive inotropic effects in isolated cardiac muscles. Different saponins vary in their relative abilities to cause each effect suggesting that different mechanisms of action may be involved. To investigate this possibility, we have compared the effects of seven different saponins on the passive Ca2+ permeability and Na+-Ca2+ exchange activity of isolated canine cardiac sarcolemmal membranes. Saponins having hemolytic activity reversibly increased the passive efflux of Ca2+ from sarcolemmal vesicles preloaded with 45Ca2+ with the following order of potency: echinoside-A greater than echinoside-B greater than holothurin-A greater than holothurin-B greater than sakuraso-saponin. Ginsenoside-Rd and desacyl-jego saponin, which lack hemolytic activity, had no significant effect on this variable. The saponins also stimulated Na+-Ca2+ exchange activity measured as Na+ dependent Ca2+ uptake by sarcolemmal vesicles. Ginsenoside-Rd and desacyl-jego seponin, which did not affect passive Ca2+ permeability, stimulated the uptake, while in contrast, echinoside-A and -B only slightly increased or decreased this latter variable. Thus, the abilities of these compounds to enhance Na+-Ca2+ exchange activity seem to be inversely related to their abilities to increase the Ca2+ permeability. Effects by the echinosides on Na+-Ca2+ exchange may be masked by the loss of Ca2+ from the vesicles due to the increased permeability. These results suggest that the saponins interact with membrane constituent(s) that can influence the passive Ca2+ permeability and the Na+-Ca2+ exchange activity of cardiac sarcolemmal membranes. PMID- 3814598 TI - Nonselective squeeze-out of dioleoylphosphatidylcholine and dioleoylphosphatidylglycerol from binary mixed monolayers with dipalmitoylphosphatidylcholine. AB - In order to enable the possible use of dipalmitoylphosphatidylcholine as an artificial lung surfactant, the addition of dioleoylphosphatidylcholine or dioleoylphosphatidylglycerol has been suggested. A preferential loss of molecules of the second component during compression of the interfacial layer was proposed. In this study two types of measurement were carried out in order to verify such a preferential squeeze-out. In the first type, electron micrographs of a pure dipalmitoylphosphatidylcholine monolayer and of mixed monolayers of dipalmitoylphosphatidylcholine and egg phosphatidylglycerol were taken in order to study the nature of the structures formed during compression of the monolayer. The electron microscopy photos show horizontally stacked layers in the collapse phase of dipalmitoylphosphatidylcholine, and long vertical ridges in the mixed monolayers up to 20% second component. At higher concentrations of the second component no such structures can be detected. The second type involved monolayer studies with binary mixtures of dipalmitoylphosphatidylcholine and dioleoylphosphatidylcholine or dioleoylphosphatidylglycerol, one of the pair being always radioactively labelled. Counting the radioactivities in bulk phase and monolayer after compression revealed nonselective squeeze-out of either component. PMID- 3814599 TI - Effect of antibody to the hemin-controlled translational repressor in rabbit reticulocyte lysate. AB - We have examined the effect of the purified IgG from the serum of guinea pigs immunized with a highly purified preparation of rabbit reticulocyte, hemin controlled translational repressor (HCR) on protein synthesis in the reticulocyte lysate. We have found that the anti-HCR (but not non-immune) IgG completely prevents or reverses the suppression of protein synthesis that occurs in hemin deficient lysate, providing a direct and definitive demonstration that the inhibitory effect of hemin-deficiency is mediated solely by the activation of HCR. The anti-HCR IgG also prevents or reverses the phosphorylation of eIF-2 alpha and the reduced binding of Met-tRNAf to 40 S ribosomal subunits that accompanies the inhibition of protein synthesis in hemin-deficient lysate. In contrast, the anti-HCR IgG has no effect on the inhibition produced by low levels of double-stranded RNA (that is due to the activation of a separate protein kinase), but it does partly reverse inhibition due to oxidized glutathione, ethanol, and phosphatidylserine, indicating that the effect of these components is mediated, at least in part, by the activation of HCR. Finally, we have confirmed our earlier observation that an excess of proHCR, the inactive precursor of HCR, has little effect on the neutralization of HCR by limiting anti HCR IgG, suggesting that the antigenic determinants on HCR are not exposed on ProHCR. PMID- 3814600 TI - Absolute values of ras p21 defined by direct binding liquid competition radioimmunoassays. AB - Several distinct and high-conserved genes comprise the ras gene family of rodents and humans, i.e., rodent Harvey and Kirsten, and human Harvey, Kirsten and neuroblastoma. Transformation, either by a point-mutation resulting in a change in one amino acid of the 21 kDa ras gene product (p21), or by increased expression of ras p21, has been demonstrated to be mediated by members of this gene family. We report here the development of direct binding liquid competition radioimmunoassays for the detection and quantitation of the ras oncogene and proto-oncogene products. Using these radioimmunoassays and ras p21 purified from Escherichia coli containing the full-length T24 mutant human Harvey ras gene protein product as a standard, we have defined the actual amount of ras p21 per micrograms of total cellular protein, or per cell, in various ras transformed and 'normal' mammalian cell lines. One of the radioimmunoassays developed is group specific, since the antigenic determinant recognized is shared by both the point mutated and proto-forms of Harvey, Kirsten and neuroblastoma members of the ras gene family, while the second may be termed type-selective, since it recognizes an antigenic determinant localized primarily on the Harvey ras p21. Both radioimmunoassays are interspecies, since they detect a ras p21 antigenic determinant common to cells of human and rodent origin. These studies thus describe the first means for defining absolute values of any oncogene or proto oncogene protein product. The assays described, when used in combination with specific c-DNA probes to define specific ras proto-oncogenes or point-mutated oncogenes being expressed, will now permit truly quantitative analyses of ras p21 expression in experimental cell culture systems, animal models and human biopsy material. PMID- 3814601 TI - Asymmetry in the distributions of the four nucleotides at mRNA initiation and 3' termini sites: some geometrical implications. AB - All mammalian and non-mammalian vertebrate sequences in the database have been aligned by their transcription initiation sites, and separately, by their mRNA 3' termini. A simple analysis of the distribution of single nucleotide composition in the 1000 nucleotides around these sites yields surprising results. An asymmetric pattern in the behaviour of complementary nucleotides, i.e., C vs. G and A vs. T, in both these sites is observed. The four nucleotides also behave in an opposite manner around mRNA transcription initiation and 3' termini. This may suggest that these are signals affecting the intrinsic dynamics of the DNA structure and as such facilitate the first stages of the recognition process of the RNA polymerase in the neighbourhood of transcription initiation. These signals may also play a role in transcription termination rather than serve as signals for the mRNA cleavage/processing machinery. PMID- 3814602 TI - Purification and characterization of an inducible mitochondrial DNA polymerase from Tetrahymena thermophila. AB - Treatment of the eukaryotic organism Tetrahymena with various types of DNA damaging agents has been reported to cause a 35-fold induction of a mitochondrial DNA polymerase. We here report that the enzyme can be induced in large-scale cultures by exposure of the cells to thymine starvation and/or intercalating agents. The induced DNA polymerase has been purified to near homogeneity, with a specific activity of approx. 300,000 units/mg protein. The relative molecular mass of the active form of the enzyme is approx. 100,000, as determined by glycerol gradient sedimentation. The subunit structure has been analysed by SDS polyacrylamide gel electrophoresis of the highly purified preparation and by immunoprecipitation with a monoclonal antibody directed to the DNA polymerase. A polypeptide of Mr 47,000 has been observed to be a subunit of the enzyme. This corresponds to the size of the subunits suggested for mitochondrial DNA polymerase from chicken embryos and mouse myeloma cells. PMID- 3814603 TI - Atypical changes in chromatin structure during development in the sea urchin, Lytechinus variegatus. AB - Embryos of several sea urchin species express three distinct sets of developmental-stage-specific histone variants: cleavage stage, early and late variants. Urchins also contain sperm-specific histone variants. We have found that the sea urchin Lytechinus variegatus, common in shallow coastal waters of the southeastern United States, also contains these four distinct sets of variants. The number and electrophoretic characteristics of L. variegatus variants are similar to those of the related species, Lytechinus pictus, but changes in variant populations are delayed in relation to stage in L. variegatus relative to L. pictus and other species. The cleavage-stage-like variants of H2a and perhaps H1 in L. variegatus are much more abundant in pre-blastula and blastula embryos than cleavage-stage variants in other species; and the appearance of L. variegatus late variants is delayed, relative to the program in L. pictus. Likewise the nucleosome repeat length in L. variegatus embryos increases from 191 to 210 base pairs (bp) upon gastrulation, while major increases in repeat length in other urchins occur before or during blastulation. In addition, the nucleosome repeat length in L. variegatus sperm is anomalously low, 201 +/- 2 bp - lower than observed in L. variegatus gastrula to pluteus stage embryos (210 bp), and much lower than previously observed in sperm of other urchins (more than 233 bp). Direct comparisons showed that Strongylocentrotus purpuratus and L. variegatus sperm contained electrophoretically identical core histones, including two high-molecular-weight H2b variants characteristic of all urchin sperm, but nucleosome repeat lengths of 240 and 201 bp, respectively. Differences in nucleosome repeats of these species appear to be due to differences in H1 variants. PMID- 3814604 TI - Redox properties of electron-transferring flavoprotein from Megasphaera elsdenii. AB - Electron-transferring flavoprotein (ETF) from the anaerobic bacterium Megasphaera elsdenii catalyzes electron transfer from NADH or D-lactate dehydrogenase to butyryl-CoA dehydrogenase. As a basis for understanding the interactions of ETF with its substrates, we report here on the redox properties of ETF alone. ETF exhibited reversible, two-electron transfer during electrochemical reduction in the presence of mediator dyes. The midpoint redox potentials of the FAD cofactor were -0.185 V at pH 5.5, -0.259 V at pH 7.1 and -0.269 +/- 0.013 V at pH 8.4, all versus the standard hydrogen electrode In the presence of the indicator dye 1 deazariboflavin, the Nernst slopes were 0.029 V and 0.026 V at pH 5.5 and pH 7.1, respectively, compared with an expected value of 0.028 V at 10 degrees C. At pH 8.4, in the presence of 2-hydroxy-1,4-naphthoquinone or phenosafranine, the Nernst slope varied from 0.021 V to 0.041 V. In the experiments at pH 8.4, equilibration was very slow in the reductive direction and a difference of as much as 30 mV was observed between reductive and oxidative midpoints. ETF exhibited no thermodynamic stabilization of the radical form of the FAD cofactor during electrochemical reduction at pH 5.5, 7.1 or 8.4. However, up to 93% of kinetically stable, anionic radical was produced by dithionite titration at pH 8.5. Molar absorptivities of ETF radical were 17,000 M-1 X cm-1 at 365 nm and 5100 M-1 X cm-1 at 450 nm. The four ETF preparations used here contained less than 7% 6-OH-FAD. However, two of the preparations contained significant amounts (up to 30%) of flavin which stabilized radical and reduced at potentials 0.2 V more positive than those required for reduction of the major form of ETF. This is referred to as the B form of ETF. The proportion of ETF-FAD in the B form was increased by incubation with free FAD or by a cycle of reduction and reoxidation. These treatments caused marked changes in the absorption spectrum of oxidized ETF and decreases of 20-25% in ETF units/A450. PMID- 3814605 TI - Structure and stability of gamma-crystallins. II. Differences in microenvironments and spatial arrangements of cysteine residues. AB - The gamma-crystallin fractions II, III and IV from calf eye lens were treated with the thiol-specific fluorescent probe 2-(4'-maleimidylanilino)naphthalene-6 sulfonate (MIANS), in order to determine the reactivity of the seven (gamma-II) or six (gamma-III, gamma-IV) cysteine residues. Two classes of reactive cysteines were distinguished by variations in fluorescence intensity with increasing molar excess of the probe, and approximately three cysteines were nonreactive in each gamma-crystallin. From the position of the emission maximum, it is apparent that MIANS-labeled cysteines of gamma-IV are in the least hydrophobic environment. Fluorescence energy transfer was observed from tryptophan to MIANS-labeled cysteines in both gamma-II and gamma-III crystallins, with efficiencies of 86% and 89%, respectively, but not in gamma-IV crystallin. We suggest that the spatial arrangements and microenvironments of cysteine residues of gamma crystallins are sufficiently different from each other to account for the variations in fluorescence characteristics of the MIANS-labeled proteins and the lack of energy transfer in gamma-IV crystallins. PMID- 3814606 TI - Isolation and structure analysis of bee venom mast cell degranulating peptide. AB - The venom of Apis mellifera was processed by gel permeation chromatography on Sephadex G-50 and by reversed-phase HPLC. The initial gel permeation step was carried out in the presence of phosphate ions (0.5 M). Ion pair reagents were required to resolve the strongly basic peptides, secapin, mast cell degranulating (MCD-) peptide and apamin, by reversed-phase (RP) HPLC. Using this relatively simple procedure it is possible to isolate these peptides essentially free of melittin (less than 1 in 10(7)) and phospholipase (less than 1 in 10(5] in high yield. The CD spectrum and secondary structure analysis are reported for MCD peptide and on this basis a solution structure is proposed for this toxin. PMID- 3814607 TI - Chemical modification of human aldehyde dehydrogenase by physiological substrate. AB - Employing 3,4-dihydroxyphenylacetaldehyde (dopal) as a substrate for human aldehyde dehydrogenase (aldehyde:NAD+ oxidoreductase, EC 1.2.1.3) in anaerobic conditions, inactivation of both cytoplasmic E1 and mitochondrial E2 isozymes during catalysis has been observed. Incorporation of 14C-labelled dopal has been demonstrated by retention of label following denaturation and exhaustive dialysis and by peptide mapping following tryptic digestion. Incorporation of label gave linear plots vs. activity remaining with up to two molecules incorporated per molecule of enzyme and 30% activity remaining. Further incorporation (up to 16 molecules) occurred, but was non-linear when plotted vs. activity remaining. Protection against activity loss during incorporation of the first two molecules was afforded by NAD, NADH, chloral, and by chloral and NAD together, the last being the most effective. Saturation kinetics gave y-axis intercepts, suggesting interaction at a specific point on the enzyme surface. The Ki value from saturation kinetics was the same as that from the slope replot in catalytic reaction. Peptide mapping of tryptic digests showed that a single peptide was labelled, confirming specificity of interaction. Even in the absence of complete inactivation, the results suggest that reaction with the first two molecules occurs at some point on the enzyme surface important for enzyme activity. The possibility of such a reaction occurring in vivo is discussed. PMID- 3814608 TI - Purification and characterization of two forms of glyoxalase II from the liver and brain of Wistar rats. AB - Glyoxalase II (S-(2-hydroxyacyl)glutathione hydrolase, EC 3.1.2.6) was purified to homogeneity and separated into two forms (alpha, pI = 8.0; beta, pI = 7.4) from both liver and brain of wistar rats by column isoelectric focusing. These forms were also found to have different electrophoretic mobilities. No significant differences were found between the alpha and beta forms from either source in the relative molecular mass (about 24,000) or in Km values using three substrates. The temperature-inactivation profiles were also similar, the two forms being stable up to 50 degrees C. Chemical modification studies with phenylglyoxal suggest that these enzyme forms probably contain arginine residues near the active site. Inactivation of alpha and beta forms by diethylpyrocarbonate and by photooxidation with methylene blue, and protection by S-D-mandeloylglutathione, a slowly reacting substrate, suggest the presence of histidine at the active site. The alpha and beta forms show different half-life values in inactivation by histidine reagents, which may be due to a difference in the active-site structures of these enzymes. The results probably indicate distinct structures (sequences) for alpha and beta forms. PMID- 3814609 TI - Concerning the mechanism for transfer of D-glucuronate from myo-inositol oxygenase to D-glucuronate reductase. AB - The D-glucuronate product of myo-inositol oxygenase (EC 1.13.99.1) is efficiently reduced by NADPH in the presence of either purified D-glucuronate reductase (EC 1.1.1.19), or reductase that is part of a protein aggregate that also contains the oxygenase. This occurs despite the fact that the maximum concentration of D glucuronate that could be formed by the oxygenase under the conditions used for the coupled enzyme experiments is 7 microM, and 10 microM externally supplied D glucuronate (Km = 7.6 mM) does not support any detectable NADPH oxidation under the reaction conditions. The most likely explanation for the results is that the uncyclized aldehyde form of D-glucuronate is the product of the oxygenase reaction, and that it diffuses into solution and is captured by the reductase before it cyclizes to the more stable but less reactive hemiacetal form. PMID- 3814610 TI - Evidence for isoforms of the phosphorylatable myosin light chain in rat uterus. AB - The phosphorylatable myosin light chain of rat uterus was resolved into four spots by two-dimensional gel electrophoresis. Antibody against the 20 kDa light chain from smooth muscle myosin recognized these four spots. Purified light chain exhibited four spots on a diagonal upon isoelectrofocusing in both first and second dimensions, proving that these spots are not due to artifactual charge modification. Accordingly, the four spots contain light chain isoforms derived from myosin. PMID- 3814611 TI - In vivo inhibition of aspartate aminotransferase in mice by L-hydrazinosuccinate. AB - L-Hydrazinosuccinate, which has been shown to be a slow-, tight-binding inhibitor of aspartate aminotransferase (EC 2.6.1.1) in vitro, was tested as an inhibitor in vivo of the enzyme as well as other pyridoxal enzymes. Intraperitoneal administration to mice at a dose of 0.6 mmol/kg rapidly decreased aspartate aminotransferase activities in liver and kidney cytosols to a minimal level lower than 10% of the original, and no appreciable reversal of the inhibition was observed after 24 h; at lower doses the activities were significantly recovered during the same period following an initial marked decrease. Of the other pyridoxal enzymes tested, alanine aminotransferase in liver was the most sensitive to the inhibitor. It was initially inhibited as severely as aspartate aminotransferase, but the inhibition was reversed considerably faster. Aspartate aminotransferase activities in brain and heart were less severely affected than those in liver and kidney; they were less markedly lowered initially and were substantially recovered after 24 h. Consistent with the observed organ specificity, heated extracts from brain and heart in the mice administered with the inhibitor showed relatively weak inhibitory activities in vitro to aspartate aminotransferase purified from pig heart, while the extracts from liver and kidney were strongly inhibitory. PMID- 3814612 TI - Purification of a proteinase inhibitor from bovine serum with C1-inhibitor activity. AB - This report describes the purification of a novel proteinase inhibitor from bovine serum. This protein was purified to apparent homogeneity employing affinity binding to sulfated dextran and precipitation by ammonium sulfate, followed by sequential chromatography on DEAE-cellulose, heparin-Sepharose and Sephacryl S-200. Quantitative enzyme-linked immunosorbent assays revealed that the concentration of this inhibitor is approximately 3 microM in bovine serum. The inhibitor is a single polypeptide chain with an estimated Mr of 83,000 as determined by SDS-polyacrylamide gel electrophoresis. An aspartic acid was found at the amino terminus of the protein; N-terminal amino acid sequence data indicated that there was no significant homology with other reported amino acid sequences. This bovine inhibitor covalently complexed the human proteinases C1-r, C1-s, factor XIIa and plasma kallikrein, which are also complexed and inactivated by human C1-inhibitor. In addition, the bovine inhibitor complexed and inactivated bovine chymotrypsin, a feature which functionally distinguishes it from human C1-inhibitor. Although the bovine inhibitor appears functionally very similar to C1-inhibitor, we found no evidence for structural homology with the human counterpart. PMID- 3814613 TI - Beta-oxidation of 2-ethyl-5-carboxypentyl phthalate in rodent liver. AB - [7-14C]-2-Ethyl-5-carboxypentyl phthalate was isolated and purified from urine of rats given [7-14C]-di-(2-ethylhexyl) phthalate. This metabolite was shown to serve as a precursor for 2-ethyl-3-carboxypropyl phthalate in vivo. 2-Ethyl-5 carboxypentyl phthalate was oxidized to 2-ethyl-3-carboxypropyl phthalate in liver slices from control or, much more rapidly, from clofibrate-pretreated rats. Inhibition by KCN in liver slices from untreated rats, and strong inhibition by acrylate, suggested that formation of 2-ethyl-3-carboxypropyl phthalate involved mitochondrial beta-oxidation. The strong enhancement of the production of this compound by clofibrate (a very weak inducer for mitochondrial dehydrogenases), and strong inhibition by chlorpromazine suggested that peroxisomes may also be able to oxidize 2-ethyl-5-carboxypentyl phthalate. We were able to detect beta oxidation of 2-ethyl-5-carboxypentyl phthalate to 2-ethyl-3-carboxypropyl phthalate using purified mitochondria, but strong phthalate monoester hydrolase activity observed during incubation of the former compound with purified peroxisomes made it impossible to determine whether 2-ethyl-3-carboxypropyl phthalate could be produced in the latter organelle or not. 2-Ethyl-5 carboxypentyl phthalate was such an inefficient substrate for beta-oxidation compared to palmitic acid that it is unlikely that it contributes significantly to the production of H2O2 in rats chronically exposed to di-(2-ethylhexyl) phthalate. Normal fatty acids are most likely to serve as the dominant substrates for peroxisomal beta-oxidase. PMID- 3814614 TI - Protein synthesis inhibition by 8-oxo-12,13-epoxytrichothecenes. AB - The Fusarium mycotoxin, 4-deoxynivalenol, is an abundant, natural contaminant of corn and wheat. 8-Oxo-12,13-epoxytrichothecenes related to 4-deoxynivalenol were synthesized; they either lacked the 7-hydroxyl but contained a hydroxyl at C-4 (7 deoxynivalenol) or lacked substituents at C-3 and C-7 (3,7-dideoxynivalenol). The ability of these synthetic analogs and their acetylated derivatives to inhibit protein synthesis by cultured mammalian cells was compared to that of 4 deoxynivalenol. Whereas the 50% inhibitory dose (ID50) for murine erythroleukemia cells was about 1 microgram/ml for 4-deoxynivalenol and 3,7-dideoxynivalenol, all of the other analogs were at least 10-fold less potent. When tested at their ID50 dose, all of the 8-oxotrichothecenes, except 4-deoxynivalenol and 3,7 dideoxynivalenol, caused polysome 'run-off', indicating that, at this dose, they are inhibitors of polypeptide chain initiation. With 4-deoxynivalenol and 3,7 dideoxynivalenol, polysomes remained at control levels indicating that these toxins prevent polypeptide chain elongation. From these results and comparisons to previous studies of 8-oxo-12,13-epoxytrichothecenes (trichothecolone, trichothecin, nivalenol and fusarenone X), trichothecenes with substituents at both C-3 and C-4 predominantly inhibit polypeptide chain initiation, whereas those lacking one substituent at either site are inhibitors of chain elongation. PMID- 3814615 TI - Iodothyronine 5'-deiodinase activity in rat brown adipose tissue during development. AB - Iodothyronine 5'-deiodinase activity in rat brown adipose tissue has a characteristic pattern of developmental changes that is completely different from that of the liver. Fetal brown fat exhibits an extremely high iodothyronine 5' deiodinase activity that is approx. 10-fold that in adult rats. Even though brown fat iodothyronine 5'-deiodinase activity falls suddenly at birth, there is a new peak in the activity around days 5-7 of life, whereas it remains very low afterwards. Just after birth, brown adipose tissue iodothyronine 5'-deiodinase activity is already capable of stimulation by noradrenaline. The postnatal peak in brown fat iodothyronine 5'-deiodinase correlates with the known increase in the thermogenic activity of the tissue in the neonatal rat, thus reinforcing the suggestion that local 3',3,5-triiodothyronine generation could be an important event related to thermogenesis in brown adipose tissue. However, the high fetal activity was only slightly related to the thermogenic activity of brown fat. Moreover, the increased iodothyronine 5'-deiodinase activity of brown adipose tissue during fetal and neonatal life suggests a substantial contribution by brown fat in the overall extrathyroidal 3',3,5-triiodothyronine production in these physiological periods. PMID- 3814617 TI - Enzymatic oxidation of bilirubin by intestinal mucosa. AB - Bilirubin oxidase, an aerobic enzyme which degrades bilirubin 'in vitro' to colourless diazo-negative compounds, including propentdyopents and trace amounts of biliverdin, has been demonstrated in homogenates of rat intestine, kidney and liver. The enzyme in the intestinal mucosa has been partially characterised and appears to be mitochondrial in origin; maximal activity was detected in the jejunum. Intestinal bilirubin oxidase has a mean activity of 0.51 +/- 0.03 (S.D.) nmol bilirubin degraded/min per mg protein. Similar bilirubin oxidase activities were found in the tissue of Sprague-Dawley and Gunn rats. The role of the enzyme 'in vivo' remains to be determined. PMID- 3814616 TI - Activated human eosinophils synthesize new proteins. AB - In order to study the biochemical consequences of prolonged in vitro activation of human blood eosinophils, aqueous whole cell lysates, cell-free supernatants from resting eosinophils, and cells activated with opsonized zymosan, calcium ionophore (A23187), N-formylmethionylleucylphenylalanine (fMet-Leu-Phe), and phorbol 12-myristate 13-acetate (PMA) were analyzed by polyacrylamide gel electrophoresis (PAGE). In comparison to resting eosinophils, opsonized zymosan activated eosinophil extracts demonstrated altered protein composition on both the native PAGE and sodium dodecyl sulfate (SDS) -PAGE. Three new polypeptides of apparent molecular mass 24 kDa, 43 kDa and 60 kDa appeared on SDS-PAGE gels when opsonized zymosan-activated eosinophil extracts were electrophoresed. In contrast, extracts from fMet-Leu-Phe, A23187, and PMA-activated eosinophils demonstrated neither altered polypeptide composition nor new polypeptides. Opsonized zymosan also induced the incorporation of L-[35S]methionine into eosinophil proteins and this was completely blocked by pretreating the cells with cycloheximide. This finding suggests that eosinophils activated by certain stimuli synthesize new proteins. These newly synthesized proteins, which are freely secreted into the medium during cell activation, may possess important immunological functions. PMID- 3814618 TI - Impaired formylation and uptake of tetrahydrofolate by rat small gut following cobalamin inactivation. AB - The effect of inactivation of cobalamin by N2O on the intestinal absorption of folate was studied using rat everted gut sacs. Further, in view of uncertainties about the presence of methionine synthetase in gut [1], this enzyme was measured. Everted gut sacs were incubated with [2-14C]tetrahydrofolate, and the subsequent appearance of labelled formyl- and methyl [14C] tetrahydrofolate in everted segments of small intestine of rats was studied. Considerable methionine synthetase activity was present in washed everted gut sacs but not in gut segments in the absence of such treatment. Methionine synthetase activity declined after exposure to N2O, which oxidizes and inactivates cob(I)alamin. Folate uptake by gut sacs was not affected by 24 h exposure of the animals to N2O but fell significantly after 7 days exposure. There was a significant fall in the amount of formyltetrahydrofolate formed after cobalamin inactivation and this was reversed by supplying either methionine, methylthioadenosine or sodium formate. Serine had no effect. The data support the hypothesis that methionine and methylthioadenosine act by supplying single carbon units at the formate level of oxidation. PMID- 3814619 TI - Isolation and characterization of an induced chondroitinase ABC from Flavobacterium heparinum. AB - During the investigation of alternative methods for the large scale preparation of chondroitinases AC, B and C from Flavobacterium heparinum, a new chondroitinase activity was observed. This new enzyme, like the other chondroitinases, acts as an eliminase, forming unsaturated sulfated disaccharides from dermatan and chondroitin sulfates. In contrast to the chondroitinases previously described, which are endoglycosidases, this chondroitinase ABC cleaves the glycosidic linkages in an exolytic fashion, beginning at the reducing end of the substrate molecules. The oligosaccharides formed as transient products by the action of either chondroitinases or testicular hyaluronidase upon dermatan and chondroitin sulfates are also rapidly degraded by the chondroitinase ABC, regardless of their size or the presence of delta-4,5 unsaturation in the terminal uronic acid residue. The maximum activity of the chondroitinase ABC occurs at 30 degrees C and at pH 6.0-7.5. Only 15% of the activity was observed at 37 degrees C, indicating that the enzyme is very sensitive to thermal denaturation. It is strongly inhibited by phosphate ions and is also inhibited by the unsaturated disaccharides formed. PMID- 3814620 TI - Transglycosylation reaction of a chitinase purified from Nocardia orientalis. AB - Chitinase from the culture filtrates of Nocardia orientalis IFO 12806 was purified to apparent homogeneity by precipitation with ammonium sulfate followed by successive chromatography on CM-Sephadex and Bio-Gel P-60, and finally by affinity chromatography on a phenyl-Sepharose CL-4B column. The enzyme, which is essentially a hydrolase, also catalyzed a transglycosylation reaction on tetra-N acetyl-chitotetraose (GlcNAc)4 and penta-N-acetyl-chitopentaose (GlcNAc)5. The enzyme converted the tetrasaccharide into hexa-N-acetyl-chitohexaose (GlcNAc)6 (21%) and di-N-acetyl-chitobiose (GlcNAc)2 (63%) as the major products. The corresponding values for penta-N-acetyl-chitopentaose (GlcNAc)5 were hepta-N acetyl-chitoheptaose (GlcNAc)7 23% and tri-N-acetyl-chitotriose (GlcNAc)3 59%. The rate of the transglycosylation depended on the temperature, the concentration of substrate and the pH. PMID- 3814621 TI - Palmitate and glucose oxidation by fetal type II pneumocytes. AB - Fetal type II pneumocytes in organotypic culture can oxidize both palmitate and glucose, with glucose being converted to CO2 at a rate substantially greater than that of palmitate. Glucose can be oxidized by both the pentose shunt pathway and the tricarboxylic acid cycle. Palmitate oxidation to CO2 is increased by carnitine and reduced by glucose and unsaturated fatty acids. These data suggest that glucose may be an important oxidative substrate during late fetal life and that fatty acids may play a relatively minor role in type II cell oxidative metabolism. PMID- 3814622 TI - Specificity and biological significance of microtubule-associated protein-DNA interactions in chick. AB - The interactions between chick brain microtubule associated proteins (MAPs) and chick DNA have been examined using DNA-cellulose chromatography, cross-blotting, and nitrocellulose filter-binding. Comparison of nitrocellulose filter-binding and cross-blotting results show that while MAPs and a minor, Mr 48,000, protein show significant binding at 50 mM NaCl, only the latter continues to bind a significant amount of DNA at 150 mM NaCl, suggesting an ionic basis for the MAP DNA interactions. MAP-DNA interactions also show weak preference for AT-rich fractions, and are sensitive to S1 nuclease digestion. We suggest that the MAPs bind preferentially to single-stranded DNA. The binding may involve an interaction between the DNA phosphates and the highly cationic tubulin-binding domain of the MAPs. Repetitive fractions of the chick genome prepared both by hydroxyapatite chromatography and by S1 nuclease digestion show binding to a number of minor proteins present in preparations of microtubule proteins, as well as to the MAPs. We conclude that the MAPs probably do not bind specifically to repetitive DNA, in contrast to earlier reports using mouse DNA. MAP-DNA interactions are therefore unlikely to be involved in the attachment of microtubules to mitotic chromosomes. PMID- 3814623 TI - Uptake, efflux and metabolism of the polyamine putrescine in rabbit lung slices. AB - The herbicide paraquat is a selective pulmonary toxin in many mammals, including man, and its pulmonary toxicity has been attributed to selective uptake by a polyamine transport system in lung. In the present study, we investigated the characteristics of this transport process in rabbit lung slices. [14C]Putrescine was accumulated by both saturable and non-saturable processes and the accumulated putrescine was non-effluxable over 60 min. The saturable component was inhibited by spermine and paraquat. Moreover, uptake studies in Na+-deficient medium indicated that the lack of Na+ may selectively enhance uptake via the non saturable process. The two components also differed in the metabolic fate of accumulated substrate. At 0.6 microM putrescine, where the saturable process predominated, 98% of the 14C in the perchloric acid-soluble fraction of tissue homogenates was present as putrescine, whilst 3% of the accumulated substrate was found in the acid-insoluble fraction. With 500 microM putrescine, where the non saturable process predominated, 82% of the 14C in the acid-soluble fraction was present as putrescine and 15% of accumulated putrescine was found in the acid insoluble fraction. The acid-insoluble 14C was localised mainly in the 700 g and 4500 g pellets obtained after homogenising the tissue. We conclude that there are two components to putrescine uptake in rabbit lung slices, both of an apparently irreversible nature. We suggest that the components represent compartmentalisation of putrescine in selective pulmonary cell-types or separate subcellular organelles. The observed metabolism and covalent binding of putrescine appeared to be associated with the non-saturable component only. PMID- 3814624 TI - A 31P-NMR study of Propionibacterium acnes, including effects caused by near ultraviolet irradiation. AB - 161.8 MHz 31P-NMR spectra were recorded from the light sensitive skin bacterium Propionibacterium acnes. The cells were grown anaerobically on synthetic phosphate-buffered Eagle's medium or on a complex yeast extract medium. The spectra showed a large accumulation of polyphosphates when grown on Eagles medium. A splitting of the inorganic phosphate peak indicated a difference between internal and external pH of the cells. Addition of glucose to the cell suspension gave rise to a change in the pH gradient across the cell membrane, as reported for other Gram-positive bacteria. A decrease in the polyphosphate peak was observed after addition of glucose. A lethal dose of broad-band near ultraviolet light (corresponding to a 10% survival in a survival test), increased the amount of polyphosphates visible in the NMR-spectra. The addition of glucose to irradiated cells decreased the pH in the external solution, but no splitting of the inorganic phosphate peak could however be observed. 31P-NMR can, therefore, be used to study immediate near-ultraviolet-induced effects at the cellular level, at least in the case of P. acnes. PMID- 3814625 TI - Characterization of the intracellular processing and secretion of hepatic lipase in FU5AH rat hepatoma cells. AB - The processing and secretion of newly synthesized hepatic lipase was characterized in FU5AH rat hepatoma cells. Pulse-chase experiments revealed two immunoreactive species with apparent molecular weights of 55,400 and 57,600. The 55.4 kDa species was detectable only in cell extracts, whereas the 57.6 kDa species was present in both cell extracts and media. Following a 5 min pulse with L-[35S]methionine and a 10 min chase, these two species represented only 0.003% of the total labelled protein. Quantitation of the 55.4 kDa and 57.6 kDa species in a chase time course taken together with their respective sensitivity and resistance to digestion with endo-beta-N-acetylglucosaminidase H indicates that the 55.4 kDa species is a high mannose precursor to the mature 57.6 kDa enzyme which contains only complex N-linked oligosaccharides. From a time course of endo beta-N-acetylglucosaminidase H digestion, it was determined that hepatic lipase contains a minimum of two N-linked oligosaccharides. Treatment of the 55.4 kDa species with endo-beta-N-acetylglucosaminidase H yields a protein with a kDa value similar to that observed after treatment of the mature secreted enzyme with endo-beta-N-acetylglucosaminidase F or trifluoromethanesulfonic acid. Therefore, processing of N-linked oligosaccharides is probably the only post-translational modification responsible for the observed change in the apparent molecular weight of hepatic lipase. The half-residence times of hepatic lipase in the endoplasmic reticulum-cis Golgi region and in the cell were estimated at 34 min and 57 min, respectively. Newly synthesized hepatic lipase in Fu5AH cells is secreted constitutively and is not stored in an intracellular pool. Finally, little of the newly synthesized enzyme is degraded during the course of a 1 h chase. PMID- 3814626 TI - Cell cycle-specific effects of sodium arsenite and hyperthermic exposure on incorporation of radioactive leucine and phosphate by stress proteins from mouse lymphoma cell nuclei. AB - Cultured mouse lymphoma cells incorporated [3H]leucine and [32P]phosphate into nuclear stress proteins within 3 h after exposure to either elevated temperature (45 degrees C) or sodium arsenite. Radiolabeled proteins were detected by autoradiography after two-dimensional polyacrylamide gel electrophoresis. To determine the cell cycle stage specificity of labeling, nuclei were isolated and sorted into two cell cycle phases using a fluorescent activated cell sorter. After either heat shock or sodium arsenite treatment, the majority of [3H]leucine incorporation into stress proteins occurred during the G0 + G1 phase with minimal labeling in the G2 phase. On the other hand, 32P labeling of stress proteins occurred in both the G0 + G1 and G2 phases after exposure to sodium arsenite, while incorporation of 32P was limited after heat stress. Following sodium arsenite treatment, a distinct set of four stress proteins (80-84 kDa) was detected with [3H]leucine only in G0 + G1 phase, but with [32P]phosphate these stress proteins were labeled in both G0 + G1 and G2. There was differential [32P]phosphate labeling between proteins of the 80-84 kDa set during cell cycling. Individual proteins of this set were isolated from gel plugs after sodium arsenite or heat-shock treatment. Coelectrophoresis of proteins from the two treatment groups showed that they had similar electrophoretic mobilities. All four proteins of the 80-84 kDa set (sodium arsenite induced) possessed similar polypeptide maps after digestion with V8 protease. Cytofluorometric analysis demonstrated a reduction in the number of nuclei in both S and G2 phases of the cell cycle two h after heat shock, but not following sodium arsenite treatment. However, there was a significant depression in the number of nuclei in S and G2 4 h after exposure to sodium arsenite and very modest labeling with 32P of stress proteins was observed at this time. PMID- 3814627 TI - Advantages of perfluorochemical perfusion in the isolated working rabbit heart preparation using 31P-NMR. AB - Quantitative 31P-NMR and enzymatic analysis of high-energy phosphates were used to characterize an isolated perfused working rabbit heart preparation. In this model, the left side of the heart works against a physiological after-load. Two perfusates, Krebs-Henseleit saline and the perfluorocarbon emulsion FC-43 (perfluorotributylamine), were evaluated in their ability to maintain cardiac function and high-energy phosphate metabolites over a period of 2-3 h. Adenine nucleotides ATP, ADP, phosphocreatine and inorganic phosphate (Pi) were measured by 31P-NMR while monitoring cardiac output and coronary flow. Intracellular pH was determined using the chemical shift of Pi. At the end of each experiment, hearts were freeze clamped and enzymatically assayed for adenine nucleotides, phosphocreatine and Pi. In every experiment, hearts perfused with FC-43 emulsion maintained the same rate of cardiac output as hearts perfused with Krebs Henseleit saline, but with half the coronary flow rate: FC-43, 22 +/- 2.5 (n = 5), Krebs-Henseleit saline 42 +/- 2.7 (n = 6) ml/min, P less than 0.001. Hearts perfused with FC-43 emulsion showed higher [phosphocreatine] and [ATP] measured by 31P-NMR. For [phosphocreatine]: FC-43 3.2 +/- 0.7 (n = 5), Krebs-Henseleit saline 1.7 +/- 0.2 (n = 6) mumol/g wet wt., P less than 0.01. For [ATP]: FC-43 1.8 +/- 0.7 (n = 5), Krebs-Henseleit saline 0.9 +/- 0.2 (n = 6) mumol/g wet wt., P less than 0.02. [phosphocreatine] and [ATP] determined by 31P-NMR values were identical within experimental error to those values obtained by enzymatic analysis. Comparing [Pi] determined by both methods, 36% of Pi in FC-43-perfused hearts, and only 24% of Pi in Krebs-Henseleit saline-perfused hearts were visible by NMR, indicating that a large proportion of Pi is bound in the intact functioning heart. Similar results were obtained for [ADP]. Using the combined techniques of 31P-NMR and enzymatic assay, we have shown in this model of the isolated working rabbit heart preparation, that FC-43 emulsion maintains significantly better function and high-energy phosphate levels than Krebs Henseleit saline. PMID- 3814628 TI - Actin polymerization modifies stimulus-oxidase coupling in rat neutrophils. AB - Oxidase activity in rat neutrophils was monitored by oxygen consumption rate and luminol-dependent chemiluminescence. Two agents which inhibit actin polymerization, cytochalasin B and dihydrocytochalasin B, produced a marked enhancement (up to 10-fold) of oxidase activation induced by two Ca2+-dependent stimuli, chemotactic peptide and ionophore A23187. In contrast, activation by the calcium-independent stimulus, phorbol myristate acetate, was unaffected by these agents. Other agents that interact with the cytoskeleton, phalloidin and colchicine have no effect on activation by any stimulus tested. The effect of cytochalasin B, when added after stimulation by chemotactic peptide, was transient with t0.5 approx. 10 s. Similarly, the degree of actin polymerization following stimulation by chemotactic peptide was transient, decaying with a t0.5 of approx. 10 s. The half-maximal concentration of cytochalasin B for inhibition of actin polymerization was similar to that for enhancement of oxidase activation. It was concluded, therefore, that the intracellular Ca2+ rise in rat neutrophils that accompanies stimulation by chemotactic peptide affects actin polymerization in a manner that modifies oxidase activation. PMID- 3814629 TI - Interrelationship between aminopyrine oxidation and gluconeogenesis in hepatocytes prepared from fructose-pretreated mice. AB - Aminopyrine oxidation was studied in isolated hepatocytes prepared from 24-h starved mice (i) after induction of the NADPH-generating malic enzyme and glucose 6-phosphate dehydrogenase, but not the mixed function oxygenases by fructose, (ii) after induction of both mixed function oxygenases and NADPH-generating malic enzyme and glucose-6-phosphate dehydrogenase by phenobarbital and (iii) without any pretreatment. Phenobarbital pretreatment, as expected, increased the rate of aminopyrine oxidation of isolated hepatocytes. However, fructose pretreatment also enhanced the rate of N-demethylation of aminopyrine by more than 100% supporting the view that the availability of NADPH is rate limiting in drug oxidation under certain conditions. The role of malic enzyme and glucose-6 phosphate dehydrogenase in the NADPH supply for aminopyrine oxidation was investigated by the addition of two groups of gluconeogenic precursors: lactate or alanine and glycerol or fructose with the simultaneous measurement of glucose synthesis and aminopyrine N-demethylation. There was a clear correlation between the increased rate of aminopyrine oxidation and the decreases of glucose production caused by aminopyrine. Gluconeogenesis in the presence of 1 mM aminopyrine was decreased by 70-80% when alanine or lactate were used as precursors, it was decreased by only 35-40% when glucose production was started from glycerol or fructose; in an accordance with the facts that NADPH generation and gluconeogenesis starting from alanine or lactate share two common intermediates--malate and glucose-6 phosphate--, while there is only one common intermediate--glucose-6 phosphate--if fructose or glycerol are used. Similar results were obtained with the addition of the structurally dissimilar hexobarbital. It is concluded that besides malic enzyme, glucose-6-phosphate dehydrogenase also takes part in NADPH supply for drug oxidation in glycogen depleted hepatocytes. PMID- 3814630 TI - [Cataract induction by products of lipid peroxidation]. AB - Liposome suspension prepared from the unsaturated phospholipids exposed to lipid peroxidation (LPO) induced posterior subcapsular cataracts after injection into the posterior vitreous of rabbit eyes. In the background of this model lies a type of lens opacity formed during retinal degeneration when toxic peroxide substances diffuse anteriorly through the vitreous body resulting in vitreous opacities and complicated cataracts. Saturated liposomes (prepared from beta oleoyl-gamma-palmitoyl) L-alpha-lecithin) did not induce lens opacities, which is the evidence that a lipid peroxidation mechanism may be responsible for the posterior cataracts. Along with cataract formation accumulation of LPO fluorescent products in vitreous, aqueous humor and lens was observed. It was followed by a decreased level of reduced glutathione in the lens. The obtained results strongly support the hypothesis of LPO initial role in cataracts. PMID- 3814631 TI - [Kinetics of the response of native skin tissue to electric stimulation using polarizing electrodes]. AB - Response kinetics of skin tissue to electric current stimulation was studied. A simple method is proposed which permits to separate the response into the electrically active and electrically passive components--inner potential and resistance. The evidence obtained is discussed. PMID- 3814633 TI - [Evaluation of heat production during propagation of the depression wave]. AB - A mathematical model is proposed to describe a heat wave accompanying the spreading cortical depression wave in the large brain. The model takes into account heat production of neurons, thermal transmission with thermoconductivity and volume thermal losses. The model fits well for the wave shape and permits one to estimate heat production which is about 4-20 J/g X min. PMID- 3814632 TI - [Effect of an anomalous broadening of the synchronization band after electric stimulation of heart tissues]. AB - Synchronization effects of the second order induced by a change of the action potential (AP) shape in relation to the frequency of periodic stimulation were studied. Mechanism of anomalous increase of the synchronization band at periodic stimulation of the heart fibers was explained. By means of a modified method of synchronization diagrams the synchronization bands were calculated for possible stimulation regimes taking into account a change in RP shape and dynamic threshold (DT) depending on the frequency of the initiated regimes. Regions of stimulating signals parameters (multiplicity regions or prolonging regions) were discovered, within the range of which the same stimulating signal may induce different synchronization regimes. Physiological meaning of the existence of anomalous synchronization regimes which significantly broaden the adaptation possibilities of the heart is discussed. PMID- 3814634 TI - [Kinetics of DNA-distaxin complex-formation]. AB - Kinetics of DNA--distaxines complexes formation was studied spectrophotometrically by means of the stop--flow method. It has been found that increase of number of bulky pyrrolcarboxamide group in the row of distaxines: -0, -1, -2, - slows down the binding reactions and increases the number of their stages. PMID- 3814635 TI - [Detection of vibron phenylalanine bands in circular dichroism spectra for collagen]. AB - For the first time the individual positive circular dichroism peaks at 268 nm, 262 nm and 256 nm have been found for collagen. These peaks are due to the vibronic nature of a weak pi-pi* phenylic chromophore transition of phenylalanine and the unique structural organization of collagen where water molecules are an essential element of the triple helix. PMID- 3814636 TI - [A new type of secondary structure: mobile conformation of polypeptide chain. Data bank for protein structures]. AB - As a result of statistical analysis of Protein Data Bank a new type of secondary structure was found in globular proteins. It is mobile (M) conformation, characterised by noncooperative hydration and the increased dynamical properties of the chain. Percentage distribution of amino acid residues between the main secondary structure types is 42.7% for alpha-helix, 19.6% for beta-structure and 19.1% for M-conformation. The most frequently occurring amino acids for M conformation are proline, cysteine and serine. Fragments of mobile conformation seem to play a major part in local and domain dynamics of protein globule. PMID- 3814637 TI - [Interrelated effects of ATP and ionic strength on Ca2+-sensitivity of isolated myofibrils]. AB - Ability of isolated myofibrils for relaxation was studied in a medium with KCl concentrations of 6 to 250 mM with ATP content varying from 0.01 to 1.0 mM. It was shown that myofibrils can relax at all the studied values of the ionic strength, but ATP concentration required for the relaxation is to increase with decreasing the ionic strength A stable state of Ca2+-sensitive system of myofibrils is maintained at approximately the same values of ATP and KCl concentrations. A possible mechanism of this phenomenon is discussed. PMID- 3814638 TI - [Photosensitized generation of singlet molecular oxygen by endogenous substances of the eye lens]. AB - It is shown that kinurenine derivatives, harmane (beta-carboline) and tetracycline hydrochloride known as photosensitizers of cataractogenesis in lens produce luminescence of singlet molecular oxygen (1O2) under photoexcitation in air saturated aqueous (D2O) solution. The quantum yields of the 1O2 generation by these substances are determined. The data obtained by this direct 1O2 determination technique suggest that 1O2 might take part in cataractogenesis. PMID- 3814639 TI - [Effect of phenylmercury derivatives on human oxyhemoglobin]. AB - By the dynamics of human oxyhemoglobin coagulation in the presence of phenyl mercury acetate in tris-AcOH buffer, pH 7.2 the number of moles of PhHg+ stechiometrically bound with protein at different temperatures was estimated. Within the temperature range 15-30 degrees C this value is constant--32-34 mole per 1 mole of HBO2-tetramer. Within the range 30-40 degrees C it rises to approximately 40. Coagulation of oxyhemoglobin modified with PhHg+ cation is reversible in contrast to HBO2 coagulation modified with uncharged PhHgCl. PMID- 3814640 TI - [Self-oscillations of biological microbodies]. AB - Theoretical analysis of natural oscillation spectra of different kind of cells is presented. The study of received dispersive equation shows that the character of the cell natural movement depends on its size and the viscosity of internal and external liquids. If the depth of viscous wave penetration is small in comparison with the cell radius, the natural movements are weak damping oscillations. If the depth viscous wave penetration is comparable to the cell size, we have a relaxation process of cell form restoration. PMID- 3814641 TI - [Transport of low molecular weight substances in protein crystals and films]. AB - Diffusion of synthetic dyes in lysozyme crystals and bovine serum albumin (BSA) amorphous films is shown to depend on the size of diffusate molecule far more strongly than in solutions. The diffusion coefficient increases from 10(-8) to 10(-13) cm2 sec-1 on about 1.5 divided by 2--fold increase in diffusate dimensions, the diffusion being completely arrested on reaching the limiting dimensions of about 14 A and 12 A for BSA films and lysozyme crystals, respectively. The diffusion in lysozyme crystals is anisotropic, with a diffusion maximum directed along their screw axes. The diffusion coefficient dependence on the charge of diffusate and its binding to proteins is discussed. PMID- 3814642 TI - [Changes in the orientation of mouse myeloma immunoglobulin G in monolayers after treatment with sodium deoxycholate]. AB - Molecules of normal mouse IgG are oriented horizontally in monolayers at air water interface unlike the molecules of mouse IgG1 kappa secreted by MOPC-21 myeloma which have vertical orientation. Sodium desoxycholate processing of both preparations at concentrations below the critical micelle concentration resulted in abnormal IgG1 kappa preservation and normal IgG acquisition of vertical orientation in monolayers. When sodium desoxycholate was used for IgG modification at concentration higher than the critical micelle concentration both normal and abnormal IgG had horizontal orientation in monolayers. PMID- 3814643 TI - [Changes in the structure of lipid bilayer membranes in magnetic fields]. AB - In terms of structural voluminous phases the structure of bilayer lipid membranes in the constant magnetic field far from the point of phase transition is examined. The field influence on the area of the membrane black part is due to surface tension of voluminous phases. It is noted that the effect is squared with the field and is negative under gomeotropic orientation of the molecules on the surface. The dependence of the effect on temperature is predicted and its possible mechanisms are examined. PMID- 3814644 TI - [Polarization of bilayer membranes in phase separation. A quasi-one-dimensional model]. AB - A theoretical quasi-one-dimensional model of nonlinear oscillations of lipid bilayer director at phase separation region is considered. An arising orientational wave of deformation of the lipid bilayer must lead to spontaneous electrical polarization of the bilayer in the transmembrane field. If the orientational wave of bilayer deformation is of a nonlinear pattern the lipid director oscillations can relate to briather solution of sine-Godon equation within the framework of our model. In terms of the theoretical model are frequencies and spontaneous electrical polarization are estimated. The conclusion about the effect of radiofrequency electromagnetic wave resonance interaction with the briather structures on the cell membrane lipid bilayer is drawn. PMID- 3814645 TI - [Models of biological membranes containing gangliosides]. AB - Molecular and supermolecular peculiarities in multicomponent liotropic systems ganglioside-water, ganglioside-cerebroside-water, ganglioside-lecithin-water, ganglioside-lecithin-troponin-tropomyosin-water were studied by polarizing microscopy and rentgenography. The results obtained by these two methods are in good agreement. Mesomorphism and phase changes depending on the concentrations of components and compounds of systems were established. PMID- 3814646 TI - [Effect of microenvironment on the conformation of m-cholinoreceptors in brain synaptic membranes]. AB - Sensitivity of m-cholinergic receptor of synaptic membranes to SH-reagents (PChMB and NEM) was compared before and after its solubilization with detergents. PChMB blocked specific binding of m-antagonist QNB to both forms of the receptor in equal extent, while NEM was effective only after solubilization. After the membranes modification with butanol or arachidonic acid the membrane-bound receptor became sensitive to NEM. The solubilized receptor lost its ability to allosteric inhibition by acid. It is suggested that the receptor conformation is under the control of the membrane microenvironment. PMID- 3814647 TI - [Photodimerization of uracil in films and their use for dosimetry of genetically active ultraviolet irradiation]. AB - On the basis of the known photodimerization of uracil it is proposed to use its films obtained by sublimation in vacuum for the dosimetry of genetically active UV radiation. Experimental estimations are presented of radiation dose rate resulting in a change of uracil optical density delta D/D0 under irradiation due to photodimerization for erythemal lamp lo-30. The data obtained are used for dosimetry of lethal damage of Chlamydomonas reinhardii. Estimations are also presented of the sun radiation dose rate which induce uracil photodimerization on the earth surface and in the extraterrestrial atmosphere. PMID- 3814648 TI - [Translocation of estradiol analogs into nuclei in a cell-free system of the rabbit uterus]. AB - The values of relative translocation of structural and steric analogs of estradiol in rabbit uterine homogenates were determined. The differences between the ligand specificity of translocation and that of the cytosol receptor was established. PMID- 3814649 TI - [The D-glyceraldehyde-3-phosphate dehydrogenase and 3-phosphoglycerate kinase complex from rabbit skeletal muscles]. AB - The experimental conditions favouring the association of Sepharose-bound D glyceraldehyde-3-phosphate dehydrogenase with soluble 3-phosphoglycerate kinase were studied. Acylation of D-glyceraldehyde-3-phosphate dehydrogenase by 1.3 bisphosphoglycerate was found to be a prerequisite for the complex formation. PMID- 3814650 TI - [The role of Na+ ions in the respiration, formation of the membrane potential and movement of the alkali-resistant marine bacterium Vibrio alginolyticus]. AB - Subbacterial vesicles capable of generating delta psi during NADH oxidation were obtained. The oxidation of NADH was stimulated by Na+ and inhibited by 2-heptyl-4 oxyquinoline-N-oxide (HQNO) in submicromolar concentrations. The generation of delta psi was inhibited by HQNO in low concentrations, cyanide, gramicidine D and carbonyl cyanide-m-chlorophenylhydrazone (CCCP) in combination with monensine. At the same time, in the absence of monensine CCCP influenced the delta psi generation in a much lesser degree. In subbacterial vesicles delta psi generation coupled with NADH oxidation necessitated Na+. Experiments with intact cells of V. alginolyticus revealed that cell motility depends on Na+, is sensitive to CCCP + monensine as well as to arsenate + HQNO, cyanide or anaerobiosis. In the absence of arsenate, the inhibition of respiration partly decreased the rate of bacterial movement. In the presence of HQNO and arsenate, NaCl addition to K+-loaded cells led to the monensine preventing restoration of the cell motility during a few minutes. However, no stimulating effect was observed in the case of artificial delta pH formation as a result of acidification of the medium (from pH 8.6 to pH 6.5). The experimental results suggest that delta mu Na+ generated by the respiratory chain and by the arsenate-sensitive enzymatic system (presumably, glycolysis and Na+-ATPase) can be utilized by the Na+-driven molecular motor responsible for the motility of V. alginolyticus cells. PMID- 3814651 TI - [Comparative study of ceruloplasmin biosynthesis in various cell-free systems]. AB - Some peculiarities of mRNA translation of ceruloplasmin (CP) from rat liver were investigated, using three cell-free protein biosynthesis systems (wheat embryo extracts, rabbit reticulocyte lysates and Zajdela ascite hepatoma extracts). It was shown that reticulocyte lysates and tumour cell extracts synthesize full-size CP mRNA translation products, whose molecular mass is close to that of mature CP molecules, i. e., 122-132 kD. Wheat embryo extracts synthesize the NH2-terminal fragment of the CP molecule (Mr = 84 kD). Addition of liver membrane fractions to wheat embryo extracts translating CP mRNA results in the reconstitution of proteolytic steps of CP maturation. PMID- 3814652 TI - [Mechanism of activation of the external pathway of NADH oxidation in myocardial mitochondria during hemorrhagic shock]. AB - The changes in the oxidative metabolism of rabbit myocardium in hemorrhagic shock were studied. The external pathway of NADH oxidation was shown to be activated, while the rates of glutamate oxidation in the presence of an uncoupler were diminished as compared to control values. These changes are probably due to the activation of phospholipase A2 and lipid peroxidation, since their inhibitors eliminate with the same efficiency the activation of the external pathway of NADH oxidation both in normal and damaged myocardium. PMID- 3814653 TI - [Characteristics of intracellular metabolism of carbohydrates and amino acids in animals with thiamine deficiency]. AB - Vitamin B1 deficiency in mongrel albino rats induced by oxythiamine is concomitant with an increase in the ratio of free forms of NAD+/NADH, NADP+/NADPH in liver mitochondria. This is accompanied with a rise in steady-state concentrations of isocitrate, 2-oxoglutarate and with a decrease of malate in liver tissue, which testifies to the prominent regulatory role of the 2 oxoglutarate dehydrogenase complex in the intracellular metabolism under vitamin B1 deficiency. Moderate physical load causes a 10-fold increase in the steady state concentration of pyruvate and lactate in the blood of thiamine-deficient animals, which seems to be due to the stimulation of glycolysis in the maintenance of energy homeostasis. The observed increase in the excretion of pyruvate, lactate, 2-oxoglutarate (30-fold against control) and pentose phosphates (3-fold) with urine, depending on the degree of vitamin B1 deficiency, points to one of essential mechanisms of cell metabolism stabilization under the given pathological condition. PMID- 3814654 TI - [Effect of rubomycin, carminomycin and adriamycin on respiration in liver mitochondria in various metabolic states, respiratory control and ADP/O ratio]. AB - A comparative study on the effects of antitumour antibiotics of the anthracycline group (rubomycin, carminomycin and adriamycin) on respiration and oxidative phosphorylation in liver mitochondria in various metabolic states has been carried out for the first time. It was shown that the antibiotics under study cause partial inhibition of mitochondrial state 3 respiration, which is eliminated by an uncoupler. Treatment of liver mitochondria with the antibiotics decreases the ADP/O and respiratory control values and stimulates state 4 respiration. The latter is partly inhibited by oligomycin. The uncoupled respiration is decelerated in the presence of the antibiotics. Under these conditions the oxidation of succinate is inhibited by lower concentrations of the antibiotics than that of NAD+-dependent substrates. It was shown that the maximal activity is exerted by the most polar agent carminomycin, while the hydrophobic rubomycin is the least active. The experimental results are discussed in terms of the toxic effect of antitumour antibiotics. PMID- 3814655 TI - [Interaction of NAD(H)-dependent dehydrogenases with active dyes and their complexes with transitional metal ions]. AB - The interaction of NAD(H)-dependent dehydrogenases--yeast alcohol dehydrogenase and rabbit muscle lactate dehydrogenase--with reactive dyes produced in the USSR was studied. The essential role of metal ions in specific binding of alcohol dehydrogenase and dyes was demonstrated by differential spectroscopy, circular dichroism spectroscopy and chromatography. Lactate dehydrogenase in contrast with alcohol dehydrogenase does not require metal ions for the binding of the above said dyes. A comparative study of eluting abilities of selected desorption agents (imidazole, adenine, 8-oxyquinoline-5-sulfonic acid, NAD, AMP, EDTA) by alcohol dehydrogenase chromatography on adsorbents with light-resistant yellow 2KT-Cu(II) and orange 5K revealed the differences in competition of the dyes for NAD-binding sites of alcohol dehydrogenase. The participation of light-resistant yellow 2KT Cu(II) in the formation of mixed complexes with imidazole, adenine, 8 oxyquinoline-5-sulfonic acid, NAD and EDTA suggests that the specific binding of alcohol dehydrogenase to light-resistant yellow 2KT-Cu(II) is due to coordination between the Cu(II) ion and the amino acid residue in alcohol dehydrogenase. PMID- 3814657 TI - [Study of the conformation of neurospecific cardioactive glycoproteins by optical spectroscopy]. AB - Using selective fluorescence quenching and circular dichroism techniques, the conformation of protein carriers of earlier detected cardiotropic hypothalamic neurohormones was investigated. The experimental results point to essential differences in the structural organization of the above compounds that were designated according to the type of their binding to corresponding hormones as BNH, BNC and BNS. For instance, the circular dichroism spectrum of BNS is typical of proteins that are characterized by a high content of non-ordered structures, a low content of beta-structures and an almost complete absence of alpha-helices. BNC and BNH with nearly the same content of alpha-helical structures are distinguished by the number of "non-ordered glomes" which are more abundant in BNC. These results are in good agreement with the fluorescence quenching data. PMID- 3814658 TI - [Unambiguous correspondence and complementarity of the chemical properties of amino acids and anticodons of the genetic code]. AB - The chemical language of genetic code is proposed. As a result of chemical language application for the analysis of the modern genetic code, the existence of an unambiguous correspondence between the chemical properties of amino acids and their coding triplets (codons and anticodons) is shown. This confirms the hypothesis of the code chemical determination. The complementarity between the chemical properties of amino acids and their anticodons (but not the codons) has been found also to exist. This observation supports the hypothesis of the genetic code determination by the direct recognition and also underlines the primary role of anticodon in the origin of genetic code in comparison with codons. PMID- 3814656 TI - [Characteristics of intracellular metabolism of procollagen and other proteins in human embryo fibroblasts in trisomy for chromosome 7]. AB - A comparative study of the relative rates of intracellular total protein metabolism in diploid and aneuploid (with trisomy for chromosome 7) human embryo fibroblasts in the logarithmic and stationary growth phases was carried out. Using double labeling with [14C]proline (24 hrs) and [3H]proline (3 hrs), it was found that: the rates of intracellular protein metabolism during transition to the stationary phase of growth are increased in diploid cells and decreased in cells with trisomy for chromosome 7; the relative rate of protein metabolism in the logarithmic phase is higher in trisomic cells than in diploid ones. The intracellular degradation of procollagen in trisomic cells is increased approximately by 17% as compared to normal fibroblasts. Treatment of cell lysates with bacterial collagenase revealed the presence of procollagen incomplete degradation products in anomalous fibroblasts. The observed differences in the rates and mode of protein metabolism during transition of diploid and trisomic fibroblasts to the stationary phase of growth suggest that the odd autosome interferes with the normal coordinated activity of genes in chromosomes. PMID- 3814659 TI - [Physicochemical characteristics of sorbitol dehydrogenase from the cytoplasm of the liver cells of susliks]. AB - Some physico-chemical properties of sorbitol dehydrogenase from squirrel liver cell cytoplasm have been investigated. Non-linear dependence of enzyme activity upon media pH is shown. Activity manifests only in the presence of NAD that can't be replaced by NADP. The enzyme exhibits stereospecificity: it dehydrates polyol of any length, the second and the fourth carbon atoms have common L-configuration concerning the first carbon atom. A diffusion zone with Rf = 0,09 is revealed on the electrophoregram. Three thin zones of activity about pH 7,2 are exposed by isoelectrofocusing method. PMID- 3814660 TI - [Effect of pulse electromagnetic radiation on erythrocyte ghosts]. AB - The pulse microwave radiation has been shown to increase the fluorescence intensity of 2-toluidinonaphthanene-6-sulfonate (2,6-TNS) and 1 anilinonaphthalene-8-sulfonate (1,8-ANS) built-in membranes of erythrocyte ghosts. In experiments with 2,6-TNS a frequency dependence of the effect of microwave radiation with maximum within the frequency range of 55-65 Hz has been found. It is suggested that the changes registered with fluorescent probes are induced by mechanical oscillations generated by the pulse microwave radiation. PMID- 3814661 TI - [Quantitative characteristics of the basilar membrane in the mammalian cochlea]. AB - The variations in width and height of the basilar membrane along the cochlea in four species of laboratory animals: white rat, guinea pig, chinchilla and cat have been investigated. The results obtained have been used to calculate the height/width ratio along the cochlea, suggested by Bruns as an estimate of basilar membrane stiffness. The given characteristic is practically identical in all species studied despite the differences in the frequency ranges of auditory reception and, therefore, cannot be used either for characterizing the basilar membrane stiffness or for frequency mapping the cochlea of mammals. PMID- 3814662 TI - [Immune complex binding by erythrocytes and its significance in the destruction of these cells during immunization]. AB - Immunization of BALB/c mice by sheep red blood cells and Salmonella typhi vaccine has been shown to augment the immune complexes in plasma and erythrocytes in blood fixing the immune complexes on their surface. The inactivation of immune complexes in immunized mice by intravenous injection of the antiserum against aggregated immunoglobulins decreases the hemoglobin in blood serum. The data obtained show that the fixation of immune complexes on erythrocytes is one of the reasons of erythrocytes destruction activation in immunization. PMID- 3814663 TI - [Effect of exogenous DNA on convulsive activity]. AB - On the corazole model of the experimental epilepsy and epileptiform activity evoked by penicillin application to the cerebral cortex with electroencephalographic registration, it has been shown that exogenous DNAs in the most cases completely or partially inhibit convulsive activity. DNA inhibited also the pacemaker activity of the Helix RPa-1 neurons. PMID- 3814664 TI - Water homeostasis in psychiatric patients. PMID- 3814665 TI - Different patterns of local brain energy metabolism associated with high and low doses of methylphenidate. Relevance to its action in hyperactive children. AB - Rates of local cerebral glucose utilization were measured by means of the quantitative autoradiographic [14C]deoxyglucose technique in conscious rats following the acute administration of methylphenidate hydrochloride (1.25-15.0 mg/kg). Significant dose-dependent alterations in metabolic activity were found in the components of the extrapyramidal system, including the substantia nigra, subthalamic nucleus, and the entopeduncular nucleus, as well as in the lateral habenula. Significant changes were also observed in the nucleus accumbens and olfactory tubercle, but occurred only following administration of low doses of methylphenidate. Comparison of the patterns of metabolic activity observed in this study with those obtained following the administration of other psychostimulant drugs suggests possible substrates for the therapeutic action of methylphenidate in the treatment of hyperactive children. PMID- 3814666 TI - Central catecholamines, cognitive impairment, and affective state in elderly schizophrenics and controls. AB - Central catecholamine concentrations were determined in autopsy samples from older schizophrenic and control subjects for both the hypothalamus and the nucleus accumbens. The results of these analyses and demographic variables were regressed on antemortem measures of cognitive function and mood state. In the hypothalamus, there are significant direct relationships of homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) with depressed mood, as measured by an adaptation of the Hamilton Rating Scale for depression. In the nucleus accumbens, dopamine (DA) and MHPG had significant inverse relationships with antemortem cognitive function, as measured by an adaptation of the Mini Mental State Exam. Results in this sample indicate that after controlling for age, the catecholamine concentrations accounted for approximately 50% of the variance in the antemortem measures of mood or cognition, depending on the loci measured. PMID- 3814667 TI - Urinary free cortisol and separation anxiety early in the course of bereavement and threatened loss. AB - Among 56 persons who were acutely bereaved or threatened with a loss, a group with worsening separation anxiety over a period of a month early after the event had higher urinary free cortisol output than a group experiencing improvement in grief. Although not tested in this study, both these psychological and physiological measures may have potential for serving as early predictors of poor outcome in bereavement for the 15%-20% of exposed persons who are at risk for unresolved grief or persistent depressive syndromes. PMID- 3814668 TI - Prediction of subtype and severity of depression by means of dexamethasone suppression test, L-tryptophan: competing amino acid ratio, and MHPG flow. AB - The score on the Hamilton Depression Rating Scale (HDRS), the L tryptophan:competing amino acid (valine + leucine) (L-TRP:CAA) ratio, and the 3 methoxy-4-hydroxyphenylglycol (MHPG) flow in 24-hr urine were recorded in 83 depressed patients undergoing a Dexamethasone Suppression Test (DST). The subjects were diagnostically subdivided according to DSM-III into minor depression (296.82, 300.40, 309.00), major depression without melancholia (296.X2), with melancholia (296.X3), or with psychotic features (296.X4). Minor depression, major depression with melancholia, and major depression with psychotic features can be regarded as distinct biological entities. Major depression without melancholia is a heterogeneous group with reference to the biological markers. By combining these biological data with age in a discriminant function analysis, 81.9% of all depressed patients can be correctly classified into minor or major depression groups. The combined biological markers can also be used to predict the severity of the depression; 42.5% of the variance in the HDRS score is accounted for by multiple regression on the biological figures. Multivariate statistical techniques considerably improve prediction for both subtype and severity of depression. PMID- 3814669 TI - Plasma phenylethylamine and phenylalanine in chronic schizophrenic patients. AB - The hypothesis that phenylethylamine (PEA) is an endogenous psychotogen in schizophrenics, particularly those with the paranoid subtype, has been previously studied by measuring PEA levels in urine and cerebrospinal fluid (CSF) of schizophrenic patients. However, plasma PEA may more accurately reflect simultaneous alterations of PEA in many organ systems, as might occur in a genetic disorder of PEA metabolism. No study to date has examined phenylalanine (Phe), which is thought to be a precursor of PEA, in the same patients who had PEA measured. In this study, we measure both plasma PEA and Phe in 17 drug-free schizophrenic patients and 17 matched controls. Plasma PEA in normal controls was found to be lower by three orders of magnitude compared to normal controls from previous studies--a finding that has not previously been reported. PEA was significantly lower in those schizophrenic patients who had a Research Diagnostic Criteria diagnosis of paranoid schizophrenia. PEA did not differ between patients and controls, and the correlation between plasma Phe and PEA was not significant. PMID- 3814670 TI - Multivariate analyses of the EEG in normal adolescents. AB - We investigated the computerized electroencephalography (cEEG) in a group of 85 normal adolescents. The spatial frequency of the cEEG was analyzed using various multivariate statistical techniques. The factor analyses revealed three factors that accounted for most of the variability in the data and that could be interpreted as a low versus high frequency, a beta frequency, and a frontal versus posterior factor. The cluster analysis revealed various EEG patterns that distinguished among subgroups of normal individuals. PMID- 3814671 TI - Effect of treatment on plasma cortisol and dexamethasone. PMID- 3814672 TI - HLA haplotype A26-B38 in affective disorders: lack of association. PMID- 3814673 TI - Diurnal variation of sodium and water metabolism among patients with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). PMID- 3814675 TI - Sequelae of neuroleptic malignant syndrome. PMID- 3814674 TI - Cholinesterase activities in blood in infantile autism. PMID- 3814676 TI - Long-term outcome of neuroleptic malignant syndrome. PMID- 3814677 TI - DST update: the hypothalamic-pituitary-adrenocortical axis and affective illness. PMID- 3814678 TI - Studies of dosage, seizure threshold, and seizure duration in ECT. AB - Seizure threshold, defined as the minimal electrical dosage necessary to elicit adequate generalized seizure, was determined throughout the course of electroconvulsive therapy (ECT) in depressed patients randomly assigned to bilateral and right unilateral treatment, with brief pulse, constant current stimulation. In Study 1, it was found that seizure threshold may be more accurately measured using the unit of charge compared to the traditional unit of watt-second. In Study 2, it was found that seizure threshold was associated with seizure duration. Patients with high thresholds had shorter seizure durations. This indicated that the seizure threshold measure assesses in part functional neural activity. In Study 3, it was found that failure for seizure threshold to increase substantially over the course of ECT was associated with poor clinical outcome. In Study 4, it was found that electrical dosage at threshold was not related to magnitude of acute cognitive impairments. This suggested that the degree to which dosage exceeds threshold may be more strongly tied to adverse effects than the absolute dosage administered to patients. Implications of the data are discussed, particularly in relation to a hypothesized link between the anticonvulsant properties of ECT and its mechanism of therapeutic action. PMID- 3814679 TI - Conditioning and the delayed onset of a haloperidol-induced behavioral effect. AB - In a series of experiments, rats were given daily injections of 0.3 mg/kg haloperidol or vehicle 1 hr prior to behavioral testing. In these experiments, when rats were placed in an illuminated compartment and given the opportunity to enter a darkened compartment, haloperidol- and vehicle-treated rats initially entered the dark compartment with similar latencies. With repeated treatments, however, the haloperidol group gradually took increasingly longer times to enter the dark compartment. Furthermore, when the drug treatments of the groups were reversed, behavioral performance was dissociated from the drug state of the animal. Vehicle rats switched to haloperidol entered the dark compartment much more rapidly than haloperidol rats switched to vehicle. As additional control procedures, rats were given haloperidol 1 hr posttrial or were given haloperidol and only placed in the dark compartment. These haloperidol treatments did not differ from vehicle treatments. The gradual development of long latencies to initiate behavior and the persistence of this behavior during withdrawal from the haloperidol are consistent with the establishment of a conditioned drug response. This observation suggests that conditioning may contribute to the delayed onset of response in the clinical use of neuroleptic drugs. PMID- 3814680 TI - Electrophysiological and behavioral correlates of psychomotor responsivity in depression. AB - Psychomotor retardation is a frequently observed clinical feature of depressive states. This study attempted to assess the relationship between response slowness and central nervous system (CNS) activity by examining cortical evoked potentials (EPs) during psychomotor task performance. Patients consisted of 21 women who met Research Diagnostic Criteria (RDC) and exhibited a minimum Hamilton Rating Scale for Depression score of 18 at the end of a drug washout period, the scheduled time of testing. The same number of normal women with no history of psychiatric illness were employed as controls. Cortical EPs from Cz and integrated electromyogram (EMG) from the dominant forearm extensor were recorded and time locked to warning and imperative stimuli of a standard, two-choice, fixed foreperiod reaction time (RT) task, which yielded behavioral measures of decision time (DT) and movement time (MT). Analysis focused on behavioral RTs, latency and amplitudes of EMG, sensory and slow cortical (CNV) EPs, and measures of input time (IPT), central processing time (CPT), and motor execution time (MET), derived from combinations of EP and EMG peak latencies. Patients exhibited slower DT and MT response times, delayed EMG latencies, and attenuated EP amplitudes. The derived CPT measure was also significantly longer in patients. These findings support the view that a central dysfunction is implicated in psychomotor retardation, and the results are discussed in relation to information processing theory. PMID- 3814681 TI - Relationship of neurological abnormalities in schizophrenics to family psychopathology. AB - Competing etiological models make opposite predictions as to the relationship between focal neurological abnormalities in schizophrenics and the prevalence of psychosis in their families. In previous studies of neurological abnormalities in schizophrenia, the authors found an increased prevalence of focal neurological signs in both patients and their nonschizophrenic relatives. The current study examines the relationship between neurological abnormalities in 24 schizophrenic patients and psychopathology in their families. A family history of psychotic psychopathology was found to be associated with an increased prevalence of focal neurological abnormalities in the schizophrenics. The results are relevant to current models of the potential role of neurological factors in the etiology of schizophrenia and illustrate how family studies of the joint distribution of psychiatric and neurological data can potentially help to distinguish between different etiological models. PMID- 3814682 TI - Serial dexamethasone suppression tests in simultaneous panic and depressive disorders. AB - Recent work suggests that the simultaneous occurrence of major depressive disorder (MDD) and panic disorder (PD) may be of relevance for clinical findings, therapeutic outcome, and prognosis. It is of interest to know whether or not this relevance extends to biological findings. We addressed this question through comparison of serial Dexamethasone Suppression Test (DST) results in patients who had either MDD alone or simultaneous MDD and PD. We were unable to describe differences between the groups. PMID- 3814683 TI - DST nonsuppressor status: relationship to specific aspects of the depressive syndrome. AB - Using a conservative definition of suppressor status in hospitalized depressives, we found a relationship between abnormal endocrine function and certain kinds of depressive symptoms, i.e., melancholic symptoms, delusions, and memory deficit. Normal suppressor status is related to an early age of onset, absence of delusions, absence of memory deficit, absence of melancholia symptoms, and a presence of a diagnosis of secondary depression or a family history of alcoholism in depressives. The data suggest the distinction between neurotic-reactive depression and endogenous depression. It is equally important to note that these specific symptoms and characteristics possibly are associated with suppressor status independently of each other. PMID- 3814684 TI - Treatment of social phobia with clonidine. PMID- 3814685 TI - Dexamethasone bioavailability: implications for DST research. AB - The bioavailability of dexamethasone (DEX) has recently been demonstrated to be a critical factor in determining Dexamethasone Suppression Test (DST) status in psychiatric patients. This brief review focuses on several aspects of DEX bioavailability as they relate to the use of the DST in neuroendocrine research. Several methodologies, including radioimmunoassay, high-performance liquid chromatography, and gas chromatography-mass spectrometry are available for quantification of DEX in biological fluids, although few detailed comparisons between methods have been reported. Surprisingly, little systematic research on the metabolism of DEX has been reported, but it appears that hepatic rather than renal mechanisms are the major source of DEX elimination. The marked variability in serum DEX levels following oral administration in psychiatric patients is also observed in normal controls and patients with Cushing's syndrome. A variety of drugs can modify serum DEX levels and thereby after the effectiveness of DEX in suppressing serum cortisol levels. Simultaneous measurement of serum DEX and cortisol levels appears to be necessary for the appropriate evaluation of DST results. This procedure may help explain many of the inconsistencies in recent DST research. PMID- 3814686 TI - Depressive symptoms and the dexamethasone suppression test in parkinsonian patients. PMID- 3814687 TI - The influence of daytime naps on the therapeutic effect of sleep deprivation. PMID- 3814688 TI - Tardive dyskinesia and cognitive impairment. PMID- 3814689 TI - NMR chemistry of red blood cell constituents. PMID- 3814690 TI - Stage-specific synthesis and fucosylation of plasma membrane proteins by mouse pachytene spermatocytes and round spermatids in culture. AB - Little is known about the ability of mammalian spermatogenic cells to synthesize plasma membrane components in the presence or absence of Sertoli cells. In this study, purified populations (greater than 90%) of pachytene spermatocytes or round spermatids were isolated by unit gravity sedimentation and cultured for 20 24 h in the presence of [35S]methionine or [3H]fucose. Cell viabilities remained over 90% during the course of these experiments. Plasma membranes were purified from these cells and analyzed by two-dimensional gel electrophoresis. Qualitatively, the same plasma membrane proteins were synthesized by both cell types with the exception of the major Concanavalin A-binding glycoprotein, p151; the synthesis of p151 is greatly diminished or inhibited after meiosis. [3H]Fucose was incorporated into at least 6 common glycoproteins of both cells. Eight components fucosylated with molecular weights from 35,000 to 120,000 were specific to pachytene spermatocyte membranes. One fast-migrating fucosylated component may represent an uncharacterized lipid whose synthesis is terminated after meiosis. Round spermatids specifically fucosylated two components with molecular weights of 45,000 and 80,000. These results demonstrate the viability of germ cells of the male mouse in short-term culture and show that they are capable of synthesizing and fucosylating plasma membrane components in the absence of Sertoli cells. PMID- 3814691 TI - The hibernating male golden hamster as a model for studying homologue pairing, chiasma formation and disjunction during spermatogenesis. AB - Although many studies have been made in an attempt to understand the mechanisms of chromosome pairing and genetic recombination, data on mammalian oogenesis and spermatogenesis are sparse. In the experiments reported here, spermatogenesis of the hibernating male golden hamster was used to test the effect of hibernation in the cold on some essential aspects of meiosis in this species. It was demonstrated that this physiologic state can result in increased duration of preleptotene synthesis of deoxyribonucleic acid (DNA), abnormalities in bivalent pairing, reduced crossing-over, and increased chromosomal nondisjunction. These data provide evidence of the usefulness of this model for further studies of these genetic phenomena in a male mammal. PMID- 3814692 TI - The permeability of the primary decidual zone in the rat uterus: an ultrastructural tracer and freeze-fracture study. AB - The rat primary decidual zone (PDZ) is a transitory avascular region of transformed fibroblasts surrounding the implanting embryo. Studies using fluorescein-labeled tracers have shown that the PDZ is selectively permeable to macromolecules, permeability decreasing with increasing molecular weight. In the present study we investigated the morphologic basis of the permeability barrier. Horseradish peroxidase (HRP) or HRP-labeled immunoglobulin G (IgG-HRP) was administered i.v. to rats on Day 7 of pregnancy, and the animals were killed 30 min to 2 h later. The reaction product of HRP was the same density in uterine blood vessels as in the intercellular spaces of the endometrium and PDZ at 30 min and 1 h after administration. Two hours after administration, the reaction product of IgG-HRP was dense in uterine blood vessels, much less dense in the interstitial spaces of the endometrium, and was not detected in the PDZ. There was an abrupt change in the density of the IgG-HRP reaction product at the intercellular clefts between endothelial cells, where cellular junctions were observed in control tissue. This suggests that the passage of large macromolecules from blood to the implantation chamber is limited initially by cellular junctions between capillary endothelial cells. The exclusion of IgG-HRP from the PDZ indicates that an additional barrier(s) to macromolecules in this region. Lanthanum nitrate tracer was uniformly present throughout the intercellular spaces of the PDZ except at tight junctions between decidual cells. Freeze-fracture replicas of the PDZ showed tight junctions that varied from single strands to interconnected networks of strands oriented mainly parallel to the long axis of the PDZ. Some strands were discontinuous. The tight junctions between decidual cells appear to be functionally discontinuous because HRP readily penetrated the PDZ, but such junctions may retard larger macromolecules such as IgG-HRP. The biological significance of the permeability barrier of the PDZ is discussed. PMID- 3814693 TI - Induction and enhancement of progressive motility in hamster caput epididymal spermatozoa. AB - Progressive motility was induced in hamster caput epididymal spermatozoa incubated in Tyrodes medium containing 50 mM theophylline, 1.0% Fraction V bovine serum albumin, and 15% (v/v) heat-treated human seminal plasma. Under these induction conditions, however, the maximum percent of caput spermatozoa exhibiting progressive motility (21%) and the time during which motility was sustained (120 min) were significantly less (p less than 0.05) than that of controls from the cauda epididymidis. Moreover, in contrast to caudal spermatozoa, the majority of the induced caput spermatozoa exhibited some degree of flagellar bending at the neck or midpiece. In subsequent experiments the procedure for motility induction was modified to achieve levels of motility in caput spermatozoa equivalent to those observed for caudal spermatozoa. The addition of 5 microM diamide, a sulfhydryl oxidant, to the induction medium prevented the flagellar angularity observed in induced caput sperm preparations. The percentage of caput spermatozoa induced to progressive motility was increased to levels characteristic of caudal spermatozoa (48%) by the addition of hamster caudal epididymal fluid (CEF) to the induction medium. Finally, the viability of the induced caput spermatozoa was significantly enhanced (p less than 0.05) by the removal of Fraction V albumin from the induction medium. In the presence of CEF and in the absence of albumin, 50% of the caput spermatozoa acquired progressive motility and sustained this motility for 4 h. Moreover, when fatty acid-free, charcoal-extracted albumin instead of Fraction V albumin was utilized in the induction procedure, a maximum of 43% of the caput spermatozoa acquired progressive motility and maintained this motility for 4 h, suggesting that the decreased sperm viability observed in the presence of Fraction V albumin was due to a contaminant of albumin, possibly fatty acids. The studies described herein demonstrate for the first time that immature quiescent caput epididymal spermatozoa can be induced to acquire progressive and sustained motility equivalent to that observed in mature caudal epididymal spermatozoa. PMID- 3814694 TI - Modulation of porcine thecal cell aromatase activity by human chorionic gonadotropin, progesterone, estradiol-17 beta, and dihydrotestosterone. AB - Porcine thecal cells synthesize estradiol, which may function as an intraovarian regulator of follicular growth. Production of estradiol by granulosa-cell aromatase is modulated by gonadotropins and local steroidal and nonsteroidal factors. Therefore, the effect of human chorionic gonadotropin (hCG) and physiological concentrations of steroids on aromatase activity of the thecal cells was determined. Theca was excised from large porcine follicles (greater than 10 mm diameter) and plated as monolayer cultures in 1 ml of serum-free medium. Twenty-four hours after culture, cells were treated as follows: 1) control; 2) hCG (5 IU); 3) progesterone (P, 3 micrograms), estradiol-17 beta (E, 4 micrograms), or dihydrotestosterone (DHT, 1 microgram); 4) hCG + P, E, or DHT. After 27, 30, 36, 48, and 72 h of culture, media were assessed for levels of P and E. Aromatase activity was determined by a radiometric assay. Levels of P in control media increased from 27 to 72 h. hCH significantly (p less than 0.01) increased P levels from 27 to 72 h of culture. Estrogen decreased (p less than 0.05) P levels at 36, 48, and 72 h compared to controls and also prevented the hCG-induced increase in P levels at these times. DHT significantly increased (p less than 0.05) P levels at 48 and 72 h. DHT + hCG reduced the hCG-associated increase in P concentration at 36 h and 72 h, but enhanced the hCG-induced increase in P levels at 48 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814695 TI - Mating-induced luteinizing hormone surge and ovulation in the female camel (Camelus dromedarius). AB - Blood samples were collected after mating from four female one-humped camels every 10 min for 9-12 h. Luteinizing hormone (LH) was quantified in plasma by radioimmunoassay using antibovine LH. Of the seven observed matings, five were followed by a release of LH, and three by an ovulation (indicated by a subsequent secretion of progesterone). LH levels at the time of mating ranged from 0.7 to 3 ng/ml. When an LH response occurred, the levels increased 1 h after mating and reached a maximum in 2-3 h (ranging from 2.9 to 19.1 ng/ml). A decrease in LH was observed starting 6 h after mating and lasting for 6 h. These results are in agreement with a coitus-induced mechanism of ovulation in the one-humped camel (Camelus dromedarius). They confirm and extend the observations reported in the bactrian camel (Camelus bactrianus). PMID- 3814696 TI - Measurement of estrogen receptors in the ovariectomized ewe is affected by body condition and secondary binding sites. AB - Two studies were carried out to examine possible causes of the variability that occurs in studies on estrogen receptors in sheep. In the first study, the concentration of estrogen receptors in the uterus of a group of 16 ovariectomized ewes was inversely related to their live weight (r = -0.52, p less than 0.05). A second study examined 8 ovariectomized controls and 7 ewes that were permanently infertile after prolonged exposure to estrogenic clover pasture. The concentration of estrogen receptors in the pituitary of these ewes was inversely related to a measure of body fatness (r = -0.67, p less than 0.05), and there were no differences between control and clover-affected ewes. In addition to the classical estrogen receptor with a dissociation constant of 0.03 X 10(-9) mole/L, there were secondary binding sites with dissociation constants of about 0.9 X 10( 9) mole/L in the pituitary. The amount of this binding varied among sheep and appeared to increase as the cytosol was diluted. It is suggested that a failure to distinguish the presence of these sites may have led to apparent differences between experimental groups in the amount of affinity of receptors in previous studies. The effect of body condition on the number of cytosolic receptors may also have confounded previous studies. PMID- 3814697 TI - Characteristics of a testosterone-estradiol binding globulin (TEBG) in goldfish serum. AB - Neuroendocrine tissues in teleost fish aromatize androgen to estrogen at extraordinarily high rates. As part of a project in which we are studying the dynamics of sex steroid uptake, metabolism, and receptor binding in goldfish (Carassius auratus) brain and pituitary, we have identified and characterized a sex-steroid-binding component of serum. This protein has been designated a testosterone-estradiol-binding globulin (TEBG) since it bound testosterone (T) and estradiol-17 beta (E2) with high affinity (Kd = 1.9 and 2.1 nM, respectively) whereas other steroids were less effective ligands (5 alpha-dihydrotestosterone greater than progesterone = 11-ketotestosterone greater than estrone = estriol = diethylstilbestrol greater than cortisol). Scatchard analysis, disc gel electrophoresis and sucrose gradient centrifugation all indicate that T and E2 are bound by the same protein. The number of available serum binding sites (Bmax = 10(-7) M) greatly exceeded reported maximal levels of T and E2 in the same species and showed no obvious sex or seasonal differences. However, the steroid TEBG interaction was unstable, exhibiting very short half-times of association (less than 15 min) and dissociation (less than 10 min). On the basis of comparison of the physicochemical characteristics of TEBG with other intracellular androgen-binding proteins in goldfish brain (androgen receptor, aromatase), we predict that the serum-binding protein would not limit but rather enhance exchange of T and E2 in central tissues. PMID- 3814699 TI - Functional maturation of the gonads of Turkish hamsters under various photoperiods. AB - The golden hamster, Mesocricetus auratus, is the only photoperiodic rodent to date that has been shown to fail to respond to inhibitory (i.e., short, less than 12.5 h/day) photoperiods until after pubertal onset. In other photoperiodic hamsters, mice, and voles, short photoperiods greatly retard gonadal maturation. The Turkish hamster, Mesocricetus brandti, is a photoperiodic rodent that as an adult is reproductively competent only on photoperiods of 15-17 h of light per day; photoperiods of less than 15 or greater than 17 h of light promote gonadal regression. In this report we addressed two questions: a) are prepubertal M. brandti photoperiodic, and b) if so, is gonadal maturation enhanced or suppressed by exposure to photoperiods of greater than 17 h of light per day? Turkish hamsters were raised on photoperiods of 12, 16, 20, or 24 (= LL) h of light per day. Testicular growth was retarded for 16 wk by 12L:12D. Very long days, 20L:4D, or LL did not retard testicular development. In females, pubertal onset, as indicated by first vaginal estrus, was delayed in young raised on 12L:12D and in 2 of 18 and 4 of 19 young raised on 20L:4D and LL, respectively. These results demonstrate that prepubertal Turkish hamsters are photoperiodic, but respond differently from adults to photoperiods greater than 17 h of light per day. PMID- 3814698 TI - Effects of fetal calf serum and bovine serum albumin on in vitro maturation and fertilization of bovine and hamster cumulus-oocyte complexes. AB - Bovine serum albumin (BSA) and fetal calf serum (FCS) were evaluated as protein supplements for in vitro maturation and fertilization of oocytes from cows and hamsters. BSA and low doses of FCS (0.1 or 1.0%) did not support viability or maturation of the cumulus-oocyte complex as well as higher doses of FCS (5, 10, or 20%) for either species. BSA failed to support cumulus expansion for bovine or hamster cumulus-oocyte complexes. All doses of FCS examined supported cumulus expansion in bovine cumulus-oocyte complexes, whereas the hamster complexes required at least 1.0% FCS to induce cumulus expansion. The addition of a serum filtrate, Solcoseryl, with BSA improved viability of the cumulus in the bovine but did not support cumulus expansion or completion of Meiosis I in bovine complexes. In vitro fertilization could be accomplished in media containing FCS by increasing the heparin concentration in the bovine system or reducing FCS for the hamster system. Polyspermy was increased when FCS was the protein supplement. It is not known whether this is an interaction of FCS with the sperm or oocyte. In conclusion, FCS was found necessary for follicle-stimulating-hormone (FSH) induced cumulus expansion. It also improved cumulus cell viability and completion of the first meiotic division in complexes of both species compared with BSA. PMID- 3814700 TI - Characterization and distribution of protein kinase C in ovarian tissue. AB - Although protein kinase C, an enzyme dependent on calcium, phospholipid and diacylglycerol, has been found in high levels in ovarian tissues, its biologic function is yet unknown. In initial studies on the role of this enzyme in regulating ovarian functions, we compared protein kinase C activity in subcellular fractions of porcine corpora lutea and medium follicles. Highest protein kinase C-specific activities were found in the cytosol, followed by microsomes and mitochondria for both follicles and luteal tissues. Solubilization of all membrane-containing fractions by 0.2% Triton X-100 was required for full expression (a 4-fold average increase) of protein kinase activity. Extraction of membrane fractions with 0.5 M NaCl or sonication in a hypotonic medium revealed that 90% of the total mitochondrial protein kinase C activity and 50% of the microsomal activity was tightly membrane-bound. Characterization of both cytosolic and Triton X-100 extracted membrane preparations of luteal tissue by diethylaminoethyl (DEAE)-cellulose chromatography revealed a single peak of protein kinase C activity eluting at 80 mM NaCl. Cytosolic fractions of corpora lutea contained 3 times more protein kinase C-specific activity than did cytosolic fractions of follicles. In contrast, mitochondria from medium follicles contained 30% more specific protein kinase C activity than did luteal mitochondria. These higher cytosolic levels of protein kinase C-specific activity in corpora lutea suggest that the enzyme may play an important role in the process of luteinization or in the regulation of luteal function. PMID- 3814701 TI - Local reproductive tract immunity to sperm-specific lactate dehydrogenase-C4. AB - Immunity to sperm-specific lactate dehydrogenase C4 (LDH-C4) results in reduction of fertility in females. Stimulation of a local mucosal immune response to LDH-C4 in the reproductive tract would guarantee the presence of antibodies at the site of fertilization, which should enhance suppression of fertility. After intrauterine immunization with LDH-C4, SJL/J female mice secrete immunoglobulin (Ig)A antibodies specific for LDH-C4 into their uterine fluids. Furthermore, these animals demonstrate a lower pregnancy rate than controls receiving an intrauterine immunization without LDH-C4. Thus, induction of a local immune response is an effective alternative to systemic immunization for administering a contraceptive vaccine. PMID- 3814702 TI - Periovulatory changes in serum concentration and ovarian content of 5 alpha androstane-3 alpha, 17 beta-diol in the adult rat. AB - The high amounts of 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha-diol) present in immature female rats decline towards first ovulation, but on the day of first proestrus a peak is seen. This raises the possibility that during adulthood similar proestrous peaks may occur. Therefore, serum concentrations and ovarian content of 3 alpha-diol were estimated every two hours between 0900 and 2100 h in adult cyclic rats on the day of proestrus. In the same rats, serum concentrations of estradiol (E2), progesterone (P) and luteinizing hormone (LH) were measured, as were ovarian contents of E2 and P. A significant elevation in ovarian 3 alpha-diol was found between 0900 and 1700 h proestrus, whereas serum concentrations of 3 alpha-diol were elevated from 1300 to 2100 h. The high morning values of ovarian 3 alpha-diol correlated with those for ovarian E2 (p less than 0.005); the elevated serum concentrations of 3 alpha-diol during the afternoon correlated with serum P (p less than 0.005) and with serum LH concentrations (p less than 0.005). Serum and ovarian values were positively correlated for P and E2, but not for 3 alpha-diol. The rise in serum 3 alpha-diol could be prevented by blocking the LH surge with sodium pentobarbitone (Nembutal; 35 mg/kg b.w.) administered at 1300 h. In Nembutal-treated rats, the concentration of 3 alpha-diol at 1700 h (886 pg/ml) was significantly lower than in saline-treated control rats (1135 pg/ml; p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814703 TI - Luteinization-specific ovarian mitochondrial proteins. AB - Mitochondria isolated from porcine medium- and large-sized ovarian follicles and corpora lutea show progressive increases in specific proteins temporally associated with luteinization. These include 12-15, 16-17, 33, 47, 50, and 60 kDa proteins. Synthesis of these same mitochondrial proteins is stimulated by incubation of large ovarian follicles with luteinizing hormone (LH) (0.10 microgram/ml) but not by follicle-stimulating hormone (0.10 microgram/ml). A dose response curve was generated indicating that synthesis of several mitochondrial proteins is stimulated in an LH-dependent manner, while synthesis of two appear to be repressed (70 and 94 kDa). Examination of mitochondrial translation products (cycloheximide-insensitive, chloramphenicol-sensitive protein synthesis) from isolated follicular and luteal mitochondria, by both one- and two dimensional electrophoresis, demonstrated that two proteins (23 and 35 kDa) are synthesized within luteal but not follicular mitochondria. Further, synthesis of two proteins within follicular mitochondria are significantly reduced in luteal mitochondrial. Regulation of mitochondrial proteins necessary for the rate limiting step in steroidogenesis is discussed. PMID- 3814704 TI - Threshold for behavioral response to testosterone in old castrated male rhesus macaques. AB - The sexual behaviors of old, intact (N = 5) and old, castrated (N = 6) rhesus macaque males were compared in six series of pair tests with receptive females. The castrated monkeys were tested when untreated and when given five doses of testosterone propionate (TP; 0.004, 0.016, 0.064, 0.256, and 1.024 mg/kg of body weight) in consecutive months. The serum testosterone (T) level was determined for each male before and after each series of tests. When untreated, none of the castrated males ejaculated, and yawning was significantly less in these monkeys than in intact males-no other behavioral measures differed significantly. Within 2 weeks of daily injections of 0.004 mg of TP/kg, two males ejaculated, and all differences in measures of ejaculation were eliminated. A third male ejaculated after 1 week of treatment with 0.016 mg of TP/kg. Yawning values did not differ during and after treatment with 0.064 mg of TP/kg. Although final mean serum T levels were six times higher in castrated (24.3 ng/ml) than in intact males (4.2 ng/ml), sexual performance levels did not exceed those of intact males. PMID- 3814705 TI - Detection of pregnancy by radioimmunoassay of a novel pregnancy-specific protein in serum of cows and a profile of serum concentrations during gestation. AB - The development of a double antibody radioimmunoassay for a bovine pregnancy specific protein (pregnancy-specific protein B; PSPB) is presented. By means of this assay, PSPB could be measured in serum of pregnant cows. Five dairy cows were bled throughout gestation to measure serum levels of PSPB. Serum concentrations (means +/- SE) exceeded 1 ng/ml by 30 days postbreeding and increased gradually through three months (9 +/- 0.6 ng/ml), six months (35 +/- 6 ng/ml), and nine months (150 +/- 75 ng/ml) of gestation. Maximum levels of PSPB (542 +/- 144 ng/ml) were reached two days before parturition and then steadily declined to less than 78 ng/ml by 21 days postpartum. In 21 cows bled daily from 15 through 30 days postbreeding, PSPB could be measured in a few cows before and in most cows by 24 days after breeding. In a commercial herd of 102 beef cows, the assay could detect pregnancy earlier and more accurately than the routine method of rectal palpation. This radioimmunoassay measures a unique antigen that, for the first time, provides a serological method for detecting pregnancy in cows. PMID- 3814706 TI - Uterine progesterone metabolism during early pseudopregnancy in the rat. AB - We measured uptake and metabolism of progesterone (P4) during the estrous cycle and Days 2-6 of pseudopregnancy (PSP) to determine uterine P4 dynamics during preimplantation. Rats were infused with [3H]P4 for 60 min, blood was obtained, the uterus was removed, and endometrium and myometrium were isolated. Tissue radiolabeled P4 and P4 metabolites (5 alpha-pregnane-3,20-dione, DHP; 20 alpha hydroxy P4; 17 alpha-hydroxy P4, and hydroxylated DHP derivatives) were extracted and separated by thin-layer chromatography (TLC). Serum P4 was measured by radioimmunoassay (RIA) in another group of rats. Endometrial and myometrial concentrations of [3H]P4 were greater (p less than 0.05) than plasma values. In contrast, [3H]DHP levels in the endometrium were higher (p less than 0.01) than values in myometrium or plasma. Compared to values in the estrous cycle, endometrial ratios of [3H]DHP/[3H]P4 and [3H]metabolites/[3H]P4 decreased (p less than 0.02) on Days 3-5 of PSP. Serum P4 levels during the estrous cycle (13-25 ng/ml) increased (p less than 0.01) to 120 ng/ml on Days 3-5 of PSP. Estimated concentration of P4 in the endometrium during the estrous cycle (90 ng/g) increased (p less than 0.05) to 580 ng/g by Day 5 of PSP. Similar observations were noted for the estimated endometrial concentrations of DHP and all P4 metabolites. We suggest that both endometrium and myometrium take up and metabolize P4 during the estrous cycle and early PSP. However, endometrial P4 metabolism during PSP is greater than during the estrous cycle, in part because of increased ovarian secretion and endometrial concentration of P4.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814707 TI - Radical ovarian resection advances the onset of persistent vaginal cornification but only transiently disrupts hypothalamic-pituitary regulation of cyclicity in C57BL/6J mice. AB - In aging laboratory rodents, neuroendocrine failure to support estrous cyclicity is in part the consequence of exposure to ovarian secretions during adulthood. Moreover, some evidence suggests that those secretions associated with the predominant postcyclic state, persistent vaginal cornification (PVC), are more deleterious than those associated with cyclicity. However, it is not clear whether postcyclic hormonal secretions are intrinsically more deleterious or whether vulnerability to ovarian secretions, regardless of their nature, increases during aging. Using relatively young, age-matched mice, this study was designed to control for age and to determine if the hormonal milieu associated with PVC would be more deleterious to neuroendocrine function than that associated with regular cyclicity. Onset of PVC was advanced about 5 mo by resecting 90-95% of the ovarian tissue from 5-mo-old mice. The resultant PVC was similar in duration, vaginal cytology and ovarian histology to that seen in normally aging mice. At age 13 mo, when mean duration of PVC was 3 mo in resected mice but only 1 mo in sham-operated controls, the ability of mice to support cyclicity upon receipt of ovarian grafts from 4-mo-old donors was tested as an index of neuroendocrine function. The response of resected mice was slightly impaired, but only during the first month after grafting. This transient disruption of neuroendocrine function in mice prematurely exposed to PVC stands in contrast to the irreversible loss of cycling potential in older animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814708 TI - Seasonal variation in the total volume of Leydig cells in stallions is explained by variation in cell number rather than cell size. AB - Stereological methods were employed in two studies with stallions 1) to determine if seasonal variation in the total volume of Leydig cells is a function of cell number or cell size and 2) to characterize the annual cycle of the Leydig cell population. In the first study, numbers of Leydig cells were calculated for 28 adult (4-20 yr) stallions in the breeding or nonbreeding seasons from nuclear volume density (percentage of the decapsulated testicular volume), parenchymal volume (decapsulated testicular volume), and the volume of individual Leydig cell nuclei. The average volume of the individual Leydig cells was calculated as the total Leydig cell volume/testis (volume density of Leydig cells in the parenchymal volume times parenchymal volume) divided by the number of Leydig cells. The average volume of an individual Leydig cell varied within each season, but means were almost identical for the nonbreeding (6.94 +/- 0.61 picoliter) and breeding (6.91 +/- 0.45 picoliter) seasons. However, Leydig cell numbers per testis were 57% higher in the breeding season, which also had a 58% higher total volume of Leydig cells per testis. In the second study, the numbers of Leydig cells were determined for 43-48 adult horses in each 3-mo period for 12 mo. The number of Leydig cells per testis in May-July was higher (p less than 0.05) than in August-October or February-April, and higher (p less than 0.01) than in November-January. Thus, seasonal fluctuations in the total volume of Leydig cells in adult stallions is a function of the number of Leydig cells that cycle annually. PMID- 3814709 TI - Relationships between ovarian morphology, vaginal cytology, serum progesterone, and urinary immunoreactive pregnanediol during the menstrual cycle of the cynomolgus monkey. AB - Three different indices of ovulation and luteal activity were studied in eight regularly cycling cynomolgus monkeys. A significant relation between changes in serum progesterone and immunoreactive pregnanediol (I-PD) in urine was obtained. The occurrence of ovulation could be determined reliably from a change in the ratio of cornified to basal epithelial cells in vaginal smears, and luteal activity could be assessed reliably from daily measurements of urinary pregnanediol. The time of ovulation could be defined more precisely by daily I-PD radioimmunoassays than by the vaginal smear pattern. Measurements of I-PD also have the advantage of ease and noninvasiveness over serum progesterone determinations. More detailed information about changes in hormonal activities could not be obtained reproducibly from thorough examination of cell types in vaginal smears. PMID- 3814710 TI - Uterine growth-promoting effects of relaxin: a morphometric and histological analysis. AB - The hormone relaxin has been implicated in the regulation of several processes in the reproductive tract during pregnancy and parturition. This study investigated the uterine effects of relaxin in immature and mature ovariectomized, estrogen primed rats using morphometric and histochemical analysis. Rats were sprayed at 30 or 70 days of age and given estrogen (5 micrograms) 7 days later. After a week, they received an injection of porcine relaxin (100 micrograms) and were killed 6 h later; controls received vehicle alone. Histological sections were obtained from 7 levels of each uterine horn, and the volumes of endometrium and myometrium were calculated by use of a Zeiss Videoplan Computer Image Analyzer. In immature animals, relaxin treatment doubled uterine weights during the treatment period, and cross sections from relaxin-treated animals exhibited significant increases in the areas of both the myometrium and endometrium, 150% and 130% respectively. Mature animals were less responsive to relaxin although they also exhibited significant increases in uterine weight (31%), myometrial volume (29%), and endometrial volume (22%). With the use of Masson's Trichrome stain for collagen, we observed that relaxin alters the connective tissue framework of both endometrium and myometrium; control uterine collagen appears highly organized and dense with compact collagen fibers, whereas the collagen of relaxin-treated uteri is loosely arranged and disorganized with widely separated collagen fibers. Relaxin-stimulated uteri exhibited significantly greater vascularization, as evidenced by the size of arteries and veins in the vascular region between the circular and longitudinal muscle layers. Increased vascularization and uterine blood flow may be one mechanism involved in relaxin's uterotropic effect and is being investigated further.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3814711 TI - Electrical conduction in bone in frequency range 0.4-1.3 GHz. AB - Dielectric permittivity and conductivity of bone in different physiological conditions and collagen, a major component of bone are measured in the frequency range 400-1300 MHz using a Network analyzer. The dielectric dispersion observed in each cases are explained in terms of the relaxation of 'bound water' in this frequency range. The relaxation frequency as well as distribution parameter are computed in each case, under certain simplifying conditions, hydration as well as static dielectric permittivity of bound water attached with bone in different physiological conditions and collagen are also calculated. The effect of ultraviolet light irradiation on the dielectric properties of bone in this frequency range is also examined. The change in dielectric properties due to radiation is attributed to the breakage of hydrogen bonds in the ring structure. A consistent physical model in line with other data is presented. PMID- 3814712 TI - The effect of post-sintering heat treatments on the tensile properties of Ti-6A1 4V alloy. AB - Previous studies have shown that the application of a porous coating to a solid substrate offers several advantages over current methods of implant fixation. However, the heat treatments required to sinter porous metal coatings have also been shown to cause significant decreases in the mechanical properties of the substrate. With Ti-6A1-4V alloy, sintering above the material beta transus results in a transformation from the as-received, equiaxed microstructure, recommended for surgical implants, to a lamellar alpha-beta microstructure. This lamellar structure has been shown to have inferior mechanical properties. In the present study, microstructural analysis and mechanical testing were performed on Ti-6A1-4V alloy subjected to various post-sintering heat treatments in an attempt to improve the mechanical properties. The microstructures examined were a fine and a coarse acicular alpha in a retained beta matrix. Tensile tests were performed on specimens containing these structures and results were compared with the lamellar and equiaxed microstructures. The fine acicular alpha structure was shown to exhibit the best tensile properties for the post-sintering Ti-6A1-4V alloy microstructures examined, displaying a 9.8% elongation value, as compared to the as-received, equiaxed microstructure value of 13.5%. This represents a significant improvement over the 5.1% value obtained with the lamellar microstructure. PMID- 3814713 TI - Bone remodeling associated with a flexible femoral intramedullary implant. AB - The tissue response and bone remodeling associated with a flexible femoral intramedullary implant was evaluated. The implant consisted of wafers of porous Co-Cr-Mo alloy and microporous LTI pyrolytic carbon. Six wafers of each material were assembled in a stack and held together using a central acrylic rod. Radiography and histology demonstrated that these implants were associated with gross bone remodeling changes in the femoral shaft. The bone remodeling consisted of endosteal surface bone resorption and periosteal surface bone deposition, most likely due to a loss of structural support from the reamed medullary canal. The periosteal surface bone deposition resulted in an increase in femoral shaft diameter of 5% - 140%. The bone-implant interface consisted of a fibrous connective tissue with limited areas of bone ingrowth or bone apposition. PMID- 3814714 TI - Electronic antihemocoagulation. AB - The purpose of this study is to determine if the volume conduction of electrical current by blood can extend or possibly prevent clotting, and if so to determine where in the clotting sequence the effects occur. The important aspects of these based as follows: All cells and surfaces of the body carry an electrical charge. The magnitude of this surface charge is determined not only by the characteristics of the cells and particles themselves, but also by the liquid or solid in which they are immersed. The majority of the particles within the blood are negatively charged. Although the intima of the vascular system is negatively charged with respect to the adventitia of the vessel, trauma to the vessel will cause the negative charge to become zero or positive with a concomitant thrombosis at that point. An incision into a vessel will result in a positive voltage at the injury site. If the incision is kept negatively charged through application of an electrical current, coagulation at the site will be inhibited and the wound will ooze for many hours. If the current is reversed and made positive, clotting will accelerate. In the laboratory when two oppositely charged electrodes were cemmersed in a beaker of blood, a clot formed at the positive electrode only. If the procedure is carried out correctly, the blood surrounding the negative electrode will have highly effective anticoagulant properties. Furthermore, under similar conditions, leucocytes will migrate toward the negative electrode, thus indicating a change in cell polarity from negative to positive, possibly as a means to combat inflammation. A special bridge circuit and several original test cell designs were developed. Some of the results of this research are as follows: a means to electronically detect coagulation was devised; clotting was extended in excess of 400% by the application of electrical currents; currents below one milliamp per cm2 would not cause any noticeable trauma to the blood as determined by routine clinical laboratory methods. Analysis of the saline compartments resulted in the conclusion that there had not been any migration of the blood components into the saline. However, since the pore size would prohibit the migration of the blood components into the saline.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3814715 TI - Osteogenesis induced by bone matrix is inhibited by inflammation. AB - This study was designed to examine the effect of inflammatory reaction elicited by percutaneous tube on bone induction. Inflammation was provoked by different types of biomaterials. In order to evaluate incorporation of percutaneous tubes, bone matrix and subcutaneous tissue, demineralizing bone matrix was implanted in the subcutaneous tissue of rats and was exposed to interaction with inflammatory conditions. Inhibition to the induction of cartilage and bone by the inflammatory process could be clearly demonstrated. It is suggested that the low pH levels, typical to enzymes operative in inflammation are a direct cause for inhibition of chondro and osteogenesis. The process of calcification is characterized by the activation of enzymes in high pH levels. PMID- 3814716 TI - Custom-made vaginal balloons for strengthening circumvaginal musculature. AB - A technique for making individualized silicone rubber intravaginal balloons is described. The method entails investing alginate vaginal impressions in silicone rubber and casting a resin model which is then dipped repeatedly in a Silastic Dispersion (Dow Corning, Q7-2213). The range of forces developed by circumvaginal muscles during maximum contractions was determined to be 0.5-4 lbs. Pressure volume relationships of the balloons showed that the pressure of filling fluid was an accurate replica of the mean pressure in the vagina. PMID- 3814717 TI - [Analysis of static stresses of hip prosthesis shafts in the frontal and sagittal plane with reference to various loosening rates and embedding tendencies]. PMID- 3814718 TI - [Stress on the elbow joint following alloplastic joint replacement]. PMID- 3814719 TI - [Recommendation for analytically based construction of an osteosynthesis miniplate made of titanium]. PMID- 3814720 TI - [Studies of stresses on modular prostheses of the lower extremities--measuring procedures and results of the last 15 years]. PMID- 3814722 TI - The bifurcating autoregression model in cell lineage studies. AB - A model for cell lineage data is presented and analysed. The model is an extension of the classical first-order autoregression, used in time-series studies, to bifurcating data trees of general size and shape. Maximum likelihood theory is developed and compared with an extensive simulation study. Some properties of moment estimators are also presented. PMID- 3814721 TI - The natural variability of vital rates and associated statistics. AB - The first concern of this work is the development of approximations to the distributions of crude mortality rates, age-specific mortality rates, age standardized rates, standardized mortality ratios, and the like for the case of a closed population or period study. It is found that assuming Poisson birthtimes and independent lifetimes implies that the number of deaths and the corresponding midyear population have a bivariate Poisson distribution. The Lexis diagram is seen to make direct use of the result. It is suggested that in a variety of cases, it will be satisfactory to approximate the distribution of the number of deaths given the population size, by a Poisson with mean proportional to the population size. It is further suggested that situations in which explanatory variables are present may be modelled via a doubly stochastic Poisson distribution for the number of deaths, with mean proportional to the population size and an exponential function of a linear combination of the explanatories. Such a model is fit to mortality data for Canadian females classified by age and year. A dynamic variant of the model is further fit to the time series of total female deaths alone by year. The models with extra-Poisson variation are found to lead to substantially improved fits. PMID- 3814723 TI - Log-normal variation belts for growth curves. AB - Prediction (confidence) or tolerance belts compound the uncertainty of sample estimates with the estimated extent of individual variation. The latter is therefore better described by variation belts, in which sample estimates are simply substituted for population parameters. Variation belts can provide valuable graphical indications concerning the goodness of fit of postulated error models. While multiplicative least-squares (MLS) methods appear appropriate in principle for biological growth, they are unsatisfactory in practice when logarithmically transformed data are heteroscedastic. Heteroscedastic multiplicative error models can be fitted by iteratively reweighted multiplicative least squares (IRMLS), but unacceptable negative or infinite residual variance estimates and unreasonably wide variation belts are occasionally obtained. These difficulties can be prevented by constrained iteratively reweighted multiplicative least squares (CIRMLS). Examples are presented concerning the metabolic allometry of white rats, the somatic growth of male elephant seals, and the growth of an experimental population of Paramecium caudatum. PMID- 3814724 TI - On multiple comparisons in the randomization analysis of growth and response curves. AB - Two multiple-comparisons procedures are suggested for supplementing randomization analysis of growth and response curves. One controls the experimentwise Type I error rate for all possible contrast curves via an extension of the Scheffe method. The other controls a family of Type I error rates via a stepwise testing procedure. Both can be approximated by standard F tests without costly recomputation of all of the test statistics for a large number of permutations. PMID- 3814725 TI - Unbalanced repeated-measures models with structured covariance matrices. AB - The question of how to analyze unbalanced or incomplete repeated-measures data is a common problem facing analysts. We address this problem through maximum likelihood analysis using a general linear model for expected responses and arbitrary structural models for the within-subject covariances. Models that can be fit include standard univariate and multivariate models with incomplete data, random-effects models, and models with time-series and factor-analytic error structures. We describe Newton-Raphson and Fisher scoring algorithms for computing maximum likelihood estimates, and generalized EM algorithms for computing restricted and unrestricted maximum likelihood estimates. An example fitting several models to a set of growth data is included. PMID- 3814726 TI - A proportional hazards model for interval-censored failure time data. AB - This paper develops a method for fitting the proportional hazards regression model when the data contain left-, right-, or interval-censored observations. Results given for testing the hypothesis of a zero regression coefficient lead to a generalization of the log-rank test for comparison of several survival curves. The method is used to analyze data from an animal tumorigenicity study and also a clinical trial. PMID- 3814727 TI - Standardized tumor rates for chronic bioassays. AB - If crude experimental proportions of animals with tumors from chronic bioassays for carcinogenicity are used for low-dose extrapolation in a risk analysis, different dose-specific patterns of mortality due to competing risks can bias the results. In order to adjust tumor rates for differential mortality across dose groups, Farmer, Kodell, and Gaylor (1982, Risk Analysis 2, 27-34) recommended using nonparametric estimates of probability distributions of times to onset of tumors, with competing causes of death removed, when performing a risk analysis. This paper extends the approach of Farmer et al. by proposing a method for adjusting tumor rates to reflect lifetime or near-lifetime tumor incidences that would be obtained if all dose groups experienced the control mortality rate from causes other than the tumor of interest. Thus, natural mortality due to competing risks is explicitly included, rather than removed. The proposed standardized tumor rates are calculated as a summation of adjusted age-specific probabilities of dying with a tumor during the course of an animal bioassay for carcinogenicity plus the probability of being alive with a tumor at the terminal sacrifice. PMID- 3814728 TI - Designs for slope ratio assays. AB - Optimal designs are obtained for the estimation of relative potency in a slope ratio assay. Three criteria are considered based on the asymptotic variance of the standard point estimator. Efficiency functions are derived and numerical examples are given. PMID- 3814729 TI - The kappa coefficient of agreement for multiple observers when the number of subjects is small. AB - Published results on the use of the kappa coefficient of agreement have traditionally been concerned with situations where a large number of subjects is classified by a small group of raters. The coefficient is then used to assess the degree of agreement among the raters through hypothesis testing or confidence intervals. A modified kappa coefficient of agreement for multiple categories is proposed and a parameter-free distribution for testing null agreement is provided, for use when the number of raters is large relative to the number of categories and subjects. The large-sample distribution of kappa is shown to be normal in the nonnull case, and confidence intervals for kappa are provided. The results are extended to allow for an unequal number of raters per subject. PMID- 3814730 TI - Alternative estimation procedures for Pr(X less than Y) in categorized data. AB - Consider two independent random variables X and Y. The functional R = Pr(X less than Y) [or gamma = Pr(X less than Y) - Pr(Y less than X)] is of practical importance in many situations, including clinical trials, genetics, and reliability. In this paper several approaches to estimation of gamma when X and Y are presented in discretized (categorical) form are analyzed and compared. Asymptotic formulas for the variances of the estimators are derived; use of the bootstrap to estimate variances is also discussed. Computer simulations indicate that the choice of the best estimator depends on the value of gamma, the underlying distribution, and the sparseness of the data. It is shown that the bootstrap provides a robust estimate of variance. Several examples are treated. PMID- 3814731 TI - Global cross-ratio models for bivariate, discrete, ordered responses. AB - A family of statistical models is presented for bivariate, discrete response to a regressor when both components of the response have ordered categories. Association between components is expressed in terms of global cross-ratios, cross-product ratios of quadrant probabilities, for each double dichotomy of the response table of probabilities into quadrants (Pearson and Heron, 1913, Biometrika 9, 159-315). These models are extensions to the work of Plackett (1965, Journal of the American Statistical Association 60, 516-522) and Mantel and Brown (1973, Biometrics 29, 649-665). The marginal cumulative probabilities may satisfy linear logistic or other generalized linear models (McCullagh, 1980, Journal of the Royal Statistical Society, Series B 42, 109-142). An analysis of patients' postoperative pain level and medication frequency illustrates these methods. PMID- 3814732 TI - Sample size for individually matched case-control studies. AB - The standard formulas used to calculate sample size for an individually matched case-control study assume a constant probability of exposure throughout the pool of possible controls. We propose new formulas that allow for heterogeneity in the probability of exposure among controls in different matched sets. Since matching factors are suspected of being confounders, they are expected to divide the total population into subgroups with different proportions exposed. Thus, the assumption of homogeneity of exposure among controls, made by the currently used formulas, is inconsistent with the assumptions used to design a matched study. The proposed formulas avoid this inconsistency. We present an example to illustrate how heterogeneity can affect the required sample size. PMID- 3814733 TI - Sample size for case-control studies using Cochran's statistic. AB - Sample size determination for case-control studies of chronic disease are often based on the simple 2 X 2 tabular cross-classification of exposure and disease, thereby ignoring stratification which may be considered in the analysis. One consequence of this approach is that the sample size may be inadequate to attain a specified power and size when performing a statistical analysis on J 2 X 2 tables using Cochran's (1954, Biometrics 10, 417-451) statistic or the Mantel Haenszel (1959, Journal of the National Cancer Institute 22, 719-748) statistic. A sample size formula is derived from Cochran's statistic and it is compared with the corresponding one derived when the data are treated as unstratified, and also with two other formulas proposed for stratified data analysis. The formula developed yields values slightly higher than one recently proposed by Munoz and Rosner (1984, Biometrics 40, 995-1004), which assumes that both margins of each 2 X 2 table are fixed, while the present study considers only the case-control margin to be fixed. PMID- 3814734 TI - Methods of estimation in log odds ratio regression models. AB - McCullagh's (1984, Journal of the Royal Statistical Society, Series B 46, 250 256) approximation to the conditional maximum likelihood estimator in log odds ratio regression models is shown to have negligible asymptotic bias unless the odds ratios are large and the sample sizes in individual 2 X 2 tables are very small. In application to two sets of case-control data, it yields results virtually indistinguishable from those of the conditional analysis. A generalization of the Mantel-Haenszel estimator proposed by Davis (1985, Biometrics 41, 487-495) does not approximate the conditional results nearly as well. PMID- 3814735 TI - Logistic regression methods for retrospective case-control studies using complex sampling procedures. AB - There are a number of possible designs for case-control studies. The simplest uses two separate simple random samples, but an actual study may use more complex sampling procedures. Typically, stratification is used to control for the effects of one or more risk factors in which we are interested. It has been shown (Anderson, 1972, Biometrika 59, 19-35; Prentice and Pyke, 1979, Biometrika 66, 403-411) that the unconditional logistic regression estimators apply under stratified sampling, so long as the logistic model includes a term for each stratum. We consider the case-control problem with stratified samples and assume a logistic model that does not include terms for strata, i.e., for fixed covariates the (prospective) probability of disease does not depend on stratum. We assume knowledge of the proportion sampled in each stratum as well as the total number in the stratum. We use this knowledge to obtain the maximum likelihood estimators for all parameters in the logistic model including those for variables completely associated with strata. The approach may also be applied to obtain estimators under probability sampling. PMID- 3814736 TI - The calculation of probabilities in rejecting bioequivalence. AB - Methods are given for deriving the lower and upper bounds of the probabilities for rejecting bioequivalence. Except when two formulations are nearly equal, the lower and upper bounds become very close and thus give an exact probability. The methods can be used in two- or higher-way crossover or parallel groups designs. One can also determine the sample size from the equations. The results are compared with the probabilities obtained by simulation. PMID- 3814737 TI - Hypothesis testing for proportions with overdispersion. AB - The properties of likelihood ratio tests and simpler t-tests are investigated by simulation under an assumed beta-binomial model for parameter values typically found in toxicological studies. It is found that likelihood ratio methods are at least as powerful as the simpler approaches and in certain situations can be significantly more powerful. PMID- 3814738 TI - Estimating the proportion of uncatchable animals in a population by double sampling. AB - Estimates of population size obtained by capture-recapture methods refer solely to the catchable portion of a population. Given a population containing marked animals, two closed-form maximum likelihood estimators of the proportion of uncatchable animals are presented. They are based on twice sampling the proportion of marked animals in the population: the first sample is drawn from catchable animals only, the second from mixed catchable and uncatchable animals. If the individuals in the first sample are not available to the second sample, both samples must be taken from a representative subpopulation of known size. The quantities required may be obtained during a standard capture-recapture session, provided the sampling methods meet the relevant assumptions; the ensuing estimate of population size can then be corrected for uncatchability. The technique is illustrated for eider ducks, using data from Coulson (1984, Ibis 126, 525-543). PMID- 3814739 TI - Precision of assessing anthelmintic efficacy. AB - In counting internal helminthic parasites (the "worm burden") of domestic animals, physical restrictions often lead to sampling by small aliquots of unequal size among affected organs, among animals treated alike, and among groups of animals treated differently. We assess the impact of that type of sampling on the precision of the analyzed variable (log of estimated worm burden), derive the variance of the standard nonlinear estimator of efficacy of anthelmintic treatment, and examine the problem of number of animals required for adequate sensitivity of experiments. The standard error of sample geometric mean worm burden, for a particular anthelmintic treatment, and the standard error of estimated efficacy of a treatment, relative to control, are given for the case of log-normal burdens. Small aliquots affect precision critically only if mean burden is small, i.e., when sampling by small aliquots is unnecessary, because the physical effort required is not great. The minimal number of animals per treatment, required for at least 80% power to detect efficacy of .7 or higher, is about 4 to 6 for species of parasites constituting major burdens (where the coefficient of variation of worm burden often is near .7). However, the minimal number of animals may be as high as 15 to 20 per treatment for cases with lowly abundant species of parasites (where the coefficient of variation may be as high as 2 or 3). An example is given to illustrate procedures. PMID- 3814740 TI - Fitting the negative binomial distribution. PMID- 3814741 TI - Omitting covariates from the proportional hazards model. PMID- 3814743 TI - On the asymptotic distribution of Tango's clustering index. PMID- 3814742 TI - Mutual independence in a mixed-effects model. PMID- 3814744 TI - A theoretical study of cooperative dual linear aggregation and the vernier effect. AB - An introductory theoretical study is presented of cooperative dual linear aggregation, originating from a surface. That is, two kinds of molecules aggregate in side-by-side strands; lateral interactions cause the aggregation in the two strands to be cooperative. The vernier effect is a special case that is given particular attention: if the two kinds of molecules have different lengths, there will be certain combinations of numbers of molecules that will give the two strands the same length (a 'vernier structure'). Such a structure has extra thermodynamic and kinetic stability, literally because there are no loose ends. The increased lifetime of a vernier structure is, however, not very impressive unless some additional feature is incorporated into the model to enhance further such a structure. Aligned multi-stranded tubular aggregates are also discussed. PMID- 3814745 TI - Elution-band relaxation method. A method to analyze isomerization kinetics by HPLC and application to protein denaturation-renaturation. AB - We present a novel method, the 'elution-band relaxation method', to analyze quantitatively reversible isomerization kinetics by elution chromatography, taking advantage of the high resolution and speed of high-performance liquid chromatography (HPLC). The kinetic information is obtained by measuring the first temporal moments of chromatograms of molecules undergoing isomerization and analyzing their dependence on the column length or flow rate. The major advantage of this method is that it is applicable to reactions as fast as the time of elution in HPLC, a speed which has not been attained previously in analysis of isomerization reactions based on the chromatographic property of molecules. We describe the method and report an experimental application to the denaturation renaturation kinetics of bovine pancreatic ribonuclease A as an example. PMID- 3814746 TI - Vitamin C interaction with cobalt-ammine cations. Synthesis, spectroscopic and structural characterization of cobalt-pentammine and cobalt-tetrammine sugar complexes containing L-ascorbate anion. AB - Interaction between [Co(NH3)5Cl]Cl2, [Co(NH3)4Cl2]Cl and L-ascorbic acid has been investigated in aqueous solution and solid complexes of the type [Co(NH3)5 ascorbate]Cl2 X H2O and [Co(NH3)4 ascorbate]Cl2 X H2O have been isolated and characterized by 13C-NMR, FT-IR and electron absorption spectroscopy. Spectroscopic and other evidence suggested that the sugar anion binds monodentately in the [Co(NH3)5 ascorbate]2+ cation via the ionized O3 oxygen atom and bidentately in [Co(NH3)4 ascorbate]2+ through the O1 and O4 oxygen atoms, resulting in a six-coordinate geometry around the Co(III) ion. The intermolecular sugar hydrogen-bonding network is perturbed upon sugar metalation and the sugar moiety shows a similar conformation to that of the sodium ascorbate compound in these series of cobalt-ammine complexes. PMID- 3814747 TI - Conformations of cyclo(L-orD-Phe-L-Pro-Aca) and cyclo(L-Pro-L- or D-Phe-Aca). Cyclized dipeptide models for specific types of beta-bends. AB - Conformational analyses on four cyclic model peptides of the beta-bend, cyclo(L- or D-Phe-L-Pro-epsilon-aminocaproyl(Aca] and cyclo(L-Pro-L- or D-Phe-Aca), were carried out both experimentally and theoretically. Cyclo(D-Phe-L-Pro-Aca) was shown to exist as a single conformer taking the type II' beta-bend. The comparison of its CD spectra with those of cyclo(L-Ala-L-Ala-Aca) revealed that type I and II' beta-bends, both with alpha-helix-like CD spectra, can be distinguished. Cyclo(L-Phe-L-Pro-Aca) was shown to exist as a single conformer with a cis L-Phe-L-Pro peptide bond, taking the type VI beta-bend. Its CD spectrum has thus been observed for the first time for the bend containing a cis peptide bond. Cyclo(L-Pro-L-Phe-Aca) was shown to exist as a mixture of two conformers, the major one taking the type I beta-bend with a trans Aca-L-Pro peptide bond and the minor one with a cis Aca-L-Pro peptide bond. Cyclo(L-Pro-D Phe-Aca) was suggested to exist as a mixture of two conformers, the major one taking the type II beta-bend with a trans Aca-L-Pro peptide bond and the minor one with a cis Aca-L-Pro peptide bond. PMID- 3814748 TI - Total internal reflection fluorescence. Measurement of spatial and orientational distributions of fluorophores near planar dielectric interfaces. AB - The fluorescence collected from a fluorophore which is near a planar interface and is excited by a laser beam that is totally internally reflected at the interface depends on the direction of the absorption and emission transition dipole moments of the fluorophore with respect to the interface, on the distance from the fluorophore to the interface, on the angle of incidence and polarization direction of the exciting beam, and on properties of the collection optics. Expressions are derived for the excitation and subsequent emission and collection of fluorescence from a population of fluorophores near a planar interface. Presented is a general model-independent method of obtaining characteristic parameters of the spatial and orientational distribution of the population of fluorophores, from a measure of the fluorescence collected as a function of the polarization and the incidence angle of the totally internally reflected laser beam. The method is illustrated with several simulation calculations. PMID- 3814749 TI - Conformational study of two synthetic peptides with sequence analogies to the N terminal fragment of RNase A. AB - The conformational properties of two synthetic model peptides, AEAAHAAEAAHMG (PA) and AEAAHAFEAAHMG (PF), have been studied using CD and 1H-NMR methods. In both peptides, glutamate and histidine residues are situated in such a way that two salt bridges between Glu- (i) and His+ (i + 3) can be formed. A salt bridge of this type (Glu- 9-His+ 12) was postulated previously to stabilize, to a great extent, the alpha-helical conformation of isolated N-terminal fragments of RNase A: C-peptide and S-peptide (A. Bierzynski, P.S. Kim and R.L. Baldwin, Proc. Natl. Acad. Sci. U.S.A. 79 (1982) 2470). Although in both PA and PF salt bridges between glutamates and histidines are formed, as demonstrated by the pH-titration curves of the glutamate gamma-proton signals, no traces of helical conformation have been detected. Evidently, the Glu- (i)-His+ (i + 3) salt bridges do not stabilize the alpha-helical conformation. A comparative analysis of PA and PF NMR spectra provides strong evidence that the phenylalanyl ring in PF interacts not only with the hydrophobic methyl groups of almost all alanine residues but also with the histidine rings and the glutamate side chains in their protonated as well as deprotonated forms. Similar interactions, involving Phe 8, can be expected in the N-terminal fragments of RNase and should be taken into account as an important factor determining the conformational properties of C- and S peptides. PMID- 3814750 TI - Nonequilibrium voltage fluctuations in biological membranes. I. General framework of charge transport in discrete systems and related voltage noise. AB - This paper continues our work on the theory of nonequilibrium voltage noise generated by electric transport processes in membranes. Introducing the membrane voltage as a further variable, a system of kinetic equations linearized in voltage is derived by which generally the time-dependent behaviour of charge transport processes under varying voltage can be discussed. Using these equations, the treatment of voltage noise can be based on the usual master equation approach to steady-state fluctuations of scalar quantities. Thus, a general theoretical approach to nonequilibrium voltage noise is presented, completing our approach to current fluctuations which had been developed some years ago. It is explicitly shown that at equilibrium the approach yields agreement with the Nyquist relation, while at nonequilibrium this relation is not valid. A further general property of voltage noise is the reduction of low frequency noise with increasing number of transport units as a consequence of the interactions via the electric field. In a second paper, the approach will be applied for a number of special transport mechanisms, such as ionic channels, carriers or electrogenic pumps. PMID- 3814751 TI - Nonequilibrium voltage fluctuations in biological membranes. II. Voltage and current noise generated by ion carriers, channels and electrogenic pumps. AB - As applications of the general theoretical framework of charge transport in biological membranes and related voltage and current noise, a number of model calculations are presented for ion carriers, rigid channels, channels with conformational substates and electrogenic pumps. The results are discussed with special reference to the problem of threshold values for sensory transduction processes and their limitations by voltage fluctuations. Furthermore, starting from the special results of model calculations, an attempt is made to determine more general aspects of electric fluctuations generated by charge-transport processes in biological membranes: different frequency dependences of voltage and current noise, and dependence of noise intensities with increasing distance from the equilibrium state. PMID- 3814752 TI - A study of the permeation of dihexadecyl phosphate vesicles by various anesthetics. AB - A simple spectroscopic method for the evaluation of the effect that perturbers may have on a membrane model is described. The model was made from dihexadecyl phosphate (DHP) bilayers. The perturbers used were unconventional anesthetics (n alcohols C1-C8; n-hexane and n-pentane) and conventional anesthetics (chloroform, methoxyflurane, halothane and enflurane). The results show a correlation between vesicle permeation by anesthetics and their clinical potency. Two modes of perturbation by which the anesthetics may induce vesicle permeation are proposed. PMID- 3814753 TI - Theoretical studies on the interaction of proteins and nucleic acid. II. The binding of alpha-helix to B-DNA. AB - Interactions between B-DNA and homopolymeric alpha-helices of glycine, alanine, serine, asparagine and aspartic acid have been studied theoretically. The complexation energy has been minimised taking into account the interactions between DNA and the polypeptides as well as the internal energy of the alpha helix and the interaction energy of counterions with the complex. The results obtained indicate the important role of strong hydrogen bonds between the peptide side chains and nucleic acid phosphate groups, these bonds being much stronger than specific interactions with the base-pairs. The formation of these structural bonds depends on the size of the alpha-helix, which in turn determines whether bridging across the major groove is possible. The steric role of the methyl group of thymine in orienting the peptide helix and the role of DNA screening cations in complex stabilization are also significant. PMID- 3814754 TI - Role of delta agent in fulminant B hepatitis. AB - The prevalence of hepatitis Delta virus among those with fulminant hepatitis has been found to be 34 to 39% as reported from different parts of the world. The majority of these patients were parenteral drug users. The mortality rate appears to be age-related. PMID- 3814755 TI - [Hepatitis D]. AB - The hepatitis D virus (or delta agent) is a defective virus whose replication has an absolute requirement for the hepatitis B virus. Type D hepatitis occurs exclusively in patients simultaneously or previously infected by the hepatitis B virus, often intravenous drug abusers or male homosexuals. Infection by the hepatitis D virus is often responsible for an increase in the severity of the hepatic lesions due to the hepatitis B virus. It can result in fulminant hepatitis. The best prevention is vaccination against hepatitis B. PMID- 3814756 TI - Hepatitis B in prisons. AB - Prisoners have been thought to be at high risk of contracting hepatitis B. Prevalence studies throughout the world show a similar hepatitis B marker rate of 28 to 51%. Seroconversion studies have shown a 0.8 to 1.4% incidence in male prisoners. These results are far less than the predicted 5 to 10% annual attack rate for a similar non-incarcerated population. Cost considerations prevent universal vaccination of prisoners, but IV drug abusers and female prisoners seem to be at especially high risk and should be targeted for immunization now. Prisoners who are chronic carriers of HBsAg and who are also "e" antigen positive or delta antibody positive should be segregated. PMID- 3814757 TI - [Therapeutic application of sequential bone marrow biopsy in myeloma: analysis of 13 medullary biopsies]. AB - The therapeutic applications of sequential bone marrow biopsy were investigated in 6 patients with myeloma. Our results showed that the response to chemotherapy is modified by data from quantitative bone marrow cytology which separate subgroups of patients (plasmocytes or plasmoblasts) with different prognosis. The selective disappearance of certain bone marrow components (plasmoblasts and/or diffuse infiltration) after chemotherapy results in tumoral growth retardation which is reflected in a higher objective response rate. These preliminary results emphasize the need for pretreatment bone marrow biopsy in order to select the most appropriate drugs. A prospective study involving a large number of patients is in progress; its purpose is to find out whether adding to the already known clinical classifications a classification based on the type of bone marrow infiltration and on the degree of cell differentiation is therapeutically useful. PMID- 3814758 TI - The effect of propranolol on protein synthesis and phagocytosis by polymorphonuclear leukocytes from newborn, children and elderly individuals. AB - The effect of propranolol on protein synthesis by polymorphonuclear (PMN) leukocytes was assessed in subjects from four age categories: elderly individuals, grown-up children, small children and newborn babies. This function was inhibited in PMN cells from individuals of all age groups, but inversely proportional to the age of the individual, i.e. the younger the subject, the more inhibited was the protein synthesis by his PMN leukocytes. The phagocytic capacity of the PMN cells of elderly subjects was decreased in comparison with that of individuals from the younger age groups. Propranolol inhibited this cell function in cells from subjects of all categories, although the inhibition was more pronounced in the cells of the younger groups. The difference in the degree of inhibition of the cell function observed in the various age groups may indicate different functional properties of the cell membrane. PMID- 3814760 TI - Therapeutic plasmapheresis. PMID- 3814759 TI - Aluminum binding activity in canine duodenal mucosal extracts. AB - Aluminum binding activity in soluble mucosal extracts from canine duodenum could be demonstrated in a single peak corresponding to proteins in the molecular weight range of 9,000 to 10,000 daltons following chromatography on Sephadex G100. Peak calcium binding activity was observed in these same fractions. These results suggest that there exist soluble proteins in duodenal mucosa which have affinity for both aluminum and calcium and that the absorption of aluminum through the gastrointestinal tract may be promoted by these proteins possibly in competition with calcium. PMID- 3814761 TI - Effects of salt loading during exercise in a hot dry climate. AB - Strenuous work or sports activities in a hot environment can cause significant fluid and salt losses due to excessive sweating. Fluid replacement is commonly accepted to be beneficial, but controversy surrounds the necessity of adding salt to the dietary intake in hot climates. Five healthy young men participated in a self-controlled experiment designed to investigate the effects of salt loading on acclimatized people exercising under controlled laboratory conditions. The additional salt ingestion was found to cause an increase in body weight, rectal temperature, heart rate, urinary sodium and potassium concentrations and in the total amounts of sodium and chloride excreted in urine during the exercise. Furthermore, it decreased plasma aldosterone level and sweat chloride excretion, but did not affect fluid intake, urine output, sweat rate, skin temperature, excretion of sodium and potassium in sweat or urinary potassium content and chloride concentration. Neither did the additional salt intake affect plasma electrolyte levels, renin activity or acid base balance. It is concluded that acclimatized people living in a hot dry climate need no supplementary salt to their daily dietary intake while engaging in physical exercise or sports activities up to two hours a day. Salt loading has no beneficial effects in these conditions and may even be hazardous. PMID- 3814762 TI - Modified elimination of prednisolone in epileptic patients on carbamazepine monotherapy, and in women using low-dose oral contraceptives. AB - The pharmacokinetics of prednisolone in serum after prednisolone-21-phosphate intravenous infusion was compared in 8 chronic epileptic patients on carbamazepine monotherapy for 2 to 12 months, in 5 healthy females having used low-dose oral contraceptives (30-40 micrograms ethinylestradiol + 50-250 micrograms levonorgestrel) for 7 to 24 months, and in 9 other healthy subjects (5 females not using oral contraceptives, and 4 males). Elimination half-lives were shorter in the patients than in the 9 healthy subjects (1.98 +/- 0.48 versus 2.73 +/- 0.76 h, mean +/- SD, 0.02 less than p less than 0.05), and total clearances higher (4.20 +/- 0.53 versus 2.96 +/- 0.54 ml X min-1 X kg-1, p less than 0.02), while the volumes of distribution did not differ significantly. Among the healthy subjects, the oral contraceptive group exhibited a longer elimination half-life, and a lower total clearance, than each of the other two groups, who gave similar results (respectively 4.75 +/- 1.27, 3.05 +/- 0.75, and 2.33 +/- 0.66 h, p less than or equal to 0.05; 1.91 +/- 0.57, 2.95 +/- 0.60, and 2.97 +/- 0.57 ml X min-1 X kg-1, p less than or equal to 0.05); the volumes of distribution were not significantly different. These findings suggest that long-term treatments by carbamazepine and by these low-dose oral contraceptives may respectively increase and decrease the therapeutic requirements of prednisolone. PMID- 3814763 TI - Reduced phagocytosis promoting activity of saliva from patients with chronic lymphocytic leukemia. AB - Patients with chronic lymphocytic leukemia (CLL) have an increased susceptibility to oral and other infections. In a previous study we have shown that normal human saliva contains phagocytosis promoting factor(s). Saliva from healthy subjects enhanced in vitro phagocytosis of latex particles by polymorphonuclear leukocytes (PMNL) and monocytes. Therefore, it was of interest to examine the phagocytosis promoting activity of saliva from patients with CLL. Homologous PMNL and monocytes from healthy subjects supplemented by saliva from patients with CLL demonstrated in vitro a decreased phagocytosis of latex particles, in comparison with cells supplemented by saliva from healthy subjects. This observation suggests that saliva from CLL patients has a reduced phagocytosis promoting ability. This finding may contribute to a further clarification of the increased susceptibility of CLL patients to oral infections. PMID- 3814764 TI - Studies on serum mucoproteins in patients with urinary calculi. AB - A significant increase in serum mucoproteins in stone patients has been observed previously. The present study describes the variation of the constituents of mucoproteins obtained on hydrolysis. The serum mucoproteins of 31 patients with urinary calculi (13 with kidney stone, 7 with bladder stone and 11 with stones in other sites) were analysed and compared with that of 15 healthy control subjects, who had no personal or family history of calculi. The mucoproteins, glycosylated serum proteins, hexosamine and sialic acid were increased in all patients irrespective of the site of stone, while uronic acid decreased as compared with the control subjects. Serum fucose increased in all patients except in kidney stone formers. Uronic acid decreased in all stone formers irrespective of the site of the stone. It is suggested that a different type of mucoprotein is present in such patients. PMID- 3814765 TI - Do asparagine-linked carbohydrate chains in glycoproteins have a preference for beta-bends? AB - X-ray structures of the conformation of carbohydrate moieties and connected regions of glycoproteins are summarized. Evidence is presented that there is some preference for carbohydrate attachment at beta-bends. Evolution may have favored glycosylation to occur at bends to ensure free mobility of the carbohydrate moieties. PMID- 3814766 TI - A sensitive procedure for quantifying the phagocytic competence of blood granulocytes. AB - The phagocytic activity of blood granulocytes can be quantitatively assayed by ingestion of opsonised paraffin oil droplets containing the dye "Oil Red-O" (Stossel, T.P., Mason, R.J., Hartwig, J., and Vaughan, M. (1972) J. Clin. Invest. 51: 615-624). We have modified this assay by incorporating [3H]glycerol into the oil droplets which allows a more sensitive and reproducible measurement of the phagocytic competence of blood granulocytes even at very low cell counts. Comparative studies after one day storage of the blood at 4 degrees C is feasible since they retain 84% of the phagocytic capacity measured when isolated from fresh blood. PMID- 3814768 TI - Regulation of acyl CoA: cholesterol acyl transferase (ACAT) activity by mevalonate and cholesterol in isolated rat hepatocytes during perinatal development. AB - Acyl CoA: cholesterol acyl transferase (ACAT) activity presents marked oscillations and differential sensitivity to the "in vitro" stimulation of the kinase-phosphatase modulatory system in the perinatal rat liver. The regulation of this enzyme activity by some modulators generally active in adulthood, such as cholesterol, lipoproteins and mevalonate, has been studied in hepatocytes isolated at different developmental stages. A lack of effect of mevalonate and a positive effort of lipoprotein cholesterol have been observed at the fetal and neonatal stages. A differential prevalence is suggested of one of the two modulatory mechanisms (phosphorylation-dephosphorylation system, or substrate effect) at each developmental stage. PMID- 3814767 TI - Inhibition of muscle tropomyosin polymerization by DNAse I. AB - Tropomyosin polymerization is inhibited by DNAse I, an endonuclease which also interacts with G-actin. A 1:4 molar ratio of DNAse I to adult chicken pectoralis muscle tropomyosin almost completely prevents the increased viscosity of tropomyosin under polymerizing ionic conditions. While G-actin binding to DNAse I inhibits the DNAse I hydrolysis of DNA, tropomyosin does not affect this enzymatic activity. G-actin-DNAse I interaction is also not altered by tropomyosin. PMID- 3814769 TI - Rapid purification and properties of protein kinase C from bovine adrenal medulla. AB - Protein kinase C was purified from bovine adrenal medulla using a rapid procedure which resulted in an approximate 1500-fold increase in specific activity. The characteristics of the enzyme are reported and for the first time it is possible to compare the effects of TPA on secretion from intact and permeabilized cells with the effect of TPA on protein kinase C purified from the same secretory tissue. PMID- 3814770 TI - Solvation properties of ubiquinone-10 in solvents of different polarity. AB - The solvation properties of ubiquinone-10 and ubiquinol-10 in a wide variety of solvents of polarity varying from alkanes to water are reported. Greatest solubility is observed in solvents of intermediate polarity and particularly where low polarity is combined with a pronounced tendency to interact with the benzoquinone substituent of the ubiquinone molecule. This includes solvents like chloroform and benzene. Ubiquinone-10 is somewhat less polar than ubiquinol-10 as judged by comparative solubilities of the two molecules. Proton-NMR chemical shift measurements and aggregation studies in selected solvents indicate that in ubiquinone-10 in the liquid phase and in solution in hydrocarbons like dodecane the molecules have a preferred association possibly involving stacking of the benzoquinone rings. Surface balance studies indicated that the surface-active character of ubiquinone-10 is relatively weak and only in a comparatively polar and highly structured solvent, formamide, was there evidence of an effect on surface tension of the solvent. The critical micelle concentration in this solvent was estimated to be about 5 microM on the basis of surface tension measurements. Ubiquinone-10 is well known to form virtually insoluble monolayers at the air/water interface. Studies of the partition of ubiquinone-10 in binary mixtures of solvents suggest that the interaction of the benzoquinone ring substituent with structured polar solvents is considerably weaker than the internal cohesion between molecules of the solvent. No evidence on the basis of wide-angle X-ray diffraction measurements was obtained to indicate that solvent molecules were a component of the crystal lattice of ubiquinone-10 that had precipitated from solvent mixtures. PMID- 3814771 TI - Inhibition and reversal of denervation-induced atrophy by the beta-agonist growth promoter, clenbuterol. AB - Dietary administration of the growth promoter, clenbuterol, ameliorated denervation-induced atrophy in rat soleus muscles. In acutely denervated muscles the drug inhibited the appearance of atrophy, and in chronically denervated muscles the atrophy was almost fully reversed. Responses in slow twitch oxidative fibres were particularly marked. PMID- 3814772 TI - A water-soluble aminated beta 1-3D-glucan derivative causes regression of solid tumors in mice. AB - Meth A sarcoma, when inoculated in the skin, grew progressively in hybrid CB6 F1(Balb/c X C57B1/6) mice. When water-soluble aminated beta 1-3D-glucan (AG) was injected intravenously or intraperitoneally on day 7 of tumor growth, the tumors underwent complete regression. When the injection was performed on day 3 there was regression of tumors in only about half of the cases. When the injection was performed on day 14 there was no apparent effect on tumor growth. Tumors in thymectonized animals did not appear to respond to treatment with AG on day 7. The relatively simple chemistry and low toxicity of AG, together with its solubility in biological fluids, makes it a promising tool in experimental--and possibly clinical--tumor therapy. PMID- 3814773 TI - Behavioral development of boys with X chromosome aneuploidy: impact of reactive style on the educational intervention for learning deficits. PMID- 3814774 TI - Prospective studies on children with sex chromosome aneuploidy. PMID- 3814775 TI - Growth and development from early to midadolescence of children with X and Y chromosome aneuploidy: the Toronto Study. PMID- 3814776 TI - Physical and psychologic parameters in children with sex chromosome anomalies: further follow-up from the Winnipeg Cytogenetic Study of 14,069 newborn infants. PMID- 3814777 TI - Chromosome examination of 20,222 newborn children: results from a 7.5-year study in Arhus, Denmark. PMID- 3814778 TI - Prospective study of development of children with sex chromosome anomalies: New Haven Study IV. Adolescence. PMID- 3814779 TI - Sex chromosomal aneuploidy: prospective and longitudinal studies. PMID- 3814781 TI - Psychologic study of XYY and XXY men. PMID- 3814780 TI - Growth, psychologic characteristics, and sleep-wakefulness cycle of children with sex chromosomal abnormalities. AB - This study of girls with Turner syndrome (16 cases) and boys with XXY (two cases) and XYY (eight cases) constitutions was designed to follow the longitudinal growth and to analyze the psychologic findings and the sleeping patterns in them. The growth curves of stature in Turner syndrome were below the 3rd percentile at all ages. The mean of SDS of height in cases less than 5 years old was -2.38, that in cases older than 6 years old -2.40. The shoulders in Turner syndrome have a tendency to broaden with time, in contrast to the development of the pelvis, which is not so good. The height of 47,XYY boys from infancy to 9 years of age was between the 10th and 90th percentiles, with one exception in which the height was above the 90th after 8 years of age. Relatively common psychologic findings in cases with Turner syndrome were as follows: low responsiveness to emotional stimuli, poor emotional expressions, passive and negative mental attitudes, low activity and low productivity, narrow and limited interests, passiveness and common sense adaptability, lower impulsiveness and aggressiveness, etc. The circadian oscillation was observed up to 3 years of age with shifting of the sleeping time to the night period. After that, day sleep gradually tends to decrease with age. Age variation in day and night sleep of an XXY boy was compared with that of a normal child. This showed the normal variation in circadian rhythms in early childhood, although the infant with this syndrome slept more, both day and night, than normal. In early childhood, no difference was noted. Similar studies were performed on a child with the chromosomal aberration XYY and revealed the sleep parameters to be quite normal in infancy and early childhood. PMID- 3814782 TI - Summary overview of behavioural development in individuals with neonatally identified X and Y aneuploidy. PMID- 3814783 TI - Cellular and molecular studies in human chromosomal diseases. PMID- 3814784 TI - Edinburgh study of growth and development of children with sex chromosome abnormalities. III. PMID- 3814785 TI - [Amplitude fluctuations in the contractile responses of small fragments of rat papillary muscle]. AB - Contractile responses of small rat papillary muscle segments (length = 0.25 mm) superfused in a normal Tyrode's solution (t = 35 degrees C) and stimulated at a frequency of 0.16 Hz have been measured, using an original technique. The amplitude of contractile responses was found to fluctuate with the variation of 3.0 +/- 0.4 mu, though the contraction amplitude of the entire muscle remained constant from beat to beat. After the addition of caffeine (6 mM) the variation of contractile responses decreased up to 0.83--0.03 mu, demonstrating a crucial role of sarcoplasmic reticulum in the phenomenon. It is believed that contractility inhibition during calcium overload may be caused by the same reason. PMID- 3814786 TI - [Noradrenaline content of the brain of rats of various ages following adaptation to a new situation and to the development of a passive avoidance conditioned reflex]. AB - Noradrenaline (NA) levels in cortico-striatal (including cerebral cortex, hippocamp, striatum) and hypothalamo-brainstem (including hypothalamus, thalamus, tectum + tegmentum) regions were determined by fluorometry in I- and 2-month-old male rats after 7-day adaptation to experimental conditions and passive avoidance learning by single electric foot shock. Neither the new environment nor a week's adaptation to it resulted in any significant alteration of NA content in both brain regions of 1- and 2-month-old rats. No considerable differences in NA levels were found in rats of both age groups with and without passive avoidance responses. But 24 hours after the exposure to foot shock NA basal levels markedly decreased in both brain regions of 1-month-old rats, while in 2-month-old ones NA basal levels markedly increased in hypothalamo-brainstem region. PMID- 3814787 TI - [The frequency parameters of electrogastromyograms]. AB - The changes in the frequency parameters of the basic electrical gastric rhythm were studied with the application of cutaneous electrodes in men. The study has demonstrated that the frequency parameters of the basic electrical gastric rhythm are dependent on the organ's functional state. The frequency parameters can be used for the identification of the gastric functional state both in healthy and sick subjects. PMID- 3814788 TI - [Antioxidative enzyme activity and metabolism of peroxide compounds in the crystalline lens during cataractogenesis]. AB - Lens antioxidative enzyme activity (catalase, superoxide dismutase, glutathione peroxidase) in cataract as well as the possibility of cataract induction by the lipid peroxidation products and their influence on the content of reduced thiols (oxy-red balance) were studied. It was shown that the rate of the H2O2 decomposition by the human cataract lenses is lowered in comparison with the normal lenses. This is not due to the lowered catalase or glutathione-peroxidase 1 activity, but depends on the deficiency of reduced glutathione in the lens. Activity of superoxide dismutase and glutathione peroxidase metabolizing organic hydroperoxides is significantly lowered in the cataract lenses. Lipid peroxidation products injected into the rabbit vitreous induce posterior subcapsular cataract, which is accompanied by depletion of reduced glutathione level in the lens. The conclusion is made that two interrelated processes: accumulation of H2O2 and of lipid peroxides induce aggregation of the soluble proteins and the fragmentation of the membrane structures in cataract lenses. PMID- 3814789 TI - [Denervation syndrome in the rat digastric muscle]. AB - Excitability parameters of m. digastricus muscle fibers were investigated in anesthetized (40 mg/kg of nembutal) rats 3-5 days after denervation. The number of fibers with high polarization level was increased as was the number of fibers with low and medium level in both bellies of m. digastricus. The differences in the level of polarization recorded in the muscle fibers of the abdominoposterior m. digastricus disappeared after denervation. It is suggested that denervation syndrome in m. digastricus deprived of spindle receptors was similar to that observed in other skeletal muscles. PMID- 3814790 TI - [Erythrocytic reactions and metabolic shifts in long-term experimental hypercatecholaminemia]. AB - The experiments on intact dogs have revealed that daily two-hour infusions of stressor norepinephrine doses are accompanied by the elevation in erythrocyte, hematocrit and hemoglobin levels, changes in circulating blood volume and signs of compensated metabolic acidosis. These adaptive responses become excessive in persistent hypercatecholaminemia and promote the development of stress-induced organic lesions. PMID- 3814791 TI - [Effect of emotional stress on the contractility, adrenoreactivity and calcium sensitivity of smooth muscles of the portal vein in spontaneously hypertensive rats]. AB - The emotional stress decreased contractility and adrenoreactivity in normotensive rats, while in spontaneously hypertensive rats (SHR) the changes were less pronounced. The changes in adrenoreactivity, as well as increased permeability of smooth muscle cells for calcium and reduced reactivity to exogenous calcium revealed in hypertensive animals contribute to high resistance of portal vein smooth muscles to stress. PMID- 3814792 TI - [Biosynthesis of corticosteroid hormones in the cortical areas of the rat adrenal during emotional stress combined with a salt load]. AB - The experiments on male albino rats have shown that excessive salt uptake increases the functional sensitivity of the adrenal cortex to emotional stress (group fighting). Emotional stress in combination with a salt load induces a much greater increment in corticosterone and 18-oxy-11-deoxycorticosterone production by fascicular and glomerular adrenal zones through the activation of the pregnenolone pathway of hormonal biosynthesis. A relatively high aldosterone production was also retained. Thus, the total mineralocorticoid potential directed to sodium retention in the body is in these conditions inadequately increased. PMID- 3814793 TI - [Mechanism of organ damage in hyperthromboplastinemia unrelated to hypoxia]. AB - Hyperthromboplastinemia in rats and dogs was induced by the infusion of xenogenic or allogenic brain suspension or extract. The suspension caused fatal blood coagulation due to fibrin-platelet isolation of cytolemma fractions. The infusion of extracts produced hypotension, caused by hyperkininemia, and primary hypocoagulation due to simultaneous fibrin-formation and fibrinolysis. Severe hepatic, renal and myocardial lesions were discovered 3-4 min after the allogenic brain extract infusion. Xenogenic brain infusion caused inverse changes. The mechanism of this phenomenon is unknown. The organs were affected by lysosomal enzymes activated not by hypoxia but by thrombin- and plasmin-induced glycocalix destruction. PMID- 3814794 TI - [Action of streptokinase on the hemostatic indices of rabbits with a toxic lesion of the liver due to carbon tetrachloride]. AB - The rabbits with CCl4-induced hepatic failure have revealed changes in hemostasis responses to streptokinase administration. The main distinction of hepatic dystrophy was the depression of plasma fibrinolytic activity accompanying the decrease in fibrinogen and antiplasmin concentrations. Streptokinase administration to rabbits with productive inflammatory liver disorders produced changes in hemostasis identical to those observed in intact rabbits, fibrinogen levels, however, remained unchanged. The common feature of all the toxic liver disorders is the increase of antithrombin III levels after streptokinase administration, whereas the antithrombin levels in the control animals were decreased. PMID- 3814795 TI - [Effect of vitamin A deficiency on the macromolecular permeability of small intestine mucosa in the adult rat]. AB - Adult rats with experimental vitamin A deficiency and control animals were intraperitoneally injected with chicken ovalbumin (OA) solution and the entrance of native OA into the blood was assessed 3 hours later by competitive radioimmunoassay. The OA amounts circulating in the blood of control animals averaged (0.39 +/- 0.06) X 10(-4)% of the consumed dose, while in the experimental group it averaged (1.33 +/- 0.42) 10(-4)%. Electron microscopy, using colloid lanthanum hydroxide, has shown vitamin A deficiency to give rise to an abrupt reduction in glycocalix layer, as compared to the control, without increasing erythrocyte membrane permeability for tracer particles. It is concluded that vitamin A deficiency leads to a considerable damage of small intestinal permeability for protein macromolecules. PMID- 3814796 TI - [Functional and morphological changes in the kidneys in acute embologenic arterial occlusion of the extremities]. AB - The results of biochemical, radioisotope and morphological investigations of dog kidneys in experimental acute occlusion of hind limb arteries during ischemia and in postischemic periods are reviewed. Morphological and functional changes in the kidneys occur in ischemia. Blood flow recovery in the extremities aggravates these changes leading in 12-hour ischemia to acute renal failure. PMID- 3814797 TI - [Isolation of periportal and centrolobular hepatocytes by isopycnic centrifugation]. AB - Suspensions of rat hepatocytes were separated by Ficoll discontinuous density gradient into four fractions. About 85% of the total quantity of cells sedimented within the range from 1.044 to 1.126 g/ml. The activity of key enzymes of glycolysis and gluconeogenesis were measured to determine the acinar origin of hepatocyte subpopulations. The activity of the gluconeogenic enzyme, phosphoenolpyruvate carboxykinase, in hepatocytes with the density of 1.044 g/ml was twice as high as in hepatocytes with the density of 1.073 g/ml. In contrast, glycolytic enzyme, hexokinase, was 3 times more active in heavy than in light cells. The results indicate that light and heavy cells correspond to periportal and centrilobular hepatocytes, respectively. PMID- 3814798 TI - [Comparison of the physicochemical properties of model immune complexes from normal and myeloma proteins]. AB - Physico-chemical properties of model immune complexes from normal and myeloma immunoglobulins were compared, and complement-binding activity of these aggregates was studied. No considerable differences were observed between aggregates from normal and myeloma Ig. Myeloma complexes have a higher complement binding activity, as compared to normal ones, and are structurally more stable. Complement-binding activity of both types of complexes depends on the complex molecular mass and is maximal in complexes of medium molecular mass. PMID- 3814799 TI - [Taftsin correction of pharmacologically induced behavioral disorders in white rats]. AB - Tetrapeptide tuftsin in doses adapted to its physiological blood concentrations partially normalized locomotor activity and orientation behaviour of rats altered by drugs affecting aminergic brain systems. At the same time tuftsin had no effect when applied after the treatment by dopaminergic drugs (DTC, haloperidol, apomorphine). It can be concluded that the central effect observed in the first minutes after tuftsin administration is mediated through dopaminergic system. Elimination of some drug-induced behavioural disturbances by tuftsin opens new prospects for its therapeutic application. PMID- 3814800 TI - [Anti-arrhythmic effect of ryanodine in the guinea pig with glycoside poisoning]. AB - The effect of ryanodine on membrane potential oscillations in vitro (in isolated guinea-pig papillary muscle) and on ventricular arrhythmias in vivo (in glycoside intoxication) were studied. 3-5 minutes after ryanodine (0.5 microM) addition the membrane potential oscillations induced by ouabain (1 microM) were abolished. 4-5 minutes after intravenous ryanodine infusion (15 micrograms/kg) ventricular arrhythmias induced by ouabain intoxication (75-115 micrograms/kg) disappeared and 8-10 minutes later sinus rhythm was restored. It is suggested that antiarrhythmic effect of ryanodine is a result of the inhibition of diastolic membrane potential oscillations. PMID- 3814801 TI - [Indices of acute inflammation against a background of lithium oxybutyrate action]. AB - The experiments on rats have shown that intraperitoneal administration of silver nitrate solution induces peritonitis while subplantar histamine, serotonin and prostaglandin E2 administration leads to an acute paw edema. Preliminary subcutaneous injection of lithium hydroxybutyrate prevents the development of inflammation. PMID- 3814802 TI - [Mechanism of fibrin formation in the tissues in gastric adenocarcinoma]. AB - The investigation of extracts from intact and tumour tissues of the human stomach has revealed that adenocarcinoma tissues possess abnormal antiheparin, antithromboplastin and fibrin-stabilizing activity. Heparin activity, as well as the level of antithrombin III and fibrinogen-heparin complex were sharply reduced. The accumulation of anti-heparin compounds normalizing heparin and displacing the coagulating albumin from the complex with anticoagulant is believed to be one of the most important factors of fibrin production in the tumour. PMID- 3814803 TI - [Effect of ascorbic acid on the frequency of the occurrence of colchicine- and methotrexate-resistant colonies]. AB - The influence of ascorbic acid (vitamin C) on the frequency of occurrence of colchicine- and methotrexate-resistant colonies of Djungarian hamster DM-15 cells was studied the number of resistant cells was found to increase 2.9-19.8-fold. The genetic effect of using high vitamin C doses is discussed. PMID- 3814804 TI - [Cessation of ovarian cycles in a young mouse while in parabiosis with an older one]. AB - Female mice 3 and 22-24 months of age were jointed in heterochronic parabiosis. That led to permanent estrus in young mice and maintenance of intact anestrus in old mice. After 8-9 weeks of parabiosis there appeared morphological signs of accelerated ageing in the ovaries of young animals, while no changes in the ovaries of old mice were observed. Serum progesterone of young partners decreased to the levels of old animals and estradiol levels remained unchanged, while prolactin content in adenohypophysis was the same as in young single animals but exceeded the level noted in young mice in parabiosis with young partners. Hormone content in old parabionts remained unchanged, as compared to the control. An old organism is thought to be the source of unidentified factors suppressing the ovarian function in young animals. PMID- 3814805 TI - [Effect of neonatal castration on sex steroid receptor levels in the hypophysis of male rats]. AB - The content of estradiol and testosterone cytosolic and nuclear receptors has been studied in the pituitary body of adult male rats gonadectomized on day 1-3 after birth (long-term castrates) or in adulthood (short-term castrates). Intact male rats and long- and short-term castrates had the same level of cytosolic and nuclear estrogen receptors. The number of cytoplasmic and nuclear testosterone binding sites was identical in the pituitary body of adult intact mice and long term castrates. Contrastingly, the concentrations of androgen cytosolic and nuclear receptors were significantly lower in neonatally castrated males compared to intact adult animals. The results obtained indicate that nuclear testosterone receptors in the pituitary body mediate negative feedback effect of androgen on the release of luteinizing hormone and that the formation of thin mechanism occurs within the first days of life. PMID- 3814806 TI - [Effect of Eleutherococcus on the subcellular structures of the heart in experimental myocardial infarct]. AB - The effect of Eleutherococcus on subcellular heart organization in rats with or without myocardial infarction was investigated. It was found that Eleutherococcus decreases ultrastructural lesions in the ischemic area, intensifies regeneration of subcellular structures and accelerates the recovery after myocardial infarction. The accumulation of glycogen, lipids and lysosomes is observed in lipocytes. It is suggested that positive effect of Eleutherococcus during myocardial infarction is related to lipid transformation into glycogen. PMID- 3814807 TI - [Adrenergic innervation of the arteries of different diameters in the human and animal pia mater]. AB - The adrenergic nervous plexuses of the pial arteries from 450- to 50 micron in diameter have been studied in dogs, cats and humans from 4 age groups (22-44 years, 55-64 years, 65-74 years and 75-86 years old). It has been found that the decrease in the vessel diameter was accompanied by a marked decline in the absolute number of nervous fibers in the nervous plexuses, however the concentration of the nerve fibers has not revealed any significant differences between human arteries from 450 to 100 micron in diameter and animal arteries from 300 to 80 micron in diameter. The number of varicosities-thickness along the nerve fiber--was the greatest in 200-100 micron human arteries and in 80-60 micron animal arteries. With ageing, the number of varicosities in the adrenergic nervous plexus of human pial vessels decreased faster than in the nerve fibers. PMID- 3814808 TI - [Morphofunctional changes in the adrenergic innervation of the major cerebral arteries during bilateral electrostimulation of the locus coeruleus]. AB - The intramural adrenergic nervous apparatus of cerebral arteries was studied in adult rabbits after 3-10 sessions of electrical stimulation of locus coeruleus. The activity of nerve structures was determined by estimating the density of adrenergic perivascular plexuses and by semi-quantitative cytophotometry of changes in the catecholamine content of nerve varicosities. The stimulation was followed by a 28.2 +/- 1.5% increase in adrenergic innervation density. while catecholamine content in perivascular nerve structures displayed a tendency to decrease. The problem of central effects on cerebral blood flow autoregulation is discussed. PMID- 3814809 TI - [Species characteristics of experimental Candida lung lesions]. AB - Intratracheal challenge of rabbits and intranasal challenge of white mice and guinea-pigs by C. albicans without the application of adhesive substances, produced candidiasis pneumonia running more severe course in mice than in rabbits. In guinea-pigs the disease was of medium severity. Specific features of pulmonary inflammation in rabbits were marked polynuclear and especially macrophage reactions, with the phagocyte activity high enough to ensure total elimination of pathogenic microorganisms in the animal. In white mice a weak macrophage reaction was actually a background for a predominant polynuclear reaction producing a massive polynuclear leukocyte disintegration. These processes, though eliminating pathogenic organisms both by phagocytosis and non phagocytic mechanisms, lead to severe fatal pulmonary edema. Specific differences in experimental lung candidiasis reveal various manifestation of human lung candidiasis. PMID- 3814810 TI - [Subcellular manifestations of the corrective effect of alpha-tocopherol on postischemic changes in the liver parenchyma of rats]. AB - The influence of an antioxidant alpha-tocopherol on the intracellular organization of hepatocytes has been studied in the postischemic period. The introduction of alpha-tocopherol (before the onset of 120-min rat liver ischemia) did not decrease the size of necrosis in the liver parenchyma, but stimulated the membrane hyperplasia of cytoplasmic organoids, predominantly in mitochondria. PMID- 3814811 TI - [Structural changes in the hepatocytes of old rats with posthemorrhagic anemia]. AB - Using light and electron microscopy, and morphometry, it has been demonstrated that 15 min and 2.5 h after a single blood loss (2% of the body mass) organelle disintegration and destruction are more marked and preserved in hepatocytes of old (25-month-old) rats, as compared to adult (8-month-old) animals. Regenerative processes in adult rats lead to hepatocyte structure normalization already by the 10th hour after the experiment was started, while in old rats disseminated fatty dystrophy of hepatic cells is observed even on day 7. Thus, hepatocytes of old animals are more susceptible to blood-loss-induced disturbances, with the regenerative processes in them being less marked and slower than in adult animals. PMID- 3814812 TI - [Function of the mononuclear phagocyte system after administration of emulsions of perfluorinated carbon compounds]. AB - Morpho-functional characteristics of mononuclear phagocyte system (MPS) have been studied in experimental animals upon the infusions of perfluorocarbon (PFC) emulsions. It has been established that the infusion of high doses of PFC emulsions following massive hemorrhage causes the reduction in the histoenzymatic activity in MPS of PFC-accumulating organs. Low doses of PFC emulsions increase histochemical activity in PFC-containing macrophages, suggesting a stimulating effect of PFC emulsions on MPS. PMID- 3814813 TI - [Diagnostic potentials of computed tomography in tumors of the thymus]. AB - 115 patients with different morphological thymus lesions, including 67 with thymoma have been examined on a computer tomograph "Somatom DR-2" ("Siemens", FRG). Characteristic features of hyperplasia and thymus cysts, as well as benign and malignant thymus tumours have been revealed by computer tomography (CT). Diagnostic value of CT in conditions of pneumomediastinum and CT employing an "amplification" technique in dynamic CT-scanning (angio-CT) in combination with puncture tumour biopsy under CT control are discussed. CT was found to have certain advantages over other diagnostic techniques: simplicity, safety, the value of the information obtained, possible shortening of the diagnostic period. PMID- 3814814 TI - Increased resistance to membrane deformation of shape-transformed human red blood cells. AB - The study of shape-transformed human erythrocytes is of hematological interest since several clinical conditions are associated with erythrocyte shape changes. Using the micropipette technique, we examined the rheological behaviors of echinocytes induced by sodium salicylate or ATP depletion and of stomatocytes induced by chlorpromazine. Both the discocyte-echinocyte and discocyte stomatocyte transformations resulted in an increased resistance to extension. Sodium salicylate-treated erythrocytes could be returned to normal morphology and normal membrane rheology by addition of chlorpromazine. We conclude that these morphological changes are associated with detrimental effects on the intrinsic membrane deformability of the human erythrocyte. PMID- 3814815 TI - Large numbers of primitive stem cells are active simultaneously in aggregated embryo chimeric mice. AB - The possibility has been repeatedly raised that erythropoiesis results from clonal succession--the differentiation of one or a very small number of the most primitive stem cells that are sequentially activated to proliferate forming clones of differentiated cells and then eventually decline, to be replaced by new stem cell clones. We studied this possibility in chimeric mice made by combining embryos from two different strains so that they would have two distinct stem cell populations, each of which produces a different hemoglobin type (d and s). These were compared with F1 hybrids in which every stem cell produces both types. We measured the percentage of type d in seven to ten serial samples of circulating reticulocytes taken at three- to seven-day intervals and found that the variability in percent of this hemoglobin was only slightly higher in the chimeric mice than in F1 controls; SD ranged from 2.7% to 5.5% in the chimeric mice and from 3.4% to 3.9% in the controls. Using the binomial formula, the numbers of new clones formed during the reticulocyte life span, approximately three days, ranged from 33 to 118 in the individual chimeric mice. However, these numbers are underestimates because estimated numbers of clones depend inversely on variabilities, and the calculations did not exclude the contribution of experimental error to the overall variability. Total percentages of type d hemoglobin were also measured in seven to nine successive serial samples at 60- to 136-day intervals. These gave mean values similar to measures of newly synthesized hemoglobin in the same mice, but SD were larger, ranging from 5.3% to 8.4%. This reflects experimental error, both because of excess day-to-day variability found in this type of measurement and because there could not be fewer primitive stem cells activated to form clones of erythrocytes during the 45 day erythrocyte life span than during the three-day life span of reticulocytes. Since most and maybe all of the variation between successive samples in the same chimeric mouse appear to result from experimental error, many or even all of the primitive stem cells may simultaneously contribute to erythropoiesis. PMID- 3814816 TI - Culture from human bone marrow of blast progenitor cells with an extensive proliferative capacity. AB - The investigation of human hematopoiesis is limited by the lack of an in vitro assay for the most primitive hematopoietic stem cell. In this report, we describe the culture from normal human bone marrow of unique colonies of morphologically immature cells with scanty, agranular, cytoplasm and a primitive nucleus with nucleoli. These "blast" cells demonstrate a significant ability for the generation of secondary colonies of multiple lineages, including additional blast cell colonies. These colonies are detected at various times during the culture period of up to 28 days. Neither the time of appearance in primary culture nor any feature of the morphological appearance of the blast cells is correlated with replating ability or the differentiation pathway followed. The progenitor cell giving rise to these colonies may represent the earliest pluripotent hematopoietic stem cell yet grown in culture. PMID- 3814817 TI - Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. AB - One hundred-nine cases of autoimmune hemolysis were reviewed to determine the frequency of reticulocytopenia, the state of the erythroid marrow in reticulocytopenic cases, and the course of reticulocyte production indices with time and glucocorticoid treatment. The mean hematocrit at presentation was 24 mL/dL, but 30% of cases had an initial hematocrit less than 20 mL/dL. Median reticulocyte percentage at diagnosis was 9%, and median reticulocyte production index was 2.8 times basal. Twenty percent of cases had an initial reticulocyte count less than 4%, and 37% had an initial reticulocyte production index less than 2.0 times basal. These reticulocytopenic patients were nearly evenly distributed between warm and cold antibody-mediated cases and between primary and secondary cases. Fifty-four percent of reticulocytopenic cases had a bone marrow examination during hospitalization. Three-fourths of these marrows showed erythroid hyperplasia, and erythroid hypoplasia was seen in only one case. Eighty eight cases had serial reticulocyte measurements, and in only 15% of patients did the reticulocyte production index remain less than 2.0 times basal. Thus, in most cases, the initially low reticulocyte production index may represent a lag in marrow responsiveness to hemolytic stress. In cases with persistent reticulocytopenia, ineffective erythropoiesis is suggested by the frequency of marrow erythroid hyperplasia. In the cases that were initially reticulocytopenic and demonstrated an increase in reticulocyte production index, the magnitude of this increase was significantly greater in glucocorticoid-treated patients than in those not so treated, indicating that a glucocorticoid sensitive component exists in the marrow erythropoietic response to hemolysis. Awareness of the frequency of an initial reticulocytopenia in cases of autoimmune hemolysis may be important in initial diagnosis and treatment. PMID- 3814818 TI - Abnormal prothrombin in the plasma of rats carrying hepatic tumors. AB - Vitamin K is required for the posttranslational formation of gamma carboxyglutamyl residues in a number of plasma clotting factors. Interference with vitamin K action results in the appearance of abnormal (des-gamma-carboxy) forms of prothrombin in human plasma. Vitamin K-sufficient patients with primary hepatocellular carcinoma also secrete significant quantities of abnormal prothrombin; this response has now been studied in a rat model. Normal Buffalo strain rats had 9 micrograms/mL of circulating plasma abnormal prothrombin, whereas Buffalo strain rats carrying the transplantable Morris hepatoma tumor no. 7777 had 33 micrograms/mL at 3 weeks after transplant. Vitamin K-dependent carboxylase activity was normal in the liver of these rats, but very low in the tumor tissue. Rats carrying Morris hepatoma tumors no. 9618A and 5123D did not secrete significant amounts of abnormal prothrombin. Carboxylase activity in these tumors was 15 times that of the 7777 tumor. The data suggest that the secretion of abnormal prothrombin by hepatocellular tumors is the result of normal expression of the prothrombin gene by those tumors and a failure of the tumor to express the carboxylase gene. PMID- 3814819 TI - Durability of responses to interferon alfa-2b in advanced hairy cell leukemia. AB - Previous studies have demonstrated that significant hematologic improvement occurs in the majority of patients with hairy cell leukemia (HCL) treated with partially purified or recombinant interferon (IFN). Fifty-three patients received IFN alfa-2b for at least 3 months in a dose of 2 X 10(6) U/m2 subcutaneously thrice weekly. Of the 49 patients evaluable for response (at least 6 months of IFN therapy), there were ten complete responses and 29 partial responses for a total response rate of 80%. The peripheral blood counts and bone marrow continued to improve over the course of a full year of therapy. IFN was well tolerated, with no patients discontinuing therapy because of toxicity. Transient myelosuppression occurred in most patients during the first 1 to 2 months of therapy, occasionally precipitating a transfusion requirement. After IFN treatment was discontinued, there was a marked decrease in normal marrow elements and a relative increase in marrow hairy cells. This was associated with a transient increase in normal elements in the peripheral blood. Only one of 24 patients followed after receiving IFN for a median of 8.5 months (range, 3 to 16 months) has required further therapy. We conclude that low-dose IFN alfa-2b is highly effective in advanced HCL; responding patients should be treated for at least 1 year. The decision to initiate a second course of IFN therapy should be based primarily on peripheral blood counts and the clinical status of the patient rather than on the bone marrow. PMID- 3814820 TI - The secretory pathway of bovine platelets. AB - Human platelets contain tortuous channels in their cytoplasm, the surface connected or open canalicular system (OCS), that communicate directly with the surrounding medium through openings on the surface membrane. Some workers have suggested that the OCS serves as the egress route for products secreted during the release reaction. Others have proposed alternate secretory pathways. Since bovine platelets lack the OCS found in human cells, the present study has examined the secretory mechanism of these cells to see whether it can shed light on the mystery of human platelet secretion. Bovine platelet granules, in contrast to human granules, are located more peripherally in resting cells (often in contact with the plasma membrane), most do not move centrally following thrombin stimulation as do human platelet granules, and many fuse directly with the external plasma membrane without any intermediate channel. The lack of peripheral location of human granules, their central rather than peripheral movement during secretion, and the presence of extensive channels are all consistent with the larger importance of the secretory channel to human platelets. Thus, though studies of bovine secretion do show that platelets can secrete their granules by direct fusion of granule and surface membranes, other differences from human platelets emphasize that this pathway, although important to bovine platelet secretion, is less important in human platelets. Studies of bovine platelets also show that the OCS is more dynamic than might have been considered from human studies and can form rapidly in response to stimulation. Such newly formed channels are used as a conduit for secretion of granule contents. The finding emphasizes the importance of channels for granule secretion in platelets generally and puts a new perspective on the ability of these cells to form channels rapidly in response to stimulation. PMID- 3814821 TI - Prognosis of chronic lymphocytic leukemia: a multivariate regression analysis of 325 untreated patients. AB - Three hundred twenty-five previously untreated patients with chronic lymphocytic leukemia were analyzed to identify significant prognostic factors for survival. Univariate analysis identified the following characteristics associated with survival: (1) clinical characteristics: age, race, sex, performance status, lymphadenopathy, and hepatosplenomegaly; (2) hematologic parameters: WBC count, absolute lymphocyte and granulocyte counts, hemoglobin level, and platelet count; and (3) biochemical parameters: serum albumin, calcium, uric acid, lactate dehydrogenase, alkaline phosphatase, BUN, and creatinine. Multivariate regression analysis in a randomly selected training subset of 217 patients demonstrated that the combination of uric acid, alkaline phosphatase, lactate dehydrogenase, external lymphadenopathy, and age had the strongest predictive relation to survival time. The resulting model was validated in the remaining independent subset of 108 patients and led to classification of patients into low, intermediate, and high-risk groups with five-year survival rates of 75%, 59%, and 14%, respectively, and with distinctively different annual mortality rates (P less than .01). Both the regression model and Rai staging were highly effective in identifying risk groups among the entire patient population (P less than 0.001). Overall the regression model was superior to Rai staging in defining prognostic risk groups. In addition, it was able to separate patients into significantly different risk categories within each Rai stage, thus improving on the prognostic prediction of individual patients with chronic lymphocytic leukemia. PMID- 3814822 TI - Functional differentiation of normal human neutrophils. AB - In the past differentiation of human neutrophils has been defined by morphology, cytochemistry, or surface markers. In our experiments we have sequenced the various events that occur during the functional differentiation of the normal human neutrophil and have also examined some of the functional properties in relationship to surface markers and biochemical events. Granulocytes were obtained from the bone marrow and blood of hematologically normal individuals. Cells were separated into different stages of maturation by their physical properties using counterflow centrifugal elutriation and density gradient separation. Three cell fractions were obtained that were enriched for either immature myeloid cells, band neutrophils, or segmented neutrophils. Since the enriched fractions were not entirely pure, methodologies for functional assays were chosen that allowed cytologic evaluation of the functional capacity of each cell type. The criteria used to classify the stages of differentiation included both morphology by light microscopy and DNA labeling with tritiated thymidine. Various neutrophilic properties were studied: Fc receptors, complement receptors (CR1, CR3), phagocytosis of both live and dead opsonized Staphylococcus aureus, microbial killing of S aureus, NBT dye reduction after cellular stimulation with endotoxin, and chemotaxis. Our results indicate that the functional properties of the neutrophil appear in a distinct order. The sequence for the functional differentiation of the human neutrophil appears to be the following: Fc receptors ---immune phagocytosis----complement receptors----oxygen-independent microbial killing----oxygen-dependent microbial killing----chemotaxis. PMID- 3814823 TI - F-actin content of neonate and adult neutrophils. AB - We utilized flow cytometric analysis of NBDphallacidin-stained cells to measure F actin content, expressed as fluorescent channel numbers, and we compared the microfilamentous cytoskeletal organization in neutrophils from healthy neonates (36 to 38 weeks gestational age) and adults. Basal F-actin content in neonate cord blood neutrophils is higher than that of adults. The elevation is intrinsic to the cell and not related to parturition because basal F-actin content of neonatal cells obtained by venipuncture (days 1 to 8 of age) is also elevated (38 +/- 10, N = 15) when compared to adults (21 +/- 7.0, N = 27). The rate of N formyl-methionyl-leucyl-phenylalanine (fMLP)-induced actin polymerization is similar in adult and neonatal neutrophils and is maximal by 30 to 45 seconds at 25 degrees C. Adult, neonatal cord, and neonatal venipuncture neutrophils increase F-actin content to a similar extent following 0.5 mumol/L fMLP activation (52 +/- 18, N = 27; 58.7 +/- 18, N = 18; 51.5 +/- 7.0, N = 15, respectively). However, the relative increase in F-actin content following fMLP activation is much greater in adult (2.37-fold) than neonatal neutrophils (1.28 fold). This difference is due to the elevated basal F-actin content of neonatal cells. Comparison of distribution of F-actin content among basal, neonatal neutrophils reveals two subpopulations of neutrophils with respect to F-actin content--approximately 25% with F-actin content similar to that of adult neutrophils and 75% with F-actin content greater than that of adult cells. Following fMLP activation, the subpopulations disappear. The results suggest that abnormalities in microfilamentous cytoskeletal organization of neonatal cells may, in part, be responsible for decreased chemotactic response of neonatal neutrophils. PMID- 3814824 TI - The synthetic RGDS peptide inhibits the binding of fibrinogen lacking intact alpha chain carboxyterminal sequences to human blood platelets. AB - The alpha chain 572-574 Arg-Gly-Asp sequence of fibrinogen appears to play only a minor role in platelet aggregation based on the ability of fibrinogen preparations lacking alpha chain carboxyterminal segments to support platelet aggregation, but synthetic Arg-Gly-Asp-Ser (RGDS) peptides are capable of inhibiting platelet aggregation and fibrinogen binding. The present study thus examined the ability of RGDS peptides to inhibit platelet interactions with a plasmic degradation product of fibrinogen (8D-50) that resembles an intermediate fragment X. Gel-filtered, human blood platelets suspended in 0.01 mol/L HEPES buffered modified Tyrode's solution, pH 7.5, were stimulated with 20 mumol/L adenosine diphosphate and the binding of 125I-labeled 8D-50 or intact fibrinogen (0.01 to 0.6 mg/mL) assessed in the presence of 0 to 117 mumol/L RGDS. The data revealed that RGDS decreased the apparent affinity of 8D-50 and intact fibrinogen for platelets but did not affect the maximum number of binding sites. RGDS thus appears to be a competitive inhibitor not only of intact fibrinogen (Ki = 12 +/- 2 mumol/L) but also of 8D-50 (Ki = 15 +/- 3 mumol/L) (mean +/- SD, n = 3). PMID- 3814825 TI - Blast cell colony assay for umbilical cord blood and adult bone marrow progenitors. AB - We previously described candidate human blast cell colonies in culture of umbilical cord blood cells. However, their replating efficiencies were low, and we were unable to grow colonies from adult marrow cells. We report here a consistent method of growth and identification of human blast cell colonies that are supported by low serum culture and by delayed addition of medium conditioned by a T lymphoblast cell line, C5MJ. Nonadherent mononuclear cord blood and bone marrow cells were prepared by use of Ficoll-Paque and overnight adherence to plastic. Bone marrow cells were further enriched for progenitors by panning with monoclonal anti-My-10 antibody. Cells were plated in methylcellulose culture containing 2% fetal calf serum and supplemented with bovine serum albumin, lecithin, cholesterol, and transferrin. On day 14 of culture, concentrated C5MJ conditioned medium was carefully added to each dish. Blast cell colonies consisting of 18 to 100 cells were detected on days 21 to 28. Forty percent to 75% of the blast cell colonies in individual samples yielded secondary colonies upon replating (positive colonies). The replating efficiency of the positive colonies ranged from 3% to 100%. The largest secondary colony contained 7,800 cells. In addition to single-lineage colonies, multilineage colonies revealing two to five lineage combinations were seen. These results suggest that human primitive progenitors are dormant in cell cycle and that they survive in the absence of colony-stimulating factors. Human blast cell colonies may provide a unique population of progenitors for studies of the early process of human hemopoiesis. PMID- 3814826 TI - Cobalamin-folate interrelations. PMID- 3814827 TI - Dilution and hemolysis causing anaemia after artificial heart implantation. PMID- 3814828 TI - Surface markers in acute non-lymphoid leukemia: analysis with a panel of 36 monoclonal antibodies. AB - The reactivity of a panel of monoclonal antibodies was studied in fifty-four cases of acute myeloid (AML) or undifferentiated (AUL) leukemias. Thirty-six antibodies from the Myeloid section of the Second Workshop on Human Leukocyte Differentiation Antigens were used in an indirect immunofluorescence assay. The antibodies could be classified into three groups recognizing respectively granulocytic, monocytic or granulomonocytic leukemias. Most antibodies stained erythroblastic and megakaryoblastic leukemias. In each group, it was possible to define antibodies staining either the less differentiated forms (FAB M 1 and M 5 a) or the more differentiated forms (M 2, M 3, M 4 and M 5 b). Six out of eight AUL were stained by some of the antibodies (mainly from the monocytic group). However, a heterogeneity of stainings in a same blast population was observed. PMID- 3814830 TI - Ultrastructural investigations on the question of mechanical activation of blood platelets. AB - The present study addresses the question whether platelets are activated by mechanical stresses as they occur in pathologically accelerated blood flow. Their potential mechanoreceptive properties were tested by subjecting human platelets to defined fluid mechanical forces for periods of milliseconds. Platelet activation was assessed by quantitative morphology, revealing besides activated platelets, irreversibly ballooned, lytic platelets. However, this morphometrically documented "shear activation" of platelets can be suppressed almost completely by the addition of enzyme-substrate systems, capable of removing adenosine diphosphate from the suspending medium. This is in keeping with a recent study from our laboratory showing that the behaviour of lactic dehydrogenase as marker for platelet lysis and beta-thromboglobulin as release marker refuted earlier data, suggesting a direct activation of platelets by shear. It is concluded that former evidence of "shear induced platelet activation" must be interpreted as the consequence of lytic damage to a small proportion of platelets. PMID- 3814829 TI - Red blood cell T-activation and hemolysis in surgical intensive care patients with severe infections. AB - The exposure of Thomsen-Friedenreich (T) antigens on RBCs, serum neuraminidase, and serum hemoglobin levels were investigated in 53 adult surgical intensive care unit (ICU) patients with septicemia. Unmasked T-antigens were assayed by a hemagglutination test using peanut agglutinin (PNA) (direct anti-T test), and by an indirect anti-T test employing rabbit anti-PNA globulin. RBC T-activation was demonstrated in 17/53 patients (32%); in 2/53 patients (4%) the direct anti-T test was positive, indicating strong T-exposure. No polyagglutination phenomena were observed. Serum neuraminidase was elevated in 12/17 (71%) patients with T activation and in 7/36 (19%) patients without T-activation. Free serum hemoglobin was elevated in 12/17 (71%) patients with T-activation and in 5/36 (14%) patients without T-activation. Correlations between T-activation and serum neuraminidase and between T-activation and serum hemoglobin were significant (p less than 0.001). Potentially neuraminidase-releasing bacteria were demonstrated in 13/17 (76%) patients with RBC T-exposure. We conclude that neuraminidase-induced RBC T activation and subsequent hemolysis may be involved in the pathomechanism of hemolytic anemia in patients with severe infections. PMID- 3814831 TI - The anemia of childhood revisited. AB - The question of the mechanism of the physiological anemia of childhood was reexamined; we took into consideration the fact that microcytosis is a feature of this anemia as well as the evidence suggesting that the 2,3 DPG/hemoglobin ratio may depend in part on red cell size. In a group of normal, not-iron deficient children a high inverse correlation was obtained between the MCV and the 2,3 DPG/Hb ratio; this latter ratio did not correlate with serum phosphorus levels, previously incriminated in the indirect causation of the anemia of childhood. PMID- 3814833 TI - Partial deficiency of eosinophil peroxidase. AB - A new case of partial eosinophil peroxidase deficiency is reported. It was identified and elaborated using an automated flow-cytochemical analyzer. The findings were confirmed by conventional cytochemistry on blood smears: decreased staining intensity in peroxidase and Sudan Black staining. These results are in agreement with other reports on this extremely rare peroxidase deficiency, which probably is of no clinical relevance. PMID- 3814832 TI - Refractory cytopenias: clinical course according to bone marrow cytology and cellularity. AB - One hundred and one patients with refractory cytopenia were reviewed for morphological classification (using bone marrow, BM, imprints for cytology and Jamshidi biopsies for BM cellularity) and clinical course. Final diagnoses were: moderate aplastic anemia (MAA), myelodysplastic syndromes (MDS) and hypoplastic acute leukemia (HAL). Ninety-two patients received high dose testosterone enanthate (TE) as first treatment (starting dose = 7-10 mg/week i.m. for at least three months). Median survival was significantly longer in MAA than in MDS and in HAL. Among MDS patients, those with primary acquired sideroblastic (AISA) and refractory (RA) anemia had median survival similar to those with MAA, but distinctly longer (p = 0.01) than patients with RA with an excess of blasts (RAEB), RAEB in transformation (RAEBtr) and chronic myelomonocytic leukemia (CMMoL). Acute leukemia (AL) developed more rarely (p less than 0.02) in MAA, AISA and RA than in RAEB, RAEBtr and CMMoL. Response to TE was seen in about two thirds of MAA and in a half of MDS and HAL patients. Among MDS patients, those with hypocellular BM developed leukemia less frequently, responded to androgens more often and survived longer than those with normocellular and, especially, with hypercellular BM. These data indicate that the cytohistological classification of refractory cytopenias identifies essentially two groups with different clinical behaviour, one (MAA, AISA and RA) having long life expectancy and a low probability of developing AL and the other (RAEB, RAEBtr, CMMoL) with a short survival and relatively frequent leukemic complication. Bone marrow hypocellularity seems to be a favourable prognostic factor in MDS. Patients with refractory cytopenias, especially those with a hypocellular BM, can be advantageously treated with androgens. PMID- 3814834 TI - Relationship between histopathology and in vitro clonogenicity in breast cancer. AB - The human tumor clonogenic assay was used to culture 268 primary and metastatic breast cancer samples. Cultures of 181 specimens were prepared in the double layer agar system and 87 in a modified system utilizing a liquid upper layer. Successful growth (greater than 5 colonies) was 53% for the agar 2-layer method and 68% for the modified system. Three morphologically distinct colony types were observed: Type I--small, dark, compact colonies; Type II--clear colonies; and Type III--mixed colonies of Types I and II. In 73 cases the histologic slides of the original tumor specimens were reviewed, and the histopathological findings correlated with the clonogenicity of the specimens. There was a significant positive relationship between the degree of differentiation and focal microscopic tumor necrosis in the original specimen and its subsequent clonogenicity. However, other histologic parameters did not show any relationship with clonogenicity. PMID- 3814835 TI - Predicting chemosensitivity of tumors. PMID- 3814836 TI - Histological grade in predicting response to endocrine treatment. PMID- 3814837 TI - Occurrence and biological activity testing of particulates in drinking water. PMID- 3814838 TI - Qualitative evaluation of the effect of a soil detoxicant on aldicarb persistence. PMID- 3814839 TI - Determination by combustion of the total organochlorine content of tissues, soil, water, waste streams, and oil sludges. PMID- 3814840 TI - Sensitivity of human lymphocyte chromosome to diazinon at different times during cell culture. PMID- 3814841 TI - Anticholinesterase properties of methamidophos and acephate in insects and mammals. PMID- 3814842 TI - Inhibition of sheep brain acetylcholinesterase by hexachlorophene. PMID- 3814843 TI - Significance of the taurine-glycine ratio as an indicator of stress. PMID- 3814844 TI - Toxicity of ethylene glycol, diethylene glycol, and propylene glycol to human cells in culture. PMID- 3814845 TI - Changes in hepatic carbohydrate metabolism of the mouse, Mus booduga (gray), by hexachlorophene treatment. PMID- 3814846 TI - Effects of treatment with sodium fluoride and subsequent starvation on fluoride content of earthworms. PMID- 3814847 TI - Effects of carbofuran on the earthworm, Eisenia fetida, using a defined medium. PMID- 3814848 TI - Phospholipids and proteins from Rhizobium meliloti exposed to parathion at different incubation times. PMID- 3814849 TI - Effects on cholinesterases of rainbow trout exposed to acephate and methamidophos. PMID- 3814850 TI - Effects of aldicarb on the blood and tissues of a freshwater fish. PMID- 3814851 TI - Acute toxicity of nitrofurazone to channel catfish, Ictalurus punctatus, and goldfish, Carassius auratus. PMID- 3814852 TI - Diet and reproductive success of bluegill recovered from experimental ponds treated with atrazine. PMID- 3814853 TI - Intrarenal distribution of mercury in the rat: effect of administered dose of mercuric chloride. PMID- 3814854 TI - Effect of beryllium nitrate on early and late pregnancy in rats. PMID- 3814855 TI - Hematological evaluation of lead intoxication in mallards. PMID- 3814856 TI - Effect of cadmium on oviposition and egg viability in Chironomus riparius (Diptera: Chironomidae). PMID- 3814857 TI - Aerobic treatment of wine-distillery wastewaters. PMID- 3814858 TI - Lichens as monitors of aerial heavy metal pollutants in and around Kampala. PMID- 3814859 TI - Model ecosystem determination of the metabolic and environmental fate of tetrachloro-DDT. PMID- 3814860 TI - Measurement of phthalates in small samples of mammalian tissue. PMID- 3814861 TI - Degradation of terbufos (Counter) soil insecticide in corn fields under conservation tillage practices. PMID- 3814862 TI - Determination of exchangeable inorganic nitrogen species in wetland soils. PMID- 3814863 TI - DDT residues in soil of areas surrounding a DDT manufacturing factory in Delhi, India. PMID- 3814864 TI - DDT residues in blood of residents of areas surrounding a DDT manufacturing factory in Delhi. PMID- 3814865 TI - Determination of dieldrin concentrations in recycled cattle feed and manure by liquid chromatography. PMID- 3814866 TI - C15-C18 isomers synthesized from [13C]-2,3,7,8-tetrachlorodibenzofuran via surface chlorination. PMID- 3814867 TI - Saline or plant-incorporated methylmercury effects on distribution, demethylation, and blood parameters in rats. PMID- 3814868 TI - Effects of endosulfan on humoral and cell-mediated immune responses in rats. PMID- 3814869 TI - Enzymatic detoxication of DDT to DDD by rat liver: effects of some inducers and inhibitors of cytochrome P-450 enzyme system. PMID- 3814870 TI - Brain cholinesterase activity in birds after a city-wide aerial application of malathion. PMID- 3814871 TI - Mammalian mitochondria as in vitro monitors of water quality. PMID- 3814872 TI - Chlorination byproducts of Arabian Gulf seawater. PMID- 3814873 TI - Combined toxicity of four toxicants (Cu, Cr, oil, oil dispersant) to Artemia salina. PMID- 3814874 TI - Arsenic toxicity changes in the presence of sediment. PMID- 3814875 TI - Metabolic consequences of methyl parathion exposure in the bivalve, Lamellidens marginalis (Lamarck). PMID- 3814876 TI - Size and mercury concentration relationship as contamination index. PMID- 3814877 TI - Sensitivity of toad tadpoles, Bufo melanostictus (Schneider), to heavy metals. PMID- 3814878 TI - Organochlorine pesticide residues in Chilean fish and shellfish species. PMID- 3814879 TI - Heavy metals in molluscan, crustacean, and other commercially important Chilean marine coastal water species. PMID- 3814880 TI - Copper, cadmium, and nickel accumulation in crayfish populations near copper nickel smelters at Sudbury, Ontario, Canada. PMID- 3814881 TI - Polynuclear aromatic hydrocarbons (PAHs) in fish from the Arabian Gulf. PMID- 3814882 TI - [26th World conference of the IUAT (International Union Against Tuberculosis) on tuberculosis and respiratory diseases. 4-7 November 1986, Singapore. Abstracts]. PMID- 3814883 TI - [Comments concerning the fallout of the Chernobyl accident]. PMID- 3814884 TI - [Current studies on schizophrenia in adolescents]. PMID- 3814885 TI - Sex therapy: current perspectives. PMID- 3814886 TI - Training schemes in medicine at two district general hospitals. AB - After 40 years, NHS planning still results in medical overmanning or shortages. The training schemes in medicine described have, for 25 years, avoided the worst errors. Success has depended on the following triad: a realistic view of career prospects, Osler's master word--work, and systematic clinical research. PMID- 3814888 TI - But need they all be Masters? PMID- 3814887 TI - Preliminary results using computerized telediaphanography for investigating breast disease. AB - An instrument (telediaphanograph) for examination of the female breast has been developed which is optically based and carries no risk to the patient. Malignant lesions, which are strongly light absorbing, can be visualized by dark shadows cast on the superior aspect of the breast. The discriminating ability of telediaphanography for carcinoma has been investigated in relation to 129 patients with suspected breast disease. The sensitivity was found to be 0.94 and the specificity 0.89. PMID- 3814889 TI - Self-neglect or chosen lifestyle? PMID- 3814890 TI - Management of raised ICP after severe head injury. PMID- 3814891 TI - Significance of a-jDO2 in cerebral ischaemia. PMID- 3814893 TI - Blindness following cosmetic blepharoplasty. PMID- 3814892 TI - The gluteus maximus muscle: experimental and clinical considerations relevant to reconstruction in ambulatory patients. AB - The gluteus maximus muscle and other haemodynamically related structures have been used for the reconstruction of significant defects in the perineum, sacrum, lumbar area and hip in 35 patients. The preservation of muscle function was achieved in all of 20 ambulatory patients and documented by gait analysis, muscle strength testing and EMG studies. Dye injection studies of the first perforating artery, inferior gluteal artery and superior gluteal artery led to the design of new flaps based on this arterial system. They include: medial advancements with extension above the sacrum, lateral advancements, lower gluteus advancements, the tensor fasciae latae gluteal extension and modifications of the gluteal thigh flap. These findings significantly increase our ability to close difficult wounds within the perineal, sacral, lumbar and trochanteric regions. PMID- 3814894 TI - A study of the saphenous venous island flap in the dog without arterial inflow using a non-biological conduit across a part of the length of the vein. AB - This paper includes material which is a follow-up on the work of Se Min Baek et al. (1985) who demonstrated that in dogs a saphenous flap could survive without arterial inflow. Here we have repeated part of their work and confirmed it. In addition, this paper shows that in dogs a saphenous venous flap with only the cephalad venous channel intact can survive even if the vein is cut and replaced by a non-biological conduit (a polyethylene tube). A total of 13 dogs and 19 flaps were studied. The possible reasons for the survival of these flaps are discussed. PMID- 3814895 TI - The distally based split soleus muscle flap. AB - A refinement of the previously described distally based soleus muscle flap is proposed. The essential features of the flap are mobilisation of the tibial origin, splitting the muscle longitudinally, partially along a distinct anatomical plane, and preservation of anatomical continuity of the muscle. We suggest that improved blood supply to this flap derives from the intact major lateral proximal pedicles via the intact lateral portion into the flap. We also think that minimal damage to intramuscular vasculature integrity contributes to the improved circulation. The flap has been designed and studied using ten fresh cadaver leg dissections. Angiographic studies proved adequate blood supply to the flap. The flap has been tested eight times on seven patients with favourable results. PMID- 3814896 TI - The square flap method. AB - We report a method for increasing the distance between two points on the skin surface by using two triangular flaps and a square flap. The theoretical lengthening is excellent when one of the triangular flaps is right-angled. The method has been used successfully in 40 cases of scar contracture, various clefts and cryptotia. PMID- 3814897 TI - Multiple seagull flaps for digital contractures in electrical burns. AB - Following legislation in the early 1970s, electrical bar fire burns are much less common in the UK than 20 years ago. However, their long-term effects are still encountered as microdactyly, syndactyly and digital flexion contractures. A case is described in which multiple seagull flaps were used as a single stage procedure to achieve sustained improvement in function in a severely affected hand, 10 years after injury, without prolonged postoperative daytime splintage. PMID- 3814898 TI - A new method of secondary correction of the bilateral cleft lip nose. AB - A technique for the secondary correction of the bilateral cleft lip nose is described in this paper. It combines a V-Y advancement flap and Cronin's technique and has given satisfactory results in 15 cases without complications. PMID- 3814899 TI - The significance of incomplete excision in patients with basal cell carcinoma. AB - Sixty-seven patients with incompletely excised basal cell carcinomas are reviewed. No recurrences were seen in seven patients who had immediate supplementary treatment; 23 of 60 patients submitted to a "wait and see" regimen developed recurrent disease, Recurrence was commoner in those in whom both the lateral and deep margins were involved, and when the incomplete excision was for recurrent disease. The latter recurrences were more difficult to control in patients who had previously had radiotherapy, when the deep margin was involved and when a flap had been used to close the resulting defect. A case is made for immediate re-excision for all patients with incompletely excised basal cell carcinomas. PMID- 3814900 TI - The principle of reversal of flow in blood vessels. AB - In this paper the enormous possibilities of using the principle of blood flow reversal in new surgical techniques are contrasted with the very limited number of scientific papers referring to this principle. Four illustrative cases are described. PMID- 3814901 TI - The pathogenicity of coagulase negative staphylococcus in the presence of silicone rubber implants. AB - Coagulase negative staphylococci have long been thought to be harmless skin commensals. However they are now recognised as important pathogens in patients who have undergone insertion of prosthetic devices. We present three patients with infection following the insertion of silicone polymer prostheses, in whom a coagulase negative staphylococcus was the pathogen. All responded to antibiotic treatment. It is important to alert the bacteriologist to the presence of an implanted prosthesis when wound swabs are sent from an area showing clinical signs of infection. The coagulase negative staphylococci may otherwise be regarded falsely as merely skin contaminants. PMID- 3814902 TI - Congenital external fistulae of the parotid duct. PMID- 3814903 TI - Effects of calcium channel blockers on gastric emptying and acid secretion of the rat in vivo. AB - Experiments were designed to evaluate the effects of three calcium channel blockers (verapamil, diltiazem and cinnarizine) on gastric emptying and secretion in the rat. Pretreatment with the calcium blockers delayed gastric emptying of phenol red in a dose-dependent manner. Verapamil was the most effective of the agents tested. Verapamil and diltiazem inhibited gastric acid secretion in the pylorus-ligated rat without affecting pepsin output. Cinnarizine was ineffective in this model. When the perfused lumen of the anaesthetized rat was used, verapamil was found to inhibit responses to carbachol or histamine more than those to pentagastrin. Further, we found a greater sensitivity to verapamil for basal compared with vagal-stimulated (2-deoxy-D-glucose) acid secretion. Neither diltiazem nor cinnarizine modified gastric acid secretion in this experimental model. These findings are discussed in relation to the role of extracellular calcium in gastric motility and secretion, and the existence of a regional and functional selectivity for calcium blockers is proposed. PMID- 3814904 TI - The role of the sympathetic nervous system in oestrogen-induced hypertension in rats. AB - Albino rats of either sex received chronic ethinyl oestradiol (EO) treatment (1.5 mg kg-1 daily, i.m.) for 3 weeks. Untreated control rats received arachis oil vehicle alone. Chronic EO treatment resulted in elevation of blood pressure in both sexes. Female rats exhibited significantly greater elevation in blood pressure than males. In chronic EO-treated rats pressor responses to low doses (0.5 micrograms kg-1) of noradrenaline were significantly increased, while those to angiotensin II, acetylcholine and isoprenaline were unaltered. Chronic EO treatment also sensitized the vascular bed of the rats' hindquarters to noradrenaline. EO-induced hypertension was associated with significant increase in dopamine-beta-hydroxylase activity of adrenal glands. Complete bilateral adrenalectomy or chemical sympathectomy prevented the development of EO-induced hypertension. It is suggested that chronic treatment of rats with EO induces and maintains hypertension. The peripheral sympathetic system plays an important role in this phenomenon. PMID- 3814905 TI - Potentiation of the depression by adenosine of rat cerebral cortical neurones by progestational agents. AB - The effects of four progestational agents pregnenolone sulphate, cyproterone acetate, norethindrone acetate and progesterone, on adenosine-evoked depression of the firing of rat cerebral cortical neurones have been studied. When applied iontophoretically, pregnenolone sulphate, cyproterone, and norethindrone enhanced the actions of iontophoretically applied adenosine and failed to potentiate the depressant effects of adenosine 5'-N-ethylcarboxamide and gamma-aminobutyric acid. Cyproterone acetate (50 micrograms kg-1) and progesterone (200 micrograms kg-1) administered intravenously enhanced the depressant actions of iontophoretically applied adenosine. When applied by large currents, cyproterone, and less frequently norethindrone, depressed the firing of cerebral cortical neurones. The depressant effects of cyproterone were antagonized by caffeine. Pregnenolone sulphate tended to excite cortical neurones but neither this action, nor its potentiation of adenosine were reproduced by application of sulphate ions. It is hypothesized that some of the psychotropic actions of progestational agents may involve an enhancement of 'purinergic' tone in the central nervous system. PMID- 3814906 TI - Muscarinic receptor modulation of release of [Met5]enkephalin immunoreactive material and catecholamines from the bovine adrenal gland. AB - Muscarinic receptor modulation of secretion from the adrenal medulla was studied using retrogradely perfused bovine tissue. Atropine, at a dose not affecting 1,1 dimethyl-4-phenylpiperizinium (DMPP)-stimulated release, inhibited the acetylcholine (ACh)-stimulated release of noradrenaline and [Met5]enkephalin immunoreactive material (ME-IRM). DMPP-stimulated release of catecholamines and ME-IRM was potentiated by the addition of methacholine. Pilocarpine significantly potentiated the release of noradrenaline only. Methacholine, pilocarpine or muscarine, when infused alone, had no stimulatory affect on the basal release of ME-IRM. These findings suggest that the muscarinic receptors in the bovine adrenal medulla function by potentiating the release of ME-IRM and catecholamines induced by nicotinic receptor stimulation. PMID- 3814907 TI - Kinetics of the generation and action of chemical mediators in zymosan-induced inflammation of the rabbit peritoneal cavity. AB - Acute inflammation was induced by intraperitoneal injection of zymosan (yeast cell walls) in the rabbit. Peritoneal inflammation was monitored by the local accumulation of intravenously-injected Evans blue dye (which binds to plasma albumin) and of polymorphonuclear leukocytes (PMNLs). The zymosan-induced exudate fluid contained a microvascular permeability-increasing factor or factors which, unlike histamine and bradykinin, had a long duration of action when tested in rabbit skin and was dependent on circulating PMNLs. Using radioimmunoassay, high levels of rabbit C5a, or C5a des Arg, were detected in the exudate fluid and accounted for much of the permeability-increasing activity, as judged by skin bioassay after separation on Sephadex G-100. The vasodilator prostaglandin, prostaglandin I2 (PGI2), was generated in the inflammatory reaction, as judged by the presence of high levels of 6-oxo-PGF1 alpha detected in the exudate by radioimmunoassay. However, in contrast to observations in rabbit skin, inhibition of prostaglandin generation had a relatively small effect on peritoneal oedema formation. C5a and C5a des Arg increase microvascular permeability by a PMNL dependent mechanism in the rabbit. However, in response to zymosan, protein leakage was detected considerably earlier than PMNL accumulation. A hypothesis to account for this difference is proposed. PMID- 3814908 TI - The relationship between noradrenaline-induced contraction and 45Ca efflux stimulation in rabbit mesenteric artery. AB - Cellular Ca2+ recycling in a branch of the rabbit mesenteric artery was investigated by measuring the time- and concentration-dependent effects of noradrenaline (NA) on contraction and 45Ca efflux in Ca2+-free solution. When NA was present continuously (15 min), both force development and 45Ca efflux stimulation consisted of a fast and a slow (often oscillatory) component. These components were sensitive to caffeine and are probably both related to Ca2+ release from the intracellular Ca2+ store, presumably sarcoplasmic reticulum (s.r.). When NA was applied for shorter time periods, both tension and stimulated 45Ca efflux decreased similarly. Repetitive short (30 s) NA applications resulted in repeated contractions and stimulations of 45Ca efflux. The NA-stimulated 45Ca efflux was not inhibited when external Ca2+ was present or in Na+-free medium. Loading the cell with Ca2+ (with physiological salt solution for 3 h or with a high K+ depolarizing solution) increases the number of subsequent NA-induced repeated contractions in Ca2+-free solution. The Ca2+ content of the sarcoplasmic reticulum (s.r.) in the smooth muscle cells of this small artery was estimated to be at least 50 mumol kg-1 wet weight, corresponding to an s.r. Ca2+ concentration of about 3.1 mM. These results indicate that the NA-induced increase in cytosolic free Ca2+ (as measured by force development) is accompanied by an increase in Ca2+ extrusion (as measured by stimulation of 45Ca efflux). This suggests that at least part of the activator Ca2+ cycles through the extracellular space during hormone-induced activation of vascular smooth muscle. PMID- 3814909 TI - Electrophysiological effects of acetyl glyceryl ether phosphorylcholine on cardiac tissues: comparison with lysophosphatidylcholine and long chain acyl carnitine. AB - Electrophysiological effects of synthetic platelet activating factor, acetyl glyceryl ether phosphorylcholine (AGEPC), were examined and compared with those of lysophosphatidylcholine (LPC) and long chain acyl carnitine (AC) in canine Purkinje fibres and guinea-pig papillary muscles, by use of standard microelectrode techniques. In canine Purkinje fibres, AGEPC at concentrations higher than 3 X 10(-5)M, decreased maximum diastolic potential, action potential amplitude and the maximum upstroke velocity of phase 0. AGEPC also induced abnormal automaticity arising from depolarized membrane potentials. LPC and AC in concentrations higher than 3 X 10(-5)M also produced virtually identical electrophysiological alterations in Purkinje fibres. Although twitch tension was slightly decreased by low concentrations (10(-6)-10(-5)M) of these amphiphilic lipids, a transient positive inotropic response appeared at the beginning of a progressive depolarization after exposure to higher concentrations of the amphiphiles. In guinea-pig papillary muscles, AGEPC in concentrations higher than 3 X 10(-5)M produced slight decreases in resting membrane potential, action potential amplitude and action potential durations, concomitantly with a positive inotropic response. These electrophysiological and mechanical changes were also induced by LPC and AC at comparable concentrations. In guinea-pig papillary muscles depolarized with 25 mM [K+]0, AGEPC, LPC and AC all evoked slow action potentials at a concentration of 10(-4)M. It is concluded that in isolated cardiac tissues AGEPC exerts electrophysiological effects similar to those of LPC and AC only at high concentrations, and that the non-specific interaction of amphiphiles with sarcolemmal membrane may be responsible for the electrophysiological and mechanical effects. PMID- 3814910 TI - Regional variation in the characteristics of histamine H1-agonist mediated breakdown of inositol phospholipids in guinea-pig brain. AB - The position of dose-response curves for histamine-induced accumulation of [3H] inositol 1-phosphate ([3H]-IP1) in lithium-treated slices of guinea-pig brain prelabelled with [3H]-inositol differed significantly between cerebellum (EC50 5.1 +/- 1.0 microM) and cerebral cortex (EC50 16.3 +/- 0.7 microM). The Hill coefficients of the curves, 1.33 +/- 0.28 and 1.24 +/- 0.03, respectively, did not differ significantly. 2-Methylhistamine, N alpha,N alpha-dimethylhistamine and betahistine were partial agonists in both cerebellum and cerebral cortex, but all produced a greater percentage of the maximum response to histamine in cerebellar slices. In hippocampal slices the response of the partial agonists was intermediate between that in cerebellum and that in cerebral cortex. The four agonists produced an appreciable accumulation of [3H]-inositol 1-phosphate in cerebellar slices even in the absence of Li+ ion. The EC50 and Hill coefficients characterizing the dose-response curves for the four agonists were the same whether 10 mM LiCl was present or not. The affinity constant for mepyramine inhibition of the histamine-induced response was similar in cerebellum, 4.2 +/- 0.6 X 10(8) M-1, and cerebral cortex, 4.6 +/- 1.0 X 10(8) M-1. Curves of mepyramine inhibition of the responses to a fixed concentration of histamine gave no indication of any second component in the response to histamine in either cerebellum or cerebral cortex. The parameters of histamine inhibition of [3H] mepyramine binding were similar in homogenates of guinea-pig cerebellum and cerebral cortex. These results indicate that H1-agonist-induced accumulation of IP1 may not be as directly related to agonist-receptor interaction as simple reaction schemes suggest. PMID- 3814911 TI - Muscarinic and nicotinic mechanisms in the responses of the adrenal medulla of the dog and cat to reflex stimuli and to cholinomimetic drugs. AB - In isolated perfused adrenal glands of the cat, muscarinic and nicotinic agonists selectively released adrenaline and noradrenaline respectively. In isolated perfused adrenal glands of the dog, the output of adrenaline and noradrenaline remained in a fixed ratio at rest and when stimulated by muscarinic or by nicotinic agonists. In the anaesthetized dog, a combination of muscarinic and nicotinic antagonists was needed to block reflex responses of the adrenal medulla. A nicotinic antagonist was more effective in blocking the baroreceptor reflex response than the chemoreceptor reflex response. PMID- 3814912 TI - A further search for selective antagonists at M2-muscarinic receptors. AB - In an attempt to obtain more selective antagonists acting at muscarinic M2 receptors, analogues of 4-diphenylacetoxy-N-methylpiperidine methobromide (4-DAMP methobromide) have been synthesized. These were tested, along with silabenzhexol, procyclidine, sila-procyclidine and AFDX-116, in dose-ratio experiments with guinea-pig isolated atria at 30 degrees C and ileum at 30 degrees C and 37 degrees C. The agonist was carbachol and the selectivity was assessed from the difference between log K for receptors in ileum and log K for receptors in atria. The selectivity was not related to the affinity and some weakly active compounds retained appreciable selectivity but no compound had greater selectivity than 4 DAMP methobromide or pentamethylene bis-(4-diphenylacetoxy-N-methylpiperidinium) bromide. Structure-activity relations are discussed. There seem to be steric limits to affinity but there are no obvious indications of the structural features associated with selectivity. It is suggested that more selective drugs may be obtained by introducing groups which may reduce affinity. PMID- 3814913 TI - Cortical acetylcholine release is increased and gamma-aminobutyric acid outflow is reduced during morphine withdrawal. AB - The effects of naloxone on acetylcholine (ACh) and gamma-aminobutyric acid (GABA) outflow from the cerebral cortex of freely moving, morphine-dependent guinea-pigs was studied. The cortical efflux of ACh in chronically-treated guinea-pigs was about half of that of normal animals. GABA efflux was unaffected. During opioid withdrawal precipitated by naloxone (0.1-10 mg kg-1, i.p.) the guinea-pigs showed jumping, hyperactivity and wet dog shakes, the intensity of which was directly related to the dose of naloxone. The withdrawal syndrome was accompanied by a dose-dependent increase in ACh release and reduction in GABA outflow; ACh release was increased by naloxone at doses lower (0.1-3 mg kg-1) than those acting on GABA efflux (1-10 mg kg-1). Atropine (10 mg kg-1) and diazepam (5 mg kg-1) did not prevent GABA and ACh changes. PMID- 3814914 TI - A pharmacological study of the rabbit saphenous artery in vitro: a vessel with a large purinergic contractile response to sympathetic nerve stimulation. AB - Mechanical responses to transmural electrical stimulation were recorded in isolated transverse ring preparations of rabbit saphenous artery. Electrical stimulation for a period of 1 s produced a rapid monophasic contraction and, for a period of 1 min, a biphasic contraction consisting of a rapid constriction followed by a slower sustained constriction. All contractions were abolished in the presence of tetrodotoxin (1 microgram ml-1) or guanethidine (4 microM). After desensitization of the P2-purinoceptor with alpha,beta-methylene ATP, contractions to electrical stimulation for 1 s were reduced significantly at all frequencies tested: responses evoked by stimulation at 4 Hz were usually almost completely inhibited, whereas those evoked by stimulation at 64 Hz were only partially inhibited. On the other hand, in the presence of the alpha-adrenoceptor antagonist, prazosin, neurogenic contractions were only partially reduced: at 4 Hz there was no significant reduction in the neurogenic contractions while at 32 and 64 Hz, contractions were reduced by an average of 20 and 28% respectively. Usually all contractions were abolished by a combination of the two drugs. Prazosin antagonized contractions of the vessel to exogenously applied noradrenaline but not to ATP, whereas desensitization of the P2-purinoceptor with alpha,beta-methylene ATP blocked responses to ATP but not those to noradrenaline. The concentration response curve to histamine was not affected by treatment of the vessel with prazosin, or after desensitization of the P2-purinoceptor with alpha,beta-methylene ATP. These results suggest that noradrenaline and ATP are co released from sympathetic nerves supplying the rabbit saphenous artery, both substances being involved in the mechanical contractions of this tissue. Further, the ratio of ATP to noradrenaline involved in these mechanical contractions is dependent upon the frequency of stimulation, but at all frequencies tested the purinergic component is greater than the adrenergic component. PMID- 3814915 TI - Electrical changes produced by injury to the rat myocardium in vitro and the protective effects of certain antiarrhythmic drugs. AB - Glass microelectrodes were used to record intracellular electrical activity from rat isolated and superfused atrial myocardium during external electrical stimulation. After 2 h in normal oxygenated physiological salt solution the muscle was exposed for 30 min to a superfusate simulating the composition of extracellular fluid during myocardial ischaemia (SI). This fluid contained lactate (20 mM), a raised potassium concentration (7 mM), no glucose and a pH lowered to 6.4, and was gassed with N2 in place of O2 (hypoxia). During SI the diastolic threshold voltage for stimulation increased, the speed of action potential conduction between the right and left atria slowed, and both the effective and functional refractory periods of the right atrium shortened, as did the duration of the right atrial action potential. The only component of SI which separately caused electrical changes similar to those of the full simulation was hypoxia. Addition to the superfusate of verapamil (0.5 micrograms ml-1), sulphinpyrazone (1-20 micrograms ml-1) or indomethacin (10-20 micrograms ml-1) attenuated many of the SI-induced electrical changes, although indomethacin was much less effective than the other two drugs. Lowering the calcium concentration of the superfusate from 2 mM to 0.5 mM protected against the SI-induced electrical changes that were inhibitable with sulphinpyrazone and verapamil. PMID- 3814916 TI - Decreased responsiveness of the aortae of hypertensive rats to acetylcholine, histamine and noradrenaline. AB - The responses to noradrenaline (NA) of the aortae of various hypertensive rats, namely the spontaneously hypertensive rat (SHR), the low blood pressure SHR (LBP SHR), and the left renal artery stenosed LBP-SHR (LRAS-LBR-SHR), were compared to those of the normotensive Wistar-Kyoto rats (WKY). The aortae of the hypertensive rats were significantly more responsive (P less than 0.05) to 10(-8) M NA. However, the reverse was true for higher doses of NA. The ED50 values for the aortae of WKY, LBP-SHR, SHR and LRAS-LBP-SHR were 20, 8.5, 7.8 and 8 nM respectively. The NA-contracted aortae of the LRAS-LBP-SHR were significantly less responsive (P less than 0.05) to the relaxant action of histamine and acetylcholine (ACh) compared to those of the WKY. This observation was not made in the aortae of the LBP-SHR. The maximal relaxation (% of the maximal contraction induced by 10(-8) M NA) observed in the aortae of WKY, LBP-SHR and LRAS-LBP-SHR were, respectively, 72 +/- 2, 66 +/- 6, 39 +/- 7 for ACh and 50 +/- 3, 36 +/- 4, 27 +/- 3 for histamine. In aortae where the endothelium had been removed by collagenase treatment, histamine induced a dose-related contraction. The rank order of this dose-related contraction was WKY greater than LBP-SHR greater than SHR greater than LRAS-LBP-SHR with the corresponding maximal tension (g) 0.89 +/- 0.04, 0.59 +/- 0.04, 0.36 +/- 0.04, 0.19 +/- 0.05. 5 The results suggested that elevation of blood pressure above the normal (due either to intrinsic or extrinsic factors), as seen in SHR and LRAS-LBP-SHR, results in a decreased response of the aortae to ACh and histamine. This effect was seen in both the endothelium mediated relaxation and the nonendothelium mediated contraction. PMID- 3814917 TI - Influence of 5-hydroxytryptamine uptake on the apparent 5-hydroxytryptamine antagonist potency of metoclopramide in the rat isolated superior cervical ganglion. AB - Metoclopramide, 1 X 10(-6) -1 X 10(-4) M, was found to behave as a reversible, competitive antagonist of 5-hydroxytryptamine (5-HT)-induced depolarization of the rat isolated vagus nerve (VN) and superior cervical ganglion (SCG). The pKB values were 6.60 (+/- 0.04) and 5.74 (+/- 0.07), respectively. The possibility that this apparent difference in potency was due to saturable 5-HT uptake was investigated. The SCG, but not the VN, accumulated tritium-labelled 5-HT via a saturable, sodium- and temperature-dependent mechanism. Ganglionic 5-HT uptake was blocked by desmethylimipramine (IC50 1.4 X 10(-6)M), chlorimipramine (8.7 X 10(-9) M), zimelidine (1.5 X 10(-7) M), paroxetine (4.3 X 10(-8) M) and citalopram (6.2 X 10(-8) M). The 5-HT uptake inhibitor paroxetine, 1 X 10(-6) M, did not modify the apparent 5-HT antagonist potency of metoclopramide on the VN, but raised the pKB obtained against 5-HT on the SCG from 5.74 (+/- 0.07) to 6.25 (+/- 0.03). It is suggested that the observed difference in the potency of metoclopramide as a 5-HT antagonist on the rat VN and SCG was due to saturable 5 HT uptake in the latter preparation. The results do not support a difference in the 5-HT receptors mediating depolarization on the VN and SCG. PMID- 3814918 TI - Differential effect of temperature on histamine- and carbachol-stimulated inositol phospholipid breakdown in slices of guinea-pig cerebral cortex. AB - Slices of guinea-pig cerebral cortex were incubated with [3H]-inositol at 37 degrees C before exposure to histamine or carbachol at 37 degrees C or 25 degrees C. Histamine-stimulated accumulation of [3H]-inositol 1-phosphate ([3H]-IP1) at 25 degrees C was only 5-7% of that at 37 degrees C, whereas for carbachol the response at 25 degrees C was 45-49% of that at 37 degrees C. The affinity of benzilylcholine, obtained from inhibition of carbachol-induced accumulation of [3H]-IP1 was similar at 25 degrees C and 37 degrees C, but the EC50 for carbachol was lower at 25 degrees C (20 +/- 2 microM) than at 37 degrees C (42 +/- 2 microM). The IC50 for histamine inhibition of [3H]-mepyramine binding to homogenates of guinea-pig cerebral cortex did not differ significantly at 25 degrees C and 37 degrees C. Histamine-induced accumulations of [3H]-IP2 and [3H] IP3 at 25 degrees C, expressed as a percentage of the accumulation at 37 degrees C, were also much less than the corresponding value for carbachol. These observations imply that the locus or pathway(s) of agonist-induced formation of [3H]-IP1 are not the same for histamine and carbachol. PMID- 3814919 TI - Purinoceptors in the rat heart. AB - The effects of an intracoronary bolus of adenosine triphosphate (ATP), alpha, beta-methylene ATP (APCPP), beta, gamma-methylene ATP (APPCP), adenosine diphosphate (ADP), adenosine monophosphate (AMP) and adenosine on coronary tone and ventricular myocardial contraction were investigated in the perfused rat heart. Adenine nucleotides, given by bolus injection were negatively inotropic in amounts greater than 3 X 10(-7) mol. The potency order was ATP greater than ADP greater than AMP. Adenosine (less than 1 X 10(-5)mol) had no effect on ventricular myocardial contraction. Adenine nucleotides and adenosine (1 X 10( 10)-1 X 10(-7) mol) reduced coronary tone. The potency order was ATP greater than ADP greater than AMP = adenosine. The ATP analogue APPCP was less active than ATP at reducing coronary tone, and APCPP had no vasodilator effect. This suggests the presence of a P2-purinoceptor, subclass P2Y, which mediates vasodilation. ATP and ADP increased the concentration of prostacyclin (measured as 6-keto prostaglandin F1 alpha) in the perfusate, but only after injection of greater than 3 X 10(-7) mol, suggesting that the vasodilator responses to ATP and ADP were not mediated by prostacyclin. AMP and adenosine had no effect, even at 1 X 10(-5) mol. At a dose of 3 X 10(-9) mol, approximately 40% of ATP and 70% of ADP was converted to AMP and adenosine whilst passing through the heart. The amounts of AMP and adenosine formed, however, were insufficient to account for the vasodilator effects of ATP and ADP. 6 Vasodilatation mediated by AMP and adenosine was inhibited by an infusion of 8-phenyltheophylline (8-PT; 2 x 10-5 M) indicating interaction with a P1-purinoceptor. Vasodilatation induced by ATP (at doses at which AMP and adenosine had no action) was also depressed by 8-PT indicating either an action of ATP on PI-purinoceptors, or an effect of 8-PT on P2y receptors. 7 Vasodilatation induced by AMP was unaltered during an infusion of alpha,beta-methylene ADP (2 x 10-6 M, which inhibited breakdown of AMP to adenosine by 54.2 +/- 1.5%, n = 4). This suggests that AMP acted directly, and it did not require conversion to adenosine to induce vasodilatation. 8 The ATP analogues APCPP (1 x 10-9_1 x 10-8 mol) and APPCP (1 x 10-8_l x 10-7mol) increased coronary tone, as did high doses (I x 10-5 mol) ofATP and ADP, indicating the presence of an additional P2-purinoceptor, subclass P2X, mediating vasoconstriction. PMID- 3814920 TI - Pharmacological characterization of 5-hydroxytryptamine-induced depolarization of the rat isolated vagus nerve. AB - A study has been made of the pharmacology of the 5-hydroxytryptamine (5-HT) induced depolarization responses that can be recorded extracellularly from the rat isolated cervical vagus nerve. Phenylbiguanide (PBG) and 2-methyl-5 hydroxytryptamine (2-methyl-5-HT) were found to mimic the effects of 5-HT on the vagus nerve. Their EC50 values were respectively 2.0 fold and 3.9 fold greater than that of 5-HT. Metoclopramide behaved as a reversible competitive antagonist of depolarization induced by PBG and 2-methyl-5-HT, with pKB values of 6.48 +/- 0.04, respectively. These agreed well with the pKB value of 6.60 +/- 0.04 obtained previously for metoclopramide against 5-HT on the rat vagus nerve. 5-HT, PBG and 2-methyl-5-HT had no demonstrable agonist effects at non-5-HT receptors on the rat vagus nerve. Tropacaine and m-chlorophenylpiperazine were found to behave as reversible competitive antagonists of 5-HT-induced depolarization of the vagus nerve. The pKB values were 6.29 +/- 0.03 and 6.90 +/- 0.03, respectively. Quipazine, MDL 72222 and ICS 205-930 were also shown to be effective antagonists of 5-HT on the vagus nerve. However, although these compounds were highly potent, they all caused a marked concentration-dependent reduction in the amplitude of the maximum response to 5-HT. This behaviour was not consistent with a simple reversible competitive mechanism. The results are discussed with reference to the current classification of mammalian peripheral neuronal 5-HT receptors. PMID- 3814921 TI - Effects of morphine on catecholamine release and arrhythmias evoked by myocardial ischaemia in rats. AB - The effects of morphine (10 mg kg-1 i.p.) on haemodynamics, arrhythmias and plasma and myocardial catecholamines (CA) were studied after coronary artery occlusion in anaesthetized rats. Myocardial intraneuronal CA were assessed histofluorimetrically and CA concentrations measured by high performance liquid chromatography. Morphine increased blood pressure, presumably due to higher plasma noradrenaline (NA) concentrations found in morphine-treated rats. Morphine increased the area of catecholamine-containing fluorescing neurones in the myocardium (as a percentage of total field area) 60 min after sham-operation (0.87 +/- 0.07%) or occlusion (0.57 +/- 0.05%) compared to untreated animals (0.67 +/- 0.06 and 0.38 +/- 0.03% respectively). Tissue NA content was not significantly affected by coronary occlusion and/or morphine within the first 60 min. Morphine had no effect on ischaemia-induced arrhythmias. Whether the higher intraneuronal NA content following morphine resulted from reduced central sympathetic outflow to the heart, presynaptic inhibition of NA release, or increased uptake due to higher plasma concentrations is unclear. Ischaemia induced local NA release appears independent of these mechanisms, as it was unaffected by morphine. PMID- 3814922 TI - Muscarinic receptors mediating suppression of the M-current in guinea-pig olfactory cortex neurones may be of the M2-subtype. AB - Guinea-pig olfactory cortical neurones in vitro were voltage clamped by means of a single intracellular microelectrode technique. Hyperpolarizing voltage commands from holding potentials between -40 to -50 mV produced slow inward current relaxations reflecting deactivation of the M-current (IM). IM was reversibly suppressed by 30 microM muscarine or carbachol; this suppression was insensitive to pirenzepine (up to 300 nM) but was inhibited by gallamine (10-20 microM) or 4 diphenyl-acetoxy-N-methylpiperidine (100, 500 nM), suggesting the involvement of the M2-type muscarinic receptor. PMID- 3814923 TI - Metabolic requirements for release of endogenous noradrenaline during myocardial ischaemia and anoxia. AB - The metabolic conditions required for noradrenaline (NA) release from ischaemic and anoxic perfused hearts of the rat were studied. Forty minutes of flow reduction to approximately 0.25 ml g-1 min-1 did not elicit enhanced noradrenaline overflow from the isolated heart perfused with normoxic perfusate even in the absence of added substrate. Enhanced overflow did occur when substrate-free ischaemia was induced after a 60 min period of substrate-free perfusion. Noradrenaline overflow was enhanced by perfusion at normal flow rates with an anoxic (Po2 less than or equal to 1 mmHg) perfusate containing no substrate. Such enhanced overflow occurred in the absence of calcium in the perfusate and was almost completely abolished by the addition of 11 mM glucose. Enhanced noradrenaline overflow occurring either during low flow ischaemia after substrate deprivation or during anoxic substrate-free perfusion at normal flow rates was markedly suppressed by desipramine. Exocytotic noradrenaline overflow induced by electrical stimulation of the left cervico-thoracic ganglion continued unchanged during 60 min of anoxia if the perfusate contained 11 mM glucose. In the absence of added substrate there was a decline in the overflow induced by such stimulation which was more rapid with anoxic than normoxic perfusate. Re introduction of calcium, oxygen and substrate after 10, 20 or 30 min of calcium free, substrate-free, anoxic perfusion was associated with a massive overflow of the intracellular enzyme lactate dehydrogenase. At 10 min there was an associated transient minor increase in NA overflow but at 20 and 30 min the overflow of NA, elevated as a result of anoxic perfusion, returned to pre-anoxic levels on the re introduction of substrate and oxygen. 7 These studies demonstrate a central role for the metabolic status of the sympathetic nerve terminal in determining the magnitude ofexocytotic and nerve-impulse independent noradrenaline release from the heart. During the course of myocardial ischaemia in vivo nerve-impulse independent release would be expected to occur only in regions of severe flow reduction. This may produce heterogeneous stimulation of the myocardium. PMID- 3814925 TI - The continuum of psychosis and its implication for the structure of the gene. AB - Three observations challenge Kraepelin's binary view of the functional psychoses: a bimodal distribution of the clinical features of manic-depressive illness and schizophrenia has not been demonstrated; affective illness appears to predispose to schizophrenia in later generations; and 'schizoaffective' illnesses cannot be separated in family studies from either of the prototypical psychoses. The alternative concept is that psychosis is a continuum extending from unipolar, through bipolar affective illness and schizoaffective psychosis, to typical schizophrenia, with increasing degrees of defect. According to this concept the genes predisposing to psychosis have a degree of stability that ensures that the form of the psychosis tends to remain the same within families, but there is also the possibility of change, implying that the genetic mechanisms themselves are variable. It is proposed that quantal changes in the 'virogene' are due to replications within the genome (e.g. the generation of tandem repeats of the element or a component of it); that such replications occur at a critical stage (e.g. gametogenesis, fertilisation, very early embryogenesis) in the course of reproduction; and that the 'season of birth effect' reflects the operation of the mechanism responsible for these replications. PMID- 3814924 TI - A comparison between the pattern of dopamine and noradrenaline release from sympathetic neurones of the dog mesenteric artery. AB - The release of dopamine and noradrenaline (NA), from the main trunk of the mesenteric artery and its proximal branches elicited by electrical nerve stimulation and K+, has been measured by using high pressure liquid chromatography with electrochemical detection. Both stimuli released dopamine and NA. With the main trunk of the mesenteric artery, dopamine represented 8% of the NA tissue content; the dopamine/NA ratio in the catecholamine overflow caused by nerve stimulation or K+-induced depolarization also averaged 8%. For the proximal branches the tissue dopamine/NA ratio was significantly greater than that observed to occur in the overflow caused by nerve stimulation and K+. When the perifusion with a K+-enriched medium was extended to 120 min the amount of NA released from both the main trunk and the proximal branches progressively declined. The same pattern of release was observed for dopamine in the main trunk, whereas for the proximal branches dopamine overflow did not decline throughout the perifusion period. The addition of alpha-methyl-p-tyrosine did not change the pattern of amine overflow. Our interpretation of these results is that both dopamine and NA are derived from the same sympathetic neurone. In the proximal branches of the mesenteric artery dopamine and NA appear to be in two different storage structures, whereas in the main trunk both dopamine and NA are located in only one storage structure. PMID- 3814926 TI - The Attachment Dynamic in adult life. AB - A case is presented for regarding the Attachment Dynamic as a theoretical model for hypotheses on the aetiology and management of neuroses and personality disorders. It is proposed that man has a number of natural propensities, including: attaining 'companionable interactions' with peers, in which competence is affirmed, self-esteem enhanced, and a state of well-being ('assuagement') is promoted. when hindered in the pursuit of interests and companionable interaction, an urge to seek support through proximity to, and often 'supportive interaction' with support-givers. severe psychological distress ('disassuagement') when support-givers cannot be induced to act effectively, with a propensity to devise defensive strategies, supplemented by psychological defence mechanisms; when maladaptive, these strategies are the source of neurotic symptoms and antisocial traits. Through these propensities, movement between companionable interaction and effective support sustains the urge to develop skills and explore interests creatively. However, this movement is hindered by the experience of repeated disassuagement and the need to maintain maladaptive defensive strategies. PMID- 3814927 TI - Significance of positive and negative syndromes in chronic schizophrenia. AB - Positive and negative syndromes were studied in relation to demographic, historical, genealogical, clinical, psychometric, extrapyramidal, and follow-up measures of 101 chronic schizophrenic patients. The criterion scales proved to be reliable, normally distributed, and strongly correlated with general psychopathology, but otherwise inversely related to one another. Multiple regression analysis identified sets of 4-6 independent variables that explained 74%-81% of the scales' variance. A positive syndrome was associated chiefly with productive features, family history of sociopathy, more previous hospital admissions, and longer in-patient stay during the 30-month follow-up period. A negative syndrome correlated with deficits in cognitive, affective, social, and motor spheres, higher incidence of major psychiatric illness but less affective disorder among relatives, lower education, and greater cognitive developmental impairment. The results underscore the importance of genetic and biodevelopmental variables for understanding schizophrenic syndromes. PMID- 3814928 TI - A haven for the severely disabled within the context of a comprehensive psychiatric community service. AB - The priorities accorded severely disabled or disturbed long-stay patients in Regional and District planning strategies vary enormously. A scheme to cater for the needs of this group is described. The scheme includes: non-stigmatising housing; a domestic regime, daytime occupation and leisure activities offering forms of enabling and caring that foster the highest possible levels of functioning; a secure home; private and peaceful outdoor space; and graduated steps towards independence that allow for the possibility of relapse. The central concept is the establishment of a Community for people with severe difficulties in making social contacts. The importance of integrating the scheme into a comprehensive District psychiatric service is emphasised. PMID- 3814929 TI - Providing information to relatives about schizophrenia: some comments. AB - There has recently been an increased interest in providing relatives of schizophrenic patients with information about the illness and how to manage the patient at home, due partly to the development of psychosocial intervention programmes (which frequently include an educational component) and a consumer demand for such information in an era of community care. Studies which describe the effects of such educational programmes are reviewed, and two different models of information acquisition are contrasted. These models have different implications, in terms of outcome measures, on how educational programmes should be evaluated. Guidelines are offered for practitioners wishing to give information to relatives. PMID- 3814930 TI - Delineating social phobia. AB - The natural history--including psychiatric symptoms, precipitating factors, onset and course of illness, and personality characteristics--of 47 social phobics, 80 agoraphobics, and 72 simple phobics was examined. The social phobia group differed from the agoraphobia group by having a lower mean age, fewer females and married members, and a higher educational and occupational status. They were less fearful generally, less obsessive, and less likely to follow a fluctuating or phasic course. There was overlap between the two groups with regard to main phobias, and they were similar with regard to adjacent symptomatology. Both the social and agoraphobia groups differed in similar and significant ways from simple phobics. PMID- 3814931 TI - The use of seclusion in psychiatric hospitals in the Newcastle area. AB - Between 1981 and 1984, the frequency with which seclusion was used decreased in Newcastle. Secluded patients were younger, more often male, unmarried, unemployed, and admitted formally, and there was an association with certain diagnoses. Most seclusions occurred early in the hospital stay, mainly in the daytime, especially at mealtimes, and first seclusions were the longest. Violent incidents were usually associated with non-psychotic patients, and staff were the commonest victims. Medication used was major tranquillisers or paraldehyde. PMID- 3814932 TI - Suicide in young doctors. AB - Fifty-five cases of suicide by doctors under the age of 40 were studied because of concern about deaths among anaesthetists in training. The excess mortality of doctors from suicide was confirmed, suggesting that risk factors associated with being a member of the medical profession continue to operate, although mortality for young male doctors from accidental poisoning is falling. Analysis of the branches of medicine in which the doctors were working showed no definite specialty predominance. There was a somewhat greater risk for women doctors born overseas. PMID- 3814933 TI - Relationship of mood alterations to bingeing behaviour in bulimia. AB - Twelve women with bulimia participated in a study in which they binged and vomited on the day after hospital admission. Caloric intake, time spent bingeing and vomiting, and self-reported mood ratings demonstrated much variation from subject to subject. Both subjective and objective ratings of mood indicated that anxiety decreased more frequently and to a greater extent than depression, both during and after bingeing and vomiting. The present data, obtained in a controlled setting, tend to confirm previous information on binge episodes obtained by self-report from bulimic patients. Bingeing and vomiting episodes may provide bulimic patients with a physiological mechanism for temporarily relieving a dysphoric mood state. PMID- 3814934 TI - Depression and anxiety in patients undergoing diagnostic investigations for head and neck cancers. AB - Patients attending a regional head and neck Oncology Unit were assessed for depression and anxiety (using the Leeds self-assessment scales) before diagnostic biopsy investigations. At the time of the assessments, neither patients nor investigators knew the biopsy results. Patients whose biopsies subsequently proved positive (showing the presence of a tumour) had significantly higher depression scores than those whose biopsies were negative. Differences in mean anxiety scores did not differ between groups. It is suggested that depression is part of the clinical picture of head and neck cancer. PMID- 3814935 TI - Post-ECT blood pressure rise and its relationship to cognitive and affective change. AB - Post-ECT blood pressure rise and its relationship to cognitive and affective change were studied in 29 depressed patients, using the Benton Visual Retention Test, the Hamilton Rating Scale for Depression, and the Leeds Self-Assessment Scale for Depression and Anxiety. No real difference was established in the Benton Test error scores before and after ECT, no correlation between rise in blood pressure and change in Benton Test error score with ECT was found, and no correlation was found between blood pressure rise and affective improvement following ECT. Previous studies which reported such correlations are not supported. PMID- 3814936 TI - Is there a lithium withdrawal syndrome? AB - Patients who discontinued lithium after a mean of 29 +/- 21 months prophylaxis were compared with a similar group who were not taking the drug; all had only been in hospital once, and satisfied DSM-III criteria for mania. During the first three months following withdrawal of lithium, significantly more patients relapsed than in the control group; after this period, the rate was identical. These findings suggest that lithium withdrawal exists as a clinical phenomenon and that a period of lithium treatment does not improve the long-term prognosis, once the drug has been stopped. PMID- 3814937 TI - Koro in an Israeli male. AB - The Koro syndrome, a 'special cultural psychiatric syndrome', is encountered in South China, Malaysia and Indonesia, especially among people of Chinese origin. There are only eight case reports of Koro from the Western hemisphere. We present a typical primary Koro patient from Israel. Jewish cultural mores are a contributory factor. PMID- 3814938 TI - Anorexia nervosa in a woman totally blind since the age of two. AB - A 28 year-old woman, blind since the age of two, had become anorexic at 21. She had eating problems as a child, and weight preoccupation from her teens onwards. Psychiatric admission with other anorexic patients preceded the illness. Inability to see oneself does not protect against anorexia nervosa. PMID- 3814939 TI - Identical twins discordant for presenile dementia of the Alzheimer type. AB - In genetically proven identical female twins, discordant for presenile dementia of the Alzheimer type, the affected twin began to dement at the age of 49, and died 15 years later; the diagnosis was confirmed at post-mortem. The surviving twin remains clinically unaffected 20 years after the onset of dementia in her sister. Environmental aetiological factors are postulated to account for this discordance. PMID- 3814940 TI - Art group psychotherapy in a psychiatric day unit. PMID- 3814941 TI - Lithium augmentation of tricyclics. PMID- 3814942 TI - Anhedonic depression. PMID- 3814943 TI - Quetelet's Index and appetite and weight change in the context of depression. PMID- 3814944 TI - Smoking in chronic schizophrenia. PMID- 3814945 TI - Procyclidine abuse. PMID- 3814946 TI - Tardive dystonia and Pisa syndrome. PMID- 3814947 TI - Lithium treatment: a refresher course. AB - Updated guidelines are presented for the safe and effective use of lithium; covering indications, treatment management, duration of prophylactic treatment, side-effects and their prevention, overdosage, interactions, and contraindications. Alternatives to lithium and patient-doctor co-operation are discussed. PMID- 3814948 TI - Some relationships between psychiatry and the social sciences. PMID- 3814949 TI - The prognosis of depression in old age. AB - The initial features and progress of depressive symptomatology over 42 to 104 months are presented for 100 elderly patients admitted with severe, non-neurotic depressive states; none had experienced a previous hypomanic episode. Sixty per cent either remained well throughout or had further episodes followed by full recovery; only 7% suffered continuous depressive symptoms. Of potential prognostic factors, only male sex and poor physical health, both at presentation and developing subsequently, were associated with poorer outcomes. The view is supported that treatment with well established methods achieves worthwhile and sustained improvement for most patients. PMID- 3814950 TI - Exposure to parental alcoholism during childhood and outcome in adulthood: a prospective longitudinal study. AB - The effects of children's exposure to parental alcoholism was assessed using records from an existing prospective 40-year longitudinal study of working-class families: 176 men who had grown up with an alcoholic parent or parents were compared with 230 men without such exposure. Degree of exposure to alcoholism in the childhood family environment was highly correlated in later life with alcohol use, alcoholism, time in jail, sociopathy, and death, but not with increased rates of unemployment, poor physical health, or measures of adult ego functioning. Most of the impairments observed occurred in those subjects who actually developed alcoholism. Exposure to alcoholism in the family environment and family history of alcoholism independently contributed to the later development of alcoholism. PMID- 3814951 TI - Marital adjustment, intimacy and needs in female agoraphobics and their partners: a controlled study. AB - Female agoraphobics and their partners were compared with three groups of control couples (non-phobic female psychiatric patients and their husbands, maritally distressed couples, and happily married couples) on measures relating to marital adjustment, intimacy, and needs. Neither agoraphobics nor their partners rated their marriages as more maladjusted or unpleasant than non-phobic psychiatric patients or their partner controls. Instead, agoraphobics and their spouses were found to be more comparable to happily-married couples than to maritally distressed controls. Non-phobic psychiatric patients and their partners were generally found to rate their marriages as being as distressing and unpleasant as those of maritally distressed controls. PMID- 3814952 TI - Prevalence of schizophrenia in an urban population. AB - The treated one-year prevalence and point-prevalence of schizophrenia, schizoaffective psychosis, and paranoid state in the city of Salford were derived from the Salford Psychiatric Case Register. The high rates found are attributed primarily to the effects of selective migration from the area. A breakdown of the use of health services in the area by patients with these diagnoses is given; hospital care was found to be the major form of treatment. PMID- 3814953 TI - HLA antigens in schizophrenia: a family study. AB - HLA haplotypes A and B were studied in eight families with two or more schizophrenic members. All index cases and all but two sick relatives satisfied Research Diagnostic Criteria for the diagnosis of schizophrenia; 45 subjects were studied. Data were analysed by sequential tests for the detection of linkage and by the affected sib-pair method. The results do not support a linkage between HLA and schizophrenia. PMID- 3814954 TI - Deliberate self-harm: how do patients view their treatment? AB - The opinions of patients who had caused deliberate self-harm about the attitudes of doctors, nurses, families and others towards their acts were studied. Their views of the attitudes of hospital staff were found to be markedly different from attitudes reported elsewhere by staff themselves. There were no differences between the patients' views of their handling by nurses, families, and others towards their acts were studied. Their views of the attitudes of families were unsympathetic. A significant association was found between repetition of an act of deliberate self-harm and the perception of an unsympathetic attitude within the family. PMID- 3814955 TI - An American validation study of the Newcastle diagnostic scale. I. Relationship with the dexamethasone suppression test. AB - The Newcastle diagnostic index was completed on 159 depressed in-patients, who received the dexamethasone suppression test during their first week in hospital. Patients suffering from endogenous depression had a significantly higher rate of DST non-suppression, were older, were more frequently psychotic, and more frequently lost weight; even after controlling for these variables, DST non suppression was significantly more frequent in the endogenous group. The relationship between Newcastle scores and the frequency of DST non-suppression was non-linear. PMID- 3814957 TI - Psychogenic skin disease: a review of 35 cases. AB - In three years of clinical practice, the authors saw 35 cases of dermatological disorders of strictly psychological origin--8 patients with dermatitis artefacta, 8 with delusional parasitosis, and 19 who presented with skin complaints but showed no dermatological pathology ('dermatological non-disease'). All but two initially presented for dermatological opinion rather than psychiatric assessment, and 12 refused psychiatric referral. Demographic and clinical details of all 35 cases are given, including possible related factors, course, treatment, and outcome, and the cases are discussed in the context of the existing literature. Liaison between dermatologists and psychiatrists is strongly advocated. PMID- 3814956 TI - Reduction in hypochondriasis with treatment of panic disorder. AB - Hypochondriasis was assessed in 60 patients with panic disorder and agoraphobia using the Illness Behavior Questionnaire. Before treatment, IBQ hypochondriasis scores were similar to those of a group of hypochondriacal psychiatric patients. In patients who improved with treatment, significant reductions in somatic preoccupation, disease phobia, and disease conviction occurred. Hypochondriasis appears to be a prominent feature of panic disorder and agoraphobia, and responds to treatment of the primary conditions. Our findings underscore the importance of providing adequate treatment and thereby avoiding wasteful use of medical resources and alienation of patients from doctors. PMID- 3814958 TI - The life satisfaction index--well-being: its internal reliability and factorial composition. AB - The internal consistency and factorial composition of the eight-item Life Satisfaction Index--Well-being, adapted for use with elderly British samples, were examined. Cross-validation was carried out with a randomly drawn community sample of 155 rural people aged 65-89 years. The scale was found to have acceptable internal reliability, but may require modification. PMID- 3814959 TI - Munchausen's syndrome and drug dependence. AB - A man with Munchausen's syndrome was treated for drug dependence, which allowed him to establish and sustain a bond with a hospital, but eventually brought about an ethical dilemma. PMID- 3814960 TI - Autocastration and biblical delusions in schizophrenia. AB - A young male castrated himself in response to the biblical passage, Matthew 19:12. Although extremely rare, autocastration usually occurs in men with chronic paranoid schizophrenia, with a long history of delusions of sexual guilt which can only be relieved by castration. Management of these patients is long-term, involving both pharmacotherapy and individual and family therapy. PMID- 3814961 TI - A case of anorexia nervosa with Klinefelter's syndrome. AB - This is the first reported case of anorexia nervosa in association with Klinefelter's syndrome. Although the patient was initially diagnosed as suffering from 'atypical' anorexia nervosa, Klinefelter's syndrome was cytogenetically proven and other organic pathology ruled out. PMID- 3814962 TI - Violent behaviour in psychiatric hospitals. PMID- 3814963 TI - Brucella arthritis among Iraqi patients. AB - The clinical features of acute Brucella arthritis were reported in a prospective study of 58 patients (29 male, 29 female). Polyarthritis occurred in 33, was migratory in ten, additive in 23 and symmetrical in ten. Monoarthritis of knee or hip joints occurred in ten patients, whilst the spine alone was involved in 15. Hip and spinal involvement was more destructive than peripheral joint involvement. Hotness, redness and joint effusions were not prominent features. Tissue-typing did not show any association with Brucella arthritis. Treatment with various antimicrobials was followed by recovery, but the relapse rate was lowest with combined tetracycline and streptomycin. Brucella arthritis is frequently seen in Iraq, and dairy products prepared locally from unpasteurized milk should be controlled by local health authorities. PMID- 3814964 TI - The potential of computer applications in rheumatology. PMID- 3814965 TI - Microwave thermography--an index of inflammatory joint disease. AB - Microwave thermography is a technique measuring microwave emission from sites of inflammation. Microwaves have a wavelength of around 10 cm and are therefore able to penetrate clinically useful depths of up to 4 cm directly measuring tissue thermal radiation. A microwave detector was applied to the study of joint inflammation in rheumatoid arthritis and in a normal control group. Fifty-two knees were scanned using the detector and a microwave thermographic index was calculated for each knee. A strong correlation was found between the microwave thermographic index, and the clinical and laboratory parameters measured. This technique was found to be reproducible, quick, simple to use at the bedside without a controlled environment and, since it measures internally emitted radiation, is inherently safe. PMID- 3814966 TI - The role of passive stretching in the treatment of ankylosing spondylitis. AB - A controlled study of 39 consecutively-admitted patients with ankylosing spondylitis was conducted to assess the effects of daily passive stretching of the hip joints during a 3-week in-patient physiotherapy course. Measurements were performed by an independent assessor on admission, at discharge and six months after discharge. Results showed that passive stretching resulted in a significant increase in the range of all movements of the hip joints except flexion during the physiotherapy course. Follow-up at 6 months in seven patients suggested that this increase in range of movement could be maintained by patients who had been performing the stretching exercises regularly. We suggest that the inclusion of passive stretching of the hip joint in the treatment of patients with ankylosing spondylitis will increase the range of movement and thus improve function and influence posture. PMID- 3814967 TI - Computers in rheumatology. AB - The results of a nationwide survey of the use of computers in rheumatology departments in the UK is presented. The survey revealed a widespread interest in the various possible uses of computer hardware and software in the specialty, and highlighted the difference between the experience of those who use computers and the aspirations of those who hope to. PMID- 3814968 TI - Intra-articular variation of synovial changes in knee arthritis: biopsy study comparing changes in patellofemoral synovium and the medial tibiofemoral synovium. AB - Variation of synovial changes in the knee joint was studied in 23 patients. Histological features of biopsies taken from the patellofemoral joint synovium were compared with biopsies taken from the synovium of the medial tibiofemoral joint. The patellofemoral compartment showed more fibrosis compared to the medial tibiofemoral compartment where there was more inflammatory cell infiltration, pigmentation, an increase in vascularity, increased fragment deposition and synovial hyperplasia. Multiple biopsy with reference to compartmental localization is likely to give more information than biopsy of a single site. PMID- 3814969 TI - Acute pseudogout of the temporomandibular joint: a report of three cases and review of the literature. AB - Three cases of acute pseudogout of the temporomandibular joint are described. The rarity of pseudogout in this joint may be partly due to a failure to recognize this diagnosis as a cause of facial pain. PMID- 3814970 TI - Gold-induced hypogammaglobulinaemia. AB - Panhypogammaglobulinaemia has recently been recognized as a rare complication of gold toxicity. We report two further cases of gold-induced hypogammaglobulinaemia which also demonstrated that monitoring of immunoglobulin levels is necessary for the early detection of this condition. PMID- 3814971 TI - Rheumatoid arthritis with vertical atlanto-axial subluxation complicated by hydrocephalus. AB - The present report describes a patient with rheumatoid arthritis and vertical atlanto-axial subluxation who developed hydrocephalus with high intraventricular pressure and neuropsychiatric abnormalities. The vertical atlanto-axial subluxation and hydrocephalus were visualized by magnetic resonance imaging, which clearly demonstrated the basilar impression by the dens and ventricular enlargement. The patient recovered completely after ventriculo-cardial drainage. PMID- 3814972 TI - A reappraisal of synovectomy and radial-head excision in rheumatoid arthritis. AB - A review of the literature reveals that radial-head excision for rheumatoid destruction of the elbow is a worthwhile operation, producing complete pain relief in many and substantial improvement in approximately 75%. Recurrence of symptoms eventually occurs in 50% patients. PMID- 3814973 TI - Henoch-Schonlein purpura associated with co-dydramol. PMID- 3814974 TI - Homozygous MM in ankylosing spondylitis. PMID- 3814975 TI - Adult Still's disease presenting as PUO; a not uncommon disorder. PMID- 3814976 TI - The gut and RA. PMID- 3814977 TI - Pulmonary oedema, jaundice and renal impairment with naproxen. PMID- 3814978 TI - False positive Monospot test in systemic lupus erythematosus. PMID- 3814979 TI - Yttrium 90 synovectomy--a new treatment for pigmented villonodular synovitis. PMID- 3814980 TI - Diuretics and patients with rheumatoid arthritis. PMID- 3814981 TI - Possible danger of intra-articular steroid injection in children with respiratory tract infections. PMID- 3814982 TI - Joint mobility with particular reference to racial variation and inherited connective tissue disorders. AB - Joint mobility scores were compared in 248 normal English Caucasian males and females between the ages of 8 and 70 years. The results were contrasted with those in a group of normal Asian Indians and patients suffering from a variety of inherited disorders including Type II Ehlers-Danlos syndrome (EDS), Type I osteogenesis imperfecta (OI), Marfan syndrome, generalized osteoarthritis (GOA), achondroplasia and pseudoachondroplasia. The first-degree relatives of ten subjects with severe or lethal OI were also examined. Asian Indians were significantly more mobile than English Caucasians. Males and females with EDS were hypermobile but only the females with OI and the female relatives of those with severe or lethal OI showed excess joint laxity. Patients with pseudoachondroplasia exhibited a grosser type of joint laxity than other subjects while those with GOA represented a relatively stiff group. No evidence was found to support the view that hypermobility is associated with particular length variants at the Type II collagen structural gene locus (COL2A1). PMID- 3814983 TI - A modified Wingate test for measuring anaerobic work of the upper body in junior rowers. AB - Eight elite junior oarsmen (ER) and sixteen club level rowers (CR) were tested for upper body strength (trunk, arms) and for mean, peak and minimum power outputs using the Double-Arm Anaerobic Work Test (DAAWT). This test is a modified version of the original Wingate test whereby athletes can be tested using trunk and both arms simultaneously. Multiple Discriminant Analysis was used to determine if the DAAWT variables alone were sensitive enough to discriminate between the two groups. Additionally, Pearson's correlation coefficients and ANOVA were employed. Results indicate that mean power and power difference expressed in absolute values (Watts) could successfully classify junior oarsmen into appropriate groups (91.8%, P less than 0.001). In addition, there was a fairly high correlation (r = 0.81) between mean power and strength in the ER. The strongest ER demonstrated the least fatigue while highly significant differences between the groups in most of the other variables examined have also been demonstrated. PMID- 3814984 TI - Motorcycle racing injuries on track and road circuits in Ireland. AB - A retrospective study was carried out on all motorcycle injuries occurring at Mondelo Park racetrack for the 1983 and 1984 seasons. In this sport there were a total of 57 injuries for the two year period, 27 occurring in 1983 and 30 in 1984. Soft tissue injuries accounted for 66.7%, fractures 22.8% and head injuries 10.5% of the total. In the fracture group, 2 patients suffered spinal fractures which is noteworthy in that neither were wearing back protectors which as yet are not compulsory safety equipment in Eire. These figures were compared with data from the same two year period on the Ulster road circuit. The incidence of each type of injury was similar and equally low in both groups. Motorcycle racing injuries compared favourably with motor car racing injuries and had a lower incidence of serious head injury. In comparison with road traffic accidents involving motorcyclists the overall number of injuries, the number of serious head, abdominal and chest injuries and the overall fatality rate, are much lower. The two most relevant factors in our lower injury incidence were lack of alcohol and the absence of collision with cars. Experience, medical attention and speed had no direct influence on our injury incidence. PMID- 3814985 TI - Haematological changes due to triathlon competition. AB - A twelve parameter blood cell profile has been measured in 6 subjects before and after each phase of triathlon event. This involved 29 miles cycling, 12 miles running and finally 18.5 miles canoeing. There was a significant decrease in plasma volume (8.7% +/- 3.1%, p less than 0.001) following the first phase (cycling); this decrease was sustained to the end of the event. A substantial increase in the number of circulating leukocytes after cycling (84 +/- 58%) and running (255 +/- 83% of pre-event value) was observed. There was no further leucocyte increment after the canoeing stage which may indicate that the circulating concentration of these cells was maximal after running. Fluid shifts following the postural alteration accompanying the different types of exercise and subject variability may have masked any subtle changes in the red cell parameters. PMID- 3814986 TI - Mechanical jumping power in athletes. AB - The Wingate cycle ergometer test is a widely used test of sustained muscular power. A limitation of the test is the lack of development and retrieval of stored elastic energy due to a lack of an eccentric phase. To measure mechanical power output of the entire stretch-shortening cycle, the test of Bosco et al (1983) was administered to 119 male athletes in 7 different activities during their pre-participation evaluations. The sports tested were indoor soccer, American football and ballet (professionals), outdoor soccer, basketball and wrestling (collegiate) and amateur bobsled. Results showed the overall average power output to be 20.37 W.kg-1 for the 60s reciprocal jumping test. Ballet dancers generated significantly less mechanical power than indoor soccer, basketball and bobsled athletes, while wrestlers generated significantly less power than indoor soccer and basketball athletes (all p less than 0.05). No other between-sport differences were seen. A subset of indoor soccer players (n = 10) were retested after 4 months of training. Power improved from 20.8 to 24.3 W.kg-1 (p less than 0.05). While between sport differences were limited, training differences in one subset of athletes were readily identified. PMID- 3814987 TI - Injuries in taekwondo. AB - During the 6th Taekwondo World Championship more than 4 per cent of the competitors were admitted to hospital. The majoirity of the severe injuries were to the head and neck. More padding and a change of rules are recommended. PMID- 3814988 TI - Surgical treatment of patellar tendon pain in athletes. AB - A series of surgically treated patellar tendon lesions among athletes is presented. The material was collected during 5 years from three sports injury clinics and from two hospitals. During this period the authors treated about 150 cases of jumper's knee, of which 34 cases were treated by operation. The athletes were mostly volley ball players, jumpers or runners. The operation revealed a necrotic focus of the patellar tendon in 21 cases, the retinaculum was thick and adherent in 16 patients and an exostosis of the patellar insertion was seen in two cases. The necrotic areas were excised, the thick and adherent retinaculum was divided and the exostoses were excised and drilled. Surgical treatment of chronic patellar tendon pains may give good results in selected cases. PMID- 3814989 TI - Anthropometric and training variables related to 10km running performance. AB - Sixty male distance athletes were divided into three equal groups according to their personal best time for the 10km run. The runners were measured anthropometrically and each runner completed a detailed questionnaire on his athletic status, training programme and performance. The runners in this study had similar anthropometric and training profiles to other distance runners of a similar standard. The most able runners were shorter and lighter than those in the other two groups and significantly smaller skinfold values (P less than 0.05). There were no significant differences between the groups for either bone widths or circumferences but the elite and good runners had significantly higher ponderal indices (P less than 0.05) than the average runners, indicating that they are more linear. Elite and good runners were also less endomorphic but more ectomorphic than the average runners. The elite runners trained more often, ran more miles per week and had been running longer (P less than 0.05) than good or average runners. A multiple regression and discriminant function analysis indicated that linearity, total skinfold, the type and frequency of training and the number of years running were the best predictors of running performance and success at the 10km distance. PMID- 3814990 TI - A longitudinal psycho-physiological study of active and inactive men. AB - After an interval of ten years, physically active and inactive male university teachers were re-examined across four measures; predicted maximum oxygen uptake, percentage body fat, personality and attitudes towards physical activity. Both groups showed a decrease in predicted oxygen uptake and an increase in body fat although the active subjects continued to possess higher predicted maximum oxygen uptake values and have a lower percentage body fat than the inactive subjects. In general the psychological assessments revealed no major changes but minor shifts in attitudes towards physical activity were noted. PMID- 3814991 TI - Severe eye injuries in cricket. AB - We report five cases of severe eye injury sustained in cricket, including retinal detachment and rupture of the globe. The eye is at particular risk from a rising ball. We comment on the need for appropriate facial protection for batsmen and close fielders. PMID- 3814992 TI - Biological basis of radiological protection and its application to risk assessment. Proceedings of a one-day seminar. Bristol, April 11, 1986. PMID- 3814993 TI - Clinically derived dose-effect relationship for hyperthermia given in combination with low-dose radiotherapy. PMID- 3814994 TI - A simple design for an accurate uniformity phantom. PMID- 3814995 TI - Principles of the International Commission on Radiological Protection system of dose limitation. AB - The current recommendations of the International Commission on Radiological Protection (ICRP), published in 1977, identify two types of effect against which protection is required. "Stochastic" effects are those for which the probability of an effect occurring, rather than its severity, is regarded as a function of dose without threshold, whereas "non-stochastic" effects are those for which the severity varies with the dose and for which a threshold may occur. The system of dose limitation recommended by the ICRP is based on the prevention of non stochastic effects and limitation of the probability of stochastic effects to levels deemed to be acceptable. The prevention of non-stochastic effects is achieved by setting dose-equivalent limits at values such that no threshold dose would be reached, even following exposure for the whole of a lifetime or for the total period of a working life. The limitation of stochastic effects is achieved by keeping all justifiable exposures as low as is reasonably achievable, economic and social factors being taken into account, subject to the constraint that reductions in collective exposure do not cause unacceptably large individual exposures. The formulation of a quantitative system of dose limitation based on these principles requires that judgments be made on several factors including: relationships between radiation dose and the induction of deleterious effects for a variety of endpoints and radiation types; acceptable levels of risk for radiation workers and members of the public; and methods of assessing whether the cost of introducing protective measures is justified by the reduction in radiation detriment which they will provide. In the case of patients deliberately exposed to ionising radiations, the objectives of radiation protection differ somewhat from those applying to radiation workers and members of the public. For patients, risks and benefits relate to the same person and upper limits on acceptable risks may differ grossly from those appropriate to normal individuals. For these reasons, and because of its historical relationship with the International Congress of Radiology, the ICRP has given special consideration to radiation protection in medicine and has published reports on protection of the patient in diagnostic radiology and in radiation therapy. PMID- 3814996 TI - Practical implementation of ICRP recommendations. International Commission on Radiological Protection. AB - This paper describes how the recommendations of the International Commission on Radiological Protection (ICRP) are transmitted to the government of the UK and the scrutiny which they undergo in that process. The essential features of any legislation, namely clarity and enforceability, are identified, as is the part played by consultation with persons affected. The practical outcome in terms of regulations and codes of practice is described in general terms and specific examples are taken from the regulations and codes, showing how the principal aspects of ICRP recommendations bearing on radiation risks have been incorporated. It is argued that the value of ICRP recommendations to the drafter of legislation is their general acceptability, giving a firm basis for requirements, against which too frequent and too positive detailed recommendations provide an unfortunate offset. PMID- 3814997 TI - Disc damage above a spondylolisthesis. AB - Fifty-two patients with low back pain and spondylolisthesis at L5/S1 had discograms performed at the L4/L5 level. Retrolisthesis at L4/L5 occurred in 44%, but no direct relationship was demonstrated between the extent of retrolisthesis and either the grade of spondylolisthesis or the presence of disc damage. There was an inverse relationship between the degree of spondylolisthesis and L4/L5 disc damage. Thirty-six patients were assessed for symptomatic pain reproduction during discography. Fourteen (39%) had normal nuclear morphology and no pain induction on injection. Twenty-two patients had disc damage and 11 (50%) had symptomatic pain induced by injection. These results were correlated with the discographic appearances. PMID- 3814998 TI - A comparative study of films and screens for mammography. AB - Ten films and six screens suitable for mammography have been compared for image quality using a realistic quantitative phantom under controlled conditions. The best screen was Min R (Kodak), but three black and white films, Min R (Kodak), Fuji II NC (Fuji) and MR3 (Agfa-Gevaert), scored highly. Patient dose was also considered and, with these three films, small gains in image quality were balanced by small increases in dose. Medichrome Blue film, however, gave the highest score of all, and did so for a dose that was less than the highest. These results were confirmed on a second phantom of entirely different design. PMID- 3814999 TI - Staging of prostatic carcinoma with radionuclide bone scintigraphy and lymphography. AB - One hundred patients with histologically proven carcinoma of the prostate were examined by radionuclide bone scintigraphy and bipedal lymphography. In 27 cases the bone scintigram and lymphogram were positive, in 16 the bone scintigram only was positive and in 10 the lymphogram only was positive. Although radionuclide bone scintigraphy is the most useful single investigation for detecting metastatic spread from prostatic carcinoma, lymphography should be performed if the bone scintigram is negative, as it is likely to demonstrate nodal metastases in 18% of patients. PMID- 3815000 TI - Image non-uniformity in magnetic resonance imaging: its magnitude and methods for its correction. PMID- 3815001 TI - Adrenal-cell carcinoma and rhabdomyosarcoma occurring in father and daughter: "SBLA" syndrome? PMID- 3815002 TI - The case of the recalcitrant Welshman. PMID- 3815003 TI - The relationship between the misonidazole "pre-incubation" effect and misonidazole-induced depletion of cellular GSH. PMID- 3815004 TI - Colour display of quantitative blood flow and cardiac anatomy in a single magnetic resonance cine loop. AB - A method of displaying on a single image both the anatomical and the quantitative blood-flow information obtainable from cardiac magnetic resonance has been developed. Anatomical and parametric blood velocity images are combined to produce a computer-processed composite image suitable for display with a specially designed colour scale. Methods for dealing with imperfections in the input images and for obviating technical problems encountered in computer cine display are described. The clinical application of the method is illustrated using eight coronal frames from a normal subject. PMID- 3815005 TI - Paget's disease of bone in Africans. AB - Fourteen cases of Paget's disease of bone seen in an African community over a 4 year period are reported. During a comparable 4-year period, no case of Paget's disease was seen in a busy radiology department of a teaching hospital in Nigeria. It is suggested that Paget's disease of bone may not be uncommon in some African communities and that the striking geographical variation in the incidence of this disease in Europe, America and elsewhere is applicable to Africa also. PMID- 3815006 TI - Neurological morbidity of arch and carotid arteriography in cerebrovascular disease. The influence of contrast medium and radiologist. AB - A prospective study of 230 arch and carotid arteriograms in 229 patients with symptomatic cerebrovascular disease revealed that neurological morbidity was not significantly affected by patient age, nature of neurological symptoms, duration of procedure, volume of contrast medium or degree of arterial stenosis. The total neurological morbidity of 132 examinations carried out with non-ionic contrast medium (iohexol) was slightly lower than that of 98 examinations carried out with ionic contrast medium (meglumine and sodium iothalamate) but the difference was not statistically significant. However, the morbidity of 185 examinations performed by an experienced vascular radiologist was significantly lower (p less than 0.025) than the morbidity of 45 examinations performed by a series of radiologists in training and the mean time required for the procedure was 18 min longer in the latter group (p less than 0.001). These findings suggest that the neurological morbidity of arch and carotid arteriography in patients with cerebrovascular disease depends largely upon catheter technique and will not be significantly reduced by the use of non-ionic contrast medium. PMID- 3815007 TI - Limb muscle compression: an alternative technique for intravenous digital subtraction angiography. AB - A simple, muscle-compression technique to introduce a bolus of contrast medium from hand or foot injections for intravenous digital subtraction angiography (DSA) is described. Fifty millilitres of the non-ionic contrast medium iopamidol 300 was used for each projection. In 18 out of the 20 examinations an acceptably diagnostic arteriogram was obtained. It is suggested that the compression technique is a useful alternative for intravenous DSA when conventional venous access is impossible. PMID- 3815008 TI - Evaluation of subjective assessment of liver function from radionuclide images. AB - The appearance of non-hepatic uptake in 99Tcm-colloid images is an important indicator of poor liver function. We undertook this study to evaluate the ability of experienced observers to assess liver function from radionuclide images. A simple model was used to simulate the changing distribution of 99Tcm-colloid in the liver, spleen and bone marrow as the liver function and mass were varied. Suitable images of these three organs were isolated from real studies and used as "templates" to create realistic simulated 99Tcm-colloid images, with the count densities of liver, spleen and bone marrow determined by the model. These images were presented in random order to several observers, who were asked to assess liver function. Comparison of the estimated with the true function shows that visual assessment is systematically inaccurate, with underestimation of poor function and overestimation of good function. It is also imprecise, especially for livers with only midly impaired function. Observers were also affected by changing liver mass and were more likely to judge small livers to be abnormal. We suggest that objective assessment using a quantitative technique should be used as an adjunct to visual inspection for the evaluation of liver function. PMID- 3815009 TI - Comparison of low-osmolar contrast media in paediatric cardiac angiography. AB - Sixty-two children investigated by cardiac angiography for a wide spectrum of congenital heart disease were randomly assigned to one of two groups, one for iohexol, 350 mg I/ml (Omnipaque, Nycomed UK Ltd) and one for iopamidol, 370 mg I/ml (Niopam, E. Merck Ltd). Changes in systolic pressure, end-diastolic pressure when the injection was made into a ventricle, heart rate and rhythm and plasma osmolality were assessed at 1 min and 3 min after the injection of contrast medium. The angiograms were subjectively assessed for angiographic quality. No significant differences were detected between the two groups. PMID- 3815010 TI - Accuracy and precision in the measurement of relaxation times from nuclear magnetic resonance images. AB - The accuracy (proximity to the true value) and precision (reproducibility) of relaxation times derived from nuclear magnetic resonance images were investigated. Two methods of deriving relaxation times were considered. A patient scanning protocol in which the minimum number of scans necessary for the calculation (three) were performed. Calculated T1 and T2 images were then formed. An animal (cat) protocol in which many more scans were performed. The data were read from the display and fitted by computer to the theoretical curves. The accuracy of the measurements was determined by an empirical method. A series of bottles with different concentrations of MnCl2 and CuSO4 in water were prepared and their relaxation times determined using the imager as a simple pulsed spectrometer. These values were compared with those derived from images. Over the normal range of tissue values (T1 less than 700 ms, T2 less than 200 ms) the animal protocol gave values of T1 up to 1% shorter than the true values. The T2 values were up to 5% shorter. Patient protocol values were up to 7% shorter for T1 and up to 20% shorter for T2. There was some difference between results for MnCl2 and for CuSO4 (particularly for patient T2s), suggesting that the results depend to a small extent on the T1/T2 ratio. The precision of the values was investigated by considering the standard deviations (SDs) of brain tissue measurements over populations of cats (animal protocols) and normal control subjects and multiple sclerosis patients (patient protocols). These were compared with the SDs of measurements of calibration bottles scanned with the patients. Standard deviations of 3% for T1 and 6% for T2 were found over 19 cats using the animal protocols; SDs of 7% for T1 and 14% for T2 were found over 15 normal control subjects using the patient protocols. Standard deviations of bottle measurements were similar to these figures. There are also variations between different subjects and different regions of the brain. There was no significant change between readings on the same patient in follow-up studies. Other sources of variation in the measurements made with the patient protocols were investigated by scanning phantoms. Noise in T1 and T2 images is about 2%. Spatial non-uniformity within slices is about 1% for T1 and 10% for T2. Non-uniformity between slices in multislice sets is 4% for T1 and 14% for T2. There is no long term variation in measured values over 9 months; short-term variation is approximately 1%. PMID- 3815011 TI - Patient doses and risks from diagnostic radiology in North-east Italy. AB - A study has been conducted to asses the impact of radiological practice in 1983 in Friuli-Venezia Giulia, a region of North-east Italy with 1,250,000 inhabitants. The design involved three phases: a region-wide frequency survey; dosimetric measurements on patients in all public X-ray facilities; derivation of organ doses from those measurements. Frequencies by type, age and sex and values of the main technical parameters of radiological examinations are presented. Organ doses, effective dose equivalents and risk estimates are given for 14 selected examinations. The annual per-capita effective dose equivalent and the genetically significant dose are estimated at 0.848 mSv and 0.253 mSv, respectively. From these values, collective risks have been predicted by using the risk factors given in the International Commission on Radiological Protection Publication 26. The results indicate that 14 persons risk induced malignancies and 2.5 persons risk genetic detriment. PMID- 3815012 TI - An investigation into the levels of radiation exposure in diagnostic examinations involving fluoroscopy. AB - In order to investigate the levels of radiation exposure resulting from fluoroscopic examinations, area-exposure product measurements were performed on 6532 patients whilst undergoing a variety of examinations at a large district general hospital. Results for both the same and different types of examinations, performed in two different X-ray rooms by a number of different radiologists, are compared in order to highlight some of the factors which influence the wide variations in patient exposure which frequently occur in radiological examinations. Variations in exposure of patients of different weights are also presented. PMID- 3815013 TI - The associated X-ray spectra of Amersham caesium-137 afterloading sources. AB - Low-energy X rays are clearly observed in the energy spectra of Amersham 137Cs afterloading sources. Examination is made of the effects of encapsulation and source train attenuation on the source spectra. Estimates of the resulting X-ray intensities are also made. PMID- 3815014 TI - Scattered radiation reaching doors and windows of diagnostic X-ray rooms. PMID- 3815015 TI - A minimum data input computer program for Selectron treatment calculation. PMID- 3815016 TI - Massive intracranial pannus and a pseudomeningocoele in the atlanto-dental interval in rheumatoid arthritis. PMID- 3815017 TI - Wandering spleen. PMID- 3815018 TI - Unilateral juvenile hypertrophy of the breast. PMID- 3815019 TI - Iodinated contrast agents as "radiosensitizers". PMID- 3815020 TI - The lead apron: room for improvement? PMID- 3815021 TI - Amersham afterloading system. PMID- 3815022 TI - TLD patient monitoring. PMID- 3815023 TI - Maximal gastric secretion and duodenogastric reflux in patients with gastric or duodenal ulcer and in control subjects. AB - Maximal gastric secretion was studied in 41 unoperated patients with gastric ulcer, 201 patients with duodenal ulcer, and 122 control subjects. The patients with a gastric ulcer were divided into high, body and prepyloric, according to the site of the ulcer. Both high and body gastric ulcers secreted significantly less than the controls, and the duodenal ulcer patients secreted significantly more. However, the patients with gastric ulcer were older and lighter than the controls and, since these factors are known to influence maximal gastric secretion, the controls and patients with duodenal ulcer were standardized to the mean weight (and age, for the controls) of the gastric ulcer group. After this standardization, there was no significant difference in secretion between the patients with body ulcers and normal controls. Pyloric loss was a similar percentage of maximal gastric secretion in all groups, but duodenogastric reflux was higher in the gastric ulcer group compared to the controls. The mean volume of duodenogastric reflux was greatest in the patients with a prepyloric gastric ulcer. It is commonly accepted that hyposecretion in patients with a gastric ulcer is due to gastritis consequent upon increased duodenogastric reflux. However, in this study, no gastric hyposecretion was evident in the body and prepyloric gastric ulcer groups, both of whom had greater than normal levels of duodenogastric reflux. PMID- 3815024 TI - Perisplenitis and perinephritis in the Curtis-Fitz-Hugh syndrome. AB - Four cases of the Curtis-Fitz-Hugh syndrome diagnosed laparoscopically and with microbiological or serological evidence of chlamydial pelvic infection are reviewed. The case histories emphasize the part played by renal angle and left upper quadrant symptoms. In one patient the surface of the spleen was affected by the same classical inflammation normally seen on the surface of the liver. In 3 patients bilateral or left-sided renal angle pain and tenderness constituted the presenting features, or a major manifestation, and in all patients renal tract investigations were entirely normal. The patient with laparoscopic perisplenitis also had perihepatitis and pelvic inflammation, the latter being florid in all cases. Perisplenitis and perinephritis are proposed as possible additional manifestations of this syndrome. PMID- 3815025 TI - Strangulating small bowel obstruction due to an intra-uterine contraceptive device. PMID- 3815026 TI - Pancreatic resection for carcinoma of the pancreas and the periampullary region in patients over 70 years of age. AB - This study was undertaken to elucidate whether or not resection for cancer of the pancreas and the periampullary region can be performed with an acceptable survival rate in patients over 70 years of age (n = 21) as compared with patients under 70 years of age (n = 47), and whether resection provides an improvement in their prognosis and longevity. The operative mortality for patients over 70 years of age and under 70 years was 10 and 9 per cent respectively and the cumulative 5 years survival 12 +/- 11 and 20 +/- 9 per cent respectively. The median survival was 11 months in both groups. It was concluded that an age of 70 years or more is not an absolute contra-indication for pancreatic resection. Prognosis is related to tumour histology. PMID- 3815027 TI - Surgical staging of gastric carcinoma: sources and consequences of error. AB - Macroscopic 'TNM' staging was performed during 78 consecutive operations for gastric carcinoma and compared with subsequent pathological staging. Surgical assessment was correct for tumour (T) in 60 per cent when depth of invasion was assessed, for nodes (N) in 61 per cent, for liver metastases (M) in 92 per cent but for all aspects in only 21 per cent. Curability (conservatively defined as T1 3, N0-1, M0) was correct in 8 of 18 patients thus assessed at surgery and incurability was pathologically correct in 58 of 60 patients. Despite inaccurate surgical staging, no patient was denied a resection although 10 patients had unduly radical procedures for their stage and 2 had inappropriately conservative procedures for their stage (but without evidence of residual disease). Staging errors did not jeopardize conventional surgical management substantially and use of intra-operative microscopic sampling of nodes would have improved surgical treatment only minimally. PMID- 3815028 TI - Present status of pharyngogastric anastomosis following pharyngolaryngo oesophagectomy. AB - Pharyngolaryngo-oesophagectomy with pharyngogastric anastomosis was described more than 25 years ago. Since then it has been employed for the treatment of cancers of the hypopharynx, cervical oesophagus and larynx. Results of recent reports showed a wide variability. Our previous report of 157 such operations gave a significant morbidity and overall hospital mortality rate of 31 per cent. In the 6-year period between 1980 and 1985, 91 patients underwent this operation. The morbidity and mortality rates gradually decreased to 30 and 5 per cent respectively. Changes in the indications for the operation resulted in a reduction in the number of procedures performed in recent years. Resection of the oesophagus for cancers of the pharyngolaryngeal region is indicated only when there is actual oesophageal involvement, and would be the prime indication of pharyngogastric anastomosis. PMID- 3815029 TI - Arrow wounds to the heart and mediastinum. AB - Wooden tipped arrows are still used in tribal fighting in the Highlands of Papua New Guinea. Thirteen cases of arrow injury to the heart and mediastinum, presenting at Mt. Hagen Hospital in a 2-year period, are described. Ten cases presented early (within 3 days) while the remaining 3 cases presented late and suffered from mediastinal abscesses. Removal of the arrow, after full visualization with repair where possible, was performed in all cases with two deaths and little morbidity. Most of the 13 patients arrived in a stable condition, withstood surgery well and made a rapid recovery (average stay in hospital 20 days). Unstable presentations included 2 cases of mild shock, one with early cardiac tamponade and one case of acute aortic incompetence. Survival figures justify attempted salvage of these patients, even with the limited facilities available. PMID- 3815030 TI - Bush thoracotomy in the highlands of Papua New Guinea. AB - Bush thoracotomy is a procedure performed by traditional medicine men to let out blood and pus from the chest. It has a significant complication rate and 60 cases presenting to the major hospital in Papua New Guinea are analysed over a 2-year period. The complications were empyema (40), osteomyelitis of the rib (2), wound infection (2), pneumothorax (1), neuralgia (1) and chest pain (4). All cases were further complicated by underlying pulmonary infection and often by delay in presentation. Fifteen cases were seen in the first year (1983-84) and forty-five in the second (1984-85). A more aggressive surgical approach was adopted in the second year (21 thoracotomies with 17 decortications compared with 1 thoracoplasty in the first year). However, this course of events was accompanied by an increase in mortality from 0 to 5. Although there were a number of contributory factors, lesser surgical procedures, such as open pleural drainage, are recommended for the sicker patients. PMID- 3815031 TI - Prognostic significance of the DNA content of human breast cancer. AB - The DNA content of paraffin embedded primary tumour tissue has been measured by flow cytometry in 354 patients with operable breast cancer. Tumour ploidy significantly correlated with tumour size, histological grade, and with menopausal status. No significant correlation with oestrogen receptor status or lymph node involvement was found. Patients with diploid cancers had a significantly improved short term survival and disease-free interval (DFI) compared with patients having aneuploid tumours. However, no difference in survival or DFI was shown after longer term follow-up (median 84 months). Multivariate analysis showed no independently significant prognostic value for tumour ploidy. No patient in this study received adjuvant therapy. PMID- 3815032 TI - The intragastric balloon: a novel idea proved ineffective. AB - Twelve grossly obese patients who weighed 121 +/- 22 kg (mean +/- s.d.) had a free-floating 600 ml spherical intragastric balloon inserted per oesophagus and have been followed for 12-24 months. Nine patients lost up to 21 kg (11 +/- 6.4 kg) over 3 months after which they reached a plateau and then regained weight so that by 1 year only one patient had maintained her weight loss. Three patients could not tolerate the balloon owing to complete reflex inhibition of gastric emptying. Such marginal and temporary weight loss is of no value in the treatment of gross obesity. PMID- 3815033 TI - Chloroquine administration for malaria suppression after abdominal surgery. AB - Administration of chloroquine after major surgery is indicated in malaria endemic areas. In emergencies it is commonly administered parenterally after the operation. The present study, undertaken at St. Francis Hospital, Ifakara (Kilombero District), Tanzania, compared plasma chloroquine levels after oral and subcutaneous administration of 300 mg of chloroquine base in 14 patients after abdominal, non-bowel-resective surgery and in 12 controls. There were no significant differences in the plasma chloroquine levels of all groups, and the chloroquine concentrations reached suppressive levels for at least 3 days (greater than 0.1 nmol/ml). Oral administration was well tolerated in both patients and controls. In all areas where the Plasmodium strains are still sensitive to chloroquine and where parenteral chloroquine may not be easily available, oral chloroquine represents a cheap, easy and safe alternative for postoperative prophylactic malaria suppression. It can be applied after abdominal non-bowel-resective emergency surgery. PMID- 3815034 TI - Kinetics of intra operative pH of the canine corpus fundal mucosa before and after truncal vagotomy. AB - The intra-operative surface pH of the corpus fundic mucosa in anaesthetized dogs was studied with a glass electrode during stimulation with graded doses of pentagastrin. The mucosal pH could be related to the dose of pentagastrin by a hyperbolic curve. With intact vagus ED50 averaged 0.67 micrograms kg-1 h-1 of pentagastrin and maximum effect corresponded to an average pH of 1.9. Immediately after truncal vagotomy there was a significant shift of the curve to the right corresponding to an average ED50 of 3.77 micrograms kg-1 h-1, an effect that could be described as that of a competitive inhibitor. Two weeks after vagotomy the value of ED50 had returned to the prevagotomy level. The high ED50 immediately after vagotomy is ascribed to the sudden fall in the subthreshold release of acetylcholine previously supplied by the intact vagus. The return to the low ED50 2 weeks later could be explained by denervation supersensitivity. The relation between the curves before and immediately after vagotomy suggests that the dose of the agonist be as low as possible, when testing the completeness of a vagotomy intra-operatively. PMID- 3815035 TI - Management of caustic ingestion in adults. AB - The treatment of 484 adults with caustic ingestion injury is discussed. Signs and symptoms are an unreliable guide to injury and a chest X-ray and fibreoptic endoscopy should be performed as soon as possible. All of the 250 patients who developed superficial lesions of the oesophagus, stomach or duodenum experienced healing without sequelae. Forty-four patients required emergency surgery of whom twenty-four died and oesophagectomy without thoracotomy is now advocated for this group, followed by interval surgery to restore continuity. The remaining 190 patients suffered gastric or oesophageal ulceration without necrosis: 92 recovered without complication, 3 succumbed to aorto-oesophageal fistula, 12 survived following delayed surgery for complications and 83 developed oesophageal and/or gastric stenosis which subsequently required endoscopic or surgical treatment. PMID- 3815036 TI - Gangrene of the right colon: a rare complication of trauma-related systemic hypotension. PMID- 3815037 TI - Actinomycosis of the pancreas. PMID- 3815038 TI - The dangers of home-brewing: oesophageal rupture. PMID- 3815039 TI - Testicular torsion. PMID- 3815040 TI - Popliteal artery trauma: a high risk injury. AB - The clinical presentation and management of 28 popliteal artery injuries following penetrating and blunt trauma during a 6 year period is reviewed. Clinical and Doppler evaluation identified an arterial injury in 24 (85 per cent) patients. In eight (29 per cent) patients with arteriovenous fistulae or false aneurysms, pedal pulses were palpable during initial assessment. Three (10.7 per cent) patients had limb amputation attributable to delayed vascular repair, crush injury and sepsis. End-to-end arterial repair following blunt trauma resulted in early failure with thrombosis in two patients. Autogenous vein grafting was used in 12 patients and is advocated in all blunt popliteal arterial injuries. Routine repair of associated venous injuries and liberal criteria for early fasciotomy were used. Exoskeletal fixation or skeletal traction for compound and comminuted fractures is recommended for simplicity of application and wound management. The significant functional orthopaedic disability following blunt arterial trauma at the knee is emphasized. PMID- 3815041 TI - Staphylococcal infection of open granulating wounds. AB - The significance of staphylococcal infection has been studied prospectively in 250 wounds healing by open granulation. In a series of 50 axillary skin excisions, 17 became infected with Staphylococcus aureus with consequent pain and delay in healing. The infections responded well to Fucidin ointment. Nasal carriers of the organism may be especially liable to this complication. In contrast, although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied. The susceptibility of superficial wounds to the infection is ascribed to friction from dressings. Deep granulating wounds are occasionally affected similarly when the cavity has filled. PMID- 3815042 TI - Auditing the vascular surgical audit. AB - The results are presented of vascular surgical audits in Oxford over the 10 years 1975-85. Changes observed include the decreasing use of endarterectomy (other than carotid), the introduction of transluminal angioplasty, and fewer lumbar sympathectomies. The number of major amputations has increased relative to arterial reconstructions. Our audit methods over the 10 years included the use of punch cards, two different computer programs, and a simple weekly audit of cases. The relative merits of these methods are compared. Numbers of procedures performed in Oxford were compared with expected figures calculated from the Hospital In-patient Enquiry, the Lothian audit, and the Vascular Surgical Society survey. In general the calculated and actual numbers are similar. Difficulties in finding comparable operation categories and the totally inadequate classification of nationally collected data highlight the need for improved audit in vascular surgery. PMID- 3815043 TI - Endoscopic surgery. PMID- 3815044 TI - Endoscopic instrumentation: evolution, physical principles and clinical aspects. PMID- 3815045 TI - Rigid endoscopies: optical and design considerations. PMID- 3815046 TI - Aspects of endoscopic documentation. PMID- 3815047 TI - Vascular endoscopy: current state of the art. PMID- 3815048 TI - Lack of laterality effect for monaural categorization of VOT and TOT stimuli. AB - Sixteen right-handed males were tested for lateral preference and consistency of identification of stimuli differing in voice-onset time (VOT) or tone-onset time (TOT). A continuum of 10 stimuli of each type was presented monaurally to the right and left ears, and reaction times (RTs) were recorded each time a participant indicated a choice between a voiced [da] and a voiceless [ta] alternative for VOT, or between the presence of one type of tone or another for TOT. Results indicated that both classes of stimuli were perceived as having unique boundaries, with the TOT boundary being lower than that of the VOT continuum. VOTs were identified more quickly than TOTs, and the two ears did not differ in consistency or speed of identification for either condition. Results cannot be used to support the idea that the two hemispheres process voice-onset time differently than tone-onset asynchronies. In view of the absence of a right ear advantage for VOT, however, the use of a monaural task for eliciting hemispheric asymmetries is not recommended. PMID- 3815049 TI - Aphasic performance on a lexical decision task: multiple meanings and word frequency. AB - The lexical access of words varying in the number of meanings and frequency of occurrence was examined in fluent and nonfluent aphasic individuals and a control group of non-brain-damaged adults, using a lexical decision task. Fluent aphasic subjects performed similarly to nonfluent aphasic and normal subjects, showing that words with a high number of meanings and with a high frequency of occurrence were recognized as real words faster than words with few meanings or a low frequency of occurrence. While previous research has demonstrated that the number of meanings associated with a word exerts a powerful influence on the internal lexicon of normals, the results of this study suggest that brain damage resulting in aphasia does not disrupt this semantic organization. PMID- 3815050 TI - Speech event related potentials reflect linguistic content and processing level. AB - Amplitude changes in the auditory event related response reflect differences in linguistic content and the level of processing of spoken sentences. Thus, the neurophysiology of the cognitive processes underlying speech perception can be evaluated by noninvasive techniques. Semantically correct, semantically incorrect, and grammatically incorrect sentences were processed either semantically or syntactically by 25 subjects while their EEGs were recorded. The amplitude of the P250 component to each word varied with processing level. A slow positive wave appeared after semantically correct sentences regardless of the linguistic processing level. N480 and P780 components were observed following words which made the sentences incorrect. PMID- 3815051 TI - Verbal expression of right cerebrovascular accident patients: convergent and divergent language. AB - This investigation examined the role of the right hemisphere in language expression. Three groups of 12 subjects each--right CVAs, left CVAs, and controls -performed convergent and divergent language tasks of naming, function, and connected speech. For all convergent tasks and for number of words, number of message units, and fluency in divergent connected speech, controls surpassed both brain-damaged groups, who performed similarly. For the other divergent tasks, controls were superior to the brain-damaged groups, but the right CVAs outperformed the left CVAs. In general, verbal expression problems of right hemisphere-damaged patients were almost as severe as those of left-hemisphere damaged patients. PMID- 3815052 TI - Unexpected reading precocity in a normal preschooler: implications for hyperlexia. AB - This is a case study of a left-handed, preschool boy of superior intelligence who read very early and at a level well beyond what his IQ would predict. He is developmentally normal with no signs of autism or related disorders. His reading age was 9.3 at age 2-11 and 11.2 at 4-2; these levels are considerably beyond what would be predicted by his IQ or language age. He was able to read nonwords and both regular and irregular words equally well, indicating his mechanisms of lexical access in reading are similar to those of normal readers. Unlike classical hyperlexics, his reading comprehension for both single words and sentences was well above age level. When his precocious reading first appeared, he was also advanced in reading-related linguistic skills, such as phoneme awareness, auditory verbal short-term memory, and word retrieval, but not in visuospatial skills. These results imply that neither pathological language and/or social development, nor pathological variation in the normal mechanisms of lexical access in reading are necessary causes for reading precocity in early childhood. A model for integrating subtypes of precocious readers with subtypes of normal and dyslexic readers is proposed. PMID- 3815054 TI - Agrammatism and the coindexation of traces: comments on Grodzinsky's reply. PMID- 3815053 TI - Isolated lexical agraphia in a right-handed patient with a posterior lesion of the right cerebral hemisphere. AB - Lexical agraphia is thought to result from impairment of the lexical spelling system and is characterized by better spelling of nonwords and regularly spelled words than irregularly spelled words. Previous reports have suggested a localization of this syndrome in the region of the left posterior-superior angular gyrus and parietal-occipital lobule, sparing the supramarginal gyrus. We describe a right-handed man who after open-heart surgery displayed lexical agraphia without aphasia, alexia, apraxia, or Gerstmann's syndrome. Computed tomography disclosed a lesion not on the left but on the right in the posterior parietal-occipital region. PMID- 3815055 TI - Aphasics' appreciation of hierarchical semantic categories. AB - The mental representative structure of hierarchically ordered semantic categories was explored with 66 aphasic patients and 60 normal adults by a word-verification task. Four words concerning living things and 10 line drawings depicting an object were prepared as stimuli. All possible pairings of each of the four words with each of the 10 line drawings were made to be verified. The results indicated that subjective category domains were more diffusive in aphasic patients than in normal adults, and that this alteration was exclusively due to increase of peripheral members, but not of central members. It was also revealed that normative category boundaries may be preserved vestigially or incompletely in aphasic patients except the severe fluent subgroup, in whom there may be profound disintegration of boundaries. On the other hand, some common features concerning intracategorical structure and preference among levels of abstraction across normal adults and aphasic patients permit the hypothesis that aphasic patients may retain partially normal semantic knowledge. PMID- 3815056 TI - Temporal processing in deaf signers. AB - The auditory and visual modalities differ in their capacities for temporal analysis, and speech relies on more rapid temporal contrasts than does sign language. We examined whether congenitally deaf signers show enhanced or diminished capacities for processing rapidly varying visual signals in light of the differences in sensory and language experience of deaf and hearing individuals. Four experiments compared rapid temporal analysis in deaf signers and hearing subjects at three different levels: sensation, perception, and memory. Experiment 1 measured critical flicker frequency thresholds and Experiment 2, two-point thresholds to a flashing light. Experiments 3-4 investigated perception and memory for the temporal order of rapidly varying nonlinguistic visual forms. In contrast to certain previous studies, specifically those investigating the effects of short-term sensory deprivation, no significant differences between deaf and hearing subjects were found at any level. Deaf signers do not show diminished capacities for rapid temporal analysis, in comparison to hearing individuals. The data also suggest that the deficits in rapid temporal analysis reported previously for children with developmental language delay cannot be attributed to lack of experience with speech processing and production. PMID- 3815057 TI - Categorical perception for voicing contrasts in normal and lead-treated rhesus monkeys: electrophysiological indices. AB - Categorical perception of voicing contrasts was evaluated in rhesus monkeys. The monkeys had been chronically exposed to subclinical levels of lead either from conception to birth, or for approximately 6 months postnatally beginning at birth, or were never exposed to lead. Auditory evoked responses were recorded at 1 year of age from scalp electrodes placed over the left and right hemispheres during stimulus presentation. A late component of the brain responses recorded from the right temporal region of all monkeys discriminated between stimuli in a categorical manner. This pattern of responses was noted to be similar to that previously reported for humans. Categorical discriminations were also noted earlier in the waveforms for control monkeys and for monkeys exposed to lead prenatally, although this discrimination pattern shifted to the left hemisphere of the latter group. No such effects were noted for monkeys exposed to lead postnatally. These results suggest that the neurocortical mechanisms associated with categorical perception for voicing information may be similar across human and nonhuman primates. However, early exposure to lead appears to alter these processes. PMID- 3815058 TI - Accessibility of case and gender contrasts for agent--object assignment in Broca's aphasics and fluent anomics. AB - Yugoslav agrammatic Broca's aphasics, fluent anomics, and control subjects were tested for comprehension of agent-object relations in a series of simple Serbo Croatian sentences in the conversational past tense, consisting of two nouns and a transitive action verb. The availability of two closed class cues--case contrasts and gender contrasts--as well as the availability of an open class lexical cue--animacy contrasts--was varied across sentences. An analysis of subjects' agent-object assignments yielded the following results: Both Broca's aphasics and fluent anomics showed a selective impairment in sensitivity to closed class morphology, although anomics were considerably less impaired than Broca's aphasics. This finding was interpreted as evidence for a non-syndrome dependent vulnerability of abilities to process closed class morphology for comprehension. In addition, the pattern of agent-object assignments for Broca's aphasics revealed that the degree to which they were able to access the two closed class cues depended on a convergence of the various cues to agent-object relations. In particular, a convergence of case and gender contrasts had an interactive effect on Broca's responses: Gender agreement cues were accessed only in the presence of convergent case contrasts. Conversely, sensitivity to case contrasts was dramatically heightened in the presence of convergent gender contrasts. These results were consistent with a view that the two cues function as intrasentential "primes" or "retrieval cues" for one another. PMID- 3815059 TI - Laterality patterns in young fluent readers. AB - Neuropsychological profiles of kindergarten children who were reading fluently with understanding were compared with those of both chronological age controls and reading level controls. Finger tapping, dichotic listening, and nonverbal intersensory tasks succeeded in differentiating the two kindergarten groups, but not the kindergarten readers and the older reading level controls. Correlations among the measures were significant only for the young fluent readers, with greater bilaterality of both fine motor and linguistic functions being associated with better intersensory skills, indicating qualitative differences in central nervous system organization. Neuropsychological predisposition to early acquisition of reading is suggested. PMID- 3815060 TI - Processing passive sentences in aphasia: deficits and strategies. AB - Broca's and Wernicke's aphasics' ability to process passive sentences in the absence of semantic cues was investigated in an experiment which varies syntactic complexity and word order. The results indicate that Broca and Wernicke patients use different strategies for sentence comprehension. Wernicke patients use rather general strategies for interpretation, which assign syntactic function according to sequential arrangements of words. Broca's aphasics, by contrast, base their interpretation on specific structural elements of the sentence's surface form, without, however, being able to exploit the full syntactic information of these elements. The different strategies are interpreted to reflect differential underlying deficits. PMID- 3815061 TI - Autoradiographic study on the distribution of vagal afferent nerve fibers in the gastroduodenal wall of the rabbit. AB - Following unilateral supranodose vagotomy which eliminated vagal efferent fibers, [3H]leucine was injected into the ipsilateral no-dose ganglion of the rabbit, which was allowed to survive for 10 days. Autoradiographic examination of the distribution of vagal afferent fibers in the gastroduodenal wall revealed many nerve bundles of labeled afferent fibers present in the subserous plexus between the serosa and the muscle coat, where they branched and descended into the muscle coat. Some of the fibers appeared to interact with some myenteric neurons and muscle fibers in a manner suggesting that the afferent fibers may make synaptic contact with the enteric neurons and innervate or attach to the muscle fibers. Furthermore, the afferent fibers were observed in the submucosal plexus between the muscle coat and the muscularis mucosae. In the mucosa the afferent nerve branched in filaments containing one or several afferent fibers extending from the muscularis mucosae through the mucous lamina propria and to the mucous membrane composed of epithelial cells. It was speculated that the afferent fibers terminated as free endings near the mucous membrane. PMID- 3815062 TI - Bilateral morphological changes in the substantia nigra of the rat following unilateral damage of the striatum. AB - The effects of damage of the striatum and globus pallidus of one side on the size of cells in the pars reticulata and pars compacta of the substantia nigra on both sides and in the contralateral globus pallidus have been examined. Cellular cross sectional areas have been compared with those for neurons in the same nuclei in normal age and sex matched littermate control animals. One week after removal of the left striatum and globus pallidus and overlying cortex, the cells in the ipsilateral pars compacta are significantly shrunken (15%). This decrease in size gets progressively more marked with longer survival times reaching 50% 112 days after operation, the longest survival time examined. The shrinkage is accompanied by marked cell loss. Neurons in the contralateral pars compacta show an initial significant hypertrophy of their cell bodies (20%) in the first week after the operation, and later show a shrinkage of 20% at 35 days. The degree of this contralateral shrinkage gradually declines to 12% at 112 days. The changes in the pars compacta are accompanied by a significant enlargement (33%) of the cells in the pars reticulata of the substantia nigra on the side of the damage. This hypertrophy is present by 35 days after operation and persists at least until 112 days. Similar hypertrophy occurs in the ipsilateral globus pallidus in the one case where this could be examined. There are no significant changes in the contralateral pars reticulata, but there is significant enlargement (23%) of the neurons in the contralateral globus pallidus. PMID- 3815063 TI - Rapid eye movement (REM) sleep and ponto-geniculo-occipital (PGO) spike density are increased by somatic stimulation. AB - It has been shown that REM sleep duration and ponto-geniculo-occipital (PGO) spike density can be enhanced by auditory stimulation. The purpose of this study was to determine whether this effect is restricted to the auditory sensory modality or whether somatic stimulation can produce similar effects. Cats implanted with electrodes for recording the sleep-wake cycle were additionally prepared with clip electrodes placed in the neck for somatic stimulation. Such stimulus was applied at the beginning and throughout each REM sleep period. The effect of this procedure was compared to a similar period when no stimulus was applied. The results showed that somatic stimulation induced a significant increase in REM duration (60.2%) and PGO spike density. Since the effects of somatic stimuli are identical to auditory ones, it is suggested that all sensory modalities may share the property of influencing the mechanisms which regulate the maintenance of REM sleep. Such mechanisms are discussed in terms of an increase in the excitability levels of polymodal medial reticular neurons. PMID- 3815064 TI - The nervus terminalis of the shark: the effect of efferent impulses on ganglion cell activity. AB - Tonic activity was recorded extracellularly in the nervus terminalis of the bonnethead shark. Cutting or cooling the nerve central to its ganglion eliminated these spikes, and was followed by an increase in multi-unit activity which appeared to arise from the ganglion. After cutting centrally, electrical stimulation of the distal stump of the nerve suppressed this multi-unit activity. The data suggest that efferent impulses may normally suppress ganglion cell activity. PMID- 3815065 TI - Autoradiographic localization and characterization of circumventricular angiotensin II receptors in duck brain. AB - Binding of [125I-5Val]angiotensin II and [125I-1Sar, 8Ile]angiotensin II to target sites in the hypothalamus of the Pekin duck was determined by quantitative receptor autoradiography and conventional membrane binding techniques. Circumventricular areas involved in body fluid homeostasis like the subfornical organ (SFO), median eminence and the anterior-ventral region of the third ventricle showed highest labeling density. Binding sites for angiotensin II were also found in the paraventricular and supraoptic nuclei. The physiological relevance of the labeled SFO angiotensin II receptor is indicated by similarities between rank orders of potency of angiotensin II analogues in displacing radiolabeled ligands and their physiological osmoregulatory potencies. Receptor density in the SFO of saltwater-acclimated ducks was increased 3-fold compared to non-acclimated freshwater ducks, indicating an up-regulation of the angiotensinergic system in ducks under conditions of dehydration or high salt intake. PMID- 3815066 TI - Pavlovian conditioning of discriminatively elicited eyeblink responses with short onset latency attributable to lengthened interstimulus intervals. AB - Conditioned eyeblink responses were obtained in cats by pairing click (CS) with glabella tap (US) and electrical stimulation of the hypothalamus (HS). Hiss was used as a discriminative stimulus (DS). Onset latencies of conditioned responses (CRs) of 20-56 ms were obtained by using an interstimulus interval (ISI) of 570 10 ms between CS and US-HS. Longer latency (90-320 ms) blink CRs were obtained with ISIs of 340-240 and 340-10 ms. The timing of associatively learned movements has been thought to increase with lengthening of the intervals between CS and US presentation. The production of shorter latency CRs of this type by lengthening the ISI is a novel result and one unexpected from widely held beliefs. PMID- 3815067 TI - Acetylcholine stores in rat diaphragm are increased by higher concentrations of dexamethasone. AB - In indirectly stimulated hemidiaphragms, dexamethasone (Dex, 2 microM) causes a significant increase in tissue acetylcholine (ACh) content. No increase in tissue ACh is found with 0.2, 0.6 or 6 microM Dex. Physostigmine (Physo, 15 microM) also causes an increase in tissue ACh, which is even greater in the presence of Dex (6 25 microM). There is no increase in ACh due to Dex, with 50 microM Dex plus Physo. The order of addition is important, as the Dex-induced increase in ACh is only found when Dex is added before Physo. No increase in twitch tension is found with any of these treatments. No Dex-induced increase in ACh is found with unstimulated hemidiaphragms. Similar increases in ACh are also found with other glucocorticoids (plus Physo), namely prednisolone (6-9 microM), corticosterone (2 microM) and hydrocortisone (2 microM). The mineralocorticoid aldosterone (2 microM), and other types of steroids cause no increase in tissue ACh. The increases in hemidiaphragm ACh are not found in a Na+-depleted medium, or in a medium containing 20 mM Mg2+ extra. The increase in ACh due to Physo is Ca2+ dependent, even though an increase in ACh due to Dex plus Physo is found in the absence of Ca2+. No increase in ACh due to either Physo, or Dex plus Physo are found in the presence of the nicotinic antagonists (+)-tubocurarine (5 microM) or alpha-cobrotoxin (5 micrograms/ml), while the muscarinic ligands atropine or oxotremorine (10 microM) abolish the extra increase in ACh due to Dex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815068 TI - Selective enhancement of dopamine utilization in the rat prefrontal cortex by food deprivation. AB - Previous studies have indicated that food deprivation exerts various effects on brain neurotransmitters and that mild stress causes a selective enhancement of dopamine activity in the rat medial prefrontal cortex. In the present study it was found that in rats 24 h of food deprivation produced an increase in levels of the dopamine metabolite 3,4-dihydroxyphenylacetic acid in the medial prefrontal cortex but not in the nucleus accumbens or caudate-putamen. This selective increase in mesocortical dopamine activity is comparable to that found with mild footshock stress exposure and indicates that food deprivation may function as a stressor. PMID- 3815069 TI - Bombesin alters the sympathetic nervous system response to cold exposure. AB - The accumulation of dopamine in interscapular brown fat, heart, kidney and mesenteric white fat has been used as an index of sympathetic nervous activity in rats in which dopamine beta-hydroxylase has been blocked. Intracerebroventricular administration of bombesin impaired the cold-induced increase of dopamine accumulation in interscapular brown fat but not in other tissues. These studies provide evidence that bombesin acts within the central nervous system to modify efferent sympathetic nervous system responses to cold exposure in a viscerotopically specific manner. This action of bombesin is consistent with the other central nervous system actions of this peptide, i.e. inhibition of heat production and disruption of thermoregulation. PMID- 3815070 TI - Responses of rat lateral hypothalamic neuron activity to vestibular nuclei stimulation. AB - Effects of lateral vestibular nucleus (LVN) stimulation on neuronal activity in the rat lateral hypothalamic area (LHA), including specific glucose-sensitive neurons, were investigated by extracellular and intracellular recordings in vivo. Stimulation of the contralateral LVN evoked 3 types of response in 46% (111/240) of the neurons recorded extracellularly: long latency (38.1 +/- 23.6 ms) excitation (62/111, 56%), short latency (6.9 +/- 3.1 ms) excitation-inhibition (33/111, 30%), and inhibition with 20.1 +/- 11.1 ms latency (16/111, 14%). Glucose-sensitive neurons, which were identified by electrophoretic application of glucose, did not respond specifically to such stimulation. Neuronal activity was recorded intracellularly from 31 LHA neurons, of which 13 responded to LVN stimulation. Seven of the 13 neurons showed a long latency EPSP (10.4 +/- 5.5 ms) and the remaining 6 exhibited an EPSP-IPSP sequence with shorter latency (4.5 +/- 3.0 ms). The amplitude of these responses was graded with a change in stimulus intensity. The EPSPs of both types of response were considered to be polysynaptic because of shortening of latencies by higher current stimulation. Since the LHA is implicated in the regulation of autonomic nerve activity, the present results showing polysynaptic pathways from the LVN to the LHA suggest functional involvement of the LHA in vestibulo-autonomic responses. PMID- 3815071 TI - The effect of an acute nicotine infusion on the local cerebral glucose utilization of the awake rat. AB - The effect of acute infusion of nicotine on local cerebral glucose utilization (LCGU) was studied in discrete regions of the central nervous system of the rat by means of the quantitative autoradiographic 2-deoxy-D-[1-14C]glucose method described by Sokoloff et al. Nicotine was administered in 3 dosages: 0.5 microgram/kg/min, 1.58 micrograms/kg/min and 5 micrograms/kg/min. The resulting plasma concentrations of nicotine were 10/39/114 ng/ml plasma. During the experiment, blood pressure, heart rate, body temperature, hematocrit, acid-base status and plasma glucose concentration showed no--or minor--changes. Nicotine significantly increased LCGU in a dose-dependent manner in the following 9 of 45 examined structures: substantia nigra (compact part), superior colliculus (superficial grey layer), interpeduncular nucleus and cingulate cortex (P less than 0.01); lateral geniculate body, optic chiasm, anteroventral and anteromedial nucleus of thalamus and mamillary body (P less than 0.05). For most of these structures with increased LCGU, other groups have reported a high regional receptor binding of nicotine (exception: mamillary body and optic chiasm). It is concluded that nicotine has distinct effects on the functional activity of localized brain areas. PMID- 3815072 TI - The fibers which leave the Probst's longitudinal bundle seen in the brain of an acallosal mouse: a study with the horseradish peroxidase technique. AB - The congenital absence of the corpus callosum, a brain anomaly frequently noted in humans, has been recently found to occur in some mice of the ddN strain in our laboratory. In the brains of these mice, the Probst's longitudinal bundle is always present on both cerebral hemispheres and gives rise to some aberrant fibers toward the midline. In this research, the neuroanatomical features of these fibers were studied by iontophoretical injections of horseradish peroxidase (HRP) into the neocortex of acallosal mouse brains. The results revealed that the fibers which leave the Probst's longitudinal bundle are, at least, of 3 kinds: namely, the fibers that run out from the anterior portion of the bundle and take a U-turn ipsilaterally without crossing the midline through the septal tissue to go back again into the longitudinal bundle at the level where they have left it; the commissural fibers that leave the bundle from its middle portion and cross through a tiny bridge of tissue associated with the ventral hippocampal commissure to the opposite hemisphere; and the fibers that arise from the posterior portion of the bundle and accumulate as an anomalous fascicle below the cingulum. The observation that no labeled fibers were seen within the anterior commissure in the present HRP materials suggests that the axons from neocortex which are prevented from crossing the midline in mice with congenital absence of the corpus callosum cannot find an alternative pathway via the anterior commissure. PMID- 3815073 TI - Multiple high-affinity [3H]serotonin binding sites in human frontal cortex. AB - High-affinity [3H]serotonin (5-hydroxytryptamine, 5-HT) binding sites from human frontal cortex can be divided into at least 3 pharmacological subtypes (5-HT1A, 5 HT1B and 5-HT3) based on affinity for [3H]serotonin and spiperone. All 3 sites are solubilized by 3% Triton X-100, 1% Tween-80 and can be enriched by serotonin linked-Sepharose 4B affinity chromatography. However, 5-HT3 sites are more sensitive to heat inactivation, long-term storage, and sulfhydrylalkylation. The pharmacological profiles are distinct for the spiperone-insensitive 5-HT1B and 5 HT3 sites in both human and bovine cortex. In addition, evidence is presented for the existence of a novel, low concentration [3H]serotonin binding site in human cortex. PMID- 3815074 TI - Interaction between neurons in precentral cortical zones controlling different joints. AB - The relationship of the strength of interaction between precentral cortical neurons and their distance of separation during active reaching movements was studied in adult primates. Chronic unit recording experiments with two independent microelectrodes were performed in the left precentral forearm area of monkeys trained to execute reaching movements with the right arm in response to a visual cue. Neurons were identified by the joint actions produced by intracortical microstimulation. Cross-correlation analysis was employed to assess the strength of interaction between units. Unit pairs which exhibited the highest strength were recorded by the same electrode. For unit pairs derived from separate electrodes, the incidence and strength of interaction fell as the separation between the units was increased. Neurons identified by intracortical microstimulation as controlling the same or contiguous joints tended to interact with each other with much higher probability than did those neurons identified as controlling non-contiguous joints. When the direction of flow of information was assessed, these was a preferential flow from neurons controlling proximal joints to those controlling distal ones. These results are consistent with recent findings of tight kinematic coupling between contiguous joints and the observation of proximal-to-distal sequence of activation at the neuronal and electromyogram levels during voluntary movement. PMID- 3815075 TI - Development of tolerance to respiratory depression in morphine- and etorphine pellet-implanted mice. AB - Tolerance to opiate-induced depression of respiratory rate was studied in unanesthetized mice following chronic treatment with morphine or etorphine. Mice implanted subcutaneously (s.c.) with morphine pellets showed development of tolerance to morphine administered both s.c. and intracerebroventricularly (i.c.v.) and to s.c. etorphine and heroin. However, no cross-tolerance to i.c.v. etorphine or heroin was observed. In contrast, mice implanted with etorphine pellets demonstrated development of tolerance to all 3 agents given either s.c. or i.c.v. These findings on development of tolerance to opiate-induced respiratory depression differ from our previous studies measuring analgesia in which mice tolerant to s.c. morphine did not demonstrate development of tolerance to s.c. etorphine or heroin (unidirectional non-cross-tolerance). To investigate a possible mechanism for this difference in development of tolerance, apparent pA2 values for respiratory rate depression were determined for s.c. morphine naloxone and etorphine-naloxone. The apparent pA2 values for these two opiates were similar, in contrast to the dissimilar apparent pA2 values previously found when analgesia was measured. The apparent pA2 values demonstrated differences between the respiratory depressant and analgesic effects of these opiates, but there was no obvious relationship between apparent pA2 values and the absence of unidirectional non-cross-tolerance observed for respiratory depression. PMID- 3815076 TI - Monoamine-containing neurons in the Aplysia brain. AB - The localization of monoamine-containing neurons in the CNS of Aplysia depilans has been studied by fluorescent histochemistry (the glyoxylic acid condensation method) and microspectrofluorimetry. Yellow fluorescent nerve cells and fibers show the emission maximum at 515-520 nm which corresponds to that of serotonin fluorophore in a model system. Green fluorescent nerve cells have the emission maximum at 485 nm which corresponds to that of catecholamine. Central catecholamine-containing neurons were found in cerebral, buccal, pedal and unpaired abdominal ganglia. The majority of them were revealed in cerebral ganglia (about 40). Serotonin-containing neurons are abundant in cerebral and pedal ganglia. More than 30 serotonin-containing nerve cells were localized in cerebral ganglia. In the right pedal ganglion approximately 100 neurons were revealed; in the left one about 150. In the abdominal ganglion all nerve cells of this chemical type (except one) are located in the right hemiganglion. The results are summarized in corresponding schemes. PMID- 3815077 TI - Acetylcholinesterase in the human retina. AB - The distribution of cholinesterase activity in the human retina was evaluated using histochemical methods. The butyrylcholine esterase (BuChE) inhibitor tetraisopropylpyrophosphoramide was used to localize acetylcholinesterase (AChE) activity, the AChE inhibitor BW284c51 was used to localize BuChE activity, and eserine was used to inhibit all cholinesterase activity in control incubations. We have found specific AChE activity in the inner plexiform layer (IPL) and BuChE activity is apparently associated with blood vessels at the light microscopic level. At the electron microscopic level, AChE reaction product is seen both at apparently synaptic and manifestly non-synaptic sites. Reaction product is found adjacent to neural processes in the IPL; these processes have an ultrastructure characteristic of amacrine cells. Although reaction product is seen adjacent to bipolar, ganglion and Muller cells, it is only present where they come into contact with apparent amacrine cell profiles. Using longer incubations, reaction product is found in the perikarya of cells with the morphology and position of amacrine and displaced amacrine cells. There is also some evidence for AChE activity adjacent to lateral processes at a rare type of rod synapse in the outer plexiform layer. The observations reported here strengthen the evidence for cholinergic neurotransmission in the human retina. PMID- 3815078 TI - On a neural mechanism for cortical processing of taste quality in the rat. AB - The responses of 31 chorda tympani fibers and 47 cortical neurons were recorded in response to 6 concentrations of NaCl, and single concentrations of sucrose, HCl, and quinine hydrochloride solutions applied to the anterior portion of the tongue in rats. The neural responses were analyzed in terms of the two hypotheses of quality coding: across-neuron response pattern and across-region response pattern notions. In a behavioral experiment, animals were given a conditioned taste aversion to one of 5 concentrations of NaCl solution by pairing it with a gastrointestinal illness caused by i.p. injection of 0.15 M LiCl. Behavioral taste profiles were constructed for each stimulus from the suppression of drinking, which indicates the extent of generalization of aversion to each of the 4 basic taste stimuli. Among the two neural analyses employed for the chorda tympani and cortical units, across-region correlation coefficients for cortical neurons that were derived from the across-region response pattern theory showed the highest correlation (r = 0.89) with the behavioral suppression rates. Across neuron correlation coefficients in the chorda tympani fibers also showed a good correlation (r = 0.81) with the behavioral data. However, the taste profile for 1.0 M NaCl in chorda tympani fibers was very similar to that for the lower concentrations of NaCl, in spite of the suggestion from the behavioral experiment and the neural analyses of cortical responses that 1.0 M NaCl has HCl and quinine components besides the NaCl component. The present result confirmed the idea that processing of taste information in the cortex involves differences in both response magnitude across neurons and the spatial localization of those neurons. PMID- 3815079 TI - Behavioral dependence of the electrical activity of intracerebrally transplanted fetal hippocampus. AB - Adult rats with unilateral aspirative lesions of the fimbria-fornix and the overlying cingulate cortex received implants of 17-day-old fetal hippocampal tissue in the lesion cavity, placed to form a tissue bridge across the cavity. From 6 to 8 months later they were equipped with chronic recording and stimulating electrodes in the transplant and the host brain. The dominant electrical pattern of the graft consisted of irregularly occurring sharp waves (SPW) or EEG spikes of 30-150 ms duration and concurrent synchronous neuronal bursts of large cell populations. SPWs occurred during all behaviors but their frequency was significantly lower during running than during drinking. Population bursts of neurons in the graft could be evoked by stimulating either the ipsilateral host hippocampus or the perforant path. Both complex spike cells and single spike cells could be recorded from the graft. The discharge frequency of single spike cells was considerably higher during running than during drinking or immobility. Some of the single spike cells in the graft fired rhythmically at 6-9 Hz during running and walking, and phase-locked with the rhythmic slow EEG activity (theta, theta-EEG) recorded from the intact host hippocampus. Occasionally field theta-EEG was also present in the graft. These findings suggest that at least a portion of the graft neurons had come under the control of the host brain, and by way of the newly established host-graft connections the activity of some graft neurons was regulated in a near-normal manner. PMID- 3815080 TI - Restoration of rhythmic slow activity (theta) in the subcortically denervated hippocampus by fetal CNS transplants. AB - Solid pieces of the fetal septal region (SG) or hippocampus (HPC) were implanted in a cavity formed by aspiration of the fimbria fornix (FF) and the overlying cingulate cortex on one side in adult rats. In other lesioned animals cell suspensions obtained from the fetal septal area (SS) or the locus coeruleus region of the brainstem (LC) were injected stereotaxically into the deafferented host hippocampus. Six to 9 months after transplantation the animals had chronic recording electrodes implanted into both hippocampi. EEG and unit activity were monitored during running in a wheel, drinking and immobility. Unilateral fimbria fornix lesions abolished rhythmic slow activity (RSA or theta, theta) in the ipsilateral hippocampus and no recovery was seen up to 9 months later in either the control FF-lesioned animals or in the rats with LC suspension grafts. Recovery of RSA, however, was observed in all animals with solid septal grafts and in some rats with solid HPC grafts. Similar to normal rats, RSA was present only during running and absent during drinking and sitting still. Coherence measurements of RSA between the transplanted and intact hemispheres resulted in high values (0.70-0.95). Concurrent with RSA, interneurons and granule cells in the host hippocampus fired rhythmically at RSA frequency (6-9 Hz). The depth profile and the antero-posterior distribution of the power of RSA correlated with the amount and distribution of the graft-induced acetylcholinesterase-positive reinnervation of the host hippocampus. In contrast to the animals with solid septal grafts, placed within the FF lesion cavity, the rats with intrahippocampal septal suspension grafts displayed only short duration bursts of RSA, and mainly during immobility. Based on these findings it is suggested that at least a proportion of the RSA 'pacemaker' cells of the host septum survives the transection of the fimbria-fornix fibers and that a graft of fetal septal or hippocampal tissue implanted into the lesion cavity may be capable of relaying this pacemaker activity to the host hippocampus. This effect may be due to the ability of the grafted tissue to promote the regeneration of new, direct or indirect, septo-hippocampal connections across the lesion cavity. PMID- 3815082 TI - Trigeminal responses to thermal stimulation of the oral cavity in rattlesnakes (Crotalus viridis) before and after bilateral anesthetization of the facial pit organs. AB - Multiunit neural responses from the superficial maxillary branch of the trigeminal nerve in prairie rattlesnakes were elicited by intraoral thermal stimulation. The responses to oral stimulation were shown to be independent of responses obtained by thermal stimulation of the loreal pits. Histological examination of the dorsal lip, palate, and fang sheath regions revealed dense ramifying neurons in the epidermal layers of the fang sheaths that were morphologically similar to suspected infrared sensitive neurons in the pit membranes. PMID- 3815081 TI - NADPH diaphorase activity in the posterior pituitary: relation to neuronal function. AB - Magnocellular neurons of the paraventricular and supraoptic nuclei, fibers of the medial basal hypothalamus, and the posterior pituitary gland all stain histochemically for NADPH diaphorase activity (NADPHd). Following 8 days of salt loading to stimulate the hypothalamo-neurohypophyseal system, NADPHd activity, as determined by a spectrophotometric assay, is markedly increased in the posterior pituitary gland but not in the hypothalamus of rats. Therefore, NADPHd activity in this system correlates with neuronal function and may provide a convenient method for the assessment of neuronal activity in selected neuronal populations. PMID- 3815083 TI - Carbamazepine suppresses synchronized afterdischarging in disinhibited immature rat hippocampus in vitro. AB - Bath application of therapeutic concentrations of the anticonvulsant carbamazepine suppressed penicillin-induced synchronized afterdischarging in immature rat CA3 hippocampal pyramidal cells. Afterdischarging was completely abolished in all preparations at a concentration of 30 microM (IC50 = 8.5 +/- 1.4 microM; mean +/- S.E.M.). The duration of the preceding epileptiform burst was not altered at this concentration and was diminished by only 24.4 +/- 1.2% at a supratherapeutic concentration of 100 microM. These results suggest that a carbamazepine-sensitive neurophysiological mechanism distinct from those responsible for epileptiform burst generation plays a key role in the generation of afterdischarges in developing hippocampus. PMID- 3815084 TI - Effect of preganglionic stimulation on neuropeptide-like immunoreactivity in the stellate ganglion of the cat. AB - In pentobarbital-anesthetized cats, treated with hexamethonium and atropine, 40 Hz stimulation of the preganglionic input to the decentralized right stellate ganglion caused cardioacceleration. When the 40-Hz stimulation is maintained for 2 h, this cardioacceleration was progressively attenuated and eventually irreversibly lost. At this time, neurotensin-like and leucine-enkephalin-like immunoreactivity associated with intraganglionic fibers and presumptive axon terminals was also lost. Preganglionic 40 Hz stimulation for 2 h did not change substance P-like, somatostatin-like, vasoactive intestinal peptide-like and corticotropin-releasing factor-like immunoreactivity in the stellate ganglion. A 40-Hz 2-h stimulation of the intact stellate ganglion output caused no change of the neuropeptide immunoreactivity pattern. These findings suggest that neurotensin and leucine-enkephalin are released by sympathetic preganglionic axon terminals and that the releasable pool of these peptides is depleted by prolonged preganglionic stimulation. The association of peptide depletion with loss of the cardioacceleration, evoked by stimulation of the input to the stellate ganglion in the presence of cholinergic antagonists, suggests the possibility that peptides are involved in the non-cholinergic mechanism of ganglionic transmission mediating the cardioacceleration. PMID- 3815085 TI - Denervation supersensitivity of 5-HT-1c receptors in rat choroid plexus. AB - Serotonin (5-HT)-stimulated phosphoinositide hydrolysis in the choroid plexus is mediated by the 5-HT-1c receptor. The current study demonstrates that treatment of rats with the serotonergic neurotoxin, 5,7-dihydroxytryptamine, caused a marked depletion of 5-HT and a supersensitive 5-HT-1c mediated phosphoinositide hydrolysis response. These data suggest that the 5-HT-1c site in choroid plexus receives tonic serotonergic input. PMID- 3815086 TI - Serotonergic involvement in the backward tumbling response of the parlor tumbler pigeon. AB - The parlor tumbler is a breed of domestic pigeon which displays a hereditary movement disorder resulting in backward somersaulting upon attempting to fly. A neurochemical abnormality has been suggested to underlie this behavior. The effect on tumbling of several drugs with serotonergic actions was studied. Increasing available serotonin with 5-hydroxytryptamine (50 mg/kg) plus fluoxetine (10 mg/kg) as well as using amitriptyline (10-20 mg/kg) significantly suppressed tumbling without sedation. This suggests that serotonin mechanisms may be involved in the tumbling response. PMID- 3815087 TI - Effects of total and partial spinal transections on the pudendal nerve-evoked response in rat lumbar axial muscle. AB - The pudendal nerve-evoked activity in lumbar axial muscle nerves 24-48 h following spinal transections was studied in order to examine the supraspinal control of the pudendal nerve-evoked response (PNER). After total transections of the spinal cord in the thoracic region the overall activity in the muscle nerves was much reduced; the evoked responses consisted only of a single peak in activity 19.8 ms (+/- 1.4 ms) following the last shock of a 3-shock pudendal nerve stimulus demonstrating that some of the earliest responses previously described for the PNER are segmental in origin. To help identify supraspinal inputs to the PNER a series of partial transections were made to cut selectively different fiber columns within the cord. Four different surgical procedures were performed: transections of the entire dorsal half of the cord; ablations of all of the medial columns; combined lesions of the dorsal half and medial columns, sparing the tracts within the ventrolateral columns and bilateral transections of the lateral columns. Following all partial transections except those of the lateral columns, the PNER was similar to that seen in intact animals. After lateral column transections however, the responses were like those seen in the totally transected animals. The combined results suggest that supraspinal influences upon the PNER are conveyed primarily via the ventrolateral columns of the spinal cord. Bilateral convergence of afferent information was evident in the totally transected animals, indicating that such convergence can occur at segmental levels. The lesions which substantially altered the PNER closely paralleled those which eliminated lordotic responsiveness in behaving female rats. PMID- 3815088 TI - Localization of optic tectal input to the ventral dendrite of the goldfish Mauthner cell. AB - Although visually evoked Mauthner cell (M-cell) startle responses occur in the goldfish, the afferent projections underlying these reactions have not been previously studied. We have recorded from the M-cell while stimulating the left optic nerve and/or right optic tectum and have traced projections of the optic nerve and restricted areas of the optic tectum using HRP histochemistry and autoradiography. Tectal stimulation elicits similar postsynaptic potentials (PSPs) in both M-cells. The responses recorded in the right (ipsilateral) cell were localized to its ventral dendrite. The existence of uncrossed tectal projections to the ventral dendrite was confirmed morphologically following application of horseradish peroxidase (HRP) to the optic tectum. The PSPs contained both inhibitory and excitatory components, but with adequate stimulus strength, excitation of either M-cell dominated. Thus, this pathway is probably sufficient to trigger visually evoked startle responses mediated by the M-cell. Stimulation of the left optic nerve also evoked PSPs capable of bringing both M cells to threshold. The blockage of this response by conditioning stimulation of the right tectum suggests that the visual information is relayed to the M-cells through this structure. In support of these findings, no label was found near any portion of the M-cell after either intraocular injection of tritiated proline or application of HRP to the cut end of the optic nerve. In summary, visual input to the M-cell is mediated via projections from the tectum, is segregated onto the ventral dendrite, and is capable of bringing this neuron to threshold. This pathway presumably accounts for the demonstrated behavioral efficacy of visual stimuli in evoking a startle response. PMID- 3815089 TI - Site-dependent central effects of aldosterone in rats. AB - A relationship between the subcommissural organ (SCO) and the adrenal glands has long been suspected. This report provides further information about the effects of a continuous D-aldosterone infusion into the SCO area of conscious, adult male Sprague-Dawley rats. A 6-day aldosterone infusion (5 ng/h) increased urinary sodium excretion, decreased adrenal medullary cross-sectional area, elevated adrenal corticosterone content and terminal plasma epinephrine concentration. Mineralocorticoid infusions directly into a lateral cerebral ventricle did not affect these parameters but, unlike SCO area infusions, decreased consummatory behavior. Infusions of tritiated aldosterone into the SCO area revealed that radioactivity was mainly confined to dorsomedial portions of the brain near the SCO, whereas the pineal body contained only background radioactivity. The data support the concept that the SCO area interacts with physiological systems related to both the adrenal cortex and medulla. PMID- 3815090 TI - Distribution of glutaminase activity in retinal layers of rat and guinea pig. AB - The glutaminase activity in rat and guinea pig retina is twice as high in photoreceptor inner segments as in any other layer. Since the inner segments are involved in non-transmitter-related metabolic functions, it is suggested that glutaminase should not necessarily be taken to imply glutamatergic neurotransmission until the function of the high activity in regions such as the inner segments is better understood. PMID- 3815091 TI - Effects of aortic nerve stimulation on cervical sympathetic preganglionic neurones in the rat. AB - The effects of aortic nerve stimulation on the activity of single cervical sympathetic preganglionic neurones have been studied. Based upon the relationship of their firing patterns to central respiratory drive the neurones were categorized as either expiratory-related, inspiratory-related or non-modulated. Aortic nerve stimulation depressed the activity of each type of neurone indicating that irrespective of their respiratory modulation they are amenable to baroreceptor control. PMID- 3815092 TI - The effects of chronic stress on corticosterone, GH and TSH response to morphine administration. AB - The effects of a chronic stress model in which several acute stressors were applied on a random basis on corticosterone, growth hormone (GH) and thyroid stimulating hormone (TSH) responses to morphine administration were studied in adult male rats. Chronic stress resulted in lower corticosterone response to the drug. In contrast, GH response to morphine was enhanced in the former animals and TSH response remained unchanged. The physiological role of changes in hormone response to opiates remains to be established, but the present results suggest that central opioid pathways involved in the neuroendocrine control of the anterior pituitary did not respond homogeneously to chronic stress. PMID- 3815093 TI - Cerebral metabolic mapping at the cellular level with dry-mount autoradiography of [3H]2-deoxyglucose. AB - The uptake and retention of radioactivity from [3H]2-deoxyglucose [( 3H]2-DG) was assessed in certain regions of the rat brain under basal conditions using dry mount autoradiography, a procedure which affords the best available conditions to accurately localize diffusable radiolabeled compounds at cellular and subcellular levels. The overall amount of radioactivity accumulated in neuropil and in neuronal cell bodies was similar in most brain regions examined. Of the regions assessed, the CA3 pyramidal cell field of the hippocampus was the only region in which the radioactivity in cell bodies was notably greater than that of neuropil. In the somatosensory cortex and in the lateral hypothalamus, a wide range of radioactivity was found among individual neurons and among different areas of neuropil. In all brain regions examined, a subpopulation of small cells, with morphological characteristics of glial cells, accumulated [3H]2-DG to a much greater extent than other glial cells or neurons. That finding suggests that certain glial cells are in a markedly higher metabolic state than other brain cells. PMID- 3815094 TI - Blood-brain transport and regional distribution of bromo-benzodiazepine. AB - The blood-brain transport and regional distribution of a tritium-labeled, brominated benzodiazepine (BFB) was determined for the rat brain in vivo. The unidirectional transport constant from blood to brain was measured by a graphical, integral method and was found to be 0.83 ml/g/min, a value which indicates that transport is essentially flow-dependent. The apparent volume of distribution increased linearly during the measurement period, suggesting that back transport from brain to blood was zero and that BFB was trapped in the tissue, possibly by specific receptors or acceptors. Under the conditions of these experiments, autoradiography of brain tissue sections indicated a regional distribution of [3H]BFB similar to that expected for regional cerebral blood flow. These results indicate that BFB is a useful blood flow tracer in brain and suggest that BFB radiobrominated with bromine-75 may, under appropriate conditions, be a suitable tracer for in vivo regional blood flow measurement or benzodiazepine receptor mapping by positron-emission tomography. PMID- 3815095 TI - Movement-related potentials within the hippocampal formation of the monkey. AB - A series of large amplitude potentials were recorded within and surrounding the hippocampal formation in association with repetitive, self-paced hand movements in the monkey. The earliest component precedes the onset of muscle contraction by approximately 100 ms, inverts in polarity across the pyramidal cell layer of CA3 and CA1 and is coincident with increased local multiple unit activity (MUA). Later components, generated within the hippocampal formation, follow the muscle contraction by as much as 600 ms and are not associated with net changes in MUA. The onset of voluntary movements is often associated with desynchronization of low-frequency rhythmic hippocampal EEG patterns and these changes antecede the movement. The findings strongly suggest that the hippocampal formation is involved in the initiation and control of even simple voluntary movements in the primate. PMID- 3815096 TI - Inhibition of spontaneous activity of spinal dorsal horn neurons in the intact cat is naloxone-insensitive. AB - Low-threshold neurons in the dorsal horn of the spinal cord of physiologically intact, awake, drug-free cats demonstrate minimal rates of spontaneous activity. Studies in acute animals suggest that the lack of spontaneous activity is due to descending inhibitory control mechanisms. The present study suggests that the inhibition of spontaneous activity is naloxone-insensitive. Intravenously administered naloxone in doses of up to 0.4 mg/kg failed to have any effect on the spontaneous activity of the 34 low-threshold neurons recorded from the dorsal horn of the spinal cord of physiologically intact, awake animals. Stimulus-evoked activity was also not significantly influenced by the doses of naloxone used in this study. These results confirm data previously obtained by others using acute preparations. This confirmation is important in that it demonstrates that, for this system, differences between acute and chronic preparations do not appear to alter neuronal sensitivity to specific drug manipulations. They also verify that, for this system, acute experiments accurately reflect conditions that exist in the intact animal. PMID- 3815097 TI - Stimulation of the pontomedullary reticular formation initiates locomotion in decerebrate birds. AB - The initiation and control of spinal locomotor mechanisms by supraspinal brainstem centers has been studied in many vertebrate species. However there is very little information regarding brainstem-spinal pathways involved in avian locomotion. To undertake these studies, birds (geese or ducks) were placed in a stereotaxic frame and decerebrated under halothane anesthesia. After anesthesia was discontinued, discrete brainstem regions were electrically stimulated. Locomotion could be evoked from several areas within the pontomedullary reticular formation. The stimulus threshold for evoking walking ranged from 25-50 microA at 30-80 Hz (pulse duration 0.5 ms). At slightly higher current strengths (50-100 microA) wing flapping ('flying') was initiated. Histological examination of the stimulation sites indicated that the predominant locomotor areas were restricted to the ventromedial gigantocellular reticular formation and a more dorsolateral location within the parvocellular reticular formation. To ascertain whether neurons in these regions of the avian brainstem project directly to the spinal cord, a retrograde fluorescent tracer dye, True blue, was injected into either the cervical or low thoracic spinal cord. Comparing the positions of the retrogradely labeled neurons and the effective locomotor stimulation sites indicated a high degree of overlap. The present results, when compared with previous studies, suggest strong similarities in descending brainstem control of locomotion for all vertebrates. PMID- 3815098 TI - Synaptic organization of the nucleus dorsolateralis anterior thalami in the Japanese quail (Coturnix coturnix japonica). AB - The nucleus dorsolateralis anterior thalami (DLA) of birds is the homologue of the mammalian dorsal lateral geniculate nucleus. The positions of terminals from the retina and visual Wulst upon identified relay neurons in the DLA were examined in Japanese quail with both light and electron microscopic techniques. Injection of horseradish peroxidase (HRP) into the visual Wulst showed that relay neurons projecting ipsilaterally or contralaterally were located in a rostrolateral subdivision (DLAlr) and in Zones A and B of a lateral subdivision (DLL) of the DLA. Removal of the contralateral eye resulted in dense terminal degeneration in the DLAlr and moderate terminal degeneration in Zones A and B. By contrast, lesions in the visual Wulst produced dense degenerating terminals in Zones A and B of the DLL. The somata and proximal dendrites of relay neurons or terminals from the retina in the DLA were identified electron microscopically following HRP injection into the visual Wulst or optic nerve, respectively. Terminals from the retina contained spherical vesicles, glycogen granules, and mitochondria with widely spaced cristae. Terminals from the retina made synaptic contact with proximal dendrites and somata of HRP-labeled relay neurons. Presynaptic dendrites formed symmetric synaptic contact with dendrites of relay neurons. Synaptic glomeruli were observed in the DLAlr that involved dendrites of relay neurons, terminals from the retina and presynaptic dendrites. Lesions of the visual Wulst resulted in degeneration of small terminals with spherical vesicles. These terminals were not involved in the synaptic glomeruli of the DLA, but made asymmetric contacts with spines of unidentified neurons and with terminals of presynaptic dendrites. PMID- 3815099 TI - A direct comparison of amphetamine-induced behaviours and regional brain dopamine release in the rat using intracerebral dialysis. AB - An intracerebral microdialysis method was used in awake rats to directly compare the effect of amphetamine on dopamine (DA) release in the striatum and nucleus (n.) accumbens with alterations in behaviour. Amphetamine (0.5-5.0 mg/kg, s.c.) caused a dose-dependent release of DA in both brain regions; however the n. accumbens appeared for the most part more sensitive to amphetamine than the striatum. At each individual dose of the drug, 0.5, 2.0 and 5.0 mg/kg s.c., DA release was closely followed over the time course by the overall behavioural syndrome. Certain components of behaviour showed a regional-specific association with DA release. The intensity of stereotyped head and forepaw movements was closely correlated over the dose range with the amount of DA released in striatum but not n. accumbens. Over the time course, however, the occurrence of this behaviour was delayed compared to increased striatal DA release. In contrast, increased locomotor activity was correlated with the time course change in, and amount of, DA released in n. accumbens by low doses of amphetamine, but not at any dose with DA released in striatum. Repetitive sniffing was better correlated with DA released in n. accumbens than striatum. These in vivo measurements of DA release add further support to the hypothesis that amphetamine-induced stereotypy and locomotion are mediated via DA released in striatum and n. accumbens, respectively. Our data suggest that the occurrence of intense stereotypy rather than locomotor activity at high doses of amphetamine is not due to a selection action in striatum but probably competition between the two behaviours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815100 TI - Membrane properties of glossopharyngeal sensory neurons in the petrosal ganglion of the cat. AB - The active and passive properties of petrosal ganglion sensory neurons with axons in the glossopharyngeal nerve were examined with intracellular microelectrodes in an in vitro preparation. Glossopharyngeal neurons could be classified into two groups: H-cells showing an inflexion or hump on the falling phase of the spike and F-cells, generating a short action potential without a hump. Most of the neurons found (85%) were H-cells. The axonal conduction velocity of both types of cells fell into the A delta range, although the average value for F-cells (13 m/s) was higher than that found for H-cells (10 m/s). H- and F-cells had similar resting membrane potentials and input resistances, but different action potential characteristics. F-cells showed a smaller action potential with a faster rate of depolarization, followed by a shorter after-hyperpolarization. The response to depolarizing current pulses applied through the microelectrode was also different in both types of cells. About half of the H-cells could not be depolarized to threshold while 85% of F-cells generated spikes. It is concluded that two different populations of petrosal ganglion neurons send axons into the glossopharyngeal nerve. PMID- 3815101 TI - Differential labeling of the vestibular complex following unilateral injections of horseradish peroxidase into the cat and rat locus coeruleus. AB - Following unilateral injections of horseradish peroxidase into the cat and rat locus coeruleus (LC), bilateral retrograde labeling was evident in all 4 vestibular nuclei. In both species, the major contributions of LC afferents arose from the ipsilateral rather than the contralateral vestibular nuclei. Quantitative analysis in the rat has indicated that approximately 90% of the total vestibular-LC projections originated from the ipsilateral vestibular nuclear complex, with 10% from the contralateral. The frequency distribution was in the order of lateral greater than medial greater than superior greater than inferior vestibular nuclei. PMID- 3815102 TI - Effect of cysteamine on somatostatin and neuropeptide Y in rat striatum and cortical synaptosomes. AB - Local injection of cysteamine into rat striatum results in a rapid but reversible reduction in somatostatin-like immunoreactivity (SLI). Since somatostatin and neuropeptide Y are co-localized in striatal and cortical neurons, we examined the effects of cysteamine in these areas. SLI and neuropeptide Y-like immunoreactivity (NPYLI) were measured following local injection of cysteamine into the striatum. In addition, we examined the effects of cysteamine on SLI and NPYLI in cortical synaptosomes. SLI was significantly reduced in both experiments, but NPYLI was unaffected. These results suggest that the mechanism by which somatostatin is depleted by cysteamine is one of specific biochemical modification, probably affecting the somatostatin disulfide bond, rather than one affecting neuronal metabolism. PMID- 3815103 TI - Inhibition of nociceptive responses of laminae V-VII dorsal horn neurones by stimulation of mixed and muscle nerves, in the cat. AB - Low frequency (1-3 Hz) stimulation of muscle nerves (ipsilateral medial and lateral gastrocnemius nerves) had to be applied at intensities which would recruit C-fibre afferents, to produce inhibition of nociceptive responses of cat lumbar spinal cord laminae V-VII units. Inhibitory responses evoked by muscle nerve stimulation and also by mixed nerve stimulation could be blocked by microionophoretically applied bicuculline. No effects on these inhibitions were obtained with naloxone. PMID- 3815104 TI - Failure to confirm report of light-evoked response of peripheral nerve to low power helium-neon laser light stimulus. PMID- 3815105 TI - Indications for a critical period for synapse elimination in developing rat cerebral cortex cultures. AB - It was observed in an earlier study that chronic tetrodotoxin (TTX) blockade of spontaneous bioelectric activity (SBA) in rat cerebral cortex cultures prevented the large-scale elimination of synapses which normally occurs during the fourth week in vitro. This prompted us to study whether the persisting high synapse density during long-term TTX-treatment would still return to the "normal' low level after restoration of SBA. Therefore, cultures grown in TTX-supplemented medium for 5 weeks were switched to control medium for an additional week prior to fixation. Electron microscopic analysis showed that the numerical synapse density remained at a high level, thus suggesting the presence of a critical period whereafter bioelectrically controlled elimination of redundant connections no longer occurs. In contrast, the mean size of synaptic structures depended only on the functional state of the tissue at the moment of fixation, being larger in TTX-silenced cultures than in bioelectrically active ones regardless of treatment during the first 5 weeks in vitro. PMID- 3815106 TI - Rat astrocytes and Schwann cells in culture synthesize nerve growth factor-like neurite-promoting factors. AB - Neurite-promoting activity in feeding medium conditioned by rat astrocytes and Schwann cells in culture was examined. The conditioned medium (CM) from both types of glial cultures stimulated extensive neurite outgrowth from embryonic chick dorsal root ganglia (DRG) as well as pheochromocytoma (PC12) cells. Both the DRG and PC12 cells also produce neurite outgrowth in the presence of nerve growth factor (NGF). With the DRG, the neurite growth rates observed with the glial cell CM were identical to growth rates seen with NGF. Although anti-NGF antibody did not inhibit the neurite outgrowth produced by either of the glial CM, a nerve growth factor radioreceptor assay did detect an NGF-like molecule in both CM. Since the extensive neurite outgrowth stimulated by the glial CM was not mimicked by pure laminin alone, we conclude that the glial neurite promoting factors are distinct from laminin. PMID- 3815107 TI - Age-related changes in striatal dopamine activity following nigral muscimol infusions. AB - Microinfusions of muscimol into the substantia nigra pars reticulata produced marked increases in striatal dopamine (DA) utilization without affecting striatal DA concentration in adult rats. In contrast, muscimol increased striatal DA concentration and decreased DA utilization in 16-day-old rat pups. The striatal norepinephrine concentration was not altered in either group. Since previous studies have shown that similar infusions of muscimol are anticonvulsant in adults and proconvulsant in rat pups, our results suggest that the nigrostriatal pathway may play an important role in mediating the nigral effects on seizures. PMID- 3815108 TI - Age-dependent capacity for somatosensory cortex reorganization in chronic spinal cats. AB - Primary somatosensory cortex was mapped in chronic spinal cats that were spinalized (T12) at two weeks and 6 weeks of age. The magnitude of cortical reorganization is age-dependent. In cats spinalized at two weeks, extensive reorganization of the deafferented hindlimb region resulted in a second complete map of intact tactile input from the trunk and forelimb, while in cats transected at 6 weeks of age, trunk afferent input only partially activated the deafferented hindlimb region. PMID- 3815109 TI - Thalamic and cortical spindles during early ontogenesis in kittens. AB - On birth, focal thalamic recordings show sporadic sequences of spindle waves whereas EEG cortical recordings show no trace of spindles. Thalamic spindles are occasionally transferred to the cortex beginning with the 3rd-4th day. On the 8th 9th day, clear-out spindle sequences, with the same patterns as in the adult animal, appear simultaneously in the thalamus and cortex. PMID- 3815110 TI - Quantitative studies of mitoses in fetal rat brain: orientations of the spindles. AB - In continuation of our quantitative studies on 15-day fetal rat brain development, evidence was obtained of ventricular mitoses whose spindles are perpendicular to the surface of the ventricle. In most locations the proportion (ratio) between cells with perpendicular mitoses and predominant cells with mitoses parallel to ventricle is only 0.064 (+/- 0.057): 1; however, in two specific locations of lamina terminalis this proportion is much higher: 2.006 (+/ 1.24): 1 and 0.634 (+/- 0.42): 1. Total mitotic counts in these two locations were also higher: 1.8 and 1.5 X higher than the average elsewhere in cerebral hemispheres. It is suggested that these perpendicular orientations are not accidental but serve some specific purpose: either they give rise to a different cell population, or they represent a stage preparatory for cell migration. PMID- 3815111 TI - Avian retinal cells express enkephalin-like immunoreactivity in culture. PMID- 3815112 TI - Acoustic imprinting in guinea fowl chicks: age dependence of 2-deoxyglucose uptake in relevant forebrain areas. AB - In 7-day-old guinea chicks play back of an imprinted acoustic stimulus was previously found to correlate with increased uptake of 2-deoxyglucose (2DG) in 3 rostral forebrain areas (HAD, LNH and MNH). Subdivisions of these areas defined by 2DG labelling may be association fields. Auditory areas did not show labelling differences between imprinted and control animals. In the present study imprinted guinea chicks of different age and with different experience were used in the 2DG experiments. Seven-day-old chicks (beyond the sensitive phase), 4-day-old (at the decline of sensitive phase) and 1- and 3-day-old chicks (within the sensitive phase) were given a 2DG injection and afterwards heard the stimulus to which they had been imprinted previously (1.8 kHz, 3 tone pips per s). While the typical labelling pattern was weak or absent in 1-4-day-old chicks the older animals consistently had high 2DG uptake in these areas. Unsuccessfully imprinted 7-day old chicks, having all the behavioral test experience, showed no or weak labelling. These results are related to current literature on reticular activation of the relevant areas and on morphological changes there with termination of the sensitive phase. It is argued that the reticular activation of these areas, e.g. attention mechanisms are instrumental in securing imprinting success and that subsequent reorganization of the areas leads to stronger metabolic activation after the sensitive phase. PMID- 3815113 TI - Differentiation of PC12 pheochromocytoma cells by sodium butyrate. AB - PC12 pheochromocytoma cells cease dividing and show increased cell-cell and cell substratum adhesion in response to treatment with sodium butyrate. These changes are accompanied by the rapid appearance of neuron-specific enolase, an APUD cell marker. However, neurofilament proteins, markers for neuronal differentiation, are not induced. These results suggest that sodium butyrate induces differentiation in the PC12 cell line, perhaps along the chromaffin cell pathway. PMID- 3815114 TI - The presence of glutamic acid decarboxylase and gamma-aminobutyric acid immunoreactivity in photoreceptors of hatching quail retina. AB - The presence of glutamic acid decarboxylase (GAD) and gamma-aminobutyric acid (GABA) was investigated in neuroretina sections from hatching quail embryos by immunocytochemistry. The photoreceptors were found to be intensely immunoreactive to anti-GAD antiserum and to two distinct anti-GABA antisera. PMID- 3815115 TI - Auditory imprinting leads to differential 2-deoxyglucose uptake and dendritic spine loss in the chick rostral forebrain. AB - Newly hatched chicks of the domestic fowl (White Leghorn) were imprinted to an acoustic stimulus (Group I: 400 Hz, 3 bursts per s, Group II: 900 Hz, 2 bursts per s) and tested in a straight runway with loudspeakers behind two opposite goal boxes. Those chicks were considered imprinted which headed for the imprinting stimulus in an approach test and subsequently preferred it to a new stimulus (imprinting stimulus of the other group) in a simultaneous discrimination test. On day 7 after hatching (after the sensitive phase) imprinted chicks and naive controls were injected with 2-[14C]deoxyglucose (2DG) and exposed to the imprinting stimulus. Autoradiographic analysis of their brains revealed 3 well demarcated areas of increased 2DG accumulation in the rostral forebrain of imprinted chicks compared to controls: HAD in the rostral Wulst; MNH, an auditory area in the rostromedial neostriatum and hyperstriatum ventrale; LNH in the rostrolateral neostriatum and hyperstriatum ventrale. Analysis of these brain areas in 7-day-old acoustically imprinted and control animals with the Golgi-Cox method revealed a highly significant reduction of spine frequency of a large neostriatal neuron type in MNH of imprinted chicks. An additional Golgi-Cox analysis was carried out with chicks imprinted on a broody hen, i.e. on the whole spectrum of natural stimuli. In that group spine frequency of the same neuron type was between that of acoustically imprinted and control animals. A hypothesis of filial imprinting is presented which considers spine loss as a crucial mechanism. PMID- 3815116 TI - Effects of morphine on DNA synthesis in neonatal rat brain. AB - Several observations have led to the hypothesis that endogenous opioids may modulate the growth and development of the brain. In the present study, we have examined the effect of morphine on the incorporation of [3H]thymidine into the DNA of neonatal rat brains in vivo and in vitro. We have found that morphine, when administered to one-day-old rats, inhibited [3H]thymidine incorporation into brain DNA in a long-lasting, naloxone-reversible manner. Morphine inhibited DNA synthesis in animals one and 4 days of age but not in older animals. This effect was tissue-specific, and did not appear to be due simply to respiratory depression or decreased availability of precursor to the brain. Naloxone, when administered acutely, or naltrexone, chronically, had no effect on [3H]thymidine incorporation, indicating that endogenous opioids do not tonically depress DNA synthesis. When neonatal brain tissue was incubated with morphine in vitro. [3H]thymidine incorporation values were not different from controls. These data indicate that the effect of morphine on DNA synthesis in vivo may be an indirect one, rather than a direct action on proliferating cells. PMID- 3815117 TI - Differential postnatal development of mu-, delta- and kappa-opioid binding sites in rat brain. AB - With selective labelling techniques and analysis of saturation curves it is shown that in rat brain the concentrations of mu-, delta- and kappa-binding sites increase differentially during postnatal development. There are no changes in the binding affinities. The concentration (pmol/g brain) of kappa-sites are first to reach adult levels, namely between 7 and 14 days after birth. Adult levels of mu sites are attained between 14 and 21 days after birth. The most striking finding is that development of delta-sites, which are not detectable 3 days after birth by the method used, lags markedly behind that of mu- and kappa-sites. The profile of development in rat brain is compared to that found previously in mouse brain. PMID- 3815118 TI - Development of adenosine deaminase-immunoreactive neurons in the rat brain. AB - It has previously been demonstrated that neurons immunoreactive for the enzyme adenosine deaminase (ADA) have a highly restricted distribution pattern in the adult rat brain. In order to determine whether the pattern of ADA expression is equally limited during the period of brain development, the localization of ADA was investigated immunohistochemically in brains of embryonic, early postnatal and young adult rats. No immunostaining for ADA was detected on the 12th embryonic day. On embryonic day 15, ADA-immunoreactive cells were first observed in the hypoglossal motor nucleus, and on day 18 in cingulate, retrosplenial and visual cortex, in the posterior basal hypothalamus, and in the facial motor nucleus. On the 20th embryonic day ADA-immunoreactive neurons appeared in various olfactory and related systems and in the superior colliculus. On the 1st postnatal day, immunoreactivity was intensified in all structures in which it was observed at preceeding ages and, in addition, appeared in several brainstem regions. On postnatal day 10 and 15, immunostained neurons appeared in several subcortical structures whereas the number of these decreased in the anterior olfactory nucleus and some related cortical areas. In animals 25 days of age the intensity of immunostaining continued to increase, essentially producing the adult pattern in all except olfactory areas where there was a dramatic loss of ADA-immunoreactive cells. These results show that the restricted pattern of ADA immunostaining observed in adult rat brain is generated over a protracted period of development, various stages of which are characterized predominantly by the expression of ADA in greater abundance, at least to the extent this can be gleaned immunohistochemically, in greater numbers of neurons and to a minor degree by a decreased capacity to express this enzyme. PMID- 3815119 TI - Neurotoxic effects of methamphetamine assessed in three-dimensional reaggregate tissue cultures. AB - Three-dimensional, rotation-mediated, reaggregate tissue cultures formed from dissociated fetal rostral mesencephalic tegmental (RMT) and corpus striatal (CS) or frontal cortical (FCx) cells were used to study methamphetamine neurotoxicity. Analysis of dopamine (DA), serotonin (5-HT) and gamma-aminobutyric acid (GABA) levels using HPLC techniques revealed decreases in RMT-CS and RMT-FCx reaggregate DA and 5-HT levels after treatment between 14 and 21 days in culture with methamphetamine in concentrations ranging from 10(-6)M to 10(-3)M. Dopamine cell numbers in RMT-CS and RMT-FCx reaggregates were estimated after visualization by histofluorescent techniques. Methamphetamine treatment caused decreases in DA cell numbers which paralleled the decreases in endogenous DA levels. Estimates of the accumulation of exogenous DA by RMT-CS reaggregates treated with methamphetamine showed that the amount of accumulation per cell remained fairly constant despite marked reductions in total DA cell numbers. This suggests that the reductions in endogenous DA levels following methamphetamine were secondary to loss of entire DA neurons rather than of a portion of the terminal axonal fields in the surviving neurons. Reaggregate tissue cultures are a useful tool in the study of potential neurotoxic effects of new or untested psychotherapeutic agents. PMID- 3815120 TI - Target-field specificity in the induction of retinal neurite outgrowth. AB - Nasal and temporal microexplants from the retina of the chicken embryo (E6; White Leghorn) were cultured on a collagen gel in the presence of extract from anterior or posterior E18 optic tectum. After 4 days of incubation maximum neurite lengths were measured as a function of protein concentration (1-500 micrograms/ml). Temporal retina was stimulated by both extracts but maximum neurite growth was obtained with anterior optic tectum at 500 micrograms/ml. Conversely, nasal retinal fiber outgrowth was best stimulated by posterior tectum, with maximum neuritic extension occurring at a concentration of 60 micrograms/ml. The stimulation was exerted by soluble protein fractions. The results show that topographically distinct axonal target fields of the optic tectum can selectively stimulate growth of neurites from the appropriate region of the retina. PMID- 3815121 TI - Permanent changes in muscle and motoneurones induced by nerve injury during a critical period of development of the rat. AB - The sciatic nerve was crushed in rats at different times during the first two weeks after birth. Following reinnervation the recovery of the fast and slow muscles and their motoneurones was compared. The main factor affecting recovery of muscle weight and tension was the age at which the nerve was crushed; the earlier the injury the greater the impairment. However, recovery also depended upon muscle type. The fast muscles, tibialis anterior and extensor digitorum longus, always recovered less well than the slow soleus muscle. The greatest difference in recovery was seen when the nerve was crushed between 3 and 6 days of age. The fatigue resistance of fast muscles was markedly increased after nerve injury at any time during the first two postnatal weeks and was greatest when the nerve crush was done soon after birth. However, this change was not just related to muscle weakness as the increase in fatigue resistance after nerve crush at 5 and 12 days was similar regardless of the difference in recovery of the muscles. Retrograde labelling of motoneurones with HRP demonstrated that about 60-70% of motoneurones innervating fast or slow muscles were lost following sciatic nerve crush at birth. It is concluded that motoneurone loss probably accounts for most of the impairment of soleus after postnatal nerve crush but only partly explains the poor recovery of fast muscles. PMID- 3815122 TI - Selection for heterosis from crossbred populations: estimation of the F1 heterosis and its mode of inheritance. AB - The heterosis inheritance backcross evaluation technique (HI-BET) is proposed as a selection strategy for developing a pair of complementary strains from a crossbred population descended from a F1 population possessing considerable heterosis. These complementary strains are expected to produce a strain cross superior to the F1 population from which they were derived. In the first stage of an experimental evaluation of HI-BET, Australorp and White Leghorn hens were compared with their F1, F2 and F1 by parental breed backcross populations for a range of egg production traits. The substantial heterosis for survivors' egg production and total egg mass was largely lost in the F2 and backcross populations indicating that this heterosis was mainly due to parental epistasis. The uneven distribution of residual heterosis in the backcross populations suggests that about two-thirds of this parental epistasis was inherited from the White Leghorn line. As the Australorp line was substantially superior to the White Leghorn line for survivors' egg production and total egg mass, it most likely contained additive genes for both these traits that were not present in the White Leghorn line. It is suggested that HI-BET should be an effective strategy for incorporating these additive genes into the White Leghorn line, together with some brown egg shell genes if also desired, as a means of further improving the performance of the F1 cross. PMID- 3815123 TI - Selection for heterosis from crossbred populations: comparison of the F3 and backcross populations. AB - An experimental evaluation of HI-BET (heterosis inheritance backcross evaluation technique) involving the comparison of the performance of F3 and backcross (BC) families with common sires is described. These crossbred populations were derived from an F1 cross between Australorp and White Leghorn fowls with substantial heterosis for egg production variables. There was considerable evidence for the presence of a statistically significant sire family by population type interaction for survivor's total egg mass. The ranking of sires varied substantially depending upon whether they were being assessed on the performance of their F3 or their BC daughters. The BC population yielded substantially higher sire component heritability estimates for egg weight, egg production and total egg mass than did the F3 population. For the latter two traits, this improvement in the correlation between genotype and phenotype is in accordance with the expectations of HI-BET. It is concluded the HI-BET should be effective strategy for selectively focussing upon the non-additive genes that are only present in one ancestral line at a high frequency, whilst ignoring non-additive genes unique to the other ancestral line. PMID- 3815124 TI - Apparent metabolisable energy values of fats for broiler chicks. AB - Seven fats were included at 30, 60 and 90 g/kg (experiment 1) and at 20, 40, 60 g/kg (experiment 2) in a semi-synthetic fat-free diet and in a practical diet respectively. Apparent metabolisable energy (AME) was evaluated with 6 replicate cages each with three Ross 1 cockerel chicks 8 d old. Diets were fed for 11 d and a total collection of excreta undertaken for the last four. There was no significant departure from linearity in the response of dietary AME to added fat, indicating no interactions between basal diet and added fat. In experiment 3 one fat was evaluated at 10 rates of inclusion (10 g/kg to 100 g/kg in 10 g increments) in both a semi-synthetic fat-free basal and a practical basal diet. A significant departure from linearity in the response of dietary AME to added fat was detected but there was no significant fat X basal diet interaction. In experiment 4 twelve commercially available fat blends were each evaluated at 10 rates of inclusion (15 g/kg to 150 g/kg in 15 g increments) in a practical basal diet. Significant departures from linearity in the responses of dietary AME to added fat were observed with some of the fats. It was concluded that the AME of fats mat be determined from multi-level assays by interpolating the quadratic relationships derived. PMID- 3815125 TI - Free-choice feeding of broilers at high temperatures. AB - Broilers fed complete diets to 21 but not 44 d of age grew faster with a better efficiency of food utilisation than broilers given a free-choice selection of the cereal and protein components. When finisher diets, varying in metabolisable energy (ME) and amino acid:ME ratios, were fed at high ambient temperatures (25 to 35 degrees C) broilers on the free-choice system selected similar amino acid:ME intake ratios, which were lower than the ratios contained in the complete diets. Differences in broiler performance between 22 and 44 d of age reflected variations in ME rather than amino acid intake. PMID- 3815126 TI - Influence of laying on iron metabolism in quail. AB - Haematological and iron content values for liver, spleen, intestines, blood, ovary and eggs were determined in female quails, from the prelaying state to full laying. A drop in hematocrit, haemoglobin and in the liver stores occurred at the onset of laying (48 to 51 d of age), but these values recovered after 5 to 10 d. The iron lost in eggs (0.3 mg Fe/egg) was responsible for this. An active homeostatic control must be necessary to supply adequate iron for both eggs and blood formation. Quails fed on an iron-deficient diet distributed iron preferentially to the haematopoietic processes, at the expense of the iron content of the eggs and a subsequent reduction of viability. PMID- 3815127 TI - Effects of times of collection and different storage methods on the microflora and nitrogen content of poultry waste. AB - An experiment was conducted to determine the effects of times of collection and storage methods on the kinds and numbers of microflora and nitrogen content of poultry excreta (waste). Fresh waste collected in the morning had a higher mean count of viable bacteria than the evening collection in both strains of hen studied. Fresh waste samples had higher mean counts than dried ones. Escherichia coli and Proteus spp. were the predominant microflora identified in waste collected at both times from both strains. Collection time had no effect on the type of micro-organisms isolated. Bacillus spp. was least frequently isolated in fresh waste but most often in dried waste. Samples of waste collected in the morning from Babcock layers contained more nitrogen than those collected in the evening. Samples collected in the morning from Warren layers and stored under aerobic conditions had the highest nitrogen content. However, there were no significant differences in the nitrogen content of waste from Babcock layers attributable to storage method. PMID- 3815129 TI - Use of the beta-carotene rich alga Dunaliella bardawil as a source of retinol. AB - Dunaliella bardawil, a beta-carotene accumulating halotolerant alga, has been tested as a source of retinol in a chick diet. Chicks were fed diets deficient in retinol or supplemented with retinol, synthetic beta-carotene or dry algae. After an initial lag, chicks grew equally well on diets supplemented with algae, retinol or beta-carotene. Serum and liver analyses revealed a normal content of retinol in all chicks except those grown on the retinol-deficient diet. Chicks fed the algae-supplemented diet contained lutein but no beta-carotene in their serum, even though the ratio of beta-carotene to lutein in the algae was over 15:1. Laying hens fed with an algae-supplemented diet showed enhanced egg yolk colour attributable to a higher lutein content. No beta-carotene was present in the egg-yolk. These studies demonstrate the possibility of using dried Dunaliella bardawil as a dietary supplement which can fully satisfy the retinol requirement and also serve as a yolk-colour enhancing agent. PMID- 3815128 TI - Effect of dietary phosphorus concentration and electrolyte balance on the growth performance of broiler chickens. AB - The performance of 1680 male and female broiler chickens given diets with either a low (4.7-4.3 g/kg) or high (8.9-8.2 g/kg) content of inorganic phosphorus and four (150, 200, 250 and 300 mEq/kg) electrolyte balances (Na+K-Cl) was measured from 1-d-old to 49 d of age. Diets with the higher concentration of inorganic phosphorus reduced body weight gains in the starter (P less than 0.01) and finisher (P less than 0.05) phases but the efficiency of food utilisation was reduced only in the starter phase (P less than 0.05). The reduction in body weight gain was greater in males than in females. The growth depression caused by the higher concentration of inorganic phosphorus in the finisher diets was partially alleviated by increasing the electrolyte balance to either 250 or 300 mEq/kg diet. The higher concentration of inorganic phosphorus significantly reduced the dressing percentage and increased the abdominal fat pad weight and litter moisture content. Electrolyte balance had no significant effects on efficiency of food utilisation, abdominal fat pad weights or litter moisture content. Neither the dietary concentration of phosphorus nor the electrolyte balance had a significant effect on mortality or ash content of the tibia. PMID- 3815130 TI - Plasma concentrations of corticosterone and thyroid hormones in laying fowls from different housing systems. AB - Plasma concentrations of corticosterone, thyroxine (T4) and triiodothyronine (T3) were measured in representative mature female domestic fowls from three housing systems: cages, covered strawyard and range. There were no between-system differences for T4 but T3 was lower in birds from range than in those from cages. Corticosterone concentrations were lower in birds from strawyards than in those from range and cages. In the strawyards there were no differences in corticosterone concentrations between normal and low-ranking hens. The latter were selected on the basis that they remained apart from the flock, were under weight, poorly feathered and unable to feed at will. Low-ranking hens had significantly higher plasma concentrations of T3 and T4 than normal birds. This was attributed mainly to the poor feather covering of most low-ranking birds. It was concluded that, in the assessment of different housing systems, plasma corticosterone and thyroid hormones were not useful measures of long-term stress or welfare. Different factors relevant to welfare may have contrary effects on the plasma concentrations of these hormones. PMID- 3815131 TI - Effect of nutrient density and energy to protein ratio on performance and carcase quality of small white turkeys. AB - One thousand eight hundred Small White turkeys were fed diets of 3 nutrient densities, representing approximately 0, 30 and 90 g added fat/kg of diet, or a fourth treatment which provided increasing nutrient densities from 6 weeks of age to slaughter at 12, 13 and 14 weeks. Within each nutrient density, 4 energy to protein ratios were derived by reducing dietary protein. Each increment in nutrient density resulted in increased body weights and improved efficiency of food utilisation. Increasing energy to protein ratio resulted in linear decreases in body weights, food intake and efficiency of food utilisation. Carcase quality, as measured by carcase fat scores and percentage of grade A carcases, improved with each increment in nutrient density and declined with increasing energy to protein ratio. Progressively increasing nutrient density from 6 weeks of age resulted in body weights, efficiencies of food utilisation and carcase finishes intermediate between those of the medium and high density groups. Such a programme avoids the disadvantages of feeding high nutrient density diets through much of the growing cycle, while providing growth, efficiency of food utilisation and carcase grades approaching those produced by the full high nutrient density programme. PMID- 3815132 TI - Effect of environment on the intake of food and water, body weight, egg production and plasma concentrations of corticosterone and prolactin in turkey hens. AB - During the first 4 weeks of egg production, there were no differences in the plasma concentrations of prolactin and corticosterone, egg production, body weight and the consumption of food and water between turkey hens which were maintained in cages or in floor pens. The plasma concentration of prolactin increased to the same extent in both environments during the period of peak egg production. A further rise in concentration of prolactin occurred in association with the termination of oviposition in 15 of the 19 hens which stopped laying eggs. Prolactin appeared to be progonadal and then antigonadal, once a threshold concentration was exceeded. This threshold value was higher in caged turkey hens. After laying ended, high concentrations of prolactin in hens maintained in cages were not maintained in the absence of a stimulus or stimuli associated with the nests. PMID- 3815133 TI - Effects of interrupted lighting regimens on the feeding activity of the laying fowl. AB - Segmentation of the main light period of an 8L:4D:2L:10D regimen into 30 min light, 30 min dark did not affect total feeding activity, rate of feeding or total intake of laying hens. When 15 min light and 45 min dark was provided each hour feeding activity and food intake were reduced, while rate of feeding and feeding during the dark periods increased. No feeding occurred in the 10 h 'night'. Hens subjected to interrupted lighting showed less feeding activity than those on a 14L:10D regimen. Insertion of a 4 h dark period in the 14 h subjective day of laying hens increased their rate of feeding, but reduced total intake. The pattern of feeding activity depended on the position of the 4 h dark period. The largest modification of feeding activity occurred on a 8L:4D:2L:10D regimen; 20% of activity occurred in the last 2 h of the apparent day. Feeding occurred during the 4 h dark period, but not during the 10 h 'night'. PMID- 3815134 TI - Comparison of amino acid digestibility using the ileal digesta from growing chickens and cannulated adult cockerels. AB - Meat-and-bone meal (MBM), which had been heated (150 degrees C) for 0, 1.5, 3 or 5 h, was used along with an indigestible marker in four diets which were fed to young growing chickens and adult cockerels fitted with ileal cannulae. The ileal digesta from each group of birds were sampled and the apparent amino acid digestibilities of the four diets containing MBM were determined. The apparent digestibility values from growing chickens were higher (P less than 0.05) than those from cannulated cockerels. Differences in apparent digestibility of amino acids between diets as a result of heat treatment were consistent for all amino acids when comparing both techniques, with the exception of glutamic acid and arginine. PMID- 3815135 TI - Effect of changes in dietary energy intake and environmental temperature on heat tolerance in the fowl. AB - The improvement in heat tolerance acquired during the acclimatization of laying hens to intermittent heat stress was lost or considerably reduced when energy intake increased following the addition of maize oil to the diet. The oxygen consumption (VO2) of acclimatised hens increased after the addition of maize oil to the diet. Reducing the environmental temperature (Ta) from 30 degrees to 10 degrees C prevented the development of acclimatization if the heat stress commenced soon after the change of Ta; if the heat stress commenced 5 weeks after the change of Ta acclimatization took place normally. Reducing the Ta from 30 degrees to 10 degrees C resulted in an increased VO2 and food intake. The administration of triiodothyronine increased VO2 and reduced the heat tolerance of acclimatised hens. It is concluded that heat tolerance, despite being reinforced by regular exposure to heat stress, remains susceptible to changes in energy metabolism brought about by dietary or environmental means. PMID- 3815136 TI - Studies of the factors causing abnormal acrosomes and crooked-necks in fowl spermatozoa during freezing and thawing. AB - In order to investigate the factors causing crooked-necked spermatozoa (CNS) or those with abnormal acrosomes during freezing and thawing, fowl spermatozoa in NaCl or glucose solutions containing 92 ml glycerol/l were examined using a scanning electron microscope before and after freezing and thawing. The incidence of CNS in NaCl solution significantly increased after freezing and thawing, but not in glucose solution. The acrosomal damage caused by freezing and thawing was considerable in both solutions, and the incidence of damage in glucose solution was significantly higher than that in NaCl solution. In neither solution was there a significant difference between the incidence of acrosomal damage in CNS and in non-CNS. The ratios of incidences of abnormal acrosome after, versus before, freezing were higher in non-CNS than in CNS. It appears from these results that the factors during freezing and thawing which cause CNS may differ from those causing acrosomal damage. PMID- 3815137 TI - [Fentanyl in peridural obstetrical analgesia. Evaluation based on 4 years of use]. PMID- 3815138 TI - [Effects of enflurane and halothane on hepatic function in biliary surgery]. AB - The effects of two volatile anaesthetics on hepatic function are compared in 80 patients in hepato-biliary surgery. 40 patients were anaesthetized either with enflurane or halothane. This study is based on the variations of blood levels of gamma GT, bilirubin, SGOT SGPT, alkaline phosphatase, L.D.H. Samples were taken the day prior to the operation, one, two and five days afterwards. The results show an increase in the levels of BD, SGPT, LDH no 5, less important with enflurane than with halothane, and mainly in patients with preoperative hepatic abnormalities. Enflurane appears to be preferable in such cases. PMID- 3815139 TI - [Prevention of bronchopulmonary superinfections in severe head injuries: study of ceftriaxone and minocycline]. PMID- 3815140 TI - [Preventive antibiotics in cardiac surgery: cefazolin versus cefamandole]. AB - A prospective, randomized study was carried out to evaluate two antibiotic prophylactic regimens for patients undergoing cardiac surgery with cardiopulmonary bypass. Each patient of the first group (cefazolin) received four intravenous injections of 1 g cefazolin during 12 hours, patients of second (cefamandole), four doses of 750 mg. 155 patients scheduled for cardiac operation were included in the study. (May 1983 to April 1984). Patients were not admitted to the study in case of emergency, if their weight was less than 20 kg, if they had received antibiotics during the week before surgery or if they had a history of anaphylactic reactions to cephalosporins. There were no differences between the two groups on age, weight, height, sex, previous history of infectious disease, surgery and intensive care. There were no significant differences between the two groups in minor infections. The rate of urinary tract infection by streptococci was significatively higher (p less than 0.02) in the cefamandole group (38.3%) than in the cefazolin group (17.6%). There were no major infections (septicemia, mediastinitis, endocarditis). Patients temperature was the same during the first four postoperative days. Hospital stay was the similar in the two groups. The two antibiotics are similarly effective to prevent major infections in cardiac surgery. However cefazolin was preferred for antibiotic prophylaxis in cardiac surgery because of the higher rate of streptococcal urinary infections in patients given cefamandole. PMID- 3815141 TI - [Contribution of hemoconcentration in the recovery of residual blood from extracorporeal circulation circuits]. AB - The effects of recuperation from the remaining pump circuit blood with restitution to the patient after hemoconcentration are studied in 80 patients undergoing cardiopulmonary by-pass. This population is randomized into two groups: group 1 of 41 patients represents the control group and is compared with the group 2 of 39 patients who undergo the post-by-pass hemoconcentration. The volume of restored blood is 669 +/- 14 ml with an hematocrit of 38 +/- 6,6% and the total protein concentration is 81,2 +/- 2 g.l-1. The heparin level is high (4,24 units.ml-i) and the perfusion of the hemoconcentrated blood must be preceded by a slow injection of 0,8 mg.kg-1 of protamine sulfate. The advantages of this method represent a saving of two homologous blood units (p less than or equal to 10(-4] and the post operative urine output is increased by 32% (p less than or equal to 0,05). No complication, particularly infectious, was observed in this study. PMID- 3815142 TI - [Surgery of acoustic neurinoma in the elderly]. AB - Eleven patients, between 70 and 85 years old, with acoustic neurinoma, were operated by translabyrinthic approach. The size of the tumor was between 2 and 4 cm in five cases, 4 cm or more in six cases. Complete tumor removal was possible in six cases (55%), in five cases (45%) residual tumor was left behind. Complications included cerebrospinal fluid leakage (2 cases), meningitis (1 case), and hemorrhage (1 case, fatal four days later). Anesthetic management is described. PMID- 3815143 TI - [Anesthetic block of the brachial plexus in children]. PMID- 3815144 TI - [Primary hypertrophic obstructive cardiomyopathy and anesthesia]. PMID- 3815145 TI - [Suffocating peroperative pneumothorax]. PMID- 3815146 TI - [Oculomotor paralysis following spinal anesthesia]. PMID- 3815147 TI - [Trends in the medical causes of death in France (1962-1982)]. PMID- 3815148 TI - [Effect of the physician-patient cohort in ambulatory practice: home visits in 2 Swiss cantons]. PMID- 3815149 TI - [Syndicated practices of practicing physicians: evaluation of the extent of syndication in France]. PMID- 3815150 TI - Effects of dimethyl sulfoxide on a model of corneal alkali injury. AB - The potential role of dimethyl sulfoxide in minimizing early structural damage to the eye following corneal alkali injury was examined. Corneal alkali injury was induced in rabbits and treated with topical applications of 20% dimethyl sulfoxide. At day 3 the rates of corneal opacification (p less than 0.01) and corneal ulceration (p less than 0.05) were significantly lower in the treatment group than in the control group, but this effect was not sustained during the rest of the study period. Further work is required to determine the therapeutic value of topical dimethyl sulfoxide in combination with other agents, such as cycloplegics, corticosteroids, ascorbic acid and citric acid, in corneal alkali injury. PMID- 3815151 TI - Norrie's disease in a French-Canadian kindred: attempt to detect carriers by DNA analysis. AB - In a French-Canadian kindred four male cousins are affected with Norrie's disease, a rare X-linked recessive disorder. Three have university education, and the fourth has some developmental delay. Only one is microcephalic. All have mild to severe hearing deficit, although only three were aware of their hearing loss. Linkage analysis of DNA from family members with the probe L1.28 failed to detect female carriers. PMID- 3815152 TI - Treatment of blepharospasm with medication, surgery and type A botulinum toxin. AB - A total of 39 patients with essential blepharospasm and 2 patients with hemifacial spasm were treated with one or more forms of therapy. All patients underwent neurologic and ophthalmic assessment to rule out ocular causes of blepharospasm. Thirty-six patients were given a trial of various medications. Only one patient was successfully treated: her condition was markedly improved with pimozide after benztropine mesylate, clonazepam and amantadine hydrochloride had failed to help. Patients who did not respond to drug therapy were offered the option of undergoing eyebrow-eyelid muscle stripping surgery. The six patients who underwent surgery showed considerable improvement; however, side effects such as frontal anesthesia, exposure keratitis, lagophthalmus, scarring and eyelid malposition occurred, and three of the six had residual spasm. At this point type A botulinum toxin became available. A total of 27 patients (26 who did not respond to drug therapy, including the 3 with residual spasm after surgery, and 1 previously untreated patient) received type A botulinum toxin injections. Most experienced rapid relief from their spasms. The beneficial effects lasted weeks to months, and there were no major side effects. Treatment with type A botulinum toxin appears to be a safe and effective means of temporarily relieving blepharospasm. The long-term results with repeated injections are yet to be determined. PMID- 3815153 TI - Pathological and clinical study of Muller's muscle in Graves' ophthalmopathy. AB - Specimens of Muller's muscle from patients with Graves' disease were examined for evidence of morphologic, histochemical, immunohistochemical and electron microscopic changes. No scarring, significant inflammation or shared antigenicity between Muller's muscle and thyroglobulin-related antigens was found. There were moderate numbers of mast cells in 48 of 66 specimens. Computed tomography in 16 patients with Graves' ophthalmopathy showed enlargement of the superior rectus levator complex in 17 of 28 orbits with lid retraction. However, no correlation was found between the amount of lid retraction and the degree of enlargement of the muscle complex. PMID- 3815154 TI - Cyanosis and cardiovascular depression in a neonate: complications of halothane anesthesia or phenylephrine eyedrops? AB - A 3-week-old patient underwent cataract extraction under halothane anesthesia. After induction of anesthesia and instillation of phenylephrine hydrochloride eyedrops, the patient experienced cyanosis and cardiovascular depression. Her condition improved over the next 10 minutes. The possible contributions of halothane and phenylephrine to this response are discussed. PMID- 3815155 TI - The present role of magnetic resonance imaging in neuro-ophthalmology. AB - At present, MR imaging is recommended as the primary imaging procedure in investigating neuro-ophthalmic disease of the orbit, chiasm, brain stem, optic radiations and craniocervical junction and in any lesion suspected to contain a hematoma. MR imaging and CT are complementary in investigating disease of the paranasal or cavernous sinus. MR imaging is contraindicated in disease of the orbit when there is any possibility of a metalic foreign body and when there are metalic clips on intracranial vascular structures, such as aneurysms. The field of imaging is rapidly changing. The evolution of MR imaging and the expansion of our knowledge may soon relegate these recommendations to the file of early indications. PMID- 3815156 TI - Extensive squamous cell carcinoma of the conjunctiva presenting as orbital cellulitis: the hermit syndrome. AB - The authors present three cases of extensive squamous cell carcinoma of the conjunctiva invading the orbit and masquerading as orbital cellulitis. All cases were in elderly alcoholic men living in relative social isolation. Total exenteration of the orbit was required in all three cases. Only one patient has had long-term follow-up; he was well 5 years after presentation. The other two patients were well 15 and 5 months after surgery. PMID- 3815157 TI - Laser therapy of conjunctival papillomas. AB - Carbon dioxide (CO2) laser therapy was successfully used in the treatment of recurrent conjunctival papillomas in a 40-year-old man. Surgical excision, cryotherapy and immunotherapy with transfer factor and dinitrochlorobenzene had all been unsuccessful in eradicating the lesions. CO2 laser therapy should be considered as an alternative treatment for conjunctival papillomas refractory to other forms of therapy. PMID- 3815158 TI - Role of chitin in the survival of Vibrio parahaemolyticus at different temperatures. AB - Washed cells of Vibrio parahaemolyticus declined in numbers when incubated in phosphate-buffered saline for 6 h at different temperatures. Addition of chitin flakes to phosphate-buffered saline not only helped the organism to survive, but also resulted in an increase in cell numbers, particularly at 10 degrees C. The effect of chitin could not be simulated by N-acetylglucosamine, yeast extract, starch, or casein. PMID- 3815159 TI - Prevention of Clostridium difficile induced mortality in gnotobiotic mice by Saccharomyces boulardii. AB - Oral preventive treatment of gnotobiotic mice by Saccharomyces boulardii significantly decreased mortality following Clostridium difficile infection. A single S. boulardii ingestion protected 16% of mice, whereas 56% were protected when S. boulardii was given continuously in the drinking water. No direct antagonistic effect of the yeast on C. difficile numbers was detected, whereas a modulation of fecal cytotoxin production was demonstrated. PMID- 3815160 TI - Structure of the exocellular D-glucan produced by Neisseria polysaccharea. AB - Neisseria polysaccharea (LNP 462, NCTC 11858), proposed as a prototype strain constituting a new taxon in the genus Neisseria, produces copious amounts of polysaccharide when grown on agar containing 1-5% sucrose. Plate-grown cells produced an exocellular polysaccharide which was composed of D-glucose, had [alpha]D +222 degrees (water), and was shown from composition, specific optical rotation, methylation, enzymic hydrolysis, and 13C nuclear magnetic resonance studies to have an amylopectinlike structure containing mainly 1,4-linked alpha-D glucopyranosyl residues, but also containing ca. 6% 4,6-di-O-substituted alpha-D glucopyranosyl branch points. PMID- 3815161 TI - Purification of isopenicillin N synthetase from Streptomyces clavuligerus. AB - Isopenicillin N synthetase was purified from Streptomyces clavuligerus by sequential salt precipitation, ion-exchange and gel-filtration chromatography using both conventional open column and high-performance liquid chromatographic techniques. Material from the final purification step had a specific activity of 204.1 X 10(-3) units/mg of protein which represented a 130-fold purification over the cell-free extract. The purified isopenicillin N synthetase was determined to have a molecular weight of 33,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and to have a Km of 0.32 mM with respect to its substrate delta (L-alpha-aminoadipyl)-L-cysteinyl-D-valine. The enzyme showed a sensitivity to thiol-specific inhibitors with N-ethylmaleimide giving the strongest inhibitory effect. PMID- 3815162 TI - Neurophysiology of a central baroreceptor pathway projecting to hypothalamic vasopressin neurons. AB - Controversy exists as to the neural network whereby peripheral arterial baroreceptor information is transmitted to vasopressin (VP)-secreting neurons of the hypothalamic supraoptic nucleus (s.o.n.). In vivo electrophysiological studies in the rat were undertaken to characterize the selective depression of VP cell activity consequent to activation of peripheral baroreceptors. Electrical stimulation of the diagonal band of Broca (DB) in the rat evoked a similar selective inhibition of vasopressinergic neurons of the s.o.n. Local application of bicuculline, a GABA antagonist, abolished both the DB-evoked and baroreceptor induced inhibition of VP-secreting neurons. In addition, recordings from DB neurons antidromically activated from the s.o.n. displayed an increase in firing consequent to baroreceptor activation, coinciding with the suppression of firing in s.o.n. VP neurons. These observations collectively indicate that an intrinsic GABA projection arising in the DB cell group selectively inhibits vasopressinergic neurons of the s.o.n. and that this pathway mediates peripheral arterial baroreceptor activity that influences the release of VP in the neurohypophysis. These data may be of critical importance in our understanding the etiology of those forms of experimental hypertension where abnormalities in central baroreceptor pathways have been implicated but not proven. PMID- 3815163 TI - Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas. AB - We make use of the unique combination of a homogeneous genetic and racial origin in the rural population of Quebec and the facilities of free and universal access to medical care, to study the distribution of the prevalence of Parkinson's disease in the 9 rural hydrographic regions of the Province. Through 3 different methods of ascertainment, confirmed by two control probes, we demonstrate that the prevalence of Parkinson's disease is of uneven distribution within rural areas. We further investigated the characteristics of the regions of high prevalence. These regions which are predominantly agricultural and areas of intensive market gardening were also the areas with the highest use of pesticides. PMID- 3815164 TI - Botulinum toxin for benign essential blepharospasm, hemifacial spasm and age related lower eyelid entropion. AB - Purified botulinum A exotoxin was used in the treatment of forty seven patients with benign essential blepharospasm, 11 patients with hemifacial spasm and 2 patients with age-related entropion. The treatment was effective in all three groups for an average of 3-4 months when symptoms recurred and repeated chemodenervation with toxin was needed. The commonest complication was transient ptosis with an overall frequency of 7.8%. This incidence increased to 11.1% with toxin doses higher than 25 units per orbicularis. The treatment was well accepted by the patients, who were subsequently able to return to pre-blepharospasm lifestyles. PMID- 3815165 TI - Adult onset systemic carnitine deficiency: favorable response to L-carnitine supplementation. AB - We report the case of a patient who at age 39 first developed an episode of muscle weakness and transient ketoacidosis with biopsy proven fatty infiltration of the liver. Over the next several years, myopathy ensued; biopsy revealed extensive deposition of lipid globules in type 1 muscle fibres. Further investigations established the diagnosis of systemic carnitine deficiency (SCD) with skeletal muscle, hepatic, and cardiac involvement. The patient has benefited from L-carnitine supplementation. Our case represents an unusually late onset of SCD and highlights the necessity, when appropriate, of a high index of suspicion of this rare but treatable disorder. PMID- 3815166 TI - Massive cerebral edema associated with meningioma. AB - Cerebral edema is a well-known complication of malignant astrocytoma and metastatic brain tumour. Though far less frequent, the association of cerebral edema with meningioma is also recognized; this is unpredictable and sometimes out of proportion to tumour size. We describe three cases where the mass effect was due to severe edema, rather than the tumour itself and was responsible for a catastrophic clinical presentation. The mechanisms responsible for the development of severe edema with meningioma which have been previously proposed are reviewed. They include tumour size, location, histologic subtype, cellularity, mitotic activity, vascularity and the presence of excretory secretory activity. None of these consistently correlate with cerebral edema. Our cases suggest that spontaneous hemorrhage into the tumour may be the common factor responsible for severe cerebral edema. It is stressed that though a decidedly rare complication, cerebral edema secondary to meningioma should be entertained in the differential diagnosis of acute neurologic deterioration of these patients. PMID- 3815167 TI - Comparison of surgical and conservative management in 208 patients with acute spinal cord injury. AB - The role of surgery in the management of acute spinal cord or cauda equina injuries remains controversial. The present study analyzed ten admission features and three outcome variables in 208 patients treated in an Acute Spinal Cord Injury Unit, 116 (56%) of whom underwent at least one spinal operation. The surgical and non-surgical groups showed no significant differences in the following seven clinical features: age, sex, distance travelled to the Unit, time interval between trauma and admission, type of accident, severity of injuries to the spinal cord, and severity of associated injuries. However, the two groups showed significant differences in level and type of vertebral column injury, and in the frequency of pre-existing spinal abnormalities. These differences were due to management policies which selected certain injuries for surgical or non surgical treatment. One-third of the operative procedures were performed primarily for neural decompression, one-third primarily for reduction of bony structures and one-third for fusion. However, 95% of the operative patients had a fusion at the initial operation. Operative treatment was associated with a lower overall mortality rate (6.1%) than non-operative (15.2%), despite a higher frequency of thrombo-embolic complications in the surgical group. Overall, there was no difference between operated and non-operated patients in length of stay or neurological recovery. Surgical management of patients with acute spinal cord injury appears safe in terms of mortality rate and neurological recovery, but it has not been proven to improve the latter. PMID- 3815168 TI - Surgical neuroangiography of intracranial vascular malformations. AB - In the three year period of 1982 to 1985, 152 patients with intracranial vascular malformations were referred to the Bicetre Hospital in Paris, France and the Toronto Western Hospital in Canada. Sixty-six patients with cerebral vascular malformations and 48 patients with dural vascular malformations underwent endovascular treatment. In 8 patients surgery was performed in combination with the embolization procedure. Detailed analysis of the angio-architecture of the vascular malformation reveals certain characteristics which may be of value in predicting the clinical outcome. Comprehensive data analysis and long term follow up is necessary to assess the role of embolization in the treatment of intracranial vascular malformations. PMID- 3815169 TI - Anterior versus posterior decompression for symptomatic spinal metastasis. AB - Management of patients with symptomatic spinal metastasis is designed to (1) relieve pain, and (2) restore or preserve neurologic function. The surgical strategy must include provisions for decompression of the dural sac and nerve roots, and stabilization of the spinal column. The optimal surgical approach, whether from in front or from behind is determined by a number of factors including (1) tumour location, (2) spinal level, (3) fixation factors, (4) patient debility. PMID- 3815170 TI - Microsurgical discectomy: a prospective study of 200 patients. AB - This report describes the results of microsurgical discectomy in a prospective study of 200 consecutive patients with intractable sciatica, followed independently by a pain clinic. Post operative morbidity was minimal, the complication rate very low, and patients were discharged home early. Leg pain was relieved in almost all patients, but back pain was relieved in only 72% of patients. The rate of return to work at one, three and twelve months post operatively was 50%, 83% and 95% respectively. Microsurgical discectomy is an effective and safe procedure. PMID- 3815171 TI - Pathology of spontaneous dissection of intracranial arteries. AB - Spontaneous dissection of a major subarachnoid artery is an uncommon cause of stroke in young and apparently healthy individuals. Such dissection does not correlate well with systemic conditions such as emboli, thrombotic or hemorrhagic tendencies or hypertension, nor with disease of blood vessels such as atherosclerosis, fibromuscular dysplasia, cystic medial necrosis or Moya-Moya disease. Unusual exertion has been implicated as a factor in some cases. Gap defects were found in the internal elastic lamina near the site of dissection in three of four cases of spontaneous dissection reported here. It is suggested that such defects, because of their unusual size or number, may be responsible for initiating dissection in susceptible individuals. A detailed study of the major cerebral arteries in cases of dissection and control cases to document the size and frequency of such defects could shed light on the pathogenesis of spontaneous dissection. The subsequent course of events tends to differ in the internal carotid and vertebro-basilar systems. In most cases, the dissection in the internal carotid system is sub-intimal leading to thrombosis and cerebral infarction, while in the vertebrobasilar system dissection lies between the media and adventitia leading to subarachnoid hemorrhage. It is not known what structural differences of the two arterial systems may underlie this difference in the pattern of arterial dissection. PMID- 3815172 TI - A technique for rapid non-suture vascular anastomosis. AB - In an attempt to overcome some of the difficulties inherent in vascular anastomosis using standard suture methods, we have developed a technique that allows for rapid non-suture anastomosis of blood vessels. The technique has been used in over 400 anastomoses, including interposition vein grafts in rat, rabbit and dog vessels ranging in size from 0.7 mm to 3 mm in diameter. Animals have been followed for over 1 year postoperatively with serial angiography and histological evaluation including scanning electron microscopy. Stress studies have compared the biomechanical properties of both non-suture and suture anastomosis. The overall patency rate in non-suture end-to-end anastomoses using an interposition vein graft was 85% at 1 year follow up. Histological evaluation revealed a healing pattern that was temporally similar to that of the suture technique. Stress tests revealed no significant difference between suture and non suture technique. These studies reveal that the non-suture technique compares favourably with the suture technique, and demonstrate the feasibility of applying this technique to man. PMID- 3815173 TI - Abdominopelvic computerized tomography and open peritoneal lavage in patients with blunt abdominal trauma: a prospective study. AB - This prospective trial compares abdominopelvic computerized tomography and open peritoneal lavage in the diagnosis of blunt abdominal trauma. Fifteen patients (group 1) were evaluated by both methods. Another 15 patients (group 2) had only computerized tomography. Criteria for a "positive" scan were hemoperitoneum and evidence of solid organ injury. Criteria for "positive" lavage were a grossly bloody return, erythrocyte count greater than 20.0 X 10(9)/L and leukocyte count greater than 0.5 X 10(9)/L. At laparotomy, only injuries requiring repair or excision were considered "true positive". Patients who did not have laparotomy and had an uncomplicated clinical course were considered "true negative". With tomographic criteria alone for diagnosis there would have been one false-positive and three false-negative results, compared with three false positive and no false negatives for open peritoneal lavage alone. None of the three patients who had negative findings on laparotomy suffered any morbidity or died. Results of computerized tomography and open peritoneal lavage agreed in 8 of 15 patients (kappa value = 0.52), indicating a low level of agreement between the two. The authors believe that open peritoneal lavage remains the diagnostic procedure of choice in blunt abdominal trauma. PMID- 3815174 TI - The value of trauma centres: a methodologic review. AB - This review examines the rationale for the development of trauma centres in North America. The value of local and regional trauma care systems is considered, emphasizing study methodology. Evidence is acquired from case-series reports, before-and-after studies and intersystem comparisons. It overwhelmingly suggests that the main determinants of survival, given the severity of the injury, are the adequacy of the initial resuscitation and the early recognition of serious injuries. Thus, doctors involved in front-line trauma care, whether in the centre city teaching hospital or in the rural community setting, must be properly prepared. PMID- 3815175 TI - Peripheral nerve injuries during carotid endarterectomy. AB - Peripheral nerve injuries associated with carotid endarterectomy are fairly common but not emphasized in reported results of carotid endarterectomy. The sensory nerves to the submandibular skin and ear lobe are often damaged. Motor nerves VII, IX, X, XI and XII may be injured at surgery. The commonest motor injuries involve the facial, vagus and hypoglossal nerves. Carotid endarterectomy was studied prospectively over 1 year to document the incidence of nerve injury. Nerve injury occurred in 12% of patients, with facial and vagus nerves being involved in 4% each. Careful surgical technique based on appropriate anatomical knowledge can prevent most of these complications. PMID- 3815176 TI - Role of total knee replacement in failed knee fusions. AB - The author describes his technique and the results of total knee replacement in four patients who already had fused knees. In two, the patella was present so a semiconstrained prosthesis was used, but in the other two a stabilized knee prosthesis was used because the patella was absent. In the first case, lack of experience with the technique led to failure of the prosthesis and revision was necessary, but in subsequent cases the patients have done well. Quadriceps control was not a problem. Range of movement improved slowly over the first year. The author concludes that disassembly of knee fusion is possible and gives acceptable results. PMID- 3815177 TI - Morbidity audit, 1984, Canadian Society for Vascular Surgery. PMID- 3815178 TI - The Hartmann procedure. AB - In 1923, Hartmann described an operation for cancer of the rectosigmoid area in high-risk patients not amenable to abdominoperineal resection. In the period 1972 to 1984 at the Queen Elizabeth Hospital in Montreal interest in the Hartmann procedure, with resection, end-colostomy and suture closure of the distal colon intraperitoneally, was renewed. The main indication for the procedure was diverticulitis, with cancer second. The author reviews the experience with 64 patients (average age 80 years) who underwent the Hartmann procedure. Obstruction, perforation and abscesses were the commoner indications. The mortality was 17%, but this included several patients who died from 1 to 6 months postoperatively of multiple-organ failure not necessarily related to the operation. A 30-day death rate was 8%. The complication rate was 35%. Restoration of bowel continuity (second stage) was done 2 to 3 months later in 28 cases with no deaths. PMID- 3815179 TI - Massive ovarian edema in a twin pregnancy. AB - A case of idiopathic ovarian edema in a 26-year-old woman with a twin pregnancy is reported. The clinical evolution of the condition was benign in spite of acute episodes of left iliac pain. In diagnosis, theca-lutein cysts had to be differentiated from other ovarian enlargements. The authors advise conservative surgery for such a condition. PMID- 3815180 TI - The epidural opioid internalized system. AB - For several years opioids have been given epidurally with success to control chronic intractable pain. The authors report their 2-year experience with internalization of the epidural catheter and injection port in 18 patients at University Hospital, Saskatoon. In all, 21 devices were used. All patients had metastatic cancer; 16 are now dead. The need for other medications was eliminated with 9 and reduced with 12 devices. In the patients who died, the devices were effective for 82% of their remaining life-span. They were able to spend 46% of this time at home. Blockage of the epidural end of the device was the most common mechanical problem, followed by leakage from the port. One patient suffered meningitis after 11 days as a result of subarachnoid placement of the catheter but responded to removal of the device and antibiotic therapy. The authors have been impressed with the excellent pain relief afforded to many of these patients, and their ability to enjoy life free of the sedative effects of other methods of narcotic administration. PMID- 3815181 TI - Strangulated femoral hernia containing acute gangrenous appendicitis: case report and review of the literature. AB - The author reports the case of a 69-year-old woman with acute gangrenous appendicitis in a strangulated right femoral hernia. The hernia was diagnosed preoperatively, but the gangrenous appendix was found in a strangulated loop of small bowel only at operation. The combination of gangrenous appendicitis and strangulated loop of small bowel in a femoral hernial sac is an unusual finding, but awareness of it will avoid delay in treatment and lead to the patient's full recovery. PMID- 3815182 TI - A biomechanical study of wire fixation. AB - A biomechanical study of wire fixation was performed using 18-gauge stainless steel wire on an Instron universal testing machine. Six groups of wires were tested--an intact piece of wire (control), a wire bent to a right angle five times, a simple knot, a square knot, a loop knot and a twist knot. The tensile load-to-failure value for each wire was recorded. The intact wire broke at a mean load of 67 kg. The wires with the bend, the simple knot and the square knot all broke at similar loads. Those wires with a knot broke at the knot. The loop and the twist knots pulled apart at much lower loads. These results indicate that bending the wire does not weaken it substantially, but kinking may initiate the site of breakage. The square knot is the strongest knot; the loop and twist knots are not recommended if the wire is to be under tension. PMID- 3815183 TI - Diplopia and diabetes insipidus secondary to type II fracture of the sella turcica: case report. AB - Fractures of the sella turcica are rare and are often difficult to diagnose radiologically. They can produce a wide variety of complications, including septic, neuroendocrine, neurovascular and neuroophthalmologic problems. The authors describe the case of a 17-year-old boy with diabetes insipidus and diplopia secondary to a type II fracture of the sella turcica. They emphasize the clinical importance of fractures in the sellar region in view of their proximity to vital structures and they discuss possible mechanisms of causation. PMID- 3815184 TI - Bilateral lower extremity amputations after prolonged application of the pneumatic antishock garment: case report. AB - The authors describe the case of a 29-year-old man with multiple trauma who suffered compartment syndromes necessitating bilateral lower limb amputations as a result of the prolonged (9.5 hours) application of a pneumatic antishock garment (PASG). There was no evidence of lower limb trauma before the garment was put on. Despite the apparent benefits of the PASG in traumatized hypovolemic patients, the lowest possible inflation pressures should be used and removal attempted as soon as hemodynamic stability can be assured. PMID- 3815185 TI - Apple-coring technique for severe gynecomastia. AB - In evaluating cases of gynecomastia it is important to differentiate between physiologic and pathologic forms. The authors review gynecomastia with reference to its occurrence in various age groups, the pathologic features and etiology, and the differentiation and classification of the two types. If the gynecomastia is large or longstanding, surgical treatment may be necessary. The authors review the various surgical techniques used from the early descriptions up to the present. The apple-coring technique has the advantages of leaving an inconspicuous scar, allowing correction of the hypertrophic areola and good chest wall contour, maintaining the viability of the nipple and decreasing the common complications of inverted nipples and a doughnut-shaped deformity. The results and outcome in four patients treated by the apple-coring technique are reported. Although the method is not perfect, the results are encouraging and the technique is an addition to the armamentarium of surgeons treating large gynecomastia. PMID- 3815186 TI - Craniocervical necrotizing fasciitis: critical factors in management. AB - Necrotizing fasciitis involving the head and neck is rare. The authors describe two such patients treated at their institution and analyse 39 cases reported in the literature. This entity may be divided into two groups based on the site of origin of the infection: group 1 (13 cases) infections, originating in the scalp and eyelids, mostly secondary to trauma, do not progress rapidly, respond well to medical and operative measures and result in minimal permanent disability. These infections usually are caused by hemolytic streptococci and Staphylococcus aureus. Group 2 (28 cases) infections, originating in the face or neck and mostly complications of dental and pharyngeal sepsis, progress rapidly to adjoining sites including the chest wall and mediastinum. These infections are caused by a wide variety of microorganisms including anaerobes; fatal complications are frequent and the death rate is high (32%). Early and very aggressive debridement and drainage are mandatory and should be repeated if warranted. PMID- 3815187 TI - Meralgia paresthetica after gastroplasty for morbid obesity. AB - In three morbidly obese patients (mean weight 169 kg), severe hip pain developed immediately after gastroplasty. The differential diagnosis included thrombophlebitis, osteoarthritis and lumbar disc protrusion. The pattern of pain and associated numbness was characteristic of compression of the lateral cutaneous nerve of the thigh, a condition known as meralgia paresthetica. The likely cause was compression of the thigh by the metal post of the Gomez retractor. Only the most obese patients suffered this syndrome and all symptoms resolved spontaneously within 3 months. PMID- 3815188 TI - Coronary sinus thrombosis: a potential complication of right heart catheterization. AB - In cardiac procedures that use access to the right atrium, the coronary sinus is at risk of accidental trauma and subsequent thrombosis as demonstrated by the two cases reported in this paper. The thromboses occurred in the setting of right heart failure and after procedures that involved catheterization or cannulation of the right atrium. A review of the literature revealed only rare instances of this complication, but, with the increasing use of the right atrium and coronary sinus for diagnostic and therapeutic purposes, injury to the coronary sinus must be considered. PMID- 3815189 TI - Postoperative gynecologic infections. AB - Postoperative gynecologic infections are caused by mixed aerobic and anaerobic bacteria that normally reside in the vagina. For the most part the infection, manifested by fever, resolves spontaneously, but occasionally serious problems result. Opinion now favours the prophylactic use of antibiotics before both abdominal and vaginal hysterectomy. Established infections are first treated with a combination of clindamycin and gentamicin. PMID- 3815191 TI - Distinguishing disease from illness. PMID- 3815190 TI - Rural crisis in family medicine. PMID- 3815192 TI - Aftermath of the heroin hoo-ha. PMID- 3815193 TI - Access to pesticide registration data in Canada: who should know? PMID- 3815194 TI - Physician distribution: back to basics. PMID- 3815195 TI - Type A behaviour pattern: a concept revisited. AB - It is generally accepted that the type A behaviour pattern is a risk factor in the development of coronary artery disease (CAD). Type A people have been characterized as hard-driving, competitive, aggressive and hurried. A number of investigators have attempted to correlate these facets of type A behaviour with increased risks of CAD. However, there have been conflicting results, primarily owing to differences in methods and CAD outcomes and inconsistencies associated with measuring the type A behaviour pattern. As a result, researchers have begun to focus on subcomponents of the type A behaviour pattern, particularly hostility and anger, that appear to be more reliable predictors of CAD outcome. A reconceptualization of the type A behaviour pattern is required. PMID- 3815196 TI - Asthma: 1. Pathophysiologic features and evaluation of severity. AB - The response of asthmatic airways to irritant stimuli is twofold: bronchoconstriction and airway inflammation. The inevitable mechanical consequence of bronchoconstriction is hyperinflation of the lungs, a phenomenon that produces characteristic clinical and radiologic signs. Hyperinflation helps to maintain airway patency at the expense of increased respiratory muscle work. Airway inflammation accounts in large part for the increased ventilatory drive of asthmatic patients, which results in alveolar hyperventilation and dyspnea. The resultant respiratory alkalosis further compromises tissue oxygen delivery both by cerebral vasoconstriction and by the leftward shift of the oxyhemoglobin dissociation curve. Optimal correction of hypoxia in the hyperventilating asthmatic patient requires delivery of oxygen at a high flow rate. Failure of patients with asthma to respond to simple bronchodilator therapy indicates the presence of continuing inflammatory activity and hence the need for anti inflammatory therapy and frequency monitoring. PMID- 3815197 TI - Factors affecting the incidence of hypertension. AB - The incidence of hypertension was determined among 10,173 patients of general practices in southwestern Ontario studied from 1978 to 1982. For both sexes the incidence of hypertension rose with increasing age. The incidence was higher among men than among women until age 50, after which it was similar for the two sexes. Obesity was positively associated with incidence for both sexes. In men this association diminished significantly with increasing age. The similar trend in women fell just short of statistical significance. In men but not women heavy alcohol consumption was positively related to the incidence of hypertension. However, the broad definition of this variable may have obscured a relation in women. Among men the effect of obesity on the incidence of hypertension was less for heavy drinkers than for light drinkers. Smoking was not related to the incidence of hypertension in either sex. PMID- 3815198 TI - The relation between personal characteristics of physicians and practice location in Manitoba. AB - A questionnaire survey of 562 physicians in Manitoba who had graduated from the University of Manitoba was carried out to assess the effect of personal characteristics on choosing a practice location. The results closely resemble those of studies performed in the United States: the choice of a nonurban practice location is significantly more likely if the physicians and their spouses have nonurban backgrounds and if the physicians have had a nonurban preceptorship during undergraduate medical education. In this study practitioners who were male and whose fathers were farmers or health care professionals were also more likely to practise in nonurban areas. These findings will help in making physician distribution more equitable. PMID- 3815199 TI - Long-term follow-up of ophthalmic Graves' disease. AB - Sixteen patients with ophthalmic Graves' disease (clinically euthyroid with ophthalmopathy or exophthalmos) were followed up for 4.3 to 14.3 (mean 9.1) years to determine whether thyroid dysfunction developed and whether their ophthalmopathy progressed, regressed or remained stable. Five patients (31%) manifested hyperthyroidism or hypothyroidism, all before the end of the fifth year of follow-up. The ophthalmopathy was mild, and none of the patients required specific treatment. The thyroid function of patients with ophthalmic Graves' disease should be periodically monitored for at least 5 years. PMID- 3815200 TI - Prevalence of iron deficiency among Chinese children aged 6 to 36 months in Montreal. AB - Screening for iron deficiency was undertaken among a group of Chinese children aged 6 to 36 months to determine the prevalence of the condition and its association with infant feeding. Of the 346 children studied, 12.1% were found to be iron deficient. The overall prevalence rate of thalassemia minor was 6.7%. Among the 166 children aged 6 to 12 months, more of those who were breast-fed for at least 2 months than of those who were bottle-fed were iron deficient (27.0% v. 7.0%; p less than 0.001). This difference persisted after controlling for the effect of iron-fortified formula. No such difference was found among those older than 12 months. The observed prevalence of iron deficiency was closer to the rate reported for black children than to that reported for white children in the United States. The findings stress the importance of conducting further studies of iron deficiency among Chinese subpopulations in North America. PMID- 3815201 TI - Endobronchial tuberculosis in an Asian man vaccinated with bacillus Calmette Guerin. PMID- 3815202 TI - Keratitis associated with the use of proparacaine hydrochloride. PMID- 3815203 TI - Into Africa: the telemedicine links between Canada, Kenya and Uganda. PMID- 3815204 TI - Suffer the little children. PMID- 3815205 TI - Patients bearing gifts can pose problems. PMID- 3815206 TI - The new funding formula: will researchers still have time for research? PMID- 3815207 TI - US aims to cut supply and demand in war on illicit drugs. PMID- 3815208 TI - Reassessing myoelectric control: is it time to look at alternatives? PMID- 3815210 TI - Fine words, but will he deliver? PMID- 3815209 TI - Achieving Health for All: implications for Canadian health and social policies. PMID- 3815211 TI - Medical education to achieve health for all. PMID- 3815212 TI - Canadian undergraduate medical education: family physician involvement. AB - A questionnaire designed to determine the nature and extent of family physicians' involvement in Canadian undergraduate medical education was sent in the fall of 1985 to the person in each department of family medicine in the 16 Canadian medical schools who was responsible for the undergraduate program. The questionnaires were followed up by visits to each school. The findings revealed that approximately 1200 family physicians were teaching 7400 Canadian medical students. There was considerable variation in the total curriculum time devoted to family medicine and in the content of and support for an undergraduate curriculum in family medicine across the country. In order to achieve nationally acceptable standards and greater continuity between undergraduate and postgraduate training, the College of Family Physicians of Canada and the Association of Canadian Medical Colleges should develop objectives and program requirements. PMID- 3815213 TI - Clinical nuclear cardiology: 2. Nuclear angiography. PMID- 3815214 TI - Cost analysis of magnetic resonance imaging at St. Joseph's Health Centre of London. AB - In April 1986 St. Joseph's Health Centre of London, Ont., completed 3 years of operating a magnetic resonance imaging unit. The first 2 years were devoted to research and development. From Apr. 1, 1985, to Mar. 31, 1986, the unit operated as the first clinical service unit in Canada. Over the 12 months 1671 patients (an average of 9 patients per 12-hour day) were examined. Studies of the brain (62%) and the spine (21%) accounted for most of the procedures. The operating costs for the year were $892,000; revenues totalled $449,000, for a deficit of $443,000. The average technical cost per patient was $534. Increasing the number of patients examined per year would lower the cost to $431. PMID- 3815215 TI - Methylene-blue-induced hemolytic anemia in a neonate. PMID- 3815216 TI - Medical schools have to change their focus, council told. PMID- 3815217 TI - Medicare: ethics versus economics. PMID- 3815218 TI - Ribavirin: a word of caution. PMID- 3815219 TI - First-trimester fetal diagnosis: prudential ethics. PMID- 3815220 TI - Methadone treatment in British Columbia: bad medicine? PMID- 3815221 TI - Doctor-patient communications revisited. PMID- 3815222 TI - Preventing war. PMID- 3815224 TI - Beefs and bouquets. PMID- 3815223 TI - Asbestos: promotion or prohibition? PMID- 3815225 TI - Carcinoma of the prostate presenting as acute disseminated intravascular coagulation. PMID- 3815226 TI - The environment of medicine in the 21st century: implications for preventive and community approaches. PMID- 3815227 TI - Caring for the dying: reflections of a medical student. PMID- 3815228 TI - Questionnaire development: 1. Formulation. PMID- 3815229 TI - Assessing hypertension control in the community: the need for follow-up measurements to ensure clinical relevance. AB - In community surveys of hypertension control the diagnosis is often based on blood pressure measurements taken on only one visit. The clinical diagnosis of hypertension requires demonstration of sustained blood pressure elevation. We conducted a survey that contrasted the results of these two approaches to determining the prevalence of hypertension and the extent to which hypertension is detected and treated. A multistage random sample of 2737 people was selected, examined and interviewed on up to three occasions. Rates of hypertension prevalence and control were computed from data from one, two and three visits. The prevalence of hypertension was overestimated by 30% when the diagnosis was based on data from one rather than three visits, the rates being 149 and 115/1000. The prevalence of undetected hypertension was overestimated by 350%, the rates being 27 and 6/1000. The proportion of subjects with controlled hypertension was underestimated by 23%, at 56%, compared with 73%. These results confirm the need for follow-up measurements to provide a valid assessment of hypertension control in the community. PMID- 3815230 TI - Neonatal resuscitation in Canadian hospitals. AB - A survey of Canadian hospitals providing obstetric care was undertaken to assess preparation, protocols, training and staff availability for neonatal resuscitation. Of the 721 hospitals contacted 577 (80%) responded. The reported availability of written guidelines for resuscitation varied greatly, depending on hospital size and proximity to a tertiary care centre. Many hospitals, especially those with 300 births or fewer annually, reported that they depend on family physicians or nurses to start and to continue neonatal resuscitation. Approximately one third of the hospitals had written guidelines for summoning personnel for additional help, and one third used a list of maternal or fetal indications for the presence of a physician specifically for the care of the infant at birth. Of 200 hospitals 138 (69%) had to summon additional medical help from outside the institution, 60% at all times. A neonatal resuscitation team in which members' roles were defined was established in 22% of the hospitals. Few hospitals held rehearsals for resuscitation. Nurses were permitted to perform intubation in 21 hospitals (4%), 7 of them in Alberta. National professional bodies should develop guidelines for training and skill maintenance, and hospitals should develop protocols for maintaining equipment and for neonatal resuscitation team activities, including regular practice. Training should be improved in family practice and obstetrics programs, and consideration should be given to training senior obstetric nurses and respiratory therapists in intubation of neonates. PMID- 3815231 TI - Atrial septal aneurysm: spectrum of clinical and echocardiographic presentations. PMID- 3815232 TI - Update on influenza in Canada, 1985-86. PMID- 3815233 TI - The prescription drug sting: be careful out there. PMID- 3815234 TI - Canadian obstetric care system among finest in world, major CMA study finds. PMID- 3815235 TI - The "Eve" decision: "it may turn out to be a meek authority indeed". PMID- 3815236 TI - Geriatric assessment. PMID- 3815237 TI - Integration of geriatric assessment into the community. AB - The integration of geriatric assessment into the community calls for more than effective communication. There should be a defined approach to comprehensive care, of which the assessment service is a regular part, and the assessment process should have a predictable influence on further care decisions. Three types of integrating approaches are described: the "recognized specialty" approach, which is typical of several other developed countries; the "consolidated model," such as the On Lok program in San Francisco; and the "brokerage" model, such as the ACCESS program in Rochester, New York. Each approach has strengths and limitations. We may expect further evolution toward fully integrated programs. PMID- 3815238 TI - An acute inpatient geriatric assessment and treatment unit. AB - The inpatient geriatric assessment unit (GAU) is an important component of the Geriatric Assessment and Treatment Centre (GATC) at the Royal Jubilee Hospital in Victoria, British Columbia. The Centre attempts to accomplish the following: to provide, at the request of the attending physician, diagnostic, treatment, and management services where it best suits the patient (ie, at home, in the outpatient service, or following admission to the ward); and to provide, if necessary, follow-up service after discharge to help prevent readmission to the acute hospital or any part of the geriatric service. PMID- 3815239 TI - Geriatric assessment on a subacute hospital ward. AB - The authors collected data on all patients admitted to the Sepulveda Veterans Administration Geriatric Evaluation Unit (GEU) during its first 6 years of operation. Analysis of these data indicate several beneficial effects associated with this type of specialized geriatric care: improved diagnostic accuracy, reduced use of drugs, improved functional status, and improved placement location. The authors also analyzed additional data from a previously published, randomized controlled trial to compare better process of care between patients randomized to the GEU and those receiving usual services. During their initial hospitalizations, GEU patients received significantly more specialty evaluations than controls (4.9 versus 1.7, p less than .001), had longer lengths of stay (85.1 days versus 44.3 days, p less than .001), had more new diagnoses discovered (2.9 versus 0.6, p less than .001), and had more drugs discontinued from their regimens (4.6 versus 2.3 p less than .001). These process differences were probably related to the previously reported outcome differences: GEU patients were more likely than controls to show improvements in functional status, affect, placement location, use of institutional services, and survival. PMID- 3815240 TI - A geriatric assessment and rehabilitation unit in a rehabilitation hospital. AB - This paper presents process and outcome data for a geriatric assessment unit in a rehabilitation hospital whose focus is on short-term rehabilitation. While the results presented here are positive, they are descriptive and do not prove a cause and effect relationship between the geriatric assessment and rehabilitation unit care and the outcomes described. This unit is currently being evaluated by a prospective randomized controlled clinical trial. PMID- 3815241 TI - Medical assessment of the elderly patient. AB - The major differences in evaluation of old individuals arise in the way one collects data, the attention to detail in physical examination, and the high suspicion for disease required when nonspecific complaints are made. There is no doubt that it takes longer to assess an old person, but the clinician who is familiar with evaluating old people watches in every interaction for subtle clues that might point toward diagnosis. The successful therapeutic interventions in many old people, especially when disease is detected early, should be adequate incentive to take the extra steps necessary for proper evaluation of the elderly individual. PMID- 3815242 TI - Outpatient geriatric evaluation. AB - This article provides a comprehensive description of an established geriatric ambulatory consultation service at Monroe Community Hospital in Rochester, New York. The history of the service is presented and clinic staffing and operations are reviewed. Descriptive information for patients evaluated during a 1-year period and the impact of this team-oriented assessment compared to assessment by physicians are provided. PMID- 3815243 TI - Outpatient geriatric assessment in a Health Maintenance Organization. Its structure, practice, and clinical implications. AB - The authors review their experience with the implementation of a geriatric assessment unit (GAU) within the Rhode Island Group Health Association, a Health Maintenance Organization (HMO). Included is a historical background of the involvement of HMOs with care of Medicare patients, a description of the structure of an outpatient GAU, and the authors' experience to date with this population of patients. This article concludes with a discussion of the future role of GAUs and HMOs in the care of older patients. PMID- 3815244 TI - Inpatient geriatric consultation. AB - Inpatient geriatric consultation services have the potential for educating large numbers of health professionals and influencing the clinical care of large numbers of patients. Such consultation can identify new diagnoses and recommend treatment of conditions whose appropriate management can improve patients' functional level. At San Francisco General Hospital, the most frequent recommendations were medication adjustment, management of dementia, delirium or depression, rehabilitation, and treatment of malnutrition. Of 35 patients slated to go to nursing homes at the time of consultation, 18 were rerouted to lower levels of care, and 14 eventually went home. Preliminary findings at the Palo Alto Veterans Administration Medical Center replicate these data. PMID- 3815245 TI - An outpatient geriatric psychiatry assessment and treatment service. AB - An outpatient evaluation and treatment program for cognitively impaired elderly and their families opened at the University of Washington in 1978. The multidisciplinary approach includes psychiatric, medical, psychological, social, and environmental assessments. The program has been well received by the public and has served as a model for similar programs elsewhere. An important finding from the clinic has been to demonstrate the high frequency of excess disability in patients with dementia of the Alzheimer's type. PMID- 3815246 TI - A geriatric neuropsychiatric inpatient unit. AB - Geriatric neuropsychiatry units have been developed in hospitals in various parts of the United States to provide an intensive diagnostic and treatment program for geriatric patients who have behavioral problems or the early signs of dementia. The Geriatric Neuropsychiatry Unit at the Boston City Hospital is described as a model unit. The process of patient selection and admissions criteria are outlined. Diagnostic interventions and the full evaluative process are then presented, followed by a summary of the therapeutic interventions. These interventions include pharmacologic, psychotherapeutic, behavioral, and milieu therapies. The communications process essential for effective multidisciplinary team function is also reviewed. Discharge planning procedures are presented, along with a summary of patient outcomes. PMID- 3815247 TI - Contrasting the models. Reflections on the pattern of geriatric evaluation unit care. AB - In order to understand geriatric assessment programs better, it is necessary to understand some of the general subgroups of such programs. This article compares various aspects of geriatric evaluation units. PMID- 3815248 TI - The assessment of cognitive function in the elderly. AB - Evidence of impaired cognitive function requires careful evaluation to arrive at correct diagnosis and, possibly, treatment. Steps in this evaluation that might be undertaken in primary care are enumerated and discussed. The role of brief formal tests of cognitive functions in such an evaluation is emphasized. PMID- 3815249 TI - Does the use of phenobarbital as an anticonvulsant permanently exacerbate hyperactivity? AB - Data is presented on 12 patients in whom phenobarbital, when used as an anticonvulsant medication, either precipitated hyperactivity or permanently exacerbated existing hyperactivity. Discontinuation of the medication resulted in a decrease in hyperactivity in all patients. None of the patients returned to a pre-drug level of activity. The effect of phenobarbital on the reticular system is discussed. It is important for clinicians to carefully consider the potential side-effects of the use of phenobarbital in children in whom overactivity is a problem. Ascertaining whether hyperactivity has been caused or exacerbated by exposure to phenobarbital may be important in the differential diagnosis of hyperactivity. PMID- 3815250 TI - The dexamethasone suppression test and the Children's Depression Inventory in psychiatric disorders in children. AB - This open study attempts to evaluate the usefulness of objective diagnostic tests in the child and adolescent age group. Fifty-eight children admitted to a Child and Adolescent Psychiatric service were administered the Dexamethasone Suppression Test (DST), the Children's Depression Inventory (CDI) or both. Rates of DST non-suppression were significantly elevated in children with major affective disorders (10/12) and in children suffering from adjustment disorders (3/18). Children with major depressions and conduct disorders both showed elevated scores on the CDI (p less than 0.025), and these two groups did not significantly differ from each other on this measure. The implications of these findings for future research are discussed. PMID- 3815251 TI - EEG findings and language patterns in autistic children: clinical correlations. AB - Several authors have used the EEG as a diagnostic tool to identify distinctive patterns of cerebral dysfunction in autistic children. However, evidence is needed to support the hypothesis that their level of functioning correlates with their EEG profile. In this study EEG's were obtained in 17 autistic children without sedation and following sleep deprivation. These children were also evaluated in a double blind procedure with regard to their speech and communication abilities. We did not find a statistically significant correlation between EEG changes and speech performance. None of the autistic children using an augmentative system of communication had any EEG abnormalities. However, a normal EEG is not sufficient to predict successful response to communication therapy. Since the effect of sedative drugs on brain electrical activity limits the value of tracings, we recommend the sleep deprivation techniques when "difficult" children have to undergo EEG testing. Parents' or guardians' participation during the procedure is encouraged. PMID- 3815252 TI - Civil commitment and consent for electroconvulsive therapy in Ontario. AB - Among the most contentious legal and ethical issues concerning the use of electroconvulsive therapy (ECT) are the criteria for obtaining a valid consent to treatment and its administration to involuntarily hospitalized patients, with or without consent. This paper reviews the consent process, in particular the assessment of competence, as it is affected by the symptoms and clinical circumstances, including civil status, of those patients for whom ECT is prescribed. The ECT caseload at one psychiatric facility was reviewed to determine the diagnosis and civil status of each patient and the source of consent for each course of ECT prescribed over a 10-year period. Significant differences were found in the diagnostic distribution and the source of consent by diagnostic group between the 1,042 courses administered to informal patients and the 249 courses to involuntary patients. The results are discussed in the context of relevant Ontario legislation and hospital policies. Recommendations are made for the improvement of procedural safeguards to protect the autonomy of all patients. PMID- 3815253 TI - [The effects of rape 6 months after the attack and factors associated with recovery]. AB - In this study a group of 27 victims seen approximately 6 months after the assault was compared to a matched control group. The results show significantly higher scores on two subscales of IPAT ("ego weakness" and "disposition to guilt") and on 4 scales of the MMPI ("denial", "hypochondriasis", "depression" and "conversion hysteria"); also, the victims' social adjustment seems inferior and the frequency of sexual relations has been reduced considerably for them. The following factors have been evaluated in order to test their relation to the adjustment to the assault: rape by a stranger versus someone known, degree of violence, feelings of self-blame, problems during the crisis, predominant thoughts, professional help, social support, stable relationship, allusion to victim's responsibility for rape and conviction or not of the aggressor. Even though most of these variables show a significant simple correlation with adjustment to rape only four among them remain significantly associated when sociodemographic variables, pre-rape psycho-social problems and life stressors are controlled; the very subjective variable "predominant thoughts" seems to best explain differences in adjustment. The importance of pre-assault variables and of the subjective reaction to rape is discussed. PMID- 3815254 TI - Geriatric referrals to a psychiatric consultation-liaison service. AB - Geriatric patients constitute a significant proportion of referrals to a psychiatric consultation-liaison service, accounting for 29% of referrals in the present study. Organic mental disorders, the most common psychiatric diagnosis, were identified in 51% of geriatric referrals. The next most common psychiatric conditions were affective disorders and adjustment disorders, each of which were diagnosed in 17% of geriatric referrals. Transfers to in-patient psychiatry were unusual and the most common recommendations were for psychotropic medications, further medical investigations, and for psychosocial and behavioural interventions to be carried out by the ward staff. Although more specialized psychogeriatric units and community treatment resources are necessary, it is likely that the general hospital setting will continue to be important in the diagnostic assessment and short-term management of medical-psychiatric problems in the elderly. PMID- 3815255 TI - Three simultaneous major sleep disorders. AB - A patient with complex symptomatology is described. Progress in the diagnosis of sleep disorders gradually led to successful diagnosis-based treatment. PMID- 3815256 TI - Folie a Deux in the aged: variations in psychopathology. AB - The etiology of Folie a Deux remains a controversial topic; the relationship between the psychopathology exhibited by the dominant partner and that shown by the submissive one being particularly unclear. Modern etiological theories attempt to reduce the phenomena of Folie a Deux to a procrustean mould, emphasizing in particular the contribution of schizophrenic pathology to the development of the condition. A case is described which raises doubts about the general applicability of this approach. PMID- 3815257 TI - Reibl v. Hughes: the consent issue. AB - Inviolability of the person is the basic principle underpinning the concept of consent to treatment. Although it is not a new concept, consent has become a major medico-legal issue because of a shift, within the doctor/patient relationship, towards more autonomy for the patient and less paternalism from the doctor. This change has been given further impetus by legal decisions such as Reibl v. Hughes and Hopp v. Lepp. In this paper the author reviews the nature of the changes and the impact of the legal decisions on the doctor/patient relationship. He concludes that a legal approach to consent is sterile if it is a substitute to open communication between the doctor and the patient, or to their acceptance of a principle of "equality of two participants". Consent is based on the basic principal of the inviolability of the person, that is, the right, at all times, of every individual not to have his body tampered with without his permission or agreement, and to be the whole decision-maker on matters that affect his physical integrity. This right is not absolute: it may be abrogated by the state for health or judicial reasons, or the person may not be in a position to exercise it, such as when unconscious or because of mental disability. This paper will review present Canadian laws on consent. It will contrast the legal approach to consent to the ethical-humanistic approach which could be developed within the context of the doctor/patient relationship. PMID- 3815258 TI - Civil liberty or unnecessary bureaucracy? PMID- 3815259 TI - Primary pulmonary rhabdomyosarcoma of the lung in children. Report of two cases presenting with spontaneous pneumothorax. AB - This report describes two cases of pulmonary rhabdomyosarcoma occurring in children, ages 21 and 30 months at diagnosis. Both patients presented with spontaneous pneumothorax and had cystic changes in the affected lung by chest x ray. Ultrastructural and immunohistochemical studies supported the myogenic phenotype of these neoplasms. The authors were unable to confirm that either of these tumors had unequivocally originated in a congenital cyst although previous authors have reported this association. An apparent morphologic spectrum of embryonic appearing neoplasms including pulmonary blastoma and a malignant mesenchymoma have been observed in the lungs of children. PMID- 3815260 TI - Laryngeal rhabdomyosarcoma. Case report and literature review. AB - A case report is presented, believed to be the first documented example of pleomorphic rhabdomyosarcoma developing in the larynx of a child. A review of the literature then follows, with evaluation of the epidemiology, treatment options, and survival of patients with this disease. Cure of this malignancy is more likely with early diagnosis and aggressive treatment. PMID- 3815261 TI - Radial scars in women with breast cancer. AB - In 84 consecutive autopsies of women with a clinical diagnosis of invasive breast cancer, radial scars were found in the contralateral breast in 35 cases (42%) by an extensive histopathologic method. Four women had radial scars on the ipsilateral side in the breast tissue available from the primary surgical procedure or at autopsy. One woman had an invasive breast cancer with morphologic features compatible with but not diagnostic of transition from a radial scar. Of the six radial scars with carcinoma in situ occurring in three women, three were of ductal and three of lobular type. In the remaining cases only radial scars with a benign appearance were found except for two with atypical hyperplasia. The frequency of radial scars was significantly higher in women with fibrocystic disease (55%) compared to women without (24%). Contralateral primary invasive and in situ breast cancer occurred in 68%. No difference in the frequency of radial scars in women with and without breast cancer was found and radial scars were not associated with any specific type of breast cancer. Our findings do not indicate a higher malignant potential of radial scars than of fibrocystic disease. It is suggested that only radial scars containing high-risk epithelial changes such as atypical hyperplasia and carcinoma in situ are associated with an increased risk of subsequent breast cancer development. PMID- 3815262 TI - Trends in gastric cancer sex ratio in the United States. AB - Recent reports have suggested that the male/female ratio for gastric cancer has decreased over time and that the mean age of cases has increased. The authors calculated age- and sex-specific mortality rates for gastric cancer from 1950 through 1979 for whites using data from US Vital Statistics and population estimates from the US Census Bureau. Whereas sex ratios based on crude mortality rates showed a decrease over time from 1.7 in 1950 to 1.5 in 1979, similar ratios based on age-adjusted mortality rates showed an increase from 1.8 to 2.1. An increase in mean age at death over time was consistent with the increase in age of the population. The authors conclude that factors responsible for the decrease in gastric cancer mortality in the United States appear to have affected males and females equally. The overall data do not support the emergence of a new form of gastric cancer with a sex ratio or age pattern different from that found in the past. PMID- 3815263 TI - Sustained complete remission in Richter's syndrome. AB - Richter's syndrome is the development of an aggressive diffuse lymphoma in chronic lymphatic leukemia (CLL) and is associated with a poor prognosis. A patient with CLL developed Richter's syndrome, which responded to intensive chemotherapy. Spontaneous regression of CLL in blood and marrow was observed at the onset of Richter's syndrome. The patient remained in complete remission from the lymphoma 4 years after the completion of treatment, and there was no evidence of CLL. PMID- 3815264 TI - Malignant lymphoma of the skin in children. AB - The clinical and histopathologic findings in eight cases of malignant lymphoma of the skin in children are presented. All patients had skin lesions as a primary manifestation of the disorder. Three patients had simultaneous regional lymph node involvement documented by the findings of subsequent biopsies. The majority (five patients) had solitary nodules involving the skin of the head and neck region. Three of the skin biopsy specimens were classified as lymphoblastic lymphoma, two large cell lymphoma, two mixed small and large cell lymphoma, and one small cleaved cell lymphoma. Disseminated disease subsequently developed in four patients in an interval that ranged from 4 to 30 months after diagnosis. The follow-up period ranged from 8 to 56 months, and median survival was 56 months. A literature review of 33 previously reported patients and our eight patients indicate that: skin of the head and the neck region is the most common site of involvement (56%); the majority of lymphomas are diffuse (93%); lymphoblastic lymphoma is the predominant type (53%), with a high proportion showing a non-T cell phenotype; Burkitt's lymphoma and Hodgkin's disease of the skin are extremely rare; and most patients presented in an early clinical stage (Stage IE 56%, Stage IIE 21%), and prolonged disease-free survival was seen mostly in Stage I patients. The cumulative probability of survival for Stage I patients at 24 months was 0.71; while for Stages II to IV patients combined, it was 0.33 at 26 months. PMID- 3815265 TI - Angiosarcoma of the face and scalp, prognosis and treatment. AB - 72 patients with angiosarcoma (AS) of the face and scalp have been analyzed with respect of various prognostic factors and the effects of different treatment regimes. This disease predominantly occurs in the elderly (age range, 56-92 years), and affects men rather more frequently than women (men: 44, women: 28). The clinical presentation varied, and included bruise-like lesions, dusky plaques, chronic edema or cellulitis, ulcerated nodules, pyoderma, and infected conditions. Due to lack of clinical awareness and problems with histologic assessment, delays in diagnosis were frequent. The majority of the tumors arose in the upper part of the face or scalp. Less commonly, the central part of the face was affected while only three tumors developed in the mandibular region. Overall the prognosis was poor; one half of the patients died within 15 months of presentation. Only 12% of the patients survived 5 years or more. Patients with lesions that were less than 10 cm in diameter responded better to treatment and statistically survived longer than those with larger lesions, emphasizing the crucial importance of early diagnosis. There is some indication that men, younger patients, patients with lesions on the central part of the face survived longer, but this was not of statistical significance. The histologic differentiation of the tumors at presentation also was of doubtful prognostic significance. Despite the overall poor prognosis, radical radiotherapy (mostly wide-field electron-beam therapy) in seven patients resulted in the apparent eradication of the local skin disease and prolonged survival of the patients. Pulmonary metastases developed 10 years later in two of those patients, however, but the face and scalp remained tumor-free. PMID- 3815266 TI - A randomized study of intensive versus moderate chemotherapy programs in metastatic breast cancer. AB - Two intensive chemotherapy regimens CFPMV (Cytoxan [cyclophosphamide], 5 fluorouracil, prednisone, methotrexate, vincristine) and CA (Cytoxan, Adriamycin [doxorubicin]) were tested against a moderate regimen, CFP, in a prospective three-arm, randomized study with crossover when relapse or failure occurred, in order to assess whether the response, duration of remission, and survival can be altered by using more intensive regimens as first-line or as rescue therapy. All three regimens were equally effective as initial chemotherapy: CFP 26/46 (57%); CFPMV 31/48 (65%) and CA 26/47 (55%) (P = 0.61) with the least toxicity for the CFP regimen. Median duration of remission were 9.5, 11, and 9 months, respectively. Complete responses were almost identical in all three regimens: 4/46 (9%); 6/48 (12%) and 5/47 (11%) (P = 0.94). CFPMV was an effective regimen as second-line therapy: 11/33 (33%) or third-line therapy: 7/21 (33%). The CA regimen was equally effective as second-line therapy: 8/25 (32%), suggesting that intensive regimens provide an effective rescue therapy, as well in previous responders as in nonresponders. Initial intensive regimens have not substantially altered long-term survival in the whole group of treated patients, Arm II (CFPMV- --CA----CFP) 17.6 months; Arm III (CA----CFP----CFPMV) 12.3 months when compared with initial moderate regimens Arm I (CFP----CFPMV----CA) 16.6 months (P = 0.24). The same lack of difference in survival was noticed in responder patients in each arm: Arm II 19.0 months; Arm III 16.0 months versus Arm I 22.0 months (P = 0.13). Our data suggest that a moderate regimen is as effective as more intense regimens for induction therapy in metastatic breast cancer, with less toxicity, preserving the opportunity for an effective rescue therapy with intensive regimens in second or third-line chemotherapy. PMID- 3815267 TI - Cisplatin. A phase II evaluation in previously untreated patients with soft tissue sarcomas. AB - A Phase II trial of moderately high-dose cisplatin (120 mg/m2 with mannitol diuresis) was conducted in 26 previously untreated patients with soft tissue sarcomas. One partial response (major response rate, 4%) and two minor responses were seen. Severe nausea and vomiting and transient increases in the serum creatinine level were the most common side effects of treatment. Cisplatin has minimal activity as a single agent in patients with soft tissue sarcoma. PMID- 3815268 TI - Pulmonary sarcoidosis following interferon therapy for advanced renal cell carcinoma. AB - A 57-year-old woman developed pulmonary sarcoidosis during therapy with interferon beta for advanced renal cell carcinoma metastatic to mediastinal lymph nodes. The possible role of interferon beta in the pathogenesis of sarcoidosis in this patient is discussed. PMID- 3815269 TI - Clinical experience with intravenous radiosensitizers in unresectable sarcomas. AB - Traditionally, adult bone and soft tissue sarcomas have been considered to be "radioresistant." Because of this philosophy, patients who present with locally advanced, unresectable sarcomas often are treated in a palliative fashion, usually with low-dose radiotherapy. Over the last 6 years, 29 patients with unresectable primary or metastatic sarcomas were treated using a combination of intravenous chemical radiosensitizers and high-dose irradiation. Twenty-two of 29 patients achieved clinical local control, with six patients having a complete clinical response. The time to tumor response is often several months or longer, which is in contrast to other tumor histologies (carcinomas, lymphomas), where tumor response usually occurs over several weeks. Several large tumors have shown only a minimal tumor response, yet were found to be sterilized in posttreatment biopsy or autopsy examination. Of 15 patients with primary sarcomas without metastases, 11 patients (73%) remain free of local tumor progression from 12 to 83 months. Adult high-grade sarcomas can be controlled with high-dose radiotherapy and intravenous radiosensitizers, although the precise role of these agents is unclear. PMID- 3815270 TI - Imaging characteristics of large lipoma and angiomyolipoma of the liver. Case reports. AB - A large lipoma and a large angiomyolipoma of the liver, one case each, are described. In the first case, a 24 X 14-cm homogeneous mass demonstrated a fatty density (-96H) on computed tomography (CT), echogenicity on sonography, and fine neovascular vessels on angiography in the right lobe of the liver. Histopathologic diagnosis of the resected specimen was lipoma. The second case showed a 9-cm fatty mass (-66H) with some enhanced interior nodules in the left lateral area of the liver on CT. Sonography disclosed a large echogenic mass with echolucent nodules, which were seen as stains on the angiogram. Angiomyolipoma was the histopathologic diagnosis. Among these diagnostic modalities, the CT scan provided the most specific and reliable findings. Both patients are doing well more than 2 years and 9 months after resection. PMID- 3815271 TI - Heterogeneity of DNA ploidy in patients with undifferentiated carcinomas of the stomach. AB - DNA ploidy was determined by cytophotometric DNA analysis in 20 patients with undifferentiated carcinomas of the stomach with serosal invasion. Measurements of DNA content were performed in 100 cells each in intramucosal, submucosal, muscular, and subserosal parts of a tumor. According to dispersion on the DNA histogram, DNA ploidy patterns were divided into low and high ploidy groups. Fourteen tumors (70%) showed the same ploidy in every layer (homogeneous DNA ploidy), 13 (65%) were low ploidy and, 1 (5%) was high ploidy. Heterogeneity of DNA ploidy was observed in the remaining six tumors (30%), which showed low ploidy in the mucosa, but high ploidy was observed in one or two deeper layers. In the six with heterogeneous DNA ploidy, there was more frequent metastasis to the lymph nodes (100%) and to the peritoneum (67%) than those with homogeneous DNA ploidy (50% and 21%, respectively). Cytophotometric DNA analysis of cells of undifferentiated gastric tumors suggested that there may be behavioral changes, depending on the degree of penetration into the gastric wall. PMID- 3815272 TI - Small non-cleaved follicular center cell lymphoma in Turkey. Burkitt's and non Burkitt's types. A retrospective clinicopathologic analysis of 53 cases in the pediatric age group. AB - Fifty-three patients in the pediatric age group diagnosed as having small non cleaved follicular center cell (FCC) lymphoma (40 Burkitt's and 13 non-Burkitt's type) have been re-evaluated. Although the histopathologic distinction between the two subgroups is fairly easy to determine there is a considerable degree of clinical overlap in regard to age, sex, anatomic presentation of the disease, the incidence of bone marrow and central nervous system involvement, and the survival. The most important determinant of survival in both subgroups is the stage of the disease. PMID- 3815273 TI - Stage I and II Waldeyer's ring and oral-sinonasal non-Hodgkin's lymphoma. AB - Sixty-six patients with Ann Arbor Stage I and II Waldeyer's ring and oral sinonasal non-Hodgkin's lymphoma are presented. Ten-year survival was better for the 32 patients with Waldeyer's ring non-Hodgkin's lymphoma (Stage I, 83%; Stage II, 75%) than for the 34 with oral-sinonasal non-Hodgkin's lymphoma (Stage I, 47%; Stage II, 50%). Diffuse large cell lymphomas were common in patients with Waldeyer's ring involvement (59%). In those affected in the oral-sinonasal region, 38% had high-grade lymphoma. There was a high incidence of extranodal relapses outside of the gastrointestinal tract in patients with oral-sinonasal lymphoma (10 cases). Gastrointestinal tract relapse occurred commonly in patients with Waldeyer's ring lymphoma and was found in five cases. PMID- 3815274 TI - Clinical significance of pepsinogen A isozymogens, serum pepsinogen A and C levels, and serum gastrin levels. AB - Gastric mucosal pepsinogen A phenotype, serum pepsinogen A level, serum pepsinogen C level, serum pepsinogen A/pepsinogen C ratio, and serum gastrin level were evaluated as potential markers for gastric cancer or its precursors in 19 healthy volunteers and 341 patients from the gastroscopy program. Gastric cancer, atrophic gastritis, and intestinal metaplasia of the stomach were associated with pepsinogen A phenotypes, characterized by an intense fraction 5, and with a low serum pepsinogen A level (less than 25 micrograms/l), a low serum pepsinogen A/pepsinogen C ratio (less than 1.5), and a high serum gastrin level (greater than 79 ng/l). The specificity of pepsinogen A phenotypes with an intense fraction 5 for gastric cancer or its precursors was 95.1% with a sensitivity of 20.4%. The sensitivity and specificity of the noninvasive tests were evaluated with the receiver operating characteristic. For clinical purposes, a serum pepsinogen A/pepsinogen C ratio less than 1.8 is the most suitable test, with a sensitivity of 74% and a specificity of 76% for gastric cancer or its precursors, with a reference population of patients with benign gastric disorders. However, the sensitivity and specificity of the single or combined tests are too low for population screening purposes. PMID- 3815275 TI - Nature of cervical involvement in endometrial carcinoma. AB - In patients with endometrial carcinoma the prognostic significance of clinical and histopathologic variants of cervical involvement is unknown. Fifty-eight patients with endometrial carcinoma and cervical involvement diagnosed by gross examination or endocervical curettage are reviewed. Three clinicopathologic groups were identified: gross cervical involvement (10 patients), occult stromal invasion (25), and no evidence of stromal invasion (23). There were no differences in clinical, pathologic, surgical, or therapeutic characteristics. There was no significant difference in actuarial 5-year survival rates between patients with gross cervical involvement (70%) and occult disease (65%). There was also no significant difference in survival rates among patients with occult cervical stromal invasion (67%). The presence of cervical involvement in endometrial carcinoma is an important prognostic factor. However, the extent of cervical involvement does not appear to be of significant prognostic value. PMID- 3815276 TI - Transitional cell tumors of the renal pelvis and ureter associated with capillarosclerosis indicating analgesic abuse. AB - An association between transitional cell tumors (TCT) and abuse of compound analgesics has been established during the past two decades. Recently thickening of basement membranes around subepithelial capillaries, known as capillarosclerosis, has been reported as a change in the urinary tract pathognomonic for a long-standing abuse of compound analgesics. Therefore the authors reviewed pathologic and clinical data in 59 patients treated for TCT of the renal pelvis or ureter. Capillarosclerosis was found in nine cases (15%) of the TCT group but not in any of the cases selected as controls. Capillarosclerosis is suggested as a valuable marker, which always should be looked for in bladder biopsy specimens. Whenever present it should arouse suspicion of analgesic abuse, and the associated increased risk for developing TCT of the renal pelvis or ureter should be borne in mind. PMID- 3815277 TI - Safety and efficacy of long-term oral anticoagulation in cancer patients. AB - The course of long-term oral anticoagulation in 25 patients (186 patient-months) with cancer managed in an outpatient anticoagulation clinic was analyzed to determine the frequency of complications. Major and minor hemorrhagic complications occurred in 10.7% and 32% of treatment courses, respectively, for an incidence of 1.6% and 4.8%, respectively, per patient-month. Recurrent thromboembolism occurred in 14% of treatment courses. These results are better than previous reports in the literature, but worse than our overall anticoagulation clinic experience. Patients with cancer requiring anticoagulation are at a higher risk of hemorrhagic and thrombotic complications. Accordingly, we recommend that such patients be monitored closely, preferably by physicians experienced with such therapy, as in an anticoagulation clinic, to avoid an excessive degree of morbidity. PMID- 3815278 TI - Is modified radical neck dissection only a staging procedure? AB - This retrospective study evaluates the clinical benefit of modified radical neck dissection among patients with squamous carcinoma of the upper aerodigestive tract. Ninety-eight modified neck dissections were performed in 86 patients over a 5-year period. The procedure entailed removal of the submaxillary and jugular chain nodes while the posterior triangle was not dissected. Thirty-two patients received postoperative radiotherapy. Lymph nodes were histologically positive in 55 of 98 dissections (56%). Among 72 determinate patients, recurrence in the dissected neck occurred in 8 of 38 with positive nodes and none of 34 with negative nodes (P less than 0.05). These recurrences occurred in patients who had clinically palpable nodes preoperatively. Postoperative radiotherapy did not significantly alter the overall recurrence rate or survival of patients with positive nodes. Cumulative disease-free survival at 5 years was 70% overall. It is concluded that the modified neck dissection described is appropriate in the clinically negative neck or when regional disease is early (i.e., N1) and located in the submandibular triangle. Postoperative radiotherapy should be given if more than one node is involved histologically or if extracapsular spread is present. PMID- 3815279 TI - Surgery as part of a combined modality approach for inflammatory breast carcinoma. AB - From November 1977 to February 1984 21 patients with inflammatory breast carcinoma (IBC) were treated in a prospective, nonrandomized study with initial chemotherapy, consisting of a combination of chlorambucil, methotrexate, 5 fluorouracil, and doxorubicin. Modified radical mastectomy was performed after three courses of chemotherapy followed by another six courses of the same chemotherapy. Locoregional radiotherapy concluded the treatment program. All patients responded clinically to the initial chemotherapy. Modified radical mastectomy provided a direct histologic control of the effectiveness of the treatment and, in case of tumor persistence, allowed cytoreduction. No scarring problems were observed and postoperative chemotherapy could be administered without any delay. Radiotherapy was decisive for locoregional tumor control which was obtained in all patients who were treated strictly according to the protocol. Dermal lymphatic involvement represented in this series of clinical inflammatory breast carcinoma no pejorative feature and positive hormone receptors failed to be of predictive value for response to treatment. Considerably variable tumor persistence after initial chemotherapy and the results relative to local tumor control advocate surgery as part of a combined modality approach for inflammatory breast carcinoma. PMID- 3815280 TI - Isolation perfusion with cisplatin for malignant melanoma of the limbs. AB - The role of hyperthermic isolation perfusion in the treatment of advanced melanoma of the limbs is clearly important. However, attention has in the past been focussed mainly on surgical aspects of the procedure. Whereas, equivalent interest in chemotherapy considerations has been lacking. A group of 15 patients have been treated by hyperthermic isolated perfusion for advanced melanoma of the limbs. The chemotherapeutic agent used was cisplatin. The follow-up period was 6 to 60 months. None of these patients had any sign or symptoms of toxicity from the drug. Twelve of these 15 patients are free of disease currently. There was one case of mortality due to unrelated cause and two cases of mortality due to disseminated disease which developed 6 months and 30 months, respectively, posttreatment. Since not uncommon toxic side effects from other drugs used for this procedure is significant, these results suggest that cisplatin may be used as an alternative chemotherapeutic agent in isolation perfusion for advanced melanoma of the extremities. PMID- 3815281 TI - Addison's disease secondary to lymphomatous infiltration of the adrenal glands. Recovery of adrenocortical function after chemotherapy. AB - This case represents the first known instance of reversal of Addison's disease after antineoplastic therapy. Malignant infiltration of the adrenal glands was demonstrated by cytologic findings of needle biopsy in a 57-year-old man suffering from disseminated large cell lymphoma and Addison's disease. He was treated with combination chemotherapy and adrenal hormone replacement. Improvement shown in his computed tomography (CT) scan and clinical status led to the successful discontinuance of cortisone and 9-alpha fluorohydrocortisone. Basal adrenal function and response to ACTH stimulation recovered. PMID- 3815282 TI - Alteration of methotrexate metabolism in rats by administration of an elemental liquid diet. II. Reduced toxicity and improved survival using cholestyramine. AB - The administration of an elemental, chemically defined liquid diet to rats significantly enhanced gastrointestinal toxicity associated with methotrexate administration compared with rats fed a regular chow diet. Chemotherapy induced enteritis is potentially enhanced by the abrasive effect of bile acids on the susceptible cells of the small bowel mucosa. This study evaluated the interactions of methotrexate and cholestyramine in vitro. An additional goal was to evaluate the effects of cholestyramine on animal survival and drug pharmacokinetics in rats given an elemental, chemically defined liquid diet. In vitro binding of cholestyramine to methotrexate increased in a linear fashion at varying concentrations of both drugs in phosphate buffer solution (r greater than 0.84, P less than 0.001) and in bile which was not influenced by pH (range 5-8). The addition of cholestyramine to an elemental liquid diet significantly improved survival following methotrexate administration (20 mg/kg IP bolus) compared with rats fed an elemental liquid diet alone (P less than 0.02). Both elemental liquid diets, either with or without cholestyramine, delayed serum and biliary clearance of methotrexate up to 72 hours compared with rats fed a regular chow diet. However, rats fed an elemental liquid diet with added cholestyramine had significantly lower levels of methotrexate in serum from the systemic and portal venous circulation at 48 hours (P less than 0.03) and in bile at 48 (P less than 0.02) and 72 hours (P less than 0.05) following methotrexate administration. The addition of cholestyramine to an elemental liquid diet improves survival and reduces gastrointestinal toxicity following methotrexate administration, by binding methotrexate in bile and reducing the delay in systemic clearance of the drug. By binding to intraluminal bile acids, cholestyramine may also have a locally protective effect on the mucosal cells of the small intestine following methotrexate administration. Cholestyramine may be of clinical benefit in patients receiving high-dose methotrexate regimens as an adjunct to leucovorin rescue. PMID- 3815283 TI - Clinical evaluation of total-body hyperthermia combined with anticancer chemotherapy for far-advanced miscellaneous cancer in Japan. AB - One hundred sixty-eight patients with miscellaneous far-advanced cancer received a total of 444 extracorporeally induced total-body hyperthermia (TBHT) treatments in seven Japanese hospitals. Overall, a regression of malignancy was observed in 39 of 132 evaluable patients (29.5%) and the most favorable results were obtained for patients with lung cancer. Irrespective of whether the tumors were primary or secondary lesions or recurrences, favorable results were obtained in patients whose tumors were in the lung, liver, lymph nodes, and soft tissue. No relationship was found between an objective response to TBHT and histologic types of the tumors. There was no clear relationship between an objective tumor response and the nature of the simultaneous chemotherapy during hyperthermia. Antitumor effects were not evaluable in 36 patients (21.4%). Of these 36 patients, 33 died before evaluation could be made; 24 died of various complications and 9 died of cachexia without complication. The mortality increased in proportion to the reduction of the performance status of patients before TBHT. These results indicate that TBHT should be used as therapy for patients whose tumors are in the lung, liver, lymph node, and soft tissue and then only on patients in generally good condition. PMID- 3815285 TI - Early diagnosis of spinal-epidural metastasis by magnetic resonance imaging. AB - Sixteen patients with various types of cancer who developed pain along the axial spine were prospectively studied by magnetic resonance imaging (MRI). The studies were performed with a Fonar Beta-3000 (Fonar Co., Melville, NY) permanent magnet operating at 0.3 Tesla (T). Detailed neurologic examinations were followed by bone x-rays, bone scans, and MRI. In 12 patients there were focal neurologic findings. Bone x-rays and bone scans were diagnostic for metastatic disease in 10 cases; MRIs were consistent with metastatic spinal-epidural disease in all 16 patients. Magnetic resonance imaging revealed bone involvement in three patients whose x-rays and bone scans were both negative indicating a higher degree of sensitivity. In six patients thecal compression was obvious on MRI; in three of these previous myelograms had been interpreted as negative. These early results suggest that MRI can serve as a useful tool for diagnosing early spinal-epidural metastases. PMID- 3815284 TI - Results of treatment of stage IA and IIA Hodgkin's disease. AB - This study analyzed the 5 year actuarial survival and disease-free survival of 122 patients with Stage IA and IIA Hodgkin's disease, (108 patients laparotomy staged) treated with mantle and paraaortic irradiation from 1975 to 1981. Prognostic subgroups and patterns of treatment failure were investigated. The 5 year actuarial survival and disease-free survival was 91% and 75% respectively for the entire group. For Stage IA patients, the 5 year survival and disease-free survival was 92% and 86% respectively, whereas for those in Stage IIA the respective figures were 86% and 65%. Individuals with greater than four sites of involvement at initial presentation; extensive mediastinal adenopathy; hilar or extramediastinal extension to lung, pleura or pericardium, had a poorer 5 year actuarial disease-free survival (43%-60%) than those without these factors (70% 85%). Of the 122 patients, there were 26 relapses: nine infield failures; two concurrent infield and systemic failures; nine marginal recurrences, and three relapses occurring systemically and three in nodal groups not irradiated. Following relapse, 17 patients were salvaged with chemotherapy. Two patients are alive with disease and seven patients died of Hodgkin's disease. Patients with less extensive mediastinal adenopathy and supradiaphragmatic nonmediastinal presentations can be satisfactorily treated with mantle and paraaortic irradiation, whereas patients with extensive mediastinal adenopathy receive six cycles of multiagent chemotherapy before irradiation. PMID- 3815286 TI - A morphometric comparison of the changes in the laryngeal skeleton associated with invasion by tumor and by external-beam radiation. AB - Patterns of cartilage invasion by squamous carcinoma were examined in 40 laryngectomy specimens with particular reference to selective involvement of ossified cartilage. The study determines whether external radiation administered at therapeutic levels to the human larynx has selective effects on the osteoclast cell population and subsequent bone resorption. Radiated and nonirradiated tissues were compared as were cases with and without laryngeal framework involvement by cancer. Morphologic changes in ossified laryngeal cartilage showed that invasion is a largely indirect process dominated by local bone destruction with osteoclasts operating in front of the advancing tumor. Morphometric studies indicate that framework invasion correlates significantly with both increased numbers of osteoclasts and increased bone resorption. An original finding here was that radiation therapy resulted in similarly increased osteoclast activity among cases without framework involvement by cancer. In these cases radiation appeared to act independently of tumor in producing osteoclast activation. PMID- 3815287 TI - Effectiveness of pilocarpine in postradiation xerostomia. AB - Pilocarpine and placebo tablets were administered for 90 day periods in a double blind, sequential crossover trial to 12 patients with postradiation xerostomia. Salivary flow was measured by two techniques, symptomatic change and adverse side effects were also recorded. Nine of the 12 patients showed marked improvement by two or more criteria while taking pilocarpine. None of the 12 patients showed meaningful improvement while on placebo. Side effects were minimal and easily controlled. These results show that pilocarpine is effective in relieving the signs and symptoms of postradiation xerostomia. PMID- 3815288 TI - A morphologic study of childhood lymphoma of the lymphoblastic type. The pediatric Oncology Group experience. AB - For this study 227 non-Hodgkin's lymphomas, registered through the Pediatric Oncology Group clinical studies between 1976 and 1982, were morphologically subclassified into major histologic types and subtypes, and their histopathologic and clinical features were compared. These lymphomas were distributed primarily into only three of the recognized major histologic types: lymphoblastic (LB), 106 (47%); undifferentiated (DU), 49 (21%); and diffuse histiocytic (DH), 72 (32%). These patient groups were found to differ in several ways: the LB lymphomas contained most of the patients under two years of age; the LB lymphomas tended to present in higher clinical stages; the LB lymphomas tended to involve lymph node groups and the bone marrow more often than did the DU and DH lymphomas; and the DU lymphomas had a greater tendency for gastrointestinal tract and other major organ system involvement. The complete remission rate of 96%, for the LB lymphomas was better than for either the DU or the DH lymphomas. The disease-free survival of the LB lymphomas was significantly better than the DU group, but not the DH group. The LB were histologically divisible into three subtypes: convoluted (C), nonconvoluted (NC), and large cell variant (LCV). The C and NC subtypes preferentially involved the mediastinum and peripheral lymph nodes initially, while the LCV tended to involve the abdomen. However, none of the subtypes differed in clinical stage. The complete remission, and the disease-free survival rates between these subtypes were not statistically different. PMID- 3815289 TI - A morphologic study of childhood lymphoma of the undifferentiated type. The Pediatric Oncology Group experience. AB - A retrospective analysis of 49 cases of undifferentiated non-Hodgkin's lymphoma, registered through the Pediatric Oncology Group's randomized clinical trials between 1976 and 1982, suggests that the histologic distinction between Burkitt's and non-Burkitt's tumor is clinicopathologically irrelevant in children. Patients with undifferentiated lymphoma were stratified morphologically into three subtypes: Burkitt's (B; 18 patients); non-Burkitt's (NB; 21 patients); and small noncleaved, not-otherwise-specified (NOS; 10 patients). Median age at presentation was 10 years for B; 12 years for NB; 6 years for NOS; and 10 years overall. Univariate analysis of clinical and laboratory data at presentation, yielded no significant differences between B, and NB patients. Complete remissions were obtained in 75% of the patients, and there were no significant differences in complete remission rate among the different morphologic subtypes of undifferentiated lymphoma. There were no significant differences in the estimated disease free survival between B, and NB patients. No morphologic parameters were identified that were predictive of prognosis. PMID- 3815290 TI - Growth mode and DNA ploidy in mucosal carcinomas of the stomach. AB - Modes of cancer growth and DNA ploidy were studied in 66 patients with mucosal carcinoma of the stomach. The modes of growth were classified into five histologic patterns; elongated tubular (three patients), expansive (18 patients), tubular and solid (14 patients), carcinoma in situ (10 patients) and infiltrative (21 patients). In every patient, all or most lesions with elongated tubular, expansive, and carcinoma in situ growths were located in the pyloric gland area of the stomach, and were less than 4 cm in diameter. Histologically, the adenocarcinomas papillary or well-, or moderately differentiated. Most lesions with an infiltrative growth were located in the intermediate pyloric and fundic glands areas, depressed in gross appearance, and composed of poorly differentiated glandular or signet ring tumor cells. The lesions with a tubular and solid growth were present in the pyloric gland or intermediate area, and were classified as well-, moderately, or poorly differentiated adenocarcinoma. All lesions with an elongated tubular, tubular and solid, and carcinoma in situ growths, and most lesions with an infiltrative growth showed a narrowly restricted DNA distribution (Type I or II), while most lesions with an expansive growth had mostly a widely scattered DNA distribution (Type III), representing a higher malignant potential. PMID- 3815291 TI - Salivary dermal analogue tumors arising in lymph nodes. AB - Dermal analogue tumor, an unusual type of monomorphic salivary adenoma, occurs in the parotid gland and rarely in other salivary tissues. This report describes three patients with dermal analogue tumors arising from ectopic salivary tissue in lymph nodes. Two tumors appeared in the periparotid lymph nodes and one in the lateral upper cervical region. All of the patients were men, aged 50 to 60 years, who all had a painless neck mass for 1 year or longer. Currently, the patients are free of disease 14, 3, and 2 years, respectively, after surgical excision. Dermal analogue monomorphic adenomas join several other salivary tumors in possible intranodal origin and should not be confused with metastases. PMID- 3815292 TI - Hormone receptor studies in axillary metastases from occult breast cancers. AB - The authors describe 11 patients with occult breast carcinoma, who initially presented with axillary nodal metastases of unknown origin. In all 11 cases, physical examination and mammography results were normal. Steroid hormone receptor studies were done on tissue from all 11 axillary masses and 2 masses underwent lactalbumin staining as well. In 8 of the 11 patients these studies were positive, suggesting breast as the primary tumor site. Estrogen (30 to 445 fmol/g) or progesterone (30 to 1059 fmol/g) receptors, or both, were positive in seven cases. Although a breast carcinoma was subsequently found in all 11 patients, receptor studies on the primary tumor could not be done in every instance. The authors concluded that performing steroid hormone receptor assays on axillary metastases from occult tumors not only may provide information regarding the identity of the primary tumor but also may be the sole opportunity to determine its hormone receptor status. PMID- 3815293 TI - Metastatic carcinoma of the breast. An unusual presentation mimicking cutaneous vasculitis. AB - Cutaneous metastatic disease which clinically mimics a cutaneous vasculitis developed in a 53-year-old postmenopausal women with Stage II adenocarcinoma of the breast. This unusual presentation is contrasted with the more common variants of cutaneous metastatic breast carcinoma. PMID- 3815294 TI - Cytological diagnosis by fine needle sampling without aspiration. AB - The merits of a simplified cytological method of fine needle sampling without aspiration are compared to those of the classical fine needle aspiration techniques in a series of benign and malignant mammary tumors which were subsequently proved histologically. A comparable cellular yield was obtained by both techniques. In a series of 635 benign and malignant breast tumors examined in 1981 with fine needle alone, insufficient cellular yield was recorded in 5.5% of the lesion. The same incidence (6%) was recorded with aspiration techniques in 7877 benign and malignant mammary tumors examined from 1954 to 1980. With the new technique, trauma is reduced and a better perception of the tumor and of its consistency is directly obtained. PMID- 3815295 TI - Fine needle aspiration biopsy in the diagnosis of thyroid cancer and thyroid disease. AB - Fine needle aspiration biopsy (FNAB) performed for diffuse and nodular goiter in the past 5 years, was evaluated in 1399 cases. Surgery was performed on the basis of FNAB cytologic diagnosis that was positive or suggestive of malignancy and/or a suggestive clinical history. Surgery also was performed in cases of cold nodules with negative FNAB results that did not respond to 6 months of suppressive thyroxine therapy. A correlation of cytologic findings with histologic findings was possible in 415 patients who underwent surgery: the evaluation of FNAB results yielded better results when suspicious cytologic findings were considered to be positive (2.4% false-negative, 86.3% sensitivity) rather than negative (6.5% and 65.7%, respectively). FNAB has become a useful procedure in the study and diagnosis of thyroid diseases. It is a simple, rapid diagnostic procedure that may be used to expedite the management of malignant lesions. PMID- 3815296 TI - Malignant ovarian tumors in children and adolescents. AB - Eighteen patients aged 4 to 18 years (median, 10 years) were treated at the Children's Cancer Research Center of The Children's Hospital of Philadelphia (CHP) from September 1973 to September 1983 for malignant ovarian tumors. The pathologic categories were endodermal sinus tumor (eight patients), embryonal carcinoma (three patients), pure dysgerminoma (three patients), adenocarcinoma (three patients), and malignant granulosa-cell tumor (one patient). In 1973 and 1975, respectively, two patients with endodermal sinus tumors were treated with surgical removal with or without radiation therapy (RT) and chemotherapy with vincristine (Vc) and actinomycin D+ cyclophosphamide + Adriamycin (Adria Laboratories, Columbus, OH) (ACAdr); both developed local recurrence within 12 months and died of tumor. Since 1977, four of six patients with endodermal sinus tumors have been managed successfully with surgery followed by chemotherapy with cisplatin (P), bleomycin (B), vinblastine (Vb), and ACAdr; none received RT. One died of recurrent tumor and the other died of congestive heart failure attributed to Adriamycin (Adr). All three patients with embryonal carcinoma were well after surgical excision alone (one patient) or surgery and chemotherapy with cisplatin + bleomycin + vinblastine (PBVb) + ACAdr (two patients). Treatment of the remaining seven patients included excision alone (two patients) or excision and chemotherapy (five patients) with various combinations of Vc, ACAdr, and P. One patient with granulosa-theca cell tumor also received whole abdominal RT (3000 rad by external beam), and died of congestive heart failure attributed to Adr. The other six children were free of detectable tumor 16 months to 8 years from diagnosis. Chemotherapy with PBVb and actinomycin D + cyclophosphamide (AC) should be used in the postoperative management of young persons with malignant ovarian tumors. Adr is of doubtful value and may be considerably toxic. RT is of limited use and usually is not indicated. PMID- 3815297 TI - Birth cohort, time, and age effects in Italian cancer mortality. AB - Italian death certification data from 1955 to 1979 for total cancer mortality and 30 cancer sites in the population aged 25 to 74, were analyzed using a log-linear Poisson model to isolate the effects of birth cohort, calendar period of death, and age. The most frequent cohort pattern was characterized by increases up to the generations born between 1920 and 1930, followed by stabilization or a slight decrease. This pattern was evident for total cancer mortality in men, and for several common sites, including larynx, lung, esophagus, bladder, female breast, and ovary. Only four sites (pancreas, pleura, intestines in both sexes, and kidney in men) showed cohort values still rising in more recent generations. Stable cohort and period of death curves were observed for cancers of the prostate and testis, whereas trends were steadily going down for neoplasms of the stomach, and (cervix) uteri. Finally, there were a few discontinuous trends (e.g., in the case of brain neoplasms, leukemias, and lymphomas), which probably reflect different effects of improvements in diagnosis and/or treatment. Period of death values increased for lung and other tobacco related sites (chiefly in males) and, up to the early 1970s, for a few other common sites, including intestines, and the female breast. Downward trends over the calendar period were evident for cancers of the stomach and of the (cervix) uteri. Therefore, total cancer mortality trends over the calendar period of death were moderately increasing for men, and slightly decreasing for women. PMID- 3815298 TI - Simultaneous cloacogenic carcinoma in dizygotic twins. AB - Dizygotic twins developed cloacogenic carcinoma of the anus almost simultaneously. The patients, although separated from the time they were 20-years old, had very similar life styles. There are several reports in the medical literature of synchronous tumors in mono and dizygotic twins. It is recommended that if a cancer diagnosis is made in one twin, the other undergo workup to exclude the presence of a tumor with similar histology. The establishment of state or national twin registries would provide valuable information regarding the role of genetic and environmental factors in the development of not only cancer but also of various nonmalignant disorders. PMID- 3815299 TI - Prognostic index for malignant melanoma. AB - This report verifies the ability of a Prognostic Index (PI) to accurately predict 5-year survival rates for 879 Stage I cutaneous malignant melanoma (MM) patients seen at New York University Medical Center. The PI used in this study was first reported from Munich, West Germany, and is calculated from standard histologic sections by multiplying the MM thickness in millimeters (Breslow method) by the number of MM mitoses per square millimeter. A PI value of less than 19 versus greater than or equal to 19 was found to be a significant and independent prognostic variable for Stage I MM when compared with seven other predictive variables (including Breslow thickness). These PI intervals identified a subgroup of patients with MM of intermediate thicknesses (1.50-3.49 mm) whose significantly worse survival would not have been anticipated if prognosis were determined by Breslow thickness alone. For example, patients with MM 1.50 to 2.49 mm thick have a 5-year survival rate of 84.1% determined by Breslow thickness alone; however, among these patients exists a subgroup with PI greater than or equal to 19 whose survival rate is only 57.6%. This study verifies the additive usefulness of the PI in predicting survival rates of patients with Stage I cutaneous MM. PMID- 3815300 TI - Lactase dehydrogenase as a tumor marker for recurrent disease in Ewing's sarcoma. AB - The serum lactase dehydrogenase (LDH) of 56 patients with Ewing's sarcoma was examined to determine the use of LDH as a tumor marker. The initial LDH level was used to determine its ability to predict survival. The follow-up LDH level also was examined, as an indicator of recurrent disease. The initial LDH level was found to have no prognostic value. Both patients with elevated and normal LDH levels had the same survival rate. The LDH level at recurrence was significantly higher, however, than the follow-up LDH level of those without recurrence (P less than 0.001). The LDH level was most sensitive as a tumor marker for recurrent disease in those patients with multiple sites of tumor involvement at the time of recurrence. PMID- 3815301 TI - High-dose, continuous-infusion cyclophosphamide, cytarabine, vincristine, and prednisone for remission induction in refractory adult acute leukemia. AB - Fifteen consecutive patients with refractory adult acute leukemia (RAAL) were treated with a combination of high-dose, continuous-infusion cyclophosphamide, cytarabine, vincristine, and prednisone (Hi-COAP). The initial nine patients received cyclophosphamide 350 mg/m2 as a 24-hour intravenous (IV) infusion over 5 days; cytarabine, 100 mg/m2 IV bolus every 12 hours for ten doses; vincristine, 2.0 mg IV bolus on day 1; and prednisone, 100 mg orally for 7 days. The last six patients had the cyclophosphamide infusion lengthened to 7 days, and the cytarabine increased to 14 doses. All patients were evaluable for toxicity and response. Seven patients (47%) obtained a complete remission and six patients (40%) a partial remission. Median duration of all remissions has been 7.0 months with a range of 1 to 32 months. Toxicity has been limited to primarily myelosuppression with no hemorrhagic cystitis, central nervous system (CNS), hepatic, or pulmonary toxicity noted. Gastrointestinal toxicity was mild, with no effect on nutritional status noted. Median duration of complete responders was 8.5 months. Thus, Hi-COAP demonstrates promising efficacy with minimal toxicity in RAAL and warrants further exploration in multiinstitutional trials. PMID- 3815302 TI - High-dose doxorubicin infusion therapy for disseminated mixed mesodermal sarcoma of the uterus. AB - Fifteen patients with metastatic mixed mesodermal sarcoma of the uterus received high dose doxorubicin infusion therapy. For 12 patients, the initial dose was 90 mg/m2; the other three patients' starting doses were 50, 75, and 75 mg/m2 respectively. Twelve patients received doxorubicin as firstline chemotherapy, with a cumulative dose of 90 mg/m2 to 675 mg/m2 (median = 495 mg/m2). Three patients treated secondarily received cumulative doses of 90, 205, and 425 mg/m2. Of nine patients who had measurable disease, none had an objective response. The median survival of the 15 patients was 11.3 months, with a range of 0.5 to 51+ months. Two patients died of neutropenia related sepsis. Cardiotoxicity occurred in two patients. Eleven patients are dead of disease, and two patients are alive without evidence of disease at 49, and 51 months. Extending the doxorubicin dosage to its tolerable limits did not appear to result in improved efficacy in patients with metastatic mixed mesodermal uterine sarcomas. Future clinical trials should concentrate on doxorubicin-containing combination regimens and Phase II single agent studies. PMID- 3815303 TI - Radiation-induced neoplasms of the brain. AB - The histopathology of two patients with radiation-induced neoplasms of the brain following therapeutic irradiation for intracranial malignancies is described. The second neoplasms were an atypical meningioma and a polymorphous cell sarcoma, respectively. They occurred 12 and 23 years after irradiation (4000 rad), within the original field of irradiation. In both cases, the radiation-induced tumors were histologically distinct from the initial medulloblastomas. Both patients were retreated with local irradiation using permanent implantation of radioactive iodine-125 seeds. PMID- 3815304 TI - Comparison of carcinoembryonic antigen levels between portal and peripheral blood in patients with colorectal cancer. Correlation with histopathologic variables. AB - Correlation between carcinoembryonic antigen (CEA) levels of peripheral and portal blood, and eight histopathologic variables, was examined in 66 patients with colorectal cancer. The change in CEA levels in the portal blood of 40 patients during operation was also examined in relation to histopathologic variables. CEA levels of portal blood (with a mean of 26.6 ng/ml and positive rate greater than 5 ng/ml, 59.1%) were significantly higher than those of peripheral blood (8.1 ng/ml, 33.3%). Elevation of CEA levels in portal and peripheral blood was most highly correlated with the venous invasion. Although the levels in the portal blood were related to six other histopathologic variables including tumor size, tumor differentiation, node metastasis, lymphatic invasion, invasive layer of the colorectal wall, and Dukes' classification except tumor location. CEA levels rose from 19.4 ng/ml and 40% to 43.6 ng/ml and 90.2% respectively following operative stimuli to cancer lesions with venous invasion. However, the levels did not rise in the lesions without the invasion. CEA levels of peripheral blood were as low as 5 ng/ml in three out of eight patients with liver metastasis. However, the levels in portal blood were much greater than 5 ng/ml in all of the patients. These results suggest that CEA may be hematogenously drained by the portal system via the draining vein from the cancer cells in the invasive veins but not by the thoracic duct of the lymphatic system. PMID- 3815305 TI - Pseudolymphoma of the stomach. A clinicopathologic study of 15 cases. AB - Fifteen cases of gastric pseudolymphoma (GPL) were studied and classified into three subtypes: The nodular type, which is elevated, representing a submucosal tumor. Histologically, the tumor is composed of lymphoid hyperplasia with no associated ulcer. The lesion is well demarcated with no sinusoidal structure. Those findings indicate a nonreactive state. The ulcerative type, which usually is accompanied by deep ulceration with extensive fibrosis. The erosive type, which is infiltrated by extensive lymphoid hyperplasia in the propria mucosa and submucosa. The latter two types represent the reactive state in response to chronic gastric ulcer or inflammation. One of four ulcerative GPLs, however, was associated with focal malignant lymphoma which accounted for one of the fifteen GPL studied. Although there is a low incidence of malignant lymphoma among GPL patients, pseudolymphoma should be considered as a precursor lesion with malignant potential. PMID- 3815306 TI - Pineocytomas of childhood. A reappraisal of natural history and response to therapy. AB - Pineocytomas are pineal parenchymal tumors composed of differentiated cells histologically similar to those of the mature pineal gland. Little is known about the incidence, pattern of growth, or response to treatment of pineocytomas. Between 1975 and 1985, six children with pineocytomas were treated at our institution, and pineocytomas constituted 11% of all newly diagnosed pineal region tumors. The clinical, radiographic, and pathologic features of these six patients with pineocytomas are presented. Initial treatment for these children included craniospinal plus supplemental local radiotherapy (three), local radiotherapy alone (one), or radiation therapy plus adjuvant chemotherapy (two). Four of six patients had tumor recurrence a median of two years after diagnosis. Three patients had leptomeningeal dissemination, one at the time of diagnosis and two following therapy. Our findings suggest that: biopsy is necessary to distinguish pineocytomas from other pineal region tumors; radiation therapy alone is inadequate; and these tumors are aggressive in the pediatric population, with a high propensity for leptomeningeal dissemination. PMID- 3815307 TI - Gastric carcinoma in the young. AB - Thirty-eight cases of gastric carcinoma in patients 35-years-old and younger, occurring in the period 1948 to 1983, are reviewed. They comprised 2.2% of 1710 cases in all ages for the same 35 year period at the Charity Hospital. Women were afflicted as commonly as men. Blacks outnumbered whites 2.9:1.0. Obstruction, pain, and weight loss of relatively short duration were prominent symptoms. Tumors tended to be located distally in the stomach, and scirrhous in appearance. Histologically, diffuse type lesions were more common than intestinal or other type tumors. Radiographic evidence of disease was usually present in patients undergoing upper gastrointestinal series. Endoscopy with biopsy was a valuable diagnostic tool. Resectability in this group was not less than that achieved for all ages, however, only one patient has survived for five years. Advanced stage lesions predominated and were associated with poor survival. Earlier stage lesions in this age group appear to bear a more favorable prognosis. PMID- 3815308 TI - Evans' syndrome associated with microcystic adenoma of the pancreas. AB - A case of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura (Evans' syndrome), associated with a microcystic adenoma of the pancreas is reported. Early recognition of this rare entity is important, as corticosteroids and splenectomy are usually ineffective, whereas removal of the tumor may be a cure for this condition. Possible mechanisms of the hemolytic anemia and thrombocytopenia are also discussed. PMID- 3815309 TI - Clinical evaluation of urothelial tumors of the renal pelvis and ureter based on a new classification system. AB - Clinical evaluation of 460 cases of urothelial tumors of the renal pelvis and ureter was performed using a new clinical classification system, since no systemic clinical classification such as the TNM system for bladder tumors has been available to date. ABC, and TS and TE categories were newly adopted. The former distinguishes tumor multicentricity, and the latter indicates the clinical tumor stage. Tumors arising in one organ and homolaterally are categorized as A, while those in both organs (ureter and renal pelvis) and/or in the bladder are B, and bilateral tumors are C. TS represents the tumors of pT1 and pT2, and TE represents pT3, and pT4. Tumors belonging to pB showed a poorer prognosis than pA tumors. The TS and TE staging system clearly reflected the histopathologic stage, and produced significant differences in relative survival rates. Regarding various prognostic factors, our series gave the same results as reported by other investigators. However, it should be stressed that female patients showed a poorer prognosis than male patients. PMID- 3815310 TI - Bone sarcomas associated with Ollier's disease. AB - Of 55 patients with Ollier's disease seen at the Mayo Clinic between 1907 and 1985, 16 had malignant bone neoplasms: 12 chondrosarcomas, two dedifferentiated chondrosarcomas, one chordoma, and one osteosarcoma. One patient had a chondrosarcoma in two different bones. These findings suggest that approximately 30% of patients with Ollier's disease will develop a malignant bone neoplasm, most probably chondrosarcoma. The prognosis for most patients is good. Five of the 16 patients survived more than 13 years after treatment. PMID- 3815311 TI - Cancer incidence in hypertensives. AB - Cancer incidence was measured over a 5-year period (1978 to 1982) in 4067 hypertensive patients, and 10,366 normotensive patients from general practices in southwestern Ontario. For cancer of all sites an elevated incidence was found among hypertensive patients. The elevation was most pronounced among newly diagnosed hypertensive patients, with hypertension of moderate or greater severity, and for sites that have been described in clinical reports as being capable of producing a rise in blood pressure. It is tentatively concluded that the causal direction is from cancer to hypertension, rather than the reverse. If this conclusion is correct, the associations that have been reported between cancer mortality and hypertension may be due to an effect of blood pressure upon survival from cancer. PMID- 3815312 TI - Malignant lymphoma in the X-linked lymphoproliferative syndrome. AB - Male patients with the X-linked lymphoproliferative syndrome (XLP) have an inherited immune deficiency to Epstein-Barr virus (EBV) infection that results in fatal infectious mononucleosis (IM), acquired hypogammaglobulinemia- or agammaglobulinemia, virus-associated hemophagocytic syndrome, and non-Hodgkin's malignant lymphoma (ML). A clinicopathologic analysis of 17 patients with XLP who developed ML was performed. The median age of the patients at the time of diagnosis was 4.0 years (range, 2-19 years). The median overall survival was 12 months (range, 1-216 months). Eight patients had maternally related male relatives with ML. Other phenotypes of XLP were documented in male relatives of the remaining nine patients. Common presenting symptoms were fever, nausea, vomiting, and abdominal pain. Nine patients had "B" symptoms. All ML occurred at extranodal sites. The intestines, most commonly ileocecal, were involved in 76.5% of the cases. Thirteen patients had localized disease (Stages I and II) and four patients had advanced disease (Stages III and IV). A diffuse histologic pattern of growth was observed in all cases. The distribution of histologic subtypes included small noncleaved (41.2%), large noncleaved (17.6%), immunoblastic (17.6%), small cleaved or mixed cell (11.8%), and unclassifiable (5.9%) ML. Surgical resection, radiation therapy, and chemotherapy resulted in disease-free survivals of up to 192 months in eight patients (median 114 months; range, 12-192 months). Eight of 17 patients (47%) are still alive. A median survival of only 6.0 months (range, 1-12 months) was observed in the nine patients who died. No residual ML was found at autopsy. The small noncleaved subtype had an adverse prognosis (seven of nine deaths versus one of eight survivors; P less than 0.05). Bacterial infection was the major cause of death (seven of nine patients). Characteristics that distinguish ML in XLP from other ML include a maternal family history of XLP, early age of onset, acquired hypogammaglobulinemia, post EBV infection, and ileocecal involvement. PMID- 3815313 TI - Agreement rates and American-Japanese pathologists' comparability of a modified Working Formulation for non-Hodgkin's lymphomas. An analysis of the cases collected for the Fifth International Workshop on Chromosomes in Leukemia Lymphoma. AB - Histopathologic slides of 368 cases collected from 16 institutions around the world for the Fifth International Chromosome Workshop were independently reviewed by a group of five hematopathologists consisting of two Americans and three Japanese. Agreement rates of their diagnoses using the Working Formulation (WF) for non-Hodgkin's lymphomas were studied. A modified classification scheme of the WF was used in order to define cytologic subtypes more specifically, enabling 65 possible diagnostic choices. Data analyses by computer revealed that at least four out of five diagnostic agreements were observed in 290 cases (78.9%). Similar agreements were observed in more than 80% of the cases for most of the categories of the WF, excepting diffuse small cleaved (73.3%), diffuse mixed (64.2%), diffuse large cell (76.5%), and immunoblastic lymphoma (70.2%). Agreement rates between American and Japanese pathologists did not demonstrate statistically significant differences against expected values. It was concluded that the WF was a reliable and useful classification system for multi institutional as well as international projects, although refinements may be necessary in some categories for better diagnostic agreement. PMID- 3815314 TI - Mediastinal lymph node metastases from gastrointestinal carcinoma. AB - Mediastinal and hilar lymphadenopathy secondary to gastrointestinal metastases rarely have been reported and have been considered to occur only in conjunction with lymphangitic lung spread. The current report is of 15 cases of hilar and mediastinal metastases secondary to pancreatic, gastric, and colonic primary tumors. In only three of these cases was lymphangitic lung involvement noted. Possible pathways of spread of these tumors to the mediastinal lymph nodes are discussed. PMID- 3815315 TI - Thymic lesions. Experience with computed tomography in 24 patients. AB - The value of computed tomography in the treatment of 24 patients with thymic lesions was analyzed. These included 21 patients with thymomas, and one each with thymic carcinoid, thymic lymphoma, and thymic cyst. Twelve patients were seen before therapy and 12 after treatment elsewhere. Computed tomography gave additional information in 14 of 24 cases and management was altered in two. The presence or absence of invasion of adjacent structures was predicted in 16 of 17 patients in whom computed tomographic-surgical correlation was available. PMID- 3815316 TI - The incidence and significance of seminal vesicle invasion in patients with adenocarcinoma of the prostate. AB - The incidence and significance of seminal vesicle invasion in patients with adenocarcinoma of the prostate were determined in 139 patients who underwent radical prostatectomy. Of the 36 patients who had seminal vesicle invasion, 27 (75%) also had capsular invasion and 13 (43%) had lymph node metastases. Disease progression rates were 31% and 58% at 5 and 8 years, respectively. Survival rate at 5 years was 90.6% and at 8 years it was 83.7%. Of the 103 patients without seminal vesicle invasion, 21 (20.4%) also had capsular invasion and 11 (12%) had lymph node metastases. Disease progression rates were 2.5% and 15.7% at 5 and 8 years, respectively. Survival rate at both 5 and 8 years was 98.4%. These data suggest that the majority of patients with seminal invasion do not have lymph node metastases on presentation and thus they cannot be detected by lymph node dissection before radical prostatectomy. Improved techniques for preoperative detection of seminal vesicle invasion can assist in patient selection for surgery and improve the results of radical prostatectomy. PMID- 3815317 TI - Childhood cancer in the Denver metropolitan area 1976-1983. AB - Incidence rates for childhood cancers (ages 0-14 years) were produced for the Denver Standard Metropolitan Statistical Area for the period 1976-1983. Some unique features of the Denver area, especially the unusually high background levels of ionizing radiation, warrant comparisons with rates generated from other regions. A total of 348 childhood cancers were identified in white (including Spanish surname) and black children, with the 200 cancers among males resulting in higher rates than for females (148 cases) for total cancers and selected major cancer types (leukemias, glial brain cancers, and non-Hodgkin's lymphomas). Compared with other geographic areas, Denver rates were very similar, with no marked excesses or deficits except for an increase in male endocrine cancers. Rates for Spanish surname children were very similar to the rates for other whites. PMID- 3815319 TI - A survey of surface glycoproteins of four human squamous cell carcinoma lines. AB - The major cell surface glycoprotein components of four new cell lines derived from human squamous cell carcinomas of the head and neck (TR126, TR131, TR138, TR146, Rupniak, H. T. et al., JNCI 75, 621-635, 1985) were identified by three complementary labelling methods. The profile of labelled glycoprotein components was very similar in the four cell lines, although quite large quantitative differences in individual bands were seen. Two galactoproteins, designated GPC 130 and GPC-80 (apparent molecular weight X 10(-3)) were labelled by galactose oxidase/NaB [3H]4 but in all four lines only GPC-130 was prominent. The cell surface galactose and N-Acetylgalactosaminyl residues of glycoproteins were quite highly sialylated, as the galactose oxidase/NaB [3H]4 reaction was increased by between 3- and 6-fold after neuraminidase treatment. The neuraminidase-galactose oxidase/NaB [3H]4 and NaIO4/NaB [3H]4 methods identified a complex profile of glycoprotein components, with very high molecular weight sialogalactoconjugates being prominent. The major sialoglycoproteins were GPC-205, GPC-175, GPC-155, GPC 90 and GPC-70 and in addition, GPC-130 and GPC-80 showed enhanced labelling. Lactoperoxidase catalyzed the iodination of a similar profile of high molecular weight glycoprotein components, with GPC-205 and GPC-175 being prominent in TR126, TR131 and TR146 but less evident in TR138. Overall, the profile of labelled glycoprotein components was similar to the pattern seen in the well differentiated transitional carcinoma lines RT112 and RT4 (Steele, J. G. et al., Biochim. Biophys. Acta. 732, 219-228, 1983). PMID- 3815318 TI - Lipid peroxidation in liver and colon of methylazoxymethanol treated rats. AB - Weanling male Sprague-Dawley rats were injected via the tail vein with methylazoxymethanol (MAM) acetate at a dose of 70 mg/kg body weight. Measurements of lipid peroxidation were carried out on mitochondrial and microsomal fractions of liver and colonic mucosa at various intervals over the first 24 h following delivery of the carcinogen. Significantly increased levels of peroxidation were observed 3-6 h after treatment in microsomal and mitochondrial fractions of both these tissues. A return to control levels was seen by the end of the first day. These results are discussed in relation to the role of lipid peroxidation in carcinogenesis and the proposed mechanism of tumor prevention by selenium. PMID- 3815320 TI - Essential metals in tissues and tumor of inbred C57BL/6 mice during the infective cycle of Lewis lung carcinoma. AB - The variation of tissue copper, zinc, iron, calcium, magnesium, potassium and sodium content of inbred C57BL/6 mice during the infective cycle of Lewis lung carcinoma have been studied. Tissue calcium, magnesium, potassium and sodium concentrations were well maintained during the infective cycle, probably because of their large dietary availability, copper, zinc and iron, however, showed a progressive decrease in their tissue concentrations. Liver zinc increased in parallel with the metastasising process. The important decrease in tissue iron observed agress with the characterized hypoferric response to infection. However, when the losses of metals were considered on a global organism basis, the loss of iron was not paralleled by an increase in tumor iron, but a global loss was observed. The hypoferric response did not deter tumor growth, as this was able to carry on its development with significantly decreasing neoplastic tissue iron content. The only metal actively concentrated by the tumoral mass was sodium. PMID- 3815321 TI - Decay-associated emission spectra and other spectral evidence for the physical intercalation of 7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene into DNA. AB - A benzo[a]pyrene derivative, 7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene, forms physical complexes with DNA. The measured absorption spectrum of the hydrocarbon in the complex is shifted approximately 10 nm to the red and the fluorescence emission spectrum is red-shifted approximately 6 nm, characteristic of a physical intercalation complex. The decay-associated emission spectra of the hydrocarbon in the presence of DNA have been measured, thus providing a new technique to obtain information about the DNA binding sites. The decay-associated emission spectra of the free and bound hydrocarbons were obtained by deconvoluting the time-dependent emission at several wavelengths. Stern-Volmer plots with iodide and silver ions as quenchers suggest that at least one set of binding sites for the formation of a physical intercalation complex between the benzo[a]pyrene derivative and DNA is at guanine sites in the biopolymer. PMID- 3815322 TI - Comparative effects of 7 beta-hydroxycholesterol towards murine lymphomas, lymphoblasts and lymphocytes: selective cytotoxicity and blastogenesis inhibition. AB - The effects of 7 beta-hydroxycholesterol on lymphoma cells in culture, on lymphocytes entering blastic transformation and on quiescent murine spleen lymphocytes have been investigated. The early events of blastogenesis as well as YAC-1, RDM-4 and EL-4 cells were shown to be very sensitive to this sterol at microM concentration, whereas constituted lymphoblasts and normal lymphocytes remained insensitive at 50 times higher concentration. The effect of some classical antitumor drugs (Adriamycin, Mitomycin-C, Methotrexate) on these lymphoma cells were of the same order of magnitude. However, the activity of 7 beta-hydroxycholesterol was closely related to the composition of the culture medium. Indeed, the cytotoxic effects of this compound were less in medium supplemented with foetal calf serum than in lipoprotein poor, Ultroser-G supplemented medium. The possible impairment of the same, or closely related, events occurring in blastic transformation and in rapid proliferation of cells is pointed out. Our results raise the question of the possible use of these compounds for an antitumor strategy. PMID- 3815323 TI - Eicosanoids and metastasis: experimental aspects in Lewis lung carcinoma. AB - Lewis lung primary carcinomas have been extracted for eicosanoids, and the findings examined in relation to lung metastases. The order of the 5 compounds measured was PGE2 greater than PGE1 greater than PGF2 alpha greater than 6-keto PGF1 alpha greater than TXB2. On the basis of the observation that the balance of PGI2 and TXA2 is altered in metastasis (Honn et al., 1983), the effects of Nafazatrom, a PGI2 enhancing agent, and imidazole, a thromboxane synthetase inhibitor, were tested. The experimental approach taken was to study spontaneous lung metastases after removal of the primary tumour at 13 days after tumour cell inoculation. Both Nafazatrom and imidazole decreased the lung weight when given during the period either before or after the excision of the primary tumour. There was a general trend toward an increase in the number of small lung nodules (greater than 2 mm) and a decrease in large lung nodules (greater than 2 mm) as a result of the chemotherapy. Mean survival time of the mice was significantly different among the five groups, with the mice surviving the longest in the group treated with Nafazatrom after the excision of the primary tumour. PMID- 3815324 TI - Ovariectomy of adult mice exposed prenatally to diethylstilbestrol. AB - Mice exposed prenatally to diethylstilbestrol (DES) were ovariectomized at 5-10 weeks of age, or at 15 months of age. They were maintained to old age and studied for incidence of DES-related pathologic changes. Uterine metaplasia and adenomyosis were not seen after early ovariectomy, but adenomyosis persisted after late ovariectomy. No adenocarcinomas of the genital tract were found in 30 mice ovariectomized early, or in 18 mice ovariectomized at 15 months of age. This result is significantly different from the 14% frequency of genital tract adenocarcinomas reported previously in non-ovariectomized mice of this strain exposed prenatally to DES. PMID- 3815325 TI - Metastasis from squamous cell carcinomas of SENCAR mouse skin produced by complete carcinogenesis. AB - The incidence of metastasis was evaluated in female SENCAR mice after induction of squamous cell carcinomas by repetitive applications of either benzo [a] pyrene (B [a] P) or N-methyl-N'-nitro-N-nitrosogaunidine (MNNG). Between 41 and 50 weeks 50% of the animals with carcinomas in the B [a] P group had metastases, whereas 20% had metastases in the MNNG group. Very few metastases were observed before 40 weeks of treatment. The major site of metastasis was the lungs; however, metastatic tumors were also found in lymph nodes, adrenal glands and kidneys. PMID- 3815326 TI - The effect of hyperthermia on the cytotoxicity of melphalan in Chinese hamster ovary cells. AB - The heat stability of melphalan during incubation at temperatures from 37 degrees C to 45 degrees C was determined by spectrophotometric and HPLC analyses and by direct measurement of melphalan cytotoxicity using a colonogenic assay Although OD 250 changed little during exposure to temperatures up to 45 degrees C for periods of up to 1 h, the melphalan HPLC peak decreased as function of incubation time and temperature. Loss of cytotoxicity following heating paralleled the decay of the melphalan HPLC peak. Despite the inactivation of melphalan by heat, the cytotoxic effects of melphalan were enhanced at elevated temperatures from 38 degrees C to 42 degrees C and synergism was observed at lethal temperatures above 42 degrees C. PMID- 3815327 TI - Distribution and metabolism of ellagic acid in the mouse following intraperitoneal administration. AB - The distribution and metabolism of ellagic acid (EA), a naturally occurring plant phenolic compound with reported antimutagenic and anticarcinogenic activity, was investigated in mice following intraperitoneal injection. Male Swiss-Webster mice were given a single i.p. injection of [3H]EA and sacrificed at 15 min, 30 min, 60 min, 120 min and 24 h post-injection. At these times urine, blood and bile samples were obtained from each animal and various organs were removed, weighed and homogenized. Radioactivity in the samples was determined at each time interval and expressed as nmol [3H] EA/mg sample. Metabolites in urine and bile were analyzed by high-performance liquid chromatography (HPLC) and water-soluble conjugates were isolated by eluting samples of urine and bile from an alumina column. Radioactivity expressed as nmol [3H] EA/mg sample (wet weight) decreased with time in most organ homogenates. The peak radioactivity in bile appeared at 60 min post-injection while the peak radioactivity in urine occurred at 120 min. The two organs showing the highest amount of radioactivity were kidney and liver and the lowest was in brain. HPLC analysis revealed one unidentified metabolite of EA in bile and three in urine. Most of the radioactivity recovered from both bile and urine was associated with EA. Water-soluble conjugates in urine were isolated as sulfate esters, glucuronide and glutathione conjugates. Water-soluble conjugates in bile were evenly distributed as glucuronide and glutathione conjugates. PMID- 3815328 TI - Comparison of stomach cancer induced in rats by N-methyl-N'-nitro-N nitrosoguanidine or N-propyl-N'-nitro-N-nitrosoguanidine. AB - N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and N-propyl-N'-nitro-N nitrosoguanidine (PNNG) were administered to male F344 rats at a single dose of 200 mg/kg by gavage and the animals were observed for 110 weeks. The results revealed that PNNG was a weaker carcinogen for the stomach than MNNG under these conditions. After MNNG, the mortality of animals was higher and their average survival time was shorter than after PNNG. Neoplasms were induced in both the forestomach and glandular stomach by both agents. The incidence of forestomach tumors was high: 85% with MNNG, 64% with PNNG, but with PNNG a greater proportion of the forestomach neoplasms were benign. The incidence of neoplasms of the glandular stomach was 18% with PNNG as compared to 65% with MNNG. Intestinal metaplasia appeared in the glandular stomach after exposure to either MNNG or PNNG. There was also a high incidence in untreated control rats. Most glandular stomach neoplasms were composed of both gastric-type and intestinal-type epithelial elements. Only 3 cases of adenocarcinomas were composed solely of intestinal-type cells. These findings suggest that intestinal metaplasia may not necessarily be a preneoplastic stage. PMID- 3815329 TI - Didemnin B inhibits biological effects of tumor promoting phorbol esters on mouse skin, as well as phosphorylation of a 100 kD protein in mouse epidermis cytosol. AB - The immunosuppressive agent Didemnin B (DB) inhibits biological effects that are induced by topical application of phorbol esters to mouse skin as measured by mouse ear edema and the alkaline phosphatase activity of mouse epidermis. Furthermore, DB suppresses the phosphorylation in vitro of an epidermal cytosolic protein (p100). In these respects DB behaves like CsA, another immunosuppressive compound. Didemnin, however, does not bind to recently described CsA-binding sites. PMID- 3815330 TI - Pancreatic carcinogenicity of N-nitrosobis(2-oxopropyl)-amine in diabetic and non diabetic Chinese hamsters. AB - To examine the role of diabetes in pancreatic cancer, 4 groups of Chinese hamsters--2 from genetically diabetic and 2 from non-diabetic lines--were treated with N-nitrosobis(2-oxo-propyl)amine (BOP) at different dose levels and intervals. In one group (referred to as the VA group), BOP was given weekly at a 5 mg/kg body wt. level for 18 or 23 weeks, whereas the other group (the EP group) received a weekly dose of 2.5 mg/kg body wt. for life. Except for diet and experimental design, all other laboratory conditions were similar in the two institutions. No VA hamster developed tumors. Three of 22 non-diabetic EP hamsters (but none of the diabetic hamsters) developed pancreatic hyperplastic and neoplastic lesions, comprising ductular cell adenomas (3 hamsters), carcinoma in situ (1 hamster), a well-differentiated adenocarcinoma (1 hamster), and a poorly differentiated adenocarcinoma (1 hamster) with regional lymph node metastases. In addition, over 50% of the EP hamsters had neoplasms for which the incidences and morphology did not vary between diabetic and non-diabetic groups or between the sexes. These were primarily of the liver (cholangiomas), lungs (adenomas) and skin (trichoepitheliomas, squamous cell carcinomas). The differing carcinogenic response of the two hamster groups to BOP apparently is not related to the total BOP dose, but rather to other factors, including the length of observation time. PMID- 3815331 TI - Regulation of ornithine decarboxylase gene expression in mouse epidermis and epidermal tumors during two-stage tumorigenesis. AB - Topical treatment of mouse skin with the potent tumor promoter 12-O tetradecanoylphorbol-13-acetate (TPA) results in an array of biochemical alterations, one of the earliest being a more than 200-fold transient induction of epidermal ornithine decarboxylase (ODC) activity. There is an excellent correlation between the induction of epidermal ODC activity and changes in the level of immunoreactive ODC protein following a single TPA treatment to skin. Both ODC activity and protein levels peak at 4.5 h after TPA treatment and rapidly fall to basal levels by 24 h. Cycloheximide treatment of mice in which ODC had been previously induced by TPA indicated a similar rapid turnover of both ODC catalytic activity and protein levels. Northern blot analysis of polyadenylated RNA isolated from mouse epidermis after a single TPA treatment revealed the stimulation of one species of ODC mRNA of 2.0 kilobases with a maximum at 3.5 h declining by 16 h. The same-sized species of ODC mRNA was detected 4.5 h after multiple biweekly treatments with TPA as well as in mouse papillomas and carcinomas not treated with TPA for at least 1 week. Southern blot analysis of EcoRI or BamHI digests of DNA derived from mouse liver, papillomas, or carcinomas revealed no ODC gene amplification or rearrangement during neoplastic progression. These observations indicate that the induction of epidermal ODC activity following TPA treatment results in a transient increase in the steady state levels of ODC mRNA and in the rate of synthesis of ODC protein, in contrast to epidermal tumors where the levels of ODC mRNA and protein are constitutively elevated. PMID- 3815332 TI - Effect of restricted caloric intake on azoxymethane-induced colon tumor incidence in male F344 rats. AB - The effect of 30% caloric restriction on azoxymethane (AOM)-induced colon carcinogenesis was investigated in male F344 rats. Starting at 5 weeks of age, groups of animals were fed ad libitum a high-fat (23.5%) semipurified diet. At 7 weeks of age, all animals except the vehicle-treated groups were s.c. injected with AOM (15 mg/kg body wt, once weekly for 2 weeks). Four days after the second AOM injection, groups of animals were continued on high-fat diet and fed ad libitum (ad libitum group) whereas other groups were restricted to 70% of total calories (calorie-restricted group) consumed by the ad libitum group, but received same amounts of fiber, vitamins, and minerals. Thirty-two weeks after AOM injections, all animals were necropsied. The animals in the calorie restricted group developed significantly fewer colon tumors and had a lower colon tumor incidence than did the rats in the ad libitum group. The size of colon tumors was also reduced in the calorie-restricted group. PMID- 3815333 TI - Monoclonal antibody-defined correlations in melanoma between levels of GD2 and GD3 antigens and antibody-mediated cytotoxicity. AB - A monoclonal antibody is described that specifically detects the ganglioside antigens GD2 and GD3, binding preferentially to GD2, in melanoma. Antibody specificity was demonstrated with solid-phase radioimmunoassay and enzyme-linked immunosorbent assay as well as by immunostaining on thin-layer chromatography plates using structurally characterized gangliosides. Binding of both the IgG3 antibody and its IgG2a switch variant were assayed on live cells by cytofluorography and by immunoperoxidase staining on frozen tissue sections. The binding patterns correlated with antitumor activity in antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity assays with human effector cells and complement in an 111In-release assay using cell lines derived from the same individual. The significant level of killing in all tumor cells tested that express GD2, GD3, or both, suggests the importance of multiple specificity towards tumor antigens, i.e., binding of a monoclonal antibody to two or more tumor-associated antigens. PMID- 3815334 TI - Estrogen inhibition of a Mr 39,000 glycoprotein secreted by human breast cancer cells. AB - We have identified a secreted glycoprotein with an apparent molecular weight of 39,000 that is inhibited by estrogens and stimulated by antiestrogens in the MCF 7 human breast cancer cell line. The protein was detected within 24 h of hormone treatment with inhibition occurring at concentrations as low as 10(-11) M estradiol and stimulation occurring with antiestrogens. When phenol red, which has been found to have estrogenic activity, is removed from the tissue culture medium, no inhibition of cell growth or induction of the Mr 39,000 protein is seen with antiestrogens. A 6-fold decrease in the amount secreted in the presence of estrogens is seen under these conditions. The induction was specific in that growth inhibition by several other means did not induce expression of the Mr 39,000 protein. The Mr 39,000 protein has been identified as a glycoprotein complex that can be resolved into four polypeptides with two major components that migrate in the pH range of 5.5 to 6.3 by two-dimensional gel electrophoresis. This protein is the first evidence that estrogens inhibit a specific protein and it may prove useful as a marker of antiestrogen-induced growth arrest in breast cancer. PMID- 3815335 TI - Role of phospholipase in the genesis of doxorubicin-induced cardiomyopathy in rats. AB - The role of phospholipase on the mechanism of doxorubicin-induced cardiomyopathy was investigated in the heart mitochondria of Wistar rats. In the in vivo study, rats were divided into 3 groups: 1, the control group, untreated; 2, the doxorubicin 1-day group, in which doxorubicin (4 mg/kg) was injected s.c. once; and 3, the doxorubicin 4-day group, in which doxorubicin (4 mg/kg) was injected once a day for 4 consecutive days. In each group, the level of lipid peroxides and the phospholipase activity, the phospholipid content, and the enzymic activities in the respiratory chain were measured. The doxorubicin 4-day group showed significant increases of lipid peroxide level and phospholipase activity and an inhibition of mitochondrial respiratory function compared with the control group, while the doxorubicin 1-day group showed no significant difference. In the in vitro study, Experiment 1, intact rat heart mitochondria were incubated with 0.1 unit of phospholipase A2. After the incubation, the enzymic activities of the respiratory chain were disturbed in the same manner as in the in vivo experiment. In Experiment 2, rat heart mitochondria were incubated with ascorbate and ferrous sulfate. The experiment demonstrated the elevation of phospholipase activity associated with lipid peroxidation. These results suggested that the enhanced phospholipase activity caused by lipid peroxidation is responsible for the mechanism of doxorubicin-induced cardiomyopathy. PMID- 3815336 TI - Effect of L-tryptophan excess and vitamin B6 deficiency on rat urinary bladder cancer promotion. AB - To further evaluate the role of tryptophan and vitamin B6 in bladder carcinogenesis, male Fischer 344 rats were fed 0.2% N-[4-(5-nitro-2-furyl)-2 thiazolyl]formamide (FANFT) in semipurified diet or were given semipurified diet alone for 4 weeks. One week later, rats from each group were assigned for the remainder of the experiment to one of four experimental diets, labeled as follows: group 1, control semipurified; group 2, L-tryptophan excess (2%); group 3, vitamin B6-deficient (1.0 mg/kg diet); or group 4, L-tryptophan excess, plus vitamin B6-deficient diet. All surviving rats were killed at 80 weeks of the experiment. Throughout the study, body weights were reduced in the groups fed FANFT and, at 70 and 80 weeks, body weights were reduced in the groups given tryptophan excess. The incidence of urinary bladder carcinoma was highest in the group treated with FANFT, followed by diet with control tryptophan and vitamin B6 levels (40%). The disease incidence was reduced in the vitamin B6-deficient group (13%) and of an intermediate range in the groups fed a tryptophan excess with or without vitamin B6 deficiency (28-29%). Tumors at other sites were greatest in number in FANFT-treated rats fed vitamin B6-deficient diet with excess tryptophan and were significantly fewer in FANFT-treated rats fed vitamin B6-deficient diet alone. Animals given diet deficient in vitamin B6 consistently had depressed levels of alanine aminotransferase activity and plasma pyridoxyl phosphate. FANFT pretreatment decreased alanine aminotransferase activities in rats in some groups and the feeding of tryptophan had variable effects on alanine aminotransferase and plasma pyridoxyl phosphate levels. Urinary tryptophan metabolites were influenced by all treatments, but the results did not correlate with tumor yields. Urinary bladder ornithine decarboxylase activity was not altered in vitamin B6-deficient female rats. These results do not support the hypothesis that increased dietary L-tryptophan promotes bladder carcinogenesis in rats, but other dietary factors might modify the process following FANFT initiation. PMID- 3815337 TI - Cell cycle-dependent initiation of hepatocarcinogenesis in rats by methyl(acetoxymethyl)nitrosamine. AB - Hepatocyte sensitivity to initiation of carcinogenesis was studied as a function of the cell cycle phase in which damage was incurred. Hepatocytes were stimulated to proliferate by a two-thirds partial hepatic resection, and their proliferation was synchronized further by postsurgical treatment with hydrocortisone. Groups of male F344 rats were given a single administration of methyl(acetoxymethyl)nitrosamine, a highly reactive methylating agent, at various times after two-thirds partial hepatic resection when hepatocytes were in defined phases of the cell cycle. Beginning 3 wk after the treatment and for 37 wk thereafter, rats were fed a diet containing 0.05% phenobarbital to promote the expression of initiated hepatocytes. At 45 wk after treatment with carcinogen hepatocytic neoplasms were enumerated. The greatest yield of neoplasms (5.4 per liver) was observed in the group treated 16 h after two-thirds partial hepatic resection or at the time when proliferating hepatocytes began to enter the S phase of the cell cycle. The least yield of neoplasms (0.8 per liver) was identified in the group treated with methyl(acetoxymethyl)nitrosamine when hepatocytes were early in G1. In the proliferating hepatocytes sensitivity rose continuously during G1 to a peak at the G1-S border and then fell continuously as hepatocytes traversed S, G2, and M. This pattern of response could not be attributed to variation in hepatic esterase which activates methyl(acetoxymethyl)nitrosamine or to variation in methylation of DNA. The results support a model in which carcinogen-induced genetic alterations, occurring at the time of or soon after damaged cells enter the S phase, represent irreversible events that contribute to the initiation of carcinogenesis. PMID- 3815338 TI - Sensitivity to melphalan as a function of transport activity and proliferative rate in BALB/c 3T3 fibroblasts. AB - Melphalan transport by exponentially dividing BALB/c 3T3 mouse fibroblasts was approximately 3-fold greater at the steady-state than that observed with resting cells at drug concentrations ranging from 1 to 100 microM. Both the rate of incorporation of [3H]thymidine and the percentage of S-phase cells estimated by a fluorescent cell sorter provided evidence of higher DNA synthetic activity in logarithmic phase cells. Transport of melphalan by BALB/c 3T3 fibroblasts was mediated by the two amino acid transport systems, the DL-beta-2 aminobicyclo(2,2,1)heptane-2-carboxylic acid-sensitive sodium-independent system preferring leucine as substrate and the sodium-dependent system preferring alanine, serine, and cysteine as substrates. At low drug concentrations (about 1 microM) the sodium-dependent mechanism predominated, but at high concentrations of melphalan (100 microM) a shift occurred from the sodium-dependent to the sodium-independent system. Both transport systems were markedly affected by the proliferative state of the cells and became progressively less active the longer cells remained in the stationary phase. Stationary-phase cells were also less sensitive to the cytotoxic action of melphalan than exponentially dividing cells. Serum deprivation experiments showed that unidirectional melphalan influx decreased about 40% when fibroblasts previously in exponential growth were shifted from normal medium to serum-depleted medium 24 h prior to drug transport studies. Thus, serum deprivation and maintenance of cells in stationary phase growth had parallel effects on drug influx. These experiments emphasize the importance of the proliferative state of the cell as a determinant of melphalan transport and cytocidal activity. PMID- 3815339 TI - Gangliosides of human melanoma: altered expression in vivo and in vitro. AB - The ganglioside composition of human melanoma was analyzed in five sets of tumor specimens obtained directly from surgery, from the autologous tissue culture cell lines, and from the autologous cell lines grown in athymic nude mice. Total gangliosides of these 15 melanoma specimens were isolated and purified, and the amount of each component ganglioside was analyzed by thin-layer chromatography and a thin-layer chromatography scanner. The ganglioside composition of the five surgical melanoma specimens clearly exhibited different patterns from each other. Moreover, none of the autologous cultured melanomas possessed the same ganglioside composition as their original biopsied tumors. However, when these melanoma cell lines were transplanted into nude mice, the ganglioside composition was converted back to the same ganglioside pattern as in the original surgical specimens. The results support the view that changes in the ganglioside composition of melanoma during in vitro growth are caused by the culture environment rather than by selection of melanoma cells with a particular genotype. Reestablishment of the original ganglioside patterns after passage in nude mice provides clear evidence that in vivo expression of gangliosides is a conserved and stable function specified by the human melanoma cells. PMID- 3815340 TI - Carcinogenicity of mutagens: predictive capability of the Salmonella mutagenesis assay for rodent carcinogenicity. AB - A total of 224 chemicals that have been tested in long-term studies for carcinogenicity in rats and mice by the National Cancer Institute and the National Toxicology Program were tested for mutagenicity in Salmonella typhimurium. Correlations between mutagenicity and carcinogenicity were examined. The influences of chemical structure, rodent species and organ responses, and bacterial strain responses on the carcinogenesis/mutagenesis correlations were also examined. Not all carcinogens induced tumors in both rats and mice. A clear mutagenic or equivocal mutagenic response in Salmonella was predictive for 77% of the carcinogens or equivocal carcinogens, although only 54% of the 149 carcinogens or equivocal carcinogens were mutagens, and 58% of the nonmutagens were carcinogens or equivocal carcinogens. The proportion of mutagens and equivocal mutagens that were not carcinogenic or equivocal was 23%. There was no apparent way to distinguish the mutagenic carcinogens from the mutagenic noncarcinogens by the responses of the specific Salmonella strains. The proportions of different chemical classes in the data base strongly affected the correlations; 40% of the chlorinated carcinogens were mutagens, whereas 75% of the amines and 100% of the nitro-containing carcinogens were mutagens. Because 29% of the chemicals (30% of the carcinogens) were chlorinated, the poor correlation of this class was reflected in the overall correlation. It is concluded that the use of the Salmonella mutagenicity assay is warranted for the identification of carcinogens, but not for noncarcinogens. The proportion of carcinogens detected as mutagens is dependent on the specific classes of chemicals tested and on the rodent species used to define the carcinogens. PMID- 3815341 TI - Effects of dietary fats and soybean protein on azaserine-induced pancreatic carcinogenesis and plasma cholecystokinin in the rat. AB - Both dietary unsaturated fat and raw soybean products are known to enhance pancreatic carcinogenesis when fed during the postinitiation phase. A comparison of these two dietary components was made to evaluate the relative potency of each ingredient for enhancing pancreatic carcinogenesis and to determine if this enhancement was correlated with an increase in plasma cholecystokinin (CCK) levels. Male Wistar rats were initiated with a single dose of azaserine (30 mg/kg body weight) at 14 days of age. The rats were weaned to test diets formulated from purified ingredients. Dietary protein at 20% by weight was either casein or soy protein isolate (heat treated or raw). Corn oil was the unsaturated fat of major interest and it was fed at either 5 or 20% by weight. Pancreases were quantitatively evaluated for carcinogen-induced lesions at 2- and 4-month postinitiation. In a second experiment designed to closely mimic the above experiment, rats were implanted with cannulae which allowed plasma to be repetitively sampled over a 2.5-week period during which the test diets were fed. Plasma was collected both prior to introduction of the test diets and afterwards. Plasma CCK was measured by a specific radioimmunoassay. Both the 20% corn oil diet and the raw soy protein isolate diet enhanced pancreatic carcinogenesis. The effects of the raw soy protein isolate on the growth of the carcinogen-induced lesions were significantly greater than the effects of the 20% corn oil diet. Plasma CCK values were not elevated in the rats fed the 20% corn oil diet, but they were significantly elevated in the rats fed the raw soy protein isolate. Heat-treated soy protein isolate neither enhanced carcinogenesis nor elevated the plasma CCK level. This study demonstrates that certain plant proteins enhance the growth of carcinogen-induced pancreatic foci and that this effect is considerably greater than the enhancement by high levels of dietary unsaturated fat. Furthermore, the enhancement by the raw soy protein isolate may be mediated by CCK; but this does not appear to be the mechanism by which the unsaturated fat, corn oil, enhances pancreatic carcinogenesis. PMID- 3815342 TI - Isolation of variants resistant to methylglyoxal bis(guanylhydrazone) from adenovirus-transformed rat cells. AB - It is presumed that proteins encoded by viral oncogenes interact with proteins encoded by cellular genes to bring about the transformed phenotype. To demonstrate the existence of such cellular genes we attempted to isolate mutants with a nontransformed phenotype from an adenovirus-transformed rat cell line (F4) which contains multiple copies of the transforming E1 region. F4 cells were mutagenized with ethyl methanesulfonate and variants resistant to the anticancer drug methylglyoxal bis(guanylhydrazone) were selected. The proportion of such variants was about one in 10(6) and increased 5-fold after mutagenesis. Two variant clones (G1 and G2) were isolated and characterized: they were 5-fold more resistant to methylglyoxal bis(guanylhydrazone); they had a stable phenotype; they showed decreased drug uptake; they had a reduced ability to grow in soft agar, low serum, and nude mice; there was no detectable change in the restriction pattern of integrated viral genes or in the expression of the E1a and E1b proteins. These properties suggest that selection for methylglyoxal bis(guanylhydrazone) resistance may result in the isolation of variants with phenotypic characteristics of nontransformed cells. It was likely that these variants were altered in a cellular function required for the maintenance of the transformed phenotype. PMID- 3815343 TI - Six monoclonal antibodies to human pancreatic cancer antigens. AB - Murine monoclonal antibodies were generated against FG, a human pancreatic carcinoma (HPC) cell line. Of the six monoclonal antibodies, five (S3-15, S3-23, S3-41, S3-60, and S3-110) reacted by indirect immunoperoxidase assays with HPC of the ductal type, and another (S3-53) reacted with both ductal and acinar HPC. Strong reactivity was also found with tumors of the stomach, colon, mouth, lung, and cervix, while a large panel of normal human tissues displayed little reactivity. Indirect immunofluorescence staining revealed that, except for S3-23, the antigens recognized by these antibodies are expressed at the cell surface. Immunoprecipitation of metabolically radiolabeled FG cells indicated that the epitopes recognized by these antibodies are carried by distinct proteins or glycoproteins, differentiated on the basis of the apparent molecular weight and/or subunit composition as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. This panel of antibodies will be useful to study antigenic variations associated with malignant cell transformation in HPC as well as other tumors. PMID- 3815344 TI - Natural killer cells in the host response to melanoma. AB - Using an immunoperoxidase technique, we have investigated natural killer (NK) cells in the host response to malignant melanomas and melanocytic nevi in frozen sections. Eight primary melanomas, 12 metastatic melanomas, and 31 dysplastic nevi were studied. NK cells were identified phenotypically using an antibody, B73.1, against an Fc receptor present only on NK cells and neutrophils. Rare NK cells were identified in three of 31 dysplastic nevi and in one of eight melanomas. In contrast, significant numbers of NK cells were identified in ten of 12 metastases. PMID- 3815345 TI - Steroid receptor-mediated cytotoxicity of an antiestrogen and an antiprogestin in breast cancer cells. AB - The antiproliferative and cytotoxic effects of 4-hydroxytamoxifen, an antiestrogen with a high affinity for the estrogen receptor, and of 17 beta hydroxy-11 beta-(4-methylaminophenyl)-17-(1-propynyl)estra-4,9-dien-3- one-6-7 (RU486), an antiprogestin with a high affinity for the progestin receptor, have been studied on human breast cancer cell lines in culture. The number of dead cells was evaluated by several techniques (trypan blue stain exclusion, DNA cleavage, lactic dehydrogenase activity, morphological changes, and cloning efficiency in soft agar) and found to be increased both by the antiestrogen and the antiprogestin at concentrations correlating with the affinities for their respective receptors. This cytotoxic effect was prevented by the occupation of the respective receptors with estrogen and progestin and was not found in the estrogen receptor- and progestin receptor-negative MDA MB 231 and BT20 cell lines. The contrast between the ultrastructural modifications of chromatin and the integrity of mitochondria suggested that the antihormone-induced cell death was by apoptosis. We conclude that in addition to the receptor-mediated cytostatic activity and the nonspecific cytotoxic activity, antiestrogens trigger a third type of effect that we designate as "receptor-mediated cytotoxic." Similar conclusions can be drawn for the antiprogestin RU486, indicating moreover that the antihormone and antiproliferative activities of this drug are clearly dissociated. The mechanism of these receptor-mediated cytotoxic activities of antiestrogen and antiprogesterone is not known but does not seem to be explained entirely by the antihormone activity of these drugs. PMID- 3815346 TI - Metabolic activation of phenacetin in rat nasal mucosa: dose-dependent binding to the glands of Bowman. AB - The metabolism and binding of the analgetic drug [ring-3H]phenacetin in the nasal mucosa were studied in vitro and in vivo in male Sprague-Dawley rats. As shown by whole-body and light microscopic autoradiography there was an irreversible binding of metabolites to the glands of Bowman in the olfactory mucosa after high but not after low doses of [3H]phenacetin. In the other tissues, the distribution of radioactivity was not changed when the dose was increased. Autoradiography of [3H]-acetaminophen showed no preferential uptake of radioactivity in the olfactory mucosa. At incubation of nasal septa with [3H]phenacetin in vitro, a binding of metabolites to the glands of Bowman was observed indicating that the metabolism occurred in situ. In rats, glutathione (GSH) depleted by pretreatment with phorone, there was a binding to the glands of Bowman in the olfactory mucosa also after a trace dose of [3H]phenacetin. Addition of GSH decreased the irreversible binding of [3H]phenacetin metabolites that occurred in 9000 X g nasal mucosa supernatants incubated with [3H]phenacetin. There was a moderate decrease in the level of nonprotein sulfhydryl groups, mainly GSH, in the olfactory mucosa after administration of 100-300 mg/kg phenacetin. Collectively, these data suggest that phenacetin is metabolized and subsequent to GSH depletion, bound preferentially in the glands of Bowman. The data also suggest that in situ metabolic activation and binding of phenacetin in the rat nasal mucosa at high doses may play a role in the pathogenesis of the nasal tumors induced by high doses of phenacetin in the rat. PMID- 3815348 TI - Clinical pharmacology and toxicity of 4'-O-tetrahydropyranyladriamycin. AB - The clinical pharmacology and toxicity of a novel anthracycline derivative, 4'-O tetrahydropyranyladriamycin (THP-adriamycin), was investigated in patients with advanced malignant diseases. The starting dose was 30 mg/m2 which was escalated by increments of 10 mg/m2. Twelve patients with a median age of 42 (range, 19-69) years and a median Eastern Cooperative Oncology Group performance score of 2 (range, 1-2) were entered into the study. The diagnoses included four testicular cancers, two breast cancers, two small cell lung cancers, two acute myeloid leukemias, one colon cancer, and one hemangiosarcoma. THP-adriamycin was given as an i.v. bolus injection every 3 weeks. Evaluable were 18 courses for general toxicity, 16 courses for hematological toxicity, and 16 courses for pharmacokinetics. THP-adriamycin had a short initial half-life of 1.4 +/- 0.3 min (mean +/- SD) due to rapid cellular uptake. Peak concentrations in unseparated blood cells were reached 5 min after drug injection and remained higher than in plasma throughout the observation period of 72 h. The half-lives of THP adriamycin in plasma were 19 +/- 2.8 min in an intermediate and 13 +/- 1.6 h in the terminal phase. A linear correlation was observed between the dose and the areas under the concentration curves for THP-adriamycin in plasma (r2 = 0.97) and blood cells (r2 = 0.99). The volume of distribution was 2124 +/- 221 liters/m2 and the total clearance rate 115 +/- 11 liters/m2h. THP-adriamycin was metabolized to Adriamycin, THP-adriamycinol, and adriamycinol. The major metabolite was Adriamycin with a terminal half-life in plasma of 33 +/- 10 h. The area under the curve of Adriamycin was also correlated to the administered dose (r2 = 0.96). Since excessive peak concentrations of Adriamycin were avoided, the treatment with THP-adriamycin might be an alternative to continuous infusions or weekly administrations. The maximum tolerated dose was 70 mg/m2, and the dose limiting toxicities were leukopenia and thrombocytopenia. Anemia, nausea, and vomiting were mild to moderate, and no other toxicity was observed. All side effects were dose dependent and reversible. In a patient with breast cancer, a disease stabilization was achieved lasting for 9 weeks. No objective remission was observed. We suggest 60 mg/m2 in pretreated or poor risk and 70 mg/m2 in untreated or good risk patients every 3 weeks for further clinical trials. PMID- 3815347 TI - Potentiation of ifosfamide neurotoxicity, hematotoxicity, and tubular nephrotoxicity by prior cis-diamminedichloroplatinum(II) therapy. AB - We investigated the relationship between prior therapy and three distinct forms of toxicity that developed during ifosfamide administration (1.6 g/m2/day for 5 days) in 36 children with malignant solid tumors. Of ten therapies that were studied by multiple regression techniques, only the number of doses of cisplatin that patients had received was significantly related to neurotoxicity, hematotoxicity, and tubular nephrotoxicity, with the more severe cases occurring after three or more doses (P less than 0.05). Increased urinary concentrations of the renal tubular enzyme N-acetyl-beta-D-glucosaminidase, measured before each course of ifosfamide, were predictive of neurotoxicity (P = 0.02) and hematotoxicity (P = 0.01). We suggest that cisplatin-induced renal tubular damage, leading to the impaired clearance of ifosfamide metabolites, may account for this added toxicity. PMID- 3815349 TI - Acetylation phenotype in colorectal carcinoma. AB - Sulfamethazine acetylation phenotype was determined in 49 patients with cancer of the colon or rectum, 41 old, and 45 young control subjects. Metabolic clearance of sulfamethazine, plasma ratio of N-acetylsulfamethazine:N-acetylsulfamethazine plus sulfamethazine and urinary ratio of N-acetylsulfamethazine:N acetylsulfamethazine plus sulfamethazine were used to classify subjects into slow and fast acetylation phenotypes. All three measures gave similar results. The proportions of slow and fast acetylators were similar in both control groups and there were significantly more fast acetylators in the cancer group than in the control groups (chi 2 = 5.0-8.5; P less than 0.05). The data suggest that there may be an association between acetylation phenotype and colorectal carcinoma. PMID- 3815350 TI - Specificity of adhesion between murine tumor cells and capillary endothelium: an in vitro correlate of preferential metastasis in vivo. AB - We have compared the rate and extent of adhesion of various types of mouse tumor cells to endothelial cells derived from different organ sources. Our panel of tumors has included sarcoma, bladder carcinoma, glioma, teratoma, hepatoma, endothelioma, mammary adenocarcinoma, and lymphoma cells. Endothelial cell monolayers have included murine microvascular endothelial cells from ovary, brain, lung, and liver as well as large vessel endothelium from thoracic duct and dorsal aorta. Tumor cells differ both in the adhesive propensity and adhesive preference for different endothelial cells. Some, but not all, of the adhesive preferences correlate with the known in vivo metastatic behavior of these tumors. Our results support the hypothesis that endothelial cell surface-associated specificities may play a significant role in determining the pattern of metastasis. PMID- 3815351 TI - Cytotoxicity of compounds that interfere with the regulation of intracellular pH: a potential new class of anticancer drugs. AB - The extracellular pH (pHe) in many solid tumors is often lower than in normal tissues. Cells may survive conditions of acid pHe because antiports in their membrane exchange Na+ for H+, or HCO3- for Cl-, and thus regulate the intracellular pH (pHi). We have therefore assessed the effects of drugs which interfere with regulation of pHi on survival of Chinese hamster ovary and human bladder cancer MGH-U1 cells in tissue culture. Nigericin, an ionophore which acidifies the cytoplasm when cells are placed in medium at low pHe, was not toxic at pHe 6.5 or above but became very toxic as pHe was reduced below this value. Amiloride and 4,4'-diisothiocyanostilbene 2,2-disulfonic acid, inhibitors of the Na+/H+ and HCO3-/Cl- exchangers, respectively, decreased pHi in the presence of nigericin at low pHe. These drugs showed little or no toxicity in the pHe range of 6.0-7.0 but added greatly to the toxicity of nigericin. A combination of all three drugs led to toxicity in the pHe range of 6.5-6.8, well within the measured range of tumor pH, but not at pHe 7.0 or above. A combination of low pH and hypoxia, two conditions likely to be found in regions distant from tumor blood vessels, caused cell mortality in the absence of drugs, and this effect was increased by nigericin used alone or in combination with amiloride and 4,4' diisothiocyanostilbene 2,2-disulfonic acid. These drugs may be regarded as prototypes for potential new anticancer agents that might achieve selective killing of tumor cells by interfering with the regulation of intracellular pH. PMID- 3815352 TI - Accelerated decomposition of 4-hydroxycyclophosphamide by human serum albumin. AB - Cyclophosphamide, a widely used anticancer agent, requires initial metabolic activation to 4-hydroxycyclophosphamide (4-OHCP) to elicit its activity. The rate of decomposition of cis-4-OHCP was much faster in plasma than in buffer at pH 7.4. This plasma activity was not affected by treatment with acid (pH 1.3) or heat (60 degrees C for 30 min). The activity was retained in the macromolecular fraction (greater than 10,000) but not in the filtrate. Serum albumin was identified as the catalyst for the elimination step that generates phosphoramide mustard from aldophosphamide; albumin had no effect on the rate of ring opening of cis-4-OHCP to aldophosphamide. This catalytic activity was dependent on serum albumin concentration and independent of pH over the range of 6.5 to 7.5, in contrast to the buffer-catalyzed reaction. The catalytic rate constants kcat (pH 7.4, 37 degrees C) for phosphate buffer, human serum albumin, and bovine serum albumin were 1.13, 285, and 83 M-1 min-1, respectively. Pretreatment of cis-4 OHCP with serum albumin resulted in a time-dependent decrease in cytotoxic activity against L1210 tumor cells in vitro. These data suggest that the albumin catalyzed reaction of cis-4-OHCP in plasma represents an important pathway for the transformation of cyclophosphamide metabolites and further emphasize the importance of considering phosphoramide mustard generated extracellularly versus intracellularly and the respective contributions of extracellular and intracellular phosphoramide mustard to cyclophosphamide cytotoxicity in vivo. PMID- 3815353 TI - Lack of effect of thermotolerance on radiation response and thermal radiosensitization of murine bone marrow progenitors. AB - We studied X-ray response, thermal radiosensitization, and time sequencing between heat and radiation for nontolerant and thermotolerant murine bone marrow cells. Survival curves of colony-forming units of granulocyte-macrophages (CFU GM) have a D0 value of 1.26 +/- 0.04 Gy when irradiated in vivo. Heating at 44 degrees C for 30 min immediately prior to X-ray yields a D0 value of 0.96 Gy, with a thermal enhancement ratio of 1.3. Similar D0 and thermal enhancement ratio values were seen for thermotolerant cells. In vitro experiments with CFU-GM gave similar results. Studies of the effect of time sequence on heat and radiation indicate that for CFU-GM, the interaction between the two modalities do not fully disappear when given within 180 min of each other. Colony-forming units of erythrocytes (CFU-E) irradiated in vivo shows a D0 value of 1.1 +/- 0.03 Gy for radiation alone. Heating at 44 degrees C for 25 min prior to irradiation gives a D0 value of 0.95 Gy (thermal enhancement ratio, 1.1). Again, there was no change in the D0 value of radiation alone or the combination of heat and radiation in thermotolerant CFU-E. Both radiation killing and thermal radiosensitization were the same for thermotolerant and nontolerant CFU-GM and CFU-E. PMID- 3815354 TI - Immunological detection of DNA damage caused by melphalan using monoclonal antibodies. AB - Immunological detection of melphalan adducts on DNA should permit new types of clinical and experimental investigations. Five cloned rat hybridoma cell lines were derived, each producing an antibody that bound to DNA alkylated with melphalan (phenylalanine mustard) but not to normal DNA. Further characterization of one melphalan specific antibody (MP5/73) used a competitive fluorogenic enzyme linked immunoabsorbent assay. Using denatured DNA, 50% inhibition of antibody binding was caused by 30 fmol of total melphalan adducts (determined using radioactive melphalan) per assay well. Denatured control DNA caused 16 to 24% inhibition at 45 micrograms (130 nmol)/well, the maximum concentration tested. Adducts on RNA behaved similarly to those on denatured DNA. Adducts on native DNA caused 50% inhibition at 272 to 1335 fmol/well dependent upon alkylation frequency and sonication treatment. Native control DNA caused no detectable inhibition at 45 micrograms/well. The adducts recognized by the antibody were thermo- and alkali labile. Denaturation of the alkylated DNA by moderate heating in the presence of 75% formamide gave 50% inhibition at 50 fmol/well, indicating that only 5% of the recognized adducts could bind antibody in native DNA. PMID- 3815355 TI - Separate mechanisms for procarbazine spermatotoxicity and anticancer activity. AB - Procarbazine causes dose-dependent decreases in sperm count after a single i.p. injection in (C57BL/6 X DBA/2)F1 male mice. Two antioxidants, N-acetylcysteine and sodium ascorbate, administered with equimolar doses of procarbazine decreased the spermatotoxicity of procarbazine. At the highest doses of procarbazine (400 mg/kg) that caused a 56% decrease in sperm count, equimolar doses of N acetylcysteine coadministered with procarbazine caused only a 17% decrease in sperm count, and equimolar doses of ascorbate coadministered with procarbazine caused only a 13% decrease in sperm count. Thus, protection against the spermatotoxic effects of procarbazine was demonstrated with either antioxidant. The effect of the antioxidants on the chemotherapeutic efficacy of procarbazine against murine L1210 leukemia was also assessed. Procarbazine at the highest dose (600 mg/kg) increased mean survival time of mice inoculated i.p. with 1 X 10(5) L1210 leukemia cells by 31%. Simultaneous administration of equimolar doses of either N-acetylcysteine or ascorbate given with procarbazine caused no change in the increased mean survival time of tumor-bearing mice. These results indicate a decrease in the toxicity of procarbazine when coadministered with antioxidants, via decreased spermatotoxicity without changing anticancer efficacy. The results also indicate that different mechanisms are involved in the spermatotoxicity and anticancer activity of procarbazine. PMID- 3815356 TI - Effects of chronic dietary beer and ethanol consumption on experimental colonic carcinogenesis by azoxymethane in rats. AB - Epidemiological studies have shown an association between consumption of alcoholic beverages, particularly beer, and carcinoma of the large bowel, especially the rectum. We studied the effects of chronic dietary beer and ethanol consumption on experimental colonic carcinogenesis, fecal bile acid and neutral sterol levels, fecal bacterial flora, and colonic epithelial DNA synthesis. Ten week-old male Fischer 344 rats were pair fed throughout the study with Lieber DeCarli-type liquid diets providing comparable total carbohydrates, proteins, fats, and calories. The diets provided 23 or 12% of calories as alcohol in beer (Hi-Beer and Lo-Beer groups), 18 or 9% of calories as reagent ethanol (Hi-EtOH and Lo-EtOH groups), or no alcohol (control group). After 3 weeks of dietary acclimatization, 10 weekly s.c. injections of the bowel carcinogen azoxymethane, 7 mg/kg, were given (weeks 1-10). At necropsy in week 26, the high alcohol groups (Hi-Beer and Hi-EtOH) showed a significantly reduced incidence of tumors in the right colon (42 and 46% versus 81% in control, P less than 0.01 and P = 0.02) but no effect on left colonic tumorigenesis. By contrast, the low alcohol groups (Lo Beer and Lo-EtOH) showed a trend toward increased incidence and proportion of tumors in the left colon (incidence of 42 and 35% versus 15% in control, P = 0.06 for Lo-Beer; 28 and 30% of tumors in left colon versus 11%, P = 0.08 and P = 0.07) but no effect on right colonic tumorigenesis. Numbers of right colonic tumors were inversely correlated with alcohol consumption of all rats (r = 0.350, P less than 0.001), but left colonic tumors were not correlated. Fecal bile acid and neutral sterol levels, fecal bacterial counts, and colonic epithelial DNA synthesis did not correlate with the effects of alcohol consumption on colonic tumorigenesis. Our findings suggest that: modulation of experimental colonic tumorigenesis by chronic dietary beer and ethanol consumption was due to alcohol rather than other beverage constituents; tumorigenesis in the right and left colon was affected differentially by the levels of alcohol consumption, reflecting complex interactions among the potential mechanisms for alcohol effects in the model used. PMID- 3815357 TI - Facilitated transport of melphalan at the rat blood-brain barrier by the large neutral amino acid carrier system. AB - Melphalan has been reported to be actively transported into tumor cells by two amino acid carrier systems. As amino acids are transported across cerebral capillaries by a facilitated mechanism, studies were undertaken to assess whether or not melphalan was transported similarly, and additionally to determine melphalan's plasma and brain pharmacokinetics. The brain uptake of [14C]melphalan was measured by an in situ brain perfusion technique in the anesthetized rat utilizing [14C]-melphalan. The cerebrovascular permeability-surface area product of [14C]melphalan was calculated at cold melphalan concentrations from O to 16.3 mumol/ml. The permeability-surface area product was concentration dependent and decreased from 10.8 +/- 0.6 (+/- SE) X 10(-4)S-1 at 0.02 mumol/ml melphalan to 5.4 +/- 0.3 X 10(-4)S-1 at 16.3 mumol/ml. The system became saturated at a concentration in excess of 0.1 mumol/ml. The Michaelis-Menten parameters Vmax and Km, determined by nonlinear regression analysis of the permeability-surface area product data, equaled 0.9 +/- 0.3 X 10(-4) mumol/s/g and 0.15 +/- 0.06 mumol/ml, respectively, for the saturable component of melphalan's brain uptake. The Kd of the nonsaturable component was 5.3 +/- 0.03 X 10(-4)S-1. Addition of the amino acid 1-phenylalanine to the brain perfusate inhibited the saturable component of melphalan's brain uptake. The analysis of the plasma and brain concentrations of melphalan by high-performance liquid chromatography, following i.v. melphalan administration, demonstrated that approximately 15% of the drug that was present in plasma entered the brain. These data suggest that the brain uptake of melphalan is facilitated, demonstrating concentration-dependent uptake, saturation, and inhibition, and that melphalan shares the large neutral amino acid carrier system at the blood-brain barrier. PMID- 3815358 TI - Molecular dosimetry of O4-ethyldeoxythymidine in rats continuously exposed to diethylnitrosamine. AB - There is considerable interest in incorporating mechanistically based biological data into the process of quantitative risk assessment. Presently, no adequate data bases for internal dosimeters, such as DNA adducts, exist for humans or experimental animals. Therefore, the major promutagenic ethyl adduct, O4 ethyldeoxythymidine (O4-EtdT), has been quantitated in liver DNA after continuous exposure of rats to drinking water containing 0.4, 1, 4, 10, 40, or 100 ppm diethylnitrosamine (DEN) for 1, 4, 7, 14, 28, 49, or 70 days. The rate of O4-EtdT accumulation was modeled as the difference between a DEN-dependent rate of formation and an O4-EtdT concentration-dependent rate of loss. In general, O4 EtdT concentrations increased rapidly during the first 7 days of exposure and by 7-28 days O4-EtdT had accumulated to apparent steady-state concentrations that were DEN concentration-dependent over the entire dose range. The concentration of the adduct increased with DEN concentration over the entire dose range for exposures of 28 days or less and for doses of 0.4 to 40 ppm DEN the adduct level increased with DEN concentration for exposures of 70 days or less. Although the dose response of O4-EtdT was relatively linear, with increasing DEN concentration a trend toward a less than linear relationship was observed. This suggests that there was a lower efficiency of formation and/or greater loss of O4-EtdT during high-dose exposures. This study provides a data base that can be used to qualitatively and quantitatively examine the relationship between external dose and O4-EtdT over a DEN dose range covering several orders of magnitude. PMID- 3815360 TI - Comparison of 1,2-dihydropyrido[3,4-b]pyrazines (1-deaza-7,8-dihydropteridines) with several other inhibitors of mitosis. AB - Several properties of four 1-deaza-7,8-dihydropteridines were compared with those of each other and with those of colchicine, nocodazole, podophyllotoxin, and vincristine. Compound NSC 370147 was more active than the other compounds of this type with respect to inhibition of proliferation of cultured L1210 cells and to increase of the mitotic index. On an equimolar basis it was more active than two of the 1-deaza-7,8-dihydropteridines, colchicine, and nocodazole and was comparable to podophyllotoxin and vincristine in inhibiting the polymerization of partially purified pig brain tubulin. All four of the 1-deaza-7,8 dihydropteridines caused decreases in the extent of binding of [3H]colchicine to partially purified tubulin and enhanced the binding of [3H]vincristine to the tubulin. Emphasis in further testing was placed upon NSC 370147, because it is easier to synthesize and is more stable than some of the other compounds of this type and because its greater solubility in water facilitates its formulation for therapeutic administration. Compound NSC 370147 inhibited competitively the binding of [3H]colchicine to purified tubulin and enhanced slightly the binding of [3H]vincristine to tubulin. It was also synergistic with vincristine in killing cultured L1210 cells and in increasing the life-spans of mice bearing P388 leukemia. It is suggested that it would be worthwhile to evaluate combinations of NSC 370147 and vincristine in tests with other experimental neoplasms. PMID- 3815359 TI - Chemosensitization of L-phenylalanine mustard by the thiol-modulating agent buthionine sulfoximine. AB - Glutathione (GSH) plays a crucial role in the protection of normal and tumor tissue against the toxic effects of numerous chemotherapeutic drugs. Therefore, the possible therapeutic benefit of thiol depletion in cancer treatment is dependent upon the relative degree to which tumor or normal tissue is sensitized to the toxic effects of subsequent chemotherapy. To address this issue, the following studies on the chemosensitization of melphalan (L-PAM) by the thiol depleting agent buthionine sulfoximine (BSO) were conducted in vivo in BDF mice inoculated with L-PAM-resistant murine L1210 leukemia. Different dosing regimens of BSO were found to potentiate L-PAM toxicity in a manner that depended upon the degree of GSH depletion. Multiple i.p. injections of BSO (450 mg/kg every 6 h X 5) were found to reduce GSH concentrations in most tissues by 70-80%, and to decrease the LD50 for L-PAM from 22 to 14 mg/kg. No two organs were found to behave entirely the same with respect to the rate of depletion or recovery of GSH, or to the maximum depletion that could be obtained by BSO. In this regard, the bone marrow was found to be the most resistant tissue to thiol depletion by BSO and was found to tolerate the combination of BSO and therapeutic doses of L PAM. However, BSO pretreatment markedly inhibited the recovery of the peripheral WBC population at the LD10 dose of L-PAM. Differences also were found in the in vivo metabolism of GSH by L-PAM-sensitive and -resistant murine L1210 leukemia cells. The intracellular concentration of GSH in the resistant cell line was 1.6 fold higher than in the sensitive tumor. Moreover, GSH levels were depleted more rapidly in the resistant tumor relative to the sensitive cell line. A single injection of BSO decreased GSH concentrations in both tumors to equivalent levels (20 nmol/10(7) cells) within 24 h. However, multiple i.p. injections of BSO failed to produce a significant increase in the life-span of L-PAM-treated animals despite a 90% reduction in tumor GSH concentrations (5.5 nmol/10(7) cells). In contrast to the median day survival data, BSO was found to enhance the antitumor activity of L-PAM as determined by an in vivo/in vitro clonogenic assay or by in vivo thymidine incorporation. Using decreased thymidine incorporation as an index of antitumor activity, BSO was found to increase the therapeutic index (LD10/ED50) of L-PAM from 3.6 to 6.5.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3815361 TI - Naturally occurring clones of cells with high intrinsic proliferation potential within the follicular epithelium of mouse thyroids. AB - The proliferation pattern of some scattered clones of naturally occurring follicular cells with an exceedingly high intrinsic growth potential was investigated in the mouse thyroid gland. In particular, evidence was sought to demonstrate that the high propensity to replicate is a stable trait transmitted from the progenitor cells to their offspring. We hypothesize that these cell clones are at the origin of the multiple adenomas that invariably arise in chronically stimulated thyroid. Growth stimulation was induced either by hemithyroidectomy or by methimazole feeding. In a first series of experiments, involving hemithyroidectomized animals, [3H]thymidine was administered continuously for 3 weeks by means of osmotic minipumps, so that all cells entering the mitotic cycle during that time were labeled. Hemithyroidectomy led to a 3-fold increase of the fraction of labeled cells in the remaining lobe. The increase was prevented by thyroxine treatment in thyroid-stimulating hormone suppressing doses. Autoradiographs of contiguous serial sections across whole follicles showed that roughly 75% of the labeled cells were clustered in groups of 3 or more, rather than being randomly distributed. In a second set of experiments, glands stimulated by methimazole-induced thyroid-stimulating hormone hypersecretion were pulse-labeled by a single i.p. injection of [3H]thymidine. Animals were sacrificed either 2 h or 3 weeks after the administration of the label. The thyroids were excised and the fate of labeled thyroid cells was analyzed autoradiographically. In the 2-h exposure, about 95% of all labeled follicular cells were single and the remaining 5% were in pairs. In contrast, about 50% of all labeled cells were clustered in groups of 3 to 12 cells 3 weeks after the pulse labeling. The number of silver grains per nucleus was compared to that of the identically exposed controls. The intensity of label per cell appeared to be decreased in proportion to the size of the labeled clusters, indicating that clusters had generated several subsequent generations of cells. The results support previously produced evidence that highly growth-prone cells naturally occur within the normal thyroid and demonstrate, in addition, that their high intrinsic growth rate is a stable, inheritable trait. Cells which replicate at a rate faster than that of the average epithelial cell have a tendency to overgrow during goitrogenesis. They may be at the very origin of the nodules and adenomas commonly found in experimentally produced and naturally occurring goiters. PMID- 3815362 TI - Increased invasion and spontaneous metastasis of BL6 melanoma with inhibition of the desmoplastic response in C57 BL/6 mice. AB - BL6 melanoma cells injected s.c. in 18-month C57 BL/6 mice elicit a markedly fibrotic response similar in myofibroblast and collagen composition to that characterizing the desmoplastic response of human breast carcinoma. This host response can be quantitated by measuring hydroxyproline (total collagen) and incorporation of i.p.-injected [14C]proline into collagenase-sensitive protein (new collagen synthesis). Inhibition (70%) of the desmoplastic response can be achieved by daily injections of L-3,4-dehydroproline. Inhibiting the response in this manner promotes local invasion of tumor and increases the incidence of spontaneous pulmonary metastasis. 10(5) BL6 melanoma cells produce tumor nodules with a mean diameter of 1.5 +/- 0.5 cm and mean collagen content of 36 +/- 15 mg/g wet tissue at 4 weeks and 10% incidence of pulmonary metastasis at 7 weeks. L-3,4-dehydroproline produces nodules with a mean diameter of 2.3 +/- 0.5 cm and mean collagen content of 12 +/- 2 mg/g with a 40% incidence of metastasis. L-3,4 dehydroproline exerts a selective effect on myofibroblast collagen synthesis in vitro and no effect on [3H]thymidine uptake, doubling time, and viability of BL6 cells and myofibroblasts. Furthermore, this drug exerts no effect on BL6 invasion and metastasis in 6-week C57 BL/6 mice, hosts which exhibit a negligible desmoplastic response. PMID- 3815363 TI - Stress-induced thermotolerance of the cytoskeleton of mouse neuroblastoma N2A cells and rat Reuber H35 hepatoma cells. AB - A conditioning treatment of 30 min at 42 degrees C or 43 degrees C, followed by a 4-h recovery period at 37 degrees C, induces thermotolerance state in the cytoskeleton of Reuber H35 hepatoma cells and N2A neuroblastoma cells. Evidence for the involvement of heat shock proteins in the development of thermotolerance in the cytoskeleton has been obtained from the following observations: only those conditioning treatments inducing the enhanced synthesis of heat shock proteins (HSPs) are able to induce the heat-resistant state of the cytoskeleton; prevention of HSP synthesis by actinomycin D or cycloheximide also prevents the acquisition of thermotolerance in the cytoskeleton; an alternative inducer of HSP synthesis, sodium arsenite, is also able to induce the cytoskeletal thermotolerance; the kinetics of development and disappearance of thermotolerance in the cytoskeleton is parallel to the kinetics of accumulation and decay of HSPs. The possible function of HSPs in the heat-resistant cytoskeleton of H35 hepatoma and N2A neuroblastoma cells is discussed. PMID- 3815364 TI - Simultaneous measurements of blood flow and blood-to-tissue transport in xenotransplanted medulloblastomas. AB - We used double-label quantitative autoradiography to study blood flow (with [131I]iodoantipyrine) and blood-to-tissue transport (with [14C]-alpha aminoisobutyric acid) in 20 TE-671 medulloblastomas xenotransplanted into nude rats. Microscopically, two distinct patterns of tumor growth were observed: (a) a solid tumor mass; and (b) a tumor in which nearly all tumor cells were located perivascularly. These two tumor patterns differed markedly in values of blood flow (F) and the transfer constant (K) of alpha-aminoisobutyric acid. The solid tumors (N = 17) had averaged mean values of F = 36.8 +/- 5.3 (SE) and K = 8.0 +/- 0.7 ml/100 g/min. The perivascular tumors, which were fewer in number (N = 3), had averaged mean values of F = 83.8 +/- 9.8 and K = 0.4 +/- 0.06 ml/100 g/min. Calculated values of the net extraction fraction (En) of alpha-aminoisobutyric acid were 0.54 +/- 0.07 for the solid tumors and 0.009 +/- 0.001 for the perivascular tumors. K and En for the solid tumors are the highest for any brain tumor model reported to date. The high rates of blood-to-tissue transport may explain why intracranial TE-671 medulloblastomas in nude mice respond to treatment with water-soluble chemotherapeutic drugs, unlike most other brain tumor models. PMID- 3815365 TI - Pharmacokinetics of 99mTc(Sn)- and 131I-labeled anti-carcinoembryonic antigen monoclonal antibody fragments in nude mice. AB - The biodistribution, radioimmunoimaging, and high pressure liquid chromatography activity profiles of 99mTc(Sn) and 131I-labeled anti-carcinoembryonic antigen monoclonal antibody fragments were compared. Nude mice, bearing specific (colon carcinoma, LS174T) and nonspecific (pancreatic carcinoma, MIA) xenografts were given injections of the respective radiolabeled antibody fragments and also of irrelevant 125I-labeled antibody fragments (MOPC-21). The animals were imaged at 24 h after being given injections, they were sacrificed, and biodistribution studies were performed. Results of the study showed high kidney uptake [48.6% injected dose (ID)/g +/- 8.1% (SD)] and low tumor uptake (1.5% ID/g +/- 0.6%) for 99mTc(Sn)-labeled fragments and higher uptake (4.4% ID/g +/- 0.6%) for 131I labeled fragments, resulting in a higher localization index for the radioiodinated monoclonal antibody fragments. Imaging results showed good tumor visualization at 24 h after injection for the 131I-labeled fragments and poor tumor visualization with predominant kidney uptake for 99mTc(Sn)-labeled fragments. After radiolabeling, high pressure liquid chromatography analysis indicated that 131I was primarily associated with F(ab')2 fragments, whereas 99mTc was mostly associated with Fab' fragments. PMID- 3815366 TI - ABH and Lewis blood group expression in colorectal carcinoma. AB - The expression of ABO(H) and Lewis blood group antigens on 68 colorectal carcinomas from 63 patients was studied by immunohistochemical staining of tissue specimens. The pattern of antigen expression was as follows: ABH was expressed in normal tissue only in secretors and was expressed in the proximal but not distal colon. In tumors, there was net loss of ABH expression in the proximal and net gain in the distal colon. Some nonsecretor tumor tissue expressed ABH. Lewis expression was similar to but less strong than ABH. Its expression occurred only in secretors and in normal epithelium only in the proximal colon. In tumors there was net loss of antigen expression proximally and net gain in the distal colon. There was no expression of Lewisb in tumors of nonsecretors. Lewisa antigen was expressed throughout the normal colon in secretors and nonsecretors with no discernible difference between proximal and distal colon. In tumors, net loss of expression of Lewisa occurred throughout the colon. No inappropriate blood group expression was observed in this study. With few exceptions, H expression paralleled expression of A and B in non-0 patients. Metastatic tumor antigen expression was similar to that of the primary in most cases. Alterations in antigen expression were not clinically or histologically distinctive. PMID- 3815367 TI - C19-radiosteroid disposition in organ cultures of transplanted prostatic adenocarcinomas of the Noble rat. AB - This study compares the disposition of 8.5-nM C19-radiosteroids in 21-h cultures of Noble rat dorsolateral prostate (DLP) and transplanted adenocarcinomas derived from the DLP. Our purpose was to determine whether differences in androgen activation could be detected between the androgen-stimulated tumor (AST) line, an androgen-independent tumor line carried in intact (AIT-I) and castrated (AIT-C) rats and their DLP tissue of origin. No differences were found between DLP, AST, AIT-I, and AIT-C for the following parameters: 5 alpha-reduction of [3H]testosterone to dihydrotestosterone (DHT); however, conversion to total 5 alpha-reduced metabolites was lower in AIT-C than DLP cultures; explant retention of [3H]testosterone-derived DHT; tissue capacity to hydroxylate [3H]5 alpha androstane-3 beta,17 beta-diol; total and nuclear high-affinity binding of [3H]DHT to salt-extractable explant protein, except for one AIT-C which yielded half the number of binding sites. Since AIT carried in either intact or castrated hosts is competent as regards formation, retention and high-affinity binding of [3H]DHT in organ culture, we conclude that the neoplasm possesses some of the characteristics considered essential for the expression of androgen responsiveness in vivo. PMID- 3815368 TI - Epidemiology of cervical cancer by cell type. AB - A multicenter case-control study of 481 invasive cervical cancer patients and 801 population controls enabled comparison of risk factors for squamous cell tumors (n = 418), adenosquamous cancers (n = 23), and adenocarcinomas (n = 40). The epidemiology of the squamous cell tumors resembled that found in other studies, with the major risk factors being absence of Pap smear screening (relative risk = 3.6 to 4.8 for those not screened within 5 yr), multiple sexual partners (relative risk = 2.9 for over ten partners), and history of genital infections or sores (relative risk = 2.3). Although based on small numbers, adenosquamous tumors appeared to share some of these risk factors, notably number of sexual partners, years since last Pap smear, and level of education. Adenocarcinomas were not similarly affected, although sexual practices were marginally predictive. Obesity increased the risk of adenocarcinoma, but no other similarities to endometrial adenocarcinoma were observed. Smoking was a significant predictor of squamous cell tumors but did not affect adenocarcinomas. Extended use of oral contraceptives was a risk factor for all tumor types, especially adenocarcinoma, and a familial tendency to cervical cancer was also observed for all cell types. PMID- 3815369 TI - Phase I/pharmacokinetic study of intraperitoneal cisplatin and etoposide. AB - We administered cisplatin and etoposide by peritoneal dialysis to 39 patients with i.p. malignancies in order to investigate the toxicity, pharmacokinetics, and clinical activity of this 2-drug combination. All patients received i.v. sodium thiosulfate concurrently with the i.p. chemotherapy. Myelosuppression, nausea, vomiting, and malaise were the primary toxicities encountered. The maximum tolerated dose of etoposide was 350 mg/m2, when administered with a fixed dose of cisplatin, 200 mg/m2. Although the total (free and protein-bound) etoposide exposure for the peritoneal cavity was only 1.5-fold greater than that for the plasma, the free (non-protein bound) etoposide peritoneal exposure was 65 fold greater than the plasma. Tumor regressions were noted in patients with ovarian and pancreatic carcinomas. This study is the first demonstration of the large pharmacokinetic advantage that exists for the i.p. administration of highly protein-bound drugs, and it also documents the clinical activity of i.p. cisplatin and etoposide. PMID- 3815370 TI - Antineuroblastoma activity of desferoxamine in human cell lines. AB - That ferritin, an iron storage protein, can be produced by neuroblastoma cells raises the possibility that iron may have some role in promoting tumor cell growth. To explore this possibility, we studied the effects of desferoxamine, a compound which chelates iron, on viability of CHP 126 and CHP 100, two human neuroblastoma cell lines. Cells (5 X 10(4)) were incubated with graded amounts of desferoxamine or ferrioxamine, an iron-saturated analogue of desferoxamine. Within 5 days of exposure to 60 microM desferoxamine, approximately 90% of cells from each of these cell lines were dead. This effect was dose dependent, was not seen with ferrioxamine, and could be prevented by coincubation with greater than stoichiometric amounts of ferric citrate. As determined by binding of OK-T9, desferoxamine also resulted in increased expression of receptors for transferrin, an iron transport protein. Desferoxamine had only minimal effects on viability of several non-neuroblastoma cell lines. These results suggest that iron is required for growth of neuroblastoma and that desferoxamine has potent, specific, antineuroblastoma activity in vitro. PMID- 3815371 TI - Transient requirement for prolactin as a growth initiator following treatment of autonomous Nb2 node rat lymphoma cell cultures with butyrate. AB - A previous study described the development of cultures of Nb2 node rat lymphoma cells which specifically require a lactogenic hormone, e.g., prolactin (PRL), as a growth factor. In the present study, sublines of these cultures have been established, including clones, which do not depend on exogenous lactogens for growth; the cells do not appear to produce autocrine, PRL-like substances. Although these autonomous cells grew readily in the complete absence of lactogens, their growth rate was stimulated (up to approximately 30%) by PRL concentrations greater than or equal to 0.1 ng/ml. When cultures of the lactogen dependent and of the cloned, autonomous lymphoma cells were incubated for 3 days with sodium n-butyrate (NaBT; 2 mM), cells were arrested in the G1 phase of the cell cycle, as shown by flow cytometric analysis. A substantial proportion of the G1-arrested cells was viable and readily resumed growth, within 1 day, when transferred to NaBT-free medium containing PRL (1-100 ng/ml). The resumption of growth of the cells from the lactogen-dependent cultures was critically dependent on PRL; in its absence cells lysed. Surprisingly, the rapid recovery of the cells from the lactogen-independent cultures also depended on the presence of PRL in the medium; in its absence growth did not resume for at least 2.3 days. The acquired need of the NaBT-treated, autonomous cells for PRL was only transient, since such cells reverted fully to the PRL-independent state within about 3 days of culturing in PRL-containing, NaBT-free medium. It is proposed, as a working hypothesis, that the autonomous lymphoma cells can be mitogenically activated by two different pathways, one requiring exogenous lactogens and another which is independent of lactogens; the latter pathway recovers much more slowly from the treatment with NaBT than the lactogen-dependent pathway. This model could explain the sensitivity of the autonomous lymphoma cells to PRL and their transient dependency on exogenous lactogens during their recovery from NaBT treatment. NaBT would appear to be a useful agent for studying the mechanism(s) by which the autonomous lymphoma cells circumvent the need for mitogenic lactogens. PMID- 3815373 TI - Induction of a tumor necrosis factor-like activity by Nocardia rubra cell wall skeleton. AB - Nocardia rubra cell wall skeleton (N-CWS) stimulated adherent cells harvested from the peritoneal cavities of thioglycollate-treated mice to produce cytotoxic activity. Depletion of macrophages from the adherent cells by 2-chloroadenosine or silica abrogated the production of this cytotoxic activity, whereas treatment of the adherent cells with anti-Thy-1.2 antibody and complement did not. This suggested that macrophages were the producer cells of the activity. Cytotoxic activity became detectable as early as 2 h after N-CWS treatment and reached peak activity at 9 h, then declined to a lower level, indicating rapid onset without persistent effects. N-CWS-induced cytotoxic factors have a fairly narrow temperature range, pH optimum for storage, and are sensitive to pronase and trypsin. By using column chromatography, N-CWS-induced cytotoxic factors were compared in detail with tumor necrosis serum obtained from Bacillus Calmette Guerin endotoxin-treated mice. Both toxins were found to be nearly identical with respect to their behavior in ion-exchange, gel filtration, and concanavalin A affinity columns. N-CWS also induced human peripheral blood lymphocytes to release cytotoxic activity. Monocytes predominantly participated in production of this activity as confirmed by treatment with monoclonal antibody and complement. The cytotoxic activity was completely neutralized by anti-human tumor necrosis factor antiserum, but not by anti-human lymphotoxin antiserum. The fact that human peripheral blood lymphocytes release tumor necrosis-like factors after stimulation with N-CWS might account for the antitumor effects of this agent. PMID- 3815372 TI - Stimulation of tumor growth in adult rats in vivo during acute streptozotocin induced diabetes. AB - The effects of acute diabetes mellitus on the growth of Morris hepatoma 7288CTC and Jensen sarcoma were studied in fed, young (less than 200 g), and adult (greater than 250 g) rats. Animals were matched for tumor size and growth; the rates of tumor growth were the same in fed, young and adult nondiabetic rats. Diabetes was induced by the i.v. injection of streptozotocin (65 mg/kg total body weight) into tumor-bearing rats and changes in arterial blood nutrient concentrations were compared to changes in the rates of tumor growth and DNA synthesis. In young rats acute diabetes did not increase the blood concentrations of the fat store-derived nutrients and did not increase the rate of tumor growth. In adult rats, however, acute diabetes raised the arterial blood free fatty acid, glycerol, triglyceride, and ketone body concentrations to high levels and increased the rate of tumor growth about three times over that observed in untreated rats. Progress curves for the mobilization of host fat stores and for incorporation of [methyl-3H]thymidine into tumor DNA during the onset of diabetes showed that these activities were closely correlated in adult rats. Both processes began to increase 2 to 4 h after streptozotocin treatment, reached an initial peak at 12 to 16 h, decreased to a low point at 18 to 20 h, and then increased again to the new steady state after 23 to 24 h. The results indicate that the rate of tumor growth in rats in vivo is limited by the availability of a substance(s) present in the hyperlipemic blood of adult diabetic rats. The tight relationship between host lipolysis and tumor growth suggests that the substance(s) is derived from host fat stores. PMID- 3815374 TI - Structural alterations and stabilization of rabbit uterine estrogen receptors by natural polyamines. AB - Estrogenic regulation of gene expression involves interaction of the hormone with its receptors, which undergo structural and conformational changes to interact with specific DNA sequences. Putrescine, spermidine, and spermine, are ubiquitous cellular components. We studied the effects of these polyamines on rabbit uterine estrogen receptors by sucrose gradient centrifugation and ligand dissociation kinetics. The native 7S receptor converted to a 9S-10S form in the presence of 100 microM spermidine or spermine. Higher concentrations caused precipitation of the receptor. This precipitation was reduced by RNase treatment of the receptor. RNase-treated receptors sedimented at 4S and 7S regions of sucrose gradient. The dissociation rate constant (k) of the 4S receptor is 2.8 X 10(-3) min-1 in the presence of 1 mM spermidine, compared to a control value of 7.7 X 10(-3) min-1. Similar effects were observed with putrescine and spermine. The dissociation of the RNase-treated 7S receptor was biphasic, with about 50% of the receptors dissociating at a faster rate (k1 = 40 X 10(-3) min-1) than the other half (k2 = 7.4 X 10(-3) min-1). Spermidine (1 mM) caused a 2-fold reduction in k2, whereas k1 was not affected. This study shows that polyamines affect the structural organization and ligand dissociation kinetics of estrogen-receptor complexes. PMID- 3815375 TI - Enhanced immunogenicity of the cultured rat fibrosarcoma KMT-17 by cultivation in a low concentration of fetal calf serum. AB - We examined in different culture conditions alterations in the tumorigenicity and immunogenicity of an A3 clone that had been derived from a rat fibrosarcoma KMT 17. When a fetal calf serum concentration in a culture medium was lowered from 10 to 1%, the tumorigenicity was diminished while the immunogenicity was enhanced in a reversible manner; this was accompanied by a reversible prolongation of the in vitro doubling time. These phenomena were not due to an increase in the quantities of the original tumor-associated antigen and/or of the rat major histocompatibility complex (RT1) but seemed to be due to the appearance of a unique antigen(s) that was detected by an antibody taken from rats immunized with A3 tumor cells cultured in the low fetal calf serum concentration; this antigen(s) may consist of glycoprotein and exist as a crypt antigen(s). These phenomena were measured by an absorption test and flow cytometric analysis. Our observations suggest that the in vitro culture condition of tumor cells, in particular their culturing in the low fetal calf serum concentration medium, modifies the surface of tumor cells and causes a diminishment in their tumorigenicity and an enhancement of their immunogenicity. PMID- 3815376 TI - Effect of sodium chloride concentration on adriamycin and N trifluoroacetyladriamycin-14-valerate (AD32)-induced cell killing and DNA damage in Chinese hamster V79 cells. AB - Exponentially growing Chinese hamster V79 cells were exposed to Adriamycin either in phosphate buffered saline (PBS) or fresh growth medium (F-med) supplemented with various amounts of NaCl in the range between 50-1000 mM and survival was measured by the colony forming assay. Compared to the survival obtained after exposure of cells to isotonic (140 mM NaCl) PBS (D0 = 0.16 microgram/ml, Dq = 0.49 microgram/ml) a potentiation in cell killing was observed after treatment in hypotonic (50 mM NaCl) PBS (D0 = 0.08 microgram/ml, Dq = 0.19 microgram/ml) and a reduction in cell killing after treatment in hypertonic (500 mM NaCl) PBS (D0 = 0.36 microgram/ml, Dq = 0.55 microgram/ml). Cells exposed to Adriamycin in F-med were more sensitive to Adriamycin (D0 = 0.1 microgram/ml, Dq = 0.27 microgram/ml) than cells exposed to Adriamycin in PBS, but cell killing was reduced when the medium was made hypertonic by the addition of NaCl (500 mM NaCl) (D0 = 0.23 microgram/ml, Dq = 0.45 microgram/ml). The amount of Adriamycin accumulated in the cells during treatment was measured in a spectrophotofluorometer and was found to vary as a function of the treatment medium and NaCl concentration. Cells exposed to Adriamycin in PBS (isotonic) were accumulating three to four times less drug than cells exposed to Adriamycin in F-med. Less Adriamycin (two to three times) was also accumulated in cells treated in hypertonic (500 mM NaCl) F med. Compared to the Adriamycin accumulation observed after exposure to cells in isotonic PBS, an increase was observed after exposure in hypotonic PBS (2.3 times) but no change after exposure in hypertonic PBS (500 mM NaCl). Adriamycin induced DNA damage was assayed with the alkaline filter elution technique and it was found to increase after treatment in hypotonic PBS and to decrease after treatment in hypertonic PBS. The modification in the survival curve slope and DNA damage induction observed after exposure in hypotonic PBS was quantitatively similar to the modification in intracellular drug concentration (factor of 2.3, comparison based on the results obtained in isotonic PBS). However, after exposure of cells to Adriamycin in hypertonic PBS, a reduction by a factor of 20 was observed in the induction of DNA damage but a reduction only by a factor of 2.3 was observed in cell killing with no modification of intracellular Adriamycin concentration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3815377 TI - Antitumor activity and mechanism of action of 6-thio-3-deazaguanine. AB - 6-Thio-3-deazaguanine (TDG), a relatively new purine antimetabolite, exhibits significant antitumor activity against a variety of experimental animal tumor models including C3H mammary adenocarcinoma, Lewis lung carcinoma, adenocarcinoma 755, and leukemias L1210 and P388. However, the drug was ineffective against 3 deazaguanine-resistant L1210 (both in vitro and in vivo) and CEM cells (in vitro). The resistant cells appear to lack HGPRTase activity because the extracts from these cell lines failed to convert hypoxanthine to IMP. These data indicate that TDG needs to be activated by hypoxanthine guanine phosphoribosyltransferase prior to its growth inhibitory effects. Cytotoxicity of TDG was completely reversed by hypoxanthine and inosine. TDG inhibited the synthesis of DNA and RNA equally and effectively, whereas the inhibition of protein synthesis required a prolonged drug exposure and appears to be a consequence of the inhibition of DNA and RNA synthesis. Data from these studies suggest that TDG is an effective antitumor agent, and its spectrum of antitumor activity and mechanism of action appears to be different from that of 3-deazaguanine. PMID- 3815378 TI - Subacute nephrotoxicity and induction of renal cell carcinoma in mice treated with ferric nitrilotriacetate. AB - We investigated the induction of renal tumors by the ferric complex of nitrilotriacetic acid (Fe-NTA) in male and female A/J mice. Fifty-three male and 21 female mice received i.p. injections of Fe-NTA, 1.8 to 2.7 mg of iron/kg of body weight/day, 6 days a wk for 12 wk, at the longest. Ten male and ten female mice received nitrilotriacetic acid (NTA) i.p. at the dose equivalent to the NTA portion of Fe-NTA for the same period of time. Twenty male and 20 female mice left untreated served as the controls. Twenty-eight of the 53 Fe-NTA-treated male mice died within 14 days of the treatment. Renal proximal tubular cell necrosis was the major autopsy finding in these mice. On the other hand, all the Fe-NTA treated female mice and NTA-treated male and female mice survived the 12 wk of treatment. Renal tubular cell carcinoma had developed in 15 of the 25 male mice and in one of the 21 female mice by the 420th day after the start of the experiment. The NTA-treated and control mice did not develop any tumors. In conclusion there is no species specificity in rats or mice in the induction of the renal carcinoma by Fe-NTA, but male mice are far more susceptible to both the acute or subacute toxicity and carcinogenic effect of Fe-NTA than are female mice. PMID- 3815379 TI - Evaluation of growth fractions with monoclonal antibodies to human alpha-DNA polymerase. AB - We have established and partially characterized a panel of monoclonal antibodies against alpha-DNA polymerase. One of the hybridomas, clone 5F, has been exploited for cell kinetic studies on three colon cancer cell lines, LOVO, SW 620, and SW 403, which are endowed with different growth patterns and differentiation status. By an immunoperoxidase method, we could demonstrate the specific intranuclear localization of alpha-DNA polymerase during the exponential phase of in vitro growth and contrast it with the diffuse distribution of the enzyme throughout the cytoplasm during the resting state. The percentage of intranuclear staining positive cells, evaluated at successive time points of in vitro growth, changed from 75 to 95% (assayed on Days 3 and 7) to 15 to 25% in confluent and resting populations assayed on Days 12 to 14. In agreement with the assumption that the enzyme moves from nucleus to cytoplasm after entering quiescence, alpha-DNA polymerase was still present in the cytoplasm or in the cytoplasmic perinuclear area of cells in resting phase cultures. Comparisons between traditional kinetic parameters (thymidine labeling index and primer-dependent alpha-DNA polymerase) and proliferative state determined by the monoclonal antibody supported the feasibility of this approach to define the proportion of actively proliferating elements in a tumor cell population. Moreover, parallel flow cytometric analysis performed on Days 5 and 14 of continuous culture showed fluctuations of alpha-DNA polymerase content in relation to exponential and steady-state phases, with a significant increase in the amount of alpha-DNA polymerase in actively proliferating populations and a progressive reduction of the enzyme as the cultures entered the resting stage. PMID- 3815380 TI - Growth inhibition by progestins in a human endometrial cancer cell line with estrogen-independent progesterone receptors. AB - The presence of estrogen-independent progesterone receptors (PgR) was demonstrated in a subline of a human endometrial cancer cell line, Ishikawa cells, although the original Ishikawa cells contained estrogen-inducible PgR. Scatchard plot analysis of cytoplasmic binding data in our subline (IK-90) revealed a high affinity binding site for R5020 (Kd, 1.0 nM) with maximum binding sites of 158 fmol/mg protein. Competition experiments showed a binding specificity similar to that of typical PgR. By low-salt sucrose gradient centrifugation, radioactive 8S and 4S peaks were found. The addition of 1 microM progesterone in culture medium resulted in a rapid nuclear translocation of cytoplasmic PgR. In contrast to the original cells, estrogen receptors could not be detected in IK-90 cells, and an addition of 17 beta-estradiol (10 nM) to culture medium failed to increase PgR. Accumulation of glycogen in cytoplasm of IK-90 cells in response to R5020 (0.1-1 microM) was observed by periodic acid Schiff staining. The addition of R5020 to culture medium (0.1-1 microM) also caused a marked decrease in the growth of IK-90 cells, whereas the other steroids including 17 beta-estradiol, tamoxifen, testosterone, and cortisol had no significant effects. These results demonstrate for the first time the presence of a progestin-responsive human endometrial cancer cell line that contains estrogen independent functional PgR. IK-90 cells appear to be an ideal model for studying the mechanism of the antiproliferative effect of progestin on endometrial cancer cells. PMID- 3815381 TI - Terminal differentiation-resistant epidermal cells in mice undergoing two-stage carcinogenesis. AB - We have used an in vivo-in vitro approach to investigate the cellular aspects of two-stage skin carcinogenesis. Female SENCAR mice initiated with N-methyl-N' nitro-N-nitrosoguanidine (MNNG) were promoted twice weekly with 12-O tetradecanoylphorbol-13-acetate (TPA). Epidermal cultures from untreated or TPA treated mice had few focus-forming cells resistant to calcium-induced terminal differentiation. Cultures from mice treated with MNNG alone formed numerous foci. Brief promotion (four TPA treatments) of MNNG-treated mice produced fewer but statistically larger foci, suggesting that TPA was selecting against more slowly growing cells. MNNG plus TPA-treated mice with very early papillomas produced more and larger foci than those due to MNNG treatment alone, suggesting that the papillomas may have comprised calcium-resistant cells. These cells may indeed be initiated cells since a permanent cell line arising after MNNG plus brief TPA treatment eventually formed histological papillomas in vivo. If calcium-resistant cells are initiated, then there were many more initiated cells in the skin (with or without TPA treatment) than papillomas expected, implying that either some initiated cells never formed papillomas, or that a significant accumulation of initiated cells had already occurred in the skin within 2 weeks of MNNG treatment. Subsequent TPA promotion of these cells apparently produced a toxic response that passively selected for more rapidly growing initiated cells, which eventually accumulated into papillomas. PMID- 3815382 TI - Comparison of monoclonal antibody delivery to intracranial glioma xenografts by intravenous and intracarotid administration. AB - Monoclonal antibody 81C6, which is directed against a human gliomamesenchymal extracellular matrix antigen, was used to evaluate the potential advantage of intracarotid (i.c.) administration versus i.v. delivery to D-54 MG human glioma intracranial xenografts in immunosuppressed rats. Two approaches were taken. In paired-label analysis, 125I-labeled 81C6 and 131I-labeled isotype control antibody were given to separate groups of animals by either the i.v. or i.c. route. Biodistribution measurements as a function of time were analyzed in terms of the percentage of injected dose/g of tissue and localization indices. No significant difference (P greater than 0.19 to P greater than 0.56) was demonstrated between the i.v. and i.c. routes. To control for the large localization variation inherent in the animal model used, an alternative experimental design, paired-injection analysis, was performed in which 125I- and 131I-labeled 81C6 were simultaneously administered by the i.c. and i.v. routes to the same animal. Significantly higher levels of percentage of dose/g of tissue and localization ratios (P less than 0.05 to P less than 0.005) were shown from Day 1 to Day 3 for 81C6 given i.c. Approximately 20% more antibody was delivered to the D-54 MG intracranial tumor by the i.c. route during the experimental period of 5 days. No difference in the levels of normal tissue exposure between the two routes of administration was seen. These data suggest an advantage exists for whole monoclonal antibody given i.c. and that, theoretically, a greater advantage may be present for smaller molecules such as Fab and F(ab')2 fragments. PMID- 3815383 TI - Phase I clinical and pharmacological study of 72-hour continuous infusion of etoposide in patients with advanced cancer. AB - Etoposide (VP-16) is a semisynthetic epipodophyllotoxin that exhibits cell cycle phase specific cytotoxicity and enhanced effectiveness with increasing duration of drug exposure. We have therefore conducted a Phase I trial to determine the side effects, tolerable doses, and pharmacokinetic parameters of VP-16 given by continuous i.v. infusion to patients with advanced cancer. Eighteen patients were treated with varying dosages of VP-16 infused continuously for 72 consecutive hours every 28 days. Using this schedule, the maximally tolerated dosage of VP-16 was 150 mg/m2/day for patients with good performance status and 125 mg/m2/day for more debilitated cancer patients. Hematological toxicity was dose limiting with median granulocyte and platelet nadirs of 700/mm3 and 116,000/mm3, respectively, at a dose of 150 mg/m2/day. Other toxicities included only mild nausea, vomiting, and alopecia. Plasma and urine VP-16 concentrations were determined using a high performance liquid chromatography assay. At a VP-16 dosage of 150 mg/m2/day, steady-state VP-16 concentrations were in the range of 2.1 to 7.0 micrograms/ml in all patients. Further pharmacokinetic analysis revealed that the plasma clearance of VP-16 was consistently near 25 ml/min/m2 (independent of dosage) and that renal clearance accounted for only 15% of VP-16 total plasma clearance. Patient age was found to be the most important factor correlating with plasma clearance of VP-16. Linear regression analysis also revealed that both the plasma VP-16 concentration at steady state and the concentration of VP-16 in plasma at 24 h from the start of the infusion correlated with hematological toxicity; no other patient characteristics correlated with hematological toxicity. The recommended VP-16 dose for Phase II trials of 72-h continuous infusion VP-16 is 150 mg/m2/day in patients with good performance status. PMID- 3815384 TI - Use of the aromatase inhibitor 4-hydroxyandrostenedione in postmenopausal breast cancer: optimization of therapeutic dose and route. AB - 4-Hydroxyandrostenedione (4-OHA) is a potent inhibitor of estrogen production by aromatase and causes suppression of plasma estradiol levels and disease regression in postmenopausal breast cancer patients. Groups of patients were given p.o. or parenteral 4-OHA, and plasma estradiol and 4-OHA levels were measured to enable the delineation of the minimal effective dose and optimal therapeutic regimen. A single injection of 500 mg i.m. suppressed estradiol levels to a mean 36.3 +/- 3.3% (SE) (n = 14) of base line after 4 to 7 days and maintained this suppression in six of seven patients for greater than 14 days. The half-life of 4-OHA was approximately 8 days, and when the level had fallen to less than 3 ng/ml, estradiol levels began to rise. Similar suppression was achieved by a single i.m. injection of 125 mg of 4-OHA and by 500 mg of 4-OHA p.o. daily after 1 wk, but escape from suppression was more rapid. PMID- 3815385 TI - Reduced systemic drug exposure by combining intraarterial cis diamminedichloroplatinum(II) with hemodialysis of regional venous drainage. AB - During cancer chemotherapy toxicity to normal tissues often limits the tolerable dose. To increase drug delivery to tumor while maintaining tolerable systemic exposure, regional treatments, such as intraarterial drug delivery, have been used. Despite intraarterial delivery, systemic toxicity often remains the dose limiting sensitivity. If systemic drug exposure could be reduced after intraarterial infusion, the intraarterial dose could be increased, which should increase the therapeutic response. We compared the pharmacokinetic advantage after cisplatin infusion into the internal carotid artery to that obtained after infusing cisplatin into the internal carotid artery during extracorporeal removal of cisplatin from the jugular blood by hemodialysis. Four patients with malignant gliomas received intracarotid cisplatin, 100 mg/m2 over 60 min, every 4 weeks. During one treatment, while cisplatin was infused into the internal carotid artery, the jugular blood was dialyzed extracorporeally at 300 ml/min and returned to the inferior vena cava. Seventy to 96% of the free platinum that entered the dialyzer was removed. By aspirating blood from the jugular vein at 300 ml/min, 30-79% of the ipsilateral carotid blood was collected for extracorporeal circulation. Hemodialysis of the cerebral venous drainage during intracarotid infusion reduced the systemic exposure to cisplatin by 51-61% when compared to the exposure from internal carotid artery infusion without hemodialysis. The pharmacokinetic advantage (brain/body exposure ratio) was increased from 3 to 5/1 during internal carotid artery infusion alone to as much as 15/1 during treatment combining intracarotid infusion with hemodialysis of the jugular blood. Systemic toxicity now limits the dose of cisplatin that can be administered safely. Increased tumor exposure without increased systemic toxicity may be possible with the technique described and greater doses of cisplatin. Assuming no associated local toxicities, the results of the current study indicate that the dose of intracarotid cisplatin can be increased while maintaining tolerable systemic exposure. PMID- 3815386 TI - Characterization of glycolipids from the gastric cancer of a patient of p,O,Le(a ,b+) blood type: presence of incompatible blood group antigens in tumor tissues. AB - The antigens present in a gastric tumor obtained from a patient of blood group p,O,Le(a-,b+) were studied. The neutral glycolipids were isolated from the cancer tissues and characterized chemically and immunologically. The glycolipid pattern of the tumor was similar to that of the surrounding uninvolved mucosae. The major neutral glycolipids were found to be glucosylceramide, galactosylceramide, lactosylceramide, and the lacto series glycolipids, including the H, Lea, and Leb active fucolipids. The cancer tissues and the uninvolved mucosae did not contain galabiosylceramide, globotriaosylceramide, or globotetraosylceramide after separations by both thin layer chromatography and gas-liquid chromatography. Thin layer chromatography immunostaining was performed to detect incompatible blood group antigens. Immunostaining revealed the presence of globotriaosylceramide, globotetraosylceramide, Forssman glycolipid, and A active glycolipids in the cancer tissues. These incompatible blood group active glycolipids were absent from the uninvolved mucosae. The results indicate that the cancer tissues possess the ability to produce the globo series of glycolipids and the A active antigens but that the surrounding uninvolved mucosae could not synthesize these glycolipids. PMID- 3815387 TI - DNA flow cytometry and histopathological grading of paraffin-embedded prostate biopsy specimens in a survival study. AB - Methods to disintegrate old paraffin-embedded tissue blocks for the application of DNA flow cytometry open up new possibilities for retrospective studies on the correlation between tumor cell nuclear DNA pattern and prognosis of the neoplastic disease. In the present work we used such a method to study the relationship between DNA ploidy, histopathological grade, and survival for 50 patients with prostate carcinomas diagnosed 1958-1974. Plugs of histologically identified tissue from benign and tumor areas were sampled from paraffin blocks of prostate biopsy specimens by using a 4-mm skin biopsy punch. Thirty-micron sections were cut from each plug for dewaxing and disintegration. The cell suspensions obtained were stained with 4',6-diamidino-2-phenylindole dihydrochloride and analyzed by flow cytometry. In about one-half of the cases where two or more plugs were analyzed we found a heterogeneous tumor cell nuclear DNA pattern. No apparent correlation was found between the histopathological grade and the DNA ploidy. Using Cox's multiple regression analysis, we found a significant correlation between DNA ploidy and survival of these patients (P = 0.043) when we controlled for histopathological grade (Dhom grade), acid phosphatase level, occurrence of metastases, age, year of diagnosis, and type of biopsy. The correlation between DNA ploidy and survival was just above the level of significance (P = 0.059) when Gleason grade was substituted for Dhom grade in the regression model. PMID- 3815389 TI - Long-term influence of levodopa on bone mass and growth hormone in postmenopausal women with Parkinson's disease. PMID- 3815388 TI - Transdihydrolisuride in parkinsonism. AB - The semisynthetic lisuride derivative transdihydrolisuride (terguride, TDHL) is an effective antiparkinsonian drug. In animals, TDHL appears to possess mixed dopamine agonist-antagonist effects, but this may not be the case in man. Single doses of TDHL were given to 21 subjects with parkinsonism. Overall, TDHL 0.25-0.5 mg caused dose-related improvement in parkinsonism for periods of up to 6 h, although 8 of 21 subjects showed no improvement or deterioration with TDHL 0.5-1 mg. In three patients with levodopa-induced psychosis, the addition of TDHL 0.75 mg daily for 5-10 days did not alter the psychotic state. In three subjects with levodopa-induced dyskinesias, the addition of TDHL 0.75 mg daily for 14 days resulted in a slight increase in the severity of involuntary movements. Side effects of TDHL, sickness and hypotension, were similar to those observed with levodopa. Transdihydrolisuride caused prolonged inhibition of prolactin release, but unlike levodopa did not elevate plasma growth hormone levels. Additionally, TDHL did cause considerable sedation. These results may be due to combined effects of TDHL on nondopamine as well as dopamine neurotransmitter systems, rather than to partial or incomplete dopamine agonist effects. PMID- 3815390 TI - Reappraisal of some dosage adjustment guidelines. PMID- 3815391 TI - Weekly 5-fluorouracil combined with PALA: toxic and therapeutic effects in colorectal cancer. AB - A total of 51 patients (eight previously treated) received PALA added to 5 fluorouracil (5FU) given weekly. After 32 patients, the PALA schedule was changed from every other week to weekly, 24 hours preceding 5FU in accordance with preclinical leads (see text). Both schedules were associated with moderately severe toxic effects related primarily to PALA (skin rash) or to the combined effects of both drugs (diarrhea, vomiting, conjunctivitis, and neurotoxicity). Overall nine partial responses were observed, including three in patients previously treated with 5FU. However, future studies with this combination utilizing the current or other previously published schedules are not warranted in colorectal cancer. Since toxicity is a prominent impediment, the possibility of therapeutic synergy may perhaps be explored at drastically reduced doses of PALA, combined with other modulating measures. PMID- 3815392 TI - Local neurotoxicity after intra-arterial cisplatin in head and neck cancer. AB - Neurotoxicity after intra-arterial administration of cisplatin, alone or in combination with other chemotherapeutic agents, is not yet well-documented. In our experience with 63 previously untreated patients with head and neck cancer, we observed four patients with cranial nerve impairment ipsilateral to the cannulated artery. The first patient has already been reported, whereas the other three are the subject of the present report. Overall, all three patients developed cranial peripheral palsy a few days after the end of intra-arterial cisplatin and after a median total dose of 200 mg (range, 160-250). The nerves involved were the 12th in the first patient, the seventh in the second, and the ninth, tenth, 11th, and 12th in the third patient. Complete recovery of the palsy was noted only in the first patient. The patient reported previously had developed a cranial nerve palsy involving the ninth, tenth, 11th, and 12th nerves of the right side. The low incidence of this toxicity (6.3% in our experience) and the very high objective remission rate achieved by the intra-arterial administration of cisplatin justify the continuation of such an approach to obtain the maximum tumor regression and to research the individual predisposing factors. PMID- 3815393 TI - Thymidylate synthase gene amplification in a colon tumor resistant to fluoropyrimidine chemotherapy. AB - We have identified amplification of the thymidylate synthase gene in a colonic tumor that had developed resistance to 5-fluorouracil/leucovorin combination chemotherapy. The tumor had previously undergone a partial response to this combination but began to progress following a prolonged period of continuous therapy and relative disease stabilization. Since thymidylate synthase is a target enzyme for 5-fluorouracil, it is likely that the observed gene amplification is responsible for the resistance. Thus, gene amplification may be a relevant mechanism of acquired resistance to fluoropyrimidine chemotherapy in the clinic. PMID- 3815394 TI - Experimental dacarbazine antitumor activity and skin toxicity in relation to light exposure and pharmacologic antidotes. AB - Decarbazine (DTIC) is reported to exhibit enhanced clinical toxicity and increased antitumor activity in vitro when exposed to light. Since it was unclear whether light exposure enhanced DTIC antitumor activity or local toxic effects in vivo, a series of experiments was performed in mice given DTIC solutions exposed to light for 2 hours at room temperature. Adenocarcinoma 07/A was implanted by trocar in adult female BALB/c mice. DTIC (50 and 100 mg/kg) was given ip three times per week for 2 weeks. Both drug doses significantly inhibited tumor growth. However, there was no significant difference between light-exposed and -protected drug treatments. In vitro clonogenic assays in L1210 leukemia and Chinese hamster ovary (CHO) cells demonstrated that DTIC cytotoxicity was not increased with light exposure (0.8 J/m2/sec). Both cell lines showed a dose-response relationship to DTIC after 1- or 6-hour exposures in the presence or absence of light. Normal dehaired BALB/c mice were given single intradermal injections of 0.5, 1.75, 5.0, or 10 mg of DTIC in 0.05 ml of saline. Dose-dependent skin ulceration was produced at the 1.75-, 5.0-, and 10.0-mg dose levels. Again, there was no consistent statistical difference in skin ulceration between treatments using light-exposed and -protected DTIC vials. However, when mice were exposed to light following intradermal DTIC, increased skin toxicity was produced (P less than 0.05 by Student-Neuman-Keuls multiple range test). A number of potential local antidotes to DTIC skin ulceration were found to be ineffective. These included: L-cysteine, dimethyl sulfoxide, hyaluronidase, hydrocortisone, and 0.9% saline. Sodium thiosulfate (0.3 M) significantly reduced DTIC skin ulcers as did pre-exposure of DTIC to S-9 rat liver enzymes and NADPH. Neither mild skin heating nor cooling reduced DTIC ulcerations. DTIC appears to synergize with light in vivo to produce increased toxicity. Patients receiving DTIC should avoid intense light exposure after drug injection. However, elaborate precautions to prevent light exposure of DTIC solutions during preparation or injection appear to be unnecessary. PMID- 3815396 TI - Percutaneous hepatic arterial infusion of cisplatin for metastatic breast cancer. AB - We treated 31 patients with breast cancer metastatic to the liver and refractory to prior chemotherapy with percutaneous hepatic arterial infusion of cisplatin (DDP) (120 mg/m2) at 4-week intervals. Partial responses occurred in five of 26 evaluable patients, with a median time to disease progression of 15+ weeks (range, 8+ to 55) and a median duration of survival of 11 months (range, 8-22). Toxic effects were acceptable and, except for catheter-related complications, were essentially similar to those encountered when DDP was given iv. Percutaneous hepatic arterial infusion of DDP has modest activity in the treatment of breast cancer metastatic to the liver. PMID- 3815395 TI - Use of nude mouse xenografts as preclinical drug screens: in vivo activity of established chemotherapeutic agents against melanoma and ovarian carcinoma xenografts. AB - To evaluate the utility of nude mouse xenografts as preclinical drug screens, the activity of ten established chemotherapeutic agents was evaluated against seven melanoma and three ovarian carcinoma xenografts. Xenografts were established using primary explants from patients who had not received chemotherapy and serially passaged as sc tumors in nude mice. In vivo drug activities for dactinomycin, carmustine, vinblastine, melphalan, amsacrine, cisplatin, bleomycin, mitomycin, doxorubicin, and etoposide were evaluated by 4 weekly ip injections of 10% less than LD10 doses. Plots of relative tumor growth versus time were nearly log-linear. Analysis of in vivo activity was performed using percent control growth (treated/control tumor volume) and by calculation of a novel growth delay index obtained by fitting growth curves to a quadratic regression model. Both modes of data analysis identified alkylating agents (melphalan, carmustine, and mitomycin) as the most active drugs against human melanomas. Melphalan, mitomycin, and cisplatin showed the greatest activity against ovarian xenografts. However, complete tumor regressions were noted only with melphalan, mitomycin, and cisplatin against a single ovarian tumor xenograft. Correlation analysis suggested xenograft tumor growth rate was an important determinant of drug response. These results suggest that preclinical, new-drug screening with melanoma xenografts would identify drugs such as alkylating agents as active, and may not provide an advantage over murine leukemia screens. However, screening with ovarian xenografts may more closely reflect clinical drug activity. Criteria for detecting active drugs in such systems are discussed. PMID- 3815397 TI - Pharmacokinetic comparison of intranasal, oral, and intramuscular metoclopramide in healthy volunteers. AB - This was a randomized, crossover study of the bioavailability and pharmacokinetics of metoclopramide given by intranasal (IN), oral (PO), and intramuscular (IM) routes. The formulations tested were 5 and 10 mg of IN gel, 10 mg PO, and 5 mg IM. The findings showed that metoclopramide follows similar absorption and elimination characteristics when given via these three extravascular routes. There were no statistically significant differences in the area under the drug concentration versus time curve (AUC) or peak metoclopramide plasma concentration (Cmax) data following PO, IM, or 10-mg IN administration. However, the 5-mg IN doses achieved an AUC that was 39.5% the AUC of the 10-mg IN dose. These data show consistent and relatively predictable metoclopramide plasma concentrations following IN administration. Further, 10-mg doses of IN and PO metoclopramide appear to be bioequivalent. PMID- 3815398 TI - Phase II study of etoposide in previously untreated squamous cell carcinoma of the head and neck. PMID- 3815399 TI - Phase II trial of esorubicin in patients with advanced melanoma. PMID- 3815400 TI - Phase II trial of cisplatin and etoposide in adenocarcinomas of the upper gastrointestinal tract. PMID- 3815401 TI - Phase II studies of PCNU and bisantrene in advanced renal cell carcinoma. PMID- 3815402 TI - Phase II clinical trial of tricyclic nucleoside phosphate for advanced colorectal cancer. PMID- 3815403 TI - Total synthesis of gangliosides GM1 and GM2. PMID- 3815404 TI - The structure of the antigenic lipopolysaccharide O-chains produced by Salmonella urbana and Salmonella godesberg. AB - The lipopolysaccharides of Salmonella urbana and Salmonella godesberg, which belong in group N (O:30) of the Kauffmann-White system, were shown by SDS-PAGE electrophoresis, glycose analysis, periodate oxidation, methylation, and 1H- and 13C-n.m.r. analyses to have identical O-chains composed of repeating, branched pentasaccharide units having the structure: [----4)-beta-D-Glcp-(1----3)-alpha-D GalNAcp-(1----2)-alpha-D-P erNAcp-(1----3)-alpha-L-Fucp-(1----]n 4 increases 1 beta-D-Glcp. The serological cross-reactivity of S. urbana and S. godesberg with Brucella abortus and Yersinia enterocolitica (O:9) can now be related to the presence of a 1,2-glycosylated N-acyl derivative of 4-amino-4,6-dideoxy-alpha-D mannopyranosyl residues in their respective lipopolysaccharide O-chains. PMID- 3815405 TI - Structural studies of a polysaccharide (S-88) elaborated by Pseudomonas ATCC 31554. AB - The structure of the extracellular polysaccharide elaborated by Pseudomonas ATCC 31554 has been investigated, methylation analyses, specific degradations, and 1H n.m.r. spectroscopy being the main methods used. It is concluded that the polysaccharide is composed of pentasaccharide repeating-units with the structure: ----3)-beta-D-Glcp-(1----4)-beta-D-GlcpA-(1----4)-beta-D-Glcp- (1----4)-alpha-L [Rha or Man]-(1---- 3 increases 1 alpha-L-Rha. An unusual feature is that a sugar residue in the chain may be either L-rhamnose or L-mannose. The polysaccharide also contains O-acetyl groups (approximately 5%) which have not been located. PMID- 3815406 TI - Chemical synthesis of 3-amino-2,3-dideoxy-D-myo-inositol (an intermediate in the biosynthesis of 2-deoxystreptamine) and its D-epi stereoisomer. PMID- 3815407 TI - Inhibition of the hydrolytic activity of thrombin by chitin heparinoids. PMID- 3815408 TI - Chemical synthesis and seroreactivity of O-(3,6-di-O-methyl-beta-D glucopyranosyl)-(1----4)-O-(2,3-di-O-methyl- alpha-L-rhamnopyranosyl)-(1----9) oxynonanoyl-bovine serum albumin--the leprosy-specific, natural disaccharide octyl-neoglycoprotein. AB - The outer disaccharide segment, namely, O-(3,6-di-O-methyl-beta-D-glucopyranosyl) (1----4)-2,3-di-O-methyl-alpha -L-rhamnopyranose, of the trisaccharide containing, leprosy-specific, phenolic glycolipid I has been synthesized as the 8 (methoxycarbonyl)octyl glycoside in high yield and absolute stereospecificity by a series of modified Koenigs-Knorr and Helferich reactions. A particular feature of the synthetic pathway involves methylation of the 2-hydroxyl group of the rhamnose moiety under neutral conditions, after first preparing the 8 (methoxycarbonyl)octyl glycoside as the alpha anomer via the 1,2-orthoacetate, and thus precluding the possible formation of an anomeric mixture. The 8 (methoxycarbonyl)octyl O-(3,6-di-O-methyl-beta-D-glucopyranosyl)-(1----4)-2,3-di O-methyl-alpha -L-rhamnopyranoside was converted into the crystalline hydrazide, and this was coupled to bovine serum albumin (BSA), via intermediate acyl-azide formation, to produce the corresponding neoglycoprotein, O-(3,6-di-O-methyl-beta D-glucopyranosyl)- (1----4)-O-(2,3-di-O-methyl-alpha-L-rhamnopyranosyl)- (1----9) oxynonanoyl-BSA, the so-called natural disaccharide-octyl-BSA. Extensive serological testing of this product against sera from leprosy patients and control populations, and comparison with the native glycolipid and previously synthesized neoglycoproteins, have shown that it is unparalleled in terms of sensitivity and specificity, and highly suited to replace the native glycolipid for the serodiagnosis of worldwide lepromatous leprosy. PMID- 3815409 TI - Structural elucidation of a water-insoluble glucan produced by a cariogenic oral Streptococcus. AB - The structure of a water-insoluble polysaccharide produced by the D-glucosyl transferase of Streptococcus mutans 6715 has been elucidated through periodate oxidation, Smith degradation, dextranase digestion, concanavalin A binding studies, and methylation combined with g.l.c.-m.s. analysis. These studies show that the D-glucan is comprised of 67% alpha-(1----3) linkages in a contiguous backbone with the remaining 33% as alpha-(1----6) linkages, possibly as linear residues extending from alpha-(1----6) branch points. Of the residues, 14% are branch points and the ratio of linear alpha-(1----3) residues in the backbone to alpha-(1----6) residues in the side chain was found to be 5:2. Dextranase digestion and Smith degradation both gave rise to a high-molecular-weight fraction that is only alpha-(1----3) linked. PMID- 3815410 TI - [Conformational analysis of the double pentasaccharide sequence of the "bisected" structure ov N-glycoproteins]. AB - In the conformational analysis of the pentasaccharide alpha-D-Manp-(1----3)-[beta D-GlcpNAc-(1----4)]-[alpha-D- Manp-(1----6)]-beta-D-Manp-(1----4)-D-GlcNAc, which represents the essential core structure within the bisected type of N glycoproteins, n.m.r. experiments and GESA calculations indicated that a gg conformation is preferred for the (1----6)-glycosidic linkage. This is in contrast to the results obtained for the tetrasaccharide alpha-D-Manp-(1----3) [alpha-D-Manp-(1----6)]-beta-D- Manp-(1----4)- D-GlcNAc, which indicated that a gt conformation with the (1----6)-linked alpha-D-mannose group folded back is preferred. The conformations of the remaining glycosidic linkages in the tetra- and penta-saccharide are similar. PMID- 3815411 TI - Synthesis of a heptasaccharide hapten related to a biantennary glycan chain of human chorionic gonadotropin of a choriocarcinoma patient. A convergent approach. AB - Synthesis of the heptasaccharide hapten 8-methoxycarbonyloctyl O-beta-D galactopyranosyl-(1----4)-O-(2-acetamido-2-deoxy-beta-D- glucopyranosyl)-(1----2) O-[beta-D-galactopyranosyl-(1----4)-O-(2-acetam ido-2- deoxy-beta-D glucopyranosyl)-(1----4)]-O-alpha-D-mannopyranosyl-(1----3) -O- [alpha-D mannopyranosyl-(1----6)]-beta-D-mannopyranoside is described, by use of the known, protected glycosyl acceptor 8-ethoxy-carbonyloctyl O-(2,3,4,6-tetra-O benzyl-alpha-D-mannopyranosyl)-(1----6)-2,4-di-O-benz yl-beta - D mannopyranoside, and the key glycopentaosyl donors O-(2,3,4,6-tetra-O-acetyl-beta D-galactopyranosyl)-(1----4)-O-(2-acetami do-3,6- di-O-acetyl-2-deoxy-beta-D glucopyranosyl)-(1----2)-O-[(2,3,4,6-tetra-O- acetyl-beta-D-galactopyranosyl)-(1- --4)-O-(2-acetamido-3,6-di-O-acetyl- 2- deoxy-beta-D-glucopyranosyl)-(1----4)] 3,6-di-O-benzyl-alpha-D-mannopyra nosyl trichloroacetimidate (5) and the corresponding fluoride 7, which, in turn, were prepared in 5 steps from allyl 3,6 di-O-benzyl-alpha-D-mannopyranoside in 35 and 22% overall yields, respectively. In model experiments, the key glycosyl donors 5 and 7 were also treated with the simple glycosyl acceptor 8-ethoxycarbonyloctanol, to give 8-methoxycarbonyloctyl O-beta-D-galactopyranosyl-(1----4)-O-(2-acetamido-2-deoxy-beta-D- glucopyranosyl) (1----2)-O-[beta-D-galactopyranosyl-(1----4)-O-(2-acetam ido-2- deoxy-beta-D glucopyranosyl)-(1----4)]-alpha (and beta)-D-mannopyranoside. PMID- 3815412 TI - Analysis of linkage positions in 2-acetamido-2-deoxy-D-glucopyranosyl residues by the reductive-cleavage method. AB - The fate of methylated 2-acetamido-2-deoxy-D-glucopyranosyl residues under reductive-cleavage conditions was investigated by using methyl 2 (acetylmethylamino)-2-deoxy-3,4,6-tri-O-methyl-beta-D-glucopyran oside (1), its alpha anomer (8), and fully methylated lacto-N-tetraitol as test compounds. Treatment of 1 with triethylsilane and trimethylsilyl trifluoromethanesulfonate in dichloromethane gave rise to (1,2-dideoxy-3,4,6-tri-O-methyl-alpha-D glucopyrano)-2,3-dimethyl- [2,1-d]-2- oxazolinium trifluoromethanesulfonate. Quenching of the reaction by addition of aqueous sodium hydrogencarbonate resulted in hydrolysis of the oxazolinium salt. Compound 8 was fully stable to reductive-cleavage conditions. Thus, participation by the 2-acetamido group is necessary for glycosidic carbon-oxygen bond-cleavage to occur. Treatment of methyl 2-deoxy-2-(ethylmethylamino)-3,4,6-tri-O-methyl-alpha,beta-D-gluco pyranoside under reductive-cleavage conditions resulted in some anomerization, but neither hydrolysis nor reductive cleavage of the glycosidic carbon-oxygen bond was observed, as expected. Reductive cleavage of fully methylated lacto-N tetraitol gave the products predicted on the basis of these and prior model studies, including 3-O-acetyl-2-(acetylmethylamino)-2-deoxy-4,6-di-O-methyl-D glucopy ranose derived from the 3-linked 2-acetamido-2-deoxy-beta-D glucopyranosyl residue. PMID- 3815413 TI - Structural investigation of the capsular polysaccharide from Klebsiella K19 by chemical and N.M.R. analyses. AB - Sugar analysis of the capsular antigen K19 from Klebsiella and of the carboxyl reduced derivative confirmed its classification into the chemotype containing rhamnose, galactose, glucose, and glucuronic acid residues. Partial acid hydrolysis and phage depolymerization of K19 provided respectively a modified, linear form of the polysaccharide and oligosaccharides of the repeating unit, these were used for the structural elucidation of the original polymer. Methylation analysis, Smith degradation, and 1H- and 13C-n.m.r. spectroscopy of the polysaccharide and derivatives permitted formulation of the following structure for K19: (formula; see text) PMID- 3815414 TI - The sequence statistics and solution conformation of a barley (1----3, 1----4) beta-D-glucan. AB - The sequence statistics and aqueous solution conformation of the 40 degrees water soluble (1----3,1----4)-beta-D-glucan isolated from barley (Hordeum vulgare) have been modeled realistically using the known sequence-distributions of (1----3) and (1----4) linkages, theoretical conformational analysis, and the statistical mechanical theory of polymer-chain conformation. This barley beta-glucan fraction consists of (1----4)-beta-glucooligosaccharides, predominantly of d.p. 4 or less, joined by single beta-(1----3) linkages. Approximate treatments of the sequence statistics which do not take into account the small mole fraction (approximately 2%) of (1----4)-beta-glucooligosaccharides of d.p. approximately 10 significantly underestimate the chain extension in solution. A correct prediction of the observed chain extension is achieved when these longer, highly extended (1----4) beta-glucooligosaccharide blocks are included in a model which randomly incorporates all (1----4)-beta-glucooligosaccharide segments in the proportions observed experimentally. Chain flexibility in the 40 degrees water-soluble beta glucan fraction is shown to arise principally from the isolated beta-(1----3) linkages; blocks of two or more contiguous beta-(1----3) linkages provide a source of additional flexibility which may influence the properties of barley beta-glucan fractions containing a significant proportion of such sequences. PMID- 3815415 TI - Synthesis of water-soluble, branched polysaccharides having D-mannopyranose, D arabinofuranose, or oligo-D-arabinofuranose side-chains and their antitumor activity. AB - Branched polysaccharides having D-mannopyranose, D-arabinofuranose, or oligo-D arabinofuranose side-chains were synthesized by the reaction of 3,4,6-tri-O acetyl-(1,2-O-ethylorthoacetyl)-beta-D-mannopyranose, 3,5-di-O-benzoyl-(1,2-O ethylorthobenzoyl)-beta-D-arabinofuranose, or 3-O-benzoyl-(1,2,5-O-orthobenzoyl) beta-D-arabinofuranose with cellulose acetate or curdlan acetate, followed by desterification. The structure and antitumor activity of the water-soluble portion of the polysaccharides thus obtained were investigated. Polysaccharides synthesized from (1----3)-beta-D-glucan as the main chain with oligo-D arabinofuranose side-chains exhibited high antitumor activity. PMID- 3815416 TI - Depolymerization of the capsular polysaccharide from Klebsiella K19 by the glycanase associated with particles of Klebsiella bacteriophage luminal diameter 19. AB - The site of cleavage of the capsular polysaccharide from Klebsiella K19 by the endoglycanase associated with particles of Klebsiella bacteriophage luminal diameter 19 was determined. The specific cleavage of the bond Rhap-(1----2)-Rhap provided a series of oligosaccharides having rhamnose at the reducing end. The enzyme is thus an alpha-rhamnosidase. Structural studies on the oligomers confirmed the sequence of the repeating unit of the polysaccharide from K19. The 1H- and 13C-n.m.r. spectra of the homologous series of oligosaccharides corresponding to one, two, three, and four repeat-units exhibit important differences that denot variation of conformation with chain length. The bacteriophage acted on modified forms of K19 polysaccharide to provide a series of linear oligomers, and emphasized the essential role of the negative charge on the uronic acid in the action of the glycanase. PMID- 3815417 TI - Two syntheses of 3-amino-3-deoxy-alpha-D-altropyranosyl 3-amino-3-deoxy-alpha-D altropyranoside, a new analog of alpha,alpha-trehalose, involving reduction of a diazide and reductive amination of a diketone. AB - A new diamino sugar, 3-amino-3-deoxy-alpha-D-altropyranosyl 3-amino-3-deoxy-alpha D-altropyranoside (5) was synthesized by two routes starting from alpha,alpha trehalose. The first route involved reduction and deprotection of a previously described, benzylidenated diazido analog. The second approach proceeded from the known 2,2'-di-O-benzyl-4,6;4',6'-bis-O-benzylidene derivative of alpha-D altropyranosyl alpha-D-altropyranoside, to the corresponding 3,3'-diketone, which was subjected to reductive amination with sodium cyanoborohydride and ammonium acetate. The major product, separated in 39% yield from by-products after N acetylation, was deprotected to give 5. Four by-products were isolated in low yields and determined to be monoaminated analogs which comprise two epimeric, 3' hydroxy structures and two 3'-epimeric, 3'-cyano-3'-hydroxy structures in their non-aminated residues. A number of observations concerning the 13C- and 1H-n.m.r. spectra of the products are discussed, especially with regard to chemical-shift dependencies for certain ring and substituent protons, and attention is drawn to some inter-residue shielding phenomena. PMID- 3815418 TI - Modulation of natural killer cytotoxicity by muramyl dipeptide and trehalose dimycolate incorporated in squalane droplets. AB - The effect on natural killer (NK) cytotoxicity of splenic cells from BALB/c mice pretreated i.v. with squalane-in-water preparations of muramyl dipeptide (MDP), trehalose dimycolate (TDM), or the combination of MDP-plus-TDM was investigated. MDP or TDM augmented the NK cytotoxicity which peaked 48 h after the pretreatment whereas the combination of MDP and TDM induced an inhibition of the NK activity. Infection with influenza virus, a potent stimulator of NK cells, after the pretreatment with biological response modifiers resulted in a markedly enhanced NK activity on day 2 in MDP and control groups. Mice pretreated with TDM or the combination of MDP and TDM showed only moderate NK activity which peaked on day 3 after influenza infection. The NK activity was susceptible to asialo GM1 and complement treatment. The cytotoxicity of MDP-plus-TDM cells could be significantly enhanced after treatment with anti-macrophage monoclonal antibody and complement. NK activity induced by MDP or TDM was reduced by mixing MDP-plus TDM cells. Addition of adherent cell-depleted MDP-plus-TDM suspension to MDP or TDM cells had a NK restorative effect. Splenic cells from mice pretreated 2 days earlier with MDP or TDM, but not MDP-plus-TDM, generated enhanced levels of luminol-dependent chemiluminescence. PMID- 3815419 TI - Increased efficiency of immunotherapy using irradiated tumor cells. AB - The efficacy of irradiated tumor cells combined with chemotherapy or non-specific immunostimulation with complete Freund's adjuvant was tested in a model of minimal residual tumor-bearing syngeneic mice. Male C57BL/6J mice were innoculated in the right rear leg with live tumor cells from a methylcholanthrene induced fibrosarcoma. The tumor was resected when it reached 0.7 cm in diameter and animals were treated with doses of irradiated tumor cells (XTC) from the primary tumor ranging in number from 1 X 10(3) to 9 X 10(3). Best survival was noted using 5 X 10(3) XTC combined with irradiated tumor cells of liver or pulmonary metastases origin, complete Freund's adjuvant or cytoxan. The combination of irradiated tumor cells of metastatic origin did not enhance the therapeutic effect of XTC alone. Freund's adjuvant was not of benefit in enhancing the efficacy of XTC. However, improved survival was noted when chemotherapy in the form of cytoxan was used to supplement XTC. Our data suggests that XTC is more efficacious as a mode of immunotherapy than are live tumor cells. The dose of XTC used is critical in determining its effect. Chemotherapy appears to enhance the benefit of XTC. PMID- 3815420 TI - Modulation of natural killer cell activity in stage I postmenopausal breast cancer patients on low-dose aminoglutethimide. AB - Natural killer (NK) cells are important in surveillance against malignant cells. The activity of NK cells can be modulated by naturally occurring mediators; interferon, interleukin-2, and hormones. Low-dose aminoglutethimide (Ag 250 mg/day) inhibits the peripheral aromatization of androstenedione hence decreasing circulating estrogens. Of ten patients treated, seven were evaluable. There was a statistically significant increase in NK activity (P = 0.0025) following the administration of Ag. There was no consistent shift in NK cell number (Leu-11b positive cells). In vitro Ag did not alter NK activity whereas 17-beta-estradiol did. These data are consistent with an indirect effect of Ag on NK activity. Hence in vivo Ag which causes a reduction in serum estrogens in postmenopausal patients, also induces an increase in NK activity. PMID- 3815421 TI - Influence of low-dose beta-interferon on natural killer cell activity in breast cancer patients subjected to chemotherapy. AB - The present study was designed to test whether immunomodulating doses of human beta-interferon would affect the natural cell-mediated cytotoxic function in untreated breast cancer patients or in those subjected to antitumor therapy. Analyses were performed on 11 breast cancer patients, 3 at stage 1 and 8 at stage 2, the latter being subjected to cyclophosphamide, methotrexate, 5-Fluorouracil (CMF) adjuvant chemotherapy. Five patients treated with CMF and 3 patients not subjected to adjuvant chemotherapy, received human beta-interferon (IF, 2 X 10(6) IU/patient, i.m.), on days 0,7, and 15 for 6 cycles of 31 days each. The natural killer (NK) activity (NKA) of peripheral blood mononuclear cells (MNC) was tested 24 and 48 h after low-dose IF administration. The results of NKA determinations carried out for the 6 cycles of treatment show that (1) chemotherapy alone depressed NKA; (2) IF alone increased NKA in stage 1 patients not treated with CMF; (3) IF antagonized the depressive activity of CMF on NK function and significantly augumented NKA in the case of low "basal" cytotocix activity detectable in MNC collected before IF administration. Parallel in vitro studies showed that the inhibitory effect on NKA provoked by CMF is due to cyclophosphamide present in the association and is effectively antagonized by IF. These data provide rational bases for using IF in immunochemotherapy regimens, when tumor cells are supposed to be susceptible to host control by the natural resistance function. PMID- 3815422 TI - [Epidemiology of myocardial infarct]. PMID- 3815423 TI - [Diet in the prevention of coronary disease]. PMID- 3815424 TI - [Smoking and ischemic heart disease]. PMID- 3815425 TI - [Physiopathology of arterial hypertension]. PMID- 3815426 TI - [Vasodilators in the therapy of congestive heart failure]. PMID- 3815427 TI - [Identification of signs of transient ischemia in dynamic electrocardiography]. PMID- 3815428 TI - [2-dimensional echocardiography study of borderline aspects between the normal mitral valve and mitral valve prolapse]. PMID- 3815429 TI - [Cardiovascular effects of pregnancy. Critical observations on the interpretation of non-invasive parameters of ventricular function]. PMID- 3815430 TI - [Accuracy of radioisotopic ventriculography with Au-195m]. PMID- 3815431 TI - [Regional myocardial contractile function: physiological and clinical implications]. PMID- 3815432 TI - [Evaluation of the volume and ejection fraction of the right ventricle by a theory of measurement applied to thermodilution]. PMID- 3815433 TI - [Pressure/telesystolic volume relation of the left ventricle obtained with angiotensin: validity of the echocardiographic method]. PMID- 3815434 TI - [Quantitative evaluation of the segmental kinetics of the left ventricle during programmed atrial stimulation]. PMID- 3815435 TI - [Programmed atrial stimulation for the study of the distensibility of the left ventricular chamber]. PMID- 3815436 TI - [Effects of pericardiotomy on the diastolic function of the inflow chamber of the right ventricle]. PMID- 3815437 TI - [Myocardial perfusion before and after intracoronary fibrinolysis]. PMID- 3815438 TI - [Can the parasympathetic nervous system influence arterial blood pressure?]. PMID- 3815439 TI - [Computerized analysis of the beat/beat variability of systolic blood pressure and heart rate in ambulatory hypertensive patients]. PMID- 3815440 TI - [Baroreceptor control of the heart rate in acute myocardial infarct]. PMID- 3815441 TI - [Role of catecholamines in the adaptation of the heart rate to muscular exercise]. PMID- 3815442 TI - Identification of low risk post infarction patients. PMID- 3815443 TI - [Echocardiography study of mechanical heart valve prosthesis]. PMID- 3815444 TI - [Role of exercise test in the functional evaluation of patients with cardiac insufficiency]. PMID- 3815445 TI - [Extent of coronary anatomic injury and left ventricular function: is there a relation?]. PMID- 3815446 TI - [Color-coded 2-dimensional Doppler in normal subjects]. PMID- 3815447 TI - [Limitations of echocardiography in the evaluation of the aortic transvalvular gradient in aortic stenosis]. PMID- 3815448 TI - [Aneurysm of the interatrial septum: clinical and instrumental findings]. PMID- 3815449 TI - [Effectiveness of intravenous diltiazem in the treatment of supraventricular paroxysmal hyperkinetic arrhythmias]. PMID- 3815450 TI - [Multiple nodule rhabdomyoma: neonatal echocardiographic diagnosis]. PMID- 3815451 TI - Echocardiographic features of hypertensive-diabetic heart muscle disease. AB - Computerized M-mode echocardiography was used to evaluate left ventricular anatomy and function in 20 patients with hypertension and diabetes mellitus, without signs of overt heart disease. A similar study was performed in 20 patients with hypertension of similar severity and duration and in 20 normal subjects. Mean posterior wall thickness and mean septal thickness were increased in hypertensive patients compared to normal (p less than 0.001), but diabetic patients had thicker septa with respect to nondiabetics (p less than 0.05). All hypertensive-diabetic patients had reduced peak lengthening rate and/or peak velocity of posterior wall thinning. Six of them also had reduced peak Vcf and/or peak velocity of posterior wall thickening. Only 9 of the 20 patients with hypertension alone had abnormal diastolic function; 4 out of these 9 also had abnormal systolic function. We conclude that diabetes causes more severe impairment of left ventricular function in patients with a similar degree of hypertension. The more consistent abnormalities are reduced rate of dimension increase during filling and slower wall thinning, suggesting impaired left ventricular relaxation and distensibility. PMID- 3815452 TI - Autonomic responses in chest pain syndromes as compared to normal subjects. AB - The heart rate response to standing, cough, hand grip, and deep breathing were examined in normal subjects and coronary artery disease patients (greater than 70% diameter narrowing). The heart rate responses to these maneuvers were reduced in coronary patients and in anginal patients with normal coronary angiograms, as compared to normals. Detection (with the heart rate response to standing) was determined by using an RR interval cutoff of 140 ms for males and 120 ms for females discriminated between normals and CAD patients. In men sensitivity was 0.58, specificity 0.87 and CCR 0.75, and in women sensitivity was 0.67, specificity 0.79 and CCR 0.75. These values are similar to those reported for ST segment depression in similar populations. When separating normals from those with 2 and 3 vessel disease--sensitivity is 0.67, specificity 0.87, predictive value 0.71 and CCR 0.80. The response to cough, hand grip, and deep breathing showed similar trends but had less specificity than the response to standing. Thus, the heart rate response to most autonomic maneuvers is blunted in subjects with coronary disease and in those with pain syndromes sent for coronary angiography. These findings need testing in larger populations but autonomic maneuvers fail to discriminate patients with coronary disease from those with normal angiograms presenting with chest pain syndromes. PMID- 3815453 TI - Paroxysmal supraventricular tachycardia induced during exercise and ajmaline tests in the Wolff-Parkinson-White syndrome. PMID- 3815454 TI - Left ventricular thrombus in agnogenic myeloid metaplasia. AB - A 40-year-old white male with agnogenic myeloid metaplasia presented to our institution with symptoms of fever, rash and pleuropericardial pain. A two dimensional echocardiogram revealed a pedunculated left ventricular mass which simulated a left ventricular myxoma. Left ventricular wall motion and coronary arteries were normal on preoperative angiography. The mass was surgically removed and found to be fibrin thrombus. A mild chronic inflammatory infiltrate was present in the base of the thrombus. The formation of thrombus in the left ventricle was ascribed to spontaneous aggregation of platelets and myocarditis of unknown cause. PMID- 3815455 TI - Intracardiac thrombosis associated with an acute consumption coagulopathy. AB - A 53-year-old man with a prior history of myocardial infarcts and small cell lung cancer presented with lower limb ischemia. Laboratory tests revealed acute consumption coagulopathy and echocardiography showed massive intracavitary thrombi in the right atrium and both ventricles. Despite the administration of heparin, the patient died 3 weeks later of ventricular fibrillation. Autopsy demonstrated no relapse of lung cancer but large old myocardial infarcts. PMID- 3815456 TI - In vitro activity of CI-934 and other antimicrobial agents against gram-positive and gram-negative bacteria. AB - The activity of CI-934, a new carboxy-quinolone antibiotic, against gram-positive cocci and bacilli and gram-negative bacilli was compared with that of reference antibiotics. CI-934 demonstrated excellent activity against gram-positive organisms, including Corynebacterium sp. In addition, although the activity of CI 934 against gram-negative bacilli was less than that reported for similar agents, it was comparable to that of aminoglycosidic aminocyclitol antibiotics. PMID- 3815457 TI - Effects of pinaverium bromide on Oddi's sphincter. AB - Twelve to 15 days after cholecystectomy, endocholedochal pressure was measured in ten patients before and one hour after oral administration of 15 mg of pinaverium bromide (six patients) or placebo. The mean endocholedochal pressure was 7.1 +/- 0.25 mmHg before and 3.1 +/- 0.2 mmHg after pinaverium (P less than 0.01), and 7.0 +/- 0.2 and 6.8 +/- 1.2 mmHg in the placebo-treated patients. The results suggest that pinaverium bromide has a specific effect on the common bile duct and probably on Oddi's sphincter. PMID- 3815458 TI - Disease-modifying drug therapy in rheumatoid arthritis. PMID- 3815459 TI - Therapeutic rounds: abnormally prolonged responses to neuromuscular blocking agents. PMID- 3815460 TI - Human leukocyte interferon in the treatment of rheumatoid arthritis. AB - Forty patients with symptoms of rheumatoid arthritis were treated with daily injections of 100 micrograms of human leukocyte interferon or saline placebo. Twenty patients received the interferon for nine weeks and were then switched to placebo for nine weeks, and 20 patients were started on placebo and were then switched to interferon. Treatment effectiveness was assessed on measures of symptom severity and activity impairment. On both measures the patients showed a rapid and constant improvement while being treated with interferon. PMID- 3815461 TI - Comparison of cefoxitin and clindamycin-gentamicin for pelvic infections. AB - Cefoxitin and clindamycin-gentamicin were compared in a randomized study of antibiotic therapy for infections of the pelvis in 91 women. Clinical diagnoses included pelvic inflammatory disease (53), endomyometritis after cesarean section (24), and cellulitis following gynecological surgery (14). Treatment failures occurred in four (10%) of the 41 patients treated with cefoxitin compared with eight (16%) of the 50 patients treated with the clindamycin-gentamicin combination. Single-drug therapy with cefoxitin was shown to be as effective as the combination of clindamycin and gentamicin. PMID- 3815462 TI - Cefotaxime monotherapy in septicemic patients with hematological malignancies. AB - Cefotaxime at a dosage of 3 gm intravenously every eight hours was administered to 80 patients with hematological malignancies and suspected septicemia. Blood samples for culturing were taken before and during antibiotic therapy. Nineteen patients had verified bacteremia and ten of them responded completely to cefotaxime. Twelve of the 19 patients had granulocyte counts of less than 0.5 X 10(9)/L. Minimal inhibitory concentrations of cefotaxime, ceftazidime, moxalactam, cefsulodin, cefoxitin, cefuroxime, and cefamandole against the pathogens were measured: cefotaxime was the best cephalosporin against gram negative isolates and was found acceptable against gram-positive bacteria. In 61 patients no bacteremia could be demonstrated, but specific pathogens were isolated in 11 patients: from the urine in five, from the sputum in five, and from a perianal abscess in one. Complete response was obtained with cefotaxime in seven of these 11 patients. Monotherapy with cefotaxime in septicemic patients with hematological malignancies appears to be a valuable alternative to other antibiotic regimens. PMID- 3815463 TI - [Familial incidence of urolithiasis]. PMID- 3815464 TI - [Adenosine deaminase activity in the lymphocytes of patients with gouty arthritis]. PMID- 3815465 TI - [Hypouricemic effect of diflunisal in patients with gout]. PMID- 3815466 TI - [Effect of low-protein diet including keto analogs of essential amino acids on lipid metabolism in patients with chronic renal insufficiency]. PMID- 3815467 TI - [Bacteriuria in patients on long-term hemodialysis]. PMID- 3815468 TI - [Our experience with endoscopic papillosphincterotomy]. PMID- 3815469 TI - [Alkalit in the treatment of hyperuricemic syndrome]. PMID- 3815470 TI - [The clinical picture and treatment in the hyperviscosity syndrome]. PMID- 3815471 TI - [Experience with the therapy of symptomatic liver porphyria using a combination of antimalarial agents--chloroquine with pyrimethamine]. PMID- 3815472 TI - [Levels of magnesium and zinc in the blood in patients treated for epileptic seizures]. PMID- 3815473 TI - [Biological and medical foundations for the healthy development of humans. Selected results from the 7th state plan for research from 1981 to 1985]. PMID- 3815475 TI - [Immunology at the All-Union Cardiology Research Center]. PMID- 3815474 TI - [Changes in hand joints in diabetics]. PMID- 3815476 TI - [Therapeutic use of hemoperfusion in internal medicine]. PMID- 3815477 TI - [Renal excretion of zinc in patients with chronic renal failure]. PMID- 3815478 TI - [Adjustment of the acid-base equilibrium during bicarbonate dialysis]. PMID- 3815479 TI - [Legionella bozemanii in a female patient with fatal pneumonia, chronic hepatitis and collagenosis]. PMID- 3815480 TI - Sacciform cells in the epidermis of the brown trout, Salmo trutta, and the Arctic char, Salvelinus alpinus. AB - Sacciform cells containing an acidophilic, proteinaceous secretion, were identified in the epidermis of the brown trout and Arctic char. This cell type increased in number during the chronic stages of infestation by the ectoparasitic flagellate, Ichthyobodo sp., in immature brown trout, and decreased during sexual maturation in male brown trout and char. It is suggested that the salmonid sacciform cell produces a secretion which protects the fish against infestation or damage by skin parasites. PMID- 3815481 TI - Subcellular organization of the yolk syncytial-endoderm complex in the preimplantation yolk sac of the shark, Rhizoprionodon terraenovae. AB - The structure of the yolk syncytial-endoderm complex of the preimplantation yolk sac of the shark is examined by light- and transmission electron microscopy. The yolk syncytium is bounded by a membrane that is anchored to the plasmalemma of adjacent endoderm cells by desmosomes. Enlarged nuclei, rough endoplasmic reticulum, Golgi complexes, mitochondria, and other cellular organelles populate the syncytium. Microtubules and filamentous elements are also observed free in the syncytium. Yolk is present as pleomorphic droplets, the profiles of which are generally spherical but may be vesicular, especially at the periphery of large yolk droplets. Occasionally, large yolk droplets have a paracrystalline configuration. Small yolk droplets are modulated through the Golgi complex of the yolk syncytium, and it is suggested that acid hydrolases are added there. Small yolk droplets released from the maturing face of the Golgi complex are sequestered in membrane-limited packets. The membrane of the packets fuses with the membrane enveloping the yolk syncytium and the yolk droplets are released into the yolk syncytial-endoderm interspace. Subsequently, the yolk droplets are endocytosed by the endoderm. Yolk droplets disperse and fuse to form the large irregular yolk inclusions of the endoderm. Yolk metabolites are transported out of the endoderm through the yolk sac endothelium. The yolk sac endoderm thus mediates the transfer of metabolites from the yolk mass to the extraembryonic circulation. PMID- 3815482 TI - Structure and postnatal development of photoreceptors and their synapses in the retina of the tree shrew (Tupaia belangeri). AB - The "all cone" retina of the tree shrew (Tupaia belangeri) was examined in the adult and early postnatal stages by light and electron microscopy. Rods are not as rare as previously thought, but make up about 4% of the photoreceptors. They are relatively short and narrow cells, which stain (toluidine blue) more intensively and lie more proximal than cones. Among the cones three morphological varieties could be distinguished. Most cones stain lightly but have a light or a dark giant mitochondrion in their inner segment; a third type stains darker but occurs only rarely. All cones possess extensive radial processes ("lateral fins") around the basal part of their inner segments. Such fins are well known from reptiles and birds, but have only once been described in a mammal (gray squirrel). The maturation of the retina in Tupaia belangeri proceeds centrifugally, i.e., from the vitreal to the scleral side, as in most mammals. A few synapses are already present at birth in the outer and inner plexiform layers, but seem to be more advanced in the latter. Such early synapses are small and have only few synaptic vesicles; they appear almost mature by day 14. The light-sensitive outer segments develop last. The first disks are seen by day 10, but regular membrane stacks are only present by day 18. Thus, it seems that the retina is functional when the young first open their eyes, which occurs around day 18. PMID- 3815483 TI - Time course and cellular site of mitotic activity in the exocrine pancreas of the rat during sustained hormone stimulation. AB - Previous studies from our laboratory indicate that the adaptive response of the exocrine pancreas of the rat to prolonged stimulation with optimal doses of caerulein (0.25 microgram X kg-1 X h-1) follows a characteristic time course in which each step in the secretory pathway is activated. The immediate response is the depletion of zymogen-granule stores followed by coordinate and anticoordinate changes in individual rates of (pro-)enzyme synthesis after a lag period of 2 h. The sum of such changes leads to an increase in total rate of protein synthesis by 3 h which is combined with acceleration of intracellular transport packaging and granule discharge. In the present study the time course of DNA synthesis and the labeling index of five populations of pancreatic cells have been analyzed after caerulein stimulation for periods ranging from 6 to 72 h, using in vivo labeling with 1 mu Ci/g 3H-thymidine 1 h prior to sacrifice of the animals. DNA synthesis did not change during the initial 18 h in spite of persistent stimulation indicated by a 80% reduction on enzyme content. Following this lag period a sharp rise in DNA synthesis 20- to 25-fold above control levels was observed, which decreased by 48 h to reach control levels by 72 h. Increase in DNA synthesis was most pronounced in animals with lowest enzyme content in the pancreas. From the five cell populations studied by autoradiography interlobular duct cells and islet cells had no significant increase in labeling index at any time of stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815484 TI - Measurement of intra-embryonic pH during the early stages of development in the chick embryo. AB - Measurements have been made of the pH in the extracellular space, adjacent to the neural tube, in 73 isolated chick embryos in vitro at stages from 4-22 somites. A pH of 7.8-8.4 was observed in the segmented region, while caudally, in the segmental plate, the pH was consistently lower falling by as much as 0.5 pH units at the regressing primitive streak. Variations were noted in the pH of embryos of the same age but the regional variation in pH was a consistent finding in all of the embryos examined. The buffering capacity of the extracellular space was found to be 12.9 mequiv/pH unit/l in the segmented region and 13.9 mequiv/pH unit/l in the segmental plate. Thus it is unlikely that the regional variations in pH result from local variations in the buffering power of the extracellular space. Varying the K+, Cl-, Mg2+ or HCO3- ion concentrations in the bathing medium caused little change in the intra-embryonic pH, while reducing the concentrations of Na+ or Ca2+ caused a small acidification. This suggests that the ectoderm and endoderm form an effective barrier between the embryo and the external environment. Exposure of the embryo to KCN reduced the intra-embryonic pH suggesting that the alkaline environment is maintained by active processes. PMID- 3815485 TI - Sertoli cells in the testis and epithelium of the ductuli efferentes are targets for 3H 1,25 (OH)2 vitamin D3. An autoradiographic study. PMID- 3815486 TI - Morphological evidence for a direct innervation of the mouse vomeronasal glands. AB - The morphological evidence for a direct autonomic innervation of the mouse vomeronasal glands is presented. Axonal varicosities containing a few dense-core vesicles and numerous clear vesicles (36-60 nm in diameter) make synaptic contacts with the secretory cells at the base of the glandular acini. The axonal presynaptic membrane is associated with a distinct dense material and it is separated from the secretory cell by a synaptic cleft of about 12-14 nm. At the postsynaptical level, coated vesicles can be found. Additional postsynaptical specializations have not been observed. PMID- 3815487 TI - Ultrastructural cytochemical localization of adenylate cyclase in the early chick embryo. AB - Adenylate cyclase activity was localized in various tissues of the early chick embryo using an ultrastructural histochemical technique. Reaction product was deposited on the lateral plasma membrane of all cells, but with a preferential localization at the apical terminal complex in the epiblast. There was no activity associated with the free surfaces of these or other cells in the embryo. Intracellular deposits were found in all cells associated with the endoplasmic reticulum, nuclear envelope and Golgi bodies. In the last organelle, the deposit was sometimes observed to be distributed through the stack in a non-uniform way, with the heaviest deposits occurring at the forming face. No clear difference could be detected between the cytochemical activity associated with cells in various regions of the embryo, or with embryos at different stages of early development. PMID- 3815488 TI - How Ca2+ works in cells. PMID- 3815489 TI - [Further evaluation on the serological assay for virulent strains of Yersinia enterocolitica]. PMID- 3815490 TI - [Study on the time limitation of carrying Yersinia enterocolitica by Periplaneta americana and flies]. PMID- 3815491 TI - [Studies of the pattern of incidence of malaria & the measures for management and surveillance in the post-eradication project for malaria]. PMID- 3815492 TI - [Findings on paragonimiasis in Yun Yang Region, Hubei Province]. PMID- 3815493 TI - [The retrovirus can be detected in hybridoma cell strains with the electron microscope]. PMID- 3815494 TI - [Case-control study of gastric cancer in high-incidence areas]. PMID- 3815495 TI - [The distribution and characteristics of carcinoma of the cervix uteri in Lue Yang County]. PMID- 3815496 TI - [Analysis of the age of onset of cerebral hemorrhage with Weibull's distribution]. PMID- 3815497 TI - [A study on the effect of inactivation of hepatitis B virus with potassium permanganate]. PMID- 3815498 TI - [The advantages of IgM antibody capture ELISA for measles diagnosis]. PMID- 3815499 TI - [A modified pattern of Reed-Frost deterministic model and its application]. PMID- 3815500 TI - Reference values of serum protein fractions in Zimbabwe by electrophoresis. PMID- 3815501 TI - Microbial pathogens associated with diarrhoea in children admitted to Harare Hospital for rehydration therapy. PMID- 3815502 TI - An activity sampling study of primary care staff of two Harare polyclinics. PMID- 3815503 TI - Iatrogenic strokes in hypertensive patients. PMID- 3815504 TI - Hemodynamic correlates of arterial compliance. AB - There is at present no good understanding of the exact clinical correlates of arterial compliance. The purpose of this study was to establish which hemodynamic variables are most strongly associated with compliance. Hemodynamic measurements were performed on 41 patients undergoing diagnostic cardiac catheterization. Cardiac outputs were determined by thermodilution, and pressures were measured in the ascending aorta with a catheter-tip manometer. Compliance was calculated from a mono-exponential fit of diastolic decay pressures. Pulse pressure(PP), stroke volume(SV), age, systolic blood pressure(SBP), and cardiac output(CO) were significantly related to compliance. The quotient SV/PP was a good estimate of compliance, as was a first-order function of both SV and PP. There appear to be specific clinical correlates of arterial compliance, as well as ways to estimate arterial compliance on the basis of conventional hemodynamic measurements when direct calculations are not possible. PMID- 3815505 TI - Coronary artery variation in a native Iraqi population. AB - The variation and distribution of the coronary arteries were studied in 119 hearts of individuals, 4 fetal months to 40 years old, who died from noncardiovascular causes. All individuals included in this study were natives of the Mosul area of northern Iraq. The coronary arteries were examined by injection corrosion and unaided dissection. Almost all (90%) of the anomalies observed were in the right coronary artery. Nine hearts (8% of total sample) possessed ectopic ostia in the right coronary sinus for the right coronary and conus arteries. The occurrence of a separate conus artery appears to be anomalous rather than ubiquitous as widely reported in the literature. One specimen had separate origins for the left circumflex and anterior descending arteries from the left coronary sinus. The patterns of coronary artery distribution were classified as left (14%) and right (46%) preponderant, and balanced (40%), following Schlesinger [Schlesinger, Arch Pathol 30:403-415, 1940]. The present study adds to the growing body of data on intrapopulation frequencies of coronary artery variants among non-Europeans and supports the contention that postpartum development may modify the pattern of coronary divergence from the aorta. As the number of non-Caucasian patients undergoing surgical treatment for ischemic or valvular heart disease increases, additional comparative data on racial, sexual, and ontogenetic variation of the coronary arteries and their aortic ostia are required to improve the care of these patients. PMID- 3815506 TI - Alterations in myocardial metabolism and function at rest in stable angina pectoris: relations with the amount of exercise-induced thallium-201 perfusion defect. AB - The relation between the amount of exercise-induced ischemia and alterations in left ventricular (LV) function and metabolism at rest was studied in 18 coronary patients with stable angina pectoris. An ischemic defect area score was computed from quantitative exercise thallium-201 (Tl-201) scintigraphy; this estimation of the amount of ischemic myocardium was used to classify the patients in group I (n = 8; score less than 15%, mean 6.7 +/- 2.5%) and II (n = 10; score greater than 15%; mean 27.2 +/- 8.9%). Hemodynamics and metabolism were studied in basal state. No patient had anginal pain during the study, and the extent of angiographic coronary artery disease (CAD) was comparable in the two groups. Heart rate, aortic pressure, coronary blood flow, and myocardial oxygen uptake were also similar in both groups. However, ejection fraction was reduced in group II (51 +/- 13 vs 63 +/- 5%; p less than 0.01) and LV relaxation was impaired as shown by the increase in time-constant of isovolumic pressure fall (55 +/- 16 vs 44 +/- 6 ms in group I; p less than 0.05); the LV end-diastolic pressure was also increased in group II (19 +/- 8 vs 10 +/- 4 mmHg in group l; p less than 0.05). Furthermore, in group II, myocardial lactate uptake was reduced (4 +/- 19 vs 30 +/- 29 mumole/min in group I; p less than 0.01) and the productions of alanine and glutamine were augmented (-7.5 +/- 4.4 vs -4.6 +/- 1.6 mumole/min in group I; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815507 TI - Unusual intra-arterial communication in the normal right coronary tree. AB - Among 136 patients with a history of angina pectoris who underwent selective coronary arteriography, two patients (1.4%) with a normal right coronary artery were found to have angiographically demonstrated communications between the various branches of the same coronary artery. Such findings, unaccompanied by coronary artery disease, have been hitherto unknown and suggest a congenital variation in coronary anatomy rather than a clinically significant condition. The purpose of this report is to demonstrate that the angiographic appearance of the anastomotic vessels in such cases is entirely different from that which obtains in cases of obstructive coronary artery disease. The author notes the rarity of angiographic visualization of homocoronary communications in normal right coronary arteries and emphasizes the necessity of distinguishing these from the homocoronary collaterals found in atherosclerotic coronary artery disease. PMID- 3815508 TI - Anomalous origin of the posterior descending artery from the first septal perforator. AB - We describe a patient with an unusual coronary anatomic variant in which the first septal perforator gives rise to the posterior descending artery. The angiographic features and clinical recognition of this anomaly are reviewed. PMID- 3815509 TI - Catheter suction biopsy in diagnosis of an intrapulmonary artery tumor. AB - Unsuspected intracardiac masses are occasionally encountered when cardiac catheterization is performed in a patient with right ventricular or pulmonary artery occlusive disease. In one of two patients, suction biopsy of the mass has been successful in obtaining a histological diagnosis. The method and its contraindications are discussed. PMID- 3815510 TI - Detection of right atrial myxoma by coronary cinearteriography. AB - During routine coronary cinearteriography, a large, right atrial myxoma was detected in a patient with angina pectoris. It was clinically unsuspected and was found at surgery to extend partially into the left atrium. PMID- 3815511 TI - A new technique for cannulation of the coronary sinus from the femoral vein. AB - Previous techniques for cannulation of the coronary sinus have required entry into the right atrium from the superior vena cava. We describe a new technique for cannulation of the coronary sinus from the femoral vein using a standard, unmodified Simmons II catheter. This method was successful in 97% of the patients attempted. The method for using this catheter from the femoral route is described. PMID- 3815512 TI - Anticoagulation with heparin during cardiac catheterization and its reversal by protamine. AB - The duration of effective anticoagulation with heparin during cardiac catheterization and angiography was determined in 201 patients. Effective anticoagulation was defined as prolongation of the activated partial thromboplastin time (APTT) by 2 or more times the upper limit of normal. When the procedure was completed within 40 min of heparin administration, all patients were anticoagulated adequately. The incidence of inadequate anticoagulation ranged from 9% to 25% as the time from heparin administration increased to 89 min. Procedures completed more than 90 min after heparin administration had a 58% incidence of inadequate anticoagulation. A protocol to estimate the appropriate protamine dose was developed based on experience accumulated in the first 78 patients and tested subsequently in 101 consecutive patients. Clotting studies returned to the normal range in 92% of the patients. The mean APTT decreased from 84.1 +/- 19.4 to 27.4 +/- 2.5 sec (p less than .001) after protamine. Patients who did not correct to normal after protamine remained only 2.8 +/- 1.4 sec (range 0.7-5.5 sec) above normal. These data provide an estimate of the duration of anticoagulation during cardiac catheterization and angiography and demonstrate the feasibility of a simple and reliable method to reverse the effects of heparin. PMID- 3815513 TI - Visualisation of left atrial thrombi by coronary arteriography. AB - Abnormal vascularity in the region of the left atrial appendage was demonstrated by coronary arteriography in 5 patients with mitral stenosis. Subsequently, three of these patients proceeded to operation, and left atrial thrombi were confirmed in all three cases. Neovascularity must be differentiated from congenital fistulae, tumours, and coronary artery disease. Thrombus in the left atrial appendage is difficult to diagnose even with the use of cross-sectional echocardiography and may occasionally be demonstrated by coronary arteriography. PMID- 3815514 TI - Myocardial damage following coronary air embolism during coronary angiography. AB - Coronary air embolism may go unnoticed or cause chest pain, electrocardiogram changes, and myocardial damage; it may mimic coronary spasm [1,2]. We report a patient who sustained subendocardial myocardial infarction following intracoronary injection of air. PMID- 3815515 TI - Clinical implication of inadvertent monitoring of pulmonary artery pressure via a "left atrial" catheter. AB - A patient is described in whom a left atrial catheter was inadvertently wedged in a pulmonary vein following mitral valve replacement. The pulmonary vein wedge pressure obtained approximated the pulmonary artery pressure and was suggestive of paraprosthetic mitral valve regurgitation. PMID- 3815516 TI - Intracoronary thrombolysis in evolving isolated right ventricular infarction. AB - In a 52-year-old man with severe chest pain of 3 hours duration and ST-segment elevation in leads V1 and V2, a nondominant right coronary artery was recanalized by an intracoronary infusion of urokinase. Coronary cineangiography revealed a total occlusion of the nondominant right coronary artery and no significant narrowing of the left coronary artery. Hemodynamic studies during the acute phase of myocardial infarction demonstrated an increase of right atrial mean pressure in association with normal pulmonary capillary wedge pressure. Following the recanalization, chest pain disappeared and hemodynamic alterations were corrected. The purpose of this report is to document a case of isolated right ventricular infarction due to a nondominant right coronary artery occlusion. PMID- 3815517 TI - Catheter-induced intimal injury during routine coronary catheterization in dogs. AB - The location and progression of changes in arterial permeability and structure were studied in nine dogs over a 13-week period following left coronary catheterization with standard coronary catheters. Changes in arterial permeability were analyzed by quantitating Evans blue dye (EBD) uptake over the aortic luminal surface (blue areas). Structural changes were assessed by light and electron microscopy. In the catheterized animals, compared to uncatheterized controls, we observed a significant increase in aortic luminal EBD uptake that was maximal 4 hours after the procedure but still present up to 13 weeks later. Microscopic analysis of "blue areas" shortly after the procedure revealed widespread endothelial denudation, platelet and leukocyte adherence, with occasional intimal avulsions, disruption of the internal elastica, and thrombi. The EBD uptake patterns in association with the electron microscopic findings in these animals suggested that 67-89% of the aortic endothelium was removed by the catheter during the procedure. The proliferative response that occurred following this catheter-induced injury produced fibrocellular intimal thickening in the aortas and left main coronary arteries of animals studied 10 to 92 days after the procedure. In the aortic root, such thickening was associated with incomplete re endothelialization, thrombogenicity, and grossly abnormal permeability patterns. We conclude that significant catheter-induced intimal injury can occur during coronary angiography. In the canine model, such injury is associated with widespread fibrocellular intimal thickening and abnormal permeability that persists for at least 13 weeks after the procedure. PMID- 3815519 TI - RPC40, a unique gene for a subunit shared between yeast RNA polymerases A and C. AB - Yeast RNA polymerases A and C share an approximately equal to 40 kd subunit. We have identified, sequenced, and mutagenized in vitro the AC40 subunit gene. The RPC40 gene is unique in the yeast genome and is required for cell viability. This gene contains an open reading frame encoding a 37.6 kd protein having no significant homology with bacterial RNA polymerase subunits. The promoter region contains a 19 bp sequence also present in the largest subunit of RNA polymerase C. It also contains a well-conserved RPG box, a sequence found in the promoter region of many genes encoding the translational apparatus. A novel, plasmid shuffling method was developed to isolate a large number of RPC40 ts mutants. One of these, ts4, was shown to be defective in the synthesis of RNA polymerases A and C at the restrictive temperature. In contrast, RNA polymerase B was made normally. PMID- 3815518 TI - Histone H2B repression causes cell-cycle-specific arrest in yeast: effects on chromosomal segregation, replication, and transcription. AB - To determine which cellular processes are dependent on histones, we blocked histone H2B mRNA synthesis in asynchronously growing yeast after fusing the H2B gene to a repressible GAL10 promoter. Chromosomal segregation, replication, and transcription were then examined. We found that the cells arrested in mitosis, with a cell division cycle (cdc) phenotype. Chromatin structure and nuclear segregation were disrupted. A full round of DNA replication took place after the repression of histone H2B mRNA synthesis. Active transcription and the induction of new transcripts also continued in the arrested cells. PMID- 3815520 TI - Somatic mutation: diversity and regulation of the immune repertoire. PMID- 3815521 TI - The cell-to-cell channel of gap junctions. PMID- 3815522 TI - Functional assembly of gap junction conductance in lipid bilayers: demonstration that the major 27 kd protein forms the junctional channel. AB - Gap junctions isolated from rat liver were incorporated into planar lipid bilayers. A channel activity that was directly dependent on voltage was recorded. Changes of pH and (Ca2+) had no direct effect on channel activity; however, they modulated the voltage-dependent gating of the gap junction channels differently. Single-channel fluctuations showed large scatter with peak amplitudes of 140 and 280 picoSiemmens in 0.1 M NaCl. The major protein of gap junctions (Mr of 27 kd) was also reconstituted into bilayers, giving channel properties similar to those of intact gap junctions. Polyclonal antibodies specific for this protein caused inhibition of the junctional conductance in bilayers. These data provide direct evidence that the 27 kd protein is the molecular species responsible for gap junction communication between cells. PMID- 3815523 TI - A multigene family encoding several "finger" structures is present and differentially active in mammalian genomes. AB - Mouse genomic DNA contains multiple copies of sequences homologous to the Drosophila "Kruppel," a member of the "gap" class of developmental control genes of the fruit fly. The most interesting aspect of the homologous region is that, like Xenopus TFIIIA, it contains multiple finger-like folded domains capable of binding to nucleic acids. We have isolated six individual phages from a mouse genomic library on the basis of their DNA homology to Kruppel finger-coding probes, and describe here the DNA sequence and expression of two such clones containing finger-like structures. Upon differentiation of mouse teratocarcinoma cell line F9 with retinoic acid and cAMP, the expression of both genes was drastically reduced, and in one instance was undetectable. Each of the several other eukaryotic DNAs analyzed contained multiple copies of homologous genes with putative finger structures, indicating the presence of a finger-containing multigene family in higher organisms. PMID- 3815524 TI - A conserved nucleotide sequence at the sites of developmentally regulated chromosomal breakage in Tetrahymena. AB - Chromosomal breakage occurs at hundreds of specific sites in Tetrahymena, including the two ends of the unique ribosomal RNA genes, during the development of the somatic macronucleus. We have identified a 15-nucleotide sequence that occurs widely in the germinal micronuclear genome and is associated exclusively with chromosomal breakage sites. When copies of this sequence were cloned and analyzed, they were found in all cases to be located at or very near sites of breakage. This general rule is further supported by the observation that in a different site in which a single nucleotide substitution is found within this sequence, no chromosomal breakage occurs. The complete sequence structure of one of the breakage junctions has also been determined in both the germinal DNA and the two somatic DNA termini. This structure reveals that the 15-nucleotide conserved sequence is located within a 54-nucleotide region that is removed following chromosomal breakage. PMID- 3815525 TI - Duplication of seven exons in LDL receptor gene caused by Alu-Alu recombination in a subject with familial hypercholesterolemia. AB - A defective LDL receptor gene in a child with familial hypercholesterolemia produces a receptor precursor that is 50,000 daltons larger than normal (apparent Mr 170,000 vs. 120,000). The elongated protein resulted from a 14 kilobase duplication that encompasses exons 2 through 8. The duplication arose from an unequal crossing-over between homologous repetitive elements (Alu sequences) in intron 1 and intron 8. The mutant receptor has 18 contiguous cysteine-rich repeat sequences instead of the normal nine. Seven of these duplicated repeats are derived from the ligand-binding domain, and two repeats are part of the epidermal growth factor precursor homology region. The elongated receptor undergoes normal carbohydrate processing, its apparent molecular weight increases to 210,000, and the receptor reaches the cell surface where it binds reduced amounts of LDL but undergoes efficient internalization and recycling. The current findings support an evolutionary model in which homologous recombination between repetitive elements in introns leads to exon duplication during evolution of proteins. PMID- 3815526 TI - Hamster cells with increased rates of DNA amplification, a new phenotype. AB - Baby hamster kidney (BHK) cells selected simultaneously with N-phosphonacetyl-L aspartate (PALA) and methotrexate (MTX) gave rise to doubly resistant colonies at frequencies 20 to 260 times greater than the product of the independent frequencies found with PALA or MTX alone. Double resistance was due to amplification of both target genes, CAD and DHFR. Four independent doubly resistant "MP" lines were selected and characterized. Cells resistant to coformycin, pyrazofurin, or ouabain were generated from all four MP lines at rates up to 25 times greater than the rates for BHK cells. These three drugs select cells that have amplified the genes for their target enzymes. Therefore, we conclude that the four MP lines have an amplificator phenotype. All four grew much more slowly than BHK cells, indicating that the amplificator phenotype may be linked to significant defects in metabolism or cell division. PMID- 3815527 TI - Analysis of replicating DNA molecules from embryos of the sea urchin, Hemicentrotus pulcherrimus, by electron microscopy. AB - DNA was extracted from embryos of the sea urchin, Hemicentrotus pulcherrimus, at the S phase and examined by electron microscopy. We detected replication microbubbles with a mean size of 404 bases, in addition to replication macrobubbles of more than 1.0 kilobase (kb) in length. Seventy-five percent of the center-to-center distances of the microbubbles were 0.6-1.8 kb with a mean of 1.2 kb. Forty-five percent of the microbubbles were arranged as clusters of four or five microbubbles. These results suggest that at least 34% of the initiation sites for DNA replication are present on a DNA molecule in clusters in which the sites are arranged at 1.2-kb intervals. PMID- 3815528 TI - Vascularization of the embryonic kidney. Detection of endothelial cells with Ulex europaeus I lectin. AB - Frozen sections of human fetal kidneys were studied for the appearance of vascular elements to the developing glomeruli using Ulex europaeus (UEA-I) lectin as a marker for endothelial cells. Chains of UEA-I-positive cells, seen to extend from larger vessels, could be observed among the uninduced cells of the nephrogenic mesenchyme. During the S-shaped body stage of nephrogenesis, the cleft of the comma-shaped cluster of epithelial cells was invaded by the UEA-I positive cells, and during further glomerular development, the UEA-I-positive cells were seen to grow in number, prior to the appearance of visible lumina to the capillaries. The present results show, in addition to revealing the vascularization pattern of developing glomeruli, that endothelial cells obtain some of their characteristic glycoconjugates during early stages of differentiation. Thus, UEA-I seems to be a valuable tool to study in detail the vascularization of various developing human tissues. PMID- 3815529 TI - Reexamination of the 'regulative development' of amphibian embryos. AB - In this article, we have reviewed a series of our recent results of isolation, defect and transplantation experiments on early embryos of Xenopus laevis. The results show that as early as the 8-cell stage an embryo consists of several kinds of cells which differ distinctly in developmental capacities and that their capacities are much more restricted than previously thought. Thus, for the formation of complete embryos a certain set of cells is necessary; and no regulation occurs whenever any one of the necessary cells is lacking. PMID- 3815530 TI - Weak bases inhibit cleavage and embryogenesis in amphibians and echinoderms. AB - The action of weak bases was studied on the early embryonic development of a number of species. Gastrulation was disrupted in the frog, Xenopus laevis, the newt, Pleurodeles watlii, the sea urchins, Paracentrotus lividus and Sphaerechinus granularis and the starfish, Asterias rubens. This required only submillimolar amounts of either NH+4 (pH 9.0) or procaine (pH 8.2). At higher concentrations even early cell division was inhibited in all the species with furrow regression particularly noticeable in Xenopus eggs. A similar action of the weak bases on early development, the lack of any action at lower extracellular pH, and the counteracting action of NH+4 on acidity-induced disruption of sea urchin development, all implicate an elevation of intracellular pH. However, a more direct intracellular action of the weak bases cannot be ruled out. PMID- 3815531 TI - Evidences that hemoglobin switch in the chick embryo depends on erythroid cell line substitution. AB - Chemical identifications of various hemoglobin types were performed on unfractionated erythroid cells derived from chicken embryos at 5 and 7 days of development and on purified primitive and definitive cells. Proteins were pulse labelled in primitive erythroid cells at various times of culture to identify those actually synthesized. The data show that primitive cells contain and synthesize only embryonic hemoglobins at all stages of maturation and definitive cells contain adult and minor embryonic hemoglobins, but no major embryonic hemoglobins, not even in trace amounts. These results support a model for hemoglobin switch in the chicken embryo based on cell line substitution. PMID- 3815532 TI - Haemolymph control of sericin gene expression studied by organ transplantation. AB - A factor that affects synthesis of sericin mRNAs of Bombyx mori was analyzed by organ transplantation and allatectomy. When silk glands of the third instar larvae were transplanted into the abdomen of fifth instar larvae, substantial amounts of sericin mRNAs were induced in the transplant. The induced sericin gene activity was suppressed upon re-transplantation into the abdomen of fourth instar larvae and induced again when the second hosts grew up to fifth instar larvae. An allatectomy performed on fourth instar larvae promoted production of these mRNAs, suggesting that the synthesis of sericin mRNA is regulated by the titer of juvenile hormone. PMID- 3815533 TI - Induction of in vivo helper activity for murine antibody responses by macrophages pulsed with ovalbumin-monomethoxypolyethylene glycol (OA-mPEG) conjugates. AB - Conjugates of protein antigens with an optimal number of monomethoxypolyethylene glycol (mPEG) chains of an appropriate molecular weight had been shown to suppress murine IgE responses to the unmodified antigen. To investigate the possibility that the tolerogenic capacity of these mPEG conjugates is attributable to a defect in macrophage (M phi) presentation of their antigenic determinants, the activity of ovalbumin (OA)-mPEG conjugates when pulsed onto mouse peritoneal adherent cells (M phi) was compared in this study with their activity in solution. Surprisingly, in contrast to the suppressogenic capacity of mPEG conjugates in solution, the OA-mPEG pulsed M phi appeared to exert a helper effect when injected intraperitoneally (ip), i.e., after subsequent immunization with dinitrophenylated OA (DNP3-OA) in Al(OH)3, the mice showed accelerated IgE and IgG1 antibody responses to OA and DNP. However, when M phi were exposed to limiting concentrations of OA or OA-mPEG, markedly higher concentrations of OA mPEG were required to yield pulsed M phi, exerting a significant helper effect. It was concluded that although M phi were capable of presenting the OA determinants of OA-mPEG conjugates to helper T (Th) cells, the preparations of modified antigen were presented less effectively than native OA. PMID- 3815534 TI - Effects of the adjuvants SGP and Quil A on the induction of experimental autoimmune thyroiditis in mice. AB - In the present study, two adjuvants, SGP and Quil A, were assessed for their ability to induce experimental autoimmune thyroiditis (EAT) in mice. SGP (a synthetic copolymer of starch, acrylamide, and sodium acrylate) and Quil A (a plant saponin) were compared with lipopolysaccharide (LPS) and complete Freund's adjuvant (CFA) given together with mouse thyroglobulin (MTg) for their ability to induce EAT in CBA/J mice. Immunization with MTg and LPS, MTg and CFA, or MTg with SGP was effective in inducing anti-MTg antibodies and histologic EAT, while MTg with Quil A was ineffective in inducing either anti-MTg antibodies or EAT. MTg with LPS was able to prime mice for the development of an in vitro spleen cell proliferative response to MTg while MTg with SGP or with Quil A was unable to prime spleen cells to proliferate detectably in response to MTg. MTg with LPS given in vivo primes CBA/J spleen cells for further activation by in vitro culture with MTg to transfer EAT to naive CBA/J recipients. MTg with SGP was also effective in priming CBA/J spleen cells for in vitro activation and transfer of EAT while MTg with Quil A was ineffective. The effective adjuvant activity of SGP and its lack of toxicity relative to LPS should make it a useful agent for further studies in murine models of EAT. PMID- 3815535 TI - Regulation of bone marrow cell survival in short-term cultures: a new macrophage function. AB - The involvement of macrophages (M phi) in the regulation of bone marrow (BM) cell survival in short-term cultures was studied. We developed a system to measure the survival of fresh BM cells in vitro, by evaluating 111indium (111In) release from prelabeled BM cells. 111In release was proportional to cell death and inversely related to the number of trypan blue excluding cells. Upon 24 hr of culture in conventional medium, more than 50% of BM cells died. In order to investigate whether BM cell death could be reduced by coculture with other cell types, 111In labeled BM cells were incubated for 24 hr with peritoneal M phi, thymocytes (THY), or polymorphonuclear cells (PMN) and then assayed for their survival. We found that coculture of BM cells with M phi dramatically increased BM survival, whereas THY or PMN consistently failed to enhance BM survival. The ability to promote BM cell survival, here designated nurse activity, represented a novel function of M phi and was further characterized. The stage of activation of M phi did not influence their nurse activity, since M phi elicited in vivo by proteose peptone, thioglycollate, or Bacillus Calmette-Guerin, as well as resident M phi unstimulated or activated in vitro with lipopolysaccharide, equally sustained survival of BM cells. BM-derived M phi (adherent cells from BM cultures maintained in 20% L-cell-conditioned medium for 14 days) were equally effective in exerting nurse activity. Moreover, nurse activity was also exerted across the histocompatibility barriers. Supernatants from M phi cultures or killed M phi were ineffective. We propose that the nurse effect of M phi on BM is a primitive function that may play an important role in the development of the hemopoietic system. PMID- 3815536 TI - Suppression of IgE responses by passive antigen inhalation: dissociation of local (mucosal) and systemic immunity. AB - Animals from high- and low-IgE-responder rat strains were preexposed to antigen containing aerosols of different droplet sizes, prior to parenteral antigenic challenge. Depending upon the type of aerosol employed, systemic immunological tolerance developed in high-IgE-responder animals in the IgE antibody class either with or without concomitant production of salivary IgA, indicating that the two antibody isotypes were under independent control, and further that IgA mediated immune exclusion was not central to the development of tolerance in the IgE class. Low-IgE-responder rats exhibited biphasic salivary IgA responses during exposure, which could not be recalled by subsequent parenteral challenge, suggesting that secretory immunity in the respiratory tract may also be down regulated by repeated exposure to airborne antigens. PMID- 3815537 TI - Dendritic cells but not macrophages are targets for immune regulation by natural killer cells. AB - Both dendritic cells (DC) and macrophages (M phi) stimulate lymphocyte proliferation in secondary mixed-lymphocyte (ML) reactions, though DC are approximately fourfold more effective. Natural killer (NK) cells suppress secondary ML reactions when DC are used, but NK cells do not suppress when M phi are used in these reactions. The findings are consistent with the idea that DC, but not M phi, are potential targets in immune regulation mediated by NK cells. PMID- 3815538 TI - Effects of tobacco glycoprotein (TGP) on the immune system. III. The effect of aging on the mitogenic response of human peripheral blood lymphocytes to TGP. AB - We have shown that the mitogenic response of human peripheral blood lymphocytes (PBL) to tobacco glycoprotein (TGP), a glycoprotein rich in rutin or rutinlike polyphenol moieties, which is isolated from cured tobacco leaves, does not decrease with age. In contrast, the proliferative response to lipopolysaccharide (LPS) tends to decline with age, and a significant decrease is observed in the mitogenic response to rutin-bovine serum albumin (R-BSA). LPS and R-BSA are similar in some aspects to TGP, the former in that TGP and LPS are both T independent B-cell mitogens for mice and are both highly negatively charged, and the latter in that covalently bound polyphenol groups are present on both R-BSA and TGP. Although the kinetics of the mitogenic responses to these three mitogens are similar (T. Francus, R. F. Klein, L. Staiano-Coico, G. W. Siskind, and C. G. Becker, Effects of tobacco glycoprotein (TGP) on the immune system. II. TGP is a mitogen for human peripheral blood lymphocytes. Submitted for publication.), multiple regression analyses show no correlation in the mitogenic responses of PBL from young donors to TGP and LPS, to TGP and R-BSA, or to LPS and R-BSA. In contrast, there are significant correlations between the proliferative responses to these mitogens by PBL from old donors. The results suggest that only a small subpopulation of the cells which are stimulated by R-BSA and LPS are not altered with age, and these are most likely the cells that are stimulated by the three mitogens studied. PMID- 3815539 TI - Unique cell surface phenotypes of proliferating lymphocytes in mice homozygous for lpr and gld mutations, defined by monoclonal antibodies to MRL/Mp-lpr/lpr T cells. AB - In mice bearing the autosomal recessive gene of either lpr or gld, generalized T cell proliferation and autoimmunity occurs. The surface antigen profiles of these proliferating cells were analyzed using two-color flow cytometry analysis with two newly established rat monoclonal antibodies (ALP-1, ALP-2) directed to lpr cells. The Lp-1 antigen, defined by ALP-1, is expressed exclusively on approximately one-half of proliferating lpr and gld lymph node cells. The Lp-2 antigen, like B 220, is expressed on 80-90% of lpr and gld lymph node cells, the cells in B-cell lineage and a small population of Ly-2+ T cells from normal mice. Thus, the lpr and gld lymph node cells were classified into three subsets, Lp 1+/Lp-2+, Lp-1-/Lp-2+ and Lp-1-/Lp-2-. After stimulation with Con A or a combination of IL-2 and phorbol ester, a small population of T cells from normal mice became Lp-1+. The same treatment increased Lp-2+/Ly-2+ and induced Lp 2+/L3T4+ T-cell populations. Therefore, it seems likely that these phenotypically unique T cells are generated at some stage during the proliferation and differentiation of certain normal T-cell subpopulations. The aberrant T cells in mice with lpr and gld mutations may even be normal regulatory T cells, if they are not proliferating abnormally. PMID- 3815540 TI - Regulation of antibody production by hybridoma cultures. I. Anti-idiotype antibody-mediated down-regulation of anti-DNA antibody production by hybridoma cells. AB - A series of anti-DNA antibody-producing hybridomas were obtained by fusing spleen cells from 6-month-old MRL/lpr, autoimmune prone, mice with P3X63-Ag8 myeloma cells. Rabbit anti-idiotype (id) antibodies specific for several of the hybridoma proteins were prepared. It was shown that the anti-id antibody inhibited immunoglobulin in secretion by the hybridoma cells in an id-specific manner. Inhibition of antibody production was not due to a cytotoxic effect, since the anti-id, in fact, stimulated proliferation of the hybridoma cells. PMID- 3815541 TI - Parallel inheritance of tissue catalase activity and immunostimulatory action of amphotericin B in inbred mouse strains. AB - Both amphotericin B (AmB) and its methyl ester derivative are potent immunoadjuvants that also stimulate murine B lymphocytes and macrophages in vitro. Most of the common inbred mouse strains show AmB-induced immunostimulation (AmB-high responders) but mice from the C57BL strains, regardless of H-2 genotype, are AmB-low responders. Lymphoid cells from AmB-high responder strains also exhibit greater resistance to H2O2 toxicity in vitro compared with cells from AmB-low responders. This result led to an evaluation of differences in the tissue catalase levels of AmB-high and -low responder strains. Results from several laboratories, including ours, indicate that C57BL mouse strains express low levels of tissue catalase activity in addition to low or absent immunostimulant effects of AmB. Several AmB-high responder strains have high spleen cell, macrophage, and liver catalase, and the mouse strain distribution of enzyme activity as well as the dominant inheritance of the low catalase phenotype is compatible with regulation by the Ce-1 locus in lymphoid organs as well as liver. Other evidence also suggests that H2O2 metabolism is important in lymphoid cell responses to AmB. For example, AmB stimulates a stronger respiratory burst in macrophages from AmB-high responder strains under the same conditions that inhibit burst activity in macrophages from low responders. Selective immune enhancement by AmB in high catalase mouse strains along with enhanced susceptibility to AmB toxicity in low responder C57BL mice with low tissue catalase activity suggests that cellular peroxidation is a major determinant of the genetic regulation of amphotericin-induced immunostimulation. PMID- 3815542 TI - Quinacrine-induced changes in mitotic PtK1 spindle microtubule organization. AB - Quinacrine, an acridine derivative which competitively binds to ATP binding sites, has been used to study the role of ATP requiring molecules in microtubule organization in mitotic PtK1 cells. Brief treatments of metaphase cells with concentrations of quinacrine ranging from 2 to 10 microM decreased spindle length and birefringence in a concentration-dependent manner. With either increasing quinacrine concentrations or duration of treatment, metaphase cells demonstrated a specific reorganization of spindle microtubules. Both polarization and electron microscopy showed a substantial loss of non-kinetochore spindle microtubules with an increase in astral microtubules: this was particularly evident in the region adjacent to the spindle domain. Addition of millimolar concentrations of dinitrophenol to quinacrine-containing medium did not potentiate the response of metaphase cells to quinacrine treatment. Time-lapse video analysis demonstrated that the astral microtubules are the result of reorganization of spindle microtubules. These data suggest that functional ATP binding sites are required to maintain stable interactions between microtubules and that these interactions are responsible for maintaining the bowed configuration of non-kinetochore spindle microtubules which are under compression at metaphase. PMID- 3815543 TI - Wave of cortical actin polymerization in the sea urchin egg. AB - The distribution of actin filaments in the cortical layer of sea urchin eggs during fertilization has been investigated by light microscopy using fluorescently labeled phallotoxins. The cortical layer of both whole eggs and cortices isolated on a glass surface was examined. In cortices of unfertilized eggs, numerous fluorescent spots were seen, which may correspond to short actin filament cores in microvilli. After insemination, one of the sperm-attaching points on the egg surface first became strongly fluorescent. This fluorescence grew around the point of sperm penetration with the growth of the fertilization cone. Then, the cortical layer of the egg around the fertilization cone became strongly fluorescent and the fluorescence propagated in a wavelike manner over the entire cortex. The mechanism of the propagation of actin polymerization is discussed. PMID- 3815544 TI - Role of cortical tension in fibroblast shape and movement. AB - In order to analyze the cellular mechanisms of shape formation, the shape of individual 3T3 cells was perturbed by micromanipulation resulting in the detachment and relaxation of a cellular extension and the bending of the extension to form an "elbow" at a variable angle beta. Finally, the tip of the extension was allowed to reattach to the substrate away from the cell. The cells reacted by drawing the extension tight. If beta less than 90 degrees, the elbow moved laterally for 8-15 min until the extension projected orthogonally at the cell surface. If beta greater than or equal to 90 degrees, the extension remained stationary. Finally, in all cases webs formed between attachment points in the perturbed area. If the tip of the extension was allowed to touch its own cell body, thus forming a loop, the cells invariably closed the loop. The paper interprets the cellular reaction as the result of cortical tension and suggests that it is a major factor in the formation of fibroblast shape and the expressions of fibroblast motility. PMID- 3815545 TI - [Synthesis and pharmacologic activity of pyrimidine derivatives]. PMID- 3815546 TI - [Esters of 3-(2-hydroxyethyl)-4(3H)-quinazolinone with an analgesic effect]. PMID- 3815547 TI - [Reconstruction after supraglottic laryngectomy]. PMID- 3815548 TI - [Acute juvenile mesotitis in ambulatory practice. II. Bacteriologic findings]. PMID- 3815549 TI - [Ossicular fixation and its resolution]. PMID- 3815550 TI - [Exostoses and osteomas of the external auditory canal]. PMID- 3815551 TI - [Esthetic aspects of salivary gland surgery]. PMID- 3815552 TI - [Hearing protectors and speech intelligibility during noise]. PMID- 3815553 TI - [Interdental sigmatism]. PMID- 3815554 TI - [Pathomorphologic findings in the larynx in small children after prolonged tracheal intubation]. PMID- 3815555 TI - [Sudden infant death syndrome in an 18-month-old female patient]. PMID- 3815556 TI - [Revision after tympanoplasty operations]. PMID- 3815557 TI - [Tasks in pediatrics in 1987]. PMID- 3815558 TI - [Missed diagnoses of diffuse connective tissue diseases]. PMID- 3815559 TI - [Transcutaneous bilirubinometry using the Minolta/Air-Shields apparatus in neonates with a low birthweight]. PMID- 3815560 TI - [Correlation of cytologic findings with lactate dehydrogenase isoenzyme levels in nasopharyngeal secretions]. PMID- 3815561 TI - [The effect of water immersion on renal function in children with nephrotic syndrome]. PMID- 3815562 TI - [The Rett syndrome--criteria and personal experience]. PMID- 3815563 TI - [The Noonan syndrome in a boy]. PMID- 3815564 TI - [Glycohemoglobin and glycosylated proteins. Biochemical indicators of long-term control in the treatment of diabetes]. PMID- 3815565 TI - [Gastroesophageal reflux in childhood]. PMID- 3815567 TI - [The Czech diabetology program in pediatrics]. PMID- 3815568 TI - [The physician and the computer. 1. The task of the physician and basic areas of application]. PMID- 3815566 TI - [Interstitial nephritis in childhood]. PMID- 3815569 TI - [Continuing education of pediatric nurses in Czechoslovakia]. PMID- 3815570 TI - [Resuscitation of the neonate]. PMID- 3815571 TI - [The development of immunity in children with neonatal hyperbilirubinemia. I. The effect of neonatal hyperbilirubinemia on morbidity in children]. PMID- 3815572 TI - [The frequently ill child (transient hypogammaglobulinemia)]. PMID- 3815573 TI - [Latent sideropenia in adolescence]. PMID- 3815574 TI - [Modern society and health]. PMID- 3815575 TI - [The significance of methodologic problems in morbidity studies in the town of Balassagyarmat]. PMID- 3815576 TI - [Assessment of health and social characteristics of medical students]. PMID- 3815577 TI - [Improving documentation in general medicine]. PMID- 3815578 TI - [What is the best size for a health institution for therapeutic and preventive care?]. PMID- 3815579 TI - [Late post-irradiation changes after treatment of malignant tumors in children]. PMID- 3815580 TI - [Use of linear quadratic models in practice]. PMID- 3815581 TI - [Monitoring cardiotoxicity during antineoplastic chemotherapy]. PMID- 3815582 TI - [Characteristics of radiation therapy in malignant tumors in childhood]. PMID- 3815583 TI - [Effective high tension on the roentgen tube in the hard chest film technic]. PMID- 3815584 TI - [Bilateral kidney tumors]. PMID- 3815585 TI - Factors influencing the sensitivity of two human bladder carcinoma cell lines to cis-diamminedichloroplatinum(II). AB - A two-fold difference in sensitivity to cis-diamminedichloroplatinum(II) (cisplatin), as judged by colony forming assays, has been demonstrated in two human bladder carcinoma continuous cell lines. Approximately twice as many DNA DNA interstrand cross-links (ISL) and a 2-fold greater inhibition of DNA synthesis occurred in the more sensitive T24 cell line than in the RT112 cell line after exposure to the same concentrations of cisplatin. Equitoxic concentrations of cisplatin resulted in similar extents of ISL and inhibition of DNA synthesis in both cell lines. Although drug uptake was identical, twice as much cisplatin was bound to the DNA of T24 cells than RT112 cells. However after equitoxic concentrations of cisplatin the DNA from both cell lines was platinated to a similar extent. In addition, levels of glutathione (GSH), glutathione reductase (GR) and total glutathione-S-transferases (GST) were higher in the less sensitive RT112 cell line. PMID- 3815586 TI - Glutathione oxidation during peroxidase catalysed drug metabolism. AB - The peroxidase catalyzed oxidation of certain drugs in the presence of glutathione (GSH) resulted in extensive oxidation to oxidized glutathione (GSSG). Extensive oxygen uptake ensued and thiyl radicals could be trapped. Only catalytic amounts of drugs were required indicating a redox cycling mechanism. Active drugs included phenothiazines, aminopyrine, p-phenetidine, acetaminophen and 4-N,N-(CH3)2-aminophenol. Other drugs, including dopamine and alpha-methyl dopa, did not catalyse oxygen uptake, nor were GSSG or thiyl radicals formed. Instead, GSH was depleted by GSH conjugate formation. Drugs of the former group, e.g. acetaminophen, aminopyrine or N,N-(CH3)2-aniline have also been found by other investigators to form GSSG and hydrogen peroxide when added to hepatocytes or when perfused through an isolated liver. Although cytochrome P-450 normally catalyses a two-electron oxidation of drugs, serious consideration should be given for some one-electron oxidation resulting in radical formation, oxygen activation and GSSG formation. PMID- 3815587 TI - DNA-binding products of nornitrogen mustard, a metabolite of cyclophosphamide. AB - Nornitrogen mustard was shown to bind to the N-7 position of guanine in DNA and guanosine. The initial binding product was NOR-G. N-(2-chloroethyl)-N-[2-(7 guaninyl)ethyl]amine but it was converted with time to a hydroxylated derivative. NOR-OH-G and to a cross-link, G-NOR-G. The NOR-OH-G adduct was also seen in the reactions of aziridineethanol. The cross-link appeared to depurinate slower than the two other adducts so that it was the main adduct after 72 h of incubation. The rate of reaction was higher at pH 6.0 than at pH 7.4 but even at pH 7.4 adducts were formed. When isolated NOR-G was incubated it was shown to be converted exclusively to NOR-OH-G at pH 5 but at pH 7.4 the main product was a dimer. The half-life of NOR-OH-G formation at pH 7.4 and 37 degrees C was 4 h. The mustard arms of NOR-G and NOR-OH-G had pKa values of about 7.5 and 10, respectively. This was probably related to the somewhat higher rate of imidazole ring-opening of NOR-OH-gua as compared to NOR-gua. The lability of the imidazole ring of the guanosine adducts of nornitrogen mustard is intermediate to those of phosphoramide mustard and nitrogen mustard. PMID- 3815589 TI - Synthesis and antitumor activity of cis-dichloroplatinum complexes coordinating nitrogen cyclic or sulfur compounds. PMID- 3815588 TI - Crystal structure of copper(II) complex with tryptamine-pyridoxal Schiff base and conformational study of tryptophan in pyridoxal-catalyzed reactions. PMID- 3815590 TI - Synthesis of imidazo[4,5-e][1,4]diazepine and imidazo[4,5-e][1,4]oxazepine derivatives using caffeidine, a hydrolysis product of caffeine. PMID- 3815591 TI - Synthesis of pyrrolidine derivatives with pharmaceutical activity. XII. Synthesis and anticholinergic activity of 1,1-dialkyl-3-diphenylmethylene-2,4 dimethylpyrrolidinium halides. PMID- 3815593 TI - Regiospecific deoxygenation of the dihydroxyacetone moiety at C-17 of corticoid steroids with iodotrimethylsilane. PMID- 3815592 TI - Studies on compounds related to antitumor agents. Synthesis of 8-substituted N6,N6-dimethyladenosine derivatives. PMID- 3815594 TI - [Chemical and chemotaxonomic studies of pterophyten. LXIV. Chemical studies on the contents of Sceptridium ternatum var. ternatum]. PMID- 3815595 TI - Studies on lignan lactone antitumor agents. I. Synthesis of aminoglycosidic lignan variants related to podophyllotoxin. PMID- 3815596 TI - Studies on lignan lactone antitumor agents. II. Synthesis of N-alkylamino- and 2,6-dideoxy-2-aminoglycoside lignan variants related to podophyllotoxin. PMID- 3815597 TI - Studies on antitumor cyclic hexapeptides RA obtained from rubiae radix, rubiaceae. VI. Minor antitumor constituents. PMID- 3815598 TI - Fluorometric determination of menadione with 3-amino-2(1H)-quinolinethione. III. PMID- 3815599 TI - Degradation kinetics of carumonam in aqueous solution. PMID- 3815600 TI - Hydrophobic chromatography of tubulin on immobilized colchicine columns with various spacers. PMID- 3815601 TI - Isolation and amino acid sequence of dentinal fluid transport-stimulating peptide from rat parotid glands. PMID- 3815602 TI - Effect of extract from salviae miltiorrhizae radix on uremic rats. PMID- 3815603 TI - Effect of nonprotein thiols in the intestinal tissue on the transport of salicylate. PMID- 3815604 TI - Simultaneous vascular and luminal perfusion of rat small intestine. PMID- 3815605 TI - Intestinal absorption of a beta-adrenergic blocking agents nadolol. II. Mechanism of the inhibitory effect on the intestinal absorption of nadolol by sodium cholate in rats. PMID- 3815606 TI - Effects of (-)-cis-2,3-dihydro-3-(4-methylpiperazinylmethyl)-2-phenyl- 1,5 benzothiaze pin-4-(5H)-one hydrochloride (BTM-1086) on ulceration, gastric secretion and mucosal blood flow in experimental animals. PMID- 3815607 TI - Studies on the origin, processing and quality of crude drugs. II. Pharmacological evaluation of the Chinese crude drug "zhu" in experimental stomach ulcer. (2). Inhibitory effect of extract of Atractylodes lancea on gastric secretion. PMID- 3815608 TI - Identification of mutagenic nitrosation products of antipyrine and evaluation of their formation under model stomach conditions. PMID- 3815609 TI - Studies on dental caries prevention by traditional medicines. X. Antibacterial action of phenolic components from mace against Streptococcus mutans. PMID- 3815610 TI - Studies on the absorption kinetics of theophylline in the steady state, following multiple oral dosing of a sustained-release theophylline tablet formation to asthmatic patients. PMID- 3815611 TI - Crystal and molecular structures of a new anti-ulcer agent, 3-[p-(trans-4 aminomethylcyclohexylcarbonyl)phenyl]propionic acid hydrochloride. PMID- 3815612 TI - Ponfolin: a new coumarin from trifoliate orange. PMID- 3815613 TI - The biological activities of podophyllotoxin compounds. PMID- 3815614 TI - A specific protease inhibitor from Streptomyces. PMID- 3815615 TI - The beta-glucosidation and beta-glucuronidation of pantothenic acid compared with p-nitrophenol in dog liver microsome. PMID- 3815616 TI - Solvolysis of N-nitroso-N-(1-acetoxyalkyl)alkylamines in phosphate buffer: characterization and mutagenicity of N-nitroso-N-(1 phosphonooxyalkyl)alkylamines. PMID- 3815617 TI - Inhibition of arachidonate 5-lipoxygenase by phenolic compounds. PMID- 3815618 TI - Effect of high cholesterol diet on rat liver peroxisomal enzymes. PMID- 3815619 TI - Tubeimoside I, a new cyclic bisdesmoside from Chinese cucurbitaceous folk medicine "tu bei mu", a tuber of Bolbostemma paniculatum. PMID- 3815620 TI - The effects of Ca2+ on lipid diffusion. AB - The effects of Ca2+ on rotational and translational diffusion of lipids in multilamellar dimyristoylphosphatidylcholine (DMPC)-water systems were investigated by time-resolved phosphorescence anisotropy steady-state fluorescence polarization and fluorescence recovery after photobleaching (FRAP) experiments. Above the phase transition temperature (Tm), addition of Ca2+ caused a steady increase in the segmental motion of the phosphorescent probe, but resulted in slower diffusion of the fluorescent and lateral diffusion probes. The former result is attributed to changes in the structure of the lipid/water interface that affects the chromophore mobility on the phosphorescence time scale but does not reflect lipid motion. Below the phase transition temperature, slower diffusion of all probes were observed with increasing concentrations of Ca2+, with sudden large changes occurring at [Ca2+] approximately 500 mM. This behaviour is attributed to association of Ca2+ with the lipid phosphate groups and the exclusion of water molecules which results in tighter packing of lipids and smaller segmental motion, leading eventually to the immobilization of lipid molecules. PMID- 3815621 TI - Hydrolysis of N-acylated glycerophospholipids by phospholipases A2 and D: a method of identification and analysis. AB - We have previously identified N-acylethanolamine phospholipids in infarcted dog heart and in normal fish brain by chemical and enzymatic degradation. We now report that hydrolysis with phospholipase D from Streptomyces chromofuscus removes N-acylethanolamine from N-acylethanolamine phospholipids and lyso N acylethanolamine phospholipids, or N-acylserine from lyso N-acylserine phospholipids. At acidic pH, a phosphatase present in the phospholipase D preparation further hydrolyzes the resulting phosphatidic acid (PA) or lyso-PA to diacyl- or monoacylglycerol. Because N-acylserine phospholipids are a poor substrate for the phospholipase D, pretreatment with phospholipase A2 (Trimeresurus flavoviridis venom) is used to remove the 2-O-acyl group. Thus, both types of N-acylated phospholipids can be analyzed by consecutive phospholipase A2 and phospholipase D treatment. Reaction products, i.e., free fatty acids, monoacylglycerols and N-acylethanolamine or N-acylserine, are separable by thin-layer chromatography. Both N-acyl components can be further characterized by conversion to the t-butyldimethylsilyl derivatives. The method was used to identify and analyze the N-acylserine phospholipids of bovine brain. PMID- 3815622 TI - Improved synthesis of cord factor analogues via the Mitsunobu reaction. AB - Treatment of trehalose with triphenylphosphine, diisopropyl azodicarboxylate and beta-O-tetrahydropyran-2-ylmycolic acid in 1:1 hexamethylphosphoric triamide/dichloromethane, followed by removal of the tetrahydropyranyl protecting group, gave cord factor (1) in good yield, under exceptionally mild conditions. Two new cord factor analogues were similarly prepared from beta-O-methylmycolic acid and from the alpha, beta-unsaturated 'anhydro' mycolic acid respectively. The procedure, employing excess trehalose, can also be used for the synthesis of trehalose monomycolates in good yield. No protection of the carbohydrate is required. PMID- 3815623 TI - Synthesis, mass spectral characterization and immunoadjuvant activity of some novel lipophilic derivatives of muramyl dipeptides. AB - Some novel lipophilic derivatives of N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) have been prepared and rigorously evaluated by spectroscopic means. Fast atom bombardment and field desorption mass spectrometry provided information about both molecular weight and structural detail. The new MDP derivatives have been tested in guinea pigs for immunoadjuvant activity using egg albumin as the model antigen. Amongst these derivatives, 6-O-[3-(5-cholesten-3 beta yloxycarbonyl) propionyl]-N-acetylmuramyl-L-alanyl-D-isoglutamine (CSMDP), 6-O-[3 1,2-dipalmitoyl-sn-glycero-3-carbonyl) propionyl]-N-acetylmuramyl-L-alanyl-D isoglutamine (GSMDP) and N-palmitoyl muramyl-L-alanyl-D-isoglutamine (PMDP) possessed significantly better activity than MDP, as judged by the antigen specific antibody and delayed hypersensitivity responses in the immunized animals. In addition, CSMDP was found to induce strong delayed hypersensitivity response even in saline. These three active compounds were also tested for their pyrogenic response in rabbits, and were found to be lesser pyrogenic than MDP. Some of these MDP derivatives hold promise as adjuvants in immunization. PMID- 3815624 TI - Pr3+ transport across phosphatidylcholine vesicles mediated by open crown synthetic ionophores. AB - Pr3+ transport experiments, varying temperature and concentration, show that open crown synthetic polyethers (podands) mediate Pr3+ translocation across phosphatidylcholine vesicles by a carrier mechanism. Enhancement of the proton countertransport induced by addition of a protonophore, increases the cation inward rate. PMID- 3815625 TI - Light scattering measurements on gangliosides: dependence of micellar properties on molecular structure and temperature. AB - Static and dynamic laser light scattering measurements on micellar aqueous solutions of gangliosides GM2, GM1, GD1a are reported. The aggregation number, the hydrodynamic radius and the micellar shape depend on the type of ganglioside and the unsaturation degree of the hydrocarbon chains. At a temperature of 25 degrees C the molecular weights of GM2, GM1 and GD1a are 740,000, 470,000 and 418,000 DA respectively. A significant decrease of micellar size with temperature has been found for saturated GM1 in the region 25 degrees-40 degrees C. The strong sensitivity of the micellar parameters to the ganglioside structure is explained by making reference to some simple model which takes into account geometrical packing considerations. By measuring the scattered light intensity at low ionic strength of the solution (0.1-30 mE) it was possible to evaluate the ganglioside micellar charge, 100 electronic units for GM2, 48 for GM1 and 60 for GD1a. PMID- 3815626 TI - Estimation of the equilibrium lateral pressure in 1-palmitoyl-2-[6(pyren-1 yl)]hexanoyl-glycerophospholipid liposomes. AB - Compression isotherms for 1-palmitoyl-2-[6(pyren-1-yl)] hexanoyl-sn-glycero-3 phosphocholine (PPHPC), -ethanolamine (PPHPE), -glycerol (PPHPG), -serine (PPHPS) and -phosphatidic acid monomethylester (PPHPM) were recorded at an argon/water interface. Thereafter, the ratios of pyrene excimer to monomer fluorescence emission intensities (Ie/Im) were determined for liposomes of these lipids and were found to be 20.15, 12.30, 11.80, 10.15 and 6.95 for the ethanolamine, choline, monomethylester, glycerol and serine derivatives, respectively. Assuming Ie/Im to depend on the reciprocal of the mean molecular area of the pyrenelipids in liposomes, equilibrium surface pressure to be the same in liposomes of these lipids regardless of the head group structure and neglecting any possible influence due to differences in the orientation of the pyrene moiety, we sought for that surface pressure value in the compression isotherms where the correlation of the reciprocal of mean molecular area in monolayers to Ie/Im values observed in liposomes was maximal. This treatment results in a value of approximately 12 mN m-1 for the equilibrium surface pressure in 1-palmitoyl-2 [6(pyren-1-yl)]hexanoyl-glycerophospholipid liposomes. PMID- 3815627 TI - Mass spectral behavior and HPLC of some unusual molecular phospholipid species. AB - The molecular species of the major phospholipids from the marine sponges Parasperella psila and Microciona prolifera were studied using chemical hydrolysis, enzymatic degradation and capillary gas chromatography (GC), high performance liquid chromatography (HPLC), desorption chemical ionization (DCI), fast atom bombardment (FAB) combined with collisionally activated decomposition (CAD) mass spectrometry. Two new solvent systems were developed for the isolation of these species from the sponges. Our investigations indicated the existence of unusual symmetrical phospholipids as major components. 1,2-Di-(5Z,9Z)-5,9 hexacosadienoyl-sn-glycero-3-phosph oethanolamine was found in both organisms, while 1,2-di(5Z,9Z,19Z)-5,9,19-hexacosatrienoyl-sn-gly cero-3-phosphoethanolamine was present in M. prolifera, 1,2-Di-(4Z,7Z,10Z,13Z,16Z,19Z)-4,7,1 0,13,16,19 docosahexaenoyl-sn-glycero-3- phosphocholine was the major molecular species in the PC fraction of M. prolifera. PMID- 3815628 TI - Conversion of radiolabelled ethanolamine plasmalogen into the dimethylethanolamine and choline analogue via transphosphatidylation by phospholipase D from cabbage. AB - Starting from biosynthetically prepared ethanolamine plasmalogen 14C-labelled in the O-alkenyl moiety, choline and dimethylethanolamine plasmalogen were prepared by transphosphatidylation utilizing phospholipase D from cabbage. Investigation of the time course of the reaction showed that transphosphatidylation was simultaneously accompanied by hydrolysis of both the substrate and the desired product, resulting in a maximum of product yield after 1-3 h under the reaction conditions investigated. Optimal reaction conditions gave yields of 40% and 62% (of total radioactivity) respectively for the purified choline and dimethylethanolamine derivatives. PMID- 3815629 TI - [Evaluation of materials and technics in vascular surgery using 111-Indium]. AB - The thrombogenicity of the graft materials is a significant factor incriminated in early failures. Some improvements have been achieved by modification of physical characteristics of the material as porosity, compliance, durability in order to improve patency rates. Platelets are major determinants of thrombus formation and may still be thrombogenic by activation of the coagulation enzymes. The purpose of this work is to study the platelets deposition on different material grafts, utilizing autologous platelets labelled with 111-Indium. The radioactivity pulses was recorder before and 4 days after surgery in aortoiliac and femoropopliteal districts. The graft material used in aortoiliac occlusions was: velour, double velour PTFE; in femoropopliteal: Double velour, PTFE, saphenous vein, umbilical vein, bovine carotid. In some patients the operation was TEA with patch in PTFE. The authors show the results of this study in 92 patients in relation of the material graft an location. PMID- 3815630 TI - [Biology and surgery: a bound pair or merely a couple of disciplines? (2)]. AB - Carcinoma of the breast, to our way of thinking, appears to be capable of providing what is virtually a master key to the interpretation of surgical oncological pathology. In the wake of the acquisitions made in this field--not always as a result of the initiative of the surgeon - a definite process of revision of the age-old concept of surgical radicality is underway, albeit in a somewhat surreptitious manner. Oncological surgery is clearly passing through a difficult phase, almost a crisis of identity, and, in the authors' opinion, may to some extent come back into its own, albeit only after a great deal of painstaking effort, by adopting a "biological" approach with greater respect for the morpho-functional integrity of the patient, who must no longer be viewed as merely the victim of disease, but rather as the prime mover of the disease itself. PMID- 3815631 TI - [Epithelial splenic cysts]. AB - The authors describe a case of an epithelial cyst of the spleen treated successfully by splenectomy. Diagnostic techniques and the principles adopted in treatment this rare disease are discussed. PMID- 3815632 TI - [Renal adenocarcinoma associated with a polycystic kidney (presentation of a case and review of the literature)]. AB - The Authors report a case of renal neoplasm association to polycystic kidney. The report was quite occasional, as the patient was not aware to be bearer of a renal dysembryopathy, although such a familiarity was existing formerly. The diagnosis was placed subsequently to ascertainments aiming at establishing the origin of a transient arterial hypertension, occurring recently, in absence of any other symptomatology. PMID- 3815633 TI - [Endoscopic excision of a pin implanted in the 3d portion of the duodenum]. AB - The Authors, while presenting a case of endoscopic extraction of a foreign body fixed in the duodenum, underline the value of operative endoscopy, which, going beyond the limits of a exclusively diagnostic technique, is intended as a first choice therapeutic procedure to be always carried out, leaving to surgery the treatment of the most complicated cases and those where the endoscopic attempt fails. PMID- 3815634 TI - [Synovial osteochondromatosis]. AB - The Authors have examined the clinical history, roentgenograms, differential diagnosis and treatment of synovial osteochondromatosis. PMID- 3815635 TI - [Biology and surgery: a bound pair or merely a couple of disciplines? (3)]. AB - In the following reports two main problems are questioned by the Authors. To start with, a sharp distinction is made between the so-called "theoretical physiology" and the "actual" use of the physiological functions adopted by the single man and woman. The second question is concerned with the biological consistency of the different surgical approaches. In the neoplastic treatments, surgeon can draw a conclusion that goes behind the single therapeutic event casting over other different areas of the surgery itself. To answer this second question by no means represents the solution of the aimed goal, on the contrary it is the starting-line towards a surgery, which, having left behind his old, obsolete, but pompous garments, does wear those, which, apparently shabby, are, on the other hand, enriched of many lapels, such as those naturally offered by the self-healing behaviour. PMID- 3815636 TI - [Exocrine carcinoma of the pancreas in Piemonte (analysis of 3053 hospitalized cases)]. AB - The study concerns 3053 cases of esocrine pancreas carcinoma observed between 1976 and 1981 in Piemonte, Italy. The authors discuss about the principal risk factors associated with that disease (age, sex, geographical distribution), the treatment and the methodological problems in an epidemiologic study concerning pancreatic carcinoma. PMID- 3815637 TI - [Injuries caused by traffic accidents: passive safety and restraint systems in automobiles]. AB - In this article are considered the multiple instruments today employed in cars, in order to prevent or ameliorate the lesions caused to the occupants in case of road accident. The acquisitions in the differentiated structure of the car, in the windshield, in the components of the passenger cell are described, and the peculiar importance of the restraint systems is evidenced. PMID- 3815638 TI - [Injuries caused by seat belts]. AB - The effectiveness of seat belts is largely proved. Nevertheless, this safety device produces typical lesions, for very violent accidents, or if it is malpositioned. The pathogenetic criterium of these lesions ("seat belt syndrome") is described, while a complete revision of literature is presented. The importance of emergency care in the identification and treatment of these lesions is emphasized. PMID- 3815639 TI - [Structural changes demonstrable by optic and electron microscopy in cellular and support components of nevi in the phase of neoplastic transformation and their therapeutic treatment]. AB - The mole can transform itself in melanoma. The transformation is caused in some's opinion by congenital cells, in some's opinion by external elements (metabolic, physical, caustic, etc.). The authors lean to external causes metabolic, physical caustic) and they consider useful the chirurgical and radiant treatment. PMID- 3815640 TI - [Liver scintigraphy using 99mTc-HIDA in the study of biliary-digestive anastomosis]. AB - Surgical operations characterised by the creation of a bilio-intestinal anastomosis are becoming an increasingly frequent procedure in bile tract surgery. Just as frequent and well known are the immediate and longer-term postoperative sequelae. Thus, one of the problems which has always interested surgeons and investigators is how best to monitor the functional efficiency of the anastomosis. Traditional x-ray methods, including highly invasive examinations such as PTC and ERCP, as well as the harmless ultrasound procedures do not provide an adequate picture of the functional efficiency of such anastomoses, the only wholly valid and efficacious method being sequential scintigraphy with 99mTc-Hida. On the basis of these principles, the authors describe their experience in this field, stressing the validity of the method, which enables surgeons to study the morphology and, above all, the functional efficiency of bilio-intestinal anastomoses. PMID- 3815641 TI - [Colonic and rectal cancer screening using fecal occult blood analysis (our experience)]. AB - The authors describe their experience with colorectal cancer screening by means of the Hemoccult test for the detection of occult fecal blood according to Gregor's method. In particular, the decentralized aspect of the screening is examined, and the results discussed are in agreement with those observed in larger study populations. The authors go on to stress the effective possibility of conducting this type of screening also on the basis of collaboration with general practitioners. PMID- 3815642 TI - [Restraint systems for children transported in automobiles]. AB - This article deals with the currently available restraint devices for car passengers up to adolescence, since standard seat belts cannot be directly used with children. PMID- 3815643 TI - [Limitations of the Italian Institute of Statistics' surveys in automobile accidents]. AB - In this article is carried out an analysis of the actual criteria used by the Italian Institute of Statistics (ISTAT) in the survey of car accidents, and some clues to improve their quality are suggested. The role of the epidemiologic information in preventing road traumatology is emphasized. PMID- 3815644 TI - [Cyclophosphamide, adriamycin and platinum (CAP) in the preoperative neoadjuvant phase and the therapy phase]. AB - Forty-two patients with metastasized, and 7 patients with locally advanced forms of carcinoma of the breast were treated with a combination of three drugs: CTX 200-400 mg/sq.m. on days 1, 3 and 5, ADM 40 mg/sq.m. on day 1, and DDP 30 mg/sq.m. on days 1, 3 and 5 (CAP), every 21 days. The 42 patients with metastasized carcinoma had already received substantial pre-treatment by surgery and with adjuvant polychemotherapy +/- chemotherapy on recurrence +/- hormonotherapy +/- radiotherapy. The disease sites were: bone (30%), skin (19%), lymph nodes (13.5%), pleura (12.5%), lung (12%) and liver (11%). The 7 patients with locally advanced carcinoma had not been pre-treated; they received the same chemotherapy in the pre-operative neo-adjuvant phase. Positive responses to CAP in the cases with metastasized carcinoma according to individual disease sites (37 pre-treated patients assessable after at least two courses of therapy) were as follows in percentage terms: 24% bone lesions, 56% skin lesions, 77% lymph node lesions, 30% liver lesions, 56% lung lesions, 22% pleural lesions. 3/37 patients (8%) showed complete remission in all disease sites, while 6/37 showed partial remission. This percentage (8 + 16 = 24%) is encouraging, as CAP, in these patients, represents on average the 3rd to 4th line of therapy. Responses to neo-adjuvant CAP therapy (7 patients assessable after at least two courses of therapy) were as follows: 5 patients showed partial remission after 3-6 courses, 1 complete remission, and 1 objective improvement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815645 TI - [Ductal adenoma of the breast: correlations between clinico-radiologic and histo pathologic aspects (considerations on a case)]. AB - The authors report on a case of ductal adenoma of the breast, pointing out that routine clinico-instrumental diagnostic signs, though suggesting a picture of malignancy, may actually relate to this rare benign form of tumor. In the presence of cases of this type, we therefore advise a cautions approach to surgery, in that oncological radicality is subordinate to confirmation in the form of a traditional histological preparation, as freezer examinations are unable to provide wholly reliable responses. PMID- 3815646 TI - [Long-term evaluation of the treatment of peptic ulcer by the Billroth II method]. AB - 120 patients subjected to Billroth II gastrectomy over the period 1966-1982 were evaluated. The very satisfactory results obtained in our experience persuade us that this technique is still extremely valid. PMID- 3815648 TI - [Endoscopic treatment of vesico-ureteral reflux in children]. AB - Endoscopic injection of Teflon behind the ureteral orifice allows correction of vesicoureteral reflux. 22 children, boys and girls, were treated by this method. Their ages varied from 1 week to 13 years. 33 refluxing ureters have been treated. All grades of reflux have been successfully treated. Only one case of reflux recurred on control cystography done 3 months later and was successfully treated by a second injection of Teflon. A second case has been operated for a multicystic non functioning kidney associated with ureteric duplication. There has been no case of ureteric obstruction or any other significant complication. The treatment takes about 15 minutes and hospitalisation is reduced to one day. By its simplicity and reliability, endoscopic treatment of reflux allows to widen the usual indication for the surgical correction of reflux usually limited to the higher grade of reflux only. PMID- 3815647 TI - [Persistent urinary infection in children after antireflux ureterovesical reimplantation in primary vesicorenal reflux]. AB - This study is the outcome of the analysis of 200 cases and concentrates solely on successful antireflux operations (i.e. with neither stenosis nor persistent reflux) performed on primary refluxes, 54 children, all of them being females, have retained refractory postoperative urinary infections. Of these cases, 24 cases (12%) have not been cured yet. In these postoperative infections, some factors play probably no part: the magnitude of the preoperative reflux, the existence of pyelonephritic lesions, the type of germ. However the fact of being female, the age (over 6), the duration of the preoperative infection and, above all, the existence of predominantly vesical symptomatology (frequency, voiding pain, and continence problems such as imperiousness, diurnal incontinence, enuresis) are basic factors. This makes it possible to compose the model of the child that will come up with a rebellious postoperative urinary infection. For these children, suppressing the reflux is only part of the treatment. It will have to be curried on by treating the vesical instability by drugs, vesical reeducation and even psychotherapy. On hand of these observations, one may question the classification of refluxes: do all of them really come under the name of "primary" refluxes? PMID- 3815649 TI - [Rupturing of valves of the posterior urethra in the newborn using a balloon catheter. Results of the technic apropos of a series of 10 children]. AB - Prenatal ultrasonographic diagnosis of urethral valves is now common. Treatment of the urethral obstruction has sometimes to be done in low weight newborn babies. In these babies, the stripping of valves using a Fogarty catheter provides an helpful way of treatment, easier than endoscopy. The technique is presented here. The results of this procedure in 10 neonates with a follow up of 3 to 22 months are reported. The urethral obstruction is easily cured in most patients without using a previous diversion. This procedure is indicated in premature or hypotrophic newborns when the urethral size is too small to allow a safe endoscopic section of the valves. We did not observe secondary stricture. Follow up is too short to allow a correct investigation of the continence. PMID- 3815650 TI - [New surgical technic in megarectum]. AB - The sphinctero-myectomy as a surgical treatment of megarectum has been generally advocated, but its results are not always satisfactory. In this paper, a new surgical treatment will be presented. Ten cases with idiopathic chronic constipation presenting megarectum in barium enema underwent this operation. After anal dilatation, incision was made in width of 2 cm at 6 o'clock on the dentate line. The blunt split between internal and external sphincter muscles was advanced to 6 cm orally. The all layers of superior part of anus and lower part of rectum in length of 5 cm were clumped by two forceps in width of 1 cm. Then the all layers in outer side of forceps were cut bilaterally. The rectum on the top of the forceps was pulled through to the dentate line and was anastomosed there. The operative results were evaluated more than one year after the operation. Complete cure was noticed in 7 cases and marked improvement in 3 cases. Our procedure, named as sphinctero-myectomy and plasty can be operation of choice for chronic constipation with megarectum. PMID- 3815651 TI - [Diagnostic value of cholinesterase activity in superficial biopsies of the rectum]. AB - Quantitative assay of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities have been estimated in superficial rectal biopsies from 168 neonates or children suspected of having Hirschsprung's disease. The AChE activity made the diagnosis in 93% of the cases. The ratio AChE/BChE improved both the specificity and the sensitivity and confirmed the diagnosis on the first series of biopsies in 99% of the cases. PMID- 3815652 TI - [Reconstructive plastic surgery of the female perineum. A personal technic]. AB - The authors present 8 cases of reconstructive plastic surgery of the female perineum carried out on patients aged between 9 months and 17 years old. As far as newborns are concerned only on five of them a "cut-back" was applied for low ano-rectal malformations, and one an abdomen perineal approach for high malformation, with post-operation complications. The others two have perineal vicious scars resulting from neo-natal phlegmon. They discuss the advantages and present results of the surgical technique applied: reconstruction of the cutaneous and muscular plans without previous colostomy. PMID- 3815653 TI - [Complications of the ritual circumcision]. AB - Over the last 8 years, 23 cases of complications following ritual circumcision in home surroundings have been admitted for treatment. Patients were seen either as emergencies for immediate complications, sometimes serious, requiring recovery surgery or at a later stage for sequelae of variable severity. PMID- 3815654 TI - [Anorectal malformations. Classification]. PMID- 3815656 TI - [Anorectal malformations. Multicenter study]. PMID- 3815655 TI - [Place of endoscopy in anorectal malformations]. AB - Miniaturised cystoscope allows exploration in neonates, but in males, it may be difficult and dangerous. Recto-urinary fistulae are generally recto-prostatic, seldom recto-bulbar. Recto-vesical cases were not observed. The fistulous orifice is quite always small and its form is round or ovoid. An anfranctuous and large orifice may be of iatrogenic origin. Endoscopic examination is mandatory when recto-urinary fistula is clinically or radiologically suspected and is always necessary before surgery of cloaca or secondary operation for ano-rectal malformations. PMID- 3815657 TI - [Definitive surgery in the neonatal period, without preliminary diversion, of high anorectal malformations. Results]. PMID- 3815658 TI - [Treatment of high and intermediate anorectal imperforations]. PMID- 3815660 TI - [Mucous ectropion and anal prolapse. Therapeutic possibilities]. PMID- 3815659 TI - [Anorectal malformations. Rectal lowering by sacro-perineal approach. Stephens' technic]. PMID- 3815661 TI - [Genital tract anomalies in anorectal malformations]. AB - Of 131 patients with imperforate anus, 16 girls (25%), 10 boys (15%) have an abnormality of the genital tract and real frequency seems under evaluate. In girls, vaginal septum, bicornuate and didelphys uterus are mostly diagnosed, associated with severe unilateral upper urinary tract malformations. Absent vagina and uterus (Rokitansky syndrome) must be seen at birth, to preserve perineal fistula used to fashion a vagina at the time of the abdomino-perineal pull through. In our 3 cases upper urinary tract was normal. In boys, uretero-vas deferens anastomosis must be documented by vesiculo-deferentography when orchi epididymitis or unilateral renal agenesis is demonstrated. PMID- 3815662 TI - [A case of syphilitic uveitis disclosing secondary syphilis]. PMID- 3815663 TI - [Congenital glaucoma treated by hemitrabeculectomy-trabeculotomy]. PMID- 3815664 TI - [Tolosa-Hunt syndrome in a child, as a manifestation of meningioma]. PMID- 3815665 TI - [Bilateral ischemic optic neuropathy suggestive of Horton's disease in a 40-year old woman]. PMID- 3815666 TI - [Value of secondary implantation]. PMID- 3815667 TI - [Indications for early surgery of open-angle glaucoma?]. PMID- 3815668 TI - [Gouty tophus of the eyelid]. PMID- 3815669 TI - [Adaptation of keratoconus using a new formula calculated by biometric moulage]. PMID- 3815670 TI - [High risk subjects: general or local anesthesia?]. PMID- 3815672 TI - [Transconjunctival approach in lower blepharoplasties]. PMID- 3815671 TI - [Idiopathic intracranial hypertension. Apropos of 2 cases]. PMID- 3815673 TI - [A case of papillitis of probable focal origin]. PMID- 3815674 TI - [The risk of recurrence of focal chorioretinitis depends on Toxoplasma serology]. PMID- 3815675 TI - [A case of atypical dural arteriovenous fistula with ophthalmologic manifestations]. PMID- 3815676 TI - ["Keratocorrection" or the corrective surgery of astigmatism]. PMID- 3815677 TI - [Round table: Preoperative treatment of exotropia without amblyopia]. PMID- 3815678 TI - [Quantitative and qualitative changes in tears of persons working in an air conditioned atmosphere]. PMID- 3815679 TI - [Congenital toxoplasmosis with eye lesions occurring in women with monitored pregnancy]. PMID- 3815680 TI - [Wide-angle contact lens based on Dudragne's principle. A very useful and little known instrument]. PMID- 3815681 TI - [Retinography using contact lens based on Dudragne's principle in veterinary medicine]. PMID- 3815682 TI - [HLA A-29--inflammatory retinal vasculitis and birdshot retinopathy]. PMID- 3815683 TI - [Epidemiological study of ophthalmologic emergencies at E. Herriot Hospital. A 1 year analysis]. PMID- 3815684 TI - [Pars planitis and retinal detachment]. PMID- 3815685 TI - [Pars planitis and multiple sclerosis]. PMID- 3815686 TI - [Corneal endothelium and surgery of the anterior segment]. PMID- 3815687 TI - [Post-radiotherapy retinopathy]. PMID- 3815688 TI - [Glaucoma and short-term changes in the visual field]. PMID- 3815689 TI - [Retinal tears and inflammation of the vitreous body. Epidemiologic approach]. PMID- 3815690 TI - [Voluminous intra-orbital ectopic conjunctival cyst]. PMID- 3815691 TI - [Conservative treatment of malignant choroid melanoma by scleral applicators of ruthenium-106. First 25 French cases]. PMID- 3815692 TI - [Clinical and electro-oculographic signs of esotropia with latent manifest nystagmus]. PMID- 3815693 TI - [New aspects of traumatic pathology. Eye injuries caused by lead shot]. PMID- 3815694 TI - [Pseudotumoral aspects of thyroid myopathies in x-ray computed tomography]. PMID- 3815695 TI - [Endocrine ophthalmopathy. A play in 4 acts with an 18-year follow-up]. PMID- 3815696 TI - [Unusual retinal aspect disclosing an inflammatory pseudotumor of the orbit]. PMID- 3815697 TI - [Choriocapillary occlusion in a case of Moschowitz's disease]. PMID- 3815698 TI - [Unusual aspects of vanishing points in central serous retinopathy associated with serous detachment of the pigment epithelium]. PMID- 3815699 TI - [Retinal detachment with extensive retraction. Treatment by scleral buckling and vitrectomy. Preliminary results]. PMID- 3815700 TI - [Course of the surgical treatment of cataract in the adult. Apropos of 100 consecutive cases]. PMID- 3815701 TI - [Artificial lenses in the posterior chamber. Results of 150 first cases]. PMID- 3815702 TI - [The picosecond YAG laser. Evaluation after a year's use]. PMID- 3815703 TI - [Epithelial corneal thesaurismosis and contact lenses]. PMID- 3815704 TI - [A case of amyloidosic glaucoma. Clinical and anatomo-pathological study]. PMID- 3815705 TI - [Periphlebitis and multilocular sclerosis]. PMID- 3815706 TI - [Principle variations of the ophthalmic artery]. PMID- 3815707 TI - Children in competitive sports--a multi-disciplinary approach. AB - This article is divided into two parts: Part 1 consists of the position stand of The Canadian Association of Applied Sport Sciences on the involvement of children in competitive sports, and Part II presents scientific background and rationale pertinent to the position statements. Each part is divided into major categories reflecting the multi-disciplinary concerns of the participation of pre- and post pubescent children in sport situations at all levels. Psychological considerations focus on the child learning a sense of competence and control through sport participation. Success in a sport should not be based solely on winning, but on one's own performance and attained goals. Sport involvement can provide one important avenue for a child's social development. Non-aggressive behaviour and a constructive problem-solving approach should be encouraged. Any form of discrimination towards sport participation or competition should be discouraged. From the physiological and medical point of view, it should be recognized that each child is different in his/her response and tolerance to exercise due to a great range of variability in growth rates, anthropometric indices, gender and state of health, even in children of a similar chronological age. Younger prepubertal children should be encouraged to participate in a wide variety of motor skills, whereas older post-pubertal children can become more specialized in their training and sport participation. A child's performance and adaptation to training should not be directly compared to an adult's as significant differences exist, especially during the years of accelerated growth. Environmental exercise tolerance is also more limited to children than adults. In younger children repetitive heavy loading of the musculoskeletal system should be approached with caution. With proper equipment design and usage, and rule modifications, serious injuries can be avoided. Medical disabilities should be evaluated on an individual basis and should not necessarily preclude a child's participation. Teachers, parents and coaches should have a thorough understanding of the implications of children involved in sports and adhere to the recommendations reviewed in this statement. PMID- 3815708 TI - Posterior cruciate ligament tears in wrestlers. AB - Two cases of isolated injury to the posterior cruciate ligament of the knee are presented. These injuries both occurred in elite wrestlers, members of the Canadian Pan American Team. The mechanism of injury was identical in both cases- the ligament rupture being a result of forced flexion with combined internal rotation of the tibia on femur. A review of the literature is added with a suggestion for conservative treatment as the initial and perhaps definitive management for this problem. PMID- 3815709 TI - [Hormonal responses to repeated lactic acid anaerobic exercise in male subjects]. AB - The hormonal response to repeated lactic acid anaerobic exercise was investigated in 6 young male adults. The exercise protocol consisted of 3 one-minute bouts of voluntary maximal effort, each bout being separated from the subsequent one by a two-minute rest period. Venous blood samples were obtained at rest and at the end of each of the 3 work bouts, as well as following 15 minutes of recovery. A marked increase in plasma catecholamine concentrations was observed in response to the repeated exercise bouts, the rise being more important for the adrenaline (x 22) than the noradrenaline (x 10) concentrations. A progressive increase in plasma somatotropin hormone was observed between the first and the last venous sampling. Moreover, a delayed rise in plasma cortisol, insulin, prolactin, and androstenedione was also observed. Hormonal concentrations of LH, FSH, DHEA-SO4, testosterone, SHBG and testosterone/SHBG ratio were not modified in response to the type of exercise. PMID- 3815710 TI - [Decision strategy: effect of the proportion of total response time taken by choice reaction time]. AB - Results from two series of studies on decision strategies suggested that subjects appeared to chose between two response modes. Subjects could use a decision strategy based either on anticipatory responses or on reaction responses. It appeared that certain characteristics specific to the task could be responsible for the discrepancy in the response mode. The aim of the present study was to ascertain whether the choice of a decision strategy could be dictated by the proportion of total response time taken up by the choice reaction time (TRC). For instance, if the TRC takes up a large proportion of the total time, reducing it in view of an anticipatory response could considerably reduce the total time. The advantage to be gained from an anticipatory response could thus be considered sufficient to warrant adoption of a decision strategy based on anticipation. On the contrary, when TRC takes up only a small portion of total time, a decision strategy based upon reactions is preferred since the cost related to an error in response would largely exceed the advantage related to anticipation. Results from the two series of experiments presented in this paper support the importance of this variable. More specifically, results revealed that the error that an individual allows himself to make depends upon the proportion of total time that is devoted to choice reaction time. An extension of the model presented by Proteau et al. is proposed in order to account for the present observations. PMID- 3815711 TI - The relationship between selected psychological traits and fear of success in senior elite level wrestlers. AB - The present study sought to examine the relationship between selected psychological traits as measured by the Institute for Personality and Ability Testing (IPAT) 16 PF inventory and fear of success as measured by the Fear of Success Scale (FOSS). The subjects were 36 Senior elite wrestlers (age 20-25) who were invited to the Colorado Springs Olympic Training Center to prepare for an up coming inter-national competition. A stepwise multiple regression analysis revealed that the following 16 PF factors predicted fear of success (p less than .05): IPAT-Q4, IPAT-L, IPAT-E, and IPAT-O. The multiple R was .75 and the R2 was 57.78%. Interpretation of the results suggest that while this sample of Senior elite wrestlers generally exhibit extremely low fear of success scores, athletes who are tense, frustrated, apprehensive, submissive, humble, and trusting tend to be more fearful of the consequences of success than those who are relaxed, unfrustrated, self-assured, assertive, competitive, and suspecting. PMID- 3815712 TI - Effects of stride length alteration on racewalking economy. AB - This study investigated the effects of stride length (SL) manipulation on racewalking economy in 7 competitive racewalkers. Following two test sessions in which VO2 max and freely-chosen stride length (FCSL) were determined, each subject completed 6-min racewalking bouts at five randomly-ordered SL conditions (FCSL and -10%, -5%, +5%, and +10% of leg length from the FCSL) while walking at a velocity approximately equal to their 10 km training pace. Actual and predicted group mean VO2 values for the five SL conditions indicated that the subjects were most economical walking at the FCSL, with progressively higher energy costs manifested at the +5% and -5% and the +10% and -10% leg length conditions, respectively. A mean absolute difference in VO2 of 0.6 ml X kg-1 X min-1 was observed between subjects' FCSL and optimal SL. Linked with this deviation in VO2 was a mean absolute SL difference of 3.2 cm (3.6% of mean leg length). These data support the hypothesis that trained subjects select locomotion patterns that are nearly optimal in terms of the aerobic demands. PMID- 3815713 TI - Laboratory and on-ice test comparisons of anaerobic power of ice hockey players. AB - The suitability of the Wingate Anaerobic Test (WAT40) as a laboratory measure of anaerobic capacity (AnCap) and power (AnPow) of ice hockey players was tested against the Reed Repeat Sprint Skate-RSS (1979) and the Sargeant Anaerobic Skate (SAS40). Twenty-four university and Junior A players (20.2 +/- 1.6 years), assigned by random draw, performed the three tests over a seven day period. Blood lactate taken from an unwarmed finger tip was used to assess work intensity. The AnCap (7.7 +/- 0.2 Watts X kg-1) and AnPow (10.1 +/- 0.2 Watts X kg-1) for WAT40 were significantly lower (p less than 0.05) than for RSS (AnCap 9.3 +/- 0.8 Watts X kg-1; AnPow 11.5 +/- 1.1 Watts X kg-1) and SAS40 (AnCap 9.7 +/- 0.8 Watts X kg 1; AnPow 11.9 +/- 1.8 Watts X kg-1). SAS40 was significantly higher (p less than 0.05) than RSS for both AnCap and AnPow. The RSS (r = 0.96; ME 4.5%) and SAS40 (r = 0.97; ME = 3.6%) showed excellent test-retest reliability and reproducibility for AnCap but were only fair on AnPow (RSS: r = 0.73; ME = 10.7%; SAS40: r = 0.65; ME = 18.4%). While the correlations among the tests (AnCap: SAS40 vs WAT40, r = 0.73; RSS vs WAT40, r = 0.69) were significant (p less than 0.05), the highest predictive capability estimate (r2) was only 53.3%. The correlations for blood lactates (WAT40: 10.8 +/- 1.5 mmol X l-1; SAS40: 10.7 +/- 1.9 mmol X l-1; RSS: 11.5 +/- 1.6 mmol X l-1) were not significant. Based upon the particular protocol used, the laboratory test WAT40 does not demonstrate a high relationship with on-ice measures of AnCap and AnPow in this group of ice hockey players. PMID- 3815714 TI - Phase II study of ifosfamide + adriamycin in advanced soft tissue sarcoma in adults. A preliminary analysis. PMID- 3815715 TI - Alternatives to CYVADIC combination therapy of soft tissue sarcomas. AB - The CYVADIC combination has been the preferred treatment for soft tissue sarcomas for the last 10 years. Other combination therapies are necessary, because the remission rate achieved with CYVADIC is only 30%. Alternative therapies for these tumors are combinations including cis-platinum, ifosfamide, epipodophyllin, and high-dose methotrexate. Our therapeutic results with combinations of cis-platinum and ifosfamide are comparable to those achieved with CYVADIC. However, the side effects, such as nausea, vomiting and fatigue, of cis-platinum used in the palliative treatment of these tumors are intolerable for many patients. A combination of adriamycin and ifosfamide, which leads to a higher remission rate of 44% and has lower toxicity than CYVADIC, is giving encouraging results. PMID- 3815716 TI - The role of ifosfamide in paediatric soft tissue sarcomas. AB - Early clinical trials in adults showed favourable results of ifosfamide (IF) in several tumours. In a previous study we used IF and vincristine (VCR) and observed 6 complete responses (CR) among 25 previously heavily treated children. Especially patients with rhabdomyosarcoma (RMS) responded well, with 4 partial responses (PR) and 2 CR among 6 patients. This and the fact that the combination of VCR, actinomycin D (ACD) and cyclophosphamide (CYT) still give good results in RMS patients led us to replace CYT with IF in this combination. This IVA protocol consists of IF 3000 mg/m2 i.v. in 1 h on days 1 and 2, VCR 1.5 mg/m2 by i.v. push on day 1, and ACD 900 micrograms/m2 by i.v. push on days 1 and 2. The course is repeated at 28-day intervals. VCR 1.5 mg/m2 is given on day 14. We used this protocol als induction therapy in 18 newly diagnosed RMS patients. The primary sites were: abdomen (4 patients), bladder and prostate (3), head and neck (9: orbita 5), extremity (1), chest wall (1). At diagnosis, 9 patients had stage I, 4 stage II and 5 stage IV disease. Except for one mixed mesodermal type, all were of the embryonal type. The patients age at diagnosis varied from 2 to 16 years. After three courses, in some patients surgery was performed if radical tumour extirpation seemed possible. The first evaluation took place after three courses. At this point one patient had no response, one had a reduction in tumour mass of less than 50% (partial response PR), 9 patients had greater than 50% tumour reduction (good partial response [GPR]), and 7 were in complete remission (CR). In 2 of these 7 (CR) no tumour was found on histopathological examination of the specimen. In patients with GPR or CR therapy was continued for 6 months and then stopped. Thirteen patients have been disease-free for 1-20 months from the date of CR. Four patients relapsed 4, 6, 11 and 11 months after CR. There was one therapy-related death. Except for this patient no major toxicity was encountered. These results indicate that by replacing CYT with IF, remission induction can be improved with a major contribution to survival and to enhanced quality of life in these patients. PMID- 3815717 TI - A phase II study of ifosfamide in the treatment of recurrent sarcomas in young people. AB - We have evaluated the activity of ifosfamide in 75 patients with recurrent sarcomas and pediatric solid tumors. All patients had previously received cyclophosphamide in combination with other chemotherapeutic agents. Ifosfamide was administered as a continuous 5 day infusion at a dose of 1800 mg per M2, except in the last 14 patients who received the drug as a daily one hour infusion at the same dose level. Partial response was observed in 9 of 20 patients with Ewing's sarcoma, 2 of 9 patients with rhabdomyosarcoma, 3 of 17 patients with osteogenic sarcoma and 4 of 29 patients with various other neoplasms. A further 6 patients had stable disease, defined as the absence of progression for at least 6 cycles of therapy. Thus overall response rate was 24%, with the highest response rate of 45% being observed in Ewing's sarcoma. Toxicity was acceptable, although there was quite marked leucopenia (median nadir 700) with less profound thrombocytopenia (median nadir 87,000). Sepsis occurred in 3 patients but no patient died as a result of infection. Hematuria occurred in 43% of patients who did not receive mesna, and in 26% of patients who did, although prior pelvic irradiation was found to be a significant risk factor for hematuria. Only 1 of 14 patients without prior pelvic irradiation or hematuria developed hemorrhagic cystitis when treated with ifosfamide and mesna. Confusional states developed in 6 patients. We conclude that ifosfamide is an active agent in patients with relapsed sarcomas and childhood solid tumors, even when such patients have been previously treated with cyclophosphamide. PMID- 3815718 TI - VP 16 plus ifosfamide plus cisplatin as salvage therapy in refractory testicular cancer. AB - In patients with refractory germ cell tumour who fail to achieve complete remission (CR) or which achieve CR but subsequently experience disease progression within 2 months of receiving cisplatin + vinblastine + bleomycin (PVB) the results of further treatment are poor. Similarly, third-line therapy after cisplatin with VP 16 salvage rarely produces clinically significant remission. From February 1983 to October 1984 we treated 53 patients with ifosfamide (1.2 g/m2 per day on days 1-5), VP 16 (75 mg/m2 per day on days 1-5), cisplatin (20 mg/m2 per day on days 1-5), and N-acetylcysteine (2.0 g p.o. every 6 h on days 1-7). This was repeated every 21 days for four to six cycles. One group of patients (group A, 20 pts) had achieved partial remission (PR) but still had nonresectable tumours after PVB therapy; a further group (group B, 4 pts) had achieved CR with PVB but then experienced disease progression within 2 months; the remaining patients (group C, 28 pts) had experienced disease progression after one or more salvage attempts, including therapy with cisplatin and VP 16. Of the original 53 patients, 51 were evaluable for response. Toxicity included moderate to severe myelosuppression in almost all patients, fever/sepsis in 8, creatinine greater than or equal to 6 mg% in 4, and hematuria in 4 patients. There were no drug-related deaths. CR was attained in 17/51 patients (34%), these being 8/20 in group A, 1/4 in group B, and 8/28 in group C, and 10 patients have remained in CR for periods ranging from over 1 month to over 17 months. PR was achieved in 20 patients (40%), but their median duration of remission was only 2 months. We feel these results, obtained in a poor-prognosis patient population, are sufficiently encouraging to warrant further study of this regimen, including investigation of its use as initial salvage therapy following PVB. PMID- 3815719 TI - Ifosfamide chemotherapy for pancreatic carcinoma. AB - From April 1982 through February 1984, 29 patients with pancreatic cancer were treated with ifosfamide (1.25-1.5 g/m2 on days 1-5) + N-acetylcysteine (NAC) 2 g p.o. every 6 h on days 1-7 every 3 weeks. In responding patients without serious toxicity, subsequent courses of ifosfamide were escalated every 3 weeks by 0.25 g/m2 per day to a maximum of 2 g/m2 per day, with escalation of NAC to 12 g/day. Patients with KPS less than 50, serum creatinine or bilirubin greater than 2 mg/d 1, or obstructive uropathy were ineligible. The median age was 54 (range 36-78), median KPS 70, and median pretreatment weight loss 9 kg. Toxicity included nausea, vomiting, moderate myelosuppression, and occasional mental confusion. Hematuria (greater than 11 RBC/HPF) developed in only 1/29 courses (17 patients) of ifosfamide at greater than or equal to 1.75 g/m2 per day, and in 7/52 courses (27 patients) overall (13%). Of 27 evaluable patients 6 responded (22%), including 1 with complete response. The median survival was 6 months. Based upon these results, we are currently evaluating ifosfamide + 5-fluorouracil in pancreatic cancer. PMID- 3815720 TI - Comparative studies of DNA cross-linking reactions following methylene dimethanesulphonate and its hydrolytic product, formaldehyde. AB - The technique of alkaline elution was employed to study the interactions of methylene dimethane sulphonate (MDMS) and formaldehyde (HCHO) with DNA from Yoshida lymphosarcoma cells treated with these agents. MDMS and HCHO produced a proteinase sensitive filter retention which indicated the presence of DNA-protein cross-links. MDMS also produced some proteinase K-resistant filter retention which was believed to indicate DNA-interstrand cross-linking, whilst only single strand breaks could be detected following treatment with HCHO. Co-incubation with semicarbazide prevented all DNA-protein cross-links induced by MDMS and HCHO as well as single-strand breaks, most obvious following HCHO treatment. Semicarbazide also reduced HCHO-induced cytotoxicity in the Yoshida lymphosarcoma cell line, while no significant alteration in MDMS-induced cytotoxicity was observed. These results suggest that HCHO-induced DNA-protein cross-links and single-strand breaks do not contribute to MDMS-induced cytotoxicity, and therefore the small but significant level of MDMS-induced DNA-interstrand cross links is the most likely cytotoxic lesion of this agent. PMID- 3815721 TI - The effect of the two epipodophyllotoxin derivatives etoposide (VP-16) and teniposide (VM-26) on cell lines established from patients with small cell carcinoma of the lung. AB - To determine whether there is any difference between the two epipodophyllotoxin derivatives etoposide and teniposide in their therapeutic effect in small cell carcinoma of the lung (SCCL), they were compared against five human SCCL cell lines in vitro. When the two were compared at equimolar concentrations teniposide was found to be 8-10 times more potent than etoposide, both with 1-h incubation and with continuous incubation in a clonogenic assay and in inducing cell cycle perturbations monitored by flow cytometry. Published pharmacokinetic data suggest that this potency difference is not accompanied by an equivalent increase in toxicity. The concentrations used for the 1-h incubation were about 100-fold the concentrations used in the experiments with continuous incubation to obtain the same degree of cell kill for both drugs. This suggests that they should be given according to a continuous rather than an intermittent schedule. PMID- 3815723 TI - Effect of verapamil on daunorubicin accumulation in Ehrlich ascites tumor cells. AB - Previous studies have demonstrated that verapamil may overcome resistance to anthracyclines. In vitro and in vivo experiments were performed on wild-type and resistant Ehrlich ascites tumor cells. Verapamil in concentrations of 25-50 microM enhances the accumulation of daunorubicin (DNR) in resistant cells to the same level as in wild-type cells. No significant effect of verapamil on influx or nuclear binding could be demonstrated, indicating that verapamil enhances DNR uptake by blocking active drug extrusion. Exposure of cells to a high concentration of Ca2+ did not influence the effect of verapamil on DNR accumulation, suggesting a different mode of verapamil action apart from the Ca2+ blocking effect. Attempts to circumvent acquired resistance to DNR in vivo with verapamil showed that the combination of the two drugs was more toxic than DNR given alone. The LD10 of DNR was determined as 3 mg/kg and the LD10 of the combination, as 2.5 mg/kg. The therapeutic effect of verapamil at a dose of 50 mg/kg and DNR of 2.5 mg/kg increased the life span of the mice by 50%. No difference was seen in the wild-type tumor in vivo. These data lead us to conclude that verapamil can reverse DNR resistance completely, but that verapamil at non-toxic dosage only reduces DNR resistance by 50% in vivo. PMID- 3815722 TI - The role of methionine in methotrexate-sensitive and methotrexate-resistant mouse leukemia L1210 cells. AB - A mouse L1210 leukemia cell line was made 25-fold resistant to methotrexate (MTX) and had altered methionine transport and metabolism. L1210 cells resistant to methotrexate also had a 50-fold decrease in the exogenous methionine requirement for optimal cell growth compared to the parent cells. This change in methionine requirement was associated with differences in methionine metabolism between MTX sensitive and MTX-resistant cell lines. Analysis of amino acid transport systems revealed different Kt and Vmax properties of methionine and nonmetbolizable amino acid analogues. There was a greater than twofold decrease in the initial sodium dependent uptake of methionine in the resistant cells. Amino acid competition experiments revealed altered substrate specificities in the resistant cells. The cellular alterations occurring upon resistance may result from methotrexate membrane interactions, and have been previously observed in cisplatinum-resistant cells. Thus modulation of methionine metabolism may provide the biochemical basis for MTX and cisplatinum collateral resistance. PMID- 3815724 TI - The enterohepatic circulation of methotrexate in vivo: inhibition by bile salt. AB - We examined the enterohepatic circulation of methotrexate (MTX) in the rat in vivo and determined the effect of the unconjugated bile salt, cholate, on the process. MTX (70 mg/kg body weight) was administered i. v. and the bile salt (1 mM) was delivered through intestinal perfusion. In the control group 38.43% +/- 4% of the administered dose of MTX appeared in bile 2 h after administration of the drug. In the bile salt-treated group 21.4% +/- 3.7% of the administered doses of MTX appeared in bile, which was significantly lower (P less than 0.01) than the proportion in the control group. The liver content of MTX was depressed by 23% in the bile salt-treated group compared with the control group. This study demonstrates, in vivo, the important role that the enterohepatic circulation plays in exposing the small intestine to toxic levels of MTX and shows that the unconjugated bile salt, cholate, inhibits the process. PMID- 3815725 TI - Methotrexate kinetics in myeloid bone marrow cells and peripheral neutrophils. AB - The pharmacokinetics of methotrexate (MTX) in the proliferating and the maturing myeloid compartments of the bone marrow and in the neutrophils of the peripheral blood was investigated in four patients with malignant non-Hodgkin's lymphoma after treatment with 24-h MTX infusions (500-790 mg/m2) followed by leukovorin rescue. The myeloid bone marrow cells were separated into two fractions, using a two-step discontinuous Percoll gradient with densities of 1.076 and 1.095 g/ml. The upper fraction consisted predominantly of immature bone marrow cells plus lymphocytes, and the lower fraction contained the mature myeloid bone marrow cells. Cells in the proliferating (immature) myeloid compartment took up and retained MTX to a much greater extent than the mature myeloid cells and the neutrophils. Two days after the MTX infusion no MTX was detected in the neutrophils in spite of a general rise in the total neutrophil count. MTX reappeared in the neutrophils on day 8 in concentrations not related to the concentrations in the proliferating myeloid cells during the MTX infusion. The time of reappearance of MTX in the neutrophils was in accordance with the time it takes for cells in the proliferating pool of the bone marrow to mature and be released into the circulation. No neutropenia was seen after the MTX infusions. PMID- 3815726 TI - Effects of N-trifluoroacetyladriamycin-14-valerate (AD-32) on human bladder tumor cell lines. AB - We have compared the in vitro activity of N-trifluoroacetyladriamycin-14-valerate (AD-32) and doxorubicin hydrochloride (ADR) on the clonal growth of human bladder tumor cell lines (HBTCL). In order to determine the relatively toxicity of ADR and AD-32 on hematopoietic stem cells, CFU-GM assays were set up using 10 normal human bone marrow samples. The mean lethal dose for 50% of the colonies (LD-50) for ADR was 1.6 +/- 1.4 microM and that for AD-32, 3.9 +/- 4.9 microM (P less than 0.55), suggesting that these agents have similar bone marrow toxicity. Both drugs produced enhanced inhibition of clonal growth of HBTCL with increasing C X Ts. The spectrum of activity of the two drugs was similar against a panel of seven HBTCL. The activity of ADR was inhibited at 4 degrees C while the activity of AD-32 was unaffected by temperature. ADR was more effective against HBTCL in the log growth phase than the plateau phase while the reverse was found using AD 32. Verapamil was found to enhance the activity of both ADR and AD-32 against a HBTCL (T24), found to be resistant to both agents. The lipophilic properties of AD-32, along with its enhanced activity when used over prolonged periods of time and its activity against tumor cells in the plateau phase, suggest that AD-32 could be useful in the management of patients with superficial bladder cancer. PMID- 3815727 TI - Toxicity of 5-fluorouracil for aerobic and hypoxic cells in two murine tumours. AB - Chronically hypoxic cells in solid tumours are reported to be more slowly proliferating than aerobic cells situated closer to blood vessels. Cycle-active drugs such as 5-fluorouracil (5-FU) might be expected to have greater activity against rapidly proliferating aerobic cells. The effect of 5-FU was therefore assessed against aerobic and hypoxic cells in murine tumours; this was done by giving the drug alone or 1 h before irradiation of the tumour under aerobic or hypoxic conditions. Aerobic and hypoxic cells appeared to have equal sensitivity to 5-FU in the KHT and 16/C tumours, and the effect of a single dose of 5-FU was additive to that of radiation. PMID- 3815728 TI - Abrogation of the prognostic significance of low leukemic cell retention of cytosine arabinoside triphosphate by intensification of therapy and by alteration in the dose and schedule of administration of cytosine arabinoside. AB - The ability of leukemic cells to phosphorylate cytosine arabinoside (araC) and retain the triphosphate form of the drug (araCTP) is strongly predictive of remission duration for patients with acute nonlymphocytic leukemia who are treated with araC-based maintenance therapy. An increase in the intensity of therapy improves the overall median duration of remission, the increased intensity of therapy being especially beneficial for patients whose leukemic cells do not retain araCTP. This alteration in therapy reduces the prognostic significance of leukemic cell araCTP retention. Further, it seems that the use of high-dose araC as intensive consolidation therapy and the administration of conventional-dose araC by continuous infusion make it possible to further reduce or even abrogate the adverse prognostic significance of low leukemic cell retention of araCTP. PMID- 3815729 TI - Disposition of total and free cisplatin on two consecutive treatment cycles in patients with ovarian cancer. AB - The disposition of total and ultrafilterable cisplatin was determined in 12 women with ovarian carcinoma receiving cyclophosphamide 500 mg/m2, adriamycin 50 mg/m2 and cisplatin 50 mg/m2 during their first and second course. Plasma samples were obtained over 96 h following the completion of the cisplatin infusion and assayed for total platinum by atomic absorption spectroscopy. Plasma samples obtained up to 4 h after cisplatin infusion contained measurable ultrafilterable (free) cisplatin. The mean disposition of free cisplatin conformed to a two-compartment model with a mean terminal half-life (+/- SD) of 46.2 +/- 20.2 min during the first course and 37.8 +/- 18.0 min during the second course of therapy. The mean disposition of total cisplatin conformed to a three-compartment model with a mean terminal half-life (+/- SD) of 57.8 +/- 19.3 h during the first course and 86.6 +/- 33.3 h during the second course of therapy. We found that the mean total cisplatin levels were significantly higher during the second course than the first course and the total body clearance of total platinum decreased from the first to the second course. Divided urine collections were obtained over 24 h after completion of cisplatin infusion, but cisplatin was not always detectable at all time intervals. The total fraction recovered was 0.14 and 0.12 of administered dose after the first and the second course, respectively. Renal clearance was 0.61 +/- 0.32 l/h/m2 and 0.45 +/- 0.16 l/h/m2 for the first and the second course, respectively. We conclude that: urinary platinum excretion is variable between patients and with time; a trend to decreased renal clearance of platinum from first to second course may be due to a decrease in renal excretion of cisplatin; and the body's elimination pathways clear less platinum upon repeat administration. PMID- 3815730 TI - Phase I trial of combination therapy of cancer with N-phosphonacetyl-L-aspartic acid and dipyridamole. AB - While N-phosphonacetyl-L-aspartic acid (PALA), an inhibitor of de novo pyrimidine biosynthesis, demonstrated a unique spectrum of activity during preclinical drug evaluation, multiple clinical trials have shown it to possess minimal clinical activity. One explanation for the disappointing results is the possibility that tumor cells are able to utilize circulating uridine in the synthesis of pyrimidines (salvage pathway). Dipyridamole, an inhibitor of nucleoside transport, has been demonstrated experimentally to potentiate the cytotoxicity of PALA significantly. In addition, this agent has a long safety record when used clinically in man. A phase I trial of this two-drug combination was therefore conducted, with a fixed oral dose of dipyridamole (50 mg/m2 every 6 h) and an escalating i.v. dose of PALA administered every 3 weeks. The dose-limiting toxicity with this schedule was diarrhea and abdominal cramping pain at a PALA dose of 3900-4200 mg/m2. Among the 65 patients participating in this trial 4 objective responses (2 partial, 2 minimal) were observed. Because of the potential for unique clinical synergy between PALA and dipyridamole further investigation should be considered. PMID- 3815732 TI - Induction of anchorage-independent growth of mouse JB6 cells by cholera toxin. AB - Cholera toxin (CT) at concentrations of 0.1-100 ng/ml induced anchorage independent growth and DNA synthesis of JB6 cells derived from mouse epidermis. This induction was reversible. CT caused marked increase in the level of intracellular cAMP. Forskolin also increased the cAMP level and induced anchorage independent growth. However, 12-O-tetradecanoylphorbol-13-acetate (TPA) and 1 alpha,25-dihydroxyvitamin D3 [1 alpha,25(OH)2D3] induced irreversibly anchorage independent growth of JB6 cells but did not increase the cAMP level. TPA resistant clone-30 cells were also resistant to CT in terms of anchorage independent growth and cAMP induction. Retinoic acid inhibited the induction of anchorage-independent growth of JB6 cells by CT, TPA and 1 alpha,25(OH)2D3. These results suggest that anchorage-independent growth of JB6 cells is induced by cAMP dependent and cAMP-independent pathways, both of which may include a retinoic acid-sensitive step. PMID- 3815731 TI - Carcinogenic doses of methylnitrosourea induce dose response related delay in transit through S and G2 phases in mouse epidermis: a cell kinetic study. AB - The cell kinetic, tumorigenic and carcinogenic effects of the short acting, alkylating carcinogen N-methyl-N-nitrosourea (MNU) on hairless mouse epidermis were investigated. The epidermal mitotic rate, the mitotic index, and the number of basal and suprabasal cells were scored in histological sections. Incorporation of [3H]thymidine and flow cytometric analysis of cellular DNA and protein content were performed on isolated basal cells at intervals for up to 10 days after a single application of either 1 or 10 mg MNU. The ensuing tumor rates and yields were observed for up to 48 weeks after 1 mg MNU and 30 weeks after 10 mg MNU. Generally, MNU induced an initial delay in epidermal cell cycle progression with an accumulation of cells in the S and G2 phases. Some days after treatment the delayed cells were released and entered mitosis. One milligram MNU caused a moderate delay of cells in S and G2, lasting for 2-3 days, and this was followed by a release leading to an increased number of suprabasal cells on day 7. The highest dose of MNU caused a more pronounced delay in transit through S and G2 and seemed to be followed by rapid regenerative proliferation. The subsequent tumor crop after 10 mg was significantly higher than that seen after the lowest dose. The present cell kinetic results are consistent with previous data from the study of other carcinogens, all showing a carcinogen-induced initial reduction in DNA synthesis after appropriate doses. A delay in transit through G2 phase was found as well, indicating that a general delay in cell cycle progression may follow the application of most (or all) carcinogens. PMID- 3815733 TI - A cytological comparison between regeneration, hyperplasia and early neoplasia in the rat liver. AB - Regeneration, hyperplasia and neoplasia are three different responses to injury in the rat liver. These phenomena were induced in rat liver and the parameters of ploidy, nuclearity and DNA synthesis were examined. Analysis of hepatocytes from animals undergoing liver regeneration following two-thirds partial hepatectomy revealed that there is an increase in the cycling of diploid hepatocytes and a large increase in the frequency of binucleated tetraploid cells undergoing DNA synthesis and amitotic cytokinesis to mononucleated tetraploid cells. This results in an overall increase in the ratio of tetraploid:diploid cells but no change in the proportion of binucleated cells. The liver appears, temporarily, to undergo an increased rate of maturation. In both hyperplasia inducted by oral administration of 25 mg/kg methylclofenapate or diethylhexylphthalate (1 g/kg for 4 weeks) and neoplasia induced by the hepatocarcinogens 3'-methyl-4 dimethylaminoazobenzene (3'M), 6-p-dimethylaminophenylazobenzthiazole (6BT), 5 phenylazoindazole (5I), diethylnitrosamine (DEN) and thioacetamide (TA) the binucleated cell is sensitive to the action of the chemicals, although its response is different. Both types of carcinogen induce a reduction in the frequency of binucleated cells but the mononucleated diploid cells produced by cytokinesis without a preceding S phase as a result of the action of genotoxic carcinogens appear to be incapable of polyploidization and give rise to a liver with a permanently depressed tetraploid:diploid hepatocyte ratio. The nongenotoxic carcinogens methylclofenapate and DEHP cause an initial hyperplastic response due to the rapid conversion of binucleated cells to mononucleated tetraploids by amitotic cytokinesis following S phase. Over a longer period of exposure there is an increase in the tetraploid:diploid ratio due to the continued conversion of newly formed binucleates to tetraploid mononucleates. PMID- 3815734 TI - Biotransformation of aromatic amines to DNA-damaging products by urinary bladder organ cultures. AB - Urinary bladder is a target tissue for aromatic amine carcinogens. The intrinsic capacity of this tissue to form DNA-damaging products was investigated in explant cultures of bladder isolated from New Zealand white rabbits. DNA repair, measured by autoradiography, was used as the indicator of DNA damage. DNA repair was induced by 2-aminofluorene (2-AF) and its acetylated derivatives 2-acetyl aminofluorene and N-hydroxy-2-acetylaminofluorene. A positive response was observed with benzidine (BZD), but no repair was seen in cultures exposed to monoacetyl BZD or diacetyl BZD. These results indicate that rabbit urinary bladder has the ability to biotransform aromatic amines to DNA-damaging products and has the capacity to repair damaged DNA. Unlike liver, where activation of BZD seems to require N-acetylation, acetylated BZD in the bladder appeared to be a detoxification product. The lack of damage by acetylated BZD is consistent with activation of BZD in bladder by prostaglandin synthetase-mediated pathways. PMID- 3815735 TI - Relative activities of thymidylate synthetase and thymidine kinase in 1,2 dimethylhydrazine-induced colon carcinomas in rats. AB - Thymidylate synthetase (TS) and thymidine kinase (TK) are known to catalyse the methylation of dUMP for the de novo synthesis of dTMP and the phosphorylation of thymidine for the salvage synthesis of dTMP in the pyrimidine pathway, respectively. High TS and TK activities and the existence of TK isozymes have been observed in rapidly proliferating tissues. TS and TK activities in 1,2 dimethylhydrazine (DMH)-induced colon carcinomas in rats increased significantly to 331 and 207% of the activities in normal colon, respectively, and were well correlated inversely (y = -0.93x + 5.24), with a correlation coefficient of 0.787. The colonic TK isozymes were separated into two types by DEAE-cellulose column chromatography. The TK isozyme eluted from the column by the elution buffer alone without NaCl was markedly higher (23.6-fold) in activity in DMH induced colon carcinoma than in normal control colon and was not affected by deoxycytidine triphosphate. This isozyme, whose mol. wt is 100,000 by h.p.l.c., is thought to be closely involved in rapid DNA replication. These results indicate that early biochemical changes in DMH-induced colon carcinoma in rats may serve as a useful model and provide valuable insight into the mechanisms involved in colonic carcinogenesis. PMID- 3815736 TI - The sizes of cellular deoxynucleoside 5'-triphosphate pools in relation to sensitivity to electron irradiation using sensitive and resistant cell lines. AB - The deoxynucleoside 5'-triphosphate (dNTP) pool sizes have been determined before and after electron (e-) irradiation in sets of radiation sensitive and resistant cell lines. In the L5178Y mouse lymphoma radiosensitive line (LS), the dTTP pool fell 50% following irradiation, whilst the three other dNTP pools remained unaltered. On the other hand, for the radioresistant line (AII) all four dNTP pools increased by 2-to 3-fold. The dNTP pools of the Chinese hamster radiosensitive (V79) line and radioresistant (V79/79) lines were unaltered by the radiation, but a difference in pool size was present before irradiation, with the pools of the V79 cells being approximately twice those of the V79/79 cells. Two out of the three ataxia telangiectasia cell lines studied show reduced dNTP pools when compared with those of normal human fibroblasts and these pools were also unaltered by the radiation. In the L5178Y and Chinese hamster cells the levels of enzymes involved in the biosynthesis of dNTPs have been determined. In general the higher the level of ribonucleoside diphosphate reductase (RDR) the larger the cellular pools. The observed levels of RDR could, in part, explain the observed results. Increasing the dTTP pool by the addition of deoxythymidine and deoxycytidine to the cell culture with the V79/79 cells reduced their sensitivity to the radiation. These results indicate a relationship between a cell's sensitivity to e- irradiation and the sizes of the cellular dNTP pools. However, the exact nature of any such relationship is unknown. PMID- 3815737 TI - Dibenz [a,j]acridine: distributions of metabolites formed by liver and lung microsomes from control and pretreated rats. AB - The structures of many dibenz[a,j]acridine (DBAJAC) metabolites formed in vitro in incubations with liver microsomes prepared from 3-methylcholanthrene pretreated male Wistar rats have previously been determined; they were trans DBAJAC-3,4-dihydrodiol, trans-DBAJAC-5,6-dihydrodiol, DBAJAC-5,6-oxide, 3-hydroxy DBAJAC, 4-hydroxy-DBAJAC and several multiply oxidized secondary metabolites. Herein are reported [14-3H]DBAJAC metabolite distributions obtained by h.p.l.c. separation of products produced in incubations with liver and lung microsomes prepared from untreated, phenobarbital-pretreated and 3-methylcholanthrene pretreated male Wistar rats. Liver microsomal metabolites were also quantitated in preparations from trans-stilbene oxide-pretreated rats. For all preparations trans-DBAJAC-3,4-dihydrodiol, the candidate proximate carcinogen according to the bay-region theory of carcinogenesis, was the major metabolite (30-40%) while DBAJAC-5,6-oxide and phenols were also quantitatively important. In incubations conducted in the presence of 3,3,3-trichloropropene-1,2-oxide (1.5 mM) formation of dihydrodiol was inhibited by about 85%. DBAJAC-N-oxide was also identified as a minor metabolite (approximately 1%) formed in incubations with phenobarbital induced and control liver microsomes. PMID- 3815738 TI - Transfer of the tobacco-specific carcinogens N'-nitrosonornicotine and 4 (methylnitrosamino)-1-(3-pyridyl)-1-butanone and benzo[a]pyrene into the milk of lactating rats. AB - The extent to which some of the more prevalent and potent carcinogens in cigarette smoke could be transferred from circulating blood into the milk of lactating rats was determined. One hour after i.v. administration of benzo[a]pyrene (BaP), N'-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3 pyridyl)-1-butanone (NNK) to the dams, the levels of these carcinogens were determined in both blood and milk specimens. The average amount of radioactivity detected 1 h after administration of 14C-labeled BaP was 0.21% of the administered dose per ml of milk as compared with 0.17% per ml of blood. The amount of NNN in milk ranged from 0.20 to 0.36% of the administered dose per ml which closely paralleled the levels detected in blood. NNK is readily converted in vivo to 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). The sum of NNK and NNAL was similar in the blood and milk of treated dams. There was, however, a major difference in the ratio of NNAL/NNK as detected in milk and blood. The ratio of NNAL/NNK in blood ranged from 1.3:1 to 1.9:1 while the ratio in milk ranged from 2.4:1 to 3.3:1. In a comparative study of the levels of NNN in the blood and milk of lactating rats at less than 1.0, 20, 60, 120 and 240 min after administration, it was confirmed that similar concentrations of NNN are present in blood and milk 1 h after administration. These data indicate that these carcinogens, which are present in both cigarette smoke and tobacco, can be transferred into the milk of lactating rats. PMID- 3815739 TI - Methylation of DNA guanine during the course of induction of liver cancer in hamsters by hydrazine or dimethylnitrosamine. AB - Hydrazine is carcinogenic to the mouse and rat, but three earlier studies have reported no carcinogenicity of hydrazine in the hamster. Administration of hydrazine to mice, rats and hamsters results in rapid methylation of liver DNA guanine for which endogenous formaldehyde appears to be the source of the methyl moiety. Hamsters were given hydrazine sulfate at 170, 340 and 510 mg/l in the drinking water for 2 years [average dose of 4.6, 8.3 and 10.3 mg hydrazine (free base)/kg body wt over the 2-year period], during which levels of methylation of DNA guanine in liver, kidney and lung, and histopathologic examinations of these tissues were carried out; dimethylnitrosamine, as a positive control, was administered at 10 mg/l in the drinking water (average dose of 1.1 mg/kg body wt over the 4-month measurement period). Both 7-methylguanine and O6-methylguanine were readily detectable at 6 months exposure in hamsters given hydrazine or dimethylnitrosamine; in hydrazine-treated animals only trace amounts of these bases could be detected after 12 months exposure; these bases were again detected in liver DNA at exposure times of 18 and 24 months. Hepatocellular carcinomas were observed in hamsters treated at the highest dose of hydrazine sulfate after 78 weeks of exposure; the incidence of liver cancer was dose-related over the course of the experiment: 32% for hamsters exposed to 510 mg hydrazine sulfate/l, 12% for 340 mg/l and none at 170 mg/l. Hamsters given dimethylnitrosamine developed high levels of 7-methylguanine and even higher levels of O6 methylguanine and both liver cholangiocellular carcinomas (73% incidence), as reported before, and hepatocellular carcinomas (27% incidence), a new finding. These results demonstrate for the first time that hydrazine is a liver carcinogen in the hamster and provide new information regarding the accumulation of DNA damage during the entire induction period for the carcinomas. PMID- 3815740 TI - Hydrogen peroxide formation and DNA base modification by tumor promoter-activated polymorphonuclear leukocytes. AB - This report shows that generation of hydrogen peroxide (H2O2) by human polymorphonuclear leukocytes (PMNs) activated with tumor promoters of varying potency as first and second stage promoters correlates well with activities of these promoters in vivo. Those tested were 12-O-tetradecanoylphorbol-13-acetate (TPA), a complete promoter, 12-O-retinoylphorbol-13-acetate (RPA), a synthetic TPA derivative almost devoid of first stage activity in some strains of mice, and mezerein (Mez), a potent second stage and much weaker first stage promoter. Mez stimulated PMNs produced up to four times less H2O2, whereas RPA-stimulated PMNs produced up to 10 times less H2O2 than TPA-activated cells when used at concentrations between 0.5 and 15 nM to activate 7.5-8.5 X 10(4) PMNs/ml. Phorbol, a non-promoter, was totally inactive in this assay. Furthermore, the tumor promoter-activated PMNs caused formation of 5-hydroxymethyl-2'-deoxyuridine (HMdU) and thymidine glycol (dTG) in DNA co-incubated with those cells. The amounts of modified thymidines formed, particularly of HMdU, correlated well with first stage tumor promoting efficacy and with the amount of H2O2 that was generated by promoter activated PMNs. In comparison with TPA, Mez- or RPA stimulated PMNs induced formation of 25 or 70% less H2O2 and 30 or 75% less HMdU, respectively, under conditions favoring HMdU formation. Thus, formation of either H2O2 by tumor promoter-stimulated phagocytes or HMdU in DNA exposed to those activated cells may serve as a measure of potency as a first stage tumor promoter. Formation of modified bases such as HMdU in DNA might constitute the genetic change imparted by the first stage tumor promoters. PMID- 3815741 TI - Identification and analysis of a new tobacco-specific N-nitrosamine, 4 (methylnitrosamino)-4-(3-pyridyl)-1-butanol. AB - A new tobacco-specific N-nitrosamine, 4-(methylnitrosamino)-4-(3-pyridyl)-1 butanol (iso-NNAL) was isolated from snuff tobacco. Structural characterization of this N-nitrosamine was confirmed by mass spectral analysis. Five popular US brands of moist snuff and three popular US brands of dry snuff tobacco were analyzed for moisture, nicotine and tobacco-specific N-nitrosamines. The moisture content varied from 20 to 53% in moist snuff and from 4.7 to 5.6% in dry snuff. The nicotine levels in these samples varied from 0.6 to 3.2%. The newly identified iso-NNAL was present in concentrations ranging from 0.07 to 2.5 p.p.m. whereas other tobacco-specific N-nitrosamines, N-nitrosonornicotine, N nitrosoanatabine, N-nitrosoanabasine and 4-(methylnitrosamino)-1-(3-pyridyl)-1 butanone were found to range from 0.1 to 178 p.p.m. Iso-NNAL was not detected in mainstream and sidestream smoke of cigarettes. Iso-NNAL is genotoxic in primary rat hepatocytes; its tumorigenic properties are currently being tested in mice and rats. PMID- 3815742 TI - Initiation of hepatocarcinogenesis in infant male B6C3F1 mice by N-hydroxy-2 aminofluorene or N-hydroxy-2-acetylaminofluorene depends primarily on metabolism to N-sulfooxy-2-aminofluorene and formation of DNA-(deoxyguanosin-8-yl)-2 aminofluorene adducts. AB - Previous work from this laboratory provided strong evidence that N-sulfooxy-2 aminofluorene is the major ultimate electrophilic and carcinogenic metabolite of N-hydroxy-2-acetylaminofluorene (N-hydroxy-AAF) in the livers of infant male B6C3F1 (C57BL/6J X C3H/HeJ F1) mice. Over 90% of the hepatic DNA adducts in these mice consisted of N-(deoxyguanosin-8-yl)-2-aminofluorene [N-(dGuo-8-yl)-AF] and less than 10% were deoxyguanosinyl adducts containing 2-acetylaminofluorene (AAF) residues. In the present study hepatic DNA adduct formation and tumor initiation by N-hydroxy-2-aminofluorene (N-hydroxy-AF) were examined in these mice. N-(dGuo 8-yl)-AF was the only adduct detected in the hepatic DNA; the level at 9 h after a single i.p. dose of 0.04 or 0.06 mumol/g body wt of [3H]N-hydroxy-AF was 1.0 or 1.7 pmol/mg DNA. Pretreatment with a single i.p. dose (0.04 mumol/g body wt) of the sulfotransferase inhibitor pentachlorophenol (PCP) decreased the DNA adduct level by greater than 80%. Similar levels of this adduct were found by 32P postlabeling analysis of DNA from mice treated with unlabeled N-hydroxy-AF. The liver DNA of infant male brachymorphic B6C3F2 mice [deficient in 3' phosphoadenosine-5'-phosphosulfate (PAPS)] contained only 0.3 pmol/mg DNA of N (dGuo-8-yl)-AF after an i.p. dose of 0.06 mumol of N-hydroxy-AF/g body wt, while their phenotypically normal (PAPS-sufficient) male littermates had 1.9 pmol/mg DNA. A single i.p. dose of 0, 0.015, 0.03, 0.06 or 0.12 mumol/g body wt of N hydroxy-AF in infant male B6C3F1 mice induced by 10 months an average of 0.2, 2.5, 7, 11 or 14 hepatomas/mouse. Pretreatment with PCP reduced the liver tumor multiplicity at each dose level by greater than 80%. Essentially the same average tumor multiplicities and inhibitions of tumor formation by PCP pretreatment were obtained following injections of N-hydroxy-AF or N-hydroxy-AAF at the three lower dose levels. Collectively these data strongly indicated that N-sulfooxy-2 aminofluorene is the major ultimate electrophilic and carcinogenic metabolite of N-hydroxy-AF in the livers of infant male B6C3F1 mice. Furthermore, since only N (dGuo-8-yl)-AF adducts were found in the hepatic DNA these lesions appear to be critical in the initiation of hepatocarcinogenesis in these mice by N-hydroxy-AF. PMID- 3815743 TI - Single GST-P positive liver cells--putative initiated hepatocytes. AB - Immunohistochemical investigation of liver tissue 48 h after single doses of the hepatocarcinogens diethylnitrosamine (DEN), dimethylnitrosamine, aflatoxin B1 and methylazoxymethanol acetate revealed the generation of a population of single glutathione S-transferase placental form (GST-P) positive hepatocytes. Yield was carcinogen dose dependent. Although the mixed function enzyme inducers sodium phenobarbital (PB), methylcholanthrene (Mech), polychlorinated biphenyls (PCB) and isosafrole (IS) did not in themselves induce comparable single cell lesions, their application prior to DEN caused significant alteration in the resultant numbers of GST-P positive hepatocytes observed. While PB and IS were associated with decreased yield, Mech and PCB, in contrast, brought about an increase. The results gained from investigation of the effects of 3-aminobenzamide administration and partial hepatectomy carried out at different times after carcinogen treatment also pointed to an 'initiated' character for the lesions and suggest that GST-P may be a useful marker for analyzing factors relevant to the initiation stage of hepatocarcinogenesis. Thus the interplay between carcinogen metabolism, DNA adduct formation and repair, toxicity and proliferation may be assessable in terms of numbers of enzyme-altered solitary hepatocytes. PMID- 3815744 TI - Diallyl sulfide, a flavor component of garlic (Allium sativum), inhibits dimethylhydrazine-induced colon cancer. AB - Diallyl sulfide, a thioether found naturally in garlic, when given by gavage to C57BL/6J mice inhibited by 74% the incidence and reduced the frequency of colorectal adenocarcinoma induced by 20 weekly injections of 1,2 dimethylhydrazine. This result was predicted from a short-term assay measuring defects in nuclear morphology in mouse colon epithelial cells. This chemical is representative of a class of naturally occurring sulfur compounds with profound pharmacologic activity, one aspect of which may be cancer prevention. PMID- 3815745 TI - Isolation and characterization of parenchymal cells from normal and cirrhotic rat liver. AB - A technique is described for isolation of adult rat hepatocytes from micronodular cirrhotic livers based on a collagenase digestion procedure. Hepatocytes from normal livers and those chronically injured by thioacetamide did not differ with respect to the viability measured by the trypan blue exclusion test or to the cellular concentrations of protein and glycogen, but the triglyceride content of cells from cirrhotic livers was significantly reduced. Hepatocytes isolated from cirrhotic livers are ultrastructurally in a good state of preservation but they appear to be poorer than controls in RER membranes, although the well-preserved mitochondria are somewhat richer in cristae. No differences were detected between the cell preparations in rates of gluconeogenesis and total de novo fatty acid synthesis, but the secretion of newly synthesized fatty acids was significantly reduced in cells from cirrhotic livers. Thus adult rat hepatocytes can be isolated from thioacetamide-induced micronodular cirrhotic livers with high yield and morphological integrity. Differentiated functions are maintained in suspension for at least 4 h. PMID- 3815746 TI - Growth hormone binding and stimulation of amino acid uptake in epithelial cells of rat ventral prostate. AB - The binding of [125I]-human growth hormone (hGH) was studied in epithelial cells isolated from rat ventral prostate. Binding and degradation were dependent on time and temperature. The effect of a lysosomotropic agent suggested internalization and lysosomal degradation of the hormone. Dissociation and stoichiometric studies indicated the existence of a single class of GH receptors with a Kd of 0.7 nM and a binding capacity of 46 fmol hGH bound mg-1 cell protein. The receptor appeared to possess a somatotrophic nature since lactogenic hormones such as human placental lactogen and rat prolactin exhibited a very low degree of competition (whereas a variety of unrelated hormones and neuropeptides showed no effect). GH-stimulated leucine uptake by the cells in a time- and dose dependent manner, half maximal effect being observed at 0.32 nM GH thus suggesting a direct relationship with the binding step. PMID- 3815747 TI - In vitro measurement and adaptive response of Fe3+ uptake by mouse intestine. AB - In order to define the importance of the mucosal uptake step in the intestinal regulation of iron absorption, unidirectional uptake rates of Fe3+ from a nitrilotriacetic acid chelate were measured in duodenal fragments from mice using an in vitro technique. [57Co]-Cyanocobalamin was used as a marker of adherent incubation medium. Uptake showed saturation kinetics over the concentration range 18-450 microM. Uptake was increased in fragments from hypoxic, dietary iron deficient and pregnant mice. The enhanced uptake was due to an increase in Vmaxapp. However, the modest increase in uptake rates in pregnancy and the gross changes observed in iron-deficiency make the hypoxic model the most convenient. The increase in uptake in hypoxic animals was located to the duodenal region and was not associated with changes in either total mucosal iron content or epithelial cell turnover. The rate of uptake of iron via the serosa did not change with hypoxia. This study implies that flux of Fe3+ across the brush border is subject to adaptive regulation. The hypoxic model is suitable for investigation into the regulation of iron homeostasis. PMID- 3815748 TI - Is breast feeding the solution to the infant nutrition problem in underdeveloped countries? AB - One hundred and thirty-three children from birth to 1 year of age were studied to investigate the value of breast milk as a solution to the infant nutrition problem. Fifteen per cent of the children were being fed exclusively breast milk, 44 (44.4%) were fed breast milk plus cow's milk and 40.6% were fed only cow's milk. Thirty-three per cent of the breast fed children, 44.4% of those on mixed feeding and 47% of those on cow's milk alone, were malnourished. PMID- 3815749 TI - Aspects of congenital hypothyroidism. AB - This article describes aspects of congenital hypothyroidism, outlining retrospective studies and indicating the effects on development in childhood of the deficiency of thyroid hormone in early life. The intellectual problems persist into adult life and are associated with motor and behavioural abnormalities, causing social difficulties to many of the patients. Prospective screening and early treatment have resolved many of these difficulties but treatment must be given appropriately to ensure adequate progress. PMID- 3815750 TI - Clinicians' assessment of stress occurring with toddler's diarrhoea. AB - From biographical and behavioural data, four clinicians independently rated the degree of stress as either due to general environmental influences or induced by family relationships likely to act upon two groups of children--one with toddler's diarrhoea and a matched control group with other physical disorders. Each clinician rated the experimental group significantly higher on both scales of stress than the control group; inter-rater correlation was positive and significant. The results suggest that environmental stress influences are associated with the aetiology and maintenance of toddler's diarrhoea, and imply that modification of such stress is relevant to treatment of the condition. PMID- 3815751 TI - The effectiveness of antenatal education of Pakistani and Indian women living in this country. AB - Eighty-two Asian women (mostly Muslims) living in East London were prospectively studied through their pregnancy and delivery. Their infants were assessed during the second year of life for growth, nutrition, morbidity, development and vaccination history. There was no increase in perinatal or infant mortality over the general population in the same borough, though there was increased infant morbidity, most commonly iron deficiency (in 25%), and one child with subclinical rickets. One child had a genetic neurodegenerative disorder. The incidence of low birth weight babies was only slightly greater than that of the district as a whole, but after 1 year of age they were less well grown than the population studied by Tanner & Whitehouse. Sixty-four per cent of the women started to breast feed, but many also gave artificial milk and they usually ceased to breast feed earlier than most women in the same district. When half of the women were randomly allocated to receive specialized education, with the others acting as controls, very few attended and little benefit was detected. Though the significance is doubtful, the infants of those educated did tend to be better grown (especially in length), be less likely to have development well below average, have reduced morbidity and have more complete immunization schedules than those of the women not receiving education. This study shows no benefit due to antenatal education, but suggests that the children have advantages when their mothers have the drive to attend the education sessions. PMID- 3815752 TI - Living with chronic renal failure. AB - We describe our impressions gained in the process of systematic interviewing of children with chronic renal failure. In spite of improved techniques of medical treatment in recent years, many of these children and their families remain under considerable strain. This is caused by anxieties about the child's general prospects for the future, problems in accepting the illness and treatment, particularly with a late onset of the condition, and multiple hospital admissions with occasional life-threatening incidents. In spite of their less serious nature, chronic features such as poor growth and urinary incontinence seem to be particularly worrying for many children and their parents. We feel that it is worth considering how to improve the supports for these families, helping parents to be more aware of community facilities that are available, and striving to improve communication between the different agencies (hospital, general practitioners, schools, etc.) involved. PMID- 3815753 TI - New method for measurement of hepatic blood flow in the rat using thermodilution method. AB - A new method for measurement of hepatic blood flow in the rat is described. The method involved the use of a thermodilution technique. A thermistor probe was placed in a right hepatic vein of the median lobe of the liver, and a thermal indicator was injected into the portal vein via a catheter. The hepatic blood flow was then estimated from changes in the blood temperature. Measured hepatic blood flow was 25.6 +/- 2.3 ml/min (mean +/- SD, n = 17) or 2.80 +/- 0.45 ml/min/g liver. These results are in a good agreement with other studies that used different techniques to estimate total hepatic blood flow in the rat. To verify this method, an in vitro isolated liver perfusion model was used. The actual flow rates determined by time collection of outflow and the measured flow rates estimated by the thermodilution technique were well correlated (r = 0.968, less than P .001). This new technique is simple and accurate and can be used for repeated serial measurements of hepatic blood flow in the same animal. PMID- 3815754 TI - Effect of hemorrhagic shock on oxidative phosphorylation and blood flow in rabbit gastrointestinal mucosa. AB - The pathophysiologic mechanism responsible for ulceration of gastric fundus and corpus mucosa following hemorrhagic shock is not well defined. We examined the effect of hemorrhagic shock (25 ml blood/kg) and resuscitation (reinfusion of shed blood) on oxidative phosphorylation in different tissues of the rabbit to determine if differences in mitochondrial response to hemorrhagic shock and resuscitation contribute to the propensity of gastric fundus and corpus to necrose before other tissues. Blood flow was measured by using radioisotope labeled microspheres to determine if changes in regional blood flow could be correlated with this propensity to ulcerate. The respiratory control index (RCI), an index of the integrity of mitochondrial function, was significantly increased in gastric antrum, liver, and kidney from the animals subjected to hemorrhagic shock and successful resuscitation when compared to control animals. In liver and kidney, these differences were largely due to increases in state 3 respirations. Duodenal and gastric corpus and fundus mitochondria showed no differences in RCI between bled and control groups. Blood flow data did not implicate ischemia as the mechanism responsible for the differential rate of ulceration after hemorrhage. The inability of fundus, corpus, and small-bowel mucosal mitochondria to respond to the stress of hemorrhagic shock and resuscitation in a manner similar to liver, kidney, and gastric antral mitochondria may place these tissues at greater risk to ulcerate. Further work is necessary to define whether this difference in mitochondrial response patterns represents a real increase in the maximal respiratory capacity of liver, kidney, and antrum after shock and resuscitation. PMID- 3815755 TI - Respiratory compensation and acidosis in endotoxin shock: effects of naloxone in conscious rats. AB - Naloxone treatment of endotoxin shock has been shown to alter many cardiovascular parameters. However, since opioids can affect ventilatory function we thought it important to assess the effects of naloxone on some respiratory variables during endotoxin shock. Male Sprague-Dawley rats (300-400 g) were surgically prepared with carotid artery and jugular vein cannulas 24 hours before experiments were begun. Conscious, unrestrained rats were challenged with 10 mg/kg E. coli endotoxin or saline. Measurements of blood gases, pH, respiratory rate, serum lactate, and medullary/pontine blood flow (radio labelled microsphere method) were made 0, 10, 30, and 60 minutes postchallenge. Rats were treated with either 2 mg/kg naloxone or saline at 25 minutes postchallenge. Arterial PO2 rose and PCO2 fell in a stepwise fashion in saline-treated endotoxic rats. These changes were unrelated to medullary/pontine perfusion or to arterial pH (up to 30 minutes postchallenge). In naloxone-treated endotoxic rats the increased ventilatory drive at 60 minutes was attenuated, apparently as a result of prevention of acidosis at this time. These data further support uncoupling of ventilatory drive and arterial pH reported earlier and also indicate that naloxone's ability to prevent acidosis in these animals is not mediated through respiratory compensation. PMID- 3815756 TI - Evaluation of the hereditary Syrian hamster cardiomyopathy by 31P nuclear magnetic resonance spectroscopy: improvement after acute verapamil therapy. AB - The relation between metabolic and functional derangement in various cardiomyopathies has not been well characterized. This information was specifically sought in a spontaneous cardiomyopathic model. Metabolic and hemodynamic parameters were obtained in glucose-perfused beating hearts of 180 200-day-old cardiomyopathic Syrian hamsters and age-matched healthy animals. This period in the cardiomyopathic hamster lifetime is intermediary between the necrotic phase and the appearance of heart failure. We used 31P nuclear magnetic resonance spectroscopy to analyze energy metabolites and intracellular pH. Cardiomyopathic hamsters had significantly higher mole fraction values for inorganic phosphate, lower phosphocreatine mole fraction as well as lower phosphocreatine/inorganic phosphate and adenosine triphosphate/inorganic phosphate ratios. Analysis of pH indicated the presence of regions of increased acidity within the heart of myopathic hamsters. Cardiomyopathic hamsters also had significantly lower left ventricular pressure, coronary flow, and myocardial oxygen consumption. Separate groups of normal and myopathic hamsters were given verapamil for 24 hours (one injection of 4 mg/kg s.c. followed by 1.2 g/l in drinking water). Verapamil-treated myopathic hamsters had evidence of markedly improved mitochondrial function when compared with untreated animals. Left ventricular pressure and coronary flow rose to normal levels. Replacing glucose by pyruvate in the perfusate of myopathic hamsters results in a marked increase in left ventricular pressure, coronary flow, and oxygen consumption with a moderate rise in phosphocreatine. Thus, 180-200-day-old cardiomyopathic hamster heart is characterized by evidence of decreased mitochondrial function, by areas of increased acidity within the heart, and by reduced left ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815757 TI - Coordination of mural elements and myofilaments during arteriolar constriction. AB - Arterioles undergo major morphological changes during vasoconstriction. We used transmission electron microscopy to study wall morphology in both dilated and constricted microvessels to understand the cellular basis of these changes. The relation between the orientation and density of myofilaments and the distribution of dense bodies was analyzed with respect to the level of microvessel tone. The data show a strong correlation between the degree of arteriolar constriction and both the orientation and density of myofilaments. In dilated arterioles, myofilament orientation was predominantly circumferential across the entire smooth muscle cell, averaging 84 +/- 2 degrees (SEM) relative to a radial reference line. In vessels constricted to 50% of their maximal diameter, myofilament orientation was dependent upon the location within the cell, being largely circumferential at the adventitial border (77 +/- 4 degrees) and shifting to a radial arrangement at the intimal border (36 +/- 5 degrees). The reorganization of myofilaments during constriction was associated with a decrease in myofilament density at the intimal-medial border of the smooth muscle cells. The decrease in myofilament density resulted from a selective withdrawal of myofilaments from periluminal areas where "ridges" had formed. Our observations suggest that an ordered distribution of membrane-associated dense bodies along the periluminal aspect of the smooth muscle cells is responsible for both the myofilament reorganization and ridge formation during vasoconstriction. Results of the present study are incorporated into a hypothetical model of arteriolar ultrastructure compatible with the mural reorganization observed during vasoconstriction. PMID- 3815758 TI - Effects of lung inflation on blood flow during cardiopulmonary resuscitation in the canine isolated heart-lung preparation. AB - Using an isolated, fibrillated canine heart-lung preparation, we studied the effects of simultaneous lung inflation and chest compression on blood flow in a model of cardiopulmonary resuscitation. The heart and lungs were placed in an artificial thorax with the great vessels and trachea exteriorized and attached to an artificial perfusion circuit and respirator, respectively. The blood volume of the system was adjusted to obtain various levels of static equilibrium pressure. Blood flow was obtained by cyclically raising and lowering the pressure in the artificial thorax, simulating the changes in pleural pressure that occur during cardiopulmonary resuscitation. Lung inflation during the compression phase caused an increase in cardiopulmonary resuscitation blood flow when the change in pleural pressure was small and when static equilibrium pressure was high. In contrast, lung inflation caused a decrease in blood flow when changes in pleural pressure were high and when blood volume was low. These results suggest that the driving pressure for blood flow during chest compression may be increased by lung inflation when the pulmonary blood vessels are filled with blood. However, blood may become trapped in the right heart and unavailable for transfer to the periphery during chest compression if lung inflation causes the alveolar blood vessels to collapse. PMID- 3815759 TI - Altered norepinephrine turnover and metabolism in diabetic cardiomyopathy. AB - Cardiac norepinephrine turnover and metabolism were examined in rats 8 weeks after the induction of chronic diabetes by an intravenous injection of streptozotocin (65 mg/kg). Cardiac norepinephrine concentration, norepinephrine turnover, and norepinephrine uptake were markedly increased in chronic diabetes in comparison with control values; these changes were reversible by 28-day insulin therapy. When the animals were exposed to cold for 6 hours, norepinephrine turnover rate constant increased in control and decreased in diabetic animals; cold exposure also increased norepinephrine concentration in diabetic hearts. Both cardiac norepinephrine concentration and turnover rate in diabetic rats were restored toward control values by ganglionic blockade with pentolinium. The conversion of [3H]tyrosine to [3H]catecholamine was enhanced and tyrosine hydroxylase as well as dopa decarboxylase activities were increased in diabetic hearts. The higher concentrations of [3H]normetanephrine and deaminated catechols indicated a faster metabolic rate of norepinephrine metabolism in hearts from diabetic rats; both monoamine oxidase and catechol-O methyltransferase activities were also increased. The increased activities of the enzymes for the synthesis and metabolism of norepinephrine were not evident on treating the diabetic animals with insulin. These data not only support the view that chronic diabetes in rats is associated with increased sympathetic activity but also indicate that the cardiac norepinephrine concentration in diabetic rats may be maintained at a higher than normal level by an increased synthesis and uptake of norepinephrine in the adrenergic nerve terminals. PMID- 3815760 TI - Phasic blood flow velocity pattern in epimyocardial microvessels in the beating canine left ventricle. AB - We quantitated phasic epimyocardial microcirculatory coronary blood flow velocity patterns in the beating left ventricle. Using a newly developed floating objective and high-speed cinematography, red cell velocities in small arterioles, capillaries, and small venules and microvascular diameters in the superficial layer of the epimyocardium of beating left ventricle were determined throughout the entire cardiac cycle in open-chest anesthetized dogs. Heart rate was maintained at 140 beats/min by means of left atrial pacing. Peak red cell velocity was observed in midsystole in small arterioles and capillaries, and in late systole in small venules. Abrupt decline in red cell velocity and, in many cases, a momentary cessation or reverse of flow, was observed in these microvessels during the pre-ejection period. The internal diameter of small venule was increased in late systole, while that of small arteriole remained almost constant during the cardiac cycle. Furthermore, in these epimyocardial microvessels, a higher percentage of the total area under the velocity curve occurred during the ejection phase; 51% in small arterioles, 43% in capillaries, and 40% in small venules. These findings indicate that the phasic blood flow pattern is markedly different in the subepimyocardial microvessels from that in the large epicardial artery and the septal artery. During vasodilation following dilazep (50 micrograms/kg, i.v.), an adenosine potentiator, red cell velocity increased throughout the entire cardiac cycle in epimyocardial microvessels with significant increases in the total area under the velocity curves accompanied by significant dilation of the arterioles. The present data will provide information useful in predicting or simulating transmural differences in the phasic blood flow pattern. PMID- 3815761 TI - Comments on "The relationship of high energy phosphates, tissue pH and regional blood flow to diastolic distensibility in the ischemic dog myocardium". PMID- 3815762 TI - A perspective of coronary disease seen through the arteries of living man. PMID- 3815763 TI - Acute myocardial infarction: diagnostic and prognostic applications of two dimensional echocardiography. AB - Now that we are entering an era when thrombolytic therapy and early invasive interventions appear to offer significant myocardium-sparing effects, it is important to attempt to exploit techniques that bear directly on the issue of anatomy to obtain an objective measure of infarct size and prognosis. Traditional tests for AMI were developed as diagnostic measures and cannot be expected to measure up to issues raised by modern therapy. Despite its pitfalls, echocardiography can be applied prognostically during the first few hours of AMI evolution to far more patients than can any other imaging technique. We believe that an adequate echocardiographic examination can be an important adjunct that should be used in the early risk assessment of any patient with AMI. Those patients with the greatest potential reversible myocardial damage are clearly the best candidates for aggressive interventions, particularly thrombolysis. For patients with small or no detectable regional wall motion abnormalities, a more conservative initial approach is in order. PMID- 3815764 TI - Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. AB - Recent studies showed that taurine, a sulphonic amino acid, could decrease blood pressure and increase sympathoadrenal tone in DoCA-salt-treated hypertensive rats. To determine whether taurine exerts its antihypertensive action in man in a similar fashion, we studied the effect of oral administration of taurine (6 g for 7 days) on blood pressure and plasma catecholamines in 19 young patients with borderline hypertension in a double-blind, placebo-controlled fashion. Systolic blood pressure in the 10 patients who were treated with taurine decreased by 9.0 +/- 2.9 mm Hg (mean +/- SE; p less than .05 by paired t test), compared with a 2.7 +/- 2.3 mm Hg decrease (NS) in the nine patients treated with placebo and diastolic blood pressure in the taurine-treated patients decreased by 4.1 +/- 1.7 mm Hg (p less than .05) compared with 1.2 +/- 3.0 mm Hg (NS) in the placebo treated subjects. In the patients receiving taurine plasma epinephrine (E) decreased significantly, with a negligible decrease in plasma norepinephrine (NE). The effect of taurine on plasma catecholamines and the response of plasma E after the stimulation with glucagon was also studied in 12 borderline hypertensive and nine age-matched normotensive subjects. Basal plasma E was significantly higher in borderline hypertensive than in normal subjects, but basal plasma NE did not differ in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815765 TI - Coronary hemodynamics and myocardial metabolism of lactate, free fatty acids, glucose, and ketones in patients with septic shock. AB - To investigate disturbances in the coronary circulation and myocardial metabolism during septic shock, we examined coronary sinus blood flow and myocardial substrate extraction in 40 patients with septic shock and 13 control patients. Patients with coronary artery disease were excluded from this study. The global hemodynamic pattern of the septic patients was characterized by a lower stroke volume, despite an elevated cardiac index. Coronary sinus blood flow was high (187 +/- 47 vs 130 +/- 21 ml/min in the control group, p less than .001) due to marked coronary vasodilation, especially in the subgroup of nonsurvivors. In contrast to the control group, myocardial lactate uptake was elevated, while that of free fatty acids, glucose, and ketone bodies was diminished in patients with septic shock. These findings were especially prominent in the nonsurvivors. Expressed as oxygen equivalents, the contribution of free fatty acids as an energy source of the myocardium was markedly diminished in septic patients (12% vs 54% in the control group, p less than .005), while that of lactate was increased (36% vs 12%, p less than .01). The observed shift in myocardial substrate extraction was associated with a discrepancy between measured myocardial oxygen consumption and that calculated chemically from commonly available exogenous substrates: 41% of myocardial oxygen consumption was not explained by the utilization of commonly available substrates extracted from coronary circulation in all patients with septic shock.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815766 TI - Follow-up evaluation of infant paroxysmal atrial tachycardia: transesophageal study. AB - We report results of follow-up transesophageal electrophysiologic studies in 35 infants seven to 27 months old (mean, 12 months) in whom paroxysmal atrial tachycardia (PAT) using an accessory atrioventricular (AV) connection had been previously evaluated by transesophageal study in the first 2 months (mean, 14 days) of life. No infants were receiving antiarrhythmic drug therapy at the time of follow-up study. To evaluate AV conduction and initiate PAT, a standard transesophageal pacing protocol was used: single extrastimuli in sinus rhythm, incremental pacing to second-degree AV block, and burst pacing at cycle lengths near those resulting in second-degree AV block. If PAT was not initiated during the baseline period, the protocol was repeated during the infusion of isoproterenol and after administration of atropine. At follow-up study, PAT was reinitiated in 24 of 35 (68%) infants, six of whom had exhibited recent spontaneous recurrence of PAT. AV nodal function did not differ in those with and those without inducible PAT. However, when initial and follow-up studies were compared, changes in antegrade conduction of the accessory AV connection were observed, since only five of 10 infants with preexcitation at initial study continued to exhibit preexcitation at follow-up study (1/5 infants only after isoproterenol). Additionally, changes in retrograde conduction of the accessory AV connection were observed; the ventriculoatrial interval in PAT induced at follow-up study increased by 20 to 40 msec in eight of 24 infants and by 50 to 80 msec in five of 24 infants compared with the interval at initial study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815767 TI - Characterization of oscillations in ventricular refractoriness in man after an abrupt increment in heart rate. AB - Oscillations in ventricular myocardial refractoriness after a change in rate have not been described in man. During 25 baseline paced cycle lengths (SB-SB) of 400 to 800 msec in 14 patients, a shorter cycle length (S'-S') was introduced that was 10 to 20 msec (mean 15 +/- 5) greater in duration than the ventricular effective refractory period (VERP) determined after 12 beats of the respective baseline cycle length (group 1 trials). In addition, during 14 of the 25 baseline cycle lengths, a second shorter cycle length was introduced that was 50 to 80 msec (mean 65 +/- 10) greater than the VERP of the respective baseline cycle length (group 2 trials). In all 39 group 1 and group 2 trials the VERP was determined after each of at least 3 beats (S'1, S'2, S'3) of the shorter cycle length and in six of the 25 group I trials the VERP was determined after each of at least 12 beats of the shorter cycle length. In all group 1 trials oscillations of the VERP were observed, with a mean S'1 VERP of 202 +/- 28 msec, an S'2 VERP of 228 +/- 25 msec (p less than .001 vs S'1 VERP), and an S'3 VERP of 210 +/- 26 msec (p less than .001 vs S'2 VERP). Oscillations dampened within 4 beats, but persisted at a lower amplitude in four of the six group I trials during which the shorter cycle length was maintained for at least 12 beats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815768 TI - Diagnosis of coronary artery anatomy by two-dimensional echocardiography in patients with transposition of the great arteries. AB - With the increasing popularity of the Jatene procedure for the treatment of common or D-transposition of the great arteries (D-TGA), the preoperative definition of coronary artery anatomy in D-TGA has assumed great importance. Consequently, the reliability of two-dimensional echocardiography for determining the coronary artery anatomy was studied in 32 infants with D-TGA. Surgical observation of the coronary anatomy was used to assess the accuracy of the echocardiographic diagnosis. The coronary arteries were visualized in 29 of 32 patients (90%), predominantly with the use of parasternal and apical views. In the three remaining patients visualization of the coronary arteries was inadequate to allow determination of their anatomy. The coronary artery anatomy was correctly predicted in 25 of the 29 patients in whom the coronary arteries were visualized. The anatomic patterns included usual coronary anatomy for D-TGA (n = 16), left circumflex coronary from the right coronary artery (n = 6), single right coronary artery (n = 1), single left coronary artery (n = 1), and inverted origin of the coronary arteries (n = 1). The errors in the remaining four patients were (1) false-negative diagnosis of origin of the left circumflex coronary from the right coronary artery (n = 1); (2) false-positive diagnosis of origin of the left circumflex coronary from the right coronary artery (n = 1), and (3) diagnosis of origin of the left circumflex coronary from the right coronary artery when the correct diagnosis was single right coronary artery (n = 2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815769 TI - Prenatal diagnosis and postnatal management of critical aortic stenosis. AB - Fetal echocardiography has yet to have an impact on the treatment of congenital heart disease. Critical aortic valve stenosis was diagnosed by echocardiography before birth in a 35 week gestation fetus. The risks to the fetus and mother associated with prolonged rupture of membranes prompted their transport to a hospital with cardiac surgical and high-risk perinatal facilities. Prenatal and postnatal echocardiographic findings agreed regarding the diagnostic criteria for critical aortic stenosis and primary forms of cardiomyopathy were excluded. Results of fetal Doppler examination were consistent with valvular aortic stenosis and excluded mitral regurgitation. Determination of the left ventricular size excluded ventricular hypoplasia. The infant was delivered by cesarean section and underwent successful emergency aortic valvotomy at 12 h of age. Fetal echocardiography, in combination with a multidisciplinary postnatal approach, can be used in the successful treatment of a severe form of congenital heart disease. PMID- 3815770 TI - Induction of coronary artery spasm by a direct local action of ergonovine. AB - To investigate whether ergonovine acts directly on coronary arteries or via remote neurohumoral reflexes, we administered small titrated increments of intracoronary ergonovine up to a maximum cumulative dose of 50 micrograms to 15 patients. In six patients with variant angina (group 1), ischemic electrocardiographic ST changes, angina, and localized coronary spasm (local coronary diameter reduction of 87.8 +/- 18.9% [mean +/- SD]) followed after 6 to 50 micrograms (mean 20.7) cumulative intracoronary ergonovine. In nine patients with atypical chest pain, normal baseline coronary arteriograms, and no evidence of variant angina (group 2), there was no ischemic ST segment change or localized coronary spasm after 6 to 50 micrograms (mean 31.6) intracoronary ergonovine. Coronary diameter of proximal vessels of patients in group 2 was reduced by 16.2 +/- 6.5% and did not differ from the response of nonspastic vessels of comparable size of group 1 (20.5 +/- 13.8%; p = .7). There was no significant difference in the median effective dose values in the dose-response curves of the spastic and nonspastic segments between groups 1 and 2. Ergonovine causes coronary spasm by a direct local effect, which seems to be caused by localized arterial hyperreactivity rather than supersensitivity. Intracoronary delivery may be safer than intravenous administration because negligible drug recirculation may prevent perpetuation of spasm and selective coronary administration can avoid branches with critical stenoses. PMID- 3815771 TI - Transcatheter umbrella closure of congenital heart defects. AB - Between October 1984 and September 1986, we attempted transcatheter umbrella closure, using the Rashkind PDA occluder, of 12 congenital or postoperative cardiovascular defects (other than patent ductus arteriosus [PDA]) in 11 patients. In each, we used the umbrella for closure because the defect was too short and/or too large to close with conventional transcatheter methods. The defects included three post-Glenn venous communications (superior vena cava-right atrium, n = 2; azygos vein to inferior vena cava), four congenital "interatrial defects" producing cyanosis ("coronary sinus" septal defect, left superior vena cava to left atrium, patent foramen ovale, left inferior vena cava to left atrium), and five non-PDA systemic-to-pulmonary arterial communications (two congenital and three postoperative). Ten of 12 defects were embolized successfully; nine had complete or subtotal closure, and one was partially closed. The first attempted closure resulted in embolization of a 12 mm device to a lower-lobe pulmonary artery, without clinical sequelae. No other complications occurred. Clinical improvement was most dramatic in those patients whose cyanosis was relieved and less obvious when pulmonary blood flow was reduced. The Rashkind umbrella device, originally designed for closure of PDA, considerably expands the list of congenital or operative defects that can be closed nonsurgically. PMID- 3815772 TI - Protection against atherogenesis with the polymer drag-reducing agent Separan AP 30. AB - The inhibitory effect of Separan AP-30, an anionic polyacrylamide, on atherosclerotic plaque formation in aortas of rabbits on a high (2%) cholesterol diet was tested over a period extending from 37 to 170 days. Atherogenesis was quantified morphometrically by application of a computer-assisted image analysis of histologic cross sections of the aorta. The area of vessel wall-atheroma interface, fraction of lumen occluded, and other indexes of atherogenesis were measured in each of 26 segments of aorta excised from the animals, half of which were administered injections (intravenous) of Separan three times a week. Regression analysis of the morphometric data indicates that the polyelectrolyte exerts a powerful antiatherogenic effect in all regions of the aorta, inhibiting the formation of plaque mass to less than half in the aortic arch and about one fifth in the descending aorta as compared with the aortic plaque masses in untreated rabbits. Results are compatible with the suggestion that a novel hemodynamic principle in vivo, polymer drag reduction, might be effectively applied against atherosclerosis. PMID- 3815773 TI - In search of afferent pathways of a cardiogenic hypertensive chemoreflex. AB - Injection of serotonin (5-HT) into the left atrium or ventricle activates a hypertensive chemoreflex. The primary purpose of our study was to determine the afferent pathway(s) that mediates this response. A secondary goal was to localize the receptive sites of this reflex. We measured changes in arterial pressure, reflex vascular responses in skeletal muscle and paw, and changes in renal nerve traffic that occurred after the left atrial or left ventricular injection of 5 HT. Injection of 5-HT (100 to 600 micrograms) into left atrium or ventricle produced large reflex increases in vascular resistance and sympathetic outflow. These responses were not reduced after bilateral cervical vagotomy. In separate experiments, increases in renal nerve traffic with left ventricular injection of 5-HT were assessed before and after cardiac sympathetic deafferentation. Interruption of cardiac sympathetic afferent pathways did not significantly attenuate increases in renal nerve activity with 5-HT. Injection of 5-HT (300 micrograms) into the aortic root produced large increases in arterial pressure but this was not observed after injections into the vertebral or common carotid arteries or descending aorta. Injection of 5-HT (100 micrograms) into the left main coronary artery (perfused via a Gregg cannula from an external reservoir) resulted in a depressor reflex (Bezold-Jarisch). In contrast, injection of 5-HT (200 micrograms) into the left ventricle when the drug was prevented from reaching the left coronary artery produced a large pressor response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815774 TI - Elimination of exercise-induced regional myocardial dysfunction by a bradycardiac agent in dogs with chronic coronary stenosis. AB - We have previously demonstrated that the beneficial effect of cardioselective beta-blockade on exercise-induced ischemia is due entirely to negative chronotropism. Therefore we studied the effect of a new bradycardiac agent (UL-FS 49) in 10 dogs with chronic coronary artery stenosis produced by an ameroid constrictor. Regional myocardial function (sonomicrometers, wall thickness) and blood flow (microspheres) were measured during a control treadmill exercise bout and an identical run 3 hr later after the administration of UL-FS 49 (1.0 mg/kg iv). In the control run, heart rate increased from 114 +/- 20 to 230 +/- 19 beats/min and systolic wall thickening (%WT) in the poststenotic myocardium decreased from 23.3 +/- 5.2% at rest to 9.3 +/- 5.0%, a 60% reduction. Subendocardial blood flow in the ischemic area decreased from 1.04 +/- 0.30 to 0.55 +/- 0.40 ml/min/g, blood flow per beat decreased from 9.1 X 10(-3) to 2.5 X 10(-3) ml/g, and mean transmural flow failed to increase (1.06 +/- 0.30 vs 1.08 +/- 0.39 ml/min/g). During exercise with UL-FS 49, heart rate increased from 89 +/- 10 to only 139 +/- 10 beats/min. End-diastolic left ventricular pressure was increased compared with that during the control run (35.7 +/- 3.0 vs 28.9 +/- 5.5 mm Hg) but left ventricular peak systolic pressure and dP/dt were unchanged. %WT in the ischemic zone did not change significantly during exercise with UL-FS 49 (23.3 +/- 7.9% at rest, 21.5 +/- 8.4% during the run), and in the nonischemic zone it increased to the same extent as during the control run.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815775 TI - Effects of the pericardium on the diastolic left coronary pressure-flow relationship in the isolated dog heart. AB - We studied the effects of the pericardium on diastolic left coronary pressure flow relationships in heart-blocked and isolated canine preparations. In these preparations, the left and right coronary arteries were dilated with adenosine and perfused by means of a pressurized arterial reservoir. The diastolic left heart pressure (LHP) was controlled by the height of a reservoir connected to the left atrium and left ventricle. The right atrial and ventricular pressure i.e., coronary outflow pressure, was kept constant at 0 mm Hg. Before and after pericardiectomy, diastolic coronary pressure-flow relationships were obtained at three values of LHP (0, 15, and 30 mm Hg) with driving pressure decreasing (2 mm Hg/sec or less) from approximately 60 mm Hg to the actual zero-flow pressure (Pf = 0) during a single long diastole induced by cessation of ventricular pacing. The slopes of the coronary pressure-flow relationships were approximated by a linear regression analysis in which the correlation coefficients were greater than .98 in all cases. Before pericardiectomy, with LHP increasing from 0 to 15 and 30 mm Hg, the value of Pf = 0 significantly increased from 7 +/- 1 to 16 +/- 1 (p less than .01) and 28 +/- 2 mm Hg (p less than .01), respectively. After pericardiectomy, it increased from 7 +/- 1 to 14 +/- 1 (p less than .01) and 17 +/- 2 mm Hg (p less than .01), respectively. When LHP was at 0 and 15 mm Hg, the pericardiectomy had no effect on the value of Pf = 0.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815776 TI - Recognition, pathogenesis, and management options in silent coronary artery disease: introduction. PMID- 3815777 TI - Recognition, pathogenesis, and management options in silent coronary artery disease. Bethesda, Maryland, April 17-18, 1986. Proceedings. PMID- 3815778 TI - Epidemiologic aspects of the asymptomatic positive exercise test. PMID- 3815779 TI - Screening of asymptomatic siblings of patients with premature coronary artery disease. PMID- 3815780 TI - Exercise testing and radionuclide procedures in high-risk populations. PMID- 3815781 TI - The concept and pathogenesis of active but asymptomatic coronary artery disease. PMID- 3815782 TI - The diagnostic and prognostic significance of an asymptomatic positive exercise test. AB - The presence of "asymptomatic" ST segment depression during exercise testing places the patient with established CAD at higher risk. The prognosis of these patients is determined primarily by the severity of CAD, the left ventricular function, and the exercise capacity on an exercise test. PMID- 3815783 TI - Electrocardiographic precursors of sudden unexpected death: the Framingham Study. PMID- 3815784 TI - Common electrocardiographic markers for subsequent clinical coronary events. PMID- 3815785 TI - Relation of transient silent ischemic episodes to daily activities. AB - In patients with coronary disease, asymptomatic ST segment depression during daily life is a reliable indicator of silent myocardial ischemia and is the most frequent form of ischemia in both symptomatic and asymptomatic patients. Silent ischemic episodes usually occur during activities not ordinarily thought to be ischemia provoking, and not necessarily with the same frequency, duration, or magnitude as painful episodes and may be the only type of ischemia detected in some patients. Some features suggest an important reduction in myocardial oxygen supply, in addition to an increase in demand, as a mechanism for silent ischemic episodes occurring during daily life. PMID- 3815786 TI - The value of Holter monitoring in managing patients with coronary artery disease. PMID- 3815787 TI - Prognosis for patients with different types of silent coronary artery disease. PMID- 3815788 TI - Prevalence and clinical significance of painless ST segment depression during early postinfarction exercise testing. PMID- 3815789 TI - Prevalence and prognostic significance of silent myocardial ischemia in patients with unstable angina. PMID- 3815790 TI - Unrecognized myocardial infarction: experience in the Multiple Risk Factor Intervention Trial (MRFIT). PMID- 3815791 TI - Cardiac findings associated with sudden death secondary to atherosclerotic coronary artery disease: comparison of patients with and those without previous angina pectoris and/or healed myocardial infarction. PMID- 3815792 TI - A prospective study of emergency room visits for contact lens related problems. PMID- 3815793 TI - Hard and soft contact lens fitting in infants. PMID- 3815794 TI - Accuracy and reproducibility of keratometer readings. PMID- 3815795 TI - Macrophage reaction on the corneal endothelium in pseudophakic keratopathy. PMID- 3815796 TI - A step beyond ECCE. PMID- 3815797 TI - On mapping the human genome. PMID- 3815798 TI - Advanced technology and its impact on the clinical laboratory. AB - The analytical capabilities of the clinical laboratory have continued to expand and improve as a result of technical developments and advancements made in a wide spectrum of allied disciplines. As a consequence, the clinical laboratory has evolved from the small, manual operations of yesterday to the large, central organizations of today. Technology continues to have an impact on the laboratory, especially with the advent of the fully automated analytical systems that are having such a profound effect on how the laboratory is staffed, equipped, organized, and operated. With the accelerating rate at which new developments are occurring, it is safe to assume that dramatic changes will continue to occur in this area. Consequently, it will become increasingly important for clinical laboratorians to be aware of these new developments, to understand them, and to anticipate how they will be assimilated and integrated into the overall health care system. To quote from a recent Bell Atlantic advertisement, "The genius of the future lies not in technology alone, but in the ability to manage it." PMID- 3815799 TI - Early diagnosis of acute myocardial infarction by rapid analysis of creatine kinase isoenzyme-3 (CK-MM) sub-types. AB - We compared the clinical sensitivity, specificity, and diagnostic efficiency of measuring creatine kinase-3 (MM) isoenzyme sub-types (CK, EC 2.7.3.2) with the measurement of CK-2 (MB) isoenzymes for the diagnosis of acute myocardial infarction. Serial blood collections at 3-h intervals from 35 patients with acute myocardial infarction were examined. In attempts to reperfuse their coronary arteries, some of these patients were treated with pharmacological thrombolysis (streptokinase, tissue plasminogen activator), with or without coronary angioplasty. The infarction patients were divided into two groups: patients who were successfully treated with thrombolytic agents (i.e., they achieved coronary reperfusion), and patients who were treated unsuccessfully or who were not treated acutely. We also examined blood from 34 non-infarction patients. We measured CK-3 sub-types by both anion-exchange liquid chromatography and a modified high-voltage electrophoresis method, and CK-2 by immunoprecipitation. Our results show that during the first few critical 3 to 9 h after onset of chest pain, measurement of CK-3 sub-types has the highest diagnostic efficiency; in contrast, CK-2 has the highest efficiency during the 10- to 21-h time intervals. Thus early diagnosis of acute myocardial infarction can be based on rapid assays of CK-3 sub-types. PMID- 3815800 TI - A two-step radioimmunoassay for free triiodothyronine in serum. AB - Using a high-affinity solid-phase-bound antibody (Ka = 1.2 X 10(11) L/mol), we have standardized a two-step radioimmunoassay for free triiodothyronine (FT3) in serum, based on immunoextraction. The method was validated by comparison with an equilibrium-dialysis procedure (r = 0.96) involving RIA of T3 in the dialysate standardized with the same antibody and by a commercial (Liso-Phase, International-CIS) method. The two-step RIA could detect as little as 0.2 pg per milliliter. The mean CVs within and between assays were 9% and 12%, respectively. FT3 values measured in 30 normal adults ranged from 1.77 to 4.77 ng/L. Comparison with ratios of total T3 to thyroxin-binding globulin showed good agreement in normal subjects, pregnant women, and hypothyroid and hyperthyroid patients. PMID- 3815801 TI - Comparison of Flavobacterium and Sphingobacterium species by enzyme profiles, with use of pattern recognition of two-dimensional fluorescence data. AB - Enzyme profiles of eight Flavobacterium species and one Sphingobacterium species were compared after using a two-dimensional fluorescence technique. Enzyme contents and corresponding activities were rapidly determined for whole-cell preparations after incubation with a mixture of preselected fluorogenic substrates. A two-dimensional fluorescence spectrum of the resulting product mixture, measured with a video fluorometer, provided a characteristic "fingerprint" for each organism. Comparison of fluorescent spectra was facilitated by a Fourier-transform-based pattern-recognition algorithm and by a clustering technique involving the Pearson product-moment correlation coefficient. F. multivorum, F. thalpophilum, and S. mizutae formed one cluster; F. indologenes, F. spiritivorum, F. odoratum, and F. balustinum formed a second. F. meningosepticum was intermediate between the first and second cluster, whereas F. breve was different from all other strains examined, based on their spectral dissimilarity indices and correlation coefficients. PMID- 3815802 TI - Two-stage transformation systems for normalization of reference distributions evaluated. AB - In two-stage transformation systems for normalization of reference distributions, the asymmetry is first corrected, and any deviation of kurtosis is then adjusted. The simulation studies reported here show that these systems have previously been assessed too optimistically because the sample variation of the transformation parameters was neglected. Applying a goodness-of-fit test to transformed values shows that one should accept gaussianity only for p-values greater than 0.15 instead of those greater than 0.05. Further, the calculated 90% confidence intervals of reference limits should be expanded by 25%. When the correct level of significance is used, only real reference distributions that deviate moderately from the gaussian form are normalized. Calculation of confidence intervals demonstrated that 50 to 450 subjects are needed for a precise parametric estimation of the 95% reference interval. For the nonparametric approach, 125 to 700 reference subjects are necessary. The larger sample sizes are needed when distributions show pronounced skewness. PMID- 3815803 TI - Desirable standards of performance for therapeutic drug monitoring. AB - Therapeutic drug monitoring is an important aspect of clinical chemistry for which no objective analytical goals yet exist. Based on fundamental pharmacokinetic theory, and the current consensus strategy for analytical goal setting for precision based upon biological variation, a theoretical model allows derivation of the goal that: analytical CV less than or equal to 1/4 [(2T/t - 1)/(2T/t + 1)] X 100%, where T is the time interval between doses, and t is the average elimination half-life. Using published data on half-lives, I have derived goals for analysis for (e.g.) digoxin, lithium, some antiepileptic drugs, and theophylline. The goal for accuracy proposed is that methods should have no bias and should generate true values. Goals for precision should therefore be viewed as goals for total analytical error. PMID- 3815804 TI - Cholesteryl ester transfer activity in plasma measured by using solid-phase-bound high-density lipoprotein. AB - We studied the ability of lipid-transfer factors in plasma to promote transfer, to endogenous lipoproteins, of [3H]cholesteryl ester from high-density lipoprotein (HDL) covalently bound to Sepharose 4B beads. After incubation for 2 h at 37 degrees C, 12 to 14% of the [3H]cholesteryl ester had been transferred to the lipoproteins of the plasma, in the proportions 57% to HDL and 43% to low- and very-low-density lipoproteins. This process was a function of the amount of plasma present and was stimulated by addition of partly purified lipid-transfer protein. Transfer also depended on the concentration of donor HDL but was independent of the amount of acceptor lipoprotein. This simple evaluation of cholesteryl ester transfer does not require removal of lipoproteins from the plasma before incubation. PMID- 3815805 TI - A new enzymic determination of guanidinoacetic acid in urine. AB - We developed and evaluated a colorimetric method for enzymic determination of guanidinoacetic acid (GAA) in urine. Endogenous urinary urea was first eliminated by urease (EC 3.5.1.5), and the added urease was then removed from the sample by centrifugal ultrafiltration. GAA in the ultrafiltrate was subsequently hydrolyzed by guanidinoacetate amidinohydrolase (EC 3.5.3.2) to glycine and urea. The latter substance produced an orange chromogen reacting with o-phthalaldehyde and N-(1 naphthyl)-N'-diethylethylenediamine, the absorbance of which at 465 nm was linearly related to concentrations as high as 200 mg/L for standard solutions of GAA. Analytical recovery of GAA added to urine ranged from 94 to 112% (mean 101%) and the within-run and between-run precision (CVs) of the method for the urinary GAA determination averaged 2.2 and 3.5%, respectively. Results correlated well (r = 0.983) between the present method and a high-performance liquid chromatographic method. The proposed method is accurate and simple. We saw a great decrease in urinary GAA of patients with suspected or proven renal insufficiency as compared with that of healthy volunteers. PMID- 3815806 TI - Transferrin binding of Al3+ and Fe3+. AB - An understanding of Al3+-induced diseases requires identification of the blood carrier of Al3+ to the tissues where Al3+ exerts a toxic action. Quantitative studies demonstrate that the protein transferrin (iron-free) is the strongest Al3+ binder in blood plasma. Under plasma conditions of pH 7.4 and [HCO3-]27 mmol/L, the successive stability constant values for Al3+ binding to transferrin are log K1 = 12.9 and log K2 = 12.3. When the concentration of total Al3+ in plasma is 1 mumol/L, the free Al3+ concentration permitted by transferrin is 10( 14.6) mol/L, less than that allowed by insoluble Al(OH)3, by Al(OH)2H2PO4, or by complexing with citrate. Thus transferrin is the ultimate carrier of Al3+ in the blood. We also used intensity changes produced by metal ion binding to determine the stability constants for Fe3+ binding to transferrin: log K1 = 22.7 and log K2 = 22.1. These constants agree closely with a revision of the reported values obtained by equilibrium dialysis. By comparison with Fe3+ binding, the Al3+ stability constants are weaker than expected; this suggests that the significantly smaller Al3+ ions cannot coordinate to all the transferrin donor atoms available to Fe3+. PMID- 3815807 TI - Sample contamination by test strips. PMID- 3815808 TI - Detection of bromocriptine-like substances in urine of an infant on soy formula. PMID- 3815809 TI - Improved separation of antigen-antibody complex in RIA involving ammonium sulfate. PMID- 3815810 TI - Interference of bromide in determination of serum chloride. PMID- 3815811 TI - Precision evaluation of the Olympus "Demand" in clinical use. PMID- 3815812 TI - Amdev's "Lytening 1" sodium and potassium analyzer evaluated. PMID- 3815813 TI - Anomalous apoprotein E isoforms in peripheral arteriopathy. PMID- 3815814 TI - Acid phosphatase activity in beta-glucuronidase/sulfatase preparation from Helix pomatia. PMID- 3815816 TI - New deproteinizing agent for determination of xylose in serum. PMID- 3815815 TI - Clinical significance of dipstick-negative, sediment-positive urines: two reagent dipsticks compared. PMID- 3815817 TI - Falsely high values for triglyceride in ultrafiltered HDL supernates. PMID- 3815818 TI - Deficiencies of sigma diagnostic's urinary oxalate method in the presence of ascorbate. PMID- 3815820 TI - Kinetic determination of fibrinogen with a random access analyzer. PMID- 3815819 TI - Digoxin radioimmunoassay that does not detect digoxin-like substance in serum of newborns, infants, or patients with renal failure. PMID- 3815821 TI - Alternative methods evaluated for assaying low concentrations of galactose in plasma. PMID- 3815822 TI - Naproxen interference with the ion-selective electrode in the RA-1000. PMID- 3815823 TI - Recognizing hyperthyroidism in the elderly. AB - Hyperthyroidism in the elderly frequently presents with atypical symptoms such as apathy, anorexia, diarrhea, atrial fibrillation, and (or) cardiac decompensation. The diagnosis may therefore be delayed or missed, as illustrated by three cases. Laboratory thyroid evaluation is justified by a wide variety of indications in elderly persons who seek medical advice or care. PMID- 3815824 TI - A patent law primer for clinical chemists and other scientists. AB - Patenting and commercialization by academic scientists, despite potential drawbacks, are on balance highly desirable if technology is to be transferred from the laboratory to the public use, and if the scientist and his institution are to be encouraged to participate in this transfer. If that premise is accepted, there is much that academic institutions can do to foster utilization of their biotechnological discoveries. Such institutions should have a patent policy that is known to all and that includes a professional patent administrator and clear administrative procedures for carrying out such policy. Scientists should be trained to recognize and protect their inventions and to appropriately disclose their inventions to their patent officers. Ideally, scientists should know the rudiments of the patent statutes of their own country and should be aware of what constitutes trade secrets. Scientists should be given guidance in working with patent attorneys in the preparation and prosecution of patent applications. Finally, given human nature, institutions should see to it that their scientists are provided with a suitable environment in which to invent, and appropriate incentives to do so. PMID- 3815825 TI - More on reference intervals for some vitamins. PMID- 3815826 TI - Temperature-dependent results with the ChemPro-1000. PMID- 3815827 TI - More on determination of ionized calcium in blood with ion-selective electrodes. PMID- 3815828 TI - Hemoglobin A1c by liquid chromatography. PMID- 3815829 TI - Negative interference with the Du Pont aca method for measuring digoxin. PMID- 3815830 TI - More on serum fructosamine assay. PMID- 3815831 TI - Steroid receptors in benign breast disease, gross cystic disease and fibroadenoma. AB - The benign breast pathology embraces a wide variety of anatomo-clinical pathological conditions producing confusion in nomenclature. The Authors collected three different types of BBP and investigated the hormonal receptor status for each. The following concentrations of ERc were found: 1-6 fmol/mg in BBD; less than 2 fmol/mg in GCD; 12-18 fmol/mg in the cytoplasm and 29-37.5 fmol/mg in the nucleus in FA. In FA, PgR was found in concentrations of 43.5-50 fmol/mg in the cytoplasm and 0.2-10 fmol/mg in the nucleus. Even if we consider these three histo-pathological entities (BBD, GCD, FA) separately, no correlation can be seen between the presence of receptors and benign breast disease. The only observation we can make is that the fibroadenomas contain more easily identifiable receptor concentrations than BBD and GCD. PMID- 3815832 TI - Our experience about the role of urodynamic tests in female urinary incontinence. AB - The author reports his own experience upon urodynamic evaluation of vesico urethral function in patients suffering from urinary incontinence. The analysis of the results confirms the high significance of urodynamic investigation in cases of urinary incontinence either preoperatively, in order to define the conditions which lead to the pathology and to decide the most suitable therapeutic approach, or postoperatively, in order to confirm the realisation of therapeutic success. PMID- 3815833 TI - Bicornuate uterus with a pregnancy in one half. AB - Bicornuate uterus is one of the important causes of female infertility. Pregnancy was observed in a patient who was 28 years old nullipara with primary infertility of 6 years and had bicornuate uterus. PMID- 3815834 TI - New trends in cesarean section. AB - The Authors studied the frequency of Cesarean section in relation to deliveries in the last trimester of pregnancy, the frequency of repetitive Cesarean section, age and parity of the patients, indication for cesarean section, week of delivery, and perinatal and maternal morbidity and mortality at the First Clinic of Obstetrics and Gynecology, University of Catania, Catania, Italy, from 1972 to 1974 and from 1983 to 1985. The frequency of Cesarean section has increased from 12.07% (735 cases out 6,086 deliveries) to 16.89% (837 cases out of 4,955 deliveries). There was a decrease in frequency of repetitive Cesarean section from 30.47% (224 cases) to 27.95% (234 cases) and in perinatal mortality rate from 4.35% (32 cases out of 735) to 3.19% (27 cases out of 845 newborn). There were no cases of maternal death, while the most common cause of maternal morbidity was uterine atonia. From 1972 to 1974 mechanical causes were the most frequent indication for Cesarean section (28.16% -207 cases), while from 1983 to 1985 previous hysterotomy (32.73% -274 cases) was the main indications for Cesarean section. PMID- 3815835 TI - Clinical considerations on the metastases of mammarian cancer. AB - The Authors examine the prognostic value of metastatic breast cancer and the consequent possibility of therapy. They discuss the role of steroid receptor determination both in prognosis and in planning treatment. Their personal experience confirms the positivity of Progestinic receptors as a more specific index of hormono-sensitivity in regard to the positivity of the single estrogen receptors. Concerning therapy, in metastatic breast cancer the association between chemo- and hormono-therapy may offer better results, acting on different cell populations, though it probably does not improve the survival rate. PMID- 3815836 TI - Analysis of the urodynamic parameters in the micturitional pathology of women in old age. AB - Urinary pathology still arouses interest today most especially among those women who are entering old age and especially in relation to the fact that in this age static pelvic changes and trophism of the uro-genital organs occur with greatest frequency. An analysis is presented here of the urodynamic parameters followed in a group of patients affected by this pathology, compared with a control group. PMID- 3815837 TI - Fetal heart rate and uterine activity following paracervical block. AB - Bupivacaine without adrenaline was used for paracervical block (PCB) anesthesia in 60 low-risk parturients in whom there were no signs of fetal asphyxia. In order to evaluate its effects on fetus and uterine activity, 30 patients were given a "high dose" of 50 mg Bupivacaine, an amide-type local anesthetic agent, while 30 patients were given a "low dose" of 25 mg. Continuous fetal heart rate (FHR) monitoring in both study groups revealed nine patients with typically post PCB bradycardia and five patients with moderate PHR depression. All of them were born with excellent Apgar score. Although a decrease in fetal heart rate following PCB was noted in both groups more significant reduction was associated with the high dose block (P less than 0.05). In 11 cases, FHR depression was clearly associated with increased uterine activity, while in another three cases it was not (P less than 0.005). Oxytocin administration during the block did not affect fetal heart rate or uterine activity. The results indicate that FHR depression following PCB using Bupivacaine is dose dependent, transient and not dangerous to a normal fetus. No adverse maternal effects were noted. It is suggested that fetal heart rate depression following PCB using Bupivacaine is related to increased uterine activity. PMID- 3815838 TI - Parity and sexual behavior in pregnancy. AB - Correlation between parity and sexual behavior during pregnancy was studied in 106 pluriparous and 69 primiparous patients. Sexual desire, frequency of coitus, frequency of orgasm, which partner initiated sexual activity, and level of sexual satisfaction were analyzed in the year before pregnancy and during pregnancy. Sexual desire, frequency of coitus, and sexual satisfaction were qualitatively equal in both groups. The frequency of coitus in particular decreased progressively in the three trimesters of pregnancy and more evidently in the pluriparous. The partner who initiated sexual activity most frequently was the male in the pluriparous group. PMID- 3815839 TI - Cervical pathology in young patients. AB - The authors have studied 152 patients aged between 15 and 20 year old who underwent colposcopy and colpocytology. They have compared the incidence of white colposcopic lesions with the results of the cytology. According to literature the results have pointed out that the very young patients are "at risk-patients" for serious cervical lesions and that depistage of gynecologic tumors must be done in all the other women. PMID- 3815840 TI - Fecal peritonitis in pregnancy. AB - The Authors report a case of fecal peritonitis caused by perforating appendicitis in a patient in the 16th week of pregnancy. Appendectomy was performed and the patient successfully delivered a normal sibling weighing 2850 grams in the 37th week. PMID- 3815841 TI - Sjogren's syndrome and vulvar cancer. AB - In the vulvar pathology surgery unit we have come across 3 patients with Sjogren's syndrome. Two of them also now show the presence of vulvar carcinoma, and one of them shows the presence of vulvar dystrophy with dysplasia. This has induced us to consider the possible connections between the 2 pathologies. All 3 of the patients, at different times and in different periods have been treated with steroids for the original disorder. The connections between the 2 affections are presumably to be found in the possible autoimmunitary genesis of the original disease and in the concomitant use of steroids. PMID- 3815842 TI - Macrophage-mediated tumoricidal activity generated by human C-reactive protein (CRP) encapsulated in liposomes is complement-dependent. PMID- 3815843 TI - The sensitivity and specificity of monoclonal antibodies URO-2 and 19-9 in the immunohistochemical classification of primary adenocarcinomas. PMID- 3815844 TI - Interocular transfer. An assessment of binocularity in strabismus. PMID- 3815845 TI - Magnetic resonance and computed tomography evaluation of tracheobronchial lesions prior to laser photoresection. PMID- 3815846 TI - Dysplasia epiphysealis hemimelica presenting as a progressive, painful flatfoot deformity. PMID- 3815847 TI - Neuroleptic malignant syndrome. An unusual cause of fever. PMID- 3815848 TI - Secretory villous tumor of the ampulla of Vater. PMID- 3815849 TI - Spontaneous cholecystocutaneous fistulas. PMID- 3815850 TI - Evaluation of the temporomandibular joint. PMID- 3815851 TI - The effect of lead on tetrahydrobiopterin metabolism. A possible mechanism for neurotoxicity. AB - The use of low levels of lead in vivo in rats has been found to inhibit dihydropteridine reductase and cause an apparent increase in tetrahydrobiopterin biosynthesis. At higher dose levels inhibition of tetrahydrobiopterin biosynthesis has been observed. At low levels the disruption of tetrahydrobiopterin metabolism has been found to give an increase in the total level of biopterin derivatives but a movement away from the fully reduced form to the oxidised species in a manner consistent with dihydropteridine reductase inhibition. Lead has been found to inhibit dihydropteridine reductase in man. PMID- 3815852 TI - Measurement of 5-aminolaevulinic acid by reversed phase HPLC and fluorescence detection. AB - A new method for sensitive measurement of delta-aminolaevulinic acid (ALA) in biological material is described. ALA is derivatized with dansyl chloride, separated by HPLC and estimated using a fluorescence detector. The pretreatment of biological samples includes desamination of L-alpha-aminoacids with L aminoacid-oxidase before dansylation. The sensitivity of the method is slightly below 1 pmol/injection for standards and the lower limit of quantification is 0.1 mumol/l for plasma and 10 nmol/l for cerebrospinal fluid. Reference values in plasma are 3.53 +/- 1.75 (SD) (n = 43) mumol/l and in packed erythrocytes they ranged from 6 to 26 mumol/l (mean: 14.0 +/- 5.5 mumol/l). In cerebrospinal fluid of non-porphyric individuals less than 2 nmol/l were recovered. PMID- 3815853 TI - Impaired hepatocellular integrity during general anaesthesia, as assessed by measurement of plasma glutathione S-transferase. AB - The measurement of plasma glutathione S-transferase (GST) concentrations have been used to assess the changes in hepatocellular integrity which occur following general anaesthesia. Of 20 selected patients, who received halothane for minor urological procedures, 16 showed a small transient rise in GST between 1 h and 3 h after anaesthesia. Similar changes were also observed in 8 consecutive patients who received halothane for various operative procedures. In 3 of these 28 patients a marked secondary rise in plasma GST was observed 24 h after anaesthesia. No significant changes in ALT were observed in either of the groups of patients. These data indicate two possible phases of hepatotoxicity following halothane administration which results in a transient impairment in hepatocellular integrity in the majority of patients who undergo anaesthesia with this agent. PMID- 3815854 TI - Assay of blood acetaldehyde by HPLC with fluorescence detection of its 2 diphenylacetyl-1,3-indandione-1-azine derivative. AB - A simple sensitive method for the assay of blood acetaldehyde is described. Samples are collected into an organic solution of 2-diphenylacetyl-1,3-indandione 1-hydrazone. Proteins are precipitated immediately and carbonyl compounds react to form fluorescent azine derivatives. Methanol in the reagent mixture prevents the oxidation of any ethanol present, precipitates protein and releases any absorbed acetaldehyde. After protein removal, the reaction is completed by the addition of an acid catalyst and a portion of the reaction mixture is subjected to quantitative analysis by high performance liquid chromatography. PMID- 3815855 TI - Hepatic damage in the rat following administration of thyroxine or triiodothyronine, assessed by measurement of plasma glutathione S-transferase YaYa concentrations. AB - A specific radioimmunoassay (RIA) has been developed that has sufficient sensitivity to allow measurement of the changes in plasma and tissue glutathione S-transferase (GST) YaYa concentrations which occur following thyroid hormone administration in the rat. Using the RIA it was demonstrated that the only tissues that had significant amounts of GST YaYa were liver, small gut and kidney. Administration of triiodothyronine (T3) or thyroxine (T4) resulted in increases in plasma GST YaYa concentration and in animals given high doses of T4 plasma alanine aminotransferase activity was also elevated. Thyroid hormone administration produced a significant fall in the hepatic content of GST YaYa and in total GST activity, as assessed using 1-chloro-2,4-dinitrobenzene as substrate. It is concluded that the elevated plasma GST YaYa concentrations observed following administration of thyroid hormones result from hepatic damage, not from induction of hepatic synthesis of the enzyme. PMID- 3815856 TI - Very long chain fatty acids in genetic peroxisomal disease fibroblasts: differences between the cerebro-hepato-renal (Zellweger) syndrome and adrenoleukodystrophy variants. AB - Very long chain fatty acids were investigated by gas chromatography in fibroblasts of patients with genetic peroxisomal diseases (cerebro-hepato-renal (Zellweger) syndrome, childhood adrenoleukodystrophy, adrenomyeloneuropathy, neonatal adrenoleukodystrophy) and of controls. Concentrations of C 26:0 were increased to about the same extent in all disorders investigated. C 26:1 concentrations, on the other hand, were considerably elevated only in the cerebro hepato-renal syndrome. In all control, adrenoleukodystrophy, and adrenomyeloneuropathy cases the C 22:0 concentration was higher than the respective C 26:0 concentration; the reverse was found in the cerebro-hepato renal syndrome. These differences seem to reflect different impairment of peroxisomes in the cerebro-hepato-renal syndrome and adrenoleukodystrophy variants, respectively. Additional experiments to characterize C 26:1 by thin layer chromatography, gas chromatography and mass spectrometry revealed the presence of two straight-chain C 26:1 isomers with similar fragmentation patterns. PMID- 3815857 TI - Effect of ileal exclusion on kinetics of very low density lipoprotein triglycerides in familial hypercholesterolemia. AB - Plasma lipoproteins, VLDL triglyceride kinetics, and bile acid and cholesterol synthesis were measured in 21 patients heterozygous for familial hypercholesterolemia with (n = 11) or without (n = 10) ileal bypass. LDL cholesterol and apoprotein B concentrations were lower, and cholesterol and bile acid synthesis, the VLDL triglyceride/cholesterol ratio, and the HDL cholesterol concentration were higher in the operated than the control patients. The VLDL triglyceride production rate was increased in the operated normotriglyceridemic patients by about 65%, whereas the fractional catabolism of VLDL triglycerides and the calculated VLDL cholesterol transport were similar in the operated and control groups. VLDL triglyceride production was not correlated with cholesterol or bile acid synthesis. The VLDL triglyceride concentration was positively correlated with the production and negatively with the fractional catabolism of VLDL triglycerides. In unoperated normotriglyceridemic patients the VLDL triglyceride production was positively correlated with LDL cholesterol (r = 0.69, p less than 0.05), LDL triglyceride (r = 0.84, p less than 0.01) and LDL apoprotein B (r = 0.80, p less than 0.01) concentrations, and with the LDL triglyceride/apoprotein B (r = 0.72, p less than 0.05) and LDL triglyceride/cholesterol (r = 0.68, p less than 0.05) ratios. None of these correlations was significant in the operated patients. We conclude that in heterozygous familial hypercholesterolemia VLDL triglyceride level depends on both VLDL triglyceride synthesis and catabolism, LDL level is proportionate to VLDL triglyceride production in the unoperated patients but not in the patients with ileal bypass, ileal exclusion results in an increase in the production rate of VLDL triglycerides in normotriglyceridemic patients but otherwise VLDL triglyceride production is poorly associated with cholesterol and bile acid synthesis, ileal exclusion may induce hepatic secretion of triglyceride-rich VLDL. PMID- 3815858 TI - Attenuation of alpha-adrenergic responsiveness in hypoxic SHR. AB - Chronic exposure to hypoxia reduces the severity of hypertension in SHR. This study explored the possibility that hypoxic moderation of spontaneous hypertension is caused by a decrease in vascular responsiveness. In vitro studies were conducted with thoracic aortic rings obtained from SHR and Wistar-Kyoto (WKY) rats maintained under hypoxic (H; simulated altitude = 3658 m) and normoxic (N; laboratory altitude = 1520 m) conditions. Vessels were removed prior to the rapid development of hypertension (5 weeks of age; 3 days of altitude exposure), during the rapid hypertension-development stage (10 weeks of age; 5 weeks of altitude exposure), and during the established hypertension stage (18 to 20 weeks of age; 11 to 13 weeks of altitude exposure). Dose-response curves were obtained using a non-specific vasoconstrictor (KCl) and an alpha-adrenergic agonist, phenylephrine. At all ages, WKY vessels developed greater maximal contraction to vasoconstrictor stimuli, whereas vessels from the two older groups of SHR were more sensitive (more responsive at lower dosages) to KCl. Hypoxia caused significant (p less than 0.05) attenuation of the contractile responses to phenylephrine in young "pre-hypertensive" SHR, while similar, though less marked, attenuation of phenylephrine responsiveness was evident in young WKY-H. Chronically-reduced responsiveness to phenylephrine was found in vessels from SHR H but not WKY-H. The lack of hypoxia-induced changes in vessel response to the non-specific vasoconstrictor, KCl, suggests a specific hypoxic attenuation of adrenergic vascular responsiveness. Thus, hypoxia may protect against the development of spontaneous hypertension through attenuation of alpha-adrenergic vasoconstrictor mechanisms. PMID- 3815859 TI - 3H-norepinephrine release in hypothalamus and brainstem of Dahl-salt sensitive and resistant rats in vitro. AB - Electrically evoked 3H-norepinephrine release was measured in slices of hypothalamus and brainstem of Dahl-salt sensitive (Dahl-S) and Dahl-salt resistant (Dahl-R) rats on both high and low sodium chloride diets. Only those Dahl-S rats fed a high sodium chloride diet became hypertensive, systolic blood pressure above 150 mmHg, although the Dahl-S rats on a low sodium diet, and Dahl R rats fed a high sodium diet, both had blood pressures that were elevated compared to the Dahl-R rats maintained on a low sodium diet, when measured at the time of sacrifice. The Dahl-S rats on a high sodium diet also showed an enhancement in the field-stimulation induced release of 3H-norepinephrine in the posterior hypothalamus. Evoked 3H-norepinephrine release was not altered in low sodium diet Dahl-S rats or in low or high sodium salt Dahl-R rats. The stimulation induced 3H-norepinephrine release was also not different in the anterior hypothalamus or the A2 region of the nucleus tractus solitarius in either Dahl-S or Dahl-R animals on either sodium chloride diet. These results suggest that the alteration of evoked 3H-norepinephrine release, specifically in the posterior hypothalamus may play a role in the development and/or maintenance of hypertension. PMID- 3815860 TI - Swimming with a mastoid cavity: what are the risks? AB - The authors have found no studies and little guidance in the literature on the advisability of people swimming with a modified radical mastoid cavity. Two groups of such outpatients were therefore followed up at 2-monthly intervals for 6 months. One group of 56 patients swam (81% without ear protection) and the other group of 55 patients maintained their ears quite dry. Swimming did not increase the incidence of an infected mastoid cavity. The most important risk of swimming was vertigo which occurred in 5% of swimmers. PMID- 3815861 TI - Tinnitus: a management model. AB - A comprehensive model of tinnitus management is proposed. As it is rarely possible to abolish the symptom, management of the tinnitus patient must aim at precipitating the habituation process. The model is split into 'evaluation' and 'remediation' sections. In each section the various aspects of management are discussed. Together with traditional factors, the importance of psychological processes is stressed. The role of the expectations of the patient in limiting remedial possibilities is also discussed. PMID- 3815862 TI - Day case surgery in otolaryngology: a 10-year analysis. AB - This paper analyses the ENT day case surgery performed over the period May 1974 to May 1984 in Cardiff. The patients undergoing such surgery, the types of surgery, forms of anaesthesia, travelling considerations, seasonal variation and admission rate are examined. The problems of list organization, patient selection and attendance are examined in detail in a 12-month period from May 1981 to May 1982. PMID- 3815863 TI - Bell's palsy and stapedial reflex. AB - In Bell's palsy the stapedial reflex may be affected or not. The object of this paper was to study the evolution of the stapedial reflex and its latency pattern during the first weeks of paralysis and to correlate these parameters with the evolution of the disease. One hundred and thirty-three patients with Bell's palsy were evaluated, and the patients could be divided into 3 groups. Group 1 was composed of subjects in whom the stapedial reflex was present in the first week of paralysis and complete recovery of facial function occurred in 30-60 days. In group 2 the stapedial reflex reappeared between the eighth and thirty-fifth days post-onset and facial function recovered within 150 days. In group 3, the stapedial reflex reappeared between the thirty-sixth and seventieth day and some paralysis was still present after 1 year. These results suggest that the reflex is important for prognostic purposes. PMID- 3815864 TI - The designs, control and pitfalls of clinical trials. PMID- 3815865 TI - Assessment of the effect of chemotherapy and radiotherapy on the auditory function of children with cancer. AB - Forty children with malignant disease underwent full audiological assessment with pure tone audiometry, tympanometry and measurement of brain stem auditory evoked potentials in an attempt to detect auditory dysfunction resulting from treatment. Significant auditory dysfunction was observed in 8 children. Three children with evidence of a conductive or sensorineural deafness on pure tone audiometry had normal brain stem evoked potentials. One child with a high tone hearing loss and 4 children with no detectable hearing loss on audiometry showed significant differences in the interaural interpeak latencies of selected brain stem auditory evoked potentials. In 2 children these abnormalities had resolved on subsequent testing, 2 had evidence of persistent retrocochlear dysfunction and the remaining child died prior to further evaluation. Routine measurement of brain stem auditory evoked potentials is probably not necessary for the majority of children undergoing treatment for cancer, although such measurements are of value when differentiation between cochlear and retrocochlear damage is required. PMID- 3815866 TI - Studies on the mechanics of the reconstructed human middle ear. AB - Using a laser-Doppler interferometer the influence of different positions of an incus prosthesis on hearing performance was examined in human temporal bone preparations. The influence of position and tension of a malleus to footplate prosthesis (columella) was studied in the same way. It is concluded that an incus prosthesis should be placed along an imaginary line through the centre of the footplate and the head of the stapes. With a malleus to footplate prosthesis the position on the footplate is relatively unimportant. Tension between the malleus, prosthesis and footplate, however, is quite important and should be as low as possible, and compatible with a stable situation. The malleus to footplate prosthesis provides a columella type of prosthesis which for lower frequencies works better than an incus prosthesis, and occasionally even better than the normal ear. PMID- 3815867 TI - Laryngeal papillomas: classification and course. AB - Seventy-one cases of laryngeal papillomas have been reviewed. Based on differences in age at presentation, female: male ratio and multiple versus solitary papillomas, the cases were classified into 4 groups: multiple juvenile papillomas, solitary juvenile papillomas, multiple and solitary adult papillomas. The clinical course in the groups is described. The authors do not support the common opinion that juvenile papillomas are influenced by puberty. PMID- 3815868 TI - Tinnitus in childhood. AB - Ninety-three healthy children attending routine school and community medical examinations were questioned about tinnitus, 27 of them (29%) described tinnitus. Nine children (9.6%) were bothered by their symptom, the others were not. The incidence of tinnitus in this group was compared with that in a group of 109 children with ear disease. Forty-two children (38.5%) in this group reported tinnitus. This difference is not statistically significant. Details of children attending paediatric ENT clinics were recorded by two ENT surgeons. Four hundred and three children were seen during the study period and of these 13 (3%) reported tinnitus spontaneously. All these children had evidence of ear disease at the time of the consultation. The incidence of tinnitus in those members of this group with abnormal ears was significantly higher than in those children with no evidence of ear disease (P = less than 0.02). Tinnitus may be a manifestation of ear disease in children, but may also be described by children with normal ears. PMID- 3815869 TI - A systematic approach to parathyroid surgery. AB - In the last 8 years 33 patients with hyperparathyroidism have been surgically treated by the authors. Thirty patients had primary, 2 secondary and 1 tertiary hyperparathyroidism. In the 30 patients with the primary disorder, 26 had a single adenoma and 28 of these patients had normal calcium levels postoperatively. Two patients were hypocalcaemic following surgery and required calcium supplements for 3 months and 9 months respectively. It is recommended that when a single adenoma is found its removal will render the patient normocalcaemic. When all 4 glands are hyperplastic the surgery should be subtotal (3 1/2 glands) parathyroidectomy except in the case of secondary hyperparathyroidism when total parathyroidectomy with autotransplantation and cryopreservation of the remainder should be performed. PMID- 3815870 TI - Inner hair cell loss and intracochlear clot in the preterm infant. AB - Little is known about the pathological changes in the cochlea of preterm infants which might be responsible for the hearing loss which the infants are at risk of developing. This study looks at the cochleas of 5 preterm infants who died at ages up to 2 weeks using light and electronmicroscopic techniques, and shows changes in the inner hair cell population in association with intracochlear clot which may be responsible for subsequent hearing loss. PMID- 3815871 TI - Results of treatment with alpha-interferon in adult-onset laryngeal papillomatosis. AB - Juvenile laryngeal papilloma occurs mainly in childhood, but is also occasionally seen in adults. The treatment of this disease has been very unsatisfactory. During the last decade, vaporization of the papillomas with the carbon dioxide laser has been the most frequently applied method of treatment, but recurrences are often observed. Alpha-interferon seems to affect the clinical course of juvenile laryngeal papillomatosis in children. We therefore started treating 3 patients with persistent adult-onset laryngeal papillomatosis with alpha interferon in combination with regular endoscopic removal using the CO2 laser. In 1 case a complete remission occurred within 3 months. Administration of alpha interferon was continued for another 6 months. Laryngoscopy in the 2 other patients showed only minor lesions after treatment with alpha-interferon for 1 1/2 years. Alpha-interferon treatment is still being continued. The dramatic improvement in the laryngeal picture of these patients during the treatment with alpha-interferon leads to the conclusion that alpha-interferon can affect the course of this disease. Whether a definite cure can be achieved is, however, still questionable. PMID- 3815872 TI - Antroscopy: its place in clinical practice. A comparison of antroscopic findings with radiographic appearances of the maxillary sinus. AB - One hundred and fifteen patients with chronic nasal symptoms underwent both radiological and antroscopic investigation of their maxillary sinuses. A total of 193 antra were studied. The radiological diagnosis completely correlated with the antroscopic findings in only 44% of the cases. The reasons for this discrepancy are discussed as well as the additional limitations of radiology in the diagnosis of the opaque antrum and the accurate detection of sinus fluid. Antroscopy provides accurate information about the nature of mucosal changes, the presence of secretions and the state of the natural ostium. This technique therefore ensures a precise diagnosis on which appropriate primary treatment can be based as well as offering the most reliable means of selecting patients who require surgery. The potential for detecting early antral tumours is stressed. It is concluded that antroscopy is the most useful investigation in the management of chronic conditions of the maxillary sinus. However, radiology still has its place as a primary screening test, particularly when the radiographic findings are negative. PMID- 3815873 TI - Cervical lymph node metastases with occult primary. AB - Patients with cervical metastases from an unknown primary tumour present both diagnostic and therapeutic problems. Twenty patients with a metastatic lesion in the neck, in whom the primary tumour was not found despite extensive, diagnostic procedures, were treated in the Department of Otolaryngology, Linkoping University Hospital, during a 14-year period (1971-1984). Since 1975 tonsillectomy has been performed regularly on the affected side as a part of the diagnostic procedure. Eight patients without any clinical signs of a tonsillar primary have been diagnosed to have carcinoma by tonsillectomy and careful examination of the serially sectioned tonsillectomy specimen. The diagnosis of the metastatic nodes was based on histopathological examination in 8 patients and on fine needle aspiration cytology in 12. Four of 9 patients with squamous cell carcinoma survived 3 years and so did 4 of 5 with anaplastic carcinoma. All 5 patients treated surgically are alive and 6 of 12 who were irradiated. Ten of 12 patients with mobile unilateral nodes (N1) were alive at follow-up after 1-13 years but only 3 of 8 patients with fixed nodes (N3) at follow-up of 1-3 years. PMID- 3815874 TI - Role of surgical treatment in pancreatic carcinoma. AB - From 1964 through 1984, we treated 810 patients for carcinoma of the pancreas. In 129 patients PDE was possible (16%). Up to 1977, we had performed Whipple's procedures, while from 1978 through 1982 total pancreatectomy was our principal procedure. Since 1983, partial PDE again has been the procedure of choice for the potentially curative treatment of pancreatic cancer. Comparing the results of both methods (60 partial/64 total), we did not find any advantages of total pancreatectomy. Operative mortality increased after total PDE and survival time related to tumor stage did not extend. The 2-year survival rate for partial PDE was 26 and for total PDE 14%. Regarding the patients with unresectable cancer of the pancreas, the rate of those not undergoing surgery rose to 25% due to better preoperative staging by modern imaging techniques, while the rate of exploratory laparotomies was reduced to 5%. Since the preoperative use of PTCD, the mortality rate of our palliative procedures dropped to 12%. The biliodigestive anastomosis of choice is the hepaticojejunostomy. Gastroenterostomy is not routinely added (6% only). PMID- 3815875 TI - Carcinoma of the ampulla of vater. PMID- 3815876 TI - Coexistent pseudohypoparathyroidism and D brachydactyly in a family. AB - The occurrence of pseudohypoparathyroidism/pseudopseudohypoparathyroidism (PH/PPH) and D brachydactyly (DB) in different persons in the same family is described for the first time. The theory that PH/PPH, E brachydactyly (EB), acrodysostosis (AD) and DB are variable expressions of the same trait or allelic traits is proposed. It is advised that newborn babies in such families are investigated carefully in order to exclude hypocalcemic PH. It is suggested that EB is subdivided into 4 groups (E1-E4) according to the degree of symptoms. The proband of this family was a unique case. In addition to normocalcemic PH she also suffered from hemochromatosis, another rare hereditary disease and she had an abnormal chromosome 20, not earlier described. Both findings were supposed to be coincidental. PMID- 3815877 TI - Ehlers-Danlos features with progeroid facies and mild mental retardation. Further delineation of the syndrome. AB - A syndrome characterized by progeroid facies, multiple nevi, mild mental retardation, skin hyperextensibility, bruisability, moderate skin fragility, joint hypermobility principally in digits, is described in two unrelated patients. Electron microscopy of the skin showed some fragmentation of the elastic fibers' portion and moderate electrodensity in the amorphous portion. Since a practically identical constellation of clinical features was previously reported in three patients, the individualization of a distinct connective tissue disorder, probably autosomal dominant, with variable expressivity is concluded. PMID- 3815878 TI - Case report: partial trisomy 20q (20q13.13----qter). PMID- 3815879 TI - Ring 21 chromosome: the mild end of the phenotypic spectrum. AB - The case is reported of a child with the karyotype 46,XY,r(21), who presented with linear growth retardation but who appears, at age 2 years 8 months, to be developing normally mentally. There is a small number of reports of mildly affected cases of r(21), and of some with an apparently completely normal phenotype. We presume a structural and functional cytogenetic heterogeneity underlies the observed phenotypic heterogeneity in the ring 21 spectrum. PMID- 3815880 TI - Neurodevelopmental and psychological aspects in a child with 49XYYYY karyotype. AB - Neurodevelopmental and psychological aspects in a child with 49XYYYY karotype are described. The developmental examination revealed mild mental retardation (I.Q.=50), disturbances in gross and fine motor development and speech disorders. The child was treated by developmental therapy which improved his abilities for a better social adjustment. PMID- 3815881 TI - Asymmetric crying facies with microcephaly and mental retardation. An autosomal dominant syndrome with variable expressivity. AB - An infant boy with asymmetric crying facies, microcephaly, developmental retardation and failure to thrive is reported. His two siblings died in the newborn period because of complex congenital heart defects. The mother and the maternal grandmother have asymmetric crying facies, microcephaly and normal intelligence. A maternal aunt has severe physical and mental retardation, facial asymmetry, microcephaly, and cleft palate. This family allows an expansion of the spectrum of malformations associated with asymmetric crying facies and suggests autosomal dominant inheritance with variable expressivity. PMID- 3815882 TI - Client reactions to genetic counseling: self-reports of influence. AB - Of 628 clients completing questionnaires six months after genetic counseling, 273 (43.5%) reported that their reproductive plans had been influenced by the counseling session. Of those who said that they were influenced, 144 (52.7%) held the same reproductive plans that they reported before counseling: 41 (15%) were planning more pregnancies, 36 (13.2%) were planning fewer, and 52 (19.1%) became reproductively uncertain. A similar pattern of stability and change appeared in the reproductive plans of those who reported that they were not influenced by genetic counseling. Stepwise logistic regression indicated that clients who reported that their plans were influenced: came to counseling to get information for making a decision about whether to have a child; discussed this decision in depth with the counselor; and had more education than clients who said that they were not influenced. We found no evidence that counseling was supplanting clients' own personal values. In the discussion, we suggest several reasons why clients of higher socio-economic status are more likely than others to report that they are influenced, and discuss the ethical implications of these results. PMID- 3815883 TI - Trisomy (18q) and tetrasomy (18p) resulting from isochromosome formation. AB - In this paper we report two clinically recognizable chromosomal syndromes, both resulting from isochromosome 18 formation, i.e. trisomy 18q and tetrasomy 18p. The possible mechanisms of the isochromosome formation are discussed and the literature on subject is reviewed. PMID- 3815884 TI - Use of a biotinylated DNA probe specific for the human Y chromosome for rapid antenatal sex determination. AB - We have cloned a male-specific 3.4 kb human DNA sequence which showed only little crosshybridisation to autosomal sequences. To further enhance the specificity of the probe, we subcloned an internal TaqI-fragment resulting in clone pH343T33. This clone was used to determine the presence of Y-chromosomal sequences in DNA extracted from amniotic cells and from chorionic villi by Southern and dot hybridisation assays, respectively. Using this clone, we correctly predicted fetal sex in all of 148 cases analysed. To facilitate the use of this clone in clinical practice, we simplified the dot hybridisation procedure so that it can be performed in less than 48 h. The procedure with 32P-labeled DNA probes requires less than 0.5 mL of amniotic fluid; when biotinylated DNA probes are used, 3-5 mL of amniotic fluid usually suffice. We have used this probe in genetic counseling of families at risk for X-linked disorders. PMID- 3815885 TI - Response to Stene's comments on the segregation of balanced pericentric inversions. PMID- 3815886 TI - A simplified method for observing and recording dermatoglyphic patterns, including counting sweat pores. PMID- 3815887 TI - Congenital non-bullous ichthyosiform erythroderma--cell kinetics before and after treatment with etretinate. PMID- 3815888 TI - Urticarial vasculitis. PMID- 3815889 TI - Anatomical location of human skin furrows. PMID- 3815890 TI - Langerhans cells--a reduction in numbers and their reappearance following steroid and cytotoxic therapy in humans. PMID- 3815891 TI - A comparative study of the allergenicity of quaternary ammonium compounds in guinea-pigs. PMID- 3815892 TI - Benign dermal Schwannoma with glandular elements--true heterology or a local 'organizer' effect? PMID- 3815893 TI - Cryosurgery of rhesus monkey skin--evaluation of epidermal thickening and effect on elastic component. PMID- 3815894 TI - Treatment of mucoid cysts of fingers and toes by injection of sclerosant. PMID- 3815895 TI - Congenital malalignment of the great toe-nails--an inherited condition. PMID- 3815896 TI - Squamous cell carcinoma in a frost-bite scar. PMID- 3815897 TI - The distribution of gluten-sensitive lymphocytes in coeliac patients--is it related to dietary gluten? AB - Cell-mediated immunity to gluten within the peripheral blood and jejunal mucosa of the same coeliac patients was measured simultaneously using migration inhibition tests. There was an inverse correlation in migration indices indicating that as cell-mediated immunity became more detectable in the peripheral blood, it was less so in the jejunal mucosa and vice versa. There was virtually no relationship, however, between this correlation and the gluten content of the diet in these coeliac patients. PMID- 3815898 TI - Imbalanced serum IgG subclass pattern in toxic shock syndrome patients: deficiency of specific IgG1 and IgG4 subclass antibodies to toxic shock syndrome toxin 1. AB - An imbalanced serum IgG subclass pattern was identified in 10 patients with toxic shock syndrome (TSS) showing remarkably low subclass levels of various combinations. IgG2 levels were significantly reduced as compared to normal controls. The IgG subclass-specificity of antibodies to toxic shock syndrome toxin (TSST-1) was investigated by a solid-phase radioimmunoassay. TSS-patients lacked pre-immunity to TSST-1 in all four IgG subclasses. Normally acquired immunity to the toxin as well as the serological response developing in two patients with TSS was generally restricted to IgG1 and IgG4. A strong booster response of all four IgG subclasses was seen in three patients with S. aureus septicaemia due to TSST-1 producing strains. The lack of specific IgG1 and IgG4 antibodies to TSST-1 and the low serum IgG subclass levels found in the TSS patients could be of pathogenetic significance and help to explain the susceptibility to TSS in certain individuals. PMID- 3815899 TI - Abnormal humoral immune response to Staphylococcus aureus in patients with Staphylococcus aureus hyper IgE syndrome. AB - Patients with the S. aureus hyper IgE syndrome (SAHIGES) have an abnormal IgE response to cell wall and surface antigens of S. aureus. In this paper we describe the detection of IgE antibodies to soluble antigens of staphylococci (S. aureus and S. epidermidis) and qualitative abnormalities of the IgG response to soluble S. aureus antigens in patients with SAHIGES. These findings may be of pathogenetic importance and help to delineate SAHIGES from other diseases. PMID- 3815900 TI - Development of anti-polysaccharide antibodies in asplenic children. AB - Splenectomized patients are highly susceptible to infections with capsulated bacteria and an impaired response to vaccination with bacterial polysaccharides has frequently been observed in these individuals. Based partly on experimental animal data, an important role for the spleen in the production of specific anti carbohydrate antibodies, i.e. mostly IgG2 in normal adults, has been suggested. We therefore determined the immunoglobulin class and subclass pattern of serum antibodies from asplenic patients against protein and carbohydrate antigens. Normal levels of total serum IgM, IgG2 and specific IgM and IgG2 anti polysaccharide antibodies were observed, suggesting only a minor role for the spleen in determining the antibody repertoire. The data imply that the impaired phagocytic capacity and/or the inability to mount a sufficiently rapid antibody response are the main factors underlying the increased susceptibility to bacterial infections noted in these patients. PMID- 3815901 TI - Functional C8 associated with human platelets. AB - Haemolytic assay for C8 revealed its association in functionally active form with washed human platelets. Platelet-bound C8 haemolytic activity was inhibited by F(ab')2 anti-C8 and was undetectable in the platelet suspension obtained from three C8 deficient patients. Incubation of platelets from C8 deficient individuals in normal plasma did not restore C8 haemolytic activity, indicating that platelets do not absorb C8 from plasma in vitro during platelet preparation. Thrombin, a mediator of the platelet release reaction, did not induce the release of C8 from normal platelets. Conversely, lysis of EAC1-7.9 by platelet bound C8 was not accompanied by release of beta-thromboglobulin or serotonin from the platelets. C8 was detected in a homogenate prepared from platelets as well as in the supernatant collected after high speed centrifugation of the homogenate. The association of C8 with platelets as an individual component rather than as part of the C5b-9 membrane-attack complex was supported by the following evidence: platelet bound C8 eluted from a Sephacryl S-200 column at the same volume as C8 from normal human serum; F(ab')2 anti-C8, but not F(ab')2 anti-C5, inhibited platelet C8 activity; the platelet homogenate, which lysed EAC1-7.9, had no effect on EAC43 which are susceptible to the lytic activity of the C5b-9 complex. PMID- 3815902 TI - Studies on the specificity of antibodies to ovalbumin in normal human serum: technical considerations in the use of ELISA methods. AB - As part of a study designed to reveal information about molecular features of allergenic food proteins after absorption from the gut the specificity of antibodies in normal human serum to hen's egg ovalbumin was investigated using ELISA techniques. Preliminary investigations with monoclonal antibodies and hyperimmune rabbit antiserum specific for ovalbumin in its native and denatured form established that the molecule underwent an extensive conformational change on adsorption to polyvinyl chloride microtitre plates. The native conformation could be retained by using antibodies to couple the protein to the surface. Serum from 90% of healthy adult human donors contained IgG antibodies to ovalbumin. In nearly all cases the antibodies were specific predominantly for the native molecule and could not be absorbed with denatured ovalbumin or peptides prepared from it by cleavage with cyanogen bromide or trypsin. Antibodies to denatured ovalbumin were detected in most sera but at very low levels and were preferentially absorbed by the homologous antigen; peptides and native ovalbumin showing variable absorptive activity. Thus, although ovalbumin is ingested largely in a denatured form, the serum antibody response is stimulated mainly by topographic epitopes of the native molecule. PMID- 3815903 TI - Malignant or accelerated hypertension in IgA nephropathy. AB - A retrospective analysis of 66 adult patients diagnosed as having IgA nephropathy by renal biopsy revealed that 24 (36%) were hypertensive when first seen. Of these hypertensive patients, 10 (15%) had malignant or accelerated hypertension. All patients but one were male and had no knowledge of their renal disease and sought medical advice for symptoms due to hypertension. Five patients had no history of gross hematuria. Histological vascular findings showed, in three proliferative endarteritis and fibrinoid necrosis, in five arteriolosclerosis and in two vascular hypertrophy. In spite of good blood pressure control, six patients reached terminal uremia within a maximum of 14 months. In summary, the incidence of malignant hypertension in adults with IgA nephropathy is higher than previously reported, and its true incidence can only be known if more histopathologic studies of patients with malignant hypertension are performed. Patients with this association reach end stage renal failure in a short period of time. PMID- 3815904 TI - Hypertension and nephrotoxicity in the rate of decline in kidney function in diabetic nephropathy. AB - Serum creatinine levels were determined prospectively every 2 to 3 months in 40 patients with diabetic nephropathy for a global observation period of 864 months. The monthly creatinine increasing rate was significantly lower in normotensive periods, mean arterial pressure (MAP) less than 115 mmHg, when compared with hypertensive periods, MAP greater than 125 mmHg. No significant difference was shown in periods with borderline hypertension (MAP between 115-124 mmHg). The mean creatinine increases were of 0.036 mg/dl/month, 0.3 mg/dl/month and 0.046 mg/dl/month respectively. Normotension was associated with a slowing down of the rate of decline in renal function in this group of moderate kidney failure with an initial mean serum creatinine of 2.26 mg/dl. The exposure of patients to nephrotoxics (aminoglycosides, and possibly anesthesia) significantly accelerated the decline in renal function: 0.39 mg/dl/month and 0.17 mg/dl/month respectively according to the concomitance or not of toxics and hypertension. The reported protective effect of diabetes against aminoglycosides nephrotoxicity in experimental conditions was not reflected in our clinical results. On the contrary, we suggest a possible enhanced sensibility of the diabetic patient with diabetic nephropathy to aminoglycosides leading to an acceleration of the progression of renal failure. PMID- 3815905 TI - Hemodynamic and volume changes by ultrafiltration in refractory edema of diabetic nephrotic syndrome with severe renal insufficiency. AB - Effects of ultrafiltration (UF) were examined in 6 diabetic nephrotics having refractory edema. Plasma volume (PV) was 139% of the normal control before and significantly reduced to 125% N after UF (p less than 0.05). Average reduction of PV was 0.3 l, while that of body weight was 4.4 kg. This means that UF induces mainly the reduction of extracellular fluid volume with very little effect on blood volume due to high intravascular refilling. Hemodynamically, cardiac index decreased and total peripheral resistance index (TPRI) remained unchanged according to the decrease of mean blood pressure (MBP). Change in MBP was linearly correlated to that in TPRI. The present study indicates that UF leads to interstitial fluid volume depletion and blood pressure reduction in diabetic nephrotics with severe renal insufficiency. Clinically, UF is a temporary relief from a life-threatening generalized edema in these patients, although neither the progress of renal dysfunction or the recurrence of nephrotic syndrome can be prevented. PMID- 3815906 TI - A single dose of a low molecular weight heparin fragment for anticoagulation during hemodialysis. AB - A low molecular heparin fragment (Fragmin, mol. wt. 4-6000 d), given as a single injection (dose 5000 anti-Xa U), was used as an anticoagulant during hemodialysis in 11 patients. In comparison, our routine heparinization procedure was used; conventional heparin was given as a bolus injection at the start and then as continuous infusion during dialysis to prolong the whole blood activated clotting time (WBACT) 125-175%. Fibrin formation, followed by visual inspection and the measuring of fibrinopeptide A and fibrin monomer concentrations were equally suppressed by the two regimens. WBACT was less prolonged with Fragmin. Anti-Xa activity above 0.39 U/ml was maintained throughout the dialyses with Fragmin. In conclusion a single dose of Fragmin gives sufficient anticoagulation for hemodialysis lasting up to 4 hours. PMID- 3815907 TI - Interstitial nephritis and primary biliary cirrhosis: a new association? AB - Interstitial nephritis may be associated with a variety of auto-immune disorders, but there have been no reports among these of primary biliary cirrhosis. A patient presenting with sodium- and potassium-losing nephropathy due to interstitial nephritis was discovered to have primary biliary cirrhosis which was asymptomatic. Correction of the electrolyte abnormalities with sodium and potassium supplements had no effect on renal function, but creatinine clearance increased from 28 to 68 ml/minute during a seven-week course of prednisolone. The occurrence in primary biliary cirrhosis of other forms of renal tubular dysfunction, the frequent presence in both interstitial nephritis and primary biliary cirrhosis of multi-system involvement and the close temporal relationship in this patient, suggest that the two conditions were related. PMID- 3815908 TI - Hemolytic uremic syndrome and prostatic adenocarcinoma. PMID- 3815909 TI - Fatal massive hemoperitoneum after cessation of CAPD. PMID- 3815910 TI - Low protein diet and 1,25 (OH)2 D3 levels. PMID- 3815911 TI - Effects of verapamil on left ventricular diastolic function at rest and during isometric exercise in patients with hypertrophic cardiomyopathy. AB - Ten patients with hypertrophic cardiomyopathy were examined with echocardiography before and during verapamil treatment to evaluate short-term and long-term effects of verapamil on left ventricular diastolic function. All patients were in sinus rhythm and in NYHA functional class I. Effects on filling and myocardial relaxation were documented by digitized echocardiography obtained at rest and during isometric exercise before treatment, after two weeks (short-term) and four months (long-term) treatment, respectively. At rest a significant decrease of the myocardial relaxation time was found during verapamil treatment. A few patients, however, returned to almost baseline conditions after an initial improvement. A small increase in the peak rate of dimension change, a parameter of filling, reached statistical significance at the end of the long-term treatment period. Isometric exercise did not induce any changes in the diastolic parameters during verapamil treatment. A positive effect of verapamil was thus seen on both myocardial relaxation and left ventricular filling, but only in resting conditions. PMID- 3815912 TI - Does the combination with handgrip increase the sensitivity of dipyridamole echocardiography test? AB - The aim of this study was to assess the possibility of increasing the sensitivity of dipyridamole-echocardiography testing (DET:2-D echo monitoring during dipyridamole infusion) by combining this procedure with handgrip testing. Dipyridamole-handgrip test (DHT) was therefore performed in 24 patients with rest/effort angina, negative DET, and negative handgrip-echo (without dipyridamole pretreatment). DHT consisted of 4.5 min of sustained 25% maximum grip strength, started 4 min after the end of dipyridamole infusion (0.56 mg/kg for 4 min). Interpretable studies were obtained in all patients. Of the 24 patients tested (10 without and 14 with significant coronary artery disease, CAD), only one CAD patient had a positive DHT, which indicates an increased sensitivity of 7% versus DET alone. In conclusion, DHT is feasible in all patients and--if compared to DET--has the same specificity. However, in spite of the theoretical premises, it provides only a modest step up in sensitivity. PMID- 3815913 TI - Acute and chronic pulmonary thromboembolism: current perspectives. Part VI: Course and prognosis and natural history. PMID- 3815914 TI - Acute myocardial infarction during streptokinase therapy. AB - A 45-year-old man developed sequential inferolateral and anterior myocardial infarctions within 10 hours of a possible allergic reaction to oral penicillin. The anterior myocardial infarction occurred during apparently successful streptokinase therapy for the initial inferolateral infarction. Subsequent coronary arteriography confirmed a subtotal stenosis of the left circumflex coronary artery and a complete thrombotic occlusion of the left anterior descending artery. This case documents the occurrence of three rare clinical phenomena; first, the occurrence of sequential acute myocardial infarctions in close temporal proximity; second, the occurrence of myocardial infarction during thrombolytic therapy; and third, the association of myocardial infarction with a possible allergic reaction. PMID- 3815915 TI - Ventricular parasystole and ventricular couplets: a re-entry within the parasystolic focus? AB - We report a 62-year-old man with a persistent ventricular rhythm originating in a parasystolic focus associated with frequent ventricular couplets with fixed coupling. Both intravenous (IV) procainamide (1 g) and propafenone (70 mg IV) promptly suppressed only the second component of ventricular couplets, suggesting that re-entry rather than enhanced automaticity was the mechanism of ventricular couplets. On the contrary, the nonresponse of ventricular rhythm and ventricular couplets to verapamil (10 mg IV) suggested that triggered activity should not play a role in the genesis of this ventricular rhythm. The mechanisms of the ventricular couplets (rapidly discharging parasystolic focus vs. re-entry) are discussed. PMID- 3815916 TI - Paradoxical embolism to the superior mesenteric artery. AB - Paradoxical embolism occurs when venous thrombi embolize into the systemic arterial circulation by passage of clots through an intracardiac septal defect. This paper describes a case of paradoxical embolism to the superior mesenteric artery in a patient with recent myocardial infarction and pulmonary embolism. This phenomenon was first described in 1877 (Cohnheim, 1877) and many case reports have followed but most of these have been autopsy findings. We emphasize that this diagnosis should be suspected in all patients who suffer systemic arterial emboli without any evidence of left heart origin and/or in association with pulmonary emboli. One author has reviewed 19 cases since 1930, most of which were reported in the past 15 years (Johnson, 1951). This probably reflects an increased awareness of the diagnosis and more sophisticated diagnostic modalities. It also raises the possibility that paradoxical embolism may be more common than originally believed. PMID- 3815917 TI - Right ventricular infarction: unusual electrocardiographic and electrophysiological manifestations. AB - Right ventricular infarction occurs in 19-43% of patients with acute inferior wall infarction (Lorell et al., 1979). Its clinical, hemodynamic, and anatomic features are well known and include associated inferior wall infarction, distended neck veins, clear lung fields, hypotension, and heart block (Cintron et al., 1981; Coma-Canella et al., 1979; Lloyd et al., 1981; Lopez-Sendon et al., 1981; Raabe and Chester, 1978; Rotman et al., 1974). Isolated right ventricular infarction is less frequent and occurs in 2.5-4.6% of autopsy studies of myocardial infarction (Cohn et al., 1974; Erhardt et al., 1976; Wartman and Hellerstein, 1948). This report describes a patient with isolated right ventricular infarction with unusual electrophysiological findings. Her initial electrocardiogram showed atrial escape rhythm with incomplete right bundle-branch block and left posterior hemiblock. Later, she developed atrioventricular (AV) block with supra- and infra-Hisian, "phase 4," conduction defects. The sinus malfunction and high degree AV block persisted over 2 weeks and an atrioventricular sequential pacemaker was implanted. Hymodynamic study showed that her cardiac output was highly dependent on the heart rate and properly timed AV interval, and the pacemaker was programmed accordingly. PMID- 3815918 TI - Right atrial vegetation in left ventricular-right atrial communication. AB - We report a case of right-sided endocarditis with left ventricular-right atrial communication in which right atrial vegetation was demonstrated by two dimensional echocardiography. The present case demonstrates that the right atrial vegetation in ventricular septal defect is suggestive of left ventricular-right atrial communication. PMID- 3815919 TI - Transplacental passage of digoxin in the case of nonimmune hydrops fetalis. AB - Successful treatment of intrauterine fetal tachyarrhythmia was reported in several cases recently. It was also pointed out that placental transfer of digoxin is unsatisfactory under certain conditions. However, it has not been clearly shown in which cases fetal digoxin level does not reach the maternal level. We present a case of nonimmune hydrops fetalis due to congenital atrial flutter in which digoxin concentration in the sera of the mother and the neonate showed significant dissociation, and discuss perinatological matters about the digoxin treatment and the factor that obstructs the transplacental passage of digoxin. Conclusively, we recommend that maternal digoxin concentration should be raised to near toxic level if the resolution of fetal and placental hydrops is not attained in the initial digoxin loading. PMID- 3815920 TI - Complete atrioventricular block in Shone's syndrome. AB - A rare case of an adult patient with Shone's syndrome is presented in whom Lev's disease seems to be the major pathology underlying the development of complete A V block. PMID- 3815921 TI - Myocardial infarction in young adults under 30 years: risk factors and clinical course. AB - The clinical features and course of 30 patients (26 men and 4 women) under 30 years of age (mean age 27.3 years) with an acute myocardial infarction (MI) are described. The most common risk factor among this group of patients was smoking in 20 patients (66%). The prevalence of the other risk factors was low: hyperlipidemia in four patients and family history of ischemic disease in another four patients, diabetes mellitus, hypertension, and obesity each in one patient. Seven patients (23%) had none of the conventional risk factors. Three patients were exerting themselves prior to the onset of their MI pain; all of them had normal coronaries. Five patients experienced chest pain prior to MI, among them only two experienced classical angina pectoris. Eighteen patients underwent uncomplicated MI. The complications in the other 12 during the acute MI were rhythm disturbances in eight and congestive heart failure in four. Cardiac catheterization was performed in 25 patients. The occurrence of zero, one, or multivessel disease was equal. The 30 patients were followed up from six months to 15 years (mean 7 years). In 18 patients circulating aggregated platelets were measured one year after the MI. Elevated values were found in all of them (mean +/- SD 34.9 +/- 9.1%). In 6 of the 18, all heavy smokers, extreme values were found in the range of 39-55%. Three out of the 30 patients died within five years after their first MI. The other 15 patients developed complications, most of them angina pectoris. Five patients were hospitalized for reinfarction. None of the 30 underwent aortocoronary bypass operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3815922 TI - Reliability of standard electrocardiogram in detecting left ventricular asynergy in 315 patients with recent myocardial infarction. AB - The relationship between asynergy of the left ventricular wall detected by two dimensional echocardiography and ECG signs of necrosis (number of Q waves greater than or equal to 40 ms, Wagner's score) was evaluated in 315 patients (NYHA I-II) 23-90 days after a first Q-wave myocardial infarction (MI). Poor correlations were found between asynergy and ECG parameters. An ECG anterior MI is an apicoseptal MI by echo (independently of the ECG extent of Q waves) and the ECG is of little or no help in predicting the extent of asynergy to the inferior wall and proximal segments of the septum. An ECG inferior MI is inferoposterior by echo and the ECG has very limited value in predicting the extent of asynergy to the apex and septum. Patients with Q waves in leads II, III, and aVF had more extensive asynergy than those with either 2Q or greater than 3Q. R/S greater than or equal to 1 in V1 and/or V2 was present in 44% of patients with inferior MI while asynergy of at least one segment of the posterior wall was observed in 94%. In conclusion, standard ECG is sensitive in identifying anterior versus inferior infarct but it is unreliable in predicting the real extent of asynergy of the left ventricle, particularly in inferior infarcts. PMID- 3815923 TI - Acute pulmonary edema as the inaugural symptom of Becker's muscular dystrophy in a 19-year-old patient. AB - A 19-year-old male presenting with acute pulmonary edema and severe biventricular heart failure was diagnosed as having Becker's muscular dystrophy. This case is remarkable in that congestive heart failure had not been largely preceded by neuromuscular symptoms. PMID- 3815924 TI - Myocardial bridging of coronary arteries associated with an impending acute myocardial infarction. AB - A 57-year-old woman developed severe substernal chest pain radiating to the left arm accompanied by pallor and marked diaphoresis. These symptoms appeared at rest, lasted 45 minutes, and terminated spontaneously. The patient had been treated for mild hypertension during the last 6 months. An ECG tracing obtained at the beginning of treatment was unremarkable. However, an ECG tracing recorded shortly after the end of the symptoms showed T-wave inversion in all anterior leads. Coronary arteriography was then performed and showed no fixed obstructive coronary artery disease. Nonetheless, a lengthened and constricted myocardial bridging of both the left anterior descending coronary artery and its major diagonal branch was detected. Also, the left anterior descending coronary artery was observed to be very short, terminating before the cardiac apex. The left ventricle was hypertrophied. The patient was treated with a beta-blocking agent which eliminated all symptoms. An ECG tracing obtained about three months after the onset of the clinical picture was normal. Our findings suggest that marked myocardial ischemia at rest does occur in patients having myocardial bridges under special circumstances, such as lengthened and constricted myocardial bridging of a short coronary artery which supplies a hypertrophied ventricle. This anomaly should be taken into account as a possible cause of a threatened myocardial infarction, which may be successfully treated with a beta-blocking agent. PMID- 3815925 TI - Pulmonary vascular disease in secundum atrial septal defect in childhood: an unusual evolution. AB - Reported is a case of a 16-month-old girl with an isolated atrial septal defect in whom severe pulmonary hypertension has developed in 26 months in spite of an important functional gradient across the pulmonic valves at a first catheterization. Individual susceptibility to an increased pulmonary blood flow is evoked. PMID- 3815926 TI - Left ventricular diastolic and systolic function during isometric exercise: an echocardiographic study. AB - Normal subjects of both sexes between 20 and 63 years were examined with M-mode echocardiography. Blood pressure (BP), heart rate (HR), and left ventricular (LV) diastolic and systolic function were measured at rest and at the end of a standardized maximal isometric handgrip test. BP and HR increased about 25%. This increase in cardiac work had no significant influence on LV systolic function. Diastolic function (myocardial relaxation and maximum rate of LV filling), however, improved significantly. Isometric handgrip test is a suitable exercise test in combination with M-mode echocardiography. Studies on LV function during exercise may improve the sensitivity for detection of mild LV dysfunction. PMID- 3815927 TI - Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study. AB - We studied 33 patients with dilative cardiomyopathy to evaluate the predicting factors for sudden death occurring within one year. The information on each of the patients included history, physical examinations, two-dimensional echocardiograms, 24-h ambulatory electrocardiograms, and cardiac catheterization or autopsy. Patients were followed up for one year. Univariate analysis showed maximum number of premature ventricular complexes per hour (PVCs/h) (p = .0012), maximum beats per episode of ventricular tachycardia (VTmax) (p = .0012), and left ventricular end-diastolic pressure (p = .046) to be significant prognostic risk indicators of sudden death within one year. To select the best combination of factors that predict sudden death, multivariate stepwise logistic regression analysis was performed. By this method, only PVCs/h and VTmax were selected as the best combination. Probability of sudden cardiac death within 1 year = 1/(1 + exp[6.65-1.78 (log PVCs/h)-0.71 (VTmax)]). The equation showed 85.7% sensitivity and 69.2% specificity at a probability cutoff point of p = .124, with accuracy of 72.7%. The incidence of sudden death was 80% in patients showing both frequent (greater than 100/h) PVCs and presence of VT (VTmax greater than or equal to 3), and 6% in patients with neither or both. We concluded that PVCs/h and VTmax are independent and significant prognostic factors in patients with dilative cardiomyopathy. PMID- 3815928 TI - Influence of cardiac function on the diuretic and hemodynamic effects of the loop diuretic piretanide. AB - The influence of cardiac function on the diuretic and hemodynamic effects of the loop diuretic piretanide was investigated in nine patients with congestive heart failure. The diuretic response to piretanide correlated significantly with the pretreatment cardiac index (r = 0.90). Furthermore, a significant correlation was found between the pretreatment fractional sodium excretion and the cardiac index (r = 0.85). The fractional sodium excretion is reciprocal to the renal sodium and water reabsorption. No change in the hemodynamics was observed prior to the onset of diuresis. At 120 minutes after administration of piretanide, the reduction of mean pulmonary capillary wedge pressure (r = 0.88) and mean right atrial pressure (r = 0.80) was significantly related to the diuretic response. We conclude that the reduced diuretic response to piretanide in patients with low cardiac index is due to increased renal sodium and water reabsorption. The hemodynamic changes following the administration of piretanide are dependent on the diuresis. PMID- 3815929 TI - Variable neurohumoral and hemodynamic responses to exercise in patients with exertional angina: influence of the severity of coronary artery disease. AB - To assess neurohumoral and hemodynamic responses to exercise in patients with exertional angina, we measured plasma norepinephrine (NE) concentrations in 23 patients with exertional angina (with no heart failure) and compared the results with their coronary arteriographic findings. The 23 patients were divided into two groups: 14 cases with multiple vessel disease (MVD) and 9 cases with one vessel disease. At resting state there were no significant differences between the two groups in levels of NE. At maximal exercise there were no significant differences between the groups in increases of heart rate, blood pressure, and rate-pressure product, but exercise-induced increase of plasma NE (%) was significantly larger in MVD (131.6 +/- 95.4%) (mean +/- SD) than in one-vessel disease (69.0 +/- 45.3%) (p less than 0.01). In conclusion, plasma NE responses to exercise differ between patients with multiple vessel disease and patients with one-vessel disease. PMID- 3815930 TI - Regional distribution of metals in human brain. AB - Progress in understanding the role of metals in diseases of the nervous system has been hampered to a large extent by a lack of normal metal concentration values in the human brain. Since several metals interact metabolically, concurrent metal levels are essential for clinical correlation. We are reporting a simultaneous analysis of 24 metals in 4 different areas of 9 human brains. Our data on previously studied metals are comparable to the past observations. Therefore, we suggest the values of all metals reported here should be regarded as "normal" for ages 58-78 years. PMID- 3815932 TI - Preterm premature rupture of the membranes. PMID- 3815931 TI - (T)he(o)retical ideas of diaphragmatic action. AB - The diaphragm can be considered as 2 muscles, 1 which displaces both rib cage and abdomen in the inspiratory direction, and another which displaces only the abdomen. A theoretical analysis indicates that although the 2 parts are arranged as muscles mechanically in parallel, or as pumps pneumatically in series - and therefore the force and pressure developed by the diaphragm is the sum of the forces and pressures developed by each part - no anatomical site can be specified where a pressure can be measured to partition transdiaphragmatic pressure (Pdi) into its 2 components. However, a pneumatic analogue of the inspiratory muscles and the structures they displace allows for the construction of a pressure balance equation between the rib cage and abdomen during a pure diaphragmatic Meuller maneuvre. This allows an expression which partitions Pdi in terms of the ratio of pleural to abdominal pressure changes, the ratio of abdominal to rib cage compliance, and the area of apposition of the costal fibres of the diaphragm to the rib cage. The first 2 are constants during pure diaphragmatic Meuller maneuvres. Published data for the 3 quantities suggest that the component of Pdi which acts to inflate the rib cage is only a small component of total Pdi. PMID- 3815933 TI - Case presentation and discussion. Premature rupture of fetal membranes. PMID- 3815934 TI - Hemangioblastoma of the cerebellum--an immunocytochemical study. AB - Immunocytochemical studies using a new antibody against endothelial cells and commercially available antibodies against glial fibrillary acidic protein (GFAP) and S-100 protein were performed on 10 cerebellar hemangioblastomas in order to clarify the controversy over the origin of stromal cells. Neither cytoplasmic immunoreactivity for endothelial cell markers nor for anti-GFAP and anti-S-100 protein was found in these cells. Endothelial cell markers reacted positively only with neoplastic capillaries of the tumors and anti-GFAP and anti-S-100 protein were only found in glial remainders in the centers and margins of the tumors. PMID- 3815935 TI - The coincidence of neurocutaneous melanosis and encephalofacial angiomatosis. AB - The case of a 21-year-old woman who was affected by both encephalofacial angiomatosis (Sturge-Weber syndrome) and neurocutaneous melanosis is reported. Her signs and symptoms consisted of an interesting overlap of the characteristics of these two neurocutaneous syndromes with glaucoma, hydrocephalus, epilepsy, mental retardation and vascular and melanotic skin lesions observed throughout her course. The clinical diagnosis presented considerable difficulties. The simultaneous occurrence of these two disorders has not been previously reported and this is the first reported case where the cutaneous lesions and their histology, the neuropathology and the clinical features of both disorders is described in one individual. PMID- 3815936 TI - Central pontine myelinolysis and abnormalities in serum sodium. AB - Central pontine myelinolysis (CPM) was found at autopsy in 21 of 220 consecutive patients with chronic liver disease. It showed the same incidence in chronic nonalcoholic as in chronic alcoholic liver disease but did not occur in acute liver disease. No patients had clinical symptoms of CPM, although 15 had encephalopathy. The lesion was active in 13 and inactive in 8. Laboratory data was incomplete in 2 patients with active and 8 with inactive CPM. Of 11 closely monitored patients with active CPM, 6 had a rapid rise in serum sodium of at least 8 meq/l per day, sustained for 5 or more days, and preceding death by 8-21 days; the other 5 showed no rise during 15-64 days prior to death. All patients with a large, rapid, sustained rise in serum sodium showed CPM at autopsy, but half of those with active CPM showed no such sodium changes even though closely monitored. PMID- 3815937 TI - Pain drawing and myelography in sciatic pain. AB - In order to assess the predictive value of pain drawings of sciatic pain, 81 patients admitted because of symptoms and signs of lumbar disc herniation were asked to chart their pain on a schematic body drawing prior to myelography. There were no differences in sexes, ages, or pain duration between the group of 37 patients with a herniated lumbar disc compared to the 44 patients with a normal myelogram. From the features of the pain drawing alone, it was possible to predict the presence or absence of a herniated disc with a high statistical significance (p less than 0.001). Patients with a disc herniation rarely had pain in the upper trunk or arms (three of 37) compared with the normal group (23 of 44). Only one of nine patients with pain in the groin had disc herniation, and the same was true concerning pain in the iliac crest. Three patients without pain below the knee had no prolapsed disc. The Ransford score was significantly higher in patients with nondiscogenic sciatica, but there was no difference between the groups in the number of types of pain sensation. PMID- 3815938 TI - Consideration of the anterior cruciate ligament injury in skiing. AB - The anterior cruciate ligament (ACL) injury of the knee is a common ski injury. At a typical ski area clinic in Wyoming, an average of one per day is diagnosed over the 120-day ski season. Other ski clinics report a similar incidence of ACL injuries. In view of the 570 registered ski slopes in the United States, the ACL injuries occur at epidemic proportions. Under consideration are causal factors involved in the typical skier's ACL injury, such as recent evolutions in skiing techniques, boot styles, the skier's environment, and the anatomic considerations relating to body mechanics that place the ACL in a position of compromise in the intercondylar notch. Clear identification of the mechanism of ski injury of the ACL is difficult. As the significant causative factors become identified, and with the stimulation of further interest and research, there is some promise for prevention in the future. PMID- 3815939 TI - External rotation of the hip. A predictor of risk for stress fractures. AB - External rotation of the hip was found to have a statistically significant correlation with the incidence of stress fractures, in a prospective study among Israeli infantry recruits of possible anthropomorphic predictors of risk for stress fractures. Soldiers in whom hip external rotation was greater than 65 degrees were at a higher risk for tibial and total stress fractures than those with external rotations of less than 65 degrees. The mean hip external rotation in this study of 57 degrees +/- 9.3 degrees was higher than in statistics reported in the American literature. The existence of a larger subpopulation with hip external rotation greater than 65 degrees may partially explain why the reported incidence of stress fractures in the Israeli army is higher than that of the American army. PMID- 3815940 TI - The treatment of congenital knee dislocation. A review of nineteen knees. AB - The treatment of 19 congenitally dislocated knees in 11 patients is reviewed. The knees were subdivided into genu recurvatum, subluxation and dislocation. Nine knees were treated conservatively and ten surgically. A good result was obtained with conservative treatment if started before the age of three months; after this, surgery was likely to be required and was satisfactory if undertaken before two years of age. A successful surgical result was achieved with quadriceps lengthening. If the quadriceps tendon and the anterior cruciate ligament were divided, then only fair results were achieved. Untreated, patients developed stiff, unstable knees. PMID- 3815941 TI - Lachman test evaluated. Quantification of a clinical observation. AB - The Lachman test has become recognized as the most reliable noninvasive clinical method for determining the integrity of the anterior cruciate ligament. The original description provided for the test is reported as either positive or negative. The purpose of this study is to present a clinical grading system for positive examinations. The criteria are as follows: Grade I, proprioceptive appreciation of a positive test; Grade II, visible anterior translation of the tibia; Grade III, passive subluxation of the tibia with the patient supine; and Grade IV, ability of the patient with a cruciate-deficient knee to actively sublux the proximal tibia. Seventy-five patients with arthroscopically documented complete anterior cruciate ligament tears were examined clinically and graded using the above criteria. In addition, all patients had arthrometric examinations to measure the amount of anterior subluxation of the tibia in millimeters. A one way analysis of variance followed by Scheffe multiple comparisons demonstrated the mean measurements of anterior displacement of the tibia in each laxity group to be significantly different. PMID- 3815942 TI - Long-term results after total condylar knee arthroplasty. Significance of radiolucent lines. AB - In a prospective study of 123 total condylar knee arthroplasties, radiolucent lines were noted at the bone-cement interface about the tibial component in 65% of the knees. In 36%, the line was thin (less than 2 mm) and under either the medial or lateral tibial plateau. In 22%, thin lines were seen under both the medial and lateral plateaus. There was no statistically significant correlation between the occurrence of thin radiolucent lines in any location and the eventual postoperative clinical result. In 7%, thick lines (greater than 2 mm) were noted about the central peg of the prosthesis as well as under both plateaus and were associated with poor results. A 1-mm radiolucent interface was attached to various tibial components, which were then cemented into cadaver knees. For the polyethylene total condylar component, flexion or rotation of the prosthesis more than 5 degrees, angulation of the roentgen beam more than 6 degrees, or offsetting the beam more than 2.5 cm prevented visualization of the radiolucent line. With metal-backed components, more than 4 degrees of flexion obscured the lines. Therefore, extremely careful positioning of postoperative radiographs is essential for evaluating radiolucent lines after total knee arthroplasty. PMID- 3815943 TI - Spontaneous rupture of the tibialis anterior tendon. A case report. AB - Spontaneous rupture of the tibialis anterior tendon occurred in a 65-year-old man with diabetes mellitus. Treatment with sliding tendon lengthening of the proximal portion of the tibialis anterior tendon was successful. This unusual injury occurs in diabetics older than 45 years of age, following minor trauma. The condition can be misdiagnosed as peroneal nerve deficit. Tibialis anterior tendon deficit should be included in the differential diagnosis of patients with isolated weakness of foot dorsiflexion. PMID- 3815944 TI - Multiple pathologic fractures of the appendicular skeleton in a patient with Cushing's disease. AB - A 33-year-old woman with asymptomatic osteoporosis sustained a spontaneous middiaphyseal fracture of the femur as the initial sign of Cushing's disease. Subsequently, she incurred a fracture of the ipsilateral hip and both bones of the forearm. All four fractures failed to unite. There were no symptoms of involvement of the axial skeleton. Although axial osteopenia is the most common skeletal finding in hypercortisolism, fractures exclusively limited to the appendicular skeleton should not preclude detailed diagnostic investigations of hypercortisolism. PMID- 3815945 TI - Prosthetic joint infections secondary to rapidly growing Mycobacterium fortuitum. AB - Infection is an uncommon but catastrophic complication of joint arthroplasty, usually requiring removal of the implant. In a 30-year-old woman a knee arthroplasty was infected with the rapidly growing mycobacterium Mycobacterium fortuitum. Review of other reports of arthroplasties infected with this organism illustrates the problem, diagnosis, and treatment. M. fortuitum is widely distributed in nature, and although usually of low pathogenicity, it can cause infection in conditions of reduced local tissue resistance, i.e. hypodermic abscesses, implant inflammations, and trauma. Only six cases of M. fortuitum prosthetic joint infection have been previously described. Persistent drainage characterized cases in which the prosthesis was left in place. Although antibiotic treatment temporarily suppressed the signs and symptoms of infection, cure required removal of the prosthesis, as in the present case. Diagnosis of M. fortuitum infection is difficult because acid-fast stains of the organisms are often negative. Routinely bacterial cultures are continued for less than about five days, a period not long enough for growth of M. fortuitum. M. fortuitum infections should be considered in draining prosthetic joints with negative bacterial cultures and in those that have had repeated glucocorticoid intraarticular injections. PMID- 3815946 TI - Changing patterns in tibial fractures resulting from skiing. AB - Of the 734 adult tibial fractures treated in Aspen, Colorado, from 1968-1978, follow-up results were obtained on 527 (72%). The fractures were analyzed with regard to rate of healing, age of patient, and location of fractures. There was a statistically significant increase in healing time with increasing age between ages 16-40. The location of tibial fracture (proximal, middle, distal) had no significant influence on rate of healing. The occurrence of open tibial fracture was low (3% of total) and in most instances wounds were benign (Class I). Compartment syndrome is rarely encountered in skiing fracture because of the relatively low energy involved. All tibial fractures occurring between 1982-1984 were reviewed and compared to the earlier series. This comparison confirmed the continual overall decline in rate of tibial fracture from skiing (from 12.9/100,000 skier days in 1968 to 2.9/100,000 skier days in 1983). This decline was primarily in spiral fractures (from 70% of total in 1968 to 50% in 1983). The percent of transverse fractures was unchanged (+/- 15%) while the percent of short oblique fractures increased from 11% to 33%. Properly adjusted and maintained safety equipment afforded reasonable protection from spiral fractures of the tibia, but a conceptual departure from the current release binding design would be required to protect against the benign moments that produced transverse and short oblique fracture. The current treatment philosophy is based on fracture type and the availability or experience with newer treatment modes. PMID- 3815947 TI - A humeral head cutting guide: instrument to secure correct humeral component retroversion in shoulder joint arthroplasty. AB - An instrument is designed for the anatomic angle of retroversion of the humeral component for nonconstrained shoulder joint arthroplasty. A follow-up study of 18 patients showed correct retroversion in all cases. PMID- 3815948 TI - SSMB syndrome. Symptomatic supernumerary muscle belly syndrome. AB - Supernumerary muscle bellies (SMBs) of the forearm, common anatomic variant, are usually asymptomatic but can produce a debilitating pain syndrome that is secondary to a tendon-muscle shear phenomenon. This shear phenomenon seems to occur when a SMB is attached to another muscle and the excursion of the two units are different, thus parts of a muscle unit are prevented from migrating proximally on contraction of the entire muscle. The anomalous muscle may have either greater excursion, as in an anomalous palmaris longus attached to the flexor digitorum superficialis, or less excursion, as in an anomalous superficialis muscle attached to the carpus. The shear at the interface between different muscle-tendon units produces a burning pain that usually is localized to the distal one-third of the forearm. Surgical excision of the abnormal restricting muscle or tendon component relieves the symptom complex and restores the ability to apply full power. Observation on typical cases, diagnostic methods, operative technique, and results of the syndrome suggest that SSMB may be responsible for undiagnosed and untreated instances of distal forearm complaints. PMID- 3815949 TI - Gouty tenosynovitis and compression neuropathy of the median nerve. AB - Two cases of gouty tenosynovitis were associated with carpal tunnel syndrome. Both patients had carpal tunnel release with good relief of symptoms. In one patient, gout was not suspected before operation; this patient developed wound dehiscence with tophaceous urate crystal drainage that eventually disappeared. Proper preoperative antigout therapy may have prevented this complication. Carpal tunnel syndrome associated with gout is rare. Preoperative investigations for gout may be indicated in patients with carpal tunnel syndrome. PMID- 3815950 TI - Soft tissue sarcoma associated with aluminum oxide ceramic total hip arthroplasty. A case report. AB - Malignant tumors around fracture fixation implants have been reported sporadically for many years. Recently, however, reports of sarcomatous degeneration around a standard cemented hip arthroplasty and around cobalt chromium-bearing hip arthroplasties raise new questions of the malignant potential of metallic ends prostheses. Sarcomatous changes around aluminum oxide ceramics seem not to have been reported in the literature. The present report may be the first documented case of an aggressive soft tissue sarcoma detected 15 months after the patient had an uncemented ceramic total hip arthroplasty. If a causal relationship exists, the incidence of this phenomenon in the United States is 250 times greater than would be expected from statistics on soft tissue sarcoma at the hip. Because of the similarity on plane roentgenograms of this tumor to lesions known to be caused by wear debris, tumors should be included in the differential diagnosis of cases of total hip loosening. PMID- 3815951 TI - Osteoarthritis of the hip. Possible protective and causative roles of trabecular microfractures in the head of the femur. AB - In contrast to the large volume of data on the cartilage and synovial fluid changes, there has been relatively little investigation of the involvement of bone in the genesis of osteoarthritis (OA). Previous researchers have hypothesized that OA follows stiffening of subchondral bone through trabecular microfractures. Although it is widely recognized that marked changes in the subchondral bone are a consistent feature of advanced OA, the nature of the changes in the bone in OA has not received significant attention. The heads of the femur from 67 patients who had joint replacement for advanced OA and 66 autopsy controls without discernible joint disease were examined microscopically to ascertain the number and distribution of trabecular microfractures in coronal slabs and to quantify the mineralization and thickness of trabecular bone in a principal compressive zone. There was a reduction in the number of trabecular microfractures in OA patients, compared with the controls, with a lack of correlation between numbers of microfractures and age in OA patients. There was no evidence for the hypothesis that increased numbers of microfractures led to the increase of bone to support the view that microfractures play a role in maintaining OA joint structure. Structural changes produced relatively sclerotic and porotic groups of OA and two subgroups of the sclerotic group. PMID- 3815952 TI - Enhanced stabilization of porous-coated metal implants with tricalcium phosphate granules. AB - Tricalcium phosphate (TCP) granules were tested as a possible alternative to bone graft as an interposition material to stabilize porous-coated metal implants in overreamed femoral intramedullary canals in dogs in vitro and in vivo. TCP granules provided as much stability as bone graft or a press fit in the in vitro testing. At six weeks in the in vivo system, the TCP stabilized specimens had an increased average resistance to tensile testing, but the increase was not significant. At six months, however, TCP-stabilized specimens exhibited a significant increase in resistance to pull-out force (p less than 0.05). Histologic examination revealed incorporation of the TCP granules in bone bridging from the endosteal cortex to the porous surfaces. TCP granules might be useful as a synthetic interposition material for stabilization of porous-coated metal components. TCP granules exhibited osteoconductive properties. PMID- 3815953 TI - Skiing-related injuries to the shoulder. AB - An analysis of 135 consecutive shoulder injuries seen in one clinic during a single ski season revealed anterior dislocation to be the most common ailment, constituting 52% of the total. Rotator cuff tears accounted for 20% of the total, followed by acromioclavicular (AC) separations (18%) and a miscellaneous group of contusions and isolated fractures comprising the other 10%. All of the shoulder dislocations were anterior, most were primary (81%) and men (83%) were involved more frequently. Twenty-four percent of the dislocations were thought to be equipment related. At follow-up examination three to four years after injury, a significant number (41%) were still symptomatic either from a recurrence (18%) or pain and weakness (23%). Patients with rotator cuff tears tended to be about ten years older than the average skier. Their injuries were usually a result of a fall on ipsilateral arm and were not equipment related. Of the 13 patients responding after a three-year follow-up period, most (10/13) were asymptomatic. There were 24 AC separations. All resulted from a direct fall on the shoulder. Sixty percent were first degree, 22% were second degree, and 18% were third degree. About one-third of the respondents with first and second degree injuries were still having significant pain at three-year follow-up examination. The most frequent isolated fracture was a minimally displaced fracture of the greater tuberosity (only three cases in 135 injuries), but this same fracture occurred in 10% of the shoulder dislocations. PMID- 3815954 TI - Immobilization-induced hypercalcemia and regional osteoporosis. AB - Immobilization hypercalcemia accompanied by unusual hormonal and bony changes complicated the Guillain-Barre syndrome in a 21-year-old woman. Metaphyseal rarefaction appeared in many sites and was severe in the lower limbs. A bone scan showed increased uptake of 99mTc methylene diphosphonate at these sites and throughout the axial skeleton. The literature on experimental metaphyseal rarefaction suggests that osteoclastic resorption and enhanced regional blood flow are associated with immobilization. Suppression of this osteoclastic component of the increased bone turnover, especially if it is widespread, was the rationale for treatment with calcitonin (CT). The patient also became amenorrheic, with low plasma gonadotropin and estrogen levels. Estrogen therapy coincided with a return of plasma calcium to normal. PMID- 3815955 TI - Nuclear magnetic resonance studies of experimentally induced delayed fracture union. AB - Delayed fracture union was produced in the rat tibia with parenteral administration of prednisolone. Phosphorus nuclear magnetic resonance spectroscopy was used to monitor the local pH changes that occurred at the fracture site throughout repair. During the fracture healing in control animals, the pH of the fracture site changed from 7.2 on Day 2 to 7.5 on Day 20 following fracture, i.e., alkaline with respect to the pH of normal extracellular fluid. Deposition of radioopaque callus occurred mainly during the alkaline phase. In the steroid-treated rats the rate and extent of pH change were significantly less and the fracture site became alkaline five to ten days later than in the control animals. Because radiopaque callus deposition still occurred predominantly in the alkaline phase, union was also delayed by about the same interval of time. The rat prednisolone model differs significantly from the human condition of delayed union. Clinical investigations are indicated to ascertain whether abnormalities of fracture site pH occur in delayed union in humans. PMID- 3815956 TI - Selection of the optimal skeletal site for fracture risk prediction. AB - Commonly known risk factors have been shown to correlate with mean bone mass in populations, but none of these risk factors, either alone or in combination, have been shown to be predictive of future fracture risk in an individual. In order to evaluate the predictive power of bone mineral measurements at various sites, bone mineral content (BMC) has been measured at four skeletal sites and compared to subsequent fracture incidence at all skeletal locations, including spine and appendicular sites. Os calcis BMC has the most consistent monotonic relationship to unadjusted fracture incidence rates; os calcis BMC also has the strongest (p = 0.009) relation to levels of relative risk, after adjustment for age, height, and weight. Based on actual ability to predict fracture risk prospectively, along with such secondary criteria as cost, ease of performance, precision, and radiation exposure, the os calcis appears to be an optimal BMC measurement site for routine screening of perimenopausal women. PMID- 3815957 TI - Rheumatoid arthritis associated with pustulosis palmoplantaris. A case report. AB - Pustulotic arthroosteitis is a relatively common disease in Japan, but coexistence of rheumatoid arthritis (RA) and pustulosis palmoplantaris (PPP) is uncommon. The case report of a 38-year-old woman illustrates a rare and poorly understood relationship between PPP and RA. The two diseases have in common a tendency of leukocyte migration, which is the basis of a hypothesis of a related cause. PMID- 3815958 TI - Clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts) with unusual roentgenologic findings. Case report. AB - Clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts) with bone invasion of the proximal tibia occurred in a 15-year-old boy. The tumor arose from the juxtacortical region and invaded the tibia. Bone involvement in this tumor is rare. PMID- 3815959 TI - Acute surgical repair of the skier's thumb. AB - Complete ulnar collateral ligament tears incurred during the period fall 1977 through spring 1979 were treated under regional anesthesia by a single group of surgeons in an identical fashion as outpatients. Of 123 thumbs repaired, 69 (59%) were available for follow-up examination. There were 34 women and 35 men with an average age of 34.5 years (range, 16-61 years). The follow-up period averaged 31.6 months (range, 16-46 months). Weakness of pinch was described as none or mild in 66 (96%) and significant in only three (4%). Stiffness was described as none or mild in 66 (96%), moderate in two (3%), and severe in one (1%). Pain was described as none or mild in 68 (99%) and moderate in one (1%). Sixty-two patients (90%) preferred outpatient surgery with regional anesthesia whereas only seven (10%) did not. Forty-five (65%) of the 69 patients who required surgery had used traditional poles with straps, suggesting the pole as the causative factor. However, only 20% of noninjured skiers during the 1981-1982 season were using traditional poles with straps, and the total number of complete ulnar collateral ligament repairs did not decrease with the same number of skiers. Therefore, the change in pole design has not decreased the incidence of total ulnar collateral ligament tears. The results of acute surgical repair as an outpatient with regional anesthesia are excellent; 96% of the patients were pleased with the results. If the lesion is overlooked, the results of secondary construction are not nearly as good. PMID- 3815960 TI - Radiocarpal fracture-dislocation. PMID- 3815962 TI - Knee pain in the adolescent. PMID- 3815961 TI - Technique of Ender's pining in femoral fracture treatment. PMID- 3815963 TI - The elbow prosthesis. PMID- 3815964 TI - Inhibitory effect of external fixation on the formation of periosteal callus. PMID- 3815965 TI - Granulomatous reaction and cystic bony destruction associated with high wear rate in a total knee prosthesis. PMID- 3815966 TI - Fractures of the tibial tuberosity. PMID- 3815967 TI - Fractures of the tibia and fibula in adults. PMID- 3815968 TI - Training for Alpine skiing. AB - Skiing requires aerobic fitness. For aerobic conditioning, there must be significant elevation in heart rate during training. Although anaerobic training benefits physical fitness in general, skiing requires more aerobic than anaerobic conditioning. Strength, power, and endurance can be maintained through the use of concentric and eccentric contractions, using a variety of equipment and sports. Care should be taken to avoid injury to the patellofemoral joint during training. It is important to use specificity in choosing sports, as well as the exercise patterns in preseason training. If these principles are recognized in ski conditioning, a successful and effective training program will result. PMID- 3815969 TI - Thoracolumbar fractures in winter sports. AB - Thoracolumbar fractures occur in 14% of snowmobile injuries, and 5% of Alpine and 8% of freestyle skiing injuries. Proper management of these injuries requires: an awareness that neurologic deficits (specifically genitourinary dysfunction) may be present in spite of a normal neurologic examination; radiographic evaluation that includes computed tomography for the assessment of the middle column of the spine (the key anatomic determinant of spine stability), and standard lateral radiographs of the entire spine to diagnose the 4%-5% of noncontiguous fractures that occur; an understanding of the biomechanical principles of spinal instrumentation; accurate classification of the type of injury (e.g., wedge compression, flexion-distraction, etc.); and selection of the appropriate instrumentation (bilateral distraction, bilateral compression, or compression combined with distraction) when open reduction and internal fixation are indicated. PMID- 3815970 TI - High-altitude medical problems. AB - A spectrum of medical problems, including self-limited acute mountain sickness, high-altitude retinopathy, and the potentially fatal high-altitude pulmonary and cerebral edemas, may afflict residents and sojourners at higher elevations. However, appropriate prevention and prompt recognition will minimize the impact of these disorders. Prevention is predicated upon slow ascent to altitude and minimizing initial exertion at altitude; in selected cases, preventive drug therapy with Diamox (Lederle, Pearl River, New York) is helpful. Early recognition and descent to lower altitude remain the cornerstones of therapy. PMID- 3815971 TI - Cold exposure injuries and the winter athlete. AB - The winter athlete is faced with the hazards of injuries from exposure to low temperatures. Physicians who treat winter sports trauma must be prepared to manage the spectrum of these injuries including hypothermia, frostbite, and the combination of both. Hypothermia is primarily a problem of mortality, which can be lowered by gentle handling, close cardiac and electrolyte monitoring, and appropriate rewarming. Frostbite, a problem of morbidity from local tissue loss, can be treated most effectively with rapid rewarming in a water bath of 40 degrees-42 degrees. Spontaneous thawing with further injury to insensitive frostbitten members and refreezing injuries give a poor prognosis. The management of hypothermia and frostbite is directed first to hypothermia to lessen mortality and second to frostbite to decrease the morbidity. PMID- 3815972 TI - Tendon injuries about the ankle resulting from skiing. AB - In essence there are three afflictions about the ankle that result from skiing: rupture of the Achilles tendon, Achilles tendinitis, and dislocation of the peroneal tendon. The cause of Achilles tendinitis and Achilles tendon rupture is, in fact, pressure within the fascial compartment of the Achilles tendon, which is caused by a swollen distal soleus muscle, occluding the circulation, and thereby producing avascular necrosis with subsequent tendinitis yielding to rupture. Four types of peroneal tendon dislocations and related problems are presented. PMID- 3815973 TI - Glenoplasty for recurrent posterior shoulder instability. An anatomic reappraisal. AB - Posterior glenoplasty, as performed for the treatment of recurrent posterior shoulder instability, was shown to thrust the humeral head forward and was able to cause symptomatic impingement of the anterior cuff between the coracoid process and the humeral head. Such subcoracoid impingement is relieved by resection of the inferolateral part of the coracoid tip and of the coracoacromial ligament. PMID- 3815974 TI - Complete acromioclavicular separations. A comparison of operative methods. AB - A retrospective study of the surgical treatment methods for complete acromioclavicular (AC) dislocations was initiated to investigate the efficacy of each. During the years 1972-1985, a total of 95 surgical procedures were performed for complete AC dislocations. The medical records of 90 cases were available for review. The operative methods compared coracoclavicular (CC) with AC fixation methods. Excision of the distal clavicle was performed for chronic dislocations. AC fixation methods included Kirschner wires alone, Kirschner-wire fixation with coracoacromial ligament transfer, and Kirschner-wire fixation with tension wiring. Results were graded using evaluation of pain, range of motion, and residual deformity. AC fixation methods proved to be more successful than CC fixation methods. Excellent results were obtained in more than 89% of both AC and CC methods. AC methods had more minor complications including infections and implant breakage, but no failure or recurrences of the dislocation. CC methods resulted in 9% failure or recurrences. Of the AC fixation methods, the Kirschner wire with tension wiring gave the best results but required a more extensive operation for removal of implants. Excision of the distal end of the clavicle is an adequate form of treatment for the chronic complete painful AC dislocation. PMID- 3815975 TI - Prosthetic replacement for chronic unreduced dislocations of the shoulder. AB - Seven patients with chronic dislocations of the shoulder were treated by humeral head or total shoulder replacement. All patients had significant humeral head damage. Three dislocations were posterior and four were anterior. All had been unreduced for at least two months. A Neer prosthesis was used in each patient and the version of the humeral component was altered by 30 degrees-50 degrees away from the direction of the dislocation. Only a sling and swathe was used postoperatively, and the patient was allowed early motion in a limited-goals physical therapy program. There were no redislocations and all patients were improved over their preoperative status. Five patients achieved a good result and two had a fair result based on a 100-unit rating system. One transient axillary nerve palsy occurred, but there were no other complications. Prosthetic replacement for chronic unreduced shoulder dislocations is a reliable procedure when severe humeral head damage exists. PMID- 3815976 TI - Interscalene block anesthesia for shoulder surgery. AB - One hundred patients had major shoulder surgery with interscalene brachial and cervical plexus block anesthesia. Successful anesthesia was obtained by using this method in 82 patients. Failure was the result of incomplete anesthesia in 16 patients or the presence of a complication. Complications from high blood levels of anesthetic included loss of consciousness and respiratory depression in three patients and seizure in one. The block lasted a mean of eight hours, decreasing the need for postoperative analgesic medications. No postoperative medical complication developed. Ninety-one percent of the patients with successful blocks were satisfied with the procedure. PMID- 3815977 TI - Intraarticular fractures of the distal humerus in the adult. AB - Intraarticular fractures of the distal humerus are notoriously difficult to treat. Three basic treatment methods are available: closed reduction, traction, and open treatment. In the past, functional results with all these methods generally have been poor because of disabling limitations of elbow motion. Thirteen adult patients were treated by open reduction and application of medial and lateral buttress plates providing rigid internal fixation and early motion. The patients were evaluated for range of motion, infection, nerve injury, avascular necrosis, myositis ossificans, varus/valgus deformity, pain, instability, weakness, and degenerative changes. Ten of the 13 patients were available for follow-up study for an average of two years. Nine of the ten achieved good or excellent results. Based on these observations, the treatment of choice is internal fixation with dual plates combined with early active postoperative motion. PMID- 3815978 TI - False-negative bone image with radiographically evident osteoblastic lesions in prostatic carcinoma. AB - A unique case of documented prostatic carcinoma with radiographically evident osteoblastic lesions and a false-negative bone image is presented. PMID- 3815979 TI - Appearance of metastatic meningioma on bone scintigraphy. AB - Extracranial metastases of meningioma are very rare, with a reported incidence of less than one in 1000 cases of meningioma. Metastases have been reported in the lungs and pleura, in the liver, in the lymph nodes, and in bone. The appearance of osseous metastases in the bony pelvis from intracranial angioblastic meningioma is described. PMID- 3815980 TI - Pelvic stress fracture in female runners. AB - Stress fractures are a common injury in long-distance runners, and typically involve the lower extremities. Although relatively rare, pubic ramus stress fractures also occur, primarily in female runners. Bone imaging visualized a pubic stress fracture and a tibial stress fracture in a female long-distance runner with groin pain. Pubic stress fractures should be considered in female runners who present with groin pain. Radionuclide bone imaging is useful in diagnosing these lesions. PMID- 3815981 TI - Adherence of radiopharmaceuticals and labeled cells to intravenous tubing. AB - A survey of 67 nuclear medicine departments revealed no agreement on which radiolabeled agents could be injected through intravenous lines (IVs) and which required direct venipuncture. Labeled cells and several common radiopharmaceuticals were tested for adherence to intravenous tubing. Residual activity remaining in the tubing after an adequate flush was less than 1% of the injected dose in each case. Administration of radiolabeled agents through existing IVs is an acceptable alternative to direct venipuncture in many cases. PMID- 3815982 TI - Primary extra-adrenal pheochromocytoma: positive I-123 MIBG imaging with negative I-131 MIBG imaging. AB - I-131 metaiodobenzylguanidine (I-131 MIBG) is a well established imaging agent that reliably detects pheochromocytoma. In some patients, however, I-131 MIBG may fail to localize pheochromocytoma. I-123 MIBG has several potential advantages over I-131 MIBG, and these advantages may enable locating pheochromocytomas which have eluded other techniques, including I-131 MIBG imaging. A patient with primary extra-adrenal pheochromocytoma is described who illustrates the superiority of I-123 MIBG for the imaging of pheochromocytoma. PMID- 3815983 TI - Incidentally evaluating the status of renal function in technetium-99m DISIDA hepatobiliary imaging. AB - During hepatobiliary imaging studies, approximately 9% of Tc-99m DISIDA normally is excreted via the kidney. In routine 2, 5, 10, 15, 30, 45, and 60-minute images, the kidneys and urinary bladder are best visualized at 5-10 minutes and after 10-15 minutes, respectively. Nonvisualization of the kidney and/or urinary bladder may indicate renal dysfunction. To evaluate this hypothesis, Tc-99m DISIDA hepatobiliary images of 63 patients were correlated with concurrent serum BUN and creatinine levels (measured within 24 hours of the hepatobiliary study). Serum creatinine and BUN values were normal in patients with renal visualization. In patients without renal visualization, 17 of 19 had abnormal BUN and creatinine levels. The values of BUN and creatinine were significantly elevated (P less than 0.001) in patients without renal visualization when compared with those showing renal visualization. One patient had visualization of a single kidney due to a nephrectomy; in another, persistent visualization was due to hydronephrosis. Nonvisualization of the kidneys and/or urinary bladder suggests abnormal renal function, and asymmetric renal activity raises the possibility of renal disease. PMID- 3815984 TI - Capillary anastomosis in vena caval thrombosis. AB - A 29-year-old woman presented with recurrent diffuse histiocytic lymphoma. Bilateral brachial venous catheters were placed for chemotherapy, which resulted in thrombotic occlusion of the superior vena cava. A lung scan with Tc-99m MAA (flow study and static images) demonstrated extensive collateral vessels in the upper thorax and trapping of particles in the right upper abdomen, anteriorly. A simultaneous liver scan with Tc-99m sulfur colloid (flow and delayed images) illustrated a normal liver with no other abnormal sites of tracer deposition. The accumulation of a lung imaging agent in the anterior abdominal wall was secondary to capillary anastomosis between the superior and inferior epigastric veins. PMID- 3815985 TI - Radionuclide demonstration of a renopleural fistula following trauma. AB - A renopleural fistula was detected on a Tc-99m DTPA renal study during evaluation for possible post-traumatic urinoma. PMID- 3815987 TI - Demonstration of post-traumatic bile leak using technetium-99m DISIDA. AB - A 25-year-old miner was admitted with an acute abdomen and marked pallor following a crush injury to the abdomen. CT showed an irregular, patchy appearance of the posterosuperior portion of the liver with a coefficient of density appreciably less than the rest of the liver, consistent with the presence of a hepatic hematoma. The patient was treated conservatively. During the two weeks that followed, fluid accumulated in the peritoneal cavity. At laparotomy, a large volume of bile- and blood-stained fluid was found in the peritoneal cavity. Tc-99m DISIDA imaging was done after laparotomy. PMID- 3815986 TI - Pelvic lesion simulated by asymmetric marrow uptake following umbilical artery injection of technetium-99m sulfur colloid. AB - There is avid first-pass extraction of Tc-99m sulfur colloid by bone marrow. This factor must be considered when injection of the isotope is made via an unusual route. Tc-99m sulfur colloid was injected via an umbilical artery catheter into an infant's left iliac artery, causing marked marrow uptake in the left pelvis. The paucity of uptake on the right side of the pelvis simulated metastatic replacement of the marrow. A repeat study done via the jugular vein demonstrated no abnormalities of pelvic marrow uptake. PMID- 3815988 TI - Ilioportal shunt during a venogram/lung scan. AB - An interesting case of ilioportal shunting in a patient with seminoma and infrarenal thrombosis of the inferior vena cava, iliac and femoral veins is presented. This case demonstrates the utility of the nuclear venogram/lung scan for revealing venous collaterals in an ilioportal shunt, and illustrates shunting of femoral venous drainage into the mesenteric circulation, the portal veins, and the liver. PMID- 3815989 TI - Bone imaging after hemipelvectomy. AB - Bone images of the pelvis, before and after hemipelvectomy, are demonstrated. The latter show a void in the surgical area. PMID- 3815990 TI - Soft-tissue uptake of technetium-99m MDP in multiple myeloma. AB - Abnormal accumulation of Tc-99m MDP in the lungs and stomach was observed in a patient with multiple myeloma and refractory hypercalcemia. There was no roentgenographic evidence of calcification. At postmortem examination, the presence of amyloid deposits was confirmed in both organs, while the corresponding metastatic calcification was demonstrated only in the gastric mucosa. It seems likely that, in our case, soft-tissue localization of bone seeking agent was attributable to the presence of amyloid deposits rather than metastatic calcification. No cases showing the combined occurrence of amyloid deposition and metastatic calcification in soft-tissues have previously been demonstrated to concentrate bone-seeking agent. PMID- 3815991 TI - CT and nuclear medicine in vertebral metastases. PMID- 3815992 TI - Submandibular uptake on indium-111 leukocyte scans in children. AB - Report is made of false-positive localization of In-111 leukocytes in the submandibular gland area in children. Possible mechanisms are discussed, but this may represent a normal finding in children. PMID- 3815994 TI - Failure of technetium-99m sulfur colloid uptake by the femoral head. Aseptic necrosis or normal variation? AB - The hips of 79 asymptomatic patients having Tc-99m sulfur colloid liver/spleen scans were imaged. Patients were not studied if they had a disease associated with nonvisualization of the femoral heads. The first group consisted of 47 consecutive patients who were imaged in a neutral position. Eighteen right and 18 (38.3%) left hips showed no activity. The second group consisted of 32 consecutive patients who were imaged in an internally rotated position. Seven (21.9%) right and nine (28.1%) left hips showed no activity. This study concludes that failure of uptake of Tc-99m sulfur colloid by the femoral head is seen in a sufficiently large group of patients to limit its use in diagnosing aseptic necrosis. PMID- 3815993 TI - Primary saphenous venous aneurysms presenting in a child. AB - Venous aneurysms are dilatations of localized venous segments having no connection with varicosities. They are most often found post-traumatically in adults. The case presented here was a rare case of primary saphenous venous aneurysms in an 8-year-old child which were well demonstrated by Tc-99m human serum albumin (HSA) angiography. PMID- 3815995 TI - Scintigraphic patterns in osteoid osteoma and spondylolysis. AB - A retrospective review was performed of radionuclide bone scans and radiographs of 54 children with diagnoses of spondylolysis or osteoid osteoma/osteoblastoma. The findings indicate that skeletal scintigraphy shows imaging patterns that can be used to help distinguish these two conditions. Most cases of spondylolysis and all cases of osteoid osteoma or osteoblastoma demonstrated focally increased activity on the delayed skeletal scintigrams. Evaluation of the bone scan images obtained during the immediate postinjection period revealed intense activity with osteoid osteoma and osteoblastoma, but minimal or no abnormal activity in cases of spondylolysis. In addition, spondylolysis was the only condition that produced bilateral abnormalities in the pars interarticularis region in these children. PMID- 3815996 TI - Technetium-99m MDP scintigraphy. An insensitive tool for the detection of bone marrow metastases. AB - Seventy-nine cases with known carcinoma of the lung or breast who underwent both bone marrow aspiration and Tc-99m MDP bone scintigraphy were reviewed. The bone images were assessed for the presence of the pattern of bone marrow expansion which is visualized by diffuse increased metaphyseal activity, particularly evident at the knees, ankles, and elbows. This pattern was found to be an insensitive marker for the presence of marrow metastases (sensitivity 15%). The specificity of the finding was 86%. When diffuse increased metaphyseal activity is present on a Tc-99m MDP bone scan in a patient with malignant disease, the possibility of bone marrow metastases should be pursued by marrow aspiration and biopsy. PMID- 3815997 TI - Three-phase bone scintigraphy in Pellegrini-Stieda disease. AB - In a patient with Pellegrini-Stieda disease, radiographs of the knees were unremarkable at the time the three-phase bone scintigraphy was abnormal. The results of follow-up radiographs three months later remained normal in the left knee, where local steroid injection was given, but revealed typical positive results in the right knee with no treatment. The three-phase bone scintigraphic pattern is rather typical and antedates the radiographic changes. Thus, the radionuclide technique would provide a useful procedure for the early diagnosis and treatment of Pellegrini-Stieda disease. PMID- 3815998 TI - False-positive liver scan due to an intrahepatic gallbladder detected by cholescintigraphy. AB - A focal defect detected by hepatic scintigraphy is a nonspecific finding with a large differential diagnosis. This paper describes a case of an ectopic intrahepatic gallbladder diagnosed by cholescintigraphy, thereby avoiding a potential false-positive liver scan. PMID- 3815999 TI - Pathognomonic scintigraphic finding of hepatic cavernous hemangioma. AB - Hemangioma is the most common benign tumor of the liver. An accurate diagnosis of such tumor is essential for proper management of patients with hepatic cavernous hemangioma (HCH). Noninvasive diagnosis of HCH can be made using sequential Tc 99m RBC scintigraphy by demonstrating a "perfusion-blood pool mismatch." In addition, a case of HCH was observed which demonstrated peripheral enhancement with subsequent central enhancement on a sequential Tc-99m RBC blood pool scintigraphy. It is felt that this scintigraphic finding is pathognomonic for HCH. PMID- 3816000 TI - A case of biliary atresia and polysplenia. Evaluation by hepatobiliary scintigraphy. AB - A 5-week old jaundiced female underwent hepatobiliary scintigraphy using technetium-99m disofenin. Early images suggested right-sided cardiac activity. A nearly symmetric, bilobed liver with left-sided predominance was discovered. No biliary ducts, gallbladder, or small bowel activity were demonstrated up to 24 hours post-injection. Laparotomy confirmed situs inversus, polysplenia, and extrahepatic biliary atresia. PMID- 3816001 TI - Postperfusion ventilation studies in the diagnosis of pulmonary embolism. An economic appraisal. AB - Postperfusion lung ventilation imaging with xenon-127 (Xe-127) gas was evaluated from an economic perspective. Results of five years experience at a tertiary referral center suggest that the use of postperfusion lung ventilation techniques can significantly reduce patient costs for diagnostic studies and may reduce institutional costs for radiopharmaceuticals. PMID- 3816002 TI - Bone scintigraphy in a patient with cerebro-costo-mandibular syndrome. PMID- 3816003 TI - Demonstration of aortic root aneurysm on first-pass study of the right heart. PMID- 3816004 TI - Liver trauma with bile leakage detected by hepatobiliary scintigraphy. PMID- 3816005 TI - Horseshoe kidney simulation by paraaortic metastases from a testicular tumor. PMID- 3816006 TI - Plasma concentrations of mianserin after single dose and at steady-state in depressed elderly patients. AB - Plasma mianserin and desmethylmianserin concentrations were measured in 17 clinically depressed elderly patients after a single 30 mg dose of mianserin. The patients then received mianserin 30 mg daily for up to 6 weeks and the plasma concentrations were measured at weekly intervals. The relationship between concentrations of mianserin and desmethylmianserin at steady-state and at 16 and 24 hours after the single test dose was not good enough to be used for prediction of dosage requirements. Reasons for this finding are discussed. PMID- 3816007 TI - Providing free samples of baby items to newly delivered parents. An unintentional endorsement? AB - Recent studies have suggested that providing free sample packs of baby items to newly delivered parents may adversely influence parental health behavior. To determine the extent of this practice in Virginia, the head nurses of all 68 newborn nurseries and a random sample of 200 pediatricians were surveyed. Formula samples were being distributed at all hospitals. Formula packs were given to breast-feeding mothers at 65 (95%) hospitals although only 66 percent of the surveyed pediatricians approved of this practice. Samples of baby items other than formula (e.g., baby powder) were being distributed at 66 (97%) hospitals. Some physicians (18%) objected to the distribution of these nonformula samples, and others were not familiar with the content of these packs. In most instances, the hospital medical staff had not voted to approve the distribution of these packs. Parents were being informed only rarely about the source and intent of the packs. The provision of sample packs to newly delivered parents affects approximately 3,000,000 babies each year in the United States. The short- and long-term effects of providing these packs have been inadequately explored. Physicians should make an active decision whether to distribute sample packs. Those physicians choosing to dispense these samples may wish to review and edit the content of the packs and to enclose in the pack a brief note explaining that the provision of the products does not constitute a medical endorsement. PMID- 3816008 TI - Erythromycin-induced drug interactions. An illustrative case and review of the literature. AB - The authors report a case of erythromycin-induced carbamazepine toxicity in a 6 year-old child following use of erythromycin ethylsuccinate (50 mg/kg/day). Within 5 days of erythromycin use, vomiting, weakness, lethargy, ataxia, nystagmus, and cogwheeling movements developed. A serum carbamazepine concentration had increased from 11.9 mg/L (measured 1 week prior to antibiotic use) to 25.8 mg/L. Following erythromycin withdrawal, serum concentrations returned toward baseline, and symptoms resolved. Erythromycin has known effects on hepatic enzyme function, with altered cytochrome P-450 function. The dramatic reduction in carbamazepine clearance observed in this patient is similar to that reported when erythromycin is used concurrently with other drugs. A brief review of potentially significant erythromycin drug interactions is presented. PMID- 3816009 TI - Initial fluid therapy for children with meningitis with consideration of the syndrome of inappropriate anti-diuretic hormone. AB - A review of 85 children with meningitis admitted to the University Children's Hospital at Hermann Hospital revealed that only six patients (7%) had sufficient clinical and laboratory evidence to be compatible with the diagnosis of inappropriate secretion of antidiuretic hormone (SIADH). This is in contrast with various communications in the pediatric literature that have reported an association between the two conditions of as high as 85%. Hyponatremia (serum sodium 135 mEq/L) was observed in 27 (32%), but neither the initial laboratory data nor the subsequent follow-up data supported the diagnosis of SIADH. Moderate to severe dehydration was documented in 16 patients (19%) and suspected in more than 50% of the cases (serial weight determinations indicating an increase in weight from admission to discharge). Although the incidence of neurologic sequelae in this series was not influenced significantly by the presence or absence of hyponatremia, SIADH, or fluid restriction, the numbers are still small. Based on these data, routine fluid restriction cannot be recommended unless there is confirmatory evidence of SIADH. PMID- 3816010 TI - Relapse markers in childhood thyrotoxicosis. AB - Childhood thyrotoxicosis is not an uncommon illness, but there is a considerable relapse rate in these patients on medical treatment. An attempt is made in this study to identify those markers that are predictive of a tendency to relapse in childhood thyrotoxicosis. A total of 32 patients with Graves disease were included in the study. Several features were correlated with a tendency to relapse. Of these features, sex, family history, and antibody status were not significantly correlated to relapse. However, of 17 patients with goiter size two times normal or larger, 16 relapsed in comparison with seven relapses of 15 patients with goiter size less than two times normal (p = 0.0039). Of eight patients without ophthalmopathy, only two relapsed, while 21 patients of 24 patients with ophthalmopathy, relapsed (p = 0.002). Of 13 patients with serum thyroxine levels below 20 mcg/dl, six relapsed; of the 19 patients with serum thyroxine levels above 20 mcg/dl, 17 relapsed (p = 0.039). Among 24 patients with a previous relapse, only one achieved a remission with a second course of treatment. The remaining 23 patients had recurrent relapses. Hence it was found that goiter size, presence of ophthalmopathy, total thyroxine levels, and a previous relapse correlated significantly with a further relapse. PMID- 3816011 TI - Thumb polydactyly as a part of the range of genetic expression for thenar hypoplasia. AB - Attempts to study the genetics of human thumb polydactyly have been hampered by lack of awareness of the extremely varied expression of upper limb preaxial anomalies. It has been appreciated that thumb polydactyly could range from a broadened distal phalanx to complete duplication of the entire thumb. Most cases are sporadic and unilateral, but rare familial cases with wide variability and occasional nonpenetrance have been described. Four unrelated families are described who have thumb polydactyly as part of the range of expression for a dominant gene that is frequently associated with absence of thenar intrinsic muscles and flexor pollicis longus with inability to flex the thumb across the palm (the Fromont anomaly). These families and previous literature reports suggest that expression of the gene can range from thumb hypoplasia (most commonly the Fromont anomaly) to triphalangeal thumb or thumb polydactyly. As a consequence of this experience, we urge that parents, siblings, and other close relatives of patients born with thumb polydactyly be carefully examined for mild degrees of thumb hypoplasia or any other thumb anomaly, and that these findings be considered when providing recurrence risk counseling. PMID- 3816012 TI - Dermatophytosis of the diaper area. AB - Six cases of dermatophytosis of the diaper area due to either Epidermophyton floccosum or Trichophyton rubrum are described herein. The clinical and laboratory features of these patients and those reported in the literature are highlighted. Dermatophytosis should be considered in the differential diagnosis of rashes in the diaper area. Most standard remedies for diaper rash will not be effective or may exacerbate diaper dermatophytosis. Recognition of this condition by the clinician will lead to earlier rational treatment and may avoid the delay caused by therapy. PMID- 3816013 TI - Anaphylaxis to cutaneous exposure to milk protein in a diaper rash ointment. AB - A 12-month-old boy, with a strong history of cow's milk allergy, developed two episodes of anaphylaxis following cutaneous application of a casein containing ointment to an inflamed diaper area. RAST testing showed a significant elevation in specific IgE antibodies to milk and milk proteins. This experience suggests that children who are highly sensitive to milk may have severe allergic reactions on cutaneous exposure to milk or milk products. PMID- 3816014 TI - Cockayne's syndrome. PMID- 3816015 TI - Rubella seronegativity. PMID- 3816016 TI - Blinding, unblinding, and the placebo effect: an analysis of patients' guesses of treatment assignment in a double-blind clinical trial. AB - We administered a questionnaire to assess maintenance of patients' blindness at the end of a double-blind clinical trial of Osmotic Release Oral System phenylpropanolamine (PPA) vs. placebo in mild obesity. Seventy-four percent of placebo participants and 43% of PPA participants guessed their treatment correctly. Appetite control was the most frequently reported basis for guessing PPA, even by placebo participants. Lack of adverse drug reactions was the most frequently reported basis for guessing placebo, even by PPA participants. Participants receiving either PPA or placebo and guessing PPA lost more weight, had less diet difficulty, and had more adverse drug reactions than had participants receiving either PPA or placebo and guessing placebo. Although blindness was probably maintained in the PPA group, the placebo group seems to have been, at least at the study's end, unblinded. These results suggest that in double-blind studies, differences in outcome or incidence of adverse drug reactions may act as unblinding factors. PMID- 3816017 TI - Additive effect of theophylline on the cardiac response to isoproterenol. AB - To ascertain the effect of theophylline on the cardiac chronotropic response to beta-adrenergic stimulation, isoproterenol dose-response curves in healthy young subjects were compared during saline and theophylline maintenance infusions. Each study was repeated 1 to 3 weeks later to evaluate reproducibility. Neither the dose of isoproterenol required to raise the heart rate by 25 bpm (2.32 +/- 0.81 vs. 1.55 +/- 0.46 micrograms on day 1 and 1.28 +/- 0.22 vs. 1.27 +/- 0.25 micrograms on day 2) nor the slopes of the dose-response curves were affected by theophylline. Higher heart rates were observed after isoproterenol bolus dosing during theophylline than during saline infusion because of additive chronotropic effects of theophylline and isoproterenol. Since theophylline does not interact in a synergistic fashion with isoproterenol, phosphodiesterase inhibition appears to be an unlikely mechanism of the chronotropic effect of methylxanthines at therapeutic concentrations. PMID- 3816018 TI - Pharmacokinetics of streptokinase in patients based on amidolytic activator complex activity. AB - The purpose of this study was to determine the pharmacokinetics of intravenous streptokinase in humans. Five patients with myocardial infarction, six patients with venous thromboembolism, and two normal volunteers were studied. The patients with myocardial infarction received 500,000 U over 30 minutes, the patients with venous thromboembolism received 250,000 U over 30 minutes followed by 100,000 U/hr over 16 to 78 hours, and the normal volunteers received 100,000 U over 15 minutes. Plasma streptokinase levels were measured based on the amidolytic activity of the streptokinase-plasminogen complex on the chromogenic substrate S 2251. Pharmacokinetic parameters were: biologic half-life 82 +/- 25 minutes, total clearance 10.8 +/- 8.8 ml/min, and apparent volume of distribution 1.10 +/- 0.71 l. Streptokinase levels declined progressively during the continuous, prolonged infusion in the patients with venous thromboembolism over 60 hours of treatment. We conclude that there are distinct time-dependent changes in the pharmacokinetics of streptokinase during continuous intravenous infusion and that this phenomenon is likely to be associated with progressively decreasing thrombolytic efficacy. PMID- 3816019 TI - Hydroxylation of desmethylimipramine: dependence on the debrisoquin hydroxylation phenotype. AB - The 2-hydroxylation of desmethylimipramine (DMI) was studied in 14 healthy subjects previously phenotyped with respect to debrisoquin hydroxylation. After a single oral dose (25 mg), slow hydroxylators of debrisoquin had significantly lower total and metabolic clearances and longer plasma half-lives of DMI and excreted less 2-hydroxydesmethylimipramine than did rapid hydroxylators. These findings strengthen the hypothesis that the hydroxylations of debrisoquin and DMI may be under common enzymatic control. PMID- 3816020 TI - Evidence for altered catalytic properties of the cytochrome P-450 involved in sparteine oxidation in poor metabolizers. AB - Sparteine metabolism was studied in human liver microsomes from nine extensive ([EM] urinary metabolic ratio [MR] less than 20) and four poor metabolizers ([PM] MR greater than 20). The formation of 2- and 5-dehydrospartein displayed monophasic Michaelis-Menten kinetics. In livers from PMs the formation of the major sparteine metabolite 2-dehydrosparteine was characterized by more than a thirtyfold increase in Michaelis-Menten constant (Km)(1880 +/- 1044 mumol/L) as compared with EM subjects with an MR less than 1 (58.3 +/- 38.8 mumol/L). EM subjects with an MR greater than 3 who may constitute heterozygous metabolizers showed Km values in between (658 +/- 301 mumol/L). There was no difference in maximum rate of metabolism (Vmax) of 2-dehydrosparteine formation between EM and PM subjects (101 +/- 39 vs. 86 +/- 52 pmol/min/mg). The formation of 5 dehydrosparteine exhibited a Km of 100 +/- 123 mumol/L similar to the Km of 2 dehydrosparteine formation. The urinary MR correlated positively with the Km for 2-dehydrosparteine formation. The intrinsic clearance for 2-dehydrosparteine showed a highly significant negative correlation with the MR. The pronounced differences in Km together with the significant correlation between Km and MR with no marked differences in Vmax between phenotypes suggest that the impaired oxidation capacity in PM subjects is more likely the result of a P-450 isozyme with altered catalytic properties rather than a decreased amount of enzyme. PMID- 3816021 TI - Age differences in trimethoprim pharmacokinetics: need for revised dosing in children? AB - The pharmacokinetics of trimethoprim was studied in children (nine girls 1.05 to 3.57 years old and nine girls 7.55 to 9.70 years old) with urinary tract infections and 12 healthy adults (27.07 to 44.62 years old) to investigate any age-related changes. Serum and urine concentrations were measured during 24 hours. The groups did not differ in the time or the height of the peak serum concentration. Thereafter the children had lower serum concentrations. They had a shorter elimination half-life (means: 1 to 3 years, 3.7 hours; 8 to 10 years, 5.4 hours; adults, 11.2 hours), because of the smaller volume of distribution (0.86 l/kg; 1.08 l/kg; 1.31 l/kg) and higher total clearance (2.8 ml/min/kg; 2.4 ml/min/kg; 1.4 ml/min/kg). The higher clearance in children was mainly nonrenal (metabolism). Calculation of the pharmacokinetic variables per unit of body surface area modified the age differences considerably. Compared with present dosage recommendations, trimethoprim in larger daily doses per kilogram of body weight for the children is suggested. The daily dose should be increased primarily by shortening the dose interval. PMID- 3816022 TI - D-xylose absorption and disposition in patients with moderately impaired renal function. AB - D-Xylose kinetics were studied after oral and intravenous administration to 10 patients with impaired renal function, three of whom were being evaluated for intestinal malabsorption. The 0.32 +/- 0.06 L/kg (mean +/- SD) distribution volume of D-xylose in patients with uncomplicated renal impairment was larger than the value of 0.23 +/- 0.04 L/kg that we reported previously for normal subjects (P less than 0.01). Renal clearance was also reduced, averaging 87% of glomerular filtration rate estimated from creatinine clearance, so that the elimination-phase half-life was prolonged to 138 +/- 39 minutes from 75 +/- 11 minutes in normal individuals (P less than 0.01). The 25 gm oral D-xylose dose was 77.4% +/- 14.8% absorbed in the patients with uncomplicated renal impairment, similar to the 69.4% +/- 13.6% absorption reported in normal individuals. However, the absorption half-life was prolonged from 31 +/- 12 minutes in normal subjects to a value of 62 +/- 23 minutes (P less than 0.02). Of the usual clinical indexes of D-xylose absorption, the serum concentration measured 1 hour after the oral dose was best correlated with the extent of D-xylose absorption (r = 0.76; P less than 0.01), and the standard lower normal limit of 0.2 mg/ml was satisfactory. PMID- 3816023 TI - Ticlopidine-theophylline interaction. AB - Ticlopidine, a new antithrombotic agent, and theophylline, a widely used bronchodilator drug, are both almost completely metabolized in the liver. To evaluate an interaction between these two drugs, we studied theophylline pharmacokinetics before, after 10 days of ticlopidine administration, and 1 month later in 10 healthy volunteers. We found a highly significant increase in the theophylline elimination half-life (P less than 0.001) and a comparable reduction in its total plasma clearance (P less than 0.001) after ticlopidine treatment. Pharmacokinetic parameters returned to initial values within 30 days after ticlopidine withdrawal. Moreover, no changes in theophylline pharmacokinetic parameters were observed 3 months later, before and after 10 days of placebo administration. Our results seem to exclude direct liver toxicity and may suggest a reversible inhibition of the liver metabolic capacity of theophylline. PMID- 3816024 TI - Roles of adroxazine, a new heterocyclic hormone of the adrenals, and leucogenenol, a thymothyroid hormone, in the formation of blood cells. AB - Treatment of normal rats with the thymothyroid hormone leucogenenol accelerates the rate at which the 'functional' cells, neutrophils, red blood cells and lymphocytes, develop in the bone marrow from their corresponding committed precursor cells. Following the initial treatment of normal rats with leucogenenol, there is a temporary elevation in the bone marrow of the relative concentrations of myeloblasts, rubriblasts and lymphoblasts. It has now been found that bilaterally adrenalectomized rats have a different response from normal rats to treatment with leucogenenol. Although treatment of bilaterally adrenalectomized rats with leucogenenol accelerates the rate of development of their functional cells, the initial injection of leucogenenol is followed by a temporary decrease in the relative concentrations of myeloblasts, rubriblasts and lymphoblasts in their bone marrow. Additionally, adrenalectomized rats treated concurrently with tritiated thymidine and leucogenenol show a significant lower percentage of labeled cells in their bone marrow than do correspondingly treated normal rats. These results indicate that adrenalectomized rats have a lower than normal concentration of stem cells in their bone marrow that can be committed to become functional cells. Treatment with adroxazine, a new recently isolated heterocyclic hormone of the adrenals, causes adrenalectomized rats to respond as normal rats to the injection of leucogenenol. There is a temporary elevation of myeloblasts, rubriblasts and lymphoblasts in their bone marrow as well as a normal increase in the percentage of cells that are labeled following concurrent treatment with tritiated thymidine and leucogenenol. It may be concluded that treatment with adroxazine increases the rate of replication of uncommitted bone marrow stem cells while treatment with leucogenenol increases the rate at which committed cells develop into their respective functional cells. A scheme is presented to show the suggested roles that leucogenenol and adroxazine play in regulating the formation of blood cells. PMID- 3816025 TI - Effect of uremic plasma on mouse liver delta-aminolevulinic acid synthetase activity. AB - delta-Aminolevulinic acid (delta-ALA) synthetase in mouse liver homogenate was significantly (p less than 0.001) higher in the presence of uremic compared with normal plasma, the ratio of the two values being 1.36 +/- 0.24 in 30 paired experiments. This effect does not seem to be due to increased concentrations of urea or creatinine nor to any possible dialyzable substances. Its relationship to the retention of an inducing factor or decreased production of erythropoietin in uremic patients is discussed. A possible inhibitory effect of erythropoietin on liver delta-ALA synthetase is suggested. PMID- 3816027 TI - Craniofacial surgery. PMID- 3816026 TI - Anthropometric guidelines in cranio-orbital surgery. AB - Surface measurements and proportions of the cranio-orbital region provide valuable information to the surgeon both before and after surgery. They supplement the data obtained from x-ray cephalometry. Preoperatively, the proportion indices help to identify the most deformed areas and reveal which measurements contribute to the disproportion. When surgery is being planned, the defective measurements help the surgeon to calculate the changes necessary. After surgery, the quality of proportionality achieved permits assessment of the degree of improvement. PMID- 3816029 TI - Deep orbital reconstruction for correction of post-traumatic enophthalmos. AB - Post-traumatic enophthalmos is a complex orbital deformity resulting from an injury disrupting orbital bone and ligament support, allowing displacement and a change in shape of the orbital soft-tissue contents. Clinically, this is manifested by inferior and posterior displacement of the globe, pseudoptosis, and deepening of the supratarsal fold. Soft-tissue changes such as canthal malposition and shortening of the horizontal dimension of the palpebral fissure are present when unreduced nasoethmoidal orbital fractures exist. The essential principles of surgical correction include full dissection of the bony orbital soft tissues including the posterior orbit with restoration of bony orbital volume by the judicious insertion of bone grafts to correct the vertical as well as the anteroposterior position of the ocular globe. The combination of techniques of craniofacial exposure, osteotomy, and bone grafting allow the condition of post-traumatic enophthalmos to be greatly improved with minimal complications. PMID- 3816028 TI - Radical treatment of craniofacial anomalies in infancy and the use of miniplates in craniofacial surgery. AB - The radical treatment of craniofacial anomalies in infancy is indicated for medical, technical, and psychosocial reasons. The major problems around the cranium, the orbits, and the face may be safely corrected by osteotomy, suture resection and disjunction, mobilization, repositioning, and reshaping of the various skeletal segments. This radical approach has been possible through the introduction of miniplate fixation. The plates and screws are removed after 3 to 6 months to take optimal advantage of the great formative power of the growing brain, which expands rapidly within the first 2 years of life. In infants, disjunction is more important than advancement, making this approach a dynamic one in contrast with the static procedures for the adolescents and adults. The complete, one-stage procedures are superior to a delayed or two-stage procedure. Experienced administration of pediatric anaesthesia and intensive care are mandatory. PMID- 3816030 TI - Tissue expansion in craniofacial surgery. AB - Craniofacial surgery has evolved through an era of refinement and finesse, both in techniques and in results. Tissue expansion offers an opportunity to improve the quantity and quality of tissue available for these procedures. It may also be of benefit in long-term molding of the craniofacial skeleton during growth of the child, obviating the need for multiple revisions. This adjunct to craniofacial surgery is being performed with minimal complications and results in improved appearance for the patient. PMID- 3816031 TI - Ophthalmic considerations in cranio-orbital surgery. AB - Interdisciplinary management of cranio-orbital problems has allowed improved surgical results in the diagnosis and management of motility and adnexal deformities. Careful evaluation of visual function preoperatively, combined with proper timing of repair, can greatly assist the development and maintenance of optimum visual function. PMID- 3816033 TI - A simple method for the correction of enophthalmos. AB - Autogenous rib cartilage grafts are used to correct enophthalmos. The grafts are introduced through two small tunnels into the posterior quadrant of the orbit. The procedure leaves almost no scar and final results are satisfactory. PMID- 3816032 TI - Psychosocial considerations in craniofacial deformity. AB - The authors evaluate the hypotheses that duration and severity of craniofacial malformations correlate with psychosocial adjustment. Reviewing data from congenital and traumatic craniofacial malformation patients of varying ages, they find partial support for the hypothesized associations; however, the relationship between psychosocial adjustment and craniofacial deformity is far from straightforward. PMID- 3816034 TI - Anesthesia for craniofacial procedures. AB - Anesthetic management of patients for craniofacial reconstruction is based on a careful preanesthethic evaluation emphasizing the airway, with examination for other associated anomalies. Specific perioperative issues include airway management, blood loss reduction and replacement, and control of brain volume. Good communication between the anesthesiologist and the craniofacial surgeon, with an understanding of each other's clinical concerns, is essential. PMID- 3816035 TI - Neurosurgical considerations in cranio-orbital surgery. AB - The neurosurgeon is an integral member of the craniofacial team. The role of the neurosurgeon in the preoperative planning, intraoperative management, and postoperative follow-up of patients with craniofacial malformations is reviewed. PMID- 3816036 TI - Vascularized calvarial flaps. AB - Vascularized calvarial transfers offer many advantages. In this article the anatomic (soft tissue, vascular, osseous) basis of flap design is summarized, and the technical details of two calvarial flaps, the temporoparietal and the frontoparietal, are presented. PMID- 3816037 TI - The anatomy of the cranio-orbital deformities of craniosynostosis: insights from 3-D images of CT scans. AB - Three-dimensional surface images from CT scans have been used to study the pre- and postoperative anatomy of patients with craniosynostosis: the sutural pattern per se, the morphology of the calvaria, the morphology of the endo- and exocranial bases, the morphology of the orbits and the position of the globes, and the morphology of the mandible. This technology assists diagnosis, treatment planning, and longitudinal follow-up. PMID- 3816038 TI - Treatment of craniosynostosis in infancy. AB - Craniosynotosis affects approximately one infant out of 1000. The increase of intracranial pressure and the risks of functional problems are more frequent than usually estimated, especially in monosutural synostosis. Frontocranial remodeling will correct both functional and aesthetic consequences of craniosynostosis. The best operative period is the first year of life, 2 to 3 months of age for the brachycephalies, and 6 to 9 months of age for the other craniosynostoses. Not only does growth not adversely affect the results of the forehead remodeling, but the adjacent orbitonasal areas improve with time. In Crouzon's disease and Apert's syndrome, early frontal advancement does not prevent the midface retrusion, and a radical frontofacial advancement may be indicated in very severe cases. PMID- 3816039 TI - The craniofacial dysostoses: guidelines for management of the symmetric and asymmetric deformities. AB - Although great diversity marks the craniosynostoses, our experience related to that from other centers allows us to draw certain conclusions for their management. For the asymmetric synostoses, operative intervention should be carried out in infancy or early childhood. Although the unilateral approach is our preferred method, the bilateral approach can yield equally satisfactory results. Surgeons should, therefore, familiarize themselves with both methods and individualize for the given deformity. Mild symmetric (upper face) synostoses are best managed in infancy or early childhood, utilizing bilateral orbital advancement with the expectation that the need for additional major surgery will be at worst 50 per cent and likely significantly less. For moderate to severe synostoses, delaying major intervention to later childhood or adolescence maximizes the chance of obtaining a satisfactory result by a single procedure, either an extended LeFort III or monoblock advancement. Individualization of each case is essential, and the need for brain and eye protection or the psychologic needs of the patient may dictate a modification of the treatment guidelines. Patients and parents must be aware that growth and development subsequent to surgery is not entirely predictable, and there may be a need for a second major intervention at a subsequent time, despite these established guidelines. PMID- 3816040 TI - Frontoethmoidal meningoencephaloceles. AB - Frontoethmoidal meningoencephaloceles constitute a well-defined clinical entity with remarkable epidemiologic peculiarities, being very prevalent in Southeast and Southern Asia, but relatively rare in Western Europe, Japan, Australia, and North America. They do not show an increased risk of recurrence in siblings and offspring, unlike other cephaloceles and neural tube defects generally, from which they should be distinguished. Combined craniofacial and neurosurgical operative treatment permits one-stage correction of the whole deformity, the associated hypertelorism being reduced by selective orbital translocation and the nasal deformity by rhinoplasty. In planning these procedures, three-dimensional CT scanning is very helpful. Although our experience is chiefly with cases referred in childhood, we have some experience with operations done in infancy and believe this to be the ideal age. PMID- 3816041 TI - Analysis and treatment of hemifacial microsomia in childhood. AB - Hemifacial microsomia (HFM) is not a fixed dysmorphic deformity, but rather a progressive, complex deformation, involving the soft tissues and skeletal structures derived from the first and second branchial arches. Secondary growth distortion is seen particularly in the failure of midface growth, because of inadequate mandibular vertical growth on the involved side. Based on this concept of a dysfunctional matrix, we treat HFM in childhood according to the severity of the mandibular hypoplasia. In the type I and type IIA children seen in the deciduous stage, we recommend use of an activator or functional appliance. The more severe type IIB and type III children with absent structures need early construction of the mandibular ramus, glenoid fossa, and temporomandibular joint. In so doing, we convert the severely hypoplastic mandible into a more symmetric and functional type IIA status. Correction of the mandible appears to maximize potential growth and minimize the documented secondary distortion in the maxilla. Preliminary study confirms that early correction minimizes the need for maxillary and orbital osteotomies as these patients enter adulthood. We have briefly outlined our approach to soft-tissue hypoplasia and neuromuscular deficiency in HMF. Further refinements are needed in these areas. PMID- 3816042 TI - Effects of HLA genotype, age and birth order on empirical risk estimates for insulin-dependent diabetes in siblings of diabetic children. An actuarial evaluation. AB - The incidence of insulin-dependent diabetes (IDDM) was evaluated as a function of time of follow-up among the 371 siblings of 193 diabetic children using actuarial methods and comparisons were carried out according to HLA genotype, sex, age and birth order. The following parameters appeared to be relevant for empirical discrimination in terms of the risk of recurrence of the disease among siblings: The number of HLA-haplotypes shared with the first affected sibling considered as the proband. Cumulative proportions 15 yr after onset of IDD in the proband were 35%, 20% and 3% in the case of 2, 1 and 0 haplotypes in common, respectively (p less than 0.02). The birth order. Cumulative risk estimates were 26% for sibs born after the proband and 11% for sibs born before the proband (p less than 0.001). The age. Risk estimates were 24% for sibs who were aged less than 10 yr at the time of the proband's onset and 5% in sibs aged greater than 10 yr (p less than 0.001). The joint analysis of birth order or age with HLA genotypes showed significantly higher risks for both identical and haplo-identical sibs with later birth order and/or younger age. Even though these results do not reflect true incidence rates because of retrospective recruitment of part of the material, the comparison of the risk figures points out the important role of some age-related effect, probably environmental, in addition to the genetic susceptibility borne by MHC genes. PMID- 3816043 TI - Diabetic nephropathy--susceptible to care? A cohort-study of 641 patients with type 1 (insulin-dependent) diabetes. AB - The aim of the study was to investigate the influence of diabetes care on the incidence and course of clinical nephropathy in patients with Type 1 (insulin dependent) diabetes mellitus. After hospitalization at a diabetes care unit within 15 yr after diabetes onset, 246 patients were followed at the care unit, whereas 395 patients were non-attenders. The 2 groups were comparable with regard to age and calendar year at diagnosis, insulin dose and body weight. After 40 yr of diabetes duration the cumulative incidence of persistent proteinuria was significantly lower among patients treated at the unit (31.9% vs 44.8%, p less than 0.003). The median survival after onset of persistent proteinuria was significantly longer among patients followed at the diabetes care unit (p less than 0.003). Among patients not developing diabetic nephropathy, no difference in survival was found between the 2 groups, since 72% of the patients in each group survived 40 yr with Type 1 diabetes. It is concluded that patient care seems to be highly important for the incidence and the course of clinical nephropathy, whereas no such influence could be demonstrated in patients not developing clinical nephropathy. PMID- 3816044 TI - Serum T3 and reverse T3 concentrations: indices of metabolic control in diabetes mellitus. AB - Several previous studies have reported that serum T3 and reverse T3 (rT3) concentrations are altered in uncontrolled diabetes mellitus and their normalization occurs when euglycemia is achieved. Therefore, this study was undertaken to examine the usefulness of serum T3 and rT3 levels as indices of metabolic control in diabetes mellitus. Serum T3, rT3, T4, Free T4, TSH and T3 resin uptake were determined in 18 normal subjects and 35 patients with newly discovered diabetes mellitus before initiation of therapy and reassessed after normalization of glycosylated hemoglobin (HbA1) concentration. These thyroid hormone concentrations were compared to the well established parameters of metabolic control such as fasting plasma glucose (FPG), peak plasma glucose (PPG), area under the curve of the oral glucose tolerance test (sigma G), 24 hr urinary glucose level (UG), HbA1 as well as glycosylated protein (GlyPr) and glycosylated albumin (GlyAlb) concentrations. Serum T4, T3RU, Free T4 and TSH concentrations in patients with diabetes mellitus prior to treatment were not significantly different from normal subjects and were not significantly correlated with any of the parameters of diabetic control. Serum T3 was significantly lower and serum rT3, significantly higher in diabetic patients prior to treatment as compared to normal subjects and both T3 and rT3 normalized in 20 patients studied when adequate metabolic control was achieved as reflected by normalization of HbA1 (less than 8.2%). Furthermore, significant negative and positive correlations were noted between parameters of metabolic control and serum T3 and rT3 levels respectively. Therefore, this study demonstrates that serum T3 and rT3 may be reliable indices of metabolic control in diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816045 TI - Impaired glucose tolerance in the biethnic (Melanesian and Indian) populations of Fiji. AB - We report a cross-sectional study of impaired glucose tolerance conducted on data collected during the Fiji Cardiovascular and Metabolic Disease Survey, which was performed in 1980. Both Melanesian Fijians and migrants from the Indian subcontinent were studied. Impaired glucose tolerance and diabetes were defined according to current WHO criteria. When impaired glucose-tolerant subjects were compared with normals and diabetics with respect to selected physiological, biochemical and environmental factors, those with impaired glucose tolerance showed greater affinities with the diabetics than with the normal subjects. This finding was true of both the Melanesian and Indian populations, but was in contrast to a study of Micronesians in Kiribati (using standardized survey methods and similar analyses) in which subjects with impaired glucose tolerance held an intermediate position between normals and diabetics, with respect to the chosen factors. A possible explanation for the discrepant findings of the 2 studies is that the cut-off point in the distribution of plasma glucose concentration which defines diabetes may vary in populations of different ethnic origin, and the studies support the concept of heterogeneity within the category of impaired glucose tolerance. PMID- 3816046 TI - A fluid-phase routine method for the detection of insulin-anti-insulin complexes. AB - A fast routine method has been devised to measure circulating insulin-anti insulin complexes. The principle lies in the calculation of the difference between the insulin binding capacity of the free antibody and that of the total amount of insulin antibody. The pH of 1 aliquot of serum was lowered to 3 by adding glycine-HCl buffer. Free insulin was removed by charcoal precipitation and the pH was again neutralized by the simple addition of NaOH; the final dilution of serum was 1/5. Radiolabelled insulin was added to this and to a second aliquot of serum, also diluted 1/5. Free and bound insulin were separated using either dextran charcoal or PEG 6000 at a final dilution of 14.3%. The first technique of separation was preferred. This method has been used in normal controls and in insulin-treated diabetic patients and the results have been compared to those obtained using other methods to detect insulin-anti-insulin complexes and insulin antibodies. Insulin-anti-insulin complexes tended to be more frequently observed in patients with high insulin antibody values. The technique described is much less laborious than other methods for detecting insulin complexes since it requires only a few hours to complete. It is reproducible and sensitive enough for clinical research. This method is of value when both free and bound insulin antibodies have to be evaluated. PMID- 3816047 TI - Dot-ELISA for the rapid serodiagnosis of human hydatid disease. AB - We studied the serodiagnosis of human hydatid disease using the dot-enzyme-linked immunosorbent assay (dot-ELISA) and the indirect hemagglutination assay (IHA). Hydatid cyst fluid antigens from sheep were highly reactive against a battery of positive human sera. Moose-derived antigen was less reactive, whereas human- and camel-derived antigens showed nonspecific false-positive reactions. Sensitivity of the Dot-ELISA was 96% using sheep-derived antigen and 45 human sera from 43 surgically proven cases of hydatidosis disease caused by Echinococcus granulosus, E. multilocularis and E. vogeli. The IHA test reacted with 100% of patient sera (P = N.S.). Specificity of the dot-ELISA was 98%; one false-positive reaction was observed in the dot-ELISA when 52 sera from healthy subjects were assayed. Cross reactions were observed with sera from patients with cysticercosis, filariasis, toxocariasis, trichinosis, visceral larval migrans, and liver cirrhosis. Of 204 sera tested in duplicate, 191 (94%) did not vary more than one twofold titer dilution. The dot-ELISA is rapid and as sensitive as the IHA test in the diagnosis of hydatidosis. In addition, unlike other currently performed tests for hydatid disease, this rapid and economical enzyme immunoassay is very antigen conservative, requiring only nanogram quantities of parasite antigen, and very serum conservative, needing only 50 microliter of diluted patient serum. PMID- 3816048 TI - Serologic study by competitive enzyme-linked immunosorbent assay of pregnancy associated alpha 2-glycoprotein in hepatitis B virus infection. AB - Serum levels of pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) in patients with hepatitis B virus (HBV) infection were compared with those of healthy male subjects used as controls by a competitive enzyme-linked immunosorbent assay (ELISA). Assay parameters were optimized, and minimal detectable concentration was 100 ng/ml. The alpha 2-PAG levels in 22/26 acute HBV patients showed a very significant statistical difference when compared with controls (x2 = 19.93, p less than 0.0005). On the other hand, 8/8 chronic persistent HBV patients showed high levels with a range between 51 to 200 ug/ml (x2 = 18.16, p less than 0.0005). There was no significant difference between asymptomatic HBsAg carriers and controls. Although alpha 2-PAG apparently exhibits immunosuppressive properties similar to other factors present in HBV infection, follow-up studies are needed to elucidate its role in the natural evolution of this disease. PMID- 3816049 TI - [Nuclear magnetic resonance tomography of the orbits. Initial experiences using the paramagnetic contrast medium gadolinium-DTPA]. AB - In 21 patients with orbital mass lesions MRI was performed before and after administration of paramagnetic contrast medium, Gadolinium-DTPA. In comparison to the plain scan the differentiation of the tumorous tissue against the surrounding structures was improved after application of contrast medium despite a partially moderate increase in signal intensity. Especially highly vascular tumors and vessel diseases show a significant contrast enhancement. With increasing experience in larger number of patients a tissue differentiation seems to be possible. PMID- 3816050 TI - [Computerized tomography studies in the assessment of radiogenic pneumopathy in an animal experiment]. AB - An animal experimental study was conducted in 56 piglets exposed to radiation to establish new assessment criteria on radiogenic pneumopathy by employing computed tomography for diagnosis. The accurately measurable density changes in the lung parenchyma exposed to radiation appear invariably as soon as a dose-dependent threshold value is exceeded. Tolerance limits can be determined for 60Co and neutron irradiation in different fractions and single doses, the enhancement of lung density being correlated with the irradiation dose. It is not possible to establish a volume-dependent decrease in the tolerance dose. Likewise, there is no radiation-promoted co-reaction of adjacent pulmonary tissue not subjected to irradiation exposure. These results apply to the experimental animals used in the study. PMID- 3816051 TI - [Spongiocytic adenoma of the adrenal cortex--risk of misinterpretation as a cyst in computerized tomography]. AB - A report on two cases where solid benign tumours of the adrenals (spongiocytic adrenocortical adenomas) were misinterpreted as adrenal cysts due to water equivalent density values. The CT scans are compared with the microscopic cuts. PMID- 3816052 TI - [CT morphology of the splenic vessels in splenoportal fistula]. AB - CT examination of a 53-year-old patient with endocarditis and clinical signs of hepatosplenomegaly revealed an atypical vascular morphology in the hilum of the spleen, for which no diagnosis could be established. Angiography indicated the presence of a symptom-free splenoportal fistula, the histological study of which suggested its congenital genesis. The paper describes the morphology, as ascertained by CT, of the splenic vessels characterised by changed haemodynamics due to a hilar splenoportal fistula. PMID- 3816054 TI - [Radiation burden in high-resolution computerized tomography of the petrous bone]. AB - Exposure to irradiation and radiation stress of the eye lens, thyroid and skin in high resolution computed tomography of the petrous bone are demonstrated by means of measurements conducted by the authors, and compared with results published to date. The radiation stress is less than the doses measured during conventional polytomography of the petrous bone. The exposure of the crystalline lens, in particular, depends decisively on the angle of the gantry or on the position at which CT is performed. The coronary plane is the projection of choice in respect of minimum irradiation exposure. The somatic dose index is higher than in conventional x-ray examinations of the skull, but lower than in cranial CT or other CT examinations. PMID- 3816053 TI - [Abdominal computerized tomography in the after-care of ovarian cancers]. AB - The diagnostic capacity of abdominal CT as a follow-up in ovarian cancer is demonstrated on 67 patients verified by a second-look operation. In the diagnosis of recurrence CT has a sensitivity of 83%, a specificity of 94% and an overall accuracy of 88%. With local recurrence or residual tumours CT has an accuracy of 91%, with liver metastases of 94%. The accuracy in finding peritoneal carcinosis is 84%. Ascites proved to be a sure sign of peritoneal carcinosis. Because of its high sensitivity second-look operation can be avoided in case of a positive report. In a negative report a second-look operation will be necessary to verify the success of therapy. In the follow-up of ovarian cancer CT should be performed every 6 month during the first 2 years and yearly for another 3 years. PMID- 3816055 TI - [CT of the sella following hypophyseal surgery]. AB - A CT control scan of 32 patients after transsphenoidal resection of a pituitary tumour revealed sellar contents of different density and varying extent. Additional criteria were used to differentiate the intrasellar structures (size, extent, shape, structure, contrast enhancement, bone changes). CT made the definite diagnosis in 6 patients with pituitary tumour recurrence. Hormonal measurements were superior to CT in identifying recurrent tumours in another 3 patients. It is concluded that hormonal methods should be used in evaluating patients after surgery of a hormone-producing tumour. However, CT is the most useful method in detecting tumour recurrence in patients with non-functioning adenomas, and, if an adequate technique is used (coronal scanning, iv-contrast), even clinical asymptomatic tumours can be identified. PMID- 3816056 TI - The appearances of multiple biliary hamartomas of the liver (von Meyenberg complexes) on computed tomography. AB - Computed tomography is well established in the management of patients with malignant disease, both as a staging procedure before initiation of treatment and in follow up. The presence of unsuspected metastases may affect the decision to perform surgery on the primary tumour and may alter the management of suspected recurrent tumour. Two cases are presented of patients with primary carcinoma whose computed tomography images showed multiple focal hepatic lesions suggestive of metastases. However multiple biliary hamartomas were found on histology, in one case by biopsy and in the other at post mortem. The differential diagnosis and significance of multiple liver defects on computed tomography is considered. PMID- 3816057 TI - The computed tomographic appearances of benign hepatic hamartoma. AB - The case of a 32-year-old female with asymptomatic hepatomegaly due to a large cystic liver mass is described. Pathological examination after total excision revealed a benign hepatic hamartoma. Benign hepatic hamartoma is a rare cause of a cystic liver mass, usually occurring below the age of 5 years. The computed tomography findings included 'daughter cysts' and it is emphasised that these must not be regarded as pathognomonic of hydatid disease. PMID- 3816058 TI - Pathogenesis of the late-side effects of radiotherapy. PMID- 3816059 TI - The influence of pelvic lymph node disease on survival for stage I and II carcinoma of the cervix. AB - Two hundred and eighteen patients were referred to the Oxford Radiotherapy Department in the 5 years 1973-77 with stages I and II tumours of the uterine cervix. One hundred and eighty-one underwent pre-operative intracavitary radiotherapy followed by Wertheim hysterectomy and pelvic lymphadenectomy. Twenty three per cent of these patients had metastatic disease in pelvic lymph nodes. Fifty-five per cent of patients with positive pelvic nodes died of carcinoma of the cervix compared with 9% of negative node cases. Prognostic factors are discussed and management of carcinoma of the cervix reviewed. PMID- 3816060 TI - Radiotherapy of choroidal malignant melanomas. AB - Choroidal malignant melanomas are relatively rare tumours and can have a very long natural history. The management of these tumours is controversial. The results of a study of a small group of patients treated by radiotherapy, either as primary treatment or following local excision or enucleation, are presented here. The value of radical radiotherapy in the management of choroidal malignant melanoma is discussed. PMID- 3816061 TI - Treatment of post-radiotherapy telangiectasia by injection sclerotherapy. AB - A new treatment for post-radiotherapy telangiectasia is reported. Five patients were successfully treated by injection of a dilute solution of sodium tetradecyl sulphate. Several (4-7) half hour sessions of injection sclerotherapy at 5-weekly intervals were necessary. PMID- 3816062 TI - Soft tissue sarcoma in Kuwait: a review of 114 patients. AB - One hundred and fourteen patients with soft tissue sarcoma were seen in the Kuwait Cancer Control Centre over a period of 11 years. Fifty per cent were liposarcomas, fibrosarcomas and rhabdomyosarcomas. The lower extremity was the commonest site involved, followed by the trunk. Treatment was in most cases surgery and adjuvant radiotherapy. The overall rate of local recurrence was 36%. Local failure was highest in abdominal tumours (66%). In extremity lesions, local recurrence was higher in proximal sites than in distal sites. Twenty-eight per cent of the patients had metastases, the lung being the commonest site (68%). The histological type had no bearing on local failure or dissemination. Histopathological grade was found to be an important prognostic indicator, both for local failure and dissemination. The rates of local recurrence and metastases were lower in low grade than in high grade tumours. PMID- 3816063 TI - Radiological contrast media. PMID- 3816064 TI - Fat necrosis of the breast: an unusual complication of lumpectomy and radiotherapy in breast cancer. AB - Fat necrosis is a well-recognised complication of trauma to the breast. It has also been described following breast surgery. In this report, we describe four patients who developed a small tender nodule following excision and radiotherapy for early breast cancer. These were in or near the excision scar. Histology of the resected nodules revealed fat necrosis with no evidence of recurrence. It is recommended that in all cases when a tender, inflamed nodule in or adjacent to the excision scar is found, a biopsy should be carried out to distinguish between this condition and recurrence. PMID- 3816065 TI - The chest radiograph in whooping cough. AB - The chest radiographs of 238 patients admitted to hospital with acute whooping cough are reviewed. Radiographic abnormalities were detected in 63 (26%) patients; pulmonary consolidation was seen in 50 (21%) patients, collapse in nine (4%) and lymphadenopathy in 22 (9%). The most common type of consolidation was peribronchial (72%). Both collapse and consolidation were commoner on the right and tended to involve the lower and middle lobes. These abnormalities were more common in those aged 1 year old or more (p less than 0.001) but no other clinical feature was found to predict those patients with an abnormal chest radiograph. Follow-up radiographs demonstrated no significant radiographic sequelae. Comparison with previous series shows a reduced frequency and change in the pattern of radiological abnormalities over the last 20 years. PMID- 3816066 TI - Compliance with the Royal College of Radiologists' guidelines on the use of pre operative chest radiographs. AB - Clinical compliance with the Royal College of Radiologists' guidelines on the use of pre-operative chest radiology was examined in a random sample of patients in four hospitals in England and Wales. Pre-operative clinical data were abstracted from medical reports and, in one hospital, from special chest radiograph request forms completed by clinicians. Seventy-five per cent of patients had clinical indications warranting a pre-operative chest radiograph. This level of compliance is compatible with that found with other guidelines and would suggest that the pre-operative chest radiograph guidelines are suitable for wider implementation in the National Health Service. PMID- 3816067 TI - A negative double-contrast barium meal--qualified reassurance. AB - Four hundred and forty-one consecutive patients referred for endoscopy after a negative double-contrast barium meal were studied to determine the reliability of good quality radiology in excluding significant upper gastrointestinal pathology. Endoscopic abnormalities were detected in 23 patients (5.2%), nine of which were reporting errors. Duodenal ulcer was the commonest lesion missed radiologically, 50% of these patients either having a history of overt upper gastrointestinal bleeding, a family history or impressive symptomatic relief with H2-receptor antagonists. The three patients with radiologically undetected gastric cancer presented with classical symptoms; the radiological demonstration of gastric mucosal atrophy in this clinical context should alert the referring clinician to initiate urgent endoscopy. PMID- 3816068 TI - Gastric and periurethral metastases from seminoma testis. AB - A case of seminoma testis with metastases to periurethral tissue and gastric submucosa is described. Response to treatment with irradiation and chemotherapy was good. Regression of the unusually sited tumour masses is demonstrated by barium meal and computed tomography. A brief review of gastric metastases is presented. PMID- 3816069 TI - Osteomas of the temporal bone: a report of three cases. AB - Osteomas of the petrous temporal bone, inaccessible to clinical examination are rare. Three such cases are reported, one in the internal acoustic meatus, one in the middle ear, and the other on the posterior surface of the petrous ridge, emphasizing the role of radiology in their diagnosis evaluation, and as an aid to management. PMID- 3816070 TI - Hodgkin's disease in childhood: the British National Lymphoma Investigation experience (BNLI Report No 27). AB - The experience of the British National Lymphoma Investigation in the treatment of 68 children with Hodgkin's disease is reported over a 14 year period from 1970. The presenting histology was reviewed by a single histopathologist; 87% of the cases were classified as nodular sclerosis (NS) and further subdivided into NSI (53%) and NSII (35%). Primary treatment consisted of local (involved field) or prophylactic (extended field) irradiation, combination chemotherapy alone or low dose irradiation and chemotherapy. An overall 5 year survival of 87% was achieved and a 5 year relapse-free survival of 64%. Eight deaths were reported during the study, all of which occurred in children who presented with NSII histology. Each child was in relapse and undergoing chemotherapy at the time of death. This histological subtype was also associated with both a lower complete remission rate and a reduced response to second line chemotherapy. PMID- 3816071 TI - Pituitary apoplexy: an unusual cause of stroke. AB - A case of pituitary apoplexy complicated by hemiparesis and dysphasia is reported. Investigations revealed complete obstruction of the left internal carotid artery due to haemorrhagic pituitary expansion. This case and the four previously reported suggest that early diagnosis of this rare complication is essential if surgery is to prevent cerebral infarction. PMID- 3816072 TI - Traumatic arterio-venous fistula involving the portal venous system. AB - A case of an aorto-mesenteric fistula presenting with portal hypertension and cardiac failure is presented. Both the computed tomographic and angiographic features proved valuable in the diagnosis of this unusual condition. PMID- 3816073 TI - Subclavian and axillary vein thrombosis following radiotherapy for carcinoma of the breast. AB - Two cases are presented of subclavian and axillary vein thrombosis in patients with carcinoma of the breast treated by radiotherapy and at least 2 years of therapy with tamoxifen. We suggest that radiation fibrosis may have been the major aetiological factor but that the treatment with tamoxifen might also have contributed to the venous thromboses. PMID- 3816074 TI - Computed tomography of the liver after biopsy. AB - Angiographic studies suggest that needle biopsy of the liver is invariably associated with some degree of haemorrhage (Wallace et al., 1972). The appearances of the liver on computed tomography after percutaneous biopsy have not been described. As an aid to the interpretation of scans in patients referred because of clinical complications of biopsy, we performed unenhanced computed tomography of the liver in 30 patients within 72 h of biopsy. None of these patients would ordinarily have been referred for computed tomography. Only one of the scans showed a parenchymal abnormality attributable to biopsy. We conclude that post-biopsy changes on unenhanced computed tomography scans of the liver are uncommon and that the needle tracks and vascular anomalies commented on by angiographers are not usually shown. PMID- 3816075 TI - Reperfusion and reperfusion injury. PMID- 3816076 TI - Effect of partial ornithine carbamoyltransferase deficiency on urea synthesis and related biochemical events. AB - The biochemical response to an intravenous alanine load of 0.25 g/kg was studied in nine adult female relatives of children with ornithine carbamoyltransferase deficiency. Six were classified as affected by partial deficiency and three as unaffected. The plasma ammonium concentration showed no change after the alanine load in the unaffected group, but marked increases occurred in all but one of the affected groups. The maximum rate of urea synthesis after the alanine load was decreased by 37% (P = 0.02) and delayed by 43% (P = 0.02) in the affected group. In the affected group a low rate of urea synthesis was associated with high urinary orotate excretion, high maximum plasma ammonium concentration and delay in the time taken to reach the maximum rate of urea synthesis (Kendall concordance W = 0.55, P less than 0.05). The effects of a higher dose of alanine and of oral protein were compared. The alanine load of 0.25 g of alanine/kg body weight was shown to provide an adequate stimulus to urea synthesis with a more rapid return of ammonium concentration to the pre-load level than with the protein load. The implication of these results in determining the distribution of flux control of urea synthesis, the discrepancy between them and predicted results and the necessary modifications to quantitative simulations are discussed. PMID- 3816077 TI - Vasoactive intestinal peptide: a direct renal natriuretic substance. AB - To establish whether or not vasoactive intestinal peptide (VIP) acts directly on the kidney and also to define the renal responses to it, we compared the natriuretic and haemodynamic responses to VIP (10(-4)-100 pmol min-1 kg-1) infused intravenously with those obtained by direct infusion into the renal artery in seven conscious male rabbits. VIP had significant effects on the renal circulation without changing systemic arterial pressure or pulse rate. There was a significant fall from control in effective renal plasma flow (P less than 0.05 renal infusion, P less than 0.01 intravenous infusion) and glomerular filtration rate (P less than 0.01 renal, P less than 0.05 intravenous). The derived renal vascular resistance rose significantly from control (P less than 0.01 renal, P less than 0.01 intravenous). Despite the significant decline in filtered sodium load (P less than 0.01 renal, P less than 0.001 intravenous), there was a significant log dose-related increase in fractional sodium excretion (P less than 0.005) with intrarenal infusion of VIP. We conclude that the actions of VIP on intrarenal blood vessels and renal tubules are direct, leading to increases in renal vascular resistance and fractional sodium excretion. PMID- 3816078 TI - Delayed postprandial plasma bile acid response in coeliac patients with slow mouth-caecum transit. AB - Coeliac patients are known to have an expanded bile salt pool which recirculates slowly due, at least in part, to impaired gall bladder contractility. We have investigated the possibility that delayed small bowel transit of chyme and bile may also contribute to this sluggish recycling. Plasma cholylglycine, total bile acids and cholecystokinin concentrations were measured after a lactulose-labelled test meal whose mouth-caecum transit time (M-C TT) was assessed by the breath hydrogen technique. Overall there were no significant differences in plasma bile acid profiles between seven healthy controls and a group of 25 coeliac patients. However, when subjects were divided according to their M-C TT, the 10 with the slowest transit were found to have significant elevation of fasting levels when compared with the 10 with the fastest transit, fasting total bile acids being 3.4 +/- 1.3 versus 0.7 +/- 0.6 mumol/l (P less than 0.02) and fasting cholylglycine being 0.43 +/- 0.17 versus 0.06 +/- 0.04 mumol/l (P less than 0.05) respectively. Peak bile acid levels did not differ significantly between subjects with fast or slow transit. However, subjects with slow transit were found to have a delay in the return of plasma bile acid levels to fasting levels so that the 4 h postprandial levels were significantly elevated when compared with those observed in the subjects with fast transit (total bile acids 3.6 +/- 1.2 versus 0.19 +/- 0.1 mumol/l and cholylglycine 0.70 +/- 0.13 versus 0.24 +/- 0.07 mumol/l respectively, both P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816079 TI - Intrathyroidal autonomic nerves can directly influence hormone release from rat thyroid follicles: a study in vitro employing electrical field stimulation and intracellular microelectrodes. AB - The role of the autonomic nervous system in the control of thyroxine release from the rat thyroid gland in vitro, has been investigated using electrical field stimulation as a device to induce intrathyroidal nerves to release their neurotransmitters. The effects of field stimulation on follicular cell membrane potential and input resistance have been investigated using continuous intracellular recordings from individual cells. Electrical field stimulation promotes up to an eightfold increase in throxine release from the thyroid gland in vitro. This effect is blocked by the neurotoxin, tetrodotoxin. Electrical field stimulation has no effect on follicular cell membrane potential or input resistance. This is consistent with the results of previous pharmacological experiments using this preparation. It is concluded that electrical field stimulation induces intrathyroidal nerves to release their neurotransmitters, and that the net effect of this is to cause thyroxine release from the thyroid follicles. The existence of a directly acting secretomotor innervation to the thyroid follicle is suggested. PMID- 3816081 TI - Effects of ethanol ingestion on blood pressure reactivity. AB - We examined the acute effects of ethanol consumption on circulatory responses to the cold pressor test, to handgrip exercise and to intravenous infusion of methoxamine in eight normal male subjects. Ethanol consumption reduced systolic blood pressure responses to the cold pressor test and to handgrip exercise and depressed both systolic and diastolic blood pressure responses to infusion of methoxamine. The depressant effects of ethanol on blood pressure responses to methoxamine were considerably greater than the effects on the cold pressor test and handgrip exercise. Catecholamine concentrations during the cold pressor test and handgrip exercise were not significantly different with or without prior ethanol consumption. Alcohol has been shown to have an acute hypotensive action with all the stimuli. PMID- 3816080 TI - The role of the autonomic nervous system in the resting tachycardia of human hyperthyroidism. AB - The mechanisms that control resting heart rate in hyperthyroidism were evaluated in six patients before and after treatment with propylthiouracil. The patients were subjected to pharmacological blockade under resting conditions in two experimental sessions: first session, propranolol (0.2 mg/kg body weight); second session, atropine (0.04 mg/kg body weight) followed by propranolol (0.2 mg/kg body weight). All drugs were administered intravenously. Resting heart rate was significantly reduced from 100 +/- 6.5 beats/min to 72 +/- 2.5 beats/min (P less than 0.005) after clinical and laboratory control of the disease. After double blockade, intrinsic heart rate was reduced from 105 +/- 6.8 beats/min before treatment to 98 +/- 6.0 beats/min after treatment (P less than 0.025). The reduction in heart rate caused by propranolol was not significantly different before (-13 +/- 1.4 beats/min) and after (-9 +/- 1.0 beats/min) propylthiouracil. In contrast, atropine induced a higher elevation of heart rate after treatment (45 +/- 8.6 beats/min) than before treatment (26 +/- 4.0 beats/min). The present results suggest no appreciable participation of the sympathetic component of the autonomic nervous system in the tachycardia of hyperthyroidism, at least under the conditions of the present study. The small change observed in intrinsic heart rate, although significant, seems to indicate that this is not the most important mechanism involved in this tachycardia. Our results suggest that an important reduction in the efferent activity of the parasympathetic component participates in the mechanisms that modify resting heart rte in hyperthyroidism. PMID- 3816082 TI - Diet-induced thermogenesis. PMID- 3816083 TI - Cardiac and renal hyperplasia in newborn spontaneously hypertensive rats. AB - Cardiac hyperplasia in newborn spontaneously hypertensive rats (SHR) has been noted by our group as well as by other investigators. The present study was designed to establish whether early (neonatal) hyperplasia is confined to the heart or is a generalized phenomenon in this hypertensive model. The ventricles, kidney and liver of newborn SHR, Wistar and Wistar-Kyoto (WKY) rats were analysed for their protein and DNA content. Total organ weight and the organ/body weight ratio of the heart and kidney but not of the liver were significantly greater in the SHR than in the control rats, irrespective of total body weight. The higher relative DNA content (per 100 mg of tissue or 100 g body weight) indicated that hyperplasia rather than hypertrophy was responsible for the enlarged heart as well as the kidney of newborn SHR. The cause of this selective cardiac and renal hyperplasia is not yet known: it may be due to putative 'haemodynamic growth stimuli', an intrinsic genetic abnormality of cells in the heart and kidney, circulating growth-promoting factors, or innervation. PMID- 3816084 TI - Aldosterone responsiveness to metoclopramide in hyperprolactinaemia. AB - Basal serum aldosterone levels in 13 hyperprolactinaemic females did not differ significantly from those of nine control individuals. There was increased responsiveness of circulating aldosterone levels to the long acting dopamine antagonist metoclopramide (10 mg intravenously) in the hyperprolactinaemic patients as compared with the controls. Prolactin responsiveness to metoclopramide was reduced in the patients as compared with the controls, such being considered characteristic of a prolactinoma. Basal serum thyrotrophin (TSH) levels, although within the euthyroid range, were increased in the patients as compared with the controls. There was no significant difference in the TSH responsiveness to metoclopramide between the study groups. However, in the five patients with exaggerated responses of TSH to metoclopramide, basal TSH levels were significantly higher than in the other patients. One explanation for these results is that prolactin can directly or indirectly modulate the aldosterone response to metoclopramide. PMID- 3816085 TI - The relationship between intestinal crypt cell production and intestinal water absorption measured in vitro in the rat. AB - In studies on intestinal adaptation it is often important to obtain contemporaneous data on the rate of cell production and the functional status of the intestine. The measure of the rate of accumulation of vincristine arrested metaphases in microdissected intestinal crypts to determine the crypt cell production rate (CCPR), is one of the most effective methods of estimating intestinal epithelial cell proliferation which is robust enough to withstand scrutiny. However, studies in the field of intestinal adaptation could be much more informative if a valid measure of intestinal function could also be included. One such method is the water absorption capacity in vitro. The intraperitoneal injection of vincristine sulphate (1 mg/kg) had no significant effect on the water absorption capacity of the small intestine, as measured by the segmented flow single pass perfusion method; thus the CCPR of the jejunum and intestinal water absorption were both measured in 19 groups of hypo- and hyper proliferative rats which should have been in a relatively 'steady state' of cell production and turnover. The minimum values were obtained after hypophysectomy and the maximum values were observed in lactation. CCPR and absorption were significantly correlated (P less than 0.001) with each other. There was a significant (P less than 0.001) correlation between both CCPR and absorption and dry weight of the intestinal segment studies with food intake. Body weight was a poor predictor of either CCPR or absorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816086 TI - Na+, K+ and water balance in young spontaneously hypertensive rats: relationship to blood pressure after high K+ treatment. AB - These studies were designed to investigate the effects of high dietary K+ on electrolyte and water balance in young spontaneously hypertensive rats (SHR) and to relate these effects to changes in blood pressure. The high K+ diet reduced blood pressure by approximately 10 mmHg during the development of hypertension. Blood pressure, however, plateaued at the same maximum level as control by age 13 weeks. Rats fed the high K+ diet showed a significant increase in water intake and urine volume throughout the treatment period but no change in plasma volume or extracellular fluid volume occurred. A slight natriuresis was also observed in rats on the high K+ diet, but this was not of sufficient magnitude to decrease total body Na+. These results confirm previous findings that K+ causes a diuresis and a natriuresis, but demonstrate that the diuretic action of K+ cannot explain its antihypertensive properties in young SHR. PMID- 3816087 TI - Circulatory response to postural change in healthy male subjects in relation to age. AB - The initial heart rate (HR) response evoked by standing up and 70 degrees head-up tilt from the supine resting position, as well as the changes in HR and blood pressure after 1-2 min in the upright position, was analysed in teenage boys (aged 10-15 years) and healthy old men (aged 60-90 years). Standing up induced a characteristic temporary HR increase that lasted 20 s and far exceeded the gradual initial HR rise induced by head-up tilt. The main effect of age on the initial HR transients was a definite diminution of the response. After 1-2 min standing and tilting, young subjects showed a pronounced increase in HR and diastolic pressure with little change in systolic pressure. In contrast, old subjects showed a lesser increase in HR and diastolic pressure and a decrease in systolic pressure. A fall in systolic pressure of greater than 20 mmHg after 1 min of active standing was, however, not observed. It is concluded that the circulatory adjustment to the stress of postural change differs markedly between young and elderly subjects. In healthy old subjects marked postural hypotension appears to be rare. PMID- 3816089 TI - Communications for the meeting of the Medical Research Society. 8 and 9 January 1987, Charing Cross. Abstracts. PMID- 3816088 TI - The effect of muscle paralysis on the radial growth of collagen fibrils in developing tendon. AB - Voluntary muscle activity in chick embryos was paralysed by administration in ovo of tubocurarine hydrochloride, administered in single or multiple doses, from day 9 to day 13 after fertilization. Control eggs were given saline instead of tubocurarine or were simply incubated without operative interference. Embryos were killed at 9, 13, 14, 16 and 19 days after fertilization. Flexor digitorum tendons were removed, fixed in glutaraldehyde, embedded in plastic, sectioned, and stained with phosphotungstic acid for electron microscopy. The diameters of the tendon collagen fibrils were measured, on electron micrographs, using a Magiscan Mk II programme. Tendon collagen fibril expansion was not inhibited by tubocurarine treatment. It is concluded that the rapid increase of collagen fibril diameters, which coincides in the normal embryo with the first onset of use of the associated muscle, is not dependent on muscle activity. There remains a possibility that other ways of producing tension in the tendon could provide sufficient stimulus to fibril expansion. PMID- 3816090 TI - Use of amantadine in nursing homes for the control of influenza A. PMID- 3816091 TI - Serum and synovial fluid antibodies to collagen in rheumatic diseases: a review. AB - The literature on the occurrence and significance of antibodies to native or denatured collagen in rheumatic diseases is reviewed. Mainly type I and type II collagen have been investigated, both in serum and synovial fluid, with special reference to their possible role in rheumatoid arthritis. Brief results of the analysis of 40 synovial fluid samples, using an ELISA technique are included. PMID- 3816092 TI - Calculating radiological progression in rheumatoid arthritis. AB - We examined two methods of calculating radiological progression in rheumatoid arthritis using hand and wrist radiographs scored by Larsen's method. Progression over 12 months was calculated in two ways: absolute change in score; relative change in score. The two methods of scoring progression were investigated in two studies. In the first 173 patients with rheumatoid arthritis treated with a variety of non-steroidal and slow-acting anti-rheumatic drugs were evaluated. There were different results using absolute and relative changes in score. Relative changes gave more meaningful results. The second study looked at 80 rheumatoid patients treated with slow-acting drugs for 6 months; patients with a persistently high ESR had significantly more progression assessed by relative change but not by absolute change. Evaluating the progression of joint damage by methods employing a scoring system must be interpreted with caution. Relative change may provide a more valuable measure than absolute change. PMID- 3816093 TI - Isokinetic and isometric muscle strength in patients with rheumatoid arthritis. The relationship to clinical parameters and the influence of corticosteroid. AB - The isometric and isokinetic muscle strength of the legs in forty-six women with rheumatoid arthritis was measured using a Cybex II dynamometer. Twenty-six of the patients had been treated with corticosteroid - prednisone - some for several years (mean 8 years, range 1-35). Twenty-three healthy age-matched women served as a comparable group (controls). In patients treated with prednisone the mean maximal isokinetic muscle strength of the knee extensors was between 64 +/- 26 Nm (SD) and 43 +/- 18 Nm (SD) at the preset angular velocities 30 degrees/s and 180 degrees/s, respectively, which was a reduction to 54%-55% of that found in controls (p less than 0.001). In patients who had not received prednisone the mean maximal isokinetic strength was between 99 +/- 39 Nm (SD) and 67 +/- 27 Nm (SD) which was a reduction to 84%-86% of that found in controls (p less than 0.05). The force velocity curve showed a parallel decrease in maximal strength with increasing velocity when comparing patients with rheumatoid arthritis to controls. Also on measuring the isokinetic muscle strength of plantar flexors a significantly lower mean maximal torque was found in patients treated with prednisone, (33 +/- 21 Nm (SD) (p less than 0.01] as compared with a control group (50 +/- 28 Nm (SD]. The patients who had not been treated with prednisone showed a lower, but not significantly lower isokinetic strength of the plantar flexors, 46 +/- 22 Nm (SD) at a corresponding angular velocity, 30 degrees/s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816094 TI - The relationship between the leg muscle strength and physical capacity in patients with rheumatoid arthritis, with reference to the influence of corticosteroids. AB - It has been shown that patients with rheumatoid arthritis have weak muscles, especially when they are treated with corticosteroids. Forty-six female patients suffering from rheumatoid arthritis were evaluated with regard to the physical capacity in the lower legs by measuring the walking speed and the climbing performance as correlated to the isokinetic muscle strength of the knee extensors and the plantar flexors. Twenty-six of the patients (average age 60 years, range 34-76) had been treated with corticosteroids. Twenty patients (average age 58 years, range 31-72) had never received corticosteroids. The mean maximal isokinetic muscle strength of the knee extensors in corticosteroid treated patients was 62 +/- 28 Nm (SD) at the angular velocity 30 degrees/s, and the mean maximal isokinetic muscle strength of the plantar flexors in the same group of patients was 33 +/- 21 Nm (SD) at the same angular velocity. Compared to patients with rheumatoid arthritis who had never been treated with corticosteroids the reduction in muscle strength was 37% and 28%, respectively (p less than 0.001 and p less than 0.01). The mean walking speed in patients with corticosteroid treatment was 0.9 m/s, which was a 36% reduction as compared with that found in patients who had not received corticosteroids (p less than 0.01). Half of the patients who had not received corticosteroids were able to climb a 50 cm step, while this was possible in only 16% of the group of corticosteroid-treated patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816095 TI - DNA microfluorometry of synovial effusion cells in rheumatic diseases. AB - A microfluorometric study of relative DNA content in lymphocytes and granulocytes from the synovial fluid of 26 patients with rheumatoid arthritis or seronegative reactive arthritis was carried out. Results obtained from individuals without treatment or treated with nonsteroid anti-inflammatory drugs were compared with measurements of 7 healthy persons. DNA content in granulocytes was more sensitive to effects of disease or therapy than in lymphocytes. Introduction of therapy resulted in decreased percentage of cells in synthetizing or mitotic phase of the cell division cycle (microfluorometric index showing non G0 (G1 population]. A possible local influence of regulatory substances produced in the arthritic joint on DNA metabolism of both cells under study was suggested. PMID- 3816096 TI - The peripheral vascular effects of nifedipine in Raynaud's syndrome associated with scleroderma: a double blind crossover study. AB - The effectiveness of nifedipine in the treatment of Raynaud's syndrome was assessed in 16 patients with systemic sclerosis or a variant of this condition. Changes in finger and forearm blood flow (venous occlusion plethysmography), skin temperature and digital systolic pressure were measured both during the acute period and after a 2-week treatment. Subjective assessment of efficacy was based on patient diary data. Finger blood flow increased significantly both during the acute period and after 2 weeks of nifedipine therapy compared to placebo (P less than 0.05). Digital skin temperature also increased during the study period (P less than 0.01). Forearm blood flow and digital systolic pressure did not change. Nifedipine significantly reduced the frequency (P less than 0.05), duration (P less than 0.05) and severity (P less than 0.01) of attacks. Eleven out of the sixteen patients experienced side effects while on nifedipine. These results suggest that nifedipine is of benefit in the treatment of Raynaud's syndrome in patients with systemic sclerosis over a short time course. PMID- 3816097 TI - Methylprednisolone pulse therapy in conjunction with azathioprine in rheumatoid arthritis. AB - In the management of rheumatoid arthritis two potentially useful roles for methylprednisolone (MP) pulse therapy are presently recognised: in patients in whom second line drugs have not led to a satisfactory remission or have caused side effects, and in bridging the gap between the start and the delayed onset of effect of a slow-acting antirheumatic drug. Recently it was shown that MP-pulse therapy was effective in accelerating the response to sulphasalazine and D penicillamine. Nineteen patients with a persistently active rheumatoid arthritis, who had failed to respond to at least two slow-acting antirheumatic drugs, were treated with MP-pulse therapy in conjunction with azathioprine. Twelve patients continued this treatment for 6 months and 8 for 12 months. MP-pulse therapy resulted in an immediate improvement in Ritchie articular index, grip strength, ESR and CRP. However, this improvement lasted less than six weeks. After 6 months some improvement due to the effect of azathioprine became apparent. Some rather serious side effects were noted. It is concluded that MP-pulse therapy has a (short lasting) beneficial effect in persistently active rheumatoid arthritis. However MP-pulse therapy is not suitable to bridge the gap between the introduction of azathioprine-treatment and the delayed response to this drug. PMID- 3816098 TI - Neonatal lupus erythematosus with congenital heart block associated with maternal systemic lupus erythematosus. AB - We report the presence of complete heart block in a girl whose mother has anti-Ro antibodies and is suffering from systemic lupus erythematosus with Sjogren's syndrome. HLA antigens studies in the two patients support the hypothesis described recently that HLA DR3 is responsible for the production of anti-Ro antibodies and not for the phenotypic expression of the tissue injury. PMID- 3816099 TI - "Swan neck" deformity following carpal spasm in a patient with benign hypermobile joint syndrome. AB - In a patient with benign hypermobile joint syndrome and normocalcemic tetany, an episode of carpal spasm caused the appearance of "swan neck" deformity in the fingers of the left hand. PMID- 3816100 TI - Calcification is rare in adult-onset dermatopolymyositis. AB - Extensive subcutaneous and muscular calcification developed in a patient having adult-onset dermatopolymyositis (DM-PM) with an 'overlap' connective tissue disease. We wish to emphasize the rarity of calcification in adult onset DM-PM, which is contrary to the generally held impression. PMID- 3816101 TI - Early recognition of tuberculous arthritis, assisted by CT scan and closed needle synovial biopsy. AB - A patient with chronic monoarthritis erroneously diagnosed as osteoarthritis, in whom a high index of suspicion for tuberculosis, assisted by CT scan and closed needle synovial biopsy led to the relatively early and correct diagnosis and treatment of tuberculous arthritis is presently reported. PMID- 3816102 TI - Colchicine suppression of local inflammation due to calcinosis in dermatomyositis and progressive systemic sclerosis. AB - Two girls, one with progressive systemic sclerosis and a second with dermatomyositis, developed calcinosis in the skin of the prepatellar area. Calcinosis was accompanied by local inflammation and skin ulceration. Oral colchicine therapy in a dosage of 1 mg per day was followed within two months by significant regression of local inflammation and healing of the skin ulcers. PMID- 3816103 TI - Vertigo. PMID- 3816104 TI - Transient levodopa withdrawal in Parkinson's disease. PMID- 3816105 TI - Evaluation of three dosage-prediction methods for initial in-hospital stabilization of warfarin therapy. AB - Three dosage-prediction methods for initial in-hospital stabilization of warfarin therapy were evaluated. Adult inpatients who had received warfarin sodium 10 mg daily for less than three days were eligible for the study. After receiving their third warfarin dose, patients were randomly assigned to have their warfarin dosages adjusted using one of three dosage-prediction methods: by analog computer (n = 31), linear regression (n = 22), or empiric dosing by the physician (n = 34). A prothrombin time (PT) ratio (patient PT divided by control PT) between 1.3 and 2.5 was considered to be in the therapeutic range. For patients who achieved a stable PT ratio (defined as a PT ratio between 1.3 and 2.5 that varied by less than 0.05 on two consecutive days or by less than 0.1 on three consecutive days without a dosage change) before discharge, the number of days (time to stabilization) from administration of the first warfarin dose to achievement of the warfarin dosage that produced a stable PT ratio (stabilization dosage) was compared. A total of 54 patients met the study criteria for a stable PT ratio before hospital discharge (analog computer, n = 20; linear regression, n = 15; empiric dosing, n = 19). The mean times to stabilization were 6.8 days in the analog-computer group, 7.3 days in the linear-regression group, and 8.4 days in the empiric-dosing group; these times were not significantly different. All 20 stabilized patients in the analog-computer group achieved a stable PT ratio by the fourth dosage prediction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816106 TI - Effect of phenytoin on serum disopyramide concentrations. AB - The effects of phenytoin on serum disopyramide concentrations in 10 volunteers were studied. Leading to the study was the case of a 59-year-old man who received phenytoin and disopyramide and who required unusually high doses of disopyramide and an unusually high serum concentration of this drug to control his ventricular tachycardia. Ten healthy men 23-36 years of age each received a single oral dose of disopyramide phosphate 300 mg. Periodic blood samples were obtained for 24 hours after the dose. On day 2, the subjects began a 13-day course of oral phenytoin sodium 300 mg/day, and on day 14 each again received a single oral dose of disopyramide, after which blood samples were obtained. Serum disopyramide concentrations were determined by enzyme-mediated immunoassay and gas chromatography and serum phenytoin concentrations by fluorescence polarization immunoassay. Pharmacokinetic values before and after phenytoin administration were calculated. The mean area under the serum concentration-time curve for disopyramide and the disopyramide half-life and elimination rate constant were significantly different before and after phenytoin treatment. The maximum serum disopyramide concentrations were not significantly different. After phenytoin therapy, subjective complaints of anticholinergic effects increased in number and severity. An interaction between disopyramide and phenytoin appears to exist and to be caused by an increase in the hepatic metabolism of disopyramide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816107 TI - Acceptability of cholestyramine or colestipol combinations with six vehicles. AB - Preferences for cholestyramine or colestipol in combination with orange drink, orange juice, grape juice, apple juice, water, or apple sauce were evaluated in 40 healthy adults. Each subject evaluated the taste, texture, and smell of 30-mL samples of 12 drug-vehicle combinations (two drugs, six vehicles) using modified five-point wine-tasting scales. Samples were prepared to contain either cholestyramine 1.0 g or colestipol hydrochloride 1.3 g. The products were tested at room temperature and were administered in a random order. Subjects and observers were blinded to the identity of the products. Acceptability scores for taste, texture, and smell were significantly higher for cholestyramine than for colestipol. Total mean preference scores for cholestyramine-vehicle combinations ranged from 9.9 to 11.7; for colestipol, 6.3 to 8.9. Orange drink, apple juice, grape juice, and orange juice were the preferred vehicles for cholestyramine. The preferred vehicles for colestipol were orange drink, apple sauce, and apple juice. PMID- 3816108 TI - Intrapatient variation in aminoglycoside disposition in cystic fibrosis. PMID- 3816109 TI - Comparison of antibiotic dosage regimens using pharmacokinetic and microbiologic factors. AB - A pharmacokinetic meta-analysis was performed for 33 antibiotics used in treating infections caused by microorganisms for which the antibiotics are considered to be agents of first choice or primary alternatives. The pharmacokinetic indices assessed were the following components of the steady-state blood concentration time profile: the magnitude of the peak antibiotic serum concentration at steady state compared with the minimum inhibitory concentration (CSSmax/MIC) and the intensity index, a dimensionless term that reflects the contribution of the peak serum antibiotic concentration and the duration that this concentration is above the MIC. Substantial differences in CSSmax/MIC and intensity-index values were observed among antibiotics within an antibiotic class for individual microorganisms and for groups of microorganisms. Piperacillin, amikacin, and tetracycline showed the best mean performances of the ureido penicillins, aminoglycosides, and tetracyclines, respectively. For the cephalosporins, cefadroxil displayed the highest mean values of the first-generation cephalosporins; cefuroxime and cefotetan showed the greatest measures for the second-generation agents; and all third-generation cephalosporins demonstrated very high mean performance indices. Meta-analysis of pharmacokinetic performance factors is a useful technique for making intergroup and intragroup comparisons of antibiotics. PMID- 3816110 TI - Haemodynamic response to exercise in patients with alcoholic liver cirrhosis. AB - Physical work capacity was evaluated by a multistage bicycle exercise test in 29 patients, 22 men and seven women aged 35-61 years (mean 49) with alcoholic liver cirrhosis and in a sex- and age-matched control group. The maximal work load was reduced in the patient group, mean 122 vs. 186 watts in men (P less than 0.001), and 60 vs. 119 watts in women (P less than 0.005). Resting heart rate was higher in patients (91 vs. 78 beats X min-1, P less than 0.005), and the maximal heart rate was lower (159 vs. 170 beats X min-1, P less than 0.001) compared with controls. Thirteen of 29 (45%) patients compared with 5 of 29 (17%) control subjects had an increase in left ventricular ejection fraction of less than or equal to 5% during exercise (P less than 0.05). The present results suggest that an impaired capacity of the cardiac function to respond adequately to physical stress may at times contribute to the reduced physical work capacity seen in patients with alcoholic liver cirrhosis. PMID- 3816111 TI - Myocardial energy metabolism in the induction phase of cardioplegia in relation to myocardial temperature during open heart surgery. AB - Changes in myocardial high energy phosphate and lactate concentrations during initiation of cardioplegia for open heart surgery were studied in 21 patients and related to their individual myocardial temperatures. Left ventricular myocardial biopsies were taken 10 min post aortic cross-clamping and were analysed for ATP, creatine phosphate (CP), creatine (C) and lactate. The patients were divided into three groups according to the achieved myocardial temperature: 6-10 degrees C, 11 15 degrees C and 16-24 degrees C. The results indicated that optimal myocardial protection during the induction phase of the cardioplegia was obtained in the 11 15 degrees C group in which the highest ATP concentration and simultaneously lowest lactate concentration was maintained. PMID- 3816112 TI - Indocyanine green plasma clearance as a measure of changes in hepatic blood flow. AB - The results from simultaneous measurements of indocyanine green (ICG) plasma clearance and hepatic blood flow (HBF) in subjects without hepatic dysfunction during changes in HBF induced pharmacologically or by food stimulation, are reported. A linear relation is established between the relative changes in HBF and that of ICG clearance (r = 0.94), but the changes are not identical, and therefore the changes in HBF cannot be accurately predicted from that of ICG plasma clearance. The reason behind the lack of identity of the changes lies in the complicated kinetics of dye removal by the liver. The hepatic venous catheterization technique is the only method when physiologically correct values for hepatic blood flow or changes therein are wanted. PMID- 3816113 TI - Effect of training on the post-exercise ankle blood pressure reaction in patients with intermittent claudication. AB - The effect of physical training on the post-exercise blood pressure reaction in the ankle was studied in 63 patients with intermittent claudication but without angina pectoris. After three months of supervised training the maximal walking distance increased by 67% and the pain-free walking distance by 73%. Compared with that after the pre-training treadmill test, the ankle blood pressure was significantly higher 2-16 min after the post-training test and more rapidly returned to the initial resting value, both with similar work loads and with a higher post-training work load. Blood pressure measurement in the ankle after exercise is useful as an objective test of the circulatory effect of training in patients with intermittent claudication. PMID- 3816114 TI - Acetylstrophanthidin does not enhance the reflex pressor response to static muscular contraction. AB - Cardiac glycosides have been shown to enhance the sensitivity of the reflex cardiovascular responses to stimulation of mechanoreceptors in the heart, carotid sinus and aorta. Little is known, however, about the effect of glycosides on the reflex cardiovascular responses to the contraction-induced stimulation of afferent endings in hindlimb skeletal muscle. We therefore examined the reflex heart rate and arterial pressure responses to static contraction of the hindlimb muscles before and after femoral arterial injection of two doses of acetylstrophanthidin (20 and 80 micrograms/kg). Neither of the two doses enhanced the reflex cardiovascular responses to contraction, although the larger of the two significantly increased femoral venous potassium concentrations from 3.4 +/- 0.2 to 3.8 +/- 0.1 mM. Although injection of the two doses as well as injection of a very large dose of acetylstrophanthidin (400 micrograms/kg) increased baseline mean arterial pressure, these effects were probably caused by the vasoconstrictor action of this agent and not by a chemoreflex, because the increase was not attenuated by denervation of the hindlimb. PMID- 3816115 TI - [Rendu-Osler-Weber disease. Study of a family and review of its genetic, clinical diagnosis and therapeutic aspects]. PMID- 3816116 TI - [Sotalol in menopausal disorders]. PMID- 3816117 TI - [Norfloxacin: hepatic tolerance]. PMID- 3816118 TI - [Use of meso-therapy with orgotein in De Quervain disease]. PMID- 3816119 TI - [Advantages of the treatment of obese subjects by compensated fasting]. PMID- 3816120 TI - [Heparin: uses and possibility. Current status]. PMID- 3816121 TI - [Coloring materials and prevention in the work environment]. PMID- 3816122 TI - [National Association for the Campaign against AIDS]. PMID- 3816123 TI - Distinguishing universal and language-dependent levels of speech perception: evidence from Japanese listeners' perception of English "l" and "r". PMID- 3816124 TI - Some origins of belief. PMID- 3816125 TI - Processing strategies in the acquisition of relative clauses: universal principles and language-specific realizations. PMID- 3816126 TI - In defense of agrammatism. PMID- 3816127 TI - A final brief in the case against agrammatism: the role of theory in the selection of data. PMID- 3816128 TI - Development and evaluation of diagnostic radiometric assays for serogroup 4 L. pneumophila urinary antigens. AB - We previously reported that 80% of patients with serogroup 1 Legionella pneumophila pneumonia excrete detectable quantities of specific antigens in their urine. The purpose of this study was to determine whether specific antigens can be detected in urine from patients with serogroup 4 L. pneumophila pneumonia. Antisera were prepared in 15 rabbits and used to set up 25 solid-phase radioimmunoassays. The best of these assays detected specific antigens in urine from 4 of 5 patients with culture-proven serogroup 4 infections and from 1 of 2 patients with culture-proven serogroup 10 infections. None of 100 control specimens was positive in the assays. The antigens from serogroup 4 and 10 infections behaved differently in the assays, suggesting that they are not identical molecules. This study demonstrates that it is possible to detect specific antigens in the urine of patients with serogroup 4 L. pneumophila pneumonia. This may be a useful method for diagnosing these infections rapidly. PMID- 3816129 TI - Clinical and ecological characteristics of Vibrio vulnificus in the northeastern United States. AB - Multiple seawater sites in the northeastern United States, particularly Long Island Sound, and shellfish from Long Island Sound were sampled from April to November for 3 successive yr, 1983-1985. Hospitals in coastal and metropolitan areas of Connecticut were surveyed for the same 3-yr period, Vibrio vulnificus can be found in these waters during the summer months. The appearance of these virulent bacteria in both seawater and shellfish are a function of the water temperature; no V. vulnificus could be isolated until the temperature was approximately 17 degrees C. Although the risk of infection is small, as shown by isolation of this organism from patients, certain high-risk groups exist. Consumption of raw shell fish during the summer months should be discouraged in people with liver disease or patients on immunosuppressive therapy. PMID- 3816130 TI - Prototheca zopfii isolated from a patient with olecranon bursitis. AB - Prototheca zopfii was isolated from a patient with olecranon bursitis. Olecranon bursitis caused by Prototheca is a distinct clinical entity. Recognition of this infection was made by observing characteristic organisms in tissue and subsequent isolation of the organism. PMID- 3816131 TI - Unusual cluster of yersiniosis in four infants due to a rare serogroup. PMID- 3816132 TI - Viral diseases and arthritis. PMID- 3816133 TI - Trace metals and immune function in the elderly. PMID- 3816134 TI - Etiology, diagnosis, and treatment of bacteremia. PMID- 3816135 TI - Management of urinary tract infections in women. PMID- 3816136 TI - Coagulase-negative staphylococcal infections. PMID- 3816137 TI - Bronchial infections: acute bronchitis and acute exacerbation of chronic bronchitis. PMID- 3816138 TI - Urinary tract infections in children. PMID- 3816139 TI - New concepts in the control of influenza. PMID- 3816140 TI - Collagen crosslinking in lungs of rats with experimental silicosis. AB - Rats were intratracheally instilled with 50 mg of size-fractionated crystalline quartz to induce silicosis. Lungs were analyzed 1, 4, 6, and 9 months after instillation for their content of the reduced difunctional collagen crosslinks dihydroxylysinonorleucine (DHLNL) and hydroxylysinonorleucine (HLNL), of the nonreducible trifunctional (mature) crosslink, hydroxypyridinium (OHP), and of hydroxylysine. Ratios of DHLNL: HLNL were elevated in silicotic lung collagen at all times sampled, due both to increased levels of DHLNL and decreased amounts of HLNL. Hydroxylysine content of collagen in the silicotic lungs was also increased as compared with age-matched control rats. Hydroxypyridinium content of silicotic lung collagen was less than control values at 1 month, but was significantly increased to about 120%, 150%, and 175% of the age-matched control values at 4, 6, and 9 months after silica instillation, respectively. The increased levels of OHP in lung collagen were temporally correlated with the appearance of mature silicotic nodules in these lungs. We conclude that the large amounts of excess collagen deposited in silicotic lungs differs biochemically from normal lung collagen despite maintenance of the normal ratio of major collagen types in silicotic lungs. PMID- 3816141 TI - Hyaluronic acid synthesized by fibroblasts cultured from normal and chronically inflamed human gingivae. AB - Hyaluronic acid is an important component of the extracellular matrix of gingivae and its quantity and molecular size appear to be altered under inflammatory conditions. Whether gingival fibroblasts from inflamed tissues synthesize quantities and molecular sizes of hyaluronic acid that differ from normal gingival fibroblasts is not known. To determine this, we isolated fibroblasts from three biopsies each of healthy and chronically inflamed human gingiva and incubated them in the presence of [3H]glucosamine. The release of labeled macromolecules into the medium was approximately 50% greater for the inflamed tissue fibroblasts than for the normal tissue fibroblasts. Of this labeled material, 35% was identified as hyaluronic acid in the medium of inflamed cell cultures, compared to only 25% in normal fibroblast cultures. Sepharose CL-4B chromatography of the labeled material revealed that most of the newly synthesized hyaluronic acid was of large molecular size in inflamed fibroblast cultures. The proportions of [3H]-labeled hyaluronic acid in these peaks varied and indicated that an increase in the amount of large molecular size hyaluronic acid was responsible for the increase in labeled hyaluronic acid noted in the medium of the inflamed tissue fibroblasts. Thus, the decrease in molecular size of hyaluronic acid previously noted in inflamed tissue most likely arises from extracellular factors rather than synthesis of smaller molecular weight species by the fibroblasts. More importantly, however, the differences noted between normal and inflamed gingival fibroblasts persisted over time in culture. This indicates that such differences between the cells may be of a stable and heritable nature. PMID- 3816142 TI - Aortic elastin abnormalities in osteogenesis imperfecta type II. AB - Skin and aortic samples from two patients who died by lethal perinatal Osteogenesis Imperfecta (O.I.) were studied by optical and electron microscopy and compared with similar samples from two normal human fetuses and one newborn child. No significant abnormalities were observed in the dermis of O.I. patients apart from small differences in the diameter of reticular collagen fibrils. On the contrary, in the aortas of both patients collagen fibrils were significantly smaller than in the controls; moreover, elastin lamellae were deeply altered and consisted of roundish aggregates of elastin, massively permeated by cytochemically recognizable glycosaminoglycans. As identical features were described in experimental lathyrism by using inhibitors of the enzyme lysyl oxidase (Pasquali Ronchetti et al., 1984), the conclusion is reached that in the two cases of lethal perinatal O.I. examined, a severe lysyl oxidase deficiency could account for the observed ultrastructural abnormalities of elastin and that, besides defects of collagen type I, additional alterations of cellular metabolism might be responsible for the clinical heterogeneity of the disease. PMID- 3816143 TI - Abstracts from the meeting on steroid hormone regulation of extracellular matrix proteins. Vergennes, Vermont, June 29-July 2, 1986. PMID- 3816144 TI - Nomenclature recommendations: Bone proteins and growth factors. PMID- 3816145 TI - A process model of posthypnotic amnesia. PMID- 3816146 TI - High sulfhydryl content in turtle erythrocytes: is there a relation with resistance to hypoxia? AB - Glutathione concentration in the erythrocytes of the fresh-water turtle Phrynops hilarii, as determined by the enzymic recycling method is 1.9 +/- 0.2 mM. The erythrocyte non-protein -SH, NPSH, content, as determined by the 5,5' dithiobis(2 nitrobenzoic acid), DTNB, reducing capacity is 4.6 +/- 0.8 mM. The total DTNB reducing capacity in the erythrocytes, including hemoglobin, is 26 +/- 5 mM. Incubation with oxidized glutathione, greatly increases the electrophoretic mobility of both hemoglobin components present in the erythrocytes of Phrynops hilarii, indicating the formation of mixed disulphides with glutathione. The high --SH content in the erythrocytes of P. hilarii might be part of a redox buffering principally an antioxidant mechanism involved in resistance to hypoxia, possibly along the hypoxic period as well as during reperfusion with oxygen. PMID- 3816147 TI - Tissue glycogen and lactate handling by the developing domestic fowl. AB - The levels of glycogen and lactate in liver, intestine, yolk sac membrane and leg and breast muscle of domestic fowl from day 10 of "in ovo" development to day 5 after hatching compared with adults have been measured and compared with the circulating concentrations in blood of glucose and lactate. Glycogen stores in most tissues increased before hatching to attain a minimum around the eclosion and then increased to adult values in muscle and liver. Lactate maintained its plasma concentrations with higher effectiveness than plasma glucose, which increased steadily up to adult levels from hatching. The study of tissue vs plasma lactate concentration ratios suggests a general activation of lactate metabolism from hatching, coinciding with the ingestion of carbohydrate-based food. Both muscles studied, as well as intestine, seem to be net lactate producers; blood cells can speculatively be considered as lactate users and liver maintains its concentration of lactate very close to that of plasma, suggesting a fast utilization of this material as well as liver being the main site for control of circulating lactate. PMID- 3816148 TI - The distribution and comparison of glutathione, glutathione reductase and glutathione S-transferase in various camel tissues. AB - Extracts prepared from liver, kidney, lung and brain of camel contain glutathione, glutathione S-transferase and glutathione reductase. Liver had the highest level of glutathione (218.7 mumol/g wet weight) whereas brain had the lowest level (66.4 mumol/g wet weight). The highest activity for glutathione reductase was found in the kidney (2.6 mumol/min/mg protein) while the lowest activity was found in the lung (0.9 mumol/min/mg protein). Glutathione S transferase activity was the highest in liver (4.2 mumol/min/mg protein) and the lowest in brain (1 mumol/min/mg protein). Purified glutathione S-transferases from lung, kidney, brain and liver were similar in their molecular size, subunit composition as well as immuno-reactivity and showed some differences in their response to heat and inhibitors. PMID- 3816149 TI - Hormonal effects and the control of gluconeogenesis from sorbitol, xylitol and glycerol in perfused chicken liver. AB - Addition of sorbitol or xylitol to perfused chicken liver caused a biphasic increase in the rate of glucose production. The second increase correlated with a decrease in the lactate to pyruvate ratio. Increased glucose production in response to the addition of glycerol was not biphasic. Aminooxyacetate inhibited both the inherent second increase in glucose production and stimulatory effects of alanine and pyruvate. The stimulatory effects of norepinephrine and glucagon on gluconeogenesis from sorbitol decreased in the presence of methylene blue. Only the stimulatory effect of norepinephrine was inhibited by aminooxyacetate. PMID- 3816151 TI - Multiple forms of juvenile hormone esterase active sites in the hemolymph of larvae of Trichoplusia ni. AB - Kinetic analysis was performed on the juvenile hormone (JH) esterase activity in the hemolymph of feeding, last instar larvae of Trichoplusia ni (Lepidoptera: Noctuidae). When the results were analyzed by several different graphical and regression procedures, all approaches yielded the same conclusion that at least two forms of JH esterase active sites exist in the hemolymph. The apparent Km for one site for JH I, II and III was 8.5 X 10(-8) M, and 6.6 X 10(-8) M, respectively. The Km for the other site for JH I, II and III was 6.6 X 10(-7) M, 7.6 X 10(-7) M, 40 X 10(-7) M, respectively. When hemolymph JHE activity was subjected to high resolution isoelectric focusing (IEF), two distinct large peaks of JHE activity were observed, with pIs of 5.3 and 5.5, as well as a small peak at pI 5.1. Separate kinetic analysis of the JHE activity in each peak showed that only the higher Km active site for each substrate was present (in the 10(-7) M range). These data necessitate a change in the current model for JHE in T. ni, and some other insects, which states that a single active site is responsible for most or all of the JH esterase activity in vivo. The data also explain the different estimates of the Km of JHE in T. ni obtained by different laboratories. Studies on the purification of, and the development of inhibitors for, JHE esterase must consider the role of both JHE forms and sites in regulation of T. ni metamorphosis. PMID- 3816150 TI - Catfish liver acid phosphatases: differently glycosylated enzyme molecules with altered kinetic properties. AB - Two forms of catfish liver acid phosphatase (AcPase I and II) were separated and purified to homogeneity and their carbohydrate compositions and some biochemical properties were studied. Evidence is given that AcPase I and II are differently glycosylated forms of the same enzyme. The enzyme forms differ significantly in the size and the composition of their carbohydrate components, sensitivity towards sulfhydryl-blocking and protecting reagents, sensitivity to ferric and ferrous ions, thermostability and ability to hydrolyze some nucleotides. The more highly glycosylated form is more sensitive to thermal denaturation. AcPase I and II behave differently towards ascorbate and changes in its concentration and it is suggested that the concentration of reducing modifiers may regulate AcPase activity at the cellular level. It is hypothesized that the differing extents of glycosylation influence the structure of the enzyme forms. This is expressed in altered conformations of two enzyme forms and results in a different exposure of the essential cysteine residues. PMID- 3816152 TI - Effects of urea, trimethylamine oxide, and osmolality on respiration and citrulline synthesis by isolated hepatic mitochondria from Squalus acanthias. AB - The effects of osmolality and of urea and trimethylamine oxide on citrulline synthesis and respiration by isolated hepatic mitochondria from Squalus acanthias (spiny dogfish) were determined. Optimal rates of citrulline synthesis and of respiration, as well as maximal respiratory control ratios, were obtained when the osmolality was about 300 mOsm when physiological concentrations of urea and trimethylamine oxide were present, analogous to mammalian mitochondria. Urea and trimethylamine oxide do not act as osmolytes and do not significantly affect these rates. When glutamate is not saturating, increasing concentrations of urea over the range of concentrations of physiological significance (e.g. 0.1-0.5 M) significantly inhibit citrulline synthesis, but not respiration. This response to urea concentration may reflect a specific homeostatic mechanism for maintaining physiological concentrations of urea. PMID- 3816153 TI - Support of respiration and citrulline synthesis by isolated hepatic mitochondria from Squalus acanthias by acyl-CoAs and other nitrogen-donating substrates. AB - The effects of different substrates supporting respiration and glutamine dependent citrulline synthesis from ornithine, ammonia, and bicarbonate by isolated hepatic mitochondria from Squalus acanthias (spiny dogfish) were determined. Highest rates of respiration were achieved with succinate, palmitoyl CoA, and beta-hydroxybutyrate as oxidizable substrates. All acyl-CoAs tested (from C-2 to C-22) supported carnitine-dependent respiration at a substantial rate. Short-chain fatty acids did not support respiration. Ammonia required for citrulline synthesis could be formed from glutamate, or from leucine plus alpha ketoglutarate which gives rise to glutamate by transamination, as the result of glutamate dehydrogenase activity, but the reaction was inhibited by succinate or other oxidizable substrates. Alanine or ornithine could not be substituted for leucine, suggesting that leucine may specifically activate glutamate dehydrogenase. Glutamate required for citrulline synthesis could be formed from alpha-ketoglutarate and ammonia as the result of glutamate dehydrogenase activity if succinate was present. Transamination of alpha-ketoglutarate with ornithine present in the reaction mixtures provided glutamate at a rapid rate whether or not succinate was present. These results are consistent with the view that hepatic dogfish mitochondria efficiently utilize acyl-CoAs derived from triglyceride stores in the liver to support respiration, glutamine-dependent citrulline synthesis from ammonia, and formation of ketone bodies as a major fuel for muscle. PMID- 3816154 TI - Phosphatidylethanolamine methyltransferase activity in chick liver microsomes. AB - The synthesis of phosphatidylcholine from phosphatidylethanolamine is carried out by chick liver microsomes (Gallus domesticus). Different concentrations of PE, NPE and NNPE were used as exogenous substrates. Saturation of the S adenosylmethionine has been found for the three different reactions with or without exogenous substrate. Kinetic parameters have been determined for this enzyme system in chick liver microsomes. The three methyl reactions had a similar pH profile with an optimum at pH = 8. Divalent ions such as Ca2+ or Mg2+ did not stimulate the enzyme activity. The results suggest that the synthesis of phosphatidylcholine from phosphatidylethanolamine by chick liver microsomes exhibits a kinetic pattern with different aspects than that described for other animal or human preparations. PMID- 3816155 TI - Hepatic 3 alpha-dehydrogenation and 7 alpha-hydroxylation of deoxycholic acid in the guinea-pig. AB - The metabolic fate of exogenous deoxycholate administered either intraperitoneally or intragastrically to male Hartley guinea-pigs was investigated. Two animals received a constant infusion of [24-14C]deoxycholate through an intraperitoneal catheter for 2 hr. Bile was quantitatively collected in 30 min samples during infusion and for 2 additional hours. Each bile sample was analyzed for composition and radioactivity. Five animals received for 15 days, through an intragastric catheter, 35 mg/kg/day of deoxycholate. The biliary bile acid composition was compared with that of a sham-operated control group. The studies with both animal models indicated that guinea-pigs, as the only species so far known, extensively oxidize deoxycholate to form 3-oxo,12 alpha hydroxy-cholanic acid, which is secreted in bile mostly conjugated with glycine. In addition a small fraction (approx. 7%) of the administered deoxycholate is 7 alpha hydroxylated to form cholic acid. The metabolites being more hydrophilic than administered deoxycholate, it is suggested that guinea-pig liver counteracts the adverse increase in bile acids detergency, which follows deoxycholate administration, by converting most of the latter into less detergent compounds. PMID- 3816156 TI - Comparative study of the structure of glyceraldehyde-3-phosphate dehydrogenase from bovine heart muscle. AB - Glyceraldehyde-3-phosphate dehydrogenase with a specific activity of 153 units/mg protein was isolated from bovine heart muscle. Its relative molecular mass was found to be 144,000. The tryptic peptide map and amino acid analysis were obtained. The N-terminal sequence was established as Val-Lys-Val-Gly-Val-Asn-Gly ... and C-terminal as ...-Ala-Ser-Lys-Glu. Fluorescence and optimal rotation dispersion measurements were performed. The data were compared with other glyceraldehyde-3-phosphate dehydrogenases. PMID- 3816157 TI - Comparison of the effects of polyamines on the activities of RNA polymerases from murine normal tissues and transplantable tumors. AB - Nuclear DNA-dependent RNA polymerases I, II and III were purified from kidney, liver and spleen from Swiss mice (Mus musculis) and from seven transplantable murine tumors. In the presence of the optimal concentration of (NH4)2SO4 for each polymerase, 1-8 mM spermidine or spermine stimulated most polymerases several fold, and generally, enzyme I was stimulated more than either enzyme II or III. Spermine was more efficacious than spermidine as a stimulant of polymerase activity except for polymerase III from three tumors. Tumor polymerases I (or II) and the corresponding normal tissue enzymes responded similarly to the polyamines. Stimulation of a RNA polymerase by a polyamine could not be correlated with the growth rate of the tissues of polymerase origin or with the tissue's RNA polymerase or RNA synthetic activities. PMID- 3816158 TI - Transfer of [14C] cholesterol and its metabolites between adult male and female worms of Schistosoma mansoni. AB - Adult male and female worms of Schistosoma mansoni are able to incorporate [14C]cholesterol and convert it into several metabolites. Schistosomula on the other hand cannot convert the incorporated cholesterol. Male worms are able to transfer the [14C]cholesterol and labelled metabolites to female worms but labelled female worms can transfer cholesterol but are unable to transfer the conversion products of cholesterol to male worms. Uptake by female worms of labelled products shed by male worms seems to occur more efficiently in the presence of serum than in its absence. PMID- 3816159 TI - Investigation on the occurrence of soluble lectins in mammalian nervous tissue extracts. AB - Five brain or retina crude extracts obtained from adult mammalians and nine fractions of brain extracts prepared by chromatography were screened for their lectin activities. All crude extracts and several fractions contained agglutinins reacting with neuraminidase-treated rabbit red blood cells. Hemagglutination activity varied widely with the method of preparation of the extracts. Hemagglutination inhibition tests were carried out to look for possible differences in the specificities of the agglutinins. All were found to be D galactosyl specific. Each crude extract was found to contain a second lectin activity, which was detected using ethanol-treated rabbit erythrocytes known to react with heparin-binding lectins. Hemagglutination and inhibition studies showed that they completely differ from the galactoside-binding lectins detected previously. The possible functions of these lectins are discussed. PMID- 3816160 TI - Tri-iodothyronine enhances the formation of light mitochondria during cold exposure. AB - The effect of cold exposure and of PTU and PTU + T3 administration on the protein content and succinic dehydrogenase activity of three mitochondrial populations obtained from rat liver was examined. Our results indicated the following: Succinic dehydrogenase activity increases mainly in the light mitochondrial fraction of cold-exposed rats. PTU administration of cold-exposed animals does not affect the increment in enzyme activity of the heavy fraction but blocks the increment of the light fraction. PTU + T3 administration restores succinic dehydrogenase activity to the values prevalent in normal cold-exposed rats. These findings suggest that thyroid hormone may stimulate the formation of light mitochondria during cold exposure. PMID- 3816161 TI - On using a self-tuning controller for blood pressure regulation during surgery in man. AB - The generalized minimum-variance self-tuning controller of Clarke and Gawthrop has been used to adjust the flow rate of a modified Vickers Treonic IP4 syringe pump delivering phenylephrine to 20 patients undergoing lower abdominal surgery during epidural analgesia. This proved to be a very effective method of restoring and maintaining normal arterial pressure. The method has also been used to produce controlled hypotension in 18 patients undergoing plastic or neurosurgical procedures via sodium nitroprusside infusions. Valuable insight into patient responses to surgical stimuli, blood loss, fluid loads, opioids, relaxants and other agents was provided. PMID- 3816162 TI - Multivariate analysis of data from two-dimensional electrophoretic separation of macromolecules. AB - Recent work on two-dimensional electrophoretic separation of molecules has concentrated on technical aspects of molecule identification, leaving little in the way of time and resources to explore new, effective methods for analyzing the data thus produced. We present a method for coding electrophorograms that is capable of capturing sufficient information in order that subsequent analysis might be revealing. Along with this coding method, we describe a flexible approach to the analysis of electrophoretic data employing multivariate methods for summarization and comparison. In this we have found an effective vehicle for revealing some unexpected properties of the electrophorograms. PMID- 3816163 TI - Computer program for the parametric and nonparametric comparison of several groups to a control. AB - A BASIC program is described which, upon the input of raw data from an experiment comparing several treatment groups to a control, will output group parameters (mean, SEM), test for outliers in each group (maximum normalized residual test), and examine the homogeneity of variance (Bartlett's test). Subsequently, one-way ANOVA and Dunnett's multiple comparison test are performed. The user also has the option of examining the data by nonparametric means using the Kruskal-Wallis test and a nonparametric multiple comparison test (Dunn's test). As a convenience, the program contains algorithms to generate critical table values for all the tests employed. PMID- 3816164 TI - A subroutine for rounding of numbers. Program in BASIC and for programmable calculators. AB - The present programs were developed to compensate for the poor precision of some microcomputer-BASICs, and to avoid printing of the non-significant figures of a numerical result. The program will round any number to a user defined number of significant digits. The subroutine is well suited for statistical programs. It enables the programmer to control the precision and format of numerical output. The program is given in two versions, one in BASIC and one for the programmable calculator TI-59. PMID- 3816165 TI - A microcomputer program for fitting enzyme inhibition rate equations. AB - This paper presents a computer program written in BASIC for fitting different enzyme inhibition kinetic models. The program, based on a nonlinear least-squares regression, can be run on any microcomputer with the CP/M operating system. Weighting of observed initial velocities is decided by the user by assessing constant variance, proportional variance or by incorporation of the variances calculated by a subroutine. The program also uses robust regression by bisquare weighting. All questions concerning data input, type of rate function, type of weight and the use of bisquare regression appear on the video display unit. PMID- 3816166 TI - The Personal Acoustics Lab (PAL): a microcomputer-based system for digital signal acquisition, analysis, and synthesis. AB - A new, integrated digital signal processing (DSP) system, the Personal Acoustics Lab (PAL), is described. This microcomputer-based system is suitable for analogue signal digitization at rates from several samples per hour to 150,000 samples per second in 12- or 16-bit words. Data may be acquired on one to sixteen single ended A/D, or one to eight double-ended A/D channels in bipolar or unipolar modes. Digitized data may be reconverted to analogue signals using one or two D/A channels. An external clock and trigger and two bidirectional digital ports are provided. Integrated PAL-ILS software commands perform all necessary DSP functions, including: data editing, time- and frequency-domain graphical display, plotting, filtering, Fourier and Hilbert transforms, linear predictive coding, auto- and cross-correlation, and summary statistics. The system is suitable for biological and engineering DSP applications. Output from selected PAL-ILS software commands is illustrated using a bioacoustical example. PMID- 3816167 TI - A voice-entry data management system: application in monoclonal antibody research. AB - A computerized system for the management of hybridoma cell growth data using voice input is described. The system permits the storage, retrieval, and analysis of data for hybridoma cells secreting monoclonal antibodies. It consists of a local system residing on a professional computer interfaced to a mainframe processing system. The local system uses voice-input to facilitate data entry while data flagged for retention is stored on the mainframe. The system permits the investigator to monitor thousands of candidate cell lines until selection for specific antibody production is completed. All record-keeping aspects of hybridoma cell culture from establishment through freezing and storage of selected cell lines can be accomplished by personnel without computer expertise. PMID- 3816168 TI - A computerized experimental set-up for in vitro evaluation of smooth muscle contractility. AB - A fully automated system is designed and developed for the investigation of in vitro contractility of muscle tissue in response to dose-dependent pharmacologic and/or electrical stimulation. The heart of the set-up is a personal technical computer. It drives the experiment by selecting and changing drug concentrations, by applying electrical stimulation, by sampling the tissue's contractile response and by real-time calculation of results. Parameters of interest are derived and updated for further selection and statistical manipulation. Alpha-numerical or graphical hardcopies may be drawn at any time. Investigator's intervention is limited to preparing perfusing solutions, mounting the muscle tissue strips, deciding test condition parameters, supervising the experimental progress and leading statistical calculations. PMID- 3816169 TI - Binary tree representation of three-dimensional, reconstructed neuronal trees: a simple, efficient algorithm. AB - A simple, efficient algorithm is presented for the transformation of dendritic trees to binary tree representations. The binary tree form significantly reduces traversal time, simplifies software for tree analysis and yields compact storage of the neuronal trees. These algorithms are easy to program and are useful in quantitative neuroanatomical studies. PMID- 3816171 TI - Software for analysis of equine ground reaction force data. AB - Software for analysis of force plate recordings of the horse at normal walk is described. The data of a number of stance phases are averaged to obtain a representative tracing of that horse. The amplitudes of a number of characteristic peaks in the force-time curves are used to compare left and right front limbs and left and right hind limbs. The averaged tracings are plotted, default on the line printer or, via separate program, on a high quality pen plotter. A version of the program applicable for analysis of human force plate recordings, is available. PMID- 3816170 TI - An application of the microcomputer as a generator of target movements for the eye tracking test (ETT). AB - We have developed a new system to produce target movements for our particular purposes using a microcomputer and 9-bit digital-to-analog converter. A continuously changing sinusoidal wave was produced to examine the relationship between the frequencies of target movements and smooth pursuit. A random sinusoidal wave was produced to make clear the predictive function of smooth pursuit. PMID- 3816172 TI - A standard multidimensional, easy-access data file structure for Apple II computers. AB - A random access file structure was designed for Apple II microcomputers that allows data storage of more than 65,500 data values at 170 per Kbyte with a dynamic range of nearly 5 orders of magnitude. All or part of the data are easily accessible from BASIC under ProDOS operating conditions. The file structure accommodates single or multiple data sets in a single data file. Data values within a file with one set of data may interrelate by equal spacing along a second coordinate, such as time or space. Multiple data sets in a file can be independent, parallel or interdependent. Each interdependent data set defines the position of a data point along its coordinate in a two- or multidimensional registration system. The lowest and highest values of each data set are separately recorded to allow easy manipulation of even part of the data, e.g. for graphical presentation. The possibility of storing large numbers of data values in a single file facilitates high-resolution recording of events and simple mathematical manipulation. PMID- 3816173 TI - An interactive, readily transportable program using a log/logit transformation for the analysis of radioimmunoassay data. AB - We describe a processing program for radioimmunoassay data which uses a log/logit transformation and maximum likelihood estimation to describe mathematically the standard curve, providing a chi 2 test of goodness of fit for the model. Sample values are returned with 95% fiducial probability intervals or standard errors. The program is written in C, which facilitates transportability and modularity. PMID- 3816174 TI - SCAN: a program library for high resolution slit-scan analysis of chromosomes in flow cytometry. AB - Computer programs for high resolution slit-scan chromosome analysis in flow cytometry are introduced. A modular program library, SCAN, contains programs for single and dual parameter data acquisition, correction of recorded profiles and computation of histograms of various parameters. Using a minicomputer system, data acquisition is programmed in assembler to realize high input rates and real time histogram calculation. Software for the processing of recorded profiles has been written in FORTRAN and allows extensions or alterations for different objectives. A sample run recording bicolor fluorescence profiles from metaphase chromosomes demonstrates the main features of the software. PMID- 3816175 TI - MULTI-FORTE, a microcomputer program for modelling and simulation of pharmacokinetic data. AB - MULTI-FORTE is an expanded version of the MULTI non-linear fitting programs written by Yamaoka et al. The functions of the three original programs (including Gauss-Newton and Simplex fitting algorithms) have been combined and translated into FORTRAN 77 on the Macintosh computer for both speed and convenience. Models can be described in integrated equation form or as a system of differential equations. Bayesian estimation is also available. Improved numerical integration routines have been added including methods suitable for systems of 'stiff' differential equations (Fehlberg's 4/5 Runge-Kutta method and Gear's DIFSUB subroutine). MULTI-FORTE is a user-friendly program taking data from keyboard or disk file to produce output on screen, printer, or disk file in tables or printer type plots. PMID- 3816176 TI - A microcomputer program for determining turnover rates before and after intervention in a single animal. AB - A set of three programs to calculate the turnover of biomolecules whose metabolism follows a steady-state precursor-product relationship and follows the open, single-compartment kinetics model has been written in MS-BASIC. The programs comprise a system for determining two values of turnover, before and after an intervention which may alter the turnover rate, in a single animal. The programs have been extensively tested in our laboratory for the determination of norepinephrine turnover under differing physiological and pharmacological conditions. The utility of the programs lies in their ability to readily adapt to turnover determinations for any substance whose metabolic pathway conforms to the model constraints. This includes the biogenic amine neurotransmitters, peptides and proteins, and many small biological molecules or pharmacological agents. PMID- 3816177 TI - A program for cycle-by-cycle shape analysis of biological rhythms. Application to respiratory rhythm. AB - A computer program for cycle-by-cycle analysis and quantification of biological rhythms, written for an Apple II microcomputer with 48k RAM is described. The program comprises 4 steps: (1) file constitution suitable for biological data collecting; (2) signal digitalization at a sampling rate up to 1 kHz with storage in central memory; (3) determination of each cycle's limits (delimitation parameters being defined by the user; following delimitation, cycles may be dropped or saved for further analyses); (4) cycle-by-cycle harmonic analysis (fast Fourier Transform algorithm). The program is written in BASIC Applesoft, hardware-dependent functions (analog inputs, graphic display and random access disk storage) are implemented in subroutines (partly assembler) which may be easily modified. The program, consisting of 4 chained procedures is run interactively, although procedure (4) may be run automatically. Analysis of human ventilatory airflow signal with this program is given as an example of cycle-by cycle shape analysis of a biological rhythm. PMID- 3816178 TI - A pulse generating and data recording system based on the microcomputer PDP 11/23. AB - A widely applicable measuring system, especially suited for all types of 'voltage clamp' (including 'patch-clamp') experiments, is presented. It is mainly based on commercially available hardware and software components. All interfacing with the analog world takes place on the front panel of the microcomputer box. Synchronization of pulse generation with data acquisition and other control actions take advantage of the four upper bits not used by the digital-to-analog converter during direct memory access transfer. PMID- 3816179 TI - A program nucleus for encoding and decoding calendar dates. AB - A novel algorithm and subroutine is presented for encoding and decoding calendar dates. For encoding a numeric calendar date in the form day, month, year is converted into an integer variable in the range between 2(15) -1 and -2(15). With decoding this integer variable is converted into numeric day, month and year. The algorithm performs very quickly and takes only 7 lines of FORTRAN code for encoding and decoding respectively. PMID- 3816180 TI - A data acquisition, display and plotting program for the IBM PC. AB - A program, AQ, has been developed to perform analog-to-digital (A/D) conversions on IBM PC products using the Data Translation DT2801-A or DT2801 boards. This program provides support for all of the triggered and continuous A/D modes of these boards. Additional subroutines for management of data files and display of acquired data have also been developed. These programs have been written so that a minimum number of keystrokes are required for their operation. Parameter files are used to simplify reconfiguration of this program for various data acquisition tasks. PMID- 3816181 TI - Digital mapping of multi-parameter contrast functions in magnetic resonance (MR) imaging using a standard MR computer system and digital display. AB - A technique is described which utilises the full analysis and display capabilities of a commercial MRI system to produce digital maps of multi parameter functions produced by MR contrast theory. The technique is utilised to determine the effects of nominating specific overall scan times on the optimum solutions as produced by the theory and it is shown that different solutions are obtained when the theory is applied using typical clinical constraints. The digital mapping approach is potentially of great value in prospectively determining pulse timing parameters to produce optimum contrast images, in producing contrast maps to aid retrospective image interpretation, and as a training aid for clinicians inexperienced in the interpretation MR images. PMID- 3816182 TI - MR of superior mesenteric artery--renal vein fistula. AB - Traumatic arteriovenous fistulas involving the superior mesenteric artery are rare. Diagnosis is most commonly made shortly after the injury. Symptoms, when present, are usually related to intestinal ischemia. Angiography has been the conventional modality used in diagnosing arteriovenous fistulas. We report a patient with a superior mesenteric artery to left renal vein fistula who presented in overt heart failure five years after a gun shot wound. The fistula was evaluated with magnetic resonance imaging. PMID- 3816183 TI - Septic portal vein thrombophlebitis: computed tomography appearance. Case report. AB - An unusual case of superinfected thrombosis of the portal and superior mesenteric veins is presented. Thrombus and gas within the portal system were accurately detected by CT. A necrotic segment of distal small bowel was believed to be responsible for the findings. Prompt recognition of this rare entity and rapid initiation of adequate therapy may aid in improving the outcome of this usually fatal condition. PMID- 3816184 TI - Residual cavities of lung metastases following chemotherapy. AB - At the sites of previously documented lung metastases from bladder carcinoma, computed tomography identified lung cavities that were virtually imperceptible by plain radiographs. Such thin-walled cavities, which developed following chemotherapy, have not been previously described in patients with bladder carcinoma. PMID- 3816185 TI - The computed tomographic findings in intracranial metastases due to breast carcinoma. AB - Seventeen patients with breast cancer had CT evidence of intracranial metastatic lesions. Sixteen patients showed neurological abnormalities on examination; one patient had no abnormalities on clinical examination. CT showed evidence of basal parasellar lesions (3 cases), orbital lesions (2 cases), or cerebral hemispheric (intracerebral or subdural) lesions (11 cases). In one case, diffuse meningeal and cortical nodular enhancement was consistent with diagnosis of carcinomatous meningitis. Ten had solitary and seven had multiple lesions. CT showed evidence of bone lesions in 8 cases and there were accompanying parasellar (3 cases), orbital (2 cases), and subdural lesions (3 cases). The intracerebral lesion(s) had an iso- or hypodense appearance on plain scan; there was peripheral rim or nodular enhancement on post-contrast scan. PMID- 3816188 TI - Ethylenediamine dermatitis. AB - 32 ethylenediamine-sensitive patients were studied to determine cross-sensitivity reactions. Reaction to other aliphatic polyamines proved to be very high, whereas no significant result was obtained to antihistamines, either topically or orally. PMID- 3816186 TI - Computerized tomography findings in posterior fossa lesions. AB - In 190 of 7000 brain CT studies performed between April 1978 and September 1984, abnormalities of the posterior fossa were found. Of these, 51.5% were primary tumors, 15.3% metastases, 12.1% vascular lesions and 5.8% congenital or developmental lesions. Frequencies, age and sex distribution and radiologic characteristics of the various posterior fossa pathologies are reviewed and discussed. PMID- 3816187 TI - Cerebral venous angioma and a varix: a rare combination. AB - A patient with a rare combination of cerebral venous angioma and a varix is reported. Only two such cases have been previously reported in the literature. The importance of being aware of the association of two such vascular malformations in the same patient is underscored. PMID- 3816189 TI - Nickel dermatitis in infants. AB - 8 cases of allergic contact dermatitis to nickel in infants are reported. All showed a papular dermatitis matching the sites of contact. Patch testing was performed on 3 patients, 2 were tested to nickel sulfate in pet. at concentrations of 1.0%, 1.5%, 2.0%. 1 was tested to 2.5% alone. All developed ++ reactions at each concentration tested. We observed a strong association of nickel dermatitis with atopy; 7 of 8 patients had a family history of atopy and 5 of 8 had features of coexistent atopic dermatitis. The relationship between atopy and allergic contact dermatitis is briefly reviewed. Nickel dermatitis may aggravate atopic dermatitis; avoidance of metal contact is crucial in the management of these patients. PMID- 3816190 TI - Triphenyl phosphate allergy from spectacle frames. AB - A case of triphenyl phosphate allergy from spectacle frames is reported. Patch tests with analytical grade triphenyl phosphate, tri-m-cresyl phosphate, and tri p-cresyl phosphate in the concentrations 5%, 0.5% and 0.05% pet. showed positive reactions to 0.05% triphenyl phosphate and 0.5% tri-m-cresyl phosphate, but no reaction to tri-p-cresyl phosphate. Gas chromatography of the tricresyl phosphate 5% pet. patch test material supplied from Trolab showed that it contained a mixture of a wide range of triaryl phosphates, including 0.08% triphenyl phosphate which is above the threshold for detecting triphenyl phosphate allergy in our patient. PMID- 3816191 TI - Contact sensitivity to aluminium. AB - Contact sensitivity to aluminium is extremely rare. Sensitization occurs during continuous application of aluminium containing antiperspirants or by aluminium adjuvants in vaccines and pollen extracts. Two types of reaction pattern are known: persistent granuloma at the injection site and recurrent eczema. We report a patient with a positive patch test reaction to Al (OH)3, who had been sensitized by aluminium adsorbed triple vaccine, Previous reports are reviewed. PMID- 3816192 TI - The sensitizing capacity of coumarins (II). AB - 5 coumarins used in perfumery, cosmetics, therapeutic ointments or occurring naturally were investigated by Freund's complete adjuvant technique (FCAT) in guinea pigs to determine their contact sensitizing potency. 4-Methylesculetin was also studied. Esculetin, dihydrocoumarin and daphnetin were found to be moderate to strong sensitizers, while fraxetin was nearly and 7-methylcoumarin completely inactive. The results corroborate the hypothetical view that only those coumarins having a catecholic disubstitution in the benzene ring, e.g., esculetin, 4 methylesculetin, daphnetin, can become sensitizers on the basis that they are capable of forming ortho-quinones under oxidizing conditions. PMID- 3816194 TI - Contact sensitivity to unsaturated polyester resin in a limb prosthesis. PMID- 3816193 TI - Aluminium allergy. AB - 13 children ranging in age from 1 to 13 years and 1 adult patient had positive patch tests to 2% AlCl3 in water. 13 of them had pruritic excoriated papules, 9 at sites of hyposensitization therapy with aluminium-bound pollen extracts, and 4 at sites of childhood immunization with an aluminium-bound vaccine (Di-Te-Pol). For the 1 adult patient, the positive patch test was not considered to be of current relevance. Aluminium is most likely to sensitize when present in preparations used for immunization. PMID- 3816195 TI - Contact sensitivity to henna. PMID- 3816196 TI - Colophony, perfumes and paper handkerchiefs. PMID- 3816197 TI - Photocontact dermatitis from ethylenediamine. PMID- 3816198 TI - Why do young girls become nickel sensitive? PMID- 3816199 TI - Contact cheilitis to shellac, Lanpol 5 and colophony. PMID- 3816200 TI - Contact urticaria induced by pyridine carboxaldehyde. PMID- 3816201 TI - Reactions to merthiolate in infants. PMID- 3816202 TI - Oral substitution in patients sensitized by transdermal clonidine treatment. AB - The safety of oral clonidine substitution in 29 patients with confirmed localized allergic contact dermatitis due to transdermal clonidine treatment was evaluated. Only 1 patient had a skin reaction to oral clonidine. The dose of topical clonidine-inducing sensitization, and the oral challenge dose administered later, appear to be insufficient to elicit a systemic reaction in most patients. An examination of current patch test technology seems indicated in view of the fact that a number of patients who gave a negative reaction to 48-h applications of 9% clonidine in petrolatum responded positively to 7-day application of transdermal clonidine. PMID- 3816204 TI - Experimental induction of rough dermatitic skin in humans. AB - The response after application of various concentrations of sodium lauryl sulfate (SLS) on human skin is reported. The induced changes associated variable degrees of roughness and erythema characterizing rough dermatitic skin (RDS). These clinical changes were almost invariably (less than 5% experimental error) associated with increased values of transepidermal water loss (TEWL) and increased cutaneous blood flow values (CBFV). A significant positive correlation was found between TEWL and CBFV at all concentrations of SLS. However, values of TEWL higher than those found in 84% of the controls (mean + SD: 8.127 + 2.89 gr/m2/h) were usually significantly correlated with clearcut clinical changes (total clinical score greater than 2 or erythema greater than 1) at all concentrations of SLS, while CBFV (mean + SD of controls: 2.717 + 2.165) which had a wider dispersion, were significantly associated only with erythema after 10% and 1% SLS. This reflects the distinction that is being made between a primary chemical insult, which we identify clinically as roughness and functionally as increased TEWL associated with alterations of barrier function of the skin, and a secondary, delayed inflammatory response, which is clinically recognized as erythema and functionally objectivated by increased CBFV. These results provide a rational basis supporting the use of this experimental model of RDS for testing of preventive and therapeutic efficacy as well as refining the evaluation of tolerance of cosmetics especially designed for use on sensitive skin. PMID- 3816205 TI - Contact dermatitis from nifuratel. PMID- 3816203 TI - Open, closed and intradermal testing in nickel allergy. AB - Open, closed and intradermal testing with NiCl2 was performed in 15 subjects with patch-test-proven allergy to 5% NiSO4 in pet. Intradermal testing proved to be a reliable method in confirming nickel sensitivity within 24 h. Open testing with non-toxic concentrations of NiCl2 in alcohol resulted in 73% and 93% positive reactions at 24 h and 48 h readings, respectively. This test method can be used as a reliable screening method in nickel allergy. Open testing often resulted in positive reactions within a few hours. This makes it possible to investigate pathogenetic events of acquired allergic contact dermatitis at a much earlier stage than with the usual 48-h occlusion. 24-h occlusion with Finn Chambers is not sufficient if one is to avoid false negative reactions in nickel allergy. Occlusion with Finn Chambers seems to delay the reaction. PMID- 3816206 TI - Contact allergy to oxiconazole. PMID- 3816207 TI - Hand dermatitis from a rubber motorcycle handle. PMID- 3816208 TI - Connubial dermatitis from a hair lotion. PMID- 3816209 TI - Nickel dermatitis mimicking sycosis barbae. PMID- 3816210 TI - A child with perioral eczema. PMID- 3816211 TI - Contact dermatitis to acupuncture needles. PMID- 3816212 TI - Protection against epoxy resins with glove materials. PMID- 3816213 TI - Contact dermatitis from propolis: role of gastrointestinal absorption. PMID- 3816214 TI - Contact dermatitis from amcinonide. PMID- 3816215 TI - Contact allergy to petrolatum. PMID- 3816216 TI - Contact dermatitis caused by "chloromethyl heterocyclic intermediates". PMID- 3816217 TI - Tin: an overlooked contact sensitizer? AB - Patch tests with metallic tin in 73 nickel-sensitive patients revealed 6 positive allergic reactions. Only 4 doubtful reactions were seen, which makes irritancy unlikely. The relevance and clinical significance of the unexpected finding deserves further evaluation. PMID- 3816218 TI - Radiation therapy of cancer of the cervix: experience at a community hospital. PMID- 3816219 TI - Arthroscopic synovectomy of the knee. PMID- 3816220 TI - Pheochromocytoma in a patient with severe coronary artery disease. PMID- 3816221 TI - Clinical comparison of H2-antagonists. PMID- 3816223 TI - The utility of therapeutic plasmapheresis for neurological disorders. National Institutes of Health. PMID- 3816222 TI - The treating physician's view of informed consent: observations made in a retrospective study. PMID- 3816224 TI - Recent opinions of the Council on Ethical and Judicial Affairs. AMA Council on Ethical and Judicial Affairs. PMID- 3816225 TI - Quality of care. AMA Council on Medical Service. PMID- 3816226 TI - Digoxin antibody fragments for digitalis toxicity. The Medical Letter. PMID- 3816227 TI - Reflections on medicine. House calls. PMID- 3816228 TI - Clarifying the therapist's duty to warn potential victims. PMID- 3816229 TI - Long-term follow-up of children breast-fed by mothers using oral contraceptives. AB - In a long-term follow-up study 48 breast-fed children, whose mothers had used oral contraceptives containing 50 micrograms of ethinylestradiol while lactating, were compared to a matched control group whose mothers had not used any hormonal contraceptives during lactation. In spite of a very large number of data collected from several different sources of information, no effect could be demonstrated of the ingested steroid, neither upon the panorama of diseases nor upon intellectual or psychological behaviour of the infants and children up to 8 years of age. The mothers who used oral contraceptives lactated a significantly shorter period of time than the controls, but no differences were found in weight gain and height increase in the children between cases and controls. PMID- 3816230 TI - Therapeutic abortion in early pregnancy with antiprogestogen RU486 alone or in combination with prostaglandin analogue (gemeprost). AB - Abortion was attempted in 39 women in early pregnancy (less than 56 days amenorrhea) with the progesterone antagonist RU486 alone (150 mg per day for 4 days) or in combination with a PG analogue, 16,16-dimethyl-trans-delta 2-PGE1 (Gemeprost) in the form of a 1 mg vaginal pessary. Complete abortion was also attempted in 5 women who received RU486 together with 2 X 1 mg PG pessaries. Vaginal bleeding followed by complete abortion occurred in 18 of 19 women who received RU486 + 1 mg PG pessary as compared to only 12 of 20 women who received RU486 alone (P less than 0.01). All women who received RU486 + 2 mg Gemeprost had a complete abortion. The onset of crampy abdominal pain (median: 3 vs 4 days) and vaginal bleeding (3 vs 3 days) was similar in the RU486 and RU486 + PG groups, respectively. Slightly less than half the patients in both groups had nausea and/or vomiting, but the incidence did not differ from that occurring prior to treatment. The mean duration (range) of vaginal bleeding [RU486 alone: 10 (0,29) days and RU486 + PG: (5,34) days], and the measured blood loss [RU486: 53 (2,227) ml and RU486 + PG: 81 (32,222) ml] did not differ significantly between the two treatments. It is concluded that the combination of RU486 and a single PG vaginal pessary is a highly effective means of inducing therapeutic abortion in early pregnancy and offers an alternative to surgery. PMID- 3816231 TI - Plasma levels of antiprogestin RU 486 following oral administration to non pregnant and early pregnant women. AB - RU 486 is a synthetic steroid which acts as an antiprogestin at the receptor level. The clinical usefulness of the compound for menstrual regulation and termination of early pregnancy is currently being evaluated. The aim of the present study was to determine the plasma levels of RU 486 following the oral administration of the compound to 42 pregnant and 10 non-pregnant women. The levels of RU 486 were measured by a radioimmunoassay method which uses chromatography on Sephadex LH 20 columns. The identity of the compound assayed as RU 486 was confirmed, but the presence of small amounts of two highly cross reacting metabolites (monodemethyl and didemethyl RU 486) in the analyzed fractions could not be excluded. Following the ingestion of a single tablet containing 25 and 50 mg of the compound, a peak plasma value of approximately 3.5 to 4.0 mumol/l in both the pregnant and non-pregnant subjects was reached one to two hours later. The half-lives of elimination were about 20 hours in both the pregnant and the non-pregnant women. Following the repeated oral administration of 50, 100 or 200 mg of RU 486 daily for four days, maximum plasma levels of 2.9, 4.5 and 5.4 mumol/l, respectively, were found. Thus, the increase in plasma levels was not directly proportional to the increase in the dose. No accumulation of RU 486 in the plasma was found, even when the duration of treatment was prolonged to six days. The data partly explain the reported lack of relation between ingested dose and frequency of induced abortion and they may be useful for designing future studies on the use of compound to prevent implantation, induce menstruation or terminate an early pregnancy. PMID- 3816232 TI - Severe pain at interval IUD insertion: a case-control analysis of patient risk factors. AB - This investigation, using a case-control analysis approach on an IUD data set from a less-developed country center, delineated four risk factors in patient characteristics that are associated with severe pain at interval IUD insertion. They are: higher education (greater than or equal to seven years), low-parity (1 2 live births), longer open interval (greater than or equal to 13 months) between the end of the last pregnancy and insertion, and non-breastfeeding at the time of insertion. Adjusted relative risks estimated by odds ratios are 2.1, 2.7, 2.7 and 5.0, respectively. For women with a combination of the above risk factors, they have a further increased (additive in nature) risk of suffering severe insertion pain. Similar analysis was also performed on a developed country center data set for which only the effect of education and parity could be studied; an odds ratio of 5.0 for nulliparity was obtained. The plausibility of these findings as well as their clinical and programmatic implications are discussed. PMID- 3816233 TI - Do insertion-related problems affect subsequent IUD performance? AB - This investigation compares the IUD performance of 372 women who had an insertion related problem (most with moderate or severe pain) and 372 matched women who had no such problem; all women had interval insertion. A woman in the Problem Cohort and her matched counterpart in the Comparison Cohort were inserted with the same IUD type by the same insertor on the same day or on close dates. The six IUD types used by these women were Lippes Loop D, Copper-7, Copper T-200, Copper T 380 Ag, Multiload Copper 250 and Multiload Copper 375. Cumulative gross life table rates of the pertinent events (accidental pregnancy, expulsion and medical removal for bleeding and pain), adjusted for age and parity, were calculated. Between the Problem Cohort and the Comparison Cohort, no differences were detected in the event rates that were of either statistical or practical significance. Results from this preliminary study suggest that the insertion related problems usually encountered during interval insertion such as insertion pain, syncope and/or mild cervical laceration are not associated with an increased risk of IUD discontinuation due to pertinent events. PMID- 3816234 TI - Technical failures in female sterilization using the tubal ring: a case-control analysis. AB - To delineate characteristics of women predisposing to sterilization technical failures, we performed an analysis of 20 technical failures that occurred during tubal ring procedures and 80 control ring procedures matched on planned surgical approach and study site. None of the women had recently been pregnant (interval procedures). The odds ratios (ORs) were elevated for women wearing an IUD in the three months prior to sterilization (OR = 5.0, 90% confidence interval [CI] 2.2, 11.2) and for women with a history of spontaneous abortion (OR = 4.3, 90% CI 1.8, 9.8). A history of pelvic inflammatory disease (PID) and/or current evidence of PID was strongly associated with technical failure (X2 = 25.0, p less than 0.001). The combined effect of any two of these three factors increased the risk synergistically. We examined these factors prospectively and confirmed the elevated risks (relative risk [RR] = 5.0, 5.5 and 22.7 for recent IUD wearing, spontaneous abortion history and history/evidence of PID, respectively). The prospective analysis also found that previous abdominal surgery is associated with technical failure (RR = 6.7). PMID- 3816235 TI - Flowers of Hibiscus rosa-sinensis, a potential source of contragestative agent. III: Interceptive effect of benzene extract in mouse. AB - In mouse, oral administration of the benzene extract of Hibiscus rosa-sinensis flowers at a dose level of 1 gm/kg body weight/day from day 5-8 of gestation led to termination of pregnancy in about 92% of the animals. The effect was associated with a significant fall in peripheral level of progesterone and increase in uterine acid phosphatase activity, as measured on day 10. The ovary exhibited signs of luteolysis, and the corpus luteal delta 5-3 beta hydroxysteroid dehydrogenase activity decreased markedly. The interceptive effect of the extract was prevented completely by exogenous progesterone (1 mg/mouse/day) or chorionic gonadotropin (1 I.U./mouse/day) and partially (62.5%) by exogenous prolactin (500 micrograms/mouse/day). In unilaterally pregnant mouse having trauma-induced deciduomata in the sterile horn, the extract caused resorption of the fetuses, and regression of the deciduomata accompanied by reduction in weight of the ovaries. Luteolysis, may be due to interference with the luteotropic influence, and a consequent fall in plasma level of progesterone have been suggested as the plausible cause of termination of pregnancy. PMID- 3816236 TI - Effects of momorcharins on the mouse embryo at the early organogenesis stage. AB - Previous studies showed that the two forms of momorcharins which are isolated from seeds of Momordica charantia L. are effective in inducing early and midterm abortions in the mouse. Momorcharins were found to be teratogenic to the cultured mouse embryos at the early organogenesis stage. Morphological abnormalities were seen in the head, trunk and limbs. Ultrastructural studies on the visceral yolk sac of the momorcharin-treated embryos showed that the endodermal layer was deranged, membrane invaginations at the apical surface were decreased and intercellular space became distended. It is likely that the teratogenic action of momorcharins on mouse embryos in vitro is mediated through the deleterious effects on the visceral yolk sac, which functions as a vital transport organ for the conceptus at the immediate post-implantation period. PMID- 3816237 TI - Subcortical transfer of cognitive information in subjects with complete forebrain commissurotomy. AB - Three complete commissurotomy subjects were tested for the ability to integrate cognitive information presented for a prolonged duration to opposite visual hemi fields. A sample stimulus was projected to one hemi-field and a three-choice array to the other, with one choice related to the sample on an abstract or concrete basis. All subjects performed the non-verbal matching task at well above chance level, with scores comparable to those attained when the task was performed completely within one or the other hemisphere. Transfer was equally successful in the two directions, though the pathway originating in the right and terminating in the left hemisphere may be more sensitive to affective components of the stimulus. The information relayed subcortically is neither verbal nor imagic in nature, but appears to correspond to contextual or connotative associates of the stimulus. The results are discussed in terms of a cognitive system common to the two hemispheres and involving associational networks but not lateralized functions such as language and complex visuospatial processes. PMID- 3816238 TI - The influences of handedness, sex, familial sinistrality and androgyny on language laterality, verbal ability, and spatial ability. AB - This study assessed possible influences of handedness, sex, familial sinistrality (FS), and self-rated androgyny on language laterality and on spatial and verbal test performances of 225 right-handers and 134 left-handers. Left-handers and right-handers performed differently on all tasks. Right-handers were significantly more lateralized on the language laterality task and were superior to left-handers on the spatial visualization task. Left-handers obtained slightly, but significantly, higher vocabulary scores. Androgyny had a significant main effect on spatial ability, the more androgynous subjects being superior. Androgyny also interacted with sex and FS factors on the spatial task. All in all, present result are consistent with the conclusion that each of the subject factors studied may prove to be of some relevance for a complete understanding of laterality and cognitive ability patterns. PMID- 3816239 TI - Laterality of cross-modal spatial processing. AB - This study examined the laterality of spatial-form perception in normal adults using a cross-modal matching paradigm involving visual and tactile processing. Randomly generated eight-point and 12-point Vanderplas and Garvin (1959) patterns were used as the stimuli. In a visual-to-tactile task, a lateralized visual pattern was followed immediately by a haptic task requiring subjects to discriminate which of two simultaneously felt shapes matched the visual pattern. In a tactile-to-visual task, subjects decided which of two simultaneously felt shapes matched a lateralized visual pattern presented after haptic manipulation. There were no main effects for laterality or for sex differences. Matching accuracy was better in the visual-to-tactile task and for less complex stimuli. A visual field by feeling hand interaction showed best recognition accuracy when visual-feeling hand combinations on the same side of the body were used in the two matching tasks. These data reflect a stimulus-response compatibility explanation of spatial-form perception that is consistent with a behavioral and not a cerebral asymmetry model. PMID- 3816240 TI - Determinants of the enhancement of the right visual field advantage by bilateral vs. unilateral stimuli. AB - Bilateral presentation of two different verbal inputs usually produces a stronger left hemispheric/right visual field (RVF) processing advantage than unilateral presentation. Previous reports of this effect confounded stimulus load with display configuration. Two experiments are presented in which the number of items during unilateral and bilateral trials was equated. The RVF advantage was enhanced during a free recall paradigm (Experiment I) but not during a partial report paradigm in which subjects were cued in advance to report only the top or the bottom of the display (Experiment II). This demonstrates that the effect does not depend upon the number of inputs per display and can not invariably be produced by bilateral/bihemispheric stimulation. It is suggested that subjects may be strongly biased to give priority to items delivered to the RVF/left hemisphere during bilateral trials. However, when this bias is constrained by rendering half of the RVF inputs irrelevant, subjects may be forced to pay equal attention to LVF inputs. Thus, eliminating the attentional bias eliminates the enhancement of the RVF advantage during bilateral trials. PMID- 3816241 TI - Birth order and lateral preferences. AB - Associations between birth order and lateral preferences of hand, eye and foot were examined in a sample of 6436 black seven year old boys and girls whose mothers participated in the Collaborative Perinatal Project (CPP) in Philadelphia. Overall, most of the subjects (87%) showed right hand preference, and the majority of subjects showed right eye (55%) and foot (63%) preferences. Analysis of cross preferences indicated some tendency for a consistent right side orientation. However, patterns of lateral preferences were similar for both boys and girls across seven birth order groups. The data were interpreted as showing that birth order and lateral preferences are not interrelated. PMID- 3816242 TI - Theoretical implications of the hyperlexia syndrome: two new Italian cases. AB - Two Italian girls (ages 12.5 and 18.6) are reported in whom excellent reading and writing skills have developed against a background of severe mental retardation. The cases have poor short-term memory, very low verbal and performance IQs, and fail many traditional Piagetian tasks at the operational stage. They similarly fail many "metalinguistic" tasks that have been regarded as prerequisites for the development of adequate reading and writing skills. Despite these failures, the girls can accurately read aloud words, non-words, sentences, and texts. However, their comprehension of such material was poor, and consistent with the overall low level of cognitive functioning. What the cases do show, very clearly, is that reading and writing qua visual-to-auditory and auditory-to-visual transcoding tasks can develop independently of many other basic cognitive systems. PMID- 3816243 TI - Short term retention with lateralized temporal lobe epilepsy. AB - This investigation focused upon whether individuals with lateralized temporal lobe epilepsy have impairments in short term memory and, if so, whether these impairments are of a material-specific nature. The Peterson short term memory distractor paradigm which consists of single, brief presentations of stimuli with varying decay intervals and appropriate interpolated distractors was employed. A significant deficit in both left and right temporal lobe seizure groups was documented in comparison to controls for verbal but not for non-verbal materials. The results suggest that one aspect of the memory problem observed in temporal lobe seizure patients relates to relatively early components of information processing where encoding is primarily based upon physical rather than semantic characteristics of the stimulus and material-specificity is less evident. PMID- 3816244 TI - Interhemispheric asymmetry in facial expression recognition: relationship to field-dependence. AB - Sixty college students, 30 males and 30 females, with a well defined cognitive style (measured by means of three tests), carried out a recognition task of six unambiguous facial expressions which were unilaterally presented in a tachistoscopic condition. A significant left visual field superiority was present for the field independenct subjects; a low but significant right visual field superiority was present for the field dependent subjects. No differences were found between the sexes. PMID- 3816245 TI - Arithmetic skills in patients with unilateral cerebral lesions. AB - In this paper we describe the construction of a Graded Difficulty Arithmetic test (GDA) consisting of 12 additions and 12 subtractions which are orally presented. The test was administered to a control group of 100 volunteer subjects with extra cerebral neurological disorders and to two experimental groups of patients with unilateral cerebral lesions of the left and right hemisphere. In the control group performance on the GDA was found to correlate highly with other measures of verbal intelligence, namely the National Adult Reading Test, the WAIS Arithmetic subtest and the WAIS Digit Span subtest. Between group analysis showed a significant groups effect on the GDA, the left hemisphere lesion group showing greater impairment compared to the right hemisphere lesion group and the controls. Using "cut-off" scores the left hemisphere lesion group's performance was shown to be significantly worse than that of the right hemisphere lesion group, who in turn were not significantly worse than the control group. PMID- 3816246 TI - Confabulation in aphasia. AB - We describe a brain-damaged patient who produced two distinctive forms of confabulation, typical and atypical (aphasic), both of which were associated with perseveration, poor self-monitoring, and denial of deficit. We propose that the typical confabulations are triggered by gaps in memory for the period surrounding the onset of his illness, while the aphasic (fantastic) confabulations are triggered by gaps in semantic representation. These observations suggest that confabulations may comprise a portion of the language deficit in patients with other varieties of fluent aphasia. PMID- 3816247 TI - Spoken sentence comprehension by good and poor readers: a study with the Token Test. AB - Good and poor readers in the third grade (age nine years) were examined on a test of immediate memory for word strings and on a version of the Token Test (De Renzi and Faglioni, 1978) to assess sentence comprehension. The poor readers made more errors than the good readers in recall of word strings and on some Token Test items. Those Token Test items that impose the greatest burden on short-term memory were the most sensitive to reader group differences; syntactic complexity alone did not distinguish the groups. The findings support other indications that poor readers make less effective use of working memory in processing spoken sentences than good readers; they do not indicate a syntactic deficit on the part of the poor readers. PMID- 3816248 TI - Manual pointing to auditory targets: performances of right versus left handed subjects. AB - In order to test the existence of an hemispheric asymmetry at a basic level of spatial information processing, six right handed and six left handed normal subjects were submitted to a manual pointing task to auditory targets. Results showed a shift in perceived target position according to the hand used for pointing, a striking asymmetry between the two auditory hemispaces reflected in both groups in directional error and dispersion. PMID- 3816249 TI - Complement activation and increased alveolar-capillary permeability after major surgery and in adult respiratory distress syndrome. AB - The concentrations of C3a des Arg were measured in bronchoalveolar fluid (BAL) and plasma from 12 patients with adult respiratory distress syndrome (ARDS). Compared with 32 controls, all patients had increased BAL fluid levels (p less than .001), and nine of 12 had increased plasma levels (p less than .001) of this split product from the third complement component. Reduced total hemolytic activity (CH50) in serum was seen in five patients (p less than .01). As an indication of damage to the alveolar-capillary barrier, ten of the 12 ARDS patients had elevated albumin concentrations in BAL fluid (p less than .001). These signs of complement activation and lung tissue damage are not specific for ARDS. Thus, in 15 patients investigated preoperatively and postoperatively, we found that major surgery induced a significant increase of BAL fluid C3a (p less than .01) and plasma C3a (p less than .02), a significant reduction of CH50 (p less than .001), and a significant increase of BAL fluid albumin (p less than .02). Similar values of CH50 and plasma C3a were seen in ARDS and after surgery (p greater than .05). Of the 12 ARDS patients, eight had increased BAL fluid concentrations of C3a (p less than .001), and ten had increased BAL fluid levels of albumin (p less than .001) compared with the post-surgical patients. Measuring complement consumption in blood by these techniques is of limited value in ARDS due to the lack of specificity. BAL fluid albumin has a similar degree of sensitivity and specificity for ARDS as does BAL fluid C3a.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816250 TI - Critical level of oxygen delivery after cardiopulmonary bypass. AB - The relationship between oxygen uptake (Vo2) and delivery (Do2) was examined in 64 patients immediately after cardiopulmonary bypass. In 44 patients with lactate levels below 2.5 mmol/L, Vo2 decreased proportionally when Do2 decreased below 300 ml/min X m2. At a Do2 over this level, Vo2 plateaued at 105 +/- 13 (SD) ml/min X m2. In a contrasting group of 22 patients with blood lactate levels above 2.5 mmol/L, Vo2 changes depended on changes in Do2 both alone and below 300 ml/min X m2. PMID- 3816251 TI - Dependence of oxygen consumption on cardiac output in sepsis. AB - We studied the relationship between oxygen consumption (Vo2) and cardiac output in 17 hemodynamically stable, septic and eight nonseptic ICU patients. Each received 300 ml of fresh-frozen plasma or 25% albumin with up to 500 ml of crystalloids, in addition to regular maintenance fluids; this treatment increased pulmonary wedge pressure (WP) by 3 to 4 mm Hg. Measurements were performed before and after approximately 5 h of volume loading. Because cardiac index (CI) decreased as WP increased in four septic and three nonseptic patients, we grouped the data according to the state of flow instead of the recording time sequence. From low to high flows, mean CI increased in septic patients and nonseptic patients. Oxygen delivery (Do2) increased in septic and nonseptic patients. Vo2 remained unchanged in nonseptic patients, while it increased in septic patients. Accordingly, arteriovenous oxygen difference narrowed in nonseptic patients from 4.46 +/- 1.62 to 3.59 +/- 1.21 ml/dl (p less than .05) but did not change in septic patients. In the septic group, the difference in CI between high and low flows was significantly (p less than .05) greater in survivors than in nonsurvivors. We conclude that the septic state is accompanied by a peripheral oxygen deficit, which can be partially reversed by maintaining an above-normal CI and Do2. PMID- 3816252 TI - Effects of breathing 80% oxygen on water and albumin accumulation in oleic acid injured rabbit lungs. AB - This study was done to determine whether breathing 80% oxygen would enhance edema formation in oleic acid (OA) lung injury. Rabbits breathed air (n = 51) or 80% oxygen (n = 51) for 1 to 7 days after OA lung injury (0.09 ml/kg iv). Control groups breathed 80% oxygen (n = 37) or room air (n = 8) without OA injury. Pulmonary vascular permeability was assessed by measuring 131I-albumin (RISA) concentration in extravascular, extracellular lung water (EVECW) relative to plasma (RISAL/RISAPL). EVECW (ml/g dry lung) was measured by 24Na, and total lung water (TLW) by wet/dry weight (g/g dry lung). Air-breathing control values were 4.53 +/- 0.25 (SD) for TLW and 0.40 +/- 0.09 for RISAL/RISAPL. In the air breathing OA group, TLW and RISAL/RISAPL increased to 8.32 +/- 0.85 and 0.93 +/- 0.16, respectively, 2 h after OA (p less than .001) but by 24 h, were equal to air-breathing controls. TLW and RISAL/RISAPL in the oxygen treated OA group did not differ from the air breathing OA group on days 2 through 7 inclusive, suggesting that 80% oxygen had no effect on edema formation in the OA-injured lung. Breathing 80% oxygen alone, without OA injury, significantly (p less than .005) increased TLW and RISAL/RISAPL on days 5 and 6. Thus, preexisting lung injury had a protective effect against edema formation from a high fraction of inspired oxygen. PMID- 3816253 TI - Validation of the mortality prediction model for ICU patients. AB - We tested recently developed admission and 24-h models of hospital mortality on 1,997 consecutive admissions to a general medical/surgical ICU. This study population was independent of the group used to develop the models. The admission prediction model estimated each patient's probability of hospital mortality based on seven routinely collected admission variables. The 24-h model utilized seven variables routinely available at 24 h in the ICU. The admission model accurately described the mortality experience of the new cohort, while the 24-h model did not. Advantages of the admission model are that it is evaluable at the time of ICU admission, is independent of ICU treatment, and can be used to stratify patients by severity of illness, thereby making ICU comparisons possible. Its excellent goodness-of-fit, correct classification rate, sensitivity, and specificity suggest that this model is now ready for multihospital testing. PMID- 3816254 TI - Acute paranasal sinusitis related to nasotracheal intubation of head-injured patients. AB - One hundred eleven head-injured patients were examined for paranasal sinusitis during early convalescence. Glascow coma scale (GCS) was less than 8 in 79 patients. Ninety-three patients had sustained blunt injuries, and 18 had penetrating ones. Sixty-five orotracheal intubations (OTI) and 31 nasotracheal intubations (NTI) were performed at the scene or on hospital arrival. Fifteen patients were not tracheally intubated. Paranasal sinus air fluid levels (AFL) were present in 30 patients on their admitting computerized tomography scans. Paranasal sinusitis developed in 19 patients with a mean GCS of 5.4 +/- 3.3 (SD). Sixteen of the 19 had NTI, and three had OTI (p less than .05). Of 30 patients with AFL, sinusitis occurred in 13. Ten of these 13 had NTI, and three had OTI (p less than .05). Penetrating injury did not increase the risk of sinusitis (p greater than .1). Seventeen of the 19 infections were polymicrobial. Sinusitis after head trauma is related to NTI, AFL, and severity of head injury. PMID- 3816255 TI - Value of a conventional approach to the diagnosis of traumatic cardiac contusion after chest injury. AB - We wanted to evaluate whether current screening techniques effectively determine a patient's need for hospital admission and intensive care monitoring after blunt chest trauma. Consequently, we reviewed 104 consecutive admissions for "blunt chest trauma; rule out cardiac contusion." Neither clinical findings, cardiac enzyme levels, chest x-rays, nor ECGs predicted the high-risk patients who would subsequently develop complications related to myocardial contusion. Since only 23% of the study patients developed such complications, the plurality of study patients did not require admission and monitoring. There is, therefore, a definite need to develop new, accurate screening tests for patients at risk for myocardial contusion complications. PMID- 3816256 TI - Lung compliance as a measure of lung function in newborns with respiratory failure requiring extracorporeal membrane oxygenation. AB - Extracorporeal membrane oxygenation (ECMO) can now be used as an alternative mode of therapy for infants 2.0 kg or more with life-threatening respiratory failure. Current criteria for removal from ECMO are limited. We attempted to determine whether lung compliance (CL) could be used as a sensitive indicator of the neonates' lung improvement while they are on ECMO, as well as a predictor of their ability to tolerate removal from bypass. We obtained serial CL measurements in 13 infants, all of whom weaned successfully from ECMO. All had an initial CL on ECMO of 0.5 ml/cm H2O X kg or less (mean = 0.3), with a final CL of 0.8 ml/cm H2O X kg or more (mean = 1.7). The average change in CL from the initial to the final measurement was 0.6 ml/cm H2O X kg or more (mean = 1.5). CL findings correlated well with estimated bypass, expressed as a percent of cardiac output, and a radiographic score of pulmonary abnormality (r = -.66, p less than .0001, and r = -.52, p less than .0001, respectively). We conclude that CL measurements can be used to monitor clinical improvement in infants on ECMO, to predict their successful removal from bypass, and ultimately to shorten their total time spent on bypass. PMID- 3816257 TI - Effect of high-frequency ventilation on extravascular lung water volume in dogs. AB - We studied the effect of high-frequency ventilation (HFV) (3 Hz for 2 h) on extravascular lung water in normal dogs and dogs with pulmonary edema. We used an endobronchial dividing tube to ventilate one lung with HFV and to keep the contralateral lung of the same dog static with an identical airway pressure, allowing each animal to serve as its own control. Results showed no change in the extravascular lung water with HFV compared with the static lungs in normal, mild pulmonary edema, and severe pulmonary edema groups. We conclude that HFV has no appreciable effect on lung fluid balance; the lymphatic system retains its ability to increase flow even with experimentally produced pulmonary edema. PMID- 3816258 TI - A clinical study of the adult respiratory distress syndrome. AB - The adult respiratory distress syndrome (ARDS) is a syndrome of diffuse lung injury with a high mortality rate. We evaluated retrospectively 35 adult patients with ARDS. Their overall mortality rate was 69% and was related to their age (32 +/- 14 yr in survivors and 54 +/- 15 yr in nonsurvivors; p less than .001) and to the number of complications during their illness (1.4 complications in survivors, 2.6 in nonsurvivors; p less than .005). The ARDS patients, due to an infectious etiology, incurred a 75% mortality rate, while those with a noninfectious etiology of ARDS had a 55% mortality rate (nonsignificant). Neither a simplified acute physiology score nor a respiratory failure severity index was significantly different between survivors and nonsurvivors on admission. The mean PEEP level on admission in survivors was 8.1 +/- 4.6 cm H2O and in nonsurvivors 3.7 +/- 3.9 cm H2O (p less than .025). We conclude that the age of the patients and superimposed multiple system organ failure are probably related with the still high mortality rate of this syndrome. PMID- 3816259 TI - Weaning from mechanical ventilation: successful use of modified inspiratory resistive training in muscular dystrophy. AB - An 18-yr-old man with Duchenne muscular dystrophy and ventilatory failure could not be weaned from mechanical ventilation using a T-piece method, despite repeated attempts over 3 months. Subsequently, we weaned the patient using inspiratory muscle resistive training (IRT), modified by the concurrent delivery of intermittent mandatory ventilation (IMV). During the training program, the sessions were gradually prolonged from 5 min to a maximum of 30 min, the IMV rate was gradually decreased, and the magnitude of the resistive load was gradually increased. After 45 days of training, his vital capacity had increased from 380 to 850 ml, his maximal inspiratory airway pressure from -28 to -50 cm H2O, and his tolerance of T-piece breathing, from less than 10 min to over 16 h. After an additional 2 wk of nocturnal mechanical ventilation, he was successfully weaned. We conclude that IRT with IMV can be an effective method of weaning patients who have severe ventilatory failure. PMID- 3816260 TI - An assessment of six different pulmonary artery catheters. AB - The performance of three samples each of six brands of flow-directed pulmonary artery (PA) catheters was evaluated. In vivo studies determined the reproducibility of PA waveforms over a range of controlled heart rates when compared to those obtained from a transducer-tipped catheter. In vitro studies determined their frequency response, thermistor accuracy, balloon characteristics, and the maximum infusion rates possible through their proximal lumens. All catheters performed similarly in vivo, with mean errors in systolic and diastolic pressures ranging, respectively, from +9% to -12%, at a HR of 80 beat/min, to +23% and -30% at a HR of 160 beat/min. The resonant frequencies of all catheters in vitro were similar at 12 Hz or less; we were unable to obtain the frequency responses (17 to 32 Hz) claimed by the manufacturers. All thermistors were accurate for clinical use when tested over the temperature range 32 degrees to 42 degrees C. Balloon characteristics and infusion rates varied with some catheter brands. Maximum infusion rates varied from 164 to 383 ml/h when infusing 20% dextrose, and from 95 to 213 ml/h when infusing 35% dextrose. PMID- 3816261 TI - Deadspace ventilation: a significant factor in respiratory failure after thermal inhalation. PMID- 3816262 TI - Plasma fibronectin in head-injured ICU patients. PMID- 3816263 TI - Spontaneous rupture of pulmonary artery. AB - We report a case of previously healthy male with hypotension and cyanosis with no evidence of underlying congenital heart disease, pulmonary hypertension, pulmonary artery aneurysm, or central venous or pulmonary artery catheter insertion. Autopsy revealed a spontaneous rupture of the pulmonary artery with hemopericardium. PMID- 3816264 TI - Accelerated idioventricular rhythm during flexible fiberoptic bronchoscopy. AB - We report the case of a patient who developed severe hypoxemia and an unusual arrhythmia, accelerated idioventricular rhythm, during flexible fiberoptic bronchoscopy. Coronary artery disease was subsequently suspected despite an unremarkable history and physical examination, and confirmed by a thallium 201 imaging. The appearance of accelerated idioventricular rhythm during fiberoptic bronchoscopy should raise the possibility of underlying coronary artery disease. PMID- 3816265 TI - Ethanol intoxication, trauma, and critical care medicine. PMID- 3816266 TI - Continuous noninvasive cardiac output: are we getting there? PMID- 3816267 TI - Can intermediate care substitute for intensive care? PMID- 3816268 TI - Bilateral pneumothoraces and pneumoperitoneum following esophageal intubation. PMID- 3816269 TI - Management of acute epiglottitis in pediatric patients. PMID- 3816270 TI - Computer program for bicarbonate dose calculation during cardiac arrest. PMID- 3816271 TI - Less invasive cardiac output monitoring by earpiece densitometry. PMID- 3816272 TI - Subarachnoid hemorrhage: a complication of CPR? PMID- 3816273 TI - Transcutaneous respiratory electromyographic monitoring. AB - The integrated diaphragm electromyogram (EMG) signal reflects function from the inspiratory centers to the neuromuscular junction. The feasibility and potential value of transcutaneous diaphragm electromyography (tcEMG) was confirmed in a group of infants using two prototype respiratory EMG monitors. Infants were monitored continuously for periods ranging from hours to days. One hundred were monitored for clinical reasons, looking for disordered respiratory behavior, while 47 were studied for technical/experimental reasons. Reliable measurements of diaphragm EMG activity were obtained, provided fully shielded electrode cables were used. Measurements in 28 ventilated infants and one adult confirmed that, unlike impedance and other non-electrophysiologic measures, tcEMG monitoring is not contaminated by ventilator-induced respiratory movements. The potential value of tcEMG monitoring in ventilated subjects is exemplified by illustrations of: diaphragmatic inactivity from phrenic nerve injury, inadequate central drive, and neuromuscular block; augmented expiratory muscle activity; and progressive increase in inspiratory diaphragmatic activity in the presence of a tension pneumothorax. TcEMG monitoring should prove a worthwhile addition to the available noninvasive respiratory monitoring techniques. PMID- 3816274 TI - Jet ventilation in support of fiberoptic bronchoscopy. AB - Mechanical ventilatory support of bronchoscopic procedures by conventional volume cycled ventilation (VCV) is technically difficult and can result in unreliable gas delivery or excessive alveolar pressure. An alternate support mode is jet ventilation through an open, uncuffed endotracheal tube. To quantitate gas delivery and airway pressures (Paw) during bronchoscopy using this technique, we used a mechanical-lung model and 15 human subjects. Jet ventilation pulsed gases at 60 to 100 cycle/min through a catheter in an uncuffed, jet endotracheal tube with a 5.9-mm (OD) bronchoscope in place. Inspiratory time was constant at 33% of cycle time, and jet-drive pressures ranged from 5 to 30 psi. In the mechanical lung model, the jet technique provided up to 30 L/min of ventilation with mean airway pressures (Paw) always less than 10 cm H2O. In contrast, VCV with an inflated cuff, while providing similar levels of ventilation, resulted in substantial air trapping and over twice the Paw. VCV with a deflated cuff provided much lower levels of ventilation, although Paw levels were also low. These delivered minute ventilations, and Paw levels were similar in six normal volunteers jet ventilated through a 9-mm jet endotracheal tube with a bronchoscope in place. Finally, in nine patients requiring mechanical ventilatory support during bronchoscopic procedures, this jet technique provided alveolar ventilation (i.e., PaCO2) and Paw levels comparable to those obtained on baseline VCV before bronchoscopy. PMID- 3816275 TI - Intra-atrial malpositions of Silastic catheters in newborns. AB - The intra-atrial position of Silastic catheters placed in the center of the right atrium was assessed by two-dimensional echocardiography in 25 newborns. In 32% of the infants, the catheter tip was located in the patent foramen ovale, and in another 40% of the infants, the catheter tip was located close to the patent foramen ovale. This placement increases the risk of systemic air and fat embolism. Consequently, the tip of Silastic catheters should be placed just behind the confluence of the superior-inferior vena cava and the right atrium. PMID- 3816276 TI - Correlations of serum potassium fluctuations with body temperature after major surgery. AB - We have observed an association between hypothermia and hypokalemia in a number of postoperative patients. In order to analyze the incidence and consequences of this correlation, 108 patients undergoing major operations were prospectively studied. Rectal temperature, serum and urinary potassium, arterial blood gases, blood glucose, and routine monitoring were analyzed. Hypothermia occurred in 35 (32%) patients, of whom 20 (57%) suffered from hypokalemia. Hypothermia was accompanied by an undercompensated metabolic acidosis in 15 (75%) and hyperglycemia in 18 (89%), while nine (45%) patients had cardiac dysrhythmias. Urinary potassium excretion was lower in hypothermic patients and therefore cannot explain the finding of hypokalemia. Administration of NaHCO3, insulin, digitalis, and calcium in patients suffering from hypothermia must be done with caution because hypokalemia may coexist with low body temperature and predispose the patients to lethal dysrhythmias. PMID- 3816277 TI - Prevention of postischemic hypoperfusion after canine cardiac arrest by nicardipine. AB - We studied the effect of nicardipine (NC) on canine cerebral blood flow (CBF) after cerebral ischemia induced by cardiac arrest. Cerebral ischemia was produced by 10 min of electrically mediated ventricular fibrillation. An iv injection of NC (10 micrograms/kg) bolus was followed by continuous NC infusion (0.33 micrograms/kg X min) immediately after the circulation re-established itself. Local CBF was measured using the hydrogen-gas clearance method. The administration of NC maintained CBF at the pre-arrest level during postischemia, thus preventing the hypoperfusion observed in the control group with no NC. However, in the controls, CBF, reduced at 180 min after re-circulation, was not improved by NC infusion. Consequently, administering NC immediately after re establishment of circulation may help maintain CBF during the postresuscitation period. PMID- 3816278 TI - Cardiorespiratory effects of exchange transfusions with synthetic erythrocytes in rats. AB - Synthetic erythrocytes (SE) can maintain life with near-normal hemodynamics in rats with hematocrits (Hct) 45% below the lethal levels, as shown when we exchanged virtually all their blood. We compared cardiorespiratory variables between the SE and control animals, which were hemodiluted with 7% albumin, at the 78% exchange level. In addition, SE animals at 92% exchange were compared with the 78% exchange and baseline levels. All our control rats died at Hct above 5% with corresponding oxygen-carrying capacity of 2.65 ml/dl. All SE rats survived, having a final Hct of 2.96% with an oxygen-carrying capacity of 7.05 ml/dl. SE animals maintained normal BP and marginally increased cardiac output, while control animals did not. Vascular resistance of control animals at 78% exchange was reduced to 30%, while in SE animals at 92% exchange, vascular resistance was lowered to 80% of baseline values. PMID- 3816279 TI - Necrotizing fasciitis from invasive Phycomycetes. AB - Invasive phycomycotic fungal infections are life-threatening complications in patients with impaired immune response. A successful outcome usually depends on early aggressive treatment. Hyperbaric oxygen (HBO) therapy has been suggested as adjuvant therapy based on theoretical considerations and in vitro evidence of fungal growth retardation. A standard gas gangrene HBO protocol was used to treat a progressive necrotizing polymicrobial soft-tissue infection of the lower extremity in a patient with normal host defenses. Progression of the fungal infection was stopped only after radical surgical debridement. This Phycomycetes (Apophycomyces elegans) has not been previously reported as a pathogen in man. PMID- 3816281 TI - Near-drowning in children. PMID- 3816280 TI - Airway obstruction: an unusual complication of infectious mononucleosis. PMID- 3816282 TI - Acyclovir treatment of varicella pneumonia in pregnancy. PMID- 3816284 TI - Severe acute pancreatitis. PMID- 3816283 TI - Case of embolization by a sheared pulmonary artery catheter tip. PMID- 3816285 TI - Cryoprotection by dimethyl sulfoxide and dimethyl sulfone. AB - Preservation of cells and tissues at low temperatures requires the presence of effective cryoprotectants with low toxicity to which cells are relatively permeable. Two similar compounds, dimethyl sulfoxide (DMSO) and dimethyl sulfone (DMSO2), exhibit both features for cryoprotectants, yet DMSO is a very effective cryoprotectant while DMSO2 is ineffective. This anomaly was investigated by relating observations on the phase behavior of DMSO and DMSO2 in aqueous solutions to the recovery of human lymphocytes frozen in the presence of these compounds. The lack of cryoprotection in the presence of DMSO2 appears to be due to the precipitation of DMSO2 from the solution at subzero temperatures. The observation of reduced cell recovery after freezing with increasing concentrations of DMSO2 implies that cell damage is related to the amount of solid DMSO2 present. Precipitation of DMSO2 occurs both intra- and extracellularly, but it is argued that intracellular precipitation of DMSO2 is the damaging phenomenon. Cryoprotective compounds are normally selected based on the criteria of low toxicity and permeability to the plasma membrane. An additional condition, solubility, must be included for interpretation of experimental data and for development of effective protocols for cryopreservation. PMID- 3816286 TI - Relative influence of unfrozen fraction and salt concentration on the survival of slowly frozen eight-cell mouse embryos. AB - This laboratory has previously reported that the survival of frozen-thawed human erythrocytes is determined more by the fraction of the extracellular solution that remains unfrozen than by the salt concentration in that fraction, especially when the cells are frozen at low hematocrit. To determine the extent to which these findings are applicable to nucleated mammalian cells, we have studied the survival of some 3300 mouse embryos as a function of the unfrozen fraction and the concentration of salt in that unfrozen fraction. Also varied in the study was the weight percentage ratio of glycerol to salt. The concentration of embryos in these experiments (i.e., the cytocrit) was so low that embryo-embryo contacts should have been rare during the freezing. As in the case of the red cells at low hematocrit, we find that the survival of slowly frozen eight-cell embryos is not affected by the high concentrations of salt produced by freezing, at least up to 3.3 molal NaCl, and therefore is not affected by the extent to which the cells shrink below their isotonic volume, nor in general is survival influenced by the temperature at which given salt concentrations and unfrozen fractions are attained or by the glycerol concentration at those temperatures. On the other hand, the attainment of low values of the unfrozen fraction (U) is damaging, but the damage appears in part to be due to the fact that low values of U had to be achieved by placing embryos in solutions hypotonic with respect to NaCl, which caused their volume to be greater than isotonic prior to freezing. PMID- 3816287 TI - Effect of several lipids, fatty acyl chain length, and degree of unsaturation on the motility of bull spermatozoa after cold shock and freezing. AB - Diluents containing sonicated liposomes of purified phosphatidylserine (PS), phosphatidylcholine (PC) with varying fatty acyl chain lengths and double bonds and cholesterol (CH) alone or in combination, or egg yolk lecithin were evaluated for protection of bull sperm during cold shock produced by rapid cooling from 25 to 0 degrees C and during freezing and thawing. Bull semen was washed twice and diluted to 50 X 10(6) sperm/ml in diluents containing no lipid, 0.5 or 5 mM sonicated lipid or 20% egg yolk and plunged into ice water to cold shock the sperm. Sperm so treated were frozen using conventional methods. The percentage of progressively motile sperm (MS) was estimated prior to cooling, after cold shock, and after freezing and thawing. Lipids with fatty acyl chains of less than 12 carbons were toxic to sperm cells. Phosphatidylserine alone or in combination with PC or CH, but not PC or CH alone, protected sperm from cold shock as well as did egg yolk lecithin liposomes or egg yolk. Liposomes of PS/PC or PS/CH were not better than PS in protecting sperm from cold shock. Lipid concentrations of 0.5 mM were more effective than liposomes at 5 mM in protecting sperm during freezing and thawing. During freezing, PS alone or in combination with PC partially protected sperm, but only PS/CH was as effective as egg yolk in protecting sperm from freeze-thaw damage. It is concluded that defined diluents, particularly those containing PS, may be useful in studies of cryobiology of spermatozoa. PMID- 3816288 TI - Vascular casts demonstrate microcirculatory insufficiency in acute frostbite. AB - The use of vascular microcorrosion casts (vascular replicas) has made it possible to demonstrate the degree of damage to the microcirculation in experimentally induced frostbite. This approach provides a direct method for demonstrating vascular patency. Four groups of animals were used in this investigation. The left hind limbs of anesthetized rats were cooled to -10 degrees C in groups one and three and to -20 degrees C in groups two and four, as measured by needle thermocouples placed under the gastrocnemius muscles. Thermocouples were also placed in the left hind footpads of groups three and four. The sheathed limbs were cooled in an alcohol bath at approximately 1.1 degree C per minute. All limbs exposed to the cold bath were rewarmed to 37 degrees C in a 40 degree C water bath. The right hind limbs served as uninjured controls. The footpad temperatures recorded in groups three and four were used in conjunction with the temperatures recorded under the gastrocnemius muscles to characterize the footpad temperatures in groups one and two. Vascular microcorrosion casts were made from the left and right hind paws of groups one and two using Batson's modified methyl methacrylate. Scanning electron microscopic examination of the casts demonstrated dramatic differences between the vascular integrity of control paws and that of frozen paws. Exposure to the cold temperatures destroyed most of the microcirculation. In addition, the weights of the casts from the control paws were significantly different from the weights of the casts from the frozen paws. It was concluded that this model for evaluating frostbite injury accurately demonstrates the extent of microvascular damage and has significant potential as a method for evaluating therapeutic drug regimens. PMID- 3816289 TI - Effect of cooling on vascular smooth muscle from the thirteen-lined ground squirrel. AB - Peripheral vascular resistance in the ground squirrel (Spermophilus tridecemlineatus) increases when the animal enters hibernation. The goals of this study were to determine if a change in vascular reactivity contributes to this hemodynamic response, and to compare the effects of temperature on vascular responsiveness in a hibernator (ground squirrel) and a nonhibernating mammal (rat). Helically cut strips of aortae and femoral arteries were mounted in organ chambers (37 degrees C) and isometric contractions were recorded. The arteries were made to contract in response to exogenous norepinephrine (5.9 X 10(-7) M). Cooling the organ chamber (11 degrees C) potentiated contractions to norepinephrine (5-15% increase) in ground squirrel femoral arteries but depressed those (80-100% decrease) in ground squirrel aortae and rat aortae and femoral arteries. Contractions in response to depolarizing concentrations of potassium in ground squirrel femoral arteries were depressed by cooling (11 degrees C), suggesting that the augmented response to norepinephrine at low temperature is specific. Treatment with indomethacin, propanolol, and ouabain did not alter the potentiating effect of temperature on contractions to norepinephrine in ground squirrel femoral arteries. Apparently, the potentiation is not related to prostaglandins generated in the vascular wall, to blockade of beta-adrenergic receptors, nor to inhibition of the electrogenic sodium pump. The observations are consistent with the hypothesis that a change in vascular responsiveness contributes to the regional control of blood flow in hibernation. This adaptive response is specific in that it does not occur in the aorta of the ground squirrel and the response is not present in the vasculature of the rat, a nonhibernating mammal. PMID- 3816290 TI - Rubella vaccination: a study in adult male volunteers. AB - One hundred adult male volunteers were randomized to receive either Merieux or Wellcome RA27/3 rubella vaccine. Prior to vaccination, 10% of the subjects were seronegative and all of these seroconverted. No significant boosting effect was found in those with a high pre-vaccine titre but some boost was shown in those with a low level. Side-effects reported were mild and self-limiting. No clinically or statistically significant difference could be found between the two vaccines. It is suggested that in view of the finding of 10% seronegative adult males it would be worthwhile considering routine screening of all medical staff who have contact with women in the early months of pregnancy. PMID- 3816291 TI - Trimoprostil decreases acid disappearance from the human stomach. AB - A double-blind, placebo-controlled, randomized crossover study involving 8 healthy volunteers was carried out to investigate the disposal of an acid load instilled into the stomach after oral administration of two doses of trimoprostil (0.125 and 1.5 mg). The results showed that trimoprostil reduced the disappearance of acid from the gastric lumen but did not influence the rate of gastric emptying of acid. PMID- 3816292 TI - Cimetropium bromide as a relaxant for the radiological examination of the stomach and duodenum. AB - A study was carried out to evaluate the efficacy of two different doses of a new hypotonizing agent, cimetropium bromide, as a premedication for X-ray of the stomach and duodenum. Forty consecutive patients were allocated at random to two groups and treated intravenously in double-blind fashion with 5 mg or 10 mg cimetropium bromide. The drug was administered immediately after the first phase of an upper gastro-intestinal series had been completed. Duration of the drug induced hypokinesia was recorded fluoroscopically. The hypotonizing effect was evaluated by measuring the diameters of the gastric antrum, duodenal bulb and loop on the pre-injection and post-injection radiographs. In both groups, the relaxant effect started promptly (within 1 minute of injection) and lasted for an average of 10 minutes, which was considered adequate for the study. There were no statistically significant differences between the two groups in relaxant activity. The treatments were scored arbitrarily as 'excellent' in 75% of the examinations after the 10 mg dose and in 60% after the 5 mg dose. The difference between the two groups was not significant. Side-effects were few, of mild entity and not dose-related. PMID- 3816293 TI - Autonomic dysfunction in perennial vasomotor rhinitis and the effect of mequitazine. AB - Thirty patients with perennial vasomotor rhinitis were submitted to pharmacological tests to assess the autonomic responsiveness of extra-nasal and intra-nasal receptors to isoprenaline and phenylephrine by infusion, and to evaluate the effect of 14-days' treatment with mequitazine (5 mg twice daily) and placebo on clinical symptoms and on autonomic sensitivity. Isoprenaline induced a similar tachycardia in all patients, more pronounced than that observed in normal subjects, at the different times of testing, and also an increase in nasal resistance. With phenylephrine, marked bradycardia was observed, reflecting high vagal baroreflex sensitivity, and a transient decrease in nasal resistance was obtained. Mequitazine improved significantly the clinical symptoms but did not modify the autonomic receptivity. It is suggested that in patients with vasomotor rhinitis an autonomic dysfunction may play a role in a predisposing factor in nasal hyperreactivity with non-specific histamine release. PMID- 3816294 TI - Is sulphonylurea therapy effective long term? A 3-year study with gliclazide. AB - Fifty non-insulin-dependent diabetic patients, aged 59.06 +/- 1.37 years and overweight (119.3% of ideal body weight), with an impaired daily glycaemic profile despite a carbohydrate restrictive diet were treated with gliclazide (40 to 320 mg per day) for 36 months. Forty-four patients completed the full study (3 drop-outs for secondary failure, 3 others for reasons not related to the treatment). Mean daily plasma glucose levels (fasting, 10.00, 12.00 and 16.00 hours) decreased significantly from 15.2 +/- 0.7 to 6.9 +/- 0.2 mmol/l after 36 months. Mean fasting plasma glucose level decreased significantly from 12.7 +/- 0.5 to 8.2 +/- 0.2 mmol/l after 3 months and continued to decrease to 6.9 +/- 0.3 mmol/l after 36 months (p less than 0.01). Fatty acids, cholesterol, and triglycerides plasma levels also decreased significantly from 0.53 +/- 0.06 mmol/l, 6.3 +/- 0.2 mmol/l and 1.9 +/- 0.2 mmol/l, respectively to 0.32 +/- 0.01 mmol/l, 5.8 +/- 0.1 mmol/l and 1.6 +/- 0.1 mmol/l, respectively. No weight gain was observed: mean body weight decreased significantly from 68.2 +/- 1.7 to 64.0 +/- 1.4 kg, indicating that gliclazide did not interfere with diet-induced weight loss. Importantly, platelet adhesiveness, abnormal before treatment 77.2 +/- 1.3% (normal less than 70%), improved throughout the study to 57.8 +/- 1.3% after 36 months of gliclazide. Treatment was well tolerated and no hypoglycaemic attacks or other side-effects were reported. PMID- 3816296 TI - The molecular biology of baculoviruses. PMID- 3816295 TI - MRI of the brain. PMID- 3816297 TI - Persistent and productive infections with the Hz-1 baculovirus. PMID- 3816298 TI - The structure of the viral genome. PMID- 3816299 TI - The regulation of baculovirus gene expression. PMID- 3816300 TI - Light and electron microscopy of Ag-NORs in domestic horse chromosomes identified after R-banding. AB - Silver staining shows the presence in the domestic horse of six NORs located on chromosomes 1, 26 and 31 as identified after R-banding. Following electron microscopy, the argyrophilic material was observed outside the terminal secondary constrictions (satellite stalks) on the terminal portion of the short arm of chromosome 1, outside the secondary constrictions on the proximal region of the long arms of chromosome 31, and beside the proximal region of the long arms of chromosome 26. Satellite staining applied to these chromosomes appears to reveal only the active NORs. PMID- 3816301 TI - K-Na transport: the Brewer model replaces the active transport model. AB - In the 1940's several experimental observations were made regarding the K+ and Na+ content of chilled and restored red blood cells. As a consequence, the concept of active transport was developed. Brewer, a physicist, developed a model for membrane transport based on the electrical properties of double bonds in the ground and excited states. Of particular importance is the membrane double bond P = O. This model was largely formulated from isotope concentration studies using mass spectroscopy, photospectrometry and the nature of malignant cells. In this study, it is shown that the Brewer model completely explains the experimental results which led to the concept of active transport. In addition, it also explains the results of some adjunct experiments. PMID- 3816302 TI - Folate-sensitive fragile sites on the X-chromosome heterochromatin of the Indian mole rat, Nesokia indica. AB - Folate-sensitive fragile sites have been demonstrated on the X chromosome of the Indian mole rat, Nesokia indica (subfamily Murinae), utilizing peripheral blood lymphocyte cultures. All normal female individuals expressed fragile sites on the constitutive heterochromatic long arm of one of their two X chromosomes (heterozygous expression); in contrast, no fragile sites were found on the single X chromosome of normal males. Preferential transmission of the maternal fragile X to the daughters is therefore suggested. Four sites have been detected so far: fra Xq1, fra Xq2, fra Xq3, and fra Xc (centromeric). It is significant that their location corresponds to the regions where constitutive heterochromatic deletions occur that result in a variety of polymorphic X chromosomes in natural populations of Nesokia. Thus there is a correlation between fragile sites, deletion sites, and karyotypic changes. In individuals that did not reproduce in the laboratory, there were more fragile sites on both X chromosomes of the females (homozygous/double heterozygous expression) and also on the X of the males (hemizygous expression). This difference in fragile site expression from the normal situation could be attributed to one or more new mutations. However, the mechanism by which fragile sites influence reproductive performance is unclear. PMID- 3816303 TI - DNase I hypersensitive sites along the XY bivalent at meiosis in man include the XpYp pairing region. AB - The DNase I nick translation technique has been applied to human meiotic chromosomes in situ. At metaphase I, distinct hot spots of autoradiographic labelling occur at three positions along the XY bivalent; over the Xpter and Ypter pairing tips, over Xq and Yq terminal/telomeric segments, and at a site just below the centromere in Xq. The latter might correspond to the postulated human inactivation centre. Compared with somatic chromosomes, human meiotic bivalents in general exhibit a greater accessibility to DNase I. Site-specific conformational changes in the DNA between somatic and germ line cells could be a necessary prerequisite for crossing-over. PMID- 3816304 TI - Aneuploidy is not induced by ethanol during spermatogenesis in the Chinese hamster. AB - Aneuploidy was scored in spermatogonial stages and at both meiotic divisions in male Chinese hamsters exposed to alcohol in vivo. After light ether anesthetization, the animals were intubated (by gastric tube) with 1.5 ml of 12.5% ethanol, whereas controls were given 1.5 ml of distilled water. Gonadectomy was performed 3.5-24 h after ethanol exposure. Ethanol-dosed animals were obviously intoxicated, as evidenced by a rolling gait; serum alcohol levels in 10 animals that were tested peaked 1-2 h after exposure. Among the animals exposed to ethanol, no significant difference over time in the rates of aneuploidy was observed. These data were pooled, and, when compared to control rates, no significant difference could be attributed to ethanol exposure. The aneuploidy found could therefore be interpreted as background rates, and these compared well with data previously published for the Chinese hamster. Several artifactual phenomena were observed: Up to 15% aneuploid spermatogonial metaphases were seen in test and control animals. These were attributed to the mechanical breaking-up of closely apposed groups of diploid spermatogonia. Significant numbers of artifactual diploid MII figures and hypohaploid MI and MII figures were also recorded. To address the possibility that a spermatogonial or other long-term effect could be detected, two animals (with controls) were dosed with 12.5% ethanol daily for 13 and 16 days before sacrifice. No aneuploidy attributable to ethanol was found at MII in these animals either. PMID- 3816305 TI - A scanning electron microscopy study of double minutes from a human tumour cell line. AB - Double minutes from a human tumour cell line were examined in intact metaphase spreads using scanning electron microscopy. They were discrete, acentromeric, compact spheres of chromatin fibres similar to the chromatin of the metaphase chromosomes within the same cells. They were closely associated with the telomeres and chromatids of the metaphase chromosomes. PMID- 3816306 TI - Ethanol-induced aneuploidy in male germ cells of the mouse. AB - The administration of alcohol to male mice 2-6 h before the preparation of second meiotic metaphases from testes resulted in an approximately six-fold increase in aneuploidy. The timing employed indicates that the observed chromosome abnormalities were a result of nondisjunction and/or anaphase lagging at the first meiotic division. A similar effect has been described in the female mouse; however, the present results suggest that the aneuploidy-inducing effect of ethanol may be substantially greater in the female than in the male. PMID- 3816308 TI - Oximetry--know thy limits. PMID- 3816307 TI - Inhalation aids of metered dose inhalers. PMID- 3816309 TI - Nonbronchoscopic lung lavage for diagnosis of opportunistic infection in AIDS. AB - Thirty patients known to have or suspected of having acquired immunodeficiency syndrome (AIDS) were evaluated for opportunistic pulmonary infection using a double lumen lavage catheter (DLL). Lavage specimens obtained were cytocentrifuged and initially stained by the Papanicolaou technique as a means of rapid evaluation for Pneumocystis carinii. If no opportunistic organism was identified, the patient underwent further diagnostic investigations. In 18 patients receiving mechanical ventilatory support, the procedure was performed via the endotracheal tube. Twelve patients who were less severely ill underwent the procedure via the transnasal route. In 43 percent (13/30), opportunistic infections were diagnosed by DLL. Twelve had P carinii, one of whom had cytomegalovirus and another of whom had Herpes simplex viruses, and one with Toxoplasma gondii. Thus, the sensitivity for all opportunistic infections was 86 percent (12/14). The volume of fluid recovered averaged 93 percent of that instilled. There was no significant difference between prelavage and postlavage PaO2. In this group of patients, double lumen lavage obviated the need for more invasive and expensive procedures. PMID- 3816310 TI - Prediction of PaO2 during treadmill walking in patients with COPD. AB - We studied the possibility of predicting PaO2 during exercise of a given oxygen uptake (VO2) from resting pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD). The three-minute incremental treadmill exercise was performed with serial measurements of PaO2 via intra arterial catheter in 46 patients (mean FEV1 = 1.09 +/- 0.49L, mean FEV1/FVC = 44 +/- 15 percent). In most of the patients, the changes of PaO2 were quite linear in relation to the oxygen uptake, so a slope (PaO2/VO2) could be obtained from the regression equation in each patient. The mean value of the slope (SL) was 23.0 +/- 16.6 mm Hg/L VO2/min. Correlation between SL and all parameters of resting PFTs were computed. Because of the high correlation coefficient between SL and %DCO (SL = -59.3 + 0.501 X %DCO, r = 0.851, p less than 0.001), it was possible to predict PaO2 at a given VO2 using the following equation: PaO2 predicted = PaO2 rest + SL X (VO2 -0.25), where SL was derived from measured %DCO and resting VO2 was assumed 0.25 L/min. There was a high correlation between the predicted PaO2 at VO2 of 1.0 L/min and the estimated PaO2 obtained from individual PaO2 regression with an r value = 0.898 and SEE = +/- 5.8 mm Hg. A prospective study in 12 patients with COPD was then carried out. There was a high correlation (r = 0.857) between the predicted PaO2 obtained from the present equation and the estimated PaO2 at VO2 = 1.0 L/min. It was concluded that PaO2 during treadmill walking with a given oxygen uptake is predictable from a resting PaO2 and a diffusing capacity. This predicted value may be useful in the management of patients with COPD. PMID- 3816311 TI - Validity of ear oximetry in clinical exercise testing. AB - Because of suspicion that the ear oximeter might measure the oxyhemoglobin saturation of arterial blood inaccurately during heavy exercise, we made concurrent ear oximetric and blood measurements on 14 consecutive patients with arterial catheters during clinical exercise tests. After correcting for carboxyhemoglobin, the estimated and measured values for the oxyhemoglobin saturation of the blood agreed well, as did resting ear and blood values; however, during heavy exercise, ear oximetric values were falsely elevated in two patients with interstitial pulmonary disease and were falsely depressed in five patients with cardiovascular limitation to exercise. In another patient, ear oximetric values declined during heavy exercise despite mild hyperoxia, suggesting hypoperfusion of the ear. Considering the clinical and physiologic importance of oxyhemoglobin saturation, ear oximetric values during heavy exercise should be cautiously interpreted. PMID- 3816312 TI - Meaning and diagnostic value of determining the lysozyme level of pleural fluid. AB - We determined the levels of lysozyme in pleural fluid and serum in 141 patients with the following different causes for their pleural effusions: tuberculosis; neoplasias; transudates; parapneumonic, not complicated; empyemas; and miscellaneous. The lysozyme level of the pleural fluid and the ratio of that level over the serum level of lysozyme (PL/SL ratio) was meaningfully increased in patients with empyema (p less than 0.01). The groups with tuberculous and neoplastic effusions showed significant differences in the PL/SL ratio (p less than 0.01). The existence of a raised PL/SL ratio suggested important local synthesis of lysozyme, and it came up in empyemas and tuberculosis, unlike the other groups. Excluding the patients with empyemas, a PL/SL ratio of 1.2 showed a sensitivity of 100 percent, specificity of 94.9 percent, positive predictive value of 94.7 percent, negative predictive value of 100 percent, and accuracy of 97.3 percent for the diagnosis of tuberculous pleural effusion. All of this suggests that the determination of the lysozyme level can be an easy method of great usefulness in the initial diagnosis of pleural effusions. PMID- 3816313 TI - Noninvasive prediction of pulmonary hypertension in chronic obstructive pulmonary disease by Doppler echocardiography. AB - Thirty-six patients with chronic obstructive pulmonary disease (COPD) were studied by pulsed Doppler echocardiography. In 32 of the 36 patients, adequate Doppler signals were obtained in the pulmonary arterial trunk and correlated with right cardiac hemodynamics. The studied group included 26 patients with mean pulmonary arterial pressure (MPAP) greater than 20 mm Hg at rest (group A, with pulmonary hypertension) and six patients with MPAP of 20 mm Hg or less (group B, without pulmonary hypertension). A control group (group C) consisted of 12 subjects with normal hemodynamic data and pulmonary function. Analysis of Doppler data included flow velocity curve pattern, presence of a negative presystolic velocity, right ventricular pre-ejection period (RVPEP) and ejection period (RVEP), time between onset and peak of pulmonary velocity (time to peak velocity, TPV) and derived ratios of TPV/RVPEP and TPV/RVEP. In patients with pulmonary hypertension, the Doppler flow velocity curve in the pulmonary trunk showed a rapid acceleration and an early deceleration. The mean value for TPV was 78 +/- 12 msec in group A, 115 +/- 11 msec in group B, and 127 +/- 10 msec in group C. In patients with COPD, significant correlations were observed between TPV and log10 MPAP (r = -0.77; SEE = 0.07) and between TPV and log10 total pulmonary resistances (r = -0.84; SEE = 0.05). Accordingly, pulsed Doppler echocardiography may be a useful tool to predict pulmonary hypertension due to chronic pulmonary disease. PMID- 3816314 TI - Evaluation of inhalation aids of metered dose inhalers in asthmatic children. AB - Many patients have incorrect aerosol inhalation technique with metered dose inhalers (MDI). Several inhalation aids have been developed and marketed for these patients. Even those who have correct inhalation technique may benefit from these devices. We compared bronchodilator efficacy of two puffs of albuterol aerosol administered either directly from a MDI mouthpiece, or from an inhalation aid (InspirEase, Aerochamber, Aerosol Bag) in 20 children who had previously demonstrated proper inhalation technique. The children received two puffs of aerosol from a MDI in each of two modalities tested each day on four different days (double blind). One modality contained albuterol aerosol and the other placebo. Pulmonary function was tested before and at 15, 30, 60, 120, and 180 minutes after treatment. Forced expiratory volume in 1 second (FEV1) increased similarly after all four modes of administration. Six patients who had incorrect inhalation technique benefited from the three inhalation aids. The aerosol bag and InspirEase produced slightly greater bronchodilator response than the Aerochamber. The inhalation aids are useful devices for those who have incorrect inhalation technique, but those who have correct technique do not derive any benefit from these devices. PMID- 3816315 TI - Comparison of 12-hour and 24-hour sustained-release theophylline in outpatient management of asthma. AB - A once-daily sustained-release preparation of theophylline (Theo-24) was compared to a twice-daily (bid) preparation (Theo-Dur). Fourteen subjects with asthma requiring daily therapy with theophylline were evaluated in a 30-day prospective study. Pulmonary function and serum levels of theophylline were measured. With the twice-daily preparation the mean variation over 12 hours between the maximum concentration (Cmax) and minimum concentration (Cmin) for theophylline was 3.0 micrograms/ml +/- 0.3 microgram/ml, and there was no significant change in tests of pulmonary function. With the once-daily preparation the mean variation over twenty four hours between Cmax and Cmin was 7.4 micrograms/ml +/- 1.1 micrograms/ml, with a small but significant associated change in the forced expiratory volume in one second (84.1 vs 79.6 percent of predicted). Several of the subjects had large differences between Cmax and Cmin with the once-daily preparation. For some, Cmin was quite low while at the same time Cmax was high enough so that further increases in the dose of the once-daily preparation would not have been possible. Thus, consideration of the variation from Cmax to Cmin is necessary in adjusting a patient's dose of the once-daily preparation and may present problems in changeover from the twice-daily preparation if the mean blood level of theophylline is already high. PMID- 3816316 TI - Systemic cardiovascular and metabolic effects associated with the inhalation of an increased dose of albuterol. Influence of mouth rinsing and gargling. AB - We designed this investigation to assess the occurrence of systemic beta adrenergic side effects associated with the inhalation of an increased dose of the beta2 receptor agonist albuterol. Since therapeutic aerosols delivered by metered dose inhaler (MDI) are preferentially deposited in the mouth and pharynx, we wished to determine whether mouth rinsing and gargling with water might reduce the magnitude of such side effects by partially removing oral and pharyngeal drug residues. Serum glucose, insulin and potassium concentrations, forced expiratory volume in one second (FEV1), heart rate (HR), and blood pressure (BP) were measured as parameters of beta-adrenergic stimulation. Each of eight nonmedicated mild asthmatic patients was studied on two separate days after an overnight fast. Measurements were obtained twice before and then repeatedly at various times up to three hours after inhalation of ten albuterol doses (total dose approximately 1 mg) delivered by MDI. On either day the patient did, or did not, rinse the mouth and gargle after drug inhalation. Aerosol-administered albuterol significantly increased HR, FEV1, systolic BP and serum concentrations of glucose and insulin and lowered diastolic BP as early as five min after inhalation, indicating early systemic drug absorption. Peak changes in all measured parameters were observed within 30 min after treatment. Mouth rinsing and gargling removed 24 +/- 11 percent of the total albuterol dose delivered, but did not lower the magnitude or shift the time course of these side effects or bronchodilation. Our data suggest that cardiovascular and metabolic side effects are associated with the inhalation of an increased dose of albuterol and that mouth rinsing and gargling are not effective in reducing the magnitude of these systemic effects. PMID- 3816317 TI - Almitrine in acute respiratory failure. Effects on pulmonary gas exchange and circulation. AB - The effects of almitrine administration on pulmonary gas exchange and pulmonary and systemic hemodynamics were assessed in eight patients with severe acute respiratory failure (ARF) secondary to sepsis or shock. A control group of five patients not receiving the drug were submitted to the same protocol. All the patients were sedated, paralyzed, and mechanically ventilated. Measurements were made before (BASELINE), during (ALM 15), at the end of (ALM 30), and at 30 minute intervals after (POSTALM 30, 60, 90, 120) the intravenous (IV) infusion of 0.5 mg/kg body weight of almitrine in 30 minutes. Almitrine produced an increase in PaO2 from 86 +/- 14 (BASELINE) to 129 +/- 69 (ALM 15) and 129 +/- 86 mm Hg (ALM 30). The PaO2 quickly declined after stopping the infusion. The P(A-a)O2 and QVA/QT decreased with almitrine administration. The Ppa and QT increased transiently at ALM 30. We conclude that IV almitrine improves gas exchange and may be useful in the management of ARF. PMID- 3816318 TI - Parotid gland biopsy and 67Ga imaging correlation in systemic sarcoidosis. AB - We correlated the results of parotid gland biopsy, chest roentgenograms, and gallium citrate scintigraphy in 24 patients evaluated for possible systemic sarcoidosis. Of 19 patients ultimately proven to have sarcoidosis, 11 (57.9 percent) had positive parotid gland biopsy. The yield of parotid gland biopsy in patients with abnormal gallium parotid activity was only marginally higher (64.7 percent). Abnormal parotid gland uptake of gallium citrate was seen in 17 of these 19 patients (89.5 percent) and was always associated with abnormal lung or perihilar activity. The parotid gland biopsy is a useful technique for obtaining the tissue diagnosis of sarcoidosis; however, gallium scintigraphy should not be performed to select patients as this will only marginally increase the biopsy yield. PMID- 3816319 TI - Pulmonary function in the Marfan syndrome. AB - To explore the causes of reported abnormalities in pulmonary function in persons with the Marfan syndrome, we analyzed retrospective anthropometric and pulmonary function tests in 79 patients. For ten subjects, there were matched, related control subjects who did not have a connective tissue disorder. Patients had lower values of FVC and TLC than the values expected for their standing heights (83 and 91 percent). However, when sitting height was used to calculate expected spirometric values, patients free of severe deformity of the thoracic cage did not have significant spirometric abnormalities (FVC 105 percent, FEV1 92 percent). However, patients with moderate-to-severe pectus excavatum or scoliosis (common features of the Marfan syndrome) had marked reductions in total lung capacity as well as in FVC and FEV1, suggesting a restrictive ventilatory defect. The abnormalities of pulmonary function often found in clinical laboratories can be explained in most cases by inappropriate use of standing height to calculate expected values, by thoracic cage deformity, or by both. We have found no evidence from standard tests of pulmonary function for a connective tissue defect of lung parenchyma that is of clinical importance in Marfan patients who lack chest wall deformity. PMID- 3816320 TI - Influenza and pneumococcal immunization strategies for physicians. PMID- 3816321 TI - Perfluorochemical artificial blood as a volume expander in hypoxemic respiratory failure in dogs. AB - The perfluorochemical O2-transport fluid, Fluosol-DA 20 percent (PFC), is being clinically evaluated as a volume expander in patients who are unable to receive blood products. Since patients treated with Fluosol-DA may be at risk of developing adult respiratory distress syndrome (ARDS) as a complication of the original disorder for which they were transfused, we examined central hemodynamics and gas exchange in anesthetized O2-ventilated dogs with oleic-acid induced pulmonary edema before and after transfusion with 400 ml of either PFC (n = 5) or whole blood (n = 5). Transfusion produced similar increases in cardiac output, pulmonary and systemic vascular pressures and intrapulmonary shunt in the two groups. Arterial O2 tension, however, fell from 209 +/- 117 to 172 +/- 81 mmHg in the blood transfused group but increased from 219 +/- 145 to 302 +/- 138 mmHg in the PFC group. Arterial O2 content, on the other hand, increased in the blood transfused group due to an increase in hematocrit, but fell with PFC because of hemodilution. This lower total arterial O2 content in the PFC group was, however, compensated for by more efficient O2 transport by the PFC in that the PFC arteriovenous O2 content difference accounted for 26 percent of the total arteriovenous O2 content difference, making it about four times as efficient as hemoglobin in tissue O2 delivery. Fluosol DA, 20 percent, is an effective volume expander in this model of hypoxemic respiratory failure, and it can transport significant amounts of O2 even in the presence of a substantial intrapulmonary shunt. PMID- 3816322 TI - Pseudoatrial dissociation. PMID- 3816323 TI - An asymptomatic nodule in an immunosuppressed patient. PMID- 3816324 TI - Unusual case of enlarging pulmonary mass. AB - Rounded atelectasis is an uncommon form of pulmonary collapse that presents as an asymptomatic lung mass, and thus, can appear very similar to a pulmonary neoplasm. One feature that has been used to differentiate rounded atelectasis from a pulmonary malignancy is the lack of growth observed in cases of rounded atelectasis. The case presented here demonstrates that it is possible for rounded atelectasis to increase in size. This is the first documented case of enlargement of rounded atelectasis and shows that this disorder should be added to the list of benign causes of an enlarging pulmonary mass. PMID- 3816325 TI - Pleural cryptococcosis in the acquired immune deficiency syndrome. AB - Pleural cryptococcosis is extremely rare. We report the first case of cryptococcal pleural effusion in association with the acquired immune deficiency syndrome. Pleural effusion without the evidence of pulmonary parenchymal involvement was the initial and only clinical finding leading to the diagnosis of disseminated cryptococcosis. The pleural effusion resolved spontaneously prior to amphotericin B therapy. PMID- 3816326 TI - Congenital coronary arteriovenous fistula associated with dilated cardiomyopathy. AB - A 59-year-old housewife with heart failure was found to have dilated cardiomyopathy associated with bilateral coronary artery fistula to the pulmonary artery. Coexistence of coronary arteriovenous fistula and dilated cardiomyopathy has not been reported and seems to be a casual association. PMID- 3816327 TI - Familial bilateral paralysis of diaphragm. Adult onset. AB - At age 50 two homozygote twin brothers developed bilateral paralysis of the diaphragm. No infectious, metabolic, degenerative or proliferative disorders of the neuromuscular system and no thoracic diseases which could explain this lesion were detected during four years of follow-up. It appears thus to be an isolated lesion of genetic origin. To the best of our knowledge, no similar cases have been reported in literature. PMID- 3816328 TI - Sudden pain on pacemaker pocket followed by explosion in a patient with a permanent pacemaker. AB - An 81-year-old woman with a mercury-zinc powered permanent pacemaker experienced the sudden pain on her pacemaker pocket followed by an explosion. We are aware of no other report of the spontaneous and symptomatic bursting of a generator battery with fracture of the pulse generator capsule. PMID- 3816329 TI - Chronic endobronchial mucormycosis. PMID- 3816330 TI - Utility of portable chest X-ray. PMID- 3816331 TI - Washington State screening of prison inmates. PMID- 3816332 TI - Eosinophilic alveolitis? PMID- 3816333 TI - Cryotherapy or Nd-YAG laser in the treatment of tracheobronchial tumors? PMID- 3816334 TI - Artificial sapphire contact endoprobe with Nd-YAG laser in the treatment of subglottic stenosis. PMID- 3816335 TI - Intensive crisis counseling in Florida. PMID- 3816336 TI - SCAN: providing preventive services in an urban setting. PMID- 3816337 TI - The admissibility of evidence in child sexual abuse cases. AB - Testimony in court by child victims of sexual abuse results in further trauma, frequently inconsistent or retracted accusations, and, in incest cases, exacerbation of family difficulties. A number of states have liberalized rules of evidence in such instances to spare the child; some states have enacted legislation simplifying introduction of the child's out-of-court statements, although the constitutionality of these statutes has yet to be tested. PMID- 3816338 TI - Videotaped interviews in child sexual abuse cases: the Texas example. AB - Suchrara writes [1977: 296] that "a child's right to humane treatment must be considered not an option on the part of adults, but an obligation." The use of videotaped interviews as admissible judicial evidence is an important step toward Suchrara's goal; videotaped testimony attempts to balance the emotional, psychological, and developmental needs of the child with the civil liberties afforded to alleged perpetrators. The Texas State Legislature, with the passage of Senate Bill 836, broadened the civil rights of children to include the notion of humane treatment in civil and criminal investigations and proceedings. The Texas law establishes explicit guidelines to enhance the child's dignity in a traumatic and personal experience. Furthermore, the law protects the civil rights of the accused guaranteed by the sixth and fourteenth amendments to the U.S. Constitution. The successful implementation of the videotape law, however, depends on the skills and expertise of the social worker. The practitioner must possess specialized training in the dynamics of child sexual abuse and an extensive understanding of related law and legal processes. This expertise is built on a foundation of knowledge and skills required for effective interviewing, counseling, and an exhaustive understanding of human behavior theory. Given the complexity and interplay of law, rights, and human behavior, the social worker requires ongoing training in these areas in order that the interests of all concerned parties be protected. The Texas State Legislature provides an opportunity for the social welfare and legal communities to determine jointly how and to what extent the rights of a victim and an alleged perpetrator may be protected. The law is in hand; the success of its implementation now rests with the practitioners. PMID- 3816339 TI - Books as therapy for children of alcoholics. AB - Books can help child welfare professionals who work with children of alcoholics as an adjunct to other therapies and interventions. Fiction books used in bibliotherapy and nonfiction books directed at the COA, adult, and professional communities can all serve useful purposes. As with any other technique, there are limitations to its effectiveness. Children who are good readers and/or used to finding solutions for other kinds of needs in books will probably profit most. When combined judiciously with personal interaction, however, books can help professionals break through COAs' defensive barriers and meet the special needs of this difficult-to-reach, at-risk population. PMID- 3816340 TI - The negative social network: when friends are foes. AB - In this study, three factors appear to influence significantly whether a child in foster care would be returned to the parent. The factors proved to be the number of persons in the parent's home, the number of friends in the neighborhood, and the frequency with which the parent saw those friends. PMID- 3816341 TI - Latent growth curves within developmental structural equation models. AB - This report uses structural equation modeling to combine traditional ideas from repeated-measures ANOVA with some traditional ideas from longitudinal factor analysis. A longitudinal model that includes correlations, variances, and means is described as a latent growth curve model (LGM). When merged with repeated measures data, this technique permits the estimation of parameters representing both individual and group dynamics. The statistical basis of this model allows hypothesis testing of various developmental ideas, including models of alternative dynamic functions and models of the sources of individual differences in these functions. Aspects of these latent growth models are illustrated with a set of longitudinal WISC data from young children and by using the LISREL V computer program. PMID- 3816342 TI - Infants' interactions with mother, sibling, and peer: contrasts and relations between interaction systems. AB - The role of the mother in structuring interactions with the infant during free play was examined at 6 and 9 months. Maternal scaffolding of turn-taking exchanges was then contrasted to the forms of turn-taking apparent in sibling infant and peer-infant observations. Infants spent more time in turn-taking exchanges with their mothers than with their siblings or peers. These exchanges most often took the form of mothers creating sequences by responding to infants' social and nonsocial acts and by eliciting social and nonsocial responses from the infants. Infants' exchanges with older siblings were briefer and more typically involved the older children eliciting nonsocial responses from the infants but not responding contingently to the infants' interests and actions. Infant peers spent less time in turn-taking exchanges, and their interactions showed less evidence of scaffolding. At the same time, the proportion of strictly social interactions was greatest with peers. Relations were apparent between infants' turn-taking experiences with their mothers and the infants' subsequent interactions with their siblings and with their peers. Relations were also found between infants' interaction experiences with their older siblings and subsequent peer interaction. Those infants with more extensive turn-taking experience with more skilled social partners were subsequently observed to engage in more extensive turn-taking interactions with a peer. These results are discussed in terms of studies on mother-infant attachment and peer competence, maternal scaffolding, and Vygotsky's zone of proximal development. PMID- 3816343 TI - Abusive and nonabusive mothers' ability to identify general and specific emotion signals of infants. AB - Slides depicting infants in 7 different emotion states were shown to 20 abusive mothers and to 20 matched, nonabusive mothers. The ability of these subjects to identify general emotional affect (positive and negative) and specific emotion signals was tested. Results indicated that abusive mothers were more likely than the comparison group to incorrectly identify specific emotion signals and to label negative affect as positive. PMID- 3816344 TI - Gender comparisons of preschoolers' behavior and resource utilization in group problem solving. AB - We tested the hypothesis that 4 - 5-year-old girls and boys in same-sex problem solving groups would perform equally well when the group task required various cooperative and self-serving behaviors to obtain a resource. The hypothesis that girls and boys would employ different behaviors to obtain the resource was also tested. 20 same-sex, same-age groups of 4 children each (10 groups of girls and 10 groups of boys) were videotaped while solving a problem involving a cartoon movie as a resource. 1 child could view the movie provided 2 other children helped, 1 to turn a crank and 1 to push a light button; the fourth child was relegated to a bystander position. Results revealed that girls and boys were equally effective in achieving viewing time; gender variance in viewing time was significantly greater for girls than for boys; girls and boys did not differ in total behavioral output, but girls tended to use more verbal behavior than boys and boys engaged in significantly more physical behavior than girls; affect in boy groups was more positive than in girl groups; girls who achieved the most viewing time within their group differed behaviorally from girls who achieved the least viewing time, but did not differ behaviorally from boys; boys who achieved the most viewing time did not differ behaviorally from boys who achieved the least viewing time. PMID- 3816345 TI - Hostile attributional biases among aggressive boys are exacerbated under conditions of threats to the self. AB - Previous studies have found a tendency for aggressive boys to display hostile attributional biases and social cue interpretation deficits. It was hypothesized that these biases and deficits would be exaggerated under conditions of social anxiety and threat. Aggressive and nonaggressive boys aged 8 - 10 (total N = 65) were administered tests of attributional tendencies and social cue interpretation skills (via videorecorded stimuli) under relaxed and threatening conditions. It was found that, relative to normal boys, aggressive boys displayed a bias toward attributing hostile intentions to peers, a deficit in interpreting accurately others' intentions, and a deficit in linking interpretations to behavioral responses. The hypothesis that these biases and deficits would be exaggerated under conditions of threat was also supported. Findings were interpreted as consistent with theories of preemptive processing and emotional vulnerability in aggressive boys. PMID- 3816346 TI - A developmental approach to reading disability: accuracy and speed criteria of normal and deficient reading skill. AB - The constructs of accuracy and speed were adopted as performance criteria against which to define 2 clinical samples of disabled readers. Accuracy-disabled subjects had failed to achieve reliable age-appropriate word recognition skills. Rate-disabled readers were age-appropriate in word recognition accuracy but deficient in reading speed. These disabled readers were compared to fluent normal children selected to be reading at the same level of accuracy as the rate disabled subjects but at a significantly faster rate. All aspects of the accuracy disabled subjects' reading systems proved deficient, and these children were less able to learn new sound-symbol associations in a task simulating initial reading acquisition. The rate-disabled subjects exhibited a basic deficit in word recognition speed, compromised accuracy when reading in context, and compromised spelling when competing visual patterns were available. A multidimensional oral language impairment was found to accompany the accuracy disability, while the rate disability appeared restricted to language in its visible form and the naming of visual representations. A visual naming speed impairment was associated with both profiles of deficient reading skill. PMID- 3816347 TI - The impact of timing of puberty on psychosomatic symptoms among fourteen- to sixteen-year-old Finnish girls. AB - All eighth-grade pupils of secondary schools in a Finnish town completed questionnaires 3 times during a 17-month follow-up. A total of 935 girls were included in the study. The mean age of the girls at the start of the study was 14.5 years. The results showed that there were differences in psychosomatic symptoms, dating, and alcohol use by age of menarche. However, the results suggested that the differences by age of menarche were largely associated with pubertal development as such. After controlling for time since menarche, the impact of timing on psychosomatic symptoms was demonstrated only at the beginning of the study, not later. Differences in behavior also seemed to be related to pubertal development rather than timing. Differences in symptoms by age of menarche remained after controlling for dating and alcohol use. PMID- 3816348 TI - Single parents, stepparents, and the susceptibility of adolescents to antisocial peer pressure. AB - According to a recent report, adolescents living in single-parent households are more likely to engage in deviant activity than are youngsters living with both natural parents, or in single-parent, extended households, allegedly because the presence of an additional adult provides greater control of youngsters' behavior. In the present study, fifth, sixth, eighth, and ninth graders from 1 of 3 family structures (both natural parents, mother alone, or 1 natural parent and a stepparent) were compared with respect to their susceptibility to peer pressure to engage in deviant activity. All comparisons controlled for sex, age, socioeconomic status, maternal employment, and patterns of family decision making. Youngsters living with both natural parents were less susceptible to pressure from their friends to engage in deviant behavior than youngsters living in other family structures. More important, youngsters growing up in stepfamilies -in the presence of an additional adult--were equally at risk for involvement in deviant behavior as were their peers growing up in single-parent households. PMID- 3816349 TI - A life-span study of the interaction of selectivity and knowledge in memory. AB - Preschool children, young adults, and old adults viewed a series of familiar scenes and were asked to remember 1 item from each. The incidental memory of both children and old adults was less accurate than that of young adults. The result for children contrasts with the typical result of selective memorization research. Memory for high-expectancy items exceeded that for low-expectancy items by a greater margin when items were incidental, suggesting that even preschool children activate scene schemas during encoding. Only the young adults, however, showed the predicted tendency to recognize low-expectancy items better than high expectancy items when items were intentional. These results may be reconcilable if some, but not all, schema-mediated encoding effects on memory depend on strategic encoding. PMID- 3816350 TI - Drug use and personality in adolescence and young adulthood: structural models with nonnormal variables. AB - An introduction to structural modeling with nonnormal continuous variables is provided using the equations language of the micro-mainframe program EQS in the context of a longitudinal study of adolescent development that followed about 700 adolescents across an 8-year span into young adulthood. 2 models relating drug use and personality are developed to assess the influence of drug use on personality, and personality on drug use. A high level of self-acceptance is shown to have a small but significant inoculating effect against subsequent cannabis use in both early and late adolescence, while a small positive effect of cannabis use on subsequent self-acceptance occurs only during early adolescence. Substantial stability of self-derogation, cannabis use, and law abidance are demonstrated, with self-derogation during adolescence leading to increased law abidance during young adulthood. PMID- 3816351 TI - Taking account of time lags in causal models. AB - Although it takes time for a cause to exert an effect, causal models often fail to allow adequately for time lags. In particular, causal models that contain cross-sectional relations (i.e., relations between values of 2 variables at the same time) are unsatisfactory because they omit the values of variables at prior times, they omit effects that variables can have on themselves, and they fail to specify the length of the causal interval that is being studied. These omissions can produce severe biases in estimates of the size of causal effects. Longitudinal models also can fail to take account of time lags properly, and this too can lead to severely biased estimates. The discussion illustrates the biases that can occur in both cross-sectional and longitudinal models, introduces the latent longitudinal approach to causal modeling, and shows how latent longitudinal models can be used to reduce bias by taking account of time lags even when data are available for only 1 point in time. PMID- 3816352 TI - Beyond autoregressive models: some implications of the trait-state distinction for the structural modeling of developmental change. AB - The use of structural modeling techniques to fit change concepts, including developmental ones, to repeated-measurements data has been rather firmly but uncritically wedded to autoregressive model specifications. The uncritical application of an autoregressive specification to repeated measures does not take into account subtleties of conceptions of stability and change (e.g., the trait state distinction) that are now recognized in the behavioral research literature. We review the basic distinction between trait and state and examine the implications of the different possibilities for modeling developmental phenomena. The arguments are illustrated with empirical examples. PMID- 3816353 TI - Abnormal in vitro immunoglobulin synthesis of lymphocytes and increased circulating immune complex in patients with ankylosing spondylitis. AB - To explore the immunopathogenetic mechanisms of hypergammaglobulinemia in ankylosing spondylitis (AS), the functions of B cell, helper T (OKT4) cell and suppressor T (OKT8) cell were examined, by using the co-cultivation technique for in vitro immunoglobulin biosynthesis, in 7 patients with active AS, 7 with inactive AS and 14 normal controls. Circulating immune complexes (CIC) in those subjects were also measured by a solid phase C1q binding assay. After B, OKT4 and OKT8 cells were separated from the heparinized peripheral blood, coculture of these cells which were either from the same patient, the same normal control, or their combination was carried out. The in vitro synthesized immunoglobulins were measured by a rate nephelometer (Immuno-chemistry system, analyzer II). The results were: In patients with active AS, the amounts of IgG and IgA synthesized by co-cultured B and T4 cells from patients (p) and T8 from the normal (n) were significantly higher than those of the normal controls; In patients with inactive AS, the amounts of IgG and IgA produced by co-cultured Bp + T4p + T8n, Bp + T4n + T8n, Bn + T4n + T8p, and Bn + T4p + T8p were significantly higher than those for the respective normal controls; The CIC in active AS was elevated significantly over that in the normal controls. These results suggest that in patients of AS, B cells and helper T cells are hyperactive, while suppressor T cells are depressed. The abnormal function of lymphocytes may cause elevated concentrations of immunoglobulins and CIC in the serum. PMID- 3816354 TI - Head-space gas-liquid chromatographic analysis for presumptive identification of bacteria in blood cultures. AB - A total of 445 strains of common aerobic and anaerobic bacteria were analyzed for their volatile microbial metabolites by head-space gas-liquid chromatography. The bacteria were incubated for 24 or 48 h in blood-containing Trypticase soy or Lombard-Dowell glucose broth before being analyzed by automatic head-space injection. From the chromatographic pattern obtained, the majority of Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Escherichia coli, Pseudomonas aeruginosa, Morganella morganii, Staphylococcus aureus, enterococci, Bacteroides fragilis, Fusobacterium nucleatum and Propionibacterium acnes could be characterized. The head-space technique developed provides a rapid, direct and easily-performed means for presumptive identification of bacteria found in blood culture. PMID- 3816355 TI - Serum immunoglobulins, complements and circulating immune complexes in oral lichen planus. AB - Serum IgG, IgM, IgA, C3, C4 concentrations and circulating immune complexes (CIC) were measured in a series of 46 patients with oral lichen planus (LP). This investigation revealed a significant increase in the level of serum IgG in patients with oral LP as compared with 36 healthy subjects. In erosive LP, serum IgM was also elevated as compared with healthy subjects and patients with the non erosive type. The results of this study did not support the suggestion that a humoral immunodeficiency underlies oral LP. Elevated serum level of IgM may be considered to represent secondary oral infection during mucosal erosion. The study also demonstrated a significant reduction in serum C4 in both variants of oral LP, but the C3 level was normal. A 3% polyethylene glycol precipitation (PEG ppt) method was used, no significant amount of CIC could be detected in the patients. It is tempting to speculate that oral LP reflects an immunologic disorder in which serum IgG and C4 is disturbed. However, further investigation is needed to clarify the pathogenesis of oral LP. PMID- 3816356 TI - Protein enrichment of sugar beet residue with the inoculation of conidia of Trichoderma album by solid state fermentation. AB - Cellulosic material was inoculated with Trichoderma album by solid state fermentation and the change of protein, total nitrogen, mineral nitrogen, cellulose and total fiber contents of raw material were measured. It was found that the water holding capacity and bulk density of substrate increased as the fermentation progressed. The optimum C/N ratio for the conidia production was between 4 and 7, and the optimum pH was around 5. The protein enrichment of sugar beet residue were the best at the initial moisture content 76%, initial pH 4.5 and supplement with 1% nitrogen. After 4 days fermentation, the final product contained 22% of protein. From the present state of technological development, the protein enrichment of cellulosic materials by solid state fermentation proved to be valuable. PMID- 3816357 TI - Characterization of hepatitis B e antigen from human breast milk. AB - Hepatitis B e antigen (HBeAg) but not surface antigen (HBsAg) was detected in 20% of the milk samples taken from HBsAg carrier mothers by radioimmunoassay. The density of milk e antigen particles was peaked at 1.32 g/ml in CsCl gradient ultracentrifugation. HBeAg was found in 1.33 M and 3.24 M (NH4) 2SO4 precipitates from breast milk but neither of HBeAg in both precipitates showed exactly identical with serum-derived e antigen. Five bands of polypeptides with molecular weight of 8,000, 21,500, 37,000, 53,000 and 68,000 daltons were seen after polyacrylamide gel electrophoresis from the milk e antigen. In addition, the IgA was shown significantly high in HBeAg positive milk. PMID- 3816358 TI - Blood spot on chromatography paper (DE 81) for detection of hepatitis B virus surface antigen (HBsAg). PMID- 3816359 TI - Effects of exogenous fat emulsion (Intralipid) on chemotactic function of monocytes and polymorphonuclear cells in sepsis. AB - Effects of exogenous fat emulsion (Intralipid) on the chemotactic function of monocytes and polymorphonuclear (PMN) cells were studied in vivo with rats. Abdominal sepsis was induced in Sprague Dawley rats by cecal ligation and puncture. Following a bolus infusion of the fat emulsion or saline, chemotactic function of monocytes and PMN cells was evaluated in animals divided into the following four groups: Group I, non-septic rats receiving saline infusion (NS-S); Group II, non-septic rats receiving the fat emulsion (NS-F); Group III, septic rats receiving saline (S-S); Group IV, septic rats receiving the fat emulsion (S F). Results of the study revealed that monocyte function was suppressed by the sepsis, whether saline or the fat emulsion was infused, and administration of the fat emulsion resulted in suppression of monocyte chemotaxis both in the non septic and the septic rats. Although in this study chemotactic function of PMN cells was not significantly suppressed by the sepsis, administration of the fat emulsion again led to a suppression of PMN cell function, in both the non-septic and the septic rats. Results of the study confirmed that administration of an exogenous fat emulsion may suppress the chemotactic function of the monocytes and PMN cells and, in the presence of severe sepsis, infusion of the fat emulsion may lead to a further deterioration of immunologic function of the host. Special care, therefore, should be taken against the use of exogenous fat emulsion in septic individuals or in those at risk of infection. PMID- 3816360 TI - Studies of natural killer cell activity. I. Normal range of a natural killer cell activity in the healthy Chinese. AB - This study was undertaken to establish a normal distribution curve for natural killer (NK) cell activity in healthy Chinese. NK cell activity was detected in 123 persons of different age groups, from the newborn to 84 years of age. None had any reported infection. The mononuclear cells were obtained from peripheral blood and cord blood for NK test; K562 cells were used as target cells to assay NK cell activity. The results indicated that cord blood had the lower NK cell activity. Increasing NK cell activity was seen with increasing age. In the 20 year to 49 year range, the NK cell activity reached maximal value. The NK cell activity gradually decreased when the age was greater than 50 years. PMID- 3816361 TI - Comparative study of the biotype, hemolysin-producing capability and antibiogram of the aquatic and the clinical strains of Aeromonas hydrophila. AB - One hundred and seventy-two Aeromonas hydrophila strains were isolated from aquatic hosts including fish, turtle, frogs, shellfish and water itself. The aquatic organisms were compared with 45 clinical strains with regard to biotype, hemolysin, and antibiogram. The carrier rate of A. hydrophila in the aquatic environment was 61.7%. Of the aquatic strains 51% were hemolysin producers, equivalent to a capability for producing enterotoxin. The hemolysin-producing capability of aquatic strains was not significantly different from that of the clinical strains. The main code numbers or biotypes of aquatic strains were 3265 (29.4%), 3065 (17.5%), 7065 (9.6%), 7265, 3225 (each 8.5%). The main code number or biotypes of clinical strains were 3265 (36.1%), 3065 (9.8%), 7261 (6.6%), 2265, 3261 and 6241 (each 4.9%). Analysis of the antibiotic susceptibility pattern of both aquatic and clinical A. hydrophila strains using the microbroth dilution method showed that there is no significant difference in antibiotic susceptibility. Most aquatic and clinical strains were highly susceptible to tobramycin, gentamicin, amikacin, cefuroxime, piperacillin, cefotaxime and cefoperazone. Most strains of aquatic A. hydrophila were highly susceptible to cefamandole and chloramphenicol; however, clinical strains were only moderately susceptible to the same drugs. Most aquatic and clinical strains were highly resistant to ampicillin, and moderately resistant to sulbenicillin. Clinical strains were moderately resistant to cephapirin; however, aquatic strains were moderately susceptible to cephapirin. Based on the above findings, we may considered aquatic environment be, at least partially, the source of clinical strains. Furthermore, biotypes of aquatic A. hydrophila do not correspond to antibiogram or hemolysin-producing patterns. PMID- 3816362 TI - [The screening of rubella virus IgG antibody in Kaohsiung area women of successive age groups]. AB - In this study, 961 females subjects were observed and their serum Rubella virus IgG antibody was analyzed by the ELISA method (Abbott Rubazyme commercial kit). The sample included 457 students from junior high school, senior high school and college; 144 female hospital workers; and 360 females 16 weeks or less pregnant. The number of positive results was 605 (63.0%). The positive rate increased when age increased: 29.1% (32/110) for ages 12-14; 52.3% (101/193) for ages 15-19; 61.6% (98/159) for ages 20-24; 68.7% (57/83) for ages 25-29 and 78.6% (44/56) ages above 30. The study also found a positive rate of 29.6% (37/125) in junior high school students, 52.7% (79/150) in senior high school students and 62.6% (114/182) in college students; The mean positive rate for the student group is 50.3% (230/457). The positive rate in the female hospital workers group is 71.5% (103/144). The positive rate for the pregnant women is 75.8% (273/360) the highest among these three groupings. The difference in positive rate between the student group and female hospital workers group or between the student group and the pregnant women's group is statistically significant (p less than 0.001). This study found that, among females whose ages are between 20-30 or who are pregnant, only 67.5% (166/246) had been infected by Rubella virus and had Rubella virus IgG antibody. From the epidemiological stand-point, it is worthwhile to screen those female's serum Rubella virus IgG antibody to give them Rubella vaccination if they test negative before marriage. PMID- 3816363 TI - [Isolation and purification of bovine retina S-antigen]. AB - Fresh bovine retinas were precipitated by ammonium sulfate, and further purified by the Sephadex G-200 column and the hydroxyapatite column. Through the SDS polyacrylamide gel electrophoresis and the isoelectric focusing gel electrophoresis, a single band of protein with molecular weight of 50,000 daltons, isoelectric point at 5.4-5.7, was identified as S-antigen. The yield of S-antigen from crude retina extract was 0.18%, higher than ever been reported. Guinea pigs were injected at the hind footpad with 5-30 micrograms of purified S antigen which had been emulsified with an equal amount of complete Freund's adjuvant. There are severe uveitis findings in both clinical and pathological examinations. An experimental autoimmune uveitis animal model was successfully established. These results showed that it is an effective and rapid method for purification of retinal S-antigen. PMID- 3816364 TI - [Comparison of plaque reduction and active mouse protection tests for estimating the potency of Japanese encephalitis vaccine]. AB - The plaque reduction test for assaying the potency of Japanese encephalitis vaccine was evaluated by comparing with the active mouse protection test. The relative potency of tested vaccine to the standard vaccine were 1.40 +/- 0.250 by the plaque reduction test with coefficient variation of 0.179 and 2.54 +/- 1.152 by the active mouse protection test with coefficient variation of 0.454. There was no significant difference between the plaque reduction and the active mouse protection test in term of relative potency, but the plaque reduction method had a better reproducibility. Furthermore, the plaque reduction method showed a higher sensitivity and time saving. PMID- 3816365 TI - [Epidemic dengue 2 on Liouchyou Shiang, Pingtung County in 1981]. AB - During the summer of 1981, an outbreak of dengue occurred on Liouchyou Shiang, an islet about 15 km. southwest of Taiwan. More than 12, 500 people, approximately 80% of the inhabitants, were estimated to be affected in this epidemic which had been the first dengue outbreak in Taiwan since 1945. Neither shock nor fatal case was found. The epidemic subsided in October and there was no confirmed dengue case in Taiwan from 1982 to 1985. All the 21 virus strains isolated from the blood of patients were now identified as type 2 dengue virus and believed to be the first isolation in Taiwan. The pathogen was probably introduced from the Philippines. PMID- 3816366 TI - Antiplatelet antibody determination using platelet factor 3 assay in thrombocytopenic patients. AB - Platelet factor 3 assay was used to detect antiplatelet antibodies in thrombocytopenic patients with platelet count less than 100,000/cu.mm. A total of 121 specimens was tested. The results gave a positive rate of 83% (61/74) for idiopathic (immune) thrombocytopenic purpura (ITP), 67% for systemic lupus erythematosus (SLE) and 54% (15/28) for others with & 13% (2/16) without history of blood components therapy. The sera from SLE without thrombocytopenic were also checked for the antibody, and a 14% positive rate was obtained. Patients with ITP with complete remission and normal platelet count were 40% positive. Antiplatelet antibody determination by platelet factor 3 assay is a sensitive and reproducible method. It can be performed in most laboratories and requires no specific equipment. PMID- 3816367 TI - [Clinical and immunological observations in myotonia]. AB - Nine patients of myotonia, 5 being myotonia dystrophica and others being myotonia congenita, were studied for their clinical manifestations and immunological function. In the cases of myotonia dystrophica, they were inherited as autosomal dominant trait; the mean age onset was 17 years. Myotonia dystrophica was a diffuse systemic disorder. In addition to myotonia, there were muscle wasting, hatchet face, frontal baldness, pseudohypertrophy, etc. In the cases of myotonia congenita, none of the parents of the patients has clinical symptoms. The mean age onset was 8 years. The disease involved mainly the skeletal muscle. The immunological functions were studied in 7 patients, including 5 myotonia dystrophica and 2 myotonia congenita. In either myotonia dystrophica or myotonia congenita, the immunological functions were impaired widely, both humoral and cellular immunity. The level of serum IgG was lowered in both diseases. PMID- 3816368 TI - [Measurements of IgG and albumin in CSF and serum in various neurological diseases]. AB - Many neurological diseases may cause increase of protein in the cerebrospinal fluid (CSF), especially IgG. Breakdown of blood brain barrier (BBB) as well as increased de novo central nervous system (CNS) IgG synthesis may result in an elevation of IgG in the CSF. To assume that the increase of CSF IgG was due to local synthesis but not to BBB damage, Link and others suggested using a more refined quotient, i.e. the IgG index. However, for evaluating local IgG synthesis, the following equation was used (modified from Tourtellotte) de novo CNS IgG synthesis II = [(C. IgG-S.IgG/278.7)-(C.Alb-S.Alb/143.1) X (S. IgG/S. Alb) X 0.43] X 5. In this study we collected 62 cases of various neurological diseases and used the nephelometer to measure their IgG and albumin level in both sera and CSF. There were 4 cases of encephalitis, 17 cases of meningitis, 16 cases of multiple sclerosis, 11 cases of other neurological diseases and 14 cases of control group. The mean value of CSF IgG was 4.1 mg/dl in control group, 21.1 in encephalitis, 11.3 in meningitis, 4.7 in multiple sclerosis and 12.9 in other neurological diseases. The mean value of IgG index was 0.52 in control group, 1.43 in encephalitis, 1.07 in meningitis, 0.68 in multiple sclerosis and 1.11 in other neurological diseases. The mean value of modified de novo CNS IgG synthesis was -0.35 mg/day in control group, 48.79 in encephalitis, 25.48 in meningitis, 6.59 in multiple sclerosis and 15.01 in other neurological diseases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816369 TI - Immunophenotyping of myeloma cells with immunoalkaline phosphatase technique. AB - An immunoalkaline phosphatase (IAP) technique was used to determine the class of cytoplasmic immunoglobulin presenting in the malignant plasma cells of patients with multiple myeloma. Using monoclonal antibodies against different human immunoglobulins (Igs) as the primary antibodies, and calf intestinal phosphatase as the enzymatic indicator. The presence of monoclonal immunoglobulin was demonstrated within the cytoplasm of malignant plasma cells. These results correlate well with the electrophoretic patterns of the Igs present in the serum samples of these patients. This IAP technique is suggested as a practical method for evaluating the immunophenotype of multiple myeloma. PMID- 3816370 TI - [Isolation and partial characterization of allergen from Bermuda grass pollen]. AB - Allergens of bermuda grass pollen extract have been studied and identified. Immunoblotting studies revealed that at least 12 SDS-denatured polypeptide showed IgE-binding activity. Molecular weight was estimated between 10,000 to 90,000 daltons. An allergenic component was isolated by a combination of ion exchange chromatography and gel filtration chromatography. The allergen preparation was shown to be homogeneous by PAGE and SDS-PAGE studies. Allergen was found to be an acidic protein with a molecular size of the order of 16,300 daltons. Ultraviolet spectrum scanning showed weak absorption at 280 nm. Amino acid analysis revealed that the purified allergen contained no tyrosine, proline and cysteine residues but contained a high percentage of glutamic acid and aspartic acid residues. The results of amino analysis indicate that tyrosine, proline and cysteine residues are not involved in the allergenic determinant site. PMID- 3816371 TI - [Fatal septicemia due to Chromobacterium violaceum]. AB - A 2-year old boy was suffered from an infection caused by Chromobacterium violaceum. This is the first case of C. violaceum infection reported in Taiwan. The boy was treated with chloramphenicol and gentamicin but died after one month of illness due to the incooperation of patient's family. The causative agent was isolated from patient's blood and scar. Complete bacteriologic characteristics and antimicrobial susceptibility pattern of this isolate are reported. PMID- 3816372 TI - Isolation and characterization of Yersinia enterocolitica in Taipei. AB - Of 187 food samples analyzed, 3(1.6%) displayed the presence of Yersinia enterocolitica. All of them were isolated from frozen food samples. Two strains were isolated from 21 sliced beef samples (9.5%), and were identified as serotype O5. One strain was isolated from 20 egg dumpling samples (5%), and was typed as serotype O9. No Y. enterocolitica was found in refrigerated food samples. In addition to serotypes O5 and O9, serotypes O3 and O8 were also identified for other local strains that were included in this study. Three different biotypes have been determined for these strains according to Wauter's schema. Most of the strains tested for their antimicrobial susceptibility were resistance to carbenicillin, ampicillin and cephalothin, and all were susceptible to aminoglycosides, tetracycline, nalidixic acid, chloramphenicol, and sulfamethoxazole-trimethoprim. Five out of 7 strains carried plasmids, but these plasmids may not code for drug resistance. PMID- 3816373 TI - [The prevalence of Paragonimus westermani in Taipei County]. AB - Paragonimus westermani is an endemic disease and has had scattered distribution in Northern Taiwan for the long period of 108 years. In order to know the current status of the prevalence of this disease in Taipei County, an investigation by means of examination of snail, crab and stool for identification of cercariae, metacercariae and ova of Paragonimus westermani was carried out in five small highly endemic foci-Alilao, Shengkeng, Shuangchi, Shihjen and Taiping from July 1984 to June 1985. The results obtained are summarized as follows: The infection rate for 17, 412 fresh-water snails, Semisulcospira libertina, the first intermediate host and for 180 fresh-water crabs, Eriocheir japoniucs, the second intermediate host was both negative in the first four places. On the contrary, the rate for 879 fresh-water snails, Semisulcospira libertina, for 298 fresh water crabs, Potamon miyazaki and Potamon dehaani and for 45 school-children was zero, 26.8% and zero respectively, in the last one. Based on the above findings, it is concluded that in the last 20 years, Paragonimus westermani might probably be under control in the former areas which are now developed districts. This development has probably influenced the prevalence and distribution of the disease. But it is still prevalent in the latter area located in remote undeveloped mountain. PMID- 3816374 TI - [Parasites detected in patients at the Veterans General Hospital in 1985]. PMID- 3816375 TI - [Exchanging intervertebral disks. The concept and clinical experience using a cement-free intervertebral disk endoprosthesis of the "Charite Modular SB" type]. PMID- 3816376 TI - [15 years' experience in the surgical treatment of scoliosis using a Harrington distractor]. PMID- 3816377 TI - [Locomotive capacity of patients after injuries of the cervical segment of the spinal cord]. PMID- 3816378 TI - [Evaluation of the endurance of the hip joint based on a calculation model]. PMID- 3816379 TI - [Pathomorphology of femur head "cysts" with advanced degenerative-deforming changes]. PMID- 3816380 TI - [Thromboembolic complications after endoprosthesis of the hip joint]. PMID- 3816381 TI - [Our method of functional treatment of compound and complicated fractures of the femur shaft]. PMID- 3816382 TI - [Treatment and subsequent management of tibial fractures using the Sarmiento method]. PMID- 3816383 TI - [Effect of various preoperative risk factors on wound healing in surgery of the locomotor system]. PMID- 3816384 TI - [Remote results of surgical treatment of inveterate dislocations of the acromioclavicular joint]. PMID- 3816385 TI - [Functional and radiologic evaluation of the shoulder joint after joint stabilizing procedures in habitual dislocation]. PMID- 3816386 TI - [Fractures of the distal epiphysis of the humerus in adults]. PMID- 3816387 TI - [Use of a fascio-cutaneous flap transplanted from the forearm in the reconstruction of hand tissues]. PMID- 3816388 TI - [Entrapment and cystic degeneration of the adventitia as a cause of occlusion of the popliteal artery]. AB - The entrapment syndrome and the cystic adventitial degeneration of the popliteal artery are diseases affecting relative young patients. Four cases of entrapment and one case of cystic degeneration are demonstrated. In one patient also an entrapment of the popliteal vein is demonstrated. In all patients the outcome of vascular reconstruction was good. For the entrapment syndrome the posterior approach is prefered. PMID- 3816390 TI - [Vein doubling for vascular access in hemodialysis]. PMID- 3816389 TI - [Barium peritonitis in animal experiments (rat, dog)]. AB - Barium sulfate-contrast medium was instilled into the peritoneal cavity of three rats and three dogs and thus a (aseptic) barium peritonitis was induced. The experiments show that barium sulfate here causes not only local reaction but important is its general deleterious effect dependent on its quantity. This is not widely appreciated, yet seems to be an intoxication. Barium sulfate-medium only may be considered non toxic as long as staying in the intestinal tract. PMID- 3816391 TI - [Aneurysm of the hepatic artery--pathogenesis and clinical aspects]. PMID- 3816392 TI - [Placental estrogen and progesterone receptors in relation to gestational stage]. PMID- 3816393 TI - [Effect of determination of lactate dehydrogenase and its isoenzymes on monitoring high-risk pregnancy]. PMID- 3816394 TI - [Preliminary observation on the hemostatic function in pregnancy-induced hypertension]. PMID- 3816395 TI - [An analysis of gravidograms of 3,278 cases]. PMID- 3816396 TI - [Histological changes in the ripening of the uterine cervix during pregnancy]. PMID- 3816397 TI - [Pathological study on 64 placentae of perinatal death]. PMID- 3816398 TI - [A seroepidemiological survey for toxoplasmosis among pregnant women and their offspring in Beijing]. PMID- 3816399 TI - [Analysis of chromosome karyotypes in 210 couples with repeated spontaneous abortions]. PMID- 3816400 TI - [Therapeutic artificial insemination]. PMID- 3816401 TI - [Assay of leucocyte adherence inhibition in patients with ovarian cancer]. PMID- 3816402 TI - [The methods and clinical analysis of induction of labor]. PMID- 3816403 TI - [Morphometric analysis of the endometrium in the proliferative phase]. PMID- 3816404 TI - Diurnal variations of performance and information processing. AB - The aim of the study was to establish whether performance of a task in which controlled search is required fluctuates during the day or, on the other hand, performance of a task in which the automatic detection is required does not fluctuate during the day. The material and the procedure for setting the subject with an automatic detection set and for controlled search were determined as experimental paradigms and based on the results of the studies published by Shiffrin and Schneider. Eighteen volunteers from first and second year students of Psychology (9 boys and 9 girls) took part in the study. The study was done in January and February 1985 in the Laboratory of experimental psychology of Tours (France) on Tuesdays, Thursdays and Fridays. Each subject individually participated in 4 sessions on the same day, at 08(30); 11(45); 13(45) and 17(00). The results indicate that the performances (number of the targets correctly detected and the reaction time) only fluctuate in the course of the day when the controlled search is required. We suggest that the independence or the dependence of performance variation may be linked to the use of one or another of the two information processes described by Shiffrin and Schneider: controlled search and automatic detection. PMID- 3816405 TI - Chronobiologic lead study cost-effectively assesses circadian-circaseptan intermodulation in murine pineal melatonin content. AB - The investment into the design of a study is usually and unfortunately proportional to the available information, i.e. the less one knows the more one is tempted to skimp and perform a minimal 'pilot' study. This is particularly true with respect to chronobiology. On the contrary, at the outset of a study, when the information available regarding a given problem is minimal or zero, the investment into a first study should be near-maximal. Accordingly, the often wasted 'pilot study' should be replaced by a rigorous chronobiologic lead study. The promise of such a chronobiologic 'guide, leading along a difficult or unknown course' is illustrated by the validation with statistical significance of an about-weekly (circaseptan) and an about 24-h (circadian) rhythm in the melatonin content of the murine pineal. Work around the clock on 48 female Lewis/S rats was avoided. Replication of 6 different circadian times on different comparable animals on consecutive days assessed a circaseptan rhythm more prominent than the concomitantly demonstrated circadian, at no added cost for experimental animals beyond those often used for circadian study and with no work around the clock. PMID- 3816406 TI - More on the circadian melatonin rhythm in pineals from domesticated B6D2F1 mice. AB - For melatonin (a chronomodulator of adrenal cortical function, immune phenomena and carcinogenesis), a circadian rhythm is demonstrated in aqueous pineal homogenate of domesticated B6D2F1 mice. Domestication as such does not eliminate a mechanism of cephalo-adrenal coordination. PMID- 3816407 TI - Ultradian chronomodulation by melatonin of a Placebo effect upon human killer cell activity. AB - The effect of melatonin injection evaluated earlier with respect to placebo treated controls is reevaluated, also with reference to spontaneous changes in natural killer cell activity. This effect consists, first, of stimulation of natural killer cell activity over and above any changes brought about by placebo (saline). After 6 h, the melatonin effect appears to be an inhibition as compared to values from placebo-treated subjects, or no effect as compared to values from untreated subjects. In this case, amplification and attenuation of the placebo effect by melatonin are found within the relatively short span of 1/4 of a day, rather than within a day or a week. An ultradian 'feed-sideward' by melatonin may be aligned with the corresponding previously reported circadian and infradian chronomodulation. PMID- 3816408 TI - Murine circadian patterns of eating and drinking behaviors revisited: rhythmometric analyses and neuro-ethological comments. AB - This research dealt with rhythmometric methods for estimating the main circadian parameters characterizing the temporal structure of feeding activities in the mouse. Such experiments provide a quantitative approach for studying some neurobiological mechanisms regulating the feeding behaviors. These basic motivational manifestations would appear to be modulated by the circadian fluctuations of vigilance. PMID- 3816409 TI - Hardware and software for (and results from) chronobiologic approaches to cancer treatment and prevention. AB - Chronobiology, aided by modern automatic instrumentation for the monitoring of marker rhythms and the administration of complex therapeutic schedules on the one hand and, on the other hand, by appropriate software for data analysis, exploits the organism's time-structure along several frequency scales. Available evidence shows that several modes of treatment, namely radiotherapy, chemotherapy and immunotherapy, can all be improved by timing. Even more important is the mapping of rhythms in health, for a comparison of rhythm characteristics between individuals at low or high risk with respect to a given disease; it may ultimately lead to a rational chronobiologic approach to cancer prevention. PMID- 3816410 TI - Antidepressants and receptor function. PMID- 3816411 TI - Adrenergic and serotonergic receptor responsiveness in depression. AB - Preliminary results are presented from a series of studies designed to characterize the regulation of release/metabolism and receptor responsiveness in the noradrenergic and serotonergic systems in acutely depressed patients and depressed patients in remission. Abnormal regulation of noradrenaline release/metabolism might be expected to be associated with the acute state of depression, while abnormalities of adrenoceptor responsiveness were hypothesized to persist in remission. Growth hormone responses to clonidine were measured as indices partially reflecting alpha 2-adrenoceptor responsiveness. Blunted responses to clonidine were found in both acutely depressed patients and patients in remission. The possible implications of these findings for the pathophysiology of the noradrenergic system in depression are discussed. Prolactin responses to the serotonergic agonist and serotonin-releasing agent fenfluramine were evaluated in acutely depressed patients, patients in remission and controls. A subset of the depressed patients appeared to have blunted prolactin responses to fenfluramine. However, very preliminary results do not show any difference in this response between patients who were acutely ill and those in remission, although the variability in both groups was great. These and related findings are discussed in terms of a possible contributory role of the serotonergic system in depression. PMID- 3816412 TI - Antidepressant-binding sites in brain and platelets. AB - [3H]Imipramine and [3H]paroxetine label with high affinity a site associated with the serotonin transporter in brain and platelets. The maximum binding capacity (Bmax) of [3H]imipramine in platelets is reduced in untreated depressed patients, and it may represent a useful biological marker in depression. The existence of an endogenous ligand acting on the [3H]imipramine-recognition site to modulate the serotonin transporter has been proposed by several laboratories. 5 Methoxytryptoline inhibits [3H]imipramine binding and [3H]serotonin uptake in the nanomolar range. This compound has been reported to occur in the pineal gland, but probably only in trace amounts. While the physiological relevance of 5 methoxytryptoline or a close analogue remains an open question, the possibility exists that the 'endocoid' for the [3H]imipramine-recognition site plays a role in the pathogenesis of depression. PMID- 3816413 TI - Functions of the proteoglycans. PMID- 3816414 TI - Functions of the proteoglycans. Introduction. PMID- 3816415 TI - Proteoglycan-collagen interactions. AB - Among the most important events in connective tissue physiology are the nucleation, growth and calcification of collagen fibrils. It has been speculated that all are associated with, or even controlled by collagen-proteoglycan interactions. We therefore developed methods for investigating these associations in tissues, particularly for understanding their significance for type I collagen, the commonest form of collagen in the body, especially predominant in bone. Using an electron-dense dye, Cupromeronic blue, in the 'critical electrolyte concentration' mode, and digestion by hyaluronidase, chondroitinase ABC or keratanase, supported by biochemical analyses, we found that dermatan sulphate proteoglycan of soft connective tissue (skin, tendon, cornea) was regularly and orthogonally arrayed at the fibril surface, at the d or e band. Keratan sulphate proteoglycan in the cornea associates orthogonally at the a and c bands. Bone, demineralized by a non-aqueous technique which retains proteoglycans in the tissue, does not contain orthogonal arrays; the interfibrillar proteoglycan filaments are oriented parallel to the fibril axis. The main proteoglycan in bone is chondroitin sulphate-rich. There are thus four separate specific binding sites on type I collagen fibrils, each one associating with one particular proteoglycan, and apparently no other. This implies that there are two corresponding binding sites in each proteoglycan. Available evidence shows that there are two species of small dermatan sulphate and keratan sulphate proteoglycans. It is suggested that each species is specific for its own band (a, c, d or e). Hyaluronate and chondroitin sulphate are probably mainly interfibrillar, acting in a space-filling capacity. PMID- 3816416 TI - Functions of proteoglycans at the cell surface. AB - Proteoglycans (primarily heparan sulphate proteoglycans) are found at the surface of most adherent eukaryotic cells. Earlier studies suggest that these molecules can be associated with the cell surface principally by two different mechanisms. Proteoglycans may occur as membrane-intercalated glycoproteins, where the core protein of the proteoglycan is anchored in the lipid interior of the plasma membrane, or they may be bound via the polysaccharide components of the molecule to specific anchoring proteins present at the cell surface. A number of functions have been proposed for cell surface-associated proteoglycans, including: regulation of cell-substrate adhesion; regulation of cell proliferation; participation in the binding and uptake of extracellular components; and participation in the regulation of extracellular matrix formation. Evidence is discussed suggesting that the cell-associated heparan sulphate helps to connect the intracellular cytoskeleton to the extracellular matrix in focal adhesions. This evidence includes: the co-localization of actin and heparan sulphate proteoglycan during the process of cell spreading, and in isolated focal adhesions; biochemical analyses of a hydrophobic heparan sulphate proteoglycan from isolated focal adhesions; and the formation of focal adhesions on substrates made from isolated fibronectin fragments requires the presence of a heparan sulphate-binding site. PMID- 3816417 TI - Structure and function of basement membrane proteoglycans. AB - Basement membranes contain at least three different proteoglycans. These are a large, low buoyant density heparan sulphate proteoglycan and two smaller, high density proteoglycans with either heparan sulphate or chondroitin sulphate side chains. The large (Mr 400K-600K and small (Mr 130K) heparan sulphate proteoglycans were purified from the mouse EHS tumour. These proteoglycans are immunologically related by sharing some protein core antigenic determinants (epitopes) but do not cross-react with cell-surface heparan sulphate proteoglycans or with proteoglycans from interstitial connective tissue. This indicates that they belong to a distinct family of proteoglycans. Structural models were developed, based on electron microscopy and analytical ultracentrifugation, demonstrating that the small proteoglycan contains on average four heparan sulphate chains of about 30 nm in length, while the large proteoglycan consists of three long (about 90 nm) heparan sulphate chains connected to one end of a large core protein. Single heparan sulphate chains were isolated from the EHS tumour proteoglycans and from the corresponding proteoglycans from Reichert's membrane of the mouse embryo. The heparan sulphate from Reichert's membrane bound to antithrombin with high affinity and was found to contain the unique 3-O-sulphated glucosamine residue previously identified in the antithrombin-binding region of heparin. The EHS tumour heparan sulphate showed a higher N-/O-sulphate ratio and a lower affinity for antithrombin. PMID- 3816418 TI - Vascular cell proteoglycans: evidence for metabolic modulation. AB - Proteoglycans accumulate in the intimal layer of blood vessels during the early stages of atherosclerosis and predispose the vessel wall to further complications of this disease. Arterial endothelial and smooth muscle cell cultures have been used to study the metabolism of vessel wall proteoglycans in an attempt to determine whether cellular events associated with the genesis of this disease, such as cellular proliferation, ageing, migration and interaction with components of the extracellular matrix, influence the metabolism of arterial proteoglycans. Proteoglycan analyses of vascular cells reveal that endothelial cells synthesize multiple species of heparan sulphate proteoglycan while smooth muscle cells synthesize little heparan sulphate proteoglycan but significant quantities of chondroitin and dermatan sulphate proteoglycan. Each family of proteoglycans synthesized by each cell type differs with regard to charge density, hydrodynamic size, glycosaminoglycan type and size, oligosaccharide content and ability to form high molecular weight aggregates. A monoclonal antibody has been generated against the chondroitin sulphate proteoglycan and used to immunolocalize this antigen to the interstitial matrix of normal and diseased blood vessels. Experiments are presented to indicate that proteoglycan metabolism is modulated when cultured arterial cells are stimulated to proliferate and migrate. Other factors shown to influence proteoglycan metabolism include the age of the cell and the nature of the substratum upon which the cells are grown. These culture systems provide useful models with which to study the factors involved in the regulation of proteoglycan synthesis by vascular cells. PMID- 3816419 TI - Molecular cloning of proteoglycan core proteins. AB - Recombinant DNA methods have been used to analyse core proteins of two different proteoglycans, one from a rat yolk sac tumour and the other from human fibroblasts and fetal membrane tissue. The processed core protein of the yolk sac tumour proteoglycan is a 104-amino acid polypeptide. This polypeptide contains a 49-amino acid serine-glycine repeat which clearly serves as the chondroitin sulphate attachment region. Genomic and mRNA blots suggest that this core protein is a member of a multigene family the members of which share the Ser-Gly repeat. The fibroblast/fetal membrane proteoglycan has a 329-amino acid core protein which is also processed from a larger precursor. This core protein contains three individual Ser-Gly dipeptides, one of which is known to be substituted with a chondroitin/dermatan sulphate side-chain. The availability of proteoglycan cDNA clones will facilitate gene transfer studies aimed at identifying the recognition sequences for the addition of the glycosaminoglycan. Gene transfer should also allow studies on the effects of proteoglycan expression on cellular properties such as adhesion and tumorigenicity. PMID- 3816420 TI - Secretory granule proteoglycans of mast cells and natural killer cells. AB - Proteoglycan research on cells that participate in immune responses has progressed from the early novel finding that heparin proteoglycans are present in the secretory granules of the connective tissue mast cell to the more recent findings that mucosal mast cells and natural killer (NK) cells possess chondroitin sulphate proteoglycans in their granules. Characterization studies of these intracellular proteoglycans have revealed that they all possess peptide cores which are very resistant to proteolytic degradation. Their glycosaminoglycans, however, differ in such parameters as the type of hexosamine, location of sulphation degree of sulphation, or extent of epimerization of the uronic acid. Amino acid compositional analyses of heparin proteoglycans from rat connective tissue mast cells and chondroitin sulphate E proteoglycans from mouse mucosal mast cells indicate that their peptide cores are homologous to, but possibly distinct from one another. It is not yet known if these differences reflect a species variation, are due to different post-translational proteolytic processing, or are the result of expression of distinct genes coding for different peptide cores. The proteoglycans of mast cells and natural killer cells are packaged in the granules with cationic proteins. In mast cells these proteins have been shown to be serine proteases, and when bound to the acidic proteoglycans their enzymic activity is inhibited. Since the type of glycosaminoglycan linked to the proteoglycan has been found to be a characteristic of that cell, the structure of the cell-associated proteoglycan has become one of the markers used to distinguish cells phenotypically. By following the expression of different proteoglycans during differentiation, the relationship of the two subclasses of mast cells has been determined. PMID- 3816421 TI - Cartilage proteoglycans. AB - The structure of the protein core of the high molecular weight aggregating proteoglycan from pig laryngeal cartilage has been investigated. Mild trypsin digestion of proteoglycan aggregates released a large (Mr approximately equal to 150K) protein-rich fragment that contained the hyaluronate-binding region (Mr 66K). Rotary-shadowing electron microscopy of this preparation showed it to contain 'double globe' structures, similar to those seen with intact proteoglycans. Interaction studies and immunochemical evidence showed that one of the globular domains was the binding region. The second globular domain did not interact with hyaluronate or share any major antigenic determinants with the binding region and its function remains unknown. Further evidence from rotary shadowing also suggested that the protein core contained a third globular domain at the C-terminal end. The complete protein core sequence thus contains long folded globular protein regions, in addition to the extended regions bearing glycosaminoglycan chains. Studies of proteoglycan turnover in explants of pig articular cartilage showed that proteoglycan fragments were continuously released into the medium during culture. These included large non-aggregating proteoglycan fragments, free binding region and also link protein. Proteoglycans retained within the cartilage matrix remained intact and able to aggregate. Only in the presence of interleukin 1 was there evidence of more extensive proteolytic digestion. The results suggest normal turnover to be a conservative mechanism involving the selective cleavage of proteoglycan close to the hyaluronate-binding region. This releases the major glycosaminoglycan-bearing domain and enables it to diffuse out of the matrix. The site of the initial cleavage appears to be in the region of the N-terminal globular domains. PMID- 3816422 TI - Biological roles of dermatan sulphate proteoglycans. AB - Dermatan sulphate-containing proteoglycans (DS-PGs) are widely distributed in the extracellular matrix of skin, sclera, tendon, cartilage and a variety of other connective tissues. Two species of dermatan sulphate proteoglycans, called DS-PGI and DS-PGII, have recently been isolated from mature bovine articular cartilages. In their monomeric forms, both DS-PGI and DS-PGII are polydisperse, have relative molecular masses (Mr) ranging from 80K to 140K, and possess protein cores with apparent Mr values of approximately 45K. DS-PGI readily self-associates whereas DS-PGII does not. Polyclonal and monoclonal antibodies against DS-PGII do not react with DS-PGI. DS-PGI and DS-PGII appear to possess different core proteins and represent two different species of dermatan sulphate proteoglycans. DS-PGs have dramatic effects on the biological functions of cells. For example, they inhibit the capacity of fibroblasts to adhere to a fibronectin substratum. BALB/c 3T3 cells were labelled with [3H]thymidine and plated onto dishes coated with plasma fibronectin, plasma fibronectin plus chondroitin sulphate proteoglycan (CS PG, cartilage-specific proteoglycan monomer), or plasma fibronectin plus DS-PGs. In the absence of proteoglycan, approximately 55% of the cells were attached at 1 h. In the presence of CS-PG, cell attachment was slightly decreased. In the presence of DS-PGs, the adhesion of the fibroblasts to fibronectin was essentially abolished. Similar results were obtained if a plasma fibronectin substratum was preadsorbed with the DS-PGs and the DS-PGs were left in the attachment medium. PMID- 3816423 TI - Common structures of the core proteins of interstitial proteoglycans. AB - Connective tissues, with few exceptions, contain easily distinguishable large and small proteoglycans with chondroitin sulphate or dermatan sulphate side-chains. One group consists of the large aggregating proteoglycans that have the capacity to interact specifically with hyaluronate, thereby forming very large aggregates. These proteoglycans can be divided into two families which can be separated by electrophoresis. Preliminary results indicate that one of these may be derived from the other by processing in the extracellular matrix. Although most prominent in cartilage, similar proteoglycans are present in many types of tissue, such as aorta, sclera and tendon. Another population are the large non-aggregating proteoglycans, identified in cartilage. These proteoglycans show structural features partially different from any of the others. They may represent a distinct population of molecules present in many connective tissues. Many tissues contain major populations of small, non-aggregating proteoglycans. These can be divided into two major groups, differing in the composition of their core proteins, while having similar types of side-chain constituents. One group is represented by proteoglycans from nasal cartilage and aorta, while the other is represented by proteoglycans from tendon, bone, sclera and cornea. PMID- 3816424 TI - Biosynthesis and processing of proteodermatan sulphate. AB - The biosynthesis and processing of the small iduronic acid-rich proteodermatan sulphate (PDS) was studied in cultured human skin fibroblasts and arterial smooth muscle cells (SMC) with the aid of core-directed antibodies and various inhibitors of protein synthesis, intracellular transport, and glycosylation. Components of the linkage region became attached to the core protein most likely in a pre-Golgi compartment. Phosphorylation of PDS precursors also occurred in the endoplasmic reticulum with a minor contribution by the Golgi complex. Serine residues and the linkage region were identified as phosphorylated species in secreted PDS. Blockade of transport by monensin did not affect 6-sulphation but affected uronic acid epimerization and 4-sulphation. On relief from the monensin block, additional sulphation along the glycosaminoglycan chain was possible, whereas chain elongation was as in the continuous presence of the drug. Asparagine-bound oligosaccharides or glycosaminoglycan chains were not required for secretion of PDS or core protein. PDS from fibroblast and SMC secretions differed markedly in the composition of the glycosaminoglycan chains. No significant difference, however, was found on isoelectric focusing of core protein and after limited proteolysis of chondroitin ABC lyase-treated core protein. Tryptic and chymotryptic peptide maps of iodinated core proteins were similar. PMID- 3816425 TI - The properties and turnover of hyaluronan. AB - Hyaluronan (HA) was discovered over 50 years ago but its metabolism and cellular interactions have only recently received detailed attention. HA is synthesized in the plasma membrane by addition of monosaccharides to the reducing terminal. In tissues, it occurs bound to plasma membranes, aggregated with other macromolecules, or as free polysaccharide. Tissue HA enters the bloodstream in significant amounts through the lymph and is rapidly absorbed via a receptor into liver endothelial cells, where degradation follows. HA levels in serum are normally 10-100 micrograms/l, but can be elevated in cirrhosis, rheumatoid arthritis and scleroderma, due either to impaired hepatic uptake or to increased production. Studies on aqueous humour, middle ear secretion, amniotic fluid, lung lavage fluid, urine, skin diseases and cancer have identified other causes of deranged HA metabolism. HA can be visualized on some cell surfaces as a coating impermeable to particulate material. Specific HA binding occurs on lymphoma cell lines, lung macrophages and SV-3T3 cells but, except in synthesis or uptake, the significance of membrane-associated HA is incompletely understood. It has been reported to activate macrophages and granulocytes, protect cells, control cell migration, and cooperate with intercellular matrix in cell detachment; it also plays a central role in growth control, cellular differentiation and tissue morphogenesis. PMID- 3816426 TI - [Thoraco-abdominal aneurysmectomy using intra-aortic long-balloon occlusion technic]. PMID- 3816427 TI - [The Fogarty embolectomy catheter in the treatment of embolism of the aortic bifurcation and common iliac artery]. PMID- 3816428 TI - [Experience in the diagnosis and treatment of an abdominal saddle embolism]. PMID- 3816429 TI - [Free omental autotransplantation in the treatment of thromboangiitis obliterans of the upper extremity: report of 4 cases]. PMID- 3816430 TI - [Impedance plethysmography in the diagnosis of arterial disease of the lower extremity]. PMID- 3816431 TI - [An experimental study after abdominal aorta clamping in animals under normothermic conditions]. PMID- 3816432 TI - [Treatment of fracture-dislocation of the thoracolumbar spine with paraplegia by a prop-up instrument]. PMID- 3816433 TI - [Semilaminectomy and lateral-anterior decompression for an old injury of the thoraco-lumbar spine]. PMID- 3816434 TI - [Surgical treatment of late cases of traumatic paraplegia]. PMID- 3816435 TI - [Effects of hyperbaric oxygenation in experimental paraplegia]. PMID- 3816436 TI - [Changes in the somatosensory evoked potentials in injuries of the spinal and peripheral nerves]. PMID- 3816437 TI - [Comparative analysis of omental transplantation and STA-MCA anastomosis in the treatment of complete stroke]. PMID- 3816438 TI - [Clinical analysis of 20 patients with liquefied petroleum gas burns]. PMID- 3816439 TI - [Renal artery embolization with absolute ethanol and its application in renal carcinoma]. PMID- 3816440 TI - [Fournier's syndrome: report of 3 cases]. PMID- 3816441 TI - [Surgical management of foreign bodies in the gastrointestinal tract: report of 100 cases]. PMID- 3816442 TI - [Analysis of the results of extended parietal cell vagotomy for duodenal ulcer]. PMID- 3816443 TI - [Surgical management of postoperative alkaline reflux gastritis]. PMID- 3816444 TI - [Tracheal and bronchial cyst]. PMID- 3816445 TI - [Short-course acidification of gastric juice: a new method in preventing wound infection after esophageal and gastric operations]. PMID- 3816446 TI - [Reconstruction of the anal sphincter with a pedicled gluteus maximus muscle for carcinoma of the lower rectum and anal canal]. PMID- 3816447 TI - [Abdominoperineal resection and anosphincteroplasty in carcinoma of the lower rectum and anal canal]. PMID- 3816448 TI - [Results of modified right colectomy for carcinoma]. PMID- 3816449 TI - [Functional observation of the artificial anus by the colon-intussusception technic after Mile's operation]. PMID- 3816450 TI - [Rubber band ligation for the treatment of polyps in the sigmoid colon and rectum]. PMID- 3816451 TI - [Cryosurgical treatment of hemorrhoids with liquid nitrogen]. PMID- 3816452 TI - [Acquired preanal fistula in children]. PMID- 3816453 TI - [Surgical treatment of trigeminal neuralgia by post-auricular suboccipital approach]. PMID- 3816454 TI - [Clinical significance of urodynamic examinations in urethral injury and stricture]. PMID- 3816455 TI - [Testis homotransplantation: experimental and clinical study]. PMID- 3816456 TI - [Delayed hypersensitivity and levels of serum transferrin in burn patients and their clinical significance]. PMID- 3816457 TI - [Clinicopathological analysis of 263 cases of giant-cell tumor of the bone]. PMID- 3816458 TI - [Smith-Petersen nailing for nonunited fracture of the femoral neck]. PMID- 3816459 TI - [Treatment of acute obstructive suppurative cholangitis by PTCD]. PMID- 3816460 TI - [Postoperative recurrent peptic ulcer]. PMID- 3816461 TI - [A one-stage abdominal operation for complete prolapse of the rectum in adults]. PMID- 3816462 TI - [Operative bleeding tendency in patients with polycythemia in plateau regions]. PMID- 3816463 TI - [Evaluation of the muscular loop formed by semitendinosus and biceps femoris muscles in the treatment of deep vein valvular incompetence of the lower extremity]. PMID- 3816464 TI - [Use of microsurgery for re-establishing blood circulation in late thromboangiitis obliterans]. PMID- 3816465 TI - [Treatment of fracture of the femoral neck with closed multiple Steinman pin fixation: experimental study and clinical application]. PMID- 3816466 TI - [Biomechanical study and clinical application of transiliac lengthening]. PMID- 3816467 TI - [Resection and reconstruction of the carina of the trachea]. PMID- 3816468 TI - [Treatment of cancer of the upper esophagus by total esophagectomy and pharyngogastrostomy]. PMID- 3816469 TI - [Pulmonary contusions]. PMID- 3816470 TI - [Spontaneous rupture of the kidney: report of 8 cases]. PMID- 3816471 TI - [Experiences in using lumbodorso vertical incision]. PMID- 3816472 TI - [Repair of severe renal trauma]. PMID- 3816473 TI - [Acute traumatic posterior fossa hematomas]. PMID- 3816474 TI - [Total transthoracic extirpation of intraspinal neurinomas expanding into the postmediastinum]. PMID- 3816475 TI - [Comparative analysis in the treatment of cerebral ischemia in children and adult patients by extra-intracranial arterial anastomosis]. PMID- 3816476 TI - [Biomechanics of the pelvis and the design of pelvic prosthesis]. PMID- 3816477 TI - Secretin provocation in normal and duodenal ulcer subjects. Is the gastrin rise in Zollinger-Ellison syndrome paradoxic or exaggeration? AB - The secretin provocation test for gastrinoma is based on the premise that secretin decreases or has no effect on serum gastrin in normal and duodenal ulcer subjects while inducing a paradoxical rise in gastrinoma. We reexamined the serum gastrin response to pharmacologic amounts of secretin in normal volunteers (N = 17) and unoperated duodenal ulcer patients (N = 10). GIH secretin caused significant early gastrin rises from baseline in both groups (P less than 0.05). The gastrin response curves after secretin were not significantly different between normal and ulcer subjects. Similar gastrin rises were seen when synthetic secretin was administered to normal subjects (N = 6). In normal volunteers, intravenous bolus saline (N = 10) or amino acid (L-cysteine, N = 8) caused no change in serum gastrin from baseline. The gastrin response curves to GIH secretin and saline were significantly different (P less than 0.05). Our findings suggest that the gastrin rise in gastrinoma patients after secretin is an exaggeration of the normal response and not paradoxical. PMID- 3816478 TI - Evaluation of electrical potential difference across gastric mucosa in patients with chronic gastritis according to site, histology, and degree of inflammation. AB - The electrical potential difference (PD) of gastric mucosa was measured under direct endoscopic visualization in 39 patients. Seventy-six observations were made, 39 in fundic mucosa and 37 in the antral region. Biopsies taken from these areas allowed the identification of a control group and a gastritis group. The PD measurements of the control group were higher in the fundic mucosa (P less than 0.001) than in the antral region. In the gastritis group, PD measurements both in the fundic and antral regions were lower than those of the control group (P less than 0.01). However, in the gastritis group, PD measurements of the fundic region were still higher (P less than 0.01) than the PD of the antral region. The correlation coefficient of PD measurements versus the semiquantitative assessment of oxyntic and chief cells of the fundus was r = 0.49 (P less than 0.01). PMID- 3816479 TI - Interobserver agreement in the physical diagnosis of alcoholic liver disease. AB - Agreement among six physicians for 18 clinical signs in 50 alcoholic patients was prospectively studied. Twenty patients had alcoholic cirrhosis, 14 noncirrhotic alcoholic liver disease, and 16 alcoholics had no clinical or biochemical abnormalities. Agreement was assessed by kappa index for categorical variables and by intraclass correlation coefficient for the others. A good agreement was observed for ascites (r = 0.75) and splenomegaly (r = 0.75). It was fair for jaundice (r = 0.65), Dupuytren's contracture (r = 0.65), and vascular spiders (r = 0.64). However, it was poor for white nails (r = 0.27) and hepatic consistency (r = 0.11). Agreement was better among senior physician's than junior physicians. In order to assess which signs contributed to differentiate the three groups of patients, a stepwise discriminant analysis was realized; it identified three variables: vascular spiders (P less than 0.001), splenomegaly (P less than 0.001), and abdominal wall collateral veins (P less than 0.01). These results suggest that studies based on physical findings must be cautiously considered. PMID- 3816480 TI - Factors affecting methane production in humans. Gastrointestinal diseases and alterations of colonic flora. AB - Breath methane was studied in 394 subjects. Among 152 controls, 50.0% produced methane--42.1% of males and 57.9% of females. One hundred sixteen patients with gastrointestinal diseases were studied. Among 32 with Crohn's disease, only 2 (6.1%) produced methane, as well as 16 of 51 ulcerative colitis patients (31.4%) and 11 of 32 patients with the irritable bowel syndrome (34.4%). Breath methane is thus unusual in Crohn's disease. After bowel cleansing for colonoscopy or surgery, 15 of 18 methane producers became nonproducers, whereas after antibiotic treatment, 24 of 30 producers sustained their methane-producing status. After gentamycin and cephazolin therapy, methane production was abolished in three of eight patients. Slight spontaneous variations in methane production were also noticed with two of 23 control subjects, becoming nonproducers on restudy after 10-25 months. Thus gastrointestinal diseases, bowel cleansing and, to a much lesser degree, antibiotic therapy, affect methane production. PMID- 3816481 TI - Absence of hepatic extraction of gastric inhibitory polypeptide in conscious dogs. AB - Fractional hepatic extraction of gastric inhibitory polypeptide was examined in conscious unrestrained dogs with catheters in the portal vein, hepatic vein, and the carotid artery and Doppler flow probes on the portal vein and hepatic artery. Following a control period, endogenous gastric inhibitory polypeptide was stimulated by oral administration of glucose with and without prior infusion of atropine. In other experiments, gastric inhibitory polypeptide (20 ng/kg/min) was infused into the portal system in association with peripheral infusion of glucose. In none of these experiments was it possible to demonstrate any significant fractional hepatic extraction of gastric inhibitory polypeptide. PMID- 3816482 TI - Aging-associated increase in intestinal permeability to polyethylene glycol 900. AB - Effect of aging on the intestinal permeability to medium size [3H]polyethylene glycol (PEG 900) was examined in vivo by gavage and in vitro in intestinal everted sacs of rats ranging in age from 5 to 102 weeks. Rats were gavaged with PEG 900 solution and urinary recovery of PEG 900 was measured for 6 hr in order to assess its absorption. Young rats, 5-15 weeks of age, absorbed 1-1.3% of administered PEG 900. In contrast, rats 35-102 weeks of age absorbed 1.8-2.4% of administered PEG 900 (P less than 0.05 vs younger animals). The increased absorption of PEG 900 with aging is due to changes in intestinal permeability since the total uptake (serosal appearance + tissue uptake) of PEG 900 by jejunum, ileum, and colonic everted sacs was significantly higher (P less than 0.05) in older rats (100 weeks) than young rats (9 1/2 weeks), while urinary excretion of PEG 900 following intravenous injection was the same in the two age groups. These studies indicate that aging rats have diminished capacity to exclude larger size molecules from penetrating the intestinal mucosa. The diminished barrier functions of the small intestine with aging may allow antigenic or mutagenic compounds to reach the systemic circulation. PMID- 3816483 TI - Role of local motility changes in the pathogenesis of duodenal ulcers induced by cysteamine in rats. AB - The possible role of local motility in the pathogenesis of duodenal ulcers was investigated in rats using cysteamine. Duodenal motor activity was measured as intraluminal pressure recordings by means of a balloon positioned in the proximal duodenum. Subcutaneous administration of cysteamine (100 mg/kg) produced two linear bandlike lesions in the proximal duodenum within 6 hr. This dose of cysteamine significantly increased gastric acid secretion in acute fistula rats, and decreased duodenal HCO3- secretion caused by acid. During this period, this agent inhibited gastric motility but did produce markedly enhanced contractions in the duodenum. The changes in duodenal motility appeared within 5-10 min and were dose-dependent for cysteamine (10-100 mg/kg). Pretreatment with subcutaneously administered atropine (10 mg/kg), 16,16-dmPGE2 (30 micrograms/kg) or dopamine (10 or 30 mg/kg) significantly reduced the development of duodenal lesions caused by cysteamine, the inhibition being 86.8%, 49.7%, 54.5% or 67.8%, respectively. In the presence of cysteamine, dopamine had minimal effect on both acid and HCO3- secretion, while atropine or 16,16-dmPGE2 markedly inhibited acid secretion or increased HCO3- secretion, respectively. The enhanced duodenal motility induced by cysteamine was blocked partially by atropine and only slightly by 16,16-dmPGE2. Dopamine showed a dose-dependent inhibition on the duodenal hypermotility following cysteamine, and at 30 mg/kg almost completely abolished the development of contractions. These results suggest that abnormal hypermotility in the duodenum may be partly involved in the pathogenesis of cysteamine-induced duodenal ulcers. PMID- 3816485 TI - Transient gastroparesis associated with cutaneous herpes zoster. AB - We report a patient who developed delayed gastric emptying with vomiting and weight loss simultaneously with herpes zoster in the sixth right thoracic dermatome. Sequential radionuclide solid egg meal gastric emptying studies were used to document gastroparesis, the response to metoclopramide and its transient nature. We present a possible explanation for this phenomenon within the context of the known pathophysiology of varicella-zoster infection. PMID- 3816484 TI - Biochemical studies in peritoneal fluid from patients with acute pancreatitis. Relationship to etiology. AB - The levels of pancreatic digestive enzymes, lysosomal hydrolases, and protease inhibitors were evaluated in ascites fluid from 24 patients with acute pancreatitis diagnosed as alcoholic, gallstone-induced, or idiopathic. In this group the concentrations of amylase (354 +/- 98 ng/ml), immunoreactive cationic trypsinogen (1840 +/- 238 ng/ml), and immunoreactive elastase 2 (1492 +/- 262 ng/ml) were greatly elevated in comparison to the corresponding serum values. Enzyme levels in ascites from the idiopathic pancreatitis group tended to be higher than the levels from the other two groups. Activity of acid phosphatase and beta-glucuronidase was significantly higher in ascites compared to serum in all groups. On the other hand, levels of immunoreactive alpha 1-protease inhibitor and alpha 2-macroglobulin in ascites fluid were about half the average concentrations reported for normal serum. Significant amounts of tryptic amidase activity (61.7 +/- 13.7 micrograms/ml) were observed, indicating a trypsin-alpha 2-macroglobulin complex. These data indicate an imbalance in the protease-to inhibitor ratio in ascites fluid from patients with acute pancreatitis. Coupled with elevated ribonuclease activity (27.4 +/- 3.4 units), a positive methemalbumin test in 23 of 24 patients (1.1 +/- 0.4 mg hematin/100 ml), and an average protein concentration of 4.0 +/- 0.2 g/100 ml, these observations demonstrate that abdominal paracentesis and the biochemical analyses of ascites fluid provide useful information related to the biochemical events in acute pancreatitis and may be useful in the diagnosis of difficult cases, but their predictive value of severity remains to be established. PMID- 3816487 TI - Molecular organization of gallstones. PMID- 3816486 TI - Massive colonic dilatation as initial presentation of mesenteric vein thrombosis. AB - The case of a patient with primary mesenteric venous thrombosis presenting with massive dilatation of almost the entire colon is described. The differential diagnosis suggested by this presentation is briefly discussed with special attention to the diagnosis of acute colonic pseudoobstruction. Possible reasons for the atypical presentation of acute mesenteric venous thrombosis should, therefore, be considered in the differential diagnosis of all patients presenting with colonic distention and pseudoobstruction. PMID- 3816488 TI - Prolonged cholestasis and cimetidine. PMID- 3816489 TI - Gallstone ileus. PMID- 3816490 TI - Familial histories in ulcerative colitis. PMID- 3816491 TI - Indomethacin therapy in premature infants with patent ductus arteriosus and oliguria. AB - Simultaneous administration of one dose of indomethacin (0.3 mg/kg, i.v.) and furosemide (1 mg/kg, i.v.) was given to 8 consecutive premature infants who had patent ductus arteriosus (PDA), and oliguria because of prerenal failure. Four infants responded with ductus closure and 2 infants showed improvement in echocardiogram and clinical distress. There was a significant increase in U/O, GFR, FENa and FECl following drug administration. This study suggests that simultaneous administration of indomethacin and furosemide can be safely used in infants with PDA and oliguria. PMID- 3816492 TI - Theophylline and caffeine disposition in the neonatal piglet. AB - A pharmacokinetic study to evaluate the piglet as a model for caffeine and theophylline disposition was undertaken in 28 animals who received a 10.0-mg/kg intravenous dose of either methylxanthine, followed by multiple blood sampling over a 24-hour period. Theophylline and caffeine concentrations were quantitated from serum using a microanalytical HPLC technique (coefficient of variability less than 7% at 0.1-100 mg/l). The influence of postnatal development on drug disposition was examined by dividing the experimental animals into three age groups (newborn, 2 days; perinatal, 4-5 days; infants or young, 15-22 days). Pharmacokinetic parameters were calculated from nonlinear curve fitting of serum concentration vs time data. On the basis of the terminal elimination rate constant (lambda z) and total clearance (CL) for both theophylline and caffeine, differences were found among the age groups. The apparent volume of distribution (Vz) for both methylxanthines was not found to be different when compared between age groups. Covariance determinations between age and pharmacokinetic parameters revealed linear correlations for Vz of caffeine and CL for both theophylline and caffeine. In all piglets receiving theophylline, no caffeine was detected in serum during a 24 hr period. Theophylline, however, was detected (0.4 +/- 0.2 mg/l at 11.5 hr) in the four oldest piglets who received caffeine. Similarities between pharmacokinetic parameters for caffeine and theophylline reported for human neonates were found only for newborn piglets. Furthermore, the biotransformation of theophylline to caffeine reported for human neonates was not observed in neonatal piglets. PMID- 3816493 TI - Effect of tolazoline on renal function in newborn puppies. AB - Tolazoline is used in pulmonary hypertension and hypoperfusion syndrome during the neonatal period. Some of the side effects of tolazoline are hypotension, bleeding disorders and renal dysfunction. The present study was designed to investigate the effect of hypoxia and tolazoline on renal function in newborn puppies. The data in normal animals administered tolazoline alone did not reveal any statistically significant changes in blood pressure or in renal function. In the hypoxia group changes in renal function were noticed in spite of normal blood pressure. When tolazoline was administered to the hypoxic animals, a marked decrease in blood pressure resulted. Indeed, changes in renal function were more profound in the hypoxic animals receiving tolazoline than in hypoxic animals not receiving tolazoline, even though some of the renal functional values did not reach statistical significance. PMID- 3816494 TI - Developmental changes in the effects of beta-adrenergic blocking concentrations of propranolol on canine Purkinje fibers. AB - We used standard microelectrode techniques to investigate the developmental changes in the effects of the beta-blocker propranolol on canine Purkinje fibers. The effects of propranolol on the transmembrane action potential were similar in neonatal and adult Purkinje fibers. In automatic Purkinje fibers we obtained concentration-response (increase in rate) curves for isoproterenol alone and with an increasing concentration of propranolol. The curve for isoproterenol in neonatal Purkinje fibers had an EC50 of 1.0 X 10(-9) M, about 5-fold lower than in adult Purkinje fibers (EC50 = 5.03 X 10(-9) M, p less than 0.05). At both ages, propranolol caused a parallel, concentration-dependent shift of the response curves for isoproterenol, with no change in the maximum effect. Equiactive dose ratios in presence and absence of 3 concentrations of propranolol were compared by the Schild plot. The pA2 values for adult and neonate Purkinje fibers were 8.32 (8.14-8.46; 95% confidence level) and 8.86 (8.69-9.03; 95% confidence level), respectively. Our results indicate significant (p less than 0.05) developmental changes in the beta-blocking effects of propranolol in canine Purkinje fibers. PMID- 3816495 TI - The Aplysia FMRFamide gene encodes sequences related to mammalian brain peptides. AB - We have characterized a precursor protein which gives rise to the neuropeptide Phe-Met-Arg-Phe-amide (FMRFamide) by determining the nucleotide sequence of a genomic and five cDNA clones. The 597-amino-acid protein contains 28 copies of the tetrapeptide FMRFamide, a single Phe-Leu-Arg-Phe-amide (FLRFamide), and other sequences flanked by paired basic residues, some of which have homologies to mammalian brain peptides. The data presented suggest the genes encoding pro opiomelanocortin, pre-pro-enkephalin, and the hypothalamic releasing factor, cortico-releasing factor (CRF), arose from a common ancestral gene. PMID- 3816496 TI - Investigation of gyrate atrophy using a cDNA clone for human ornithine aminotransferase. AB - Gyrate atrophy of the choroid and retina is an autosomal recessive disease associated with reduced or absent ornithine aminotransferase (OAT) activity. To approach the defect in OAT at the molecular level, we have cloned a cDNA for the mRNA encoding the OAT precursor from human liver. The clone contains the complete coding region of 1317 nucleotides along with 44 nucleotides of 5' and 654 nucleotides of 3' untranslated sequences. When used to probe genomic DNA, the OAT cDNA did not detect any evidence of gene deletion or rearrangement in patients with gyrate atrophy. The cDNA hybridizes to a 2.15-kb RNA species in liver, fibroblasts, and lymphoblasts. The size and approximate amount of this mRNA is not altered in fibroblasts and/or lymphoblasts of seven gyrate atrophy patients who display a 25- to 100-fold reduction in OAT activity. Our results suggest the defect in these individuals may be caused by a subtle sequence alteration in the mRNA that does not affect its apparent size. PMID- 3816497 TI - Stimulation by acetoacetate of hepatic triacylglycerol synthesis. AB - The factors responsible for the huge accumulation of hepatic triacylglycerols in the ketotic diabetic state are not established. Our earlier work suggested a role for ketone bodies in the increased hepatic triacylglycerol synthesis observed in the ketotic diabetic state. Isolated hepatocytes obtained from normal fed rats were incubated with sodium acetoacetate or sodium chloride (control) and [1 14C]palmitate in Krebs-albumin buffer. Acetoacetate stimulated triacylglycerol synthesis in a concentration-dependent manner without increasing palmitate uptake or inhibiting palmitate oxidation. Beta hydroxybutyrate showed no effect on palmitate esterification to triacylglycerols. Isolated hepatocytes of normal fed rats were incubated with either sodium acetoacetate or sodium chloride and the nuclear-free homogenate was incubated with [U-14C]glycero-3-phosphate and cofactors. The synthesis of triacylglycerol and the activity of the cytosolic phosphatidate phosphohydrolase were increased in the cells pre-incubated with acetoacetate. The results of this study demonstrate that the increases in triacylglycerol synthesis and the cytosolic activity of phosphatidate phosphohydrolase previously observed by us in the ketotic diabetic liver, could be reproduced in normal fed rat liver cells by incubating them with acetoacetate. The results identify acetoacetate as a potential factor, in the regulation of hepatic triacylglycerol synthesis and for hepatic accumulation of triacylglycerols observed in the ketotic diabetic state. PMID- 3816498 TI - [Permeability of the blood-brain barrier to blood globulins after allotransplantation of embryonal tissue into the brain of intact and hypoxic adult rats]. PMID- 3816499 TI - [Formation of protein cross-links and breaks in the polynucleotide chain of tobacco mosaic virus RNA in situ after exposure to high-intensity pico-second laser UV-irradiation]. PMID- 3816500 TI - [Relation between the contraction force of the frog heart atrium and calcium ions, adrenaline and D-600]. PMID- 3816501 TI - [4 discrete states of the supramolecular structure of interphase chromatin in hepatocytes]. PMID- 3816502 TI - [Various hydrodynamic characteristics of cerebral circulation regulation]. PMID- 3816503 TI - Cefonicid, a long acting cephalosporin: in vitro activity compared with three cephalosporins and gentamicin. AB - Minimum inhibitory concentrations of cefonicid, cefazolin, cefuroxime, ceftazidime and gentamicin were determined against 688 bacterial strains (234 Gram-positive and 454 Gram-negative) from 20 different genera. Cefonicid showed a broader spectrum than cefazolin but was not as active as ceftazidime or gentamicin. Cefonicid most closely resembled cefuroxime in terms of microbiological properties. Disc testing accurately predicted sensitivity to cefonicid except for Staphylococcus aureus (which was sensitive by MIC, but appeared resistant in the disc test) and Proteus vulgaris (which was resistant by MIC but appeared sensitive in the disc test). In combination with gentamicin, synergy or addition was observed in 94% of 35 strains tested by the chequerboard technique. In view of its long half-life and wide range of microbiological activity, cefonicid promises to be a useful addition to the range of cephalosporins already available. PMID- 3816504 TI - Protective activity of habekacin and four other aminoglycosides in mouse septicaemia caused by Enterobacteriaceae. AB - The in vivo efficacy of habekacin, an aminoglycoside antibiotic obtained by chemical derivation from dibekacin, was compared to that of gentamicin (GEN), tobramycin (TOB), kanamycin (KAN) and amikacin (AMI) in a protection test in mice. The 50% effective dose (ED50) was determined in groups of animals challenged with bacterial suspensions injected intraperitoneally together with mucin, and treated subcutaneously 1 h and 6 h later. The bacterial strains used were: Escherichia coli (three GEN sensitive strains and one GEN-KAN-TOB resistant strain), Enterobacter cloacae (one GEN-KAN resistant strain), Serratia marcescens and Klebsiella pneumoniae (one GEN sensitive strain and one GEN resistant strain). In this model, habekacin was found to be as active as GEN against GEN sensitive strains and more active than AMI on GEN, GEN-KAN and GEN-KAN-TOB resistant strains. PMID- 3816505 TI - Penetration of piperacillin into renal cysts. AB - Concentrations of piperacillin in the cystic fluid of eight patients with simple renal cysts were assessed after each patient had been given single or multiple doses of the antibiotic. Concentrations ranged from non-detectable to 9 mcg/ml. PMID- 3816506 TI - Factors affecting the bactericidal action of disinfectants. Implications for selection of resistant strains. AB - The efficacy of some disinfectants was studied in the presence of known interfering factors by the AFNOR test (NFT 72-150, 170 and 171) with five bacterial strains: P. aeruginosa, E. coli, S. aureus, S. faecalis and M. smegmatis. These factors included proteins (albumin and yeast extract), hard water and pH (5 and 9). The effect of each interfering factor was found to depend on the bacterial strain and on the chemical composition of the disinfectant. For Gram-negative bacteria, especially P. aeruginosa, and for M. smegmatis the minimal bactericidal concentration rose significantly in the presence of hard water and of proteins. This phenomenon may explain the selective effect of disinfectants at their commonly used concentrations. PMID- 3816507 TI - Efficacy and stability of two chlorine-containing antiseptics. AB - Dakin's solution and a chloroxydizer in a hypertonic sodium chloride solution were tested for bacteriological and clinical effectiveness and stability. No real difference in effectiveness was observed between the two products; however, only the chloroxydizer showed satisfactory stability at 150 days under the test storage conditions. PMID- 3816508 TI - Effect of acetyl-L-carnitine on conditioned reflex learning rate and retention in laboratory animals. AB - The aim of the study was to evaluate the effects of acetyl-L-carnitine on learning and/or memory processes in laboratory animals. In the water maze test, acetyl-L-carnitine, given intraperitoneally at doses ranging from 0.3 to 100 mg/kg, improved performances in both mice and rats. In the latter the drug also proved active when administered orally in the 3-100 mg/kg dosage range. In the pole climbing test in the rat, acetyl-L-carnitine at doses ranging from 0.03 to 10 mg/kg i.p. increased the conditioned reflex learning rate. In the passive avoidance test in the rat, significant increases in retention were observed after treatment with acetyl-L-carnitine at doses ranging from 1 to 30 mg/kg i.p. In the passive avoidance plus electroconvulsive shock test in the mouse, acetyl-L carnitine antagonized amnesia at doses ranging from 0.1 to 3 mg/kg i.p. PMID- 3816509 TI - A comparison of the effect of Lipo PGE1 and other related compounds on experimental peripheral arterial occlusive disease in rats. AB - The effect of Lipo PGE1 (prostaglandin E1 incorporated in lipid microspheres) on laurate-induced peripheral arterial occlusive disease in rats was evaluated and compared with that of other related compounds. Lipo PGE1 showed a potent inhibitory effect on the progression of lesions in this model, but Lipo PGA1 had no such effect. Moreover, the effect of Lipo PGE1 was more potent than that of PGE1 X CD (cyclodextrin clathrated PGE1) and PGE1 on this model. These results suggest that incorporation of PGE1 into soybean oil microspheres might exert a more potent effect by facilitating drug delivery to the lesions in this model. It would appear that Lipo PGE1 is suitable for clinical use in peripheral vascular disorders. PMID- 3816510 TI - Effects of benfluorex on sterol biosynthesis in incubated human blood mononuclear cells. AB - The hypocholesterolaemic drug Benfluorex has been shown to inhibit the rate of sterol synthesis in rat hepatocytes. At present no data on a similar effect in human cells are available. The results of the present study demonstrate that Benfluorex has an inhibitory activity on the incorporation of 14C-acetate and of 14C-HMG-CoA into non-saponifiable lipids in human blood mononuclear cells incubated in lipid-deficient medium. The lack of effect on the incorporation of 14C-mevalonate into non-saponifiable lipids strongly suggests that the reduction of sterol biosynthesis is mainly due to the inhibition of HMG-CoA reductase activity. PMID- 3816511 TI - Proxen in the treatment of gonarthrosis. A controlled clinical double-blind study. AB - Forty patients of both sexes, aged between 25 and 65 years and suffering from gonarthrosis, took part in a controlled double-blind study of Proxen vs naproxen. Proxen was administered to 20 patients and the control drug to the other 20, in doses of 500 mg twice a day for 60 days. Both drugs demonstrated a good level of activity and tolerance. Proxen proved effective in 94% of the cases, while naproxen was effective in 80%. PMID- 3816512 TI - [Experimental studies on sick sinus syndrome: relation between electrophysiologic parameters and pathologic changes]. PMID- 3816513 TI - [Estimating sinus node function by measuring the effective refractory period of the sinus node]. PMID- 3816514 TI - [The electrogram of the sinuatrial node and the measurement of SACT]. PMID- 3816515 TI - [Study of trace elements in the hair of patients with chronic cor pulmonale]. PMID- 3816516 TI - [Fistula from the coronary artery to the right heart. Surgical treatment of 6 cases]. PMID- 3816517 TI - [Discussion on the diagnostic value of the persantine test in coronary artery disease]. PMID- 3816518 TI - [A study of the value of serum enzymes activities in the diagnosis of acute myocardial infarction]. PMID- 3816519 TI - [Evaluation of the combined use of pulsed Doppler echocardiography and contrast echocardiography in diagnosing intracardiac shunts]. PMID- 3816520 TI - [Corrected congenital transposition of the great arteries: analysis of 13 cases]. PMID- 3816521 TI - [M-mode echocardiography of congenital left ventricular-right atrial communication]. PMID- 3816522 TI - [Pathological changes in the myocardium of 4 cases of pheochromocytoma]. PMID- 3816523 TI - [Diagnosis and treatment of 97 cases of peripheral arterial aneurysm]. PMID- 3816524 TI - [Determination of the superoxide dismutase activity of erythrocytes in children with acute myocarditis]. PMID- 3816525 TI - [Histomorphologic changes in the myocardium in rabbits after ligation of the anterior descending branch of the left coronary artery]. PMID- 3816526 TI - [Ultramicroscopic pathological changes in a case of hypertrophic obstructive cardiomyopathy containing giant mitochondria]. PMID- 3816527 TI - The effects of acute and chronic ingestion of ethanol on the autonomic nervous system. AB - Evidence is reviewed linking clinical effects of ethanol with actions on the sympathetic and parasympathetic nervous systems. The studies reported include a series of investigations by the authors. Acutely, ethanol causes peripheral vasodilation and may also result in changes in heart rate and blood pressure. Ethanol may contribute to acute problems which may present clinically, including micturition syncope, accidental hypothermia and facial flushing. However, increased sympathetic nervous activity plays a role in causing hypertension and other symptoms during ethanol withdrawal in chronic alcoholics. Some chronic alcoholics may have neuropathy involving sympathetic nerves, and this can result in distal sweating loss and occasionally in orthostatic hypotension. Also, hypothalamic lesions associated with Wernicke's encephalopathy may result in hypothermia. Neuropathy involving parasympathetic nerves in not uncommon in alcoholics with other evidence of nervous system damage, but it is generally asymptomatic. Occasionally, vagal neuropathy may cause disorder of gastrointestinal motility, and neuropathy affecting the sacral innervation may be a factor in alcoholic impotence. PMID- 3816528 TI - Comparison of two benzodiazepines in the treatment of alcohol withdrawal: effects on symptoms and cognitive recovery. AB - Forty newly admitted alcohol-dependent patients were randomly allocated to equivalent 6-day regimes of either lorazepam or diazepam, to compare involvement in physical, emotional and cognitive state during the first 8 days in hospital. Diazepam provided a more comfortable withdrawal period and was associated with slightly better cognitive functioning on the eighth day. PMID- 3816529 TI - The appearance of 2,3-butanediol in the chronic ethanol treated pregnant rat. AB - The chronic administration of ethanol to pregnant rats at term results in the appearance of high concentrations of glycols such as 2,3-butanediol and 1,2 propanediol in their blood and urine. The results support the idea that 2,3 butanediol formation could be a mechanism for ethanol detoxication. The clinical implications of the findings are referred to. PMID- 3816530 TI - Effect of methadone dose contingencies on urinalysis test results of polydrug abusing methadone-maintenance patients. AB - Drug abuse outcomes were examined during 2 contingency management procedures in which the size of the methadone dose was determined by recent urinalysis test results. Twenty polydrug-abusing methadone-maintenance patients were exposed to one of two specific altered dose consequences: a positive incentive procedure in which dose could only increase above baseline levels as a result of drug-free urines and a negative incentive procedure in which dose could only decrease below original baseline levels as a result of drug-positive urines. About 13% of urinalysis test results were drug-free during a 10-week pre-study baseline period while about 40-50% of urines were drug-free for both treatment groups during an 18-week intervention period. About half of the subjects in each study condition showed marked improvement during the intervention, while the other half failed to improve their urine test results. Treatment failures in the dose decrease as compared with the dose increase condition were more likely to drop out of the study. The study showed that size of the methadone dose can be effectively used as a consequence to influence illicit drug use during treatment. The study suggests that positive reinforcement as compared with aversive control procedures can produce an equivalent number of successful cases while avoiding dropout among patients who fail to respond to treatment. PMID- 3816531 TI - Suppression of ethanol tolerance and dependence in rats treated with DSP-4, a noradrenergic neurotoxin. AB - The formation of tolerance to the hypothermic effect of ethanol was inhibited in rats after intraperitoneal injection of the neurotoxin DSP-4 50 mg/kg. The neurotoxin also significantly suppressed the ethanol withdrawal syndrome; hyperlocomotion, audiogenic seizures and spasticity. These behavioural changes were accompanied by a 52% decrease of the brain norepinephrine (NE) content, with no alterations in the dopamine or serotonin levels. The results indicate that intact NE neurons are necessary for the development of tolerance to ethanol induced hypothermia and are involved in the expression of the ethanol withdrawal syndrome. PMID- 3816532 TI - Lack of agreement between two questionnaires that evaluate the severity of the alcohol dependence syndrome. AB - The Short-Alcohol Dependence Data (SADD) and the Alcohol Dependence Scale (ADS) questionnaires, both designed to evaluate the degree of severity of alcohol dependence, were compared in a sample of 201 known alcoholics. Although a significant correlation was found between the scores obtained on the two scales (r = 0.61; P less than 0.01), respondents were classified differently by the two questionnaires (Kappa = 0.20). Subjects were generally considered less dependent by the ADS than by the SADD. Different possibilities that could explain the differential classification are discussed. PMID- 3816533 TI - A study of sex differences in cognitive impairment in alcoholics using traditional and computer-based tests. AB - Female alcoholics were found to report a similar pattern of cognitive impairment to male alcoholics immediately prior to discharge from an inpatient unit. Yet females reported a shorter history of heavy drinking and lower habitual levels of consumption. Clinical implications are discussed. PMID- 3816534 TI - Erythrocyte and plasma lipid peroxides in chronic alcoholic patients. AB - Erythrocytes from alcoholics without liver cirrhosis and control subjects were examined for the susceptibility to lipid peroxidation. Erythrocytes of patients were found to be sensitive to H2O2-induced peroxidation as compared to controls. In addition, chronic alcoholics showed a high level of plasma lipid peroxide levels. These results suggest the stimulation of lipid peroxidation in chronic alcoholics. PMID- 3816535 TI - Sex differences in acetaldehyde on body temperature and open-field performance in the rat. AB - Using the open field, for making an overall assessment of behavioural change in response to acetaldehyde (AcH) treatment, the results from the present study demonstrate that AcH produces behavioural and physiological effects similar to those of ethanol. High doses of AcH produced a similar degree of change as high doses of ethanol. Both compounds render the animal incapable of locomotor activities, such as ambulation and rearing and both produce a decrease of 2-3 degrees C in body temperature. AcH, however, appears to be a much more potent compound as behavioural and physiological changes are exhibited even after a dose of 10 mg/kg, while the dose of ethanol necessary to produce a decrease in open field behaviour is at least 10 times as much. Females were more sensitive to the effects of AcH at the 100 mg/kg dose. PMID- 3816536 TI - The effects of food deprivation on the self-administration of psychoactive drugs. AB - Under conditions of food deprivation, relative to the equivalent satiation condition, increases in the self-administration of d-amphetamine in three out of three monkeys, of cocaine in two out of three monkeys, and of nicotine in one out of three monkeys, were observed. Furthermore, these increases were dose dependent, i.e. with low doses there were large increases in number of infusions, but with high doses there were no differences in number of infusions between the two feeding conditions. For some doses of diazepam there were increases in number of infusions under the deprivation condition relative to the satiation condition, but these increases were not statistically significant. In contrast, food deprivation produced slight, but significant, increases in the number of perphenazine infusions in one monkey but inappropriate level responses were also high for this monkey as well. In most cases, increases under food deprivation occurred with drugs that already maintained responding above saline under satiation conditions. Therefore, food deprivation does not appear to convert non reinforcers into reinforcers, but instead increases intake of drugs that function as reinforcers. This effect may contribute to the persistence of psychomotor stimulant drug-seeking behavior in humans. PMID- 3816537 TI - Liver cirrhosis mortality in Argentina: its relationship to alcohol intake. AB - In Argentina, rates of liver cirrhosis mortality increased significantly in both sexes (men 81.3% and women 79.8%) between 1962 and 1970. A tendency towards a decrease in mortality rates for liver cirrhosis was observed in all groups, except for men aged 35-44 years, between 1970 and 1978, but the age-adjusted mortality rate persisted in 1978 at a level significantly higher than in 1962. The high mortality rate caused by liver cirrhosis may be the consequence of high alcohol intake in Argentina. In 1975, the average per capita consumption of alcoholic beverages, per year was 80 l of wine, 16.75 l of beer and 7.5 l of distilled liquors. These results indicate that important educational and legislative measures should be undertaken to try to correct life styles in an attempt to decrease the incidence of alcohol-related diseases and accidents in Argentina. PMID- 3816538 TI - Effect of ethanol on liver cell-development in the male albino mouse. AB - The aim of this study is to determine the influence of ethanol on the development of periportal and pericentral hepatocytes and their nuclei, comparing it with the development of these cells and nuclei in a control, age-matched population. In male albino mice fed with 20% ethanol added to drinking water and sacrificed at day 25, 35, 85 and 180 of life haematoxylin-eosin stained liver specimens were studied with the aid of a LEITZ ASM semiautomatic autoanalyzer. The nuclear area of at least 25 hepatocytes with evident nucleoli was measured at each of 3 periportal and 3 pericentral fields. The area of the cells of the same fields was estimated by dividing the area of the fields by the number of hepatocyte nuclei present in them. Both cellular and nuclear areas of periportal and pericentral hepatocytes of the 25-day-old animals were smaller than those of age-matched controls. By contrast, the experimental group showed a striking increase both in cellular and nuclear size in the pericentral hepatocytes, but not in the periportal ones. Thus, ethanol seems to inhibit the initial growth of cells and nuclei; but, after maturation, it causes a marked increase not only in cellular size of pericentral hepatocytes, especially in 180-day-old animals, but also in nuclear size, already evident in the 35-day-old mice. PMID- 3816539 TI - Serum dopamine-beta-hydroxylase activity and alcohol withdrawal symptoms. AB - Fifty male alcoholics had serum dopamine-beta-hydroxylase (DBH) activity, and serum prolactin (PRL) levels measured on the day of withdrawal, and 22 of them also on days 7 and 28 after it. The obtained values were related to the development of withdrawal symptoms. Treatment was begun with meprobamate on the first day of withdrawal, and from day 7 it was completed with disulfiram (250 and 500 mg/day, respectively). Serum DBH activity decreased significantly by day 7, however a further fall of it occurred by day 28 only in patients receiving high doses (500 mg) of disulfiram. PRL levels rose over the period of withdrawal which reached significance level on day 28. No correlation was found between serum DBH activity and the severity of withdrawal symptoms. Serum DBH activity did not differ from that of the healthy controls at either point of time, while serum PRL level was significantly elevated throughout the period of the study. PMID- 3816540 TI - Self-estimates of blood alcohol concentration in drinking-driving context. AB - A total of 72 social drinkers between the ages of 20 and 57 years participated in an ad lib social drinking session. At various intervals throughout the session participants provided estimates of their blood alcohol concentration (BAC) along with breath samples for objective determination of their BAC. Participants were classified into three groups, based on the pattern of their BAC estimation errors Underestimators, Overestimators, or Mixed Pattern estimators. Underestimators consumed more alcohol and attained higher BACs during the drinking session than the other two groups. Underestimators also rated their level of intoxication significantly lower than other groups and were most likely to judge themselves fit to drive when their actual BAC was in excess of the statutory limit. PMID- 3816541 TI - Changes in alcohol problems as a result of changing alcohol consumption: a natural experiment. AB - Alcohol consumption declined by about 10.5% in Quebec and 2.5% in Ontario but increased by 9.5% in Alberta in the years 1974-1983. This created a 'natural experiment' in which the effects of various changes in alcohol consumption on alcohol problems could be assessed. Declines in rates of most alcohol problems were found in Quebec and Ontario despite their different rates of decrease in consumption. However, there were declines in alcoholism rates, and deaths from liver disease and the alcohol dependency syndrome in Alberta. Some problems such as impaired driving and toxic or accidental deaths from alcohol increased in Alberta, probably because of its relatively youthful population compared to Ontario and Quebec. Changes in alcohol consumption appeared to be an unreliable indicator of how various problems are changing. PMID- 3816542 TI - Serum sickness associated with cefoxitin and pentoxifylline therapy. AB - Human serum sickness is a syndrome characterized by fever, malaise, skin rashes, arthralgias, gastrointestinal disturbances, and lymphadenopathy. It is believed to be mediated by circulating immune complexes composed of a foreign antigen and host antibody. Several cephalosporins have been associated with serum sickness. We report the occurrence of serum sickness in a patient who received cefoxitin, a commonly used cephamycin antibiotic, and pentoxifylline, a xanthine derivative that improves the flow properties of blood by decreasing its viscosity. Serum sickness has not been previously reported with the use of cefoxitin or pentoxifylline. PMID- 3816543 TI - Sudden death associated with switching monoamine oxidase inhibitors. AB - A drug-free interval is often recommended when switching monoamine oxidase inhibitors, although the evidence firmly supporting this caution has been minimal. A case is reported where an abrupt change in monoamine oxidase inhibitor was followed by the death of a patient. PMID- 3816544 TI - Dialyzability and pharmacokinetics of indomethacin in adult patients with end stage renal disease. AB - Indomethacin, a nonsteroidal antiinflammatory drug, has been shown to be effective for the treatment of pericarditis in chronic hemodialysis patients. Data regarding the dialyzability of indomethacin in these patients, however, is lacking. The aim of this study, therefore, was to evaluate (1) the dialyzability, and (2) the absorption and elimination kinetics of indomethacin, using six stable anephric adult patients who were maintained on chronic hemodialysis and were receiving indomethacin for the management of their uremic pericarditis. The results from this study demonstrate that indomethacin is dialyzable, but not to an appreciable extent. The mean predialysis and postdialysis indomethacin plasma levels were 3.4 and 1.6 micrograms/ml, respectively. The mean total amount of indomethacin removed by five hours of hemodialysis was 19.6 percent of the single dose of indomethacin 100 mg po. However, mean Cpmax, tmax, t1/2, and AUC0 infinity during and in the absence of hemodialysis were 5.4 and 5.4 micrograms/ml (not statistically significant [NS]), 1.9 and 2.0 h (NS), 6.1 and 5.3 h (NS), and 30.9 and 35.7 micrograms h ml-1 (NS), respectively. Based on these findings, it can be concluded that although indomethacin is dialyzable, no dosage adjustment is required in patients receiving indomethacin for the management of their uremic pericarditis when undergoing maintenance hemodialysis. PMID- 3816545 TI - Compatibility of clindamycin phosphate with amikacin sulfate at room temperature and with gentamicin sulfate and tobramycin sulfate under frozen conditions. AB - The stability and compatibility of clindamycin phosphate with three aminoglycosides, amikacin sulfate, tobramycin sulfate, and gentamicin sulfate, admixed in either glass bottles or plastic bags, were studied under various storage conditions. In addition to the various two-drug combinations, each antibiotic was studied alone in the same solutions under the same storage conditions investigated for the various combinations. Clindamycin phosphate was admixed with amikacin sulfate in 100 ml glass bottles of both dextrose 5% in water (D5W) and NaCl 0.9%. The resultant solutions were examined for visual clarity; both pH and antibiotic concentrations were measured at the time of mixing and at 1, 4, 8, 12, 24, and 48 hours later. The solutions were maintained at room temperature under ambient lighting conditions throughout the observation period. Clindamycin phosphate was also admixed with tobramycin sulfate and gentamicin sulfate, in separate experiments, in 50 ml plastic bags of D5W and NaCl 0.9%. These solutions were examined, at the time of mixing, for visual clarity, pH, and antibiotic concentration and then frozen at -20 degrees C. They were thawed 14 and 28 days later and reexamined. Clindamycin phosphate concentrations were measured by high performance liquid chromatography; those of the aminoglycosides were determined by a fluorescence polarization immunoassay. A working definition of significant instability or incompatibility was defined as a greater than 10 percent loss of original antibiotic concentration. All single antibiotic solutions were stable throughout the observation periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816546 TI - Effect of warfarin on the activated partial thromboplastin time. AB - Outpatients followed in an anticoagulation clinic were studied retrospectively to determine the effect of warfarin on the activated partial thromboplastin time (APTT). Twenty-nine patients were studied in part 1 of the trial to determine whether their APTT values were elevated when their prothrombin time (PT) was within 1.5 to 2.5 times the control PT. Part 2 was carried out using the data of 32 patients to determine whether a correlation existed between the degree of elevation of the patients' PT values due to warfarin and the concurrent degree of elevation of their APTT results. Baseline PT and APTT values and a minimum of three concurrent PT and APTT values determined during anticoagulation therapy with warfarin were used. Data were collected by chart review and review of Hematology Department records. Results indicated that a statistically significant difference was evident between the baseline APTT (30.79 sec) and the mean APTT (55.10 sec) when the PT was within the therapeutic range of 1.5 to 2.5 times the control while on warfarin therapy. Good linear correlation was evident (r = 0.821) between the degree of elevation of the PT and the degree of elevation of the APTT for the group. In most cases, a good linear correlation was also evident for individual patients. Routine ordering of concurrent APTT and PT tests for patients receiving warfarin therapy is not needed since the PT alone can be monitored under most circumstances. PMID- 3816547 TI - Wound healing properties of cimetidine in vitro. AB - Cimetidine was one of a variety of drugs frequently given to surgical patients perioperatively tested for their effect on gap closure of wounded monolayers of human fascia cells in vitro. Cimetidine-treated cultures closed faster and had greater cell proliferation than controls. Closure of cimetidine-treated cultures occurred at six hours compared to ten hours in controls. Cimetidine concentrations of 1000 micrograms/ml resulted in 13.5 +/- 0.67 (SEM) X 10(4) cells/cm2 at six hours compared to 7.9 +/- 0.48 X 10(4) cells/cm2 in controls (p less than 0.05); the area covered by cells was 6.5 +/- 0.02 mm2 in treated cultures compared to 3.0 +/- 0.01 mm2 in controls (p less than 0.05). It is concluded that cimetidine stimulates fibroblast proliferation in vitro. PMID- 3816548 TI - Is there cost reduction potential for extended half-life cephalosporins? AB - Two new second-generation cephalosporin derivatives with extended half-lives, ceforanide and cefonicid, have recently entered the U.S. marketplace. Because longer dosing intervals require fewer daily doses, potential exists for overall cost reduction if pharmacy and nursing time can be effectively saved. Reduction in personnel costs, however, must be sufficient for these more expensive products to be truly cost effective. We studied the impact of substituting these newer agents for older, less expensive products with formulary status at our 200-bed community hospital. Results show that no nursing expenses could be recovered, and there is little chance of consistently reducing pharmacy compounding expenses. Within the constraints of these studies, particularly physician prescribing habits, the GRASP (Grace Reynolds Application and Study of PETO) system of determining nurse staffing, and our drug acquisition costs, we find that the newer extended half-life products have very limited usefulness and may only increase the cost of antibiotic utilization. PMID- 3816549 TI - The pharmacist prescriber. PMID- 3816551 TI - Pharmacists as prescribers: the Florida experience. PMID- 3816550 TI - The pharmacist prescriber: a family pharmacist takes a critical look at the Report of the Study Commission on Pharmacy. PMID- 3816552 TI - Diltiazem-nifedipine-digoxin interaction. PMID- 3816553 TI - Transient bilateral pupillary dilation from scopolamine discs. PMID- 3816555 TI - Comment: specialization revisited. PMID- 3816554 TI - Comment: haloperidol effect on dopamine-induced increase in renal blood flow. PMID- 3816556 TI - Financial support for clinical pharmacy services. PMID- 3816557 TI - A model for inpatient clinical pharmacy practice and reimbursement. AB - The development and expansion of clinical pharmacy over the past 15 years have resulted in several debates. One debate that was very lively in the late 1970s concerned proper reimbursement for clinical pharmacy services. Although this debate is less heated now, its importance is even more significant with today's major changes in health care reimbursement. This article reviews the key reasons for the original debate and discusses how recent changes have increased and added direction to the debate. A model is presented that the authors believe represents the key to the increasing acceptance of the pharmacist's clinical role. PMID- 3816558 TI - Time course of gentamicin serum concentration rebound following hemodialysis. AB - The rebound in gentamicin serum concentration following hemodialysis was studied in six patients with chronic renal failure. The patients were not infected at the time of the study and received a single dose of gentamicin 2 mg/kg before hemodialysis. Serum samples were obtained immediately after dialysis and at 0.5, 1, 2, and 3 hours following hemodialysis. The average increases in gentamicin serum concentrations were 3.6 percent at 0.5 hour, 12.6 percent at 1 hour, and 6.6 percent at 2 hours. An average decline of 4.2 percent occurred at three hours. Only the increase seen at one hour was significantly different from the gentamicin serum concentration immediately following hemodialysis. This rebound was of small magnitude, though, and may not be clinically significant. PMID- 3816559 TI - Drug information services in Quebec: determination of community and hospital pharmacists' needs. AB - A survey of Quebec pharmacists was conducted to determine drug information resources currently available, obtain information on pharmacists' involvement as drug information providers, and determine their perceived drug information needs. Responses were obtained from 665 of 3283 registered pharmacists for a response rate of 20.3 percent. Hospital and community pharmacists represented more than 90 percent of the respondents. The two reference texts most frequently found in community pharmacists' libraries were Compendium of Pharmaceutical Specialties and Goodman and Gilman's The Pharmacological Basis of Therapeutics, the latter being available to only 49 percent of the pharmacists. More than 60 percent of the hospital pharmacists had at least 10 of the reference texts listed on our survey instrument. The majority of pharmacists were actively involved in a variety of clinical pharmacy services. Providing drug information to consumers or health professionals was one of the most common activities. Several pharmacists expressed their needs for drug information center (DIC) support in different drug information categories. Information on drug interactions and adverse drug reactions was rated as an important need by 68 and 59.9 percent of the community pharmacists, respectively. The institution of a regional DIC may provide the support system needed by the pharmacists of Quebec. PMID- 3816560 TI - Suprofen-induced acute renal failure revisited. PMID- 3816561 TI - Determination of clearance from a trough serum concentration at steady state. PMID- 3816562 TI - Counseling in a nondispensing clinic. PMID- 3816563 TI - Comment: therapeutic decision making. PMID- 3816564 TI - Development of clinical scientists. AB - The education and training of clinical scientists has served society in several ways. For academic pharmacy, the emergence of clinical science has provided research and scholarship opportunities for clinical faculty development. Clinical scientists have also begun to play important roles in industrial drug research and development. For all faculty and students, clinical science research reinforces a "research mindset" that will become increasingly important as our society moves from a production/extraction to an information-based economy. Pharmacy will best evolve by increasing its commitment to clinical science research. In the process, academic pharmacy must continue to improve and support excellent education and training programs for clinical scientists. PMID- 3816565 TI - Conceptual issues in designing a clinical scientist program. PMID- 3816566 TI - Academic research fellowships in clinical pharmacy. PMID- 3816567 TI - Preparing clinical pharmacists for the drug development task. PMID- 3816569 TI - Are academic pharmacists meeting the clinical scientist role? PMID- 3816568 TI - Academic-drug industry fellowships. AB - The UNC/BW fellowship, like other industry/academia collaborative fellowships, provides a unique training experience in clinical research. Both academia and the pharmaceutical industry have opened their doors and allowed clinical pharmacists to spend a year or more developing clinical research skills and an understanding of the drug development process. Is it worth it? Is this program a benefit to the individuals, to the sponsors, or to the profession of pharmacy? The survey of these fellows provides us with the individual's perspective on the benefit and quality of the fellowship. Most believed the fellowship provided them with training to meet their needs and interests. However, given this small number of individual opinions and comments, how do we determine whether the fellowship is meeting the original goal to train clinical pharmacists to be clinical researchers? By looking at the career paths of those who have completed the program, we may gain insight into whether the fellows are involved with research. Since the fellowship has been in existence for only six years, we really can look only at the initial placement of these clinical pharmacists. A majority have gained employment with clinical research responsibilities within the pharmaceutical industry. One measure of the research capabilities of these fellows is their contributions to the scientific literature; 10 papers and 3 abstracts have been generated by fellows since they completed their fellowships (Appendix I). As expected, the research contributions of the two-year fellows are greater than that of the one-year fellows. Seven one-year fellows did not have a publication.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816570 TI - The clinical pharmacist in drug research and development. Pharmacodynamics. AB - Today, clinical pharmacists are involved in various types of pharmacodynamic research. Fellowship training programs encompassing research on pharmacodynamics, pharmacokinetics, and their relationships are becoming more prevalent. The training needs of future clinical pharmacist investigators require careful consideration, especially with regard to standards for fellowship programs and the evolving science of pharmacodynamic-pharmacokinetic modeling. Liability and legal issues as well as stable sources of funding for fellowships are current concerns of clinical pharmacist investigators. These issues notwithstanding, the prospect of continued growth and evolution of the clinical pharmacists' role in pharmacodynamic research looks bright. PMID- 3816571 TI - The clinical pharmacist in drug research and development. Pharmacoepidemiology. AB - From the inception of drug monitoring research programs, pharmacists have played a key role in their design and implementation. As greater emphasis is placed on the value of these data bases, pharmacists will be increasingly called upon to conduct epidemiologic studies. Formalized training in the principles of epidemiology and biostatistics will allow pharmacists to expand their role in this important area of research. PMID- 3816572 TI - The clinical pharmacist in drug research and development. Clinical research units. PMID- 3816573 TI - The clinical pharmacist in drug research and development. An academic-industrial center. AB - The center for Pharmacodynamic Research represents a novel approach to academic industrial research agreements that may be a useful model for others to pursue. It is designed to take advantage of the strengths of the company and the university in order to enhance the research conducted and to provide benefits to both. At the same time, it takes into account the responsibility of the university to provide graduate education and the need of industry for scientists in the future. The center was only recently established, however, and must be considered work in progress. Although it has been successful to this point, its value will only be established by longevity and productivity. We have every confidence that it will prove to be a valuable experiment. PMID- 3816574 TI - An experience in clinical pharmacology. PMID- 3816575 TI - The project leader for new drug development. PMID- 3816576 TI - Postmarketing drug research and development. PMID- 3816578 TI - Cephalosporins--what's changed? PMID- 3816577 TI - The clinical pharmacist in drug research and development: the publication record. AB - A viable discipline requires the generation of new information. Clinical pharmacists have recognized that their success depends on their ability to contribute to (Table: see text) the expansion of the body of knowledge of their discipline. They have developed practice and research programs in a variety of areas. One of the results of these programs is the publication of articles in a variety of pharmacy and medical journals. Clinical pharmacists with specialty interests publish in journals that represent those interests. In comparing the type of clinical pharmacists' publications in the area of drug development, it is also clear that they are most suited for research in the clinical phase; that is, clinical pharmacists conduct research on the pharmacokinetics, pharmacodynamics, and safety and efficacy of new and old drugs. Clinical pharmacists tend to be members of research teams but bring a unique perspective to the team. In their collaboration with physicians, basic scientists, and other health-care personnel, clinical pharmacists are often cited as first author. Their research is important to researchers with similar specialty interests, regardless of whether they are pharmacists. Data retrieval has developed so that researchers with similar interests can identify key publications wherever they are published. Articles published by clinical pharmacists in pharmacy journals are quoted by other researchers. Therefore, I conclude that a number of clinical pharmacists are active in drug research and development. Many of these pharmacists were trained as practitioners, but have developed into researchers through trial and error and hard work.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816579 TI - The management of febrile convulsions. PMID- 3816580 TI - [Metal allergies. Results of patch tests from 1981 to 1984]. AB - From 1981 to 1984 987 patients of the Allergy Department of the Wurzburg University Dermatological Hospital were evaluated with patch testing using a standard series; 199 patients were additionally tested with a specially composed metal battery. The results of the standard series with regard to the four metals contained in it, namely mercuric chloride, nickel sulphate, cobalt sulphate and potassium bichromate, were contrasted with the test results of the metal battery. Here there were conspicuous discrepancies between the two collectives, above all, with respect to cobalt. In comparison to the data contained in the literature we found appreciable differences in the metals copper, cobalt and potassium bichromate. PMID- 3816581 TI - [Development and regression of dermal corticosteroid atrophy. 2. Changes in compression rate]. AB - In the 1st comm. results on development and remission of steroid-induced dermal atrophy were presented. Measurements were carried out with an instrument we constructed ourselves. This device enabled calculation of the rate of compression (CR) of a skin fold as well as determination of skin fold thickness (SFT). CR is specified in mm/log t. It is postulated that the CR depends on the viscosity of the basic substance and on the density of the collagen fiber skeletons led to an increase of SFT and CR. Loss of basic substance in quantitatively unchanged collagen skeletons led to a reduction of SFT and CR. In skin areas treated with corticosteroids, CR was reduced at roughly the same time as SFT. With the exception of hydrocortisone, the reduction was observed from about the 5th to the 10th d onwards in all products tested and became most pronounced after the 12th d. Following the end of steroid treatment (17th d), CR normalized within 6 to 10 d. It is concluded from the results that early steroid-induced dermal atrophy is caused by a lowering of the water/basic substance system. A steroid-specific inhibition of hyaluronic acid and glycosamine synthesis by the fibroblasts is assumed to be the cause of thickness loss. Skin areas treated with control ointments free of active substance displayed signs of increased hydratation. PMID- 3816582 TI - [Recombinant leukocyte A interferon in metastasized malignant melanoma]. AB - The efficacy and tolerance of recombinant leukocyte A interferon (interferon alpha-2a) in 30 patients with metastasized malignant melanoma in clinical stages III and IV were tested in a phase II study. During the first 10 weeks, the patients received 18 X 10(6) IU interferon alpha-2a i.m. daily and afterwards the same dose three times a week for a further four months. In 21 patients, the tumor growth was progressive. In six patients in clinical stage IV, there was a standstill for at least two months, and in three patients in clinical stage III, there was complete remission lasting between 12 and 16 months so far. The side effects of therapy differed in the individual patients. Fever, chills, limb pain, tiredness, nausea and lack of appetite were observed most often. All these symptoms as well as the frequently occurring leukopenia and elevation of the transaminases were especially pronounced at the beginning of therapy. They were dose-dependent, but reversible. PMID- 3816583 TI - [Cryptosporidium infections in AIDS]. AB - Investigations for cryptosporidia were carried out on 250 fecal samples from 131 HIV-positive patients between December 1985 and July 1986 with kinyoun carbolfuchsin staining. Cryptosporidial oocysts could be detected in six homosexual men. All of the cryptosporidia excretors had symptoms of enteritis. The clinical course and the prognosis depended on the immunological resistance of the host. Five patients with pronounced immune defect had therapy-resistant chronic diarrhea. In one patient with a slight immune defect, the cryptosporidial infection cured spontaneously. A spacial separation of cryptosporidia excretors and patients with weakened resistance is to be considered in view of the possible severe progress form with low tendency to cure and the still lacking specific chemotherapy. PMID- 3816584 TI - [Surgical interventions in psoriatic arthritis]. AB - As a general disease, psoriatic arthritis (which besides the skin and the joint can also affect internal organs) takes a special place amongst chronic polyarthritis conditions. It is characterized by combination of psoriasis with a seronegative polyarthritis affecting the spine and above all the joints in the hands and feet (frequently asymmetrically). The form and extent of the often painful joint and spinal involvement not uncommonly lead to an appreciable impairment of various functions and thus to a handicap for the patient. A series of different operations extending from synovectomy to arthrodesis and joint replacement improve the pain as well as functional restrictions. However, they also lead to new knowledge on the nature, etiology and development of this disease via photographic documentation of findings and investigation of the tissue obtained intraoperatively. In the years 1967 to 1984, 457 single operations were carried out in 80 patients with psoriatic arthritis. The results allow the conclusion that patients with psoriatic arthritis should be admitted to special hospitals for surgical treatment more frequently than was the practice up to now. PMID- 3816585 TI - [Diagnosis of lupus nephritis]. PMID- 3816586 TI - [Rate-responsive cardiac pacemaker. State of development and clinical value]. PMID- 3816587 TI - [When is surgery for carotid artery stenosis still indicated?]. PMID- 3816588 TI - [Pain intensity and outcome in acute herpes zoster under acyclovir therapy]. PMID- 3816589 TI - [Joint endoscopy]. PMID- 3816590 TI - [Rush hyposensitization with Hymenoptera venoms. Tolerance and results of therapy]. AB - During 290 courses of rush hyposensitization with bee or wasp venoms performed on an in-patient basis there were systemic anaphylactic side effects in 38% before the maintenance dose of 100 micrograms was reached. These reactions were usually mild, occurred mostly at higher venom doses (threshold doses greater than or equal to 1 microgram in about 75%) and were more frequent (P less than 0.05) in patients with a history of a full shock due to stings than in individuals with milder symptoms. Furthermore, systemic anaphylactic side effects occurred more often (P less than 0.01) in bee venom allergic patients with a greater sensitivity in the prick test (threshold less than 10 micrograms/ml) than in those being less reactive; no such dependence was found in wasp venom allergy. RAST results were not correlated to the occurrence of systemic anaphylactic side effects. Evaluation of the therapeutic effect was performed by 163 sting challenge tests, which caused only local sting reactions in 80%. Compared to prior stings improvement of symptoms was achieved in 95% of 157 patients with a history of systemic reactions. Individuals with more severe challenge reactions were older (P less than 0.05) than those with merely generalized skin symptoms. Furthermore, there was a correlation between the occurrence of systemic challenge reactions and systemic anaphylactic side effects during rush hyposensitization as well as between a history of more severe sting reactions and symptoms exceeding generalized skin symptoms at challenge. Thus, hyposensitization with hymenoptera venoms induces partial or complete protection in a high percentage of patients. The course of rush hyposensitization as well as the therapeutic effect depend to some degree on the original intensity of hypersensitivity. PMID- 3816591 TI - [Congenital protein C deficiency and thromboembolic diseases]. AB - Besides its cofactor protein S and antithrombin III, protein C is one of the most important inhibitors of plasma coagulation. In seven members of a family as well as in three further unrelated patients, a congenital protein C deficiency with thromboembolic diseases including a coumarin necrosis was observed in two cases. Deficiency of protein C predisposes to the occurrence of thromboembolism, but the severity of the underlying heterozygotic genetic defect can also vary within the family. Long-term oral anticoagulation with phenprocoumon is the therapy of choice. Genetic counselling should always be carried out. PMID- 3816592 TI - [When which arthroscope?]. PMID- 3816593 TI - [Lipoprotein electrophoresis]. PMID- 3816594 TI - [Acute granulomatous interstitial nephritis with iritis. Possible induction by non-steroidal antiphlogistics]. AB - A 49-year old woman developed non-oliguric acute renal failure accompanied by bilateral acute anterior uveitis, following a three weeks' period of lethargy, anorexia and temporary fever. Kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of lymphocytes and monocytes, as well as multiple perivascular epithelioid granulomas. A substantial improvement of renal function was achieved under treatment with systemic corticosteroids. The uveitis resolved completely under additional topical treatment. During a follow-up period of 9 months, there has been no relapse of nephritis or uveitis. The disease of this patient resembles the so-called TINU syndrome of unknown aetiology. Remarkable features of the present case are the histological diagnosis of granulomatous acute interstitial nephritis in the absence of systemic granulomatous disease, as well as a possible association with the administration of non-steroidal antiinflammatory drugs. PMID- 3816595 TI - [Spontaneous splenorenal shunt in liver cirrhosis]. AB - A 52 year old patient was admitted to the hospital for further clarification of a cystic structure in the region of the spleen hilus noticed in the upper abdominal sonogram. The investigations revealed a spontaneous splenorenal shunt in hepatic cirrhosis. PMID- 3816596 TI - [The physician's duty to inform the patient about alternative treatments]. PMID- 3816597 TI - [Secondary effects of calcium antagonists]. PMID- 3816598 TI - [Contrast media secondary effects]. PMID- 3816599 TI - [Skin metastases following ultrasound-guided fine-needle puncture of pancreatic cancer]. PMID- 3816600 TI - [Vegetative hyperthermia]. PMID- 3816601 TI - [Colonic lipoma]. PMID- 3816602 TI - [Skin diving]. PMID- 3816603 TI - [Treatment of bone metastases of breast cancer]. PMID- 3816604 TI - [Sodium content of liquid antacid preparations]. AB - The sodium content of 13 liquid antacids was determined using two independent analytical methods (flame photometry). With a neutralisation buffering capacity of 564 mmol/d (pH 3.5) the possible body sodium load was calculated by evaluating the sodium content in the supernatant of the antacid suspensions, ranging from 0.56 to 568 mmol/d (method A) and from 0.42 to 468 mmol/d (method B). Therefore, in patients who are on a sodium restriction of 50 mmol/d this critical intake may be easily exceeded by the intake of certain antacids. PMID- 3816605 TI - [Ankylosing hyperostosis of the sternoclavicular joint]. AB - The rarely occurring ankylosing hyperostosis of the sternoclavicular joints can be taken as a paradigm of chronic seronegative inflammation of tendinous insertion involving the capsular apparatus of the sternoclavicular joints. Etiologically uncertain erosions of the insertion lead to reparative ossifications. There are few symptoms but the course is protracted. If the condition cannot be arrested by anti-inflammatory drugs in its initial stages, there develops a progressive loss of sternoclavicular joint function. The case is described of a 66-year-old woman who has had the condition for 33 years. At wide intervals she has had severe pain. Electromyography a few years after biopsy gave an indication of mild irritation of the roots C 7 and C 8. Resulting from loss of function of the sternoclavicular joint the acromioclavicular joint was dislocated. No specific drug or surgical treatment has so far been necessary. PMID- 3816606 TI - [Drug treatment of depression]. PMID- 3816607 TI - [Recommendations for the evaluation and expert assessment of respiratory diseases in practice]. PMID- 3816608 TI - [Long-term results in 172 highly malignant non-Hodgkin's lymphomas with special reference to older patients]. AB - In 172 patients of the years 1976-1984 with a median age of 61 (16-89 years) the probability of survival was 55% after nine years. The seventh to ninth decade of life (n = 88) did not differ significantly in terms of the survival prognosis (47%) from the younger age groups (n = 84) with 59%. Immunoblastic (n = 72), centroblastic (n = 65) and unclassifiable (n = 35) lymphomas were prognostically similar and could hence be evaluated together. Stages I A (n = 58) with 83% and IV B (n = 15) with 20% differed from all others (n = 99), for which a survival rate of 41% was calculated. With the CHOP scheme (n = 76), a complete remission could be induced in 70% of the stages II A/B, III A/B and IV A (n = 54) and in 95% of stage I A (n = 19). In stage IV B (n = 14), more intensive schemata were not successful, only inducing two remissions. After sequential combination of polychemotherapy and large-field radiotherapy, the relapse-free survival was higher than after radiation or cytostatics alone. This was shown most distinctly in stage I A, in which a value of 82% compared to only 29% after radiotherapy was found for the combined method. Since this was not associated with higher rates of complications so far even with the older patients, we regard this procedure as major advance in the therapy of prognostically unfavorable lymphomas. PMID- 3816609 TI - [Transient ischemic attacks in primary hyperparathyroidism. Prevention with calcium antagonists]. AB - In a normotensive 67 year old female patient, transient ischemic attacks occurred in the context of a primary hyperparathyroidism, probably owing to calcium induced cerebrovascular spasms. Since nimodipine therapy brought about freedom from attacks, prophylactic therapy with calcium antagonists in primary hyperparathyroidism should be considered preoperatively. PMID- 3816610 TI - [The latest court decisions]. PMID- 3816611 TI - [Effect of pirenzepine on sigmoid motility]. PMID- 3816612 TI - Ethylene glycol monomethyl ether (EGME) inhibits rat embryo ornithine decarboxylase (ODC) activity. AB - The effects of ethylene glycol monomethyl ether (EGME) on reproductive outcome in the rat, and on ornithine decarboxylase (ODC) activity in the rat embryo were evaluated. Dams (n = 8) were treated by gavage on gestation days 6-12 (sperm = day 0) with 0, 25, 50 or 75 mg/kg EGME in 10 ml/kg distilled water. EGME had a dose-dependent effect on reproductive outcome. Gestation length was prolonged, and the number of litters delivered and neonatal body weight were reduced. Whole embryo ODC was measured on gestation days 9, 11, 13 and 15. ODC attained maximum activity in controls on day 11, increasing by more than an order of magnitude above the activity found on day 9. On day 11, a statistically significant dose dependent inhibition of ODC activity was observed with the maximum dose of EGME inhibiting ODC activity 60 percent. On days 13 and 15, ODC activity declined markedly from peak values, and the dose-dependent inhibition was no longer evident. The study demonstrates a correlation between the inhibition of embryonic ODC activity by EGME and the effect of EGME on reproductive outcome. PMID- 3816613 TI - Effect of volatile anesthetics on protein synthesis and secretion by rat hepatocyte suspensions. AB - The effect of volatile anesthetics on protein synthesis and secretion by isolated rat hepatocytes in suspension was investigated. Halothane and enflurane inhibited protein synthesis in a dose-dependent manner. Diethyl ether had little effect on protein synthesis while isoflurane caused a mild inhibition. This effect was more pronounced in hepatocytes from phenobarbital treated male rats when compared to hepatocytes from control rats. Protein synthesis in hepatocytes from phenobarbital treated female rats was inhibited similar to that seen with control male rat hepatocytes. Isoflurane, enflurane, and halothane also caused a dose dependent inhibition of protein secretion, while diethyl ether was only mildly inhibitory. From these studies it appears that inhibition of protein synthesis and secretion might be an early and sensitive indicator of cellular injury by volatile anesthetics. PMID- 3816615 TI - Evaluation of a new approach to the safety assessment of biomaterials. AB - The effectiveness of a bacterial luminescence inhibition assay in assessing the toxicity of compounds which are released from biomaterials was evaluated. Luminescence from a strain of bacteria most closely resembling Photobacterium phosphoreum was measured. The concentration that inhibited luminescence by 50% (EC50) was determined for selected plasticizers, monomers and additives. The intraperitoneal (i.p.-ALD) and intravenous (i.v.-ALD) approximate lethal doses were determined using mice. By ranking the reference compounds toxic/non-toxic, a 37.5% agreement was obtained for the i.p.-ALD and i.v.-ALD toxicity data. While there was only a 12.5% agreement for the i.p. ALD and EC50 values, there was a 75% agreement between the i.v.-ALD and EC50 values. Although additional validation is required, these results provide preliminary indications that the bacterial luminescence inhibition assay is a promising alternative approach to the safety assessment of biomaterials. PMID- 3816614 TI - The effect of lead on insecticide metabolism. AB - The possibility that lead could affect the metabolism of the insecticide 1,1 dichloro-2, 2-bis(p-chlorophenyl)ethane, DDD, was examined by studies of the effects of chronic oral Pb treatment on DDD conversion to 2,2-bis(p chlorophenyl)acetic acid, DDA. Rats were given either distilled deionized water or 0.05, 0.58, 17 or 352 ppm Pb solutions as drinking water. Systolic blood pressure and body weight were measured weekly. Rats drinking 352 ppm lead chloride manifested a statistically significant increase in blood pressure. Rats drinking 352 ppm and 17 ppm lead chloride showed a significant decrease in the rate of weight gain compared to controls. All groups showed an increase in the excretion of total DDA compared to controls. PMID- 3816616 TI - Early biological indicators of S-(1,2-dichlorovinyl)-L-cysteine nephrotoxicity in the rabbit. AB - The progression of changes in rabbit kidney function following dosing with the nephrotoxin S-(1,2-dichlorovinyl)-L-cysteine (DCVC, 20-50 mg/kg) was determined. Proteinuria was observed 0.5-1 hr after administration of DCVC at doses of 20-50 mg/kg. Blood urea nitrogen levels, glomerular filtration rates, urinary glucose excretion, and urine volume were also altered following DCVC dosing; however, these parameters were less sensitive than proteinuria as markers of early renal dysfunction. None of these latter four indicators were affected by low DCVC doses, nor were they altered by high DCVC doses until 1.5-2.5 hr after dosing. Dose-dependent morphological changes to kidney structure were also observed 5 hr after DCVC administration. Low doses caused damage restricted to brush border membranes in the pars recta, while higher doses produced a necrotic lesion encompassing all regions of the proximal tubule. This study indicates that DCVC can cause rapid renal dysfunctional changes which are first detected by elevated urinary protein excretion. PMID- 3816617 TI - [Neurophysiological findings in the differential diagnosis of cervico-brachial syndromes]. PMID- 3816618 TI - [C-reactive protein in the diagnosis of pelvic inflammatory disease]. PMID- 3816619 TI - [Subcutaneous nodules in a patient with polymyalgia rheumatica]. PMID- 3816620 TI - Experiences in cochlear implantation. PMID- 3816621 TI - A 15-year retrospective of chronic rhinitis and cryosurgery. PMID- 3816622 TI - Intraturbinal steroid injections. PMID- 3816623 TI - Clinical allergy approach efficacy. PMID- 3816624 TI - Yes, it can be fun. PMID- 3816625 TI - Nasal balloons. PMID- 3816626 TI - Rhytidectomy in the younger patient. PMID- 3816627 TI - Osteoid osteoma of the mandible. PMID- 3816628 TI - Malignancy of the maxillae. PMID- 3816629 TI - Benign pharyngeal foreign body. PMID- 3816630 TI - Sexually transmitted diseases (STDs) PMID- 3816631 TI - A survey of sexually transmitted diseases in the Democratic Republic of Somalia. PMID- 3816632 TI - Prevalence of syphilis in Mbeya, Tanzania--the validity of the VDRL as a screening test. PMID- 3816633 TI - Treatment of urethral strictures. PMID- 3816634 TI - Acute pulmonary oedema (toxic alveolitis) associated with traditional fever therapy. PMID- 3816635 TI - Urogenital myiasis: a case report. PMID- 3816636 TI - Observation of Enterobius vermicularis ova in urine: 3 case reports. PMID- 3816637 TI - Cardiovascular abnormalities in thoracopagus twins: embryological interpretation and review. AB - The cardiovascular abnormalities of two sets of thoracopagus twins with conjoined heart and liver are described and compared with 27 well documented cases. An embryological interpretation of the cardiovascular abnormalities is suggested. The common heart in both sets showed a common atrium and two ventricles. In case 1 the great arteries were L. malposed in twin A. In case 2 the great arteries originated from their respective double outlet single ventricle. The systemic and pulmonary veins drained directly into the common atrium in case 1 and indirectly via systemic veins in case 2. The type of cardiovascular abnormalities are complex and discordent from one set to another and in the same set. However among 27 published cases of thoracopagus twins, cardiac union, including atrial union with separate ventricles, or atrial and ventricular union, was encountered in 16 cases. Approximately 90% of them are not suitable for surgical separation because of the high degree of cardiac union and the complexity of cardiovascular abnormalities. Surgical separation could be attempted in only two cases, but at the cost of the life of one of the twins. PMID- 3816638 TI - New birthweight and head circumference centiles for gestational ages 24 to 42 weeks. AB - Based on 20,713 singleton livebirths at the John Radcliffe Hospital, Oxford, in 1978-1984, we calculated new birthweight and head circumference values for males and females between 24 and 42 weeks of gestation. Among the 803 babies born at or before 34 weeks of gestation, 28% were delivered electively for fetal problems; they were considerably lighter and had smaller heads than infants born after spontaneous preterm labour. As we and others have recommended elsewhere, the electively delivered preterm infants were excluded from the calculation of the new birthweight and head circumference centiles. In our series males were heavier and had larger head circumferences than females at most gestational ages. There were consistent and statistically significant differences in birthweight at all gestational ages from 37 weeks and in head circumference at all gestational ages from 35 weeks. PMID- 3816639 TI - Episodic pollution--a comparison of brief and continuous exposure of rainbow trout to cadmium. AB - The toxicity of cadmium to rainbow trout fry resulting from brief or continuous exposure is compared. Results of tests involving brief cadmium exposure followed by restoration to clean water indicate that postexposure mortalities may result from contact for as little as 32 min to 1.0 mg Cd liter-1 or 10 min to 10 mg Cd liter-1. These results highlight the inadequacy of standard toxicity tests in predicting the consequences of an episodic pollution incident such as that resulting perhaps from an accidental spillage. For example, the median lethal time (LT50) following continuous exposure to 1.0 mg Cd liter-1 is 1900 min whereas exposure for only 32 min will ultimately result in 50% mortality. The term median postexposure lethal time (peLT50) is proposed as a means of assessing and comparing the results of brief exposure to a pollutant and it is suggested that brief or episodic exposure tests should be incorporated into the hazard evaluation process. PMID- 3816640 TI - In vitro effects of cadmium chloride on preimplantation rat embryos. AB - Preimplantation rat embryos (8-cell, morulae, blastocysts) were incubated for 24 hr in vitro in a Brinster medium with or without cadmium chloride (1 microgram/ml). CdCl2 arrested the development of both the 8-cell and morulae into blastocysts. Morphologic observations revealed the 8-cell embryo to have shrunken cells and pyknotic nuclei. Morulae appeared smaller in size with fewer cells than comparable controls. CdCl2 was clearly cytotoxic to the early blastocysts, inner mass cells were most damaged with cell death, pyknosis, and accumulation of debris. PMID- 3816641 TI - Immuno-, neuro-, and general toxicologic animal studies on a synthetic pyrethroid: cypermethrin. AB - The toxicologic properties of the synthetic pyrethroid insecticide cypermethrin have been studied in animal experiments. In the course of acute and subchronic experiments performed by the administration of 1/2 and 1/40, 1/20, and 1/10 proportions of the oral LD50 value, no considerable changes were found in the general toxicologic tests. The compound known to affect the central nervous system, however, induced only a mild enhancement of the central excitation level shown by the EEG investigations in the doses applied. In the immunotoxicologic studies an early and dose-dependent suppression was induced as a result of humoral immune response of rabbits immunised by S. typhi following the administration of cypermethrin. The cell-mediated immune response was also decreased. In rats the immune response determined by anti-sheep erythrocyte and antiovalbumin titer as well as by autologous rosette formation of spleen lymphocytes was hindered. The earliest detectable group of symptoms indicating the effect of a mild cypermethrin exposure is the appearance of the positivity of the immunotoxicologic tests. On the basis of the experimental findings the sensitive immunotoxicologic tests have been regarded as of great importance in the series of toxicologic methods. PMID- 3816642 TI - Effects of long-term exposure to pentachlorophenol on the free amino acid pool and energy reserves of the freshwater amphipod Gammarus pseudolimnaeus Bousfield (Crustacea, Amphipoda). AB - The freshwater amphipod Gammarus pseudolimnaeus was exposed for 45 days to pentachlorophenol (PCP). The total concentration of free amino acids (FAA) decreased significantly after 5 days exposure to 0.77 or 1.25 mg PCP/liter. Exposure to PCP had no effect on the relative concentrations of individual amino acids exposed to 0.77, 1.06, or 1.25 mg PCP/liter. Whole body concentrations of glycogen, protein, and caloric content were significantly decreased after 15 days and lipid content after 30 days exposure to 0.77 mg PCP/liter. Since energy reserves and caloric content were not measured on the 5th day of PCP exposure, the relative sensitivity of FAA as a biochemical indicator of toxicant-induced stress cannot be compared directly. However, since reductions in growth and/or energy reserves can significantly influence the fecundity of amphipods, alterations in the FAA pool are indicative of future adverse effects on the organism. The use of alterations in the concentration of FAA is discussed with respect to its application as a biochemical indicator of toxicant exposure in freshwater invertebrates. PMID- 3816643 TI - S-adenosyl-L-methionine and lead intoxication: its therapeutic effect varying the route of administration. AB - A comparative study on the effect of oral and subcutaneous (sc) or intravenous (iv) administration of S-adenosyl-L-methionine (SAM) in lead poisoning was carried out. SAM was given daily sc (20 mg/kg) and orally (80 mg/kg) to acute lead-intoxicated mice for 20 days. Chronic lead-poisoned patients received SAM, administered intravenously at a daily dose of 12 mg/kg or orally at a dose of 25 30 mg/kg. Independent of the method of administration in either animals or patients, GSH concentration in reduced lead intoxication was increased after SAM dosing. Corresponding blood lead content rapidly decreased and a significant recovery of hepatic and erythrocytic delta-aminolevulinate dehydratase (ALA-D), initially reduced, was clearly produced in the groups receiving SAM, although the response was slightly slower when SAM was given orally. It was found that the bulk of body lead burden was excreted in the feces, showing a peak within the first 24-48 hr and being much greater in animals treated with SAM. In these cases, urinary lead excretion was very low. Lead ALA-D inhibition was also evidenced by elevated urinary excretion of delta-aminolevulinic acid (ALA), porphobilinogen (PBG), and porphyrins. During treatment, precursors and porphyrins elimination declined, reaching normal levels soon after therapy ended. A good correlation between the recovery of both GSH levels and ALA-D activity and decreased lead content was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816644 TI - Effects of phenobarbital, chlordane, and oxytetracycline on DDT excretion in rats. AB - The effects of phenobarbital, chlordane, and oxytetracycline on DDT biliary excretion in rats were evaluated. The relationship between the increase of biliary flow induced by these drugs and the elimination of DDT was also evaluated. Phenobarbital (2.5 mg/ml) was fed to rats in their drinking water and chlordane (200 mg/kg) was added to the diet over a period of 3 days; oxytetracycline (200 mg/kg/day) was fed to rats orally for 8 days. After these treatments [14C]DDT was administered orally to anesthetized rats and then the bile was collected through cannulation of the bile duct. The data obtained show that phenobarbital and chlordane decrease zoxazolamine paralysis time and increase liver weight and biliary flow. Both drugs increase biliary excretion of [14C]DDT and decrease [14C]DDT levels in plasma; oxytetracycline increases zoxazolamine flow significantly. Oxytetracycline does not change biliary excretion of [14C]DDT but decreases the blood levels of the insecticide; and pretreatment of animals with phenobarbital, chlordane, and oxytetracycline does not significantly change [14C]DDT concentration in bile. These data demonstrate that the increased biliary excretion of DDT depends on the rate of bile elimination. PMID- 3816645 TI - [Neuropharmacological research on a newly synthesized derivative of 2 aminotetralin]. PMID- 3816646 TI - [Effect of gentamycin on plasma digoxin concentrations in the rabbit]. PMID- 3816647 TI - [Experimental prerequisites for using extracts of a representative of the genus Potentilla as an antivaricose agent]. PMID- 3816648 TI - [Bilateral adrenalectomy in rats and the modulating effects of exogenous hydrocortisone]. PMID- 3816649 TI - [Inhibition of the regional graft vs. host reaction in F1 mice preliminarily treated intrahepatically with semiallogeneic lymphocytes]. PMID- 3816650 TI - [Toxicity studies of the Bulgarian cytostatic biocarbazine on the lung, kidneys and small intestine]. PMID- 3816651 TI - [Immunochemical analysis of circulating immune complexes in the serum isolated with polyethylene glycol by different methods]. PMID- 3816652 TI - [Blocking antibodies and methods for their determination]. PMID- 3816653 TI - [Confinement stress in mice]. PMID- 3816654 TI - [DNA alkylation during endogenous synthesis of N-nitrosodimethylamine]. AB - The simultaneous administration of 14C-dimethylamine and sodium nitrite to rat stomach produces the formation of O6-methylguanine and 7-methylguanine in the liver DNA as a result of the endogenic synthesis of N-nitrosodimethylamine (NDMA). Methylation of DNA was also observed in the rat kidney and lung. Alkylation of O6-position of guanine and removal of its methylated product from the DNA occurred in the liver to a greater extent than in the other NDMA target organs. Pretreatment of rats with sodium nitrite increased the alkylation of liver DNA caused by endogenic synthesis of NDMA. The formation of alkylated products in DNA may be used as a marker for the endogenic formation of NDMA from precursors. PMID- 3816655 TI - [Molecular electron carriers in mouse tissues during development of sarcomas induced by 3-methylcholanthrene and Moloney virus]. AB - Regular changes are revealed in electron-transport chains of the energy and detoxifying systems. The changes occur mainly in iron-sulphur centres and cytochrome P-450 under chemical and viral blastomogenesis in the muscular tissue induced by 3-methyl cholanthrene and Moloney oncornavirus. In the tissue of developing Moloney tumour and spleen kinetics of the formation of triplet signal of nitrosyl complexes is recorded in the region of g-factor of free radicals of semiquinone type and its transformation into singlet signal of EPR with the Moloney sarcoma regression. PMID- 3816656 TI - [Expression of various cellular oncogenes in rat rhabdomyosarcoma]. AB - An increased number of transcripts of c-Ha-ras, c-myc, c-sis and c-src protooncogenes has been detected in the chemically induced rat rhabdomyosarcoma related to the expression of that genes in normal muscle tissue of inbred rats. A degree of transcription elevation varies among the tested genes: c-src, c-Ha-ras and c-sis, c-myc. PMID- 3816657 TI - [Effect of a delayed type hypersensitivity reaction on the cytotoxic activity of macrophages, natural and antibody-dependent killer cells]. AB - It is established that preparations which cause the delayed type hypersensitivity reaction (DTHR), such as old tuberculine of Koch (OTK) and staphylococcal phagolysate (SPL), being administered to mice sensibilized preliminary by BCG vaccine or staphylococcus, lead to considerable reinforcement of natural cytotoxicity of peritoneal macrophages and natural killer cells (NK-cells) and killer cells (K-cells) to a small extent. In the course of DTHR there is an increase in the ability of effector cells to bind with target ones (especially in macrophages) as well as in the quantity of cytolytic effectors. The cultural medium from macrophages of mice with DTHR which have internalized the opsonized particles of zymosan or have interacted with target cells P815, intensifies the activity of NK- and K-cells while the same medium from macrophages of intact animals possesses a depressed action on the NK- and K-cells activity. The cultural medium from spleen lymphocytes which mediated the NK- and K-cells activity of the intact animals as well as mice with DTHR does not influence cytotoxicity of macrophages. PMID- 3816658 TI - [Immunological and electron microscope characteristics of peripheral blood lymphocytes in myeloma disease]. AB - B-lymphocytes of peripheral blood were examined with cytochemical, immunological and electron-microscopic methods in 18 patients with myeloma. The results made it possible to divide all patients into 3 groups distinguishing by cytomorphology of peripheral blood lymphocytes, expression of surface and cytoplasmic immunoglobulins and determination on the surface membrane of receptors to Fc fragments of IgG and IgM and C3-component of the complement. Data revealed clonal character of B-lymphocytes. PMID- 3816659 TI - [Changes in the fluorescence parameters of lipophilic probes bound to the erythrocyte membrane in cancer patients]. AB - The fluorescence of intensivity of membrane-bound diphenylhexatriene (DFHT) of erythrocytes of the cancer patients is found to increase as compared to that of donors. No reliable differences are detected in a degree of fluorescence polarization of DFHT and pyren excimerization in erythrocyte membranes of cancer patients and donors. The data obtained show that under the development of malignant tumours the structure state of lipid bilayer of erythrocyte membrane does not undergo significant changes. However an increase of the fluorescence intensivity of the membrane-bound DFHT, evidently, is the result of changes in protein-lipid interactions in the membrane. PMID- 3816660 TI - [Lethal effect of glucose load on tumor cells in hypoxia]. AB - The in vitro treatment of the Ehrlich ascites tumour (EAT) cells with glucose for 15 and 60 min under hypoxic conditions leads to a decrease in their survival by a factor of 10(2) and 10(4). Glucose load is ineffective under normal oxygenation. The mass destruction of EAT cells under the influence of glucose takes place within the first 24 hours in the interphase. The lethal effect of different pH values on EAT cells is independent of the way by which the given pH value was reached (glucose load or phosphate buffer). The same values of pH lead to the same effect on EAT cells. The lethal effect markedly increased when the value of pH was lower than 5.6. It is concluded that the lethal effect of the glucose load is due to self acidification of EAT cells. PMID- 3816661 TI - [Experimental evaluation of tumor therapy with cytostatic agents deposited in the abdominal cavity in acetylcellulose]. AB - For the purpose of improving the effectiveness of the chemotherapy of gastrointestinal tract tumours, the experimental investigation of the possibility to deposit the various antitumour preparations in the abdominal cavity by including them into acetylcellulose microspheres was carried out. It was shown that the use of the polymeric drug complexes permits obtaining a significantly more pronounced antitumour effect than the introduction of the same preparation in a free form. A decrease of the toxic effect of the deposited preparations was established. PMID- 3816662 TI - [Effect of solcoseryl on oxygen metabolism and growth of experimental tumors]. AB - Antihypoxant and antitumour properties of solcoseryl were studied on intact and tumour-bearing rats and mice. By the polarographic method it is found that solcoseryl increases the oxygen metabolism only in animal hypoxic tissues and improves, probably, energy production of their mitochondria. On many tumour strains it is shown that the injections of solcoseryl decelerate the growth of some tumours, inhibit the metastatic process and produce no toxic effect on the animals. PMID- 3816663 TI - [Functional state of the sympatho-adrenal system at late stages of the tumor process after cyclophosphamide and 5-fluorouracil administration]. AB - The effect of cyclophosphamide and 5-fluorouracil on the neurochemical determinants of the functional state of the sympatho-adrenal system (SAS) is studied in C57BL mice with metastatic Lewis carcinoma and tumours induced by subcutaneous administration of 20-methylcholanthrene. It is established that pathologic effect of cytostatics on the SAS is especially pronounced at the late stages of the tumour process. In this case urine excretion of DOPA, catecholamines and their catabolites is observed. PMID- 3816664 TI - Significance of motor unit action potential parameters in normal and neurogenic situations. PMID- 3816665 TI - Spinal evoked potentials and single fibre E.M.G. in diabetic neuropathy. PMID- 3816666 TI - A study of the application of the Fourier series in the analysis of the electrophysiological pattern of development of muscle fatigue. PMID- 3816667 TI - Electromyographical studies of the bulbo-cavernosus reflex in diabetic men with sexual dysfunction. PMID- 3816669 TI - EMG activities of facial muscles in resting state. PMID- 3816668 TI - Standardization of changes in M-wave area to repetitive nerve stimulation. PMID- 3816670 TI - Hand posture. In writing with the nonpreferred hand. Education of the right hemisphere. PMID- 3816671 TI - Studies of somatosensory evoked potentials in Duchenne muscular dystrophy. PMID- 3816672 TI - Changes of the blink reflex and visual evoked potentials in patients with diabetes mellitus. PMID- 3816673 TI - Effect of adrenergic agents on the electrophysiological activity of the ureter in rabbits. PMID- 3816674 TI - Some features of the extracellular potential field of active single muscle fibres. A model investigation. PMID- 3816675 TI - [Disorders of autonomic responses to emotional stimuli in patients with unilateral hemispherical lesions]. AB - The authors have studied in 31 patients affected by right (N = 12) or left (N = 19) hemispheric lesions and in 10 normal controls the autonomous response to emotional stimuli. Stimuli consisted of 3 short films, aiming to provoke respectively a negative emotional reaction, a positive emotional response or a non-emotional reaction. Galvanic skin response and heart rate were considered as the dependent variables of our research. Both normal controls and left brain damaged patients were very influenced by the emotional nature of the stimuli and showed clear signs of activation of the sympathetic and para-sympathetic systems in front of emotional films. By contrast, right brain-damaged patients were not influenced by the emotional or non-emotional nature of the stimuli and showed neither a clear galvanic skin response nor a significant decrease of heart rate in front of emotional films. PMID- 3816676 TI - [Electroencephalography and the confusional syndrome in a hospital center specializing in psychiatry]. AB - In psychiatric hospitals confusional states are frequent and represent about 20% of requests for EEG's. This study, covering a one year period, at S-Jean de Dieu psychiatric hospital in Lyon, revealed among all EEG's carried out for a confusional state the existence of a high proportion of pathological signs (59%). Etiological research demonstrates that a large proportion of these patients is diagnosed as senile dementia. Nevertheless, even if pure organic causes are rare, EEG remains an indispensable complement to clinical practice. PMID- 3816677 TI - [French adaptation and validation of the Carroll rating scale for depression]. AB - The authors translated the Carroll Rating Scale for depression published in 1982. They evaluated the reliability of this scale in 50 normal volunteers. They validated the French Version against the Hamilton Rating Scale and the Beck Depression Inventory. The translation has been shown to be reliable. The correlation between the Hamilton Rating Scale and the Carroll Rating Scale is better than the one between the Hamilton Rating Scale and the Beck Depression Inventory. The Carroll Rating Scale appears to be useful for a quick evaluation of depressive symptoms. PMID- 3816678 TI - [From Procustes to Theseus or etiology in psychiatry]. PMID- 3816679 TI - [Panic attacks and anxiety depression. Clinical, biological and therapeutic update]. AB - The breaking-up of anxiety neurosis and the particularization of panic attacks according to the DSM III square with the recent data of clinical, biological and therapeutic research. The alterations of anguish nosography go with a renewed outbreak of studies of clinical and biological ties between anxiety and anxious depressions. A review of the main recent work and their bibliography is displayed as their therapeutical involvement. PMID- 3816680 TI - [Sleep in Pick disease]. AB - 19 polygraphic sleep recordings from 12 patients with Pick's Disease, including four histologically proved cases, were compared to those of an age-matched control group. Symptoms had been present for a mean 8 years, the patients being aged 59 to 78 (mean 70.5 years). All sleep stages could be identified. Total sleep time was reduced and the number of awakenings was sharply increased. High proportion of stage 1 contrasted with the reduction in the other sleep stages with disappearance of stage 4 in advanced cases. REM Sleep was identified in all recordings, although reduced as a function of the length of the illness; its production as a function of total sleep time was not different from that of the control. REM Sleep appeared often fragmented and with a remarkably short latency, reminiscent of that observed in severely depressed patients. PMID- 3816681 TI - [Psychiatric emergency and somatic disorders]. AB - The authors made a survey in the setting of the Ste Anne hospital Emergency outpatient clinic to determine the incidence of somatic troubles in mental patients during a crisis situation. 1,000 patients were examined during a 24 day period. More than half of somatic problems had not been addressed to priori to Psychiatric consultation. More over, during those psycho-organic troubles, no precise information had been made available in half of the patient population. In 3% of cases, hospitalization could not continue in a psychiatric setting, which points to both the difficulty in assessing the medical capacity of psychiatric institutions ("secteurs") and acceptance of mental patients by the general medical hospital. PMID- 3816682 TI - [International colloquium. Depression resistant to antidepressive treatment. Paris (France), 17 January 1986]. PMID- 3816683 TI - [Concept of resistant depression]. AB - Resistant depressions can be defined as those depressions in which the spontaneous course is not influenced by therapeutic measures. Resistance to treatment is not an exceptional phenomenon, as it occurs in 15 to 30% of cases; the imprecision of this evaluation is essentially due to the losse definition of resistant depression and the various ways in which it is interpreted. For example, the concept of a "therapeutic measure" varies between the epidemiological approach, according to which it implies any form of therapy designed to treat the depression, and the clinical psychiatric approach, which reserves this term for the administration of rational antidepressant treatment over a sufficient period of time. The concept of "lack of influence" (or failure) of a therapeutic measure is also open to discussion: in the absence of absolute criteria for the characterisation of the patient's state of health, the definition of resistant depression can vary considerably. The study of factors of resistance to treatments allows therapeutic factors to be distinguished from clinical factors. In practice, inadequate treatment is the principal cause of "resistance". This inadequacy can be due to a number of reasons: poor choice of treatment, inappropriate dosage, insufficient duration of treatment, rejection of certain tried treatments (electroshock, MAOI), etc. Some cases of depression are found to be more frequently resistant, whichever treatment is administered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816684 TI - [Psychological factors, compliance and resistance to antidepressant treatment]. AB - The compliance, or the degree of adhesion of the patient to the doctor's prescription, is a variable which must be taken into account in the interpretation of the results of a given treatment. It is generally estimated that the level of non-compliance with psychotropic or other classes of drugs is between 20 and 50% of cases. Among the factors favouring non-compliance, the authors initially discuss those related to the drug and to the modalities of prescription: severity of side effects, quality of clinical improvement obtained, complexity and duration of treatment. However, many other factors also appear to be involved, particularly related to the patient: personal beliefs and the attitude towards the disease and the drug can constitute important factors of resistance, and to the psychiatrist, whose attitude can never be considered to be neutral in relation to a particular drug or to a particular patient. The capacity of the therapist to manage and control the treatment is an essential part of the therapeutic relationship between the doctor and his patient. PMID- 3816685 TI - [Review of studies of trazodone at the Feighner Research Institute in ambulatory and hospitalized patients]. AB - The effectiveness of trazodone in the treatment of endogenous depression and related anxiety was reported by Pozzi et al. in 1967. Since that time other studies conducted primarily in Europe and Canada and in more recent years in the United States have confirmed the antidepressant properties of trazodone. We have conducted two major trials comparing the efficacy of trazodone under double blind circumstances, one involving seriously ill depressed inpatients with comparison to placebo and imipramine. The other compares imipramine and trazodone under double blind circumstances on a maintenance antidepressant study over 12 months. Both studies demonstrate that trazodone is an effective antidepressant and is statistically superior to placebo. In both studies, trazodone showed an overall trend of greater improvement with fewer dropouts than imipramine and on several parameters reached statistical superiority over imipramine. PMID- 3816686 TI - [Telematic multicenter study of Pragmarel 100 mg (trazodone)]. AB - Trazodone is a molecule which is already well known throughout the world for its antidepressant properties and its good global safety. We have conducted a large national study in outpatients. By means of a computerized communication network (233 psychiatrists equipped with Minitel), almost 2,000 depressed patients have been followed over a four week period of treatment with Pragmarel 100 mg, in less than three months. Computerized DSM III diagnostic criteria were used to define two sub-groups of patients. The results confirm the therapeutic indications of trazodone in various forms of depression, major affective disorders (689 cases) and other affective disorders (1,257 cases). 82% good and very good results were obtained in the overall population of patients, with a decrease by more than 50% in the initial score on the MADRS scale in 65% of cases. The low incidence of side effects and the excellent acceptability of treatment also confirm the date reported in the literature. PMID- 3816687 TI - Practice management and administration. PMID- 3816688 TI - The emergency department medical director. AB - This article has presented an overview of the duties, responsibilities, and management roles of the emergency department Medical Director, a position that can be among the most challenging, stimulating, and exciting in medicine. However, prior to accepting a position as an Emergency Department medical director, one should have a clear understanding of what the job entails. Careful discussions with the hospital administration, medical staff, nursing personnel, and staff emergency physicians should be undertaken to learn the perceptions of these people and expectations of the position. Once the job has been accepted, using the roles, responsibilities, and duties detailed herein may be of benefit- but should always be applied with good judgment, tactful cooperation, and common sense. Finally, it should not be surprising to a medical director to find, as Spinoza did many years ago, that the excellent thing he aspires to are as difficult as they are rare. PMID- 3816689 TI - The impact of ambulatory care centers on emergency medicine. AB - This article traces the origin and evolution of freestanding ambulatory care centers, and relates their development to corresponding changes in medicine in general and in emergency medicine in particular. The impact of these centers on the practice of emergency medicine is discussed. The future relationship of the physicians practicing in these centers to the specialty of emergency medicine and the changes that they will most probably foster in the medical care delivery system are examined. PMID- 3816690 TI - Medical direction in emergency medical services: the role of the physician. AB - The past two decades has seen the development of sophisticated systems of prehospital care. The task now is to intensify the input of well-trained physicians into all aspects of EMS systems. This article tracks the history of EMS in this country and provides some suggested answers to the difficult questions facing this new specialty. PMID- 3816691 TI - The future of emergency medicine. AB - I have made some predictions about what I feel will be the future of our specialty. I have carefully avoided entering into details of our practice because these will evolve gradually rather than in predictable quantum jumps. Although I fear and believe that the economic future of medicine lies with the corporate entity, and that more and more physicians will become employees of such corporations, I don't believe that this alters the professional responsibilities, nor do I think it will interfere with professional satisfactions. I believe that so long as the field continues to believe its primary mission is that of the life or limb threat, that there will continue to be a need for the specialty of Emergency Medicine. Finally I believe that given that mission, there is now and will continue to be in the future, no more fulfilling career. PMID- 3816692 TI - An administrative perspective on emergency medicine. AB - Administrators expect that their emergency room will meet the expectations of all the patients they serve. To do so requires leadership, planning, and cooperation. To not do so is a contradiction of the term emergency, and a misrepresentation of purpose, intent, and capability. PMID- 3816693 TI - Pricing strategies and optimizing reimbursement. AB - A carefully developed pricing strategy will allow the emergency physician to supplement excellent clinical care with a fee structure that recognizes the concerns of patients, physicians, hospitals, health insurers, and physician billing staff. The development and implementation of such a strategy requires involvement of the emergency physician group members. This article discusses the mechanics of instituting a pricing strategy. PMID- 3816694 TI - Risk management in emergency medicine. AB - This article discusses risk management and control of malpractice risk in the Emergency Department. Particular emphasis is placed on actuarial information related to Emergency Department losses. PMID- 3816695 TI - Financial and contractual considerations. AB - Emergency physicians function in a highly competitive and financially oriented environment. To remain professionally and economically viable in this situation, it is imperative that individual emergency physicians and emergency physician groups develop and maintain a thorough understanding of the aspects of emergency department finance and contractual relationships. Otherwise, emergency physicians run the considerable risk of becoming controlled and therefore being "minor players" in the burgeoning health care industry. PMID- 3816696 TI - Electrostatically induced growth of spiral lipid domains in the presence of cholesterol. AB - The formation of crystalline domains of the phospholipid L-alpha-dimyristoyl phosphatidic acid containing 1 mol% cholesterol, was studied as a function of head group charge by fluorescence microscopy with monolayers at the air/water interface. It is shown that the usual dendritic growth occurs at low pH (8), whereas spiral domains are formed at high pH (11), where the head group contains two negative charges. The findings are ascribed to an electrostatically induced chain tilt that, in conjunction with an in-plane dipole moment, causes a ferroelectric state. This allows for domain aggregation and orientation originating in elongated domains that, additionally, are bent because of the chirality of the molecules. The structure is stabilized and further elongated due to the anisotropic edge activity of cholesterol. PMID- 3816697 TI - Fluorescence of 3-keto-steroids in aqueous solution. Probes for steroid-protein interactions. AB - The physiologically important 3-keto-steroids are non-fluorescent or only weakly fluorescent in protic as well as in aprotic solvents. In contrast, the 4,6,8(14) triene-3-one steroids are highly fluorescent in aqueous solution but they do not appreciably fluoresce in other solvents. Evidence is presented that the introduction of double bonds into the skeleton of the 3-keto-steroids leads to a decrease of the energy of the lowest pi-pi* state, bringing this level into the neighbourhood of the non-fluorescent n-pi* state. As a consequence, for two states of approximately the same energy, relatively small perturbations such as those due to solvent interactions, protein binding and micelle formation, will then determine whether a system will fluoresce (pi-pi* state lowest) or not (n pi* state lowest). When the fluorescent 3-keto-steroids, having three conjugated double bonds, bind to proteins, the fluorescence intensity becomes almost zero, making these compounds useful as probes for steroid-protein interactions. This quenching of the fluorescence is explained by a decrease in energy of the n-pi* state relative to the pi-pi* state of th steroids due to hydrophobic interactions with the proteins. PMID- 3816699 TI - The shape of a membrane protein derived from rotational diffusion. AB - Membrane proteins are modelled as cylinders with an elliptic cross-section in the plane of the membrane. The coefficient for rotational diffusion about the cylinder axis is calculated as a function of the axial ratio of the elliptic cross-section. PMID- 3816698 TI - A hydrogen bond study in tobacco mosaic virus using Moessbauer spectroscopy. AB - The Moessbauer method was applied to obtain information on a suggested hydrogen bond in tobacco mosaic virus (TMV), between the hydroxyl group of Tyr 139 and a carboxyl oxygen of Glu 22 in a neighbouring subunit. Spectra of 129I were taken of 3,5-di-iodo-L-tyrosine as a free amino acid and in situ in TMV. The increase of the pK value of 3,5-di-iodo-L-tyrosine by 0.8 units at position 139 in TMV compared to the free value is a strong argument in favour of the existence of a hydrogen bond via the relevant hydroxyl group. The reported study demonstrates the surprising sensitivity of the observable Moessbauer parameters to details of the electronic configuration in the neighbourhood of the probe nucleus. PMID- 3816700 TI - XANES of carboxy and cyanomet-myoglobin. The role of the distal histidine in the bent Fe-C-O configuration. AB - The ligand bonding geometry of carboxy- and cyanomet-myoglobin (MbCO and MbCN) has been measured by the XANES method (X-ray Absorption Near Edge Structure). A comparison between the ligand bonding geometry of carboxy- and cyanomet-myoglobin and of chelated protoheme methyl ester shows that the bent Fe-C-O configuration is the same in both systems. Therefore, we suggest that this configuration is not associated with any steric constraint imposed by the side chains of the aminoacid residues at the distal side of the heme pocket. PMID- 3816701 TI - Fluorescent styryl dyes applied as fast optical probes of cardiac action potential. AB - Several styryl dyes were tested as fast optical probes of membrane action potentials in mammalian heart muscle tissue. After staining, atrial specimens were superfused in physiological salt solution, and fluorescence was excited by an argon ion laser. Excitation spot size on the surface of the preparation was 60 microns in diameter. Dyes RH 160, RH 237, and RH 421 performed excellently as fast fluorescent probes of cardiac membrane potential. Fractional fluorescence changes, delta F/F, due to the action potential were in the range 2 to 6% at 514.5 nm excitation. Rise times of the action potential onset detected with each of the dyes were less than 0.5 ms, which is as fast or even faster than microelectrode measurements (atria of the rat). Thus membrane potential changes could be monitored with high resolution in both time and space. Emission spectra from heart muscle preparations stained with these dyes were shifted to shorter wavelengths by 70 nm and more as compared to spectra of the dyes in ethanol solution. The fluorescence spectrum of RH 160 at resting potential and the spectrum recorded during the plateau phases of the action potential were measured and showed no difference within the spectral resolution. As can be concluded from measurements of fluorescence changes at different excitation wavelengths, electrochromism cannot be the only mechanism causing the potential response. PMID- 3816702 TI - Flow orientation of brain microtubules studied by linear dichroism. AB - Flow orientation of bovine brain microtubules has been studied using phase modulation detected linear dichroism, LD, in a Couette cell with radial light propagation. LD could be sensitively measured in a wide flow gradient interval: 10(-3)-10(3) s-1, without any apparent degradation of the microtubule structure. An extremely small flow gradient, 10(-3) s-1 is sufficient to give significant orientation, and 10 s-1 rapidly produced a very high degree of orientation. It is also shown that thermal convection effectively orients microtubules in vitro. The apparent linear dichroism is dominated by an anisotropic scattering from the aligned microtubules, superimposed on a weaker absorption dichroism due to intrinsic chromophores. The linear dichroism due to anisotropic turbidity, LD tau, is found to be an excellent tool for monitoring the formation of microtubules and in contrast to ordinary turbidity measurements, non-specific aggregates contribute to a far less extent. Time resolved LD tau was used to study the orientational relaxation of microtubules upon stopped shear. The relaxation towards random orientation can be described by a slow, multi exponential decay. With increasing protein concentration the relaxation becomes slower and above approximately 1 mg/ml a fraction with a semipermanent orientation is formed. Finally, the development of orientation with time upon applying a small, constant gradient has been measured and the results are considered in terms of a model for flow orientation of rigid rods. PMID- 3816703 TI - Flicker spectroscopy of erythrocytes. A sensitive method to study subtle changes of membrane bending stiffness. AB - Frequency analysis of thermally excited surface undulations of erythrocytes leading to the flicker phenomenon is applied to determine biochemically and physically induced modulations of the membrane curvature elasticity. Flicker spectra of individual cells fixed to the window of a flow chamber by polylysine are taken by phase contrast microscopy, enabling investigations of the reversibility of the structural modifications. The spectra may be approximated by Lorentzian lines in most cases. By measuring the amplitude (at zero frequency) and the line width, effects of the structural changes on the curvature elastic constant, Kc, and the wavelength distribution of the undulations may be studied separately. Effect of physically induced modifications: The temperature dependence of the flicker spectra are taken from 10 degrees C to 37 degrees C. Above 20 degrees C, Kc decreases with increasing temperature whereas the reverse holds below this limit. The latter anomalous behaviour is explained in terms of a conformational change associated with protein and lipid lateral phase separation. The bending stiffness increases when the cells swell osmotically, owing to surface tension effects. The dependence of the flicker spectra on the viscosity of the suspension medium agrees with the theoretical prediction. Biochemically and drug induced modifications: 5 vol% of ethanol leads to a pronounced and reversible suppression of the long wavelength undulations without altering the discoid cell shape and without affecting the bending stiffness appreciably. Adsorption of dextran to the glycocalix increases Kc by a factor of 1.6 at saturation. The bending stiffness is increased by a factor of 1.3 after cross linking the proteins with the SH-oxidizing agent diamid. Injection of Ca++ into the cell via ionophores evokes (within 10 min) the formation of fine--probably spectrin free--spicules. This leads to an increase in Kc by a factor of 1.3 which is explained in terms of a lateral condensation of the spectrin/actin network. The spicule formation and Kc change is completely reversible (within 2 min) after perfusion with Ca++-free buffer. Cholesterol depletion leads first to a continuous increase in Kc without change of the cell shape whereas a sudden discocyte- to echinocyte transformation sets in below a critical steroid content. The latter transition is also observed in cell suspensions and is reminiscent of a phase transition. The anti-tumor drug actinomycin D evokes an increase in the bending stiffness Kc by a factor of two, suggesting that its effect is at least partially due to a modulation of the membrane structure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3816704 TI - Mixtures of lecithin with polymerizable derivatives of cholesterol. A monolayer film balance study. AB - One of the best investigated binary lipid mixtures is the lecithin-cholesterol system. We show here that it is possible to modify the cholesterol in such a way that it can be polymerized without changing its behaviour in mixtures with lecithin. The polymerizable derivatives exhibit a very similar phase diagram in the mixture with dipalmitoylphosphatidylcholine as the cholesterol itself. This is demonstrated by filmbalance measurements. PMID- 3816705 TI - Ozone-induced adaptive and reactive cellular changes in respiratory bronchioles of bonnet monkeys. AB - To characterize the response of respiratory bronchioles (RBs) to chronic high ambient levels of ozone, bonnet monkeys were exposed for 90 days to 0, 0.4, or 0.64 ppm ozone (UV photometric standard; 3 monkeys/exposure). Morphologic changes in respiratory bronchiolar epithelium and interstitium were evaluated quantitatively at both the light and transmission electron microscopic levels. Significant changes in respiratory bronchioles following exposure included: a thicker wall and a narrower lumen, a thicker epithelial compartment and a much thicker interstitial compartment, shifts in epithelial cell populations with many more nonciliated bronchiolar epithelial cells and fewer squamous type I epithelial cells, larger nonciliated bronchiolar epithelial cells with a larger complement of cellular organelles associated with protein synthesis, greater amounts of both interstitial fibers and amorphous ground substance, greater numbers of interstitial smooth muscle cells per epithelial basal lamina surface area, and greater volumes of interstitial smooth muscle, macrophages, mast cells, and neutrophils per epithelial basal lamina surface area. These observations imply that chronic ozone exposure causes a concentration-dependent reactive peribronchiolar inflammatory response and an adaptive response consisting of hypertrophy and hyperplasia of the nonciliated bronchiolar cell. PMID- 3816706 TI - Psychosocial sequelae of epilepsy: the role of associated cerebral pathology. AB - The psychosocial problems of a group of subjects with idiopathic epilepsy and another with posttraumatic epilepsy were assessed using the Washington Psychosocial Seizure Inventory (WPSI). A comparison between the two aetiological groups suggests that the associated cerebral pathology is the salient epilepsy related factor in the emergence of psychosocial disability in a proportion of people with epilepsy. It is suggested that cerebral pathology may account for variations in previous psychosocial comparisons and future research should minimise possible confounding by attempting to control this factor. PMID- 3816707 TI - High-dose phenytoin in the treatment of refractory epilepsy. AB - Refractory, long-standing, high-frequency epilepsy was successfully managed with high-dose phenytoin treatment. Side effects were observed in only three patients and were easily corrected. Most of the patients had partial seizures, but many also had a myoclonic component. Emphasis was placed on monotherapy whenever possible. Results, interpretation of serum levels, and toxic reactions to phenytoin are discussed. PMID- 3816708 TI - Effects of taltrimide, an experimental taurine derivative, on photoconvulsive response in epileptic patients. AB - Taltrimide is a lipophilic taurine derivative with definitive anticonvulsive effects in experimental epilepsy models. In this study, taltrimide was administered for 6 days, and the effects of the treatment on photoconvulsive response in EEG in eight epileptic patients were evaluated. Discharges provoked by intermittent photic stimulation (IPS) were increased by greater than 50% in four patients after taltrimide treatment. Only one patient had reduction of sensitivity. There was only a slight change in discharges after hyperventilation and no change in spontaneous paroxysms. The effects of taltrimide on photosensitivity appear to be rather specific. The study does not reveal anticonvulsive effects of taltrimide in humans. PMID- 3816709 TI - Homovanillic acid and prolactin in plasma and CSF of medicated epileptic patients. AB - Homovanillic acid (HVA), the main dopamine metabolite, and prolactin (PRL) were estimated in plasma and cerebrospinal fluid (CSF) of 11 male epileptic patients treated with antiepileptic drugs and of 14 neurologic controls. A trend toward higher concentrations in plasma and lower concentrations in CSF in the patient group as compared with controls was observed for both parameters. The plasma to CSF ratios of HVA and PRL levels were significantly higher in the patient group. This shift may be due to an influence of the drugs on the blood-brain barrier (BBB) permeability. The PRL levels in the CSF correlated negatively to the HVA levels in CSF in the patient group only. PMID- 3816710 TI - Effect of prolonged anticonvulsant medication in epileptic patients: serum lipids, vitamins B6, B12, and folic acid, proteins, and fine structure of liver. AB - Twenty-seven epileptic patients, most from low socioeconomic groups and aged 15 54 years, were studied for effects of prolonged anticonvulsant medication. They had received the usual doses of phenobarbitone and diphenylhydantoin (PHT) regularly for 3-32 years, with control of seizures, and had not taken any B vitamins in the year before investigation. Besides reduced serum and cerebrospinal fluid (CSF) folate levels, significantly increased levels of total vitamin B6 in CSF and serum and of vitamin B12 in serum were found in patients as compared with normal healthy subjects. The bone marrow was normoblastic, and significant elevation of serum triglycerides and/or cholesterol was observed in patients. The total protein level was only slightly reduced as compared with that of controls, but there was significant increase in beta-lipoprotein fraction on gel electrophoresis. Plasma proteins concerned with vitamins and lipid transport showed no remarkable change, and no abnormal protein was detected. Although there was no clinical hepatic involvement, liver biopsy performed in 9 of 27 patients revealed fine structural changes in hepatocytes suggestive of varying degrees of drug-induced changes. A ramifying network of short, smooth, endoplasmic cisternae with depleted rough endoplasmic reticulum (RER), distended sinusoids with Kupffer cells, dark shrunken hepatocytes with reduced mitochondria, and increased lipofuscin were observed. This suggested an adaptive response of the liver, a reversible change, possibly related to the increased serum lipids in the same patients. PMID- 3816711 TI - Antiepileptic effects under steady state of phenytoin serum levels produced in acute experiments. AB - The antiepileptic effects of phenytoin (PHT) were examined during steady-state serum levels. Experiments were conducted on 69 adult male rabbits weighing 2.5 3.5 kg. A steady state of one or two different PHT serum levels per rabbit was produced with intravenous (i.v.) injections of loading and infusion doses. A train of focal and generalized seizure discharges (SDs) induced by electrical stimulation was compared before and after dosing with PHT. The results showed that PHT levels of 10-40 micrograms/ml induce inhibitory effects, shortening the duration of neocortical focal SDs. The inhibitory effects paralleled the PHT levels and were proportionally related to epileptogenicity in individual neocortical areas. At serum levels under approximately 5-10 micrograms/ml, the spread of secondarily generalized SDs originating from neocortical focal SDs was suppressed more than the shortening of the duration of the primary focus. On the other hand, PHT showed no effects or only slight inhibitory effects on hippocampal SDs, and the SDs spread from them even at levels of 15-40 micrograms/ml. Electroshock (ES)-induced generalized SDs were slightly suppressed in duration at levels of 20-30 micrograms/ml. Moreover, both the focal and the generalized SDs were greatly prolonged at high serum levels (greater than 40 micrograms/ml), although such facilitative effects were rare. The clinical contributions of these results to PHT treatment in human epilepsy are discussed. PMID- 3816712 TI - Pentylenetetrazole-induced changes in cerebral energy metabolism in Tupaia glis. AB - The convulsant pentylenetetrazole was administered to the lower primate, the tree shrew. Shortly after the onset of seizures, the animals were killed using a microwave device at 25 Kw and 915 MHz. The energy metabolites glycogen, glucose, ATP, and phosphocreatine were measured in five layers of the cerebral cortex and three layers of the cerebellum. Results showed that, as compared with controls, seizing animals had decreased energy metabolites selective to certain layers. Glucose was decreased in all cortical layers, but only in the granular layer of the cerebellum. Phosphocreatine was decreased in the outer small pyramidal layer and the polymorphous layer of the cortex but was unchanged in the cerebellum. ATP was decreased only in the outer small polymorphous layer of the cortex. These changes are consistent with the concept that selective changes may occur during seizures and that these changes are localized to layers that contain pyramidal cells. Examination of whole cortex may mask more subtle regional changes. PMID- 3816713 TI - Early treatment and prognosis of epilepsy. AB - Community-based studies and our own prospective hospital-based studies suggest that the prognosis for control of epilepsy is more favorable than previously reported. Approximately three quarters of newly diagnosed patients can enter prolonged remission on currently available medication. The first 2 years of treatment are crucial in determining the subsequent course of epilepsy. The longer seizures continue, the less likely they are to be controlled. Factors that contribute to the evolution of chronic epilepsy are the presence of brain lesions, neuropsychiatric handicaps, and poor compliance. Early effective treatment may also be important in preventing the evolution of chronic epilepsy. Recent studies have not revealed any significant differences in efficacy between the major antiepileptic drugs, and the choice of drug will therefore be influenced by costs and side effects, especially cognitive and behavioral effects. The majority of patients with a single unprovoked tonic-clonic seizure go on to develop epilepsy. Studies are required to evaluate the need for and outcome of therapy in such patients. Information about the natural history of untreated epilepsy, and also the possible influence of drug therapy on the prospects for spontaneous remission, is lacking. PMID- 3816714 TI - Mutagenesis of L5178Y/TK(+/-)-3.7.2C mouse lymphoma cells by the clastogen ellipticine. AB - Ellipticine is a potent clastogen in CHO cells (Bhuyan et al: Cancer Res 32:2538 2544, 1972). The reported mutant frequencies produced by ellipticine at the hprt locus in CHO cells are less than or equal to 50/10(6) survivors (background approximately 2/10(6); survival = 10%) (DeMarini et al: Cancer Res 43:3544-3552, 1983; Singh and Gupta: Cancer Res 43:577-584, 1983; Environ Mutagen 5:871-880, 1983). In the present study, the mutagenic and clastogenic activities of ellipticine were evaluated in L5178Y/TK(+/-)-3.7.2C mouse lymphoma cells. Unlike the results at the hprt locus, ellipticine is a potent mutagen at the tk locus, with as little as 50 ng/ml producing an induced mutant frequency of 142/10(6) survivors (background = 56/10(6); survival = 61%) and 198/10(6) survivors (background = 72/10(6); survival = 50%) in two separate experiments. This same dose of ellipticine induced 44 aberrations per 100 metaphases (background = 5/100 cells). At 400 ng/ml, ellipticine induced over 1,000 mutants/10(6) survivors at approximately 10% survival and produced 242 aberrations/100 cells. Under the test conditions, most of the aberrations were chromosome rather than chromatid events. As expected for a compound acting primarily by a clastogenic mechanism, almost all of the TK-deficient mutants were small colonies. Thus, ellipticine is a potent clastogen in both Chinese hamster cells and in mouse lymphoma cells; however, it is a potent mutagen at only the tk locus and not at the hprt locus. These results support the hypothesis that the location of the target gene affects the ability of the assay to detect both intragenic events and events causing the loss of multiple loci. Thus, a heterozygous locus (like tk) but not a functionally hemizygous locus (like hprt) may permit the more efficient detection of mutagens that act primarily by a clastogenic mechanism. PMID- 3816715 TI - Re-evaluation of 1,2-dimethylhydrazine in the mouse bone marrow micronucleus assay: observation of a positive response. AB - 1,2-Dimethylhydrazine showed dose-related clastogenic activity in the mouse bone marrow micronucleus assay following intubation of an aqueous solution of the dihydrocholoride salt (10 and 50 mg/kg, 24 h sampling). These data counter earlier reports of the inactivity of this material in a rat and a mouse micronucleus assay, following its intraperitoneal injection. In the present study, 2,000 polychromatic erythrocytes were assessed per animal. However, had only 300 cells been assessed for micronucleated polychromatic erythrocytes, it is shown that a negative result could have been recorded. This may explain the earlier and negative results. PMID- 3816716 TI - Second International Symposium on Health Effects of Drinking Water Disinfectants and Disinfection By-products. August 27-29, 1985, Cincinnati, Ohio. PMID- 3816717 TI - Products identified at an alternative disinfection pilot plant. AB - Many drinking water utilities have recently changed or are seriously considering changing their disinfection practice from chlorine to some alternative treatment process. However, most of these utilities are changing their disinfectants without evaluating chemical impacts. Therefore, a research cooperative agreement was developed with Jefferson Parish, LA, to evaluate four parallel streams treated with four different disinfectants (chlorine, monochloramine, chlorine dioxide, and ozone.) These streams, along with a fifth parallel stream, which was not treated with a disinfectant (control), were passed through both sand and granular activated carbon (GAC). Ozonation reduced the total organic carbon (TOC) and total organic halide (TOX) concentration by 0.3 mg/L and 10 micrograms/L, respectively. The average concentration of TOC for the other disinfectants was comparable to that associated with the nondisinfected stream (3.3 mg/L). The average instantaneous TOX concentration for chlorine dioxide, chloramine, and chlorine disinfection after 30 min contact time increased by 60, 92, and 238 micrograms/L, respectively, from a nondisinfected concentration of 25 micrograms/L. The volatile organics most affected by disinfection (chlorination) were the trihalomethanes. No significant change in concentration was noted after disinfection for the other volatile organics evaluated, such as 1,2 dichlorethane, dichloromethane, trichloroethylene, 1,1,2-trichloroethane, and carbon tetrachloride. Ozonation produced an average concentration reduction of 11 to 84% for most of the nonvolatiles evaluated. Conversely, a concentration increase of 43 to 100% was noted, after chlorination, for some of the nonvolatile organics. PMID- 3816718 TI - Results of toxicological testing of Jefferson Parish pilot plant samples. AB - Five toxicological tests were performed using concentrated drinking water samples collected at a pilot-scale drinking water treatment plant that had streams treated with different disinfectants (no disinfectant, ozone, chlorine dioxide, monochloramine, or chlorine) before treatment with granular activated carbon (GAC). The toxicological tests used in this study were the Ames Salmonella assay, a subchronic in vivo toxicity assay in mice, the SENCAR mouse skin initiation promotion assay, a rat liver foci assay, and the lung adenoma assay in strain A mice. These tests were conducted to determine the general toxicity and the mutagenic/carcinogenic potential associated with the use of disinfection and/or GAC in the treatment of drinking water. The stability of the mutagenic activity of the samples tested was determined by repeated analysis using the Ames Salmonella assay. Results indicated that the samples remained mutagenic for the duration of the tests. All the drinking water concentrates (4000 X) prepared by the XAD resin adsorption procedure failed to provide statistically significant indication of carcinogenic activity in the SENCAR mouse, rat liver foci, and the lung adenoma assays. However, concentrates of the chlorine, chlorine dioxide, and monochloramine treated waters gave consistent mutagenic responses in the Ames Salmonella assay. GAC was effective for 6 months in removing both the mutagenicity of chlorine-treated water and the potential of water to become mutagenic when treated with chlorine. In the in vivo, subchronic 30-day toxicity test in mice, some statistically significant differences in organ weights and body weights of animals exposed to different concentrates of some of the samples were observed. However, a consistent pattern of these differences indicating overt toxicity was not detected. PMID- 3816719 TI - Mutagenic activity of concentrated drinking water samples. AB - Concentrated drinking water extracts prepared by adsorption onto XAD-2 resin have been tested for their ability to induce chromosome damage in mammalian cells. Extracts prepared from drinking waters derived from upland and lowland sources have been found to induce chromosome aberrations in Chinese hamster ovary (CHO) cells and human lymphocytes in vitro. Although the identity of the compounds responsible for this activity is unknown, they are generated when the water is chlorinated and appear to bind readily to exogenous protein. When groups of mice were dosed orally with a concentrated water extract, however, no evidence of clastogenic activity in bone marrow cells was apparent. The absence of an in vivo effect may indicate that the mutagenic compounds failed to reach the bone marrow. The possibility that genetic damage could be induced in the cells first encountered in the body after ingestion (i.e., cells in the esophagus, stomach, and intestinal tract) is not precluded by this result. The relevance of these findings in evaluating the potential health hazard of mutagenic compounds in drinking water is discussed. PMID- 3816720 TI - Role of ozone and granular activated carbon in the removal of mutagenic compounds. AB - The identification of certain organic compounds in drinking water has led water treatment specialists to be increasingly concerned about the eventual risks of such pollutants to the health of consumers. Our experiments focused on the role of ozone and granular activated carbon in removing mutagenic compounds and precursors that become toxic after chlorination. We found that if a sufficient dose of ozone is applied, its use does not lead to the creation of mutagenic compounds in drinking water and can even eliminate the initial mutagenicity of the water. The formation of new mutagenic compounds seems to be induced by ozonation that is too weak, although these mutagens can be removed by GAC filtration. Ozone used with activated carbon can be one of the best means for eliminating the compounds contributing to the mutagenicity of water. A combined treatment of ozone and activated carbon also decreases the chlorine consumption of the treated water and consequently reduces the formation of chlorinated organic compounds. PMID- 3816721 TI - Mutagenic activity of disinfection by-products. AB - Data on raw water quality, disinfection treatment practices, and the resulting mutagenic properties of the treated water were compiled from pilot- and full scale treatment experiments to evaluate that parameter which might produce variability in the results of a mutagenic study. Analysis of the data and comparison of treatment practices indicated that the measured mutagenic activity is strongly related to the characteristics of the organic matter in the raw water, the methodology used to sample and detect mutagens, the scale of the study both in terms of treatment flow and period of study, and the point at which and the conditions under which oxidants are added during treatment. Conclusions regarding disinfection systems in full-scale water treatment plants include the following: When raw water is pretreated and high concentrations of organics are present in the raw water, both ozonation and chlorination increased mutagenic activity. However, no significant difference in mutagenicity was found between the two oxidants. Both in the case of a nitrified groundwater and a clarified surface water, the mutagenic activity of the water after ozonation was related to its mutagenic activity before ozonation. With ozonation, mutagenic activity decreased after granular activated carbon (GAC) filtration. Thus, when GAC filtration follows ozone disinfection, early addition of oxidants may not be deleterious to the finished water quality. When chlorine or chlorine dioxide is added after GAC filtration, chlorine dioxide was found to produce a less mutagenic water than chlorine. Although these conclusions suggest means of controlling mutagenic activity during treatment, it must be stressed that the measurement of mutagenicity is a presumptive index of contamination level. PMID- 3816722 TI - Toxicology of haloacetonitriles. AB - Haloacetonitriles are by-products of water chlorination and may form in vivo from the reaction of residual chlorine with endogenous compounds such as amino acids. Dibromoacetonitrile (DBAN) was negative in selected mutagenic assays; dichloroacetonitrile (DCAN) was mutagenic in S. typhimurium, but not in S. cerevisiae. Both DBAN and DCAN may be carcinogenic. There is a paucity of basic toxicological data for these compounds. The studies described were conducted to determine the acute, subacute, and subchronic toxicity of DBAN and DCAN. The acute oral LD50 values (mg/kg) in mice and rats are: DBAN, mice: 289 (M), 303 (F); DBAN, rats: 245 (M), 361 (F); DCAN, mice: 270 (M), 279 (F); DCAN, rats: 339 (M), 330 (F). Death was preceded by slowed respiration, depressed activity, prostration, and coma. There were no apparent compound-related gross pathological effects. DBAN (in corn oil) was administered by gavage to male and female CD rats for 14 or 90 days at levels of 23, 45, 90, and 180 mg/kg/day or 6, 23, and 45 mg/kg/day, respectively. Mortality was 100% at 180 mg/kg and 40% (M) and 20% (F) at 90 mg/kg/day. Compound-related mortality was 10% (M) and 5% (F) at 45 mg/kg and 0% (M) and 10% (F) at 23 mg/kg during the 90-day study. No consistent, significant, adverse compound-related effects on any of the parameters evaluated were evident. Possible target organs might be spleen, thymus, and liver. The no observed adverse-effect level (NOAEL) for 14 days was 45 mg/kg/day and for 90 days was 23 mg/kg/day. DCAN (in corn oil) was administered by gavage to male and female CD rats for 14 or 90 days at levels of 12, 23, 45, and 90 mg/kg/day or 8, 33, and 65 mg/kg/day, respectively. There were no deaths during the 14-day study. Compound-related mortality was 50% (M) and 25% (F) at 65 mg/kg, 10% (M) and 5% (F) at 33 mg/kg, and 5% (M) and 0% (F) at 8 mg/kg during the 90-day study. Body weights were significantly lower at 90 and 65 mg/kg/day; weight and ratios of spleen and gonads and cholesterol levels were significantly lower at 90 mg/kg/day. No consistent, significant adverse compound-related effects on any of the parameters evaluated were evident. The NOAEL for 14 days was 45 mg/kg/day and for 90 days was 8 mg/kg/day. PMID- 3816723 TI - Studies of the toxic interactions of disinfection by-products. AB - A large number and variety of compounds are formed in the process of chlorinating drinking water. The classes of compounds formed include trihalomethanes, haloacetic acids, haloacetonitriles, halophenols, and halopropanones. Many of the compounds have been shown to be toxic and are currently being further evaluated by the U.S. Environmental Protection Agency (EPA). One group of the halopropanones found in chlorinated drinking water is the dichloropropanones. The toxicological properties of this group have not been well characterized. In addition, a number of investigators have shown that ketones potentiate the hepatotoxicity of haloalkanes. We conducted a series of studies to explore both the toxicity of the dichloropropanones and their potential interactions with a well-characterized haloalkane, carbon tetrachloride. A variety of toxicological and biochemical endpoints were used to evaluate the toxicity of the dichloropropanones and their interaction with CCl4, including cytochrome P-450 concentration, reduced glutathione levels, pentane generation, serum enzyme activities, and histopathology. Administration of 1,1-dichloropropanone (DCP) resulted in elevated serum enzymes associated with periportal necrosis. Glutathione levels were reduced by the administration of 1,1-DCP; pentane generation was not increased. When 1,1-DCP was given prior to CCl4, the data were consistent with additivity. Administration of 1,3-DCP did not result in elevated serum enzymes, nor was there histopathologic evidence of necrosis. Glutathione levels and pentane generation in the 1,3-DCP-treated groups were the same as those of controls. Inhibition of the toxicologic effects of CCl4 in a dose related manner was observed when 1,3-DCP was administered prior to CCl4. PMID- 3816724 TI - Effect of chloroacetic acids on the kidneys. AB - The effects of dichloroacetate (DCA) and trichloroacetate (TCA) administered in drinking water were studied. At high concentrations of either compound, weight loss, or failure to gain weight, was observed. Food consumption was also decreased; both effects were attributed to decreased water consumption. Renal phosphate-dependent glutaminase activity was increased at the highest concentration, and urinary ammonia was also increased. These changes indicated renal adaptation to an acid load. DCA, in pharmacological doses, impairs glucoenogenesis from lactate in part by decreasing lactate availability. Similar tendencies were observed in the present studies; however, female rats showed a biphasic response. At lower DCA concentrations, tissue lactate and plasma glucose concentrations were increased, whereas at higher concentrations of DCA, the expected decreases were observed. PMID- 3816725 TI - Excretion and tissue disposition of dichloroacetonitrile in rats and mice. AB - The excretion and tissue distribution of [1-14C]dichloroacetonitrile and [2 14C]dichloroacetonitrile were studied in male Fischer 344 rats and male B6C3F1 mice. Three dose levels of dichloroacetonitrile (DCAN) (0.2, 2, or 15 mg/kg) were administered to rats and two dose levels of DCAN (2 or 15 mg/kg) to mice. Daily excreta including exhaled volatiles and radiolabeled carbon dioxide (14CO2) were analyzed for radiolabeled carbon (14C) until greater than 70% of the radioactivity was excreted. At that time the animals were sacrificed and tissues were collected. Tissues and excreta were analyzed for 14C by combustion and liquid scintillation counting. Rats administered [1-14C]DCAN excreted 62 to 73% of the 14C in 6 days, with 42 to 45% in urine, 14 to 20% in feces, and 3 to 8% as CO2. Rats administered [2-14C]DCAN excreted 82 to 86% of the 14C in 48 hr, with 35 to 40% in urine, 33 to 34% as CO2, and 10 to 13% in feces. Mice administered [1-14C]DCAN excreted 83 to 85% of the 14C in 24 hr, with 64 to 70% in urine, 9 to 13% in feces, and 5 to 6% as CO2. Mice administered [2-14C]DCAN excreted 84 to 88% of the 14C in 24 hr with 42 to 43% in urine, 8 to 11% in feces, and 31 to 37% as CO2. Liver tissues retained the most 14C in all studies except the study of [1 14C]DCAN in rats, where blood contained the most 14C. These results indicate that DCAN was absorbed rapidly after oral administration in water. The differences in the route of excretion of [1-14C]DCAN compared to [2-14C]DCAN indicated that the molecule was being cleaved in the body and metabolized by different mechanisms. PMID- 3816726 TI - Long-term in vivo carcinogenicity tests of potassium bromate, sodium hypochlorite, and sodium chlorite conducted in Japan. AB - Long-term in vivo carcinogenicity tests of potassium bromate (KBrO3), sodium hypochlorite (NaClO), and sodium chlorite (NaClO2) have been conducted in Japan from 1977 to 1985. In these investigations, groups of approximately 50 male and 50 female F344 rats or B6C3F1 mice were given solutions of the compounds as their drinking water ad libitum at two dose levels determined on the basis of preliminary 13-week tests. Control animals were given distilled water. The carcinogenic potential of KBrO3 was tested by administering doses of 500 or 250 ppm to rats for 110 weeks. Significantly elevated incidences of renal cell tumors in males and females and mesotheliomas of the peritoneum in males as compared to controls were observed. When female mice were given KBrO3 at doses of 1000 or 500 ppm for 78 weeks, no significant differences in tumor incidences between experimental and control groups were apparent. NaClO was administered to male and female rats, respectively, at doses of 1000 or 500 ppm and 2000 or 1000 ppm for 104 weeks. In mice, NaClO was given at doses of 1000 or 500 ppm to either sex for 103 weeks. The incidences of tumors in NaClO-treated and control animals of both sexes were not significantly different in both rat and mouse studies. NaClO2 was given to rats of both sexes at a dose of 600 or 300 ppm for 85 weeks. No statistically significant differences were observed in the incidences of tumor formation between NaClO2-treated and control groups of both sexes. NaClO2 was administered to mice at a concentration of 500 or 250 ppm for 85 weeks. In males, the combined incidences of hyperplastic nodules and hepatocellular carcinomas of the liver in a low-dose group, and adenomas and adenocarcinomas of the lung in a high-dose group, were marginally increased compared to controls (p less than 0.05). However, these incidences in treated males were within the range of values of historical control data in our program. We concluded that KBrO3 was carcinogenic in rats of both sexes. NaClO was not carcinogenic in either rats and or mice under the conditions of the present studies. Although NaClO2 was shown to be noncarcinogenic in rats, the results for mice were evaluated as inconclusive. Also the results of two-stage mouse skin carcinogenesis using KBrO3, NaClO, and NaClO2 are presented. The necessity for further testing of oxidant chemicals to determine potential carcinogenic and/or promoting effects is suggested in view of the recently proposed role of active oxygen species in carcinogenesis. PMID- 3816727 TI - Reproductive effects of alternative disinfectants. AB - Organohalides formed through the reaction of chlorine and organic compounds in natural and waste waters pose potential health hazards. For this reason, alternative water disinfectants that do not form organohalides are being investigated with great interest. Limited data are available on the health effects, in particular reproductive toxicity effects, of these compounds. In our laboratory, we have examined the reproductive effects of chloramine and chlorine administered by gavage in Long-Evans rats. Animals were treated for a total of 66 to 76 days. Males were treated for 56 days and females for 14 days prior to breeding and throughout the 10-day breeding period. Females were treated throughout gestation and lactation. Following breeding, the males were necropsied and evaluated for sperm parameters and reproductive tract histopathology. Adult females and some pups were necropsied at weaning on postnatal day 21. Other pups were treated postweaning until 28 or 40 days of age. These pups were evaluated for the day of vaginal patency and thyroid hormone levels. No differences were observed between control rats and those rats exposed to up to 5 mg/kg/day chlorine or 10 mg/kg/day chloramine when fertility, viability, litter size, day of eye opening, or day of vaginal patency were evaluated. No alterations in sperm count, sperm direct progressive movement (micron/sec), percent motility, or sperm morphology were observed among adult male rats. In addition, male and female reproductive organ weights were comparable to their respective control groups, and no significant histopathologic changes were observed among chlorine- or chloramine-treated male and female rats. PMID- 3816728 TI - Relationship of dietary iodide and drinking water disinfectants to thyroid function in experimental animals. AB - The importance of dietary iodide on the reported hypothyroid effect of drinking water disinfectants on thyroid function was investigated. Previous studies have also showed differences in the relative sensitivity of pigeons and rabbits to chlorinated water. Pigeons and rabbits were exposed for 3 months to diets containing high (950 ppb) or low (300 ppb) levels of iodide and to drinking water containing two levels of chlorine. Results showed that the high-iodide diet prevented the hypothyroid effect observed in pigeons given the low-iodide diet and chlorinated drinking water. Similar trends were observed in rabbits exposed to the same treatment; however, significant hypothyroid effects were not observed in this animal model. The factor associated with the observed effect of dietary iodide on the chlorine-induced change in thyroid function is unknown, as is the relative sensitivity of rabbits and pigeons to the effect of chlorine. Several factors may explain the importance of dietary iodide and the relative sensitivity of these species. For example, the iodine formed by the known reaction of chlorine with iodide could result in a decrease in the plasma level of iodide because of the relative absorption rates of iodide and iodine in the intestinal tract, and the various types and concentrations of chloroorganics (metabolites) formed in the diet following the exposure of various dietary constituents to chlorine could affect the thyroid function. The former factor was investigated in the present studies. Results do not confirm a consistent, significant reduction in the plasma level of iodide in rabbits and pigeons exposed to chlorinated water and the low-iodide diet. The latter factor is being investigated. PMID- 3816729 TI - Mechanistic aspects of ingested chlorine dioxide on thyroid function: impact of oxidants on iodide metabolism. AB - Toxicological studies dealing with recent findings of health effects of drinking water disinfectants are reviewed. Experiments with monkeys and rodents indicate that the biological activity of ingested disinfectants is expressed via their chemical interaction with the mucosal epithelia, secretory products, and nutritional contents of the alimentary tract. Evidence exists that a principal partner of this redox interaction is the iodide of nutritional origin that is ubiquitous in the gastrointestinal tract. Thus the observation that subchronic exposure to chlorine dioxide (ClO2) in drinking water decreases serum thyroxine levels in mammalian species can be best explained with changes produced in the chemical form of the bioavailable iodide. Ongoing and previously reported mechanistic studies indicate that oxidizing agents such as chlorine-based disinfectants oxidize the basal iodide content of the gastrointestinal tract. The resulting reactive iodine species readily attaches to organic matter by covalent bonding. Evidence suggests that the extent to which such iodinated organics are formed is proportional to the magnitude of the electromotive force and stoichiometry of the redox couple between iodide and the disinfectant. Because the extent of thyroid uptake of the bioavailable iodide does not decrease during ClO2 ingestion, it seems that ClO2 does not cause iodide deficiency of sufficient magnitude to account for the decrease in hormonogenesis. Absorption of one or more of iodinated molecules, e.g., nutrients, hormones, or cellular constituents of the alimentary tract having thyromimetic or thyroid inhibitory properties, is a better hypothesis for the effects seen. PMID- 3816731 TI - Summation from a regulatory perspective. AB - There is an urgent need to discuss the Office of Drinking Water's standard setting or rulemaking process since most of the researchers whose papers are presented here directly or indirectly play a crucial role in this complex undertaking. Therefore, this paper will address the research data required to support policymaking and regulatory decisions pertaining to health effects of disinfectants and disinfection by-products. PMID- 3816730 TI - Type of disinfectant in drinking water and patterns of mortality in Massachusetts. AB - Chlorination has been the major strategy for disinfection of drinking water in the United States. Concern about the potential health effects of the reaction by products of chlorine has prompted use of alternative strategies. One such method is chloramination, a treatment process that does not appear to have carcinogenic by-products, but may have less potent biocidal activity than chlorination. We examined the patterns of mortality of residents in Massachusetts who died between 1969 and 1983 and lived in communities using drinking water that was disinfected either by chlorine or chloramine. Comparison of type of disinfectant among 51,645 cases of deaths due to selected cancer sites and 214,988 controls who died from cardiovascular, cerebrovascular, or pulmonary disease, or from lymphatic cancer showed small variation in the patterns of mortality. Bladder cancer was moderately associated with residence at death in a chlorinated community (mortality odds ratio = 1.7, 95% confidence interval = 1.3-2.2) in a logistic regression analysis using controls who died from lymphatic cancer. A slight excess of deaths from pneumonia and influenza was observed in communities whose residents drank chloraminated water compared to residents from chlorinated communities, as well as to all Massachusetts residents (standardized mortality ratio = 118, 95% confidence interval = 116-120 for chloraminated communities, and standardized mortality ratio = 98, 95% confidence interval = 95-100 for chlorinated communities). These results are intended to be preliminary and crude descriptions of the relationship under study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816732 TI - Health research needed to resolve scientific issues surrounding drinking water disinfection. PMID- 3816733 TI - Mechanisms of chloroform and carbon tetrachloride toxicity in primary cultured mouse hepatocytes. AB - Mechanisms of chloroform (CHCl3) and carbon tetrachloride (CCl4) toxicity to primary cultured male B6C3F1 mouse hepatocytes were investigated. The cytotoxicity of both CHCl3 and CCl4 was dose- and duration-dependent. Maximal hepatocyte toxicity, as determined by lactate dehydrogenase leakage into the culture medium, occurred with the highest concentrations of CHCl3 (5 mM) and CCl4 (2.5 mM) used and with the longest duration of treatment (20 hr). CCl4 was approximately 16 times more toxic than CHCl3 to the hepatocytes. The toxicity of these compounds was decreased by adding the mixed function oxidase system (MFOS) inhibitor, SKF-525A (25 microM) to the cultures. The addition of diethyl maleate (0.25 mM), which depletes intracellular glutathione (GSH)-potentiated CHCl3 and CCl4 toxicity. The toxicity of CHCl3 and CCl4 could also be decreased by adding the antioxidants N,N'-diphenyl-p-phenylenediamine (DPPD) (25 microM), alpha tocopherol acetate (Vitamin E) (0.1 mM), or superoxide dismutase (SOD) (100 U/mL) to the cultures. These results suggest that: in mouse hepatocytes, both CHCl3 and CCl4 are metabolized to toxic components by the MFOS; GSH plays a role in detoxifying those metabolites; free radicals are produced during the metabolism of CHCl3 and CCl4; and free radicals may be important mediators of the toxicity of these two halomethanes. PMID- 3816734 TI - Lethal and sublethal effects of chlorine, phenol, and chlorine-phenol mixtures on the mud crab, Panopeus herbstii. AB - The mud crab, Panopeus herbstii, was acutely exposed (96-hr) to chlorine-produced oxidants (CPO), phenol, and a CPO-phenolic mixture (1:1) to determine lethal and sublethal effects. The 96-hr (LC50) values were determined for each individual compound and mixture. Additionally, whole-animal respiration rates were measured following acute exposure to sublethal concentrations of each compound or mixture. Phenol uptake/depuration rates were measured in the phenol and CPO-phenol mixture concentrations. Results indicated 96-hr LC50 values of 1.06 mg/L for CPO (fiducial limits (FL) = 0.53-2.01 mg/L), 52.8 mg/L for phenol (FL = 45.6-64.5 mg/L), and 184.7 mg/L total toxicant units (TTU) for the CPO-phenol mixture (FL = 143.7-250.2 mg/L TTU). Statistical analysis indicated that the acute toxicity of the CPO-phenol mixture was less than additive. Sublethal studies indicated that only acute exposure to sublethal concentrations of CPO caused altered respiration rates. After 96-hr depuration, metabolic rates in all CPO-exposure crabs generally returned to control rates. Uptake/depuration rate studies indicated significantly lower phenol uptake rates in crabs exposed to the CPO-phenol mixture. These findings suggest that the less-than-additive toxicity of the CPO phenol mixture may result from lowered uptake/depuration rate kinetics and indicate that the discharge of chlorinated-phenolic waste may not result in additive and/or synergistic interactions, but rather in less-than-additive effects on decapod aquatic species. PMID- 3816735 TI - Effects of disinfectants in renal dialysis patients. AB - Patients receiving hemodialysis therapy risk exposure to both disinfectants and sterilants. Dialysis equipment is disinfected periodically with strong solutions of hypochlorite or formaldehyde. More recently, reuse of dialyzers has introduced the use of additional sterilants, such as hydrogen peroxide and peracetic acid. The use of these sterilants is recognized by the center staffs and the home patient as a potential risk, and residue tests are carried out for the presence of these sterilants at the ppm level. Gross hemolysis resulting from accidental hypochlorite infusion has led to cardiac arrest, probably as a result of hyperkalemia. Formaldehyde is commonly used in 4% solutions to sterilize the fluid paths of dialysis controllers and to sterilize dialyzers before reuse. It can react with red cell antigenic surfaces leading to the formation of anti-N antibodies. Such reactions probably do not occur with hypochlorite or chloramines. The major exposure risk is the low concentration of disinfectant found in municipal water used to prepare 450 L dialysate weekly. With thrice weekly treatment schedules, the quality requirements for water used to make this solution must be met rigorously. Standards for water used in the preparation of dialysate have recently been proposed but not all patients are treated with dialysate meeting such standards. The introduction of sterilants via tap water is insidious and has led to more pervasive consequences. Both chlorine and chloramines, at concentrations found in potable water, are strong oxidants that cause extensive protein denaturation and hemolysis. Oxidation of the Fe2+ in hemoglobin to Fe3+ forms methemoglobin, which is incapable of carrying either O2 or CO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816736 TI - Enhancement of the hepatotoxicity of chloroform in B6C3F1 mice by corn oil: implications for chloroform carcinogenesis. AB - A recent study of the ability of chloroform in drinking water to produce cancer reported that male Osborne-Mendel rats developed renal tumors, but that female B6C3F1 mice failed to develop hepatocellular carcinomas. The results obtained in the male Osborne-Mendel rats were comparable to those observed in an earlier study sponsored by the National Cancer Institute (NCI). On the other hand, the lack of an increased incidence of hepatocellular carcinomas in female B6C3F1 mice was in sharp contrast to previously reported results. The doses of chloroform used were comparable to that which produced an 85% incidence in the NCI study. We have investigated the extent to which the vehicle might be responsible for the different results in these two studies by examining the differential effects of chloroform when it was administered by gavage using corn oil versus a 2% Emulphor suspension as the vehicle. Male and female B6C3F1 mice were administered chloroform at 60, 130, and 270 mg/kg per day for 90 days. At sacrifice, body and organ weights were measured, and blood was recovered to perform the following serum chemistry measurements (in order of priority): glutamate oxalacetate transaminase (SGOT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN), and triglyceride (TG) levels. The liver was sectioned for histopathological examination. Chloroform increased SGOT levels significantly only when administered in corn oil at a dose of 270 mg/kg in both male and female mice. It had no effect on LDH activity. There was a small increase in BUN when chloroform was administered in corn oil, but not when administered in 2% Emulphor. When administered in corn oil, chloroform significantly decreased serum TG levels but was without effect on this parameter when administered in 2% Emulphor. Chloroform decreased body weight and increased liver weight with both vehicles, but the effects were significantly greater when it was administered in corn oil. Mice administered chloroform in corn oil displayed a significant degree of diffuse parenchymal degeneration (5 of 10 males and 1 of 10 females) and mild to moderate early cirrhosis (5 of 10 males and 9 of 10 females); significant pathological lesions were not observed in the animals administered corn oil without chloroform nor in mice receiving chloroform in 2% Emulphor. These data indicate that administration of chloroform by corn oil gavage results in more marked hepatotoxic effects than observed when it is provided in an aqueous suspension.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3816737 TI - Haloacetonitriles: metabolism, genotoxicity, and tumor-initiating activity. AB - Haloacetonitriles (HAN) are drinking water contaminants produced during chlorine disinfection. This paper evaluates metabolism, genotoxicity, and tumor-initiating activity of these chemicals. The alkylating potential of the HAN to react with the electrophile-trapping agent, 4-(p-nitrobenzyl)pyridine, followed the order dibromoacetonitrile (DBAN) greater than bromochloroacetonitrile (BCAN) greater than chloroacetonitrile (CAN) greater than dichloroacetonitrile (DCAN) greater than trichloroacetonitrile (TCAN). When administered orally to rats, the HAN were metabolized to cyanide and excreted in the urine as thiocyanate. The extent of thiocyanate excretion was CAN greater than BCAN greater than DCAN greater than DBAN much greater than TCAN. Haloacetonitriles inhibited in vitro microsomal dimethylnitrosamine demethylase (DMN-DM) activity. The most potent inhibitors were DBAN and BCAN, with Ki = 3-4 X 10(-5) M; the next potent were DCAN and TCAN, with Ki = 2 X 10(-4) M; and the least potent inhibitor was CAN, with Ki = 9 X 10( 2) M. When administered orally, TCAN, but not DBAN, inhibited hepatic DMN-DM activity. The HAN produced DNA strand breaks in cultured human lymphoblastic (CCRF-CEM) cells. TCAN was the most potent DNA strand breaker, and BCAN greater than DBAN greater than DCAN greater than CAN, which was only marginally active. DCAN reacted with polyadenylic acid and DNA to form adducts in a cell-free system; however, the oral administration of DBAN or DCAN to rats did not result in detectable adduct formation in liver DNA. None of the HAN initiated gamma glutamyltranspeptidase (GGT) foci when assayed for tumor-initiating activity in rat liver foci bioassay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816738 TI - Microbial resistance to disinfectants: mechanisms and significance. AB - Drinking water disinfection provides the final barrier to transmission of a wide variety of potentially waterborne infectious agents including pathogenic bacteria, viruses, and protozoa. These agents differ greatly in their innate resistance to inactivation by disinfectants, ranging from extremely sensitive bacteria to highly resistant protozoan cysts. The close similarity between microorganism inactivation rates and the kinetics of chemical reactions has long been recognized. Ideally, under carefully controlled conditions, microorganism inactivation rates simulate first-order chemical reaction rates, making it possible to predict the effectiveness of disinfection under specific conditions. In practice, changes in relative resistance and deviations from first-order kinetics are caused by a number of factors, including microbial growth conditions, aggregation, and association with particulate materials. The net effect of all these factors is a reduction in the effectiveness and predictability of disinfection processes. To ensure effective pathogen control, disinfectant concentrations and contact times greater than experimentally determined values may be required. Of the factors causing enhanced disinfection resistance, protection by association with particulate matter is the most significant. Therefore, removal of particulate matter is an important step in increasing the effectiveness of disinfection processes. PMID- 3816739 TI - Contribution of chlorination to the mutagenic activity of drinking water extracts in Salmonella and Chinese hamster ovary cells. AB - The production of chlorinated by-products through chlorine disinfection of drinking water has been well documented. Natural organic precursors for these chemicals include fulvic and humic acids, the chlorination of which leads to the production of mutagenic compounds. Comparisons of extracts of raw versus treated waters have confirmed that clorination during water treatment produces mutagenic activity in the Salmonella (Ames) test. Present work on XAD-2 extracts of raw and chlorinated water from six municipalities in the Great Lakes region of Canada has involved a battery of mutagenicity assays for various genetic endpoints: the Salmonella test, the sister-chromatid exchange (SCE), and the micronucleus (MN) induction in Chinese hamster ovary (CHO) cells. All extracts of treated (chlorinated), but none of untreated, water were mutagenic in the Salmonella assay. On the other hand, extracts of both treated and untreated water samples showed activity in the SCE and MN assays, but no consistent pattern of response with regard to treatment (chlorination) was evident. These data show that chlorination contributes mutagens to drinking water and suggest that mammalian in vitro assays may be more sensitive for detecting mutagenicity in water samples than the Salmonella test. PMID- 3816741 TI - Psychosocial adjustment to and control of diabetes mellitus: differences by disease type and treatment. AB - The relationship of diabetic patients' psychosocial adjustment to disease type, treatment mode, and indexes of control was examined in a representative community population. The psychometric properties of the Diabetes Educational Profile (DEP) and its application to psychosocial research in diabetes were also investigated. Findings support the reliability and validity of the DEP. Various measures of psychosocial adjustment were related to diabetes control but the specific relationships depended on the particular aspect of adjustment, the specific measure of diabetes control, and the type of disease and treatment. The findings suggest that analyses that aggregate dissimilar patient groups are subject to misinterpretation due to ecological masking and supressor effects. The results indicate that clinicians and researchers must recognize that patients with different disease types and treatment modes have different norms for psychological adjustment and diabetes control. Further, the particular aspects of psychosocial adjustment associated with diabetes control differ across patient groups. PMID- 3816740 TI - Carcinogenicity of chlorinated methane and ethane compounds administered in drinking water to mice. AB - The chlorinated hydrocarbons chloroform (CHCl3), 1,1-dichlorethane (1,1-DCE) and 1,2-dichloroethane (1,2-DCE) have been detected in finished drinking water. When administered to B6C3F1 mice by gavage in corn oil, these compounds have been shown to induce hepatic tumors. The present study examines the effect on liver tumor incidence of continuous treatment of CHCl3 (600 mg/L and 1800 mg/L), 1,1 DCE (835 mg/L and 2500 mg/L), and 1,2-DCE (835 mg/L and 2500 mg/L) administered in drinking water to male B6C3F1 mice using a two-stage (initiation/promotion) treatment protocol. Seventy 4-week-old male B6C3F1 mice constituted each treatment group. Of these mice, 35 were initiated by treatment with diethylnitrosamine (DENA) (10 mg/L) in the drinking water for 4 weeks. The remaining 35 received deionized drinking water. Each group was subsequently treated with one of two concentrations of CHCl3, 1,1-DCE, or 1,2-DCE in drinking water for 52 weeks. An additional group received phenobarbital (PB) (500 mg/L) and served as the positive control for liver tumor promotion. Mice were sampled after 24 weeks (10 mice) and 52 weeks (25 mice). At sampling, liver and lung tumors were detected. None of the compounds increased the number or incidence of lung or liver tumors by themselves. PB promoted liver tumor formation (but not lung tumors) in the DENA-initiated mice. 1,1-DCE and 1,2-DCE did not affect the incidence or number of liver or lung tumors in the DENA-initiated animals. CHCl3, however, inhibited liver and lung tumorigenesis in the DENA-initiated mice. PMID- 3816742 TI - Health status, perceptions of risk, and prevention interest for health and nonhealth problems. AB - Healthy and acutely ill college students indicated their risk compared to their peers for 10 health and nonhealth problems. Participants as a whole showed clear evidence of optimistic bias. However, whereas healthy participants showed an equal tendency to be biased optimistically for health and nonhealth problems, ill participants felt significantly more vulnerable to future health relative to nonhealth problems. This was the case even though the future health problems were objectively unrelated to their current illnesses. Perceptions of the preventability of the health and nonhealth problems paralleled the comparative risk judgments. Finally, those who were ill expressed relatively little interest in receiving prevention information. Possible mechanisms and implications are discussed. PMID- 3816743 TI - Patient exposition and provider explanation in routine interviews and hypertensive patients' blood pressure control. AB - Hypertensive patients' expressing themselves in their own words (Exposition) and providers' giving information (Explanation) during medical interviews were hypothesized to be associated with subsequent blood pressure control. Transcripts of routine return visits to clinics in low-income areas of Houston, TX, were coded using the Verbal Response Modes (VRM) system. VRM indexes of Patient Exposition and Provider Explanation were tested in relation to systolic and diastolic blood pressure obtained during home interviews 2 weeks after the clinic visits. Patient Exposition was significantly correlated with reductions in systolic and diastolic blood pressure from clinic visit to home interview, and Provider Explanation was significantly correlated with lower diastolic blood pressure at home interview. The results suggest that patients' and providers' verbal behavior in medical interviews should be included in predictive models of blood pressure control. PMID- 3816744 TI - Heart rate perception in the type A personality. AB - Heart rate (HR) estimation and actual HRs were obtained from 28 Type A and 28 Type B males before and after receiving feedback about their actual HR levels, and during performance of a moderately stressful task, digit recall. Self-reports of affective arousal during digit recall were also obtained from the Anxiety scale of the Multiple Affect Adjective Check List (MAACL) and a self-report questionnaire measuring affective reactions. Type As showed significantly higher HR increases during the digit recall than did Type Bs. Type As also reported significantly more affective reactions than Type Bs on the self-report questionnaire, but not on the MAACL Anxiety scale. Type As significantly overestimated their HRs relative to Type B at rest before receiving feedback, and during the digit-recall task. These results contradict the usual assumption that Type As underestimate their arousal levels. PMID- 3816745 TI - Psychosocial aspects of genital herpes virus infection. AB - Genital herpes virus infection is one of the most prevalent and perhaps the most emotionally difficult of the sexually transmitted diseases. This article examines the current empirical and clinical understanding of the psychosocial aspects of the disease and proposes a framework for future investigation. Psychosocial issues of importance in the disease are discussed and responses characteristic of the psychosocial adjustment process are presented. Evidence of the role of stress and psychosocial factors is reviewed. Finally, a biopsychosocial research approach to the psychoneuroimmunological mechanisms of the disease is suggested as a way of understanding etiology and process. PMID- 3816746 TI - Effects of changes in sitting work posture on static neck and shoulder muscle activity. PMID- 3816747 TI - Load moments and myoelectric activity when the cervical spine is held in full flexion and extension. PMID- 3816748 TI - Manual card sorting compared to automatic card presentation for assessing visual lobe size. PMID- 3816749 TI - The effect of non-visual preview upon the walking speed of visually impaired people. PMID- 3816750 TI - Productivity on a weekly rotating shift system: circadian adjustment and sleep deprivation effects? PMID- 3816751 TI - Shoulder load during machine milking. An electromyographic and biomechanical study. PMID- 3816752 TI - Metabolic and perceptual responses while carrying external loads on the head and by yoke. PMID- 3816753 TI - Discomfort and load on the upper trapezius muscle when operating a wordprocessor. PMID- 3816754 TI - The effect of brightness on colour recognition under water. PMID- 3816755 TI - Kinetics of endosome acidification detected by mutant and wild-type Semliki Forest virus. AB - The fusogenic properties of Semliki Forest virus (SFV) and its mutants were used to follow the kinetics of acidification during the endocytic uptake of virus by BHK-21 cells. It has previously been shown that the low pH of endocytic vacuoles triggers a conformational change in the SFV spike glycoprotein, activating membrane fusion and initiating virus infection. This conformational alteration was here shown to occur in endosomes and to follow the same time course as the intracellular fusion reaction, demonstrating that fusion occurs rapidly after virus exposure to endosome acidity. The kinetics of endosome acidification were monitored using wild type (wt) SFV and fus-1, an SFV mutant with a lower fusion pH threshold. The results presented here demonstrated that wt and mutant virus were internalized with a t1/2 of 10 min, and that endosomes were acidified to the wt threshold of pH 6.2 with a t1/2 of 15 min. In contrast, endosome pH reached the fus-1 threshold of 5.3 with a much longer t1/2 of 45 min. The subsequent degradation of SFV in lysosomes had a t1/2 of 90 min. It was found that after the initial uptake of virus from the plasma membrane, its transit through the endocytic pathway, exposure to endosome acidity and eventual delivery to lysosomes were markedly asynchronous. PMID- 3816756 TI - Functional characterization of toposomes from sea urchin blastula embryos by a morphogenetic cell aggregation assay. AB - This paper documents the evidence that the large oligomeric glycoprotein complexes of unknown function first isolated as 22S particles from sea urchin embryos are the sole agents responsible for the adhesive integrity of sea urchin blastula embryos. The conclusion rests on the demonstration that polyclonal IgG (as serum or monovalent Fab) against whole membranes or butanol-solubilized components of membranes, as well as against the purified particle itself, completely blocks reaggregation of dissociated blastula cells and that this inhibition is reversed by neutralization of the inhibitory antibodies with purified 22S antigen. An essential aspect of the evidence is the combination of quantitative endpoint titrations in microtiter wells with the qualitative parameters of morphogenesis. The new data complement previous evidence that morphogenesis is mediated by a general class of particles, toposomes, responsible for mechanical linkage between cells and their positional guidance in embryogenesis. PMID- 3816757 TI - Purification and properties of a new clathrin assembly protein. AB - A clathrin assembly protein (AP180) has been purified and characterized from coated vesicles of bovine brain. This protein has hitherto escaped detection because in SDS-gel electrophoresis it is obscured by the 180 kd heavy chain of clathrin. Despite the similarity in electrophoretic mobility, AP180 differs from clathrin in both its subunit and native mol. wt, as well as hydrodynamic properties, surface charge and tryptic peptide composition. It also appears immunologically distinct from clathrin, since neither a polyclonal antiserum nor a monoclonal antibody, that have been shown to be specific for AP180, cross-react with the heavy chain of clathrin. AP180 binds to clathrin triskelia and thereby promotes clathrin assembly into regular polyhedral structures of narrow size distribution (60-90 nm), reminiscent of the surface coat of coated vesicles. In this respect AP180 bears a functional resemblance to the 100-110 kd clathrin assembly polypeptides that have been previously described. PMID- 3816758 TI - Analysis of acetylcholine receptor phosphorylation sites using antibodies to synthetic peptides and monoclonal antibodies. AB - Three peptides corresponding to residues 354-367, 364-374, 373-387 of the acetylcholine receptor (AChR) delta subunit were synthesized. These peptides represent the proposed phosphorylation sites of the cAMP-dependent protein kinase, the tyrosine-specific protein kinase and the calcium/phospholipid dependent protein kinase respectively. Using these peptides as substrates for phosphorylation by the catalytic subunit of cAMP-dependent protein kinase it was shown that only peptides 354-367 was phosphorylated whereas the other two were not. These results verify the location of the cAMP-dependent protein kinase phosphorylation site within the AChR delta subunit. Antibodies elicited against these peptides reacted with the delta subunit. The antipeptide antibodies and two monoclonal antibodies (7F2, 5.46) specific for the delta subunit were tested for their binding to non-phosphorylated receptor and to receptor phosphorylated by the catalytic subunit of cAMP-dependent protein kinase. Antibodies to peptide 354 367 were found to react preferentially with non-phosphorylated receptor whereas the two other anti-peptide antibodies bound equally to phosphorylated and non phosphorylated receptors. Monoclonal antibody 7F2 reacted preferentially with the phosphorylated form of the receptor whereas monoclonal antibody 5.46 did not distinguish between the two forms. PMID- 3816759 TI - Upstream sequences required for tissue-specific activation of the cardiac actin gene in Xenopus laevis embryos. AB - The entire DNA sequence of the Xenopus laevis cardiac actin gene was determined. A recombinant plasmid comprising the cardiac actin gene promoter fused to the bacterial chloramphenicol acetyl transferase (CAT) gene is correctly regulated after introduction into fertilized Xenopus eggs. The fusion gene shows a temporal and tissue-specific pattern of expression in the early embryo which is indistinguishable from that of the endogenous cardiac actin gene. The fusion gene is also activated in cultured embryo fragments that are induced by cell interactions to form embryonic muscle tissue. Tissue-specific expression of the recombinant requires sequences between 217 and 416 nucleotides upstream from the transcription initiation site. In contrast, both the chimaeric gene and the entire cardiac actin gene are expressed at a basal level after microinjection into Xenopus oocytes, requiring only the presence of a TATA box upstream from the cap site. PMID- 3816760 TI - Sequence-specific DNA binding of the progesterone receptor to the uteroglobin gene: effects of hormone, antihormone and receptor phosphorylation. AB - The effects of ligand binding and receptor phosphorylation on the interaction of progesterone receptor with specific DNA sequences in the uteroglobin gene were studied by nitro-cellulose filter binding and DNase I footprinting. High affinity sites were mapped upstream from the transcription start and in the first intron. They contained a common TGTTCACT sequence. These sites were occupied with similar affinity by the receptor, either in its free state, or complexed with the hormone or an antagonist (RU486); and also by receptor which had been phosphorylated in vivo in a hormone-dependent manner. In all cases identical footprints were observed. These experiments led to the following conclusions. The hormone dependency of receptor binding to DNA or chromatin is observed in intact cells and in crude cellular extracts but not with purified receptor. Thus in situ, the unliganded receptor probably interacts with some nuclear component(s) which stabilizes it in a 'non-activated' form (non-chromatin and non-DNA binding form). When isolated, the receptor may undergo activation, even in the absence of the hormone. Binding by receptor of an antihormone (and possibly receptor phosphorylation) exerts an effect on gene transcription through a mechanism which is different from (and probably follows) receptor interaction with the gene. PMID- 3816761 TI - A signal regulating mouse histone H4 mRNA levels in a mammalian cell cycle mutant and sequences controlling RNA 3' processing are both contained within the same 80 bp fragment. AB - Fragments from the 3' end of a mouse histone H4 gene, when introduced into transcription units controlled by the SV40 early promoter, yield correctly processed RNA with histone-specific 3' ends, both in monkey and mouse cell lines. The processed RNA is regulated in parallel with endogenous H4 mRNAs in 21-Tb cells, a temperature-sensitive mouse mastocytoma cell cycle mutant that is specifically blocked in G1 phase at the non-permissive temperature. Mutational analyses of the H4 gene fragment indicate that the minimal sequences for this regulation and for RNA 3' processing are both contained within the same 80 bp. This fragment contains two histone-specific, highly conserved sequence elements that are located at the 3' end of histone mRNA and in the adjacent spacer region, respectively. Our data suggest that the observed cell cycle regulation is achieved either at RNA 3' processing or at some later step involving the conserved 3'-terminal sequence element of mature histone mRNA. PMID- 3816762 TI - Structure and genomic organization of proretrovirus-like elements partially eliminated from the somatic genome of Ascaris lumbricoides. AB - A clone containing a middle repetitive element next to satellite DNA has been isolated from a germ line genomic library of the chromatin eliminating nematode Ascaris lumbricoides var. suum. The structure of this element has been elucidated by comparison of several clones containing the element in different environments. It is flanked by 256-bp-long terminal repeats (LTRs) and has an internal region of approximately 7 kb. The nucleotide sequences of both the 5' and the 3' LTRs have been determined. The element has a strong structural similarity with retroviral proviruses and related mobile elements. It was therefore named 'Tas', for transposon-like element of Ascaris. Approximately 50 Tas copies are dispersed over approximately 20 different chromosomal sites. Their genomic distribution varies between individuals, indicating that Tas elements are mobile in the Ascaris genome. Two variant forms, Tas-1 and Tas-2, present in a ratio of approximately 2 to 1 in the germ line genome, have been characterized. They differ not only in their restriction pattern, but also in their elimination behaviour. While only about one-fourth of the Tas-1 elements are expelled from the somatic cell lineage, all Tas-2 copies are specifically eliminated and are thus confined to the germ line cells. We have demonstrated that a cloned representative of Tas-1 elements is expelled concomitantly with its flanking DNA sequences during the chromatin elimination process. PMID- 3816763 TI - Regulatory sequences in the promoter of the Dictyostelium Actin 6 gene. AB - The promoter region of the developmentally regulated Actin 6 gene of Dictyostelium has been dissected by a series of deletions. Functional analysis of the deletions in Dictyostelium transformants revealed two short regulatory sequences: a positive upstream element (PUE) between -599 and -572 which increases transcription by a factor of 10 but does not affect the developmental pattern of expression and an upstream activator sequence (UAS) between -249 and 215 which is essential for transcription and proper developmental regulation. The UAS partially coincides with a conserved sequence with dyad symmetry found upstream of several Dictyostelium actin genes (Romans and Firtel, 1985a). PMID- 3816764 TI - Child health in a large-scale Ethiopian institution--the Children's Village. I. Somatic health. PMID- 3816765 TI - Child health in a large-scale Ethiopian institution--the Children's Village. III. Growth and malnutrition. PMID- 3816766 TI - Idiopathic facial paralysis (Bell's palsy) in 167 Ethiopians, with a controlled therapeutic trial in 59 patients. PMID- 3816767 TI - Optic atrophy in Ethiopians. PMID- 3816768 TI - Tuberculous meningitis presenting as an acute illness. PMID- 3816769 TI - An abdominal pregnancy with infected gestational sac. PMID- 3816770 TI - Gastric volvulus in Nigerians: report of 3 cases. PMID- 3816771 TI - Hypertrophic osteoarthropathy in an Ethiopian. PMID- 3816772 TI - Trachoma: frequency and treatment in the Gondar region. PMID- 3816773 TI - Child health in a large-scale Ethiopian institution--the Children's Village. II. Psychosomatic health. PMID- 3816774 TI - Tissue-specific expression of porphobilinogen deaminase. Two isoenzymes from a single gene. AB - Porphobilinogen deaminase (hydroxymethylbilane synthase; EC 4.3.1.8), the third enzyme of the heme biosynthetic pathway, catalyzes the stepwise condensation of four porphobilinogen units to yield hydroxymethylbilane, which is in turn converted to uroporphyrinogen III by cosynthetase. We compared the apparent molecular mass of porphobilinogen deaminase from erythropoietic and from non erythropoietic cells by sodium dodecyl sulfate/polyacrylamide gel electrophoresis and immune-blotting. The results indicate that two isoforms of porphobilinogen deaminase can be distinguished and differ by 2000 Da. Analysis of cell-free translation products directed by mRNAs from human erythropoietic spleen and from human liver demonstrates that the two isoforms of porphobilinogen deaminase are encoded by distinct messenger RNAs. We cloned and sequenced cDNAs complementary to the non-erythropoietic form of porphobilinogen deaminase encoding RNA. Comparison of these sequences to that of human erythropoietic mRNA [Raich et al. (1986) Nucleic Acids Res. 14, 5955-5968] revealed that the two mRNA species differ by their 5' extremity. From the mRNA sequences we could deduce that an additional peptide of 17 amino acid residues at the NH2 terminus of the non erythropoietic isoform of porphobilinogen deaminase accounts for its higher molecular mass. RNase mapping experiments demonstrate that the two porphobilinogen deaminase mRNAs are distributed according to a strict tissue specificity, the erythropoietic form being restricted to erythropoietic cells. We propose that a single porphobilinogen deaminase gene is transcribed from two different promoters, yielding the two forms of porphobilinogen deaminase mRNAs. Our present finding may have some relevance for further understanding the porphobilinogen deaminase deficiency in certain cases of acute intermittent porphyria with an enzymatic defect restricted in non-erythropoietic cells. PMID- 3816775 TI - Interaction of non-histone proteins HMG1 and HMG2 with core histones in nucleosomes and core particles revealed by chemical cross-linking. AB - Chemical cross-linking was used to study the interaction of the non-histone chromosomal proteins HMG1 and HMG2 with core histones in H1,H5-depleted nucleosomes or core particles. Cross-linking with a 'zero-length' cross-linker 1 ethyl-3-(3-dimethylaminopropyl)carbodiimide and with a longer (cleavable) cross linker dimethyl-3,3'-dithiobispropionimidate revealed an interaction of HMG1 and HMG2 with (or proximity to) core histones in both types of particles. These results indicated that the presence of the 40-50-base-pairs-long segment of the 'linker' DNA in nucleosomes was not necessary for the establishment of mutual contacts of HMG1 and HMG2 proteins with core histones. Possible implications of the interaction of HMG1 and HMG2 proteins with histones for the structure and functioning of chromatin are discussed. PMID- 3816776 TI - Tyrosination of microtubules and non-assembled tubulin in brain slices. AB - Brain slices were used to examine comparatively the incorporation of [14C]tyrosine into the C terminus of alpha-tubulin of the microtubule and non assembled tubulin pools. We found that the incorporation of [14C]tyrosine from 5 min up to 60 min of incubation was higher in microtubules than in non-assembled tubulin. The possibility that this result was due to the activity of tubulin carboxypeptidase or tubulin:tyrosine ligase during the in vitro isolation of tubulin was discarded. We also found that tubulin:tyrosine ligase was mainly associated with microtubules when brain slices were homogenized under microtubule preserving conditions. Conversely the enzyme behaved as a soluble entity when homogenization was performed under conditions that do not preserve microtubules. In addition, soluble tubulin:tyrosine ligase did not become sedimentable when in vitro conditions were changed to induce the formation of microtubules. The results presented in this work indicate the possibility that, in vivo, microtubules and not tubulin dimers are the major substrate for tubulin:tyrosine ligase. This is in contrast with previous findings from in vitro experiments, which showed a preference of the ligase for non-assembled tubulin. PMID- 3816777 TI - The Ca2+-dependent actions of the alpha-adrenergic agonist phenylephrine on hepatic glycogenolysis differ from those of vasopressin and angiotensin. AB - The stimulation of hepatic glycogenolysis by the Ca2+-dependent hormones phenylephrine, vasopressin and angiotensin II was studied as a function of intracellular and extracellular Ca2+. In the isolated perfused rat liver the decline in glucose formation was monophasic ('half-life' approximately equal to 3 min) with vasopressin (1 nM) or angiotensin II (0.05 microM), but biphasic (half life of 4.8 min and 17.6 min) in the presence of the alpha-agonist phenylephrine (0.01 mM), indicating either a different mode of mobilization or the mobilization of additional intracellular calcium stores. Under comparable conditions an elevated [Ca2+] level was maintained in the cytosol of hepatocytes for at least 10 min in the presence of phenylephrine, but not vasopressin. Titration experiments performed in the isolated perfused liver to restore cellular calcium revealed differences in the hormone-mediated uptake of Ca2+. The onset in glucose formation above that seen in the absence of exogenous calcium occurred at approximately 30 microM or 70-80 microM Ca2+ in the presence of phenylephrine or vasopressin respectively. The shape of the response curve was sigmoidal for vasopressin and angiotensin II, but showed a distinct plateau between 0.09 mM and 0.18 mM in the presence of phenylephrine. The plateau was also observed at phenylephrine concentrations as low as 0.5 microM. The formation of plateaus observed after treatment of the liver with A 23187, but not after EGTA, is taken as an indication that intracellular calcium stores are replenished. A participation of the mitochondrial compartment could be excluded by pretreatment of the liver with the uncoupler 2,4-dinitrophenol. Differences in the Ca2+ dependence of the glycogenolytic effects of these hormones were also revealed by kinetic analysis. It is concluded that phenylephrine differs from vasopressin and angiotensin II in that, in addition to a more common, non-mitochondrial pool, which is also responsive to the vasoactive peptides, the agonist mobilizes Ca2+ from a second, non-mitochondrial pool. The results are consistent with the proposal that Ca2+ transport across subcellular membranes may be subject to different hormonal control. PMID- 3816778 TI - Phosphorus-31 nuclear-magnetic-resonance study of phosphorylated metabolites compartmentation, intracellular pH and phosphorylation state during normoxia, hypoxia and ethanol perfusion, in the perfused rat liver. AB - A quantitative analysis of the phosphorus-31 NMR spectra of excised perfused rat liver has been carried out at 80.9 MHz using a 30-mm sample cell. The results indicate that in liver from fed rats, all intracellular ATP is detected by NMR. In contrast, only the cytosolic fractions of Pi and ADP can be observed as indicated by careful analysis of spectra obtained from perchloric acid liver extracts and intact liver under valinomycin perfusion. In well-oxygenated perfused liver the ATP concentration is 7.4 mM. Values of 5.3 mM and 0.9 mM are found respectively for Pi and ADP concentrations in the cytosolic compartment. Cytosolic pH value (pHi) is 7.25 +/- 0.05 and free magnesium concentration 0.5 mM. Addition of 70 mM (0.4%) ethanol to the perfusate of a fed rat liver induces 25% and 38% reduction of ATP and Pi levels, respectively. A large amount of sn glycerol 3-phosphate is synthesized (up to 11 mM) in the cytosol. After ethanol withdrawal, a large overshoot in cytosolic Pi is observed, which is indicative of a net uptake of Pi across the plasma membrane that occurred during ethanol oxidation. No significant pH variation is observed during ethanol infusion. In perfused liver of rats subjected to 48-h fasts, the concentrations of cytosolic phosphorylated metabolites are 5.3 mM, 0.8 mM and 11.5 mM for ATP, ADP and Pi, respectively. The perfusion of the liver with 70 mM ethanol does not change the adenine nucleotide levels, while the Pi content is decreased by 10%. During a 4 min hypoxia, induced by reducing the perfusion flow rate from 12 ml to 3 ml min-1 (100 g body weight)-1, ATP concentration decreases to 5.8 mM in the fed rat liver. Cytosolic Pi and ADP increase to 8.7 mM and 1.6 mM, respectively. The cytosolic pH evolves to more acidic values and reaches 7.02 +/- 0.05 at the end of the 4-min hypoxic period. PMID- 3816779 TI - Biochemical analysis of synoviocytes from normal and arthritic rats. Evidence for an activated state associated with adjuvant polyarthritis. AB - Adjuvant-induced polyarthritis in rats is a common model system used for the study of the synovitis that occurs in rheumatoid arthritis. Synoviocytes A, the major cell type covering the internal surface of the joint, could be involved in the pathogenesis of rheumatoid arthritis because of their increased proliferation and the intraarticular manifestations of the disease. So far only a few molecular studies have been reported on synoviocytes upon arthritis induction. We report here changes in polypeptides, between control and arthritic synoviocytes, by using two different radiolabeling methods and two-dimensional gel electrophoresis analysis. Major differences were found using metabolic labeling on regions of tropomyosins, cyclin, tubulins and vimentin. In addition, external surface labeling of the cells with lactoperoxidase showed clear differences between control and arthritic synoviocytes in the region of 77-100-kDa proteins. Some of these differences can be reproduced by certain macrophage activators such as phorbol myristate acetate and lipopolysaccharide acting on synoviocytes in vitro and in vivo respectively. These results exclude the possibility that the changes observed were due to a possible infiltration of other cell types in the arthritic synovia and strongly support the existence of an activated state of synoviocytes associated with arthritis induction. PMID- 3816780 TI - Fluctuation domains in myoglobin. Fluorescence quenching studies. AB - The dynamics of two domains in the myoglobin molecule, close to the heme and inside the protein medium including the surface, are investigated through the study of the fluorescence oxygen quenching of two probes imbedded in the heme pocket: zinc protoporphyrin IX (with a fluorescence lifetime of 2.1 ns) and metal free protoporphyrin IX (with a fluorescence lifetime of 17.8 ns). PMID- 3816781 TI - Characterization of three isoenzymes of rat alcohol dehydrogenase. Tissue distribution and physical and enzymatic properties. AB - Rat tissues contain three different isoenzymes of alcohol dehydrogenase (ADH) that we have named ADH-1, ADH-2 and ADH-3, ADH-1 is an anodic isoenzyme present in high amounts in the ocular tissues, stomach and lung. ADH-2 is also anodic and has been found in all the rat organs examined. ADH-3 is the group of cathodic ADH forms, mainly present in liver, that has been the subject of the majority of the previous studies on rat ADH. The three isoenzymes have been purified to homogeneity and characterized. All of them have similar physical characteristics: Mr 80,000, with two subunits of Mr 40,000; they contain four atoms of Zn per molecule, and prefer NAD+ as cofactor. Isoelectric points are, however, different: 5.1 for ADH-1, 5.95-6.3 for ADH-2 and 8.25-8.4 for ADH-3. ADH-3 exhibits a Km for ethanol of 1.4 mM, a broad substrate specificity and is strongly inhibited by pyrazole (Ki = 0.4 microM). ADH-2 shows substrate specificity toward long-chain alcohols and aldehydes, cannot be saturated by ethanol and is practically insensitive to pyrazole (Ki = 78.4 mM). ADH-1 has intermediate properties, with a Km for ethanol of 340 mM, a broad substrate specificity and Ki for pyrazole of 0.56 mM. Rat ADH-1, ADH-2 and ADH-3 exhibit many analogies with human ADH classes II, III and I respectively. The specific localization and kinetic properties of rat ADH isoenzymes suggest that ADH-1 and ADH-3 may act as metabolic barriers to external alcohols and aldehydes whereas ADH-2 may have a function in the metabolism of the endogenous long-chain alcohols and aldehydes. PMID- 3816782 TI - Binding mode of nucleosome-assembly protein (AP-I) and histones. AB - Studies were made on the binding mode of the nucleosome-assembly protein AP-I with histones H2A + H2B and/or H3 + H4. Histones H2A + H2B bound with AP-I to form a 7-S complex which contained twice as much AP-I (by weight) as histones. Histone H3 + H4 formed an 8-S complex with AP-I. The 7-S and 8-S complexes did not form a new complex when mixed, but significant amounts of two histone pairs were assembled into a 12-S complex on mixing the (H2A + H2B)--AP-I complex (7-S) with free H3 + H4. In contrast, when the (H3 + H4)--AP-I complex (8-S) was incubated with free H2A + H2B, almost no assembly occurred, but the 7-S complex of H2A + H2B was newly formed. Binding studies by enzyme-linked immunosorbent assay showed that AP-I bound with H2A + H2B faster than with H3 + H4. From these results, it is suggested that AP-I has a higher binding affinity for histone H2A + H2B than for H3 + H4, and that the 7-S complex is an intermediate in formation of the 12-S octamer complex (H2A + H2B + H3 + H4)2. PMID- 3816783 TI - Biosynthesis of 1-alkenes in higher plants. A model study with the composite Carthamus tinctorius L. AB - Uneven numbered 1-alkenes, such as 1-pentadecene, 1-heptadecene, 1,8 heptadecadiene, 1,8,11-heptadecatriene and 1,8,11,14-heptadecatetraene are the predominant hydrocarbons in germinating safflower (Carthamus tinctorius L.). According to their chain length and positions of double bonds they are derived from palmitic, stearic, oleic, linoleic or linolenic acid, respectively. This has been proved by administration of synthetic alpha-, beta-, or gamma-deuterated 12 phenyldodecanoic acids to germinating safflower. Mass spectrometric analysis of the resulting deuterium-labelled 11-phenyl-1-undecenes shows that only a single hydrogen from C-3 and carbon dioxide from C-1 of the precursor fatty acid is lost during vinyl group formation. A strong isotope effect (kH/kD greater than or equal to 10) during the conversion of racemic 12-phenyl[3-2h]dodecanoic acid to 11-phenyl-1-[2-2H]undecene is consistent with an initial enzymatic attack on a non-activated hydrogen at C-3 accompanied by simultaneous fragmentation into the respective 1-alkene and carbon dioxide. Mechanisms, based on ionic or radical abstraction of a hydrogen from C-3 of the fatty acid, followed by decarboxylation are discussed. The results are applicable to the formation of various vinylic substituents in natural products such as porphyrins, acetylenic hydrocarbons, pheromones from marine brown algae and terpenoids. PMID- 3816784 TI - Effects of inverse changes in dietary lipid and carbohydrate on the synthesis of some pancreatic secretory proteins. AB - The effect of ingesting isocaloric and isonitrogenous diets with increasing amounts of lipid (0-30%) and consequently decreasing amounts of carbohydrates (68.7-1.25%) on the exocrine pancreas was studied in adult male Wistar rats. Pancreatic contents of chymotrypsin, lipase and colipase activity, as well as synthesis of amylase, lipase, procarboxypeptidases and individual serine proteases were examined. Lipid-free diets and diets containing 1% lipid were found to have little effect on pancreatic proteins as compared with lipid-rich diets where two distinct patterns of response were observed. Ingestion of diets containing 3-20% lipid resulted in a progressive increase in the activity of lipase, colipase and chymotrypsin up to 2-fold in the first case and 1.6-fold in the two other cases when animals were fed the 20% fat diet. Under the latter conditions, the relative synthesis of secretory proteins, as expressed as percentage of the radioactivity incorporated into individual proteins compared to that incorporated into the total mixture of exocrine proteins, was unchanged for procarboxypeptidases, whereas it was stimulated for lipase (2-fold) and serine proteases (1.6-fold). Amylase relative synthesis progressively decreased as the lipid content of diets increased. Consumption of hyperlipidic diets containing 25% and 30% fat resulted in a further enhancement in the activity of lipase and colipase in the gland in contrast with chymotrypsin activity which was unchanged as compared to the control diet (3% lipid). As far as biosynthesis was concerned, a plateau in the relative synthesis of lipase and serine protease was reached. Amylase relative synthesis further decreased down to 2.2-fold when rats were fed the 30% fat-rich diet whereas that of procarboxypeptidases was markedly increased (about 1.7-fold). Absolute rates of synthesis of total pancreatic secretory proteins, as expressed with regard to the DNA content of the tissue, indicated that biosynthesis of all secretory pancreatic proteins was stimulated by hyperlipidic diets (at least 2-fold with the 30% lipid diet). Consequently, when such an increase was taken into consideration, the absolute synthesis of amylase was found to be unchanged throughout the dietary manipulations, whereas that of lipase, procarboxypeptidases and serine proteases were stimulated by 4.0-fold, 3.4-fold and 3.2-fold, respectively. PMID- 3816785 TI - Nucleotide sequence of cloned cDNA specific for rat ribosomal protein L31. AB - A cDNA clone, specific for rat ribosomal protein L31, was isolated by hybrid selected translation from a cDNA library made for 8-9-S poly(A)-rich RNA from regenerating rat liver. The nucleotide sequence of the cDNA was determined. It consists of 25 base pairs from the 5' leading sequence, the entire coding sequence of 378 base pairs and the 3' trailing sequence of 36 base pairs besides the poly(A) tail. The primary structure of protein L31 was deduced from the nucleotide sequence. It consists of 124 amino acids with a relative molecular mass of 14,331. The calculated amino acid composition is consistent with the reported composition determined for the hydrolysate of L31. The amino acid sequence showed marked homology with that of yeast ribosomal protein L34. PMID- 3816786 TI - Non-covalent interactions between Fab and Fc regions in immunoglobulin G molecules. Hydrogen-deuterium exchange studies. AB - To reveal non-covalent interactions between the Fab and Fc regions of IgG molecules the average conformational free-energy change (delta Go), associated with reversible micro-unfoldings, was measured by hydrogen-deuterium exchange for the Fab and Fc fragments and the complete molecule. Human monoclonal IgG1 and pooled IgG samples were used in these experiments. Hydrogen-deuterium exchange data were summarized and compared in the form of exchange relaxation spectra. The experimentally observed relaxation spectrum of intact IgG could not be deduced by weighted summation of spectra measured for Fab and Fc fragments. A comparison of the measured and calculated data revealed a 5-kJ/mol increase in the conformational free energy upon splitting the IgG molecule into two Fab and Fc pieces, i.e. an increase of conformational mobility occurred. This change can be explained either by related fluctuation patterns of the Fab and Fc pieces in the intact molecule or by a shielding effect on the contact surfaces. Both interpretations suppose non-covalent interactions between Fab and Fc that can be a means of information transduction between recognition and effector sites. The pH dependence of the hydrogen-deuterium exchange also indicates interactions between the Fab and Fc regions. A shift in the relaxation spectra of the Fab fragment was observed between pH 8.2 and 7.3 revealing destabilization of the structure at lower pH. This effect is absent in the intact molecule, reflecting interactions that stabilize the Fab structure. Comparison of the relaxation spectra of Fab and Fc shows a difference of about 10 kJ/mol in the microstability of these fragments: the Fab part possesses more conformational flexibility (i.e. its microstability is smaller) than the Fc part. PMID- 3816787 TI - Chemical characterization of enterobacterial common antigen isolated from Plesiomonas shigelloides ATCC 14029. AB - Serologically characterized samples of enterobacterial common antigen (ECA) from Plesiomonas shigelloides, Salmonella montevideo and Shigella sonnei were investigated by chemical methods including methylation and NMR techniques. All showed the same sugar composition and contained a lipid moiety with palmitic acid as main fatty acid and with a phosphodiester group. Additional enzymatic studies, reported in the preceding paper, provided evidence that the lipid moiety is an L glycerophosphatidyl residue attached via a phosphodiester linkage to C-1 of GlcNAc as the reducing end of the ECA sugar chain. ECA of P. shigelloides showed the best-resolved 13C-NMR spectra, especially after the removal of non stoichiometric O-acetyl groups at C-6 of GlcNAc of the ECA repeating unit and of the lipid moiety by mild acid hydrolysis (0.01 M HCl, 100 degrees C, 10 min). Subsequent 13C-NMR studies were therefore carried out with the mild-acid-treated ECA of P. shigelloides which allowed a tentative assignment of all resonances of the ECA repeating unit. 13C-NMR spectra of Salmonella and Shigella ECA were essentially the same as those obtained with Plesiomonas ECA. The same trisaccharide repeating unit was encountered as demonstrated previously in the cyclic form of ECA isolated from S. sonnei by Dell et al. [Carbohydr. Res. 133, 95-104 (1984)]. Methylation analysis, however, afforded small amounts of terminal GlcNAc thus proving, in combination with the demonstration of the attached lipid moiety, an acyclic nature of ECA from P. shigelloides and from the two enterobacterial species. The question of whether the cyclic form co-exists in S. sonnei phase I and possibly in other enterobacterial species or, whether it had been formed during extraction as an artifact, has not yet been answered. The way in which ECA was isolated in our studies would preclude the presence of a non amphiphilic (cyclic) polysaccharide. The finding that the sugar chain of ECA is attached to an L-glycerophosphatidyl residue is in full corroboration with serological, enzymatic and gel electrophoretic studies shown in the preceding paper and with the character of ECA as a surface antigen being anchored by hydrophobic interactions in the outer membrane of Enterobacteriaceae and P. shigelloides. PMID- 3816788 TI - The role of N-glycosylation for the plasma clearance of rat liver secretory glycoproteins. AB - The clearance of total rat liver secretory glycoproteins and of alpha 1-acid glycoprotein carrying no or different types of oligosaccharide side chains was studied in vivo and in the isolated perfused rat liver. In order to obtain unglycosylated or differently glycosylated forms of secreted glycoproteins, rat hepatocyte primary cultures were incubated with various inhibitors of N glycosylation. Tunicamycin was used for the synthesis of unglycosylated (glyco)proteins, the mannosidase I inhibitor 1-deoxymannojirimycin for the synthesis of high-mannose type and the mannosidase II inhibitor swainsonine for the synthesis of hybrid-type glycoproteins. Glycoproteins carrying carbohydrate side chains of the complex type were synthesized by control hepatocytes. In vivo and in the perfused rat liver, high-mannose-type glycoproteins were cleared at the highest rate, followed by unglycosylated and hybrid-type glycoproteins. The lowest clearance rate was found for the glycoproteins with carbohydrate side chains of the complex type. For the highly glycosylated alpha 1-acid glycoprotein the differences in clearance rates were more pronounced. The following plasma half-lives were determined in vivo: complex type, 100 min; hybrid type, 15 min; unglycosylated form, 5 min; and high-mannose type less than 1 min. In the recirculating perfused liver 28% of complex-type alpha 1-acid glycoprotein, 40% of hybrid type, 47% of unglycosylated and 93% of high-mannose-type alpha 1-acid glycoprotein were removed from the perfusate within 2 h. It is concluded that N glycosylation and processing to complex-type oligosaccharides seems to be of great importance for the circulatory life time of plasma glycoproteins. PMID- 3816789 TI - Urea synthesis from ammonia in periportal and pericentral regions of the liver lobule. Effect of oxygen. AB - Rates of urea synthesis were determined in periportal and pericentral regions of the liver lobule in perfused liver from fed, phenobarbital-treated rats by measuring the extra O2 consumed upon infusion of NH4Cl with miniature O2 electrodes and from decreases in NADPH fluorescence detected with micro-light guides. Urea synthesis by the perfused rat liver supplemented with lactate (5 mM), ornithine (2 mM) and methionine sulfoximine (0.15 mM), an inhibitor of glutamine synthetase, was stimulated by stepwise infusion of NH4Cl at doses ranging from 0.24 mM to 3.0 mM. A good correlation (r = 0.92) between decreases in NADPH fluorescence and urea production was observed when the NH4Cl concentration was increased. Sublobular rates of O2 uptake were determined by placing miniature oxygen electrodes on periportal or pericentral regions of the lobule on the liver surface, stopping the flow and measuring decreases in oxygen tension. From such measurements local rates of O2 uptake were calculated in the presence and absence of NH4Cl and local rates of urea synthesis were calculated from the extra O2 consumed in the presence of NH4Cl and the stoichiometry between O2 uptake and urea formation. Rates of urea synthesis were also estimated from the fractional decrease in NADPH fluorescence, caused by NH4Cl infusion in each region, measured with micro-light-guides and the rate of urea synthesis by the whole organ. When perfusion was in the anterograde direction, maximal rates of urea synthesis, calculated from changes in fluorescence, were 177 +/- 31 mumol g 1 h-1 and 61 +/- 24 mumol g-1 h-1 in periportal and pericentral regions, respectively. When perfusion was in the retrograde direction, however, rates were 76 +/- 23 mumol g-1 h-1 in periportal areas and 152 +/- 19 mumol g-1 h-1 in pericentral regions. During perfusion in the anterograde direction, urea synthesis, calculated by changes in O2 uptake, was 307 +/- 76 mumol g-1 h-1 and 72 +/- 34 mumol g-1 h-1 in periportal and pericentral regions, respectively. When perfusion was in the retrograde direction, urea was synthesized at rates of 54 +/ 17 mumol g-1 h-1 and 387 +/- 99 mumol g-1 h-1 in periportal and pericentral regions, respectively. Thus, maximal rates of urea synthesis were dependent upon the direction of perfusion. In addition, rates of urea synthesis were elevated dramatically in periportal regions when the flow rate per gram liver was increased (e.g. 307 versus 177 mumol g-1 h-1).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3816790 TI - Purification and characterization of cystathionine gamma-synthase type II from Bacillus sphaericus. AB - Cystathionine gamma-synthase type II, which catalyzes L-cystathionine synthesis from O-acetyl-L-homoserine and L-cysteine was purified from Bacillus sphaericus (IFO 3536) in seven steps. The purified enzyme appeared to be homogeneous by the results of polyacrylamide electrophoresis and ampholyte electrofocusing. The enzyme is a typical pyridoxal-P dependent enzyme, has a molecular mass of 165 kDa and consists of four subunits identical in molecular mass. The enzyme catalyzed the gamma-replacement reaction and the elimination reaction was hardly detected even when a large amount of enzyme was added. In the replacement reaction, O acetyl-L-homoserine and the following thiol compounds: L and D-cysteine, L and D homocysteine, sodium sulfide, various alkyl and aryl mercaptans, acted as the most suitable substrate to produce L-cystathionine and the corresponding S substituted L-homocysteine derivatives. PMID- 3816791 TI - Kinetics of the oxidation of ascorbic acid, ferrocyanide and p-phenolsulfonic acid by chloroperoxidase compounds I and II. AB - For the first time elementary reactions involving chloroperoxidase compounds I and II have been investigated. A multi-mixing stopped-flow apparatus was used to study the kinetics of the reactions of compounds I and II with ascorbic acid, ferrocyanide and p-phenolsulfonic acid. The second-order rate constants of the reactions of both compounds with all three substrates were determined between pH 3 and pH 7. In all cases the rate constants decrease with increasing pH. The reactions of p-phenolsulfonic acid are influenced by a catalytically important group on both compounds I and II with a pKa of 3.7 +/- 0.2. With ascorbic acid and ferrocyanide as substrates, a decrease in rate was observed upon ionization of the substrate. Comparisons with horseradish peroxidase show that chloroperoxidase is a much less efficient peroxidatic enzyme. The kinetic data were used to calculate the percentage composition of the mixture of chloroperoxidase species which contribute to the spectra measured during the turnover with ascorbate as substrate. PMID- 3816792 TI - Synthesis of beta-glucans in Prototheca zopfii. Evidence for the existence of a glycoprotein primer. AB - Membrane preparations from the non-photosynthetic alga Prototheca zopfii incorporate glucose from UDP-[3H]glucose into the trichloroacetic-acid-insoluble fraction and the polysaccharides insoluble in hot alkali. Time course and pulse chase experiments indicate that the acid-insoluble fraction was a precursor of the alkali-insoluble fraction. Isolation of 3H-labeled membrane or soluble fraction showed that only membrane fractions were able to transfer radioactivity into polysaccharides. Treatment of glucosylated membranes with trypsin or cellulase only partially affect their transfer ability, indicating that the precursor was internalized in vesicles. Analysis of the in vitro synthesized polysaccharides by enzymatic and acid hydrolysis showed that glucose and cellobiose were present as radioactive sugars. Permethylation of the polysaccharide indicates that 80% of the glucose was beta-1,4-bonded with 20% in beta-1,3-linkages. This polysaccharide was found to be identical with the cell wall beta-glucan obtained in vivo [Rivas, L.A. & Pont Lezica, R. (1978) Planta (Berl.) 165, 348-353]. PMID- 3816793 TI - Synthesis of beta-glucans in Prototheca zopfii. Isolation and characterization of the glycoprotein primer. AB - When Prototheca zopfii cells were pulse-labeled with 14C-containing amino acids and homogenized, 14C-labeled membranes were obtained. In vitro incubations with the previously labeled membranes and UDP-[3H]Glc produced a trichloroacetic-acid insoluble fraction having both isotopes. A double-labeled glucoprotein was isolated and characterized. It has a relative molecular mass of 28,000-30,000 and a carbohydrate content of 10%. The oligosaccharide chain is linked to the protein through an O-glycosidic bond between hydroxyproline and glucose. The oligosaccharide has a polymerization degree ranging over 10-20 hexose units. Glucose is the only monosaccharide found; most of the glucose residues are beta 1,4-linked (90%) but some are beta-1,3-linked (10%). PMID- 3816794 TI - Partial reassembly of active 60S ribosomal subunits from rat liver following treatment with dimethylmaleic anhydride. AB - Rat liver 60S ribosomal subunits were treated with dimethylmaleic anhydride, a reagent for protein amino groups, at a 1/15,000 mol/mol ratio. This caused the dissociation of specific proteins, which were separated from the 56S residual core particles by centrifugation and identified by two-dimensional gel electrophoresis. The core particles lacking 30% of the total proteins retained most of the initial activity measured by the puromycin reaction but only small percentages of activities measured by polyphenylalanine synthesis, elongation factor-2(EF-2)-dependent GTP hydrolysis and EF-2-mediated GDP binding. Upon reconstitution, the complementary amount of split proteins was incorporated into ribosomal particles, which had almost the same catalytic activities and biophysical properties (density, sedimentation coefficient and capability to reassociate to 40S subunits) as the original subunits. PMID- 3816795 TI - The complete amino acid sequence of rubredoxin from the green phototrophic bacterium Chlorobium thiosulphatophilum strain PM. AB - A complete amino acid sequence for the rubredoxin from the photosynthetic bacterium Chlorobium thiosulphatophilum is proposed. The sequence, a single polypeptide chain of 53 amino acids, was deduced from the sequences of peptides obtained by chymotryptic, tryptic, thermolytic or mild acid digestion. The rubredoxin shows a high degree of sequence homology with rubredoxins from non photosynthetic bacteria, and the evolutionary implications of this are considered. PMID- 3816796 TI - Two new vitamin B-12 factors from sewage sludge containing 2 methylsulfinyladenine or 2-methylsulfonyladenine as base component. AB - Two hitherto unknown vitamin B-12 factors were isolated from sewage sludge. They were degraded with cerous hydroxide to cobinamide and the corresponding nucleoside. The nucleosides were further split with dilute hydrochloric acid to the bases and D-ribose. The structure of the two bases was found to be 2 methylsulfinyladenine and 2-methylsulfonyladenine. This was revealed by mass, infrared and nuclear magnetic resonance spectroscopy, and by comparison with the synthetic compounds. On addition of the synthetic bases to fermentations with Propionibacterium acidi-propionici the vitamin B-12 factors containing the corresponding base were formed. They were identical with the 2 methylsulfonyladenylcobamide and 2-methylsulfonyladenylcobamide originally isolated from sewage sludge. PMID- 3816797 TI - Regulation of synthesis and cell content of the low-density-lipoprotein receptor protein in cultured fibroblasts from normal and familial hypercholesterolaemic subjects. AB - Incorporation of [35S]methionine into low-density-lipoprotein (LDL) receptors by normal fibroblasts and those from a homozygous familial hypercholesterolaemic (FH) subject who produced defective but immunoprecipitable receptor proteins of normal size, was compared with the ability of the cells to bind LDL and their content of LDL receptor protein determined using a double-antibody radioimmunoassay. The FH cells produced precursor protein with a longer half-life (3-4 h) than normal cells (40 min), most of which was eventually processed to a mature form of the receptor. Total receptor half-life was similar to normal (approx. 12 h) and LDL binding about 20% of normal. Incubation of normal fibroblasts with lipoprotein-deficient serum (LPDS) led to an increase in the amount of LDL receptor protein in the cells which was closely followed by the increase in their ability to bind LDL. Receptor synthesis increased rapidly at first, but then fell by more than 60% before remaining constant. The peak of synthesis coincided with the greatest rate of increase in receptor content. At equilibrium in LPDS receptor synthesis, LDL binding and receptor protein content were all approximately 3.3-fold higher than in cells maintained in 10% foetal calf serum (FCS). The FH cells also responded to LPDS with a rise and fall in the rate of receptor synthesis. They did not compensate for their inefficiency in producing active receptors with an increase in total receptor content. In LPDS, peak synthesis and maximum receptor content of the FH cells were similar to normal. In FCS receptor synthesis and content were well below maximum so that they did not fully employ even the low capacity for LDL uptake of which they were capable. With both types of cell, inhibition of mevalonic acid and cholesterol synthesis with compactin delayed, but did not prevent the secondary fall in the rate of receptor synthesis, again suggesting a regulatory role for some factor not directly related to cholesterol metabolism. PMID- 3816798 TI - Perivascular nerve stimulation and phenylephrine responses in rat liver. Metabolic effects, Ca2+ and K+ fluxes. AB - Electrical stimulation of perivascular nerves (20 Hz/2 ms/20 V) in perfused rat liver led to a transient increase of 14CO2 production from [1-14C]glutamate, glutathione and thiol efflux, an increase in the lactate/pyruvate and the 3 hydroxybutyrate/acetoacetate ratio, glucose release and of portal pressure. These metabolic effects were accompanied by a Ca2+ release from the liver within the initial 2 min, being followed by Ca2+ reuptake, which lasted about 3 min. The initial Ca2+ release was 67 nmol/g liver and was smaller than that observed after phenylephrine (5 microM) addition (156 nmol/g liver). Hepatic Ca2+ release following nerve stimulation or phenylephrine was not significantly affected when the hemodynamic changes were largely prevented by sodium nitroprusside (10 microM). Although the amounts of Ca2+ released were different, the glycogenolytic responses, but not the other metabolic effects, were quantitatively similar with nerve stimulation and phenylephrine. Within the first 3 min of nerve stimulation there was a K+ uptake by the liver being followed by a K+ release over the next 5 6 min and a subsequent slow K+ uptake phase. These changes resembled those observed with phenylephrine. Phentolamine, an alpha-adrenergic antagonist, abolished the Ca2+ and K+ movements following nerve stimulation as well as glucose release and the hemodynamic changes. During continuous infusion of phenylephrine, nerve stimulation led still to an increase of portal pressure; however, the effects of nerve stimulation on Ca2+ and K+ fluxes and glucose release were largely suppressed. It is concluded that the metabolic effects of electrical nerve stimulation are mediated by a redistribution of cellular Ca2+ following alpha-receptor activation. Nerve stimulation involves Ca2+ and K+ fluxes across the plasma membrane. The metabolic effects are qualitatively similar to those induced by phenylephrine. The quantitative difference between nerve stimulation and phenylephrine is explained by a differential subacinar response, with fewer cells being reached by nerve stimulation than cells containing alpha-receptors. The hemodynamic changes of nerve stimulation point to the existence of sphincters near the inflow of the sinusoidal bed. PMID- 3816799 TI - Differential expression of heat-shock proteins and spontaneous synthesis of HSP70 during the life cycle of Blastocladiella emersonii. AB - The heat-shock response in Blastocladiella emersonii is dependent on the developmental stage. Cells exposed to elevated temperatures at different stages of the life cycle (sporulation, germination or growth) show a differential synthesis of heat-shock proteins (hsps). Of a total of 22 polypeptides induced, particular subsets of hsps appear in each phase, demonstrating a non-coordinate heat-shock gene expression. In contrast, heat-shock-related proteins (hsp76, hsp70, hsp39a) are spontaneously expressed at a high level during sporulation. By the criteria of two-dimensional gel electrophoresis and partial proteolysis mapping, the 70,000-Da protein, whose synthesis is induced spontaneously during sporulation, is indistinguishable from the heat-inducible hsp70. The techniques of in vitro translation, and Northern analysis using a Drosophila hsp70 probe, demonstrated that enhanced synthesis of hsp70, which occurs during heat-shock treatment and spontaneously during sporulation, is associated with an accumulation of hsp70 mRNA. These observations suggest that hsp70 gene expression is induced during sporulation. PMID- 3816800 TI - Quasi-irreversibility in the unfolding-refolding transition of phosphoglycerate kinase induced by guanidine hydrochloride. AB - The reversibility of the unfolding-refolding transition of horse muscle phosphoglycerate kinase, induced by guanidine hydrochloride (Gdn X HCl), was studied using the regain of enzyme activity as a probe of the native structure. An irreversibility in the reactivation process was detected when the protein was incubated in a critical concentration of denaturant (0.7 +/- 0.1 M Gdn X HCl). This apparent irreversibility was observed for the unfolding process (N----D) as well as for the refolding process (D----N). The formation of the trough followed biphasic kinetics at 23 degrees C, the first phase obeying a first-order reaction corresponded to an isomerization of an intermediate; the second phase, protein concentration-dependent, was suppressed by lowering the temperature to 4 degrees C. The structural properties of the inactive species were studied; all the beta structures were recovered, but about 29% of the helical structures remained unfolded, and two SH groups were buried. Simulated kinetics were compared with the experimental results and were used to extend the minimum folding scheme previously proposed from equilibrium and kinetic studies [Betton et al. (1984) Biochemistry 23, 6654-6661; Betton et al. (1985) Biochemistry 24, 4570-4577]. The intermediates trapped under these conditions were structured but devoid of catalytic activity. Taking into account the structural properties of these species, the nature of the interactions involved in their formation and stabilization is discussed. PMID- 3816801 TI - The oxygenation-linked binding of neutral red to spiny lobster hemocyanin. A structural study of the partially oxygenated protein. AB - The structural change of lobster hemocyanin in cooperative O2 binding was studied by the dye-binding method. It was found that neutral red shows an O2-linked binding to hemocyanin with a higher affinity for the oxy form. The number of the dye-binding sites was estimated to be three in the hexameric molecule of oxyhemocyanin. The course of the structural change in the partially oxygenated hemocyanin was examined using the absorbance change of the bound dye as a measure. It was found that the fractional change in the dye binding was considerably greater than the degree of O2 saturation of hemocyanin. The three state allosteric model, which was proposed for explanation of the O2 binding properties of lobster hemocyanin [N. Makino (1986) Eur. J. Biochem. 154, 49--55], was also consistent with the effects of the dye on the O2 binding to the native hemocyanin. On the basis of this model, the dye binding to partially oxygenated hemocyanin could be connected with the populations of the affinity states. It was inferred that the binding of neutral red reflects the quaternary structure of the protein. In contrast, O2 binding to the stripped (EDTA-treated) hemocyanin showed a considerable decrease in the cooperativity in the presence of the dye. The O2 binding isotherms could not be explained by the three-state model. It is suggested that the subunit interaction is partially blocked by the dye in the absence of divalent cations. PMID- 3816802 TI - The glycoprotein Ib complex of human blood platelets. AB - Human glycoprotein Ib (GPIb) is a major integral membrane protein on human blood platelets responsible for the initial attachment of platelets to the exposed vascular subendothelium. In this report we describe an isolation method for a 'GPIb complex' as well as for its individual components. A three-step procedure involving Triton X-114 phase-partition, affinity chromatography on wheat germ agglutinin and ion-exchange chromatography on DEAE-Sephacel yielded milligram quantities of purified GPIb complex. The single components of the complex were further purified by gel filtration on AcA34 in 0.1% sodium dodecyl sulfate. As well as GPIb, the complex contains GP17, actin-binding protein, actin and a series of unidentified proteins with different molecular masses. In contrast to GPIb alpha, which is very rich in O-linked oligosaccharides, sugar analysis revealed that GPIb beta and GP17 seem to have only N-linked chains of the lactosamine type. The C-terminal alpha-chain remnant, which probably spans the plasma membrane, was identified and isolated for the first time. Western blotting with polyclonal rabbit anti-GPIb antibodies and silver-staining of one- or two dimensional dodecyl sulfate/polyacrylamide gels revealed that it has an apparent molecular mass of 20 kDa and is linked to GPIb beta by a disulfide bridge close to the membrane. The thrombin-binding site on GPIb is located near the N-terminus on a 40-kDa fragment of GPIb alpha. A disulfide bridge in the N-terminal region is not essential for thrombin binding to GPIb. PMID- 3816803 TI - Distinct patterns of glycosylation of colligin, a collagen-binding glycoprotein, and SPARC (osteonectin), a secreted Ca2+-binding glycoprotein. Evidence for the localisation of colligin in the endoplasmic reticulum. AB - Mouse parietal endoderm PYS cells were labelled with [2-3H]mannose for 16-24 h. Colligin, an Mr-47000 collagen-binding protein, and SPARC, a Mr-43000 protein, highly homologous to the Ca2+-binding protein osteonectin, were isolated from labelled cell extracts and culture medium respectively. Glycopeptides obtained by exhaustive digestion with pronase were analysed by lectin-affinity, ion-exchange, and gel-filtration chromatography and by paper chromatography of high-mannose oligosaccharides after endo H release. The results show that the N-linked carbohydrate chains of colligin are exclusively the high-mannose type, of which (Man)8(GlcNAc)2 and (Man)9(GlcNAc)2 make up 77%. This carbohydrate structure provides strong evidence that colligin is a component of the endoplasmic reticulum, and argues against a role in cell-surface interactions. By contrast to colligin, SPARC secreted by PYS cells contains predominantly a diantennary complex type of chain containing a variable number of sialic acid and core substituted fucose residues. Similar glycosylation patterns to those discussed above were seen in colligin isolated from primary mouse embryonic parietal endoderm cells and the murine 3T3 cell line, and in SPARC secreted by bovine corneal endothelial cells. Unlike the type-IV-collagen-binding glycoprotein studied by Dennis, J., Waller, C. and Schirrmacher, V. [J. Cell Biol. 99, 1416 1423 (1984)], removal of N-linked oligosaccharides from colligin had no effect on its binding to native type IV collagen. PMID- 3816804 TI - Purification and characterisation of ribonuclease activities that interact with the cytoplasmic inhibitor protein of rat tissues. AB - Evidence is presented that a number of different ribonuclease activities interact with the cytoplasmic ribonuclease inhibitor of rat and that these enzymes vary in their distribution in different tissues. Two ribonuclease activities were purified from rat liver and three from rat uterus. They were characterised with respect to their activity, substrate preference and pH optima. PMID- 3816805 TI - High-resolution solid-state 13C-NMR study of carbons C-5 and C-12 of the chromophore of bovine rhodopsin. Evidence for a 6-S-cis conformation with negative-charge perturbation near C-12. AB - Solid-state 13C magic-angle spinning NMR spectroscopy has been employed to study the conformation of the 11-cis-retinylidene Schiff base chromophore in bovine rhodopsin. Spectra were obtained from lyophilized samples of bovine rhodopsin selectively 13C-labeled at position C-5 or C-12 of the retinyl moiety, and reconstituted in the fully saturated branched-chain phospholipid diphytanoyl glycerophosphocholine. Comparison of the NMR parameters for carbon C-5 presented in this paper with those published for retinyl Schiff base model compounds and bacteriorhodopsin by Harbison and coworkers [Harbison et al. (1985) Biochemistry 24, 6955-6962], indicate that in bovine rhodopsin the C-6-C-7 single bond has the unperturbed cis conformation. This is in contrast to the 6-S-trans conformation found in bacteriorhodopsin. The NMR parameters for bovine [12-13C]rhodopsin present evidence for the presence of a negative charge interacting with the retinyl moiety near C-12, in agreement with the model for the opsin shift presented by Honig and Nakanishi and coworkers [Kakitani et al. (1985) Photochem. Photobiol. 41, 471-479]. PMID- 3816806 TI - Phenobarbital-mediated modulation of gene expression in rat liver. Analysis of cDNA clones. AB - Phenobarbital evokes a pleiotypic response in the liver characterized by cell hypertrophy and mono-oxygenase induction. These phenomena arise through complex modulation mechanisms changing the pattern of protein synthesis, distinct from those triggered by other well known inducers, like steroid hormones or polycyclic hydrocarbons. To investigate the mechanisms involved in regulating the expression of the phenobarbital-inducible tissue-specific genes, we constructed two libraries of recombinant bacterial plasmids pBR322 in Escherichia coli. Each library contains cDNA copies of polysomal poly(A)-rich RNA obtained from control and 16-h phenobarbital-induced rat liver. A thousand cloned sequences from each library were screened by double-cross colony hybridization using [32P]cDNA prepared from homologous and heterologous poly(A)-rich RNAs as the probes. The statistical analysis of the results revealed that phenobarbital treatment significantly changes the relative abundance of different polysomal mRNA classes in rat liver. Clones corresponding to mRNAs clearly induced following phenobarbital treatment have been further selected by plasmid DNA dot hybridization, and used as probes for measuring the changes in each mRNA concentration in the whole cell and in the polysomal RNAs from rat livers, at different times after phenobarbital treatment. The fact that changes in the concentration of each specific mRNA in the polysomes does not parallel the variation of its total concentration in the cell indicates that the induced modulation of protein synthesis in the liver is brought about by mechanisms involving both transcriptional and translational regulation, since besides the increases in whole cellular mRNA concentration a marked mobilization of mRNA into active polysomes could be demonstrated during the onset of the adaptive response to phenobarbital. PMID- 3816807 TI - Formation of D-Phe-Pro-Val-cyclo-Orn by gramicidin S synthetase in the absence of L-leucine. AB - The preparation of both enzymes of gramicidin S synthetase was efficiently improved by introduction of the fast protein liquid chromatography technique. High-resolution anion-exchange chromatography on Pharmacia Mono Q HR 5/5 was used as the final purification step. D-Phe-Pro-Val-cyclo-Orn was obtained as a product of the multienzyme by omission of L-leucine from the complete bioassay mixture. This tetrapeptide was formed by cyclization of the C-terminal ornithine to 3 amino-2-piperidone. It was identified and characterized by chromatographic and spectroscopic procedures using chemically synthesized reference compounds. PMID- 3816808 TI - Recombinant-DNA-derived bovine growth hormone from Escherichia coli. 2. Biochemical, biophysical, immunological and biological comparison with the pituitary hormone. AB - Bacterially synthesized, recombinant-DNA-derived bovine growth hormone (r-bGH), prepared as described in the preceding paper in this journal, has been characterized in comparison with pituitary bovine growth hormone (pit-bGH). The characterization criteria include sodium dodecyl sulfate/polyacrylamide gel electrophoresis, automated N-terminal sequence analysis, amino acid composition, isoelectric focusing, reverse-phase high-performance liquid chromatography, ultraviolet absorbance, analysis for free protein thiol, sizing by gel filtration, circular dichroism, radioimmunoassay and biological activity in the hypophysectomized rat weight-gain assay. In every respect the r-bGH appears to be virtually identical to pit-bGH. PMID- 3816810 TI - The two fast-reacting thiols of 3-phosphoglycerate kinase are structurally juxtaposed. Chemical modification with bifunctional reagents. AB - The two fast-reacting thiol groups of pig muscle 3-phosphoglycerate kinase can be simultaneously blocked by one mole equivalent of bifunctional reagent: either mercuric chloride (HgCl2) or 1,4-bis(bromomercuri)butane. The reactions are accompanied by an enzyme activity loss of about 50-70% and 60-80% with mercuric chloride and 1,4-bis(bromomercuri)butane respectively. Removal of either of the reagents with excess cysteine leads to the recovery of at least 70-90% of the original enzymic activity. Gel chromatographic analysis revealed no change in the molecular mass of the enzyme modified with mercuric chloride, while an increase of about 30% of the apparent molecular mass was observed after the reaction with 1,4-bis(bromomercuri)butane. Since no dimer formation could be detected by independent crosslinking, the increase of the apparent molecular mass is probably due to modification causing protein conformational change. The results strongly suggest that the fast-reacting thiols are intramolecularly connected by either of the above bifunctional reagents. In the light of the known structural data on the enzyme, it may follow that the two fast-reacting thiols belong to the two sequentially neighbouring cysteinyl residues. PMID- 3816809 TI - Studies on the stability of the higher-order structure of rat liver chromatin containing high-mobility-group proteins. AB - The stability of the higher-order structure of chromatin containing high-mobility group (HMG) proteins has been studied in rat liver nuclei by mild micrococcal nuclease digestion at low temperature and fractionation by sucrose gradient centrifugation. Nuclei preparation and digestion, chromatin solubilization and analysis have been carried out in two ionic conditions, 140 mM and 40 mM monovalent cation concentration, avoiding drastic changes in ionic conditions and temperature during preparation and analysis. During the time course of digestion at 140 mM ionic strength a material stable at 80 S appears, whose DNA is cleaved at values around 12 nucleosomes. The distribution of HMG proteins in different chromatin fractions was analyzed by immunodot using antibodies elicited against proteins HMG-1, HMG-2, and HMG-14 and 17. It appears that these proteins have a distribution distinctly different from the bulk of chromatin. They are never found in the chromatin fragments that keep their internucleosomal interactions, indicating that these proteins tend to accumulate in points where the chromatin has a less stable structure. PMID- 3816811 TI - [Structural and metabolic study of the mycolic acids of Mycobacterium fortuitum]. AB - The biosynthesis of mycolic acids was studied in whole cells of Mycobacterium fortuitum. At first the structures of the main mycolates produced by the used strain were established as diunsaturated and epoxymycolates. By using [1 14C]acetate as a radiotracer of the lipid synthesis, it was observed that the turnover of the mycolates during the exponential phase of growth of M. fortuitum is fast enough to make very difficult the identification of their precursors. If the growth of the bacterial cells is stopped or highly diminished, by the removal of a large part of their nutritional medium, mycolate synthesis, in contrast to the synthesis of other fatty acids, is stopped as shown by incubation of the concentrated bacterial culture with [1-14C]acetate. After removal of aliquots of the sedimented bacteria at intervals, during several hours, mycolate synthesis resumes when the cell concentration becomes lighter. In these conditions the sequence of radiolabeling of mycolates and of their potential precursors (tetracosanoate and meromycolates) can be observed. In spite of their low accumulation, tetracosanoate and meromycolates were isolated and purified and their specific radioactivity, after different incubation times, could be measured. The results are in agreement with the hypothesis that meromycolates are condensed with tetracosanoate to produce mycolates. However, because of the large differences of isotopic dilution of these two precursors inside the mycolate molecule, this hypothesis, generally taken as evidence, has to be modified. A hypothetical pathway of the mycolate synthesis is proposed, taking into account all these observations. PMID- 3816812 TI - A DNA polymerase with unusual properties from the slime mold Physarum polycephalum. AB - Two forms of a DNA polymerase have been purified from microplasmodia of Physarum polycephalum by poly(ethyleneimine) precipitation and chromatography on DEAE Sephacel, phosphocellulose, heparin Sepharose, hydroxyapatite, DNA-agarose, blue Sepharose. They were separated from DNA polymerase alpha on phosphocellulose and from each other on heparin-Sepharose. Form HS1 enzyme was 30-40% pure and form HS2 enzyme 60% with regard to protein contents of the preparations. Form HS2 enzyme was generated from form HS1 enzyme on prolonged standing of enzyme preparations. The DNA polymerases were obtained as complexes of a 60-kDa protein associated with either a 135-kDa (HS1) or a 110-kDa (HS2) DNA-polymerizing polypeptide in a 1:1 molar stoichiometry. The biochemical function of the 60-kDa protein remained unknown. The complexes tended to dissociate during gradient centrifugation and during partition chromatography as well as during polyacrylamide gradient gel electrophoresis under nondenaturing conditions at high dilutions of samples. Both forms existed in plasmodia extracts, their proportions depending on several factors including those which promoted proteolysis. The DNA polymerases resembled eucaryotic DNA polymerase beta by several criteria and were functionally indistinguishable from each other. It is suggested that lower eucaryotes contain repair DNA polymerases, which are similar to those of eubacteria on a molecular mass basis. PMID- 3816813 TI - Fate of injected 125I-labeled cholera toxin taken up by rat liver in vivo. Generation of the active A1 peptide in the endosomal compartment. AB - Subcellular fractionation techniques have been used to assess the localization of injected 125I-labeled cholera toxin (125I-CT) taken up by rat liver in vivo, and to determine whether internalization of the toxin is required for the generation of the active A1 peptide. The uptake of injected 125I-CT into the liver is maximal at 5 min (about 10% injected dose/g). At this time the radioactivity is for the most part recovered in the microsomal (P) fraction, but later on it progressively associates with the mitochondrial-lysosomal (ML) and supernatant fractions. The radioactivity is enriched 7-fold in plasma membranes at 5-15 min, and 15-60-fold in Golgi-endosome (GE) fractions at 15-60 min. On analytical sucrose gradients the radioactivity associated with the P fraction is progressively displaced from the region of 5'-nucleotidase (a plasma membrane marker) to that of galactosyltransferase (a Golgi marker). On Percoll gradients, however, it is displaced towards acid phosphatase (a lysosomal marker). Density shift experiments, using Triton WR 1339, suggest that some radioactivity associated with the P fraction (at 30 min) and all the radioactivity present in the ML fraction (at 2 h) is intrinsic to acid-phosphatase-containing structures, presumably lysosomes. Comparable experiments using 3,3'-diaminobenzidine cytochemistry indicate that the radioactivity present in GE fractions is separable from galactosyltransferase, and thus is presumably associated with endosomes. The fate of injected 125I-labeled cholera toxin B subunit differs from that of the whole toxin by a more rapid uptake (and/or clearance) of the ligand into subcellular fractions, and a greater accumulation of ligand in the ML fraction. Analysis of GE fractions by SDS/polyacrylamide gel electrophoresis shows that, up to 10 min after injection of 125I-CT, about 80% of the radioactivity is recovered as A subunit and 20% as B subunit, similarly to control toxin. Later on there is a time-dependent decrease in the amount of A subunit and, at least with the intermediate GE fraction, a concomitant appearance of A1 peptide (about 15% of the total at 60 min). In contrast the radioactivity associated with plasma membranes remains indistinguishable from unused toxin. It is concluded that, upon interaction with hepatocytes, 125I-CT (both subunits A and B) sequentially associates with plasma membranes, endosomes and lysosomes, and that endosomes may represent the major subcellular site at which the A1 peptide is generated. PMID- 3816814 TI - Plasma membrane isolated from Giardia lamblia: identification of membrane proteins. AB - Two methods are introduced for preparing plasma membranes from Giardia lamblia trophozoites. Isolated membranes were purified by centrifugation on either a sucrose step-gradient or a self-generated Percoll gradient, where they band at a density of approximately 1.04 g ml-1. In pure fractions, membranes formed vesicles or extensive sheets. Electron microscope profiles show that they are asymmetric with a thin filamentous coat on one side. Membrane proteins were resolved by SDS/PAGE. They included a major component of apparent Mr 75,000 (75 kDa), and additional bands detectable by gel staining at 58 kDa, 54 kDa, 32 to 38 kDa (5 bands), 22 kDa, and 15 to 20 kDa. To probe the surface location of proteins, gels were also prepared from Giardia cells that were surface radio iodinated using the immobilised catalyst IODOGEN. The 75 kDa membrane protein was strongly labelled in the corresponding autoradiograph, also the bands at 58 kDa and 54 kDa, the 22 kDa polypeptide, and some faint bands not resolved in the isolated membrane preparations. The set of close-running bands at 32 to 38 kDa were not iodinated. The labelled 58 kDa and 54 kDa proteins comigrated with alpha and beta-tubulins. Controls showed that cytoskeleton and flagellar tubulins were not iodinated in this experiment, indicating that the labelled tubulin is surface derived. The principal approximately 75 kDa surface protein identified in isolated membranes probably corresponds to an iodinatable and antibody precipitated "82 kDa" antigen reported previously. PMID- 3816815 TI - The tetragonal surface layer of Clostridium aceticum: three-dimensional structure and comparison with the hexagonal layer of Clostridium thermohydrosulfuricum. AB - The regular surface layer (S-layer) of Clostridium aceticum has been isolated and the three-dimensional structure determined to a resolution of 2.0 nm from tilt series of negatively stained preparations. It has tetragonal symmetry with a lattice constant of 12 nm and a thickness of 6 nm; there are probably 4 protein monomers per unit cell. A large proportion of the protein is concentrated in massive "cores" at the major four-fold axes which are situated towards the inner surface of the layer. From these cores, delicate arms extend towards the minor four-fold axes, where secondary connectivity is established near the exterior surface. When viewed from the outside, each of the cores appears to have a large central depression, rather than a true "pore". Since this general pattern of mass distribution is shared by the hexagonal S-layer of Clostridium thermohydrosulfuricum, some consideration has been given to the possible evolutionary steps leading to changes in symmetry. From modelling experiments, it is evident that the change from four-fold to six-fold symmetry in this instance could be accomplished simply by the loss of a structural "domain" from the protomer. PMID- 3816816 TI - Secretion of phytohemagglutinin by monkey COS cells. AB - The entire coding region of a gene, which encodes a polypeptide of phytohemagglutinin (PHA-L), obtained from a library of genomic DNA of the common bean Phaseolus vulgaris cv. Greensleeves, was introduced into the SV40 expression vector pJC119. Monkey COS1 cells were transfected with the recombinant clone and the synthesis, glycosylation, and transport of PHA-L studied and compared with the normal processes in bean cotyledons. In the bean, phytohemagglutinin is synthesized on the rough endoplasmic reticulum and transported via the Golgi complex to protein bodies, vacuole-like organelles. Phytohemagglutinin was synthesized and glycosylated at the ER and processed in the Golgi apparatus of the transfected COS1 cells. After passing the Golgi apparatus, PHA-L was slowly secreted into the culture medium (half-time of 3-6 h), a result indicating that the signals for targeting proteins beyond the Golgi apparatus in plant cells are different from those in animal cells. PHA, which is stored in protein bodies in the plant cells, is secreted by animal cells. Tunicamycin inhibited both glycosylation and secretion of PHA by the COS1 cells, a finding indicating an essential role of the oligosaccharides for transport of PHA in these cells in contrast to the situation found in bean cotyledons. PHA, secreted into the culture medium, was partially sensitive to endo H, a result indicating the presence of one high-mannose and one complex oligosaccharide chain, a situation identical to that in beans. PMID- 3816817 TI - Heterogeneity in transformation efficiency of NIH 3T3 cells as determined by transfection with oncogenes. AB - Clones of cells have been isolated from a culture of NIH 3T3 cells and characterized. A high degree of variation between the clones was observed in their efficiency of transformation following transfection with the ras and myc oncogenes. No correlation was found between this characteristic and either the growth rate of these cells in vitro or the efficiency of transfection, as judged by the acquisition of geneticin resistance and chloramphenicol acetyl transferase activity. Continuous maintenance of NIH 3T3 cells in culture resulted in a significant decrease in susceptibility to transformation. It is suggested that the NIH 3T3 cell line comprises a heterogeneous population of cells, and it is the balance between the various types of cells which determines the phenotype of the culture. This balance can be spontaneously disrupted while the culture is grown continuously in vitro. PMID- 3816818 TI - Influence of phospholipids on the formation and stability of vimentin-type intermediate filaments. AB - The interaction of vesicles produced from individual phospholipids and mixtures thereof with preformed vimentin filaments as well as the influence of these vesicles on filament assembly were investigated employing negative stain electron microscopy and sucrose density gradient equilibrium centrifugation. Liposomes with a phospholipid composition characteristic of Ehrlich ascites tumor cells were able to bind efficiently to vimentin filaments without significantly affecting their morphology at higher concentrations. However, in sucrose density gradient centrifugation partial disintegration of the filaments was observed. In addition, larger quantities of phospholipid mixture totally blocked intermediate filament (IF) formation. Using vesicles of individual phospholipids, these effects could be shown to be due to the presence of negatively charged lipid species in the phospholipid mixture. While these were highly active in preventing filament assembly and in dissociating preformed filaments, electrically uncharged phospholipids were virtually inactive. The highest efficiency was shown by phosphatidylinositol-4,5-diphosphate. These results demonstrate that a negative surface charge of liposomes is an essential prerequisite for their successful and tight association with vimentin filaments. However, the high susceptibility of these filaments to photoaffinity labeling with the membrane-penetrating reagent 1 azidopyrene in the presence of phospholipid vesicles, points to additional interactions between hydrophobic regions of both reactants. Finally, the data also suggest a direct relationship between IFs and the lipid bilayer as the active principle underlying the association of IFs with natural membranes as observed by electron and immunofluorescence microscopy. PMID- 3816819 TI - Microtubule disruption does not prevent intracellular transport and secretory processes of cultured fibroblasts. AB - The effect of microtubule disruption on intracellular protein translocation and secretion of cultured human fibroblasts was studied. Experiments with fluorochrome-labeled wheat germ agglutinin showed that treatments with demecolcine or vinblastine sulfate rapidly brought about dispersal of Golgi organization. Similarly, monoclonal tubulin antibodies revealed in immunofluorescence a complete disappearance of microtubules under these conditions. Cells exposed to demecolcine or vinblastine sulfate appeared to secrete both fibronectin and other polypeptides similar to the control cells, as judged by electrophoretic analysis of the culture medium. In line with this, immunofluorescence studies of the cells, treated with the antimitotic drugs and then exposed to puromycin, showed a rapid depletion of intracellular fibronectin and collagen type III-specific staining. On the contrary, cells exposed first to monensin and then to demecolcine or vinblastine sulfate and puromycin, showed an accumulation of these proteins in vesicles in the Golgi region. The results suggest that in cultured fibroblasts microtubules do not have a direct permissive role in the intracellular translocation of the secreted proteins although they are involved in the maintenance of the Golgi apparatus. The secretory processes, however, appear to continue also in cells with dispersed Golgi organization and lacking microtubules. PMID- 3816820 TI - Preparation of protein colloidal gold complexes in the presence of commonly used buffers. AB - In the presence of various commonly used buffers, phosphate-buffered saline (PBS), tris-buffered saline (TBS), Na-cacodylate, bovine serum albumin and a wide range of cytochemically active proteins (monoclonal and polyclonal IgG, concanavalin A, Ricinus communis lectin I, Helix pomatia lectin, protein A) were complexed to colloidal gold of different particle sizes (6 nm, 9 nm, 22 nm). The resulting complexes were active in cytochemical labelling. Complex-formation in the presence of electrolyte opens the possibilities of: maintenance of ionic environment during complexing of proteins sensitive to low ionic strength, pH control by addition of buffers to the protein solution or to the gold sol, direct coupling of protein supplied in PBS or saline avoiding dialysis against low ionic strength buffers. Using the electron microscope to estimate the protein amounts needed for stabilization provided a sensitive and economical method to obtain aggregate-free protein-gold complexes. PMID- 3816822 TI - Is the lamina lucida of the basement membrane a fixation artefact? PMID- 3816821 TI - The role of the cytosolic free Ca2+ transient for fMet-Leu-Phe induced actin polymerization in human neutrophils. AB - We have addressed the important question as to if and how the cytosolic free Ca2+ concentration, [Ca2+]i, is involved in fMet-Leu-Phe induced actin polymerization in human neutrophils. Stimulation of human neutrophils with the chemotactic peptide (10(-7) M), known to result in a prompt rise of the [Ca2+]i to above 500 nM, also induced a rapid decrease of monomeric actin, G-actin, content (to 35% of basal) and increase of filamentous actin, F-actin, content (to 320% of basal). A reduction of the fMet-Leu-Phe induced [Ca2+]i transient to about 250 nM, resulted in a less pronounced decrease of G-actin content (to 80% of basal) and increase of F-actin content (to 235% of basal). A total abolishment of the chemotactic peptide induced [Ca2+]i rise, still led to a decrease of the G-actin content (to 85% of basal) and increase of F-actin (to 200% of basal). These results indicate that the [Ca2+]i rise is not an absolute requirement, but has a modulating role for the fMet-Leu-Phe induced actin polymerization. Another possible intracellular candidate for fMet-Leu-Phe induced actin polymerization is protein kinase C. However, direct activation of protein kinase C by phorbol 12-myristate 13-acetate (PMA) only resulted in a minor increase of F-actin content. The recent hypothesis that a metabolite of the polyphosphoinositide cycle, independently of [Ca2+]i and protein kinase C, is responsible for actin polymerization agrees well with these results and by the fact that preexposure to pertussis toxin totally abolished a subsequent increase of F-actin content induced by fMet-Leu-Phe. PMID- 3816823 TI - International Workshop on Early Post-infarction Angina. 6-7 September 1985, Pavia, Italy. Proceedings. PMID- 3816824 TI - Indications for surgical treatment in post-infarction angina. AB - In order to evaluate whether or not criteria for surgical revascularization in patients with early post-infarction angina (EPIA) should be different from those commonly used for patients with angina, the incidence and prognostic implications of EPIA were analysed in 188 AMI patients in Killip's class I or II on admission. Sixty-two patients (33%) complained of EPIA (Group I) and 126 patients were symptom-free (Group II). There were no differences between the two groups in in hospital and late mortality and reinfarction. On the contrary, severity of angina was significantly associated with the occurrence of in-hospital and late cardiac death, reinfarction and revascularization procedures. EPIA patients underwent revascularization procedures significantly more frequently than group II patients, both during hospitalization (29% versus 1%; P less than 0.001) and follow up (10% versus 1%; P less than 0.01). Coronary artery involvement was significantly more severe in group I than in group II and in the operated patients compared with the non-operated ones. Our data suggest that the severity of angina should be the leading criterion for surgery, as it is able to identify most of the patients with severe coronary artery disease and poor prognosis. PMID- 3816825 TI - Is post-infarction angina related to poor residual left ventricular function? AB - To investigate the relationship between left ventricular function and presence and type of myocardial ischaemia in the post-acute phase of myocardial infarction (MI) 313 patients admitted consecutively to our Center of Rehabilitation were studied. In all subjects a good quality two-dimensional echocardiogram, 24-h ambulatory electrocardiogram and in 308 of them a symptom-limited exercise test were performed. Clinical observation was for 3 months since MI occurrence. Transient episodes of post-MI ischaemia were observed in 164 patients (52%). No differences in left ventricular asynergy or ejection fraction were noted among patients with and without post-MI ischaemia as a whole, nor in subsets identified on the basis of occurrence of pain or ischaemia characteristics (at rest or exercise-induced). Episodes of left ventricular failure occurred more frequently in patients with silent, myocardial ischaemia at rest. Sublingual isosorbide dinitrate (5 mg), administered to 20 patients, did not differently change asynergy and ejection fraction in patients with and without documented post-MI ischaemia. In conclusion, extent of asynergy and degree of left ventricular dysfunction at rest seem to be: unrelated to the risk of post-MI ischaemia occurrence; related to the infarct size and not to the presence of stunned myocardium. PMID- 3816826 TI - Pathogenetic mechanism of post-infarction angina. PMID- 3816827 TI - Angina following a first non-Q wave infarction relationship to coronary anatomy. AB - In patients under 60 years who are hospital survivors of a first non-Q wave infarction, outcome is good and the incidence of angina is high at 60%. Post infarction angina is related to pre-infarction angina and responds to medical treatment in over 80% of patients. Angina is related to the extent and distribution of coronary artery stenosis. Patients with severe obstruction of the left anterior descending coronary artery and those with a totally obstructed infarct-related artery and jeopardized collaterals have a very high incidence of post-infarction angina. Coronary arteriography early after may help determine the subsequent management in patients who survive non-Q wave infarction. PMID- 3816828 TI - Detection of spontaneous episodes in post-infarction angina. Comparison between CCU and Holter monitoring. AB - The objects of this study are: to evaluate the incidence of early post-infarction angina in patients who developed transmural infarction (Q-AMI) or sub-endocardial infarction (no Q-AMI) during hospitalization; to compare data obtained from patients monitored in Coronary Care Unit (CCU) with those obtained from Holter monitoring. The 107 patients under study (55 with Q-AMI and 52 with no Q-AMI) presented the acute event on average 7.4 and 5.1 days after admittance in the CCU, respectively. A history of angina was present in all except 1 patient with Q AMI and in all with no Q-AMI. After AMI the angina disappeared in 22 of the patients with Q-AMI and in 31 with no Q-AMI, while it continued in 33 and 21 of these patients, respectively. Twenty-one patients underwent ECG recording according to the Holter technique while in CCU, for an average of 4.4 days before and 5.2 days after the onset of AMI. The comparative analysis of the results obtained from the CCU and from Holter monitoring shows that the CCU greatly underestimates the number of ischaemic episodes, even when pain is present (4.5 episodes per patient per day before AMI and 2 after, versus 13.7 and 6.8 with Holter monitoring). The number of ventricular arrhythmias also seemed lower when analysing data from CCU monitoring. These data demonstrate the importance of Holter monitoring, even in patients admitted to a CCU, for a precise evaluation of the ischaemic and arrhythmic phenomena. PMID- 3816829 TI - Provocative test in recent myocardial infarction. AB - Coronary artery spasm has become a frequently recognized cause of angina. Since spontaneous spasm is a rare occurrence, a number of provocative tests have been proposed. We will not discuss the different criteria of various tests, but having compared them, it seems to us that the ergometrine is the most sensitive, the most reproducible and the easiest to perform. Thus we will discuss only the ergometrine test. PMID- 3816830 TI - Provocative test in early post-infarction angina: exercise test. AB - Nowadays, the majority of patients undergoing aortocoronary bypass surgery have a history of myocardial infarction. In our first series of 1000 patients operated between 1973 and 1979, about two thirds of the patients had suffered myocardial infarction; about 80% of them within the previous three months. The method most frequently used to select post-infarction patients for coronary angiography is a simple exercise test. The post-infarction period in the context of this symposium was defined as the first 12 weeks after infarction. As far as exercise tests are concerned, we may divide this period into three subperiods: the very early post infarction period, especially the first week after infarction. Exercise testing does not play a role in this very early period; the second period is the time of an early post-infarction exercise test or the predischarge exercise test (second and third week); from the fourth to the twelfth week in many European countries, rehabilitation measures will follow, usually in a special institution. This is the time of what we will call in short 'the late post-infarction exercise test'. PMID- 3816831 TI - Early post-infarction angina: usefulness of dipyridamole-echocardiography test. AB - Thirty-nine patients with early post-infarction angina (all with significant, angiographically assessed coronary artery disease and a baseline asynergy on 2-D echo), performed a dipyridamole-echocardiography test (DET: 2-D echo monitoring with dipyridamole infusion, 0.14 mg kg-1 min-1 for 4 min). Twenty-nine patients had a positive DET (sensitivity = 74%). Two mechanical patterns of DET-positivity could be identified: a worsening of the asynergy in that same region showing a baseline asynergy (11 patients); a 'de novo' asynergy in a region remote from the one showing a baseline asynergy (18 patients); The prevalence of single-vessel disease was significantly higher in patients with type 1 positivity pattern (6 single-, three double- and two triple-vessel disease), while patients with type 2 positivity always showed a multivessel coronary involvement (8 double-, 10 triple vessel disease). In 4 of the 10 patients with 3-vessel disease and type 2 asynergy, such asynergy developed in a territory different from the one supplied by the more stenotic non-infarct-related vessel. In conclusion, DET represents a safe and feasible tool effectively to localize ischaemia, relative to the infarcted region, and to evaluate the haemodynamic significance of coronary lesions in patients with post-infarction angina. PMID- 3816832 TI - Clinical and angiographic data in early post-infarction angina. AB - The preliminary results of a prospective study undertaken in patients with a first episode of acute myocardial infarction are presented. The clinical, electrocardiographic and angiographic characteristics of 34 patients who developed early post-infarction angina (group I) were compared with those of 144 patients who remained asymptomatic after the acute infarct (group II). No difference was found between the two groups as to age, sex prevalence, risk factors, presence of stable angina before infarction, severe ventricular arrhythmias or transient congestive heart failure in CCU and peak CK value. Patients of group I had more frequently ecg signs of myocardial infarction in anterior leads (P less than 0.01) than patients of group II. Exercise testing, performed by 23 patients of group I and by 140 patients of group II, was positive in 14 patients with early post-infarction angina and in 37 who remained asymptomatic after the acute infarct (P less than 0.01). The two groups had similar values of left ventricular end diastolic volume index, left ventricular end diastolic pressure and ejection fraction. Patients with early post-infarction angina however had more frequently double or triple vessel disease, while single vessel disease prevailed in group II patients. Although the follow-up period was limited (average 9 months), a higher incidence of cardiac complications was found in group I patients (P less than 0.01). These data show that early post infarction angina defines a high-risk subset of patients among those with recent myocardial infarction. A more aggressive approach, including thrombolytic therapy and coronary angioplasty, seems warranted. PMID- 3816833 TI - An experimental approach to the problem of post-infarction angina and sudden cardiac death. PMID- 3816834 TI - Early post-infarction angina. Incidence and prognostic relevance. AB - Early post-infarction angina (2-15 days after infarction) occurred in 132 out of 616 consecutive coronary care unit admissions for acute myocardial infarction within 24 h from onset of symptoms. Patients with early post-infarction angina more often had a history of stable pre-infarction angina as well as late post infarction angina. Coronary artery disease was more extensive in patients with early post-infarction angina compared with those without angina. Forty-five patients with angina were treated before hospital discharge with coronary artery bypass (CABG) (N = 35) or percutaneous transluminal coronary angioplasty (PTCA) (N = 10). Survival and incidence of non-fatal reinfarctions during 1-year follow up was similar in patients with and without early post-infarction angina (respectively 83% versus 82% and 13% versus 11%). The incidence of angina in the follow-up was higher in the whole group of patients with early post-infarction angina then in patients without angina (53% versus 32%, P less than 0.001), but was lowest (22%) in the subset who underwent CABG or PTCA before discharge. In patients with early post-infarction angina, age, left ventricular dysfunction, extensive coronary artery disease, stable pre-infarction angina and electrocardiographic ischaemic changes distant from the infarct zone during angina were significantly associated with a poor survival. PMID- 3816835 TI - Effect of labetalol on indices of myocardial necrosis in patients with suspected acute infarction. AB - The role of combined alpha and beta blockade as a means of limiting infarct size has been studied in a randomised controlled trial using labetalol. Only 166 of 630 (26%) consecutive patients admitted to a cardiac care unit with suspected myocardial infarction were deemed suitable for inclusion; most of the remainder had delayed admission to hospital, were over the age limit of 75, or had complications which precluded the use of labetalol. Those on active treatment received a loading dose followed by a slow intravenous infusion over six hours, and oral therapy for the subsequent five days. Doses were adjusted to maintain systolic pressure in the range 100 to 120 mmHg. The control group received only conventional therapy. Labetalol caused lowering of the blood pressure and heart rate during the phase of intravenous treatment, but little effect occurred subsequently because oral dosage was constrained by low systolic pressures. The group that received active treatment had significantly greater release of CKMB enzyme. Little difference was observed in R wave scores or ejection fraction. Only low doses of labetalol can be used for most patients with acute myocardial infarction. Labetalol cannot be recommended as routine treatment for normotensive patients admitted to hospital with suspected infarction. PMID- 3816836 TI - Positivization of T wave with or without ST segment elevation in patients with unstable angina. Coronary angiographic findings and in-hospital prognosis. AB - The coronary angiographic findings and the in-hospital prognosis of unstable angina pectoris presenting with T wave positivization only (group A: 32 patients) or with additional ST segment elevation (group B: 27 patients) were evaluated. Clinical data and haemodynamic parameters before and during unstable anginal events showed no significant statistical difference, indicating blood flow reduction as the probable mechanism of ischaemia in both groups. The incidence of hospital myocardial infarction was higher in patients of group B (group A 6.24% vs group B 31%; P less than 0.02). Death due to haemodynamic deterioration occurred in 2 patients of group B. This finding can be partially explained by more developed collateral circulation in patients with T wave changes only (25 of 65 obstructed arteries in group A vs 8 out of 48 obstructed arteries in group B; P less than 0.05). Left ventricular function was comparable between the two groups. The extent, severity and location of coronary artery disease was similar in the groups. Thus, the electrocardiographic pattern of T wave changes only, in patients with unstable angina pectoris (group A) define a subgroup who have a favourable prognosis and development similar to patients with chronic stable angina pectoris. Urgent measures may be delayed in this group. PMID- 3816837 TI - Dipyridamole-echocardiography test as a clue for assessing the organic 'ceiling' of individual coronary reserve. AB - Twenty-four patients with a history of effort angina, a positive exercise stress test (EST) and coronary artery disease were enrolled in the study; 12 patients had a positive dipyridamole-echocardiography test (DET) and 12 had a negative DET. Each patient performed a total of 4 ESTs in the absence of therapy on two successive days; for each test the rate-pressure product (RPP), an established index of myocardial oxygen demand, was measured at the onset of ischaemia (ST depression greater than 0.15 mV) or at the peak of maximal exercise (if a repeated EST was negative). Taking into account the lowest of the 4 RPP values (X 1/100) in each patient, there was no significant difference between DET-negatives and DET-positives (185.2 +/- 49.3 vs 157.4 +/- 32.4). Conversely, when considering the highest of the 4 RPP values in each patient, there was a significant difference between DET-negatives and DET-positives (280.3 +/- 63.9 vs 183.3 +/- 37.0; p less than 0.01). Thus, DET may provide a clinically useful tool for assessing in the individual the organic 'ceiling' of coronary reserve, by eliminating the variability in coronary tone, which may affect EST reproducibility and the correct evaluation of the impairment of organic coronary reserve. PMID- 3816838 TI - Acute changes in blood pressure as a cause of cardiac arrhythmias. AB - The effect of an acute change in blood pressure (BP) on ventricular ectopic activity and the influence of antiarrhythmic agents on this effect were examined in 24 patients. In 11 patients with premature ventricular complexes (PVCs), the BP was temporarily reduced by a sodium nitroprusside drip. In all of them the incidence of PVCs was reduced (or annihilated) by the induced hypotension. In 13 patients without ventricular ectopic activity, a metaraminol drip was given until either a PVC appeared or the systolic BP reached 200 mmHg, or symptoms appeared. In 12 cases at least one PVC appeared and in 8 of them the total number of PVCs was 13 or more, usually in the form of bigeminy. The repetition of the test following quinidine administration (serum quinidine level 1.7 +/- 0.5 ng ml-1) in 6 cases did not change this pattern, with one exception. It prevented the appearance of idioventricular accelerated rhythm in one case in whom this rhythm had been induced by the hypertension provocative test before the quinidine administration. All cases, in whom the test failed to induce more than 3 PVCs, had no cardiac problem at all. Six of the 8 cases in whom the test induced 13 or more PVCs had organic cardiac disease or palpitation. Other arrhythmias observed on BP elevation, were supraventricular extra beats, nodal escape rhythms and atrioventricular block. In one case with cardiomyopathy, the BP elevation was associated with early signs of heart failure that subsided quickly. In conclusion, acute elevation on BP may be associated with the generation of PVCs and its reduction with their reduction or disappearance. PMID- 3816839 TI - Generation of a subtraction mask for digital angiography based on the movement of the coronary arteries. AB - A synthetic mask technique for angiography of coronary arteries was experimentally studied, using conventional 35 mm film sequences of coronary arteries. The method makes use of the fact that because of the movement of the heart vessels different parts of the background will be hidden. The background is extracted from two or more neighbouring frames by computer assistance and afterwards used for a subtraction mask. The experiments showed that the synthetic masks are of a good accuracy, the background anatomy is markedly reduced and the contrast is increased. PMID- 3816840 TI - Echocardiographic features of right ventricular dilated cardiomyopathy and Uhl's anomaly. AB - The echocardiographic features of six patients with isolated right ventricular dilated cardiomyopathy and two with Uhl's anomaly are described. The M-mode echocardiogram was similar in both groups showing increased right ventricular dimensions and normal or paradoxical septal motion. Cross-sectional echocardiography confirmed a dilated but poorly contracting right ventricle. However, patients with right ventricular cardiomyopathy had normal ventricular wall thickness, whereas those with Uhl's anomaly showed areas of thin right ventricular myocardium. These areas of the right ventricle also exhibited regional wall motion abnormalities. In conclusion, cross-sectional echocardiography can be used to differentiate between these two forms of right ventricular enlargement. PMID- 3816841 TI - Congenital calcified, apical aneurysm of the left ventricle in an adult. AB - A rare case of a congenital, calcified, apical, left ventricular aneurysm in a 30 year-old man with normal coronary arteries is presented. The successful surgical management and the developmental anatomy and pathology of such aneurysms is discussed. PMID- 3816842 TI - Strategies for the prevention of coronary heart disease: a policy statement of the European Atherosclerosis Society. AB - Of the highest priority for preventive medicine in Europe is to achieve a major reduction in coronary heart disease (CHD) and other manifestations of atherosclerosis. To this end a policy based upon reduction of risk factors has been formulated by experts from 19 countries: it employs complementary strategies directed to CHD-prone populations as a whole and to individuals at particular risk. The population strategy includes improved nutrition, avoidance of smoking, blood pressure reduction and promotion of suitable exercise. These should be based upon health education for all age groups and actions by governmental and supranational agencies (including implementation of food labelling, smoking control measures and wide provision of exercise facilities). Only measures directed to the population can reach the large proportion of people at mild to moderate risk of CHD. To provide care for individuals at particular risk of CHD, case finding requires that risk factor assessment, including measurement of plasma cholesterol and blood pressure, be included in full medical examinations. The relative merits of other modes of case finding, including selective screening and general screening, are discussed. Decisions concerning management of elevated lipid levels should be influenced by overall cardiovascular risk, by a family history of CHD and by age. Lipid lowering dietary and drug therapy should take these variables into account in addition to the extent and type of the hyperlipidaemia. Cholesterol levels exceeding about 5.2 mmol l-1 (200 mg dl-1) deserve consideration, and the goal of therapy should be to reduce levels towards this value. For most persons with levels of 5.2-6.5 mmol l-1 (200-250 mg dl-1) dietary advice and correction of other risk factors are appropriate, i.e. management comprises reinforcement of population strategy. Dietary recommendations for the control of hyperlipidaemia are reviewed, and indications for drug therapy are presented. Non-pharmacological methods for reducing mildly elevated blood pressure are discussed, and reduction of CHD risk in diabetes is reviewed. Implementation of these recommendations will be furthered by their endorsement by cardiologists and other physicians. PMID- 3816843 TI - A new radiographic method for cardiac output and cardiac shunt determination in vivo. AB - The present paper describes a new method for the measurement of cardiac output (CO) and cardiac shunt (CS). The CO method is based on the accurate determination of the concentration of the indicator in large vessels. For the measurement of the left to right shunting volumes, a double tracer technique is used by which radioactively labeled transferrin or erythrocytes are applied together with radioactively labelled human-serum-albumin (HSA) microspheres. The results obtained using these methods were compared with the data obtained by invasive methods. High correlation of both sets of data suggests that the proposed methods might provide an excellent extension of noninvasive procedures in the first months of a childs life. PMID- 3816844 TI - Preliminary findings in the evaluation of hepatic malignancies by radioimmunodetection, X-ray computed tomography, and magnetic resonance imaging. AB - In 12 consecutive patients with suspected metastatic carcinoma of the liver, we evaluated the sensitivity of radiolabeled antibodies to tumor antigens, magnetic resonance imaging, and X-ray computed tomography imaging in the detection of hepatic malignancies. Studies were performed with 131I labeled antibodies to CEA and/or CSAp; polyclonal, monoclonal and F(ab')2 antibodies were used. Nontarget radioactivity was diminished by administration of 99mTc reagents simulating nontumor distribution and use of a computer subtraction method. In nine patients with confirmed liver neoplasms, radioimmunodetection disclosed the foci of hepatic malignancies. In three patients with suspected liver neoplasms, the antibody studies were positive, but at this time have not been confirmed. X-ray computed tomography each disclosed mass lesions in five patients and magnetic resonance in three. These findings suggest that radioimmunodetection provides greater accuracy in the detection and localization of cancer than other diagnostic modalities currently used. PMID- 3816845 TI - Sensitivity and specificity of radionuclide equilibrium angiocardiography for detection of hemodynamically significant secundum atrial septal defect. AB - To determine the value of gated equilibrium angiography in secundum atrial septal defect (ASD) in children, the first pass pulmonic/systemic flow ratio (Qp/Qs) was compared with diastolic count ratio (DCR) and stroke count ratio (SCR) of the two ventricles. In 50 children we have found a correlation between Qp/Qs and DCR (r = 0.71) and between Qp/Qs and SCR (r = 0.66). For detection of significant atrial shunt (QP/Qs greater than 1.5) the sensitivity of DCR greater than 2 was 0.81 and the specificity 0.75. For SCR greater than 1.5 we sensitivity and specificity values of 0.87 and 0.71 respectively. Left and right ventricular ejection fractions were normal (0.67 +/- 0.08 and 0.50 +/- 0.07). PMID- 3816846 TI - Autologous platelet labelling using "Monovette" vials is not septic. PMID- 3816847 TI - Very low birth weight infants. PMID- 3816848 TI - Infant mortality in a region of Finland, 1968-1982. AB - Infant mortality in a region of Finland with about 450,000 people and 5400 annual births was examined during a 15-year period, 1968-1982. Total infant mortality declined from 15.8 per 1000 live births in 1968 to 5.0 in 1982. The lowering of neonatal mortality accounted for the decline, as postneonatal mortality remained at the same level throughout the study period. Despite a decrease of nearly 80%, perinatal disorders remained the leading category of primary causes of death. Mortality from congenital malformations decreased by 50%, mortality from sudden infant death syndrome increased from 0.2 to 0.9 per 1000 live births while mortality from accidents, infectious diseases and other diseases remained minor causes of death with no change in frequency. In the low birth weight category, postponement of deaths from early to late neonatal and postneonatal periods occurred, but total infant mortality in the low birth weight category declined by about 60%. During the last two 3-year periods, decrease in birth weight-specific infant mortality was found in the 500-999 g and greater than 2500 g categories. The reasonably high standard of living, good educational level of mothers, well organized primary maternal and child health services and the rapid advances in obstetric and neonatal care equally available and regionalized, have contributed to the favourable progress in infant mortality in Finland. PMID- 3816849 TI - A comparison between the neurological and intellectual abnormalities in children and adults with congenital hypothyroidism. AB - Standardised intellectual, motor and behavioural tests have been undertaken in a group of 73 children and 43 adults with congenital hypothyroidism in a regional study in the north of England. These provide comprehensive data with which to compare the results of studies of children diagnosed by screening and indicate the degree of abnormalities persisting into adult life in those patients diagnosed before screening was introduced. The mean IQ scores of the hypothyroid children and adults were 1-2 standard deviations (SD) below the population means. Longitudinal IQ data indicate persistence of intellectual abnormalities, though there was an increase in IQ score in several patients. The mean motor scores were reduced by 1-2 SD in the children and 1-3 SD in the adults. Behavioural problems and personality difficulties mainly of a neurotic nature also persisted into adult life. PMID- 3816850 TI - Influences of neonatal serum IgE concentration, family history and diet on the incidence of cow's milk allergy. AB - Serum IgE concentration was measured on the 5th day of life in 943 infants. All infants were included in a 3 month follow-up study. The frequency of cow's milk allergy was studied according to either family history, IgE level, or both. Feeding (mother's milk or formula feeding) was taken into account. Manifestations suggestive of food allergy were hardly observed in breast-fed babies. In the formula-fed group a positive family history correlated with a 40% incidence of allergic manifestations, compared to a 13% incidence (P less than 0.001) in the group with negative family history. A high IgE level (IgE greater than 1.3 U/ml) indicated a 43% risk of developing allergic manifestations in formula-fed babies as compared to 15% (P less than 0.001) in the group with normal results of a screening test. Frequency of allergic manifestations in a subgroup with a negative family history and a high IgE level (38%) was equal to the frequency in the subgroup with a positive family history and negative screening test results (IgE less than 1.3 U/ml)(36%). The incidence in the subgroup with both positive screening test results and a positive family history was 49%. None of these differences were significant. The frequency in the subgroup with both parameters negative was 8% (P less than 0.001 to 3 other subgroups). Our results indicate that the family history seems to correlate as well with the incidence of allergic manifestations as the neonatal serum IgE concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816851 TI - Vitamin-K status beyond the neonatal period. A prospective study in normal breast fed and formula-fed infants. AB - Vitamin K-dependent clotting factors (FII, FVII, FX) and PT and TT were studied prospectively in 113 healthy newborns during the first 6 weeks of life. No vitamin K prophylaxis was given. Infants were divided into three groups: breast fed, formula fed or combination. The method of nutrition could not be found to influence the coagulation status. PMID- 3816852 TI - Low antithrombin III in neonatal shock: DIC or non-specific protein depletion? AB - Low antithrombin III (AT III) levels in shock are usually ascribed to disseminated intravascular coagulation (DIC). However, decreased activities of clotting factors and their inhibitors could reflect a generalised fall in plasma proteins rather than DIC. AT III and albumin were compared in 48 asphyxiated and non-asphyxiated newborn rabbits (pH 6.70-7.30). Both AT III and albumin were markedly decreased in the sickest animals and there was a direct linear relationship between the two proteins (P less than 0.001). Similar results were obtained in ten newborn infants suffering from shock and haemorrhagic diathesis. In all cases AT III and albumin were decreased below the normal range and significantly correlated (P less than 0.01). Our findings suggest that AT III is not a useful diagnostic marker of DIC. Further, a similar fall of clottable and non-clottable proteins in shock questions the general assumption that the ensuing coagulopathy is due to intravascular coagulation. PMID- 3816853 TI - Infant dumping syndrome: reversal of symptoms by feeding uncooked starch. AB - Two infants with dumping syndrome after Nissen's fundoplication were bolus-fed with regular cows' milk formula and with test meals containing either cooked or uncooked starch. Cows' milk formula and test meals made with cooked starch provoked dumping symptoms, hyperglycaemia and hyperinsulinaemia. Dumping symptoms vanished and normoglycaemia was established when meals contained uncooked starch as the sole carbohydrate. The findings suggest that uncooked starch has a place in the dietary control of dumping syndrome in infants and possibly in adults. PMID- 3816854 TI - Prenatal diagnosis of Zellweger syndrome and related disorders: impaired degradation of phytanic acid. AB - Normal amniocytes and chorionic villous cells in culture are able to produce 14CO2 from exogenous [1-14C] phytanic acid. In contrast, cells from four fetuses at risk for the cerebro-hepato-renal (Zellweger) syndrome and related disorders showed a greatly reduced activity, indicating a block in oxidation of the fatty acid. Our data confirm that phytanic acid oxidase activity measurement can be used for the prenatal assessment of this group of disorders. PMID- 3816855 TI - Inhibition of lymphocyte DNA synthesis by plasma from patients with Kawasaki disease. AB - Plasma obtained from patients with Kawasaki disease during the acute phase markedly inhibited DNA synthesis in autologous peripheral blood lymphocytes (PBLs) stimulated by phytohaemagglutinin-P (PHA-P) or concanavalin A (Con A). The inhibition became less marked with the progression of the disease and there was no effect on DNA synthesis in PBLs stimulated by pokeweed mitogen (PWM). The plasma also inhibited DNA synthesis in PBLs obtained from healthy adults. The postulated suppressors markedly inhibited DNA synthesis in PBLs from healthy adults stimulated by PHA-P, Con A, purified protein derivative (PPD) or mixed lymphocyte culture reaction (MLR) but they had little effect on the DNA synthesis stimulated by PWM or protein A. With respect to the mechanism, the suppression was found to be potentiated by an increase in the concentration of the patients' plasma, and not to be associated with cytotoxicity nor with a deficiency of factor(s) indispensable for PBL proliferation. It was also evident that the suppression was not related to the concentration of the stimulant, to the lengths of the culturing period nor to the presence of prostaglandins. PMID- 3816856 TI - Ultrasound: a method for kidney size monitoring in children. AB - Normal kidneys were studied echographically in 170 children from 0-15 years of age. The length, thickness, width, volume and largest sagittal and transverse areas were measured and plotted against the children's height and body surface to establish standard growth curves. The usefulness of this non-invasive inter- and intra-individual estimation of renal size in following the progress of kidney alteration in children was illustrated in one case of malakoplakia and one case of parenchymal scars. PMID- 3816857 TI - The velo-cardio-facial (Shprintzen) syndrome. Clinical variability in eight patients. AB - Eight patients (three sporadic, five from two families) with the velo-cardio facial syndrome (VCFS) or Shprintzen syndrome are reported. Major clinical findings of this syndrome include a characteristic pattern of facial dysmorphisms, cleft palate, cardio-vascular malformations, and (mostly mild-to moderate) mental retardation or learning difficulties. The syndrome probably is caused by a dominant gene with very variable expression. From previous reports mostly ascertained from cardio-vascular or cleft palate clinics, the incidence of cleft palate and heart defects was calculated to be 98% and 82%, respectively. Out of eight patients of this study who were diagnosed mainly through their pattern of facial dysmorphisms, only two and four had clefts and heart defects, respectively, further demonstrating the variability in the expression of this gene. Similarly, mental retardation, noted in 100% of previous publications, was not present in all of our patients. In two instances, examination of the mother revealed that she probably carried the mutant gene, but that she showed a milder clinical expression than the index patient. It is suggested that careful family investigations should be performed following detection of an index patient, and that the rate of fresh mutations might be not as high as previously assumed. PMID- 3816859 TI - Infantile cystinosis and insulin-dependent diabetes mellitus. AB - A 13-month-old infant was admitted to our Institution because of difficult metabolic control of diabetes mellitus. Clinical and laboratory findings revealed that the child was affected by both insulin-dependent diabetes mellitus and nephropathic cystinosis. Treatment with indomethacin was associated with growth improvement at an early stage of renal insufficiency, but not in more advanced renal failure. PMID- 3816858 TI - Foramen magnum stenosis in homozygous achondroplasia. AB - A 4-month-old female with homozygous achondroplasia and daytime apnea was found to have a small foramen magnum by computerized tomography. Following suboccipital craniectomy and C1-C2 laminectomy respiratory problems did not recur during a 7 month post-operative period. We suggest that the respiratory problems in homozygous achondroplasia may be due to brainstem compression from an abnormally small foramen magnum. PMID- 3816860 TI - Obstructive endocarditis in an immunodeficient infant. AB - We report the case of 5-week-old male infant who presented as a 'near miss cot death'. He had the immunodeficient syndrome of defective neutrophil mobility and delayed umbilical cord separation. He was shown to have staphylococcal endocarditis with a large vegetation on the mitral valve, and acute obstruction of the mitral valve flow may have accounted for the suddenness of his presentation. Death resulted from overwhelming sepsis with widely disseminated micro-abscesses. PMID- 3816861 TI - Effect of age on homovanillic and 4-hydroxy-3-methoxymandelic acid levels in plasma. AB - The plasma levels of homovanillic and 4-hydroxy-3-methoxymandelic acids have been determined in 524 normal subjects ranging from birth to 49 years of age using a mass fragmentographic method. The mean concentration of homovanillic acid in plasma declines exponentially from the age of 1 day (X = 2342.0 nmol/l, 426.6 ng/ml) to adulthood (X = 60 nmol/l, 10.9 ng/ml). 4-Hydroxy-3-methoxymandelic acid behaves in a similar although not so extreme manner (392 nmol/l, 77.6 ng/ml-50 nmol/l, 10 ng/ml). PMID- 3816862 TI - Plasma zinc levels in children with chronic diarrhoea. AB - We measured the plasma zinc concentration in a group of children with chronic diarrhoea. Fifteen patients with untreated coeliac disease had a mean plasma zinc level significantly lower than that of healthy children (69 micrograms/dl vs 96 micrograms/dl). In patients with chronic post-enteritic diarrhoea (n = 70) the mean plasma zinc level was in the normal range (100 micrograms/dl). The latter result suggests that our country a secondary zinc deficiency is not a feature of chronic post-enteritic diarrhoea. PMID- 3816863 TI - Generalized amyloidosis secondary to xanthogranulomatous pyelonephritis. AB - Unilateral nephrectomy in an 8-year-old male with chronic renal failure and urosepsis revealed a combined histologic lesion of xanthogranulomatous pyelonephritis and amyloidosis. Amyloid deposits were found also in the rectum and liver. On clinical grounds xanthogranulomatous pyelonephritis was also suspected in the remaining kidney. Common causes of systemic amyloidosis were excluded. After operation the signs of amyloidosis diminished, probably due to removal of the infected kidney, but renal function deteriorated rapidly. PMID- 3816864 TI - Internal male pseudohermaphroditism in a 6 week old child. AB - Here we describe a 6-week-old infant with internal male pseudo-hermaphroditism, detected during the repair of a left inguinoscrotal hernia. We advocate early orchidopexy during a first laparatomy and call attention to the risk of adhesions and subsequent complications if the gonads are replaced into the peritoneal cavity in advance of a precise histological and cytogenetic diagnosis. PMID- 3816865 TI - Megaloblastic anaemia in one of monozygous twins breast fed by their vegetarian mother. AB - Megaloblastic anaemia in infancy is uncommon in western countries. We describe a case of an exclusively breast-fed monozygous twin with severe vitamin B12 deficiency with haematologic and neurologic abnormalities. Treatment with vitamin B12 resulted in a rapid haematological and clinical improvement. PMID- 3816866 TI - Intrauterine exposure to indomethacin. PMID- 3816867 TI - Cutaneous nodule resulting from blood-letting in neonates. PMID- 3816868 TI - Relationship between nerve function, retinopathy and duration of diabetes. PMID- 3816869 TI - Metabolic acidosis in osteogenesis imperfecta. PMID- 3816870 TI - Androgens and hypoproliferating anaemia. PMID- 3816871 TI - Endocardial fibroelastosis in two siblings with the infantile type and the childhood type. PMID- 3816872 TI - [Relative bioavailability in man of 2 pharmaceutical forms of canrenone]. AB - The relative bioavailability of 100 mg canrenone capsules and the commercial 50 mg capsules has been determined in 12 healthy male subjects. The study was conducted in a cross over design. After the absorption phase canrenone plasma concentrations followed a biexponential decay. The half lives of the three phases observed were respectively 40.7 +/- 21.7 min, 1.94 +/- 0.558 hr and 18.5 +/- 3.93 hr after administration of a 100 mg capsules; they were respectively 31.8 +/- 14 min, 1.64 +/- 0.513 hr and 16.1 +/- 3.09 hr after administration of two 50 mg capsules. These values were similar to those reported in man. Bioequivalence of the two forms tested was ascertained by a two way analysis of variance and by the Westlake symmetrical confidence interval (95%). Peak plasma levels, Cmax, time to reach the peak, tmax, and the rate constant of absorption showed great inter and intra individual variations. In vivo hydrolysis of canrenone into canrenoic acid and subsequent lactonization of the acid are pH-dependent and could give rise to these variations if occurring before absorption. PMID- 3816873 TI - Blood level, distribution, metabolite pattern and excretion of [14C]alinidine in mice and rats. AB - Following oral and intravenous administration the absorption, distribution, metabolite pattern and excretion of [14C]alinidine, a drug with specific bradycardic efficacy, was studied in mice and rats. [14C]alinidine was rapidly and extensively absorbed. The distribution of radio-labelled drug over the entire animal body was rapid as indicated by blood level curves as well as by whole body autoradiography. In both species radioactive compounds were eliminated from blood with half-lives ranging from 5.6 h to 7.4 h. More than 50% of the renally excreted radioactivity was a uniform substance behaving in in TLC and HPLC experiments like the drug administered. From rat urine this compound could be identified as [14C]alinidine using mass spectrometry. In mice and rats no definite substance with clonidine-like chromatographic properties was found. Biliary excretion was demonstrated in both species. The renal portion of the total radioactivity elimination was 67.2-70.1% of the dose administered in mice and 68.1-85.1% in rats. Total excretion was 85.1-101.3% of radioactivity given and was complete 3-4 days after [14C]alinidine administration. No significant differences in pharmacokinetic behavior in mice and rats could be found. PMID- 3816874 TI - Comparative study of the effects of some inducers with or without protein binding properties on bioavailability of isoxazolylpenicillins in rats. AB - The effect of various inducers with or without protein binding properties on serum levels and half life of Oxacillin, Cloxacillin and Dicloxacillin was studied. A total of 102 male rats classified in 3 "categories" according to the administered penicillin with 6 groups of rats in each of them were used. Each group was pretreated for 15 days with the following inducers: phenobarbital, diphenylhydantoin, diazepam, chlorpromazine and phenylbutazone. The control groups received saline. The d-glucaric acid concentration in the urine prior to and after the administration of inducers and the liver weight were taken as enzyme induction indices. The results showed a decrease of serum levels and half life of three penicillins with a negative correlation between urine d-glucaric acid and serum penicillin levels. Phenobarbital, diphenylhydantoin and chlorpromazine affected the 3 penicillins in the following statistically significant order: oxacillin, dicloxacillin, cloxacillin. Diazepam affected: cloxacillin, dicloxacillin, oxacillin, and phenylbutazone: dicloxacillin, cloxacillin and oxacillin. However all drugs finally produced a uniform effect on all 3 penicillins in the following decreasing order: phenobarbital (r = -0.910), diphenylhydantoin (r = -0.864), phenylbutazone (r = -0.851), chlorpromazine (r = 0.842) and diazepam (r = -0.821). For all inducers, the effect was most significant for oxacillin (r = -0.869), second most significant for dicloxacillin (r = -0.811) and finally for cloxacillin (r = -0.778). The results suggested an interaction of isoxazolylpenicillins and the above drugs. PMID- 3816875 TI - Metabolism of pheneturide in the rat and in man. AB - The biotransformation of pheneturide was studied in humans and in the rat. Human volunteers received a single oral dose of 10 mg/kg of pheneturide and the rats were given repeated doses of 250 mg/kg. Urine from both study groups was extracted with Amberlite XAD-2 and the extracts were separated by preparative HPLC after enzymatic hydrolysis. Five metabolites were isolated in man and their structures were determined using NMR and mass spectrometry. The hydrolysis of the ureide function and the 4-hydroxylation of the benzene ring led to the formation of two major metabolites: 2-(4-hydroxyphenyl)-butyroylurea (37.5%) and 2 phenylbutyric acid (40.6%), and to one minor metabolite: 2-(4-hydroxyphenyl) butyric acid (11.9%). Seven metabolites were isolated in the rat. The 4 hydroxylation of the benzene ring and the C 3 hydroxylation of the aliphatic chain led to the formation of two major metabolites: 2-(4-hydroxyphenyl) butyroylurea (70.5%) and 3-hydroxy-2-phenyl-butyroylurea (19.6%), whereas the hydrolysis of the ureide function was less important. Only traces of the parent drug were found in humans as well as in the rat. PMID- 3816876 TI - Pharmacokinetic profile of metaclazepam (Talis), a new 1.4-benzodiazepine. Influence of different dosage regimens on the pharmacokinetic profile of metaclazepam and its main metabolite under steady-state conditions. AB - The pharmacokinetic parameters of the new 1.4-benzodiazepine metaclazepam (Talis) were investigated. In particular, the question of whether the drug and/or its main metabolite accumulates in the body under steady-state conditions was studied. Two dosage regimens were compared by a randomized two-way crossover design: a once-a-day dosing (15 mg metaclazepam in the evening, = A) versus a twice-a-day dosing (5 mg in the morning plus 10 mg in the evening, = B) over ten days in twelve healthy male volunteers. Plasma levels of metaclazepam and its major biotransformation product, N-desmethylmetaclazepam, were determined. Comparing the treatments, significant differences were found for Cmax, but not for AUC-3 and Tmax. These results are also valid for the comparison of days 1 and 10 of each treatment. Higher Cmax values for dosage regimen A were found but Tmax and Cl/F remained stable in both treatments taking into account that 12 hours after the first medication, another dosing took place in treatment B. Eight hours after application, plasma levels were markedly low, Cmax values after single dosing were nearly twice as high as after multiple dosing. Therefore based on these pharmacokinetic findings, a second dosing seems to be necessary; the clinical relevance needs further investigation. It has been reported, in fact, that it is in general very difficult to demonstrate a correlation between blood levels and therapeutic effects for 1.4-benzodiazepines (1,2). PMID- 3816877 TI - [Experimental filariasis in Proechimys oris by Dipetalonema dessetae. 5. Effect of parasitism on metabolism of diethylcarbamazine]. AB - The metabolism of diethylcarbamazine (DEC) in healthy and filaria-infected Proechimys oris Rodents was investigated. DEC and 14C labelled DEC were orally administrated (100 mg/kg). The drug was quickly and intensively metabolised. About 90% of the dose administered was eliminated in the urine within 24 hours. Monodeethylation was the major pathway. The major urinary metabolites were ethylcarbamazine and its N-oxide. Traces of N methylpiperazine 2,5 dione and their N-oxide were also found. Elimination was faster in filarial than in healthy animals, but metabolites were the same. PMID- 3816878 TI - The metabolic fate of 14C or 35S labelled tiadenol in rabbit after i.v. and oral administration. AB - Tiadenol is a hypocholesterolemic drug that inhibits the early steps of cholesterol synthesis. No pharmacokinetic data have thus far been reported for man and few for animals. We investigated the pharmacokinetics, biotransformation and distribution of two differently labelled tiadenol molecules (14C and 35S) in the rabbit. Following a short protocol (up to 8 h), a regular decrease of the plasma radioactivity was observed after i.v. route for 4 or 5 h and plateaued thereafter. Most of the radioactivity was found in the urine, the lungs and the liver with low levels in bile and feces. By oral route, the plasma radioactivity increased regularly and decayed for a short period. Thereafter, a second increase was observed. Drug and metabolites accumulated in the kidneys and in the liver but most of the radioactive compounds were recovered from the urine. From results obtained with a longer protocol (4 days in a metabolic cage), it could be extrapolated that 10 to 15 days are necessary to completely clear the drug. Tiadenol was extensively metabolized with a wide tissue distribution. The main metabolites identified were oxidation products (free or conjugated). No statistically significant differences in biotransformation were found between the two differently labelled tiadenol molecules. PMID- 3816879 TI - Pharmacokinetics of hydroxy-3(S)-dihydroquinidine in healthy volunteers after intravenous and oral administration. AB - The pharmacokinetics of hydroxy-3(S)-dihydroquinidine (HDHQ) were studied in 6 healthy volunteers following a 15 min intravenous infusion of a 300 or 400 mg dose, a 300 mg oral dose in solution and a 300 mg tablet administration on three separate occasions (random order) with at least one week intervals. Using a specific HPLC assay for HDHQ, the post-infusion and post-absorption plasma HDHQ concentrations declined bi-exponentially. Both oral forms of HDHQ were absorbed rapidly (tmax 1 h-1.2 h) with an absolute bioavailability of the oral solution (F = 0.54 to 0.93) which was not significantly different from that of the tablet (F = 0.66 to 0.90). HDHQ was rapidly and extensively distributed to the tissues with a high steady-state volume of distribution (6.82 +/- 1.85 l X kg-1). Mean elimination half-life was 6.7 +/- 1.4 h after IV infusion, 8.4 +/- 1.7 h after the oral solution and 11.3 +/- 4.4 h after the tablet administration. HDHQ was partially eliminated from the body in the unchanged non-conjugated form by the urine and renal clearance represented approximately 50% of the total body clearance. These results show that HDHQ is rapidly and almost completely absorbed and has potential for a twice daily administration regimen for the treatment of cardiac arrhythmias. PMID- 3816880 TI - Interaction of ethanol with codeine metabolism in rat hepatocytes: a multicompartmental model. AB - A multicompartmental pharmacokinetic model is presented, which based upon data from a previous study, describes the effects of ethanol (60 mM) on the metabolism of codeine (10 microM) in isolated rat hepatocytes. According to this model, about one third of codeine metabolized was transformed to morphine (13%) and norcodeine (18%), and two-thirds to unknown metabolites in the absence of ethanol. In the presence of ethanol, the apparent first order fractional rate of total codeine metabolism was reduced by 66% (0.0783 vs 0.0271 min-1). There was no alteration in the portion of codeine metabolized to norcodeine, but there was a 44% decrease in the fraction transformed to unknown metabolites and a tripling in the portion transformed to morphine. The fractional rate of codeine O demethylation to morphine was apparently not sensitive to ethanol. In the absence of ethanol, about two-thirds of morphine was metabolized to morphine-3 glucuronide and the other third to unidentified metabolites. Only the glucuronidation process seemed to be inhibited by ethanol. The fractional rate of further metabolism of norcodeine to normorphine was similar in the absence or presence of ethanol. In conclusion ethanol co-incubation with codeine resulted in an inhibition of codeine conversion to unknown metabolites and norcodeine, and with morphine to morphine-3-glucuronide, but no inhibition in morphine production. PMID- 3816881 TI - Sweating dysfunction in Parkinson's disease. AB - Sweating was measured with an evaporimeter in 5 different positions on both sides of the body in 23 patients with idiopathic Parkinson's disease and in 11 age matched control subjects before and after a heating stimulus. Perspiration was increased significantly both before and after the heating provocation in the upper part of the body (the forehead, chest and forearm) of Parkinson patients in comparison with the control subjects (p less than 0.05). The increase of perspiration correlated significantly (p less than 0.05) with the severity of Parkinson's disease as estimated by the Webster scale. The results indicate wide and clear autonomic nervous system dysfunction in Parkinson's disease. PMID- 3816882 TI - Congenital muscular dystrophy with central nervous system involvement: case report. AB - A case of a mediterranean boy with congenital muscular dystrophy (CMD) and central nervous system (CNS) involvement with mild intellectual impairment and seizures is reported. Muscular dystrophy involved both skeletal and mimic muscles, and histological findings were consistent with a congenital dystrophy. EEG recordings showed generalized and localized paroxysmal activities. CT scan demonstrated low-density periventricular areas. Ophthalmoplegia was also observed. A literature review disclosed that in some western cases of CMD plus CNS involvement, cranial muscles other than mimic muscles may be involved. PMID- 3816883 TI - Correlation of autonomic dysfunction to CSF concentrations of noradrenaline and 3 methoxy-4-hydroxyphenylglycol in Parkinson's disease. AB - In order to study the role of the neurotransmitter noradrenaline (NA) and its main brain metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in autonomic failure in Parkinson's disease (PD), an analysis of the relation of cerebrospinal fluid (CSF) NA and MHPG levels and a rating of autonomic nervous system (ANS) impairment was carried out. The mean baseline NA level in CSF of PD patients was 220.0 +/- 110.0 pg/ml, and the mean baseline MHPG level 9.9 +/- 3.9 ng/ml. These levels did not differ from those of age-matched controls. Within the group of patients with PD neither the duration of the disease nor its medication influenced the results. No correlation could be found in patients with PD between the CSF NA levels and the severity of autonomic failure, but a clear correlation was found between the CSF MHPG concentrations and the severity of autonomic failure. PMID- 3816884 TI - Isolated supraclinoid occlusive disease of the internal carotid artery. AB - Isolated supraclinoid occlusive disease of the internal carotid artery is a rare cause of cerebral ischemia. The authors of the only review of this subject concluded that it is caused predominantly by factors other than atherosclerosis. We examined 6 patients with isolated supraclinoid occlusive lesions. Five of them had one or more risk factors for atherosclerosis. Thus, the isolated stenosis of that part of the internal carotid artery does not seem to represent a particular pathologic entity. PMID- 3816885 TI - Cardiovascular reflexes in multiple sclerosis. AB - Cardiovascular autonomic function was studied in 50 patients with multiple sclerosis using 5 simple non-invasive tests: the heart rate responses to the Valsalva manoeuvre, deep breathing and standing, and the blood pressure responses to standing and sustained handgrip. Abnormalities of one or more tests were found in 37 subjects. There was a variable distribution of abnormalities with most occurring in the heart rate response to deep breathing and the blood pressure response to sustained handgrip. This pattern contrasts with that in diabetics and probably reflects the scattered central pathological lesions of multiple sclerosis. PMID- 3816886 TI - Sleep EEG with or without sleep deprivation? Does sleep deprivation activate more epileptic activity in patients suffering from different types of epilepsy? AB - A sleep EEG of 190 patients without sleep deprivation was recorded, followed by a sleep EEG after 24 h of sleep deprivation on the next day. The patients suffered from various types of epilepsy, in their routine EEGs no epileptic discharges were seen. Both sleep EEGs were recorded under the same antiepileptic drugs. A waking EEG was recorded immediately before each sleep EEG. The activation rates of epileptic activity in 52.6% (without sleep deprivation) and 53.2% (with sleep deprivation) of the patients showed no significant differences. Also on classifying the epileptic discharges no real difference was found between the 2 methods (generalized: 29.5 vs. 29.5%, generalized with lateral emphasis: 11.1 vs. 9.5%, focal: 12.1 vs. 14.2%). Only in the waking EEG, recorded immediately before the sleep EEG after sleep deprivation, a few more patients showed epileptic discharges (33.6 vs. 27.4%). Without there being any significant differences between the 2 methods there were some different results in comparing the EEG with the clinical findings: significantly more epileptic activity was shown in patients who had their first seizure before the age of 20 (55.6 and 55.6% vs. 26.3 and 31.6%), amongst females (59.8 and 61.9% vs. 45.2 and 44.1%), in awakening grand mal (= primary generalized tonic-clonic seizures, 76.5 and 70%) and in absences (69 and 72.4%). The higher activation rates in young subjects, in patients with a family history of seizures, with pathological neurological findings, mental retardation and delayed psychomotoric development in early childhood, were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816887 TI - Coagulation defects during extracorporeal circulation in the dog. AB - This study was undertaken in an attempt to diminish the frequency and severity of postextracorporeal circulation hemorrhage in dogs. Its purpose is to ascertain the amount of 99mTc-labeled autologous fibrinogen deposited in the oxygenator, as well as the coagulation defect originated during the surgical procedure when heparin is not administered (group I) and when it is at doses of 1 mg/kg body weight (group II) and 3 mg/kg body weight (group III). The result demonstrate that the fibrinogen deposition in the oxygenator decreased as the dose of heparin administered was augmented. The coagulation disorders were produced by factor consumption, affecting all dogs in group I. The same type of alteration was produced with the use of heparin, but in some the platelet count, fibrinogen and fibrinogen degradation products and the prothrombin and thrombin times were maintained within normality or were only slightly altered. Significant differences were not detected between groups II and III. For this reason, we recommend the utilization of heparin in experimental extracorporeal circulation in a single dose of 1 mg/kg body weight, administered at the initiation of bypass, which provides a sufficient level of anticoagulation for at least 60 min and makes its neutralization with protamine unnecessary, the effects of which are especially adverse in the dog. PMID- 3816888 TI - Effect of intraarterial, intraportal or combined norepinephrine infusion on hemorrhage at experimental liver trauma in the rat. AB - The effect of intraarterial, intraportal or simultaneous intraarterial and intraportal norepinephrine (NE) infusion on hemorrhage after standardized liver trauma was evaluated in the rat. Infusion of NE through a catheter in the gastroduodenal artery or/and vein, was started 5 min prior to the liver trauma and continued throughout the experiment. Blood pressure was continuously registered after cannulation of the femoral artery. Standardized liver trauma involved resection of the left anterior liver lobe. Bleeding time, blood loss from the traumatized liver surface, hemoglobin (Hb), hematocrit (Hct), platelet count (PC) and white blood cell count (WBC) were measured. Infusion of NE resulted in significant increase of blood pressure compared with controls. Infusion of NE (i.a., i.p., i.a. + i.p.) caused significant decrease in bleeding time and blood loss. Hb, Hct, PC and WBC were not affected. NE infusion proved effective in decreasing hemorrhage at liver trauma; the route of administration did not influence the results. PMID- 3816889 TI - Effect of splenectomy and hemisplenectomy on pneumococcal infection and bacteria clearance in the rat. AB - Median survival times 1 month after intraperitoneal inoculation of Streptococcus pneumoniae Felton UC 41 show that the difference between hemisplenectomized and control rats is not at all significant (chi 2 = 0.04). On the other hand, comparing splenectomized rats with hemisplenectomized and control rats taken together, there is a significant difference: 10% level (chi 2 = 2.84; 1 degree of freedom; p less than 0.10). The blood concentrations of pneumococci at different time intervals after inoculation do not differ between control and hemisplenectomized rats (F = 0.02; 1 and 135 degrees of freedom), but they differ very significantly when the splenectomized rats are compared with the hemisplenectomized rats and controls taken together (F = 10.00; 1 and 135 degrees of freedom; p less than 0.01). PMID- 3816890 TI - Body composition after 'very-little-stomach' biliopancreatic bypass. AB - The nutritional status prior to and 3 months and 1 year after biliopancreatic bypass surgery was evaluated. The common nutritional indexes (serum albumin and transferin concentrations, daily urinary creatinine excretion and delayed hypersensitivity) were determined. The body compartments were derived from total body water (TBW) and total body sodium (TBNa), measured by dilutional technique, and total body potassium (TBK), calculated from TBW, TBNa, and the ratio of the sodium plus potassium content divided by the water content in a sample of whole blood. Before surgery, obese patients showed a dilatation of both fat an lean compartments with a normal lean body mass (LBM) qualitative composition, as indicated by TBNa/TBW, and TBNa/TBK ratios not greater than those measured in controls. Three months following very-little-stomach biliopancreatic bypass (VLS BPB), a consistent reduction of body weight and body fat were observed. The body cell mass value fell and reached a level closely similar to that found in lean control subjects. LBM showed only a slight decrease. A sharp increase of TBNa/TBW and TBNa/TBK ratios demonstrated a dilatation of the extracellular space. This malnutritional status was not detected by the usual nutritional parameters. One year after VLS BPB surgery, the patients' body composition became very similar to that of lean subjects, though a TBNa greater than that of controls suggested that a slightly expanded extracellular space was still present. PMID- 3816891 TI - Regional blood flow and acid secretion associated with damage and restitution of the gastric surface epithelium in cats. AB - The gastric mucosa of anesthetized cats was exposed to 2 M NaCl for 10 min. After returning to gastric perfusion with 150 mM NaCl and pH 7.40, with and without pentagastrin stimulation, transmucosal potential difference decreased to zero and then gradually increased to approximately half the original value during the following 90 min. H+ secretion decreased and remained close to zero after exposure to 2 M NaCl in nonstimulated cats, whereas pentagastrin-stimulated secretion gradually increased to nearly half the preexposure level. Mucosal blood flow increased, and the vascular resistance decreased in the posterior wall of the stomach corresponding to epithelial damage, as observed by light microscopy after 15 min. Blood flow during pentagastrin stimulation was initially high in fundus and corpus and did not increase further after exposure to 2 M NaCl, but showed similar changes as without pentagastrin in the antrum. Epithelial restitution occurred within 90 min during both nonstimulated conditions and pentagastrin stimulation. In control animals subjected to 150 mM NaCl there were no changes in transmucosal potential difference, H+ secretion, or blood flow throughout the experiment and epithelial damage was not found. In conclusion, damage caused by 2 M NaCl to the gastric surface epithelium was associated with decreased acid secretion and increased mucosal blood flow. These factors may contribute to creating favorable conditions for the epithelial restitution, indicated by restoration of transmucosal potential difference and observed by light microscopy. PMID- 3816892 TI - A case for preoperative chemotherapy in advanced urothelial cancer of the upper urinary tract. AB - A case of a 36-year-old male patient with a metastatic renal pelvic tumor is presented. Preoperative systemic chemotherapy with cis-platinum and methotrexate induced tumor regression. After radical nephroureterectomy and adjuvant chemotherapy the patient is without any evidence of disease 1 year later. PMID- 3816893 TI - Antireflux in adults: a long-term follow-up. AB - The long-term results after antireflux operation in 47 adults are presented. Reflux was eliminated in all but 3 cases. Preoperatively most patients complained of urinary tract infection with or without fever, but sometimes investigation for hypertension or urolithiasis also led to the diagnosis. Postoperatively 70% of the patients are free of symptoms and infection. Renal scarring in pyelonephritic patients seems to stop after intervention. In all patients with a normal preoperative creatinine level, this level stays normal after the intervention. However, in 6 of 7 patients with a creatinine level of greater than 1.5 mg% before operation, the intervention could not stop the evolution toward terminal renal failure. PMID- 3816894 TI - Repair of fistulas in the vesicovaginorectal area by forming a urinary reservoir. AB - For the repair of urethrovesicovaginorectal fistulas, a vulvocolpocleisis was made and reinforced by an island flap in 5 cases. A vesicovaginorectal urinary reservoir was so prepared. Fecal diversion is ensured by a preternatural anus. All 5 patients void urine through the rectum every 3-4 h without recurrence of fistula. PMID- 3816895 TI - Urinary tract stone disease in modern Japan. Stone incidence, composition and possible causes in Osaka district. AB - 2,969 stones, obtained from affiliated hospitals as well as the Osaka University Urologic Clinic were analyzed by infrared spectrophotometry. 2,724 of the 2,969 stones were obvious upper urinary tract stones, and the composition of these 2,724 stones is reported. The incidence and possible cause of stones in 750 patients with upper urinary tract calculi, managed in Osaka University Urologic Clinic, are discussed, as well as the recent figures on urinary tract stone disease in Osaka district. These figures are representative of stone disease in Japan. PMID- 3816896 TI - Selective sacral nerve blockade for the treatment of unstable bladders. AB - 38 patients with severe urge or urge incontinence, who did not respond to conservative therapy, were treated with selective sacral nerve blockade using a local anesthetic (bupivacaine). 6 patients of this group had definite selective sacral denervation with phenol. In 31 patients a urodynamic study was done previous to the sacral nerve block as well as 10 and 90 min after the injection. Within the first 2-7 weeks the success rate was about 70% in regard to bladder capacity and mean volume at first desire to void. On long-term follow-up (greater than 7 months), the success rate decreased to about 16%. Only 1 patient of the phenol group still has complete detrusor areflexia for now more than 2 years. 4 male patients with advanced or locally recurrent bladder tumors had the sacral block because of severe perineal or suprapubic pain. Subjectively their response seemed to be better. According to our experience nonoperative central bladder denervation with selective sacral nerve blockade using local anesthetics or phenol shows no convincing results on long-term follow-up. Since it is a minimal invasive technique, which can be repeated several times, it may be helpful for some patients and offers a chance to bypass major surgical denervation procedures. PMID- 3816897 TI - Intracavernous therapy in impotence after pelvic trauma. A preliminary study. AB - Pelvic trauma, especially when complicated by a posterior urethral disruption, may cause impotence in 50% of patients. The treatment of this kind of impotence has always been troublesome for the urologist. In fact penile prostheses or the revascularization procedures have sometimes been failures. We present a series of 6 patients with impotence after pelvic trauma managed by intracavernous injection of papaverine and we describe here the preliminary results obtained. PMID- 3816898 TI - Serum levels of neopterin as related to the prognosis of human prostatic carcinoma. AB - In 93 patients suffering from prostatic cancer, serum levels of neopterin, a pteridine reflecting activation of the immune defence system, were measured at the time of diagnosis and 6 and 12 months after treatment with orchidectomy or estrogens. Neopterin levels were initially greater than 10 nM/l in 27% of the patients and in this group tumor recurrences occurred in 28% as compared to 7% in the group with neopterin less than 10 nM/l. No apparent correlation between tumor stage and grade and neopterin levels could be demonstrated. Neopterin levels decreased significantly after onset of treatment (p less than 0.001), which implicates a hormone dependence. But still patients with initially elevated serum neopterin levels, and thus an assumed activated immune defence system at the time of diagnosis, had lower survival rates than those without elevated neopterin levels (p less than 0.001). It is concluded that elevated levels of neopterin in serum is a sign of poor prognosis in human prostatic cancer. PMID- 3816899 TI - Prognosis of renal cell carcinoma related to nuclear grade, DNA content and Robson stage. AB - In 135 renal cell carcinomas (RCCs), nuclear grade, Robson stage and DNA content, determined by flow cytometry, were related to the 3-year survival rates of the respective patients. All three parameters showed prognostic value, nuclear grading being most effective. Combined evaluation of the parameters showed that staging and also DNA determination add supplementary prognostic information. As the four nuclear grades clearly uncover the biological potential of RCC, they are regarded as the most significant criteria for the prognostic assessment of RCC. PMID- 3816900 TI - Aneurysmal hemorrhage of the kidney caused by angioleiomyoma. AB - A small angioleiomyoma consisting of proliferating smooth muscle cells and vessels caused macrohematuria in a 52-year-old female patient. The locally ill defined tumor in the fatty tissue of the renal pelvis immured small arteries and veins as well as an interlobar artery, and caused damage to the vascular walls accompanied by the development of aneurysm, perforation and fistulation into the renal pelvis, by mechanisms open to various pathogenetic interpretations. Preoperative radiological diagnosis yielded a subcapsular hematoma, and showed more intense contrast medium staining of the upper renal pole. Dysontogenetic tumors are most frequently located in the renal cortex and are capable of locally destructive growth. They are usually well defined and of nodular structure. As, in our case, an exact diagnostic assessment of the process was lacking and both the location and growth pattern of the tumor were atypical, an organ-preserving resection was deemed unsuitable and nephrectomy was performed. PMID- 3816901 TI - Carcinosarcoma of the prostate. AB - Carcinosarcoma of the prostate is a very rare malignant tumor in men. Only 4 cases have been reported in the English literature. We give herein the 5th case report of carcinosarcoma of the prostate. PMID- 3816902 TI - Malignant testicular tumors in identical twins. AB - Two cases of testicular malignancy in a pair of identical twins are reported. The literature is also reviewed. The tumors appeared within 7 years of each other. The histology was different in both cases. PMID- 3816903 TI - Primary melanoma in the female distal urethra. AB - A case of primary urethral oligomelanotic melanoma is presented. Melanoma of the female distal urethra is a rare tumor with a poor prognosis. Imprint cytology was used for detection. Electron microscopy and immunohistochemistry were used to confirm the histologic diagnosis. PMID- 3816904 TI - Bladder tumor occurring in the contracted bladder following urinary tract tuberculosis. AB - We report a case of bladder squamous cell carcinoma which occurred in the contracted bladder following urinary tract tuberculosis 20 years earlier. The patient came to our hospital complaining of gross hematuria, so we suspected recurrence of urinary tract tuberculosis. We administered rifampicin and ethanbutol. However, urine culture was negative and urine cytology was positive. Following internal urethrotomy, cystoscopy was performed and a bladder tumor was found. Although in this case there was a long time lag between urinary tract tuberculosis and bladder tumor, it was very difficult to make an exact diagnosis. It would have been even more difficult if there had been coexistence of active tuberculosis. We discuss the points of diagnosis and treatment. PMID- 3816905 TI - Duplicated exstrophy: report of three cases. AB - Three cases of duplicate exstrophy are described and the theoretical mechanisms of embryogenesis discussed. In all 3 cases there was classic pelvic skeletal deformity. Urinary control was normal in 2 of the 3 patients. The surgical approach consisted of plastic repair of the abdominal wall defect in all patients and correction of urinary incontinence in 1 patient. PMID- 3816906 TI - Diagnosis and surveillance of infections in cytopenic cancer patients. PMID- 3816907 TI - Effects of cis-diamminedichloroplatinum (II) loaded liposomes on mouse Ehrlich tumor cells. AB - Cis-diamminedichloroplatinum II (cisplatin) heavily or lightly loaded (fluid, solid, negatively charged or neutral) liposomes were prepared. Cisplatin release from liposomes was observed only after long dialysis times or after liver lysosomal enzymatic disintegration in solution. Mouse Ehrlich tumor cells (ELT) cultured in vitro were treated with cisplatin, liposomes or cisplatin loaded liposomes, and the effects on the mitotic activity, the DNA content and the ultrastructure were compared. Cisplatin (1-10 micrograms/ml) had an antimitotic activity and modified the DNA content in ELT cells. Ribosome aggregation, perichromatin or interchromatin granule accumulation, and chromatin condensation or some degree of dispersion could be observed. Negatively charged fluid liposomes had an antimitotic activity and modified the DNA content in ELT cells at lower concentrations (0.3 mumoles/ml) than in the case of neutral fluid liposomes (1.5 mumoles/ml). Negatively charged solid liposomes were not toxic at these concentrations. Ultrastructural analysis of ELT cells treated in vitro with negatively charged fluid liposomes revealed their extracellular adsorption and their disintegration in phagolysosomes. A fusion between liposomes and the plasma membrane was not definitely demonstrated. Cisplatin loaded liposomes also had an antimitotic activity and modified the DNA content in ELT cells. These effects were similar to or more pronounced than those induced by free cisplatin. Ultrastructural analysis revealed some kind of electron dense material in phagolysosomes which was never observed after the treatment with free cisplatin or liposomes alone. Effects on nucleic acids were rarely observed. PMID- 3816908 TI - In vitro and in vivo activity of 12-O-3-N-dansylamino TPA. AB - Dansyl-TPA, a fluorescent TPA analogue, which is a label with a high affinity for C3H/10T1/2 cells and induces 3H-choline release from these cells (Tran et al. Nouv. J. Chim 1984, 8, 751-757), has been studied for in vitro promoting activity in the same cell line initiated by a carcinogen MNNG and in vivo short-term mouse skin tests. In vitro, dansyl-TPA expresses transforming effect in its own (without MNNG pretreatment) as well as increases the production of transformed foci in MNNG-treated cells. In in vivo skin tests, dansyl-TPA displays lower effects than TPA on mouse skin. These results indicate a low promoting potential of dansyl-TPA. PMID- 3816909 TI - Comparison of two CEA assays in primary and recurrent large bowel carcinoma with different DNA ploidy pattern. AB - Pre-operative CEA levels were measured in 100 patients with large bowel carcinomas with different DNA ploidy pattern and serial post-operative determinations performed in the 64 who had been operated for cure. The follow-up period was 3 1/2-8 yr. All CEA measurements were performed consecutively with a RIA (Roche), and subsequently repeated in one batch with an EIA (Roche) based on a monoclonal antibody. Both assays showed a similar number of 'false-negative' CEA levels pre-operatively--varying from 69% in aneuploid (AN) Dukes' A to 8% in AN Dukes' D tumours, and from 75% in near diploid (ND) Dukes' A to 40% in ND Dukes' D tumours. The sensitivity for detecting recurrence in patients with tumours of either ploidy pattern was slightly better with EIA than with RIA. A difference between the AN and ND group was shown somewhat better with RIA, the sensitivity in the AN group being 79% and the median lead time 7 months compared to 13% and 2 months in the ND group. The corresponding figures with EIA were 71% and 7 months for the AN group and 63% and 1 1/2 months for the ND group. However, all but one of the patients with ND DNA pattern who showed recurrence-associated CEA elevation with EIA also had an elevated level pre-operatively. We conclude that all patients operated for cure should be followed by regular CEA measurements post-operatively if they had an elevated CEA level prior to operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816910 TI - 6-day subrenal capsule assay (SRCA) as a predictor of the response of advanced cancers to chemotherapy. AB - The 6-day subrenal capsule assay (SRCA) chemosensitivity prediction test using fresh human tumor xenografts was performed in BALBc mice for 80 advanced cancer bearing patients. Among 97 SRCA, nine were non-evaluable because patients either received no chemotherapy or non-assayed drugs, and 12 were non-interpretable because of inadequate control growth. One hundred and six correlations were established between test results and clinical response, 56 retrospective (chemotherapy then test) and 50 prospective (test then chemotherapy). Among the 56 retrospective correlations there are 45 true negative (-/-) and three false positive (+/-) corresponding to 48 poor clinical responders; and eight true positive (+/+) and 0 false negative (-/+) corresponding to eight good clinical responders. Among the 50 prospective correlations there are 26 true negative (-/ ) and four false positive (+/-) corresponding to 30 poor clinical responders; and 19 true positive (+/+) and one false negative (-/+) corresponding to 20 good clinical responders. In total among the 106 correlations there are 98% good negative correlations and 79% good positive correlations. The SRCA is practicable and is available for routine clinical use providing results relevant to cancer site and reflecting previous treatment status. PMID- 3816911 TI - Estrogen-linked 2-chloroethylnitrosoureas: anticancer efficacy in MNU-induced rat mammary carcinoma, uterine activity in mice and receptor interactions. AB - A series of estradiol-linked N-(2-chloroethyl)-N-nitrosocarbamoyl(CNC)-L-alanines attached in various positions (positions 3, 6 alpha, 17, 3 + 17 of estradiol) have been synthesized and tested in hormone-dependent MNU-induced rat mammary carcinoma. Compounds were given i.p. on day 1, 8, 22 and 29 after randomization in equimolar dosage. Equimolar mixtures of unlinked agents were tested in comparison. The results show that the 17-linked derivative was significantly superior to the other congeners and to the unlinked equimolar mixture. The 6 alpha-linked analogue unexpectedly was highly toxic and ineffective. Binding affinities to cytosolic estrogen receptors cannot fully explain the findings of the chemotherapy experiments. Especially the 3-linked derivative we found to exhibit much higher values for relative binding affinity than the 17-analogue, which was a distinctly more effective antineoplastic agent. Estradiol liberation by facile cleavage of the phenolic 3-ester bond might be responsible. Estradiol receptor contents in tumours were diminished or disappeared completely during treatment with individual analogues, progestin receptor contents behaved differently. After a single dose of CNC-L-alanine-estradiol-17-ester, a long lasting disappearance of estradiol-receptors, measured for up to 192 hr, and a strong induction of progesterone receptors was observed with a maximal value reached at 16 hr, and return back to normal at 192 hr. In the Dorfman uterine weight test in mice, all compounds exhibited distinct uterotrophic activity with no clearcut differences. The relevance of estradiol receptor contents in tumours for antineoplastic activity of the most effective analogue, the 17-ester, became evident from the observed reduced responsiveness of MNU-induced rat tumours after ovariectomy. In these hormone-independent tumours the linked compound revealed only the same antitumour efficacy as CNC-L-alanine alone. PMID- 3816912 TI - Treatment of alkylating resistant multiple myeloma with vincristine, BCNU, doxorubicin and prednisone (VBAP). AB - A total of 33 evaluable patients with multiple myeloma refractory to alkylating agents were treated with the regimen vincristine, BCNU, doxorubicin, and prednisone (VBAP) at 3-week intervals in a single institution for a 5-yr period. An overall response rate of 21.2% was achieved (9% objective plus 12.2% improvement). Treatment was well tolerated. The overall median survival was 7.5 months. However, responding patients attained a median survival of 27.4 months vs. 5 months for similarly treated nonresponding subjects (P = 0.051). These results indicate that VBAP is an effective treatment for a proportion of patients with advanced refractory multiple myeloma. PMID- 3816913 TI - Growth characteristics of head and neck squamous cell carcinoma in nude mice. AB - Growth behaviour of human squamous cell carcinoma from the head and neck region was studied in nude mice. Tumour growth was observed in 10 out of 13 tumours transplanted with a primary take rate of 77 and 100% for serial passaging. The take rate percentage related to the number of tumour inocula used, varied from 10 to 90% in the first passage and from 70 to 100% in the subsequent passages. No significant difference could be established in the growth character, except from the first to the second passage. Histological studies demonstrated preservation of the original histopathological features, micro- and macroinvasion of two tumour lines into the fibrous capsule and cyst formation. Comparison of growth curves with histological features demonstrated that growth curves are not a reliable measure for the number of vital tumour cells present. PMID- 3816914 TI - Prognostic factors of advanced colorectal cancer patients. AB - The cooperative oncology group for Chemotherapy of Gastrointestinal Tumors (CGT) retrospectively examined 139 patients with metastatic colorectal cancer for prognostic factors. Clinical characteristics, tumor parameters, and blood parameters were investigated for prognostic explanation of survival from the start of chemotherapy for the advanced disease. A combination of a univariate regression and a multivariate step down procedure with Cox's regression model led to the identification of performance status, sex, white blood count and, to a lesser degree, blood sedimentation rate and albumin as important prognostic factors. Based on these variables an individual risk score was calculated for each patient. PMID- 3816915 TI - Natural killer activity of blood lymphocytes in patients with primary intracranial tumors. Correlation to histological tumor type and anatomical site. AB - The possible relationship between the natural killer (NK) activity of blood lymphocytes and the histological tumor type or anatomical location of the lesions was examined in 116 patients with primary intracranial tumors. The patients had not undergone any surgical intervention or received any treatment with ionizing radiation or cytotoxic drugs. However, some of them had received corticosteroid medication. Regardless of the histological type of tumor, there was no significant difference in the NK activity of the non-corticosteroid treated patients and the healthy control subjects. However, there was a trend towards an increased NK-activity in patients with low-grade gliomas, in particular oligodendrogliomas. The NK-activity was reduced in patients who were treated with corticosteroids. There was no relationship between the NK-activity in non-steroid treated patients and the anatomical location of the tumor. The latter finding contrasts to a recent observation showing a strong relationship between tumor site and PPD-reactivity of blood lymphocytes in patients with intracranial tumors. PMID- 3816916 TI - Controlled double blind trial of nisoldipine in the treatment of idiopathic Raynaud's phenomenon. AB - In a controlled double blind trial the symptomatic effect of the calcium channel blocker nisoldipine was assessed in 19 patients with idiopathic Raynaud's phenomenon. Nisoldipine significantly reduced the frequency of attacks (p less than 0.05), whilst having a non-significant tendency (p less than 0.10) to reduce the severity of attacks. Side-effects were uncommon. It is concluded that nisoldipine is a promising agent for the symptomatic treatment of idiopathic Raynaud's phenomenon. PMID- 3816917 TI - Effect of two different doses of nitrendipine on steady-state plasma digoxin level and systolic time intervals. AB - The effect of two different doses of nitrendipine on plasma digoxin levels, urinary recovery and systolic time intervals was investigated in 8 healthy volunteers. Following a loading dose, digoxin 0.25 mg b.d.p.o. was given alone for 2 weeks. Then 0.25 mg digoxin b.d. was administered for two 1-week periods combined with nitrendipine 10 mg or 20 mg once daily. The study was completed with another digoxin monotherapy phase lasting 7 days. Nitrendipine 20 mg daily led to a significant increase in plasma digoxin levels and in its area under the plasma concentration-time curve AUC (0-12) was 9.7 ng ml-1h when digoxin alone was given and 11.2 ng ml-1h on co-administration of the calcium antagonist. Urinary recovery and renal clearance of digoxin were slightly but not significantly increased by nitrendipine. Nitrendipine 10 mg once daily caused a small, insignificant tendency to elevate the plasma digoxin level. Nitrendipine co-administration (10 and 20 mg once daily) did not significantly alter systolic time intervals, as non-invasively measured haemodynamic parameters, compared to digoxin treatment alone. Thus, nitrendipine 20 mg daily caused a significant increase in plasma digoxin concentrations and in its AUC, which would rarely be of clinical relevance. PMID- 3816918 TI - Comparative pharmacokinetics and cardiovascular effects of tiapamil in healthy volunteers and patients with hepatic cirrhosis. AB - Tiapamil 70 mg was administered i.v. to 8 healthy male volunteers and 8 patients (7 males, 1 female) with biopsy proven hepatic cirrhosis. Two of the patients also received 600 mg p.o. Serial plasma and urine samples were collected and the parent drug in plasma and urine and desmethyl-tiapamil in urine were assayed by a specific HPLC method. The plasma and urine data for the parent drug after i.v. and p.o. dosing were simultaneously fitted to linear p.o. and i.v. two compartment models with exit from and input into the central compartment. Absorption was assumed to be a first order process. In the volunteers the mean pharmacokinetic parameters were: 101 l for the steady-state volume of distribution 750 ml X min-1 for nonrenal clearance, 195 ml X min-1 for renal clearance and 1.7 h for the half-life of the terminal disposition phase. The urinary recoveries of the parent drug and desmethyltiapamil averaged 21.4 and 0.8% of the dose, respectively. In the patients the steady-state volume of distribution, the amount of unchanged drug in urine and the half-life of the terminal disposition phase were significantly increased (171 l, 29.0% of the dose, 3.5 h, respectively). Decreased plasma protein binding in the patients accounted for the larger steady-state volume of distribution. The nonrenal clearance of 519 ml X min-1, tended to be smaller in the patients than in the volunteers. Together with the increased urinary recovery of tiapamil in the patients this indicates a moderately impaired elimination capacity in the cirrhotics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816919 TI - Hypotensive and antiplatelet actions of motapizone depend on dose and time after ingestion. AB - Single doses of motapizone 1 to 10 mg were given to 12 healthy subjects. Before and up to 8 h after each dose the blood pressure and heart rate were measured, as well as thrombocyte aggregation "ex vivo" with collagen, ADP and adrenaline. Motapizone produced a dose-dependent reduction in diastolic blood pressure and an increase in heart rate. These effects were demonstrated with individual variations after 1 to 3 mg and as a rule they were very marked after more than 6 mg. With the highest dose (mean 7.7 +/- 2.3 mg) the diastolic pressure fell by an average of 23% 1 h after medication as compared to with the baseline values. At the same time there was marked inhibition of thrombocyte aggregation, which also became apparent after about 3 mg and increased in proportion to the dose. The inhibition of aggregation peaked after 2 h and had disappeared within 8 h. The inhibition of ADP-induced aggregation was particularly marked. PMID- 3816920 TI - Inhibition of thrombocyte aggregation by oral motapizone and other drugs. AB - Ten healthy subjects took single oral doses of placebo, 8.8 +/- 1.8 mg motapizone, 40 +/- 13 mg captopril, 25 mg dihydralazine, 20 mg nifedipine and 4.5 +/- 1.1 mg prazosin in random order, and, as the last preparation 500 mg acetylsalicylic acid. Thrombocyte aggregation induced "ex-vivo" with collagen, ADP and adrenaline was measured before and after 60 min. Immediately before each dose, the "threshold concentration" of each agent was determined in each subject, i.e. the concentration producing about 90% of maximal aggregation. After the preparation had been taken, aggregation was induced with 1-, 2- and 4-times the threshold concentration. Both motapizone and also acetylsalicylic acid caused marked inhibition of aggregation at up to 4-times the threshold concentration; the dose ratio was about 1:50. Motapizone produced greater inhibition of the aggregation induced by ADP and acetylsalicylic acid than of that due to collagen. The inhibitory actions after captopril, dihydralazine, nifedipine and prazosin were weak and did not significantly differ from placebo. PMID- 3816921 TI - Pharmacokinetics of slow-release diltiazem and its effect on atrioventricular conduction in healthy volunteers. AB - The pharmacokinetics and effect of a slow-release and a conventional diltiazem tablet on atrioventricular conduction were compared in a randomized cross-over study after a single dose and at steady state in 12 healthy volunteers. The time to peak concentration was significantly delayed after the slow-release as compared to the conventional tablet, both after a single dose (2.7 vs. 0.9 h) and at steady-state (1.9 vs. 0.9 h). The peak concentration was also significantly reduced. There was no marked loss in bioavailability with the slow-release formulation. The maximal fluctuations in serum diltiazem at steady-state for the slow-release tablet were markedly less than after the conventional tablet (62 vs 87%). The PQ-interval was longer after the conventional tablet as compared to the slow-release tablet (both in doses of 120 mg) after a single dose (187 vs 163 ms) and at steady-state (197 vs 174 ms). The maximal prolongation was seen 1 h after intake of the drug. Heart rate was decreased only by 6-9 beats/min, irrespective of the dose. Slow-release diltiazem appears to have many advantages over a conventional tablet. PMID- 3816922 TI - Safety and efficacy of alinidine in symptom-free asthmatics. AB - Alinidine is a new bradycardic agent which has been shown to be beneficial in the treatment of coronary heart disease. Patients with both coronary heart disease and obstructive lung disease are difficult to treat, because the use of beta blockers in them is greatly limited by their potential to provoke bronchospasm. Alinidine has no beta-blocking, muscarinic or quinidine-like properties. In a randomized double-blind cross-over study the heart rate reducing effect and safety of alinidine 40 mg p.o. has been examined in 12 symptom-free asthmatics. Alinidine significantly reduced mean heart rate from 81 +/- 10.5 beats/min to 65 +/- 9.7 beats/min two hours after administration. Forced expiratory volume in one second (FEV1), vital capacity (CV), airway resistance (Raw), functional residual capacity (FRC), and specific airway conductance (SGaw) were not affected. It is concluded that alinidine did not influence respiratory function in patients with bronchial hypersensitivity. PMID- 3816923 TI - Comparison of a controlled-release tablet of salbutamol given twice daily with a standard tablet given four times daily in the management of chronic obstructive lung disease. AB - In a double-blind cross-over study 20 patients with reversible airways obstruction were treated either with conventional 4 mg tablets of salbutamol a.i.d., or 8 mg controlled release (CR) tablets of salbutamol b.d. Each treatment was given for 2 weeks. The morning PEFR was significantly higher with the CR tablets (p less than 0.05) but although the evening PEFR was also better the difference was not significant. Wheeze was significantly lower (p less than 0.05) and extra "rescue" inhalation of bronchodilators was required less often and on fewer occasions during treatment with the CR tablets. Comparison of the 12-h mean plasma salbutamol profile showed a peak and trough every 6 h with the standard tablets, and a flatter profile with a single, lower and delayed peak during the 12 h between CR tablets. Although the minimum and average plasma salbutamol levels were similar in the groups on the two preparations, the maximum plasma level was significantly lower and there was significantly less fluctuation on CR tablets (p less than 0.02). The CR and standard tablets had equivalent bio availability. PMID- 3816925 TI - Treatment of hydatid disease with high oral doses of mebendazole. Long-term follow-up of plasma mebendazole levels and drug interactions. AB - Plasma mebendazole levels were analysed retrospectively in patients treated for inoperable infections with Echinococcus multilocularis or granulosus. In 10 patients receiving mebendazole at 4 dose levels there was no relation between dose and plasma concentration. In 17 patients followed on the same dose for more than 18 months, the plasma levels varied with individual coefficients of variation ranging from 27 to 72%. The data reveal the limitations of single measurements of plasma mebendazole and emphasize the need for repeated monitoring. Coadministration of phenytoin and carbamazepine seemed to lower plasma levels, presumably as a result of enzyme induction. It was not possible appreciably to raise the mebendazole concentrations by inhibition of drug metabolizing enzymes with cimetidine. PMID- 3816924 TI - Polymorphic debrisoquine and mephenytoin hydroxylation in patients with pulmonary hypertension of vascular origin after aminorex fumarate. AB - During the period 1967 to 1971 an increase in the incidence of pulmonary hypertension of vascular origin (PHVO) was observed in Austria, Federal Republic of Germany, and Switzerland. Most patients had been given aminorex fumarate and a possible link was suspected. We therefore investigated the possibility of genetically-determined drug hydroxylation deficiencies (debrisoquine or mephenytoin type) in these patients as an explanation for the development of PHVO. Seventeen patients took 10 mg debrisoquine and 100 mg mephenytoin orally. Sixteen PHVO patients were classified as extensive metabolizers of debrisoquine with logarithmic metabolic ratios of -0.35 +/- 0.11 (mean +/- SEM), whereas one patient was a poor metabolizer with a logarithmic metabolic ratio of 1.82. For the mephenytoin hydroxylation sixteen patients with PHVO were extensive metabolizers, with logarithmic hydroxylation indices of 0.27 +/- 0.05. One poor metabolizer of mephenytoin had a logarithmic hydroxylation index of 1.59. Deficient hydroxylation of debrisoquine and mephenytoin was found in two different patients. The prevalence of poor metabolizers among patients with PHVO after aminorex fumarate was therefore approximately 9% for both debrisoquine and mephenytoin. This corresponds closely to the data of our reference population study where genetic debrisoquine and mephenytoin hydroxylation deficiencies occurred independently, with a prevalence of 10% and 5% respectively. Thus, the normal prevalence of extensive drug hydroxylation phenotypes in patients with PHVO is not consistent with the hypothesis that the development of PHVO after aminorex fumarate might be related to a pharmacogenetically determined impairment of polymorphic drug oxidation. PMID- 3816926 TI - Lithium therapy and the turnover of phosphatidylcholine in human erythrocytes. AB - In 17 lithium-treated patients with manic-depressive disorders and 11 healthy subjects the concentrations of choline, phosphorylcholine, cytidyldiphosphate choline, lipid bound choline, and glycerophosphorylcholine were measured in plasma and erythrocytes. Plasma levels of high density, low density, and very low density lipoproteins were also estimated as well as the concentrations of 4 free fatty acids. Free choline (more than 10-fold) and phosphorylcholine (2-fold) were significantly increased in erythrocytes of lithium-treated patients as compared to the healthy untreated controls. Differences in the other substrates were not significant. Osmotic resistance of the erythrocytes was not changed during lithium treatment. Inhibition of the choline flux across the erythrocyte membrane in vitro from lithium-treated patients was not abolished by equilibration of the concentration gradient. It is concluded that the accumulation of choline in erythrocytes from patients on lithium therapy may be due to trapping of lipid derived choline because of an alteration in membrane permeability and not to increased breakdown of phosphatidylcholine. PMID- 3816927 TI - Renal clearance of sulphinpyrazone in man. AB - Six healthy young volunteers received a single dose of sulphinpyrazone 200 mg p.o. Plasma concentration and urinary excretion rate curves showed large intersubject variation for sulphinpyrazone and its metabolites. The sulphide metabolite could only be detected in plasma and not before 3-7 h after ingestion. The total recovery in urine of all compounds varied from 30-56% of the dose. In two subjects the mean residence time of sulphinpyrazone was twice as long as in the other subjects (10.4 h compared with 4.6 h), but the area under the plasma concentration-time curve was comparable to that in the others (mean: 3.0 mg X ml 1 X min), indicating that drug absorption was quantitatively similar but delayed. The renal clearance of sulphinpyrazone varied from 14-40 ml X min-1 (mean: 28 ml X min-1). In view of the very high plasma protein binding of sulphinpyrazone, active tubular secretion is the predominant mechanism in its renal clearance. The same holds for the sulphone metabolite, which has a mean renal clearance of 24 ml X min-1, and even more for the p-hydroxysulphinpyrazone metabolite, which has a renal clearance of 118 ml X min-1. No unambiguous evidence was found in favour of concentration-dependent renal clearance of sulphinpyrazone or its metabolites over the concentration range studied. The renal clearance, especially of sulphinpyrazone, appeared to be dependent on urine pH and not on urine flow rate. PMID- 3816928 TI - Pharmacokinetics of intravenous and intraperitoneal ceftriaxone in chronic ambulatory peritoneal dialysis. AB - The kinetics of ceftriaxone was investigated in 8 patients without infection, who were receiving continuous ambulatory peritoneal dialysis (CAPD). Ceftriaxone 1 g was injected i.v. and 1 g was given intraperitoneally in the CAPD fluid during a 4-h dwell time. Ceftriaxone was assayed by HPLC. After intravenous administration, the kinetic parameters of ceftriaxone were: plasma t1/2, 12.3 h, total plasma clearance, 14.0 ml/min, volume of distribution at steady state 0.18 l/kg, and peritoneal clearance 0.59 ml/min. Over 72 hours only 5.5% of the dose was eliminated by the peritoneal route. After intraperitoneal administration, ceftriaxone rapidly appeared in serum; the absorption t1/2 was 1.1 h and the mean peak concentration was 38.8 micrograms/ml. The absorption of ceftriaxone from the peritoneal space was 39%. A single 1.0 g IP dose led to serum and dialysate concentrations of ceftriaxone above the minimum inhibitory concentration for susceptible pathogens for 24 hours. PMID- 3816929 TI - Therapeutic drug monitoring of digoxin: help or hindrance? AB - A major role of therapeutic drug monitoring services is to advise on the dose of a drug which would be required to bring the concentration in the blood to within specific 'therapeutic' limits. Monitoring digoxin usage constitutes a substantial part of the work load. We have examined the potential variability in recommendations for digoxin dosages based on a series of serum digoxin measurements in each of 80 out-patients. In over a third of cases a dose, which seemed to be optimal on the basis of the first assay result, would have produced concentrations outside the conventional therapeutic range when the measurement was repeated. This was despite careful supervision of medication and the timing of the blood sample in relation to its administration. In routine practice the apparent variability in dose requirements would be far greater. Objectives of therapeutic drug monitoring services remain the same, the way forward would seem to lie in their taking on a heavy commitment to counsel and supervise patients before repeated blood sampling. However, effort and resources might be better channelled into producing simple prescribing aids relating the risk of cardiotoxicity directly to the size of the maintenance dose and the individual's renal function. PMID- 3816930 TI - Urinary metabolites of caffeine in the premature infant. AB - Caffeine metabolites in urine from premature infants were analysed by TLC and HPLC. Caffeine, dimethyluric acids, mono- and dimethylxanthines and, for the first time, a uracil derivative (6-amino-5-[N-methylformylamino]-1,3 dimethyluracil) were identified. PMID- 3816931 TI - Response to tilting in hypertensive patients receiving ketanserin. PMID- 3816932 TI - A surface molecule on guinea pig lymphocytes involved in adhesion and homing. AB - A monoclonal antibody, CT 4, which recognizes an antigenic determinant on the majority of guinea pig lymphocytes, was tested for its ability to interfere with adherence and homing capacity of lymphocytes. Incubation with F(ab')2 fragments of the antibody blocks the in vitro binding to high endothelial venules (HEV) of both peripheral lymph nodes and Peyer's patches. When tested in vivo using a short-term homing assay with radiolabeled cells also a reduction of migration into the spleen was observed. Fluorescence-activated cell sorter analysis of lymph node cells showed a separation into duller and brightly positive cells whereas in the thymus the bright population is absent. Thymus cells adhere less effectively to HEV and this binding can only marginally be blocked by CT 4 incubation. The results suggest a role of CT 4 in adhesion processes. PMID- 3816933 TI - A 93-kDa glycoprotein expressed on human cultured monocytes and dendritic reticulum cells defined by an anti-K562 monoclonal antibody. AB - An IgG2a monoclonal antibody, referred to as 12B1 and raised against the K562 cell line, reacted with adherent monocytes maintained in culture for several days but not with bone marrow or peripheral blood cells including freshly isolated monocytes. Among human leukemic cell lines, 12B1 reacted essentially with the promyelocytic HL60 cell line. 12-O-Tetradecanoylphorbol 13-acetate treatment, but no other differentiation inducer, strongly enhanced its reactivity on K562, HL60 and the histiocytic U937 cell line. Immunoperoxidase staining of sections of normal human tissues showed that 12B1 specifically recognized dendritic reticulum cells in germinal centers of lymph nodes, spleen and tonsils. The 12B1-detected antigen is a highly glycosylated polypeptide of an apparent molecular mass of 93 86 kDa. The 12B1 antigen appears to be a new glycoprotein marker shared by adherent monocytes and dendritic reticulum cells. The association of the 12B1 epitope with cells which present antigen and/or exert accessory function suggests that this molecule could play a role in these activities. PMID- 3816934 TI - Large granular lymphocytes or "pit cells" from rat liver: isolation, ultrastructural characterization and natural killer activity. AB - Considerable numbers of large granular lymphocytes (LGL) were isolated from rat liver by a simple method consisting of sinusoidal lavage at elevated (50 cm water column) perfusion pressure. This method gave a yield comparable with the enzymatic dissociation method commonly used for the isolation of nonparenchymal liver cells, but was shorter in time and had the advantage of avoiding the potentially harmful effects of the dissociating enzymes. The isolated LGL were highly cytotoxic against YAC-1 lymphoma cells and this cytolytic activity was blocked by treatment of the effector cells with an antibody against natural killer cells (anti-asialo GM1). We characterized the hepatic LGL as nonphagocytic, nonadherent, peroxidase-negative and acid phosphatase-positive cells which could be enriched in the low-density fraction of a Percoll gradient. At the light microscopic level, they showed characteristic azurophilic granules which corresponded to strongly osmiophilic granules with a specific morphology in electron microscopy. It is concluded that these LGL are identical to the "pit cells" which were formerly described by electron microscopy in situ as normal components of the liver sinusoids and which are easily recognized by their fine structure. It is also proposed that the liver may represent one of the major natural killer organs. PMID- 3816935 TI - Homozygosity in the major histocompatibility complex region influences natural killer cell activity in man. AB - The effect of homozygosity at HLA loci on natural killer (NK) cell activity has been examined. Lymphocytes obtained from heterozygous and homozygous individuals were incubated with 51Cr-labeled, NK-sensitive K562 cells at different effector/target ratios, and lytic activity was determined. Homozygous cells, obtained from individuals who are known HLA homozygotes (homozygous typing cells) and from selected families, had low NK activity compared to those heterozygous donors. This low cytotoxic activity had no correlation with sex, but did correlate with homozygosity at the HLA-A, B and/or DR loci. A significantly lower number of cells, which bind to anti-Leu 7 antibody, was found in homozygous donors. However, this reduced number of Leu 7+ cells could only partially account for the decrease in NK activity. These studies suggest that in some individuals homozygosity at HLA may be linked to genes that control NK activity. PMID- 3816936 TI - Glycoprotein profiles of macrophages at different stages of activation as revealed by lectin binding after electrophoretic separation. AB - Glycoprotein profiles of rat macrophages (M phi) at different stages of activation were studied by examining the reactivity of various lectins to the glycoproteins separated by polyacrylamide gel electrophoresis. Ricinus communis agglutinin 1 (RCA1) revealed several components including glycoproteins of Mr 160 kDa and 65 kDa prominent in resident M phi. A pokeweed mitogen (PWM) isolectin, Pa-4, recognizes branched poly(N-acetyllactosamine)-type carbohydrate chains, and revealed a significant increase in glycoproteins of Mr ranging from 70 kDa to 150 kDa on thioglycolate-elicited M phi. Increased reactivity of PWM to thioglycolate elicited M phi was observed by direct binding of 125I-labeled Pa-4 to intact or glutaraldehyde-fixed M phi. Histochemical staining of formaldehyde-fixed M phi in vitro with biotinylated Pa-4 was consistent with the gel analysis, that is, resident M phi had no reactivity while thioglycolate-elicited M phi showed slight reactivity. Alveolar and intratumoral M phi bound more Pa-4 than resident or thioglycolate-elicited M phi. The PWM isolectin may therefore serve as a marker for an early stage of M phi activation. PMID- 3816937 TI - beta-Cyclodextrin as a substitute for fetal calf serum in the primary antibody response in vitro. AB - Fetal calf serum (FCS) must be present at 10% in the culture medium for optimally eliciting the primary antibody response to sheep erythrocytes (SRBC) in murine lymphocytes. The response was no longer observed when FCS was reduced to less than 1%. However, we found that the addition of 250-500 micrograms/ml beta cyclodextrin (beta-CD) to RPMI 1640 medium containing 1% FCS restored the immune response to a level comparable to that observed in 10% FCS-containing medium. beta-CD did not further augment the response in the presence of 10% FCS. The order of effectiveness of various cyclodextrin compounds tested was as follows: beta-CD (100) greater than alpha-CD(30) greater than gamma-CD(10) greater than heptakis (2,6-O-dimethyl)beta-CD (less than 1). The in vitro antibody response varied drastically depending on the lot of FCS added to the culture medium. The important observation was that even a deficient lot of FCS could elicit the antibody response as efficiently as a good lot if it was added to the culture medium at 1% in combination with beta-CD. beta-CD was also effective in inducing the primary antibody responses to both SRBC and dinitrophenylated Ficoll in serum free RPMI 1640 medium containing bovine serum albumin, insulin and transferrin. In serum-free conditions, the responses were 40-50% of those in serum-containing medium. beta-CD did not increase the number of antibody-forming cells nonspecifically, nor did it show a significant mitogenic activity and cytotoxicity. These data suggest that beta-CD is a useful material as a serum substitute in inducing primary antibody response in vitro. PMID- 3816938 TI - Relationship between thymus ontogeny and DNA ligase expression in the chicken. AB - DNA ligase expression was studied in the embryonic chicken thymus. As previously reported, during thymus ontogeny two separate and successive (8S and 6S) forms of enzyme are found. The switch from the heavy to the light form takes place at around 18 days of incubation in situ. The demonstration that two successive generations of thymic lymphoid precursor cells develop in the embryonic bird thymus and that the replacement of the first by the second thymocyte generation takes place at around 18 days suggested the possibility that each form of enzyme could be restricted to a given thymocyte generation. By either culturing or transplanting embryonic thymuses of different ages it appears that the switch from the heavy to the light form of DNA ligase is not related to a change over of the first by the second generation of embryonic thymocytes but rather to some maturation process of the thymic lymphocytes starting from 17 days of embryonic life. The influence of extrathymic factors on the turning on of the expression of the 6 S DNA ligase in the post-natal environment is also suggested. PMID- 3816940 TI - Dopamine antagonists induce gastric lesions in rats. AB - Gastric lesions were provoked in all rats that had received intraperitoneally a single dose of the dopamine antagonists haloperidol, metoclopramide or domperidone 24 h before. Dose-dependence was demonstrated for haloperidol. This drug induced gastric lesions as early as 90 min after its application. The ulcerogenic effect of haloperidol was completely prevented or markedly reduced by simultaneous applications of dopamine agonists bromocriptine or L-dopa. We conclude that the model of gastric lesions induced by dopamine antagonists could be successfully applied in further investigations of the role of dopamine in the pathogenesis of ulcer disease. PMID- 3816939 TI - gamma-Aminobutyric acid release from synaptosomes as influenced by Ca2+ and Ca2+ channel blockers. AB - We studied the correlation between the high affinity binding of Ca2+ channel blockers to purified synaptic plasma membranes (SPM) and the effect of these drugs in blocking the 45Ca2+ uptake and the release of [3H]gamma-aminobutyric acid [( 3H]GABA) by preloaded synaptosomes. The Ca2+ channel blocker binding sites were characterized by studying the binding of the dihydropyridine, [3H]nimodipine, and of the phenylalkylamine, (-)-[3H]desmethoxyverapamil, to purified SPM isolated from sheep brain cortex synaptosomes. The purified SPM had high affinity binding sites for both Ca2+ channel blockers. The binding parameters were similar to those previously reported for whole brain homogenates: KD = 0.64 nM and Bmax = 160 fmol/mg of protein for [3H]nimodipine, and KD = 7.9 nM and Bmax = 1,500 fmol/mg of protein for (-)-[3H]desmethoxyverapamil. The Ca2+ channel blockers inhibited the release of [3H]GABA induced by K+ depolarization in the presence or in the absence of Ca2+. The Ca2+-dependent component of [3H]GABA release was inhibited by verapamil, (-)-D 600, d-cis-diltiazem, nifedipine and PY 108-86 with IC50 values of 2.2 X 10(-5) M, 6.3 X 10(-5) M, 3 X 10(-4) M, greater than 10(-4) M and 3 X 10(-5) M, respectively. Furthermore, the Ca2+ channel blockers also inhibited the Ca2+-independent [3H]GABA release which occurred in the presence, but not in the absence, of external Na+. The Ca2+ channel blockers at concentrations which inhibited [3H]GABA release inhibited the entry of Ca2+ through the Ca2+ channels and also the entry of Ca2+ by Na+/Ca2+ exchange. We conclude that the concentrations of Ca2+ blockers necessary to block Ca2+ uptake through the Ca2+ channels and by Na+/Ca2+ exchange coincide with the concentrations at which they inhibit [3H]GABA release, but that their effect on the relationship between Ca2+ uptake and [3H]GABA release is different for the various blockers. The effects of the drugs on Ca2+ movements and [3H]GABA release are not specifically mediated through the high affinity binding of the drugs since relatively high concentrations were necessary (greater than 10(-5) M) for the effects reported here. PMID- 3816941 TI - Antagonistic activity of tiotidine and ranitidine on guinea-pig and rabbit atria. AB - Isolated, spontaneously beating atrial pairs from rabbits and guinea-pigs were used to determine and to compare the activity of ranitidine and tiotidine as antagonists of histamine stimulated chronotropic activity. Ranitidine produced a classical competitive, reversible antagonism of histamine effects with a pA2 in rabbit atria of 8.2. In contrast, tiotidine produced both a dextral shift of the log dose-response curve, as well as a previously unreported suppression in the maximal response produced by histamine. In accordance with receptor theory, this type of activity represents a dualistic antagonism of histamine chronotropic responses. PMID- 3816942 TI - Acute in vivo exposure to ethylcholine aziridinium (AF64A) depresses the secretion of quanta from motor nerve terminals. AB - Quantal release of acetylcholine was evaluated for soleus nerve-muscle preparations removed from mice treated with the cholinergic neurotoxin AF64A. Treatment with two and three times the LD50 (i.p.) of AF64A caused a marked reduction of the frequency of miniature end-plate potentials (mepps) and the amplitude of end-plate potentials (epps). Since the amplitude of mepps was not altered, the reduction of epps was not due to reduction in the number of molecules of acetylcholine (ACh) per quantum or the end-plate sensitivity to ACh, but to a reduction of the number of quanta released in response to a nerve action potential. While this effect was not reversed when preparations were washed for 3 h, exposure to the potassium channel blocker, 3,4-diaminopyridine returned the mean quantal content of epps to normal. These data further support a presynaptic site of action for AF64A, and suggest that it may acutely disrupt the ionic processes underlying transmitter release. PMID- 3816943 TI - Diazepam and muscimol blockade of the gastrointestinal motor disturbances induced by acoustic stress in dogs. AB - The influence of various drugs on the gastric motor inhibition induced by acoustic stress (AS) was investigated in fasted dogs fitted with strain-gauge transducers implanted on the antrum and proximal jejunum at 10 and 80 cm from the pylorus respectively. Started 40-50 min after the last gastric migrating motor complex (MMC), a 1 h acoustic stress delayed by 75% the occurrence of the next gastric but not jejunal MMC and was associated with a 4-fold increase in plasma cortisol. This AS-induced inhibition of the gastric MMC cycle was abolished after previous administration of diazepam (0.2 and 0.5 mg/kg i.m.) or muscimol (10 micrograms/kg i.v.) and partially reduced by a lower dose of diazepam (0.1 mg/kg i.m.); in contrast, it was still present after either naloxone (0.1 mg/kg i.m.), phentolamine (0.2 mg/kg i.v.) or propranolol (0.1 mg/kg i.v.) treatment. This selective benzodiazepine or GABA agonist blockade of noise-induced gastric motor alteration supports the hypothesis that release of CRF may be responsible for the gastrointestinal motor effects induced by acoustic stress. PMID- 3816944 TI - Two types of spontaneous contractions in rat myocardium and their possible relation to different Ca release processes. AB - The potency of putative blockers (lidocaine, dantrolene Na, DAN, SKF 525A) for various forms of Ca2+ release from sarcoplasmic reticulum (SR) against two types of spontaneous contractions induced by 0.5 mM caffeine (caffeine response) or myocardium Ca2+ overload (after-contractions) was tested in rat papillary muscle. There were differences in the sensitivity of spontaneous contractions to the agents employed. The caffeine response was depressed by DAN but not affected by lidocaine. Conversely, conventional diastolic after-contractions were eliminated by lidocaine and SKF 525A but DAN failed to affect them. The two types of spontaneous contractions were suggested to be triggered by different CA2+ release processes supposedly originating from different SR compartments. PMID- 3816945 TI - Increase in catecholamine release and 45Ca2+ uptake induced by GABA in cultured bovine adrenal chromaffin cells. AB - The role of Ca2+ in GABA-evoked catecholamine (CA) release from adrenal medulla was investigated in primary cultures of bovine adrenal chromaffin cells. GABA facilitated the 45Ca2+ uptake associated with the increase of Ca release in cultured bovine adrenal chromaffin cells. The effects of GABA on both 45Ca2+ uptake and CA release were blocked by bicuculline and picrotoxin. Nifedipine reduced the 45Ca2+ uptake and CA release induced by GABA. These data support our previous suggestion that the activation of GABA receptors on adrenal chromaffin cells facilitates the Ca2+ influx through voltage-sensitive Ca2+ channels, leading to the release of CA. PMID- 3816946 TI - Creatine phosphate and protection against reperfusion-induced arrhythmias in the rat heart. AB - An isolated perfused working rat heart preparation was used to assess the effect of including creatine phosphate (10 mmol/l) in the perfusion fluid of hearts subjected to aerobic perfusion (20 min), regional ischaemia (15 min) and reperfusion (2 min). Creatine phosphate had no detectable effect upon pre ischaemic, ischaemic or post-ischaemic contractile function, it also had no statistically significant effect upon myocardial tissue ATP content. However, creatine phosphate was found to afford striking protection against reperfusion induced arrhythmias. The incidence of ventricular fibrillation was reduced from over 80% (13/16) in the control group to 10% in the creatine phosphate-treated group (P less than 0.001). Possible mechanisms underlying the anti-arrhythmic effects of creatine phosphate were investigated using isolated rat papillary muscles superfused with or without added creatine phosphate (10 mmol/l). During aerobic superfusion at 37 degrees C creatine phosphate did not cause any statistically significant changes in contractile (developed tension) or electrophysiological (dV/dtmax and action potential duration) indices. Creatine phosphate did however influence the extent to which hypoxia (10 min) and reoxygenation (10 min) altered tension and electrophysiological characteristics. It accelerated the hypoxia-induced decline in developed tension and also the reoxygenation-induced recovery of developed tension. Relatively small changes in dV/dtmax and action potential duration were observed during hypoxia and these rapidly normalized during reoxygenation. In general creatine phosphate acted to exacerbate any changes during hypoxia and accelerate the recovery during reoxygenation. While some of the electrophysiological changes observed would indicate an anti-arrhythmic effect, they were relatively small and perhaps insufficient to explain fully the potent anti-arrhythmic properties of creatine phosphate. PMID- 3816947 TI - Binding of a thromboxane A2/prostaglandin H2 receptor antagonist to guinea-pig platelets. AB - The binding of [125I]9,11-dimethylmethano-11,12-methano-16-(3-iodo-4-hydroxypheny l)-13,14- dihydro-13-aza-15 alpha beta-omega-tetranor-TXA2 [( 125I]PTA-OH), a thromboxane A2/prostaglandin H2 receptor antagonist, to washed guinea-pig platelets was studied. [125I]PTA-OH bound to guinea-pig platelets in a saturable and displaceable manner. The Kd for [125I]PTA-OH was 14.5 +/- 2 nM (n = 4) and the Bmax was 32 +/- 7 fmol/10(7) platelets or 1,927 +/- 422 binding sites/platelet. The IC50 value for a series of 13-azapinane TXA2 analogs to antagonize the TXA2/PGH2 mimetic U46619-induced platelet aggregation and displace [125I]PTA-OH from its binding site was determined. The IC50 values for the series of five antagonists were highly correlated (r = 0.99) in the binding assays and aggregation studies. The ability of a series of five agonists to displace [125I]PTA-OH from its binding site was compared to their ability to induce platelet aggregation. All the agonists completely displaced the ligand from its binding site but their rank order did not correlate well with their ability to induce aggregation (r = 0.37). Collectively, the data are consistent with the notion that [125I]PTA-OH binds to a putative TXA2/PGH2 receptor in guinea-pig platelets. PMID- 3816948 TI - Smooth muscle contractility and changes in histaminergic mechanisms in the pig trachea during development. AB - Maximal contractile reactivity was compared in isolated tracheas from different sized (aged) pigs. Maximum force and tension to histamine declined by approximately 10-fold in tracheas from 150-200 kg pigs compared to 30 kg animals, whereas acetylcholine-induced contractions were little changed. Furthermore, contractions to Ca2+ in chemically skinned muscle were not different in different sized animals. The effect of maturation on the reactivity to histamine was unaltered in preparations from which superficial connective tissue had been dissected but it was reduced or abolished by preincubation with indomethacin. The data indicate that maturation affects histaminergic mechanisms of contraction selectively, with respect to acetylcholine, rather than the intrinsic contractile properties of the muscle. PMID- 3816949 TI - The dopamine autoreceptor agonist B-HT 920 stimulates denervated postsynaptic brain dopamine receptors in rodent and primate models of Parkinson's disease: a novel approach to treatment. AB - B-HT 920 (6-allyl-2-amino-5,6,7,8-tetrahydro-4H-thiazolo-[4,5-d]azepine), an agonist at alpha 2-adrenoceptors and at dopamine autoreceptors, was tested with respect to stimulation of postsynaptic brain dopamine receptors in mice, rats and rhesus monkeys. In mice B-HT 920 (0.2-20 mg/kg s.c.) injected 4 h after reserpine did not stimulate locomotor activity; this was in contrast to apomorphine (0.1-10 mg/kg s.c.) which elicited locomotor activity in a dose-dependent manner. However, B-HT 920 was effective in inducing locomotor activity when injected 12, 24 and 48 h after reserpine. This effect was dose-dependent and increased with the duration of reserpine pretreatment. In naive rats, B-HT 920 (0.02-2.0 mg/kg s.c.) only decreased exploratory activity and did not elicit stereotyped activity in doses up to 4 mg/kg s.c. This was in contrast to the stereotypy-inducing effect of apomorphine (2.0 and 4.0 mg/kg s.c.). In rats with unilateral striatal ibotenic acid lesion, B-HT 920 (0.2-2.0 mg/kg s.c.) was ineffective in producing significant ipsilateral rotation, whereas apomorphine (0.5-10.0 mg/kg s.c.) was very potent in this model. In rats with unilateral 6-OH-dopamine lesions of the medial forebrain bundle B-HT 920 elicited strong contralateral rotation in a dose dependent manner (0.02-1.0 mg/kg s.c.). In this model B-HT 920 was equi-effective but long acting when compared with apomorphine. The contralateral rotation produced by B-HT 920 was antagonized by the D2-antagonist sulpiride but not by the D1-antagonist SCH 23390. In rhesus monkeys with severe parkinson-like symptoms induced by MPTP, B-HT 920 in doses of 10 micrograms/kg i.m. and higher restored normal behavior, resulting in complete relief of parkinson symptoms in all animals with 100 micrograms/kg i.m. It is concluded that the property of B-HT 920 to stimulate the 'denervated' supersensitive (reserpine, 6-OH-dopamine, MPTP) but not the normosensitive postsynaptic dopamine receptor in the striatum may represent a novel principle for a specific approach to dopamine substitution treatment of Parkinson's disease. PMID- 3816950 TI - Electrophysiological effects of cocaine on central monoaminergic neurons. AB - The electrical activity of three different single, identified, spontaneously firing central neurons was monitored by extracellular microelectrodes. Intravenous cocaine administration (0.25-2 mg/kg) elicited an activation of cerebellar Purkinje neurons (PN) and an inhibition of serotonergic dorsal raphe (DRN) and noradrenergic locus coeruleus (LC) neurons. These effects were not temporally correlated with the increase in mean arterial pressure elicited by the intravenous administration of cocaine. In addition, the administration of procaine, a structurally related local anesthetic, did not significantly affect any of the three central neurons studied. Our results suggest that cocaine has potent effects on the activity of DRN, LC and PN neurons, which are not directly related to its cardiovascular or local anesthetic actions. PMID- 3816951 TI - Pharmacological effects of L-AMP-PCP on ATP receptors in smooth muscle. AB - The pharmacological effects of ATP and of two of its analogues, AMP-PCP and L-AMP PCP, were investigated in various isolated smooth muscle preparations. In the guinea-pig vas deferens, the rat portal vein and the rat anococcygeus the nucleotides all caused contraction, and the order of potency was L-AMP-PCP greater than AMP-PCP greater than ATP. In the guinea-pig field-stimulated ileal longitudinal muscle the nucleotides all inhibited the contractions, and the order of potency was ATP greater than AMP-PCP greater than L-AMP-PCP. In the guinea-pig thoracic aorta ATP and AMP-PCP caused relaxations, ATP being more potent than AMP PCP, and L-AMP-PCP caused contractions. These results are consistent with the suggestion that the ATP receptors mediating contraction of smooth muscle are different from those mediating relaxation, and show that L-AMP-PCP is a potent, specific agonist at excitatory ATP receptors. PMID- 3816952 TI - Effects of PAF-acether and structural analogues on platelet activation and bronchoconstriction in guinea-pigs. AB - PAF-acether (platelet-activating factor) (1-O-alkyl-2-acetyl-sn-glycerol-3 phosphorylcholine) induces platelet-dependent bronchoconstriction in the guinea pig which correlates with its in vivo thrombocytopenic effect. We investigated the influence of modifications of the polar head group in position 3 of the glycerol skeleton of PAF-acether on guinea-pig platelet activation and bronchoconstriction. PAF-acether itself induced concentration-dependent platelet activation (EC50 for aggregation = 0.41 nM and EC20 for secretion of ATP = 0.56 nM). The 3-phosphoryl-N-methyl-morpholino ethanol analogue was slightly more active than PAF-acether and the 3-phosphoryl-N-methyl-piperidinium ethanol, 3 phopshoryl-(N-methyl-piperidino-3') methanol and 3-phosphoryl-(N-methyl-hydroxy 4') piperidine analogues were equieffective to PAF-acether in activating platelets. The 3-phosphoryl-piperidino ethanol analogue was 8 times less active than PAF-acether; the 3-phosphoryl-morpholino ethanol analogue and the 1-O octadecyl-2-O-acetyl-3-O-[trimethyl-ammonio)-propyl) glycerol were inactive up to 1 microM. Our data show that the choline head group is not a compulsory requirement for activity. When injected i.v. to the propranolol-treated guinea pigs, the platelet-activating analogues also induced bronchoconstriction. Two PAF acether antagonists, compounds 48740 RP and BN 52021, inhibited PAF-acether induced platelet activation when added to PRP at the final concentration of 0.1 mM (aggregation inhibited by 91 +/- 4 and by 94 +/- 3% respect.; secretion inhibited by 80 +/- 12 and 79 +/- 10% respectively, mean +/- S.E.M., n = 4). Both antagonists also suppressed platelet activation and in vivo bronchoconstriction, thrombocytopenia, leukopenia and hypotension induced by PAF-acether and the various analogues. Our results indicate that PAF-acether and the analogues studied trigger platelet activation and the consequent bronchoconstriction through mechanisms which share sensitivity to same antagonists. PMID- 3816953 TI - Disposition of apomorphine in rat brain areas: relationship to stereotypy. AB - Apomorphine-induced stereotyped behavior and apomorphine levels in plasma, striatum and nucleus accumbens were determined in rats at various intervals after a single i.p. injection of serial doses of apomorphine hydrochloride (0.625, 1.25, 2.5 and 5 mg/kg). Apomorphine disappeared from plasma in a mono-exponential mode with a half-life of about 10 min. In striatum and nucleus accumbens apomorphine concentrations peaked 10 min after administration, declining thereafter with a half-life comparable to that in plasma. Apomorphine was concentrated and distributed similarly in the two brain regions; the brain areas/plasma ratio was approximately seven for all doses tested. The rise of apomorphine levels in brain areas slightly preceded the behavioral response, whereas after the peak effect (20-30 min) the intensity of stereotypy declined almost parallel with the log drug concentrations. Plotting apomorphine levels in the tissues assayed against the drug response at the same interval for individual rats, regardless of dose, indicated a highly significant relation between the degree of behavioral effects and brain apomorphine levels. The threshold apomorphine concentrations for inducing stereotyped behaviour were 108 and 95 ng/g respectively in striatum and nucleus accumbens. These findings show that the time course and magnitude of the behavioral effects of apomorphine corresponded with its brain levels in 'dopaminergic' areas, suggesting that apomorphine induced stereotyped behavior in rats can be described by a direct mechanism. Reserpine (5 mg/kg s.c.) enhanced the apomorphine stereotypy but did not affect apomorphine's disposition in brain and plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3816954 TI - Competitive interaction of pirenzepine with rat brain muscarinic acetylcholine receptors. AB - In the present work, we studied the details of the interaction of the nonclassical muscarinic receptor antagonist pirenzepine with [3H]quinuclidinyl benzilate binding sites in rat brain homogenates. Pirenzepine showed biphasic competition curves with a Hill coefficient lower than unity, and these curves were better described according to a two-site receptor model. The affinities and the relative preponderance of these sites were constant at different ligand concentrations, in accordance with a competitive type of interaction. Similarly, pirenzepine did not influence the rate of dissociation of the [3H]quinuclidinyl benzilate-receptor complex, even at relatively high concentrations. However, although low concentrations of pirenzepine decreased the affinity of [3H]quinuclidinyl benzilate for the receptor without affecting the density of the binding sites, higher concentrations of the antagonist decreased the receptor number in a reversible fashion. Schild plots of these data indicated an apparent deviation from simple competition in this experimental design, an observation which can be attributed to the selectivity of pirenzepine for different receptor subtypes. Furthermore, pirenzepine, at concentrations high enough to saturate both its high- and low-affinity sites protected [3H]quinuclidinyl benzilate binding sites in the brain against irreversible alkylation by propylbenzilylcholine mustard. Therefore, our data support a competitive nature of interaction of pirenzepine with rat brain muscarinic receptors. PMID- 3816955 TI - Effect of sotalol, aprindine and their combination on maximum upstroke velocity of action potential in guinea-pig papillary muscle. AB - Microelectrode experiments were performed on papillary muscle of 11 guinea-pigs at driven heart rates of 60 and 120 b.p.m. to study the effect of sotalol 10(-4) M, aprindine 10(-6) M and the combination of both on Vmax, action potential duration and effective refractory period. Only sotalol exerted tonic Vmax block. Aprindine, sotalol and their combination produced an increase in phasic, combined tonic and phasic, and in steady state Vmax block: the effect of the combination on these parameters being larger than the effect of the single agents alone. Action potential duration was lengthened by both drugs and their combination. A statistically significant increase in effective refractory period was observed for sotalol and the combination sotalol-aprindine but not for aprindine. It can be concluded that simultaneous application of sotalol and aprindine enhances phasic, combined tonic and phasic, and steady state Vmax block with an unchanged effect of sotalol on repolarization. The effect of combinations can be explained on the basis of competition for the same receptor in the Na+ channel. PMID- 3816956 TI - Intracellularly applied sodium mimics the effects of ouabain in single cardiac myocytes. AB - Sodium was applied intracellularly, in single myocytes from guinea-pig hearts via the potential-recording electrode. With electrodes containing 75 mM NaCl (but not with 15 mM) contractility increased and the action potential duration shortened. Aftercontractions, delayed afterpotentials and spontaneous activity as observed with toxic concentrations of ouabain (10 microM) appeared within 1 min when 150 mM NaCl was applied. The results demonstrate that sodium load without pump inhibition can mimic the effects of cardiac glycosides. PMID- 3816957 TI - Effects of ryanodine on inotropic and arrhythmogenic actions of cardiotonic steroids. AB - In addition to its role in myocardial excitation-contraction coupling, the sarcoplasmic reticulum may be involved in arrhythmogenic actions of cardiotonic steroids. This study in isolated cardiac muscle demonstrates that ryanodine can prevent the arrhythmias and reduce the positive inotropic effect produced by cardiotonic steroids without affecting their specific binding to sites on Na,K ATPase. These data suggest that the antagonism is mediated by ryanodine-induced alterations in Ca2+ release from the sarcoplasmic reticulum. PMID- 3816958 TI - 5-Hydroxytryptamine depresses depolarizing responses to GABA in the rat isolated vagus nerve. AB - Axons of the rat isolated cervical vagus nerve responded to gamma-aminobutyric acid (GABA) and 5-hydroxytryptamine (5-HT) with a readily reversible dose dependent depolarization. Prior application of 5-HT at 2 or 30 microM equally depressed the depolarizing responses to GABA, shifting the GABA dose-response curve to the right and depressing the maximum; by contrast, responses to 5-HT were affected only by large doses of GABA (greater than 300 microM), and to a lesser degree. In addition, the fade in responses to high doses of GABA was also reduced in the presence of 5-HT. It is suggested that such all-or-none depressive actions may explain the blockade of GABA-induced responses by 5-HT observed in other tissues such as the guinea-pig ileum. PMID- 3816959 TI - Heterogeneous effects of Ca2+ entry blockers on biphasic constriction of the rabbit ear artery. AB - In the rabbit ear artery, nifedipine, verapamil, diltiazem and bepridil were found to be more potent in inhibiting the tonic than the phasic response to norepinephrine, while KB-944 and W-7 blocked these two responses equally. Since in the ear artery norepinephrine utilizes intracellular and extracellular Ca2+ for its phasic and tonic responses, respectively, the non-selective inhibitory effect of KB-944 suggests that Ca2+ entry blockade may not account solely for its vasodilator effect. PMID- 3816960 TI - Pitrazepin: a central glycine and GABA antagonist. AB - In the spinal cord of the pentobarbitone-anaesthetised cat, microelectrophoretic pitrazepin reduced the inhibitory effects on neuronal firing of both glycine and GABA. PMID- 3816961 TI - Further evaluation of the mechanism by which amphetamine reduces striatal dopamine metabolism: a brain dialysis study. AB - An intracerebral dialysis method was used in the halothane-anaesthetized rat to further clarify the site which mediates the amphetamine-induced decrease of the striatal dopamine (DA) metabolites dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA). Following subcutaneous injection of amphetamine (0.1-5.0 mg/kg), DOPAC and HVA in striatal perfusates decreased over the 2 h time course, with 0.5 mg/kg of the drug having maximal effect. In comparison, amphetamine (0.1 5.0 mg/kg) caused a strictly dose-dependent increase of DA in striatal perfusates. Following low (0.1-5.0 mg/kg) but not high (2.0-5.0 mg/kg) doses of amphetamine there was a negative correlation between the increase of DA and decrease of DOPAC in the striatum. Amphetamine (0.5 mg/kg) caused a reduction in DA metabolism in the ibotenic acid-lesioned striatum. Intranigral injection of 10 micrograms, but not of 1 microgram amphetamine, decreased DOPAC (-27%) in the striatal perfusates. However, injection of 1 microgram amphetamine into the striatum caused a strong decrease in striatal DOPAC (-46%) and HVA (-22%). The possible mechanisms of action of amphetamine are discussed in the light of these data. PMID- 3816963 TI - Age-related change in serotonin-mediated prejunctional inhibition of rat vas deferens. AB - The effect of age on the serotonin (5-HT)-induced prejunctional inhibition of twitch contractions induced in rat vas deferens by single-pulse field stimulation at 0.1 Hz was studied. The inhibitory effect of 5-HT gradually decreased with increasing age of the rats (4-15 weeks old) and was no longer detectable in preparations from rats over 15 weeks old. Moreover, on a further increase in age to 45 weeks, 5-HT conversely enhanced the twitch response of the vas deferens. The 5-HT2 antagonists ketanserin and mianserin potentiated the 5-HT-induced inhibition of contractions of the vas deferens of young rats (8-15 weeks old), and attenuated the amplifying effect of 5-HT on the responses of preparations from old rats (95 weeks old). Thus unmasking of the inhibition depended on the age of rats. This change occurred earlier in life in the prostatic portion of the vas deferens than in the epididymal portion. A functional decrease in 5-HT mediated prejunctional inhibition and the resultant increase in amplification of the twitch response by 5-HT are probably responsible for the age-related decrease in prejunctional inhibition. PMID- 3816962 TI - Agonist-induced muscarinic acetylcholine receptor down-regulation in intact rat brain cells. AB - Intact brain cells were prepared by dissociating whole adult rat brains without the cerebellum using a sieving technique. It has been found that preincubation of these cells with the muscarinic acetylcholine receptor agonist, carbamylcholine, results in a significant reduction in the specific binding of [3H]N methylscopolamine to the receptors after the agonist was washed away. This agonist-mediated receptor down-regulation increased with prolongation of the exposure period to the agonist, and a steady state was achieved after 3 h at 37 degrees C. This effect of agonist was concentration-dependent, reaching a 30-35% decline in subsequent ligand binding upon preincubation with 1 mM carbamylcholine for 3 h. Carbamylcholine-induced receptor down-regulation was not apparent when exposure to the agonist was performed at 15 degrees C. In addition, it was abolished when the receptors were blocked by atropine. The decline in [3H]N methylscopolamine binding induced by agonist was reflected as a significant reduction in the receptor density with no change in receptor affinity, suggesting that 'true' receptor down-regulation takes place. Moreover, when the receptors were labeled with the lipophilic antagonist [3H]quinuclidinyl benzilate instead of the hydrophilic ligand [3H]N-methylscopolamine, the magnitude of the observed receptor down-regulation was significantly lower in case of the former than the latter. This suggests that exposure of intact brain cells to muscarinic agonists might induce a slight degree of accumulation of receptors in intracellular sites before the receptors are actually degraded. These results are discussed in relation to previous findings regarding muscarinic receptor regulation in clonal cell lines. PMID- 3816964 TI - Structural relationships in the inhibition of [3H]tryptamine binding to rat brain membranes in vitro by phenylalkylamines. AB - The ability of various phenylalkylamines to inhibit the binding of [3H]tryptamine to rat frontal/parietal cortical membranes was examined in vitro. Affinity for [3H]tryptamine binding sites improved as the alkyl side chain was extended to include four carbons or when a methoxy group was added at the para position of the ring. One compound, p-methoxyphenylpropylamine (IC50 = 3.6 nM), was as potent as unlabelled tryptamine as a displacing agent. Based on the unique structure activity relationship obtained, it appears that [3H]tryptamine binding sites do not mediate the actions of phenethylamines on serotonin uptake or release. PMID- 3816965 TI - Lack of effect of verapamil on urinary prostaglandin E2 excretion in the rabbit. AB - The effects of verapamil on renal function, the renin-angiotensin-aldosterone system and renal prostaglandin E2 were investigated in the rabbit. Verapamil, administered with rate-controlled osmotic pumps, showed no significant effects on plasma renin activity, plasma aldosterone and urinary prostaglandin E2 excretion. There were marked rises in the glomerular filtration rate and calcium excretion but no significant change in slat and water excretion was observed with verapamil. It is concluded that the hypotensive response to verapamil is unrelated to the renin-angiotensin-aldosterone system and to renal prostaglandin E2. PMID- 3816966 TI - Bradykinin inhibits a slow spike afterhyperpolarization in visceral sensory neurons. AB - Intracellular recordings were made from visceral sensory neurons in vitro. Bradykinin (BK) depressed a slow Ca2+-activated K+-dependent (KCa) spike afterhyperpolarization (AHPs) in the range of 0.2-1 nM. BK did not affect the fast KCa spike afterhyperpolarization preceding the AHPs or the action potential waveform. Indomethacin pretreatment abolished the BK effect. These results indicate that BK can influence the excitability of vagal afferent neurons. PMID- 3816967 TI - Species specificity of thrombin-induced changes in vascular tone. AB - We studied the effects of acetylcholine and human thrombin on the tone of rabbit and dog isolated femoral arteries and aortas with intact endothelium. Acetylcholine (10(-9)-10(-6) mol/l) produced relaxation in the vessels from both species whereas thrombin (10(-9)-3 X 10(-8) mol/l) relaxed only canine arterial smooth muscle. Thrombin pretreatment increased significantly the relaxant potency of acetylcholine in femoral arteries of dogs. The results suggest an interspecies difference in the thrombin-induced endothelium-dependent vasorelaxation. PMID- 3816968 TI - Attenuation of endothelium-dependent relaxation in aorta from diabetic rats. AB - Endothelium-dependent relaxation was examined in aortic ring preparations obtained from rats with streptozotocin-induced diabetes. The endothelium dependent relaxation which was produced by acetylcholine and histamine in aortic rings precontracted with norepinephrine was significantly attenuated in aortic rings from diabetic rats when compared with the relaxation in rings from age matched control animals. However, the relaxation induced by sodium nitroprusside (an endothelium-independent relaxant agent) in diabetic preparations was comparable to the control. These results show that diabetes leads to an impairment of the endothelium-dependent relaxation of aorta. PMID- 3816969 TI - Phenethylamine hallucinogens in the locus coeruleus: potency of action correlates with rank order of 5-HT2 binding affinity. AB - The rank order of potency for the physiological effects of three phenethylamine hallucinogens in the locus coeruleus (LC) was identical to that previously shown for their 5-HT2 binding affinity [-) DOB greater than DOM greater than ( + )DOB). The behaviorally inactive positional isomer of DOB, SL-7161, did not significantly affect LC unit activity. These results offer insight into structure activity relationships at 5-HT2 receptors and support earlier findings that the actions of hallucinogens displayed in the LC are mediated via 5-HT2 receptors. PMID- 3816970 TI - Ketamine depression of excitatory and inhibitory cholinergic responses in Aplysia neurons. AB - The effects of ketamine on the cholinergic excitatory and inhibitory (Cl component) responses in Aplysia neurons were examined using the iontophoretic application of ACh and the two-microelectrode voltage clamp technique. Ketamine reduced both responses non-competitively to the same extent in a dose-dependent and reversible manner at concentrations between 10(-6) and 10(-3) M, without changing the reversal potentials. These findings suggest that ketamine depresses the cholinergic responses by affecting the gating mechanism at postsynaptic membranes. PMID- 3816971 TI - Antagonism by antidepressants of serotonin S1 and S2 receptors of normal human brain in vitro. AB - Using radioligand binding techniques and human frontal cortex, we determined the equilibrium dissociation constants (KDs) of 25 antidepressants at the serotonin S1 (probably the S1A subtype) and serotonin S2 receptors using [3H]WB4101 and [3H]ketanserin, respectively. At the serotonin S1 receptor, the most and least potent antidepressants were trazodone (KD = 60 nM) and bupropion (KD = 170 microM), respectively. At the serotonin S2 receptor, the most and least potent antidepressants were amoxapine (KD = 0.6 nM) and bupropion (KD = 90 microM), respectively. Analysis of the data revealed a relationship between structure and serotonin S1 affinity for some tricyclic antidepressants. Buspirone, a new anxiolytic agent, possessed high affinity for the serotonin S1 receptor (KD = 3.8 nM). PMID- 3816972 TI - Decreased binding of the muscarinic antagonist [3H]N-methylscopolamine in mouse brain following acute treatment with an organophosphate. AB - The effect of the irreversible acetylcholinesterase inhibitor diisopropylfluorophosphate (DFP) on mouse brain muscarinic acetylcholine receptors was assessed using the muscarinic antagonists [3H]N-methylscopolamine [( 3H]NMS) and [3H]quinuclidinyl benzilate [( 3H]QNB). No alteration in the maximal binding capacity (Bmax) or equilibrium dissociation constant (KD) was observed in brain homogenates obtained from mice 12 h after a single injection of DFP when [3H]NMS was employed as the ligand. However, one administration of DFP produced a 24 and 33% decrease in Bmax as measured by [3H]NMS binding after 18 and 24 h, respectively. A similar decrease in Bmax was found after two (31%) and three (29%) days of daily DFP treatment. On the other hand, Scatchard analysis using [3H]QNB binding in the brain revealed no difference in KD or Bmax between untreated and 24 h DFP-treated mice. Thus, there is a differential alteration in mouse brain muscarinic acetylcholine receptors using these two ligands which suggests that [3H]NMS binding sites are more sensitive to regulation following acute organophosphate administration. PMID- 3816973 TI - Effects of VIP and related peptides and Gila monster venom on genitourinary smooth muscle. AB - The pharmacological effects of peptide histidine isoleucine (PHI), glucagon and secretin were compared with vasoactive intestinal polypeptide (VIP) on rabbit urethra and anococcygeus muscle. VIP and PHI dose-dependently inhibited induced contractions of both smooth muscle preparations. Cross-tachyphylaxis between VIP and PHI was demonstrated in the urethra preparation, suggesting that their activity is mediated via a common receptor or second messenger. Glucagon and secretin were without effect on either preparation. Radioimmunoassays demonstrated substantial concentrations of VIP and PHI in both urethra and anococcygeus tissue extracts. These observations suggest that PHI is an additional candidate together with VIP to mediate relaxation of rabbit urethra and anococcygeus muscle. When compared with VIP, Gila monster venom was found to inhibit both smooth muscle preparations, producing concentration-response curves parallel to those produced by VIP. PMID- 3816974 TI - Comparison of the muscarinic cholinoceptors in the rabbit ciliary body and the guinea-pig ileum. AB - Interactions of several muscarinic drugs with their receptors were studied in the ciliary body smooth muscle of rabbits and the ileal longitudinal muscle of guinea pigs, using pharmacological and biochemical procedures. The dissociation constants of carbachol, pilocarpine, atropine and pirenzepine estimated by these procedures indicate no heterogeneity of muscarinic receptors in either tissue; thus both are probably of the M2 type. However, the density of the receptors in the ciliary body is lower than in the ileum. Pilocarpine, with lower intrinsic efficacy, demonstrated a pronounced organ selectivity when compared to carbachol as it was a potent full agonist in the ileum and a competitive antagonist in the ciliary body. These results suggest the importance of both receptor density and threshold as determinants of agonist potency. PMID- 3816975 TI - Satiety and scratching; effects of bombesin-like peptides. AB - Two novel amphibian peptides, [Ser7]litorin-like peptide (Ser-LIT) and [Ser7]bombesin-like peptide (Ser-BN), recently isolated from the skin of the South American frog Phyllomedusa sauvagei, are characterized by the occurrence of a Ser residue in place of His7 in the C-terminal tripeptide. For testing on food intake in fasted rats the peptides were injected intraperitoneally (i.p.) and intracerebroventricularly (i.c.v.) and their activity compared with that of bombesin (BN) and litorin (LIT). Ser-LIT was completely ineffective on food intake while Ser-BN was about ten times less potent than LIT by i.p. injection; given i.c.v., Ser-BN inhibited food intake in the first 15 min after injection but its effect faded within 60 min. The i.c.v. administration of both [Ser7] substituted peptides, elicited intense scratching with a potency equal to or higher than that of BN or LIT. The existence of two different kinds of receptors for BN-like peptides may be hypothesized: the first, specific for the C-terminal tripeptide sequence, is apparently involved in the inhibition of feeding; the second, responsible for the stimulating activity on the urinary bladder and for scratching, shows higher affinity for the N-terminal portion of the biological active sequence. PMID- 3816976 TI - Rapid and brief tolerance to (+)- and (-)-nicotine in unanesthetized rats. AB - When given intravenously to unanesthetized rats as a bolus dose, (-)-nicotine produced a dose-related rise in blood pressure and fall in heart rate in the dose range of 5-40 micrograms/kg. Tolerance did not develop when doses were given at 30 min intervals. At the highest dose, the effects on heart rate persisted. In addition, severe arrhythmias and apnea were observed. (+)-Nicotine at 100 micrograms/kg produced effects similar to 10 micrograms/kg of (-)-nicotine. When given at 1 min intervals, tolerance quickly developed after only 6 injections at 5 micrograms/kg and after 4 injections at 10 micrograms/kg. Tolerance to (+) nicotine also developed rapidly and was no longer evident at 5 min. The results suggest the tolerance is related to frequency of administration and dose. The implication of these results are discussed with regard to cardiovascular disease and dependence. In addition, we postulate that the relatively low degree of biological stereoselectivity of the optical isomers of nicotine, compared with that of the enantiomers of morphine, is due to the simplicity and flexibility of the nicotine molecule. It can be shown using Dreiding models that the nitrogen atoms in the enantiomers are nearly superimposable. PMID- 3816977 TI - Anticonvulsant action of a kainate antagonist gamma-D-glutamyl aminomethylsulphonic acid injected focally into the substantia nigra and entopeduncular nucleus. AB - Focal injection of gamma-D-glutamylaminomethylsulphonic acid (GAMS) into basal ganglia areas, the substantia nigra and entopeduncular nucleus, protects against electroshock (50 mA, 60 Hz, 0.2 s) and pilocarpine (380 mg/kg i.p.) induced seizures in rats. GAMS infusion into substantia nigra pars reticulata significantly protects against generalised (5, 10 nmol) and limbic (10, 50 nmol) seizures. The highest dose of GAMS results in similar suppression of seizure activity following injection into substantia nigra pars compacta against generalised (10 nmol) and limbic (50 nmol) seizures. The anticonvulsant action of GAMS is less marked after infusion into the entopeduncular nucleus. High doses of GAMS are required to provide protection against electroshock test (10 nmol) and limbic (40 nmol) seizures. Protection against limbic and electroshock seizures is more pronounced after infusion of GAMS into substantia nigra than into the entopeduncular nucleus. The substantia nigra pars reticulata is particularly sensitive to the anticonvulsant action of GAMS suggesting that antagonism at the kainate receptor is functionally important. PMID- 3816978 TI - Full and partial relaxing CCK-C-terminal fragments in hog duodenal circular muscle. AB - The essential active moieties in the cholecystokinin (CCK) ligand for relaxing duodenal circular muscles of pigs were investigated. The decrease in isotonic tension from the normal tone was expressed as a percentage of the relaxation obtained with Ca2+-free EGTA (2 mM) solution. Inhibition was expressed as a percentage of the relaxation induced by CCK-C-terminal tetrapeptide (CCK-4, 4.23 microM) without antagonists. Amino acid sequences from CCK-(27-28) to CCK-(27-31) increased the potency. CCK-(27-30) or CCK-(27-31) attained the same extent of relative intrinsic activity as CCK-8. The amino acid sequence from Tyr27, CCK (27), to Trp30, CCK-(30), is another prerequisite for relaxation, in addition to the sequence of CCK-4. Newly synthesized CCK-(27-30)-R derivatives with increasingly bulky substituents (R = H, ethyl, phenyl, n-butyl and allyl) were changed from full agonists to partial agonists. Phenyl, n-butyl and allyl derivatives of CCK-(27-30)-R, in particular, had a mixed agonist and antagonist action. CCK-(27-30)-allyl antagonized competitively the CCK-4-induced relaxation (IC50 = 123 (75.9-200) microM). PMID- 3816979 TI - Ketanserin and pirenperone attenuate acute morphine withdrawal in rats. AB - The involvement of serotonin2 (5-HT2) receptors in the expression of opiate withdrawal was examined using a behavioral test for acute morphine dependence. The 5-HT2 antagonists, ketanserin and pirenperone, injected shortly before naloxone, attenuated the naloxone-induced suppression of an autoshaped lever touch response in rats treated 4 h earlier with a moderate dose of morphine. A low dose of pirenperone was also effective in blocking withdrawal-induced hypothermia. These data support the hypothesis that 5-HT is involved in the expression of opiate withdrawal. PMID- 3816980 TI - Kainic acid stimulates GABA release from a subpopulation of cerebellar astrocytes. AB - The effect of acute exposure to micromolar concentrations of kainic acid was studied in rat cerebellar astroglial cultures consisting of two antigenically and functionally distinct subpopulations of astrocytes. Kainate (20-100 microM) released [3H]GABA preaccumulated by A2B5-positive stellate astrocytes in a concentration-, Na+- and Ca2+-dependent way, and did not interfere with [3H]GABA transport. We hypothesize that kainate depolarizes this class of cells by activating cationic channels and that this results in an imbalance of GABAergic transmission. PMID- 3816981 TI - Possible involvement of histamine H2-receptors in the vasodilator effect of clonidine on isolated and perfused canine coronary arteries. AB - The mechanism of clonidine-induced vasodilatation was investigated in the isolated and perfused canine coronary arteries. Clonidine produced a slight vasoconstriction at small doses whereas it induced a dose-related vasodilatation at large doses (more than 3 micrograms). The vasodilatation was reversed to vasoconstriction by treatment with 100 micrograms of cimetidine (a selective H2 receptor antagonist) but was not affected by 100 micrograms of chlorpheniramine (a selective H1-receptor antagonist). These results suggest that clonidine can dilate the isolated and perfused canine coronary arteries by acting on histamine H2-receptors. PMID- 3816982 TI - Characterization of 2-[125I]iodomelatonin binding sites in hamster brain. PMID- 3816983 TI - Octadecaneuropeptide (ODN; 'anxiety peptide') displaces diazepam more potently from astrocytic than from neuronal binding sites. PMID- 3816984 TI - Nicotine preferentially stimulates dopamine release in the limbic system of freely moving rats. PMID- 3816985 TI - 5HT2 binding sites after mianserin: comparison of loss of sites and brain levels of drug. AB - The purpose of this study was to evaluate the role of residual drug in mediating the loss of 5HT2 binding sites after in vivo treatment with mianserin. Brain levels of mianserin were measured using a radioreceptor assay and compared with the extent of receptor loss. Peak brain levels were found within 0.5 to 1 h after dosing and the drug disappeared from brain with a half-life of 1-3 h. A dissociation was found between the levels of mianserin and the loss of binding sites. At the time of peak drug levels, the density of 5HT2 sites was not changed, while 24 h later, a significant loss of sites was evident. Although some drug-related material remained in the brain at 24 h after treatment, there was no apparent relationship between the regional distribution of residual drug and the distribution of 5HT2 binding sites. Studies with [3H]mianserin confirmed these results. Furthermore, incubation of brain slices with mianserin did not lead to a decrease in 5HT2 binding site density, consistent with the conclusion that the in vivo effects of the drug do not reflect a direct action. PMID- 3816986 TI - Experimental production of transgenic mice carrying human beta-globin genes. AB - To produce transgenic mice carrying human beta-globin genes, we introduced the following two constructs of the genes to male pronuclei of fertilized mouse eggs: 4.4 kb Pst I/Pst I sequences of the human beta-globin gene (experiment 1) and the human beta-globin gene cluster (cosHG 28) containing G gamma, A gamma, delta and beta-globin genes and cosmid vector pJB8 (37.5 kb, experiment 2). In experiment 1, 25 mice were born, and four (one female and three males) carrying the injected gene sequences were identified. One of these mice carried the entire sequence of the human beta-globin gene but three others appeared to carry only a part of the entire sequence. The mouse with the entire sequence showed a slight increase in the minor component of the mouse beta-globin chain in the same position as the human beta-globin chain. In experiment 2, 61 mice were born, and nine (three females and six males) carried the sequences of the injected gene. However, from DNA analysis, no appropriate sequences present within the A gamma- or beta-globin gene were identified in any of the founder mice. In this case, DNA fragments of the gene cluster that were digested in the mouse nucleus after microinjection of the gene might be integrated into host DNA. PMID- 3816987 TI - [Study on the optimum number of trials and intensity of unconditioned stimulants and strain difference in the two-way shuttle-box avoidance test using rats]. AB - In order to determine the optimun conditions suitable for a number of trials and the intensity of unconditioned stimulant (US) in the two-way shuttle-box avoidance test in Sprague-Dawley strain rats, which are used most frequently in reproduction studies, conditioned avoidance response was observed under various conditions for 30 and 60 trials and the low and high US levels. Investigation was also conducted in Wistar rats under a high US level with 30 and 60 trials. Latency time of the escape response in Sprague-Dawley rats was shortened with increasing trials. Body weight gains of both strains of rats in the high US level with the 60-trial group decreased during the observation period. These findings suggest that the high US level with the 60-trial group is not suitable for the two-way shuttle-box avoidance test. The rate and latency time of the avoidance response were lower in Wistar rats than in Sprague-Dawley rats, although those of the escape response were higher. Significant changes in the following were observed, mainly from first to third sessions: the avoidance rate of all groups in strains of rats, escape rate of 60-trial group in Sprague-Dawley rats, avoidance and escape latency time of the 60-trial groups in both strains of rats and escape latency time of the 30-trial group in Sprague-Dawley strain rats. PMID- 3816988 TI - [Coprophagy in the germfree mouse]. AB - Coprophagy was observed in germfree (GF) ICR mice of both sexes, and the results were compared with those of conventional mice. Frequency of coprophagy per animal per day in GF mice was 5.1 in males and 5.8 in females. In conventional (CV) mice, the frequencies were 6.2 in males and 5.3 in females (data from Zoological Science 2:249-255, 1985), with no significant differences compared with GF mice. Coprophagy in CV mice was frequently observed during 6-8 hr after lighting, whereas such close time relationships tended to weaken in GF animals. In a comparison of levels of constituents per unit weight between feces and diet, fecal crude protein and crude fat exhibited lower values than those in the diet. Levels of fecal crude ash and crude fiber were higher than those in the diet, and nitrogen-free extract was almost equal to that in the diet. No essential difference in these tendencies was found compared with CV mice. Levels of fecal vitamin B1, B2, B12 and folic acid were lower than those in the diet. In CV mice, except for vitamin B1, these vitamins exhibited either almost equal or much higher levels compared with those in the diet (data from Experimental Animals 35: 381-386, 1986). From the fact that coprophagy was observed in GF mice, it is suggested that the behavior is inherent in the mouse. PMID- 3816989 TI - Nonsurgical collection of embryos in Shiba goats. AB - A method of nonsurgical embryo collection in the Shiba goat, a native Japanese miniature goat breeding nonseasonally, was developed. The apparatus used for flushing the uterus was made on the model of the two-way catheter for cows. Embryo collection was performed on days 5 to 7 in 37 females superovulated with PMSG and hCG and resulted in successful recovery of 69 embryos in 19 females (51.4%). The average number of embryos collected from each successful female was 3.6. The recovery rate of embryos calculated on the basis of the number of embryos recovered and corpora lutea observed by culdoscopy in 15 successful females was 89.5%. This nonsurgical method seem to be efficient enough for collecting morulae and blastocysts in Shiba goats. PMID- 3816990 TI - Postnatal development of the testis in the Mongolian gerbil, Meriones unguiculatus. AB - The testicular development in gerbils was studied over 16-week periods starting from birth. Testicular weight and seminiferous tubule diameter increased considerably between 1 and 11 weeks of age. At 16 weeks the testicular weight was about 540 mg. Spermatogenesis commenced at about 2 weeks when mitoses first appeared in spermatogonia. Spermatozoa appeared in a few of the seminiferous tubules by 7 weeks and consistently so in all of the tubules at 10 weeks. Epididymal spermatozoa appeared first in the cauda epididymis at 10 weeks and were consistently present at 12 weeks. Formation of mature Leydig cells with a grouped perivascular arrangement appeared by 3 weeks and continuously so thereafter. From these results, it is evident that the male Mongolian gerbil is almost sexually matured by 10 to 12 weeks of age. PMID- 3816991 TI - Linkage of faded gene (fe) to chromosome 6 of the mouse. AB - Linkage tests on the faded gene were carried out with some coat color and biochemical markers, It was shown that the faded locus was not closely linked to the following loci: Idh-1 (chromosome 1), a (2), Car 2 (3), Mup-1 (4), Pgm-1 (5), Hbb (7), Gpi-1 (7), Es-1 (8), Trf (9), Es-3 (11), s (14), Sod-1 (16) and Ce-2 (17). The mutant locus showed linkage with Ggc on chromosome 6. PMID- 3816992 TI - [Method of separating mouse platelets by discontinuous sucrose-gradient centrifugation]. AB - A discontinuous sucrose gradient was employed in the separation of mouse blood platelets using a modified Booyse method. The platelets of male CD-1 mice aged 8 to 12 weeks were divided into five distinct populations (A, B, C, D & E). Distribution of light to heavy platelets patterns in 10 normal CD-1 mice was demonstrable at; A (S.G. 1.188), as 14.8 +/- 5.6%; B (S.G. 1.199), 44.0 +/- 4.6%; C (S.G. 1.207), 24.1 +/- 3.4%; D (S.G. 1.214), 13.0 +/- 3.6%; and E (S.G. 1.221), 4.0 +/- 1.5%. PMID- 3816993 TI - [Breeding and growth of the inbred strain of seizure-prone Mongolian gerbils (Meriones unguiculatus)]. AB - Recently a Mongolian gerbil has become a useful laboratory animal, while little of the basic data are known about the breeding and growth of this laboratory rodent. In our animal center, an inbred strain of the seizure prone gerbil has been produced and kept these ten years. The data on the breeding and growth of the animal were obtained and described as following in the present paper. The mean life span was 26 +/- 14 month old for males and 27 +/- 13 month old for females. The mean body weight of the Mongolian gerbils at 16 weeks of age was 72 +/- 5.6 g for males and 62 +/- 7.3 g for females. The mean litter size at birth was 4.8 +/- 1.7 head. (range; 1-9) More newborn pups were born in the warm seasons (March-October) than the cold seasons (November-February). The mean rate of weaning was 80.2%. The man litter size was relatively constant in each generation. PMID- 3816994 TI - The Mexican hairless dog, its morphology and inheritance. AB - Some morphological characteristics of the Mexican hairless dog and their inheritance were investigated. The dogs examined were hairless and had defective teeth. From the results of mating experiments, an autosomal dominant semi-lethal gene was considered to be responsible for the hairlessness accompanied by defective teeth in the dog. The possible usefulness of the dog was also discussed. PMID- 3816995 TI - Copulatory behavior of male rats paired with natural proestrous and hormone treated ovariectomized females. AB - The male's sexual behavior paired with estrogen-progesterone primed induced ovariectomized receptive females was compared with natural proestrous females. The former showed longer ejaculation latency and more intromissions to the first ejaculation than the latter. PMID- 3816996 TI - [The survey of laboratory animal allergy in Japan: study group on the present state of laboratory animal allergy and its countermeasures]. PMID- 3816997 TI - Production of sexual steroids in rats during pre- and early postnatal life. AB - To get a comprehensive picture of the normal perinatal production of sexual steroids, we determined progesterone, estradiol and testosterone content in the sera, gonads and adrenal glands of rats of both sexes between 14th day of gestation and 24th day of postnatal life. The first sign of testosterone synthesis in the testicles could be detected on the 17th day of gestation followed by a large peak between the 19th intrauterine and 4th postnatal day. A second smaller increase in testosterone production was found around the 14-15th postnatal days. The first peak matches well the time of the critical period of sexual differentiation of the rats brain. No detectable amount of steroid were found in the ovary during the perinatal period. The ovaries seem not to be involved in the early period of sexual differentiation. The small quantity of progesterone found in the sera of early postnatal animals is produced by the adrenal glands. PMID- 3816998 TI - The secretion of parathyroid hormone and its fragments from dispersed cells of adenomatous parathyroid tissue at different calcium concentrations. AB - The effect of varying calcium concentrations on PTH release from dispersed cells of adenomatous parathyroid tissues (n = 15) was studied. During high calcium concentrations PTH secretion was inhibited up to 62.5% as compared to low calcium concentrations. There was no correlation between iPTH secretion rate and suppressibility. Each adenoma had a different iPTH secretion rate. Three adenomas showed a high suppressibility (28.0%, 53.8%, and 62.5%). The supernates of their media were chromatographed and examined by midregion and C-terminal specific PTH RIAs. Carboxyl-terminal PTH fragments were found to be released by two adenomas. There was no evidence for the release of midregion PTH fragments. Comparison of incubation media revealed that the adenoma with the lowest suppressibility released the highest amount of intact PTH (per 100,000 cells/ml). This adenoma exclusively secreted intact PTH, whereas PTH fragments were only released from two adenomas with higher suppressibility. In these media the ratio of PTH fragments to intact PTH increased with the calcium content of the media. The ratio was also dependent on the suppressibility of the adenomas; i.e. the ratio was greater when the suppressibility was higher. This suggests that in adenomas the intracellular hormone degradation is responsible for the degree of PTH suppression. As the suppressibility of PTH secretion is reduced in hyperfunctioning parathyroid tissue, diminished intracellular hormone degradation seems to be involved in the pathogenesis of primary hyperparathyroidism. PMID- 3816999 TI - Increased urinary antidiuretic hormone excretion by imipramine. AB - Seven normal healthy individuals and ten depressive patients treated with imipramine (75 mg orally) were evaluated for their urinary ADH profile. It was observed that imipramine treated patients excreted higher amounts of urinary ADH (10.6 +/- 0.83 mU/hr) as compared to the control subjects (2.6 +/- 0.35 mU/hr) (P less than 0.01). Blood pressure in both groups was within the normal range. PMID- 3817000 TI - Circulating blood volumes in diabetic patients. AB - To examine the mechanism of cardiac dysfunction in diabetes, total circulating blood volume, cardiac and stroke volumes were measured by radioisotope method in 44 patients with type 1 and type 2 diabetes. Considerable difference in actually circulating blood volume could be demonstrated in diabetic patients, which seemed to be dependent on the control of the carbohydrate metabolism. The achievement of well controlled carbohydrate metabolism in diabetics has a great importance with special respect also to the blood volumes. PMID- 3817001 TI - Oestradiol and testosterone binding sites in mice tibiae and their relationship with bone growth. AB - High affinity oestradiol and testosterone binding sites were found in tibiae cytosol from entire male and female of different ages. Scatchard assay allowed to estimate a Kd of 2.7 X 10(-9) M for oestradiol binding sites indicating that the 3H-oestradiol binding was of high affinity. Oestradiol and testosterone binding sites abundance in mice tibiae are subject to change with age. It is not easy to establish a direct correlation between these changes and the values reported here on bone growth in weight and length, however seems possible to point a negative relationship between bone lengthening and oestradiol binding site levels in female, as well a positive relationship with testosterone in both sexes. The presence of oestradiol and testosterone binding sites in epiphyses and not in the diaphyses reinforces the hypothesis that both are playing some role in bone growth. PMID- 3817002 TI - A morphometric study of cortisol-induced changes in the development of neuronal process outgrowth in the corticoid zone of the embryonic chick telencephalon. AB - The development of dendritic arborization was analysed and quantitative data (number of stem dendrites, their segments and total length of dendritic tree) were obtained. Early administration of cortisol (on day 11) inhibited all three dendritic parameters of small stellate neurones situated in the corticoid zone of the telencephalon in 19-day-old chick embryos, but in large stellate neurones the number of dendritic segments and their total length were only impaired. Late administration of this hormone (on day 17) did not influence the development of the dendritic network of large neurones, but it affected the number of segments and total dendritic length of small neurones. These results suggest that the number of stem dendrites is set in first, followed by elongation and ramification of the fibres. The main effect of cortisol on the neuronal differentiation is the inhibition of dendritic outgrowth with a dependence on period when dendrites, their branches and dendritic spines develop most rapidly. PMID- 3817003 TI - Effect of oestrogen on prolactin receptors in porcine granulosa cells. AB - The binding of 125I-labelled PRL to the porcine granulosa cells was examined. Displacement studies demonstrated that 125I-labelled PRL was specifically bound to the granulosa cells. The specific binding of 125I-labelled PRL to the granulosa cells decreased significantly as the follicles matured. The addition of diethylstilboestrol diphosphate enhanced the binding of 125I-labelled PRL to the granulosa cells harvested from small, medium and large follicles. The results of the present study suggest that oestrogen might have an important role in modulating PRL receptors in porcine granulosa cells. PMID- 3817004 TI - Sex differences in adrenocortical structure and function. XXIII. Time-studies on the long-term effects of gonadectomy on rat adrenal cortex. AB - The aim of the study was to investigate the changes in the size and function of the rat adrenal gland in relation to time-intervals elapsed from postpubertal gonadectomy. Eight weeks after testectomy absolute adrenal gland weights were higher than in intact rats. After that time gradual decrease in the weight was observed and at week 32 the weights were similar to that in intact rats. At weeks 8 and 12 after ovariectomy there was no change in the weight of the gland, however from week 16 onward a gradual decrease occurred. Corticosterone output by adrenal homogenate of orchiectomized rats was lower than in control male rats from week 24 of experiment while in ovariectomized rats such a drop was observed from week 12 of experiment. Activity of adrenal 5 alpha-reductase was markedly higher in either orchiectomized or ovariectomized rats as compared to intact rats at week 8 of experiment. After that time enzyme activity decreased reaching at weeks 24 and 32 control levels. This suggests that 5 alpha-reductase plays only transitional role in adaptation of adrenals to gonadectomy. Neither orchiectomy nor ovariectomy had significant effect on mitochondrial 11 beta-hydroxylase activity. Obtained results clearly show that gonadectomy-induced changes in rat adrenal depend upon time-interval elapsed from surgery. Moreover, they suggest that additionally to 5 alpha-reductase activity, also other factors induced by gonadectomy are responsible for the drop in corticosterone output by adrenals of gonad-deprived rats. PMID- 3817005 TI - ABH-secretion and Lewis red cell groups in diabetic and normal subjects from Ethiopia. AB - The possible relationship between Lewis red cell groups and secretor status and diabetes mellitus has been investigated in diabetic patients from Northwestern Ethiopia. The Lewis negative phenotype [Le(a-b-)] showed similar frequencies in diabetics and a control sample. Determination of the secretor status revealed a tendency to higher non-secretor rates in diabetics, particularly of the insulin dependent type, in comparison with non-diabetic Ethiopians. A lack of effective immune protection from secretory IgA antibodies as a plausible explanation for the relationship between non-secretor status and IDDM is discussed. However, the available data from our study showed no statistically significant association between secretor state and IDDM. Without a detailed genetic characterization of our diabetic patients (HLA association data) it will be difficult to define precisely the postulated contribution of the Se gene to the aetiopathogenesis of IDDM. PMID- 3817006 TI - Calcitonin- and katacalcin-like immunoreactivity in human seminal plasma. AB - iCT was determined in 74 patients by direct RIA. A highly significant increase (371 pg/ml) compared with normal serum concentration (100 pg/ml) was observed. There was no correlation between iCT concentration and ejaculate parameters. In addition monomeric bioactive CT and from the same RNA derived KT were determined from a seminal plasma pool gathered from 25 patients. The measured amounts were similar to those found in plasma. Monomeric CT or KT is not responsible for high amounts of iCT in seminal plasma found by direct radioimmunoassay. High amounts of iCT or iKT are due to two heterogenous peptides with greater molecular mass but have no influence on fertility. PMID- 3817007 TI - Serum electrolytes and parathyroid hormone concentrations in acute myocardial infarction. AB - Serum concentrations of calcium, magnesium, potassium and phosphate can be lowered experimentally by adrenaline, which also can stimulate the secretion of parathyroid hormone (PTH). In order to evaluate the possible clinical importance of these mechanisms serial blood samples were drawn during the first three hospital days in 26 patients with acute myocardial infarction (AMI), a condition known to increase plasma catecholamine levels. During the study period there were no consistent significant changes of the serum electrolytes. The serum PTH levels, however, were significantly raised in the AMI patients already on admission and did not normalize during the observation time. The PTH concentrations were unexplained by infarct size, concomitant diseases or medication. These findings suggest that PTH could be an independent risk factor for AMI. PMID- 3817008 TI - Differences in the response of early and mid or late G1 WI38 cells treated with cyclohexamide to HeLa inducers of DNA synthesis. AB - The inducibility of DNA synthesis after treatment with cyclohexamide (CHM) during mitosis and the G1 phase of WI38 cells has been studied in the heterokaryons following fusion with HeLa cells in S phase. Synchronized mitotic cells treated for up to 5 h with CHM were not delayed in the initiation of DNA synthesis in the heterokaryons. The G1 cells treated with CHM for 3-24 h were slow in responding to inducers of DNA synthesis generated by HeLa cells in the heterokaryons. The results suggest that there is a specific point in early G1 that regulates the entry of cells into a cycling state. In the presence of CHM, mitotic cells divide, but the daughter cells fail to enter G1 leading to DNA synthesis, and CHM treatment of G1 cells results in their transient entry into a G0 state. PMID- 3817009 TI - Methionine metabolism defect in cells transfected with an activated HRAS1 oncogene. AB - Methionine dependence is a metabolic defect characterized by the inability of eukaryotic cells in culture to proliferate in a medium where methionine has been replaced by its immediate metabolic precursor, homocysteine. This defect has been reported to be a specific property of diverse tumour-derived and transformed cell lines; normal cell strains grow well under the above culture conditions. The basis of methionine requirement in such cells is not known. We asked whether this defect might be controlled by activated oncogenes and in particular by the mutated (activated) HRAS1 oncogene derived from the EJ/T24 human carcinoma line. We report that this oncogene induces methionine requirement after transfection in non-transformed immortalized rat cells. PMID- 3817010 TI - Characteristic shape and surface changes in epithelial transformation. AB - Previous work has suggested that adhesive or cytoskeletal structures alter during epithelial transformation. The purpose of the present studies was to see whether such reorganizations were accompanied by consistent changes in the biophysical characteristics of cells. We used in vitro cell lines from rat liver and respiratory tract epithelium that became tumorigenic over a period of 11-15 months. For populations sampled at several time points before and after this transition, the shape of individual cells was analysed by calculating the values of many geometrical descriptors. The data were collected from cells imaged by reflected light interference. Interference contours on the cells were digitized, and the descriptor values calculated by computer program. Cell lines derived from both liver (IAR 20PC1) and respiratory epithelium 1,000 W) lines showed progressive changes in the values of certain descriptors. The time-dependent differences among groups were statistically significant at a level of p less than 0.0001. By determining which descriptors underwent large changes, we found that some structural revisions occurred in common in the two types of cells. Cells from later passages of the lines rose from the substrate at a steeper angle, as determined by measuring the fraction of the area of the first interference contour that was occupied by successive contours. In addition, the projections on the perimeter became broader, and the perimeter became less complex. This kind of 'smoothing' of the cell perimeter took place in several contours, indicating that it was a surface change. Surface changes of this sort have not been noted previously in transformation. The results suggest that the structure of cells is altered in a consistent way during transformation, as detected by measuring of shape and surface configuration. PMID- 3817011 TI - Immobilized glycolipids from human diploid fibroblasts inhibit DNA synthesis of cultured human fibroblasts. AB - Several previous studies have shown that glycolipids isolated from plasma membranes of cultured cells and added to cells in culture inhibit the growth rate in a concentration-dependent fashion. In order to investigate the possible involvement of glycolipids in the growth regulation of normal cells by cell-cell contacts, we tested the effect of immobilized glycolipids, isolated from human fibroblasts, on the DNA synthesis of freshly seeded fibroblasts. Gangliosides inhibited DNA synthesis to a great extent, whereas neutral glycolipids had only a minor effect. The degree of inhibition of DNA synthesis by immobilized gangliosides depended both on the cell density of the cultures from which the gangliosides were isolated and on the pretreatment of the immobilized gangliosides: Preincubation with DMEM without FCS of immobilized gangliosides, isolated from confluent cultures, resulted in a 75% inhibition of growth rate of embryonal human lung fibroblasts (FH109) cultured on immobilized gangliosides. Under the same conditions, gangliosides from sparse cultures reduced the growth rate by about 30%. On the other hand, the degree of inhibition exerted by immobilized gangliosides isolated from confluent cultures was found to be greatly reduced by preincubation with DMEM with FCS, whereas the slight inhibition of growth rate, exerted by gangliosides from sparse cultures, was found to be reversed into a slight stimulation of growth rate after preincubation with complete medium. Concomitantly with the reduction of the inhibition of DNA synthesis, it was found that the complete medium, used for preincubation of the gangliosides, was no longer able to support DNA synthesis to the same extent as untreated complete medium. The data suggest that gangliosides bind growth supporting factors of the serum, gangliosides isolated from sparse cultures being more potent in the binding of these molecules than gangliosides isolated from dense cultures. PMID- 3817012 TI - Effects of fibroblastic growth factor on protein degradation, the migration of non-histone proteins to the nucleus and DNA synthesis in diploid fibroblasts. AB - Stimulation of resting WI38 cells, prelabeled with [3H]leucine, with fibroblastic growth factor (FGF) or serum, caused increased nuclear translocation of [3H]non histone proteins [( 3H]NHP) and DNA synthesis, and a parallel decrease of proteolysis. [3H]NHP migration was independent of protein synthesis. Fractionation of the nuclear proteins in a pH gradient of 2.5-6.5 showed that [3H]NHP fractions with high degradation rates in resting cells corresponded to the [3H]NHP fractions with high migration rates in stimulated cells, suggesting that degradation and migration of [3H]NHP are linked. FGF inhibited cellular uptake of [3H]chloroquine, suggesting that FGF inhibits NHP degradation via lysosomes. The lysosomotropic amine eserine had similar effects as FGF. It is proposed that FGF induces NHP migration to the nucleus by inhibiting their lysosomal degradation. FGF also caused migration of [3H]histones, however, the mechanism is not clear. PMID- 3817013 TI - Patterns in the distribution of intracellular ATP concentration in relation to coordination of amoeboid cell behavior in Physarum polycephalum. AB - The Physarum plasmodium reacts tactically to external stimuli. The cell behavior of this giant amoeboid cell was studied by analysing intracellular ATP concentration. The two-dimensional (2D) spatial distribution of ATP depended on cell shape: a polar pattern for a unidirectionally migrating plasmodium, a bowl shape for a circular plasmodium, a hump shape for an oval plasmodium, or a wavy pattern for plasmodia stimulated with blue light or confined in a small chamber, etc. Local external stimulation brought about new patterns of ATP distribution. The ATP concentrations around the stimulated frontal region were reduced by about a half stimulation with KCl (repellent) or casamino acids (attractant). In both cases, migration was inhibited. Migration velocity increased almost linearly with increasing concentration of intracellular ATP above the threshold (about 20 micrograms/mg protein). Under anaerobic conditions or at low temperatures, the intracellular ATP oscillated slowly with a periodicity of about 30 min. Pattern formations in the intracellular ATP concentration and amoeboid coordination are discussed in terms of coupled chemical oscillators in a self-organizing system. PMID- 3817014 TI - c-myc mRNA is elevated as differentiating lens cells withdraw from the cell cycle. AB - Explants of the central region of lens epithelia from early chicken embryos differentiate in vitro to form lens fiber cells when cultured in the presence of chicken vitreous humor. Hybridization of a 32P-labeled v-myc viral oncogene DNA probe to RNA extracted from differentiating explants and immobilized on nitrocellulose filters indicates that levels of 2.5 kb c-myc mRNA are transiently elevated 5-10-fold in the differentiating cells. Increased levels of c-myc mRNA are observed within 30 min of the initiation of differentiation in vitro and persist for 8-9 h. Thymidine labeling of nuclei in differentiating explants indicates that entry of cells into S phase is inhibited during this period, as differentiating cells complete a final round of mitosis and withdraw from the cell cycle. Levels of c-myc mRNA are also elevated in the peripheral region of the lens epithelium, which contains cells undergoing differentiation in vivo, suggesting that the regulation of c-myc mRNA which occurs in vitro may also occur in vivo. c-myc mRNA, c-fos mRNA, and c-src mRNA showed distinct patterns of regulation associated with lens fiber formation in vivo, thus providing evidence that the regulation of c-myc mRNA is specific to this proto-oncogene. The finding that c-myc mRNA undergoes a specific, transient elevation in differentiating lens cells as they withdraw from the cell cycle contrasts with a large body of evidence linking enhanced c-myc expression with increased cell proliferation. PMID- 3817015 TI - RNA polymerase activity in PtK1 micronuclei containing individual chromosomes. An in vitro and in situ study. AB - Micronuclei have been induced by colchicine in rat kangaroo (Potorous tridactylis) PtK1 cells. The synthesis of RNA was investigated both in isolated micronuclei by quantifying RNA polymerase activities at different ionic strengths with or without inhibitors, and in micronucleated cells by radioautography after [3H]uridine pulse labeling. In vitro transcription shows that isolated micronuclei are able to take up [3H]UTP. The rate curves of incorporation are close to those of isolated diploid nuclei, though the level of incorporation was relatively lower (65-70%) than control nuclei. This indicates that micronuclei react to the ionic environment and to inhibitors in the same manner as described for many species of isolated diploid nuclei. The labelling distributions plotted from radioautographs show that micronuclei were able to efficiently incorporate the hot precursor. Furthermore, for short pulses there is no homogeneity in the labelling density among the different micronuclei and there is no correlation between the labelling intensity and the size of micronuclei. After 60-min pulse time, there is an enhanced uptake of [3H]uridine and all the micronuclei exhibit considerable labelling, although less than control cells. Thus, the micronuclei exhibit some characteristic RNA transcriptional activity in situ as well as after isolation. This material should be a particular interesting model with which to study the physiological activity and the role of each individual interphasic chromosome. PMID- 3817016 TI - Increased synthetic capacity for metallothionein in cultured liver cells following dimethyl sulfoxide pretreatment. AB - Cultured TRL 1215 cells in log phase of growth were exposed to dimethyl sulfoxide (DMSO; 14-280 mM) followed 48 h later by cadmium (10 micron). Intracellular concentrations of metallothionein (MT) were measured 24 h after cadmium addition. Cadmium alone caused a 10-fold increase in the levels of MT, while DMSO alone had no effect on cellular MT levels. DMSO pretreatment followed by cadmium exposure, however, resulted in MT levels that were elevated by a factor of as much as 25 fold those observed in control cells. Concurrent treatment with the DNA synthesis inhibitor hydroxyurea (HU) eliminated the enhancing effect of DMSO pretreatment on cadmium induction of MT, indicating the requirement of DNA synthesis. An enhancement of the cellular accumulation of the metal ion did not account for the increased cadmium-induced MT synthesis in DMSO-pretreated cells as these cells did not show significantly increased uptake of cadmium during the initial period of exposure. DMSO pretreatment enhances cadmium induction of MT synthesis through a mechanism that appears to be dependent on the synthesis of DNA. PMID- 3817017 TI - Human c-fos proto-oncogene mapped to chromosome 14, band q24.3-q31. Possibilities for oncogene activation by chromosomal rearrangements in human neoplasms. AB - The human c-fos proto-oncogene was mapped by in situ hybridization to chromosome 14, band q24.3-q31. As a probe we used 3H-labelled mouse c-fos RNA transcribed in vitro by SP6-RNA-polymerase. Of a total of 40 grains on chromosome 14, 19 (47.5%) were located within the 14q24.3-q31 region (p much less than 0.001). Mechanisms for c-fos to gain transforming ability by a break in a critical part of the gene have recently been described. Thus there are several possibilities for chromosomal aberrations within the 14q24.3-q31 region to be responsible for c-fos deregulation and which may result in neoplastic growth. Such specific aberrations are found in a variety of human neoplasms. PMID- 3817018 TI - Mammalian sperm cannot penetrate the zona pellucida solely by force. AB - The zona pellucida of the mammalian egg is a barrier which sperm must penetrate if fertilization is to proceed. The physical properties of zonae remain unknown. The response of intact hamster zonae to defined force and shear stress has been established by using quartz fibres as 'pokers' mounted on tungsten beams of known stiffness. Fibres with cross-sectional areas as small as 2.8 micron 2 fail to penetrate zonae even when subjected to forces of 150 nN, i.e. stresses greater than 50 kN/m2. Moreover, although a force of 150 nN produces extensive strain, zonae recover essentially elastically, and show little or no creep over 1 200 sec. These forces and stresses are in excess of those which are currently thought to be produced by sperm, and it follows, therefore, that sperm cannot penetrate zonae solely by force. PMID- 3817019 TI - Molecular cloning of mRNA sequences transiently induced during rat liver regeneration. AB - In order to isolate genes which are induced during liver regeneration, we have constructed a cDNA library from 16-h-regenerating liver poly(A)+ RNA. By computer analysis of autoradiograms produced by differential plaque hybridization with cDNA from normal or 16-h-regenerating liver, we have isolated several recombinant clones representing sequences transiently increased during liver regeneration. Three of these were further characterized: the level of the corresponding mRNAs increase rapidly after partial hepatectomy, before the onset of DNA synthesis. Two clones were identified as fibrinogen clones. It is speculated that alpha fibrinogen may be involved in the growth process, or in its regulation. PMID- 3817020 TI - Unidirectional co-stimulation by a non-mating strain of Tetrahymena thermophila. AB - We report that a fatty acid auxotroph of Tetrahymena thermophila (RH179E1) fails to mate, yet retains the ability to co-stimulate normal cells unidirectionally. Thus, co-stimulation can be analyzed experimentally in the absence of pair formation. We show that the co-stimulation of normal cells of one mating type is sufficient to shorten the waiting period for pair formation of those cells with initiated cells. This is the first evidence that co-stimulation causes a hyperinduction of mating reactivity in T. thermophila, generating in turn a positive feedback mechanism for (presumably) gamone production. Co-stimulation by the variant strain is at a maximum after 3-4 h of exposure when the variant and wild-type cells are at a ratio of 1:1. When mixed with wild-type cells, RH179E1 induces the formation of progeny (at low frequency) which inherit exclusively genetic material of the wild-type cells. PMID- 3817021 TI - Light conductance in the ocular lens. AB - The collimated beam of a He-Ne laser aimed tangentially at the equator of submerged bovine or rabbit ocular lenses enters the lens and travels in the surface of the lens. We suggest that the effect is the result of light conductance along the interface between the bulk of the lens (including the lens epithelium on the anterior surface) as the medium of higher refractive index and the capsule as a medium of lower refractive index. Light conductance can be demonstrated in isolated lenses as well as in intact eyes. It is very sensitive to alterations of the state of the lens and therefore it may offer a new method to study very early stages of lens damage and cataract formation. PMID- 3817022 TI - Age-related variations in the distribution of crystallins within the bovine lens. AB - The native water-soluble proteins of equator, anterior cortex, posterior cortex and nucleus from bovine lenses in the age range 0.3-33.7 years were analyzed by high-pressure gel-permeation chromatography and high-pressure ion-exchange chromatography. Unlike the equator and cortices, the nucleus shows a gradual decrease in alpha-crystallin proportion with age which is not compensated for by an increase in HM-crystallin. The beta 6H-crystallin species, almost the only beta H-component in the youngest lens, is largely replaced by at least four fractions with higher and lower molecular weights in the older lenses. In the nucleus a beta L-component (39,000 MW) increasingly seems to replace the major beta L-crystallin (beta 2L, 50,000 MW). Moreover, a switch in the synthesis of monomeric crystallins is demonstrated. This study clearly reveals an age-related increase in the size heterogeneity of the native soluble crystallins with age. PMID- 3817023 TI - Analysis of an inductive interaction between lens and neural retina in rats of different ages. AB - Lens epithelial cells from neonatal rats cultured with neural retinas or neural retina-conditioned medium (RCM), undergo fibre differentiation. This is characterized by cell elongation, increased alpha-crystallin synthesis and the initiation of beta and gamma-crystallin synthesis. To determine if this tissue interaction continues in later life we developed an ELISA method to analyse patterns of alpha and beta-crystallin accumulation in epithelia from 3-day-, 10 day- and 21-day-old rats. Culture of lens epithelia with RCM resulted in the formation of multilayers of elongated fibres and the accumulation of alpha and beta-crystallins. The patterns of crystallin accumulation were essentially similar whether expressed as microgram crystallin per explant, or crystallin per DNA (ng per ng). alpha- and beta-Crystallins accumulated rapidly in explants after 2 days of culture in RCM, whereas explants grown in control medium showed no change in the crystallin levels from day 0 to day 10. Patterns of alpha- and beta-crystallin accumulation showed that there were no significant differences between the ability of lens epithelia from 3-day-, 10-day or 21-day-old rats to undergo fibre differentiation in response to RCM. Therefore we conclude that the inductive interaction between lens and neural retina is not restricted to embryonic or neonatal stages, but continues on throughout life maintaining normal patterns of fibre differentiation in the lens. PMID- 3817024 TI - A critical maturation period in neonatal-rat-lens development. AB - The transition of the immature lens to the mature lens was investigated in the Sprague-Dawley rat during the neonatal period which extends for 21 days after birth. The lens of the newborn rat consists of uniformly hydrated cortical and primary fiber cells while the mature lens is characterized by the presence of a nucleus which has a lower water content relative to the surrounding cortex. Our studies reveal that a critical maturation period occurs between days 12-16. In this investigation, the period is defined by the following physiological and anatomical alterations: A significant decline in the rate of lens wet weight growth occurs between days 12-16. However, the growth in dry weight is linear throughout the neonatal period. There is a significant decline in lens percentage water during this 12-16-day period. The loss in lens water is primarily from the intracellular compartment since the lens extracellular space is constant throughout the neonatal period. Lens anterior-posterior and equatorial dimensions exhibit a zero growth rate between days 14-16 and 12-14, respectively. The permeability of lens extracellular space declines significantly during the critical maturation period as determined by Procion Yellow, an extracellular marker. The significant decline in lens percentage water and the decline in the depth of penetration of Procion Yellow to the lens interior during the critical maturation period is related to the transition of an immature to a mature lens. PMID- 3817025 TI - In vitro damage to rat lens by xanthine-xanthine oxidase: protection by ascorbate. AB - The potential of ascorbic acid acting against the toxic effects of active oxygen species on the lens has been studied. The active species of oxygen were generated by the action of xanthine oxidase on xanthine. Rat lenses incubated in medium containing xanthine and xanthine oxidase were physiologically damaged, as evidenced by the decrease in the ability of the tissue to accumulate rubidium or alpha-aminoisobutyric acid against a concentration gradient. The pressure of ascorbate in the medium protected against the tissue damage. One of the functions of high ascorbate in the aqueous humor of many primates including human beings may, therefore, be to protect the lens and other surrounding tissues against the toxic effects of active oxygen derivatives produced in situ under ambient, as well as under photochemical, conditions. PMID- 3817026 TI - Some effects of phagocytosis on bovine meshwork cells in culture. AB - In this tissue-culture study, some effects of phagocytosis on the cell were investigated. Third-passage bovine trabecular-meshwork cells were incubated with latex microspheres for periods of up to 60 hr. Cells which had been involved in phagocytosis were found to settle at a faster rate than control cells, but if microspheres were added to the medium of recently settled cells, there was a reduction in their proliferative activity. Incorporation of tritiated proline remained unchanged, whereas uptake of tritiated glucosamine increased with the time period of phagocytosis. The fibronectin scaffold was more extensive and elaborate when cells were pre-incubated with microspheres before settlement. Exposure to a low concentration of microspheres promoted a higher uptake of a second presentation of 125I-labelled microspheres--an effect which was not seen if the original dose was too high. PMID- 3817027 TI - Patterns of crystallin expression during differentiation in vitro of several chick genotypes with different effects on lens cell growth rate. AB - We have recently reported that chick lens cells during differentiation in long term culture show a programme of change in crystallin expression which mimics events during lens development in vivo. The aim of the present work was to examine the stability of the programme by testing the response to genetic influences and exposure to a carcinogen. Five genetically distinct inbred strains of chick, differing in the intrinsic growth rates of lens epithelial cells in vitro, were used to study the effects of the rate of mitosis on crystallin expression, both during lens development and in long-term cell culture. The time of appearance of lentoids, their size and abundance and the rate of change in crystallin expression were all modified in a genotype-specific way, related to the rate of mitosis, but the programme of changes in crystallin expression was the same for all genotypes. Genetic differences were also found in the patterns of response to treatment of cultures during the logarithmic growth phase with a nitrosoguanidine compound known to affect cell differentiation in lens cultures and several other systems. The changes in crystallin expression and fibre differentiation were delayed, but cultures of the faster growing genotypes were least affected. With further culture, crystallin expression tended to recover to control values although levels of fibre differentiation and cell growth remained depressed. The results indicate that genetic differences in intrinsic growth rate moderate but do not change the programme of crystallin expression shown by lens epithelial cells in culture, and that this programme shows resistance to change. PMID- 3817028 TI - A comparison of membrane potentials, sodium and calcium levels in normal and cataractous human lenses. PMID- 3817029 TI - The concentration-dependent aggregation of calf and human crystallins. PMID- 3817030 TI - Laser-induced glaucoma in rabbits. AB - Argon laser energy was applied to the trabecular meshwork of pigmented rabbits in an attempt to develop an animal model of 'glaucoma'. Laser energy was varied to determine the optimal level needed to produce sustained ocular hypertension. An initial response of ocular hypertension followed by hypotension was observed in all of the animals tested. Approximately half of the laser-treated rabbits developed a secondary buphthalmus and sustained ocular hypertension. In these animals outflow facility was decreased by approximately 60%. Histologic examination at 4- and 8 weeks after laser treatment demonstrated a wound-healing response resulting in closure of the intertrabecular spaces and obstruction of outflow to injected carbon particles. Optic nerve cupping and a loss of ganglion cells were also observed. Topical application of L-timolol (0.5%), pilocarpine (2.0%) and forskolin (1.0%) were found to be effective in decreasing intraocular pressure in the laser-treated, hypertensive eye with no significant effect in control non-laser-treated eyes, suggesting that this model can be a useful tool for screening potential antiglaucoma medications. PMID- 3817031 TI - Effect of vitamin E on glutathione content in red blood cells, aqueous humor and lens of humans and other species. AB - High doses of orally administered vitamin E have been given to humans, rabbits and rats. Placebo has been given to control groups. At the end of the treatment period, enhanced levels of reduced glutathione (GSH) were found in the red blood cells (humans and rabbits), aqueous humor (humans and rabbits) and lens (rabbits and rats) of treated subjects and animals. The percentage of GSH converted to oxidized glutathione (GSSG) was the same in both vitamin E-supplied and control groups. The GSSG--GSH ratio remained unchanged. The plasma levels of vitamin E were significantly higher in treated than in control subjects and animals. At the end of the study, the levels of vitamin E in aqueous humor and lens of rabbit were the same in animals which received vitamin E and in animals which received placebo. Lastly, vitamin E administration did not influence ascorbic-acid levels in plasma (humans and rabbits), aqueous humor, lens and vitreous body (rabbits). PMID- 3817032 TI - Photostasis: regulation of daily photon-catch by rat retinas in response to various cyclic illuminances. AB - Albino rats were born and raised in 12 hr light: 12 hr dark regimes of illuminances varying from 3- to 800 lx. At 15 weeks of age, the animals were killed and determinations were made of the following: dark-adapted and steady state rhodopsin levels; rod outer-segment length and photoreceptor-cell density; retinal topography of rhodopsin absorbance, and regeneration rate of visual pigment in vivo. It was found that there is a four-fold drop in the dark-adapted rhodopsin level of animals raised in 400-lx cyclic light compared with those raised in 3 lx. This difference can be accounted for by differences in rod outer segment length and transverse absorbance of frozen retinal sections. Further, this change in rhodopsin content, coupled with variations in the visual pigment regeneration rate, allows the rat to control the amount of pigment in its retina at steady-state bleach. In this way, the rat can regulate the number of photons its retina catches each day. Animals raised in cyclic illuminances differing by more than two orders of magnitude catch very nearly equal number of photons (1.10 +/- 0.2 X 10(16) per eye) during the light period. A reduction in the number of photoreceptor cells also occurs with increasing illuminance, and these changes are more pronounced in the inferior region of the retina. This is not typical of the type of light-induced retinal damage caused by acute exposures. PMID- 3817033 TI - Solubilization of the lens water-insoluble fraction by sonication. AB - A method is reported whereby the solubilization of the bulk of the lens water insoluble fraction is accomplished by a short sonication of the suspended proteins in low salt buffers. This procedure solubilized greater than 90% of a bovine lens water-insoluble fraction and 80% of the normal human lens water insoluble fraction. Decreased protein was solubilized from cataractous lenses, but in every case sonication was at least equivalent to extraction with 6.0 M urea. Fractionation of the solubilized proteins by Agarose A-1.5 m gel filtration chromatography showed native molecular weights for bovine lens, but only partial disaggregation with human lens extracts. A sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) comparison of the proteins solubilized by sonication and 6.0 M urea extraction showed no major differences except that sonication solubilized more of the highly cross-linked protein which remained at the top of the gel. PMID- 3817034 TI - Bendazac prevents cyanate binding to soluble lens proteins and cyanate-induced phase-separation opacities in vitro: a possible mechanism by which bendazac could delay cataract. AB - The reaction of lens proteins with cyanate (carbamylation) causes many changes seen in human cataract including disruption of the protein conformations. Bendazac, a putative anti-cataract drug, decreases the binding of cyanate to lens proteins and prevents the cyanate-induced elevation of the phase separation temperature in incubated rat lenses. Its major metabolite, 5-hydroxybendazac, also inhibits the binding of cyanate to lens proteins even when it is present only during a pre-incubation period. The metabolite is more effective than the parent compound. PMID- 3817035 TI - 2-Substituted 1, 3, 4-thiadiazole-5-sulfonamides as carbonic anhydrase inhibitors: their effects on the transepithelial potential difference of the isolated rabbit ciliary body and on the intraocular pressure of the living rabbit eye. AB - In order to understand the pharmacology of carbonic anhydrase inhibitors in reduction of aqueous secretion, three sorts of studies were conducted using five 2-substituted 1, 3, 4-thiadiazole-5-sulfonamides: an inhibition study of carbonic anhydrase II, electrical measurements of the isolated ciliary body, and pharmacological study on intraocular pressure of living animals. The inhibitors of carbonic anhydrase employed here were 2-amino-1, 3, 4-thiadiazole-5 sulfonamide; 2-methylamino-1, 3, 4-thiadiazole-5-sulfonamide; 2-formylamino-1, 3, 4-thiadiazole-5-sulfonamide; 2-acetylamino-1, 3, 4-thiadiazole-5-sulfonamide (acetazolamide); and 2-propionylamino-1, 3, 4-thiadiazole-5-sulfonamide. All of these compounds showed significant inhibitory activity to carbonic anhydrase II which exists in the ciliary epithelium, but their potencies of inhibition varied relative to one another (I50S were 1.91 X 10(-7) to 3.3 X 10(-8) M). The effects of the five compounds on electrical phenomena were observed using isolated rabbit ciliary body mounted on an Ussing's chamber. Each compound decreased the negative electrical potential of the tissue (-0.70 mV as the average of the initial values) by 10- to 33%, and this effect was proportional to its inhibitory activity to carbonic anhydrase II. The effects of the five compounds on intraocular pressure were determined, and each compound decreased the intraocular pressure (18 mmHg as the average of the initial values) by 7- to 32%. This effect was also proportional to the inhibitory activity to the enzyme. Correlation between the two effects was studied, and good correlation was observed. This implies that both effects have a common basis which relates to the physiological role of carbonic anhydrase. The present study, therefore, shows the importance of the bicarbonate ion in the aqueous humor formation since it is both substrate and product of carbonic anhydrase II. PMID- 3817036 TI - Purification and properties of rat lens methionine adenosyltransferase. AB - Methionine adenosyltransferase (MAT) has been partially purified from rat lenses using a combination of ammonium sulfate fractionation and hydrophobic chromatography on phenyl Sepharose columns. The partially purified enzyme resembles purified Type II MAT from non-hepatic tissues. The Km for methionine is 3.0 microM, and the Km for ATP is 80 microM. The enzyme is activated by potassium ions (25-50 mM), and inhibited by higher concentrations of potassium. A divalent cation (magnesium or manganese) is essential for activity. The Vmax with magnesium is about five times higher than with manganese, but the optimal manganese concentration is around 2.0 mM, compared with 10-20 mM for magnesium. The enzyme is active over a broad pH range, with optimal activity between pH 7.0 and 8.0. The enzyme is inhibited by all three of its products, phosphate, pyrophosphate, and S-adenosylmethionine. Individually phosphate and pyrophosphate are weak inhibitors, but in combination they show a marked synergistic inhibitory effect. Tripolyphosphate is also an effective inhibitor. The inhibition of the enzyme by the cataractogenic agent, dimethylsulfoxide, further confirmed the similarity to Type II MAT. PMID- 3817037 TI - The biomedical challenge of the next half century. The search for new knowledge of the aging process and its associated disease. PMID- 3817038 TI - Impaired conversion of rat uterine estradiol receptors during aging. AB - We have examined the effects of aging on the capacity of rat uterine estradiol receptors to be transformed from 8S to 4S and 5S species. Cytosol receptors from mature (6-month-old) rats or senescent (24-month-old) rats have been exposed to various KCl concentrations, ammonium sulfate precipitation and 25 degrees C heating. Estradiol receptors of both the mature and senescent age groups exist in an 8S form on linear 5-20% sucrose gradients in the absence of KCl and are converted to a 4S molecule in the presence of 0.4 M KCl. At intermediate salt concentrations a greater portion of mature receptors was converted to the 4S species. At 0.15 M KCl 62.3% +/- 2.8 of the mature receptors are converted to 4S versus 41% +/- 1.9 of the senescent receptors, and at 0.2 M KCl 79.6% +/- 3.2 of the mature receptors are converted to the 4S versus 58.2% +/- 2.1 of the senescent. Ammonium sulfate treatment in the presence of 0.3 M KCl converted about 80% of the receptors from the 4S to the 5S form, while only about half of the old receptors are affected. When ammonium sulfate precipitates were heated to 25 degrees C all to mature receptors were converted to the 5S species, while only two thirds of the senescent receptors were sedimented at 5S under the same conditions. Inclusion of 20 mM molybdate during preparation blocks conversion of about 15% of the senescent receptors from the 8S to the 4S form but does not affect the mature preparations. Similarly, molybdate treatment does not affect the conversion of the mature estradiol receptors to the 5S form but increases the percentage of senescent receptors remaining in the 4S form from 30 to 45%. Such qualitative differences in receptor conversion may be related to age associated deterioration of estradiol stimulated uterine responsiveness. PMID- 3817039 TI - A colloid osmotic model of macromolecular aggregation to explain tissue water loss in aging. AB - We have evolved from the sea, are composed mostly of water, the medium and solvent wherein most vital processes occur, and phylogenetically and ontogenetically lose water continually as we age. An embryo is about 90% water, a newborn child about 80% water, a mature adult about 70% water, an older adult about 60% water with recent work indicating that in senescence the percentage of body water is actually below 60%. The mechanisms of the water loss in aging have not been elucidated. From a theoretical point of view, there is good reason to believe that there may be profound changes in the chemical potential of intracellular and interstitial water with age due to increased macromolecular interaction or aggregation from cross linking, polymerization, insolubility, etc.; all of which are known to increase with aging. The resultant increased macromolecular solute-solute interaction would be accompanied by decreased macromolecular solute-solvent interaction, thereby causing a higher solvent (water) chemical potential. This would facilitate the loss of bound water, thereby explaining the observed losses in body water with age. The ocular lens is a microcosm of aging, in that from its nucleus to cortex, the oldest to youngest cells are concentrically arranged, as in a tree. We have developed a method to directly measure lens tissue oncotic pressure in an attempt to experimentally test the above cited hypothesis. PMID- 3817040 TI - Aging as entropy. AB - Like the weather, many people talk about aging, but no one seems able to do anything about it. This implacability derives, at least in part, from our inability to provide a conceptual base from which analytic insight might derive. The emerging field of nonlinear thermodynamics presents a new view of the universe. It relates matter and energy in the framework of time. Entropy, "time's arrow," gives direction. Energy, rendered coherent through the metabolism of biology, acts to retard dissipation as entropy. For physicians, particularly those interested in geriatrics, this provides the challenge to understand how these forces are inscribed onto the human condition. The homeostatic controls which order our existence are energy dependent. As energies diminish, homeostasis as order deteriorates, aging proceeds and life is threatened. It seems to follow that if we are to diminish the entropic declines of aging our clinical strategies should emphasize actions which might retard the disruption of ordering processes. Homeostasis is at risk to the ravages of disease. This has been the standard business of medicine. But homeostasis is manifestly determined by the ordering effects of an energy flow. Either too little energy flow as disuse, or too much, as stress, lends further major burden to homeostatic controls. Every body system, at every level of organization, is beholden to this mandate. As our wisdom stretches to encompass the notion that aging and illness have other dimensions than just disease our view of ourselves will become more whole and in enlarging consonance with universal law. PMID- 3817041 TI - Factors affecting attrition in the Baltimore Longitudinal Study of Aging. AB - In a longitudinal study of aging, the influence on attrition of age, marital status, education, occupation, distance between a subject's residence and study center, self-health and financial assessment, and method of recruitment was examined. Prospective, follow-up information on the subsequent active/dropout and alive/dead status on the 1088 subjects, who joined the Baltimore Longitudinal Study of Aging during the first twenty years (1958-1977), were studied using a proportional hazards model. Three analyses, each controlling for death in a different manner, produced similar results. The analysis indicates that age, education and distance have the strongest association with attrition (p less than 0.001), while self-health assessment has a lesser association (p less than 0.05). The lowest risk in age, for example, occurs in 40-49.9 year olds with subjects less than 30 having an increased risk of 91% and subjects 70 or older having an increased risk of 189%. Examination of attrition probabilities show that subjects living 500 or more miles from study center, ages 70 and older, with less than bachelors degree, and perceiving their health as average or below have the greatest probability of dropping out-approximately 3-fold greater than the average subject's probability. PMID- 3817042 TI - The comparability of longitudinal studies and the role of clinical trials in normal aging research. PMID- 3817043 TI - Postural changes in cardiac volumes in men in relation to adult age. AB - Cardiac volumes by equilibrium gated cardiac blood pool scans and heart rate were measured in the supine and sitting positions in 64 male volunteer subjects (age 25-80 yrs) who had been rigorously screened to exclude cardiovascular disease. After the upright position was assumed, the average cardiac output of all subjects was unchanged but heart rate increased and stroke volume decreased due to a decrease in end diastolic volume. Neither the supine or sitting cardiac output nor the average postural change in cardiac output, cardiac volumes or heart rate was age-related. While the average cardiac output among the subjects was unaltered with a change in posture, in some individuals it increased slightly while in others it decreased. The postural change in cardiac output among the individuals correlated by linear regression analysis with a change in heart rate only in younger subjects and with a change in stroke volume in all age groups, but the slope of this relationship was greater in older than in younger subjects. The postural change in stroke volume was strongly correlated with a change in end diastolic volume and this relationship did not vary with age. Thus, although the average postural change in cardiac output among healthy subjects is not age related, a given change in cardiac output with posture in an older individual depends more on a change in stroke volume and less on a heart rate change than in a younger one. This result, like the response to vigorous upright exercise previously demonstrated to occur with aging, indicates a greater reliance in the elderly on the Frank-Starling mechanism than on heart rate for a given change in cardiac output in response to perturbations from the basal supine state. PMID- 3817044 TI - Urinary diluting capacity in elderly diabetic subjects. AB - Urinary concentrating ability declines with normal human aging but diluting capacity has been less well studied as a function of age. We studied free water clearance (CH2O) in a group of Type II diabetic patients, aged 47 to 70 years. Conventional water load testing in sulfonylurea-treated diabetic patients revealed preservation of diluting capacity (ability to achieve Uosm less than 100 mOsm/kg) in subjects greater than 60 years of age. Tolazamide permitted expression of normal CH2O; chlorpropamide administration predictably reduced CH2O relative to tolazamide by 58% in subjects greater than 60 years. Free water clearance (CH2O) and glomerular filtration rate (GFR) were comparable in elderly subjects (greater than 60 years) and those less than or equal to 60 years. Normal CH2O in these diabetic patients was explained by persistently normal GFR in the study group. Osmolar clearance (Cosm) was insignificantly lower in diabetics greater than 60 years. Thus, a fall in CH2O in elderly diabetic patients is not a factor contributing to clinical hypoosmolar states encountered in this population. PMID- 3817045 TI - Survey research guiding public policy making in Maryland: the case of Alzheimer's disease and related disorders. AB - The Maryland Governor's Task Force on Alzheimer's Disease and Related Disorders conducted a comprehensive 18-month assessment of the extent of dementing illness in Maryland, the needs of Maryland dementia victims and their families, and the availability of resources to meet these needs. A major tool in this assessment was a series of 16 specially designed surveys which were sent to physicians, family caregivers, nursing homes, geriatric aide training programs, and other populations. The survey findings, along with hearing testimony, provided the basis for the Task Force's 18 principal and 35 further recommendations, published in the Maryland Report on Alzheimer's Disease and Related Disorders (Governor's Task Force, 1985). These recommendations have become the basis of public policy discussion for services to dementia victims and their families in Maryland. PMID- 3817046 TI - Effects of age, hypertension history, and neuroticism on health perceptions. AB - The effects of measured blood pressure, history of hypertension diagnosis, age, and neuroticism on number of somatic complaints and self-rated health were examined in a sample of 970 non-health-care-seeking adult men and women. Significant differences in number of somatic complaints and self-rated health were found due to age, neuroticism, and history of hypertension diagnosis. Measured blood pressure, however, was unrelated to both measures of health perception. With the exception of the effect of neuroticism on somatic complaints, the effects of the independent variables on health perceptions were rather small in magnitude and explained only small proportions of the variance. Age differences had a particularly weak effect on health perceptions, accounting for less variance than either neuroticism or history of hypertension diagnosis. A significant interaction of neuroticism with awareness of hypertension was found, but only for number of somatic complaints. These results suggest that health perception is a complex, multidimensional construct. The relatively weak influence of hypertension diagnosis on health perception may account for the difficulties in maintaining patient compliance with antihypertensive treatment. PMID- 3817047 TI - Hemopoietic progenitor cells are sensitive to the cytostatic effect of pyruvate. AB - The addition of certain oxidizable substrates (such as pyruvate and oxalacetate) produced a marked diminution of the number of colonies formed in vitro by mouse bone marrow cells (BMC) stimulated by spleen cell-conditioned medium (SCM). Pyruvate apparently exerted an all-or-none inhibition on colony forming cells (CFCs), affecting neither the size nor morphology of detectable colonies, which were essentially composed of immature cells, neutrophils, and monocytes macrophages. Pyruvate furthermore reduced BMC proliferation in SCM-stimulated liquid cultures, apparently without modifying the cell population's morphological profile. The effects of pyruvate on hemopoietic progenitor cells were further studied by replating aliquots of BMC liquid cultures with or without pyruvate into agar medium devoid of this substrate. Pyruvate did not interfere with the increase in CFC number observed in the controls during the first few days of incubation, indicating that CFC generation is not inhibited by this substrate. However, the plating efficiency of CFCs recovered from liquid cultures with or without pyruvate was strongly inhibited when these cells were seeded into pyruvate-containing agar plates, thus supporting the theory that CFCs generated in vitro in both conditions have the same sensitivity to pyruvate as those originally present in bone marrow. On the whole, our results indicated that the pyruvate cytostatic effect is a metabolic feature distinguishing CFCs from their progenitors. These differences are discussed in the light of the explanation advanced for the pyruvate cytostatic effect in other cell systems. PMID- 3817048 TI - Changes in expression of major histocompatibility complex (MHC) class-I antigen on hematopoietic progenitors during murine development. AB - Changes in the expression of H-2K antigen on murine hematopoietic progenitors (CFU-E, BFU-E, CFU-C and CFU-mix) were examined during murine development using the complement-dependent cytotoxicity assay. The results revealed that CFU-mix, BFU-E, and CFU-E had begun to express H-2K antigen as early as day 16 of gestation, and antigens increased sequentially thereafter. On the other hand, CFU C expression began as late as days 12-15 after birth and the antigen increased rapidly until week 8 after birth. Expression of H-2K antigen on CFU-mix was higher than that on CFU-E and BFU-E, while that on CFU-C was lowest during the period between day 16 of gestation and days 12-15 after birth. The possibility of an indirect effect of antibodies on T cells was unlikely because thymocytes added to week-8 bone marrow cells after antibody treatment did not produce a significantly different effect on the culture. PMID- 3817049 TI - Expression of a selectable gene transferred by a retroviral vector to hematopoietic stem cells and stromal cells in murine continuous bone marrow cultures. AB - Retroviral-mediated gene transfer to multipotent and committed hematopoietic stem cells and marrow stromal cells was evaluated in long-term bone marrow cultures (LTBMCs). The retroviral vector pZIP-Neo(SV)(X) carrying the bacterial neomycin resistance (neor) gene that confers resistance to the neomycin analog G418 in mammalian cells was packaged in a Moloney envelope either as a replication competent or replication-defective virus. Virus was introduced by infection of long-term marrow cultures at day 7. During a period of 12 weeks in culture, 10% 50% of harvested hematopoietic progenitor cells that formed differentiated CFU GEMM colonies in response to pokeweed mitogen-containing spleen cell-conditioned medium (SCCM) and erythropoietin expressed the neor gene. In contrast, 1%-10% of hematopoietic progenitor cells that formed colonies in agar in response to WEHI 3B- or L-cell-conditioned medium expressed resistance to G418. The percentage of resistant progenitors was not detectably enhanced when replication-competent Moloney murine leukemia virus (M-MuLV) was present as helper virus, even though M MuLV infected greater than 90% of cells in the long-term marrow cultures. In a separate CFU-F assay, 12%-17% of the adherent stromal cells in LTBMCs were found to express the neor gene. Thus gene transfer is limited by the fraction of progenitor cells that can integrate and express the transferred genetic sequences, rather than by the fraction of cells that are initially infected by the vector. PMID- 3817050 TI - Triglyceride synthesis by human bone marrow fibroblasts. AB - An increase in triglyceride synthesis has been observed in cultures of human bone marrow fibroblasts after the cells reach confluence. The addition of hydrocortisone further enhances triglyceride synthesis. Conditioned medium from confluent cultures also stimulates adipogenesis, probably mediated by a factor released through a hydrocortisone-dependent process. Subcultures derived from confluent cultures grown in the presence of hydrocortisone show a decrease in replicative capacity, as measured by DNA synthesis. This effect may represent the onset of a more differentiated phenotype, which seems to correspond to a cell showing a buoyant density of 1.052 g/ml and a high rate of triglyceride synthesis. PMID- 3817051 TI - Purification of murine bone-marrow-derived granulocyte-macrophage colony-forming cells. AB - Previous attempts to purify progenitor cells that form colonies and clusters of granulocytes and/or macrophages (CFU-GM) from adult murine bone marrow have had limited success because of the paucity of these cells. In the present paper we report studies with a rapid, reproducible method involving pretreatment of mice, three days prior to sacrifice, with 200 mg/kg of Cytoxan (cyclophosphamide), density separation on Ficoll-Hypaque, and counterflow centrifugal elutriation, that yielded highly enriched populations of CFU-GM. The peak CFU-GM-containing fraction (FR-28) eluted at a flow rate of 28 ml/min and contained very little contamination by other in vitro colony-forming cells (BFU-E, CFU-GEMM, CFU-MK). FR-28 contained 0.54% +/- 0.30% (16 experiments) of the unfractionated post Cytoxan bone marrow nucleated cells and lacked significant contamination by lymphocytes and monocytes. The mean CFU-GM cloning efficiency of FR-28 was 44% +/ 9% in agar (11 experiments) and 75% +/- 10% in agarose (nine experiments). CFU GM from FR-28 demonstrated linear plating characteristics even at very low cell density (25 cells), and formed colonies and clusters of granulocytes, macrophages, or both in the same proportions as did unfractionated post-Cytoxan or untreated bone marrow. Approximately 10% (assuming a seeding efficiency of 10%) of FR-28 cells were in vivo spleen colony-forming cells (CFU-S) measured at day 12. These results represent the highest degree of purity (up to 94%) of CFU GM thus far reported and should prove useful in studies of this cell population. PMID- 3817052 TI - New monoclonal antibody enzymoassay for the specific measurement of placental ferritin isotype in hematologic malignancies. AB - A new enzymoimmunoassay, specific for the measurement of placental ferritin (PLF) isotype, has been described. Two monoclonal antibodies (McAbs) with different binding specificities to placental ferritin have been used in this assay. One antibody (CM-G-8) binds to all ferritins, whereas the second (CM-H-9) binds to placental ferritin only. In addition, a second enzymoassay was developed for the measurement of total common serum ferritin using CM-G-8 McAb. Serum levels of total ferritin and PLF were measured in healthy individuals and in patients with lymphoproliferative diseases and multiple myeloma. The majority of normal subjects were deficient in PLF in the serum. Increased serum levels of PLF were observed in patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma of low and intermediate grades, as well as in patients with acute lymphocytic leukemia (ALL). Total ferritin was also elevated in these patients. Chronic lymphocytic leukemia (CLL) and multiple myeloma patients exhibited normal levels of common serum ferritin, whereas PLF in the serum was lacking. PMID- 3817053 TI - In vitro reappearance of myeloid progenitors killed by mafosfamide. AB - Cyclophosphamide derivatives active in vitro, such as mafosfamide, are potentially capable of reducing the number of leukemic cells remaining in marrow explanted for autografting. Although this treatment kills nearly all the committed hemopoietic progenitors, it does not prevent the reinstatement of hemopoiesis after chemoradiotherapy. This points to the persistence of more immature hemopoietic progenitors not detectable with current semi-solid culture techniques and resistant to cytotoxic treatment. Treatment of normal marrow with 80-140 micrograms/ml mafosfamide is followed in medium-term cultures by a gradual and dose-dependent reduction in total cellularity, whereas granulomonocyte progenitors (CFU-GM), virtually absent at the start of the culture, progressively reappear. The quantity of progenitors present after day 14 in liquid culture is, however, less in the treated marrows than in the controls, and the reappearance of CFU-GM is inversely related to the mafosfamide dose. In addition, the recovery of the more immature (day-14) CFU-GM is greater than that of the more mature (day 7) CFU-GM. PMID- 3817054 TI - Evidence for a multistep pathogenesis in the generation of tumorigenic cell lines from hemopoietic colonies exposed to Abelson virus in vitro. AB - The present studies were undertaken to investigate the ability of Abelson murine leukemia virus (A-MuLV) to transform cells derived in vitro from pluripotent hemopoietic progenitor cells of high proliferative potential. We now report that continuously growing, autonomous cell lines could be obtained from a high proportion of individually infected multilineage colonies generated in assays of spleen cells from normal adult mice if the infected cells were cocultivated for the first two to three months with irradiated NIH-3T3 cells. No lines were obtained if the 3T3 cell feeders were not initially present. Similar results were obtained when the cells exposed to virus were from multilineage colonies originating from isolated single cells obtained by replating small blast colonies. Characterization of the transformants and a number of derivative cloned sublines revealed the consistent presence of a mast cell phenotype, with some suggestion of macrophage differentiation in a few cases. All cell lines tested produced virus, showed a variable pattern of A-MuLV integration, and gave rise directly to tumors when injected subcutaneously, as shown by both Southern analysis and cytogenetic studies. The early absolute but transient dependence of these A-MuLV mast cell transformants on a fibroblast feeder suggests a multistep process in their evolution, in which the acquisition of autonomy from factors of mesenchymal cell origin may play an important role. PMID- 3817055 TI - Tobacco: doctors and the pandemic. PMID- 3817056 TI - Smoking and giving of patient information by chest physicians. AB - A survey of the 115 members of the Norwegian Thoracic Society with a response rate of 94% yielded 17% smokers. Almost half of the smokers were cigar smokers only. Smoking was less prevalent among the younger physicians. All 83 physicians who answered the questionnaire recorded the smoking habits of their patients, and 99% of the doctors gave information to patients on the health hazards of smoking. However, only 22% of the physicians devoted more than 5 min to this work at each consultation. Physicians who were ex-smokers repeated questions on smoking habits and more often gave patients advice on drug treatment than non-smoking physicians. PMID- 3817057 TI - Clinical efficacy of aspirin in "desensitised" aspirin-sensitive asthmatics. AB - The effect of daily aspirin (ASA) administration after "desensitisation" was studied in 16 aspirin-sensitive asthmatics. Fourteen patients completed the trial; 12 of them also had perennial rhinitis and eight in addition suffered from chronic headache. During 4 weeks of daily treatment with 600 mg of ASA a marked reduction of the nasal symptoms score was noticed in 8/12 patients and head pain score was significantly decreased in 6/8 patients when compared with the 4-week non-ASA period. Daily aspirin resulted in decreases in both the mean asthma score and in daily beta-agonist usage in 7/14 patients, and 10/13 patients showed a decrease in bronchial responsiveness to inhaled histamine (geometric mean of provocative concentration of histamine 1.8 and 5.8 mg/ml, respectively. In four patients we noticed untoward epigastric symptoms. A decrease in thrombocyte counts was observed during ASA treatment. Our study suggests that daily aspirin administration after "desensitisation" may be helpful in the management of some ASA-sensitive asthmatics. PMID- 3817058 TI - Human alveolar macrophage subpopulations isolated on discontinuous albumin gradients: functional data in normals and sarcoid patients. AB - Cells recovered by bronchoalveolar lavage from seven normals and seven sarcoid patients were centrifuged on discontinuous bovine albumin (BSA) gradients to study alveolar macrophage (AM) heterogeneity. The gradient was made with nine BSA concentrations from 8 to 30%. After centrifugation, the cells were recovered from the nine interfaces, named a to i. The majority of the AM was recovered from layers b to g. Regulatory activity of AM subpopulations was tested on mitogen induced blood mononuclear cells (BMC) proliferation: autologous BMC were cocultured with AM from the different layers; 16-h culture supernatants of AM subfractions were added to allogeneic BMC cultures from normal donors. In the autologous assay, AM from the middle layers exhibited a stimulatory activity in normals and even more in sarcoid patients, while AM from the upper layers showed an inhibitory activity in normals but a stimulatory activity in sarcoid patients. In the allogeneic assay, a suppressive effect was found in culture supernatants from normal AM. On the other hand, in sarcoid patients, culture supernatants were less inhibiting, but the inhibitory activity was in both cases maximal in b. These results confirm functional heterogeneity of human AM, and demonstrate that the AM subpopulations differ between normals and sarcoid patients. PMID- 3817059 TI - Evaluation of antileukoprotease in surgical lung specimens. AB - To evaluate the presence of antileukoprotease in the lung and its possible contribution to parenchymal protection, surgically removed lungs or lobes of 41 patients were studied. Tissue slices were stained immunohistochemically for antileukoprotease. Site and number of antileukoprotease-containing cells were recorded. To measure emphysema, the mean linear intercept of each slice was determined. Antileukoprotease was observed in bronchial epithelium and glands and in at least two types of nonciliated cells and in a few basal cells of bronchiolar epithelium. No relationship existed between the frequency of antileukoprotease positive cells in membranous bronchioles and the mean linear intercept, the smoking history or lung function except for total lung capacity. These results do not support a protective activity of antileukoprotease against emphysema, but neither do they provide evidence against it. PMID- 3817061 TI - Pulmonary haemodynamic response to two-stage exercise in patients with chronic bronchitis. AB - The pressure/flow relationship in the pulmonary circulation has been studied in 43 patients with chronic bronchitis, at rest (R) and during exercise at two levels: 30 or 40 W (E1), and 60 or 80 W (E2), without interruption. For the entire group, pulmonary vascular resistance was 142 +/- 70 dyn X s X cm-5 at rest, 131 +/- 55 at the first exercise level and 118 +/- 60 at the second level. Individual changes were variable, however; a "linearity index" was computed as delta(PPA-PW)/delta Q from the first to the second exercise level divided by the same value from rest to the first exercise level. This index was below 0.75 in 27 patients (i.e. the pressure/flow slope was lower for the second exercise level and the pressure/flow curve was concave to the flow axis), it was above 1.25 in nine patients (i.e. the slope increased with exercise and the pressure/flow curve was convex to the flow axis), and the pressure/flow relationship was close to rectilinear in seven patients. Functional disturbances were mild in these subjects, and in the majority of them pulmonary vascular resistance did not increase with exercise. PMID- 3817060 TI - Adult respiratory distress syndrome: evidence of early fibrogenesis and absence of glucocorticoid receptors. AB - In five lung biopsies from patients who developed the clinical picture of Adult Respiratory Distress Syndrome (ARDS) after cardiopulmonary bypass the pulmonary alterations were studied morphologically and glucocorticoid receptors determined. The time between cardiac surgery and pulmonary biopsy was 4-7 days. The results showed severe pulmonary lesions, with marked endothelial damage and active collagen secretion in the pulmonary interstitium, along the capillary bed. The glucocorticoid receptor level of the lungs with ARDS was 4.7 +/- 7.04 fmol/mg protein (control 4.28 +/- 4.32 fmol/mg protein). The results indicate that the process of collagen secretion may begin in the early phase of ARDS and that the benefits of glucocorticoid therapy in the management of ARDS should be reassessed. PMID- 3817062 TI - Chylothorax in adult age in association with congenital lymphedema. PMID- 3817063 TI - Behcet syndrome: a rare case of pulmonary involvement. PMID- 3817064 TI - Mucus secretion by tracheas of ferret and dog. AB - Mucus secretion, stimulated by nerve excitation or drugs, was measured from the ferret trachea in vitro by two methods: from the whole trachea, and compared with the volume of submucosal glands estimated from histological sections; and from mounted segments of trachea, by displacement of tantalum dust applied to the epithelium and compared with changes in tissue volume estimated by probing the epithelial surface between hillocks. Maximal secretion rates (2-3 microliters X min-1 X cm-2) with tracheal segments were 5-6 times greater per unit area than those with the whole trachea. During secretion the tissue shrank by a volume close to that of the secretion. Similar experiments with the hillock method and dog trachea in vivo gave variable results. Although the ferret submucosal glands can secrete 0.7-5.4 times their volume per minute, any change in tracheal resistance to airflow would be rather small. PMID- 3817065 TI - Combined asthma and alveolitis induced by cobalt in a diamond polisher. AB - A diamond polisher presented with a history of dyspnea, chest tightness, chills and weight loss related to exposure to diamond cobalt disks at work. Pulmonary function showed slightly reduced lung volumes, low normal diffusing capacity and a moderate bronchial hyperresponsiveness to histamine. Chest X-ray and cell count in bronchoalveolar lavage fluid were normal. After 3 months of non-exposure, a bronchial cobalt challenge test caused an immediate decrease in specific airway conductance and in vital capacity (VC) but not in FEV1/VC. After 6 h, chills, fever, tachycardia and crackles appeared along with moderate reductions in lung volumes. After 24 h, the bronchoalveolar lavage fluid showed 43% granulocytes, and there was a marked increase in bronchial hyperresponsiveness to histamine. These changes are interpreted as combined asthma and alveolitis induced by cobalt. PMID- 3817066 TI - Young's syndrome. PMID- 3817067 TI - Attacks of dyspnoea in a patient with keratoconjunctivitis sicca. PMID- 3817069 TI - Interaction between isoniazid and theophylline. AB - Metabolic interactions between theophylline and several other drugs have been described in a number of studies. They may be of importance because of the narrow therapeutic range of theophylline. A significant risk for interactions has been considered to exist only with drugs metabolized by oxidative enzyme systems, and thus is not expected to occur with isoniazid. However, an increased clearance of theophylline with oral isoniazid medication has been reported. On the other hand, we found a significant increase in plasma levels of intravenously infused theophylline, and a corresponding decrease in plasma clearance of theophylline, when isoniazid was administered orally, compared to similar infusions in these individuals without concomitant isoniazid medication. The effect was seen irrespective of acetylator status. In five of the seven subjects an increase of isoniazid half-life and AUC was seen with theophylline, but this increase was not statistically significant. PMID- 3817068 TI - Serum calcium in bronchial carcinoma: a population-based study. AB - Serum calcium (s-Ca) was measured in 245 patients with bronchial carcinoma. Mean s-Ca (+/- SD) was 2.52 +/- 0.14 mmol/l in the cancer patients, compared to 2.48 +/- 0.14 mmol/l in a control group (p less than 0.01). Sixty-one (25%) of the patients with bronchial carcinoma had hypercalcaemia (s-Ca greater than or equal to 2.60 mmol/l), compared to 16% of the controls. Squamous cell carcinoma was the histological type most often associated with hypercalcaemia. Patients with hypercalcaemia were not overrepresented among those with bone metastases. During follow-up another 32 patients developed hypercalcaemia. Altogether 93 patients (38%) became hypercalcaemic at some time in the course of the disease. In 20 patients s-Ca fell below 2.60 mmol/l after radiotherapy, after operation, or spontaneously. The survival time was significantly shorter for patients with s-Ca above 2.68 mmol/l on admission than for those with s-Ca below this value. PMID- 3817070 TI - Obstructive sleep apnea caused by hemarthrosis-induced micrognathia. AB - A 42-year-old male hemophiliac with micrognathia caused by temperomandibular hemarthrosis was studied for obstructive sleep apnea and successfully treated without the use of a tracheostomy. Prevention of nocturnal hypoxemia by nasopharyngeal intubation was found to relieve daytime hypersomnolence while he was awaiting corrective jaw surgery. The association of obstructive sleep apnea with micrognathia secondary to hemophilia has not previously been reported to our knowledge. PMID- 3817071 TI - Phosgene poisoning from a smoke grenade. PMID- 3817072 TI - Bronchial neoplasia in a young man. PMID- 3817073 TI - Oral N-acetylcysteine: how does it act? PMID- 3817074 TI - No penetration of orally administered N-acetylcysteine into bronchoalveolar lavage fluid. AB - Six healthy volunteers underwent bronchoalveolar lavage (BAL) before and after receiving N-acetylcysteine (NAC) 600 mg daily for 2 weeks. Free and total NAC, cysteine and glutathione were determined in the lavage fluid, lavage cells and plasma. No NAC was demonstrated, free or bound in disulfides, in either of the lavage components; furthermore, the cysteine and glutathione content of these components and their respective redox states were unaltered during therapy. Plasma free and total cysteine content was unaltered by administration of the drug, but both free and total plasma glutathione increased significantly. Free NAC could not be detected in plasma following dosing. However, a mean of 0.3 nmol/100 microliters plasma was released from disulfides in plasma following reduction with dithiothreitol. N-acetylcysteine has been proposed to act as a mucolytic by cleavage of disulfide bonds. Our findings do not support this direct mode of action and alternative mechanisms of action must be sought. PMID- 3817075 TI - Relationships between functional measurements and childhood respiratory diseases according to the age of onset. AB - In a working population of 912 men, aged 22 to 54 years, 8.3% reported a history of childhood respiratory illness before 16 years of age. Those reporting a history of bronchitis or pneumonia (BP) before 2 years of age had significantly lower FEV1 values than those who did not report such a history, whereas those reporting BP at a later age, or primary tuberculosis, did not have lower values. The observed association was unlikely to be due to preferential recall bias, since BP before 2 years of age was not associated with a higher reported prevalence of current respiratory symptoms of cough, phlegm, or dyspnea, and the observed association remained after exclusion of those with a history of wheezing or asthma. Furthermore, the relation remained significant after taking into account parental smoking, Pi phenotype and a history of eczema in childhood. These results suggest that BP before 2 years of age, a period of rapid alveolar multiplication, may be related to the occurrence of adult chronic air-flow limitation. PMID- 3817076 TI - Clinical consequences of inadequate inhalation technique in asthma therapy. AB - The FEV1-increase after inhalation of a beta 2-stimulant metered-dose aerosol was studied in 23 patients treated by specialists. The effect of their spontaneous inhalation technique was compared with that of controlled inhalation, which was optimised by means of a device controlling the breathing pattern and release of the metered-dose aerosol. This allowed quantitative assessment of the loss of bronchodilatation caused by the spontaneous inhalation technique. Thirteen patients who were observed to make inhalation errors showed a significant loss of bronchodilatation (30%), whereas ten patients who were observed to make no inhalation errors showed an insignificant loss of bronchodilatation (13%). It is concluded that when a metered-dose aerosol is used in general clinical practice there is a considerable loss of potential efficacy. PMID- 3817077 TI - Endobronchial tuberculosis: report of three cases. AB - Three patients are presented who had had a chronic cough for several months, a normal physical examination and a negative chest X-ray. Fiberoptic bronchoscopic examination revealed ulcerohaemorrhagic and/or stenotic lesions which proved to be of tuberculous origin. In one case there was a life-threatening haemoptysis, and a pneumonectomy was performed. PMID- 3817078 TI - Correlation between parameters of spinal cord impact and resultant injury. AB - It is difficult and expensive to produce and maintain animals with experimental spinal cord injuries. In order to reduce the expenditure of time, money, and animals, a method of predicting the final neurologic deficit from the mechanical parameters of the initial injury is needed. An attempt was made to ascertain the mechanical parameter(s) of a spinal cord injuring impact which best predict(s) the extent of the subsequent injury. Twelve rats were laminectomized and the spinal cords contused with an impactor which recorded force and cord surface displacement. Spinal cord lesion volume was measured after killing at 21 days. The records of displacement and force were used to generate velocity, momentum, power, and energy. The maximum values of the six descriptors of the impact were checked for linear statistical correlation with lesion volume. The nonparametric correlations of the impact descriptors with gait scores from other work were also examined. All descriptors correlated at the 1% level many times; force and displacement correlated at the 1% level most of the time. The displacement of one cord surface with respect to the other was judged to be the most useful parameter because it correlated very nearly as well as force with the subsequent measures of trauma and better than the others (but perhaps not significantly better), and because it is technically easier to measure and control. PMID- 3817079 TI - A behavioral and anatomical analysis of spinal cord injury produced by a feedback controlled impaction device. AB - In order to provide a reproducible experimental spinal cord injury with immediate feedback on the mechanical properties of the impact, we have developed an electro mechanically driven, feedback-controlled impaction device. The device is sensitive to the characteristics of the injured tissue and allows continuous manipulation of impact force or tissue displacement. The current study describes the anatomical and behavioral outcomes of a range of impacts and examines the ability of the device to produce a consistent traumatic injury. Rats were subjected to spinal cord trauma at the midthoracic level. Group II received a wide range of impacts that were preset at a desired force level and group III received impacts preset for a constant displacement of the spinal cord surface. Group I served as laminectomy controls. Behavioral testing included assessments of general and fine locomotor skills (open field and grid walking) and postural adjustment to displacement (inclined plane). Lesion volumes and percentage area of the cord occupied by the lesion were assessed postmortem. For group II, significant correlations between the physical descriptors of the impact and the behavioral measures were observed early during the postoperative period for open field and inclined plane performance and later in the recovery period for grid walking. Lesion measures correlated significantly with impact descriptors and with behavioral measures as well. Group III showed consistent behavioral deficits which partially recovered in the postoperative interval. The behavioral results correlated well with the lesion measures for this group also. The results indicate that it is possible to produce an intermediate lesion in the rat which results in consistent recovery with a residual deficit 3 weeks postoperatively, using a device that allows for immediate assessment of the physical descriptors of impact trauma. PMID- 3817080 TI - Modification of vestibular-induced pause neuron firing during anesthesia and light sleep. AB - Anatomic and electrophysiologic evidence suggests there is a vestibular input to eye movement-related pause neurons in the midline of the pontine reticular formation of the cat. The present investigation sought to explore the functional significance of this vestibular drive by examining pause neuron response to horizontal rotational stimulation as cats were anesthetized with halothane or went into natural light sleep. Anesthesia unmasks the vestibular input to pause neurons in that during anesthesia, pause neurons continue to fire but their firing rate is modulated by vestibular stimulation. The particular response patterns of pause neurons to anesthesia are not uniform. We suggest that the results observed could be explained if pause neurons received input from both vestibular nuclei, either directly or possibly via the prepositus hypoglossi. PMID- 3817081 TI - Heredity and alcohol-induced brain anomalies: effects of alcohol on anomalous prenatal development of the corpus callosum and anterior commissure in BALB/c and C57BL/6 mice. AB - Using two inbred strains of mice which have similar rates of alcohol metabolism, we asked whether prenatal alcohol exposure would cause greater incidence and severity of defects in the development of two forebrain fiber tracts, the corpus callosum and the anterior commissure, in mice prone to these defects (BALB/c) than in mice not prone to these defects (C57BL/6). Pregnant animals were fed 0.6 kcal/g body weight of a Sustacal-based liquid diet containing 0, 15, 17.5, 20, or 25% ethanol-derived calories from day 7 to fetal assessment on day 18 of gestation. Most of alcohol's greatest effects and the greatest strain differences in alcohol's effects on fetal variables were produced by the 17.5% diet. This dose had inhibitory effects on fetal body, brain, and midsagittal corpus callosum and anterior commissure growth. All these effects, except that on brain weight, were significantly greater in C57s than in BALBs. When the results were compared with prenatal growth curves for normal untreated mice, the effect of alcohol on corpus callosum but not anterior commissure growth was largely explained by its effects on overall development. The 17.5% diet had a greater specific effect on size of the anterior commissure in C57s than BALBs but increased the incidence and severity of its permanent dysmorphology in BALBs more than in C57s. Anterior commissure size and morphology may be sensitive indicators of alcohol's effects on prenatal brain development. Hereditary differences in rate of maternal alcohol metabolism no doubt have important consequences for risks arising from prenatal alcohol exposure. However, this study clearly indicates that inherited factors, other than those that influence rate of alcohol metabolism, are important influences on the overall fetal response and the specific responses of the anterior commissure to prenatal alcohol exposure. PMID- 3817082 TI - Caffeine contractures in denervated slow-twitch and fast-twitch muscles of the rat. AB - Caffeine contractures (25 mM) and twitches were registered in vitro (34 degrees C) in normal and denervated soleus and extensor digitorum longus of the rat. Both muscles lost weight progressively after denervation although the loss of weight in soleus muscles was more manifest. Denervated extensor digitorum longus muscles showed an increase in the caffeine contracture tension (expressed in g/g muscle) whereas the response generated by denervated soleus muscles was smaller than the control values. The time to peak of the caffeine responses was shortened in both types of muscles after denervation. Twitches were larger and had a slower time course than in normal muscles, especially in the extensor digitorum longus muscles. These findings suggest that some changes in the excitation-contraction coupling could be responsible for the potentiation of the twitches in denervated muscles. PMID- 3817083 TI - Morphologic changes in nerve cell bodies induced by experimental graded nerve compression. AB - The effects of experimental nerve fiber compression on the morphology of nerve cell bodies were studied. Rabbit cervical vagus nerves were crushed or subjected to compression at 0 (sham compression), 30, 200, or 400 mm Hg for 2 h. Morphometric measurements and light microscopical evaluation of the nerve cell bodies in the nodose ganglion were carried out 7 days after the injury on the injured and control sides. Crush and compression at 30, 200, or 400 mm Hg induced a slight decrease in total cell profile area compared with the control side, but it was not related to degree of injury. There was a marked decrease in the ratio between nuclear and total cell profile area (nuclear volume density) after compression at 200 and 400 mm Hg, as well as after crush, and to a lesser extent after compression at 30 mm Hg. Compression at 30, 200, or 400 mm Hg as well as crush of the vagus nerve induced migration of the nucleus to the periphery and dispersion of Nissl substance in the cytoplasm of the nerve cell bodies. Sham compression induced no obvious changes in total cell profile area, nuclear volume density, or migration of nucleus. There was a somewhat increased percentage of cells showing dispersion of Nissl substance in sham-compressed animals than in controls. The results show that nerve fiber compression induced pronounced reactive changes in nerve cell bodies, even at low pressures, corresponding to those found in human carpal tunnel syndrome. Such pressures are known to induce reversible inhibition of fast axonal transport as well as inhibition of retrograde axonal transport. The nerve cell body changes in the nodose ganglion may thus be a reaction to disturbances in axonal transport. PMID- 3817084 TI - Effect of microinjections of gamma-vinyl GABA or isoniazid into substantia nigra on the development of amygdala kindling in rats. AB - The effects of bilateral microinjections into the substantia nigra pars reticulata of gamma-vinyl GABA and isoniazid, i.e., drugs which manipulate GABA mediated inhibition, were studied on kindling and kindled seizures induced by daily stimulation of the amygdala in rats. In comparison to saline-injected controls, both gamma-vinyl GABA (5 or 10 micrograms) and isoniazid (150 micrograms/side) retarded the rate of kindling development as measured by the increase in seizure severity. The duration of the motor seizures and the duration of afterdischarges recorded from the stimulated amygdala were less sensitive to the anticonvulsant effect of both drugs, although significant reductions were measured during kindling acquisition. In fully kindled rats, only gamma-vinyl GABA exerted significant effects on kindled seizures, whereas isoniazid was ineffective after intranigral injection, suggesting that the kindling acquisition period is more sensitive to alterations in GABA-mediated transmission than the fully kindled state. The data provide further evidence that the substantia nigra is involved in the development and expression of kindled seizures. PMID- 3817085 TI - Somatosensorimotor function of the superior colliculus, somatosensory cortex, and lateral hypothalamus in the rat. AB - The role of the superior colliculus in multimodal sensory function is unsettled, in large part because a clear distinction between the somatosensory effects and the postural/motor effects of damage to the deep layers of the superior colliculus has not been obtained. Unilateral lesions of the entire superior colliculus impair orienting of the head and eyes to tactile, visual, and auditory stimuli presented on the side of the body contralateral to the lesion; however, even in the absence of sensory stimulation animals with such a lesion tend to circle ipsiversively and fail to make contralateral head movements. To determine whether or not unilateral damage to the superior colliculus produces a somatosensory asymmetry independently of head movement/circling biases, a neurological test was used in which lateral head or trunk movements were not required. Small pieces of adhesive-backed paper were attached to each forelimb and the latencies to contact and remove the stimuli were recorded. A battery of standard neurological tests was administered as well. The entire superior colliculus was removed unilaterally, and for comparison, the sensorimotor cortex or lateral hypothalamus were damaged in additional groups. Lesions of the superior colliculus produced the expected deficit in contralateral orienting and ipsilateral circling/postural biases, but failed to produce a somatosensory asymmetry in the head movement-independent sensorimotor test. In contrast, both sensorimotor cortex and lateral hypothalamus lesions produced a severe asymmetry in the head-movement-independent sensorimotor test. We conclude that the superior colliculus is involved in the control of lateral head movements and that its role in somatosensory function is fundamentally different from that of the sensorimotor cortex or lateral hypothalamus regions. PMID- 3817086 TI - Magnetic field influence on central nervous system function. AB - The effects of strong static magnetic fields on the excitability of striate cortex in adult cats was studied. The visual evoked response was used as a measure of cortical excitability. In all animals a 1200-G field was associated with a significant decrease in both amplitude and variability of the evoked response. This effect began more than 50 s after the field was turned on and persisted, even after the field was turned off, for several minutes. This phenomenon appears to be due to action of the magnetic field at the synapse rather than on axonal conduction. PMID- 3817087 TI - Postictal events in amygdala-kindled female rats with and without estradiol replacement. AB - This study investigated the effect of estradiol on ictal and postictal events in ovariectomized female rats kindled by daily amygdala stimulation during the presence or absence of estradiol replacement. Although ictal components of kindled seizures were not altered by estradiol, several postictal events such as myoclonic jerks were significantly increased by estradiol. Twelve days after kindling, estradiol-replaced rats with electrodes in the basal, lateral, or cortical amygdala nuclei developed brief postictal "bursts" of behavioral and EEG activity which developed into a secondary seizure in some rats. Rats without estradiol never displayed these postictal events. Pretreatment of rats with pentylenetetrazol, 20 mg/kg, 15 days after kindling, resulted in a further increase in the incidence of bursts and secondary seizures in the presence of estradiol; these events were most prominent in rats kindled in the absence of estradiol. Pentylenetetrazol also caused a significant increase in myoclonic jerks in estradiol-replaced rats, and postictal spikes in all rats. A series of five consecutive generalized seizures at 48-h intervals caused an increase in bursts in rats with estradiol replacement, but not in rats without estradiol. The results indicate that estradiol exerts excitatory effects during the postictal period following amygdala-kindled seizures and suggest that multiple regions mediate the postictal effects of estradiol, perhaps depending on the intraamygdala site of kindling stimulations. PMID- 3817088 TI - State-dependent respiratory depression elicited by stimulation of the orbital frontal cortex. AB - The effect of electrical stimulation of the orbital frontal cortex on respiration was studied in unanesthetized, freely moving cats across sleep-waking states. Single trains of forty 300-microA, 0.5-ms, constant-current pulses at 60 Hz were delivered to the orbital frontal cortex at four points in the respiratory cycle. Stimuli delivered during expiration produced an immediate switch to inspiration. Stimuli delivered during inspiration reduced inspiratory EMG slope and peak EMG amplitude, and prolonged inspiration. Stimuli delivered during early inspiration produced greater effects than stimuli delivered during late inspiration. Stimulation effects were elicited during quiet waking and quiet sleep but not during rapid-eye-movement sleep. These results suggest that the orbital frontal cortex may contribute to respiratory phase switching, and that its influence on brain stem structures is attenuated during rapid-eye-movement sleep. PMID- 3817089 TI - Differential inhibition of the diaphragm and posterior cricoarytenoid muscles induced by transient hypertension across sleep states in intact cats. AB - Arterial pressure was transiently elevated by intravenous infusion of phenylephrine in intact, freely moving cats during sleep and waking states to determine pressure effects on diaphragmatic and laryngeal abductor EMG activity. Transient hypertension caused respiratory cycle duration to increase and integrated EMG area to decrease for several breaths in both the diaphragm and posterior cricoarytenoid, the integrated inspiratory area of which decreased to a greater extent than did that of the diaphragm. Cycle duration increases resulted from increases in expiratory duration. Expiratory duration of the posterior cricoarytenoid initially increased proportionately more than that of the diaphragm, causing a transient phase disassociation between that upper airway muscle and diaphragmatic timing. This disassociation disappeared after several breaths. Changes in posterior cricoarytenoid expiratory duration and integrated inspiratory area were sleep state-dependent: area decreases were greatest in rapid eye movement sleep; expiratory duration increases were greatest in quiet sleep. Neural mechanisms underlying laryngeal abductor activity are sleep state dependent and appear to be affected more than diaphragmatic mechanisms by baroreceptor stimulation. PMID- 3817090 TI - Changes in the nuclear pore complexes of the dentate granule cells in aged rats. AB - In 3-, 9-, 24-, and 30-month-old male rats (Fischer 344), the nuclear perimeter and the density and diameter of nuclear pore complexes in the granule cells of the dentate fascia were studied. Whereas the nuclear perimeter and the diameter of nuclear pore complexes did not change as a function of age, there was a significant loss of them at 24 months (20%), compared with the third month. This change suggests that the nucleocytoplasmic communication may be impaired with age which would adversely affect protein synthesis, and could explain the loss of the postsynaptic sites of the dentate fascia of aged rats. PMID- 3817091 TI - Simultaneous recordings from two types of hippocampal nonpyramidal cells during electrically induced paroxysmal discharges. AB - To reveal the relationship between hippocampal nonpyramidal cells and seizure activity, single-unit activities of nonpyramidal cells were studied during electrically induced paroxysmal discharges in the hippocampal CA1 region of lightly anesthetized rabbits. Type I nonpyramidal cells (N = 21) that were located in or near the pyramidal cell layer tended to cease firing during the early part of paroxysmal discharges, but refired during the late part. In contrast, type II nonpyramidal cells (N = 14) which were found in the inferior subzone of the stratum oriens continued to fire during the entire course of the paroxysmal discharge. PMID- 3817092 TI - Megaesophagus: induction by a simple animal experiment. Report on the method. AB - The report describes a method for a simple animal experiment in which esophageal changes similar to megaesophagus can be produced by distal esophageal constriction. Whereas the esophagus of the operated rats with distal stenosis of the esophagus underwent no change in length, there was an increase in width, especially in the middle third, by an average of about 4.5 times. Optical microscopy revealed no inflammatory infiltrates in the esophageal mucosa as a possible indication of retention esophagitis in any of the animals. The histomorphometric investigation of the various portions of the esophageal wall revealed, during the initial period (12 days), a statistically significant thinning of the submucosa and muscularis in almost every region of the esophagus. An early hypertrophy of the tunica muscularis in almost every region of the esophagus. An early hypertrophy of the tunica muscularis was observed only in the area of the distal stenosis. The cornifying squamous epithelium showed a slight increase in thickness in the middle and distal regions of the esophagus. The animal experimental model presented here appears to us to be well suited for further investigation of functional esophageal disorders through future animal experiments. PMID- 3817093 TI - Changes in blood urea nitrogen (BUN) concentration during pregnancy in the rat with or without obstructive uremia. AB - Bilateral ureteral ligation changes the blood urea nitrogen (BUN) concentration in pregnant and non-pregnant rats. Marked increases of the BUN concentration occurred in both pregnant and non-pregnant specimens after ligation. The BUN concentration in sham-ligated rats did not change from day 16 through 19 of pregnancy, but increased on day 20 of pregnancy and thereafter. There was no significant difference in BUN between ligated pregnant rats on days 16 and 17 of pregnancy and ligated non-pregnant rats. As pregnancy progressed from day 18 onward, the BUN in ligated pregnant rats decreased when compared with that of ligated non-pregnant rats, but did not reach the level in sham-ligated pregnant rats. The BUN of mothers and fetuses both in the ligated and the sham-ligated groups were similar. Amniotic fluid urea nitrogen levels were higher than in blood on late fetal days. In ligated mothers, a significant relationship between maternal BUN and the number of fetuses was noted on day 22 of pregnancy. These results suggest that the fetal kidney becomes functional for excreting urea in late fetal life. PMID- 3817094 TI - Peroxisomes in lymphatic leukemia P 388 in mice--cytoenzymatic and ultrastructural investigations. AB - The study comprised mice of BDF1 hybrides, i.e. cross-breds F1/C57BL/6 X DBA/2, sires, aged 3 months, injected peritoneally with lymphatic leukemia P 388 in the amount of 10(4) cells. The mice were killed 5 or 11 days after injection. Peroxisomes were examined in the liver. Therefore, cytoenzymatic studies were conducted to determine the catalase activity. It was found that, after initial increase of activity (5th day of the experiment) a total or nearly total lack of catalase occurred in leukemic lymphocytes after 11 days of the disease. This was accompanied by gradual vanishing of peroxisomes-catalase transfer. It was also found that free radicals participated actively in the destabilisation of biological membranes by damaging cellular peroxisomes. PMID- 3817096 TI - DNA content of lymphocytes in adjuvant arthritis of rats. PMID- 3817095 TI - The effect of adrenalectomy on the proteinuria of spontaneously hypertensive rats and normotensive controls. AB - Urinary proteins were studied by quantitative and electrophoretic methods in 6 month-old spontaneously hypertensive rats and normotensive controls. Protein analysis was carried out before and after adrenalectomy and during gluco- or mineralocorticoid treatment. Urinary protein excretion was significantly diminished after adrenalectomy both in the hypertensive and control groups. The original level of protein excretion was restored only by glycocorticoid treatment. Normal or pathologic electrophoretic pattern of urinary proteins was not influenced by the experimental procedure. Moderately non-selective glomerular proteinuria persisted in the spontaneously hypertensive rats referring to a definitely damaged glomerular barrier. One protein fraction of about 130,000 dalton molecular weight disappeared from the urine of hypertensive animals after adrenalectomy and reappeared after glucocorticoid treatment only. This fraction probably represents the dimeric form of albumin. Quantitative changes of urinary protein excretion can be explained by haemodynamic factors. PMID- 3817097 TI - Postnatal development of hepatocytes following oxygen deficiency in utero. AB - Pregnant rats were exposed to altitude hypoxia (5,000 m = pO2 11.33 kPa) 8 h daily, from the 16th through 21st d of pregnancy. The livers of the newborn male rats were morphometrically examined by electron microscopy for both qualitative and quantitative parameters, on the 2nd, 5th, 11th and 22nd d of age and were compared with those of controls during the same periods of postnatal development. Substantive changes were exhibited by the mitochondria. Processes of autophagocytic decomposition were recorded (focal vacuolisation, formation of myelin structures). Volume densities on the 2nd (0.2041), 11th (0.2048), and 22nd (0.2495) d of age were clearly higher than in control animals and were all on a rising trend. Numerical density, on the other hand, trebled in the controls (0.0738 on the 2nd d and 0.2261 on the 22nd) and almost doubled in the hypoxia animals (0.0849 on the 2nd d and 0.1471 on the 22nd). In other words, the volume of the average mitochondrion was larger in hypoxia animals, whereas surface densities were lower. Hepatocytes differed from cardiomyocytes, in that increased autophagocytosis of mitochondria and glycogen was recordable from the former only on the 5th d. Glycogen levels of hepatocytes went up considerably, with the rise recorded from controls (0.0181 on the 2nd d and 0.1911 on the 22nd) being somewhat stronger than that observed from hypoxia animals (0.0276 on the 2nd d and 0.1742 on the 22nd). The changes postnatally recorded from liver cells in the wake of prenatal hypoxia are believed to be processes of adaptation which do not cause any irreversible damage. PMID- 3817099 TI - Intraluminal bile salt increases rate of firing in afferent fibers from the small intestine of the rat. AB - Perfusion of a rat intestinal segment with a solution containing sodium deoxycholate (8 mM) increases the rate of firing in periarterial afferent nerves from the gut. This observation indirectly supports our earlier proposal that bile salt evokes a net fluid secretion in the small intestine via an activation of the enteric nervous system. PMID- 3817098 TI - Uptake and toxic effects of heavy metal ions: interactions among cadmium, copper and zinc in cultured cells. AB - Absorption of metal ions by KB, HeLa and L-59 cells has been analyzed by atomic absorption spectrophotometry in the course of culture. Ions of the elements of the fourth period in the periodic chart such as Fe(II), Cu(II), Zn(II), Mn(II) and Ni(II) were not taken up, but those of the higher periods, such as Cd(II), Pb(II), Hg(II) and Ag(I) were were taken up easily. The uptake behavior by the cultured cells was in accordance with the characteristic features of metals, that metals in the fourth period are essential elements, and most of the elements of the fifth and the sixth periods are non-essential or toxic elements. The initial rate of Cd(II) uptake and the Cd(II) concentration has a sigmoidal relationship. Cd(II) was absorbed homotropically through cell membranes. The uptake of Cd(II) was specifically inhibited by Cu(II), but was affected little by Zn(II). The toxicity of Cd(II) to KB cells was greatly enhanced in the presence of Cu(II). On the contrary, the toxicity of Cd(II) was reduced by the addition of Zn(II) at several concentrations of Cd(II). The toxicity of Cd(II) did not depend on the amount of Cd(II) absorbed in the cells, but was determined by cofactors such as Cu(II). The interaction between Cd(II) and Cu(II) may be important for Itai-itai disease. PMID- 3817100 TI - Sclerotization of mosquito cuticle. AB - The mode of sclerotization of Aedes aegypti pupal and adult cuticle was examined by employing biochemical and radioactive techniques. During larval-pupal metamorphosis, tyrosine is converted to tanning precursors and is incorporated into aryl-amino adducts and beta-crosslinks. The major hydrolysis product of beta crosslinks in pupal cases is identified to be arterenone. Examination of tanning modes in five different mosquito species shows that the ratio of quinone to beta sclerotization not only differs within the life stages of the insects, but also differs between species. PMID- 3817101 TI - The enhanced induction of metallothionein by zinc, its half-life in the marine fish Pleuronectes platessa, and the influence of stress factors on metallothionein levels. AB - Intraperitoneal injection of zinc raised levels of a hepatic metallothionein-like species. Assuming that this species was metallothionein (MT) then levels were raised from approximately 20 micrograms/g to 300 micrograms/g in 7 days, and levels thereafter remained high for the next 4 weeks. The half-lives of the protein in liver and kidney from starved fish, measured using in vivo incorporation of 35S cysteine at 11 degrees C, were approximately 27 days and 32 days respectively. The following agents failed to stimulate synthesis of MT in plaice: stress (due to catching), endotoxin, dexamethasone, cortisol and turpentine. PMID- 3817102 TI - Tetanus toxin does not affect the release of noradrenaline and taurine from rat cerebral cortex slices evoked by high K+ and Na+-free media. AB - Noradrenaline and taurine release from superfused rat cerebral cortex slices was stimulated by potassium ions, veratrine, ouabain and omission of sodium ions. Tetanus toxin enhanced only the ouabain-evoked calcium-dependent noradrenaline release and the ouabain-evoked calcium-independent taurine release. The uptake of both was marginally affected. PMID- 3817103 TI - The membrane attack complex of Xenopus laevis complement. AB - Rabbit erythrocyte membranes lyzed by Xenopus laevis serum exhibited a typical ultrastructural complement lesion with an inner diameter of 80 +/- 9 A. The protein pattern associated with lyzed membrane is compared to a similar human preparation. PMID- 3817104 TI - Retinoic acid enhances the proliferation of smooth muscle cells. AB - Retinoic acid (RA, 10(-5) - 10(-7) M) is shown to enhance the proliferation of cultured rat aortic smooth muscle cells (SMC). This effect is not connected with a synergistic action of RA together with serum mitogens. Moreover, the expression of L1, a surface antigen specific for modulated SMC entering the cell cycle, is amplified by RA treatment. PMID- 3817105 TI - Development and use of shell-less quail chorio-allantoic-membrane cultures to study developing skeletal tissues; a qualitative study. AB - A technique is described for in vitro culture of the quail embryo from the 1st to the 18th day of development. The embryos are cultured in Teflon hammocks, suspended in glass supports and kept in a humidified atmosphere at 36.5 degrees C. The quail CAM is used as support and cell source for developing non-quail cartilage and bone. The quail cells can be identified histologically and easily recognized by Feulgen-staining which is demonstrated in the presence of quail chondro- or osteoclasts in a mouse long bone rudiment cultured on the CAM. PMID- 3817106 TI - Bombesin promotes pancreatic growth in suckling rats. AB - The pancreatic growth promoting effect of long term administration of bombesin was investigated in suckling rats. The authors showed that bombesin given in 10 micrograms/kg b.wt doses s.c. every 8 h for 10 days from the day of parturition stimulated pancreatic growth: it increased pancreatic weight, protein and DNA content, trypsin and amylase activity and trypsin/DNA ratio. CONCLUSION: Bombesin is an effective stimulator of pancreatic growth in suckling rats. PMID- 3817107 TI - Inhibition of cadmium teratogenesis by a mercaptoacrylic acid (MFA). AB - The teratogenic effect of cadmium can be diminished by a number of mechanisms including zinc and pretreatment with cadmium and mercury. In this study, the oral administration of alpha-mercapto-beta-(2-furyl)-acrylic acid (MFA) protects against cadmium-induced malformations and embryonic death. This protection is probably mediated by the chelation of the cadmium ion rather than metallothionein (MT) synthesis. PMID- 3817108 TI - Residual influences on fecundity in drosophilid species. AB - A residual influence of males and females on oviposition has been examined in 7 drosophilids. There was evidence for oviposition deterrence in Drosophila funebris, with males as well as females producing the inhibitory effect. In contrast, male residues stimulated oviposition in Zaprionus tuberculatus. Male residues also stimulated oviposition and appeared to serve as an aggregation cue in D. melanogaster. PMID- 3817109 TI - Sex pheromones of two Asian moths (Creatonotos transiens, C. gangis; Lepidoptera- Arctiidae): behavior, morphology, chemistry and electrophysiology. AB - Two sympatric species of Asian arctiid moths (Creatonotos spp.) use a sequential, dual luring and mating system. After sunset males pneumatically expand their coremata from a cavity between the abdominal sternites 7 and 8 and release their pheromone. They attract other males and thus, scent-emitting male groups may develop. About 30 min later females are attracted to the calling males. Upon contact with a female the male's corema deflates and mating follows. After 1-2 h the male calling subsides and now the remaining virgin females continue to emit their pheromone bouquet from internal, tubular glands located in the dorsal part of the abdomen, rostrad from tergite 8/9. This attracts males and further matings occur.- The coremata are huge, pneumatically eversible organs composed of two pairs of tubes, up to 37 mm long, each covered by ca. 3000 scent hairs (scales). There is a giant epidermal (trichogen) gland cell at the base of each hair. One large corema may contain up to 0.5 mg of the pheromone, hydroxydanaidal. The internal, tubular female glands are antler shaped; their air-filled lumen is ventilated by abdominal pumping. The major components of the female attractant are (Z,Z,Z)-3,6,9-heneicosatriene and (Z,Z)-2 (2,5-octadienyl)-3-undecyloxirane with different ratios in the two species. One of the minor components, common to both species, is (Z,Z,Z)-3,6,9-tricosatriene. Only the male antennae possess specialized receptor cells for the female attractants; other antennal cells of both sexes respond to the male pheromone. PMID- 3817110 TI - Relationship between elevation of the labellar threshold after raising by increasing sucrose concentrations and impulses of a single sugar receptor in the LL-type hair of the blowfly. AB - The threshold for proboscis extension to sucrose stimulus of a single sugar receptor on different labellar hairs was elevated by raising blowflies on higher concentrations of sucrose. The reaction time was defined as the duration from stimulus of a single sugar receptor in the LL-type hair until occurrence of proboscis extension. Reaction times at the threshold concentrations of sucrose did not change among blowfiles raised on different sucrose levels. The average value is about 0.35 s. Relationship of the average number of impulses during 0.35 s to log median acceptance thresholds of sucrose for proboscis extension was linear. PMID- 3817111 TI - The roles of the recurrent nerve and the ventral nerve cord in the feeding response of the blowfly, Phormia regina M. AB - The interaction of sensory activities from internal stretch receptors and from external sugar receptors was studied in relation to proboscis extension and sucrose intake of the blowfly. The tarsal threshold for proboscis extension was elevated in flies after the recurrent nerve was cut. Cutting either the recurrent nerve or the ventral nerve cord did not alter the labellar thresholds for proboscis extension but did influence sucrose intake by prolonging the duration of intake. After the ventral nerve cord was cut, the flies did not stop ingestion as long as sugar receptors in the interpseudotracheal papillae were stimulated. Tonic impulse discharges from the intact recurrent nerve were divided into efferent and afferent types. Efferent impulses from the brain were thought to be transmitted to the hypocerebral ganglion-corpus cardiacum complex for regulation of opening and closing of the foregut valves, of peristaltic movements in the foregut. Afferent impulses were thought to be discharged from the foregut stretch receptors which detected peristaltic movements in the foregut. PMID- 3817112 TI - Analysis of queen recognition by honey bee workers (Apis mellifera L.) in a metabolic bio-assay. AB - Queenless groups of honey bee workers (Apis mellifera L.) respond with typical increases in their metabolic activity when exposed to queens. Volatile queen odors release 46.8% of the reaction in worker groups compared to combinations of volatile odors and non-volatile factors. Worker groups which were allowed to learn the odor of a given queen were able to discriminate between volatile odors of related and unrelated queens. Although non-volatile queen compounds seem to be of minor importance for kin recognition they override effects releasable by volatile odors. PMID- 3817113 TI - Maternal and larval effects of photoperiod on the induction of larval diapause in two species of fly, Calliphora vicina and Lucilia sericata. AB - The induction of larval diapause in the blowflies Calliphora vicina and Lucilia sericata was studied in relation to maternal and/or larval exposure to photoperiod. In C. vicina, maternal experience of short daylength was shown to be more important than larval exposure, although diapause was only observed when the larval rearing temperature was below 15 degrees C. The critical daylength was between 12 and 15 h per day. Recovery from diapause was temperature- but not photoperiod-dependent. Some evidence was obtained, however, to suggest that the rate of recovery was more rapid among larvae from short-day mothers which were bred in pre-diapause conditions of long days. By transferring adult flies from short days into darkness several days before oviposition, it was shown that the important photoperiodic effects were truly maternal. In L. sericata, larval sensitivity to photoperiod was also demonstrated, short days inducing a protracted rate of pupariation. 'Waves' of pupariation in short-day cultures indicated intrinsic differences in diapause intensity. The critical day-length for larval sensitivity was close to 14 h per day. It is suggested that the maternal effects of photoperiod on larval diapause probably involve an unknown maternal factor which is incorporated into the developing oocytes during short day exposure. PMID- 3817114 TI - Comparison of the osmotic fragility of red blood cells in samples from anaesthetised and unanaesthetised trout and eel and the effect of varying oxygen levels. AB - The osmotic fragility of trout and eel red blood cells has been tested in fresh blood samples and following equilibration at low PO2 (7.5-25 mmHg). Percentage haemolysis curves obtained were similar to those in other vertebrates. Blood sampled shortly after cannulation (OP) shows higher % haemolysis at a given saline concentration than in samples taken 24 h after recovery from anaesthesia. Following exposure to low PO2's greater haemolysis is present and is reduced by raising the oxygen level. PMID- 3817115 TI - Architecture of swine lymphnode: light- and scanning electron microscopical studies. AB - The overall architecture of the swine lymphnode was studied on: nodes injected for the visualization of the lymph pathway, serially sectioned nodes, and material processed for scanning electron microscopy. Despite the commonly reported scheme of the node architecture, cortical-like and medullar-like tissue appeared to be intermingled seemingly with no rules in the node substance. Thus it was not uncommon to find cortical-like tissue in a peripheral position like in other mammals. A scheme of the node organization is proposed and the features of the different components of the parenchyma are described with particular emphasis on the lymphatic sinuses and the lymph pathway. Finally, scanning electron microscopical data on swine nodes are discussed and comparison made with observations reported for other mammals. PMID- 3817116 TI - Morphological and histochemical studies on Joseph cells of amphioxus, Branchiostoma belcheri Gray. AB - Joseph cells, assumed to be photoreceptive organs in amphioxus, were studied by electron microscopy as well as by a histofluorescence technique. Each Joseph cell is composed of three parts: the microvilli extending in the peripheral portion, the cell body, and a cytoplasmic process. Light and dark treatments affected the ultrastructure of the microvilli. In darkness, microvilli became more numerous, thinner, and more regularly arranged. A specific fluorescence, indicative of the presence of retinal-based proteins, appeared only in the dorsal wall of the neural tube where the Joseph cells are situated. These results suggest that the Joseph cells are in fact photosensory with the microvilli containing a rhodopsin like substance. PMID- 3817117 TI - Behavioral transition of crayfish avoidance reaction in response to uropod stimulation. AB - Unilateral mechanical stimulation of a uropod elicited an avoidance reaction in the crayfish Procambarus clarkii. Depending upon the animal's size, either one of two alternative behavioral acts emerged as the avoidance reaction to similar stimuli. A stationary resting posture of the crayfish and a passive extension of the abdomen were prerequisite conditions for inducing the avoidance reaction. In small animals (less than 10 cm in body length), the "dart" response was mainly elicited. Animals responded with a sudden closing of both uropods and rapid forward walking to scuttle away from the stimulus source. This act was regarded as one form of escape behavior. With increasing animal size, the "turn" response became more probable than the "dart" response. During the "turn" response, the uropod on the stimulated side opened and that on the contralateral side closed. This act was frequently followed by a rapid turning movement towards the stimulus source with an extension or flexion of the abdomen. This act was also regarded as a variant form of defensive behavior. In large animals with autotomized chelipeds, the response to the uropod stimulation reverted to that of the "dart" response after 2 to 3 days. PMID- 3817118 TI - Mating and embryo yield of mice injected with gonadotropins on specific days of the estrous cycle and in acyclic periods. AB - Pregnant mare serum gonadotropin and human chorionic gonadotropin, hormones that can be used to induce superovulation, were administered to hybrid female mice (C57BL/6J X CBA/J) on known days of the estrous cycle, or when the mice were known to be acyclic, in order to determine whether certain reproductive states of the animals either enhanced or inhibited effects of the exogenous gonadotropins. Days of the estrous cycle on which the hormones were given did not significantly affect the numbers of animals that mated and in most cases did not affect embryo yield. When hormone treatment was initiated on the day of estrus in the 5-day cycle, the embryo yield was greater than when treatment was initiated on the first day of diestrus but even the difference between these groups had only marginal significance. Mice that were not exhibiting regular estrous cycles, some of which had been rendered acyclic by exposure to constant light, did not differ from mice with regular cycles in numbers that mated or in embryo yield following gonadotropin administration. When gonadotropin injection of regularly cycling mice was initiated on metestrus, on the first day of diestrus, or on estrus, the vaginal cycle was retarded as indicated by failure of cornified cells subsequently to predominate in vaginal smears at proestrus, estrus, or metestrus but initiation of hormone treatments on the second day of diestrus advanced the occurrence of vaginal cornification. Following gonadotropin injection, vaginal cornification became less reliable as a predictor of the time at which the animals would mate and ovulate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817119 TI - The relationship between lipofuscin and neuromelanin in some sites of the nervous system of the horse. AB - Histochemical and cytochemical features of neuronal pigment in the spinal cord, and in the sympathetic and spinal ganglia of the adult horse have been studied. Light and electron microscopical observations revealed that lipofuscin pigment is present in the spinal ganglia and in the spinal cord, whereas in the sympathetic ganglia both lipofuscin and neuromelanin are present. The ultrastructural studies showed that lipofuscin granules exhibited a triphasic organization consisting of a matrix, a system of lamellae and one or more lipid vacuoles. Neuromelanin granules have structural features in common with lipofuscin-like granules, except the former types store a highly electron dense material on their matrix. The electron dense material has been identified as melanin by a modification of the Lillie ferrous sulfate reaction applied at the ultrastructural level. From the ultrastructural appearance and cytochemistry of the neuronal pigments in horse it is concluded that neuromelanin should be considered as melanized lipofuscin. The possibility that the different ratio of lipofuscin to melanin within the same granule is responsible for the peculiar reaction of certain neuromelanin granules to lipophilic dyes, the PAS reaction, a histochemical assay for melanin and exposure to ultraviolet light, is discussed. PMID- 3817120 TI - Induced abortion: a worldwide perspective. PMID- 3817121 TI - Screening for sexually transmitted diseases by family planning providers: is it adequate and appropriate? AB - Of more than 3,000 women interviewed in the 1982 National Survey of Family Growth (NSFG) who had made at least one family planning visit in the 12 months preceding the interview, 50 percent report that they were tested for a sexually transmitted infection. Black women are far more likely to have been screened than are white women (67 percent compared with 47 percent); moreover, a racial differential is seen in every subgroup examined. There is also a large difference in the proportion screened according to the woman's source of family planning care: Those who attended a clinic are much more likely to have been screened than are women who saw a private doctor (62 percent and 43 percent, respectively). As with the race differential, this relationship persists after other variables are controlled for. In addition, women who live in the South are more likely to have been screened than are residents of other regions (58 percent compared with 46 percent). Differences by metropolitan and non-metropolitan area of residence are small and are not statistically significant. Differences by marital status and age at first intercourse appeared statistically significant in preliminary analyses, but when controls for other factors were introduced, these differences became nonsignificant. Since many characteristics that are believed to be important risk markers for sexually transmitted infections are also predictors of whether a woman will be screened for such infections, current screening practices appear, in general, to target the appropriate groups. PMID- 3817122 TI - Public funding of contraceptive, sterilization and abortion services, 1985. AB - In FY 1985, the federal and state governments spent $398 million to provide contraceptive services and supplies. The two leading sources of funding were the Medicaid program and Title X of the Public Health Service Act. The former accounted for $137 million, or 34 percent of all public expenditures; and the latter program accounted for $133 million, also 34 percent. Two blockgrant programs--Social Services and Maternal and child Health--provided $40 million and $23 million, respectively; together, they were responsible for 16 percent of public support for contraceptive services. State governments, which spent $64 million of their own revenues, accounted for another 16 percent of funding. The federal and state governments together spent $64 million to subsidize sterilizations in FY 1985. The federal government provided 94 percent of the funding--84 percent through the Medicaid program. In addition, the states and the federal government spent $66 million to subsidize 188,000 abortions; in this case, however, the federal government contributed less than one percent of the funds used. These data come from a survey of state agencies, and should be viewed as approximations rather than as precise figures. PMID- 3817123 TI - Will grandparent liability help curb teenage pregnancy? PMID- 3817124 TI - The new politics of natural family planning. PMID- 3817125 TI - Systemic practice. AB - In this paper we propose to develop a methodology, based on a set of isomorphic patterns of practice, for studying the operational competencies of systemic therapists. By attending to the therapists' actions at the level of practice, we have identified unifying principles that run across the different models of systemic family therapy. This is a pattern of action that we call "systemic practice." In order to show the application of this methodology in the art of practice, we have analyzed excerpts from two videotaped sessions. PMID- 3817126 TI - In defense of "lineal causality". AB - It has often been said that ideas about lineal and circular causality may be theoretically profound, but that the reputed impossibility of lineal causality seems to fly in the face of our experience and our common sense. The above humorous jibe at theory goes straight to the heart of the matter. Bateson's epistemology of lineal and circular causality does not describe our everyday experience. Bateson's epistemology explains our experience. PMID- 3817127 TI - "If I don't get simple, I cry". AB - Poor families have taught us special lessons that are applicable to all families. They have instructed us about the problems, within families, of developing relationships adequate to the tasks of family life. One consequence is that therapists are attending more to the evolution of the structure of family relationships, particularly, the phenomenon of underorganization. Poor families have also provided insight into the dynamic relationship between families and their social context. As a result, a therapeutic perspective is emerging that focuses on the influence of the community on the individual and the family, a perspective that may be called an eco-structural approach to therapy. PMID- 3817128 TI - The march of time: rigid or chaotic transactions, two different ways of living time. AB - In this paper the author shows that families do not live time in the same way. In families with rigid transactions, time is arrested; in families with chaotic transactions time is eventful. These different ways of living time are true of all systems, and parallels are drawn with political systems. Therapists must thus manage the therapeutic time in different ways, and this depends, among other factors, on their "personal equation." To achieve this, some guidelines are given, and two techniques that we call photograms and historiograms are described. PMID- 3817129 TI - "Detoxification" of Vietnam War trauma: a combined family-individual approach. AB - Treatment with families of veterans suffering from the aftereffects of combat trauma in the Vietnam War often requires a preliminary phase of disjoint treatment, in which family members are seen separately, before conjoint treatment can proceed. In this disjoint phase of treatment, wives and children are introduced to the brutal realities of Vietnam combat experience and to an understanding of its sequelae. This disjoint phase of family therapy detoxifies combat experience so that it can be approached in subsequent conjoint sessions along with more traditional family therapy issues. PMID- 3817130 TI - An existential/dialectical model for analyzing marital functioning and interaction. AB - Many experienced marital therapists will acknowledge that it is difficult for them to really understand the dynamics of a couple's interaction and to plan the direction of couple therapy. This article presents a new tool, a Profile of Marital Functioning and Interaction, for developing a broad, many-faceted, but still concise picture of a couple's strengths and weaknesses. The profile is based on an existential/dialectal model for analyzing marital functioning and interaction. It is intended to assist the therapist in selecting a systematic focus in marital therapy. PMID- 3817131 TI - Evaluation of family therapy trainees: acquisition of cognitive and therapeutic behavior skills. AB - In this study, which describes the evaluation of a structural family therapy training program, we developed an evaluation procedure that can be used with other similar training programs. Trainees were evaluated before and after training as to their improvement in cognitive, case-planning and in-therapy intervention skills. Results suggest a progression of skill learning, beginning with cognitive understanding, followed by case planning, and then intervention skills. Though trainees made significant progress in cognitive and planning skills, this was not the case with intervention skills. Trainees' self evaluations were similar to their results on other measures. PMID- 3817132 TI - The impact of structural family therapy training on conceptual and executive therapy skills. AB - The importance of empirical evaluations of family therapy training is gaining increased recognition. This study reports the results of a controlled assessment of a training seminar in structural family therapy. Changes in the conceptual and executive skills of 44 therapy trainees (22 family trainees and 22 controls) were assessed over a 16-week period using repertory grid and videotaped therapy simulation techniques. Results indicated significant conceptual gains in family therapy trainees, but only among those with little previous exposure to family training. Differences in the overall number as well as the type of interventions were also noted. Results generally supported the predicted impact of therapy training, but left unanswered questions regarding the unique impact of family therapy training over individual training. These qualifications are discussed and directions for future work are highlighted. PMID- 3817133 TI - Employing the God-family relationship in therapy with religious families. AB - In many religious families, God functions as a crucial family member, stabilizing interpersonal relationships and engaging in daily family transactions. In the psychological role of a transitional object, God can be usefully employed by the family therapist in therapeutic interventions, when the therapist keeps the focus upon the interpersonal relationship with God rather than the specific content of religious beliefs. This approach can access a vital resource in the family, particularly when conditions for therapy are otherwise difficult, such as an isolated, enmeshed dyad presenting alone for therapy. Four case examples illustrate how one may use this approach in family therapy. PMID- 3817134 TI - Family therapy with delinquents: a critical review of the literature. AB - A critical review of the theoretical and outcome studies on family therapy with delinquents is presented. Assessment of the theoretical developments reveals that families of delinquents may be distinguishable from other families by their interactional sequences and processes. The available outcome studies within the field indicate that family therapy is viable for interventions with this population, with behavioral, structural, strategic, and communication approaches receiving the most support, but more specific and robust evidence is still needed. Trends in the research and critical issues are identified and used to provide suggestions for future research and practice. PMID- 3817135 TI - International family therapy: a view from Kyoto, Japan. AB - "International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy. PMID- 3817136 TI - Solid dispersions of ibuprofen in urea. Effects of urea on dissolution. PMID- 3817137 TI - [Determination of morphine in opium poppies with near infrared reflectance spectrophotometry]. PMID- 3817138 TI - Determination of zinc in serum, hair and urine in homozygous thalassaemic patients by atomic absorption spectrophotometry. PMID- 3817139 TI - [Electroencephalographic analysis of the central action of halonal]. AB - The experiments on rabbits revealed the depressant effect of anticonvulsant drug halonal on spontaneous bioelectrical activity and electroexcitability of the motor area of the cerebral cortex, caudate nucleus, intralaminar nuclei of the thalamus and midbrain reticular formation. The drug exerts no effect on the amygdala and hippocamp. The mechanism of the anticonvulsant effect of halonal involves inhibition of the caudo-thalamo-cortical synchronizing system that presumably disorders the occurrence of the hypersynchronous charge in the cortical neurons and prevents the development of a convulsive fit. PMID- 3817140 TI - [Relationship between the chemical structure and anticonvulsant activity of 3 hydroxypyridine derivatives]. AB - It was revealed in experiments on mice, that 3-hydroxypyridine derivatives possess marked anticonvulsive activity, especially in convulsions induced by GABA ergic substances, less in corasol, maximal electroshock and strychnine induced ones. The anticonvulsive activity in the rows of 2-substituted and 2.6 disubstituted derivatives of 3-hydroxypyridine gets increased due to the introduction of larger in volume alkyl substitutes into the 2nd molecule position. Among the 2,6-disubstituted 3-hydroxypyridine derivatives, agents were revealed that are able to enhance hyperkinesis induced by 5-hydroxytryptophan. PMID- 3817141 TI - [Effect of the vascular wall polypeptide factor vasonin on hemostatic function in an experimental peroxidation syndrome]. AB - The process of blood coagulation was found to be activated in the peroxidation syndrome caused by the use of antioxidant-free diet. Vasonin prevents the development of hypercoagulation in rabbits at the peroxidation syndrome but fails to prevent the development of the latter. PMID- 3817142 TI - [Influence of bigumal on the blood coagulation system and on the anticoagulant effect of heparin]. AB - It was found that in the blood plasma bigumal even at high dose (15 mg/kg) exerted no effect on the parameters of partial thromboplastin and thrombin time but increased the blood plasma tolerance to heparin. Both in buffer medium and blood plasma bigumal effectively decreased the specific effect of heparin. Oral acute (5 mg/kg) and long-term (3 mg/kg daily for 5 days) administration of bigumal to rabbits decreased the time of whole blood coagulation, partial thromboplastin time and reduced the sensitivity of animals to heparin. PMID- 3817143 TI - [Effect of clofelin on blood coagulability]. AB - In experiments on rabbits single intravenous injections of clopheline (0.002 mg/kg) and droperidol (1 mg/kg) reduced coagulatory properties of the blood. Preliminary administration of the drugs excluded the development of sodium thiopental hypercoagulatory effect. PMID- 3817144 TI - [Changes in thrombocyte aggregation as affected by the sodium salt of galbanic acid in an experiment]. PMID- 3817145 TI - [Crucial tasks of pharmacologists of the USSR in accelerating scientific and technological progress]. PMID- 3817146 TI - [Effect of 17 alpha-ethinyl estradiol on the blood serum lipid indices of rats]. AB - The administration of 17-ethinyl estradiol (0.25 mg/kg) to male Wistar rats caused on the 3rd day a decrease of the levels of free and esterified cholesterol, blood serum triglycerides and also a reduction of the content of esterified cholesterol with respect to total cholesterol while the lecithin cholesterol-acyltransferase activity appeared to be unchanged. The effect of ethinyl estradiol on blood lipid parameters against the background of lipemia induced by triton WR 1339 was reduced. PMID- 3817147 TI - [Hypolipidemic, hypocholesterolemic and antisclerotic action of the rotenoid glycoside amorphin]. AB - Amorphin--24-vicyanoside (C34H4O16(2)H2O)--in a dose of 10 mg/kg orally decreases the content of cholesterol, total lipids, atherogenic lipoproteids in the blood and organs of intact rats and rats with endogenous or ethanol hyperlipemia, inhibits the development of experimental atherosclerosis in rabbits induced by the combination of risk factors (cholesterol + glucose + hypodynamia), decreases the content of lipids in the blood and organs (especially in aorta), prevents the development of morphological manifestations of the aorta atherosclerosis. PMID- 3817148 TI - [Pharmacological activity of the furfuryl amine salt of 4-chloro-N-(2 furylmethyl)-5-sulfamoyl anthranilic acid]. AB - Furfuryl amine salt of 4-chloro-N-(2-furylmethyl)-5-sulfamoyl anthranilic acid was shown to exert more pronounced diuretic and saluretic action in rats, mice and dogs than that of furosemide. The previous administration of furfuryl amine salt of furosemide promoted normalization of the excretory processes of the kidney and increased survival rate of rats in ischemia of the single kidney. The antiedema activity of the drug was found to be much more pronounced than that of furosemide. PMID- 3817149 TI - [Dose-dependent effect of mezaton on kidney and heart functions]. AB - In unanesthetized dogs within 20 min after intravenous administration of 0.05 mg/kg of mezaton an increase of diuresis, the rate of glomerular filtration, effective renal plasma flow, filtration fraction, sodium and potassium excretion by the kidneys was observed. The dose of 0.5 mg/kg of mezaton produced the opposite changes. In the experiments on frogs mezaton administration in a dose of 200 mg/kg exerted the positive inotropic effect. PMID- 3817150 TI - [Effect of the antihypoxic agent isothiobarbamine on gastric secretion]. AB - The experiments on dogs with the isolated Pavlov's ventricles showed that isothiobarbamine (30 mg/kg) in the days of administration decreased the volume of the gastric juice secretion and its total and free activity. PMID- 3817151 TI - [Effect of pharmacological agents on the body of experimental animals in immobilization stress]. AB - The experiments on rats demonstrated that barbamyl, aminazine, seduxen, haloperidol, apressin, phentolamine, inderal, dopegit, amizil prevent to a large extent the development of morphological and biochemical manifestations in the body of animals during long-term immobilization. PMID- 3817152 TI - [Mechanisms of the hemodynamic effects of nonachlazine in ischemic heart disease patients]. AB - During course therapy with nonachlazine of patients with ischemic heart disease, stable angina pectoris a negative inotropic effect of the drug in persons with eukinetic and in particular hyperkinetic type of hemodynamics was revealed. Enhancement of beta-adrenoblocking effect of nonachlazine with an increase of its daily dose was found. Nonachlazine effect on hemodynamic parameters was shown to be mediated through adrenoreactive structures. PMID- 3817153 TI - [Clinico-pathogenetic basis for using crystalline lysozyme in the combined therapy of food toxinfections]. AB - In food toxinfections caused by various microorganisms (Staphylococcus, Escherichia, Klebsiella, Proteus, Citrobacter, etc.) a decrease of lysozyme debit and an increase of pH of gastric juice were found. One third of patients exhibited lactose deficiency of the small intestine. Treatment with furazolidone contributed to the development of lactase deficit and delayed stools normalization. Crystalline lysozyme shortened duration of febrile reaction and diarrhea, its intake facilitated lactose hydrolysis. PMID- 3817154 TI - [Metabolism of antipyrine during pregnancy]. AB - Dynamics of the saliva antipyrine content in women throughout the period of pregnancy was studied. There were estimated the half-life of antipyrine in the saliva, elimination constant, total clearance, apparent volume of distribution, area below pharmacokinetic curve. PMID- 3817155 TI - Detection and enzymatic deglycosylation of a glycosylated variant of prolactin in human plasma. AB - Immunoperoxidase electrophoresis was applied to the plasma of a patient showing a high level of prolactin (PRL) secreted by a pituitary adenoma. Two PRL monomers were detected with an anti-hPRL antiserum: a major 22 kDa form and a minor 25 kDa form. Concanavalin A-Sepharose 4B chromatography revealed that the 25 kDa form was a glycosylated variant of PRL. Incubation of this variant with endoglycosidase F led to its transformation into the 22 kDa form. PMID- 3817156 TI - Homology between the pyrazine-binding protein from nasal mucosa and major urinary proteins. AB - Sequence analysis of the pyrazine-binding protein from bovine olfactory mucosa reveals marked homology with a family of proteins of unknown function found in the urine of the adult male mouse and rat. In view of the dramatic biological responses to odorants transmitted in male rodent urines, it is proposed that these proteins play important roles in some aspects of odor transmission and reception. PMID- 3817157 TI - Identification of disulfide bonds in carboxy-terminal propeptides of human type I procollagen. AB - Intra-chain and inter-chain disulfide bonds within the carboxy-terminal propeptides of human type I procollagen were studied using cyanogen bromide cleavage of the propeptides and electrophoresis on SDS-polyacrylamide/glycerol gels. The results could provide a better understanding of the assembly of pro alpha-chains into procollagen. PMID- 3817158 TI - Probing DNA polymerase alpha with monoclonal antibodies. AB - DNA polymerase alpha was purified from human KB cells by immunoaffinity chromatography. Enzyme activity was inhibited by three different monoclonal antibodies (SJK-132, SJK-211, SJK-287). Kinetic analysis showed that each antibody neutralized polymerase activity by a different mechanism. SJK-132 was competitive with DNA indicating it interacts with the DNA binding domain of the polymerase. SJK-287 showed a biphasic response to dCTP suggesting two dCTP binding sites exist on polymerase alpha. SJK-211 was non-competitive with DNA, dCTP and dATP. PMID- 3817159 TI - Higher order folding of chromatin is induced in different ways by monovalent and by bivalent cations. AB - The condensation of the 10 nm chromatin filament in the 30 nm fiber by monovalent cations, polyamines and bivalent cations was studied with light scattering at 90 degrees and flow linear dichroism methods. It was found that monovalent cation- and polyamine-induced folding was a two-step process: a precondensation, when a rotation of nucleosomes takes place only, and a condensation step without changes in nucleosome orientation. Divalent cations affected the structure of chromatin in one step only -- condensation of the chromatin filament being accompanied by nucleosome reorientation. PMID- 3817161 TI - Nuclear matrix and chromosome scaffold preparations of in vitro cultured bovine liver cells have two proteins in common. AB - Nuclear matrices and chromosome scaffolds of in vitro cultured bovine liver cells were prepared under conditions that preserve the specific binding of the DNA. Protein compositions were analysed by electrophoresis and peptide mapping. Two slightly acidic polypeptides of apparent molecular masses 47 and 53 kDa were present in nuclear matrix as well as chromosome scaffold preparations. The corresponding matrix and scaffold proteins had identical peptide maps. Their putative function in the spatial organization of the DNA during the cell cycle is considered. PMID- 3817160 TI - Degradation by the 2',5'-phosphodiesterase activity of mouse cells requires the presence of a ribo hydroxyl group in the penultimate position of the oligonucleotide substrate. AB - A series of 9-beta-D-xylofuranosyladenine (xyloA or xyloadenosine) substituted analogs of 2-5A core trimer and tetramer were examined for their ability to be degraded by the 2',5'-phosphodiesterase activity of cytoplasmic extracts of mouse L cells. Two distinct groups of xyloA-substituted analogs could be readily discriminated. The first group contained xyloadenosine at the 2'-termini and included A2'p5'A2'p5'(xyloA) and A2'p5'A2'p5'A2'p5'(xyloA). These oligomers behaved as did their parent oligoadenylates in that they were equally sensitive to degradation by the 2',5'-phosphodiesterase activity. The second group of oligonucleotides bore a xyloadenosine residue in the penultimate nucleotide residues of the oligomers and included A2'p5'(xyloA)2'p5'(xyloA), (xyloA)2'p5'(xyloA)2'p5'(xyloA), A2'p5'A2'p5'(xyloA)2'p5'(xyloA) and (xyloA)2'p5' (xyloA)2'p5'(xyloA)2'p5'(xyloA). This group was quite resistant to 2',5' phosphodiesterase activity. In all, the findings demonstrate that the ribo configuration 3'-hydroxyl group in the penultimate nucleotide of the oligonucleotide substrate is a prerequisite for the 2',5'-phosphodiesterase activity. PMID- 3817162 TI - Interaction of synthetic analogs of distamycin with DNA. Role of the conjugated N methylpyrrole system in specificity of binding. AB - Interaction of two synthetic analogs of distamycin (Dst), PPA and PAP, containing a saturated beta-alanine moiety replacing one N-methylpyrrole ring, with different polynucleotides and natural DNAs were studied using UV and CD spectroscopy. The results indicate that, similar to Dst, these analogs bind to DNA via the minor groove with a specificity towards AT-base pairs. It may be proposed that pyrrole chromophores in Dst probably do not play a role in the AT base selectivity exhibited by Dst. PMID- 3817163 TI - Increased chloride efflux in fibroblasts from X-linked muscular dystrophies and clones from Duchenne carriers. AB - Previous studies have suggested an increased chloride membrane permeability in Duchenne muscular dystrophy (DMD) fibroblasts. We report that an increased chloride efflux with respect to controls is present not only in fibroblasts from DMD, but also from two other X-linked muscular dystrophies, Becker and Emery Dreifuss, as well as in clones from DMD carrier females. The latter observation suggests that, at least in DMD, the increased chloride efflux phenotype might be subject to lyonization. PMID- 3817164 TI - CpA containing oligoribonucleotides specifically inhibit protein synthesis in rabbit reticulocytes. AB - The diribonucleoside monophosphate CpA (and no others) inhibits polypeptide chain elongation in rabbit reticulocyte lysates at 10-50 microM. Furthermore, all the trinucleotides containing CpA, i.e., XpCpA and CpApX (X = U, C, A or G) block polypeptide chain elongation as well. At 10 microM the inhibition by XpCpA and not CpApX is transient because a 3'-exonucleolytic activity destroys the critical CpA moiety. The inhibitors do not appear to interfere with the aminoacylation of tRNAs or disrupt the interaction of amino-acyl-tRNAs with the protein synthetic machinery. High levels (200 microM) of CpA or the trinucleotides containing CpA have no effect on translation in a wheat germ cell-free system. PMID- 3817165 TI - Glucose metabolism in patients with gastrointestinal malignancy but without excessive weight loss. AB - Patients with gastrointestinal malignancy demonstrate impaired glucose disposal during steady state hyperglycaemia, 20.5 +/- 1.4 mumol/kg min when compared with controls 28.2 +/- 2.2 mumol/kg min. This appears to be unrelated to antecedent weight loss, but is related to the presence of metastatic spread (P less than 0.05). Insulin response to hyperglycaemia is normal, but analysis of glucose disposal with time suggests insulin resistance as a factor in the causation of impaired glucose disposal. Free fatty acid levels fail to suppress in cancer patients but their role in the causation of insulin resistance remains unclear. PMID- 3817167 TI - Male choriocarcinoma of the spleen: a case report. AB - The success with treatment of extragonadal germ cell tumours is well recognized and emphasizes the need for an early diagnosis. In young men presenting with undifferentiated carcinoma a non-testicular germ cell tumour should be considered. We report a case of choriocarcinoma involving the spleen. PMID- 3817168 TI - Oncological surgery--to be or not to be. PMID- 3817166 TI - Phagocytosis of yeast cells by monocytes: effects of fluorouracil, doxorubicin and mitomycin. AB - The drugs in the FAM combination (fluorouracil, doxorubicin, mitomycin) were tested for a possible effect on monocyte function by means of a glass-surface fluorescence-quenching technique of monocyte phagocytosis. The individual drugs significantly inhibited monocyte phagocytosis. The inhibition was located at the engulfment phase of phagocytosis and in an order of magnitude of 20-30%. The FAM combination did not suppress monocyte phagocytosis more than each one of the individual drugs. It is suggested that a slight inhibition of monocyte phagocytosis is a cost of cytotoxic treatment. PMID- 3817169 TI - Use and abuse of clomiphene citrate. PMID- 3817170 TI - Protein, progesterone, and protease inhibitors in uterine and peritoneal fluids of women with endometriosis. AB - This study was undertaken to determine whether women with endometriosis have altered protein, progesterone (P), and protease inhibitor concentrations in their uterine fluid and peritoneal fluid (PF) compared with controls at different phases of the menstrual cycle. Uterine flushings (UFs), PF, and blood were obtained during the follicular and luteal phases of the cycle from 29 normal women and 16 women who were diagnosed as having endometriosis. Protein content in UF did not change significantly throughout the cycle in either group. However, PF protein in patients with endometriosis was significantly (P less than 0.05) higher than in controls during the luteal phase. Total UF P was significantly (P less than 0.05) reduced in women with endometriosis during the late luteal phase. During the early luteal phase, trypsin inhibitory activity in UF from normal women was significantly (P less than 0.05) higher than at any other phase of the cycle, whereas inhibitory activity in UF from patients with endometriosis remained relatively constant. Patients with endometriosis had significantly (P less than 0.05) higher total activity in PF during the early luteal phase than did controls. These results indicate that women suffering from endometriosis have significantly lower levels of P and less protease inhibitor within their uterine cavity during the luteal phase of the cycle, and significantly higher concentrations of protein and protease inhibitor in PF during the luteal phase. PMID- 3817171 TI - Monitoring techniques to predict and detect ovulation. AB - This study was designed to evaluate the accuracy of various methods in predicting and detecting ovulation in 14 spontaneous and 17 clomiphene citrate (CC)-induced cycles. From cycle day 11 all subjects (n = 27) were followed with daily transvaginal ultrasound; rapid measurement of serum luteinizing hormone (LH) and estradiol (E2); determination of urinary LH with First Response (Tambrands Inc., Palmer, MA) and Ovustick (Monoclonal Antibodies, Inc., Mountain View, CA) kits; and recording of basal body temperature (BBT). The results demonstrated that transvaginal ultrasound detected ovulation in all cycles. Mean daily serum LH levels were similar in both groups, and peak values of 40 mIU/ml or greater preceded the day of ovulation in all cycles. Serum E2 peak was significantly greater in CC cycles (961 +/- 96 versus 463 +/- 39 pg/ml) (P less than 0.01) and preceded the LH peak in 97% of the cycles. First Response and Ovustick predicted ovulation in 53.3% and 87.5% of the cycles, respectively (P less than 0.01). BBT nadir predicted the day of ovulation in only 10% of cycles. In conclusion, this study revealed that transvaginal ultrasound is an excellent method for detection of ovulation and that Ovustick is a very useful method for prediction of the day of ovulation. PMID- 3817172 TI - Urinary human chorionic gonadotropin among intrauterine device users: detection with a highly specific and sensitive assay. AB - The mechanism by which the intrauterine device (IUD) prevents clinical pregnancy has not been established. The possibility that the IUD works primarily at the time of implantation or beyond has raised legal and ethical concerns. Numerous studies have measured human chorionic gonadotropin (hCG) among IUD users as a way to determine whether implantation routinely occurs in the presence of an IUD. Both positive and negative findings have been reported, reflecting major difficulties in the measurement of hCG at low levels. In this study, we collected daily urine specimens for up to three menstrual cycles from 40 women who used nonmedicated IUDs. We assayed these urines with an immunoradiometric assay that is highly specific for hCG at very low concentrations. This assay allows us to describe patterns of hCG rise and fall that would be undetectable by standard radioimmunoassays. In this study of IUD users, we found only one incident of probable early pregnancy loss among 107 cycles. With the use of an assay sensitive to hCG at levels as low as physiologic background, the possibility of frequent unrecognized implantation among IUD users can be reasonably excluded. PMID- 3817173 TI - Endocrine studies of the ovulatory disturbances in Wilson's disease (hepatolenticular degeneration). AB - Women with Wilson's disease may have severe oligomenorrhea or amenorrhea whose cause is unknown. The endocrine profile of four such cases was investigated by measuring basal values and the response to dynamic tests of hypothalamic, pituitary, thyroid, and adrenal function, which all proved normal. Ovarian function was disturbed, as witnessed by low estradiol, high total testosterone (T) levels with normal free T, and mildly elevated androstenedione. An interference of ovarian follicular aromatase activity possibly due to copper intoxication could explain these findings as the cause of the ovulatory disturbances of Wilson's disease. PMID- 3817174 TI - Progesterone and estradiol in saliva after in vitro fertilization and embryo transfer. AB - The importance of the luteal function to ensure adequate implantation prompted us to assay salivary estradiol (SE2) and salivary progesterone (SP) concentration serially after embryo transfer by simple and rapid radioimmunoassays to allow a noninvasive easily repeatable approach. SE2, which has fallen 1 day after human chorionic gonadotropin injection, increased after reimplantation (day 3), plateaued during approximately 1 week, and returned to basal levels before menstruation in absence of conception or in chemical pregnancy, whereas it increased steadily in successful pregnancy. SP increased in all the cases, formed a plateau, and returned progressively to basal levels before menstruation, whereas in ongoing pregnancy there was a transitory decline in the midluteal phase followed by a rapid and continuous increase, with a significantly higher ratio day 13/day 10 in successful pregnancy. PMID- 3817175 TI - Objective measurement of hot flushes associated with the premenstrual syndrome. AB - Because the majority of women with PMS complain of sweats and chills resembling menopausal flushes, we attempted to document the physiologic changes during these episodes. A 26-year-old nulliparous woman with PMS described the occurrence of hot flush-like episodes coincident with PMS symptoms. The patient completed prospective self-rating scales for two consecutive cycles to establish the pattern and severity of PMS. On day 26 of the first cycle when PMS symptom scores were elevated, continuous monitoring of skin resistance and finger temperature and frequent blood sampling for LH were performed for 8 hours. The patient experienced five flush episodes, each of which was associated with a drop in skin resistance of up to 4000 ohms and was coincident with an LH pulse. Three of the flushes were associated with a rise in finger temperature of up to 10 degrees C. These physiologic changes are identical to those seen during menopausal flushes and suggest that PMS may be associated with neuroendocrine events typical of E withdrawal. PMID- 3817176 TI - Oviductal cilial phagocytosis in patients undergoing tubal reanastomosis. AB - Chronic salpingitis has been reported in patients undergoing reversal of sterilization. For investigation of a possible microbial etiology for this process and characterization of its ultrastructural features, segments from the midportion of the fallopian tubes of five patients who underwent sterilization reversal were studied by comprehensive tubal cultures, and light and electron microscopy. Three patients undergoing sterilization by partial salpingectomy were studied as controls. Chlamydial IgG and IgM antibody titers were performed on serum samples. No microbiologic or serologic evidence for active infection by known pathogens was found. In three of the study patients mild oviductal mural fibrosis was present. However, in two other study patients chronic salpingitis with phagocytosis of cilia by luminal macrophages was demonstrated. It is suggested that if this active process persists after tubal reanastomosis, it may result in impaired oviductal function. PMID- 3817177 TI - Surgical induction of endometriosis in the rat. PMID- 3817178 TI - Pregnancy-specific parameters after IVF. PMID- 3817179 TI - Does tubal patency depend on surfactant? PMID- 3817180 TI - A comparison of the penetration of human sperm into bovine and artificial cervical mucus. PMID- 3817181 TI - [Action of serotonin on isolated smooth muscles of the human gastrointestinal tract and its potential use in the clinic]. PMID- 3817182 TI - [Neuronal organization of conditioned inhibition]. PMID- 3817183 TI - [Neuronal reactions of the associative cerebral cortex in the cat arising from the interaction of transcallosal and peripheral impulses]. PMID- 3817184 TI - [Inhibitory parameters and characteristics in the neurons of the associative cerebral cortex of the cat]. PMID- 3817185 TI - [Characteristics of the inhibitory processes in the neurons of the posterior lateral thalamic nucleus when exposed to different afferent stimulations]. PMID- 3817186 TI - [Neuronal activation of the ventroposteromedial thalamic nucleus in the cat by the stimulation of different groups of trigeminal nerve fibers]. PMID- 3817187 TI - [Spike activity of neurons of the ventromedial hypothalamus of the rabbit in response to cholecystokinin application to the cornea]. AB - Microapplication to the rabbit eye cornea of the [Glu26] analogue of nonsulphated C-terminal octapeptide cholecystokinin reduced 2-5-fold the firing rate of the ventromedial hypothalamus neurons whereas [Glu26, 32] induced a 2-3-fold increase of the firing rate. Contralateral application increased 1.2-2.3-fold the latencies of responses. Nonsulphated C-terminal octapeptide cholecystokinin, its analogue [Glu32] and 0.9% NaCl solution exerted no obvious effect. PMID- 3817188 TI - [Surface architectonics of peripheral blood erythrocytes of the rat according to scanning electron microscopy findings]. AB - Proceeding from the G. I. Kozinets et al. (1977) classification of human red cells, 9 types of red cells were distinguished with scanning electron microscopy in peripheral blood of Wistar male rats: discocytes, discocytes with processes on their surface, mulberry-like red cells, dome-like red cells, spherical red cells with smooth and rough surface, red cells similar to a flat ball, degeneratively altered red cells. Percentage of different shapes of the erythrocytes was determined. PMID- 3817189 TI - [Theoretical basis for the method of calculating blood-flow volume velocity from hydrogen clearance curves]. AB - Two models: a hemodynamic one where the was out velocity is determined by means of the blood flow intensity alone, and a microcirculation one taking into consideration diffusion processes in tissue as well as architectonics of the vascular bed, gave ground for calculation of interrelationship between the time constant of the clearance curve and the local blood flow velocity. The data obtained showed the necessity of amendment depending on the time constant of the clearance curve when using the hemodynamic model. PMID- 3817190 TI - [Systemic hemodynamic shifts in the arterial and venous portions of the vascular bed in hypoxia]. AB - A reduction of total peripheral resistance is of a major importance for depressor shifts of arterial pressure in moderate hypoxia. The hypoxic stimulus induces a deficiency of increment in cardiac output shifts as compared with venous return. An increment of venous return and cardiac output suggests that the compensation for the depressor shifts induced with the lack of O2 in air and blood, occurs on account of flow induces of the circulation system. PMID- 3817191 TI - [Filtration-absorption function of the vessels of the small intestine in response to reflex effects]. AB - The reflex activation of the cat intestine sympathetic nerves induced changes in capillary hydrostatic pressure depending on the perfusion regimen in the vascular bed: the pressure rose in stable blood expenditure and dropped in perfusion under constant pressure. The capillary filtration coefficient decreased in response to sympathetic effects, irrespective of the blood supply conditions. PMID- 3817192 TI - [Changes in the contractile activity of the portal vein of the rat in response to corticosteroid hormones]. AB - Corticosterone (8 X 10(-8) g/ml) augmented the amplitude of the rat portal vein phasic contractions within first minutes. The dose 5 X 10(-7) g/ml first augmented and then reduced the amplitude, simultaneously increasing the rate of autorhythmic activity and the vascular tone. Hydrocortisone and dexamethasone exerted no initial effect but reduced the amplitude of phasic contractions within 5-10 min. Glucocorticoids did not affect the rate of contractions, but dexamethasone (5 X 10(-7) g/ml) augmented the vascular tone. The mineral and glucocorticoid action of corticosteroids seems to be actualized through different mechanisms, the initial action of hormones being determined by their membrane effects upon vascular myocytes. PMID- 3817193 TI - [Dynamics of oxygen in the pregnant uterus during hypo- and hyperoxia]. PMID- 3817194 TI - [Characteristics of histamine-sensitive adenyl cyclase from cells of the gastric mucosa of the rat]. AB - Effects exerted by specific modifiers and ions on the adenylate cyclase activity of coarse membrane fractions of cells isolated from the rat gastric mucosa, were investigated. Fluoride ions cause 7-8-fold activation of the enzyme affecting neither the enzyme's affinity towards Mg2+-ATP, nor the cooperativeness of substrate binding. Cations Mg2+ and Mn2+ produce activating while Ca2+ inhibiting effects. GTP (10-5 M) enhances histamine activation of the enzyme and reduces maximal stimulating concentrations of histamine. GTP and Gpp(NH)p exert activating action on the enzyme causing 2- and 5-fold activation, resp. Adenosine suppresses the enzyme activity, the effect being potentiated by GTP. The plausible role of N-protein in the regulation of the enzyme activity is discussed. PMID- 3817195 TI - [Features of the hydrolysis and transport of nutrients in the proximal and distal portions of the jejunum]. AB - In polyfistulae dogs, deceleration of protein hydrolysis, of nitrogen, potassium and water absorption in the ileum distal portion as compared with the proximal one seems to be associated with own abilities of the distal areas for nutrients hydrolysis and transport rather than with their evacuatory activity. Different ways of creating polycomponent mixtures for administration into the ileum distal areas, are discussed. PMID- 3817196 TI - [Patterns of redistribution of calcium and magnesium in the tissues of lactating white mice]. AB - The Ca2+ and Mg2+ contents in the blood, milk and tissues involved in lactation, were studied in lactating and non-lactating albino mice. The Ca2+ concentration in the blood plasma of lactating mice was raised by 25%, and Mg2+--by 78%. The tissue concentrations of these ions did not change during lactation in muscles. The Ca2+ level was raised by 41% in the red cells in lactation, and Mg2+--by 55%; the concentration of Ca2+ and Mg2+ in the mammary alveolar tissue was respectively 4.4 and 2.9 times higher than in non-lactating animals. The data obtained suggest an interrelationship between the tissue ion content and the degree of enhancement of specific activity of the tissue during lactation. PMID- 3817197 TI - [Thermoregulatory activity of the motor units of skeletal muscles in the pigeon]. AB - The firing rate of single motor units was 5-12/sec during cold tremor in anesthetized pigeons. Some differences of the firing rate characteristics were found between pigeons captured in winter and in summer. PMID- 3817198 TI - [A simple manipulator for inserting microelectrodes into the brains of the freely moving rat]. PMID- 3817199 TI - [Method of assessing changes in the summary electromyogram]. PMID- 3817200 TI - [Method of raising and long-term maintenance of the body temperature of an animal without the use of drugs]. PMID- 3817201 TI - [Features of the antidromal and synaptic activation of neurons of the Bekhterev nucleus reticularis tegmenti pontis induced by cortico- and cerebello-fugal spiking]. AB - Antidromic activation on the Bechterew nucleus neurons with stimulation of brachia pontis and conjunctivum as well as cerebellar central nuclei and pyramidal tract, was studied in anesthetized cats. The Bechterew nucleus neurons were found to receive direct activating inputs from brachium conjunctivum, cerebellar central nuclei and the pyramidal tract. Convergence of the inputs in single neurons was shown to exist. PMID- 3817202 TI - [Ontogenetic features of the development of evoked potentials in the visual cortex of the alert rabbit]. AB - Formation of optical EPs was studied in alert rabbits during postnatal ontogenesis. The pathways of the transmission of light stimuli to the brain cortex were found to develop heterogeneously causing the EPs to have different forms in the early stages of ontogenesis. PMID- 3817203 TI - [Physiologic basis for the "attractiveness" of female rats for males]. AB - Sexual behaviour of intact male rats was studied in tests with ovariectomized female rats and with those injected with sexual hormones. The data obtained support the hypothesis of the existence of central and peripheral mechanisms regulating the sexual behaviour of male rats. The treatment of castrated females with androgen resulted in males sniffing at them mor often, the copulatory behaviour being only observed in tests with females treated with estrogens in combination with progesterone. PMID- 3817204 TI - [Steady electric field of the rat during adaptation to functional unloading of the hindlimbs]. AB - Unloading of the hindlimbs' weight--bearing muscles induced considerable changes in animal's static electrical field on the 5th--8th day of experiment. PMID- 3817205 TI - [Phenomenon of rapid increase in loudness during residual masking of a tone with a tone]. AB - The loudness recruitment effect mainly depended on masker and test-tone frequencies and to some extent on perception thresholds. The data obtained suggest connections among such properties of the auditory system as frequency selectivity, adaptation and loudness recruitment. PMID- 3817206 TI - [Physiologic properties of the smooth muscles of the cervix uteri in the rat]. AB - Contractile activity of the isolated smooth muscle of the cervix and cornea was studied in nongravid, gravid (10-21 days) and parturient rats. Smooth muscle of the cervix having alpha- and beta-adrenoreceptors, generated spontaneous contraction, revealed no sensitivity to histamine and small sensitivity to oxytocin and serotonin, whereas the sensitivity to acetylcholine was very high. Prostaglandins (PGF2 alpha and PGE2) could inhibit spontaneous contractions of the smooth muscle in the parturient rat cervix. PMID- 3817207 TI - [Age and features of thrombus formation in the rat]. AB - With the aid of a laser-induced thrombosis model, the process of thrombus formation was studied in the microvessels of the small intestine mesentery of 3-4 and 12-14-month old rats. Venules and arterioles were laser-irradiated. The thrombus formation developed faster in both types of vessels in elder rats. The data obtained suggest an increase of the thrombotic potential of the mesentery microvessels in the course of ageing in rats. PMID- 3817208 TI - [Various morphofunctional properties of erythrocytes of animals acclimatized to heat]. AB - The effect of prolonged experimental heat exposure on morpho-functional characteristics; of animal erythrocytes involved formation of a new erythrocyte population with increased cell diameter, volume and hemoglobin content, enhanced electrophoretic velocity and resistance against various hemolytic factors. PMID- 3817209 TI - [Effect of complexes of heparin with plasma proteins on the anticoagulant and fibrinolytic activity of blood]. AB - Mixture of heparin complexes with plasma proteins of the rat blood with no fibrinogen, prothrombin or factors of prothrombin complex obtained either in presence or absence of CaCl2, revealed strong anticoagulating, fibrinolytic, antiaggregating and antipolymerizational activities. 1--2 mM CaCl2 solution increased the enzymatic and non-enzymatic activities of the mixture in vitro. The i.v. administration of the mixture to albino rats potentiated the anticoagulating and fibrinolytic activities of the blood plasma. PMID- 3817210 TI - [Peripheral mechanisms of regulating lymph heart activity]. AB - The data obtained suggest double regulation of the activity of lymphatic hearts. Activation of the local mechanisms of regulation occurred in increasing production of lymph and stretching of cavity of the lymphatic heart and adjacent subcutaneous sack. PMID- 3817211 TI - [Functional changes in the argentaffin cells of the stomach and electrical activity of the brain of the rat after injection of neurotensin into the hypothalamus and 3d ventricle of the brain]. AB - Administration of neurotensin or its analogue into the hypothalamic structures altered the degree of activity synchronization among hypothalamic and brain-stem structures, the synchronization becoming most obvious among ventro-medial nucleus, amygdala and the central grey matter. Administration of the drugs into the 3rd ventricle and paraventricular nuclei suggested antagonistic effects of these peptides at the hypothalamic level. The data obtained could be regarded as local effects of the neuropeptides upon neurons of the paraventricular nucleus and as systemic effects upon argentaffin cells of the stomach antral portion. PMID- 3817212 TI - [Method of evaluating the dynamic characteristics of autoregulation of organ blood flow]. PMID- 3817213 TI - [Quantitative evaluation of local cerebral blood flow by the clearance method with inhalation and electrochemical generation of hydrogen]. PMID- 3817214 TI - [Isolated secretory stomach of the duck]. PMID- 3817215 TI - [Fertilization of human oocytes in vitro and embryo transplantation]. PMID- 3817216 TI - Reproductive apparatus of Fasciola hepatica L. I. Localization and activity of enzymes of anaerobic respiration. PMID- 3817217 TI - Quantity of DNA in foetal liver after X-irradiation and/or AET, MEA, or 5-HT treatment of pregnant Porton mice. PMID- 3817218 TI - Activity of reticulocyte and erythrocyte acetylcholinesterase of rats in normal and experimental conditions. PMID- 3817219 TI - Cadmium accumulation in tissues, organ weights, and foetal mortality in females from two inbred mice strains treated with cadmium chloride. PMID- 3817220 TI - Circumventricular organs in acutely hypertonic rats. II. Area postrema and choroid plexus. PMID- 3817221 TI - Postnatal changes in the time and space pattern of non-neuronal cell divisions within the dorsal part of the rat cerebral hemisphere. PMID- 3817222 TI - Peptide synthesis in rat liver slices. Effect of cycloheximide. PMID- 3817223 TI - Tubifex bioassay test in studies on the pyrethroid Decis 2.5 EC. PMID- 3817224 TI - Postembryonal development of the testicular germ cells in cockerels of two breeds. PMID- 3817225 TI - Electron microscopic observations on giant vacuoles present in the median eminence of rats. PMID- 3817226 TI - Importance of skeletal muscle environment for ectopic bone induction in mice. PMID- 3817227 TI - [A reverse phase high performance liquid chromatography-UV spectrometry method for the analysis of several intrinsic adrenal delta 4-steroid concentrations]. AB - Taking an advantage of the property of delta 4-steroid that have a maximum absorbance around 250 nm wave-length of ultraviolet, we devised an assay method for the determination of serum delta 4-steroids concentration using a reverse phase high performance liquid chromatography (HPLC)-UV spectrometry. The assay procedure was as follows: A mixed solvent containing methanol, acetonitrile and water in 55/3/42 by volume was used as a mobile phase, and which was pumped at a constant flow rate of 1.5 ml/min. The main column and precolumn used were ERC-ODS 1161 (phi 6 mm X 10 cm) and ERC-ODS-1652 (phi 6mm X 3 cm), respectively. Two liquid-liquid extraction methods were used. One was a conventional method using dichloromethane for an extraction solvent, and the other was a simplified method using Extrelut column and ethyl acetate. Before a practical assay we examined the retention time of each steroid determined and its ratio of peak height to that of the internal standard (dexamethasone). We found good correlations between the concentrations of cortisol (F), 17 alpha-hydroxyprogesterone (17-OHP) and 21 deoxycortisol (21-DOF) estimated by this HPLC method and those by highly specific radioimmunoassay method. The concentrations of cortisone (E) and F of eight umbilical venous blood specimens were 159.7 +/- 26.3 (Mean +/- SD) ng/ml and 93.3 +/- 58.9 ng/ml, respectively, and 17-OHP was detected 7 of them and its concentration was 17.4 +/- 12.4 ng/ml. On the other hand, 17-OHP and 21-DOF peaks could not be detected in 1 month old normal infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817228 TI - [Histological changes and operative findings of pituitary adenomas after bromocriptine treatment]. AB - Twenty-eight patients with various types of pituitary adenomas were studied endocrinologically and neuroradiologically. We observed the changes of tumor size during bromocriptine treatment. After various periods of bromocriptine therapy, we operated on these tumors and examined then histologically. One of 5 patients with nonfunctioning adenomas improved remarkably in his visual field and acuity after 7-month bromocriptine therapy. The pathological findings disclosed remarkable changes in tumors composed of shrunken island-like cell nests and acellular spaces. These shrunken island-like cell nests were composed of tumor cells whose cytoplasmic volume decreased and whose nuclear chromatin clumped. In acellular spaces, there were irreversibly destructed tumor cells, hyaline substances, tumor cell debris and collagen fibrils. One of 8 cases of acromegalies showed a remarkably reduced tumor on CT with clinical improvement after treatment with bromocriptine for 10 months. This patient's serum growth hormone titer was raised by an abnormal response to intravenously injected TRH (thyrotropin releasing hormone), and his serum prolactin was abnormally high. Therefore, this tumor was thought to be a mixed adenoma with growth hormone secreting and/or prolactin secreting cells. Histological examinations disclosed cell shrinkage of tumor cells. Interestingly, there were scanty fibrotic changes in this tumor in spite of the long term bromocriptine therapy. In 15 cases of prolactinomas, the larger the tumor size and the longer the period of the bromocriptine therapy, the more fibrosis was seen. Under a period of bromocriptine therapy longer than 3 months, the fibrotic changes of tumor progressed, and this made more difficulty in selective adenomectomy even in the case of intrasellar adenomas. Therefore we thought that transsphenoidal surgery could successfully be done within 3 months during continuation of bromocriptine therapy. PMID- 3817229 TI - [Selective augmentation of cellular hCG alpha mRNA levels and immunoreactive hCG alpha secretion by 17 beta-estradiol in the normal placenta]. AB - In order to elucidate a possible self-regulation for hCG synthesis in placenta, effects of estradiol on hCG production and secretion were evaluated by culturing early placental tissue in the presence or absence of estradiol. The cellular level of mRNAs encoding hCG (alpha, beta) and hPL were estimated by mean grain count per syncytial nucleus on the placental sections hybridized in situ with labeled cDNA probes corresponding to these mRNAs. Immunoreactive hCG, hCG alpha and hPL in the media and explanted tissues were measured by the homologous RIAs. Addition of estradiol at concentration of 1 approximately 10 ng/ml into the medium caused an increase in the cellular levels of hCG alpha mRNA after 24-hour cultured, and exhibited significant increases in immunoreactive hCG alpha levels in the media and explanted tissues after 72-hour culture. The addition of estradiol neither affected the cellular levels of mRNA encoding hCG beta and hPL nor immunoreactive hCG and hPL levels in the media and tissues. The appropriated concentration of estradiol (1 approximately 10 ng/ml) used in above experiments was found to be similar to the tissue concentration in normal placenta. These findings suggest that the physiological concentration of estradiol selectively stimulates hCG alpha synthesis and secretion by normal placenta. Thus, estradiol in placenta may be a factor responsible for the increase of hCG alpha in maternal serum and placental tissue with the progress of gestation. PMID- 3817230 TI - [Regulation of epidermal growth factor receptors by TSH, and effects of EGF, TSH and phorbol ester on DNA synthesis in cultured porcine thyroid cells]. AB - Using porcine thyroid cells of primary monolayer culture, this study was conducted to clarify the nature and characteristics of epidermal growth factor (EGF) receptors on porcine thyroid cells and also to investigate the effects of EGF, TSH and phorbol ester on DNA synthesis. Receptors for EGF on porcine thyroid cells exist in two forms which differ in both affinity and capacity. Scatchard analysis of saturation binding assay performed at 4 degrees C for 6h indicates that there is a high affinity class of receptors with low capacity (K1 = 4.70 +/- 0.90 X 10(-9)M and 8,600 +/- 1,200 sites/cell) and low affinity receptors with high capacity (K2 = 2.24 +/- 1.17 X 10(-7)M and 65,500 +/- 18,000 sites/cell) on the cells cultured for 4 days in the absence of TSH. When thyroid cells were cultured in the presence of various concentrations of TSH (0 approximately 50 mU/ml) and for various times (0 approximately 96 h) with TSH (10 mU/ml), specific EGF binding to the cells increased dose- and time-dependently. On TSH (10 mU/ml) treated cells for 4 days, two kinds of EGF receptors, i.e. high affinity and low capacity (K1 = 5.39 +/- 1.75 X 10(-9) M and 17,200 +/- 2,500 sites/cell) and low affinity and high capacity (K2 = 1.70 +/- 1.40 X 10(-7)M and 76,300 +/- 17,900 sites/cells), were resolved. The results indicate that TSH can modulate EGF receptors by increasing the number of high affinity sites on porcine thyroid cells. Next, using [Me-3H] thymidine incorporation into TCA precipitable materials for 48h, we studied the biological effects of EGF, TSH and phorbol myristate acetate (one of the potent phorbol esters) on DNA synthesis. Both EGF and PMA can promote [Me-3H] thymidine incorporation. Maximal responses were obtained with EGF ranging from 10(-9) to 10(-7)M and with PMA from 10(-9) to 10( 7)M. In contrast, TSH inhibits [Me-3H] thymidine incorporation dose-dependently. Almost the same results were obtained by these agents on TSH (10 mU/ml)-treated cells for 4 days, but EGF stimulated cell growth at a lower concentration of 10( 11)M, which was possibly related to an increase of high affinity receptor numbers. The growth promoting effect of EGF and PMA in combination was additive, and TSH suppressed the cell growth in the concomitant presence of EGF and PMA.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3817231 TI - [Studies on monoclonal antibodies to TSH receptors--heterogeneity and pathophysiological significance of antibodies to TSH receptor]. AB - Recent studies revealed that anti-TSH receptor autoantibodies are involved in the pathogenesis of both Graves' disease and a part of hypothyroidism, but precise mechanism of action of these antibodies remained to be studied. In order to delineate the heterogeneity of these antibodies and their pathophysiological significance, we produced monoclonal antibodies to TSH receptor and studied their characteristics. Mouse monoclonal antibodies to TSH receptor were derived from spleen cells of mice immunized with partially purified human TSH receptor, which was prepared by TSH-coupled affinity chromatography of thyroid membrane solubilized with Triton X-100. By fusing spleen cells and mouse myeloma cells in the presence of polyethylene glycol and selecting with limiting dilution method, 5 hybridomas were obtained. Among 3 antibodies, which inhibited TSH binding to thyroid membrane (TSH displacing activity, TDA), 2 inhibited TSH stimulation of thyroid adenylate cyclase (AC) (human thyroid adenylate cyclase inhibitor activity, HTACI), and one showed no bioactivity. Among other 2 antibodies without TDA, 1 stimulated AC (human thyroid adenylate cyclase stimulator activity, HTACS) and the other inhibited TSH stimulation (HTACI). All activities of these antibodies were dependent on IgG concentration and disappeared by treatment of anti-mouse IgG antibodies. In addition, 4 human-human hybridomas were established by fusing human peripheral lymphocytes of patients with Graves' disease and nongoitrous hypothyroidism with human lymphoblastoid cell line. Among 2 antibodies with TDA, one antibody inhibited TSH stimulation of AC, inhibiting TSH binding competitively and another antibody stimulated AC, inhibiting TSH binding noncompetitively. Among the other 2 antibodies, which did not inhibit TSH binding but were shown to bind to TSH receptor by immunoprecipitation, one stimulated AC and the other inhibited TSH stimulation of AC. Among 2 antibodies with HTACI, one antibody with positive TDA inhibited stimulation of AC by stimulative antibodies with positive TDA, but the other without TDA inhibited stimulation of AC by both antibodies with or without positive TDA. These inhibitory antibodies did not inhibit stimulation of AC by Forskolin and Gpp(NH)p, which are known to affect other parts of receptor-AC system than receptor unit. These data suggest that anti-TSH receptor antibodies are heterogenous in the mode of binding to the receptor and in their bioactivities, and may be involved in the pathogenesis of both Graves' disease and a part of idiopathic hypothyroidism. PMID- 3817233 TI - Involuntary commitment in Delaware--never the same again? PMID- 3817232 TI - Pneumococcal vaccine failure in a child with sickle-cell disease: a case report. PMID- 3817234 TI - [Blastomatous hemangiomas. Spontaneous remission and regression following soft roentgen radiotherapy]. PMID- 3817235 TI - [Evaluation of the oncotherapy concept in basal cell cancers of the head and neck]. PMID- 3817236 TI - Enzyme activity in circulating neutrophils in patients with various clinical forms of common psoriasis. PMID- 3817237 TI - Anthralin. PMID- 3817238 TI - Natural history of dermatitis herpetiformis in southern Sweden. AB - A retrospective clinical survey of 96 patients with dermatitis herpetiformis (DH) was performed in two defined populations of 425,000 in southern Sweden. The incidence of DH was 1.05-1.13/100,000 inhabitants/year and the prevalence was approximately 20-25/100,000 inhabitants. In one-third of DH patients the age at onset was greater than 60 years. In women with DH a strong connection to thyroid dysfunction was observed, but also other conditions of probable autoimmune pathogenesis were found in both sexes. No connection to malignant disease was observed. DH seems to be less active the later in life it starts. Several patients with DH manage without dapsone or need dapsone just occasionally in connection with bouts. This is the case even without a gluten-free diet. Many mild cases of DH were observed without a gluten-free diet; therefore, this restricting regimen should be prescribed only in more active cases of DH. PMID- 3817239 TI - Treatment of psoriasis with dithranol cream compared with dithranol paste. AB - In a paired-comparison study in 15 hospitalized patients suffering from psoriasis, Dithrocream was compared with dithranol in Lassar's paste. The therapeutic effectiveness of the two preparations was about the same, but Dithrocream gave fewer side effects in the form of staining and irritation. PMID- 3817240 TI - Irritant potential of dithranol. AB - The minimal irritation dose (MID) for dithranol in 5% salicylic acid vaseline was determined by open patch testing. From the MID, the irritation dose 50 (ID50) was evaluated. It was 0.057% in 100 controls and 0.046% in 100 psoriatic patients, which is not statistically different due to the great differences between individuals. 20 other patients claimed a dithranol hyperreactivity in their history. Only 13 of them, however, showed a decrease in the MID, which was between 0.01 and 0.02% (means = 0.014%), i.e. outside the confidence interval found in the 100 psoriatic patients. 8 of these 13 reacted with blister formation after exposure to 0.1-0.16% dithranol. An allergic contact dermatitis was excluded as the cause of the hyperreactivity. The tolerance to increasing dithranol concentrations after beginning with the MID up to clearance of the lesions, as well as the predominance of granulocytes as compared to lymphocytes in blisters due to dithranol testing, suggest an irritant inflammatory mechanism. In such hyperreactive cases therapy should be started with the MID established in the open patch test. PMID- 3817241 TI - Dysplastic nevus syndrome: ultraviolet hypermutability confirmed in vitro by elevated sister chromatid exchanges. AB - The dysplastic nevus syndrome (DNS) is a clinical and genetic entity in which affected individuals have increased numbers of dysplastic nevi and a markedly increased risk of developing one or more cutaneous melanomas. Sister chromatid exchanges (SCE) are one of the cytogenetic end points that are positively correlated with the mutation rate and may therefore be used to estimate the spontaneous and the UV-induced mutagenesis in cultured and stored fibroblasts. SCE were presented and stained according to the Hoechst-Giemsa method. The normal control fibroblasts showed 9.48 +/- 1.74 SCE per metaphase (n = 23) with an UV-C induced increase (delta SCE) of 1.61 +/- 0.53 SCE per mJ/cm2 in the range of 0-5 mJ/cm2. Fibroblasts from DNS patients with melanoma (n = 12) showed normal values of spontaneous SCE but a significant increase (p = 0.01) of 2.43 +/- 0.68 SCE per mJ/cm2. As in xeroderma pigmentosum, UV-C-induced delta SCE appears as a valuable tool for measuring the individual hypermutability in DNS. delta SCE indicates the increased susceptibility to UV-induced somatic mutations and may be etiologically related to the increased melanoma incidence in DNS. PMID- 3817242 TI - Minoxidil induces selective regrowth of androgenetic dependent hair. PMID- 3817243 TI - The proteins in Lumbricus terrestris and Eisenia foetida coelomic fluids and on coelomocytes reacting with sheep and goat IgG molecules. AB - Sheep and goat fast migrating IgG molecules and their F(ab')2 fragments react with L. terrestris and E. foetida coelomic fluid proteins. The reaction was not mediated by antibody binding site but by some other part of the IgG molecule, since affinity purified antibodies of different antigen specificities as well as IgG preparations from normal sheep sera reacted with the same coelomic fluid proteins. The presence of at least two reacting proteins was detected by immunoelectrophoresis and immunoblotting analysis. Molecular weights of these proteins were 47 and 50 kD in L. terrestris and 42 kD in E. foetida. Sheep antibodies and IgG molecules also bind to the Sheep antibodies and IgG molecules also bind to the surface of about 2% of coelomic leukocytes and the immunoblotting analysis showed that the IgG binding proteins in coelomic fluids and in cell lysates were similar. PMID- 3817244 TI - Characteristics of a galactose-binding hemagglutinin (lectin) from hemolymph of Spodoptera exigua larvae. AB - Hemolymph from Spodoptera exigua larvae agglutinates rabbit and human O erythrocytes. The agglutinin appears to be naturally occurring i.e., injury (by injection) or injection of larvae with fungal cells does not induce an increase in titer of hemolymph samples. Hemagglutinin activity is destroyed by heat or EDTA, and galactosidic carbohydrates inhibit agglutination of both red blood cell types. The agglutinin was purified by affinity chromatography using an Affi-Gel ovalbumin column. Binding to the column is calcium (cation) dependent. SDS gel electrophoresis shows that the agglutinin is a minor component of whole hemolymph represented by two bands with molecular weights of 30,500 and 31,000 daltons. Fluorescence microscopy using rhodamine-labeled agglutinin indicates that the agglutinin binds to fungal cell wall surfaces known to have galactose residues (e.g., Paecilomyces ochraceus), and that binding is specifically inhibited by galactose. There is no specific binding to fungal walls known to lack galactose residues (e.g., Paecilomyces ochraceus, Nomuraea rileyi). The agglutinin may be involved in the immune response of the insect e.g., by opsonization of microbial (fungal) surfaces which render the invading cells more susceptible to phagocytosis or agglutination. PMID- 3817245 TI - Snailine: a possible diagnostic reagent from a common marine snail, the southern periwinkle, Littorina angulifera. AB - A substance which strongly precipitates human serum proteins is released into the environment by the southern periwinkle, Littorina angulifera. Two-dimensional crossed immunoelectrophoresis revealed that the snail precipitin reacts with a number of human serum proteins, including 11 not detected by mammalian antiserum. The precipitin is readily collected in saline solution, which then is referred to as snailine, a potentially useful diagnostic reagent. Precipitins released into the environment by marine species may represent a little-known external immunologic system. PMID- 3817246 TI - Macrophage-like effector of spontaneous cytotoxicity from the shark. AB - The effector of spontaneous cytotoxicity from shark peripheral blood has been shown to be a macrophage-like cell. Effector cells are isolated by centrifugation over Lymphocyte Separation Medium, adherence to glass, Percoll density gradient centrifugation and adherence to fibronectin sequentially. Effector cells are adherent to glass, sediment to densities of 1.048-1.052 g/ml and are adherent to fibronectin. The isolated effectors represent less than 1% of the peripheral blood leukocytes, and exhibit potent cytotoxic capability, both spontaneous and in the presence of phytohemagglutinin. In addition, the activity of these cells is resistant to 3000 rads gamma irradiation. Although nurse sharks have natural antibody to trinitrophenol, spontaneously cytotoxic cells are incapable of killing trinitrophenol modified targets indicating that natural antibody is not required for reactivity, and that natural antibody and spontaneous effectors do not have the same repertoire. However, cold target inhibition studies showed that these effector cells can recognize four of five human lymphomyeloid targets. It is concluded that the spontaneous, extracellular killing by the macrophage-like effector most closely resembles that of activated mammalian tumoricidal macrophages with the exception that they do not appear to require in vitro activation. PMID- 3817247 TI - Effects of X-irradiation and thymectomy on the immune response of the marine teleost, Sebastiscus marmoratus. AB - Effects of X-irradiation and thymectomy on the immune response of the rock fish, S. marmoratus were studied. Animals were thymectomized and irradiated at the dose of 2000 R. In non-thymectomized and irradiated fish, injected with SRBC one week after irradiation, antibody production was completely suppressed and they required twice the time for rejection of scales allografted three days after irradiation. On the other hand, fish which were irradiated four days after thymectomy and injected one week after irradiation, showed a fairly high level of antibody, although, in the allograft rejection, no significant difference was observed when compared to the irradiated fish. Furthermore, animals thymectomized, irradiated and autoimplanted showed higher production of antibody when immunized three months after irradiation compared to matched controls. In the same manner, in the allograft rejection, a slight restoration was found in fish reconstituted with a non-irradiated thymus. From these results, it is considered that, as in mammals, the adult thymus of fish plays an important role in recovery from the damage to the immune system caused by irradiation. Furthermore, a combination of X-irradiation and thymectomy suggests that suppressor T-cells which are resistant to X-rays exist in the fish thymus. PMID- 3817248 TI - Local immunological response in the posterior intestinal segment of the rainbow trout after oral administration of macromolecules. AB - This paper deals with the effect of an orally administered antigen (human immunoglobulin G, IgGH) on the local intestinal immune system of trout kept at 12 degrees C. Significantly increased numbers of antigen-binding (ABC) and plaque forming cells (PFC) were induced in the epithelium by a single oral administration of antigen. In the primary immune response, ABC and PFC first occurred on days 4 and 6 respectively and peak counts were obtained at day 6 and 10 respectively. PFC counts returned to background levels by day 18. Lymphoid cells recovered from the intestinal epithelium 3 days after immunization were able to proliferate and to secrete Ig in vitro. 24 h after administration, the antigen could be visualized by immunofluorescence on the outer surface of the intraepithelial macrophages. An intestinal secretory immune system stimulated by oral administration of antigens is operative in trout, a carnivorous species with a well differentiated stomach. PMID- 3817249 TI - Macrophage activation during experimental allergic orchitis in rainbow trout (Salmo gairdneri). AB - Macrophages isolated from fish undergoing an experimentally induced autoimmune response against the testis were found to have been activated using several morphological and functional criteria. They exhibited increases in cell spreading, phagocytosis, reduction of nitroblue tetrazolium and acid phosphatase activity. In addition they possessed larger and more numerous cytoplasmic organelles and peripheral processes compared with control cells. Culture of the autoimmunologically elicited cells for 1 or 2 days resulted in their return to a non-activated state. PMID- 3817250 TI - Partial characterization of different cell types found in the Xenopus laevis lymphoreticular tumor based on the presence or absence of surface immunoglobulins and Fc molecules. AB - Cells of Xenopus laevis lymphoreticular tumor induced by tumor tissue transplantation were examined for surface Ig and Fc receptor molecules in order to evaluate the different cell types found in the tumor. Direct immunofluorescent technique, using fluorochrome conjugated rabbit antisera to Xenopus Ig's, detected Ig molecules on the surface of a mean of 31.7 +/- 11.3% of cells in tumor suspensions. Most of these molecules were of IgM isotype, reversibly bound to the cell membrane (cytophilic) and could be dissociated by acid pH or overnight cell culturing. In addition integral membrane IgM was detected on the surface of 10.2 +/- 5.9% of the cells. The serum origin of cytophilic Ig's and the cellular origin of integral membrane Ig's were confirmed by analysis of electrophoretic mobility of their heavy chains on SDS-polyacrylamide gels. The existence of Fc receptor molecules on the surface of 48.6 +/- 16.6% of the cells was demonstrated by fluorescent staining using heat aggregated FITC labelled IgM or FITC or TRITC labelled antigen-complexed IgY antibodies. 32.2 +/- 12.4% and 16.4 +/- 6.8% of the cells bore receptors for IgY or receptors for IgM respectively, while 6.3 +/- 3.1% carried receptors for both Ig's. Double fluorescent staining revealed that 28.9 +/- 4.5% of cells bearing IgM on their surface expressed also receptors for IgY. These results attest to the heterogeneity of the tumor cell population, in respect to the presence or absence of FcR-IgY, FcR-IgM, sIgM, and cytophilic IgM surface molecules. PMID- 3817251 TI - Proliferative responses of snake lymphocytes to concanavalin A. AB - Spleen cells (SC) of adult snakes Psammophis sibilans responded to concanavalin A (Con A) in vitro by strong proliferation during the spring and autumn seasons. Con A-mediated mitogenesis was, however, poor in summer and abrogated in winter. Removal of Sephadex G 10-adherent cells from the SC suspensions did not inhibit the lymphoproliferative responsiveness to Con A in spring. This supports the view that the weak responses in summer and winter are essentially due to lack of competent T lymphocytes. PMID- 3817252 TI - Comparative phenotypic and ultrastructural characteristics of OKT6-positive cells in normal peripheral blood (adult and infant), in cord blood and in epidermis. AB - Simple and rapid procedures have been developed to isolate T6-positive cells in epidermal cell suspensions, in peripheral blood of adult, and in cord blood. The isolated T6-positive cells were tested by double immunogold labelling at ultrastructural level to analyze their phenotype (T6/HLA-DR antigens) and their morphological features in order to understand their origin, their fate, and their relationship to the early precursors of dendritic cells, immature neonatal lymphoid subsets, and immature macrophagic leukocytes. PMID- 3817253 TI - Aspects of the immunology of the female genital tract of the elasmobranch, Scyliorhinus canicula L. PMID- 3817255 TI - Molecular aspects of invertebrate immunology. ISDCI-Conference 1986. 28th-30th September 1986, Berlin (West). Program and abstracts. PMID- 3817254 TI - Quantitative analysis of lymphocyte migration from the thymus to periphery in the Mexican axolotl. PMID- 3817256 TI - Carbohydrate metabolism of female rat adipocytes: effects and mechanisms of action of progesterone. AB - This short review describes the role of progesterone in the insulin-resistance of pregnancy and the present knowledge of the intracellular mechanisms of action of the steroid in carbohydrate metabolism of female rat adipocytes. Observations concerning steroid effects on the binding of insulin to its specific receptors are often contradictory, and depend on cells used to study it. It is now generally accepted that, in isolated adipocytes, the decreased responsiveness to insulin produced by progesterone is due to a post-receptor effect. Furthermore, basal glucose metabolism (in the absence of insulin) is decreased by progesterone treatment and by the acute effect of progesterone when added directly into the incubation medium. Progesterone induces an intrinsic post-receptor effect which is related to decreased phosphorylation of glucose by hexokinase but has no effect on glucose transport. The effect on hexokinase activity is an indirect one taking place either before or after activation of the enzyme. During the last decade, a large body of evidence (Xenopus oocytes and other cells) indicates that steroids interact with the cell surface rather than penetrating the cell and interacting exclusively with a nuclear receptor. The second messengers, such as cyclic AMP and calcium, play a major role in this non-genomic mechanism. The direct and rapid effect (20 min.) of progesterone in adipocytes supports the non genomic mechanism of action; there is neither any lag period prior to the appearance of the physiological response nor any inhibition of protein synthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817258 TI - Zinc concentration in umbilical cord tissue and cord plasma in appropriate-for gestational-age babies. AB - Zinc concentration in cord plasma was determined in 148 healthy appropriate-for gestational-age babies delivered at various gestational ages. Zinc concentration in cord tissue was also determined in 62 of these babies. There was a significant rise in the cord tissue zinc concentration just after the 35th week of gestational age; thereafter the levels remained relatively unchanged. The cord plasma zinc concentration decreased slightly with increasing gestational age, but these changes were not significant. There was a statistically significant positive correlation between cord tissue zinc concentration and birth weight. No correlation was found between cord plasma zinc concentration and birth weight or cord tissue zinc concentration. PMID- 3817257 TI - Effect of metformin on peripheral insulin sensitivity in non insulin dependent diabetes mellitus. AB - To test whether metformin treatment might improve peripheral insulin sensitivity in non insulin dependent diabetes, we measured peripheral glucose uptake in 12 non insulin dependent diabetics before (A) and after 4 weeks (B) of metformin therapy (2 X 850 mg/day) by the hyperinsulinemic clamp technique (80 mU/m2/min). In addition, insulin binding to monocytes was compared between A and B. Diabetic control, evaluated by measurement of fasting blood glucose and glycosylated hemoglobin, was significantly improved by metformin treatment (P less than 0.01). Insulin binding to monocytes was not significantly influenced by metformin (A 4.53% vs. B-5.12%, n.s. at insulin tracer concentration). Peripheral glucose utilisation improved slightly, but significantly after 4 weeks of metformin therapy (A: 4.4 +/- 0.6 mg/kg/min, B: 5.4 +/- 0.8 mg/kg/min, p less than 0.01). Improvement in peripheral glucose utilisation correlated significantly with improved metabolic control, estimated by fasting blood glucose measurements (p less than 0.01). PMID- 3817259 TI - Concentrations of ritodrine hydrochloride in maternal and fetal serum and amniotic fluid following intravenous administration in late pregnancy. AB - Seven healthy pregnant volunteers undergoing elective cesarean section at 39-40 weeks of gestation were studied for transplacental passage of ritodrine hydrochloride, which was administered by intravenous infusion at the rate of 72 149 micrograms/min for 161-335 min. The concentrations of ritodrine in the collected maternal and fetal blood and the amniotic fluid were radioimmunoassayed. The levels of ritodrine in maternal serum were between 22.5 and 51.0 ng/ml one hour after the initiation of infusion, 33.7-66.4 ng/ml after 2 h, 18.2-73.6 ng/ml after 4 h and 45.7-189.6 ng/ml at delivery, respectively. The umbilical blood and amniotic fluid concentrations of ritodrine at delivery were between 15.6 and 35.1 ng/ml in arterial blood, 12.5-29.6 ng/ml in venous blood and 10.0-49.1 ng/ml in amniotic fluid. The ratio of umbilical venous blood concentrations to maternal venous concentrations (CV/MV) ranged from 0.066 to 0.544 with the mean of 0.263 +/- 0.063 (M +/- S.E.). The results obtained substantiate the rapid and appreciable transfer of ritodrine to the fetus and amniotic fluid. PMID- 3817260 TI - Effect of a strict preoperative hygienic routine on the rate of infections following cesarean section. AB - The frequency of postoperative infections after cesarean section was studied during two periods. In the first period no strict preoperative hygienic routines were applied; 321 patients were delivered by cesarean section during this period. In the next period strict hygienic routines were introduced; this period included 337 patients. The infection rate was significantly reduced during the second period from 20% to 16%. This reduction was found among the elective operations, and among parturients who had been treated in the hospital for more than 24 h prior to delivery. The frequency of endometritis decreased significantly from the first to the second period, whereas no difference was found concerning wound infections. Significantly fewer patients contracted septicemia during the second period. Since all septicemia cases occurred in endometritis patients the results might indicate that not only the number of patients contracting infection but also the severity of the infections was reduced. No reduction of infections was found after emergency operations. Antibiotic prophylaxis might therefore be of value in this group of patients. PMID- 3817261 TI - The influence of short-term estrogen replacement therapy (ERT) on the blood pressure and daily urinary catecholamine excretion in a small group of post menopausal women. AB - The blood pressure and daily urinary catecholamine excretion were examined in nineteen non-smoking post-menopausal women, receiving estrogen replacement therapy for a period of 4 months. The estrogens administered consisted of 17 beta estradiol combined with estriol and norethisterone acetate administered sequentially (Trisequens, Novo, Denmark). Before the institution of treatment, the blood pressure and urinary catecholamine excretion were normal. After a period of 4 months, no change in blood pressure was observed. However, a marked and significant increase in daily urinary catecholamine excretion was noticed (72.3 +/- 18.96 micrograms/day to 102.0 +/- 26.0 micrograms: p less than 0.01). The pathogenetic implications of this increase are discussed. PMID- 3817262 TI - Equine estrogen-dydrogesterone therapy in the management of postmenopausal women. AB - The clinical and metabolic effects of equine estrogen and dydrogesterone combined therapy were investigated in twenty healthy women aged 45 to 59 years with menopausal complaints. Equine estrogens (0.625 mg per day) were given for 2 months, then dydrogesterone (20 mg daily) was cyclically added for 12 days per month, during an additional period of 6 months. The combination was very efficacious in reducing complaints, with a limited number of side effects. Blood pressure, body weight and cervical smears were unaffected. No influence on glucose tolerance, liver or blood coagulation parameters was seen. A VLDL cholesterol decrease of 41% and an increase in apo AI concentrations of 41% was observed. Total, HDL and LDL cholesterol remained almost unaltered, as well as the total:HDL cholesterol ratio. We conclude that the use of the equine estrogen dydrogesterone combination provides an efficacious, acceptable and probably safe therapy for menopausal complaints. PMID- 3817263 TI - The impact of prenatal care on the outcome of pregnancy. AB - In a 12-months' prospective project all women delivering at the Soroka Medical Center, Beer-Sheba, Israel, were studied with regard to the type of prenatal care (P.C.) and the outcome of pregnancy. The Soroka Medical Center is the sole medical facility providing obstetric and neonatal services to the 300,000 inhabitants of the region. Prenatal care is delivered by a uniform network of 70 community-based stations. The availability, type and quality of services were uniform for all women and were not altered throughout the study period. The project encompassed 7308 deliveries. 2154 Bedouin women were excluded in order to avoid possible bias due to cultural and genetic characteristics. Data regarding 5154 Jewish women were analysed. Perinatal mortality was inversely proportional to the number of prenatal contacts. The uncorrected mortality rates were 12.7% in women entirely lacking P.C. and 6.2%, 1.9% and 1.0% in patients who had 1-6, 7-10 and 11 or more prenatal contacts respectively. The low-birthweight rate was significantly increased in women lacking prenatal care (22.8%) or having rudimentary care (17.4%) as compared to those who had 11 or more prenatal contacts with medical personnel (5.9%). Prenatal care reduced neonatal morbidity as expressed by the length of hospitalization, the frequency of infants with multiple diagnoses and the incidence of specific pathologies such as respiratory distress syndrome, light for dates and asphyxia. The incidence of some complications of pregnancy (abruptio placentae, premature labor, PROM) was significantly increased in women lacking P.C. or having inadequate P.C. (1-6 prenatal contacts). Moreover, lack of prenatal care was clearly connected with high-risk delivery, thus increasing the danger to the baby. It is suggested that many adverse effects of various socio-economic, genetic and general health factors may be diminished by proper prenatal care coupled with adequate obstetric and neonatal services. PMID- 3817264 TI - Obstetrical policy during labor and perinatal results: a comparison between two university clinics. AB - The obstetrical policy during labor at two University clinics in Nottingham (United Kingdom) and Nijmegen (The Netherlands) was investigated prospectively and simultaneously during a period of three months (1984). At the University of Nijmegen the obstetrical population tended to be more 'pathologic', and less intervention during labor was observed for early amniotomy, pain relief, induction and augmentation of labor. The pH in umbilical arterial blood was as a mean 0.01 unit lower in Nijmegen than in Nottingham. The validity of electronic fetal monitoring appeared to be higher in Nijmegen. It is concluded that data on the neonate probably cannot give an answer in favor of one of these policies. Parenthood information could give more conclusive evidence. PMID- 3817265 TI - Septate uterus and habitual abortion: a case report illustrating successful outcome of pregnancy after second metroplasty. AB - A case is reported of a woman with septate uterus who suffered failure of the first metroplasty. This measure was undertaken before any pregnancy; thereafter she had 12 consecutive miscarriages, and repeated hysterograms showed the presence of broad septum. A second metroplasty was performed 12.5 years after the first, and after two miscarriages she conceived and delivered a viable male infant after 32 weeks gestation. The thorough investigations, the indications and the correct technique for metroplasty are discussed, as well as the value of cervical cerclage in patients with malformed uterus. The strict indications and successful choice of technique in metroplasty are stressed as leading to good results after metroplasty. PMID- 3817266 TI - Enterobius (Oxyuris) vermicularis of the pelvic peritoneum--a cause of infertility. AB - A case of Enterobius (Oxyuris) vermicularis granulomatous disease of the pelvic peritoneum causing pelvic adhesions and infertility is presented and discussed. Since parasitic diseases are common in the developing countries, the infertility team has to bear in mind that a parasitic disease might be the main cause of infertility. PMID- 3817267 TI - Aneurysmal bone cyst of the ilium associated with pregnancy. AB - A 19-yr-old primigravida presented with a back mass which was found to originate from the right ilium and was associated with oblique fetal lie. Elective caesarean section and excision of the mass were done. Histologically, the lesion proved to be an aneurysmal bone cyst. Review of bone tumors associated with pregnancy is presented, with discussion of the problems related to diagnosis of this condition. PMID- 3817268 TI - A pregnant woman with severe epistaxis--a rare manifestation of folic acid deficiency. AB - The case-history of a pregnant woman with a life-threatening thrombocytopenia, due to folic acid deficiency, caused by an extremely low dietary intake is described. As folic acid deficiency manifests itself in a variety of ways, its clinical features are not always easily recognized. Timely recognition is important because of the rapid progressive nature of the disorder, especially in pregnancy, and because rapid improvement is achieved by simple treatment: supplementation of the deficiency. This is well illustrated in the patient described in this case report. A short review of the literature is presented. PMID- 3817269 TI - Pregnancy outcome in women perceiving decreased fetal movement. AB - Out of 1914 women who had been instructed to count fetal movements (FMs) throughout the third trimester of pregnancy, 158 consulted the delivery ward staff about decreased FMs; they constituted the study group. Each woman who reported decreased FMs was examined by cardiotocography, analysis of plasma estriol and objective recording of FMs. Appropriate clinical management was decided on by the obstetrician in charge. In 133 (84%) of the 158 women, the results of the fetal examinations proved normal and no intervention was undertaken; in one of these cases the fetus died within 48 h. In two previously uncomplicated pregnancies the maternally perceived decrease in FMs coincided with seriously and persistently abnormal fetal heart rate test results. In both cases caesarean section was carried out within 24 h; the babies had Apgar scores less than or equal to 6 at 1 and 5 min but subsequently developed normally. Babies with congenital malformations (p = 0.001) and small-for-gestational age babies (p = 0.040) were significantly more common among consulters than non-consulters. The fetuses of women who report decreased FMs constitute a risk group and should be carefully monitored; if abnormalities are disclosed there is a potential for improving the fetal outcome by taking appropriate action. PMID- 3817270 TI - X-linked centronuclear myopathy as a cause of floppy baby. AB - Two families with X-linked recessive centro-nuclear myopathy (XLR-CNM) are described. Evidence is accumulating that XLR-CNM forms a distinct entity, in contrast to the commoner later-onset forms. Family history often provides a clue to the diagnosis. Pregnancy is very often complicated by hydramnios and reduced fetal movements. We describe two families with five affected male babies who all died. An isolated case with severe fetal brady-arrhythmias in combination with acute increase in polyhydramnios is mentioned. The neonatal mortality in all recorded cases is 80 percent, with respiratory insufficiency as the cause of death. An attempt is made to establish early prenatal diagnosis and the possibility of carrier detection is briefly discussed. PMID- 3817271 TI - Influence of microsurgical reanastomosis of the fallopian tube on luminal pH and PO2 and on the fertilization rate and embryo development in the rabbit oviduct. AB - The luminal pH and PO2 were measured in rabbit oviducts to evaluate the influence of microsurgery on the environment within the fallopian tube before and after resection of a 1 cm ampullary portion with subsequent tubal reanastomosis. While the oxygen tension showed no difference between the operated oviduct (56 +/- 16 mmHg, n = 8) and the control side (53 +/- 13 mmHg, n = 8), there was a significant pH decrease in the oviducts after microsurgery (7.94 +/- 0.10, n = 8, versus 7.75 +/- 0.16, n = 8, p less than 0.0025). In the second part of the experiment the operated animals were induced to ovulate by hCG injection, and artificial insemination was performed at the same time. The number of fertilized and unfertilized oocytes and the stages of embryonic development (64 h post hCG) were compared between the operated and control oviducts. From the operated oviducts a lower number of ova were recovered and a lower rate of fertilization was observed. The data indicate that microsurgery of the rabbit fallopian tube does not disturb the luminal oxygen tension but may cause a lower pH. Ultimately a reduced rate of fertilization and impaired early development were observed. PMID- 3817272 TI - Phospholipid composition and phospholipid asymmetry of ram spermatozoa plasma membranes. AB - The phospholipid composition of ram spermatozoa plasma membranes has been investigated. An exclusively high participation of the choline- and ethanolamine plasmalogens in the phosphatidylcholine and phosphatidylethanolamine fractions has been established. Phosphatidylcholine of ram spermatozoa plasma membranes contains a great amount of polyunsaturated fatty acids. The phospholipid distribution in spermatozoa plasma membrane was investigated. It was established that the choline containing phospholipids are situated mainly in the outer membrane lipid monolayer, whereas diphosphatidylglycerol and phosphatidylserine are localized predominantly in the inner monolayer. The rest of the phospholipids are evenly distributed among the two monolayers. Ram spermal plasma membranes exhibit high phospholipase A2 activity. PMID- 3817273 TI - Variations of fructose-2,6-diphosphate levels in cultured HT29 human colon cancer cells: influence of hexoses and lactate concentrations. AB - Under the standard conditions of culture, Fru-2,6-P2 level in HT29 cells is transitorily increased as a consequence of medium change; the peak value occurs after 2 hr, followed by a gradual return to a basal value (40 pmol/mg protein) which is maintained as long as medium glucose concentration stands above 2 mM. A 20 hr glucose deprivation lowers Fru-2,6-P2 level to trace value, but, when glucose is reintroduced, the peak value is much higher; large Fru-2,6-P2 accumulation is correlated with higher rates of glucose uptake and lactate release, which suggests an activation of glycolysis at the level of phosphofructokinase-1. Fru-2,6-P2 level depends on the glucose concentration within the range of 0 to 5 mM. At this concentration and above, maximal effect is reached. Previous glucose deprivation renders the Fru-2,6-P2 forming system more sensitive to glucose. When given instead of glucose, fructose enters the glycolytic pathway and produces same effect as glucose on the Fru-2,6-P2 level. Galactose turns it to almost zero which coincides with low glycolytic rate. Acidity of the culture medium favorishes the Fru-2,6-P2 formation; however, change in pH cannot explain the variations of Fru-2,6-P2 level observed under the standard culture conditions. Lactate concentrations over 10 mM in the medium are found to significantly inhibit the Fru-2,6-P2 producing system. Therefore, lactate accumulation in the medium could be an important factor controlling Fru 2,6-P2 level during standard cell culture. PMID- 3817274 TI - A simple and sensitive solid-phase radioimmunoassay for measuring the transferrin content of human biological fluids: its application to seminal plasma. AB - A highly sensitive and reproducible radioimmunoassay was established to detect transferrin in human fluids. By this technique, applied to seminal fluid, transferrin levels (micrograms/ml) were found in normozoospermic individuals (64.49 +/- 25.41) at level higher than in oligozoospermic (38.93 +/- 21.35), azoospermic (19.49 +/- 10.23), or vasectomized (19.61 +/- 8.95) subjects. A relationship between transferrin and spermatozoid concentration in sperm was shown. These results reinforce previous findings that seminal transferrin can be used as a reliable clinical marker of Sertoli Cell function. PMID- 3817275 TI - Permeability of membrane of Babesia canis infected erythrocytes--influence of an external electric field. AB - The erythrocytes infection by a parasite (Babesia canis) induced a modification of the biological membrane which was studied using the effect of electric pulses of short duration. This process induces the formation of pores and during the opening hemoglobin and other cytoplasmic proteins diffuse out of the cells and are recovered in the external medium. The rate of molecular permeation across the electrically perforated membranes depends on several factors: electric-field strength, pulses number, pulse duration, temperature and cellular concentration. Even for low parasitemia, differences in the effect of these parameters were observed between infected and non-infected erythrocytes. PMID- 3817276 TI - Regulation of the hepatic glycine-cleavage system. PMID- 3817277 TI - Cellular transport in the regulation of amino acid metabolism. PMID- 3817278 TI - Regulation of hepatic aromatic amino acid metabolism. PMID- 3817279 TI - The Lugano statements on controlled clinical trials. AB - During a consensus conference in Lugano, Switzerland, 175 statements on controlled clinical trials were drafted by 47 representatives from academia, governmental registration agencies and industry in nine countries. Their opinion on these statements was similar to that of 47 'matched pairs' who did not attend the conference. Thus, the opinion of participants and non-participants appears to reflect the general opinion of those currently involved in designing, conducting and analysing controlled clinical trials. The Lugano statements give answers to the following questions: Is the controlled clinical trial in a crisis? What is the motivation to perform controlled clinical trials? Is it possible for a physician participating in a controlled clinical trial to act in the patient's best interest? Is it possible to obtain truly informed consent in a controlled clinical trial? When is it ethical to withhold active treatment in a controlled clinical trial? What are the controversial issues in the design of a good controlled clinical trial? Is there a double standard with respect to efficacy and adverse drug reactions in controlled clinical trials? What are the alternatives to controlled clinical trials and when should they be performed? How can sponsor bias be minimized? How should an ethics committee decide whether a controlled clinical trial is ethical? Should registration agencies become directly involved in the planning and conduct of controlled clinical trials? Do the declarations of Tokyo and Helsinki facilitate the conduct of ethically valid controlled clinical trials? Is it possible to create an international standard for the conduct and regulation of controlled clinical trials? Why do messages from controlled clinical trials filter into medicine so slowly? Is it possible to bridge the gap between controlled clinical trials and clinical reality? What are the costs of doing and not doing controlled clinical trials? When should drug companies decide to start a trial programme with a specific compound? Is there public hostility against controlled clinical trials? If so, how can it be reduced? The respondents almost unanimously felt that controlled clinical trials are a must: the public must be told that progress in medicine depends on controlled clinical trials, that patients often benefit from participating in them and that the alternative, practising in the face of constant uncertainty, is worse than the possible disadvantages related to the conduct of the trial. PMID- 3817280 TI - Comparative and non-comparative studies of the efficacy and tolerance of tioconazole cream 1% versus another imidazole and/or placebo in neonates and infants with candidal diaper rash and/or impetigo. AB - Eleven open multicentre studies were conducted to evaluate the efficacy of tioconazole cream 1% as a treatment for diaper rash with or without fungal (Candida) involvement, or impetigo in neonates and infants. In the dermal candidiasis/diaper rash group, 320 patients had either tioconazole (n = 220), a comparative imidazole (n = 43), or vehicle cream (n = 57) applied to the affected area twice daily. Twenty-one impetigo patients had only tioconazole cream 1% applied three times daily to lesions. The overall cure rate (patients with both clinical and mycological cure) at the end of treatment for tioconazole treated patients was 78%, for the comparative imidazole group it was 76% and for vehicle cream it was 39%. At the long-term follow-up evaluation approximately 6 weeks after treatment for patients with diaper rash, the overall cure rate was about the same in both tioconazole- and comparative imidazole-treated patients (87% and 90%, respectively), and 14% in patients using vehicle cream. Side-effects were coincident with disease symptoms and consisted primarily of erythema localized to the treatment area; they occurred in 5.4% (13/241) of the patients who received tioconazole and in 21% (9/43) of the patients who received comparative imidazole (econazole or miconazole). No side-effects were reported in this open study for the 57 patients who used vehicle cream. The results of these studies show that tioconazole cream 1% is safe and effective for the treatment of neonates and infants with dermal candidiasis, diaper rash and impetigo. PMID- 3817281 TI - Rifaximin, a rifamycin derivative for use in the treatment of intestinal bacterial infections in seriously disabled patients. AB - This study reports the results of an evaluation of the effectiveness and tolerability of rifaximin, an intestinal topical antibiotic. It was administered using a nasogastric tube in patients with severe enterocolitis and bacterial superinfections causing intestinal inflammatory diseases and portosystemic encephalopathy. The drug proved highly effective clinically and produced neither local nor systemic side-effects. PMID- 3817282 TI - Preliminary data on the action of nesosteine, a mucomodifying drug, on mucociliary transport. AB - Nesosteine, which is active on airway secretions, has been studied by assessment of the mucociliary clearance of the frog palate. Sputum was collected from patients admitted to hospital with acute exacerbations of chronic bronchitis with mucous expectoration. The relative speed of transport was measured for each patient before and after oral administration of 600 mg/day nesosteine. A significant increase in the mucus transport rate was found at the end of treatment. PMID- 3817283 TI - Internal pH can regulate Ca2+ uptake and the acrosome reaction in sea urchin sperm. AB - The egg jelly-induced acrosome reaction of sea urchin sperm is accompanied by intracellular alkalinization and Ca2+ entry. We have previously shown that in the absence of egg jelly, NH4Cl, which increases intracellular pH (pHi), induces Ca2+ uptake and the acrosome reaction in sperm of the sea urchin, Strongylocentrotus purpuratus. Here we show that at a constant concentration of NH4Cl (20 mM) in seawater, sperm react less as external pH is lowered from the normal 8 to 7.25. The pH dependence of the NH4Cl response is not very sensitive to temperatures between 12 and 17 degrees C. NH4Cl (15-50 mM) stimulates Ca2+ uptake and acrosome reactions in sperm suspended in Na+-free seawater, a condition known to inhibit the inductive effect of jelly. Jelly does not further stimulate Ca2+ uptake of sperm preincubated in NH4Cl, indicating that once the permeability to Ca2+ is increased by raising the pHi, the jelly has no further effect. We have used the membrane potential-sensitive dye 3,3'-dipropylthiadicarbocyanine iodide to follow the membrane potential change that occurs when NH4Cl is added. Depolarization (25 mV) is associated with the acrosome reaction when either the natural inducer, egg jelly, or NH4Cl is added to sperm. Response to both inducers is inhibited under conditions known to abolish the acrosome reaction, i.e., low-pH seawater and nisoldipine. These results indicate that the NH4Cl-induced depolarization that accompanies the reaction is probably due to the opening of channels that allow Ca2+ to enter the cell and not to the depolarization by NH4+ ions. High-K+ seawater, which depolarizes sperm, and tetraethylammonium, a K+ channel blocker, inhibit the jelly-induced depolarization and the acrosome reaction, but do not inhibit NH4Cl-induced changes. It has already been shown that nigericin promotes Ca2+ entry and the acrosome reaction in sea urchin sperm. We found that the action of this ionophore depends on the pH of normal seawater. In the absence of external Na+ (replaced by choline), nigericin does not induce the reaction and does not stimulate Ca2+ uptake. PMID- 3817284 TI - Rearrangement of enveloping layer cells without disruption of the epithelial permeability barrier as a factor in Fundulus epiboly. AB - Silver nitrate staining of blastoderms of Fundulus heteroclitus gastrulae shows that the number of marginal cells of the enveloping layer (EVL) is reduced from 160 to 25 during epiboly. To determine whether this decrease in the number of marginal cells was due to ingression, cell death, or rearrangement of cells, marginal and submarginal regions of the late gastrula were observed directly by time-lapse cinemicrography. Marginal cells rearrange to occupy submarginal positions by first narrowing their boundary with the external yolk syncytial layer (E-YSL), thus becoming tapered in shape. Then, the narrowed marginal boundary retracts from the E-YSL and moves submarginally in the plane of the epithelium. Concurrently, the marginal cells on both sides come into apposition; no gap or break appears in the circum-apical continuity of the epithelial sheet. Marginal cells leave the margin of the EVL during epiboly at a rate of about six per hour. The rate of movement of the EVL cells with respect to one another is about 0.5 to 1.0 micron/min at 21 degrees C. Submarginal cells rearrange in a similar fashion. Although no protrusive activity was seen at the lateral aspects of rearranging cells, the tapering or narrowing associated with rearrangement was accompanied by formation of microfolds on their apical surfaces, and separating or recently separated submarginal cells form "flowers" of microfolds on their apices adjacent to the site of separation. Morphometric analysis shows that about half the narrowing of the margin of the EVL during epiboly is accounted for by cell rearrangement and the other half by the associated tapering and narrowing. These results suggest that epiboly of the EVL may have an active component as well as a passive one. PMID- 3817285 TI - Is a mosaic embryo also a mosaic of communication compartments? AB - We have studied the pathways of cell communication in embryos of the mollusc Lymnaea stagnalis in which the developmental fate of a cell or a group of cells is known from cell lineage studies. We iontophoretically injected Lucifer Yellow CH and followed the spread of fluorescence between cells interconnected via gap junctions. In early stages all blastomeres appear to be dye-coupled, but later on communication is restricted within compartments. The pattern of cell communication corresponds with the development of compartments with specific cell fates. Dye-spread is limited by communication boundaries which completely or mostly prevent the passage of dye to adjacent compartments with different developmental fates. These boundaries appear progressively during development. Our results suggest that, during the development of Lymnaea, the progressive changes in the pattern of dye spread correspond with the progressive restrictions of the developmental fates of individual cells or groups of cells. We conclude that changes in the pattern of cell communication and in the appearance of communication compartments are not exclusive features of regulative embryos. PMID- 3817286 TI - Reciprocal regulation of acetylcholinesterase and butyrylcholinesterase in mammalian skeletal muscle. AB - Developmental regulation, from the fetal period to 11 months of age, and the influence of denervation on the appearance and disappearance of the molecular forms of acetylcholinesterase (AchE) and butyrylcholinesterase (BuchE) in rat skeletal muscle were examined. The enzyme forms were extracted from anterior tibialis in 0.01 M sodium phosphate buffer, pH 7.0, containing 1 N NaCl, 0.01 M EGTA, 1% Triton X-100, and a cocktail of antiproteases, and analyzed by velocity sedimentation on 5-20% linear sucrose gradients. Three principal forms, denoted by sedimentation coefficients of 4, 10.8, and 16 S, were observed in muscle from all age groups. The amounts of each of the molecular forms of AchE and BuchE in skeletal muscle exhibited distinct and reciprocal patterns of appearance and disappearance during pre- and postnatal development. In tissue derived from animals less than 2 weeks of age, BuchE represented the predominant component of activity in the 4 S form, was present equally with AchE in the 10.8 S form, and was subordinate to AchE in the 16 S form. Between 1 and 2 weeks of age a progressive increase in AchE activities coincident with a reduction in BuchE activities resulted in inversion in the amounts of the two enzymes present in adult muscle. Denervation of muscle caused a dramatic reduction in the presence of AchE molecular forms with no discernable influence on the presence of BuchE molecular forms. These results indicate that biosynthesis of BuchE is strictly regulated in a reciprocal manner with that of AchE, and that BuchE metabolism is independent of the state of muscle innervation. Increased synthesis of AchE and either reduced synthesis or increased degradation of BuchE can account for the reciprocal regulation of these enzymes. These characteristics of mammalian muscle contrast sharply with characteristics deduced for avian tissue (Silman et al. (1979) Nature (London) 280, 160-162). The innervation-independent metabolism of BuchE and the diverse modes of its regulation in different tissue from different species signify that BuchE function may be unrelated to cholinergic neurotransmission. PMID- 3817287 TI - Rabbit oocyte maturation: changes of membrane resistance, capacitance, and the frequency of spontaneous transient depolarizations. AB - Immature oocytes from rabbits were examined with electrophysiological techniques to determine if their membrane properties change during maturation. The input resistance increased and input capacitance decreased during maturation, although no significant change in membrane potential was observed. The changes observed were consistent with a decrease of corona radiata-oocyte electrical coupling accompanying maturation. Spontaneous transient depolarizations were recorded from immature oocytes surrounded by corona radiata, but not from mature ova. Each event consisted of a rapid depolarization, sustained for 1-100 sec, and a slow repolarization to the resting potential. Spontaneous inward currents with a time course similar to the spontaneous transient depolarizations occurred when the oocyte's membrane potential was held constant by voltage clamp. The frequency with which spontaneous transient depolarizations occurred decreased during maturation. These findings are consistent with a model in which spontaneous depolarizations originate in corona radiata cells and are detected in the oocyte via electrical coupling. PMID- 3817288 TI - Specific expression of the chicken delta-crystallin gene in the lens and the pyramidal neurons of the piriform cortex in transgenic mice. AB - Two transgenic mice, 5-8 and 7-5, carrying the chicken delta-crystallin gene were produced by microinjecting cloned genes into male pronuclei. The mice were analyzed at 8 weeks of age with respect to gene integration and expression by means of blotting techniques and immunohistochemistry. Southern blot analysis indicated that both mice carried, on average, 50 copies of intact delta crystallin gene per cell. Histological analysis of the mice using DNA-DNA in situ hybridization indicated that mouse 5-8 carried the delta-crystallin gene in every cell while mouse 7-5 was mosaic, with 20-40% of the cells of various tissues carrying the gene. Western blot analysis indicated that in both mice delta crystallin is expressed in the lens and the cerebrum, but not in any other tissue examined. Immunohistological analysis revealed that, in the cerebrum of the mice, delta-crystallin was expressed specifically in pyramidal neurons located in layer IIb of the anterior piriform cortex. Thus, our results with transgenic mice not only demonstrate the primary specificity of delta-crystallin gene expression in authentic lens tissue, but reveal the unexpected specificity of this chicken gene in the central nervous system of the mouse. PMID- 3817289 TI - Mapping of the early neural primordium in quail-chick chimeras. II. The prosencephalic neural plate and neural folds: implications for the genesis of cephalic human congenital abnormalities. AB - Mapping of the avian neural primordium was carried out at the early somitic stages by substituting definite regions of the chick embryo by their quail counterpart. The quail nuclear marker made it possible to identify precisely the derivatives of the grafted areas within the chimeric cephalic structures. A fate map of the prosencephalic neural plate and neural folds is presented. Moreover the origin of the forebrain meninges from the pro- and mesencephalic neural crest is demonstrated. In the light of the data resulting from these experiments, we present a rationale for the genesis of malformations of the face and brain and of congenital endocrine abnormalities occurring in man. PMID- 3817290 TI - Spatial and temporal expression pattern of N-cadherin cell adhesion molecules correlated with morphogenetic processes of chicken embryos. AB - N-cadherin is a Ca2+-dependent cell-cell adhesion molecule, which was identified in brain cells of mouse and chicken. In the present study, we have determined the pattern of expression of N-cadherin in chicken embryos at various stages by means of immunohistochemistry. N-cadherin was expressed in cells derived from all three primary germ layers. Its expression was transient in many tissues but permanent in others. The transient expression occurred in nephric tubules, skeletal muscles, mesenchymal tissues, endodermal organs, and epidermis, while the permanent expression occurred in nervous systems, lens, and myocardiac cells. Appearance or disappearance of N-cadherin could be generally correlated with morphogenetic events, such as rearrangement, segregation, or association of cells. Comparison of the expression pattern of N-cadherin with that of L-CAM and N-CAM determined by other workers suggests that there is some mechanism controlling expression of multiple classes of adhesion molecules. The pattern of expression of N-cadherin was generally complementary to that of L-CAM; that is, if N-cadherin appeared, L-CAM disappeared or vice versa. We also found cases in which N-cadherin was expressed in the same local regions as L-CAM. The distribution of N-cadherin was similar to that of N-CAM with some exceptions. Thus, N-cadherin and other cell-cell adhesion molecules seem to be expressed under a precise spatial and temporal control so as to be associated with a variety of morphogenetic events during development. PMID- 3817291 TI - Glycoconjugate synthesis during early pregnancy: hyaluronate synthesis and function. AB - The synthesis of various glycoconjugate classes by mouse uteri during the pre- and peri-implantation period has been examined using [3H]glucosamine as a metabolic precursor. A unique and dramatic (five- to sixfold) increase was observed in the synthesis of hyaluronate on the day upon which embryo implantation normally occurs. Mated, but nonpregnant mice did not display increased hyaluronate biosynthesis. In contrast to hyaluronate, the synthesis of most other types of glycoconjugates remained fairly constant during the first 5 days of pregnancy. Low (1500-5000)-molecular-weight N-linked oligosaccharides constituted the major class of oligosaccharides synthesized under all conditions. High (greater than 10,000)-molecular-weight glycoconjugates constituted the second most abundant class of glycoconjugates synthesized (20-30%). Most (85%) of the newly synthesized hyaluronate was associated with the nonepithelial cell types of the uterus. Experiments using ovariectomized mice receiving steroid hormones demonstrated that uterine hyaluronate synthesis was induced preferentially by an artificial decidual stimulus and implicated stromal cells as the site of hyaluronate synthesis. In addition, it was demonstrated that tissue culture plates coated with hyaluronate, but not other polysaccharides, support attachment and spreading of a large fraction (60 to 70%) of embryos cultured in serum-free medium. Collectively, these studies indicate that increased hyaluronate biosynthesis accompanies decidual responses in the endometrium and may promote embryo implantation following initial penetration of the uterine epithelium. PMID- 3817292 TI - Iron supports myogenic cell differentiation to the same degree as does iron-bound transferrin. AB - T. Hasegawa, K. Saito, I. Kimura, and E. Ozawa (1981, Proc. Jopan Acad. B 57, 206 210) have shown that Fe ion can promote myogenic cell growth as Fe-bound transferrin. In the present work, the effects of these substances in supporting myogenic cell differentiation were examined. The hallmarks of differentiation adopted were appearance of structural and regulatory proteins, myofibrils, sarcoplasmic reticulum, and Ca-activated activities of myosin B and phosphorylase kinase; isoform transition of creatine kinase; and acquisition of cell membrane excitability and contractility following electrical stimulation of myotubes. The degree of differentiation of myotubes cultured in the presence of Fe ion was almost the same as that of myotubes cultured in the presence of Fe-bound transferrin. These facts suggest that transferrin protein molecules do not play a primary role in differentiation. Further, it has also been shown that myotubes acquire excitation-contraction and metabolism coupling qualitatively similar to that of adult muscle fiber. PMID- 3817294 TI - Centrifugation redistributes factors determining cleavage patterns in leech embryos. AB - In the normal development of glossiphoniid leech embryos, cytoplasmic reorganization prior to the first cleavage generates visibly distinct domains of yolk-deficient cytoplasm, called teloplasm. During an ensuing series of stereotyped and unequal cell divisions, teloplasm is segregated primarily into cell CD of the two-cell stage and then into cell D of the four-cell and eight cell stages. The subsequent fate of cell D is also unique in that it alone undergoes further cleavages which generate five bilateral pairs of embryonic stem cells, the mesodermal (M) and ectodermal (N, O/P, O/P, and Q) teloblasts. Here we report studies on the effects of centrifugation on cleavage pattern and protein composition of individual blastomeres of the leech Helobdella triserialis. Centrifugation partially stratifies the cytoplasm of each cell, generating a layer of clear cytoplasm in cell CD derived largely from teloplasm. After centrifuging embryos at the two-cell stage, clear cytoplasm present in cell CD and normally inherited by cell D is redistributed and can be inherited by both cells C and D at the second cleavage. The developmental fates of cells C and D in centrifuged embryos correlate with the amount of clear cytoplasm they receive. In particular, when clear cytoplasm has been distributed roughly equally between the two cells, both cell C and cell D undergo further cleavages resembling the pattern of divisions normally associated with cell D. Likewise, non-yolk associated proteins, normally found in higher quantities in cell D than in cell C, appear evenly disbursed between the two cells under conditions which induce this fate change. These results are consistent with the idea that the fates of cells C and D are influenced by the distribution or cellular localization of cytoplasmic components. PMID- 3817293 TI - Milk protein expression and ductal morphogenesis in the mammary gland in vitro: hormone-dependent and -independent phases of adipocyte-mammary epithelial cell interaction. AB - Epithelial cell differentiation frequently occurs in situ in conjunction with supporting mesenchyme or connective tissue. In embryonic development the importance of the supporting mesenchyme for cytodifferentiation and morphogenesis has been demonstrated in several epithelial tissues, but the importance of epithelial-connective tissue interactions is less well studied in adult epithelial organs. We have investigated the interaction of adult mammary epithelial cells with adipocytes, which compose the normal supporting connective tissue in the mammary gland. Mammary epithelial cells from mice in various physiological states were cultured on cellular substrates of adipocytes formed from cells of the 3T3-L1 preadipocyte cell line. We found that there were two distinct phases to the interaction of epithelial cells with adipocytes. Cytodifferentiation of the epithelial cells and milk protein production were dependent on lactogenic hormones (insulin, hydrocortisone, and prolactin), whereas ductal morphogenesis was lactogenic hormone independent. When cultured on preadipocytes or adipocytes, mammary epithelial cells from never pregnant, pregnant, lactating, and involuting mice responded to lactogenic hormones rapidly by producing and secreting large amounts of alpha-, beta-, and gamma-casein and alpha-lactalbumin. This response was seen in individual as well as in clusters of epithelial cells, but was not seen if the same cells were cultured on tissue culture dishes without adipocytes, on fibroblasts (human newborn foreskin fibroblasts) or in the presence of adipocytes but in the absence of lactogenic hormones. Continued incubation of mammary epithelial cells on adipocytes in the presence or absence of lactogenic hormones resulted in the formation of a branching ductal system. Mammary epithelial cells in ducts that formed in the absence of lactogenic hormones produced no casein, but rapidly synthesized casein when subsequently exposed to these hormones. Ultrastructural studies revealed that the formation of a basement membrane occurs only in co-cultures of mammary epithelium with adipocytes or preadipocytes. Ultrastructural changes associated with secretion occurred only in the presence of lactogenic hormones. We propose that growth and formation of a ductal system in vitro can occur in the absence of lactogenic hormones, but that certain environment-associated events must occur if the epithelium is to become responsive to lactogenic hormones and undergo the cytodifferentiation associated with lactation. PMID- 3817295 TI - In vitro culture of Drosophila imaginal disc cells: aggregation, sorting out, and differentiative abilities. AB - This paper describes the aggregation in vitro of cells dissociated from imaginal discs and demonstrates the sorting out of undifferentiated cells from different imaginal discs and from differently determined regions of the same imaginal disc, as well as the abilities of such cells to undergo pattern reconstruction when injected into larvae. Dissociated cells begin to aggregate by 1.5 hr of rotation. By 5 hr of rotation, large aggregates of loosely associated cells appear. By 18 hr the aggregates have condensed and taken on a characteristic epithelial structure. To study sorting out in undifferentiated cells, we combined a histochemical stain for acid phosphatase with the use of the acid phosphatase null mutant acphn-11. We performed cell mixing experiments with 0-2 (prospective notum) and 2-8 (prospective wing) fragments, with the A and P (prospective anterior and posterior) fragments of the dorsal mesothoracic disc and with mixtures of cells from ventral prothoracic and dorsal mesothoracic discs. We found that prospective anterior and posterior dorsal mesothoracic cells do not sort out, but that prospective notum and wing and leg and wing cells do. The results from differentiated implants are consistent with those from undifferentiated mixes. PMID- 3817296 TI - Expression of an altered cAMP binding protein by rapid-developing strains of Dictyostelium discoideum. AB - Immunoblotting with a monoclonal antibody raised against a novel cAMP binding protein termed CABP1 revealed that the molecular weights of the two CABP1 subunits are altered in certain strains of Dictyostelium discoideum. Cell-free translation followed by immunoprecipitation showed that the altered CABP1 polypeptides are derived from primary translation products. In addition, the affinity of the altered CABP1 for cAMP is much higher than the wild-type form. Morphologically, these strains are indistinguishable from other wild-type strains except that their developmental phase is considerably shorter. The rapid developers also exhibit a precocious appearance of CABP1. These results indicate a good correlation between an altered CABP1 and rapid development. PMID- 3817297 TI - The first cleavage furrow demarcates the dorsal-ventral axis in Xenopus embryos. AB - To determine the relationship between the first cleavage furrow and the dorsal ventral axis of the Xenopus embryo, a heritable intracellular marker was injected into one blastomere at the two-cell stage. Embryos were selected in which the cleavage furrow bisected the crescent-shaped region of pale pigmentation or in which it formed 45-90 degrees from this region. This region, which is located in the animal hemisphere of the Xenopus embryo, meets the criteria of the grey crescent as defined in other amphibian species. At tailbud stages the interface between the labeled and unlabeled halves was always coincident with the midsagittal plane. This correlation shows that the first cleavage furrow demarcates the dorsal-ventral axis. The labeling pattern was the same whether the first cleavage furrow bisected the region of pale pigmentation or whether it formed 90 degrees from it. However, when this region was bisected (70% of embryos) it always was located on the dorsal side of the embryo. Thus the region of pale pigmentation indicates the dorsal side of the embryo only when it is bisected by the first cleavage furrow. PMID- 3817298 TI - Differences in monoamine oxidase activity between cultured noradrenergic and cholinergic sympathetic neurons. AB - Two types of monoamine oxidase activity (MAO-A and MAO-B) help regulate the levels of biogenic amines such as catecholamines and serotonin. Although MAO-A has greater activity toward most catecholamines than MAO-B, no direct experiments have determined the types and levels of MAO activity that are normally expressed in noradrenergic neurons. Noradrenergic neurons from neonatal rat superior cervical ganglia were isolated and cultured under conditions that permit either continued expression of the noradrenergic phenotype or promote a transition to a predominantly cholinergic phenotype. After 14-21 days in vitro, neurons from both types of cultures were assayed for the type and amount of monoamine oxidase activity using tryptamine, a common substrate for both MAO-A and MAO-B. Neurons cultured under noradrenergic conditions expressed sevenfold greater MAO activity than neurons cultured under cholinergic conditions. Essentially all MAO activity in the noradrenergic cultures was inhibited by preincubation with 10(-8)-10(-9) M clorgyline, which indicated that this activity was primarily MAO-A. Cultures grown under cholinergic conditions exhibited 6- to 10-fold lower MAO-A activity and an 8- to 10-fold lower level of catecholamine synthesis from labeled precursors compared to neurons grown under noradrenergic conditions. These results directly demonstrate that high MAO-A activity is expressed in noradrenergic neurons in vitro. The corresponding decreases in both MAO-A specific activity and catecholamine synthesis as neurons become cholinergic in vitro suggest that the expression of the noradrenergic phenotype involves the coordinate regulation of degradative as well as synthetic enzymes involved in catecholamine metabolism. PMID- 3817299 TI - Behavior of neural crest cells on embryonic basal laminae. AB - Neural crest cells separate from the neural epithelium in a region devoid of a basal lamina and migrate along pathways bordered by intact basal laminae. The distribution of basal laminae suggests that they might have an important role in the morphogenesis of the neural crest by acting as a barrier to migration. The experiments reported here have tested directly whether neural crest cells can penetrate a basal lamina. Isolated neural tubes, neural crest cells cultured for 24 hr, or pigmented neural crest cells were explanted onto human placental amnions from which the epithelium had been removed to expose the basal lamina. In no case did neural crest cells or crest derivatives penetrate the basal lamina to invade the underlying stroma. If crest cells were grown on the stromal side of the amnion, they invaded the connective tissue. Pigmented neural crest derivative and [3H]thymidine-labeled nonpigmented crest cells were also confronted with chick embryonic basal laminae by grafting the cells into the lumen of the neural tube at the axial levels where host crest migration had commenced. Most of the grafted cells invaded the neural epithelium and accumulated after 24 hr at the basal surface of the neural tube. A few crest cells escaped through the dorsal surface of the neural tube and entered the overlying ectoderm, presumably through the wound created during the grafting procedure. Some of these grafted cells, located initially by light microscopy, were examined at the higher magnification and resolution offered by the transmission electron microscope to determine the relationship of the grafted cells to the basal lamina. In 50% (14 total) of the cases, the crest cells never reached the basal lamina of the neural tube, but were trapped by cell junctions between the neural epithelial cells. Of the remaining grafted cells that were relocated in the TEM (50%, total 15) all were spread on the basal lamina, but were not seen penetrating it. Likewise, in the three cases where crest cells were found in the epidermal ectoderm, all were in contact with the basal lamina of the ectoderm but did not have any processes extending through it. In three cases, at the level of the light microscope, crest cells were found to extend through the basal surface of the neural tube. In all these instances, the cells followed the dorsal root nerve exiting through a region of the neural tube that is devoid of a basal lamina.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3817301 TI - Difference in the expression of asymmetric acetylcholinesterase molecular forms during myogenesis in early avian dermomyotomes and limb buds in ovo and in vitro. AB - The A12 (asymmetric) form of acetylcholinesterase (AChE) is generally considered to be synthesized in leg muscle tissues by myotubes under neural influence, but not by myoblasts. We have examined the expression of the different molecular forms of AChE in explants of developing limb buds and dermomyotomes (the myogenic part of the somites) obtained from 3-day-old chick and quail embryos, either directly after removal or during in vitro culture. We describe a muscular differentiation of both territories in vitro, leading to the formation of myotubes which are morphologically similar to the class of early muscle cells described by Bonner and Hauschka (1974). In vivo the A12 form is present in quail dermomyotomes which are almost entirely composed of mononucleated poorly differentiated cells; in contrast, it is absent from similar cells in chick dermomyotomes and from limb buds in both species. This shows that in the case of quail embryos the appearance of the A12 form precedes the fusion of myoblasts into myotubes. In both species, dermomyotome explants express asymmetric and globular forms of the enzyme during muscular differentiation in vitro, whereas limb buds synthesize only globular forms. After surgical removal of neural tube and/or neural crest at 2 days in ovo, the biosynthesis of the A forms in quail dermomyotomes is not suppressed and is consequently not dependent upon prior connection of the dermomyotomes to central neurons or upon the presence of autonomic precursors. Since limb bud muscle cells derive from somites our results raise questions concerning the differentiation of migrating somitic cells in this territory where a neural influence appears necessary to induce the biosynthesis of asymmetric AChE forms. PMID- 3817300 TI - Sulfated glucuronic acid-containing glycoconjugates are temporally and spatially regulated antigens in the developing mammalian nervous system. AB - Monoclonal antibody 4F4, which was raised against a cell suspension of embryonic rat forebrain, reacts with acidic glycolipids and several high-molecular-weight glycoproteins in rodent brain. The major reactive glycolipid is maximally expressed at Embryonic Day 15 (E15) and is no longer detectable at Postnatal Day 14 (P14) in the rat. 4F4 antibody reacts with a glucuronic acid- and sulfate containing lipid isolated from human sciatic nerve as well as with lipids from mouse and rat embryonic brain tissue. Although the glycolipid disappears postnatally, the immunoreactive glycoproteins continue to be expressed in brain until adulthood. Both sciatic nerve and embryonic brain glycolipids are hydrolyzed by glucuronidase/sulfatase treatment but are insensitive to all other glycosidases tested. In addition, the observed 4F4 reactivity with extracted glycolipids, glycoproteins, and tissue sections of embryonic brain is identical to the reactivity demonstrated by HNK-1 antibodies. Immunocytochemical studies in developing brain showed stage-specific distribution of this carbohydrate antigen. At E10 in the mouse, immunoreactivity is associated with the mantle layer of the neural tube. At E15 in the cortex, the most intense staining is associated with the molecular layer and the subplate, and weaker staining is seen in the intermediate zone and cortical plate, suggesting that the antigen is highly concentrated on postmigratory cells in the embryonic nervous system. PMID- 3817302 TI - Insulin and insulin-receptor autoantibodies in children with newly diagnosed IDDM before insulin therapy. AB - Twenty-nine children, aged 1-15 yr, with newly diagnosed insulin-dependent diabetes mellitus (IDDM) had sera taken before insulin therapy to be examined for the presence of insulin-receptor antibodies by measuring the inhibition of binding of radiolabeled insulin to IM-9 lymphocytes in both whole serum and purified IgG fractions. Groups of children with long-standing IDDM and autoimmune endocrine disease as well as a normal control group were studied. A positive result, defined as binding greater than or equal to 2 SD below the mean zero standard, was found in 3 (10.3%) of the 29 newly diagnosed diabetic patients. As a group, they showed significantly greater binding inhibition than the normal control group for both whole serum and purified IgG (one-tailed t test, P less than .05 and P less than .002, respectively). Insulin autoantibodies were also measured by a sensitive radioimmunoassay technique. A positive result, defined as binding greater than 3 SD above the normal control pooled sera, was found in 9 (37.5%) of 24 of the newly diagnosed IDDM group tested. All 3 subjects positive for insulin-receptor antibodies were also positive for insulin autoantibodies, whereas 6 of the 21 receptor-antibody-negative subjects were positive for insulin autoantibodies (Fisher's exact test, P = .0415). This suggests the possibility that the presence of insulin autoantibodies is a prerequisite for the development of insulin-receptor antibodies, i.e., as an anti-idiotypic response. Insulin receptor antibodies and insulin autoantibodies may play a currently undefined pathophysiologic role in the development of IDDM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817303 TI - Relationship of organ lipoprotein lipase activity and ketonuria to hypertriglyceridemia in starved and streptozocin-induced diabetic rats. AB - Although lipoprotein lipase (LPL) is believed to be rate limiting in the catabolism of triglyceride-rich lipoproteins, LPL activity has not correlated with plasma triglyceride concentrations in experimental rat diabetes. To gather more information about this enzyme system in diabetes, LPL activities were measured in representative tissues from control and streptozocin-induced diabetic rats fed fat-free chow and in 48-h-starved animals. The DNA content of each tissue was determined so that LPL activity could be expressed in a way that was unaffected by tissue wasting. Diabetic animals lost approximately 20% of their body mass. Adipose tissue and soleus muscle cell masses were reduced, and there was marked fat atrophy at necropsy. Adipose tissue LPL was decreased in both starved and diabetic animals, whereas skeletal muscle activities were variably affected. Lipase content and distribution among the individual organs were calculated with published data for rat carcass composition. In diabetic rats, total LPL (adipose tissue, muscle, and parenchymal organs) was reduced by nearly two-thirds so that skeletal muscle became the predominant source of LPL. Ketonuria was less frequent in diabetic than in starved rats (P less than .018) despite their severe wasting. Serum triglyceride concentrations were higher in ketonuric than nonketonuric diabetic animals, and severe hypertriglyceridemia was seen exclusively in heavily ketonuric animals. These observations together with published information suggest that plasma triglyceride concentrations in the rat model are determined by a complex interplay between very-low-density lipoprotein synthesis, the capacity of the LPL removal system, properties of the lipoprotein substrate, and other unidentified factors. PMID- 3817304 TI - Alteration of phenytoin binding by glycosylation of albumin in IDDM. AB - We measured glycosylated albumin and hemoglobin and serum protein binding of phenytoin in 57 children and adolescents with insulin-dependent diabetes mellitus (IDDM). Serum was incubated with phenytoin to yield concentrations of 15 and 25 mg/L, and a serum ultrafiltrate was prepared from an aliquot of each sample. We observed a linear correlation between glycosylated albumin and the free fraction of phenytoin at serum phenytoin concentrations of 15 mg/L (r = .35, P = .03) and 25 mg/L (r = .40, P = .003). A better correlation existed between the free fraction of phenytoin and total albumin concentrations for both serum concentrations (r = .45, P = .005 for 15 mg/L; r = .56, P = 10-5) for 25 mg/L), whereas the best linear correlation resided between the free fraction of phenytoin and the concentration of nonglycosylated albumin (r = .54, P = .0005 for 15 mg/L; r = .63, P less than 10(-6) for 25 mg/L). There was no correlation between the free fraction of phenytoin and the concentration of glycosylated albumin. Incubation of solutions of glycosylated and nonglycosylated albumin demonstrated significantly lower binding to the glycosylated fraction (P = 8.1 X 10(-6)). These results indicate that glycosylation of albumin diminishes the affinity of the phenytoin binding site on albumin. This alteration may have clinical significance in that it may alter the disposition of phenytoin in patients with IDDM and produce free phenytoin serum concentrations that are not accurately reflected by total serum phenytoin concentrations. PMID- 3817305 TI - Rate of glucose fall does not affect counterregulatory hormone responses to hypoglycemia in normal and diabetic humans. AB - To test the hypothesis that variations in rate of glucose fall influence counterregulatory hormone responses to hypoglycemia, we have modified the glucose clamp technique to provide a reproducible hypoglycemic stimulus in normal and type I diabetic subjects that varied only in the rate of glucose fall. Responsive elevations in plasma epinephrine and norepinephrine and in growth hormone, glucagon, and cortisol were not significantly affected by a ninefold change in the rate at which plasma glucose was lowered from 83 +/- 1 to 50 +/- 1 mg/dl in normal subjects. Similarly, wide variation in the rate of fall produced no substantive differences in counterregulatory hormone responses to hypoglycemia in diabetic subjects. The plasma glucose threshold at which epinephrine release began, determined from the slow-fall studies, was 63 +/- 3 mg/dl in normal subjects but exhibited a wide range (48-74 mg/dl). Similar values were found in the diabetics. Thresholds for growth hormone, cortisol, and glucagon were slightly lower, ranging from 45 to 68 mg/dl in the normals. Our data suggest that counterregulatory hormone responses to hypoglycemia are triggered by the glucose level per se and not by its rate of fall. Furthermore, individual differences in glucose thresholds for epinephrine release may contribute to variations in the glucose level associated with hypoglycemic symptoms. PMID- 3817306 TI - Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20-74 yr. AB - The prevalence of physician-diagnosed diabetes and of undiagnosed diabetes and impaired glucose tolerance (IGT) that meet National Diabetes Data Group (NDDG) and World Health Organization (WHO) criteria have been estimated for the U.S. population aged 20-74 yr from the 1976-1980 National Health and Nutrition Examination Survey. This survey included a demographic/medical history questionnaire administered in the participant's home and a detailed examination composed of a physician's exam, special clinical procedures, other tests, and collection of blood and urine specimens. Survey participants were selected from 1970 census data through a stratified multistage probability sampling scheme. Of 17,390 eligible residents aged 20-74 yr, 15,357 (88.3%) participated in the interview and are the basis for estimates of diagnosed diabetes; 11,858 (68%) participated in the exam. A half sample of 5901 examinees was selected to receive a 75-g oral glucose tolerance test (OGTT) performed in the morning after an overnight 10- to 16-h fast. Of these examinees, valid OGTT data were obtained for 3772 people without a medical history of diabetes, and these are the basis for estimates of undiagnosed diabetes and IGT. The major reasons for incomplete OGTT data were inability of participants to attend the examination center in the morning and lack of adherence to the fasting instructions. Despite the relatively low response rates, evidence is presented that data on both the interviewed sample and those receiving the OGTT, when adjusted for the 1970-1980 census characteristics by age, race, sex, income, and geographic location, are representative of the U.S. population. Extrapolation of these data to the U.S. population aged 20-74 yr indicates a total diabetes prevalence of 6.6% by NDDG criteria, or more than 8 million people with diabetes. The prevalence of undiagnosed diabetes (3.2%) was almost equal to that of previously diagnosed diabetes (3.4%). Total rates of diabetes increased with age, from 2.0% at age 20 44 yr to 17.7% at age 65-74 yr. Rates were approximately equal by sex but were greater in Blacks than in Whites. The prevalence of undiagnosed diabetes by WHO criteria (3.4%) was similar to that by NDDG criteria, but the rate of impaired glucose tolerance (11.2%) was more than twice the NDDG estimate (4.6%). Both obesity and parental history of diabetes were associated with significantly higher rates of diabetes and IGT. Fasting plasma glucose was relatively insensitive to age, but 1-h and 2-h post-75-g glucose values increased significantly with age. PMID- 3817307 TI - Aims and outcomes of therapy for the cerebral-palsied child. PMID- 3817308 TI - Causal origins of major mental handicap in the Canadian Maritime provinces. AB - From a retrospective epidemiological survey, the prevalence of major mental handicap among seven- to 10-year-old children in the Maritime region of Canada in 1980 was estimated to be 36.5 per 10,000 children. Based on information obtained for 221 of the 307 children ascertained by the survey, prenatal origins dominated (58 per cent), followed by perinatal (10 per cent) and postnatal (4 per cent). No specific cause could be determined for 27 per cent of the children, but 41 per cent of this group had epilepsy and/or cerebral palsy in addition to major mental handicap. Significant differences were found in the causal spectrum between the Maritime region of Canada and regions studied in other developed countries. The results of this survey have implications for planning prevention programs, and for epidemiological surveillance and monitoring of adverse reproductive outcomes. PMID- 3817309 TI - Bio-availability and dissolution of three phenytoin preparations for children. AB - A study of bio-availability of three drug companies' brands of phenytoin preparations (50mg capsule/tablets) was undertaken on 30 children with tonic clonic or complex partial seizures. Eight children were excluded because of non compliance and three because of abnormally high serum levels. Phenytoin capsules (Parke Davis) and tablets (Boots) produced significantly higher serum-level profiles than phenytoin tablets (Evans). Seizure frequencies did not differ significantly with the three brands of phenytoin. Dissolution of the three preparations tested in vitro was different. As a result of this study the authors recommend that children remain on the same manufacturer's brand of phenytoin throughout their treatment. PMID- 3817310 TI - A study on carbamazepine levels, including estimation of 10-11 epoxy carbamazepine and levels in free plasma and saliva. AB - Blood and saliva were collected from 48 children, aged three to 17 years, before a morning dose of carbamazepine and then at three, six and eight hours afterward. There was no significant difference in the ratio of 10-11 epoxy-carbamazepine to total carbamazepine for children on carbamazepine alone (0.18) and those on an additional anticonvulsant (0.19). 11 children were studied on their first day of therapy. Though four of them achieved levels of total carbamazepine which would have given a readily measurable 10-11 epoxide on the above ratio, 10 of the 11 consistently had levels less than 4 mumol/l. This may be of help in detecting non compliance. For 16 children free carbamazepine also was estimated and there was an over-all correlation coefficient of 0.85 between saliva and free-drug levels. The proportion of free to total carbamazepine varied between 19 and 54 per cent. There was a significantly higher proportion of free drug at the pre-dose sampling time than at other times. Protein binding of carbamazepine therefore is very variable and saliva estimations can contribute usefully to the monitoring of drug levels. PMID- 3817311 TI - Growth of severely impaired children: neurological versus nutritional factors. AB - Nineteen children with cerebral palsy who have had gastrostomies since 1981 and who have been followed for at least six months postoperatively were reviewed to assess the effects of gastrostomy feeding on their growth and to determine whether growth failure was due to neurological or nutritional dysfunction. The children's ages ranged from five to 168 months (mean 60.4 months) and follow-up extended from six to 41 months (mean 23.1 months). All were profoundly handicapped, with involvement of all four limbs. 11 also had seizures and all 19 were severely to profoundly retarded. Heights and weights were recorded during the visit immediately before surgery and at most recent follow-up. Data were recorded as a standard deviation score (Z-score). Before surgery the mean weight/height was -2.71 Z. Postoperatively this improved to -1.18 Z. 16 of the 19 children increased their weight/height ratio. Three children had a weight/height ratio greater than 10th percentile preoperatively. 11 achieved this on follow-up. Seven children were greater than 25th percentile for weight/height. Improvement in weight/height did not correlate with length of follow-up. For severely neurologically impaired children, nutritional factors play a major role in growth. By ensuring adequate caloric intake via gastrostomy, a significant number of children achieved adequate growth and better nutritional status. PMID- 3817312 TI - Suboccipito-vault skull diameter: an early indicator of ventricular dilatation in preterm babies. AB - The distance between the inferior surface of the occiput and the superior surface of the vault of the skull was measured weekly during the first nine weeks of life in 56 preterm but appropriately grown babies with birthweights less than 1850g. For seven babies with dilatation of the cerebral ventricles (shown by ultrasonography) the suboccipito-vault height increased above the 97th centile within the first five weeks of life, although over the same period the occipitofrontal head circumference did not exceed the 75th centile. In the only other baby with ventricular dilatation the suboccipito-vault height did not increase while therapy with frequent removal of lumbar cerebrospinal fluid was performed. Suboccipito-vault height is a sensitive early indicator of progressive dilatation of the cerebral ventricles, and may be of value in centres without ultrasound facilities. PMID- 3817313 TI - Morphometry and pathology of the paraspinous muscles in idiopathic scoliosis. AB - Muscle biopsies from the apex of both sides of the curve of 31 patients with idiopathic scoliosis showed abnormalities in fiber-type distribution in 68 per cent and in fiber size in 55 per cent. There was no preference for either side. Type 1 fiber predominance was as common as type 1 fiber deficiency. Atrophy occurred in 33 per cent and affected mainly type 1 fibers: atrophy of type 2 fibers was rare. Hypertrophy was limited to type 2 fibers, and occurred in 26 per cent. The strength factor for type 1 fibers exceeded that for type 2. Type 2A fibers were no larger than 2B fibers: there was a large type 2A predominance, more so on the convex side. Most of the muscle changes appear to be secondary and compensatory: none suggests a pathogenesis for the curve. PMID- 3817314 TI - The effects of babywalkers on early locomotor development. AB - The mothers of 66 infants were interviewed to obtain information on their children's motor development. The children were divided into three groups according to the length of time they spent in a babywalker. There was no difference between the groups in age at onset of sitting or walking, but children in the high-user group showed a significant delay in onset of prone locomotion compared with the low-user and non-user groups. This suggests that for some infants the excessive use of babywalkers alters the pathway of normal locomotor development. PMID- 3817315 TI - Clinical linguistic and auditory milestone scale: prediction of cognition in infancy. AB - At each well-child examination between birth and two years, parents of 448 infants were questioned about their child's age at attainment of 25 linguistic and auditory milestones. Parental reports were compared with the results of independently administered Bayley Mental Developmental Index (MDI) at one year of age. Parental recall of information was high, ranging from 70 to 99 per cent for 21 of the 25 milestones. The milestone performance of infants with normal MDI scores showed an orderly, sequential progression of expressive and receptive language. Across the entire population studied, the correlation between milestone attainment and MDI was statistically significant for 24 of the 25 milestones, and later attainment of milestones correlated with lower MDI. As a group, 'delayed' infants (MDI less than 68) attained milestones significantly later than 'average' infants (MDI 85 to 116) for 20 of 25 items. Attention to linguistic and auditory milestones early in infancy can contribute to the early detection and diagnosis of mental retardation and disorders of communication. PMID- 3817316 TI - Quantitative vibratory perception thresholds of healthy and epileptic children. AB - Quantitative vibratory perception threshold (VPT) measurements were performed on 102 healthy children and 79 children receiving anti-epileptic medication. Their ages ranged from three to 16. The VPTs correlated significantly with age and height. The rise in VPT with age may be associated with decreased receptor density. The level of mental alertness seemed to have no significant effect on vibratory perception. Only three of the children on anti-epileptics showed elevated VPTs. On the basis of this study, epileptic children seem to be free of the adverse effects of medication which occur later in adulthood. Children as young as three or four are quite capable of co-operating in this examination. The method can be recommended for use in follow-up studies of children and as a diagnostic aid when a disturbance of the sensory tract is suspected. PMID- 3817318 TI - Upper-limb function of children with myelomeningocele. AB - Upper-limb function of 33 children aged between four and 17 years, all with myelomeningocele and hydrocephalus, was investigated by clinical examination and formal tests of hand function. Cerebellar ataxia alone or with other neurological signs was the most common disorder detected. Hand-function scores were determined for each child and for different components of hand function, and the mean score for the whole group was only 59 per cent. In general, children over 11 years of age scored significantly better than younger ones. Children under 11 years of age with a milder degree of hydrocephalus or who were right-handed also scored significantly better. Only two children had clinically normal upper limbs. PMID- 3817317 TI - Assessment of visual acuity in infants and children: the acuity card procedure. AB - The 'acuity card' procedure described here is a simplified method of testing visual acuity of infants and young children, and has been developed to allow preferential looking to be assessed in a laboratory or clinic. A higher proportion of children can be tested successfully than has been reported for more traditional procedures. Initial studies indicate that the acuity card procedure is a fast, accurate method for assessing the acuity of normal infants and children, and those with visual or neurological impairments, across a wide age range and in both clinical and laboratory settings. PMID- 3817319 TI - High density on computed tomography in infantile Krabbe's disease: a case report. AB - In a child with a compatible clinical presentation and course of illness, Krabbe's disease was proven by white blood-cell galactocerebrosidase estimation in the homozygous range. A CT head scan performed at five months of age revealed symmetrical high density in the thalami, posterior limbs of the internal capsules and corona radiata. It also showed low density in the deep white-matter of the cerebral and cerebellar hemispheres and minor cerebral atrophy. Similar CT findings have been recorded in four other cases of infantile Krabbe's disease, and the authors consider that they are sufficient to alert the clinician to the probability of this diagnosis when the clinical signs are appropriate. PMID- 3817320 TI - Bonding and attachment: its relevance for the present-day clinician. PMID- 3817321 TI - The effects of hyperthermia on the fetus. PMID- 3817322 TI - Congenital myasthenia. PMID- 3817323 TI - Tuberous sclerosis and autism. PMID- 3817325 TI - Fenfluramine and autism. PMID- 3817324 TI - Lipid abnormalities in serum in Batten's disease. PMID- 3817326 TI - Standardisation of recording and reporting cerebral palsy. PMID- 3817327 TI - Ultrasonographic study of sucking and swallowing by newborn infants. PMID- 3817328 TI - Altered fecal bile acid pattern in patients with inflammatory bowel disease. AB - Alterations of the enterohepatic circulation of bile acids in patients with Crohn's disease (CD) and ulcerative colitis (UC) are known, but fecal bile acid patterns are less well defined. In this study total and individual fecal bile acids of 10 patients with CD (8 patients without bowel resection) 6 patients with UC and 5 healthy volunteers (HV) were determined by capillary gas chromatography. In comparison to HV (782 + 82 mg) the daily fecal excretion rate of bile acids was increased in CD (2,739 +/- 877 mg) and decreased in UC (409 +/- 55 mg). CD (80 +/- 19%) and UC (83 +/- 7%) had mainly primary bile acids, while secondary bile acids were predominant (80 +/- 4%) in HV. Bacterial conversion from primary to secondary bile acids is likely to be altered by rapid mouth-anus transit time (52 +/- 21 min) in UC and in CD by acidic stool pH (5.2 +/- 0.5). This lack of intestinal secondary bile acids may have pathophysiologic significance. PMID- 3817329 TI - Detectable colonic nitrite levels in inflammatory bowel disease--mucosal or bacterial malfunction? AB - In the healthy colon, sodium nitrite stimulates mucosal metabolism of short-chain fatty acids and absorption of ions, both functions that are impaired in the mucosa of patients with ulcerative colitis (UC). To assess the role of nitrite in colonic inflammatory disease, sodium nitrite was measured in rectal dialysate of 49 subjects (18 controls, 23 UC and 8 other colitis). None of the control or quiescent UC patients had measurable levels of nitrite while 78% of patients with acute UC and 38% of patients with other colitis had measurable nitrite levels (acute UC vs. other colitis chi 2 = 5.555, p less than 0.02). Functional activity of the colonic mucosa, judged by bicarbonate output, was impaired in all subjects with measurable nitrite levels in UC. Detection of nitrite in acute colitis suggests impaired oxidation of nitrite to nitrate in the colonic mucosa or impaired luminal reduction of nitrite to NH4 by bacteria. PMID- 3817330 TI - Effect of secretin and caerulein on the absorption of water, electrolytes and glucose from the jejunum of dogs. AB - The effects of secretin and caerulein on the absorption of water, sodium, potassium and glucose from the jejunum of dogs were investigated. Intravenous infusion of 1 clinical unit (CU; 82 pmol/kg/h) of secretin inhibited jejunal absorption of water, sodium and glucose compared to control period. Adding an intravenous infusion of 0.4 micrograms (300 pmol)/kg/h of caerulein to the infusion of secretin, the jejunal absorption rates of water, sodium and glucose were restored to control values. Intravenous infusions of 0.2 and 0.4 micrograms/kg/h of caerulein induced no significant difference in the absorption compared to control. Thus it seems that secretin inhibits the absorption of water, sodium and glucose from the jejunum of dogs and caerulein, added to secretin, reverses the effect of secretin. PMID- 3817331 TI - Prostaglandins are not involved in the differentiation or growth of cultured small intestinal cells. AB - Prostaglandins have been reported to exert trophic effects on gastrointestinal tissues. To determine whether there is a direct interaction with enterocytes, prostaglandins PGE2, PGF2 alpha, PGA2, PGB2 and the stable PGE2 derivative suleprost as well as the prostacyclin derivative nileprost were tested in rabbit ileal mucosa under organ culture conditions. At concentrations between 10(-9) and 10(-5) M, none of the prostaglandins significantly affected biopsy DNA or protein content, or the activity of the brush border enzymes alkaline phosphatase, lactase, sucrase or maltase. The inhibition of endogenous prostaglandin synthesis with indomethacin also failed to alter these parameters. Moreover, the growth rate of a rat duodenal crypt cell line was unaffected when cultured in the presence of PGE2, PGF2 alpha or indomethacin. Thus, there was no evidence for a direct effect of exogenous or endogenous prostaglandins or their deficiency on the differentiation or growth in cultured small intestinal cells. PMID- 3817332 TI - Pathways of enzyme transfer in sodium taurocholate-induced acute hemorrhagic pancreatitis. AB - The pathways of enzyme transfer from the pancreas into the systemic circulation were analyzed in sodium taurocholate-induced acute hemorrhagic pancreatitis in the rat by estimating lipase concentrations in blood, lymph and ascites. During the first few hours of pancreatitis high enzyme levels were observed in thoracic duct lymph. However, cannulation of the thoracic duct did not prevent a significant increase in the lipase concentration in peripheral blood. The portal vein lipase concentration was found to exceed the peripheral values by approximately 10%. Extremely high concentrations of lipase were measured in the ascites collected during pancreatitis. When the ascites was transferred to the peritoneal space of healthy rats, a significant increase in the lipase concentration in peripheral blood was measured. This increase could not be prevented by transection of the parasternal lymphatics. It was concluded that the hematogenous rather than the lymphatic transport of lipase from the pancreas and the peritoneal surface is the most important pathway. In this respect, this study does not support thoracic duct drainage but advocates peritoneal lavage as a logical therapeutic measure to reduce the concentration of circulating toxic substances from the pancreas in acute pancreatitis. PMID- 3817333 TI - Crohn's disease in Jewish people--an epidemiological study in south-east Wales. AB - The prevalence of Crohn's disease in the Jewish population of south-east Wales was established by a postal survey, review of case notes and a survey of Jewish congregations in the three synagogues of the area. The prevalence of Crohn's disease had been established in various earlier studies at 52/10(5). Seven Jewish patients were identified amongst a population of between 1,750 and 2,500. The prevalence ranged from 280 to 400/10(5) (95% confidence interval 120-862/10(5]. There was no significant difference in prevalence between orthodox and reformed Jews. Jewish people are at a relative risk of developing Crohn's disease of 5.4 7.7 (95% confidence interval 2.3-17.2, p less than 0.001), but the role of diet is yet to be established. PMID- 3817334 TI - Quantifying early diabetic retinopathy. AB - A precise and accurate method of numerically quantifying diabetic retinopathy, on standardised retinal colour photographs, has been developed which allows small changes and trends to be monitored. Colour slides are projected onto a screen and features noted on an acetate sheet which provides a permanent record. Sector analysis showed microaneurysms and haemorrhages to occur most often at the temporal-to-macula area, exudates at the macula and cotton wool spots on the nasal side of the retina. Seventy percent of microaneurysms appeared in the previous year, irrespective of the severity of the retinopathy. In proportion to their usual relative prevalences, after normalisation of distribution, the various features can be combined to provide a single value, the Retinopathy Index. This provides an overall assessment of retinopathy which is suitable for comparing the progress of mild retinopathy in prospective studies. PMID- 3817335 TI - Increased glucose turnover and glucose cycling in acromegalic patients with normal glucose tolerance. AB - To characterize the diabetogenic effects of growth hormone, we simultaneously measured glucose turnover with 2-3H- and 6-3H-glucose in six acromegalic patients with normal fasting blood glucose and oral glucose tolerance tests. Eight healthy volunteers served as controls. All subjects were studied under both basal conditions and during glucose infusion (2 mg X kg-1 X min-1). We determined true glucose production and irreversible glucose uptake using 6-3H-glucose and glucose cycling (difference between 2-3H- and 6-3H-glucose). After an overnight fast, glucose production was higher than normal in the acromegalic patients (2.18 +/- 0.15 vs 1.85 +/- 0.03 mg X kg-1 X min-1, p less than 0.05) despite hyperinsulinaemia. The metabolic clearance rate was normal. During the glucose infusion, glucose production was not suppressed as effectively in the acromegalic patients as in controls nor was glucose uptake augmented, while metabolic clearance rate was decreased. In acromegaly, basal glucose cycling was increased (0.44 +/- 0.08 vs 0.25 +/- 0.07 mg X kg-1 X min-1, p less than 0.05). Furthermore cycling of endogenous glucose measured during glucose infusion was also augmented (0.41 +/- 0.05 vs 0.24 +/- 0.05 mg X kg-1 X min-1, p less than 0.05). Hence the increase of glucose cycling (70%) was much more pronounced than that of glucose production (17%). In conclusion, small defects in glucose metabolism in acromegaly can be detected with sensitive tracer methods. These derangements are confined to the liver under fasting conditions, but are of both hepatic and extrahepatic origin during glucose loading. PMID- 3817336 TI - Insulin-like growth factors (IGF) I and II in diabetic pregnancy: suppression of normal pregnancy-induced rise of IGF-I. AB - The concentrations of somatomedins/insulin-like growth factors were measured by a specific radioimmunoassay for insulin-like growth factor-I and a specific radioreceptor assay for insulin-like growth factor-II in sera of term normal and Type 1 (insulin-dependent) diabetic pregnant women and in various cord sera of their newborn infants. Serum insulin-like growth factor-I levels in normal (non diabetic) maternal serum were higher than in non-pregnant women (486 +/- 26 versus 215 +/- 26 ng/ml). The normal pregnancy-induced increment of insulin-like growth factor-I was markedly reduced in diabetic pregnancy. It was not different in patients with good or poor glycaemic control, as judged by normal or elevated blood levels of haemoglobin A1c content. Insulin-like growth factor-I levels in cord serum of infants of diabetic women with good glycaemic control (86 +/- 11 ng/ml) and poor glycaemic control (91 +/- 19 ng/ml) were significantly higher (p less than 0.01) than in infants of non-diabetic women (43 +/- 42 ng/ml). The fetal birth weight ratios were not significantly correlated with insulin-like growth factor-I levels in cord serum. Serum insulin-like growth factor-II levels in maternal and cord serum in diabetic and normal pregnancy were not different from each other or from normal non-pregnant women. The increment in insulin-like growth factor-I levels in maternal serum in pregnancy may influence placental structure and function. Lack of this increment in maternal diabetes may have direct implication in placental abnormalities in diabetes and indirect implications on fetal development and metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817337 TI - Effects of metformin on insulin receptor tyrosine kinase activity in rat adipocytes. AB - The cellular mechanism(s) by which the biguanide, metformin, exerts its antihyperglycaemic effect was investigated. Rat adipocytes were either treated acutely (2 h) or maintained in a biochemically defined medium (20 h) in the presence or absence of metformin (1 X 10(-4) mol/l). Exposure to the drug resulted in a significant enhancement (p less than 0.01) of hexose transport in both the absence (basal) and presence of insulin. Stimulation of transport was not explained by the increase in the basal state alone, since the incremental response to maximally effective concentrations of insulin was significantly enhanced p less than 0.025. Insulin-receptor tyrosine kinase activity was examined under the same experimental conditions. Activity of the kinase was unaltered as evaluated by phosphorylation of an artificial substrate and by phosphorylation of the receptor in situ. Furthermore, in this investigation neither insulin receptor number nor affinity was changed in adipose tissue treated with metformin. These studies indicate that metformin potentiates the effect of insulin on glucose transport at a site(s) beyond insulin receptor binding and phosphorylation. PMID- 3817338 TI - A new model of type 2 (non-insulin-dependent) diabetes mellitus in spontaneously hypertensive rats: diabetes induced by neonatal streptozotocin treatment. AB - This study was designed to develop an animal model of Type 2 (non-insulin dependent) diabetes with persistent hypertension. Male spontaneously hypertensive rats were treated with 25.0, 37.5, 50.0, 62.5 or 75.0 mg/kg of streptozotocin given intraperitoneally at 2 days of age and maintained for 12 weeks. In the rats which received 50.0 mg/kg or more streptozotocin, overt hyperglycaemia gradually and consistently developed following incomplete recovery from an initial hyperglycaemia. Compared to vehicle-treated controls, body weight gain in these animals did not differ for the first 8 weeks; thereafter, it was slightly but significantly (p less than 0.05) reduced. The animals treated with 25.0 or 37.5 mg/kg streptozotocin developed mild to moderate hyperglycaemia, but their body weight gain was similar to controls. The relationships between streptozotocin dose and metabolic responses (plasma glucose, glycosylated haemoglobin, urinary glucose, food intake, etc.) were clearly demonstrated. Systolic blood pressure rose with progressing age in both controls and streptozotocin-treated rats, irrespective of dosage or metabolic response. This new rat model of Type 2 diabetes associated with persistent hypertension may be useful in studying these combined effects on small and large vessels. PMID- 3817339 TI - Obesity and diabetes. PMID- 3817340 TI - Hyperkalaemia after interruption of CSII. PMID- 3817341 TI - Additional generics on the market. PMID- 3817342 TI - Suprofen labeling revised. PMID- 3817344 TI - Risks with gastric bubble. PMID- 3817343 TI - Etretinate approved. PMID- 3817345 TI - New sulfite regulations. PMID- 3817346 TI - FDA requests comments on IDE regulations. PMID- 3817348 TI - Monovalent flu vaccine available soon. PMID- 3817347 TI - Request for reports of suspected toxicity with dietary supplements. PMID- 3817349 TI - Data do not support association between spermicides, birth defects. PMID- 3817350 TI - [Man and scientific-technological progress]. PMID- 3817351 TI - [Reactions of neurons and evoked potentials in the subcortical structures of the human brain during visual recognition. III. Effect of the meaningful and physical characteristics of irrelevant stimuli on evoked responses of neurons]. PMID- 3817352 TI - [Role of the left and right hemispheres of the human brain in the processes of probabilistic prediction]. PMID- 3817353 TI - [Superslow oscillations of the potentials of lesioned human optic nerves as an indicator of their condition]. PMID- 3817354 TI - [Neurophysiologic mechanisms of facial expression reactions]. PMID- 3817355 TI - [Features of central blood flow in patients with ischemic heart disease during changes in sleep stages]. PMID- 3817356 TI - [Role of the internal model in the perception of position and planning of hand movements]. PMID- 3817357 TI - [Characteristics of the muscular activity of healthy schoolchildren and schoolchildren with postural disorders and scoliosis]. PMID- 3817358 TI - [Cellular mechanisms of disordered locomotor function of muscles in children with cerebral spastic paralysis]. PMID- 3817359 TI - [Age and features of the condition of the pituitary-thyroid system in healthy children]. PMID- 3817360 TI - [Relation between the effectiveness of the occupational activity of operator supervisors and their psychophysiologic and personal characteristics]. PMID- 3817361 TI - [Significance of spectral-correlation parameters of human neocortical potentials with respect of short-term memory characteristics. II. Spectral-correlation parameters of human neocortical potentials during correct and incorrect responses]. PMID- 3817362 TI - [Central venous pressure and hormonal regulation of water metabolism and changes in it during antiorthostasis]. PMID- 3817363 TI - [Study of the age dynamics of a metabolic and immune complex of indicators by the technic of statusometry]. PMID- 3817364 TI - Systolic time intervals in patent ductus arteriosus before and after corrective surgery. AB - Systolic time intervals (STI) were analyzed in 11 patients with isolated patent ductus arteriosus (PDA) and unidirectional left-to-right shunt, before, shortly after (within 2 months) and a long time (at least 10 years) after the corrective surgery. The measurements were obtained from simultaneous high speed photographic recordings of electrocardiogram, external carotid pulse and phonocardiogram. Before the operation, the left ventricular ejection time (LVET) was significantly prolonged (p less than 0.01) and this abnormality was correlated with Qp/Qs (r = 0.74, p less than 0.01). Shortly after the operation, the LVET was shorter than normal, and became normal only a long time after. It is concluded that the most likely explanation for these abnormalities is: 1) before the operation, the increased stroke volume of the left ventricle secondary to the shunt, and 2) after corrective surgery, the depressed contractility of the left ventricle secondary to the long-standing volume overload which tends to persist after the corrective surgery. PMID- 3817365 TI - [The linking phenomenon in tachycardia-dependent intraventricular block]. AB - Seven cases of tachycardia-dependent, or phase-3, intraventricular block have been examined. Analysis revealed a constant overlap between the range of the R-R intervals ending in normal conduction and the range of the R-R intervals where the second beat is associated with intraventricular block. The block, indeed, may occur at the end of relatively long R-R intervals, whereas R-R intervals which are shorter (up to 0.11 sec) can unexpectedly result in normal intraventricular conduction. A relatively late QRS complex, however, can reflect an intraventricular block only when the preceding complex also manifests the block. This phenomenon has been interpreted as due to the so called "linking", namely the retrograde concealed penetration of an anterogradely blocked bundle branch by the impulse traversing the controlateral bundle branch. This delays the activation of the affected bundle branch, whose refractory period is, accordingly, "shifted to the right" within the cardiac cycle. A relatively late sinus impulse, thus, can result in intraventricular block since the refractory period of the affected bundle branch ends later, with respect to the beginning of the QRS complex, than it does after a normally conducted sinus impulse. PMID- 3817366 TI - [Cardiac imaging with nuclear magnetic resonance. Preliminary experience]. AB - Magnetic Resonance Imaging (MRI) is a new completely noninvasive diagnostic tool available for studying the cardiovascular system. In order to assess its utility in cardiovascular protonic imaging, we studied normal individuals and patients with different heart diseases by means of a 0.5 Tesla superconductive magnet triggered by the ECG. Images were obtained in 38 subjects. By electronically angulating the gradients and by acquiring the images at different phases of the cardiac cycle we obtained several different diagnostic possibilities which can allow both anatomic and functional studies of the heart. On the 21 patients, MRI showed the main features of each disease. Our initial experience with MRI confirms the need for oblique images of the heart in order to obtain planes useful in cardiovascular diagnosis. Among many diagnostic possibilities we tested the ability of MRI in the detection of acute and old myocardial infarction. Although MRI requires extensive application in order to delineate its role in cardiovascular diagnosis it is to be considered an important diagnostic tool and a very interesting investigative method. PMID- 3817367 TI - [Use of amrinone in refractory cardiac insufficiency: clinical and hemodynamic evaluation]. AB - Amrinone is a nonadrenergic, nonglycosidic agent with combined positive inotropic and vasodilator properties. To determine its clinical and hemodynamic effects we treated 14 patients (12 men and 2 women ranging in age from 36 to 78 years, mean 56) with severe chronic heart failure (New York Heart Association functional class IIIa or IVa) not controlled by conventional therapy. Drug administration: 1 mg/Kg intravenous bolus followed by infusion of 10 mcg/Kg/min over 24 hours; in 11 patients, upon termination of long term infusion, oral therapy was begun (100 mg tid) for a period of four weeks. After bolus and during infusion dyspnea, pulmonary and jugular vein congestion, hepatomegaly rapidly improved, and increase of diuresis was noted. All patients responded with a substantial reduction in central venous pressure (CVP 9.64 +/- 5.96----4.79 +/- 5.66 mmHg, P less than 0.01), wedge pressure (WP 26.3 +/- 4.6----19.00 +/- 4.66 mmHg, P less than 0.01), pulmonary and systemic vascular resistances (PVR 212.07 +/- 121.08--- 127.64 +/- 50.37 dyne. sec. cm-5; SVR 1687 +/- 301----1297 +/- 357 dyne. sec. cm 5; P less than 0.01); these changes were accompanied by an increase of cardiac index (CI 1.96 +/- 0.38----2.84 +/- 0.83 L/Min/m2; P less than 0.01), stroke index (SI 23.43 +/- 5.85----31.64 +/- 8.86; P less than 0.01) and left ventricular stroke index (LVSWI 22.36 +/- 8.45----34.50 +/- 12.29 g.m/b/m2; P less than 0.01). These positive clinical and hemodynamic effects were not maintained in long term therapy. Moreover we observed adverse effects: fever, nausea and vomiting, thrombocytopenia, liver enzyme elevation, tachycardia and ventricular arrhythmias. CONCLUSIONS: good efficacy and tolerability during short term intravenous therapy in emergency conditions; no clinical improvement and sometimes adverse effects in oral long term therapy. PMID- 3817368 TI - [Digoxin-propafenone interaction: values and limitations of plasma determination of the 2 drugs. Anti-arrhythmia effectiveness of propafenone]. AB - Propafenon's influence on the pharmacokinetic and actions of digitalis and viceversa have been evaluated in 27 patients (25 with ventricular hyperkinetic arrhythmias and 2 with paroxismal atrial fibrillation). Patients were divided in two groups according to whether the drug firstly administered were digoxin or propafenon. Plasmatic digoxin and/or propafenon's concentrations, these last performed only in 12 patients, were determined before and during the association and after propafenon's interruption at 7.55-9-11 and at 3-8 p.m. During drug's association area under the plasmatic digoxin concentration curve (AUC 12h) increased on the average by 13.8% (from 19.27 +/- 6.002 ng hours/ml to 21.94 +/- 6.198 ng hours/ml: P less than 0.05) and by 19% at the first hour. Neverthless individual behaviour was not homogeneous since the plasmatic digoxin concentration (PDC) increased in 22 cases (81.4%) and decreased in 5 (18.6%). In 6 patients mean increase was 38.8% (from 16.72 +/- 3.0 ng hours/ml to 23.21 +/- 5.44 ng hours/ml) without signs of digoxin intoxication. Another patient with congestive heart failure and basal PDC 1.87 ng/ml experienced digoxin poisoning with fatal ventricular fibrillation after propafenon. Digoxin administration in the second group's patients produced a not significant increase of plasmatic propafenon concentration (PPC). There was a good correlation among propafenon's absolute amount and plasmatic concentration and antiarrhythmic effect and no correlation among PPC and body-weight related dose. Propafenon's to digitalis association induced, in propafenon's steady state, significant P-R longation from 170 to 190 ms (P less than 0.01) but HR, QRS and QTc didn't show any important change (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817369 TI - [Usefulness and limitations of the ergonovine maleate test in the evaluation of calcium-antagonist therapy in Prinzmetal variant angina]. AB - Ergonovine testing was carried out in a selected group of 25 patients with Prinzmetal's variant angina treated with calcium-antagonists in order to: define its usefulness in the evaluation of the short-term effectiveness of calcium antagonist treatment; compare the results of the test with those of Holter monitoring; verify if the results of the test during the acute phase are correlated with the long-term response to treatment. In all patients a control period lasting 2-6 days was carried out, after which a treatment period with calcium-antagonists (nifedipine, diltiazem, verapamil), lasting 2-8 days, was instituted. In 20 patients only 1 calcium-antagonist was evaluated, in 1 patient 2 calcium-antagonists and in 4 all of them. Scalar ergonovine test was carried out in control conditions and repeated during each calcium-antagonist treatment period. During both control and treatment periods all patients underwent Holter monitoring for evaluation of frequency of the spontaneous attacks. After the acute phase 21 of the 25 patients were discharged on calcium-antagonist treatment and followed-up for a mean period of 11 +/- 7 months. In control conditions ergonovine test was positive in 24 patients at a mean dose of 0.11 +/- 0.09 mg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817370 TI - [Electrocardiographic aspects simulating acute myocardial infarct in massive pulmonary embolism. Description of 2 cases]. AB - Two cases of massive pulmonary embolism, with elevation of the ST segment in the right precordial leads, are reported. In the presence of this electrocardiographic sign, simulating acute coronary insufficiency involving right ventricle, the diagnosis of acute cor pulmonale should be suspected. PMID- 3817372 TI - [Collateral effects of amiodarone]. PMID- 3817373 TI - [Clinical experimentation with anti-angina drugs]. PMID- 3817371 TI - [Left ventricular fibroma in childhood: 2-dimensional echocardiographic diagnosis and surgical treatment. Description of a case]. AB - We describe the case of a patient 4 months old transferred to our hospital for evaluation of occasionally detected cardiac alterations: ecg showed abnormal Q and negative T waves in D1 - aVL leads and chest x-ray was consistent with enlargement of the left ventricular cavity. After admission, 2D echocardiographic examination disclosed, in the left ventricular cavity, a large mass extending from the papillary muscles to the outflow tract. The mass was of uniform density and easily recognizable as a tumor. Although asymptomatic, the patient underwent operation 10 months later because of the risk of occurrence of severe conduction disturbances or arrhythmias. Histological examination demonstrated that the mass was a fibroma. At post-op echocardiographic and angiographic evaluation the left ventricle appeared abnormally dilated with a large aneurysm of the lateral wall and very poor pump function. Nevertheless the patient did well in the following months until a ventricular fibrillation occurred at home. He was immediately brought to hospital and resuscitation was attempted unsuccessfully. We discuss the role of 2D echocardiography in the diagnosis of cardiac tumors, the indication of the early surgical removal and the possible limitations of the technique we used in this case. PMID- 3817374 TI - [Genetic bases and mechanisms of bacterial resistance to antibiotic drugs]. PMID- 3817375 TI - [Co-tetroxazine: review and personal contributions]. PMID- 3817376 TI - [Antibacterial activity of 3d-generation cephalosporins and other antibiotics on recently isolated strains]. PMID- 3817377 TI - [Changes in the surface structure of bacteria treated with antibiotics (cephalosporins, aminoglycosides]. PMID- 3817378 TI - [In vitro antiviral activity of octophene]. PMID- 3817379 TI - [Formulation of a mathematical model of bacterial killing by antibiotics]. PMID- 3817380 TI - [Spectrum of resistance of strains of hospital bacteria to antibiotics in common use]. PMID- 3817381 TI - [Effects of bromhexine on levels of netilmicin in serum, saliva, bronchial secretions and bronchial tissue in patients with chronic obstructive pneumopathy]. PMID- 3817382 TI - [Concentrations of cefoperazone in lung tissue]. PMID- 3817383 TI - Gastric and esophageal emptying in dystrophia myotonica. Effect of metoclopramide. AB - Gastric and esophageal emptying were measured using scintigraphic techniques in 16 patients with dystrophia myotonica and in 22 normal volunteers. Gastric emptying of a solid meal was slower than the normal range (defined as the mean +/ two standard deviations obtained in the normal volunteers) in 15 of the 16 patients, and gastric emptying of the liquid meal was slower than the normal range in 10 of the patients. Esophageal emptying was also markedly delayed in patients, with 15 of 16 patients having an emptying time longer than the normal range. There was no relationship between gastrointestinal symptoms, or the severity of the peripheral (skeletal) muscle weakness, and either gastric or esophageal emptying. Oral administration of metoclopramide resulted in a significant improvement in gastric emptying of the solid meal and a nonsignificant trend toward more rapid liquid emptying, but no change in esophageal emptying. These results indicate that there is a very high prevalence of gastric and esophageal smooth muscle dysfunction in dystrophia myotonica and that gastroparesis is likely to be a treatable cause of morbidity in this disease. PMID- 3817384 TI - Metabolic bone disease in asymptomatic men after partial gastrectomy with Billroth II anastomosis. AB - We sought to determine whether gastric surgery might be associated with metabolic bone disease in a well-characterized population, and if so to explore its etiology. Sixteen asymptomatic middle-aged men who had had partial gastrectomy with Billroth II anastomosis but no other risk factors for metabolic bone disease were compared with unoperated healthy controls. Studies included a dietary survey, biochemical tests of bone and mineral metabolism, radiographs of the spine, determinations of bone mineral content, and bone histomorphometry. The gastric surgery subjects exhibited frequent vertebral fractures and an unusual constellation of bone abnormalities characterized by decreased bone mineral content and hyperosteoidosis without evidence of osteomalacia. Although serum immunoreactive parathyroid hormone and 25-hydroxyvitamin D levels were not different, 1,25-dihydroxyvitamin D levels were significantly higher (p = 0.037), and 24,25-dihydroxyvitamin D levels were significantly lower (p less than 0.0001) in subjects than in controls. Partial gastrectomy with Billroth II anastomosis may be associated with asymptomatic but clinically important metabolic bone disease. The pathophysiology is uncertain, but appears to involve alterations in vitamin D metabolism. PMID- 3817385 TI - Elevated plasma enteroglucagon alone fails to alter distal colonic carcinogenesis in rats. AB - The effect of physiologic increases of plasma enteroglucagon, induced by massive bypass or resection of small bowel, on large bowel cell turnover and carcinogenesis was studied in rats in which the distal colon was isolated as a mucous fistula. After injections of azoxymethane, either 85% end-to-side jejunoileal bypass, 85% jejunoileal resection, or sham bypass was performed. Controls underwent colonic transection and resuture, azoxymethane treatment, and then sham bypass. Thirty weeks later the plasma enteroglucagon level had almost trebled after jejunoileal bypass (p less than 0.001) and almost doubled after jejunoileal resection (p less than 0.002) when compared with sham bypass; sham values did not differ from controls. The median number of tumors per rat in the distal (defunctioned) colon fell from 2 to 0 (p less than 0.05). Segmental weight fell by 45% (p less than 0.001) and crypt cell production rate by 75% (p less than 0.001). Neither tumor yield nor adaptation was affected by jejunoileal bypass or jejunoileal resection. Plasma enteroglucagon has no effect on colonic cell turnover or carcinogenesis in the absence of luminal content. PMID- 3817386 TI - Affinity purified immunoglobulin G transfers immediate hypersensitivity to guinea pig colonic epithelium in vitro. AB - Our aim was to establish whether the epithelial type 1 hypersensitivity reaction in response to a dietary antigen, as we have previously described, had an immunologic basis. Using serum from guinea pigs fed with milk proteins we examined the passive transfer of sensitivity to beta-lactoglobulin. Biophysical methods were used to measure electrogenic chloride secretion across colonic epithelia. This response has been shown previously to be the cellular function that is altered after antigen challenge. Affinity column chromatography was used to separate immune serum into immunoglobulin G-(IgG)-rich and immunoglobulin G depleted fractions and the purity of these fractions was established. Passive transfer of sensitivity was possible with the immunoglobulin G-rich, but not the immunoglobulin G-depleted, fraction. We have proven, therefore, that the reaction is mediated, at least in part, by immunoglobulins of the G class. This finding may have implications for the study of phenomena of food allergy. PMID- 3817387 TI - Responses of the human esophagus to paired swallows. AB - The present study was performed to characterize the interaction between two closely timed swallows, with particular attention being paid to short swallow intervals (less than 6-8 s) when the first wave is still traversing the esophagus and the effect of afferent stimulation in the form of bolus size. The contractile response of the esophagus to paired swallows (2-8 ml) over a range of swallow intervals (1.5-20 s) was studied in 13 normal humans using a 7-lumen perfused manometry catheter. At the shortest swallow intervals (less than 4 s), the first swallow wave is arrested in the striated muscle, while the second progresses normally. As swallow intervals lengthen (3-8 s), the first wave is arrested in the striated muscle, or is arrested or attenuated in the smooth muscle esophagus, but can continue for up to 3 s after initiation of the second swallow. The second wave is then arrested in the striated muscle, while beyond, a rapid or nonperistaltic low-amplitude wave occurs 3-5 s after the second swallow. At longer swallow intervals (greater than 6-8 s), the nonperistaltic second wave is replaced abruptly by a low-amplitude peristaltic wave of low velocity that traverses the entire esophagus. A larger first bolus increases the swallow interval required for this abrupt change, whereas a larger second bolus shortens the interval. The larger second bolus also increases the amplitude and decreases the velocity of the peristaltic second wave in both striated and smooth muscle portions. At swallow intervals greater than 10-15 s, two normal peristaltic waves occur. These studies demonstrate that each swallow of a closely timed pair directly affects the other. Not only does the second wave inhibit the first, but the first swallow and its wave markedly affect the second swallow wave. These interactions involve both the striated and the smooth muscle esophagus, and the latter interaction in particular is highly sensitive to afferent stimulation. This suggests that the interactions are predominantly neurogenic and have a significant central neural component. PMID- 3817388 TI - Esophageal manometry and radionuclide emptying in chronic alcoholics. AB - Eighteen asymptomatic alcoholics, half with neuropathy, were studied within 3 days of drinking to evaluate the frequency, nature, and underlying causes of esophageal dysmotility. Ten were restudied after a month of sobriety. The mean lower esophageal sphincter pressure and esophageal contraction amplitude in alcoholics were significantly higher than controls. Radionuclide esophageal emptying was slower than controls. Abnormal motility studies included 9 patients with nutcracker esophagus and 5 patients with nonspecific motor disorder. After 1 mo of abstinence, 5 of 6 patients with nutcracker esophagus and one with nonspecific motor disorder became normal. Lower esophageal sphincter pressure and esophageal contraction amplitude also returned to normal. These abnormal findings were independent of neuropathy. One patient who had normal manometry and emptying had esophagitis. We demonstrated that esophageal dysfunction is common in alcoholics, even in the absence of esophagitis and neuropathy, suggesting that these do not play a major role in esophageal dysmotility. Nutcracker esophagus is a reversible and common manometric finding in asymptomatic alcoholics. PMID- 3817389 TI - Comparative stimulation of motilin duodenal receptor by porcine or canine motilin. AB - Motilins purified from porcine and canine intestine differ in their amino acid composition in positions 7-8-12-13-14. We studied in vitro the contractile response of longitudinal duodenal muscles from various animals (guinea pig, rabbit, dog) to porcine and canine synthetic motilins. Both substances failed to elicit contraction of the guinea pig duodenum but were active and equally potent on rabbit muscle. In dogs, porcine motilin was inactive at the concentrations tested (up to 10(-4) M) whereas canine motilin induced duodenal contractions in a dose-response fashion (mean dose required to induce half-maximal response: 4.82 +/- 0.25 X 10(-5) M). The contraction generated by synthetic canine motilin (10( 5) M) was not influenced by atropine, hexamethonium, tetrodotoxin, naloxone, or sodium nitroprusside (all used at 10(-4) M) but was blocked by verapamil (10( 4)). Our study shows that species-related structural alterations in motilin molecules generate different bioactive capacities in some animal species, suggests that the middle portion of the molecule is important for its bioactive expression, suggests the presence of motilin receptors on canine duodenal muscle, and suggests that an influx of extracellular calcium is involved in the canine duodenal muscle contraction elicited by canine motilin. PMID- 3817390 TI - Effect of gluten supplementation in healthy siblings of children with celiac disease. AB - The clinical, functional, and histopathological effects of 18 g additional gluten intake daily for 4 wk was studied in 13 healthy siblings of Spanish children with celiac disease, including two pairs of discordant monozygotic twins. Five of the 13 children were HLA-DR identical to the celiac sibling, 5 shared only one HLA-DR antigen with the celiac sibling, and 3 had completely different HLA-DR antigens than their respective celiac brothers or sisters. Clinical evaluation and functional tests (routine blood, xylose absorption, and fecal fat excretion studies) were performed before, during, and after gluten challenge. A jejunal biopsy specimen was taken at the end of the 4-wk period of gluten supplementation. No clinical abnormalities were found during the period of the study and there was no significant decrease of xylose absorption. Fecal fat excretion studies gave normal results, both before and after gluten challenge. The high gluten diet did not lead to histopathologic abnormalities in any of the jejunal biopsy specimens, which showed a normal range of crypt to villus ratio and surface-cell height. The present results do not support the view that excessive gluten intake is toxic for individuals who are genetically predisposed but do not have overt celiac disease. The findings also suggest that other factors besides HLA-DR antigens and gluten intake are important for expression of the disease. PMID- 3817391 TI - Abnormal pattern of cell proliferation in the entire colonic mucosa of patients with colon adenoma or cancer. AB - Using autoradiography after 1 h of pulsed labeling with tritiated thymidine in endoscopic biopsy specimens from normal-appearing mucosa, cell proliferation was determined at six predetermined sites of the whole colon in patients with neoplastic disease of the large bowel and was compared with that of subjects without macroscopic colonic pathology. The labeling index (the percentage of cells incorporating [3H]thymidine) was 8.6 +/- 0.5 (mean +/- SEM) in 13 patients with colon carcinoma (p less than 0.001 vs. 16 control patients whose labeling index was 4.9 +/- 0.2) and 9.1 +/- 0.4 in 11 patients with a large adenoma in the colon (p less than 0.001 vs. controls). Twenty-one patients with one or more small adenomas (diameter less than 1 cm) had a moderately increased cell proliferation compared with controls (labeling index 6.2 +/- 0.3, p less than 0.02 vs. controls). In patients with neoplastic disease an enlargement of the proliferative compartment was found, whereas 6 patients with Crohn's colitis had values for labeling index and a distribution of labeled cells along the crypt comparable to that of control subjects. An increased cell proliferation was found along the entire colon under each of the neoplastic conditions studied. These findings indicate that although neoplastic lesions develop in a limited area of the colon, the entire large bowel may be at risk for tumor growth. PMID- 3817392 TI - Alkaline secretion. A protective mechanism against acid injury in rabbit duodenum. AB - The role of alkaline secretion in the protection against acid-induced (50 mM HCl) damage was investigated in the perfused rabbit duodenum. Basal alkaline secretion was 3.86 +/- 0.23 mu Eq/cm2 . 10 min (pH-stat method). Perfusion with HCl increased alkaline secretion to 4.39 +/- 0.17 mu Eq/cm2 . 10 min and led to superficial damage of 51.8% of the villi. Intravenous treatment with NaHCO3 and glucagon increased alkaline secretion (+25% and +37%, respectively) and decreased damage (-27.7% and -25.3%, respectively), whereas mucosal blood flow as assessed by radioactive microspheres was stimulated only by glucagon. Intravenous treatment with NH4Cl, vasopressin, and furosemide decreased alkaline secretion ( 31%, -52%, and -50%, respectively) and led to increased damage (+18.5%, +19.3%, and +19.6% superficial and 30%-50% deep lesions), and mucosal blood flow was decreased (vasopressin) or unchanged. There was a direct linear relationship (r = 0.88, y = 103-15.8x) between the degree of damage and alkaline secretion. These results support the hypothesis that duodenal alkaline secretion is indeed a protective factor against acid damage. PMID- 3817393 TI - Effects of omeprazole on gastric mucosal microcirculation and acid secretion in the rat. AB - Omeprazole, a potent long-acting inhibitor of gastric acid secretion that exerts its inhibitory action by direct blocking of the H+, K+-adenosine triphosphatase in the parietal cells, was either applied topically to the solution bathing the exposed mucosa of the test rats or administered intravenously as a bolus injection. The superficial mucosal vessels were monitored on a television screen through a microscope and videorecorded for off-line analysis of red cell velocities and vessel diameters, from which blood flow was calculated. Intravenous omeprazole (5 or 10 mumol/kg) totally abolished the basal secretion 15-25 min after injection, with a parallel decrease in blood flow of approximately 25% for both doses. Omeprazole, 5 mumol/kg, given intravenously to rats stimulated with pentagastrin (20 micrograms/kg X h) significantly inhibited the stimulated acid output, but the blood flow was not significantly decreased. Topical application of omeprazole (2.5 mM in 6 ml) significantly increased blood flow (approximately 15%) while in contact with the mucosa both in the resting and in the pentagastrin (20 micrograms/kg X h)-stimulated situations. However, 10-20 min after the application period, blood flow was restored to the values before application of omeprazole and the acid output was significantly decreased. The results indicate that omeprazole exerts only minor influences on the gastric mucosal microcirculation in spite of its potent acid-inhibitory effect. PMID- 3817394 TI - Calcium-induced contraction and contractile protein of gallbladder smooth muscle after high-cholesterol feeding of prairie dogs. AB - Feeding a high-cholesterol diet to prairie dogs causes a reduction in contractile responses of gallbladder smooth muscle from these animals. In this study, the influence of cholesterol feeding on the contractile response to calcium and on the concentration of the contractile proteins actin and myosin was determined. Strips of gallbladder smooth muscle, at their optimal length for tension development, were stimulated maximally with carbachol. Then the muscle cell membranes were made permeable and strips were exposed to a maximally effective concentration of calcium. Strips from cholesterol fed animals developed less stress than those from control animals under all conditions. The concentration of actin and myosin was determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. There were no differences in the concentrations of either protein between the cholesterol-fed and control animals. Our results indicate that the decreased contractile response seen in muscle from cholesterol-fed animals is not due to alterations in membrane excitation, excitation-contraction coupling, or in total contractile proteins. PMID- 3817395 TI - Portal hemodynamics in idiopathic portal hypertension (Banti's syndrome). Comparison with chronic persistent hepatitis and normal subjects. AB - A comparative study of portal hemodynamics was made in 17 patients with idiopathic portal hypertension, 5 patients with chronic persistent hepatitis having no portal hypertension, and 21 healthy adults who served as the control for certain measurements. Venous pressures were measured by portal and hepatic vein catheterizations, blood flow by the pulsed Doppler flowmeter, organ volume by computed tomography, and intrahepatic shunt index by 99mTc-macroaggregated albumin instilled in the portal vein. The patients with idiopathic portal hypertension were divided into two groups: group A (n = 8) and group B (n = 9), consisting of those who respectively had portal venous flow per liver volume above and below the mean + 2 SD of healthy adults. In group A, portal vein pressure was moderately elevated, portal venous flow was significantly increased compared with the control, and portal vascular resistance was not much altered. In group B, portal vein pressure was markedly elevated above that of control, portal venous flow was comparable, and portal vascular resistance was significantly elevated. Splenic venous flow measured in the splenic vein between the left and short gastric veins was markedly increased in groups A and B, the increase being greater in the former. It was concluded that in some patients with idiopathic portal hypertension, increased portal venous flow, partly a result of increased splenic venous flow secondary to splenomegaly of an undetermined process, is the main contributor initially to the elevation of portal vein pressure; in others, possibly later, increased portal vascular resistance plays an important role. PMID- 3817396 TI - Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope. AB - Pseudomonas aeruginosa was present in bile cultures from 10 patients who had undergone previous endoscopic retrograde cholangiopancreatography in 1984. After environmental cultures and review of instrument disinfection, we traced the infections to a single endoscope contaminated with P. aeruginosa, serotype 10. Although the instrument had been cleaned repeatedly with an automatic endoscope cleaning machine, P. aeruginosa survived on residual moisture left in the channels of the endoscope. Contamination ended only after we began to manually suction alcohol through the endoscope before air drying. In 5 of 10 patients, P. aeruginosa caused clinical infections including gangrenous cholecystitis, abscesses, and death. We could identify no factor that distinguished symptomatic from asymptomatic patients. In asymptomatic patients, P. aeruginosa was recovered from gallbladder bile up to 2 mo after endoscopic retrograde cholangiopancreatography. As this P. aeruginosa epidemic was discovered retrospectively because we monitor bile cultures, we advocate this practice as part of endoscopic retrograde cholangiopancreatography procedures. PMID- 3817398 TI - Pancreatic polypeptide enhances postcontractile gallbladder filling in the prairie dog. AB - The hypothesis that pancreatic polypeptide promotes postcontractile gallbladder filling was tested in the prairie dog model. Fifteen animals underwent laparotomy with catheter placement into the gallbladder, distal common bile duct (vent), and femoral vein. The gallbladder was perfused with [14C]polyethylene glycol labeled lactated Ringer's solution at 0.03 ml/min and vent effluent was collected at 2.5 min intervals. All animals received a 20-min intravenous infusion of cholecystokinin-octapeptide, 2.5 ng/kg X min, immediately followed by 60-min infusions of either lactated Ringer's solution or bovine pancreatic polypeptide (PP), 10 or 50 ng/kg X min. Gallbladder emptying and intragallbladder pressure were similar for all three groups after cholecystokinin-octapeptide. When lactated Ringer's was administered after cholecystokinin-octapeptide, gallbladder filling increased by 15.6% with a minimal change in gallbladder pressure. In contrast, infusion of PP10 resulted in a significant (p less than 0.02) increase in gallbladder filling, 64.1% +/- 17.1%, and a significant (p less than 0.05) decrease in intragallbladder pressure, as compared to controls. Similar findings were noted with PP50. These data indicate that exogenous PP significantly increases gallbladder filling after cholecystokinin-induced gallbladder contraction. This enhanced filling results from gallbladder relaxation as manifested by decreased intraluminal pressure. These findings coupled with the observation that serum PP levels remain elevated for up to 6 h after a meal suggest that PP may play a role in the regulation of postprandial gallbladder filling. PMID- 3817397 TI - Pharmacologic characterization of excitatory and inhibitory cholecystokinin receptors of the cat gallbladder and sphincter of Oddi. AB - The pharmacologic properties and specificity of cholecystokinin (CCK) receptors of the biliary tract were investigated by testing various sulfated and desulfated CCK fractions and by using specific CCK-gastrin antagonists. Sulfated CCK-7 (5-80 pmol/kg) caused gallbladder contraction and sphincter of Oddi relaxation. Denervation with tetrodotoxin decreased the gallbladder response by 50% and changed the sphincter of Oddi response from relaxation to contraction. Desulfated CCK-7 (80-400 pmol/kg) caused a weak gallbladder contraction that was unaffected by tetrodotoxin. The gallbladder did not respond to CCK-3 (10-80 nmol/kg) or to CCK-2 (10-160 nmol/kg) in doses that completely relaxed the sphincter of Oddi. These doses, however, were 5-2000 times higher than the maximal dose of sulfated CCK-7. After denervation with tetrodotoxin, desulfated CCK-7 (10-400 pmol/kg) induced a weak sphincter of Oddi contraction even with doses five times greater than the maximal dose of sulfated CCK-7. The denervated sphincter of Oddi did not respond to CCK-3 (10-80 nmol/kg) or CCK-2 (10-160 nmol/kg). Furthermore, a continuous proglumide infusion (5-20 mg/kg X min) and bolus doses of dibutyryl cyclic guanosine monophosphate (250-1000 micrograms/kg) blocked the effect of sulfated CCK-8 on the gallbladder and sphincter of Oddi. Higher doses of these antagonists were needed, however, to block the CCK effect on the sphincter of Oddi than on the gallbladder. In contrast, high doses of desulfated CCK-7 (100 pmol/kg) or CCK-3 (200 nmol/kg) did not antagonize the effect of sulfated CCK-8 (10-80 pmol/kg) on the gallbladder. These findings suggest the existence of three sets of specific CCK receptors with molecular configuration requirements determined by the type of cell where these receptors are located: on the postganglionic cholinergic neurons, on the smooth muscle cells of the gallbladder, and sphincter of Oddi, or on the postganglionic noncholinergic, nonadrenergic inhibitory neurons. PMID- 3817399 TI - Hepatic abscesses as a complication of the sump syndrome: combined surgical and endoscopic therapy. Case report and review of the literature. AB - The "sump syndrome" is an unusual complication of side-to-side choledochoduodenostomy in which the portion of the common bile duct distal to the anastamosis acts as a sump and may collect bile, stones, food, and other debris. Partial or complete obstruction of the stoma and resultant bacterial proliferation may result and lead to recurrent cholangitis or pancreatitis. A single hepatic abscess as a complication of the sump syndrome has been reported only once. We have recently seen a patient presenting with multiple hepatic abscesses as a complication of the sump syndrome. This is the first report of endoscopic treatment of this syndrome associated with a hepatic abscess. The literature on the endoscopic approach to this problem will be reviewed. PMID- 3817400 TI - Vibrio vulnificus infection after raw oyster ingestion in a patient with liver disease and acquired immune deficiency syndrome-related complex. AB - Sepsis, peritonitis, and gastroenteritis developed in a 45-yr-old homosexual man 1 day after ingestion of raw oysters. The patient had chronic active hepatitis and cirrhosis with hepatitis B virus and delta-infection. He also had persistent generalized lymphadenopathy associated with HTLV-III antibody positivity. Vibrio vulnificus was isolated from the patient's blood and peritoneal fluid as well as from the same batch of oysters at the restaurant where the patient had visited. To our knowledge, this is the first report relating direct microbiologic and clinical evidence that the infection is acquired through the gastrointestinal tract by consuming raw seafood containing the pathogen. This is also the first reported case of peritonitis associated with sepsis and gastroenteritis from this organism. Patients with liver disease and other immunocompromised states should be warned about such life-threatening infections and complications associated with the consumption of raw oysters or other undercooked seafoods. PMID- 3817401 TI - Neuronal dysplasia and chronic intestinal pseudoobstruction: rectal biopsy as a possible aid to diagnosis. AB - We report a patient with an unusual cause of chronic intestinal pseudoobstruction, i.e., neuronal intestinal dysplasia. This disorder is characterized by hyperplasia of the nerve plexuses of the intestine or colon, or both. Detailed morphologic and manometric studies are provided. The discussion emphasizes the various motor abnormalities that may be found in chronic intestinal pseudoobstruction. We propose that rectal biopsy may be of value in the diagnosis of this unusual form of pseudoobstruction. PMID- 3817402 TI - Pyoderma gangrenosum occurring at multiple surgical incision sites. AB - Ten weeks after subtotal colectomy and ileostomy for ulcerative colitis, a 16-yr old girl developed wound drainage and back pain. Massive ulceration and skin separation occurred at the abdominal wound incision as well as at the incision sites of a previous central venous line. A diagnosis of pyoderma gangrenosum was made. High-dose steroid treatment induced prompt healing of the abdominal wound as well as the catheter sites. Pyoderma gangrenosum has rarely been seen in surgical wounds. To our knowledge, this is the first reported case of pyoderma gangrenosum occurring simultaneously in multiple surgical incision sites in a patient with ulcerative colitis. PMID- 3817403 TI - Esophagoscopy in acquired immune deficiency syndrome. PMID- 3817405 TI - Duration of swallow-induced upper esophageal sphincter relaxation artifact, not physiological. PMID- 3817404 TI - Reversibility of pancreatic failure in chronic pancreatitis? PMID- 3817406 TI - Do surgeons led by surgeons operate better than internist-led surgeons? PMID- 3817407 TI - [Melanoma in gynecology]. AB - The malignant malignoma originates from the neutral tube and can be found in nearly every part of the body. Middle-aged women are most frequently affected. Histopathologically the melanoma can be subdivided into lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma and non-classifiable melanoma. The histopathological classification as suggested by Clark and Breslow, completed by the "Prognosis-Index" of Schmoeckel and Braun-Falco, is of prognostic and therapeutic value. 3-5% of all melanomas are localised in the vulva at an average age of 60 years. The vagina is rarely affected, and, if so, at an earlier age. The tumour must be removed in total. Diagnostic biopsy is generally accepted, if followed by adequate therapy. Therapeutic possibilities are discussed. The influence exercised by pregnancy on the formation and evolution of a malignant melanoma is still controversial. Diaplacentar metastases are described. As long as the malignant melanoma remains limited to the upper chorium and the diameter does not exceed 1.5 mm, pregnancy can be tolerated with close supervision without influencing the further evolution of the tumour. Total excision should be performed regardless of the pregnancy stage. PMID- 3817408 TI - [Possibilities and value of discontinuous labor monitoring by cardiotocography. A retrospective study based on a continuous cardiotocogram]. AB - The effectiveness of fictitious discontinuous intrapartum CTG monitoring was investigated and compared with available continuous CTG's by means of a retrospective analysis of 200 CTG tracings. CTG is a method of high sensitivity and offers, together with foetal intrapartum blood sampling, a possibility to detect foetal distress with high specificity and predictive value. From these CTG tracings the fictitious periods of time were assessed according to a certain schema to give women a possibility of being unrestricted in their activities without intrapartum monitoring while at the same time they were under satisfactory surveillance to notice sufficiently early any foetal distress that might lead to severe acidosis. The study was subdivided into 4 groups: Group 1: Patients at no risk during pregnancy and/or risk on admittance or during labour, no alarming signs from the foetus during the intrapartum period. Group 2: No risk, but with alarming signs from the foetus. Group 3: Patients at risk, no alarming signs from the foetus. Group 4: Patients at risk and with alarming signs from the foetus. The results suggest the possibility of discontinuous intrapartum monitoring according to a certain schema up to the second stage of labour, at minimum intrapartum risk for the baby, especially if there were no risks during pregnancy and at the beginning of delivery. According to these results 83% of all patients in labour would not have needed continuous CTG for more than half of the time spent in the labour ward. Only one in 6 deliveries (17%) would have required continuous monitoring.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817409 TI - [Light and electron microscopy changes in the endometrium caused by the administration of a norgestimate-containing oral contraceptive (Cilest)]. AB - Endometrium morphology has been analysed by means of light microscopy, scanning and transmission microscopy in patients before and during treatment with a norgestimate containing low dose combined pill (Cilest). Endometrium biopsies were taken after 1 (N = 3), 2 (N = 3), 3 (N = 7), 5 (N = 1) and 6 (N = 4) OC cycles. Light microscopy of the endometrium obtained during the OC-free pretreatment cycles shows a regular secretory transformed endometrium. During the first OC cycles of Cilest treatment slight growth retardation of endometrial glands was observed. Endometrium after 3 to 6 OC cycles showed an increasing delay of the growth of endometrial glands in terms of an abortive secretion. Morphometric studies revealed a retardation of the development of endometrial glands and an "arrest of secretion". The degree of proliferation varied slightly; a general delay between the date of the menstrual cycle and endometrial dating was evident. Using scanning electron microscopy the endometrium presented mostly a regular surface corresponding to the midcycle or a late proliferative phase up to the early secretory phase. Infiltrative dysplasia or inflammatory changes as well as local proliferations could not be detected. In transmission electron microscopy with semi-thin and ultrathin slices, stroma, structure of glands and surface appeared to be normal. Furthermore, no time delay between the endometrium and the day of menstrual cycle was observed. During treatment with a norgestimate containing low dose combined pill, only slight changes of the endometrium in terms of a growth retardation of endometrial glands were seen in the first 6 treatment cycles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817410 TI - [Results of a representative survey of family planning behavior in West Germany 1985]. AB - A report on the result of a representative survey of family planning behavior in the Federal Republic of Germany in 1985. Interviewers from the EMNID Institute questioned 1267 German women aged between 15 and 45. Of the women interviewed, 6.1% had been sterilized, while in 1.3% of cases, their partner had been sterilized. Regarding the use of reversible methods of contraception, the following figures were established: pill, 37.1%; IUD, 10.3%; condom, 5.9%; rhythm method, 3.9%; withdrawal 3.4%; vaginal diaphragm, 2.1%; mini-pill, 1.3%; locally effective chemical substances, 0.8%. A few women (1.9%) stated that they used a mixture of methods. No information about family planning methods was offered by 13.4% of the women interviewed. The figures obtained were further differentiated according to age, marital status, school education, religion, number of children, desire for more children, profession, and net income. The authors' own questions concerned the early use of contraceptives, the reasons for abandoning a particular method, the reasons for choosing a certain type of contraceptive, sources of information about family planning, the frequency of changes from one type of contraceptive to another, and opinions about the rhythm method. Finally, the result of the EMNID survey is compared with that of known studies both at home and abroad. PMID- 3817411 TI - [Prevention of infection in hysterectomy by local preoperative antibiotics]. AB - By once-only administration of a vaginal ovulum containing tetracyclin (Mysteclin) in the evening prior to surgery wound infections, in particular following vaginal hysterectomies, are significantly reduced. This does not apply to the infection parameters fever and urinary tract infections, which are not influenced by local preoperative antibiosis. The method should only be used in cases with a low primary infection risk, where it is justified by virtue of the simlicity of performing it, its lack of complications, and its low cost. PMID- 3817412 TI - [Spontaneous splenic rupture as a cause of postoperative hemorrhage]. AB - Following a vaginal hysterectomy without complications, intraperitoneal after bleeding from an adnexal stump occurred, making a laparotomy necessary. On the following day a second laparotomy had to be performed because of a recurrence of hemorrhage in the abdominal cavity. The source of the bleeding could not be found. A third laparotomy the next day revealed a splenic rupture, which had evidently occurred spontaneously. Spontaneous ruptures of a normal spleen are considered rare. In cases of intraperitoneal hemorrhage where the source of bleeding cannot be found, the possibility of splenic rupture should be considered, even if there is no history of trauma. PMID- 3817413 TI - [Effect of polidez on blood coagulation in patients with atherosclerosis of the major arteries]. PMID- 3817414 TI - [Approaches to the development of complex blood substitutes for the treatment of shock]. PMID- 3817415 TI - [Cryopreservation of granulocytes using "Leukocryodmac" solution]. PMID- 3817416 TI - [Rheological properties of the blood and the state of microcirculation during experimental administration of a perfluororganic emulsion as a blood substitute]. PMID- 3817417 TI - [Results of research and prospects for studies in the field of hematology]. PMID- 3817418 TI - [The use of polyethylene glycol for the isolation of the prothrombin complex]. PMID- 3817419 TI - [Cerebral disorders in multiple myeloma]. PMID- 3817420 TI - [Immunocorrection in the treatment of beta-thalassemia]. PMID- 3817421 TI - [Various indices of cellular and humoral immunity in patients with autoimmune cytopenia]. PMID- 3817422 TI - [Sedimentation-electrophoretic heterogeneity of the peripheral blood lymphocytes of healthy donors and chronic lymphatic leukemia patients]. PMID- 3817423 TI - [Chief directions in the improvement of the performance of the blood services of the Ukrainian SSR in the 12th five-year-plan]. PMID- 3817424 TI - [In vitro and in vivo modulation of cellular immunity using human transfer factor]. PMID- 3817425 TI - [Effect of experimental choriogonin and azathioprine on hematopoietic and lymphoid tissue]. PMID- 3817427 TI - [Various aspects of the toxicologic aspects of alcohol]. PMID- 3817426 TI - [Age structure of the population of hematopoietic stem cells demonstrable by the exogenous colony-forming technic]. PMID- 3817428 TI - [Bacterial endocarditis treated surgically in a patient with acute renal failure after septic abortion and transfusion of incompatible blood]. PMID- 3817429 TI - [Erythrocyte and leukocyte alloantigens of donors immunized with staphylococcal toxoid]. PMID- 3817430 TI - [Serologic markers of viral hepatitis B in hematologic patients]. PMID- 3817431 TI - Effects of N-acetyl-DL-methionine on the liver, GSH synthesis and plasma ALAT level in male Bom:NMRI mice. AB - A single high peroral dose of N-acetyl-DL-methionine (859.5 mg/kg) was administered to Bom:NMRI male mice using methylcellulose as a drug vehicle. The administration of a single high peroral dose of N-acetyl-DL-methionine (859.5 mg/kg) to Bom:NMRI male mice caused an inhibition of the hepatic glutathione decrease compared to a control group treated with methylcellulose only. N-acetyl DL-methionine caused a reduction and time delay of the hepatic glutathione decrease found in the group treated with methylcellulose only. There was no observed cellular damage of the liver or kidneys assessed histologically or by plasma ALAT after dosing with a racemic mixture of N-acetyl-DL-methionine. PMID- 3817432 TI - Tetraethylammonium-methohexitone induced contractures and miniature end-plate potential discharge in the chick biventer cervicis muscle. AB - End-plate and miniature end-plate potentials (EPP, MEPP) were recorded in the chick biventer cervicis muscle in vitro. The control frequency of discharge of MEPPs was 5.97 +/- 1.04 min-1, n = 10. Methohexitone (8.8 X 10(-5) M) did not affect the frequency of MEPP discharge, but tetraethylammonium (TEA, 2.4-9.5 mM), reduced the frequency to 32.9 +/- 8.6% of the control. In the presence of neostigmine (3.3 X 10(-6) M) methohexitone (8.8 X 10(-5) M) reduced MEPP frequency to 38.7 +/- 5.4% of the control and TEA (2.4-9.5 mM) further reduced the frequency to 8.7 +/- 2.1% of the control. After a transient facilitation of the EPP, TEA (2.4-9.5 mM) in the presence of methohexitone (8.8 X 10(-5) M) and neostigmine (3.3 X 10(-6) M) markedly reduced EPP amplitude. The contractures which TEA produced in the presence of methohexitone were not due to an increase in the spontaneous release of vesicular ACh. PMID- 3817433 TI - Variability of changes in obese rat brain monoamines in response to cholecystokinin. AB - The interactions between cholecystokinin (CCK) and brain monoamines have been investigated. The data found in the literature are quite dissimilar. Several reasons for these disparities have been suggested. We have sought to test some of them, such as the strain of rat, the nutritional state (by the use of two models of obesity), the length of the peptide (CCK 8 and CCK 33), the route of administration (i.p. and i.c.v.) and the time of sacrifice. We indeed found all these experimental conditions to be the cause of differential effects on brain monoamines and metabolites. However, by repeating the same experiments several times, we did not always obtain the same variations, even under the same conditions. In addition to the different parameters tested, another source of variability exists, possibly due to the molecule itself or to seasonal variations. PMID- 3817434 TI - Effects of two tranquilizers, reserpine and chlorpromazine, on neurosecretory cells and the ovary of the fiddler crab, Uca pugilator. AB - Reserpine produced alterations in neurosecretory cell types I and II in the eyestalk, brain, and thoracic ganglion, most notably a decrease in the amount of stored neurosecretory material. The ovarian index decreased, but the oocyte area increased in the reserpinized crabs. Chlorpromazine did not produce any significant changes in the structure of cell types I and II. In spite of having a normal area, the oocytes in the chlorpromazine injected crabs were devoid of yolk. Neurosecretory cell type III showed no change. PMID- 3817435 TI - Comparative aspects of cerebellar [3H]flunitrazepam and [3H]GABA binding. AB - [3H]Flu and [3H]GABA binding has been studied in mice and Rabbit cerebellum (Ce). The Bmax of [3H]Flu binding in Ce membranes is similar in all mice strains examined and Rabbit. However, in Ce homogenate there are significant differences in both kd and Bmax. Subcellular distribution shows higher [3H]Flu binding in the nuclear than in the membranous fraction. However, the [3H]GABA binding is lower in the nuclear than the membranous fraction. PMID- 3817436 TI - Effects of morphine on noradrenaline release from cerebral and peripheral vascular smooth muscle. AB - Morphine reduced the [3H]noradrenaline uptake in cat cerebral and femoral arteries and induced a dose-dependent tritium release from these vessels prelabelled with this amine, which was diminished in Ca2+-free medium. The opioid decreased the radioactivity release induced by electrical field stimulation as well as its potentiation by tetraethylammonium. These effects were unaffected by naloxone. These results indicate: the reduction by morphine of tritium release from both kinds of vessels is through a mechanism unrelated to opiate receptors, and the noradrenaline release elicited by morphine could be due in part to inhibition of its reuptake. PMID- 3817437 TI - In vitro metabolism of [3H]NA induced by pargyline in the superior cervical ganglion. AB - The deaminated glycol, [3H]DOPEG, is the main metabolite in spontaneous outflow from ganglia labelled with [3H]NA. After exposure to pargyline 0.5 mM, [3H]NMN formation may be the first step of the metabolism of [3H]NA in the cat superior cervical ganglion. PMID- 3817438 TI - Substrate-ligand interactions with acetylcholinesterase and energetics of binding. AB - Ester hydrolysis by acetylcholinesterase (from electric eel, Electrophorus electricus) increased in the presence of low concentrations (ca 10(-7) M) of edrophonium, propidium, d-tubocurarine, gallamine, decamethonium or bis-N methylacridinium, and decreased at higher concentrations. The overall sensitivity of the substrates to inhibition by the ligands was acetylcholine (Ach) greater than phenylacetate (PA) greater than indophenylacetate (IPA). Complete (saturable) inhibition was unattainable with edrophonium or gallamine for IPA and, to a lesser degree, with propidium for PA. Reaction heats between the enzyme and the ligands (edrophonium, propidium and decamethonium) measured directly in a microcalorimeter revealed binding sites that are different from each other in their interaction energetics. PMID- 3817439 TI - Testis cytological structure, plasma sex steroids, and gonad cytosol free steroid receptors of heterologous gonadotropin (hCG)-stimulated silver eel, Anguilla anguilla L. AB - Complete testicular maturation was induced in silver eels, kept at 24 degrees in fresh water, by a single injection of 1000 I.U. of heterologous gonadotropin (hCG). Each week, for 4 weeks, some eels were examined for testis structural pattern, plasma sex steroids, and gonad cytosol steroid receptors. The first effect of the hCG was on the tubular organization of the testis, followed by spermatogenesis. Plasma androgens were not detectable in the untreated eels, whereas a peak was detected a week after in those treated with the injection and afterward a decline. Plasma progesterone and estradiol showed a peak 2 weeks after treatment. Untreated eel gonads showed a high content of cytosolic free estradiol receptors which disappeared in the hCG-treated ones, a peak of free progesterone receptors was found 1 week after injection. The results are discussed in relation to the differentiation and maturation of eels testes. PMID- 3817441 TI - Ontogeny of the hypothalamo-neurohypophysial system in the toad, Bufo melanostictus: an immunohistochemical study. AB - Employing unlabeled antibody enzyme technique, the development of the hypothalamo neurohypophysial system of the common Indian toad, Bufo melanostictus, has been studied by using antiserum raised in rabbit against bovine neurophysin. Immunoreactivity to the antiserum is first observed at stage 22 (Gosner, 1960) in the presumptive preoptic nucleus and at stage 23 in the presumptive median eminence and pars nervosa. As development proceeds, progressive increase in the immunoreactivity in all the components of the hypothalamo-neurohypophysial system is observed. The detection of neurohypophysial hormones (stages 22-23) much before the appearance of limb buds (stages 25-26) may be due to the greater sensitivity of the immunohistochemical technique. PMID- 3817440 TI - Immunoreactive salmon calcitonin-like molecule in crustaceans: high concentrations in Nephrops norvegicus. AB - A salmon calcitonin (CT)-like peptide was characterized in various crustaceans by radioimmunological and radioreceptor assays. The highest levels of the molecule were found in the anterior part of the gut and the hepatopancreas of the Norway lobster: Nephrops norvegicus. Molecular sieving of this molecule suggested an apparent molecular weight of 4500 Da, that is higher than that of calcitonin. This peptide can be referred to as crustacean calcitonin as it inhibits the binding of labeled salmon CT to rat kidney membranes. The high concentration found in crustaceans suggested that this molecule could have an important role in this class of arthropods. PMID- 3817442 TI - Effect of the injection solvent on steroid activity. AB - The effects of testosterone, 5 alpha-dihydrotestosterone, and androstenedione on cloacal gland and sternotracheal muscle growth and on luteinizing hormone plasma levels were studied in Japanese quail. The steroids were given to the animals in daily intramuscular injections and were dissolved either in propylene glycol or in ethanol:saline (1:1). The three steroids had significant effects on the responses which were measured, but the magnitude of this effect was clearly related to the type of vehicle in which the steroids were dissolved. Furthermore there was a significant interaction between the effects of solvents and of steroid; for example, testosterone was much less androgenic than 5 alpha dihydrotestosterone when dissolved in propylene glycol, but both had similar effects when dissolved in ethanol:saline. The effects of the mode of administration of different steroids on a given physiological response should be taken into consideration. PMID- 3817443 TI - [Demonstration of specific binding sites for carp gonadotropin in ovary membrane preparations of Anguilla (Anguilla anguilla L.)]. AB - Membrane preparations from silver eel ovary bind specifically labeled carp gonadotropin (cGTH 125I); similar preparations from kidney, liver, brain, and muscle exhibit either no or negligible specific binding. cGTH and partially purified eel pituitary extract, but neither hCG nor bTSH, inhibit cGTH 125I specific binding in a dose-dependent way. However, a high membrane concentration can bind hCG 125I and this binding is partly inhibited by excess hCG, thus suggesting the existence of a relatively small number of sites able to recognize this hormone. Studies of either cGTH inhibition of cGTH 125I specific binding or cGTH 125I dose-dependent binding have permitted, according to Scatchard, the binding parameters to be determined. Specific binding seems to have two components: one with low affinity and high capacity, and the other with high affinity (Kd = 1.2 10(-10) M) and low capacity (N = 0.2 fmol/mg ovary). PMID- 3817444 TI - Apparent role of melatonin and prolactin in initiating winter fur growth in mink. AB - A study was conducted to determine the effects of exogenous melatonin and bromocriptine (CB-154), an inhibitor of prolactin synthesis and secretion, on the induction of winter fur growth in mink. Melatonin (10 and 120 mg) was administered to mink (N = 5/group) via silastic implants inserted sc over the scapular area during the last week of June 1985. Treatment of mink (N = 5) with CB-154 alone or in combination with 10 mg melatonin (N = 5) consisted of daily sc injections of 2 mg of the drug in sterile saline from June 25 through July 30. Control animals (N = 5) did not receive injections of vehicle or sham implants. Administration of CB-154 alone or in combination with 10 mg melatonin, as well as 120 mg melatonin alone, initiated growth of the winter fur significantly earlier than that of controls or mink treated with 10 mg melatonin (P less than 0.05). These data suggest that inhibition of prolactin secretion by melatonin is requisite for induction of molt of summer fur and growth of winter fur of mink. PMID- 3817445 TI - Seasonal profiles of sex steroids in blood plasma and ovarian tissue of Clarias batrachus. AB - Sex steroids were measured in plasma and ovaries of the catfish, Clarias batrachus, mainly over the course of their annual reproductive cycle. Plasma testosterone levels increased in a stepwise fashion, the first significant increase occurring in the previtellogenic phase (March) and the second in the early vitellogenic phase (May). The levels remained elevated till the early postvitellogenic phase (July) and reached basal levels in the regressed phase (September). Estradiol 17 beta and estrone were at low levels in the previtellogenic phase, increased rapidly in the vitellogenic phase, and attained their peaks in the late vitellogenic phase. Ovarian testosterone levels were very low without any significant change from the late previtellogenic to the postvitellogenic phases (April to August). Estradiol-17 beta and estrone levels in the ovary increased significantly in the previtellogenic phase (April), reached a peak in the vitellogenic phase (June), and declined in the postvitellogenic period (July). Ovarian levels of sex steroids were always lower than plasma levels, indicating low storage and rapid secretion. Gonadosomatic index (GSI) was low in the regressed and previtellogenic phases and increased in the vitellogenic and postvitellogenic phases, with a peak in July. Plasma estradiol-17 beta levels could be correlated with GSI from May to July, and plasma estrone and testosterone levels with GSI in early June and July, respectively. PMID- 3817446 TI - Effects of testosterone manipulations on nonbreeding season territorial aggression in free-living male lizards, Sceloporus jarrovi. AB - Seasonal changes in testosterone levels in male mountain spiny lizards (Sceloporus jarrovi) are correlated tightly with seasonal changes in intensity of aggressive territorial defense. Testosterone levels are lowest in the winter when males aggregate, are moderately elevated during the summer when males show low intensity territorial defense, and are highest during the fall breeding season when males show high-intensity territorial defense. In this study, we tested the hypothesis that changes in testosterone levels cause these seasonal changes in territorial behavior. We experimentally increased and decreased circulating testosterone levels in free-living males during the summer, when they display non breeding season territoriality. Artificially increasing testosterone levels to levels equivalent to the breeding season significantly increased some, but not all, measures of territorial aggression. Levels of aggression attained, however, were still well below those typical of breeding season males. This implies that the transition to full breeding season levels of aggression is caused only partly by an increase in testosterone levels. Castration of males during the summer had no effect on several measures of territorial aggression. Thus the activation of nonbreeding season territoriality, which precedes testicular recrudescence by several months, is relatively unaffected by testosterone levels. Taken together these results suggest that the same behavior, in this case territorial aggression, may be controlled by different mechanisms in different seasons. PMID- 3817447 TI - The plasma sex steroid profiles in the freshwater, sex-reversing teleost fish, Monopterus albus (Zuiew). AB - The plasma levels of both the free and conjugated forms of six sex steroids (androstenedione, testosterone, 11-oxotestosterone, 11 beta-hydroxytestosterone, estrone, and 17 beta-estradiol) were determined by radioimmunoassay combined with Celite chromatography in different sexual phases of the protogynous Monopterus albus throughout the reproductive cycle. The amounts of 11-oxotestosterone and 11 beta-hydroxytestosterone were found to be very low and variable in all the specimens investigated. No conjugated 17 beta-estradiol or free estrone was detected. Female individuals showed a prespawning rise of androstenedione which subsequently dropped to a low level in the spawning period. The estrogen levels in the female phase were found to be higher than those in all other sexual phases during the spawning period, but the testosterone level remained constant throughout the reproductive cycle in the female phase. The level of androstenedione was highest in the early intersexual and mid-intersexual phases during the postspawning/inactive period. Compared with the female specimens in the same reproductive period, the early intersexual individuals showed a higher level of 17 beta-estradiol, while the mid-intersexual animals showed a higher level of testosterone in the postspawned/inactive period. In the mid-intersexual phase, the levels of androstenedione, testosterone, 17 beta-estradiol, and estrone dropped progressively in relation to the seasonal reproductive cycle. The male fish had a constant level of androstenedione, estrone, and 17 beta estradiol. However, the level of testosterone increased as the spawning period approached. The hormonal profile in the late intersexual phase was essentially similar to that in the male phase. The changes in the plasma levels of sex steroids in M. albus apparently were related to the maturation of the female and male sex tissues and to their seasonal reproductive cycle. PMID- 3817448 TI - Characteristics of prolactin binding sites in the brain of the ring dove (Streptopelia risoria). AB - Radiolabeled ovine prolactin ([125I]oPRL) was found to bind specifically to crude membrane fractions prepared from ring dove brain homogenates. Specific binding changed with incubation time and temperature but did not fluctuate systematically with pH. Specific binding levels were highest in hypothalamus and forebrain and were lowest in cerebellum and brain stem. A linear increase in specific binding was observed in pooled midbrain and forebrain membrane fractions as membrane protein concentrations increased from 0.2 to 6.0 mg/ml. Scatchard analysis of binding saturation and competitive binding data revealed that dove midbrain/forebrain membranes bound oPRL with high affinity (Kd = 2.1-2.6 X 10( 10) M) but had low binding capacity (Bmax = 2.9-4.8 fmol/mg protein). Unlabeled oPRL and human growth hormone competed most effectively with radiolabeled oPRL for occupation of midbrain/forebrain binding sites. Turkey PRL and human placental lactogen were less effective as competitors but were 8-15 times more effective than ovine or turkey growth hormone, porcine insulin, or ovine luteinizing hormone. Subcutaneous injection of unlabeled oPRL lowered specific binding in liver and midbrain/forebrain by 76 and 39%, respectively, over that observed after saline injection. Prior MgCl2-induced desaturation of membrane binding sites greatly reduced or eliminated these treatment differences. These results suggest the existence of specific, saturable binding sites for PRL in dove brain which conceivably could mediate the reported effects of PRL on behavior and gonadal function in this species. PMID- 3817449 TI - Annual cycles in plasma testosterone and thyroxine in the male aspic viper Vipera aspis L., (Reptilia, Viperidae), in relation to the sexual cycle and hibernation. AB - Blood samples were taken monthly from males of Vipera aspis kept in outdoor terraria. Plasma testosterone was estimated by radioimmunoassay and plasma thyroxine by the technique of isotopic competition, between October 1979 and September 1985. Plasma testosterone showed an annual bimodal profile. The highest peak was observed from February 15 to the end of March. 2 to 5 weeks after the first emergence from hibernation. Values then decreased greatly, to reach a minimum level when the vernal spermiogenesis was at its maximum. The secondary peak of plasma testosterone was lower and less well marked. It occurred at the end of summer, during the strongest spermiogenesis, and preceded the autumnal facultative mating period. Plasma thyroxine was at a maximum concentration from February to March after which levels decreased markedly. The seasonal profile of plasma thyroxine was clearly marked during the period of hibernation. From September to October, 2 months before the beginning of hibernation, thyroxine levels began to decrease, and they reached a minimum in November-December. Endocrine reactivation of the thyroid appeared at the end of hibernation. However, in contrast to the plasma testosterone, endocrine activity of the thyroid began 2 to 3 weeks before the end of hibernation. Mechanisms of reactivation for testicular and thyroidal endocrine structures are discussed. PMID- 3817450 TI - Kinetics of T4 and T3 binding to plasma sites in salmonid teleost fish. AB - The relative affinities and maximum capacities of the classes of L-thyroxine (T4) and 3,5,3'-triiodo-L-thyronine (T3)-binding sites in plasma of three species of salmonid teleost fish were determined by saturation analysis on miniature Sephadex G-25 columns at 20-21 degrees and kinetic data were analyzed by the multiligand, multisite LIGAND computer program. In plasma of rainbow trout (Salmo gairdneri) homologous ligand displacement indicated that both thyroid hormones (TH) bound to a minimum of two classes of saturable sites and at least one nonsaturable site. For T4 (n = 13) the relative site affinities were 0.61 +/- 0.08 (SEM) X 10(7) M-1 and 0.86 +/- 0.11 X 10(5) M-1 and the site capacities were 8.3 +/- 1.16 X 10(-7) M and 5.15 +/- 1.34 X 10(-5) M, respectively; for T3 (n = 14) the relative site affinities were 1.8 +/- 0.16 X 10(7) M-1 and 1.7 +/- 0.17 X 10(5) M-1 and the site capacities were 7.8 +/- 1.3 X 10(-7) M, respectively. The greater affinities of T3 than T4 for plasma binding sites would explain the lower proportion of free T3 than free T4 in trout plasma. Two-site models with comparable values for TH-binding parameters were determined for brook trout (Salvelinus fontinalis) and arctic charr (Salvelinus alpinus). The TH-binding parameters were uninfluenced by severe hemoglobin contamination of plasma, bleeding of fish 24 hr previously, or 2 weeks starvation. Heterologous ligand displacement (T4 displaced by T3 or T3 displaced by T4) on rainbow trout plasma suggested two low-affinity, high-capacity sites, one binding predominantly T4 and one binding predominantly T3: a high-affinity, low-capacity site binding T3 exclusively: and a high-affinity, low-capacity site binding T4 predominantly but also binding T3 with low affinity. PMID- 3817451 TI - Evidence for neurosecretory control of the optic gland in terrestrial pulmonates. AB - The optic gland in terrestrial pulmonates secretes gonadotropic hormone. The present study investigates the fine structure of the optic gland to clarify the control of secretion. Animals used were the slug, Limax marginatus, and the snail, Euhadra peliomphala. The optic gland cell has a process and the cytoplasm is filled with large granules about 750-1300 nm in diameter with a thin cortex in L. marginatus and 800-1700 nm delimited by a thick peripheral layer in E. peliomphala. These gland cells are characterized by well-developed granular endoplasmic reticulum. Granule formation was seen in the region of the Golgi apparatus. During the breeding season, the medial neurosecretory cells of the brain are active in the production and release of secretory materials. Although no neurosecretory cell bodies occur in the tentacular ganglion, neurosecretory axons penetrate into the optic gland cells. Cobalt filling reveals that axons of the medial neurosecretory cells project to the tentacular ganglion, near the optic gland. These results suggest that the optic gland is controlled by a neurohormone originating from the medial neurosecretory cells of the brain. PMID- 3817452 TI - Thyroid and gonadal regulation of hair growth during the seasonal molt in the male European badger, Meles meles L. AB - In the male badger we showed that hair growth and molt are related to plasma testosterone and thyroxine cycles. We established the action of testosterone by castration and subcutaneous testosterone implants, and the action of thyroxine by thyroidectomy and dietary supplementation with thyroxine. The following groups of animals were studied: controls, thyroidectomized, thyroidectomized and thyroxine treated, castrated, castrated and thyroxine-treated, thyroidectomized and castrated and thyroxine-treated, castrated and testosterone-implanted, and intact testosterone-implanted. In control animals, molt and hair growth occurred during the summer, with a maximum growth in autumn. Molt ended at the beginning of winter when the plasma testosterone level had started to rise, and began again after this level had started to decline. Both the start of molt and the period of maximum hair growth coincided with high thyroxine levels of about 20 ng/ml. Castration advanced molt and hair follicle activity, whereas testosterone implants delayed both molt and hair growth. In thyroidectomized badgers, neither hair growth nor seasonal molt was observed. However, when thyroxine levels were restored to 20 ng/ml or more by dietary T4 supplementation, molting was resumed in animals that had undergone either thyroidectomy or thyroidectomy plus castration. In those that underwent castration only, the molt was advanced leading to early hair growth further stimulated by the suppression of testosterone. Testosterone had an inhibitory effect on the molt--since testosterone implants in intact control animals delayed it by 4 weeks--but did not inhibit it completely. On the other hand, a T4-enriched diet advanced the date of the molt. However, the molt could not be induced, nor could hair follicle growth be reactivated, at all times during the annual cycle. Thus, in castrated animals. T4 enrichment of the diet in early January, at the end of the molt, caused follicle reactivation only toward the end of May, despite the lack of testosterone. This 18-week latency period from January to May might therefore constitute a "refractory period" in this species. The above findings show that the regulation of the seasonal molt and hair growth in the European badger involves both the thyroid and genital axes. This regulation is discussed in terms of joint control by the hypothalamus and pituitary governed, in turn, by an external factor--the photoperiod--considered to be the main synchronizer. PMID- 3817453 TI - Psychological and demographic correlates of perceptions of sexual harassment. AB - This study examines the relationship of American students' attitudes toward women, sex, religiosity, self-esteem, and locus of control to variations in perceptions of sexual harassment. The set of two-way interactions of these variables accounted for a substantial portion of the variance in perceptions. A model of perceptions of sexual harassment is introduced suggesting potential theoretical and empirical linkages to be tested in future research. PMID- 3817454 TI - A conceptual model for educating primary care providers in the diagnosis and treatment of depression. AB - Primary care physicians consistently have been found to under-recognize or misdiagnose depressive disorders. However, it remains unclear whether diagnostic accuracy is related to the physician's knowledge base, interviewing skills and behavior, problem solving ability, and/or attitudes towards these disorders. As strategies are contemplated for improving physician recognition of depression, it is clear that psychiatric education must be guided by a comprehensive conceptual model. Such a model is proposed based upon the several educational domains intrinsic to the mastery of clinical diagnosis. PMID- 3817455 TI - The risk of AIDS: psychologic impact on the hemophilic population. AB - The psychologic impact of the risk of the acquired immune deficiency syndrome (AIDS) was evaluated by questionnaire survey of 116 hemophiliacs, age 16 or older, and 40 mates and 94 parents of hemophiliacs. Although the mean group distress ratings indicate a lessening of emotional discomfort over time, ongoing distress as well as interference with life activities are reported. Parents indicate more distress than either hemophiliacs or mates. Health preoccupation, the fear of being contagious, interference with parent-child intimacy and sexual intimacy between hemophiliac and mate are noted. A significant decrease in the use of clotting factor concentrates for the treatment of bleeding episodes is reported because these products have been linked to the transmission of AIDS. Although the overall hemophilic population is coping effectively with the AIDS risk, some hemophiliacs are at increased risk for psychiatric morbidity, social isolation, hypochondriasis, and medical noncompliance. Increased parental anxiety is likely to lead to over-protective child-rearing practices. Although it examines only the hemophilic population, this study describes stress responses likely to be present in other at risk groups and suggests that specific psychosocial interventions are urgently needed. PMID- 3817456 TI - A British view of liaison psychiatry. AB - Although the general hospital patients' needs for the psychologic care are similar in Britain and the United States, the role, boundaries, and organization of liaison psychiatry are very different. These differences are examined and the British approaches described. Greater awareness of the nature of these differences and of clinical developments and research in the two countries would contribute to the further development of consultation and liaison. PMID- 3817457 TI - Assessment of patient-staff and intrastaff problems in psychiatric consultations. AB - In a study of 249 consecutive inpatient consultations, the occurrence of patient- staff or intrastaff problems as determined by the psychiatric consultation team was compared with questionnaire answers, provided by the consultant following each consultation, and interpreted as indications for such staff problems. According to the consultation team, staff problems played a role in 33% of the consultations. In the questionnaires, of the nine criteria statistically significantly related to the occurrence of staff problems, the following were the most relevant: 1) emotional tone or wording of request; 2) abnormal timing of referral; 3) request unclear; 4) unjustified urgency of referral; and 5) existence of hidden questions. If none or only one of these criteria were positive, then there was little chance that staff problems were present. If three or four criteria were positive, then the probability of staff problems was much higher. If the first three criteria were negative, then staff problems were hardly ever encountered. PMID- 3817458 TI - Ethical and management considerations in factitious illness: one and the same. AB - The literature on factitious illness raises many ethical problems regarding diagnosis and treatment. The author briefly reviews ethical issues in factitious illness and argues for viewing these patients as autonomous citizens, capable of accepting responsibility for their behavior. Some factitiously ill patients psychologically resemble those with borderline personality disorder, and ethical implications are developed. In a case example, the author illustrates how good clinical management assists with the resolution or prevention of these ethical dilemmas. PMID- 3817459 TI - Involuntary hospitalization: an issue for the consultation-liaison psychiatrist. AB - Little has been written about the issue of involuntary hospitalization in consultation-liaison psychiatry. Nevertheless, patients frequently seen in medical and surgical settings may be judged to be a danger to themselves or others because of psychiatric disorders that cloud cognition, impair judgment, or modify insight, and judicial or administrative proceedings leading to involuntary commitment may be needed. The C-L psychiatrist will be the physician most knowledgeable about the concepts of involuntary hospitalization, competency and informed consent. Clinical examples illustrate issues that may arise. PMID- 3817460 TI - The self-inflicted dermatoses: a critical review. AB - The self-inflicted dermatoses, namely dermatitis artefacta, neurotic excoriations, and trichotillomania, have been reported to be associated with various degrees of psychopathology in the dermatologic literature, but have received surprisingly little emphasis in the psychiatric literature. This probably reflects, firstly the fact that most of these patients initially deny any psychologic problems and hence may not receive psychiatric interventions, and secondly a lack of adequate collaboration between the psychiatrist and dermatologist. These disorders may be associated with serious sequelae, such as suicide and repeated major surgical procedures. Their treatment is also primarily psychiatric. This article critically reviews the literature and comments upon the salient clinical features and treatments for these disorders, which are relevant for the psychiatrist doing consultation-liaison work. Knowledge of these disorders is important in the evaluation of any psychiatric patient, as these disorders are essentially a cutaneous sign of psychopathology. PMID- 3817461 TI - Denial of illness: a reappraisal. AB - The authors attempt to understand the nature of denial of illness by an examination of two patients with serious and disfiguring physical disorders who postponed medical treatment for over a decade. Both patients subsequently had dramatic negative reactions to the therapeutic efforts of physicians caring for them. Various social, experiential, and characterologic determinants are discussed. In addition, the authors argue that the illness served important organizing functions: it sheltered these patients from the exigencies of everyday life; it allowed them to defeat the physician's efforts to effect a cure; and, finally, the disfigured physical state appeared to correspond to their internalized defective self-image and self-esteem. PMID- 3817462 TI - Survey of attitudes of nurses working with AIDS patients. AB - This article reports the results of a ten-question anonymous survey given to nurses at Westchester County Medical Center in July 1983 and January 1984 concerning attitudes about caring for AIDS patients. Two-thirds of the responding nurses reported that they had friends or family express concern about associating with hospital personnel who have contact with AIDS patients. Other questions showed that between one fourth and one half of nurses have a fear of caring for homosexual men and male prisoners because of their awareness about AIDS. One half of the nurses believe that AIDS can be transmitted to hospital personnel because of contact with patients despite precautions. The fear of caring for patients with AIDS as compared to caring for patients with hepatitis, a more contagious but less serious disease than AIDS, was highest in the intensive care unit staff. Eighty-five percent of the health care personnel responding believed that pregnant nurses should not care for AIDS patients and one half of the nurses responding indicated that they would ask for a transfer if they had to care for AIDS patients on a regular basis. The implication of these findings for future treatment programs, medical and nursing education and psychologic support for staff are discussed. PMID- 3817463 TI - Ombudsman Rounds on the otolaryngology service. AB - An attempt to enhance psychiatric teaching on the Otolaryngology Service was undertaken by employing the vehicle of Ombudsman Rounds. The structure of these rounds is dictated by its major goal of maximizing the relationship of the surgeon and liaison psychiatrist as coteachers among the staff of the ENT surgical unit. Surgical residents, surgical clerks, nurses, and the social worker meet with the Chairman of the ENT Department and the liaison psychiatrist in a scheduled weekly conference, which addresses both staff and patient needs on the in-patient surgical service. Through patient interviews, multidiscipline staff presentations, chief of service surgical and prognostic summaries, and liaison psychiatrists' formulations, group discussions are undertaken. Through such an experience the staff become aware of the patient's feelings and understandings about their illness and care. The goal of Ombudsman Rounds is to enhance patient care, advance psychiatric knowledge of the multidiscipline staff, and provide an ongoing vehicle to change attitudes so that they incorporate a biopsychosocial approach to patient management on the ENT Service. PMID- 3817464 TI - The depressed hyperthyroid patient. AB - The case of a person who developed episodic psychotic depression both during hypothyroid and hyperthyroid states is presented. This case illustrates the clinical interaction between an endocrine disorder and predisposing and concurrent psychologic risk factors for an affective disorder. The patient's troubled clinical course demonstrates the critical importance of expert clinical attention to both the psychologic and neuroendocrinologic factors involved. Successful management requires a collaborative interdisciplinary treatment plan as well as cross specialty knowledge. Finally, this case offers information about that complex interaction between the limbic and endocrine systems and their respective contributions to the development of affective disorders. PMID- 3817465 TI - Munchausen's/AIDS. PMID- 3817466 TI - [Effect of t12 haplotype on the manifestation and inheritance of fused and kinky genes in house mice]. AB - The influence of some t-haplotypes on the phenotypic manifestation of fused and kinky genes located on chromosome 17 of the house mouse was studied. It was shown that t12-haplotype decreases the penetrance of these genes to 59-70%. The effect was observed when the Fu gene (or Ki) is transmitted from the females heterozygous for t12-haplotype. This haplotype only affects manifestation of the Fu and Ki genes in the F1. PMID- 3817467 TI - [Clinico-genetic analysis of omphalocele]. AB - The study of 302 cases of omphalocele in foetus and newborns revealed genetic heterogeneity of this congenital malformation. Multiple birth defects were found in 54.3% of probands, including 11% of cases (Wiedemann-Beckwith syndrome being neglected), diagnosed as syndromes with hereditary etiology. The spectrum of anomalies associated with omphalocele in non-classified complexes corresponds to that for caudal regression and cloaca extrophy syndromes. A positive syntropy index for these anomalies shows that these combinations are not coincidental. The increase of omphalocele incidence among relatives of probands with descending gradient, depending on relationship, is demonstrated, which testifies to multifactorial determination of some omphalocele cases. Empirical risk for sibs was 0.6 +/- 0.3% and the index of inheritance was 50.7 +/- 11.4%. PMID- 3817468 TI - [The use of discriminant analysis of serum creatine kinase levels for detection of heterozygote carriers of Duchenne muscular dystrophy]. AB - The possibility of using discriminant analysis of creatine kinase levels for detection of Duchenne muscular dystrophy heterozygote carrier was studied. Application of combined genealogical and biochemical information enhanced detection of heterozygotes. It is proposed to apply this method for medical and genetic counselling. PMID- 3817469 TI - [Phenotypic variability of the levels of autoantibodies against thyroglobulin and myoglobin in healthy individuals]. AB - Regularities of distribution of the levels of autoantibodies to thyroglobulin and myoglobin in healthy tweens were studied by immunoenzyme assay. The expressed variability, the absence of sex dimorphism and complete partypical determination of phenotypic variability of the levels tested were shown. PMID- 3817470 TI - [Incidence of oligophrenia with fragile X chromosome (FraXq27)]. AB - The study of 50 retarded males imbezilitat and idiots, and 100 males with oligophrenia-debilitat in 16-18 years. Severe macroorchism (1.8-4.5 times more, then anthropometric norma for this years) was found at 5 males in first group (10%), and in 8 males in second group (8%). The karyotype was study in 4 males with macroorchism. In 9-15% cells FraX (q27) was found. These data were extrapolated to 600 retarded children preschool and school age. The frequency of oligophrenia with FraX (q27) among all retarded males-8.5 +/- 1.5; retarded heterozygous females among all retarded girls-5.0 +/- 1.3; incidence of oligophrenia with FraX (q27) among all males in population-1:1000; all heterozigous for this gene among all females in population-7:750; retarded heterozygous females in all girls-1:2250 were established. PMID- 3817471 TI - [Modeling of induction and elimination of sister chromatid exchanges in time]. AB - Induction and elimination of sister chromatid exchanges (SCE) have been simulated during several cell cycles. Two models of SCE elimination are suggested. The first model postulates that the mutagen-induced lesions are not repaired, a lesion being only inherited by one daughter cell after DNA synthesis. According to the second model, lesions are completely repaired at the first S-phase. No SCE induction takes place during next cell cycles. SCE frequency ranges for both models are described by an equation, including the probability distribution function. The best correspondence in experimental and theoretical results was obtained using the model claiming repair of lesions during one cell cycle. PMID- 3817473 TI - Actual number of alleles contained in a multigene family. PMID- 3817472 TI - Growth, efficiency and body composition of mice selected for post-weaning weight gain on ad libitum or restricted feeding. PMID- 3817474 TI - Models of long-term artificial selection in finite population with recurrent mutation. PMID- 3817475 TI - Heterosis among lines of mice selected for body weight. 3. Thermoregulation. PMID- 3817476 TI - Geriatric emergencies: on improving older people's chances. PMID- 3817477 TI - Realistic exercise goals for the elderly: is feeling good enough? PMID- 3817478 TI - Managing osteoporosis: current trends, future possibilities. AB - The management of osteoporosis after fracture has occurred is currently difficult. The most effective approach is clearly prevention. Reduction in risk factors, adequate calcium nutrition, and physical activity are all important features, but the mainstay is estrogen therapy. Although this treatment early in the postmenopausal period has been shown to reduce bone and fracture, it must not be forgotten that other biochemical abnormalities in calcium homeostasis may also cause bone loss with aging. Despite the difficulties in treating established disease, newer strategies are being developed in the hope that increments in bone mass may reduce the frequency of fracture recurrence. PMID- 3817479 TI - Testing older patients' mental status: practical office-based approach. AB - Dementia and depression are among the commonest psychiatric disorders in the aged. Their detection can be considerably enhanced if the physician includes in the medical evaluation seven components of a psychiatric nature, giving particular attention to signs and symptoms of dementia and depression, and performs a brief formal mental status examination. PMID- 3817480 TI - Admitting elderly patients to the ICU: dilemmas and solutions. AB - Since intensive care is expensive and has limited efficacy, its use should be reserved primarily for patients with acute, reversible illnesses. Although age is related to ICU mortality, more important predictors of ICU outcome are severity of the acute illness, the admitting diagnosis, and previous health status. Thus, age should not be the sole factor considered prior to ICU transfer or the initiation or denial of resuscitative efforts. Geriatric physicians should prospectively develop individualized plans for each of their patients based upon the patients' wishes after a discussion of diagnosis, prognosis, and the likely efficacy and side effects of the available treatments. PMID- 3817481 TI - Cholesterol changes with aging: their nature and significance. AB - Aging is associated with progressive increases in plasma triglyceride, total cholesterol, and high-density lipoprotein cholesterol levels. In the general population, total cholesterol correlates directly and high-density lipoprotein cholesterol correlates inversely with the risk of coronary artery disease. In the elderly, similar correlations between serum lipids and coronary risk also exist but are less powerful than in younger subjects. The mechanisms of the plasma lipid alterations and the current guidelines for their management in the elderly are presented. PMID- 3817482 TI - Prophylactic anticoagulants in managing embolic stroke. AB - The primary risk of anticoagulant therapy in cardiac embolic stroke is hemorrhage -particularly cerebral hemorrhage in the elderly. Improving the benefit/risk ratio for indicated anticoagulation involves consideration of the following: hemostatic competence, blood pressure, drug interactions, falls, interval surgery, diet, aspirin and last but not least, the intensity of anticoagulant prophylaxis. For the present it would be prudent to limit heparin administration to a low-dose regimen not exceeding 20,000 units/24 hours and warfarin maintenance to a low-dose prothrombin time ratio of 1.5. PMID- 3817483 TI - Appendicitis in the elderly: the case for better diagnosis. AB - Appendicitis in the elderly is a serious disease with increased morbidity and mortality. This and other studies show that there is a delay in operating on patients over age 55 who may have appendicitis. While symptoms are milder in the elderly, they are of the same kind as in younger patients. The same is true of physical findings. Greater suspicion and early surgery should improve the outcome in caring for elderly patients with appendicitis. PMID- 3817484 TI - [Dynamics of the respiratory indices of adolescents training for occupations in the textile industry]. PMID- 3817485 TI - [Effect of synthetic detergents on levels of endogenous surface-active substances in the bodies of animals]. PMID- 3817486 TI - [Hygienic evaluation of the decoloration of natural water by the oxidation sorption method]. PMID- 3817487 TI - [Experimental study of the carcinogenicity of dichlorobromomethane and dibromochloromethane formed during the chlorination of water]. PMID- 3817488 TI - [Regulating arsenic in drinking waters of different hardness]. PMID- 3817489 TI - [Level of physical development of 6-year-old children enrolled in rural schools of Dagestan]. PMID- 3817490 TI - [Physical development of the preschool children of Perm and degree of their functional readiness to enter school]. PMID- 3817491 TI - [Method of preventive surveillance for regional planning]. PMID- 3817492 TI - [Problems in training physician-laboratory workers of community health divisions of sanitary-epidemiologic stations]. PMID- 3817493 TI - [Principal types of work of the sanitary-epidemiologic service in solving health problems in monitoring the implementation of the general plan of a town]. PMID- 3817494 TI - [Organization and conduct of government sanitary surveillance in the area of the control of industrial, transportation and residential noise in the UkrSSR]. PMID- 3817495 TI - [The 27th Congress of the CPSU and the tasks of occupational medicine]. PMID- 3817496 TI - [Serum levels of thiocyanate as a criterion for monitoring smoking intensity]. PMID- 3817497 TI - [Device for testing human psychophysiologic functions during work activity]. PMID- 3817498 TI - [Mathematical analysis of the kinetics of biochemical reactions using the Elektronika B3-34 microcomputers]. PMID- 3817499 TI - [Evaluation of the electromagnetic environment created by airport radio communications equipment during its hygienic regulation]. PMID- 3817500 TI - [Gas chromatographic determination of clay in air]. PMID- 3817501 TI - [Method of determining fluorine in nails using a fluorine-selective electrode]. PMID- 3817502 TI - [Theoretical and practical significance of the most timely recent research concerning child and adolescent health]. PMID- 3817503 TI - [Complex solution of environmental protection problems at petrochemical plants]. PMID- 3817504 TI - [Experience with the use of "Vibroshum" laboratory in the work of a regional sanitary-epidemiologic station]. PMID- 3817505 TI - [Comparative study of the transformation capacity of anthraquinone derivatives in an aqueous medium]. PMID- 3817506 TI - [Effect of high doses of liquid swine dung on the viability of bacteria of the genus Pseudomonas in sea and river water]. PMID- 3817507 TI - [Hygienic evaluation of a method of electrodialysis mineralization of desalinated water]. PMID- 3817508 TI - [Experimental study of the nature of the dose-effect relationship of general vibrations]. PMID- 3817509 TI - [Hygienic evaluation of the electrochemical method of water decontamination using silver]. PMID- 3817510 TI - [The integral of action as a criterion for the comparative evaluation and management of chronic exposure regimens to substances with a pronounced physical accumulation]. PMID- 3817511 TI - [Hygienic standards for electromagnetic fields taking into account species traits and the time of action of the factor]. PMID- 3817512 TI - [Hygienic significance of work training in school workshops]. PMID- 3817513 TI - [Biomedical research in environmental hygiene and prospects for its development in the 12th Five-Year Plan]. PMID- 3817514 TI - [Gas chromatographic determination of acrylic compounds in biological media]. PMID- 3817515 TI - [Determination of aluminum in aerosols in the presence of fluorine]. PMID- 3817516 TI - [Morphometric method of assessing the effect of chemicals on the formation of the fetal bone system]. PMID- 3817517 TI - [Rapid methods for monitoring mine air for the content of trace aldehyde concentrations]. PMID- 3817518 TI - [Further comment on the training of public health officers]. PMID- 3817519 TI - [A unit for the elution of samples recovered on a solid granulated sorbent]. PMID- 3817520 TI - [Methodological approaches to the complex assessment of cause and effect relations in hygiene work]. PMID- 3817521 TI - [Experimental research to assess the effect of biologically purified sewage on the sanitary regimen and processes of self-purification in reservoirs]. PMID- 3817522 TI - [Hygienic evaluation of elements in the daily regimen of secondary school pupils with different instructional profiles]. PMID- 3817523 TI - [Experimental establishment of the maximum permissible concentrations of polyoxypropyleneamines in water]. PMID- 3817524 TI - [Effect of night watches and divided sleep on the circadian rhythm of the physiological functions of fishermen]. PMID- 3817525 TI - [Sialic acid content and hydrolase activity of the myocardium and blood serum in pesticide exposure (experimental data)]. PMID- 3817526 TI - [Experimental research on the specific types of biological action of synthetic resin-based varnish and painting materials]. PMID- 3817527 TI - [Relations of the levels of chemical migration from medical rubbers on the conditions for extract preparation]. PMID- 3817528 TI - [Allergenic properties of printing inks intended for the design of packaging materials used in the food industry]. PMID- 3817529 TI - [Data on establishing the maximum permissible concentration of ammonia in the gaseous medium of insulating materials for individual protection]. PMID- 3817530 TI - [5 years of tubal microsurgery. Evaluation of results]. PMID- 3817531 TI - [Current management of carcinoma of the cervix. Stage IB and pregnancy]. PMID- 3817532 TI - [Procoagulant properties of the amniotic fluid. II. Thromboplastin acceleration in the amniotic fluid in the diagnosis of prolonged pregnancy]. PMID- 3817533 TI - [Histologic aspects of microinvasive carcinoma of the uterine cervix. Study of 70 cases]. PMID- 3817534 TI - [Retropubic urethrocystopexy by vaginal approach. Preliminary report]. PMID- 3817535 TI - [Relation between health tasks in the foundry shop of a machine-building complex and the resolution of the 27th Congress of the CPSU]. PMID- 3817536 TI - [Evaluation of features of operators' work at post offices]. PMID- 3817537 TI - [Health status of workers engaged in preparing the raw charge in copper production]. PMID- 3817538 TI - [Ergonomic studies of workplace organization at swine-breeding complexes]. PMID- 3817539 TI - [The mechanism of action of vibration on man]. PMID- 3817540 TI - [Hygienic evaluation of pulsatile local vibration in industrial and experimental situations]. PMID- 3817541 TI - [Effect of infrasound on pulmonary structure]. PMID- 3817542 TI - [Method of calculating a noise dose]. PMID- 3817543 TI - [Processing of data reflecting morbidity with temporary disability on the microcomputers Elektronika MK-54 and Elektronika BZ-34]. PMID- 3817544 TI - [Silicosis among workers engaged in the production of construction gravel]. PMID- 3817545 TI - [Method of determining ammonium thiocyanate]. PMID- 3817546 TI - [Information search of material in foreign sources in the field of occupational health and occupational pathology]. PMID- 3817547 TI - [Data providing a basis for the maximum permissible concentration of vinyl phosphate in workplace air]. PMID- 3817548 TI - [Individual automated evaluation of the work capacity of operators of large technological facilities based on the use of the computer technology of the enterprises' automatic control system]. PMID- 3817549 TI - [Hygienic problems in the reconstruction of chemical plants]. PMID- 3817550 TI - [Immunologic status of workers in the resin-processing industry]. PMID- 3817551 TI - [Various indicators of respiratory function, the blood and immunity in workers handling isocyanates]. PMID- 3817552 TI - [Effect of a complex of chemical substances released during the production of polyurethane foam insulation in the manufacture of refrigerators on workers]. PMID- 3817553 TI - [Effect of antihypertensive pharmacotherapy on reaction time in patients with hypertension under the conditions of monotony]. PMID- 3817554 TI - [Hygienic evaluation of working conditions in the production of polyisocyanate in an outdoor area]. PMID- 3817555 TI - [Hygienic evaluation of working conditions at a present-day combined petroleum processing plant of the LK-6u type]. PMID- 3817556 TI - [Hygienic evaluation of the environmental air in the production of caprolactam]. PMID- 3817557 TI - [Working conditions and ways to improve them at carton factories]. PMID- 3817558 TI - [Results of experimental study of the cardiotoxic effects of harmful substances]. PMID- 3817559 TI - [Sanitary standardization of synthetic detergents "Lotos", "Era" and "Oka" in the air of the work area]. PMID- 3817560 TI - [Specific and nonspecific effects of carbon disulfide on workers in relation to its level in the work area]. PMID- 3817561 TI - [Treatment of toxic lesions of the liver in chronic occupational phosphorus poisoning]. PMID- 3817562 TI - [Cytologic picture of the bronchial mucosa in occupational bronchial asthma]. PMID- 3817563 TI - [Tissue circulation in patients with vibration disease and its characteristics during physical exertion and "pale fingers" attacks]. PMID- 3817564 TI - [Toxic properties of 1-methyl-3-isopropylbenzene and the substantiation of its MPEL in the air of the work area]. PMID- 3817565 TI - [A polarographic method of determining bismuth and its compounds in the air of the work area]. PMID- 3817566 TI - [Results of dynamic monitoring of the health status of workers in the synthetic leather industry]. PMID- 3817567 TI - [Duration of the contractile activity of the uterus and amniotic fluid outflow and the condition of the prematurely born infant]. PMID- 3817568 TI - [Plasma immunoglobulins in pregnant women with the syndrome of intrauterine fetal growth retardation]. PMID- 3817569 TI - [Evaluation of secondary ovulation induction using bromocriptine in normo- and hyperprolactinemia]. PMID- 3817570 TI - [Estrogen receptor and transfer RNA (tRNA) in women with uterine myoma]. PMID- 3817571 TI - [Aromatization of androgens by the neoplasm-transformed endometrium in women]. PMID- 3817572 TI - [Studies of oxytocinase in obstetrics]. PMID- 3817573 TI - [Emotional problems of women after wedge resection of the ovaries]. PMID- 3817574 TI - [Predicting the course of pregnancy in threatened abortion by quantitative determination of serum HCG level]. PMID- 3817575 TI - [Diagnostic and prognostic value of determining the estradiol-17beta level in the serum of women between the 6th and 20th weeks of pregnancy. II. Serum estradiol 17beta level in women with threatened abortion whose pregnancies terminated in labor]. PMID- 3817576 TI - [Diagnosis of cervical cancer]. PMID- 3817577 TI - [NMR spectroscopy and imaging in gynecology and obstetrics]. PMID- 3817578 TI - Functional gastroenterological disorders: the name's the thing ... PMID- 3817579 TI - Effect of cisapride on the gastrointestinal transit of a solid meal in normal human subjects. AB - The effect of cisapride, a new gastrointestinal prokinetic agent, on the transit of a standard meal through the stomach, small intestine and colon was studied in 10 normal subjects. Cisapride had no significant effect on gastric emptying but decreased mouth to caecum transit time (p less than 0.01). Stool weight and frequency were not significantly increased but the time for the first appearance of stool markers and the arrival of 20% and 50% of stool markers was decreased after cisapride (p less than 0.05). PMID- 3817580 TI - Twenty four hour manometric recording of colonic motor activity in healthy man. AB - The motor activity of the transverse, descending, and sigmoid colon was recorded for 24 hours in 14 healthy volunteers with a colonoscope positioned catheter. During the study the patients ate two 1000 kcal mixed meals and one continental breakfast. Colonic motor activity was low before meals and minimal during sleep; the motility index increased significantly after meals and at morning awakening. Most of the motor activity was represented by low amplitude contractions present singly or in bursts, which showed no recognisable pattern. All but two subjects also showed isolated high amplitude (up to 200 mmHg) contractions that propagated peristaltically over long distances at approximately 1 cm/sec. Most of these contractions occurred after morning awakening, and some in the late postprandial period, with a mean of 4.4/subject/24 h. The peristaltic contractions were often felt as an urge to defecate or preceded defecation, and could represent the manometric equivalent of the mass movements. PMID- 3817581 TI - Evaluation of gastric carcinoembryonic antigen analysis as an aid during screening for gastric neoplasia in atrophic gastritis. AB - The value of gastric juice and tissue carcinoembryonic antigen (CEA) analysis as an adjunct to endoscopic screening for gastric neoplasia was investigated in 61 patients with atrophic gastritis of whom 41 had other (superimposed) gastric lesions: six adenocarcinoma, four carcinoid, 23 regenerative polyps with or without dysplasia and eight fundic, or antral mucosal dysplasia. The gastric concentration of CEA did not differ between patient groups with different superimposed lesions. In these patients the gastric juice CEA concentrations were significantly increased in comparison with those in patients without superimposed lesions (p = 0.002). Gastric juice CEA concentrations above the upper range (+2SD) of those observed in normal controls were found in 40 (98%) of 41 patients with superimposed lesions and in 13 (65%) of 20 patients without such lesions (p = 0.001). At re-examination of 26 patients without neoplasia initially, after a mean interval of 32 months two (without polyps initially), had developed regenerative polyps, one an adenoma, and one an adenocarcinoma. These four had raised gastric juice CEA concentrations at the initial examination. PMID- 3817582 TI - Enteroglucagon and experimental intestinal carcinogenesis in the rat. AB - To assess the association between the putative intestinal trophic hormone enteroglucagon and the development of intestinal tumours, four groups of 20 rats underwent either jejunal transection or 20%, 50%, or 80% proximal small bowel resection. Tumours were induced with azoxymethane 10 mg/kg weekly for 12 weeks. At 26 weeks there was a promotion of colonic neoplasia from a median of 0.5 (range 0-3) per rat in the transection group to 1.0 (0-3) in the 50% resected group (p less than 0.01) but no significant promotion in the 80% resection group. In the small bowel, increasing resection resulted in a progressive promotion of tumours from a median of 1.0 (range 0-3) per rat in the transection group to 2.0 (0-5) in the 50% resection group (p less than 0.001) and 3.0 (0-11) in the 80% group (p less than 0.01). Plasma enteroglucagon was measured at 2, 16, and 26 weeks and was raised seven-fold in the 80% resected group (p less than 0.001). There was a significant correlation between enteroglucagon concentrations and number of duodenal tumours but not colonic tumours. Crypt cell production rate in the duodenum increased from 11.5 +/- 1.9 to 29.2 +/- 1.4 cells/crypt/h in the 80% resected group (p less than 0.001) and showed a close correlation with both enteroglucagon levels and tumour promotion in the small bowel. There were no changes in crypt cell production rate in the colon with resection. This study shows a close association between enteroglucagon concentrations, promotion of tumours and crypt cell production rate in the duodenum but not in the colon. PMID- 3817583 TI - Discriminant value of dyspeptic symptoms: a study of the clinical presentation of 221 patients with dyspepsia of unknown cause, peptic ulceration, and cholelithiasis. AB - This study aims to determine whether the features of dyspepsia can discriminate a subgroup of patients who present with non-ulcer dyspepsia from other diagnostic categories. The following groups were studied: One hundred and thirteen patients with endoscopically confirmed non-ulcer dyspepsia in the absence of clinical, biochemical or radiological evidence of other gastrointestinal diseases or disorders, termed essential dyspepsia; Fifty five patients with symptomatic and endoscopically proven peptic ulceration (32 duodenal ulcers, 23 gastric ulcers); Fifty three patients admitted to hospital with biliary pain and cholelithiasis without other lesion at laparotomy. All patients completed a structured history questionnaire at personal interview. Stepwise logistic regression analysis was done on 19 predefined variables to determine if one or more of these could discriminate between the diagnostic categories. The results suggest that certain groups of symptoms may be of diagnostic value, but many are not. Upper abdominal pain aggravated by food or milk, pain severity, night pain, vomiting, weight loss, and age significantly discriminated essential dyspepsia from the other diagnostic categories. A scoring system was established based on these discriminating symptoms. Using the weighted score, at a sensitivity of 57%, the specificity for a diagnosis of essential dyspepsia was 94%, but only prospective studies will determine if this scoring system is of actual clinical value. PMID- 3817584 TI - Chronic idiopathic intestinal pseudo-obstruction: clinical and intestinal manometric findings. AB - We report the clinical and intestinal manometric findings in a group of 42 patients with chronic idiopathic intestinal pseudo-obstruction evaluated at the Mayo Clinic. The main clinical manifestations in these patients were nausea and vomiting (83%), abdominal pain (74%), distension (57%), constipation (36%), diarrhoea (29%), and urinary symptoms (17%). These symptoms preceded surgery in all patients. Air fluid levels or distended bowel loops occurred in 57% and a dilated bladder or urinary excretory pathway in 17%. All patients showed intestinal manometric abnormalities none of which are seen in healthy individuals: aberrant configuration or propagation of interdigestive motor complexes in 25 patients; bursts (greater than 2 min duration) of non-propagated phasic pressure activity in fasting and/or fed state in 30 patients; sustained incoordinated fasting pressure activity in 15 patients; and inability of an ingested meal to convert fasting into fed pattern in 28 patients. We conclude that qualitative analysis of intestinal manometry provides evidence of gut dysmotility in patients with the clinical syndrome of chronic intestinal pseudo obstruction. These abnormalities of motility can help to establish the correct diagnosis. PMID- 3817585 TI - Effect of chronic ethanol ingestion on enterocyte turnover in rat small intestine. AB - Whether chronic ethanol ingestion significantly damages the small intestine remains controversial. To clarify this we have analysed the morphology of the small intestinal epithelium and quantified its renewal in chronically ethanol fed rats. Twenty adult male rats were pair fed for 28 days a nutritionally adequate liquid diet containing either ethanol as 36% of total calories or an isocaloric diet in which fat substituted for ethanol. Crypt cell production rate was determined in the jejunum and ileum by the metaphase arrest method. Weight gain and small intestinal morphology were similar in ethanol fed and control rats, but enterocyte turnover was significantly reduced in the jejunum (p less than 0.05) and ileum (p less than 0.01) of the ethanol fed rats. This effect of ethanol on the small intestine is probably systemic rather than local, because the changes in jejunum and ileum were similar, and it may contribute to the development of malnutrition in chronic alcoholics. PMID- 3817586 TI - Teeth and benign oesophageal stricture. AB - In patients undergoing upper gastrointestinal endoscopy, benign oesophageal strictures were significantly more frequent (p less than 0.01) in those with severe tooth loss than in controls of the same age. This may be because of edentulous patients eating less solid and more liquid food, which would otherwise dilate the lower oesophagus, or poor salivary flow leading to both tooth loss and impaired neutralisation of refluxed gastric acid, or malnutrition. No association was found, however, between either oesophagitis or hiatus hernia and dentition. PMID- 3817587 TI - Antecedent long term ethanol consumption in combination with different diets alters the severity of experimental acute pancreatitis in rats. AB - The effect of fat rich (F), protein rich (P) and carbohydrate rich (C) diets and chronic ethanol consumption on experimental acute pancreatitis was studied in rats. One hundred and ninety two animals with induced acute pancreatitis were divided into eight groups fed either a mixture of water and 15% ethanol (v/v), or tap water combined with standard or special diets according to their group, for 12 weeks. The other control 192 rats were divided into equal groups. Bile induced experimental acute pancreatitis caused the highest mortality (37.5%) in the animals receiving F diet and ethanol. In this group significant haemoconcentration, peritoneal exudate formation and the most extensive fat necrosis were also observed. The carbohydrate rich diet with or without ethanol did not have any significant effect on the severity of acute pancreatitis. Diet and ethanol may alter the metabolism of the pancreas and cause derangements at the systemic level. These derangements might cause the increased susceptibility to acute pancreatitis. These changes in the metabolism may be fatal because of the increased toxicity of the peritoneal exudate secreted during the inflammation. PMID- 3817588 TI - In vitro effect of duodenal juice on R binders cobalamin complexes in subjects with pancreatic insufficiency: correlation with cobalamin absorption. AB - Absorption of cobalamin free or bound to chicken serum was assessed in nine patients with pancreatic insufficiency. Simultaneously the in vitro effect of duodenal juice collected from six patients and seven controls was tested on labelled cobalamin complexed to chicken serum or to R salivary binder. Malabsorption of free cobalamin was observed in one of nine patients and in four of nine patients when cobalamin was administered bound to chicken serum. The in vitro effect of duodenal juice on cobalamin complexed to chicken serum or to R salivary binder was studied: the percentage of free cobalamin released was significantly decreased in pancreatic insufficiency compared with controls whatever the binder used; the degradation of R salivary binder was different in pancreatic insufficiency and in controls. Despite the in vitro abnormalities observed in pancreatic insufficiency, these did not correlate with the in vivo absorption of cobalamin which was often normal in our patients. PMID- 3817589 TI - Penetration of albendazole sulphoxide into hydatid cysts. AB - The penetration of albendazole sulphoxide, the principal metabolite of albendazole into hydatid cysts (E granulosus) was measured by means of in vitro animal and clinical studies. The drug freely diffuses across the parasitic membranes. Cyst/serum concentrations of 22% were achieved in patients, longer pre operative therapy produced higher concentrations. PMID- 3817590 TI - Managing radical surgery: notes from the patient's viewpoint. AB - Based on a diary which was kept while preparing for and undergoing pan proctocolectomy, the paper describes the process of coming to terms with an ileostomy. A number of stages in the process are identified: anticipation, reorientation, trauma, maintenance of selfimage and accommodation. The social psychological strategies for coping with the process are elaborated. PMID- 3817591 TI - Neurological sequelae in patients recovered from fulminant hepatic failure. AB - Two teenage patients with fulminant hepatic failure progressing to grade 4 encephalopathy with clinical signs of cerebral oedema are described, in whom permanent neurological injury (involving the brain stem in one and the cerebral cortex in the other) was the sequel to an otherwise full recovery. The present day management of cerebral oedema may, as in these two cases, ensure the survival of patients with fulminant hepatic failure who would previously have been likely to die from the effects of raised intracranial pressure. As a result it is now possible more recovered cases will be seen with residual neurological deficits, a previously very rarely recorded event. PMID- 3817592 TI - [Epidemiologic and social medicine aspects of the climacteric]. PMID- 3817593 TI - [Pathogenesis and therapy of osteoporosis in the postmenopausal period]. PMID- 3817594 TI - [The postmenopausal period and urinary incontinence]. PMID- 3817595 TI - [Oral hormone therapy in the pre- and postmenopausal period]. PMID- 3817596 TI - [Hormone substitution by injectable preparations and skin implants]. PMID- 3817597 TI - [Treatment of disorders of the climacteric by vaginal, rectal and transdermal estrogen substitution]. PMID- 3817598 TI - [Contraception in the premenopausal period]. PMID- 3817599 TI - [Hormone therapy and the risk of cancer in the climacteric]. PMID- 3817600 TI - [Psychological and familial status of the aging female with reference to psychopathologic behavior patterns]. PMID- 3817601 TI - Indices of collagen metabolism in pregnancy and postpartum period. AB - A progressive increase in total and free hydroxyproline and collagen-like protein concentration in blood serum was found in pregnancy, and high values of these indices were observed in the postpartum period as compared to nonpregnant women. PMID- 3817602 TI - L-alanine carriers at maternal and fetal surfaces of the guinea pig placenta trophoblast. AB - An active transport for amino acids exists in maternofetal direction through the hemochorial placenta of man and guinea pig. With respect to the trophoblastic barrier some properties of the transplacental transport at both sides of this tissue are investigated. The results are compared to the methods of the transport of amino acids at intestine and kidney. The maternal and the fetal (basic) membrane can be investigated separately and one after another at one placenta by the technique of the bolus injections. The results were as follows: The 3H-L alanine uptake is significantly higher by maternal injection than by fetal injection. Opposite to this the backflux is higher out of the trophoblast into the perfusion medium of the donor side at fetal injections. Out of this transplacental transport is higher in materno-fetal direction than in the opposite direction (p less than or equal to 0.05). A sodium dependence of the 3H L-alanine transport is found at the maternal and fetal side. Nevertheless, the withdrawal of sodium ions inhibits more strongly at the maternal than at the fetal side. The sodium-dependent transport system predominates at the maternal membrane of the trophoblasts. Phloretin only inhibits significantly the uptake (maximal) and the transport of 3H-L-alanine at the fetal side (at the basic membrane). That means that the sodium independent by phloretin inhibited transport system exists mostly, if not totally, at the fetal membrane. Ouabain reduces uptake (maximal and total) and transport of 3H-L-alanine only significantly at the maternal side (p less than or equal to 0.05). Therefore the active sodium transport must be mostly localized at the maternal membrane. The flux of L-alanine diminishes with increasing L-alanine concentrations at the fetal and maternal side. The determinations of the transport capacity (Jmax) and the transport affinity (Km) show that Jmax is significantly higher at the maternal side and Km at the fetal side (p less than or equal to 0.05). By means of these results a model can be described to characterise the transport of amino acid through the placenta. PMID- 3817603 TI - Rapid immunochemical assay of pregnanediol-3-glucuronide in urine and its clinical application. AB - A rapid and simple technique for assessing ovulation and luteal function is needed in clinical practice. A sensitive immunoassay kit is presented here for clinical use. An immunoassay of pregnanediol-3-glucuronide (Pd-3G) in urine was established. The sensitivity of this assay was 0.4 mg/l of Pd-3G. The standard error range of the recovery test was within 0.8 mg/l, and the coefficients of variation of within-run and day-to-day precision test were within 4%. Cross reactions of various steroids were observed in free pregnanediol, pregnanetriol and progesterone, but their reactivity exhibited less than 4%. The Pd 3G/creatinine (mg/g) ratio was demonstrated as nearly constant over a 24-hour period. A significant rise of Pd-3G coincided with a luteinizing hormone surge and continued during the luteal phase in the ovulatory menstrual cycle. In an anovulatory cycle, Pd-3G was found to be under 4 mg/g creatinine. This Pd-3G direct-assay method could be widely used in infertility clinics. PMID- 3817604 TI - Thromboplastin activity in blood monocytes from oral contraceptive users. AB - The thromboplastin activity in blood monocytes from 13 women on oral contraceptives and from a reference group of 20 women not on oral contraceptives has been compared. The thromboplastin activity in endotoxin-stimulated monocytes from the oral contraceptive (OC) users was on average 54% of the activity in the reference group (p less than 0.05). The thromboplastin activity in unstimulated monocytes was also lower in the OC group than in the reference group although not statistically significant. Factor VII was significantly higher (p less than 0.05) in the OC group, whereas no difference was observed in fibrinogen and factor V levels. PMID- 3817605 TI - Estrogen induction of liver proteins and high-density lipoprotein cholesterol: comparison between estradiol valerate and ethinyl estradiol. AB - The effects of ethinyl estradiol and estradiol valerate were compared in 135 postmenopausal women during estrogen replacement therapy. Subfractions of high density lipoprotein (HDL) cholesterol and its apolipoproteins and the serum levels of 2 estrogen-sensitive liver proteins were followed during 3 cycles of unopposed treatment with either ethinyl estradiol 10 or 30 micrograms or estradiol valerate 2 mg daily. Estrogen therapy induced significant and dose dependent changes in all serum factors except HDL3 cholesterol. The effects of 10 micrograms of ethinyl estradiol upon the lipoproteins were 1.5-2.5 times greater than those of 2 mg of estradiol valerate. Sex-hormone-binding globulin and the pregnancy zone protein were the most sensitive markers for the estrogenic effect and these 2 liver-derived plasma proteins were also much more sensitive to ethinyl estradiol than to estradiol valerate. Although satisfactory therapeutic effects were achieved with both estrogens, the marked influence of ethinyl estradiol on liver protein synthesis should make estradiol valerate the first choice in clinical replacement therapy. PMID- 3817606 TI - Major and modified nucleosides as markers in ovarian cancer: a pilot study. AB - A number of major and modified nucleosides were measured in urine samples of patients with ovarian cancer. The patients were divided into three groups based on histological criteria: benign, borderline, malignant. 44% of the measured marker levels of the benign group were in the normal range, whereas 97% of the borderline and malignant groups were outside the normal range. After a total hysterectomy with adnexectomy and omentectomy in a patient with a borderline type malignancy, six of the seven elevated markers decreased to normal values. PMID- 3817607 TI - Good laboratory practice before and after blood transfusion. AB - Among the general principles that govern good laboratory practice before and after blood transfusion, there are two aspects which receive little attention: the importance of transfusion medicine as a distinct discipline; and the interrelationships within the hospital needed to make the "Blood Bank" effective. PMID- 3817608 TI - Intra- and extraerythrocyte pH at 37 degrees C and during long term storage at 4 degrees C: 31P NMR measurements and an electrochemical model of the system. AB - A 31P NMR method based on pH dependent variation of the chemical-shift-difference between the resonances of orthophosphate and methylphosphonate was used to measure simultaneously intracellular pH (pHi) and extracellular pH (pHc) during long term storage of erythrocytes; pH was determined at both 4 degrees C and 37 degrees C. An equation describing the equilibrium distribution of membrane permeant ions was derived by consideration of the electrochemical and osmotic constraints in the RBC suspension. Calculations using the model-equation and the measured pHi yielded the Donnan ratio and therefore pHo; the relationship between experimentally determined pHi and pHo values was accurately predicted by the model. Sensitivity analysis of the model-equation revealed that the observed increase in transmembrane pH gradient during storage is principally due to the alteration of the total net charge of intracellular (poly)-anions. PMID- 3817609 TI - Alterations in the number of glucocorticoid receptors of circulating lymphocytes in sepsis. AB - A 2-to 16-fold increase in the number of glucocorticoid receptors of circulating lymphocytes was observed in 17 septic patients as compared to 10 control patients with no inflammatory disease. The number of receptors was low in 3 septic patients who did not respond to antibiotic and glucocorticoid therapy and died. Intravenous administration of 100 mg of cortisol reduced the number of receptors available to the assay by about 30% in both septic and control patients. PMID- 3817610 TI - Decreased number of steroid receptors of circulating lymphocytes in Crohn's disease and ulcerative colitis. AB - The number of steroid receptors of circulating lymphocytes was determined in 13 patients with inflammatory bowel disease and in controls. Marked reduction of the number of receptors was observed both in Crohn's disease and in ulcerative colitis; no receptors were detected by radioactive hormone binding assay in 4 cases. PMID- 3817611 TI - [Importance of early administration of intravenous streptokinase in acute myocardial infarction]. PMID- 3817612 TI - [Silent vs symptomatic ischemia during daily activities and treadmill testing]. PMID- 3817613 TI - [Primary familial hyper-alpha-lipoproteinemia in Israel]. PMID- 3817614 TI - [Acute myocardial infarction in the elderly: increased incidence of atypical presentations]. PMID- 3817615 TI - [Role of prostanoids in the pathogenesis and therapy of peptic ulcer]. PMID- 3817616 TI - [Dawn phenomenon]. PMID- 3817617 TI - [Colorectal carcinoma in the elderly]. PMID- 3817618 TI - [Current surgical treatment of ulcerative colitis]. PMID- 3817619 TI - [Gastro-intestinal tract reconstruction following acid ingestion]. PMID- 3817621 TI - [Crisis and challenges in the public health system]. PMID- 3817620 TI - [Lead poisoning in West Bank Arabs caused by contaminated flour]. PMID- 3817622 TI - [Influence of the development of medicine on medical education]. PMID- 3817623 TI - [Housestaff guidelines for interpersonal relationships]. PMID- 3817624 TI - [Treatment of hyperlipidemia with bezafibrate]. PMID- 3817625 TI - [Near-drowning and epilepsy during swimming]. PMID- 3817626 TI - [Peripheral false arterial aneurysms in Behcet's disease]. PMID- 3817627 TI - [Austrian syndrome]. PMID- 3817628 TI - [Combined pellagra, porphyria variegata and chronic alcoholism]. PMID- 3817629 TI - [Acute renal failure associated with cimetidine]. PMID- 3817630 TI - [Torsion of a floating gallbladder presenting as inguinal hernia]. PMID- 3817631 TI - [Diagnostic methods for cervical lump]. PMID- 3817632 TI - [The ethical attitude toward the defective newborn]. PMID- 3817633 TI - [Pathological laughter and weeping: treatment with amitriptyline]. PMID- 3817634 TI - [New drugs for epilepsy]. PMID- 3817635 TI - [Anemia among Jewish and Bedouin infants in Beer-Sheba and the Negev]. PMID- 3817636 TI - [Can simple small bowel obstruction be differentiated from strangulated obstruction?]. PMID- 3817637 TI - [Thyroid function in elderly patients with atypical signs and symptoms]. PMID- 3817638 TI - [Tinea capitis in Nazareth]. PMID- 3817639 TI - [Referral letters of family physicians to the psychiatric emergency room]. PMID- 3817640 TI - [Cryohemorrhoidectomy]. PMID- 3817641 TI - [The radial forearm flap]. PMID- 3817643 TI - [The responsibilities of the physician for his patient]. PMID- 3817642 TI - [Orbital lymphangioma]. PMID- 3817644 TI - [Blood transfusion--does it improve athlete's performance?]. PMID- 3817645 TI - [The treatment of food allergy in infants]. PMID- 3817646 TI - A volunteer program for helping families in a critical care unit. AB - When patients are critically ill, their families suffer extreme emotional distress, often without the support of staff who must focus first on patients' needs. This article describes a social work program that has successfully used volunteers in a critical care unit to facilitate communication between family members and staff, lessen the family's sense of isolation, and provide responsive services in a crisis-oriented setting. PMID- 3817647 TI - Health care practices and health status of the mentally ill in the community. AB - The chronically mentally ill generally need a variety of social supports to maintain themselves in the community. This study assessed the health care practices and health status of community-based respondents to determine if the health care needs of this chronic population were being met. Although positive results were found, service gaps deserving of attention were also revealed. PMID- 3817648 TI - Discharge planning: an organizational perspective. AB - Economic pressures and the advent of prospective payment systems have heightened the importance of effective discharge planning. In this examination of the organizational dimension of the discharge process, a conceptual approach for understanding complex organizations is outlined and strategies for negotiating multifaceted systems are presented. PMID- 3817649 TI - A template for analyzing ethical dilemmas in discharge planning. AB - Involvement in discharge planning in acute-care hospitals can produce troubling ethical conflicts for social workers. Using case material, the authors present a model for analyzing these dilemmas. Exploration of available data, value systems, and decision-making dimensions of the situation at hand is suggested as a way of understanding a dilemma and moving toward necessary action. PMID- 3817650 TI - [A method for evaluating visual impairments using operant behavior in mice]. AB - A behavioral method, using a shuttle box (one of the conditioned behaviors) for assessing visual function in mice, was investigated. Normal ICR mice were trained to avoid the unconditioned stimulus (electric footshock) during the presentation of conditioned stimuli (tone and light). After acquisition of avoidance response, normal ICR mice were presented randomly tone or light as the conditioned stimulus. The percent of avoidance in the presentation of light was decreased suddenly, but that of tone was not. However, the decrease of avoidance response to light stimulus was recovered by following trainings. The mice, which had acquired the condition response to tone and light stimulus alone, were treated in their cornea with 4N NaOH. The decrease of percent of avoidance in the mice with alkali-treated cornea after differentiation of conditioned stimuli did not recover following training. These results suggested that visual impairment of mice can be detected by this method. Therefore, we attempted to detect the visual impairments of dominant (Cts) and recessive (cac) hereditary cataract mice, hereditary retina degenerated mice (C3H) and first filial generation mice of C3H, F1 [(ICR X C3H) F1]. The acquisition curves of both Cts and cac cataract mice were similar to that of normal ICR mice, but those of C3H and F1 were similar to that of ICR mice treated with alkali. Moreover, changes in recovery %, which was calculated from avoidance response in the presentation of light alone after differentiation of conditioned stimuli, corresponded to the above results. These findings demonstrated that the visual impairment of Cts and cac cataract mice is weak, while that of C3H and F1 mice is strong. PMID- 3817651 TI - [Pharmacological studies on ginger. V. Pharmacological comparison between (6) shogaol and capsaicin]. AB - Pharmacological actions of (6)-shogaol and capsaicin were studied. Both (6) shogaol (0.5 mg/kg, i.v.) and capsaicin (0.1 mg/kg, i.v.) caused a triad such as a rapid fall in blood pressure, bradycardia and aponea in rats. Both drugs induced marked pressor responses in blood pressure, which occurred after the rapid fall, were markedly reduced by a spinal destruction. In pithed rats, both drugs-induced peripheral pressor responses were markedly reduced with the combined treatment of [D-Arg1, D-Pro2, D-Trp7,9, Leu11]-substance P (0.5 mg/kg, i.v.), phentolamine (10 mg/kg, i.v.) and the section of sciatic nerves. In isolated guinea-pig trachea, (6)-shogaol (100 microM) and capsaicin (10 microM) induced contractile responses which were slightly inhibited by substance P antagonist (10 microM), but exhibited also a tachyphylaxis. Furthermore, although (6)-shogaol (3.6 microM) showed positive inotropic and chronotropic actions on isolated atria in rats, this effect of (6)-shogaol disappeared by repeated injections or pretreatment (100 mg/kg, s.c.) of (6)-shogaol. These results suggest that (6)-shogaol and capsaicin have similar actions, and that both drugs may cause a peripheral action by releasing an unknown active substance from nerve ends. PMID- 3817652 TI - [Effects of 3-methyl-4-oxo-2-phenyl-N-[2-piperidinyl) ethyl]-4H-1-benzopyran-8 carboxyamide hydrochloride monohydrate (FL-155), a new anti-pollakiuria agent, on rhythmic bladder contractions in anesthetized rats]. AB - The effects of FL-155, which was synthesized to develop a new orally-active anti pollakiuria agent, on the rhythmic bladder contractions were studied in anesthetized rats. At a pressure exceeding 10 cm H2O in the bladder, a rhythmic bladder contraction was observed up to at least 120 min. This response was abolished by a spinal (C1 level) cut, cuts of both pelvic nerves, thiopental (3.0 mg/kg, i.v.) or lidocaine (1.0 mg/kg, i.v.); and atropine (0.01 mg/kg, i.v.) strongly inhibited the amplitude of the response. FL-155 and flavoxate, in intravenous (0.3-3.0 mg/kg and 1.0-3.0 mg/kg, respectively) and intraduodenal (12.5-100 mg/kg and 200-400 mg/kg, respectively) administrations, dose dependently abolished the rhythmic bladder contractions, and FL-155 was 8-16 times more potent than flavoxate in intraduodenal administrations. These results suggest that the rhythmic bladder contraction in anesthetized rat may be a polysynaptic reflex through pelvic nerves and the central nervous system (supraspinal level), and FL-155 appears to be a candidate for an orally active anti-pollakiuria agent. PMID- 3817653 TI - [Pharmacological studies on Y-8894. (IV). Ameliorative effect on a cerebral energy metabolism disorder induced by KCN]. AB - The amelioration of energy metabolic disturbance in cerebral anoxia is valuable for the treatment of various cerebral ischemic diseases and insufficiency. In this study, the effect of Y-8894 on the cerebral energy metabolism was investigated using a KCN-induced cerebral anoxia model with mice. The intravenous injection of a lethal dose of KCN (2.5 mg/kg) induced rapid and marked decreases of brain glucose, phosphocreatine and ATP contents, with a remarkable enhancement of lactate and AMP levels, indicating a severe disorder of the cerebral energy metabolism. This phenomenon was also shown by an irreversible deterioration of the energy charge potential (ECP), an index of the cerebral energy state. The treatment with Y-8894 (30 mg/kg, i.p.) remarkably ameliorated this KCN-induced energy metabolic disturbance: markedly reducing the changes in brain phosphocreatine, glucose and lactate contents, while keeping ATP, AMP and ECP at nearly their normal levels. In addition, these changes in the Y-8894 treated group recovered promptly to normal, whereas those in the control group were irreversible. In normal mice, Y-8894 induced a significant increase in the cerebral glucose content without affecting either the cerebral glycolytic metabolism or the energy state. The present findings suggest that Y-8894 has an ameliorative effect on the cerebral energy metabolic disturbance, and this effect likely plays an important role in the improvement of amnesia and other neurological deficits related to cerebral anoxia. PMID- 3817654 TI - [Effect of cysteine ethylester hydrochloride (Cystanin) on host defense mechanisms (III): Potentiating effects on phagocytosis and nitroblue tetrazolium (NBT) reduction by leukocytes of mice and guinea pigs]. AB - ICR mice were treated orally with cysteine ethylester hydrochloride (ethylcysteine, 10 and 100 mg/kg) immediately before the intraperitoneal injection of yeast particles. This agent significantly potentiated phagocytosis of yeast particles by peritoneal polymorphonuclear leukocytes in mice obtained 2 hr after the yeast injection, and the treatment with this agent (3 and 30 mg/kg, p.o.) 4 hr before the injection of yeast potentiated phagocytosis of yeast particles by mouse peritoneal leukocytes. This agent (30 mg/kg, p.o.) restored the suppression of phagocytosis of mouse leukocytes by the intraperitoneal administration of cyclophosphamide (30 mg/kg, i.p.) 24 hr before the yeast injection. This agent (10-100 mg/kg, p.o.) had no effect on the decrease of peripheral leukocyte number in irradiated mice (560 rad), but restored the suppression of phagocytosis, nitroblue tetrazolium (NBT) reduction and stimulated NBT reduction by the addition of lipopolysaccharide. Furthermore, this agent (3 30 mg/kg, p.o.) potentiated phagocytosis, NBT reduction and stimulated NBT reduction of peripheral leukocytes obtained from guinea pigs 2 and 6 hr after ethylcysteine treatment. It is suggested that ethylcysteine potentiates phagocytosis and NBT reduction of leukocytes in animals, and it restores phagocytosis and NBT reduction inhibited by the treatment with cyclophosphamide or X-ray irradiation. It may be possible that this stimulating effect of ethylcysteine could be at least in part involved in the stimulation of nonspecific resistance to infection in the compromised host. PMID- 3817655 TI - [Effect of sodium salicylate on renal handling of calcium, phosphate and magnesium]. AB - Effect of sodium salicylate (SS) on renal handling and plasma concentration of calcium (Ca), phosphate (Pi) and magnesium (Mg) was studied in over-night fasted rats. Hypophosphatemic hypocalcemia was observed after the administration of 200 mg/kg of SS; on the other hand, hypermagnesemia was induced only with the dose of 400 mg/kg. A clearance study with the smaller dose of SS showed a decrease in urinary flow rate; however, the glomerular filtration rate remained unchanged. Reduction of urinary Ca excretion which was mainly due to a decreased filtered load was observed. On the other hand, we observed increased urinary excretion of Pi and decreased Mg excretion, which resulted from the changes in tubular reabsorption of Pi and Mg, respectively. It was concluded that the administration of SS caused a hypocalcemia by the action on a tissue other than the nephron, followed by a decreased filtered load, then a reduction of urinary Ca excretion. a decreased tubular reabsorption, which contributes to hypophosphatemia. However, the temporary increase in tubular reabsorption of Mg makes only a small contribution to the hypermagnesemia. It was suggested that an inhibition of cyclooxygenase was not related to these effects of salicylate on renal handling of these electrolytes. PMID- 3817656 TI - Production of quinomycin A in Streptomyces lasaliensis. AB - In addition to lasalocid, an oligoether coccidiostatic compound, other compounds are synthesized by Streptomyces lasaliensis. Mutants producing either of two antibiotics, lasalocid A or quinomycin A (an antibiotic of quinoxaline character), were obtained by natural selection and by mutagenesis. Methods of isolation, purification and estimation of both compounds were established. PMID- 3817657 TI - Metabolism of n-alkanes by Aspergillus japonicus. AB - Cells of Aspergillus japonicus could degrade n-alkanes as a sole source of carbon. One of the pathways operative during the degradative process was the terminal pathway. Electron micrographs showed that the hydrocarbons were present in the cells as microdroplets. PMID- 3817658 TI - A two-generation reproductive and developmental toxicity study of sucrose polyester. AB - Sucrose polyester (SPE) is a mixture of hexa-, hepta- and octa-esters of fatty acids with sucrose, and has physical and organoleptic properties similar to those of conventional dietary fats. Because SPE is neither absorbed nor metabolized it forms a bulk lipid phase in the small intestine, resulting in effects on the absorption and enterohepatic circulation of lipid-soluble materials, such as cholesterol and fat-soluble vitamins. Such effects could potentially alter the physiology of animals to the extent of interfering with reproduction and/or the normal development of the embryo/foetus. To determine the likelihood of such phenomena, Sprague-Dawley rats were continuously fed SPE at dietary levels of 1, 5 or 10% along with controlled levels of vitamins A and E for two generations, with a reproductive and a teratogenic phase in each generation. Body-weight gain of rats fed SPE was comparable to that of the controls throughout the study, but feed consumption increased with increasing levels of SPE. Pregnancy or lactation had no effect on these growth patterns. Throughout the study, SPE had no deleterious effect on mating, conception, embryonic development, foetal or post natal viability, or on post-natal growth. Nor was there any treatment-related histopathology. Thus, it is concluded that SPE would not represent a reproductive or teratogenic hazard to human consumers of products containing SPE. PMID- 3817659 TI - Effect of T2 toxin on the spontaneous antibody-secreting cells and other non lymphoid cells in the murine spleen. AB - The Fusarium secondary metabolite, T2 toxin was investigated for its effects upon spontaneous antibody-producing cells in the murine spleen. Changes in the number of non-lymphoid cells in the spleen were also studied. A statistically significant increase in the number of spontaneous antibody-secreting cells, as detected by the protein A plaque assay, was observed. A dose-dependent increase was found after chronic exposure to T2 toxin for 3 wk. An increased number of erythroblast cells was also found in the spleens of these animals. At all the T2 toxin concentrations studied, the mice showed a dose-dependent reduction in blood levels of haemoglobin. Reduction in the suppression of B cell growth and stimulation of B cells caused by erythropoiesis or activated macrophages could be responsible for the increase in antibody production. PMID- 3817660 TI - Development of a short-term model of decalin inhalation nephrotoxicity in the male rat. AB - Fischer 344 male rats and C57BL/6 male mice were exposed 'continuously' (22 hr/day, 7 days/wk) for 20, 28 or 35 days to a model compound, decalin, at 0, 25, 62.5 or 125 ppm. Fischer 344 female rats were exposed 'continuously' to decalin at 0 or 125 ppm for 28 days. No histopathological changes were observed in selected organs of female rats or male mice exposed to up to 125 ppm decalin for 28 or 35 days, respectively. However, kidney lesions were observed in all three test groups of male rats after 20, 28 and 35 days' exposure. The nephrotoxicity was characterized by the formation of hyaline droplets in the cytoplasm of proximal convoluted tubule epithelial cells, by the presence of granular casts at the outer zone of the medulla, and by chronic nephrosis. These changes were time and dose dependent and were identical to the renal toxicity that has been reported to occur in male rats following 90 days of continuous exposure to decalin by inhalation. No histopathological effects were observed in the heart, liver, lung or nasal turbinates of male rats. Our results indicate a sex and species specificity for the kidney toxicity. This leads to questions with regard to the appropriateness of using the male rat to assess the potential inhalation toxicity of volatile hydrocarbons. By producing nephrotoxicity in less than 90 days, decalin may now be used to examine, in a well-defined manner, the effect on nephrotoxicity of variables such as dose, exposure regimen, sex, species, and route of exposure. Data from these studies can be used to ascertain whether or not the male rat is an appropriate test animal for predicting potential human nephrotoxic responses to volatile chemicals such as perfumes and perfume raw materials. PMID- 3817661 TI - Decalin-induced nephrotoxicity: light and electron microscopic examination of the effects of oral dosing on the development of kidney lesions in the rat. AB - Male and female Fischer 344 rats were given decalin by oral gavage for 5 or 12 consecutive days in order to determine whether oral dosing would result in light microscopically evident renal effects that were comparable to those that have been observed after inhalation exposure. Decalin (in corn oil vehicle) was administered at doses of 0, 0.1, 0.5, 1.0 or 2.0 g/kg body weight to male rats, and 0, 1.0, 1.5, 1.75 or 2.0 g/kg to female rats. Biopsies of the kidneys of selected control and high-dose male rats were taken for examination by electron microscopy. Sections of kidneys from all control and treated rats were examined by light microscopy. The kidneys of all male control rats contained minimal levels of hyaline droplets within the cytoplasm of proximal convoluted tubule (PCT) epithelial cells. Decalin-induced alterations in the kidneys of male rats included an exacerbation of the hyaline droplet/globule levels found in controls and the formation of granular casts in the outer zone of the renal medulla. The exacerbated formation of hyaline droplets was characterized light microscopically by a marked dose-related increase in the number and size of individual droplets/globules and ultrastructurally by a marked increase in the size range of, and the presence of crystalline inclusions in, the PCT epithelial cell phagolysosomal populations. No other ultrastructural alterations occurred that differentiated treated male rats from control males. The formation of granular casts was dose and time related, occurring in 60% of male rats given 0.5 g decalin/kg for 12 days and in 100% of those given 1.0 g decalin/kg for 12 days. Light microscopy revealed no differences between the kidneys of control and decalin-treated female rats, and no hyaline droplets or granular casts were observed in the kidneys of any female rat killed after 5 or 12 days. These results were in agreement with those of inhalation studies and provide additional evidence that the formation of hyaline droplets in response to exposure to volatile hydrocarbons may be unique to the male rat. PMID- 3817662 TI - Morphogenesis of decalin-induced renal alterations in the male rat. AB - Adult male Fischer 344 rats were killed after 5, 12, 19 or 31 days' 'occupational' (6 hr/day, 5 days/wk), 'semi-continuous' (22 hr/day, 5 days/wk) or 'continuous' (22 hr/day, 7 days/wk) exposure to 125 ppm decalin vapour. Control rats were exposed to filtered air. Kidney sections were evaluated to determine the nature and time-course of development of decalin-induced lesions. The development of renal lesions was characterized by a specific sequence of light microscopically evident alterations. The extent of the alterations was dependent on time and exposure regimen. Severe exacerbation of the spontaneous protein accumulation (hyaline droplets) routinely observed in the kidneys of control male rats was present in kidneys of all decalin-exposed animals at day 5, and was considered to be the primary morphological alteration associated with decalin exposure. The following sequelae of the hyaline droplet response were observed: the variable occurrence of light microscopically evident proximal convoluted tubule (PCT) epithelial cell degeneration/necrosis, presumably a reflection of cellular injury associated with excessive protein accumulation; the occurrence of granular casts at the junction of the inner and outer bands of the outer zone of the medulla secondary to PCT epithelial cell injury; chronic nephrosis, occurring secondary to tubular obstruction by granular casts. This triad of lesions (hyaline droplet accumulation, granular cast formation and chronic nephrosis) lends specificity to the decalin response and establishes a potential mechanistic relationship with other chemicals that induce these effects. PMID- 3817663 TI - Experimental sensitization of guinea-pigs to nickel and patch testing with metal samples. AB - Two groups each of 30 guinea-pigs were painted on 5 days/wk for 4 wk with 1% nickel sulphate in lanolin. The dose was applied to the shaved dorsal skin, which was prepared daily before treatment with sodium lauryl sulphate and injected intradermally each week during this period with 0.1 ml 1% potassium alum in distilled water, close to the site of NiSO4 application. Of the two groups of guinea-pigs submitted to this epicutaneous procedure, 63 and 80% developed skin allergy in response to challenge with 2% NiSO4 after a rest period of 2 wk, whereas no sensitization response was elicited by 1% NiSO4 in the guinea-pig maximization test. When two further groups were sensitized by the epicutaneous procedure, the first group, with a sensitization rate of 52% at the first challenge, showed no decline in response with five successive monthly challenges. Addition of NiCl2 to the drinking-water of the second group did not increase the sensitization rate induced by the monthly rechallenges with NiSO4. In guinea-pigs allergic to nickel, plating of Ni-coated brass discs with chromium as a special surface treatment prevented the occurrence of the contact allergy elicited by brass discs coated with Ni alone, whereas plating with gold/copper/cadmium did not. PMID- 3817664 TI - Toxic-oil syndrome: case reports associated with the ITH oil refinery in Sevilla. AB - Toxic-oil syndrome (TOS), a new disease that occurred in epidemic form in Spain in 1981, has been associated with the ingestion of unlabelled oil bought principally from travelling salesmen. Chemical analysis of oils taken from ill families has shown them to consist of varying proportions of different vegetable oils and animal fats, often showing chemical evidence of prior treatment with aniline. We investigated the unusual circumstances surrounding the reported occurrence of three TOS cases in two families in Sevilla, a city located far away (approximately 300 km) from the group of 14 provinces in central and northwestern Spain where 99% of the TOS cases occurred. Each case we investigated fitted the clinical picture of TOS and was not consistent with any other diagnosis. Illness apparently occurred as a result of ingestion of oil taken from the ITH oil refinery in Sevilla, a plant in which rapeseed and grapeseed oils were refined for the distributing firm through which oil bearing the causative agent of TOS is thought to have entered the market. These data provide further strong support for the hypothesis that food oil was the vehicle by which the aetiological agent of TOS was transmitted. Because ingestion of refined denatured rapeseed oil was most closely associated with the illness in time, the TOS agent was probably contained initially in this type of oil. The agent very probably entered later oil mixtures through such contaminated rapeseed oil. PMID- 3817665 TI - Urinary and faecal mutagenicity in Sprague-Dawley rats dosed with the food mutagens quercetin and rutin. AB - The natural flavonoid quercetin was administered to Sprague-Dawley rats by ip injection or gastric intubation of a single dose of 500, 1000 or 2000 mg/kg body weight. Mutagenicity assays with Salmonella typhimurium strain TA98 showed moderate mutagenic activity in the urines and faecal extracts but not in plasma samples from the treated animals. The mutagenic activity detected in the urines accounted for about 0.5% of the administered dose, irrespective of the route of administration and the dose level. Higher mutagenicity was demonstrated in faecal extracts. Rutin (quercetin-3-O-rutinoside) was administered by gavage and ip injection at 2000 mg/kg. Although the chemical was inactive as a mutagen in vitro, significant mutagenicity was detected in the urines and faecal extracts of the treated rats. Such activity was similar to that detected after administration of free quercetin in a dose some four times lower (by weight). PMID- 3817666 TI - Assessment of the risk of formation of carcinogenic N-nitroso compounds from dietary precursors in the stomach. AB - A literature review has shown that the daily intakes of various N-nitroso precursor classes in a typical European diet span five orders of magnitude. Amides in the form of protein, and guanidines in the form of creatine and creatinine, are the nitrosatable groups found most abundantly in the diet, approaching levels of 100 g/day and 1 g/day, respectively. Approximately 100 mg of primary amines and amino acids are consumed daily, whereas aryl amines, secondary amines and ureas appear to lie in the 1-10 mg range. The ease of nitrosation of each precursor was estimated, the reactivities being found to span seven orders of magnitude, with ureas at the top and amines at the bottom of the scale. From this information and an assessment of the carcinogenicity of the resulting N-nitroso derivatives, the potential health risk due to gastric in vivo nitrosation was calculated. The combined effects of these risk variables were analysed using a simple mathematical model: Risk = [daily intake of precursor] X [gastric concentration of nitrite]n X [nitrosatability rate constant] X [carcinogenicity of derivative]. The risk estimates for the various dietary components spanned nine orders of magnitude. Dietary ureas and aromatic amines combined with a high nitrite burden could pose as great a risk as the intake of preformed dimethylnitrosamine in the diet. In contrast, the risk posed by the in vivo nitrosation of primary and secondary amines is probably negligibly small. The risk contribution by amides (including protein), guanidines and primary amino acids is intermediate between these two extremes. Thus three priorities for future work are a comprehensive study of the sources and levels of arylamines and ureas in the diet, determination of the carcinogenic potencies of key nitrosated products to replace the necessarily vague categories used so far, and the development of short-term in situ tests for studying the alkylating power of genotoxicity of N-nitroso compounds too unstable for inclusion in long-term studies. PMID- 3817667 TI - The biomechanics of lower extremity action in distance running. AB - The role of quantitative biomechanical measurements in the evaluation of the running patient is discussed. Many techniques are now available to provide insight into the external mechanics of lower extremity action during running, and results from such measurements are presented for symptom-free subjects at distance running speeds. Details of stride length, stride time, and foot placement are first presented followed by a discussion of kinematic data, including stick figures, angle-time graphs, and angle-angle diagrams for the sagittal plane motion of the hip, knee, and ankle joints. The measurement of rearfoot motion, as an approximation of coronal plane subtalar joint movements, is also discussed. Results from acceleration, force, and pressure measurements are considered, and the assertion is made that bilateral asymmetry in many of these measures is a fairly common finding. There are, at present, few reports in the literature of the application of biomechanical techniques to the evaluation of patients with running injuries. It is anticipated that there will be rapid developments in this area in the future and that this will provide considerable insight into the etiology, diagnosis, and treatment of running injuries. PMID- 3817668 TI - Injuries to the hallucal sesamoids in the athlete. AB - The sesamoids of the great toe, which are small and seemingly insignificant bones, can be the site of disabling pathology for the athlete. Sesamoiditis, osteochondritis, partite sesamoids with stress fractures, displaced fractures, and osteomyelitis have all been reported in the athlete. Bursitis beneath the tibial sesmoid and flexor hallucis brevis tendonitis also occur in the athlete and may be confused with sesamoid injury. Excision of the involved bone is the recommended treatment for displaced fractures and for less severe conditions such as sesamoiditis, osteochondritis, and nondisplaced fractures, if conservative management fails to relieve symptoms. PMID- 3817669 TI - Fractures of the base of the fifth metatarsal distal to the tuberosity: a review. AB - Fractures of the proximal part of the fifth metatarsal can be separated into two types: those involving the tuberosity, and those involving the proximal part of the diaphysis distal to the tuberosity. Recently it has been recognized that the latter group, Jones' fractures, may be difficult to treat. Although reports in the literature have indicated the potential difficulties in the treatment of Jones' fractures, prevailing guidelines for their management are ambiguous. Apparently the varied clinical and roentgenographic manifestations of these fractures have not been correlated with their response to treatment. In this paper we describe a classification of these fractures and a plan of treatment based on clinical and roentgenographic criteria that were developed to define acute fractures, delayed unions, and nonunions. The treatment of choice for acute fractures is immobilization of the limb in a toe to knee cast with nonweight bearing. Fractures with delayed union may eventually heal if they are treated conservatively, but an active athlete with delayed union or an established nonunion will benefit from operative intervention. The procedures of choice are medullary curettage and bone grafting, and closed axial intramedullary screw fixation using a 4.0-mm ASIF malleolar screw. PMID- 3817670 TI - Achilles tendon ruptures--peroneus brevis transfer. AB - Peroneus brevis tendon transfer has been utilized in 40 individuals during the last 13 years. All cases consisted of complete Achilles tendon ruptures. In 34 cases the rupture was in the distal one-third of the tendon substance, in four cases bony avulsion of the calcaneal tuberosity occurred, and in two cases there was a diffuse tear in the proximal two-thirds of the tendon near the musculotendinous junction. The middle-aged athlete sustained the majority of these injuries during sports. Eleven patients were less than 30 years old, 23 patients were 30 to 40 years old, and six were over 40 years old. Five patients had reruptures that involved prior nonoperative treatment of cast immobilization, and one had undergone simple direct suture. This repair has been used in acute, chronic, and recurrent ruptures of the tendoachillis. Thirty-three patients presented within 1 week of injury, and seven after more than 1 week. A. Perez Teuffer personally described the preferred technique in 1971 and subsequently published in 1978. The transfer of the peroneus brevis is combined with a direct end-to-end suture of the triceps surae tendon that allows a secure reconstruction with the foot at a right angle. The peroneus brevis tendon is detached from the base of the fifth metatarsal and then tunnelled through the distal Achilles tendon stump. The distal portion of the tendon transfer is then drawn proximally along the medial calcaneal tendon border. The proximal triceps surae tendon is pulled distally and secured to the peroneal tendon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817671 TI - The high male range. PMID- 3817672 TI - [Selected problems of aerodynamics in playing wind instruments]. PMID- 3817673 TI - The brain in language and reading: research application and interpretation. PMID- 3817674 TI - Effect of echo and reverberation of a restricted information capacity on the speech process. PMID- 3817675 TI - The determination of carboxyhaemoglobin in the presence of sulphaemoglobin. AB - The quantitative analysis of carboxyhaemoglobin (HbCO) in fresh blood samples containing sulphaemoglobin (SHb) and in post-mortem blood samples was investigated using two automated spectrophotometers. The OSM 3 Hemoximeter gives much more accurate determinations of HbCO than the IL 282 Co-Oximeter in the presence of SHb. In addition, the OSM 3 Hemoximeter is designed to correct for the presence of SHb and turbidity of blood samples. It is thus suitable for the analysis of post-mortem samples from fire victims and decomposed bodies which may be very putrefied and contain SHb. PMID- 3817676 TI - alpha-L-fucosidase phenotyping in human tissues, dental pulps and hair roots. AB - Phenotypes of alpha-L-fucosidase (Fu) were demonstrated from tissue samples of spleen, liver, lung and kidney stored for a few weeks at room temperature. Activity was fairly low in pancreas, heart, muscle, skin and brain, and typing was not reliable after 1 week storage. Fu types were detectable from dental pulp tissue of up to 1 week storage. Activity was present in hair root cells, but was extremely low. The results show that the Fu typing may be applicable to individual identification of organ tissues and teeth. PMID- 3817677 TI - Agarose gel electrophoresis of human erythrocyte glutamic-pyruvic transaminase (GPT EC 2.6.1.2). AB - The method of choice to determine erythrocyte glutamate-pyruvic transaminase (GPT) including rare variants was starch gel electrophoresis. Methods using agarose as gel medium were not reported to our knowledge. We present an adapted method using the Tris/maleate buffer system and an agarose of low endosmosis. The common as well as rare variant types of GPT were quickly and reliably separated. In addition, a method for the consecutive determination of esterase D (ESD) and GPT on the same gel using the malic acid buffer system is described. PMID- 3817678 TI - [Chronic, bilateral keratoconjunctivitis with vascular convolutions under the temporal conjunctiva]. PMID- 3817679 TI - [Unusual course of degenerative vitreoretinal disease following pars plana vitrectomy]. PMID- 3817680 TI - [Geographic choroiditis--a progressive disease of the choroid and retina]. PMID- 3817681 TI - [Uncertain retinal tumor in a child: retinoma? Astrocytic hamartoma?]. PMID- 3817682 TI - [Ocular findings in Chlamydia psittaci-induced keratoconjunctivitis in the human]. PMID- 3817683 TI - [Lymphomas and lymphoid tumors of the conjunctiva]. PMID- 3817684 TI - [Differential diagnosis of dilated episcleral blood vessels]. PMID- 3817685 TI - The effect of hyperosmolarity on tear mucus ferning. PMID- 3817686 TI - [Regeneration of artificial corneal wounds with cyclosporin A eyedrops]. PMID- 3817687 TI - [Epithelial changes in the cornea and conjunctiva of the rabbit following chronic administration of cyclosporin A eyedrops]. PMID- 3817688 TI - [Experiences with the Molteno implant in secondary glaucoma]. PMID- 3817689 TI - [Clinical experiences using a silicone implant in glaucoma with a severely changed chamber angle]. PMID- 3817690 TI - [Animal experiment studies of an implant in glaucoma surgery]. PMID- 3817691 TI - [Preoperative prediction of expected postoperative visual acuity in cataract surgery with intraocular lens implantation]. PMID- 3817692 TI - [Preoperative prediction of expected postoperative visual acuity before YAG laser capsulotomy in extracapsular pseudophakia and aphakia]. PMID- 3817693 TI - [Practical implant biometry--a comparative study of currently available instruments]. PMID- 3817694 TI - [Comparison of functional and dioptric aniseikonia following unilateral implantation of a posterior chamber lens]. PMID- 3817695 TI - [Experiences with operations for a high-degree of myopia]. PMID- 3817696 TI - [Individual therapy of problem patients with chronic retinal and chorioretinal circulatory disorders of various origins]. PMID- 3817697 TI - [Differentiation of 2 types of ophthalmoplegia: loss of rapid eye movements and fixation impairment]. PMID- 3817698 TI - [Computerized perimetry of color stimuli]. PMID- 3817699 TI - [Independence of amplitudes, latency and spike behavior of retinal summation potentials]. PMID- 3817700 TI - [Oculo-auricular dysplasia associated with congenital hydrocephalus]. PMID- 3817701 TI - [Determination of carcinoembryonic antigen (CEA) in the aqueous humor in intraocular tumors]. PMID- 3817702 TI - [Automated perimetry in forensic assessment for blindness compensation]. PMID- 3817703 TI - [Will there soon be better weapons against cancer? An interview with Professor zur Hausen, director of the Germany Cancer Research Center]. PMID- 3817704 TI - [Determining infertile days in the female cycle. Initial test results of technical aids for methods of natural family planning]. PMID- 3817705 TI - [Psychosocial factors and cardiovascular diseases. Current studies and initial results of the WHO Augsburg MONICA project]. PMID- 3817706 TI - [Tumor markers in the diagnosis of pancreatic cancer]. PMID- 3817707 TI - [Hepatitis in heroin-dependent patients]. PMID- 3817708 TI - [Life-saving operations: can a minor refuse? Various forensic aspects--competence of the legal guardian]. PMID- 3817709 TI - [Viruses and the development of cancer]. PMID- 3817710 TI - [Value of venoactive substances in phlebology. Treatment of varicose veins and post-thrombotic syndrome]. PMID- 3817711 TI - [Hypertension]. PMID- 3817712 TI - [Chernobyl--an evaluation]. PMID- 3817713 TI - [Artificial lenses. Advantages and disadvantages]. PMID- 3817714 TI - [Possibilities and weaknesses of psychopathometric diagnosis of dementia]. AB - As cognitive deficiencies in aged people constitute a growing factor in our societies, the possibilities for diagnosing dementia are described and analyzed critically. Based on a discussion of those changes in intellectual performance which are typical for normal aging (e.g., reduction in so-called fluid intelligence combined with preservation of so-called crystallized intelligence), the pathological forms of aging, especially Alzheimer's disease, are outlined. The present, internationally favored psychometrical measures for recording dementia in the aged and for evaluating and diagnosing it differentially are listed. Finally, certain requirements which have to be imposed on a diagnostic test for dementia are discussed. PMID- 3817715 TI - [An attribution psychological approach for explaining productive psychotic symptoms]. AB - This study is an attempt to interpret productive psychotic symptoms within the framework of attribution psychology. The fundamental principles of this approach were supplied by Schachter in his publications on attribution research (basing on his theory of emotionality). First of all, an outline of Schachter's somatocognitive theory of emotion is given where emotions are interpreted as a result of (unspecific) neurovegetative excitation and certain characteristics of the external situation (the so-called cognitions). Experimental findings in connection with this approach are described. The concept of "incongruence attribution" was developed by us using a central element of Schachter's concept as well as currently accepted principles of attribution psychology. "Incongruence attribution" points to situations in which an individual is confronted by somatic alterations without the presence of attributable external cognitions. The present article refers to two psychiatric cases where a somatocognitive incongruence existed in the form of excessive physical changes. The psychotic pattern of symptoms occurring in both patients is interpreted by us as a result of incongruence attribution. Finally, the article deals with an extension of these deliberations in the sense of a large-scale application of concepts of attribution psychology to the range of psychoses. Productive symptoms as seen in endogenous and exogenous psychoses should generally be interpreted as examples of incongruence attribution. PMID- 3817716 TI - Variations in the talar articular facets of Japanese calcanei. PMID- 3817717 TI - [Change in polyamines in amniotic fluid and its clinical implication]. PMID- 3817718 TI - The measurements of the canalis caroticus of Japanese males. PMID- 3817719 TI - Directional character of spreading of vasogenic cerebral edema after radiation damage in rhesus monkeys, and effects of removal of the primary lesion. PMID- 3817720 TI - [A clinico-pathological study of primary nephrotic syndrome]. PMID- 3817721 TI - Pyroantimonate deposition patterns observed in the motor endplate myopathy following esterase inactivation. PMID- 3817722 TI - [Doppler echocardiography determination of the orifice area in aortic valve stenosis using a continuity equation]. AB - The continuity equation, derived from the study of fluid mechanics, may serve as the basis for calculation of orifice area of stenosed cardiac valves. As applied to aortic stenosis, the continuity equation states that the flow across the narrowed valve is equal to the flow in the left ventricular (LV) outflow tract such that A1 X v1 = A2 X v2, where A1 = LV outflow tract area, v1 = prestenotic velocity, A2 = stenotic orifice area and v2 = poststenotic velocity. Accordingly, at each point in time during pulsatile flow, the respective valve orifice area can be calculated. Hence, from the sum of all areas throughout the ejection time, the mean valve orifice area can be constructed as integral of A2/ET = A1 X integral of (v1/v2)/ET, assuming A1 to be constant, where integral of denotes the integral over the ejection time ET. To assess the usefulness of this method with respect to its clinical relevance, in 36 patients with aortic stenosis, the Doppler echocardiographically-determined orifice areas were compared with those calculated by the Gorlin formula based on invasively-obtained data. LV outflow tract area A1 was measured by echocardiography from a parasternal long-axis view. Prestenotic velocity v1 was recorded in the LV outflow tract by pulsed Doppler from an apical transducer position, whereby care was taken in positioning the sample volume not too close to the stenotic valve to avoid the prestenotic area of increased velocity. Continuous-wave Doppler was used, usually from an apical or right parasternal transducer position, to record the stenotic jet velocity v2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817723 TI - [Doppler echocardiography determination of the pressure gradient and valve orifice area in mitral valve stenosis]. AB - Pressure gradient and orifice area of stenosed mitral valves can be determined with Doppler echocardiography using the modified Bernoulli equation and the pressure half-time method, respectively (Figures 1 and 2). There was a close linear correlation between Doppler-echocardiographically determined pressure gradients and valve orifice areas with those obtained by invasive methods. In this study, in 85 patients with mitral stenosis of various severity, the valve orifice areas, as derived by the two methods respectively, correlated well (y = 0.89x + 0.15) with a correlation coefficient r = 0.96 and standard error of the estimate SEE = 0.12 cm2 (Figure 3). The correlation was not influenced by the prevailing cardiac rhythm, ventricular function, left ventricular mass or coexistent mitral or aortic regurgitation (Table 1). Accordingly, the Doppler echocardiographic method also appears applicable in the presence of concomitant mitral and aortic regurgitation which precludes an exact determination of valve orifice area with invasive methods. The Doppler echocardiographic method is currently so well validated that it can be regarded as a reliable noninvasive procedure for determination of the severity of mitral stenosis. PMID- 3817724 TI - Analysis of methodology for quantifying mitral regurgitation by Doppler echocardiography. AB - It is generally agreed that Doppler echocardiography is highly sensitive and specific for the detection of mitral regurgitation. There is more confusion about its ability to quantitate the degree of mitral regurgitation. Studies of the intensity of the Doppler signals, as well as cross sectional Doppler studies apparently can provide a straightforward, but rough estimate of the degree of regurgitation in term of atrial extent of the disturbed flow. The methods are also sensitive to methodological errors as beam direction, movement of the heart, signal/noise relationship and the size of the left atrium. Another approach to the non-invasive measurement of mitral regurgitation includes the use of Doppler echocardiography for the determination of both aortic and mitral volumetric flow. In a study of patients with mitral regurgitation, we found a close correlation between the regurgitant fraction determined by Doppler echocardiography, and the regurgitant severity determined by left ventriculography. This technique can only be used in pure mitral regurgitation, while associated atrial fibrillation, mitral stenosis, and combined aortic and mitral regurgitation make correct measurements difficult. PMID- 3817725 TI - [Doppler echocardiography determination of the severity of tricuspid valve stenosis]. AB - To evaluate the diagnostic usefulness of Doppler echocardiography for assessment of tricuspid stenosis, data of eleven patients were compared with hemodynamic results. Using the pressure half-time method, stenotic tricuspid orifice area was calculated as the quotient of 220 divided by the pressure half-time. The pressure gradient across the stenotic valve was determined according to the modified Bernoulli equation using four times the square of the maximal velocity of the stenotic jet. A close correlation was found between the Doppler echocardiographically and invasively determined orifice areas (r = 0.97, SEE = 0.23 cm2). There was also a good linear relationship between the pressure gradients derived from both methods (r = 0.89, SEE = 1 mmHg). Thus, the assessment of tricuspid stenosis can be achieved reliably by noninvasive means with the aid of Doppler echocardiography. PMID- 3817726 TI - [Determination of the severity of tricuspid valve insufficiency using Doppler echocardiography]. AB - In 187 patients with combined mitral and aortic valve lesions, to assess and quantify tricuspid regurgitation, biplane right ventriculograms were obtained and Doppler echocardiography performed for study of the tricuspid valve and right atrium. After definition of regurgitant turbulance across the tricuspid valve with pulsed Doppler, on mapping the right atrium the maximal length of regurgitant flow in the right ventricular inflow tract was determined from the short-axis parasternal view. In seven of 70 patients in whom angiographically tricuspid regurgitation was not detected, Doppler echocardiography demonstrated holosystolic insufficiency of the valve. In all patients with the angiographic diagnosis of tricuspid regurgitation grades I to III, this lesion was also documented Doppler echocardiographically with only slight divergence of the regurgitant area in the right atrium as viewed from the short-axis parasternal transducer position. In all patients, the tricuspid valve was morphologically unremarkable. In 32 patients, in agreement with angiographic findings, grade I tricuspid regurgitation was diagnosed; in seven patients the angiographic severity was overestimated by one grade. In 44 patients, in agreement with angiographic findings, tricuspid regurgitation grade II was detected; in four patients the Doppler echocardiographic severity was overestimated and five patients underestimated by one grade. In 23 patients with grade II tricuspid regurgitation angiographically, there was agreement with Doppler echocardiographic findings; in two patients the severity was underestimated by one grade.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817727 TI - [Noninvasive determination of the orifice area of aortic valve prostheses using Doppler echocardiography]. AB - In aortic valve stenosis, Doppler echocardiography enables reliable estimation of the orifice area with the use of the continuity equation. This study was carried out to determine the usefulness of the method in evaluation of prosthetic aortic valve area. Accordingly, 32 patients with normally-functioning mechanical Bjork Shiley prostheses underwent Doppler investigations two to three weeks after aortic valve replacement. Pre(v1)- and post(v2)-prosthetic velocities were recorded by pulsed and continuous-wave Doppler, respectively, and the prosthetic annulus used as cross-sectional area of flow (A1). For calculation of prosthetic orifice area (A2), the continuity equation at peak flow (v1,p) was employed where A2 = A1 X v1,p/v2 (at the point in time of v1,p). Mean pressure gradients across the prostheses were determined with the use of the modified Bernoulli equation. In addition, the ratio of acceleration to ejection time (AT/ET) was derived from the velocity profile of v2. Consistent with increasing prosthetic sizes (A 23 to A 29), there were increases in the calculated orifice areas A2 (A 23: 1.46 +/- 0.26, A 25: 1.71 +/- 0.24, A 27: 2.12 +/- 0.26, A 29: 2.53 +/- 0.35 cm2). Albeit with a substantial overlap between the various sizes, mean values for the respective sizes differed statistically significant and were comparably within the range established by in-vitro measurements. Pressure gradients across the prostheses were also different for the various sizes and were within the range reported from hemodynamic studies. In contrast, the AT/ET-ratio showed no significant difference between different prosthetic sizes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817728 TI - Tightening the reins on the tobacco industry. PMID- 3817729 TI - Trends in health personnel. PMID- 3817730 TI - Administrative medicine: a new medical specialty? PMID- 3817731 TI - Impact of increasing physician supply: a scenario for the future. PMID- 3817732 TI - Does increased physician supply affect quality of care? PMID- 3817733 TI - How many doctors are enough? PMID- 3817734 TI - Trends in the growth of family practice residency training programs. PMID- 3817735 TI - The effects of hospital ownership on nontraditional services. PMID- 3817736 TI - [Alteration in coagulation and fibrinolysis after burn injury and significance of anticoagulation therapy using heparin and antithrombin III concentrate]. AB - Burn injury causes dynamic alterations in the coagulation and fibrinolysis, and so-called DIC often occurs in burned patients. In this study the clinical significance of heparin therapy combined with antithrombin III concentrate in animal experiments and clinical experiences were discussed. The changes in blood coagulation, fibrinolysis and kidney function and the effect of anticoagulation therapy using heparin were investigated in rabbits with third degree burn covering 35% of the total body surface area. The animals were subjected to determinations for various kidney function tests, blood coagulation and fibrinolysis tests, blood viscosity and hematocrit value before induction of the burn and after 8 and 24 hours respectively. Thirty rabbits were divided into a non-therapy group, an intravenous infusion group, a heparin group, an antithrombin III group, and an antithrombin III plus heparin group and the results were compared among them. Oliguria and a disturbance of kidney function were noted even at hour 8 after burn in the non-therapy group. In the intravenous infusion group urine volume was maintained well although the early stage of non oliguric renal insufficiency was noted. The changes noted in the intravenous infusion group were prevented almost completely in the heparin group at hour 8, but FENa and CH2O were elevated at hour 24 probably because antithrombin III activity was depressed markedly. In the antithrombin III group and the antithrombin III plus heparin group, however, creatinine clearance was moderately elevated while FENa and CH2O remained unchanged as compared with the values before the burn. The antithrombin III plus heparin group showed slightly better results than the antithrombin III group in Ucr/Pcr ratio, creatinine clearance and CH2O. The results of the present study indicate that it is extremely effective to initiate appropriate fluid infusion therapy immediately after a burn and administer antithrombin III concentrate in combination with or without heparin for the prevention of acute renal insufficiency in patient with a severe burn. The effects of antithrombin III concentrate when used clinically were also discussed. PMID- 3817737 TI - [Kinetics of hemopoietic stem cells in hypoxic culture]. AB - In an effort to develop more nearly optimal conditions for the clonal growth of hemopoietic stem cells (CFC, BFU-E, CFU-mix and Mast-CFC) iv vitro, I examined the influence of low oxygen tension (7% O2) on plating efficiency. The numbers of colonies derived from human bone marrow CFC increased by 1.7 fold in 7% O2 than under a gas phase containing air (19% O2). Bursts obtained from bone marrow BFU-E and mixed colonies from CFU-mix increased by about 2.5 fold in 7% O2. Total cell count of mixed colonies showed that the average cell per colony gassed with 7% O2 were 900 compared with 511 in 19% O2. However the subpopulation of CFC and composed cell type of mixed colonies were not different in the two gas phase. With mouse spleen cell in 7% O2 a dramatic increase in Mast-CFC numbers without 2 ME and decreased enhancement by 2-ME were seen. Blood gas analysis of human bone marrow showed a Po2 of 51.8 +/- 14.5 mmHg, which was close to O2 tension in culture media of gas phase contained 7% O2. These data showed that physiological O2 tension enhances hemopoietic stem cell proliferation in vitro, and that part of the enhancing effect by 2-ME is due to a prevention of O2 toxicity at 19% O2. PMID- 3817738 TI - Revascularization surgery for 28 patients with moyamoya disease--operative methods, outcome and postoperative angiography. AB - 51 times (sides) of reconstructive surgery using 28 patients with moyamoya diseases were evaluated concerning operative methods, outcome and postoperative angiographic findings. Twenty patients (72%) showed excellent results, 7 patients (25%) good and 1 patient (3%) poor. Development of collaterals shown on postoperative angiograms was excellent on 20 sides, good on 9 sides, and fair on 8. Abundant neovascularization was most commonly noted on angiogram in superficial temporal artery-middle cerebral artery bypass with encephalo-myo synangiosis. Encephalo-myo-arterio-synangiosis, devised by the authors, or encephalo-myo-synangiosis alone also produced preferable development of collaterals shown on angiogram. Superficial temporal artery-middle cerebral artery bypass alone was insufficient for development of neovascularization. PMID- 3817739 TI - [A new technique for proximal esophagography and quantitative analysis of pharyngeal function]. AB - The roentgenologic examination of the upper esophagus in somewhat difficult due to the rapid passage of barium. Therefore we designed a new technique for proximal esophagography, using magnetic video disc recorder and multiformat camera (VDR-MC technique). The video signal from fluoroscopic unit is led to video disc recorder (VDR) and after the examination have been finished the recorded images are transferred into multiformat camera, and then the images are copied sequentially on a sheet film VDR have a storage capacity, 600 frames per 20 seconds. The sequential pictures of barium swallowing in one deglutition movement are shown as the time-intervals of each 0.03 seconds on a sheet film. The movement of barium bolus in one deglutition will be demonstrated exactly and except any failure. This working process of VDR-MC technique in very simple and convenient, and when the reading and diagnosis of X-ray appearances, we can easily compare with the changes of each image. This is a characteristic merit of new technique. In order to examine the function of deglutition we designed a new technique by means of the dynamic pharyngo-esophagrams as before. The recorded dynamic images are transferred into multiformat camera and copied on a sheet film by the intervals of 0.03 seconds in turn. Viewing these sequential images the each measuring points are determined ane the barium transit times are calculated from the number of frames, and then transferred to the time in millisecond unit. According to the results of experiment, the measured values well correspond to that by EMG on the pharyngeal movement of deglutition. These quantitative analysis on the pharyngeal function and morphological diagnosis will be performed in easy procedure at the same time. The outline of the discussion about the advantages of this technique is as follows; The performance of the examination by new technique will be done with extreme easy. A difficult examination will be performed without failure and finished in a short time successfully. We can examine enough the patients who are not able to understand the doctor's indication, for example children and patients having hard hearing. In comparison with cinefluorographic unit, development of films, patient's position, observation and copy of images and storage of film, became extremely easy. A quantitative measurement on pharyngeal function was designed and the reproducibility of measurements was given proof. PMID- 3817740 TI - [Effect of splenectomy on cancers induced with ENNG (N-ethyl-N'-nitro-N-nitroso guanidine) in the alimental canal]. AB - The effect of splenectomy on cancers in the alimental canal induced with ENNG was investigated. Wistar rats were given 100 micrograms/ml ENNG in tap water ad libitum for four months. Splenectomy was carried out one month on group A (n = 19), two months on group B (n = 18), three months on group C (n = 19) and four months on group D (n = 16) after administration of ENNG. In the control group splenectomy was not performed and ENNG was only given. For the results, the size of tumors in group A and B rats were grossly reduced compared with group C and D rats. Histologically, epithelial tumors seemed to be differentiated in group A and B rats compared with those of group C and D rats. In the early stage when it was difficult to determine the tumors macroscopically and histologically, splenectomy seemed to inhibit the growth of alimental tumors induced with ENNG and splenectomy itself seemed to decrease the growth of alimental tumors induced with ENNG. PMID- 3817741 TI - [Clinicopathological studies on adenocarcinoma of the lung--relationship between subclassification based on cell origin and prognosis of surgical patients]. AB - The relationship between the light- and electron-microscopic subclassification of a tumor based on the morphological similarity to the cell origin and the prognosis of 67 surgical patients with adenocarcinoma of the lung was studied. The prognosis of patients with each subtype was different due to the frequency of metastasis into the lymph nodes. The bronchial gland cell type and the nonciliated bronchiolar cell type consisting of cuboidal cells showed a poorer prognosis than the bronchial surface epithelial cell type (both with and without mucus) and the nonciliated bronchiolar cell type composed of columnar cells. The more unfavorable type as far as prognosis was concerned frequently metastasized into the lymph nodes. In particular, the bronchial gland cell type metastasized into the mediastinal lymph nodes even if the tumors were small in size, and it included more fibrotic focus of the tumors. The cells of the bronchial gland cell type and the nonciliated bronchiolar cell type consisting of cuboidal cells were smaller in cellular size and were connected loosely, but they were arranged in a larger cluster. These findings might explain the reason why these cells frequently metastasized into the lymph nodes. The X-ray films revealed a characteristic appearance corresponding to the subtype. The radiographic findings of the patients with poorer prognosis tended to show three patterns of tumor shadows: more than 5 cm in diameter, dense with spicular radiation, ill marginated, faint and pseudomorphic with pleural indentation. Subclassification based on cell origin was considered to reflect the degree of malignancy of adenocarcinoma of the lung, and it seemed possible to assess the prognosis of the patients by chest radiographic manifestations. PMID- 3817742 TI - [Effects of hydrostatic pressure on cardiac function in human]. AB - Effects of hydrostatic pressure on cardiac function were measured by echocardiography and radiography. Seven normal subjects (three females and four males) aged from 21 to 45 years were performed echocardiography on long axis of the heart at standing position in air and in head-out water (36 degrees C) immersion. A same trials were done at long sitting position in four subjects (one female and three males). The measurement of cardiac functions was calculated by Pombo's method. A chest radiography of a normal male individual (45 years) was taken at the time of functional residual capacity of lung in air and in head-out water (36 degrees C) immersion. For taking the chest radiography in water and in air, a box made by wood was used. X-ray exposure was synchronized with R wave of electro-cardiogram. The end-diastolic left ventricular volume, end-systolic volume and cardiac output in water immersion were significantly increased to compare with that of in air. Mean +/- SD of these percent changes were 213 +/- 71% (p less than 0.005), 193 +/- 90% (p less than 0.05), 220 +/- 83% (p less than 0.005), respectively. A same results were obtained at long sitting position. There was no significant changes on the heart rate between in water and in air. The circumstance of the abdomen decreased significantly in water immersion in comparison to in air. The percent change was 94.4 +/- 3.1% (p less than 0.001). There was a significant correlation between percent changes of abdominal circumstance and percent changes of end-systolic left ventricular volume (r = 0.754, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817743 TI - [Radical transurethral resection of prostate for spinal cord bladder: its therapeutic effects and urodynamic evaluations]. AB - 89 spinal cord injury patients who had voiding disturbance and were refractory to conservative therapy, were treated by radical transurethral resection of prostate (radical TUR-P). We evaluated the therapeutic effects of this procedure using clinical, urographic and urodynamic studies. 80 of 89 cases attained satisfactory voiding parameters after radical TUR-P. Postoperative incontinence was not seen and in some cases incontinence was improved. The vesicoureteral reflux was abolished in 15 of 23 refluxing ureters and ameliorated in 3 ureters. Hydronephroureters were normalized in 9 of 10 cases. Urodynamically, vesical compliance was increased after radical TUR-P. Detrusor hyperreflexia was suppressed in 6 of 15 cases. Detrusor sphincter dyssynergia was abolished or suppressed in 25 of 31 dyssynergic patients. By referring to the neuroanatomy and physiology of the denervated urethra, why radical TUR-P works was ascribed to its possible "sympathectomy" effect. PMID- 3817744 TI - [A macroscopical observation of the nerves to the pelvic floor muscles, the obturator internus and the quadratus femoris in some mammals]. AB - Using dogs, cats, rabbits, guinea pigs and rats, the nerves to the Levator ani, the Coccygeus, the Obturator internus and the Quadratus femoris are observed and compared macroscopically. The main findings obtained are summarized as follows: The nerve to the Levator ani of dogs is one (95.0%) or two (5.0%) in number and arises most frequently from S2 and S3. That of rats is one in number and arises most frequently from S minus 1 (S-1) and S1. The nerve to the Coccygeus of dogs is one (70.0%) or two (30.0%) in number and arises most frequently from S2 and S3. That of rabbits is one (65.9%), two (24.4%) or three (9.7%) in number and arises most frequently from S2 and S3. The nerve to the Levator ani is observed in dogs and rats, but it is not observed in rabbits. The common trunk which is formed by the nerves to the pelvic floor muscles and the pelvic splanchnic nerves is observed in dogs and rats, but it is not observed in rabbits. The number of the nerves to the Obturator internus of dogs, cats and rabbits is either one or two. That of guinea pigs and rats is one. The number of the nerves to the Quadratus femoris of cats and guinea pigs is one. The common trunk which is formed by the originating root of the nerve to the Obturator internus and that of the nerve to the Quadratus femoris is observed in guinea pigs, but it is not observed in cats. The new classification in proposed according to the arising position of the nerve to the Obturator internus and the Quadratus femoris and classified into the following types: Type 1 (sciatic nerve type); the nerve arises from the main trunk of the sciatic nerve or it's originating root. Type 2 (transitional type); the nerve arises from the point where the bigeminal nerve joins the sciatic nerve. Type 3 (pudendal nerve type); the nerve arises from the pudendal nerve or it's originating root. The types most frequently observed are as follows; In dogs, cats, rabbits and rats the nerve to the Obturator internus is pudendal nerve type, and in guinea pigs it is transitional type. In cats the nerve to the Quadratus femoris is pudendal nerve type, and in guinea pigs it is transitional type. PMID- 3817745 TI - Glucagon-degrading activity in acid-ethanol extract of rat submandibular gland. AB - To investigate whether immunoreactive glucagon really exists in salivary gland, the integrity of glucagon radioimmunoassay was tested in the acid-ethanol extract of rat submandibular gland. Though immunoreactive glucagon was apparently measured in acid-ethanol extract of rat submandibular gland, the extract contained a significant amount of intact glucagon-degrading activity. The apparent % bound in radioimmunoassay highly correlated with the degradation of [125I] glucagon during incubation. Gel filtration profiles of [125I] glucagon incubated with acid-ethanol extract were the same as those of [125I] glucagon damaged by submandibular acid-saline extract. These data suggest that the immunoreactive glucagon in acid-ethanol extract is, as in the case of acid-saline extract, an artifact due to degradation of [125I] glucagon during radioimmunoassay. PMID- 3817746 TI - Noradrenaline, propranolol and adrenochrome interactions with the dynamic of haemolymph lipids in worker honeybees. AB - Injection of worker honeybees with noradrenaline, in vivo, depresses the haemolymph levels of phospholipid, steroid and triacylglycerols. The major fatty acids fraction shows large amplitude variations which seem to be dependent on several distinct factors. Adrenochrome exhibits a tendency to induce global hypoglycemic effects without evident correlation with the other hormones, whereas propranolol counteracts the effects of noradrenaline, particularly for phospholipids, steroids and diacylglycerols. The results suggest that the major lipoproteic complex is partly under the control of low specificity adrenoceptors. PMID- 3817747 TI - Adaptation of male and female rats to iodine deficiency. AB - The response of the hypothalamic pituitary axis to chronic iodine deficiency was compared in male and female Sprague-Dawley rats. The animals were kept on a low iodine diet for 12 weeks. Blood samples as well as thyroid and pituitary weights were obtained every two weeks. Baseline values of thyroid weight and serum thyroxine (T4) were similar in both sexes. However, females had lower serum TSH and higher serum triiodothyronine (T3), pituitary weight and pituitary TSH content. After initiation of the low iodine diet, both sexes showed similar decreases in serum T4 and similar increases of serum TSH and thyroid weight. Serum T3, pituitary weight and TSH content remained higher in females throughout the study. Pituitary TSH was directly correlated with serum TSH in both sexes. When adjusted for pituitary TSH and analyzed by a stepwise regression analysis, serum TSH was lower in females suggesting a difference in TSH secretion between males and females. Our studies demonstrate significant sex differences in the regulation of TSH secretion and maintenance of serum T3 level in response to a chronic stimulus. PMID- 3817748 TI - Effect of short- and long-term stress on plasma calcium and calcitonin in the rat. AB - Although hypocalcemia has been observed during stress, the cause(s) is still unknown. The effect of short- and long-term restraint stress on calcitonin (CT) secretion and on plasma calcium (Ca), inorganic phosphate (P), total protein (TP), and corticosterone (CORT) were investigated in the male and female Sprague Dawley rat. The rats were restrained in the supine position for two hours/day for either one day (STS) or for 14 days (LTS), and compared to normal controls (CON). Plasma Ca levels in both STS and LTS rats were significantly lower and mean plasma CORT levels in female stressed rats were significantly higher than those in sex-matched CON rats. However, mean basal levels of plasma CT did not differ among these three groups for either sex. Similarly, mean increment of plasma CT after Ca infusion (Ca 10 mg/100 g, i.v.) did not differ between STS or LTS rats and CON rats. These data reveal no causal relationship between CT and the hypocalcemia during either short-or long-term stressful stimuli. PMID- 3817749 TI - Glucose turnover in compensated hepatic cirrhosis. AB - Glucose turnover and recycling from glucose derived 3-carbon intermediates were examined in overnight fasted patients with compensated hepatic cirrhosis and in age- and weight-matched normal control subjects. Fasting blood concentrations of glucose, lactate and glycerol were similar in both groups but blood pyruvate (60 +/- 10 vs. 80 +/- mumol/l, P less than 0.05), blood alanine (0.23 +/- 0.02 vs 0.34 +/- 0.02 mmol/l, P less than 0.01) were decreased and serum insulin increased (19 [13-24]v 7 [4-11] mU/l, P less than 0.01) in cirrhotic subjects. Absolute glucose turnover, assessed by analysis of decay of [3H]-3-glucose specific activity was decreased in cirrhotic patients (8.1 +/- 0.6 v 12.1 +/- 0.7 mol/kg-1 min-1). Glucose "recycling", assessed by the difference between absolute glucose turnover and that given by [14C]-1-glucose data, was normal in cirrhotic patients suggesting that Cori cycle (glucose-lactate-glucose) activity was normal. These data support previous findings of decreased peripheral glucose utilisation and insulin resistance in cirrhotic patients. PMID- 3817750 TI - Variations in the size of growth hormone-antibody complexes. AB - Guinea pigs were immunized with extracted human growth hormone. Human sera were obtained after treatment with biosynthetic methionyl hGH. The size of hGH-anti hGH antibody complexes was determined from the sedimentation velocity at 100,000 g. At an excess of hGH over antibodies 8 S complexes were uniformly observed in human and guinea pig sera. S values between 11.8 and 15.6 were observed at antibody excess in individual guinea pig sera. Antibodies from humans treated with methionyl hGH formed smaller complexes (7.5 S). One patient with GH deficiency developed resistance to treatment. Complexes of 12.3 S were formed by his antibodies. HGH sustains the formation of antibody complexes containing more than three IgG molecules (15.6 S). It is discussed that human antibodies of higher diversity may form complexes larger than trimers which initiate the complement cascade. PMID- 3817751 TI - Congenital goiter sustaining normal level of serum triiodothyronine. AB - We attempted to elucidate the deficient site of thyroid hormone biosynthesis in the thyroid gland and the mechanism of sustaining normal T3 level in sera of a patient with congenital goiter. TY, a 8-yr-old boy, first noted the onset of a diffuse goiter at the age of 2. There was no clinical evidence of hypothyroidism except for the slight impairment of intellectual development and the awkward physical activity. BMR, T3-RSU and T4 showed low values (-13%, 20.8% and 2.2 micrograms/dl), but serum T3 was normal (180 ng/dl). Serum TSH was 18 microU/ml. The intrathyroidal T3 and T4 were slightly low. Thyroidal 131I uptake was high, but KSCN discharge test was negative. Percent distribution of 131I labelled amino acids in the pancreatin digested thyroid homogenate was 17.4% in MIT, 33.4% in DIT and 11.3% in T3 and T4. Thyroid iodide peroxidase activities in mitochondrial and microsomal fractions were slightly low (19.6 and 26.8 (normal: 32 +/- 3.0 and 37.4 +/- 9.5) mumoles/mg protein). The activity was not increased by the addition of hematin. Thyroglobulin was found to be normal. A biological half life of 131I labelled T4 was shorter (3.5 days) than that of the normal. Electron microscopic examination exhibited the increment and expansion of endoplasmic reticulum in the follicular cell. Low iodide peroxidase activity of this patient may correlate to low T3 and T4 level in the thyroid cell. Moreover, shortened biological half life of T4 implies that normal T3 level in serum is sustained by the accelerated conversion of T4 to T3 in peripheral tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3817752 TI - Urinary oxalate and calcium excretion in response to oral glucose load in man. PMID- 3817753 TI - Normal calcitonin secretion in acromegaly. AB - Calcium and phosphate metabolism has been studied in eight patients with active acromegaly. Plasma calcium, phosphate, alkaline phosphatase, creatinine and parathyroid hormone levels were in the normal range in all patients, while urinary calcium excretion, calcium/creatinine ratio and hydroxyproline were higher than in controls (p less than 0.01, p less than 0.01, p less than 0.02, respectively). Basal plasma calcitonin levels were in the normal range and stimulation with calcium (3 mg/kg body weight in 10 min) showed similar calcitonin responses in acromegalic and normal subjects. Our data show that in normocalcemic acromegaly with high bone turnover calcitonin secretion is not abnormal. PMID- 3817754 TI - Salivary cortisol for monitoring adrenal activity during marathon runs. AB - In non-elite male runners (n = 8), changes in adrenal activity were monitored by measurement of salivary cortisol in samples collected at 4-mile intervals during marathon runs. These changes were compared with those in similarly timed samples collected on rest days. Immediately prior to the Cardiff marathon, at 09.00 h, mean salivary cortisol concentrations (21.5 nmol/l) were higher than those in similarly timed rest day samples (14.9 nmol/l). Cortisol concentrations increased during the marathon, and although values at 25 miles were high (79.4 nmol/l), maximum values (87.9 nmol/l) were observed in samples collected 30 min after completion of the run. Some Cardiff marathon runners also participated in the Bristol marathon (n = 4) and a non-competitive event (n = 3). The changing pattern in secretory activity was similar in all events. The easy collection of saliva without cessation of exercise is ideal for monitoring the hormonal response to exercise. PMID- 3817755 TI - Methionyl- and pituitary derived human growth hormone have identical effects on the expression of growth hormone responsive rat hepatic mRNA. AB - Pituitary extracts of human growth hormone have been used extensively for therapy of growth hormone deficiency, although they are known to contain a variety of contaminating polypeptides. Biosynthetic human growth hormone is now available for this use and appears to be functionally identical in promoting growth. To establish additional criteria of identity we compared the effect of these two hormone preparations on a family of hepatic messenger RNA sequences in hypophysectomized adult male rats. Total hepatic RNA from these animals was translated in a cell-free rabbit reticulocyte lysate. Five translational products previously demonstrated to be responsive to ovine and methionyl-human growth hormone were found to be equally induced by pituitary derived human growth hormone, despite demonstrable heterogeneity in pituitary derived preparations. In addition, no significant alterations in approximately 200 non-growth hormone responsive translational products were identified. Methionyl and pituitary derived growth hormone have identical effects on the expression of hepatic mRNA. PMID- 3817757 TI - Depressed progesterone accumulation by the brain and peripheral tissues of diabetic C57BL/KsJ mice: normalization by estrogen therapy. AB - The effects of diabetes on the uptake and incorporation of 3H-progesterone (P) in various brain areas and peripheral tissues were analyzed in C57BL/KsJ mice. Littermate control (+/?) and diabetic (db/db) mice were pulse-treated (60) min with 10 mu Ci of 3H-P at either 8 or 16 weeks of age. Subsequently, the peripheral tissues and brains were dissected, weighed, digested and the amount of incorporated 3H-P assessed. The pituitary, amygdala, septum and hypothalamus were found to concentrate the highest levels of 3H-P of all the brain areas examined. The brain areas of 16-week-old (+/?) mice accumulated higher concentrations of 3H P than the comparable 8-week-old brain tissues. In addition, all the brain areas of 8-week-old (db/db) mice accumulated equal or more 3H-P than the comparable (+/?) brains. By 16 weeks of age, however, the 3H-P accumulation rate was significantly higher in all brain areas of (+/?), as compared to (db/db), mice. Of the peripheral tissues examined, the ovary, uterus, pancreas, kidney and mesometrial fat pad consistently exhibited the highest rates of 3H-P accumulation in both (+/?) and (db/db) mice. By 16 weeks of age, all peripheral tissues of (+/?) mice exhibited greater accumulation rates of 3H-P than the comparable (db/db) tissues. Following 4 days of estradiol treatment (10 micrograms/day s.c.), the 3H-P accumulation rates in 16-week-old (+/?) and (db/db) brain were essentially equal. Only the hypothalamus, septum and amygdala of the (db/db) mice failed to normalize to (+/?) levels following estradiol treatment. In a similar manner, the pancreas, uterus, ovary and fat of (db/db) mice exhibited 3H-P accumulation rates similar to those of (+/?) mice following estradiol treatment. These data indicate that estradiol therapy effectively normalizes the normal age- and diabetes-related declines in brain and peripheral tissue sensitivity and/or responsitivity to progesterone in C57BL/KsJ mice. PMID- 3817756 TI - Characterization of molybdate-stabilized estrogen receptors by hydrophobic interaction HPLC: resolution of two 8S subunits. AB - This report describes the separation and characterization of estrogen receptors (ER) according to their degree of hydrophobicity and surface charges. Molybdate stabilized [3H]ER from rabbit uterine cytosol was sequentially purified by passage through a size-exclusion pre-column, an anion-exchange column, and a hydrophobic interaction column. With fresh cytosol, a major radioactive peak was eluted from the DEAE columns; a major peak and a minor, less hydrophobic, peak were eluted from the hydrophobic column. In contrast, ER from frozen cytosol showed one peak in the DEAE-column and exhibited four radioactive peaks in the hydrophobic column. By sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis, [3H] tamoxifen aziridine(TA)-labelled ER showed radioactive bands at 62 and 48 kd. The subunits which were characterized by these radioactive bands were successfully separated by the hydrophobic column; the more hydrophobic subunit corresponded to the 62 kd band. The HPLC-purified [3H]TA-labelled ER subunits sediment at a 7.4-8.5S region in a low-salt sucrose gradient. These results show that differential negative surface charge and hydrophobic areas exist in the holo receptor and its subunits, and the hydrophobic interaction HPLC column separates the two major 8S steroid binding subunits of ER. PMID- 3817758 TI - Calcium antagonists and hormone release. V. Effects of a calcium-antagonist (verapamil) on pituitary hormone release in hypersecretory states. AB - Twenty-five patients with various syndromes of pituitary hyperfunction, of tumoral and nontumoral origin, were infused with verapamil (VE), a Ca2+-channel blocker (5 mg/h X 3 h) to assess the calcium dependence of the augmented hormone secretion. In 5 hypogonadal women with elevated gonadotropin secretion, VE produced a marked inhibition of LH (54.6%) and FSH (49.4%) release, comparable to that observed in normal subjects who were infused with VE. In 5 patients with latent or mild hypothyroidism, TSH levels decreased during the VE infusion, and the magnitude of the decrease was directly correlated with the basal levels (r = 0.986, p less than 0.01). In patients harboring a pituitary tumor, differential effects of VE infusion were observed: it induced an inhibition (28.5%) of ACTH secretion in patients with Cushing's disease; in acromegalic patients, no alterations in HGH levels were noted; on the contrary, in prolactinoma patients, a clear PRL increment (47.2%) was present. These experiments confirm that the need for extracellular Ca2+ varies from hormone to hormone and that VE infusion can modify the secretion of pituitary hormone in a hypersecretory state, as well as those hormones which are unaffected by VE infusion in basal condition. PMID- 3817759 TI - Absence of anti-Mullerian activity of inhibin in the chick embryo. AB - Inhibin extracted from bovine follicular fluid and administered to chick embryos at a dosage increasing from 0.4 to 30 micrograms per embryo did not induce the regression of the Mullerian ducts of treated females. This result contrasts with that obtained with a testis graft which acts through its anti-Mullerian hormone. Although both hormones were of glycoproteic nature and secreted by the same cells, this study shows no functional analogy between them. PMID- 3817760 TI - Effect of two-week infusion of deamino D-arginine vasopressin in rats. AB - Our purpose was to investigate a method of prolonged desmopressin (DDAVP) infusion in a free roaming rat to better understand the SIADH (syndrome of inappropriate antidiuretic hormone secretion) syndrome in man. DDAVP was infused for 2 weeks from implanted self-powered osmotic minipumps. At the end of that time, plasma DDAVP and urine osmolality were both significantly elevated in experimental as compared with control animals. However, hyponatremia and hypoosmolality, which are characteristic in the SIADH, did not develop. Our observations suggest that inappropriate high antidiuretic hormone levels do not necessarily lead to the SIADH either by urine sodium loss or by water retention if animals decrease water intake. PMID- 3817761 TI - Patterns of basement membrane deposition in benign and malignant breast tumours. AB - We have examined epithelial basement membranes in tissue samples of seven normal breasts, 64 benign breast lesions and 63 malignant breast tumours by immunocytochemistry, using polyclonal antisera specific for type IV collagen. In normal breast tissue as well as in all benign tumours a continuous basement membrane was found at the epithelial stromal interface. In benign proliferative lesions, epitheliosis and papillomatosis could be more accurately distinguished with basement membrane staining. This approach also facilitated the differentiation between sclerosing adenosis and tubular carcinoma, since the tubules in sclerosing adenosis are surrounded by a continuous basement membrane whereas in tubular carcinoma basement membranes are almost entirely absent. In radial scar lesions the tubules were always surrounded by intact basement membranes, which underlines the fact that these are benign lesions. In breast carcinoma we could not detect a relationship between histological grade and the extent of basement membrane deposition. However, in different tumour types the basement membrane alterations varied. In infiltrating lobular carcinoma of the alveolar type, fragments of basement membrane were found, whereas in the classic and trabecular type, basement membranes were absent, suggesting that the alveolar type may be an intermediate phase in the progression of lobular carcinoma in situ to infiltrating lobular carcinoma. It is concluded that basement membrane immunocytochemistry, using antibodies to type IV collagen, is useful in the differentiation between benign and malignant breast lesions and in the classification of breast neoplasms. PMID- 3817762 TI - The prognostic value of sulphomucin positive intestinal metaplasia in the development of gastric cancer. AB - Gastric biopsy specimens from 230 patients with chronic atrophic gastritis were investigated with the use of mucin stains for the presence and type of intestinal metaplasia. Metaplasia was not shown in 59 cases; 92 of the 171 cases with metaplasia were sulphomucin positive and 79 were negative. The patients were followed-up from 1976 to 1985. Eight patients were registered as having gastric cancer over this period. However, five of them had to be eliminated from the study because on careful review of all the clinical data it was clear that they had gastric cancer at the time of the biopsy. Two of the three remaining patients had sulphomucin negative biopsies. Thus, only one patient out of 90 with chronic atrophic gastritis and sulphomucin positive intestinal metaplasia developed gastric cancer when followed-up for 8-9 years. None of the patients with unequivocal type IIb metaplasia developed gastric cancer. We conclude that sulphomucin positive intestinal metaplasia does not identify a high risk group and its recognition is thus of no value in surveillance for gastric cancer. PMID- 3817763 TI - Secretory component in pulmonary adenocarcinoma and mesothelioma. AB - The distribution of secretory component was examined by an immunoperoxidase method in 40 pulmonary adenocarcinomas, 11 malignant pleural mesotheliomas and areas of normal lung adjacent to the tumours. Secretory component was demonstrated in tumour cells in 25 (67%) adenocarcinomas. Its presence correlated with the degree of differentiation but was not related to tumour pattern. In the normal lung secretory component can be demonstrated in bronchial ciliated cells, bronchial gland serous cells, bronchiolar epithelium and hyperplastic alveolar epithelium. Although not usually detectable in normal mucous cells it was frequently present in mucin-producing tumours. None of the mesotheliomas examined contained secretory component and this may be an additional useful feature in the differential diagnosis between mesothelioma and adenocarcinoma. PMID- 3817764 TI - Spitz naevi and malignant melanomas of childhood and adolescence. AB - We reviewed 33 cases of Spitz naevus and 19 of malignant melanoma in patients aged 20 years or less who were evaluated at our institution from 1950 to 1975 and followed-up for up to 32 years. The histological findings were studied prior to review of clinical data. There were no malignant melanomas in patients less than 9 years old; almost half (15/33) of the Spitz naevi were in this age group. Among the 25 histological criteria evaluated in the 52 lesions, the most striking differences between malignant melanomas and Spitz naevi were a higher degree of pagetoid spread, cellular pleomorphism, nuclear hyperchromasia and mitotic activity in the malignant melanomas, and a more prominent spindle cell component in Spitz naevi. We stress the importance of cytological as well as architectural criteria in distinguishing between Spitz naevi and malignant melanomas and emphasize the pitfalls that may be encountered because of overlap in histological features between the two groups. PMID- 3817765 TI - Humana boosts its receivables through ECP. PMID- 3817766 TI - Medical care inflation alarms may be premature. PMID- 3817767 TI - Uncompensated care costs rise nationwide. PMID- 3817768 TI - A genesis: advertising low death rates. PMID- 3817769 TI - Change the HMO Act? Congress is busy elsewhere. PMID- 3817770 TI - Nurses applaud court's push for maternity leave. PMID- 3817771 TI - CA hospitals riled by surgicenter inpatient project. PMID- 3817772 TI - Corporate restructuring opens referral avenues. Interview by Myk Cherskov. PMID- 3817773 TI - Avoid three common myths when buying an HIS. PMID- 3817774 TI - Multis pessimistic about indigent care issue. PMID- 3817775 TI - Survey prompts call for defining indigent care. PMID- 3817776 TI - Nursing enrollment decline is everyone's problem. PMID- 3817777 TI - Right to die: public balks at deciding for others. PMID- 3817778 TI - More outpatient services may not up profits: study. PMID- 3817779 TI - CEOs cite ways to improve medical staff relations. PMID- 3817780 TI - VA adopts no-fault birth injury pool. PMID- 3817781 TI - Technology winners, losers under capitation. PMID- 3817783 TI - Quality of care tops AHA chairman's agenda. PMID- 3817782 TI - DP hires, wages to outpace average until 1990. PMID- 3817784 TI - Are purchasing practices hurting your cash flow? PMID- 3817785 TI - Insurers dabble in stop-loss policies for hospitals. PMID- 3817786 TI - Hospital ads in bounds legally. PMID- 3817787 TI - What's ethical in health care advertising? PMID- 3817788 TI - Hospital ad spending slows in fourth quarter of 1986. PMID- 3817789 TI - Mistakes can be fatal to sales. PMID- 3817790 TI - HMO review bidders stew over delayed RFP. PMID- 3817791 TI - Consolidation afoot among Chicago HMOs. PMID- 3817792 TI - UR contracts can lead to HMO coverage later. PMID- 3817793 TI - Risk contracts require key legal considerations. PMID- 3817794 TI - TN struggles with antidumping rules. PMID- 3817795 TI - Suppliers as employers: a business conflict? PMID- 3817796 TI - Flexible benefits: a catastrophe for providers? PMID- 3817797 TI - Multis, vendors reexamine payment policies. PMID- 3817798 TI - Application of RNA-RNA tissue in situ hybridization in an analysis of a patient with leukemia. AB - RNA-RNA tissue in situ hybridization is a relatively new technique that detects gene expression in individual cells. In this report we compare and contrast the technique with conventional biologic analysis. We illustrate how this technique could function as a diagnostic tool by applying it to a 58-year-old man with a four-month history of lymphadenopathy and peripheral lymphocytosis. RNA-RNA tissue in situ hybridization performed on sections of one of this patient's lymph nodes and on cytospins of his peripheral blood demonstrated the presence of an apparent monoclonal population of B cells producing mu and lambda immunoglobulin (Ig) messages in the lymph node and peripheral blood as well as a T-cell population in the lymph node only. These results were corroborative and complementary to conventional DNA (Southern) and RNA (Northern) analyses. The data were consistent with the diagnosis of chronic lymphocytic leukemia (CLL). With the use of this technique, an intriguing pattern of cellular heterogeneity was observed within the mu-lambda population of cells in the lymph node. A subset of these cells appeared to express a much greater amount of immunoglobulin message and to cluster around the lymph node vessels. The combination of RNA-RNA in situ hybridization and routine histopathology has the potential for providing an additional dimension to tumor analysis. PMID- 3817799 TI - Exogenous pigment in Peyer's patches. AB - Dark brown granular pigment was found consistently in macrophages in the deep aspect of adult Peyer's patches. Tissue sections from intestinal resections of 35 patients with a variety of pathologic diagnoses and of seven postmortem cases with no evidence of gastrointestinal disease were examined for the presence of this pigment. It was found in all patients over the age of 6 years (34 cases) but was not found in any children below that age (eight cases). Scanning electron microscopy with secondary and backscattered electron imaging and x-ray energy spectroscopy were performed on routine histologic sections. The pigmented macrophages contained aluminum and silicon, diffusely present throughout the cytoplasm, and numerous discrete foci of titanium. Pigment containing these same elements has also been found around dilated submucosal lymphatics, in mesenteric lymph nodes, and in some transmural inflammatory aggregates of Crohn's disease. The pigment probably is derived from the diet and actively taken up by Peyer's patches, which are able to incorporate inert particulate matter. PMID- 3817800 TI - Optimal examination of the normally formed perinatal heart. AB - Because infants rarely suffer coronary artery thrombosis, it is mistakenly assumed that they seldom have significant ischemic myocardial injury. However, ischemic myocardial necrosis (INM) is common in the papillary muscles and subendocardium of stressed newborns and other infants. Standard dissection methods encourage only routine examination and limited sampling of the small perinatal heart, and most myocardial injury is never discovered. After evaluating published methods, a simple technique was developed to open and prepare the normally formed infant heart for optimal macroscopic and microscopic evaluation. Symmetrical anterior incisions of the atria and ventricles allow the atria, ventricles, and outflow tracts to be viewed almost simultaneously. A single change allows the heart to be "unrolled" into a plane for roentgenographic study of injected coronary arteries. The method for sampling the myocardium and the conduction system allows identification of more than 90 per cent of the IMN sites without adding significant costs. The recognition of significant IMN plays a valuable role in evaluating and explaining certain infant deaths. PMID- 3817801 TI - Endocrine inactive pituitary carcinoma metastasizing to cervical lymph nodes: a case report. AB - A 64-year-old woman experienced an episode of disorientation in relation to time, place, and people, as well as of visual defect and impaired balance. Physical examination showed a bitemporal hemianopsia and truncal ataxia. Computerized tomography of the skull revealed a sellar mass consistent with the diagnosis of pituitary adenoma. The patient progressively lost consciousness and died. At postmortem examination, a pituitary neoplasm with arachnoid metastases was present. Metastatic cervical lymph nodes were also detected. Histologic aspects of the primary tumor and of lymph node metastases were quite similar. Immunohistochemical investigation revealed the epithelial origin of the neoplasm and failed to disclose endocrine activity. At ultrastructural examination, the cells of the primary tumor and of the metastases lacked specific granules. These findings support the evidence of a primary metastasizing pituitary carcinoma. PMID- 3817802 TI - Sinus of Valsalva aneurysm associated with multiple conotruncal congenital malformations. AB - A case of rupture of a sinus of Valsalva aneurysm in a middle-aged woman with an unusual assortment of associated conotruncal and other cardiac anomalies is reported. The anomalies included bicuspid aortic valve, aortic sinus aneurysm (ruptured), quadricuspid pulmonic valve, membranous coarctation of the aorta, subclavian and common carotid arteries arising directly from aorta, and atrial septal defect. Excluding the atrial septal defect, these anomalies may be explained by a single embryologic event affecting conobulbar septation and aortic arch development occurring at the level of neural crest development. PMID- 3817803 TI - Keratoacanthomas presenting as squamous cell carcinomas. PMID- 3817804 TI - Subclassification of follicular lymphomas by computerized microscopy. AB - The pilot feasibility study reported was carried out to determine whether computerized morphometry could be used to discriminate between different subtypes of follicular lymphomas. Thirteen cases of follicular lymphomas of the small cell and large cell types were examined by map-guided computerized microscopy. Initially, each specimen was digitized over a 5,120- X -5,120-microns area. Follicle maps depicting well-defined follicles were generated from these digitized images and used to guide a robot microscope to examine follicular center cells using from 20 to 100 fields, each 160 X 160 microns. Mathematical morphology was used to estimate the number of connected regions within each field examined. Based on the assumption that each connected region corresponded to a cell nucleus, it was expected that the number of connected regions found per unit area would correlate with the number of cells per unit area. Three prototypical small cell lymphomas and three prototypical large cell lymphomas were used as a training set to calibrate the methodology. Data obtained on these prototypical cases were used to establish statistical decision boundaries. Seven test cases, judged to be less typical but classifiable by experts, were then examined. Five of the seven were classified correctly, and the remaining two were identified as outliers. These results suggest that subclassification of follicular lymphomas may be aided by computerized microscopy. This pilot feasibility study is currently being expanded using a much larger sample of case material. PMID- 3817805 TI - Cystic malformation of the bowel. PMID- 3817806 TI - Different reactivity of Z-DNA antibodies with human chromosomes modified by actinomycin D and 5-bromodeoxyuridine. AB - Antibodies against Z-DNA react with fixed metaphase chromosomes of man and other mammals. Indirect immunofluorescence staining shows that chromosomal segments corresponding to R- and T-bands preferentially fix Z-DNA antibodies. In this work Z-DNA antibodies were used as a probe for DNA conformation in euchromatin of fixed human chromosomes whose condensation or staining were modified by actinomycin D (AMD) and by 5-bromodeoxyuridine (BrdU). Treatments with AMD and BrdU were performed to induce a G-banding by modification of chromosomal segments corresponding to R- and T-bands. Long BrdU treatments were used to induce asymmetrical and partially undercondensed chromosomes by substitution of thymidine in one or both DNA strand. Our results show a clear difference of Z-DNA antibodies reactivity after AMD or BrdU treatment. The G-banding obtained after AMD treatment is not reversed by Z-DNA antibodies staining since these antibodies bind very weakly to the undercondensed R-bands. On the other hand, the G-banding obtained by BrdU is completely reversed giving typical R-banding, as on untreated chromosomes. For asymmetrical chromosomes an R-, T-banding pattern is always observed but there is a decrease of the fluorescence intensity proportional to the degree of BrdU incorporation. We conclude that AMD treatment greatly disturbs Z-DNA antibodies binding suggesting a change in DNA conformation, whereas BrdU treatments do not suppress but only weaken the specific binding of Z-DNA antibodies on R- and T-bands. The direct involvement of thymidine substitution in DNA sequences recognized by Z-DNA antibodies is discussed. PMID- 3817807 TI - Nucleolus, nucleolar chromosomes, and nucleolus-associated chromatin from early diplotene to dictyotene in the human oocyte. AB - The shape, relationships, relative DNA content, and nucleolar activity of the short arm of acrocentric bivalents were studied in human oocytes from early diplotene to dictyotene. At the beginning of diplotene, the short arms of the previously paired chromosomes were again separated and displayed the same morphological features as in mitotic prophase chromosomes. They were connected only with the nucleolus. In situ hybridization and silver staining showed that the nucleolar organizer regions (NORs) were located in the peripheral region of the nucleolus. Tritiated-uridine incorporation was active. At birth, the relationships of the acrocentric short arms showed increasing complexity. The chromosomes ended in nucleolus-associated chromatin blocks of irregular shape, containing large quantities of DNA as demonstrated by intense binding of 3H actinomycin D. The number of chromosomes converging on these chromatin blocks exceeded the number of acrocentrics, suggesting that heterochromatic regions of other chromosomes were associated with the short arm of acrocentrics. In the electron microscope, the NORs were represented by fibrillar centers located on the periphery of the nucleolus and consistently connected with the blocks of dense chromatin. These relationships remained unchanged in the primordial oocyte in the adult ovary. Persistence of 3H-uridine uptake showed that the oocyte was not at a "resting" stage. The possible cytogenetic consequences of these observations are discussed. PMID- 3817808 TI - Size variation in kinetochores of human chromosomes. AB - Aneuploidy, the loss or gain of chromosomes from cells, is likely in many cases to involve the kinetochore, the site of attachment of spindle microtubules. We analyzed human fibroblast cells with antikinetochore-antibody indirect immunofluorescence, and noted an apparent heterogeneity in the sizes of kinetochores among different chromosomes. The Y chromosome in particular always showed minute kinetochores, an observation which was quantified and substantiated using computer-assisted image analysis. This finding, combined with literature reports about in vivo and in vitro involvement of the Y chromosome in aneuploidy, was used to frame a novel hypothesis about the generation of chromosome imbalance. PMID- 3817809 TI - Posttreatment with sodium arsenite is coclastogenic in log phase but not in stationary phase. AB - Posttreatment with sodium arsenite in log phase synergistically increases the chromosomal aberrations induced by ethyl methanesulfonate in Chinese hamster ovary cells, human fibroblasts, and human lymphocytes. However, posttreatment with sodium arsenite in stationary phase has no apparent effect on the clastogenicity of ethyl methanesulfonate. These results indicate that the cycling state of the cell plays a crucial role in the action of arsenite coclastogenicity. One prediction from this finding is that in combined treatment, posttreatment with sodium arsenite should preferentially kill cancer cells. PMID- 3817810 TI - Genetic and clinical studies on 19 families with adenine phosphoribosyltransferase deficiencies. AB - Adenine phosphoribosyltransferase (APRT) deficiency leading to 2,8 dihydroxyadenine (DHA) urolithiasis has been considered a rare cause of urolithiasis and renal insufficiency. We have examined samples from 19 Japanese families with DHA lithiasis. In 79% of the families, patients only partially lacked hemolysate APRT activities, clearly contrasting with the complete deficiency in all the patients from non-Japanese families so far reported. All patients with DHA lithiasis were homozygotes for defective APRT genes, whether the deficiency was complete or partial. In family studies we found two symptomatic and four asymptomatic homozygous family members. The segregation figures are compatible with the hypothesis of a simple autosomal recessive mode of inheritance. By analyzing the data stored by a large clinical laboratory in Japan, we estimated that 0.00368% of the general population has DHA lithiasis. These data indicate that more than 1% of the general population possess mutant alleles of the APRT gene as heterozygotes. Our present studies indicate that most of the patients with this disease are undiagnosed in Japan, and probably in other countries also. PMID- 3817811 TI - X-chromosomally inherited split-hand/split-foot anomaly in a Pakistani kindred. AB - A Pakistani kindred comprising seven generations and 36 members with the split hand/split-foot anomaly is described. The full expression of the trait, monodactylous or split hand and split foot, mainly of the lobster-claw type, was present in 33 males and 3 females. Other females showed a distinctly milder expression of the trait, usually in the form of partial syndactyly, metacarpal and phalangeal hypoplasia, and malformation. The distribution of the affected members in the pedigree is compatible with X-chromosomal inheritance. Hemizygous males and presumably homozygous females exhibit the typical split-hand/split-foot anomaly, whereas only a part of the obligatory heterozygous females show the milder expression. There were no associated anomalies, such as ectodermal dysplasia, cleft lip/palate, macular degeneration, malformations of the long bones or internal organs, and overt mental retardation. PMID- 3817812 TI - Does "ring syndrome" exist? An analysis of 207 case reports on patients with a ring autosome. AB - Analysis of 207 case reports on patients with ring autosome showed that: Forty patients, a fifth of the total, had extreme growth failure together with an otherwise almost-normal appearance, viz. no major malformation, no specific deletion syndrome, no or only a few unspecific minor anomalies. This phenotype may be regarded as the "ring syndrome", a term proposed by Cote et al. (1981) since it is independent of what chromosome is involved. Severe growth failure, the sole major physical abnormality in the "ring syndrome", was seen significantly more often among patients with ring of larger chromosomes than among patients with a smaller ring, indicating that the greater the chromosome involved in ring formation, the higher is the probability of severe growth failure. Larger ring chromosomes showed significantly more often instability than smaller rings, suggesting that there may be a correlation between ring instability and the size of the chromosome involved. Growth failure was present in significantly more patients with a "labile" ring than with a "stable" ring, indicating that a correlation may exist between ring instability and growth failure. It is suggested that the "ring syndrome" observed in many cases with ring autosome may result from end-to-end fusion of chromosome ends, an event not involving deletion in the genetic sense. It is also suggested that the "ring syndrome" is caused by a continuous generation of secondary aneuploid cells with increased mortality, i.e. structural ring instability which seems to be a function of the size of the chromosome involved. Thus, formation of a ring chromosome in certain cases might be regarded as a "structural mutation", i.e. an alteration in the structure of the genetic material per se, rather than a loss or gain of genetic dosages. PMID- 3817813 TI - A new case of familial paracentric inversion of chromosome 2. AB - A phenotypically otherwise normal homosexual man with a 46,XY,inv(2)(q21q33) karyotype inherited from his mother is described. The breakpoints were different from those observed in the only other case of familial paracentric inversion of chromosome 2 reported in the literature, but in our case they seem to correspond to constitutive and aphidicolin-induced fragile sites. PMID- 3817814 TI - Relation between incidence of gonorrhoea in Sheffield and efficiency of contact tracing: a paradox? AB - An attempt has been made to correlate the yearly incidence of gonorrhoea in Sheffield (1979-85) with two variables to show contact tracing efficiency: infectious patient days (days from the start of contact tracing to the attendance of contacts) and the percentage of source contacts brought to investigation within 30 days. No such correlation has been found. The possible reasons for this, which include the unreliability of incidence figures as a sole criterion of control and the organisation of contact tracing activities, are discussed. PMID- 3817815 TI - Reduction of cell mediated immunity in patients with genital warts of long duration. AB - Cell mediated immunity was studied by a leucocyte migration inhibition assay and by tuberculin and dinitrochlorobenzene skin tests in 30 patients with recurrent genital warts and in 34 healthy people (with no history of genital warts) who served as controls. Migration inhibition was significantly less in patients suffering from recurrences for more than one year than in controls (p less than 0.001). Dinitrochlorobenzene and tuberculin sensitivity were also found to be impaired in those with infection of long duration (p less than 0.001). PMID- 3817816 TI - Malignant melanoma of prepuce: case report. AB - A 58 year old man presented with what seemed to be a simple penile lesion, but which on subsequent histological examination proved to be a malignant melanoma. The lesion was excised by circumcision. No further treatment was considered to be necessary. PMID- 3817817 TI - Quinolones in non-gonococcal urethritis. PMID- 3817818 TI - Clotrimazole pessary compared with cream in treating women with vaginal candidosis. PMID- 3817819 TI - Survey of medical undergraduate teaching in genitourinary medicine in Britain. PMID- 3817820 TI - Prevalence of chlamydial infection in acute epididymo-orchitis. AB - The prevalence of sexually transmitted infection was studied in 40 men presenting with acute epididymo-orchitis in Leeds. Chlamydia trachomatis infection was identified in 13 of 29 men (45%) aged under 35 years. Neisseria gonorrhoeae was isolated from four of these 13 men with chlamydial urethritis. C trachomatis was isolated from the urethra of only one of 11 men (9%) aged over 35. Appreciable bacteriuria was found in six of these 11 men (55%). Noting details of sexual history and screening for sexually acquired pathogens is advocated in younger men with acute epidiymo-orchitis. PMID- 3817821 TI - Transmission of chlamydial infections to sexual partners. AB - The incidence of chlamydial infections was studied in 33 male and 48 female regular sexual partners of 81 patients attending a sexually transmitted disease clinic who had chlamydial infections. Chlamydia trachomatis was isolated from 42% of the male partners and 62% of the female partners (p greater than 0.05). The number of infected partners was independent of the incidence of sexual intercourse and of the presenting symptoms. The use of condoms was the only contraceptive method that seemed to lower the risk of transmission of chlamydial infection. If diagnostic facilities for C trachomatis are not available, and sexual partners of patients with chlamydial infection are treated epidemiologically, a high proportion of both men and women may be treated unnecessarily. PMID- 3817822 TI - Evaluation of single whole inclusion serum test for IgG antibody to Chlamydia trachomatis in asymptomatic women. AB - IgG antibody titres against Chlamydia trachomatis were measured using a whole inclusion assay (Electro-Nucleonics Laboratories, Bethesda, Maryland, USA) in single serum samples of patients who presented for termination of pregnancy with evidence of infection with this organism (case group) and of 30 women with no evidence of infection (control group). Case and control patients were matched for age, race, marital status, history of sexually transmitted diseases, number of lifetime sexual partners, and whether they had had a new sexual partner in the preceding month. Fifty eight of 60 (97%) serum samples tested had chlamydial antibodies present at a titre of 1/8 or more. There was no significant difference between the geometric mean titres of the 30 case patients and the 28 controls with chlamydial antibodies (1/161.3 and 1/77.4 respectively). Significantly more case patients than controls, however, had a titre of 1/128 or more (p less than 0.01). The sensitivity, specificity, and positive and negative predictive values of a single serum antibody titre of 1/128 or more as an indicator of recent infection compared with isolation of the organism in cycloheximide treated McCoy cells or antigen detection by Chlamydiazyme (Abbot Laboratories; North Chicago, Illinois, USA), or both, were each 67%. The value of the antibody assay seems to be questionable as high levels of antibodies failed to correlate with isolation or antigen detection results, or both, in our population. PMID- 3817823 TI - Survey of diagnostic facilities for Chlamydia trachomatis and herpes simplex virus, 1984. British Co-operative Clinical Group. AB - During 1984 the British Co-operative Clinical Group undertook a survey of genitourinary medicine clinics in the United Kingdom to assess the availability of laboratory diagnostic facilities for Chlamydia trachomatis and herpes simplex virus. Of the 115 clinics assessed, 68% (78) had adequate facilities for culture for C trachomatis and 87% (100) for herpes simplex virus. PMID- 3817824 TI - Cervical cytology screening in sexually transmitted diseases clinics in the United Kingdom. British Co-operative Clinical Group. AB - During a three month prospective study in 116 sexually transmitted disease (STD) clinics throughout the United Kingdom, out of 17,261 women who underwent cervical cytology, 1167 had dysplastic smears and 115 had positive smears. Positive smears were more prevalent in women attending Welsh clinics than elsewhere in the United Kingdom and increased in incidence with rising patient age. Of all cytological abnormalities reported, 56% of dysplastic smears and 33% of positive smears were found in women aged under 25 years. A subsequent retrospective study in 10 teaching hospitals suggested that past or present genital warts were associated with these cytological abnormalities of the cervix, especially in younger women. PMID- 3817825 TI - Sigmoidoscopy--a necessary procedure in the routine investigation of homosexual men? AB - In a study to assess the value of sigmoidoscopy in the routine investigation of homosexual men, this procedure was undertaken on 1118 men who attended a sexually transmitted diseases clinic as "new" or "return new" patients. Serious rectal disease was not identified in any of the 557 men who were symptomless at the initial attendance. Though the extent of the proctitis diagnosed in 166 men would not have been defined, 99% (465) of 470 anorectal lesions would have been identified if proctoscopy alone had been performed. It is concluded that sigmoidoscopy does not have a role in the routine investigation of homosexual men. PMID- 3817826 TI - Pseudoelephantiasis induced by donovanosis. AB - In a recent survey the incidence of pseudoelephantiasis induced by donovanosis was found to be 5%. The ratio of women to men was 3:1. The incubation period was two to 20 days, and the duration was two to 24 months. The disease was contracted through premarital or extramarital sexual intercourse. The morphological features were characterised in women by globular pedunculated verrucous surfaced swellings affecting the labia majora and the clitoris and accompanying ulceration or its aftermath (depigmentation), or both. Constitutional symptoms were absent. Intracytoplasmic Donovan bodies in the tissue or a smear from the ulcers were diagnostic. Immune markers, such as total T lymphocytes and their subsets (T4 (helper/inducer) and T8 (suppressor/cytotoxic), B lymphocytes, immunoglobulins G, A, and M, and the pivotal complement component C3 were largely inconsequential. PMID- 3817827 TI - Syphilitic juxta-articular nodes: case report. AB - Multiple juxta-articular nodes occurring in usual and unusual sites in a patient with late syphilis are described. PMID- 3817828 TI - Sexually transmitted diseases in rape victims. PMID- 3817829 TI - Proceedings of the Second European Symposium on Paraquat Poisoning. 27th January 1986, London. PMID- 3817830 TI - Paraquat poisoning: the rationale for current treatment regimes. AB - The critical events leading to death from the ingestion of paraquat are absorption from the gastrointestinal tract, active accumulation in the lung almost certainly preceded by acute renal failure and redox cycling in the lung which initiates certain, as yet unidentified, biochemical events leading to cell death with subsequent destruction of the lung and death from anoxia. Present evidence suggests that absorption of paraquat is rapid and the use of absorbents more than 6 hours after ingestion is likely to be ineffective. Further work is needed to characterize the mechanism of absorption and to identify an innocuous chemical which could be added to formulations of paraquat to inhibit absorption; this approach may be the best solution to the problem of paraquat poisoning. Steps to actively remove paraquat from the systemic circulation will probably only succeed in a small number of patients taking moderate doses and developing early renal failure. The 'window' for such treatment may be as narrow as 6-18 h after ingestion. This 'window' would also operate for chemicals designed to inhibit the pulmonary uptake of paraquat. The biochemical events leading to paraquat-induced cell death are not sufficiently defined to permit the design of treatments to prevent or reverse these processes. PMID- 3817831 TI - Haemodialysis for paraquat poisoning. AB - Paraquat can be removed by haemodialysis and haemoperfusion but, although clearance values are high, the quantities recovered are insignificant. Prevention of death is most unlikely except perhaps in patients with plasma paraquat concentrations very close to the previously proposed line separating concentrations in fatal cases and survivors at different time intervals. Even if delays incurred in measuring plasma paraquat concentrations and in setting up haemodialysis or haemoperfusion could be reduced to a minimum, elimination by these procedures would achieve little because paraquat disappears rapidly from the plasma in the first few hours after ingestion as it is taken up by the tissues and excreted into the urine. Further studies on patients at borderline risk are required and the value of 'continuous' haemoperfusion requires further assessment. PMID- 3817832 TI - Paraquat lung: is there a role for radiotherapy? AB - We have previously reported the clinical course of a patient poisoned with paraquat who was treated with whole lung irradiation and who survived severe pulmonary damage. Four further cases are reported who were much more severely poisoned and who died despite early pulmonary irradiation. There is no definite evidence that this or any other form of cytotoxic therapy can influence the course of paraquat lung. As there is no adequate laboratory model, further investigation of such therapy should be in the context of a prospective clinical trial. Treatment of only one lung would allow rapid identification of a therapeutic effect of irradiation. PMID- 3817833 TI - Epidemiology of paraquat in Japan and a new safe formulation of paraquat. PMID- 3817834 TI - The effectiveness of a cation resin (Kayexalate) as an adsorbent of paraquat: experimental and clinical studies. AB - The cation-exchange-resin Kayexalate has an adsorption capacity for paraquat 15 times greater than activated charcoal and 6 times greater than Adsorbin. The oral LD50 of paraquat in rats rose 2.1 times by intragastric injection of Kayexalate. In the present study, the survival rate of rats given Kayexalate or Adsorbin after paraquat administration was examined. Results of clinical studies on 22 patients are also presented. PMID- 3817835 TI - Prognostic value of plasma and urine paraquat concentration. AB - A non-exponential mathematical equation was used to extrapolate the 'predictive line' for plasma paraquat concentrations beyond 24 h. Plasma paraquat concentrations were measured in 30 patients who were admitted more than 24 h after overdose. The extrapolated line accurately predicted the outcome in 27 of these 30 patients. Urine paraquat concentrations were measured in 53 patients. All patients with urine paraquat concentrations of less than 1 mg/l (colourless or light blue test result using the colorimetric test) within 24 h of overdose survived. In contrast, patients with urine paraquat concentrations of more than 1 mg/l had a high probability of death. Even if plasma paraquat concentrations have a higher predictive value, urine data may contribute to a more rapid evaluation of prognosis. PMID- 3817836 TI - Evidence for lipid peroxidation in man following paraquat ingestion. AB - Four patients were investigated for evidence of lipid peroxidation between 4.5 and 36 h (mean 22 h) after ingestion of paraquat by measuring plasma phospholipid 2-esterified, diene-conjugated 18:2 delta 9,11-linoleic acid (9,11-LA) and expressing it also as a ratio R (9,11-LA/9,12-LA X 100) of the 'parent' linoleic acid. The mean value for R was 4.73 (range 3.7-7.1) at presentation and 6.91 at peak values (range 3.8-13.4) which occurred at a mean of 34 h after ingestion. Both values were significantly higher (P less than 0.001) than that of 107 healthy controls (1.94, range 0.67-3.8). Parallel changes in plasma vitamin E and 9,11-LA occurred in the 2 patients in whom serial measurements were made suggesting an involvement of vitamin E in the formation of this isomer. These findings support the hypothesis that lipid peroxidation occurs during paraquat poisoning in man and the early appearance of 9,11-LA suggests that it may be a primary event. PMID- 3817837 TI - Multichannel, single trial event related potential classification. PMID- 3817838 TI - Classification of EEG spatial patterns with a tree-structured methodology: CART. PMID- 3817839 TI - A maximum likelihood method for estimating EEG evoked potentials. PMID- 3817840 TI - Classification and detection of single evoked brain potentials using time frequency amplitude features. PMID- 3817841 TI - Enhancement of event related potentials by iterative restoration algorithms. PMID- 3817842 TI - Testing correlated "EEG-like" data for normality using a modified Kolmogorov Smirnov statistic. PMID- 3817843 TI - A multichannel signal processor for the detection of epileptogenic sharp transients in the EEG. PMID- 3817844 TI - The analysis of noisy signals by nonparametric smoothing and differentiation. PMID- 3817845 TI - An efficient formula for estimating the generalized moments of the power spectral density (PSD) without computing the Fourier transform. PMID- 3817846 TI - High-frequency electrocardiogram analyzer. PMID- 3817847 TI - Reduction of heart sounds from lung sounds by adaptive filtering. PMID- 3817848 TI - Power spectral analysis of heart rate variability in sudden cardiac death: comparison to other methods. PMID- 3817849 TI - Quantitative investigation of QRS detection rules using the MIT/BIH arrhythmia database. PMID- 3817850 TI - Rhythm analysis of arterial blood pressure. PMID- 3817851 TI - Short time Fourier analysis of the electromyogram: fast movements and constant contraction. PMID- 3817852 TI - Uterine EHG processing for obstetrical monitoring. PMID- 3817853 TI - Passive neuronal membrane parameters: comparison of optimization and peeling methods. PMID- 3817854 TI - Current source density estimation using microelectrode array data from the hippocampal slice preparation. PMID- 3817856 TI - Joint annual conference of the Cardiological Society of India & the Association of Thoracic and Cardiovascular Surgeons of India. Srinagar, October 15-18, 1986. Abstracts. PMID- 3817855 TI - GMDH correction modeling of distorted signals recorded by mandibular kinesiograph. PMID- 3817858 TI - Dermoid cyst of the testis (a case report). PMID- 3817857 TI - A profile of the malignant tumours of the paranasal sinuses (a study of 57 cases). PMID- 3817859 TI - Value of imprint cytology in the diagnosis of common malignant tumors. PMID- 3817860 TI - Serum alpha-tocopherol, lipo-peroxides, and ceruloplasmin and red cell glutathione and antioxidant enzymes in patients of oral cancer. PMID- 3817861 TI - Fine needle aspiration cytology of thyroid. PMID- 3817862 TI - Renal angiomyolipoma in tuberous sclerosis. PMID- 3817863 TI - Pregnancy and head and neck malignancy. PMID- 3817864 TI - A comparison of IgA in portal and peripheral venous blood. AB - A comparison of IgA in portal and peripheral venous blood was made to elucidate further any possible role of the liver in IgA functions in man. Over fifty paired samples of portal and peripheral blood were obtained from patients undergoing abdominal surgery. The samples were examined for total IgA and secretory IgA content, IgA immune complexes, and the proportion of polymeric IgA and IgA antibodies to Streptococcus mutans and Escherichia coli. No significant differences in the overall IgA concentration in portal and peripheral venous blood were found, but the concentration of secretory IgA was raised in portal blood (P less than 0.02). The IgA content of immune complexes (PEG precipitates) was significantly raised in portal sera compared with peripheral sera. Antibody levels to S. mutans or E. coli were not significantly different in the paired samples. A mean of 18.1% of the IgA in portal blood was greater than 7S in size compared with a mean of 15.3% in peripheral blood (P less than 0.01). Detectable differences between IgA in portal and peripheral venous blood could indicate some role of the liver in the transport of polymeric IgA and IgA complexes from serum to bile in man, but could represent increased production of these types of IgA in tissues drained by the portal vein. PMID- 3817865 TI - The mouse macrophage-specific glycoprotein defined by monoclonal antibody F4/80: characterization, biosynthesis and demonstration of a rat analogue. AB - F4/80, a mouse macrophage-specific membrane marker defined by a rat monoclonal antibody, was precipitated by a rabbit antiserum raised against partially purified mouse antigen. The antiserum, when tested against a variety of mouse tissues and cells, bound only to, and was cytotoxic for, macrophages, and it precipitated a similar macrophage-specific protein from rat cells. The F4/80 antigen is a glycoprotein of apparent molecular weight (MW) 150,000, and was labelled biosynthetically with [14C]glucosamine. Neuraminidase treatment removed small amounts of sialic acid, and tunicamycin and 2-deoxyglucose both inhibited antigen synthesis. Pulse/chase labelling with [35S]methionine demonstrated a precursor of 110,000 MW. Proteinase treatment of intact cells cleaved the molecule to an initial 100,000, and then to an 80,000 MW fragment. Without reduction, the MW of the molecule was unchanged by proteinases. These studies indicate that the F4/80 antigen consists of at least two domains linked by disulphide bridges, of MW 80,000 and 20,000. Both domains are extracellular. PMID- 3817866 TI - Purification of eosinophils from normal human blood, preparation of eosinoplasts and characterization of their functional response to various stimuli. AB - Eosinophils from the blood of normal individuals were purified by centrifugation over discontinuous Percoll gradients. Eosinophil suspensions were obtained with a mean purity of 96% and a mean recovery of 64% (n = 19). When incubated with phorbol-myristate acetate, eosinophils consumed twice as much oxygen as did neutrophils from the same donors. With serum-treated zymosan, 70% and 100% of the maximal oxidative response (i.e. the response to phorbol-myristate acetate) was obtained with eosinophils and neutrophils, respectively. The calcium ionophore A23187 is a weak stimulus that triggered only 2.5% of the eosinophil and 10% of the neutrophil oxidative capacity. The response of both cell types to formyl methionyl-leucyl-phenylalanine (fMLP) was rapid, with a maximum after 3 min. The magnitude of this eosinophil reaction was half that of neutrophils. Although the activities of the granule enzymes beta-glucuronidase and arylsulphatase were 2.5 and 6 times higher in eosinophils than in neutrophils, respectively, the exocytosis of these enzymes in response to various stimuli was lower in eosinophils. The high yield of eosinophils from our separation method enabled us to prepare eosinoplasts by centrifugation of eosinophils over discontinuous Ficoll gradients that contained cytochalasin B. Eosinoplasts are plasma membrane vesicles derived from eosinophils, filled with cytoplasm but devoid of granules and nucleus. The eosinoplasts contained 30% of the cytoplasm and plasma membrane present in intact eosinophils. Eosinoplasts still possessed a functionally intact oxidase enzyme that could be stimulated with various stimuli. Therefore, eosinoplasts may provide a valuable tool to study separately the role of the oxidase products and that of the granule contents in eosinophil functions. PMID- 3817867 TI - The membrane attack complex of complement induces permeability changes via thresholds in individual cells. AB - Flow cytometry was used to quantify the fluorescence of propidium iodide in rat polymorphonuclear leucocytes (PMN) attacked by the membrane attack complex (MAC) in order to establish the existence of permeability and lytic thresholds in individual cells, a 'threshold' being defined as a cellular event involving the rapid transition of cells from one state to another under physiological conditions. Activation of the complement pathway resulted in PMN being attacked by MAC within 5 min. Approximately 30-40% of the cell population subsequently became permeable to small molecules and macromolecules. Individual PMN passed through 'thresholds' of cell permeability and cell lysis, or recovered from complement attack at different times. In the flow cytometer, three distinct populations of PMN were identified: cells that had recovered before the permeability 'threshold', cells that had recovered after the permeability 'threshold' but before the lytic 'threshold', and cells that failed to recover from complement attack. Individual PMN attacked by MAC passed through permeability and lytic thresholds at different times after an initial lag of 7.5 +/- 2.5 min and 11.5 +/- 1.0 min, respectively. Adenosine, an activator of adenylate cyclase, inhibited removal of MAC from the cell surface. Consequently, more cells passed through the permeability and lytic 'thresholds', resulting in an increased percentage of lysed cells. PMID- 3817868 TI - Production of passive immunity in neonatal ferrets following maternal vaccination with killed influenza A virus vaccines. AB - Neonatal ferrets may be passively immunized following maternal vaccination with formalin-inactivated influenza A virus vaccine, but the level of protection from partial to complete depends upon the number of doses used to vaccinate the mother, the presence or absence of aluminum hydroxide adjuvant, whether or not the mothers were 'primed' by prior infection with a serologically heterologous type A virus, and the age of the neonate at challenge. Neonates were completely protected up to 2 weeks of age, but susceptibility returned to nasal epithelium at 5 weeks and to lung at 7 weeks. Mothers immunized up to 9 months previously also partially or completely protected their offspring, this correlating with the maternal serum haemagglutination-inhibition (HI) antibody titre at the time of neonatal challenge, not the duration of immunity. PMID- 3817869 TI - Suppression of IgE responses by antigen inhalation: studies on the role of genetic and environmental factors. AB - Repeated inhalation of low levels of ovalbumin (OVA) by mice or rats preferentially induces tolerance in the IgE antibody class, and this process may represent an important protective mechanism that normally prevents allergic sensitization to air-borne antigens. Dose-response experiments involving exposure of a number of inbred rat strains to graded doses of aerosolized OVA confirmed the inverse relationship between sensitivity to tolerogenesis and IgE-responder phenotype. These experiments additionally demonstrated that F1 hybrids derived from low X high responder crosses co-inherited high sensitivity to tolerance induction, together with the low IgE-responder phenotype. Sensitivity to tolerance induction in low versus high IgE-responder strains was found to be independent of the route of administration of OVA, indicating that the relevant genetically determined control mechanism(s) operated systemically. However, pre exposure of animals to a variety of exogenous agents, noteably inhaled irritants (NO2 and histamine), the inflammatory adjuvants pertussigen and aluminium hydroxide injected at sites that stimulate the regional lymph nodes draining the respiratory tract, or a single subcutaneous injection of the reticuloendothelial system stimulator oestradiol, were shown to partially abrogate this natural tolerance process and promote allergic sensitization. PMID- 3817870 TI - Vaccination with syngeneic monoclonal anti-idiotype protects against a tumour challenge. AB - Rat X rat hybridomas secreting monoclonal anti-idiotypic antibodies have been prepared from Hooded rats immunized with two tumour-reactive, syngeneic monoclonal antibodies 11/160 and M10/76 (specific, respectively, for the Hooded rat sarcomata HSN and MC24). The hybridomas were selected on the basis that the secreted antibodies competed with antigen for binding to the immunizing idiotype. One monoclonal anti-idiotype (HIM/1/230, gamma 2a isotype) that recognizes an antigen-binding site idiotope of antibody 11/160 has been found to substitute for antigen. Hooded rats vaccinated by three challenges with HIM/1/230 produce serum Ab3 that is indistinguishable in antigen specificity from the 11/160 Ab1, and show reduced tumour take following an i.v. challenge with 10(6) HSN cells. The response to vaccination with anti-idiotype was both qualitatively and quantitatively dependent on the mode of immunization. High titre 11/160-like Ab3 was generated only when the vaccine contained Freund's adjuvant, whereas resistance to tumour challenge was found only in animals vaccinated with anti idiotype in the absence of adjuvant. PMID- 3817871 TI - Influence of reserpine on in vivo localization of injected lymph node cells in the mouse. AB - The effects of reserpine, and other agents that affect the storage and availability of 5-hydroxytryptamine (5HT), on the localization of injected 51Cr labelled syngeneic lymph node cells have been investigated. A high dose (5 mg/kg) of reserpine to the recipients reduced localization in the lymph nodes and prevented the usual accumulation of lymphocytes in lymph nodes draining the site of an antigen (sheep erythrocytes: SE) injection. These effects were partially reversible by the monoamine oxidase inhibitor nialamide. This dose of reserpine produced deep sedation throughout the period of the experiment. Lower doses, up to 2.5 mg/kg, produced little sedation and had no effect on the localization of lymphocytes. Other workers had previously reported reduced localization of cells in delayed-type hypersensitivity (DTH) lesions after treatment of the recipients with 5 mg/kg reserpine, and had interpreted this in terms of a role of 5HT in promoting vascular permeability and egress of blood cells. The effect of lower doses of reserpine was not reported. We suggest that the effects on cell localization in both sets of experiments may have been secondary to the general state of sedation and not attributable to a direct local influence of 5HT. Other effects of reserpine included prolonged retention of lymphocytes in lungs and blood, and a reduction of cellularity and DNA synthesis in the thymus, spleen and lymph nodes. PMID- 3817872 TI - Clearance kinetics and organ uptake of complement-solubilized immune complexes in mice. AB - C3-bearing immune complexes were prepared by in vitro solubilization of BSA-anti BSA complexes at equivalence. Sucrose density gradient analyses showed a size heterogeneous population of solubilized complexes with a range of 7S to greater than 29S and a peak at around 19S. The presence of C3bi was demonstrated by precipitation with antibodies to C3c and to C3d and by binding to conglutinin. Immune complexes solubilized in two and three times antigen excess were selected as controls due to their size similarities with complement-solubilized complexes. Blood clearance curves were very similar for C3-bearing complexes and controls. At 1 hr, the percentage of injected material remaining in the circulation for complement-solubilized and two and three times antigen excess complexes were 29.5 +/- 1.3, 30.9 +/- 1.7 and 26.1 +/- 2.7, respectively. Uptake by liver accounted for the majority of complement- and antigen-solubilized immune complexes removed from circulation. Although the uptake by the spleen was no more than one-tenth of the liver uptake, more complement-solubilized complexes than antigen-solubilized complexes were removed by this organ. The present data indicate that soluble immune complexes bearing C3 components and soluble immune complexes without C3 components, but of comparable size, are cleared from the circulation of mice at comparable rates. The mechanisms of clearance of these two populations of complexes, however, may differ. PMID- 3817873 TI - Modulation of human monocyte Fc receptor function by surface-adsorbed IgG. AB - Fc receptor-mediated phagocytosis was measured with monocytes subjected to various treatments. Monocytes exposed to IgG during their adherence, or after they had adhered to a surface, experienced functional impairment. This was manifested in the requirement of a higher antibody density on target particle for efficient phagocytosis, and in an enhanced susceptibility to inhibition by fluid phase IgG. The impairment was found to be due to an interaction of IgG adhering to the surface with the Fc receptors. This effect could be induced with monomeric IgG, devoid of IgG aggregates or immune complexes. IgG coatings that resulted in inefficient Clq fixation promoted considerable functional impairment of monocytes within 1 hr. In addition, the prolonged contact of monocytes with polystyrene in the absence of IgG also led to a functional reduction. The study points to a compromised function of phagocytes exposed to artificial surfaces. PMID- 3817874 TI - The secondary immune response to Staphylococcus aureus vaccines in efferent popliteal lymph of sheep. AB - The secondary immune response to live and killed Staphylococcus aureus vaccines was studied in efferent popliteal lymph of sheep. Animals were immunized with either live or killed S. aureus intracutaneously on the lateral hock, in an area draining into the popliteal lymph node. Six weeks later, an efferent popliteal lymphatic vessel in the vaccinated leg was cannulated, and 48 hr after surgery a second inoculation (identical to the primary) was placed in the skin adjacent to the primary vaccination lesion. A dramatic decrease in lymphocyte output ('cell shutdown') was observed in lymph collected from sheep given the secondary inoculation of live S. aureus during the first 8 hr after inoculation. However, only a moderate decrease in lymphocyte output occurred in lymph from animals receiving killed S. aureus or from control animals. The proportion of eosinophils in lymph collected from animals given live S. aureus increased to a peak (14% of total leucocytes in lymph) between 6 hr and 8 hr, and returned to prechallenge levels by 24 hr post-inoculation. The percentage of neutrophils in lymph peaked between 8 hr and 1 day after injection of live bacteria. This granulocyte response was not observed in animals given killed S. aureus or control animals. IgM-, IgG1- and IgG2- containing cells (-cc) in lymph were quantified by indirect immunofluorescence. Animals given live S. aureus produced lymph with greater numbers of Ig-cc of these isotypes than those given killed organisms. The ratio of IgG2-cc:IgG1-cc was significantly greater in lymph from animals given live S. aureus from Day 2 to Day 6 post-challenge. IgM and IgG1 anti-staphylococcal antibody levels increased in lymph collected from all vaccinated animals, but only sheep given live S. aureus showed any increase in levels of IgG2 antibody. PMID- 3817875 TI - Persistence of oral tolerance in mice fed ovalbumin is different for humoral and cell-mediated immune responses. AB - The duration of oral tolerance after a single feed of OVA at the age of 6 weeks was studied in BDF1 mice. Significant suppression of systemic antibody responses was present 3 months later, but not at 6.5 months; in contrast, at all times studied from 2 weeks to 17 months after an OVA feed there was suppression of systemic CMI to OVA as measured by an in vivo skin test. This indicates that the two limbs of the immune response differ in the factors responsible for the maintenance of oral tolerance. PMID- 3817876 TI - In vitro concanavalin A-induced agglutination characteristics of granulosa cells: effect of pregnant mare serum gonadotropin and follicular fluid. PMID- 3817877 TI - Transaminase activity in normal and irradiated minced muscle autografts on frog gastrocnemius. PMID- 3817878 TI - Isolation and characterization of an unsaturated fatty acid requiring mutant (UFA4) of Aspergillus niger. PMID- 3817879 TI - Monoamine oxidase inhibitor activity of selective and non-selective inhibitors: an in vivo dose-response and time-course study. PMID- 3817880 TI - Inductive changes in hepatic metallothionein profile in the climbing perch, Anabas testudineus (Bloch) by industrial pollutants. PMID- 3817881 TI - Role of patulin as a diabetogenic lactone. PMID- 3817882 TI - Genotoxicity of amino acids--a probe. PMID- 3817883 TI - Increased osmotic fragility of red cells after incubation at 37 degrees C for 24 hr in dogs with acute myocarditis produced by scorpion (Buthus tamulus) venom. PMID- 3817884 TI - Effects of mercuric chloride antioxidant defense components of rat erythrocyte and plasma: influence of vitamin E supplementation. PMID- 3817885 TI - Evaluation of the fate of blastocysts in pregnancy-blocked mice: effect of sterile mating. PMID- 3817886 TI - Effect of removal of epididymal fat on spermatogenesis in albino rats. PMID- 3817887 TI - Serum from women at high risk for foetal abnormalities causes malformations in developing chicks. PMID- 3817888 TI - Properties of two semisynthetic penicillins and their biosynthetic production. PMID- 3817889 TI - Levels of FDP-aldolase enzyme activity in Plasmodium knowlesi parasitized monkey erythrocytes. PMID- 3817890 TI - Response and action of 5-hydroxytryptamine in experimental head injury. PMID- 3817891 TI - Assessment of some tumorigenic risks associated with fresh and used cutting oil. PMID- 3817892 TI - In vitro catabolism of cholic acid in caecum of the domestic chick Gallus domesticus. PMID- 3817893 TI - Modulation of cardiovascular reactivity with calcium channel blockers in rats subjected to haemorrhagic shock. PMID- 3817894 TI - Antiarrhythmic activity of some synthetic basic amide compounds: Part I--In electrical and aconitine arrhythmia models. PMID- 3817895 TI - Antiarrhythmic activity of some synthetic basic amide compounds: Part II--In mouse chloroform and ischaemic arrhythmia models. PMID- 3817896 TI - Effect of scopolamine on physostigmine potentiated convulsions produced by pentylenetetrazole in rats. PMID- 3817897 TI - A study of pulmonary functions and serum theophylline levels in bronchial asthma. PMID- 3817898 TI - Acute chest syndrome in adult homozygous sickle cell disease. PMID- 3817899 TI - Bronchodilators in acute bronchial asthma--a comparative study. PMID- 3817900 TI - Tumours of the lung--a histomorphological study. PMID- 3817901 TI - Giant pulmonary cavity associated with systemic lupus erythematosus. PMID- 3817902 TI - Laryngeal cyst-causing haemoptysis. An unusual presentation. PMID- 3817903 TI - Chronic respiratory disease, chronic bronchitis, field screening and tools for documentation. PMID- 3817904 TI - Lung cancer and circulating DNA. PMID- 3817905 TI - An overview of the congenital malformations of the lower respiratory tract. PMID- 3817906 TI - The gene for MRC OX-2 membrane glycoprotein is localized on human chromosome 3. PMID- 3817907 TI - Genetic nomenclature for loci controlling mouse lymphocyte antigens. PMID- 3817908 TI - Oligonucleotide genotyping shows that alleles at the HLA-DR beta III locus of the DRw52 supertypic group segregate independently of known DR or Dw specificities. AB - Using locus- and allele-specific oligonucleotide probes, we have studied the polymorphism of the HLA-DR beta III locus within the haplotypes of the DRw52 supertypic group. DNA from a number of homozygous typing cells typed for both Dw and DR was used. The DR beta III polymorphisms, DRw52a and DRw52b, do not segregate with Dw typing, or with DR typing, indicating that the determinants responsible for Dw-defined T-cell response and for DR haplotypic recognition are not encoded by the DR beta III locus. Hence, we can conclude that these DR specificities are encoded by the other functional DR locus, DR beta I, while the DR beta III locus encodes only the supertypic product. PMID- 3817909 TI - Water-soluble form of RT1.A class I MHC molecules in the kidney and liver of the rat. AB - The RT1.A (H-2K,D type) class I major histocompatibility complex (MHC) antigens of the rat are well recognized as membrane-bound glycoproteins. In this report, we demonstrate that liver and kidney in the DA rat strain contain large amounts of a water-soluble RT1.A class I molecule with a discrete heavy chain approximately 5 kd smaller than the membrane-bound form. An identical molecule could be identified in DA rat serum. This small class I molecule carries all of the polymorphic antigenic determinants of the RT1.A av1 class I molecule. The water-soluble molecule is readily denatured in its pure form when frozen and thawed, but this does not occur when it is mixed with serum, presumably because of a stabilizing interaction with one or more carrier proteins. The half-life of the class I molecule in serum was measured to be approximately 1.5 h. The LEW rat strain produced detectable but substantially smaller amounts of water-soluble RT1.A molecules. Our studies indicate that RT1.A class I MHC antigens are synthesized and presumably secreted in a smaller water-soluble form by liver, kidney, and possibly other tissues under physiological conditions, a point of considerable interest in view of the immunoregulatory functions of the membrane bound forms of these molecules. PMID- 3817910 TI - Role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with post cholecystectomy problems. PMID- 3817911 TI - Inflammation and necrosis of the colon due to pancreatitis. PMID- 3817912 TI - Factors influencing oesophageal ulcer formation following sclerotherapy. PMID- 3817913 TI - Diagnostic papillotomy: application of endoscopic sphincterotomy (EST) to the diagnosis of diseases in cholangio-pancreatic tracts. PMID- 3817914 TI - Clinical spectrum of solitary rectal ulcer. PMID- 3817915 TI - Effect of norethisterone enanthate on intestinal digestive and absorptive functions in protein deficient rat. PMID- 3817916 TI - Solitary rectal ulcer (digital bowel evacuation: mucous colitis). PMID- 3817917 TI - Diagnostic evaluation of post cholecystectomy symptoms. PMID- 3817918 TI - Giant pedunculated haemangioma of the liver. PMID- 3817919 TI - Gastric inflammatory fibroid polyp. PMID- 3817920 TI - Abdominal cocoon causing small bowel obstruction. PMID- 3817921 TI - Primary squamous cell carcinoma of the caecum. PMID- 3817922 TI - Multiple bile duct hamartomas. PMID- 3817923 TI - Absorption of IgG with Staphylococcus aureus in a diagnostic test for IgM antibodies to Japanese encephalitis, West Nile & dengue viruses. PMID- 3817925 TI - Enzymes of tricarboxylic acid cycle in microfilarial & adult stages of Setaria cervi. PMID- 3817924 TI - Autoantibodies to intermediate filaments in acute viral hepatitis. PMID- 3817926 TI - Purification & characterization of lactate dehydrogenase from Setaria cervi. PMID- 3817927 TI - Atypical features in lymphatic filariasis. PMID- 3817928 TI - Quantitative grading of Leishmania donovani amastigotes in bone marrow aspirates smears. PMID- 3817929 TI - Transovarial transmission of Japanese encephalitis virus in Culex vishnui mosquitoes. PMID- 3817930 TI - Naturally occurring rose eye mutant in Culex quinquefasciatus. PMID- 3817931 TI - Percutaneous ligation of vas. PMID- 3817932 TI - Relevance of transferrin receptors to gynaecological malignancy. PMID- 3817933 TI - Apo C-III levels in type IV hyperlipoproteinemia associated with non-insulin dependent diabetes. PMID- 3817934 TI - Forced expiratory capacity & volumes in factory workers of Iraq. PMID- 3817935 TI - An epidemiological study of cataract in a rural area of Pondicherry. PMID- 3817936 TI - The histological observations on the progress of the mermithid (Mermis sp) infection in Culex quinquefasciatus Say larvae in the laboratory. PMID- 3817937 TI - A study of Cu to Zn ratio in blood samples of liver patients using ENDXRF system. PMID- 3817938 TI - Dermal reactions due to cosmetic products--a case. PMID- 3817939 TI - Isolation of Salmonella typhi from brain tumor--a case report. PMID- 3817940 TI - Sero-immunity to poliomyelitis in Himachal Pradesh. PMID- 3817941 TI - Dimethyl sulfoxide (DMSO) induced regression of experimental amyloidosis in mice. A preliminary study. PMID- 3817942 TI - Carcino embryonic antigen levels in lung carcinoma and other malignancies: its relationship to tumor histopathological classification. PMID- 3817943 TI - Cerebral mucormycosis--a clinico pathological study of four patients with review of literature. PMID- 3817944 TI - Histopathological study of placenta in viral hepatitis. PMID- 3817946 TI - Histopathological study on the effect of venom from the scorpion Heterometrus fulvipes. PMID- 3817945 TI - Changes with age in the human liver. PMID- 3817947 TI - Incidence and relationship of sex chromatin with histological appearance of tumor in breast carcinoma. PMID- 3817948 TI - Cytologic diagnosis of chordoma by fine needle aspiration. PMID- 3817949 TI - Hepatotoxicity of copper: studies on the developing animals. PMID- 3817950 TI - S. cerro (18:z4,z23-), a rare serotype isolation from infants with diarrhoea in Ambajogai. PMID- 3817951 TI - Osteoclastoma-like giant cell tumor of the thyroid. Report of two cases. PMID- 3817952 TI - Preoperative carcinoembryonic antigen level in colorectal cancer. PMID- 3817953 TI - Modified TALC colour change medium for the identification of Ureaplasma urealyticum. PMID- 3817954 TI - Counterimmunoelectrophoresis in respiratory candidiasis. PMID- 3817955 TI - Effect of iron deficiency anaemia on LAP activity and NBT dye reduction test. PMID- 3817956 TI - Histoplasmosis in India: a clinico-pathological review with report of a case in a child. PMID- 3817957 TI - An experimental study of furosemide induced hepatotoxicity. PMID- 3817958 TI - Vascular complications of hepatic amoebiasis--a retrospective study. PMID- 3817959 TI - Clinico-pathological correlation in neonatal myocardial ischaemia. PMID- 3817960 TI - Carcinosarcoma of renal pelvis in a child. A case report. PMID- 3817961 TI - Amyloidosis of the urinary bladder. PMID- 3817962 TI - Malignant melanomatous schwannoma. PMID- 3817963 TI - A study of diagnostic accuracy of fine needle aspiration cytology in diagnosis of hepatic malignancies. PMID- 3817964 TI - Relevance of quality control to chemical pathology service in India. PMID- 3817966 TI - Genito-urinary brucellosis in men. PMID- 3817965 TI - A clinico-pathological study of ovarian tumours. PMID- 3817967 TI - Histopathological studies on the effects of cimetidine on stress induced peptic ulcer in rats. PMID- 3817968 TI - Amoebic cervicitis masquerading as carcinoma cervix. PMID- 3817969 TI - Sickle cell trait in the scheduled castes of Rajasthan (India). PMID- 3817970 TI - Cellular immune response in squamous cell carcinomas of head and neck: evaluation by histological indices. PMID- 3817971 TI - Filter paper cyanmethaemoglobin estimation. PMID- 3817972 TI - Retinoblastoma--a clinicopathological review of 78 cases. PMID- 3817973 TI - Carcinoid tumours: a collective review of the last twelve years. PMID- 3817974 TI - Acquired B character in a "A" group subject (a case report). PMID- 3817975 TI - Enterotoxigenic staphylococci from human sources their correlation with heat stable nuclease test and other biological properties. PMID- 3817977 TI - Regulation of hypothalamo-pituitary-gonadal axis by inhibin. PMID- 3817976 TI - Neonatal apnea. PMID- 3817978 TI - Cardiopulmonary resuscitation. PMID- 3817979 TI - The management of neonatal hyperbilirubinemia--Part I. PMID- 3817980 TI - Current concepts in phototherapy. PMID- 3817981 TI - Childhood injuries in India: extent of the problem and strategies for control. PMID- 3817982 TI - Current management of juvenile arthritis. PMID- 3817983 TI - D-penicillamine in rheumatoid arthritis. PMID- 3817985 TI - Anemia in children of rural Kathmandu. PMID- 3817984 TI - Erythrocyte protoporphyrin and blood lead levels of children from Jammu and Srinagar and papier mache trainees. PMID- 3817986 TI - Auditory brainstem evoked response in at risk children. PMID- 3817987 TI - A study on working educated mothers and its impact on child health. PMID- 3817988 TI - Pancytopenia and leukemoid reactions in tuberculosis. PMID- 3817989 TI - Wigglesworth's simplified classification of perinatal deaths. PMID- 3817990 TI - Infant mortality rates, 1984. The Registrar-General. PMID- 3817991 TI - Lay reporting and verbal autopsy in assessment of infant mortality. PMID- 3817992 TI - Can we improve survival of the newborn in India? PMID- 3817993 TI - Radionuclide studies in nephrourological disorders. PMID- 3817994 TI - Treatment of idiopathic thrombocytopenic purpura. PMID- 3817995 TI - Health for all by 2000--myth or reality. PMID- 3817996 TI - Innovative child health projects. PMID- 3817997 TI - Improved home care for better child health. PMID- 3817998 TI - Child health work in China: a brief account. PMID- 3817999 TI - Planning for child health in Sri Lanka. PMID- 3818000 TI - The recognition of new infant health paradigms in developing countries. PMID- 3818001 TI - Chorionic villus sampling: first trimester prenatal diagnosis. PMID- 3818002 TI - Genetic aspects of congenital cerebellar ataxia. PMID- 3818003 TI - Duchenne muscular dystrophy: recent concepts. PMID- 3818004 TI - The contemporary role of fetoscopy in prenatal diagnosis of genetic disorders. PMID- 3818005 TI - Epidemiology of low birth weight in Ahmedabad. PMID- 3818006 TI - Suprapubic voiding cystourethrography in the evaluation of lower urinary tract. PMID- 3818007 TI - Biliary atresia: early diagnosis through operative cholangiography. PMID- 3818008 TI - Pica in children. PMID- 3818009 TI - Long-term prophylaxis of febrile seizures. PMID- 3818010 TI - Vascular amplifier properties in renovascular hypertension in conscious rabbits. Hindquarter responses to constrictor and dilator stimuli. AB - The local responses of the resistance vessels of the hindquarters of conscious, renal hypertensive (cellophane wrap) and sham-operated normotensive rabbits were studied during infusions of constrictor (norepinephrine, methoxamine, angiotensin II) and dilator (acetylcholine, adenosine, serotonin) drugs. The rabbits had implanted Doppler ultrasonic flow probes on the lower aorta and an indwelling catheter for intra-arterial infusion of drugs. Autonomic blockade with mecamylamine and propranolol was used to determine local vascular effects of each drug uncomplicated by reflex changes. Logistic dose-vascular response curves were characterized by their range from resting to maximum response, their 50% effective dose (i.e., sensitivity or dose at middle of the response range), and the average slope about the 50% effective dose. At maximum dilatation the vascular resistance was about 70% greater in hypertensive rabbits than in normotensive rabbits. There were no significant differences in 50% effective dose values between curves for hypertensive and normotensive rabbits for constrictor or dilator drugs. However, with all drugs the hypertensive rabbits showed about twice the change in vascular resistance per unit dose compared with the normotensive rabbits. These results suggest that hypertrophy of the muscles of the precapillary vessels makes them a nonspecific amplifier of vascular resistance changes evoked by constrictor and dilator stimuli. They do not support previous claims of specific changes in "sensitivity" or claims that local amplifier action is unimportant in hypertension. PMID- 3818011 TI - Influence of magnesium on blood pressure and the effect of nifedipine in rats. AB - The influence of long-term alterations in dietary magnesium intake on blood pressure and on the antihypertensive effect of the calcium antagonist nifedipine was investigated in normotensive Wistar-Kyoto (WKY) and in spontaneously hypertensive rats (SHR). The rats were fed a diet either high (1%), normal (0.1%), or low (0.01%) in magnesium for 12 weeks (WKY) and 20 weeks (SHR), respectively. Nifedipine was added to the diet for 4 weeks in concentrations of 300 and 1000 ppm. Each dose was given for 2 weeks. Plasma and intraerythrocytic concentrations of sodium, potassium, and magnesium were measured before and at the end of nifedipine treatment. Blood was obtained by cardiac puncture. In the WKY and SHR, blood pressure was not influenced by magnesium intake. The blood pressure-lowering effect of nifedipine was most pronounced on normal dietary magnesium and was significantly suppressed in the magnesium-deficient rats. Plasma and intracellular total magnesium concentrations were consistently increased during high and reduced during low dietary intake of the ion. Intracellular sodium concentration increased during magnesium deficiency and was normalized by nifedipine. The marked and long-term alterations in plasma and intracellular concentrations of magnesium did not influence arterial blood pressure levels in either the normotensive WKY or the SHR. Therefore, dietary magnesium intake does not appear to play an important role in long-term regulation of blood pressure in rats. However, magnesium depletion attenuates the blood pressure-lowering effect of nifedipine. PMID- 3818012 TI - Endothelium-dependent vascular responses in normotensive and hypertensive Dahl rats. AB - Experiments were designed to study endothelium-dependent responses in salt sensitive (DS) and salt-resistant Dahl rats (DR). The rats were fed a low sodium (0.1% NaCl) or high sodium (8% NaCl) diet for 8 weeks. Blood pressure in DS fed a high sodium diet was higher than that in the remaining animals. Aortic rings with and without endothelium were suspended for isometric tension recording. Acetylcholine, adenosine 5'-diphosphate, and thrombin induced endothelium dependent relaxations that were significantly depressed in the aorta of DS fed a high sodium diet. The relaxations in response to sodium nitroprusside were only slightly, but significantly, depressed in DS fed a high sodium diet. Removal of the endothelium greatly enhanced the response to serotonin and norepinephrine. In rings with, but not without, endothelium taken from rats fed a high sodium diet, the tension developed in response to serotonin and norepinephrine was significantly greater than that in animals fed a low sodium diet. These experiments indicate that endothelium-dependent relaxations to acetylcholine, adenosine 5'-diphosphate, and thrombin are depressed in hypertensive Dahl rats; this effect probably reflects a decreased release of endothelium-derived relaxing factor(s), although structural changes might contribute; and the responsiveness to vasoconstrictor agents is increased in DS and DR fed a high sodium diet. These findings may indicate differential effects of blood pressure and dietary salt on endothelial function. PMID- 3818013 TI - Microvascular tone in a skeletal muscle of spontaneously hypertensive rats. AB - We studied the degree of arteriolar smooth muscle constriction in the spinotrapezius muscle microcirculation of spontaneously hypertensive rats and their normotensive controls, Wistar-Kyoto rats. The constriction was expressed in the form of a nondimensional tone as the difference between steady state and dilated diameter (after papaverine treatment) divided by the dilated diameter. Both animal strains showed on average a progressive increase of tone toward the more distal arterioles, with a peak tone being reached in the transverse arterioles. Tone values in the hypertensive animals were consistently elevated. The number of arterioles that had more than 5% tone (so-called responder arterioles) was higher in the hypertensive animals. These studies suggest that, besides the anatomical adjustments documented earlier in our laboratory in the arteriolar network of this muscle, functional adjustments in the form of an elevated microvascular tone are associated with the elevated resistance in spontaneously hypertensive rats. PMID- 3818014 TI - Sex difference in the development of deoxycorticosterone-salt hypertension in the rat. AB - To investigate a possible sex difference in the development of deoxycorticosterone (DOC)-salt hypertension in rats, systolic blood pressure was measured over 6 weeks in unilaterally nephrectomized male and female rats with or without DOC-salt treatment. Throughout the treatment, systolic blood pressure was significantly lower in female than in male DOC-salt rats (at the end of the sixth week: 190 +/- 8 vs 163 +/- 7 mm Hg, p less than 0.05). The difference in blood pressure was also confirmed by the direct measurement of mean arterial pressure at the end of the experiment. The 24-hour urinary excretion of vasopressin was significantly higher in male control rats than in female control rats; however, no difference was observed between male and female DOC-salt rats, in which the urinary excretion of vasopressin was four to five times higher than in control rats. The plasma vasopressin concentration was higher in DOC-salt rats, but there were no differences between sexes. There were no differences in the metabolic clearance rate of vasopressin among the four groups of rats. This indicates that the elevated plasma vasopressin concentration in DOC-salt hypertensive rats is due to increased release of the hormone, rather than to impaired metabolism. Thus, although vasopressin plays a pivotal role in the pathogenesis of DOC-salt hypertension, the sexual dimorphism in this form of hypertension cannot be attributed to differences in the secretion, metabolism, or plasma concentration of vasopressin. PMID- 3818015 TI - Blood pressure and physical fitness in children. AB - The association between physical fitness and blood pressure was studied in 2061 children selected from all fourth graders in 44 elementary schools in the New York City area. Their blood pressure and physical fitness were measured on two consecutive examinations 1 year apart. Systolic and diastolic blood pressure were highest in children with poor physical fitness. The change in physical fitness between the 2 examination years was related to the change in systolic and diastolic blood pressure (i.e., children with a decline in physical fitness showed the largest rise in blood pressure). These observations suggest that the level of systolic and diastolic blood pressure in children is associated with the level of physical fitness. They also indicate that change in blood pressure in childhood may be related to change in physical fitness. PMID- 3818016 TI - Clinical significance of cognitive performance by hypertensive patients. AB - Fifty-four subjects with uncomplicated essential hypertension and 54 normotensive subjects were compared with regard to a widely employed clinical index of cognitive dysfunction (the Average Impairment Rating) calculated from neuropsychological tests that discriminate between brain-damaged and neurologically normal persons. Hypertensive subjects exhibited lower mean scores on this index when education was ignored, but results were not the same for highly educated and less well educated groups. There were no differences between exceptionally well educated hypertensive and normotensive subjects, but in the less well educated group, hypertensive subjects performed more poorly than normotensive subjects. The percentages of hypertensive and normotensive subjects scoring in a cognitively impaired range on the Average Impairment Rating were low and did not differ for either education group. These data indicate the important role of subtle differences in education level with respect to positive or negative findings for studies comparing hypertensive and normotensive subjects and illustrate the important role of clinical neuropsychological indices of cognitive dysfunction when one wishes to make meaningful inferences regarding cerebral cortical function in hypertensive subjects. PMID- 3818017 TI - The prognosis of hypertension according to age at onset. AB - Data from a program for hypertension screening and follow-up were used to study the relationship between age at onset of hypertension and the risk of cardiovascular complications. The risk for hypertensive subjects, compared with normotensive subjects of similar age, declined significantly as age of onset increased from 40 to 69 years. This pattern was not explained by differences in initial severity of hypertension, control of hypertension, obesity, smoking, or alcohol consumption. A sex-specific analysis showed that the pattern was confined to male subjects, but it is argued that it might be seen in female subjects if data for women of more advanced age were available. Further lines of investigation of this interesting phenomenon are proposed. PMID- 3818018 TI - Alerting reaction and rise in blood pressure during measurement by physician and nurse. AB - Blood pressure was monitored by a continuous intra-arterial recording in 46 subjects to investigate whether the alarm reaction and the blood pressure and heart rate increases that occur during cuff blood pressure measurement made by a physician 1) attenuate when the physician's visit is repeated several times and 2) are less pronounced if a nurse measures the blood pressure. In 16 subjects the peak mean blood pressure and heart rate rises that occurred in the early part of the physician's first visit (22.6 +/- 1.8 mm Hg and 17.7 +/- 1.7 beats/min) were virtually identical to those occurring during three subsequent visits by the same physician throughout a 2-day intra-arterial blood pressure monitoring. The less pronounced pressor and tachycardic responses observed in the last part of the physician's visit also were virtually identical among the four visits. In contrast, in 30 other subjects the blood pressure and heart rate rises that occurred during the nurse's visit were 46.7% and 42.1% less (p less than 0.01) than those occurring during the physician's visit. The late and less pronounced pressor and tachycardic responses to the visit were also significantly less (p less than 0.01) in the former than in the latter condition. These results indicate that the error of overestimation of blood pressure inherent in cuff blood pressure measurement by a physician cannot be avoided by repeated visits by the physician over a short time span. It clearly can be reduced, however, if blood pressure measurements are performed by a nurse. PMID- 3818019 TI - Intracellular calcium and sodium in hypertensive patients. AB - Untreated subjects with mild to moderate hypertension were compared with normotensive controls recruited from the same ambulatory screening clinic. All subjects were black. Resting levels of cytosolic free calcium were estimated in washed platelets with the fluorescent intracellular probe fura 2, and sodium and potassium were measured in red blood cells. Calcium levels were 21% higher in the hypertensive subjects (p = 0.02), and a 9% increase in sodium was observed in an expanded sample (p = 0.04). Neither intracellular calcium nor intracellular sodium had a significant linear correlation with blood pressure when hypertensive subjects and controls were examined separately or when the two groups were combined. Potassium was slightly but not significantly increased in hypertensive subjects. Among the participants for whom both calcium and sodium measurements were available, a weak, nonsignificant correlation between these ions was noted (r = 0.2; n = 48). This correlation was significant among participants in the control group examined separately (r = 0.3; n = 33; p = 0.05). Although the measurements were performed in different cell lines, these findings demonstrate increases in both intracellular calcium and sodium in hypertensive humans. PMID- 3818020 TI - Increased basal and thrombin-induced free calcium in platelets of essential hypertensive patients. AB - Intracellular free calcium, [Ca2+]i, was studied in platelets of essential hypertensive subjects and normotensive controls under basal conditions and after stimulation with epinephrine, norepinephrine, angiotensin II, ouabain, and thrombin, using the fluorescent calcium indicator quin 2. Basal [Ca2+]i was significantly higher in hypertensive subjects (n = 32) than in normotensive controls (n = 30; 167.4 +/- 5.0 vs 143.2 +/- 3.1 nmol/L; p less than 0.001). Epinephrine, norepinephrine, angiotensin II, and ouabain had no effect on platelet calcium, whereas thrombin induced a dose-dependent increase in [Ca2+]i in both the presence and absence of extracellular calcium. This [Ca2+]i increase in the presence of extracellular calcium, which depends mainly on calcium influx, was significantly higher (p less than 0.05) in platelets of hypertensive subjects at all thrombin concentrations (ranging from 0.025-0.1 U/ml), while the [Ca2+]i increase in the absence of extracellular calcium, which depends only on release from intracellular stores, was similar in hypertensive subjects and controls. These results suggest that, in essential hypertension, there is not only increased platelet resting [Ca2+]i but also an increase in agonist-mediated calcium influx, which appears to indicate a cell membrane abnormality in the platelets of subjects with essential hypertension. PMID- 3818021 TI - Body fat patterning and blood pressure in children and young adults. The Bogalusa Heart Study. AB - The relationship of central body fat (measured by subscapular skinfold) and peripheral body fat (measured by triceps skinfold) to blood pressure was investigated in 3784 subjects aged 5 to 24 years old from the biracial community of Bogalusa, Louisiana. After adjustment for height, age, sex, and race, significant relationships were found for both central body fat (r = 0.19 and 0.14, p less than 0.0001) and peripheral body fat (r = 0.15 and 0.12; p less than 0.0001) with systolic and diastolic (fourth phase) blood pressure, respectively. However, the relationship between peripheral body fat and blood pressure, after controlling for the level of central body fat, was negligible (r = 0.00 and 0.01 for systolic and diastolic blood pressure, respectively). In contrast, the central body fat-blood pressure relationship remained statistically significant even after controlling for the peripheral body fat level. For central body fat, the partial correlations with systolic blood pressure were highest in young children (r = 0.15), dropped slightly during adolescence (r = 0.12), and became nonsignificant only in 18- to 24-year-old female subjects; correlations remained high in both black and white 18- to 24-year-old male subjects (r = 0.18 and 0.16, respectively). Mean levels of systolic blood pressure from the lowest to the highest quartile of central body fat ranged from 100.4 to 108.9 mm Hg. The adult hypertension-central body fat relationship, which has been shown by others, appears to exist in children. Continued efforts at early identification and prevention of obesity in children are warranted. PMID- 3818022 TI - Platelet activating factor vasoconstriction of dog kidney. Inhibition by alprazolam. AB - Systemic administration of platelet activating factor (PAF; acetyl glyceryl ether phosphorylcholine) reduces renal blood flow, but the mechanism responsible for that effect has not been defined. To address that problem, we determined the effects on renal blood flow of PAF administered directly into the renal artery in pentobarbital (30 mg/kg)-anesthetized dogs. Bolus injections of PAF (0.2-0.8 microgram) caused transient renal vasoconstriction, reducing renal blood flow by 20 to 60% without altering systemic blood pressure; lyso-PAF (1 microgram) had no effect. The effects of PAF on renal blood flow were not altered by alpha adrenergic blockade (phentolamine, 3 mg/kg) or by angiotensin II receptor blockade ([Sar1,Ala8]angiotensin II, 6 micrograms/kg/min), but they were increased in magnitude and duration by meclofenamate (5 mg/kg), a cyclooxygenase inhibitor. Methysergide (3 mg/kg), a serotonin antagonist, slightly reduced PAF effects, but a specific blocker of vascular serotonin receptors did not. Renal venous plasma platelet density was not altered by infusion of PAF into the renal artery at a dose (1-2 micrograms/min) that caused a sustained 20% renal blood flow decrease. Alprazolam, a benzodiazepine that competitively inhibited PAF induced aggregation in canine platelet-rich plasma, also inhibited the renal vasoconstrictor action of PAF (0.8 mg/min, into the renal artery) but did not alter renal vasoconstrictor effects of norepinephrine or angiotensin II. PMID- 3818023 TI - Paroxysmal hypertension due to sinoaortic baroreceptor denervation in humans. AB - A 41-year-old man with a remote history of neck and mediastinal radiation was seen with severe paroxysms of hypertension, headache, and cutaneous flushing after bilateral carotid bypass surgery. Investigation revealed marked parallel fluctuations in blood pressure and heart rate and elevation of plasma norepinephrine to 1164 pg/ml during a paroxysm. We systematically evaluated his arterial and cardiopulmonary baroreceptor reflex function by assessing changes in heart rate, arterial pressure, and efferent muscle sympathetic nerve activity, which was measured directly by the microneurographic technique. Elevating resting arterial pressure from 130/88 to 164/100 mm Hg with phenylephrine or lowering it to 88/56 mm Hg with nitroprusside produced no reflex changes in heart rate or efferent sympathetic nerve activity. In contrast, decreases in cardiac filling pressures with lower body negative pressure produced a marked increase in sympathetic nerve activity. These findings indicate complete loss of the afferent limb of the arterial baroreceptor reflex but preservation of the cardiopulmonary baroreceptor reflex. They suggest that both carotid and aortic baroreceptors were impaired by the previous radiation and surgery. Despite the loss of arterial baroreceptor function, the patient did not have sustained hypertension. The paroxysms of hypertension appear to be due to spontaneous fluctuations in central sympathetic drive not buffered by arterial baroreceptors in a manner similar to that seen in sinoaortic-denervated animals. PMID- 3818024 TI - Beta-adrenoceptor blockade and cardiovascular response to the cold pressor test. AB - Seven healthy subjects immersed a hand in random order in either warm water or in cold water at 5 degrees C for 2 min, after taking orally a single dose of 120 mg of propranolol or a placebo in a double blind fashion. The cold stress resulted in a significant increase in blood pressure and the rate pressure product without a change in heart rate. Beta-adrenoceptor blockade did not affect the pressor response the cold. The changes induced by the cold stress in the cardiovascular variables in the placebo and propranolol experiments were not statistically different. The highest rate pressure product during the cold pressor test was about 109 units. This was well below the pain threshold value of about 200 found during exercise in patients with ischaemic heart disease. In the recovery phase, the cardiovascular variables reverted to pre-immersion values within 1 min inspite of continued low hand skin temperature. PMID- 3818025 TI - A study of abnormal CSF total proteins and immunoglobulins levels in patients of depression. PMID- 3818026 TI - Studies on the effect of ascorbic acid, zinc sulphate and their combination on carrageenan-induced oedema in rats. PMID- 3818027 TI - Evidence against conversion of histamine H1 to H2 receptors in the guinea-pig ileum at low temperatures. PMID- 3818028 TI - Serum concentration of isoniazid following administration of the drug alone and in combination with rifampicin in patients of pulmonary tuberculosis. PMID- 3818029 TI - Assessment of oestrogenecity of neem leaf extract in rats. PMID- 3818030 TI - Relationship of examination stress to serum lipid profile. AB - Although mental stress as well as hypercholesterolaemia have been individually linked with atherosclerosis, the relationship between mental stress and hypercholesterolaemia is poorly understood. Serum lipid profile was studied in eight male medical student volunteers before, near and after examinations. Identical observations were also made on seven well-matched control volunteers. As compared to pre-exam levels, total serum cholesterol (T-C) increased significantly (P less than 0.05) near exams, and so did low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). The HDL-C/T C and HDL-C/LDL-C ratios remained essentially constant throughout the study. Control subjects did not show any significant change in serum lipid profile. Further serial measurement in five of the subjects revealed that examination related changes were transient. Moreover, a second examination after about 40 days did not evoke any change in the lipid profile. The response to examination stress may be related to the enhanced utilisation of cholesterol in the adrenal cortex for steroidogenesis. PMID- 3818031 TI - Thermoregulatory response in rats following administration of histamine in different CSF compartments. AB - Recently histamine is being considered as an important neurotransmitter/neuromodulator in the central nervous system. This has been supported from the present observations with regard to thermoregulatory responses elicited following histamine administration into different CSF compartments. Administration of histamine into the right lateral cerebral ventricle of rats showed a dose dependent fall in rectal temperature. This hypothermic response was evident only at moderately low or at thermoneutral ambient temperature. Administration of histamine into fourth ventricle produced hypothermic response at low ambient temperature and hyperthermia at thermoneutral ambient temperature, which was no longer observed when the ambient temperature remained above the thermoneutral zone. Infusion of histamine into spinal subarachnoid space produced hyperthermia which developed very slowly. However, the infusion of histamine into the subarachnoid space around the brain stem did not exhibit any change in rectal temperature. The significance of these observations has been discussed. PMID- 3818032 TI - Alcoholism: newer methods of management. AB - Chronic alcoholics were selected from hospitals and A.A. Centres and subjected to different methods of treatment namely, psycho therapy, stereotaxic surgery, nonvolitional biofeedback, Yoga and meditation and extremely low frequency Pulsed Magnetic Field. Each group comprised a minimum of 20 subjects. All were males between the ages of 20 and 45 years. Investigations done were clinical, psychological, biochemical, neurochemical and electrophysiological. Improvement was noticed in all the patients, the degree varying with the different methods of treatment. The patients were followed up at least for a period of one year. PMID- 3818033 TI - Cardiac activity disease by experimental interference in brain processes. AB - In 65 dogs by the method of motor alimentary condition reflexes and delayed reaction, an experimental model of the informational disease was created, which produced chronic increase of the heart rate and significant change in the segment of the ECG. PMID- 3818034 TI - Modification by tricyclic antidepressants of cortical EEG changes induced by clonidine in conscious rats. AB - The effects of various tricyclic antidepressants on clonidine-induced electroencephalographic changes were investigated in rats. The EEG pattern of conscious rats was recorded by means of bipolar electrodes, implanted chronically. Clonidine (50, 150 and 300 micrograms/kg) not only synchronized cortical EEG pattern but also evoked signs of behavioural depression within 15 min of its administration. Pretreatment with imipramine, desipramine, trimipramine, amitriptyline, nortriptyline and doxepin reduced clonidine-induced EEG synchrony without showing any effects per se. Acute treatment with tricyclic antidepressants failed to modify but, chronic treatment abolished the clonidine induced behavioural depressive signs. Chronic administration of tricyclic antidepressants (10 mg/kg/day) evoked more pronounced antagonism of the EEG effects of clonidine. Yohimbine (200 micrograms/kg) pretreatment inhibited both, clonidine-induced EEG synchrony and behavioural effects. Guanfacine as well as B HT 920, elicited clonidine-like effects on cortical EEG pattern and behaviour. The present data suggests that antagonism of clonidine-induced EEG synchronization in conscious animals could serve as a useful test for screening of antidepressant drugs. PMID- 3818035 TI - A study of lung function abnormalities in workers of cotton spinning shops. AB - Lung function was studied by forced expiratory spirograms and measurement of peak expiratory flow in fourteen young male subjects of the age 20 to 30 years. Seven of the subjects were cotton spinners in small shops in Paharganj market with the duration of work from 1 to 3 years. The other seven subjects served as controls. All the subjects were of the same socio-economic status and were North Indians. Forced vital capacity; forced expiratory volume in 1 sec; forced expiratory volume in 1 sec expressed as a percentage of forced vital capacity; forced expiratory flow between 80 and 70 per cent, between 55 and 45 per cent, between 30 and 20 per cent and between 15 and 5 per cent of the forced vital capacity were determined from forced expiratory spirograms. Peak expiratory flow and FEB 80-70% were significantly lower in cotton spinners suggesting involvement of larger airways. PMID- 3818036 TI - Diuretic effect of Aerua lanata with water, normal saline and coriander as controls. AB - The extract (200 ml of 50 g/L) of common garden herb (in Sri Lanka) Aerua lanata (S. Polpala, T. Thengapookeerai) induced diuresis, consistent ovet four repetitions in 70% of the subjects. The rest of the subjects needed higher concentration of the solution (100 g/L), to induce diuresis. The urine output observed with the fresh plant extract was significantly elevated (P less than 0.001) when compared with controls who received the same quantities of water, 0.9% saline of extracts of the seeds of another medicinal plant, Corlandrum sativum. Raw flowers of Aerua lanata were found to be the most effective in inducing diuresis when compared to the other parts of the raw plant and its dried form. PMID- 3818037 TI - Immediate metabolic effects following oral ingestion in humans--a preliminary report. PMID- 3818038 TI - Effect of yoga on exercise tolerance in normal healthy volunteers. AB - Twelve normal healthy volunteers (6 males and 6 females) undergoing yoga training for 90 days were studied for the effect of yoga on exercise tolerance. Their ages ranged from 18 to 28 years. The volunteers were taught only Pranayama for the first 20 days and later on yogic asanas were added. Sub-maximal exercise tolerance test was done on a motorized treadmill by using Balke's modified protocol, initially, after 20 days (Phase-I) and after 90 days of yoga training (Phase-II). Pyruvate and lactate in venous blood and blood gases in capillary blood were estimated immediately before and after the exercise. Minute ventilation and oxygen consumption were estimated before and during the test. Post exercise blood lactate was elevated significantly during initial and Phase I, but not in Phase-II. There was significant reduction of minute ventilation and oxygen consumption only in males in Phase-I and II at the time when the volunteers reached their 80% of the predicted heart rate. Female volunteers were able to go to higher loads of exercise in Phase-I and II. PMID- 3818039 TI - Role of H-reflex latency studies in the diagnosis of subclinical diabetic neuropathy. AB - Motor conduction velocity (MCV) in the median, ulnar and peroneal nerves and H reflex studies have been conducted in 50 diabetics aged 20-65 years and 25 controls. MCV in the upper limb was below the normal range in 16% of diabetics. 28% diabetics showed abnormal MCV in the peroneal nerve. H-reflex abnormality consisting of either prolonged latency or its complete absence could be observed in 54% of diabetics. The results indicate the greater sensitivity of H-reflex in the detection of sub-clinical diabetic neuropathy. Greater prevalence of neuropathy in the early onset diabetes than in the late onset type is also suggested. PMID- 3818040 TI - Hypnotizability and performance at examination. A correlative study. AB - Hypnotizability of 45 medical students was assessed by applying the Harvard Group Scale of Hypnotic Susceptibility, Form: A (HGSHS:A) of Shor and Orne. Comparison of hypnotizability with performance of the students at a test examination evolved a significant positive correlation (r = 0.59). The prevalent misconception that only psychologically weak or sick people with poor intelligence are hypnotizable is disproved. Probable causes, responsible for such a relationship between hypnotizability and performance at examination are discussed. PMID- 3818041 TI - The effect of acute and chronic treatment of verapamil on pressor response to angiotensin II in rats. AB - The effect of verapamil on pressor response to Angiotensin II (A II) was investigated in rats. The responses to A II (10, 20, 40 ng, iv) was reduced after verapamil (50 and 100 micrograms, iv per rat) in a dose dependent manner. Treatment for 5 day with verapamil (18 mg/100 g/day, po) let to some reduction in basal blood pressure but pressor response to A II was not changed. Treatment for 20 days significantly reduced the basal blood pressure and increased the responsiveness to A II. it is concluded that Ca++ plays a major role in the pressor responses to A II and that chronic treatment with verapamil may reduce basal blood pressure. PMID- 3818042 TI - Some pharmacological actions of the essential oil of Blumea membranacea. AB - The essential oil obtained from the plant Blumea membranacea produced a marked and long lasting fall in blood pressure in anaesthetized dogs. The oil exerted a direct depressant action on frog heart and spasmolytic effect on rabbit ileum. It also depressed the conditioned avoidance response, adversely affected rotarod performance and potentiated the pentobarbitone induced hypnosis in rats. PMID- 3818043 TI - Effect of intra-uterine administration of dimethylsulfoxide on fertility of rats. AB - A single intra-uterine injection of 60 microliters of dimethylsulfoxide prevented implantation when administered before mating and induced resorption of the conceptus in rats when given during early pregnancy. PMID- 3818044 TI - Effect of Ca++ channel blockers and saralasin on angiotensin II induced contraction in rabbit aortic strip. AB - To investigate the role of calcium in angiotensin II (A II) induced contractions in rabbit aortic strip, the action of verapamil, nifedipine, cinnarizine and saralasin was studied. The cumulative dose response curves obtained with A II shifted to right with increasing concentrations of all these four agents. The antagonism was noncompetitive. The pD'2 value of saralasin was 8.49 of nifedipine, 8.15 and or verapamil 7.92. Cinnarizine which mainly acts at intracellular site had pD'2 value 5.54. The results indicate that A II induced contractions critically depend on entry of calcium through channels which appear to be closely associated with angiotensin receptors. PMID- 3818045 TI - Diagnostic and prognostic significance of serum phosphohexose isomerase, aldolase and hexokinase in carcinoma cervix. AB - Serum levels of phosphohexose isomerase (PHI), aldolase (ALD) and hexokinase (HK) activities have been determined in 76 patients of carcinoma cervix, in search of proper diagnostic and prognostic parameters. All the three glycolytic enzyme levels studied were found to be significantly elevated in all the groups of malignancy and showed a relation to the clinical stage and tumor. Serum PHI levels were of best diagnostic significance even at an early stage of the disease. The enzyme levels correlated well with the prognosis of the disease. PMID- 3818046 TI - Combined effect of cyclophosphamide and extracts of Crotalaria and Senecio plants on experimental tumours. AB - The combined effect of cyclophosphamide (CTX) and extracts of six patients belonging to Crotalaria and Senecio genera was assessed on experimental transplantable S180 (both ascitic and solid forms) tumour. Successive petroleum ether and methanolic extracts from these plants were obtained. The combined administration of CTX and petroleum ether extract of C. albida and the methanolic extracts of C. albida, S. chrysanthemoides, S. densiflorus and S. jacquemontianus led to prolonging the life span of S180 (ascitic) tumour bearing mice. The data indicate that the most effective extract in combination with CTX was the methanolic extract of S. chrysanthemoides. The extracts alone had no effect on survival of tumour-bearing mice. The same extracts and the same combinations had no effect on S180 solid tumour. PMID- 3818047 TI - Influence of reserpine and guanethidine on the responses of the isolated rat ileum to catecholamines. AB - The sensitivity of the isolated ileum of the rat to catecholamines has been investigated using normal, reserpinized and guanethidine treated animals. Both reserpine and guanethidine treatment produces supersensitivity to adrenaline, noradrenaline and to a greater extent to isoprenaline. PMID- 3818048 TI - Role of prostaglandins in hypotension following pressor response to intravenous infusion of noradrenaline in dogs. PMID- 3818049 TI - [Comparative studies of the metabolism of MCT/LCT and LCT emulsions in diabetics]. AB - In 7 moderately overweight non-insulin dependent diabetics with slightly elevated triglyceride levels, disappearance rates of MCT/LCT- und LCT-emulsions were compared. 5 metabolically healthy volunteers served as control. During a 3-hour lipid infusion, serum triglycerides reached a steady state with both emulsions in the healthy controls, whereas in diabetic patients, steady state triglyceride levels were seen only with MCT/LCT. After the end of the lipid infusion, the longest half life value concerning the decline of triglyceride levels was found with LCT in diabetics, while significantly shorter and quite similar half life values were found with LCT in healthy controls and MCT/LCT in diabetics. The shortest half life for serum triglycerides was expectedly found in healthy controls. According to these data, parenteral nutrition with lipids in states of disturbed glucose and lipid metabolism--if necessary--should preferentially be done with MCT/LCT emulsions. PMID- 3818050 TI - Alcohol and traumatic brain damage. AB - Many head-injured patients have been drinking alcohol, and it has been suggested that the effect of a raised blood alcohol may be to potentiate brain damage after head injury. To investigate this, a study was carried out on 38 consecutive, recently head-injured patients admitted to the Glasgow Neurosurgical Unit. Conscious level, blood alcohol and serum creatine kinase BB (CKBB) were measured on admission (the latter by radioimmunoassay). Conscious level related strongly to outcome (chi 2 = 11.678, P less than 0.001), and serum CKBB (chi 2 = 8.333, P less than 0.01) but not to blood alcohol level. In patients with severe head injury admitted to a neurosurgical unit, coma is more likely to be due to the injury than to the blood alcohol level, and alcohol does not adversely affect outcome in such patients. PMID- 3818051 TI - Fatal cervical spinal injuries in road traffic accidents. AB - The present study analyses fatal road traffic accidents involving private cars and vans in Finland during the period 1972-1982, in which an injury to the cervical spine was the main cause of death. The material consists of 289 victims; this being 10.5 per cent of all the fatalities in this category of road traffic accidents. Front seat and rear seat passengers seem to have an equal risk of sustaining a fatal cervical spinal injury. However, front seat passengers have a significantly greater chance (P less than 0.001) of having fatal cervical spinal injuries than the drivers. Of the victims 21.1 per cent had worn safety belts but there was no statistical difference between those who did and those who did not wear safety belts. Increasing age seems to increase the risk of fatal cervical spinal injuries. Patients between 16 and 25 years of age had the lowest risk and patients over the age of 60 had the highest risk of sustaining a fatal cervical spinal injury (P less than 0.001). In 48.1 per cent of the cases, the victims were multiply injured and this is similar to other main causes of death in road traffic accidents. Wearers of safety belts had significantly (P less than 0.001) more multiple injuries. Of the patients who died of cervical injury, only 8.8 per cent survived transportation to hospital and 1.4 per cent survived longer than 24 hours. A direct blow was the most common mechanism of the cervical injury (47.1 per cent) and deceleration was found in 13.1 per cent of the cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818052 TI - Avascular femoral head necrosis following fracture fixation. AB - A prospective, randomized trial of 104 consecutive patients with displaced fractures of the femoral neck treated with either a sliding screw plate or four AO cancellous bone screws was performed to study the influence of the fixation device and the fixation procedure on the vascularity of the femoral head. The vitality of the femoral head was determined by 99mTc-MDP scintigraphy performed 2 3 months after the operation. Eighty-seven patients (84 per cent) were available for assessment. The two treatment groups were comparable with regard to age, degree of primary displacement and quality of reduction. There were significantly more (P less than 0.01) avascular femoral heads or femoral heads with reduced vascularity in the sliding screw plate group (14/40, 35 per cent) than in the four AO cancellous bone screw group (5/47, 11 per cent). PMID- 3818053 TI - Bilateral stress fractures of the femoral neck associated with abnormal anatomy- a case report. PMID- 3818054 TI - Arthroscopy in children, with special emphasis on meniscal lesions. AB - Seventy-six children under 16 years of age (mean age 14.5) underwent diagnostic arthroscopy of the knee. Seventeen were examined under local anaesthesia as outpatients. The referring doctors suspected a meniscal lesion in 25 cases, but in only 6 of these was the diagnosis confirmed. The surgeon's diagnosis was verified in 9 out of 31 cases; unsuspected lesions of both menisci in one knee make a total of 10 patients with meniscal lesions (10 knees, 11 menisci). The most frequent lesion found was rupture of the anterior cruciate ligament (12). Because of the arthroscopy, three minor meniscal lesions could be observed without treatment, and no menisci were totally removed. In two cases an arthrotomy would have been done on the wrong side of the knee if the operation had not been preceded by arthroscopy. Fifteen arthroscopic operations were done but only three for meniscal lesions. PMID- 3818055 TI - Drawbacks of traction-absorbing wiring (TAW) in displaced fractures of the olecranon. AB - Drawbacks of traction-absorbing wiring (TAW) in displaced fractures of the olecranon were observed in 29 out of 55 consecutive patients. Sliding of the K wires, with resulting skin troubles in 24 patients (10 patients with perforation of the skin), required premature removal of the implant. Minor operative modifications in the TAW technique are suggested in order to avoid these drawbacks. PMID- 3818056 TI - Isolated traumatic anterior dislocation of the radial head--a mechanism of injury in children. PMID- 3818057 TI - Supracondylar fractures of the humerus in adults. AB - Thirty consecutive supracondylar fractures of the humerus, treated by open reduction and internal fixation over a 4-year period from 1980 to 1984, are reviewed. We feel that anatomical reduction with rigid fixation allowing immediate postoperative movement gives the least morbidity and best results. PMID- 3818058 TI - Bier's block--an improved technique. AB - A simple modification to the method of regional anaesthesia known as Bier's block is presented. This was applied to patients with Colles' fractures. In a controlled trial the technique produced anaesthesia more quickly than the other method. PMID- 3818059 TI - Fractures of the metacarpal neck of the little finger. AB - A prospective study of 73 patients with fractures of the metacarpal neck of the little finger is reported. Fifty-seven (78 per cent) of the patients were followed up between 1 and 2 years after the injury. Forty-three (75 per cent) of these patients complained of symptoms, though only one patient considered himself disabled. The normal head/shaft angle at the fifth metacarpal neck measured in 12 control subjects as viewed on an oblique radiograph was 26 degrees. The importance of allowing for this normal angulation when assessing the angulation at the fracture is discussed. After manipulation, the corrected position of the fracture is not adequately maintained by a volar plaster slab. No definite relationship between the presence of symptoms and the residual angulation at the fracture site was demonstrated. Manipulation of these fractures is thus seldom indicated. PMID- 3818060 TI - The Third Whitbread Round the World Race. AB - A medical report from the Third Whitbread Round the World Race (1981-1982) is presented by the doctor on board the Swedish entry, who was also the contact doctor for the fleet. The race is the longest ocean race in the world at 27,000 nautical miles. It is divided into four legs with the yachts being offshore for 4 6 weeks on each leg. The medical preparation for the Swedish entry and the organization for the contact between the 28 participating boats are presented. The problems of medical interest during the race, as well as the possible dangers on board and their prevention, are listed and discussed. It is concluded that good medical preparation for the race is of great importance for the results. PMID- 3818061 TI - Breakdancer's thumb--partial rupture of the ulnar collateral ligament with a fracture of the proximal phalanx of the thumb. AB - Breakdancing is an acrobatic dance that involves spinning on various parts of the body including the head, dorsal spine and hand. Three cases are reported of partial rupture of the ulnar collateral ligament (UCL) of the thumb, associated with a fracture of the base of the proximal phalanx which occurred as a result of torsional forces applied to the abducted and hyperextended thumb. It appears to be a distinct clinical entity. In all cases, open reduction was required and led to excellent functional recovery. PMID- 3818062 TI - Skier's thumb--a method of prevention. AB - Skiing is increasingly popular among people of all ages and as the number of enthusiasts grows so does the incidence of ski-related injuries. Injuries to the thumb, which account for up to 17 per cent of skiing injuries, are associated with considerable morbidity. The cause of these injuries is discussed and a simple method of prevention is proposed. PMID- 3818063 TI - Ice-skating injuries. AB - The range of injuries sustained at an ice-rink and presented to an Accident Service department is described. A total of 203 patients with 222 injuries presented themselves during a 2-month period. There were 103 noteworthy injuries, including 61 fractures, 2 dislocations and 2 severed tendons, but the commonest injuries were wounds, sprains and bruises. Beginners appear to be more prone to injury than experienced skaters. In addition to using well-fitting skate-boots to protect the ankle, some injuries could be avoided by wearing elbow and knee pads, and a thick pair of gloves. The number of injuries compared with the total number of skaters was small but produced a noteworthy increase in the workload of the Accident Service. PMID- 3818064 TI - Artificial ski slope injuries: a 1-year prospective study. AB - Skiing is one of the fastest growing sports in the United Kingdom. A prospective study of 119 patients who sustained injuries while skiing on the Edinburgh artificial ski slope was performed. The ratio of injury of the arm to that of the leg was 4.2:1, which is the reverse of that found with snow skiing. In particular, thumb injuries accounted for 32 per cent of all injuries. Attention is drawn to the high incidence of damage to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, which is related to the construction of the 'snow slope' matting. The pattern of injury is described and the mechanisms of injury discussed. PMID- 3818065 TI - The effect of head restraints and seat belts on the incidence of neck injury in car accidents. AB - During a 5-month period a study was made of motor vehicle occupants presenting at an Accident and Emergency department following an accident. Records were made of the incidence of neck injuries in relation to the presence of head restraints and the use of seat belts. There was a slight reduction in injuries when a head restraint was fitted but this difference did not achieve statistical significance. The incidence of neck injury was not increased if a seat belt was worn. It may be that the reason for the failure of head restraints to afford the expected protection is their inappropriate design and lack of adequate adjustability. PMID- 3818066 TI - Spinal and abdominal injury in an infant due to the incorrect use of a car seat belt. PMID- 3818067 TI - Distal arterial emboli following seat belt injury of the aorta. PMID- 3818068 TI - Should pedal cyclists wear helmets? A comparison of head injuries sustained by pedal cyclists and motorcyclists in road traffic accidents. AB - Five hundred and thirty-eight motorcyclist (MCs) and 523 pedal cyclist (PCs) victims of road traffic accidents were studied. Nineteen out of 21 of the PCs who died suffered major head injuries (AIS greater than or equal to 4) whereas 21 out of 87 MCs suffered no head injury at all. PCs who died more commonly sustained a head injury, and on average sustained more severe head injuries than dying MCs. Surviving PCs suffered head injuries more commonly than surviving MCs. MCs who died having sustained a head injury usually suffered other, often multiple, injuries of equal or greater severity whereas dying PCs commonly suffered no other injury of comparable severity to their head injury. It is suggested that if the severity of head injuries sustained by injured PCs could be reduced (e.g. by wearing helmets) survival rates would improve as most fatalities do not involve other major injuries. Helmets might also reduce the incidence and severity of head injuries in PCs who survive their accident. PMID- 3818069 TI - Protective helmets for motorcyclists--a new British Standard (BS 6658). PMID- 3818070 TI - A new treatment of stable lateral ligament injuries of the ankle joint. AB - A support for the treatment of stable injuries of the lateral ligament of the ankle has been designed. One hundred and seventy-five consecutive patients with acute injuries were studied. Unstable injuries were excluded by the use of the radiological anterior stress test. One hundred and forty-four patients with stable injuries were randomly allocated to three treatment groups: double Tubigrip, eversion strapping and the new support. The change in the range of movement was used as an objective measure of improvement. The new support was noticeably better than Tubigrip and eversion strapping. PMID- 3818071 TI - Broken necks of the femur in a psychogeriatric hospital. AB - We report a prospective study of the results of treatment of fractures of the neck of the femur in 102 patients in a psychogeriatric hospital. The results show that early operation may reduce complications but the aftercare should be in the familiar surroundings of the mental hospital. The costs of this policy are also considered. PMID- 3818072 TI - Fractures of the femur treated by femoral plating using the anterolateral approach. AB - A review of 56 fractures of the femoral shaft plated by the anterolateral approach was undertaken. The final results were graded as excellent or good in 37 cases (66 per cent). Loss of flexion of the knee of more than 10 degrees occurred in 17 cases (30 per cent); these were mostly patients whose plating was delayed by more than 14 days, or was done as a secondary procedure. Patients with open fractures and with other fractures in the same femur tended to have poorer final results. The late complication rate was 18 per cent, which was similar to that for the posterolateral approach for plating the femoral shaft. It is our view that the anterolateral approach is satisfactory for plating the femoral shaft. PMID- 3818073 TI - Detection of glass foreign bodies by radiography. AB - During a 14-month period patients with suspected glass foreign bodies were radiographically examined before removal of the glass. In 25 out of 26 patients the glass foreign bodies were detected. In 9 patients the glass foreign bodies had been overlooked on previous visits to doctors or hospitals, where the examination had been limited to inspection and sometimes probing of the wound. Almost all glass foreign bodies can be detected radiographically. With high resolution or mammographic techniques even minute splinters may show up. PMID- 3818074 TI - Pasteurella multocida wound infections--a commonly unrecognized problem in the casualty department. AB - Wounds inflicted by animal bites are a common cause of attendance at casualty units. Many of these injuries are of little consequence, but if they are inappropriately treated, serious consequences can ensue. Pasteurella multocida is a common contaminant of wounds inflicted by domestic animals, in particular cats. We report here a series of six severe P. multocida wound infections, and refer to the current literature on the subject. Strains of P. multocida isolated from some wounds failed to respond to conventional chemotherapy with penicillin. PMID- 3818075 TI - A case of traumatic atlanto-occipital dislocation with survival. PMID- 3818076 TI - Injury to horseshoe kidneys--an unusual event? PMID- 3818077 TI - An unusual combination of rare hand and wrist injuries. PMID- 3818078 TI - Diaphragmatic rupture in late pregnancy due to blunt injury. PMID- 3818079 TI - Fatigue fracture of the distal part of the radius in a pool player. AB - A stress fracture of the radius occurred in a 22-year-old pool player who was well known for his unique style of putting 'English' on the billiard ball. Typical radiographic findings were seen, and the fracture subsequently healed. Only a few cases of stress fracture of the radius have been previously reported. PMID- 3818080 TI - Stress fracture of the femoral neck following internal fixation: a case report. PMID- 3818081 TI - Nucleotide sequence homology to pertussis toxin gene in Bordetella bronchiseptica and Bordetella parapertussis. AB - Multiple strains of Bordetella parapertussis and B. bronchiseptica were examined for the presence of nucleotide sequences which hybridized with a cloned 4.5 kilobase (kb) fragment of B. pertussis DNA containing the genes responsible for pertussis toxin expression. All six B. parapertussis strains tested had nucleic acid sequences that hybridized with the cloned 4.5-kb fragment in Southern blot analyses. When the B. parapertussis DNA was digested with restriction endonuclease PstI, the pattern of hybridization was identical to that obtained with B. pertussis. Only five of the seven B. bronchiseptica strains tested had sequences that hybridized with the 4.5-kb fragment. Three of these B. bronchiseptica strains had a hybridization pattern identical to B. pertussis upon PstI digestion and Southern blot analyses. Two B. bronchiseptica strains were shown to lack a PstI cleavage site downstream from the region analogous to that coding for the pertussis toxin structural genes. Monoclonal antibody analyses were unable to detect pertussis toxin subunits S1 and S2 in Western blots with cellular material or culture supernatant from several B. bronchiseptica and B. parapertussis strains that possessed the DNA homologies. In addition, preliminary Northern hybridizations with RNA isolated from B. bronchiseptica and B. parapertussis strains suggested that the homologous regions were not transcribed. The data show that the gene coding for the toxic component of B. pertussis is common in other Bordetella species, though the gene probably is not expressed. PMID- 3818082 TI - Antibody- and complement-dependent cell injury assayed by 51Cr release from human peripheral blood mononuclear cells pretreated with lipopolysaccharide. AB - Exposure of human peripheral blood mononuclear (MN) cells to deesterified (alkali treated) lipopolysaccharide (LPS-OH) and then to 51Cr rendered the cells susceptible to 51Cr release in the presence of specific antibody and complement. The assay was optimized by using rough (Rb2 or Re) LPS. 51Cr release did not occur from cells preexposed to untreated or electrodialyzed LPS. Studies of isolated monocytes and lymphocytes revealed that the majority of the 51Cr released was derived from monocytes. The optimum concentration of LPS-OH was 10 micrograms/ml. Antiyersinia agglutinin-positive serum, but not a negative serum, obtained from patients with reactive yersinia arthritis caused 51Cr release from MN cells pretreated with yersinia LPS-OH. This implies that during yersinia infection antibodies are generated that can attack the cell membrane--LPS-OH complex. We conclude that the method provides a tool to demonstrate binding of LPS to MN cells in a manner that leads to cell injury in an immune host. PMID- 3818083 TI - Isolation and characterization of spontaneous avirulent variants of Histoplasma capsulatum. AB - A selection procedure was developed which allowed us to isolate spontaneous isogenic avirulent clones from virulent strains of Histoplasma capsulatum. The avirulent yeasts had a unique phenotype: they did not aggregate like the parental strains but grew as dispersed budded and unbudded single cells in liquid medium. On solid medium, the avirulent variant strains grew as smooth-textured colonies, whereas the virulent parental strains grew as rough convoluted colonies. Virulence testing in mice demonstrated that the smooth variants gave 50% lethal dose values similar to those of the avirulent Downs strain. Growth curves for the paired rough and smooth strains were similar. Furthermore, they had the same protein profiles when crude cell fractions were separated on one-dimensional polyacrylamide gels or when whole-cell extracts were separated by two-dimensional gel electrophoresis. Electrophoresis of culture supernatants, however, revealed a difference in a released low-molecular-weight peptide that may be related to virulence. In addition to their usefulness in comparative virulence studies, these avirulent strains should prove valuable for H. capsulatum genetic experiments because of the unique ability of these yeasts to grow without clumping. PMID- 3818084 TI - Candidacidal factors in murine bronchoalveolar lavage fluid. AB - Respiratory secretions provide an efficient method for protecting the large surface area of the lower respiratory tract. To determine whether lung secretions contribute to antifungal defenses, we tested bronchoalveolar lavage fluid for fungicidal activity. Candida albicans (blastoconidia) was incubated in unconcentrated cell-free lavage fluid from Swiss Webster mice and then cultured quantitatively to measure residual viability. In control buffer the residual fractions of viable fungi were 1.03 +/- 0.12 at 60 min and 0.84 +/- 0.05 at 120 min, whereas the residual fractions in lavage fluid were 0.64 +/- 0.07 and 0.23 +/- 0.05, respectively (P less than 0.05 by t tests). This activity was trypsin sensitive and heat stable (56 degrees C) and did not require divalent cations. It did not sediment with the surfactant fraction of lung lavage fluid. Unconcentrated lavage fluid reduced the adherence of C. albicans to serum-coated glass tubes to 2.3 +/- 1.5% of that of control Candida suspensions (n = 5, P less than 0.05 by t test). It did not alter Candida ingestion or intracellular processing by alveolar macrophages. Lavage fluid also killed clinical isolates of Candida tropicalis and Torulopsis glabrata but did not kill Candida krusei or Candida parapsilosis. Lavage fluid was concentrated and passed through an acrylamide-agarose gel matrix. The chromatogram indicated that the candidacidal activity eluted in a peak with a molecular weight range of 29,000 to 40,000. After electrophoresis on 15% sodium dodecyl sulfate-polyacrylamide gels, these fractions resolved into three bands. These were transferred to nitrocellulose and then eluted with Triton X-100; this procedure permitted the isolation of a single band of candidacidal activity with a molecular weight of 29,000. In summary, murine lavage fluid contains a heat-stable protein with direct antifungal activity. This soluble factor may contribute to lung defense processes by reducing fungal viability and adherence to tissue surfaces. PMID- 3818085 TI - Resistance to pesticin, storage of iron, and invasion of HeLa cells by Yersiniae. AB - The independent abilities of Yersinia pestis to absorb exogenous pigments including hemin and Congo red (Pgm+) and to produce the bacteriocin pesticin with genetically linked invasive enzymes (Pst+) are established virulence factors of the species. Pst- Pgm+ strains of Y. pestis are sensitive to pesticin (Psts), and mutation of these isolates to pesticin resistance (Pstr) is known to result in concomitant conversion to Pgm-. Wild-type cells of Yersinia pseudotuberculosis and Yersinia enterocolitica are Pgm- but may be Psts; mutation of the latter to Pstr also results in avirulence. In this study, typical Pgm- mutants of Y. pestis exhibited a dramatic nutritional requirement at 37 degrees C but not 26 degrees C for iron which could be fulfilled by either Fe3+ or hemin. Iron privation of Pgm- yersiniae resulted in formation of osmotically stable spheroplasts similar to those previously observed after exposure of Psts bacteria to pesticin. At 37 degrees C, Pgm+ organisms rapidly overgrew initially predominant Pgm- populations in iron-deficient medium. However, Pgm-isolates could undergo a second mutation that permitted successful competition with Pgm+ cells in this environment. The mutation to Pstr in Y. pseudotuberculosis and Y. enterocolitica did not promote a similar requirement for iron but rather prevented these organisms from penetrating HeLa cells. The ability to invade these nonprofessional phagocytes was not shared by Pgm+ or Pgm- cells of Y. pestis. PMID- 3818086 TI - Release of outer membrane fragments by exponentially growing Brucella melitensis cells. AB - Rough and smooth strains of Brucella melitensis released a membranous material that was devoid of detectable NADH oxidase and succinic dehydrogenase activity (cytoplasmic membrane markers) but that contained lipopolysaccharide, proteins, and phospholipids. This material was composed of two fractions that had similar chemical compositions but that were of different sizes which were separated by differential ultracentrifugation. Electron microscopy showed that both fractions are made of unit membrane structures. The membrane fragments were released during the exponential phase of growth, and no leakage of malic dehydrogenase activity (cytosol marker) was detected. Thus, the fragments were unlikely a result of cell lysis. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis showed that, although group 2 Brucella outer membrane proteins and lipoprotein were not detected, the proteins in the membranous material were outer membrane proteins. Gas-liquid chromatography analysis showed a similar fatty acid profile for the cell envelope and the outer membrane fragments of the smooth strain B. melitensis 16M. In contrast, the outer membrane fragments from the rough 115 strain were enriched in palmitic and stearic acids. With respect to the unfractionated cell envelope, outer membrane fragments were enriched in phosphatidylcholine, a phospholipid that is unusual in bacterial membranes. PMID- 3818087 TI - Fluid accumulation in infant mice caused by Vibrio hollisae and its extracellular enterotoxin. AB - Vibrio hollisae, a halophilic bacterium isolated from patients with diarrhea, was examined for virulence factor production. Intragastric administration of 2 X 10(7) CFU per mouse elicited fluid accumulation which peaked at ca. 6 h postchallenge in infant mice. An enterotoxin which elongated Chinese hamster ovary (CHO) cells was detected in extracts of infected-mouse intestines and in culture fluids from various growth media. The yield of the enterotoxin was maximal beginning at the onset of the stationary phase of growth in heart infusion broth supplemented with 0.5% NaCl. A concentrated preparation obtained by ammonium sulfate precipitation of culture supernatant fluids induced intestinal fluid accumulation which peaked at 2 h postchallenge in infant mice. The abilities of the enterotoxin preparation to elongate CHO cells and to elicit fluid accumulation in infant mice were inseparable by gel filtration, isoelectric focusing, and hydrophobic interaction chromatography. The enterotoxin has a molecular weight of ca. 33,000 by gel filtration and an isoelectric point of ca. 4 and is sensitive to heat. PMID- 3818088 TI - Induction of delayed-type hypersensitivity to Leishmania major and the concomitant acceleration of disease development in progressive murine cutaneous leishmaniasis. AB - BALB/c mice injected intradermally with 10(5) or higher doses of formaldehyde fixed promastigotes (FFP) of Leishmania major developed strong delayed-type hypersensitivity (DTH) to leishmanial antigens injected into the hind footpad 3 to 10 days later. The DTH peaked 15 to 18 h after footpad injection and disappeared by 48 h. This specific DTH correlated with the homing of 51Cr-labeled syngeneic bone marrow cells and the infiltration of proliferating cells to the site of antigen administration. Spleen cells from FFP-sensitized mice also gave significant proliferative response to FFP in vitro. The DTH was adoptively transferable by Lyt-1+2-L3T4+ T cells and was H-2 restricted. DTH could be substantially enhanced by pretreatment with cyclophosphamide or pertussigen. Such DTH enhancement was accompanied by concomitant exacerbation of disease progression after L. major infection. Mice injected intravenously with FFP developed substantial immunity to cutaneous leishmaniasis but specifically suppressed DTH reactivity. Treatment of mice with pertussigen before intravenous immunization, however, abolished the protection and reversed the suppression of DTH. These results therefore demonstrate that the early-appearing type of DTH is not involved in host protection but that it actually facilitates disease progression in cutaneous leishmaniasis. Further evidence, which also shows the nonspecific nature of this disease exacerbation, is provided by local cell transfer experiments. Splenic T cells from mice sensitized to keyhole limpet hemocyanin or FFP induced significantly larger lesions compared with normal T cells when they were transferred into the footpad together with specific antigen and L. major promastigotes. PMID- 3818089 TI - Oxygen sensitivity of sugar metabolism and interconversion of pyruvate formate lyase in intact cells of Streptococcus mutans and Streptococcus sanguis. AB - Pyruvate formate-lyase (PFL) (formate acetyltransferase; EC 2.3.1.54) of oral streptococci is essential for metabolizing sugar into volatile compounds (formate, acetate, and ethanol). This enzyme is extremely sensitive to oxygen, and its activity is irreversibly inactivated by oxygen. When Streptococcus sanguis was anaerobically starved, a part of the active form of PFL was converted into a reversible inactive form that was tolerant of oxygen. This reversible inactive enzyme could be reactivated to the active enzyme by anaerobic sugar metabolism, with the recovery of volatile compound production. The PFL in Streptococcus mutans was not converted into an oxygen-tolerant inactive form by anaerobic starvation, and after exposure of the cells to oxygen the PFL could not be reactivated. These findings suggest that S. mutans can produce acids rapidly under anaerobic conditions because of its capacity to keep PFL active and that S. sanguis can protect its sugar metabolism from oxygen impairment because of its interconversion of PFL. PMID- 3818090 TI - A bacteriocin of Actinobacillus actinomycetemcomitans. AB - An inhibitory factor from Actinobacillus actinomycetemcomitans Y4 was isolated, and its properties indicated that it was a bacteriocin (actinobacillicin). The bacteriocin was active against Streptococcus sanguis strains, Streptococcus uberis (FDC1), and Actinomyces viscosus T14 as well as other strains of A. actinomycetemcomitans, but not against other crevicular bacteria, including other streptococci and actinomycetes. The activity of this bacteriocin was inhibited by pronase, trypsin, and heat (45 min at 56 degrees C) but not by DNase, RNase, phospholipase, exposure to UV light, or low pH (1.0 to 6.5). Although actinobacillicin markedly inhibited glycolysis in S. sanguis, the primary mechanism of its bactericidal action appears to be alterations in cell permeability, with the resultant leakage of RNA, DNA, and other essential intracellular macromolecules. These findings provide an ecologic explanation for the reciprocal growth relationship between A. actinomycetemcomitans and S. sanguis/Actinomyces viscosus observed in localized juvenile periodontitis. PMID- 3818091 TI - Purification and biochemical properties of a bacteriocin from Actinobacillus actinomycetemcomitans. AB - Extracts of certain strains of Actinobacillus actinomycetemcomitans are inhibitory to strains of Streptococcus sanguis such as S. sanguis ATCC 10556. The isolation of a protein from an A. actinomycetemcomitans sonic extract which copurified with the inhibitory activity was accomplished by preparative isoelectric focusing, Sephadex G-100 gel filtration chromatography, and preparative polyacrylamide gel electrophoresis (PAGE). The resulting isolated protein, which focused at a pH of 6.1 to 6.3, appeared as a single band in anionic nondissociating PAGE analysis. This protein could be dissociated into two subunits with molecular weights of 50,000 and 70,000, which were resolvable by PAGE analysis. A 1,758-fold increase in specific activity was seen in the purified inhibitory protein compared with the crude sonic extract starting material. The properties of the inhibitory activity in the A. actinomycetemcomitans extract are characteristic of a bacteriocin. Accordingly, we propose the name actinobacillicin for the inhibitory protein. PMID- 3818093 TI - Adhesion of Aeromonas salmonicida strains associated with net electrostatic charges of host tissue cells. AB - The adhesion of Aeromonas salmonicida, the pathogenic bacterium of fish furunculosis in salmon and trout, to the surface of host tissue cells was investigated with two fish tissue culture cell lines (RTG-2 cells from rainbow trout, Salmo gairdneri, and CHSE-214 cells from chinook salmon, Oncorhynchus tshawytscha) and four A. salmonicida strains. Bacterial cells of pathogenic strains were highly adhesive to RTG-2 and CHSE-214 cells and were negatively charged in the net electrostatic charges, as determined by electrophoresis on filter paper strips at pH 7, whereas bacterial cells of nonpathogenic strains were nonadhesive and positively charged. The electrophoresis of RTG-2 and CHSE 214 cells with balanced salt solution (BSS), phosphate-buffered saline, or fish serum diluted with BSS (pH 7) was carried out with an appropriate electrophoretic apparatus that was devised for this study. After electrophoresis with 20 mA of direct current for 15 min at pH 7, the electrophoretic dispositions of these tissue culture cells were determined by the mode of frequency of occurrence of these cells in the partitioned chambers of the device. RTG-2 and CHSE-214 cells with BSS and fish serum were attracted from the central chamber (to which each cell sample was added) to the cathode chambers, but no attraction was detected when these cells were used with phosphate-buffered saline. Noradrenaline- and phosphoenolpyruvate-pretreated RTG-2 cells migrated more to the cathode chambers, whereas succinate- and valine-pretreated RTG-2 cells moved to the anode chambers. These movements to the cathode and anode were alleviated by the use of RTG-2 cells preincubated with pathogenic and nonpathogenic bacterial cells, respectively. The adhesion of the pathogenic bacteria to RTG-2 cells was enhanced by the use of RTG-2 cells pretreated with noradrenaline and phosphoenolpyruvate, whereas the nonpathogenic bacteria were adherent to RTG-2 cells pretreated with succinate and valine. These findings indicate that the adhesion of A. salmonicida strains to host tissue cells is closely associated with mutually converse net electrostatic charges. PMID- 3818092 TI - Metabolism of glycosylsucrose by oral microorganisms and its hydrolysis by Streptococcus salivarius fructosyltransferase. AB - Resting-cell suspensions of oral microorganisms grown in sucrose were studied for the production of acid from glucosylsucrose and maltosylsucrose. Most oral microorganisms fermented these sugars to only a limited extent. Streptococcus salivarius, however, metabolized glucosylsucrose as well as sucrose. We therefore looked for a specific enzyme in S. salivarius which was capable of hydrolyzing glucosylsucrose. Fructosyltransferase and invertase were purified from S. salivarius 13419, and the substrate specificities and hydrolytic activities of these enzymes were determined. Purified fructosyltransferase catalyzed fructan synthesis from glucosylsucrose or maltosylsucrose, whereas purified invertase barely hydrolyzed these sugars. These results suggest that the high fermentative efficiency of glycosylsucrose by S. salivarius is due to the hydrolysis of these sugars by fructosyltransferase, but not by invertase. The partially purified fructosyltransferases of Actinomyces viscosus NY1 and Streptococcus mutans NCIB 11723 catalyzed fructan synthesis from glucosylsucrose or maltosylsucrose. The fructosyltransferases of these oral microorganisms are also responsible for the hydrolysis of glycosylsucrose. PMID- 3818094 TI - Production and characterization of serovar-specific monoclonal antibodies to serovars 4, 8, and 9 of Mycobacterium intracellulare. AB - Serovar-specific monoclonal antibodies against Mycobacterium avium-Mycobacterium intracellulare-Mycobacterium scrofulaceum complex serovars 4, 8, and 9 were prepared. Nine, four, and one monoclonal antibodies, respectively, to the serovars were prepared by the usual cell fusion technique. All nine monoclonal antibodies to serovar 4 were monospecific for their homologous serovar and reacted with several native glycopeptidolipids (GPLs) and one major deacylated GPL from the homologous serovar. One of the four monoclonal antibodies to serovar 8 seemed to be monospecific for its homologous serovar, but the other cross reacted with serovar 6 because serovar 6 organisms contain the same components as does the major deacylated GPL from serovar 8. One monoclonal antibody to serovar 9 was monospecific for its homologous serovar and reacted with one of the two major deacylated GPLs from this serovar. These antibody preparations proved useful for serovar identification. PMID- 3818095 TI - Induction of human granulocyte chemiluminescence by bacterial lipopolysaccharides. AB - Bacterial lipopolysaccharides (LPS) have been reported to influence the oxidative response of human polymorphonuclear leukocytes (PMN). However, results sometimes conflict. In the present study, we demonstrated that activation of human PMN by LPS depends on the class (smooth [S] or rough [R]) to which the LPS belongs. Lucigenin-dependent chemiluminescence was used to assay oxygen radical production. Twenty different S- and R-form LPS and free lipid A were tested in concentrations of 0.01 to 100 micrograms/ml. S-form LPS activated PMN only at maximal concentrations and to a low extent. R-form LPS and free lipid A were potent inducers of granulocyte chemiluminescence even at a concentration of 0.1 microgram/ml. The results indicated that R-form LPS are very effective in inducing granulocyte chemiluminescence, whereas true S-form preparations are inactive. It is not known at present whether this higher activity is due to a more lipophilic character of R-form LPS or whether the presence of the O polysaccharide in S-form LPS exerts an inhibitory effect on their action on granulocytes. PMID- 3818096 TI - Lipoarabinomannan and lipid-free arabinomannan antigens of Mycobacterium paratuberculosis. AB - Lipoarabinomannan (LAM) and lipid-free arabinomannan (AM) were prepared from Mycobacterium paratuberculosis. Purification of LAM was done by ultracentrifugation of the phenol-water-extracted crude polysaccharide, followed by affinity and anion exchange chromatography. AM was purified from the supernatant of the ultracentrifuged polysaccharide or from alkaline-extracted material by gel filtration and anion exchange chromatography. Chemical analysis revealed arabinose and mannose in LAM (1.4:1) and AM (3.5:1) and the presence of palmitic, stearic, and tuberculostearic acids for a total of 7.8% lipid in LAM. Traces of phosphorus were found in the AMs, particularly LAM (0.05%). Nuclear magnetic resonance confirmed the presence of alpha-arabinosyl residues and the acylated nature of LAM. LAM exhibited lipid-dependent aggregation, as indicated by a Triton-induced decrease in molecular weight. By using bovine sera, LAM was found to be active in the complement fixation test, whereas AM was inactive and inhibited this activity. Thus, the presence of AM in crude polysaccharide could explain the variable complement fixation results. Triton-dissociated LAM exhibited a precipitin (Cl) in common with that of AM, confirming shared determinants. LAM in its lipid-dependent aggregated form, however, exhibited a second precipitin (C2), which may be due to the disparity in antigen size or a novel epitope. The lipid content of LAM rendered it 100 times more effective for coating plates in the enzyme immunoassay than lipid-free AM. PMID- 3818097 TI - Production of monoclonal antibodies that recognize specific and cross-reactive antigens of Fusobacterium nucleatum. AB - Monoclonal antibodies (MAbs) against the cell surface antigens of Fusobacterium nucleatum 263 were obtained by fusion of murine myeloma cells (P3-NSI/1-Ag4-1) with the splenocytes of BALB/c mice immunized with whole cells of F. nucleatum 263. Screening was performed using an enzyme-linked immunosorbent assay (ELISA) against the immunizing strain, F. nucleatum 263. Further selection was done using a bacterial panel consisting of Bacteroides, Actinomyces, Streptococcus, Fusobacterium, and Escherichia species. Twelve MAbs were selected on the basis of this screening procedure, seven of which reacted specifically with F. nucleatum 263. Two reacted with F. nucleatum 263 and ATCC 25586, and three reacted with F. nucleatum 263, ATCC 25586, and UQD-003 (a clinical isolate) and also cross reacted with Fusobacterium russii ATCC 25533. The selected MAbs were then further characterized by absorption experiments with suspensions of intact whole bacterial cells, and the residual binding activity of the supernatants was determined in an ELISA. To determine whether the MAbs reacted with the same or different epitopes, pairs of MAbs were reacted together and independently in a checkerboard manner in an ELISA. The additive or nonadditive nature of the reactivity was determined. A competitive inhibition assay was performed using one labeled and selected unlabeled MAbs. The results of these experiments suggested some epitope sharing among the selected MAbs that reacted with a specific antigen on F. nucleatum and also shared cross-reactive antigens with the three strains of F. nucleatum and F. russii. PMID- 3818098 TI - Strain-specific antigens of Toxoplasma gondii. AB - A detailed immunological assessment of strain-specific antigens of Toxoplasma gondii has not been reported. We developed rabbit antisera against three strains of toxoplasma obtained from divergent sources. These strains included the frequently studied laboratory strain RH, strain C, obtained from a naturally infected kitten, and strain P, which is maintained by passage in mice. The rabbit antisera were used to identify unique strain-specific and commonly shared tachyzoite antigens by radioiodination followed by immunoprecipitation and Western blot analysis. Both qualitative and quantitative differences of a number of the major tachyzoite antigens were found in these assays. A parasite plaque reduction assay using parasiticidal monoclonal antibody showed marked differences in the ability to kill these three different tachyzoite subtypes, further supporting antigenic variation among T. gondii strains. PMID- 3818099 TI - Demonstration of a flagellar antigen shared by a diverse group of spiral-shaped bacteria that colonize intestinal mucus. AB - Western blot analysis showed that there is little immunological cross-reactivity of the human pathogens Campylobacter jejuni and Campylobacter coli with Campylobacter pyloridis, except for a very strong cross-reaction between the flagellins. This same antigenic cross-reaction was found with two isolates of gram-negative spiral microaerophilic bacteria that are known to colonize the intestinal mucosa of rodents, but not with the flagellins of a number of other motile bacteria. It is proposed that this shared flagellin antigen may be important structurally and functionally. PMID- 3818100 TI - Detection of specific antibody in adult human periodontitis sera to surface antigens of Bacteroides gingivalis. AB - Sera from adult periodontitis patients were analyzed for antibody activity against surface antigens of Bacteroides gingivalis by immunoblotting analysis. PMID- 3818101 TI - Comparison of Bacteroides vulgatus strains in the enhancement of experimental ulcerative colitis. AB - Strains of Bacteroides vulgatus from a variety of sources were tested for their abilities to enhance the inflammatory response in an experimental model for ulcerative colitis. Although there were considerable differences noted in inflammatory responses when guinea pigs were immunized with the various strains, there did not appear to be any correlation between the source of the isolates and the severity of the carrageenan-induced lesions. Strains from patients with ulcerative colitis were no more active in the model system than were strains from patients with antibiotic-associated colitis or strains from a healthy human source. The antibody titer to the strain used for immunization did not correlate with the severity of the cecal ulcerations, as determined by histopathologic evaluation. PMID- 3818102 TI - Mediation of Staphylococcus saprophyticus adherence to uroepithelial cells by lipoteichoic acid. AB - Treatment of uroepithelial cells with lipoteichoic acid from Staphylococcus saprophyticus resulted in a decrease in the adherence of this organism. Similar effects were observed when bacteria were pretreated with the lipoteichoic acid ligands albumin and anti-polyglycerophosphate monoclonal antibodies. Lipoteichoic acid might behave as an adhesin of S. saprophyticus. PMID- 3818103 TI - Prostatitis. PMID- 3818104 TI - Occurrence of campylobacter pyloridis in patients from Vienna with gastritis and peptic ulcers. AB - During routine gastroduodenoscopic examination of 120 patients, biopsies of gastric mucosa were taken for the isolation of Campylobacter pyloridis. The organism was isolated from six of seven patients with ulcus ventriculi, 14 of 15 with ulcus duodeni, 15 of 20 with erosions of the gastric mucosa, 31 of 61 with gastritis and five of five with duodenitis. In contrast, the cultures were negative in all of the 12 patients with histologically normal mucosa. C. pyloridis was isolated significantly more frequently from patients with active chronic gastritis than from those with inactive chronic gastritis (100% vs. 50%). These results support the suggestion of Marshall and Warren that this bacterium may play an important role in the development of gastritis and peptic ulcer. PMID- 3818106 TI - Epidemiology of hepatitis A in northern Italy: a seven-year survey. AB - During a seven-year survey of acute symptomatic viral hepatitis in Padua (Northern Italy), the epidemiological features of hepatitis A were evaluated in 207 consecutive patients (120 males, mean age 22.7 +/- 11.4 years). The annual attack rate of the disease decreased significantly (p less than 0.05) between 1978 and 1979 (0.11/1000 inhabitants) and 1981 and 1984 (0.04-0.03/1000 inhabitants), mainly due to its declining prevalence in the pediatric age. In parallel with the shifting of hepatitis A towards adulthood, single sources of infection, mainly associated with adult life-style such as foreign travel and raw shellfish ingestion, have become more and more prominent. The spread of drug abuse has not influenced the epidemiology of hepatitis A in our area. PMID- 3818105 TI - Infections due to Achromobacter xylosoxidans. Case report and review of the literature. AB - Achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause many serious infections. A 69-year-old woman with diabetes mellitus and chronic renal failure was admitted with pulmonary edema. The patient developed fever and pulmonary infiltrate with bilateral pleural effusions while she was on a respirator in the intensive care unit. Culture of sputum, pleural fluid and blood grew A. xylosoxidans. Bilateral chest tubes were inserted and the patient was treated for one month with piperacillin and trimethoprim-sulfamethoxazole. Gradual response, both clinically and radiologically, was noted after prolonged therapy. A review of the literature on infections due to A. xylosoxidans, the unique susceptibility pattern of the organism to various antibiotics and the use of combination therapy in Achromobacter infections are discussed. PMID- 3818107 TI - Penetration of ciprofloxacin into human lung tissue following intravenous injection. PMID- 3818108 TI - Pericarditis in Erysipelothrix rhusiopathiae septicemia. PMID- 3818110 TI - Bloodpumps. PMID- 3818109 TI - Mineral status in children with end stage renal failure. PMID- 3818111 TI - Renal failure and thyroid function. PMID- 3818112 TI - Osmotic agents for peritoneal dialysis. AB - Glucose has more advantages than drawbacks and is now the sole agent used in clinical practice. Yet there is interest in finding a substitute for glucose as an osmotic agent in peritoneal dialysis solution. Work has identified several promising agents such as albumin, amino acids, gelatin and glycerol but it appears that every one of them, including glucose, would be useful for a short dwell or for a long-dwell exchange but not for both. Some of them, such as albumin and the amino acids, are close to being an ideal osmotic agent but are prohibitively costly to manufacture. We predict that interest in the future will focus on dialysis solutions containing a mixture of osmotic agents. Such a solution would be acceptable for both short and long-dwell exchanges. It will have a sufficiently low concentration of different agents to minimize toxicity and long-term undesirable side effects. We expect that solutions will be available to better meet patients needs in the near future. PMID- 3818113 TI - Renal involvement in malaria. PMID- 3818114 TI - Potential sorbents for medical and some related applications. PMID- 3818115 TI - Peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients dialyzed exclusively with lactate-buffered dialysate. AB - Peritoneal sclerosis occurred in two patients treated by continuous ambulatory peritoneal dialysis (CAPD) using only lactate-buffered dialysate. Both patients had recurrent peritonitis and the second patient had multiple, minor abdominal operations. Patients receiving lactate-buffered CAPD are not immune from peritoneal sclerosis. Recurrent peritonitis and repeated abdominal surgery might be important causative factors. PMID- 3818116 TI - Hypervitaminosis B12 in maintenance hemodialysis patients receiving massive supplementation of vitamin B12. AB - We have administered routinely a multivitamin preparation containing a megadose of B12 to 106 hemodialysis patients after dialysis treatments. We found that these patients had very high levels of serum vitamin B12 which returned to original values only after a period of three years after stopping the vitamin. Discontinuing therapy had no effect on hemoglobin, mean erythrocyte corpuscular volume, or motor nerve conduction velocity. It is not known whether maintaining a prolonged high level of vitamin B12 is harmful. However, animal and epidemiologic studies have suggested that both cobalamin and cobalt may be potentially toxic. In view of the absence of demonstrable benefit and the possible risk of toxicity, we believe that the use of such megadose vitamin compounds in dialysis patients should be re-evaluated. PMID- 3818117 TI - Influence of dialysis membranes on the convective transport of middle molecules. AB - Ultrafiltrates from 10 patients in chronic maintenance hemodialysis (7 males and 3 females) were obtained simultaneously using three different membranes: cuprophan, polyacrilonitrile and polysulfone. Middle molecules (MM) chromatographic profiles and total MM amount were determined by gel chromatography and high performance liquid chromatography. The convective transport of MM was similar and not membrane related. Hemofiltration, a predominantly convective solute transfer procedure using high flux membranes such as polyacrilonitrile and polysulfone, in which large amounts of fluids have to be ultrafiltered, is an effective form of MM removal. PMID- 3818118 TI - Plasmapheresis in acute liver failure. AB - A series of 9 patients with acute hepatic failure and Grade IV hepatic coma received daily plasmapheresis until they recovered or death ensued. Of the nine, seven (77%) showed an improvement in coma grade and five (55%) survived to leave hospital. Plasmapheresis significantly decreased serum bilirubin, aspartate aminotransferase and plasma ammonia concentrations. Survival following plasmapheresis appeared substantially better than in a non randomized group of similar patients not plasmapheresed. The simplicity of the procedure, biochemical improvements observed and apparent efficacy, suggest that further evaluation of the technique as a means of providing temporary hepatic support is indicated. PMID- 3818119 TI - Acute renal failure in fulminating beriberi. PMID- 3818120 TI - Tobacco and occupation as risk factors in bladder cancer: a case-control study in southern Belgium. AB - A pilot case-control study on bladder cancer, with population-based controls matched for each of 74 cases, has been conducted in two industrial areas of Southern Belgium in order to analyze the influence of tobacco use and occupation. Observed bladder cancer risk for smokers is more than 5 times higher than that for non-smokers, and the risk for people having an a priori hazardous occupation is about 3.5 times higher than that of other subjects. A dose-response relationship was found for tobacco exposure and duration of employment. It seems that the risk is increased in a log-linear way by these variables. Population attributable risks show that in 20 cases of bladder cancer, 17 could be explained by the two factors combined. This study also reveals an increased risk for metal workers, truck and engine drivers, coal-miners, and rubber and coal-tar workers. The risk for metal workers is specially high in the case of turners, metal fitters, blacksmiths, stokers and workers exposed to hot metal. PMID- 3818121 TI - Volatile nitrosamine levels in common foods from Tunisia, south China and Greenland, high-risk areas for nasopharyngeal carcinoma (NPC). AB - On the basis of anthropological pilot studies on diet in Tunisia, south China and Greenland, food items consumed frequently by these populations at high risk for NPC were analysed for volatile nitrosamines using gas chromatography combined with a thermal energy analyzer. Relatively high levels of N-nitrosodimethylamine (NDMA), N-nitrosopyrrolidine (NPYR) and N-nitrosopiperidine (NPIP) were detected in Tunisian stewing base ("Touklia") and dried mutton preserved in olive oil ("Qaddid"). NDMA was also detected at levels ranging from trace amounts to 133 micrograms/kg in several Chinese salted and dried marine fish and in Greenland dried, unsalted fish preparations. NPYR and NPIP were also occasionally detected in several vegetables fermented in brine collected in Tunisia and China. The possible role of nitrosamines in the etiology of NPC is discussed. PMID- 3818122 TI - Mass screening for cervical cancer in Ostfold county of Norway 1959-77. AB - In 1959, the Norwegian Cancer Society started a research project in Ostfold county to assess the effect of a mass screening program for cervical cancer. The program comprised 5 screening rounds during the period 1959-77. At each screening a clinical gynecological examination was performed in addition to the cytological test. A total of 45,960 women aged 25-59 years at the first screening were invited to participate. The follow-up, which was based on the data base of the Cancer Registry of Norway, lasted until December 31, 1982. For the follow-up period as a whole, the observed incidence and mortality were reduced to 78% and 83% of the expected values, respectively. Through the initial phase of the program there was a cumulation of patients with early-stage disease, while the incidence of advanced disease and mortality were reduced. In the later part of the follow-up period, a decrease in incidence of early and advanced disease as well as in mortality was observed. Women not participating in the screening program had a significantly higher risk of cervical carcinoma than the reference population, and a less favorable stage distribution as well. Among participants in the screening program, the reduction of risk was dependent upon the number of previous negative smears. Women with 5 previous negative smears had a risk of disease which was only 18% of that expected. Problems concerning choice of reference population, migration, attendance rates, sensitivity and specificity of the cytological tests and intervals between screenings are discussed. Also, the probable conversion rates of pre-cancerous lesions to cancer and the health hazards involved in possible over-treatment of pre-cancerous cases which otherwise would have regressed, are considered. A dynamic model is suggested. In order to achieve a reduction of mortality in the short term, the efforts of the program should initially be concentrated on older women. To achieve a reduction of incidence in the long run, younger women should gradually be included. Finally, special efforts should be made to increase attendance rates among high risk women. PMID- 3818123 TI - Sister chromatid exchange induction by benzo(a)pryene in cultured peripheral blood lymphocytes of lung cancer patients and healthy individuals with or without familial history of neoplasms. AB - The inducibility of sister chromatid exchanges (SCEs) by benzo(a)pyrene (BP) was studied in cultured peripheral blood lymphocytes of 15 untreated lung cancer patients and 25 healthy persons including 11 high- and 14 low-cancer-risk individuals tentatively classified by the familial history of lung cancer and other neoplasms. The baseline SCE frequency in cultured lymphocytes was significantly high in lung cancer patients, as compared with all healthy persons or low-cancer-risk individuals. Following exposure to BP, the lymphocytes of lung cancer patients and high-cancer-risk individuals exhibited significantly greater SCE yields than those of persons at low risk, although no significant difference was observed in the lymphocyte SCE yields when the levels of lung cancer patients were compared with those of all healthy persons. A comparison of the net SCE increase (delta SCE) in BP-exposed lymphocytes among the study groups, however, revealed a significant difference in delta SCE values only between high- and low cancer-risk individuals. The present findings on both the observed SCE yields and delta SCE values suggest that lymphocytes of high-risk individuals may be more susceptible to BP-induced DNA damage than those of persons at low risk, and that such a chromosomal hypersensitivity to genotoxins may be associated with a high risk of neoplasms. PMID- 3818124 TI - Characterization of 3LL-tumor variants generated by in vitro macrophage-mediated selection. AB - Following sequential interactions between activated syngeneic M phi s and 3LL tumor cells, stable M phi-resistant 3LL variants were isolated. Unlike the unselected 3LL cells, these M phi-selected variants were relatively resistant to the cytostatic and cytolytic activity of activated effector M phi s. Such M phi resistant 3LL variants evade the M phi tumoricidal activity by at least two mechanisms. Firstly, they manifest a reduced susceptibility towards M phi-related cytotoxins such as TNF. Secondly, they actively suppress the cytotoxic potential of M phi s through secretion of M phi-inhibitory factors. The resistance of the 3LL variants to M phi effector cells in vitro was reflected in vivo by a higher tumorigenic and metastatic potential. No strict correlation was found between the NK sensitivity of M phi-resistant and M phi-sensitive 3LL cells and their metastatic ability. Hence, activated tumoricidal M phi s may play a central role in either the elimination or selection of neoplastic cells. PMID- 3818125 TI - Transformation-related changes in the expression of endogenous cell lectins. AB - Endogenous lectins purified from UV-2237-IP3 murine fibrosarcoma cells by affinity chromatography consisted of two polypeptide species of Mr 14,500 (L 14.5) and Mr 34,000 (L-34). Antibodies against this material immunoprecipitated the lectins from cells radiolabelled on the cell surface as well as in the cytoplasmic compartment. Similar analyses of normal rat embryonal fibroblasts revealed the presence of only the L-14.5. In contrast, both L-14.5 and L-34 were found in oncogene-transfected, immortalized cell clones derived from the normal rat cells, as well as in untransformed BALB/c-3T3 clone A31 and its descendant subclones selected for expression of the transformed, the tumorigenic and the metastatic phenotypes. Among the cells constituting the latter system, a marked increase in the amount of cellular and cell-surface lectins was observed upon progression to the metastatic phenotype. These results suggest that the expression of endogenous tumor-cell-surface lectins is associated with transformation and metastasis. PMID- 3818126 TI - Lack of fibronectin-binding plasma membrane proteins may explain defective pericellular matrix formation in transformed fibroblasts and fibrosarcoma cells. AB - Affinity of iodinated fibronectin (Fn) and its defined proteolytic fragments to electrophoretically separated polypeptides of normal and malignant cells was studied in an overlay assay. Cellular 125I-Fn and a major 125I-Fn fragment (Mr 120,000-140,000), containing the cell-binding site, revealed in fibroblasts Mr 170,000, Mr 140,000, and Mr 47,000 Fn-binding polypeptides of which the first two could also be found in the plasma membrane preparations. Binding of 125I-Fns to Mr 170,000 and Mr 140,000 polypeptides was inhibited by the synthetic peptide Arg Gly-Asp-Ser and to all 3 polypeptides by Fns and Mr 120,000-140,000 fibronectin fragment. Both fibrosarcoma cells and SV40-virus-transformed fibroblasts appeared to lack the Mr 140,000 Fn-binding polypeptide. Binding was similar when Fn from normal fibroblasts or fibrosarcoma cells was used in the assay, while plasma 125I Fn had weaker affinity towards the Mr 140,000 polypeptide. Instead, proteolytic Fn-fragments, lacking the cell binding site, did not bind to any proteins in the assay. Radioactive cell-surface labelling showed differences in the corresponding surface polypeptide profiles of normal and malignant cells. The results suggest that the failure of pericellular matrix deposition in malignant cells could be due to either defective surface exposition or defective binding property of the Fn-receptor-like polypeptides. PMID- 3818127 TI - Cytogenetic studies on B-cell leukemias of AKR origin. AB - The karyotype of B-cell leukemias of AKR origin was studied by G-banding. In contrast to previous observations indicating trisomy of chromosome 15 in spontaneous and chemically-induced B-cell leukemias, 11 out of 15 tumors analyzed had normal diploid karyotypes. Four tumors with the modal number 39-41 had different chromosome markers specific for each tumor. The possible correlation between non-random chromosomal changes and the target cell involved in the initial transformation in AKR leukemogenesis is discussed. PMID- 3818129 TI - Training of the "invasive" cardiologist. PMID- 3818130 TI - Cardiological terminology: worldwide or not. PMID- 3818128 TI - Tumor type-specific differences in cell-substrate adhesion among human tumor cell lines. AB - Cell lines derived from human tumors of 4 different histological types (squamous carcinomas, melanomas, gliomas and a fibrosarcoma) were examined for cell substrate adhesion on plastic culture dishes and dishes coated with 50 micrograms of type-IV collagen. In the absence of exogenous adhesion factors, the squamous carcinoma cells attached and spread more rapidly than the other cells on both substrates. Once attached, the squamous carcinoma cells were also more difficult than the other cells to remove with proteolytic enzymes/EDTA. While the cell lines derived from melanomas, gliomas and the fibrosarcoma were less adhesive than the squamous carcinoma lines in the absence of exogenous adhesion factors, these cells were highly responsive to laminin. In contrast, laminin only slightly enhanced the attachment and spreading of squamous carcinoma cells on the plastic dishes and actually inhibited attachment and spreading on the collagen-coated dishes. These results indicate that there are tumor-type-specific differences in adhesiveness among human tumor cell lines and that cells from different tumor types may have distinct mechanisms for carrying out one of the functions critical to invasion. PMID- 3818131 TI - Echocardiographic evaluation of left ventricular reserve in normal children during supine bicycle exercise. AB - To evaluate left ventricular reserve in normal children 127 healthy boys and girls (71 males, 56 females) were investigated with echocardiography during supine bicycle exercise at levels of 6, 9, 12 and 15 kpm/min/kg body weight. Left ventricular function parameters were obtained from the M-mode echocardiogram, electrocardiogram and phonocardiogram. The children were separated into three groups according to body surface area: group I less than 1.1 m2, group II 1.1-1.4 m2, and group III greater than 1.4 m2. Fractional shortening (FS) of the left ventricle rose during exercise from 37 +/- 4 to 46 +/- 4% with no significant differences between the three groups. Velocity of circumferential fiber shortening (Vcf) in group I augmented from 1.3 to 2.25 circ./sec, in group II from 1.29 to 2.60 circ./sec, and in group III from 1.17 to 2.74 circ./sec (P = 0.01). In the recovery period heart rate (HR) and blood pressure normalized earlier than did fractional shortening and velocity of circumferential fiber shortening. This could be expressed best by the ratios FS/HR and Vcf/HR. There were no significant differences between sexes, although there was a tendency to higher blood pressure and heart rate, a greater increase in velocity of circumferential fiber shortening and a smaller increase in fractional shortening in girls. These data indicate that girls increased cardiac output during exercise more by increasing their heart rate than did boys. PMID- 3818132 TI - Cellular electrophysiology of coronary artery ligation in chronic pressure overload. AB - We evaluated ischemia-induced cellular electrophysiologic abnormalities in chronic pressure overload ventricular myocardium in vitro. Left ventricular systolic hypertension was induced in cats via partial supracoronary aortic constriction (overload); at 1 1/2-3 months, resulting pressure overload was accompanied by ventricular hypertrophy (25-35% by weight) and patchy endocardial fibrosis. Two hours of subsequent acute myocardial ischemia (ischemia) was imposed on overload (ischemia/overload) via total occlusion of distal branches of the left coronary artery system. Spontaneous premature depolarizations in vitro were increased in ischemia/overload compared to control, ischemia or overload alone; bursts of spontaneous, repetitive depolarizations were also unique to these preparations. Multiple site recordings of endocardial transmembrane action potentials overlying the borders (interface) of fibrotic areas in ischemia/overload demonstrated numerous electrophysiologic abnormalities, including several not observed in control, ischemia or overload. Unique to the border areas of ischemia/overload preparations was the presence of maintained but depressed resting potential without action potentials; also, the incidence of depolarizations at the onset of the plateau phase was highest in these preparations. In non-fibrotic areas, electrophysiologic properties including resting potential and action potential amplitude and rate of rise were diminished in ischemia/overload compared to ischemia or overload preparations. These data demonstrate that acute myocardial ischemia in the setting of chronic pressure overload leads to additional cellular electrophysiologic abnormalities compared to ischemia or overload alone. PMID- 3818133 TI - Congenitally corrected transposition with mirror-image atrial arrangement. AB - Congenitally corrected transposition (discordant atrioventricular and ventriculoarterial connexions) with mirror-image atrial arrangement is much less frequent than the same chamber combinations in the setting of usual atrial arrangement. This scarcity of cases has made their analysis difficult. In this study we have compared the anomalies found in 19 patients with congenitally corrected transposition in mirror-image arrangement with those in 39 patients having usual atrial arrangement. Absolute, relative and attributable risks were calculated for the presence of subvalvar pulmonary stenosis, ventricular septal defect, tricuspid regurgitation, atrioventricular block or the absence of these anomalies for each of the two groups. A greater absolute risk was found for both subvalvar pulmonary stenosis (68.4 vs. 43.6%, respectively) and ventricular septal defect (63.2 vs. 58.9%, respectively). The absolute risk for tricuspid regurgitation was 25.6% in those with usual arrangement as against 21.1% in those with mirror-image arrangement. Atrioventricular block was also more frequent in those with usual arrangement (25.6 vs. 10.5%) as was absence of associated cardiac defects (17.9 vs. 10.5%, respectively). The relative risks were greater for subvalvar pulmonary stenosis and ventricular septal defect in the patients with mirror-image as opposed to usual atrial arrangement (1.57: 1.00 and 1.07: 1.00, respectively), contrasting with greater relative risk for tricuspid regurgitation (1.26: 1.00), atrioventricular block (2.43: 1.00) and absence of associated anomalies (1.70: 1.00) in the patients with usual arrangement. The attributable risk for subvalvar pulmonary stenosis was estimated to be 24.8% and ventricular septal defect 4.3% for those having mirror-image atrial arrangement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818134 TI - The 5-hydroxytryptamine system of blood platelets: physiology and pathophysiology. AB - The 5-hydroxytryptamine (5HT)-system of human blood platelets consists of a relatively specific uptake mechanism for 5HT at the plasma membrane, intracellular storage organelles (dense bodies), a metabolizing enzyme (monoaminoxidase B) and a 5HT2-receptor whose stimulation leads to activation of the phosphatidylinositide turnover, a rise in free cytoplasmic Ca2+, phosphorylation of proteins and a shape change reaction. There is neither a relevant 5HT-biosynthesis nor a marked physiological 5HT-turnover in platelets. Under physiological conditions the platelet 5HT-system may have a role as a scavenger for free extracellular 5HT and in hemostasis. Disturbances which have been described in pathophysiological states include impairment of 5HT-uptake (hypertension, migraine), impairment of 5HT-storage (storage pool deficiencies, thromboembolic disorders, hypertension) and increased sensitivity to activating agents like 5HT (cardiovascular disorders, diabetes). Besides their role in physiology and pathophysiology platelets may be useful partial models for vascular smooth muscle cells. PMID- 3818135 TI - Serotonin and the vascular wall. AB - Serotonin possesses both vasoconstrictor and vasodilator properties. The constrictor action of the monoamine can be due to: (a) direct activation of vascular smooth muscle; in most blood vessels, this is mediated by S2 serotonergic receptors; (b) augmentation (amplification) of the action of other endogenous vasoconstrictors such as catecholamines, angiotensin II and the prostanoids; and (c) release of norepinephrine from adrenergic nerves. The dilator action of serotonin can be due to: (a) activation of endothelial cells which release endothelium-derived relaxing factor(s); this response appears to be mediated by S1-serotonergic receptors; (b) direct inhibition of vascular smooth muscle; (c) inhibition of adrenergic neurotransmission by an action on S1 serotonergic prejunctional receptors; and (d) release of other endogenous mediators. The net effect of serotonin on the blood vessel wall depends on: (a) the integrity of the endothelium; (b) the degree of activation of the vascular smooth muscle; (c) the level of sympathetic tone; and (d) local (e.g. PO2, temperature) and chronic (e.g. blood pressure) modulating factors. S2 serotonergic antagonists prevent the constrictor action of serotonin, and often unmask its dilator potential. PMID- 3818136 TI - Serotonin and experimental vascular disease. AB - We have examined effects of atherosclerosis on constrictor responses to serotonin in several vascular beds. In normal monkeys, serotonin produces modest constriction of large arteries. In atherosclerotic monkeys, vasoconstrictor responses to serotonin are greatly potentiated in the limb, cerebral, and mesenteric circulation. The findings may be pertinent to the pathogenesis of vasospasm, which is an important complication of atherosclerosis. Platelets release serotonin when they aggregate. If platelets aggregate at atherosclerotic lesions and release serotonin, and vasoconstrictor responses to serotonin are greatly potentiated in atherosclerotic arteries, serotonin may be an important mediator of vasospasm. To determine whether treatment of atherosclerosis alters vascular responses, atherosclerotic monkeys were fed a low-cholesterol diet for 18 months. This treatment produced marked improvement in vascular lesions, but maximal vasodilator responses were not consistently improved by treatment of atherosclerosis. We speculated that fibrosis of the vessel may prevent improvement of vasodilator responses in vessels with fixed lesions. In contrast, we have found recently that dietary treatment of atherosclerosis abolishes hyperresponsiveness to serotonin in the limb. We conclude that atherosclerosis potentiates vasoconstrictor responses to serotonin and these abnormalities are reversible by dietary treatment of atherosclerosis. PMID- 3818137 TI - Serotonin and haemorrheology. AB - One of the crucial determinants of tissue perfusion is the flow behaviour, that is the rheology, of the blood itself. In the microcirculation the most important factor is the ability of the cellular components of blood to deform as they pass through the narrower capillary passages. Until recently, it was thought that the deformability of the red cells was more important than that of the white cells, because of their numerical superiority. Recently, the flow behaviour of white cells is thought to be at least equally important. There is now extensive epidemiological, experimental and clinical evidence linking the microrheological properties of blood to tissue ischaemia. The possible role of serotonin in altering haemorrheology is inferred from studies using specific serotonin antagonists. Ketanserin, given orally has been shown to improve blood filterability in patients with myocardial infarction and intermittent claudication. There was also a specific effect on white cells. It is postulated on the basis of these and other experiments that in situations of tissue ischaemia, when there is a local increase in plasma serotonin levels, the deleterious effect of serotonin on blood cell rheology may have an important role in perpetuating the ischaemia. PMID- 3818138 TI - Mitral atresia with premature closure of the oval foramen, right-sided levoatriocardinal vein and thrombus formation in the left atrium. AB - We describe a 4-week-old baby with mitral atresia, hypoplastic left ventricle, ventricular septal defect, preductal coarctation and premature closure of the oval foramen whose only outlet from the left atrium was a stenosed right-sided levoatriocardinal vein and who in addition developed left atrial thrombi. Cross sectional echocardiography was extremely helpful in establishing the diagnosis. PMID- 3818139 TI - Polymorphous ventricular tachycardia due to alpha-blockade. AB - We report a case of polymorphous ventricular tachycardia caused by treatment with the post-synaptic alpha-blocking agent indoramin. This has not been reported with indoramin previously, nor to our knowledge with any other alpha-blocker. This pro arrhythmic effect appears to be related to its class 3 anti-arrhythmic properties (QT interval prolongation) which is dose dependent, occurring only at large doses. PMID- 3818140 TI - Absent right atrioventricular connexion with a straddling left atrioventricular valve connecting the left atrium to a ventricular mass with a dominant left ventricle. AB - We present clinical and postmortem examination of a child who presented in life with severe obstruction to the left ventricular outflow tract. The heart was right-sided with usual atrial arrangement. The right atrioventricular connexion was absent. There was straddling of the left atrioventricular valve which had a double orifice. Each orifice was connected to a well-differentiated ventricle, the left ventricle being dominant and right-sided (left-hand topology). An inlet ventricular septal defect was restricted by the leaflet tissue of the straddling valve. PMID- 3818141 TI - Paroxysmal supraventricular tachycardia in supero-inferior ventricles with intact ventricular septum. AB - We describe a case with supero-inferior relations of the ventricles in which the atrio-ventricular and the ventriculo-arterial connexions were concordant and the interventricular septum was intact. In this patient there was associated Wolff Parkinson-White syndrome with paroxysmal supraventricular tachycardia. Positional anomalies of the heart, where there appears to be displacement of ventricular mass in the horizontal plane, add another dimension to the consideration of morphology and nomenclature. They emphasize the need for separate analysis and description of segmental connexions, relations and morphology. PMID- 3818142 TI - Torsade de pointes complicating atrioventricular block: report of two cases. AB - One patient with complete atrioventricular heart block and another with high degree atrioventricular block, complicated by "torsade de pointes" are presented. Both patients were symptomatic. One had a syncopal episode and the other presented with signs and symptoms of congestive heart failure. The electrocardiographic phenomena of torsade de pointes was repeatedly recorded. No other known predisposing factors for torsade de pointes were identified. The use of right ventricular endocardial pacing suppressed the paroxysms in both patients. PMID- 3818143 TI - Pharmacokinetics of metronidazole in hospitalized patients. AB - The recently expanded indications of metronidazole increase the use of the drug in the hospitalized patients. However, most of the pharmacokinetic information on metronidazole was derived from normal subjects. The pharmacokinetics of metronidazole was, therefore, evaluated in nine hospitalized patients who have no evidence of liver or kidney failure. The patients received the drug for prophylaxis or treatment of infectious conditions. Serial blood samples were obtained from the patients and serum metronidazole concentrations were determined by high performance liquid chromatography. The following pharmacokinetic parameters (mean +/- standard deviation) were obtained: half-life = 10.2 +/- 3.1 hours, elimination rate constant = 0.075 +/- 0.026 hour-1, volume of distribution = 0.65 +/- 0.25 l kg-1, and total body clearance = 0.048 +/- 0.024 l h-1 kg-1. The mean value of these parameters are not substantially different from those obtained in the normal subjects. However, a higher interpatient variation was found in the hospitalized patients. The heterogeneity of health condition, body composition, fluid balance, hemodynamics and nutritional status may all contribute to the variability in pharmacokinetic characteristics. PMID- 3818144 TI - Acute effects of pirenzepin on bronchospasm. AB - The response to pirenzepin, a new acetylcholine receptor blocking agent, was assessed and compared to placebo in patients with reversible bronchoconstriction. A single intravenous injection of 20 mg of pirenzepin induced a significant reduction of airway resistance compared to placebo (p less than 0.05). The anticholinergic substance pirenzepin appears to be useful in the treatment of bronchospasm. PMID- 3818145 TI - On the specificity of the aminophenazone breath test. AB - In 15 patients suffering from ulcer of the stomach or the duodenum, but without liver disease, the demethylation capacity was studied by the use of 14C aminophenazone before and under the treatment with the H2-blocker cimetidine in daily doses of 1.0 g. As a measure of demethylation the expired 14CO2 (DPM/mmol CO2/70 kg body weight) was used before and 1 h after intake. Under cimetidine the mean 14CO2-value decreased from 724.7 DPM (SD 127.7 DPM) to 404.1 DPM (SD 153.1 DPM). In 3 patients the cimetidine medication was continued for additional 6 to 8 weeks with a dosage of 0.4 per day. In these subjects a mean of 533.2 DPM was measured. The enzyme activities (ALAT, ASAT, AP, AAP, gamma-GT, ChE) and the albumin and bilirubin concentration in serum measured concomitantly to the ABT did not differ from control values. Thus, the ABT is a useful test to assess changes of the demethylation capacity that can be caused by drugs or xenobiotics without affecting biochemical parameters used for diagnosis of liver diseases. The ABT might be a useful and simple technique to discover environmental disorders due to occupational conditions. PMID- 3818146 TI - Plasma concentrations of ketanserin in chronic hemodialysed patients. AB - Six patients on chronic hemodialysis received 20 mg ketanserin p.o. twice daily for 3 days. Plasma levels were measured daily 2 hours after application of the morning dose; however, on the third day, plasma levels were taken before, during and after dialysis. On the 4th day elimination was measured after a single dose of 20 mg ketanserin for 24 hours. Mean plasma levels ranged from 19 to 31 ng/ml. Both ketanserin and reduced ketanserin were not eliminated by dialysis. Elimination half-life was about 12 hours. PMID- 3818147 TI - The effect of hemodialysis on piperacillin pharmacokinetics. AB - The disposition of piperacillin given as a 4 gm i.v. infusion was assessed during an interdialytic period and during hemodialysis in 12 chronic hemodialysis patients. Piperacillin concentrations in serum and dialysate were determined by HPLC. The half-life decreased from 2.84 +/- 2.04 h (mean +/- SD) during the interdialytic period to 1.30 +/- 0.43 h during the hemodialysis period (p = 0.008). Piperacillin total body clearance was 74.9 +/- 34.0 ml/min during the interdialytic period and the hemodialysis clearance was 92.4 +/- 30.0 ml/min. A significant change in the volume of distribution was observed from the interdialytic to dialytic period (0.21 +/- 0.06 vs 0.26 +/- 0.07 l/kg) (p = 0.026). A significant correlation between the hemodialysis clearance of piperacillin and hemodialysis clearance of creatinine and blood flow rate was also noted. No significant rebound in serum piperacillin concentrations was observed after cessation of hemodialysis. Approximately 46% of the amount of piperacillin in the body was removed by dialysis. PMID- 3818148 TI - Inhibition of food stimulated acid secretion by association of pirenzepine and ranitidine in duodenal ulcer patients. AB - The effects of pirenzepine and ranitidine alone and combined, on gastric acid secretion and gastrin release stimulated by liquid peptone meal were evaluated in 12 duodenal ulcer patients. Six patients received placebo and ranitidine 150 mg per os and the other six patients were given placebo, pirenzepine 50 mg and pirenzepine 50 mg plus ranitidine 150 mg per os, according to randomized sequences. In the first experiment ranitidine markedly inhibited (69%) gastric acid secretion for entire two hours period (p less than 0.01). In the second experiment acid secretion after pirenzepine, was reduced by 39% while the combination of pirenzepine plus ranitidine almost completely inhibited the meal stimulated acid secretion (99%). Mean integrated gastrin responses after pirenzepine and ranitidine alone as well as pirenzepine plus ranitidine were not significantly different from placebo. The results of these studies show that in duodenal ulcer patients, the simultaneous block of muscarinic and H2-receptors, suppresses meal stimulated gastric acid secretion, without affecting gastrin release. This therapeutic combination might be used in clinical situations (non responders, Zollinger-Ellison syndrome) in which complete inhibition of gastric acid secretion is needed. PMID- 3818149 TI - Determination of "heavy" organotin pollution of water and shellfish by a modified hydride atomic absorption procedure. AB - Tin speciation in aquatic environment is very complex. To the natural SnIV and methylated compounds, human activities add mainly butylated, octylated, phenylated or even methylated derivatives. The most environmentally significant, due to their high toxicity and direct introduction in water through biocidal use, are the trisubstituted ones. Several sophisticated speciation procedures have been proposed, they are not susceptible of common use. We propose a simple and fast procedure allowing routine global distinction of "heavy" tin species that are most susceptible of exerting harmful effects. This AA method use the differences in volatility of stannanes generated by reduction with NaBH4. SnIV and the methylated species have very close response coefficients whereas "heavy" compounds respond very slightly at room temperature and are eliminated in a -40 degrees C cold trap. "Heavy" tin determination in water is thus obtained by the difference between two hydride AA experiments, one performed on the untreated sample ("light tin") and the other on a UV mineralised subsample (total tin). (The mineralisation of organotins is realised by UV irradiation-2 hours--in a quartz container--yields 95-100%.) The analysis of shellfish tissue relies also on two experiments. Total tin is measured on a mineralised sample and "light tin" is obtained on a subsample "solubilised" with an Ultra Turrax homogeneizer in a diluted HCl solution. PMID- 3818150 TI - Strengthening the practice of epidemiology in the European Community. AB - At the request of the COMAC EPID committee of the Commission of the European Communities the author visited all the countries of the EEC except Luxembourg in 1983-84 in order to prepare a report on 'Upgrading in epidemiology'. The report was presented at a meeting organized by COMAC EPID in April 1984 and subsequently revised and finally presented in January 1985. This paper is an abbreviated version of the report and describes some main features and some of the obstacles in the organization of undergraduate and postgraduate education, and research in epidemiology in the EEC. The application of epidemiological knowledge at national, regional and local level and communications between epidemiologists are also discussed. PMID- 3818151 TI - Analgesics and kidney disease. PMID- 3818152 TI - Occupation, social class and male cancer mortality in New Zealand, 1974-78. AB - Occupational and social class differences in cancer mortality among New Zealand males aged 15-64 are examined for the period 1974-78. Age-standardized cancer mortality rates are presented for the Registrar General's social classes as well as for each of six occupational orders and 79 occupational groups. The rates for specific cancer sites are also presented for each social class and for those occupational groups with significantly elevated relative risks. The findings of the social class analyses were generally consistent with those of recent British studies with mortality from cancer of the liver, larynx, lung, buccal cavity and stomach being particularly high in the lower social classes and mortality from multiple myeloma, malignant melanoma and lymphatic leukaemia being particularly high in the upper social classes. The findings of the occupational group analyses were also generally in line with those of recent British studies and those associations which have been found in British studies and were also present in the New Zealand data are discussed. It is concluded that there are a number of associations which warrant further investigation including: large bowel cancer in woodworkers and printers; bladder cancer in hairdressers and beauticians; and malignant lymphoma in farmers. PMID- 3818153 TI - Carrots, green vegetables and lung cancer: a case-control study. AB - A total of 417 lung cancer cases and 849 controls were interviewed on their life long tobacco usage and their current intake of four food items rich in retinol or carotene. The study was a hospital-based case control where 'cases' were lung cancer patients diagnosed during the period 1979/80 at seven hospitals in the Lombardy region (90% pathologically confirmed) and controls were patients admitted to the same hospitals for causes unrelated to tobacco smoking (epithelial cancers being excluded from present analysis). Odds ratios (OR) have been computed for increasing frequencies of consumption of liver, cheese, carrots and leafy green vegetables, having controlled for the confounding effects of tobacco usage, residence and birthplace. Current smokers who did not consume carrots showed a three-fold risk of developing lung cancer compared with those who ate them more than once a week (OR = 2.9 less than p less than 0.01); the ORs for consumers in the categories of 1-2 and 3-4 times per month were 1.8 and 2.0 respectively, with a significant test for linear trend (p less than 0.01). Among ex-smokers or non-smokers, no decrease of lung cancer risk is evident associated with carrot consumption. An excess risk was also associated with low intake of green vegetables although it was not significant, while no excess risk was evident for non-consumers of liver and cheese. The effect of carrots is independent of histological type of lung cancer while the effect of green vegetables was confined to epidermoid carcinomas: low versus high intake group OR = 1.3. PMID- 3818154 TI - Relationship between risk factors for breast cancer and hormonal status. AB - A total of 512 breast cancer patients and 540 controls were compared to examine the risk factors for different categories of breast cancer as defined by age, menopausal status and estrogen receptor (ER) tumor status. Significant differences were found by menopausal status, for age at first birth and age at menarche for all women, and for age at first birth and family history for women between 45 and 54 years old. No significant differences were found with ER status alone; however there was a significant difference between ER status and body weight in premenopausal women; the above significant differences with menopausal status were not found when stratified by ER tumour status. These findings support the hypothesis for aetiological differences for pre- and postmenopausal breast cancer and suggest that ER tumour status may influence the risk associated with body weight. PMID- 3818155 TI - The Melbourne colorectal cancer study: incidence findings by age, sex, site, migrants and religion. AB - During a 12-month period, age, sex, site, country of birth and religion data were obtained on all new cases of colorectal cancer (CRC) in Melbourne (population 2.8 million) yielding 1150 cases, this being the incidence study arm of a large-scale epidemiological and clinico-pathological investigation of CRC in Melbourne. The age, sex, site and subsite findings had, as expected, the characteristics of a high-risk population for CRC. Unexpectedly, rectal cancer rates were some of the highest recorded in the world. Incidence was greater in males than in females except for colon cancer between ages 35 and 58 where there was a female excess. There was an increasing male to female ratio from caecum to rectum and the crossover age to male excess had a monotonic pattern as it became younger from caecum to rectum. This site and subsite sex pattern may represent an aetiological difference and warrants further study. The data on first generation migrants supported the concept that with migration from low-risk to high-risk countries for CRC, such as Australia, there is a transition of rates towards the risk levels of the new country. Migrant rates for CRC were lower for each subsite than in the Australian born, but became closer to the Australian rate the further the distance down the bowel. Jews had rates nearly double those of the Melbourne population, a hitherto unreported finding in Australia. The possible causes of the very high rectal rates, the transition in migrant rates and the high Jewish rate will be reported in the case-control arm of the study. PMID- 3818156 TI - Beer consumption and rectal cancer. AB - The association of beer drinking with cancer of the rectum was investigated in a case-control study of 130 male and 88 female rectal cancer cases and 336 male and 249 female controls. Information was obtained on consumption of beer, wine, and hard liquor throughout adulthood (quantity and duration), as well as on smoking and sociodemographic characteristics. Beer intake was not significantly associated with estimated risk of rectal cancer in females but was in males, with an increasing gradient in the odds ratio (OR) with increasing beer consumption. For drinkers of 32 or more ounces of beer per day, the OR was 3.5 (95% CI 1.8 7.0). No association was seen with duration of beer drinking. Wine and hard liquor consumption showed no association with the development of rectal cancer. In multiple logistic regression analyses, the relative risk for beer drinking was reduced slightly when potential confounding variables were included in the model (RR adjusted for religion and education: 2.7, 95% CI 1.3-5.7). The study results are discussed in the light of other epidemiological studies of rectal cancer and beer drinking. We conclude from the aggregate evidence that the association of beer drinking with rectal cancer is probably not causal and that the slightly elevated OR's observed for males in this study are most likely due to incomplete control for confounding variables. PMID- 3818157 TI - The anatomical distribution of skin cancers. AB - The relative density of skin tumours by anatomical site has been drawn from a variety of clinical studies and tumour registry investigations. The data sources are remarkably consistent and support current theories implicating chronic solar exposure in the development of non-melanoma and intense exposure for melanoma tumours. PMID- 3818158 TI - Effects of personal, environmental and occupational factors on ischaemic heart disease in white miners in South Africa. AB - The objective of this study was to determine which personal, environmental and occupational factors were associated with risk of non-fatal ischaemic heart disease in a group of 3930 white underground miners born between 1916 and 1930. Evidence of previous myocardial infarction, based on their electrocardiograms and answers to the Rose questionnaire, was found in 179 men who were taken as the cases of interest. Because of difficulties in coding the occupational histories of all available miners, a representative sample of the remaining 'non-infarct' miners was drawn as a reference sample. Univariate analysis of the 179 cases and 669 referents showed that the personal factors such as age, systolic and diastolic blood pressure, serum cholesterol and smoking were significantly different in the two groups at the 1% level of significance. Logistic regression analysis showed similarly that these same variables were significantly associated with IHD when included in a multivariate model. None of the environmental and occupational variables was significant. PMID- 3818159 TI - Factors associated with measured differences between fourth and fifth phase diastolic blood pressure. AB - Data from the Munich Blood Pressure Study I were used to investigate the distributions of fourth (D4) and fifth (D5) phase diastolic blood pressures in a population and to identify factors related to their difference. Muffling (in contrast to change of amplitude) of sounds was taken as the criterion for fourth phase Korotkoff sounds. D4 could not be detected (ie D4 = D5) in 33.7% of the 1032 men and in 42.1% of the 1163 women. The difference D4-D5 (mean +/- SEM) was 3.1 +/- 0.1 mmHg for male and 2.4 +/- 0.1 mmHg for female participants. Only 28.0% of D4-D5 differences were greater than 4 mmHg in men and 20.2% in women. D4 D5 varied considerably between the three measurements of each examination both related to participants and observers. Participant characteristics associated with greater D4-D5 were higher SBP, higher D4, and lower D5. Smoking was more common in men with greater D4-D5. Inter-observer variability was very strong. Non detection of D4 ranged from 78.8% to 10.2% between observers. To assess the relative importance of participant and observer influence on the magnitude of D4 D5, we fitted a polychotomous logistic regression model. In this model, participant characteristics had only a weak effect on measured D4-D5. This was outweighted by potential observer effects several-fold stronger than the strongest participant effect. We conclude that for reliability reasons D5 should be given preference over D4 when measuring diastolic blood pressure in adults, whether for clinical or for epidemiological purposes. PMID- 3818160 TI - Change in smoking status among a cohort of late adolescents: prediction and explanation of initiation, maintenance and cessation. AB - This study examined the degree and type of changes in adolescent smoking status that occurred over an eight-year period, when the group was in grades four to six, to late adolescence and early adulthood. Where changes in smoking occurred, they were more likely to be in the direction of increased (57.7%), as compared to decreased (4.1%) involvement with smoking, particularly among females. Discriminant function models were developed and resulted in 60% accuracy of classification. Variables measured in 1975 found to be related to change in status (from 1975 to 1983) were early smoking, sex, age, peer and parental smoking, prediction of future smoking, attitude and knowledge. Changes in some of the independent variables were examined and found to be related to changes in smoking. Implications for prevention and cessation programmes are discussed. PMID- 3818161 TI - Alcohol and mortality: a cohort study of male Japanese physicians. AB - The relationship between drinking habit surveyed in 1965 and cause-specific mortality over 19 years was investigated in 5135 male Japanese physicians taking into account smoking habit and separating ex-drinker from non-drinker. As compared with non-drinkers, daily drinkers with high consumption had a significantly increased mortality from all causes. Drinking was significantly related to the so-called alcohol-related causes of death; upper aerodigestive cancer, liver cancer and liver cirrhosis. Mortality from acute myocardial infarction was inversely related to drinking, whereas other coronary heart disease showed a somewhat higher mortality among men consuming a large amount of alcohol than among non-drinkers. There was a weak, but significant, association between stroke and drinking, and the relation did not differ between haemorrhagic stroke and other stroke. No obvious relationship with drinking was observed for cancers of the stomach, large bowel, pancreas and lung. PMID- 3818162 TI - Pregnant immigrant women: occupational activity, antenatal care and outcome. AB - Data from a national sample of births in France in 1981 were used to analyse the relationship between occupational activity, antenatal care and pregnancy outcome among immigrant women. On the whole, occupational activity was less common among immigrant than among French women, although the occupational activity rate varied according to country of origin. Among French women, work during pregnancy was related to better antenatal care and more favourable outcome. The same tendency was observed among immigrant women whatever their origin, though they had less qualified occupations and harder working conditions than those of French women. Occupational activity of immigrant women was more frequent among women with a higher educational level, better knowledge of the French language, and residence in France for a longer time. These characteristics were also associated with better antenatal care, but the relationship between work and antenatal care remained significant after taking them into account. PMID- 3818163 TI - Injury mortality and socioeconomic development: an exploratory analysis. AB - Injury mortality is commonly viewed as a 'disease of development'--a viewpoint which may well be incorrect. This exploratory study found no relationship between reported injury mortality rates and per capita gross national product for 46 developing and industrialized countries; the highest rates reported were all from developing or transitional nations. Greater attention should be given to injuries as a cause of death and disability in developing countries. PMID- 3818164 TI - A model basis for the control of whooping cough. AB - The problems of controlling and ultimately eradicating pertussis are addressed in the face of the apparent impermanence of vaccine immunity, and the limited protection offered while it lasts. Interactions between partial immunity, reduced infectiousness, responses to a superimposed natural infection, changing mean ages of infection and alternative rates of transmission before the vaccine was introduced, are considered in an integrated manner. Mathematical expressions were developed for these different components, from which a computer program was constructed for predicting the levels of control to be expected from different vaccination strategies. The most important of the parameters determining outcomes are those relating to levels of uptake, the choice of a one-course or two-course policy, and the specification of the vaccine itself. As might be expected, high levels of uptake and a two-course policy are necessary for high levels of control, but they will not necessarily succeed. The detailed specification of the type of protection to be offered by a vaccine is also crucial. The most important necessity is for a vaccine immunity with a low rate of decay; but in the presence of decay (which greatly reduces the feasibility of eradication) it is important that the vaccine should protect against the clinical disease without preventing the child from being infected with the organism, and thus attaining permanent immunity. PMID- 3818165 TI - Acute respiratory infections: a longitudinal study of 151 children in Burkina Faso. AB - A longitudinal study of 151 children under five years of age was performed in a rural village of Burkina-Faso (West Africa). During systematic examinations by a physician during the rainy season, 44% of the children were found to be ill and 59% of these had an acute respiratory infection (ARI). During the dry season, the rates were 48% and 73% respectively. Weekly interviews by a field worker showed 6.2 attacks of ARI during the six months of the rainy season and 7.0 during the six months of the dry season. Risk factors for ARI were malnutrition assessed by arm circumference, and a high birth rank. At the 'field-dispensary', ARI accounted for 41% of the visits; lower respiratory infections (LRI) accounted for 24%, similar to the proportion of LRI among illnesses found during the systematic examination. PMID- 3818166 TI - Prevalence of dental caries and associated teeth cleaning habits among children in four primary schools. AB - A study was conducted in four primary schools of Mehrauli block of rural Delhi. Four hundred and fifty eight primary school children of both sexes in the age group of 5-14+ were medically examined in daylight using a mouth mirror and probe. The children came from low socioeconomic backgrounds. Presence of clinical caries was recorded by naked eye examination. Dental caries prevalence was 33.19% and DMF index was 0.52. Teeth cleaning habits of the school children in terms of regularity and associated caries prevalence was also noted. The 'Regular' teeth cleaning group showed significantly less caries prevalence while 'Not Regular' and 'Never Cleaning' groups had higher caries prevalence. Since childhood is such an impressionable age all students were made aware of the need for proper oral hygiene to minimize the incidence of caries among them. PMID- 3818167 TI - Personal habits and attitudes towards smoking in a sample of physicians from the north-east of Italy. PMID- 3818168 TI - Rubella epidemicity and endemicity in Japan: analysis of birth years of the 365 cases of deaf children with history of maternal rubella. PMID- 3818169 TI - Blood group antigens: synthesis of Ss antigenic peptides related to human glycophorin B. AB - The human Ss blood group antigens are located on glycophorin B, a minor human erythrocyte membrane glycoprotein. The structural difference in Ss antigens is determined by a Met/Thr polymorphism at position 29. This report describes the first synthesis of the two peptides carrying the Ss specificities, SS: Asn-Gly Glu-Met-Gly-Gln-Leu-Val and ss: Asn-Gly-Glu-Thr-Gly-Gln-Leu-Val. PMID- 3818170 TI - Phenylethylamide derivatives of the C-terminal tetrapeptide of gastrin. Potent inhibitors of gastrin-stimulated acid secretion. AB - Peptide analogues of the C-terminal tetrapeptide of gastrin in which the phenylalanine had been replaced were synthesized and their biological activity on acid secretion evaluated. Compounds Boc-Trp-Leu-Asp phenylethylamide 6, Boc-beta Ala-Trp-Leu-Asp phenylethylamide 9, Boc-Trp-Leu-Asp p-fluorophenylethylamide 19, Boc-Trp-psi(CH2NH)-Leu-Asp phenylethylamide 23, Boc-Trp-Leu-Asp 2,2 diphenylethylamide 15, and Boc-D Trp-Leu-Asp 2,2-diphenylethylamide 21, in which the phenylalanine had been replaced by phenylethylamine, p-fluorophenylethylamine or 2,2-diphenylethylamine were synthesized. None of these derivatives showed activity on acid secretion in the anaesthetized rat at doses as high as 5 mg/kg. However, they were potent inhibitors of gastrin-induced acid secretion, with ED50 varying from 0.1 to 0.6 mg/kg. PMID- 3818171 TI - Solid phase synthesis of thymosin beta 9. AB - Thymosin beta 9, a 41 residue thymic polypeptide, has been synthesized by a solid phase method. A modification of the low HF method was used to deprotect and cleave the peptide from the resin. Thymosin beta 9 was then obtained in analytically pure form by a one-step purification procedure in 32% yield. The activity of thymosin beta 9 in the terminal deoxynucleotidyl transferase assay was greater than calf thymus fraction 5, but comparable to thymosin beta 4. In contrast to thymosin alpha 1, neither beta 4 nor beta 9 was active in the rosette inhibition assay. PMID- 3818172 TI - Independent folding of autolytic fragments of thermolysin and their domain-like properties. AB - High molecular weight autolysis products from thermolysin have been isolated and identified. The primary fragments correspond to residues 1 to 187-204 (21kD) and residues 187-204 to 316 (12kD), respectively. The fragments are both capable of independent refolding upon removal of denaturant. On the basis of these results, we suggest that the first step in the unfolding pathway of thermolysin involves unfolding of an interdomain region and domain separation. Bound calcium ions at sites 1, 2 and 4 play a major role in protecting the protein against both autolysis and unfolding, probably by stabilizing the interdomain region and enhancing domain-domain interactions. PMID- 3818173 TI - Conformation and structure of mildly heat-treated ovalbumin in dilute solutions and gel formation at higher protein concentrations. AB - The conformation of heat-denatured ovalbumin aggregates has been examined at several concentrations and pH values, using measurements of optical rotation dispersion (ORD), circular dichroism (CD) and viscosity. The protein was subjected to heating at relatively low temperatures, ranging from 48.5 to 76 degrees; the particular temperature chosen depended on pH. The heat treatment was sufficient to remove the ability of the molecules to absorb heat on re-heating. The denatured molecules were shown to be rather compact, i.e. not much larger than the native molecule, and to retain a significant amount of secondary structure; this was also the case for molecules present in small aggregates. It is suggested that this type of ovalbumin monomer builds three-dimensional networks in denatured solutions at higher concentrations, and that gelation should be looked upon as arising from surface contacts between hydrated globules. The present results also imply that such globules have gelation properties which depend on whether pH is acidic or basic compared to the isoelectric point of the protein. PMID- 3818174 TI - Synthesis of a gamma-carboxyglutamic acid containing heptapeptide corresponding to bovine prothrombin residues 17-23. AB - The vitamin K-dependent proteins involved in blood coagulation processes each contain a small cystine loop with the sequence -Gla-Cys-X-Gla-Gla-X-Cys-. A method for the synthesis of the heptapeptide derivative representing the 17-23 sequence of bovine prothrombin, Z-Gla-Cys-Leu-Gla-Gla-Pro-Cys-OBzl, has been developed. The 25Mg2+ n.m.r. spectrum of the heptapeptide derivative has been obtained and is compared to the n.m.r. spectra obtained from the interaction of 25Mg2+ with Z-Gla-OMe and Z-Gla-Gla-OMe. PMID- 3818175 TI - Enantioselective synthesis of (R)- and (S)-2-methyl-[3,3,2-2H3] alanines. AB - The synthesis of optically pure (R)- and (S)-2-methyl-[3,3,3-2H3] alanines of biological interest is described. The stereochemistry of the reaction of the lithio derivative of (R)-(-)-2,5-dimethoxy-3-benzyl-3-methyl-3,6-dihydropyrazine with alkyl and deuterated alkyl iodides is discussed. The configuration of the newly formed center of chirality in (R)- and (S)-2-methyl-[3,3,3-2H3] alanines is derived from 1H NMR. PMID- 3818176 TI - Polytetrapeptide of elastin. Temperature-correlated elastomeric force and structure development. AB - High molecular weight polytetrapeptide of elastin, (L.Val1-L.Pro2-Gly3-Gly4)n, was synthesized using activation of the (GGVP) permutation for polymerization. The temperature-dependence of aggregation was characterized as a function of concentration and the circular dichroism spectra were obtained in the 20 degrees to 70 degrees C temperature range. The latter showed an inverse temperature transition centered near 50 degrees C in which polypeptide order increased on raising the temperature. A concentration of 0.6 g of polytetrapeptide in 1 g of water was gamma irradiation cross-linked (20 Mrad) to form an elastomeric matrix. A study of the temperature-dependence of elastomeric force demonstrated a transition toward increased force on raising the temperature with a midpoint of the transition near 50 degrees C. Thus, there is a correlation between increase in intramolecular order and elastomeric force development. These results are compared to previous results on the polypentapeptide of elastin, (VPGVG)n and on an analog, (IPGVG)n, to demonstrate that the temperature of the transition is proportional to the hydrophobicity of the repeating unit. The point is noted that the elastomeric force development correlates better with intramolecular ordering than with intermolecular processes. PMID- 3818177 TI - Hypertension and renal insufficiency in children with chronic glomerulonephritis. AB - Ninety five children with chronic glomerulonephritis were studied to analyze the correlation between hypertension and functional deterioration in each of the following histology groups; minor glomerular abnormalities (MGA), proliferative glomerulonephritis (PGN), membrano-proliferative glomerulonephritis (MPGN), membranous glomerulonephritis (MGN) and focal segmental glomerulosclerosis (FSGS). Among the 95 patients, 14 patients revealed to be hypertensive. All patients with MGA and MGN revealed normal blood pressure. There were no statistically significant differences in the prevalence of hypertension in patients with PGN, MPGN and FSGS. The overall incidence of renal insufficiency was significantly higher in the hypertensives (50.0%) than in the normotensives (4.9% p less than 0.0001). The incidences of renal insufficiency were significantly higher in the hypertensives than in the normotensives in patients with PGN (P less than 0.01) and MPGN (P less than 0.05). These data suggest that there is a significant correlation between functional deterioration and hypertension, and that the hypertensive patients with PGN and MPGN are at risk for progression to renal insufficiency. PMID- 3818178 TI - A chemotactic inhibitory factor in the minimal change nephrotic syndrome. AB - This study attempts to investigate the role of neutrophil in the increased incidence of infection in nephrotic syndrome. We investigated the function of neutrophils in the various categories of nephritis and the relationship to the response of steroid therapy in the nephrotic syndrome. We used peripheral blood for the study of chemotaxis in 62 children suffering from nephritis in the acute phase and in remission. These patients included minimal change nephrotic syndrome (9 cases), focal segmental glomerular sclerosis (3 cases), mesangial cell proliferative nephropathy (23 cases), Hepatitis B antigenemia associated membranous glomerulonephropathy (4 cases), poststreptococcal glomerulonephritis (20 cases) and chronic glomerulonephritis (3 cases). The chemotactic index was significantly increased in normal range in the remission stage. The molecular weight of the chemotactic inhibitory factor was estimated to be about 89,000 using Sephacryl S-200 column. All cases of mesangial proliferative nephropathy had nephrotic syndrome with frequent relapses or steroid resistance. These results suggest that the chemotactic index may serve as an important parameter between steroid responsive and non-responsive nephrotic syndrome. PMID- 3818180 TI - Arteriovenous hemodiafiltration in children. AB - Continuous arteriovenous hemofiltration is a safe and effective renal replacement therapy system for critically ill patients. In hypercatabolic states urea elimination is too low resulting in high serum urea levels. The aim of this report is to describe the technique of arteriovenous hemodiafiltration and its efficiency on urea elimination. Using two different hemofilters urea clearances achieved by means of arteriovenous hemodiafiltration approximately doubled when compared with spontaneous arteriovenous hemofiltration (urea clearance: 1.25 +/- 0.24 ml/min.-CAVH versus 2.6 +/- 0.59 ml/min.-CAVHDF-0.1sqm hemofilter and 11.77 +/- 1.82 ml/min.-CAVH versus 21.63 +/- 2.63 ml/min.-CAVHDF-0.6sqm hemofilter). Arteriovenous hemodiafiltration is a safe and simple extracorporal technique well tolerated by children. It's a useful adjunct to spontaneous arteriovenous hemofiltration to control azotemia in critically ill hypercatabolic patients. PMID- 3818179 TI - Characterization of proteinuria using random urine samples. AB - The urinary albumin to creatinine ratio (Ualb/Ucr) was compared with quantitative albumin excretion in normal subjects and patients with renal disease. Urinary albumin excretion varied from 3.4 to 4,699 mg/m2/day and Ualb/cr from 5.3 to 6,600 micrograms/mg; the correlation was highly significant (r = .979, p less than .001, n = 20). To characterize normal proteinuria using random urine samples, specimens were obtained from 279 healthy subjects (2 months - 62 years). Total protein, albumin and lysozyme were measured in all samples. Glomerular permeability and tubular function were assessed using the random Ualb/Ucr, the urinary albumin to protein ratio (Ualb/Up) and the urinary lysozyme to albumin ratio (Uly/Ualb). Ualb/Ucr was higher in children less than four years although no age-related differences were noted for Ualb/Up or Uly/Ualb. Furthermore, no differences were seen between males and females and normal reference values are provided. The results of this study support the use of Ualb/Ucr as an estimate of urinary albumin excretion and characterizes normal proteinuria using markers of both glomerular and tubular function. PMID- 3818181 TI - Renal function in cystic fibrosis. AB - The effect of saline extracellular volume expansion (4 ml/min/10 kg b.w. X 60 min) on renal function has been studied in patients with cystic fibrosis (CF) and in normal age-matched controls. Basal values for glomerular filtration rate (GFR), renal plasma flow (RPF), tubular sodium and chloride (Na, Cl) handling were similar in both groups. Saline expansion resulted in an increase in GFR and RPF in the CF patients: 127 +/- 18 ml/min/1.73 sqm BSA to 166 +/- 5; p less than 0.001, but not in the control group: 112 +/- 10 to 120 +/- 20. These hemodynamic changes were associated with increased proximal tubular reabsorption of NaCl in the CF patients whereas controls had reduced NaCl reabsorption. Renin and aldosterone levels suggested that increased NaCl reabsorption in CF patients was not secondary to chronic extracellular volume contraction or salt loss. These results support the hypothesis that the renal tubule is involved in the generalised electrolyte transport disorder exhibited in other epithelial structures. This study also indicated that the regulation of renal hemodynamics is altered in CF. The relationship between the disorder of proximal tubular salt handling and changes in renal hemodynamics is not known, but the observed changes imply a tubulo-glomerular feedback mechanism. PMID- 3818182 TI - Studies on the urinary calcium excretion in children with hematuria of postglomerular origin: effects of the variation of dietary calcium and sodium intake. AB - The effect of different dietary regimens and of an oral calcium (Ca) load was studied in 30 children with postglomerular hematuria, 8 of whom were renal stone formers. In addition we investigated the urinary inorganic phosphate complex composition in 12 of them, based on the principles of complex equilibria. Twenty one of the 30 hematuric children with a urinary Ca/creatinine (Ca/cr) ratio of greater than or equal to 0.6 (mmol/mmol) were regarded as hypercalciuric. Low calcium intake normalised the ratio in 11 patients, fulfilling the definition of absorptive hypercalciuria, but not in the other 10 patients with renal hypercalciuria. Sodium restriction combined with low calcium diet induced a further significant decrease of the urinary Ca/cr ratio to a normal range in both forms of hypercalciuria (mean +/- SD: 0.325 +/- 0.112 in absorptive hypercalciuria; 0.533 +/- 235 in renal hypercalciuria). There was a significant difference in the composition of phosphate complexes between the 6 normocalciuric patients and the 6 children with renal hypercalciuria investigated. Lithogenic urinary phosphate complexes (CaHPO4, MgHPO4) were excreted by the latter group in a significantly higher amount under basal conditions. On the basis of these data sodium restriction added to low calcium diet could represent a dietary approach in preventing excessive calcium excretion in idiopathic hypercalciuria, and therefore renal stone formation. PMID- 3818183 TI - The synergistic effect of angiotensin II and urea on systemic blood pressure. AB - The hypertensive synergism of A-II and urea was studied in anesthetized cats. Femoral arterial pressure was measured while test substances were infused in a femoral vein. Dose-response analysis of the A-II + urea interaction suggested that A-II pressor effects and A-II + urea potentiation involve a common mechanism. Methylurea and mannitol + A-II also induce a similar potentiation. While plasma osmolality and plasma volume indicated no systemic changes, intracellular osmotic shifts may be a factor in the synergism. Since inhibition of the potentiation by indomethacin was not replicated, prostaglandins can no longer be considered important. No effect of ganglionic blockade also eliminated CNS influences as a factor. Dual infusion suggested urea-induced A-II changes were not important for the synergism. Since a synergism of A-II with amino acids occurred, alteration of A-II receptors was indicated. Thus, the A-II + urea pressor synergism may involve either intracellular osmotic shifts or a receptor modification so A-II is more accessible. PMID- 3818184 TI - Acute renal failure due to atraumatic rhabdomyolysis in coma diabeticum. AB - A case report of a twelve year old boy with coma diabeticum and atraumatic rhabdomyolysis is presented. At admission the patient was comatose. Hyperglycemia and hyperosmolarity were the main metabolic disorders. 32 hours after admission marked myoglobinuria due to atraumatic rhabdomyolysis led to acute renal failure. At first uremia was compensated by arteriovenous hemofiltration and later by conventional hemodialysis. During the sixth week after admission urinary output started and serum creatinine and urea levels gradually declined to normal. Special attention should be paid to atraumatic rhabdomyolysis in patients with coma diabeticum. Continuous arteriovenous hemofiltration is an effective extracorporal therapeutic technique to compensate uremia in critically ill patients. PMID- 3818185 TI - Auditory brainstem evoked potentials in evaluating the central effects of middle ear effusion. AB - Auditory brainstem evoked potentials (ABEP) were recorded to determine whether children who suffered in the past, or suffered at time of examination from Secretory otitis media (S.O.M.), exhibited slowed conduction along their auditory brainstem. Five groups of subjects were examined: children with active S.O.M. during the examination, children with S.O.M. in the past who were treated non surgically and recovered, children with S.O.M. in the past who were treated surgically and recovered, children who were treated by insertion of ventilating tubes (V.T.), and had S.O.M. during the examination (recurrent S.O.M.), and a control group of neurologically and audiologically normal, age-matched children with no history of S.O.M. 205 ears were tested in all. Each of the groups was subdivided according to the severity of hearing loss, duration and type of treatment. These parameters were evaluated within and between groups, and in relation to the control group. Significant increases of interpeak latency differences (IPLD) between peaks V and III as well as V to I were found in the S.O.M. groups compared to the control group. The duration of the disease was found to be the dominant factor slowing central conduction. These findings confirm the suggestion that attenuation in auditory stimulation at an early age affects central conduction. PMID- 3818186 TI - Auditory brainstem evoked potentials in evaluating the efficacy of surgical ventilation of the middle ear. AB - Conductive hearing loss in children is most commonly associated with Secretory otitis media (S.O.M.). Since auditory brainstem evoked potentials (ABEP) reflect conductive damage in prolonged peak latencies, the present study evaluated the efficacy of surgery for ventilating the middle ear, by comparing changes in peak latencies. These changes were compared in 4 groups of children (4-12 years old): children with S.O.M. in the past, who recovered as a result of conservative treatment; children with S.O.M. in the past, who had been operated on with insertion of ventilation tubes (V.T.); children with S.O.M. in the past, who had been operated on and who still had V.T. at the time of study, and a control group with healthy ears. In all, 183 ears were tested. The results indicate that there is no significant audiometric and electrophysiological difference between the groups who recovered with or without V.T. PMID- 3818187 TI - Posterior glottic pathology. AB - In infants and children, pathology in the posterior glottis is usually congenital or acquired due to endotracheal intubation. Diagnostic errors and omissions are less likely to occur with an anaesthetic technique where no endotracheal tube is used, where the posterior commissure and arytenoids are deliberately separated by a laryngoscope and where movements of the vocal cords and arytenoids are carefully assessed. PMID- 3818188 TI - A controlled study of a 'new' ventilating tube. The gold standard? AB - A prospective controlled study of a gold ventilation tube was undertaken in which a gold tube was inserted in one ear of 88 children and a Paparella silicone tube was inserted in the contralateral ear as a control. The tubes were evaluated with respect to length of time of intubation, episodes of otorrhea and early occlusion. Sixty-three patients were available for a follow-up of at least 6 months. The gold tube remained in place for a shorter period of time when compared to the control tube. Episodes of otorrhea were infrequent and there was not any significant difference between the two types of tubes. The gold tube became occluded more frequently than the control tube. Since the gold tube is approximately 3 times more expensive and has no proven advantages over our conventional silicone tube, we have no reason to recommend its use in preference to any other available tube. PMID- 3818189 TI - Otitis media with effusion and academic attainment. AB - In 1968 an investigation was started into the middle ear function of a group of 80 children aged approximately 5 years. Serial acoustic impedance measurements were performed at closer than monthly intervals over the first full year of their full time education and at increasingly wider intervals thereafter for a period of 10 years. In 1985 the academic attainment levels of the young persons was, where possible, ascertained by questionnaire, supported by search of the school records. For 64 subjects complete data were available and for these, correlations were sought between a measure of academic rating and various measures of middle ear function during the first one or two years of full time education. No correlations were found to support the hypothesis that middle ear dysfunction during the early years of schooling is causally related to poor academic achievement. PMID- 3818190 TI - Intralaryngeal nevus in a child. A case report. AB - A case of junctional nevus of the true vocal cord in a 10-year-old black girl is described. It appears to be the first reported case of lesion in the larynx. The significance of melanocytes in the larynx of a child is discussed. PMID- 3818191 TI - Middle ear tuberculosis--a series of 24 patients. AB - A study of 24 cases (25 ears) of tuberculous otitis media is revealed. Characteristic findings of the disease e.g. painless ottorhea and multiple perforations of the tympanic membrane, are not considered consistent with our findings of the clinical features of the pathology. Severe conductive hearing loss, abundant pale granulations and an eroded maleus handle consistently occurs in the pathology and in our opinion are more significant clinical features of the disease. As mixed infections are often present, histological examination of the granulation tissue from the middle ear and mastoid is the best diagnostic procedure. Treatment with anti-tuberculous therapy combined with surgery is shown to give good results. PMID- 3818192 TI - Nasal septal deviation: effective intervention and long term follow-up. AB - Nasal septal deviation (DNS) occurs more frequently during childhood although it occurs at any age due to trauma. Recently, it has been increasingly recognized that nasal septal deviation is seen also at birth and a number of explanations for this occurrence is forwarded. Awareness of such occurrence and its recognition at birth both by pediatricians and obstetricians is essential for early interventional management of this condition in close collaboration with the otorhinolaryngologists. Closed surgical intervention of this defect carried out early after it was detected at birth benefitted the afflicted in terms of nasal airway improvement and its maintenance resulting in normalization of its anatomy and physiology in long term follow-up. Septal deviation detected at birth if left alone without interventional procedure continues to persist. It is furthermore accompanied by statistically valied symptoms like upper respiratory infections, cough, earache, ear discharge, fever, mouth breathing and at times feeding difficulty during infancy and childhood. Long term follow-up of children who underwent closed surgical correction of DNS at birth, revealed no untoward effects such as nasofacial disproportion or retardation of facial growth. Early interventional management of DNS detected at birth therefore appears to be a safe procedure. It can even be performed by neonatologists or an obstetrician. Such an intervention procedure early in life can prevent septoplasty surgery at a latter date besides preventing a number of nasal airway-related conditions. PMID- 3818193 TI - Burkitt's lymphoma. AB - Cancer is the second leading cause of death in children and, among cancers, lymphoma is the third most frequently diagnosed type. The majority of these are non-Hodgkin's lymphomas (NHL). Although NHL have been grouped in a variety of confusing ways, recent research in cytogenetics and immunology, coupled with a better understanding of the normal pathways of lymphoid differentiation, has greatly lessened this confusion. Burkitt's lymphoma (BL) is a type of B-cell NHL which is sub-classified as either endemic (African) or non-endemic (American). Kinetic studies have demonstrated a doubling time of only 24 h. As a result of this extremely rapid growth, symptomatic complaints occur early in the disease course. Structures contiguous to the primary become compressed and metabolic derangements occur. Signs of chronic debilitation such as cachexia, diarrhea, generalized lymphadenopathy, and weight loss usually are not found. Thirteen cases of American BL have been treated since 1980 at the Texas Children's Hospital and form the basis of this review. Ten patients had obstructive abdominal symptoms including constipation and pain, and 3 had masses in the neck, maxilla, or tonsil. Systemic manifestations included ascites, jaundice, fever, and hepatosplenomegaly. Two patients ultimately developed central facial nerve paralysis. PMID- 3818194 TI - The evaluation of choanal atresia by computed tomography. AB - The radiographic evaluation of choanal atresia has traditionally consisted of a nasopharyngeal contrast study, however, this procedure has certain diagnostic limitations. The contrast nasopharyngogram does not define the type or thickness of the atresia. Computed tomography (CT) accurately characterizes the nature and thickness of the atresia, and visualizes the associated thickening of the vomer and narrowing of the posterior nasal cavity. CT evaluation with three dimensional reconstruction adds an additional diagnostic dimension. Seven patients have been evaluated by CT. The results show CT is a cost effective method to clearly define the abnormal anatomy. CT is the radiographic procedure of choice in the evaluation of choanal atresia. PMID- 3818195 TI - Temporomandibular joint dysfunction in infancy. AB - Temporomandibular joint (TMJ) dysfunction describes a pain-dysfunction phenomenon that usually afflicts persons in their 4th or 5th decade. The syndrome can be produced by a variety of etiologic factors including occlusal disharmony, articular disorders, and muscle imbalance. It may cause severe otalgia and refer pain to the temple, occiput, nape of neck, and shoulders. Often, associated joint clicking or popping, aural fullness, vertigo, tinnitus, subjective hypoacusis, and nausea occur. As it has not been previously reported in infants, we would like to describe our experience with this disorder in an 11-month-old boy who was referred to our clinic with a presumed diagnosis of otitis media. The embryology of the temporomandibular joint is reviewed and appropriate treatment with anti inflammatory analgesics, warm compresses, orthodontics, and external brace appliances is discussed. Because of referral patterns in the infant age group, the pediatric otolaryngologist should be similar with this entity and its presentation in children. PMID- 3818196 TI - Tear film physiology. PMID- 3818197 TI - The role of tears in the prevention of infections. PMID- 3818198 TI - Chronic blepharitis and dry eyes. PMID- 3818200 TI - Punctal occlusion. PMID- 3818199 TI - General measures in management of the dry eye. PMID- 3818201 TI - Topical tretinoin treatment for dry-eye disorders. PMID- 3818202 TI - Contact lens wear in the management of the dry eye. PMID- 3818203 TI - Fears of physicians and other professionals groups. AB - Physicians, attorneys, and professors express a significantly different degree of fearfulness, although they prioritize their fears similarly. Physicians appear particularly to fear sickness and ageing, issues directly relevant to their chosen profession. The other two groups, however, do not demonstrate any specific outstanding fears. Results are discussed for a mixed sex, and an all male sample. PMID- 3818204 TI - The self image of Chinese-American adolescents: a cross-cultural comparison. AB - The aim of this study was to assess the self-concept of Chinese-American adolescents and then to compare them with standard samples of normal United States and Chinese adolescents. The instrument used to measure self-concept was the Offer Self-Image Questionnaire (OSIQ). As expected, the Chinese-American adolescent group very closely resembled the normal United States adolescent group and differed markedly from the normal Chinese adolescent group. The few areas in which the Chinese-American group significantly differed from their American peers, such as on the Sexual Attitudes Scale, appeared to be in a direction that was influenced by Chinese culture. The poorer adjustment shown on the Body and Self-Image scale by the Chinese-American adolescents points to the effect of racial stereotyping in the United States. PMID- 3818205 TI - Family typology and family interaction in psychiatric disorders. PMID- 3818206 TI - Causal attributions for psychological illness among Turkish psychiatric in patients and their relationships with hope. AB - The causal attributions for psychological illness were investigated in a sample of seventy Turkish psychiatric in-patients, using the levels of causal attributions proposed by the transtheoretical model of Prochaska (1984). The factor analysis of replies to a questionnaire tapping various levels of causality revealed seven factors which were greatly overlapping with the causal attributional levels proposed by the transtheoretical model and verified in western samples. However, there were important dissimilarities on attributions to family, self, and interpersonal conflicts. Family conflicts and interpersonal conflicts appeared as two separate causal factors, whereas attributions to personal symptoms and family conflicts merged under a single higher-order factor. Results also revealed that types of attributions were related to hope for future well-being. The results and their implications were discussed within the framework of the transtheoretical model, attribution theory research and studies on the Turkish family structure and values. PMID- 3818207 TI - Use of the term "borderline patient" by Swedish psychiatrists. AB - Four hundred and sixty seven Swedish psychiatrists (response rate = 52.5%) returned a questionnaire on their understanding of the term "borderline patient". Virtually all had heard of it and 75.2% regularly used it as a diagnosis. Its use was positively associated with female sex, psychotherapy interest and training. 38.8% of the respondents aligned themselves with a predominantly constitutional, and 57.8% with a psychodynamic, understanding of the term. This difference was strongly associated with those diagnoses to which the term was considered equivalent, the symptoms most characteristic of it and with various aspects of the responding psychiatrists' training and work. Swedish psychiatrists emphasized the subjective aspects of the patients' disorder rather than the lability and socially disruptive behaviour which are so prominent in the DSM-III diagnosis. The results of this study underline the urgent need for the establishment of simpler and more practical criteria for the diagnosis. PMID- 3818208 TI - Psychiatric consultation in Micronesia: the question of organicity. AB - The authors report on 37 referrals seen for psychiatric consultation during visits to various islands in Micronesia. A large number demonstrated either organic mental disorders or contributory medical illnesses. Observed differences between males and females are examined. In such cross-cultural settings, the authors emphasize the need for psychiatric expertise responsive not only to the dimension of culture in evaluation and treatment, but also to the importance of vigilance for organic processes that may require special attention. PMID- 3818209 TI - The social identity of the chronic schizophrenic. AB - Using ethnographic research methods in a sample of institutionalized male schizophrenics, an emic typology of patient social identities was derived. Interview and observational data yielded three general status classes comprising thirteen associated identities: killer, fighter, assaultive person, fag, rapist, doper, drunk, victim, con, nut, weirdo, snitch, and disoriented. An individual's social identity varied depending upon his current setting within the hospital (official, private, patient-staff interaction, or outside). This emic-derived typology is contrasted with the etic typologies which dominate the literature (e.g. Goffman, Salisbury and Henry), and the importance of ethnographic study in social psychiatry is highlighted. PMID- 3818210 TI - Attitudes of health care professionals towards patients who take overdoses. AB - The attitudes of health care professionals in Malta towards patients who take drug overdoses were studied. It was found that the intention of the overdose had a marked effect on the attitude of the health care professional towards the patients. Differences between different professionals were noted and the Maltese results were compared with those of a similar study in London. PMID- 3818211 TI - Psychiatric day hospitals: the patients and their preferences in treatment. AB - One hundred and sixty-five patients were seen after one week of day-hospital attendance, and 82 of them four weeks later. Their demographic characteristics, and their preferences in day-hospital treatment are described. Non specific factors of getting out of the home and mixing with other people, the opportunity to discuss problems, and taking part in various occupational activities concerned with improving coping skills were seen by the patients as valuable. Staff visits to the patient's home, family interviews and ward rounds were much less supported. PMID- 3818212 TI - Percutaneous nephrostomy for deflation and stone treatment, I. AB - A simple technique of percutaneous nephrostomy and renal calculus treatment is reported. The pertaining equipment and method are so highly accomplished today that the majority of stones can be removed percutaneously, largely dispensing with the need for surgical operation. The method has proved particularly efficient in secondary operations. It can be put to work at every urologic department where an X-ray table with closed-circuit TV is available and a surgical team is at hand, ready to cope at once with complications, presenting themselves rarely in the form of secondary bleeding, injury of a nearby organ, etc. Therefore the urologist should be advised to perform the renal puncture himself. Endoscopic removal of the stone, the easier part of the operation, can be carried out in a single session; but for larger stones which are less easy to cope with, it should be done a few days after creation of the fistula, when the tunnel has sufficiently indurated to permit effortless work. The percutaneous method, since it removes the stone at once, is usually superior to the more expensive extracorporeal nephrolithotripsy but the two may complement each other. PMID- 3818213 TI - Unilateral renal oncocytoma: a case report. AB - A case of unilateral renal oncocytoma is reported. Diagnosis, clinical features and management of the tumour are discussed in the light of international literature. The value of angionephrography in the diagnosis of the tumour and in the preoperative planning of surgical therapy is emphasized. PMID- 3818214 TI - Preoperative diagnosis of renal oncocytoma and treatment possibilities. AB - We report 2 cases of renal oncocytoma and review the literature. A number of radiological, cytological and ultrastructural differential features of oncocytoma that are known today make preoperative diagnosis of this tumour possible. Analysis of the reported cases allows to conclude that oncocytomas are of universally benign character with a very good prognosis. Metastases have not been documented. Thus we suggest that many patients with oncocytoma could be spared the operation of nephrectomy. Partial kidney resection or heminephrectomy are to be preferred with solitary oncocytomas of a moderate size. PMID- 3818215 TI - Operative treatment of bilateral vesicoureteral reflux by our own method of ureter reimplantation. AB - The results of treatment of 50 patients with bilateral vesicoureteral reflux (VUR) are presented. In all patients our own method of reimplantation of the ureters consisting in making a single, common submucosal tunnel situated on the back wall of the bladder was employed. The observations made and the results obtained prove the usefulness of the described operative technique in the treatment of bilateral vesicoureteral reflux. PMID- 3818216 TI - Our experience in the application of the biocompatible indwelling ureteral stents. AB - The need of indwelling ureteral stents for long-term use is established. The authors describe the indications for the indwelling ureteral stents and report their experience with the application of two types of endoprostheses: Gibbons stent and Double J ureteral catheters. The technique of the insertion of the stents is described and the complications are listed. It is concluded that the modern ureteral stents for long-term use have the place in the daily practice and are a real step forward in the fight against hospitalism and nosocomial infections. PMID- 3818217 TI - Prognostic factors in superficial bladder cancer. AB - A retrospective analysis of 91 patients with superficial transitional cell carcinoma (stages Ta and T1) is reported. In all of the patients transurethral resection was the treatment of choice. With the recurrence rate as the primary endpoint of interest it appeared that the number of tumours at presentation, invasion of the lamina propria, and histological grade were to be of prognostic importance. The frequency of tumour progression in our group was found to be 10 per cent. All of the patients who developed muscle invasion had lamina propria invasion at presentation. PMID- 3818218 TI - The Helmstein bladder distension treatment for tumours and severe bleeding. AB - The Helmstein bladder distension treatment was applied to 26 patients, who received a total of 70 treatments (52 for bladder tumour and 18 for severe bleeding; in 7 cases for both tumour and bleeding). In the T2 tumours total necrosis occurred in 27% of the cases, partial necrosis in 50% and no necrosis in 23%. Of the patients with total necrosis 64% had recurrences within 12 months. In the T3-T4 tumours only 33% had a temporary slight reduction of the tumour mass. In patients with severe bleeding from the bladder, haematuria ceased within 1 to 5 days after the treatment in 12 out of 18 cases. Bleeding, however, recurred after an average of 3 months. It is concluded that the treatment is useful in selected cases with multiple tumours of the bladder, and the method is effective in controlling severe bleeding from the bladder. PMID- 3818219 TI - Urethral stricture complicating transurethral prostatic surgery. AB - The incidence of urethral stricture was 9 per cent among 336 patients after transurethral prostatic resection for benign hyperplasia. The strictures were mostly in the penile part of the urethra and could be treated with regular dilation, internal urethrotomy or meatal incision. Bacteriuria or indwelling catheter preoperatively did not seem to predispose to stricture formation. When there is an indication of a narrow urethra before TUR, a fine-calibre resectoscope should be used and a preliminary internal urethrotomy is advisable. PMID- 3818220 TI - Xanthogranulomatous prostatitis. AB - Two cases of rarely observed granulomatous prostatitis are presented. Unspecific clinical symptoms and a close similarity in clinical course to prostatic adenoma or adenocarcinoma may be misleading and produce severe diagnostic difficulties even for an experienced urologist. Close cooperation with a pathomorphologist is necessary for their avoidance. Relying on published evidence the authors briefly analyse this nosological entity, the aetiology of which is still controversial. PMID- 3818221 TI - Serum testosterone, testicular connective tissue protein and testicular histology in rats treated with hyperbaric oxygen. AB - This study was done to ascertain whether hyperbaric oxygenation really affects testicular activity in rats. We evaluated serum testosterone concentration, testicular content of connective tissue protein and histological analysis of testes in each rat treated with 2 or 3 atmospheric pressures associated with oxygen saturation, together or singly for 90 minutes daily for 58 days. There were no significant differences in serum testosterone concentrations between the examined groups. The amounts of collagen, non-collagenous protein or elastin in testis were similar in all groups except one set of determinations. In addition, no prominent histological differences were noted in the testes of the animals. Thus, the pressure environment of this study, which can be regarded as almost the same as that of the hyperbaric oxygenation chamber in clinical use, appears to be nontoxic to rat testes. PMID- 3818222 TI - Intrascrotal metastases from renal cell carcinoma. AB - This is an up-to-date report about two patients suffering respectively from testicular and epididymal metastases of a renal adenocarcinoma in the condition following tumour nephrectomy in anamnesis. It is a survey on literature including the number of cases published. PMID- 3818223 TI - Changes of serum lipids and lipoproteins during haemodialysis treatment in dialysed chronic uraemic patients. AB - Changes of serum lipids and lipoproteins were determined quantitatively before and after haemodialysis in chronic uraemic patients. Serum beta-lipoprotein significantly decreased due to haemodialysis, while alpha-lipoprotein and the FFA level significantly increased. Slight correlations were observed between the applied transmembrane pressure and the serum concentration of FFA, HDL cholesterol or total cholesterol levels. Hyper-beta-lipoproteinemia was found in 70.9 per cent and Frederickson-HLP in 33.3% of the haemodialyzed chronic uraemic patients. PMID- 3818224 TI - The Association for Research in Vision and Ophthalmology. Annual spring meeting. Sarasota, Florida, May 4-8, 1987. Abstracts. PMID- 3818225 TI - Effects of the new mitotic inhibitor pyrimidinsulfone NY 4137 on human cells in vitro and on colchicine binding to tubulin. AB - The effect of 2-(2-thenyl)sulfonyl-5-bromopyrimidine (NY 4137) on cells of the human line NHIK 3025 was investigated. It was shown that NY 4137 induces cell cycle specific inhibition in metaphase. A dose-dependent prolongation of metaphase was found and the fraction of cells able to escape metaphase arrest declined gradually as the concentration of NY 4137 increased. A total block in metaphase was achieved with 0.016 mM and higher concentrations of NY 4137. Interphase was also prolonged in cells treated with 0.016 mM. Inhibition of valine incorporation by NY 4137 was also found to be dose-dependent. Following a 2-h exposure to 0.2 mM NY 4137 valine incorporation was inhibited by 80-85%. Inhibition of colchicine and vincristine binding to purified tubulin was also investigated. Double reciprocal plot and gel filtration chromatography showed that NY 4137 competitively inhibited colchicine binding to DEAE-cellulose purified tubulin. NY 4137 had no effect on vincristine binding to tubulin. The binding of NY 4137 to tubulin at or near the colchicine binding site may be responsible for the metaphase arrest. PMID- 3818226 TI - Activity of RA-700, a cyclic hexapeptide from Rubiae Radix, in the human tumor clonogenic assay. AB - In vitro phase II study of a new cyclic hexapeptide anticancer agent, RA-700 was studied on the human tumor clonogenic assay. From the results of the study using the human tumor cell line of lung cancer (PC-6), RA-700 appears to possess time dependent antitumor activity. Therefore, against the 148 human specimens of various malignancies, the chemosensitivity of RA-700 was tested at the concentrations of 10 micrograms/ml, 1 microgram/ml and 0.1 microgram/ml in continuous exposure schedule for 2 weeks by using the human tumor clonogenic assay. If the criteria for in vitro sensitivity was based on greater than or equal to 70% inhibition of colony formation, out of 148 specimens 59 specimens (40%) were evaluable and the chemosensitivity rate of RA-700 were 67% (4/6), 22% (2/9), 17% (3/18) and 10% (1/10) for ovarian cancer, non-small cell lung cancer, breast cancer and colorectal cancer, respectively. An overall chemosensitivity rate against 13 different histologic types of cancers was 22% (13/59) (greater than or equal to 70% inhibition of colony formation) and 39% (23/59) (greater than or equal to 50% inhibition of colony formation). RA-700 showed almost same chemosensitivity compared to that of five standard anticancer drugs (adriamycin, mitomycin C, cisplatin, vinblastine and 5-FU), but the spectrum of RA-700 activity appears to be different from that of the standard drugs. Furthermore, the antitumor activity of RA-700 had no relationship with prior chemotherapy. These results indicated that RA-700 is a candidate for phase I study. PMID- 3818227 TI - Aminoglutethimide. Penetration of the blood brain barrier. AB - The uptake of 14C-labeled aminoglutethimide into the brain was investigated in the rat after intracarotid injection according to the method of Oldendorf, as well as in cisternal cerebrospinal fluid obtained by suboccipital puncture after i.v. injection of the drug. The brain uptake index of aminoglutethimide after intracarotid injection was 30.7 + 2.4%. Cerebrospinal fluid/blood quotients after i.v. drug injection were 0.53 at 10 min and 0.26 at 60 min. The results of both methods clearly show that aminoglutethimide easily penetrates the blood brain barrier. PMID- 3818228 TI - A phase I trial of topically applied trans-retinoic acid in cervical dysplasia clinical efficacy. AB - Forty-two patients were entered into a phase I trial to evaluate the vitamin A derivative, trans-retinoic acid, in cervical intraepithelial neoplasia. Treatment consisted of four consecutive 24-h applications of retinoids via an inert collagen sponge in a cervical cap. Patients were followed for response at 3-month intervals using cytology, colposcopy, and selected biopsies. Thirty-six patients were evaluable (mild dysplasia, 13; moderate dysplasia, 17; severe dysplasia, 6) with follow-up from 5 to 18 months. Complete regression was seen in 2/14 (14%) patients treated with concentrations of 0.05%----0.1167% and in 10/22 (45%) patients treated with concentrations of 0.1583%----0.484% (p less than 0.05). One patient with negative biopsies at 12 months has subsequently recurred at 18 months. PMID- 3818229 TI - Cervical tissue uptake of all-trans-retinoic acid delivered via a collagen sponge cervical cap delivery device in patients with cervical dysplasia. AB - The present study was undertaken to evaluate the systemic absorption and cervical tissue uptake of all-trans-retinoic acid (TRA), delivered via a collagen spongecervical cap delivery device in patients with intraepithelial cervical dysplasia. Ten patients with histologically proven mild or moderate cervical dysplasia were included in this pharmacologic study. The two TRA concentrations (0.05% and 0.372%) selected for study represent the starting and maximally tolerated doses used in phase I clinical trial. All-trans-retinoic-11-3H acid (3H TRA, 500 mu Ci) was used to facilitate cervical tissue uptake studies. Cervical biopsies and post-treatment blood samples were obtained from each patient after TRA exposure. The uptake of TRA into cervical tissues four hours after drug administration was significantly increased at the maximally tolerated TRA dose. There was a rapid decrease in cervical tissue concentration of TRA at the 0.372% dose between 4 and 24 h after drug exposure, suggesting a relatively short elimination half-life of TRA in cervical tissues. HPLC analysis of post-treatment blood samples indicate that there was no systemic absorption of TRA after local cervical administration. PMID- 3818230 TI - Phase I clinical study of nafazatrom. AB - Nafazatrom, a synthetic pyrazolinone derivative, has been shown to have substantial antitumor activity in vitro and antitumor and antimetastatic activity in experimental animal systems. The drug has produced no substantial toxicity in preclinical studies and during limited human trials. A phase I clinical trial with this substance was performed at this institution. Nafazatrom was administered orally in a single daily dose. The initial starting dose was 30 mg/m2 and, in the absence of toxicity, subsequent dose levels were reached after 100% escalation. Six patients were treated at each dose level. Forty-eight patients with various metastatic malignant tumors (mostly with melanoma, breast carcinoma, soft tissue sarcoma, renal cell carcinoma and colorectal carcinoma) were entered on this program. No objective remissions were observed. Twelve patients remained stable for periods in excess of 8 weeks. No consistent, substantial or dose-limiting toxicity was detected. The maximum tolerated dose was not reached, and dose escalation was stopped at 4,000 mg/m2/day as initially planned. With the oral preparation, within this dose range and at this schedule, nafazatrom has no antitumor or other biologic activity. PMID- 3818231 TI - Phase II trial of esorubicin (4' deoxydoxorubicin) in cancers of the breast, colon, kidney, lung and melanoma. AB - A phase II trial of esorubicin (4' deoxydoxorubicin) was performed in patients with cancers of the breast, colon, kidney, lung and melanoma. Two partial responses were observed out of 16 patients with breast cancer treated with esorubicin. No objective responses (complete or partial) were seen in patients with colon cancer (18 patients), lung cancer (12 patients), renal cell cancer (12 patients) and melanoma (18 patients). Myelo-suppression was the most significant toxicity encountered with granulocytopenia (neutrophils less than 1,000) observed in 38% of patients. As discussed, we feel that further investigation of esorubicin in anthracycline-sensitive tumors is warranted. PMID- 3818232 TI - Optimizing electrocardiograph electrode placement for cardiac-gated magnetic resonance imaging. AB - Electrocardiographs recorded in a magnetic field for cardiac-gating in magnetic resonance imaging (MRI) are complicated by blood flow-induced potentials. This study examines which lead of the standard 12-lead ECG maximizes the QRS while minimizing flow-induced interference. Twelve-lead ECGs were performed on normal volunteers (n = 9) and patients (n = 13) in and out of the bore of a 1.5 Tesla imaging magnet. The amplitude of the major flow-induced potentials was measured, and the vectors of largest induced potential and the QRS axis were plotted for each subject. ECGs obtained outside and inside the magnet were digitized and subtracted (in magnet ECG--out of magnet ECG = artifact ECG) and the peaks of the resultant curves measured. Superimposed potentials were largest in the early T wave and late S-T segment in leads I, II, V1, and V2, and smallest in III and AVF. A low-amplitude 7-to 10-Hz signal occurred in most leads. In the frontal plane, QRS axes and flow potential vectors were closely clustered. In the transverse plane, QRS axes generally followed leads V5 or V6, whereas the flow potential vectors followed leads V1, V2, or V3. The normal and patient groups did not differ. Although leads III and AVP showed the smallest superimposed potentials, V5, V6, or a left posterior chest lead may maximize QRS and reduce artifact most consistently. A 7- to 10-Hz frequency filter may help eliminate artifacts in some subjects. PMID- 3818233 TI - Computed tomographic staging of gastrointestinal tract malignancies. Part I. Esophagus and stomach. AB - The utility and limitations of CT staging of carcinomas of the esophagus, stomach, small bowel, and colon are reviewed. Routine preoperative staging of esophageal carcinoma is recommended because of CT's sensitivity of more than 90% in detecting mediastinal invasion and a specificity of more than 85% in collected series. We recommend the use of CT as a problem-solving technique rather than as a routine preoperative test in patients with gastroesophageal junction, and gastric and small bowel malignancies. Routine use of CT to stage colorectal carcinomas also does not seem justifiable, due to the inability of CT to determine the depth of bowel wall involvement and to detect tumor in normal size lymph nodes. CT can help differentiate tumors that invade the pelvic side walls from more limited cancers and, therefore, in certain cases can aid in therapy planning. CT is the best method for detecting local recurrence in patients with rectosigmoid carcinomas. PMID- 3818234 TI - Observer variation in quantitative assessment of rheumatoid arthritis Part II. A simplified scoring system. AB - A new and more comprehensive simplified scoring system to provide quantitative assessment of radiographic findings in rheumatoid arthritis was studied by six observers with different levels of expertise. Since the observers, film set, and joints scored were the same as in a prior study of a more detailed scoring method, a precise comparison of the results was made. Interobserver variation with the simplified scoring system was small; there were highly significant correlations of the total radiographic scores for all observers (R = .898-.978, P less than .001). There were highly significant correlations between scores obtained with the simplified scoring system and those obtained with the more detailed method (R = .920-.955, P less than .001). When the same joints were evaluated by the two methods, a significantly greater number of possible observations could be scored with the simplified scoring system than with the more detailed method (X2 = 131.07, P less than .001). The simplified scoring system required 2.3 times less time to use in the hands of experienced observers. PMID- 3818235 TI - The production and evaluation of contrast-carrying liposomes made with an automatic high-pressure system. AB - An automatic, high-pressure system (Microfluidizer) has been found useful for producing contrast-carrying liposomes on an industrial scale. The goal of this investigation was to determine the feasibility of using this new microemulsification process to manufacture contrast-carrying microemulsified liposomes (MELs). Seven contrast media (three ionic, four nonionic) were encapsulated into the MELs. Light and electron microscopy, light scattering, radioisotope, and CT scan techniques were used to characterize these MELs, and the contrast entrapments among the studied media were compared. The contrast carrying MELs had good properties for imaging normal reticuloendothelial tissues, selectively. They had a narrow size range (0.1-3.0 micron), a single bilayer wall, high liver and spleen upake, and low leakage rates. The nonionic media were significantly more effectively entrapped in the MELs than the ionic media (P less than .05). The iodine-to-lipid weight ratio was about 1:16 for ionic media and 1:4 for nonionic media. Physical properties of the contrast media such as osmotic pressure and charge appeared to affect contrast entrapment. It was concluded that the microemulsification process is a useful system for producing contrast carrying liposomes continuously, on a large scale and in a reproducible manner. PMID- 3818236 TI - Vascular injury and thromboembolism in a young woman. PMID- 3818237 TI - How the NIH processes a grant application. Implications for radiology. PMID- 3818238 TI - Using animals in research. What's going on here? PMID- 3818239 TI - The imaging research laboratory. The rationale for sharing of equipment. PMID- 3818240 TI - A critical eye. PMID- 3818242 TI - Diagnostic value of ventilation-perfusion lung scanning in patients with suspected pulmonary embolism. PMID- 3818241 TI - Esophageal carcinoma: CT findings. PMID- 3818243 TI - The normal movements of the hyoid bond during swallow. PMID- 3818244 TI - Visualization of the popliteal lymph node by angiography. PMID- 3818245 TI - Dynamic tension. PMID- 3818246 TI - Health care in Iowa: where are we heading? PMID- 3818247 TI - Wandering spleen in a child. PMID- 3818249 TI - What's it all for, anyway? PMID- 3818248 TI - Giant myometrial cyst: report of a case. PMID- 3818251 TI - Iowa: the victim state. PMID- 3818250 TI - Recombinant alpha interferons 1986: a review. PMID- 3818252 TI - The future of medicine: plan for tomorrow. PMID- 3818253 TI - Use of factor IX intragenic recombinant DNA probes for evaluation of carrier status in haemophilia B families of Irish origin. PMID- 3818254 TI - Blunt trauma to the pancreas: a report of 10 cases. PMID- 3818255 TI - Ketanserin, a 5-HT antagonist, in symptomatic treatment of carcinoid syndrome. PMID- 3818257 TI - Small bowel adenocarcinoma and Crohn's disease. PMID- 3818256 TI - Upper limb venous thrombosis complicating amyloidosis. PMID- 3818258 TI - Proceedings of Irish Association for Rheumatology and Rehabilitation and Society of Irish and American Rheumatologists: combined meeting. October 11, 1985. Abstracts. PMID- 3818259 TI - Direct suppression of antibody responses by chlorinated dibenzodioxins in cultured spleen cells from (C57BL/6 x C3H)F1 and DBA/2 mice. AB - Direct addition of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD; 5-20 nM) to cultures of spleen cells from (C57BL/6 x C3H)F1 (B6C3F1) mice produced a suppression of the number of antibody-producing cells which developed in response to lipopolysaccharide, dinitrophenyl-Ficoll and sheep erythrocytes. The suppression of all three parameters was dose-related and parallel. This parallelism and the observation that the magnitude of the suppression was comparable in all three models suggested that the B-lymphocyte was the primary target. The defect was attributed to an effect on early activation or impaired differentiation because direct addition of TCDD had no effect on mitogen-induced proliferation. Temporal studies showed that TCDD produced the greatest suppression of the polyclonal antibody response to lipopolysaccharide when added at the beginning of the culture and that there was no suppression when TCDD was added as soon as 3 h after 200 micrograms/ml lipopolysaccharide. The observation that TCDD could directly suppress the antibody response by spleen cells from DBA/2 mice, at concentrations comparable to those required to suppress the B6C3F1 mice, suggested that the effect on the B-lymphocyte was atypical of the profile of activity (i.e., dependence on the Ah locus) previously reported to characterize the effects of dioxin in other systems. Similar results were demonstrated with congenic mice, as Ahd/d homozygotes were suppressed comparably to Ahb/d heterozygotes. The direct suppression by 2,7-dichlorodibenzo-p-dioxin, a congener previously demonstrated to be devoid of affinity for the Ah locus, further suggests a dissociation from the traditional profile of activity. PMID- 3818260 TI - Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on IgA serum and bile levels in rats. AB - Serum IgA is actively transported from blood to bile against a concentration gradient in the liver by the binding of dimeric IgA to secretory component, endocytosis and transport to the bile canaliculus by vesicles. As 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) has been shown to elicit hepatotoxicity, the effects of TCDD on rat serum and bile IgA levels were investigated. Rats were orally administered 50 micrograms TCDD/kg body weight in 95% corn oil: 5% acetone. At days 5, 10, 15, 20 and 30 after treatment, rats were anesthetized and a cannula inserted into the bile duct for collection of bile. In addition, blood was drawn, and, after euthanasia, the liver and thymus weights were recorded. Enzyme-linked immunosorbent assay (ELISA) techniques were employed to determine IgA in serum and bile and IgG levels in serum. Rocket immunoelectrophoresis was carried out to support ELISA results. It was found that serum IgA increased with time while serum IgG remained unchanged. In addition, while serum IgA levels were increasing, there was a concomitant decrease in biliary IgA. Thymus and liver weight changes were also observed. The data indicate that TCDD affects hepatic clearance of serum dimeric IgA and suggests that liver damage may be reflected by increased serum levels of IgA. PMID- 3818261 TI - Benign paroxysmal vertigo in childhood: a longitudinal study. PMID- 3818262 TI - Familial hemiplegic migraine: a new case. PMID- 3818263 TI - The time relationships of migraine and cluster headache when occurring in the same patient. PMID- 3818264 TI - Idiopathic headaches: relationship to life events. PMID- 3818265 TI - Migraine and intercalated seizures with occipital EEG paroxysms: observations on a family. PMID- 3818266 TI - Migrainous olfactory hallucinations. PMID- 3818267 TI - Basilar artery migraine after uncomplicated whiplash injuries. PMID- 3818268 TI - Migraine-induced epistaxis. PMID- 3818269 TI - Sublingual flunarizine. PMID- 3818270 TI - The appropriate use of diagnostic services: (XI). The autopsy: a personal view. PMID- 3818272 TI - Perinatal mortality in Scotland, 1985. PMID- 3818271 TI - The application of recent advances in clinical genetics. PMID- 3818273 TI - Medical staffing in the National Health Service in Scotland. PMID- 3818274 TI - General medical practice as a career among 1977 Scottish graduates. PMID- 3818275 TI - Pregnancy and HTLVIII/LAV transmission in heroin users. PMID- 3818276 TI - Patient location on the standard immunisation recall system. PMID- 3818277 TI - Fact or fluke: 100% measles immunoprophylaxis in general practice. PMID- 3818278 TI - The use of plastic identification cards and hand imprinters in general practice. PMID- 3818279 TI - [News from american dermatology]. PMID- 3818280 TI - [Suppression of phagocyte function by seminal plasma: possible predisposition for AIDS]. AB - A pathogenic retrovirus (HTLV-III) has recently been isolated in the seminal plasma (SP) of patients with AIDS. In order to test whether SP may influence non specific immunity we compared the influence of SP on the phagocytic release of lysozyme, chemotaxis and chemiluminescence. SP inhibited the release of lysozyme from granulocytes in a log-linear fashion; incubation with undiluted SP resulted in about 50% inhibition. Chemotaxis of granulocytes remained stable under the influence of SP. Chemiluminescence of both granulocytes and monocytes was completely blocked by undiluted SP; 1000-fold dilutions still caused an inhibition of about 20%. The separation of SP by column chromatography yielded fractions with a molecular weight of 10(4) to 2 X 10(4), 10(5) to 4 X 10(5) and greater than 10(6) inhibiting chemiluminescence. A cell-free chemiluminescent system showed the reduction of chemiluminescence to be based to a large extent on quenching of the photons generated. Our results indicate that SP possesses potent properties that suppress non-specific immunity, possibly an important predisposing factor to AIDS. PMID- 3818281 TI - [Pigmented actinic keratoses]. AB - Four cases of pigmented solar keratoses are reported. The brownish pigmented lesions on sun-exposed skin are clinically similar to lentigo simplex, lentigo senilis, lentigo maligna and pigmented seborrhoic keratosis. The surface is rather rough. Histologically, in addition to characteristic findings of solar keratoses, melanin can be found within the lower epidermis and within melanophages in the upper dermis (incontinence of pigment). PMID- 3818282 TI - Age-dependent lung doses from ingested 222Rn in drinking water. AB - The U.S. Environmental Protection Agency currently is considering regulatory standards limiting the concentration of 222Rn in public drinking water supplies. As part of this effort, a criteria document has been prepared detailing the health risks expected to occur from the presence of 222Rn in water used in homes. The present report examines the dose equivalent delivered to lung tissue following direct ingestion of 222Rn in water. Irradiation from both in-situ decay of 222Rn in lung tissue and the decay of 222Rn in lung air passages following exhalation are examined and results presented for ages from neonate through adult. These results indicate that the risk of lung cancer from inhalation of airborne progeny following emanation of 222Rn from water into home air is significantly greater than the risk from both irradiation pathways considered in ingestion at all ages. PMID- 3818283 TI - Using cost/risk procedures to establish recovery criteria following a nuclear reactor accident. AB - In the event of a major accidental release of radionuclides at a nuclear power plant, large populated areas could become seriously contaminated. Local officials would be responsible for establishing radiation recovery criteria that would permit the evacuated population to return safely to their jobs and homes. The range of acceptable criteria could imply variations in property losses in the billions of dollars. Given the likely public concern over the health consequences and the enormity of the potential property losses, a cost/risk analysis can provide important input to establishing the recovery criteria. This paper describes procedures for conducting a cost/risk analysis of a site radiologically contaminated by a nuclear power plant accident. The procedures are illustrated by analyzing a hypothetically contaminated site, using software developed for determining the property and health effects of major reactor accidents. PMID- 3818284 TI - Cesium-137 body burdens in Norwegian Lapps, 1965-1983. AB - Results of measurements of the whole-body contents of 137Cs during the period 1965-1983 in Lapps from the Kautokeino area in Norway are reported with measurements of 137Cs in reindeer meat during the period 1966-1983. By using available data on 137Cs in precipitation for the period 1950-1980, transfer coefficients from 137Cs in precipitation to reindeer meat have been assessed. A correlation between the 137Cs content in reindeer meat and the 137Cs content in Lapp reindeer breeders has been established. The average whole-body committed dose equivalent, H50, to the reindeer breeders from internally deposited 137Cs from intakes up to year 2000 was assessed to 13 mSv with a peak value of 30 mSv. In comparison, the corresponding committed dose equivalent to the Norwegian population from internally deposited 137Cs has been estimated to be about 1 mSv. The higher intake of 137Cs by reindeer breeders is due to the lichen-reindeer-man exposure pathway. PMID- 3818285 TI - Actinide distribution in the human skeleton. AB - Radiochemical analysis of two half skeletons donated to the United States Transuranium Registry from individuals with occupationally incurred depositions, one of 241Am and the other of 239Pu, revealed an inverse proportionality between the concentration of actinide in the bone ash and the fraction of ash (or the calcium content of the ash). A similar relationship was observed in a third case suffering from osteoporosis, but the slope was shallower. These results suggest that accurate estimates of the total skeletal content of actinide can be made from radiochemical analysis of only a few bone samples. PMID- 3818286 TI - Ingestion intake of fallout Pu in Japan. AB - Ingestion intakes of fallout Pu throughout Japan in the 1959-1962 and 1978-1980 periods were measured by analyzing composite samples of each foodstuff or duplicate composite food samples consumed by five persons for a period of 1 d. Cumulative ingestion intake in Tokyo for the period from 1954-1980 was estimated by regression analysis. The cumulative ingestion intake, calculated by simple regression analysis between the natural log of the intake and that of annual fallout deposition of Pu, was estimated to be 450 pCi. Calculated by a multiple regression analysis, including the natural log of annual fallout deposition rates for a previous year as an additional independent variable, it was estimated to be 600 pCi. Considering in combination an ingestion intake, the value of which is calculated by the multiple regression analysis; an absorption ratio from the gastrointestinal tract of 0.001 (a recently reported value for low-level soluble Pu independent of chemical form); and the metabolic model in ICRP Publication 30, it is possible to estimate that the contribution of ingestion intake to liver and bone burden would be approximately 30%. PMID- 3818287 TI - Trees as indicators of subterranean water flow from a retired radioactive waste disposal site. AB - Tree sampling helped locate a subterranean flow of tritiated water from a low level radioactive waste disposal site that had not been detected by well water monitoring alone. Deciduous trees growing in a natural forest on the hillsides downslope from the site were sampled for the presence of tritiated water in sap of maple trees and in leaf water extracted from oak and hickory trees. Elevated concentrations of 3H were detected in the leaf water extracted from several trees located 50 m downslope from the western boundary of the fenced exclusion zone. A 3-m-deep well drilled near these trees indicated that the source of tritiated water was a narrow zone of subterranean flow. PMID- 3818288 TI - Radiation protection aspects of the Sequoyah Nuclear Plant thimble tube ejection. PMID- 3818289 TI - The lung model and fluctuations in air activity. PMID- 3818290 TI - Concentration ratios of natural U for cattail pollen. PMID- 3818291 TI - More comments on Rn risk estimates in NCRP Report No. 77. PMID- 3818292 TI - Fallout sheltering: is it feasible? AB - The feasibility of sheltering the U.S. population from fallout resulting from a large-scale nuclear attack is assessed using a mathematical model. The model is used to calculate the reduction in cumulative dose received by a sheltered survivor, as a function of five adjustable parameters. Three time periods are postulated: time in the shelter, a transition period during which time out of the shelter increases and a final period in which half the time is spent outside the shelter. The parameters are varied independently, and the resulting dose reduction factor is compared with what seems to be necessary for survival in different regions of the country under the postulated attack. Another model developed by K.S. Gant and C.V. Chester is compared with this one. Similarities and differences are pointed out, and where possible the results of the two are checked for compatibility. An important question addressed in this paper is whether under the conditions of a large-scale nuclear attack sheltering a relatively unprepared population is at all feasible. Sensitivity tests of the various parameters in our model show that relatively low protection factor areas such as basements or inner rooms already existing in homes or other buildings could quite adequately serve as shelters for most of the area of the contiguous United States. Furthermore, continuous stays in these shelters of more than three weeks do not seem to be necessary for these large parts of the United States. PMID- 3818293 TI - Potable water as a source of airborne 222Rn in U.S. dwellings: a review and assessment. AB - Using a long-term-average, single-cell model and available data for U.S. housing, the concentration of 222Rn in indoor air due to the use of potable water is assessed. The ratio of the airborne 222Rn concentration to the concentration in water is represented by a lognormal distribution with geometric mean and geometric standard deviation of 0.65 X 10(-4) and 2.88, respectively, in fair agreement with the previously reported results of direct measurements of the ratio in 13 houses. By combining this result with data on 222Rn concentrations in U.S. water supplies, potable water is estimated to contribute an average of 24, 1.3, and 0.1 Bq m-3 to the airborne 222Rn concentration in residences served by private wells, public ground water, and surface water supplies, respectively. PMID- 3818294 TI - Theoretical evaluation of the 222Rn emanation coefficient for coal fly ash. AB - The release of 222Rn, from individual material grains in which it is formed, may be largely a diffusion process. This paper presents an analytical model purporting to describe the physical process of the release of 222Rn atoms from a 226Ra-bearing material grain. The solution of the diffusion equation for a spherical grain permits us to calculate theoretically the diffusion and emanation coefficient. Using this analysis to interpret experimental release data is explained. PMID- 3818295 TI - Radium-226 contents and Rn emanation coefficients of particle-size fractions of alkaline, acid and mixed U mill tailings. AB - Alkaline circuit and mixed, acid and alkaline circuit U mill tailings sampled at an inactive mill site near Monticello, UT, and tailings from an active, acid leach U mill were separated into particle-size fractions ranging from +10 mesh to -325 mesh by dry and wet separation techniques. The 226Ra contents and 222Rn emanation coefficients of these fractions were determined. Dry tailings show a high degree of aggregation that tends to mask the relation of properties, such as Ra content and Rn emanating power, to dispersed-particle size. Coarse-tailings fractions (+325 mesh) had emanation coefficients which were from 25 to 45% lower than those of their fine-fraction counterparts. Emanation coefficients measured for tailings derived from a salt roast/carbonate-leach process suggest that such are roasting does not lead to reductions in Rn emanation in the tailings derived therefrom. PMID- 3818296 TI - Partitioning of natural radionuclides in the waste streams of coal-fired utilities. AB - Five coal-fired electric utility plants were sampled to determine radionuclide concentrations in all major process streams. The results, together with plant operating data, were used to track the following six naturally occurring radionuclides: 238U, 226Ra, 210Po, 210Pb, 230Th and 232Th. For each plant, radionuclide balances were computed and the amount and extent of volatilization and enrichment of any radionuclides in the stack effluent were determined. In general, most of the radioactivity was found in boiler bottom ash or particulate control equipment hopper ash; atmospheric emissions were quite small in comparison. Radionuclides in the stack effluent were not detected in the gaseous state and some (especially 210Po and 210Pb) were preferentially associated with the smallest fly-ash particles. PMID- 3818297 TI - Dose assessment from incineration of deregulated solid biomedical radwaste. AB - Medical and educational institutions generate large amounts of solid radwaste from biomedical tracer research. It is currently shipped to a commercial low level waste site in the form of paper, plastic and glass contaminated principally with 3H, 14C and 125I (MSLC85). This waste stream could also be deregulated as are other forms of radwaste, for example, 3H and 14C liquid scintillation fluids. Incineration of this proposed deregulated, solid, low-level radwaste in concentrations comparable to currently deregulated radwaste would pose minimal risk to the occupants near these incinerators. PMID- 3818298 TI - Determining picogram quantities of U in human urine by thermal ionization mass spectrometry. AB - The U concentration in Standard Reference Material 2670 (Toxic Metals in Freeze Dried Urine) and the urine of two preschool-age children were determined by measuring the chemically separated U by isotope dilution thermal ionization mass spectrometry using ion counting detection. This procedure can detect about 1% of the U atoms loaded into the mass spectrometer and has a total chemical blank of about 5 pg U. The U concentration in SRM 2670 was found to be 113 +/- 2 pg 238U/ml (1 s). At this concentration, a 1-ml sample is sufficient for a determination with a total uncertainty of less than 5%. The U concentrations in the two children were 3.1 +/- 0.9 and 3.6 +/- 0.9 pg 238U/g. These values suggest that the U concentration in urine of unexposed persons may be at this low level or lower. PMID- 3818299 TI - A method for estimating the systemic burden of Pu from urinalyses. AB - It is generally agreed that Langham's model for urinary excretion of Pu substantially overestimates the systemic burden several years after exposure. Improved estimates can be derived from information obtained since the development of that model, including comparative urine and autopsy data for occupationally exposed persons; reanalyzed and updated data for human subjects injected with Pu; and a large body of general physiological and Pu-specific information on the processes governing the behavior of Pu in the body. We examine modeling approaches based on each of these sets of information and show that the three approaches yield fairly consistent estimates of the urinary excretion rate over three decades after contamination of blood. Estimates from the various approaches are unified to obtain a single set of predicted urinary excretion rates that, in effect, is based on all three bodies of information. A simple method is described for using these excretion rates to estimate intakes and systemic burdens of Pu. PMID- 3818300 TI - Cosmic-ray ionization in the lower atmosphere. AB - A high-pressure ion chamber filled with 2.5825 X 10(5) kg m-2 argon as used to measure the dose rates of several sites of interest in an attempt to evaluate the dose rates contributed by cosmic rays. Observation sites included two water reservoirs deeper than 110 m, Mount Ali which is higher than 2500 m, airliners flying at altitudes higher than 6700 m, and some sites at sea level. The results of this investigation were compared with those reported by the United Nations Scientific Committee on the Effects of Atomic Radiation and used for the determination of background radiation monitored with thermoluminescent dosimeters and sodium iodide detectors. PMID- 3818301 TI - A model for predicting food and water ingestion and inhalation rates of humans. PMID- 3818302 TI - Ground-water concentrations of 226Ra and 222Rn in North Carolina phosphate lands. PMID- 3818303 TI - Occupational radiation exposures during maintenance activities at nuclear power plants in Japan. PMID- 3818304 TI - Reduced radiostrontium absorption in a human subject treated with composite treatment for mixed fission product contamination. PMID- 3818305 TI - Distribution of low-level concentrations of 239,240Pu in tissues of a beagle. PMID- 3818306 TI - Gamma activity in struverite. PMID- 3818307 TI - Holder for uncovered high-activity radionuclide sources of alpha particles and fission fragments. PMID- 3818308 TI - Marble attenuation characteristics for diagnostic x rays. PMID- 3818309 TI - Comments on "An alternative technique for attaching thermoluminescent dosimeters to small mammals". PMID- 3818310 TI - Comments on limits of the spectral ranges in the non-ionizing radiation region of the electromagnetic spectrum for classification and exposure limit determination. PMID- 3818311 TI - Government health policy and the diffusion of new medical devices. AB - The combination of absent financial incentives, aspects of physicians' clinical training, and the uncertainty surrounding the appropriate application of expensive new medical devices have been the most significant factors in promoting their wasteful diffusion and use. This presentation summarizes the forces that have resulted in regulatory and reimbursement initiatives to make more efficient the acquisition and utilization of new medical devices. The case histories of computed tomography (CT) and magnetic resonance imaging (MRI) serve as a paradigm demonstrating why such initiatives have thus far proved ineffectual. More effective would be to abandon distinctions between inpatient and outpatient reimbursement for using new medical devices and to improve the relationship between reimbursement and technology assessment. PMID- 3818312 TI - An antibody-desferrioxamine conjugate labelled with 67Ga. AB - The optimum conditions for producing a 67Ga labelled antibody-desferrioxamine conjugate were determined. The mouse monoclonal antibody LICR-LON-M8 was coupled to the metal chelating compound desferrioxamine (DFO) using glutaraldehyde (GLUT). A DFO:GLUT:M8 molar ratio of 500:150:1 gave an immunoreactive antibody with low amounts (less than 5%) of high molecular weight polymer. The labelling efficiency with 67 Ga was greater than 90%, with a specific activity of 2-4 MBq/mg antibody. This 67Ga labelled antibody is suitable for evaluation as a diagnostic imaging agent. PMID- 3818313 TI - Radionuclide cholescintigraphic imaging: an evaluation of several 99mTc labelled hepatobiliary radiopharmaceuticals. AB - Recently, much interest has been shown in the development of 99mTc labelled cholescintigraphic agents for imaging the hepatobiliary tract. In this study six cholescintigraphic agents were compared in rabbits with respect to transit efficiency through the liver and the halftime on the washout portion of the liver time-activity curve. The agents compared were p-butyl-IDA (PBIDA), diisopropyl IDA (DISIDA), two mebrofenin (MBF) agents and two pyridoxylaminates (PDA). Best transit efficiencies were obtained with MBF (34.1 and 31.2%) followed by PDA (27.7 and 24.9%) while DISIDA (23%) and PBIDA (19.3%) were the lowest. The same phenomenon was observed regarding the washout halftime, with MBF the most rapid (6.3 and 5.9 min), PDA more prolonged (10.1 and 12.0 min) and DISIDA and PBIDA the slowest (23.0 and 23.2 min). This study confirms the difference in physiological behaviour of the various cholescintigraphic agents and shows identical flow patterns for locally produced and imported compounds. PMID- 3818314 TI - Studies on the lysosomal binding of 141Ce, 239Np, 239Pu and 241Am in rat and Syrian hamster liver using carrier-free electrophoresis. AB - The binding of 141Ce, 239Np, 239Pu and 241Am in the liver of rats and Syrian hamsters, following injection in essentially monomeric form, was analyzed by carrier-free electrophoresis at 4-9 days and several months after radionuclide injection. In contrast to density gradient methods lysosomes can be clearly separated from other cell organelles by carrier-free electrophoresis. These, and previous results from this and other laboratories confirm that lysosomes are the main initial binding site for these four radionuclides in the livers of rats and Syrian or Chinese hamster. Light microscopic autoradiography showed that at all the time intervals studied 241Am was more or less uniformly distributed in the liver of all three species. Thus, the changes in the electrophoretic pattern of the nuclides, observed at later time periods in hamsters, cannot be explained by gross redistribution phenomena such as accumulation in macrophages. PMID- 3818315 TI - The development of an 191Os----191mIr generator using an osmium chelate parent complex--I. Trans-dioxobismalonatoosmate(VI). AB - A 191Os----191mIr generator has been developed that has higher 191mIr yield and lower 191Os breakthrough than previous designs. These improvements have been realized through the use of the osmium chelate complex trans dioxobismalonatoosmate(VI) as the parent species on the generator. The new generator provides an initial 191mIr yield of 40%/mL and 191Os breakthrough of 2 3 X 10(-3)% when eluted with a solution of 0.05 M malonic acid/0.10 M sodium chloride at pH 4. Other advantages of the new design include faster clearance of the 191Os breakthrough products and simpler assembly. PMID- 3818316 TI - Biodistribution of N-alkyl and N-fluoroalkyl derivatives of spiroperidol; radiopharmaceuticals for PET studies of dopamine receptors. AB - There is great interest in the application of positron labeled ligands to map the dopamine receptor in vivo. A series of fluorine-18-labeled N-alkyl and N fluoroalkyl spiroperidol (SP) derivatives N-methyl[18F]SP; N-ethyl[18F]SP; N-(2 [18F]fluoroethyl)SP; N-propyl[18F]fluoropropyl) SP; N-(3-fluoropropyl) [18F]SP; N (2-[18F]fluoropropyl)SP; N-(2-[18F]fluorobutyl)SP; N-(2-[18F]fluoropentyl)SP; and N-(2-[18F]fluorohexyl)SP were synthesized. The lipophilicity of these ligands (log octanol/water partition coefficient) varies from 2.67 to 5.56 and the initial brain uptake in rats, measured at 2 min, was greatest with the methyl, ethyl, propyl, fluoroethyl, and fluoropropyl derivatives. The highest striatum/cerebellum values 1 h after administration were obtained with the N methyl, N-propyl, and N-3-fluoropropyl derivatives, while that of N-2-fluoroethyl showed the greatest uptake of total activity in the brain at this time. The uptake of all these ligands in the striatum could be blocked by cold SP showing the striatal uptake to be by the dopamine receptors. PMID- 3818317 TI - The preparation of 99mTc-tertiarybutylisonitrile (99mTc-TBI) by a method suitable for routine clinical use. AB - The myocardial imaging agent technetium-99m-hexakis (tertiarybutylisonitrile) (99mTc-TBI) was prepared by the reaction of [99mTc]pertechnetate with TBI in 50% ethanol/0.9% saline at 100 degrees C, using stannous chloride as the reducing agent. A study of the reaction parameters enabled the yield to be optimized to better than 90%, although this was reduced to approximately 60% if a purification step was carried out. Chromatographic analysis on ITLC-SG medium showed the final product to be of high radiochemical purity. Biological studies comprising biodistribution in mice over a 2-h period, imaging studies in animals and sub acute toxicity testing in mice indicated that 99mTc-TBI prepared as here described is a suitable agent for routine clinical use in humans. PMID- 3818318 TI - Pituitary localization of 3H-spiroperidol by an uptake/storage mechanism? AB - The lack of a pituitary imaging agent combined with the considerable clinical value for such an agent prompted an examination of 3H-spiroperidol (3HSp). Spiroperidol was selected for initial evaluation based on its high affinity for D2 receptors which are known to be present in the pituitary. A time course study of 3HSp concentration in rat pituitary and other tissues was conducted. Pituitary activity levels were found to be constant from 5 min to 4 h and were about 8 times levels in corpus striatum at 1 h. Blocking studies with (+) butaclamol and with unlabelled spiroperidol suggested the existence of both a D2 receptor mediated binding localization and a second uptake which is postulated to be an internalization process. Further studies involving ultracentrifugation of pituitary homogenates resulted in evidence for association of 3HSp with dense subcellular particles. 3HSp thus appears to be internalized by pituitary cells. PMID- 3818319 TI - Use of DES-treated rats as an animal model for assessment of pituitary adenoma imaging agents. AB - Prolactin (PRL) secreting pituitary adenomas are the most common type of pituitary tumors. An imaging agent which specifically localized in prolactinomas would be of considerable clinical value for both initial detection and also for monitoring the effects of dopamine agonist therapy. Tritiated spiroperidol (3HSp) was selected for initial evaluation as a possible imaging agent based on: demonstrated localization in the pituitary and demonstrated binding to human PRL secreting tumor tissue. DES was implanted in Fischer F344 rats and induced prolactinoma formation was evidenced by increased pituitary weight, elevated serum PRL levels and by an increase in the proportion of PRL-secreting cells in the pituitary. 3HSp concentrations in pituitary and other tissues of DES-treated rats were assessed in female rats and correlation studies showed that a 5-fold increase in serum PRL was associated with a 6-fold increase in both pituitary weight and % dose/organ accumulation of 3HSp. The number of pituitary D2 receptors per mg of protein in tissue homogenates was similar in both normal and DES-treated females. A blocking study with (+)-butaclamol demonstrated a D2 receptor-mediated component to 3HSp localization. In summary, an animal model for prolactinoma was characterized. An assessment of 3HSp accumulation indicates that radiolabelled spiroperidol shows excellent potential for detecting PRL-secreting tumors of the pituitary. PMID- 3818320 TI - Synthesis and biodistribution of 125I labeled bivalent analogs of practolol as potential myocardial imaging agents. AB - Iodinated bivalent ligands 3 and 4 and a monovalent ligand 5 were prepared from the cardioselective beta-antagonist, practolol. 125I-labeled 3, 4 and 5 were prepared by solid phase isotopic exchange reaction with carrier-free Na125I and examined in rats as potential receptor-site-directed myocardial imaging agents. Biodistribution of these agents in rats indicated that 125I-3 and 125I-4 were localized in the heart similarly to 125I-5 and the [125I]iodobenzoyl (6) that was previously reported. Localization of 125I-3 and 125I-4, was more persistent in the heart than that of 125I-monovalent ligands 5 and 6. Heart-to-blood ratios of 125I-3 and 125I-4 were significantly lower than those of 125I-5 and 125I-6, due mainly to slow blood clearance rates of 125I-3 and 125I-4. PMID- 3818321 TI - Investigation of the zinc status of surgical patients--II. Influence of vascular reconstruction on the zinc status. AB - Patients admitted for major vascular reconstruction operations received an i.v. dose of 65Zn. From the increased whole-body retention of 65Zn and the findings on other parameters it was concluded that the was concluded that the post-operative zinc metabolism of these patients differed from that of the control subjects. Unexpectedly, this difference persisted for several months. These patients can probably serve as controls in studies of patients who have undergone surgery of the intestinal tract. Increase of whole-body retention of 65Zn may be a sensitive indicator for subclinical zinc deficiency, but application in practice is hampered by the long duration of the period required for the measurement. From the present results it seems likely that measurement of the retention of 65Zn in the forearm as a function of time yields the same information but in a considerably shorter time. PMID- 3818322 TI - 67Ga binding to sulfated proteoglycan in normal and CCl4-damaged liver. AB - The binding of 67Ga and 59Fe to sulfated proteoglycan in the normal and CCl4 damaged mouse livers have been studied by means of Sepharose CL-4B column chromatography in guanidine hydrochloride. 67Ga uptake in the liver was elevated to approximately 1.8 times that of the control 2 days after a single administration of CCl4. 67Ga was bound to two types of sulfated proteoglycan (average mol. wt 1,700,000 and 35,000) in the normal and CCl4-damaged liver. However, the percentage of 67Ga bound to sulfated proteoglycan (mol. wt about 1,700,000) in the CCl4-damaged liver was increased as compared with that in the normal liver. Papain digestion of these sulfated proteoglycan fractions caused the 67Ga radioactivities to shift to a low molecular weight fraction (about 10,000). Cellulose acetate electrophoresis of this fraction (mol. wt about 10,000) isolated from the normal and CCl4-damaged livers resulted in identifying heparan sulfate (HS). The 35SO4 incorporation into HS band isolated from the CCl4 damaged liver, as an indicator of HS synthesis, was increased compared with that of the normal liver. 59Fe was not bound to sulfated proteoglycan and its gel filtration pattern was evidently different from that of 67Ga. PMID- 3818323 TI - Metabolism of 2-[18F]fluoro-2-deoxyglucose in tumor-bearing rats: chromatographic and enzymatic studies. AB - The activities of hexokinase and glucose-6-phosphatase, as well as the in vivo metabolic products of 2-[18F]fluoro-2-deoxyglucose ([18F]FDG) (45 min after an i.v. injection), were determined from several tissues of Rous sarcoma implanted rats. The HK/G-6-Pase ratio was found to be high in brain and tumor, and low in liver with intermediate values for kidney and muscle. In accordance with the measured enzyme activities about 90% of the 18F was found as [18F]FDG-6-P in brain, heart and tumor, whereas most of its was as [18F]FDG in liver and kidney. In addition three minor metabolites, tentatively identified as nucleotide derivatives of [18F]FDG, were formed. Our results suggest that at least Rous sarcoma tumor effectively converts [18F]FDG to [18F]FDG-6-P and thus PET studies with [18F]FDG can be applied to tumor diagnosis and to quantitative measurement of glucose utilization in tumor tissue according to the model of Sokoloff. PMID- 3818324 TI - Astatine (211At) as a therapeutic radionuclide. The plasma:blood cell distribution in vitro. AB - Therapy of carcinoma of the thyroid may include the use of the radionuclide 131I, which localizes to thyroid tissue. In considering the use of another halogen, the alpha particle emitting radionuclide astatine, 211At, there is also the requirement that it too can be taken up by the thyroid. However, in view of its short half-life (7.2 h) it is important that its transport in the blood is not a factor likely to render it less available. For example, retention of 211At by red cells may retard its uptake by the thyroid. This in vitro investigation of the partitioning of the 211At between erythrocytes and plasma indicates that it is not strongly bound by the red cells in blood. PMID- 3818325 TI - Breast milk content of 131I in a hypothyroid patient. AB - An oral dose of 185 MBq of 131I (sodium iodide) was administered to a lactating mother for whole body scanning. Breast milk was collected at several points in time, and assayed for radioactivity. The radioiodine concentration in the milk was found to be 4 MBq/dL at 6 h (about 2% of the dose). The radioactivity in breast milk decreased with a biological half-life of about 15 h in this hypothyroid patient. Following ingestion of radioiodide (such as [131I]sodium iodide), the appearance of radiolabel in breast secretion has been well documented. However, data do not appear in the literature on this process in the grossly hypothyroid state. We, therefore, are reporting our experience with such a situation. PMID- 3818326 TI - [Diagnosis and therapy of candidiasis in the premature infant]. AB - Extension of intensive care seems to have increased the risk of systemic candida infection. We report the incidence of systemic candida infection in 8 low-birth weight infants (gestational age 27-32 weeks, birth weight 710-1,550 g). All infants required respiratory treatment. Various silastic catheters were inserted. Antibiotic therapy was started on the first day of life, usually a combination of ampicillin and gentamycin. Candida septicaemia was diagnosed at the age of 8-69 days of life based on blood and urine cultures, in two children at autopsy. There were no specific clinical symptoms in regard to candida infection. Sonographic technique revealed hydronephrosis in 3 infants due to candida mycelium. Antimycotic therapy included amphotericin B (dosage 0.44-1.0 mg/kg X day) and 5 fluorocytosine (80-100 mg/kg X day) as well as a monotherapy of 5-fluorocytosine (100-200 mg/kg X day). Four children were treated successfully. We like to advice a regular search for candida in urine, blood, tracheal secretion, stool and skin in low-birth-weight infants under intensive care conditions. If antimycotic therapy is started in time, therapy can be successful. PMID- 3818327 TI - Leukocyte locomotory function in children with the immotile cilia syndrome. AB - The random motility of polymorphonuclear leucocytes (PMN), cellular chemotaxis and chemokinesis in kinetic fashion in 4 patients with immotile cilia syndrome (ICS) have been evaluated. No impairment of granulocyte ability of orientation and migration was found. Ultrastructural alterations of cilia which are the primary factor in the pathogenesis of respiratory tract disease in patients with ICS do not impair the PMN function. PMID- 3818329 TI - Jaundice and behavioral organization in the full-term neonate. AB - Hyperbilirubinemia is the most common problem experienced by full-term neonates during the first days of life. The short-term behavioral sequelae in infants with mild hyperbilirubinemia not requiring phototherapy were investigated by means of the Brazelton Neonatal Behavioral Assessment Scale. The behavioral integrity of 76 mildly jaundiced infants (maximum serum bilirubin 200-250 mumol/l) was compared with that of 401 control infants without clinical signs of hyperbilirubinemia (maximum serum bilirubin less than 100 mumol/l). The two groups differed on 12 of the 28 scale items reflecting five of the six dimensions of newborn behavior: habituation to disturbing stimuli when asleep, orientation to environmental events when alert, motor performance, regulation of state, and autonomic stability. The jaundiced infants showed an impaired behavioral organization compared to the control infants. PMID- 3818328 TI - Longitudinal assessment of children with congenital hypothyroidism detected by neonatal screening. AB - Clinical and laboratory data from 42 children (31 females and 11 males) with primary congenital hypothyroidism (CH) diagnosed by neonatal screening over a six year period are reported. The mean age at onset of thyroid hormone therapy was 33 days. The adequacy of replacement therapy was assessed by repeated TT4, FT4, T3 and TSH serum determinations. The high serum TT4 concentrations frequently observed were not accompanied by clinical evidence of hyperthyroidism. rT3 levels determined in 28 CH children with TT4 greater than 15 micrograms/dl were clearly higher than in the controls. The mean weight, length and head circumference remained always between the 50th and 75th centile. The radiological assessment of the knee, mainly the distal femoral surface, has been considered as an important clinical value in the initial diagnosis and in the evaluation of both severity and duration of disease. The psychomotor development was assessed using Brunet Lezine's test until age 36 months, Stanford-Binet at 4 and 5 and WISC at 6 years of age. The mean global developmental quotients (GDQ) were always between 85 and 97 at 6 to 72 months of age, only eight children were below 85. A significant correlation was found between GDQ at 6 months and the bone age. The neurological examination showed an impairment of posture, coordination and subtle deficits in motor and perceptual abilities in a small percentage of children. PMID- 3818330 TI - Localized intestinal perforation after intravenous indomethacin in a premature infant. AB - A female premature infant born after 27-week gestation developed a localized perforation of the terminal ileum six days after the administration of intravenous indomethacin for PDA closure. This complication has been reported after enteral and rectal administration of the drug. However, our clinical finding supports that these lesions in premature infants are not only related to the local effects of enteral indomethacin. PMID- 3818331 TI - Dissociation between adrenarche and gonadarche in two longstanding hypothyroid youngsters. AB - An evident dissociation between adrenarche and gonadarche was found in two longstanding hypothyroid youngsters, one male and one female, with advanced gonadal development and absent sexual hair. This discrepancy rapidly vanished after the institution of thyroxine substitutive treatment. These case reports underline the important relationships existing between thyroid function and endocrine systems involved in the regulation of adrenarche and gonadarche. PMID- 3818332 TI - [Malignant atrophic papulosis (Degos' syndrome) in a suckling infant]. AB - The clinical and histological diagnosis of Degos' syndrome could be made in a 8 month-old infant with scarring skin lesions. Some weeks later the baby developed severe intestinal symptoms and died from perforations of multiple necrotic lesions of the small bowel. Autopsy revealed in addition to the skin and gut lesions a haemorrhagic cortical infarction of the brain and fibrotic areas in the myocardium. In all these lesions characteristic stenotic endovascular proliferations were seen. Malignant atrophic papulosis is an extremely rare disease in infancy (our patient is the fifth reported case) with a well defined clinical picture, characteristic histological appearance of obliterating vasculitis, but unknown aetiology. PMID- 3818333 TI - Persistent neonatal hyperinsulinemic hypoglycemia in two siblings successfully treated with diazoxide. AB - Two siblings with persistent neonatal hyperinsulinemic hypoglycemia are reported. Diazoxide (10 mg/kg/d) was successful in controlling hypoglycemia for eight years and one year, respectively, without serious side effects. Pancreatic surgery was not necessary. PMID- 3818334 TI - [Cow's milk protein intolerance as a cause of small bowel occlusion]. AB - Two one- and three-month-old infants were admitted with clinical and radiologic signs of acute small bowel occlusion. They had been fed since the first day of life with a formula containing cow's milk proteins. The withdrawal of the allergen alone without surgical intervention led to normalization of bowel function within one day. At a new challenge with cow's milk protein the infants had an immediate clinical and biochemical response. The precocious introduction of formula containing cow's milk proteins was responsible for the allergic reaction. PMID- 3818335 TI - Hypocalciuric effect of chlorthalidone in two hypoparathyroid children. PMID- 3818336 TI - Further observations in haemorrhagic shock and encephalopathy syndrome. PMID- 3818337 TI - Genetics of myopia and associated mental traits. PMID- 3818339 TI - Effect of dithioerythritol on human lymphocyte chromosome length. PMID- 3818338 TI - Chromosomes and chromosomal evolution in human mesotheliomas as reflected in sequential analyses of two cases. PMID- 3818340 TI - Eskimoes and Caucasians have the same SCE levels both in Greenland and in Denmark. PMID- 3818341 TI - Quantitative genetics and fitness: lessons from Drosophila. AB - This paper examines patterns of heritability and genetic covariance between traits in the genus Drosophila. Traits are divided into the categories, morphology, behaviour, physiology and life history. Early theoretical analyses suggested that life history traits should have heritabilities that are lower than those in other categories. Variable pleiotrophy, environmental variation, mutation and niche variation may, however, maintain high heritabilities. In Drosophila the heritabilities of life history traits are lower than morphological or physiological traits but may exceed 20 per cent. The pattern of variation in the heritability of behavioural traits is similar to that of life history traits. Genetic covariance between morphological traits and between morphological and life history traits are all positive but those between life history traits have variable sign. Negative covariance between traits supports the variable pleiotropy hypothesis but other factors such as environmental heterogeneity, or mutation cannot be excluded. PMID- 3818343 TI - Genetic transformation of chickens using irradiated male gametes. AB - Results have been obtained which corroborate those of Pandey and Patchell (Molec. Gen. Genet., 186, 305, 1982) in demonstrating that genetic material from irradiated semen is incorporated into the embryo and expressed, albeit at rather a low rate, and is subsequently transmitted to progeny of the transfected birds. The method provides a technically straightforward means of transferring genetic material where rapid and reliable means of detecting the transferred gene exist. An advantage of the method is that regulatory regions are likely to be carried with the transferred gene but there is equally a disadvantage in the simultaneous transfer of unwanted material. PMID- 3818342 TI - Large scale patterns of genetic differentiation at enzyme loci in the land snails Cepaea nemoralis and Cepaea hortensis. AB - Samples of 231 populations of the land snails Cepaea nemoralis and C. hortensis from Britain, France, Switzerland and Spain were analysed for genetic polymorphism in six enzyme systems. These sibling species show similar levels of variation detected by electrophoresis, and have a generally similar degree of local divergence over homologous enzyme loci. As well as extensive local and regional differentiation, both species show large-scale changes in allele frequency across Europe. In C. hortensis there is a continuous gradient in allele frequency from northern Britain to northern Spain, while in C. nemoralis north south clines on the continent of Europe are reversed in direction in Britain. There are few obvious correlations of allele frequency change at single loci with components of the environment. Patterns of allele frequency variation in 24 sympatric populations of the two species are generally independent of each other, although there is a positive association of the frequencies of alleles at a leucine aminopeptidase locus in the two species. The statistical significance of this association depends on a single locality, and there is little indication of shared patterns of allele frequency change which might reflect a common response to natural selection. In addition, there is no evidence that the extensive geographical change in C. nemoralis and C. hortensis is a precursor of speciation. PMID- 3818344 TI - Cytological, linkage and insecticide studies on a genetic sexing line in Anopheles stephensi Liston. AB - T(Y-D1)35 is a genetic sexing line in Anopheles stephensi (2n = 6; XX female, XY male) based on the translocation of the dieldrin resistance gene to the male determining chromosome. A cytological analysis demonstrated the presence of a 3 chromosome multiple translocation in which part of the Y chromosome formed the differential segment. An analysis of egg karyotypes enabled the segregation behaviour of the complex to be determined and only alternate and adjacent I segregations could be demonstrated. The breakpoint of the translocation in chromosome 3 was located using polytene salivary gland preparations. Linkage studies using chromosome three markers revealed contrasting effects of the translocation on recombination in this chromosome. An insecticide treatment method, based on the exposure of newly emerged adults, was developed enabling large numbers of individuals to be treated for the production of only males. PMID- 3818345 TI - The hip. Proceedings of the fourteenth open scientific meeting of The Hip Society, 1986. PMID- 3818346 TI - The John Charnley Award paper. Efficacy of using a bone graft substitute to enhance biological fixation of a porous metal femoral component. AB - The efficacy of using hydroxyapatite/tricalcium phosphate (HAP/TCP) particles to enhance the biological fixation of a canine cementless femoral component with a noninterference fit was evaluated with a custom-designed collarless, wedge-shaped femoral component with titanium fiber metal pads along the anteroposterior surfaces of the stem. A polyethylene acetabular component was cemented into the pelvis. Three groups of dogs were employed: group I (n = 7) had a femoral component with an interference fit; group II (n = 6) had a component with a noninterference fit with uniform voids along the anteroposterior stem surfaces; and group III (n = 6) had a component with a noninterference fit including uniform voids filled with HAP/TCP particles. All dogs were harvested after 12 weeks of unrestricted weight bearing. Cross-section specimens from three different levels from each bone-component composite were evaluated histologically to determine the type and extent of tissue ingrowth and the percentage of peripheral bone or HAP/TCP particles adjacent to the fiber metal pad surfaces. Three other cross-section specimens, adjacent to the histological section levels of the same composites, were assessed for shear strength at the fiber metal tissue interface and for biochemical composition of the ingrown tissue. PMID- 3818347 TI - Surgical treatment of acetabular fractures. PMID- 3818348 TI - Management of metastatic tumors of the proximal femur: a continuing study. PMID- 3818349 TI - Current status of noncemented hip implants. AB - Recently the operative techniques, instrumentation, design, and material properties of bony ingrowth total hip replacement have been greatly improved. I prefer a hemispherical acetabular component fixed with screws going through the metal shell. The titanium mesh allows microinterlock with new bone, and macrointerlock is obtained by adding bone graft into the unused screw holes. The femoral component, made of Tivanium with titanium mesh attached to it by a new process called diffusion bonding, retains superalloy fatigue strength characteristics. An intimate press fit is assured by the specific operative technique, and both the fiber mesh and the collar provide proximal stress transfer. The design affords a nondestructive method for removal if necessary. The short-term clinical results are promising; most patients function as well as with cemented total hip replacement. The incidence of thigh pain has been significantly reduced since prior reports of cementless total hip replacement; however, a few patients still have thigh pain. The results in revision surgery are also promising, but as in cemented total hip replacement, the functional capacity of revision cases is usually lower than primary cases. There is an increased capacity to correct complex and difficult acetabular problems with this acetabular component. Obviously, long-term data are needed to establish the behavior of these implants over the immediate and long term. PMID- 3818350 TI - Evaluation of bony ingrowth by technetium diphosphonate and sulfur colloid scanning in porous hip resurfacing. PMID- 3818351 TI - Theory and practice of cementless revision total hip arthroplasty. PMID- 3818352 TI - Non cemented hip implants. Failures of biologically fixed devices: causes and treatment. AB - Complications of cementless prostheses are similar to those presented by the cemented ones. They are all the consequence of a failure (lack) of the bony fixation, which may be primary (the components never become fixed) or secondary (the components lose their bony attachments that were initially achieved). The bony fixation is often very difficult to assess, and a localized radiolucent line is always a bad indication. Failure of fixation may be partial or total for one or both components. Removal of distal broken cementless stems is much more difficult than for the cemented ones. Loosening may damage the bone at least as much as a mobile cemented mantle, and bone grafting at revision is often needed. Revisions for loosening of uncemented prostheses are at least as difficult as for the cemented ones. The lifetime of the Judet prosthesis has been shortened by an initially poor manufacturing process. Perhaps this has allowed us to get information about the outcome of uncemented prostheses in a shorter period. Finally, I believe in the concept of uncemented prostheses because their possible fixation by bony ingrowth is proved, but the definitive solutions have to be found and improvements are needed: A screwed socket appears to be good. A better plastic than HDP with less wearability and better mechanical properties is needed. A stem better adapted to the shape of the medullary canal bedding would probably facilitate bony ingrowth. The kind of porosity does not affect many things in my experience. Failures of prostheses that are no longer commonly used today have been reported. These were state-of-the-art devices 10 years ago- perhaps that is good food for thought. PMID- 3818353 TI - The case for cemented hips. PMID- 3818354 TI - The Frank Stinchfield Award paper. Improvement of femoral head blood flow in steroid-treated rabbits using lipid-clearing agent. PMID- 3818355 TI - Ultrastructural localization of the major proteoglycan and type II procollagen in organelles and extracellular matrix of cultured chondroblasts. AB - The mechanisms of synthesis and intracellular routing of the various cartilage matrix macromolecules are still unclear. We have studied this problem in cultured chondroblasts at the ultrastructural level using monospecific antibodies against the core protein of the keratan sulfate/chondroitin sulfate-rich cartilage proteoglycan (KS:CS-PG) or Type II procollagen, and cuprolinic blue, a cationic dye that binds to the glycosaminoglycan chains of proteoglycans. Intracellularly, the proteoglycan antibodies localized KS:CS-PG and its precursors primarily in the Golgi complex and secretory vesicles. In contrast, the bulk of Type II procollagen was found within the rough endoplasmic reticulum (ER). While devoid of collagen, the extracellular matrix was rich in KS:CS-PG molecules some of which studded the chondroblast plasmalemma. Cuprolinic blue staining indicated that the proteoglycans present in the Golgi complex fell into a predominant class of large proteoglycans, probably representing KS:CS-PG, and a minor class of smaller proteoglycans. Groups of these divergent proteoglycans often occupied distinct Golgi subcompartments; moreover, single large proteoglycans appeared to align along the luminal surface of Golgi cisternae and secretory vesicles. These results suggest that in cultured chondroblasts KS:CS-PG and Type II procollagen are differentially distributed both in organelles and in the extracellular matrix, and that different proteoglycan types may occupy distinct subcompartments in trans Golgi. PMID- 3818356 TI - Enzyme histochemical reactions in unfixed and undecalcified cryostat sections of mouse knee joints with special reference to arthritic lesions. AB - The use of unfixed and undecalcified cryostat sections of mouse knee joints is described for the study of enzyme histochemical reactions. Non-inflamed knee joints and knee joints of mice with antigen induced arthritis have been used. Joints were embedded in gelatin and subsequently cut at low speed with a motor driven cryostat fitted with a tungsten carbide knife at an obtuse angle (10 degrees). The sections were attached to transparent tape to keep the integrity of the tissue intact. The following histochemical reactions were carried out successfully: the tetrazolium salt reaction for dehydrogenase and reductase activity, the post-azo-coupling method for acid phosphatase and cathepsin B activity and the simultaneous azo-coupling method for esterase activity. In all cases the morphology and integrity of the sections were well kept and serial sections were obtained without any difficulty. Nonspecific staining of the tape did not occur. The localization of the final reaction product was meeting criteria for specific and precise histochemical methods with the exception of the metal salt method because of nonspecific staining of undecalcified bone. Cytophotometry of the final reaction product appeared to be reproducible and valid as demonstrated by reaction for glucose-6-phosphate dehydrogenase activity in synoviocytes from knee joints with induced arthritis. End point measurements as well as kinetic measurements of the formazan production were performed and linear relationships were found between the specific formazan formation and section thickness or incubation time, respectively. It is concluded that cryostat sections attached to transparent tape are an excellent tool for the study of the metabolism in tissues adjacent to bone matrix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818357 TI - Monoclonal antibodies demonstrating GABA-like immunoreactivity. AB - Mouse monoclonal antibodies (mAb) to GABA were developed following immunization with GABA coupled to bovine serum albumin (GABA-BSA). The selection of hybridoma cell lines producing antibodies which reacted with GABA-BSA but not with glutamate-BSA conjugates as well as the characterization of chosen mAb was performed by enzyme linked immunosorbent assays (ELISA). The five mAb selected were all of the IgG class and displayed different patterns of cross reactivities with the amino acid- and dipeptide-BSA conjugates tested. MAb 3A12 reacted approximately 4,000 times better with GABA-BSA than with beta-alanine-BSA conjugates according to serial dilution experiments of the antibody in ELISA. Immunoreactivity was even lower for other conjugates tested including glycine-, taurine-, glutamate-, and glutamine-BSA. Immunohistochemical results in rat and chicken brain indicated that the patterns of GABA-like immunoreactivity observed with these mAb were consistent with the available information on the distribution of GABA-containing neurons. PMID- 3818358 TI - Immunocytochemical localization of pancreatic carboxylic ester hydrolase in human paneth cells. AB - The protein-A gold method using specific rabbit sera directed against pure human pancreatic chymotrypsinogen and carboxylic ester hydrolase was applied to locate these (pro)enzymes in human pancreatic acinar cells and intestinal Paneth cells. Quantitative evaluation of the labelling indicated that both (pro)enzymes are present in pancreatic acinar secretory granules. In Paneth cell secretory granules, only carboxylic ester hydrolase was present in significant amounts, although the labelling for this enzyme was less intense than that observed in pancreatic zymogen granules. The results obtained support the view that Paneth cells represent a "diffuse exocrine gland" scattered along the intestine, whose role is either to act as a substitute in the event of a deficient pancreas or to regulate the intestinal flora. PMID- 3818359 TI - Reabsorption of fluorescein-isothiocyanate-labelled-ovalbumin in the kidney of normal and castrated male and female rats. AB - The reabsorption of ovalbumin double labelled with fluorescein isothiocyanate (FITC) in the kidneys of normal and castrated male and female rats was investigated using fluorometry and fluorescence microscopy. The animals received an intravenous injection of either 2 or 7 mg fluorescein-thiocarbamyl (FTC) ovalbumin per kilogram bodyweight (bw) and were killed 4 or 8 min post-injection. Animals injected with unlabelled ovalbumin (7.0 mg/kg bw) served as controls. Fluorescence microscopy revealed that FTC-ovalbumin was reabsorbed exclusively in the renal proximal tubule, the highest level of reabsorption being observed in its first part. Four and eight minutes after the injection, FTC-ovalbumin was only observed in apical reabsorption vacuoles, with lysosomes exhibiting no specific fluorescence. Fluorometric determinations for the renal homogenate supernatant showed that the renal reabsorption of FTC-ovalbumin was up to 24% higher in normal females than in normal males. Castration resulted in a significant increase in renal reabsorption in male rats (up to 38%; significant), whereas a minor decrease was observed in castrated females. The renal uptake differences in normal and castrated animals are discussed in the light of the sex hormone-dependent catabolism of lysosomal proteins in the renal proximal tubule of rats. PMID- 3818360 TI - An experimental study on nerve conduction velocities and biochemical parameters in lead-administered rats. PMID- 3818361 TI - The effect of VDT work on the fluctuations of accommodation. PMID- 3818362 TI - Changes of adrenaline concentration in various organs of the rat during and following four hours' swimming. PMID- 3818363 TI - Learning impairment in rats following low-level toluene exposure during brain development--a comparative study of high avoidance rats and Wistar rats. PMID- 3818364 TI - Measurement of blue-light effective radiance of welding arcs. PMID- 3818366 TI - Acute effect of methyl bromide on sleep-wakefulness and its circadian rhythms in rats. PMID- 3818367 TI - Urinary metabolites levels in workers exposed to chlorobenzene. PMID- 3818365 TI - The effects of methylmercury chloride of low concentration on the rat brain. PMID- 3818368 TI - Quantitative determination of urinary delta-aminolevulinic acid as an index of lead exposure by high-performance liquid chromatography. PMID- 3818369 TI - [Current status of the diagnosis and treatment of laterobasal skull fractures]. AB - Latero-basal fractures of the skull base due to a blunt head injury may cause vascular and nervous lesions. The most important lesion is rupture of the middle meningeal artery in the foramen spinosum leading to an acute epidural haematoma. Its early diagnosis is of vital importance. Lesions of the cranial nerves are rarely surgically remediable. Diagnostic steps in the management of these lesions are outlined. Close cooperation between ENT specialists and neurosurgeons is of the highest importance, particularly when dealing with petrous bone lesions producing C.S.F. otorrhea or the prolapse appearance of contused brain into the auditory canal. PMID- 3818370 TI - [Evaluation of risk factors in various forms of inner ear hearing loss]. AB - As in cardio-vascular diseases certain risk factors are held responsible for the genesis of inner ear affections. We thoroughly examined 205 patients, suffering from various kinds of internal ear disorders. Examinations included audiometric tests, medical, neurological and ophthalomological consultations and laboratory findings. Evaluation showed a significant increase of certain risk factors in our patients compared to the normal population. 50.2% of our patients were overweight, 29.3% had a high blood cholesterol, 28.8% had anaemia, and 22.4% had hypertension. These lesions of the auditory system thus share the same risk factors as the coronary and cerebral circulations. In the second stage of the study we looked for correlations between individual parameters and certain variations of inner ear disturbances, eg. sudden hearing loss, progressive or non progressive hearing loss, low or high frequency disorders. It was not possible to distinguish between the forms of inner ear disease mentioned on the basis of the prevalence of certain risk factors. PMID- 3818371 TI - [Galvanic stimulation of the vestibular system: indications and determination of normal values based on the frequency of the slow nystagmus phase]. AB - The most important features of the galvanic test are the persistence of galvanic nystagmus after complete destruction of the labyrinth and its impairment as soon as the peripheral neurone is damaged. 25 normal subjects, 4 patients with an acoustic neuroma and 4 patients with Meniere's disease were investigated. A difference in slow phase velocity between the right and left sides of more than 22% indicates a lesion of the vestibular nerve. In patients with an acoustic neuroma the difference lay between 59% and 100%. In Meniere's disease the difference measured was between 1% and 15%. PMID- 3818372 TI - [Current aspects of evaluating wood dust-induced adenocarcinomas of the nose and paranasal sinuses]. AB - The evaluation of 40 patients with adenocarcinoma of the nasal cavity shows that these patients had been exposed to oak and beech dusts proving the causal connection between this type of wood dust and adenocarcinoma of the nose. In view of this knowledge, compensation in accordance with section 551 (2) RVO (Reichsversicherungsordnung: social insurance statute) can be recommended in individual cases after intensive occupational exposure to oak or beech dust over many years. PMID- 3818373 TI - Handedness, footedness and finger and toe movement-related cerebral potentials. AB - Sixteen right-handed and 16 left-handed subjects were compared with respect to their foot dominance and the topography of their pre-movement cerebral potentials (Bereitschaftspotential, BP). First, righthanders were usually also found to be right-footed. Lefthanders showed a similar trend in preferring their left foot. Second, the BP prior to volitional self-paced movements of fingers and toes on either side was examined. For finger movements, the BP always showed higher amplitudes over the contralateral hemisphere as compared to the ipsilateral one (contralateral preponderance of negativity, CPN). For toe movements a significant ipsilateral preponderance of negativity (IPN) occurred in all subjects. The CPN was larger for finger movements of the dominant hand than it was for finger movements on the non-dominant side. By contrast, the IPN was larger prior to movements of the "non-dominant toes" than it was for movements of the dominant toes. This can be explained by assuming that the hemisphere contralateral to the dominant hand, generates more negativity than the one contralateral to the non dominant hand. This assumption is further discussed in the context of a vector model for the BP. PMID- 3818374 TI - Adaptive gain control of saccadic eye movements. AB - Properties of gain adaptivity in the saccadic system were studied. Subjects had to track a target which moved in single or double steps. The first target step which elicited the primary saccade had an amplitude in the range of 8-16 deg. The primary saccade triggered a further target displacement of 4 deg either in the same or--in different experimental sessions--in the opposite direction of the first target step. These consistent intrasaccadic target displacements lead to adaptive changes of saccadic amplitudes. The experimental data show that the saccadic system adapts to the stimulus sequence in a simple, parametric manner, namely by changing its gain. Consequently, it is assumed that a single gain element determines saccade sizes for all target eccentricities. Further, it is shown that adaptation has different time courses for gain increase and decrease, and its performance is close to completeness. The results are discussed with respect to the undershooting behaviour of goal-directed saccades and the functional demands to the saccadic system. PMID- 3818375 TI - Surgeon General's report on acquired immune deficiency syndrome. PMID- 3818376 TI - Theoretical considerations in regard to the demonstration of musculoskeletal and cardiovascular interactions. PMID- 3818377 TI - A low-velocity, high-amplitude procedure for demonstrating osteopathic principles and concepts of technique. PMID- 3818378 TI - Somatic manifestations in renal disease: a clinical research study. PMID- 3818379 TI - Elevated serum cholesterol values preceding myocardial infarction: the need for physician referral to lipid education. PMID- 3818380 TI - Combined perforation of the rectum and urinary bladder secondary to autoanal stimulation: report of a case. PMID- 3818381 TI - Radiologic manifestations of acquired immunodeficiency syndrome. PMID- 3818382 TI - Psychiatric aspects of AIDS: overview for the general practitioner. PMID- 3818383 TI - Stage I testicular seminoma: rationale for postorchiectomy radiation therapy. AB - The cases of 163 patients with Stage I seminoma of the testis treated by orchiectomy and adjuvant radiation therapy (XRT) were retrospectively evaluated to document outcome and to determine the prognostic significance of age side or primary, cryptorchidism, prior ipsilateral herniorrhaphy, status of the contralateral testis, history of prior testicular cancer, scrotal incision, postorchiectomy beta- human chorionic gonadotropin (BHCG) level, invasion of the epididymis, spermatic cord involvement, vascular invasion in the primary and mediastinal XRT. Of the prognostic factors evaluated, only spermatic cord involvement proved to be a significantly adverse factor. However, the true significance of cord involvement is unclear because the para-aortic regions were not irradiated in 2 of the patients in whom there was this finding, and in 1 of these there was failure in the retroperitoneum. Spermatic cord involvement was not a prognostically significant finding in patients whose para-aortic region was treated. For all 163 patients who underwent XRT, disease-free survival was 95% at 5, 10, and 15 years. Total survival corrected for intercurrent death was 97% from 5 through 20 years. Seven patients relapsed (4%) and 4 died of seminoma (2%). The XRT technique described is simple to implement and is extremely effective. Of 161 patients whose para-aortic region was irradiated, none developed subdiaphragmatic nodal recurrence. Only 1 patient developed acute leukemia. No patient developed any of the recognized delayed XRT-induced complications involving small bowel, large bowel, bladder, kidney, liver or spinal cord. The virtues and limitations of surveillance in Stage I testicular seminoma are discussed, and it is concluded that routine postorchiectomy XRT is the treatment of choice. PMID- 3818384 TI - The role of radiation in stage II testicular seminoma. AB - This is a retrospective review of 62 patients with Stage II testicular seminoma treated either by initial radiation therapy (48 patients) or by platinum containing chemotherapy (14 patients). For all 62 cases, disease-free survival from 2 to 20 years was 86%, uncorrected survival was 86% at 5 years and 83% at 15 years, and survival corrected for deaths from intercurrent disease was 90% from 2 to 20 years. There were no significant differences in outcome between the two treatment groups. An analysis of potential prognostic factors for the initial radiation therapy group and for the whole group revealed that age, site of primary, cryptorchidism, ipsilateral hernia repair, contralateral testicular atrophy, scrotal incision, elevated postorchiectomy beta-human chorionic gonadotropin level, epididymal invasion, spermatic cord involvement, and vascular invasion in the primary were not significant. However, bulk of abdominal disease was a prognostic factor. Patients with small-volume abdominal disease defined as nonpalpable disease or as a mass less than 10 cm in largest diameter accounted for two-thirds of the series and had a disease-free survival of 95% when treated with initial radiation therapy. Patients with bulky disease, either palpable or greater than or equal to 10 cm in diameter, had a disease-free survival of 64%. The relative roles of the two treatments in bulky abdominal disease are discussed, but in the absence of a prospective study it is not possible to definitively answer the question of which modality is best in this setting. In our series, the patients treated with platinum-containing chemotherapy fared as well as the primarily irradiated patients, but 71% of the former had palpable masses, compared with 22% of the latter. The chemotherapy-treated patients who relapsed were treated with radiation therapy for salvage, leading to a 100% survival corrected for intercurrent death. We have therefore elected to continue the policy of initial radiation therapy for small-volume (less than 10 cm) disease and platinum-containing chemotherapy for bulky disease (greater than or equal to 10 cm), with irradiation used for residual masses. PMID- 3818385 TI - Acute radiation-induced pulmonary damage: a clinical study on the response to fractionated radiation therapy. AB - Acute radiation-induced pulmonary damage can be a significant cause of morbidity in radiation therapy of the thorax. A prospective, clinical study was conducted to obtain dose-response data on acute pulmonary damage caused by fractionated radiation therapy. The endpoint was a visible increase in lung density within the irradiated volume on a computed tomographic (CT) examination as observed independently by three diagnostic radiologists. Fifty-four patients with various malignancies of the thorax completed the study. CT chest scans were taken before and at preselected times following radiotherapy. To represent different fractionation schedules of equivalent biological effect, the estimated single dose (ED) model, ED = D X N-0.377 X T-0.058 was used in which D was the average lung dose within the high dose region in cGy, N was the number of fractions, and T was the overall treatment time in days. Patients were grouped according to ED and the percent incidence of pulmonary damage for each group was determined. Total average lung doses ranged from 29.8 Gy to 53.6 Gy given in 10 to 30 fractions over a range of 12 to 60 days. Five patient groups with incidence ranging from 30% (ED of 930) to 90% (ED of 1150) were obtained. The resulting dose-response curve predicted a 50% incidence level at an ED value (ED50) of 1000 +/- 40 ED units. This value represents fractionation schedules equivalent to a total average lung dose of 32.9 Gy given in 15 fractions over 19 days. Over the linear portion of the dose-response curve, a 5% increase in ED (or total dose if N and T remain constant), predicts a 12% increase in the incidence of acute radiation-induced pulmonary damage. PMID- 3818386 TI - Radiation therapy in hyperbaric oxygen for head and neck cancer at Royal Adelaide Hospital--1964 to 1980. AB - This report describes experience with radiation therapy in hyperbaric oxygen in 201 patients with squamous carcinoma arising in the mobile portion of tongue (anterior 2/3), oropharynx, hypopharynx, and supraglottic larynx, treated between the years 1964 and 1980. Although not statistically different, the overall 5-year determinate survival figures of 35% for all patients with tumors arising in the hypopharynx, 87.5% for Stage I and II, 55% for Stage III, and 27.1% for Stage IV supraglottic carcinoma were perceptibly better than those obtained in a contemporary but not randomly controlled series of patients treated in air at Royal Adelaide Hospital from 1970 to 1980. The results obtained for tumors arising in the oropharynx and mobile portion of tongue however were found to be very similar to those achieved in air. The results achieved in this series are discussed in the context of experience at other centers and the role of randomly controlled clinical studies in evaluating new treatment modalities is emphasized. PMID- 3818387 TI - Changes of the blood lymphocyte population following 131I treatment for nodular goiter. AB - The blood lymphocyte population was examined in 34 patients who were treated with 131I for toxic or atoxic nodular goiter. The patients received one to three doses of 300-550 MBq of 131I administered at 1 week intervals. Lymphocyte counts were significantly reduced both 1 and 6 weeks after treatment. This reduction was accompanied by a changed composition of the lymphocyte population. The frequency of lymphocytes expressing membrane receptors for C'3 (EAC-rosette forming) was significantly reduced 1 and 6 weeks after 131I-administration. At 6 weeks there was a slight but statistically significant increase of the frequency of T-cells as identified by Leu 1 monoclonal antibodies. This was largely caused by an increased proportion of helper/induced T-cells as identified by Leu 3a monoclonals. 131I-treatment also reduced the capacity of lymphocytes to secrete immunoglobulins (Ig) upon PWM-stimulation. The most pronounced effect was observed for IgM. Secretion of IgG and IgA were less reduced. Mitogenic stimulations of lymphocytes with PHA and ConA were not significantly changed. We conclude that these changes observed, with the exception of mitogen reactivity, are essentially similar to those occurring after external radiation therapy for cancer. We speculate that blood lymphocytes passing through the continuously irradiated gland are damaged mainly by emitted beta-particles. PMID- 3818388 TI - Solid tumor models for the assessment of different treatment modalities: XXVI. Estimates of cell survival from tumor growth delay after alternating radiotherapy and chemotherapy. AB - The doubling time (Td) for hepatoma 3924A in ACI rats is relatively constant between different treatments when growth resumes after treatment with either chemotherapy or radiotherapy. Advantage was taken of this to estimate the fraction of surviving cells (SF) from in vivo growth delay (GD) data using the expression SF = 1/2GD/Td. Survival curves were constructed for several recently published treatment schedules which employed alternating radiotherapy and chemotherapy, and for both daily and multiple fractions per day (MFD) radiation schedules. A doubling time of 5.2 days was assumed, in the range observed for control and regrowing treated tumors, which yields one surviving cell at the TCD37 (3650 cGy single dose). The single fraction, multi-target, single hit model, SF = 1 - (1 - e-D/D0)n with D0 = 406 cGy and n = 1.63 is a reasonable representation of the data over the dose range 375-2250 cGy. The D0 of 406 cGy should be considered as a relative, not absolute value which is dependent on the radiosensitivity of the tumor cells and the accuracy of the doubling time, but is useful in relating the single dose data to more complex radiation schedules. Using D0 = 406 cGy, n = 1.63, and f = number of fractions, the multi-fraction, multi-target, single hit model SF = (1 - [1 - e-D/D0]n)f closely fits our data for 30 daily fractions given at 100 to 375 cGy/day for total radiation doses of 3000 to 11,250 cGy. The fraction of surviving cells for daily radiation alternated with three courses of cyclophosphamide (CP) was in good agreement with an additive effect of the two modalities at radiation doses of 3000 to 5640 cGy. Multiple fractions per day radiation given as 250 cGy fractions was more effective than predicted by the model both when given alone or alternately with cyclophosphamide. PMID- 3818389 TI - Radiation nephropathy in young and adult rats. AB - The effects of bilateral kidney irradiation were compared in young and adult rats. During a 1 year period after a single dose of 0, 7.5, 10, 12.5, or 15 Gy on both kidneys, renal function (glomerular filtration rate and effective renal plasma flow), urine composition, and systolic blood pressure were measured periodically. The first changes after irradiation were observed in the glomerular filtration rate and urine osmolality. One month after 10, 12.5, and 15 Gy, glomerular filtration rate (GFR) and urine osmolality had declined below control values in the young rats. After this initial decline, renal function increased at control rate or even more during the third and fourth month after irradiation but decreased progressively thereafter. In the adult rats, GFR and urine osmolality started to decrease 3 months after 10, 12.5, and 15 Gy. A rise in systolic blood pressure and proteinuria started 2-3 months after 12.5 and 15 Gy in both age groups. Early changes in the glomerular filtration rate with a drop in urine osmolality in young rats, occurring during a period of rapid renal development indicated an irradiation-induced inhibition of glomerular and tubular development. Although renal function deteriorated at a later time in adult rats, dose-response relationships obtained in young and adult rats did not show significant differences. PMID- 3818390 TI - Altered turnover and synthesis rates of lung surfactant following thoracic irradiation. AB - Between 2-6 weeks after thoracic irradiation with 10 Gy X rays, when levels of surfactant in the alveoli show the greatest increase, there is a reduction in the rate of radioactivity loss from 3H-choline labeled disaturated phosphatidylcholine from the lung. This indicates a reduced turnover of surfactant. Discrepancies between the halving times for specific activity and for total radioactivity of the disaturated phospholipids suggest that at between 2 and 3 weeks post-irradiation, removal and degradation of surfactant almost ceases, but that synthesis continues normally. However, by 3 weeks post irradiation, choline-3H incorporation into disaturated phosphatidylcholine suggests that surfactant synthesis is increased about two-fold. The reduced number of macrophages recovered from alveolar lavage between about 2 and 6 weeks post-irradiation may indicate a reason for the lengthened turnover times of surfactant over this period. Nevertheless the stimulated surfactant production that takes place from about 3 weeks onward suggests an additional active response to radiation or to radiation damage by the type II pneumonocytes. These studies confirm that the maximum levels of alveolar surfactant seen at 3 weeks post irradiation result from a different lung response than that responsible for the increase in surfactant, which occurs within hours of irradiation. PMID- 3818391 TI - Regional hyperthermia combined with blockade of the hepatic arterial blood flow by degradable starch microspheres in pigs. AB - The benefit of hepatic arterial microembolization by degradable starch microspheres (DSM) was investigated in regional hyperthermia of the liver. Hyperthermia with and without blood flow blockade of the hepatic artery using degradable starch microspheres was performed on six pigs. Heat was given for 30 min in each treatment by 8 MHz radiofrequency capacitive heating equipment. To maintain blood flow blockade during hyperthermia, 10 mg/kg of degradable starch microspheres was administered into the hepatic artery as an initial dose and 5 mg/kg of the drug was added periodically under the measurement of hepatic arterial blood flow by an electromagnetic flowmeter. To evaluate the effect of degradable starch microspheres, the temperature increase in the liver and rectum was compared between the treatment with and without DSM. All pigs showed a larger increase in intrahepatic temperature when heated in combination with degradable starch microspheres than without. On the other hand, temperature increase in the rectum as a result of hyperthermia to the liver was suppressed by DSM as compared with hyperthermia alone. These results indicate that hepatic arterial embolization by degradable starch microspheres potentiates radiofrequency capacitive heating of the liver. Although this study was not made with liver tumors, regional hyperthermia may be effective in the control of liver tumors when heat is given after the blockade of the hepatic artery by DSM. PMID- 3818392 TI - Optimization of dose-time factors for a tumor and multiple associated normal tissues. AB - This study explores the feasibility of identifying, for a given tumor and its associated normal tissues, that combination of dosimetric and technical factors which will provide the best chance of achieving local control of the tumor without significant complications. Tumor control probability depends on the number of clonogenic cells surviving the course of treatment, which is a function of the initial tumor volume and the computed cellular surviving fraction. This in turn depends on the physical dose, number of fractions, and overall time. Similarly, the risk of injury to any one associated normal tissue is also a function of dose, field-size, fractions, and time. The best treatment scheme is assumed to be one which maximizes the chance both of tumor control and of avoiding complications. Computer programs can achieve this end by searching a wide range of fractionation schemes and selecting that with the largest therapeutic ratio or probit difference (difference between tumor control and normal tissue damage probabilities). When two or more normal tissues are involved, this process is much more complex. Fractionation schemes that reduce the risk of injury in one tissue may be worse for another. The safest procedure is then one which reconciles these conflicting requirements, searching for that combination of factors which will maximize the conditional probability of controlling the tumor and avoiding injury in any of the several tissues concerned. Results of a computer-derived solution for this type of problem: control of a hypothetical lung cancer associated with lung parenchyma, late reacting stroma, and acutely reacting esophageal epithelium, are presented. PMID- 3818393 TI - Update on low dose rate irradiation for cancers of the oropharynx--May 1986. AB - At the conclusion of our recently published article in this Journal on low dose rate irradiation in moderately extensive cancers of the oropharynx, we updated our results in May 1986. Here we report on an expanded group of 65 patients with a 2 year minimum follow-up; 32 patients were treated by low dose rate irradiation and 33 by conventional fractionation. Forty-four percent (14/32) low dose irradiation patients survived with NED vs 8/33 (24%) conventional fractionation patients. The highly significant differences in the level of local recurrences between patients treated by low dose rate irradiation, 5/32 (16%), compared with conventional fractionation, 20/33 (61%), highlights the enhanced efficacy of the low dose rate irradiation technique in the local cure of cancers of the oropharynx. This superior local control however is achieved at the cost of a number of necrosis, 5/32 (16%). PMID- 3818394 TI - High dose para-aortic lymph node irradiation for gynecologic cancer: technique, toxicity, and results. AB - A technique for high dose (5600-6100 cGy) extended field irradiation to the para aortic lymph nodes is described. Fourteen patients have been treated with this technique, of whom 10 have had histologic confirmation of para-aortic node metastases. With follow-up ranging from 11 to 78 months, 7 of 14 patients are alive and clinically cancer-free. Acute effects of extended field treatment on patient weight and circulating blood counts are analyzed, and late treatment morbidity assessed. The findings suggest that such treatment, executed with modern equipment and appropriate technique, is not significantly more hazardous than pelvic irradiation, and can result in a substantial probability of disease free survival. PMID- 3818395 TI - Is correction for lung density in radiotherapy treatment planning necessary? AB - From 1978-981 a series of 30 patients with cancer of the esophagus were treated at the National Cancer Institute. Each of these patients had a CT scan of the chest taken in the treatment position, but prior to any treatment being given. Using these scans a retrospective analysis of the effect of lung density on delivered dose was performed. This indicated that failure to correct for tissue inhomogeneity results in a much higher dose being delivered than is prescribed. This effect is dependent on the energy of the beam being used for treatment; it may exceed 30% for 60Co. It also showed that there is wide patient to patient variation in lung density and that this variation is non-randomly distributed. The average lung density in his group of patients was 0.21 compared to the standard estimate of 0.35 but some had densities substantially lower than this, these being the patients with the largest lung volumes. This variability acts to further increase the discrepancy between prescribed and delivered dose even in a very homogeneous group of patients being treated under identical conditions for the same malignancy. The implications of this for future clinical trials in thoracic malignancies are discussed. PMID- 3818396 TI - Isoeffect models and fractionated radiation therapy. PMID- 3818398 TI - A method for the control of patient data in a clinical study. PMID- 3818397 TI - Could amiodarone increase acute cutaneous and mucosal toxicity of radiotherapy? PMID- 3818399 TI - Tolerance revisited. PMID- 3818400 TI - Perfluorochemicals and hyperbaric oxygen in radiation therapy: a cautionary note. PMID- 3818401 TI - Perineal irradiation following combined abdominal perineal resection for rectal adenocarcinoma. PMID- 3818402 TI - Developmental pharmacology in adolescence. The inauguration of a new field. PMID- 3818403 TI - Disparities in adolescent-physician views of teen health information concerns. AB - To enhance communications between physicians and adolescents, 600 middle school students and 99 physicians completed written questionnaires assessing the importance of 45 items from seven subscales: smoking; physical fitness; weight control; self-actualization; comparison with others; peer opinion; and communications. Adolescents rated the importance of knowing about items from each scale. Physicians rated how much importance they attached to each scale and their perception of the adolescents' ratings. Physicians placed more importance on each scale than did the adolescents, and they did not accurately judge the importance adolescents placed on the items. Physicians and adolescents differed significantly in the ratings of all but one scale, weight. With the exception of one scale (peer opinion), physicians estimated that adolescents would place less importance on the items in each scale than the adolescents actually reported. Our results suggest the need to concurrently consider adolescent-physician views when seeking to meet adolescents' health needs. PMID- 3818404 TI - Health care delivery and the concerns of gay and lesbian adolescents. AB - One hundred twenty-one self-identified homosexual adolescents presenting to a New York City gay/lesbian community clinic were questioned over a period of 18 months concerning their perceived needs and health care requirements. These individuals reported using various traditional and nontraditional methods to learn about the homosexual lifestyle. Through this socialization many developed a stereotypic view of homosexuality and its associated lifestyle. Family discovery and other specific concerns of these patients are detailed. The implications of this psychosocial process are important to professionals who provide health care to adolescents. PMID- 3818405 TI - Adolescent mothers' successful participation in a well-baby care program. AB - Previous research suggests that adolescent mothers and their infants may benefit from participation in specialized well-baby care programs. Yet the literature has not addressed the issue of predictive factors related to continued program participation. In a retrospective study, stepwise multiple regression analyses were used to explore this issue in 61 mothers from one well-baby program. The results were partially cross-validated using 59 other mothers. Mothers ranged in age from 13 to 17 years. Most were Black, single, and receiving public assistance. Twenty-two percent of the variance in the number of routine clinic visits made and 34% of the variance in the number of visits made for specific health problems were accounted for by the predictive equations. Cross-validation supported these results, with the most significant predictive variable for both measures of program participation being inconsistent appointment keeping. PMID- 3818406 TI - A review of Society for Adolescent Medicine abstracts and Journal of Adolescent Health Care articles. AB - Adolescent medicine research has dramatically increased over the past 20 years. The object of this study was to assess the status of design in adolescent health care research. All abstracts of presentations at the 1978-1985 Society for Adolescent Medicine (SAM) Meetings are included as well as all articles from the Journal of Adolescent Health Care (JAHC) from 1980 through September of 1985. The abstracts were analyzed for basic design, subject, sample size, study site, number of authors, and type of statistical analysis. A descriptive design comprised 32.8% of the SAM abstracts and 62.9% of the JAHC articles. An observational design comprised 57.8% of the SAM abstracts and 35.5% of the JAHC articles. An experimental design comprised 9.3% of the SAM abstracts and 1.6% of the JAHC articles. Of the 203 abstracts, 46% involved medical and 45.6% psychosocial topics. The JAHC articles were also fairly equally divided. Descriptive studies have decreased from 1978 to 1985 whereas observational studies have increased. The medium sample size of SAM abstracts increased from 1978 (83) to 1985 (100). Statistical methods were only analyzed for JAHC articles. Sixty-one percent used either no methods or used descriptive statistics only. The major statistical tests used were contingency tables, t-tests, analyses of variance, and Pearson correlations. Adolescent medicine research from these two sources usually involves descriptive and observational designs. The few clinical trials conducted involved small sample sizes. An increase in experimental and collaborative projects is needed. PMID- 3818407 TI - Low profiles of salivary progesterone among college undergraduate women. AB - High incidences of amenorrhea and oligomenorrhea are often found among late adolescent, college-aged women. We studied menstrual profiles of salivary progesterone in 17 undergraduate women (average age 20.2 years) who were experiencing regular menstrual cycles, and compared the results with similar data obtained from older women, both recreational runners (30.7 years) and nonexercising controls (29.3 years), to see whether this late adolescent population showed evidence of compromised luteal function not manifested by menstrual irregularity. The profiles obtained from the undergraduates and the older women were similar in shape but different in level. The undergraduate profiles were significantly lower than the controls (average progesterone level during the luteal phase, 154 +/- 14 versus 287 +/- 30 pmol/L; peak progesterone level, 352 +/- 35 versus 655 +/- 46 pmol/L; mean +/- SE, p less than 0.01), and remained at a significantly elevated level for fewer days (1.3 +/- 0.4 versus 4.5 +/- 0.6 days, p less than 0.01). The undergraduates were more comparable in all measures to the older women runners; however, reported exercise and weight differences did not account for the low levels in the undergraduates. We suggest that the low progesterone levels in the undergraduates reflect an extended process of ovarian maturation that does not culminate until the mid to late twenties. PMID- 3818409 TI - Tumor of the back in a break dancer. AB - Break dancing is a form of recreation that may result in minor and major trauma among participants. A case is presented of an adolescent who developed an unusual swelling on his back after persistent vigorous involvement in break dancing. Resolution of the tumor occurred after several months of avoiding the activity. Other injuries caused by break dancing are reviewed, and preventive measures are discussed. PMID- 3818408 TI - Sudden nontraumatic death in adolescence. Deaths at school. AB - Sudden and unexpected nontraumatic death of adolescents in a school setting was studied in a defined population. All deaths of Allegheny County, Pennsylvania, residents between 12 and 21 years of age for a nine-year period were reviewed. One hundred twenty-four sudden, nontraumatic events were identified. Fourteen events (11.3%) were school related, of which seven were associated with physical exertion. Of the four events occurring during organized school sports, no subject had a condition that would have been easily detectable by preathletic screening. Further evaluation of preventive measures, such as identification and treatment of individuals at high risk for sudden death, and improved cardiopulmonary resuscitation by trained personnel, is recommended. PMID- 3818410 TI - Community resources for adolescents. AB - The optimal approach to adolescent health care frequently requires that physicians and other health care providers work with community support systems to develop a multidisciplinary diagnostic and therapeutic team. Just as the primary care providers must be aware of the capabilities of specialist consultants to whom patients are referred for complicated medical problems, they must also develop a working knowledge of the community services available for the specific needs of adolescents with behavioral and developmental problems. This article provides some practical guidelines toward this goal. PMID- 3818411 TI - Iron deficiency among incarcerated juvenile delinquents. PMID- 3818412 TI - Liability of directors, officers, and committee members of veterinary medical associations. PMID- 3818413 TI - Protecting your practice and the food animal industry. PMID- 3818414 TI - Trustees urge second surgical opinion. PMID- 3818415 TI - Comments on carbohydrate malabsorption. PMID- 3818416 TI - Intraoperative radiotherapy of carcinoma of the prostate gland in ten dogs. AB - Ten dogs with carcinoma of the prostate gland were treated with intraoperative orthovoltage radiotherapy (radiation therapy to surgically exposed tumors). Seven dogs had tumor growth confined to the prostate gland and urethra, and 3 dogs had carcinoma of the prostate gland and regional lymph node involvement. Total radiation doses delivered to the prostate gland of 9 dogs and the affected regional lymph nodes of 3 dogs, using orthovoltage x-rays, ranged from 20 to 30 Gy. Carcinoma of the prostate gland of one dog was intraoperatively irradiated to 15 Gy and was then given a boost of 40 Gy, using cobalt-60 teletherapy. Survival time ranged from 41 to 750 days after intraoperative radiotherapy. Median and mean survival times for all dogs were 114 and 196 days, respectively. The median survival time for 7 dogs with localized prostatic carcinoma was 180 days, which was longer, but not significantly longer (P = 0.09), than the median survival time of 80 days in 3 dogs having prostatic carcinoma and metastatic disease. Intraoperative radiotherapy was tolerated well and caused complete response in 5 dogs. However, surgical complications in 2 dogs, which had subtotal lymphadenectomy or prostatic biopsy performed concurrently at the time of irradiation, resulted ultimately in their deaths. The 2 other dogs with metastatic disease and 1 dog without metastatic disease also had poor response to treatment. Our results indicated that intraoperative radiotherapy is an effective treatment for localized prostatic carcinoma in the dog. PMID- 3818417 TI - Biased statistical analysis when the animal is not the experimental unit. PMID- 3818419 TI - Histopathologic features of pyotraumatic dermatitis. AB - The skin of 17 dogs with pyotraumatic dermatitis was studied microscopically. Two patterns were seen. The first pattern was a superficial, ulcerative, inflammatory process of undetermined cause and pathogenesis. Current recommended treatment, which includes corticosteroids, was believed to be appropriate for such lesions. The second pattern, suppurative folliculitis, was considered to be localized pyoderma. Dogs with severe folliculitis were believed to represent those cases of pyotraumatic dermatitis in which the response to corticosteroid treatment has been poor. It was concluded that antibiotics should be used for treating pyotraumatic dermatitis with suppurative folliculitis, in lesions responding poorly to treatment with corticosteroids, or possibly in any severe lesion of pyotraumatic dermatitis, especially in Golden Retrievers and Saint Bernards. PMID- 3818418 TI - Laboratory diagnosis of Giardia duodenalis infection in dogs. AB - Results of trichrome staining of fecal samples and intestinal contents preserved in polyvinyl alcohol fixative, fecal flotation utilizing unpreserved feces, and enzyme-linked immunosorbent assay of serum specimens were compared for the diagnosis of Giardia duodenalis infections in dogs. Trichrome staining of preserved fecal samples resulted in the identification of 44 (92%) of the 48 infected dogs from a group of 200 dogs. Trichrome staining of preserved intestinal contents resulted in the identification of 26 (54%) of the infected dogs, and fecal flotation resulted in the identification of 23 (48%) of the infected dogs. Giardia duodenalis antibodies were not detected consistently in the sera of infected dogs. PMID- 3818420 TI - Orientation of veterinarians toward research. PMID- 3818421 TI - Intestinal lymphangiectasia associated with chylothorax in two dogs. PMID- 3818422 TI - Recurrent plasmacytic stomatitis-pharyngitis in a cat with esophagitis, fibrosing gastritis, and gastric nematodiasis. PMID- 3818423 TI - Laryngeal chondrosarcoma in a dog. PMID- 3818424 TI - Renal ectopia in a dog and a cat. PMID- 3818425 TI - Proliferative glomerulonephritis and chronic active hepatitis with cirrhosis associated with Corynebacterium parvum immunotherapy in a dog. PMID- 3818427 TI - Swine consultation practice: a telephone and a computer modem. PMID- 3818426 TI - Is industrial veterinary medicine an outlet for a manpower surplus? PMID- 3818428 TI - Economic impact of the use of prostaglandin to induce estrus in dairy cows. AB - An economic model concerning the value of using prostaglandin (PG) in dairy cows with nondetected estrus was developed. Considering numerous and varied assumptions, it was more profitable to treat cows with PG and to breed the cows at a detected estrus than it was not to treat the cows and to wait to breed the cows at a detected estrus. Generally, using timed artificial insemination, it was also more profitable to breed PG-treated cows than it was not to use PG. However, timed insemination was less profitable than was breeding PG-treated cows by artificial insemination at a detected estrus. PMID- 3818429 TI - Bovine anaplasmosis: susceptibility of seronegative cows from an infected herd to experimental infection with Anaplasma marginale. AB - Adult cows from an Anaplasma marginale-infected herd that were negative to the A marginale rapid card agglutination (RCA) and complement fixation (CF) tests for 1 to 4 years developed acute anaplasmosis after inoculation with 0.5 ml of blood from an A marginale carrier cow. The test cattle were as susceptible as the control cattle of similar ages. Also, 2 cows that had seroconverted from RCA/CF positive to RCA/CF-negative status naturally were fully susceptible to anaplasmosis when they were experimentally infected. Results of the study indicated that indigenous seronegative cattle in anaplasmosis-enzootic regions probably do not have acquired or natural immunity to A marginale infection. PMID- 3818430 TI - Chemotherapy of lymphoma in 75 cats. AB - Seventy-five cats with lymphoma were treated with combination sequential chemotherapy consisting of vincristine, cyclophosphamide, and methotrexate. Thirty-nine cats had mediastinal, 16 had multicentric, 14 had alimentary, and 6 had renal lymphoma. The median survival time of the 75 cats was 8 weeks, with a mean of 32 weeks. Sixty-two cats had follow-up evaluation until death or cure and had a median survival time of 7 weeks, with a mean of 37 weeks. Of the 62 cats, 32 (52%) attained complete remission, with a median remission duration of 16 weeks and a mean of 46 weeks. The addition of prednisolone and/or L-asparaginase to the protocol did not improve the results. Sixteen cats with multicentric lymphoma had the longest survival times (median, 18 months) and remission durations (median, 25 months). Prognostic factors were evaluated in each anatomic form of lymphoma. PMID- 3818431 TI - Postpartum hemolytic-uremic syndrome in a cow. PMID- 3818432 TI - Ataxia and hypermetria caused by Parelaphostrongylus tenuis infection in llamas. PMID- 3818433 TI - Toxic hepatopathy and intrahepatic cholestasis associated with phenytoin administration in combination with other anticonvulsant drugs in three dogs. PMID- 3818434 TI - Ehrlichia equi infection in a foal. PMID- 3818435 TI - Failure of ketamine to induce anesthesia in two horses. PMID- 3818436 TI - Employment, starting salaries, and educational indebtedness of 1986 graduates of US veterinary medical colleges. PMID- 3818437 TI - Isolation and structural elucidation of new saframycins Y3, Yd-1, Yd-2, Ad-1, Y2b and Y2b-d. AB - A new series of saframycins Y3, Yd-1, Yd-2, Ad-1, Y2b and Y2b-d was produced by directed biosynthesis employing resting cells of saframycin producer, Streptomyces lavendulae No. 314. Their structures were determined by comparison with the spectral data of UV, IR, and 1H and 13C NMR of saframycin A, whose structure has already been established. Saframycin Y3 is 25-deoxy-25 aminosaframycin A, while saframycin Yd-1 is 26-homosaframycin Y3, and saframycin Y2b is a dimer of saframycin Y3. Saframycin Ad-1 is 26-homosaframycin A. Saframycin Yd-2 is 26-demethylsaframycin Y3, and saframycin Y2b-d is a dimer of saframycin Yd-1. PMID- 3818438 TI - PD 124,895 and PD 124,966, two new antitumor antibiotics. AB - The isolation and characterization of the title antibiotics, which are produced by the same Streptomyces sp., is described. The potent antitumor agent, PD 124,895, is an analog of hydroxyelactocin (PD 114,721). PD 124,966 is a new member of the depsipeptide family of antibiotics. PMID- 3818439 TI - Metabolic products of microorganisms. 234. Urdamycins, new angucycline antibiotics from Streptomyces fradiae. I. Isolation, characterization and biological properties. AB - The colored urdamycins A to F, six new angucycline antibiotics produced by Streptomyces fradiae strain Tu 2717, were detected by chemical screening. They are biologically active against Gram-positive bacteria and stem cells of murine L1210 leukemia. The urdamycins are glycosides and differ in their aglycones, which can be liberated by acidic hydrolysis besides the sugars D-olivose and L rhodinose. The structure of the main compound, urdamycin A, follows from the spectroscopic and chemical data in connection with an X-ray analysis. The aglycone urdamycinone A is identical with aquayamycin. The structures of urdamycin B, E, F and partial structures of urdamycin C and D, will be presented in a subsequent paper. The new term "angucycline/angucyclinone" is used for an increasing group of related antibiotics. PMID- 3818440 TI - Monacolin M, a new inhibitor of cholesterol biosynthesis. AB - Monacolin M, a new specific inhibitor of cholesterol biosynthesis structurally related to monacolin K (mevinolin), was isolated from cultures of a strain of Monascus ruber. The structure of monacolin M was determined to be beta hydroxybutyryl ester of monacolin J by a combination of physical techniques. It was suggested that monacolin M is derived from monacolin J via a synthetic pathway distinct from that for the synthesis of monacolin K, alpha-methylbutyryl ester of monacolin J. The inhibitory effect of monacolin M on beta-hydroxy-beta methylglutaryl-CoA reductase was slightly lower than that of monacolin K. PMID- 3818441 TI - OF4949, new inhibitors of aminopeptidase B. I. Taxonomy, fermentation, isolation and characterization. AB - New aminopeptidase B inhibitors that we named OF4949-I, II, III and IV were isolated from the culture broth of a fungus, Penicillium rugulosum OF4949. The molecular formula of I was C23H26N4O8 and that of II, C22H24O8, judging from elemental analysis and secondary ion mass spectrometry. The concentrations of I, II, III and IV required for 50% inhibition of aminopeptidase, using Ehrlich ascites carcinoma cells as the source of the enzyme, were 0.0054, 0.0048, 3.4 and 1.7 micrograms/ml, respectively. Components I and II augmented delayed-type hypersensitivity in mice to sheep red blood cells. PMID- 3818442 TI - OF4949, new inhibitors of aminopeptidase B. II. Elucidation of structure. AB - The structures of OF4949-I, II, III and IV were identified by analysis of the products of their chemical degradation and by 1H NMR, 13C NMR, and mass spectrometry. These compounds were new cyclic peptides containing diphenyl ether as a chromophore. OF4949-I had two amino acids, beta-hydroxy-L-asparagine and 4 methylisodityrosine. The structural differences between I and II and between III and IV lay solely in the diphenyl ether moiety; the phenolic hydroxyl group in II and IV was methylated in I and III. OF4949-III and IV contained L-asparagine instead of the beta-hydroxy-L-asparagine moiety of I and II. PMID- 3818443 TI - OF4949, new inhibitors of aminopeptidase B. III. Biosynthesis. AB - To elevate production of OF4949 by Penicillium rugulosum OF4949 and to elucidate the pathway of its biosynthesis, mutants were selected on the basis of their resistance to growth inhibition by phenylalanine analogs. A mutant resistant to m fluorophenylalanine, strain No. M414, had 3-fold the production of the parent. In a study of the biosynthesis of OF4949-I and II, several 14C-labeled compounds were examined as possible precursors of OF4949. L-[14C]Tyrosine and L [14C]asparagine were incorporated efficiently. Most of the radioactivity of L [14C]tyrosine was found in the 4-methylisodityrosine (B2) or isodityrosine (B1) moieties, and that of L-[14C]asparagine was in the beta-hydroxyasparagine moiety. PMID- 3818444 TI - Novel polyether antibiotics X-14873A, G and H produced by a Streptomyces: taxonomy of the producing culture, fermentation, biological and ionophorous properties of the antibiotics. AB - Novel polyether antibiotics X-14873A, X-14873G, and X-14873H are produced by the fermentation of Streptomyces sp. X-14873 (ATCC 31679). This report presents taxonomic studies and fermentation conditions for the antibiotic producing culture. The antibiotics are mainly active against Gram-positive bacteria. The ionophore properties of X-14873A are also characterized. PMID- 3818445 TI - Izupeptins A and B, new glycopeptide antibiotics produced by an actinomycete. AB - In the course of screening for new high molecular weight peptidoglycan synthesis inhibitors, izupeptins A and B, antibiotics active against Gram-positive bacteria including methicillin-resistant Staphylococci and Clostridium were discovered. The antibiotics were found to be new members of the glycopeptide antibiotic family, namely of the vancomycin type, based on chemical and spectroscopic data. The molecular weight of izupeptin A was determined to be 1,475 by SI (secondary ion)-MS (integer molecular weight, 1,473), and it contains two chlorine atoms. PMID- 3818446 TI - Preparation and evaluation of 3,4''-ester derivatives of 16-membered macrolide antibiotics related to tylosin. AB - A large group of ester derivatives of tylosin-related macrolides was prepared in which the hydroxyl groups at C-3 and C-4'' were acylated by either chemical or biochemical methods. Most of the derivatives exhibited excellent in vitro antimicrobial activity. However, only the 3,4''-diacyl derivatives of tylosin and macrocin showed any significant improvements of in vivo efficacy against experimental infections in rodents. PMID- 3818447 TI - Direct enzymatic synthesis of natural penicillins using phenylacetyl-CoA: 6-APA phenylacetyl transferase of Penicillium chrysogenum: minimal and maximal side chain length requirements. AB - In vitro synthesis of different natural penicillins (hexanoyl, heptanoyl and octanoyl-penicillin) have been carried out by direct acylation of 6 aminopenicillanic acid (6-APA) with several fatty acid-CoA derivatives (hexanoyl CoA, heptanoyl-CoA and octanoyl-CoA). The reactions were catalyzed by the enzyme Acyl-CoA: 6-aminopenicillanic acid acyltransferase from Penicillium chrysogenum AS-P-78. This enzyme only accepts as substrate, aliphatic side chain precursors whose carbon length is between 6 and 8 atoms. Although the enzymatic synthesis of octanoylpenicillin has been previously reported the in vitro synthesis of hexanoyl and heptanoyl penicillins is described here for the first time. PMID- 3818448 TI - Galbonolides A and B--two non-glycosidic antifungal macrolides. PMID- 3818449 TI - Laidlomycin phenylcarbamate, a semisynthetic polyether antibiotic. PMID- 3818450 TI - Verlamelin, a new antifungal agent. PMID- 3818451 TI - Aldgamycin G, a new macrolide antibiotic. PMID- 3818452 TI - 8''-Hydroxypactamycin and 7-deoxypactamycin, new members of the pactamycin group. PMID- 3818453 TI - Syntheses and antimicrobial activities of 9-O-acyl derivatives of tylosin and demycarosyltylosin. PMID- 3818454 TI - Studies on semi-synthetic 7 alpha-formamidocephalosporins. I. Structure-activity relationships in some semi-synthetic 7 alpha-formamidocephalosporins. PMID- 3818455 TI - Studies on semi-synthetic 7 alpha-formamidocephalosporins. II. Synthesis and antibacterial activity of some 7 alpha-formamidoceph-3-em-1-oxide and 7 alpha formamido-1-oxadethiaceph-3-em derivatives. PMID- 3818456 TI - Effect of lasalocid on fall-calving beef cows. AB - The effects of lasalocid on fall-calving beef cows were examined in a 196-d trial that began October 12, 1983. Forty-two crossbred cow-calf pairs were stratified to six groups by breed, calving date and sex of calf. Three replications of each of two treatments, 0 and 200 mg lasalocid X head-1 X d-1, were used. The cows were fed a combination of haylage and grass hay ad libitum. The cow-calf pairs were allowed access to pasture at all times, except during the breeding season. At this time they were kept in confinement to facilitate heat detection and artificial insemination. Cow weight changes and body condition (0 = very thin, 9 = very fat) were unaffected (P greater than .10) by feeding lasalocid to the cows. Twelve-hour milk production per cow, percent fat and percent protein were each determined three times during the trial. A slight increase in milk yield was observed in treated cows (P greater than .10). Percent milk fat and protein were also unaffected by treatment (P greater than .10). Lasalocid supplementation of cows did not affect calf gain or 205-d adjusted weaning weight (P greater than .10). Average days open was evaluated for the cows. There were no differences between treatments for actual average days open (P greater than .10). No detrimental effects were observed in long-term feeding of lasalocid to fall calving beef cows. PMID- 3818457 TI - Effect of misidentification on the estimation of breeding value and heritability in cattle. AB - For daughter groups of 15 test bulls, controls of paternity were performed by using blood group factors and biochemical polymorphisms. Data of incorrectly assigned daughters influenced the estimation of breeding values, heritabilities and correlations for milk performance traits. Formulae are given that show the effects of variable misidentification rates on estimation of breeding values, selection intensities, heritabilities, and genetic gains. For example, for milk fat yield, the genetic gains drop at a misidentification rate of 15% between 8.7% (for h2 = .5) and 16.9% (for h2 = .2) below values attained without misidentifications. Consequently, decreasing misidentification rates in progeny of test bulls can be used to diminish the progeny size per test bull for constant genetic gain, to achieve more precise ranking of all or distinct test bulls according to their "true" breeding values and(or) to increase the number of test bulls by using the same amount of test inseminations and the same precision of ranking. Actions to reduce misidentification rates in cattle populations are discussed. PMID- 3818458 TI - Lambing performance of Morlam and Dorset ewes under accelerated lambing systems. AB - Two accelerated lambing systems, Morlam using Morlam sheep (USDA, Beltsville 1966 to 1975) and Camal using Dorset ewes (Cornell 1978 to 1981), were evaluated for first lambing ages, interlambing intervals and conception probabilities. Morlam ewes were continuously exposed to rams over the year, while Camal Dorset ewes were exposed every other month. Morlam lambs were mated as early as 367 d of age and Camal Dorset lambs as early as 340 d. Early lambing was associated with higher rates of perinatal mortality (P greater than .05) and smaller litter size (P less than .01). Lambing years among Morlam ewes and season of birth of Camal Dorset ewes influenced (P less than .01) their first lambing ages. Lambing intervals averaged 293 and 303 d among Morlam and Camal Dorset ewes, respectively. Age at first lambing and season in which the previous lambing occurred with influential factors (P less than .01) on lambing intervals of Morlam ewes; longer intervals resulted when ewe lambs were mated at early ages (less than 12 mo), and when the previous lambing occurred in winter. Estimates of conditional probabilities of conception by month given the occurrence of estrus, reflected seasonal changes in both systems. The overall probability of conception for the Morlam system (P = .16) was relatively higher than that for the Camal Dorset system (P = .14); numbers of lambings per ewe per yr were 1.28 and 1.21, respectively. Estimates of heritability for age at first lambing, lambing interval and conception probability were .31, .06 and .30, respectively. PMID- 3818459 TI - Symmetric differences squared and analysis of variance procedures for estimating genetic and environmental variances and covariances for beef cattle weaning weight: I. Comparison via simulation. AB - Analysis of variance (ANOVA) and symmetric differences squared (SDS) methods for estimating genetic and environmental variances and covariances associated with beef cattle weaning weight were compared via simulation. Simulation was based on the pedigree and record structure of 503 beef weaning weights collected over 19 yr from a university herd. The SDS methodology was used with four models. The simplest model included direct (g) and maternal (gm) additive genetic effects, genetic covariance between direct and maternal additive genetic effects (sigma ggm), permanent maternal environmental effects (m) and temporary environmental effects (e). The second model also allowed for a nonzero environmental covariance (sigma mem) between dam and offspring weaning weights. Models 3 and 4 were models 1 and 2, respectively, expanded to include a grandmaternal genetic effect (gn) and covariances sigma ggn and sigma gmgn. Two ANOVA solution sets for the parameters of model 4 were obtained using sire, dam, maternal grandsire, maternal grandam and phenotypic variances and offspring-dam (covOD), offspring-sire (covOS), offspring-grandam (covOGD), and offspring-maternal half-aunt or uncle (covOMH) covariances. Four ANOVA solution sets for the parameters of model 2 were obtained using sire, dam, within dam and maternal grandsire variances, covOD and either covOS or covOGD. Two sets of 1,000 replicates of the data were simulated. These data were used to compare precision and accuracy of SDS and ANOVA estimators, to estimate correlations among SDS and ANOVA estimators, and to study the importance of taking inbreeding into account with SDS methodology. All ANOVA estimators for rho ggm were biased downward. The SDS procedure had a clear advantage over ANOVA. Averages of SDS estimates were closer to parameter values used to simulate the data and their standard deviations were generally smaller. The standard deviations of both SDS and ANOVA estimates of rho ggm were very large. It is important to allow for a nonzero sigma mem (at least when it is negative) when using SDS methods; otherwise estimators of sigma 2gm and sigma ggm are biased upward and downward, respectively. PMID- 3818460 TI - Symmetric differences squared and analysis of variance procedures for estimating genetic and environmental variances and covariances for beef cattle weaning weight: II. Estimates from a data set. AB - Analysis of variance (ANOVA) and symmetric differences squared (SDS) methods were used to estimate additive genetic and environmental variances and covariances associated with weaning weight. The two methods were applied to 503 beef records collected over 19 yr from a relatively unselected university Angus herd. The SDS methodology was used with four models. The first model included direct (g) and maternal (gm) additive genetic effects, the genetic covariance between direct and maternal additive genetic effects (sigma ggm), permanent maternal environmental effects (m) and temporary environmental effects (e). The second model also allowed for a nonzero environmental covariance (sigma mem) between dam and offspring weaning weights. Models 3 and 4 were models 1 and 2, respectively, expanded to include a grandmaternal genetic effect (gn) and covariances sigma ggn and sigma gmgn. Two ANOVA solution sets for the parameters of model 4 were based on sire, dam, maternal grandsire, maternal grandam and phenotypic variances and offspring-dam (covOD), offspring-sire (covOS), offspring-grandam (covOGD) and offspring-maternal half-aunt or uncle (covOMH) covariances. Four ANOVA solution sets for the parameters of model 2 were based on sire, dam, within dam and maternal grandsire variances, covOD and either covOS or covOGD. Symmetric differences squared estimates of h2g and h2gm averaged .30 and .16, respectively. All SDS estimates of rho ggm (correlation between direct and maternal genetic effects) were less than -1. Estimates of sigma mem were positive. Both SDS estimates and one of the two ANOVA estimates of the grandmaternal variance were negative. The ANOVA model 4 estimates of h2g were .33. The estimates of h2gm were .44 and .39, while the estimates for rho ggm were -.88 and -.80. Both estimates of sigma mem were positive. The four ANOVA model 2 estimates of h2g and h2gm averaged .33 and .48, respectively. Three of the four estimates of rho ggm were less than -.97; the fourth was .35. Three of the four estimates of sigma mem were positive. Expectations show the extent to which SDS and ANOVA estimators were biased by nonzero grandmaternal components that were not accounted for. The extent to which dominance components bias the ANOVA estimators also is shown. Nonzero grandmaternal effects need to be taken into account in either SDS or ANOVA solution sets, or important biases occur with most of the estimators. More numerous, and generally more severe, biases occur with ANOVA estimators than with SDS estimators in solution sets that do not account for grandmaternal effects. PMID- 3818461 TI - Effects of photoperiod on growth, carcass composition, prolactin, growth hormone and cortisol in prepubertal and postpubertal Holstein heifers. AB - Effects of photoperiod on growth, carcass composition and serum concentrations of prolactin, growth hormone and cortisol were determined in prepubertal and postpubertal Holstein heifers. Forty-two prepubertal (avg body wt 84 +/- 3.0 kg) and 42 postpubertal (avg body wt 303 +/- 7.1 kg) Holstein heifers were utilized. Ten prepubertal and 10 postpubertal heifers were slaughtered before treatment began to obtain initial carcass data. The remaining 32 prepubertal and 32 postpubertal heifers were paired by body weight and randomly assigned to short day (8 h of light: 16 h of dark) or long-day (16 h of light: 8 h of dark) photoperiods. After exposure to treatments for an average of 139 d, 10 prepubertal and 10 postpubertal heifers from each photoperiod treatment were slaughtered. In prepubertal heifers, photoperiod did not affect (P greater than .10) average daily body weight gain, carcass weight, carcass composition, accretion of carcass fat and carcass protein, or serum concentrations of prolactin, growth hormone or cortisol. However, prepubertal heifers exposed to long-day photoperiods had reduced (P less than .01) urinary N tau-methylhistidine excretion compared with heifers given short-day photoperiods. Postpubertal heifers exposed to short-day photoperiods had greater average body weight daily gain than animals exposed to long-day photoperiods. Although there was no effect of photoperiod (P greater than .10) on carcass or fat depot weights, postpubertal heifers exposed to short days had greater (P = .06) percentages of fat and reduced (P = .07) percentages of protein in the soft tissue of the 9-10-11 rib sections. Fat accretion was greater (P less than .05) in carcasses of postpubertal heifers exposed to short days than heifers given long-day photoperiods, but there was no effect (P greater than .10) of photoperiod on protein accretion. Photoperiod did not affect serum concentrations of growth hormone and cortisol, but serum prolactin tended (P less than .10) to be greater in postpubertal heifers exposed to long days. Under the conditions of this experiment, we conclude that exposure to short-day photoperiods stimulated body weight gain and fat accretion in postpubertal but not prepubertal Holstein heifers. PMID- 3818462 TI - Substrate utilization by fetal pig skeletal muscle. AB - The ability of fetal pig skeletal muscle (biceps femoris) to metabolize glucose, fructose, lactate, acetate and palmitate in vitro was examined at 70, 90 and 110 d of gestation. Even though succinate dehydrogenase activity increased as fetal age increased (P less than .01), the rate of oxidation of glucose, fructose, acetate and palmitate to CO2 was not influenced by fetal age (P greater than .05), but each rate was dose-dependent (P less than .01). At higher concentration, lactate oxidation to CO2 proceeded at a faster rate in the muscle of 70-d fetuses when compared with 90- or 110-d fetuses. Muscle glycogen content increased (P less than .01) from 70 to 110 d of gestation. The rate of glucose incorporation into glycogen increased over this same time frame (P less than .06). Glucose-6-phosphate dehydrogenase activity did not change with age when activity was expressed per unit wet weight of muscle (P greater than .05). The ratio [1-14C]glucose/[6-14C]glucose oxidized to CO2 was independent of age and substrate concentration, and indicated significant pentose cycle activity in fetal muscle. Incorporation of lactate and palmitate into phospholipid was greatest at 70 d of gestation, a time period that coincides with establishment of mature muscle fiber number and fiber hypertrophy. The rate of palmitate incorporation into triacylglycerol was dependent on concentration of substrate (P less than .01) but not on age (P greater than .05). The rate of fructose oxidation to CO2 was lower than the rate for glucose, lactate and acetate when compared at similar concentrations. Acetate carbons were not incorporated into free fatty acids or lipid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818463 TI - The effects of rate change in body weight on tissue development and meat quality of youthful bulls. AB - Forty-eight Angus bulls about 13 mo of age were used to study the effects of rate of change in live weight on muscle fiber, collagen and sensory characteristics of meat. Bulls were fed a finishing diet before treatment, and assigned to three treatments: negative, zero or positive weight gain for 30 or 60 d prior to slaughter. Treatments were imposed by adjusting feed intake. Seventy-two hours after slaughter, carcasses were observed for quality and yield grade characteristics and longissimus muscle samples were obtained for fiber type, collagen and sensory characterization. Carcass lean at the 12th rib interface became darker in color (P less than .01), softer (P less than .05), coarser textured (P less than .01) and more physiologically mature (P less than .01) when bulls were fed an additional 30 d. Increases in average daily gain improved lean texture (P less than .05), but had insignificant effects on lean color. Marbling scores and percentages of kidney and pelvic fat increased (P less than .01) with length of time fed. Quantities of carcass fat were reduced by reducing daily weight gains through restricting dietary intake. Neither length of time fed nor rate of change in live weight affected (P greater than .05) muscle fiber characteristics. Increased age of bulls tended (P greater than .05) to be associated with an increase in red muscle-fiber quantity. Length of time fed or rate of change in live weight did not affect collagen characteristics or tenderness of meat.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818464 TI - Effects of slaughter weight and carcass electrical stimulation on the quality and palatability of beef from young purebred bulls. AB - Seventy-eight purebred Angus and Brahman bulls (10 to 18 mo at slaughter) were used to determine the effects of slaughter weight (60, 80, 90 or 100% of the average mature-cow weight for the respective breed) and carcass electrical stimulation (500 V, 20 2-s impulses on the right side) on carcass and meat characteristics. Angus bulls grazed summer forage (millet) after weaning, while Brahman bulls were fed to stimulate gains achieved on forage by Angus bulls. Bulls were then placed in the feedlot for finishing to their designated slaughter weight (293, 381, 412 and 463 kg for Angus and 316, 420, 463 and 516 kg for Brahman). Coarse dark band formation and lean color problems normally associated with bullock carcasses were either eliminated or reduced by stimulation. Increasing slaughter weight from 60 to 90% was associated with an increase in panel tenderness scores for loin steaks. However, increasing slaughter weight from 90 to 100% little change was detected. On the other hand, shear values for loin steaks decreased with increasing slaughter weight. Stimulation increased the tenderness of loin steaks as determined by both panel scores and shear values, and of bottom round steaks (shear-force values). The data from this study suggest that meat from the bulls slaughtered at lighter weights was generally tough, but was improved when bulls were fed to heavier, yet acceptable weights. This research encourages implementation of electrical stimulation on carcasses from young bulls to improve quality-indicating factors. PMID- 3818465 TI - Effect of nutritional status, age at weaning and room temperature on growth and systemic immune response of weanling pigs. AB - Two experiments were conducted to determine the effect of nutritional status, age at weaning and room temperature on growth and immune response of pigs. In the first experiment, 72 pigs were weaned at either 2 or 3 wk and fed either a complex, simple-adequate or simple-inadequate diet for a 24-d period. Total antibody (TAb) titers in response to injections of human red blood cells (RBC) on either 0, 4, or 16 d postweaning were not affected by age at weaning or dietary treatments even though the nutritional status was compromised to such an extent that pigs fed the simple-adequate diet gained at one-half the rate (.172 vs .349 kg/d) of pigs fed the complex or simple-adequate diets (P less than .01). In Exp. 2, the immunological response of 144 pigs weaned at 3 wk were evaluated at 4 and 8 d postweaning. Pigs were weaned into rooms that averaged either 25 or 18 C, and were fed either a complex or simplex-adequate diet at either ad libitum (AL) or restricted (Res) levels for a 24-d period. Restriction of either the complex or simple diet for the first 16 d of the trial drastically reduced (P less than .01) the growth rates of Res pigs compared with AL pigs (.042 vs .236 kg/d). There were no differences in skinfold thickness (Sf) or TAb, 2-mercaptoethanol sensitive (MEs) and resistant (MEr) antibody titers when pigs were inoculated with phytohemagglutinin-P (PHA-P) or RBC at 4 d postweaning regardless of room temperature, diet source or feeding level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818466 TI - Effect of energy level in lactating sows on yield and composition of milk and nutrient balance of piglets. AB - The effects of energy level on milk yield, milk composition and growth of the piglets were studied in 20 gilts (10 replicates of two littermates) and their litters during a 21-d lactation. The metabolizable energy (ME) levels were 14.2 and 10.4 Mcal ME X d-1 X sow-1 in the high energy (HE) and low energy (LE) groups, respectively. The daily supply of other nutrients in the diets was identical in both treatments. Milk yield measured every 4 d was lower in the LE group. But fat (8.0 vs 6.9%), energy (1.27 vs 1.14 Mcal/g) and nitrogen (.78 vs .74%) contents of milk were significantly higher in the LE gilts compared with the HE gilts. The daily output of energy and nitrogen was therefore equivalent in both treatments (respectively, 8.28 Mcal and 51.8 g/d), but the fat output was higher in the energy-restricted gilts (532 vs 490 g/d). Growth rate of the litter was similar in both treatments, but piglets suckling LE dams had higher dry matter, fat and energy contents in their body at weaning. Piglets retained 89, 54 and 55% of nitrogen, fat and energy, respectively, of milk between birth and weaning. The results suggest that the ability of sows to mobilize body lipids in order to maintain the output of energy in milk is reduced as body fat reserves are depleted. PMID- 3818467 TI - Importance of diet of dam and colostrum to the biological antioxidant status and parenteral iron tolerance of the pig. AB - Fifteen second-parity sows were used to determine the importance of vitamin E (E) and selenium (Se) supplementation of the sow's diet and colostrum consumption by the neonatal pig on tolerance to parenteral iron. Selenium (.1 ppm) and E (50 IU/kg) supplementation of the diet of the sow increased plasma tocopherol and Se concentrations, but did not increase plasma glutathione peroxidase (GSH-Px) activity. Colostrum had greater concentrations of E (primarily alpha-tocopherol) and Se than milk. Plasma biological antioxidant status (tocopherol level and GSH Px activity) of pigs at birth was very low, but by 2 d of age had increased, especially in alpha-tocopherol (nearly a 20-fold increase). Liveability and body weight gain of pigs were not affected by the pre-colostrum iron injection (200 mg Fe as gleptoferron); however, plasma tocopherol concentrations of Fe-injected pigs were lower and plasma Se concentration and GSH-Px activities were higher at 2 d of age than values of pigs not receiving parenteral Fe. Supplementation of the dam's diet with E and Se maintained high tocopherol and Se levels in her colostrum and milk and a high biological antioxidant status in her pigs throughout the nursing period. PMID- 3818468 TI - Sulfur influences on rumen microorganisms in vitro and in sheep and calves. AB - When continuously cultured ruminal microbes were given orchardgrass hay and sufficient sulfuric acid or hydrochloric acid to maintain a pH of 5.5, fermentation and numbers of protozoa were reduced compared with cultures whose pH was controlled with phosphoric acid. Likewise, when sulfur-deficient, purified diets were supplied to cultures, less methane (mmol X liter-1 X d-1), 3.2 vs 32.6, was produced and fewer cellulolytic bacteria (log10/ml), 5.8 vs 7.2 were present than when cultures were given the same diet supplemented with .3% elemental sulfur. The rumen of sheep fed the .04% sulfur diet had reduced digesta weights (1.69 vs 3.2 kg) compared with sheep fed the diet with .34% sulfur at the same intake. There also was reduced methanogenesis 12.3 vs 25.8 mmol X liter-1 X d-1) and reduced numbers of cellulolytic bacteria (7.4 vs 8.4 log10/ml) in sulfur deficient sheep in comparison to sulfur-supplemented sheep. In growing calves, the same types of bacteria predominated in the rumen, but more facultative anaerobic bacteria were isolated from calves fed .04% sulfur than from calves fed diets with .34 to 1.72% sulfur. None of the dietary levels of sulfur appeared toxic. Regardless of treatment, volatile fatty acids were more predominant than lactic acid as end-products of fermentation of ruminal microbes in fermenters, sheep and calves. The greater methanogenesis and the greater cellulolytic bacterial numbers of sulfur-supplemented sheep compared with sulfur-deficient in vitro cultures, is interpreted to be the result of recycling of sulfur to the rumen in sheep where it is efficiently scavengered by ruminal bacteria. PMID- 3818469 TI - Effects of dietary monensin and potassium on apparent absorption of magnesium and other macroelements in sheep. AB - Twelve ruminally cannulated lambs (average weight, 31.1 kg) were used to determine the effects of monensin and K on apparent absorption of Mg in lambs. Lambs were assigned randomly to two groups and fed a basal high concentrate diet containing .44% K with or without 20 mg/kg monensin for 19 d of dietary adjustment. During adjustment, lambs were housed by treatment group and given ad libitum access to their diets. Following dietary adjustment, lambs were placed in individual metabolism stalls and fed 450 g of their respective diet twice daily. Within each monensin group, lambs were infused ruminally with 0, 7.6 or 31.6 g K/d (equal amounts at each feeding in 158 ml of distilled-deionized water) during three periods in a 3 X 3 Latin-square arrangement of K treatments. Each period consisted of a 10-d preliminary phase and a 7-d collection phase followed by a 3 d D2O infusion phase to determine water turnover. Addition of monensin to the diet decreased (P less than .05) fecal Mg excretion 15.9%. Apparent absorption and retention of Mg were increased (P less than .05) with the addition of monensin. Increasing K level increased (P less than .05) fecal Mg excretion. Apparent absorption of Mg decreased (P less than .05) from .93 to .80 g/d when either level of K was infused into the rumen. Monensin decreased the acetate:propionate (A:P) ratio. There was a significant interaction between monensin and K level for acetate and propionate (molar %), and A:P ratio. In the presence of higher K concentrations, monensin appears to be more effective in decreasing the A:P ratio.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818470 TI - Effect of nutrition, age and size on compensatory growth in two breeds of steers. AB - Compensatory gain in cattle was studied to determine if age, previous rate of gain or size were factors of importance. A factorial experiment was conducted with growing diet regimen (control vs restricted), age [spring-born (older) vs fall-born (younger)] and breed (Angus vs Charolais) as the factors. During a growing phase, the two diets, (control = dehydrated alfalfa pellets; restricted = cubed grass-alfalfa hay, cottonseed hulls and soybean meal) were fed to both the older and younger steers of each breed to provide groups of similar age but different weights (growing regimen within age) and groups of similar weights but different ages (older-restricted vs younger-controls) at the time at which the steers were switched to a high concentrate diet. Interactions of breed with age and previous growing regimen diet on digestibility of some nutrients in the finishing diet were evident. During the growing phase, control steers averaged .72 kg/d gain, whereas the restricted steers averaged .25 kg/d. The older restricted steers compensated (P less than .05) from 30 to 120 d after the beginning of the feedlot phase compared with older-control steers. Rates of gain of younger steers were intermediate to those of the older steers throughout the finish phase and were not influenced by growing diet, except on d 30. Rate of gain during the growing phase was negatively correlated (P less than .05) with rate of gain during the finishing phase (60 to 120 d). Within breed, weight at the beginning of the feedlot phase also was negatively correlated with gain during the finishing phase. Skeletal growth was reduced (P less than.05) by the restricted diet during the growing phase, and small compensation (P greater than .05) was observed during the finishing phase. Feed/gain for restricted steers was slightly lower (P greater than .05) than control steers. Younger steers were more efficient (P less than .05) overall in converting dry matter to gain, due to the relatively shorter growing phase when compared with the older steers. These data indicate that both previous gain and weight upon realimentation are influential on compensatory growth. PMID- 3818471 TI - Changes in ruminal concentrations of microbial ammonia and amino acids due to monensin and time. AB - The effect of monensin (33 mg/kg) and no monensin on distribution of ammonia and free amino acids in fluid and particulate phases of ruminal contents was studied. Two Jersey cows and two Angus-Hereford steers, weighing approximately 350 kg and each containing a ruminal cannula were meal fed a 65% concentrate diet for two periods. Feed was available for 30 min; any feed not eaten was removed after this time. Whole ruminal contents were sampled before feeding, immediately after feed removal and 1, 2, 3, 4, 6, 8, 10 and 12 h after feed removal. A crossover design with split-plot in time was used with four observations per time point per treatment. Extracellular (E) ammonia and amino acids were determined on high speed supernatants of strained ruminal fluid. Total (T) ammonia and amino acids were obtained by lysing microbial cells with 1% cetyltrimethylammonium bromide (CTAB) and one freeze treatment before centrifugation. Intracellular (I) amino acids and ammonia were determined as T minus E. Squeezed particles were suspended in .1 N HCl containing 1% CTAB. Total and E ammonia were higher throughout the study for no monensin vs monensin (P less than .05). Intracellular ammonia was low (.03 to 1 mM) and did not change (P greater than .10) across time for either dietary treatment. Intracellular amino acids ranged from 1.2 to 4.5 mM and were higher (P less than .05) than E amino acids (.9 to 2.2 mM) for both diets immediately after feeding. Monensin did not significantly lower (P greater than .10) T amino acids compared with no monensin throughout sampling (2.6 and 3.1 mM, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818472 TI - Effect of salinomycin supplementation on characteristics of digestion and feedlot performance of cattle. AB - One hundred fifty large-frame British-cross calves, 75 heifers and 75 steers averaging 220 kg, were used in a 187-d growing-finishing trial to study the influence of dietary salinomycin levels of 0, 5.5, 11, 16.5 and 22 mg/kg on rate and efficiency of gain. The basal diet to which the ionophore was added was composed largely to steam processed grains, and contained 3% supplemental fat. Performance responses to salinomycin supplementation were similar for steers and heifers. Rate of gain was not influenced (P greater than .20); however, feed conversion was improved by an average of 5% at the 11- to 22-mg/kg levels of salinomycin supplementation (P less than .05). Although not necessarily mutually exclusive, this improvement in feed conversion could be accounted for as either a 5% increase in the net energy value of the diet (P less than .05) or a 10% reduction in maintenance requirement (P less than .10). Four steer calves (234 kg) with cannulae in the rumen and proximal duodenum were used in a 4 X 4 Latin square design trial to determine the influence of salinomycin supplementation on characteristics of digestion. Four levels of supplementation (0, 55, 11 and 16.5 mg/kg) were evaluated using the same basal diet as in the performance trial. Total tract digestion of organic matter, acid detergent fiber, starch and protein was not significantly altered by salinomycin supplementation. However, ruminal digestion of organic matter was reduced 6.2% (P less than .05). Neither ruminal degradation of feed protein nor net microbial synthesis was significantly altered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818473 TI - Influence of forage level on response of feedlot steers to salinomycin supplementation. AB - Two trials were conducted to evaluate the influence of forage level on the response of feedlot cattle to salinomycin. Diets containing 10, 15 and 20% forage were compared with 0 or 11 mg/kg salinomycin. In trial 1, treatment effects on feedlot performance were evaluated using 108 crossbred steers (295 kg) in a crossover design experiment. There were no salinomycin X forage level interactions (P greater than .20). Weight gain response to salinomycin supplementation averaged 5.4, 5.3 and 6.9%, respectively, for diets containing 10, 15 and 20% forage. Corresponding values for feed conversion response to salinomycin supplementation were 5.1, 3.9 and 5.9%. Averaged across forage level, salinomycin supplementation improved rate of weight gain and feed conversion by 5.9 and 5.2%, respectively (P less than .01). In trial 2, treatment effects on characteristics of ruminal and total tract digestion were evaluated in a 6 X 6 Latin-square design trial involving six crossbred steers (191 kg) with cannulae in the rumen and proximal duodenum. There were no interactions between salinomycin supplementation and forage level on characteristics of ruminal digestion (P greater than .20). Salinomycin supplementation did not influence synthesis of microbial N, ruminal digestion of organic matter, acid detergent fiber and starch, or molar proportions of acetate, propionate and butyrate (P greater than .20). Salinomycin supplementation increased passage of non-ammonia N to the small intestine (5.4%, P less than .10) and increased ruminal escape of feed N (24%, P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818474 TI - Short-term effect of antibiotic feeding on site and extent of digestion of growing and finishing diets in feedlot cattle. AB - Two metabolism trials were conducted to evaluate the influence of therapeutic antibiotic supplementation on characteristics of digestion of growing and finishing diets. Treatments consisted of a basal diet supplemented with: no antibiotics, 350 mg chlortetracycline and 350 mg sulfamethazine and 700 mg chlortetracycline and 700 mg sulfamethazine. In trial 1, treatment effects were evaluated in a replicated 3 X 3 Latin-square design experiment involving six crossbred steers (462 kg) with cannulas in the rumen and proximal duodenum. The basal diet contained (dry matter basis) 16.1% alfalfa hay, 72% steam flaked corn, 3.3% molasses, 5.8% fat, .96% urea, .79% limestone, .50% trace mineral salt, 33 mg/kg lasalocid, 2,200 IU/kg vitamin A and .44% chromic oxide. Dry matter intake was limited to 1.4% of body weight. In trial 2, treatment effects were evaluated in a 3 X 3 Latin-square design experiment involving three steers (399 kg) with cannulas in the rumen and proximal duodenum. The basal diet contained (dry matter basis) 10.1% sudangrass hay, 34.9% alfalfa hay, 43.9% steam flaked corn, 6.1% molasses, 4.0% fat, .46% urea, .49% trace mineral salt, 33 mg/kg lasalocid and 2,200 IU/kg vitamin A. Dry matter intake was limited to 1.65% of body weight. Antibiotic supplementation did not influence microbial efficiency, passage of microbial and feed N to the small intestine, or either ruminal or total tract digestion of organic matter and acid detergent fiber in either growing or finishing diets (P greater than .20).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818475 TI - Growth, intakes and metabolic responses of artificially reared lambs weaned at 14 d of age. AB - In two experiments, a total of 46 Finn Cross and Dorset lambs were artificially group-reared. Thirty eight were weaned abruptly at 14 d of age from a commercial milk replacer (MR) to a dry starter diet (SD). Lambs were self-fed cool (10 to 15 C) MR reconstituted to 25% dry matter (DM). The ground (2-mm screen) SD averaged 26.2% crude protein and 7.4% fat (DM basis). For both experiments, birth and weaning weights averaged 3.8 and 8.0 kg, respectively. Experiment 1 tested a strategy for encouraging postweaning DM intake. Fifteen lambs received MR reconstituted to 33% DM from d 11 to 14, and 15 lambs received standard 25% DM MR. Between d 14 and 15, intakes of DM, gross energy, crude protein and water dropped 86, 89, 85 and 64%, respectively. Lambs doubled their birth weights during the milk-feeding period and consumed 1.41 kg SD between d 14 and 25. The MR reconstitution rate did not affect weaning weight, postweaning SD or water intake, or growth check (GC, P greater than .10). Postweaning GC averaged 12.2 d and was not influenced (P greater than .10) by birth weight, sex or weaning weight. Mortality and disease rates under these conditions were negligible. Experiment 2 was designed to differentiate between the dual effects at weaning of altering the type of diet and of reducing the level of nutrient intake. Eight lambs were weaned to SD at 14 d, and eight lambs were bottle-fed isocaloric levels of MR from d 12 to 30. At weaning, plasma glucose concentration declined 1.4 mM from 6.7 mM due to fasting and an additional 1.0 mM due to the change of the type of diet (P less than .01). Plasma acetate and urea N concentrations rose steadily after d 16 in the SD-weaned lambs, but not in the MR-fed lambs (P less than .01), suggesting that the SD-weaned lambs absorbed ruminal fermentation products. These results indicate that artificially reared lambs may be routinely weaned to a dry diet at 14 d of age. The major alterations in plasma metabolites that occur within 6 to 8 d after abrupt weaning may define the period when these lambs become functional ruminants. PMID- 3818476 TI - Net energy value of ammoniated wheat straw. AB - Eight steers (327 kg average) were fed diets containing either nontreated or anhydrous NH3-treated wheat straw in a two-period crossover design. Intake and digestibilities of dry matter, gross energy, neutral detergent fiber, acid detergent fiber and crude protein were measured by total collection. Energy losses in urine and methane were determined. Heat production was determined by indirect respiration calorimetry on steers fed both diets and after they were fasted. Ammoniation of the straw raised its N content from .49 to 1.59% (P less than .001). Dry matter (DM) intake was increased (P less than .01) by the process from 1.0 to 1.3% of body weight. Digestibility coefficients of dry matter and energy, as well as those for fiber, were increased (P less than .001) by four percentage units or more. Crude protein digestibility, however, was depressed (P less than .001) from 67.8% to 53.5% by ammoniation. Urinary energy as a percentage of gross energy intake (GEI) was reduced (P less than .05) by NH3 treatment from 4.10 to 3.74%. Methane energy was not different (P greater than .10). Metabolizable energy was improved (P less than .001) by ammoniation, increasing from 45.2 to 50.0% of GEI. Daily heat production was higher (P less than .01) for steers consuming the ammoniated straw diet, increasing from 113.7 to 125.3 kcal/wt.75), and was due to higher metabolizable energy intake (MEI) since partial efficiency of MEI used for maintenance did not differ (P greater than .10) between diets. The higher net energy value of the ammoniated wheat straw diet (1.45 vs 1.26 kcal/g DM) was due mainly to decreased fecal loss and a slight decline in urinary loss. PMID- 3818477 TI - Effect of dietary fluorine on growth, blood and bone characteristics of growing finishing pigs. AB - Three hundred eighty-four growing-finishing pigs were used in two experiments to determine the effect of dietary fluorine (F) on growth, blood and bone physical characteristics. Fourteen dietary treatments were formulated by supplementing F (as NaF) to a milo-soybean meal basal diet (7 ppm F) to provide levels of 7, 132, 257, 382, 507 and 632 ppm F for Exp. 1, and 7, 25, 43, 61, 79, 97, 115 and 133 ppm F for Exp. 2. Average daily gain (ADG) and average daily feed intake (ADFI) were not affected (P greater than .09) when F was fed at levels between 7 and approximately 132 ppm. Average daily gain and ADFI were reduced (P less than .0001) for pigs consuming diets with F concentrations greater than 132 ppm (Exp. 1). Feed conversion was not affected (P greater than .17) by any level of F fed. Serum F and alkaline phosphatase concentrations increased (P less than .01) with increasing dietary F levels. Serum and bone Ca and P concentrations were not affected (P greater than .13) by dietary F levels (Exp. 1). In Exp. 1 and 2, bone F increased (P less than .0001) and metatarsal stress and modulus of elasticity decreased (P less than .0001) as level of F increased in the diet. Bone thickness decreased quadratically (P less than .02) in Exp. 1 and linearly (P less than .0007) in Exp. 2 with increased dietary F levels. Scanning electron microscopy showed an increase in porosity of bones from pigs fed the higher levels of F. Growing-finishing pigs were able to tolerate approximately 132 ppm F for growth, but all of the F levels (greater than or equal to 7 ppm) fed in these two experiments affected bone integrity. PMID- 3818478 TI - Dietary urea influences on digestibility and utilization of diets containing peanut skins by steers. AB - Metabolism and feedlot trials were conducted to evaluate increased dietary urea as a method of reducing detrimental effects of peanut skin (PS) tannins on nutrient digestibility and finishing steer performance. The PS fed in the trials contained 17.8% crude protein and 20.1% tannin. Urea (.7%) was included in a control (C) diet without PS, and with 15% PS in low-urea (.3%; LUPS), moderate urea (.7%; MUPS) and high-urea (1.1%; HUPS) diets that contained ground corn and 15% peanut hulls. Apparent digestibility coefficients for dry matter, organic matter and crude protein were higher (P less than .05) for the C diet than for PS diets. Fecal N (g/d) was consistently higher (P less than .05) for PS diets than for the C diet. Retained N (g/d) was similar for steers fed C and HUPS diets, but lower (P less than .05) than C for LUPS and MUPS diets. Average daily gain at 91 d was highest (P less than .05) for C steers in the feedlot, intermediate (P less than .05) for MUPS and HUPS steers and lowest (P less than .05) for LUPS steers. Feed:gain ratio was 97% higher (P less than .05) for LUPS steers compared with C steers, but average daily feed intake was similar for all treatments. Rumen fluid propionic acid was lower (P less than .05) on all PS diets compared with the C diet on d 90. Plasma urea nitrogen (d 90) was reduced (P less than .05) by 48.5, 55.5 and 57.6%, respectively, on LUPS, MUPS and HUPS diets compared with the C diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818479 TI - Influence of varying levels of blood progesterone upon estrous behavior in cattle. AB - The effect of four levels of progesterone on the occurrence and intensity of estrous behavior was determined in ovariectomized cows. Twelve Holsteins were bilaterally ovariectomized at least 2 mo before treatment. Progesterone (P4) was administered im two times/day for 5 d followed 72 h later with 2 mg estradiol (E2) im to induce estrous behavior. Treatments were control = oil, 100 mg P4/d, 300 mg P4/d and 500 mg P4/d. Each animal received all P4 treatments in a 4 X 4 Latin-square design. From d 2 through 6, with d 1 being the first day of P4 treatment, serum P4 concentrations averaged .3, 2.5, 6.1 and 12.3 ng/ml in treatments I to IV, respectively. Progesterone levels at the time of peak E2 (d9) were less than 1 ng/ml for treatments I, II and III and 1.8 ng/ml for treatment IV. Peak E2 levels for all groups averaged 23.9 pg/ml (12 h after E2 injection). Cows were observed continuously for 48 h after E2 injection to quantitate estrous behavior. Behavioral traits measured were: mounts initiated, mounts received, standing when mounted, chin rests initiated and chin rests received. Progesterone treatment caused a decrease in frequency of all five traits measured. As P4 levels increased, there was a linear (P less than .01) decrease in frequency of a behavioral trait. The percentage of the cows that showed each behavioral trait and mean time to first occurrence of each trait were not different after progesterone treatment, with the exception of standing behavior.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818480 TI - Effects of selection for rapid postweaning gain on maturing patterns of fat depots in mice. AB - Correlated responses to selection for rapid 3 to 6-wk postweaning gain in male mice were estimated for five fat depots weighed at specific degrees of maturity in body weight (37.5, 50.0, 62.5, 75, 87.5 and 100%). Fat pads measured were from regions of the subcutaneous hindlimb, subcutaneous forelimb, epididymides, mesentery and kidneys. At the same degree of maturity, selected mice (M16) were older (P less than .01) than controls (ICR). M16 had heavier (P less than .01) fat depots than ICR for all sites at each degree of maturity. From 62.5 to 100% maturity, M16 was larger than ICR in fat depot weight as a percentage of body weight at all sites. Mesenteric fat made up the largest percentage of total fat in both lines and perirenal fat the smallest percentage. Development of degree of maturity in each fat depot relative to degree of maturity in body weight was studied using the constrained quadratic and standardized allometric models. Both models showed similar trends, but the latter identified more significant line differences. The standardized allometric analysis indicated that total fat and all individual fat depots except mesenteric fat matured at a slower rate (P less than .01) in M16 than in ICR. Bivariate allometric analyses of ln fat depot weight on ln body weight showed that M16 exceeded (P less than .01) ICR in relative growth of all fat depots except mesenteric fat; at lower body weights, ICR had larger fat depots than M16, but the reverse was true at higher body weights.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818481 TI - Factors affecting measurements of glucose metabolism and lipolytic rates in porcine adipose tissue slices in vitro. AB - Porcine adipose tissue glucose metabolism and lipolytic rates have been measured for many years by numerous investigators. However, there is little or no documented indication of the effects of variation in tissue handling procedures or variations in incubation medium components on metabolic rates. We have systematically varied conditions to provide such documentation for these much used techniques. The temperature (18 to 38 C) of tissue during transport had little effect. The medium for tissue transport probably should be buffered. Use of Hepes buffer at greater than 10 or 25 mM in incubation media inhibited glucose metabolism and lipolysis. Calcium ion effects on glucose metabolism or lipolysis could not be demonstrated. Dimethyl sulfoxide should not be used routinely. Ascorbate at .56 mM did not inhibit glucose metabolism or lipolysis. Glucose metabolism was increased by glucose concentration to about 5 mM and not inhibited at higher concentrations; we recommend 10 or 20 mM glucose to ensure maximal rates. Insulin stimulated glucose metabolism but effects were slight, not related to insulin concentration and not consistently observed. Addition of some albumin preparations did not allow expression of insulin stimulation; we recommend albumin be omitted or, if included, carefully monitored. Lipolytic rates were dependent on albumin concentration, but rates were similar with all albumin preparations. Insulin markedly inhibited hormone-stimulated but not basal lipolysis. Adenosine, an inhibitor of lipolysis, did not affect glucose metabolism rates. An artificial oxygen carrier did not increase anabolic activity. Incubation in serum increased rates of glucose metabolism relative to lipolysis so that refinement of the incubation might lead to greater anabolic than catabolic rates in vitro to reflect the status of adipose tissue in growing pigs in vivo. Tissue handling and incubation conditions can markedly affect metabolic rates, and should be understood and controlled. PMID- 3818482 TI - Tryptophan availability of some feedstuffs determined by pig growth assay. AB - Three experiments were conducted with young pigs to measure the availability of tryptophan in soybean meal, meat and bone meal, cottonseed meal, corn and sorghum. In Exp. 1, a 17.5% crude protein corn and gelatin-based diet, deficient in tryptophan, was supplemented with graded levels of L-tryptophan to establish the growth response of 10- to 20-kg pigs to graded additions of dietary tryptophan. From these data the requirement for maximal growth was calculated to be .16% of the diet using a broken-line model. In Exp. 2, the effects of excess amino acids in a test feedstuff, i.e., soybean meal, on the growth assay method for estimating tryptophan availability was evaluated. The addition of excess crystalline amino acids to the basal diet in proportions equal to the excesses contributed by a test level of soybean meal resulted in a 17.7 percentage unit reduction in the estimate of tryptophan availability (82.3%). When the standard diet was supplemented with amino acids to provide the pattern of excess amino acids found in the corn-gelatin basal diet with added soybean meal, the availability of tryptophan in soybean meal was estimated to be 95.2%. In Exp. 3, the tryptophan availabilities for meat and bone meal, cottonseed meal, corn and sorghum were estimated to be 82.2%, 80.9%, 94.0% and 86.4%, respectively. The diets used in this experiment were supplemented to contain excesses of individual amino acids in the same proportions as found in the basal diet, with the test feed ingredient added as a source of tryptophan. In these experiments the tryptophan content of the various feedstuffs was measured by ion-exchange liquid chromatography following alkaline hydrolysis. PMID- 3818483 TI - Changes in hepatic function tests to induced toxicity in the bovine liver. AB - Graded hepatic damage was induced in mature lactating dairy cows to measure the sensitivity of several hepatic diagnostic tests. In a preliminary study, cows were dosed with .05, .10 and .20 ml/kg body weight of carbon tetrachloride. Extreme changes occurred in hepatic tests by 24 h post-dosing, and all died by 35 h with massive diffuse centrilobular necrosis of hepatic cord cells. Dosing was decreased to induce non-fatal hepatic changes. Cows in Groups 1, 2, 3 and 4 were orally dosed with .002, .004, .006 or .01 ml/kg body weight of carbon tetrachloride, respectively. Serum enzymes of hepatic origin, bilirubin, plus bromosulfophthalein dye clearance were assayed before dosing and up to d 14 post dosing. Liver biopsies were performed 24 h post-dosing for histological evaluation and cytochrome P-450 content. Hepatic concentrations of cytochrome P 450 were decreased in all the dosed cows. Serum activities of sorbitol dehydrogenase and gamma-glutamyl transferase were elevated in cows of Groups 3 and 4 and glutamic-oxaloacetic transaminase in cows of Group 4 by 24 h. Serum alkaline phosphatase, glutamic-pyruvate transaminase, lactate dehydrogenase, bilirubin, urobilinogen and bromosulfophthalein dye clearance were not significantly different. Mild to moderate diffuse centrolobular necrosis was observed in livers of cow of Groups 3 and 4, but no pathological changes were seen in Groups 1 and 2. PMID- 3818484 TI - Interlobular distribution of hepatic xenobiotic-metabolizing enzyme activities in cattle, goats and sheep. AB - Microsomal and cytosolic enzymes that metabolize xenobiotics were measured in composite samples representing entire livers and in samples from three lobes, using livers of cattle, goats and sheep. Within individual species, concentrations of cytochrome P-450 and b5 and activities of NADPH cytochrome c reductase, aldrin epoxidase, aminopyrine N-demethylase, ethoxycoumarin O deethylase, microsomal and cytosolic stilbene oxide (epoxide) hydrolase and glutathione S-transferase were not different (P greater than .05) among the various hepatic lobes. Among species, several activities differed (P less than .05), with cattle livers generally having lower values than sheep or goats. PMID- 3818485 TI - Comparison of surface diameters and dissected diameters of bovine ovarian follicles. AB - Comparisons were made between diameters of 54 bovine follicles greater than 5.9 mm from 32 pairs of ovaries measured on the ovarian surface and diameters of the same follicles subsequently dissected from the ovaries. Seventy-eight percent of follicles measured on the ovarian surface were within 1.9 mm of the size measured after dissection. The remaining 22% of follicles measured on the surface had diameters recorded that were 2.0 to 3.9 mm different than their diameter after dissection. Surface diameter tended to underestimate dissected diameter for small follicles (less than 8.0 mm) and to overestimate dissected diameter for large (greater than or equal to 12.0 mm) follicles. The correlation coefficient between surface and dissected follicular diameters was .83. We conclude that measuring the diameter of the largest follicles on the ovarian surface and after dissection yield approximately equivalent results. PMID- 3818486 TI - Effects of adrenalectomy and glucocorticoids on puberty in gilts reared in confinement. AB - The effect of adrenal function and flumethasone (FM, a synthetic glucocorticoid) on induction of puberty in crossbred gilts raised in confinement was examined in two experiments. In Exp. 1, gilts were adrenalectomized (Adx) or subjected to sham adrenalectomy (Sham) between 140 and 160 d of age. Twenty days later indwelling jugular catheters were implanted in Adx, Sham and another group of intact gilts designated as Controls, and the gilts were moved from confinement to outdoor pens and checked daily for estrus with a mature boar. Fewer (P less than .05) Adx (1/11) than Sham (9/14) gilts showed estrus and ovulated by 205 d of age. Response of Control gilts (6/14) was not different from the other groups. Although Adx gilts received 40 mg cortisone acetate and 10 mg deoxycorticosterone acetate daily throughout the experiment, mean plasma glucocorticoids were lower (P less than .05) in Adx (24 +/- 4.7 ng/ml) than in either Sham (47 +/- 8.1 ng/ml) or Control (44 +/- 6.1 ng/ml) gilts. Experiment 2 was conducted to determine whether FM given to Adx gilts immediately after surgery could have inhibited estrus and ovulation. Intact gilts received a total of 27.5 (FM1) or 17.5 (FM2) mg FM over 4 d between 150 and 160 d of age before relocation and boar exposure 20 d later. Control gilts received no injections. Nine of 13 FM-treated but none of the Control gilts showed estrus. It is concluded from these results that the adrenal glands may facilitate the onset of puberty in gilts through increases in glucocorticoid production, but that this is not required for puberty to occur. PMID- 3818487 TI - Relationship of absolute numbers of Sertoli cells to testicular size and spermatogenesis in young beef bulls. AB - Testes were obtained from 34 Hereford or Angus bulls at about 1.5 yr of age and were used to investigate the relationship between the absolute number of Sertoli cells vs testicular size and daily spermatozoal production (DSP). Quantitative determination of DSP was based upon enumeration of elongated spermatids in testicular homogenates. The ratio of step 8 spermatids to Sertoli cells (S:SC) was established by direct counts of these cells in each of 20 round stage VIII seminiferous tubular cross sections for each bull. The number of Sertoli cells per paired testes was calculated as (total spermatids divided by S:SC)/.394, where total spermatids equalled the number of homogenization-resistant spermatids. The factor of .394 adjusted for the fact that the latter cells are present for only 39.4% of the spermatogenic cycle. All data were subjected to simple linear and second-order regression analyses. A positive linear relationship (P less than .005) was found between testicular weight (Y, in grams) and the absolute number of Sertoli cells per paired testes (X, in billions), which was characterized by the equation Y = 315.2 + 10.74X and a coefficient of correlation (r) of .56 (P less than .01). A similar relationship was observed between DSP (Y, in billions) and Sertoli cell numbers (X, in billions). This was characterized by the equation Y = 1.36 + .222X (P less than .005) and a coefficient of correlation of .70 (P less than .01). Daily sperm production was unrelated to the S:SC ratio (P greater than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818488 TI - Testicular development, daily sperm production and epididymal sperm reserves in 15-mo-old Angus and Hereford bulls: effects of bull strain plus dietary energy. AB - Bull calves (n = 143) were obtained from two strains of Angus and two strains of Hereford cattle for which replacements were selected on the basis of superior feedlot growth performance on either high- or medium-energy diets. From weaning to slaughter at 15 mo of age, bulls were fed either the high-energy (80% grain + 20% forage) or medium-energy diet (100% forage) corresponding to their strain. Bulls in high-energy diet groups had a greater (P less than .05) scrotal circumference at 12 mo, but not 15 mo of age, than bulls in medium-energy diet groups. Compared with Hereford bulls, Angus had greater (P less than .01) scrotal circumference (36.1 vs 33.9 cm) and greater (P less than .05) paired testes weight (570 vs 464 g) at 15 mo of age. Daily sperm production per gram testicular parenchyma (DSP/g) was affected by strain-diet (P less than .01) but not by breed. Bulls in medium-energy diet groups had 12% greater DSP/g than did high energy diet bulls (17.4 X 10(6) vs 15.5 X 10(6)). Daily sperm production (DSP) was 9% and 30% greater (P less than .01) for medium-energy diet bulls in 1980 (8.2 X 10(9) vs 7.5 X 10(9)) and 1981 (8.0 X 10(9) vs 6.2 X 10(9)), respectively, compared with high-energy diet bulls. The effect (P less than .01) of breed on DSP was attributed to breed differences in paired testes weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818489 TI - Relative contributions of ruminal bacteria and protozoa to the degradation of protein in vitro. AB - Mixed ruminal microorganisms from a cow fed timothy hay and concentrate supplement (50:50) were incubated with various protein sources for 15 h (no carbohydrates or growth), and deamination was studied under enzyme-limiting substrate-excess conditions (n = 3). Addition of amphotericin (10 micrograms/ml) killed protozoa and decreased (P less than .05) ammonia production from killed bacteria but it had no effect (P greater than .05) on casein deamination. Monensin (5 micrograms/ml) also killed protozoa; however, it decreased (P less than .05) casein deamination to a much greater extent than amphotericin. Antibacterial antibiotics (penicillin G, polymixin B, cephalosporin C and streptomycin) greatly reduced (P less than .05) ammonia formation from casein. Isolated bacteria always produced more ammonia than isolated protozoa, but the difference was less with heat-treated, particulate proteins. Heated soybean protein was as soluble as heated casein but it was deaminated (P less than .05) at a faster rate by bacteria. Nonammonia-nonprotein N accumulation was greater (P less than .05) with the protozoa than bacteria. When incubations containing bacteria or protozoa were compared with combinations of protozoa and bacteria, the combinations always caused a synergistic increase in ammonia and decrease (P less than .05) in nonammonia-nonprotein N. These results suggest: soluble proteins were primarily degraded by bacteria; protozoa could contribute to the degradation of insoluble, particulate proteins; protozoa were limited in their ability to assimilate peptides (or amino acids); low molecular weight products could be fermented more readily by bacteria and monensin was toxic to protozoa, but decreases in ammonia were primarily due to action of monensin on bacteria. PMID- 3818490 TI - Gluconeogenesis in isolated lamb hepatocytes. AB - Isolated sheep hepatocytes were used to obtain estimates of kinetic parameters, identify substrate preference and interactions and study regulation of gluconeogenesis. Respective Vmax estimates for propionate, pyruvate and alanine conversion to glucose were 59.5, 12.8 and 21.5 mol glucose formed X (h X g dry weight)-1. Respective KS estimates for propionate and pyruvate were 1 mM and 18 to 40 microM. Rates of lactate utilization varied among cell preparations, possibly because of loss of lactate dehydrogenase during isolation. Dihydroxyacetone and glycerol were utilized for glucose synthesis at similar rates of 8.6 and 8.7 mumol glucose formed X (h X g dry weight)-1, respectively. Respective rates of glucose synthesis from 5 mM fructose and 10 mM galactose were 63.2 and 31.4 mumol X (h X g dry weight)-1. Maximum rates of pyruvate carboxylase and phosphoenolpyruvate carboxykinase were estimated to be 101.6 and 160.4 mumol substrate converted X (h X g dry weight)-1, respectively. Neither butyrate nor acetate accelerated gluconeogenesis from propionate while acetate increased glucose synthesis from pyruvate, presumably through activation of pyruvate carboxylase. Glucagon stimulated gluconeogenesis from propionate. Dibutyrylcyclic AMP mimicked the effect of glucagon, implying that the glucagon effect is translated via the adenyl cyclase system as in rats. The kinetic parameters established in these experiments should be useful in future experiments and in computer modeling analyses of ruminant liver and whole animal metabolism where Michaelis-Menten type equations are widely used. PMID- 3818491 TI - Duodenal bacterial and nonbacterial protein supply in steers fed forage and grain diets. AB - Four beef steers (avg wt 300 kg) fitted with duodenal re-entrant cannulae were used to study the effect of dietary concentrate to forage ratio on bacterial and nonbacterial N flow in the duodenum. According to a change-over design, the steers were designated to receive an all forage (83% alfalfa hay and 17% wheat straw) and an 80% sorghum grain diet. Lignin (ADL) and chromium oxide (Cr2O3) ratio techniques were compared with automated total collection (ATC) of digesta for quantitating duodenal protein flow and efficiency of bacterial N yield in the rumen. Estimates of bacterial protein synthesis and ruminal escape of feed protein based on Cr2O3 and lignin tended to be higher by 8 to 16% than those obtained by ATC. Efficiency of ruminal bacterial protein yield estimated by these two markers tended to be greater than that based on ATC (16 vs 12 g of bacterial protein/100 g ruminal true digestion of dry matter corrected for bacterial cell synthesis). Efficiency values did not differ between diets. Crude protein flow into the duodenum was about 33% greater (P less than .01) for the grain than the forage diet, although protein intake was about 10% less on the grain diet. Duodenal bacterial protein, rather than feed protein escaping ruminal degradation, accounted for most of this difference. Average duodenal flow of N, expressed as g/Mcal metabolizable energy (ME) intake, was 11.9 for the forage diet and 10.3 for the grain diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818492 TI - Reproductive rates, birth weight, calving ease and 24-h calf survival in a four breed diallel among Simmental, Limousin, Polled Hereford and Brahman beef cattle. AB - Calving and weaning rates, birth weight, calving ease, and 24-h calf survival were evaluated in a four-breed diallel of Simmental (S), Limousin (L), Polled Hereford (H) and Brahman (B) beef cattle in five calf crops. Limousin dams tended to have the highest calving and weaning rates because they were able to have heavier calves with less calving difficulty and higher survival rates. Brahman sired calves were the heaviest at birth (P less than .05) and B dams produced the lightest calves (P less than .001). Lower birth weights tended to be the limiting factor on survival of these calves. A linear comparison among means to evaluate purebred, additive, maternal and specific combining ability effects showed most of the reduction in birth weight from B dams was due to maternal effects. Breed of dam accounted for a higher proportion of variation in calving ease than did sire breed. Simmental sires had significantly heavier calves at birth and S and H dams tended to have more calving difficulty and lower survival rates. Heterosis for these traits was generally not significant. Correlations were generally positive and significant for birth weight and calving ease, but were more variable for birth weight and survival. Linear regressions of calving ease on birth weight both within years and within dam-breed-year subclasses were very similar in that the association of these two traits was reduced as dam age increased. PMID- 3818493 TI - Growth performance for four breeds of swine: crossbred females and purebred and crossbred boars. AB - Purebred and two-breed cross (F1) boars were mated to F1 females to produce all possible three- and four-breed cross pigs involving the Duroc, Yorkshire, Landrace and Spotted breeds. Individual postweaning average daily gain (ADG), age at 100 kg (AGE) and probed backfat thickness at 100 kg (BF) data were collected on 3,456 pigs. A total of 213 pens with an average of 15.58 pigs per pen was evaluated for postweaning feed-to-gain ratio (F/G) and average daily feed consumption (ADF). Genotype X environment interactions, specifically breed X year season farrowed and breed X parity (for ADG), were found to be highly significant. Certain results, however, were reasonably consistent across environments. Duroc-sired pigs grew more efficiently than other sire breed groups (3.11 vs 3.21 F/G), although there were no significant differences in ADF between sire groups. Duroc-sired pigs had less BF than other three-breed cross pigs, based upon within breed of dam comparisons, suggesting differences in composition between the more efficient Duroc-sired pigs and other breed groups. Landrace sired pigs were fatter than other sire groups. No real differences between crossbred-sired pigs and the average of contemporary pure-bred-sired pigs were apparent for F/G, ADF, ADG, AGE, or BF. Assuming paternal heterosis to be zero, these results suggested recombination effects to be negligible for postweaning performance traits. Apart from via direct genetic effects, mating crossbred rather than purebred boars to females of different breeding should have little or no impact on feedlot performance of offspring produced. PMID- 3818494 TI - Protoscolicidal effect of praziquantel--in-vitro and electron microscopical studies on Echinococcus granulosus. AB - Praziquantel was investigated in an in-vitro culture system of protoscoleces of Echinococcus granulosus (hydatid disease). Live protoscoleces were obtained from ovine pulmonary and hepatic cysts. As well as testing for serial viability, protoscoleces were examined by scanning and transmission electron microscopy. Praziquantel concentrations as low as 50 micrograms/l had a profound and rapid effect on the viability of protoscoleces. Electron microscopy of treated parasite demonstrated gross damage to the tegument. Praziquantel is a most effective and rapid scolicidal agent which may well be of clinical value. PMID- 3818495 TI - In-vitro and in-vivo potency of five new fluoroquinolones against anaerobic bacteria. AB - The MICs of difloxacin (A-56619), A-56620 and ofloxacin were similar or within one to two-fold dilutions against a variety of anaerobic bacteria. Ciprofloxacin was slightly less active (two- to four-fold dilutions) than difloxacin, A-56620 and ofloxacin. Norfloxacin was less active than the other fluoroquinolones tested against anaerobic bacteria. The MICs of norfloxacin, A-56620, ciprofloxacin and ofloxacin against most anaerobes, except the Gram-positive cocci, were lower at pH 8.1 than at pH 6.6. MICs of the fluoroquinolones against anaerobic cocci were the same at pH 6.6, 7.3 and 8.1. Norfloxacin and ciprofloxacin were most affected by the acidic pH. Ofloxacin and A-56620 were affected to a lesser extent by an acidic pH than norfloxacin and ciprofloxacin. The potency of difloxacin was similar at the three pHs tested. A subcutaneous anaerobic infection model in mice was used to determine the in-vivo efficacy of the new fluoroquinolones against Bacteroides fragilis. Difloxacin was the most potent compound in this test. PMID- 3818496 TI - Pharmacokinetics of mezlocillin in patients with hepatobiliary dysfunction. AB - The pharmacokinetics of mezlocillin were investigated in 26 patients with alcoholic liver disease. Serum concentrations of mezlocillin were measured following intravenous administration of 3 g doses over 30 min. The mean peak serum concentration (+/- standard deviation) of mezlocillin at the end of infusion was 138.8 +/- 55.7 mg/l and the mean terminal half-life (T 1/2 beta) was 2.10 +/- 0.9 h. The 24 h urinary recovery of mezlocillin was 35.4 +/- 12.4% of the administered dose. Serum clearance was found to be inversely correlated with alkaline phosphatase and with total bilirubin. The T 1/2 beta was related to the following clinical measurements: age, SGOT and prothrombin time. This relationship suggests it may be prudent to adjust the dosage and the dosage interval of mezlocillin in patients with hepatobiliary dysfunction. PMID- 3818497 TI - The effect of clofazimine on the pharmacokinetics of rifampicin and dapsone in leprosy. AB - Fifteen untreated leprosy patients were given rifampicin and dapsone for seven days, and then rifampicin, dapsone and clofazimine for seven days. Concentrations of rifampicin and dapsone were estimated in timed plasma specimens and in 24 h urine specimens on days 7 and 14. No significant differences in the pharmacokinetics of rifampicin and dapsone were observed between the two occasions of sampling. PMID- 3818498 TI - Comparison of the side effects and gastrointestinal motility observed after administration of erythromycin and josamycin to dogs. AB - The effects of intravenous erythromycin and josamycin on gastrointestinal motility in dogs have been compared. Erythromycin interrupted the basal motility pattern in the fasted state and induced irregular bursts of spikes in both the fasted and fed states. Emesis occurred in all the dogs in the fasted state experiments and in four out of six dogs in the fed state experiments. Josamycin did not disturb gastrointestinal motility and no dog showed signs of discomfort. The difference in the chemical structure of erythromycin and josamycin is the main reason for their differential effect on the gastrointestinal tract. PMID- 3818499 TI - Activity of CI-934 against gram-positive bacteria. PMID- 3818501 TI - Hypoprothrombinaemia and bleeding associated with cefazolin. PMID- 3818500 TI - Cure of a case of Haemophilus aphrophilus endocarditis with a combination of fosfomycin and gentamicin. PMID- 3818502 TI - Hamster tracheal organ culture in serum-free media: a quantitative comparison of in vitro epithelial morphology with that of in vivo controls. AB - The epithelial morphology of the hamster trachea in serum-free organ culture was compared with that of age-matched in vivo control tissues by collecting and statistically analyzing several quantifiable parameters. By this technique it was possible to detect both subtle and dramatic epithelial alterations. Midtracheal tissues from 6-wk-old male Syrian golden hamsters were used as the explants. Explants were placed on Gelfoam sponges and cultured for 1,2, and 3 wk in CMRL 1066 alone and in CMRL 1066 to which seven factors were added: insulin and transferrin (5 micrograms/ml); hydrocortisone (5 X 10(-7) M); epidermal growth factor (5 ng/ml); bovine pituitary extract (0.5%); and phosphoethanolamine and ethanolamine (5 X 10(-5) M). The following data were collected and statistically analyzed for each tracheal ring: number of epithelial cells; proportion and number of each cell type; basement membrane length; linear density of epithelial cells; epithelial height; and mitotic index. Compared to controls, ciliated cells decreased by 52% during washes in Leibovitz (L15) medium and tissue manipulation performed before culture and this loss persisted after culture for 1 wk. Explants cultured without the factors showed marked changes after 2 and 3 wk including epithelial thickening and folding, which was associated with increased linear density. Many cells in these specimens could not be categorized by type (22% were unidentifiable after 3 wk). Epithelial migration onto the outside of the explant was inhibited. In contrast, explants cultured with the factors maintained a morphology similar to controls at 2 and 3 wk and epithelial migration onto the outside of the explant was supported. This study shows that explants in CMRL 1066 with the seven factors provide a useful biological model for the in vitro study of mucociliary respiratory epithelium. PMID- 3818503 TI - Isolation and characterization of chemically transformed pancreatic acinar cell lines from young and old mice. AB - To evaluate the role of animal age in chemically induced transformation, pancreatic cells were grown in culture 6 to 8 wk after injecting mice at either 6 or 22 mo. of age with a single dose of N-methyl-N-nitrosourea (NMU). The cell type and the frequency with which lines were obtained from aged animals paralleled the frequency and pattern of tumor induction by NMU in vivo. Outgrowth of pancreatic explants from young animals required the presence of the tumor promoter 12-otetradecanoyl-phorbol-13-acetate to establish continuously growing cell lines. Whereas NMU alone produced lines from aged mice, the promoter did not increase the frequency with which continuous lines were recovered from the aged animals. Of eight cloned cell lines (four young and four old), all had characteristics of transformed mouse pancreatic acinar cells when tested for lectin binding, lactate dehydrogenase isozyme pattern, chromosome number, and anchorage-independent growth. Cell lines derived from aged animals were slower growing and had higher chromosome numbers than lines derived from their younger counterparts. PMID- 3818504 TI - The comparative study of cardiovascular toxins utilizing a sensitive indicator of sublethal toxic injury. AB - This study measures the inhibition of [3H]uridine uptake by smooth muscle cells to determine sublethal toxic injury by the cardiovascular toxins, allylamine, isoproterenol, and beta-aminopropionitrile. The exposure period or the concentration of toxin which inhibited 30% of [3H]uridine uptake by smooth muscle cells could be utilized as an endpoint for ranking toxicity. Cytotoxicity of the three toxins to smooth muscle cells were ranked as: allylamine greater than isoproterenol greater than beta-aminopropionitrile. Recovery of cells utilizing [3H]uridine uptake inhibition as a method for assessing comparative cytotoxicity and for screening of agents potentially injurious to vascular cells. PMID- 3818505 TI - A photomicrographic technique for measuring the activity of Amoeba populations. PMID- 3818506 TI - Stereo techniques to enhance scanning photomacrography. PMID- 3818507 TI - Depth and enlarging factors in ultra-close-up and photomacrographic prints and slides. PMID- 3818508 TI - Photomicrographic documentation of mixed isotropic/anisotropic specimens. PMID- 3818509 TI - Mnemonic effects of asthma medication in children. AB - Asthmatic children receiving theophylline or steroid-theophylline combination therapy and normal nonasthmatics were given tests of visual retention and paired associate learning. The performance of children receiving combination therapy was significantly worse than that of the nonasthmatics 6-8 hours after receiving steroid medication, but not 22-24 or 46-48 hours after medication. Children receiving theophylline alone did not differ from nonasthmatics on these tasks. These observations suggest that steroid-inclusive medication regiments can affect cognitive performance. PMID- 3818511 TI - The fate of sulfites, new rates for nitrites, mates about mites, etc.: civil rights or social rites? By I. Ron Ikkal and Lynn Guist. PMID- 3818510 TI - A comparison of two delivery methods for aerosolized metaproterenol sulfate. AB - The bronchodilator response to metaproterenol sulfate delivered by metered-dose inhaler (MDI) with a spacer device (Aerochamber) and by jet nebulizer was studied in 15 asthmatic patients. The mean percent increase in absolute forced expiratory volume in 1 second (FEV1) with an MDI plus Aerochamber was 28.6%, and 28.8% with jet nebulization. There were no significant differences in the mean percent increases in FEV1, forced vital capacity (FVC), maximum midflow rate (MMFR), and peak expiratory flow rate (PEFR) with the two delivery methods. It is concluded that there is no difference in the bronchodilator responses to metaproterenol sulfate delivered by MDI plus Aerochamber or by jet nebulizer. The MDI plus Aerochamber has the advantage of being less expensive and more convenient to use. PMID- 3818512 TI - Hairy cell leukaemia (HCL) PMID- 3818513 TI - Hairy cell leukaemia: a clinicopathological study. PMID- 3818514 TI - Rheumatoid factors in health and disease. PMID- 3818515 TI - Skin thickness in normal subjects and in patients with endocrine disorders. PMID- 3818516 TI - Effect of manganese on prevention of atherosclerosis in cholesterol fed rabbits. PMID- 3818517 TI - Electrocardiographic abnormalities in subarachnoid haemorrhage. PMID- 3818518 TI - Clinical effects of alcohol in intermittent acute porphyria. PMID- 3818519 TI - Nitroblue tetrazolium test in the diagnosis of amoebic liver abscess. PMID- 3818520 TI - Echocardiographic evaluation of left ventricular dimensions and function before and after haemodialysis. PMID- 3818521 TI - Sodium nitroprusside in hypertensive emergencies. PMID- 3818522 TI - Comparative evaluation of lung functional changes with atropine methonitrate and salbutamol in plain and sustained forms. PMID- 3818523 TI - Pacemaker update. PMID- 3818524 TI - Hypercalcaemia. PMID- 3818525 TI - Prosopagnosia (a report of two cases). PMID- 3818526 TI - Haemophilia A in a phenotypic female. PMID- 3818527 TI - Pacemaker mediated endless loop tachycardia. PMID- 3818528 TI - Thrombotic thrombocytopenic purpura. PMID- 3818529 TI - Tropical pyomyositis with agammaglobulinaemia. PMID- 3818530 TI - Hairy cell leukaemia with possible pulmonary and renal involvement. PMID- 3818531 TI - Snake bite and renal failure. PMID- 3818532 TI - Hydrocarbon pneumonitis--a hazard in fire-eaters. PMID- 3818533 TI - Blood transfusion in cases of chronic severe anaemia--how safe? PMID- 3818534 TI - [Radiology of cardiac pacemakers. Normal aspects, complications, pitfalls]. PMID- 3818535 TI - Basic methods in quantitative CT. PMID- 3818536 TI - Acute focal bacterial nephritis (acute lobar nephronia). PMID- 3818537 TI - [Difficult intubations. Clinical pitfalls. Contribution of radiology]. PMID- 3818538 TI - Traumatic cerebrospinal fluid leakage into the maxillary sinus. PMID- 3818539 TI - Intravascular bronchioloalveolar tumor as a secondary manifestation of an epithelioid hemangioendothelioma. PMID- 3818540 TI - Aneurysm of the superior mesenteric vein. PMID- 3818541 TI - Binding of laminin to oral and endocarditis strains of viridans streptococci. AB - Attachment of bacteria to the host tissue is regarded as a crucial step in the development of many types of infections. Recent studies by us and others have shown that matrix proteins which serve as adhesion proteins for eucaryotic cells may also be recognized by some bacteria. In the present communication, we report that several strains of viridans streptococci are able to bind to laminin. Most strains isolated from blood and heart valves of patients with endocarditis expressed laminin receptors, whereas only a few of the strains isolated from the oral cavity recognized this protein. This observation indicates that laminin binding might be an important factor in the pathogenesis of viridans endocarditis. Laminin binding to two strains (Streptococcus mitis UAB594 and UAB597) isolated from patients with endocarditis was characterized further. The bacterial cells expressed a limited number of laminin receptors (4 X 10(2) to 1 X 10(3) per cell) which bound the protein in a high-affinity interaction (Kd, 40 to 80 nM). This receptor of S. mitis UAB594 was heat labile and could be solubilized from bacteria by brief digestion with trypsin. Solubilized receptors which competed with cell-bound receptors for 125I-laminin could be adsorbed on laminin Sepharose but not on Sepharose substituted with fibrinogen or fibronectin. Comparison of laminin receptors from S. mitis with those previously described for Streptococcus pyogenes suggest that different sites in the laminin molecule are recognized by the two bacteria and hence that the corresponding receptor molecules are not identical. PMID- 3818542 TI - Effects of Rhizobium meliloti nif and fix mutants on alfalfa root nodule development. AB - Ineffective alfalfa nodules were examined at the light and electron microscope level after inoculation with Rhizobium meliloti strains with mutations in nif and fix genes. All the mutant strains induced nodules that contained elongated bacteroids within the host cells, but the bacteroids quickly senesced. The nodules were small and numerous, and the host cells also exhibited symptoms of an ineffective symbiosis. nifB, fixA, and fixB bacteroids appeared to be completely differentiated (by ultrastructural criteria), i.e., as bacteroids developed, they increased in diameter and length and their cytoplasm underwent a change from homogeneous and electron dense to heterogeneous and electron transparent after enlargement. In contrast, nifA bacteroids rarely matured to this state. The bacteroids degenerated at an earlier stage of development and did not become electron transparent. PMID- 3818543 TI - Transformation of vegetative cells of Bacillus thuringiensis by plasmid DNA. AB - Plasmid DNA-mediated transformation of vegetative cells of Bacillus thuringiensis was studied with the following two plasmids: pBC16 coding for tetracycline resistance and pC194 expressing chloramphenicol resistance. A key step was the induction of competence by treatment of the bacteria with 50 mM Tris hydrochloride buffer (pH 8.9) containing 30% sucrose. Transformation frequency was strongly influenced by culture density during the uptake of DNA and required the presence of polyethylene glycol. Growth in a minimal medium supplemented with Casamino Acids gave 35 times more transformants than growth in a rich medium. The highest frequencies were obtained with covalently closed circular DNA. With all parameters optimized, the frequency was 10(-3) transformants per viable cell or 10(4) transformants per microgram of DNA. Cells previously frozen were also used as recipients in transformation experiments; such cells gave frequencies similar to those obtained with freshly grown cells. The procedure was optimized for B. thuringiensis subsp. gelechiae, but B. thuringiensis subsp. kurstaki, B. thuringiensis subsp. galleriae, B. thuringiensis subsp. thuringiensis, and B. thuringiensis subsp. israelensis were also transformed. Compared with protoplast transformation, our method is much faster and 3 orders of magnitude more efficient per microgram of added DNA. PMID- 3818544 TI - Cell cycle changes in the buoyant density of exponential-phase cells of Streptococcus faecium. AB - Cell buoyant densities were determined by centrifugation in Percoll gradients containing exponential-phase cells of Streptococcus faecium ATCC 9790 grown at a mass doubling time of about 33 min. This bacterium showed the highest average density values (1.13 g/ml) measured to date for any eucaryotic or procaryotic organism. Fractions having the highest densities were enriched with cells that were in the process of dividing or had just divided. These high-density fractions were also enriched with cells that had newly initiated sites of cell wall growth. It appears that S. faecium shows minimum cell densities in the midportion of its cycle. PMID- 3818545 TI - Characterization of extracellular Mn2+-oxidizing activity and isolation of an Mn2+-oxidizing protein from Leptothrix discophora SS-1. AB - Supernatant fluid from Leptothrix discophora SS-1 cultures possessed high Mn2+ ozidizing activity. Studies of temperature and pH optima, chemical inhibition, and protease sensitivity suggested that the activity may be enzymatic. Kinetic studies of unconcentrated supernatant fluid indicated an apparent Km of 7 microM Mn2+ in the 1 to 200 microM Mn2+ range. The greatest Vmax value observed was 1.4 nmol of Mn2+ oxidized min-1 micrograms of protein-1 in unconcentrated samples. When the supernatant fluid was concentrated on DEAE-cellulose and the activity was eluted with MgSO4, an Mn2+-oxidizing protein was detected in the concentrate by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The Mn2+-oxidizing protein appeared to have a molecular weight of 110,000 in 10% polyacrylamide gels and of 100,000 in 8% gels. Periodic acid-Schiff base staining of overloaded polyacrylamide gels showed that the DEAE-cellulose concentrate contained abundant high-molecular-weight polysaccharides; concurrent staining of the Mn2+-oxidizing band suggested that it too contained carbohydrate components. Isolation of the protein was achieved by subjecting the DEAE-cellulose concentrate to Sephacryl gel filtration in the presence of 1% sodium dodecyl sulfate, followed by preparative electrophoresis and reverse-polarity elution. However, these procedures resulted in loss of a large proportion of the activity, which precluded recovery of the protein in significant quality. PMID- 3818546 TI - Ultrastructure and biochemistry of the cell wall of Methanococcus voltae. AB - The ultrastructure and chemical composition of the cell wall of the marine archaebacterium Methanococcus voltae were studied by negative-staining and freeze etch electron microscopy and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. M. voltae possesses a single regularly structured (RS) protein layer external to the plasma membrane. Freeze-etch preparations of cells indicated that the protein subunits are hexagonally arranged with a center-to center spacing of approximately 10 nm. The extracted RS protein had a molecular weight of 76,000. It was present on envelopes prepared by shearing in a French press, osmotic lysis, or sonication, as indicated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. NaCl was not required for attachment of the RS protein to the underlying plasma membrane. The hexagonal array could be demonstrated by platinum shadowing and freeze-etching of envelopes, but negative staining in the abscence of NaCl failed to stabilize the array. The RS protein could be solubilized by urea, guanidine hydrochloride, dithiothreitol, and several detergents, including Nonidet P-40, Triton X-100, and Tween 20. However, the most specific release of the wall protein from envelopes occurred after a heat treatment in HEPES (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid) buffer at 50 to 60 degrees C. PMID- 3818547 TI - Effect of growth temperature on the long-chain diols and fatty acids of Thermomicrobium roseum. AB - Long-chain 1,2-diols constitute the hydrophobic backbone of membrane lipids (replacing glycerolipids) in the thermophilic eubacterium Thermomicrobium roseum. The effects of incubation temperature on chain length and chain branching of diols and fatty acids were investigated. The percentage of branched chains decreased, and chain length increased slightly, with increased growth temperatures. PMID- 3818548 TI - Properties of a hydrogen-inhibited mutant of Desulfovibrio desulfuricans ATCC 27774. AB - A mutant of Desulfovibrio desulfuricans ATCC 27774 has been obtained which is incapable of sulfate respiration with molecular hydrogen but which grows normally on lactate plus sulfate under argon. Growth characteristics of the mutant suggest that the defect is involved in electron transfer to sulfate or nitrate but not thiosulfate. PMID- 3818549 TI - Efficient transfection of the archaebacterium Halobacterium halobium. AB - We developed an efficient polyethylene glycol-mediated spheroplast transfection method for the extremely halophilic archaebacterium Halobacterium halobium. The 59-kilobase-pair linear phage phi H DNA molecule routinely produced between 5 X 10(6) and 2 X 10(7) transfectants per microgram of DNA. Between 0.5 and 1% of spheroplasts were transfected per microgram of luminal diameter H DNA. Under our conditions, survival and regeneration of H. halobium spheroplasts were also quite efficient, suggesting that this method will be useful for introducing other DNAs into these bacteria. PMID- 3818550 TI - Imipramine and tinnitus. AB - Although tinnitus is listed among the rare neurologic side effects of tricyclic antidepressants, little is known about its prevalence, mechanism of development, course, and management. A chart review of 475 patients treated with tricyclic antidepressants indicated that tinnitus occurred in about 1% of the patients. The case vignettes of 5 patients who developed tinnitus in the course of imipramine therapy are presented. Each developed tinnitus in the second or third week of treatment with imipramine at daily dosages of 150-250 mg and at combined plasma imipramine-desipramine levels between 200-450 ng/ml. In each patient, tinnitus subsided spontaneously within 2-4 weeks of onset without any specific treatment, even though the daily dosage of imipramine and the plasma tricyclic levels were constant or increased. Possible mechanisms of development of tinnitus and implications for tricyclic antidepressant therapy are discussed. PMID- 3818551 TI - The effect of methylphenidate on school grades in children with attention deficit disorder without hyperactivity: a preliminary report. AB - Ten children, aged 7-12 years, were diagnosed by DSM-III criteria for attention deficit disorder (ADD) without hyperactivity. Each child was treated with methylphenidate for one academic grading period. School grades were obtained for the grading periods before, during, and after drug treatment. Correlated t tests revealed that academic performance during drug treatment was significantly superior to that during the preceding grading period (p less than .01) and the period following drug treatment (p less than .001). ADD without hyperactivity may represent a potentially drug-treatable disorder in children. PMID- 3818552 TI - Impotence associated with compulsive gambling. AB - A 49-year-old patient who presented initially for treatment of inhibited sexual desire and secondary impotence was found to meet DSM-III criteria for compulsive gambling. The relationship between sexual dysfunction and gambling is discussed. Compulsive gambling should be considered in the differential diagnosis of impotence, and a sexual history should be obtained from patients with compulsive gambling. PMID- 3818553 TI - A case of alprazolam, but not lorazepam, inducing manic symptoms. AB - A patient developed manic symptoms during treatment with alprazolam. These symptoms remitted upon discontinuation of treatment, but reemerged during a second trial with alprazolam. Subsequent administration of an equivalent dosage of lorazepam did not induce manic symptoms. The clinical and theoretical implications of these findings are discussed in relation to the possible mechanisms of action of alprazolam, a novel benzodiazepine. PMID- 3818554 TI - Lithium-verapamil: further considerations. PMID- 3818555 TI - Primary and secondary depression in alcoholic men: an important distinction? AB - The primary-secondary depression distinction was investigated in male alcoholic patients from five Veterans Administration Medical Centers. The Psychiatric Diagnostic Interview, a DSM-III-compatible, criterion-referenced, structured interview, was administered to 565 patients admitted to the Alcoholism and Drug Treatment Units. Seventy-eight patients (13.8%) who exhibited only alcoholism and depression were divided into three subgroups based on the temporal onset of depression relative to the onset of alcoholism. Although few statistical differences were found, observed trends suggested more impairment in alcoholic patients with primary depression than in those with concurrent or secondary depression. The findings indicate that the primary-secondary depression distinction may have important clinical relevance and should be made whenever possible. PMID- 3818556 TI - An intermediate state of G-actin between native and denatured: polymerization rate decreases but extent of polymerization remains unchanged. AB - The rate of actin polymerization gradually decreased without changing the final level of polymerization, when incubated in the presence of 0.2 mM ATP at pH 8.0 and 25 degrees C. This change was much faster in Mg2+-actin than Ca2+-actin, and Mg2+-actin became denatured and unpolymerizable on prolonged incubation. The drop in the polymerization rate was due both to weakened nucleation and a slowed elongation rate in the incubated actin. The change in the polymerization rate was partially reversible by storing the sample at 0 degrees C. When the rate of polymerization dropped markedly on prolonged incubation, a gel filtration profile showed that Ca2+-actin existed as monomer not as oligomer. On the other hand, Mg2+-actin formed dimers, and other oligomers, as revealed by crosslinking analysis. There were changes in fluorescence intensities due to tyrosine and/or tryptophan residues of the actin molecule, and in difference absorption spectra, suggesting that conformational changes intermediate between native and denatured states occurred during incubation. PMID- 3818557 TI - Active movement of synthetic myosin filaments observed by dark-field light microscopy. AB - Long bipolar filaments synthesized from rabbit skeletal myosin have been visualized directly under a dark-field light microscope. It was also possible to observe movements of single myosin filaments in the presence of F-actin, which was invisible. When the two kinds of filaments were mixed (final concentrations: 17 micrograms/ml myosin and 0.6 mg/ml actin) in a medium containing 0.13 M KCl, 3 mM MgCl2, and 1 mM ATP, myosin filaments did not aggregate for a long period of time but were distributed separately in the field of microscope. Under these conditions, myosin filaments intermittently moved along their length in a bidirectional manner with a maximum instantaneous velocity of 5 micron/s. Individual filaments alternated, at random, between motile and nonmotile periods of time, with the motile fraction of filaments at any moment being roughly 10%. The in vitro movement of myosin filaments may be caused by their active sliding relative to F-actin in the background. PMID- 3818558 TI - Radial locations of amino acid residues in a globular protein: correlation with the sequence. AB - The location measure of a residue in a globular protein is defined as the number of C alpha atoms surrounding the residue located within a sphere of the radius of 14 A. This quantity is a measure of the exposure of a residue to solvent, and is related closely to the distance from the center of mass of a protein. In this work, the experimental value for each residue of a protein is obtained from the X ray crystallographic data, and the quantity is also calculated from the amino acid sequence data by applying an empirical parameter set to it. The correlation between the experimental and computed quantities is as high as 0.50 on the average over 92 proteins of known three-dimensional structure. Therefore, the location measure of every residue in a globular protein is predictable with good accuracy from the sequence. PMID- 3818559 TI - Purification and properties of glucoside 3-dehydrogenase from Flavobacterium saccharophilum. AB - A membrane-bound glucoside 3-dehydrogenase [EC 1.1.99.13], which oxidizes validoxylamine A to the 3-keto derivative, was solubilized from the membrane fraction of Flavobacterium saccharophilum by Triton X-100 and purified about 280 fold with an overall yield of 30% from the membrane fraction by column chromatography on DEAE- and CM-Sepharose CL-6B and gel filtration on Sephacryl S 300. The purified enzyme exhibited a single protein band on disc gel electrophoresis, and FAD was shown to be the prosthetic group. The enzyme had a molecular weight of 270,000 as determined by gel filtration on Sephacryl S-300 and consisted of 4 identical subunits each with a molecular weight of 66,000. The enzyme reacted with various artificial electron acceptors such as 2,6 dichlorophenolindophenol (DCIP), phenazine methosulfate, and ferricyanide. The optimum pH for DCIP reductase activity was 6.0. The enzyme was inhibited by Hg2+ and p-chloromercuribenzoate. D-Glucose and methyl-alpha- and beta-D-glucoside showed the highest susceptibility to the enzyme, and were converted to the corresponding 3-keto sugars. PMID- 3818560 TI - Purification and chemical characterization of human platelet membrane glycoprotein IV. AB - Human platelet membrane glycoprotein IV (GPIV), one of the major glycoprotein components, was purified by successive affinity chromatographies on columns of Lens culinaris agglutinin-Sepharose and wheat germ agglutinin-Sepharose followed by preparative polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate (SDS). On SDS-polyacrylamide gel electrophoresis in either the presence or absence of dithiothreitol, GPIV gave a single band with an apparent molecular weight of 97,000, suggesting that GPIV is composed of a single polypeptide chain without interchain disulfide bonds. Compositional analysis showed that GPIV contains large amounts of acidic and hydroxy amino acids, but only very small amounts of cystine and methionine, and 28.1% (w/w) carbohydrate consisting of galactose, glucosamine, and sialic acid as the principal sugars with smaller amounts of fucose, mannose, and galactosamine. This suggested that GPIV contains both N-linked and O-linked sugar chains. The O-linked sugar chains isolated from GPIV, together with those from GPIb and glycocalicin, were comparatively analyzed on a Bio-Gel P-4 column after neuraminidase treatment. The results indicated that all three glycoproteins have two common species of carbohydrate chains, a disaccharide, Gal-GalNAc, and a tetrasaccharide, Gal GlcNAc-(Gal-)GalNAc. The ratio of the tetrasaccharide to the disaccharide in GPIV was found to be somewhat different from that in GPIb or glycocalicin. PMID- 3818561 TI - Facile release of NADPH oxidase from polymorphonuclear leukocyte membrane by mild pressure treatment. AB - NADPH oxidase, a complex enzyme system in the cell membrane responsible for the bactericidal function of polymorphonuclear leukocytes through the production of superoxide anion, was facilely released by mild treatment with a press. At the pressure where almost all NADPH oxidase activity was released, releases of the activities of lactate dehydrogenase, 5'-nucleotidase, lysozyme, and N-acetyl-beta glucosaminidase, and of the amount of total protein were negligible. This method can be useful for the elucidation of NADPH oxidase. PMID- 3818562 TI - The regulation by growth hormone of microsomal testosterone 6 beta-hydroxylase in male rat livers. AB - The relationship between growth hormone and testosterone (T) 6 beta-hydroxylase was investigated in normal and hypophysectomized (hypox) male rats. The administration of human growth hormone (hGH) by either intermittent injections or continuous infusion to normal and hypox rats decreased the activity of T 6 beta hydroxylase in hepatic microsomes. Hypophysectomy did not reduce, but rather increased the 6 beta-hydroxylase activity, while the 16 alpha-hydroxylase activity decreased. These results, together with the data from a Western blot, indicate that growth hormone acts as a repressive factor for the expression of T 6 beta-hydroxylase in a manner different from the regulation of T 16 alpha hydroxylase. PMID- 3818563 TI - Extracellular phospholipase A2 activity in peritoneal cavity of casein-treated rats. AB - An extracellular phospholipase A2 was detected in the peritoneal cavity of rats injected intraperitoneally with casein. This activity required Ca2+ ion and had a pH optimum of 9. The increase of phospholipase A2 activity in the peritoneal fluid as a function of time roughly paralleled the increase in the number of polymorphonuclear (PMN) leukocytes found in the peritoneal cavity. Phospholipase A2 activity was also observed in rat PMN homogenates, and its characteristics were similar to those of the enzyme found in cell-free peritoneal fluid fraction. PMN leukocytes may release non-lysozomal phospholipase A2 into the extracellular space as 'inflammation reactions' proceed. PMID- 3818564 TI - Glycosphingolipid composition of a renal cell line (MDCK) and its ouabain resistant mutant. AB - Glycosphingolipids were isolated from a canine kidney cell line (MDCK) and its ouabain-resistant mutant (MDCK-OR) by solvent extraction, mild alkaline methanolysis, a DEAE-Sephadex column, and preparative TLC. The glycolipids were characterized by their mobilities on TLC, an analysis of carbohydrates as trimethylsilyl methyl glycosides and acetates of partially methylated alditols, as well as by treatment with specific glycosidases. In the neutral glycolipid fraction of both cell lines, galactosylceramide (GalCer), glucosylceramide (GlcCer), lactosylceramide (LacCer), digalactosylceramide (Ga2Cer), globotriaosylceramide (Gb3Cer), globoside (Gb4Cer), and the Forssman antigen (IV3GalNAc alpha-Gb4Cer) were identified. The contents of Ga2Cer (4.4 nmol/mg protein), Gb3Cer (0.6), Gb4Cer (2.9), and IV3GalNac alpha-Gb4Cer (19.5) in MDCK OR were 1.4- to 2.1-fold higher than those in MDCK, while the concentrations of GlcCer (5.3) and LacCer (1.4) in MDCK-OR were about half of those in MDCK. Among acidic glycolipids of MDCK-OR, galactosyl sulfatide (GalCer-I3-sulfate) and lactosyl sulfatide (LacCer-II3-sulfate) were increased to 1.9 (2.7-fold) and 0.2 nmol/mg protein (2.0-fold), respectively, as compared to MDCK. However, N acetylneuraminosyllactosylceramide (GM3), the predominant ganglioside in both cell lines, was decreased to about one third of the level (1.5 nmol/mg protein) in the parent MDCK (4.7 nmol/mg protein). The fatty acid of the glycolipids in both cell lines consisted mainly of saturated acids of 16, 18, 22, and 24 carbons. PMID- 3818565 TI - A cell-binding, immunoglobulin-like protein from human plasma. I. Isolation and subunit structure. AB - A protein having Mr of more than 900K (900,000) was isolated by chromatography on a column of Sepharose 4B coupled with solubilized elastin, followed by sucrose density gradient centrifugation. The protein is composed of several disulfide linked subunits. SDS-polyacrylamide gel electrophoresis and immunoblotting indicated that two of the subunits are identical with the heavy chains of IgM and IgG, and one is immunologically related to the heavy chain of IgA. The results suggested that this protein is a new protein that belongs to the category of, or is closely related to, the immunoglobulins. As described in the succeeding paper, it has cell-binding activity (Fukamizu et al. (1986) J. Biochem. 100, 843-848). We tentatively refer to this protein as "cell-binding immunoglobulin-like protein (CIP)." PMID- 3818566 TI - Spectral and kinetic studies on Pseudomonas L-phenylalanine oxidase (deaminating and decarboxylating). AB - Pseudomonas L-phenylalanine oxidase (deaminating and decarboxylating) contains two FAD molecules in one molecule of the enzyme (Koyama, H. (1983) J. Biochem. 93, 1313-1319). When the enzyme was mixed anaerobically with L-phenylalanine, beta-2-thienylalanine, L-tyrosine, or L-methionine, a spectral species (purple intermediate) with a broad absorption band around 540 nm was observed with each substrate, and decayed slowly. From the data on the overall reaction kinetics, the rate of the L-phenylalanine oxidase reaction was expressed as follows. e/v = e/Vm + A/[S] + B/[O2] where e represents the concentration of enzyme unit, v the rate of the overall reaction, Vm the maximum velocity, and A and B are constants. Furthermore, the reactions of the enzyme with beta-2-thienylalanine (mostly an oxygenase substrate) and L-methionine (an oxidase substrate) were analyzed by the "stopped flow" method. The following scheme for the mechanism of L-phenylalanine oxidase reaction with both substrates is proposed, based on the data obtained. (formula; see text) Where Eox represents the oxidized form of the enzyme unit, EoxS the enzyme unit (oxidized form)-substrate compound, X the purple intermediate with a characteristic broad absorption band around 540 nm, S the substrate and P the product. PMID- 3818567 TI - A 2H NMR study on alteration of the membrane organization of mouse B16 melanoma cells treated with 12-O-tetradecanoylphorbol-13-acetate. AB - In order to monitor the membrane fluidity of cells without perturbation by an introduced probe, we developed a method for large-scale preparation of 2H-labeled melanoma cells for a 2H NMR study by incubating melanoma cells with [18,18,18 2H3]stearic acid/phosphatidylcholine liposomes for 2 h at 37 degrees C. It turned out that this treatment did not significantly change the cell viability, lipid metabolism or membrane fluidity. The 2H from C-18 of stearic acid is dominantly located at the original position of the fatty acid in the 2H-labeled membrane vesicles, as studied by a tracer experiment with [1-14C]stearic acid. We found that three to four 2H-labeled species were present at 19 degrees C in 2H NMR spectra of the 2H-labeled membrane vesicles prepared from B16 melanoma cells. The extent of peak-splittings due to 2H-quadrupole interaction decreased as the temperature rose, and a definite point of phase transition was not observed. At elevated temperature, 2H-labeled lipids undergo fast exchange between the bilayer and an isotropic phase such as oil phase of triolein or inverted micelles in lipid polymorphs. We further analyzed the change of membrane organization in mouse B16 melanoma cells treated with 12-O-tetradecanoylphorbol-13-acetate (TPA), which strongly inhibited melanogenesis. The magnitude of the quadrupole splitting at 19 degrees C in membranes from TPA-treated cells was significantly less (40%) than in the untreated control. This is mainly explained by decreased molecular ordering (fluidity) due to the increased amount of unsaturated fatty acids in the membranes of TPA-treated cells. PMID- 3818568 TI - Identification of the tryptophan residue located in the calcium binding site of Trimeresurus flavoviridis phospholipase A2. AB - When phospholipase A2 from the venom of Trimeresurus flavoviridis (the Habu snake) was oxidized with N-bromosuccinimide at pH 4.0, its activity decreased linearly with increase in the extent of oxidation of tryptophan residues. Oxidation of two of the four tryptophan residues caused an apparent loss of activity. The accessibilities of the tryptophan residues were analyzed with differently oxidized phospholipase A2 preparations and were determined to be in the following order: Trp-3 approximately Trp-30 greater than Trp-68 greater than Trp-108. The magnitude of the difference spectrum with a negative peak at 292 nm which is produced upon the binding of Ca2+ in the vicinity of tryptophan residue(s) decreased in a concave manner with increase in the extent of oxidation of tryptophan residues and was greatly diminished when 2 mol of tryptophan residues were oxidized. The activity and Ca2+-induced difference spectrum are thus related to either Trp-3 or Trp-30 or both. Des-octapeptide(1-8) phospholipase A2 (L-fragment) is 14% as active as phospholipase A2 and is able to give a Ca2+-induced difference spectrum which is smaller than, but similar to, that of phospholipase A2. Its activity and the magnitude of the Ca2+-induced difference spectrum decreased along similar paths with increase in the amount of tryptophan residues oxidized, but in a manner indicating that two tryptophan residues are apparently responsible for the activity and the Ca2+-induced difference spectrum. The order of accessibility of the tryptophan residues of L fragment was Trp-30 approximately Trp-108 greater than Trp-68. Trp-108, however, could be excluded from the residues located in the active site by reference to the tertiary structure of homologous Crotalus atrox phospholipase A2. Thus, Trp 30 is located in the Ca2+ binding site and is responsible for the activity of L fragment. It is thus concluded that in phospholipase A2 Trp-30 is located in the Ca2+ binding site. From the concave decrease of relative magnitude of the Ca2+ induced difference spectrum and the linear decrease of relative activity upon oxidation of phospholipase A2, it may be assumed that both Trp-3 and Trp-30 are required to produce the Ca2+-induced difference spectrum, while only Trp-30 need be intact for activity. Anomalous binding of Ca2+ was observed for oxidized phospholipase A2. PMID- 3818569 TI - Effect of growth hormone and ectopic transplantation of pituitary gland on sex specific forms of cytochrome P-450 and testosterone and drug oxidations in rat liver. AB - The effects of growth hormone and ectopic transplantation of pituitary gland on the amounts of sex-specific cytochrome P-450, P-450-male and P-450-female, and the activities of testosterone and drug hydroxylases in male rat liver microsomes were studied. Hypophysectomy decreased the content of P-450-male, without changing the total cytochrome P-450 level. The continuous infusion of growth hormone into hypophysectomized rats and the transplantation of pituitary gland under the renal capsule caused a further decrease in P-450-male content and an expression of P-450-female. In contrast, the intermittent injection of growth hormone into hypophysectomized rats increased P-450-male content to the level seen in intact male rats. The activities of testosterone 2 alpha- and 16 alpha-, but not 6 beta-, 7 alpha-, or 15 alpha-hydroxylase, were changed in association with the level of P-450-male by these treatments. Anti-P-450-male immunoglobulin G inhibited testosterone 2 alpha- and 16 alpha-hydroxylations, but not 6 beta-, 7 alpha- or 15 alpha-hydroxylation. These results indicate that growth hormone regulates the expression of P-450-male responsible for testosterone 2 alpha- and 16 alpha-hydroxylations. The metabolism of 7-propoxycoumarin, benzo(a)pyrene and aminopyrine also changed with the content of P-450-male, although the correlation was less than that observed with testosterone 2 alpha- and 16 alpha hydroxylation. PMID- 3818570 TI - The fusogenic effect of synthetic polycations on negatively charged lipid bilayers. AB - The effect of synthetic polycations, polyallylamine, and polyethylenimine, on liposomes containing phosphatidylserine was investigated along with that of polylysine and divalent cations. The addition of polycations caused aggregation of sonicated vesicles composed of phosphatidylserine and phosphatidylcholine (molar ratio 1:4) as determined by measuring the turbidity changes. Liposomal turbidity increased 10 times compared with that of control liposomes at charge ratios of polymer/vesicle from 0.23 (polylysine) to 2.5 (linear polyethylenimine), while the turbidity was unchanged by the addition of Ca2+ or Mg2+ at charge ratios up to 500. These polycations also induced intermixing of liposomal membranes as indicated by resonance energy transfer between fluorescent lipids incorporated in lipid bilayers, without inducing drastic permeability changes as determined from the calcein release. Fifty percent intermixing of liposomes (0.05 mM as lipid concentration) was induced by these polycations at charge ratios of around 1.0. However, the highest resonance energy transfer was produced by the addition of polyallylamine, which caused multicycles of membrane intermixing between vesicles. Polycation-induced membrane intermixing and permeability changes of phosphatidylserine liposomes were also investigated. At charge ratios of around 1.0, these polymers caused resonance energy transfer of fluorescent lipids incorporated in separate vesicles; however, polyallylamine and branched polyethylenimine also caused permeability increases of liposomal membranes. Membrane intermixing and permeability changes of phosphatidylserine vesicles induced by polyallylamine were dependent on the polymer/vesicle charge ratio, and were different from those induced by Ca2+ since the latter caused half maximal membrane intermixing or permeability change of phosphatidylserine vesicles at about 1 mM at the liposomal concentrations investigated. PMID- 3818571 TI - Purification and characterization of 3-hydroxy-3-methylglutaryl CoA reductase from potato tubers. AB - 3-Hydroxy-3-methylglutaryl coenzyme A reductase (NADPH) was solubilized by trypsin digestion from sliced potato tuber microsomes, and purified to apparent homogeneity in the absence of detergent with a recovery of 1.8%. The enzyme had a specific activity of 7,910 nmol of mevalonate formed per min per mg of protein. On molecular-sieving high-performance liquid chromatography, the activity was coincident with the single protein peak corresponding to a molecular weight of approximately 110 kDa. On SDS-polyacrylamide gel electrophoresis, the purified enzyme showed only one protein staining band corresponding to a molecular weight of approximately 55 kDa. The apparent Km value for S-HMG-CoA was 6.4 microM and that for NADPH was 25 microM. PMID- 3818572 TI - Wheat germ trypsin inhibitors. Isolation and structural characterization of single-headed and double-headed inhibitors of the Bowman-Birk type. AB - A number of trypsin inhibitors were isolated from wheat germs by affinity chromatography on immobilized trypsin, gel-filtration, and ion-exchange and reverse-phase chromatography. These inhibitors were classified into two groups, inhibitors I (Mr = 14,500) and II (Mr = 7,000), based on their molecular sizes. Inhibitors I and II inhibited bovine trypsin stoichiometorically at an enzyme to inhibitor ratio of 2 and 1, respectively. Sequence analysis of these inhibitors indicated a high degree of homology and that inhibitors I had a duplicated structure of inhibitors II. They are highly homologous to double-headed proteinase inhibitors (Bowman-Birk inhibitors) of Leguminosae plants. Inhibitors II are the first example of single-headed inhibitor corresponding to one inhibitory domain of the Bowman-Birk type double-headed inhibitors, which suggests that inhibitors II are relic of an ancestral single-headed inhibitor before the gene-duplication that led to the formation of present-day Bowman-Birk type inhibitors. PMID- 3818573 TI - Studies on the methods for the determination of phosphorylation sites in highly phosphorylated peptides or proteins: phosphorylation sites of hen egg white riboflavin binding protein. AB - To determine the phosphate binding sites in hen egg white riboflavin binding protein (RBP), a highly phosphorylated peptide, which consisted of 23 amino acid residues including eight phosphoserines, was isolated from the tryptic digest of reduced and carboxymethylated RBP. The conditions of the beta-elimination addition reaction to convert phosphoserine residues in the peptide to cysteic acids, S-methylcysteines, alanines, and beta-methylaminoalanines (DL-alpha-amino beta-methylamino propionic acid) were examined. These converted peptides were purified by HPLC and subjected to Edman degradation. The results of Edman degradation indicated that the S-methylcysteine derivative of the peptide gave the most satisfactory result for determining the phosphate binding sites in the peptide. The phosphorylation sites of the peptide determined by the method mentioned above are as follows: His182-Leu-Leu-Ser185-Glu-Ser(P)-Ser(P)-Glu Glu190-Ser (P)-Ser(P)-Ser(P)-Met-Ser195(P)-Ser(P)-Ser(P)-Glu-Glu-. These studies indicated that the conversion of phosphoserines in phosphoproteins to S methylcysteines followed by Edman analysis was a useful method for the elucidation of the phosphorylation sites in phosphopeptides. PMID- 3818574 TI - Polymorphonuclear leukocyte-platelet interactions: acetylglyceryl ether phosphocholine-induced platelet activation under stimulation with chemotactic peptide. AB - A mixture of rabbit polymorphonuclear leukocytes (PMNs) and platelets at concentrations of 5 X 10(6) PMN and 3.5 X 10(8) platelets/ml Tyrode's solution was stimulated with the chemotactic peptide, formyl-methionyl-leucyl phenylalanine (FMLP). A micromolar concentration of FMLP elicited an immediate weak aggregation, followed by a strong aggregation with a time lag of about 1 min. Microscopic examination showed that the immediate aggregation was due to PMNs and the delayed one was more complex and involved platelets. The delayed aggregation was dependent upon the concentrations of both the PMNs and FMLP. The delayed aggregation was completely blocked by pretreatment of the PMN-platelet mixture with 8 microM CV-3988, a specific receptor antagonist of 1-alkyl-2-acetyl sn-glycero-3-phosphocholine (AGEPC), or by the application of platelets desensitized to AGEPC. The time course of AGEPC production by PMNs was well matched to that of the biphasic aggregation response. Furthermore, nordihydroguaiaretic acid inhibited both the AGEPC production by PMNs and the delayed aggregation in a similar dose-dependent manner. These result demonstrate that AGEPC, newly-generated by PMNs under FMLP-stimulation, is of primary importance in platelet aggregation in a PMN-platelet mixed system. PMID- 3818575 TI - Modulation of branched-chain 2-oxoacid dehydrogenase activity by adenine nucleotides in isolated rat liver mitochondria. AB - Feeding a 17.5% amino acid diet to rats results in inactivation of the hepatic branched-chain 2-oxoacid dehydrogenase complex. Reactivation occurs when preincubating mitochondria in the presence of 0.3 mM ATP, ADP, and AMP. The effect of AMP is assumed to be due to de novo formation of ADP. NaF (25 mM) blocks reactivation suggesting the involvement of a protein phosphatase in the activation process. At high nucleotide concentrations (3 mM) the enzyme is inactive. In the presence of Mg2+ ions nucleotide induced activation is further increased. Mg2+ ions themselves influence the equilibrium state of the enzyme complex. Low concentrations (1 mM) favor inactivation while high concentrations (10 mM) stimulate activation of the enzyme suggesting that Mg2+ ions may act by regulating the associated kinase and phosphatase. PMID- 3818576 TI - Purification and general properties of a metal-insensitive lipase from Rhizopus japonicus NR 400. AB - Lipase [triacylglycerol lipase, EC 3.1.1.3] has been purified to homogeneity from Rhizopus japonicus NR 400 by chromatography on hydroxylapatite, octyl-Sepharose and Sephacryl S-200. It showed a molecular weight of about 30,000 by SDS-PAGE and a specific activity of 68,900 units/mg protein. The enzyme catalyzed the hydrolysis of tricapryn and tricaprylin rapidly in comparison with other triglycerides. This lipase had an optimum pH of around 5, and albumin enhanced its activity between pH 3 and 8. The composition of fatty acids liberated from linseed oil by the lipase was similar to that in the case of pancreatic lipase. The lipase activity was not affected by the addition of 1 mM metal ions or bile salts. Stimulation of the lipase activity was observed upon addition of albumin to the reaction mixture. Immunotitration experiments were also performed with antibodies raised against the purified lipase. PMID- 3818577 TI - Analyses of prealbumin mRNAs in individuals with familial amyloidotic polyneuropathy. AB - The distribution of prealbumin mRNA in various tissues of a control subject and an individual with familial amyloidotic polyneuropathy (FAP) was investigated using a cloned human prealbumin cDNA as a probe. Prealbumin mRNAs were detected in the total RNAs from liver and choroid plexus of brain, but not in those from brain, heart, kidney, and thyroid gland. The level of prealbumin mRNA in the choroid plexus was about 100-fold higher than that in the liver. We detected no differences in the sizes of prealbumin mRNAs in the liver and choroid plexus of the control subject, or in those of the individual with FAP, and found that the prealbumin mRNAs in these tissues had been transcribed from a common transcription initiation site. The levels of prealbumin mRNAs in the livers of four control subjects and those of six individuals with FAP were much the same. Because all the individuals with FAP so far examined were heterozygous for the prealbumin gene, carrying one normal and one mutant gene, the levels of the normal and mutant prealbumin mRNAs in the liver and the brain tissue containing choroid plexus were separately estimated and were found to be approximately equal. PMID- 3818578 TI - Effects of NaCl and glycerol on photosynthetic oxygen-evolving activity with thylakoid membranes from halophilic green alga Dunaliella tertiolecta. AB - It is known that the halophilic green alga Dunaliella tertiolecta grows under hypertonic conditions (with NaCl), which induce the intracellular accumulation of high concentrations of glycerol in order to counterbalance the osmotic change. The effects of NaCl and glycerol on the photosynthetic oxygen-evolving activity of thylakoid membranes prepared from D. tertiolecta were investigated in relation to the dissociation of the membranes. It was found that proteins with Mr of 24,000, 17,000, and 13,000 were dissociated from thylakoid membranes of D. tertiolecta by washing with 1 M NaCl, whereas the photosynthetic oxygen-evolving activity was stimulated 2-fold by 0.1-1.5 M NaCl. The antibodies against spinach 24K and 17K proteins did not cross-react with Dunaliella 24K and 17K proteins, respectively. The salt-tolerant feature of the oxygen-evolving activity with Dunaliella thylakoid membranes may be related to the difference of the properties of these two proteins between D. tertiolecta and spinach. When the membranes were washed with 1 M Tris, proteins with Mr of 50,000 and 31,000 were also dissociated in addition to the 24K and 17K proteins described above. The antibody against spinach 33K protein cross-reacted with 31K protein of D. tertiolecta, showing that Dunaliella 31K protein corresponds to spinach 33K protein. When the membranes were treated with a mixture of 1% cholate and 2% deoxycholate, the oxygen-evolving activity was completely depressed, but the depressed activity was significantly restored by organic solvents. Glycerol and dimethylsulfoxide were the most effective for the restoration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3818579 TI - Processing-independent in vitro translocation of cytochrome P-450(SCC) precursor across mitochondrial membranes. AB - In the presence of a membrane-permeable metal chelator, bovine adrenal cortex mitochondria imported P-450(SCC) precursor without processing of the amino terminal extension peptide. The imported precursor was bound to the matrix side surface of the inner membrane. When the inhibition due to the metal chelator was removed, the imported precursor was processed to the mature form. Unprocessed precursor was also detected in mitochondria when the import reaction was carried out at relatively low temperature. These results suggest that the translocation of P-450(SCC) precursor across mitochondrial membranes is independent of its processing to the mature form. Both membrane-bound and solubilized P-450(SCC) could be cleaved by trypsin into two fragments with molecular weights of 29 kDa and 26 kDa, respectively, suggesting a two-domain structure of the molecule. The in vitro-imported and processed P-450(SCC) was also cleaved by trypsin in the same way. This finding indicated that the in vitro-imported and processed P 450(SCC) has the same conformation as the native form. PMID- 3818580 TI - Structures of the carbohydrate chains of membrane glycoproteins IIb and IIIa of human platelets. AB - Human platelet membrane glycoproteins IIb (GPIIb) and IIIa (GPIIIa), which have been proposed to be subunits of a receptor for fibrinogen, were purified from Triton X-100-solubilized platelet membranes by affinity chromatography on a concanavalin A (Con A)-Sepharose column followed by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Compositional analyses of the purified glycoproteins showed that GPIIb and GPIIIa contain 15% and 18% carbohydrate by weight, respectively, which consists of galactose, mannose, glucosamine, fucose, and sialic acid. This suggested that these glycoproteins contained N-linked carbohydrate chains. The carbohydrate chains were released from each glycoprotein by hydrazinolysis and then fractionated by ion-exchange chromatography on a Mono Q column. From each glycoprotein, mono-, di-, and trisialylated and neutral oligosaccharide fractions were obtained. The structures of these oligosaccharides were investigated by means of compositional and methylation analyses and digestion by exoglycosidase, and their reactivities to immobilized lectins were also examined. The neutral oligosaccharides, which comprised about 14% of the total oligosaccharides released from GPIIb and about 52% of that from GPIIIa, were found to be of the high mannose-type, in that they contained 5 or 6 mannose residues. On the other hand, a major part of the acidic oligosaccharides was found to consist of typical bi- and triantennary complex type sugar chains, and much smaller amounts of tetraantennary complex-type sugar chains, and complex-type sugar chains with a fucosyl residue at a N acetylglucosamine residue in the peripheral portion or a bisecting N acetylglucosamine at a beta-mannosyl residue in the core portion were also detected. In conclusion, we found that GPIIb contained mainly complex-type sugar chains, whereas high mannose-type sugar chains were the predominant carbohydrate units in GPIIIa, and that the detected differences in the carbohydrate moieties of GPIIb and GPIIIa were quantitative but not qualitative. PMID- 3818581 TI - Structure of the carboxyl-terminal half of human alpha 2-plasmin inhibitor deduced from that of cDNA. AB - A 1.7 kilobase cDNA clone isolated from a human liver cDNA library contained 822 nucleotides encoding the carboxyl-terminal 274 amino acid sequence of alpha 2 plasmin inhibitor, a stop codon and a 3' noncoding region of 0.9 kilobases. The amino acid sequence deduced from the cDNA shows 29-31% homology with those of other plasma protease inhibitors. The inhibitor's putative reactive-site peptide bond was Met-Ser, and the Met residue was located at the 91st position from the carboxyl-terminal end. The plasminogen binding site was located in the carboxyl terminal region. PMID- 3818582 TI - Thrombospondin interaction with fibrinogen. Evidence for binding to the A alpha- and B beta-chains of fibrinogen. AB - Platelet thrombospondin interacts with fibrinogen in a specific and saturable manner. Thrombospondin was found to specifically bind to the A alpha- and B beta chains of fibrinogen; binding was independent of divalent ions. Binding could be blocked either by preincubation of thrombospondin with 9.4 microM fibrinogen or by preincubation of fibrinogen with 1.1 nM thrombospondin. Thrombospondin bound only to the beta-chain component of the D and DD plasmin fragment of fibrinogen. Thrombospondin interaction with fibrinogen was not blocked by preincubation with synthetic peptides which have previously been identified as either the fibrinogen receptor (alpha 572-575, the synthetic tetrapeptide arginyl-glycyl-aspartyl serine) or cell attachment (gamma 400-411) domains. Fibrinogen, therefore, possesses at least two unique and distinct sites, within the A alpha- and B beta chains, for its interaction with thrombospondin. PMID- 3818583 TI - Membrane penetration of bovine factor V and Va detected by labeling with 5 iodonaphthalene-1-azide. AB - The membrane-binding properties of Factor V and Factor Va were investigated using the lipophyllic, photoactivable probe 5-[125I]iodonaphthalene-1-azide. In the presence of vesicles composed of 75% phosphatidylcholine and 25% phosphatidylserine, both Factor V and Va were found to be labeled by the probe. The label was almost exclusively localized to the carboxyl-terminal-derived component E of Factor Va. The results are consistent with the interpretation that component E is the membrane binding subunit of Factor Va and that the interaction between Factor V or Factor Va and the membrane involves the penetration of the protein into the lipid bilayer. PMID- 3818584 TI - Purine 8-bromination modulates the ribonuclease L binding and activation abilities of 2',5'-oligoadenylates. Possible influence of glycosyl torsion angle. AB - Analogs of the 2',5'-linked adenylate trimer diphosphate (pp5'A2'p5'A2'p5'A or 2 5A) containing 8-bromoadenosine in the first, second, third, first and third, or second and third nucleotide positions (from the 5' terminus) were synthesized and found to vary dramatically in their ability to bind to and activate the RNase L of mouse L cells. Whenever the 8-bromoadenosine residue was substituted for adenosine in the first or 5'-terminal residue, there resulted a marked decrease in ability to bind to the 2-5A-dependent endonuclease. A similar result was obtained when the second adenosine nucleotide was replaced by 8-bromoadenosine. To the contrary, all analogs that bore an 8-bromoadenosine (br8A) in the third or 2'-terminal position were bound about as well as parent 2-5A to RNase L. Additionally, the 5'-diphosphate pp5'A2'p5'A2'p5' (br8A) was 10 times more effective than 2-5A as an inhibitor of translation. An increase in stability could not explain this significantly enhanced ability since the 2'-terminally brominated analog showed a similar half-life to 2-5A itself. Finally of particular interest was the analog monophosphate p5'A2'p5'(br8A)2'p5'(br8A) which possessed nearly 10% of the translational inhibitory activity of 2-5A triphosphate itself. These results suggest that changes in the base-sugar torsion angles of 2-5A may modulate both binding to and activation of mouse L cell RNase L. PMID- 3818585 TI - Purification and characterization of the potent endonuclease in extracts of bovine heart mitochondria. AB - A potent endonuclease identified in a crude fraction of soluble proteins from bovine heart mitochondria has been purified 2500-fold and partially characterized. Physical studies of the enzyme indicate a Stokes radius of 30.3 A and a sedimentation coefficient, S20 degrees, w, of 4.1 yielding a native molecule weight of 59,000 and a frictional coefficient of 1.2. Analysis of extensively purified fractions by sodium dodecyl sulfate-polyacrylamide gel electrophoresis reveals a major band at 29,000 Da accounting for 50% of the total protein and suggesting a dimeric subunit structure. The endonuclease maintains two distinct pH optima: pH 5.1-5.5 and 7-8. Both acid and neutral activities nick supercoiled M13 circular double-stranded replicative form I DNA and fragment single-stranded DNA templates to generate 5'-phosphoryl-3'-hydroxyl breaks. The endonuclease requires a divalent cation (preferring Mn2+ over Mg2+) and is sensitive to N-ethylmaleimide and moderate levels of salt. Analysis of the digestion products of double-stranded DNA after prolonged nuclease treatment yields a mixture of oligonucleotides, 13% of which are di- and trinucleotides. Despite the enzyme's ability to degrade DNA to oligonucleotides under some conditions, a strikingly nonrandom pattern of cleavage is observed when a restriction fragment composed of bovine D-loop DNA is used as a template. In this case, a strong preference for guanine tracts is seen. PMID- 3818586 TI - Transfer of recA protein from one polynucleotide to another. Kinetic evidence for a ternary intermediate during the transfer reaction. AB - We have analyzed the transfer kinetics of recA protein from one polynucleotide to another by monitoring the change in fluorescence of a modified single-stranded M13 DNA, referred to as etheno M13 DNA, that accompanies recA protein dissociation. The observed rate of transfer is dependent on the concentration of competitor polynucleotide, polythymidylic acid (poly(dT]; increasing the poly(dT) concentration increases the rate of transfer. These data are inconsistent with the rate-limiting step in the transfer mechanism occurring by a simple dissociation process. Under certain conditions, the apparent rate constant displays plateau behavior at high poly(dT) concentrations. This result is indicative of transfer occurring through a ternary intermediate including etheno M13 DNA and poly(dT). The transfer reaction was found to occur through two kinetically distinct species of transferring recA protein X DNA complexes. The relative amounts of these two species was affected by both the MgCl2 and protein concentration, suggesting that the two kinetic components reflect different aggregation states of the recA protein X DNA complex. Because etheno M13 DNA and poly(dT) contain no complementary sequences, we have concluded that recA protein has the intrinsic ability to form a kinetic ternary intermediate with two separate single-stranded DNA molecules in the absence of homology. PMID- 3818587 TI - Transfer of recA protein from one polynucleotide to another. Effect of ATP and determination of the processivity of ATP hydrolysis during transfer. AB - The transfer of recA protein from a fluorescently modified single-stranded DNA, containing 1,N6-ethenoadenosine and 3,N4-ethenocytosine, to polydeoxythymidylic acid (poly(dT)) was shown to occur by a complex mechanism in both the absence and presence of ADP (Menetski, J. P., and Kowalczykowski, S. C. (1987) J. Biol. Chem. 262, 2085-2092). A part of the mechanism involves the formation of a kinetic ternary intermediate. Since the binding and hydrolysis of ATP by recA protein is involved in many of the recA protein in vitro activities, we have analyzed the effect of ATP on the transfer reaction. In the presence of ATP, the transfer reaction is dependent on the concentration of the competitor single-stranded DNA, poly(dT). This result suggests that transfer does not occur by a simple dissociation mechanism. The reaction occurs via two kinetically distinct species of protein X DNA complexes with properties that are similar to those characterized for the transfer reaction in the absence of ATP. There is a complicated effect of nucleotide concentration on the rate of transfer. At low concentrations of ATP (less than 50 microM), increasing nucleotide concentration increases the rate of transfer; this is similar to the effect of ADP. However, at high concentrations of ATP (greater than 50 microM), increasing ATP concentration decreases the rate of transfer. Finally, the processivity of ATP hydrolysis during transfer was found to increase with increases in ATP concentration. Less than one ATP molecule was hydrolyzed per transfer event at low ATP concentrations (less than 20 microM) while greater than 50 molecules were hydrolyzed at high ATP concentration (greater than 250 microM). These data suggest that the rate of transfer is not directly coupled to the rate of hydrolysis. PMID- 3818588 TI - Fibronectin gene expression in polymorphonuclear leukocytes. Accumulation of mRNA in inflammatory cells. AB - Using a fibronectin cDNA probe, we have studied the accumulation of fibronectin mRNA in polymorphonuclear leukocytes (PMN) in response to inflammation. Nonactivated PMN from human peripheral blood were used as a source of noninflammatory cells and PMN from inflamed knee joints of patients with chronic inflammatory joint disorders (rheumatoid and psoriatic arthritis) were used as a source of inflammatory cells. By dot blot and Northern hybridization analysis, we have found the presence of fibronectin mRNA in these cells. Its size was estimated at approximately equal to 8.7-8.8 kilobases. When noninflammatory PMN were compared to inflammatory PMN in terms of fibronectin mRNA accumulation, a marked increase was found in inflammatory cells (2- to 12.7-fold stimulation). It was also observed that the increased mRNA levels in inflammatory PMN lead to increased synthesis of the protein. These findings establish that PMN are part of the fibronectin-producing cells and that the level of mRNA in these cells is influenced by the inflammatory process. PMID- 3818589 TI - Acylation of endogenous myelin proteolipid protein with different acyl-CoAs. AB - Fatty acyltransferase activity that catalyzes the transfer of palmitic acid from palmitoyl-CoA to the endogenous myelin proteolipid protein has been demonstrated in isolated rat brain myelin. Optimum enzyme activity for the acylation of proteolipid protein was obtained in 0.1% Triton X-100, 2 mM MgCl2, and 1 mM dithiothreitol at a pH of 7.5 and at 37 degrees C. Other detergents had little or no effect on the reaction whereas acylation was completely abolished by sodium dodecyl sulphate (0.1%). Pulse-chase experiments indicated that the reaction involves the net addition of fatty acid to the protein and not a rapid fatty acid exchange. The rate of acylation was linear up to 30 min, indicating that the concentration of endogenous protein acceptor was constant. Under these conditions and at short time periods, the enzyme activity versus acyl-CoA concentration showed a hyperbolic curve. The apparent Km and Vmax for palmitoyl-CoA was 41 microM and 115 pmol/mg protein/min. Similar values were obtained for stearoyl and oleoyl-CoA, whereas myristoyl-CoA showed a lower specificity for the enzyme. The acyl-CoA specificity was also studied in competition experiments using several saturated and unsaturated fatty acid-CoAs. The product of the reaction was identified as myelin proteolipid protein and the fatty acid was shown to be attached to the protein via an ester linkage. Limited proteolysis and peptide mapping showed that the same sites on the proteolipid protein were acylated when the reaction was carried out in isolated myelin preparations or in brain tissue slices, suggesting physiological importance for the in vitro acylation of endogenous myelin proteolipid protein. PMID- 3818590 TI - Interaction of the alpha-toxin of Staphylococcus aureus with the liposome membrane. AB - When the liposome membrane is exposed to the alpha-toxin of Staphylococcus aureus, fluorescence of the tryptophan residue(s) of the toxin molecule increases concomitantly with the degree of toxin-hexamer formation (Ikigai, H., and Nakae, T. (1985) Biochem. Biophys. Res. Commun. 130, 175-181). In the present study, the toxin-membrane interaction was distinguished from the hexamer formation by the fluorescence energy transfer from the tryptophan residue(s) of the toxin molecule to the dansylated phosphatidylethanolamine in phosphatidylcholine liposome. Measurement of these two parameters yielded the following results. The effect of the toxin concentration and phospholipid concentration on these two parameters showed first order kinetics. The effect of liposome size on the energy transfer and the fluorescence increment of the tryptophan residue(s) was only detectable in small liposomes. Under moderately acidic or basic conditions, the fluorescence energy transfer always preceded the fluorescence increment of the tryptophan residue(s). The fluorescence increment at 336 nm at temperatures below 20 degrees C showed a latent period, whereas the fluorescence energy transfer did not. These results were thought to indicate that when alpha-toxin damages the target membrane, the molecule interacts with the membrane first, and then undergoes oligomerization within the membrane. PMID- 3818591 TI - Assembly of the alpha-toxin-hexamer of Staphylococcus aureus in the liposome membrane. AB - It has been shown that the access of the alpha-toxin of Staphylococcus aureus to the target membrane and assembly of the hexamer can be monitored independently by respectively measuring the fluorescence energy transfer from the tryptophan residue(s) of the toxin to the dansylated phosphatidylethanolamine in the liposome membrane and the fluorescence increment of the toxin at 336 nm (Ikigai, H., and Nakae, T., (1987) J. Biol. Chem. 262, 2150-2155). Measurement of these parameters under various conditions showed the following results: when phosphatidylcholine (PC) liposomes composed of saturated fatty acids were mixed with the toxin, the fluorescence energy transfer occurred below, at, and above the transition temperature of the lipid, but the change of fluorescence at 336 nm was never detectable; when PC-liposomes containing unsaturated fatty acids were used, both the fluorescence energy transfer and the fluorescence increment of 336 nm were observed. These results suggested that the toxin-membrane interaction occurs in PC-membranes containing saturated and/or unsaturated fatty acids and that the oligomerization occurs only in the presence of PC containing unsaturated fatty acid(s). This conclusion was supported by the results of quantitative determination of the toxin-hexamer assembly and leakage of carboxyfluorescein from PC-liposomes under conditions similar to the above. PMID- 3818592 TI - A growth inhibitory protein secreted by human diploid fibroblasts. Partial purification and characterization. AB - We have identified and partially purified a growth inhibitor protein secreted by human diploid fibroblast cells. This protein is not secreted constitutively but only after induction with the double stranded hetero duplex polyriboinosinic:polyribocytidylic acid. The growth inhibitory activity has been purified 3,800-fold and has an estimated molecular mass of 12,000 daltons. The protein will inhibit the growth in culture of human diploid fibroblast cells, human cells derived from tumors, and mouse L cells. Although interferon-beta is secreted with the growth inhibitory protein, the partially purified growth inhibitory protein has no antiviral activity, and its activity is not neutralized by antibodies to interferon-alpha, interferon-beta, and interferon-gamma. We believe this growth inhibitory activity to reside in a newly defined protein and have named it fibroblast-derived growth inhibitor. PMID- 3818593 TI - Purification and characterization of eukaryotic initiation factor 2 and a guanine nucleotide exchange factor from rat liver. AB - Two polypeptide chain initiation factors, eukaryotic initiation factor 2 (eIF-2) and guanine nucleotide exchange factor (GEF), were isolated from rat liver. Two forms of eIF-2 were identified, one contained three subunits (alpha, beta, and gamma), and the other contained only the alpha- and gamma-subunits. The three subunit form was similar to eIF-2 from rabbit reticulocytes with respect to the sedimentation coefficient, Stokes radius, molecular weight of the alpha- and gamma-subunits, ability to restore protein synthesis in hemin-deficient reticulocyte lysate, and immunological cross-reactivity of the alpha-subunits using antibodies against liver eIF-2. In contrast, the beta-subunits of the liver and reticulocyte factors were distinct; they had different molecular weights, and antibodies against rat liver eIF-2 beta did not recognize the beta-subunit of the reticulocyte factor. Furthermore, the GDP dissociation constant for reticulocyte eIF-2 was more than twice that of the liver factor. GEF from rat liver reversed GDP inhibition of the ternary complex assay and catalyzed the exchange of eIF-2 bound GDP for free GDP or GTP, characteristics ascribed to the corresponding protein from rabbit reticulocytes. However, its subunit composition and molecular weight were different from those reported for reticulocyte GEF. The T1/2 for GDP exchange mediated by GEF was about 5-fold slower with two-subunit than with three subunit eIF-2. In addition, the KD for GDP was lower for two-subunit than for three-subunit eIF-2 when GEF was present. Taken together, these data demonstrate species-associated variability in the beta-subunit of eIF-2 and suggest a crucial role for the beta-subunit in the functional interaction of eIF-2 and GEF. PMID- 3818594 TI - Protein kinase C in fibroblasts. Characteristics of its intracellular location during growth and after exposure to phorbol esters and other mitogens. AB - Using an N-bromosuccinimide cleavage fragment of histone H1 as a relatively specific substrate for protein kinase C, we evaluated the partitioning of this kinase activity between soluble and particulate cellular fractions in 3T3-L1 fibroblasts. In confluent, serum-deprived cells, protein kinase C activity was approximately equally divided between soluble and detergent-extractable particulate fractions; both rapidly growing and transformed cells appeared to contain higher levels of particulate enzyme activity. Soluble protein kinase C activity and immunoreactivity decreased to virtually undetectable levels after exposure of the cells to phorbol 12-myristate 13-acetate (PMA), associated with a commensurate increase in particulate kinase activity and immunoreactivity. In intact cells, PMA appeared to cause a shift of immunoreactive protein kinase C from the cytosol to the perinuclear region, as assessed by immunofluorescent microscopy; however; subcellular fractionation revealed that PMA caused increases in the protein kinase C activity associated primarily with non-nuclear membranes. Exposure of the cells to sn-1,2-dioctanoylglycerol resulted in a modest and transient membrane association of protein kinase C, whereas platelet-derived growth factor, fibroblast growth factor, and bombesin caused no detectable increases in the membrane association of the kinase. Activation of protein kinase C by growth factors in fibroblasts may occur without the gross disturbances in intracellular kinase location which occur in response to phorbol esters. PMID- 3818595 TI - Effect of low pH on the conformation of Pseudomonas exotoxin A. AB - Previously we examined factors involved in the entry mechanism of Pseudomonas exotoxin A (PTx) at the level of lipid-protein interactions (Farahbakhsh, Z. T., Baldwin, R. L., and Wisnieski, B. J. (1986) J. Biol. Chem. 261, 11404-11408). Exposure to a low pH environment appears to be an obligatory trigger of the entry pathway. In this report we describe the effect of pH upon the conformation of PTx. We have found that the intrinsic fluorescence of PTx is strongly dependent on pH, decreasing between pH 7.4 and 4.0 with a red shift in the emission lambda max. The changes are reversible and associated with the acquisition of a binding site for the fluorescent dye 1-anilino-8-naphthalenesulfonic acid (ANS). The fluorescence intensity of ANS in the presence of PTx increases with decreasing pH and is accompanied by a blue shift in emission spectra, indicative of exposure of hydrophobic surfaces. These changes are also reversible. Both the intrinsic fluorescence and ANS binding profiles show a dramatic dependence on pH, with the transitions centered on pH 5.0 and 4.5, respectively. Circular dichroism studies reveal a 9% decrease in alpha-helicity between pH 7.7 and 4. The susceptibility of toxin to trypsin cleavage is also a function of pH, increasing with decreasing pH. The pH 7.4 cleavage profile is regained when the acid-treated samples are brought back to pH 7.4. The conformational changes observed in these pH shift experiments are likely to be physiologically significant because the conditions closely resemble those that the toxin would encounter if entry into the cytoplasm of a cell involves escape from an endosomal compartment. PMID- 3818596 TI - Purification and characterization of a human plasma cholesteryl ester transfer protein. AB - The cholesteryl ester transfer protein (CETP) binds to plasma lipoproteins and promotes transfer of cholesteryl esters between the lipoproteins. CETP has been purified 55,000-fold, with a 27% recovery of activity, from the d greater than 1.21 g/ml fraction of human plasma. In the final purification step, partially purified CETP is incubated with a synthetic lipid emulsion consisting of phosphatidylcholine, triglyceride, and fatty acid, and the bound activity, which elutes in the void volume, is separated from nonbound proteins by gel filtration on Sepharose 4B. Sodium dodecyl sulfate-gel analysis of fractions containing bound activity shows the presence of a single protein with an apparent Mr of 74,000. Inclusion of fatty acid in this emulsion was required to prevent the binding of a contaminant protein. However, incubation of CEPT with fatty acid emulsions containing lipid peroxides resulted in substantial inactivation and covalent degradation of the 74-kDa protein. This could be prevented by the inclusion of antioxidants during preparation of the emulsion. Solvent extraction of emulsion-bound CEPT gave a delipidated, active preparation. Purified IgG from a rabbit immunized with the 74-kDa protein completely removed activity from partially purified fractions. Amino acid analysis of the purified protein showed it to contain an unusually high content (45%) of nonpolar residues; the calculated hydrophobicity was greater than that of any other plasma apolipoprotein. These results show human CETP to be a unique plasma apolipoprotein with an apparent Mr of 74,000 which is hydrophobic, self associating, and susceptible to covalent degradation by lipid peroxides. PMID- 3818597 TI - Domain structure and phosphorylation of protein kinase C. AB - The phospholipid- and calcium-dependent protein kinase C has been shown to autophosphorylate on both the catalytic and the regulatory domains. The autophosphorylation displays zero-order kinetics, indicating that it is an intramolecular event. Autophosphorylation increases the activity of protein kinase C by decreasing the Km for the substrate H1 histone. The catalytic fragment obtained by limited proteolysis can no longer autophosphorylate and has a reduced affinity for H1 histone, exhibiting a Km 5-fold higher than that of the intact enzyme. Monoclonal antibodies produced against the enzyme can distinguish between the catalytic fragment and the intact enzyme by inhibiting their activities in a specific manner. Evidence suggesting that dimerization of protein kinase C occurs upon activation is presented. PMID- 3818598 TI - Differing utilization of homologous transcription initiation sites of rat K and T kininogen genes under inflammation condition. AB - Two types of rat kininogen mRNAs exhibit marked differences in the regulation of their expressions. The two T kininogen (T) mRNAs considerably increase under acute inflammation conditions, although no such increase occurs in the high molecular weight and low molecular weight K kininogen (K) mRNAs encoded by the same gene. This investigation examines the sequences of the 5' portions of the K and the two T genes and analyzes transcription initiation sites and their utilization at differently regulated conditions of the K and T genes. The sequence analysis indicates that the K and the two T genes are extremely homologous at the 5' portions as well as the 5'-flanking regions of at least 1.0 kilobase pairs. The S1 nuclease and primer extension analyses show that both T and K mRNAs start with three sets of the homologous initiation sites, and the utilization of the two 3'-side initiation sites of the T genes markedly increases under inflammation conditions. In contrast, no such elevation is observed for the three initiation sites of the K gene. Thus, although the sequences involved as transcription initiation sites are extremely homologous, their utilizations in the expressions of the K and T genes are regulated differently under inflammation conditions. PMID- 3818599 TI - The covalent tagging of the cell surface insulin receptor in intact cells with the generation of an insulin-free, functional receptor. A new approach to the study of receptor dynamics. AB - A new method is described in which the cell surface insulin receptor can be radioactively tagged in a specific manner with a small insulin-free probe. After protecting the amino groups of insulin essential for binding and bio-activity, insulin is coupled to the heterobifunctional, cleavable cross-linking reagent SASD (sulfosuccinimidyl 2-(p-azidosalicylamido)-1,3'-dithiopropionate), via displacement of the N-hydroxysuccinimide moiety of SASD. Removal of the protecting groups results in the formation of 2-(p-azidosalicylamido)-1,3' dithiopropionate (ASD)-insulin with insulin receptor binding activity equivalent to unmodified insulin. Iodination of ASD-insulin results in the incorporation of 125I into both the azidohydroxybenzoyl moiety of SASD and a tyrosine residue of insulin. Following binding of 125I-ASD-insulin to intact monolayers of 3T3-C2 cells, radiolabel is incorporated exclusively into a 135-kDa protein in a manner dependent upon the length of exposure of the cells to short wavelength ultraviolet light. This protein corresponds in molecular weight to the alpha subunit of the insulin receptor. Labeling of this protein can be inhibited by excess unlabeled insulin. Reduction of the disulfide bond of ASD with 10 mM glutathione causes the release of the 125I-insulin portion of the reagent from the receptor complex, with the iodinated photoactivated end of ASD covalently attached to the receptor. Insulin receptor labeled in this manner retains its ability to bind insulin. General metabolic processes of the intact cells do not appear to be perturbed by this labeling procedure, and the cellular processing of the insulin receptor does not appear to be modified by the covalent labeling of the receptor protein. This procedure therefore provides a way to specifically label the cell surface insulin receptor in a manner which does not perturb the normal functioning of the labeled cell and equally importantly, does not perturb the normal cellular processing of the insulin receptor itself. PMID- 3818600 TI - Human placenta estrogen synthetase (aromatase) purified by affinity chromatography. AB - Microsomal estrogen synthetase (cytochrome P-450ES), also known as aromatase, was purified from fresh human placenta microsomes by DEAE-Trisacryl and testosterone agarose chromatography. Estrogen synthetase assays were done with androstenedione as substrate, NADPH as electron donor, and a partially purified P-450 reductase from human placenta as the electron carrier. The specific cytochrome P-450 content of the purified P-450 was 0.67 nmol mg-1 of protein, and the preparation contained no cytochrome P-420. The absorbance maximum was 448.5 nm. The specific estrogen synthetase activity of the purified P-450ES fraction was 35 nmol min-1 nmol-1 of cytochrome P-450 or 23.3 nmol min-1 mg-1 of protein. The latter value shows a 179-fold purification with a yield greater than 1% in the two-step procedure. Kinetic constants for the reaction were measured with androstenedione as the aromatizable substrate. The Km was 1.4 nM and the Vmax was 37 nmol min-1 nmol-1 of P-450. The purified enzyme aromatized androstenedione and testosterone at identical rates; androstenedione gave only estrone, and testosterone gave only estradiol-17 beta. Dehydroepiandrosterone was not detectably aromatized or otherwise metabolized. Neither 16 alpha-hydroxytestosterone nor 16 alpha hydroxyandrostenedione was aromatized. No hydroxysteroid dehydrogenase or reductase was detected in direct assays. No free reaction intermediates were detected in aromatization assay incubation mixtures. The purity of the product and the simplicity of the preparation recommend it for use in further studies of the enzyme. PMID- 3818601 TI - The molecular basis of inhibitor resistance in a mammalian mitochondrial cytochrome b mutant. AB - The mitochondrial gene for the cytochrome b of Complex III has been cloned from a mouse L-cell mutant with increased resistance to 2-n-heptyl-4-hydroxyquinoline-N oxide and other inhibitors which block reactions at the b562 heme group. Nucleotide sequencing revealed that this gene contained a G:A transition on the coding strand at position 14,830. At the amino acid level, this mutation results in the substitution of an aspartic acid residue for a conserved glycine at position 231 of cytochrome b. Based upon current models for the secondary structure of cytochrome b, the altered amino acid lies in close proximity to one of the invariant histidine residues involved in binding the heme groups. Combining this result with the previous biochemical studies of this mutant, we hypothesize that the insertion of this highly charged side chain alters the conformation around the b562 heme group such that 2-n-heptyl-4-hydroxyquinoline-N oxide and the other inhibitors of this group have reduced access to the inhibitor binding domain. PMID- 3818602 TI - Inhibition of translation of mRNAs for ornithine decarboxylase and S adenosylmethionine decarboxylase by polyamines. AB - The effect of spermidine and spermine on the translation of the mRNAs for ornithine decarboxylase and S-adenosylmethionine decarboxylase was studied using a reticulocyte lysate system and specific antisera to precipitate these proteins. It was found that the synthesis of these key enzymes in the biosynthesis of polyamines was much more strongly inhibited by the addition of polyamines than was either total protein synthesis or the synthesis of albumin. Translation of the mRNA for S-adenosylmethionine decarboxylase was maximal in a lysate which had been substantially freed from polyamines by gel filtration. Addition of 80 microM spermine had no significant effect on total protein synthesis and stimulated albumin synthesis but reduced the production of S-adenosylmethionine decarboxylase by 76%. Similarly, addition of 0.8 mM spermidine reduced the synthesis of S-adenosylmethionine decarboxylase by 82% while albumin and total protein synthesis were similar to that found in the gel-filtered lysate. Translation of ornithine decarboxylase mRNA was greater in the gel-filtered lysate than in the control lysate but synthesis of ornithine decarboxylase was stimulated slightly by low concentrations of polyamines and was maximal at 0.2 mM spermidine or 20 microM spermine. Higher concentrations were strongly inhibitory with a 70% reduction occurring at 0.8 mM spermidine or 150 microM spermine. Further experiments in which both polyamines were added together confirmed that the synthesis of ornithine and S-adenosylmethionine decarboxylases were much more sensitive to inhibition by polyamines than protein synthesis as a whole. These results indicate that an important part of the regulation of polyamine biosynthesis by polyamines is due to a direct inhibitory effect of the polyamines on the translation of mRNA for these biosynthetic enzymes. PMID- 3818603 TI - Allosteric inhibition of methylenetetrahydrofolate reductase by adenosylmethionine. Effects of adenosylmethionine and NADPH on the equilibrium between active and inactive forms of the enzyme and on the kinetics of approach to equilibrium. AB - In this paper we report on the allosteric regulation of the dimeric flavoprotein methylenetetrahydrofolate reductase (E.C. 1.5.1.20) by the inhibitor, AdoMet, and by one of the substrates, NADPH. These metabolites play antagonistic roles in this regulation, with NADPH recruiting active forms of the enzyme and AdoMet recruiting inactive forms. At high NADPH concentrations, activity dependence on AdoMet is sigmoidal, indicating cooperativity. The kinetics of inhibition induced by AdoMet are slow enough to be studied by conventional methods and exhibit marked biphasicity. Both the extents and rates of these phases are again affected antagonistically by the ligands, AdoMet increasing the extent of the faster phase, and NADPH decreasing the extent of the faster phase and the rate of the slower phase. We present a model consistent with these observations. Our model postulates two states of the enzyme, R and T. NADPH and AdoMet exhibit antagonistic binding to a given subunit, so that occupancy by one ligand decreases or abolishes affinity for the other ligand. However, within a given state, the subunits do not interact with each other, so the ligation of one does not affect the affinities of its neighbor. R-T transitions occur between all similarly ligated states. The ligands have different affinities for the R and T states, and AdoMet binding to a given subunit is measurably slow. This model predicts the observed features of the equilibrium and kinetic data noted above. We also present a system for simulation of reaction schemes in which each step is pseudo first order that is fast and versatile enough to allow least squares fitting of microscopic rate constants to kinetic data. PMID- 3818604 TI - Reconstitution of muscarinic cholinergic inhibition of adenylate cyclase activity in homogenates of embryonic chick hearts by membranes of adult chick hearts. AB - We have previously demonstrated that during embryonic development of the chick heart between days 2 1/2 and 10 days in ovo, muscarinic cholinergic inhibition of isoproterenol-stimulated adenylate cyclase activity increased 4-fold, and the sensitivity of isoproterenol-stimulated adenylate cyclase activity to inhibition by carbamylcholine increased 26-fold. Although the number of muscarinic receptors remained constant between days 2 1/2 and 10 in ovo, the levels of a 39- and 41 kDa pertussis toxin substrate increased in parallel with the ability of muscarinic agonist to inhibit adenylate cyclase activity (Liang. B.T., Hellmich, M. R., Neer, E. J., and Galper, J. B. (1986) J. Biol. Chem. 261, 9011-9021). These data are consistent with the hypothesis that between days 2 1/2 and 10 in ovo muscarinic receptors were uncoupled from inhibition of adenylate cyclase activity because of limiting levels of pertussis toxin substrates. In the current studies, in order to test this hypothesis homogenates of embryonic chick hearts 3 1/2 days in ovo were reconstituted with membranes from hearts of hatched chicks. In order to rule out reconstitution by factors from hatched chick hearts other than pertussis toxin substrates, muscarinic receptors from hatched chick hearts were inactivated by covalent binding of benzilycholine mustard and adenylate cyclase inactivated by N-ethylmaleimide prior to reconstitution. Reconstitution of benzilylcholine mustard/N-ethylmaleimide treated hatched chick heart membranes with homogenates of embryonic chick hearts 3 1/2 days in ovo resulted in a 2 1/2 fold increase in the ability of carbamylcholine to inhibit adenylate cyclase activity and reconstitution of hatched chick heart membranes with homogenates of hearts 2 1/2 days in ovo resulted in an approximately 10-fold increase in the sensitivity of isoproterenol-stimulated adenylate cyclase activity to inhibition by carbamylcholine. Membranes from hearts of hatched chicks which had been injected with pertussis toxin were incapable of reconstituting muscarinic inhibition of adenylate cyclase activity in homogenates of hearts 3 1/2 days in ovo. These data support the conclusion that early in embryonic development coupling of muscarinic receptors to inhibition of adenylate cyclase activity is limited by the availability of a pertussis toxin substrate. PMID- 3818605 TI - Assignment of disulfide bonds in proteins by fast atom bombardment mass spectrometry. AB - A rapid and sensitive method for assignment of disulfide bonds using fast atom bombardment mass spectrometry is described for hen egg white lysozyme and bovine ribonuclease A. The protein is initially digested to a mixture of peptides using chemical and enzymatic methods under conditions which minimize disulfide bond reduction and exchange. The digested sample is analyzed directly by fast atom bombardment mass spectrometry before and after chemical reduction of cystine residues. An important feature of the method is that it is not necessary to completely resolve the peptides in the digest chromatographically prior to analysis. The disulfide-containing peptides are also characterized directly by prolonged exposure of the sample to the high energy xenon atom beam which results in the reduction of cystine residues. Intra- as well as interchain disulfide bond assignments are made on the basis of the mass difference between the molecular ions (MH+) of the oxidized and reduced peptides. Confirmation of the mass assignments may be obtained from the mass spectra of the digests after one cycle of manual Edman degradation. Although the quantity of protein required to unambiguously assign all of the disulfide linkages will depend on the ease with which the appropriate peptide fragments can be formed, results from these studies indicate that approximately 1 nmol of protein is usually sufficient. PMID- 3818606 TI - Mechanism and rate of permeation of cells by polycyclic aromatic hydrocarbons. AB - The principal mechanism of cellular uptake of benzo(a)pyrene and other polycyclic aromatic hydrocarbons (PAH) from lipoproteins into cells is spontaneous transfer through the aqueous phase (Plant, A. L., Benson, D.M., and Smith, L.C. (1985) J. Cell Biol. 100, 1295-1308). Cellular uptake of benzo(a)pyrene from low density lipoproteins followed first-order kinetics with a rate constant that was independent of the relative lipoprotein concentrations or cell number but which was 2 orders of magnitude smaller than the rate constant for benzo(a)pyrene desorption from low density lipoproteins. Moreover, identical rate constants for cellular uptake of benzo(a)pyrene were observed when the donor vehicle was high density lipoproteins, very low density lipoproteins, or single bilayer phosphatidylcholine vesicles, even though rate constants for benzo(a)pyrene transfer from these donor vehicles differed by 10-fold. When phosphatidylcholine vesicles containing benzo(a)pyrene and a nontransferable fluorescence quencher were mixed with cells in a stopped-flow system, two kinetic components were distinguished: a fast component with a rate constant corresponding to that measured for transfer of benzo(a)pyrene out of vesicles, followed by a much slower component, with a time course approximating that measured for cellular accumulation of benzo(a)pyrene by other techniques. Rate constants for desorption of a series of PAH which contained different number of aromatic rings from phosphatidylcholine vesicles differed over a 70-fold range. First-order rate constants for cell uptake of benzo(a)pyrene and five other PAH of different molecular sizes had the same 70-fold range of values, but were 2 orders of magnitude smaller than their respective rate constants for desorption from single bilayer vesicles. In addition, activation energies for cell uptake were essentially identical to the respective activation energies for desorption of PAH from phosphatidylcholine vesicles, confirming the mechanistic similarity of the two processes. PMID- 3818607 TI - 1,25-Dihydroxyvitamin D3 stimulates 45Ca2+ uptake by cultured adult rat ventricular cardiac muscle cells. AB - This study tested the hypothesis that 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) and its previously described cardiac receptors play roles in regulating intracellular calcium homeostasis in cardiac muscle cells. This question was addressed by assessing whether 1,25-(OH)2D3 influences 45Ca2+ uptake by homogeneous cultures of adult rat ventricular cardiac muscle cells. Twenty-four h prior to the measurement of 45Ca2+ uptake, the cells were transferred to serum-free medium ([Ca2+], 1.0 mM) containing 1.0 nM 1,25(OH)2D3 or vehicle. The cells were then incubated with 45Ca2+ for periods up to 60 min at room temperature, followed by removal of excess external 45Ca2+ by washing repeatedly with La3+. Pretreating the cells with 1,25-(OH)2D3 caused 3-fold stimulation (p less than 0.005) of 45Ca2+ uptake. Stimulation of 45Ca2+ uptake required a prolonged (8-12 h) exposure to 1,25-(OH)2D3, suggesting a receptor-mediated phenomenon. Concentrations of 0.01-10 nM 1,25-(OH)2D3 yielded a dose-response curve which peaked at 1.0 nM and decreased at higher concentrations. Steroid specificity was established by the failure of 1.0 nM levels of 25-hydroxyvitamin D3, estradiol-17 beta, and progesterone to change 45Ca2+ uptake. Sucrose gradient analysis confirmed the presence of a specific 3-4 S 3H-1,25-(OH)2D3 binding component both in freshly isolated and in cultured ventricular cardiac muscle cells. The stimulatory effect of 1,25-(OH)2D3 on 45Ca2+ uptake was abolished by the concomitant incubation of the cells with cycloheximide or actinomycin D, demonstrating a requirement for protein and nucleic acid synthesis. In conclusion, these data demonstrate that 1,25-(OH)2D3 stimulates 45Ca2+ uptake in adult ventricular cardiac muscle cells by a mechanism resembling a receptor mediated phenomenon. PMID- 3818608 TI - The calmodulin binding domain of chicken smooth muscle myosin light chain kinase contains a pseudosubstrate sequence. AB - Smooth muscle myosin light chain kinase contains a 64 residue sequence that binds calmodulin in a Ca2+-dependent manner (Guerriero, V., Jr., Russo, M. A., and Means, A. R. (1987) Biochemistry, in press). Within this region is a sequence with homology to the corresponding sequence reported for the calmodulin binding region of skeletal muscle myosin light chain kinase (Blumenthal, D. K., Takio, K., Edelman, A. M., Charbonneau, H., Titani, L., Walsh, K. A., and Krebs, E. G. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 3187-3191). Inspection of these sequences reveals that they both share a similar number and spatial arrangement of basic residues with those present in the myosin light chain substrate. We have synthesized a 22-residue peptide corresponding to residues 480-501 (determined from the cDNA) of the smooth muscle myosin light chain kinase. This peptide, Ala Lys-Lys-Leu-Ser-Lys-Asp-Arg-Met-Lys-Lys-Tyr-Met-Ala-Arg-Arg-Lys-Trp- Gln-Lys-Thr Gly, inhibited calmodulin-dependent activation of the smooth muscle myosin light chain kinase with an IC50 of 46 nM. At saturating concentrations of calmodulin, the 22-residue peptide inhibited myosin light chain and synthetic peptide substrate phosphorylation competitively with IC50 values of 2.7 and 0.9 microM, respectively. An 11-residue synthetic peptide analog, corresponding to part of the calmodulin-binding sequence in skeletal muscle myosin light chain kinase, Lys Arg-Arg-Trp-Lys-Lys-Asn-Phe-Ile-Ala-Val, also competitively inhibited synthetic peptide substrate phosphorylation with a Ki of 1 microM. The competitive inhibitory activity of the calmodulin binding regions is similar to the apparent Km of 2.7 microM for phosphorylation of the 23-residue peptide analog of the smooth muscle myosin light chain and raises the possibility that the calmodulin binding region of the myosin light chain kinase may act as a pseudosubstrate inhibitor of the enzyme. PMID- 3818609 TI - Isolation and characterization of a cDNA encoding a chick alpha-actinin. AB - We have isolated and sequenced a 2.1-kilobase cDNA encoding 86% of the sequence of alpha-actinin. The cDNA clone was isolated from a chick embryo fibroblast cDNA library constructed in the expression vector lambda gt11. Identification of this sequence as alpha-actinin was confirmed by immunological methods and by comparing the deduced protein sequence with the sequence of several CNBr fragments obtained from adult chicken smooth muscle (gizzard) alpha-actinin. The deduced protein sequence shows two distinct domains, one of which consists of four repeats of approximately 120 amino acids. This region corresponds to a previously identified 50-kDa tryptic peptide involved in formation of the alpha-actinin dimer. The last 19 residues of C-terminal sequence display an homology with the so-called E-F hand of Ca2+-binding proteins. Hybridization analysis reveals only one size of mRNA (approximately 3.5 kilobases) in fibroblasts, but multiple bands in genomic cDNA. PMID- 3818610 TI - The kinetics of bovine growth hormone folding are consistent with a framework model. AB - The framework model of protein folding requires the hydrogen-bonded secondary structure to be formed early in folding (i.e. the formation of secondary structure precedes the tertiary structure) (Kim, P. S., and Baldwin, R. L. (1982) Annu. Rev. Biochem. 51, 459-489). To test the framework model directly the kinetics of bovine growth hormone (bGH) folding were compared utilizing two methods of detection, one that measures the secondary structure (far ultraviolet circular dichroism) and another that measures the tertiary structure (near ultraviolet absorbance). The results demonstrate that, under identical folding conditions, the kinetics observed by far ultraviolet circular dichroism are faster than those observed by ultraviolet absorption. The faster kinetics observed by circular dichroism indicate the existence of a helix-containing intermediate which is consistent with the framework model. The effect of protein concentration and denaturant concentration on the kinetics of refolding were studied. The rate of refolding measured by absorbance and circular dichroism was dependent on protein concentration. The protein concentration dependence on refolding is due to the transient formation of an associated intermediate. The concentration dependence of folding is taken as evidence that folding is a sequential process with partially folded monomers responsible for the observed association effect. At dilute protein concentrations the refolding can be studied independent of the association phenomena. The growth hormones utilized in this study were derived from Escherichia coli through recombinant DNA technology and from bovine pituitaries. The pituitary-derived bGH has been shown to be heterogeneous at the NH2 terminus (Lorenson, M. F., and Ellis, S. (1975) Endocrinology 96, 833-838), whereas the recombinant DNA-derived bGH contains a single NH2 terminus. No differences in the folding kinetics between the recombinant DNA and pituitary derived-bGH were observed. It is concluded that the heterogeneity of the NH2 terminus of growth hormone obtained from bovine pituitaries does not affect the observed in vitro folding kinetics. PMID- 3818611 TI - Purification and characterization of a protein tyrosine kinase from bovine spleen. AB - Protein tyrosine kinase was purified extensively from a 30,000 X g particulate fraction of bovine spleen by a procedure involving four column chromatographies: DEAE-Sepharose, polyamino acids affinity, hydroxylapatite, and Sephacryl S-200 molecular sieving. The purification resulted in more than 3,000-fold enrichment in [Val5]angiotensin II phosphorylation activity (specific activity 202 nmol/min/mg). All column chromatography profiles showed single protein tyrosine kinase activity peaks with the exception of that of affinity chromatography, where about 50% of the enzyme activity appeared with the breakthrough fraction; only the bound enzyme was further purified. Analysis by sodium dodecyl sulfate polyacrylamide gel electrophoresis and autoradiography of a purified sample phosphorylated in the presence of [gamma-32P]ATP revealed the presence of a single phosphorylated polypeptide of molecular weight 50,000 which represents about 40% of total protein. Analysis by polyacrylamide gel electrophoresis under nondenaturing conditions showed that protein tyrosine kinase activity co-migrated with the phosphoprotein. Stoichiometry of the phosphorylation of the 50-kDa polypeptide was found to be 1.0 mol/mol. The purified sample did not appear to contain phosphotyrosine protein phosphatase activity. Both casein and histone could be phosphorylated by the purified sample, and the phosphorylation occurred only at tyrosine residue, suggesting that there was no protein serine and threonine kinase contamination. PMID- 3818612 TI - The primary structure of a new Mr 18,000 calcium vector protein from amphioxus. AB - The amino acid sequence of a new Ca2+-binding protein (CaVP) from Amphioxus muscle (Cox, J. A., J. Biol. Chem. 261, 13173-13178) has been determined. The protein contains 161 amino acid residues and has a molecular weight of 18,267. The N terminus is blocked by an acetyl group. The two functional Ca2+-binding sites have been localized based on homology with known Ca2+-binding domains, on internal homology and on secondary structure prediction, and appear to be the domains III and IV. The C-terminal half of CaVP, which contains the two Ca2+ binding sites, shows a remarkable similarity with human brain calmodulin (45%) and with rabbit skeletal troponin C (40%). Functional domain III contains 2 epsilon-N-trimethyllysine residues in the alpha-helices flanking the Ca2+-binding loop. Sequence determination revealed two abortive Ca2+-binding domains in the N terminal half of CaVP with a similarity of 24 and 30% as compared with calmodulin and troponin C, respectively. This half is also characterized by the presence of a disulfide bridge linking the N-terminal helix of domain I to the C-terminal helix of domain II. This disulfide bond is very resistant to reduction in the native state, but not in denatured CaVP. The optically interesting aromatic chromophores (2 tryptophan and 1 tyrosine residues) are all located in the nonfunctional domain II. PMID- 3818613 TI - Human hemoglobin cross-linked through the polyphosphate-binding site. Functional properties and evidence for conformers. AB - The properties of human hemoglobin reacted with 2-nor-2-formylpyridoxal 5' phosphate, a bifunctional derivative of pyridoxal 5'-phosphate, have been investigated both from an equilibrium and kinetic point of view. The experimental data, interpreted in terms of the two-state allosteric model, indicate that a perturbed R state is characteristic of this modified low ligand affinity hemoglobin. In flash photolysis experiments, a quickly reacting component is always observed, in spite of the lack of dissociation into free dimers; this kinetic behavior is thought to reflect the presence of functionally independent alpha beta dimers, still connected by the flexible cross-link but forming an open hemoglobin tetramer. Two possible models for the interpretation of the kinetics of CO and/or haptoglobin binding are presented and discussed. PMID- 3818614 TI - Identification of pyridoxine 3-sulfate, pyridoxal 3-sulfate, and N methylpyridoxine as major urinary metabolites of vitamin B6 in domestic cats. AB - Preliminary studies of vitamin B6 metabolism in three adult domestic cats detected very little pyridoxic acid in the urine. At oral doses of 49 to 490 mumol of [14C]pyridoxine hydrochloride, 50% of the excreted dose occurred as pyridoxine 3-sulfate and 25% as N-methylpyridoxine. The identity of these two metabolites was confirmed by isolation from urine and comparison with known compounds. A third compound was identified as pyridoxal 3-sulfate on the basis of chromatographic behavior and fluorescent properties before and after hydrolysis. At pyridoxine intakes of 0.97 mumol/day, the concentration of pyridoxal 3-sulfate in the urine sometimes exceeded the concentration of pyridoxine 3-sulfate. Pyridoxic acid remained a minor urinary metabolite at pyridoxine intakes ranging from 0.97 to 490 mumol/day. Although sulfation of phenol groups and methylation of the ring nitrogen are well-known detoxication reactions, this appears to be the first time such reactions have been observed in normal metabolism of vitamin B6. These observations provide further evidence of the diversity of vitamin B6 metabolism between species. While such diversity complicates the extrapolation of data from animal studies to humans, it does provide a variety of models for examining the influences of various factors on vitamin B6 metabolism. PMID- 3818615 TI - Molecular interactions between micellar polysialogangliosides and affinity purified tetanotoxins in aqueous solution. AB - Two-affinity purified tetanotoxin forms, TeToA and TeToB, with different affinities for gangliosides were characterized by analytical ultracentrifuge, circular dichroism (CD), and amino acid composition. Both toxin forms share a common sedimentation coefficient of about 6-7 S and similar alpha-helicity values, but they vary in amino acid composition. Incubation of TeToB with micellar polysialogangliosides results in formation of high (21-24 S) and medium (13-15 S) size toxin-micellar ganglioside aggregates as revealed by analytical ultracentrifuge technique. At TeToB/[N-acetylneuraminyl]-galactosyl-N acetylgalactosaminyl- [N-acetylneuraminyl-N-acetylneuraminyl] galactosylglucosylceramide (GT1b) molar ratios of greater than 26, high molecular weight aggregates (Mr greater than or equal to 700,000) which contain between 3 and 5 toxin monomers are formed, whereas at molar ratios less than 15, about 1-2 monomers are present. TeToA does not form aggregates in the presence of gangliosides. A marked increase in the alpha-helix from about 20 to 39% is apparent in the CD spectrum of TeToB after interaction with ganglioside mixture (G1b). Cerebrosides, sulfatides, sphingomyelin, and phosphatidylserine also increase the alpha-helix, presumably because of an overall effect of lipids on the protein. TeToA and fragment B but not C also undergo similar changes in the presence of G1b, suggesting that the effect of ganglioside is not specific. The polarity of the CD spectra of a number of gangliosides is shifted from a negative to a positive value after interaction with tetanotoxin. The data are consistent with the interpretation of a discrete hydrophobic domain on the toxin heavy chain which interacts with micellar gangliosides to form macromolecular complexes. PMID- 3818616 TI - Primary structure of an analog of crustacean pigment-dispersing hormone from the lubber grasshopper Romalea microptera. AB - An octadecapeptide capable of inducing pigment dispersion in the chromatophores of the fiddler crab Uca pugilator has been isolated from lyophilized heads of the lubber grasshopper Romalea microptera. This pigment-dispersing factor (PDF) was purified by gel filtration, ion-exchange chromatography, partition chromatography, and reversed-phase high performance liquid chromatography. Automated gas-phase sequencing, followed by the identification of the carboxyl terminal amide, established the primary structure of this PDF as Asn-Ser-Glu-Ile Ile-Asn-Ser-Leu-Leu-Gly-Leu-Pro-Lys-Leu-Leu-Asn-Asp-Ala- NH2. This structure was confirmed by chemical synthesis and by demonstrating that the synthetic and native PDF displayed identical chromatographic behavior and biological activity. The Romalea PDF is structurally related to the crustacean pigment-dispersing hormones (PDHs), which are also octadecapeptides. The sequence of grasshopper PDF shows 78% homology with beta-PDH (from the crabs U. pugilator and Cancer magister) and 50% homology with alpha-PDH (from the prawn Pandalus borealis). This study provides the first direct chemical evidence for the structural relatedness of insect PDF to the crustacean PDHs, thus identifying them as an authentic family of arthropod peptides. PMID- 3818617 TI - Precursor supply for insect juvenile hormone III biosynthesis in a cockroach. AB - The biosynthesis of the sesquiterpenoid juvenile hormone III (JH III) was studied using corpora allata of the cockroach Diploptera punctata incubated in vitro and a radiochemical assay for the hormone produced. The influence of several exogenous precursors such as glucose, trehalose, acetate, amino acids, and mevalonate on JH synthetic rates was studied. Glucose or trehalose were needed for an optimal rate of JH synthesis. Highest rates were achieved at trehalose concentrations below the normal hemolymph levels (35-40 mM). About one-third of the glucose utilized for the biosynthesis of JH III was metabolized through a pentose pathway, but acetyl-CoA derived from glucose was significantly diluted by acetyl-CoA from other sources. Amino acids provided both a source of carbon for JH III synthesis and a source of energy that allowed JH III synthesis from acetate and stimulated JH III synthesis from glucose. Acetate was a poor substrate, because it could not support JH III synthesis in long term incubations. The incorporation of exogenous mevalonate into JH III was dependent on the physiological state of the glands, but there was a significant dilution with endogenous mevalonate. This dilution reflected in part the poor penetration of mevalonate into the corpora allata cells, because JH synthesis in mevinolin treated cells was not fully rescued by mevalonate. PMID- 3818618 TI - Chronic ethanol administration impairs the binding and endocytosis of asialo orosomucoid in isolated hepatocytes. AB - We have examined the effect of ethanol administration on receptor-mediated endocytosis of asialo-orosomucoid by isolated hepatocytes. Significantly less ligand was bound, internalized, and degraded by hepatocytes isolated from rats fed an ethanol diet for 5-7 weeks than by cells isolated from chow-fed or pair fed controls. Reduced binding was shown to be primarily due to a decreased number of cell surface receptors rather than to a lowered affinity of the receptor for its ligand. This reduction in cell surface receptors resulted in a marked inhibition of internalization and degradation of ligand by hepatocytes from the ethanol-fed rats. In addition, a defect in the initial stages of receptor-ligand internalization was also indicated, since less surface-bound ligand was internalized and subsequently degraded in cells from the ethanol-treated animals as compared to controls. Rates of internalization and degradation of internalized ligand were, however, similar for all three groups, suggesting that neither degradation per se nor rate of delivery of internalized ligand to the lysosomes was affected by ethanol feeding. Receptor recycling was impaired in ethanol-fed rats, as indicated by a decrease in the binding site number after stimulation of endocytosis for 120 min when compared to initial binding capacity. Receptor recycling was not impaired in hepatocytes from control animals. These results indicate that chronic ethanol feeding impairs the process of receptor-mediated endocytosis by the liver; the major cause of this impairment appears to be due to a decreased number of cell surface asialoglycoprotein receptors in the ethanol fed animals, along with a decreased ability of these cells to internalize all of the surface-bound ligand. PMID- 3818619 TI - Acyl-CoA-independent esterification of retinol bound to cellular retinol-binding protein (type II) by microsomes from rat small intestine. AB - Cellular retinol-binding protein (type II) (CRBP(II)), a newly described retinol binding protein, is present in the small intestinal absorptive cell at high levels. Retinol (vitamin A alcohol) presented as a complex with CRBP(II) was found here to be esterified by microsomal preparations from rat small intestinal mucosa. The esterification observed utilized an endogenous acyl donor(s) and produced retinyl esters containing linoleate, oleate, palmitate, and stearate in a proportion quite similar to that previously reported for retinyl esters in lymph and isolated chylomicrons of rat. No dependence on endogenous or exogenous acyl-CoA could be demonstrated. The apparent Km for retinol-CRBP(II) in the reaction with endogenous acyl donor was 2.4 X 10(-7) M. Retinol presented as a complex with CRBP(II) was esterified more than retinol presented as a complex with cellular retinol-binding protein or retinol-binding protein, two other proteins known to bind retinol in vivo, but about the same as retinol presented bound to bovine serum albumin or beta-lactoglobulin. The ability of protein-bound retinol to be esterified was related to accessibility of the hydroxyl group, as judged by the ability of alcohol dehydrogenase to oxidize the bound retinol. However, whereas retinol bound to CRBP(II) was unavailable for esterification in any acyl-CoA-dependent reaction, retinol bound to bovine serum albumin was rapidly esterified in a reaction utilizing exogenous acyl-CoA. The results suggest that one of the functions of CRBP(II) is to accept retinol after it is absorbed or generated from carotenes in the small intestine and present it to the appropriate esterifying enzyme. PMID- 3818620 TI - Microcalorimetric investigation of the interactions in the ternary complex calmodulin-calcium-melittin. AB - Flow microcalorimetric titrations of calmodulin with melittin at 25 degrees C revealed that the formation of the high-affinity one-to-one complex in the presence of Ca2+ (Comte, M., Maulet, Y., and Cox, J. A. (1983) Biochem, J. 209, 269-272) is entirely entropy driven (delta H0 = 30.3 kJ X mol-1; delta S0 = 275 J X K-1 X mol-1). Neither the proton nor the Mg2+ concentrations have any significant effect on the strength of the complex. In the absence of Ca2+, a nonspecific calmodulin-(melittin)n complex is formed; the latter is predominantly entropy driven, accompanied by a significant uptake of protons and fully antagonized by Mg2+. Enthalpy titrations of metal-free calmodulin with Ca2+ in the presence of an equimolar amount of melittin were carried out at pH 7.0 in two buffers of different protonation enthalpy. The enthalpy and proton release profiles indicate that: protons, absorbed by the nonspecific calmodulin-melittin complex, are released upon binding of the first Ca2+; Ca2+ binding to the high affinity configuration of the calmodulin-melittin complex displays an affinity constant greater than or equal to 10(7) M-1, i.e. 2 orders of magnitude higher than that of free calmodulin; the latter is even more entropy driven (delta H0 = 7.2 kJ X site-1; delta S0 = 158 J X K-1 X site-1) than binding to free calmodulin (delta H0 = 4.7 kJ X site-1; delta S0 = 112 J X K-1 X site-1), thus underlining the importance of hydrophobic forces in the free energy coupling involved in the ternary complex. PMID- 3818621 TI - Rat testosterone 7 alpha-hydroxylase. Isolation, sequence, and expression of cDNA and its developmental regulation and induction by 3-methylcholanthrene. AB - A P-450, designated P-450a, with high testosterone 7 alpha-hydroxylase activity was purified from rat liver microsomes. Specific polyclonal antibody against this P-450 was used to screen a lambda gt11 expression cDNA library and a 1687-base pair cDNA was isolated and sequenced. The deduced protein had 492 amino acids, a calculated Mr of 56,016, and it shared 51 and 45% amino acid similarities to P 450e and P-450f, respectively. Regions of similarity were distributed in distinct areas of high and low similarity along the P-450a primary sequence. P-450a cDNA was introduced into yeast cells using the expression vector pAAH5, and the resultant yeast microsomes contained both a protein of identical electrophoretic mobility to that of rat P-450a and testosterone 7 alpha-hydroxylase activity. These results confirm enzyme reconstitution data and antibody inhibition data that P-450a possesses testosterone 7 alpha-hydroxylase activity. The antibody and cDNA probes were used to examine the mechanism of regulation of P-450a by inducers and during development. P-450a and its mRNA were present at low level in newborn rats and increased to maximal level at 1 week of age in both males and females. At age 12 weeks, however, the P-450a level decreased in males but remained elevated in females. Concomitant with the decrease in P-450a in adult males was an increase in level of another immunologically related P-450. In adult male rats, P-450a was induced almost 5-fold by administration of 3 methylcholanthrene and this induction was the result of an increase in its mRNA. These results establish testosterone 7 alpha-hydroxylase as a member of the P 450e gene family that is developmentally regulated, sex-dependent, and markedly inducible by 3-methylcholanthrene. PMID- 3818622 TI - Chromobindin A. A Ca2+ and ATP regulated chromaffin granule binding protein. AB - A variety of studies have shown that about 20 proteins can be isolated from bovine adrenal medullary cytosol by virtue of their ability to bind to chromaffin granule membranes in the presence of Ca2+. In the present study we have examined the properties of a group of seven of these proteins. This group of proteins binds to granule membranes in the presence of Ca2+, however, the proteins are not released from the membrane by the removal of Ca2+ unless ATP is present. The proteins range from 53 to 59 kDa and they form a multisubunit complex of about 800 kDa. This complex, which we have named chromobindin A, has 13 subunits joined together in a ring, 175 A in diameter and 115 A in height. The binding of chromobindin A to membranes is stimulated by Ca2+, Sr2+, and Ba2+. The release is stimulated by a variety of nucleotides, including the nonhydrolyzable nucleotide analog adenyl-5'-yl imidodiphosphate. At present the function of chromobindin A in vivo is not clear, although the observation that Ca2+ stimulates chromobindin A binding together with observations that imply that chromobindin A binds to a protease-sensitive receptor on the granule membrane suggest that the complex is involved in exocytosis and that it may be partially responsible for the ATP dependence of this process. PMID- 3818623 TI - Prostatic spermine-binding protein. Cloning and nucleotide sequence of cDNA, amino acid sequence, and androgenic control of mRNA level. AB - cDNA for mRNA of an androgen-dependent spermine-binding protein (SBP) of rat ventral prostate was cloned by inserting cDNA into a dG-tailed expression vector, pUC8, and screening the expression library with anti-SBP antibodies. Hybrid selected translation using plasmid DNA from positive clones yielded a 34-kDa protein which was immunoprecipitated by affinity-purified anti-SBP antibodies. SBP mRNA is about 1260 bases long as measured by Northern blot hybridization. An amino acid sequence deduced from the nucleotide sequence of the cDNA was identical to an amino acid sequence found in SBP. SBP is extremely rich in acidic residues. Aspartic and glutamic acids, which make up about 33% of the total sequence, comprise 89 of a stretch of 126 amino acids at the carboxyl-terminal end. By dot hybridization analysis, SBP mRNA was not detected in rat liver, kidney, brain, submaxillary gland, or uterus. The prostate levels of SBP mRNA were measured by mRNA translation and dot hybridization. SBP mRNA level decreased to less than 20% of normal 2 days after castration of rats, and this decrease was reversed by 5 alpha-dihydrotestosterone injection into castrated rats. PMID- 3818624 TI - Histone H4 from cuttlefish testis is sequentially acetylated. Comparison with acetylation of calf thymus histone H4. AB - The differently acetylated subfractions of histone H4 isolated from cuttlefish testis and from calf thymus were separated by ion exchange chromatography on sulfopropyl-Sephadex, using a shallow linear gradient of guanidine hydrochloride in the presence of 6 M urea at pH 3.0. The tetra-, tri-, di-, mono-, and nonacetylated forms of cuttlefish H4 represent 2, 6.4, 18, 32.2, and 41.4% of the whole histone, respectively. The di-, mono-, and nonacetylated forms of calf H4 represent 11.7, 41.3, and 44% of the whole histone, respectively. The acetylation sites were determined in each subfraction by identification of the acetylated peptides. In each acetylated H4 subfraction, the acetylated tryptic peptides were identified by peptide mapping and amino acid analysis with reference to the peptide map of nonacetylated H4. In cuttlefish testis H4, lysine 12 is the main site of acetylation in the monoacetylated subfraction; lysines 5 and 12 are found acetylated in diacetylated H4; lysines 5, 12, and 16 are found acetylated in triacetylated H4. From these results and the stoichiometry of the different H4 subfractions, it can be concluded that lysine 5 is acetylated after lysine 12. In calf thymus, lysine 16 is the only site of acetylation in the monoacetylated subfraction. All the diacetylated forms are acetylated in lysine 16, the second site of acetylation being, in decreasing order, lysine 12, lysine 5, or lysine 8. These observations suggest that acetylation occurs in a sequential manner. Moreover, the sites of acetylation depend upon the biological event in which acetylation is involved. PMID- 3818625 TI - Rat ceruloplasmin. Molecular cloning and gene expression in liver, choroid plexus, yolk sac, placenta, and testis. AB - A rat ceruloplasmin cDNA clone was isolated from a rat liver cDNA library and identified by partial nucleotide sequence analysis. Rat liver ceruloplasmin mRNA levels were measured during the acute phase response to inflammation by cytoplasmic dot hybridization to ceruloplasmin cDNA. Regulation of ceruloplasmin synthesis appeared to be at the mRNA level, with the concentration of ceruloplasmin mRNA increasing significantly 12 h after induction of inflammation, reaching a maximum of 350% of normal at 36 h and returning to normal levels within 60 h. Using Northern blot analysis, extrahepatic ceruloplasmin gene expression was observed in choroid plexus, yolk sac, placenta, and testis. All these tissues are at the interface between, and possibly involved in maintaining homeostasis in, adjacent extracellular compartments. No ceruloplasmin mRNA was detected in RNA from stomach and small intestine. PMID- 3818626 TI - Surfactant apoprotein Mr = 26,000-36,000 enhances uptake of liposomes by type II cells. AB - The alveolar type II cell which synthesizes and secretes surfactant also plays a major role in the reuptake of surfactant lipids. In a recent in vivo study we found that the subfractions of natural surfactant that contained the surfactant protein with molecular weights of 26,000-36,000 (SP-26-36) were preferentially taken up into lamellar bodies of type II cells to a greater extent than were fractions that did not contain SP-26-36. Because the subfractions of natural surfactant in that study differed in other properties than the presence or absence of SP-26-36, the current study was undertaken to determine whether purified SP-26-36 enhanced the uptake of surfactant-like lipids by freshly isolated type II cells. SP-26-36 increased the uptake of label in radioactive surfactant-like lipids by up to 10-fold, and the effect of SP-26-36 was dependent on time, protein concentration, and temperature. The enhancement was inhibited by heat-treating the protein, by a polyclonal antibody against SP-26-36, and by metabolic inhibitors. The distribution of radioactivity in cell-associated phospholipids differed if cells were incubated with or without SP-26-36. If SP-26 36 was present during the incubation, greater than 96% of the radioactivity remained associated with phosphatidylcholine. In the absence of SP-26-36, only 85% of the radioactivity remained associated with phosphatidylcholine and 7% of the label appeared in phosphatidylglycerol. We hypothesize that SP-26-36 may act as a ligand to direct surfactant lipids to type II cells, perhaps to different metabolic pathways, and to regulate recycling and surfactant homeostasis. PMID- 3818627 TI - Molecular cloning and nucleotide sequence of cDNA encoding hydroxyindole O methyltransferase of bovine pineal glands. AB - Messenger RNA for hydroxyindole O-methyltransferase (EC 2.1.1.4) was partially purified from poly(A)+ RNA isolated from bovine pineal glands by sucrose density gradient centrifugation. The enriched mRNA was used to prepare a cDNA library by use of expression vector lambda gt11. The library was screened with monoclonal antibodies to the enzyme, and three cDNA clones were isolated. These cloned cDNAs cross-hybridized with one another, and their fusion proteins reacted to the monoclonal antibodies with different binding properties. Hydroxyindole O methyltransferase enzymatic activity was demonstrated in the bacteria lysate infected with lambda HIOMT-A16, the clone that contained the longest insert. An almost full-length cDNA clone was isolated from lambda gt10 cDNA library by use of the lambda HIOMT-A16 cDNA as a probe. The primary structure of hydroxyindole O methyltransferase was determined by analyzing the nucleotide sequence of the cDNAs. It consisted of 1939 nucleotides including a 1050-nucleotide region coding for 350 amino acids. RNA transfer blot analysis indicated that mRNA encoding hydroxyindole O-methyltransferase was present only in the pineal gland and not in the brain, retina, and liver of cow. PMID- 3818628 TI - Spatially resolved cytosolic calcium response to angiotensin II and potassium in rat glomerulosa cells measured by digital imaging techniques. AB - The response of cytosolic calcium [Ca2+]i to angiotensin II (AII) and potassium (K+) in individual rat glomerulosa cells was determined using the calcium sensitive fluorescent dye, fura-2 and digital imaging. Control (4 mM K+) cytosolic calcium levels were generally in the 80-120 nM range and increased monotonically as [K+] was increased from 4 to 12 mM. There was no delay in the onset of the response. In most cells the [Ca2+]i decreased from its peak after 3 4 min, even in the presence of superfusate containing elevated K+. The time course of the change in [Ca2+]i in response to AII stimulation, on the other hand, was more variable. It was most often characterized by an early decrease followed by a large delayed increase. The response also was observed to decline during sustained AII stimulation. The majority of the cells showed some response to one or the other secretagogue with a sizeable minority (25%) having an increase in [Ca2+]i in excess of 200%. While the majority showed a response, the cell to cell variation was substantial. Finally, the pattern of cytosolic calcium increase sometimes showed a marked dependence on the secretagogue used, with different regions of the same cell being more strongly affected by one agent or the other. A few cells (10%) responded to AII only at one pole, establishing a large concentration gradient of calcium across the cell. Because of differences in time course, pattern, and degree of responsiveness, it is likely that the mechanisms underlying the Ca2+ elevation with K+ and AII are different. PMID- 3818629 TI - Fibronectin's cell-adhesive domain and an amino-terminal matrix assembly domain participate in its assembly into fibroblast pericellular matrix. AB - Fibroblasts organize the modular cell-adhesive glycoprotein fibronectin into a highly structured pericellular matrix by poorly understood mechanisms. Previous studies implicated an amino-terminal domain in matrix assembly and suggested that fibronectin's cell-adhesive domain and the corresponding fibroblast receptor were not involved in this process. To further elucidate the fibronectin region(s) involved in matrix assembly, we mapped a library of proteolytic fragments and antibodies to various fibronectin domains. The fragments and antibodies were used to probe the role of fibronectin's amino-terminal and cell-adhesive domains in a fibroblast matrix assembly assay. We found that fibronectin fragments including the first 25-kDa sequence of fibronectin and antibodies to amino-terminal domains inhibited pericellular matrix assembly. Polyclonal antibodies to the 40-kDa collagen binding domain following the 25-kDa amino-terminal domain also inhibited matrix assembly. However, collagen binding is not required for matrix assembly as neither monoclonals blocking collagen binding nor purified collagen binding domains themselves inhibited matrix assembly. Therefore, the amino-terminal region of fibronectin contains a site important in matrix assembly, and most activity is present in the first 25-kDa of fibronectin. Fibronectin's cell adhesive domain and the fibroblast receptor binding to this domain also play an important role in fibronectin matrix assembly. Apart from a monoclonal antibody to the amino-terminal domain, only monoclonal antibodies binding to fibronectin's cell-adhesive domain and inhibiting cell adhesion also inhibited matrix assembly. In addition a 105-kDa fragment containing the cell-adhesive domain inhibited matrix assembly. We conclude that at least two discrete and widely separated sites in fibronectin with different binding properties--the carboxyl-terminal fibroblast cell-adhesive domain and an amino-terminal matrix assembly domain localized primarily within the first 25 kDa--are required for fibronectin pericellular matrix assembly by fibroblasts. Fibronectin's cell-adhesive domain and its cell surface-receptor complex appear to be involved in the matrix assembly process prior to a step involving the amino-terminal domain. We believe that this step is likely to be the initiation of cell-associated fibronectin fibril formation by the fibronectin-adhesive-receptor complex. PMID- 3818630 TI - Isolation and characterization of an abundant and novel 22-kDa protein (SM22) from chicken gizzard smooth muscle. AB - Chicken gizzard smooth muscle contains a highly abundant protein (SM22) with an apparent Mr on sodium dodecyl sulfate-polyacrylamide electrophoretic gels of 23,000. The ratio of actin:SM22:tropomyosin in this tissue is estimated to be 6.5(+/- 0.8):2.0(+/- 0.2):1.0. At least three isoelectric isoforms are present in ratios of alpha:beta:gamma of 14:5:1 with alpha the most basic and gamma the most acidic. A method for the purification of SM22 and partial separation of its isoforms is described. Amino acid analyses of purified alpha and beta demonstrate the presence of 1 and 2 half-cystines, respectively, and a lower content of basic amino acids in beta. A value of 22,000 for the Mr of alpha estimated by sedimentation equilibrium indicated its presence as a monomer at physiological ionic strengths. Estimates of the translational frictional coefficient (f/fmin) of alpha calculated from its Stokes radius (25.5 A) and Mr were consistent with its existence as a moderately asymmetric globular protein. Calculations based on its far-ultraviolet CD spectrum provided values of 37% alpha-helix, 31% beta sheet, 5% beta-turn, and 27% random coil. SM22 was shown not to share functional properties with several proteins of similar Mr and isoelectric point such as myokinase, brain 23-kDa protein, and troponin I. We conclude that it is a novel protein not previously isolated or characterized from any tissue. PMID- 3818631 TI - The chicken receptor for endocytosis of glycoproteins contains a cluster of N acetylglucosamine-binding sites. AB - The oligomeric state of the chicken hepatic receptor for N-acetylglucosamine terminated glycoproteins (the chicken hepatic lectin) has been examined in detergent solution, in various membrane preparations, and in hepatocytes. In detergent solution, the cross-linking reagent, 1,5-difluoro-2,4-dinitrobenzene produces covalent complexes containing up to six receptor polypeptides. This result, along with hydrodynamic studies of the receptor-detergent complex, indicates that the purified receptor is a hexamer. Analysis of large proteolytic fragments of the receptor reveals that portions of the receptor polypeptide near the membrane anchor are essential for hexamer stability. This analysis also demonstrates that each receptor polypeptide has an N-acetylglucosamine-binding site, indicating that the native hexameric receptor contains a cluster of six such sites. Immunoblot analysis of membrane fractions and cells cross-linked with 1,5-difluoro-2,4-dinitrobenzene or dimethyl adipimidate reveals that the receptor is also oligomeric in intact cells and in subcellular fractions representing cell surface and internalized receptor. Although the pattern of cross-linking observed in membranes differs from that observed with purified receptor, experiments indicate that the differences may be explained by the presence of membrane components which compete with receptor for reaction with cross-linking reagent. The presence of a cluster of carbohydrate-binding sites in the hepatocyte membrane can account for the preferential endocytosis of multivalent glycoprotein ligands by hepatocytes. PMID- 3818632 TI - Interspecies variations in the transient heme species generated subsequent to CO photolysis from hemoglobins. AB - The structure, ligand binding kinetics, and thermodynamics of hemoglobin have been the subject of a great deal of investigation. However, the exact pathway(s) by which cooperative energetics are communicated within the protein remain undefined. The effects of interspecies variations in quaternary and tertiary structure, oxygen affinity, cooperativity, and ligand binding kinetics upon the overall ligand binding process are, therefore, of great importance in understanding and solving these problems. The demonstrated sensitivity of resonance Raman spectroscopy to heme structure and environment make it an ideal probe of ligand binding dynamics. It is possible to examine how specific vibrational modes change with time and correlate this with solution conditions and protein structural and conformational differences. Those modes which exhibit the greatest change with ligand photolysis are also indicative of possible paths of cooperative energy dissipation within the protein. The changes which occur in the vibrational modes of the heme within 10 ns of CO photolysis have been determined for a wide variety of mammalian and reptilian hemoglobins. The modes most affected by this process are, without exception, nu(Fe-His), nu4, and the substituent bending modes, delta(cb - s) and delta(cb - c alpha - c beta). Furthermore, a direct correlation exists between the shift in porphyrin pi electron density upon CO photolysis (as indicated by the transient changes in nu 4) and the Hill coefficient of cooperativity. The implications of those results concerning ligand binding cooperativity in hemoglobins are discussed. PMID- 3818633 TI - The mechanisms of ATP hydrolysis accompanying the polymerization of Mg-actin and Ca-actin. AB - The hydrolysis of ATP that accompanies actin polymerization occurs on the F-actin subsequent to the elongation step. For Mg-actin, the rate of ATP hydrolysis is similar to the rate of elongation at low concentrations of G-actin but increases more slowly as the G-actin concentration is increased. This behavior can be quantitatively modeled by assuming that ATP hydrolysis occurs predominantly, but not exclusively, on a single subunit of Mg-F-actin at the interface between an ATP-subunit cap and an ADP-subunit core. The rates of elongation of Ca-actin and Mg-actin are similar but the rate of ATP hydrolysis on Ca-F-actin is appreciably slower than the rate of elongation at all concentrations of Ca-G-actin. The data for Ca-actin can be modeled by assuming that ATP hydrolysis occurs essentially randomly on Ca-F-actin within a large ATP cap which can be as long as 2,000 subunits in a 10,000-subunit long filament. PMID- 3818634 TI - Flexibility in the phosphorylase catalytic reaction. Glucosyltransfer from pyridoxal (5')-triphospho(1)-alpha-D-glucose to glycogen catalyzed by phosphorylase. AB - When rabbit muscle phosphorylase reconstituted with pyridoxal (5')-diphospho(1) alpha-D-glucose is incubated with glycogen, its glucosyl moiety is transferred to the nonreducing end of glycogen with the formation of a new alpha-1,4-glucosidic linkage. This finding provided the first evidence for the direct phosphate phosphate interaction between the coenzyme pyridoxal 5'-phosphate and the substrate alpha-D-glucose 1-phosphate in the phosphorylase catalytic reaction (Takagi, M., Fukui, T., and Shimomura, S. (1982) Proc. Natl. Acad. Sci. U. S. A. 79, 3716-3719). We have examined whether pyridoxal(5')triphospho(1)-alpha-D glucose can act in a similar manner to the diphospho compound or not. In the absence of glucan the enzyme-bound triphospho compound was stable for 1 day at pH 6-9. In the presence of glucan, however, its glucosidic linkage was cleaved, and the glucosyl moiety liberated was transferred to glycogen with the formation of a new alpha-1,4-glucosidic linkage. Allosteric activator AMP accelerated the reaction and allosteric inhibitor glucose 6-phosphate showed the reverse effect. The pH optimum of the reaction was pH 8.1-8.4. Mg2+ slightly but significantly accelerated the reaction, whereas Mn2+ and Ca2+ inhibited the reaction. These results indicate that the glucosyltransfer from the triphospho compound occurs in an identical manner to that from the diphospho compound. Based on the present and previous data, we discuss the catalytic mechanism of phosphorylase, especially in comparison with that of phosphoryltransferases. PMID- 3818635 TI - Peroxisomal dihydroxyacetone phosphate acyltransferase. Effect of acetaldehyde on the intact and solubilized activity. AB - The peroxisomal enzyme dihydroxyacetone phosphate (DHAP) acyltransferase shows a differential response to acetaldehyde. Employing whole peroxisomes, the enzyme displays a 130-400% stimulation of activity when assayed in the presence of 10 250 mM acetaldehyde. Following taurocholate solubilization of the enzyme the response to 0.25 M acetaldehyde is one of almost total inhibition. This inhibition of the taurocholate-solubilized enzyme is not observed at acetaldehyde concentrations below 200 mM. The stimulation of DHAP acyltransferase by acetaldehyde is solely a response of the peroxisomal enzyme as evidenced by its insensitivity to N-ethylmaleimide and 5 mM glycerol 3-phosphate. Furthermore, microsomal dihydroxyacetone phosphate acyltransferase activity is inhibited at all acetaldehyde concentrations. The activation of membrane-bound DHAP acyltransferase by acetaldehyde appears to be specific for this enzyme in comparison to several other peroxisomal and microsomal enzymes. The specificity of activation and differential response of the peroxisomal enzyme to acetaldehyde indicates that the microenvironment of the peroxisomal membrane is important for normal enzymatic function of this enzyme. PMID- 3818636 TI - Labeling of human erythrocyte band 3 with maltosylisothiocyanate. Interaction with the anion transporter. AB - Maltosylisothiocyanate (MITC), synthesized as an affinity label for the hexose carrier, has been reported to label a Band 3 or Mr = 100,000 protein in human erythrocytes, in contradistinction to many studies showing the carrier as a Band 4.5 or Mr = 45,000-66,000 protein on gel electrophoresis. In this work the possibility that MITC interacts with the Band 3 anion transporter was studied. In intact human erythrocytes, MITC labeling was largely confined to Band 3 and was decreased by several competitive inhibitors of hexose transport. However, MITC also appeared to react with the anion transport protein, since MITC labeling of Band 3 was irreversibly decreased by the anion transport inhibitor 4,4' diisothiocyanostilbene-2,2'-disulfonate (DIDS) and since MITC also irreversibly inhibited both tritiated dihydro-DIDS labeling of Band 3 and sulfate uptake in intact cells. Although 20 microM DIDS had little effect on hexose transport, the labeling of erythrocyte Band 3 by the dihydro analog was significantly diminished by competitive inhibitors of hexose transport. These data suggest that MITC labels in part the anion transporter as well as other DIDS-reactive sites on Band 3 which appear to be sensitive to competitive inhibitors of hexose transport. PMID- 3818637 TI - Structural elucidation of the major phenolic glycolipid from Mycobacterium kansasii. I. Evidence for tetrasaccharide structure of the oligosaccharide moiety. AB - Data from the literature indicate the presence, in the Mycobacterium kansasii wall, of a phenolic glycolipid called mycoside A. A tentative trisaccharide structure was proposed for the oligosaccharide part, whereas the aglycone was found to correspond to a phenol phthiocerol residue esterified by two mycocerosic acids. In the present work, structural information mainly arising from fast atom bombardment-mass spectrometry, tandem mass spectrometry, and 1H NMR of native and chemically degraded phenolic glycolipid indicates a tetrasaccharide structure for the inherent oligosaccharide. This structure is now determined as: 2,6-dideoxy-4 O-methyl-arabino-hexopyranosyl(1 alpha----3)2-O-methyl-4-O- acetylfucopyranosyl(1 alpha----3)2-O-methyl-rhamnopyranosyl(1 alpha----3)2-4-di- O methylrhamnopyranosyl-1 alpha----phenolglycol. Evidence for the structure of the dideoxyhexose, unique in mycobacteria, is presented in the following paper (Fournie, J.-J., Riviere, M., Papa, F., and Puzo, G. (1987) J. Biol. Chem. 262, 3180-3184). PMID- 3818638 TI - Structural elucidation of the major phenolic glycolipid from Mycobacterium kansasii. II. Presence of a novel dideoxyhexose. AB - A novel O-methyl-2,6-dideoxyhexose was isolated from the major phenolic glycolipid (previously called mycoside A) of Mycobacterium kansasii. Its molecular weight (162) was determined by gas chromatography-mass spectrometry analysis (chemical ionization with ammonia as reactant gas) of its underivatized reducing form. The methoxyl group was located by electron impact-mass spectrometry of its alditol acetate. The configuration was established by 1H NMR of its peracetylated derivative. The structure 2,6-dideoxy-4-O-methyl-arabino hexopyranose is proposed for this new sugar. Evidence is also presented that the phenolic glycolipid previously called mycoside A is an antigen of M. kansasii since it reacts with rabbit antisera raised against whole M. kansasii. PMID- 3818639 TI - Substrate stereospecificity and active site topography of gamma-aminobutyric acid aminotransferase for beta-aryl-gamma-aminobutyric acid analogues. AB - The substrate and inhibitory properties of (R)- and (S)-4-amino-3-phenylbutanoic acid, (R)- and (S)-4-amino-3-(4-chlorophenyl)butanoic acid (baclofens), (E)-4 amino-3-phenylbut-2-enoic acid, and (E)-4-amino-3-(4-chlorophenyl)but-2-enoic acid are determined and compared with those of 4-aminobutanoic acid, 4-aminobut-2 enoic acid (4-aminocrotonic acid), and the racemic mixtures of 4-amino-3 arylbutanoic acids. All compounds in both series were found to be substrates, except for the R-isomers, which were identified as competitive inhibitors. These results are compared with known pharmacological data regarding the appropriate isomers. PMID- 3818640 TI - Fractionation of transcription factors for RNA polymerase II from Drosophila Kc cell nuclear extracts. AB - Drosophila Kc cells were utilized to prepare nuclear extracts in which promoter containing DNA templates were efficiently transcribed by RNA polymerase II. A combination of fractionation schemes was used to identify and partially purify seven activities (factors) which affected the transcription of four different genes in vitro. Reconstructing specific transcription required exogenous RNA polymerase II in addition to these factors. Moreover, the high efficiency of transcription characteristic of the crude extract was preserved in reconstruction reactions. The methods used are presented in detail. Functions were assigned to several of the factors. One essential factor appeared to affect initiation and displayed chromatographic properties unlike any other Drosophila transcription factor previously described. Two factors specifically affected RNA chain elongation. Another activity was a DNase inhibitor required to preserve template integrity in the fractionated system. The remaining three factors were not absolutely essential but affected the specific in vitro transcription either qualitatively or quantitatively. A comparison of these transcription factors with other Drosophila and mammalian transcription factors is made. PMID- 3818641 TI - Purification and properties of a megakaryocyte stimulatory factor present both in the serum-free conditioned medium of human embryonic kidney cells and in thrombocytopenic plasma. AB - Megakaryocyte stimulatory factor (MSF) has been purified to homogeneity (7.5 X 10(5)-fold) from serum-free conditioned medium obtained from cultured human embryonic kidney cells and to near homogeneity (1.44 X 10(7)-fold) from thrombocytopenic rabbit plasma. MSF activity from either source was assayed by its ability to enhance the rate of synthesis of platelet factor 4-like proteins in a rat promegakaryoblast cell line. The 125I-labeled factor prepared from human embryonic kidney cell conditioned medium is homogeneous as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and isoelectric focusing in the presence of 9.2 M urea. MSF obtained from the above source is an acidic protein (pI = 5.1) with an Mr = 15,000 which stimulates platelet factor 4-like protein synthesis in rat promegakaryoblast cells by as much as 7-fold, and exhibits half-maximal activity at a concentration of 0.8 pM. MSF was also purified from thrombocytopenic rabbit plasma by a nearly identical isolation procedure, and 125I-labeled factor prepared from this source also possessed an Mr = 15,000. MSF exhibited no biologic activity corresponding to other known hemopoietic growth factors, and appears to be specific for the megakaryocyte lineage. PMID- 3818642 TI - Activation of human prothrombin by human prothrombinase. Influence of factor Va on the reaction mechanism. AB - The kinetics of the activation of human prothrombin catalyzed by human prothrombinase was studied using the fluorescent alpha-thrombin inhibitor dansylarginine-N-(3-ethyl-1,5-pentanediyl)amide (DAPA). Prothrombinase proteolytically activates prothrombin to alpha-thrombin by cleavages at Arg273 Thr274 (bond A) and Arg322-Ile323 (bond B). The differential fluorescence properties of DAPA complexed with the intermediates and products of human prothrombin activation were exploited to study the kinetics of the individual bond cleavages in the zymogen. When the catalyst was composed of prothrombinase (human factor Xa, human factor Va, synthetic phospholipid vesicles, and calcium ion), initial velocity studies of alpha-thrombin formation indicated that the kinetic constants for the cleavage of bonds A or B were similar to the constants that were obtained for the overall reaction (bonds A + B). The progress of the reaction was also monitored by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The results indicated that the activation of human prothrombin catalyzed by prothrombinase proceeded exclusively via the formation of meizothrombin (bond B-cleaved) as an intermediate. Kinetic studies of the cofactor dependence of the rates of cleavage of the individual bonds indicated that, in the absence of the cofactor, cleavage at bond B would constitute the rate-limiting step in prothrombin activation. Progress curves for prothrombin activation catalyzed by prothrombinase and monitored using the fluorophore DAPA were typified by the appearance of a transient maximum, indicating the formation of meizothrombin as an intermediate. When factor Xa alone was the catalyst, progress curves were characterized by an initial burst phase, suggesting the rapid production of prethrombin 2 (bond A-cleaved) followed by its slow conversion to alpha-thrombin. Gel electrophoresis followed by autoradiography was used to confirm these results. Collectively, the results indicate that the activation of human prothrombin via the formation of meizothrombin as an intermediate is a consequence of the association of the cofactor, human factor Va, with the enzyme, human factor Xa, on the phospholipid surface. PMID- 3818643 TI - Factors involved in specific transcription in mammalian RNA polymerase II. Functional analysis of initiation factors IIA and IID and identification of a new factor operating at sequences downstream of the initiation site. AB - Transcription from the major late promoter of adenovirus type 2 DNA (including DNA sequences from 56 nucleotides upstream to 33 nucleotides downstream of the CAP site) was reconstituted with transcription factors purified from HeLa cells. Five components, transcription factors (TF) IIA, -B, -E, -D and RNA polymerase II, were required for accurate initiation of transcription. Kinetic analyses combined with order of addition experiments suggested that TFIIA acted first during the initiation reaction and that this interaction was followed by the action of TFIID. In agreement with these conclusions, both TFIIA and TFIID were required to render a transcription reaction partially resistant to concentrations of Sarkosyl previously shown to inhibit an early step in the formation of a preinitiation complex. Related Sarkosyl studies indicated that the inferred complex was subsequently recognized by RNA polymerase II, which resulted in an increased level of Sarkosyl-resistant transcription (in the presence of TFIIA and TFIID), and that this interaction occurred independently of TFIIB and TFIIE. However, TFIIB and TFIIE were implicated, along with the other factors and RNA polymerase II, in the subsequent formation of a highly stable preinitiation complex, which was inferred from its ability to initiate (with added nucleotides) in the presence of heparin concentrations which blocked unbound factors. The identification of a new transcription factor, which was required only when viral sequences 3' to the major late promoter were part of the transcription unit, is also reported. PMID- 3818644 TI - Factors involved in specific transcription by mammalian RNA polymerase II. Transcription factor IIS stimulates elongation of RNA chains. AB - A factor that stimulates random transcription of purified DNAs by RNA polymerase II has been partially purified and analyzed with respect to its possible role in specific transcription from class II promoters. Studies of the effect of this factor (transcription factor IIS) on transcription from the adenovirus major late promoter in a system reconstituted with RNA polymerase II and purified factors (IIA, IIB, IIE, and IID) indicated that it acted subsequent to the initiation step and that it stimulated the rate of elongation. Kinetic experiments indicated that the factor affected the efficiency with which the RNA polymerase II passed through pausing sites. The relationship of transcription factor IIS to a protein previously purified from Erlich ascites tumor cells (Sekimizu, K., Nakanishi, Y., Mizuno, D., and Natori, S. (1979) Biochemistry 18, 1582-1588) was also studied. PMID- 3818645 TI - Alu-Alu recombination deletes splice acceptor sites and produces secreted low density lipoprotein receptor in a subject with familial hypercholesterolemia. AB - A Japanese subject with homozygous familial hypercholesterolemia was found to have a 7.8-kilobase deletion in the gene for the low density lipoprotein receptor. The deletion joins intron 15 to the middle of exon 18, which encodes the 3' untranslated region, thereby removing all 3' splice acceptor sites distal to intron 15. By S1 nuclease mapping, we demonstrated that the 5' splice donor site of intron 15 is no longer used. Instead a continuous transcript is produced in which exon 15 is followed by the remaining segments of intron 15 and exon 18. The translational reading frame of exon 15 continues for 165 nucleotides into intron 15 before a termination codon is reached. This mRNA should produce a truncated receptor that lacks the normal membrane-spanning region and cytoplasmic domain and that has 55 novel amino acids at its COOH terminus. A cDNA expression vector containing this sequence produced a receptor that behaved similarly to the truncated protein produced by the Japanese patient, i.e. greater than 90% of the receptor was secreted from the cell, and the receptors remaining on the surface showed defective internalization. The deletion in this subject resulted from a recombination between two repetitive sequences of the Alu family, one in intron 15 and the other in exon 18. To date, Alu sequences have been observed at the deletion joints of all four gross deletions in the low density lipoprotein receptor gene that have been characterized. Within these Alu sequences, six out of the seven breakpoints have occurred in the left arm. These data suggest that recombination between Alu sequences may be a frequent cause of deletions in the human genome. PMID- 3818646 TI - Association of heparan sulfate proteoglycan and laminin with the cytoskeleton in rat liver. AB - Rats were injected with 35SO4 and after 2 h their livers were removed and used to prepare a detergent-insoluble cytoskeleton fraction. Spectrin, cytokeratins, and actin were major protein components of the isolated cytoskeletons. The cytoskeleton fraction accounted for approximately 14% of the total trichloroacetic acid-insoluble 35SO4 radioactivity incorporated into the liver. The cytoskeleton-associated radioactivity was present in a single species of macromolecule. This molecule was not present to a significant extent in the detergent-soluble fraction containing the cell supernatant and dissolved membrane proteins. Further characterization revealed the cytoskeleton-associated molecule was a heparan sulfate proteoglycan: it was eluted from a Sepharose CL-4B column under denaturing conditions at Kav = 0.4; following mild alkaline hydrolysis the radioactivity was eluted at a Kav = 0.7; when this material was subjected to nitrous acid hydrolysis all of the radioactivity was eluted near the column included volume. The isolated cytoskeletons contained attached nuclei. Pure nuclei isolated without associated cytoskeletal elements contained less than 1% of the total liver trichloroacetic acid-insoluble 35SO4 radioactivity and no detectable heparan sulfate proteoglycan. These results suggested that other matrix proteins might be associated with the liver cytoskeleton. When the subcellular distribution of laminin was monitored by immunostaining proteins transferred to nitrocellulose, laminin was detected exclusively in the cytoskeleton fraction. These results provide evidence for an association between extracellular connective tissue proteins and intracellular structural proteins. PMID- 3818647 TI - An investigation of the molecular properties and stability of intermediates of proenkephalin in isolated bovine adrenal medullary chromaffin granules. AB - An antiserum to a synthetic peptide corresponding to residues 95-117 of bovine proenkephalin recognizes all the major intermediates of this prohormone in bovine adrenal medulla (Birch, N. P. and Christie, D. L. (1986) J. Biol. Chem. 261, 12213-12221). This antiserum enabled an investigation of the stability and molecular properties of intermediates in the processing of proenkephalin in bovine adrenal medullary chromaffin granules. Intact and hypotonic lysates of chromaffin granules were incubated at 37 degrees C and the stability of intermediates assessed by gel filtration followed by radioimmunoassay and gel electrophoresis in combination with immunoblotting. Processing was slow in intact granules compared with incubations of hypotonic lysates which resulted in the selective cleavage of an Mr 27,000 intermediate and increases in the amounts of immunoreactivity of lower molecular weight. Protease inhibitors increased the stability of the 27-kilodalton intermediate, the most effective being p chloromercuribenzoate. Preliminary evidence was obtained for the regulation of the processing of this intermediate by soluble factors present in chromaffin granules. It appears that membrane-associated intermediates of proenkephalin are relatively stable, although analysis of soluble immunoreactivity released during the incubation of chromaffin granule membranes showed a decrease in the 27 kilodalton intermediate and increased amounts of lower molecular weight intermediates. Analysis of hypotonic lysates by two-dimensional gel electrophoresis showed that proenkephalin intermediates exhibit significant microheterogeneity. It will be important to compare the products of proenkephalin generated by purified proteases with a putative role in the processing of this prohormone with the properties of endogenous intermediates as revealed in this study. PMID- 3818648 TI - Purification and characterization of an ATP-sensitive actin gelation protein from Acanthamoeba castellanii. AB - A protein which cross-links actin filaments in a nucleotide-sensitive manner has been purified to homogeneity from Acanthamoeba castellanii. This protein, GF-210, is a slightly asymmetric molecule composed of six subunits, each with an apparent mass of 35,000 Da. As determined by the method of falling ball vicometry, GF-210 was shown to cross-link actin filaments at hexamer:actin molar ratios of 1:500, with gelation occurring at molar ratios of 1:300 and higher. Actin gels did not form in the presence of 10 microM ATP, and filament cross-linking was completely inhibited by 100 microM ATP. Although ATP was the most effective inhibitor of actin filament cross-linking, other phospho-compounds including ADP, GTP, sodium phosphate, and sodium pyrophosphate prevented gelation at concentrations lower than 1.5 mM. In contrast, 50 mM KCl was required to inhibit the formation of actin networks. Direct binding studies showed that GF-210 binds to F-actin with a KD of 1.2 microM in the absence of ATP but with a KD of 72.8 microM in the presence of 2 mM ATP. This weakening of the interaction between F-actin and GF 210 may explain the inhibition of GF-210-induced actin cross-linking by nucleotides and other phospho-compounds. PMID- 3818649 TI - Biosynthesis and secretion of the rat core-specific lectin. Relationship of post translational modification and assembly to attainment of carbohydrate binding activity. AB - A soluble lectin, the core-specific lectin (CSL), is synthesized and secreted by rat hepatocytes and the rat hepatoma cell line, H-4-II-E. This lectin binds mannose and N-acetylglucosamine residues in the "core" region of Asn-linked oligosaccharides. Secretion of the CSL was found to occur over an extended period of time, greater than 4 h being required for secretion of 50% of the lectin (Brownell, M. D., Colley, K. J., and Baenziger, J. U. (1984) J. Biol. Chem. 259, 3925-3932). We have determined that following synthesis in the endoplasmic reticulum, the CSL is rapidly transported to the Golgi where it is retained for an extended period of time prior to secretion. The lectin undergoes two post translational modifications within the Golgi: an increase from Mr 24,000 to 25,000 and a progressive decrease in pI with an accompanying increase in Mr to a final value of 26,000. The lectin is also assembled into high molecular weight complexes of 150-260 X 10(3) and acquires the ability to bind carbohydrate in the Golgi. In hepatoma cells, the 24,000-25,000 modification is completed 20 min after initiation of synthesis. Assembly of the CSL subunits into high molecular weight complexes, acquisition of carbohydrate binding activity, and the 25,000 26,000 modification occur between 20 and 80 min after initiation of synthesis. These events have slower kinetics in primary hepatocytes and this allowed us to determine that the sequence of these biosynthetic events is: the 24,000-25,000 modification, complex assembly, the 25,000-26,000 modification, and acquisition of carbohydrate binding activity. The 24,000-25,000 modification occurs prior to complex assembly. Complex assembly may occur prior to, or concomitant with, the 25,000-26,000 modification. Assembly into the oligomeric form and the 25,000 26,000 modification correlate with the attainment of carbohydrate binding activity. The kinetics of CSL modification and assembly cannot account for its retention within the Golgi. Interaction with Golgi components either through carbohydrate binding or another interaction, may act to selectively retain the lectin within the Golgi. PMID- 3818650 TI - Exposure of HeLa DNA polymerase alpha to protein kinase C affects its catalytic properties. AB - Protein kinase C (Ca2+/phospholipid-dependent protein kinase) purified from rat brain or endogenous to cell-free extracts from HeLa cells stimulates, by a factor of 2-3, HeLa DNA polymerase alpha but not beta or gamma. Monoclonal antibody to the kinase prevents the stimulation, and monoclonal antibody to human DNA polymerase alpha neutralizes the enhanced activity. Reduced DNA polymerase alpha activity is obtained from noncycling HeLa cells and this activity has lower fidelity when copying synthetic primer-templates than that obtained from log phase cultures. After exposure to the kinase, the fidelities and activities of the polymerase from both sources increase by 2- to 3-fold. This improved accuracy is not accompanied by the appearance of triphosphatase or DNase activities. Exposure to the protein kinase reduces the Km for activated DNA and for poly(dA dT) but not for dNTPs. Moreover, the Vmax for activated DNA but not for poly(dA dT) is increased approximately 2- to 3-fold. These alterations suggest a role for protein phosphorylation in modulating DNA polymerase alpha. PMID- 3818651 TI - Phosphatidylcholine breakdown in rat liver plasma membranes. Roles of guanine nucleotides and P2-purinergic agonists. AB - Release of P-choline and choline from purified rat plasma membrane preparations was increased by GTP and its less hydrolyzable analogues, whereas other nucleotide triphosphates had little or no effect. Stimulation by guanosine 5'-(3 O-thiol)triphosphate (GTP gamma S) was dependent upon magnesium, inhibited by guanosine 5'-(2-O-thiol)diphosphate, and independent of calcium. ATP and ADP (1 100 microM) markedly enhanced the GTP gamma S stimulation of P-choline plus choline release but had no effect alone. ADP was as effective as ATP and nonhydrolyzable ATP analogues produced a similar or greater stimulation, whereas AMP and adenosine were much less effective. Vasopressin (0.1 microM) also produced a small stimulation. Under conditions in which protein kinase C was activated, PMA also stimulated the response to GTP gamma S but was ineffective in its absence. P-choline was the initial product which was hydrolyzed to choline. Guanine nucleotide and purinergic effects were also apparent on phosphatidylcholine degradation. EGTA, at 0.5 mM, completely removed purinergic stimulation but did not affect P-choline plus choline released in response to GTP gamma S alone. Prior treatment of plasma membranes with cholera toxin or prior injection of animals with islet-activating protein did not affect the stimulation of P-choline plus choline release either by GTP gamma S alone or by GTP gamma S plus ATP. These results indicate that a phosphatidylcholine phospholipase C is coupled to purinergic receptors in rat liver plasma membranes by a GTP-binding protein. Hydrolysis of phosphatidylcholine could contribute to hepatic diacylglycerol levels and thus influence protein kinase C activity. PMID- 3818652 TI - Fourier transform infrared spectroscopic study of the structure and conformational changes of the human erythrocyte glucose transporter. AB - Fourier transform infrared spectroscopy has been used to study the secondary structure of the human erythrocyte glucose transporter after purification and reconstitution in erythrocyte lipids. The spectra indicate that the glucose transporter contains, in addition to the predominant alpha-helical structure, an appreciable amount of beta-structure and random coil conformation. A study of the time dependency of H-2H exchange revealed that more than 80% of the polypeptide backbone is readily accessible to the solvent. This result indicates that a portion of the intramembrane-spanning region of the membrane protein is exposed to the solvent, suggesting the existence of an intraprotein aqueous channel. The residual (10-20%) portion of the protein which exchanges slowly includes some alpha-helical structure, probably situated in a hydrophobic environment inside the membrane. The infrared spectra of transporter preparations were also examined after incubation with substrate and substrate analogues. Compared with the spectra recorded under conditions in which the "inward-facing" form predominates, a small but reproducible shift in the bands assigned to alpha-helical and beta strand structures is observed after incubation with 4,6-O-ethylidene-D-glucose, which largely fixes the transporter in the "outward-facing" conformation. An increase of temperature, which is known to increase the proportion of transporter in the outward-facing conformation, results in a similar shift in this alpha helical absorption band. PMID- 3818653 TI - Phosphorylation of ribosomal protein S6 by cAMP-dependent protein kinase and mitogen-stimulated S6 kinase differentially alters translation of globin mRNA. AB - The effects of phosphorylation of ribosomal protein S6 by two different protein kinases, the cAMP-dependent protein kinase and the mitogen-stimulated S6 kinase, or translation of globin mRNA in a reconstituted system and on binding of globin mRNA to 40 S ribosomal subunits were examined. The cAMP-dependent protein kinase incorporated 1.5 mol of phosphate/mol of 40 S ribosomal subunits. Phosphorylation of S6 by the cAMP-dependent protein kinase had no effect on binding of 3' terminus-labeled globin mRNA to 40 S ribosomal subunits. [3H]Leucine incorporation with 40 S ribosomal subunits phosphorylated by the cAMP-dependent protein kinase was identical to that observed with nonphosphorylated 40 S ribosomal subunits, although on occasion, a slight inhibition (less than 10%) was observed; there was no effect on the rate of synthesis of either the alpha or beta chains of globin. Phosphorylation with the mitogen-stimulated S6 kinase (2.5 mol/mol) did not alter binding of globin mRNA to 40 S ribosomal subunits; however, translation of globin mRNA in the reconstituted protein-synthesizing system was stimulated up to 4-fold over that observed with nonphosphorylated subunits. Synthesis of both the alpha and beta chains of globin was enhanced by phosphorylation as shown by electrophoretic analysis. Since the sites phosphorylated by the mitogen-stimulated S6 kinase are identical to those observed in vivo in response to insulin and growth-promoting compounds, the data support the hypothesis that enhanced synthesis of specific proteins may be due to phosphorylation of S6 and that differential phosphorylation of S6 can alter translation of natural mRNA. PMID- 3818654 TI - The presence of novel glucuronic acid-containing, type-specific glycolipid antigens within Mycobacterium spp. Revision of earlier structures. AB - Previously, we had described the structures of the haptenic oligosaccharides of the surface glycopeptidolipid antigens from serotypes 9 and 25 of the Mycobacterium avium complex and had synthesized these units as putative antigenic probes. The lack of chemical concordance between the synthetic products and the haptens has prompted a re-examination of these structures utilizing the instrumental techniques not previously available of fast atom bombardment-mass spectrometry, Fourier transform infra-red, and high resolution NMR spectroscopy. With the additional information thus available, more extensive chemical fragmentations by base degradation, followed by alkylation, have furnished supportive evidence to allow formulation of revised and novel structures, all of which contain glucuronic acid: serotype 9, 2,3-di-O-Me-L-Fucp(alpha 1----4)-D GlcAp(beta 1----4)-2,3-di-O-Me-L-Fucp(alpha 1----3)-L-Rhap(alpha 1----2)-6dTal; and serotype 25, 4-acetamido-4,6-dideoxy-2-O-Me-hexosyl(alpha 1----4)-D- GlcAp(beta 1----4)2-O-Me-L-Fucp(alpha 1----3)-L-Rhap(alpha 1----2)6dTal. Glucuronic acid, acetamido sugars, and other novel sugars appear to be widespread in the glycopeptidolipid antigens of Mycobacterium spp. The revised structures will allow renewed synthesis of artificial antigen probes and rational approaches to preparing monoclonal antibodies, both necessary for the new diagnostics required to trace the sources of widespread infections due to M. avium and Mycobacterium intracellulare. PMID- 3818656 TI - Transient state kinetics of the reactions of isobutyraldehyde with compounds I and II of horseradish peroxidase. AB - Elementary reactions have been studied quantitatively in the complex overall process catalyzed by horseradish peroxidase whereby isobutyraldehyde and molecular oxygen react to form triplet state acetone and formic acid. The rate constant for the reaction of the enol form of isobutyraldehyde with compound I of peroxidase is (8 +/- 1) X 10(6) M-1 s-1 and with compound II (1.3 +/- 0.3) X 10(6) M-1 s-1. Neither the enolate anion nor the keto form is reactive. The reactivity of enols with peroxidase parallels that of unionized phenols and a common mechanism is proposed. The overall catalyzed reaction of isobutyraldehyde and oxygen consists of an initial burst followed by a steady state phase. The burst is caused by the following sequence: 1) an initial high yield of compound I is formed from reaction of native enzyme with the autoxidation product of isobutyraldehyde, a peracid and 2) compound I rapidly depletes the equilibrium pool of enol which is present. After this burst a steady state phase is observed in which the rate-limiting step is the conversion of the keto to the enol form of the aldehyde catalyzed by phosphate buffer. The rate constant for the keto form reacting with phosphate is (8.7 +/- 0.6) X 10(-5) M-1 s-1. All constants were measured in dilute aqueous ethanol at 35 degrees C, pH 7.4, and ionic strength 0.67 M. Both the initial burst of light and the steady state emission from triplet acetone can be observed with the naked eye. Since the magnitude of the burst is a measure of the equilibrium amount of enol, the keto-enol equilibrium constant is readily calculated and hence also the rate constant for conversion of enol to keto. The keto-enol equilibrium constant is unaffected by phosphate which therefore acts as a true catalyst. PMID- 3818655 TI - Reduction in S100 protein beta subunit mRNA in C6 rat glioma cells following treatment with anti-microtubular drugs. AB - S100 protein is a calcium-binding protein found in vertebrate nervous tissue. Synthesis of S100 protein in the rat glioma cell line, C6, is inhibited by the addition of anti-microtubular drugs. We have cloned a cDNA for the beta subunit of S100 protein from rat brain in a lambda gt 11 expression vector and used this cDNA to measure the amounts of S100 beta subunit mRNA in C6 cells after treatment with anti-microtubular drugs. Levels of alpha-tubulin and beta-actin mRNAs were also measured. All measurements were performed using RNA-RNA hybridization techniques at high stringency with rat mRNA-specific probes. After 24 h of treatment, the S100 beta subunit mRNA was reduced to levels of 25% by colchicine and 32% by vinblastine when compared to untreated controls. In contrast, the levels of tubulin and actin mRNAs were only slightly changed by these treatments. These studies demonstrate that disruption of the microtubular cytoskeleton causes a specific reduction in the level of S100 protein mRNA in C6 cells. PMID- 3818657 TI - Closely related alpha-tropomyosin mRNAs in quail fibroblasts and skeletal muscle cells. AB - We describe the analysis of two quail cDNA clones representing distinct but closely related alpha-tropomyosin mRNAs. cDNA clone cC101 corresponds to a 1.2 kilobase RNA which accumulates to high levels during myoblast differentiation and which encodes the major isoform of skeletal muscle alpha-tropomyosin. cDNA clone cC102 corresponds to a 2-kilobase RNA which is abundant in cultured embryonic skin fibroblasts and which encodes one of two alpha-tropomyosin-related fibroblast tropomyosins of 35,000 and 34,000 daltons apparent molecular mass (class 1 tropomyosins). The cC102 protein is unique among reported nonstriated muscle tropomyosins in being identical in amino acid sequence to the major isoform of skeletal muscle alpha-tropomyosin over an uninterrupted stretch of at least 183 amino acids (residues 75-257). The two protein sequences differ in the COOH-terminal region beginning with residue 258. Because the cC101 and cC102 RNAs share an extensive region (at least 373 nucleotides) of nucleotide sequence identity upstream of the codon for residue 258, they are likely derived from a single gene by alternative RNA splicing, as was recently proposed in the case of related beta-tropomyosin mRNAs in human fibroblasts and skeletal muscle (MacLeod, A. R., Houlker, C., Reinach, R. C., Smillie, L. B., Talbot, K., Modi, G., and Walsh, F. S. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 7835-7837). No alpha tropomyosin-related RNAs are abundant in undifferentiated myoblasts. This suggests the possibility of a fibroblast-specific function, as opposed to a general nonmuscle-cell function for class 1 tropomyosins and also has implications for the regulation of alpha-tropomyosin gene expression during embryonic development. PMID- 3818658 TI - Regulation of pantothenic acid transport in the heart. Involvement of a Na+ cotransport system. AB - Pantothenic acid transport was studied in the isolated perfused rat heart and isolated sheep cardiac sarcolemmal vesicles. In the perfused heart, pantothenic acid transport was significantly greater if hearts were perfused as working hearts rather than Langendorff hearts, but was unaffected by the perfusion substrates used (11 mM glucose or 1.2 mM palmitate). Uptake rates of pantothenic acid in working hearts are dependent on perfusate concentrations of pantothenic acid (a Vmax of 418 nmol/g dry weight/30 min and a Km for pantothenic acid of 10.7 mircoM were obtained). Reduction in perfusate Na+ concentration from 145 to 105 mM (the Na+ was replaced with 40 mM choline) resulted in a small but significant decrease in pantothenic acid uptake. At 145 mM Na+, addition of a mixture of amino acids, whose uptake is Na+-dependent, resulted in a significant decrease in pantothenic acid uptake by the heart (173 +/- 5 to 132 +/- 12 nmol/g dry weight). If an inward Na+ gradient in isolated, purified sarcolemmal vesicles, was imposed, a rapid uptake of pantothenic acid was observed. Uptake rates are markedly reduced if Na+ was replaced by equimolar concentrations of K+ or if external Na+ was reduced below 40 mM. In the presence of Na+, increasing pantothenic acid concentrations resulted in an increase in pantothenic acid uptake by the vesicles. Combined, these data demonstrate that pantothenic acid is transported across the myocardial sarcolemmal membrane by a Na+-dependent mechanism, which may be common to a number of small molecules. PMID- 3818659 TI - Structures of the sialylated oligosaccharide chains in swine tracheal mucin glycoproteins. AB - The structures of the major sialylated oligosaccharide chains in swine tracheal mucin glycoprotein were established. The oligosaccharide chains were released by treatment with alkaline borohydride and isolated by gel filtration on Bio-Gel P6 columns and chromatography on DEAE-cellulose. The neutral oligosaccharide chains in this glycoprotein have been characterized in previous studies (Rana, S.S., Chandrasekaran, E.V., Kennedy, J., and Mendicino, J. (1984) J. Biol. Chem. 259, 12899-12907; Chandrasekaran, E.V., Rana, S.S., Davila, M., and Mendicino, J. (1984) J. Biol. Chem. 259, 12908-12914). The present study reports the isolation of four monosialylated chains ranging in length from 6 to 14 sugar units, two disialylated chains containing 6 and 12 sugar units, and one trisialylated chain containing 9 sugar units. The structure of the sialylated oligosaccharides was determined by permethylation analysis and sequential hydrolysis with specific exoglycosidases. The following structures (where GalNAcol is N acetylgalactosaminitol) were assigned to these oligosaccharides. PMID- 3818660 TI - Binding and processing of fibrinogen by rabbit hepatocytes. AB - We describe a specific fibrinogen-hepatocyte interaction. Rabbit 125I-labeled fibrinogen (125I-FGN) was incubated at 4 degrees C with suspensions of rabbit hepatocytes (approximately 1 X 10(6) cells/ml). Bound ligand was separated from free by centrifugation of cells through oil and quantitated by gamma scintillation counting. Specific binding, determined by subtraction of nonspecific binding in the presence of 8 mM EDTA from total binding in the presence of 2 mM CaCl2, required 3 h to plateau and represented approximately 70% of total binding. Specific binding was calcium-dependent and was negligible in buffer containing 2 mM MgCl2. Half-maximal saturation occurred at approximately 30 nM 125I-FGN with approximately 480,000 molecules/cell at saturation. Dilution experiments revealed comparable affinities for labeled and unlabeled fibrinogen. Total binding was irreversible as determined by addition of excess unlabeled fibrinogen or EDTA. Specific binding of 25 nM 125I-FGN was inhibited, in a concentration-dependent fashion, by unlabeled fibrinogen or fibrinogen fragment D95 (Mr = 95,000), but not by fibrinogen fragment E or Arg-Gly-Asp-containing peptides. Unlabeled fibrinogen (3.1 microM) completely abolished specific binding, whereas greater than 80% inhibition was achieved with 10 microM fragment D95. Sodium dodecyl sulfate polyacrylamide gel electrophoresis and autoradiography of 125I-FGN bound in the presence of calcium demonstrated disappearance of A alpha chains with formation of products of Mr greater than 200,000; EDTA or unlabeled fibrinogen prevented fibrinogen processing. These data describe a unique fibrinogen-hepatocyte interaction which differs considerably from the platelet-fibrinogen interaction, especially with regard to the processing of the fibrinogen molecule. PMID- 3818661 TI - Carbon monoxide dehydrogenase from Methanosarcina barkeri. Disaggregation, purification, and physicochemical properties of the enzyme. AB - Carbon monoxide dehydrogenase from acetate-grown cells of Methanosarcina barkeri exists in a high molecular weight form (approximately 3 X 10(6)) under conditions of high ionic strength but is converted to a much smaller form by dialysis. The enzyme was purified by a procedure which exploits isolation of the aggregated form by gel filtration and subsequent dissociation. Following this, the enzyme was purified to within 92% of homogeneity by chromatography on phenyl-Sepharose and finally on hydroxylapatite. Due to the extreme oxygen lability of the enzyme, the entire procedure was carried out within the anaerobic laboratory at the National Institutes of Health. The enzyme has an alpha 2 beta 2 oligomeric structure composed of subunits with molecular weights of 19,700 and 84,500. The amino acid compositions of the individual subunits were determined. Analysis of the metal content by plasma emission spectroscopy indicated 1.3 +/- 0.3 (n = 4) nickel and 15.6 +/- 5.6 (n = 5) iron per mol of alpha 2 beta 2. The enzyme did not contain significant amounts of cobalt or molybdenum. Ferredoxin, FAD, FMN, 2,3,5-triphenyltetrazolium chloride, methyl viologen, and phenazine methosulfate served as electron acceptors; however, the enzyme failed to reduce NAD+, NADP+, or the 8-hydroxy-5-deazaflavin factor F420. The optimum pH was between 7 and 9. The apparent Km for methyl viologen was 7.1 mM, whereas the value for 2,3,5 triphenyltetrazolium chloride was below 0.5 mM. Strong inhibition was observed by oxygen and cyanide. Inactivation by glyoxaldehyde required enzymatic turnover which suggested that a reactive group was formed, or exposed, on an enzyme intermediate in catalysis. A high degree of thermostability was noted. Carbon monoxide, however, rendered the enzyme more susceptible to temperature inactivation. PMID- 3818662 TI - Affinity-purified melittin antibody recognizes the calmodulin-binding domain on calmodulin target proteins. AB - Melittin is a 26-amino acid amphipathic peptide which binds to calmodulin in a calcium-dependent manner. The utility of melittin as a peptide replica of the calmodulin-binding region of calmodulin acceptor proteins (CaMBPs) was investigated. Antibody against melittin was raised and purified by antigen affinity chromatography. Interaction of the antibody with CaMBPs was initially suggested by the ability of anti-melittin-Sepharose, but not nonimmune IgG Sepharose, to bind calmodulin-dependent cyclic AMP phosphodiesterase. Direct interaction of melittin antibody with the calmodulin-binding domain of acceptor proteins was demonstrated by quantitative inhibition of calmodulin binding to the purified CaMBPs, myosin light chain kinase, and eel electric organ CaMBP55. These results indicate that melittin antibody identifies regions of structural similarity between calmodulin acceptor proteins, and this region includes a common calmodulin-binding domain. PMID- 3818663 TI - Cell substrate adhesion-induced redistribution of proteins among the apical, basal, and internal domains of the plasma membrane of HeLa cells spreading on gelatin. AB - The establishment of the asymmetric distribution of proteins among the apical, basal, and internal plasma membrane (PM) domains was studied in HeLa cells. Comparisons were made of the amount of membrane and the redistribution of individual PM proteins in the three PM domains for cells on substrates that either induced cell attachment and spreading (gelatin), or induced only attachment (bovine serum albumin (BSA]. Many PM proteins were asymmetrically segregated among the apical, basal, and internal PM domains when cells were attached to gelatin. However, most of the proteins were not totally excluded from any of the domains. In contrast, there was no segregation of membrane components in cells attached to BSA. The segregation of most proteins was well established within 7.5 min of cell attachment when the cells were only partially spread. Cell adhesion induced a change in the movement of total membrane between the internal PM and the external PM domains. When cells attached to either gelatin or BSA there was a transient decrease in the internal PM pool that lasted less than 20 min. For cells attached to BSA the transient decrease was followed by the re establishment of the internal PM pool which was equivalent to that found in cells in suspension, whereas in cells spreading on gelatin there was only a partial re establishment of the internal PM pool. Taken together, these observations suggest that the internal PM rapidly moved to the external PM domain during cell adhesion, and that particular PM proteins moved from the internal PM pool into the newly established basal and apical PM domains. PMID- 3818664 TI - A novel cell line (Caco-2) for the study of intestinal lipoprotein synthesis. AB - Lipoprotein synthesis by the colonic adenocarcinoma cell line Caco-2 was investigated to assess the utility of this cell line as a model for the in vitro study of human intestinal lipid metabolism. Electron micrographic analysis of conditioned medium revealed that under basal conditions of culture post-confluent Caco-2 cells synthesize and secrete lipoprotein particles. Lipoproteins of density (d) less than 1.063 g/ml consist of a heterogeneous population of particles (diameter from 10 to 90 nm). This fraction consists of very low density lipoproteins (d less than 1.006 g/ml) and low density lipoproteins (d = 1.019 1.063 g/ml). Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of [35S]methionine-labeled Caco-2 lipoproteins revealed that very low density lipoproteins contain apolipoprotein E (apoE) and C apolipoproteins, while low density lipoproteins contained apoB-100, apoE, apoA-I, and C apolipoproteins. The 1.063-1.21 g/ml density fraction contained two morphological entities, discoidal (diameter 15.6 +/- 3.9 nm) and round high density lipoprotein particles (diameter 10.2 +/- 2.3 nm). The high density lipoproteins contained apoA-I, apoB-100, apoB-48, apoE, and the C apolipoproteins. Using isoelectric focusing polyacrylamide gel electrophoresis newly secreted apoA-I was identified as pro-apoA-I. ApoE and apoC-III released by Caco-2 cells were highly sialylated. mRNA species for apoA-I, apoC-III, and apoE, but not apoA-IV were identified by Northern blot analysis. ApoA-I, apoB, and apoE were visualized in Caco-2 cells by immunolocalization analysis. This intestinal cell line may be useful for in vitro studies of nutritional and hormonal regulation of lipoprotein synthesis. PMID- 3818665 TI - Golgi endo-alpha-D-mannosidase from rat liver, a novel N-linked carbohydrate unit processing enzyme. AB - An enzyme has been found in Triton-treated rat liver Golgi membranes which trims Glc1Man9GlcNAc to Man8GlcNAc with the release of Glc alpha 1-3Man. By removing a glucosylmannose disaccharide and yielding only one Man8GlcNAc isomer, this endo alpha-D-mannosidase provides a processing route alternative to the sequential actions of alpha-glucosidase II and alpha-mannosidase I. The endomannosidase was fully active in the presence of 1-deoxynojirimycin and EDTA which inhibited exoglycosidase release of glucose and mannose, respectively, and these agents were, therefore, included in the standard assay. The specific activity of the endomannosidase was found to be 69-fold greater in Golgi than in rough endoplasmic reticulum (RER) membranes, and Golgi-RER mixing experiments excluded the possibility that the low activity in the RER was the result of some inhibitor present in this fraction. The neutral pH optimum (approximately 7.0) of the enzyme was consistent with a role in N-linked oligosaccharide processing. The existence of an endo-alpha-D-mannosidase pathway for glucose removal could provide an explanation for the incomplete block in oligosaccharide processing which is observed in cells with inhibited or deficient alpha-glucosidase. PMID- 3818666 TI - Limited chymotryptic digestion of bovine adrenal 190,000-Mr microtubule associated protein and preparation of a 27,000-Mr fragment which stimulates microtubule assembly. AB - A heat stable microtubule-associated protein of Mr 190,000 (190-kDa MAP) has been purified from bovine adrenal cortex (Murofushi, H., Kotani, S., Aizawa, H., Hisanaga, S., Hirokawa, N., and Sakai, H. (1986) J. Cell Biol. 103, 1911-1919). Limited chymotryptic digestion of 190-kDa MAP produced a fragment of Mr 27,000 (27-kDa fragment), which bound to microtubules reconstituted in the presence of taxol. This fragment was purified with the aid of cosedimentation with microtubules. The purified 27-kDa fragment showed an ability to stimulate tubulin polymerization in the absence of taxol. Electron microscopic observation of microtubules reconstituted from purified 27-kDa fragment and tubulin revealed that the microtubules were in the form of thick bundles and that lateral projections which can be seen in microtubules reconstituted from intact 190-kDa MAP and tubulin were not observed. These results indicate that 27-kDa fragment includes or is a part of microtubule-binding domain of 190-kDa MAP and that this fragment is active in stimulating microtubule assembly. Amino acid analysis revealed that the 27-kDa fragment was rich in lysine, proline, and alanine, the sum of these three being about 45% of the total amino acids and that the contents of methionine, tyrosine, phenylalanine, and histidine were very low. These data suggest that the microtubule binding domain of the 190-kDa MAP comprises an unique structure. PMID- 3818667 TI - The dermatan sulfate proteoglycans of bovine sclera and their relationship to those of articular cartilage. An immunological and biochemical study. AB - Dermatan sulfate proteoglycans were isolated from adult bovine sclera and adult bovine articular cartilage. Their immunological relationships were studied by enzyme-linked immunosorbent assays using polyclonal antibodies raised against the large and small dermatan sulfate proteoglycans from sclera and a polyclonal and monoclonal antibody directed against the small dermatan sulfate proteoglycans from cartilage. The small dermatan sulfate proteoglycans from sclera and cartilage displayed immunological cross-reactivity while there was no convincing evidence of shared epitope(s) with the larger dermatan sulfate proteoglycans, nor did these larger proteoglycans share any common epitopes with each other. A hyaluronic acid binding region was detected immunologically on the larger scleral dermatan sulfate proteoglycan but was absent from the larger dermatan sulfate proteoglycan of cartilage and both the small dermatan sulfate proteoglycans. These antibodies were used in immunofluorescence microscopy to localize the scleral proteoglycans and molecules containing these epitopes in the eye. The large scleral dermatan sulfate proteoglycan was restricted to sclera while molecules related to the small scleral and cartilage proteoglycans were found in the sclera, anterior uveal tract, iris, and cornea. Amino acid sequencing of the amino-terminal regions of the core proteins of the small dermatan sulfate proteoglycans from sclera and articular cartilage showed that all the first 14 amino acids analyzed were identical and the same as reported earlier for the small bovine skin and tendon dermatan sulfate proteoglycans. These studies demonstrate that the larger dermatan sulfate proteoglycans of sclera and cartilage are chemically unrelated to each other and to the smaller dermatan sulfate proteoglycans isolated from these tissues. The latter have closely related core proteins and probably represent a molecule with a widespread distribution in which the degree of epimerization of glucuronic acid and iduronic acid varies between tissues. PMID- 3818668 TI - Structural studies of rabbit skeletal muscle myosin light chain kinase with monoclonal antibodies. AB - Monoclonal antibodies directed against rabbit skeletal muscle myosin light chain kinase have been used to study the domains of this kinase. Specificity of nine monoclonal antibodies against rabbit skeletal muscle myosin light chain kinase was demonstrated by immunoblot analysis and immunoadsorption of kinase activity. None of the antibodies reacted by immunoblot analysis with either chicken skeletal or rabbit smooth muscle myosin light chain kinases. Epitope mapping of trypsin-digested rabbit skeletal muscle myosin light chain kinase showed that antibodies 2a, 9a, 9b, 12a, 12b, 16a, and 16b are directed against the 40-kDa catalytic domain. In addition, these seven antibodies reacted with sites that are clustered within a 14-kDa fragment of the kinase generated by Staphylococcus aureus V8 protease digestion. Two monoclonal antibodies, 14a and 19a, reacted with two distinct epitopes located within the inactive, asymmetric trypsin fragment. Six of nine monoclonal antibodies (2a, 9a, 9b, 12a, 12b, and 14a) inhibited kinase activity. Kinetic analyses demonstrated that antibodies 2a, 12a, and 14a inhibited kinase activity competitively with respect to myosin phosphorylatable light chain; 2a, 12a, and 14a exhibit noncompetitive inhibition with respect to calmodulin. These data suggest that monoclonal antibodies 2a, 12a, and 14a bind at or adjacent to the active site of the kinase. PMID- 3818669 TI - Constitutive protein secretion from the exocrine pancreas of fetal rats. AB - Two general kinds of exocytotic secretion of proteins are known: that which is stimulated by secretagogues; and constitutive exocytosis, which is unable to be stimulated. The exocrine pancreas has often been cited as a model system for the first kind of secretion. However, the release of digestive enzymes from the exocrine pancreas of 1-day prenatal rats cannot be stimulated by secretagogues; therefore, its secretion is constitutive. To gain insight into the intracellular pathways which mediate secretion in the fetal gland, we examined the kinetics of release of newly synthesized proteins. We find that fetal pancreas in a steady state of secretion releases pulse-labeled secretory proteins in two kinetically distinct phases. The first phase occurring during 0-6.5 h of chase comprises approximately 12% of total incorporated radioactivity, the second phase beginning at greater than 7 h of chase comprises the remainder. Based on analysis by electron microscope autoradiography, radiolabel is localized during the first phase of secretion in immature granules/condensing vacuoles, Golgi compartments, and few mature granules. The second phase of secretion occurs when radiolabel is predominantly in mature granules. We propose that secretion occurs via (at least) 2 exocytotic routes, both of which are constitutive in fetal pancreatic tissue. PMID- 3818670 TI - A cellular 3,3',5-triiodo-L-thyronine binding protein from a human carcinoma cell line. Purification and characterization. AB - A cellular binding protein for 3,3',5-triiodo-L-thyronine (T3) was solubilized with 3-[(3-cholamidopropyl) dimethylammonio]-1-propanesulfonate (CHAPS) from A431 human epidermoid carcinoma cells. The binding activity is T3 specific. Analysis of the equilibrium binding data indicated that the binding protein has one class of binding sites for T3 with a Kd of (17 +/- 3) nM and Bmax of (1.8 +/- 0.6) pmol/50 micrograms of protein. The pH optimum for binding is 6.8. The T3 binding protein elutes from Sephadex G-200 in an included peak which has a Stokes radius of 40 A and sediments on glycerol gradients at 3.7 S. By affinity labeling with [3,5-125I]thyroxine a protein with a molecular weight of 58,000 was specifically labeled. Its isoelectric point was determined to be 7.1, which is different from the reported pIs of other thyroid hormone binding proteins. p58 was successively purified to apparent homogeneity by chromatography on Sephadex G-200, QAE Sephadex, SP-Sephadex, and hydroxylapatite. Approximately 50 micrograms of purified protein was obtained from 2.5 X 10(9) cells with a yield of 1.1%. The purified protein retains its binding activity. The specific binding activity is enriched by approximately 1000-fold. With the availability of a purified protein with T3 binding activity, it becomes possible to study its cellular function. PMID- 3818671 TI - Pelvic stress. AB - Biomechanics testing simulated stress concentrations in the acetabulum resulting from a blow to the right trochanter, as commonly occurs in recreational and passenger contexts. Developing tolerance criteria for the pelvis is addressed in this paper in terms of the load distribution and energy transmission to the pelvis via both soft tissues and the femur, the instability of the femur-pelvis complex, and the difficulty of predicting stress using simple, experimentally derived, parameters. PMID- 3818672 TI - A global mathematical model of the cerebral circulation in man. AB - A mathematical model of the cerebral circulation has been formulated. It was based on non-linear equations of pulsatile fluid flow in distensible conduits and applied to a network simulating the entire cerebral vasculature, from the carotid and vertebral arteries to the sinuses and the jugular veins. The quasilinear hyperbolic system of equations was numerically solved using the two-step Lax Wendroff scheme. The model's results were in good agreement with pressure and flow data recorded in humans during rest. The model was also applied to the study of autoregulation during arterial hypotension. A close relationship between cerebral blood flow (CBF) and capillary pressure was obtained. At arterial pressure of 80 mmHg, the vasodilation of the pial arteries was unable to maintain CBF at its control value. At the lower limit of autoregulation (60 mm Hg), CBF was maintained with a 25% increase of zero transmural pressure diameter of nearly the whole arterial network. PMID- 3818673 TI - When and how does steady state gait movement induced from upright posture begin? AB - The aim of this research was to study when and how the stationary process of gait begins when walking starts from upright posture. The subject initially stood up on a large force plate, then walked. Three conditions of speed (slow, normal, fast) were examined. Five subjects participated in the experiment. A total of 105 trials were performed. The results show that, at the end of the first step, the progression velocity of the center of gravity is not significantly different from the mean progression velocity of gait during the second step of gait and that the time necessary to reach steady state gait from initial posture phase is constant. Furthermore, the frequency of the first step, when compared to published values of the steady state gait frequency, is not significantly different from these frequencies. It can be concluded that the aim of the gait initiation process is to place the subject in steady-state gait within the first step, in an invariant time which is dependent only on the body segment parameters of each subject. PMID- 3818674 TI - The effect of the interface on the bone stresses beneath tibial components. AB - It was proposed that the stresses in the layer of bone immediately beneath a tibial component are an important determinant of fixation durability. Using finite element analysis, (ANSYS), the stresses were determined as a function of the amount of bone resection, the localization or completeness of implant-bone contact, and the interface material. The model was of two-dimensional sagittal slices consisting of quadrilateral elements (1 mm) with a range of seventeen material properties determined by CT scans. Typical prosthesis designs shifted the center of pressure more centrally rather than posteriorly, and thus increased anterior bone stresses. Resection up to 10 mm could actually decrease bone stresses due to an increase in bone surface area as long as complete coverage was obtained. A cement interface or direct metal on bone produced identical stresses. However a 1 mm compliant interface significantly reduced stresses in regions of high elastic modulus gradient. For rigid interfaces, the contact can be irregular, which leads to areas of over and under-stressing of bone. These conclusions have implications related to implant design. PMID- 3818675 TI - Use of quadruped models in thoraco-abdominal biomechanics research. AB - Pigs and dogs have become common models of human thoraco-abdominal impact response. This paper summarizes a comparative analysis of the dog and pig to the live human accomplished through a series of necropsies performed on pigs and dogs. The results are summarized below. Emphasis is placed on specific aspects which are felt to be important for impact biomechanics. In particular, emphasis is placed upon the effect of tethering structures because of their potential in explaining mechanisms of injury for specific types of trauma such as aortic and certain liver injuries. Some aspects of tethering in the pig and dog are significantly different from that of the live human so care should be taken when using these animals in thoraco-abdominal biomechanics experiments. PMID- 3818676 TI - An in vitro simulation study of impulsive force transmission along the lower skeletal extremity. AB - Several investigators have revealed that a relationship exists between articular cartilage deterioration and the mechanical stress that results from transient impulsive forces created in the lower extremity during gait. This study is an investigation of the transmission of impulse waves through the lower extremity and the effect of knee pathology and prosthetic knee replacement on their transmission. An in vitro experiment is performed using human cadaver specimens that are instrumented with accelerometers. The distal end of the tibia is impacted with a vibration shaker to simulate heel strike. The results indicate that the normal knee joint is able to attenuate 59% of the transient peak force applied to it by the tibia. This attenuation capacity is reduced by knee pathology and decreases further with implantation of a knee prosthesis. The results indicate that abnormalities at the knee may increase the risk of degenerative changes at the ankle, hip and in the spine due to increased transient impulsive forces. PMID- 3818677 TI - A biomechanical model of the foot. AB - The foot is modeled as a statically indeterminate structure supporting its load at the heads of the five metatarsals and the tuberosity of the calcaneous. The distribution of support is determined through an analysis of the deformations caused in the structure as a result of the forces at these locations. The analysis includes the effect of the plantar aponeurosis and takes into account the deformation of the metatarsals and bending of the joints. A parametric study is presented to illustrate the behavior of the solution under a broad range of conditions. PMID- 3818678 TI - The chronic effects of beta-adrenoreceptor antagonists on the efflux of tritiated noradrenaline from sympathetic nerves of the pithed rat. AB - The effect of chronic administration of two beta-adrenoreceptor blocking drugs, propranolol and timolol, on transmitter noradrenaline release from sympathetic nerves has been investigated in vivo using the pithed rat preparation. Oral treatment for 4 weeks with either propranolol (46.3 mg/kg/day) or timolol (7.1 mg/kg/day) significantly raised the stimulation frequency threshold for release of radioactivity on stimulation of the whole spinal outflow of the pithed rat after i.v. injection of 3H-NA. No differences in the stimulation-evoked rise in mean arterial pressure were observed between control or treated rats nor was the heart rate response to stimulation altered after timolol treatment. However, in propranolol treated rats the mean rises in heart rate were significantly higher with 3 and 30 Hz stimulation than in control rats. Timolol treatment significantly increased the blood concentration and lowered the heart content of 3H-NA whilst propranolol treatment did not significantly change either blood or heart levels. Log dose-response curves for mean rises in heart rate after i.v. isoprenaline were not shifted to the right in either propranolol or timolol treated pithed rats. With the lowest doses of isoprenaline (1 and 25 ng), the mean rises in heart rate in timolol treated rats were significantly greater than in the controls. Thus chronic administration of propranolol or timolol decreased the stimulation-induced increase in plasma 3H-NA but this change in release was not related to reduced rises in blood pressure or heart rate. PMID- 3818679 TI - Protein adsorption to polymer particles: role of surface properties. AB - Adsorption isotherms of four plasma proteins (fibrinogen, IgG, human serum albumin, and bovine serum albumin) using four different types of small particles as substrates (siliconized glass, Teflon, polyvinylchloride, and Nylon-6,6) are reported. The suspending liquid medium was phosphate-buffered saline, with a surface tension higher than that of any of the proteins. In keeping with the thermodynamic expectations for these systems, protein adsorption decreases for all solids in sequence from fibrinogen (the most hydrophobic) to IgG, human serum albumin, and bovine serum albumin (the most hydrophilic). Furthermore, the extent of protein adsorption also decreases from the low surface tension (hydrophobic) to the higher surface tension solids, again as expected on thermodynamic grounds. There is one minor yet interesting exception to the thermodynamic pattern: In spite of the slightly lower surface tension of siliconized glass, the extent of protein adsorption is slightly higher to Teflon than to siliconized glass. This result is attributed to the theoretically well known phenomenon of "screening." PMID- 3818680 TI - Localized prevention of postsurgical adhesion formation and reformation with oxidized regenerated cellulose. AB - We evaluated oxidized regenerated cellulose (ORC) in experimental rabbit and dog models to assess its potential for reducing or preventing adhesion formation and reformation. Evaluation was performed in the following anatomical sites: uterine horn trauma; small bowel resection and anastomosis; parietal peritoneum excision; and adhesion reformation in the uterine horn. Ten to 14 days after ORC treatment, adhesion formation was macroscopically and microscopically evaluated. Results demonstrate that ORC produced graded reduction in adhesion formation and significantly prevented adhesion reformation. PMID- 3818681 TI - Polarimetric assay for the determination of the native collagen content of soluble collagen. AB - Two standardized assays for determining the amount of native collagen in a collagen solution are described which are based on polarimetric measurements. Native collagen content is calculated from the loss of optical rotation during transition from the original to the denatured conformation using constants which were obtained from standard collagen of highest available native collagen content. While Method I gives information on the content of helical collagen, Method II estimates collagen which is resistant to peptic degradation. Both methods are simple to perform and suitable for routine quality control. PMID- 3818682 TI - Angular dependent ESCA and infrared studies of segmented polyurethanes. AB - The understanding of surface bonding and composition of complex polymer mixtures used for biomedical implant materials can be accomplished by a combination of techniques. In this study, vibrational spectroscopic probes of bulk and surface bonding and composition are combined with measurements with angular dependent X Ray Photoelectron Spectroscopy (XPS or ESCA). These data provide a detailed description in the surface composition of Biomer and Avcothane, commercially available biomedical grade polymers and model systems polydimethylsiloxane (DMS) and Avcomat, all of which have been cast as smooth films from solution. Impurities are observed segregated in the near surface region sampled by ESCA which are not observed in the surface infrared results. Both Attenuated Total Reflectance (ATR) and Photoacoustic (PA) sampling are utilized, ATR to provide a depth profile and demonstrate the higher surface sensitivity of PA sampling. The combined results describe the depth of segregation of DMS blocks in Avcothane, the presence of DMS within the topmost 20 A in Biomer, and similar impurities in the model polymers. These results point out the need for multitechnique approach and the control of sample preparation and morphology in understanding complex polymer surfaces. PMID- 3818683 TI - Biodegradation of a polyurethane in vitro. AB - This study examines the effect of in vitro exposure to enzymes on the performance properties of Biomer, a segmented polyetherurethane used in a number of blood contacting devices such as catheters, heart assist pumps, and chambers for artificial hearts. The ultrathin samples were treated with two proteolytic enzymes, papain and urease, for periods of 1-6 months at 37 degrees C. The treated Biomer samples were subjected to chemical and physical analysis. Effects of biodegradation by the enzymes were assessed by fatigue tests, gel permeation chromatography (GPC), and attenuated total reflectance-Fourier transform infrared (ATR-FTIR) analysis. Papain was found to be more effective in degrading the polymer than urease. Mechanisms for enzymic degradation are proposed. PMID- 3818684 TI - Bone-particle-impregnated bone cement: an in vitro study. AB - Bone-particle-impregnated bone cement specimens (up to 30% by weight) were characterized by various test methods. The experimental bone cement showed decreased crack propagation rates and increased Young's modulus, while the ultimate tensile strength and impact strength were decreased. The viscosity could be adjusted by adding initiators lost when substituting the PMMA powder with bone particles. The present study warranted further in vivo experiments on the possibility of tissue ingrowth for which the new bone cement was developed. PMID- 3818685 TI - Serum complement deposition on platinum and titanium oxide surfaces measured by ellipsometry at liquid-solid interface. PMID- 3818686 TI - Social change, migration and pregnancy intervals. PMID- 3818687 TI - Cause of death in widow(er)s and spouses. PMID- 3818688 TI - Maternal characteristics and the distribution of birthweight standardized for gestational age. PMID- 3818689 TI - Biosocial behaviour cycles: a field study in an East Indian village community. PMID- 3818690 TI - Differentials of fertility between polygynous and monogamous marriages in rural Bangladesh. PMID- 3818691 TI - Regional variation in the age-specific natural fertility curve. PMID- 3818692 TI - Cessation of childbearing in the absence of contraception in Sri Lanka. PMID- 3818693 TI - The relative rate of maturation and its psychological effect. PMID- 3818695 TI - Reasons for consanguineous marriages in Japan. PMID- 3818694 TI - Contraceptive choice in an urban clinic in Nigeria. PMID- 3818696 TI - Prior deposit of autologous blood for transfusion. PMID- 3818697 TI - Prior deposition of autologous blood in elective orthopaedic surgery. AB - We retrospectively analyzed a program of prior deposit and storage of autologous blood that was used for patients who underwent elective orthopaedic procedures over a period of thirty-six months at the Walter Reed Army Medical Center. Of a total of 211 patients who underwent total joint replacement or spinal fusion during this period and who had sufficient records to be included in the study, a total of 159 patients enrolled in the program. The fifty-two patients who did not enroll in the study, twelve of whom were rejected because of medical problems, served as a control group. Since the preoperative hematocrit values for patients in the group that received autologous blood were similar to those for the control group, multiple preoperative phlebotomies in these patients, who had received supplemental iron, did not seem to have any deleterious effects. One hundred and thirteen (71 per cent) of the 159 patients who were enrolled in the program received only autologous blood. The remaining forty-six patients required homologous blood also, but 64 per cent of their transfusion needs were provided by autologous blood. The only reactions to the transfusions in the study were in four patients who received homologous blood. We think that a program of prior deposit and storage of autologous blood should be an option for patients who are to undergo elective orthopaedic surgery. Such a program is well tolerated by the patients and easily managed by the staff, and it was not difficult to implement at our tertiary referral hospital. PMID- 3818698 TI - Transfusion of previously deposited autologous blood for patients undergoing hip replacement surgery. AB - The efficacy of a program of transfusion of previously deposited autologous blood for patients undergoing total hip-replacement surgery was studied by comparing five different parameters for a group of fifty consecutive patients who deposited blood for autologous transfusion and a randomly chosen, closely matched control group of fifty patients who received only homologous blood. Sixty-two per cent of the patients in the group that deposited autologous blood did not receive additional homologous blood while in the hospital. The patients who deposited autologous blood had a mean preoperative hematocrit of 36 per cent, compared with 39 per cent for the control group, but the average postoperative hematocrits of the two groups did not differ (33 per cent). There was no significant difference in the average total loss of blood or need for replacement of blood between the groups. Transfusion-related complications developed in two patients in the control group. We concluded that previous deposit of autologous blood for transfusion is an effective method for reducing the need for transfusion of homologous blood and for avoiding the attendant complications of transfusion of homologous blood. This method of the replacement of blood should be considered for patients who are to undergo a major orthopaedic procedure on the hip. PMID- 3818699 TI - The use of banked autologous blood in patients undergoing surgery for spinal deformity. AB - The cases of fifty-two patients who underwent sixty elective spinal fusions for spinal deformity were studied to evaluate the efficacy of the use of banked autologous blood to replace operative loss of blood. The patients ranged in age from ten to forty-nine years. Each patient began to take 325 milligrams of ferrous sulphate, three times a day, as soon as surgery was scheduled, and was evaluated weekly at the Shepeard Community Blood Bank. If a patient's hemoglobin level was more than eleven milligrams per 100 milliliters, either a whole unit of blood or a half-unit was drawn at each visit. An average of 3.3 units of blood (range, 1.5 to 6.0 units) was obtained and was stored for as long as forty-two days. Either citrate phosphate dextrose with adenine (CPDA-1) or adenine, dextrose, and mannitol (ADSOL) was used as a preservative. In 85 per cent of the procedures only autologous blood was required for transfusion. This method proved to be simple, safe, and very well accepted. PMID- 3818700 TI - Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. AB - The results in ninety-three knees that had been treated by proximal tibial opening-wedge osteotomy for varus deformity and osteoarthritis of the medial compartment were evaluated after a mean length of follow-up of 11.5 years (range, ten to thirteen years). After ten years, only forty-two (45 per cent) of the ninety-three knees had an excellent or good result, and in fifty-one knees there was recurrent pain for which seventeen had another operation. At five years, on the other hand, 90 per cent of the knees had a good result. Deterioration occurred at an average of seven years after the osteotomy and was always associated with recurrence of pain. Although the results deteriorated with time, time was not the only determinant of the result. Alignment, measured as the hip knee-ankle angle on radiographs of the whole limb that were made with the patient bearing weight, was also a determinant of long-term results. The best results were obtained in the twenty knees that had a hip-knee-ankle angle of 183 to 186 degrees. In these knees, there was no pain and no progression of the arthrosis in either the medial or the lateral tibiofemoral compartment. Of the five knees that had an angle of more than 186 degrees, all five had progressive degenerative changes in the lateral compartment. In the sixty-eight undercorrected knees (an angle of less than 183 degrees), the results were less satisfactory, and there was a tendency toward recurrence of the varus deformity and progression of the arthritis of the medial compartment. However, when the correction was insufficient the deterioration was slow (average, seven years), and it was not associated with lateral laxity and deterioration of the lateral compartment, which are the changes that characterize the natural course of gonarthrosis as described by Hernborg and Nilsson. Therefore, proximal tibial osteotomy is a very suitable operation for patients who have gonarthrosis of the medial compartment, but a rigidly standardized and precise operative technique is required as well as accurate radiographic measurements of the mechanical axis of the limb, because exact postoperative alignment is the prerequisite for the longest possible period of relief of symptoms after osteotomy. PMID- 3818701 TI - The early healing of tibial osteotomies stabilized by one-plane or two-plane external fixation. AB - The pattern of early healing of canine tibial osteotomies associated with two different types of external fixation devices was investigated. Two-plane fixation was significantly more rigid than one-plane fixation in three of the five loading conditions that were examined. The more rigid fixation allowed less lateral displacement at the site of the osteotomy, induced less formation of callus early in the healing process, permitted direct bridging by osteons more frequently, and provided healing that was more rigid early in the process of repair. In the later stages of healing there were no differences in the quantity of callus or in the strength of the healing bone. In this canine model, external fixation with higher rigidity resulted in rapid union that differed from the union that resulted after less rigid external fixation only with regard to porosity, torsional stiffness, and displacement at the site of the fracture. PMID- 3818702 TI - The reconstruction of defects in the femoral shaft with vascularized transfers of fibular bone. AB - Seven major reconstructions of the femoral shaft using a vascularized graft of bone from the fibula were performed at the Massachusetts General Hospital from 1981 to 1984. Three patients had a post-traumatic infected non-union; one, extensive osteomyelitis of the femoral shaft; one, a fractured allograft; one, an atrophic non-union associated with radiation therapy; and one, post-traumatic loss of a ten-centimeter segment of bone. Six of the seven patients had a skeletal femoral defect, ranging from seven to fifteen centimeters in length. The average length of fibula that was used for reconstruction was 19.6 centimeters. Primary skeletal union occurred in five of the seven patients. Two patients had healing only at the distal junction and required a conventional bone graft and supplementary internal fixation of the proximal junction. At an average length of follow-up of thirty-four months, all of the patients were able to walk. Only two patients, both of whom had an extreme limb-length discrepancy, required additional support. PMID- 3818703 TI - Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases. AB - Seventeen patients who had a closed fracture of the radial head that was not associated with a dislocation of the elbow or another injury were evaluated eight to forty-six years after resection of the radial head. Few patients complained of even mild, intermittent pain. The ranges of motion of the wrist and elbow were nearly normal, but pronation and supination were decreased by an average of 7 and 15 degrees, respectively. Cybex testing showed losses of strength in pronation and supination of approximately 5 and 11 per cent, respectively. The ulnar variance became increasingly positive by an average of approximately two millimeters, and cubitus valgus increased an average of 9 degrees. These excellent results did not appear to deteriorate over time. In one patient a radio ulnar synostosis developed. PMID- 3818704 TI - The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. AB - Both feet of 441 normal subjects, who ranged in age from one to eighty years, were studied to document the configuration of the longitudinal arch. The findings showed that flat feet are usual in infants, common in children, and within the normal range of the observations made in adult feet. Documentation and observation is the recommended management of the flexible flat foot that falls within the normal range. PMID- 3818705 TI - Occipito-atlantal instability in children. A report of five cases and review of the literature. AB - We are reporting the cases of five patients who had occipito-atlantal instability, a rare condition that may be due to either trauma or congenital abnormalities. In three of the patients the instability was secondary to trauma. The clinical and neurological manifestations were varied and included cardiorespiratory arrest, motor weakness, quadriplegia, torticollis, pain in the neck, vertigo, and projectile vomiting. All of the patients underwent posterior arthrodesis of the occiput to the first or second cervical vertebra. In the patients who had trauma-related instability, surgery was performed when immobilization in a cast failed to stabilize the spine; in the patients who had a congenital abnormality, arthrodesis was indicated because of persistent symptoms and the potential for catastrophe with minor trauma. Based on our experience, we recommend surgical stabilization by posterior arthrodesis when this form of instability of the cervical spine is diagnosed. PMID- 3818706 TI - Gait patterns in spastic hemiplegia in children and young adults. AB - Four homogeneous patterns of gait were defined in forty-six patients who had spastic hemiplegia secondary to cerebral palsy or other neurological disorders by analyzing kinematic data in the sagittal plane and electromyographic data. In Group I (twenty patients) the primary abnormality was a drop foot in the swing phase. The thirteen patients in Group II had a tight heel cord in the stance phase as well as a drop foot in the swing phase. The five patients in Group III also had more proximal involvement (that is, restricted motion of the knee) as well as an equinus deformity of the ankle. In Group IV, the eight patients had, in addition, restricted motion of the hip. PMID- 3818708 TI - Osteoid-osteoma. Report of a case in a sixty-seven-year-old man. PMID- 3818707 TI - The use of urokinase in ischemic replanted extremities in rats. AB - We compared the efficacy of intra-arterial infusion of urokinase, a fibrinolytic agent, with that of intra-arterial infusion of nitrendipine, a peripheral calcium channel blocking agent, in preventing the no-reflow phenomenon in rats after prolonged ischemia at room temperature. Urokinase increased the survival of the limbs after both four and five hours of ischemia at room temperature to 100 per cent compared with 50 and 20 per cent, respectively, in untreated controls. Nitrendipine significantly increased the blood flow but failed to significantly increase the survival of the limb. Scanning electron microscopy was used to assist in the evaluation of the endothelium of the vessels. The etiological mechanism of the no-reflow phenomenon appears to be that ischemia damages the endothelial cells, causing impairment of the fibrinolytic system, retraction of the endothelial membrane, exposure of the subintimal collagen, and fibrin platelet deposition. Thrombosis of the vessels ensues, resulting in the no-reflow phenomenon. CLINICAL RELEVANCE: Experimentally, intra-arterial infusion of urokinase increased the survival of the limb in replanted extremities that were subjected to ischemia. This effectively lengthened the safe limit of ischemia at room temperature before microsurgical replantation or elective free-tissue transfer. Clinical trials of the use of intra-arterial fibrinolytic agents for the treatment of revascularized tissue are indicated. PMID- 3818709 TI - Coexistent infection and tumor of the spine. A report of three cases. PMID- 3818710 TI - Vertebral malacoplakia. A case report. PMID- 3818711 TI - Fundamentals of statistics for orthopaedists: Part IV. PMID- 3818712 TI - The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement. PMID- 3818713 TI - Stabilisation of the cervical spine. PMID- 3818714 TI - Early bleeding into upper limb muscles in severe haemophilia. Clinical features and treatment. AB - The clinical features, management and outcome of bleeding into the muscles of the upper limb of 44 patients are reported. Of 158 episodes of bleeding, 99% were treated within two hours of onset of symptoms and the mean time to complete restoration of function was 2.1 days. The most frequent site of bleeding was the deltoid muscle (24%), followed by the forearm flexors (23.5%), brachioradialis (19.5%), biceps (14%), forearm extensors (11%) and triceps (8%). The majority of bleeds presented with pain, either on movement or at rest, or with tenderness. Bleeds into the biceps required the most transfusions (mean 2.00) and took the longest to resolve (mean 4 days). Bleeding into the flexors and extensors of the forearm resolved most rapidly. The policy of early treatment has been shown to be effective in prompting early and complete recovery. PMID- 3818715 TI - The Magnuson-Stack operation for recurrent anterior dislocation of the shoulder. A review of 38 cases. AB - The modified Magnuson-Stack procedure of lateral and distal transfer of the insertion of the subscapularis muscle was used in 38 consecutive patients with recurrent anterior dislocation of the shoulder, all of whom have been followed-up for a minimum of three years. There was only one failure; the other 37 patients had an excellent or satisfactory result with an adequate range of movement. Bankart and Hill-Sachs lesions were not a constant finding but subscapularis laxity was detected in almost every case, an observation that helps to confirm its central role as a cause of recurrence. PMID- 3818716 TI - Arthroplasty of the elbow. Twenty years' experience of a new approach. AB - We report the use of a new approach for elbow arthroplasty in 58 cases over a 20 year period. A wide exposure, obtained by elevating the triceps attachment and dividing the radial collateral ligament, allows the excision of diseased tissue, articular irregularities and osteophytes. Normal anatomy is restored and active mobilisation can be started 10 days after operation. Good or fair results, with over 70 degrees of joint movement, were achieved in 88% of cases. PMID- 3818717 TI - The Herbert screw for fractures of the scaphoid. A review of results and technical difficulties. AB - We have reviewed 22 patients with scaphoid fractures treated by internal fixation with the Herbert screw. Three patients had trans-scaphoid perilunar dislocations, one had an oblique displaced fracture of the waist of the scaphoid and 18 had fractures with delayed or non-union. Corticocancellous bone grafts were added in nine of the cases of non-union. Results were excellent or good in 80% of cases after a mean duration of postoperative immobilisation of four weeks. The technical difficulties are analysed and the problems of applying the jig and of operative exposure are discussed. PMID- 3818718 TI - Fat embolism and the fat embolism syndrome. A double-blind therapeutic study. AB - Fifty-five adults who had sustained a tibial fracture, or a femoral fracture, or both, were subjected to a double-blind randomised study to determine the efficacy of methylprednisolone in treating the fat embolism syndrome. This drug maintained arterial oxygen levels, stabilised or reduced the serum level of free fatty acids, and decreased the risk of the fat embolism syndrome in a statistically significant proportion of patients. Gurd's criteria for the diagnosis of the fat embolism syndrome were found inadequate. Other more sensitive criteria for early diagnosis and effective management were determined. There were no deaths or serious morbidity in our series. PMID- 3818719 TI - Adolescent idiopathic thoracic scoliosis. A prospective trial with and without bracing during postoperative care. AB - Fifty patients with adolescent idiopathic scoliosis treated by posterior fusion and Harrington instrumentation augmented by a Cotrel bar or by sublaminal Luque wires were studied in a prospective trial to ascertain the need for postoperative bracing. Twenty-five patients wore a plaster brace postoperatively for six months, while 25 were managed without a brace. The mean loss of correction from the first standing postoperative radiograph to one obtained two years later was 7 degrees in the braced group, and 6.3 degrees in the unbraced group, the difference not being statistically significant. We conclude that postoperative bracing is unnecessary after augmented Harrington instrumentation. PMID- 3818720 TI - Chondrosarcoma developing in synovial chondromatosis. A case report. AB - Synovial chondromatosis is a rare condition in which osteocartilaginous nodules are formed by synovial metaplasia and become intra-articular loose bodies. It is usually monarticular, most commonly affecting the knee and is regarded as invariably benign. There are reports of malignant change, but only the two case studies of Mullins, Berard and Eisenberg (1965) and of Dunn et al. (1974) fully document the development of chondrosarcoma in this condition. We report a patient with a long history of histologically proven synovial chondromatosis in whom the condition became clinically aggressive and underwent malignant transformation to chondrosarcoma. PMID- 3818721 TI - Combined chemotherapy and surgery for hydatid bone disease. AB - Surgical treatment of hydatid bone disease is rarely completely successful because radical excision is only possible at certain sites and secondary infection frequently occurs. Antihelmintic drugs have in the past been only palliative due to poor absorption and consequent low concentration in serum or cysts. We report five patients with Echinococcus granulosus infestation treated with a new chemotherapeutic agent albendazole; in two it was given postoperatively, in two pre-operatively and one child is being followed expectantly. We believe that a combination of chemotherapy and surgery may be efficacious in the treatment of hydatid bone disease. PMID- 3818722 TI - Acute calcific supraspinatus tendinitis in a three-year-old child. PMID- 3818723 TI - Osteoid osteoma of the atlas. PMID- 3818724 TI - Vesico-acetabular fistula. PMID- 3818725 TI - Aneurysm after arthroscopy. PMID- 3818726 TI - A prospective study of parachute injuries in civilians. AB - A prospective study of 33 civilian parachutists with 41 injuries is presented. Because the training for civilians is less rigorous than that for military parachutists, the hospital admission rate for severe injuries was high (81.8%). Most injuries occurred during landing and the ankle was most frequently involved. The types and possible mechanisms of injury are discussed, as well as recommendations for modifying the civilian training programme. PMID- 3818727 TI - Anterior and posterior instrumentation and fusion of thoracolumbar scoliosis due to myelomeningocele. AB - Twenty-three patients with severe paralytic thoracolumbar scoliosis due to a myelomeningocele were treated by a two-stage procedure. Before operation the mean scoliosis was 98 degrees: after the first-stage procedure, an anterior spinal fusion and correction with Dwyer instrumentation, this was reduced to a mean of 45 degrees. Approximately two weeks later a posterior spinal fusion with Harrington instrumentation was performed, further reducing the scoliosis to a mean of 29 degrees. The pelvic obliquity also was reduced from a mean of 32 degrees to 6 degrees. Although such management carries risks (one patient died of cardiorespiratory failure after the first stage and one patient was made worse), 21 of the 23 patients had improved posture and function. PMID- 3818728 TI - Discitis after discography. AB - Infection after intradiscal injections has been recognised as a distinct entity, but discitis after discography has often been attributed to an aseptic process or a chemical reaction to the contrast material. We examined the hypothesis that discitis after discography is always due to infection, and report a clinical review and an experimental study. Part I. We reviewed the case records and radiographs of 432 patients who had undergone lumbar discography. When an 18 gauge needle without a stilette had been used, discitis was diagnosed in 2.7% of 222 patients but stiletted needles and a two-needle technique at each level reduced the incidence to 0.7%. Seven patients with discitis after discography had undergone anterior discectomy and fusion; in them the histopathological findings were of a chronic inflammatory response. Bacteria were isolated from the discs of three of the four patients who had open biopsy less than six weeks from the time of discography. These findings suggest that bacteria were initiators rather than promoters of the response. Part II. Multiple level lumbar discography was carried out in mature sheep, injecting contrast material with or without various concentrations of bacteria. Radiographs were taken and the discs and end-plates were examined histologically and cultured for bacteria at intervals after injection. None of the controls showed any evidence of discitis but all sheep injected with bacteria had typical radiological and histopathological changes by six weeks, though cultures were almost all negative. However, at one and two weeks after injection, but usually not after three weeks, bacteria could be isolated. We suggest that all cases of discitis after discography are initiated by infection, and that a very strict aseptic technique should be used for all injections into intervertebral discs. PMID- 3818729 TI - Cauda equina and lumbar nerve root compression in patients with AIDS. AB - Five patients known to be HIV (human immunodeficiency virus)-positive--that is, susceptible to AIDS--presented with symptoms initially thought to be indicative of lumbar disc lesions. Signs of nerve root or cauda equina compression were found in all five patients. Lumbar radiculography and, in one patient, computerised tomography produced no evidence of compressive pathology. We recommend that orthopaedic surgeons exercise caution in diagnosing nerve root compression in patients who may be HIV-positive. PMID- 3818730 TI - Nutritional osteomalacia presenting with plantar fasciitis. AB - We report five patients with nutritional osteomalacia who presented with the symptoms and signs of plantar fasciitis. All the patients were Asian vegetarian women. All improved with treatment of the osteomalacia, albeit slowly in two cases. PMID- 3818731 TI - The articular diversity of early haemochromatosis. AB - This report details seven patients who had an arthropathy at presentation of their haemochromatosis. The spectrum ranged from arthralgia and normal radiographs to classic polyarthritis and the typical radiological triad of joint space narrowing, sclerosis and cysts. Some atypical presentations are highlighted. An early diagnosis of haemochromatosis requires clinical suspicion; support can be obtained from serum iron studies, particularly saturation of iron binding capacity and ferritin, and from biopsy of liver and/or synovium. PMID- 3818732 TI - Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. AB - Total hip replacement using porous-coated cobalt-chrome femoral implants designed for biological fixation has been evaluated in 307 patients after two years and in 89 patients after five years. Histological study of 11 retrieved specimens showed bone ingrowth in nine and fibrous tissue fixation in two. Fixation by bone ingrowth occurred in 93% of the cases in which a press fit of the stem at the isthmus was achieved, but in only 69% of those without a press fit. The clinical results at two years were excellent. The incidence of pain and limp was much lower when there was either a press fit of the stem or radiographic evidence of bone ingrowth. Factors such as age, sex, and the disease process did not influence the clinical results. Most cases showed only slight resorptive remodelling of the upper femur, but in a few cases with a larger, more rigid stem, more extensive bone loss occurred. The results after five years showed no deterioration with time. Fixation by the ingrowth of bone or of fibrous tissue both appeared to be stable, but bone ingrowth gave better clinical results. PMID- 3818733 TI - Healing time of tibial fractures in Ugandan Africans. PMID- 3818734 TI - Revision of failed total hip arthroplasty. AB - Ninety-seven revisions of total hip replacements are reviewed with a median time of observation of 47 months. Satisfactory pain relief was obtained in 86%. There were six complete failures which were reduced to three by further surgery. One hip became infected and was excised. In 12 cases the revisions were complicated by peroperative fractures and in five by dislocations. Radiographic analysis disclosed a high percentage of periarticular ossification and 25 cases of radiographic loosening of the femoral implant. PMID- 3818735 TI - External wear of the polyethylene socket in cemented total hip arthroplasty. AB - We examined 59 cemented high density polyethylene sockets removed at revision hip arthroplasty. Of these 19 showed areas of wear between the outside of the socket and the acetabular bone. This was associated with lack of acrylic cement in those areas and was also related to the depth of the wear on the articulating surface of the socket. It is suggested that, in some cases, changes at the bone-cement junction are secondary to socket loosening and abrasion against the bone of the acetabulum, rather than to particles migrating from the metal-polyethylene interface. It is therefore important that impingement of the neck of the femoral stem on the edge of the cup be avoided and that, when the socket is inserted, it is not in direct contact with the bone. PMID- 3818736 TI - Treatment of fractures of the distal third of the femur. A prospective trial of the Derby intramedullary nail. AB - We report a prospective study of 26 cases of fracture of the distal third of the femur treated with the Derby intramedullary nail. This new design controls rotation and allows compression of the fracture, permitting early weight-bearing. All the fractures united in good position within four months, 12 of them with minimal external callus. There were no implant failures and the only serious complication was one case of deep infection. PMID- 3818737 TI - The influence of joint posture on intra-articular pressure. A study of transient synovitis and Perthes' disease. AB - The pathogenesis of Perthes' disease has been related to increased intra articular pressure secondary to a joint effusion. The pressure within the hip in different positions was measured in eight children with transient synovitis and four with the synovial stage of Perthes' disease. In the position of comfort for the hip this pressure was always less than the arteriolar blood pressure and in a supine position it did not exceed the systolic blood pressure. However, in extension with medial rotation the intra-articular pressure always became several times the systolic blood pressure. This high pressure was also recorded in the stable lateral position which occurs normally during sleep. It is concluded that in the presence of a synovial effusion in the hip, a position of extension and medial rotation causes an increase in intra-articular pressure which may compromise the blood supply to the capital epiphysis of the femur. PMID- 3818738 TI - Femoral anteversion. A clinical assessment of idiopathic intoeing gait in children. AB - Hip rotation in extension and flexion was studied in 23 patients with idiopathic intoeing gait. In extension all the hips had markedly increased medial rotation and limited lateral rotation, fulfilling the criteria of excessive femoral anteversion. In flexion, however, rotation varied widely; in one group of patients medial rotation remained greater than lateral, but in the second group lateral rotation was equal to or greater than medial. CT scans showed that the hips in the first group were significantly more anteverted than those in the second. Clearly measurement of hip rotation in extension alone does not provide a dependable indication of femoral anteversion in children with intoeing gait; rotation in flexion also needs to be measured. PMID- 3818739 TI - Surgical stabilisation of the rheumatoid cervical spine. A review of indications and results. AB - We have reviewed 32 patients with rheumatoid disease of the cervical spine who underwent a total of 40 operations aimed at correcting instability and improving any associated neurovascular deficit. Apart from four patients with intractable pain, the main indication for surgery was progressive neurological impairment. Of the 32 primary operations, 19 (60%) were successful; the remainder failed to achieve their objective and there were two deaths in the immediate postoperative period. Of eight secondary operations performed for recurrence of symptoms or failure to relieve cervical myelopathy, only four were successful. Of nine operations for bony decompression to relieve cord compression from irreducible subluxation, only four were successful. The overall results show a success rate of 57% and a failure rate of 35% with early operative mortality in 8%. Indications for operation are discussed and earlier diagnosis is considered to be the key to improved results. PMID- 3818740 TI - Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. AB - We report the results of a prospective longitudinal study of 147 athletes who had had a meniscectomy for an isolated meniscus injury. The patients were reviewed in detail after median periods of 4.5 years and 14.5 years and the results analysed. The frequency of complaints related to the operation increased from 53% at 4.5 years to 67% at 14.5 years, while demonstrable knee instability increased from 10% to 36%. The incidence of radiographic changes of degeneration rose from 40% to 89% and at late review 8% of patients had definite osteoarthritis by the criteria of Ahlback (1968). In consequence 46% had given up or reduced their sporting activity, and 6.5% had changed their occupation. Radiographic deterioration started after the 4.5-year review in 49% of the patients and was more frequent after lateral than medial meniscectomy. PMID- 3818741 TI - Computerised axial tomography for tibial plateau fractures. AB - Sixteen consecutive patients with tibial plateau fractures were investigated by standard radiography, biplanar tomography and computerised axial tomograms (CT scans). It was found that CT scanning proved most helpful for classifying the type of fracture, for evaluating the degree of comminution, and for measuring displacement. Moreover, because a single position was maintained throughout the investigation, the patients felt less discomfort than during other assessment procedures. For these reasons CT scanning is recommended for evaluating this type of fracture. PMID- 3818742 TI - Osteochondral fractures of the talus. A long-term follow-up. AB - Sixty-eight patients with 71 osteochondral fractures of the talus were evaluated an average of 7.5 years after the onset of symptoms to determine which factors influenced the final result. It was found that the type of fracture was the most important; delay in treatment also affected the result adversely. A scheme of treatment for each type of fracture is proposed. PMID- 3818743 TI - Osteochondritis dissecans of the ankle. A 20-year follow-up study. AB - Thirty patients with osteochondritis dissecans of the ankle have been followed up for an average of 21 years. The histories and radiographs were reviewed, and it was found that most patients had only minor radiographic changes and symptoms. Two patients had developed osteoarthritis but in only one was this severe. Osteochondritis dissecans in the ankle thus seems to differ from the same lesion in the knee where late osteoarthritis often occurs. Two lesions were located on the joint surface of the distal tibia, a site not previously reported. PMID- 3818744 TI - Scoliosis in juvenile chronic arthritis. AB - Structural scoliosis occurs more commonly in patients with juvenile chronic arthritis than in the normal population. We have reviewed 32 patients with both juvenile arthritis and a scoliosis and suggest that structural curves may arise from postural curves associated with asymmetrical involvement of lower limb joints. PMID- 3818745 TI - The rib deformity in adolescent idiopathic scoliosis. A prospective study to evaluate changes after Harrington distraction and posterior fusion. AB - A prospective study to investigate changes in the rib hump or rib deformity after correction of the lateral curvature in adolescent idiopathic scoliosis is reported. The operative treatment for 47 patients was by a Harrington distraction rod and posterior fusion. Before operation and at follow-up, measurements of the Cobb angle, of vertebral rotation, and of the rib deformity were taken. Despite operative correction of the lateral curve, there was a progression of the rib deformity in 64% of the cases after four years. Correction of the lateral curve may thus have no effect on vertebral rotation and cannot be guaranteed to effect a permanent reduction of the rib hump. PMID- 3818746 TI - Atlanto-axial tuberculosis in adults. AB - Twelve adult patients with confirmed tuberculosis of the atlanto-axial spine are presented and a classification proposed. Stage I has minimal ligamentous or bone destruction and no displacement of C1 on C2; the suggested treatment is transoral biopsy and decompression followed by an orthosis. Stage II has ligamentous disruption and minimal bone destruction but anterior displacement of C1 on C2; treatment involves transoral biopsy and decompression, reduction by halo traction, then a posterior C1-2 fusion. Stage III has marked ligamentous and bone destruction with displacement of C1 forward on C2; the suggested treatment is transoral biopsy and decompression, reduction by halo traction, then fusion from the occiput to C2 or C3. One patient died before treatment started; all the others have gone on to solid union with resolution of any neurological deficit. There has been no evidence of reactivation of disease over an average follow-up of 36 months. PMID- 3818747 TI - Radiographic features of the spine in fluoride therapy for osteoporosis. AB - In the search for a simple method of assessing the therapeutic efficacy of sodium fluoride, a prospective study of vertebral radiography during such treatment was carried out. Treatment of osteoporosis with sodium fluoride, calcium and vitamin D was found to enhance the vertical markings of the vertebral trabecular pattern in 69% of patients. This response was graded 1 (failure), 2 (good) and 3 (excellent); Grade 2 or 3 was attained after a mean treatment period of 31.7 months. Subsequent analysis of the vertebral fracture rate revealed that new vertebral fractures had occurred only in patients with Grade 1 and not in those with Grade 2 or 3. We recommend that treatment should aim at increasing the vertebral trabecular pattern to Grade 2 or 3 and that the duration of therapy should be approximately 30 months. PMID- 3818748 TI - Neuralgic amyotrophy. AB - Thirty-nine patients with neuralgic amyotrophy were reviewed. In addition to the clinical findings reported in the neurological literature, we commonly found pain throughout the upper limb, and diffuse involvement of the brachial plexus. Five patients had spinal accessory nerve lesions and five had glenohumeral instability. Sixty-four per cent of the patients had had an orthopaedic consultation during their acute illness. It is therefore important that orthopaedic surgeons are aware of this clinical syndrome and its management. The prognosis is excellent with non-invasive treatment. PMID- 3818749 TI - Excision of the distal ulna in patients with rheumatoid arthritis. AB - The results of excision of the distal ulna in 34 wrists of 25 patients with chronic rheumatoid arthritis of the distal radio-ulnar joint were reviewed. Rest pain had been cured or relieved in 77%, pain on pronation-supination in 86%, and limitation of pronation-supination in 90%, while 88% of the patients graded the result as excellent or fair. Despite this marked relief of symptoms, function of the upper limb was improved in only 25% of patients and remained unchanged in 60%. Ulnar subluxation of the carpus had occurred in 24% but seemed to be related to the destructive disease process rather than to the operation itself. The length of ulna resected was not related to the outcome of the operation. PMID- 3818750 TI - External fixation of Colles' fractures. An anatomical study. AB - In a prospective, controlled study 58 patients aged under 60 years with Colles' fractures were treated either by a forearm plaster or by the application of an external fixator. In 94% of those treated by a fixator it was possible to insert the distal pins of the frame into the fracture fragment, the fixation obtained being sufficient to forgo additional splintage. The external fixator proved more effective at holding the manipulated position, and the radiological loss of position during fracture union was minimal compared with that seen in patients treated in plaster. PMID- 3818751 TI - Carpometacarpal dislocation. An easily missed diagnosis. AB - We have reviewed 21 cases of dorsal dislocation of carpometacarpal joints. In 15 of them the diagnosis was missed when they were first seen in an accident and emergency department. General swelling may obscure the characteristic clinical deformity and routine radiographs may not show the displacement clearly. It is recommended that a true lateral radiograph of the hand be requested when this injury is suspected. PMID- 3818752 TI - Myelopathy hand. New clinical signs of cervical cord damage. AB - A characteristic dysfunction of the hand has been observed in various cervical spinal disorders when there is involvement of the spinal cord. There is loss of power of adduction and extension of the ulnar two or three fingers and an inability to grip and release rapidly with these fingers. These changes have been termed "myelopathy hand" and appear to be due to pyramidal tract involvement. The characteristic nature of the signs permit the distinction between myelopathy and changes due to nerve root or peripheral nerve disorder. The clinical significance of these signs has been assessed against other tests and their value in management is discussed. PMID- 3818753 TI - The Colonna-Hey Groves arthroplasty in the late treatment of congenital dislocation of the hip. A long-term review. AB - Forty-four patients who had undergone 50 capsular arthroplasties for congenital dislocation of the hip were reviewed after a mean follow-up of 20 years. Their average age at operation was 5.9 years; 31 of the operations were undertaken because of late presentation, the remainder because of the failure of previous surgery. In all, 70% of the hips showed good function despite a reduced range of movement, but patients with bilateral arthroplasties fared poorly. Excellent containment within the acetabulum was found in 80%, but the femoral head was always abnormally high though not unduly lateral or medial. This configuration had remained unchanged during follow-up. The accuracy of reduction along the mediolateral axis was the only variable found to influence the outcome significantly. Functional deterioration, associated with pain, was noted to be more common after 20 years than before, and was associated with radiographic evidence of joint degeneration. PMID- 3818754 TI - Transient synovitis of the hip. Its incidence, epidemiology and relation to Perthes' disease. AB - In a prospective five-year study, 294 episodes of acute transient synovitis of the hip were diagnosed in 275 children. The average annual incidence was 0.2% and the accumulated risk of suffering at least one episode was 3%. The risk of recurrence was 20 times greater than the risk of having a single episode. Perthes' disease was diagnosed from one to five months after the acute attack of synovitis in 10 cases (3.4%). Review of the initial radiographs revealed signs of avascular necrosis in three of the 10 cases, and an increased joint space in five. Only two cases had had completely normal radiographs. The value of routine radiographs taken after three months was minimal. Factors associated with the incidence of Perthes' disease included prolonged time in traction before the range of hip movement became normal, increase in joint space on the initial radiographs and the recurrence of hip symptoms after initial relief. PMID- 3818755 TI - The long-term prognosis of unilateral Perthes' disease. AB - We have attempted to identify the most important long-term prognostic factors in Perthes' disease by studying 61 patients affected unilaterally. The average age at diagnosis was 7 years 5 months and at follow-up it was 32 years, an average interval of 25 years. The age at diagnosis, age at follow-up, Catterall group, acetabular coverage, femoral head subluxation and the other head-at-risk signs were statistically correlated with Stulberg, Cooperman and Wallensten (1981) radiographic classes and the Iowa hip score. Statistically significant correlations were found between Stulberg class and Iowa hip score; age at diagnosis and Stulberg class; age at follow-up and Iowa hip score; and between lateral subluxation of the femoral head and Iowa hip score. Three age-groups of patients were found to carry different long-term prognoses. Those below five years of age at diagnosis showed a statistically significant correlation between Catterall group and Stulberg Classes I and II. Patients between five and nine years of age at diagnosis showed a significant correlation between Catterall group and Stulberg Classes I, II, III and IV while in patients diagnosed after nine years of age there was no statistical correlation between Catterall group and Stulberg class, all having a poor prognosis and ending up in Stulberg Classes III, IV and V. PMID- 3818756 TI - Bone scanning for suspected hip fractures. A prospective study in elderly patients. AB - Of 693 elderly patients admitted with suspected hip fractures, 43 had normal radiographs and were investigated by isotope bone scan. The 30 patients (70%) with normal scans were mobilised and none developed a fracture. All 13 of the patients with specific bone scan abnormalities were subsequently proved to have fractures, five of which became displaced. Clearly conventional radiography does not exclude fracture of the femoral neck in elderly patients; bone scanning is advisable in doubtful cases. PMID- 3818757 TI - Splintage for congenital dislocation of the hip. Is it safe and reliable? AB - Two-hundred and fifteen children with 288 unstable hips have been treated by splintage during the first nine months of life. A simple treatment protocol was followed and the aim was to test the safety and reliability of this protocol as well as of the Von Rosen splint and the Pavlik harness. A vascular necrosis occurred in 3.8% of the splinted hips. Despite splintage, a proportion of children needed operation at a later date. PMID- 3818758 TI - Impedance plethysmography. A screening procedure to detect deep-vein thrombosis. AB - Impedance plethysmography has great potential in the non-invasive detection of dangerous iliofemoral thrombosis. It was used to examine 198 patients undergoing total hip replacement for evidence of proximal venous segment thrombosis. There were 13 abnormal results, and subsequent venography in 12 of these revealed a false-positive rate of 4.0%; there was one false-negative result giving a sensitivity of 85.7%. A venographic study of 46 other patients clinically suspected of having a proximal deep-vein thrombosis confirmed this sensitivity. The iliofemoral thrombosis rate was 3.9% after total hip replacement and this rate increased significantly in the group of patients over 70 kg in weight. Impedance plethysmography was found to be a useful non-invasive screening procedure for potentially fatal proximal venous thrombosis. PMID- 3818759 TI - Function after partial pelvic resection for Ewing's sarcoma. AB - Seven patients with Ewing's sarcoma of the pelvis were treated by chemotherapy followed by wide resection of the primary tumour. Although good function after operation is possible, survival in this series reflects the poor prognosis associated with the disease; two patients died, two are alive with local recurrence and metastases and three patients are alive with no evidence of disease. PMID- 3818760 TI - Distal femoral replacement by custom-made prostheses. Clinical follow-up and survivorship analysis. AB - We report the long-term clinical follow-up and survivorship analysis of 40 distal femoral replacements performed between 1964 and 1980 for traumatic, locally aggressive and malignant conditions. Custom-made prostheses with fully constrained knee joints were used to replace a mean of 42% of the length of the femur. Survivorship analysis showed a cumulative success rate of 80% at eight years, with no subsequent deterioration at 18 years. Clinical assessment revealed 78% excellent or good results. Failure was due to infection in three cases, and in two to fracture of a now-outmoded femoral stem. PMID- 3818761 TI - Vascular injury associated with low-velocity dislocations of the knee. AB - Complete dislocation of the knee is a relatively rare condition. When it occurs as a result of high-velocity injury, such as in a road traffic accident, associated vascular injury is generally suspected. In low-velocity injuries, however, distal pulses are often maintained throughout, and the possibility of vascular injury may erroneously be discounted. We report four cases of low velocity dislocation of the knee, only one of which had an overt vascular disruption, but three of which had arterial damage. On the basis of our experiences, we recommend arteriography in all cases of complete dislocation of the knee. PMID- 3818762 TI - Vibration arthrography as a diagnostic aid in diseases of the knee. A preliminary report. AB - The detection and recording of vibration emission from human joints, a technique which we have termed "vibration arthrography", is a sensitive, non-invasive method for the objective study of the locomotor system. Using vibration sensors attached to bony prominences around the knee, we studied the joints of both normal and symptomatic subjects. Normal subjects produced three signal types- physiological patellofemoral crepitus, patellar clicks, and the lateral band signal. In symptomatic subjects we identified and categorised many signal types and related them to pathology. Lesions of the menisci produced distinctive signals, and it was possible not only to lateralise the tear, but in many cases to determine the type of meniscal injury present. Vibration arthrography promises to be a useful tool in the non-invasive diagnosis of knee disorders. PMID- 3818763 TI - Grading the pivot shift. Objective tests with implications for treatment. AB - A logical, objective and reproducible grading system for the pivot shift test is proposed. The rationale is based on performing the examination in varying positions of rotation of the tibia, allowing the type and degree of the different laxities to be defined and quantified. The system has been assessed against a new "unblocked" test for anterior subluxation and against radiographic measurements, operative findings and results. This grading system can be valuable in pre operative assessment and planning and its use in postoperative evaluation would enable results from different centres and different procedures to be compared more accurately. PMID- 3818764 TI - A no-touch test for the anterior cruciate ligament. PMID- 3818765 TI - Intramuscular pressure and muscle blood flow during exercise in chronic compartment syndrome. AB - In nine patients with chronic compartment syndrome, the intramuscular pressure and muscle blood flow during constant dynamic exercise was studied by the microcapillary infusion method and by the 133-xenon clearance technique. Although muscle blood flow was normal at the start of exercise, pain and impaired muscle function eventually developed; muscle blood flow decreased while muscle relaxation pressure increased. The changes of muscle blood flow could not be correlated with any change of mean muscle pressure during exercise. Eight months after fasciotomy the exercise test was repeated. Patients experienced no symptoms and the muscle relaxation pressure and blood flow during exercise were normal. It is suggested that chronic compartment syndrome is due to increased muscle relaxation pressure during exercise which causes decreased muscle blood flow, leading to ischaemic pain and impaired muscle function. PMID- 3818766 TI - Wedge resection of amputation stumps. A valuable salvage procedure. AB - We describe the technique of wedge resection for revision of an amputation stump, and report the results of this at below-knee level in 57 patients with peripheral vascular disease; healing occurred in 42 of these (74%). PMID- 3818767 TI - Stress fractures of the tibia in osteoarthritis of the knee. AB - Three women with osteoarthritis of the knee presented after sudden worsening of their symptoms. In each case this was found to be due to a stress fracture of the tibia. With treatment by rest and reduced activity, the fracture healed uneventfully in all three patients. PMID- 3818768 TI - Osteochondritis dissecans of the patella. AB - We reviewed 13 cases of osteochondritis dissecans of the patella followed-up for 18 months to 19 years. Two were treated conservatively with excellent results, and 11 by operation with six excellent, four good and one fair result. There was complete radiographic healing of the defect in 10 cases and partial healing in three. The size of the osteochondritic lesion appeared to be of prognostic significance. Osteochondritis dissecans of the patella is the result of repeated minor injuries to the articular surface. Operation is indicated for persistent pain, intra-articular loose bodies and subchondral sclerosis; excision of the fragment and curettage of the crater, with or without drilling, is recommended. PMID- 3818769 TI - Stress fractures and tibial bone width. A risk factor. AB - A prospective study of 295 infantry recruits has shown that the mediolateral width of the tibia measured radiographically at each of three different levels in the bone had a statistically significant correlation with the total incidence of stress fractures as well as with those in the tibia alone or the femur alone. A narrow tibial width was shown to be a risk factor, but cortical thickness was not found to be significant. PMID- 3818770 TI - Reverse club foot. Rigid and recalcitrant talipes calcaneovalgus. AB - We describe a congenital deformity of the foot which is characterised by calcaneus at the ankle and valgus at the subtalar joint; spontaneous improvement does not occur and serial casting results in incomplete or impermanent correction of the deformities. Experience with five feet in four children indicates that release of the ligaments and tendons anterior and lateral to the ankle and lateral to the subtalar joint is the minimum surgery necessary; subtalar arthrodesis may be required in addition. The foot deformity described may occur as an isolated condition or in association with multiple congenital anomalies. The possibility of a neurological deficit should always be excluded. PMID- 3818771 TI - A useful projection in radiography of the shoulder. PMID- 3818772 TI - Unilateral oedema of the lower limb caused by an osteochondroma. PMID- 3818773 TI - Longitudinal rupture of the peroneus brevis tendon. PMID- 3818774 TI - Risk assessment and evaluation of chemical carcinogens--present and future strategies. PMID- 3818776 TI - Feasible model for locoregional and systemic longterm administration of drugs and concomitant blood sampling in Sprague-Dawley rats. AB - This methodological study describes three surgical procedures for locoregional and systemic drug administration, which are based on a similar experimental design. Cannulation of the arterial and portal access to the liver in comparison to the general venous system, and arterial access to the large intestine through a permanently implantable system, suitable for serial bolus injections and infusions in unrestrained rats, is presented (experiment I). Furthermore, an infusion system for longterm administration (experiment II) and a method for blood sampling during locoregional or systemic infusion procedures (experiment III) have been developed. The positioning and free flow of the catheters were checked by means of scintigraphy, administration of fluorescein under UV light and angiography in animals of experimental series I. After 7 days, no obstruction was detected. On day 15 and 30 following implantation 73.3% and 58.3% of the animals, respectively, showed unimpeded flow through the catheter system. The methods described here were well tolerated by the animals without alteration of their general condition and are currently in use in a series of chemotherapeutic and pharmacokinetic investigations. PMID- 3818775 TI - Activity of cancer chemotherapeutic agents against human colorectal carcinomas grown as primary tissue culture. AB - Improved procedures are described for the seeding of primary cultures from human colon adenocarcinoma and for the use of these cultures in the evaluation of drug effects. Two of the specimens studied were xenografts maintained in athymic (nude) mice, while the other six were biopsies obtained directly from patients. Tumor cells obtained directly from the patients proliferated in defined hormone supplemented medium to the exclusion of other cells. In drug-response studies with cultures from a colon tumor biopsy all four drugs studied (4' deoxydoxorubicin, 4'-O-methyldoxorubicin, 5-fluorouracil, and 1,3-bis [chloroethyl]-1-nitrosourea) inhibited growth of the cells within 3-6 days after drug treatment. On an equitoxic dose basis (LD10 in mice), 4'-deoxydoxorubicin appeared to be the most active drug. This drug also showed dose-dependent activity against one of the xenografted tumors in vitro. In dose-response studies with cultures from another patient's colon tumor, doxorubicin and 5-fluorouracil showed significant activity against the tumor 10 days after the drug treatment with concentrations at 1X and 10X average peak plasma levels. PMID- 3818777 TI - Changes in intestinal mucosa above lymph follicles during carcinogenesis in rats. A light and electron microscopic study. AB - Changes in the intestinal mucosa during carcinogenesis were investigated in 36 rats after weekly s.c. injection of 20 mg dimethylhydrazine/kg bodyweight. More changes were seen in the large than in the small intestine. In the first week, 60% of colonic lymphoid plaques displayed various crypt abscesses and glandular regenerations. These mucosal changes correspond to the glands covering the lymph follicles, in direct contact with lymphoid cells. Beginning in week 8, dysplastic glands developed in these mucosal areas above the lymph follicles. The number of lymphoid plaques with dysplastic glands in the large intestine increased week by week, attaining 75% in week 20. At the end of week 12 the first adenocarcinoma was detected in the cecum by light microscopy, and classified as a poorly differentiated adenocarcinoma with signet ring cells infiltrating the lymph follicles which contained endocrine cells. The majority of adenocarcinomas (10 cases) occurred in week 20. Of these, 7 were localized above the lymphatic plaques in the intestine. Endocrine cells were found in varying numbers in 6 of 10 adenocarcinomas. Three endocrine cell carcinomas, corresponding to human adenocarcinoids or goblet cell carcinoids, developed within the intestinal mucosa; all were identified as poorly differentiated intestinal adenocarcinomas, two of them situated above lymph follicles. These suprafollicular tumors developing from the glandular base, were composed of mucoid cells, endocrine cells, and undifferentiated cells. Microcarcinomas are considered as initial stages of endocrine cell carcinoma. PMID- 3818778 TI - Inhibition of liver metastasis in mice by blocking hepatocyte lectins with arabinogalactan infusions and D-galactose. AB - According to our hypothesis, organ-specific lectins (e.g., the D-galactose specific hepatic binding protein) play an important role in the organ location of metastatic malignant cells. The rapid clearance and uptake by the liver of tritiated alpha 1-acid-(asialo)glycoprotein from the circulation of Balb/c mice was markedly delayed after preinjection of D-galactose or arabinogalactan. The preinjection (1 h) and regular application (for 3 days after tumor cell inoculation in Balb/c mice) of the receptor blocking agents D-galactose and arabinogalactan prevented the settling of sarcoma L-1 tumor in the liver completely, but did not influence the settling in the lung. Other galactans, dextrans, and phosphate-buffered saline showed no effect. Therefore, when lectins were blocked with competitive-specific glycoconjugates, colonization was prevented. PMID- 3818779 TI - Enhancement of carcinogen-induced mutations or recombinations by 12-O tetradecanoyl-phorbol-13-acetate in the mammalian spot test. AB - The mammalian spot test is suitable for detecting gene mutations and reciprocal recombinations. When given alone 12-O-tetradecanoyl-phorbol-13-acetate (TPA) did not have any statistically significant effect upon these genetic alterations. In combination with ethylnitrosourea (ENU) however TPA enhanced the effect of the mutagen/carcinogen. The effective dose range of TPA + ENU was very small, i.e., between 2 X 0.2 and 2 X 0.33 mg/kg, but the effect was very strong as shown by the steep slope of the dose-effect curve. The results agree with the hypothesis that the mode of action of cocarcinogens and tumor promoters is a genetic one and that recombination plays an important role in this process. PMID- 3818781 TI - Determination of growth fractions in benign breast disease (BBD) with monoclonal antibody Ki-67. AB - Certain types of benign breast disease (BBD) carry an increased risk of malignancy. Several morphological criteria such as an atypia score are used to define this group, and the use of a kinetic parameter may provide additional information. Therefore, the growth fractions of 120 benign breast lesions were determined using the monoclonal antibody Ki-67. The values obtained range from 0.3% to 10.8% (average 3.1% +/- 2.2%) compared to breast carcinomas with an average of 15.3% +/- 10.1%, range 0.8% to 47.8%. All specimens were classified using the terminology of Azzopardi. The prevailing histological entities were cystic disease, fibroadenoma, and blunt duct adenosis. Between these groups no differences in growth fractions were observed. Postmenopausal patients had slightly lower values than premenopausal women. Further prospective studies are needed to evaluate whether those cases of BBD with a high number of Ki-67 positive cells have an increased risk of breast cancer, independently from conventional histological classifications. PMID- 3818780 TI - 6-Methylguanine and 6-methylguanosine inhibit colony-forming ability in a malignant xeroderma pigmentosum cell line but not in other xeroderma pigmentosum and normal human fibroblast strains after treatment with 1-(2-chloroethyl)-1 nitroso-3-(2-hydroxyethyl)-urea. AB - The XP cell strain XP29MA, its malignant counterpart XP29MAmal and a normal human fibroblast strain were tested for colony-forming ability after treatment with HECNU in the presence of m6G, m6Gua, and he7G. In XP29MAmal, inhibition of post HECNU colony-forming ability was 35% when 0.25 mM of either m6G or m6Gua were present, whereas in XP29MA and the normal fibroblast strain no inhibition was detected. The he7G caused a similar but smaller inhibitory effect in XP29MAmal, but failed to do so in XP29MA. HECNU predominantly exerts its killing effect by alkylating O-6 of DNA-bound guanine and causing DNA interstrand crosslinks. Alkylation of O-6 of guanine can be repaired by 6-methylguanine-DNA methyltransferase. From our experiments we conclude that in XP29MAmal this methyltransferase was inhibited in the presence of the 6-alkylguanines, thus leaving more 2-chloroethylated sites in DNA unrepaired. This results in sensitization in terms of decreased colony-forming ability observed only in the malignant cell line. PMID- 3818782 TI - Synchronization of stimulated urothelial proliferation. Experimental models for cell cycle specific testing of bladder carcinogens. AB - In the present experiments an attempt was made to synchronize urothelial proliferation in the urinary bladder of rats stimulated by either a partial cystectomy (one-third resection) or a single i.p. administration (100 mg/kg) of CP. To temporarily inhibit DNA synthesis HU was given intraperitoneally in multiple fractionated doses (0.1 mg/g each) at hourly intervals during the period of most pronounced proliferative activity between 33 and 55 h after partial cystectomy and between 26 and 44 h after injection of CP. Following partial cystectomy the 3H-TdR index rapidly increased after termination of the HU administration reaching peak values of 54% and 56% at 6 and 8 h, respectively. Thereafter, there was a sharp decline of the percentage of DNA synthesizing cells within 2 h to 24% at 10 h. Then 16 h after removal of the HU block the 3H-TdR index amounted to 15%. At 20 h the labeling increased again to 22%, indicating that the initially blocked cells were capable of going through another cell cycle. After 1 week the 3H-TdR index was 2.5% and after 15 days 0.2%. Synchronously with the decrease of DNA synthesis the mitotic index rapidly increased reaching a maximum value of 4.3% at 10 h. The total fraction of 3H-TdR labeled cells (growth fraction) was 57%. Following administration of CP 3H-TdR incorporation increased steeply after the last injection of HU and at 6 h a maximum value of 50% was obtained. Subsequently, the 3H-TdR index gradually decreased to 11% after 12 h. At 8, 15, and 30 days labeling indices of 1.9%, 0.5%, and 0.3% were determined. The mitotic index was highest with 0.21-0.22% between 12 and 16 h after removal of the HU block. The growth fraction amounted to 53%. The results reported here show a satisfactory degree of synchrony of stimulated urothelial proliferation obtained by multiple fractionated doses of HU. In particular the cystectomy model will be useful for testing possible cell cycle specificity of urothelial carcinogenesis. PMID- 3818783 TI - Does in vitro colony formation and chemosensitivity relate to DNA ploidy and S phase fractions? AB - In vitro colony formation and chemosensitivity were analyzed in 65 human solid tumors and compared to proliferation parameters simultaneously obtained by DNA flow cytometry of the same tumor specimens. Colony growth in the human tumor colony assay was enhanced in aneuploid tumors (39/65) in comparison to diploid tumors (26/65, P less than 0.05). In addition, there was a relationship between % S-phase and colony growth. The existence of polyploid sublines (23/65) improved in vitro growth even in tumors with a diploid main G0/1-peak or with a low % S phase. Metastases exhibited a higher proportion of aneuploidy and showed slightly better growth in vitro than primary tumors. Sensitivity testing in 34 of the 65 tumors showed no convincing relation between DNA parameters and the inhibition of colony formation by five standard anticancer agents with different mechanisms of action. This indicates additional factors other than the proliferative activity of the tumor to be responsible for drug sensitivity or resistance. PMID- 3818784 TI - Clinical trial of attenuated vaccinia virus AS strain in the treatment of advanced adenocarcinoma. Report on two cases. AB - Two cases of advanced adenocarcinoma treated with attenuated vaccinia virus AS strain are reported. One was a primary lung adenocarcinoma with metastatic lesions in brain, right kidney, and rib. The other was a left renal adenocarcinoma with multiple lung and vertebral metastases. In both patients, good antitumor effects against lung and bone lesions were obtained, respectively, and no adverse reactions were noted. Therefore, treatment of patients with AS vaccinia virus appears to suppress the growth of tumor cells without adverse effects on normal human cells. This is the first report to describe the effects of attenuated vaccinia virus AS strain on human cancer. PMID- 3818785 TI - Twice weekly vindesine, a phase II study in lung cancer. AB - Vindesine 1.75 mg/m2, twice weekly for 2 weeks followed by 2 weeks rest, was given to 26 lung cancer patients. In 6 patients a partial response was seen (23%). Neurotoxicity was present in 15 patients after 1 course; in 6 patients this was the reason for stopping therapy. This regimen has no advantage over weekly vindesine. PMID- 3818786 TI - Genetic analysis of microtubule structure: a beta-tubulin mutation causes the formation of aberrant microtubules in vivo and in vitro. AB - A recessive male sterile mutation (B2t8) that encodes a stable variant of the testis-specific beta 2-tubulin of Drosophila causes the assembly of aberrant microtubules both in vivo and in vitro. The B2t8 mutation appears to cause defects in the formation of interprotofilament bonds. In testes from homozygous mutant males, the most commonly observed aberrant structures were sheets of protofilaments curved to form an S in cross section rather than a normal, closed microtubule. These characteristic S-shaped structures appear in the meiotic spindle, in place of axonemes in differentiating spermatids, and in cytoplasmic microtubules, including those that lie next to the nucleus during nuclear elongation. Homozygous mutant males exhibit defects in chromosome movement and cytokinesis during meiosis, flagellar elongation, and nuclear shaping, indicating that the ability to form normal closed microtubules is required for each of these events. The presence of the aberrant microtubules in three architecturally different microtubule arrays demonstrates conclusively the multifunctional nature of the beta 2-tubulin gene product. Although the mutant beta 2-tubulin subunit causes assembly of aberrant microtubules in vitro and in homozygous males, in the presence of wild-type beta 2-tubulin in heterozygous males, the variant subunit coassembles with the wild-type subunit into functional sperm. PMID- 3818787 TI - Flagellar gyration and midpiece rotation during extension of the acrosomal process of Thyone sperm: how and why this occurs. AB - The midpiece of Thyone sperm contains a large mitochondrion and a centriolar pair. Associated with one of the pair, i.e., the basal body of the flagellum, are satellite structures which apparently anchor the flagellar axoneme to the mitochondrion and to the plasma membrane covering the midpiece. Immediately before and as the acrosomal process elongates, the flagellum and the midpiece begin to rotate at 1-2 rotations per second even though the head of the sperm, by being firmly attached on its lateral surfaces to the coverslip, does not rotate at all. This rotation is not observed in the absence of flagellar beating whose frequency is much greater than that of its gyration. To understand how the midpiece rotates relative to the sperm head, it is first necessary to realize that in Thyone the flagellar axoneme projects at an acute angle to the principal axis of the sperm and is bent towards one side of this axis. Thus movement of the flagellum induces the sperm to tumble or yaw in solution. If the head is stuck, the midpiece will rotate because all that connects the sperm head to the midpiece is the plasma membrane, a liquid-like layer. A finger-like projection extends from the proximal centriole into an indentation in the basal end of the nucleus. In contrast to the asymmetry of the flagellum, this indentation is situated exactly on the principal axis of the sperm and, along with the finger-like projection, acts as a biological bearing to maintain the orderly rotation of the midpiece. The biological purpose of flagellar gyration during fertilization is discussed. PMID- 3818788 TI - Subpellicular and flagellar microtubules of Trypanosoma brucei brucei contain the same alpha-tubulin isoforms. AB - The cytoskeleton of the parasitic hemoflagellate Trypanosoma brucei brucei essentially consists of two microtubule-based structures: a subpellicular layer of singlet microtubules, which are in close contact with the cell membrane, and the flagellar axoneme. In addition, the cells contain a small pool of soluble tubulin. Two-dimensional gel electrophoretic analysis of the tubulins present in these subcellular compartments revealed two distinct electrophoretic isoforms of alpha-tubulin, termed alpha 1 and alpha 3. alpha 1-Tubulin most likely represents the primary translation product, while alpha 3-tubulin is a posttranslationally acetylated derivative of alpha 1-tubulin. In the pool of soluble cytoplasmic tubulin, alpha 1 is the predominant species, while the very stable flagellar microtubules contain almost exclusively the alpha 3-tubulin isoform. The subpellicular microtubules contain both isoforms. Neither of the two alpha tubulin isoforms is organelle specific, but the alpha 3 isoform is predominantly located in stable microtubules. PMID- 3818789 TI - Microvascular pericyte contractility in vitro: comparison with other cells of the vascular wall. AB - Collagen lattices containing bovine retinal pericytes (RPs), vascular smooth muscle cells (VSMCs), pulmonary microvessel endothelial cells (PMECs), or aortic endothelial cells (AECs) were prepared and contraction was quantitated by measuring the resulting change in lattice area. VSMCs were the most efficient at lattice contraction followed by RPs and then PMECs. AECs did not contract the lattices. To document further that these observations represent contraction, cells were grown on inert silicone rubber sheets. Substratum wrinkling was indicative of tension development and quantitated as percent of cells contracted. RPs were more contractile than PMECs, and AECs were incapable of developing tension. VSMCs were less contractile than RPs, unlike the comparative contractility observed with the lattice system. Alteration of actin-containing filaments by cytochalasin B significantly reduced RP contraction of silicone rubber and inhibited their contraction of collagen lattices in a dose-dependent manner. Rhodamine-phalloidin staining of contracting RPs revealed microfilament bundle orientations that suggested their association in the force applied for contraction. RP, VSMC and PMEC contraction of collagen lattices was directly proportional to the concentration of fetal calf serum. Also, RP contraction was greater in calf serum than calf plasma-derived serum, an indication that RPs respond to substances that appear continuously and episodically in blood. These in vitro findings support the theory that pericytes in vivo are contractile but that endothelial cells may also contribute to microvascular tonus. PMID- 3818790 TI - Using antibodies against Dictyostelium membranes to identify an actin-binding membrane protein. AB - Polyclonal antibodies made against Dictyostelium discoideum membranes were used to block the interaction of those membranes with actin. As expected, actin interacted mostly with the internal surface of the membrane, demonstrated by the fact that whole cells could only absorb out a minor fraction of the blocking antibody. The antibody was used to show that the membrane component(s) which interacted with actin were probably integral; they could be extracted with detergent but not with solutions designed to extract peripheral membrane proteins. To identify the responsible protein(s), Western transfers of membranes were cut into fractions which were tested for their ability to absorb out the blocking activity of the antibody. We observed a single peak at a molecular weight of approximately 20,000, and thus conclude that a 20,000-mol-wt protein is a major integral membrane actin-binding protein in Dictyostelium. This approach to the identification of proteins involved in actin-membrane interaction has allowed us to make the first identification of an actin-binding membrane protein which is based on its activity in native membranes. PMID- 3818791 TI - Beta spectrin bestows protein 4.1 sensitivity on spectrin-actin interactions. AB - The ability of protein 4.1 to stimulate the binding of spectrin to F-actin has been compared by cosedimentation analysis for three avian (erythrocyte, brain, and brush border) and two mammalian (erythrocyte and brain) spectrin isoforms. Human erythroid protein 4.1 stimulated actin binding of all spectrins except the brush border isoform (TW 260/240). These results suggested that the beta subunit determined the protein 4.1 sensitivity of the heterodimer, since all avian alpha subunits are encoded by a single gene. Tissue-specific posttranslational modification of the alpha subunit was excluded by examining the properties of hybrid spectrins composed of the purified alpha subunit from avian erythrocyte or brush border spectrin and the beta subunit of human erythrocyte spectrin. A hybrid composed of avian brush border alpha and human erythroid beta spectrin ran on nondenaturing gels as a discrete band, migrating near human erythroid spectrin tetramers. The actin-binding activity of this hybrid was stimulated by protein 4.1, while either chain alone was devoid of activity. Therefore, although both subunits were required for actin binding, the sensitivity of the spectrin-actin interaction to protein 4.1 is a property uniquely bestowed on the heterodimer by the beta subunit. The singular insensitivity of brush border spectrin to stimulation by erythroid protein 4.1 was also consistent with the absence of proteins in avian intestinal epithelial cells which were immunoreactive with polyclonal antisera sensitive to all of the known avian and human erythroid 4.1 isoforms. PMID- 3818792 TI - Functional gap junctions are not required for muscle gene activation by induction in Xenopus embryos. AB - Muscle gene expression is known to be induced in animal pole cells of a Xenopus blastula after 2-3 h of close contact with vegetal pole cells. We tested whether this induction requires functional gap junctions between vegetal and animal portions of an animal-vegetal conjugate. Muscle gene transcription was assayed with a muscle-specific actin gene probe and the presence or absence of communication through gap junctions was determined electrophysiologically. Antibodies to gap junction protein were shown to block gap junction communication for the whole of the induction time, but did not prevent successful induction of muscle gene activation. The outcome was the same whether communication between inducing vegetal cells and responding animal cells was blocked by introducing antibodies into vegetal cells alone or into animal cells alone. We conclude that gap junctions are not required for this example of embryonic induction. PMID- 3818793 TI - Immunolocalization of MP70 in lens fiber 16-17-nm intercellular junctions. AB - Thin section electron microscopy reveals two different types of membrane interactions between the fiber cells of bovine lens. Monoclonal antibodies against lens membrane protein MP70 (Kistler et al., 1985, J. Cell Biol., 101:28 35) bound exclusively to the 16-17-nm intercellular junctions. MP70 localization was most dramatic in the lens outer cortex and strongly reduced deeper in the lens. In contrast, the 12-nm double membrane structures and single membranes were consistently unlabeled. In freeze-fracture replicas with adherent cortical fiber membranes, MP70 was immunolocalized in the junctional plaques which closely resemble the gap junctions in other tissues. MP70 is thus likely to be associated with intercellular communication in the lens. PMID- 3818794 TI - Type VII collagen forms an extended network of anchoring fibrils. AB - Type VII collagen is one of the newly identified members of the collagen family. A variety of evidence, including ultrastructural immunolocalization, has previously shown that type VII collagen is a major structural component of anchoring fibrils, found immediately beneath the lamina densa of many epithelia. In the present study, ultrastructural immunolocalization with monoclonal and monospecific polyclonal antibodies to type VII collagen and with a monoclonal antibody to type IV collagen indicates that amorphous electron-dense structures which we term "anchoring plaques" are normal features of the basement membrane zone of skin and cornea. These plaques contain type IV collagen and the carboxyl terminal domain of type VII collagen. Banded anchoring fibrils extend from both the lamina densa and from these plaques, and can be seen bridging the plaques with the lamina densa and with other anchoring plaques. These observations lead to the postulation of a multilayered network of anchoring fibrils and anchoring plaques which underlies the basal lamina of several anchoring fibril-containing tissues. This extended network is capable of entrapping a large number of banded collagen fibers, microfibrils, and other stromal matrix components. These observations support the hypothesis that anchoring fibrils provide additional adhesion of the lamina densa to its underlying stroma. PMID- 3818795 TI - Multiple influences of a heparin-binding growth factor on neuronal development. AB - Heparin-binding growth factor-2 (HBGF-2; also known as basic fibroblast growth factor) is mitogenic for most anchorage-dependent cells. It is shown here that HBGF-2 stimulates cell-substratum adhesion and neurite extension in the sympathetic nerve cell line PC12. When HBGF-2 is adsorbed to artificial extracellular matrices consisting of heparin or chondroitin sulfate, it causes the formation of cellular aggregates or circles of cells, respectively. HBGF-2 is also a nerve cell survival molecule, for it potentiates the survival of primary cultures of embryonic chick ciliary ganglion cells but not of embryonic neural retina cells. Finally, a series of synthetic peptides from the HBGF-2 sequence is described that selectively alter the biological effects of HBGF-2. The amphiphilic nature of one of these peptides is discussed with respect to its ability to stimulate cell adhesion. PMID- 3818796 TI - Perturbation of human endothelial cells by thrombin or PMA changes the reactivity of their extracellular matrix towards platelets. AB - In this study we have examined the influence of perturbation of endothelial cells on the amounts of fibronectin and von Willebrand factor in their extracellular matrix and the consequences of a changed composition of the matrix on platelet adhesion. For this purpose, we have used an in vitro perfusion system with which we can investigate the interactions of platelets in flowing blood with cultured endothelial cells and their extracellular matrix (Sakariassen, K. S., P. A. M. M. Aarts, P. G. de Groot, W. P. M. Houdgk, and J. J. Sixma, 1983, J. Lab. Clin Med. 102:522-535). Treatment of endothelial cells with 0.1-1.0 U/ml thrombin for 2 h increased the reactivity of the extracellular matrix, isolated after the thrombin treatment, towards platelets by approximately 50%. The increased reactivity did not depend on de novo protein synthesis but was inhibited by 3-deazaadenosine, an inhibitor of phospholipid methylation, which also inhibits the stimulus-induced instantaneous release of von Willebrand factor from endothelial cells. However, no changes in the amounts of von Willebrand factor and fibronectin in the matrix were detected. Thrombin may change the organization of the matrix proteins, not the composition. When endothelial cells were perturbed with the phorbol ester PMA or thrombin for 3 d, the adhesion of platelets to the extracellular matrix of treated cells was strongly impaired. This impairment coincided with a decrease in the amounts of von Willebrand factor and fibronectin present in the matrix. These results indicate that, after perturbation, endothelial cells regulate the composition of their matrix, and that this regulation has consequences for the adhesion of platelets. PMID- 3818797 TI - Free diffusion to and from the inner nuclear membrane of newly synthesized plasma membrane glycoproteins. AB - Sindbis virus-infected baby hamster kidney (BHK) cells were analyzed by thin section fracture-label. Specific immunolabel with antiviral glycoprotein antibodies was used in conjunction with colloidal gold-conjugated protein A. As we previously reported (Torrisi, M. R., and S. Bonatti, 1985, J. Cell Biol., 101:1300-1306), Sindbis transmembrane glycoproteins are present in the inner nuclear membrane as well as in the outer nuclear membrane, endoplasmic reticulum, Golgi stacks and vesicles, and plasma membranes. Viral glycoproteins located on the inner nuclear membrane resemble those present on the outer membrane in terms of amount, distribution, and preferential partition after fracture. We show in this paper that Sindbis glycoproteins after treatment with cycloheximide are removed from the inner nuclear membrane with the same kinetics as their counterparts present on the outer membrane. This finding strongly suggests that newly synthesized transmembrane glycoproteins may freely diffuse to and from the inner nuclear membrane before entering into the intracellular transport pathway to the plasma membrane. PMID- 3818798 TI - The solution to the cytological paradox of isomorphy. AB - Cells with polyploid nuclei are generally larger than cells of the same organism or species with nonpolyploid nuclei. However, no such change of cell size with ploidy level is observed in those red algae which alternate isomorphic haploid with diploid generations. The results of this investigation reveal the explanation. Nuclear DNA content and other parameters were measured in cells of the filamentous red alga Griffithsia pacifica. Nuclei of the diploid generation contain twice the DNA content of those of the haploid generation. However, all cells except newly formed reproductive cells are multinucleate. The nuclei are arranged in a nearly perfect hexagonal array just beneath the cell surface. When homologous cells of the two generations are compared, although the cell size is nearly identical, each nucleus of the diploid cell is surrounded by a region of cytoplasm (a "domain") nearly twice that surrounding a haploid nucleus. Cytoplasmic domains associated with a diploid nucleus contain twice the number of plastids, and consequently twice the amount of plastid DNA, than is associated with the domain of a haploid nucleus. Thus, doubling of ploidy is reflected in doubling of the size and organelle content of the domain associated with each nucleus. However, cell size does not differ between homologous cells of the two generations, because total nuclear DNA (sum of the DNA in all nuclei in a cell) per cell does not differ. This is the solution to the cytological paradox of isomorphy. PMID- 3818799 TI - Propagation of differentiating normal human tracheobronchial epithelial cells in serum-free medium. AB - Serial-passage cultures of normal human tracheobronchial (TB) epithelial cells that exhibit functional differentiation have been established in serum-free medium supplemented with bovine pituitary extract (25 micrograms/ml), insulin (5 micrograms/ml), hydrocortisone (0.5 micrograms/ml), EGF (5 ng/ml), 10(-6)M each of ethanolamine and phosphoethanolamine, and antibiotics. The cells proliferated in this medium with a population doubling time of approximately 80 hours. Further, the passaged cultures retained differentiated morphology as evidenced by secretion of glycoproteins, binding of concanavalin A lectin, and presence of alcian blue and periodic acid Schiff-positive material in their cytoplasm. Ultrastructural observations further supported the functional epithelial nature of the cultures. Most cells exhibited characteristic microvilli on cell surfaces and showed junctional complexes between them. The cytoplasm contained a large number of perinuclear secretory vesicles, a characteristic feature of the differentiated cells. These cultures provide an excellent model to study factors that regulate synthesis and secretion of glycoproteins in normal human TB cells. PMID- 3818800 TI - Conditional responsiveness of a chemically transformed cell line to growth factor stimulated DNA synthesis. AB - BP3T3, a clonal benzo(a)pyrene-transformed BALB/c-3T3 cell line, is conditionally responsive to growth factor stimulation. Density arrested cell populations deprived of growth factors by pretreatment with 0.5% platelet-poor plasma synthesized DNA both in response to ng/ml concentrations of PDGF, EGF, and somatomedin C, and in response to insulin, plasma, and serum. The above agents acted singly to induce DNA synthesis, but synergism is suggested because a higher percentage of cells were stimulated to enter the S phase when the growth factors were added in combination. Desensitization to growth factors occurred when cultures were pretreated with the high concentration of growth factors present in 10% serum (or plasma). In desensitized cultures none of the above agents, added singly or in combination, stimulated DNA synthesis. This effect appears to be global because pretreatment with one growth factor (e.g., insulin) inhibited the action of another (e.g., PDGF). Cell density appears to play a critical role in regulating DNA synthesis. Unlike nontransformed BALB/c-3T3 cells whose density is regulated by the serum concentration, the density of BP3T3 cells reached a plateau when cultures were grown in a serum (or plasma) concentration of 3% or greater. Such density arrested cultures were growth factor unresponsive; however, the cells rapidly responded to growth factors by synthesizing DNA and replicating when reseeded at a lower cell density. Thus the growth of BP3T3 cells is regulated by both growth factors and cell density. PMID- 3818801 TI - Comparison of the phosphorylation events in membranes from proliferating vs. quiescent endothelial cells. AB - In an attempt to elucidate the intracellular events regulating the proliferation of endothelial cells (EC), we have compared the phosphorylation events in membranes prepared from proliferating (sparse) and quiescent (confluent) EC. Triton-solubilized membranes from sparse and confluent EC were incubated at pH 6.5 in the presence of divalent cations and [32P]ATP. Membrane proteins were then separated by SDS-PAGE and the radiolabeled phosphoproteins visualized by autoradiography. The overall kinase activity per milligram protein was 1.7 +/- 0.2-fold greater in membranes prepared from proliferating than from quiescent cells. The extent of phosphorylation was dramatically elevated in sparse over confluent samples for four phosphoproteins having the following approximate molecular masses: 180, 100, 97, and 55 kDa. The 180 and 100 kDa phosphoproteins exhibited 3.6- and 7.4-fold higher labeling, respectively, in sparse than in confluent membranes and both were phosphorylated on serine residues exclusively. The 97 kDa phosphoprotein was 11.6-fold higher in sparse membranes and contained both phosphoserine (p-ser) and phosphotheronine (p-thr), the latter comprising 61% of the radioactivity. The 55 kDA phosphoprotein contained 62% p-ser, 16% p thr, and 22% phosphotyrosine (p-tyr) and was 2.3-fold higher in sparse membranes. Of these four phosphoproteins, only the 55 kDa protein was phosphorylated in confluent samples to an appreciable degree. Whereas the p-ser and p-thr content of the 55 kDa band increased moderately in sparse vs. confluent sample (1.8-fold increase), the tyrosine residues of this protein in sparse membranes were radiolabeled to a much greater extent relative to confluent membranes (5.4-fold increase). Analysis of the cofactor requirements of the FC membrane kinase(s) revealed that Mn2+ is the optimum cofactor and that Mg2+ can replace Mn2+ only for the kinase acting on the 100 kDa band. This suggests the presence of multiple EC membrane kinases. In the presence of both cofactors, the phosphorylation pattern is similar to the pattern obtained with Mn2+ alone. The kinase activity acting on all four phosphoproteins was independent of Ca2+, cAMP, cGMP, and phorbol 12-myristate 13-acetate. The mechanism responsible for the difference in kinase activity of proliferating vs. quiescent cells was not due to an inhibitor or enhanced phosphatase activity in confluent cells; the phosphorylation patterns obtained with sparse solubilized membranes and a mixture of sparse and confluent solubilized membranes were similar.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3818802 TI - Retention of differentiated characteristics by cultures of defined rabbit kidney epithelia. AB - Rabbit nephron segments of proximal convoluted tubules (PCT); proximal straight tubules (PST); cortical and medullary thick ascending limbs of Henle's loop (CAL, MAL); and cortical, outer medullary, and inner medullary collecting tubules (CCT, OMCT, IMCT) were individually microdissected and grown in monolayer culture in hormone supplemented, defined media. Factors favoring a rapid onset of proliferation included young donor age, distal tubule origin, and the addition of 3% fetal calf serum to the medium. All primary cultures had polarized morphology with apical microvilli facing the medium and basement membrane-like material adjacent to the dish. Differentiated properties characteristic of the tubular epithelium of origin retained in cultures included ultrastructural characteristics and cytochemically demonstrable marker enzyme proportions. PCT and PST were rich in alkaline phosphatase; CAL stained strongly for NaK-ATPase; CCT contained two cell populations with regard to cytochrome oxidase reaction. A CCT-specific anti-keratin antibody (aLEA) was immunolocalized in CCT cultures, and a PST cytokeratin antibody stained PST cultures. The biochemical response of adenylate cyclase to putative stimulating agents was the same in primary cultures as in freshly isolated tubules. In PCT and PST adenylate cyclase activity was stimulated by parathyroid hormone (PTH) but not by arginine vasopressin (AVP); CAL and MAL adenylate cyclase was stimulated by neither PTH nor AVP; CCT, OMCT, and IMCT adenylate cyclase was stimulated by AVP but not by PTH. NaF stimulated adenylate cyclase activity in every cultured segment. It is concluded that primary cultures of individually microdissected rabbit PCT, PST, CAL, MAL, CCT, OMCT, and IMCT retain differentiated characteristics with regard to ultrastructure, marker enzymes, cytoskeletal proteins, and hormone response of adenylate cyclase and provide a new system for studying normal and abnormal functions of the heterogeneous tubular epithelia in the kidney. PMID- 3818804 TI - Management of wrist problems. PMID- 3818803 TI - The prevention and treatment of complications from fractures of the distal radius and ulna. AB - Almost one third of fractures of the distal radius are associated with some complication, either bony or soft tissue. Proper reduction and appropriate stabilization of the fracture are necessary to prevent many of these complications, particularly those involving the articular end of the radius. Although closed treatment is usually satisfactory, an open reduction and internal fixation of the fracture often is indicated in younger patients. PMID- 3818805 TI - Management of chronic rotary subluxation of the scaphoid by scapho-trapezio trapezoid arthrodesis. Rationale for the technique, postoperative changes in biomechanics, and results. AB - In cases of static or symptomatic dynamic scapholunate instability, reduction of the scaphoid proximal pole into the scaphoid fossa of the radius and stabilization of the relationship of the scaphoid and lunate by distal arthrodesis to the trapezium and trapezoid will significantly alter carpal mechanics; however, elimination of pain, preservation of a functional arc of motion, and restoration of the ability to pursue routine activities (including heavy labor) all suggest that the planes of radiocarpal and intercarpal motion following distal scaphoid arthrodesis are compatible with long-term physiologic function without late loss of reduction. PMID- 3818806 TI - Midcarpal instability. AB - The pathomechanics of midcarpal instability are described, particularly as they relate to the ring model of the wrist. A review of the clinical history, evaluation, and treatment of patients with midcarpal instability is presented. PMID- 3818807 TI - Fractures of the carpus, excluding the scaphoid. AB - Carpal bone fractures comprise an important group of injuries that present difficulties in both diagnosis and treatment. These fractures may be missed for the following reasons: physician's low index of suspicion, the carpal bones' irregular contours and degree of overlap on radiographs making the fractures difficult to visualize, and the common occurrence of concomitant fractures of neighboring metacarpals, distal radius, or scaphoid, which misdirects the examiner. A high index of suspicion with careful clinical examination and elicitation of point tenderness is key to making the correct diagnosis (Fig. 14). Swelling, loss of motion, deformity, and crepitus are often minimal and are not reliable in distinguishing carpal fractures. Specific radiographic projections, tomograms, computerized tomographic scans, or bone scans are often required and should be considered in any wrist injury where the diagnosis is in question. A greater awareness of the fracture types, methods of diagnosis, and choices of treatment is essential for optimal management of these injuries. PMID- 3818808 TI - Proximal row carpectomy. AB - In an era when surgical treatment of wrist disorders is becoming increasingly complex, proximal row carpectomy is still a reasonable salvage operation to consider in carefully selected patients. Realistic expectations should be understood by the surgeon and patient prior to the operation. PMID- 3818809 TI - Implant arthroplasty of the rheumatoid wrist. AB - Implant arthroplasty of the rheumatoid wrist is indicated for relief of pain in those patients with advanced destruction of the joint. Two types of implant arthroplasty are useful in selected cases: silicone interpositional arthroplasty and total wrist replacement. PMID- 3818810 TI - The carpal joint. Anatomy and function. AB - The carpal joint can be approached as a mechanism consisting of kinematic chains. In these chains, the proximal carpals function as intercalated segments. Intercarpal displacements are linked to one another and are based upon the mutual attuning of carpal bone geometry, joint contacts, and ligamentous interconnections. PMID- 3818811 TI - The distal radioulnar joint. Anatomy, biomechanics, and triangular fibrocartilage complex abnormalities. AB - The distal radioulnar joint plays an intricate part in the function of the wrist and thus in the function of the entire upper extremity. The radius and hand move in relation to and function about the distal ulna. Significant loads are transmitted to the forearm unit through the distal ulna via the triangular fibrocartilage complex. The anatomic relationships between the distal radius and ulna and ulnar carpus are precise, and even minor modification in these relationships leads to significant load changes and resultant pain syndromes. Evaluation of a patient with ulnar wrist pain is, at best, difficult. Despite a careful and thorough history and physical examination and the use of sophisticated ancillary diagnostic studies, some patients with distal radioulnar joint and ulnar carpal complex problems remain diagnostic and therapeutic mysteries. These patients are best followed; exploratory surgery is rarely satisfying to either the patient or the surgeon. Armed with an understanding of the normal anatomy and biomechanics, the examination of such a patient and subsequent treatment should become a challenge that is rewarding for both patient and treating physician. PMID- 3818812 TI - The distal radioulnar joint. AB - Reconstructive surgery of the distal radioulnar joint should be considered for those in the age range of 20 to 50 years, particularly in those patients having sustained a high-energy injury and in cases where there is a great demand on the wrist joint for heavy work and sports activities. Meticulous preoperative planning in terms of correct clinical and radiologic evaluation and strict adherence to restoration of the joint congruency and restoration of ligament function are most important in obtaining reliable, long-term results in the vast majority of patients. PMID- 3818813 TI - Pain on the ulnar side of the wrist. AB - Pain on the ulnar side of the wrist is frequently encountered in clinical practice. Its causes may be difficult to diagnose and are best evaluated using a systematic sequence of clinical, radiographic, and special procedures. Soft tissue, articular, and osseous causes of ulnar wrist pain are reviewed. PMID- 3818814 TI - Capsulodesis in reconstructive hand surgery. Dorsal capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna. AB - The use of a soft tissue flap of wrist capsule in reconstructive surgery is described. Stabilization is achieved by capsulodesis for rotatory subluxation of the scaphoid, and for the distal ulna after excision of the ulnar head. PMID- 3818815 TI - The NCI Drug Information System. 1. System overview. AB - An interactive computer system has been designed to handle all the data associated with the National Cancer Institute's (NCI) drug screening program. The system resides on the NIH DEC System 10 computers and allows interactive access to the entire NCI screening data system. This contains over 20 separate databases, including a chemistry file of about 400,000 structures and a biology file of approximately 1.5 million test records. New compounds and test data are added daily to the files, and the system also controls and records all the daily operations of the screening program, such as acquisition, shipping, and biological testing of chemicals. PMID- 3818816 TI - The NCI Drug Information System. 2. DIS Pre-Registry. AB - The Pre-Registry Module of the Drug Information System (DIS) is a staging area through which all new compounds are passed prior to acquisition and testing. Several methods are available for the entry of structures into the Pre-Registry; all involve built-in data validation. Newly entered structures are examined by computer programs for structural novelty and potential for anticancer activity. For those compounds that proceed to acquisition, the various acquisition steps, such as letter writing and record updating, are performed automatically. When a sample is obtained, the entire Pre-Registry record is updated and moved forward into the permanent DIS chemistry files. PMID- 3818817 TI - The NCI Drug Information System. 3. The DIS Chemistry Module. AB - The Chemistry Module of the Drug Information System (DIS) handles a database of 400,000 structures. New or modified records are created in this database on a daily basis and are merged into the file promptly. The Chemistry database is searchable in a wide variety of ways and provides novel methods for both input and output of chemical structures. PMID- 3818818 TI - The NCI Drug Information System. 4. Inventory and Shipping Modules. AB - The Inventory/Shipping package of the NCI Drug Information System (DIS) is designed to support all inventory and shipping operations associated with the testing by the NCI of large numbers of chemicals for anticancer activity. Two major databases, an Inventory database and a Shipping History database, contain all of the data associated with these operations. Software that supports the operations in an online interactive manner also provides for the accessing and updating of these databases as necessary. Special hardware in the form of barcode reader/printers and digital balances is also interfaced to the system to improve the efficiency of the operations. PMID- 3818819 TI - The NCI Drug Information System. 5. DIS Biology Module. AB - The NCI drug screening program tests over 10,000 chemicals per year for activity against cancer. The associated Drug Information System (DIS) captures all the raw testing data and provides for its validation. The large quantity of numeric data gathered during testing is maintained within the DIS in a database that is interactively searchable and automatically updated at regular intervals. PMID- 3818820 TI - General reversed-phase high-performance liquid chromatographic method for the separation of drugs using triethylamine as a competing base. AB - Triethylamine (TEA) was evaluated as a competing base for the retention control and peak shape improvement in the reversed-phase high-performance liquid chromatographic (RP-HPLC) analysis of selected acidic, basic, and neutral drugs. The effects of this amine on the capacity factor and theoretical plate number values of ephedrine, phenol, and sulfamerazine were examined on three unmodified commercial octadecylsilane chromatographic columns. Based on these results, a general RP-HPLC elution scheme using a mu Bondapak C18 10-micron column, methanol acetic acid-TEA-water mobile phases, and an ultraviolet detector was developed for more than 150 drugs of pharmaceutical interest. The proposed method was applied to the separation of groups of chemically or pharmacologically related drugs that included sympathomimetic amines, antihistamines, phenothiazines, local anesthetics, Cinchona and tropane alkaloids, xanthines, sulfonamides, and steroids. In addition, paired-ion drugs such as physostigmine salicylate and combinations of ascorbic acid, benzoic acid, salicylic acid, pamoic acid, and 8 chlorotheophylline with various basic moieties were readily and effectively resolved into their ionic components using almost identical RP-HPLC conditions. PMID- 3818821 TI - Metallic copper-containing post-column reactor for the detection of thiram and disulfiram in liquid chromatography. AB - A reaction detector has been developed for the selective detection of thiram and disulfiram. The detection is based on the post-column complexation of these analytes on a solid-state reactor packed with finely divided metallic copper to form a coloured copper complex, copper(II) N,N-dimethyldithiocarbamate, with an absorption maximum at 435 nm. The method is combined with a pre-concentration and clean-up step on a pre-column to permit the sub-ppb determination of, e.g., thiram in surface water samples or disulfiram in urine. Separation is achieved by reversed-phase liquid chromatography. PMID- 3818822 TI - Thin-layer electrophoretic behaviour of oligo- and mono-saccharides, uronic acids and polyhydroxy compounds obtained as biomass degradation products. AB - A recently developed thin-layer electrophoretic method has been applied to the determination of biomass degradation products comprising mono-, oligo- and polysaccharides and their derivatives as well as phenolic compounds. The separation was carried out using 0.3 M aqueous borate solution as the buffer and silanized silica gel as the support, the surface of the latter being covered with a thin film of octanol-1. For visualization of the carbohydrates, specific sulphuric acid-containing naphthoresorcinol and orcinol reagents were applied. The mobility of hydrolyzed products is determined by the number and position of their reactive sites and, to a less extent, by the size of their molecule. The good separations obtained confirm this method as an alternative to the commonly utilized chromatographic procedures. PMID- 3818823 TI - Correlation of urokinase activity from biopotency and high-performance liquid chromatographic assays. AB - A simpler, less expensive, and faster high-performance liquid chromatographic method was shown to be an alternative to urokinase potency determinations by the Ploug method. Post-elution recovery of the low-molecular-weight form was 104 +/- 2.4% as determined by the Ploug method. Two analysts reported relative standard deviations of 1.6% and 1.1% based on peak height determination of eight replicate injections of a single sample of low-molecular-weight material. Linearity at the same wavelength for low- and high-molecular-weight forms was 0.9999 and 0.9992, respectively, for peak height versus potency. PMID- 3818824 TI - Purification of copper-zinc-superoxide dismutase and catalase from human erythrocytes by copper-chelate affinity chromatography. AB - A relatively simple and reproducible procedure involving copper-chelate affinity chromatography for the isolation of copper-zinc-superoxide dismutase (E.C. 1.15.1.1) and catalase (E.C. 1.11.1.6) from human erythrocytes has been developed. Using this method, the two enzymes were easily and highly purified and appeared to be homogeneous as judged by polyacrylamide gel electrophoresis. PMID- 3818825 TI - Simple device for high-performance liquid chromatographic separation on microbore columns. PMID- 3818826 TI - One-step chromatographic isolation of collagen cross-links. PMID- 3818827 TI - Development of a gas chromatographic-mass spectrometric method using multiple analytes for the confirmatory analysis of anabolic steroid residues in horse urine. II. Detection of administration of 19-nortestosterone phenylpropionate to equine male castrates and fillies. AB - Esters of 19-nortestosterone form an important group of anabolic preparations used in veterinary practice. Based upon results from detailed metabolic studies for 19-nortestosterone in the horse, a method to confirm the administration of anabolic preparations of this steroid to castrated male horses and fillies is described; the method is based upon the use of multiple analytes. Following administration of the anabolic preparations, solid-phase extraction of urinary conjugates and the separation of the conjugate groups prior to hydrolysis allow for the determination of specific metabolites conjugated with either glucuronic acid or sulphate. Following hydrolysis of the conjugates, purification of the free neutral steroids on thin-layer chromatography, derivatisation and gas chromatographic-mass spectrometric analysis, the presence of the major metabolites, estrane-3,17 alpha-diol in the glucuronic acid fraction and 19 nortestosterone and two isomers of estrane-3,17-diol in the sulphate fraction, could be confirmed for 17-18 days after administration of Nandrolin (19 nortestosterone phenylpropionate). PMID- 3818828 TI - Determination of nicainoprol, a new antiarrhythmic agent, in human plasma and urine by high-performance liquid chromatography. AB - A new method for the determination of nicainoprol in human plasma and urine has been developed. Nicainoprol and p-chlorodisopyramide as the internal standard are extracted into dichloromethane under basic conditions, and then evaporated to dryness. A reconstituted aliquot is injected onto a cyanopropyl column with an automatic high-performance liquid chromatographic system and quantitated using ultraviolet detection at 250 nm. The whole system-elapsed time to analyse a sample is ca. 10 min, and the detection limit using 1 ml of plasma is 15 ng/ml. Preliminary plasma and urinary concentration-time data from a healthy subject following an oral nicainoprol administration are reported. The assay method presented appears to be selective, and is of sufficient sensitivity, precision and accuracy to be applicable to the study of the pharmacokinetic behaviour of nicainoprol in humans. PMID- 3818829 TI - Determination of aditoprim, a new dihydrofolate reductase inhibitor, in the plasma of cows and pigs. AB - A selective and sensitive high-performance liquid chromatographic method was developed for the determination of aditoprim, a new dihydrofolate reductase inhibitor, in the plasma of cows and pigs. The compound and its internal standard were extracted with chloroform from plasma buffered at pH 9 and chromatographed on a muBondapak reversed-phase column with a mixture of acetonitrile and 0.5% ammonium carbonate aqueous solution and detected by UV absorption. Aditoprim can be quantitatively extracted from plasma. The limit for quantitative determination was ca. 0.050 micrograms/ml with a standard deviation of +/- 0.006 micrograms/ml and an accuracy of +/- 3%. The assay was linear over the concentration range 0.1 5.0 micrograms/ml (precision 0.007-0.09 micrograms/ml), and the day-to-day accuracy was better than +/- 3.5%. No interference was observed from either metabolite(s) or coadministered sulphonamides. The new procedure was compared with a microbiological assay by analysing plasma samples from pigs treated with aditoprim. The two methods gave similar results in the range 0.5-5.0 micrograms/ml. PMID- 3818830 TI - Development of a rapid extraction and high-performance liquid chromatographic separation for amitriptyline and six biological metabolites. AB - The development of a rapid high-performance liquid chromatographic method for the determination of amitriptyline, amitriptyline-N-oxide, 10-hydroxyamitriptyline, 10-hydroxynortriptyline (E and Z isomers), nortriptyline and desmethylnortriptyline in plasma and liver tissue is described. A liquid--liquid extraction with hexane--butanol and back-extraction into phosphoric acid provides efficient extraction of amitriptyline-N-oxide along with amitriptyline and the other metabolites. A Supelcosil C8 reversed-phase column with 5-micron packing and a methanol--sodium phosphate buffer--amine modifier mobile phase was used. The combination of mobile phase pH and amine modifier concentration for the best separation within a reasonable analysis time for all seven solutes plus an internal standard was determined using a factorial design coupled with a multi factor window diagram technique. Ultraviolet detection at 214 nm provided limits of detection of approximately 1 ng/ml. PMID- 3818831 TI - Simplified column liquid chromatographic method for measuring urinary oxalate. PMID- 3818832 TI - Assay for L-p-tyrosine in plasma and brain by column liquid chromatography with electrochemical detection using m-tyrosine as the internal standard. PMID- 3818833 TI - Determination of the relative detector response for unstable bilirubin photoproducts without isolation. PMID- 3818834 TI - Determination of ketocyclazocine in human plasma by gas chromatography-negative ion chemical-ionization mass spectrometry. PMID- 3818835 TI - N-nitrosobutyl-N-(4-hydroxybutyl)amine glucuronide in vitro synthesis, characterization by mass spectrometry and determination by gas chromatography thermal energy analysis. PMID- 3818836 TI - Improved method for assaying digoxin in serum using high-performance liquid chromatography-radioimmunoassay. PMID- 3818837 TI - Electrochemical determination of histamine derivatized with o-phthalaldehyde and 2-mercaptoethanol. AB - High-performance liquid chromatography coupled with electrochemical detection was used to determine histamine following precolumn derivatization with o phthalaldehyde (OPA) and 2-mercaptoethanol. The isoindole derivative which is obtained as reaction product was electrochemically active at a moderate potential (peak potential +0.4 V). Direct oxidation of histamine required a much higher potential (peak potential +1.05 V) and was of no practical use. No electrochemical signal was observed for the reaction product of histamine with OPA. Changing the pH of the mobile phase had little effect on the electrochemical response of the isoindole derivative of histamine, which was well separated from analogous derivatives of methylated histamines, mono- and polyamines and amino acids by isocratic elution from a reversed-phase column. An example of a practical application of the method to the estimation of histamine in rat brain is presented. PMID- 3818838 TI - Liquid chromatographic analysis of a new antihypertensive agent, 3-(4-[4-(3 methylphenyl)-1-piperazinyl] butyl)-2,4-imidazolidinedione, in plasma. PMID- 3818839 TI - High-performance liquid chromatographic determination of zolpidem, a new sleep inducer, in biological fluids with fluorimetric detection. PMID- 3818840 TI - Automated capillary gas chromatographic determination of flunarizine. PMID- 3818841 TI - Assay of enzyme activities and low-molecular-mass constituents in serum using stopped-flow technique coupled with gel-permeation chromatography. PMID- 3818842 TI - Determination of bupivacaine in human plasma by capillary gas chromatography with nitrogen-selective detection. PMID- 3818844 TI - Purification of human plasma lipid transfer protein using fast protein liquid chromatography. AB - A system for the isolation of human plasma lipid transfer protein (LTP) has been devised using a combination of conventional and high-performance ion-exchange chromatography. Following initial purification by ammonium sulphate precipitation, ultracentrifugation, hydrophobic interaction and cation-exchange chromatography, appropriate fractions were further purified using the Pharmacia fast protein liquid chromatography system. Using this method of purification, human plasma LTP has been purified more rapidly and with greater recovery than with conventional column chromatography. Whereas two forms of LTP were previously reported from the authors' laboratory [LTP-I, molecular mass (Mr) 69,000 and LTP II, Mr 55,000], with an improved chromatographic system only one form of LTP (LTP I) has been isolated. This suggests that LTP-II may have been a fragment of LTP I, produced during the previously used lengthy purification process. PMID- 3818843 TI - Removal of an endogenous fluorescent compound from urine to allow quantitation of low concentrations of hydroxychloroquine and metabolites by high-performance liquid chromatography. PMID- 3818845 TI - Determination of beta-aspartylpeptidase activity in human faeces by high performance liquid chromatography using pre-column derivatization with phenyl isothiocyanate. AB - Bacterial enzymes are responsible for degradation of beta-aspartyl peptides in the intestinal tract. These peptides, especially the dipeptide beta aspartylglycine, are useful as indicators of an impaired anaerobic intestinal microflora of antibiotic-treated patients. A method to separate the dipeptides beta-aspartylalanine, beta-aspartylglutamine, beta-aspartylglycine and beta aspartylserine, using reversed-phase high-performance liquid chromatography and precolumn derivatization with phenyl isothiocyanate, was developed. This method was used to determine beta-aspartylpeptidase activity in faecal supernatants of healthy human volunteers and antibiotic-treated patients with beta aspartylglycine as substrate. This activity was absent in the antibiotic-treated group, while in individuals with an intact intestinal flora it ranged from 16 to 100% degradation per 18 h. In addition, it was found that faecal enzyme preparations cleaved beta-aspartylglycine at a much lower rate than the other beta-aspartyl peptides. PMID- 3818847 TI - Gas chromatographic assay for the new antitumor agent pyrazine-2-diazohydroxide (diazohydroxide) and its stability in buffer, blood and plasma. AB - Diazohydroxide is a new antitumor agent being considered for clinical trial. A sensitive and specific assay for diazohydroxide in physiological media, plasma and blood has been developed based on conversion of diazohydroxide to 2 chloropyrazine in the presence of strong hydrochloric acid. The 2-chloropyrazine is extracted into the ethyl acetate and separated by capillary gas chromatography with nitrogen-phosphorus detection. Using 0.2 ml plasma the assay was linear up to 100 micrograms/ml diazohydroxide and had a lower limit of detectability for diazohydroxide of 50 ng/ml. The coefficient of variation of the assay at 1 micrograms/ml was 6.7%. Breakdown of diazohydroxide was rapid under mild acid conditions but slower under alkaline conditions,. The half-life of diazohydroxide in 0.1 M sodium phosphate buffer, pH 6.0, at room temperature was 5 min and at pH 8.0, 480 min. Breakdown of diazohydroxide in plasma was biphasic. In fresh mouse plasma diazohydroxide had a terminal half-life at 37 degrees C of 72 min while in fresh human plasma the terminal half-life was 23 min and in fresh blood 21 min. Diazohydroxide accumulated in red blood cells at 37 degrees C to a concentration 68% above the concentration in plasma. Diazohydroxide was 49% bound to human plasma proteins at room temperature. PMID- 3818846 TI - Use of 4-bromomethyl-7-methoxycoumarin for derivatization of pyrimidine compounds in serum analysed by high-performance liquid chromatography with fluorimetric detection. AB - Derivatization of the pyrimidine nucleobases and nucleosides with 4-bromomethyl-7 methoxycoumarin was studied with the aim of developing a sensitive and selective column liquid chromatographic method for these substances in serum. The labeling reactions and the nature of derivatives are discussed, together with the chromatographic properties of these derivatives. The derivatives are stable for at least several weeks. Typical detection limits are 50 pg for inosine, 150 pg for uridine, 50 pg for uracil, 50 pg for thymine and 100 pg for fluorodeoxyuridine, respectively. Within-day coefficients of variation averaged 5.0% for the stored-frozen serum pools; the mean day-to-day value was 5.2%. Thirty samples could be processed per working day. PMID- 3818848 TI - Quantitation of hexaprazol in human plasma and urine by capillary gas chromatography with nitrogen-sensitive detection. AB - A selective and sensitive gas chromatographic assay for hexaprazol, a new antiulcer drug, in human plasma and urine has been developed. The method involves liquid-liquid extraction and capillary gas chromatography with nitrogen-sensitive detection. The limit of quantitation of plasma hexaprazol is ca. 25 ng/ml. The assay procedure permits the measurement of the levels of the unchanged drug following its clinical administration to humans. PMID- 3818849 TI - Quantitative determination of the fatty acid composition of human serum lipids by high-performance liquid chromatography. AB - A high-performance liquid chromatographic method for the analysis of the fatty acid composition of human serum lipids with fluorescence detection was examined. Both free and total fatty acids extracted from serum were derivatized with 9 anthryldiazomethane and were analysed using methanol-water (94.7:5.3) as mobile phase. Twelve kinds of fatty acid were detected, both in the free and total fatty acids, and were well separated. Concentrations of individual fatty acids of serum lipids were estimated from an internal standard, heptadecanoic acid. The results correlated well with those from two other quantitative analyses. These results indicate that the high-performance liquid chromatographic analysis of fatty acids is a reliable method for determining individual fatty acids of human serum lipids. The compositions of free fatty acids and total fatty acids of serum lipids were analysed and compared in 27 normal subjects, 27 diabetics, and 20 angina pectoris patients by this method. PMID- 3818850 TI - Zone formation in ion-pair reversed-phase liquid chromatography. III. Step gradient elution of oligodeoxyribonucleotides. AB - Step-gradient elution by decrease of the counter-ion concentration or increase of the co-ion concentration was studied in an ion-pair reversed-phase system. As analytes, polyvalently negatively charged oligodeoxyribonucleotides were used. In the co-ion step-gradient technique, the retention volumes can be predicted by use of a simple equation. This technique gives a drastic decrease in peak width, which makes it possible to decrease the separation time by using an optimized composition of the two eluents used. Furthermore, the detectability of organic ions is considerably improved. The time for the introduction of the second eluent, containing the co-ion, into the column after the sample injection is critical. PMID- 3818851 TI - Tenth International Symposium on Column Liquid Chromatography. San Francisco, CA (U.S.A), May 18-23, 1986. Proceedings. Part II. PMID- 3818852 TI - Counter-current chromatography. Applications to the separation of biopolymers, organelles and cells using either aqueous-organic or aqueous-aqueous phase systems. AB - Counter-current chromatography is a form of liquid-liquid chromatography which uses low-speed centrifugation to hold one phase of an immiscible liquid pair stationary while the other is eluted through it. Two types of countercurrent chromatography are described: one suitable for preparative/analytical separation with aqueous-organic phase systems and the other for analytic fractionations using aqueous-aqueous phase systems. Applications of both processes are described, ranging from the purification of antibiotics, pesticides, and peptides to the fractionation of whole cells. PMID- 3818853 TI - Micellar liquid chromatography for the analysis of nucleosides and bases. AB - A new high-performance liquid chromatographic method for the analysis of nucleosides and bases was developed in which a micellar mobile phase is used. Separation was achieved on a polyvinyl alcohol (PVA) column by isocratic elution with micellar sodium dodecyl sulfate (SDS) as the mobile phase. The retention behavior of the nucleosides and bases was significantly different from that obtained by reversed-phase chromatography. Effect of pH, temperature, and concentration of SDS and the counter ion (Na+) on retention behavior were investigated. With the PVA column, the best conditions for an isocratic separation were 0.01 M SDS (pH 3.4) and a flow-rate of 2 ml/min at ambient temperature. Mechanisms for the retention of the nucleosides and bases on the PVA column with a micellar mobile phase were proposed and an application of the separation was demonstrated by the analysis of human serum. PMID- 3818854 TI - Solvatochromic solvent polarity measurements and selectivity in reversed-phase liquid chromatography. AB - The ET(30) polarity values of binary acetonitrile-water and methanol-water mobile phases, used in reversed-phase liquid chromatography, were measured and compared with methylene selectivity (alpha CH2) for both traditional siliceous bonded phases and for a polystyrene-divinylbenzene resin reversed-phase material. The variation in methylene selectivity for both was found to correlate best with percent organic solvent in methanol-water mixtures, while the ET(30) polarity provided the best correlation in acetonitrile-water mixtures. The polymeric resin column was found to provide higher methylene selectivity than the siliceous bonded phase at all concentrations of organic solvent. PMID- 3818855 TI - Retention reproducibility of thiazide diuretics and related drugs in reversed phase high-performance liquid chromatography. AB - A method has been developed for the separation of thiazide diuretics and a number of related drugs by high-performance liquid chromatography on an ODS-Hypersil column with acetonitrile-1% aqueous acetic acid as the eluent. The effects caused by changes in the separation conditions on the reproducibility and robustness of alternative methods for recording retentions (including capacity factors, retention indices based on the alkyl aryl ketone scale, and relative capacity factors compared to a thiazide standard) have been examined. The results confirm that good interlaboratory reproducibility will only be achieved when operators control the temperature of the column and use the same brand of column packing material. The retentions should be recorded using a relative method, as these were found to be virtually independent of minor variations in the eluent composition. PMID- 3818856 TI - Structural classification of flavonoids in beverages by liquid chromatography with ultraviolet-visible and electrochemical detection. AB - Liquid chromatography with both UV-VIS and electrochemical detection is used to structurally classify flavonoid compounds in wine and grape juice without isolation of the pure compound. Compounds are classified as flavonols, proanthocyanidins, or anthocyanidins, based on their absorption maxima. Catechol substituted compounds are identified using a dual electrode detector. PMID- 3818857 TI - Chemical reduction system for the detection of phylloquinone (vitamin K1) and menaquinones (vitamin K2). AB - Both isocratic and gradient elution systems for fluorometric detection of K vitamins after post-column reduction with zinc metal to their hydroquinones are described. The reaction detection system for K vitamins (phylloquinone and menaquinones) in liquid chromatography is based on reduction of K vitamins to their corresponding hydroquinones with zinc metal in the presence of zinc ions. It was found that 95% of the injected quinones (K vitamins) could be reduced to their corresponding hydroquinones with zinc metal compared to 60% reduction for electrochemical detectors. Menaquinones could be detected down to 100 pg with relative ease during gradient elution. PMID- 3818858 TI - Determination of mycotoxins in grain by high-performance liquid chromatography and thermospray liquid chromatography-mass spectrometry. AB - An high-performance liquid chromatographic method is described for determination of deoxynivalenol, patulin, diacetoxyscirpenol, HT-2-toxin, T-2-toxin, zearalenone and ochratoxin A using a reversed-phase column and a diode-array detector. The extraction and purification steps and optimum chromatographic conditions are described. Detection limits and recoveries from spiked wheat samples were investigated. The combination of the high-performance liquid chromatographic system described together with a modern thermospray quadrupole mass spectrometer is a very specific and sensitive method for analyzing a wide range of mycotoxins in biological samples. PMID- 3818859 TI - Effect of column degradation on the reversed-phase high-performance liquid chromatographic separation of peptides and proteins. AB - Many reversed-phase separations of proteins and peptides are currently performed in acidic mobile phases, e.g., 0.1% trifluoroacteic acid in water (pH 2) with organic modifiers. Such conditions are known to promote the cleavage of the silane from the silica in bonded-phase columns, especially for monomeric stationary phases. The stability of some columns commonly used for proteins and peptides has been examined, and it has been shown by both chromatographic and elemental analysis that degradation occurs very rapidly with fresh, "totally covered" column materials. Despite the loss of over half of the bonded phase in some cases, certain columns still exhibit adequate chromatographic performance, although reproducibility can be affected. The implications of these results with respect to both bonded-phase synthesis and mechanistic interpretation of chromatographic data is discussed. PMID- 3818860 TI - An evaluation of microextraction/capillary column gas chromatography for monitoring industrial outfalls. AB - Microextraction and capillary-column gas chromatography techniques are applied to plant discharge streams for repetitive wastewater discharge permit analyses. This combination allows the analyst to reduce sample preparation since microextraction replaces both purge-and-trap for volatiles and microextraction for semi volatiles. An additional advantage is the elimination of a concentration step, which is often a major contributor to low method recoveries. The overall procedure is shown to be more precise than purge-and-trap but slightly less precise than conventional extraction. The results of each method are shown to be equivalent. PMID- 3818861 TI - Liquid chromatographic determination of the enantiomeric composition of amphetamine prepared from norephedrine and norpseudoephedrine. AB - The stereochemical course of the synthesis of amphetamine from norephedrine and norpseudoephedrine is investigated using liquid chromatography. The results show that the chiral carbon common to both compounds remains unaffected during the reaction sequence. The presence of individual amphetamine enantiomers in the reaction products is determined by reversed-phase liquid chromatographic separation on an achiral stationary phase (C18) following precolumn derivatization with 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl isothiocyanate (GITC). The GITC derivatization procedure allows for the liquid chromatographic separation of the individual enantiomers of amphetamine, norephedrine, norpseudoephedrine, and the intermediate 1-chloro-1-phenyl-2-aminopropanes. PMID- 3818862 TI - The unknown reviewer: an expression of policy and gratitude. PMID- 3818863 TI - Risk of osteoporotic fractures in women with breast cancer: a population-based cohort study. AB - A population-based study was undertaken to assess the risk of osteoporotic fractures in an inception cohort of breast cancer patients and an age-matched cohort of women from the community. Prior to the index date, 9.4% of cases and 12.3% of controls (p = 0.30) had one or more osteoporotic fractures. After the index date, these proportions were 16.2 and 20.0% (p = 0.28), but follow-up was shorter for cases due to reduced survival. When duration of follow-up was accounted for in a person-years analysis, the relative risk of any fracture was 1.0 and for any osteoporotic fracture was 0.9 (95% C.I. 0.7-1.2). After adjusting for other factors in a proportional hazards model, the relative risk of any osteoporotic fracture in breast cancer cases compared to controls was 0.9. Despite contentions that breast cancer patients have more often been exposed to estrogenic factors, we found little to suggest that such women are substantially protected from osteoporotic fractures. PMID- 3818864 TI - The decline of grip strength in the menopause: relationship to physical activity, estrogen use and anthropometric factors. AB - The focus of this study was the relationship of grip strength to age, physical activity and anthropometric factors, in a population of 255 post-menopausal women not on estrogen therapy (mean age = 57.6) and 55 women currently on estrogen replacement therapy (mean age = 56.9). Grip strength was measured as an indicator of muscular strength in the upper limbs. The grip strength of the estrogen users was significantly higher than that of the estrogen abstainers. Grip strength was related to age (r = -0.25, p less than 0.01), and the body habitus parameters of height (r = 0.36, p less than 0.01) and weight (r = 0.18, p less than 0.01). Although estrogen use was univariately correlated with strength (r = 0.16, p less than 0.05), multiple regression analyses revealed that only the height, age and physical activity were independent determinants of grip strength. These data suggest: height is the major determinant of upper body strength in older women; the reduction in physical activity with advancing age may contribute to strength decline, and modest increase in physical activity may retard the loss of strength that accompanies aging; the loss of ovarian estrogen in menopause may be related to the loss of strength in postmenopausal women. PMID- 3818865 TI - Patients with primary hyperparathyroidism operated on over a 24-year period: temporal trends of clinical and laboratory findings. AB - Temporal trends of clinical and laboratory data of 441 patients operated upon for primary hyperparathyroidism (HPT) during 1956-1979 were analysed retrospectively. There was a marked increase in the number of operations for HPT during that time period, from 32 during 1956-1964 to 326 in 1970-1979. In parallel there was a decrease in the proportion of patients with classical manifestations of HPT such as renal stones or bone disease, the latter being on the whole rarely seen in this population. The increased number of operations was instead largely attributable to the more frequent diagnosis of HPT in patients with vague psychiatric or neuromuscular symptoms or with no clinical manifestations; the majority of these persons were older women, the proportion of operations in women 45 years of age or older, increasing from 56% during 1956-64 to 71% during 1970 79. The increased number of operations for HPT during the last decades should be mainly the consequence of a greater awareness of the disease. PMID- 3818866 TI - Behavioral factors and blood pressure in black college students. AB - The relationship of behavioral factors and resting blood pressure was assessed in a random sample of 192 young middle class black adults. Framingham Type A behavior was positively associated with diastolic blood pressure (r = 0.17, p less than 0.05) among the women. Also, anger-in and trait anxiety were positively correlated with diastolic blood pressure for the women, r = 0.20, p less than 0.05 and r = +0.28 and p less than 0.01, respectively. After control for body mass index, trait anxiety and anger-in remained independent predictors of diastolic blood pressure among the women. For men, marijuana use was positively associated with blood pressure. Marijuana use was an independent predictor for systolic blood pressure after adjusting for body mass index among the males. The present study demonstrated a sex difference related to behavioral factors and blood pressure in young middle class blacks. PMID- 3818868 TI - Electrocardiographic abnormalities and mortality among middle-aged black men and white men of Evans County, Georgia. AB - The distribution of electrocardiographic (ECG) abnormalities and the relationship between ECG abnormalities and mortality after 20 years of follow-up were examined among 40-64-year-old black men and white men enrolled in the Evans County Heart Study. Major or minor ECG abnormalities, as defined in the Pooling Project, were present at entry for 53% of blacks (164 of 308) and 31% of whites (159 of 511). For both races, the presence of ECG abnormalities was directly related to age, blood pressure, and Quetelet's index at baseline. After adjustment for these and other risk factors, major ECG abnormalities were similarly predictive of all cause mortality for blacks [rate ratio (RR) = 1.7 (1.1.2.8)] and whites [RR = 2.2 (1.4, 3.4)]. Associations of similar magnitude were observed in relationship to deaths from all cardiovascular diseases and deaths from coronary heart disease. These results are consistent with the hypothesis that ECG abnormalities convey risk for blacks as well as whites. PMID- 3818867 TI - Declining trends in blood pressure level and the prevalence of hypertension, and changes in related factors in Japan, 1956-1980. AB - Trends in age-specific and age-adjusted blood pressure and the prevalence of hypertension were obtained from the National Nutrition Survey of Japan, 1956 1980. The national trends in the age-adjusted blood pressure of people (30-69 years old) in Japan during the 1956-1980 period show an increasing pattern reaching a peak around 1964 followed by a decreasing pattern. To explore the possible factors which have contributed to the change in blood pressure levels, we analyzed the relationship between the blood pressure and several possible factors, including the rate of treatment for cardiovascular diseases (CVD) for men and women, annual salt and alcohol consumption per captia and body mass index (MBI) for men and women. Only alcohol consumption was considered in the analysis of men because women in Japan still tend to drink relatively little alcohol. In simple descriptive analyses, the increasing trend in the treatment rates of CVD seemed to be related to the decrease in the blood pressure level and in the prevalence rate of hypertension for both men and women. The impact of treatment rate seemed to overcome the adverse influence of the increasing trends in BMI. Recent decrease in salt consumption may account in part for the later period of the decreasing trends in blood pressure level and the prevalence of hypertension. In multiple regression analysis using these time series data, CVD, BMI and alcohol consumption were significantly related to blood pressure level and the prevalence of hypertension, although salt was not significant in these analyses. PMID- 3818869 TI - Interhospital differences in cancer survival. AB - We examined variations in cancer survival rates among a large number of hospitals in the United States. Survival rates for breast cancer, prostate cancer, and Hodgkin's disease were calculated from patient care studies of the American College of Surgeons and were linked to data on hospital characteristics from the surveys of the American Hospital Association. When patient, disease, treatment, and institutional characteristics were examined in multivariate analyses, medical school affiliation, residency training, and community size were not related to hospitals' cancer survival experience. Patterns of care involving greater use of staging laparotomy with splenectomy for Hodgkin's diseases, lesser use of mastectomy without axillary dissection for breast cancer and, greater use of bone scanning and lesser use of hormone therapy for prostate cancer all were associated with better survival. The differences between hospitals' survival rates were large but we found that the differences were more a function of patient characteristics, disease stage, and tumor histology than of hospital affiliations, location, size, facilities, or treatment patterns. These findings provide some data upon which future public health interventions to affect cancer mortality may be planned and evaluated. PMID- 3818870 TI - Simple test of the Multifactorial-Polygenic Model with sex dependent thresholds. AB - Under the Multifactorial-Polygenic Model, a sex difference in population incidence implies higher risk in relatives of low risk sex probands than in those of high risk sex probands. The relationship between sex ratio in population incidence and expected relative risk (RR) to first-degree relatives of probands of the low risk sex vs the high risk sex under the Multifactorial-Polygenic Model was examined. Five observations were made from this analysis: as the sex ratio increases, the expected RR increases for each combination of incidence and r, the liability correlation between relatives, RRs are higher for low risk sex relatives than for high risk sex relatives at each combination of incidence, r, and sex ratio, the expected RR increases as r increases at each incidence and sex ratio, and variation in population incidence has little effect on RR at a given sex ratio and r, and the expected RRs are small, rarely exceeding two-fold. The quantitative relationship between sex ratio and RR provides the basis for a simple test of the Multifactorial-Polygenic Model when two different sex or severity thresholds can be identified. PMID- 3818871 TI - Measuring change over time: assessing the usefulness of evaluative instruments. AB - Reliability, the ratio of the variance attributable to true differences among subjects to the total variance, is an important attribute of psychometric measures. However, it is possible for instruments to be reliable, but unresponsive to change; conversely, they may show poor reliability but excellent responsiveness. This is especially true for instruments in which items are tailored to the individual respondent. Therefore, we suggest a new index of responsiveness to assess the usefulness of instruments designed to measure change over time. This statistic, which relates the minimal clinically important difference to the variability in stable subjects, has direct sample size implications. Responsiveness should join reliability and validity as necessary requirements for instruments designed primarily to measure change over time. PMID- 3818872 TI - Subject selection in hospital-based case-control studies. PMID- 3818873 TI - The fragility of an altered proportion: a simple method for explaining standard errors. PMID- 3818874 TI - Causative factors in the etiology of peptic ulcer disease become effective before the age of 15 years. AB - Peptic ulcer mortality in Western Europe, Japan, and the United States is characterized by marked temporal changes which suggest that environmental factors are important in the etiology of gastric and duodenal ulcer. The present study examines at what age these factors start becoming effective. When the average age specific death rates from 18 countries are plotted vs the year of birth, the fall of gastric and duodenal ulcer mortality related to successive birth-cohorts is continuously preserved in the age group of 15-19 years. Although the younger age groups also display a decline in ulcer mortality, it is not possible to discern unequivocally whether they follow the temporal pattern of birth-cohort risks. In the second analysis, the number of deaths from each individual country is accumulated over time, and the geographic variation in the age-specific mortality is compared for these countries. The death rates of consecutive age groups from different countries change in a parallel manner. The linear relationships between each two consecutive age groups start at the age of 5 years in gastric ulcer and at the age of 15 years in duodenal ulcer. These findings again suggest that the determinants for the risk of dying from gastric and duodenal ulcer begin to act at an age lower than 15. The contention of environmental factors starting to act before the age of 15 would remain valid, even if factors unrelated to etiology, such as different reporting for childhood and adult mortality, contributed to the different patterns of childhood and adult death rates. However, the actual cut off age of gastric and duodenal ulcer would then be shifted towards younger ages. PMID- 3818875 TI - Attribute frequency and misclassification bias. AB - Allowances for potential misclassification bias were performed for three epidemiologic studies. Although the error rates were assumed to be identical for the three studies, there were differences in the degree and even in the direction of the bias. It is shown that they are the result of differences in the true frequencies of the misclassified attributes in these studies. In this regard, the relation of misclassification bias to predictive value is described. Misclassification bias is highly dependent upon the interactions between error rates and the true frequencies of attributes. In general, relative risk estimates are more subject to substantial bias from disease misclassification when cohort studies have very low disease frequencies. Odds ratio estimates are more likely to be substantially biased from exposure misclassification when case-control studies have either very high or very low exposure frequencies. Attribute frequency is an important determinant of bias from misclassification. PMID- 3818876 TI - Serum total and HDL cholesterols according to reproductive status in Japanese females. AB - In order to observe variations according to reproductive status, serum total cholesterol (TC) and HDL cholesterol (HDL-C) were investigated in 153 pregnant, in 153 age-adjusted non-pregnant females, in 787 females aged 45-54 years living in a northern suburb of Tokyo, and in 150 12-year-old girls from a private junior high school in a southern suburb of Tokyo. Non-menstruating (non-menarcheal, postmenopausal) females had significantly higher TC and significantly lower HDL C/TC than menstruating (menarcheal, premenopausal) females did in both the age groups of 12 and 45-54 years, although no significant difference of HDL-C was found between them. The menstruating females tended to be more overweight in Quetelet's index and had thicker skinfolds. Pregnant females at the eighth month of gestation revealed a significantly high value of both TC and HDL-C vs age adjusted non-pregnant females, while at the fourth month of gestation only HDL-C was high. PMID- 3818877 TI - The cross-cultural study of U.S. and Greek adolescents: blood pressure data. AB - Blood pressures (BP) were determined in 1409 boys aged 8-16 years at three one year intervals in New York City (NYC) and in Greece, areas of high and low incidence of coronary heart disease (CHD), respectively. Non-Greek American boys had significantly lower systolic and diastolic BP than all the Greek boys from NYC and from Greece. The boys residing in Crete and in Athens had higher BP than all other cohorts. After covariance adjustment for height, ponderal index and age, significant differences among the cohorts showed the non-Greek American cohort to have the lowest and the Cretan cohorts the highest BP levels. The Cretans lead a lifestyle noted for the absence of other risk factors for CHD. Thus, while the incremental increase in blood pressure might have a corresponding increase in CHD risk among individuals, there are fewer individuals in Crete at elevated risk overall based on the CHD experience of the U.S. and Greece. PMID- 3818879 TI - The effect of socioeconomic factors on the early prognosis of cancer. AB - Previous studies have suggested that cancer patients of low socioeconomic status (SES) have poorer short and long-term survival than cancer patients of higher SES. In this study male and female patients between the ages of 25 and 70, admitted to two Ontario Cancer Treatment and Research Foundation Clinics with newly diagnosed cancers of a number of common sites, were interviewed to obtain information on education and occupation, and chronic illnesses other than cancer. Information on stage of disease at diagnosis, exact pathologic diagnosis, date of diagnosis, and treatment before and after admission to the clinic was obtained from clinic charts. Using multiple logistic regression analysis to control for the effect of stage and other variables, there was no convincing evidence that cancer patients of low SES measured by either education or occupation had a less favourable outcome at one year after diagnosis from cancers of all sites combined or lung cancer specifically. The data suggested that any single measure of SES affects males and females differently. PMID- 3818878 TI - Alcohol consumption and mortality in Alameda County. AB - The association between level of alcohol consumption and 15-year mortality, focusing particularly on the possible protective effect of light drinking compared to abstention, was studied in a representative population sample of 6928 residents of Alameda County, California. Because abstainers differ from light, moderate and heavy drinkers on a number of demographic, physical, and psychosocial characteristics, the role of these as confounders of the alcohol/mortality association was examined. Using multiple logistic models, the mortality experience of abstainers, moderate drinkers, heavy drinkers and very heavy drinkers was compared with that of light drinkers. Among men only, very heavy drinkers were at significantly greater risk of death from all causes than were light drinkers (OR = 2.5, p less than 0.01). Neither abstainers nor other drinkers were at significantly higher risk of death from ischemic heart disease than were light drinkers. This pattern of results persisted with adjustment for 11 covariates of alcohol consumption in addition to age. PMID- 3818880 TI - Heterogeneity of blood pressure response to dietary sodium restriction in normotensive adults. AB - To investigate the effect of dietary sodium restriction on blood pressure in healthy, normotensive adults, 82 individuals (36 men, 46 women) participated in a study of restricted sodium intake (less than or equal to 75 mEq/day) for a period of 12 weeks. For the entire population there was a small but significant (p less than 0.01) decrease in mean arterial pressure during sodium restriction. The change in blood pressure was significantly correlated with age (r = 0.23, p less than 0.05). Division of the population at age 40, showed that the older individuals were more likely to have a decreased blood pressure during sodium restriction, while as a group younger adults showed no change. The individual blood pressure responses were heterogeneous with increases in pressure observed in some subjects. These results suggest that "sodium sensitivity" of blood pressure may be more evident with increasing age. Further, sodium restriction in all normotensive adults may not be innocuous. PMID- 3818881 TI - Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. AB - Hospital admissions for herniated lumbar intervertebral disc or sciatica were followed up over a period of 11 years in 57,000 men and women who had participated in medical check-ups in various parts of Finland. Information on their hospitalizations after the baseline examination was obtained by record linkage to the National Hospital Discharge Register. To identify factors predicting back diseases, four controls matched individually for sex, age and place of residence were chosen for each of the 592 incidence cases who were free from severe back trouble and aged 20-59 at entry. Low or intermediate social class and blue-collar occupations in services or industry in men and symptoms suggesting psychological distress in women proved significant predictors for hospitalization due to herniated lumbar disc or sciatica. An association with the risk was suggested for smoking or chronic cough in men and parity in women. Marital status or leisure time physical activity were not predictive of herniated lumbar intervertebral disc or sciatica. PMID- 3818882 TI - Occupation and risk of herniated lumbar intervertebral disc or sciatica leading to hospitalization. AB - Various occupations were studied for the prediction of herniated lumbar intervertebral disc or sciatica in 592 men and women who had been discharged from hospital with these diagnoses during an 11-year follow-up after a health examination. The cases were compared with 2140 controls matched individually for sex, age and place of residence. Subjects who, at the initial examination before the follow-up, had reported a history of back pain or sciatica were excluded. In men, the risk of being hospitalized due to herniated lumbar disc or sciatica was lowest in professional and related occupations, significantly higher in all other groups and highest among blue-collar workers in industry and among motor vehicle drivers. The variation in the risk between occupational groups of women proved less but was nevertheless still apparent. However, in women, but not in men, the risk was significantly associated with self-assessed strenuousness of work. PMID- 3818883 TI - Ethics and informed consent. PMID- 3818884 TI - The concept of cause in disease. PMID- 3818885 TI - High density lipoprotein and low density lipoprotein utilization by human granulosa cells for progesterone synthesis in serum-free culture: respective contributions of free and esterified cholesterol. AB - Human preovulatory granulosa cells cultured in serum- and gonadotropin-free medium secreted progressively less progesterone as time elapsed. Addition of purified high density lipoproteins (HDL) as well as low density lipoproteins [very low density (VLDL) plus low density lipoproteins (LDL)] restored optimal synthesis of progesterone, and HDL was as effective as VLDL + LDL. The use of cholesterol doubly labeled lipoproteins allowed calculation of the proportions of free and esterified cholesterol converted into progesterone. Granulosa cells used either free or esterified cholesterol from VLDL + LDL. In contrast, HDL esterified cholesterol was a poor substrate for progesterone synthesis, while HDL free cholesterol was used preferentially. LH increased the use of both kinds of lipoproteins without changing the way in which they were used. Pretreatment of HDL by purified phospholipase A2 increased the conversion of free cholesterol into progesterone. Similar treatment of VLDL + LDL had little effect on progesterone secretion. We conclude that HDL as well as VLDL + LDL can provide cholesterol to human preovulatory granulosa cells and that utilization of HDL cholesterol may depend on gonadotropin (LH) and enzymatic (phospholipase) regulation. PMID- 3818886 TI - Early effects of cranial irradiation on hypothalamic-pituitary function. AB - Hypothalamic-pituitary function was studied in 31 patients before and after cranial irradiation for nasopharyngeal carcinoma. The estimated radiotherapy (RT) doses to the hypothalamus and pituitary were 3979 +/- 78 (+/- SD) and 6167 +/- 122 centiGrays, respectively. All patients had normal pituitary function before RT. One year after RT, there was a significant decrease in the integrated serum GH response to insulin-induced hypoglycemia. In the male patients, basal serum FSH significantly increased, while basal serum LH and testosterone did not change. Moreover, in response to LHRH, the integrated FSH response was increased while that of LH was decreased. Such discordant changes in FSH and LH may be explained by a defect in LHRH pulsatile release involving predominantly a decrease in pulse frequency. The peak serum TSH response to TRH became delayed in 28 patients, suggesting a defect in TRH release. Twenty-one patients were reassessed 2 yr after RT. Their mean basal serum T4 and plasma cortisol levels had significantly decreased. Hyperprolactinemia associated with oligomenorrhoea was found in 3 women. Further impairment in the secretion of GH, FSH, LH, TSH, and ACTH had occurred, and 4 patients had hypopituitarism. Thus, progressive impairment in hypothalamic-pituitary function occurs after cranial irradiation and can be demonstrated as early as 1 yr after RT. PMID- 3818887 TI - Endometrial cytosolic and nuclear progesterone receptors in the luteal phase defect. AB - Basal body temperature profiles, serial serum progesterone levels, and serial endometrial biopsies were studied in 15 infertile women during 21 ovulatory cycles. Ten cycles (in 9 women) demonstrated luteal phase defects (LPD), diagnosed by a histological lag in endometrial maturation, normal luteal phase length, and normal luteal phase serum progesterone levels. Both normal and LPD cycles had a maximum amount of endometrial cytosolic progesterone receptor (PgR) on days 13-15, with a significant decline thereafter. LPD cycles had significantly lower endometrial nuclear PgR concentrations than did normal cycles during the proliferative phase, but luteal phase endometrial nuclear PgR levels were similar in both groups. In 2 LPD women treated with dydrogesterone, normal endometrial maturation and a decline in endometrial cytosolic PgR concentrations in the late luteal phase were found. Therefore, with the exception of endometrial nuclear PgR concentrations during the proliferative phase, we found no evidence for a major abnormality in endometrial PgR levels in LPD cycles with a lag in endometrial histology. PMID- 3818888 TI - Progressive increase in non-sex-hormone-binding globulin-bound testosterone from infancy to late prepuberty in boys. AB - Recent evidence suggests that human albumin-bound testosterone (HSA-bound T), the major constituent of nonsex hormone-binding globulin-bound T (non-SHBG-bound T), is biologically important. To examine the potential exposure of peripheral tissues to T in normal prepubertal boys, we determined the distribution of serum T into SHBG-bound, HSA-bound, non-SHBG-bound, and free fractions in 80 normal males, aged 0.5-14 yr, all at Tanner stage I of sexual development. A model assuming equilibrium between free T and T bound to 2-binding proteins (HSA and SHBG) was used. A computer program, using as constants the SHBG-T and HSA-T affinity constants and the serum HSA concentration and as variables the serum SHBG and total T concentrations, was used to calculate SHBG-bound T, HSA-bound T, non-SHBG-bound T, and free T. Serum total T increased 2.6-fold from 0.5 to 14 yr, whereas non-SHBG-bound T, HSA-bound T, and free T increased 8- to 9-fold during the same period. On the other hand, SHBG-bound T increased only 1.9-fold. Expressed as a function of serum total T, non-SHBG-bound T increased from 6.6% to 30.4%, the relative increment being greater for HSA-bound than for free T. We conclude that with advancing age, there is a progressive increase in the exposure of all tissues to T in normal prepubertal boys. At the level of the central nervous system, this increase in serum bioavailable T could induce maturative changes in brain cells that result in the onset of puberty in normal boys. PMID- 3818889 TI - Adrenal and steroidal cell antibodies in patients with autoimmune polyglandular disease type I and risk of adrenocortical and ovarian failure. AB - Thirty-one patients with autoimmune polyglandular disease type I who initially had no adrenocortical and/or ovarian failure were followed for 1.2-12.1 yr (mean, 8.3) by determinations of adrenal (AA) and steroidal cell antibodies (SCA) and functional tests. Adrenocortical failure developed in 13 and ovarian failure in 11 patients. SCA or AA preceded adrenocortical failure in 12 of the 13 patients and were found in 2 of 9 patients (so far) who still have normal adrenal function (P = 0.001). SCA preceded ovarian failure in all 11 patients and were found in 6 of 11 patients who still have normal ovarian function (P = 0.02). The sensitivities/specificities/predictive values were 0.77/0.78/0.90 in all patients for SCA predicting adrenocortical failure, and 0.92/0.89/0.92 for adrenal-binding antibody (which includes all AA and most SCA) in predicting adrenocortical failure. The sensitivities/specificities/predictive values in females who initially had normal adrenocortical and ovarian function were 1.0/0.56/0.50 for SCA in predicting ovarian failure, 0.86/0.83/0.86 for SCA in predicting adrenocortical failure, and 1.0/1.0/1.0 for adrenal-binding antibody in predicting adrenocortical failure. Thus, the appearance of AA or SCA in a male patient without adrenocortical failure or a female patient without adrenocortical or ovarian failure signals a high risk of their development. PMID- 3818890 TI - Measurement of insulin-like growth factor I (IGF-I) responsiveness of fibroblasts of children with short stature: identification of a patient with IGF-I resistance. AB - Somatomedins are important mediators of GH action on skeletal tissues. A possible cause of growth failure, therefore, is impaired somatomedin (Sm) responsiveness of the target tissues. To investigate Sm responsiveness, we studied fibroblasts from 11 normal-statured individuals and 9 patients with short stature. Five of the short patients had normal serum GH and normal or increased Sm levels and, therefore, are considered possibly to be Sm resistant. The other short patients include 2 with Laron-type dwarfism and 2 with GH resistance of undefined type. As a measure of Sm responsiveness, we determined the ability of insulin-like growth factor I (IGF-I; Sm-C) to stimulate uptake of [3H]alpha-aminoisobutyric acid by fibroblasts. The mean ED50 of the 11 normal fibroblast cell lines was 3.2 +/- 0.9 (+/- SD) ng/ml. Fibroblasts from 8 of the 9 short-statured patients had ED50 values within the normal range. This included 2 fibroblast lines isolated from children with Laron-type dwarfism. Fibroblasts from 1 patient, however, were significantly less sensitive to IGF-I in 9 separate assays, with an ED50 of 10.7 +/- 1.8 ng/ml. Fibroblasts from the mother of the patient had an ED50 of 5.0 +/- 1.4 ng/ml, and fibroblasts from the father had an ED50 of 4.3 +/- 0.7 ng/ml, both above the normal mean. Measurements of [125I]IGF-I binding by suspended fibroblasts from this patient and her parents failed to demonstrate significant abnormalities in either the number of binding sites or the affinity of binding. We conclude that the ability of IGF-I to stimulate [3H]alpha-aminoisobutyric acid uptake by human fibroblasts provides a useful method of identifying short children with Sm resistance. Of five patients with clinical evidence of possible Sm resistance, fibroblasts from one consistently were hyporesponsive to IGF-I. Cells from two patients with Laron-type dwarfism were normally responsive to IGF I. PMID- 3818891 TI - Molecular cloning and partial characterization of a new autoimmune thyroid disease-related antigen. AB - To clone and characterize antigens to autoantibodies in Hashimoto's thyroiditis we constructed a cDNA library in the expression vector lambda gt11 using mRNA prepared from Grave's thyroid tissue. This library was screened using serum from a patient with Hashimoto's thyroiditis which had an antimicrosomal antibody titer greater than 1:10(6). Five positive recombinants were identified and cloned. Of these, 3 reacted with 7 of 17 normal serum samples. The 2 other clones (IL-28 and IL-33) reacted with none of the 17 normal serum samples. IL-28 reacted with 4 of 15 and IL-33 with 2 of 15 Hashimoto's thyroiditis serum samples (antimicrosomal antibody titers, greater than 1:6400). The specificity of the interaction between the Hashimoto's thyroiditis samples and the fusion protein was demonstrated by Western blot analysis. In addition, neither 10(-6) M human thyroglobulin nor 100 mU/ml bovine TSH inhibited binding of the serum samples to these 2 clones. Lysate from clones IL-28 and IL-33 did not reduce the antimicrosomal antibody titer in a hemagglutination assay. Absorption of Hashimoto's thyroiditis serum with purified thyroid microsomes reduced the serum antimicrosomal antibody titer, but not binding to these 2 clones. The cDNA inserts of clones IL-28 and IL-33 were approximately 0.6 and 0.4 kilobases (kb), respectively. The 0.6-kb IL-28 insert was used to probe human thyroid and human liver poly(A)+ mRNA. A single band of 3.3 kb was evident only with the thyroid mRNA. The IL-28 insert was subcloned into M13 and sequenced in both directions by the dideoxy technique and found to be 572 basepairs in length. When tested against the GenBank and Dayhoff gene banks, no significant homology with any known sequence was determined. In summary, a cDNA fragment of a previously unrecognized gene coding for an autoimmune thyroid disease-related antigen has been cloned and partly characterized; and the protein produced by this clone is not thyroglobulin, the thyroid microsomal antigen, or the TSH-binding site of the TSH receptor. We have, therefore, identified a new autoimmune thyroid disease-related antigen, the pathogenetic significance of which remains to be determined. PMID- 3818892 TI - The significance of impaired pancreatic polypeptide and epinephrine responses to hypoglycemia in patients with insulin-dependent diabetes mellitus. AB - The impaired epinephrine and glucagon responses to hypoglycemia often found in patients with insulin-dependent diabetes mellitus (IDDM) may be due to autonomic neuropathy. Since the pancreatic polypeptide response to hypoglycemia is mediated by cholinergic mechanisms, we used this response as an indicator of autonomic neuropathy to determine whether deficient epinephrine and glucagon responses in IDDM could be ascribed to an autonomic defect. The relationships between pancreatic polypeptide, epinephrine, and glucagon responses during insulin induced hypoglycemia were assessed in 18 patients with IDDM who had no overt evidence of autonomic neuropathy, including normal standard cardiovascular reflex tests, and 11 age-matched nondiabetic subjects. All of the diabetic patients had impaired glucagon responses [19 +/- 3 (SEM) vs. 96 +/- 11 pg/ml, peak increment, P less than 0.001]. Ten of the 18 diabetic patients had either impairment of plasma epinephrine or plasma pancreatic polypeptide responses or both to hypoglycemia. Moreover, pancreatic polypeptide responses were significantly correlated with epinephrine responses (r = 0.53, P less than 0.003). There was no association between the plasma glucagon response and the epinephrine (r = 0.02, NS), norepinephrine (r = 0.03, NS), or pancreatic polypeptide (r = 0.35, NS) response. Last, there was no correlation between the plasma hormone responses and the cardiovascular reflex test results. Therefore, the association of impaired plasma pancreatic polypeptide responses with impaired plasma epinephrine responses suggests that the impaired epinephrine responses are due to autonomic neuropathy, whereas the dissociation of plasma glucagon responses with both plasma pancreatic polypeptide and epinephrine responses suggests that the impaired pancreatic alpha-cell response to hypoglycemia is not due to autonomic neuropathy. In addition, the plasma pancreatic polypeptide and epinephrine responses to hypoglycemia appear to be an earlier indicator of underlying autonomic dysfunction than standard cardiovascular reflex tests. Thus, the responses of plasma pancreatic polypeptide and epinephrine to insulin-induced hypoglycemia may be a useful test for the identification of early autonomic neuropathy in IDDM. PMID- 3818893 TI - Increased aromatase activity in pubic skin fibroblasts from patients with isolated gynecomastia. AB - Aromatase activity (AR) was studied in pubic skin fibroblasts from eight patients with isolated gynecomastia (PSFG) and five normal subjects (PSFC). Cell monolayers were incubated in the presence of [3H]androstenedione (2 nM) for 4 or 24 h. Culture medium was extracted after addition of [14C] carriers to monitor recovery. Metabolites were separated by two successive chromatographic steps. Estrone (E1) and estradiol (E2) were characterized by crystallization, the other metabolites: 16-hydroxyestrone (16 alpha-OHE1) estriol (E3), and epiestriol (epiE3) by their chromatographic migration. AR was expressed either as femtomoles of E2 per microgram DNA (ARE2) or as total aromatized metabolites (ART = E1 + E2 + 16 alpha-OHE1 + E3 + epiE3/microgram DNA). After 4 h of incubation, no ARE2 could be measured in PSFC; it was low but significant in PSFG (0.03 +/- 0.02 (SEM) fmol/microgram DNA, P less than 0.01). The difference in ART was even more striking: 0.28 +/- 0.1 fmol/microgram DNA in PSFC, 3.15 +/- 2.88 in PSFG (P less than 0.05). 16 alpha-OHE1 represented in this latter group 62.5% of total aromatized metabolites vs. 39% in PSFC. After 24 h, ART was 4.17 +/- 3.70 and 1.02 +/- 0.42 fmol/microgram DNA in PSFG and PSFC, respectively (P less than 0.05); E3 + epiE3 represented 50% of the metabolites in both groups. In conclusion, AR is increased in PSFG relative to PSFC and an important oxidative metabolism of estrogens exists in both types of cells. This increased peripheral AR could result in increased formation of estrogens at the target cell site and represent an element of androgen-estrogen imbalance which would favor the development of gynecomastia. PMID- 3818894 TI - 5 alpha-reduced androgens in the human fetal testis. AB - The androgen content was measured in testes from 34 male and in ovaries from 30 female embryos that varied in age from less than 12 to approximately 20 weeks. The 5 alpha-reduced androgens dihydrotestosterone and 3 alpha-androstanediol were found in testes at a level of about a 30th of that of testosterone at all ages examined, whereas very little or no testosterone, androstenedione, or either of the 5 alpha-reduced androgens were detected in the ovaries. Whether dihydrotestosterone plays a role in the development of the testes is unknown. PMID- 3818895 TI - Expression of the growth hormone variant gene in human placenta. AB - Besides the hGH-N gene, which codes for the pituitary 22 and 20K GH variants, the human genome contains a second GH gene, namely the GH-V, which has been thought to be silent. We recently discovered a placental variant of human growth hormone (hPGH), which appears in maternal serum at mid-pregnancy and which rises in concentration thereafter to term. As hPGH and GH-V proteins display very similar characteristics, including a high affinity for hepatic GH receptors, they could be identical. To verify this hypothesis, we sought hGH-V mRNA in placenta. Hybridization experiments were performed between dot-blotted mRNA originating either from placenta or from one pituitary hGH secreting adenoma and synthetic polynucleotide probes corresponding to specific portions of the hGH-V or hGH-N gene sequences. The results indicate that the V gene is indeed expressed in the placenta and, at a very low level, in the pituitary adenoma. Therefore hPGH is most likely the expression product of the hGH-V gene. PMID- 3818897 TI - The effect of circulating growth hormone-binding protein on metabolic clearance, distribution, and degradation of human growth hormone. AB - We recently described a specific binding protein for human GH (hGH) in human plasma, with which a substantial portion of circulating hGH is complexed. The biological function of the complexed fraction is unknown. To test the hypothesis that complexed hGH may have different in vivo kinetics than free hGH, we compared the MCRs, distribution volumes (Vd), and degradation rates of complexed and free [125I] hGH in the rat. A partially purified GH-binding protein preparation, generated by affinity chromatography on a hGH column, was used for this purpose. A mixture of hGH with binding protein (equivalent to the amount contained in 0.9 mL human plasma) was injected iv as a single dose. Parallel experiments were conducted with hGH in the absence of binding protein. Disappearance of total, immunoprecipitable, and trichloroacetic acid-precipitable radioactivity from rat plasma was followed, and MCR, Vd, and degradation rates were derived by standard mathematical techniques. The MCR was 6-fold slower for complexed than for free hGH (2.3 vs. 14 mL/min X kg), Vd was 4-fold smaller for complexed hGH than for free hGH (71 vs. 256 mL/kg), and initial degradation rate was 4.5-fold lower for complexed than for free hGH (13.2% vs. 59.9%/15 min). The Vd of complexed hGH was close to the intravascular volume, while the Vd for free hGH corresponded to the extracellular volume. We conclude that one function of the hGH-binding protein is relative confinement of hGH to the vascular compartment, thereby protecting it from degradation and prolonging its biological half-life. PMID- 3818898 TI - Feminizing testicular Leydig cell tumor: hormonal profile before and after unilateral orchidectomy. AB - The effect of chronic hyperestrogenism on gonadal function was studied in three men who had estrogen-secreting Leydig cell tumors before unilateral orchidectomy and for 11-43 months after surgery. All three men had low plasma gonadotropin and testosterone levels and increased estradiol levels. Impairment of testicular steroidogenesis was also suggested by increased progesterone to 17 hydroxyprogesterone and 17-hydroxyprogesterone to androstenedione ratios in both spermatic venous plasma and the medium of Leydig tumor cells from one patient incubated in vitro. Before surgery, spermatogenesis was abnormal in two men. Testicular endocrine function and spermatogenesis did not return to normal after surgery. During the follow-up period, plasma gonadotropin levels were high in all three men, and testosterone was low normal. Estradiol levels decreased to normal immediately after surgery and then returned to the upper normal limit. The response to hCG stimulation in one man was subnormal. We conclude that chronic hyperestrogenism produced hypothalamo-pituitary inhibition as well as direct steroidogenic blockade at the testicular level. Long term impairment of both endocrine and exocrine testicular functions may be secondary to slowly reversible (or irreversible) estrogen-induced damage to tubular and Leydig cells. PMID- 3818896 TI - Postpartum return of ovarian activity in nonbreastfeeding women monitored by urinary assays. AB - Assays of first morning urine samples for pregnanediol-3 alpha-glucuronide (PdG), estradiol-17 beta-glucuronide (E2G), and LH were used to monitor endocrine function in 16 regularly cycling women and 22 postpartum nonbreastfeeding women. Twice weekly blood samples were also obtained from the postpartum group. Ovulation was inferred by a significant rise in LH and PdG, and reversal of the E2G to PdG ratio. Luteal phase PdG excretion was measured by the peak of smoothed PdG levels and the area under the smoothed luteal phase PdG curve. The lower limits of normal established in 16 cycling women were a peak luteal phase PdG of 4 micrograms/ml and an area under the PdG curve of 20 micrograms/ml. In the postpartum women, 32% of first cycles were anovulatory, and among ovulatory cycles, 73% had abnormally low luteal phase PdG excretion or short luteal phases. In second and subsequent cycles, 15% were anovulatory and 26% had luteal phase abnormalities. There was a progressive increase in luteal PdG excretion from the first to third cycles. The mean delay before first ovulation was 45.2 days, and no woman ovulated before 25 days after delivery. The correlations between blood and urinary hormone levels were 0.78 for PdG, 0.65 for E2G, and 0.55 for LH. We conclude that assays of daily early morning urine samples provide reliable information on ovulation and luteal phase adequacy, and that there is gradual recovery of pituitary ovarian function after parturition. PMID- 3818899 TI - Studies on adrenorphin in pheochromocytoma. AB - We studied the secretion and tissue contents of adrenorphin in human pheochromocytomas. In 17 human pheochromocytomas from 11 patients, we found a remarkably wide distribution in immunoreactive adrenorphin levels (3-7771 pg/mg tissue). Adrenomedullary pheochromocytomas contained a significantly larger amount of immunoreactive adrenorphin (2295 +/- 1092 pg/mg, mean +/- SE) than did extramedullary ones (17.8 +/- 8.4 pg/mg). Gel chromatographic studies revealed that immunoreactive adrenorphin consisted largely of material emerging at the position of synthetic adrenorphin in both pheochromocytoma and normal adrenal medulla tissue. Nicotine (10(-5) M) significantly stimulated the secretion of immunoreactive adrenorphin as well as catecholamines from cultured human pheochromocytoma cells. Adrenorphin was a more potent inhibitor of catecholamine secretion evoked by 10(-5) M nicotine than was met-enkephalin in cultured human pheochromocytoma cells. The 50% inhibitory concentrations (IC50) were 1.1 X 10( 6) and 6.5 X 10(-5) M for adrenorphin and met-enkephalin, respectively. The effect of adrenorphin was much the same as that of dynorphin-(1-13) (IC50, 1.0 X 10(-6) M) and BAM-12P (IC50, 4.5 X 10(-6) M). These results indicate the presence and secretion of adrenorphin in human pheochromocytomas. Adrenorphin may play an important role in regulating catecholamine secretion in human pheochromocytoma. PMID- 3818900 TI - Angiotensin II promotes prolactin release from normal human anterior pituitary cell cultures in a calcium-dependent manner. AB - Renin and angiotensin II (AII) have been demonstrated in the mammalian central nervous system, and AII has been found to promote PRL release in the rat and monkey. We added AII to monolayer cultures of human anterior pituitary cells and found significant PRL release by 30 min with concentrations of AII as low as 10( 10) M. This AII-induced PRL release was inhibited by the specific AII antagonist saralasin. AII-induced PRL release was a calcium-dependent process, since the calcium channel blockers verapamil and nifedipine as well as the calcium calmodulin antagonist R2471 significantly inhibited AII-induced PRL release. Prostaglandins E2, A2, and F2 alpha also inhibited AII-induced PRL release. The significance of this latter observation is not clear, however, as indomethacin, an inhibitor of the cyclo-oxygenase prostaglandin metabolic pathway, had no effect on AII-induced PRL release. In light of recent immunohistochemical evidence of the presence of renin, angiotensinogen, and converting enzyme in human lactotrophs, our data support the concept that AII may be an important autocrine regulator of PRL secretion. PMID- 3818901 TI - Relationships of plasma estradiol, testosterone, and sex hormone-binding globulin with lipoproteins, apolipoproteins, and high density lipoprotein subfractions in men. AB - Plasma estradiol, testosterone, and sex hormone-binding globulin (SHBG) were studied in relation to plasma lipoproteins, high density lipoprotein (HDL) subfractions, and apolipoproteins in 73 healthy but sedentary middle-aged men. Among potentially confounding variables, a strong positive association was found between estradiol levels and cigarette use, while testosterone and SHBG correlated negatively with percent body fat and alcohol intake. After adjustment for smoking, percent body fat, and alcohol, plasma estradiol levels correlated negatively with total cholesterol and low density lipoprotein cholesterol, and testosterone levels correlated positively with apolipoprotein B, while SHBG levels correlated positively with HDL2 mass and apolipoprotein A-I. SHBG was also strongly associated with the waist to hip girth ratio (WHR). Adjustment for WHR eliminated the significant associations of SHBG with triglycerides, HDL2 mass, and apolipoprotein A-I. SHBG levels and WHR may reflect tissue sensitivity and the impact of exposure to fluctuating levels of sex hormones for a period of days, or longer. These variables may provide more insight into the role of sex hormones in lipoprotein metabolism than do single samples of circulating hormones. It is also suggested that long term effects of sex hormones on adipose tissue distribution may at least partially underlie sex-related differences in lipoprotein metabolism. PMID- 3818902 TI - QT interval prolongation and sudden cardiac death in diabetic autonomic neuropathy. AB - Alterations in cardiac sympathetic innervation may result in QT interval prolongation and predispose to sudden arrhythmias and death. Sudden cardiac death occurs in diabetic patients who have autonomic neuropathy, but the cause is uncertain. In 30 patients with insulin-dependent diabetes mellitus who had no evidence of ischemic heart disease, cardiac autonomic neuropathy, determined by clinical tests, was found in 17. The corrected QT interval (QTc), measured using Bazett's formula at rest and peak exercise, was prolonged (greater than 440 msec) in 12 of these patients at rest and in 15 at peak exercise. Prolonged QTc intervals were found only in patients who had definite cardiac autonomic neuropathy. As a group, the QTc interval (mean +/- SD) in the diabetic patients with cardiac autonomic neuropathy was prolonged compared to that in patients without cardiac autonomic neuropathy at rest (447 +/- 28 vs. 405 +/- 9 ms; P less than 0.0001) and peak exercise (468 +/- 23 vs. 402 +/- 23 ms; P less than 0.0001). There was a direct linear relationship between the extent of cardiac autonomic neuropathy and the QTc interval (r = 0.71; P less than 0.001). One of the patients with cardiac autonomic neuropathy and prolonged QTc intervals had a nonuniform loss of adrenergic neurons in his heart demonstrated by meta iodobenzyl-guanidine scintigraphy, indicating sympathetic imbalance; he subsequently died unexpectedly. These data suggest that diabetic cardiac autonomic neuropathy may result in sympathetic imbalance and QTc interval prolongation, predisposing these patients to sudden arrhythmias and death. PMID- 3818903 TI - Variability of midcycle estradiol positive feedback: evidence for unique pituitary responses in individual women. AB - In women the preovulatory estradiol (E2) level must reach a peak concentration and dose (strength and duration) to initiate the LH surge. The variability of the surge-initiating serum E2 level in individual women from cycle to cycle, however, has not been studied. Accordingly, we studied 24 normally ovulating women longitudinally during a total of 221 menstrual cycles (range, 4-17 cycles/woman). In those women we measured periovulatory serum E2 and LH concentrations daily from 3 days before the LH peak to the day after the LH peak. The mean peak E2 concentration was 343 pg/mL, and the mean E2 dose (concentration X time) was 979 pg/mL. When the values in individual women were compared between women by components of variance analysis of variance, the differences were significant (concentration, P less than 0.01; dose, P less than 0.005), indicating that individual women have discrete and characteristic responses to E2 positive feedback. When E2 peaks and doses from initial cycles were compared with subsequent cycles by regression analysis, there were strong positive correlations (peak: r = 0.47; P less than 0.001; dose: r = 0.60; P less than 0.001). Of the total group variance in mean E2 peak and mean dose, 67% of the peak and 54% of the dose variance resulted from an individual woman's cycle to cycle variability, while 33% of the peak and 46% of the dose variance was attributable to differences among the women's responses to positive feedback. We conclude that individual women have characteristic and predictable periovulatory E2 production, leading to a LH surge which is maintained from cycle to cycle; and approximately two thirds of the total variance in mean peak E2 concentration (67%) and approximately half the variance in mean dose (54%) are the result of cycle to cycle biological variability around this characteristic periovulatory pattern of E2 production. PMID- 3818904 TI - Turnover and urinary excretion of circulating diiodotyrosine. AB - The MCR of diiodotyrosine (DIT) was determined by measuring serum DIT concentrations by RIA after a single injection of 200 micrograms DIT and noncompartmental analysis. Comparison of the stable DIT method with the tracer DIT technique in dogs yielded good agreement of measured DIT MCRs. The mean (+/- SD) MCR and blood production rate of DIT were 122 +/- 29 L/day X 70 kg and 24.2 +/- 12.7 nmol/day X 70 kg (10.5 micrograms/day X 70 kg), respectively, in 10 normal subjects. Urinary DIT was measured by RIA after its immunoprecipitation from urine. Acid hydrolysis had no effect on measured urinary DIT concentrations, suggesting the presence of predominantly unconjugated DIT. Mean urinary DIT excretion was 1.23 +/- 0.43 (+/- SD) nmol/24 h (533 ng/24 h) or 0.108 +/- 0.048 nmol/nmol creatinine in 32 normal individuals. In patients with defective thyroidal iodine metabolism, urinary DIT was extremely elevated, ranging from 1.2 17.7 nmol/mmol creatinine. Comparison of normal production and excretion rates suggests that about 5% of the daily extrathyroidal DIT turnover is excreted in the urine unchanged or in a DIT-like form. PMID- 3818905 TI - Early postmenopausal bone loss is not associated with a decrease in circulating levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, or vitamin D-binding protein. AB - To study changes in the rate of bone loss before and after the menopause, 19 normal premenopausal women of the same age were followed with annual measurements of appendicular bone mass for 8 yr. Their serum estrone, estradiol, 25 hydroxyvitamin D, 1,25-dihydroxyvitamin D, and vitamin D-binding protein levels also were measured annually. The serum estrogen levels declined before the menopause, and the rate of bone loss more than doubled at the time of the menopause. There were no significant changes in the serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin LD or vitamin D-binding protein levels from the pre- to the postmenopausal period. We conclude that changes in vitamin D metabolite levels are not associated with early postmenopausal bone loss. PMID- 3818906 TI - Factors affecting suppression of endogenous thyrotropin secretion by thyroxine treatment: retrospective analysis in athyreotic and goitrous patients. AB - Factors affecting TSH suppression by L-T4 administration were retrospectively evaluated in 452 patients: 180 who were athyreotic after total thyroidectomy and remnant radioiodine ablation for differentiated thyroid carcinoma and 272 with nontoxic diffuse or nodular goiter. All patients were considered clinically euthyroid. TSH secretion was assessed by iv TRH stimulation testing. The T4 dose associated with an undetectable basal serum TSH level and no increase in serum TSH after TRH administration (suppressive dose) averaged 2.7 +/- 0.4 (SD) micrograms/kg body weight (BW)/day in athyreotic patients and 2.1 +/- 0.3 micrograms/kg BW/day in goitrous patients (P less than 0.001). The 25th-75th percentile intervals were 2.5-2.9 micrograms/kg BW/day for athyreotic patients and 1.9-2.3 micrograms/kg BW/day for goitrous patients. The suppressive dose of T4 was dependent in both groups on patient age, younger patients needing higher doses than older patients. The duration of treatment also proved to be an important parameter, since in both groups the percentage of patients with suppressed TSH secretion increased if TRH testing was carried out after at least 6 months after the initiation of therapy. Serum total T4, total T3, free T3 (FT3), free T4 (FT4) index, and FT3 index values did not differ in the two groups and were significantly higher (P less than 0.001) than in normal subjects. Mean serum FT4 was significantly higher in athyreotic patients than in goitrous patients with suppressed TSH secretion. Among athyreotic patients with suppressed TSH secretion, 24% had elevated serum FT4 and FT3, and 47% had elevated serum FT4 alone. Of goitrous patients with suppressed TSH secretion, 20% had elevated serum FT4 and FT3, and 27% had elevated serum FT4 alone. On the other hand, 35% of athyreotic patients and 14% of goitrous patients whose TSH secretion was not suppressed had elevated serum FT4. Serum sex hormone-binding globulin concentrations were measured in 3 groups of goitrous women. Values above normal limits were found in 13/26 patients (50%) with high serum FT4 and FT3, in 4/30 patients (13%) with elevated serum FT4 alone, and in 1/25 patients (4%) with normal FT4 and FT3. IN CONCLUSION: TSH suppression requires daily doses of T4 between 2.5 and 2.9 micrograms/kg BW in athyreotic patients and between 1.9 and 2.3 micrograms/kg BW in goitrous patients, with appropriate adjustments in relation to the age of the patient; Assessment of the adequacy of treatment should not be carried out before 6 months after the institution of therapy. PMID- 3818907 TI - Melatonin in human preovulatory follicular fluid. AB - Melatonin, the major hormone of the pineal gland, has antigonadotrophic activity in many mammals and may also be involved in human reproduction. Melatonin suppresses steroidogenesis by ovarian granulosa and luteal cells in vitro. To determine if melatonin is present in the human ovary, preovulatory follicular fluids (n = 32) from 15 women were assayed for melatonin by RIA after solvent extraction. The fluids were obtained by laparoscopy or sonographically controlled follicular puncture from infertile women undergoing in vitro fertilization and embryo transfer. All patients had received clomiphene citrate, human menopausal gonadotropin, and hCH to stimulate follicle formation. Blood samples were obtained by venipuncture 30 min or less after follicular aspiration. All of the follicular fluids contained melatonin, in concentrations [36.5 +/- 4.8 (+/- SEM) pg/mL] substantially higher than those in the corresponding serum (10.0 +/- 1.4 pg/mL). A positive correlation was found between follicular fluid and serum melatonin levels in each woman (r = 0.770; P less than 0.001). These observations indicate that preovulatory follicles contain substantial amounts of melatonin that may affect ovarian steroidogenesis. PMID- 3818908 TI - Identification of relaxin immunoreactivity in human follicular fluid. AB - Relaxin immunoreactivity has been found in samples of human follicular fluid collected from artificially stimulated pre-ovulatory follicles. The crude extract caused a reduction in the height of the contractions in a rat uterine strip bioassay. The reactive material eluted from Sephadex G50 in two major peaks. The first contained approximately 60% of the immunoreactivity and had an elution position corresponding to that of porcine relaxin, indicating a mol. wt of approximately 6000 daltons. The second peak was of a lower mol. wt, but its exact size and significance are unknown. A possible role for relaxin in the process of follicular rupture is suggested. PMID- 3818911 TI - Ultrastructure of the early human implantation in vitro. AB - Four hatched human blastocysts obtained after in-vitro fertilization and development were placed on monolayer cell cultures of human endometrial epithelium, and subsequently examined by transmission electron microscopy. All four blastocysts became adherent to the monolayer and three implanted and exhibited outgrowth of their trophoblastic cells. During implantation the blastocysts differentiated into mural and polar trophoblastic cells, and embryonic cells including endodermal cells. The endometrial cells were displaced and stacked into a multilayer at the periphery of the implantation sites, allowing the trophoblastic cells to come in contact with the culture dish. The endometrial cells displayed local exo- or endo-cytosis where they contacted the trophoblastic cells. The trophoblastic cells were not observed to be phagocytosing endometrial cells. These observations suggest that human blastocysts portray an intrusive type of implantation during the initial stages. PMID- 3818909 TI - Meiotic chromosome studies and synaptonemal complex analyses by light and electron microscopy in 47 infertile or sterile males. AB - Mitotic and meiotic chromosome studies and synaptonemal complex analyses by light and electron microscopy have been carried out in a selected series of 47 infertile or sterile males with highly abnormal seminograms, affecting the number of spermatozoa, their morphology and/or motility. In 46 cases, the karyotype was 46,XY. One patient had a 13/14 translocation. With the exception of the patient with a 13/14 translocation, and three patients with desynapsis (8.5%), all other cases showed either normal or absent metaphase I figures. However, synaptonemal complex analysis by light and electron microscopy demonstrated the presence of pairing anomalies (desynapsis, fragmented or irregular synaptonemal complexes) in 31.9% of the patients studied. The total number of synaptic anomalies observed (40.4%) is higher than in a former light microscopy study of 111 infertile or sterile patients (28.8%) probably because the higher resolution of the electron microscope permits the characterization of some anomalies that cannot be detected with the light microscope. The electron microscope should therefore be used in all cases in which the light microscope provides doubtful results. PMID- 3818910 TI - Time course of human sperm transformation in the cytoplasm of zona-free hamster ova. AB - The time required for nuclear transformation of human spermatozoa in the cytoplasm of zona-free hamster ova was determined using semen samples from four individuals. Zona-free ova were incubated with capacitated spermatozoa for either 3 h or for 4-8 h. After the first hour of insemination, up to 85 ova were fixed at 1-h intervals. Assessments of sperm transformation were carried out on Giemsa stained preparations of ova. Considerable variation between individuals was found in the maximal time of sperm decondensation, ranging from 2 to 7 h. Decondensing sperm heads developed into pronuclei within 3-5 h. At and subsequent to pronuclear formation, the incidence of decondensing sperm heads was considerably reduced in both insemination times. This variability in sperm transformation is relevant in clinical evaluations of the functional capacity of spermatozoa. PMID- 3818912 TI - Predictive value of in-vitro sperm function tests in the context of an AID service. AB - Our inability to predict the fertilizing potential of an ejaculate in vivo is central to the dilemmas which confront clinical andrologists. In this paper, we examine the ability of laboratory tests of sperm function to predict the fertilizing ability of an ejaculate in vivo, in the context of a retrospective analysis of cryostored semen used in an AID programme. Samples were subjected to a conventional semen analysis, measurement of ATP levels, zona-free hamster oocyte penetration testing and examination of sperm movement characteristics by time-exposure photography. Using a multivariate discriminant analysis, we were able to distinguish successful from unsuccessful ejaculates with an overall accuracy of 81.25% (P = 0.0191) based upon data derived from the conventional semen profile, hamster oocyte penetration and the assessment of sperm movement. PMID- 3818913 TI - Chromosome investigations in early life. I. Human oocytes recovered in an IVF programme. AB - Fifty-five oocytes recovered in an in-vitro fertilization (IVF) programme and remaining unfertilized when observed 42 h after insemination were prepared for chromosomal analysis. Sixteen oocytes displayed no polar body at the time of fixation and were supposed to be in metaphase I. In fact only two of them were in diakinesis, the others containing a diploid set of metaphase II chromosomes indicating that in 89% of the cases oocytes achieved meiosis without any extrusion of the first polar body. Thirty-nine oocytes in metaphase II were analysed. Nine were abnormal showing three D nullosomies, one G disomy, one double disomy for a 3 and a D chromosome, one deletion of the long arm of a G chromosome, one cell with extra chromosomes and/or chromosome breaks, one endoreduplication and one tetraploidy. The overall rate of abnormalities reached 22%. This high rate of chromosome anomalies can be explained by the nature of this population of fertilization failure, the frequently advanced maternal age and the use of superovulation treatments. PMID- 3818914 TI - In-vitro techniques: can they replace animal testing? AB - In-vitro tests for the long-term safety evaluation of drugs offer certain advantages. Specific properties of drugs can be identified including mutagenic and carcinogenic effects. The mechanisms leading to toxicity can be assessed. Tissue from several species, including man, can be examined. These tests should reduce the number of animal tests required for screening new drugs. PMID- 3818915 TI - The child and/or the embryo. To whom does it belong? AB - The relationships between embryos and children conceived by assisted procreation and their genetic and uterine parents are discussed. The situations arising in AID, embryo donation, surrogacy, etc. are debated in relation to the status of embryos and children as projects of the parents producing them. The same principle is applied to the use of embryos in research. PMID- 3818916 TI - Characterization of hemolysin in extracellular products of Pseudomonas cepacia. AB - Pseudomonas cepacia is recognized as an opportunistic pathogen in immunocompromised patients. We screened 120 strains of P. cepacia isolated from clinical specimens for production of extracellular products. About 70% of these strains produced lipase, protease, and lecithinase, but only 4% produced hemolysin. A hemolysin produced by P. cepacia JN106 was characterized. The hemolysin was most active against human erythrocytes. Horse, sheep, chicken, and rabbit erythrocytes were also susceptible. The hemolysin was heat labile and was inhibited by sterols but was not activated by 2-mercaptoethanol and dithiothreitol. Four hemolysin-negative mutants obtained by N-methyl-N'-nitro-N nitrosoguanidine treatment produced the other extracellular products. A 58 kilobase-pair plasmid found in the parent strain was also found in the mutant strains, suggesting that the hemolysin gene resides on the chromosome. PMID- 3818917 TI - Bacterial concentration correlations in experimental endocarditis caused by Staphylococcus epidermidis. AB - Using 13 strains of Staphylococcus epidermidis to produce catheter-induced experimental endocarditis in rats, we found that bacterial concentrations in blood cultures obtained at the time of sacrifice correlated significantly with the number of organisms per gram of endocardial vegetation (P less than 0.001) and the total number of organisms per vegetation (P less than 0.001). Furthermore, blood culture concentrations correlated with vegetation weights (P less than 0.001) and sizes of infecting inocula (P less than 0.0001). Mean bacterial concentrations in vegetations more than doubled as bacterial concentrations in blood rose from less than 10 to greater than 100 CFU/ml. Mean values for vegetation weights, total organisms per vegetation, and sizes of infecting inocula were also reflected by the intensity of bacteremia. Moreover, intracardiac catheters were more likely colonized as bacterial concentrations in blood cultures increased, with all catheters culture positive in the 25 animals that exhibited high-grade bacteremia (greater than or equal to 100 CFU/ml). Slime production by the bacteria did not influence the above-mentioned correlations. These data indicate that the blood concentration of bacteria reflects the microbiologic status of infected vegetations in experimental infective endocarditis. PMID- 3818918 TI - Production and purification of Streptococcus pneumoniae hemolysin (pneumolysin). AB - Pneumolysin was found to be produced by 112 of 113 clinical isolates of Streptococcus pneumoniae and to be an intracellular hemolysin. A 10-liter-scale fermentor production and purification procedure was developed for this hemolysin. The culture was concentrated by filtration 10 times before centrifugation. The cellular content was purified by ion-exchange chromatography, covalent thiopropyl gel chromatography, and gel filtration. One batch operation resulted in 6 mg of highly purified pneumolysin, with a yield of 66% and a specific activity of 1,400,000 hemolytic units per mg. The pneumolysin had a molecular weight of 53,000 and an isoelectric point of 5.2. The purification method developed will be of value in future studies on this hemolysin. PMID- 3818919 TI - Diagnosis of pneumococcal pneumonia by enzyme-linked immunosorbent assay of antibodies to pneumococcal hemolysin (pneumolysin). AB - An enzyme-linked immunosorbent assay (ELISA) with a highly purified pneumolysin as the antigen was evaluated for serological diagnosis of pneumococcal pneumonia. One hundred four healthy controls were tested, and the specificity of the test was set to 95%. In samples from patients with bacteremic pneumococcal pneumonia, 82% (18 of 22) were positive, i.e., at least one serum sample had a titer above the upper normal limit or at least a twofold rise in antibody titers was noted. In nonbacteremic pneumococcal pneumonia, 45% (21 of 47) of samples were positive. All sera were negative for patients with pneumonia caused by Haemophilus influenzae, Legionella pneumophila, Chlamydia psittaci, and influenza A virus. However, in patients with a diagnosis of Mycoplasma pneumoniae infection, 8 of 25 (32%) samples were positive for antibodies to pneumolysin. All sera, including those from patients with mycoplasma infection, were negative to a protein control antigen by ELISA. Serum immunoglobulin G response to pneumolysin as measured by ELISA might thus be an aid in the laboratory diagnosis of pneumococcal pneumonia. This assay may also help to further elucidate the occurrence of dual infections with pneumococci. PMID- 3818920 TI - Detection of immunoglobulin G to Pasteurella haemolytica capsular polysaccharide by enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of immunoglobulin G (IgG) to the capsular polysaccharide (CP) of Pasteurella haemolytica serotype 1. Purified CP was first covalently coupled to poly-L-lysine and then optimally adsorbed at a concentration of 5 micrograms/ml to microtiter plates in the presence of carbonate-bicarbonate buffer (pH 9.8). The ELISA was used to evaluate and compare the CP-specific IgG response of calves vaccinated with different P. haemolytica-derived experimental vaccines. Elevated levels of ELISA IgG titers were detected in postvaccination sera and lung lavage from calves vaccinated intradermally with live logarithmic-phase organisms or the culture supernatants. The ELISA was found to be a rapid, reproducible, and sensitive technique for the detection of CP-specific antibodies and may be useful to delineate the protective role of these antibodies in bovine pneumonic pasteurellosis. PMID- 3818921 TI - Propionibacterium acnes osteomyelitis: case report and review of the literature. AB - Propionibacterium acnes, a part of the skin flora, caused vertebral osteomyelitis in a man who had recently undergone a microdiskectomy. The identifying characteristics and antibiotic susceptibility pattern are presented for this unusual human pathogen. The relationship of P. acnes to bone infection is summarized for the first time. A typical patient with P. acnes osteomyelitis is an adult male who has had prior surgery. Most patients respond favorably to prolonged antibiotic therapy. PMID- 3818922 TI - Effect of heat or chemical treatment on leptospiral antigens. AB - The use of bacterins is one of the primary methods in the control of leptospirosis in domestic animals, especially cattle, swine, and dogs. Bacterins have been made using chemically treated or heat-inactivated organisms. Many of the initial studies indicated that the bacterins gave complete protection, whereas later reports found that some inactivation methods resulted in bacterins that protect against death but not against kidney infection and renal shedding. This raised the possibility that some of the antigens had been altered. To investigate this possibility, we heat or chemically treated Leptospira interrogans serovar icterohaemorrhagiae CF-1, L. interrogans serovar canicola Moulton, L. interrogans serovar grippotyphosa SC4397, L. interrogans serovar hardjo Hardjoprajitno, and L. interrogans serovar pomona MLS. Temperatures used to determine alterations in antigens were 50, 56, 80, 100, and 121 degrees C. The chemicals used were formaldehyde, phenol, and thimerosal. Analysis was done using Laemmli gels and Western blots. We found that heating at 50 or 56 degrees C had the smallest effect on antigens, whereas heating at 80 or 100 degrees C caused the appearance of high-molecular-weight bands on Western blots. Heating at 121 degrees C caused almost all the bands to disappear, in both the stained gel and the Western blot. Both phenol and Formalin treatment altered proteins, whereas thimerosal treatment appeared to have little effect compared with heating at 50 degrees C. PMID- 3818923 TI - Utilization of nitrate or nitrite as single nitrogen source by Mycobacterium avium. AB - Twenty L-amino acids and several inorganic compounds were tested individually, as a sole nitrogen source, for ability to support the growth of Mycobacterium avium LM1 serovar 1. Of the amino acids tested, only L-glutamine provided nutritional support comparable to that of ammonium chloride at 1 mM. With either 1 mM potassium nitrate or nitrite substituted for ammonium chloride, similar numbers of CFU were produced. M. avium cells were grown in potassium nitrate or nitrite concentrations of 0.25, 0.5, 1.0, and 2.0 mM, and the medium was assayed for remaining nitrogen compound at several times during growth. Rates of utilization were of first-order kinetics, with nitrite removed more rapidly than nitrate. The rates were approximately 10 times as rapid at 0.25 mM than at 2 mM for either nitrogen source. Nine clinical isolates that included M. avium serovars 1, 4, and 8 and Mycobacterium scrofulaceum serovar 43 were tested for rate of utilization of ammonia, nitrate, or nitrite. Ammonia and nitrite were utilized with first order kinetics by all strains. Nitrate utilization occurred but was not at the same level for all strains. Clinical tests indicate that M. avium is negative for nitrate reductase; this is because of the rapid reduction of nitrite produced from nitrate. PMID- 3818924 TI - Enzyme-linked immunosorbent assay for detection of Salmonella typhi protein antigen. AB - A double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was designed for the detection of Salmonella typhi protein antigen. The optimal concentration of antibody for coating the plate was found to be 50 micrograms/ml. The optimum conditions for antibody coating and antigen and conjugate incubation were 37 degrees C for 3 h, 37 degrees C for 2 h, and 4 degrees C overnight, respectively. The enzyme-substrate reaction was allowed to take place at 30 degrees C for 1 h. The established ELISA was found to be reproducible, with an inter-run coefficient of variation of less than 12% for the detection of an S. typhi protein antigen concentration of 0.5 to 50 micrograms/ml. The minimal detectable level of the antigen was 0.5 micrograms/ml. Cross-reactions were observed with the high level (50 micrograms/ml) of protein antigens obtained from Salmonella typhimurium, Escherichia coli, Salmonella paratyphi A, and Salmonella enteritidis. The ELISA established was used for the detection of S. typhi protein antigen in serum from 62 patients with typhoid, 30 patients with clinically diagnosed typhoid fever, 21 patients with paratyphoid, 17 patients with pyrexia caused by other bacteria, and 160 normal, healthy individuals. It was found that the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this assay were 83.87, 89.04, 87.93, 67.53, and 95.31%, respectively. PMID- 3818926 TI - Comparison of BIOGRAM and commercial microdilution antimicrobial susceptibility test systems. AB - The BIOGRAM (Difco Laboratories, Detroit, Mich.) system, which is designed to calculate MICs from disk diffusion zone diameters, was compared with two commercial microdilution antimicrobial susceptibility systems. A total of 111 clinical isolates were evaluated with each test system. Six additional isolates were tested in a comparison between BIOGRAM and Sceptor (Johnston Laboratories, Inc. Towson, Md.) systems. BIOGRAM demonstrated an overall correlation with the Sceptor microdilution method of 95.7% for 1,287 organism-antimicrobial susceptibility combinations. The BIOGRAM and UniScept (Analytab Products, Inc., Plainview, N.Y.) systems were in agreement in 90.3% of 1,048 organism antimicrobial susceptibility combinations tested. All methicillin-resistant staphylococci were detected by the standard disk agar diffusion method used with the BIOGRAM system. The BIOGRAM system provides an acceptable alternative to these commercial systems for the determination of quantitative susceptibility. PMID- 3818925 TI - Bifidobacterium, Bacteroides, and Clostridium spp. in fecal samples from breast fed and bottle-fed infants with and without iron supplement. AB - Bifidobacterium, Bacteroides, and Clostridium spp. isolated from the feces of 23 neonates during the first 3 months of life were identified. Of the 23 neonates, 10 were breast fed, 6 received an infant formula with iron supplement (5 mg/liter), and 7 received the formula without iron supplement (iron concentration, less than 0.5 mg/liter). The Bifidobacterium spp. most frequently isolated from the three groups of infants were B. longum, B. breve, B. adolescentis, and B. bifidum. The bacteroides spp. most frequently isolated were B. fragilis and B. vulgatus. The most common Clostridium sp. in the three groups of infants was C. perfringens. The type of milk did not select for species of Bifidobacterium, Bacteroides, or Clostridium, except for Clostridium butyricum, which was isolated significantly more often from bottle-fed infants with iron supplement than from the other groups, and Clostridium tertium, which was more often isolated from breast-fed infants. The species of the three anaerobic genera did not persist for a long period of time in the three groups of infants. PMID- 3818928 TI - Pythium insidiosum sp. nov., the etiologic agent of pythiosis. AB - Pythium insidiosum sp. nov., the etiologic agent of pythiosis, a cosmopolitan disease of horses, cattle, and dogs, is described and illustrated. PMID- 3818927 TI - Detection and quantitation of toxic shock syndrome toxin 1 in vitro and in vivo by noncompetitive enzyme-linked immunosorbent assay. AB - Toxic shock syndrome toxin 1 (TSST-1), an exotoxin produced by many Staphylococcus aureus strains, is implicated as the prime causal agent of toxic shock syndrome (TSS). A sensitive and specific noncompetitive enzyme-linked immunosorbent assay (ELISA) capable of detecting TSST-1 at concentrations from 0.5 to 16 ng/ml was developed. This assay did not detect other staphylococcal enterotoxins including A, B, C1, C2, C3, D, and E. Possible interactions with protein A were readily eliminated by pretreatment of test samples with 10% normal rabbit serum. The assay was adapted for rapid screening of TSST-1 production by S. aureus isolates in culture supernatants in vitro and for detection of TSST-1 in vaginal washings of TSS patients and healthy controls in vivo. All 35 S. aureus isolates confirmed to be TSST positive by Ouchterlony immunodiffusion and 59 of 60 isolates confirmed to be TSST-1 negative gave concordant results by ELISA. Interestingly, toxigenic S. aureus strains isolated from TSS patients quantitatively produced significantly more TSST-1 in vitro compared with toxigenic control strains (P less than 0.05, Mann-Whitney rank sum test). TSST-1 could be detected by ELISA in three of four vaginal washings collected within 3 days of hospitalization from three women with acute menstrual TSS, compared with 0 of 17 washings from nine TSS patients hospitalized longer than 3 days (P = 0.003, Fisher's exact test) and 1 of 15 washings from 14 healthy control women (P = 0.016). This noncompetitive ELISA should be particularly useful for rapid screening of TSST-1 production by S. aureus isolates, for the purification and biochemical characterization of TSST-1, and for human and animal studies of the pathogenesis of TSS. PMID- 3818929 TI - Qualitative and quantitative determination of enterobacterial common antigen (ECA) with monoclonal antibodies: expression of ECA by two Actinobacillus species. AB - The presence and quantity of the enterobacterial common antigen (ECA) in several species belonging to the family Enterobacteriaceae as well as to other gram negative families were determined by a solid-phase enzyme-linked immunosorbent assay system and Western blotting by using mouse monoclonal antibodies specific for ECA. Except for Erwinia chrysanthemi, previously known to be an exception, all species known or presumed to belong to Enterobacteriaceae produced ECA (89 of 90 species). Most species not belonging to Enterobacteriaceae did not produce ECA (25 of 28 species), with one already known (Plesiomonas shigelloides) and two hitherto unknown (Actinobacillus equuli and Actinobacillus suis) exceptions. Interestingly, all strains of P. shigelloides produced ECA, regardless of the presence of the Shigella sonnei cross-reacting O antigen. Quantitation of the amount of ECA in members of the family Enterobacteriaceae revealed a remarkable heterogeneity among genera and species as well as within one species. We conclude that the rapid, sensitive, and reliable determination of ECA is a useful aid in taxonomic classification and may help to characterize the relatedness of the family Enterobacteriaceae to other families. However, a quantitative analysis of ECA appears to be without value for these purposes. PMID- 3818930 TI - Hemo-De as substitute for ethyl acetate in formalin-ethyl acetate concentration technique. AB - In comparative studies, Hemo-De (PMP Medical Industries, Inc., Irving, Tex.) was found to be a suitable replacement for ethyl acetate in the Formalin-ethyl acetate concentration technique. With essentially equivalent recovery rates for both procedures, the Formalin-Hemo-De concentration technique is considered to be the preferred technique because Hemo-De is less toxic and less flammable and does not present disposal problems, and its cost is approximately one-fourth that of ethyl acetate. PMID- 3818932 TI - Comparative evaluation of commercial enzyme immunoassay kits for detection of hepatitis B seromarkers. AB - The commercial hepatitis B enzyme immunoassay kits of Abbott Laboratories and Organon Teknika were compared for their sensitivity, specificity, and reproducibility in detecting the hepatitis B seromarkers hepatitis B surface and e antigens and antibodies to hepatitis B core, e, and surface antigens. With the exception of the Organon kit for antibodies to hepatitis B surface antigen, the specificity and reproducibility were about the same for both products, but the level of sensitivity was generally lower for the Organon kits; this, however, may not be critical in routine clinical application. The Organon kits have a longer shelf life and are cheaper. PMID- 3818931 TI - ATP measurements obtained by luminometry provide rapid estimation of Ureaplasma urealyticum growth. AB - ATP content obtained by luciferin-luciferase luminometry with commercially available reagents provided rapid estimates of Ureaplasma urealyticum populations. Each cell contained about 4.7 X 10(-18) mol of ATP. We could detect 10(4) CCU50 (color change unit50) per 100 microliters. We correlated urease activity with growth and confirmed the differential response of ureaplasma strains to Mn2+. PMID- 3818933 TI - DNase production by Clostridium septicum. AB - Sixty-two Clostridium septicum isolates were assayed for extracellular DNase activity. All of the C. septicum isolates tested produced greater DNase activity than did the other DNase-producing clostridial isolates tested. The molecular weight of the DNase of C. septicum was determined to be approximately 45,000. DNase is a major extracellular protein produced by this organism. PMID- 3818934 TI - Rapid catalase supplemental test for identification of members of the family Enterobacteriaceae. AB - A simple, rapid, semiquantitative slide catalase test useful for differentiating members of the family Enterobacteriaceae is described. Judging by the time required for appearance of oxygen bubbles in 3% hydrogen peroxide, the immediate catalase reactors were Yersinia, Serratia, Proteus, Morganella, Providencia, Cedecea, and Hafnia spp. The delayed catalase reactors were Escherichia, Shigella, Klebsiella, Enterobacter, Salmonella, Citrobacter, Edwardsiella, Kluyvera, and Tatumella spp. This information is especially useful for differentiating Serratia from Enterobacter spp. and Yersinia from Escherichia and Shigella spp. PMID- 3818937 TI - Presence of hepatitis B virus DNA in serum of surface-antigen-seronegative immunocompromised patients. AB - We compared the prevalence of serum hepatitis B virus (HBV) DNA in cancer patients who were immunocompromised with that in healthy subjects. Testing positive for serum HBV DNA were 27 of the 232 (11.6%) surface-antigen-negative cancer patients and 7 of the 382 (1.8%) surface-antigen-negative healthy subjects. These data suggest that the negative serology, at least in immunocompromised individuals, is probably not sufficient to exclude HBV infection. PMID- 3818935 TI - Spontaneous bacterial peritonitis caused by Pasteurella ureae. AB - Pasteurella ureae is uncommonly isolated from patients and rarely causes disease. The case of a patient with spontaneous bacterial peritonitis caused by P. ureae is described and contrasted with other reported cases of P. ureae colonization and infection. Respiratory colonization has been described in older patients, predominantly men, with underlying lung disease consisting principally of bronchitis, bronchiectasis, and tumors. Only 11 patients (including the present patient) have been reported to have illness with P. ureae. Seven had meningitis, two had pneumonia, and one had hepatitis. Skull fracture, alcoholism, and liver disease are common antecedents of P. ureae infection. PMID- 3818936 TI - Detection of metabolites by frequency-pulsed electron capture gas-liquid chromatography in serum and cerebrospinal fluid of a patient with Nocardia infection. AB - Serum (SR) and cerebrospinal fluid (CSF) from a patient suspected of having tuberculous meningitis were submitted to our laboratory for analysis by frequency pulsed electron capture gas-liquid chromatography (FPEC GLC). The samples were tested for the presence of carboxylic acids, alcohols, hydroxy acids, and amines by methods described previously (C. C. Alley, J. B. Brooks, and D. S. Kellogg, Jr., J. Clin. Microbiol. 9:97-102, 1977; J. B. Brooks, C. C. Alley, and J. A. Liddle, Anal. Chem. 46:1930-1934, 1974; J. B. Brooks, D. S. Kellogg, Jr., M. E. Shepherd, and C. C. Alley, J. Clin. Microbiol. 11:45-51, 1980; J. B. Brooks, D. S. Kellogg, Jr., M. E. Shepherd, and C. C. Alley, J. Clin. Microbiol. 11:52-58, 1980). The results were different from previous FPEC GLC profiles of SR and CSF from patients with known tuberculous meningitis. Both the SR and CSF contained several unidentified compounds that were not previously detected in tuberculous meningitis or any of our other studies of body fluids. Nocardia brasiliensis was later isolated from the patient. Detection of these metabolites by FPEC GLC could prove to be useful for rapid diagnosis of Nocardia disease, and their identification will provide a better understanding of metabolites produced by Nocardia sp. in vivo. PMID- 3818938 TI - Pathogenicity of Yersinia enterocolitica serotype O3 biotype 3 strains. AB - It is known that Yersinia enterocolitica infection in Japan is caused mainly by serotype O3 biotype 4 strains. Recently, however, a number of serotype O3 strains which were classified biotype 3 and which ferment lactose and xylose, instead of sorbose, and give a negative Voges-Proskauer reaction have been isolated from both humans and animals. In this study, comparisons of four properties were made among isolates of Y. enterocolitica serotype O3 biotype 3 from humans, pigs, dogs, cats, and rats and the laboratory stock strains of Y. enterocolitica biotype 4. All strains were tested for the presence of plasmids, calcium dependent growth at 37 degrees C, autoagglutination activity at 37 degrees C, and recovery of the organisms from the stools of intravenously challenged mice. Biotypes 3 and 4 were positive for these four properties. Plasmid digestion with restriction endonucleases showed the same digestion patterns in both biotypes. These results suggest that Y. enterocolitica serotype O3 biotype 3 strains are pathogenic, as are biotype 4 strains. PMID- 3818939 TI - Ability of ciprofloxacin but not pipemidic acid to differentiate all three biovariants of Mycobacterium fortuitum from Mycobacterium chelonae. AB - When tested against 312 clinical isolates of rapidly growing mycobacteria, the quinolone pipemidic acid correctly separated Mycobacterium chelonae (M. chelonei) from Mycobacterium fortuitum biovar fortuitum but not from biovar peregrinum or the third biovar complex. The new 4-quinolone ciprofloxacin correctly separated all three biovars of M. fortuitum from M. chelonae and appears to provide a better taxonomic test. PMID- 3818940 TI - Pseudomonas stutzeri pneumonia and septicemia in a patient with multiple myeloma. AB - A case of septicemia caused by Pseudomonas stutzeri belonging to the unusual biotype Vb-3 in a patient with multiple myeloma is described. The origin of the septicemia was attributed to a community-acquired pneumonia. The bacteriology and pathogenicity of P. stutzeri are reviewed. PMID- 3818941 TI - Administration of monthly-pulse cyclophosphamide in multiple sclerosis patients. Effects of long-term treatment on immunologic parameters. AB - Eleven patients with chronic progressive multiple sclerosis received monthly pulses of cyclophosphamide (CY) for approximately one year. During the final 9 months the monthly dose ranged between 1000 mg/m2 and 2000 mg/m2. This resulted in a marked (47% or greater) reduction in CD4 (T helper/inducer) cells a less striking (22%) decrease in CD8 (T suppressor/cytotoxic) cells and a decline in the CD4/CD8 ratio. The magnitude of the decrease in CD4 cells correlated with the total dose received (r = 0.88, P less than 0.05). B cells were reduced 50% and FcR+ lymphocytes were reduced 48% without comparable reduction in natural killer cells or antibody-dependent cellular cytotoxicity. Proliferative responses to PHA were suppressed. Two patients improved, seven stabilized and two continued to worsen. Monthly pulses of CY can achieve substantial and differential reduction in immune parameters and appear to slow the disease progression in some MS patients. PMID- 3818942 TI - Antibody to sialosyllactosaminylparagloboside in a patient with IgM paraproteinemia and polyradiculoneuropathy. AB - Serum from a patient with IgM paraproteinemia and polyradiculoneuropathy, diagnosed as malignant lymphoma, reacted specifically with a ganglioside, sialosyllactosaminylparagloboside (SLPG), in human peripheral nerve but not with myelin-associated glycoprotein (MAG). This finding demonstrates the existence of anti-SLPG antibody in the patient's serum, suggesting that this antibody may play a role in the pathogenesis of neuropathy. PMID- 3818943 TI - Increased binding of anti-acetylcholine receptor antibodies to thymic antigen in patients with myasthenia gravis and other autoimmune diseases, as compared to those with myasthenia gravis alone. AB - We compared the binding activity against acetylcholine receptors solubilized from human muscle (AChRM) and human thymus (AChRT), of sera from patients with myasthenia gravis (MG) alone, to those of sera from patients with myasthenia gravis and associated autoimmune diseases (MG AD). The sera of the MG AD group bound relatively better to thymic antigen (86% vs. 62%). This group was found to contain a higher proportion of women over 40 years of age (more than 50% of the group). The expression of a particular AChR antigen in normal human thymus may be one of the factors involved in the pathogenesis of MG, especially when this disease is associated with other autoimmune disorders. PMID- 3818944 TI - Ammonia transport by early and late proximal convoluted tubule of the rat. AB - Free-flow micropuncture experiments were performed to examine ammonia transport separately in early and late proximal convoluted tubule (PCT) of the rat. In control rats, ammonia was secreted along the early PCT but was reabsorbed along the late PCT. In rats with chronic metabolic acidosis, ammonia secretion along the early PCT was increased compared with controls, and ammonia absorption by the late PCT was converted to small net ammonia secretion. In the acidotic rats, ammonia secretion rate in the early PCT was six times higher than that in the late PCT. Thus, most or all of ammonia secretion by the PCT occurred along its early portion. In control and acidotic rats, luminal NH3 concentration in the early PCT was significantly higher than that in the late PCT, indicating that ammonia is not in diffusion equilibrium throughout the renal cortex. It is proposed that differences in ammonia transport rate in early vs. late PCT may be due to differences in ammonia production rate and/or to differences in the rate of an ammonia backflux that detracts from net ammonia secretion. PMID- 3818945 TI - Effect of methotrexate on intracellular folate pools in purified myeloid precursor cells from normal human bone marrow. AB - We investigated the effects of the antifolate methotrexate on intracellular folate pools of human myeloid precursor cells (MPCs). Immature MPCs, representing 3.2% of the original marrow population, were selected from normal human bone marrow by immune rosetting. The intracellular folate pools were labeled by incubation with 5 X 10(-8) M [3H]5-formyl-FH4 and were quantitated by high performance liquid chromatography. The predominant folates were 5-methyl tetrahydrofolate (5-methyl-FH4) (36%), 10-formyl-FH4 (41.4%), 5-formyl-FH4 (12.3%), and FH4 (10.3%). A 12-h exposure to 1 microM methotrexate (MTX) resulted in a 34% reduction in the intracellular concentration of 10-formyl-FH4, a 61% decrease in 5-formyl-FH4, and a 62% decrease in 5-methyl-FH4, as well as the appearance and progressive expansion of the FH2 and 10-formyl-FH2 pools. These changes were maximal after 4 h of incubation with MTX. Paralleling the changes in folates, particularly the increase in FH2, were a 64% reduction in myeloid colony formation and a 77% depression of de novo purine synthesis after 4 h of MTX. We conclude that MTX does not produce quantitative depletion of 10-formyl-FH4 and that its antipurine effect may be mediated by direct inhibition of de novo purine synthesis by FH2 and, at later time points, by MTX polyglutamates. PMID- 3818946 TI - Molecular basis for the deficiency of complement 1 inhibitor in type I hereditary angioneurotic edema. AB - Hereditary angioneurotic edema (HANE) results from deficiency of complement 1 inhibitor (C1 INH). In type I HANE, C1 INH is present in serum at levels 5-30% of normals. Using cultured monocytes and biosynthetic labeling of proteins, C1 INH was detected in supernatants of cells from HANE patients at levels 20% of those detected in normals. The intracellular reduction of C1 INH in patients' monocytes approached 50%. The study of C1 INH messenger RNA (mRNA) by Northern blot analysis indicated that in HANE patients' monocytes a message of normal size is present at about half the concentration of that from normal cells. One of the patients analyzed showed the presence of a genetically inherited abnormal mRNA (1.9 kb) in addition to the normal mRNA (2.1 kb). Southern blot analysis of DNA from peripheral blood leukocytes did not show any difference in quantity or in sizes of endonuclease restriction fragments between patients and normals. The defect(s), therefore, in type I HANE is pretranslational, but is not due to a deletion or to a major chromosomal rearrangement. PMID- 3818948 TI - Actions of estradiol on discrete attributes of the luteinizing hormone pulse signal in man. Studies in postmenopausal women treated with pure estradiol. AB - We assessed the time-dependent impact of estradiol on properties of the luteinizing hormone (LH) pulse signal in 12 hypoestrogenemic postmenopausal volunteers studied basally and after 1, 5, 10, and 30 d of estradiol delivery via an intravaginal Silastic ring. Computerized analysis of the plasma LH time series revealed a significant decrease in LH pulse frequency within 24 h of estrogen treatment, followed by a secondary increase (days 5 and 10), and then a sustained decline (day 30) in LH pulsatility. Estradiol also significantly suppressed incremental and maximal (but not fractional) LH pulse amplitudes in a biphasic manner. In contrast, LH peak duration was invariant until day 30 of estradiol replacement. These observations indicate that the well recognized biphasic actions of estradiol on mean serum LH concentrations can be modeled in relation to specific and time-dependent alterations in LH pulse frequency and amplitude. PMID- 3818947 TI - Calcitriol, parathyroid hormone, and accumulation of aluminum in bone in dogs with renal failure. AB - Accumulation of aluminum in bone is a frequent finding in patients requiring chronic dialysis and is associated with considerable morbidity and/or mortality. Until now, evidence seemed to point to relatively low circulating levels of parathyroid hormone as a contributing factor, but because levels of parathyroid hormone and calcitriol are interrelated, calcitriol might be also involved. In this study we employed an animal model to evaluate the single and combined effects of parathyroid hormone and calcitriol on bone aluminum accumulation. The results show significantly less aluminum accumulation in calcitriol-replete dogs independent of the presence or absence of parathyroid hormone. These results indicate that low levels of calcitriol may play a role in the development of aluminum related bone disease. Further studies are needed to demonstrate whether administration of calcitriol in patients with renal insufficiency will prevent development of aluminum-related bone disease. PMID- 3818949 TI - Monomeric (7S) IgM found in the serum of rheumatoid arthritis patients share idiotypes with pentameric (19S) monoclonal rheumatoid factors. AB - Serum from some seropositive (RF+) rheumatoid arthritis (RA) patients contains relatively high concentrations of monomeric (7S) IgM molecules. Seven S IgM molecules fail to bind the Fc portion of IgG, unlike 19S IgM RFs that bind aggregated IgG in classical RF assays. Some pentameric IgM RFs are marked by crossreactive idiotypes (RCRI) defined by prototypic monoclonal RFs. In previous studies, we observed that a proportion of pokeweed mitogen (PWM) induced plasma cells from RA patients' blood lymphocytes express the major RCRI as assayed by indirect immunofluorescence with polyclonal anti-RCRI antibodies. In this study, 7S IgM obtained from three different RF+ RA patients inhibits specific anti-RCRI intracytoplasmic staining of PWM induced RF+ RA-derived plasma cells. These 7S molecules also block polyclonal anti-RCRI antibodies from reacting with red blood cells bearing 7S IgM molecules from RF+ patients with RA or Waldenstrom's macroglobulinemia. We conclude that some 7S IgM molecules in the serum of RF+ RA patients are marked by the major RCRI idiotype and are related to 19S monoclonal and polyclonal RFs. PMID- 3818950 TI - Characterization and isolation of thyroid microsomal antigen. AB - We investigated the structure of the 107-kD thyroid protein recognized as microsomal antigen. Solubilized microsomes were incubated with affinity gels consisting of IgG, from thyroiditis patients or controls, linked to Reacti-gel. Eluates were analyzed by SDS polyacrylamide electrophoresis and Western blot. 107 and 101-kD proteins were augmented in eluates from gels containing patient IgG and had microsomal antigenicity. In a Western blot of microsomes run under unreduced conditions, poorly defined large proteins were identified by antibody. When eluted electrophoretically and reanalyzed in reducing conditions, they demonstrated the 107-kD antigen. The 107-kD protein identified in reducing conditions was extracted and reanalyzed under nonreducing conditions. Large molecular mass proteins were then observed. On two-dimensional electrophoresis, a 107-kD antigen was isolated with isoelectric point of 7.0. The microsomal antigen may be complexes or multimers of a 107-kD peptide with isoelectric point of 7.0. PMID- 3818951 TI - Hereditary xanthinuria. Evidence for enhanced hypoxanthine salvage. AB - We tested the hypothesis that there is an enhanced rate of hypoxanthine salvage in two siblings with hereditary xanthinuria. We radiolabeled the adenine nucleotide pool with [8-14C]adenine and examined purine nucleotide degradation after intravenous fructose. The cumulative excretion of radioactivity during a 5 d period was 9.7% and 9.1% of infused radioactivity in the enzyme-deficient patients and 6.0 +/- 0.7% (mean +/- SE) in four normal subjects. Fructose infusion increased urinary radioactivity to 7.96 and 9.16 X 10(6) cpm/g creatinine in both patients and to 4.73 +/- 0.69 X 10(6) cpm/g creatinine in controls. The infusion of fructose increased total urinary purine excretion to a mean of 487% from low-normal baseline values in the patients and to 398 +/- 86% in control subjects. In the enzyme-deficient patients, the infusion of fructose elicited an increase of plasma guanosine from undetectable values to 0.7 and 0.9 microM. With adjustments made for intestinal purine loss, these data support the hypothesis that there is enhanced hypoxanthine salvage in hereditary xanthinuria. Degradation of guanine nucleotides to xanthine bypasses the hypoxanthine salvage pathway and may explain the predominance of this urinary purine compound in xanthinuria. PMID- 3818952 TI - Thrombospondin binds to monocytes-macrophages and mediates platelet-monocyte adhesion. AB - Thrombospondin (TSP) is a multifunctional platelet glycoprotein synthesized by a variety of cells in culture including monocytes and macrophages. We now report that 125I-TSP binds specifically, saturably, and reversibly to mouse peritoneal macrophages and to cells of the monocyte-like human cell line U937 with dissociation constants of 6.7-14.5 X 10(-8) M and 3-4 X 10(5) binding sites per cell. TSP mediates an adhesive interaction between thrombin-stimulated platelets and both U937 cells and human blood monocytes. Using a sensitive rosetting assay, we found that monocytes were not rosetted by resting platelets whereas greater than 90% were rosetted by thrombin-stimulated platelets. Monoclonal and polyclonal anti-TSP antibodies markedly inhibited rosetting as did TSP itself. Neither control antibodies nor heparin, fibronectin, fibrinogen, nor the fibronectin adhesion tetrapeptide Arg-Gly-Asp-Ser inhibited rosetting. TSP may thus serve as a molecular bridge linking activated platelets with monocytes at sites of early vascular injury. Such interaction may be of critical importance in the regulation of thrombosis and the initiation of atherosclerosis. PMID- 3818953 TI - Safety, infectivity, immunogenicity, and in vivo stability of two attenuated auxotrophic mutant strains of Salmonella typhi, 541Ty and 543Ty, as live oral vaccines in humans. AB - Two Salmonella typhi mutants, 541Ty (Vi+) and 543Ty (Vi-), auxotrophic for p aminobenzoate and adenine, were evaluated as live oral vaccines. 33 volunteers ingested single doses of 10(8), 10(9), or 10(10) vaccine organisms, while four others received two 2 X 10(9) organism doses 4 d apart. No adverse reactions were observed. Vaccine was recovered from coprocultures of 29 of 37 vaccinees (78%) and from duodenal string cultures of two; repeated blood cultures were negative. The humoral antibody response to S. typhi O, H, Vi, and lysate antigens in serum and intestinal fluid was meager. In contrast, all vaccinees manifested cell mediated immune responses. After vaccination, 69% of vaccinees overall and 89% of recipients of doses greater than or equal to 10(9) responded to S. typhi particulate or purified O polysaccharide antigens in lymphocyte replication studies but not to antigens of other Salmonella or Escherichia coli. All individuals, postvaccination, demonstrated a significant plasma-dependent mononuclear cell inhibition of wild S. typhi. PMID- 3818954 TI - Binding of quinine- and quinidine-dependent drug antibodies to platelets is mediated by the Fab domain of the immunoglobulin G and is not Fc dependent. AB - The antibody domain controlling reactions between platelet membranes and drug dependent (dd) antibodies from patients with thrombocytopenia induced by cinchona alkaloids was studied using F(ab')2, Fab, and Fc fragments made from purified dd IgG. By direct binding radioimmunoassay (RIA) measurements, 20,000 to 50,000 antibody molecules bound per platelet equivalent of purified platelet membranes at apparent saturation with three different antibodies. F(ab')2 and Fab fragments bound to platelet membranes drug dependently but Fc fragments did not. The ability of dd-IgG fragments to compete with intact IgG was quantitatively measured by RIA and by complement fixation. F(ab')2 and Fab competed with intact IgG at an 8:1 and greater than 50:1 molar ratio, respectively, in RIA, and at a 1.6-3:1 and 44-75:1 ratio, respectively, by complement fixation assays. Fc did not compete with IgG in either assay. We conclude that the Fab domain supports attachment of dd antibody to the platelet surface. PMID- 3818956 TI - Pathophysiology and pathogenesis of stunned myocardium. Depressed Ca2+ activation of contraction as a consequence of reperfusion-induced cellular calcium overload in ferret hearts. AB - Contractile dysfunction in stunned myocardium could result from a decrease in the intracellular free [Ca2+] transient during each beat, a decrease in maximal Ca2+ activated force, or a shift in myofilament Ca2+ sensitivity. We measured developed pressure (DP) at several [Ca]0 (0.5-7.5 mM) in isovolumic Langendorff perfused ferret hearts at 37 degrees C after 15 min of global ischemia (stunned group, n = 13) or in a nonischemic control group (n = 6). At all [Ca]0, DP was depressed in the stunned group (P less than 0.001). Maximal Ca2+-activated pressure (MCAP), measured from tetani after exposure to ryanodine, was decreased after stunning (P less than 0.05). Normalization of the DP-[Ca]0 relationship by corresponding MCAP (Ca0 sensitivity) revealed a shift to higher [Ca]0 in stunned hearts. To test whether cellular Ca overload initiates stunning, we reperfused with low-[Ca]0 solution (0.1-0.5 mM; n = 8). DP and MCAP in the low-[Ca]0 group were comparable to control (P greater than 0.05), and higher than in the stunned group (P less than 0.05). Myocardial [ATP] observed by phosphorus NMR failed to correlate with functional recovery. In conclusion, contractile dysfunction in stunned myocardium is due to a decline in maximal force, and a shift in Ca0 sensitivity (which may reflect either decreased myofilament Ca2+ sensitivity or a decrease in the [Ca2+] transient). Our results also indicate that calcium entry upon reperfusion plays a major role in the pathogenesis of myocardial stunning. PMID- 3818955 TI - Modulation of erythrocyte membrane mechanical stability by 2,3-diphosphoglycerate in the neonatal poikilocytosis/elliptocytosis syndrome. AB - To explain the transient anemia and poikilocytosis seen during infancy in hereditary elliptocytosis (HE), we resealed erythrocyte (RBC) ghosts from affected children or their elliptocytic parents with 2,3-diphosphoglycerate (DPG) (0-8 mM), a compound that dissociates membrane skeletons, then measured ghost mechanical stability in the ektacytometer. Without added 2,3-DPG, ghost mechanical stability was subnormal in infantile poikilocytosis (IP) and HE but was even more abnormal in hereditary pyropoikilocytosis (HPP). Addition of 2,3 DPG (2.55 mM) to IP or HE ghosts, decreased their stability to that of HPP ghosts (without 2,3-DPG). Nonphysiological 2,3-DPG levels (6-8 mM) were required to elicit a similar effect in normal ghosts. The data suggest that free 2,3-DPG, present in neonatal RBC as a consequence of diminished binding to HbF, may render HE susceptible to in vivo fragmentation. The developmental switch from fetal to adult hemoglobin, by diminishing available free 2,3-DPG, may explain the abatement of poikilocytosis and hemolytic anemia that accompanies maturation. PMID- 3818957 TI - A variant of Glanzmann's thrombasthenia with abnormal glycoprotein IIb-IIIa complexes in the platelet membrane. AB - Patient C.M. presented platelet function defects symptomatic of Glanzmann's thrombasthenia. However, analysis of surface-labeled platelets by SDS polyacrylamide gel electrophoresis revealed the usual presence of the major glycoproteins, including GP IIb and GP IIIa. Platelet fibrinogen was not detected. Analysis of Triton X-100 extracts of Ca2+-washed C.M. platelets by crossed immunoelectrophoresis (CIE) showed normal amounts of GP IIb-IIIa complexes. However, when samples were electrophoresed through an agarose gel containing 125I-fibrinogen, the usual binding of fibrinogen to GP IIb-IIIa did not occur. Furthermore, the GP IIb-IIIa complexes showed an increased sensitivity to dissociation with EDTA, either after Triton X-100 solubilization or in the intact platelet membrane. For example, after incubation with EDTA at room temperature, the patient's platelets bound little of the monoclonal antibodies AP 2 or T10 (anti-GP IIb-IIIa complex) although normally binding Tab (anti-GP IIb). Patient C.M. appears to represent a subgroup of thrombasthenia where platelets contain unstable GP IIb-IIIa complexes unable to support fibrinogen binding. PMID- 3818959 TI - A later look at borderline and mildly retarded preschoolers. AB - A group of 38 preschool children, first evaluated when 2 to 4 years old, functioning within the borderline or mildly retarded ranges of intelligence, were reevaluated at the ages of 6 or 7 years. It was found that cognitive and linguistic limitations remained fairly stable over time. The most global of the early measures best predicted subsequent attainment, both for children with language skills significantly below performance and for those with more even function. Preschool language deficiencies reflected in a significant discrepancy between verbal and performance abilities in early intelligence testing were not subsequently associated with greater academic difficulties. At the time of reevaluation, receptive understanding of language exceeded expressive competence, and semantic skills were stronger than syntactic abilities. PMID- 3818958 TI - Unique alpha-spectrin mutant in a kindred with common hereditary elliptocytosis. AB - We report here a unique variant of alpha spectrin in a kindred with hereditary elliptocytosis. This novel red blood cell-membrane protein migrated to a position between the normal alpha- and beta-spectrin subunits in SDS polyacrylamide gel electrophoresis. It was identified as an alpha spectrin by its binding to anti alpha spectrin antibodies, by the absence of a phosphorylation site, and by the normal 1:1 stoichiometry between total alpha- and beta-spectrin molecules. The quantity of the alpha-spectrin mutant, expressed as a percentage of the total alpha spectrin, varied from 9.9-45.2% among six affected individuals. Two dimensional electrophoretic analysis of spectrin tryptic digests was qualitatively normal but showed a decreased quantity of a normal alpha IV fragment. The variable quantity of alpha-spectrin mutant among family members correlated directly with the increased percentage of spectrin dimers in cold low ionic strength spectrin extracts (r = 0.92) and inversely with red blood cell ghost mechanical stability (r = -0.98). The data suggest that this new alpha spectrin mutant is responsible for decreased spectrin dimer-dimer association and for red cell instability in affected individuals. PMID- 3818960 TI - Behavior as a diagnostic aid in failure-to-thrive. AB - The presence of a defined set of behaviors was examined in 67 hospitalized infants, 3-24 months old; 17 with organic failure-to-thrive (OFTT), 17 with nonorganic failure-to-thrive (NOFTT), and 33 with no signs of failure-to-thrive. The usefulness of assessing these behaviors to distinguish nonorganic from organic failure-to-thrive infants was evaluated. The frequency of behaviors per infant as well as the intensity of behaviors was greater for NOFTT. The order of decreasing frequency of behaviors was similar in both OFTT and NOFTT infants. Four of the 7 most prevalent behaviors occurred significantly more frequently in NOFTT than OFTT infants. The presence of these behaviors does not rule in NOFTT or rule out OFTT. However, when a number of the behaviors are present, particularly if they occur in high intensity, and when no organic disease is found, a diagnosis of NOFTT is suggested. Response to appropriate treatment remains the most reliable confirmation of the diagnosis. PMID- 3818962 TI - Early language development in infants with cortical and subcortical perinatal brain injury. AB - To understand better the cognitive sequelae of mild perinatal brain injury, we studied three groups of high-risk infants, using the Early Language Milestone Scale (ELM Scale). Premature infants with Grades I and II intraventricular hemorrhages (IVH) were delayed on the expressive but not the receptive subscale of the ELM Scale. Mildly asphyxiated full-term infants were slightly delayed on both the expressive and receptive subscales. Premature infants without IVH performed the same as the normal sample on which the scale was based. Although normal intellectual functioning has been reported in infants with Grade I-II IVH, this study demonstrates early specific deficits in expressive language in these children. These results are discussed in relation to localization of language in the adult brain, and the influence of subcortical structures on development and maturation of the cortex. PMID- 3818961 TI - Long-term hospitalization of nonorganic failure-to-thrive infants: patient characteristics and hospital course. AB - Hospitalization remains an available treatment option for nonorganic failure-to thrive (NOFT) infants, even though it separates an infant from his/her caregiver and may further weaken an already impaired caregiver-infant attachment. Long-term hospitalization as an intervention for NOFT has been noted, but not documented, in previous reports in the literature. The present study describes patient characteristics, growth in hospital, and length of stay among a group of NOFT infants referred for and treated through long-term hospitalization. The study also investigated the effects of an additional family-oriented outpatient intervention program on hospital course and discharge planning for these infants. Results of the study found that NOFT infants referred for extended hospitalization were an impoverished group, with the majority showing below average development functioning. One-third presented with "interactional" failure to-thrive, in which biological vulnerability coexisted with, but was not causative of, the infant's poor growth. Infants averaged 18 weeks in hospital, but lengths of stay differed, dependent on the presence of an outpatient treatment group and additional medical problems with both factors reliably associated with shorter lengths of stay. Infants in county welfare custody who did not receive additional outpatient intervention were also more likely to be placed outside the parental home at discharge. PMID- 3818964 TI - Failure-to-thrive: transitional perspective. PMID- 3818963 TI - Child and family attributes of failure-to-thrive. AB - Forty-one Boston children hospitalized with non-organic failure-to-thrive (FTT) were matched with 41 control subjects on age, socioeconomic status (SES), sex, and race. A precoded maternal interview was used to evaluate family stress, isolation, infant health, and the temperament and social maturity of the child. A regression analysis was performed with 27 variables thought to be potentially associated with the FTT diagnosis. Ten variables explained 81% of the between group variance on F-tests. The most significant distinctions were poor child health (p less than 0.001), high reactivity to visual and auditory stimuli (p less than 0.001), and disordered feeding interaction (p less than 0.005). Other case-comparison differences included social isolation, few maternal opportunities to escape caregiving, the presence of a male adult in the family, fewer available extended family, fewer violent disagreements between parents, greater number of maternal unmarried years. Children with FTT appeared to have developmental idiosyncrasies. These conspire with social and familial factors to yield the current profile of non-organic FTT. This study questions whether such findings are the cause of FTT or are better understood as a result. PMID- 3818965 TI - Implications of recent advances in neonatal and infant behavioral assessment. PMID- 3818967 TI - Chemical stabilities of lignocaine hydrochloride and phenylephrine hydrochloride in aqueous solution. AB - The chemical stabilities of lignocaine hydrochloride (lidocaine hydrochloride) and phenylephrine hydrochloride in a combination aqueous solution have been determined using stability-indicating high-performance liquid chromatographic methods. The drugs did not interact and were stable for at least 66 days at room temperature. The pH value changed from 6.0 to 5.8 after 66 days but was still within the optimum pH range for the stabilities of lignocaine and phenylephrine. PMID- 3818966 TI - A comparison of graphical nomogram methods with a computerized Bayesian analysis method in the interpretation of serum phenytoin concentrations. AB - A study was performed to compare the predictability of a reported Bayesian graphical method, the drug nomogram used in the Bayesian Computer Method and the Driessen Nomogram with that of a computerized Bayesian analysis method in the interpretation of serum phenytoin concentrations. It was found that the results generated by the graphical method were similar to those of the computer with a mean prediction error of 3.9 mg/day in the dose to achieve a concentration at steady-state of 20 ml/l. Overall the results of the graphical method were less biased and had more precision with a significant improvement in relative precision (P less than 0.01) than the initial estimate or Driessen methods. PMID- 3818968 TI - Clinical value of ELISA assays for IgM and IgG rheumatoid factors. AB - The clinical value of enzyme linked immunosorbent assays (ELISA) assays for IgM and IgG rheumatoid factors was assessed in a series of studies using rabbit IgG as antigen. The tests were reproducible with intra-assay coefficients of variation of 6% and could be simply and rapidly performed. Normal ranges were established using 106 sera from healthy controls. In a cross sectional study of 208 rheumatoid patients these assays were compared with the Rose-Waaler and laser nephelometric assessments of rheumatoid factor. In some patients there were discrepancies between rheumatoid factor positivity determined by one method or another. IgM ELISA and Rose-Waaler titres showed a significant correlation (r = +0.58; p less than 0.001), but there was a low correlation between IgM and IgG ELISA (r = +0.27; p less than 0.001). There was no evidence to show that the measurement of IgM or IgG rheumatoid factor gave significantly more clinical information than traditional tests such as the Rose-Waaler or latex agglutination tests. PMID- 3818969 TI - Hyperferritinaemia associated with splenic infarction. PMID- 3818970 TI - Pseudoleucocytosis and pseudothrombocytosis due to cryoglobulinaemia. PMID- 3818971 TI - Histopathogenesis of intestinal metaplasia: minute lesions of intestinal metaplasia in ulcerated stomachs. AB - Minute lesions of intestinal metaplasia composed of a few metaplastic tubules were observed in the gastric mucosa during routine histological examination of gastrectomy specimens. The histological findings indicated that these lesions might be an initial stage of more advanced intestinal metaplasia. Accordingly, more than 18,000 serial sections in 10 stomachs with chronic ulcers were examined to clarify the histopathogenesis of the intestinal metaplasia. It was concluded from the three dimensional reconstruction of minute intestinal metaplasia lesions that these lesions originated during the regenerative process of healing of gastric erosions. The lesions were roughly globoid with a depression on the surface. It is thought that with continuous formation and healing of gastric erosions, more extensive intestinal metaplasia lesions would be formed by an increase in size and confluence of these focal minute intestinal metaplasia lesions. PMID- 3818972 TI - Correlation of nuclear ploidy with histology in adenomatous polyps of colon. AB - Histological sections of adenomatous polyps of the colon showing carcinoma were studied by video image analysis. Nuclear DNA content and morphology were measured in regions identified as either dysplasia, carcinoma confined to the mucosa, or carcinoma invading the muscularis mucosa. Where carcinoma was present, areas of dysplasia in the same polyp were found to have similar distributions of nuclear DNA content and size, supporting the notion that adenomatous polyps becomes cancer. The method can be used to detect those regions in sections of adenomatous polyps with the most severe nuclear abnormality. PMID- 3818973 TI - Myocardial infarction caused by cardiac disease in disseminated zygomycosis. AB - A case of disseminated zygomycosis is described, in which myocardial infarction rather than coincident coronary or heart disease was seen at necropsy. As zygomycosis is an opportunistic fungal infection, which tends to invade blood vessels, thereby causing thrombosis and infarction, it is surprising that cardiac disease is unusual and that premortem evidence of such disease has only rarely been reported. PMID- 3818974 TI - Alpha-interferon responses in cerebrospinal fluid of patients with suspected meningitis. AB - Cerebrospinal fluid from 100 patients with clinically diagnosed meningitis was examined for alpha-interferon. In the laboratory four patient groups were identified: bacterial meningitis (n = 12), viral meningitis (n = 15), normal cerebrospinal fluid (n = 57) and abnormal cerebrospinal fluid (n = 16). A further 14 patients with cerebrospinal fluid shunts but no abnormality in the cerebrospinal fluid provided a control group for alpha-interferon determinations. The group with viral meningitis and the group with abnormal cerebrospinal fluid had significantly higher alpha-interferon concentrations (p less than 0.001) when compared with those of the three other groups. This assay had great predictive value in determining those patients with abnormal cerebrospinal fluid who did not have a bacterial cause of meningitis. As the groups with abnormal cerebrospinal fluid and viral meningitis had a similar spread in alpha-interferon values it is likely that both reflect viral infection of the central nervous system. PMID- 3818975 TI - Reduced in vitro erythroid progenitor cell growth in bronchial cancer. AB - Peripheral blood and bone marrow were studied in 21 men with disseminated untreated bronchial cancer in an attempt to define abnormalities of erythropoiesis associated with the development of anaemia. Haemoglobin concentration at or below 13 g/dl was present in 13 cases. Marrow morphology was normal in all cases except one, in which small numbers of tumour cells were found. Clonal assay of erythroid progenitors showed a significant decrease in the number of BFU-E (p = 0.03) and CFU-E (p = 0.01) compared with cultures from normal marrow (12 subjects). The growth of granulocyte and macrophage progenitors (GM-CFCs) was similar in patients with bronchial cancer and normal subjects. When normal marrow was incubated in the presence of serum from bronchial cancer patients, no inhibitory factors could be detected either for BFU-E or CFU-E growth. In all patients circulating T8 numbers were significantly raised (p = 0.0002). Consequently, the median T4:T8 ratio in blood was 1.2, and this was significantly lower than the ratio of 1.7 found in 20 normal subjects (p = 0.036). In 18 patients the bone marrow T4:T8 ratio of 1.1 was significantly lower than the ratio of 2.9 found in seven normal subjects (p = 0.04). Total blood white cell counts, neutrophils, and monocyte numbers were also increased (p = 0.0001; p = 0.0001; p = 0.002). PMID- 3818976 TI - Mast cells in the human carotid body. AB - Mast cell counts were carried out on sections of human carotid bodies from 39 subjects showing one of four stages of histological change associated with aging, and in five subjects showing different forms of histopathology in the carotid body associated with disease. There was no relation between mast cell density and age or the histological changes associated with aging of glomic tissue. The normal range of mast cell density calculated in terms of the 80% confidence limits was 18.5 to 67.5/mm2. In three middle aged subjects with carotid bodies of normal histological appearance there was an abnormally high density of 83 to 96/mm2. In two elderly subjects showing age changes of fibrosis and accumulation of lymphocytes there was an abnormally low density of 12/mm2 or less. Mast cell density was not related to different types of carotid body hyperplasia. The mast cells were essentially stromal in location, usually closely applied to the walls of small glomic blood vessels, and were rarely found in intimate association with glomic chief cells. This suggests that mast cells are not directly concerned with the functions of glomic cells but does not preclude the possibility that they may have some effect on regulating glomic blood vessels and thus participate in the distribution of blood supply within the carotid body. PMID- 3818977 TI - Factor II, VII, IX and X concentrations in patients receiving long term warfarin. AB - Using standard one stage clotting assays the concentrations of factors II, VII, IX and X were determined in 37 patients stabilised on warfarin for between three months and 17 years. Contrary to popular belief, the concentrations were not equally depressed, with factor X the lowest, factor II at intermediate value, factors VII and IX the highest. Some 71% of the variance of the British corrected ratio (BCR) could be accounted for by measurement of the factors assayed. Analysis of this variance showed 91% of the explained variance attributable to factor II, 7% to factor VII, 1.6% to factor IX and 0.4% to factor X. With the sudden and recent withdrawal of human thromboplastin, investigation of the sensitivities of the animal thromboplastins to changes in vitamin K dependent factors in orally anticoagulated patients is needed to ensure that the potentially alarming falls in factors II and X in these patients are being adequately detected. PMID- 3818978 TI - Use of piracetam improves sickle cell deformability in vitro and in vivo. AB - Microsieving diluted suspensions of oxygenated sickle cell anaemia (HbSS) cells on polycarbonate filters shows that piracetam improves the red cell deformability in vitro. In vivo an oral intake of 160 mg/kg/day divided in four doses enhances the HbSS cell deformability as actively as it does in in vitro experiments. The drug is also able partially to restore the impaired deformability of physiologically deoxygenated HbSS cells. These findings are consistent with the results of clinical trials, which show that continuous treatment with piracetam reduces the incidence of vaso-occlusive crises in patients with sickle cell disease. PMID- 3818979 TI - Pulmonary adenocarcinoma: review of 106 cases and proposed new classification. AB - The gross and microscopic appearances of 106 resected pulmonary adenocarcinomas were reviewed and correlated with postoperative survival. Instead of using an established classification based on histological pattern, the tumours were categorised by cellular morphology and site as either parenchymal adenocarcinoma (67%), bronchial adenocarcinoma (13%), or adenocarcinoma of uncertain origin (20%). Despite their pleomorphic appearance parenchymal adenocarcinomas should be regarded as a single entity, derived from multipotential cells of the distal airway; bronchial adenocarcinomas were generally, but not invariably, associated with short postoperative survival; those tumours that could not be reclassified on histological grounds were large adenocarcinomas consisting mainly of mucus cells. Tumours of this type carry a poor prognosis. PMID- 3818980 TI - Importance of showing HBsAg and HBcAg positivity in the liver for better aetiological definition of chronic liver disease. AB - Serum and tissue hepatitis B virus (HBV) markers were compared in 35 alcoholic and 23 non-alcoholic subjects affected by chronic liver disease. Seventeen point one per cent of alcoholic and 21.7% of non-alcoholic subjects had HBV tissue markers, but not serum markers, for this virus. It is therefore concluded that showing the presence of HBV tissue markers permits a better aetiological definition of hepatitis B surface antigen (HBsAg) negative chronic liver disease, both in alcoholic and non-alcoholic subjects. PMID- 3818981 TI - Value of perinatal necropsy examination. AB - In a retrospective study of 150 stillbirths and 150 neonatal deaths carried out between 1981 and 1985 the necropsy findings were compared with the clinical diagnoses, which had been obtained from the postmortem request form, and the case notes completed before the necropsy was performed. In all cases the necropsy comprised macroscopic findings and histological examination of all organs, with microbiology, radiology, and cytogenetics where appropriate. Clinically important differences between clinical and pathological diagnoses in 54 of 150 cases (36%) were noted in the cases of stillbirth. Of the neonatal deaths, examination showed clinically important information that had not been recognised during life in 66 cases (44%). Histological examination of tissues was essential for making or confirming the pathological diagnosis in 20% of all perinatal deaths. PMID- 3818982 TI - Diffuse axonal injury in early infancy. AB - Diffuse axonal injury typified by retraction balls and axonal swellings was identified in the brains of a series of infants, 5 months old and younger, who had suffered closed head injuries. These axonal discontinuities were shown by using Nauomenko and Feigin's silver method, which is particularly useful for showing fine axons such as those found in the developing brain. Diffuse axonal injury in early infancy may occur in the same way as that described in adults. The low incidence of intracerebral haematomata suggests that recurrent trauma to the head from a combination of direct contact and shaking results in axonal damage to the poorly myelinated axons and that blood vessels are rarely damaged. PMID- 3818983 TI - Fatal infection in neonates of 26 weeks' gestation due to Streptococcus milleri: report of two cases. AB - Fatal sepsis due to a particular biotype of Streptococcus milleri occurred in two neonates born at 26 weeks' gestation. The clinical importance of this biotype in association with premature labour and neonatal sepsis is discussed. PMID- 3818984 TI - Distribution of IgA1 and IgA2 subclasses in normal bone marrow trephines and in trephines infiltrated by IgA producing multiple myeloma. AB - A series of 20 bone marrow trephines biopsy and necropsy specimens were strained for IgA1 and IgA2 activity, together with total IgA, by means of an indirect immunoperoxidase technique using murine monoclonal antibodies applied to paraffin sections. The specimens showed normal histology and had been taken from patients not known to be suffering from haematological or related systemic disease. The IgA1, IgA2, and total IgA containing cells were counted and expressed as a percentage of all nucleate cells in the marrow cavities. Remarkably constant percentages of and ratios between these cell types were found. The same was true for a further 10 trephines taken from patients undergoing staging procedures for epithelial malignancies, where the marrow histology was normal. The pooled mean percentage of IgA1 containing cells from both groups was 1.18% of all cells, that for IgA2 containing cells 0.18%, and for total IgA positive cells 1.41%. In addition, 12 trephines containing known IgA producing myeloma were examined. Of these, 11 contained IgA1, the remainder contained IgA2 subclass. PMID- 3818985 TI - Autoimmunity: a decision theory model. AB - Concepts from statistical decision theory were used to analyse the detection problem faced by the body's immune system in mounting immune responses to bacteria of the normal body flora. Given that these bacteria are potentially harmful, that there can be extensive cross reaction between bacterial antigens and host tissues, and that the decisions are made in uncertainty, there is a finite chance of error in immune response leading to autoimmune disease. A model of ageing in the immune system is proposed that is based on random decay in components of the decision process, leading to a steep age dependent increase in the probability of error. The age incidence of those autoimmune diseases which peak in early and middle life can be explained as the resultant of two processes: an exponentially falling curve of incidence of first contact with common bacteria, and a rapidly rising error function. Epidemiological data on the variation of incidence with social class, sibship order, climate and culture can be used to predict the likely site of carriage and mode of spread of the causative bacteria. Furthermore, those autoimmune diseases precipitated by common viral respiratory tract infections might represent reactions to nasopharyngeal bacterial overgrowth, and this theory can be tested using monoclonal antibodies to search the bacterial isolates for cross reacting antigens. If this model is correct then prevention of autoimmune disease by early exposure to low doses of bacteria might be possible. PMID- 3818986 TI - Serum alpha-thiol protease inhibitor concentrations in health and disease. AB - Serum alpha-thiol protease inhibitor (alpha-TPI) concentration was assayed by radial immunodiffusion in normal subjects, pregnant women, and in a wide variety of diseases. The normal concentration (448 (SD 75) mg/l) increased significantly (p less than 0.001) in pregnancy to 575 (89) mg/l, and in prostatic cancer treated by oestrogens to 666 (87) mg/l. Inconsistent changes were observed in inflammatory and malignant disease and in liver disease. A temporary pronounced fall of alpha-TPI was seen after burn injury, and a sustained fall after bone marrow transplantation. Crossed immunoelectrophoresis showed that the serum alpha TPI occurred in two forms, with alpha 2 and alpha 1 electrophoretic mobilities. A heavy demand on this antiprotease may result in suppression of the alpha 1 form. PMID- 3818987 TI - Prealbumin: its association with amyloid. AB - In recent years prealbumin has been shown to be a major component of two forms of systemic amyloid, senile systemic amyloid (SSA), and familial amyloidotic polyneuropathy (FAP). Despite the fact that the amyloid fibril proteins associated with these two forms of amyloid, designated ASc1 and AF, respectively, share many similarities the clinical features of the two diseases are remarkably different. To understand better this paradox the clinical, histochemical, immunological and biochemical features of SSA and FAP were reviewed. PMID- 3818990 TI - Bioequivalence of generic drugs in clinical psychopharmacology. PMID- 3818989 TI - Identification of non-capsulate strains of Streptococcus pneumoniae by coagglutination. PMID- 3818988 TI - Proposed classification of resistances to oral anticoagulant therapy. PMID- 3818991 TI - Disabling obsessive thoughts responsive to antidepressants. AB - The authors report four patients with disabling obsessive thoughts who responded in dramatic fashion to antidepressant medication. None met criteria for major depression. This response is discussed in light of the current literature on obsessive-compulsive disorder. PMID- 3818992 TI - Amoxapine associated with hepatotoxicity. PMID- 3818993 TI - Treatment of chronic anorexia nervosa with opiate blockade. PMID- 3818994 TI - Neuroleptic malignant syndrome after imipramine withdrawal. PMID- 3818995 TI - Hepatotoxicity following treatment with maprotiline. PMID- 3818996 TI - Development of neuroleptic malignant syndrome during simultaneous amoxapine treatment and alprazolam discontinuation. PMID- 3818997 TI - Using street drugs while on MAOI therapy. PMID- 3818998 TI - What is the degree of risk of hepatotoxicity for depressed patients receiving phenelzine therapy? Is the risk sufficient to require that we modify the written advice (as to diet and risks) that we regularly give our patients before we institute this therapy? PMID- 3818999 TI - The instantiation of general terms by deaf adolescents/adults. AB - Two studies were conducted using severely and profoundly deaf high school students to determine their ability to instantiate particular exemplars of general nouns and to use those instantiations as retrieval cues. The results indicated that the deaf adolescents/adults could instantiate when asked to do so but did not do so spontaneously; sentence recall was best when the retrieval cue matched the word used in the original sentence; and recall of sentences in which all information was explicit was better than of sentences in which some information had to be inferred. Impoverished semantic representations, difficulty in integrating semantic representations, and insufficient strategy use were suggested as possible alternative and competing explanations for the obtained results. PMID- 3819000 TI - The interactive nature of auditory comprehension in aphasia. AB - This study assessed the interaction between information derived from context and the auditory signal as it related to comprehension of specific words in narratives. Contextual influences were manipulated by varying the degree to which the narratives predicted the target words. The auditory influences were manipulated by varying the amount of auditory signal available, either all of the target word or only the initial sound sequence. The results indicated that aphasic subjects use information from both sources but that the contextual information, in its strong form, may take precedence over the auditory information. PMID- 3819001 TI - Correlates of sophisticated listener judgments of esophageal air intake noise. AB - Twenty-four laryngectomies, ranging widely in speaking ability, read a standard passage for audio recording. Four experienced voice clinicians rated the acceptability of the speakers' air intake noise. Independently, overall speech proficiency ratings were obtained for 18 of the subjects. Five objective measures of the subjects' esophageal speech were obtained using a real-time intensity display on a storage oscilloscope. Judges' reliability was determined by Pearson Product Moment Correlations. Ratings were submitted to multiple regression analysis. The means of air intake noise acceptability were the criterion variables; the objective measures and speech proficiency scores were the predictor variables. Three predictors were positively correlated (less than .01) with air intake acceptability: the number of syllables per intake, the sound intensity of the intake, and the rate of speech. Syllables per intake provided the largest share of the variance. PMID- 3819002 TI - A comparison of the speech acceptability of good and excellent esophageal and tracheoesophageal speakers. AB - Thirteen esophageal speakers (8 male, 5 female) and 12 tracheoesophageal (t-e) speakers (7 male, 5 female) were placed into eight groups based on gender, voice type, and speaking proficiency (excellent or good). Audio recordings of each speaker reading the Rainbow Passage (Fairbanks, 1960) were made. The resultant samples were judged for acceptability of speech by 25 naive listeners trained in use of a five-point equal-appearing-interval scale. An analysis of variance of the listener data indicated that speaker proficiency but not voice type had a significant effect on judgments of acceptability, indicating that the listeners perceived no difference in the acceptability of esophageal and t-e speech. PMID- 3819003 TI - The effects of emotional arousal and increased speaking rate on children's newly learned (r) productions. AB - Generalization of newly learned phones into spontaneous speech remains a serious problem for many children with articulation disorders. It has been suggested that generalization may be governed, at least in part, by the stability of the new phone. Various clinicians have argued that response stability, in turn, may be affected by emotion and speaking rate. The present study was designed to determine whether children's newly learned (r) phones would be adversely affected by unpleasant emotions and/or faster than normal speaking rates. Sixteen misarticulating children retold a story after frustration and no frustration procedures, in combination with slow and fast slide presentations. In contrast to previous clinical assumptions, no significant differences in subjects' (r) productions were found among the conditions. The research implications and limitations, and suggestions for future research, are discussed. PMID- 3819004 TI - Durational changes of apraxic speakers. AB - Durations of phrases, words, and phones were obtained for apraxic and normal speakers during normal and fast speaking conditions. Utterances were a word (permit) and a nonsense disyllable (perpit) embedded in a carrier phrase. Each test utterance was spoken with two syllabic stress patterns. Durations of the phrase, target word, / /(/ /), /I/, and the medial consonant of the target word were measured from oscillograms. Absolute segment durations were longer for apraxic than for normal speakers. During the fast rate condition, normal subjects decreased the duration of three of the four words. There was no evidence that apraxic speakers changed their speaking rates between the two rate conditions. Further investigation of temporal control and segment duration is suggested. PMID- 3819005 TI - The cognitive orientation of expressive communicability in schizophrenics and normals. AB - The study dealt with expressive communicability (EC), i.e., the amount, fluency, elaboration, clarity, and veracity of the voluntarily transmitted information about oneself. Low EC is considered as a schizophrenic symptom and as a cause of interpersonal difficulties in normals. For investigating the motivational antecedents of EC we applied the cognitive orientation (CO) theory that deals with explaining, predicting, and manipulating behaviors by means of cognitive contents and processes. The hypotheses were that schizophrenics would have fewer positive and more negative EC manifestations than normals, and that beliefs of four types would predict EC in both groups. Subjects were 30 hospitalized schizophrenics and 30 matched normals of both genders. They were administered individually the CO questionnaire and role-playing situations providing EC scores. Hospital personnel and close acquaintances answered a 13-item questionnaire about the subjects' EC. The findings confirmed the hypotheses: schizophrenics differed from normals on all EC measures, and the beliefs predicted 81%-100% EC measures in each group and the whole sample. The discussion focused on theoretical implications for cognitive motivation, the similarity of the motivational processes in schizophrenics and normals, and therapeutic implications for changing EC by changing the relevant beliefs. PMID- 3819006 TI - Responses of rat dorsal horn neurons to natural stimulation and to iontophoretically applied norepinephrine. AB - Extracellular recordings were obtained of 177 neurons throughout the lumbar spinal dorsal horn of urethane- or halothane-anesthetized rats. These neurons all responded to iontophoretically applied L-glutamate and their responses to natural stimulation of the ipsilateral hindlimb were characterized. Iontophoretically applied norepinephrine was tested on 94 of these neurons. Fifty-one neurons were inhibited and 22 were excited. Norepinephrine produced a biphasic inhibitory/excitatory effect on nine neurons. Norepinephrine was exclusively inhibitory on superficial dorsal horn neurons that responded only to innocuous brush and touch and on neurons in the nucleus proprius that responded to brush, touch, and noxious skin pinch. Norepinephrine excited some superficial brush/touch/pinch neurons and produced short inhibitions that were followed by prolonged excitations of some nucleus proprius neurons that responded only to noxious skin pinch. Neurons in the base of the dorsal horn that responded to low threshold proprioceptive stimulation were excited by norepinephrine. Both the inhibitory and excitatory effects of norepinephrine were stereoselective, but they were not blocked by receptor subtype-selective antagonists. Desensitization to norepinephrine occurred for 30% of the neurons. This study demonstrates that the inhibitory effects of norepinephrine on rat dorsal horn neurons are not restricted to neurons that are responsive to noxious stimuli and that some of these neurons are primarily excited by norepinephrine. The excitatory effects of norepinephrine on low-threshold proprioceptive neurons may contribute to norepinephrine's known enhancement of spinal flexor reflex activity. PMID- 3819007 TI - Correcting errors in estimating neuron area caused by the position of the nucleolus. AB - The technique of measuring soma cross-sectional area at the plane of the nucleolus leads to systematic errors that depend on how far the nucleolus is displaced from the center of the soma. A set of correction factors was produced based on calculations from a geometric model of the measurement process. Applying the correction factors to measurements of second-order auditory neurons led to substantial changes in the estimated soma area. PMID- 3819008 TI - Relationship between astrocytes, ganglion cells and vasculature of the retina. AB - We have studied the distribution of astrocytes in the ganglion cell and nerve fibre layers of the retina in cat, rat, rabbit, and possum using anti-serum and a monoclonal antibody against glial fibrillary acidic protein (GFAP) and our own monoclonal antibody against glial filaments. The distribution of retinal astrocytes appears to be strongly determined by the vasculature of the retina; astrocytes are absent from almost all the retina of the possum and from the avascular regions of the rabbit retina. In the cat and rabbit, retinal astrocytes also show a strong affinity for the bundles of ganglion cell axons found at the inner surface of the retina. Retinal astrocytes do not invest the somas of ganglion cells, and even in areas of retina in which they are numerous, they are sharply confined to the layer of ganglion cell axons. It is suggested that retinal astrocytes are "immigrant" fibrous astrocytes that enter the retina with its vasculature. PMID- 3819009 TI - Ontogeny of the area centralis in the cat. AB - Previous studies have shown that after embryonic day 50 (E50) the kitten retina undergoes a relatively rapid period of maturation that begins at the area centralis and spreads toward the retinal periphery. The mechanism controlling this pattern is unknown. One possibility is that the area centralis is the most developmentally advanced region of retina from the earliest stages of eyecup formation. The present study tests this hypothesis. Retinae from ten kittens aged between E21 and E54 were sectioned horizontally at 10 micron and stained with haematoxylin and eosin. During the earliest stages of development in other vertebrate species, the oldest part of the retina is at the posterior pole of the eyecup, just dorsal to the optic fissure. At E21 in the kitten retina, this site appeared to be developmentally advanced by several criteria. A developmentally advanced region (DAR) was recognized at each subsequent age. It gradually became displaced temporally toward the site of the area centralis in the adult. Developmental events beginning here include the formation of cell-free channels at the vitreal margin; the appearance of the first ganglion cells and their axons; the formation of continuous inner and outer plexiform layers; the differentiation of cells in the ganglion cell, inner, and outer nuclear layers; and the cessation of cytogenesis at the outer limiting membrane. By E54 the DAR could be recognized as the area centralis by the criteria used in the adult. Between E25 and E37 cell density in the ganglion cell layer is higher in the DAR than at other retinal eccentricities. During the E40s cell density becomes uniform across the retina because more cells migrate into the ganglion cell layer in peripheral retina than in the DAR. Several observations suggest that cells added to the ganglion cell layer from E37 onward are not ganglion cells. The proportion of retinal area occupied by the DAR decreases geometrically between E21 and E54, indicating that this region grows at a slower rate than the rest of the retina. It is suggested that this differential growth combined with differential cell addition may be the principal mechanism responsible for generating centroperipheral cell gradients in the retina. PMID- 3819010 TI - Membrane area and dendritic structure in type-identified triceps surae alpha motoneurons. AB - The size and branching structure of the dendritic tree were studied in nine type identified triceps surae alpha-motoneurons that were labeled intracellularly with horseradish peroxidase and reconstructed from serial sections in the light microscope. The average total membrane area (AN) for motoneurons of type S (slow twitch) motor units was about 22% smaller than AN for cells of type F units (including both FF and FR motor unit types in this category) (480.1 X 10(3) microns 2 vs. 617.7 X 10(3) microns 2, respectively). Systematic correlations were found between stem dendrite diameter and three measures of dendritic size: dendrite membrane area, combined dendritic length, and number of terminations. All of these correlations were significantly different for the dendrites of F and S motoneurons. Power-function relations between stem diameter and dendritic membrane area were used to estimate AN for a sample of 79 type-identified motoneurons. Mean estimated AN values were significantly different for the F and S motoneuron groups, despite a large overlap in AN values between these groups. The branching structure of dendrites of F and S motoneurons also showed clear differences. Type S motoneuron dendrites showed less-profuse branching and a more even radial distribution of branch points than found in type F cells. Examination of two forms of the "3/2 power rule" for the relation between the diameters of parent and daughter dendritic branches at branch points showed that the dendrites of type S motoneurons conform less well with the anatomical constraints necessary to represent binary branching trees as equivalent cylinders than do dendrites of type F cells. There was no systematic difference between F and S motoneuron dendrites in the degree of asymmetry of first-order daughter trees. The results overall indicate that the dendrites of F and S motoneuron groups are structurally different, giving rise to a systematic difference in AN between these groups. Such structural differences suggest that the F and S groups of alpha-motoneurons can be viewed as intrinsically distinct cell types and not just large vs. small variants of the same cell species. PMID- 3819011 TI - Three-dimensional architecture of dendritic trees in type-identified alpha motoneurons. AB - We have studied the spatial distribution of dendrites of type-identified triceps surae alpha-motoneurons, labeled intracellularly with HRP, using a variety of analytical approaches that were designed to quantify the ways in which dendrites occupy three-dimensional space. All of the methods indicated a strong tendency for motoneuron dendrites to project radially. However, regions dorsal and ventral to the somata contained fewer dendritic elements, and less membrane area, than expected for complete radial symmetry. Individual dendrites projecting into these regions tended to be smaller than those projecting rostrocaudally or mediolaterally. Nevertheless, the center of mass of membrane area for five of six fully analyzed cells was within 100 micron of the soma and, in all six cells, was located in the same dorsoventral plane as the cell soma. Maps of the projection of dendritic branches onto concentric shells at various radial distances from the soma showed that some regions have high concentrations of branches, sometimes with considerable overlap between branches arising from different stem dendrites, while other regions have relatively few branches, or none at all. Each motoneuron exhibited a different pattern of projection and there were no systematic differences between fast-twitch (type F, including both types FF and FR units) and slow-twitch (type S) motoneurons evident in the patterns of dendritic concentration. Assessment of the three-dimensional territories of individual dendrites showed that dendrites with larger numbers of terminal branches tended to have larger spatial territories. Despite considerable scatter, the results suggest that the density of branches tends to be approximately the same in large and small dendrites, and in F and S cell groups. The results are discussed in relation to the spatial location of synaptic input to motoneurons. PMID- 3819012 TI - Fate of uncrossed retinal projections following early or late prenatal monocular enucleation in the mouse. AB - In mammals binocular vision is made possible by the existence in the temporal retina of ipsilaterally projecting ganglion cells (IGCs) (with axons that do not cross the brain midline and join optic fibers from the opposite eye). To learn whether early interactions between fibers of each eye play a role in generating a mixed ipsi + contralateral projection pattern, we studied with horseradish peroxidase the origin of uncrossed retinal projections in mice that developed after one eye was destroyed at very early embryonic ages. One eye was removed on embryonic day 16 (E16; when optic fibers have grown past the chiasm bilaterally, but very few have grown into the visual centers) or on E13 or E12 (when few or no optic fibers have passed the presumptive chiasm region). Normal adult mice have a mean of 946 IGCs (range: 784-1,073) within the temporal sector of the retina, and less than 25 in the rest of the retina. In adult mice enucleated at E16, an average of 1,354 (1,215-1,484) IGCs are present within a clearly demarcated temporal sector of the remaining retina and 265 (152-312) are present throughout the rest of the retina. In both the temporal and nasal retina the excess IGCs in these mice have, generally, very small somas. In some of these mice the most peripheral part of the temporal sector contains fewer IGCs. In E12 or E13 enucleates, IGCs are also generally located in a narrow (often narrower than normal) region along the temporo-inferior retinal border, but their number is less than in normal or E16-enucleated mice: E13 enucleates have a mean of 639 cells (range: 361-875) in the temporal sector and 109 (8-275) in the rest of the retina. Following enucleation of one mouse at E12, the respective values are 349 and 31 cells. The reduction in numbers of IGCs in these mice is especially pronounced for ganglion cells with small cell bodies. These findings suggest that the development of uncrossed projections in mice depends on selective guidance mechanisms of axons from temporal retina through the chiasm. These may consist of interactions of optic axons with guidance cues distributed in the presumptive chiasm (possibly at early stages) and also of fiber-fiber guidance mechanisms, in particular between fibers from each eye. PMID- 3819013 TI - The morphology, number, and distribution of a large population of confirmed displaced amacrine cells in the adult cat retina. AB - The presence of a large population of some 730,000 displaced amacrines is confirmed in the ganglion cell layer of the cat retina. These cells correspond to the microneurons of Hughes and Wieniawa-Narkiewicz (Nature 284:468-470, '80) and the bar-cells of Hughes (J. Comp. Neurol. 197:303-339, '81): a population of profiles of which the majority had previously been presumed to be glia (Stone: J. Comp. Neurol. 12:337-352, '65; J. Comp. Neurol 180:753-772, '78; Hughes: J. Comp. Neurol. 163: 107-128, '75). A sample of such nonganglion cells was identified by Nissl criteria in an area of retina subsequently subjected to serial sectioning and electron microscopy. Such cells form synapses with other processes in the inner plexiform layer. Members of each morphological subclass were found to bear synapses. In some instances, synapses occurred both onto and from the soma and processes of a cell, which is strong evidence for their being displaced amacrines, or preferably, "amacrines of the ganglion cell layer." In confirmation of their amacrine nature, it was established that the microneurons and bar-cells survive optic nerve section for up to 2.5 years. Ganglion cells underwent retrograde degeneration and completely disappeared in a much shorter time. Injection of kainic acid, a neurotoxin, into an eye whose optic nerve had been cut over 2 years previously resulted in the pyknosis of all morphologically classified microneurons and bar-cells without influence on conventional glial cells. These results further support the conclusion that microneurons and bar cells are neurons and that they collectively form the displaced amacrine population of the cat ganglion cell layer. The topographic distribution of the displaced amacrines resembles that of the ganglion cells in form; their density peaks at 4,500-5,000 cells mm-2 in the area centralis and falls to less than 1,000 mm-2 in peripheral retina. A ganglion cell distribution map based on the latest morphological criteria derived from this study confirms that there are 170,000 ganglion cells in the cat retina. Displaced amacrines form some 80% of the total neuron population of the cat ganglion cell layer. The large population magnitude of these confirmed displaced amacrines implies their nonectopic origin and now provides a fresh insight into the ontogeny of the cat retinal ganglion cell layer. PMID- 3819014 TI - Glial patterns during early development of antennal lobes of Manduca sexta: a comparison between normal lobes and lobes deprived of antennal axons. AB - The synaptic neuropil of the olfactory (antennal) lobe of the moth Manduca sexta is subdivided into histologically conspicuous structures called glomeruli that are typical of olfactory systems in vertebrates and invertebrates. Each glomerulus consists of the highly branched neuritic arbors of both primary olfactory axons and antennal-lobe neurons, bounded by a nearly complete envelope of glial cells. We have studied events occurring during the first half of metamorphic adult development. The first signs of organization of the neuropil into glomeruli are changes in glial cells. Prior to the ingrowth of olfactory axons from the antenna, glial cells form a continuous border around the neuropil. When olfactory axons begin to reach the lobe, glial cells embark on a stereotyped series of changes: the border becomes disrupted, glial cells begin to proliferate and extend processes into the outer regions of the neuropil, and some glial cells migrate toward the center of the neuropil. Shortly thereafter, glomeruli emerge from the neuropil, delineated by glial cells. If, however, afferent axons are prevented from ever reaching the antennal lobe, glomeruli never develop and the glial cells remain almost entirely restricted to a thick layer bordering the neuropil. Thus sensory axons have a direct influence not only on neuronal but also on glial differentiation. Our results lead us to suggest that the glial cells may be in a position to act as intermediaries in developmental interactions between sensory axons and antennal-lobe neurons. PMID- 3819015 TI - Synaptic organization of cholinergic neurons in the monkey neostriatum. AB - Cholinergic neurons in the monkey neostriatum were examined at the light and electron microscopic level by immunohistochemical methods in order to localize choline acetyltransferase (ChAT), the synthesizing enzyme for acetylcholine. At the light microscopic level a sparse distribution of cholinergic neurons was identified throughout the caudate nucleus. Neurons had large (25-30 microns) somata, eccentric invaginated nuclei, primary dendrites of unequal diameters, and varicosities on distal dendritic branches. Ultrastructural study showed that the cholinergic cells had a cytoplasm abundant in organelles. Within dendritic branches, mitochondria and cisternae were localized primarily to varicosities. Synaptic inputs were distributed mostly to the dendrites and at least four types that formed symmetric or asymmetric synapses were observed. Immunoreactive fibers were relatively numerous within the neuropil and exhibited small diameters (0.1 0.15) micron) and swellings at frequent intervals. Cholinergic boutons that formed synapses were compared to unlabeled terminals making asymmetric synapses with dendritic spines. Results showed that ChAT-positive axons had significantly smaller cross-sectional areas, shorter synaptic junctions, and a higher density and surface area of mitochondria than the unlabeled boutons. Cholinergic axons formed symmetric synapses mostly with dendritic spines (53%) and the shafts of unlabeled primary and distal dendrites (37%). A relatively small proportion of the boutons contacted axon initial segments (1%) and cell bodies (9%) that included medium-sized neurons with unindented (spiny) and indented (aspiny) nuclei. The majority of dendritic spines contacted by cholinergic axons were also postsynaptic to unlabeled boutons forming asymmetric synapses. The results suggest that cholinergic neurons in the primary neostriatum belong to a single morphological class corresponding to the large aspiny (type II) interneuron identified in previous Golgi studies. Present results along with earlier Golgi electron microscopic observations from this laboratory suggest that neostriatal cholinergic cells integrate many sources of intrinsic and extrinsic inputs. The observed convergence of ChAT-immunoreactive boutons and unlabeled axons onto the same dendritic spines suggests that intrinsic cholinergic axons modulate extrinsic inputs onto neostriatal spiny neurons at postsynaptic sites close to the site of afferent input. PMID- 3819016 TI - Somatosensory nuclei in the brainstem of the rat: independent projections to the thalamus and cerebellum. AB - The dorsal column nuclei and the sensory trigeminal nuclei project not only to the ventrobasal thalamus but also to the cerebellum. In this study the numbers and distribution of neurones projecting to these two regions were examined for the following nuclei: the rostral part of the main cuneate nucleus, the external cuneate nucleus, nucleus x, the principal sensory nucleus of the trigeminal nerve, and the oral, interpolar, and caudal subnuclei of the spinal nucleus of the trigeminal nerve. A thalamic projection from nucleus x and from the external cuneate nucleus was confirmed, and a distinct group of neurones projecting to the ventroposteromedial thalamus was distinguished near the ventromedial aspect of the principal sensory nucleus. Of the 165,000 neurones examined, only one was found to be double labelled. It was concluded that the populations of neurones that project to the ventrobasal thalamus and to the cerebellum are separate, and that somatosensory neurones in the brainstem do not send axon collaterals to both regions. PMID- 3819017 TI - Morphological and physiological survival of goldfish Mauthner axons isolated from their somata by spinal cord crush. AB - Axon segments isolated from their somata degenerate within days or months depending on species and neuronal type. To better understand the time course of morphological and physiological changes associated with degeneration of axon segments of vertebrate central neurons, we have studied the goldfish Mauthner axon (M-axon) when it has been separated from its soma by spinal cord crush. M axon segments survive morphologically for at least 77 days at 14 degrees C. Cross sectional areas of isolated M-axon segments (measured 25-30 mm caudal to the wound site at postoperative days 64 and 77) were greater than those of control axons at the same level. Sheath areas did not change. Electron microscopic observations at the same spinal cord location indicated no clear changes in the configuration or number of neurofilaments or any other organelle. M-axon segments studied morphologically after 87 postoperative days had all degenerated. Mauthner axon segments were capable of conducting action potentials and eliciting ipsilateral EMG responses. Repetitive firing of the M-axon segments elicited EMG responses that fatigued more easily and remained fatigued over a longer interval than did those of control axons. The long duration of M-axon segment survival is unusual in a vertebrate and may be due to the low temperature at which the experiments were conducted (14 degrees C) and/or temperature-independent factors. The increased susceptibility to synaptic depression, which has not reported previously, may represent an early sign of the degenerative process. PMID- 3819018 TI - Morphological and physiological studies of rod-driven horizontal cells with special reference to the question of whether they have axons and axon terminals. AB - Rod-driven (intermediate) horizontal cells were examined in the carp retina to determine whether they bear axons and axon terminals. These cells were injected with HRP after physiological identification of the response type; which consisted of a higher sensitivity to light and a slower response time course than cone driven (external) horizontal cells, and spectral sensitivity peaking at 520 nm. The labeled cells were further identified morphologically by tracing their dendrites to rod photoreceptors by light and electron microscopy. About two thirds of the labeled cells (18/30) had a slender, axonlike process (less than 1 micron in diameter, 70-300 micron in length) running horizontally from the soma. No axonlike process was found in the remaining cells. Unlike the axons of external horizontal cells, this axonlike process was short and did not form a long fusiform expansion. No membrane specialization was found along the axonlike process. Since it has been reported that the syncytium made of axon terminals of external horizontal cells serves as a signal bypass of the syncytium made of the somata, it was asked, in separate experiments, whether the intermediate horizontal cells also had such a double syncytial layer. Response amplitudes to a slit of light were measured by placing the slit at various distances from the recording electrode. The response amplitude decayed with distance with a single exponential function, indicating that the syncytium of intermediate horizontal cells consists of a monolayer. These physiological data are consistent with the morphological observations. PMID- 3819019 TI - A quantitative study of morphological reorganization following chronic optic deafferentation in the adult cat dorsal lateral geniculate nucleus. AB - Neuronal and synaptic reorganization in the lateral geniculate nucleus (dLGN) of adult cats following chronic visual deafferentation has been investigated with the aid of GABA immunocytochemistry and quantitative electron microscopy. The main purpose of this study was to establish the morphological counterpart of the functional plasticity of dLGN relay cells after total visual deafferentation (Eysel: Brain Res. 166:259-271, '79). The results provide evidence that the regained excitability of relay cells is not the result of disinhibition (caused hypothetically by the selective loss of GABAergic cells) since the proportion of GABA-positive and GABA-negative cells as well as the inhibitory synaptic density did not change. The alternative suggestion that the enhanced excitability could be the result of compensatory axonal sprouting by corticothalamic fibers had also to be dropped: the absolute number of corticothalamic axons to the deafferented dLGN remains unchanged. Because of shrinkage of the dendritic trees of dLGN neurons, however, the density of cortical synaptic input at dLGN cells becomes elevated by almost 60%. It is suggested that the regained excitability of relay neurons is the consequence of the combined effects of adaptive (structural) reduction in size ("atrophy") of retinally denervated nerve cells, and, as a consequence, increase of input resistance, reduced shunting effects, and relative increase in density of the excitatory cortical input per neuron. PMID- 3819020 TI - Axon trajectories and pattern of terminal arborization during the prenatal development of the cat's retinogeniculate pathway. AB - In this study we have examined the trajectories taken by populations of ganglion cell axons and the spatial gradients of terminal arbor maturity within the lateral geniculate nucleus (LGN) during the prenatal development of the cat's visual system. To do so, an in vitro method of labeling optic tract axons from fetal brains between embryonic day 37 (E37) and postnatal day 2 (P2) with horseradish peroxidase (HRP) was used. At the earliest ages studied (E37-E53), optic axons leave the optic tract to run across the LGN toward their sites of termination in straight trajectories parallel to each other. At later ages (E57 P2), however, axons with abrupt changes in their course across the nucleus can be clearly identified. When the detailed terminal arbor morphology of the set of retinogeniculate axons filled with HRP at a given age was examined, two different spatial gradients of maturation could be detected. The terminal arbors of axons within LGN layer A are always more mature than those ending in layer A1, an observation consistent with previous findings that axons from the contralateral eye arrive within the LGN several days before those from the ipsilateral eye. Moreover, the terminal arbors of axons projecting to the medial portions of each layer are always more mature than their more lateral counterparts. These gradients are likely to be a direct reflection of the central-first, peripheral last gradient associated with the neurogenesis of the retinal ganglion cells themselves. In the oldest animals studied (E58-P2), a remarkable periodic pattern of terminal arbor labeling was seen following a localized HRP injection into the optic tract. Within the labeled portions of the LGN, densely filled axon terminal arbors are separated by unlabeled gaps of similar width. This pattern of labeling could reflect local topographic disorder within the optic tract or could arise if axons of different classes of retinal ganglion cells run in separate portions of the optic tract. Taken together, all of these observations suggest that there may be a fair degree of topographic order in the retinogeniculate projection within the cat's LGN early on in development. However, when topographic errors are present, some can be corrected by minor readjustments in axonal trajectories. PMID- 3819021 TI - Topographic organization of the orientation column system in large flat-mounts of the cat visual cortex: a 2-deoxyglucose study. AB - We developed a flat-mount technique in order to visualize, without additional reconstruction, the system of orientation columns in the cat visual cortex by using 2-deoxyglucose-autoradiography. Experimental animals were injected with 2 deoxyglucose and then stimulated for 45-60 minutes either with vertical or horizontal or oblique gratings alone or with vertical and horizontal gratings presented in alternation. In both areas 17 and 18 stimulation with either vertical or horizontal or oblique stripes produced similar and highly ordered patterns of parallel bands of increased 2-deoxyglucose uptake that were perpendicular to the boundaries of the areas. In area 17 they occasionally extended without interruption from the 17/18 border on the top of the lateral gyrus to the monocular segment in the splenial sulcus. Superposition of serial sections revealed that these bands were present in all cortical layers and in precise register along lines orthogonal to the lamination. The center-to-center spacing of the bands was 1.0-1.1 mm in area 17 and 1.2-1.4 mm in area 18. Stimulation with alternating vertical and horizontal contours led to a pattern the general organization of which resembled that induced by a single orientation but the spacing of which was reduced by a factor of 0.5. This strongly supports the concept that orientation is mapped in a system of parallel bands and argues against a recently formulated hypothesis that iso-orientation bands extend like spokes from centers that lack orientation selectivity (Braitenberg and Braitenberg, Biol. Cybern. 33:179-186, '79). Another characteristic feature, revealed by the flat-mount technique, was a periodic variation of 2-deoxyglucose uptake along the bands that gave them a beaded appearance. The mean center-to center distance between adjacent beads on the same band was in the range of 0.9 1.2 mm and remained unchanged when horizontal and vertical gratings were presented in alternation. We propose that these beads reflect another columnar system whose features have yet to be determined. PMID- 3819022 TI - Effects of monocular deprivation on the cat's geniculate neurons projecting to both areas 17 and 18. AB - When a kitten is reared with one eyelid sutured closed, there are profound changes in the developing visual system. In the lateral geniculate nucleus, the neurons in the laminae innervated by the deprived eye are smaller than normal, and some of these neurons may lose connections with the visual cortex. In the present study a variety of double label retrograde transport methods were used to define the effects of monocular deprivation on cortical projections of geniculate neurons. One marker was injected into area 17 and the other was injected into area 18. Neurons projecting to area 17 are on average 16.4% smaller than those in the nondeprived laminae. The neurons that normally would project to both areas 17 and 18 by an axon that branches are the most severely affected by monocular deprivation. These cells are nearly 40% smaller than their counterparts in the nondeprived laminae, and many of the neurons appear to lose their projection to one of the cortical areas. These neurons may be at a distinct disadvantage, since they must compete with neurons from the nondeprived laminae for a considerable amount of cortical territory in two different cortical areas. This competition may be so severe that some of the neurons are no longer capable of maintaining connections with both cortical areas. PMID- 3819023 TI - Inability of neural crest cells to colonize the presumptive aganglionic bowel of ls/ls mutant mice: requirement for a permissive microenvironment. AB - The enteric system is formed by cells that migrate to the bowel from the neural crest. In order to gain insight into intraenteric factors that influence this migration, the colonization of the bowel of the ls/ls mouse was investigated. The terminal 2 mm of ls/ls intestine fails to become colonized by crest cells and thus remains aganglionic. The entire bowel of control mice and ls/ls mice was explanted before the appearance in situ of recognizable neurons and grown in organotypic tissue culture. Neurons, detected by the histochemical demonstration of acetylcholinesterase activity, developed throughout the length of the control gut, but, even in vitro, were excluded from the terminal segment of the ls/ls intestine. Co-culture experiments were done, in which primary and secondary sources of crest cells were combined with recipient segments of bowel, to test the ability of the recipient tissue to become colonized by neural precursors. The primary source was murine crest cells migrating away from an explant of the neuraxis. Secondary sources included avian and murine foregut (control and ls/ls) containing migratory crest cells as well as the quail ganglion of Remak. Recipient segments of bowel included control avian and murine hindgut, explanted before the tissue had become colonized by crest cells in situ, as well as the presumptive aganglionic bowel of ls/ls mice. Both primary and secondary sources of crest cells proved to be able to contribute neurons to the control segments of recipient hindgut. Species differences were no barrier to the colonization of the bowel in vitro. Moreover, the ls/ls foregut was as good a source of neural precursors for a normal recipient bowel, as was control avian or murine foregut. In contrast, none of the sources of crest cells that were utilized contributed neurons to the presumptive aganglionic gut of ls/ls mice. Both cells and processes of enteric neurons developing in vitro (detected by demonstrating neurofilament immunoreactivity) tended to be excluded from the presumptive aganglionic tissue. On the other hand, neurites, but not cell bodies, of dorsal root ganglia co-cultured with presumptive aganglionic ls/ls bowel did enter the abnormal zone. These data are consistent with the hypothesis that nonneuronal elements of the wall of the presumptive aganglionic region of the ls/ls gut are abnormal and prevent the colonization of this segment of the gut with viable neural precursors from the neural crest.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3819024 TI - Spinal and trigeminal projections to the nucleus of the solitary tract: a possible substrate for somatovisceral and viscerovisceral reflex activation. AB - This study used the retrograde transport of a protein-gold complex to examine the distribution of spinal cord and trigeminal nucleus caudalis neurons that project to the nucleus of the solitary tract (NST) in the rat. In the spinal grey matter, retrogradely labeled cells were common in the marginal zone (lamina I), in the lateral spinal nucleus of the dorsolateral funiculus, in the reticular part of the neck of the dorsal horn (lamina V), around the central canal (lamina X), and in the region of the thoracic and sacral autonomic cell columns. The pattern of labeling closely resembled that seen for the cells at the origin of the spinomesencephalic tract and shared some features with that of the spinoreticular and spinothalamic tracts. Labeled cells in lamina IV of the dorsal horn were only observed when injections spread dorsally, into the dorsal column nuclei, and are thus not considered to be at the origin of the spinosolitary tract. They are probably neurons of the postsynaptic fibers of the dorsal column. Retrogradely labeled cells were also numerous in the superficial laminae of the trigeminal nucleus caudalis, through its rostrocaudal extent. The pattern of marginal cell labeling appeared to be continuous with that of labeled neurons in the paratrigeminal nucleus, located in the descending tract of trigeminal nerve. Since the NST is an important relay for visceral afferents from both the glossopharyngeal and vagus nerves, we suggest that the spinal and trigeminal neurons that project to the NST may be part of a larger system that integrates somatic and visceral afferent inputs from wide areas of the body. The projections may underlie somatovisceral and/or viscerovisceral reflexes, perhaps with a significant afferent nociceptive component. PMID- 3819025 TI - The structural and functional characteristics of tectospinal neurons in the golden hamster. AB - Intracellular recording and horseradish peroxidase (HRP) injection techniques were used to delineate the structural and functional characteristics of the superior collicular cells in the hamster, which could be antidromically activated from the first cervical segment of the spinal cord. Thirty-one such neurons were characterized, filled with HRP, and recovered. Complete physiological data were obtained from another 21 tectospinal cells for which anatomical data were sufficient only to define the laminar location of the cell body from which recordings were made. Of the total sample of 52 cells, 7.7% had their somata in the stratum griseum intermediale (SGI), 50% were in the stratum album intermedium (SAI), 36.5% were in the stratum griseum profundum (SGP), and 5.8% were in the stratum album profundum (SAP). The tectospinal cells were fairly uniform morphologically. They had large (27.7 +/- 5.5 microns diameter) cell bodies, which gave rise to an average of 6.7 +/- 1.2 primary dendrites. These were generally smooth and extended up to 500 microns away from the cell body. In many cases, they ascended out of the deep laminae into the stratum opticum (SO) and/or stratum griseum superficiale (SGS). The axons of TS cells averaged 3.4 +/- 0.8 microns in diameter, and they generally coursed radially to the SAP where they curved around the periaqueductal gray and entered the predorsal bundle. These axons often gave rise to collaterals that arborized in the deep laminae of the ipsilateral superior colliculus and subjacent reticular formation. The tectospinal cells were also fairly uniform physiologically. Their average conduction latency was 2.0 +/- 2.3 ms, and this variable had a strong negative correlation (-.81) with axon diameter for the recovered cells. Most (63.5%) of the TS cells were exclusively somatosensory and gave rapidly adapting responses to deflection of vibrissae and/or guard hairs; 7.7% were bimodal (visual somatosensory); 11.5% had complex (Rhoades et al., '83) somatosensory receptive fields; 1.9% were discharged only by a noxious pinch, and 15.4% were unresponsive. A common feature of all bimodal tectospinal neurons was dendrites that extended at least as far dorsally as the SO. Whereas there were no other clear-cut correlations between the structural and functional characteristics of these tectal neurons, we did note that all of the cells with complex somatosensory receptive fields received inhibitory input from axons that either originated from, or passed through, the contralateral superior colliculus. PMID- 3819026 TI - Time course of reactive synaptogenesis in the subcortical somatosensory system. AB - These experiments were designed to determine when synaptogenesis begins in the adult rat ventral posterolateral nucleus of the thalamus following lesions of the dorsal column nuclei. Given the relatively uncomplicated structure of the neuropil in the ventral posterolateral nucleus of the rat, the specificity of reactive synaptogenesis of the lemniscal input and the effect of the loss of lemniscal terminals on terminals from other sources could be determined. By use of morphometric analysis of electron micrographs, the numerical density of the 3 terminal types in the neuropil was determined at a series of postlesion survival times ranging from 12 hours to 50 days. Synaptogenesis began about 30 days after the lesions of the dorsal column nuclei and was complete by 50 days. The slow onset of synaptogenesis was in response to a loss of the lemniscal terminals, which account for only 3% of the total number of synapses in the ventral posterolateral nucleus. The low level of synaptogenesis early in the recovery process differs from the recovery seen in other central nervous system sites, which show an early rapid increase in synapses in response to much greater denervation. The loss of lemniscal terminals has relatively little effect on the numerical density or distribution of the terminals of other types. The new terminals that are formed come both from axons that originate from the undamaged portion of the dorsal column nuclei and from axons originating in the spinal cord. PMID- 3819027 TI - Time course of the reaction of glial fibers in the somatosensory thalamus after lesions in the dorsal column nuclei. AB - These experiments were designed to examine the relationship of glial hypertrophy to the time course of reactive synaptogenesis in the ventral posterolateral nucleus of the rat thalamus after lesions in the dorsal column nuclei. Because synaptogenesis is delayed for 30 days following lesions of the dorsal column nuclei, the initial hypertrophy of the glial processes in response to degeneration can be separated temporally from synaptogenesis. Glial hypertrophy was determined by measuring the relative area of neuropil occupied by profiles of glial processes on electron micrographs. The initial glial hypertrophy reached its peak 2 days after the lesion. However, at the time when synaptogenesis began, the area of neuropil occupied by glial processes was less than normal. When synaptogenesis was complete, the area of glial profiles also returned to normal. The role of glia in synaptogenesis was clearly different from its role in response to degeneration. In those systems such as the hippocampus, in which reactive synaptogenesis starts early in the recovery sequence, the relationship of glia to synaptogenesis may be masked by the glial response to degeneration. Hypertrophy of glial processes after lesions of other afferent pathways to the ventral posterolateral nucleus was compared to the hypertrophy following lesions of the dorsal column nuclei in order to see if there was a special relationship between glia and the lemniscal afferents to the ventral posterolateral nucleus. Lesions were placed in the medial lemniscus, somatosensory cortex, and the mesencephalon in addition to the dorsal column nuclei. The area of neuropil occupied by the glial processes expanded markedly after each of the lesions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819028 TI - Analysis of the habenulopetal enkephalinergic system in the rat brain: an immunohistochemical study. AB - The enkephalinergic afferent system in the rat habenula was examined by the indirect immunofluorescence method with antibodies against leucine-enkephalin. Leucine-enkephalin-like immunoreactive (L-ENKI) fibers were observed in the dorsal portion of the medial habenular nucleus (MHb), the intermediate portion of the lateral habenular nucleus (LHb), and the border zone between the MHb and the LHb (BZHb). Knife-cut studies demonstrated that almost all the fibers were supplied via the stria medullaris. Also two discrete ENKergic afferents to the MHb and the LHb were found by several kinds of lesion studies: the MHb was ipsilaterally innervated from L-ENKI neurons in "septoperiventricular area," which is the junctional area between the ventral supracommissural septum and the rostral thalamic periventricular region. The LHb was ipsilaterally innervated from L-ENKI neurons in the rostral portion of the lateral hypothalamus. Our findings also suggested that the L-ENKI fibers in the BZHb are supplied via the stria medullaris with an ipsilateral predominance and that, at the most caudal level, they arise not only from the ipsilateral stria medullaris but also from the contralateral stria medullaris via the habenular commissure. PMID- 3819029 TI - Ultrastructural studies of physiologically identified electrosensory afferent synapses in the gymnotiform fish, Eigenmannia. AB - Eigenmannia is a weakly electric fish that emits a constant-frequency electric organ discharge (EOD). Probability coder (P unit) and phase coder (T unit) electroreceptive afferents differentially encode changes in EOD amplitude and phase, respectively. physiologically identified T and P units were intracellularly labelled with HRP and their terminals were examined with electron microscopy to determine their postsynaptic targets. This technique reveals that phase and amplitude are relayed to first-order electrosensory neurons by two parallel but not independent pathways. P-type afferents terminate on granular interneurons, basilar pyramidals, and polymorphic cells, electrosensory lateral line lobe targets that monitor amplitude modulations, but P-type afferents do not contact spherical cells. T-type afferents relay phase information to spherical cells and thus form a separate afferent pathway. T unit terminals do not synapse directly on basilar pyramidal cells. Collateral branches from T-type afferents, however, were also found to terminate on granule and polymorphic cells, thereby adding phase information into the amplitude channel. P- and T-type afferents exhibit cellular specificity by forming synaptic junctions with different subsets of post synaptic targets in the deep neuropil. The afferent terminals make either asymmetric chemical or gap junction synapses depending on the identity of the post synaptic target. T units contacting granule cells or polymorphic cells had not been previously described. Two possible roles of adding phase to amplitude information are discussed in terms of electrolocation. PMID- 3819030 TI - Postembryonic neurogenesis in the CNS of the tobacco hornworm, Manduca sexta. I. Neuroblast arrays and the fate of their progeny during metamorphosis. AB - The tobacco hornworm Manduca sexta exhibits dramatic changes in its body morphology and behavior as it is transformed from a larva into an adult during metamorphosis. Accompanying these changes is an extensive reorganization of this moth's central nervous system (CNS), which involves both the death and remodeling of subsets of larval neurons. We report here that the segmental ganglia of the larvae also contain a stereotyped array of identifiable neuronal stem cells (neuroblasts) that contribute over 2,000 cells to each thoracic ganglion and about 40-80 cells to each abdominal ganglion. The distribution of these neuroblasts varies in a segment specific manner. Dormant neuroblasts are found adjacent to the neuropil in late embryos and early first instar larvae. After the molt to the second instar, these cells enlarge and begin to divide. Through a series of asymmetrical divisions, each neuroblast generates a discrete nest of 10 90 progeny by the end of larval life. These progeny (the imaginal nest cells) are developmentally arrested at an early stage of differentiation and remain so until metamorphosis. At the onset of metamorphosis, a wave of cell death sweeps through the nests, the extent of the death being much greater within the abdominal nests than in the thoracic nests. The surviving imaginal nest cells then differentiate to become functional neurons that are incorporated into the adult CNS. PMID- 3819031 TI - Hair cell innervation by spiral ganglion neurons in the mouse. AB - Horseradish peroxidase (HRP) was injected extracellularly into the auditory nerve of adult mice so that the enzyme could infuse individual spiral ganglion neurons. Forty-two well-stained neurons were reconstructed through serial sections from their cell bodies to peripheral terminations in the organ of Corti with the aid of a light microscope and drawing tube. No neuron was observed to innervate both inner and outer hair cells (IHCs and OHCs). Previous observations from neonatal mammals that reported that IHCs and OHCs were innervated by the same neuron are thus presumed to describe a transient developmental phenomenon. Two populations of spiral ganglion neurons were determined on the basis of the differences in receptor innervation. The type I neurons innervated exclusively IHCs by way of thick (1-2 microns) radial fibers, whereas the type II neurons innervated only OHCs by way of thin (approximately 0.5 micron) outer spiral fibers. Certain features of the peripheral process in the vicinity of the cell body were highly correlated with fiber type. This pattern of separate innervation of IHCs and OHCs by type I and type II neurons, respectively, may represent the general plan of afferent organization for the adult mammalian cochlea. PMID- 3819032 TI - Selective retrograde labeling of lateral olivocochlear neurons in the brainstem based on preferential uptake of 3H-D-aspartic acid in the cochlea. AB - We have previously shown that perfusion of the gerbil cochlea with probe concentrations of 3H-D-aspartic acid (D-ASP) results in immediate, selective labeling of 50-60% of the efferent terminals under the inner hair cells, presumably by high-affinity uptake. The present study was undertaken to determine the origin of these endings. Twenty-four hours after cochlear perfusion with D ASP, labeled neurons were observed in the ipsilateral, and to a much lesser extent in the contralateral, lateral superior olivary nucleus (LSO). The cells were small, primarily fusiform, and showed fewer synaptic contacts than other LSO cells. Combined transport of D-ASP and horseradish peroxidase indicated that all olivocochlear neurons within the LSO that projected to the injected cochlea were labeled by D-ASP. Labeled fibers coursed dorsally from the LSO, joined contralateral fibers that had passed under the floor of the fourth ventricle, and entered the VIIIth nerve root at its ventromedial edge. Adjacent to the ventral cochlear nucleus (VCN), densely labeled collateral fibers crossed the nerve root to enter the VCN. Labeled fibers and terminals were prominent in the central VCN. Neither retrograde transport of D-ASP by medial olivocochlear and vestibular efferents nor anterograde transport by VIIIth nerve afferents was observed. The D ASP-labeled cells and fibers are clearly lateral olivocochlear efferents. Retrograde transport of D-ASP thus allows the cells, axons, and collaterals of the lateral olivocochlear system to be studied, morphologically, in isolation from other cells that project to the cochlea. Since the olivocochlear neurons are almost certainly cholinergic, retrograde amino acid transport does not necessarily identify the primary neurotransmitter of a neuron. Rather, it indicates the presence of selective uptake by the processes of that neuron at the site of amino acid injection. Retrograde labeling appears to be markedly enhanced by the use of metabolically inert compounds such as d-isomer amino acids. PMID- 3819033 TI - Do early lesions affect cell death in the central nervous system? A study on the effects of early cerebellar hemispherectomy in rats. AB - Cell death patterns in the lateral and interposed nuclei were compared in control rats and rats in whom a unilateral cerebellar hemispherectomy was performed at day 2 of life. Both groups were studied between days 2 and 20 of life. Pyknotic cells and live neuronal and glial cells were counted from Nissl stained sections. After correction of these values, pyknotic to live cell ratios were calculated. In the lateral nucleus of normal rats, around 14-28 pyknotic cells per 1,000 live cells occurred from day 2 to day 12. Thereafter this value decreased, and from day 16 less than 3 pyknotic/1,000 live cells were observed. In the interposed nuclei, 18-28 pyknotic cells/1,000 live cells occurred at day 2, and from this age onward values gradually decreased. At day 20 values ranged around 1.6/1,000. After unilateral cerebellar hemispherectomy, values in both nuclei began to decrease as early as from day 8. Results from the present study strongly suggest that these cells are prevented from dying because they find an aberrant synaptic target in the ipsilateral red nucleus. Our results demonstrate that early lesions interfere with the regulation of fundamental processes of neuro-ontogeny. PMID- 3819034 TI - Serotonin storage and uptake by identified neurons in the leech Haementeria ghilianii. AB - Characterization of serotonin-containing neurons in the glossiphoniid leech Haementeria ghilianii was undertaken to provide a reference for developmental studies of their differentiation and for comparative studies of their distribution and function. Five types of serotonin-containing neurons were identified with an antiserum against serotonin and by radioenzymatic assay of individual isolated somata. They contain high concentrations of serotonin (in some cases exceeding saturation in aqueous solution) and their serotonin content increases with growth of the animal. Each type is capable of taking serotonin up from the extracellular fluid, as demonstrated autoradiographically. They exhibit segment-specific, and on comparison with hirudinid leeches, species-specific, differences in distribution, morphology, and the expression of serotonin metabolism. PMID- 3819035 TI - Effects of corpus callosum section on functional compensation in the posteromedial lateral suprasylvian visual area after early visual cortex damage in cats. AB - A visual cortex lesion made in adult cats leads to a loss of direction selectivity and a loss of response to the ipsilateral eye among cells in posteromedial lateral suprasylvian (PMLS) cortex of cats. However, a visual cortex lesion made in young cats results in normal direction selectivity and normal ocular dominance in PMLS cortex. Thus cats with an early lesion demonstrate functional compensation in PMLS cortex. The present experiment determined whether the functional compensation depends upon an intact corpus callosum. Cats received a unilateral visual cortex lesion on the day of birth (day 1) or at 8 weeks of age. When the cats were adult, the corpus callosum was sectioned and 24 hours later recordings were made in PMLS cortex ipsilateral to the visual cortex lesion. Results were compared to cats with a similar lesion and an intact corpus callosum. In cats with a lesion made on day 1, a corpus callosum section did not affect receptive-field properties or ocular dominance in PMLS cortex. Therefore, functional compensation is not dependent on input via the corpus callosum in these animals. However, in cats with a lesion made at 8 weeks. a corpus callosum section resulted in a decrease in the percentage of direction selective cells and in the percentage of cells driven by the ipsilateral eye. Despite the decrease, the percentage of direction-selective cells still was greater than in cats with an adult unilateral visual cortex lesion. Thus, while partly dependent on callosal inputs, some functional compensation for direction selectivity remains on the basis of ipsilateral inputs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819036 TI - Subdivisions and connections of inferior temporal cortex in owl monkeys. AB - Patterns of cortical connections and differences in architectonic appearance were used to subdivide inferior temporal cortex of owl monkeys into four main regions. These regions were named by location: ITC (the caudal subdivision of inferior temporal cortex), ITR (the rostral subdivision of inferior temporal cortex), ITP (the polar subdivision of inferior temporal cortex), and ITM (the medial subdivision of inferior temporal cortex). Two of these regions may contain further subdivisions--ITC, separate dorsal and ventral areas, and ITM, medial and lateral areas. The most caudal subdivision, ITC, was defined in an earlier report (Weller and Kaas: J. Comp. Neurol. 234:35-59, '85) as the projection zone of the dorsolateral visual area (DL). ITC occupies roughly the caudal half of the architectonic zone temporal area E (TE) (after von Bonin and Bailey: The Neocortex of Macaca mulatta. Urbana: University of Illinois Press, '47). TE is characterized by a dense, broad layer IV of granule cells and a dark inner band of myelination. Injections of 3H-proline in ITC demonstrated major projections to a more rostral division of the temporal lobe, ITR. Other projections were to the frontal eye field (FEF), a more ventral region of frontal cortex (FV), and a medial division of inferior temporal cortex, ITM, on the ventral surface of the temporal lobe. Feedback projections of ITC were to DL and adjoining temporal parietal cortex (TP), while interhemispheric projections were to ITC and ITR. Connections between dorsal and ventral ITC, together with earlier evidence for two projection zones of DL in ITC (Weller and Kaas: ibid., '85), suggest that dorsal and ventral sectors of ITC are separate visual areas. The rostral division of inferior temporal cortex, ITR, was defined as the projection zone of ITC. ITR occupied the rostral half of the architectonic region TE. Slight differences in cortical architecture between ITC and ITR were noted, but an architectonic border between the two fields could not be reliably distinguished. Injections in ITR demonstrated projections to the rostral pole of temporal cortex, ITP, feedback projections to ITC, and inputs to FEF, FV, dorsomedial frontal cortex, and the rostroventral superior temporal gyrus. Interhemispheric projections were to ITR and ITP. The projections of ITR to the rostral pole defined ITP. ITP has broad, less distinct layers of cortex and appears to correspond to temporal area G (TG) of von Bonin and Bailey (ibid., '47). The only known input to ITP is from ITR, and its projections have not yet been determined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3819037 TI - Interhemispheric connections in the visual cortex of the squirrel monkey (Saimiri sciureus). AB - The callosal connections within the posterior parietal and occipital cortices were studied in the squirrel monkey with horseradish peroxidase tracing techniques. The data were evaluated with particular emphasis on the relationship of major callosal connections along the 17-18 border. The overall pattern of callosal connections in the squirrel monkey also was compared with callosal patterns in other New World simians. Our results show that the dense band of callosal connections along the 17-18 border in the squirrel monkey differs from the connections observed in other New World monkeys in that it is virtually confined to area 18 and avoids area 17. In addition to a continuous band of callosal connections in area 18 that parallels the 17-18 border, rostral extensions of the band are oriented perpendicular to the 17-18 border and present an obvious periodicity. The remaining parieto-occipital cortex contains a complex pattern of callosal connections that is strikingly similar to patterns reported for other New World monkeys. Thus, it is likely that the dorsolateral extrastriate visual cortex in the squirrel monkey is organized in a manner similar to that found within other New World monkeys. PMID- 3819038 TI - Immunocytochemical localization of GABA-, cholecystokinin-, vasoactive intestinal polypeptide-, and somatostatin-like immunoreactivity in the area dentata and hippocampus of the rat. AB - Hippocampal neurons containing GABA-, cholecystokinin(CCK)-, vasoactive intestinal polypeptide(VIP)-, or somatostatin(SS)-like immunoreactivity (LI) were localized in sections of rat hippocampus. GABA-, CCK-, VIP, and SS-LI are found exclusively in interneurons of the area dentata and hippocampus. In the area dentata, GABA-LI occurs in cells of all strata but predominates in type 1 and 2 basket cells. CCK-LI is present in a subset of these basket cells and some hilar cells. VIP-LI is present in a distinct subset of dentate interneurons that, unlike the type 1 and 2 basket cells, do not contribute to the fiber plexus in the inner molecular layer. These VIP-LI interneurons send their axons to nearby granule cells and form a plexus in the hilus. SS-LI, although rare in cells of the molecular and granular layers, is present in a large population of hilar interneurons that do not exhibit GABA-, CCK-, or VIP-LI. In area CA3 of the hippocampus, a variety of morphologically diverse interneurons containing GABA-, CCK-, VIP-, or SS-LI are present in all strata. In area CA1, SS-LI is present mainly in cells of strata oriens and pyramidale. GABA- CCK- and VIP-LI interneurons are present in all strata of CA1 but, unlike the SS-LI cells, are most numerous in strata pyramidale and radiatum. These findings in the area dentata, taken together with those of Kosaka et al. (J. Comp. Neurol. 239:967 969, '85), indicate that two main populations of interneurons can be discriminated on the basis of the substances they contain. One is a group of GABA LI cells, some of which also contain CCK- and/or VIP-LI. These cells innervate the granule cells and the second group of interneurons, the SS-LI hilar cells, which apparently form part of the dentate ipsilateral associational/commissural projections. PMID- 3819039 TI - Terminations of individual optic tract fibers in the lateral geniculate nuclei of Galago crassicaudatus and Tupaia belangeri. AB - The morphology and laminar distribution of individual optic fibers projecting to the lateral geniculate nucleus (GL) of Galago and Tupaia were studied following iontophoretic injections of horseradish peroxidase (HRP) into the optic tract. In Galago the GL is composed of three functionally matched pairs of layers, each characterized by cells of a given size, one large, one medium-sized, and one small. The results show that there is a close correspondence between the size of the afferent fibers and the size of the neurons in the target layer: large axons project to the magnocellular layers, medium-sized axons project to the parvicellular layers, and small fibers project to the intercalated layers. In Tupaia the GL is composed of two functionally matched pairs and two unmatched layers. Optic fibers that project to the medial matched pair (1 and 2) are only slightly larger than those that project to the lateral matched pair (4 and 5), but both are larger than those that project to the unmatched layers (3 and 6). In both species terminal arbors and the distribution of terminal boutons within layers corresponded closely with the organization of dendritic processes of cells in the target layer. This correspondence was particularly evident in the parvicellular layers in Galago and in layer 6 in Tupaia: parvicellular terminal arbors, like the dendrites of parvicellular cells, are organized in narrow columns oriented along lines of projection, whereas layer 6 terminal arbors, like the dendrites of layer 6 cells, are oriented in elongated strips perpendicular to lines of projection. In both species there was evidence for sublaminar terminations in some layers. These were restricted to the parvicellular layers in Galago and layers 4 and 5 in Tupaia. With the exception of a small number of fine fibers in the intercalated layers in Galago, optic fibers in both species terminated in one and only one layer in a set. The significance of this result depends on the relation between ganglion cell classes and what is being segregated in different GL layers. Lateral geniculate lamination varies even in closely related species and has evolved independently in such distantly related lines as carnivores and primates. It is not surprising, therefore, that what is being segregated varies from species to species. PMID- 3819040 TI - Neural inputs into the temporopolar cortex of the rhesus monkey. AB - Temporopolar cortex (TP) can be subdivided into agranular, dysgranular, and granular components. The telencephalic input into the temporopolar cortex arises from the orbitofrontal and medial frontal regions, modality-specific visual and auditory association areas, paralimbic regions, the piriform olfactory cortex, the hippocampus, the amygdala, the claustrum, and the basal forebrain. Afferents from limbic and paralimbic regions are directed mostly to the agranular and dysgranular sectors of the temporal pole, whereas afferents from isocortical association areas are distributed predominantly within the granular sector. The temporopolar cortex provides a site for the potential convergence of sensory and limbic inputs. Auditory inputs predominate in the dorsolateral part of the temporopolar cortex whereas visual inputs become prominent only in the ventral portions of this region. Olfactory inputs are directed mostly to the medial parts of the temporal pole. These medial parts also receive more extensive projections from the amygdaloid nuclei. PMID- 3819041 TI - An ultrastructural study of the kidney of normal, copper poisoned and thiomolybdate-treated sheep. AB - Histological, ultrastructural and kidney function techniques were used to assess changes in the kidney of sheep given either copper (Cu) or Cu and the Cu complexing agent thiomolybdate (TM), or TM alone. Kidney function was normal in sheep given Cu and TM together or TM alone. In these animals the cells lining cortical tubules accumulated Cu within numerous, large, electron-dense lysosomes. Sheep given Cu alone developed haemolysis, impaired kidney function and a variety of morphological defects including an increase in number of large lysosomes in cells of the cortical tubules. There was a breakdown of the glomerular endothelial lining and fusion of foot processes. Cells of the cortical tubules showed degeneration and necrosis and an increase in microbodies and rough endoplasmic reticulum. Cortical and medullary blood vessels were dilated, with evidence of breakdown of the endothelial lining. Copper appeared to injure kidney tissue at three sites, tubular epithelium, glomerular basal lamina and capillary blood vessels. Changes reported here are similar to the renal lesions in cadmium toxicity. PMID- 3819042 TI - Non-response of rough endoplasmic reticulum containing intracisternal microtubules to axotomy in the dog. AB - Responses of the RER containing intracisternal microtubules in the canine ganglion nodosum to axotomy were observed at 3, 7, 14, 30, 50 and 99 days after section of the vago-sympathetic trunk. At 3 days, neurons showed no changes. From 7 days to 50 days, a retrograde reaction occurred in the cell bodies; nuclei were irregular in outline and eccentric in position and flattened RER disintegrated and dispersed. On the other hand, dilated RER containing intracisternal microtubules, which was detected as cytoplasmic inclusions under the light microscope, was present at the opposite pole to the eccentric nucleus. The ratio of areas of cytoplasmic inclusion to cell body significantly decreased. However, there were no changes in the size and arrangement of intracisternal microtubules within the RER. At 99 days, axotomized cell bodies had recovered and the RER containing intracisternal microtubules was indistinguishable from the contralateral controls. These findings indicate that the RER containing intracisternal microtubules is not disrupted by axotomy, though it is compactly packed at the periphery of cell bodies during the retrograde reaction. It appears, therefore, that the RER containing intracisternal microtubules does not respond to axotomy. PMID- 3819043 TI - Cytogenetic analysis of leukaemic cells in the dog. A report of 10 cases and a review of the literature. AB - Cytogenetic abnormalities were found in 9 of 10 leukaemic dogs. Important findings were aneuploidy, especially hyperdiploidy, extra-metacentric chromosomes, double minute chromosomes and tetraploidy. Six dogs had a normal chromosome modal number of 78, but 4 other dogs had modal numbers of 54, 81, 83 or 85 and 156. One to 16 extra-metacentric chromosomes were seen in cells from 5 dogs. Double minute chromosomes, which appear to be markers for neoplasia, were seen in one or more cells from 3 leukaemic dogs. Too few adequate, simultaneous studies were available to compare cytogenetic results from blood and bone marrow samples of leukaemic dogs. Extra-metacentric chromosomes and double minute chromosomes were not found in cells from the normal control dogs and cells with more than 78 chromosomes were rare. Specific chromosome changes were not associated with any of the various types of leukaemia and prognosis could not be predicted from the cytogenetic findings but, in general, the prognosis was poor. However, it does appear that many or most dogs with leukaemia have chromosomal abnormalities. With additional research and improvements in leukaemia therapy, cytogenetic studies of canine leukaemia may provide diagnostic and prognostic information. PMID- 3819044 TI - Lobular capillary haemangiomas in young horses. AB - Seven cases of cutaneous haemangiomas in young horses are described, characterized by scattered, well demarcated but unencapsulated lobules, consisting of capillary sized vascular structures, separated by strands of fibrous tissue. In one case, a more cellular variant was distinguished with minor vasoformative capacity. The morphological features of these haemangiomas are compatible with bovine cutaneous angiomatosis and human granuloma pyogenicum. The lesions are considered to be vascular tumours rather than hamartomas or granulation tissue and "lobular capillary haemangioma" is suggested to designate this type of haemangioma. In one tumour, cavernous vascular structures were also present in addition to the capillary structures and so this tumour is considered to be a combined capillary and cavernous haemangioma. PMID- 3819045 TI - Immunohistochemical distribution of immunoglobulin and secretory component in the ileum of normal and paratuberculosis-infected cattle. AB - The immunohistochemical distribution of IgA, IgG, IgM and secretory component in the ileum of 10 normal and 21 paratuberculosis-infected cattle was investigated. Semi-quantitative analysis of the number of each class of Ig-containing cells in the lamina propria mucosa of infected ileums showed that IgG and IgM-containing cells and total Ig-containing cells were significantly more numerous than those in the normal ileums. There was no significant difference in the numbers of IgA containing cells between the two groups of cattle. The distribution of IgA, IgM and SC was basically similar in the two groups. However, IgG-containing cells characteristically accumulated around the granulomas. It was considered that excessive local production of Ig in the intestinal mucosa, along with subsequent formation of immune complex or release of histamine from mast cells, could account for the occurrence of diarrhoea and participate in the pathogenesis of bovine paratuberculosis. A comparison of the local immunological state in paratuberculosis and Crohn's disease was made. PMID- 3819046 TI - Chronic inflammatory and lymphoproliferative lesions of the equine small intestine. AB - A retrospective study was made of 20 horses with severe and extensive chronic disease of the small intestine. Many of the animals had clinical evidence of malabsorption, with progressive loss of weight, hypoalbuminaemia and sometimes anaemia. All but two of the horses were Thoroughbreds. The pathology was diverse. Nine of the cases were alimentary lymphomas (Platt, 1986) and five had lymphocytic and eosinophilic infiltrations in the bowel wall which were considered to be probable reactions to parasitic invasion. One had acute thrombosis associated with partial occlusion of the anterior mesenteric artery by a verminous thrombus, superimposed on granulomatous lesions resulting from earlier ischaemic episodes. Two animals, from one stud, had dense mononuclear infiltration of the intestinal mucosa with villous atropy accompanying an unidentified acid-fast bacillary infection in the mesenteric lymph nodes and other sites. Three horses had granulomatous or lymphogranulomatous infiltration of the small intestine accompanied by marked mucosal and villous atrophy. One of these had multiple abscessation in part of the affected bowel. Only the three latter cases had lesions resembling those of equine granulomatous enteritis and the results of this study indicate the rarity of this condition in Thoroughbreds in Britain. The different types of lesion were only distinguishable by histological examination, since their clinical effects and gross pathology were not characteristic. PMID- 3819047 TI - Focal myocardial necrosis with calcification in two young chickens. AB - Focal myocardial necrosis with calcification was seen in two 10-week-old SPF chickens. Histologically, hyaline necrosis of myocardial fibres, frequently accompanied by calcification, was present in the subendocardial area of the left ventricle. Fibrosis was observed around the necrotic area. There were few inflammatory cells. The aetiology is not known. PMID- 3819048 TI - Hyperbiliverdinemia in the bronze baby syndrome. AB - The bronze baby syndrome is an unusual complication of phototherapy for hyperbilirubinemia in the neonate. The pigment or pigments responsible for the discoloration in this syndrome have not yet been identified. Suspected pigments include photodegradation products of bilirubin and copper-porphyrins. We present here the case of a neonate with bronze baby syndrome whose serum had increased spectral absorbance in the region of maximum absorbance for biliverdin. We suggest that biliverdin pigments may also contribute to the "bronze" color associated with this syndrome. PMID- 3819050 TI - Hyperkeratosis lenticularis perstans (Flegel's disease). Case report and literature review. AB - A case of Flegel's disease, or hyperkeratosis lenticularis perstans, is reported. This rare chronic disorder is characterized by asymptomatic hyperkeratotic papules, usually located on the lower extremities. Most reported cases have been from Europe. We report a case of hyperkeratosis lenticularis perstans from our institution that was treated successfully with topical 5-fluorouracil. PMID- 3819049 TI - Acrokeratosis paraneoplastica (Bazex' syndrome). AB - A 55-year-old white man born in Canada presented with all the clinical features of acrokeratosis paraneoplastica of Bazex. He showed the characteristic violaceous erythema and scaling of the nose and face, the aural helices, and the palmoplantar regions with severe nail dystrophy. Extensive examinations failed to reveal any associated malignancy up to 5 months after the onset of the skin eruption. While the skin was improving, and although the patient was still asymptomatic except for a weight loss of 5 kg, evidence of metastatic squamous cell carcinoma of the cervical region was obtained. Only palliative treatment could be undertaken. The bizarre clinical aspects of the syndrome are reviewed. PMID- 3819051 TI - Epidermolysis bullosa progressiva. AB - The first case of epidermolysis bullosa progressiva in the North American literature is described. Electron microscopic examination of a bulla confirmed that blistering is junctional in this rare type of epidermolysis bullosa. PMID- 3819052 TI - Partial lipodystrophy associated with a type 3 form of membranoproliferative glomerulonephritis. AB - Partial lipodystrophy can be associated with a glomerulonephritis, most commonly a membranoproliferative form, of either the classic type 1 or the type 2 (dense deposit) disease in 50% of cases. We describe a woman affected by partial lipodystrophy associated with a type 3 form of membranoproliferative glomerulonephritis. To our knowledge, this is the first reported case in the English-language literature. PMID- 3819053 TI - Catheter infections during continuous peritoneal dialysis. AB - A typical tunnel infection is described in a patient receiving continuous ambulatory peritoneal dialysis. This complication of peritoneal dialysis is important to study and manage well because the infection leads to removal of the catheter and interruption of therapy. Most infections are due either to Staphylococcus aureus or to S. epidermidis. PMID- 3819054 TI - Alopecia associated with underlying nerve sheath myxoma. AB - This report describes a 16-year-old girl who was referred for a 2.5-cm macular area of alopecia of the posterior portion of the scalp. A subcutaneous nerve sheath myxoma was found underlying the area of alopecia. Hair growth resumed within 4 weeks after removal of the nerve sheath tumor. PMID- 3819055 TI - Argyria: the intradermal "photograph," a manifestation of passive photosensitivity. AB - X-ray microprobe and electron microscopic study was made of the remarkable blue black pigmentation that sunlight elicits in patients with argyria. The patient under study had developed argyria following injection of silver nitrate as a sclerosant into his varicose veins 41 years ago. Similarities are demonstrated between the darkening of the skin and the darkening of a photographic film following light exposure. In both instances, colorless silver salts and compounds present in an inert matrix (collagen versus gelatin) are reduced by incident light to black metallic silver. This passive photosensitivity reaction leads to silver tattooing of the light-exposed skin and to photographic imaging in the film. PMID- 3819056 TI - Inflammatory acquired oral hyperpigmentation: association with melanophages demonstrating phenotypic characteristics of antigen presenting cells and activated monocytes. AB - A case of a 30-year-old black woman who developed acute, extensive intraoral hyperpigmentation is reported. Its relationship to previously described entities is discussed. The condition was associated with the presence of melanophages both in the submucosa and in the oral epithelium. The melanophages displayed phenotypic markers of a population of intraepidermal melanophages previously described as potent T cell-activating, antigen presenting cells (T6- DR+ OKM5+ OKM1-) and of activated monocytes (Mo3e+), as well as other monocyte-macrophage markers (Mono 1 and My7). The distinct phenotype of these melanophages suggests that they could play an active role in the promotion of inflammatory disease. PMID- 3819057 TI - Toxic shock syndrome as a complication of dermatologic surgery. AB - We report a case of toxic shock syndrome occurring after an excisional skin biopsy in an otherwise healthy woman. Her clean-appearing wound grew Staphylococcus aureus and was implicated as the source of toxin. Dermatologists should be aware that toxic shock syndrome may occur as a complication of simple dermatologic surgery. PMID- 3819058 TI - Subungual basal cell carcinoma presenting as longitudinal melanonychia. AB - Subungual basal cell cancers are extremely rare, and a case is presented herein. This cancer had as its only manifestation the unique presence of a deeply pigmented streak in the nail for many years. Longitudinal melanonychia can signal baleful or banal conditions, and basal cell cancer must now be added to this list. PMID- 3819059 TI - Anhidrosis (hypohidrosis) in Sjogren's syndrome. AB - There has been a relative lack of literature on the association of hypohidrosis in Sjogren's syndrome with any lesion having specific histologic findings. We looked at a recent case presentation of a 55-year-old man with complaints of dry mouth and dry eyes, becoming easily overheated in direct sunlight, and having difficulty in perspiring. Physical examination showed fissuring and atrophy of the tongue and angular cheilitis. A punch biopsy of the skin showed a moderate number of eccrine gland and ductal structures in the lower reticular dermis, each surrounded by a dense cellular infiltrate of plasma and lymphocytic cells. Our patient also had a markedly decreased sweating response to methacholine. In reviewing the literature as far back as 1951 and on the basis of findings in our present case study, we conclude that it seems probable that the severity of the skin disease is an important determining factor in predicting whether the sweat gland lesion does exist. PMID- 3819060 TI - Cutaneous botryomycosis in a patient with acquired immunodeficiency syndrome. AB - A patient with acquired immunodeficiency syndrome presented with multiple pruritic papules and nodules over the trunk and extremities. Biopsy specimens from two of these lesions contained granules within abscesses of the papillary dermis. There were numerous gram-positive cocci within the granules. Culture of one lesion failed to produce growth. A mouse inoculated with tissue from a lesion revealed no evidence of sepsis or organ involvement. The skin lesions showed no obvious response to systemic antimicrobial therapy but gradually resolved after treatment had been discontinued. Such lesions should be clinically distinguished from other cutaneous manifestations of acquired immunodeficiency syndrome, such as Kaposi's sarcoma. PMID- 3819061 TI - Unilateral facial telangiectasia macularis eruptiva perstans. AB - A 36-year-old man developed unilateral facial telangiectases over a 10-year period. Histopathologic examination showed collections of mast cells. This patient has an unusual variant of telangiectasia macularis eruptiva perstans. The differential diagnosis of facial telangiectases is discussed. Mastocytosis should be considered in patients presenting solely with telangiectases. PMID- 3819062 TI - Diffuse, progressive hyperpigmentation: an unusual skin manifestation of mycosis fungoides. AB - Pigmentary changes in mycosis fungoides usually occur in association with poikiloderma atrophicans vasculare or following therapy and regression of lesions. Several cases of hypopigmented mycosis fungoides have also been reported. We present the case report of a patient who developed pruritic, diffuse macular hyperpigmentation of the skin. Biopsy specimens from hyperpigmented skin revealed histologic and ultrastructural features typical of mycosis fungoides. Giant melanin granules were found in the tumor cells, as well as in keratinocytes and Langerhans cells. As far as we know, this is the first report of cutaneous hyperpigmentation as a single presenting sign of mycosis fungoides. PMID- 3819063 TI - Connective tissue nevus masquerading as a localized linear epidermal nevus. AB - A 22-year-old black female patient presented to the dermatology clinic with an eruption on her left arm. The eruption consisted of hyperpigmented grouped papules with a verrucous appearance. Because the lesions were soft on palpation, the eruption was diagnosed clinically as an atypical localized linear epidermal nevus. Examination of a biopsy specimen of the lesion, however, revealed marked fibroblastic proliferation and pronounced dermal fibrosis, along with epidermal changes of hyperkeratosis, focal hypergranulosis, and papillomatosis. These findings are consistent with connective tissue nevus with epidermal changes suggestive of epidermal nevus. Therefore a deep biopsy is strongly suggested to rule out the possibility of connective tissue nevus in suspected cases of atypical linear epidermal nevus. PMID- 3819064 TI - Zinc deficiency in two full-term breast-fed infants. AB - Zinc deficiency occurs as a genetic disorder, acrodermatitis enteropathica, or as an acquired disorder resulting from inadequate intake or malabsorption of zinc. It is now apparent that human breast milk may not always protect against the development of clinical zinc deficiency in premature and in full-term infants. In the absence of other predisposing factors, low levels of zinc in breast milk may precipitate zinc deficiency in breast-fed infants. This report confirms that breast-fed full-term infants may develop a clinical picture indistinguishable from acrodermatitis enteropathica. PMID- 3819065 TI - Syringoma presenting as milia. AB - We present two unrelated patients with numerous infraocular milium-like lesions that histologically revealed syringoma with many overlying keratin cysts in the papillary dermis. A Fontana-Masson stain revealed no melanin-containing cells in the keratin cyst walls, suggesting that they originated from eccrine ductal structures. A classification of the clinical variants of syringoma is presented. PMID- 3819066 TI - Connective tissue diseases and bovine collagen implants. AB - Bovine collagen implants are biomaterial used for the correction of dermal contour deformities. The use of bovine collagen implants in patients with a personal history of autoimmune diseases is contraindicated by the manufacturer. In our study, sera from fifty patients with scleroderma, rheumatoid arthritis, and systemic lupus erythematosus were examined for antibodies to bovine collagen implants by means of a previously described enzyme-linked immunosorbent assay. None of the patients had received bovine collagen implants. The anti-bovine collagen implant antibody levels in the sera of patients with scleroderma, systemic lupus erythematosus, and rheumatoid arthritis were not, in general, statistically different from those in the normal population. PMID- 3819068 TI - Lymphomatoid papulosis following Hodgkin's disease. AB - Lymphomatoid papulosis has occurred in association with Hodgkin's disease. In all cases previously described, Hodgkin's disease has developed after, or concurrently with, the onset of lymphomatoid papulosis. Two patients who developed lymphomatoid papulosis 1 and 10 years after the diagnosis and therapy for advanced Hodgkin's disease are reported. The purpose of this report is to document this unusual sequence. PMID- 3819067 TI - Quantification of cutaneous mast cells using morphometric point counting and a conjugated avidin stain. AB - Mast cells in normal human skin and in lesional cutaneous tissue from two patients with mastocytosis were quantified with the use of a morphometric point counting technic in combination with the mast cell-specific stain, conjugated avidin. Mast cells in normal human flank skin occupied a relatively small percentage of the dermal volume, with a mean value of 0.40% (+/- 0.14 SD), while a marked increase in mast cell content was demonstrated in cutaneous lesional tissue from two patients with the macular and nodular forms of mastocytosis (2.5% and 64.3%, respectively). In a comparative study with the use of morphometric analysis, conjugated avidin proved objectively to be as good as toluidine blue, and subjectively superior to this stain for mast cell identification in both human and murine skin. The combination of morphometric point counting and the conjugated avidin stain provides a useful tool for establishing the diagnosis of mastocytosis and is applicable to a variety of experimental systems. PMID- 3819069 TI - Ecology of dermatophyte infections in South Bronx, New York, 1969 to 1981. AB - This survey describes the ecology of superficial dermatophyte infections in South Bronx, New York from 1969 to 1981. The predominant species were Trichophyton rubrum (Castellani) Sabouraud, 1911 (57.5%), followed by Trichophyton tonsurans Malmsten, 1845 (18.5%), Trichophyton mentagrophytes (Robin) Blanchard, 1986 (11.5%), Microsporum canis Bodin var. canis Matsumoto, Padhye, and Ajello, 1902 (5%), Epidermophyton floccosum (Harz) Langeron and Milochevitch, 1930 (3.9%), and M. audouinii Gruby, 1843 (2.8%). PMID- 3819070 TI - Familial anetoderma. AB - Two families with anetoderma are described. Unlike previous reports of familial anetoderma, the disease process seemed to be limited to the skin, and there were no associated ocular, gastrointestinal, or orthopedic anomalies in the affected patients or in any other family members. Although infrequently reported, anetoderma may occur in families, and patients must be examined for associated systemic abnormalities for a thorough assessment of their skin disorder. PMID- 3819071 TI - Comparison of methods for assessing photoprotection against ultraviolet A in vivo. AB - Photoprotection against ultraviolet A (UVA) by three sunscreens was evaluated in humans, with erythema and pigmentation used as end points in normal skin and in skin sensitized with 8-methoxypsoralen and anthracene. The test sunscreens were Parsol 1789 (2%), Eusolex 8020 (2%), and oxybenzone (3%). UVA was obtained from two filtered xenon-arc sources. UVA protection factors were found to be significantly higher in sensitized skin compared with normal skin. Both Parsol and Eusolex provided better and comparable photoprotection (approximately 3.0) than oxybenzone (approximately 2.0) in sensitized skin, regardless of whether 8 methoxypsoralen or anthracene was used. In normal unsensitized skin, Parsol 1789 and Eusolex 8020 were also comparable and provided slightly better photoprotection (approximately 1.8) than oxybenzone (approximately 1.4) when pigmentation was used as an end point. The three sunscreens, however, were similar in providing photoprotection against UVA-induced erythema. Protection factors obtained in artificially sensitized skin are probably not relevant to normal skin. It is concluded that pigmentation, either immediate or delayed, is a reproducible and useful end point for the routine assessment of photoprotection of normal skin against UVA. PMID- 3819073 TI - A possible new tool for clinical diagnosis of melanoma: the computer. AB - The analysis of cutaneous melanoma images by two coupled computers (IBM 7350/4361) was carried out on twenty color slides. Each color slide was digitized with a spatial reduction of 25 X 25 microns. Classic technics of digital image analysis and new algorithms were used to improve the contrast on the full image or a portion of it, contrast a skin lesion with statistical information deduced from another lesion, evaluate the shape of the lesion, the roughness of the surface, and the transition region from the lesion to the normal skin, and analyze a lesion from the chromatic point of view. The theoretical reasons of interest are to have an objective method that is easy to standardize and reliably repeatable and to be able to analyze details not perceivable by the human eye. If the same technic are used in the evaluation of histologic characteristics of the lesions, a chance of making much more sophisticated clinicopathologic correlations will be available. The system needs to be improved at the technical level so that the response time of acquisition of the digitized images is shortened by the use of a digital television camera and the development of new computer programs to be run on a small computer. Evaluation of the system's sensitivity and specificity and an adequate clinical trial are needed. PMID- 3819072 TI - The infected hairs of tinea capitis due to Microsporum canis: demonstration of uniqueness of the hair cuticle by scanning electron microscopy. AB - Scanning and transmission electron microscopic studies were done on scalp hairs of four patients infected with ectothrix Microsporum canis. Both freeze fracture and cross-sectioning of hairs revealed a thick sheath of fungal spores encircling the hair shaft beneath an intact cuticle. These spores were not visible on surface inspection but became apparent only where the cuticle had been rubbed off or broken. Daily selenium sulfide shampoos removed all of the spores from these sites. The cuticle is viewed as being an effective barrier to the penetration of fungi, so that the hair is vulnerable to fungus infection only deep within the hair follicle below the level of the mature cuticle. Once the fungus enters the hair cortex just above the hair bulb, it produces myriads of spores that remain trapped and hidden beneath the cuticle for the length of the intact hair. PMID- 3819074 TI - Pulmonary complications following methotrexate therapy. AB - Methotrexate is frequently used in the treatment of severe psoriasis, and its hepatotoxicity has long been recognized by dermatologists. Pulmonary complications resulting from use of the drug are uncommon but should be considered in any patient on methotrexate who develops pulmonary symptoms in the absence of infection. We describe two patients, one who developed an acute pneumonitis and one with progressive pulmonary fibrosis following long-term, low dose methotrexate for psoriasis. Early recognition of these complications by lung function testing and withdrawal of the drug, when necessary, may arrest or reverse methotrexate-induced lung disease. PMID- 3819075 TI - Skin abscesses caused by Candida albicans in heroin abusers. PMID- 3819076 TI - Urticaria pigmentosa and sunlight. PMID- 3819077 TI - Treatment of psoriatic arthritis with bromocriptine. PMID- 3819078 TI - Bronchial reactions to photochemotherapy (PUVA) PMID- 3819079 TI - Malignant pyoderma. PMID- 3819080 TI - Effect of time on male pattern baldness. PMID- 3819081 TI - Acquired ichthyosis in a patient with acquired immunodeficiency syndrome and Kaposi's sarcoma. PMID- 3819082 TI - Norwegian scabies in acquired immunodeficiency syndrome: report of a case resulting in death from associated sepsis. PMID- 3819083 TI - The skin in Ehlers-Danlos syndrome. PMID- 3819084 TI - Melanomas arising in married couples. PMID- 3819085 TI - Topical (bathwater) PUVA therapy. PMID- 3819086 TI - Skin tags and colonic polyps. PMID- 3819087 TI - Skin tags and colonic polyps--a gastroenterologist's perspective. PMID- 3819088 TI - Basic science conferences in residency training: a national survey. AB - Basic science teaching is an important component of dermatology residency training, and the basic science conference is the major tool utilized by departments of dermatology for its implementation. To characterize the role of basic science conferences in dermatology training, a national survey of chief residents was conducted. Although the survey confirmed that a high value is placed on basic science conferences, a surprising finding was a significant level of dissatisfaction among chief residents, particularly those from university based programs. Results of the survey have been used to redefine our own objectives in basic science teaching and to propose elements of methodology and curriculum. PMID- 3819089 TI - Laugier-Hunziker syndrome. AB - The Laugier-Hunziker syndrome represents a rare acquired pigmentary disorder of the lips, oral mucosa, and nails. We report the first case of this syndrome to be recognized in the United States and review other causes of hyperpigmentation in these locations. PMID- 3819090 TI - Subcutaneous fat necrosis of the newborn with hypercalcemia. AB - A newborn infant with subcutaneous fat necrosis and hypercalcemia is presented. Literature on the association between subcutaneous fat necrosis of the newborn and hypercalcemia is reviewed. Affected infants generally experience severe perinatal difficulties. Both vaginal deliveries and cesarean sections can be associated with subcutaneous fat necrosis. PMID- 3819091 TI - Severe ocular involvement in a patient with epidermolysis bullosa acquisita. AB - A patient with epidermolysis bullosa acquisita and prominent ocular involvement that resulted in blindness is described. Because the severe eye involvement dominated the clinical picture, she had been diagnosed as having cicatricial pemphigoid. Clinicians should be aware that epidermolysis bullosa acquisita may mimic cicatricial pemphigoid and bullous pemphigoid. PMID- 3819092 TI - Metastatic squamous cell carcinoma in linear porokeratosis of Mibelli. AB - We describe the clinical and pathologic observations of a 45-year-old woman with linear porokeratosis who developed squamous cell carcinoma in lesional sites. The squamous cell carcinoma metastasized to a regional lymph node. This is the second case of metastatic squamous cell carcinoma reported in porokeratosis and the first reported in the linear variety. PMID- 3819093 TI - Fibrofolliculomas, trichodiscomas, and acrochordons: the Birt-Hogg-Dube syndrome. AB - The Birt-Hogg-Dube syndrome is a triad of cutaneous lesions including multiple fibrofolliculomas, trichodiscomas, and acrochordons. The inheritance is autosomal dominant in nature. We present a family of three with multiple firm, skin-colored papules in whom the three types of lesions are documented. In addition, we discuss the clinical differential diagnosis of multiple firm, skin-colored papules. PMID- 3819094 TI - Thrombotic phenomena associated with intravenous cocaine. AB - A patient with infarctive skin lesions and associated involvement of the kidney and liver caused by an intravenous overdose of cocaine is described. The thrombotic tendency may possibly be related to endothelial cell damage from prolonged vasoconstriction or cocaine toxicity, with disturbance of prostacyclin thromboxane balance and enhancement of platelet aggregation and thrombotic tendency. PMID- 3819095 TI - Concurrent features of cutaneous lupus erythematosus and pemphigus erythematosus following myasthenia gravis and thymoma. AB - A case that exhibits the pathologic features of cutaneous lupus erythematosus and the immunopathologic characteristics of pemphigus erythematosus following myasthenia gravis and thymoma is presented, and the literature pertaining to these disease associations is reviewed. The findings in this case were analyzed with respect to the accepted diagnostic criteria for lupus erythematosus, pemphigus, and pemphigus erythematosus. The pathogenic mechanisms that lead to acantholysis in pemphigus are examined in an attempt to explain why acantholysis did not occur in this case. PMID- 3819096 TI - Azathioprine in the treatment of pemphigus vulgaris. A long-term follow-up. AB - In a prospective long-term study, thirty-seven patients with severe generalized pemphigus vulgaris were treated with a combined corticosteroid-azathioprine regimen. Twenty-nine patients were available for complete follow-up lasting from 4 to 16 years after initiation of therapy. At the time of final evaluation, twenty-seven patients (93%) were alive; two deaths were unrelated to therapy; thirteen (45%) of the patients were free of disease and had not received treatment for up to 132 months; five of these patients had been off therapy for periods ranging from 60 to 132 months; eleven (38%) of the patients were clinically free of disease but still had low titers of antibodies and thus required low-dose maintenance therapy; five (17%) of the patients were well controlled but not completely free of disease. Side effects were rare and mostly related to corticosteroids. Of the original thirty-seven patients, only one death related to disease or therapy occurred and was due to pulmonary tuberculosis. It is concluded that azathioprine-corticosteroid treatment of pemphigus is highly effective and safe; it leads to long-term remissions in most patients and possibly to a cure in some. PMID- 3819097 TI - Cutaneous sarcoidosis in Caucasians. AB - One hundred eighty-eight Caucasian patients with cutaneous sarcoid lesions were studied prospectively. Twenty-five had erythema nodosum, while 163 had infiltrative cutaneous lesions. One hundred thirty-eight patients had systemic as well as cutaneous lesions, and fifty had cutaneous lesions only. All types of clinical lesions were seen among patients with cutaneous lesions only. The extent of cutaneous lesions did not correlate with the extent of systemic disease. Papular lesions were relatively uncommon and occurred as the only manifestation of the disease or were associated with hilar adenopathy and acute disease. Lupus pernio, scar infiltrates, and plaque lesions were the most common clinical lesions and were typically chronic and commonly associated with pulmonary mottling and/or fibrosis. Forty-eight of 127 had a histologically positive Kveim test. Among patients followed for more than 2 years, dinitrochlorobenzene (DNCB) sensitivity was higher among those with acute disease than among those with chronic disease. Seventy-nine patients with infiltrative cutaneous lesions were followed until the cutaneous lesions had healed. Those with lupus pernio were often left with unsightly telangiectatic scars, while the other types of lesions left either pale, slightly depressed scars or no scars at all. PMID- 3819098 TI - Pathologic features of diabetic thick skin. AB - Skin thickening simulating scleroderma, or progressive systemic sclerosis, has previously been reported in children and adults with insulin-dependent diabetes mellitus. We have studied eighty-nine patients with insulin-dependent diabetes mellitus and twenty-five normal control subjects. Clinical evidence of skin thickening (diabetic thick skin) was found in 22% of patients with insulin dependent diabetes mellitus and in 4% of control subjects (p less than 0.05). Full-thickness skin biopsy specimens were taken from the forearm of nine patients with insulin-dependent diabetes mellitus and diabetic thick skin, four patients with insulin-dependent diabetes mellitus and clinically normal skin, four patients with progressive systemic sclerosis, and four normal control subjects. The sections stained with hematoxylin and eosin showed increased thickness of the dermis of the forearm skin in all diabetic patients. In diabetic thick skin the collagen bundles were large, disorganized, and separated by clear spaces. Small amounts of acid mucopolysaccharides were present in the upper reticular dermis of five patients with diabetic thick skin. Electron microscopy of the dermis showed capillary basement membrane thickening in Groups 1, 2, and 3. All patients with diabetic thick skin showed active fibroblasts and extensive collagen polymerization in the rough endoplasmic reticulum. Occasional collagen flowers were noted in all patients with diabetic thick skin. Measurements of 100 collagen fibers in the upper and lower reticular dermis of each biopsy specimen showed predominance of large fibers (greater than 60 nm) in Groups 1 and 2. Unlike scleroderma, diabetic thick skin resulted in small fiber sizes (less than 60 nm) only rarely, and bimodality of fiber sizes was not seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819099 TI - Melanoma/skin cancer screening in Michigan. AB - The Michigan Dermatological Society sponsors free skin cancer detection clinics annually. In 1985, fifty-four volunteer dermatologists screened 1,909 patient participants. In 1986, following establishment of the program and structure discussed here, 102 volunteer dermatologists screened 4,431 patient-participants. PMID- 3819100 TI - Pigmentary demarcation lines: a population survey. AB - An examination of 380 patients was accomplished in order to determine the frequency of occurrence of pigmentary demarcation lines in an unselected population. Both white and black patients were included in the study, and there was an equal sex distribution. Separation of data by age groups enabled us to determine that the age of onset is in early childhood in the majority of cases. Seventy-nine percent of black female adults have at least one type of pigmentary demarcation line, with types A and B being present in over 50% of the cases. Seventy-five percent of black male patients had at least one pigmentary demarcation line, with type C being most prevalent. Fifteen percent of white female patients had one pigmentary demarcation line. Finally, it was determined that seven of fifty black women (14%) had the new appearance of type B lines with pregnancy. PMID- 3819102 TI - Computers in dermatology. Review of communication software for dermatology. PMID- 3819101 TI - Familial granuloma annulare. Report of two cases and review of the literature. AB - We report two sisters with granuloma annulare who possessed identical histocompatibility antigens. The occurrence of granuloma annulare in families and the demonstration of particular human lymphocyte antigens (HLA) with granuloma annulare may indicate that hereditarily predisposed individuals could develop this specific cell-mediated immune reaction in response to an unknown antigen (e.g., connective tissue or infectious or toxic substances). PMID- 3819103 TI - Intracellular elastin in cutaneous giant cell reaction. PMID- 3819104 TI - Desmoplastic melanoma of the penis. PMID- 3819105 TI - Topical erythromycin preparations. PMID- 3819106 TI - Subcutaneous fat necrosis and brown fat deficiency. PMID- 3819107 TI - Acquired ichthyosis associated with dermatomyositis. PMID- 3819108 TI - Degradation of anthralin by coal tar. PMID- 3819109 TI - Chloroquine-induced neutropenia in a patient with dermatomyositis. PMID- 3819110 TI - Antibacterial therapy. PMID- 3819111 TI - Earrings for nickel-sensitive women. PMID- 3819112 TI - Antibacterial therapy continued. PMID- 3819113 TI - Commercial air travel and medical kits. PMID- 3819114 TI - Melanoma/skin cancer screening program in a private office setting. PMID- 3819115 TI - Skin cancer screening--a local experience. AB - During a local voluntary Melanoma/Skin Cancer Detection Week, 983 participants were screened with 356 (36%) referrals made to exclude possible malignancy of the skin. The median age of the screened participants was 59 years, with actinic keratosis (62%) the most common referral diagnosis. Referrals for presumptive clinical diagnoses of basal cell carcinomas and malignant melanomas numbered 28% and 8%, respectively. Through the support of the local media and a central organized format, local skin cancer detection programs can successfully screen large numbers of participants. These examinations provide maximum visibility for dermatologists while meeting the primary goals of early disease detection and enhancing public awareness of skin cancer and the harmful effects of actinic radiation. PMID- 3819116 TI - MR relaxation times of cerebrospinal fluid. AB - A review of 15 recent publications purporting to provide the relaxation times of CSF reveals a considerable disparity in the quoted results, by a factor of five in terms of T1 (range 1,000 to 5,500 ms) and by a factor of 16 for T2 (range 166 to 2,640 ms). In this article measurements are performed independently on both a spectrometer and an imager. The results indicate that for CSF T1 is greater than 3,000 ms and T2 is approximately 2,000 ms at 6 MHz. The vast differences in relaxation behaviour between CSF and other body tissues have considerable clinical implications and present profound diagnostic opportunities. The application of this knowledge to ventriculography, myelography, and image contrast methodology is discussed. PMID- 3819117 TI - Anterior and posterior lobes of the pituitary gland: assessment by 1.5 T MR imaging. AB - Pituitary glands of 60 normal volunteers (30 men 20-36 years old, and 30 women 18 42 years old) were studied by 1.5 T magnetic resonance (MR) imaging. The T1 weighted images (T1WI) [repetition time (TR) = 400 ms; echo time (TE) = 25 ms] were obtained in the coronal, sagittal, and axial planes. Proton density (PD)/T2 weighted images (PDWI/T2WI) (TR = 2,000 ms; TE = 25/100 ms) were obtained in the sagittal plane using 3 mm slice thickness. On T1WIs of all subjects the posterior part (PP) of the pituitary fossa showed the highest signal, which was indistinguishable from fatty tissue. This study reveals that this region of high signal intensity (PP) corresponds to the posterior lobe and not intrasellar fat because its shape, size, and position are compatible with the posterior lobe; its signal intensity differs from that of fatty tissue on PDWI and T2WI; the absence of an intrinsic chemical shift artifact (CSA) characteristic of fat; and due to CSA, a dorsum with fatty marrow is shifted relative to the PP (or may be made to merge with it). Regarding the differentiation of the two lobes of the pituitary gland on MR, the morphology of the anterior and posterior lobes was evaluated and great variation found. Appreciation of normal is particularly important in evaluating coronal images for small pituitary lesions. PMID- 3819118 TI - Posterior lobe of the pituitary in diabetes insipidus: MR findings. AB - The posterior lobe of the pituitary gland was evaluated by 1.5 T magnetic resonance (MR) in five cases of diabetes insipidus (DI), including one primary (idiopathic) and four secondary DI cases due to germinomas (two), teratoma (one), and histiocytosis X (one). The normal posterior lobe displays high signal indistinguishable from fatty tissue on T1-weighted images (T1WI) (short T1 value). In all five DI cases the normal high signal of the posterior lobe was not detected in the pituitary fossa on T1WI. Hence, because of this characteristic finding, MR may greatly assist in the diagnosis of DI. We may speculate that the short T1 value of the posterior lobe is closely related to its functional integrity and may be due to the neurosecretory materials in the axons of the hypothalamohypophyseal tract. PMID- 3819119 TI - Accelerated myelination in early Sturge-Weber syndrome demonstrated by MR imaging. AB - Magnetic resonance imaging of the brain in two infants with Sturge-Weber syndrome has demonstrated a pattern of accelerated myelination in the abnormal cerebral hemisphere. The extent of myelination was most apparent on the T1-weighted inversion recovery sequence while the T2-weighted images demonstrated concomitant changes in hydration of the brain. We propose an explanation for this finding based on cerebral ischemia underlying the leptomeningeal angioma. PMID- 3819120 TI - MR imaging of intracranial arachnoid cysts. AB - The magnetic resonance characteristics of 16 intracranial arachnoid cysts were evaluated and several features identified that allowed the differentiation from other cystic lesions. Uncomplicated arachnoid cyst contents respond like CSF to both T1 and T2 weighted sequences. Signal from the contiguous brain is of normal intensity. The absence of signal from cortical bone and the ease of obtaining multiplanar views enable the margins of the cyst, its contents, and the full extent of the lesion to be easily defined. PMID- 3819121 TI - Spinal subarachnoid tumor seeding from intracranial metastasis: MR findings. AB - We describe the magnetic resonance findings in two cases of spinal subarachnoid seeding from an intracranial metastatic lesion. Magnetic resonance imaging techniques using T1 and intermediate T1-T2 pulse sequences improve anatomical definition of the spinal cord-thecal sac and allow for optimal contrast to define metastatic deposits in the subarachnoid space. Heavily T2 weighted pulse sequences do not appear to be useful in the diagnosis of subarachnoid metastases. PMID- 3819122 TI - Spinal cord compression induced by steroid therapy: CT findings. AB - Long-term steroid therapy has many well documented complications. Both epidural fat deposition and vertebral compression fractures are among such complications. We report two cases in which acute paraplegia occurred following compression fracture without retropulsion of bone fragments or significant narrowing of the spinal canal. However, both patients had abnormally large epidural fat deposits as an underlying and contributing condition. Therapy to relieve the compression was disappointing. PMID- 3819123 TI - MR imaging of normal extrahepatic bile ducts. AB - Abdominal scans of 48 patients without evidence of biliary tree or pancreatic head pathology were retrospectively evaluated to determine how often the normal common bile duct (CBD) could be visualized, as well as to determine which projections and pulse sequences optimized its visualization. Axial sequences with long repetition time (TR) and for echo time (TE) intervals (2,000-2,500 and 60-80 ms, respectively) were the most useful, identifying the normal CBD in 15 of 30 diagnostic studies. Axial sequences using short TR/TE intervals (300-800 and 20 25 ms, respectively) were less informative, identifying the CBD in only eight of 30 studies. Coronal studies were not useful, identifying the CBD in only one of 10 long TR/TE pulse sequences. PMID- 3819124 TI - Computed tomography of masses in periportal/hepatoduodenal ligament. AB - The CT findings in 70 patients with masses in or adjacent to the porta hepatis/hepatoduodenal ligament were analyzed. Underlying disease processes included metastatic disease (44 cases), lymphoma/leukemia (10 cases), biliary carcinoma (seven cases), hepatoma (four cases), benign disease (three cases), and gallbladder carcinoma (two cases). Location of the mass was confirmed in 62 patients and showed six patterns: four along the hepatoduodenal ligament or within the porta hepatis; another within the liver impinging on the hepatoduodenal ligament/porta hepatis; the sixth, an intraductal mass. Of the masses along the hepatoduodenal ligament or within the porta hepatis the four patterns were well defined nodular masses caused by discrete nodes; matted masses due to confluent adenopathy; mixed, well defined and confluent masses in various locations along the hepatoduodenal ligament; infiltrating, enhancing soft tissue densities obscuring the portal vein margins. No disease specific pattern was seen; nonetheless, knowledge of these patterns is very helpful in detection of masses in this region. PMID- 3819125 TI - CT and MR imaging of radiation hepatitis. AB - The authors describe two cases of radiation hepatitis evaluated by magnetic resonance imaging and CT with CT angiography (CTA) additionally performed in one patient. On CT the radiation hepatitis appeared as sharply demarcated region of lower attenuation than the adjacent normal liver. The region of radiation hepatitis demonstrated decreased perfusion in the portal venous phase of CTA, and 4 min delayed images following CTA showed increased density or relative increased accumulation of contrast. Magnetic resonance in both cases showed that the area of low density on CT had high signal on the T2-weighted image and had increased water content as determined by proton spectroscopic imaging method. PMID- 3819126 TI - Computed tomography of hepatic fascioliasis. AB - In seven patients with active fascioliasis of the liver, CT revealed nodular intrahepatic lesions of diminished attenuation, as well as peripheral branching formations. Computed tomography was negative in a single patient with quiescent disease. Computed tomography can be a useful tool for the diagnosis of this disease during the invasive period and also to evaluate response of patients to medical treatment. PMID- 3819127 TI - MR and CT demonstration of levator sling in congenital anorectal anomalies. AB - Demonstration of the levator ani muscle is important in evaluating children with anorectal anomalies. Using magnetic resonance and CT we have imaged the levator sling in three children prior to their definitive surgery for imperforate anus. The levator mechanism was seen as a low signal band extending from the coccyx to the pubis. PMID- 3819128 TI - CT demonstration of dissecting hematoma originating in abdominal aorta. AB - This report presents two cases of abdominal aortic dissecting hematoma without involvement of the thoracic aorta. Computed tomography can reliably diagnose or exclude aortic dissection by demonstrating the specific findings of an intimal flap and displacement of intimal calcification into the aortic lumen. PMID- 3819129 TI - CT evaluation of myometrium invasion in endometrial carcinoma. AB - Myometrium invasion (M) is one of the principal prognostic factors in the early clinical stages of endometrial carcinoma and can be evaluated presurgically only by CT, although with conflicting results. We compared CT of 65 patients with early clinical stage endometrial carcinomas with the corresponding anatomopathological findings. Myometrial infiltration of the same degree may present different CT images. Therefore, we identified five fundamental CT patterns, each of which corresponded to one of the three degrees of myometrium infiltration (M1, M2, M3). Furthermore, we defined the infiltration index as the ratio of minimum free myometrium to maximum free myometrium. Overall diagnostic accuracy was 76%; however, for clinical purposes CT provided adequate guidelines for therapeutic decisions in 93% of the cases. These criteria proved to be less reliable in elderly women with atrophic myometria, especially when the neoplasia was polypoid in shape. PMID- 3819130 TI - Limitations of CT in evaluation of neoplasms involving chest wall. AB - We reviewed the CT of 20 patients with peripheral lung malignancies in which CT appearance suggested chest wall invasion on the basis of extension of mass around ribs into fat or muscle of the chest wall, or definite bone destruction. We correlated these findings with other radiographic studies and surgical and autopsy results. All 11 cases in which CT indicated chest wall involvement on the basis of definite bone destruction were confirmed. Tumor extension into the chest wall was disproven in six of the remaining nine cases in which invasion was suggested on the basis of tumor infiltration between ribs or extension of tumor into fat or soft tissue planes. Our findings confirm the lack of reliability of CT findings in determining the extension of malignancy into the chest wall, except when definite bone destruction is present. PMID- 3819131 TI - Venous air embolization as a complication of pressure injection of contrast media: CT findings. AB - Pressurized contrast medium infusion for CT carries a risk of potentially fatal air embolization if improperly or carelessly administered. Two cases of intracardiac air embolization and three cases of subclavian venous air due to faulty contrast medium administration have been seen by the authors during a 2 year period. PMID- 3819132 TI - MR imaging of osteochondral lesions of talus. AB - Ten patients with osteochondral lesions of the talus had magnetic resonance (MR) imaging to determine if this modality could accurately characterize the bone lesion and overlying articular cartilage. Eight patients had arthroscopy, five of whom also had arthrotomy. Magnetic resonance detected abnormal cartilage in all eight patients and disruption of cartilage in four of five, proven at surgery. One patient had disrupted cartilage at surgery not diagnosed by MR. Four patients had excision of the osteochondral fragment and curettage of the talar defect and in these patients MR accurately characterized the bony lesion. Three patients had conservative surgical procedures (drilling) and the extent of the bony lesion could not be determined at surgery. Magnetic resonance can accurately characterize the osteocartilaginous components of talus lesions and even though it should not replace plain radiography for diagnosis, it is ideally suited for evaluation of the articular cartilage and has proven to be useful in planning surgical procedures. PMID- 3819133 TI - Bone changes in oophorectomized monkeys: CT findings. AB - Single and dual energy CT (75 and 125 kVp) measurements of density were made on the excised lumbar vertebrae (L5) of oophorectomized (n = 17) and control (n = 19) monkeys. The single-energy results at 75 and 125 kVp indicated an annual bone diminution of 9.1 and 10.9%, respectively, but the dual-energy determination showed only a 6.6%/year loss. The difference between single- and dual-energy results could be explained by a putative increase in marrow fat of slightly greater than 100 mg/cm3. Changes in single-energy CT density with oophorectomy and aging may be substantially overestimated. PMID- 3819134 TI - Partially thrombosed giant aneurysm simulating an arteriovenous malformation on MR imaging. AB - A case of a partially thrombosed giant intracranial aneurysm with a magnetic resonance appearance simulating an arteriovenous malformation is presented. Causes for the similarity in signal pattern are discussed. PMID- 3819135 TI - Dural carcinomatosis: MR demonstration. AB - A case of pachymeningeal carcinomatosis is presented in which CT evaluation revealed an extraaxial, heterogeneous density over the left cerebral convexity. The finding was believed to be consistent with subdural hematoma, empyema, or meningeal thickening. Magnetic resonance evaluation demonstrated a similar crescentic lesion that was of intermediate signal intensity on both T1- and T2 weighted images. This was thought to be uncharacteristic of either subdural hematoma or empyema. The T2-weighted image showed CSF interposed between the cerebrum and the lesion, limiting the abnormality to the dura or subdural space. PMID- 3819136 TI - Atypical CT scans in adrenoleukodystrophy. AB - Computed tomography has become a valuable tool in the diagnosis of adrenoleukodystrophy because of a characteristic CT pattern of symmetrical low density areas in the parietooccipital region often with a peripheral rim of enhancement. However, a few cases have been reported that depart from this classic pattern. We have recently observed an atypical CT pattern where instead of diminished attenuation in the white matter, extensive calcifications were seen with a symmetric distribution in the parietooccipital regions. There was no associated contrast enhancement. PMID- 3819137 TI - MR imaging of diffusely infiltrating gastric carcinoma. AB - Magnetic resonance imaging of a diffusely infiltrating gastric carcinoma showed a markedly thickened gastric wall with low signal intensity on T1 and T2 weighted images. The T2 relaxation of the thickened gastric wall was very short, which was consistent with the histologically proven fibrous nature of the lesion. PMID- 3819138 TI - Angiomyolipoma and renal cell carcinoma occurring in same kidney: CT evaluation. AB - A case of angiomyolipoma and renal cell carcinoma occurring adjacently in the same kidney without tuberous sclerosis is reported. It was difficult to differentiate the renal cell carcinoma from the angiomyolipoma by angiography, but CT was able to make this distinction. PMID- 3819139 TI - Extramedullary hematopoiesis in the adrenal glands: CT characteristics. AB - A patient with agnogenic myeloid metaplasia was discovered by CT to have bilateral asymmetric adrenal enlargement. A CT guided needle biopsy demonstrated extramedullary hematopoiesis. The CT and cytological findings are presented. PMID- 3819140 TI - CT detection of aortocaval fistula. AB - We describe a patient in whom a secondary aortocaval fistula was diagnosed on dynamic CT by noting transient enhancement of the inferior vena cava simultaneously with maximum enhancement of the aorta. This pattern of caval enhancement is contrasted with the gradual increase and subsequent plateauing of caval opacification seen normally. PMID- 3819141 TI - Aortocaval fistula: CT appearance with angiographic correlation. AB - As CT is often the initial imaging method in the evaluation of suspected complications of abdominal aortic aneurysm, especially rupture of the aneurysm, it is important to be aware of other less common complications that can be detected by CT. A patient with an aortocaval fistula and renal venous hypertension is discussed. The constellation of CT findings that suggest this diagnosis is described as is the angiographic correlation. Awareness of these CT findings, including early equivalent enhancement of the inferior vena cava and aorta; enlarged, poorly functioning kidney; and perirenal "cobwebs," will lead to the appropriate confirmatory angiographic studies. PMID- 3819142 TI - MR imaging of intradural disk herniation. AB - The magnetic resonance findings in a case of lumbar intradural disk herniation are described and compared with myelography. Magnetic resonance was superior to myelography in visualizing all components of the herniation including adhesions and inflammatory tissue. PMID- 3819143 TI - CT and MR findings in Aicardi syndrome. PMID- 3819144 TI - Transection of orbital rectus muscle demonstrated by computed tomography. PMID- 3819145 TI - Idiopathic inflammation of optic nerve simulating optic nerve sheath meningioma: CT demonstration. PMID- 3819146 TI - Ewing sarcoma of the temporal bone: CT appearance. PMID- 3819147 TI - MR imaging of mediastinal thymolipoma. PMID- 3819149 TI - Abstracts of papers presented at the 24th annual meeting of the American Society of Dermatopathology. New Orleans, Louisiana, USA, December 4-5, 1986. PMID- 3819148 TI - Primitive neuroectodermal tumor in the skin with features of neuroblastoma in an adult patient. AB - A case of primitive neuroectodermal tumor of an 81-year-old man is presented, which was located in the cutis. The occurrence in this age and this superficial location is unusual and raises wide differential diagnostic possibilities. The tumor demonstrated Homer Wright rosettes, was positive for neuron-specific enolase and ultrastructurally revealed neurosecretory granules. These features support the diagnosis of a peripheral neuroblastoma. We discuss the controversy about the terminology of peripheral neuroblastoma vs. neuroepithelioma, as well as the differential diagnosis of these tumors. PMID- 3819150 TI - Metabolism of the lactating cow. II. Digestive elements of a mechanistic model. AB - The structure and characteristics of a model suitable for estimating digestion within the rumen and rates and patterns of nutrient entry in lactating cows are presented. The model consists of 12 state variables comprising a large particle pool, small particle pools representing insoluble dietary nutrients, soluble pools representing soluble dietary nutrients, and fermentation intermediates and end products. The model was constructed assuming continuous feeding, using Michaelis-Menten or mass action kinetics. The computer program was written in ACSL to run on a VAX computer. A fourth-order Runge-Kutta procedure was used for numerical integration. Sensitivity and behavioural analysis demonstrated that overall stability and sensitivity of the model to individual parameters was generally satisfactory, but the need to improve the description and parameterization of aspects such as particle size in relation to availability, rate and affinity constants for amino acid degradation and rate constants for particle outflow from the rumen was established. Adjustments of the model to examine discontinuous feeding regimes were undertaken and initial results with respect to changes in fermentation rates, rumen acetate levels and microbial metabolism were considered realistic. Comparisons with experimental data were considered satisfactory on forage-based and medium concentrate-containing diets, but with diets comprising 90% cereal, some inconsistencies, especially with respect to predictions of volatile fatty acid production rates, were observed. Reasons for this are put forward and suggestions for improvements in the model are discussed. PMID- 3819151 TI - Effect of nature of forage on spontaneous lipolysis in milk from cows in late lactation. AB - Levels of free fatty acids (FFA) were determined in milk from cows after 7 months of lactation and 4 months of pregnancy immediately after milking (initial FFA) and after 22 h storage at 4 degrees C (FFA-22). During the pre-experimental period, cows were at pasture. When housed indoors (experimental period) they were fed hay or grass silage for 3 weeks. Then all cows received grass silage for 3 weeks (post-experimental period). Feeding hay did not increase FFA-22 content in milk compared with pasture, but grass silage feeding enhanced FFA-22 content in milk compared with pasture (+130%) or hay (+93%). Increased lipolysis with grass silage was not due to underfeeding of the cows because grass silage and hay were both of high nutritive value. As pasture, hay and grass silage were of the same type (native mountain grassland), the high level of lipolysis occurring with grass silage probably resulted from the method of forage conservation. PMID- 3819152 TI - Metabolism of the lactating cow. III. Properties of mechanistic models suitable for evaluation of energetic relationships and factors involved in the partition of nutrients. AB - Two models of lactating dairy cows were constructed by combining mechanistic models of digestion and metabolism reported previously and by adding elements to allow simulation of changes in tissue metabolic capacities over time. One model (day version) had an integration interval of 0.005 d and was suitable for simulation of within-day dynamics of nutrient supply and partition. The other (lactation version) had an integration interval of 1 d and was suitable for simulation of full lactation cycles. A number of simulation analyses were conducted to characterize and evaluate the models, to examine quantitative and dynamic properties of mechanisms which influence partition of nutrients, to identify aspects requiring further study, and to illustrate the potential usefulness of mechanistic, as compared to empirical, models in analyses of energy balance in lactating dairy cows. PMID- 3819153 TI - Optimization of porous glass chromatography for size-fractionation of bovine casein micelles. AB - Permeation chromatography on porous glass was carried out with skim milk at 20 or 30 degrees C using CPG-10 (50 nm) or a dual column system of CPG-10 (50 nm) followed by CPG-10 (300 nm). On columns of CPG-10 (50 nm) casein micelles were eluted at the void volume and were rapidly and efficiently resolved from non micellar protein without micelle dissociation. The dual column system resulted in the additional resolution of the micelles into different size ranges. Examination of the resolved micelle fractions by electron microscopy showed a gradual decrease of weight average diameter (Dw) from 228.4 nm in the void volume fraction to 86.3 nm in the smallest micelle fraction. The translucent upper layer of a micelle sediment obtained by ultracentrifugation of skim milk at 30 degrees C consisted of casein aggregates intermediate in size between monomeric protein and the bulk micelle fraction as shown by its elution behaviour on CPG-10 (50 nm). These aggregates were enriched more than 2-fold with kappa-casein relative to skim milk, were devoid of alpha S2-casein and had an estimated value of Dw of 33 nm. The ultracentrifugate serum contained approximately 2.5% of total milk casein which had the elution characteristics of monomeric protein on CPG-10 (50 nm). It was concluded that the translucent sediment consisted of the smallest micelle fraction of skim milk and represented the minimum size range for casein polymerization in the natural milk environment. Overall, the results show that porous glass chromatography is an effective and convenient tool for the isolation and study of casein micelles. PMID- 3819154 TI - Effect of combined ultrasonic and heat treatment (thermoultrasonication) on the survival of a strain of Staphylococcus aureus. AB - The combined effect of ultrasonic waves (20 kHz, 150 W) and heat treatment applied simultaneously (thermoultrasonication) on the survival of a strain of Staphylococcus aureus was studied in 0.05 M-phosphate buffer pH 6.8 and ultra heat-treated whole milk. This combined process decreased by 63% the decimal reduction times for the heat treatment when the organism was suspended in buffer and by 43% when suspended in milk. These effects were much greater than the additive effect of the two agents considered independently. PMID- 3819155 TI - Effect of breed of cow (Friesian and Montbeliarde) on spontaneous and induced lipolysis in milk. AB - Levels of free fatty acids (FFA) were determined immediately after milking (initial FFA), and after 22 h storage at 4 degrees C, either without (FFA-22) or with a mechanical induction of lipolysis (FFA-22I), in milk from Friesian and Montbeliarde cows in the same herd, at identical stages of lactation and pregnancy and receiving the same feeding regimes. There was no difference between the two breeds in initial FFA and FFA-22 contents whatever the lactation period. This was also true during late lactation when lipolysis was further increased after feeding a poor quality grass silage. The observation that milk FFA-22I content from the Montbeliarde cows was higher than that from Friesian cows in summer, but not in winter, requires cautious interpretation as the activation treatments were not comparable, owing to the different ambient temperatures during activation in these two periods. PMID- 3819156 TI - Metabolism of the lactating cow. I. Animal elements of a mechanistic model. AB - A mechanistic model of dairy cow metabolism is described. The model was constructed as part of a programme directed toward quantitative and dynamic analysis of concepts and data regarding factors which influence the partition of nutrients in lactating dairy cows. Sensitivity and behavioural analyses undertaken using the model indicate that concepts and data arising from tissue level experiments conducted in vitro can be used to structure and parameterize whole-animal models since the quantitative and dynamic behaviour of such a model is acceptable. These analyses indicate further that such models can be used to evaluate factors which influence patterns of nutrient utilization. By way of illustrating the model's utility regarding evaluation of concepts relating to the interpretation of energy balance experiments, results of a simulated energy balance experiment are presented. Apparent costs of milk synthesis are partitioned among biosynthetic costs, physiological costs, ion transport costs and the reductions in energy expenditures in synthesis of body components which accompany increasingly negative energy balances due to feed restriction. PMID- 3819157 TI - Hair graft trimming--or not? PMID- 3819158 TI - Stump the experts: granuloma annulare disseminatum. PMID- 3819159 TI - Learning the basics #5: segmental cryosurgical treatment. PMID- 3819160 TI - The midline forehead island flap. AB - The midline forehead island flap exemplifies pedicled island flaps based on random circulation. The use of this flap for medial canthal reconstruction is set forth by photographs, diagrams, and appropriate commentary. PMID- 3819161 TI - Multiple eruptive vellus hair cysts treated with carbon dioxide laser vaporization. AB - The use of carbon dioxide laser to treat multiple facial, eruptive vellus hair cysts is described. An excellent cosmetic result without scarring or recurrence of lesions was obtained. PMID- 3819162 TI - Pregnancy and hormonal influences on malignant melanoma. AB - Halo cutaneous melanoma developed in a 30-year-old woman. Following wide excision of the melanoma, she remained clinically free of tumor for 5 years. In a subsequent pregnancy, she developed metastases to the liver which became evident in the immediate postpartum period. Long-term survival associated with cutaneous hypopigmentation has been reported and occurred in our patient. The interaction between hormonal and immunologic factors and melanoma is explored. PMID- 3819163 TI - Treatment of flat facial warts with interferon-beta cream. PMID- 3819164 TI - [Physicochemical patterns in body adaptation to extreme exposures]. PMID- 3819165 TI - [Importance of monovalent cations in tetracycline antibiotic transport in bacteria]. PMID- 3819166 TI - [Enhancement of erythrocyte hemolytic resistance by derivatives of nitrogenous heterocycles]. PMID- 3819167 TI - Frequency discrimination in the mammalian cochlea: theory versus experiment. AB - A three-dimensional hydroelastic model for the motion in the cochlea is analyzed for the case of a pure-tone forcing. It is shown to agree well with experiment, including moderate intensity tuning curves and the frequency map, for a variety of mammals. In doing this, the parameters that are needed for each animal are geometric; thus the theory is easy to apply. The analysis also indicates that the fluid viscosity is the dominant dissipation mechanism, at least for moderate to high frequencies. PMID- 3819168 TI - Threshold characteristics of the human auditory brain stem response. AB - Auditory brain stem responses (ABRs) were recorded from ten normal-hearing subjects in response to 100-microseconds clicks from a TDH 49 earphone at a rate of 48 pps and at levels randomly varied in 2-dB steps between 34 and 52 dB p.e. SPL. At each level, 10 000 epochs were averaged with use of a weighted concept and a running estimate was made of the signal-to-noise ratio (SNR). This quantity was used to detect the presence of the ABR and the median threshold was found at 38 dB p.e. SPL. The mean averaged background noise level was 11.3 nVrms, and the "true" ABRrms amplitude function crossed this value at 35.5 dB p.e. SPL, which indicates the level where the SNR = 1. By extrapolation, it was found that the ABR amplitude became zero at 32 dB p.e. SPL. The perceptual thresholds of the click were estimated by means of a modified block up-down procedure, and the median value was found at 33 dB p.e. SPL. The slope of the amplitude function and the magnitude of the averaged background noise are the two factors responsible for the ABR threshold sensitivity, which thus depends on both physiological and technical parameters. Therefore, these have to be considered together with the method of detection when the ABR is used to indicate the hearing sensitivity. PMID- 3819169 TI - Binaural versus monaural loudness: supersummation of tone partially masked by noise. AB - A series of three experiments used the method of magnitude estimation to examine binaural summation of the loudness of a 1000-Hz tone heard in the quiet and against various backgrounds of masking noise. In the quiet, binaural loudness as measured in sones, is twice monaural loudness. Two conditions of noise masking acted to increase the ratio of binaural/monaural loudness in sones above 2:1- that is, to produce supersummation. (1) When tone was presented to both ears, but masking noise to just one ear (dichotic stimulation), the loudness of the binaural tone was 30%-35% greater than the sum of the loudness of the monaural components. This increase in summation provides a suprathreshold analog to increases in threshold sensitivity observed with dichotic stimulation (masking level differences). (2) Supersummation was also evident when tone and noise alike were presented to both ears (diotic stimulation); here, the binaural tone's loudness was 10%-25% greater than the sum of the monaural components. The increase in summation with diotic stimulation may be related to the characteristics of binaural summation of the noise masker itself. PMID- 3819170 TI - Comparative learning of pitch and loudness identification. AB - This study investigated possible similarities between the ability to identify pitches and the ability to identify loudnesses. Systematic training of musically naive subjects indicated that frequency identification performance improves at about the same rate as intensity identification performance. Examination of frequency and intensity identification behavior of musically trained subjects showed that their ability to code pitch information efficiently does not generalize to an ability to encode loudness information more efficiently than untrained subjects. Intensity identification training curves of musically trained and untrained subjects are similar, but final performance levels are below frequency identification performance levels exhibited by musically trained subjects, especially those with absolute pitch. PMID- 3819171 TI - Temporal gap resolution in listeners with high-frequency sensorineural hearing loss. AB - Temporal gap resolution was measured in five normal-hearing listeners and five cochlear-impaired listeners, whose sensitivity losses were restricted to the frequency regions above 1000 Hz. The stimuli included a broadband noise and three octave band noises centered at 0.5, 1.0, and 4.0 kHz. Results for the normal hearing subjects agree with previous findings and reveal that gap resolution improves progressively with an increase in signal frequency. Gap resolution in the impaired listeners was significantly poorer than normal for all signals including those that stimulated frequency regions with normal pure-tone sensitivity. Smallest gap thresholds for the impaired listeners were observed with the broadband signal at high levels. This result agrees with data from other experiments and confirms the importance of high-frequency signal audibility in gap detection. The octave band data reveal that resolution deficits can be quite large within restricted frequency regions, even those with minimal sensitivity loss. PMID- 3819172 TI - An aerodynamic study of Korean stop consonants: measurements and modeling. AB - Measurements were made of intraoral air pressure and oral flow of ten native speakers uttering word pairs contrasting Korean fortis and lenis voiceless stop consonants in initial position. The production of fortis stops was found to be characterized by a higher intraoral pressure before release, yet a lower oral flow after release, than corresponding lenis stops. Possible reasons for this difference were explored with the use of a computer implemented aerodynamic model, giving an output of air pressure and flow. Input parameters were adjusted in accordance with known or hypothesized variations in glottal area function, vocal tract wall tension, respiratory muscle force, and supraglottal cavity volume, as given in the literature. In addition to the previously known differences in glottal area, it is inferred from the results of the modeling experiment that fortis stops are produced with greater vocal tract wall tension than lenis stops. Speaker-specific production strategies such as larynx lowering and heightened subglottal pressure during fortis stops and differences noted between word pairs are also discussed. PMID- 3819173 TI - Minimum spectral contrast for vowel identification by normal-hearing and hearing impaired listeners. AB - To determine the minimum difference in amplitude between spectral peaks and troughs sufficient for vowel identification by normal-hearing and hearing impaired listeners, four vowel-like complex sounds were created by summing the first 30 harmonics of a 100-Hz tone. The amplitudes of all harmonics were equal, except for two consecutive harmonics located at each of three "formant" locations. The amplitudes of these harmonics were equal and ranged from 1-8 dB more than the remaining components. Normal-hearing listeners achieved greater than 75% accuracy when peak-to-trough differences were 1-2 dB. Normal-hearing listeners who were tested in a noise background sufficient to raise their thresholds to the level of a flat, moderate hearing loss needed a 4-dB difference for identification. Listeners with a moderate, flat hearing loss required a 6- to 7-dB difference for identification. The results suggest, for normal-hearing listeners, that the peak-to-trough amplitude difference required for identification of this set of vowels is very near the threshold for detection of a change in the amplitude spectrum of a complex signal. Hearing-impaired listeners may have difficulty using closely spaced formants for vowel identification due to abnormal smoothing of the internal representation of the spectrum by broadened auditory filters. PMID- 3819174 TI - Matching impedance of a nonuniform transmission line: application to cochlear modeling. AB - A generalization of the concept of characteristic impedance to nonuniform transmission lines leads to an impedance having a local character. This matching impedance depends on the solution of the transmission line equations, and cannot generally be obtained in analytical form. However, when the propagation properties of the line vary only slowly (as is the case in cochlear macromechanics), a convenient analytical approximation of the matching impedance can be derived by means of the Liouville-Green method. PMID- 3819175 TI - An overview of the Rio de Janeiro Aerosol Characterization Study. PMID- 3819177 TI - Species identification of airborne molds and its significance for the detection of indoor pollution. PMID- 3819176 TI - Major sulfur dioxide point-source emissions inventories for the Eastern United States and Southeastern Canada for 1978 and 1980. PMID- 3819178 TI - An analysis of utilization, costs, funding, and preadmission requirements of small college health services. PMID- 3819179 TI - Delayed sleep and sleep loss in university students. PMID- 3819180 TI - Effectiveness of a case management protocol in improving follow-up and referral of Papanicolaou smears indicating cervical intraepithelial neoplasia. PMID- 3819181 TI - AIDS and the college health service. PMID- 3819183 TI - General statements on institutional response to AIDS. American College Health Association. December 2, 1985. PMID- 3819182 TI - AIDS on the college campus. Introduction. PMID- 3819184 TI - Statement on confidentiality of information. PMID- 3819185 TI - Bulimia: some psychological considerations. PMID- 3819186 TI - Bulimia: some physiological considerations. PMID- 3819187 TI - Practicing the ethical heart. PMID- 3819188 TI - Perceptions of health services by student affairs officers: is the partnership healthy? PMID- 3819189 TI - A healthy campus--forecasting from the 1990 health objectives for the nation. PMID- 3819190 TI - A student health center for the urban campus: a nontraditional, primary health care model. PMID- 3819191 TI - Foreign student syndrome: fact or fable? PMID- 3819192 TI - Establishing a safe system for administration of allergy extracts in a college health service. PMID- 3819193 TI - Taking care of the intramural athlete: University of Maryland sports medics program. PMID- 3819194 TI - Effects of gender and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women. AB - Controversy has arisen concerning whether gender influences the prognosis after myocardial infarction. Although some studies have shown there to be no difference between the sexes, most have indicated a worse prognosis for women, attributing this to differences in baseline characteristics. It has been further suggested that black women have a particularly poor prognosis after infarction. To determine the contribution of gender and race to the course of infarction, 816 patients with confirmed myocardial infarction who were enrolled in the Multicenter Investigation of the Limitation of Infarct Size (MILIS) were analyzed. Of those patients, 226 were women and 590 were men, 142 were black and 674 were white. The cumulative mortality rate at 48 months was 36% for women versus 21% for men (p less than 0.001, mean follow-up 32 months). The cumulative mortality rate by race was 34% for blacks versus 24% for whites (p less than 0.005). Both women and blacks exhibited more baseline characteristics predictive of mortality than did their male or white counterparts. It was possible to account for the greater mortality rate of blacks by identifiable baseline variables; however, even after adjustment, the mortality rate for women remained significantly higher (p less than 0.002). The poorer prognosis for women was influenced by a particularly high mortality rate among black women (48%); the mortality rate for white women was 32%, for black men 23% and for white men 21%. The mortality for black women was significantly greater than that of the other subgroups. Thus, findings in the MILIS population indicate that the prognosis after myocardial infarction is worse for women, particularly black women. PMID- 3819195 TI - Determinants of ventricular arrhythmias in mildly symptomatic patients with coronary artery disease and influence of inducible left ventricular dysfunction on arrhythmia frequency. AB - To determine the relation among ventricular arrhythmias, prognostic factors and reversible ischemia in coronary artery disease, 131 drug-free, minimally symptomatic patients were studied by radionuclide angiography and 24 hour Holter electrocardiographic monitoring. High grade ventricular arrhythmias (couplets, salvos of premature ventricular complexes and R on T phenomenon) were observed in 33 patients (25%) and were related to lower rest and exercise ejection fraction, greater number of stenotic coronary arteries and higher prevalence of regional wall motion abnormalities at rest (all p less than or equal to 0.1). Among patients with subnormal rest ejection fraction, high grade arrhythmias occurred with greater prevalence in those with reversible left ventricular dysfunction (reduction in ejection fraction) during exercise compared with those with a normal ejection fraction response (59 versus 23%, p less than 0.05), a relation observed principally in patients with multivessel disease. These data indicate that in minimally symptomatic patients with coronary artery disease, arrhythmias are related to both extent of disease and severity of regional and global ventricular dysfunction and are most prevalent in patients with ventricular dysfunction and evidence of inducible ischemia, factors indicating poor long-term prognosis during medical therapy. PMID- 3819196 TI - Determinants of QRS alternans during narrow QRS tachycardia. AB - This study was designed to prospectively determine the incidence of QRS alternans during various types of narrow QRS tachycardia and to clarify the determinants of QRS alternans. An electrophysiologic study was performed in 28 consecutive patients with a narrow QRS tachycardia. Persistent QRS alternans was observed in 6 (43%) of 14 patients during orthodromic reciprocating tachycardia, 5 (71%) of 7 patients during atrial tachycardia and 3 (43%) of 7 patients during atrioventricular (AV) node reentrant tachycardia. Incremental atrial pacing during sinus rhythm resulted in QRS alternans in patients who had QRS alternans during tachycardia, unless the shortest pacing cycle length associated with 1:1 AV conduction exceeded the tachycardia cycle length. In patients without QRS alternans during narrow QRS tachycardia, incremental atrial pacing during sinus rhythm resulted in persistent QRS alternans in five patients in whom the shortest pacing cycle length associated with 1:1 AV conduction was 60 to 180 ms less than the tachycardia cycle length. In an additional 20 patients without a narrow QRS tachycardia, persistent QRS alternans was observed during incremental atrial pacing in 11 (55%) of the patients. In six of six patients who had QRS alternans during abrupt rapid atrial pacing, QRS alternans was not observed when the same pacing rates were achieved gradually. Among the patients with narrow QRS tachycardia, the mean tachycardia cycle length in those who had QRS alternans (mean +/- SD 288 +/- 44 ms) was significantly shorter than in those who did not (369 +/- 52 ms, p less than 0.001). The presence of QRS alternans was not related to the tachycardia mechanism, relative or functional refractory period of the His Purkinje system (at a drive cycle length of 500 ms), age, presence of structural heart disease, direction of input into the AV node or concealed retrograde conduction in the His-Purkinje system. In conclusion, QRS alternans during narrow QRS tachycardias is a rate-related phenomenon that depends on an abrupt increase to a critical rate and is independent of the tachycardia mechanism. PMID- 3819197 TI - Geometric and functional correlates of electrocardiographic repolarization and voltage abnormalities in aortic regurgitation. AB - Although electrocardiographic left ventricular hypertrophy is a recognized marker of disease severity in patients with chronic aortic regurgitation, the quantitative relations of repolarization abnormalities and QRS voltage to measurements of cardiac structure and function have not been established. The presence or absence of the "strain" pattern of repolarization and QRS voltage was compared with echocardiographic and radionuclide cineangiographic findings in 95 adults with sever, pure, chronic aortic regurgitation and no evidence of coronary artery disease. In contrast to 54 patients with normal repolarization, 41 patients with an abnormal repolarization pattern had greater left ventricular end diastolic and end-systolic dimensions (7.2 +/- 1.1 versus 6.6 +/- 0.8 cm, p less than 0.002 and 5.2 +/- 1.2 versus 4.4 +/- 0.7, p less than 0.001, respectively), greater left ventricular mass (431 +/- 138 versus 303 +/- 89 g, p less than 0.001), higher end-systolic stress (128 +/- 46 versus 95 +/- 27 dynes-cm2 X 10(3), p less than 0.001), lower fractional shortening (28 +/- 8 versus 34 +/- 5%, p less than 0.001) and lower exercise ejection fraction (39 +/- 11 versus 51 +/- 8%, p less than 0.001). Multiple logistic regression analysis revealed that left ventricular mass and end-systolic stress were independently related to the presence of repolarization abnormalities (p less than 0.005). Among the 73 asymptomatic patients, those with normal repolarization had significantly lower prevalences of fractional shortening less than 25% (1 of 45 versus 5 of 27, p less than 0.05), left ventricular systolic dimension greater than 5.5 cm (1 of 45 versus 8 of 27, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819198 TI - Intraaortic balloon pump insertion: a randomized study comparing percutaneous and surgical techniques. AB - To compare the percutaneous and surgical techniques of intraaortic balloon pump insertion, 101 patients referred for this procedure were randomly assigned to either percutaneous or surgical insertion. Insertion using the designated technique was successful in 45 (88%) of 51 patients with percutaneous insertion and 48 (96%) of 50 patients with surgical insertion (difference not statistically significant). The time from the beginning of the insertion procedure to the initiation of counterpulsation was 13 +/- 8 minutes for the percutaneous technique versus 31 +/- 16 minutes for the surgical technique (p less than 0.001). In the percutaneous group, 10 patients required Fogarty thrombectomy after balloon pump removal, and 1 patient developed severe leg ischemia requiring immediate termination of balloon pump support. In the surgical group, one patient developed leg ischemia requiring surgical intervention, three patients developed sepsis with bacteremia (including one patient who required vein patch repair of the femoral artery), one patient developed a wound infection requiring debridement and one patient had a cerebral embolus. Aortic dissection, aortoiliac perforation or amputation did not occur in either group. Major vascular complications occurred in 11 patients (22%) with percutaneous insertion versus 2 patients (4%) with surgical insertion (p less than 0.05). It is concluded that although the percutaneous technique for intraaortic balloon pump insertion is faster than the surgical technique and is technically easy, it is associated with a higher incidence of vascular complications. PMID- 3819199 TI - Incidence and management of limb ischemia with percutaneous wire-guided intraaortic balloon catheters. AB - In 103 patients who underwent placement of 106 percutaneous wire-guided intraaortic balloon catheters between August 1983 and January 1986, all placements were successful and the average duration of counterpulsation was 3.4 +/- 1.6 days. During counterpulsation, 45 patients developed limb ischemia that required premature balloon removal in 29 patients. The development of limb ischemia was significantly related to the presence of diabetes (risk ratio 2.0), peripheral vascular disease (risk ratio 1.9), female gender (risk ratio 1.8) and the presence of a postinsertion ankle-brachial pressure index less than 0.8 (risk ratio 7.9). There was no association between the development of limb ischemia and age, body surface area, balloon size (10.5F/12F) or adequacy of anticoagulation. Fifteen patients underwent vascular surgery for treatment of balloon-related limb ischemia, which was associated with one operative death. Nine patients had persistent limb ischemia (seven asymptomatic, two symptomatic) at the time of hospital discharge. Improvements in wire-guided balloon technology have increased the probability of successful balloon placement over that of surgical placement and have reduced the incidence of major aortic injury, but there is no evidence that these improvements have reduced the incidence of limb ischemia or its sequelae. This should be borne in mind before proceeding with balloon insertion in patients with one or more risk factors for developing limb ischemia. PMID- 3819200 TI - Prediction of serious arrhythmic events after myocardial infarction: signal averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. AB - Noninvasive assessment was undertaken before hospital discharge in 210 patients who had recovered from acute myocardial infarction. This comprised signal averaged electrocardiography, Holter monitoring and radionuclide left ventriculography. An abnormal signal-averaged electrocardiogram was defined as the presence of a low voltage signal less than 20 microV in the terminal 40 ms of the filtered QRS complex or a long filtered QRS complex greater than 120 ms. During a follow-up period of 6 months to 2 years (median 14 months), 15 patients had arrhythmic events: eight died suddenly and seven presented with sustained, symptomatic ventricular tachycardia. Using univariate analysis, abnormalities in each of the three noninvasive tests were able to predict arrhythmic events. Stepwise logistic regression demonstrated that each test was independently significant in predicting outcome, with a left ventricular ejection fraction less than 40% being the most powerful variable (beta = 2.8, p less than 0.005). This process generated an algorithm that allowed assessment of combinations of variables: the finding of an abnormal signal-averaged electrocardiogram in the presence of an ejection fraction less than 40% identified patients with a 34% probability of arrhythmic events. By contrast, in patients with left ventricular dysfunction but a normal signal-averaged tracing, the risk of arrhythmic events was 4% (p less than 0.001). This combination of variables was associated with a sensitivity of 80% and a specificity of 89%. Hence, using a combination of noninvasive tests after myocardial infarction, patients can be stratified according to risk of serious arrhythmic events. PMID- 3819201 TI - The signal-averaged electrocardiogram as a screening test for inducibility of sustained ventricular tachycardia in high risk patients: a prospective study. AB - The role of the signal-averaged electrocardiogram in predicting the induction of sustained monomorphic ventricular tachycardia in high risk patients was assessed prospectively in 100 consecutive patients. Presenting diagnoses were syncope (38 patients), nonsustained ventricular tachycardia (24 patients), sustained ventricular tachycardia (25 patients) and sudden cardiac arrest (13 patients). Using programmed ventricular stimulation, 71 patients (group I) did not have and 29 patients (group II) did have inducible sustained monomorphic ventricular tachycardia. Using the signal-averaged electrocardiogram with filtering (6 dB/octave) at high pass corner frequencies of 67 and 100 Hz, the two groups were compared. The signal-averaged electrocardiogram was considered abnormal if all of the following criteria were satisfied: 1) the total filtered QRS complex duration was greater than 120 ms, 2) the duration of the terminal QRS complex of less than or equal to 20 microV was greater than or equal to 30 ms, and 3) at least one deflection (late potential) was present in this region. Differences between groups I and II in these three measures were highly significant (p less than or equal to 0.001). The sensitivity and specificity of signal averaging for predicting the induction of sustained ventricular tachycardia were 93 and 94%, respectively. Stepwise logistic regression analysis identified the signal averaged electrocardiogram as the best predictor of induction of sustained monomorphic ventricular tachycardia, independent of left ventricular ejection fraction, presence of ventricular aneurysm, myocardial infarction and other clinical variables (chi-square = 93.2, p less than 0.0001). The signal-averaged electrocardiogram is a sensitive and specific test for the induction of sustained monomorphic ventricular tachycardia, having independent predictive value. PMID- 3819202 TI - Intraoperative two-dimensional echocardiography in congenital heart disease. AB - Intraoperative epicardial two-dimensional echocardiography was used in 195 patients undergoing surgery for congenital heart disease to evaluate its potential to identify new diagnostic information immediately before and after surgical correction. In 168 patients the preoperative diagnosis was confirmed by intraoperative echocardiography. In four patients, unsuspected findings were revealed, which resulted in modification of the surgical approach. In 18 patients additional morphologic information was obtained which contributed to alteration or refinement of surgical management. The adequacy of cardiac repair was assessed before closure of the chest in all patients. In six patients this information led to immediate reoperation and in four other patients to inotropic drug therapy. During congenital heart surgery, epicardial two-dimensional echocardiography may yield important information for surgical management. The technique is an essential adjunct when preoperative diagnostic studies are not conclusive or when the initial response to repair is unsatisfactory. PMID- 3819203 TI - Pulsed Doppler echocardiographic assessment of extraparenchymal pulmonary vein flow. AB - Extraparenchymal pulmonary vein flow profiles were assessed by pulsed Doppler echocardiography in three groups of patients. Group I comprised 41 normal patients. Group II comprised 16 patients, 10 of whom had nonpulsatile pulmonary artery flow (5 with a right atrium to pulmonary artery Fontan procedure and 5 with a Glenn shunt). Six patients with pulsatile pulmonary artery flow had simultaneous Doppler and left atrial pressure measurements during cardiac catheterization. Group III comprised one patient with pulmonary vein obstruction, six with a large left to right shunt at ventricular level and two with pulmonary vascular disease. In Group I, biphasic forward pulmonary vein flow occurring during ventricular systole and diastole was observed in 26 subjects, 15 others had triphasic flow. In those with triphasic flow, the ventricular systolic component was divided into early and late. Reversed flow in the pulmonary veins during atrial systole was seen in 36 of the 41 subjects. The flow pattern in Group II was identical irrespective of the presence of pulsatile or nonpulsatile flow. The two periods of ventricular systolic flow occurred during the a to c and c to x descent, with the ventricular diastolic flow occurring during the y descent. Variations in waveform were mirrored in the left atrial pressure. Neither increased nor decreased pulmonary artery flow substantially altered the pattern. Pulmonary vein obstruction produced a distinctive pattern of high velocity turbulent flow. This technique demonstrates that extraparenchymal pulmonary vein flow is dependent on left atrial pressure events. It has major potential applications in patients who are prone to develop pulmonary vein obstruction. PMID- 3819204 TI - Pulmonary venous and systemic ventricular inflow obstruction in patients with congenital heart disease: detection by combined two-dimensional and Doppler echocardiography. AB - Obstruction to pulmonary venous return may be associated with a number of congenital cardiovascular abnormalities occurring both before and after surgery. Hemodynamic assessment by cardiac catheterization is often difficult. A noninvasive method for detection and quantitation of obstruction to systemic ventricular inflow would be clinically useful. Two-dimensionally directed pulsed and continuous wave Doppler echocardiography was performed before cardiac catheterization in 31 patients thought clinically to have possible obstruction to left ventricular inflow or pulmonary venous return. Primary diagnoses included transposition of the great arteries after the Mustard or Senning procedure in nine patients, total anomalous pulmonary venous connection in nine (in two after surgical repair), cor triatriatum in eight (in four after surgical repair), congenital mitral stenosis in four (in one after surgical repair) and mitral atresia in one. Severe obstruction was defined as a mean pressure gradient at catheterization of greater than or equal to 16 mm Hg at any level of the pulmonary venous return or of the systemic ventricular inflow. Severe obstruction was predicted if Doppler examination measured a flow velocity of greater than or equal to 2 m/s across any area of inflow obstruction. At catheterization, 12 patients (39%) had severe obstruction to left ventricular inflow or pulmonary venous return and all obstructions were correctly detected by Doppler echocardiography. The site of pulmonary venous obstruction was localized by two dimensionally directed pulsed Doppler study. Patients with a lesser degree of obstruction had a lower Doppler velocity, but none had a maximal Doppler velocity of greater than or equal to 2 ms/s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819205 TI - Sinus of Valsalva aneurysm complicating bacterial endocarditis in an infant: diagnosis with two-dimensional and Doppler echocardiography. AB - Sinus of Valsalva aneurysm is a rare complication of bacterial endocarditis in infancy and childhood. This report describes an infant with congenital aortic stenosis who developed bacterial endocarditis after abdominal surgery and placement of indwelling central venous catheters for long-term parenteral nutrition. Bacterial endocarditis in this infant was complicated by the development of an aneurysm of the left sinus of Valsalva. Surgical intervention was necessary because of gradual expansion of the aneurysm with compression of the adjacent right pulmonary artery and descending aorta. Two-dimensional and Doppler echocardiography proved useful for the initial diagnosis and serial follow-up of this unusual disorder and for its successful surgical management. PMID- 3819206 TI - Thrombolytic therapy for prosthetic cardiac valve thrombosis. AB - To determine the efficacy and safety of thrombolytic therapy for prosthetic valve thrombosis, a composite series of 41 patients who received either streptokinase or urokinase intravenously for this disorder were analyzed. The series comprised 3 patients treated at Rhode Island Hospital and 38 previously reported on. Short term success was achieved in 32 patients (78%). Prosthetic valve thrombosis recurred in seven (22%) of the successfully treated patients, four of whom were retreated with thrombolytic therapy. A favorable clinical outcome was observed in each. Fever and venipuncture bleeding were the most frequent side effects. Systemic embolization occurred in 4 (15%) of 26 patients with either aortic or mitral prosthetic valve thrombosis. None of these latter patients experienced a permanent neurologic or circulatory deficit. It is concluded that thrombolytic therapy is of value in the treatment of prosthetic valve thrombosis. PMID- 3819207 TI - Internal cardiac defibrillation: histopathology and temporal stability of defibrillation energy requirements. AB - The automatic implantable cardioverter/defibrillator is tested intraoperatively to ensure effectiveness by performing a number of induced fibrillation defibrillation trials. The temporal stability of defibrillation energy requirements and the histopathologic effects of multiple defibrillating shocks were studied in 12 dogs chronically instrumented with an internal spring-patch lead system identical to that used in humans. Dogs were studied on days 1, 11, 18, 25 and 32. Data were analyzed by logistic regression and the energy required for 50% (E50) and 80% (E80) success was compared. On day 32 the dogs were killed and the heart was removed for gross and microscopic pathologic examination. There was a significant decrease in energy requirements from day 1 to day 11, as the E50 decreased from 6.9 +/- 4.5 to 4.9 +/- 2.5 J (p less than 0.02) and the E80 decreased from 8.5 +/- 5.2 to 6.1 +/- 3.4 J (p less than 0.02). The energy requirements then remained stable over the remainder of the experiment. The dogs were administered 209 +/- 18 shocks (range 1 to 24 J) for a total cumulative dose of 1,524 +/- 571 J. In all cases, both grossly and microscopically, there was no evidence of pathologic changes in the myocardium or coronary vessels. In all cases there was a fibrous plaque beneath the patch electrodes, at times containing an area of patchy hemorrhage; in a single specimen a mixed inflammatory infiltrate accompanied the hemorrhage. Endothelialization of the spring electrode with mild right atrial endocardial fibrosis was also observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819208 TI - Photosensitization of experimental atheromas by porphyrins. AB - Arteriosclerotic arteries have been shown to fluoresce when treated with hematoporphyrin derivative. This study investigates the incorporation and distribution of a partially purified form of hematoporphyrin derivative (Photofrin II) in normal and arteriosclerotic rabbit aortas. A thoracoabdominal exploration was performed in 15 rabbits. Group I comprised normal rabbits, Group II normal rabbits given 5 mg/kg Photofrin II 48 hours before surgery, Group III arteriosclerotic rabbits and Group IV arteriosclerotic rabbits given 5 mg/kg Photofrin II 48 hours before surgery. Multiple aortic biopsy specimens for frozen section were taken from all rabbits. In addition, open laser endarterectomy (with an argon ion laser) was performed on Group III and Group IV rabbits. Frozen sections were studied by digital video fluorescence microscopy to determine the distribution of Photofrin II within the layers of the aortic wall. The fluorescence of the intima of Group IV rabbits was found to be significantly greater than that of the intima, internal elastic lamina, media or adventitia of the other groups (p less than 0.01) and significantly greater than that of the internal elastic lamina, media or adventitia of Group IV rabbits (p less than 0.01). When open laser endarterectomy was performed, Group III rabbits required 103 +/- 14 J/cm2 and Group IV required 33 +/- 3 J/cm2 (p less than 0.01). It is concluded that porphyrins are selectively localized within the intima of arteriosclerotic arteries. This localization sensitizes atheromas to argon ion laser light and facilitates laser endarterectomy. PMID- 3819209 TI - Determinants of infarct size during permanent occlusion of a coronary artery in the closed chest dog. AB - One hundred nine dogs subjected to experienced experimental coronary occlusion were retrospectively examined in an attempt to identify factors influencing infarct size. A coronary artery was occluded by an embolus. The field of the occluded artery (zone at risk) was determined by subsequent autoradiography of 141-cerium-labeled microspheres that were injected into the left ventricle 2 minutes after embolization. Fifty-eight dogs were analyzed after 24 hours of embolization and 51 after 48 hours. Infarct size (assessed by tetrazolium staining) was directly proportional to the size of the zone at risk in both groups. The percent of the risk zone that developed infarction was independent of risk zone size in both the 24 and 48 hour groups. No differences were seen between male and female animals or between the dogs with left circumflex or left anterior descending artery occlusion. Infarct size was also independent of the heart rate-systolic pressure product at the time of coronary occlusion, and of the time of year. Eighty percent of the variability in the portion of the risk zone that infarcted in this population could be explained by the level of collateral flow in the risk zone 2 minutes after embolization. The linear regression between the percent of the risk zone that developed infarction and collateral flow was the same in slope and intercept between the 24 and 48 hour groups. The correlation between infarct size and collateral flow was slightly better when collateral flow was expressed as a percent of flow in the nonischemic zone than when it was expressed in absolute terms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819210 TI - Role of myocardial perfusion imaging in evaluating thrombolytic therapy for acute myocardial infarction. AB - Myocardial thallium-201 scintigraphy is being increasingly employed as a method for assessing the efficacy of coronary reperfusion in acute myocardial infarction. New thallium uptake after intracoronary tracer administration after successful recanalization indicates that nutrient blood flow has been successfully restored. One may also presume that some myocardial salvage occurred if thallium administered in this manner is transported intracellularly by myocytes with intact sarcolemmal membranes. However, if one injects thallium by way of the intracoronary route immediately after reperfusion, the initial uptake of thallium in reperfused myocardium may predominantly represent hyperemic flow and regional thallium counts measured may not be proportional to the mass of viable myocytes. When thallium is injected intravenously during the occlusion phase the degree of redistribution after thrombolysis is proportional to the degree of flow restoration and myocardial viability. When thallium is injected for the first time intravenously immediately after reperfusion, an overestimation of myocardial salvage may occur because of "excess" thallium uptake in the infarct zone consequent to significant hyperemia. Another approach to myocardial thallium scintigraphy in patients undergoing thrombolytic therapy is to administer two separate intravenous injections before and 24 hours or later after treatment. Clinical studies have demonstrated that the improvement in defect size on serial images predicts improvement in regional function and patency of the infarct-related vessel. Finally, patients with acute myocardial infarction who receive intravenous thrombolytic therapy are candidates for predischarge exercise thallium-201 scintigraphy for risk stratification and detection of residual ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819211 TI - Computers in cardiac imaging. AB - Imaging has become a widely used technique for the evaluation of cardiac disease. Computer technology and techniques have had an enormous impact on many of the available cardiac imaging methods. These methods include echocardiography, digital angiography, radionuclide imaging, X-ray computed tomography and nuclear magnetic resonance imaging. Computers have performed a number of functions in these cardiac imaging methods, including image acquisition, formation, management, display, enhancement and analysis. This article describes each of these roles that computer technology and techniques currently play in cardiac imaging and concludes with an assessment of the impact that computers have had on the various cardiac imaging methods. PMID- 3819212 TI - Noninvasive diagnosis of left ventricular outflow tract obstruction caused by a porcine mitral prosthesis. AB - A patient developed shortness of breath 8 years after mitral valve replacement with a porcine prosthesis. Doppler echocardiography revealed left ventricular outflow tract obstruction created by a protruding prosthesis. PMID- 3819214 TI - High frequency pulsed versus continuous wave Doppler echocardiography (continued) PMID- 3819213 TI - Doppler echocardiographic profiles in obstructive right and left atrial myxomas. AB - Previous reports have suggested that atrioventricular (AV) flow disturbances accompanying atrial myxomas mimic mitral stenosis. Two patients complaining of orthostatic syncope and positional intolerance had a large right and left atrial myxoma, respectively. Doppler flow records showed abrupt early diastolic flow cessation and normal velocity half-times, unlike AV valve stenosis. Large, obstructing atrial myxomas may behave as ball valves. PMID- 3819215 TI - The current status of immunization principles: recommendations for use and adverse reactions. PMID- 3819216 TI - Diagnostic specificity of a sandwich ELISA for Aspergillus-related diseases. AB - A sandwich ELISA with specificity for a major antigen (Ag 7) of Aspergillus fumigatus has been compared with indirect ELISAs with use of crude antigenic (culture filtrate) extracts and found to have a sensitivity of 100% and specificity of 92.3% for antibody detection in sera of patients with allergic bronchopulmonary aspergillosis (ABPA) and aspergilloma. In the Ag 7 ELISA, all sera from groups with ABPA (21) and aspergilloma (15) had positive titers, and mean values for both these groups were significantly higher (p less than 0.001) than control levels. By comparison, in the indirect ELISAs, most sera of patients with ABPA were positive; the sensitivity was 81% to 90%, and the specificity was 87%. Sera from other disease groups including sera from 13 patients with farmer's lung, 16 with tuberculosis, and 10 individuals with positive prick test to either A. fumigatus or Alternaria alternata were also tested by both types of assay. Up to five of these sera elicited significant positive results in the indirect ELISA, and although two sera were also positive in the Ag 7-specific ELISA, these latter titers were both below the range of values for the sera from patients with ABPA. With the use of an IgG calibration curve, the sensitivity of the assay was determined as within the range of 1 to 10 microgram of specific IgG antibody per milliliter. The Ag 7-specific ELISA is therefore a highly specific, sensitive assay for antibody detection in Aspergillus-related diseases. PMID- 3819217 TI - The late onset form of C1 esterase-inhibitor deficiency presenting as food allergy. AB - Two cases of late onset recurrent angioedema associated with deficiency of C1 esterase inhibitor are described. Both patients had life-threatening episodes of angioedema that they had related to the ingestion of certain foodstuffs. This was not confirmed by food challenges or by food allergy skin testing, although both patients had embarked on strict exclusion diets before the diagnosis of C1 esterase-inhibitor deficiency. Clinicians should be aware of the entity of late onset angioedema caused by C1 esterase deficiency mimicking food allergy and hence delaying the diagnosis of this potentially lethal condition. PMID- 3819218 TI - Chronic allergic airway disease in the sheep model: functional and lung-lavage features. AB - We developed an animal model of chronic allergic airway disease by repeatedly exposing nine sheep to tracheal instillation of ascaris antigen until stable increase in lung resistance at three times control in six reactive sheep (group C) was obtained. They were then compared to the three nonreactive sheep (group B) and a control group of eight sheep exposed to saline only (group A) in terms of pulmonary function tests and bronchoalveolar lavage (BAL) analyses. Lung resistance was 1.5 +/- 0.3 cm H2O/L/sec in group A, 1.8 +/- 0.3 in group B, and 5.9 +/- 1.3 in group C. Trapping volume (functional residual capacity by plethysmography and by helium rebreathing technique) was 0 +/- 0.1 L in group A, 0.05 +/- 0.1 in group B, and 0.51 +/- 0.17 in group C. Upstream resistance at peak flow did not differ between any two groups, but upstream resistance near residual volume was 1.8 +/- 0.3 cm H2O/L/sec in A, 6.2 +/- 1.0 in B, and 28 +/- 6 in C. In BAL, total cells were 25 +/- 5 X 10(4)/ml in A, 35 +/- 8 in B, and 31 +/ 6 in C. Macrophages in BAL were 16 +/- 2 in A, 27 +/- 9 in B, and 24 +/- 4 in C. Neutrophils were 0.5 +/- 0.2 in A, 3.4 +/- 2.5 in B, 2.8 +/- 1.5 in C. Eosinophils were 0.1 +/- 0.1 in A, 0.5 +/- 0.2 in B, and 0.9 +/- 0.3 in C (p less than 0.05 group C versus group A). Total proteins, albumin, alkaline phosphatase, and fibronectin did not differ between groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819219 TI - Seasonal increase of bronchial reactivity in allergic rhinitis. AB - Twenty-seven patients with hay fever had a carbachol inhalation challenge both out of season and during the pollen season. Eight patients with allergic asthma were used as a control group. Only three patients (11.1%) demonstrated a value of a provocative dose causing a 20% fall in FEV1 in the asthmatic range out of pollen season, but during pollen exposure, the number of positive responses significantly increased to 13 (48.1%). We observed differences regarding mean age, age of onset of symptoms, sex, and family history between patients with positive responses and patients who failed to react to inhalation challenge. It appears reasonable that an aspecific bronchial provocation test, performed during the pollen season, can detect with greater sensitivity patients with hay fever at risk of developing asthma in the future, and it also appears reasonable that these patients should be treated differently from subjects with "pure" allergic rhinitis. We expect the ongoing follow-up to clarify the prognostic value to be attributed to these findings. PMID- 3819220 TI - Isotypic and antigenic restriction of the blocking antibody response to ryegrass pollen: correlation of rye group I antigen-specific IgG1 with clinical response. AB - To investigate the role of blocking antibodies in allergen immunotherapy (IT), we analyzed IgE, IgG, and IgG subclass 1 to 4 antibody responses to ryegrass group I antigen (RGGI) in a prospective double-blind, heterologous allergen, allergen controlled trial of grass-pollen IT in 18 adults with seasonal rhinitis and asthma. Serum was assayed preseasonally before starting IT and again in midseason at time of documented highest natural exposure. Antibodies were measured by ELISA, and immunogenic specificities of ryegrass extract were examined by Western immunoblots. Nine subjects receiving grass-pollen IT and nine control subjects had similar clinical and immunologic status before IT. RGGI-specific IgE antibodies (sIgE) did not change from pretreatment levels in actively treated subjects but increased in control subjects (p less than 0.002). RGGI sIgG increased approximately thirteen-fold with active IT versus threefold during natural seasonal exposure (p less than 0.0005). The IgG-blocking response to RGGI was restricted to IgG1 and IgG4. Ten nonatopic subjects had similar RGGI sIgG1 but lower or undetectable sIgE and sIgG4 than the 18 atopic study subjects. Active IT dramatically increased RGGI sIgG4 (p less than 0.001) and to a lesser extent RGGI sIgG1 (p less than 0.01). Immunoblots demonstrated eight IgE-binding ryegrass-polypeptide allergens, with RGGI ubiquitous, and 11 IgG-binding polypeptides, including all eight allergens. A negative correlation between seasonal rhinitis symptom-medication scores and RGGI sIgG1 levels was found (r = 0.62, p less than 0.01), but no other immunologic parameters assayed were related to clinical improvement. Although RGGI sIgG4 predominates in the blocking response and is a useful marker of effective IT, early beneficial biologic effects may involve IgG1 antibodies. PMID- 3819221 TI - The temporal relationship between increases in airway responsiveness to histamine and late asthmatic responses induced by occupational agents. AB - The temporal relationship between increases in airway responsiveness and the late asthmatic response was assessed in nine patients challenged with occupational agents toluene diisocyanate (one patient), carmine (one patient), maleic anhydride (two patients), colophony (four patients), and trimellitic anhydride (one patient). The provocation concentration of histamine causing a 20% decrease in FEV1 (PC20) was measured before challenge and at approximately 3 hours and 24 hours on control and active-challenge days. Thirteen active challenges provoked eight definite late asthmatic responses (maximum fall in FEV1 greater than 15% at 3 to 11 hours). At 3 hours after the challenges that provoked late responses, there was a significant (p less than 0.02) decrease in PC20 that was more (p less than 0.03) than that observed for the five tests provoking early (late FEV1 fall 0% to 5%) or equivocal late (FEV1 fall 6% to 15%) responses. At 24 hours, PC20 remained decreased (p less than 0.05), although it was less so than at 3 hours (p less than 0.05) and not significantly when compared with challenge tests causing single early or equivocal late responses. The 3-hour decreases in PC20 were identified when FEV1 (five of seven observations) was greater than 90% of prechallenge values. For the nine independent tests, the 3-hour decreases in PC20 correlated (r = 0.72; p less than 0.05) with the magnitude of the late falls in FEV1, whereas this was not observed at 24 hours (r = 0.35; p, not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819222 TI - Bee venom allergy in a patient with urticaria pigmentosa. PMID- 3819223 TI - Taxonomic and immunochemical identification of two house dust mites Dermatophagoides farinae and Dermatophagoides microceras. PMID- 3819224 TI - Clinical ecology. PMID- 3819225 TI - Passive transfer of methacholine sensitivity from man to monkey. AB - A model of human allergic disease, in which nonhuman primates were infused with serum from allergic humans and challenged with appropriate antigen, was used to determine whether the animals also develop hyperreactive airways characteristic of asthma. Anesthetized monkeys were insufflated with increasing concentrations of methacholine aerosol, and changes in pulmonary function were measured. Airway reactivity as assessed by the dose of methacholine aerosol culminating in apnea was determined after infusion of serum from allergic or nonallergic humans or with heated allergic serum. A comparison of the results indicated that only infusion of unheated serum from allergic humans resulted in an increase in airway reactivity to aerosolized methacholine. These results suggest that a factor in the serum of allergic humans may play a role in the hyperreactivity of airways characteristic of asthma. PMID- 3819226 TI - The determination of the eosinophil count: comparison of two techniques. AB - The total eosinophil count obtained by use of the standard hemacytometer is considered by several investigators to be the most reliable method for the determination of the circulating eosinophil levels in the blood because it is believed to be less subject to error than the calculated eosinophil count obtained with Wright stained blood smears from the differential count. We compared the two techniques in outpatients as well as inpatients with and without allergies (total of 514 patients). Our results demonstrate that the eosinophil count by the two methods are similar. PMID- 3819227 TI - Investigations of culture medium-free house dust mites. III. Antigens and allergens of body and fecal extract of Dermatophagoides farinae. AB - Crossed immunoelectrophoresis (CIE) and crossed radioimmunoelectrophoresis (CRIE) were used to characterize antigens (Ags) and allergens derived from Dermatophagoides farinae (DF) culture media-free mite body and mite fecal matter extracts. CIE of DF body and DF feces extracts revealed the presence of 35 and 20 Ags, respectively. CRIE experiments demonstrated IgE binding by 14 and seven DF body and DF feces Ags, respectively, when CIE gels were incubated with reference sera from clinically mite-sensitive patients. Binding of specific IgE to the various Ags in the two extracts varied significantly both in frequency and in strength from patient to patient and within the same patient's serum. Sera from some patients demonstrated IgE binding predilection for specific DF body Ags, whereas other sera exhibited greater binding preference for DF feces Ags. Homologous, heterologous, and intermediate gel CIE and CRIE clearly demonstrated that DF bodies and DF feces share some common Ags or epitopes, but the two different extracts also were quantitatively different. Some Ags and allergens originate from mite body material and are not present in mite feces. These results indicate that only extracts containing high concentrations of both body and fecal allergens should be used in clinical testing and therapy. PMID- 3819228 TI - Acute desensitization of a patient with cystic fibrosis allergic to both beta lactam and aminoglycoside antibiotics. AB - A 15-year-old patient with cystic fibrosis developed urticarial reactions to tobramycin, gentamicin, and cephoperazone, and an anaphylactic reaction to ticarcillin during therapy for an extensive pulmonary infection with Pseudomonas aeruginosa and Staphylococcus aureus. Immediate wheal-and-flare skin tests were positive with tobramycin and with penicilloylpoly-L-lysine. Desensitization with tobramycin in gradually increasing intravenous doses was accomplished during 8 hours. The procedure was complicated by a macular rash that remitted within minutes without therapy, but no symptoms or signs of an allergic reaction to tobramycin were detected during full dose therapy. Skin test responses to tobramycin became negative by the end of the desensitization procedure, whereas the responses to penicilloylpoly-L-lysine and histamine remained positive. A worsening course led to an unsuccessful attempt to desensitize the patient to beta-lactam determinants. Wheezing appeared during the administration of oral doses. This case demonstrates the feasibility of acute, antigen-specific desensitization of an aminoglycoside-allergic patient and the failure to achieve a second, simultaneous desensitization. This patient experienced the first serious reaction to oral penicillin desensitization. PMID- 3819229 TI - Management of drug allergy in patients with acquired immunodeficiency syndrome. AB - Management of patients with acquired immunodeficiency syndrome (AIDS) is complicated by a high frequency of adverse drug reactions to trimethoprim sulfamethoxazole and pentamidine. Because of the lack of suitable alternative antiparasitic drugs, some patients who have experienced previous allergic-type reactions to antimicrobial agents may require readministration with incriminated drugs. We report the outcome of seven drug-allergic patients with AIDS evaluated from 1982 to 85. Readministration of pentamidine was carried out without repeated reactions in three patients, and sulfadiazine and sulfamethoxazole-trimethoprim were readministered after very cautious test dosing in two other patients. A generalized maculopapular rash developed after 10 days of sulfadiazine therapy for Toxoplasma chorioretinitis but has been managed with prednisone, 20 to 30 mg/day for 3 months, and sulfadiazine has been continued. The administration of prednisone, 100 to 200 mg daily for treatment of severe cutaneous vasculitis from azulfidine in another patient, did not result in suprainfection. The complexities and potential legal risk of readministration of drugs in the drug-allergic patient with AIDS are emphasized in that coincidental deaths occurred in two patients 48 and 96 hours after readministration of pentamidine. PMID- 3819230 TI - Occupational asthma and rhinitis related to laboratory rats: serum IgG and IgE antibodies to the rat urinary allergen. AB - Allergic reactions to rat urinary proteins are an important cause of occupational asthma and rhinitis among laboratory workers. We have measured IgG and IgE antibodies to a purified rat urinary allergen in sera from 179 laboratory workers of whom 30 reported symptoms on exposure to rats. There was a very good correlation between IgE antibodies and positive skin tests. In addition, there was a close correlation between reported asthmatic reactions and serum IgE antibody to rat allergen: IgE ab was present in 12/18 of workers with asthmatic reactions but in only 2/135 of workers without symptoms (p less than 0.001). Serum IgG antibodies to rat allergen were present in all sera with IgE antibody but were also present in 30% of asymptomatic individuals. The incidence and quantity of IgG antibody correlated with the degree of exposure to animals (i.e., hours per day) but not with the length of exposure in years. Our results on rat allergy confirm that there is an increased incidence of asthma among individuals who were atopic as judged by positive skin tests to other allergens. However, this relationship did not apply to individuals with rhinitis alone, and excluding atopic individuals from employment would have been a very inefficient method of reducing asthma or rhinitis in this group. Our results confirm that IgE antibody responses to rat urinary allergen are an important cause of occupational disease. The results for IgG antibody suggest that their prevalence represents a marker for the degree of exposure to rat proteins. PMID- 3819231 TI - Elevated urinary histamine in the hyperimmunoglobulin E and recurrent infection (Job's) syndrome: association with eczematoid dermatitis and not with infection. AB - To test the hypothesis that IgE-mediated release of histamine may be, in part, responsible for the abnormal inflammatory response observed in the hyperimmunoglobulin E (HIE) and recurrent infection syndrome, urine and plasma histamine levels were measured. Twenty-four-hour urinary histamine concentrations from 15 patients with HIE (23.7 +/- 6.9 micrograms/24 hr) were significantly elevated (p less than 0.001) compared to a large historical control population (10.5 +/- 0.7 micrograms/24 hr; n = 97). However, urinary histamine levels in HIE were much less abnormal (p less than 0.01) than in five patients with biopsy proven systemic mastocytosis (159 +/- 62 micrograms/24 hr) and were not significantly elevated when levels were compared to 13 concurrently studied normal subjects (10.1 +/- 1.7 micrograms/24 hr) and nine patients with chronic granulomatous disease (8.1 +/- 1.2 micrograms/24 hr). Overall, there was no clear relationship between urine histamine values and the presence of infection as well as no significant correlation between urine histamine and total IgE or anti Staphylococcus aureus IgE. However, urine histamine levels in a subgroup of six patients with HIE with chronic eczematoid dermatitis (42.4 +/- 12.5 micrograms/24 hr) were elevated compared with values from the historical control subjects (p less than 0.001), the concurrent control subjects (p less than 0.01), the patients with chronic granulomatous disease (p less than 0.01), and five patients with HIE who did not have skin manifestations (4.6 +/- 1.1 micrograms/24 hr; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819232 TI - Acute and chronic desensitization of penicillin-allergic patients using oral penicillin. AB - The efficacy, safety and mechanisms of penicillin desensitization were studied in 24 adults and two children with serious infections that required therapy with a beta-lactam drug. Indications for desensitization included debilitating as well as life-endangering infections. Increasing oral doses of phenoxymethyl penicillin were administered at 15-minute intervals to a cumulative dose of 1.3 million units. Parenteral therapy with the beta-lactam drug of choice was instituted at that point. Immunologic complications of desensitization or therapy, ranging from pruritus to serum sickness, occurred in 12 patients. The appearance of gradually worsening wheezing led to abandonment of the procedure in one subject with cystic fibrosis and severe pulmonary disease. The remaining 25 patients were successfully desensitized and received full-dose parenteral therapy. Chronic desensitization was maintained in seven individuals with twice daily oral penicillins for 3 weeks to more than 2 years. No allergic complications of chronic desensitization or recurrent full-dose parenteral therapy were detected. Skin test reactions to one or all penicillin determinants became negative in 11 of 15 patients retested after acute desensitization. Two desensitized patients became skin test negative, remained skin test negative after cessation of desensitization, and tolerated subsequent beta-lactam therapy without allergic reactions or resensitization. The results of this study provide new evidence that acute and chronic penicillin desensitization is useful and an acceptably safe approach and suggest that antigen-specific mast cell desensitization contributes to the protection against anaphylaxis. PMID- 3819233 TI - Integrating research into clinical practice: a model and call for action. PMID- 3819234 TI - Planning diets to meet the National Research Council's guidelines for reducing cancer risk. PMID- 3819235 TI - Scoring of prudent dietary habits and its relation to 25-year survival. AB - To evaluate the effect on longevity of a diet that is concurrent with common dietary guidelines, a simple diet scoring system was developed and applied in a follow-up study of 2,820 middle-aged Dutch civil servants and their spouses. In the early 1950s those civil servants were seen for a health examination that included a dietary survey. Consumption frequency data of the quantitatively most important food items at that time were used for the diet scoring. Overall survival after 25 years was 46.8% among men and 68.6% among women. In men, a significant positive association between prudent diet score and 25-year, age adjusted survival could be demonstrated. Of the 10 food items that constituted the diet score, a higher intake of brown bread, porridge and/or yogurt, vegetables, fish, and fruit was associated with a slightly better survival. In a separate analysis we had found a significant inverse relationship between coffee consumption and survival. A similar trend, which, however, was not significant, was observed for alcohol intake. In women, the results for the separate food items were inconsistent, and no effect of a prudent diet score on longevity was observed. The proposed diet scoring system provides a means for evaluating the effects of the individual's food choice behavior on subsequent health and longevity. PMID- 3819236 TI - Discretionary salt use in airline meal service. AB - Salt use in airline meal service was studied through observation of returned meal trays of 932 passengers. Observation and weighing of salt packets on returned trays revealed that 64% of passengers did not salt their airline dinner, while 6% used the entire salt packet, 0.92 gm NaCl (362 mg Na). Average discretionary salt use among the 234 passengers (25%) who added salt was 0.57 gm NaCl (232 mg Na). Estimates of total sodium in the four airline dinners averaged 2.0 gm NaCl (786 mg Na). Laboratory assays of menu items produced by the airline foodservice differed 3% to 19% from estimated values. Sodium content of the four airline dinner menus was similar and did not affect salt use. Discretionary salt use was related to the total amount of entree consumed but was not affected by the amount of salad consumed. It is postulated that salt use in the "captive" airline situation is predicated on consistent, habitual practices. Lowering sodium consumption in this setting may require alteration in both food preparation methods and quantity of salt presented in the packets. PMID- 3819237 TI - Adult dietary characteristics affecting iron intake: a comparison based on iron density. AB - Food frequency information from 762 Utahns, aged 24 to 80 years, selected from the general population using a random digit dialing technique was studied to determine the characteristics of diets that provide 18 mg iron/2,000 kcal, the Recommended Dietary Allowances (RDAs) of iron and energy for women aged 23 to 50 years. The diets were divided into three categories according to iron per 1,000 kcal: category 1, 9.0 mg or more iron; category 2, 6.0 to 8.99 mg iron; and category 3, 5.99 mg or less iron. Twenty-seven percent of the women and 16% of the men reported consuming diets containing more than 9 mg iron/1,000 kcal. Six percent of the women consumed 18 mg iron daily. Total energy intake decreased dramatically as iron density increased, as did intake of protein, carbohydrate, and fat. However, the percentage of energy consumed as protein and carbohydrate increased in the high-iron density categories. Individuals in the high-iron density categories consumed greater proportions of their iron and energy from vegetable, fruit, and cereal products; those in the low-iron density category consumed more pastries, beverages, sweets, and added fats, i.e., high-calorie foods. When fortified breakfast cereals were removed from the diets, only 14% of the women and 6% of the men consumed diets that provided at least 9 mg iron per 1,000 kcal. Women can meet the RDA for iron from their diets if they consume the recommended amount of energy distributed across food groups as follows: cereals, 14% to 16%; vegetables, at least 11%; meat, fish, poultry, and eggs, 16% to 18%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819238 TI - Comparing participants' and managers' perception of services in a congregate meals program. AB - Managers and participants in a Title III C meals program were surveyed to explore how differences in perception of program and service quality affect participant acceptance and evaluation of the program. A nutrition monitoring instrument was designed for managers at 14 meal sites to assess major components of the foodservice operation. A survey addressing participant perception of meal quality, meal acceptance, program administration and management, and foodservice personnel was designed and administered to 264 participants. The two surveys contained 17 identical or similar questions to determine any perceptual differences. The influence of social variables on participant response was examined. A significant positive correlation was found for age vs. food temperature, age vs. frequency of participation, and education level vs. evaluation of foodservice workers. Significant negative correlations were found for sex vs. special diets, sex vs. food aversion, education level vs. food temperature, and education level vs. evaluation of the nutrition education component. Manager vs. participant response significantly differed for food temperature, special diets, nutrition education, transportation, and accuracy of posted menus. Assessment of participant vs. manager perception of meal and service quality is recommended to management for more effective program planning, evaluation, and continuous quality assurance. PMID- 3819239 TI - Anthropometric and computerized tomographic measurements of lower extremity lean body mass. AB - The loss of lean muscle mass is one of the hallmarks of protein-calorie malnutrition. Anthropometry is a standardized technique used to assess the response of muscle mass to nutrition therapy by quantifying the muscle and fat compartments. That technique does not accurately reflect actual limb composition, whereas computerized tomography does. Twenty lower extremities on randomly chosen men and women patients were evaluated by anthropometry and computerized tomography. Total area, muscle plus bone area, total volume, and muscle plus bone volume were correlated, using Heymsfield's equation and computerized tomography generated areas. Anthropometrics overestimated total and muscle plus bone cross sectional areas at almost every level. Anthropometry overestimated total area and total volume by 5% to 10% but overestimated muscle plus bone area and muscle plus bone volume by as much as 40%. Anthropometry, while easily performed and useful in large population groups for epidemiological studies, offers a poor assessment of lower extremity composition. On the other hand, computerized tomography is also easily performed and, while impractical for large population groups, does offer an accurate assessment of the lower extremity tissue compartments and is an instrument that might be used in research on lean muscle mass. PMID- 3819240 TI - Prenatal nutrition services: a cost analysis. AB - The scarcity of information about program costs in relation to quality care prompted a cost analysis of prenatal nutrition services in two urban settings. This study examined prenatal nutrition services in terms of total costs, per client costs, per visit costs, and cost per successful outcome. Standard cost accounting principles were used. Outcome measures, based on written quality assurance criteria, were audited using standard procedures. In the studied programs, nutrition services were delivered for a per client cost of $72 in a health department setting and $121 in a hospital-based prenatal care program. Further analysis illustrates that total and per client costs can be misleading and that costs related to successful outcomes are much higher. The three levels of cost analysis reported provide baseline data for quantifying the costs of providing prenatal nutrition services to healthy pregnant women. Cost information from these cost analysis procedures can be used to guide adjustments in service delivery to assure successful outcomes of nutrition care. Accurate cost and outcome data are necessary prerequisites to cost-effectiveness and cost-benefit studies. PMID- 3819241 TI - Dietary habits of patients with cholelithiasis: do we need to instruct? PMID- 3819243 TI - Educational laboratory component of a clinical nutrition course for medical students. PMID- 3819242 TI - Nutrient intakes and energy expenditures of residents with senile dementia of the Alzheimer's type. PMID- 3819244 TI - Child nutrition services: technical support paper. PMID- 3819245 TI - Do you have any daughters? An update on the state of affairs between women scientists and the National Institutes of Health. PMID- 3819246 TI - Selenium content of a core group of foods based on a critical evaluation of published analytical data. AB - References published since 1960 that report analyses of selenium in foods were collected and evaluated according to criteria in five categories: number of samples, analytical method, sample handling, sampling plan, and analytical quality control. Data were grouped by food item and rated according to the criteria that had been developed specifically for evaluating the quality of selenium data. Ratings assigned to the data from each study yielded a Quality Index, indicating which data would be included in the calculation of the mean selenium value for each food item. The Quality Indexes for acceptable studies were summed to determine a Confidence Code, intended to indicate the relative degree of confidence the user can have in each mean selenium value. The selection of selenium core foods was based on their selenium concentration and frequency of consumption. Foods were ranked by multiplying selenium concentration by the amount consumed by the 36,255 individuals who provided 3-day dietary intake data in the U.S. Department of Agriculture's 1977-78 Nationwide Food Consumption Survey. Mean, minimum, and maximum selenium values, Confidence Codes, ranks, and references have been compiled for 114 food items. The five most highly ranked food aggregates (beef, white bread, pork, chicken, and eggs) provided half of the selenium accounted for in the diets of the survey respondents. PMID- 3819247 TI - Trace mineral supplementation of burn patients: a national survey. AB - Much research effort has been devoted to determination of caloric and protein requirements in burn patients. Although it is generally accepted that trace mineral requirements increase concomitantly with caloric and protein needs, little research has been conducted to document that assumption. Our survey was undertaken to assess current practice and identify research needs. One hundred ninety-six survey questionnaires were sent to burn units in North America. Forty percent (78) were returned. Ninety percent of respondents prescribe or recommend trace mineral supplements in their facilities. "Higher risk" was the single criterion most often mentioned as a basis for supplementation (54 [77%] of 70 respondents), with 49 of them indicating that they provide trace mineral supplements to patients receiving total parenteral nutrition support. Fifty-six respondents provided detailed information concerning trace mineral supplementation. Of that group, 88% prescribe zinc supplements, 75% prescribe iron supplements, and 26% prescribe chromium supplements. Thirteen percent supplement selenium. Less than 2% supplement molybdenum or vanadium and do so only when administering total parenteral nutrition. Many respondents expressed concern about the lack of guidelines for trace mineral supplementation in the burn patient, leading to the conclusion that further research in that area would benefit burn-injured patients and the health care providers who care for them. PMID- 3819248 TI - The relative validity of reports of food intake of Dutch and Finnish boys aged 8 and 9 years. AB - Two studies were carried out to assess the relative validity of the techniques used in measuring the food intake during school lunch or home dinner of 30 Finnish and 68 Dutch boys aged 8 and 9 years. For each of the 30 Finnish boys, duplicate portions of three lunches provided to the boys were collected by a non participating observer. Nutrient intakes were calculated with the use of a food composition table, and the results were compared with those from the records that were kept by the boys' mothers. For each of the 68 Dutch boys, duplicate portions of the hot meal, taken at home, were collected and analyzed chemically. The results were compared with those from the records that were kept by the boys' mothers. The mean values for the absolute intakes of energy and nutrients for the boys from both Finland and The Netherlands as reported by the boys themselves or their mothers were generally higher (15% to 35%) than those measured by chemical analysis of a duplicate portion or calculated from a weighed portion as collected by a non-participating observer. However, the results for the relative proportions of energy generally showed closer agreement (range of difference, +11% to -15%). The authors found in this study that collection of duplicate portions of food resulted in lower (3% to 15%) recorded food intakes in comparison with measurements recorded for meals consumed on other days. PMID- 3819250 TI - Menstrual cycle and food cravings in young college women. AB - The effect of the menstrual cycle on food cravings was examined in a population of 83 young college women during a 6-week longitudinal study. Food cravings and menstrual symptoms were evaluated by measuring subject responses in weekly questionnaires ("craving sheets"). The women were not told that the central objective of the study was to examine the effects of the menstrual cycle on food cravings. The menstrual cycle was divided into four stages: menstrual flow; the first half of the cycle, excluding menstrual flow; the second half of the cycle, excluding the premenstrual phase; and 1 week premenstrual. Cravings for 32 foods were examined on a weekly basis under controlled environmental conditions. Foods tested were categorized according to common characteristics. The women exhibited a greater preference for chocolate foods during menstrual flow than during the other menstrual stages. Cravings for high-sugar foods, high-starch foods, or lower carbohydrate foods were not significantly affected by the stage of the menstrual cycle. PMID- 3819249 TI - Longitudinal assessment of vitamin B-6 status in southern adolescent girls. AB - The vitamin B-6 status of 62 black and 50 white adolescent girls living in Virginia and Alabama was assessed in 1981 and again in 1983, using the parameters coenzyme stimulation of erythrocyte alanine aminotransferase activities and dietary intakes of the vitamin. The subjects were 12 or 14 years old in 1981. The height and weight measurements of the subjects were within normal ranges. The mean daily vitamin B-6 intake of the girls from food was 1.25 mg both years, as estimated by two nonsequential 24-hour food recalls. Approximately half of the girls reported consuming less than 0.02 mg vitamin B-6 per gm protein during both years. Almost half of the girls had coenzyme stimulation values indicative of marginal or deficient status. Coenzyme stimulation and dietary values of the race, age, and income groups were similar. Changes in the status grouping of the girls between the 2 years as reflected by the coenzyme stimulation measurement were associated with changes in their vitamin B-6 intakes in 70% of the cases. Vitamin B-6 inadequacy seems to be prevalent among both black and white adolescent girls. PMID- 3819251 TI - Biological and sociocultural determinants of successful lactation among women in eastern Connecticut. AB - Postpartum factors affecting the duration of lactation were identified for 250 women through a telephone survey. The survey examined the behaviors and attitudes of women who had chosen to nurse and who were still nursing at 2 weeks postpartum. Sixty percent of the mothers nursed their infants after delivery. However, by 10 weeks postpartum, only 34% of the babies were still breast fed. By self-report, the most significant factors associated with the maintenance of lactation at 10 weeks were related to perinatal hospital protocol, especially letting the infant suckle soon after birth. Other significant predictors of successful lactation outcome included early milk "let down," little use of supplemental formula, the mother's expectation at parturition of an extended nursing period, her feeling well and being satisfied with her body weight, her previous successful experience with lactation, and her perception that she feeds her infant on demand. Few of the women who had stopped nursing after 2 weeks sought advice on breast feeding from anyone other than the pediatrician. Most coped with their nursing problems themselves. The data reinforce the importance of labor and delivery practices that support early maternal-infant contact. They also suggest the use of infant health indexes and weight and height percentile placement records rather than reliance solely on weight gain as the index of lactation adequacy. Further, they indicate the need for clinical intervention before 2 weeks postpartum. PMID- 3819252 TI - Food discard practices of householders. AB - Food discard patterns and reasons were determined for a sample of 243 households in Oregon. Personal interviews were conducted, and 7-day records of discards were collected. Discards over a 3-day period also were collected from a subsample of 50. The householder's estimate of amount, converted from measures to grams using food composition tables, was found to be 97% of the actual grams of food, as weighed in the laboratory. Households discarded an average of 1,587 gm ($2.88) food in a 7-day period on the basis of the 79% completed usable records. Major reasons were poor quality for fruits and vegetables; storage time for meat, fish, and poultry; non-use of leftovers for combination dishes; and plate waste for cereals and dairy products. Twenty-nine percent of the discarded food (by cost) was considered to be unsafe to eat by the householder. Aesthetic factors dominated decisions by the 18- to 25-year age group, but experiences related to food storage were the basis for decisions by half of the respondents more than 65 years old. Discards increased with number of members in the household and were influenced by age of children. Household income was not linearly related to amount of discard. As household refrigerator temperatures increased from 1.7 degrees C to 20 degrees C, the amount of discards also increased. Consumers generally lacked criteria for evaluating the safety of foods. PMID- 3819253 TI - Training in geriatrics for future dietitians. AB - Inclusion of geriatric training for future dietitians was assessed through a questionnaire mailed to directors of all internship programs and coordinated undergraduate programs (CUPs) accredited by The American Dietetic Association. All respondents, internship programs (70%) and CUPs (77%), included some exposure to geriatrics. Ninety-six percent of the CUPs included geriatric-related topics in undergraduate courses. Of the 95% internship programs providing class sessions on geriatrics, most included 6 hours or less. Major topics related to nutrition assessment; physical, social, and psychological needs; diet-related diseases; and nutrition programs benefiting the elderly. Fifty-one percent of the CUPs and 23% of the internship programs trained students 3 weeks or more in a geriatric setting, while 45% and 72%, respectively, trained 2 weeks or less. Nursing homes were the primary site of training. The most frequently required activities included identifying specific needs of the elderly in relation to other adults, completing diet histories, and presenting nutrition education to a geriatric population. The question remains as to whether the quantity and type of geriatric experiences currently included are sufficient to keep pace with the increasingly aging population. PMID- 3819254 TI - Adolescent obesity intervention: validation of the SHAPEDOWN program. AB - The effectiveness of the adolescent obesity intervention SHAPEDOWN was evaluated for 15 months through a randomized experimental design study. Test groups (no. = 37) participating in the intervention were compared with a no-treatment control group (no. = 29) at four sites in northern California. The program employs a variety of cognitive, behavioral, and affective techniques adapted to make successive small modifications in diet, exercise, communication, and affect that are sustainable. Very-low-calorie or restrictive diets are avoided in the program. Parents are instructed on strategies for supporting their adolescents' weight-loss efforts. Participation in the group application of the program was associated with significant improvement in relative weight, weight-related behavior, depression, and knowledge of weight management concepts at post treatment and at 1-year follow-up. Self-esteem increased significantly regardless of condition. Change in relative weight for the test group was -9.9 +/- 14.9% (mean +/- standard deviation) and for the control group was -0.10 +/- 13.2%. At month 15 of the study period, weight change in the test group compared with the controls was -5.15 kg. For all subject variables examined in the test group, mean change in relative weight at 1-year follow-up was negative, suggesting that none of the characteristics examined contraindicate program participation among obese adolescents seeking care. Drop-out rate was 16%. The study suggests that the program produces significant long-term outcomes in obese adolescents and is transferable to a variety of settings. PMID- 3819255 TI - A comparison of two methods for the determination of body frame size. PMID- 3819256 TI - Evaluation of commercial multivitamin supplements. PMID- 3819257 TI - Marked decline in trabecular bone mineral content in healthy men with age: lack of association with sex steroid levels. AB - To define the association of age-related changes in bone mineral content to gonadal function in normal men, we measured radial (largely cortical) and vertebral (largely trabecular) bone mineral content (BMC), testosterone (total and free), estrone and estradiol-17B levels in 62 healthy subjects, ages 30 to 92. Radial BMC fell 2 to 3.4% per decade but vertebral trabecular BMC declined more rapidly at 12% per decade. Of the sex steroids measured the only statistically significant change occurred in free testosterone levels which decreased with age (r = -.57, P less than .0001). Free testosterone levels correlated significantly with trabecular vertebral BMC (r = .458, P less than .0002) but not with bone mineral measures at the predominantly cortical radial sites. However, by multiple regression analysis free testosterone did not add to the effect of age on vertebral BMC. There were no associations of total testosterone, estrone, or estradiol levels to bone mineral content at any of the three sites measured in these healthy men. Age-related declines in male gonadal function do not appear to be of primary importance in male age-related bone loss. PMID- 3819258 TI - Visual field limitation in the patient with dementia of the Alzheimer's type. AB - This paper investigates the existence of a visual field limitation and its effect on the advanced Alzheimer's patient. The data presented was obtained by testing 12 Alzheimer's and 12 control patients. The control patients were demented from causes secondary to reasons other than Alzheimer's disease. The results indicated that patients demented due to Alzheimer's have visual field losses significantly greater than other demented patients. This significant visual loss is of importance in assisting in differential diagnosis, performing patient cares, and planning patient environments. PMID- 3819259 TI - Longitudinal change in three brief assessments of SDAT. AB - Previous research has shown that there is considerable interest in the development of brief indices for use in the diagnosis and staging of senile dementia of the Alzheimer's type (SDAT). Examples of such measures include the Blessed Dementia Scale (BDS) and Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ). A third measure used in the assessment of organic cognitive impairment is the Face-Hand Test (FHT). This study, which was part of a large longitudinal investigation of SDAT, examined the performance of 43 subjects with SDAT and 57 healthy controls over 30 months. The subjects were assessed three times during this period. In addition to the brief measures (BDS, SPMSQ, and FHT) all subjects were rated on a Clinical Dementia Rating (CDR) Scale based on a lengthy clinical interview. The data were analyzed by means of a series of univariate, repeated measures ANOVAs, and discriminant analysis. Results indicate: control scores did not change over time on any of the measures; when classified according to severity of SDAT, different patterns of performance emerged over time for each measure; and it is difficult to accurately predict progression of SDAT from the three scores. PMID- 3819260 TI - Gram-negative bacillary bacteremia in the elderly: incidence, ecology, etiology, and mortality. AB - The incidence, ecology, and mortality of gram-negative bacillary bacteremia in elderly patients were studied in an analysis of 334 episodes over a four-year period in a 489-bed North Carolina community teaching hospital, 135 (40.4%) of which occurred in patients 70 years of age or older. The bacteremia rate per 1000 hospital admissions increased sharply with increasing age. The ecology and in vitro antimicrobial susceptibilities of the bacterial isolates were strongly influenced by community v hospital acquisition, but not by age. Urosepsis was significantly more likely to be the underlying source of hospital-acquired bacteremia in patients 70 years or older (P less than 0.01). Total bacteremia related mortality did not increase with increasing age; in the group of patients aged 70 years or older with nonfatal/ultimately fatal underlying diseases (NF/UFUD), however, mortality was 9.1% compared to 2.9% in the younger age group (P less than 0.001). Significantly increased bacteremia-related mortality was also noted in the older patients with NF/UFUD admitted from nursing homes (P less than 0.05) and those not treated with an appropriate antimicrobial agent within 24 hours (P less than 0.01). Overall, the older patients with hospital-acquired bacteremia, neutropenia-associated infection, those bacteremic from a nonurinary source of infection, and those treated with multiple-drug regimens had higher mortality (P less than 0.05). Gram-negative bacteremia is much more common in patients 70 years of age or older and compared with younger patients mortality appears to be significantly increased for the important subgroup of older patients with nonfatal or ultimately fatal underlying diseases. PMID- 3819261 TI - A controlled double-blind study of high-dose dihydroergotoxine mesylate (Hydergine) in mild dementia. AB - In a double-blind study of 41 outpatients aged 55 to 80 years with mild memory impairment, the efficacy of dihydroergotoxine mesylate (DEM, Hydergine) at 6 mg per day, administered orally, was tested during a twelve-week period. Specific etiologies for the amnesic syndrome were ruled out by history, physical examination, and laboratory tests. Subjects with a Hamilton Depression Scale rating above 18, ie, possible pseudodementia, were excluded. Physician rating of memory, employing the Inventory of Psychic and Somatic Complaints in the Elderly (IPSC-E), indicated statistically significant improvement of memory function in DEM treated subjects (N = 22) v those on placebo (N = 19), (F = 3.34; df = 1,39; P less than .04). In contrast, structured testing of recent memory using digit symbol substitution and Zahlenverbindungs test (ZVT) showed improvement in both groups (P less than .001) with no significant intergroup differences (P less than .10). Out results indicate that in cases of mild, though subjectively distressing impairment, DEM at higher dosages may help to enhance short-term memory function. PMID- 3819262 TI - A review: prostaglandins, aging, and blood vessels. PMID- 3819263 TI - Neuroleptic-induced neutropenia in the elderly. AB - A case reported here of Haloperidol-induced neutropenia demonstrates one of many important drug reactions to which the elderly may be predisposed. Neuroleptics can lead to neutropenia by toxic or immunologic mechanisms, and it is impossible to predict which patients will sustain this potentially life-threatening reaction. Fever and infection may be the only clue to this blood dyscrasias. The diagnosis of drug-induced neutropenia is largely one of exclusion coupled with the observation of increasing neutrophil counts after cessation of the drug. PMID- 3819264 TI - Extracorporeal shock wave lithotripsy for the treatment of urinary calculi in the elderly. AB - Renal calculus in the elderly patient is associated with the same symptoms and risks as in other patient populations. With the recent development of extracorporeal shock wave lithotripsy (ESWL), many older patients can now be treated for renal calculi. The Department of Urology at the University of Iowa Hospitals and Clinics has performed 107 ESWL treatments on a total of 96 patients over 70 years of age. This represents over 12% of all patients treated at our institution. No deaths related to ESWL treatment have occurred in this group, nor has increased morbidity been observed in comparison to all patients treated. In spite of the increased age and associated medical problems of this patient population, ESWL offers a safe and effective means of treating upper tract urinary calculi in the geriatric age group. PMID- 3819265 TI - Misleading thyroid function tests and several homeostatic abnormalities induced by "disalcid" therapy. PMID- 3819266 TI - Male osteopenia: a brief review. PMID- 3819267 TI - The character of love to guide re-humanizing dying. PMID- 3819269 TI - Comment on "Lovable decisions". PMID- 3819268 TI - Dexamethasone suppression test in dementia. PMID- 3819270 TI - Arm muscle mass and malnutrition. PMID- 3819271 TI - Hearing impairment and cognitive function in Alzheimer's disease. PMID- 3819272 TI - Nursing home patient participation in medical education. PMID- 3819273 TI - Octogenarians and higher are able to perform activities of daily life. PMID- 3819274 TI - Affective state and symptoms prevalence in the elderly. PMID- 3819275 TI - Sex role stereotyping: reactions of women anesthesiologists. PMID- 3819276 TI - Interpersonal stress in medical education: correlates for men and women students. PMID- 3819277 TI - Ethics and emotions of organ transplants. PMID- 3819278 TI - Understanding premenstrual syndrome. PMID- 3819279 TI - Cardiac life support: a matter of life or death. PMID- 3819280 TI - Morality. PMID- 3819281 TI - Radial keratotomy postscript. PMID- 3819282 TI - The mentally handicapped patient: a perspective. AB - The patient exhibiting decreased cognitive abilities (mental retardation) requires full scope optometric care, but may often receive little or no vision care whatsoever. This paper will provide the optometrist with a review of the history of exceptionality, Public Law 94-142, the educational classification of mental retardation, and various examination techniques appropriate for this population. The optometrist should contribute his/her knowledge and skill as a member of the patient's rehabilitation team and provide those services required by this unique population. PMID- 3819283 TI - Evaluation of the Parsons Visual Acuity Test in screening exceptional children. AB - The Parsons Visual Acuity Test (PVAT) is a non-verbal picture based visual acuity test designed for the difficult-to-test preschool child, school age child and adult with handicapping conditions. It is designed primarily for vision screening of the exceptional child and adult with special needs. Since visual acuity measures are quite important in these populations, a comparative study between the PVAT and standard Snellen acuity were designed and completed. There was no significant difference in acuity measures at near, however, the validity of the distance PVAT visual acuity measure was not supported in this study. Implications of the findings and cautions for the use of this test in screening and clinical situations for exceptional children and adults are discussed. PMID- 3819284 TI - The special educator and the optometrist. AB - This article is meant to give optometrists practical suggestions about how to better communicate their specialized knowledge to teachers. The optometrist has a wealth of information that can be not only useful to the teachers, but also extremely beneficial to the students. As team members, the optometrist and teacher share and exchange professional information. The teacher gains an understanding of how the student's vision loss affects learning while the optometrist gains an insight about the child's educational programming. PMID- 3819286 TI - Serving the mentally handicapped patient: a self assessment. PMID- 3819285 TI - Vision therapy for the child with cerebral palsy. AB - There has been an abundance of data collected on the high prevalence of visual anomalies in cerebral palsy. Relatively little has been written about remediation. This article discusses the problems encountered in the CP population, and therapy programs which can be utilized to deal with them. Heavy emphasis is placed on ocular motility and accommodation because deficits in these two visual skills are encountered very frequently, are most amenable to therapy, and show the greatest improvement as a result of vision therapy. PMID- 3819287 TI - Cyclotherapy in the treatment of symptomatic latent hyperopia. AB - Many practitioners have long been frustrated with traditional treatments of symptomatic latent hyperopia (fogging techniques, bifocals, etc.). A technique employing short-acting cycloplegia has been developed which provides rapid relief of symptoms by promoting full correction of latent refractive error. Fifteen symptomatic subjects ages 3-40 were diagnosed as latent hyperopes with the aid of 1% cyclopentolate, and subsequently recyclopleged utilizing full correction in constant wear spectacles. Acuity was maintained via slow diminution of cycloplegia. Short-term and long-term follow-up, with continued use of spectacles or contact lenses, revealed rapid and complete resolution of symptoms and restoration of visual efficiency in each case. Cyclotherapy offers both practitioners and patients an efficient, rapid-acting, and satisfying alternative treatment for this vexing accommodative anomaly. PMID- 3819288 TI - An evaluation of visual acuity with the Corning CPF 527 lens. AB - The effect of visual acuity on the Corning 527 photochromatic lens was studied for a group of 50 normal patients and 53 low vision patients. Visual acuity was measured at 10 feet using three Lighthouse Low Vision Distance Acuity Charts, whose letters were randomly arranged. Acuity measurements were performed under three conditions: through a plano lens, a Corning 527 lens and an equivalent neutral density filter, each placed over the best corrective lenses. No statistically significant difference in acuity measurements were found between these three conditions. PMID- 3819289 TI - What is the student's role in the future of optometry? PMID- 3819290 TI - Subjective comparison of office perimetry. AB - The Fieldmaster 50 and the Dicon AP2000 are automated perimeters which perform threshold static testing. In this study, 50 patients and 10 perimetrists determined their preference after being randomly tested by each automated perimeter. Subjects responded to a series of questions comparing the perimeters. The Fieldmaster 50 automated perimeter was preferred for most of the question categories. PMID- 3819291 TI - Toward better eye and vision care for the mentally handicapped. PMID- 3819292 TI - Management of patients with age-related cataracts: a survey of Oklahoma optometrists. AB - Many advances have been made in recent years in the treatment of patients with cataracts, particularly in the area of aphakic vision correction. In this study, 60 optometrists were surveyed about their role in the management of patients who have cataracts significantly affecting vision. It was found that over 90% of the optometrists surveyed attempted to educate their patients about cataracts, cataract surgery, and alternatives for aphakic vision correction. However, these optometrists felt least knowledgeable about intraocular lens implants, the most common form of aphakic vision correction used today. It is recommended that the optometrist keep abreast of advances in the fields of cataract management and aphakic vision correction to provide patients with state of the art optometric care. PMID- 3819293 TI - Acute posterior multifocal placoid pigment epitheliopathy. AB - The pathogenesis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is not fully understood. Some believe it to be a primary dysfunction of the retinal pigment epithelium while others assume that its development follows a choroidal vasculitis. It generally presents as a bilateral condition and shows no sex predilection. The visual prognosis is generally good, though severe and permanent visual loss occasionally occurs. The funduscopic presentation consists of multiple flat, yellow-white lesions of the posterior pole at the level of the retinal pigment epithelium. This paper discusses a case of APMPPE and reviews and summarizes the current literature on this disorder. PMID- 3819294 TI - Optic nerve pit. AB - Optic nerve pits are an uncommon congenital anomaly of the optic nerve head. Pits are generally recognized to represent an atypical form of optic nerve coloboma. The appearance of optic nerve pits can be quite variable and may simulate other anomalies of the optic nerve head, such as glaucoma or optic nerve tumor. Visual loss is present in a significant number of cases. Arcuate scotomas and a serous macular detachment have been associated with pits of the optic nerve. The mechanism for development of the serous maculopathy is not well understood. PMID- 3819295 TI - Optic nerve hypoplasia. AB - Optic nerve hypoplasia is now recognized as a common developmental anomaly of the optic nerve. It has a large clinical spectrum of findings, but is most often associated with impaired vision and a small optic disc. Additional findings which aid in the diagnosis include a Marcus Gunn pupil, a double peripapillary ring, and pathological thinness of the retinal nerve fiber layer. Bilateral optic nerve hypoplasia may be a clue to midline developmental anomalies of the brain. Our case of optic nerve hypoplasia illustrates its variability of presentation and underscores the importance in investigating every case of unexplained decreased vision. PMID- 3819296 TI - Professionalism and ethical practice in optometry. AB - Today there are groups of people who would deprofessionalize optometry by creating conditions which can infringe upon professional decision making and replace it with marketplace decisions based upon cost-effectiveness and products. Traditional definitions of professionalism include words and phrases such as: ethical standards, human concern, patients, public, society, colleagues, compassion, and devotion to service. These are not words traditionally associated with the business marketplace. This paper addresses the conduct which is expected from one who wishes to be judged a professional. PMID- 3819297 TI - Marketing a sports vision practice. PMID- 3819299 TI - Eye and vision care in the Soviet Union. PMID- 3819298 TI - Clinical and legal considerations in the diagnosis and management of ocular tumors. AB - Although some ocular tumors are symptomatic, others can be silent. An examination routine is suggested which could reveal such silent intraocular lesions, and special diagnostic procedures for patients with suspicious intraocular lesions are presented. The legal responsibility of optometrists for the detection of silent and symptomatic ocular tumors is described also, and the standard of care for patients at high risk for tumors is discussed. PMID- 3819300 TI - Radial keratotomy. PMID- 3819301 TI - The effects of visual-spatial and verbal skills on written and mental arithmetic. AB - The relative influences of visual-spatial and verbal factors on the performance of written and mental arithmetic by normally achieving fourth and fifth grade children are compared. The independent perceptual and verbal measures were correlated with the Arithmetic Subtest of the Wide Range Achievement Test (WRAT) and the Arithmetic Subtest of the WISC-R using both bivariate and multivariate analysis. In the performance of the written arithmetic, spatial factors yield a statistically significant higher positive correlation than verbal skills. On the other hand, verbal skills appear to render a higher positive, but not statistically significant, correlation with mental arithmetic than spatial skills. Optometrists should be aware of the potential for treatment of visual and perceptual dysfunctions present in children who are experiencing problems in written and mental arithmetic. PMID- 3819302 TI - School of optometry at Tel Aviv University. AB - The following article describes the program for the study of optometry to begin at Israel's Tel Aviv University in the 1987/1988 academic year. Details of the proposed structure, facilities and curriculum are presented. In addition, background is provided as to the current vision care system in Israel, and how the absence of a school of optometry has influenced its condition. PMID- 3819303 TI - The microstructure of free association. AB - The author's purpose is threefold: first, to demonstrate the redundancy in the events of the complex life of a patient as told to a psychoanalyst; second, to show two novel ways to represent those events simply; and third, to suggest that the field of psychoanalysis, under assault from philosophers of science and hermeneuticists alike for either not being or for trying to be a science, can in principle be reclaimed for science. It can be done by abandoning a widely held belief that human behavior is simply too complex, too malleable, too rooted in ineffable experience to permit of systematic scientific capture. PMID- 3819304 TI - Institutional problems of psychoanalytic education. AB - I believe that psychoanalytic education is suffering from serious disturbances, which, by analogy, might be examined as an illness affecting the educational structures of psychoanalytic institutes and societies. After describing the symptoms of this illness, I shall explore its causes and suggest a possible course of treatment. My objective is not to present "ideal solutions" to problems, but to provide a theoretical frame that might facilitate such solutions. PMID- 3819305 TI - Robert Waelder and the application of psychoanalytic principles to social and political phenomena. AB - This presentation reveals a little-known area of Robert Waelder's work. As his literary executor, I have been privileged with access to his unpublished material, notes, and correspondence. And, of course, I am familiar with his mode of thinking. I wish to pass on some of this knowledge. What cannot be passed on, however, in some abstract intellectual way, are psychoanalytic principles themselves. Therefore, while this paper sheds light on a very particular aspect of Robert Waelder's work, it is also in some ways a cautionary tale, a plea that the reader understand what is behind the psychoanalytic point of view and its basic concepts--namely, clinical experience. PMID- 3819306 TI - A preliminary report on defenses and conflicts associated with borderline personality disorder. AB - The authors present preliminary psychodynamic findings from a naturalistic study of borderline personality disorder compared to antisocial personality disorder and bipolar type II (depression with hypomania) affective disorder. An independent psychodynamic interview of each subject was videotaped from which ratings were made of the presence of 22 defense mechanisms and 11 psychodynamic conflicts. A factor analysis of ratings from 81 subjects supported the separation of borderline (splitting, projective identification) from narcissistic defenses (devaluation, omnipotence, idealization, mood-incongruent denial). While certain groups of defenses were associated with each diagnosis, defense ratings did not significantly discriminate the three diagnostic groups, suggesting a limit to their diagnostic value. Among 27 subjects rated, borderline personality was strongly associated with two conflicts: separation-abandonment, and a global conflict over the experience and expression of emotional needs and anger. Antisocial personality was psychodynamically distinct and more heterogeneous. Bipolar type II was associated with two hypothesized depressive conflicts: dominant other and dominant goal. Chronic depression, which was more common in both personality disorder groups than in bipolar type II, was associated with a third depressive conflict, overall gratification inhibition. Overall, conflicts were powerful discriminators of the three diagnostic groups. The heuristic value of these findings is discussed. PMID- 3819307 TI - Recontact with the analyst following termination: a survey of seventy-one cases. AB - A questionnaire was sent to graduate members of the Denver Psychoanalytic Society asking for their experience with patients making contact with them after the analysis. They reported that within three years after termination two thirds of "successfully analyzed" patients had recontacted them. Seventy-one cases were surveyed. Most contacts were brief and did not seem to be the result of incomplete analysis. Rather, they aimed to satisfy ongoing needs for: the continuing deidealization of the analyst, the reactivation of the self-analytic function, and the restructuring of self- and object representations by reporting developmentally significant accomplishments to the former analyst. The analyst's acknowledgement appears to be an integral part of the restructuring. This is work which either cannot be done before termination or the need for which has not been recognized during the analysis. PMID- 3819308 TI - Reconstruction and perceptual experience: further thoughts on psychoanalytic listening. AB - Freud's monumental shift to the fantasy theory heralded the view that "it is psychical and not material reality" which is our sole domain of inquiry. Yet despite theoretical agreement and cogent technical admonitions against concerning ourselves with absolute or "external" truths, psychoanalytic listening betrays a stance in which the analyst attunes to a reality other than that of the patient's inner world, assuming the position of arbiter--even if a silent one--of what is or is not "distorted" in the patient's perceptual experience. The central impact of perception as a significant component of the patient's inner experience--past and present--goes unattended. Clinical examples from differing theoretical persuasions are reviewed to demonstrate this occurrence. An alternative mode of listening is considered which assumes an underlying shift in outlook, suspending any notion that we can "know" what is "correct" in the patient's perception, while sharpening attunement to its clinical impact--as may be evidenced by a shift in affect or state, a turn of phrase, or the transient appearance of a symptom or old behavior. It is argued that such a stance will lead to a more singular focus on the patient's psychic reality, permitting the emergence of a deepening realm of psychic phenomena, enhancing the capacity of self-observation, and richly facilitating the reconstructive process. PMID- 3819309 TI - Determinism, possibility, and ethics. AB - This essay reexamines the age-old "determinism-free will" problem from a psychoanalytic perspective. The first section recapitulates the author's (1985) earlier argument on the nature of causation in psychoanalysis; the second part examines the compatibility of determinism and freedom; and the final section looks at the ethical ramifications of the issues at hand. The author exposits his adherence to universal determinism and attempts to answer the question, "What sort of possibility and ethics are permitted in a deterministic universe?" PMID- 3819310 TI - The place and value of bestophilia in perversions. AB - An attempt is made to place bestophilia in cultural, clinical, and theoretical perspective. Archeological and anthropological documentation and records of the widespread appearance in mythology of this practice are cited. This archaic form of perversion is still practiced in rural environments and isolated communities. The treatment of a man who grew up in such an environment gave the author the opportunity to study this form of perversion. The correlation of clinical findings with culturally sanctioned bestophilia provides a bridge between the understanding of psychopathology and anthropological variation. PMID- 3819311 TI - Evidence for a vagally mediated satiety signal derived from hepatic fatty acid oxidation. AB - To test the possibility that vagally mediated signals derived from hepatic fatty acid oxidation affect feeding, we investigated the influence of selective hepatic vagotomy on the acute hyperphagic effect of the fatty acid oxidation inhibitor 2 mercaptoacetate (MA) in rats kept on a medium fat diet (18% fat). An i.p. injection of MA (400 mumol/kg b.wt.) stimulated feeding in sham-vagotomized rats clearly more than in vagotomized rats. A high dose of MA (800 mumol/kg b.wt.) initially increased food intake in sham-vagotomized but not in vagotomized rats and later decreased food intake similarly in both surgical groups. MA retained its potency to stimulate feeding after an i.p. injection of atropine methylnitrate (5 mg/kg b.wt.). These results indicate that hepatic fatty acid oxidation provides a satiety signal that is mediated by vagal afferents. PMID- 3819312 TI - Vagal afferent discharge from gastric mechanoreceptors during contraction and relaxation of the ferret corpus. AB - Vagal afferent fibres with mechanoreceptive fields in the gastric corpus were studied electrophysiologically in the urethane-anaesthetized ferret in an attempt to assess how changes in muscle tension and length modulate receptor discharge. Single afferent units were spontaneously active and increased their firing on distension of the corpus. During vagally evoked isovolumetric contractions and relaxations, the afferent discharge closely followed changes in intracorpus pressure. Under near-isotonic conditions, changes in both intracorpus pressure and afferent discharge were attenuated to similar degrees despite large changes in corpus volume, although the latter had a modulating influence on afferent discharge. These mechanoreceptors appeared to behave as tension receptors but were also influenced by muscle length as would occur if the receptor were associated with the laminar intramuscular septa of connective tissue which may serve as intramuscular tendons in this tissue. PMID- 3819313 TI - Cat carotid body chemoreceptor responses before and after nicotine receptor blockade with alpha-bungarotoxin. AB - The nature of nicotine receptors in the carotid body was studied in anesthetized, paralyzed and artificially ventilated cats. Chemoreceptor discharge in single or few-fiber preparations of the carotid sinus nerve was measured during isocapnic hypoxia, hyperoxic hypercapnia and in response to nicotine injections before and after administration of alpha-bungarotoxin (10 cats) and after alpha-bungarotoxin plus mecamylamine (7 cats) which binds to neuromuscular-type nicotine cholinergic receptors. alpha-Bungarotoxin caused a slight enhancement of the chemoreceptor response to hypoxia without affecting the chemoreceptor stimulation by nicotine. Mecamylamine (1-5 mg, i.v.), a ganglionic-type nicotinic receptor blocker, had no further effect on the response to hypoxia while it completely abolished the chemoreceptor stimulation by nicotine. Thus the nicotinic receptors in the cat carotid body which elicit excitation of chemosensory fibers appear to be of the ganglionic-type. Blockade of neuromuscular and ganglionic types of nicotinic receptors in the carotid body by alpha-bungarotoxin and mecamylamine does not attenuate the chemosensory responses to either hypoxia or hypercapnia. These nicotinic receptors therefore, do not appear to play an essential role in hypoxic or hypercapnic chemoreception in the cat carotid body. PMID- 3819314 TI - Rhythmic contractile activity of the pulmonary artery studied in vivo in cats. AB - The rhythmic contractions of the intact pulmonary artery branch were recorded in anaesthetized cats. In order to investigate the temporal relationship between the contractions and the cardiac events, the heart rate was varied by various manoeuvres. The rhythmic contractile activity synchronous with pulse pressure was found to be locked to the pulsatile activity of the right atrium. Administration of acetylcholine or electrical stimulation to the cut peripheral end of either vagus produced similar reduction in the rate of contractions and the heart rate, a 1:1 relationship between the two was always maintained. Prior treatment with atropine abolished the acetylcholine and vagal stimulation responses. Thus, a cholinergic mechanism which affects the activity of the cardiac pacemaker also influences the arterial smooth muscle contractility. PMID- 3819315 TI - Reflex responses to baroreceptor, chemoreceptor and nociceptor inputs in single renal sympathetic neurones in the rabbit and the effects of anaesthesia on them. AB - Reflex responses of renal postganglionic neurones to stimulation of arterial baroreceptors, arterial and central chemoreceptors and cutaneous nociceptors, and the rhythmicity of their resting activity were studied in paralyzed, artificially ventilated rabbits, anaesthetized with either alfathesin or chloralose-urethane. A 'vasoconstrictor' response pattern was seen in all units. Perivascular balloon induced falls in blood pressure increased firing while pressure rises silenced 90% of units and reduced firing in the rest. Resting activity was linked to pressure changes within the cardiac cycle and to the artificial respiratory cycle. The largest excitation occurred during hypoxia and injections of CO2 saturated solutions into the carotid artery while hypercapnia and stimulation of cutaneous nociceptors only slightly increased firing. Parameters characterizing rhythmicities and reflex responses were unimodally distributed with no apparent subgrouping of units on quantitative grounds. Unit response patterns were similar to those recorded in the whole renal nerve. With one exception, no silent units were found which responded to the afferent inputs studied. Nor was there a small spike fibre group which was excited by angiotensin. However, reflex responses were significantly influenced by the anaesthetic regime selected for use. Under alfathesin, baroreceptor and chemoreceptor reflexes were double those found with chloralose-urethane. Under chloralose-urethane, hypoxia increased both rhythmicities, while under alfathesin, cardiac rhythmicity was decreased and respiratory rhythmicity was variably affected. We concluded that renal sympathetic neurones are a functionally uniform population which behave like vasoconstrictors. PMID- 3819316 TI - Inhibition of cardiopulmonary input to thoracic spinothalamic tract cells by stimulation of the subcoeruleus-parabrachial region in the primate. AB - Effects of electrically stimulating the subcoeruleus-parabrachial (SC-PB) region on 31 spinothalamic tract neurons which receive excitatory input from cardiopulmonary sympathetic afferent fibers were studied in 21 monkeys anesthetized with chloralose. A conditioning stimulus to the SC-PB region inhibited the activity of 5 cells responding to the test stimulus applied to sympathetic afferent fibers. At a conditioning-test interval of 10 ms, test responses were maximally reduced to 47 +/- 6% of the control. Inhibitory effects were present at conditioning-test intervals up to 150 ms. Excitatory effects of both A delta-and C-fiber sympathetic afferents were reduced by stimulation of the SC-PB region; however, C-fiber input was more powerfully inhibited. Intracardiac injection of the algesic agent bradykinin excited 8 of 12 spinothalamic tract neurons tested; the responding cells increased their activity from 12 +/- 13 to 31 +/- 8 impulses/s. SC-PB stimulation (212 +/- 45 microA) reduced the peak activity caused by bradykinin to 6 +/- 2 impulses/s. Aortic occlusion increased the discharge rate of 5 out of 8 neurons from 13 +/- 3 to 21 +/- 4 impulses/s. At the peak of the response of aortic occlusion, SC-PB stimulation (238 +/- 20 microA) decreased neuron activity to 3 +/- 0 impulses/s. Effective sites for inhibition of spinothalamic tract cell activity were located in the lateral and medial parabrachial nuclei and the nucleus subcoeruleus. This study demonstrates that stimulation of the dorsolateral pons can inhibit the responses of upper thoracic spinothalamic tract neurons to cardiopulmonary sympathetic afferent input. Our laboratory previously has shown that stimulation of cardiopulmonary vagal afferents inhibits spinothalamic tract cells via supraspinal mechanisms. The SC-PB region may be a site activated by cardiac vagal afferents during ischemia and therefore, may be involved in the etiology of painless myocardial infarctions. PMID- 3819317 TI - Use of the fluorescent dye, fast blue, to label sympathetic postganglionic neurones supplying mesenteric arteries and enteric neurones of the rat. AB - Neuronal pathways in the peripheral nervous system have been traced using the fluorescent dye, Fast blue. Following implantation of a gelatin pellet containing the dye, or direct injection of the dye into the mesentery beside an artery, Fast blue is taken up by both nerve terminals and axons of passage, retrogradely transported by large numbers of sympathetic neurones and retained within the neurones for long periods of time without diffusion. Neurones projecting to both blood vessels of the mesentery and submucosa and to enteric ganglia of the segment supplied by the artery were found labelled in prevertebral and paravertebral ganglia as well as in ganglia lying along the major splanchnic nerves. Attempts to separate the vascular component from those neurones innervating enteric ganglia suggest that the latter are located in the prevertebral, coeliac and superior mesenteric ganglia and to a lesser extent in the splanchnic ganglia, while the vasomotor neurones are located in prevertebral, paravertebral and splanchnic ganglia. PMID- 3819318 TI - Sources of excitatory synaptic inputs to neurochemically identified submucous neurons of guinea-pig small intestine. AB - The locations of the cell bodies of axons responsible for synaptic potentials evoked in neurochemically identified submucous neurons of the guinea-pig small intestine were investigated using a combination of intracellular recording, immunohistochemical and lesioning techniques. The myenteric plexus was removed from an 8-15 mm wide ring of small intestine in 15 anaesthetized guinea-pigs. After the operations, the animals were allowed to recover for 3-7 days so that nerve terminals that were disconnected from their cell bodies would degenerate. Preparations of submucous plexus were then made from the region under the lesion. Submucous neurons were impaled with electrodes containing a mixture of KCl and the fluorescent dye, Lucifer yellow CH, and their electrophysiological properties determined. They were then filled with the dye for subsequent reidentification after processing for immunohistochemical localization of vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY). The synaptic inputs to 33 neurons were characterized: 19 of these were found to be VIP-reactive, 7 were NPY-reactive and 7 were negative for both VIP and NPY. These results were compared to those obtained from 43 neurons in control preparations: 25 VIP-reactive, 9 NPY-reactive and 9 negative for both VIP and NPY. Removal of the myenteric plexus caused a significant reduction in the number of inputs providing fast excitatory synaptic potentials to each of the neurochemically defined classes of neurons. The lesions also caused a significant reduction in the number of VIP-reactive neurons that exhibited slow excitatory synaptic potentials (other neurochemical types do not normally exhibit such responses).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819319 TI - [Retinal detachment caused by small tears in the equatorial region of the retina]. AB - 46 Phakic rhegmatogenous retinal detachments due solely to round atrophic holes in the equatorial region were observed in 42 patients. The clinical characteristics and the prognosis of the retinal detachments differ from those of retinal detachments associated with horse-show retinal tears. The 46 phakic retinal detachments due solely to round atrophic holes in the equatorial region account for 5.8% of all rhegmatogenous retinal detachments operated during the same period of time, 81% of the patients were under 40 years of age, 93.5% of the eyes were myopic. The round atrophic holes were located within foci of equatorial lattice degeneration in 97.8% of the eyes. The number of holes per eye varied from 1 to 16 with a mean number of 4.54. The location of the holes showed a significant prevalence for the lower temporal quadrant (83.3% of the eyes) and then the upper temporal quadrant (47.8% of the eyes). The retinal detachments had a slow progression and demarcation lines were present in 56.5% of the eyes. In spite of the long standing duration none of the detachments were associated with clinical evidence of proliferative vitreo retinopathy. Surgical prognosis was excellent. Retinal reattachment was achieved in all cases. Post operative visual acuity of 20/40 or better was achieved in 60% of the eyes. It is assumed that the absence of proliferative vitreo retinopathy in those retinal detachments is related to the absence of significant vitreous degeneration and posterior vitreous detachment. PMID- 3819320 TI - [Ocular contusion and cellular density of the corneal endothelium]. AB - Specular microscopy was performed on 24 patients with an history of blunt ocular trauma, after a 2 to 35 months follow up. In 29.1% of the patients, there was a cellular loss greater than 5%. No significant association was noted between cell loss and angle recession. This data should be evaluated in medico-legal examinations. PMID- 3819321 TI - [Ocular manifestations of myasthenia. Apropos of 60 cases of myasthenia observed at the Dakar University Hospital Center]. AB - The authors report 43 cases with ocular signs among 60 cases of myasthenia gravis encountered over a period of 23 years in the Ophthalmologic and Neurologic clinics of the University Teaching Hospital of Dakar. After analysis of the aetiological, clinical, evolutional and therapeutic features, they insist on the importance of the ocular symptoms that eventually can help to early diagnosis and treatment. PMID- 3819322 TI - [En bloc excision in the conservative surgery of neoformations of the anterior uvea. Apropos of 2 cases of adenoma of the ciliary body]. AB - Indications of enucleation for uveal tumors were systematic in the past. They should become more adapted actually. Anterior limited uveal tumors, as in our two personal observations, should be an indication to realize a preservative treatment of the eye; the authors recommend the "block-excision" method, which allows: first, the ablation of the whole tumor and consequently the best possible prognosis, then, an anatomopathologic study which confirms the clinical diagnosis and avoids performing excessive enucleation in case of benign tumors as adenoma. PMID- 3819323 TI - [Analysis of microangiopathy in young diabetics using retinal angiofluorography. Relation to diabetes duration, HbA1, HLA-DR antigens and neuropathy]. PMID- 3819324 TI - [Oculomotor disorders in orbital pathology. Thyroid ophthalmopathy. Involvement of the extraocular muscles]. PMID- 3819325 TI - [Intraocular penetration of fosfomycin in man and rabbits]. AB - The intraocular distribution of fosfomycin was studied in 32 patients undergoing cataract surgery and or vitrectomy and in 8 rabbits after experimental infection of one eye by Staphylococcus aureus. In subjects perfused with 4 g of fosfomycin, concentrations ranged from 14 to 18.8 mg/l in aqueous humour (AH) and from 8 to 12.5 mg/l in vitreous fluid (VF) between 1 and 6 hours after the end of the perfusion; these levels were higher than MICs for 80-90 per cent of bacteria found in endophthalmitis. In rabbits the concentration in infected eyes with respect to healthy eyes was found to be from 2.5 to 5 times in AH and from 4.9 to 19.2 times higher in VF. Therefore fosfomycin in association with third generation cephalosporins (ceftriaxone) or with new quinolones can be recommended in the prevention and early treatment of endophthalmitis. PMID- 3819326 TI - [A case of ocular involvement in AIDS]. AB - The authors describe a case of retinopathy in a patient suffering from AIDS. A study of the Fundus of a 25 year-old homosexual and drug-addict suffering from AIDS revealed cotton wool spots and edema of the optic disc in both eyes. In this paper the authors reports increased lesions of the retina with the progression of the disease and discuss the role of the ophthalmologist in early diagnosis of AIDS. PMID- 3819327 TI - [Ocular hypotonia and retinal injuries in Steinert disease. Angiographic aspects]. AB - The authors study ocular complications, mainly retinal, in three patients with myotonic dystrophy. The association of cataract, ocular hypotony, reticular or butterfly-shaped dystrophy of the macular pigmentary epithelium was observed in all cases. A bibliographical study regarding retinal lesions: clinical aspects (macular lesions and peripheral retinopathy), retinal functions (visual acuity, color sense, dark adaptation, electrophysiological examinations), histopathological aspects with proliferation of peripheral pigmentary epithelium, retinal and choroidal fibrohyalinosis. The authors report vitreous and retinal modifications (disc, macula, retinal vessels, peripheral retinopathy), evolutive aspects, electrophysiological anomalies in order to understand at best Steinert's ocular lesions. PMID- 3819328 TI - [Meningeal hemorrhage and Hermansky-Pudlak syndrome]. AB - We studied the case of a young patient affected by a Hermansky-Pudlak syndrome: oculocutaneous albinism of variable intensity with essentially an haemorrhagic diathesis due to a "pool vide" thrombopathy. In beginning the only obvious symptom was a nystagmus and an ocular albinism. Cerebrospinal hemorrhage has up to now never been reported to our knowledge. Healthy carriers can be detected by ophthalmological examination and hematological coagulation tests. Albinos must benefit of systematical coagulation tests in order to prevent drug induced haemorrhagic accident. PMID- 3819329 TI - [Retinoblastoma: 21-year review]. AB - The natural history and prognosis of retinoblastoma were analysed using data from 73 medical records with diagnosis of retinoblastoma registered during 1963-1983 at University Hospital of Kinshasa (Zaire). Of the 73 cases, 24 children (33%) were bilaterally affected. There were 38 (52%) boys and 35 (48%) girls. Ages at diagnosis ranged from 1/2 year to 6 years with an average age of 2.4 years. The white pupil was the most common initial sign. Many of our patients were severely affected with massive tumor filling the entire eye with vitreous seeding and poor general condition. Because of the more advanced stage of the tumor at time of diagnosis, surgery was the usual form of treatment. Only 5 children in our series showed a long-term survival, longer than 3 years after surgical treatment for retinoblastoma. PMID- 3819330 TI - [Hemorrhagic complications in drusen of the optic papilla]. AB - A case of optic disc drusen complicated by retinal hemorrhages similar to those seen in central retinal vein occlusion is presented. While haemorrhagic complications of optic disc drusen are rare, three types have been described: small disk haemorrhages, vitreous haemorrhages and deep peripapillary haemorrhages. This clinical aspect of the haemorrhagic retinopathy presented in this paper has rarely been described; the pathogenesis of this lesion can be attributed to a progressive compression by the drusen on the central vein in the optic disk, causing a venous stasis retinopathy. Since it is impossible to remove the cause of the venous compression, the prognosis of this clinical form is always poor. Finally, the author emphasizes the need to consider this rare complication of drusen of the optic disk, especially in young patients with no systemic pathology who present this ophthalmoscopic picture, in order to avoid useless, time consuming tests and ineffective therapies. PMID- 3819331 TI - [Retinal detachment caused by late-stage retinopathy of prematurity]. AB - Retinal detachment occurring in late stages of retinopathy of prematurity may appear spontaneous when a short oxygen therapy in low birthweight infant has been failed to recognized. As it is initially a tractional detachment the understanding of underlying pathogenic mechanisms is still important to choose adequate treatment which will determine the success of the surgery. Six patients with R.D. were recognised as having late complication of R.P. on the aspect of pathological posterior retinal vasculature and typical history of prematurity and oxygen therapy. All cases were treated successfully by different procedures varying with the severity of the disease. Use of vitrectomy can be advised in some cases but, is still a dangerous procedure, especially in this peculiar condition. PMID- 3819332 TI - [Supranuclear disorders of eye movements]. PMID- 3819333 TI - Toxicity of some ricefield pesticides to the crayfish P. clarkii, under laboratory and field conditions in Lake Albufera (Spain). AB - Static toxicities in mature crayfish (Procambarus clarkii) were determined, for eight insecticides, two herbicides and one fungicide which were frequently used in rice cultivation at Lake Albufera in Valencia (Spain). Three concentrations of each product were used: a) The concentration that was recommended by the dealer (in mg/L of active ingredient): Carbofuran 0.40, Carbaryl 0.80, Malathion 0.80, Trichlorfon 0.40, Endosulfan 0.56, Lindane 0.56, Fenitrothion 0.40, Cyfloxylate 0.02, Molinate-Thiobencarb 1.50, Copper Sulfate 0.42, b) Half of the recommended concentration. c) Double of the recommended concentration. In all three of the concentrations tested, only Fenitrothion and Cyfloxylate caused a considerable mortality. The other ones do not actually produce any important effects on P. clarkii in our conditions. Nevertheless, insecticides are more toxic than herbicides or fungicides, as the latter show a rather low toxicity. PMID- 3819335 TI - General slowing of nonverbal information processing: evidence for a power law. AB - Data were analyzed from studies of nonverbal information processing in which the dependent measure was the latency of pressing or releasing a response key. Positively-accelerated power functions described the relationship between the response latencies of groups of older (50 to 60 years and 65 to 75 years) and younger adults (20 to 25 years) with extreme precision (r2 = .99). The exponent of the best-fitting power function increased with the age of the older group. The form of the relationship is allometric, and is consistent with a model (Botwinick, 1984) in which response latency increases exponentially with task difficulty. The present findings suggest that this model holds across a wide variety of information-processing tasks and over a very broad range of latencies. PMID- 3819334 TI - Progressive loss of the macrophage respiratory burst in oxygen toxicity. AB - The respiratory burst of rat alveolar macrophages stimulated by a variety of agents declines as a function of time of exposure to hyperoxia. Previous studies have evaluated this effect in terms of the stimulated O(2) production of a population of cells. The present study was designed to determine whether this decline is due to a "turning off" of the respiratory burst activity of some cells within the alveolar macrophage population or a general suppression of the activity of all cells. The phorbol myristate acetate (PMA) initiated respiratory burst of individual rat alveolar macrophages was monitored using the reaction of nitroblue tetrazolium (NBT), which results in the formation of a precipitate on active cells. The formazan staining was evaluated using black and white photographs of the cells and comparison to a scale constructed from photographed cells of four differing intensities of staining. Frequency distributions indicated that when the respiratory burst capability in the population of alveolar macrophages is impaired approximately 50% by oxygen exposure and/or culture in plastic vessels with artificial media, there is a gradual shift in NBT reduction rather than an "all or nothing" mechanism, in which the distribution would have reflected a shift from darkly stained cells to the very lessened or negligible staining observed at the end stage of oxygen toxicity. PMID- 3819336 TI - Estimating sample size for longitudinal studies of age-related cognitive decline. AB - Cross-sectional age-group norms for cognitive tests reveal a progressive age related decline. There is current interest in the possibility of developing interventions that forestall the normal cognitive decline in elderly adults. This raises new research design issues, one of which is the estimation of appropriate sample sizes for longitudinal studies when only cross-sectional data are presently available. Formulae for estimating change parameters from cross sectional data are presented in this article. Based on age-related changes in cross-sectional norms for the Wechsler Adult Intelligence Scale (WAIS), the sample sizes required for controlled intervention studies of 1 to 3 years duration are very large. If cognitive decline within individuals is not as great as the decline evident in cross-sectional norms, the required sample sizes will be even larger. PMID- 3819337 TI - Age differences in autonomic variables during sleep. AB - Relationships of autonomic variables and sleep were assessed in men and women at two age levels (18 to 23 and 57 to 71 years) to check for alleged associations between physiological arousal and age-related sleep disturbance. Heart rate, although relatively high at the upper age level, was unrelated to sleep measures. For the most part, underarousal rather than hyperarousal characterized older sleepers. Women's body temperature declined significantly with age. Vasoconstrictions, which were more frequent in young adults, showed some association with better sleep. The earlier the overnight temperature nadir, the more wakefulness after sleep onset. Together with other studies, this suggests that an age-related phase advance in the temperature rhythm disrupts sleep. These results are at odds with the view that sympathetic hyperactivity associated with elevated plasma norepinephrine causes age-related sleep disturbance. PMID- 3819338 TI - Mental health services use by elderly adults in a primary care setting. AB - This study examined the use of general health, mental health, and other medical specialty services by elderly persons 65 and older with mental disorders and compares them with adults 45 to 64 and 18 to 44. Data were collected at the Bunker Hill Health Center (BHHC), a Boston neighborhood health center providing a broad range of ambulatory medical and specialty mental health services. Results show that the 5-year rate of mental disorder diagnoses for elderly individuals is not significantly different from persons 45 to 64, although it is higher than the rate for young adults 18 to 44. Not only were elderly adults less likely to see a mental health specialist, but when they did, their use of mental health specialty services was usually lower. PMID- 3819339 TI - Rate of aging and dietary restriction: sensory and motor function in the Fischer 344 rat. AB - Sensory and motor task performance was assessed at 3 to 4 month intervals in chronically underfed and ad libitum-fed control rats from maturity into senescence. Diet-restricted rats weighed less than controls and lived significantly longer. Diminished body mass improved the underfed rats' abilities to hang suspended from a wire, to maintain balance on a narrow beam, and to descend from a wire mesh pole in a coordinated fashion. Underfed rats, however, lost these abilities at the same rate as did control rats. Undernutrition did not affect the startle response to acoustic stimulation, nor did it influence auditory or visual lead stimulus inhibition of the startle response. Both groups of animals showed progressive, age-related losses of sensory-motor function which proceeded at the same rate in each group. Life-prolonging undernutrition did not appear to retard aging of these simple, reflexive behaviors. PMID- 3819340 TI - Perceptual elaboration and memory in older adults. AB - This experiment investigated the effects of perceptual elaboration on the memory performance of 15 older (M = 70.4 years) and 15 younger adults (M = 25.2 years). Participants were presented tachistoscopically with line drawings that varied in contour completeness. As predicted, both old and young persons' identification response times for those drawings increased with decreases in contour completeness, indicating increased elaborative processing (Kunen et al., 1979). Moreover, a moderate decrease in contour completeness was associated with increased recall of the drawings for both age groups, although older persons identified the drawings more slowly and recalled fewer drawings than did younger persons. These findings complement those of Park et al. (1986) and demonstrate that older persons engage in active cognitive elaboration of pictorial stimuli when those stimuli are presented in such a way as to encourage elaboration. PMID- 3819341 TI - The influence of communication effectiveness on evaluations of younger and older adult speakers. AB - Earlier research has shown that young adults exhibit less favorable reactions to older speakers than to their peers, especially for intellectual and social competence. The present study examined the role of age in modifying the evaluations of listeners for effective and ineffective speakers. In a communication paradigm, 80 undergraduate students listened to and followed the taped instructions of a male speaker who was then evaluated. Communication effectiveness was the only significant factor for the speaker's ratings on the dimension of competence. On the benevolence dimension (e.g., trustworthiness, kindness), however, effectiveness interacted with age, such that for younger adults ineffective speakers were viewed significantly less positively than their more effective peers. PMID- 3819342 TI - Locus of control and retirement preparation. AB - Locus of desired control and participation in a retirement preparation program were investigated in relation to retirement attitudes and adjustment. Fifty-nine older workers and retirees, approximately half of whom had participated in a retirement preparation program, completed measures assessing locus of control, attitudes toward work and retirement, life satisfaction and self-esteem. Retirement preparation was found to maintain both the desirability and expectancy of internal control and positive retirement attitudes among the worker participants relative to controls. Retirees did not differ on measures of adjustment; those with retirement preparation, however, evidenced higher externality than those without. Although the results indicated that internal expectancies were associated with positive psychological functioning, the role of retirement preparation in maintaining such expectancies into retirement remained equivocal. PMID- 3819343 TI - Comparisons of blood and urinary responses to cold exposures in young and older men and women. AB - Minimally dressed men and women between 20 and 72 years old rested for 2 hr in 28, 20, 15, and 10 degrees C room temperatures (Ta). Older women maintained core temperatures during all exposures, partially due to rapid increases in metabolism. Regardless of Ta, blood glucose levels were higher in older than younger women during the first hour of the exposures (p less than .05). Free fatty acid levels in older women were double those of others (p less than .001). Epinephrine levels were 25% higher in men than women (p less than .05). Cortisol levels were 30% higher in younger than older adults, regardless of sex (p less than .01). All measurements, and norepinephrine, were elevated in all groups during the 10 degrees C exposure. Rapid increases in metabolism in older women during cold exposure may have been facilitated by substrate availability. This advantage may have resulted from greater utilization of cortisol and epinephrine, increased catecholamine sensitivity, or hormonal changes consequent to menopause. PMID- 3819344 TI - The effect of age on the care of women with breast cancer in community hospitals. AB - We studied the process of care received by 1,680 female breast cancer patients treated in 17 community hospitals. The probability of receiving various diagnostic, consultation, therapy, or rehabilitation services was almost always significantly associated with patient age for one or more disease stages. Most often there was a linear trend for older patients to receive fewer services (e.g., biopsies prior to definitive treatment, number of lymph nodes examined, chemotherapy, radiation therapy) but other age patterns also were found. Age was not significantly associated with clinical staging or estrogen receptors. PMID- 3819345 TI - Post-geriatric evaluation unit follow-up: team versus nonteam. AB - Twenty-six matched pairs of elderly male patients who had been evaluated in an outpatient geriatric evaluation unit (GEU) were assigned randomly to be followed in either a geriatrics clinic with an interdisciplinary team or a general medical clinic without an interdisciplinary team. Patients were medically stable and living in the community. At 12 months no difference was found in cognitive, affective, or functional status. Both groups of patients had similar frequencies of hospitalization, community placement, use of community services, and number of deaths. These findings suggest that the major benefit from GEUs may be in the initial assessment and treatment rather than in the subsequent care provided by interdisciplinary teams in geriatrics specialty clinics. PMID- 3819346 TI - Aging effects on the interaction of hypercapnia and hypoxia as ventilatory stimuli. AB - We measured ventilatory responses to progressive hypercapnia at two steady-state levels of oxygenation and to progressive hypoxia at two steady-state levels of CO2 in 10 elderly and 10 young individuals. Under hyperoxic conditions, the ventilatory response to progressive hypercapnia was not significantly different between age groups but, under hypoxic conditions, the response to hypercapnia was lower in the elderly group. The interaction of hypercapnic and hypoxic stimuli was greater among young persons as indicated by a higher ratio of the hypercapnic response slopes (hypoxic/hyperoxic); 1.48 +/- 0.19 versus 0.98 +/- 0.11, p less than .05. The ventilatory response to hypoxia at the lower CO2 level was significantly greater among elderly than among young adults but not significantly different between age groups at the higher CO2 level. The ratio of hypoxic response slopes (high PCO2/lower PCO2) was 1.56 +/- 0.17 among elderly participants and 3.14 +/- 0.63 among young participants (p less than .05). These results suggest that aging diminishes the multiplicative effect of hypercapnia and hypoxia as ventilatory stimuli. PMID- 3819347 TI - Senescent beagle coronary arteries in response to catecholamines and adrenergic nerve stimulation. AB - With advancing age from 2 to 12 years, relaxations induced by norepinephrine and epinephrine were suppressed or reversed to contractions in large and medium-size coronary arteries isolated from beagles. Norepinephrine-induced contractions in the senescent beagle arteries treated with propranolol were greater than those in the young beagle arteries and were inhibited by prazosin but not by yohimbine. Relaxant responses to isoproterenol were less in the arteries from old beagles than in the young beagle arteries. The magnitude of relaxations induced by norepinephrine and epinephrine was greatest in small arteries from old beagles, followed by medium and large arteries, in that order. Transmural electrical stimulation tended to produce a contraction in the old beagle arteries and a relaxation in the strips from young beagles. It appears that alpha 1 adrenoceptor function increases with advancing age in beagle coronary arteries of large and medium sizes, and beta receptor function declines. Vasoconstriction mediated by alpha 1 receptors is postulated to be related inversely to the distance from the coronary orifice in senescent beagles, and vice versa with vasodilatation mediated by beta receptors. PMID- 3819348 TI - Suicide in middle age and later life: sex and race specific life table and cohort analyses. AB - Cross-temporal data on suicide for the period 1962 to 1981 from the National Center for Health Statistics were analyzed. These data were used to estimate period and cohort suicide rates for the four middle-aged and elderly groups (ages 45 to 64, 65 to 74, 75 to 84, and 85 and older) by sex and race. Statistical procedures included multiple decrement life table analyses and cause elimination life table analyses for each year 1968 to 1981. Results from an age, period, cohort analysis of cohort trends 1962 to 1981 also were presented. The analysis showed that suicide continues to be a serious problem in later life especially among the "oldest-old" (those aged 85 and over) and among nonwhite males. It also showed important differences in cohort risks that may strongly affect future suicide risks among elderly adults. PMID- 3819349 TI - [The physician, The French judiciary and transsexuals in 1986. II. Three basic questions: treatment, legal change of sex and possible recourse to the legislator]. AB - The authors, having taken a general view of French jurisprudence and law and having compared western and European law about transsexualism, now attempt to reply to three essential questions that specialist doctors and the judiciary should direct themselves to on this subject; As far as medical and surgical treatment is concerned this can only be decided on after a very careful diagnosis of transsexualism authenticated by thorough observation over a period of months that may even extend to 2 or 3 years. The patient should have access to a team of several disciplines, including a psychiatrist, an endocrinologist and a surgeon. This seems to be the minimum size of the team to decide what the hormonal treatment should be and, later, what the surgical treatment may be. The economic repercussions of the whole of the treatment for a transsexual are not negligible and are important to be taken into account. This includes the prevention of legal action against the doctors if the treatment fails or if the transsexual later is disillusioned or regrets what has been done. As far as the law is concerned the chronology of the legal decisions for a legal change of sex a opposed to an anatomical change of sex, achieved by hormone treatment and surgery, is far from being solved. The Conseil National de l'Ordre des Medecins are insisting that a legal change of sex should precede surgical intervention whereas the lawyers, following the lead given by those in Scandinavia and in other European countries, say that tests of medical and surgical procedures to change the person should be undertaken before the law changes the gender of the person. Finally, there is the problem that has been raised by an attempt to replace the legal position that has already been tried. This plan, both medical and legal, has hardly been supported by the majority of French authors who have been consulted. They tend to take up the position of the Academie Nationale de Medecine which was frightened that changing the law would give too much importance socially to transsexualism. This phenomenon is still fairly limited in France but would become more widespread if a new liberal law was passed. Although the authors cannot give positive answers to the main questions raised by this difficult problem they think that these problems should not be avoided, although they are so complex, by doctors and jurists who have to take serious decisions when handling authentic transsexuals. PMID- 3819350 TI - [Screening for cancer of the cervix uteri. The role of contraception and socio occupational class]. AB - This work was carried out on 12,036 patients. It demonstrates that useful screening for cervical cancer depends on several factors. First among these are age, contraception and the socio-economic class of the man and the woman. These three parameters, while certainly they are linked one with the other, also work independently on the practice of making smears, as a study of these factors using a logistic regression system shows. This study completes the census that we have made on the practice of taking smears for screening in the region of Lyon. It confirms that there is still a lot of work to do to improve the value of such screening methods for larger groups of the population. PMID- 3819351 TI - [Anesthesia in gynecology and obstetrics: a national epidemiologic study]. AB - A sample of 33,508 anaesthetics taken from a national enquiry between the years 1978 and 1982 and representative of the overall activity in this field in France made it possible to look at anaesthesia in gynaecology and obstetrics in France. This study has made it possible to estimate that the annual number of anaesthetics that are given in this filed in France come to about 600,000 of which 22% are in obstetrics. The means that 2.2% of all women have an anaesthetic for these reasons. The most common operations are induced abortion and curettage of the uterus. Epidural anaesthesia was used in 12% of obstetric manoeuvres and 0.8% of gynaecological procedures. 70% of the women who were anaesthetised were aged between 20 and 40 and 64% had already had an anaesthetic in the past. 91% were in satisfactory health before the operation. One in 4 interventions were emergencies. University departments performed 21% of the cases, non-university hospitals 34% and private clinics 45%. In 30% of the cases, the anaesthetic was given by a nurse or a midwife. The risks of major complications while under anaesthetic or in the 24 hours after the operation were higher in obstetrical manoeuvres (2.4 p. 1,000) than in gynaecological procedures (1.1 p. 1,000). 78% of the complications in gynaecology could be attributed to anaesthesia as compared with 44% in obstetrics. PMID- 3819352 TI - [Early diagnosis of premalignant and malignant lesions of the endometrium. Evaluation of a device for collecting intrauterine samples (the Inocurette) compared with exploratory curettage]. AB - Screening methods for detecting more accurately carcinoma of the endometrium is becoming increasingly important because of the rising incidence of the condition. Inocurette has recently been invented to combine a scraping action with suction. This study investigates 385 patients who were admitted for diagnostic curettage or hysterectomy to which were added a series of 120 patients who were examined as out patients. Inocurette has a sensitivity of 86% and a specificity of 99%. It therefore can be considered as a reliable method of screening for the limits within which fractional diagnostic curettage should be used. Marked pain and great difficulty in introducing the apparatus made its use limited in respectively 15% and 14.5% of cases. So, the method is acceptable and useful within these limits. The results could be improved if on the one hand a thinner apparatus could be designed and on the other hand a substance could be found to soften the cervix so that it became easier to introduce the apparatus. PMID- 3819353 TI - [Study of peripheral resistance in pregnant women. Preliminary results]. AB - Variations in blood pressure (BP), heart rate (HR) and peripheral arterial blood flow (BF) were measured during the "roll-over" test (ROV) by impedance plethysmography. With these parameters, the peripheral vascular resistance (PR) was estimated in 17 normotensive and 8 hypertensive women between 28 and 32 weeks of pregnancy. In the normotensive women, a mean drop of 10.97% in BF and mean increase of 49.85% in PR were observed. Chronic hypertensive women with good evolution during pregnancy had a 96.30% (p less than 0.01) drop in their BF and a 399.38% (p less than 0.01) increase in their mean PR. Changes in BF and PR in chronic hypertensive women with obstetrical complications were similar to the normotensive women: BF increased by 4.50% and PR decreased by 0.04%. The increase in PR in the normotensive group could be due to a release of circulating vasopressive agents. In the chronic hypertensive group without complication this release could be more important or there might be an increase in the peripheral vascular sensitivity. In contrast, the lack of variation in PR in the chronic hypertensive group with obstetrical complications could be due to already established arterial vasospasm. PMID- 3819354 TI - [Is prolonged psychological stress an etiological factor in breast cancer?]. AB - 1,088 women with cancer were seen in a period of 4 1/2 years at the Cancer Centre of the Greek Social Security Department in Athens. The authors present their results as far as psychological stress influences the development of cancer of the breast in 813 patients (Group A) and in 685 women who did not have cancer of the breast (Group B). They were able to show that Group A had a positive correlation which was statistically very significant (p less than 0.001) with the following parameters: the death of a much-loved person; the negative behaviour of the husband; an unexpected change in life style; continual conflicts in the family; financial problems; unsatisfactory sex life; consultations with a psychiatrist and allergy. There was a positive correlation which was statistically significant (p less than 0.01) with the parameters: disappointment in sentiment; a lowering in life style; a family history of cancer of the breast; hypertension; late start in the menarche and the onset of the menopause. The authors conclude that they believe that it is useful to look at all the factors that are known as risks for cancer of the breast, including the influence of psycho-traumatic factors. PMID- 3819355 TI - [Intrauterine death of one of the fetuses in a twin pregnancy]. AB - A case of twin pregnancy complicated by intra-uterine death of one fetus 10 weeks before term is described. The occurrence of this complication raises difficult questions about the management and outcome of this rare event. A review of 23 patients with similar findings brought us to the conclusion that the management protocol to be applied should be based, if possible, on the type of placentation. PMID- 3819356 TI - [Anencephaly and diprosopy: 2 cases]. AB - We have seen two cases of diprosopy associated with anencephaly in Brittany between 1975 and 1984. Diprosopy is a partial or total duplication of the face. It consists of the phenomenon of late division in the embryo of the cephalic portion of the neural plate between the 16th and the 18th days. This gives rise to an incomplete type of monozygotic twinning or a conjoint twin. There are several different forms of the organs that are duplicated. We have seen a case of diprosopos distomos dirhinos diophthalmos and a case of disprosopos distomos dirhinos triophthalmos. These two cases were associated with anencephaly, the second also having a spina bifida and a diaphragmatic hernia. One can explain the incidence of anencephalies in cases of diprosopies by the desturbance created by the latter on the embryological events that succeed it. The delay in nerve formation makes it impossible for the neural tube to close completely, and this is why sometimes the anencephaly is associated with spina bifida. In more general terms one can postulate that all conjoint twins that are, of course, monozygotic and monochorial can interfere with early enbryological development and increase the risks of failure of the neural tube to close. PMID- 3819357 TI - [Spinous fixation (vaginae fixatio sacrospinalis) in the treatment of vaginal prolapse after hysterectomy]. AB - The authors describe an operation for treating true prolapse of the vagina which can follow total hysterectomy. The vault is fixed to the little sacro-coccygeal ligament. They report 133 case histories. The results are very good indeed in 60% of cases. True failures are rare: 2 out of 100 cases in Richter's series and 3 out of 12 cases in Dargent's series. PMID- 3819359 TI - [Incidence of cesarean section in Belgium]. PMID- 3819358 TI - [Peridural anesthesia in obstetrics: impact on the lower urinary tract]. AB - The results of non-invasive urodynamic examinations (urinary flow rates and ultrasound determination of residual urine in the bladder) and of urinary bacteriology were studied 4 or 5 days after delivery in 305 patients. The method of delivery and other clinical and obstetric parameters that could influence lower urinary tract function have been considered. The numbers of urines that contain bacteria in quantities of more than 10(5)/ml are significantly raised as compared with the control group after spontaneous delivery under continuous epidural analgesia (15% as compared with 4.5% - p less than 0.01). Continuous epidural anaesthesia increases the risk of urinary tract infection and is significantly associated with a prolongation of labour as well as an frequency of catheterisations as well as episodes of urinary retention. This compromises the likelihood of starting normal micturition after delivery. PMID- 3819360 TI - [Management of agreeable vaginal delivery in breech presentation]. PMID- 3819361 TI - [Early delivery in breech presentation]. PMID- 3819362 TI - [Obstetrical paralysis of the brachial plexus in breech presentation]. PMID- 3819363 TI - [Micro-invasive cancers of the uterine cervix]. PMID- 3819364 TI - [Microinvasive carcinomas of the cervix, evaluation of 9 years of conizations]. PMID- 3819365 TI - [Morphology of microcarcinomas of the uterine cervix]. PMID- 3819366 TI - [Difficulties in the clinical and histologic diagnosis of the first stages of invasive cancer of the uterine cervix]. PMID- 3819367 TI - [Microcolposcopy and microinvasive cervical cancer]. PMID- 3819368 TI - [Preclinical forms of cancer of the uterine cervix in pregnant women]. PMID- 3819369 TI - [31st meeting of French language gynecologists and obstetricians. Tours, 17-20 September 1986. Proceedings and abstracts]. PMID- 3819370 TI - Fluid and electrolyte disturbances in the perioperative period. PMID- 3819371 TI - Primary cardiac angiosarcoma with disseminated bone and soft tissue metastases. A reassessment of diagnostic criteria based upon a review of the literature. PMID- 3819372 TI - Psychosomatic dyspnea. PMID- 3819373 TI - Penetrating cardiac injury: can we improve survival? PMID- 3819374 TI - Hospital medical staff bylaws: an Indiana model. PMID- 3819375 TI - An improved immunocytochemical method for subcellular localization of serotonin in rat enterochromaffin cells. AB - Serotonin-like immunoreactivity (5-HT-LI) has been localized at the ultrastructural level in enterochromaffin (EC) cells of rat gastrointestinal tract. Ultra-thin sections of tissues embedded in epoxy resin were incubated with 5-HT antisera and antibody binding sites were visualized with protein A-gold. Three different antisera were compared and were shown to require different fixation regimens for optimal preservation of 5-HT-LI. For one antiserum, tissues fixed in glutaraldehyde and osmium tetroxide could be used to demonstrate 5-HT-LI in EC cells. Immunocytochemical localization of 5-HT can thus be performed with good ultrastructural preservation of tissues. Quantitative evaluation of the intracellular distribution of 5-HT-LI was performed on EC cells from antrum, duodenum, and proximal colon, fixed in glutaraldehyde only. In all three locations, the majority of the gold particles (90%) in EC cells were localized over the dense core of the secretory granules, while a minor fraction (10%) were localized in parts of the cytoplasm devoid of granules. In EC cells fixed in glutaraldehyde and post-fixed in osmium tetroxide, 5-HT-LI was reduced by about 85%, although intracellular distribution was essentially the same as in cells fixed in glutaraldehyde alone. The results indicate that 5-HT in EC cells is stored mainly in secretory granules, with a small fraction of 5-HT being localized outside the granules. PMID- 3819376 TI - Postnatal development of growth hormone and prolactin cells in male and female rat pituitary. An immunocytochemical light and electron microscopic study. AB - Localization and ultrastructural maturation of prolactin (PRL) and growth hormone (GH) cells were studied in pituitaries from neonatal, immature (4-6 weeks old), and adult rats (2-3 months old) by light and electron microscopic immunocytochemistry. The distribution pattern of these cells did not change with age. Both cell types were concentrated laterodorsally, with PRL cells adjacent to the intermediate lobe and GH cells nearer the center of the pars distalis. Labeling density of the immunogold reaction was highest for both hormones in immature rats. In neonatal and immature rats, one PRL cell type with granules 200 nm in diameter was present. In adult rats, two types of PRL cells were present: one containing polymorphous granules measuring about 500 nm (prevalent in female rats), the other with spherical granules about 200 nm (prevalent in male rats). No changes were detected in GH cells during maturation. PMID- 3819377 TI - Ultrastructural cytochemical and autoradiographic demonstration of nonspecific esterase(s) in guinea pig basophils. AB - We used ultrastructural autoradiographic and cytochemical methods to localize esterase activities in unstimulated guinea pig basophils and in basophils undergoing degranulation or recovery from degranulation. We used tritium-labeled diisopropylfluorophosphate (DFP) as a probe for serine enzymes and localized this probe by ultrastructural autoradiography to cytoplasmic granules of immature or mature unstimulated basophils, as well as to granules released by degranulating basophils. Ultrastructural cytochemistry using alpha naphthyl acetate (ANA) as substrate localized nonspecific esterase activity to extruded granules, either within the interiors of degranulation sacs or within granules completely separated from degranulating basophils. Extruded granules retained their esterase activity for as long as 24 hr after antigen-induced degranulation. The plasma membranes of unstimulated or degranulating basophils, as well as of basophils recovering from degranulation, displayed prominent cell surface ANA esterase ectoenzyme activity. Lipid bodies, organelles present in the cytoplasm of both control and recovering basophils, were also alpha naphthyl acetate esterase (ANAE)-positive. Thus, cytochemical and autoradiographic techniques localized esterase and/or [3H]-DFP-binding activities to cytoplasmic granules, lipid bodies, and cell surface of basophils, and these enzyme activities persisted during both degranulation and recovery from degranulation. PMID- 3819378 TI - Rapid-freezing and malachite green-acrolein-osmium tetroxide freeze-substitution fixation improve visualization of extracellular lipids in rat incisor pre-dentin and dentin. AB - Rat incisor tissue sections were fixed by a modified version of the malachite green-aldehyde method (MGA) composed of rapid-freezing, malachite green-acrolein staining, and osmium tetroxide freeze-substitution (Fr.MGAO). In the pre-dentin, a thick, dense network of branched fibrous structures was observed. Cryotechniques allowed visualization of complexes about twice as thick and dense as the aggregates visualized on MGA-treated sections. Pretreatment of rapid frozen samples with methanol before freeze-substitution fixation and staining prevented staining of the complexes otherwise revealed by the Fr.MGAO method. Electron-dense material stained by this procedure resisted de-mineralization with EDTA, while intramitochondrial granules and dentin crystallites were dissolved. EDTA treatment demonstrated unequal distribution of Fr.MGAO staining in dentin in the form of tiny dots underlining the collagen fibers. These results support the concept that rapid-freezing, followed by staining and freeze-substitution fixation, improves preservation of the phospholipids visualized as extracellular matrix components in pre-dentin and dentin of rat incisors. PMID- 3819379 TI - Quantitative histochemistry of mucosubstance in tracheal epithelium of the macaque monkey. AB - Experimentally applied irritants and chronic respiratory diseases appear to alter the amount and composition of secretory cell product in surface epithelium and submucosal glands of pulmonary airways. Previous methods used to quantify these changes have been very time-consuming or have not measured the same components of the airway wall. The present study describes a rapid, reproducible, and standardized automated method for quantifying secretory products. The tracheas from eight macaque monkeys were fixed with glutaraldehyde-paraformaldehyde, embedded in glycol methacrylate, serially sectioned at 2 microns, and histochemically stained to demonstrate neutral, sialylated, and sulfated mucosubstances in the cartilaginous, intercartilaginous, and membranous regions of both proximal and distal trachea. Volume densities were determined using an image analyzer and are expressed as volume of stained mucosubstance per unit surface area of epithelial basal lamina. Comparison of the automated method to manual point counting and evaluation of internal variance showed that the automated method had a twelve-fold increase in efficiency with no significant differences in measurements. After weighting the values of each region according to their anatomical contribution, the total secretory product (TSP) for the entire trachea was determined. Periodate-reactive acid material predominated (73%) in luminal surface epithelium, and neutral material predominated (78%) in submucosal glands. Surface epithelium contained 66% of the TSP. The greater contribution by surface epithelium and predominance of acid mucins there resulted in a TSP from the trachea that consisted of 59% acid material (most of which was sulfated) and 41% neutral material. The method proved to be a valid, reproducible, and rapid technique for evaluating variability in abundance of mucosubstances within airway epithelium. PMID- 3819380 TI - The role of color and pattern as mediators of product selection. PMID- 3819381 TI - Relations of motor ability and somatological characteristics to blood pressure in adolescents. PMID- 3819382 TI - Effects of heat stress on temperature regulation in initial exercise. PMID- 3819383 TI - The interest of collateral activities in ergonomics. PMID- 3819384 TI - Effects of rural residence and low income factors on the mortality of total Japanese population by age and sex. PMID- 3819385 TI - Proceedings of the twentieth annual conference of the Human Ergology Research Association. Tokyo, July 18-19, 1985. Abstracts. PMID- 3819386 TI - Cardio-respiratory and muscle responses in static, dynamic and combined work. PMID- 3819387 TI - Physical training effect on relationship of physical, mental, and emotional fitness in adult men. PMID- 3819388 TI - Ankle joint flexibility in college soccer players. PMID- 3819389 TI - Pressor response to NaCl solution administered intracerebroventricularly or intracisternally to conscious normotensive and spontaneously hypertensive rats. AB - We examined the central action of NaCl on blood pressure using intracerebroventricular (i.c.v.) and intracisternal (i.c.) injections of hypertonic NaCl solution in conscious, unrestrained spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats. The dose-dependent pressor response produced by i.c.v. hypertonic NaCl was greater in SHR than in WKY rats, while the dose-related pressor action produced by i.c. NaCl did not differ between the two strains. The hyperresponsiveness to i.c.v. NaCl in SHR was abolished by pretreatment with an i.c.v. injection of the angiotensin II (ANG II) analogue 1-Sar, 8-IIeu ANG II. Both ANG II and a combination of ANG II and NaCl given by i.c.v. injection had a greater pressor response in SHR than in WKY rats, although both ANG II and phenylephrine given intravenously elevated blood pressure to the same extent in both strains. Furthermore, i.c.v. ANG II both with and without hypertonic NaCl caused dipsogenic behaviour which lasted longer in SHR than in WKY rats. This response to i.c.v. hypertonic NaCl without ANG II was not substantially different between the two strains. Intracisternal hypertonic NaCl did not induce drinking behaviour. These observations suggest that in the SHR, the third ventricle rather than the brain stem is a more sensitive area to NaCl. The brain renin-angiotensin system in the SHR may play an important role in this accelerated pressor response and may be responsible, at least to some extent, for the enhanced reaction to chronic oral salt loading. PMID- 3819390 TI - Prevention of arteriolar rarefaction in the spontaneously hypertensive rat by exposure to simulated high altitude. AB - Microvascular alterations associated with reversal of hypertension by exposure to simulated high altitude were investigated in the gracilis muscle of the spontaneously hypertensive rat (SHR). Male, 4-week-old SHR were either placed in a hypobaric chamber (SHR-HA) at 430 mmHg or maintained at ambient barometric pressure (SHR-SL) for 8-10 or 12-14 weeks. Measurements of microvascular diameter and density were made by closed-circuit television microscopy. Mean arterial blood pressure was significantly lower in the SHR-HA groups. Functional arteriolar rarefaction occurred in SHR-SL at 8-10 weeks while structural arteriolar rarefaction occurred after 12-14 weeks. In contrast, neither functional nor structural rarefaction of arterioles was observed in the SHR-HA groups. Although functional rarefaction of capillaries did occur in SHR-HA, it was less than that in SHR-SL. Total capillary density, however, was similar in SHR-SL and SHR-HA after 12-14 weeks. Vasoconstriction was decreased in SHR-HA and vasodilated arteriolar diameters were greater than those of SHR-SL. These results show that simulated high altitude lowered blood pressure in SHR and resulted in a microcirculatory bed resembling that seen in a normotensive animal. PMID- 3819391 TI - Effect of calcium antagonism on intracellular concentrations and transmembrane fluxes of cations in erythrocytes of men at rest and during exercise. AB - The effect of calcium (Ca2+) antagonism with felodipine on the intracellular concentrations and transmembrane fluxes of cations in erythrocytes, was studied in 10 normal volunteers at rest and during exercise. All subjects performed two uninterrupted incremental exercise tests on a bicycle ergometer in a randomized order either after placebo administration or after 3 days of pretreatment with felodipine 5 mg t.i.d. Felodipine did not affect the erythrocyte ouabain sensitive 86rubidium uptake, furosemide-sensitive sodium (Na+)- and potassium (K+)-effluxes and the Na+,Li+-countertransport at rest and during exercise and recovery. Intra-erythrocyte and plasma Na+ and K+ concentrations were not different during felodipine whereas the plasma Ca2+ concentration was significantly increased. Plasma magnesium (Mg2+) concentration was reduced during felodipine treatment while the intra-erythrocyte Mg2+ concentration tended to be increased. The intra-erythrocyte to plasma concentration ratios for Na+ and K+ were not significantly affected by felodipine whereas the ratio for Mg2+ was increased. It is concluded that short-term Ca2+ antagonism with felodipine is not accompanied by major alterations in the intracellular concentrations and transmembrane fluxes of Na+ and K+ in red blood cells of normotensive subjects. The red cell transmembrane gradient for Mg2+ is however altered by felodipine. PMID- 3819392 TI - INTERSALT Study an international co-operative study on the relation of blood pressure to electrolyte excretion in populations. I. Design and methods. The INTERSALT Co-operative Research Group. AB - INTERSALT is a collaborative study of the relationship between blood pressure and sodium and potassium intake in more than 50 population samples from 32 countries, representing a wide range of sodium intakes. The study uses standardized techniques for blood pressure measurement, collection of 24-h and spot urine samples, and recording the major confounding variables. Investigators, who have been trained at regional meetings, follow rigorous quality control checks. Laboratory work and data analysis are all conducted centrally. This report presents the study design and methods. PMID- 3819393 TI - NK susceptibility varies inversely with target cell class I HLA antigen expression. PMID- 3819395 TI - Activated macrophages and antibodies against the plant lectin, GSI-B4, recognize the same tumor-associated structure (TAS). AB - Activated macrophages that were stabilized with either formalin or glutaraldehyde absorbed two polypeptides (Mr 100,000 and 60,000) from detergent extracts of all of the tumor cell lines tested, but not from detergent extracts of normal human peripheral blood lymphocytes. A major polypeptide (Mr 95,000) was retained from spent culture media of tumor cell lines. Polypeptides with molecular sizes of 100,000 and 60,000 daltons were also adsorbed by activated macrophages from detergent extracts of chicken embryo cell membranes, suggesting an oncofetal nature for these proteins. The 100,000 dalton polypeptide, but not the 60,000 dalton component, was found to be available to lactoperoxidase-catalyzed cell surface iodination. Polypeptides with identical molecular sizes could be adsorbed to immobilized galactopyranoside, indicating that they are vertebrate lectins. Activated macrophages and affinity adsorbents prepared by the covalent coupling of galactopyranoside to agarose also bind the plant lectin isolectin B4 prepared from the seeds of Griffonia simplicifolia. On the basis of these findings, we put forth the hypothesis that macromolecules of the same specificity, that is affinity to galactopyranosyl residues, must show homologies in their binding sites. We have predicted therefore that antisera prepared against this plant lectin should cross-react with galactopyranosyl-binding vertebrate lectins present on the surface of tumor cells. In this communication, we also report the generation of hybridomas that produce antibodies reactive with both the plant and vertebrate lectins. Inhibition experiments that make use of various mono- and disaccharides suggest that the specificities of these antibodies are for determinants intimately associated with the galactosyl binding site on the lectin molecule. Two of the antibodies were found to have moderate selectivity for tumor cells when tested in an immunohistochemical procedure that made use of fresh frozen or paraffin-embedded sections of human biopsy material. These two antibodies on immunoblots of tumor cell membrane extracts reacted with a polypeptide with an apparent molecular size of 100,000 daltons. PMID- 3819396 TI - Arthroscopy of the elbow. AB - Elbow arthroscopy is a valuable adjunctive means to diagnose difficult elbow problems and is a relatively atraumatic means to remove loose bodies. It is also helpful with the patient in whom the objective findings do not coincide with persistent and significant subjective complaints. However, the use of elbow arthroscopy in a routine fashion is to be avoided, and the procedure should have limited indications at this time. Ideally it should be done primarily only by those experienced in the technique of arthroscopy who possess a significant knowledge of elbow anatomy and pathology. PMID- 3819394 TI - Human monocyte adherence: a primary effect of chemotactic factors on the monocyte to stimulate adherence to human endothelium. AB - Monocyte emigration into areas of inflammation is initiated by monocyte adherence to the microvascular endothelium which may be induced by the local production of chemotactic factors at the inflammatory site. However, it is not clear whether such stimuli act on the monocyte and/or the endothelial cell to promote this effect. Accordingly, the effect of the chemotactic peptides C5a des arg and formyl-methionyl-leucyl-phenylalanine (FMLP) on human monocyte adherence to human microvascular endothelial cell monolayers was investigated in vitro. Monocytes (92 to 98% pure) were isolated by discontinuous plasma-Percoll density gradients and cell elutriation, methods designed to minimize monocyte exposure to endotoxin. Mean spontaneous (unstimulated) adherence of 111Indium-tropolonate radiolabeled monocytes to microvascular endothelial cell monolayers was 19.7% +/- 1.3. Monocyte adherence to microvascular endothelial cell monolayers was stimulated in a dose-response fashion in the presence of C5a des arg or FMLP to a maximum mean adherence of 47.2% +/- 2.9 or 43.8% +/- 2.2, respectively. C5a des arg or FMLP stimulated monocytes to adhere to monolayers of human vascular smooth muscle cells, human dermal fibroblasts, or serum-coated plastic wells in a comparable fashion as to endothelial cells. The simultaneous presence of both chemotactic peptides C5a des arg and FMLP in the assay system stimulated monocyte adherence to the same degree as either stimulus alone. This finding suggested that those monocytes stimulated to adhere by C5a des arg were the same subpopulation responding to FMLP. Spontaneous monocyte adherence (in the absence of chemotactic peptides) to both endothelial cell monolayers and serum-coated plastic wells was reduced in the presence of plasma, but chemotactic peptides induced a significant, albeit reduced, adhesion of monocytes in this circumstance. The pretreatment of monocytes with either C5a des arg or FMLP prior to the adherence assay induced stimulus-specific desensitization of monocyte adherence. Neither a desensitization nor stimulated monocyte adherence occurred when endothelial cell monolayers or serum-coated plastic wells were pretreated with either of the chemotactic peptides. The fixation of endothelial cell monolayers prior to the adherence assay did not alter the degree of spontaneous, C5a des arg-stimulated, or FMLP-stimulated monocyte adherence. These data suggest that the stimulated adhesion of monocytes to endothelial cells by C5a des arg or FMLP represents primarily an effect of these chemotactic peptides on the monocyte. PMID- 3819397 TI - Reconstruction of complex elbow problems. PMID- 3819398 TI - Osteoarthritis of the young adult hip: etiology and treatment. AB - Childhood hip disorders contribute to a significant proportion of young adults with painful osteoarthritis of the hip. Prosthetic hip replacement rarely is indicated for active young adults with osteoarthritis of the hip because of high failure rates without subsequent solutions. Modern osteotomies provide a viable alternative for these individuals. Recently published data indicate that the osteotomy can have reliable results with more modest expectations. Four requirements must be met. The orthopaedist should grasp the modern principles of osteotomy and be willing to carry out more involved operative planning. The patient should exhibit a mature understanding of alternatives and long-range goals of treatment. Both orthopaedist and patient should commit themselves to a long-term relationship, beyond the 6-month rehabilitation period. The patient should be willing to compromise some motion (hip mobility) for pain relief and increased function. PMID- 3819399 TI - Intertrochanteric osteotomy in osteoarthritis of the hip. PMID- 3819400 TI - Fracture treatment for the multiply injured patient. AB - Multiply injured patients are benefited by an intradisciplinary approach to treatment. Consultants provide expertise in the treatment of particular injured systems. Resuscitation and diagnostic evaluation are life-saving priorities of treatment in the emergency room. Definitive surgical treatment of body cavity injury is combined with careful monitoring while the patient is under anesthesia. The orthopaedic surgeon's responsibility then is to stabilize the fractures, thus minimizing the risk of infection, lung failure, and debilitation so that the patient may be gotten out of bed and rehabilitation started. Prolonged recumbency is probably the worst thing that can happen to a traumatized patient. The goal of fracture treatment is bone union without infection and with stable soft tissue coverage and normal motion of associated joints. It is important to realize that in these multiply injured people, fractures of the femoral or tibial shafts and unstable pelvic fractures threaten survival and should be surgically treated as soon as feasible. The operative treatment of fractures of the humerus, forearm, knee, and ankle can be addressed on an emergent basis. The condition of the skin around the ankle and knee influences the timing of surgery; a 24-hour delay may preclude surgery for weeks because of swelling and blisters. Orthopaedic surgeons now are beginning to understand the concepts of spine instability and have devices to stabilize the fractures. We think that unstable fractures should be given the same priority that fractures of major long bones receive. Free vascularized tissue provides excellent coverage when skin loss occurs over the distal two-thirds of tibial fractures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819401 TI - Mechanical properties of porous metal total hip prostheses. AB - The forged condition is the strongest form of the Co-Cr-Mo and Ti-6Al-4V alloys used in orthopaedics. Both the Co-Cr-Mo alloy and the Ti-6Al-4V alloy lose strength when incorporated into porous implants. The strength loss in the Co-Cr Mo alloy is a generalized condition and is largely a result of the microstructure of these cast and then gravity-sintered prostheses. The greatest fatigue strength achieved throughout these porous Co-Cr-Mo implants is that of the cast alloy. The strength loss in diffusion-bonded, porous titanium-alloyed implants is largely a result of notch sensitivity. This strength loss is not a generalized condition; it is localized on the implant to regions of porous coating attachment. In implant regions apart from the porous coatings, these titanium implants can have the strength of other wrought or forged titanium alloy implants. To achieve a functionally strong implant, porous implant design needs to account for these losses in material strength. Implant strength should be verified experimentally and communicated to the orthopaedic surgeon for assessment of implant adequacy for a particular patient. Patient weight, activity, and life expectancy are important elements in judging the adequacy of an implant's strength. PMID- 3819402 TI - Results of revision total hip replacement. PMID- 3819403 TI - Revision of aseptic, loose, broken femoral components. PMID- 3819404 TI - Revision of total hip arthroplasty for aseptic loosening: the acetabulum. AB - Very predictable results can be obtained from revision of the aseptically loose acetabular prosthesis by using cement fixation if: the hip is taken apart completely so that complete access to the acetabulum is obtained, a bed of bone of adequate strength completely devoid of soft tissue is prepared, a new prosthesis, backed with a metal shell, is selected to distribute the applied load as evenly as possible and thus minimize peak stresses in cement or bone, and this prosthesis is inserted as far medially, inferiorly, and anteriorly as possible to create a new anatomic geometry that, during function, will place as little load on the hip as possible. PMID- 3819405 TI - Principles, techniques, results, and complications with a porous-coated sintered metal system. AB - Experience with biologic fixation hip arthroplasty using the powder-made sintered porous system has been very encouraging over the past 8 years. With simple implant design, accurate instrumentation, and careful attention to surgical technique, the results of surgery can be made equal to those obtained with conventional cemented arthroplasty (using the current improved implant designs and cementing techniques). Most of the problems associated with this new technology have been recognized and solved. The most serious problem is probably that of stress shielding and disuse osteoporosis, and this may well be overcome through judicious design modification. It is the next decade that will determine whether the incidence of late aseptic loosening is reduced through design for a "living" interface between implant and bone. PMID- 3819406 TI - Factors controlling optimal bone ingrowth of total hip replacement components. AB - The major factors dealing with optimization of bony ingrowth for total hip replacement have been shown by experimental and limited clinical experience to be apposition, pore size, rigid initial fixation, the type of bone surface, weight bearing, biocompatibility, remodeling, bone grafting, other forms of stimuli, and the distinctions between the human response and the response of the experimental animals. PMID- 3819407 TI - Self-bearing, uncemented, ceramic total hip replacement arthroplasty. AB - The results for young patients in three diagnostic groups--osteoarthritis, posttraumatic arthritis, and osteonecrosis--show clearly that the uncemented procedure requires longer a recovery time than the cemented procedure. A more aggressive physical therapy program has resulted in an earlier return to function, as shown in these graphs. In conclusion, our experience with this operative procedure includes excellent patient acceptance, a failure rate comparable to that in Europe, a longer period of recovery than that for cemented arthroplasty, excellent results in revision of failed cemented arthroplasty, and an encouraging facility in the difficult case. PMID- 3819408 TI - A cementless titanium hip endoprosthesis system based on press-fit fixation: basic research and clinical results. PMID- 3819409 TI - Initial resuscitation of trauma victims. PMID- 3819410 TI - One-staged exchange arthroplasty for septic total hip replacement. PMID- 3819411 TI - Treatment of the infected total hip arthroplasty. AB - Based on our present experience, excisional arthroplasty is the most reliable option. Infections caused by organisms of significant virulence are best treated with excisional arthroplasty or Girdlestone resection followed by delayed reinsertion after adequate antibiotic treatment has controlled the sepsis, as determined by clinical and laboratory criteria. In patients with infections caused by organisms of relatively low virulence, for example, Staphylococcus epidermidis or anaerobic diphtheroids, the surgeon should seriously consider either incision and drainage, debridement, and local and systemic antibiotics if there is no component loosening, or direct exchange (removing both components and reinserting them with antibiotic cement) if there is loosening of one or both components. However, if incision and debridement or direct exchange fails, then excisional arthroplasty as a definitive procedure or as a first stage of a removal and reinsertion should be carried out. While we have not been successful in treating even early infections caused by Staphylococcus aureus with incision, drainage, and antibiotics, the morbidity associated with this procedure is extremely low compared with that of the other procedures; therefore it seems reasonable to use this modality as an emergency treatment for acute infections, with the full realization that it probably will not succeed as the definitive procedure, and the surgeon should prepare for early, more definitive surgical intervention. PMID- 3819412 TI - Prosthetic reimplantation for salvage of the infected hip. PMID- 3819413 TI - Preoperative planning of total hip arthroplasty. AB - Preoperative planning of a total hip replacement is a necessary first step in arthroplasty. If properly done, it can shorten the learning curve for new prosthetic systems, minimize intraoperative guesswork, and decrease surgical time. It also will allow the surgeon to fulfill one of the universal goals of reconstructive surgery--precision with reproducibility. PMID- 3819414 TI - General considerations in total knee arthroplasty. AB - Total knee replacement is a powerful but complex surgical procedure. Recognizing and addressing all planes of motion at the knee is mandatory for good results. Accurate alignment of the prosthetic component and the limb is crucial. Close attention to surgical detail and prosthetic interaction is necessary. Current prosthetic replacement fails to return the bone to its normal strain environment. Clinical results with current resurfacing components rival or exceed those obtained with conventional total hip replacement in properly selected patients. PMID- 3819415 TI - Resection arthroplasty: an alternative to arthrodesis for salvage of the infected total knee arthroplasty. AB - Arthrodesis remains the procedure of choice for salvage of an infected total knee arthroplasty in patients with relatively minor preprosthetic arthroplasty disability. Patients with very severe preprosthetic disability resulting from multiarticular disease or other systemic disease may be treated best by a resection arthroplasty. Systemic sepsis can be eliminated in almost all patients, and drainage can be eliminated in most. Those patients who find the stability of a resection arthroplasty inadequate for their needs can have a secondary arthrodesis performed with an intramedullary rod, which yields a high probability of success. External immobilization is not necessary. The advantages of a two stage arthrodesis are that it is an elective procedure, performed in a limb free of sepsis. The patient has been psychologically prepared for the arthrodesis, and the two-stage procedure has a high probability of success. Neither the underlying diagnosis, nor the infecting organism, nor the type of infected prosthesis is a reliable predictor of success or failure of either a resection arthroplasty or a second-stage arthrodesis. PMID- 3819416 TI - Revision of total knee replacement. PMID- 3819417 TI - Revision total knee arthroplasty: indications and contraindications. PMID- 3819418 TI - Biomechanics of the hip joint. AB - A great deal of biomechanical research remains to be done in the area of hip joint trauma so that bioengineers and other medical scientists can work with accurate bone failure data, which are essential to the design of sports equipment, vehicles, workplace situations, and prostheses. The application of biomechanical data, in addition to being essential in prosthesis design and ergonomics, also can be useful in such diverse problems as pathogenesis of degenerative joint disease, management of the postfracture patient, bracing in Perthes' disease, and in many other pathologic conditions. PMID- 3819419 TI - Revision total knee arthroplasty. AB - Careful attention to axial alignment, soft tissue balance, and stability will minimize prosthetic failure. In revision arthroplasty a prosthesis designed to replace bone loss with the least constraint possible should be used. In the current series revision of the noninfected failed total knee arthroplasty has provided satisfactory results in 50% to 60% of the patients. We believe that use of the newer implants and instrumentation will improve results markedly. PMID- 3819420 TI - Massive blunt trauma: radiologic diagnosis and intervention. PMID- 3819421 TI - Infection of total knee arthroplasty. PMID- 3819422 TI - Hallux valgus. PMID- 3819423 TI - Impending pathologic fractures from metastatic malignancy: evaluation and management. AB - Both lytic and blastic long bone metastases are at risk to develop pathologic fractures in instances where more than 50% of the circumferential cortical bone has been destroyed or where the pain with weight-bearing stresses persists, increases, or recurs despite adequate local irradiation. Moreover, those most commonly encountered lesions of the proximal femur are at high risk to fracture if they are in excess of 2.5 cm in any dimension or if they are associated with avulsion of the lesser trochanter. Such lesions should be treated aggressively by prophylactic internal fixation. This will avoid the development of a secondary fracture with its concomitantly high risk that true bony healing will not occur even with adequate fixation. When internal fixation is chosen for a large metastasis with extensive cortical destruction, that fixation should be augmented by debulking of the lesion and by packing it with methylmethacrylate polymerizing in situ. Such an expedient not only improves the efficacy of subsequent radiotherapy but also prevents shortening of the bone with weight bearing while enhancing the torque capacity and sheer resistance inherent in the metal fixation device. PMID- 3819424 TI - Acute head injuries. PMID- 3819425 TI - Surgical management of acetabular fractures. AB - We have each experienced a significant learning phase for surgical treatment of these fractures. However, problems of articular reduction remain significant, particularly for complex fractures. It is our opinion that a certain degree of centralization of acetabulum fracture treatment--especially for the associated types--can lead to an improved standard of care overall. PMID- 3819426 TI - Spinal column trauma. PMID- 3819427 TI - Posterior stabilization of thoracic, lumbar, and sacral injuries. AB - While new spine-stabilizing devices are beginning to appear as alternative methods of providing operative spine stability, a careful review of those methods used by the Spine Injury Service at Northwestern University was undertaken. The method of stabilization most frequently used was the Harrington distraction rod device. With the coming of the Luque rod "segmental instrumentation" technique, improved spine stability was attained, although the attributes of the Harrington distraction system could not be substituted by the Luque system. A natural spin off was the combination of the Harrington and the Luque methods of internal fixation. This has been a significant addition to the spine surgeon's surgical armamentarium. Still there are problems of implant stability, for which the Jacobs AO rods were developed, and the need for better correction of the spine's malposition following fracture (Edwards system). Because of the concern for the placement of sublaminar wires beneath the lamina, particularly in the area of the very narrow thoracic neural canal, the "Wisconsin" system of spinous process wires was developed. The discussion in this chapter is limited to the statistical data gathered from the management of 646 fracture-dislocations of the spine, of which 374 were surgically managed. As noted in Table 39-3, there are hazards to the instrumentation of the thoracic, lumbar, and sacral spine. In this surgical group, neurologic deterioration occurred in 2.39%; however, there was evidence of significant "risk-benefit" in surgery, with 15.22% of surgical patients demonstrating neurologic improvement after surgery of at least one Frankel grade. When compared with those patients managed conservatively, 6.57% demonstrated neurologic improvement, whereas only 0.34% demonstrated neurologic deterioration. PMID- 3819428 TI - Spinal stenosis. PMID- 3819429 TI - Anesthesia and the trauma patient. PMID- 3819430 TI - Applied anatomy and biomechanics of the elbow joint. AB - A clear understanding of the unique anatomic features of the elbow joint aids in a more full appreciation of the biomechanical aspects of this joint. This knowledge may, it is hoped, be translated into a broader understanding of the scientific basis of the management of elbow problems. PMID- 3819431 TI - Adult elbow dislocations: mechanism of instability. AB - From these data it appears reasonable to advocate open repair of fracture dislocations of the elbow joint, particularly those associated with radial head fractures. In these instances improved functional results can be anticipated. In simple elbow dislocations in adults, it is possible that open repair of the medial collateral ligament will produce improved functional results. However, the data, although suggestive, are not conclusive at this time. It is our belief that the indications for surgery in elbow dislocations can be summarized as follows. Surgical intervention is indicated if spontaneous redislocation occurs, unless the arm is flexed above 90 degrees. Surgery is indicated if a spontaneous redislocation of the elbow dislocation occurs with the arm in plaster. Surgical repair of the medial collateral ligament is indicated in all instances of fracture dislocations of the elbow, particularly those associated with radial head fractures. In adult simple elbow dislocations surgical repair of the anterior oblique ligament certainly does not impair elbow function at follow-up and indeed may lead to better results. PMID- 3819432 TI - Physeal fractures of the distal humerus: avoiding the pitfalls. PMID- 3819433 TI - Tennis elbow. PMID- 3819434 TI - Cell cycle kinetics model of LPS-stimulated spleen cells correlates switch region rearrangements with S phase. AB - The cell cycle kinetics of lipopolysaccharide (LPS)-stimulated spleen cells were measured by acridine orange (AO) staining and flow cytometry. We have devised a computer model to predict the proportions of cells in each cell cycle phase using iteratively varied parameters. The optimum fit between the predicted and observed proportions of cells in various phases of the cell cycle was determined using the minimum sigma chi 2. The model then correlates the variability of intermitotic phase time with the proportion of genomic DNA available for immunoglobulin (Ig) switch region (S mu) rearrangement. This analysis predicts that rearrangements at S mu are cell cycle-dependent events which occur during the first S phase after LPS activation. Molecular analysis of this system confirms these predictions. PMID- 3819435 TI - A one-step isolation procedure for phospholipase A2-free cobra venom factor by fast protein liquid chromatography. AB - A very rapid and efficient procedure for isolation of cobra venom factor (CoF) from Naja naja venom is presented. The method is based on Mono Q anion exchange chromatography on a system for fast protein liquid chromatography (FPLC). CoF was eluted by a buffer of pH 7.4 at 280 mM salt. A purification of 33.7 X was reached with a yield of at least 27%. Contamination with phospholipase was under the detection limit of a sensitive radiometric assay (less than 25 ppm), while the starting material contained 5%. The preparation displays high C-depleting activity in vivo. PMID- 3819436 TI - Limiting dilution assays. Experimental design and statistical analysis. AB - Two issues in limiting dilution analysis are considered. The first concerns the experimental design: a mathematical algorithm has been developed which calculates the number of replicate culture groups, and the (mean) number of cells per well to be used on the basis of the experimenter's a priori information about the unknown frequency. The procedure guarantees useful data if the a priori interval estimate of the frequency to be determined is correct and the cells are willing to grow. The second issue concerns the statistical method to be used for estimation of the unknown frequency. Several methods (minimum chi-square, maximum likelihood and the jackknife version of the maximum likelihood method) have been evaluated with artificial data from extensive Monte Carlo experiments. All three methods were useful in the statistical analysis of data. As a result of these experiments and theoretical considerations the jackknife version of the maximum likelihood estimation procedure is proposed as the statistical procedure of choice. The next best method is the maximum likelihood procedure. PMID- 3819437 TI - A solid-phase radioimmunoassay using digitonin-permeabilized cells to screen surface or intracellular membrane-bound antigens. AB - Membrane-bound receptor or enzyme distribution between cell surface and cell interior can be determined using the non-ionic detergent digitonin. A solid-phase radioimmunoassay using myocardial cells from newborn rats was performed to screen hybridoma culture supernatants and the cells were rendered permeable with increasing concentrations of digitonin (0-0.1%). This was achieved in 5 min at 37 degrees C and did not require the continuous presence of detergent. A characteristic amount of cytoplasmic protein (approximately equal to 45%) was released with subunit molecular weights of up to 200,000. This allowed exogenous molecules such as immunoglobulin G to gain access to the intracellular targets. The binding to rat myocardial cells of 36 monoclonal antibodies was examined by this procedure. The binding assays were carried out for 30 min at 37 degrees C using cells previously treated for 10 min with 0.05% of digitonin. This appears to be a simple and rapid method of screening and selecting the hybridoma culture supernatants. PMID- 3819438 TI - Use of protein G for preparation and characterization of rabbit antibodies against rat adipose tissue hormone-sensitive lipase. AB - The newly described immunoglobulin G-binding streptococcal surface protein, protein G, was used to prepare and characterize rabbit antibodies. The antibodies were directed against rat hormone-sensitive lipase, the rate-limiting enzyme in the hydrolysis of the triacylglycerols stored in adipose tissue. Antiserum was obtained after two injections with 20 micrograms enzyme protein, and the immunoglobulin fraction was obtained using a protein G-based solid-phase radioimmunoassay. The hydrolysis of acylglycerols by the enzyme was inhibited by the antibodies, and the enzyme could be efficiently removed from a solution using the antibodies and heat-killed streptococci expressing surface protein G. By Western blot and detection with 125I-protein G, the antibodies were found to selectively bind to hormone-sensitive lipase and to a smaller extent to two minor contaminants, possibly proteolytic fragments of the lipase. The amount of 125I labelled protein G bound to the lipase on the blot was quantitatively related to the amount of enzyme protein down to the detection limit 10 ng. PMID- 3819439 TI - Improved production of high-affinity antisera to progesterone by castration and adrenalectomy of the immunised animals. AB - The titre and affinity of antisera to progesterone were increased by ablation of the progesterone-secreting organs of immunised rats. The animals were maintained for several months following castration and adrenalectomy by daily fludrocortisone. PMID- 3819440 TI - A novel coloured latex test for the detection and identification of more than one antigen. AB - A novel latex agglutination test employing coloured latex particles is described. The latex reagent contains two or more differently coloured latex suspensions, each colour having been coated before mixing with at least one specific antibody, so that two or more antigens can be detected and identified with a single reagent. The antigen is identified by observing the colour of the agglutinated particles against a contrasting change in the colour of the background. PMID- 3819441 TI - In vitro proliferation of lymphocytes from cyclophosphamide-pretreated mice immunized with antigen mixed with dimethyl dioctadecyl ammonium bromide. AB - A blastogenesis assay employing lymphocytes from cyclophosphamide-pretreated mice immunized with antigen mixed with the immunopotentiating compound dimethyl dioctadecyl ammonium bromide is described. The model antigen used for determining the assay parameters was inactivated purified measles virus. The optimal time for removal of immunologically primed T cells was 7 days after immunization of mice pretreated 2 days previously with 200 mg of cyclophosphamide/kg. The peak lymphoproliferative response was found to occur after 3-5 days in culture, depending on the concentration of antigen used. Although fetal bovine serum and syngeneic mouse serum each worked well as a medium supplement, significantly higher specific and lower non-specific lymphoproliferation were obtained when the mouse serum was used. Most of the lymphocytes responding to antigen were of the Ly 1.2 phenotype. Specificity of the blastogenic response was shown by a lack of cross-reactivity among measles virus, herpes simplex virus type 1 and vesicular stomatitis virus antigens. This approach to a mouse blastogenesis assay involves an easy way to induce strong T cell priming in mice, while still providing an assay which has an ideal combination of low non-specific and high antigen specific responses. PMID- 3819442 TI - Production of monoclonal antibodies selective for aggregation-competent chick neural retina cells. An immunosuppressive approach. AB - We present here a rapid means of preparing mouse monoclonal antibodies which bind selectively to aggregation-competent, embryonic chick neural retina cells. The approach couples two existing technologies: well-defined procedures for manipulating the adhesive properties of embryonic retinal cells through control of the dissociation conditions, and an immunosuppressive technique designed to reduce the immune response against unwanted 'background' antigens. This approach greatly increases the likelihood of generating monoclonal antibodies directed against cell surface molecules mediating intracellular adhesion in this tissue. Fab prepared from the combined supernates of all IgG-producing clones obtained in this manner inhibited retinal Ca2+-dependent adhesion, suggesting that at least one clone in the group was reactive with elements of the Ca2+-dependent adhesion mechanism. PMID- 3819443 TI - Application of a microseparation technique allowing for extensive marker studies on small bone marrow specimens. AB - The characterization of surface and intracellular markers of hematopoietic cells by immunocytochemical methods is widely used. While examination of cells of the peripheral blood can easily be performed, investigations of bone marrow cells can be hampered by technical difficulties in labeling routine marrow smears or by limited size of specimens required for cytocentrifugation. A simple and highly efficient method for isolation of bone marrow cells by a microseparation technique is described. Only two to three drops of a routine bone marrow aspirate are necessary for preparation of up to 100 cytocentrifuge slides thereby exceeding separation efficiency of conventional gradient centrifugation by three- to more than four-fold. The application of the method for marker studies on normal marrow and marrow from patients with hematologic malignancies is exemplified. PMID- 3819444 TI - Comparison of Candida killing activity measured by chemiluminescence and cytomorphological methods in human phagocytes. AB - Phagocyte function can be assayed by many laboratory tests including a cytomorphological method that uses Candida cells as target. The aim of this study was to correlate this technique with the production of toxic oxygen metabolites, measured by chemiluminescence (CL). The biological function of polymorphonuclear (PMN) cells and monocytes from the blood of 24 normal subjects and 25 patients with immunodeficiency diseases were studied. CL was measured using opsonized zymosan as the stimulating agent and, for the evaluation of Candida killing activity, C. pseudotropicalis and C. albicans were used as targets. A linear correlation between CL and lytic activity was observed with both PMN and monocytes from normal subjects and patients (r = 0.563 to 0.955; P less than 0.05 to less than 0.001). Our results indicate that the production of toxic oxygen metabolites, as measured by CL is closely related to the killing of Candida by PMN and monocytes. PMID- 3819445 TI - ELISA for measurement of secretory IgA distinct from monomeric IgA. AB - A micro enzyme-linked immunoassay (ELISA) is described for the quantitation of secretory IgA as distinct from monomeric IgA. The assay is sensitive (linear down to 30 ng/ml) and reproducible (inter-assay variation: 17.0%; intra-assay variation: 11.5%). The assay has the further advantages of rapidity, the ability to handle large numbers of samples, and uses commercially available reagents throughout. Minimal interference from a large (greater than 25-fold) excess of monomeric IgA was observed. The results obtained for serum secretory IgA concentrations by this method correlated well with those reported by other workers for normal control patients, patients with IgA deficiency and patients with liver disease. PMID- 3819446 TI - A simple technique for increased sensitivity in immunoelectrophoresis by the use of antiserum against IgG. AB - Precipitates in two-dimensional immunoelectrophoresis (2D-IE) plates can be amplified by the application of an antiserum against IgG after the second dimension run. Thereby, the sensitivity of the IE method is increased; faint precipitates and antigen-antibody reactions close to but below the level of forming recognizable precipitates are made visible. The advantage of the method was demonstrated for a multilinear Mycobacterium phlei system. PMID- 3819447 TI - Aberrant H-2-like allospecificities on K36.16 thymoma. Studies by radiobinding and immunoprecipitation with anti-H-2 monoclonal antibodies. AB - The K36.16 thymoma expresses an H-2Dd-like allospecificity as detected by the 34 5-8 monoclonal antibody directed against H-2Dd using immunoprecipitation techniques. This monoclonal antibody gives a negative result by radio-immune assay but other anti-Dd antibodies react positively with this tumour. These results confirm and extend previous observations and are attributed to probable gene-conversion events possibly involving a donor gene from the Qa/Tla region, the products of which cross-react with Dd. PMID- 3819448 TI - Structural variations in the H-2 genes of AKR lymphomas. AB - K36.16 is an AKR H-2k thymoma which expresses an aberrant H-2Dd-like allospecificity, does not have a detectable amount of the H-2Kk syngeneic antigen and grows very easily in syngeneic mice. By DNA-mediated gene transfer experiments, we were able to obtain transformed clones which do express the H-2Kk molecules and are rejected by AKR mice. Southern hybridization was performed to assess whether any gross changes had occurred in the K36.16 H-2K locus or elsewhere in the MHC, which might explain the lack of H-2K expression and/or the presence of the aberrant H-2Dd-like allospecificity. Specific H-2 class I DNA probes were used to compare the K36.16 genomic DNA with normal AKR thymus DNA after digestion with a variety of restriction enzymes. After hybridization with the pH-2IIa probe a 2.8 kb 'Hind III' fragment was identified in the K36.16 genomic DNA which is absent from AKR DNA. The pH-2IIa probe detects the third, transmembrane and cytoplasmic domains of class I genes. Although these changes are indicative of MHC genome modifications it is not yet possible to link these specific Southern blot pattern variations with the phenotypic changes mentioned above. PMID- 3819449 TI - Manipulation of metastasis and tumour growth by transfection with histocompatibility class I genes. AB - Approximately 50% of fibrosarcomas induced with methylcholanthrene A were found to be defective in H-2 expression. In tumours which lack H-2K antigens, H-2 gene transfection was used to restore H-2K expression. The de novo expression of H-2K reduced tumorigenicity and abolished the formation of metastases in syngeneic mice. Expression of H-2K seems to render the tumour cells immunogenic and leads to effective recognition of the tumour cells by the host immune system. PMID- 3819450 TI - Immunogenicity of H-2 positive and H-2 negative clones of a mouse tumour, GR9. AB - The GR9 tumour was induced with methylcholanthrene in a BALB/c mouse, adapted to tissue culture and cloned without any passage in vivo GR9 clones were typed for H 2 with three monoclonal antibodies that define H-2Kd + Dd, Kd and Dd antigens. A great heterogeneity of H-2d expression was found from clones which were Kd and Dd positive to clones Kd and Dd negative. These results were confirmed for A7 and B9 clones using immunoprecipitation with anti-H-2D.4 and anti-H-2K.31 alloantisera and SDS-PAGE analysis. In addition, the number of chromosomes per cell was heterogeneous amongst the clones, ranging from 38 +/- 2 to pseudotetraploid clones which have 75 +/- 2 chromosomes. GR9 clones were injected into syngeneic BALB/c mice to measure local tumour growth. We found that the growth correlated with the amount of H-2 antigen expressed, i.e. clones with low H-2d expression were highly malignant while clones with normal H-2d expression were highly immunogenic. Finally we found that BALB/c mice immunized against A7 (Kd, Dd positive) protected against A7, as expected, but surprisingly also against B9 (Kd, Dd-negative). PMID- 3819451 TI - Characterization of the syngeneic anti-tumour response against the GR9 tumour with the production of isoantisera and monoclonal antibodies. AB - Isoantisera and syngeneic monoclonal antibodies have been produced against A7, a clone derived from a BALB/c methylcholanthrene-induced tumour named GR9. The antigens defined by the isoantisera and mAbs are widely distributed in a large number of GR9 clones as well as in other tumour cell lines of different aetiology and origin. Two GR9 clones with marked differences in H-2 expression and syngeneic in vivo growth (A7, which is H-2d-positive and highly immunogenic and B 9, which is H-2d-negative and highly malignant) were selected to further analyse the presence or absence of the antigens recognized by the syngeneic anti-tumour antibodies. Immunoprecipitation data with two different isoantisera revealed a group of proteins with a molecular weight of Mr 65-70,000 present in both clones. Furthermore, immunoprecipitation with the A7-1 mAb again showed a single Mr 65K band present in A7 and B9 clones. We conclude that the marked differences observed in the syngeneic growth of the two clones are not due to differences in tumour associated antigens (TAA), defined by syngeneic antibodies, and emphasize the role that class I H-2 antigens could play in tumour rejection. PMID- 3819452 TI - Expression of HLA molecules on cells from fresh explants of human digestive tract cancer. AB - It has been recently established that there is a correlation between the lack of MHC class I gene expression on murine tumour cells and their ability to grow and metastasize. We have studied the expression of HLA-ABC and HLA-DR products on human malignant tumours from the digestive tract using monoclonal antibodies, by indirect immunofluorescence on the cell suspensions obtained from 29 freshly explanted digestive tumours. Our results show that digestive tract cancers have an heterogeneous expression of HLA class I molecules on their surface. Whereas 50% have high levels of expression of these molecules (more than 60% positive cells), 25% have a moderate level of expression (20-60% positive cells) and 25% have weak expression (less than 20% positive cells). It has been found that there is a correlation between the level of HLA class I molecule expression and the degree of histological differentiation of a tumour. The absence of MHC class I antigens on human tumour cells, detected in this study, may play a relevant role in oncogenesis, as has been established in experimental models. PMID- 3819453 TI - Anti-MHC immunity detected prior to intentional alloimmunization. IV. Natural monoclonal H-2-specific antibodies. AB - Naturally occurring H-2-specific antibodies can be detected rather frequently in sera of non-alloimmunized mice by sufficiently sensitive techniques (Cerny Provaznik et al., 1985a; Cerny-Provaznik & Ivanyi, 1985). In this report, we summarize our experiences with the preparation of monoclonal anit-H-2 antibodies obtained from hybridization experiments from non-alloimmunized mice. From a total of 30 spleen cell hybridization experiments, we could isolate only four anti-H-2 monoclonal antibodies (mAB). Two of the mAB are described in this report. Monoclonal antibody By-2 is anti-Kf and mAB By-3 is anti-Db, Ds. We investigated which conditions favour the isolation of monoclonal H-2-specific antibodies from non-alloimmunized mice. The presence of naturally occurring serum antibodies, the age of the spleen donor mouse or non-specific B cell stimulation were not critical for the isolation of natural anti-H-2 mAB. We hypothesise that the 'natural' H-2-specific antibodies represent compartments of the B cell repertoire which were triggered by modified or aberrant self-MHC expression. PMID- 3819454 TI - Non-gonococcal infectious arthritis: a retrospective study. AB - In a retrospective study the outcome of non-gonococcal infectious arthritis was evaluated in 76 adult patients admitted to the Leiden University Hospital between 1970 and 1984. The mortality rate was 12%, and complete recovery was achieved in only 19 of the 76 patients (25%). Each of the following had a significantly unfavourable influence on the residual joint function: duration of infection more than 14 days, female sex, presence of rheumatoid arthritis, and presence of a joint prosthesis. PMID- 3819455 TI - The aetiology of pneumonia. Application of bacterial serology and basic laboratory methods. AB - The aetiology of community-acquired pneumonia was studied by use of new bacterial and established viral serological methods besides blood culture in 162 patients. Evidence for a specific aetiology was obtained in 79 patients (49.4%). The pneumococcus was the most common aetiological agent, identified in 25.6% of cases. Other bacteria, Haemophilus influenzae, Branhamella catarrhalis, Neisseria meningitidis and Chlamydia spp. were demonstrated in 23.5%, Mycoplasma pneumonia in 1.2% and viruses in 7.4% patients. In 58% those with viral pneumonia there was evidence of mixed infection with bacteria. The predictive value of rapid laboratory tests, erythrocyte sedimentation rate, white blood cell count and C reactive protein (CRP), was evaluated in relation to the aetiological diagnosis. They all differentiated viral from bacterial pneumonia, with CRP having the best predictive value. On the basis of these tests, most cases in which our serological tests remained negative would appear to have a bacterial aetiology also. PMID- 3819456 TI - The spectrum of pneumonia in 1983 at the Riyadh Armed Forces Hospital. AB - The agents causing pneumonia have been assessed in 112 adult patients admitted to the Armed Forces Hospital in Riyadh during a period of one year: pathogens were identified in 78 patients (69.6%). Sputum culture produced a significant isolate in 60 patients (53.5%), and in 17 (15.2%) the causative agent was suggested by serological tests. Streptococcus pneumonia was the commonest infecting agent (21.4%). Pneumonia due to Mycobacterium tuberculosis was diagnosed in eight patients, to Mycoplasma pneumoniae in seven, to Chlamydia psittaci in two and to Legionella pneumophila in one. Three renal transplant patients had pneumonia caused by Staphylococcus aureus, cytomegalovirus and Pneumocystis carinii respectively, the latter diagnosed by lung biopsy. Two patients with acute Brucella melitensis infections developed pneumonia. In 34 patients (30.4%) the causative organism was not identified. Most of the epidemiological and aetiological factors studied in this survey are inconsistent with previous reports on pneumonia from western countries. For example, the commonest age group affected was younger than in western series. Tuberculous and brucella pneumonia, not commonly seen in western countries, are diagnoses to be considered in Saudi Arabia. PMID- 3819457 TI - Short-chain fatty acids produced by anaerobic bacteria alter the physiological responses of human neutrophils to chemotactic peptide. AB - The effect of some short-chain fatty acids (SCFA) produced by anaerobic bacteria, namely acetic, propionic, isobutyric, butyric, isovaleric and succinic acids, on production of light and release of lysozyme by human neutrophils exposed to chemotactic peptide fMet-Leu-Phe was investigated. A short period of incubation of neutrophils with SCFA led to marked inhibition of both granulocytic chemiluminescence and degranulation (P less than 0.001). Ultrastructural studies of neutrophils, incubated with concentrations of SCFA inhibiting the chemotactic response, chemiluminescence and release of lysozyme (30 mmol/l), effected alterations in cellular morphology with formation of protrusions of varying shape. The data reported indicate that SCFA might be regarded as important pathogenicity factors. The observed effect on neutrophils could also partially explain the ability of anaerobes to inhibit their own phagocytosis and killing as well as that of the aerobic species present in mixed infections. PMID- 3819458 TI - Infection with Streptococcus milleri. AB - Streptococcus milleri is unique among the viridans streptococci because it produces abscesses. Five serious S. milleri infections were seen in our hospital in 1 year. The English literature dealing with S. milleri was reviewed. An infection caused by S. milleri is often associated with a gastro-intestinal source. Thus, the speciation of viridans streptococci from pus or blood cultures is clinically relevant. The identification of S. milleri from blood cultures suggests the possibility of serious purulent infection, the source of which may lie in the gastro-intestinal tract. The resultant clinical approach to S. milleri infection is discussed. PMID- 3819459 TI - Cryptosporidium among children with acute diarrhoea in the west of Ireland. AB - During a period of 12 months beginning on 18 February 1985, 1246 specimens of faeces from 935 children aged 3 weeks to 12 years with acute diarrhoea of varying severity were examined for the presence of cryptosporidium oocysts. Twenty-six patients required admission to hospital; four of them needed intravenous rehydration. Predominant clinical features were diarrhoea, often watery, and vomiting. Diarrhoea varied in duration between 7-15 days. Cryptosporidium oocysts were found in specimens from 41 patients, an incidence of 4.3%. In four patients an additional enteropathogen was identified (Campylobacter species in two and enteropathogenic Escherichia coli in two - serotypes 0126: K71 (B16) and 018C: K77 (B12]. None of the patients had recently travelled abroad. Of the children 23 were from a farming or rural background. Eight of the farms had recently had significant outbreaks of diarrhoea among calves. There was a marked seasonal variation with 27 of the cases arising between 18 February and 18 June, an incidence during this period of 8%. PMID- 3819460 TI - Congestive heart failure complicating Salmonella virchow septicaemia. PMID- 3819461 TI - Limitation of cusum plots in monitoring therapy of staphylococcal bacteraemia. PMID- 3819462 TI - Leishmaniasis in a HIV (LAV/HTLV III) serologically positive patient. PMID- 3819463 TI - Fatal Stevens-Johnson syndrome associated with Fansidar and chloroquine. PMID- 3819464 TI - Spontaneous breakage of a double pigtail stent and bladder stone formation. AB - Five years after prostate resection and hormonal treatment for carcinoma of prostate a 76 year old patient presented with bone and lung metastases and dilatation of left upper collecting system. After castration a double J stent was inserted in the ureter. Two years later he was admitted for alteration in general condition related to cholecystitis. A standard radiograph showed the catheter fractured into four pieces, although no urinary signs had been reported during this 2-year period. Cholecystectomy was performed and the patient reviewed 6 weeks later: urography showed good functioning of the kidney and the absence of obstruction of the collecting system. The process of fragmentation continued and a bladder calculus developed on fragments falling into bladder: it was extracted by lithotripsy. The patient was asymptomatic and refused further investigation or treatment. This case is one of several reported in the literature and silicone or C-flex should be substituted for polyethylene. PMID- 3819465 TI - [The pedicled lateral flap. Its use in the treatment of anterior hypospadias]. AB - Many methods exist for repair of anterior penile hypospadias but one of the most commonly used is certainly Mathieu's operation. However, this procedure can give rise to different complications due essentially to necrosis of a cutaneous flap brought anteriorly to reconstitute the missing portion of urethra. Based on the pedunculated cutaneous flap described by Blandy for use in urethral shortening, a proposal is made to obtain the flap for canal reconstruction laterally, this allowing conservation of its total vascularization and thus avoiding the risk of ischemic necrosis. PMID- 3819466 TI - Anti-elastofibril monoclonal antibody NKH-1: production and application. AB - A new monoclonal antibody NKH-1 was developed using human subepidermal basement membrane zone substances as immunogen. NKH-1, IgG1 kappa light chain, labeled proteins in the subbasement membrane zone in a linear fashion. It also labeled oxytalan fibers and elaunin fibers in the papillary dermis. Mature elastic fibers were labeled only in their peripheral microfibrils (elastofibrils) and the center core of elastin was nonreactive. Basal lamina itself was not decorated with NKH-1 even at the immunoelectron microscopic level. Skin appendages such as eccrine and apocrine glands, arrector pili muscle, hair follicle, and sebaceous gland were surrounded with NKH-1-positive substances. This substance was in linear fashion closely associated with the basal lamina but deposited linearly outside of it. Species specificity tests were performed only in nonprimates: mouse and guinea pig skins were nonreactive with NKH-1. NKH-1 seems to recognize a new substance in the subbasal lamina region (subbasal lamina proteins) which crossreact with elastic fiber microfibrils. PMID- 3819467 TI - Sensitivity of mouse Skh:HR-2 to ultraviolet radiation: melanocyte inactivation. AB - The hairless mouse, Skh:HR-2, was exposed to doses of ultraviolet (UV) radiation known to induce skin pigmentation. Three parameters associated with perturbations in skin pigmentation were monitored following UV exposure. These include spectroscopy (skin darkness), histology (melanocyte density), and biochemistry (melanin). Within 90 min of UV exposure, the skin became lighter. This was associated with a reduction of quantifiable melanin and the inactivation of epidermal melanocytes. PMID- 3819468 TI - In vivo mediator release and degranulation of mast cells in hematoporphyrin derivative-induced phototoxicity in mice. AB - This study was designed to assess the role of the mast cell in the early phase of hematoporphyrin derivative (HPD)-induced phototoxicity. BALB/c mice were rendered phototoxic by i.p. injection of hematoporphyrin derivative, followed by exposure to 13.6 kJ/m2 of 400-410 nm radiation. The phototoxic response was quantified by measurement of ear thickness immediately before the irradiation, and at 0, 0.5, 1, 1.5, and 2 h after. At these time-points, determinations of serum histamine and plasma leukotriene C4 levels and histologic examination of the ears were undertaken. Mice injected i.p. with buffered saline and subsequently irradiated served as controls. In mice exposed to HPD and radiation, a maximal peak increased ear-thickness of 125.7 +/- 14.4% (mean +/- SEM) was noted at 2 h; this was associated with a net increased serum histamine of over 120% and histologic evidence of mast cell degranulation. In addition, moderate increases in plasma levels of leukotriene C4 were observed at 0 h and 1.5 h in the HPD- and irradiation-treated animals. These data provide direct evidence for the participation of mast cells in the early phase of HPD-induced phototoxicity. PMID- 3819469 TI - Radioautographic measurement of electron-induced epidermal kinetic effects in different aged rats. AB - We have previously shown that the ability of rat epidermal cells to repair electron-induced DNA damage decreases as a function of age. The present investigation was performed to examine the relationship between this finding and sensitivity of epidermal cells to the cytotoxic effects of the radiation. Male CD rats at ages 2, 28, 100, 200, 420, and 728 days were injected with [3H]-thymidine [( 3H]Thd) at a dose of 2 mu Ci/g body weight. One hour later, the rats were anesthetized and the dorsal skin irradiated with various doses of 0.8 meV electrons at a dose rate of 660 rads/min. At 24 h after irradiation, radioautographs were made of a sheet of epidermis that was separated by trypsinization from the underlying dermis. Labeled cells were scored either as singlets or doublets (adjacent labeled cells). The percent labeled cells and percent labeled cells as doublets were determined. The estimated labeling index (the proportion of cells labeled by a single exposure to [3H]Thd) of the epidermal basal layer decreased as a function of age. The slope of the semilog plot of the percent labeled cells as doublets as a function of electron dose indicates that the Do value decreases with increasing age. The results show, however, that the greatest difference in sensitivity occurs between 2-day (neonatal) and 28-day (pubescent) animals and again between 420-day (adult) and 728-day (senescent) animals. PMID- 3819470 TI - Acquired immunity to Trichophyton mentagrophytes in thymus-grafted or peritoneal exudate cell-injected nude rats. AB - Congenitally athymic "nude" (RNU/RNU) rats were grafted with syngeneic neonatal thymus glands and 30 days later cutaneously inoculated with Trichophyton mentagrophytes. Nude rats and thymus-grafted nude rats were susceptible to infection with T. mentagrophytes but only thymus-grafted nude rats cleared the dermatophytosis. Clearance of the fungal infection took twice as long (approximately 60 days) in thymus-grafted nude rats when compared with heterozygous euthymic (+/RNU) controls (approximately 35 days). Following clearance of the primary dermatophytosis, peritoneal exudate cells (PEC) were adoptively transferred from either thymus-grafted or heterozygous rats to nude rats. Eight of 12 PEC-recipient nude rats acquired the capacity to resolve T. mentagrophytes-induced dermatophytosis (mean clearance time was approximately 40 days). All heterozygous (+/RNU) rats, thymus-grafted nude rats (4/4), and 8 of 12 PEC-recipient nude rats, which had cleared a primary dermatophytosis also expressed delayed-type hypersensitivity and elevated serum antibody titers to trichophytin antigen. These results demonstrate that immunity to T. mentagrophytes can be acquired in congenitally athymic nude rats following thymus grafting or injection of PEC from syngeneic +/RNU rats; however, injection of PEC from trichophytin-sensitized +/RNU donor rats to nude recipient rats did not result in transfer of specific adoptive immunity to T. mentagrophytes. Interestingly, PEC transfer from non-sensitized +/RNU rats was comparable to thymus grafting in effecting clearance of T. mentagrophytes dermatophytosis. These results suggest that acquired immunity to T. mentagrophytes in the rat is T cell-dependent, and that the absence of functional T lymphocytes and not an epithelial defect results in chronic dermatophytosis in the nude rat. PMID- 3819471 TI - Connective tissue photodamage in the hairless mouse is partially reversible. AB - Photodamaged connective tissue in animal and human skin is characterized by excessive accumulations of elastic fibers, loss of mature collagen, concomitant overproduction of new collagen, and greatly increased levels of glycosaminoglycans. Formerly considered irreversible changes, we recently showed in hairless mice, post irradiation, that a band of normal connective tissue was laid down subepidermally. The present studies focused on 2 aspects of this repair: whether repair would occur if animals were protected by sunscreens after dermal damage was induced and irradiation continued; whether retinoic acid could enhance the repair process. To examine the first aspect, albino hairless mice were irradiated with Westinghouse FS 20 sunlamps thrice weekly for 30 weeks. Sunscreens of high sun-protection factors were applied after 10 and 20 weeks. Not only was further damage prevented, but the damage incurred before sunscreen application was repaired. This appeared as subepidermal reconstruction zones containing normal, mature collagen and a network of fine elastic fibers. The second aspect was examined by applying 0.05% retinoic acid, topically, to animals preirradiated for 10 weeks. In contrast to controls treated with vehicle, the reconstruction zone was significantly wider in retinoic acid-treated mice. The enhanced repair was dose-related. PMID- 3819472 TI - Recent investigations of mechanisms of chemically induced skin irritation in laboratory mice. AB - The time course, dose response, components of inflammation, and involvement of putative mediators of inflammation in irritation induced by different chemicals was compared using a mouse ear swelling technique. Differences in time courses of inflammation produced by the irritants were not solely due to differences in rates of penetration. Changes in blood flow and permeability of vessels were phasic with different numbers of phases induced by different irritants. Effects of antagonist, synthesis, inhibitors, and depleting agents of putative inflammatory mediators on intensity of inflammation varied for different irritants. These studies demonstrate that all chemicals do not produce skin irritation by a common inflammatory pathway. PMID- 3819473 TI - Polymorphous light eruption. AB - Polymorphous light eruption (PLE) is a common photodermatosis of unknown etiology. It afflicts mainly fair-skinned patients, with a preponderance of young females. There is, however, no absolute restriction as to age, sex, or race. Clinical variants include the papular, vesiculo-bullous, and hemorrhagic variety, as well as plaque, erythema multiforme-like, and insect bite (strophulus)-like types. Skin lesions appear only in certain exposed areas hours or a few days after intense sunshine, and are nearly always monomorphous in the same patient. The rash subsides spontaneously within several days without leaving scars. The histopathologic picture is characteristic and shows a perivascular lymphocytic infiltrate in the upper and middle corium with subepidermal edema, vacuolization of basal cells, and spongiosis in the lower epidermis. The most important differential diagnoses are solar urticaria, photosensitive erythema multiforme, and lupus erythematosus. The action spectrum of PLE is under debate. Reproduction of skin lesions has been reported with UVB, UVA, and, rarely, visible light, with UVA probably being the most effective part of the spectrum. More important than treatment of PLE is prophylaxis. UVA- and UVB-effective sunscreens are of some help. Phototherapy and especially photochemotherapy (psoralen + UVA; PUVA) offer effective ways to decrease light sensitivity. Systemic treatment with chloroquine or beta-carotene has been disappointing. PMID- 3819474 TI - Surfactants cause in vitro chemotaxis and chemokinesis of human neutrophils. AB - The surfactant sodium lauryl sulfate (SLS) and alkyldimethylbenzylammonium chloride (ADB) cause erythema and leukocyte infiltration on epicutaneous application. To elucidate the mechanism of this inflammatory response, the in vitro effect of the same agents was studied on human neutrophil migration, basophil histamine release, and leukocyte lysosomal enzyme (beta-glucuronidase) release. At concentrations of greater than 0.02%, both surfactants were cytotoxic, as was evident by decreased eosin exclusion, massive histamine and beta-glucuronidase-release, and absent migration of cells. At dilutions of less than 0.002% of both surfactants, viability of cells was normal, and small amounts of histamine and beta-glucuronidase were released at a dilution of 0.001%. The most striking finding was a dose-dependent chemotactic and chemokinetic response at dilutions from 10(-3) to 10(-8)%. These observations offer a possible explanation for the pathomechanisms of irritant dermatitis due to surfactants. PMID- 3819475 TI - Pathogenesis of Campylobacter fetus infections: serum resistance associated with high-molecular-weight surface proteins. AB - Campylobacter fetus subspecies fetus causes both systemic and diarrheal illnesses. We studied 38 strains of C. fetus isolated from 34 patients; underlying illness was present in eight (89%) of nine patients with only systemic isolates compared with three (20%) of 15 patients with only fecal isolates (P = .002). In a standardized assay of susceptibility to normal human serum, 27 (71%) strains were resistant, six (16%) had intermediate susceptibility, and five (13%) were serum sensitive. Major protein bands migrating at 100 kDa or 125 kDa on polyacrylamide gels were present in all of the 25 serum-resistant strains tested but in only four of seven serum-sensitive isolates of C. fetus from humans and animals (P = .007). The presence of these bands was associated with type A lipopolysaccharide. A low-passaged strain, 82-40, was serum resistant and contained the 100-kDa protein; however, a spontaneous mutant of this strain lacked this band and was serum sensitive. The 100-kDa and 125-kDa proteins of three strains of C. fetus were antigenically cross reactive or identical and were exposed on the surface of the C. fetus cell. Serum resistance is inherent to most C. fetus isolates from humans and is associated with the presence of cross reactive surface proteins. PMID- 3819476 TI - Nonlipopolysaccharide protective antigens shared by classical and El Tor biotypes of Vibrio cholerae. AB - The prophylactic significance of the nonlipopolysaccharide (non-LPS) antigens of Vibrio cholerae was investigated further with use of the infant mouse cholera model. Of 16 strains examined to date, 12-including eight recent field isolates of both biotypes and both common serotypes-express common non-LPS protective antigens. The exceptional strains are four old isolates of El Tor biotype, the outer membrane proteins of which are not atypical when analyzed by immunoblotting. The protective activities of antibodies to the shared non-LPS components correlated with their capacities to inhibit the in vitro attachment of Vibrio organisms to isolated murine enterocytes. PMID- 3819477 TI - Specific secretory IgA in the milk of Giardia lamblia-infected and uninfected women. AB - We measured the levels of specific secretory IgA in human milk by using an enzyme linked immunosorbent assay. We studied Giardia lamblia-infected and -uninfected mothers to determine the role of such IgA in providing protection against Giardia infection to their children. Titers of specific secretory IgA in the milk of infected mothers were significantly higher than were those of uninfected mothers (P less than .01). Only 16% of infants of mothers with high titers of antibodies (higher OD) in their milk were infected with Giardia. In contrast, there was an infection rate of 63.0% in infants of mothers with low titers of antibody in their milk (lower OD; P less than .01). PMID- 3819478 TI - A computer-assisted image-analysis system for analyzing polymorphonuclear leukocyte chemotaxis in patients with diabetes mellitus. AB - A computer-assisted image-analysis system that precisely tracks the cell movements of up to 50 polymorphonuclear leukocytes (PMNLs) was developed and used to quantitatively measure cellular chemokinesis and chemotaxis in normal individuals and in diabetic patients with hyperglycemia. The PMNLs were tested in Zigmond chambers with or without a gradient of 10(-7) M n formylmethionylleucylphenylalanine (f-Met-Leu-Phe). Cellular movement was recorded on videotape by using a videocamera mounted on the microscope. The videotapes were analyzed by computer programs to calculate the speed and direction of each PMNL at 10-sec intervals. Average rates of chemokinesis were 19.6 microns/min without and 25.3 microns/min with f-Met-Leu-Phe. McCutcheon indices, which measure chemotaxis, were 0.01 without and 0.48 with f-Met-Leu-Phe. Similar values were observed in diabetic patients after fasting (average glucose, 217 mg/100 ml) and 2 hr after glucose challenge (average glucose, 309 mg/100 ml). These values demonstrate that PMNLs from diabetic patients with hyperglycemia move at normal rates and respond appropriately to f-Met-Leu-Phe. PMID- 3819479 TI - Isolation of antigenic components from the Lyme disease spirochete: their role in early diagnosis. AB - Patients with early Lyme disease produce IgM antibodies to a 41,000-dalton polypeptide of Borrelia burgdorferi. With advancing disease, IgG antibodies recognize a larger number of spirochetal polypeptides. Sodium dodecyl sulfate treatment of spirochetes at a concentration of 0.03% resulted in an outer envelope (OE) fraction in the supernatant and a protoplasmic cylinder (PC) flagellar fraction in the pellet. Shearing of the PC pellet followed by ultrafiltration and dialysis resulted in a flagellin-enriched fraction. From the OE and flagellin-rich fractions, individual polypeptides with Mr of 66,000, 41,000, and 31,000/34,000 daltons were eluted in microgram quantities after electrophoresis. The flagellin-enriched fraction as well as the eluted polypeptides were used as antigens in the ELISA. The flagellin-enriched fraction was superior to the standard ELISA antigen. The 41-kilodalton (kDa) flagellin antigen was not useful. Antigens of 66 kDa and 31/34 kDa were confirmed to be part of the late antibody response. PMID- 3819480 TI - Pharmacokinetics of amphotericin B in infants and children. AB - The pharmacokinetics of amphotericin B (AmB) have not previously been evaluated in children. Five very small, premature infants and five older children received 0.25-1.0 mg of AmB/kg per 24 hr for Candida infections. Serum concentrations of AmB, measured by bioassay, were used to determine various pharmacokinetic parameters of AmB. A one-compartment model of drug distribution was most consistent with the data. The volume of AmB distributed per kilogram of body weight was smaller and the elimination clearance more rapid than those previously reported for adults. Serum levels were approximately one-half those seen in adults given comparable doses. The mean concentrations of AmB after various doses were as follows: at 0.25 mg/kg, 0.08 microgram/ml; at 0.50 mg/kg, 0.20 microgram/ml; at 0.75 mg/kg, 0.42 microgram/ml; and at 1.0 mg/kg, 0.54 microgram/ml. Interpatient variability was, however, marked, especially among the premature infants. AmB pharmacokinetics are different in infants and children than in adults; these differences may have implications for determining optimal pediatric dosing regimens. PMID- 3819481 TI - The infectious diseases specialist: practice other than infectious diseases. PMID- 3819482 TI - How much blood is in a needlestick? PMID- 3819483 TI - Staphylococcus aureus colonization in intravenous drug abusers, dialysis patients, and diabetics. PMID- 3819484 TI - Occlusive dressings and wound infection. PMID- 3819485 TI - Possible involvement of endotoxic lipopolysaccharide in diarrhea associated with typhoid fever and non-typhoid salmonellosis. PMID- 3819486 TI - Short-term ciprofloxacin therapy for typhoid fever. PMID- 3819487 TI - Whither infectious diseases, continued. PMID- 3819488 TI - [Clinical and anatomical evaluations of Manouguian's procedure]. PMID- 3819489 TI - [Effects of various weaning methods from mechanical ventilation on hemodynamics and arterial oxygenation after open heart surgery]. PMID- 3819490 TI - [Selection of surgical procedure for mitral stenosis based on the mitral stenosis index]. PMID- 3819491 TI - [Pacemaker implantation in infants and children for atrioventricular block]. PMID- 3819492 TI - [Pre-and postoperative comparative studies of mitral stenosis between the group of open mitral commissurotomy and mitral valve replacement--the assessment of quality of cardiac and valve function by dynamic exercise]. PMID- 3819493 TI - [Congenital heart disease in newborn infants: non-surgical death and surgical results]. PMID- 3819494 TI - [Clinical study of the relationship between cardiac functions, myocardial preservations and myocardial degenerations in valvular heart diseases]. PMID- 3819495 TI - [A comparative study between blood and crystalloid cardioplegia during prolonged aortic occlusion in dogs]. PMID- 3819496 TI - [Clinical and hemodynamic results of valve replacement with St. Jude medical prosthetic heart valves--a five-year appraisal]. PMID- 3819497 TI - [Successful resection of biventricular cardiac rhabdomyoma in a nine-month-old girl]. PMID- 3819499 TI - [A case treated with broncho-cutaneous stoma for postoperative bronchial stump fistula]. PMID- 3819498 TI - [Closure method of bronchopleural fistula by omental pedicle flap]. PMID- 3819500 TI - [Dysfunction of the Ionescu-Shiley bioprosthesis in the mitral position]. PMID- 3819501 TI - [Left sleeve pneumonectomy of a patient with pulmonary blastoma required for stump recurrence after left upper lobectomy]. PMID- 3819502 TI - [Changes in enzyme activity associated with polyamine metabolism in the liver of experimental IUGR rats]. AB - Changes in ODC, SAMDC and SAT activities, the rate limiting enzymes in the polyamine metabolism were measured in the liver of the rat fetuses with experimental intrauterine growth retardation (IUGR). The following results were obtained: In IUGR, which was induced by ligation of uterine vessels in one of the two uterine horns at the 17th day of gestation, the weight of the carcass and the liver was significantly reduced. During normal development of the rat fetus, ODC activity in liver of the control group decreased. ODC activity of IUGR liver decreased significantly from the 18th day of gestation compared with that of the control group. SAMDC activity of IUGR liver increased and was significantly greater than that of the control group. Thereafter the activity decreased at a similar rate to that of the control group. SAT activity of IUGR liver decreased significantly from the 18th day of gestation compared with that of the control group. These results suggest that it is suppressed to raise the putrescine level caused by ODC (ornithine----putrescine) and SAT (spermidine----putrescine) in IUGR liver from the viewpoint of polyamine metabolism. PMID- 3819503 TI - [An ultrastructural study of the rabbit intraovarian lymphatic capillaries after ovulatory stimulus]. AB - Fine distribution and ultrastructural changes in intraovarian lymphatics were studied at accurately timed intervals after the injection of human chorionic gonadotropin (hCG). Four and six hours after hCG injection, edema around the lymphatic capillaries in the theca externa followed that around the blood capillaries. The lymphatic capillaries were markedly dilated and displayed wide openings between neighboring endothelial cells in them. At these stages, lysosome disappeared from the lymphatic endothelium, while macrophages with numerous lysosomes appeared around the lymphatic capillaries and some of them entered the lumen. Eight hours after hCG injection, the ultrastructure of the lymphatic capillaries resumed the appearance of their pre-injection stage. Three days after hCG injection, lymphatic capillaries were observed among the theca lutein cells, but not among the granulosa lutein cells. Edema around the lymphatic capillaries and openings between neighboring endothelial cells reappeared as shown 4 and 6 hours after hCG injection. Five and seven days after hCG injection, macrophages and degenerated lutein cells were observed in the lymphatic capillaries. Fourteen days after hCG injection, lymphatic endothelium began to degenerate, but that of the blood capillaries showed no degenerative signs. These results suggest that the functions of the lymphatic capillaries are absorption and transport of excess fluid, waste products and hormones. PMID- 3819504 TI - [Contact hysteroscopic exploration of the uterine cavity]. AB - The contact hysteroscope gives a clear view only upon contact with the observed surface. There are 6mm and 8mm diameter models. A total of 172 contact hysteroscopic examinations were performed to view the uterine cavity. The following results were obtained: After the previous observation with the panoramic hysteroscope, the rate of correct diagnosis with the 6mm model was 83.3% and that with the 8mm one was 98.5%. The rate of correct diagnosis with the 8mm model was 85.3% and that with the 6mm one was 92.7%, when used initially. The main disadvantages of the contact hysteroscope were a lack of perspective view and occasional existence of a dead angle just above the internal os. Among the contact hysteroscopic diagnosis, that of endometrial polyp was the most difficult, followed by those of slightly bulging submucous myoma and endometrial hyperplasia, while diagnosis of IUD, hydatidiform mole and endometrial carcinoma were easier. After acquiring the necessary experience, the 6mm model also gave very accurate results, requiring no cervical dilatation in multiparous cases. The 6mm model should therefore be a useful instrument to use in outpatient diagnosis. PMID- 3819505 TI - Gap junction formation in the human uterine muscle cell of the corpus and cervix during the menstrual cycle and pregnancy. AB - The difference between sex steroid hormone dependency on gap junction (GJ) formation in human uterine muscle cells of the cervix and corpus was investigated using electron microscopic morphometry and steroid hormone radio-immunoassay. The results obtained are summarized as follows: The number of GJ in human uterine cervical muscles changed during the menstrual cycle and became greater in the periovulatory phase, whereas the GJ of myometrial muscle changed little in number during the menstrual cycle. During pregnancy, the number of GJ in myometrial muscle increased at delivery (before labor v.s. during labor 8.1 +/- 0.6 v.s. 12.8 +/- 1.0, n = 7-2, p less than 0.01), while the number of GJ in the cervix showed no significant change. When the number of myometrial as well as cervical muscle GJ around the third trimester was compared to that of the nonpregnant (luteal phase) status, there was a significant increase in the number of GJ (luteal phase v.s. during labor 6.6 +/- 1.2 v.s. 12.8 +/- 1.0, p less than 0.05 in the myometrium and 4.6 +/- 1.0 v.s. 9.6 +/- 0.7, p less than 0.05 in the cervix). This increase in the number of myometrial GJ correlated well with the increase in the circulating E2 to P ratio (r = 0.75, p less than 0.001), whereas a slight correlation was found between cervical GJ and these levels (r = 0.42, p less than 0.05). The results of the present study support the hypothesis of an estrogen-dependent formation of myometrial muscle GJ, although the current observations of the human cervix continue to raise the question whether or not identical mechanisms may operate in the cervix. PMID- 3819506 TI - [Ontogenic development of the human neutrophil]. PMID- 3819507 TI - [Malignant ovarian tumors associated with pregnancy]. PMID- 3819508 TI - [Carcinoma of the cervix in pregnancy]. PMID- 3819509 TI - [A case with ovarian endocrine activity in association with hormonally inactive neoplasms]. PMID- 3819510 TI - [The study of drug sensitivity on newly established three choriocarcinoma cell lines]. AB - After serial transplantation in nude mice, we had established three new human choriocarcinoma cell lines (NaUCC-1,2 and 3). These three cell lines and BeWo were examined for sensitivity to Act-D, MTX and the combined agents (Act-D + MTX) 3H-Act-D uptake and 3H-MTX uptake, and were compared for each treatment. NaUCC-1 showed low sensitivity to MTX (p less than 0.05), but showed high sensitivity to Act-D (p less than 0.05). BeWo showed low sensitivity to Act-D (p less than 0.05). In examining sensitivity to the combined agents (Act-D+ MTX), the sensitivity of NaUCC-2 to Act-D was decreased (p less than 0.05) by MTX added at the same time. In the 3H-Act-D uptake experiment, NaUCC-1 did uptake a relatively larger amount of 3H-Act-D (p less than 0.01) and BeWo a smaller amount of it (p less than 0.05). In the 3H-MTX uptake experiment, NaUCC-1 did uptake a relatively smaller amount of 3H-MTX (p less than 0.05), but NaUCC-2 uptook a larger amount of it (p less than 0.005). NaUCC-1 established from the patient in whom tumor cells were resistant to treatment, had a low response to MTX. NaUCC-2 was established from the patient in whom it was found that MTX inhibits the Act-D effect on tumor cells. In the study of combined agents in NaUCC-2, the growth inhibition effect of Act-D was suppressed by the MTX added. PMID- 3819511 TI - [Influence of pregnancy on HB virus carriers]. AB - Liver function tests (GOT, GPT) were performed on 269 female HB virus carriers during pregnancy and puerperium with the following results: Pregnancy in HB virus carriers did not result in any deterioration in liver function, but was rather associated with its gradual normalization particularly in symptomatic carriers. At 1 month of puerperium, in contrast, the occurrence or rebound flare-up of hepatitis was frequently observed among the virus carriers, notably with overt liver dysfunction being seen in 43% of those positive for e antigen. Of 28 e antigen-positive carriers in whom a follow-up study was extended to the next pregnancy, 12 whose liver function was normal during puerperium had normal liver function during the next pregnancy and was positive for e antigen. In the other 16 carriers showing deteriorated liver function during puerperium, liver function during the next pregnancy was abnormal in 6 and normal in 10, with seroconversion and negativity for e antigen being observed in 2 and 4, respectively, of these 16. It is inferred that fluctuations in liver function and e antigen during pregnancy and puerperium might be consequent on increased secretion of corticoids during pregnancy. PMID- 3819512 TI - [Synergistic effect of amphotericin B and actinomycin-D against two human choriocarcinoma cell lines]. AB - The sensitivity to actinomycin-D (Act-D) and the changes in survival rate of two human choriocarcinoma cell lines (BeWo and SCH) were studied in vitro and the following results were obtained. BeWo was shown to be more sensitive to Act-D than SCH, when the survival rate was compared in the two cell lines. 3H X Act-D uptake was 39 pmol/10(6) cells in BeWo and 12 pmol/10(6) cells in SCH after a two hours treatment. Those results suggested that the sensitivity to Act-D of choriocarcinoma cells was positively correlated with the intracellular Act-D concentration. The intracellular Act-D concentration was increased depending upon the concentrations of amphotericin B (AMB). After a two hours treatment with Act D and AMB, the intracellular Act-D concentrations were twice in BeWo, and 2.3 times in SCH comparing with those treated with Act-D alone. The synergistic effects of Act-D and AMB on the survival rate were 1,000 times in BeWo and 100 times in SCH compared with those treated with Act-D alone. From the above, combination therapy with Act-D and AMB was supposed to be one of the trial methods in the treatment of drug resistant choriocarcinoma. PMID- 3819513 TI - [Study on Na+ and L-alanine cotransport of the human placenta using microvillous membrane vesicles]. AB - Using microvillous membrane vesicles prepared from human normal term placenta, placental cotransport system of Na+ and L-alanine was studied using rapid filtration technique. The uptake of L-alanine into microvillous membrane vesicles was Na+ ion electrochemical gradient (extravesicular greater than intravesicular) dependent and showed typical overshoot phenomenon. Both Na+ dependent L-alanine uptake and Na+ ion uptake into microvillous membrane were membrane potential dependent and were markedly increased when the intravesicular space was rendered electrically more negative by membrane diffusion potentials, induced by the use of highly permeant anions. L-alanine gradient (extravesicular greater than intravesicular) induced a temporary accumulation of Na+ ions. These results indicated that L-alanine and Na+ ions were cotransported across microvillous membrane and this cotransport was dependent on the electrical potential difference in the membrane. PMID- 3819514 TI - [Clinical significance of sialic acid determinations in patients with gynecologic cancer]. AB - Sialic acid (SA) levels were measured in human sera by the enzymatic procedure using neuraminidase. Sera were obtained from healthy controls (70 females), patients with uterine myoma (27 cases), cervical cancer (53 cases), benign ovarian tumor (36 cases) and ovarian cancer (70 cases). The upper normal limit of 72mg/dl was obtained from the mean +2SD for healthy controls. The mean value for serum SA in patients with primary ovarian cancer (71.2 +/- 20.6mg/dl) was statistically higher than those for both uterine myomas (59.0 +/- 12.4mg/dl) and controls. The mean level for SA in patients with ovarian cancer was further elevated and it was statistically higher than that for benign ovarian tumors (58.8 +/- 14.3mg/dl), uterine myomas and cervical cancers. SA levels were not well correlated with tumor histologic types or clinical stages of cancer patients. As to the relationship between SA and the clinical course of cancer patients, changes in SA values were well correlated with the curability of tumor resection. The lack of specificity, however, will require careful interpretation of the SA value to assure that inflammation is not causing changes in the test values, because SA shows a transient increase due to the inflammatory reaction during the postoperative period even in patients with benign tumor. These results indicate that SA determination is highly recommended as an addition to the conventional diagnostic methods. PMID- 3819515 TI - [Cytologic studies of cervical adenocarcinoma]. AB - Seventy three cases of cervical adenocarcinoma, classified histologically according to WHO classification, were cytodiagnostic examined for cellular arrangement, cellular shape, nuclear shape, chromatin pattern and appearance rate of nucleolus. In adenosquamous carcinoma, the observed cancer cells were classified further into five categories and the incidence of each type was clarified. The authors obtained the following conclusions. The cytological findings in cellular arrangement, cellular shape, chromatin pattern and nucleolus findings were closely related with the degree of differentiation of endocervical type adenocarcinoma. Since no substantial cytodiagnostic differences were seen between endometrioid adenocarcinoma and endocervical type adenocarcinoma, it appears to be difficult to differentiate between them. Clear cell adenocarcinoma is characterized by sheet-like cell arrangement, polycrystal cell shape, round nuclei, finely granular chromatin pattern and appearance of macronucleolus. Among them the occurrence of macronucleolus was clearly observed and appeared of high value in making a diagnosis. Adenosquamous carcinoma, showing no characteristic finding in cytology, is proved to have morphological diversity. Careful observation of the intermediate type cancer cells is necessary to presume the histology of adenosquamous carcinoma. PMID- 3819516 TI - [Fundamental and clinical study of chemotherapy of refractory choriocarcinoma]. AB - Since the introduction of MAC therapy in 1973, choriocarcinoma has become one of the most curable gynecologic malignancies. But in MAC resistant cases, the therapeutic results have been unsatisfactory. To establish the proper therapy for MAC resistant choriocarcinoma, fundamental experiments with MTX resistant HM cell lines were carried out with the aim of their clinical application. The effective combination in the treatment of choriocarcinoma appeared to be 10 to the minus 5th power mol of MTX and 10 to the minus 8th power mol of Act-D, considering its effect in cell proliferation inhibition, deoxyuridine uptake inhibition and dihydrofolate reductase activity suppression. Taking the effects of Oncovin confirmed by the experiments with nude mice into consideration, a combined moderate dose of MTX, Oncovin and Act-D, namely MOA therapy was used. The protocol of MOA therapy is as follows: The first day, MTX 150mg bolus, 300mg drip infusion for 4 hours, Oncovin 2mg bolus and Act-D 0.5mg bolus. From the second to the fifth day, Act-D bolus. MAC was effective in only one of the eight recurrent cases, but on the other hand, MOA was effective in five cases of choriocarcinoma including two MAC resistant cases. Therefore, MOA seemed to be a more effective therapy than MAC. PMID- 3819517 TI - [Presence of dehydrogenases of the pentose phosphate pathway in boar spermatozoa and testis]. AB - There is insufficient evidence of direct oxidation of glucose through the pentose phosphate cycle in mammalian spermatozoa. We separated the key enzymes (G6P-DH, 6PG-DH) in the pentose pathway using 2',5'ADP-Sepharose 4B. The purpose of this study is to establish the intracellular location of these two enzymes in boar spermatozoa and testis by histochemical techniques. Histochemical localization of the two pentose phosphate pathway dehydrogenases was achieved by the use of the tetrazolium salt nitro blue tetrazolium (Nitro BT). Both G6P-DH and 6PG-DH was present in the mid pieces of boar spermatozoa and in the Leydig cells and seminiferous tubules of testis. The present findings indicate that the pentose pathway could be involved in the energy production of spermatozoa and that these enzymes may be important in supplying NADPH for steroid synthesis in the testis. PMID- 3819518 TI - [Ephedrine administration for cesarean section under spinal anesthesia]. AB - Prophylactic ephedrine was administered to healthy parturients undergoing elective cesarean section under spinal anesthesia. The methods of ephedrine administration were as follows: intramuscular injection of 0.3 mg/kg, 15 minutes before the block (20 cases: group M), infusion of 0.02% solution immediately after the block (20 cases: group D), premedication with atropine 0.5 mg and infusion immediately after the block (20 cases: group AD). The mean ephedrine dosage was 18.8 +/- 2.2 gm (SD) in group M, 12.6 +/- 6.2 mg in group D and 5.2 +/ 0.7 mg in group AD, and there were significant differences among the three groups. The base line (a), the minimal postanesthetic (b) and the maximal postpartum systolic blood pressures (c) revealed no significant difference among the three groups, and 'b' was significantly higher than 'a' and lower than 'c' in all groups. Only one case (group M) was transiently hypotensive, while hypertension was not found in any of the subjects. One- and 5-minute Apgar scores were 8 or more in all, and umbilical acid-base values were within normal limits in all of them, though the base deficit in group AD was significantly lower than that in group M. Atropine premedication makes it possible to retrench the ephedrine dosage without any harmful effect on either mother or fetus, and ephedrine infusion makes it easy to cope with changes in maternal blood pressure. Consequently, for healthy parturients receiving elective cesarean section under spinal block, we recommend atropine premedication and minimal infusion of ephedrine immediately following the block. PMID- 3819519 TI - [Follow-up study of children born following immunization therapy for habitual abortions]. AB - A follow up study was carried out on 24 children whose mothers were treated with HLA immunization as therapy for habitual abortion. Among 350 couples who had experienced recurrent spontaneous abortions registered at this clinic, 117 women were immunized with their husbands' leucocytes. Seventy became pregnant and so far 24 have delivered. The sex ratio of the babies was 16 males to 8 females. The average body weight and height at birth were 3,294 +/- 88.5 g (mean +/- S.E., male) and 3,079 +/- 114.4 g (female), 50.0 +/- 0.38 cm (male) and 49.0 +/- 0.60 cm (female), respectively. Average gestational duration was 39.0 +/- 0.23 weeks and mean labor hours were 7.0 +/- 0.73 without any complication except two cesarean sections. Four out of 24 children were more than 2 years old and 12 were less than one year old. All of them were interviewed or investigated by questionnaires on the developments of body weight, height, sensory organs as well as dental development after birth. Emotional and other physical developments and history of disease after the neonatal period were also examined. Though basic immunological studies will be required in future, all investigations indicate that no abnormal sign normal developments were found in these children, indicating further application of this therapy for habitual abortion. PMID- 3819520 TI - [Ca2+, phospholipid-dependent protein kinase (C-kinase) in the rat placental chorion]. AB - C-kinase is one of the enzymes which phosphorylate cellular proteins, and is reported to be involved in transmission of the extracellular signals regarding hormones, etc. to inside the cell. This enzyme is widely distributed in many tissues and organs and several C-kinase-mediated cellular responses were reported. However, in the placenta, the presence of C-kinase has not been reported. In this paper we reported for the first time the purification of C kinase from rat placental chorion and investigated the physiological functions of C-kinase. The results were as follows: A considerable amount of C-kinase was detected in the membrane fraction of rat placenta. C-kinase specifically phosphorylated several membrane proteins, and the phosphorylation pattern was different from those of mid pregnancy and late pregnancy. The C-kinase activity in late pregnancy was 6 times higher than that of mid pregnancy. Hemin and Polylysine inhibited partially-purified membrane-bound C-kinase. Substrate specificity C-kinase from rat placenta was similar to those from other organs. PMID- 3819521 TI - [Combined passive and active immunization for preventing the development of the infantile carrier state in hepatitis B virus vertical transmission]. AB - By applying hepatitis B (HB) immunoglobulin (HBIG) and HB vaccine (vaccine) to 43 infants born to HB e antigen (HBeAg)-positive HB surface antigen (HBsAg) carrier women intramuscularly, and sub-and/or intra-cutaneously, respectively, the clinical usefulness of combined passive and active immunization in preventing infantile development of the carrier state was evaluated. The results obtained in this study are summarised as follows: Of the 43 infants, 5 (11.6%) developed the carrier state and 38(88.4%) were persistent HBsAb-positive. This carrier-rate was found to be significantly lower than that of 78 non-treated infants (73.1%) born to HBeAg-positive carrier women (control). Four of 15 infants (26.7%), who received HBIG every 4 months, developed carrier state, while only one case (3.6%) fell into carrier state in 28 infants who received HBIG every 3 months. In 30 infants whose vaccination was started at 2 or 4 months of age, 93.3% of the cases became persistent HBsAb-positive within 12 months, while 76.9% of 13 infants who underwent the first vaccination at 12 months of age became persistent HBsAb positive. No adverse effects of HBIG and HB vaccine were observed in this study. In addition, the mean values for serum glutamic pyruvic transaminase (SGPT) were 35 and 69mu/ml in the treated and control groups, respectively. Thus, the present study demonstrates that the infantile development of HBsAg carrier state by HB virus-vertical transmission could be safely, economically and easily prevented by early initiation of vaccination and re-administration of HBIG within 3 months. PMID- 3819522 TI - Small dose of 2-deoxy-D-glucose completely excludes the overgrowth of fibroblasts. AB - The present work has been undertaken to assess the effects of a small dose of 2 deoxy-D-glucose on proliferation of fibroblasts in culture by morphological criteria. Fibroblasts in culture medium with 2-deoxy-D-glucose proliferated only to a slight degree, but cell confluence was not achieved. They became swollen and the cytoplasm was increasingly occupied by lucent area. These changes became prominent on the 10th day of incubation. When cell mixtures of fibroblasts and TYK-nu (cell line of undifferentiated adenocarcinoma of the ovary) or TYK-nu only were incubated under the influence of 2-deoxy-D-glucose, the degenerative changes aforementioned were observed only in fibroblasts, while no significant changes were ascertained in the cell line of the cancer by morphological criteria. These results suggest that a small dose of 2-deoxy-D-glucose shows considerable promise in specific inhibition of fibroblastic proliferation during the process of establishing the cell line of the cancer. PMID- 3819523 TI - Establishment and characterization of the cell-line of a human endometrial carcinoma. AB - A new cell line of a human endometrial carcinoma, designated as NUE-1, has been established in culture and maintained for more than five years. The cell line has a doubling time of 40 h and grows as a confluent monolayer together with a constant population of free-floating cells. Electron microscopically, NUE-1 cells showed poorly differentiated features. Chromosome analysis revealed hyperdiploidy and two marker chromosomes. When cells from passage 6 were injected subcutaneously into nude mice, tumors developed. The histological pattern was indistinguishable from that of the original tumor, and was undifferentiated carcinoma. The cells contained no estrogen or progesterone receptors. PMID- 3819525 TI - [39th symposium of the Japan Society of Obstetrics and Gynecology. Tokyo, Japan, April 1-3, 1987. Abstracts]. PMID- 3819524 TI - [A case of hemolytic disease of the newborn due to anti-Dib antibody]. PMID- 3819526 TI - Natural killer (NK) cell activity and reversal reaction in leprosy. AB - Two studies were conducted to assess natural killer (NK) cell activity in leprosy patients and healthy Ethiopian controls. The first study tested 26 untreated leprosy patients across the spectrum of the disease. It was found that lepromatous leprosy and all untreated, nonreactional patients had lower NK activity than healthy controls. However, patients presenting with reversal reaction (RR) had NK activity within the normal range. Heterogeneity was particularly marked in the NK activity of borderline patients. In the second study, NK cell activity was assessed in treated borderline tuberculoid leprosy (BT) patients. There were 30 patients with a history of RR and 27 BT patients without such a history (NR). All patients had had at least 3 years of dapsone treatment and 6 months of multidrug therapy. There were 26 control subjects. NK activity was higher in controls than in patients only at one effector:target (E:T) ratio tested, but NK cells from the BT patient group appeared to be more "aggressive" in that there was significantly (p less than 0.001) less reduction of activity with dilution of effector cells. There were no significant differences in NK activity between RR and NR patients. The NK activity of NR patients was positively correlated with the size of induration of the lepromin response. We conclude that higher NK activity in acute RR would appear to be a consequence rather than a cause of reversal reactions. PMID- 3819527 TI - Intra-adipose administration of monoacetyldapsone to healthy volunteers. AB - The pharmacokinetics of intra-adiposely administered monoacetyldapsone (particle size less than 20 micron) were investigated in 11 male and 11 female healthy volunteers. Dapsone and monoacetyldapsone concentrations in serum were determined by high-pressure liquid chromatography (HPLC). Injection of 1175 mg monoacetyldapsone, which is equivalent to 1000 mg dapsone, resulted in dapsone concentration/time profiles in all the volunteers characterized by peak concentrations ranging from 0.14 to 0.85 mg/l, and by averaged dapsone concentrations after 28, 42, and 56 days of 0.33, 0.19, and 0.10 mg/l, respectively. Areas under the curves ranged from 6.7 to 25.3 mg X day/l. Detectable concentrations (greater than 6 ng/ml) of dapsone were achieved for 56 days in most of the subjects. An estimation of the mean concentration after repeated injection every 4 weeks ranged from 0.24 to 0.90 mg/l. No differences in dapsone concentration/time course were detectable between men and women or between rapid and slow acetylators. The injection was generally well tolerated by the subjects. This, combined with the excellent sustained release properties, makes it a promising injection. In the future, it might contribute to combat noncompliance among leprosy patients, which is believed to be one of the main causes of dapsone resistance. PMID- 3819528 TI - Evaluation of a continual compliance monitoring program for dapsone in an outpatient Hansen's disease clinic. AB - Guidelines for the assessment of patient compliance to dapsone were developed and evaluated. The urinary dapsone-to-creatinine (D/C) ratio following standardization by dose, ideal body weight, and time since last dose was used for assessment of compliance. Compliance standards were established in 12 patients of known compliance and confirmed prospectively in nine inpatients on 14 occasions. Compliance increased significantly among outpatients (N = 30) attending the University of Illinois Hansen's Disease Clinic from 47% at base line to 73% at 6 months and 80% at 18 months after establishing the monitoring program. In a subgroup of 18 patients, a similar increase in compliance was observed from 50% to 80%. A good therapeutic response was seen in the subgroup patients who were compliant. A poor therapeutic response was seen in the consistently noncompliant patients. These results demonstrate that use of a continual compliance monitoring program can improve patient drug compliance in an outpatient Hansen's disease clinic. PMID- 3819529 TI - Objective grading of the loss of pain and touch sensations in leprosy patients. AB - Two new instruments named Pain/Touch Sensation Testing and Grading devices, which provide standardized and graded stimuli of pain and touch, respectively, were employed to grade the sensory loss at the center of 110 lesions in 97 patients. The grades of sensory loss for pain were 0 (no sensory loss) in 8 lesions, 1 in 6 lesions, 2 in 14 lesions, 3 in 26 lesions, 4 in 19 lesions, and 5 (complete loss) in 37 lesions (total 110 lesions). Grades of sensory loss for touch were 0 in 12 lesions, 1 in 3 lesions, 2 in 5 lesions, 3 in 9 lesions, 4 in 15 lesions, and 5 in 22 lesions (total 66 lesions). Reevaluation done after 2-40 weeks in 46 of these lesions revealed that the grade for pain had decreased in 17 lesions, increased in 4, and remained the same in 25. The grade for loss of touch sensation had decreased in 10, increased in 1, and remained the same in 35. Grading of the sensory loss in most of the 1-cm-square areas of the entire lesion, done in 19 patients (26 lesions), revealed that the sensory loss was not uniform all over the lesion and it was also not maximum at the center of the lesion, though generally it was less at the margin in comparison with the central area. Follow up of 11 of these lesions revealed a decrease in the grades in 7 lesions for both pain and touch sensations, while 2 lesions showed a decrease in the grades for touch sensation only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819530 TI - Studies of cell death (apoptosis) and cell division in leprosy granulomas. AB - We have studied the histological changes across leprosy lesions by taking biopsies from the center and edge of the lesions and from the clinically uninvolved skin outside the lesions. A comparison of the granuloma fraction (GF) between biopsies from the center and edge of lesions and the adjacent unremarkable skin shows that the greatest GF is found at the edge of lesions, except in early tuberculoid (BT) cases when biopsies from the center have the greatest GF. Central healing of leprosy lesions occurs without tissue necrosis or appreciable fibrosis. Apoptosis, a form of individual cell death in living tissues, is known to be the mechanism of cell loss in a variety of situations, and we have found it to occur in leprosy lesions. Apoptotic activity is greatest at the edge of established tuberculoid lesions, but can be found in the center of the lesion in early cases. We, therefore, suggest that apoptosis is the mechanism by which epithelioid cells are lost during central healing in tuberculoid leprosy lesions. In the small number of multibacillary cases studied, apoptosis were found in biopsies from both the center and edge of the lesions. Mitoses can be found in biopsies from both lepromatous and tuberculoid lesions. However, the degree of mitotic activity does not appear to be related to the position of the biopsy within the lesion, and immigration of monocytes into the granulomas may be of greater importance than cell division in maintaining the numbers of epithelioid cells or macrophages present. PMID- 3819531 TI - Comparability among histopathologists in the diagnosis and classification of lesions suspected of leprosy in Malawi. AB - Identical slides from 200 biopsies obtained from individuals suspected of having leprosy during the course of an epidemiological survey in Northern Malawi were examined sequentially and independently by three histopathologists, using a standard protocol to report their findings. Their results are compared among themselves and with a standardized clinical assessment of each subject. There was more agreement among the histopathologists as to classification of leprosy cases than there was on the diagnosis of leprosy. The proportion of biopsies considered to show definite evidence of leprosy varied from 39% to 58% among the histopathologists. An appreciable additional proportion of biopsies (11.5% to 38.5% for the three histopathologists) was considered to show evidence suggestive but not pathognomonic of leprosy. Although there was, in general, good agreement on classification, the proportion of biopsies considered to show evidence of indeterminate leprosy varied from 1.5% to 21.5% among the three histopathologists. This suggests that some of the reported differences in the prevalence and proportion of indeterminate leprosy in different populations is due to terminology alone. A follow-up meeting of the study participants revealed that many of the differences in diagnosis certainty were due to difficulties in interpreting evidence of nerve involvement. It is recommended that greater attention be paid to the difficulties of diagnosing leprosy on histopathological as well as clinical grounds. A revised standard protocol for reporting histopathological evidence of leprosy is presented. PMID- 3819532 TI - Macrophage-induced procoagulation assay for the detection of defective macrophage activation in leprosy patients. PMID- 3819533 TI - Trial of cimetidine in lepromatous leprosy--a futile attempt. PMID- 3819534 TI - Leprosy in children one year of age and under. PMID- 3819535 TI - [Examination, prevention and treatment of congenital dislocation of the hip in the newborn infant--experience over an eighteen-year period]. AB - On the basis of the authors' experience during the past 18 years, clinical data on CDH in the newborn were studied and summerized as follows. The use of diaper with hip-flexed position decreased not only the incidence of click, but also the frequency of CDH in infancy, indicating their effectiveness for the prevention of CDH. It is important to know whether the hips are dislocated or dislocatable at the original examination, when one decides on indication and initiation of treatment. The affected hips should be treated when "dislocated state" is found and the instability persists for 1 or 2 weeks or when "dislocatable state" is found and the instability persists for 2 or 3 weeks. Treatment with harness is useful for the newborn with CDH. The use will not cause any complication. Development of infants with CDH following after newborns with CDH is influenced by postnatal environmental factors as well as late diagnosis. PMID- 3819536 TI - [Follow-up results of brace treatment of adolescent idiopathic scoliosis]. AB - Assessment of brace treatment for idiopathic scoliosis should be based on long term follow-up results compared with those in untreated cases. Such comparison, however, is extremely difficult from an ethical standpoint. Therefore, we conducted a comparable follow-up study on three groups of patients divided according to how well the brace had been worn during the period of treatment. Two hundred and twenty-six adolescent idiopathic cases in which brace treatment had been initiated before skeletal maturity were studied, 170 of which were followed up after the termination of the treatment. In 131 single curve cases, those who had worn the brace well showed significantly less progression than those who had worn it poorly, while 38 double curve cases failed to show significant difference between the two groups. Approximately two thirds of the cases demonstrated no major progression whether the brace had been worn well or not. Development of a method to select cases based on prediction of curve progression is an important project in the near future. PMID- 3819537 TI - [Ehlers-Danlos syndrome--clinico-pathology and orthopedic treatment]. AB - Eight cases of Ehlers-Danlos syndrome (EDS) were surveyed for clinical manifestations and orthopaedic treatment. Cases of EDS were clinically subdivided into three groups. The first group was characterized by multiple congenital contractures in the extremities, so that it was very difficult to distinguish it from arthrogryposis multiplex congenita in early infancy. Since laxity of the soft tissue coexists with contracture in this group, over-correction of deformity caused much more disability than under-correction, especially in clubfoot. Care should therefore be taken to avoid this. The third group was characterized by marked laxity of the soft tissue from birth. Diagnosis in this group was easily made by the obvious triad of EDS. Lengthy immobilization in an appropriate position was necessary to maintain a corrected position for the treatment of any deformity in the hip, foot or hand. In the second group, deformity and disability were clinically so mild that no orthopaedic management was generally required. PMID- 3819538 TI - [Clinical studies on the significance of en bloc laminoplasty for cervical compressive myelopathy]. AB - The aim of this study was clinical evaluation of en bloc laminoplasty for compressive myelopathy. Subjects were 55 patients with severe myelopathy due to ossification of posterior longitudinal ligament or spinal canal stenosis in the cervical spine. The average age at surgery was 58 years old and average follow-up period 25 months. Stable expansion of the spinal canal was shown and the average extent of the canal enlargement in sagittal diameter was 4.8 +/- 1.8 mm roentgenologically. Symmetrical expansion of the canal, good bony fusion and remodelling of the posterior elements of the spine were observed in CT. No marked malalignment or instability of the cervical spine were found, but limitation of flexion-extension movement was noticed. Neurological recovery was remarkable; 44 patients were rated as excellent or good by Robinson's criteria. The average recovery rate was 76.4 +/- 20.1% according to the evaluation system of Japanese Orthopaedic Association (JOA). En-bloc laminoplasty can accomplish a stable expansion of the canal with adequate decompression of the spinal cord. PMID- 3819539 TI - [Effect of synovial extract from patients with rheumatoid arthritis on the proliferation of cultured chondrocytes]. AB - To determine whether or not some growth factor (or factors) plays a significant role in the disease process of rheumatoid arthritis, the effects of pathological synovial extract, cultured synovial cell medium and partially purified extract and medium by fast protein liquid chromatography on cultured rabbit chondrocyte proliferation were studied. The synthesis of DNA was investigated by incorporation of 3H-thymidine into cultured cells and by flow cytometry using propidium iodide. The following results were obtained. The incorporation of 3H thymidine into the cultured cells was increased by addition of synovial extract and the medium of cultured synovial cells. The molecular weights of active materials from the synovial extract were 13-18, 36-52, and 105-150 K daltons and those from the medium of cultured synovial cells were 13-18, 36-52 K daltons. The increase of S and G2 + M phase cells was observed flow-cytometrically 24-48 hr after addition of the synovial extract. PMID- 3819540 TI - [Dynamic analysis of the shoulder girdle muscles during tracking movements in the scapular plane and in the sagittal plane--an electromyographic study]. AB - Analyse were made of electromyograms from the upper trapezius, middle deltoideus, supraspinatus and infraspinatus during tracking movements in the scapular plane and the sagittal plane of ten males. The purpose was to determine electromyographically how these muscles act in various phases and speeds of the shoulder movements in those planes. The middle deltoideus and the supraspinatus showed significantly greater electrical activity with a shoulder motion in the scapular plane than in sagittal plane having a higher efficiency in the scapular plane. There was no change observed in the electrical activity of the infraspinatus, whatever the speed or direction of the shoulder movements was. The upper trapezius seemed to play an important role in the fast scapulohumeral rhythm. The middle deltoideus played a similar important role in the slow rhythm and the supraspinatus was important in both fast and slow rhythms. PMID- 3819541 TI - Dynamic function of medial foot arch. AB - The purpose of this study was to analyse the dynamic function of the medical arch in the foot during walking. The change of the medical arch was measured by an "electro arch gauge" (EAG). The change of the medical arch, the angle of first metatarsophalangeal joint, ground reaction force and action potential of the tibialis anterior muscle, peroneus longus muscle, triceps surae muscle, abductor hallucis muscle, and the flexor hallucis muscle were measured simultaneously. In customary gait, the medical arch was stretched rapidly just after heel-strike and become longest at the early period of the foot-flat phase, then shortened gradually until about heel off. After that it was stretched slightly and shortened rapidly just before toe-off. Dynamic change of the medial arch occurred under a complex relationship of body weight, bone structure, ligaments and muscular force. PMID- 3819542 TI - Degeneration and regeneration of Ruffini corpuscles in the joint capsule. AB - The Ruffini corpuscle is a highly-differentiated sensory corpuscles which consists of complexly-arborized axon terminals surrounded by Schwann cells. The present study examined by electron microscopy the morphological changes of Ruffini corpuscles in rat joint capsule during their degeneration and regeneration, following nerve crush. Initial sign of axonal degeneration was seen as early as one day after nerve crush, and by day 3, axon terminals disappeared from Ruffini corpuscles, Schwann cells became shrunken and atrophic by day 5. Regenerating small-diameter axons first appeared about 10 days later in the denervated corpuscles, and they gradually thickened, developing into matured terminals. At the same time, atrophic Schwann cells recovered their original vigorous state about 30 days after nerve crush. No findings were obtained that suggested the neogenesis of the corpuscle by regenerating nerves. These findings show that regenerating axons enter the original denervated corpuscle and, by associating with remaining atrophic Schwann cells, develop into axon terminals as in the normal corpuscle. PMID- 3819543 TI - [Study on experimental suppurative osteomyelitis--influence of an intramedullary nail on infection in open fractures]. AB - Studies were conducted on temporary intramedullary fixation of open fractures containing pathogens to determine the degree of involvement of metal splints in the "establishment of infection" and whether or not there is a so-called "golden hour" for antibiotic administration. An open fracture was experimentally produced in the tibia of mice and inoculated with 10(2) or 10(3) cells of staphylococcus aureus. Two separate groups of intramedullary fixation and plaster cast fixation were compared. In the intramedullary fixation group, infection was established in 77.8% of the mice inoculated with 10(2) bacteria and in 100% of those inoculated with 10(3) cells, compared with 35.0% and 70.0% in the plaster cast fixation group. When antibiotic administration was started 12 hours after the inoculation, 4 of 5 mice of the intramedullary fixation group inoculated with 10(3) cells showed abundant bacterial cells after 2 weeks. Antibiotic administration started 6 hours after the inoculation achieved bacterial elimination in all mice. PMID- 3819544 TI - [Experimental studies on the effective factors and the neural control system of intraosseous pressure in the patella of dogs]. AB - Physiological studies on the patellar intraosseous pressure gave the following results: The mean value of the intraosseous pressure was 12.5 mmHg (range 7-19.5 mmHg). The effects of femoral vascular occlusion and intravenous infusion of epinephrine or norepinephrine were similar to those reported on long bones. Not only the elevation of intraarticular pressure but also the compression of the infrapatellar fat pad increased intraosseous pressure during extension or flexion of the knee as a result of venous engorgement. The results of efferent nerve stimulation suggested that the femoral nerve carried the vasomotor fibers supplying the vessels of the patellar bone marrow. The afferent nerve responded to more than 20-39 mmHg elevation of the patellar intraosseous pressure. PMID- 3819545 TI - [The review of the treatments of carcinoma of the uterine cervix in Ehime University Hospital]. PMID- 3819546 TI - [The follow up study of intra-arterial infusion chemotherapy in combination with local vein blocking operation of locally advanced breast cancer]. PMID- 3819547 TI - [Thymidine kinase isozyme in cancer of the colon--correlation to pathology and prognosis]. PMID- 3819548 TI - [Diagnosis of early lung cancer by applying the TV-bronchoscopy with a sensing device]. PMID- 3819549 TI - [Right sleeve pneumonectomy after bronchial arterial infusion in lung cancer]. PMID- 3819550 TI - [Histopathological changes induced by human bladder cancer xenografts implanted under the kidney capsule of immunocompetent mice]. PMID- 3819551 TI - [Combined CHOP and radiotherapy in non-Hodgkin's lymphoma of unfavorable histology]. PMID- 3819552 TI - [A new anti-cancer agent K-18 (conjugate of human IgG and melphalan). (I). K-18 accumulates selectively into the tumor]. PMID- 3819553 TI - [Clinical application of sequential dose methotrexate and 5-FU as a neoadjuvant chemotherapy in advanced stomach carcinoma]. PMID- 3819554 TI - [Chronic renal failure: present and future]. PMID- 3819555 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--myocardial lesions, cardiac function and arrhythmias in patients on maintenance hemodialysis]. PMID- 3819556 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--hemodynamic response to exercise test and the control of daily activities]. PMID- 3819557 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--hypertension]. PMID- 3819558 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--Recent advances of therapeutic approach toward renal osteodystrophy]. PMID- 3819559 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--body fluid homeostasis]. PMID- 3819560 TI - [Chronic renal failure: present and future. Conservative treatment of chronic renal failure with special reference to the diet therapy]. PMID- 3819561 TI - [Chronic renal failure: present and future. Dialytic treatment--recent problems in chronic hemodialysis]. PMID- 3819562 TI - [Chronic renal failure: present and future. Dialytic treatment--peritoneal dialysis]. PMID- 3819563 TI - [Familial factors of airway reactivity and serum IgE levels in bronchial asthma]. PMID- 3819564 TI - [Two cases (a father and his son) of Noonan syndrome with hypertrophic cardiomyopathy and suspected chromosomal trisomy in F group]. PMID- 3819565 TI - [A case of pheochromocytoma associated with hypercalcitoninemia and ectopic production of many peptide hormones]. PMID- 3819566 TI - [A case of congenital lipoatrophic diabetes with conjunctival pseudolymphoma and Sjogren's syndrome]. PMID- 3819567 TI - [A case of allergic granulomatous angiitis with special reference to cardiac lesions]. PMID- 3819568 TI - [A case of reversible hyperkalemic distal renal tubular acidosis associated with chronic pyelonephritis]. PMID- 3819569 TI - [A female case of march hemoglobinuria induced by kendo (Japanese fencing) exercise]. PMID- 3819570 TI - [Abruptly appearing hemorrhagic pleural effusion preceded by dialysis ascites in a patient undergoing hemodialysis]. PMID- 3819571 TI - Use of cells cultured from human mammary carcinomas for studies of malignant progression and chemotherapeutic drug sensitivity. AB - We describe techniques to readily culture human mammary epithelium from normal and malignant tissue. The cells were characterized as to their epithelial origins and qualities distinguishing tumor from normal cells. Using a highly efficient clonogenic assay, we now are able to routinely assay breast tumors for chemotherapeutic drugs. Initial studies suggest that these assays correlate with patient response. PMID- 3819572 TI - Assessment of tamoxifen as adjuvant therapy in stage II breast cancer: a long term follow-up. AB - Results of a prospective, randomized clinical trial of three treatment regimens- cyclophosphamide, methotrexate, and 5-fluorouracil (C); C plus the antiestrogen, tamoxifen citrate (CT); and CT plus bacillus Calmette-Guerin (CTBCG)--in 311 women with stage II breast cancer are reported. The data were analyzed by univariate (product limit and log rank) analysis and by multivariate analysis. Estrogen receptors were measured in all primary tumors. The mean follow-up period was 78.2 months. The regimens containing tamoxifen citrate significantly decreased the risk of recurrence in patients with positive estrogen receptors. The addition of tamoxifen does not, however, appear to provide an advantage in overall survival. No benefit in disease-free or overall survival was observed resulting from the addition of BCG to the treatment regimen. The design of the study did not permit an evaluation of the efficacy of the chemotherapy used inasmuch as all patients received it. PMID- 3819573 TI - Endocrine complications after radiotherapy for tumors of the head and neck. AB - One hundred sixty-six patients 6 to 80 years of age with nasopharyngeal cancer and paranasal sinus tumors who were free of the primary disease were studied from 1 to 26 years after radiotherapy. Studies in 65 of these patients were performed prospectively. Both the hypothalamus and the anterior pituitary gland were in the field of irradiation. The median radiation dose was estimated to be 5700 rad to the anterior pituitary gland and 5000 rad to the hypothalamus. We found evidence of endocrine deficiencies in 134 of the 166 patients observed. One hundred eleven patients showed evidence suggestive of hypothalamic lesions and 67 patients showed evidence of primary pituitary deficiency. Forty-eight of the 110 patients who received radiotherapy to the neck for treatment or prevention of lymph node metastasis showed evidence of primary hypothyroidism. The median dose to the thyroid area was 5000 rad. Adolescents younger than 15 years of age had a higher incidence of growth hormone deficiency soon after radiotherapy, but the older group showed adrenocortical and luteinizing hormone deficiency. These results indicate that endocrine deficiencies after radiotherapy for tumors of the head and neck are common. The highest incidence of complications occurred 1 to 5 years after radiotherapy, but long-term follow-up is indicated because complications may appear years after radiotherapy. PMID- 3819574 TI - Progressive renal disease: is the slippery slope species specific? PMID- 3819575 TI - In host defense, leukocytes that are counted may not count. PMID- 3819576 TI - Glomerular function and morphology after renal mass reduction in dogs. AB - To determine whether the proteinuria, glomerular sclerosis, and decline in glomerular filtration rate (GFR) described in rodents after renal mass reduction develop in another species, 24-hour proteinuria, glomerular structure, and fasting and postfeeding GFR were examined in dogs subjected to seven-eighths reduction in renal mass. All dogs were fed a diet containing 26% protein. Six dogs with a GFR less than 10 ml/min (8% to 17% of control two-kidney GFR) were killed within 6 months after renal mass reduction. Twenty-four-hour urinary protein excretion was modestly although definitely increased (236 +/- 26 mg/24 hr, P less than 0.01). All remnant kidneys demonstrated structural changes of mesangial hyperplasia or focal glomerular sclerosis. Ten dogs with a remnant kidney and early GFRs 16% to 39% of control values were followed for 18 to 39 months. In seven dogs, GFR showed little tendency to decrease with time. In one of them, proteinuria was 106 mg/24 hr with normal-appearing glomeruli at 14 months. In three dogs, proteinuria was progressive, averaging about 1 gm/24 hr at 18 months and 2 gm/24 hr at 24 to 34 months; glomerular pathologic findings progressed from focal mesangial hyperplasia or focal glomerular sclerosis at 8 to 16 months to focal and segmental sclerosis or diffuse glomerular obsolescence at 25 to 34 months; and fasting GFR progressively declined starting at 21 to 24 months after renal mass reduction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819577 TI - Neutrophil localization in acute and chronic experimental abscesses. AB - Abdominal abscesses are associated with a high mortality, and usually require surgical drainage for cure. A potential mechanism explaining the inability of the host to clear this infection may be in part a result of the inability of the neutrophil to localize at the site of an established infection. To study this question, either acute (4 hours old) or chronic (2 weeks old) abscesses caused by Staphylococcus aureus were created in perforated capsules implanted in the peritoneal cavity of rabbits. Homologous neutrophils were obtained from donor rabbits 4 hours after peritoneal glycogen stimulation and labeled with indium 111 oxine. Only 0.71% of injected 111In-labeled neutrophils localized in the chronic abscesses, compared with 1.77% in acute abscesses (P less than or equal to 0.01). Animals with chronic infections had a lower intravascular recovery of injected neutrophils (P less than 0.002). Failure of neutrophil localization was not associated with less chemotactic activity within the abscess, as measured by a chemotaxis-under-agarose assay, or caused by a barrier surrounding the abscess as detected by radionuclide imaging. Only 0.07% of injected neutrophils localized into acute abdominal abscesses in animals with a concomitant chronic subcutaneous abscess. These chronically infected animals also demonstrated a low peak intravascular recovery of injected neutrophils when compared with animals with only an acute infection (P less than 0.002). These data reveal that neutrophils localize to abscesses poorly in animals with chronic infections. The mechanism is possibly related to a systemic factor(s) associated with a lower intravascular recovery of injected neutrophils in chronically infected animals. PMID- 3819578 TI - Prostaglandin synthesis is independent of androgen levels in rat male genitalia. AB - We examined the hypothesis that androgens influence prostaglandin (PG) biosynthesis in rat male genitalia. Prostaglandin synthesis was measured on the basis of the amount of prostaglandin released per unit weight of tissue over time. On this basis, castration increased the synthesis rate of radioimmunoassayable PGE2 from 1.3 +/- 2.5 to 7.4 +/- 2.5 ng/mg protein/180 min (P less than 0.01) in slices of prostate gland, and from 8.5 +/- 1.5 to 24.9 +/- 4.1 ng/mg protein/180 min (P less than 0.01) in slices of seminal vesicle, but decreased PGE2 formation from 27.8 +/- 2.0 to 14.3 +/- 1.2 ng/mg protein/180 min (P less than 0.01) in the vas deferens. Castration had no effect on synthesis of PGE2 in slices of renal cortex or liver. The peak effect of castration for each tissue was variable, ranging from 4 to 14 days. Treatment of castrated animals with testosterone reversed the effect of castration on prostatic prostaglandin biosynthesis: control 1.62 +/- 0.26 ng/mg protein/180 min, castrate 6.05 +/- 1.10 ng/mg protein/180 min, and castrate treated with testosterone T 1.72 +/- 0.16 ng/mg protein/180 min. Testosterone administration also decreased PGE2 formation in normal (noncastrate) animals from 1.62 +/- 0.26 to 0.91 +/- 0.23 ng/mg protein/180 min (P less than 0.04). Similar patterns of stimulation or reduction in biosynthesis of PGF2 alpha and 6-keto-PGF1 alpha were also observed. When considered for the whole gland and not per slice, all the differences disappeared. These results demonstrate that the androgenic effect on the male genitalia occurs in a component of the gland that is unrelated to the production of prostaglandins and that prostaglandin synthesis is maintained despite the occurrence of widespread atrophy. PMID- 3819579 TI - Biotransformation of primaquine in vitro with human K562 and bone marrow cells. AB - Although the antimalarial activity, hemolytic and methemoglobinemic side effects, and detoxification of primaquine are all thought to depend on various biotransformation products of the drug, their site and mechanism of formation and degradation are unknown and their specific biologic effects remain very poorly understood, particularly in humans. We have therefore explored the feasibility of studying primaquine metabolism in cultured human cells. We found that the biotransformation of primaquine can be investigated in vitro in serum supplemented liquid cultures of partially synchronized and exponentially growing human erythroleukemic K562 cells. Further, these cells can be replaced by cells present in normal bone marrow. Primaquine is rapidly and predominantly converted in vitro into carboxyprimaquine (CPQ) in a quantitative manner and without further modification. In addition to CPQ, a compound Xc that is not 6-methoxy-8 aminoquinoline, and is not derived from CPQ, appears in minor amounts in a delayed fashion. With the K562 as well as with the bone marrow cells the formation of CPQ from primaquine can be totally blocked by large concentrations of the nitrosourea, 1,3-bis-(2-chloroethyl)-nitrosourea (BCNU). With bone marrow, increasing blockade of CPQ formation by BCNU leads invariably to a progressive and striking accumulation of Xc. The availability of reproducible, quantitative, and practical new tools for the study of primaquine metabolism in vitro raises a number of challenging questions and may improve understanding of the mode of action, toxicology, and pharmacogenetics of 8-aminoquinolines. PMID- 3819581 TI - Platelet survival in rats with spontaneous diabetes mellitus. AB - The results from these studies show that platelet survival is prolonged in spontaneously diabetic rats. These results confirm those obtained in rats 4 weeks after they had been made diabetic by an injection of streptozocin. Platelet survival was also prolonged in the nondiabetic littermates (normoglycemic) of diabetic rats indicating that the effect on platelet survival may be unrelated to blood glucose concentrations. The mechanism responsible for this prolongation of platelet survival is unclear. Thus, under these experimental conditions in which rats do not have vascular disease, diabetes is associated with prolonged platelet survival. Vascular injury induced by indwelling aortic catheters shortened platelet survival to the same extent in diabetic rats, their nondiabetic littermates, and controls. There was a significantly greater accumulation of platelets on the damaged aortas of diabetic animals than on the aortas of nondiabetic littermates or controls. This could be a result of increased accumulation or decreased turnover of platelets on the vessel wall; macroscopic thrombi were not observed in any of the groups with indwelling aortic catheters. We conclude that the prolongation of platelet survival previously observed in rats with streptozocin-induced diabetes is attributable to the diabetic state and not to some other effect of the drug and that chronic diabetes in rats in the absence of vascular disease is not necessarily associated with shortened platelet survival. PMID- 3819580 TI - Atypical cobalamin deficiency. Subtle biochemical evidence of deficiency is commonly demonstrable in patients without megaloblastic anemia and is often associated with protein-bound cobalamin malabsorption. AB - We performed studies in 25 patients with low serum cobalamin levels who had few if any clinical or hematologic findings of cobalamin deficiency. All but three had morphologically normoblastic hematopoiesis, and 15 were not even anemic. None of those tested excreted methylmalonic acid or homocystine. Nevertheless, the dUST identified metabolic abnormalities in 18 of the 25 cases. In vitro additives were essential in the dUST. Especially noteworthy was MTHF, whose addition unmasked an otherwise undetectable dUST abnormality in four cases. Why MTHF appears to act as a "stress test" in this setting is unknown but deserves further attention. Seven patients had early forms of classical malabsorptive states such as pernicious anemia, defined by abnormal Schilling test results. Among the rest, seven of 13 patients displayed malabsorption of protein-bound cobalamin despite normal absorption of free cobalamin by the Schilling test. In two patients, initially normal Schilling test results became abnormal the following year. These findings demonstrate that seemingly falsely low serum cobalamin levels often indicate subtle biochemical cobalamin deficiency. Early stages of pernicious anemia or other classical malabsorptive states are sometimes responsible for such subtle deficiency. However, malabsorption confined to protein-bound cobalamin is an equally common cause. Current concepts of cobalamin deficiency and the absorptive defects that can cause it should be expanded to include atypical defects requiring newer methods of identification. PMID- 3819582 TI - Assessment of the hydration state of sickle cells by phthalate ester density distribution. AB - Intracellular hemoglobin S (Hb SS) concentration, a function of cell hydration, has a major influence on the rate of Hb SS polymerization and, therefore, cellular sickling. To determine the density distribution of homozygous sickle hemoglobin cells as a function of cell hydration, cells were incubated in autologous plasma buffer mixtures with final osmolalities ranging from 195 to 490 mosm/kg at ambient Po2. The density distribution of the cells was determined by differential flotation on 20 mixtures of di-n-butyl and dimethyl phthalates with specific gravities of 1.062 to 1.142. Mean cell hemoglobin concentration (MCHC) and mean cell volume (MCV) were determined by standard manual procedures. Cell shape was assessed by scanning electron microscopy (SEM), and the axial ratio (L/W) of the elliptical dense cell fraction measured by an image analyzer interfaced with a computer. The density distribution of normal red blood cells lies within a narrow 1.090 to 1.118 gm/ml density band with the middle or transitional 60% (T60) of the cells occupying a density range of 0.0067 +/- 0.0007 gm/ml (+/- SD). The density distribution of sickle cells shows a broader density band of 1.064 to 1.134 gm/ml, and the T60 was 0.0139 +/- 0.0022 gm/ml. The mean T60 did not change with osmotic variation but the mean T60 of Hb SS cells was significantly greater (P less than 0.005). MCHC and 1/MCV varied directly with the median density of the density distribution. By linear regression analysis and Ponder's osmotic equation, it is evident that sickle cells exhibit restricted volume increases in hypotonic media.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819583 TI - Nerve blocks utilizing 0.5% bupivacaine in the treatment of post-herpetic neuralgia. PMID- 3819584 TI - [Drug selection after overdose recovery: carbamazepine or lithium]. PMID- 3819585 TI - Sarcomas of the retroperitoneum. PMID- 3819586 TI - Newer approaches to geriatric care. The multidisciplinary assessment team. PMID- 3819587 TI - Foreign medical graduates in Kentucky. PMID- 3819588 TI - Polypharmacy in the elderly. PMID- 3819589 TI - Diagnosis and treatment of intra-abdominal fluid collections. Concepts and tactics. PMID- 3819590 TI - Evaluation of a cytologic cervical cancer screening program. PMID- 3819591 TI - Anesthetic management of a parturient with myasthenia gravis. PMID- 3819592 TI - A plague amongst us? PMID- 3819593 TI - AIDS: A special issue. PMID- 3819594 TI - Psychologic issues related to AIDS. PMID- 3819595 TI - Meeting the mental health challenge of AIDS and related disorders. PMID- 3819596 TI - The Georgia Task Force on AIDS. PMID- 3819597 TI - Surgeon General's report on acquired immune deficiency syndrome. PMID- 3819598 TI - Legal issues involving AIDS. PMID- 3819599 TI - Unproven methods of treatment. PMID- 3819600 TI - AIDS controversy. PMID- 3819601 TI - Smokeless tobacco. PMID- 3819602 TI - Ethical problems in clinical trials. PMID- 3819603 TI - Consent and randomized clinical trials: are there moral or design problems? AB - The purpose of this paper is to examine whether randomized clinical trial (RCT) methods are necessarily morally problematic. If they are intrinsically problematic, then there may be a dilemma such that tragic choices might have to be made between this socially very useful method for making medical progress on the one hand, and patients' rights and welfare, or physicians' duties on the other. It is argued that the dilemma may be avoided if RCTs can sometimes be viewed as an honorable and cooperative venture between investigators and subjects. Another dilemma may take shape, however, if too few people are willing to cooperate to maintain the structural integrity of many important RCTs. Given their importance, does this method justify easing some of the consent requirements? It is argued that RCT methods are not so ideal that special consideration should be given to them regarding consent requirements. To examine the compatibility of current consent requirements and frequently used RCT schemas, seven RCT designs are discussed. It is found that some, but not all, RCTs, are intrinsically problematic but that sufficient reason has not been found to hold all RCT schemas as intrinsically morally troubling. PMID- 3819604 TI - The conflict between randomized clinical trials and the therapeutic obligation. AB - The central dilemma concerning randomized clinical trials (RCTs) arises out of some simple facts about causal methodology (RCTs are the best way to generate the reliable causal knowledge necessary for optimally-informed action) and a prima facie plausible principle concerning how physicians should treat their patients (always do what it is most reasonable to believe will be best for the patient). A number of arguments related to this in the literature are considered. Attempts to avoid the dilemma fail. Appeals to informed consent and mechanisms for minimizing the resulting harm are important for policy, but informed consent is problematic and mechanisms for minimization of harm do not address the dilemma. Appeals to some sort of contract model of justification are promising and illuminating. PMID- 3819605 TI - An argument that all prerandomized clinical trials are unethical. AB - Conversion of slowly accruing conventionally randomized studies to a prerandomized design has apparently been successful in increasing accrual enough so that some of these studies can be completed. Ellenberg (1984) has pointed out some of the ethical dangers of prerandomization. This paper argues that prerandomization must be either unsuccessful or unethical: either conversion to prerandomization will result in no significant increase in the rate of completion of the study or a significant increase in accrual rate will be achieved either at the price of an inadequate attempt to obtain informed consent, at the price of the deceit of patients, or at the price of violations of patient autonomy. The argument of the paper can be sketched as follows: For any given randomized study, either patients prefer one treatment arm to the other or they do not. On the one hand, if they do, then conventional randomization fails. But prerandomization, if done ethically, will fail also. Hence, if prerandomization succeeds in this sort of case, then the trial has been conducted unethically. On the other hand, if patients do not prefer one arm to the other, then prerandomization will succeed. So will conventional randomization. Hence, prerandomization is either unnecessary or unethical. Ellenberg's concerns count as good moral reasons for not prerandomizing if prerandomization is unnecessary. It follows that prerandomization is always wrong. PMID- 3819606 TI - Progress toward a more ethical method for clinical trials. AB - Methodology for conducting clinical trials of new drugs and treatments on people need not be regarded as fixed. After reviewing the currently most popular method (randomization) and its ethical problems, this paper explores the possibilities of a new method for conducting such trials. It relies on new Bayesian technology for eliciting the opinions of medical experts. These opinions are conditioned on specific predictor variables, and are held in a computer. At any stage in a trial, these opinions can be updated in the computer using the information collected in the trial up to that point. Consider as an admissible treatment for a patient having specific values of predictor variables only those treatments that at least one expert regards as best (in the computer model) for this patient. It is proposed that only admissible treatments, so defined, be allowed to be assigned to the patient. The ethical and statistical consequences of this principle are explored. Experience to date with a trial at Johns Hopkins designed on this principle is reported. PMID- 3819607 TI - Effect of bisulfite and caffeic acid on thiamin cleavage. PMID- 3819608 TI - Accuracy of peripheral venous contrast echocardiography in diagnosis of atrial septal defect. PMID- 3819609 TI - Prevalence of hepatitis B virus markers in hospital personnel. PMID- 3819610 TI - Human uterine muscle contraction in vitro. PMID- 3819611 TI - Prevention of pre-term labour with progesterone. PMID- 3819612 TI - Riboflavin status in preschool children in Northeast Thailand: a community survey. PMID- 3819613 TI - Renal failure in nephrotic syndrome. PMID- 3819614 TI - Treatment of superficial dermatophytosis (review and update). PMID- 3819615 TI - Comparative study of Baralgan and hyoscine-N-methyl bromide in the treatment of intestinal and renal colicy pain. PMID- 3819616 TI - Pain relief during labour. PMID- 3819617 TI - Painless labor by continuous epidural bupivacaine. PMID- 3819618 TI - Serial symphysis--fundal height measurements in detection of abnormal fetal growth. PMID- 3819619 TI - Aging changes of the knee in the Thai population. PMID- 3819620 TI - The diameter of lumbar vertebral canals in Thais and Netherlanders: a correlation study. PMID- 3819621 TI - Edwardsiella tarda infection in Hat Yai Hospital. PMID- 3819622 TI - Intestinal cryptosporidiosis. Report of four cases. PMID- 3819623 TI - Scleredema adultorum in a child. PMID- 3819624 TI - Single unilateral vaginal ectopic ureter. PMID- 3819625 TI - Facial palsy from Koon seed foreign body in left ear. PMID- 3819626 TI - Eighth Asia & Oceania Congress of Endocrinology. November 30-December 4, 1986, Bangkok, Thailand. Abstracts. PMID- 3819627 TI - Recombinant human insulin-like growth factor: testing the somatomedin hypothesis in hypophysectomized rats. AB - The in-vivo biological activity of recombinant methionyl insulin-like growth factor I (met-IGF-I) was demonstrated in hypophysectomized rats by following blood glucose after an i.v. bolus injection of met-IGF-I; a dose-dependent decrease in blood sugar was seen. Membrane transport was studied using the non metabolizable amino acid alpha-aminoisobutyric acid; stimulation was obtained with the highest dose used (90 micrograms/rat). To test the original somatomedin hypothesis, growth studies were performed in hypophysectomized rats. Two or three doses of met-IGF-I were given with three different administration regimes (i.v. or s.c. infusion, or s.c. injections twice daily) for 6 or 8 days. Little growth promoting activity was observed, with a significant effect on body weight gain obtained only when met-IGF-I was given continuously at the highest dose used (180 micrograms/day). No effect was seen on the in-vivo uptake of radioactive sulphate into cartilage. Epiphyseal cartilage width increased slightly at the highest dose of met-IGF-I, but only when the hormone was given by infusion. When 180 micrograms met-IGF-I/day were given by injections, a significant effect on longitudinal bone growth was obtained (90 micron above control). The levels of IGF in the serum were not measurably increased after s.c. administration of met IGF-I, whereas after i.v. infusion, significantly raised levels were obtained at the higher dose rates (3.0 +/- 0.3 and 2.8 +/- 0.1 units/ml). Growth hormone was much more effective than met-IGF-I even at 50-fold lower doses. Priming the animals with 10 mu. bovine GH/day followed by combined infusions of GH and met IGF-I did not reveal any potentiating effects of met-IGF-I in the presence of GH. We conclude that met-IGF-I is a relatively poor growth-promoting agent when given systemically, and that somatomedins are more likely to act as local growth factors rather than as circulating mediators of the growth-promoting effects of GH. PMID- 3819628 TI - Effects of ageing and hormonal manipulations on the level of oestrogen receptors in the guinea-pig prostate. AB - Cytosolic oestrogen receptor levels in guinea-pig prostate tissue were found to decrease with increasing age, irrespective of whether the binding was expressed relative to cytosolic protein or cellular DNA. This decrease in oestrogen receptor levels was also observed using enriched fibromuscular stromal tissue prepared by mechanical fractionation of the prostate. The most pronounced change in cytosolic oestrogen receptor levels (from 133 to 35 fmol/mg protein) occurred at the onset of puberty. The pubertal decrease in receptor levels could not be attributed to an increase in the level of proteolytic activity in prostatic cytosol fractions derived from mature animals, a change in the affinity of the receptor for oestradiol or an increase in oestrogen receptor levels in salt extracted nuclear fractions. Administration of tamoxifen (1 mg/day) to intact guinea-pigs throughout the transpubertal growth phase did not influence the age related decrease in cytosolic and nuclear oestrogen receptor levels. In contrast, the decrease in oestrogen receptor levels was prevented by castration. Administration of dihydrotestosterone (DHT; 1 mg/day) to intact prepubertal animals for 4 days before study resulted in diminished cytosolic oestrogen receptor levels; this effect of DHT was blocked by the non-steroidal antiandrogen flutamide (2 mg/day). Furthermore, elimination of testicular hormones by castration during the late-pubertal growth phase resulted in a greater than twofold increase in prostatic oestrogen receptor levels. Collectively, these observations suggest an age-related decrease in oestrogen receptor levels in the guinea-pig prostate which, in part, may be due to increased testicular function at puberty. PMID- 3819629 TI - Diurnal progesterone rhythms in the female mouse. AB - The patterns of peripheral progesterone concentrations were investigated in a number of murine models on a 13 h light: 11 h darkness lighting regime. The pattern in the intact mouse at dioestrus was compared with that in the ovariectomized mouse. A diurnal pattern was recorded in both, maxima occurring around the end of the light period; no conspicuous nadir was recorded, levels of progesterone remaining relatively constant over a 14-h period. Adrenalectomized mice displayed no such rhythm, indicating that the adrenal is responsible for any diurnal rhythm in peripheral plasma progesterone concentrations at dioestrus. At pro-oestrus in intact animals a similar rhythm was observed, but the maximum levels of progesterone were approximately five times greater than at dioestrus and, moreover, persisted in adrenalectomized mice, indicating that the rhythm of adrenal secretion of progesterone is masked by ovarian secretion. Ovariectomized mice with implants of oestradiol-17 beta displayed a similar rhythm to that of intact mice at dioestrus, but had significantly higher plasma progesterone levels around the time of the maxima although not over the total 24-h period. An s.c. injection of oestradiol benzoate superimposed on oestrogen levels produced by implants had no significant effect on plasma progesterone levels. Also at pro oestrus the pattern of peripheral LH concentration was investigated in both the intact and the adrenalectomized mouse. For both, maxima were recorded just before darkness, at 19.00 h, in advance of the progesterone surge. In adrenalectomized mice this surge at 19.00 h was attenuated. The possible role of adrenal progesterone in ovulation and the mechanisms by which endogenous oestrogens might enhance adrenal progesterone output are considered. PMID- 3819630 TI - Differentiation of granulated metrial gland cells in ovariectomized mice given ovarian hormones. AB - A study has been made of the differentiation of granulated metrial gland (GMG) cells in ovariectomized mice given progesterone and oestradiol at a time equivalent to the first 6 days of pregnancy. By varying the hormone regime, it was shown that progesterone is the ovarian hormone likely to be involved in stimulating GMG cell differentiation in the early pregnant uterus. Progesterone, however, failed to maintain, or allow further differentiation, of GMG cells during stages equivalent to the early post-implantation period, suggesting that the progesterone is not directly stimulating this cell population. The hypothesis that the differentiation and maintenance of GMG cells is under the control of activated stromal cells in the preimplantation period is supported by these results. PMID- 3819631 TI - Hormone regulation of the rodent Harderian gland: binding properties of the androgen receptor in the male golden hamster. AB - Studies were conducted in castrated golden hamsters to assess whether sexual dimorphism and sensitivity to sex steroid hormones in the rodent Harderian gland are mediated by an interaction of androgens with specific intracellular receptors. Physical properties, binding kinetics and stereospecificity of the androgen receptor were analysed using [3H]mibolerone as the radioligand. The presence of [3H]mibolerone-androgen receptor complexes with a sedimentation coefficient of 7-8S was demonstrated in Harderian gland cytosol by a linear sucrose gradient ultracentrifugation technique using a vertical rotor. Kinetic analysis revealed an androgen-binding site with an apparent dissociation constant of 0.3 +/- 0.07 (S.D.) nmol/l and a saturation binding capacity of 113 +/- 15 fmol/mg protein. Displacement studies indicated that unlabelled mibolerone, methyltrienolone, 5 alpha-dihydrotestosterone and testosterone were efficient competitors for the androgen-binding sites, while progesterone, 17 beta oestradiol, dexamethasone, dehydroepiandrosterone, ethiocholanolone and 5 alpha 16-androsten-3-one were not. Experiments in longterm castrated animals revealed that the Harderian gland androgen receptor concentration and sedimentation coefficient remained unmodified. The results of these studies were interpreted as demonstrating the presence of a specific high-affinity intracellular androgen receptor in the male hamster Harderian gland. PMID- 3819632 TI - Coronary artery ligation and reperfusion in rabbits made diabetic with alloxan. AB - The biochemical and functional changes associated with ligation (40 min) of the left circumflex coronary artery and subsequent reperfusion (60 min) in the rabbit made diabetic with alloxan were studied and compared with those of control animals. Measurement of haemodynamic parameters revealed that both left ventricular pressure and mean arterial pressure were significantly (P less than 0.05) decreased after ligation and reperfusion in the diabetic animals compared with controls. Analysis of subcellular organelle enzyme markers from the ischaemic tissue revealed that sarcolemmal Na+,K+-ATPase, mitochondrial ATPase and sarcoplasmic reticulum ATPase activities were decreased after ligation to the same extent in the diabetic and control animals. However, upon reperfusion, the recovery of mitochondrial ATPase activity was significantly (P less than 0.05) less in the diabetic animals than in the controls. Ion measurements revealed a significant (P less than 0.05) depletion of Mg in diabetic hearts before ligation, and this was augmented during reperfusion. In contrast, a significantly (P less than 0.05) higher calcium accumulation was observed upon reperfusion in the hearts of diabetic animals. Similarly, both tissue ATP levels and the ability of the mitochondria to generate ATP were depressed to a greater degree in the diabetic animals. Our results indicate, therefore, a greater susceptibility of the diabetic myocardium to ischaemic/reperfusion injury which in the clinical situation would exacerbate the problems associated with atherosclerosis and possibly contribute to the high mortality from cardiovascular complications in diabetic patients. PMID- 3819634 TI - The use of a multiwire camera for the detection of 3H labelled cDNA/mRNA hybrids. AB - We have investigated the use of a multiwire camera for the rapid direct quantitation of 3H labelled cDNA/mRNA hybrids. Growth hormone (GH) complementary DNA (cDNA) probes were labelled with either 3H or 32P and used in dot-blot hybridization assays of pituitary cytoplasmic samples. The results were assessed either by counting in the multiwire camera (3H) or by autoradiography and scanning densitometry (32P). Results obtained by both methods were comparable over a similar range of pituitary cytoplasmic dilutions. The use of a multiwire camera may have several advantages over conventional methods for the detection of radioisotopically labelled cDNA/mRNA hybrids and has great potential for use in this field of endocrine research. PMID- 3819633 TI - Osmoregulatory actions of growth hormone in rainbow trout (Salmo gairdneri). AB - The seawater-adapting actions of GH, which are independent of growth, were studied in juvenile rainbow trout (Salmo gairdneri). Hormones examined were chum salmon (Oncorhynchus keta) GH (sGH) and prolactin (sPRL), and ovine GH (oGH). Plasma Na levels of freshwater-adapted fish peaked 24 h after transfer to 67% seawater and remained high for at least 48 h. Twenty-four hours after transfer, plasma Na levels were inversely correlated to body weight. In order to limit size and growth effects in all subsequent experiments, fish having a narrow range of body weights, fed a fixed diet, and injected with hormones over a short time period were used. Plasma Na levels 24 h after transfer to 80% seawater were reduced significantly by sGH (0.25 and 2.5 micrograms/g) and oGH (2.5 micrograms/g) compared with saline injections, whereas sPRL (2.5 micrograms/g) had no significant effect. All the GH-treated fish had lower plasma Mg levels than controls; Ca levels were significantly reduced by the high dose of sGH. Salmon prolactin had no effect on concentrations of divalent ions. When the effects of a range of doses (0.01-1.25 micrograms/g) of sGH on plasma ion levels was tested, 0.25 micrograms/g was the most potent in reducing Na and Mg levels, while 1.25 microgram/g alone reduced plasma Ca concentrations significantly. These studies show that the seawater-adapting actions of GH in trout are specific to that hormone and are not consequent to an increase in size. PMID- 3819635 TI - Dopamine regulation of aldosterone secretion: an open question? PMID- 3819636 TI - Ornithine decarboxylase activity in small ovarian follicles from the laying hen (Gallus domesticus): a comparison of follicles from several regions of the ovary. AB - Small non-atretic follicles (1.5-250 mg) were collected from four distinct areas of the ovary of the laying hen. These were as follows: the stalks of the two largest preovulatory follicles; the stalks of the third largest preovulatory follicle; the stalks of the fourth and fifth largest preovulatory follicle and zona parenchymatosa. There was an increase in the proportion of small follicles in the size range 1.5-10 mg collected from the stalks of the large yellow yolky preovulatory follicles approaching ovulation, with a corresponding decrease in the number of small follicles in the size group 10-250 mg. In addition, the ornithine decarboxylase activity in follicles collected from regions 1 and 2 was significantly greater than that in small follicles collected from region 4. Since the level of ornithine decarboxylase activity is critically dependent on the degree of hormonal stimulation and growth rate of the tissue, it is suggested, on the basis of the differences in their ornithine decarboxylase activity, that small follicles located on the stalks of the large yolky preovulatory follicles are stimulated by trophic hormones and growth factors to a greater degree than similarly sized follicles located elsewhere in the ovary. It is proposed that this increased stimulation may increase the chances of these small follicles being recruited into the hierarchy. PMID- 3819637 TI - Effects of hyperprolactinaemia on male sexual behaviour in the golden hamster and mouse. AB - In the male rat, hyperprolactinaemia is associated with significant reductions in plasma LH and FSH levels and in several measures of copulatory behaviour. In contrast to this situation, experimental induction of hyperprolactinaemia in male mice and hamsters is associated with an increase in plasma gonadotrophin levels. It was therefore of interest to determine the effects of hyperprolactinaemia on the copulatory behaviour of these animals. Hyperprolactinaemia was induced by transplantation of pituitaries from adult females and sexual behaviour was tested in the presence of ovariectomized, oestrogen- and progesterone-treated females. Because hyperprolactinaemia increases plasma testosterone levels in intact male hamsters, the animals were castrated and implanted with testosterone-filled silicone elastomer capsules before induction of hyperprolactinaemia. In mice of two inbred strains, DBA/2J and C57BL/6Bg, hyperprolactinaemia appeared to stimulate male sexual behaviour as shown by a significant increase in the proportion of animals mating (C57BL/6) and a significant decrease in mount (DBA/2J) and intromission (C57BL/6Bg and DBA/2J) latencies. Similarly, hyperprolactinaemia did not suppress male copulatory behaviour in the hamster. In contrast, in two experiments in which the animals were tested three times for sexual behaviour, mount or intromission latencies were significantly reduced in pituitary-grafted, as compared with sham-operated males, in the first of the tests. Thus, in the mouse and the golden hamster, experimentally induced chronic hyperprolactinaemia stimulates both gonadotrophin release and male copulatory behaviour. These observations, together with the association of suppressive effects of hyperprolactinaemia on plasma LH and FSH levels and on sexual behaviour in the male rat, suggest the possible existence of a common mechanism underlying both endocrine and behavioural effects of hyperprolactinaemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819638 TI - Effect of corticosterone on circulating concentrations of corticosterone, prolactin, thyroid hormones and somatomedin C and on fattening in broilers selected for high or low fat content. AB - Daily changes in the concentrations of plasma corticosterone, prolactin, thyroid hormones and somatomedin C were measured in 28-day-old fat and lean lines of broilers produced by selection for high and low concentrations of very low density lipoproteins (VLDL). The effects of daily injections of corticosterone on the concentrations of these hormones and on fattening were compared in the two lines. The selection procedure had no effect on the concentrations of any of the hormones. However, daily rhythms in concentrations of plasma corticosterone, tri iodothyronine (T3) and prolactin were less often observed in the fat line than in the lean line. No differences were seen between lines in the daily rhythms in plasma thyroxine (T4) and somatomedin C. Daily injections of 2500 micrograms corticosterone/kg body weight, in both lines, depressed mean concentrations of plasma prolactin, T3 and somatomedin C and body weight. This dose of corticosterone also increased abdominal fat pad and liver weights expressed as a percentage of body weight. The liver and fat pad responses to 2500 micrograms corticosterone in both lines were greater when the steroid was injected at the end rather than towards the beginning of the 14-h daily photoperiod. There was no difference between the lines in the fattening response to corticosterone. Lower doses of 100 and 500 micrograms corticosterone per day did not induce fattening or affect concentrations of plasma prolactin. They did, however, depress concentrations of plasma T3. Concentrations of plasma T4 were increased in both lines treated with 2500, but not with 100 or 500 micrograms corticosterone, towards the beginning of the daily photoperiod.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819639 TI - Inhibition of post-partum maternal behaviour in the rat by injecting an oxytocin antagonist into the cerebral ventricles. AB - Endogenous oxytocin released into the brain at parturition may stimulate the onset of maternal behaviour. In this study an attempt was made to block spontaneous maternal behaviour following natural delivery in Wistar rats by the injection of an antagonist of oxytocin into the cerebral ventricles. The analogue antagonist, d(CH2)5-8-ornithine-vasotocin, was administered by injection into a chronically implanted cannula in the right lateral ventricle at hourly intervals, beginning immediately after the expulsion of the first pup. The antagonist did not interfere with the normal progress of parturition or birth-related behaviours. After delivery of the last pup, mothers rested for 40 min in the test cage with the pups having been removed. Four pups and standard nesting material were then presented. Latency to pup carrying and duration of pup manipulation, nest building, and time spent on the nest with the pups, as well as duration of autogrooming and general activity were determined. Saline-injected controls started gathering the pups immediately and usually showed all elements of maternal behaviour within 10 min. Antagonist-treated mothers showed a marked delay in the onset of pup grouping and other maternal behaviours. At the end of 1 h, two out of six mothers had not yet picked up a single infant. Pups left overnight with their mothers were gathered into the nest and suckled, and no long term effects of the antagonist were evident on retesting. The effectiveness of oxytocin antagonist in suppressing the rapid onset of post-partum maternal behaviour supports the hypothesis that centrally released oxytocin is involved in this process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819640 TI - Role of protein kinase C in the pigment cell of the lizard (Anolis carolinensis). AB - The role of protein kinase C in melanosome dispersion was examined using the melanophores of the lizard Anolis carolinensis and an in-vitro rate method of bioassay. The phorbol ester 12-O-tetradecanoyl-phorbol-13-acetate (TPA), which directly activates protein kinase C, was able to potentiate the melanophore response to alpha-MSH in a dose-dependent manner. Similarly, the stimulatory response to forskolin, which activates the adenylate cyclase catalytic subunit, was also potentiated by TPA. The response of the melanophore to cyclic AMP, however, remained unaltered by any dose of TPA. We thus propose that the potentiation of alpha-MSH potency by TPA is through an interaction of protein kinase C with adenylate cyclase and, more specifically, that this interaction may be at the level of the linkage of the nucleotide regulatory subunit Ns with the catalytic moiety C of adenylate cyclase. PMID- 3819641 TI - Endocrine and behavioural factors affecting water balance in sheep subjected to isolation stress. AB - The effect of stress on drinking, water balance and endocrine profile was studied using ten castrated rams. Individual sheep were exposed to 30-h periods of total isolation (psychological stress) or physical separation from their social group (control). Plasma was analysed for haematocrit, osmolality, electrolyte levels and concentrations of cortisol and arginine vasopressin. Isolation stress significantly reduced water intake, increased haematocrit and plasma concentration of cortisol, but did not alter osmolality or vasopressin concentration. The physiological effects of this self-imposed water restriction contrast with those obtained by depriving the sheep of water for 24 h under conditions that were not stressful, i.e. by keeping them grouped together. These results suggest that cortisol may act to defend plasma volume in sheep exposed to acute stress. The results also indicate that vasopressin probably should not be considered to be a 'stress hormone' in the sheep. PMID- 3819642 TI - Indomethacin treatment prevents prolactin-induced luteolysis in the rat. AB - Adult female rats were hypophysectomized and their pituitary glands autotransplanted beneath the left kidney capsule on day 2 (day 1 was the day of ovulation). In such rats the pituitary secretes prolactin fairly constantly and the corpora lutea secrete progesterone for several months. To induce the luteolytic effect of prolactin the rats were first injected s.c. with 2-bromo alpha-ergocryptine (CB-154) on cycle days 12, 13 and 14 (i.e. 10, 11 and 12 days after operation) to depress prolactin secretion, and then with CB-154 vehicle (70% ethanol) daily until cycle day 21, to allow prolactin secretion to resume. One ovary was removed from each rat on day 15 and the remaining one on day 22. The mean (+/- S.E.M.) weight of the corpora lutea on day 15 was 1.46 +/- 0.06 mg and 0.98 +/- 0.07 mg on day 22 (n = 17). In contrast, rats in which the CB-154 treatment was maintained to day 21 had corpora lutea which weighed 1.31 +/- 0.09 on day 15 and 1.47 +/- 0.08 mg on day 22 (n = 15). To investigate whether indomethacin, a prostaglandin synthesis inhibitor, affected the luteolytic action of prolactin, the experiment was repeated, but on day 15 (after the removal of one ovary) the groups in which CB-154 treatment was stopped, as well as the group in which CB-154 treatment was maintained, were each divided into two groups. In one, indomethacin-containing silicone elastomer wafers and, in the other, blank silicone elastomer wafers, were placed within the bursa of the remaining ovary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819643 TI - A quantitative study of steroid bioconversions in the testis of the African catfish, Clarias gariepinus (Burchell), under natural spawning and natural and cultivated non-spawning conditions. AB - Quantitative aspects of bioconversions in the testes of the African catfish (Clarias gariepinus) were studied in vitro by incubation of tissue with [3H]pregnenolone or [3H]androstenedione. During the breeding period, spawning and non-spawning animals were collected from their natural habitat, the Hula nature reserve, in northern Israel. In the same period, non-spawning animals were collected from a fish pond in the same region. It was shown that spawning was accompanied by significant changes in steroid bioconversions, i.e. a reduction in androgen synthesis, especially of 11 beta-hydroxyandrostenedione and 11 beta hydroxytestosterone and an increase in the production of C21-steroids, especially progesterone, 17 alpha-hydroxyprogesterone and a pregnenolone ester. These changes resulted from a decreased contribution of the cytochrome P-450 enzymes 17 alpha-hydroxylase, C17-20-lyase and 11 beta-hydroxylase. A rise in plasma gonadotrophin concentration was observed only in spawning catfish. In the absence of such an increase in plasma gonadotrophin, steroid synthesis in the testes of non-spawning feral and pond catfish was primarily directed towards the production of 11-oxygenated androgens and 5 beta-pregnane-3 alpha,17 alpha,20 alpha-triol. It is suggested that spawning is induced by gonadotrophin and the ensuing change in steroidogenesis. It is possible that husbandry conditions inhibit the necessary increase in gonadotrophin release. PMID- 3819644 TI - 6th joint meeting of British endocrine societies. 23-26 March 1987, Warwick. Abstracts. PMID- 3819645 TI - Lethal toxicity of lipopolysaccharide and tumor necrosis factor in normal and D galactosamine-treated mice. AB - The toxic properties of human recombinant tumor necrosis factor (TNF) were investigated in mice made hypersensitive to endotoxin by treatment with D galactosamine. C3H/TifF mice treated with D-galactosamine were rendered sensitive to the lethal effects of submicrogram amounts of TNF. In the absence of D galactosamine, TNF caused approximately 80% lethality with 500 micrograms. The duration of sensitization to TNF lasted up to 8 h after D-galactosamine administration, that towards LPS, up to 4 h. As with LPS, with TNF sensitization could be inhibited by uridine administered up to 2 h after D-galactosamine/TNF, showing that the early biochemical alterations in the liver known to be necessary for sensitization to LPS are also necessary for sensitization to TNF. In contrast to LPS, the toxicity of TNF was expressed also in D-galactosamine-treated endotoxin-resistant C3H/HeJ mice. The susceptibility of these mice to TNF was identical to that of endotoxin sensitive mice. In the absence of D-galactosamine the toxicity of TNF in C3H/HeJ mice was comparable to that obtained in C3H/TifF mice, being lethal with amounts of the order of 500 micrograms. The present results support the hypothesis that TNF is a mediator of lethal toxicity of endotoxin. PMID- 3819646 TI - Opsonization of bacteroides by the alternative complement pathway reconstructed from isolated plasma proteins. AB - Opsonization of clinical isolates of B. fragilis and B. thetaiotaomicron with the six isolated proteins of the alternative complement pathway under physiological conditions resulted in considerable C3 deposition on the bacterial surfaces. The time course of C3 deposition was similar to that observed in EGTA-serum; however, the magnitude of C3 deposition was twofold greater in EGTA-serum. Opsonization of the bacteria with the isolated alternative pathway proteins failed to promote adherence, uptake, or killing by polymorphonuclear leukocytes, whereas opsonization of the bacteria with EGTA-serum facilitated these events. The difference in opsonic capacity of isolated proteins and EGTA-serum was not related to the quantitative difference in C3 deposition, because repeated opsonization of the bacteria with isolated proteins resulting in C3 deposition comparable to that observed in EGTA-serum only minimally increased adherence of the bacteria to polymorphonuclear leukocytes. SDS-PAGE and autoradiographic analysis of C3 extracted from bacteria opsonized with isolated proteins or EGTA serum using methylamine and SDS demonstrated that the predominant form of C3 bound by ester bonds under both sets of conditions was iC3b. A low molecular weight C3 cleavage fragment was detected in extracts from bacteria opsonized with isolated proteins, but it accounted for only a minor fraction of the bound C3. The results of our study demonstrate that the early phase of opsonization involving activation of the alternative pathway by B. fragilis and B. thetaiotaomicron and resultant C3 deposition on the bacterial surfaces does not require auxiliary serum factors, but the effector phase of opsonization of these bacteria involving recognition of bacteria-bound C3 by polymorphonuclear leukocytes and the induction of phagocytosis and intracellular killing is dependent on such factors. Natural IgM antibodies serve as auxiliary factors is opsonization of B. thetaiotaomicron by the alternative pathway, whereas additional serum factors are required for alternative pathway-mediated opsonization of B. fragilis. PMID- 3819647 TI - Guinea pigs sublethally infected with aerosolized Legionella pneumophila develop humoral and cell-mediated immune responses and are protected against lethal aerosol challenge. A model for studying host defense against lung infections caused by intracellular pathogens. AB - We have employed the guinea pig model of L. pneumophila infection, which mimics Legionnaires' disease in humans both clinically and pathologically, to study humoral and cell-mediated immune responses to L. pneumophila and to examine protective immunity after aerosol exposure, the natural route of infection. Guinea pigs exposed to sublethal concentrations of L. pneumophila by aerosol developed strong humoral immune responses. By the indirect fluorescent antibody assay, exposed guinea pigs had a median serum antibody titer (expressed as the reciprocal of the highest positive dilution) of 32, whereas control guinea pigs had a median titer of less than 1. Sublethally infected (immunized) guinea pigs also developed strong cell-mediated immune responses. In response to L. pneumophila antigens, splenic lymphocytes from immunized but not control animals proliferated strongly in vitro, as measured by their capacity to incorporate [3H]thymidine. Moreover, immunized but not control guinea pigs developed strong cutaneous delayed-type hypersensitivity to intradermally injected L. pneumophila antigens. Sublethally infected (immunized) guinea pigs exhibited strong protective immunity to L. pneumophila. In two independent experiments, all 22 immunized guinea pigs survived aerosol challenge with one or three times the lethal dose of L. pneumophila whereas none of 16 sham-immunized control guinea pigs survived (p less than 0.0001 in each experiment). Immunized guinea pigs were not protected significantly from challenge with 10 times the lethal dose. Immunized but not control animals cleared the bacteria from their lungs. This study demonstrates that guinea pigs sublethally infected with L. pneumophila by the aerosol route develop strong humoral immune responses to this pathogen, develop strong cell-mediated immune responses and cutaneous delayed-type hypersensitivity to L. pneumophila antigens, are protected against subsequent lethal aerosol challenge, and are able to clear the bacteria from their lungs. The guinea pig model of L. pneumophila pulmonary infection is as an excellent one for studying general principles of host defense against pulmonary infections caused by intracellular pathogens. PMID- 3819648 TI - Histidine-rich glycoprotein inhibits the antiproliferative effect of heparin on smooth muscle cells. AB - Histidine-rich glycoprotein (HRGP), an alpha-glycoprotein in human plasma that is also present in platelets and macrophages, binds heparin with high affinity and neutralizes its anticoagulant activity. We now report that HRGP specifically inhibits the antiproliferative effect of heparin on arterial smooth muscle cells while other heparinoid-binding proteins do not influence mitogenesis. The multicellular inflammatory response to endothelial injury characterized, in part, by the influx of platelets and macrophages, may be associated with HRGP release into the arterial microenvironment. This release of HRGP may allow smooth muscle cell proliferation and atherogenesis by inhibiting the action of endothelial cell derived heparinoid substances. PMID- 3819649 TI - Differential conditioning of the rabbit's nictitating membrane response to serial compound stimuli. AB - Three experiments were conducted to determine the time course and contents of CS representations through an examination of differential conditioning of the rabbit's nictitating membrane response to two serial compounds. One compound (A X+) was always paired with the unconditioned stimulus, and the other (B-X-) was always presented alone. All three experiments entailed manipulation of the interstimulus interval between the initial distinctive element of each compound (A and B) and the second, shared element (X). The joint results revealed that (a) conditioned response acquisition to the initial elements depended on the presence of X in the A-X+ compound; (b) differentiation between A and B appeared across interstimulus intervals up to 4,600 ms; and (c) conditional control over responding following A and B appeared at interstimulus intervals of at least 4,600 ms and perhaps up to 12,600 ms. The results are discussed with respect to mechanisms of occasion setting, generalization, and configuration. PMID- 3819650 TI - Evaluation of the relation between Pavlovian occasion-setting and instrumental discriminative stimuli: a blocking analysis. AB - Experiments with rat subjects used a blocking design (A+, then AB+) to assess the relation between Pavlovian occasion-setting and instrumental discriminative stimuli. Prior conditioning of both associative and occasion-setting functions of A in a serial feature-positive procedure blocked acquisition of an instrumental discriminative function by a novel stimulus (B) trained in compound with A. However, neither prior conditioning of only an A-US (unconditioned stimulus) association nor prior conditioning of Stimulus A using a Pavlovian simultaneous feature-positive procedure, which does not endow A with an occasion-setting function, blocked acquisition of an instrumental discriminative function by B. Prior acquisition of an instrumental discriminative function by A blocked acquisition of a Pavlovian occasion-setting function by a novel stimulus (B) trained in compound with A, but did not block acquisition of an association between B and the US. These outcomes indicate that Pavlovian occasion-setting and instrumental discriminative properties of a stimulus are functionally equivalent and that both Pavlovian occasion-setting and instrumental discriminative properties of a stimulus are functionally independent of simple associative relations between that stimulus and other events. PMID- 3819651 TI - Extinction reveals stimulus control: latent learning of feature-negative discriminations in pigeons. AB - Various discriminations based on the presence versus absence of a single feature are supposedly learned much better when the feature appears on reinforced rather than nonreinforced trials. However, failures to show discriminative acquisition with the feature on negative trials could reflect a deficiency in control of performance rather than a lack of learning. Five experiments supported this alternative possibility. Pigeons that had yielded little or no evidence of learning (with distinguishing features like a small white square on the response key or a tone located some distance away) revealed clear differences between keypecking to the formerly positive and negative stimuli when all food was removed from the situation. Besides extinction, several other procedures for decreasing the positive predictiveness of the most informative stimulus element also unmasked feature-negative learning, whereas general and specific contextual changes did not. Incompletely mastered feature-positive discriminations improved during extinction, too. The findings of better discrimination performance in extinction were related to analogous effects in previous generalization and discrimination research employing other tasks and arrangements. A sign-tracking analysis could not completely account for the present results. PMID- 3819652 TI - Associative effects of US preexposure: modulation of conditioned responding by an excitatory training context. AB - In two experiments we examined factors that contribute to retarded emergence of conditioned responding to a conditioned stimulus (CS) trained in a context in which unsignaled unconditioned stimuli (USs) had previously been administered. In both experiments water-deprived rats were used in a conditioned lick suppression task to measure the conditioned response elicitation potential of the CS and the training context. From Experiment 1 we determined that nonreinforced exposure to the excitatory context after US preexposure and prior to CS-US pairings in that context eliminated the conditioned response deficit observed on a subsequent test of the CS. The recovery from the US preexposure deficit was nearly as great in animals that received nonreinforced exposure to the excitatory training context after the CS-US pairings but prior to the ultimate test of the CS. From Experiment 2 we determined that the recovery induced by contextual deflation after CS training was specific to deflation of the context in which the CS was trained as opposed to another excitatory context. In total, these experiments suggest that context-US associations partially mask the expression of a learned CS-US association. These results are discussed in terms of recent models of conditioned response generation. PMID- 3819653 TI - Hunger enhances the expression of calorie- but not taste-mediated conditioned flavor preferences. AB - Rats learned to associate one flavor conditioned stimulus (CS; grape or orange) with an ethanol (caloric) or saccharin (sweet but noncaloric) solution unconditioned stimulus (US), and the other flavor CS with either the other US or plain tap water. They were then given two-bottle choice tests between the flavor CSs apart from the USs. Flavors associated with 5% ethanol were preferred over saccharin-paired and water-paired flavors by sated rats, and food deprivation during the choice test enhanced this preference. The ethanol-paired flavor preference was not affected by feeding conditions (deprived vs. ad lib) during CS US conditioning. Flavors associated with 8% sucrose (caloric + sweet tasting) were preferred over water-paired flavors during ad lib testing, and this preferences was also enhanced by food deprivation. Flavors associated with 0.028% or 0.25% saccharin were preferred over flavors paired with water; however, these preferences were not enhanced by deprivation at test time. In all cases, calorie mediated preferences, at their highest levels, were stronger than taste-mediated preferences. These experiments indicate that preferences for flavors associated with caloric substances are positively related to hunger level at test time, but preferences mediated by a prior preferred taste are independent of test-time hunger level. PMID- 3819654 TI - The kinematics of locomotion toward a goal. AB - A mathematical model is developed that treats rats in runways as uniformly accelerated bodies. The purpose of the model is to permit conversion of the continuously varying measures of runway speeds at different points in the alley into three invariant parameters of performance: start latency, acceleration, and brakepoint. This simple model fits most of the data examined, and changes in the parameters throw new light on phenomena such as the partial reinforcement acquisition effect. In particular, it is shown that partially reinforced rats accelerate faster but cease accelerating earlier in the runway than do continuously reinforced rats. This explains the qualitative differences often found between start and goal speed measures. The analysis takes as its unit patterns of terminal behavior rather than the rate of the responses that constitutes them, and thus may permit coherent treatment of instrumental and operant behavior. PMID- 3819655 TI - Two-dimensional gel electrophoresis, isoelectric focusing and agarose gel electrophoresis in the diagnosis of multiple sclerosis. AB - Two dimensional gel electrophoresis (2-DE), isoelectric focusing (IEF) and agarose gel electrophoresis (AGE) were used to examine cerebrospinal fluid (CSF) and sera from 22 patients with confirmed multiple sclerosis, 11 patients with probable multiple sclerosis and 20 control patients with non-inflammatory neurological diseases of the central nervous system (CNS). All of the 22 patients with confirmed multiple sclerosis showed abnormal patterns of oligoclonal IgG in all three methods. In the CSF from patients with probable multiple sclerosis, oligoclonal IgG was detectable in 18 percent with AGE, in 72 percent with IEF and 90 percent with 2-DE. No oligoclonal IgG was observed in subjects with non inflammatory neurological diseases. Many artefacts in IEF, which lead to misinterpretation, are eliminated in the 2-DE system. Based on our observations and this study in particular, it is evident that some patients have IgG changes which can be detected only by 2-DE. The application of research-oriented 2-DE for routine clinical purposes is still limited by its cost and technical complexity. PMID- 3819656 TI - Two-dimensional electrophoresis of proteins in tumours of the lung. AB - The proteins of solid lung tumours (15 adenocarcinomas and 10 squamous cell carcinomas) were examined by high resolution two-dimensional electrophoresis (2 DE) and compared with the proteins of adjacent lung tissue which demonstrated no histological evidence of malignant transformation, and with the proteins of other malignant tumours and normal tissues. To investigate tumour cell-specific protein synthesis, we isolated malignant and normal cells enzymatically with collagenase, elastase, and DNase. Tissue and tumour cells were enriched in an additional step on a Percoll gradient. The 2-DE gel patterns derived from entire tissue and enriched tissue cell preparations were compared. No specific differences were found between the 2-DE protein patterns from adenocarcinomas and squamous cell carcinomas of the lung, but three proteins identified on the 2-DE gels appeared to be tumour-associated. Spot A is present in non-neoplastic and neoplastic epithelial tissues. Spot B is pronounced in 2-DE gels of sarcomas, but is also present in preparations of other malignant tissues. Spot C is present in all malignant cell preparations. These three spots were also demonstrated in 2-DE protein patterns from tissue cultures of malignant cell lines. Spot B and spot C were also present in some normal tissues. PMID- 3819658 TI - Screening in family practice: prevention, levels of evidence, and the pitfalls of common sense. PMID- 3819657 TI - The age dependency of the creatinine-related concentration of ribonucleosides in human urine. AB - We investigated the urinary excretion of ribonucleosides and an unidentified substance in 345 healthy probands from the age of a few weeks to 40 years. The concentration of ribonucleosides, related to the corresponding concentration of creatinine, decreases until nearly 20 years and remains constant between 20 and 40 years. The polynomial functions describing this dependency are presented. The biological significance of our findings is briefly discussed. PMID- 3819659 TI - Primary care in academic health centers. PMID- 3819660 TI - Choice of instrument for flexible sigmoidoscopy. PMID- 3819661 TI - Needle aspiration and cellulitis. PMID- 3819662 TI - Acute interstitial pneumonitis. PMID- 3819663 TI - Ten years of screening for cancer in a family practice. AB - The Cohocton office of Tri-County Family Medicine has maintained an active screening program for breast cancer, colorectal cancer, and cervical cancer since 1974. This article reports a retrospective study of all patients with a diagnosis of cancer during the ten-year period from July 1974 to June 1984. Particular attention was paid to the relationship of screening to the diagnosis of these cancers. Sixty-nine cancers were diagnosed during the study period. Screening detected 7 of 11 breast cancers, 2 of 11 colorectal cancers, and 2 of 3 cervical cancers. In addition, all cases of respiratory cancer occurred in cigarette smokers and were therefore theoretically preventable. The data suggest that a large population of inactive, unscreened patients is a major obstacle to cancer prevention. PMID- 3819664 TI - A false-positive hepatobiliary scan: case report and literature review. AB - This case report describes a false-positive hepatobiliary scan in a young woman suspected to have acute cholecystitis who apparently had none of the reasons stated in the literature for a false-positive scan. The literature review shows that the negative predictive value of hepatobiliary scanning for acute cholecystitis is nearly 100 percent, while the positive predictive value is also quite good if conditions known to cause false-positive scans are ruled out. Common causes of positive hepatobiliary scanning, other than acalculus cholecystitis, include chronic cholecystitis, cholecystitis, hepatitis, alcoholism, total parenteral nutrition, pancreatitis, prolonged fasting, and ingestion of food less than one hour prior to scanning. Whether the postpartum state affects the accuracy of hepatobiliary scanning is speculative. PMID- 3819665 TI - Estimating the prevalence of depression in family practice using variant methods. AB - Prevalence estimates for depression in primary care vary depending on diagnostic methods and classification criteria. The present study assessed the prevalence of depression in new, female, family practice patients using self-report and office visit data. Psychological and somatic symptoms and physician interventions were used to create classification criteria. Prevalence was higher by self-report than by physician assessment. The single checklist item "depression" appeared to yield a valid prevalence estimate. Agreement between self-report and physician recognition was low. Prevalence estimates were enhanced when single-visit patients were excluded. The findings suggest that patients who report depression by questionnaire may differ from those admitting depression to physicians; therefore, patient and physician characteristics are likely to contribute to the underrecognition of depression in primary care. PMID- 3819667 TI - Consultant utilization by family physicians in a university hospital practice. AB - All inpatient consultations obtained by family physicians at a university hospital were monitored for 2 1/2 years to determine the number and types of consultations obtained. Overall, 1,017 consultations were obtained on 2,155 patients (0.47 consultations per patient). The consultation rate, however, gradually decreased from 0.56 consultations per patient at the beginning of the study to 0.36 consultations per patient at the end of the study, probably corresponding to cost-containment pressures placed on physicians by increasing involvement with prepaid health care plans. The specialties most frequently consulted were cardiology, gastroenterology, neurology, and pulmonary medicine, which together accounted for more than one third of all consultations obtained. PMID- 3819666 TI - Selection of a physician for prenatal care. AB - The selection of a physician for prenatal care was studied as a model of the generic process of choosing a physician. The results suggest that factors important in this process are similar to those relating to satisfaction with care: physician competence, cost and convenience, and personal qualities. Women selecting obstetricians for prenatal care placed a higher emphasis on physician competence, whereas those selecting family physicians placed a greater emphasis on cost and convenience. PMID- 3819668 TI - Enteroliths in a Meckel's diverticulum mimicking gallstone ileus. PMID- 3819669 TI - Prescription-filling patterns of patients in a family practice. PMID- 3819670 TI - Gatekeeping in primary care: a comparison of internal medicine and family practice. AB - Five hundred twenty new patients were randomly and prospectively assigned to receive their care in the Internal Medicine Clinic or Family Practice Clinic of a large university hospital. The patients were followed by residents in training under the supervision of board-certified internists or family physicians. After a mean length of care of slightly over two years, the charts were reviewed for frequency of visits to primary care providers (internal medicine or family practice), Emergency Room, Acute Care Clinic, and all clinics other than the two primary care clinics. The records were also reviewed for laboratory tests ordered. Frequency of visits to the clinic of primary care, Emergency Room, Acute Care Clinic, and broken appointments were all significantly higher for patients randomized to the Internal Medicine Clinic. In addition, the median total annual cost of laboratory tests for patients followed by internal medicine physicians was significantly higher, largely because of higher laboratory charges generated by the specialist consultants. Over the study period, internal medicine patients had a significantly higher number of visits to all nonprimary care clinics and specifically to the dermatology, obstetrics and gynecology, and general surgery consultant clinics. It can be concluded that in this clinical environment, the practice styles of internal medicine and family practice are different. PMID- 3819671 TI - HTN-APT: computer aid in hypertension management. AB - Hypertension-aid in physician treatment (HTN-APT) is an expert computer system that assists the physician in determining the best form of treatment for the individual hypertensive patient. The HTN-APT system aids the physician in managing the hypertensive patient by keeping a record of the patient's progress, allowing easy access to drug information, and generating recommendations and critiques about treatment options. The treatment recommendations are ranked by an analogue indication-contraindication scheme whereby each drug both singly and in combination is evaluated for patient suitability on the basis of more than 30 possible patient factors. When the computer-generated recommendations were evaluated by a group of family physicians, the HTN-APT system was found to make beneficial treatment recommendations without major judgmental error. PMID- 3819672 TI - Cocaine and sudden "natural" death. AB - The cardiovascular effects of cocaine may culminate in clinical episodes of angina pectoris, myocardial infarction, arrhythmias, and intracranial hemorrhage. To clarify whether or not cocaine causes fatalities by these mechanisms, we studied 24 cases of sudden, apparently natural deaths as a result of coronary arteriosclerosis (15 cases), hypertensive cardiovascular disease (4 cases), and intracranial hemorrhage (5 cases) associated with cocaine use. In 11 cases, cocaine was found in the blood (average concentration: 0.57 mg/L, range: 0.05 to 1.45 mg/L), whereas in the remainder, cocaine or its major metabolite was found in the urine or other tissues. In the majority of decedents, autopsy disclosed the existence of severe natural disease which could have been exacerbated by the administration of stimulant drugs, including cocaine. These data, and a review of the current medical literature, indicate that cocaine may precipitate the sudden death of an individual with undiagnosed cardiovascular disease. A contributory role of cocaine should be considered in any apparently natural death occurring in a population where cocaine abuse is prevalent. PMID- 3819673 TI - Maxillary suture obliteration: aging the human skeleton based on intact or fragmentary maxilla. AB - Obliteration of the four sutures of the bony palate is examined to determine its value as an age indicator. Thirty-six maxillae from a predominately white series representing both sexes and a wide variety of ages are studied. It is concluded that the amount of obliteration of these sutures is useful in estimating general biological age. PMID- 3819674 TI - Seat belts and human rights: an appraisal. AB - Mandatory seat belt legislation has been passed in 15 states. Accompanying this action has been a deluge of information concerning the lives saved and the injuries prevented by the wearing of seat belts by the front seat passengers in automobiles. This study presents data relating to the injuries and deaths attributable to their usage. There is virtually no major area of the adult body that has escaped such involvement. Mechanisms by which seat belt injury is effected are described in relation to the restraint systems currently available in the United States and abroad. PMID- 3819675 TI - Injury patterns in motor vehicle fatalities. AB - A retrospective pilot study of motor vehicle incident fatalities was conducted to determine what relationships exist between injuries received by deceased drivers, passengers, and a control population of pedestrians, and some of the environmental factors existing at the time of the incident. A number of correlations were established between the types and locations of injuries received, seat belt use, position of the injured party, and so forth. A study of this type, if performed on a large enough population, could lead to predictive models for the determination of position of the victims within a motor vehicle at the time of a fatal crash, based on a unique clustering of injuries. PMID- 3819676 TI - Identification of skulls by video superimposition. AB - A method of matching skulls with photographic portraits or impressions of the face in clay by video superimposition is described. Two different practical cases are presented. The first one deals with the identification of a skull of a six year-old girl, the second with the identification of the skull of the famous Swiss Pedagogue Johann Heinrich Pestalozzi, who died about 160 years ago. The advantages and versatility of this method are shown; also the setup of the equipment and the working technique. PMID- 3819677 TI - Suicide far from home: the concept of transjurisdictional suicide. AB - A review of a series of eleven persons who committed suicide in a city long distances from home is presented, and the concept of transjurisdictional suicide is introduced. Those eleven cases suggest a high likelihood that the victim will be found in a hotel or motel bed by a hotel/motel employee within a day of check in; the victim will be a white male who drove to the city and who lived in a hometown closely associated with an urban center which is within a day's drive and on an interstate route connecting the hometown to the city selected; the victim will be older than twenty-one years, married or never married but not divorced or widowed, and will not have been born in the state where death occurred; a suicide message will be found, and a specific reason for selecting a given city will not be apparent. PMID- 3819679 TI - The relationship of court clinics to correctional mental health services: opportunities for cooperation and potential sources of conflict. PMID- 3819678 TI - Quantitative determination of cocaine and heroin by Fourier transform infrared spectrophotometry. AB - Cocaine hydrochloride salt (HCl) and heroin HCl were determined quantitatively by choosing a carbonyl absorption peak as the analytical peak and measuring absorbance versus concentration in standard KBr pellets. The effect of various additives and diluents such as starch, sugars, mannitol, caffeine, and procaine was also studied. Methods were devised to correct for interference contributions based on spectral subtraction of the interfering component or subtraction of the interfering spectral contribution based on absorbance ratios with a noninterfering spectral peak. In mixtures containing both the free base and the hydrochloride salt, the most satisfactory method for determining the concentration was by area integration of the two carbonyl peaks. PMID- 3819680 TI - Policy implications of private sector involvement in correctional services and programs. AB - The movement toward private sector involvement in our correctional services and programs is growing. Before our focus is turned completely to privatization of these services, it would be prudent to analyze the "policy impact of such change. It is evident that the diverse and incompatible policies guiding the government approach to corrections and the absence of any rational planning to answer public interest goals is costly. Moreover, despite the increasing complexity of problems now confronting public authorities, little change has been made in their approach to resolving them. However, is it realistic to assume that the profit/loss barometer of the private sector can be applied in an area of social problems that are so pluralistic and ill defined? What of the many areas of potential legal concern, that is, vicarious litigation, First Amendment right of prisoners, and so forth? These are all areas that need to be researched so that any judgements or decisions made will be sound. PMID- 3819681 TI - Models of mental health service delivery to correctional institutions. AB - The mentally disordered offender falls into the "no man's land" between prison and mental health systems. A number of reasons are given to explain why mental health service to this special group is in crisis again, and to lay the base for understanding the advantages and disadvantages of five different models of service delivery. The authors conclude by favoring small psychiatric units attached to major prisons. PMID- 3819682 TI - Mental health and corrections: towards a working partnership. AB - This paper describes the development of mental health services to the courts and correction facilities in the City of New York. The origins, structure, and functions of the interagency New York City Task Force on Prison Mental Health Services are explained. The Task Force's role in the development, promulgation, and implementation of the Minimum Standards for Mental Health Services in New York City Correctional Facilities are outlined. These standards, enacted by the New York City Board of Correction, are described and discussed. PMID- 3819683 TI - Suicide disguised as murder: a dimension of Munchausen syndrome. AB - This case study reports on a suicide made to look like murder. The case highlights the issue of false claims of criminal victimization and suggests the need for a reexamination of the dynamics of factitious allegations of criminal victimization. Factitious complaints of mental or physical illness are typically self-reported to psychiatric or medical authorities. This paper illustrates a different kind of phenomenon: one in which an injury or disorder is brought to medical attention by way of the police, who report the death or injury as arising from criminal victimization. PMID- 3819684 TI - An unusual pattern of gunshot injury linking two homicides to the same assailant. AB - This case report describes an unusual pattern of gunshot firing that proved useful in convicting one assailant of two murders. The assailant fired into the first victim, successively through the same entrance hole at contact range. This technique of firing twice through the same hole was also demonstrable on his second victim in the bare skull of the decomposed body. This unusual pattern noted in two homicides found two weeks apart, in concert with other circumstantial evidence, led to the successful conviction of the man for both murders. PMID- 3819685 TI - Computerized axial tomography as an aid in bite mark analysis: a case report. AB - A case is presented to demonstrate the use of computerized axial tomography (CAT) to develop precise registration of incisal edges for comparison to bite marks. Emphasis is drawn to the availability of CAT Scanning equipment and the importance of understanding its use as an adjunct or alternative to already accepted methods of incisal registration. PMID- 3819686 TI - Medicolegal aspects of necrotizing fasciitis of the neck. AB - Necrotizing fasciitis of the neck (NFN) is a relatively rare, fulminating infectious process of the cervicofacial tissues which may cause sudden and unexpected death. Although often the result of a dental infection, injuries of the soft tissues of the neck may also initiate rampant cellulitis, and recognition of the underlying etiology of such cases is necessary to determine properly the manner of death. Five cases of NFN are presented with a review of the causative factors and usual bacteriology, and specific factors of medicolegal interest are addressed. PMID- 3819687 TI - Use of scanning electron microscopy and energy dispersive X-ray analysis (SEM EDXA) in identification of foreign material on bullets. AB - The authors report two cases in which examination of foreign material embedded in or adherent to bullets provided critical information in the reconstruction of a crime scene. Analysis of small particles by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA) can be accomplished without destruction or injury of the particles. In one case, the detection and identification of mineral fragments embedded near the nose of a bullet provided conclusive evidence that the bullet had ricocheted from a fireplace before striking the victim. In the second case, analysis of particles from two bullets identified them as them as bone fragments, thus proving which shots fired from a police officer's gun had killed a suspected burglar. SEM-EDXA has not been widely used to identify such material on bullets, but should be considered a potentially powerful tool in forensic science. PMID- 3819688 TI - In vitro accuracy and precision studies comparing direct and delayed analysis of the ethanol content of vapor. AB - In vitro accuracy and precision studies were conducted using silica gel, magnesium perchlorate, and indium encapsulation breath collection tubes in conjunction with three infrared breath ethanol analyzers (BAC Verifier, Intoxilyzer 5000, and Intoximeter 3000), the Breathalyzer 900A, and the GC Mark IV. Statistical analyses revealed good accuracy and precision and correlation between direct and delayed vapor ethanol analyses for each combination of instruments and collection devices (range = 0.000 to 0.250 g/210 L, N = 42/instrument, r greater than 0.99). Delayed vapor ethanol analysis utilizing each instrument and collection device combination appears to predict satisfactorily original vapor ethanol concentrations. PMID- 3819689 TI - Evaluation of the Abbott TDx-radiative energy attenuation (REA) ethanol assay in a study of 1105 forensic whole blood specimens. AB - In a preliminary study to determine the applicability of the Abbott radiative energy attenuation (REA) method for the quantification of ethanol in whole blood specimens it was concluded that a larger number of samples was required to evaluate the method, particularly for use in forensic toxicology applications. In this study, 573 blood specimens from suspected driving while intoxicated individuals (DWI blood) and 532 postmortem blood specimens (PM blood) were analyzed by the REA method and a headspace gas chromatographic method (GC) currently used in this laboratory. "Negative" specimens (less than 10 mg/dL by GC) and "positive" specimens (greater than or equal to 10 mg/dL by GC) in each category were analyzed. Linear regression analysis comparing the REA values with the GC values was performed for each type of blood specimen. The equation obtained for DWI blood specimens was REA = 0.943 GC + 1.54; the equation for PM blood specimens was REA = 0.980 GC + 2.76. The correlation coefficient for each group was greater than 0.99. The data suggested that a limit of detection of 10 mg/dL could be applied for DWI blood specimens, while 20 mg/dL would be recommended as the limit of detection for PM blood specimens. PMID- 3819690 TI - Automated gunshot residue particle search and characterization. AB - The main disadvantage to gunshot residue (GSR) particle analysis utilizing scanning electron microscope/energy dispersive X-ray (SEM/EDX) instrumentation has been the excessive operator time required for search and identification. This study uses an automated particle search and characterization program for unattended GSR search and identification. This system allows for automatic matrix search, particle sizing, chemical typing, and spectral aquisition with subsequent storage of data to disk for later operator review and verification. This work describes various aspects of the program, determines appropriate parameters adequate for both unique and characteristic GSR particle identification, and evaluates the reliability of data obtained. Samples are collected via the tape lift method from test-firings of .38, .32, .25, and .22 caliber handguns at time after firing intervals of 0 to 6 h. Unique GSR particles are consistently and correctly identified by this method on tape lift samples taken up to 4 h after firing. False positive results of unique GSR particles are not encountered on control handblank samples. This technique appears to provide the forensic science community with an operator-free method of reliable GSR particle search and an improved analyst-time-per-case ratio. PMID- 3819691 TI - Malpractice--a defendant's perspective. PMID- 3819692 TI - Osteoporosis screening: review of experience at a local center. PMID- 3819693 TI - Continuing medical education--a professional responsibility in the public interest. PMID- 3819694 TI - Morphological and biochemical properties of four members of a novel group of reoviruses isolated from aquatic animals. AB - The morphological, biochemical and growth characteristics of four members of the Reoviridae, three from the fish hosts, golden shiner (Notemigonus crysoleucas), chum salmon (Oncorhynchus keta) and channel catfish (Ictalurus punctatus) and one from American oyster (Crassostrea virginica), were compared. Electron microscopy of negatively stained virions revealed icosahedral particles approximately 75 nm in diameter composed of a double capsid. Complete particles had buoyant densities in CsCl of 1.34 to 1.36 g/ml. The viruses replicated well in several fish cell lines, forming plaque-like syncytia in monolayer cultures. Each virus could be distinguished by the range of cell lines supporting its growth. Polyacrylamide gel electrophoresis showed that the genome of each virus was composed of 11 segments of dsRNA distributed among three size classes. There were three large, three medium and five small segments in each genome and each isolate had a unique electropherotype. The segments ranged from 2.5 X 10(6) to 0.31 X 10(6) mol. wt. with a total genome of approximately 15 X 10(6) mol. wt. Analysis by SDS-PAGE revealed that each virus had five major structural proteins. There were two large polypeptides of approximately 135,000 and 125,000 mol. wt., one medium size polypeptide of 70,000 mol. wt. and two small polypeptides of 45,000 and 34,000 mol. wt. Of the major structural proteins, those of approximately 70,000 and 34,000 mol. wt. were consistently present in the highest concentrations. Minor virion proteins were detected but were not characterized. These four viruses, isolated from aquatic animals, were unlike viruses of the six established genera of the Reoviridae. PMID- 3819695 TI - Mechanism of protection during the early phase of a generalized viral infection. II. Contribution of polymorphonuclear leukocytes to protection against intravenous infection with influenza virus. AB - The contribution of phagocytes to the early protection of mice inoculated intravenously with influenza virus was investigated in phagocyte-depleted mice. Following the inoculation of a sublethal dose of influenza virus, virus titres in the liver and lung of both untreated and carrageenan-treated mice were reduced rapidly by day 1 and decreased slowly to reach an undetectable level by day 7. The titres in gamma-irradiated mice decreased transiently by day 1 and increased progressively thereafter to kill all of the hosts by day 8. The clearance of virus from blood at the early stage of infection was retarded by gamma irradiation but not by carrageenan treatment. In addition, increase in virus titres in the liver and lung in the early stage of the infection was prevented by adoptive transfer with syngeneic polymorphonuclear leukocytes into gamma irradiated mice. No significant rise of neutralizing antibody was detectable by day 3 after the inoculation, in any of the three groups of mice. These observations imply that gamma-sensitive and carrageenan-resistant polymorphonuclear leukocytes play a protective role at the early stage in the infection, whereas fixed macrophages or natural killer cells, both of which are carrageenan-sensitive and gamma-resistant, scarcely participate in the early phase. PMID- 3819696 TI - Protective mechanisms against pulmonary infection with influenza virus. I. Relative contribution of polymorphonuclear leukocytes and of alveolar macrophages to protection during the early phase of intranasal infection. AB - The relative contribution of polymorphonuclear leukocytes and macrophages in the early protection against intranasal infection of mice with influenza virus was investigated. Virus multiplication in the lung in the early phase of infection with less than 1.5 X 10(3) plaque-forming units was enhanced by X-ray irradiation. The intranasal administration of carrageenan did not influence the titre of virus. However, when mice were infected with 1.5 X 10(4) plaque-forming units, the virus titre was elevated by intranasal administration of carrageenan as well as by X-ray irradiation, but not by intraperitoneal administration of carrageenan. The intranasal administration of carrageenan not only inhibited the phagocytic activity of alveolar macrophages but also enhanced susceptibility to the virus. On the other hand, polymorphonuclear leukocytes were capable of phagocytosing the virus in vitro and were non-permissive for virus infection. Neutralizing antibody and interferon were not detectable in the early stage of the infection. These results suggested that polymorphonuclear leukocytes (X-ray sensitive, carrageenan-resistant) were the cells primarily responsible for early protection in influenza virus infection and that after infection with a high dose of the virus alveolar macrophages (X-ray-resistant, carrageenan-sensitive) also played a protective role in the early phase. PMID- 3819697 TI - Demonstration of an immunosuppressive action of detergent-disrupted influenza virus on the antibody response to inactivated whole virus vaccine. AB - In a series of experiments performed in hamsters and mice, administration of mixtures of detergent-disrupted (SV) influenza A X49 (H3N2) virus and inactivated X49 whole virus (WV) vaccine induced lower serum antibody titres than equivalent or lower doses of WV vaccine alone. This reduction in antibody titre was also observed using influenza A (H1N1) and influenza B (B/Hong Kong/8/73) SV and WV vaccine preparations. The results suggested that SV preparations can suppress the serum antibody response to WV vaccine. A suppressive effect of SV influenza virus on WV vaccine was also observed in an in vitro antibody-forming system, using primed mouse spleen cells. In this system, SV induced markedly lower IgG and IgM antibody responses than WV vaccine, and mixtures of SV with WV reproducibly resulted in lowered antibody responses compared to those elicited by WV alone. Possible reasons for these findings are discussed in the light of the known low immunogenicity observed for split and subunit influenza virus vaccine preparations in animals and in unprimed human populations. PMID- 3819698 TI - Role of prostaglandins and non-steroid anti-inflammatory drugs in the pathogenicity of vaccinia virus. AB - The effect of prostaglandins (PGs) of the A series (A1 and dimethyl PGA2), E1, D2, F2 alpha and PGI2 (prostacyclin) and of inhibitors of PG synthesis (aspirin and indomethacin) on the pathogenicity of vaccinia virus was studied in BALB/c mice. PGs of the A series, D2 and F2 alpha conferred little or no protection to mice against the lethal effects of vaccinia virus. Mice treated with PGE1 showed a dramatic increase in mortality after viral infection. However, when mice were treated with PGI2, their survival was greatly enhanced. Mice treated with aspirin and indomethacin showed a marked increase in mortality. Increased mortality correlated with higher virus yields in target tissues (spleen) and with inhibition of antibody response, whereas the increase in survival correlated with lower virus yields and with normal antibody responses. The significance of our findings is that PGI2 can block the outcome of the disease caused by vaccinia virus whereas other PGs and their inhibitors not only worsen the disease, but may activate and enhance viral infections through immune suppression. PMID- 3819700 TI - Protection of mice against dengue 2 virus encephalitis by immunization with the dengue 2 virus non-structural glycoprotein NS1. AB - Immunization of mice with the dengue 2 virus (DEN 2)-specified non-structural protein NS1 provided significant protection against intracerebral challenge with the virus in the absence of detectable neutralizing or other anti-virion antibody. NS1, purified from lysates of infected Vero cells by immunoaffinity chromatography, expressed an antigenic site(s) common to each of the four DEN serotypes, and hyperimmunization of rabbits with NS1 stimulated production of complement-fixing (CF) antibody with broad DEN serotype specificity. However, cross-protection was not observed: mice immunized with DEN 2 NS1 developed little or no heterologous CF antibody and were not protected against challenge with neurovirulent DEN 1. Induction of a protective immune response by NS1 suggests that it be considered for incorporation into possible synthetic or recombinant DNA DEN vaccines. PMID- 3819699 TI - Genetic relatedness of corriparta serogroup viruses. AB - Eight viruses of the Corriparta serogroup (Reoviridae: Orbivirus) that were known to be heterogeneous on the basis of serology and polyacrylamide gel electrophoresis were examined by reciprocal RNA-RNA blot hybridization of genomic RNA. Conserved and variant genes were identified by the degree of hybridization between cognate genes of different isolates. The eight viruses were divided into three subsets on the basis of the number of shared genes. Four of the viruses, isolated in Australia, formed one subset of related isolates and shared five conserved genes. Another isolate, Acado, was variant in all 10 genes and was considered to be a second subset. The remaining three isolates formed a third subset and shared four conserved genes. Genes 1, 3 and 10 were the most variable among the Corriparta serogroup isolates. Subsets of isolates within a serogroup which are highly related in the majority of the 10 genes and less related to serogroup viruses in another subset have not been reported previously. The phylogenetic relationship of Corriparta serogroup members suggested by the blot hybridization data is not apparent in the current taxonomic classification of these viruses which is based primarily upon serological data. The hybridization data on the Corriparta serogroup viruses are discussed and contrasted with other Orbivirus serogroups which have been examined similarly. PMID- 3819701 TI - Relationship between the replication of hepatitis B virus and the localization of virus nucleocapsid antigen (HBcAg) in hepatocytes. AB - According to the localization of hepatitis B virus (HBV) core antigen (HBcAg), detected by the avidin-biotin complex method, infected hepatocytes were classified into three types, i.e. those having nuclear (type I), nuclear and cytoplasmic (type II) or only cytoplasmic (type III) antigen. HBcAg-positive hepatocytes of all specimens (three) from non-specific reactive hepatitis and of most (five of seven) from chronic persistent hepatitis (CPH) patients were only type I; the other two CPH samples and all (seven) chronic active hepatitis samples were composed of a mixture of types I, II and III. Linear correlations between the frequency of type I, as well as that of of all types (I, II and III) of the HBcAg-positive hepatocytes, and the amount of HBV DNA in serum were found. The relative HBV production of HBcAg-positive hepatocytes (serum HBV DNA amount/frequency of HBcAg-positive cells) was 0.11 in type I and 0.07 in all hepatocytes including types I, II and III. HBV core particles and complete HBV particles were found in type I hepatocytes. On the other hand, these particles were not found in a predominantly type III liver specimen. These results suggest that type I hepatocytes are more involved in the propagation of HBV than types II and III. PMID- 3819702 TI - Structural and functional homology of parvovirus and papovavirus polypeptides. AB - We have compared the sequences of the putative polypeptides of the human pathogenic B19 parvovirus with protein sequences in the National Bethesda Research Foundation Library, and have discovered a significant homology between a B19 parvovirus non-structural (NS) protein and the T antigens of polyomaviruses and simian virus 40 (SV40) and the putative E1 proteins of papillomaviruses. The region of highest homology with the papovavirus proteins corresponds to the region that is most highly conserved in the NS1 proteins of several other parvoviruses. Studies with the T antigen of both polyomaviruses and SV40 have implicated this region as having an ATPase activity and nucleotide-binding function. PMID- 3819703 TI - Growth of 293 cells in suspension culture. AB - A subline of 293 cells able to grow in suspension culture has been developed by passage of 293 cells through nude mice. This new line, designated 293N3S, grows with a doubling time of approximately 30 h, continues to express adenovirus 5 early region 1 (E1) antigens, and remains permissive for adenovirus 5 host range mutants defective in E1 functions. PMID- 3819704 TI - Dynamics and impact of perinatal transmission of hepatitis B virus in North India. AB - The magnitude and significance of perinatal transmission of hepatitis B virus (HBV) were assessed in infants of 8,575 women, of whom 3.7% were seropositive for HBV surface antigen (HBsAg). The e antigen of HBV (HBeAg) was found in 7.8% of these carriers, the antibody to HBeAg (anti-HBe) was found in 30.1% of them, and HBsAg alone was found in 62.1% of them. The estimated incidence of HBsAg positivity by 6 months of age in infants of carrier women was significantly (P less than .001) higher than in controls (18.6% vs 3.0%). Transmission was most frequent (87.5%) if the carrier mother was HBeAg positive and was much less so if she was positive for anti-HBe (17.5%) or for HBsAg alone (9.6%). Toward the end of infancy incidence of HBsAg positivity among offspring of carriers and among controls was not different. Most infants positive for HBsAg and HBeAg continued with the infection beyond 6 months of age. It is estimated that about one-third of the adult asymptomatic HBV carriers in India evolve directly from perinatal infection, while the majority become infected during childhood or early adulthood. PMID- 3819705 TI - Alphabetical trilemma. PMID- 3819706 TI - Tumoral calcinosis and hyperparathyroidism. PMID- 3819707 TI - Consumer price differentials between containers and brand products of oral antibiotics in Louisiana. PMID- 3819708 TI - Anxiety and the span of apprehension. AB - Previous research using the visual span of apprehension procedure has interpreted the performance deficits commonly demonstrated by schizophrenic subjects as indicative of a core, central processing deficit. Gjerde recently suggested that the attentional problems of schizophrenic subjects may be associated with excessive levels of arousal. The present study was designed to explore the relationship between arousal level in normal subjects and their performance on the span of apprehension task. Consistent with Gjerde's proposals, the normal subjects who expressed high levels of trait anxiety were significantly and selectively impaired on the more complex conditions of the task, a performance pattern similar to that exhibited by schizophrenic subjects in previous research. These data illustrate the influence that arousal level may exert on tasks purporting to reflect attentional abnormalities among schizophrenic subjects. PMID- 3819709 TI - The value of DSM-III for psychotherapy. A feasibility study. AB - Establishing the usefulness of DSM-III for psychotherapy will probably require numerous studies. This paper reports a feasibility study for one kind of investigation: the use of clinical records to survey the DSM-III diagnoses and therapy outcome of 30 patients who had outpatient psychotherapy. We were interested in what range of DSM-III diagnoses was represented by patients in outpatient therapy; whether judgments of diagnosis and outcome could be made reliably from clinical records; how well patients in the therapy fit DSM-III diagnoses; if patients did not fit well, why not? We found that an exploration of the relationship between DSM-III diagnosis and outcome from clinical records is feasible; a relatively wide range (13) of DSM-III diagnoses was represented by the 30 patients; 80% of the patients fit well or moderately well into a DSM-III diagnosis; most of the 20% who did not fit well represent the class of problems of living, which does not mean, however, that their problems were minor or unimportant; in some cases the diagnosis--even when it fit the patient well--did not express the essence of the problem for which he or she was to be treated; there was a small correlation (.19) between the patient's rating on axis V and therapy outcome. The findings are discussed in terms of the pro and con arguments that have been made about DSM-III. PMID- 3819710 TI - Expressed emotion and schizophrenic outcome among Mexican-American families. AB - This study has demonstrated that among low-income, relatively unacculturated Mexican-American households, a high level of expressed emotion on the part of key relatives significantly increases the risk of relapse for remitted schizophrenics who return home to live with their families after hospital discharge. This cross cultural replication of earlier research findings in London and southern California suggests that critical, hostile, or emotionally overinvolved attitudes and behaviors may be general major stressors that adversely influence the fragile adaptation of schizophrenic individuals in diverse cultural settings. The finding of a lower prevalence of high levels of expressed emotion among Mexican-American compared to Anglo-American and British households lends support to the hypothesis that intrafamilial behaviors may account for different schizophrenic outcomes in different cultures. PMID- 3819711 TI - Outcome predictors in acute schizophrenia. Prospective significance of background and clinical dimensions. AB - In a prospective 2-year follow-up of 37 young acute schizophrenics, we examined the predictive significance and relative contribution of historical, genealogical, course, and clinical dimensions. Patients were evaluated multidimensionally at index admission and after 21 to 33 months, at which time 19 cooperated in follow-up involving clinical, functional, psychometric, and objective outcome measures. Multiple regression analysis found that combinations of 3 to 4 index variables significantly predicted 13 of 14 outcome measures, yielding multiple R values between .63 and .93 (X = .78). In total, a set of eight parameters contributed in explaining the outcome variance. The strongest overall predictor of favorable outcome was baseline negative syndrome. Other significant predictors were good premorbid school functioning, favorable prior disposition, sudden onset of illness, nonparanoid subdiagnosis, family history of alcoholism, psychomotor retardation, and depression. Accordingly, a patient's premorbid adjustment, course of illness, and presenting clinical profile provided nonoverlapping sources of outcome prediction. Of these three dimensions, it was proposed that the prognostic significance of the clinical profile may be phase specific, carrying different implications when assessed in the acute vs. chronic stage of illness. PMID- 3819712 TI - Pathological display of affect in patients with depression and right frontal brain damage. An alternative mechanism. AB - Two patients are reported with the acute onset of pathological crying following right inferior frontal brain damage. Both had severe endogenous depression and neither had pseudobulbar palsy. These and other cases argue that two organic brain diseases--one structural and the other "physiopharmacological"--may interact to produce pathological display of affect that cannot be accounted for by traditional neurological explanations. A pharmacological mechanism for the rapid amelioration of pathological affect by tricyclic medications and its possible relationship to the newly discovered descending motor systems of the brain that use norepinephrine and serotonin as neurotransmitters is offered. These cases also suggest that pathological affect is a valuable clinical indicator of an underlying major depression in some brain-injured patients. PMID- 3819713 TI - Affective disorder in the neurological patient. AB - An index sample of neurological patients diagnosed as clinically depressed (83) was compared with a "major depression" sample (43) and a "neurological sample" (44) who were free from psychiatric disorder. There was no difference in global Hamilton Scores between the index and the major depression sample. The latter, however, more often exhibited family and personal history of psychiatric illness, early awakening, guilt, suicidal ideas, shorter index episodes of depression, and better response to treatment. The three samples were followed up for a period of up to 5 years. The index sample did worse on follow-up than did the depressed and the neurological samples. The disease profiles of both the index and neurological samples were similar, but there were more cases of epilepsy in the former. The index sample responded badly to conventional antidepressant treatment. It is concluded that the presence of chronic affective disorder in the neurological patient has an adverse effect on prognosis. PMID- 3819714 TI - Soft sign neurological abnormalities in borderline personality disorder and normal control subjects. AB - Patients with borderline personality disorder were found to have a significantly greater number of soft sign neurological abnormalities when compared with a group of normal control subjects. Sensitivity analysis revealed that the presence of two or more soft signs differentiated the two groups statistically. The authors speculate that nonfocal soft sign neurological abnormalities may reflect underlying central nervous system dysfunction, which may in turn be associated with the development of borderline personality disorders. PMID- 3819715 TI - Hyperreligiosity in temporal lobe epilepsy: redefining the relationship. AB - Seventy-six subjects with the primary diagnosis of complex partial seizures with a unilateral temporal lobe focus were examined for the presence of hyperreligiosity. Fifty-one subjects had a left temporal lobe seizure focus and 25 had a right temporal lobe seizure focus. In addition to the temporal lobe epilepsy (TLE) groups, two reference groups were also examined. The first consisted of 31 subjects with primary generalized seizures. The second control group consisted of 27 subjects with documented pseudoseizures and no objective evidence of recurrent epileptic seizures. In all cases, the documentation of seizures or pseudoseizures as well as the localization of the seizure focus was accomplished through simultaneous videotaped recording of the 16-channel scalp EEG tracing and the concurrent overt behavior during the ictal phase. The results of this study fail to support the hypothesis that individuals with TLE are characteristically hyperreligious during the interictal state. There were no significant group differences between the left vs. the right TLE groups, nor were there any significant group differences between the two TLE groups vs. the two comparison groups. PMID- 3819716 TI - Alleviation of severe emotional symptoms by carbidopa-levodopa, MSD, in a Parkinson's patient: a personal report. AB - This is a personal account of the rapid disappearance of long-term severe emotional symptomatology following the diagnosis of parkinsonism and the beginning of Sinemet medication. It raises two questions. First, can mental health practitioners be sensitized to earlier detection and diagnosis of parkinsonism by reviewing the specific patterns of emotional disturbances in older patients? Second, is there a presymptomatic psychiatric syndrome in parkinsonism that is more akin to a global emotional instability than to a depressive state? PMID- 3819717 TI - A spectroscopic study of nickel(II)-bovine serum albumin binding and reactivity. AB - The pH dependence of the uv/visible and CD spectra of the 1:1 Ni(BSA) complex in aqueous solutions is interpreted in terms of a major square-planar form and an octahedral form. At pH 7.4, the two forms, respectively, account for ca. 70% and 30% of the total Ni(II). The two forms are in rapid equilibrium with each other and so both probably involve Ni(II) binding to the N-terminal region of the albumin protein. The kinetics of the equilibrium reaction of Ni(BSA) with His were studied at 37 degrees C in buffered media of pH 7.4 and 9.3. In line with predictions, the two Ni(BSA) forms show markedly different reactivities, with the square-planar form being the more thermodynamically stable and the less reactive. The octahedral form reacts with an observed zero-order dependence on His concentration while the square-planar form shows both zero-order and first-order dependence, the latter being the more dominant. The significance of the slow equilibrium rate at pH 7.4 to the possible physiological role of Ni-albumin in blood serum is discussed. PMID- 3819718 TI - Evidence for two distinct forms of native glutamic acid decarboxylase in rat brain soluble extract: an immunoblotting study. AB - Immunoblots of the soluble proteins from a rat brain high-speed supernatant dissociated under reducing conditions showed two monomers (molecular weights, 59,000 and 62,000 +/- 2,000) immunolabeled by a glutamic acid decarboxylase (GAD) antiserum. In this extract, a GAD monoclonal antibody trapped the same two monomers, thus confirming that they are both constitutive subunits of GAD. Without treatment under reducing conditions, two additional bands were stained by immunoblotting. Their molecular weights were estimated to be 115,000 and 122,000 +/- 5,000. These results demonstrate the presence, in rat brain soluble extract, of two distinct forms of native GAD. They further support our previous hypothesis that each form is composed by the homodimeric association of each constitutive subunit through disulfide bridges. PMID- 3819719 TI - Phosphatidylinositol phosphodiesterase (phospholipase C) activity in the pineal gland: characterization and photoneural regulation. AB - Phosphatidylinositol phosphodiesterase (PL-C) appears to be a key element in the adrenergic regulation of pineal cyclic AMP levels. In the present study, the rat pineal enzyme was characterized using exogenous [3H]phosphatidylinositol (0.5 mM) as substrate. Half the enzyme activity was found in the cytosolic fraction, but the highest specific concentration was associated with the membrane fraction. Two pH optima (5.5 and 7.5) of enzyme activity were observed for the membrane fraction but only one in the cytosol fraction (pH 5.5). Enzyme activity in both fractions was Ca2+ dependent. In the case of the membrane protein in pH 7.5, the enzyme activity was sensitive to changes in Ca2+ in the 10-100 nM range. Addition of an equimolar concentration of phosphatidylinositol 4-phosphate nearly completely inhibited the hydrolysis of [3H]phosphatidylinositol; other phospholipids (1.0 mM) were less potent. This may reflect our present finding that [3H]phosphatidylinositol 4-phosphate is a better substrate than [3H]phosphatidylinositol for the enzyme. Stimulus deprivation (2 weeks of constant light or superior cervical ganglionectomy) reduced the cytosolic activity by 30% and had no effect on the membrane-associated enzyme. PMID- 3819720 TI - Triiodothyronine-induced shortening of chromatin repeat length in neurons cultured in a chemically defined medium. AB - At the time of terminal differentiation, mammalian cortical neurons undergo a dramatic change in the structural organization of their chromatin: the nucleosomal repeat length shortens from approximately 200 base pairs in fetuses to a value of 165 base pairs after birth. These events occur several days after the end of neuronal proliferation. Previously, we reported that rat cortical neurons cultured in a very selective synthetic medium were not yet programmed to these events at the end of mitotic cycles. Herein, we report that addition of triiodothyronine to neuronal cultures induces a shortening of the chromatin repeat length comparable to the natural one. PMID- 3819721 TI - Position of the peptide linkage in glutamyl-taurine from calf brain synaptic vesicles. AB - To elucidate the position of the peptide bond in glutamyl-taurine this dipeptide was extracted from calf brain synaptic vesicles and subjected to paper electrophoresis. It was analyzed further in an automatic amino acid analyzer prior and subsequent to acid hydrolysis. Both alpha- and gamma-forms were found to be present in approximately equal amounts. PMID- 3819722 TI - Subcellular location and neuronal release of diazepam binding inhibitor. AB - Diazepam binding inhibitor (DBI), a peptide located in CNS neurons, blocks the binding of benzodiazepines and beta-carbolines to the allosteric modulatory sites of gamma-aminobutyric acid (GABAA) receptors. Subcellular fractionation studies of rat brain indicate that DBI is compartmentalized. DBI-like immunoreactivity is highly enriched in synaptosomes obtained by differential centrifugation in isotonic sucrose followed by a Percoll gradient. In synaptosomal lysate, DBI-like immunoreactivity is primarily associated with synaptic vesicles partially purified by differential centrifugation and continuous sucrose gradient. Depolarization induced by high K+ levels (50 mM) or veratridine (50 microM) released DBI stored in neurons of superfused slices of hypothalamus, hippocampus, striatum, and cerebral cortex. The high K+ level-induced release is Ca2+ dependent, and the release induced by veratridine is blocked by 1.7 microM tetrodotoxin. Depolarization released GABA and Met5-enkephalin-Arg6-Phe7 together with DBI. DBI is also released by veratridine depolarization, in a tetrodotoxin sensitive fashion, from primary cultures of cerebral cortical neurons, but not from cortical astrocytes. Depolarization fails to release DBI from slices of liver and other peripheral organs. These data support the view that DBI may be released as a putative neuromodulatory substance from rat brain neurons. PMID- 3819723 TI - Synaptosomal uptake and release of dopamine in rat striatum after hypoxia. AB - Hypoxia induces alterations of central monoaminergic transmission and of behavior. We studied the effect of hypoxia on adult and newborn rats to obtain more information about long-lasting changes of dopamine (DA) transmission caused by neonatal hypoxia. One single exposure of adult rats to hypoxia leads to short term alterations of DA uptake: decreased affinity of the uptake carrier to DA (Km, 269.5% versus control) and a sharp increase of Vmax up to 301.4% resulting in an increase of total uptake of DA into the striatum synaptosomes. The K+ evoked DA release decreased to 69.5%. After 1 week of recovery all parameters are normalized. Chronic postnatal hypoxia (postnatal day 2-11) caused long-lasting changes of DA release and uptake opposite to those observed in adult rats. Three months after hypoxia, the K+-stimulated DA release was enhanced (132% of control), and the uptake was reduced due to decreased affinity of the uptake carrier system for the substrate (Km, 187% of control value). In conclusion, the alterations observed after chronic postnatal hypoxia reflect special adaptive processes that are related to the high plasticity of the immature neonatal brain and contribute to an increased DA function in the nigrostriatal system. PMID- 3819724 TI - Localization of phospholipid synthesis to Schwann cells and axons. AB - Quantitative electron microscopic autoradiography was used to detect and characterize endoneurial sites of lipid synthesis in mouse sciatic nerve. Six tritiated phospholipid precursors (choline, serine, methionine, inositol, glycerol, and ethanolamine) and a protein precursor (proline) were individually injected into exposed nerves and after 2 h the mice were perfused with buffered aldehyde. The labeled segments of nerve were prepared for autoradiography with procedures that selectively remove nonincorporated precursors and other aqueous metabolites, while preserving nerve lipids (and proteins). At both the light and electron microscope levels, the major site of phospholipid and protein synthesis was the crescent-shaped perinuclear cytoplasm of myelinating Schwann cells. Other internodal Schwann cell cytoplasm, including that in surface channels, Schmidt Lanterman incisures, and paranodal regions, was less well labeled than the perinuclear region. Newly formed proteins were selectively located in the Schwann cell nucleus. Lipid and protein formation was also detected in unmyelinated fiber bundles and in endoneurial and perineurial cells. Tritiated inositol was selectively incorporated into phospholipids in both myelinated axons and unmyelinated fibers. Like inositol, glycerol incorporation appeared particularly active in unmyelinated fibers. Quantitative autoradiographic analyses substantiated the following points: myelinating Schwann cells dominate phospholipid and protein synthesis, myelinated axons selectively incorporate tritiated inositol, phospholipid precursors label myelin sheaths and myelinated axons better than proline. PMID- 3819725 TI - Concomitant increases in the levels of choline and free fatty acids in rat brain: evidence supporting the seizure-induced hydrolysis of phosphatidylcholine. AB - The main objective of this study was to determine whether the excitotoxic cholinesterase inhibitor soman increases the catabolism of phospholipids in rat brain. Injections of soman (70 micrograms/kg, s.c.), at a dose that produced toxic effects, increased the levels of both free fatty acids (175-250% of control) and free choline (250% of control) in rat cerebrum 1 h after administration. All fatty acids contained in brain phosphatidylcholine were elevated significantly including palmitic (16:0), stearic (18:0), oleic (18:1), arachidonic (20:4), and docosahexaenoic (22:6) acids. The changes observed were consistent with those reported to occur following ischemia and the administration of other convulsants. Pretreatment of rats with the anticonvulsant diazepam (4 mg/kg, i.p.) prevented both the signs of soman toxicity and the soman-induced increase of choline and free fatty acids. Diazepam alone did not affect the levels of choline or free fatty acids, cholinesterase activity, or soman-induced cholinesterase inhibition, suggesting that soman toxicity involves a convulsant mediated increase in phosphatidylcholine catabolism. In addition, administration of the convulsant bicuculline, at a dose that produces seizures and increases the levels of free fatty acids in brain, significantly increased the levels of choline. Results suggest that excitotoxic events enhance the hydrolysis of phosphatidylcholine in brain as evidenced by a concomitant increase in the levels of choline and free fatty acids. PMID- 3819726 TI - Rapid release of [3H]dopamine from median eminence and striatal synaptosomes. AB - Release of preaccumulated, tritium-labeled dopamine ([3H]DA) from preparations of isolated nerve terminals (synaptosomes) of rat median eminence (ME) and corpus striatum (CS) was examined over short time intervals (1-20 s). In both preparations, basal efflux of [3H]DA was linear with time. Depolarization with high K+ resulted in an initial rapid release of [3H]DA which stabilized by 20 s, whereas veratridine elicited an increased rate of release over basal levels that was linear over the first 20 s. The calculated rate constants of release for both the initial phase of K+- and the veratridine-stimulated release were approximately threefold greater in CS than in ME synaptosomes. The major component of the high K+-induced release of [3H]DA from both synaptosome preparations increased as a graded function of [Ca2+]o. However, a smaller component, independent of external Ca2+, existed in both ME and CS synaptosomes. Increasing the [Mg2+] in the external solution resulted in a right shift of both the [K+]o and the [Ca2+]o dose-response curves, consistent with actions of Mg2+ on screening surface membrane charges and blocking voltage-dependent Ca2+ channels. In all studies, steady-state uptake of the [3H]DA was about twofold greater into CS than into ME synaptosomes. Moreover, the fraction of incorporated [3H]DA released by stimulation from the CS was much greater than that released from ME synaptosomes. These data are consistent with differences between these two types of dopaminergic terminals with respect to packaging and/or distribution of the accumulated neurotransmitter in intraneuronal pools, as well as marked differences in the apparent kinetics of DA release. PMID- 3819727 TI - [3H]dipyridamole binding to guinea pig brain membranes: possible heterogeneity of central adenosine uptake sites. AB - The binding of [3H]dipyridamole ([3H]DPR) to guinea pig brain membranes is described and compared to that of [3H]nitrobenzylthioinosine ([3H]NBI). The binding of [3H]DPR is saturable, reversible, and specific with pharmacologic evidence indicating that this ligand is binding to the adenosine uptake site. Compared to [3H]NBI the binding of [3H]DPR is of higher capacity (Bmax = 208 +/- 16 fmol/mg protein for [3H]NBI and 530 +/- 40 fmol/mg protein for [3H]DPR) and lower affinity (KD = 0.35 +/- 0.02 nM for [3H]NBI and 7.6 +/- 0.7 nM for [3H]DPR). The adenosine uptake inhibitors are the most potent inhibitors of binding (Ki of 10(-8)-10(-7) M) whereas adenosine receptor ligands such as cyclohexyladenosine, 2-chloroadenosine, and various methylxanthines are several orders of magnitude less potent (Ki 10(-5)-10(-2). The inhibition of [3H]DPR binding by NBI is biphasic, with only 40% of binding being susceptible to inhibition of NBI concentrations less than 10(-5) M. The tissue distribution of [3H]DPR binding parallels that of [3H]NBI although in most cases significantly more sites are observed with [3H]DPR. Calcium channel blocking agents such as nifedipine, nimodipine, and verapamil are also inhibitors of [3H]DPR binding with potencies in the micromolar range. The data are consistent with [3H]DPR being a useful additional ligand for the adenosine uptake site and provide evidence that multiple uptake binding sites exist of which only about 40% are NBI-sensitive. PMID- 3819728 TI - Ganglioside GM1 antibodies and B-cholera toxin bind specifically to embryonic chick dorsal root ganglion neurons but do not modulate neurite regeneration. AB - Polyclonal antibodies to ganglioside GM1 have been prepared and characterised by direct and competitive enzyme-linked immunoassay. An immunoglobulin fraction was prepared from a rabbit antisera showing high specificity and antibody titre for GM1 relative to the other major brain gangliosides. The anti-GM1 immunoglobulin fraction and B-cholera toxin specifically labelled neurons in primary cultures of embryonic chick dorsal root ganglia and there was a good correlation between the relative increase in binding of anti-GM1 immunoglobulin and B-cholera toxin following neuraminidase treatment of a variety of cell types. At antibody concentrations that show saturable binding to endogenous ganglioside in the neuronal membrane, the anti-GM1 immunoglobulin fraction did not interfere with the nerve growth factor (NGF)-mediated fibre outgrowth and neuronal survival as indexed by measurement of neurofilament protein levels. Similarly, at levels in excess of those shown to stimulate thymocyte proliferation, B-cholera toxin was also without effect. These data are not consistent with GM1 in the neuronal membrane functioning as a receptor molecule for NGF and/or other differentiation factors present in the tissue culture media. PMID- 3819729 TI - Effect of lithium on Schwann cell proliferation stimulated by axolemma- and myelin-enriched fractions. AB - Cultured Schwann cells stimulated with an axolemma- or myelin-enriched fraction incorporated 2.5 to three times as much [3H]thymidine when 10 mM lithium was added to the extracellular medium. The ability of lithium to enhance the mitogenic activity of either fraction was dose dependent. This result was not due to an increase in osmolarity, because addition of 10 mM NaCl had no effect on the amount of labeled thymidine accumulated by Schwann cells treated with either membrane fraction. In an earlier study, the effect of either membrane fraction could be potentiated with active phorbol esters. Lithium significantly enhanced the incorporation of [3H]thymidine into Schwann cells treated with a myelin enriched fraction and phorbol esters. In contrast, lithium slightly increased the amount of labeled thymidine incorporated into Schwann cells stimulated with an axolemma-enriched fraction and phorbol esters. The mitogenic activity of either membrane fraction was impaired when the calcium channel blockers Mn2+ and nifedipine were added. Addition of lithium stimulated an increase in the amount of [3H]thymidine accumulated by Schwann cells treated with either the axolemma- or myelin-enriched fraction in the presence of either Mn2+ or nifedipine. PMID- 3819730 TI - Effects of in vitro anoxia and low pH on acetylcholine release by rat brain synaptosomes. AB - Acetylcholine and choline release from rat brain synaptosomes have been measured using a chemiluminescent technique under a variety of conditions set up to mimic anoxic insult, including conditions of low pH (6.2) and the presence of lactate plus pyruvate as substrate. Lactate plus pyruvate as substrate consistently gave higher respiration rates than glucose alone, but with either substrate (glucose or lactate plus pyruvate) the omission of Ca2+ caused an increase in respiration whereas a low pH caused a decreased respiration. Acetylcholine release under control conditions (glucose, pH 7.4) was Ca2+-dependent, stimulated by high K+ concentrations, and decreased significantly during anoxia but recovered fully after a period of postanoxic oxygenation. Low pH (6.2) suppressed K+ stimulation of acetylcholine release, and after a period of anoxia at low pH the recovery of acetylcholine release was only partial. With lactate plus pyruvate as substrate, the effects of anoxia and/or low pH on acetylcholine release and its subsequent recovery were exacerbated. Choline release from synaptosomes, however, was not affected by anoxic/ionic conditions in the same way as acetylcholine release. At low pH (6.2) there was a marked reduction in choline release both under aerobic and anoxic conditions. These results suggest that acetylcholine release per se from the nerve is very sensitive to anoxic insult and that the low pH occurring during anoxia may be an important contributory factor. PMID- 3819731 TI - Phenylalanine transport across the blood-brain barrier as studied with the in situ brain perfusion technique. AB - Unidirectional L-phenylalanine transport into six brain regions of pentobarbital anesthetized rats was studied using the in situ brain perfusion technique. This technique allows both accurate measurements of cerebrovascular amino acid transport and complete control of perfusate amino acid composition. L Phenylalanine influx into the brain was sodium independent and could be described by a model with a saturable and a nonsaturable component. Best-fit values for the kinetic constants in the parietal cortex equaled 6.9 X 10(-4) mumol/s/g for Vmax, 0.011 mumol/ml for Km, and 1.8 X 10(-4) ml/s/g for KD during perfusion with fluid that did not contain competing amino acids. D-Phenylalanine competitively inhibited L-phenylalanine transport with a Ki approximately 10-fold greater than the Km for L-phenylalanine. There were no significant regional differences in Km, KD, or Ki, whereas Vmax was significantly greater in the cortical lobes than in the other brain regions. L-Phenylalanine influx during plasma perfusion was only 30% of that predicted in the absence of competing amino acids. Competitive inhibition increased the apparent Km during plasma perfusion by approximately 20 fold, to 0.21 mumol/ml. These data provide accurate new estimates of the kinetic constants that describe L-phenylalanine transport across the blood-brain barrier. In addition, they indicate that the cerebrovascular transfer site affinity (1/Km) for L-phenylalanine is three- to 12-fold greater than previously estimated in either awake or anesthetized animals. PMID- 3819732 TI - [Demonstration of carcinine synthetase, a new enzyme catalysing the metabolism of histamine in the central nervous system of Carcinus maenas]. AB - Carcinine biosynthesis was induced in vitro from its two components, beta-alanine and histamine. The reaction was catalyzed by muscle, heart, and CNS extracts from Carcinus maenas. The specific activity of the enzyme, carcinine synthetase, was 15 times higher in CNS than in other organs. Only CNS extracts induced biosynthesis of carcinine from histidine, and only in the presence of pyridoxal 5'-phosphate. Hence the seat of carcinine biosynthesis seems to be the CNS. It is highly probable that in the CNS, histidine is transformed into histamine, which is then catabolized into carcinine. The latter would then be transported and accumulated in the cardiac tissue. Thus histamine--the metabolism of which takes place totally within the CNS--would be implicated as a participant in the neuronal activity of Carcinus maenas. Carcinine synthetase is a soluble enzyme that requires the presence of ATP, beta-alanine, and histamine. Mg2+ and dithiothreitol are also essential for activity. Optimum pH is approximately 7.6. Carcinine synthetase differs from carnosine synthetase and gamma glutamylhistamine synthetase in that it does not catalyze synthesis of beta alanylhistidine or gamma-glutamylhistamine. PMID- 3819733 TI - Rankinidine, a new indole alkaloid from Gelsemium rankinii. AB - A new oxindole alkaloid, rankinidine (1), has been isolated from the MeOH extract of the stem of Gelsemium rankinii. Its structure was elucidated by comparison with an analog, humantenirine (3), which also occurred in this plant. PMID- 3819734 TI - Herbicidal effects of geldanamycin and nigericin, antibiotics from Streptomyces hygroscopicus. AB - Geldanamycin (2) and nigericin (1) (primarily the Na+ salt) are responsible for the phytotoxicity of a Streptomyces hygroscopicus strain found to be highly active in our screens for producers of herbicidal antibiotics. After extraction from the cells, the compounds were purified with column and thin layer layer chromatography on silica gel, bioassayed for inhibition of garden cress (Lepidium sativum L.) radicle elongation, and identified with ms, ir, nmr, and co chromatography with authentic standards. Both caused 50% reduction in garden cress radicle growth at concentrations of 1-2 ppm and nearly complete inhibitions at 3-4 ppm. Symptoms of toxicity differed markedly for the two compounds. Geldanamycin at high concentrations caused radicles to turn brown and disintegrate, whereas, nigericin did not cause visible necrosis. Geldanamycin is structurally similar to the herbimycins, which are also produced by S. hygroscopicus and have been reported to have herbicidal activity. The phytotoxicity of geldanamycin and nigericin has stimulated investigation of their potential for use as natural product herbicides. PMID- 3819735 TI - Fercoperol, an unusual cyclic-endoperoxynerolidol derivative from Ferula communis subsp. communis. PMID- 3819736 TI - Cytotoxic and antitumor activity of vismiones isolated from vismieae. PMID- 3819737 TI - Sigmoidin D: a new prenylated flavanone from Erythrina sigmoidea. PMID- 3819738 TI - Pain in sciatica depresses lower limb nociceptive reflexes to sural nerve stimulation. AB - The inhibitory effects of acute pain produced by the Lasegue's manoeuvre on the lower limb nociceptive flexion reflexes induced by electrical sural nerve stimulation were explored in patients complaining of sciatica as a result of an identified unilateral disc protrusion. Lassegue's manoeuvre on the affected side produced a typical radicular pain and resulted in a powerful depression of nociceptive reflexes elicited either in the normal or in the affected lower limb. Simultaneously, patients reported relief of the electrically-induced pain. In contrast, painless Lasegue's manoeuvre on the normal side had no effect on these parameters. PMID- 3819739 TI - Paraganglioma of the cauda equina: a case report. AB - This case report describes a paraganglioma of the cauda equina in a 63 year old woman. Very few examples of paraganglioma have been recorded in this site. Histologically these neoplasms may have considerable similarity with ependymoma, the most common neoplasm of the lower spinal cord, and the diagnosis can be easily missed unless special techniques are employed. The clinical and pathological data obtained from this and the other reported examples suggests that paragangliomas of the cauda equina are benign, slowly growing neoplasms. In contrast to ependymomas and to paragangliomas elsewhere, they are well circumscribed, amenable to complete resection and have an excellent prognosis. PMID- 3819740 TI - AIDS and catatonia. PMID- 3819741 TI - Paraplegia following oral hypotensive treatment of malignant hypertension. PMID- 3819742 TI - Hemiballism and CT-documented lacunar infarct in the lenticular nucleus. PMID- 3819743 TI - Parkinson's disease in twins. PMID- 3819744 TI - Sporadic adult onset distal myopathy. PMID- 3819745 TI - Adult onset of nemaline myopathy presenting as diaphragmatic paralysis. PMID- 3819746 TI - Taste loss as an initial symptom of primary amyloidosis. PMID- 3819747 TI - Sino-atrial arrest due to temporal lobe epilepsy. PMID- 3819748 TI - Mental status changes induced by eye drops in dementia of the Alzheimer type. PMID- 3819749 TI - Age-specific incidence rates for motor neuron disease. PMID- 3819750 TI - Cryptococcal meningitis and cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome. PMID- 3819751 TI - Cryptococcal meningitis and cerebral toxoplasmosis in AIDS: another case report. PMID- 3819752 TI - Evoked taste thresholds in a normal population and the application of electrogustometry to trigeminal nerve disease. AB - No standardised method for taste threshold measurement is available and therefore comparison between clinical studies is difficult. An electrogustometer was evaluated in normal subjects. No sex difference in taste threshold was noted; however, there was a significant elevation in detection threshold with age and smoking. Electrogustometric values both in patients before and after surgery for trigeminal neuralgia and in patients with trigeminal sensory neuropathy were determined. Many patients with trigeminal nerve disorders had abnormal electrogustometric detection thresholds suggesting that there is possibly an accessory taste pathway through the trigeminal nerve, although in some individuals the site of lesion may be in the brain stem. Electrogustometry is a convenient method for clinically assessing taste. PMID- 3819753 TI - Tuberculous meningitis: role of CT in management and prognosis. AB - Serial computed tomographic scans were performed during the course of tuberculous meningitis in 25 patients aged 1-70 years. Hydrocephalus rarely occurred without other abnormalities. Marked ventricular enlargement was associated with extensive basal enhancement. Basal meningeal enhancement was not a good indicator of the clinical state although marked enhancement was a risk factor for the development of basal ganglia infarction. Infarcts were much more common in children than in adults and were sometimes asymptomatic. Radiological abnormalities sometimes developed during treatment and often did not resolve completely. Many patients had severe residual neurological problems. PMID- 3819755 TI - Premorbid prevalence of poor academic performance in severe head injury. AB - A study of 80 head injured patients revealed poor premorbid academic performance in up to 50% of the sample. Poor academic performance, as defined by diagnosis of learning disability, multiple failed academic subjects, or school dropout during secondary education, is not a previously cited risk factor for head injury. These findings have important implications in the identification of a high risk population and in the subsequent ability to reduce the incidence of head injury. PMID- 3819754 TI - Do white matter changes on MRI and CT differentiate vascular dementia from Alzheimer's disease? AB - MRI showed white matter changes in all 29 patients with vascular dementia and in eight out of 22 patients with Alzheimer's disease. The corresponding figures for CT were 26 and 1, respectively. White matter changes are therefore a useful diagnostic aid in the differential diagnosis between vascular dementia and Alzheimer's disease. PMID- 3819756 TI - Regeneration following tibial nerve crush in the rabbit: the effect of proximal constriction. AB - In order to test the regenerative capacity of atrophic axons, a constricting ligature was placed around the proximal tibial nerve of the rabbit, and the nerve crushed at the ankle one week later. Axonal atrophy with altered g ratios was subsequently confirmed in fibres distal to the site of ligature and proximal to the site of crush. In nerves with tight proximal ligatures the reinnervation of plantar muscles and the subsequent recovery of distal motor latency were delayed, indicating impaired regeneration. This result may be relevant to the "double crush" theory of nerve damage. PMID- 3819757 TI - Medium and long latency EMG responses in leg muscles: Parkinson's disease. AB - Short, medium, and long latency EMG responses to muscle stretch from triceps surae and anterior tibialis muscles were recorded in normals and in 33 patients with Parkinson's disease. The latencies of all EMG responses except short latency were normal in patients with Parkinson's disease. The integrals of the medium latency responses in the stretched triceps surae muscle were significantly increased in patients. This result indicates a modulatory influence of the basal ganglia on medium latency EMG responses. PMID- 3819758 TI - Long latency EMG responses in hand and leg muscles: cerebellar disorders. AB - Electromyographic responses to stretches of hand muscles (first dorsal interosseus) and leg muscles (triceps surae, tibialis anterior) were investigated in patients with cerebellar disorders of different locations. Stimuli consisted of short dorsiflexions of the index finger during background force and in tilting (toe up) of a movable platform on which the subject stood. The most important findings were increased long latency responses in upper and lower extremities. For hand muscles it was the late part of the long latency complex, which was increased. For leg muscles it was the long latency response in the anterior tibialis muscle, the antagonist of the stretched triceps surae. The medium latency response in the triceps surae was unaffected. Latencies of the early segmental reflexes and the long latency responses were normal except for cases with peripheral neuropathy (moderate increase in latency of all EMG responses) and diseases affecting both the peripheral nerves and the dorsal columns (for example Friedreich's ataxia). The latter leads to a pronounced delay of the short latency response and a massive delay of the long latency complex in the first dorsal interosseus and of the long latency response in the anterior tibialis muscle. PMID- 3819759 TI - Cigarette smoking and subarachnoid haemorrhage: a population-based case-control study. AB - Smoking habits were analysed in 114 patients with subarachnoid haemorrhage, less than 70 years old, obtained from an epidemiological study. One control, matched for age, sex, and domicile, was selected for each patient. Current cigarette smokers were significantly more prevalent among cases than controls, and the relative risk of subarachnoid haemorrhage compared with non-smokers was 2.7 in men and 3.0 in women. The so called metastatic emphysema theory with increased elastolytic activity in the serum of smokers is proposed as biochemical basis for the increased risk of subarachnoid haemorrhage. PMID- 3819760 TI - Olfactory threshold in Parkinson's disease. AB - Olfactory threshold to differing concentrations of amyl acetate was determined in 78 subjects with idiopathic Parkinson's disease and 40 age-matched controls. Impaired olfactory threshold (previously reported by others) was confirmed in Parkinsonian subjects compared with controls. There was no significant correlation between olfactory threshold and age, sex, duration of disease, or current therapy with levodopa or anticholinergic drugs. In a sub-group of 14 levodopa-treated patients with severe "on-off" fluctuations, no change in olfactory threshold between the two states was demonstrable. Olfactory impairment in Parkinson's disease may involve mechanisms that are not influenced by pharmacologic manipulation of dopaminergic or cholinergic status. PMID- 3819761 TI - Causes of late onset epilepsy in Saudi Arabia: the role of cerebral granuloma. AB - Cerebral granulomas, due to infections, have been rarely reported as a cause of late onset epilepsy. The incidence of cerebral granulomas was 7% in this prospective study of 56 consecutive patients with onset of seizures after the age of 20 years. Other main causes included cerebral tumours (20%), arteriovenous malformations (5%) and cerebrovascular disease (15% amongst patients with onset of seizures above the age of 40 years). The incidence of structural abnormalities was higher with increasing age at the onset of seizures and declined with long duration of history of epilepsy. Simple partial seizures were strongly associated with structural abnormalities (86%) as opposed to complex partial (33%) and generalised tonic-clonic seizures (33%). PMID- 3819762 TI - Clinical neurological examination, neuropsychology, electroencephalography and computed tomographic head scanning in active amateur boxers. AB - Twenty active amateur boxers were studied seeking evidence of neurological dysfunction and, if present, the best method for detecting it. Seven of these boxers had an abnormal clinical neurological examination, eight an abnormal EEG and nine of 15 examined had abnormal neuropsychometry. The CT scan was abnormal in only one. An abnormal clinical examination correlated significantly (p less than 0.05) with an increasing number of fights, and an abnormal EEG with decreasing age (p less than 0.05). In several of the neuropsychometric tests, the boxers were significantly worse than controls (p less than 0.05). Neuropsychometry was the best method for detecting neurological dysfunction. PMID- 3819763 TI - The compartmental IgM and IgA response within the central nervous system. AB - The diagnostic value of the locally synthesized IgA and IgM fractions in cerebrospinal fluid is described. The differentiation of the CSF immunoglobulins was performed with the help of a diagram that had been established on empirical grounds. Immunoglobulin G generally dominates the humoral immune response within the central nervous system, but in some diseases a comparatively strong participation of the other immunoglobulins was found: IgA in purulent meningitis and neurotuberculosis, IgM in tick-borne early summer meningoencephalitis. In meningopolyneuritis Bannwarth and mumps meningoencephalitis a broad three class response was found. The diagnostic significance of these findings is independent of the disease stage, since the compartmental immune response lacks the Nossal Switch from IgM- to IgG- antibodies. PMID- 3819764 TI - Management of Wilson's disease with zinc sulphate. Experience in a series of 27 patients. AB - Evaluation of the literature concerning the various approaches for the treatment of Wilson's disease led to the conclusion that zinc sulphate might be a good choice because it is effective and relatively safe. Twenty seven patients were managed with zinc sulphate for a total period of 142 patients-years. The drug was administered in doses varying from 300 to 1200 mg/day. Of the 9 patients who were treated with zinc from the start, 8 improved and one died from severe cirrhosis. All 8 patients who were placed on zinc after intolerance to penicillamine did well on zinc therapy. Ten patients were changed to zinc after they had first been treated with penicillamine without developing signs of intolerance. Of this group 8 patients were kept on long-term zinc therapy, 2 were changed back to penicillamine because of personal preference. Signs of intolerance to zinc were not observed. All patients kept a diet containing about 1.2 mg of copper a day. Our experience supports the idea that zinc sulphate is a good choice for the treatment of Wilson's disease: the drug is effective, safe and cheap. PMID- 3819765 TI - Chronic periphlebitis retinae in multiple sclerosis. A histopathological study. AB - Retinal periphlebitis in multiple sclerosis is of particular interest in relation to our understanding of the pathogenesis of the demyelinating central nervous system plaques. Previous studies have largely been clinical, and there is little detailed histopathological information relating to this condition. We present the first detailed report in the neurological literature on the histological findings in chronic periphlebitis retinae associated with multiple sclerosis. The most significant abnormalities of the affected retinal veins were the presence of thick laminated collagen in the wall, associated with a scanty infiltration of plasma cells. PMID- 3819766 TI - Intravenous pyruvate loading test in Leigh syndrome. AB - Diagnosis of defective pyruvate metabolism can present difficulties in clinical practice. In search of a diagnostic procedure that can give a clear indication of a disturbance of pyruvate metabolism, we have developed an intravenous pyruvate loading test. The loading test was applied to 9 patients with Leigh syndrome. Results and characteristics are described. The test proved to be a sensitive procedure to detect disturbances in pyruvate oxidation. The intravenous pyruvate loading test can be a useful tool in the diagnosis of mitochondrial (encephalo) myopathies. PMID- 3819767 TI - Myopathology of hypothyroid myopathy. Some new observations. AB - Eight muscle biopsies (3 from the left biceps, 3 from the left gastrocnemius, and 2 from the left quadriceps) of patients with hypothyroid myopathy were studied in the light of the previous literature. Some new observations have been made. First, the percentage of type II fibres is higher than that of type I fibres in all but 1 cases before treatment. Second, 5 of 8 cases before treatment disclosed 'core-like' structures, readily recognized with oxidative enzyme preparations in eccentric positions or in the periphery of type I fibres. They were reactive with myofibrillar adenosine triphosphatase (ATPase) activity and periodic acid Schiff(PAS) staining, whereas with hematoxylineosin (HE) and modified Gomori trichrome the regions were more strongly reactive than the rest of the fibre. When examined by electron microscopy, within the 'core-like' structures of affected fibres, the A, I, and Z banding pattern was markedly disrupted. These structures disappeared after treatment with L-thyroxine. Third, none of the cases with Hoffmann's syndrome showed individual muscle fibre hypertrophy. Further study of these findings may yield information on clarifying the characteristics of muscle pathology of hypothyroid myopathy. PMID- 3819768 TI - Sensorimotor performance of the hand during peripheral nerve regeneration. AB - Conventional neurological testing procedures outline the sensory and motor incapasities which occur following peripheral nerve injury, but they provide little practical information on the ability of the patient to use the injured part in daily life activities. In the present study functional tests are introduced which lend themselves to statistical analysis and can be routinely and universally applied. The tests did also permit a study of the role of sensation in motor performance. The tests were able to distinguish between nerve-damaged and normal hands; with all differences being statistically significant. Rating scales were devised to indicate how much a motor or sensory performance deviated from normal: function was assessed as poor, satisfactory, or good. No correlation could be established between the results obtained from functional and routine neurological tests nor between sensorimotor performance and the response behavior of single afferents recorded in the same patients. The results indicate that the functional tests are useful and promising for a more general application. The results do also underline the need for sensation in the successful execution of a sequence of coordinated, skillful movements. PMID- 3819769 TI - Distribution of biogenic amines and their catabolites in brains from patients with Alzheimer's disease. AB - Norepinephrine, epinephrine, dopamine, serotonin and their major catabolites were measured in 17 regions of the left hemisphere of two brains obtained from two brothers with Alzheimer's disease with very early onset. The clinical diagnosis was confirmed by histological examination of the right hemispheres and brain stems. The quantitative data were compared with our values in normal brains. In the patient suffering from the less severe dementia, there was a severe reduction of the serotonin concentration in all examined neocortical areas and its concentration was even below the detection limit in the nucleus amygdalis, hippocampus, caudate nucleus, putamen, globus pallidus and substantia nigra. In the other patient, who suffered from a more pronounced dementia with myoclonus, the serotonin concentration was below the detection limit in all examined structures. In contrast with these findings, the noradrenergic, adrenergic and dopaminergic systems appeared to be relatively unaffected by the disease process. Focusing our attention on the nuclei wherein the monoamine transmitter systems originate, it appeared that neuronal losses and neurofibrillary tangles clearly predominated in the substantia grisea subependymalis, the nucleus centralis superior and the nucleus raphe dorsalis, origin of the main serotonergic system. The serotonin deficiency sheds light on possible mechanisms of myoclonus in Alzheimer's disease. PMID- 3819770 TI - Recovery of integrative central nervous function after one hour global cerebro circulatory arrest in normothermic cat. AB - Functional and metabolic recovery of a female cat is described which survived for 1 year following 1 hour global cerebro-circulatory arrest at normothermia. Ischemia was produced by intrathoracal occlusion of the innominate, the left subclavian and both mammary arteries. Following ischemia the animal was kept under intensive care for 46 h. EEG and evoked potentials began to recover after 3 h following ischemia, and spontaneous respiration returned promptly on the 2nd day when the animal was weaned from the respirator. The neurological deficit score declined from a maximum of 395 immediately after ischemia to 158 during the first week and to 40 within 4 weeks. At this time the animal was slightly ataxic but she was able to walk and to feed and clean herself. One year after ischemia EEG and evoked potentials were normal. Morphological studies and the autoradiographic evaluation of protein biosynthesis revealed an almost normal pattern in cortical structures but there was almost complete atrophy of dorsal hippocampus and striatum leading to enlargement of the ventricular system. These observations demonstrate that despite these lesions the central nervous system is able to recover integrative neurological function after cerebro-circulatory arrest in normothermia of as long as 1 h. PMID- 3819771 TI - Neonatal adrenoleukodystrophy. Impaired plasmalogen biosynthesis and peroxisomal beta-oxidation due to a deficiency of catalase-containing particles (peroxisomes) in cultured skin fibroblasts. AB - Neonatal adrenoleukodystrophy belongs to the newly recognized group of inherited diseases, the peroxisomal disorders. Based on the reported similarities between neonatal adrenoleukodystrophy and the cerebro-hepato-renal (Zellweger) syndrome, we have studied peroxisomal functions in cultured skin fibroblasts from 5 neonatal adrenoleukodystrophy patients. The results indicate that multiple peroxisomal enzyme activities are deficient in fibroblasts from neonatal adrenoleukodystrophy patients. Digitonin titration experiments revealed that peroxisomes are strongly deficient in these fibroblasts as found earlier in fibroblasts from Zellweger patients. These findings not only explain the generalized loss of peroxisomal functions in neonatal adrenoleukodystrophy, but also provide an explanation for the observed resemblance in clinical and biochemical abnormalities between neonatal adrenoleukodystrophy and Zellweger syndrome. The implications for the pre- and postnatal detection of this disease will be discussed. PMID- 3819772 TI - Hyperosmotic urea reversibly opens the tight junctions between brain capillary endothelial cells in cell culture. AB - The effect of hyperosmotic solutions of urea on primary cultures of bovine brain microvessel endothelial cells was examined. Confluent monolayers of cells positive for Factor VIII-related antigen were obtained by seven days in culture. The cells were: incubated in media containing 1 M, 2 M or 3 M urea and horseradish peroxidase (HRP) for various periods of time and then examined by transmission electron microscopy. Exposed to hypertonic urea solutions and 14C-3 O-methyl-D-glucose for determination of the intracellular water space. In control cultures endothelial cells were bound together by tight junctional complexes over 91% of which excluded HRP. In experimental cultures 82% of the interendothelial clefts became permeable to HRP after one minute of incubation with 3 M urea. The degree of cell shrinkage corresponded well with the extent of junctional opening. In monolayers examined 24 hours following removal of urea from the media more than 63% of the intercellular clefts were impermeable to HRP. These observations indicate that hyperosmotic solutions of urea reversibly open the tight junctions between brain microvessel endothelial cells in tissue culture. Decrease in cell volume appears to be linked to the increased junctional permeability. PMID- 3819773 TI - Effects of lactic acid on astrocytes in primary culture. AB - Excessive tissue lactic acidosis is considered to be detrimental to the central nervous system (CNS) and may adversely affect recovery from anoxia, ischemia, trauma and epilepsy. Since astrocytes are believed to play a role in pH regulation in the CNS, we studied the effect of this acid on primary astrocyte cultures. Cells exposed to lactic acid showed chromatin clumping, an increase of lipid and dense bodies, a loss of polyribosomal clusters, slightly increased cytoplasmic lucency, swollen mitochondria and tangled intermediate filaments. These alterations progressed with lower pH and longer exposure. Irreversible changes occurred one to two hours after exposure at pH 6; after 30 to 60 minutes (min) at pH 5.5 and after ten to 30 min at pH 5. Comparable results were obtained with the use of other weak acids indicating that the observed changes were due to increased hydrogen ion concentration rather than secondary to lactate per se. Additionally, various concentrations of lactic acid adjusted to identical pH produced similar morphologic alterations. Thus, while lactic acid caused marked and at times irreversible alterations in astrocytes, severe and prolonged acidosis was required to produce such injurious effects. This relative resistance of astrocytes to acidosis is in keeping with their potential role in pH regulation in brain. PMID- 3819774 TI - Tangled masses of central axons (central axonomas) in the brain stem: anatomical evidence for the regenerative growth of human central axons. AB - Eight additional cases of tangled masses of unmyelinated fine axons occurring in the brain stem in association with cystic infarcts or traumatic cysts are described. Because they are solely composed of bare axons and because of their consistent association with old, destructive lesions, they are called axonomas in lieu of the previous designation as non-myelinated neuromas. Axonomas were located at the border of the associated lesions exclusively in or near the central tegmental tract of the midbrain, pons or medulla. Their occurrence in the restricted region is considered as the reason for their rarity and for the failure to observe them in the past. The discrete, compact, mass formation, the occurrence of a large number in groups, the exclusive occurrence in specific regions of the central nervous system (CNS), and the consistent association with old axonal injury are presented as circumstantial evidence that axonomas represent regenerative growths of central axons. Based on the restricted site of predilection, it is inferred that axonomas originate from a special group or groups of CNS neurons which may have an exceptionally high capacity to regenerate. In other words, certain central neurons in man are not only capable of abundant regenerative sprouting but also are able to sustain the newly formed sprouts in the form of axonomas for years or perhaps permanently, but the specific neurons are not yet identified. PMID- 3819775 TI - Vacuolated anterior horn cells in wobbler mouse motor neuron disease: peripheral axons and regenerative capacity. AB - We investigated whether vacuolated cervical anterior horn cells of the wobbler mouse maintain axons to the periphery, and if these morphologically abnormal neurons are capable of supporting axonal regeneration. Using retrograde axonal transport, we applied horseradish peroxidase (HRP) to peripheral nerves or muscles and with electron microscopy sought evidence for perikaryal labeling in vacuolated neurons in 23 wobbler mice. When HRP was injected into forelimb muscles, 12 of 36 vacuolated neurons became positively labeled indicating that these neurons have axons in continuity with the periphery. In regeneration studies, after nerve crush at the brachial plexus, 23 out of 85 vacuolated neurons were labeled after HRP application at the elbow level. However, after a sufficient regeneration period, none of the 36 vacuolated neurons were labeled if HRP was applied in muscles below the elbow. In all experiments, morphologically normal neurons were always labeled. Our studies indicate that some vacuolated neurons of wobbler mice not only maintain axons into the periphery, but are also capable of supporting regeneration. However, the overall function of these vacuolated neurons appears marginal compared with the majority of morphologically normal neurons in this motor neuron disease. PMID- 3819776 TI - Remodelling of internodes in regenerated rat sciatic nerve: electron microscopic observations. AB - Twelve adult rats received a crush lesion of the left sciatic nerve in the upper thigh. Following survival times of 2 weeks to 6 months, the animals were perfused with glutaraldehyde. Longitudinal thin sections from regenerated nerve segments were examined by electron microscopy. At survival periods of 2 weeks to 1 month, exceptionally short internodes composed of a Schwann cell lacking myelin, a more or less wrinkled Schwann cell-myelin sheath unit, or Schwann cell cytoplasm containing lamellated bodies and lipid droplets, were found intercalated between conventional regenerated myelin sheaths. Such intercalated sheaths were always bordered by sites with a nodal differentiation. Although much less frequent, short distorted myelin sheaths were also found at regeneration times of 2 and 3 months, but they have not been found in sections from 6-month specimens. In the long-term regenerated nerves many paranodes were distorted by prominent myelin folds and some nodes of Ranvier exhibited abnormal axon-Schwann cell networks and adaxonal Schwann cell protrusions. These observations show that internodes in regenerated rat sciatic nerves are subject to extensive remodelling. This includes internodal shortening and nodal migration, myelin sheath breakdown and demyelination, elimination of redundant Schwann cells and nodal fusion. These morphological changes may have important physiological implications. PMID- 3819777 TI - Distribution of synaptic ribbons in the developing organ of Corti. AB - Studies of synaptogenesis in the developing organ of Corti in the intact mouse and in culture indicate that the inner and outer hair cells contain three populations of synaptic ribbons, i.e. ribbons adjacent to nerve fibres, free intracellular ribbons and misplaced ribbons apposed to non-neuronal elements. Ribbons adjacent to nerve fibres can be further classified into: ribbons synaptically engaged, ribbons participating in formation of presynaptic complexes only and ribbons that are not engaged to the hair cell membrane. In the developing innervated cultures the ribbon distributions are similar to those in the normal animal. Inner and outer hair cells differ in distribution of the ribbons. In the inner hair cells the ribbons adjacent to the nerve fibres are dominant (over 90%) and most of them (88%) are synaptically engaged. In the outer hair cells the presynaptic ribbons dominate the population (up to 60%) during the first postnatal week when the cells acquire afferent synaptic connections. This stage is followed by a marked reduction in the number of all ribbons. In the intact animal the rapid decrease results in a relative increase of misplaced and free ribbons. These changes are presumably due to the loss of some of the afferents. In the denervated hair cells the distribution of ribbons indicated the presence of conspicuous scatter. In the areas of incomplete denervation, however, the ribbons are apposed to the preserved fibres. Despite denervation, most of the ribbons develop the entire presynaptic complex in apposition to non-neuronal structures. The different populations of synaptic ribbons appear to reflect different stages in synapse formation. Possibly, the synaptic body originates in the interior of the hair cell and subsequently migrates to the cell membrane. In any case, a nerve fibre appears critical in influencing the location of the synaptic ribbon. At the apposition of the ribbon to the hair cell membrane, presynaptic densities are formed and the ribbon appears to become anchored. Typically, the nerve fibre membrane apposed to the presynaptic complex responds with the formation of postsynaptic densities. PMID- 3819778 TI - Effects of delayed myelination by oligodendrocytes and Schwann cells on the macromolecular structure of axonal membrane in rat spinal cord. AB - The macromolecular structure of axonal membrane from dorsal funiculi of control and irradiated spinal cord of 45-day-old rats was examined with freeze-fracture electron microscopy. In control spinal cords, virtually all myelination is mediated by oligodendrocytes, and the internodal axonal membrane of these fibres displays highly asymmetrical partitioning of intramembranous particles (IMPs). The internodal P-face particle density is approximately 2350IMPs per micron 2, whereas the E-face IMP density is approximately 150 per micron 2. In control dorsal spinal roots, myelination is mediated by Schwann cells, and the ultrastructure of the internodal axolemma of the myelinated fibres is similar to that displayed by myelinated fibres of dorsal funiculi. On the internodal P-face of Schwann cell-myelinated fibres the IMP density is approximately 2350 per micron 2, whereas on the E-face the density is approximately 175 per micron 2. Irradiation of the lumbosacral spinal cord at 3 days of age results in a glial cell-deficient region within the spinal cord such that myelination in irradiated dorsal funiculi is delayed and subsequent myelination is mediated by both oligodendrocytes and Schwann cells. By 45 days of age, dorsal funiculi of irradiated spinal cords are well populated with fibres myelinated by oligodendrocytes and Schwann cells. However, fibres myelinated by oligodendrocytes display very thin myelin sheaths whereas Schwann cell-myelinated fibres exhibit myelin sheaths with normal thicknesses. Internodal membrane of fibres myelinated by Schwann cells and oligodendrocytes exhibit similar macromolecular structure, with approximately 2400 IMPs per micron 2 on P-faces and approximately 150 IMPs per micron 2 on E-faces. Occasional large (greater than 1.5 micron diameter) axons without glial-Schwann cell ensheathment are observed. These axons display a high density of P-face particles (approximately 2000 per micron 2) and a moderate density (approximately 350 per micron 2) of E face IMPs on their fracture faces. These results demonstrate that CNS fibers exhibit similar axonal membrane ultrastructure irrespective of whether they are myelinated by Schwann cells or oligodendrocytes, or whether myelination is delayed. Moreover, when myelination does not occur, the axolemmal E-face IMP density, which may be related to the density of voltage-sensitive sodium channels, is not reduced. PMID- 3819779 TI - MAP5: a novel brain microtubule-associated protein under strong developmental regulation. AB - A novel microtubule-associated protein, MAP5, is described, whose chemical properties and cytological distribution distinguish it from other known microtubule-associated proteins (MAPs). Its status as a MAP is indicated by the observations that (i) it co-assembles efficiently with microtubules in vitro, (ii) it is localized on microtubules in brain sections by immunogold staining with monoclonal antibody against MAP5 and (iii) immunoaffinity purified MAP5 stimulates tubulin polymerization. Immunoperoxidase staining of brain sections showed that MAP5 is present in neurons throughout the brain and that in them it is evenly distributed throughout axons, dendrites and cell bodies. In this respect it differs from previously described MAPs (1, 2, 3 and tau) which are differentially compartmentalized in brain neurons. MAP5 is not present in axon terminals, dendritic spines or other synaptic elements. It is present at substantially higher levels in neonatal brain than adult and it is more abundant than either MAP1 or MAP2a up to postnatal day 10. The fall in amount of MAP5, from juvenile to adult levels, is completed between postnatal days 10 and 20. This suggests that MAP5 is particularly important in modulating microtubule function during the formation of neuronal processes. PMID- 3819780 TI - Comparative dynamics of retrograde transport of nerve growth factor and horseradish peroxidase in rat lumbar dorsal root ganglia. AB - The dynamics of the retrograde transport of [125I] nerve growth factor (NGF) and horseradish peroxidase (HRP) in dorsal root ganglion (DRG) neurons were studied in rats. After injection of [125I]NGF or HRP into crushed sciatic nerve, labelling was examined in spinal nerves, dorsal root ganglia, dorsal roots and spinal cord. Retrograde transport of either [125I]NGF or HRP was first observed in DRG neurons 6 h after injection: The maximal rate of transport (7 mm h-1) was similar for both proteins. Significant differences in the sizes of DRG neurons labelled by [125I]NGF were observed and were dependent upon survival time. No such difference was seen in HRP-injected animals. At 6 h after injection, 60% of all the HRP-labelled cells had a diameter of more than 25 micron, whereas 90% of all the [125I]NGF-labelled neurons had a diameter of less than 25 micron. With increasing survival times there was a gradual shift in the size of [125I]NGF labelled neurons towards larger diameters. Thus, 24 h after the [125I]NGF injection, 83% of the labelled cells had a diameter greater than 25 micron. The data suggest that small diameter neurons retrogradely transport and turnover NGF faster than larger diameter neurons. There was a preferential accumulation of silver grains in small DRG neurons (mean diameter 25 micron) at early survival times (4 and 8 h); at the later survival time (24 h) the reverse was observed, i.e. larger neurons (mean diameter 42 micron) were labelled. In contrast, the mean diameter of HRP-labelled neurons remained constant (30 micron) at all times after injection. The total number of neurons ultimately labelled (approximately 80-85%) appeared to be the same with both tracers. In addition, the lack of transganglionic transport of NGF into the spinal cord and the short time span of the observable accumulated radioactivity in DRG neurons suggest the rate of degradation of transported NGF seems to be faster than HRP. As a practical matter, these data indicate that observing cells within DRG which accumulate retrogradely transported [125I]NGF at any one time gives an inaccurate picture of the size properties of cells capable of transporting the ligand. PMID- 3819781 TI - Distribution of the adhesion molecules N-CAM and L1 on peripheral neurons and glia in adult rats. AB - There is considerable evidence that the cell surface glycoproteins N-CAM and L1 are important mediators of cell-cell adhesion in the nervous system, at least during development. Numerous studies have been devoted to the molecular properties of these proteins and their adhesion role in embryonic and early postnatal development. Much less is known about their importance in mature tissues. A rigorous and comprehensive description of the cell distribution of these molecules in the adult nervous system would clearly form a useful baseline for functional and biochemical studies. In the present work we have addressed this issue and studied the distribution of N-CAM and L1 throughout adult, as opposed to developing, rat peripheral nervous tissue. Particular attention was paid to the ganglia of the enteric nervous system, since adhesion mechanisms within these ganglia are likely to be placed under unusual demands. We report, for the first time, the presence of N-CAM and L1 on mature sensory, sympathetic and enteric neurons in adult rats. Thus, immunostaining of cell suspensions or short-term cultures showed N-CAM and L1 surface labelling on sympathetic and both large and small dorsal root sensory neurons. Both antigens were also present on the surface of enteric neurons in cultures prepared from 10-day-old rats and neonatal guinea pigs. Immunostaining of sections of enteric ganglia from adults indicated that both molecules were also expressed by mature enteric neurons. In sections of mature sciatic nerve neither N-CAM nor L1 immunoreactivity were detected at the site where the plasma membrane of myelinated axons meets the ad axonal plasma membrane of the myelin-forming Schwann cell. Thus, both N-CAM and L1 were detected on all major classes of peripheral neurons, while their levels in the plasma membrane of myelinated axons may be significantly down-regulated. Similarly, both N-CAM and L1 were present on all major classes of non-myelin forming peripheral glia in adult rats. This includes the enteric glial cells of the myenteric ganglia, non-myelin-forming Schwann cells in the sciatic nerve, sympathetic trunk and fine autonomic nerves in the gut wall, and the satellite glial cells of sympathetic and dorsal root sensory ganglia. In contrast, myelin forming Schwann cells did not express detectable levels of N-CAM and only very low levels of L1, which was mainly located near the nodes of Ranvier.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3819782 TI - Nonspecific dementia, cortical blindness, and Congophilic angiopathy. A clinicopathological report. AB - Postmortem examination of an elderly male with cortical blindness and features of both cortical and subcortical dementia revealed extensive neuronal dropout most marked in the occipital cortex, moderate gliosis, rare neuritic plaques, no neurofibrillary tangles, and extensive Congophilic angiopathy. The unprecedented association of Congophilic angiopathy with nonspecific dementia provides further support for the concept that Congophilic angiopathy is usually a nonspecific manifestation of neuronal degeneration and of little clinical significance except when it results in intracerebral hemorrhage. PMID- 3819783 TI - Multiple sclerosis and Hashimoto's thyroiditis. AB - A case of multiple sclerosis and Hashimoto's thyroiditis confirmed by cytology is reported. The association of multiple sclerosis with other autoimmune diseases is infrequent but supports the immune hypothesis of the pathogenesis of multiple sclerosis. The authors suggest the inclusion of immunological tests in the screening of all patients diagnosed as having multiple sclerosis. PMID- 3819784 TI - Syndromes of a complex lesion of greater and lesser superficial petrosal nerves (paradoxical facial hyperaemia, salivation, lacrimation and mucus excretion). AB - After closed cranial trauma with paralysis of the facial nerve, a patient had a fracture into the petrosus apex with a bony bridge over the nerve, and a subdural haematoma, which were dealt with during an operation for nerve decompression. Examination of the patient 2.5 years later revealed the presence of the crocodile tears syndrome, mucus secretion and the salivary atropine paradox, i.e. severe hyperaemia of the paretic half of the face during intense salivation in response to atropine. Other patients who suffered similar trauma but had no operation demonstrated the same syndrome. The crocodile tears syndrome is considered to be a result of an ephaptic union of the central portion of the damaged lesser superficial petrosal nerve (SPN) with the peripheral portion of the greater SPN. The salivary atropine paradox is then due to the loss of the peripheral portion of the former nerve combined with denervation of the salivary parotid gland. Facial hyperaemia during intense salivation after atropine administration is explained as a result of the intensified release of vasoactive intestinal polypeptide from the gland, stimulated by atropine, into the blood circulation. PMID- 3819785 TI - Chronic progressive neurological involvement in Borrelia burgdorferi infection. AB - Five patients with chronic meningitis were hospitalized several times for progressive neurological symptoms. The clinical manifestations included cranial neuritis, radiculoneuritis, myelitis and encephalitis. In two cases cerebral infarction occurred. The course was commonly characterized by a tendency to deteriorate. From the clinical point of view, it was repeatedly difficult to exclude multiple sclerosis or tuberculous meningitis. Finally, specific antibodies against Borrelia burgdorferi were detected by indirect immunofluorescence assay. The diagnosis of a borreliosis was not considered initially because there was no history of tick-bite or erythema chronicum migrans, and the neurological involvement of the central nervous system seemed unusual. The latency between the first symptoms and diagnosis varied from 3 months to 5 years. After a parenteral, high-dose therapy with penicillin, there was a significant improvement in all patients. In two cases, there was evidence of intrathecally produced antibodies to myelin basic protein. PMID- 3819786 TI - Ultrastructural localization of glucocerebrosidase in cultured Gaucher's disease fibroblasts by immunocytochemistry. AB - The subcellular localization of glucocerebrosidase was studied in cultured skin fibroblasts from eight patients with Gaucher's disease. The enzyme, in situ, was visualized under the electron microscope by incubating ultrathin frozen sections of fibroblasts with antibodies against glucocerebrosidase, followed by a second incubation with goat anti- (rabbit IgG) coupled to colloidal gold. In control cells, most of the gold label was found in lysosomes, associated with the membrane. Labelling of the rough endoplasmic reticulum (RER) and Golgi complex was also observed. In fibroblasts from three Gaucher's disease patients without neurological symptoms (type 1 disease), a near normal amount of cross-reactive material (CRM) was detected in lysosomes, but in a fourth such patient, the lysosomal CRM was reduced. Little lysosomal glucocerebrosidase was detected in cells from patients with the acute neuronopathic form (type 2) or the subacute neuronopathic form (type 3) of Gaucher's disease. CRM in lysosomes correlates with amount of mature, 59 kDA glucocerebrosidase which is undetectable in type 2 and type 3 Gaucher's disease cell lines. These findings demonstrate that different mutations in the gene for glucocerebrosidase result in mutant proteins that have different intracellular localizations. They also suggest that there is a relationship between the amount of cross-reactive material in the lysosomes and the phenotypic expression of the disease. PMID- 3819787 TI - Early sarcolemmal dysfunction in skeletal muscle amyloidosis. AB - Weakness and stiffness appeared in a 65-year-old man affected by multiple myeloma. Muscle fibre conduction velocity was recorded in situ in the biceps brachii and found to be significantly decreased. Muscle biopsy, performed in the same muscle, showed amyloid deposition and moderate atrophy of muscle fibres, which was not sufficient to explain the reduction in muscle fibre conduction velocity. The results of the study suggest that amyloid interferes with conduction along the sarcolemma and that this plays a pathogenetic role mainly in the early stages of the disease. PMID- 3819788 TI - Chronic intracranial hypertension secondary to neurobrucellosis. AB - Chronic intracranial hypertension in the presence of hydrocephalus and/or arachnoiditis is a rare presentation of neurobrucellosis. The present case is exceptional because neither hydrocephalus nor arachnoiditis were present. Brucellosis was diagnosed by serological tests. The patient developed asthenia, anorexia, weight loss, violent headaches, explosive vomiting, bilateral papilloedema, diplopia with paralysis of the abducens nerves, left supranuclear facial paralysis and left hemiparesis. A skull radiograph showed destruction of the sella turcica. Rapid recovery was attained with the use of antibiotics. The pathogenesis of this intracranial hypertension syndrome with destruction of sella turcica is discussed. PMID- 3819790 TI - Afferents for the human corneal reflex. PMID- 3819789 TI - Clinical improvement after administration of coenzyme Q10 in a patient with mitochondrial encephalomyopathy. AB - In a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes [MELAS] who had normal mitochondrial enzyme activity, high doses of coenzyme Q10 (CoQ) were administered. Clinical improvement with decreased serum lactate and pyruvate levels was observed. Though the mechanism of action of CoQ is not known, a trial is worthwhile in patients with MELAS. PMID- 3819791 TI - Monitoring technique affects measurement of recovery from succinylcholine. AB - To compare recovery time from neuromuscular blockade after the administration of a single intravenous bolus of succinylcholine (1 mg/kg), we measured, both mechanically and electromyographically, the evoked twitch responses in the hand muscles of 10 patients. Electromyographic data were obtained, electronically integrated, and recorded by a newly available clinical monitoring device. Using both the mechanical and the electromyographic devices, we recorded the times for first return of twitch, as well as for 25% and 75% recovery of twitch height compared with prerelaxant twitch baseline values and compared the values by calculating least-squares regression lines. Times given by the electromyographic device for these measures of returning neuromuscular function were notably longer than those given by the mechanical evoked force monitor. No such findings have been reported in previous studies that compared these two techniques for monitoring of muscle recovery from nondepolarizing relaxants. The specific reasons for the differences found in this study are unknown. PMID- 3819792 TI - The effect of fatigue on the performance of a simulated anesthetic monitoring task. AB - In a simulated monitoring situation, 21 anesthesia residents were tested for their ability to detect significant changes in four critical variables in the presence of a concurrent distraction. Each resident was tested after a night without clinical responsibility (rested) and after 24 hours of in-house call (fatigued). When fatigued, the residents scored significantly worse on the vigilance test than when rested (57.2 +/- 15.4 versus 65.9 +/- 10.9, P less than 0.02). Despite the small population size, the possibility of subject and investigator bias, and the artificial setting, these results support the intuitive proposition that a fatigued person is less likely than a rested person to detect important changes in monitored variables. PMID- 3819793 TI - Thromboelastography as an indicator of post-cardiopulmonary bypass coagulopathies. AB - Postoperative hemorrhage in patients undergoing open-heart surgery is a major cause of morbidity and mortality. Monitoring of coagulation in these patients has routinely involved the activated clotting time. Thromboelastography is currently used as a monitor of coagulation during liver transplantation. The thromboelastogram, by providing information on the interaction of all the coagulation precursors, gives more clinically useful information on coagulation than that available from the coagulation profile or the activated clotting time alone. This study was done to assess the usefulness of thromboelastography in open-heart surgery. Thirty-eight patients (29 undergoing coronary artery bypass grafting and 9 undergoing valve replacement) were studied with activated clotting time, thromboelastography, and coagulation profiles during three periods: before bypass, during bypass, and after protamine administration. Thromboelastography was a significantly better predictor (87% accuracy) of postoperative hemorrhage and need for reoperation than was the activated clotting time (30%) or coagulation profile (51%). Thromboelastography is easy to use and provides diagnostic data within 30 minutes of blood sampling. PMID- 3819794 TI - Measurement and interpretation of maximal oxygen uptake in patients with chronic cardiac or circulatory failure. AB - Rapidly responding gas analyzers have simplified the monitoring of oxygen uptake (VO2) in the clinical exercise laboratory. An incremental, exhaustive, upright exercise test can be safely used to determine the plateau in oxygen uptake during exercise, or maximal VO2 (VO2max), in patients with chronic cardiac or circulatory failure. We define VO2max in these patients as an increase in VO2 of less than 1 ml/min/kg despite an increment in work load. The value for VO2max indicates the patient's aerobic capacity; it also predicts the maximal cardiac output during exercise and therefore serves as an estimate of cardiac reserve and of the severity of cardiac or circulatory failure. Symptom-limited VO2 during exercise, termed maximum oxygen uptake but more appropriately peak VO2, bears no relationship to VO2max. The two terms should not be used interchangeably. PMID- 3819795 TI - Intraoperative monitoring of sensory evoked potentials may be neither a proven nor an indicated technique. AB - Excluding specific neurosurgical indications for cortical localization or peripheral nerve surgery, the use of sensory evoked potentials as a monitor in the operating room should be controversial at this time. Whether appropriate or not, legal and medical forces have largely established the use of somatosensory evoked potential monitoring as a standard during procedures that threaten the integrity of the spinal cord. The author believes that such monitoring should not replace the use of a "wake-up" test during these procedures because of the recognized possible occurrence of false negative results (i.e., normal evoked potentials despite abnormal spinal cord function). Another apparent established practice is monitoring of brainstem auditory evoked potentials to recognize the onset of disturbance in the auditory system. It has not been established that other recommended evoked potential monitoring practices, such as somatosensory evoked potential monitoring for such purposes as recognizing cerebral ischemia, or brainstem auditory evoked potential monitoring for recognizing untoward medullary stimulation, are as good as or better for these purposes than currently recognized and simpler monitors. PMID- 3819796 TI - Continuous fiberoptic arterial oxygen tension measurements in dogs. AB - An experimental study using a new fiberoptic sensor for the continuous intraarterial measurement of oxygen tension is described. This "optode" sensor uses the phenomenon of fluorescence quenching to determine the oxygen tension of the surrounding medium. To assess the accuracy of this device, we anesthetized 4 dogs and monitored them continuously with arterial catheters and an intraarterial optode probe, and intermittently with arterial blood gas analysis. The inspired oxygen fraction was varied from 1.0 to 0.1, and arterial blood gases were measured for comparison with the optode reading. Two hundred ninety data sets yielded a correlation coefficient of 0.96, with a linear regression slope of 0.98 and intercept of 5.1 mm Hg. In the 72 data sets from the last dog, the bias and precision of the optode arterial oxygen tension values were -10.3 mm Hg and 20.0 mm Hg, respectively. The optode probe was easily inserted through a 20-gauge catheter and did not interfere with continuous arterial pressure measurement or blood sampling. This study suggests that the optode has great potential as a continuous, real-time monitor of arterial oxygen tension. PMID- 3819797 TI - A QRS detection algorithm. AB - In this article we present the choices that the designers of any QRS detector must make and explain the constraints we adopted. We outline the signal processing that precedes and the beat analysis that follows QRS detection in our single-channel, arrhythmia-monitoring algorithm and then expound the QRS detection algorithm in detail. Finally, we present the results of a QRS detector performance evaluation and comment on their importance. This article can be read to three depths: the text affords an overview of QRS detection for on-patient, ambulatory arrhythmia analysis; the commented pseudocode documents the logic of our QRS detector; and the pseudocode "footnotes" supply technical detail. PMID- 3819798 TI - Noninvasive continuous blood pressure measurement from the finger: optimal measurement conditions and factors affecting reliability. AB - We recorded finger arterial blood pressure (FINAP) in 50 male patients during various types of surgical operations. Three different types of cuffs were used on four fingers of each patient. Measurements were made by the arterial volume-clamp method of Penaz. The FINAP measurements were compared with pressure data obtained ipsilaterally from a radial artery catheter-transducer system (intraarterial pressure [IAP]) to find optimal recording conditions and to document factors affecting FINAP readings. The thumb, with a specially designed cuff, gave the most accurate results. The mean FINAP - IAP difference for the thumb was -4.8 mm Hg for systolic pressure, 1.49 mm Hg for diastolic pressure, and 0.29 mm Hg for mean pressure. The differences were statistically significant for systolic and diastolic pressure but not for mean pressure. The regression slope for thumb systolic FINAP/IAP was 0.979, that for thumb diastolic FINAP/IAP was 0.963, and that for mean thumb FINAP/IAP was 0.996, whereas the intercepts were 7.499 for systolic pressure, 0.802 for diastolic pressure, and 0.083 for mean pressure. The correlation coefficients were 0.945 (systolic), 0.884 (diastolic), and 0.949 (mean). The correlation coefficients with the other fingers ranged from 0.502 to 0.922 for systolic pressure, 0.757 to 0.932 for diastolic pressure, and 0.767 to 0.892 for mean pressure. The slopes for the various finger-cuff combinations ranged from 0.537 to 0.996, and the intercepts ranged from 0.083 to 32.387 from mean pressure. In 3 patients (6%) the FINAP measurement was not possible because of insufficient peripheral circulation. In 9 other patients (18%) the FINAP measurements were not accurate during some periods of time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819799 TI - Extrapleural hematoma: a recognizable complication of central venous pressure monitoring. AB - Variations in the roentgenographic appearance of an extrapleural hematoma are discussed using an illustrative case. Information for making the diagnosis based on radiographic findings is provided. PMID- 3819800 TI - Elevated pulmonary capillary wedge pressure in a patient with hypovolemia. AB - Since its introduction in 1969, the balloon-tipped pulmonary artery catheter has become widely accepted. Pulmonary capillary wedge pressures have been used diagnostically to determine left ventricular preload and volume status. We report on a patient with noncardiogenic pulmonary edema, secondary to a heroin overdose, who was hypovolemic and had an elevated pulmonary capillary wedge pressure. We discuss possible explanations and present evidence that the pulmonary capillary wedge pressure does not always accurately reflect volume status. PMID- 3819801 TI - Stress factors and breast cancer outcome. PMID- 3819802 TI - Coping with ineffective therapies. PMID- 3819803 TI - The other CHOP. PMID- 3819804 TI - Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective randomized study. AB - Fifty-nine evaluable patients under 65 years of age with measurable metastatic breast cancer and without prior chemotherapy were randomly assigned to treatment with fluorouracil, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (FAC) at standard or high doses (100% to 260% higher than standard FAC) following a dose escalation schedule. Patients randomized to the high-dose FAC received the first three cycles of therapy within a protected environment. Subsequent cycles for this group were administered at standard doses of FAC in an ambulatory setting, the same as for the control group. After reaching 450 mg/m2 of Adriamycin, patients in both groups continued treatment with cyclophosphamide, methotrexate, and fluorouracil until there was disease progression. Analysis of pretreatment patient characteristics showed an even distribution for most known pretreatment factors, although the control group had slightly (but nonsignificantly) more favorable prognostic characteristics. Fourteen patients (24%) achieved a complete remission (CR) and 32 (54%) achieved a partial remission (PR), for an overall major response rate of 78%. There were no differences in overall, CR, or PR rates between the high-dose FAC and control groups. The median response durations were 11 and 10 months for the protected environment and control groups, respectively, and the median survival was 20 months for both groups. Hematologic, gastrointestinal (GI), and infection-related complications were significantly more frequent and severe in the group treated with high-dose chemotherapy. Stomatitis, diarrhea, and skin toxicity were dose limiting. However, there were no treatment-related deaths. High-dose induction combination chemotherapy with the agents used in this study failed to increase the response rate or survival duration, and resulted in a substantial increase in toxicity. PMID- 3819805 TI - Prognosis in chronic lymphocytic leukemia: a retrospective multicentric study from the GIMEMA group. AB - Clinical and biological data were evaluated using Desu univariate analyses or Cox multivariate analyses in a series of 1,777 chronic lymphocytic leukemia (CLL) patients from an Italian Cooperative Group. In univariate analyses, age and sex of patients, presence of bone marrow (BM; greater than or equal to 50%), and peripheral blood (PB; greater than or equal to 60,000/microL) lymphocytosis, anemia (hemoglobin [Hb] less than 11 g/dL), thrombocytopenia (less than 100,000/microL), direct Coombs' test positivity, hepatomegaly, splenomegaly, and extent of lymph node involvement were shown to be of significant prognostic value. Multivariate analyses, through a stepwise procedure, showed that the most important prognostic variables are Hb, hepatomegaly, lymph node involvement, PB lymphocytosis, and age and sex of patients. Further covariates would produce an improvement having a nonsignificant P value. Based on the results of multivariate analyses, a four-step staging using the significant variables of the Cox model is proposed. PMID- 3819806 TI - Results of MIME salvage regimen for recurrent or refractory lymphoma. AB - Based on encouraging results of two previous ifosfamide-VP-16 salvage combinations, methyl-gag was added to ifosfamide, methotrexate, and etoposide (VP 16). This combination is called MIME. A total of 208 patients with recurrent lymphoma were treated with this regimen. Response rates were 24% for complete remission and 36% for partial remission. The MIME regimen was more effective in patients who were treated after being off front-line therapy for longer than 6 months. However, responses were also seen in patients with disease clearly resistant to front-line therapy, suggesting that MIME was at least partially non cross-resistant with front-line doxorubicin-containing regimens. The 15-month median relapse-free survival of complete responders and the 9-month overall median survival time for all patients treated were both similar to results from previous ifosfamide-VP-16 combination use. This regimen has been effective in the treatment of patients with recurrent or refractory lymphoma, but cannot be considered curative in the majority of cases. PMID- 3819807 TI - Effect of the degree of nodularity on the survival of patients with nodular lymphomas. AB - The survival of patients with favorable lymphoma entered on various Eastern Cooperative Oncology Group (ECOG) studies was analyzed according to the degree of nodularity. A pure nodular pattern (NN), defined as nodularity involving 75% or more of the cross-sectional area, was found to be an important favorable prognostic indicator as compared with a nodular-diffuse pattern (ND). The median survival in 336 patients with NN of 68.2 months was significantly better than the 39.6 months in 87 patients with ND (P less than .003). The median survival in NN lymphocytic poorly differentiated (LPD) was 77.2 months v 44.3 months for ND-LPD. NN-M median survival of 56.4 months contrasted with only 25.5 months for ND-mixed lymphocytic and histiocytic (M). The degree of nodularity as defined in this study appears to have significant prognostic implication and should be more widely used by pathologists. PMID- 3819808 TI - Sequential hydroxyurea-cytarabine chemotherapy for refractory non-Hodgkin's lymphoma. AB - In experimental systems, hydroxyurea (HU) and cytarabine (ara-C) produce synergistic cytotoxicity to murine and human leukemia cells due to both cytokinetic and biochemical interactions that tend to enhance the effectiveness of ara-C. Therefore, we began a phase II trial of the combination of HU and ara-C to determine the efficacy and toxicity of this combination in treatment of patients with refractory non-Hodgkin's lymphoma. Chemotherapy began with HU 500 mg administered orally every six hours for four doses. Twelve hours following the fourth HU dose, ara-C 100 mg/m2/d was administered by continuous intravenous (IV) infusion for three days. Concomitantly with the three-day ara-C infusion, patients again received HU 500 mg orally every four hours. Cycles of therapy were repeated every 28 days. Twenty-five patients ranging in age from 26 to 70 years were enrolled in the study. Of 21 patients evaluable for response, nine (43%) obtained complete (CR) or partial remissions (PR). Most responding patients had either large-cell or cutaneous T cell lymphoma, and all but two had a performance status of 0 to 1 at entry in the study. The median survival for all responding patients was 13 months compared with 2.5 months for nonresponders. Patients obtaining a CR had a median survival of 27.5 months, and two of the four CRs remain alive and in remission at 10+ and 30+ months from achievement of CR status. The primary toxic effect of this regimen was bone marrow suppression. The median WBC nadir was 2,200 cells/microL, and the median platelet nadir was 80,000/microL. Other toxicities included mild nausea and vomiting and diffuse maculopapular rash. This biochemically rational approach to enhancing ara-C activity may have significant clinical utility and should be further explored in treatment of patients with large-cell and cutaneous T cell lymphomas. PMID- 3819809 TI - High-dose intensity systemic therapy of metastatic bladder cancer. AB - Forty-three consecutively diagnosed patients with widely metastatic transitional cell carcinoma of the bladder (TCCB) were treated with a high-dose intensity, chronobiologically timed combination of doxorubicin and cisplatin, followed by Cytoxan (Mead Johnson Pharmaceuticals, Evansville, IN), 5-fluorouracil (5-FU), and cisplatin maintenance for up to 2 years. Fifty-seven percent of the 35 evaluable patients with widespread metastatic cancer responded objectively. Twenty-three percent had complete disappearance of all cancer. Median survival from first treatment for complete responders (CRs) was more than 2 years, and 1 year for partial responders (PRs). Three of the CRs were alive without evidence of cancer more than 2 years after stopping all therapy. High-dose intensity combination chemotherapy can induce durable CRs of widespread bladder cancer. PMID- 3819810 TI - Wound complications in the multimodality treatment of extremity and superficial truncal sarcomas. AB - The incidence and severity of wound complications were examined in 105 patients with extremity and superficial truncal sarcomas who were eligible for wide local excision with or without adjuvant perioperative brachytherapy (BRT) and/or chemotherapy. Fifty-four cases from the eligible group were entered into a randomized prospective trial of the efficacy of BRT in decreasing local recurrence. In the eligible patients, major wound complications occurred in nine of 41 (22%) of the BRT cases, compared with two of 64 (3%) of the non-BRT patients, which was a significant increase (P = .002). The combined frequency of major and moderate wound complications was also significantly increased in the BRT (18 of 41, 44%) compared with the non-BRT (nine of 64, 14%) patients (P = .0006). The median duration to complete resolution of these complications was 189 days (14 to 597) in the BRT, compared with 49 (11 to 170) days in the non-BRT group (P = .0005); however, no amputations were required, and only 14% of the BRT associated wound complications were of prolonged duration, ie, greater than 200 days. In the randomized study, both the total number of complications, and the combination of major and moderate complications were increased significantly in the BRT v the non-BRT patients. Adjuvant Adriamycin (Adria Laboratories, Columbus, OH) administered in 60 mg/m2 increments to a cumulative dose of 540 mg/m2 did not appear to impair wound healing even when administered within 15 days of operation. Significant wound complications occur in major resections of extremity and superficial truncal sarcomas. If the addition of adjuvant BRT produces a decrease in local recurrence, then either patient selection will have to be more rigidly applied, especially in wounds where skin flap blood supply is tenuous, or the technique will need to be modified to balance the short-term aim of reducing wound complications with the long-term goal of local tumor control. PMID- 3819811 TI - Effect of calcium channel blockers on human CFU-GM with cytotoxic drugs. AB - Calcium channel blockers (CCBs) such as verapamil and nitrendipine are capable of increasing drug sensitivity in resistant murine and human tumor cells. This finding has potential value in the treatment of acquired drug resistance in human malignancies. Thus, we tested the ability of CCBs of two different structural classes to enhance the toxicity of doxorubicin (DOX), vinblastine (VBL), and vincristine (VCR) for normal myeloid and macrophage colony formation (marrow colony forming units-granulocyte-monocyte [CFU-GM]). Drug effects on colony formation from 35 normal volunteer marrows and from seven patient marrows in the recovery phase after cytotoxic chemotherapy were determined. No enhancement of toxicity was mediated by verapamil or nitrendipine when these drugs were co incubated with the cytotoxic drugs for one hour or 24 hours before plating marrow cells in a semisolid agar system. PMID- 3819812 TI - Effects of patient management guidelines on physician practice patterns: the Community Hospital Oncology Program experience. AB - The Community Hospital Oncology Program (CHOP), funded under contracts by the National Cancer Institute (NCI) from 1981 to 1984, was designed to be a model for delivery of the most up-to-date cancer care in the community setting. Site specific patient management guidelines (PMGs) were developed by physicians who saw a majority of cancer patients in each community and represent a consensus of the most current information on pretreatment evaluation and management for each cancer site. There was the potential for PMGs to have a strong effect on physician practice patterns. A patterns of care study (POC) was conducted in the 17 CHOPs to determine the influence of guidelines on practice patterns. The practice elements examined in this report are clinical staging for breast and small-cell lung cancer, medical oncology consultation for breast cancer patients with positive lymph nodes, and radiation therapy consultation for rectal and small-cell lung cancer. These elements were in all CHOP guidelines. Except for physicians most active in the CHOP, the data provide no evidence of diffusion of guideline principles to the majority of practicing physicians. Although all guidelines contained discussion of the importance of staging before definitive treatment for breast cancer, only 33% of the 1,922 charts examined had a stage recorded. In small-cell lung cancer, 67% of the 388 charts examined had stage recorded. The years in practice of the primary physician had an inverse relationship to practice patterns as defined by the guidelines. Physician specialty was also a determinant of practice patterns for small-cell lung cancer. However, participation in guideline development and their dissemination did not significantly influence the patterns of care elements examined in this study. PMID- 3819813 TI - Ifosfamide neurotoxicity in children. PMID- 3819814 TI - Prognostic factors in metastatic carcinoma of unknown primary. PMID- 3819815 TI - An indoleamine system in photoreceptor cell terminals of the Long-Evans rat retina. AB - Uptake of 3H-serotonin is localized to the outer plexiform layer in Long-Evans rat retinas. Autoradiographic accumulation is seen only after in vitro incubation in the light, with retinas isolated from the underlying sclera. Potassium stimulates the release of 3H-serotonin. In this species, amacrine cells do not accumulate these compounds; thus the outer plexiform layer appears to be the only site of uptake and release of this indoleamine. The age-related loss of 3H serotonin accumulation in the outer plexiform layer of retinal dystrophic rats coincides temporally with the spontaneous degeneration of photoreceptor cells that occurs in this species. Electron-microscopic autoradiography of 3H-serotonin accumulation further confirms that uptake is localized to rod and cone terminals in the outer plexiform layer. The specific accumulation of indoleamines into rod and cone terminals that is observed in the light but is absent in darkness suggests that indoles have an important physiological role in photoreceptors. PMID- 3819816 TI - Functional subdivisions of the temporal lobe neocortex. AB - In order to gather evidence on functional subdivisions of the temporal lobe neocortex of the primate, the activity of more than 2600 single neurons was recorded in 10 myelo- and cytoarchitecturally defined subdivisions of the cortex in the superior temporal sulcus (STS) and inferior temporal gyrus of the anterior part of the temporal lobe of 5 hemispheres of 3 macaque monkeys. First, convergence of different modalities into each area was investigated. Areas TS and TAa, in the upper part of this region, were found to receive visual as well as auditory inputs. Areas TPO, PGa, and IPa, in the depths of the STS, received visual, auditory, and somatosensory inputs. Areas TEa, TEm, TE3, TE2, and TE1, which extend from the ventral bank of the STS through the inferior temporal gyrus, were primarily unimodal visual areas. Second, of the cells with visual responses, it was found that some neurons in areas TS-IPa could be activated only by moving visual stimuli, whereas the great majority of neurons in areas TEa-TE1 could be activated by stationary visual stimuli. Third, it was found that there were few sharply discriminating visual neurons in areas TS and TAa; of the sharply discriminating visual neurons in other areas, however, neurons that responded primarily to faces were found predominantly in areas TPO, TEa, and TEm (in which they represented 20% of the neurons with visual responses); neurons that were tuned to relatively simple visual stimuli such as sine-wave gratings, color, or simple shapes were relatively common in areas TEa, TEm, and TE3; and neurons that responded only to complex visual stimuli were common in areas IPa, TEa, TEm, and TE3. These findings show inter alia that areas TPO, PGa, and IPa are multimodal, that the inferior temporal gyrus areas are primarily unimodal, that there are areas in the cortex in the anterior and dorsal part of the STS that are specialized for the analysis of moving visual stimuli, that neurons responsive primarily to faces are found predominantly in areas TPO, TEa, and TEm, and that architectural subdivisions of the temporal lobe cortex are related to neuronal response properties. PMID- 3819817 TI - Site-specific sensitization of defensive reflexes in Aplysia: a simple model of long-term hyperalgesia. AB - Brief, noxious, electrical or mechanical stimulation of the skin of Aplysia produces enhancement of defensive reflexes triggered at the same site for at least a week after the noxious stimulation. This site-specific behavioral sensitization can be expressed as an increase in duration of the siphon withdrawal reflex and as an increase in magnitude of the tail-withdrawal reflex. It is unlikely that peripheral factors play a predominant role in the long-term memory. First, long-term enhancement is blocked when the CNS is disconnected from the noxious stimulation site by nerve transection. Second, long-term enhancement is blocked by preventing neural activation at the noxious stimulation site, indicating that persistent physical damage alone is insufficient to cause the enhancement. A role for activity-dependent extrinsic modulation (ADEM) of mechanosensory neurons is suggested by similar site-specific enhancement produced when weak sensory activation is paired with general modulation elicited by strong stimulation of a distant site. Because this pairing represents a form of classical conditioning, site-specific sensitization and cutaneous classical conditioning appear to be closely related in this system. These findings suggest that site-specific sensitization reflects, at least in part, a central, long-term memory of injury. This form of memory may be phylogenetically widespread, and functionally similar to aspects of hyperalgesia. In addition, the close relationship between site-specific sensitization and cutaneous classical conditioning supports the hypothesis that some forms of classical conditioning evolved from mechanisms of sensitization. PMID- 3819818 TI - Multiple sensory neuronal correlates of site-specific sensitization in Aplysia. AB - Noxious stimulation of a restricted site on the skin of Aplysia (training) causes site-specific sensitization of the tail-withdrawal reflex that is associated with several sensory correlates that are evident both 10 min and 2 hr after training. First, extracellularly recorded afferent activity evoked by test stimulation of the trained site increases, indicating peripheral sensory changes. Second, central sensory alterations are manifested by tail sensory neurons within the pleural VC cluster that innervate the trained site and are activated during training. These mechanosensory/nociceptive cells display a number of differences from unactivated tail sensory neurons innervating other sites: slow depolarization of the soma observed immediately after training, decrease in soma action potential threshold, and enhancement of monosynaptic EPSPs to identified motor neurons. Noxious stimulation of a more extensive region also produces site specific sensitization of the tail-withdrawal reflex and site-specific enhancement of EPSP amplitude measured 1 d after training. This training produced a novel cellular correlate of behavioral enhancement in Aplysia--regenerative bursting responses (2-35 spikes) in response to brief depolarization of the sensory neuron soma. The changes in peripheral and central excitability appear similar to changes associated with mammalian models of primary hyperalgesia. Site specific enhancement of nociceptive signaling also occurs during aversive associative conditioning in a noxious unconditioned stimulus (US) pathway. These site-specific changes involve activity-dependent extrinsic modulation (ADEM) of the VC sensory neurons, suggesting a close relationship to changes underlying associative conditioning in conditioned stimulus (CS) pathways in Aplysia. PMID- 3819819 TI - Mechanisms controlling accurate changes in elbow torque in humans. AB - This paper addresses a fundamental question of how motor commands specify target torque levels. Human subjects produced fast and accurate changes in torque with the isometric elbow joint. Visual stimuli were used to indicate target torque levels as well as to cue subjects to initiate their responses. During rapid changes in torque from one steady-state level to another, target torque was achieved through a sequence of approximations. During the first 200-250 msec of responses produced in the presence of visual feedback, 3 distinct control mechanisms were recruited to guide torque to the target level. The timing and accuracy of each control mechanism were evaluated. The first control mechanism was triggered by the visual stimulus and produced the initial rise in torque. Target torque predictability was found to strongly influence the accuracy of this control mechanism. The second control mechanism produced a corrective adjustment in torque within roughly the first 100 msec of responses. This mechanism incorporated target torque information provided by the stimulus into the response. The third control mechanism began 200-250 msec after response onset and produced corrective adjustments based on visual feedback of torque errors. The stability of the visual feedback mechanism was evaluated because of a long loop delay. Two strategies were used to control stability: low gain and information transfer between the visual feedback mechanism and the preceding (second) control mechanism. PMID- 3819820 TI - Brain-stem perturbations during cortically evoked rhythmical jaw movements: effects of activation of brain-stem loci on jaw muscle cycle characteristics. AB - The purpose of the present study was to further elucidate with the use of microstimulation techniques the influences of rostral pons and midbrain loci on the neuronal networks responsible for cortically induced rhythmical jaw movement (RJM) activity in the anesthetized guinea pig and to establish if these rostral brain-stem loci are capable of modulating the timing as well as the amplitude of rhythmical digastric (DIG) EMG activity. It was found that repetitive electrical stimulation of widespread areas of the rostral pons and mid-brain produced suppression of ongoing cortically induced rhythmical EMG activity. Prior to complete EMG suppression there was a reduction in amplitude of the DIG EMG and an increase in cycle duration. Repetitive stimulation of these suppressive loci also produced a reduction in the amplitude of the short-latency DIG EMG response produced by short pulse train stimulation of the masticatory cortex. This indicates that part of the suppression of cortically induced rhythmical EMG activity was due to a reduction in excitability of the polysynaptic short-latency pathway from cortex to DIG motoneurons. Short pulse train stimulation of these brain-stem suppressive loci during various phases of the rhythmical DIG cycle produced a phase-dependent increase in duration of the ongoing perturbed cycle. The cycles following the stimulus perturbation did not show any compensatory shortening in their durations suggesting that the stimulus produced a true resetting of the cycle. These data suggest that the brain-stem loci that produce suppression of RJMs evoked by repetitive cortical stimulation can affect the excitability of the central circuits responsible for cycle oscillation and timing as well as the excitability of the polysynaptic short-latency corticotrigeminal pathway to DIG motoneurons. PMID- 3819821 TI - Spatial and temporal selectivity in the suprasylvian visual cortex of the cat. AB - We recorded from single units in the medial and lateral banks of the posterolateral suprasylvian visual cortex (PMLS/PLLS) of the cat. The responses to drifting high-contrast gratings of optimum orientation and direction of motion, but varying in spatial and temporal frequency, were examined quantitatively for a sample of cells, whose receptive fields covered a wide range of eccentricities. The optimum spatial frequencies (average about 0.2 cycles/deg) were low compared to the values reported for striate cortex but similar to those for area 18. The mean spatial bandwidth (about 2 octaves) was slightly broader than that of cells in other cortical visual areas. The cut-off spatial frequencies ("acuities") covered a wide range, from 0.05 to 2.1 cycles/deg, similar to those of cells in area 18. Responses to drifting sinusoidal gratings were usually dominated by an unmodulated elevation of discharge, although some modulation occurred at the temporal frequency of drift, especially at low spatial frequencies. Modulated responses were relatively stronger in PMLS than in PLLS. For those cells that responded to flashed stimuli, stationary, contrast-modulated gratings presented at different spatial positions typically evoked small responses at the fundamental frequency (dependent on spatial phase) and a larger component at the second harmonic of temporal frequency, with no overall "null position." The optimum spatial frequency was usually higher than would be predicted by simple summation within the dimensions of the receptive field. Thus, neurons in PMLS and PLLS, like complex cells in areas 17 and 18, behave nonlinearly and their spatial selectivity is determined by "subunits" smaller than their receptive fields. The range of preferred temporal frequencies ranged from less than 2.5 Hz to more than 10 Hz. In their temporal selectivity neurons in PMLS resembled cells in area 17, with little attenuation at low temporal frequencies, whereas there was a tendency for cells in PLLS to prefer higher temporal frequencies, as is common in area 18. PMID- 3819822 TI - Response properties of nociceptive and low-threshold mechanoreceptive neurons in the hamster superior colliculus. AB - There are many somatosensory neurons in the hamster superior colliculus (SC); some respond to innocuous tactile stimuli, while others respond either preferentially, or solely, to noxious stimuli. Yet, there are little quantitative data describing the responses of these neurons. We sought to provide such information by relating stimulus intensity to the magnitude of the neural response using controlled innocuous and noxious mechanical and thermal stimuli. Of 122 somatosensory SC neurons studied in urethane-anesthetized hamsters, the majority (52%) had low-threshold mechanoreceptive properties (LT). LT neurons had force thresholds less than 1 gm, adapted rapidly to maintained stimuli, and did not respond with higher numbers of impulses to noxious mechanical or thermal stimuli. A smaller, though substantial, proportion of neurons (45%) responded either preferentially, or solely, to noxious stimuli. A few neurons (3%) were inhibited by either light tactile or noxious mechanical stimuli. Two populations of nociceptive neurons were found and classified either as wide dynamic range (WDR) neurons (n = 25), those that responded to gentle mechanical, noxious mechanical, and/or thermal stimuli; or nociceptive-specific (NS) neurons (n = 30), those that responded solely to high-intensity mechanical or noxious thermal stimuli. WDR neurons responded monotonically to increases in the intensity of innocuous mechanical stimuli, and displacement-response relationship for this population was a slightly negatively accelerating power function with an exponent of 0.785. However, the thermal stimulus-response relationships (to graded skin temperatures) of both WDR and NS neurons were positively accelerating power functions with exponents of 2.3 and 2.5 (r2 = 0.988), respectively. These values are consistent with both electrophysiological data from dorsal horn nociceptive neurons and from human psychophysical results using the same range of thermal stimuli. These experiments demonstrate that SC neurons are capable of signaling not only the presence and location of a noxious stimulus but its intensity as well. Presumably, these neurons play a significant role in the animal's reactions to potentially harmful stimuli. The partial laminar segregation of WDR and NS neurons may reflect different involvements of particular nociceptive subtypes in the various overt responses mediated by the SC. PMID- 3819823 TI - FMRFamide-like substances in the leech. III. Biochemical characterization and physiological effects. AB - FMRFamide-like immunoreactivity has been previously localized to identified neurons in the CNS of the leech, Hirudo medicinalis (Kuhlman et al., 1985a). These leech antigens have been characterized biochemically by reverse-phase high pressure liquid chromatography (HPLC) followed by radioimmunoassay (RIA). The majority of the FMRFamide-like immunoreactivity recovered by HPLC from extracts of leech nerve cords coelutes with authentic FMRFamide. We have tentatively identified this major leech peptide as authentic FMRFamide. Two neurons that control heartbeat in the leech, the HE motor and HA modulatory neurons, and their neural processes on the heart are FMRFamide-like immunoreactive (Kuhlman et al., 1985a). Single individually dissected HE and HA cells were analyzed by HPLC and RIA. Only 1 FMRFamide-like peptide was found in extracts of HA cells; this peptide was chromatographically indistinguishable from authentic FMRFamide. The FMRFamide-like peptide in HE cells could not be isolated by experimental procedures used. Most of the FMRFamide-like immunoreactivity contained within the neural processes on the heart also coeluted with authentic FMRFamide. HE motor neurons, which are believed to be cholinergic (Wallace, 1981a, b; Maranto and Calabrese, 1984a, b), were examined for their FMRFamide-like effects on the heart. The presence of curare in the bathing medium did not block the ability of FMRFamide to induce myogenic activity in heart muscle, suggesting that FMRFamide and ACh act at different receptor sites on the heart. Prolonged firing in HE cells in the presence of curare also induced myogenic activity in heart muscle. This FMRFamide-like action of the HE motor neurons may be normally masked by their cholinergic actions. PMID- 3819824 TI - A steroid anesthetic prolongs inhibitory postsynaptic currents in cultured rat hippocampal neurons. AB - Whole-cell patch-clamp recordings were made from cultured rat hippocampal neurons to examine the effects of the steroidal general anesthetic alphaxalone (3 alpha hydroxy 5 alpha-pregnane 11,20-dione) on responses to pharmacologically applied and physiologically released GABA. At low micromolar concentrations in the anesthetic range, alphaxalone potentiated Cl- conductance responses elicited by GABA and also prolonged evoked GABA-mediated postsynaptic potentials. Under voltage clamp at -40 mV, rapid outwardly directed synaptic currents were evoked that decayed with single exponential kinetics; mean decay time constant was 24 msec at room temperature. Alphaxalone prolonged the decay of these inhibitory postsynaptic currents by 5- to 8-fold, with no increase in peak amplitude or change in growth time. This substantial prolongation of GABA-mediated inhibitory synaptic conductance at clinically effective concentrations may contribute significantly to the anesthetic activity of alphaxalone. PMID- 3819825 TI - Nerve fiber growth in culture on tissue substrata from central and peripheral nervous systems. AB - In adult mammals, injured neurons regenerate extensively within the PNS but poorly, if at all, within the CNS. We have studied the effect of substrata consisting of tissue sections from various nervous systems on nerve fiber growth in culture and correlated our results with the growth potential of these tissues in vivo. Ganglionic explants from embryonic chicks (9-12 d) fail to extend nerve fibers onto sections of adult rat optic nerve or spinal cord (CNS) but do so on sciatic nerve (PNS). Dissociated DRG neurons behave similarly whether in serum containing or defined medium. Tissue substrata from nervous systems that support regeneration in vivo--i.e., goldfish optic nerve, embryonic rat spinal cord, degenerating sciatic nerve--also support fiber growth in culture. Within the same culture, neurons will grow onto sciatic nerve rather than neighboring optic nerve sections, suggesting that the responsible agent(s) is not soluble. In addition, neurons adhere more extensively to sciatic nerve substrata than to optic nerve. The occurrence of 3 molecules known to be involved in neuron-substratum adhesion and nerve fiber growth in vitro has been documented immunocytochemically in the tissue sections. One of these, laminin, is demonstrable in all tissues tested that supported nerve fiber growth. Immunoreactivities for fibronectin and heparan sulfate proteoglycan are found in only some of these tissues. None of these 3 molecules can be demonstrated in neural cells of normal adult rat CNS tissue. Our data suggest that these molecules may be important effectors of nerve regeneration in neural tissues. PMID- 3819826 TI - Variants of radiculomeningeal vascular malformations of the spine. AB - In recent years, it has become evident that the most common form of arteriovenous malformation to involve the spinal cord in adults is a low-flow fistula with its nidus located on the dura in relation to the dorsal nerve root. This lesion, termed "radiculomeningeal fistula" (RMF), is drained by the intradural coronal venous system and most likely causes neurological deficits due to raised venous pressure within the spinal cord. The therapy that was formerly recommended was multilevel laminectomy with microsurgical stripping of the intradural vessels. However, that procedure focused on the draining veins rather than the nidus, and it has been replaced by direct treatment of the nidus or by disconnecting the nidus from the coronal venous system. This paper reports variants of RMF's that show a wider spectrum of the clinical and radiological findings than has been previously reported. Three patients presenting with extradural venous drainage, intraspinal hemorrhage, and/or sudden non-hemorrhagic neurological decline are reported. A more complete understanding of RMF facilitates the radiological and clinical evaluation of these patients and enables the surgeon to modify the therapy in a significant way. PMID- 3819827 TI - Thoracic spinal canal stenosis. AB - Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological, metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Over a 2-year period the authors have treated six cases of thoracic myelopathy associated with thoracic canal stenosis. In four patients the deficits developed gradually and painlessly. The three older patients had a clinical profile characterized by complaints of pseudoclaudication, spastic lower limbs, and evidence of posterior column dysfunction. Two patients were younger adults with low thoracic myelopathy associated with local back pain after minor trauma. Both patients also had congenital narrowing of the thoracic spinal canal. Oil and metrizamide contrast myelography in the prone position were of limited value in diagnosing this condition; in fact, myelography may be misleading and result in erroneous diagnosis of thoracic disc protrusion, when the principal problem is dorsal and lateral compression from hypertrophied facets. Magnetic resonance imaging and computerized tomography sector scanning were more useful in the diagnosis of this disorder than was myelography. Thoracic canal stenosis may be more common than is currently recognized and account for a portion of the failures in anterior and lateral decompression of thoracic disc herniations. PMID- 3819828 TI - Interhemispheric approach for the surgical removal of thalamocaudate arteriovenous malformations. AB - A series of 250 surgically treated cerebral arteriovenous malformations (AVM's) is presented, in which 22 lesions were located primarily in the thalamus and caudate nucleus. A standardized interhemispheric approach through the posterior corpus callosum and into the atrium of the lateral ventricle was utilized for the surgical removal of these AVM's. Total removal was confirmed by angiography in 18 patients; removal was subtotal in four cases. There were no deaths in this group of patients. Disturbances of recent memory pre- and postoperatively were seen in half of the patients, but most of these deficits were temporary. Other complications included: postoperative homonymous hemianopsia (six cases), transient hemiparesis (three cases), hemisensory loss (two cases), Parinaud's syndrome (one case), and recurrent hemorrhage 2 years after surgery (one case). All 22 patients returned to their previous occupations and are leading independent lives. The results of this experience indicate that thalamocaudate AVM's can be effectively treated by resection. PMID- 3819829 TI - Surgical treatment of arteriovenous malformations of the striatothalamocapsular region. AB - Sixteen patients with arteriovenous malformations (AVM's) located in the striatothalamocapsular region were treated microsurgically at the Hau Shan Hospital, Shanghai. These AVM's had a tendency to bleed intracerebrally and typically presented with hemiplegia, hemianesthesia, and hemianopsia. Angiographically the lesions were primarily located in the triangle of Reil. Postoperative outcome was not as good as that of AVM's in other locations, but the operation may have prevented the risk of further hemorrhage. This report details the operative technique used and the clinical course in this group of patients. PMID- 3819830 TI - Risk of intracranial hemorrhage in glioma patients receiving anticoagulant therapy for venous thromboembolism. AB - To determine the risk of intracranial hemorrhage in patients with malignant gliomas who are treated with anticoagulant drugs for late postoperative venous thromboembolism, the authors retrospectively reviewed the computerized data base of all patients with primary brain tumors seen at the University of California, San Francisco, over a 9-year period. Of 915 patients 18 years of age or older who had a pathological diagnosis of malignant glioma and an initial Karnofsky performance scale score of 60% or higher, 36 (4%) developed venous thromboembolism 6 to 246 weeks postoperatively and 22 were treated with anticoagulant drugs. Anticoagulant therapy usually consisted of intravenous heparin for 7 to 10 days, followed for at least 3 to 6 months by either subcutaneous heparin (5000 to 8000 U twice daily) or oral warfarin. All patients were closely monitored to ensure control of hypertension, compliance with therapy, maintenance of prothrombin time within the therapeutic range, and early recognition of adverse side effects. No patient had an intracranial hemorrhage. Thus, anticoagulant agents can be safely administered after intracranial operations for malignant gliomas without increased risk of morbidity or mortality if the patients are carefully monitored according to established guidelines. PMID- 3819831 TI - Long-term results of praziquantel therapy in neurocysticercosis. AB - The long-term results of praziquantel therapy in 141 patients with neurocysticercosis are presented. Seventy-five patients (53%) were considered to be cured because the cysts or nodules disappeared or became calcified following praziquantel treatment and the patients were asymptomatic at the end of a 5-year follow-up period. An additional 35 patients (24.8%) improved clinically and radiographically. The intraventricular Cysticercus cysts of five patients in this group were not affected by praziquantel and had to be surgically removed. The remaining 31 patients (21.9%) were unchanged or became worse probably because, prior to therapy, Cysticercus larvae had caused tissue damage. The fact that praziquantel did not affect intraventricular cysts suggests a low concentration of the drug in the cerebrospinal fluid. Surgery continues to be an important tool in the treatment of cysticercosis to remove parasites that do not respond to praziquantel therapy as well as for the relief of intracranial hypertension. PMID- 3819832 TI - Cerebral blood flow in patients with normal-pressure hydrocephalus before and after shunting. AB - Cerebral blood flow (CBF) was measured by xenon-133 inhalation and single photon emission tomography in 17 demented patients with normal-pressure hydrocephalus before and after shunt treatment. All patients had a decreased conductance to outflow (C out) of cerebrospinal fluid as measured by lumboventricular perfusion (C out less than 0.12 ml X mm Hg-1 X min-1). Computerized tomography (CT) scanning, clinical assessment, and neuropsychological grading were performed pre- and postoperatively. The preoperative CBF studies revealed abnormal flow patterns in all patients. Fourteen patients showed moderate-sized, large, or very large central low-flow areas, and four patients had reduced flow bilaterally in the occipital and contiguous temporoparietal regions. After shunting, six patients had a significant reduction in the size of the central low-flow area on the CBF map, agreeing well with the changes of ventricular size on the CT scan. All six patients showed an improvement in either clinical or neuropsychological grading. In 10 of the remaining 11 patients flow patterns were essentially unchanged; one patient deteriorated further. Four of these 11 patients improved on postoperative clinical or neuropsychological testing. Thus, a positive correlation was found between the changes in CBF and the reduction of the ventricular size on the CT scan, but changes in CBF as measured by the present technique did not accompany improvement in the functional state in all patients. PMID- 3819833 TI - Physiological and metabolic response to isolated closed-head injury. Part 2: Effects of steroids on metabolism. Potentiation of protein wasting and abnormalities of substrate utilization. AB - In order to determine the effects of steroid administration on the metabolic response to isolated closed-head injury, a longitudinal study was performed. Metabolic indices were prospectively evaluated for the first 5 days postinjury in six patients who received steroids and 10 patients who did not. Patients were carefully screened to eliminate those with associated injuries as well as those with abnormalities due to sepsis. Other than steroid administration, a uniform treatment regimen was used in both groups. Metabolic indices measured on postinjury Days 1, 3, and 5 were analyzed. In addition, data were compared to results in large data banks obtained both from overnight-fasted patients (fasted controls) and from polytrauma victims (stressed controls). Both treatment groups were comparable with respect to age, mean Glasgow Coma Scale scores on admission and on Day 5, and initial intracranial pressure. Metabolic data indicated significantly higher levels of nitrogen excretion and somatic protein mobilization in steroid-treated patients than in patients not receiving steroids. In both groups, glucose levels, the lactate/pyruvate ratio, and branched-chain amino acid levels (all metabolic indices that correlate well with level of stress) initially corresponded to values for stressed controls. By Day 5, values for these variables were similar to fasted controls for the group not receiving steroids. In patients receiving steroids, however, the data remained similar to those for stressed controls. It is concluded that steroids prolong the metabolic abnormalities associated with the initial phase of head injury. In view of inconclusive data regarding benefit from steroid administration, serious questions must be raised regarding the use of these catabolic agents in this setting. PMID- 3819834 TI - Deterioration following spinal cord injury. A multicenter study. AB - The results are presented of a prospective study of the course of 283 spinal cord injured patients who were consecutively admitted to five trauma centers participating in the Comprehensive Central Nervous System Injury Centers' program of the National Institutes of Health. Of the 283 patients, 14 deteriorated neurologically during acute hospital management. In 12 of the 14, the decline in neurological function could be associated with a specific management event, and in nine of these 12 the injury involved the cervical cord. Nine of the 14 patients who deteriorated had cervical injuries, three had thoracic cord injuries, and two had thoracolumbar junction injuries. Management intervention was identified as the cause of deterioration in four of 134 patients undergoing operative intervention, in three of 60 with skeletal traction application, in two of 68 with halo vest application, in two of 56 undergoing Stryker frame rotation, and in one of 57 undergoing rotobed rotation. Early surgery on the cervical spine when cord injury is present appears hazardous, since each of the three patients with a cervical cord injury who deteriorated was operated on within the first 5 days. No such deterioration was observed following surgery performed from the 6th day on. In two other patients, deterioration did not appear to be related to management but was a direct product of the underlying disease or of systemic complications. Deterioration following hospitalization for spinal cord injury is relatively uncommon--4.9% in this large series. In most instances, decline in function could be attributed to specific management procedures. These changes must not be interpreted as representing failure to provide optimal care but rather should be seen as the inevitable product of an attempt to manage patients with spinal cord and column injuries, many of which are clearly unstable. PMID- 3819835 TI - Correlation of meningioma hormone receptor status with hormone sensitivity in a tumor stem-cell assay. AB - Several investigators have detected progesterone receptors in a high percentage of meningioma specimens and have noted progesterone receptors to be more common than estrogen receptors in these specimens. However, a functional significance of such hormone receptor positivity in control of meningioma growth has not been described. This paper describes a paired test of the estrogen and progesterone receptor assay as the biochemical assay and of the human tumor stem-cell clonogenic assay (HTSCCA) as the functional assay in 17 meningioma specimens. Only one (6%) of the 17 specimens was estrogen receptor-positive, while 11 (69%) of 16 specimens were progesterone receptor-positive. The HTSCCA revealed that only two (15%) of 13 specimens were sensitive to estradiol while five (31%) of 16 specimens were sensitive to progesterone. Comparison of progesterone results for the 15 specimens on which both hormone receptor assay and HTSCCA were performed revealed correlation in a majority of cases; four specimens were positive for both assays and five specimens were negative for both assays. No specimen that was negative for progesterone receptors was sensitive to progesterone by HTSCCA. These results suggest that the hormone receptor and sensitivity pattern of meningiomas may differ from that of breast cancer, and that progesterone addition or ablation may be a reasonable therapeutic approach for meningiomas. PMID- 3819836 TI - The shaken baby syndrome. A clinical, pathological, and biomechanical study. AB - Because a history of shaking is often lacking in the so-called "shaken baby syndrome," diagnosis is usually based on a constellation of clinical and radiographic findings. Forty-eight cases of infants and young children with this diagnosis seen between 1978 and 1985 at the Children's Hospital of Philadelphia were reviewed. All patients had a presenting history thought to be suspicious for child abuse, and either retinal hemorrhages with subdural or subarachnoid hemorrhages or a computerized tomography scan showing subdural or subarachnoid hemorrhages with interhemispheric blood. The physical examination and presence of associated trauma were analyzed; autopsy findings for the 13 fatalities were reviewed. All fatal cases had signs of blunt impact to the head, although in more than half of them these findings were noted only at autopsy. All deaths were associated with uncontrollably increased intracranial pressure. Models of 1-month old infants with various neck and skull parameters were instrumented with accelerometers and shaken and impacted against padded or unpadded surfaces. Angular accelerations for shakes were smaller than those for impacts by a factor of 50. All shakes fell below injury thresholds established for subhuman primates scaled for the same brain mass, while impacts spanned concussion, subdural hematoma, and diffuse axonal injury ranges. It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome. PMID- 3819837 TI - Effect of clot removal at 24 hours on chronic vasospasm after SAH in the primate model. AB - The efficacy of complete clot removal 24 hours after subarachnoid hemorrhage (SAH) in the prevention of chronic cerebral vasospasm was evaluated in monkeys in a blind randomized controlled trial. Twenty-four monkeys were randomized to one of three groups to undergo sham-operation (sham-operated group), clot placement only (clot group), or clot placement and removal (clot-removal group). By means of standard microsurgical techniques, the major cerebral vessels bilaterally were dissected free of arachnoid. An autologous hematoma averaging 5 gm was placed around the vessels in the subarachnoid spaces in the clot and clot-removal groups. Saline solution was instilled in the subarachnoid spaces of the sham operated group. All animals underwent reoperation 24 hours after the first procedure. In the clot-removal group, the hematoma was evacuated. In the sham operated and clot groups, the incision was simply closed again after 3 hours of anesthesia. Indices monitored before and 7 days after SAH induction included neurological status, angiographic cerebral vessel caliber, and arterial blood pressure. All animals were evaluated with magnetic resonance imaging (MRI); representative animals were evaluated with computerized tomography (CT) brain scans. There were no neurological deficits in either the sham-operated or the clot-removal groups. One animal in the clot group developed a progressive delayed ischemic deficit on Day 5 after SAH. A second animal in this group died suddenly on Day 4 post-SAH. An autopsy revealed a recent infarct in the territory of the superior cerebellar artery. Clinical findings correlated with MRI and CT images. Significant vasospasm (25% to 100% reduction in vessel caliber) was present on Day 7 in 100% of the clot animals (p less than 0.01). There was no significant vasospasm (p greater than 0.05) on Day 7 in either the sham-operated or the clot removal groups. A large volume of clot placed bilaterally resulted in a 25% incidence of delayed ischemic deficit. Evacuation of subarachnoid hematoma within 24 hours of SAH prevented the development of chronic vasospasm and delayed ischemic deficit in the primate model. PMID- 3819838 TI - Effect of a calcium channel blocker on posttraumatic spinal cord blood flow. AB - The normal rat spinal cord blood flow (SCBF) has been shown to increase after administration of nimodipine, a calcium channel blocker. The present study investigates the capability of nimodipine to improve SCBF, as measured by the hydrogen clearance technique, after a 53.0-gm clip compression injury to the T-1 segment of the rat spinal cord. The profound drop in mean systemic arterial blood pressure (MSAP) after cervical cord injury precluded any improvement in posttraumatic SCBF by nimodipine alone. Hence, in a randomized controlled study with five rats per group, pressor agents (whole blood, angiotensin, or adrenaline) were infused to maintain MSAP between 100 and 120 mm Hg after injury. Control animals received only a saline infusion. Nimodipine at the optimal dose found in normal animals (1.5 microgram/kg/min) was added to the pressor agents. The MSAP and other physiological parameters were measured in rats receiving the pressor agents only and in those receiving pressor agents combined with nimodipine. In rats receiving whole blood, angiotensin, or adrenaline the posttraumatic MSAP improved to between 100 and 120 mm Hg, but there was no improvement in SCBF compared to the saline group. The addition of nimodipine decreased MSAP and SCBF in all groups except those animals also receiving adrenaline, where the MSAP was maintained at 109 +/- 5 mm Hg. In these animals a significant increase in posttraumatic SCBF from 16.5 +/- 2.1 to 20.2 +/- 2.3 ml/100 gm/min (mean +/- standard error of the mean) occurred at the site of injury with the addition of nimodipine. The maintenance of an adequate MSAP by a pressor agent was crucial for nimodipine to improve posttraumatic SCBF by its ability to dilate the spinal vascular bed. Adrenaline was the only pressor agent that could fulfill the above criteria, although other pressor agents need to be investigated. Experiments are underway with the combination of adrenaline and nimodipine to further verify these encouraging results demonstrating an improvement in posttraumatic ischemia of the spinal cord. PMID- 3819839 TI - Microangioarchitecture of the feline spinal cord. Three-dimensional observation of blood vessel corrosion casts by scanning electron microscopy. AB - The microangioarchitecture of corrosion casts of the cat spinal cord was studied by scanning electron microscopy. On the ventral surface of the spinal cord, the anterior spinal artery and the anterior spinal vein ran parallel along the anterior median fissure. Many central arteries branching from the anterior spinal artery coursed in a wavelike manner in the anterior median fissure. The number of central arteries was lowest in the thoracic spinal cord. Central arteries at some spinal cord levels revealed well-developed anastomoses with other central arteries in the anterior median fissure. These well-developed anastomotic central arteries were frequently observed in the thoracic spinal cord, in which the number of central arteries was lowest. On the dorsal surface of the spinal cord, the posterior spinal vein ran longitudinally at the midline and was drained by circumferential veins and posterior central veins. This vein formed a characteristic anastomotic plexus. Small arterioles (20 microns in diameter) in the spinal parenchyma revealed a ring-like compression at the branching site. PMID- 3819840 TI - Multiple intracranial aneurysms due to Coccidioides immitis infection. Case report. AB - True mycotic (fungal) aneurysms are distinctly uncommon. The case of a young woman with multiple intracranial aneurysms of Coccidioides immitis origin is presented. Coccidioides immitis organisms are not uncommon central nervous system pathogens and usually cause basilar meningitis and hydrocephalus. There are no previous reports of a coccidioidal mycotic aneurysm. The management of intracranial coccidioidomycosis and fungal aneurysms is reviewed. PMID- 3819841 TI - Lumbosacral intramedullary myolipoma. Case report. AB - Intradural myolipoma is an unusual tumor. A case is described in which extramedullary and intramedullary striated muscle fibers caused gross contraction of a lipomatous tumor as well as of the spinal cord during electrical stimulation. PMID- 3819842 TI - Sleep palsy (Saturday-night palsy) of the deep radial nerve. Case report. AB - A patient with a long-recognized asymptomatic lipoma adjacent to the deep radial nerve developed paralysis of this nerve from a compression similar to the sleep palsy, or "Saturday-night palsy," mechanism. PMID- 3819843 TI - Spontaneous carotid-cavernous fistula and multiple arterial dissections in type IV Ehlers-Danlos syndrome. Case report. AB - A 43-year-old woman without phenotypic expression of Ehlers-Danlos syndrome developed a spontaneous unilateral carotid-cavernous fistula (CCF). Attempts at balloon occlusion of the CCF were unsuccessful, and caused multiple arterial dissections and lacerations eventually leading to massive retroperitoneal hemorrhage and death. The CCF was demonstrated during postmortem studies. In addition, the patient had independent dissections of the internal carotid artery at the site of the fistula and an intracavernous aneurysm of the contralateral internal carotid artery. Despite widespread dissections, the major arteries showed only mild histological abnormalities. Morphometric analysis of collagen from the aorta revealed an increase in large-sized fibers, consistent with deficiency of Type III collagen. PMID- 3819844 TI - Treatment of bilateral spontaneous dural carotid-cavernous fistulas by coils and sclerotherapy. Case report. AB - A case of bilateral spontaneous carotid-cavernous fistulas producing increased intraocular pressure is reported. The fistulas lay between the meningeal branches of the internal carotid artery (ICA) and the cavernous sinus, but the ICA itself was not involved. Successful treatment was accomplished by the introduction of steel coils and a sclerotic liquid into the cavernous sinus via the distal superior ophthalmic vein. PMID- 3819845 TI - Reconstruction of cerebral cortical veins using silicone tubing. Technical note. AB - A technique for reconstruction of a cerebral cortical vein which has been sacrificed during an interhemispheric or subtemporal surgical approach is described. The method involves the use of silicone tubing. The author's clinical experience in six patients is summarized. PMID- 3819846 TI - CT localization of a convexity brain tumor on the scalp. Technical note. AB - Preoperative localization of a tumor on the scalp can be achieved with the help of computerized tomography (CT) but is liable to error. A simple method is presented to relate the data provided by the CT scan precisely to the scalp of the patient. PMID- 3819847 TI - Incision of facial nerve branch at aneurysm surgery. PMID- 3819848 TI - Effect of early aneurysm surgery and nimodipine administration. PMID- 3819849 TI - Effectiveness of chymopapain chemonucleolysis. PMID- 3819850 TI - Quantitation of iodine-123 MIBG uptake by normal adrenal medulla in hypertensive patients. AB - Eighteen hypertensive patients with a clinical suspicion of pheochromocytoma and raised or borderline raised plasma catecholamine and urinary vanillyl mandelic acid (VMA) levels were studied by scintigraphy using 123I-labeled metaiodobenzylguanidine (MIBG). None of these patients had any scintigraphic evidence of pheochromocytoma at the time of study or on subsequent clinical follow-up. A quantitative approach was taken to calculate the adrenal medullary uptake of [123I]MIBG in these patients. Three different methods of quantitation were evaluated using data acquired from an anthropomorphic phantom and analysed by three independent observers. In the patient studies 34 out of 35 adrenal medullas were visualized with uptake in the range of 0.01-0.22% of the administered dose 22 hr postinjection which was calculated using the preferred quantitation method. This is an appropriate control group range for comparison with patients who have proven norepinephrine and epinephrine secreting tumors. A quantitative approach to [123I]MIBG imaging provides an important tool for studying adrenomedullary pathophysiology. PMID- 3819851 TI - Comparison of the biodistribution of manganese-54 DTPA and gadolinium-153 DTPA in dogs. AB - The biodistribution of [54Mn]DTPA and [153Gd]DTPA dimeglumine were investigated and compared following i.v. administration to fasting anesthetized dogs. Unlike most previously reported metal ion-DTPA complexes, [54Mn]DTPA showed high uptakes in several organs including the liver, bile, pancreas, bowel, and kidney. This uptake was independent of the pH of the injected solution. Accumulation in these organs suggests a potential role for [Mn]DTPA as a paramagnetic contrast agent for NMR imaging. With the exception of the kidneys, [153Gd]DTPA showed no evidence of tissue specific uptake over the course of 4 hr, consistent with it being an extracellular ion that is cleared by glomerular filtration. PMID- 3819852 TI - Radioactive iodine exchange reaction of HIPDM: kinetics and mechanism. AB - In conjunction with single photon emission computed tomography (SPECT), iodine 123 (123I)-labeled N,N,N'-trimethyl-[2-hydroxy-3-methyl-5-iodobenzyl]-1,3 propanediamine (HIPDM) has been used clinically as a regional cerebral perfusion imaging agent. The [123I]HIPDM can be prepared by a simple aqueous exchange reaction in a kit form. We synthesized unlabeled HIPDM by condensation of 2 hydroxy-3-methyl-5-iodobezaldehyde and N,N,N'-trimethyl-1,3-propanediamine, followed by a sodium borohydride reduction reaction. The kinetics of the radioactive iodine exchange reaction for the preparation of [123I]HIDM is controlled by the pH, the temperature, and the presence of reductant (sodium bisulfite), and oxidant (sodium iodate). The reaction is a second order iodine iodine exchange with an activation energy of 30.6 kcal/mole. The mechanism of this reaction probably involves the formation of an active 1+ or iodine free radical, which is sensitive to the presence of a reductant, such as sodium bisulfite. PMID- 3819853 TI - Single-sample method for the estimation of glomerular filtration rate in children. AB - A method for the determination of the glomerular filtration rate (GFR) in children which involves the use of a single-plasma sample (SPS) after the injection of a radioactive indicator such as radioiodine labeled diatrizoate (Hypaque) has been developed. This is analogous to previously published SPS techniques of effective renal plasma flow (ERPF) in adults and children and GFR SPS techniques in adults. As a reference standard, GFR has been calculated from compartment analysis of injected radiopharmaceuticals (Sapirstein Method). Theoretical volumes of distribution were calculated at various times after injection (Vt) by dividing the total injected counts (I) by the plasma concentration (Ct) expressed in liters, determined by counting an aliquot of plasma in a well type scintillation counter. Errors of predicting GFR from the various Vt values were determined as the standard error of estimate (Sy.x) in ml/min. They were found to be relatively high early after injection and to fall to a nadir of 3.9 ml/min at 91 min. The Sy.x Vt relationship was examined in linear, quadratic, and exponential form, but the simpler linear relationship was found to yield the lowest error. Other data calculated from the compartment analysis of the reference plasma disappearance curves are presented, but at this time have apparently little clinical relevance. PMID- 3819855 TI - Relationship between thallium uptake and blood flow. PMID- 3819854 TI - Gastroesophageal reflux demonstrated by hepatobiliary imaging in scleroderma. AB - Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide. PMID- 3819856 TI - Correction factor for left ventricular volume measurement. PMID- 3819857 TI - Mathematic models to assess platelet kinetics. PMID- 3819859 TI - Simulation of the metabolism of absorbed energy-yielding nutrients in young sheep: efficiency of utilization of lipid and amino acid. AB - A previously described mathematical model that simulates the metabolism of absorbed nutrients in a sheep weighing 25 kg was used to examine the effects of altering lipid and amino acid absorption, and the potential of the animal to deposit protein on the efficiency of utilization (kf) of metabolizable energy. The predicted kf of energy from lipid added to several diets ranged from 0.65 to 0.74 and was influenced by both the protein and glucose content of the diet. The highest efficiency occurred when body protein deposition was limited by amino acid absorption. Lower values occurred with high protein diets when the proportion of body energy deposited as fat declined and, with low protein diets, when NADPH supply limited the synthesis of fatty acids from acetyl-CoA. Predicted kf of energy from amino acid added to several diets ranged from 0.003 to 0.47. Low values occurred when protein synthesis was limited by amino acid absorption; an increase in amino acid supply increased ATP utilization for protein synthesis and substantially reduced fat deposition with little resulting change in energy retention. The higher values occurred when most of the additional amino acid was oxidized. Glucose supply increased the kf of added amino acid primarily by reducing the synthesis of glucose from amino acids. Predicted kf of a whole diet generally declined as the proportion of protein in the diet increased. However, when the balance of absorbed nutrients was such that fat synthesis was limited by the supply of NADPH, kf increased with increasing dietary protein. Predicted kf of a diet also declined when the proportion of body energy deposited as protein increased, except when fat synthesis was limited by the supply of NADPH. The predictions suggest that kf is determined primarily by the energetic efficiency of biochemical reactions for maintenance and growth. However, most kf values less than 0.5 were associated with a flux of more than 1 g mol/d of ATP through the degradation pathway (representing substrate cycles) that occurred when NADPH supply limited the synthesis of fatty acids from acetyl-CoA. PMID- 3819858 TI - Simulation of the metabolism of absorbed energy-yielding nutrients in young sheep: efficiency of utilization of acetate. AB - A previously described mathematical model that simulates the metabolism of absorbed nutrients was used to examine factors influencing the efficiency of utilization of acetate in a sheep weighing 25 kg. A significant component of the model was a function representing substrate cycles that degraded ATP when its concentration reached twice initial levels. Acetate utilization was simulated when up to 2 g mol/d were added to four diets (representing forages and concentrates) that supplied varying proportions of absorbed volatile fatty acids, glucose and protein. The basal diets provided either 4.375 (near energy balance) or 8.75 MJ/d absorbed energy. The predicted net efficiency of utilization (kf) of the energy in added acetate was high (0.58-0.70) for all combinations of absorbed nutrients at the low level of energy absorption, whereas at the higher level, it ranged from 0.16 (forage) to 0.49 (high protein concentrate). Low kf values were always associated with a considerable flux of ATP through the degradation pathway. The increase in ATP concentration that caused this pathway to operate was linked to an inhibition in the utilization of acetyl-CoA for fatty acid synthesis and an increase in its oxidation. The simulated addition of exogenous NADPH or its precursors (particularly glucose and propionate) to these diets repartitioned acetyl-CoA flux towards fatty acid synthesis instead of oxidation, decreased the flux of ATP through the degradation pathway and increased the kf of added acetate. Although a negative relationship was predicted between kf of added acetate and NADPH production for diets with increasing protein content, kf still depended on ATP flux through the degradation pathway. Addition of glucose to the high protein diets decreased this flux by decreasing acetyl-CoA oxidation and increasing fatty acid synthesis. The predictions suggest that the efficiency of acetate utilization in ruminants may be influenced by NADPH availability when a considerable amount of absorbed energy is derived from acetate. Increased absorption of glucose or propionate enhanced NADPH production, but the major effect on acetate utilization of increasing dietary protein was not through NADPH production. PMID- 3819860 TI - Manganese balance and clinical observations in young men fed a manganese deficient diet. AB - A balance study was conducted to determine the minimum requirement for manganese (Mn) and to examine the effects of Mn depletion. Seven male subjects, age 19-22, were fed a Mn-adequate diet of conventional foods (2.59 mg Mn/d, 135 mg cholesterol, and P:S ratio of 0.86) for 3 wk to establish base-line data. Then a purified diet containing 0.11 mg Mn/d was fed for 39 d (depletion), followed by two 5-d periods of 1.53 and 2.55 mg Mn/d (repletion). Diets, feces, urine, and integument were analyzed for Mn, and blood was analyzed for Mn, cholesterol, and other constituents. Plasma levels of cholesterol decreased from 170 to 152 mg/dL during the base-line period, and then to 142 mg/dL at the end of depletion, but did not respond to 10 days of repletion. A fleeting dermatitis, Miliaria crystallina, developed in five of the seven subjects at the end of depletion, but disappeared as repletion began. The minimum requirement for Mn on this purified diet, calculated by the factorial method using Mn balance at three levels of intake was 0.74 mg/d. This requirement would be increased to 2.11 mg/d if the obligatory loss was combined with the lowest individual percentage of retention. PMID- 3819861 TI - Enzyme markers of maternal malnutrition in fetal rat brain. AB - The impact of maternal starvation in late gestation on development of some enzymatic mechanisms concerned with neurotransmission and polyamine synthesis was studied in fetal rat brain. Between 17 and 20 d, acetylcholinesterase and choline acetyltransferase activity increased in fetal brains of fed dams, whereas maternal starvation from day 17 to day 20 resulted in heightened acetylcholinesterase but not choline acetyltransferase activity. Ornithine decarboxylase activity on a per-gram wet-weight basis fell between 17 and 20 d in fetal brain from fed dams. Increasing the duration of maternal starvation resulted in a progressive increase in fetal brain ornithine decarboxylase. Arginine and putrescine levels in the brain were lower in fetuses of starved mothers while spermidine and spermine concentrations were unchanged. Since the Km of ornithine decarboxylase for ornithine was found to vary directly with levels of putrescine in fetal brain, lower concentrations of putrescine and greater ornithine decarboxylase activity in fetal brains from starved mothers suggested that levels of this enzyme may be controlled in part by putrescine. Changes in the maternal nutritional state had no effect on the activity of glutamate decarboxylase in fetal brain, and tissue levels of the product, gamma aminobutyric acid, were unchanged. Thus changes in ornithine decarboxylase and acetylcholinesterase activity in fetal brain may uniquely reflect biochemical alterations consequent to maternal starvation. PMID- 3819862 TI - Influence of thyroid status on body weight gain, food intake and serum lipid levels in genetically obese Zucker rats. AB - Body weight gain, food intake and serum concentrations of total lipids, cholesterol, triglycerides, phospholipids and free fatty acids were measured in genetically obese and lean female Zucker rats after surgical thyroidectomy and treatment with 3,5,3'-triiodothyronine (T3) (3 micrograms/100 g body wt per day) for 4 wk. There were large differences in the major serum lipids between the control obese and lean rats. Obese rats were characterized by high levels of the various categories of lipids, especially of triglycerides. Thyroidectomized rats had higher serum concentrations of total lipids and cholesterol than controls in both obese and lean rats. The serum concentration of triglycerides was higher in the thyroidectomized lean rats than in lean controls but lower in their thyroidectomized obese littermates than in obese controls. The T3 treatment resulted in a marked reduction in serum total lipid, cholesterol, triglyceride and phospholipid levels in both thyroidectomized and control obese rats. The same treatment given to thyroidectomized and control lean rats also produced a lower concentration in serum total lipid, cholesterol and triglyceride levels but had no significant effect on serum phospholipid levels. The serum concentration of free fatty acid was not significantly affected by T3 administration in either obese or lean rats. Thyroidectomy induced a lower body weight gain in both obese and lean rats. The T3 treatment restored the body weight gain in the thyroidectomized lean rats but not in the thyroidectomized obese rats, although the food intake was increased by T3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819863 TI - Development of gluconeogenesis from various precursors in isolated rat hepatocytes during starvation or after feeding a high protein, carbohydrate-free diet. AB - Gluconeogenesis from dihydroxyacetone (DHA), glycerol, lactate, pyruvate or alanine was studied in the absence or in the presence of glucagon in hepatocytes isolated from starved rats or from rats fed a high protein diet for 2-48 h. In both groups, gluconeogenesis from DHA, glycerol, lactate and pyruvate exhibited similar changes over 48 h; the rates of glucose production increased progressively until 24 h and then plateaued. During the early phase (2-11 h), gluconeogenesis from DHA and glycerol were higher than gluconeogenesis from lactate and pyruvate. During the first 24 h of the experiment, gluconeogenesis from alanine displays a kinetic similar to that from lactate or pyruvate. After feeding a high protein diet for 24 to 48 h, gluconeogenesis from alanine was slightly higher than that in starved rats and paralleled the increase in alanine aminotransferase activity. Glucagon stimulated gluconeogenesis from DHA up to 48 h, but with glycerol this effect occurred only during the early phase (2-11 h). Glucagon stimulated gluconeogenesis from lactate, pyruvate or alanine by 1.35 fold throughout the experimental period. These findings suggest that the development of gluconeogenesis during starvation or after feeding a high protein diet displays different kinetics, depending on the substrate used and on the level of entry in the gluconeogenic pathway: triose phosphates or pyruvate. PMID- 3819864 TI - Macrophage function as studied by the clearance of 125I-labeled polyvinylpyrrolidone in iron-deficient and iron-replete mice. AB - This study evaluated the effects of iron deficiency and iron repletion on in vivo macrophage function determined by the clearance of 125I-labeled polyvinylpyrrolidone (PVP). Two experiments were done. There were four groups of C57BL/6 female mice in experiment 1: the iron-deficient (ID), pair-fed (PF), control (C) and the high iron (HI) groups. In experiment 2, there were three ID groups (severe to moderate anemia), three PF, one C and four ID groups that were fed adequate iron for 14 (R-14), 7 (R-7), 3 (R-3) days before or on the day of PVP injection (R-0). The overall rate of PVP clearance from blood was lower in ID than in C or PF groups. This clearance is expressed by a constant, K, calculated from natural log (ln) of the cpm and the time postadministration of PVP that blood was drawn. The theoretical individual macrophages function (alpha PVP), derived from K and the weights of body, spleen and liver, was also lower in ID than in C or PF groups. The impairment was most severe with the most severe iron deficiency. Repletion for 7 to 15 d before PVP administration resulted in a partial correction of the clearance. Moderate undernutrition in the PF group had no effect. PMID- 3819865 TI - Studies of nutrition and autoimmunity. Failure of zinc deprivation to alter autoantibody production when initiated in disease-established mice. AB - Earlier studies have demonstrated that zinc deprivation, when begun in young NZB mice, can retard the development of autoimmunity and result in an increased life span. The present study evaluated the possible benefits of zinc deprivation in NZB mice with established disease, as this model is more relevant to the human patient. Female NZB mice aged 6-8 mo were fed diets containing either 80 micrograms Zn/g and 10 micrograms Cu/g (control) or 1 microgram Zn/g and 10 micrograms Cu/g (zinc-deficient) for 4 mo. In addition, another group was fed a diet containing 1 microgram Zn/g and 100 micrograms Cu/g to determine whether zinc deficiency could be exacerbated by high dietary copper through a competition of copper with zinc at the intestinal level (zinc deficient + high copper). A fourth group of mice was fed the control diet at the same intake as that of the zinc-deficient group in order to control for the inanition associated with zinc deficiency (restricted intake). Regardless of dietary treatment, all mice developed antierythrocyte antibodies at the same rate. At the end of 4 mo, 82% of the control and the restricted-intake groups had survived, whereas the zinc deficient group had a 38% survival rate and the zinc-deficient + high copper group had a 50% survival rate. These observations show that, in contrast to findings with younger NZB mice, zinc deprivation of adult NZB mice with established autoimmunity will not improve survival. Indeed, severe zinc deficiency increased the mortality rate, demonstrating the need to consider the potential hazards of dietary extremes. PMID- 3819866 TI - Metallothionein synthesis and mRNA levels in cultured hepatocytes from lethal milk mutant mice. AB - Primary hepatocyte cultures from adult lethal milk (lm) mutant mice displayed approximately a 2.5-fold increased metallothionein (MT) synthesis compared to wild-type cells in uninduced as well as zinc-treated cells, over a 0- to 160 microM zinc dose-response range. Mutant hepatocytes also exhibited a greater level of MT-1 mRNA in both untreated and zinc-treated cultures compared to wild type. Despite these measures of MT synthesis, untreated lm/lm hepatocytes exhibited twofold-reduced 6-h uptake of 65Zn compared to wild-type, zinc and copper levels in soluble fractions of lm/lm hepatocytes were equivalent to wild type levels and lm/lm hepatocytes showed increased susceptibility to zinc toxicity as measured by zinc-induced detachment of cells from the culture dishes. These results suggest that the elevated MT synthesis observed in lethal milk mice does not, as previously reported in wild-type hepatocytes (1-3), increase zinc uptake or protect against heavy-metal toxicity (4, 5). Taken together with studies in vivo, our results suggest that an alteration in MT synthesis is probably a secondary affect of the lethal milk mutation. PMID- 3819867 TI - Diet as an external factor in the expression of scoliosis in a line of susceptible chickens. AB - An inbred line of chickens that develops severe scoliosis, an isogenic line and a line of birds derived from crossing the isogenic and inbred lines were used to study factors that influence the expression of scoliosis. Using the line of birds derived from the cross, the incidence of the lesion, defined as a spinal curve greater than 20 degrees, was influenced by deficiencies of copper, manganese or vitamin B-6. In the cross, scoliosis was expressed in 40-50% of birds. Vitamin B 6, manganese or copper deficiency, however, caused an increase in expression to 60-75% of birds. In contrast, protein deficiency, mild vitamin A deprivation, pantothenic deficiency, food restriction or calcium deficiency did not influence expression. Also, the addition of zinc (400 micrograms/g) or cadmium (5 micrograms/g) to a commercial nonpurified diet did not influence expression. That vitamin B-6, manganese and copper are dietary factors important to the expression of scoliosis may be related to their roles in the formation of connective tissue components, such as matrix glycoproteins, collagen or proteoglycans. For example, alterations and abnormalities in connective tissue may partly underlie progression of scoliosis and its potential for expression. PMID- 3819868 TI - Effect of short fasts on the development of tibial dyschondroplasia in chickens. AB - The length of time each day that feed is available to young broiler-type chickens significantly influenced the development of tibial dyschondroplasia. Birds that were fasted for 8 or 10 h per day had reduced incidences of tibial dyschondroplasia as compared to birds fed ad libitum (5-11% vs. 59-68%). When birds were fasted for only 2 or 4 h each day there was no significant effect on the development of tibial dyschondroplasia. Birds fasted for 8 h every other day or every 4th d had lower incidences of tibial dyschondroplasia compared to ad libitum fed controls. Fasting for 8 h on the 4th d or the 4th and 8th d of a 20-d experiment had no effect on the incidence of tibial dyschondroplasia as compared to controls. Except for the daily fasting there was little effect of fasting on 20-d body weight or gain per feed intake. Fasting increased the percent bone ash in the tibia in all experiments. Fasting had no effect on total calcium, ultrafilterable calcium, dialyzable phosphorus or growth hormone levels in plasma taken from the birds the 18th and 19th day. The hour of the day that the birds were bled had a significant influence on the plasma total calcium, dialyzable phosphorus and growth hormone levels. PMID- 3819869 TI - Effects of dietary calcium and age on parathyroid hormone, calcitonin and serum and milk minerals in the periparturient dairy cow. AB - Ten pregnant heifers and 10 pregnant cows (three or more pregnancies) were assigned to groups of five and fed either the recommended (low) amount of calcium or excess (high) calcium in their diet for 4 wk before parturition to determine the influence of prepartum calcium intake and age on hormonal control of peripartum calcium homeostasis. After parturition all groups received a diet with calcium adequate for lactation. Jugular blood samples from 21, 14, 7, 6, 5, 4, 3, 2, and 1 d prepartum through 0, 1, 2, 3, 5, 7, 14 and 21 d postpartum were assayed for concentration of parathyroid hormone, calcitonin, calcium, magnesium and phosphorus. Heifers and cows receiving high calcium diets had higher calcium and lower parathyroid hormone in blood serum before parturition than animals receiving the low calcium diets. Cows, but not heifers, fed high calcium diets exhibited severe hypocalcemia at parturition, remained hypocalcemic for 3 d and had low serum calcitonin. Regardless of dietary group, concentrations of parathyroid hormone and magnesium in serum increased after the first week of lactation. Feed intake during lactation, corrected for metabolic body weight, was similar for both dietary treatments and ages. Milk production per kilogram metabolic body weight was highest during the first week of lactation for cows fed low calcium diets before parturition. There was no correlation between hypocalcemia and loss of calcium in colostrum or milk. Feeding low dietary calcium to cows in the prepartum period was effective in the prevention of severe hypocalcemia at parturition. In contrast, dietary treatment of heifers had no effect on serum calcium concentration at parturition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819871 TI - Do women using oral contraceptive agents require extra zinc? PMID- 3819870 TI - Differential effects of riboflavin and RRR-alpha-tocopheryl acetate on the survival of newborn RCS rats with inheritable retinal degeneration. AB - The dystrophic RCS rat is one of the most important animal models available for investigating retinal degeneration. In addition to the characteristic progressive loss of neural retina the strain is hampered by a high rate of mortality during the first week of life. Death rate during this period is greatly influenced by diet. A 69% reduction in mortality was achieved by supplementing a purified diet with double the amount of AIN-76 vitamin mix. The objective of this study was to identify vitamin(s) in the AIN-76 mix responsible for the enhanced survival. The experiment determined the effect on survival of independently doubling the concentration of each vitamin present in the AIN-76 vitamin mix. This was done by single addition of individual vitamins to a complete purified diet. Survival was determined in litters whose mothers and grandmothers had been provided the supplemented diets as their sole source of food. Supplementation with riboflavin increased mortality by 19%, whereas RRR-alpha-tocopheryl acetate supplementation reduced the mortality by 73%. The effect of RRR-alpha-tocopheryl acetate was equivalent to that achieved by supplementation with complete vitamin mix. First week survival of pups (born alive) rose from 72.3% +/- 11.0 to 92.5% +/- 3.8 when the level of vitamin E was increased from 50 to 100 IU/kg diet. PMID- 3819872 TI - Should RDA values be tailored to meet the needs of their users? PMID- 3819873 TI - Measurement of iron bioavailability using the hemoglobin regeneration-anemic rat assay. PMID- 3819874 TI - Effects of dietary animal and plant proteins on the cholesterol metabolism in immature and mature rats. AB - Three- and 9-mo-old rats were fed purified diets that contained either casein, cottonseed or soybean protein for 28 d, and plasma total and high density lipoprotein (HDL) cholesterol, lecithin cholesterol acyltransferase (LCAT) activity and excretion of fecal neutral sterols were measured. These analyses were performed in order to examine how various dietary proteins from animal and plant sources fed in a purified diet influence the changes in the cholesterol metabolism of the young and old rats. Both immature (3-mo-old) and mature (9-mo old) rats fed purified diet containing casein maintained significantly higher plasma total and HDL cholesterol levels than their counterparts fed the same diets but containing plant proteins (soybean and cottonseed). The fractional rate of esterification (FR) of plasma free cholesterol in mature casein-fed rats was lower than that in immature rats. The FR was also lower in immature rats fed casein than in those fed plant protein. The net turnover rate (NR) of plasma cholesteryl esters (CE) tended to be higher in mature rats and in general was not affected by the dietary protein source. The rate of fecal excretion of neutral sterols was significantly higher in immature rats than in mature rats and in animals fed plant proteins at both ages than in those fed casein. PMID- 3819875 TI - Effect of amino acid supplementation to low protein diet on brain and plasma levels of tryptophan and brain 5-hydroxyindoles in rats. AB - The contribution of amino acid transport across the blood-brain barrier toward the concentration of brain 5-hydroxyindoles [serotonin and 5-hydroxyindole acetic acid (5HIAA)] was investigated. Several amino acids were individually supplemented to a 5% whole egg protein diet. Close correlation between serum tryptophan, brain tryptophan and 5-hydroxyindoles were observed regardless of diet fed. When a large neutral amino acid (LNAA such as methionine, threonine, leucine or phenylalanine) was added to the control diet, brain 5-hydroxyindole concentration was lower than when the control diet was fed; however, when tryptophan was added, brain 5-hydroxyindole concentration was significantly higher. Lysine supplementation did not affect brain 5-hydroxyindole concentration. Leucine supplementation caused a lower tyrosine concentration in hypothalamus than the control diet, but phenylalanine supplementation caused higher hypothalamus level of tyrosine. There was no correlation between tyrosine and norepinephrine concentrations in hypothalamus (norepinephrine turnover might also be changed by the nutritional state). These observations indicate that the supplementation of an amino acid at two- or fourfold of the requirement to a low protein diet can generate major changes in the concentrations of neurotransmitters in rats. PMID- 3819876 TI - Quantitation of microorganisms associated with the particulate phase of ruminal ingesta. AB - Microbial organic matter associated with rumen particulate and fluid phases was quantified using 15N as the microbial marker in two rumen fistulated cows fed a 65% alfalfa haylage diet. During two collection periods, feed was removed 1 h after initiation of feeding, and cows were dosed with (15NH4)2SO4. Whole rumen contents were sampled before feeding and at various times up to 12 h after feeding. Fluid microorganisms were those that passed through eight layers of cheesecloth. Particle-associated microorganisms were obtained by chilling squeezed particles prior to seven successive extractions with saline solution. The amount of microorganisms removed from particles ranged from 32.1 to 59.9% as measured by 15N. Organic matter (mg/mL strained rumen fluid equivalent) of fluid and particle-associated microorganisms was respectively: 10.7 and 47.5; 12.5 and 35.5; 12.2 and 30.1; 10.7 and 26.1; 10.9 and 26.7; and 8.9 and 20.6, at 2, 3, 4, 7, 9 and 11 h after initiation of feeding. These ratios indicated that 70-80% of microbial organic matter in whole rumen contents was associated with the particulate phase and that particle-associated microbial organic matter was greatest soon after feeding. Analysis of 15N in extracted rumen particles indicated that 50-65% of particle nitrogen and 17-27% of particle dry matter was of microbial origin. These results provide evidence that particle-associated microorganisms make up a major proportion of the total microorganisms in ruminal ingesta and that a large proportion of ingesta particle N can be of microbial origin. PMID- 3819877 TI - Potentiation of ethanol-induced hepatic vitamin A depletion by phenobarbital and butylated hydroxytoluene. AB - Administration of ethanol, phenobarbital or butylated hydroxytoluene (BHT) each resulted in significantly lower hepatic vitamin A than in untreated controls. When ethanol was combined with either phenobarbital or BHT, a striking potentiation of the depletion was observed, resulting in hepatic vitamin A values of less than 5% of normal, whether expressed per gram of liver or per 100 g body wt. These effects were observed for both retinol and retinyl esters, measured by high pressure liquid chromatography. By contrast, lung levels of retinol and retinyl esters were significantly higher in rats treated with ethanol, but remained unchanged in rats treated with phenobarbital or butylated hydroxytoluene compared with control animals. PMID- 3819878 TI - Zinc and copper in milk and tissues of nursing lethal milk mutant mice. AB - Zinc concentration was lower in liver of suckling 1-d-old lethal milk (lm/lm) mutant mice than in wild-type pups, in accordance with the hypothesis of milk induced zinc deficiency previously proposed to underlie this mutation. Despite the initial deficiency, by 3 d of age suckling lm/lm pups exhibited higher levels of hepatic zinc than did lm/lm-nursed wild-type pups. Intestinal zinc and copper concentrations were normal in 1-d-old lm/lm pups, but by 3 d of age were also higher in lm/lm pups than in wild-type pups foster-nursed on lm/lm dams. Contrary to a previous report, we found that zinc concentration in milk of lm/lm dams was not significantly different from those of controls, between 4-20 d postpartum. Mutant milk showed normal zinc distribution as determined by gel-filtration chromatography or by DEAE-cellulose chromatography of zinc-binding ligands derived from EDTA-dissociated micelles, normal copper levels, normal amounts of citrate, a zinc (II) and copper (II)-binding ligand and normal amounts of glutamate, a proposed copper (II)-binding ligand. Total mammary glands and mammary gland cytosols from lm/lm mice exhibited normal zinc concentrations. Copper levels, however, were higher in lm/lm mammary gland cytosols than in controls. These results suggest that an increased uptake and/or retention of zinc and copper in the tissues studied may underlie the signs of zinc deficiency seen in lethal milk mutant mice. PMID- 3819879 TI - Effect of selenium depletion and repletion on plasma glutathione and glutathione dependent enzymes in the rat. AB - Selenium deficiency has several known biochemical effects. In the rat, these effects include loss of glutathione peroxidase (GSH-Px) activity, increased plasma glutathione concentration and increased liver glutathione S-transferase (GSH S-Tr) activity. The time course of the development of these changes in rats fed selenium-deficient diets and the time course of reversal of these changes in selenium-deficient rats fed graded levels of selenium were determined. As selenium deficiency was produced, liver cytosolic and plasma GSH-Px activities decreased first and were less than 5% of control when plasma glutathione concentration and liver GSH S-Tr activity began to increase. Elevated liver GSH S Tr activity in selenium-deficient rats was corrected by refeeding selenium at the lowest level of supplementation (0.015 ppm) for 4 wk. GSH-Px activity required a supplementation of 0.10 ppm selenium for correction to control levels in 4 wk. Based on these studies a classification of the severity of selenium deficiency into mild, moderate and severe categories is proposed. In addition, the effect of dietary sulfur amino acid supplementation on plasma glutathione concentration was studied. PMID- 3819880 TI - Women in the labor force: are sex mortality differentials changing? AB - The relationship between the increasing participation of women in the labor force, female mortality, and the male-female mortality differential is examined in this work. The mortality experience of women and men 16 to 64 years of age in the Wisconsin civilian labor force is examined for the period 1974 to 1978 through comparisons of central death rates and sex mortality ratios. In general, this study suggests that, at this time, female mortality is not negatively affected by female labor force participation. Furthermore, there is little evidence to suggest that the entrance of women into the labor force will narrow the sex mortality differential in the general population. However, among certain occupation groups, males and females of similar marital status experience mortality rates that are quite similar. Possible interpretations of these unusual findings are presented. PMID- 3819881 TI - Unusually aggressive transmission of tuberculosis in a factory. AB - A case of pulmonary tuberculosis in a factory worker was studied to identify infected contacts and to gauge the degree of transmission. Initial findings suggested far more extensive transmission than anticipated, and the study was expanded. Of all factory workers tested, 33% were infected with the tubercule bacillus in spite of massive air volume-to-contact ratio. Deliberate stagnation of the air to prevent occupational exposure to lead and asbestos was believed to be a contributing variable. PMID- 3819882 TI - Evaluation of an employee assistance program. AB - The objective of the EAP effectiveness study was to determine the effectiveness of the EAP counseling services. The results demonstrate that employees who received help from the company's EAP subsequently improved their work performance. Although these results cannot be generalized to other EAPs, the results are encouraging and point toward a need for more research in this area. PMID- 3819883 TI - Respiratory symptoms and pulmonary function in farmers. AB - A questionnaire was given to 1,824 farmers and 556 control subjects in Saskatchewan to assess respiratory health and pulmonary function tests. With data corrected for age and smoking, farmers were found to have increased prevalences of the respiratory symptoms of phlegm, wheeze, shortness of breath, and the condition of chronic bronchitis. In addition, farmers had significantly lower values for the pulmonary function test variables forced vital capacity (FVC), forced expired volume in one second (FEV1) and maximum midexpiratory flow rate. However, the FEV1/FVC ratio was slightly but significantly greater in farmers than in control subjects. These findings suggest an increase in respiratory symptoms in farmers compared with rural control subjects who are not farmers and a decrease in lung volume and expired flow rates. The slightly high FEV1/FVC ratio may indicate a mixed obstructive and restrictive picture. PMID- 3819884 TI - The prevalence of silicosis in Orange Free State gold miners. AB - The prevalence of silicosis in the migrant laborer in the South African, Orange Free State gold mines has not previously been estimated. Two methods were used to estimate the prevalence of silicosis in this population. The two techniques are described. The difference between the two estimates illustrates the difficulty of epidemiologic studies in this type of working population. It is noted that the highest estimate of 138 cases per 10,000 workers is certainly less than the true prevalence of the disorder. The use of routine miniature (100-mm) chest radiographs for the detection of silicosis was validated through comparison with normal size (125-kV radiographs and through analysis of the consistency of reading of second miniature films from the same subjects. PMID- 3819885 TI - Occupation and industry data obtained from death certificates: the effect and influence of case selection. AB - This study first examined the accuracy of death certificate diagnoses of 4,954 cases of cancer of the lung, liver, nasopharynx, and pleura/peritoneum, then compared usual occupation and industry based on case selection from the Metropolitan Detroit Cancer Surveillance System (MDCSS), a population-based cancer registry, with cases selected from death certificates for the above types of tumors to examine the effect of misclassification. Accuracy of death certificate cancer diagnoses ranged from 93.4% for lung cancer to 28.6% for malignancies of the pleura/peritoneum. The mix of usual occupation/industry titles obtained from death certificate cases and MDCSS cases was similar for lung cancer but not for malignancies of the pleura/peritoneum (35.7% of cases from the registry v 11.1% from death certificates for the automobile industry, P = .05). The effect of misclassification and utility of usual occupation/industry statements on death certificates is discussed. PMID- 3819886 TI - Predictors of successful alcohol rehabilitation in an Air Force population. AB - In order to find predictors of success in alcohol treatment, the authors conducted a 1-year follow-up of 71 active duty military personnel treated in a 28 day inpatient program. Success at 1 year follow-up was then compared with variables collected on a patient questionnaire completed at the beginning of rehabilitation. A family history of emotional disorders, together with a single incident precipitating treatment, was associated with a positive alcohol rehabilitation outcome. PMID- 3819887 TI - Occupational risks for meningiomas of the CNS in Sweden. AB - Using the Cancer-Environment Registry of Sweden, which links cancer incidence (1961 to 1979) with census information (1960) for all employed individuals in Sweden, a systematic, population-based assessment was made of the occurrence of meningiomas of the CNS according to industrial and occupational classifications. Statistically significant standardized incidence ratios (SIR) between 5 and 6 for meningioma were observed among glass, porcelain, or ceramic workers of both sexes. SIRs of similar magnitude were also found for men employed in the headwear fabrication and book publishing industries. Significantly elevated two- to three fold risks were observed for men employed in health care, railroad and trolley construction, sheet and plate metal fabrication, and as moving equipment operators. Some of the findings of this descriptive survey may have arisen as a result of multiple comparisons, but several are consistent with earlier observations for brain cancer from other countries and deserve further study. PMID- 3819888 TI - Fatal logging injuries in Washington state, 1977 to 1983. AB - The logging fatalities in Washington state during the years 1977 to 1983 were analyzed using death certificates and the investigations of the Washington Department of Labor and Industries. Each source identified more than 92% of the 135 fatalities. The annual injury mortality rate for logging was approximately 2/1,000 workers. Loggers were killed by falling trees in 34% of fatalities and by equipment in 24% of fatalities. None of the 12 men killed in vehicle rollovers were wearing seat belts. Risk was greatest for tree fellers and choker-setters. Risk was also greatest during the morning, during the first two days of the workweek, and during the month of June. Size of logging company was inversely related to risk of injury, with the smallest companies having mortality ratios ten times higher than the largest companies. The study suggests that routinely collected occupational data on injuries and employment can be combined to identify high-risk categories in specific industries and thereby target inspection activities or suggest new regulations addressing specific occupational hazards. PMID- 3819889 TI - Transient bilateral peroneal palsy in a painter's model. AB - Peripheral neuropathies caused by pressure are common. The most common causes are pressure of the ulnar nerve at the elbow and of the median nerve at the wrist. Pressure neuropathy of the peroneal nerve at the level of the fibular neck is a rare syndrome. The literature describes well-defined etiologies of that syndrome: external pressure, tumors, ganglion, or stretching of the limb. A case of bilateral peroneal palsy in a painter's model caused by prolonged sitting in a specific position is described. Review of the literature revealed no such case described previously. PMID- 3819890 TI - Video display terminal use and reported health symptoms among Massachusetts clerical workers. AB - Few well-controlled studies have assessed the extent and magnitude of adverse health conditions reported by video display terminal (VDT) operators. To evaluate the association between typical, daily VDT use and the prevalence of adverse conditions related to vision, musculoskeletal conditions, headaches, and colds or sore throats, we conducted a cross-sectional, epidemiologic study of 1,545 Massachusetts clerical workers. The study results indicated an increased prevalence of adverse conditions pertaining to vision, musculoskeletal discomfort, and headaches among clerical workers who used VDTs. The magnitude of the increased prevalence was dose dependent. The effects related to musculoskeletal discomfort and headaches were higher among VDT workers in computer and data processing services, public utilities, and the Commonwealth of Massachusetts than among workers in banking, communications, and hospitals. These latter effects, however, may have been due to random variation. PMID- 3819891 TI - Job stress, mental health, and accidents among offshore workers in the oil and gas extraction industries. AB - Psychosocial and occupational stressors among 194 male employees on drilling rig and production platform installations in the United Kingdom and Dutch sectors of the North Sea were studied. Mental well-being and job satisfaction were also assessed, with attention to the incidence of accidents offshore. This occupational group were found to be much less satisfied with their jobs than their onshore counterparts. Although overall mental well-being compared favorably with that of the general population, levels of anxiety were significantly higher. Multivariate analysis showed "relationships at work and at home" to be a strong predictor of both job dissatisfaction and mental ill-health. Type A coronary prone behavior was also found to be a significant predictor of reduced mental well-being and increased accident rates offshore. PMID- 3819892 TI - Factors affecting individual injury experience among petroleum drilling workers. AB - To identify factors affecting the number of injuries experienced by petroleum drilling workers, we carried out a 44-month incidence density study on a cohort employed in January 1979 on mobile drilling units in the Gulf of Mexico. To control for job-related hazards, we computed a standardized ratio of observed to expected injuries for each worker based on his job history. The effect of personal and work history factors was then examined using analysis of variance. Age, rate of job changes, and rate of rig transfers had independent effects on injury rates. Length of service had little effect when age was controlled. The findings suggest that younger workers under stress such as job change may be more susceptible to injury than older workers, regardless of job. If so, targeted changes in procedures and environment which protect workers of all ages are important alternatives to reliance on supervision and experience in injury reduction. PMID- 3819893 TI - Coronary artery disease deaths in the Toronto Fire Department. AB - The occupation of fire fighting is alleged to be associated with an increased risk of death from circulatory disease, but not all mortality studies confirm this finding. An historical prospective study was done in the Toronto Fire Department to examine the relationship between fire fighting and mortality from coronary artery disease. Using adjusted city of Toronto rates for comparison, the overall standardized mortality ratio (SMR) for fire fighters aged 45 to 54 was 1.73 (P less than .005). Stratification by age and year of death produced the highest SMR of 2.47 (P less than .10) in fire fighters aged 45 to 49 during the period 1975 to 1979. A relative index of fire fighting activity was created and tested but proved difficult to use in an historic study. Explanations are offered and recommendations for further studies are made. PMID- 3819894 TI - Comparison of methods for determining occupational exposure in a case-control interview study of chronic lymphocytic leukemia. AB - A comparison was made between two indirect methods for linking reported lifetime occupations and industries of employment with specific exposures and with directly reported exposure information, using data from a population-based case control interview study of chronic lymphocytic leukemia (CLL). Exposures previously suspected of being associated with CLL were examined using a job exposure matrix developed by Hoar et al and a linkage between observed occupational exposures and specific occupations, by industry, based on data collected in the National Occupational Hazard Survey (NOHS). In general, concordance on exposure for the two occupation-exposure linkage methods was fairly poor, although it was better for some of the exposures studied (butadiene and asbestos, for which most kappas were between 0.40 and 0.60) than for others (carbon tetrachloride and benzene with kappas ranging from 0.01 to 0.12). Higher proportions of cases and controls directly reported exposure to benzene and asbestos than was determined using the two more indirect methods, neither of which showed consistently greater agreement with direct reporting. PMID- 3819895 TI - Investigation and work-up of tight building syndrome. AB - In recent years, incidents involving health-related complaints due to poor indoor air quality have increased dramatically. These problems have generally occurred in new or remodeled buildings. Following relocation to a new building, some employees began to experience health complaints, including upper respiratory tract irritation, headaches, fatigue, and eye irritation. A questionnaire was designed which elicited information about specific work locations, symptom experience, and timing of such symptoms. Although no causative agent(s) could be isolated, the data collected indicate that over the 5-week time period of investigation the rate and persistence of new symptoms decreased. The health complaints experienced appeared to be neither persistent nor pervasive enough to constitute an ongoing health and safety hazard at the facility. Reasons were proposed why some new and/or remodeled buildings have this type of problem while others do not. PMID- 3819896 TI - Epidemiologic features that may distinguish between building-associated illness outbreaks due to chemical exposure or psychogenic origin. PMID- 3819897 TI - G6PD deficiency. PMID- 3819898 TI - Drug testing controversy. PMID- 3819899 TI - Thyrotoxic hypokalemic periodic paralysis: report of four cases and review of the literature (1). PMID- 3819900 TI - Phone transmission of fetal heart rate (FHR) tracings in a rural setting. PMID- 3819901 TI - Psychiatric treatment of erectile dysfunction. PMID- 3819902 TI - Three-dimensional spinal curvature in idiopathic scoliosis. AB - Scoliosis is usually considered as a deformity of the spine in the frontal plane, without reference to curvatures in other planes. In this study, the three dimensional shape of the spine of 104 patients with untreated idiopathic scoliosis (5-55 degrees Cobb) was studied by means of stereo radiographs to determine relationships between curvature of the spine in the frontal plane view, in the lateral view, and in the intermediate views. There was a weak but statistically significant correlation (r = 0.2) relating greater scoliosis with lesser kyphosis or greater lordosis. In the thoracic region, the sagittal plane spinal curvature was less than that measured in a population without scoliosis (mean difference, 7.72 +/- 9.9 degrees). Seventy-four of 76 scolioses in the upper region of the spine with lateral curvature greater than 5 degrees Cobb were kyphotic. Sixty-four of 84 curves greater than 5 degrees Cobb in the lower region were lordotic. Measuring curvatures in the plane of symmetry of the rotated apical vertebra altered these ratios to 69 of 76 kyphotic in the upper region and 68 of 84 lordotic in the lower region. The plane of maximum curvature of sections of the spine with scoliosis was not related to the plane of symmetry of the rotated apical vertebra, for in kyphotic regions of the spine the rotations of these two planes were in opposite directions. In all cases, the magnitudes of the rotations were quite different, i.e., by a factor of -0.22 for curves in thoracic region and by a factor of 0.24 for curves in the lumbar region. This implies that mechanical measures to correct this spinal deformity or to prevent progression should apply different rotations to the apex from those applied to the curve as a whole and, in opposite senses, in curves in kyphotic regions. There was no evidence of an abnormality of sagittal curvature of a magnitude to implicate it in the etiology or in the treatment. PMID- 3819903 TI - Cytosolic calcium concentration in bovine growth plate chondrocytes. AB - The cytosolic free calcium ion concentration for mammalian cell systems is believed to be maintained within a narrow range compatible with cellular homeostasis. Growth plate chondrocytes have been shown to accumulate large quantities of calcium within their mitochondria, but the cytosolic free calcium concentration has not been determined. This study measures the cytosolic free ionic calcium concentration in growth plate chondrocytes using two variations of the Quin II fluorescence technique. The results indicate that in isolated growth plate chondrocytes, the cytosolic free ionic calcium concentration is similar to other nonmineralizing mammalian cell types (106-137 mM). PMID- 3819904 TI - Electron microscopic analysis of articular cartilage proteoglycan degradation by growth plate enzymes. AB - To assess the effect of intracellular growth plate chondrocyte enzymes on proteoglycan structure, we examined enzyme-treated articular cartilage proteoglycans and untreated articular cartilage proteoglycans with the electron microscopic monolayer technique. The untreated proteoglycan monomers ranged in length from less than 20 nm to more than 700 nm, with a mean length of 224.5 +/- 101.6 nm in one experiment and 224.6 +/- 95.7 nm in a second experiment. Incubation with growth plate enzymes reduced proteoglycan monomers to fragments with lengths that varied from less than 5 nm to 143 nm, increased the variability in monomer length, and destroyed proteoglycan aggregates. The enzyme treated monomers had an average length of 29.5 +/- 17.9 nm in one experiment and 35.2 +/- 17.0 nm in a second experiment. The smallest common fragments were 15 nm long and would be expected to contain about 15 glycosaminoglycan chains. This experiment demonstrates that enzymes extracted from growth plate chondrocytes can degrade the chondroitin sulfate-rich region of proteoglycan monomer core proteins, produce a range of monomer fragment sizes with less than 2% of the fragments shorter than 5 nm or longer than 100 nm, increase the variability in monomer length, and degrade proteoglycan aggregates. PMID- 3819905 TI - "Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage. AB - We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free. PMID- 3819906 TI - Fracture failure mechanisms in patients with osteogenesis imperfecta. AB - This investigation examines the failure mechanism of bone from patients with osteogenesis imperfecta (OI). Mechanical testing and ultrastructural analysis of surgically obtained bone specimens, from patients with OI and from approximately age matched normal controls, were performed. Small rectangular bone samples (1.0 mm X 1.2 mm X 15 mm) with a prismatic cross section were put under three-point bending to determine the work to fracture. Furthermore, the fracture surface was observed with scanning electron microscopy (SEM). The SEM observation of partially dissected lamellae was also performed to determine the collagen organization of the bone. The OI bone has a consistently lower work to fracture and reduced collagen organization than the normal controls. The fracture surface of the OI bone is rough and exhibits a "pull-out" type of morphology, as opposed to the smoother fracture surface of the controls. This study shows that a relatively simple mechanical test utilizing a small amount of bone can differentiate between a diseased state (OI) and a normal state of bone. PMID- 3819907 TI - Influence of stable fixation on trabecular bone healing: a morphologic assessment in dogs. AB - The healing patterns of trabecular bone are different from those of compact bone. In order to investigate further this observation, a histomorphometric assessment was undertaken. The influence of internal fixation devices on trabecular bone healing was also studied. Intercondylar osteotomies were produced in 19 dogs and fixed with screws. All dogs were killed between 1 and 14 weeks; eight of them had the screws removed 4 weeks after osteotomy and were killed 4 or 10 weeks later. The results of morphometry were compared to the histologic and radiologic pictures. Anatomic reduction with stable fixation led to contact healing characterized by a narrow endosteal bone formation at the osteotomy site that disappeared only after union was complete (4 weeks). In gap healing, the endosteal bone formation was greater. Internal fixation devices appeared to cause a diffuse osteopenia once union was complete. Their removal just after completion of union seems to prevent the bone loss. Screws induced bone formation around their threads; after they were removed, the reaction disappeared but the screw holes were not filled with normal trabeculae 10 weeks later. Union of fractures through trabecular bone can be assessed radiologically. A decrease of band-like bone density at the fracture site indicates completion of union. This is the optimal time for implant removal. It prevents the osteopenia observed in cases of continuous presence of screws. PMID- 3819908 TI - Evaluation of double-exposure holographic interferometry for biomechanical measurements in vitro. AB - Double-exposure holographic interferometry is a nondestructive testing technique for measuring displacement and strain in a test object. A standard hologram contains three-dimensional information about an object. However, the holographic interferogram has additional information, as a series of interference bands overlaid on the three-dimensional image of the object contains information about object deformation. Interferograms were produced for intact cadaveric femora and cadaveric femora with implanted titanium alloy and cobalt-chromium alloy femoral components. A force was applied to the femoral head to simulate single leg stance, and changes in specimen deformation were observed as additional incremental loads were applied. We have observed that the femur behaves as a bending beam and that the holographic technique allows the position of maximal deflection to be identified and the magnitude of femoral displacement from the load axis to be determined at any point within the field of view. The effects of the modulus of the implanted stem on the bending characteristics of the composite structure were clearly seen in the interferograms. This communication presents a photographic analysis of the double exposure interferograms recorded, as well as a critique of the technique for biomechanical measurements in vitro. PMID- 3819909 TI - Controlled bending instability in the healing of diaphyseal osteotomies in the rat femur. AB - Ninety-six rats underwent a midshaft transverse osteotomy followed by osteosynthesis with an intramedullary nail, so that the effect of bending instability on time to union and on the mechanical properties of experimental diaphyseal fracture could be evaluated. Rotation was reduced by cementing both nail ends to the bone. Rigid nails made of stainless steel were used on one group and flexible nails made of polyacetal resin were used on another group. Serial radiographs were evaluated at 4-6-week intervals. Twelve animals with either nail type were killed at 4, 8, 16, and 24 weeks. Both femora were mechanically tested and the callus diameters were measured. There was no significant difference in time to union between the two groups. The cross-sectional area of callus was significantly higher at 8 and 16 weeks in femora with flexible nails. The strength, toughness, and resilience of the bone increased in this group until 24 weeks. Between 16 and 24 weeks, these parameters did not improve in femora with rigid nails. Poorer mechanical properties in femora with steel nails are interpreted as an effect of stress protection of the bone. This study, therefore, indicates that flexible nails prevent stress protection effects without delaying union. PMID- 3819910 TI - Viscoelastic properties of proteoglycan solutions with varying proportions present as aggregates. AB - Monomer and aggregated proteoglycans were prepared from pig laryngeal cartilage. Vascoelastic flow properties, comprising linear complex dynamic shear modulus, nonlinear steady-state shear-rate dependent viscosity, and primary normal stress difference, were measured in proteoglycan solutions containing varying proportions of aggregate (0-80%) and at different concentrations (10-50 mg/ml). Results were analyzed using the simple Oldroyd four-parameter nonlinear rate-type rheological equation. All solution properties were strongly dependent on proteoglycan concentration and on the proportion of aggregates present. Aggregation was found to have a great effect on the zero shear-rate viscosity at 50 mg/ml, which increased fivefold from 0-100% aggregate. The results showed that network formation in proteoglycan solutions increased with concentration from 10 50 mg/ml and also increased with aggregation. All proteoglycan solutions showed shear thinning, which was most marked with aggregated proteoglycan at high concentration (50 mg/ml), where the viscosity decreased tenfold from the zero shear-rate limit to the infinite shear-rate limit. The intermolecular interactions in the network were therefore increasingly disrupted by increasing shear rate, but repeated measurements showed that these were reversible changes and that testing did not induce disaggregation or degradation of proteoglycan. These rheological properties show that aggregation is likely to immobilize proteoglycan at high concentration within cartilage and to contribute to the material properties of the porous solid matrix of articular cartilage that are important for its load-bearing function. PMID- 3819911 TI - Biochemical, histological, and biomechanical analyses of canine tendon. AB - To define the matrix composition and architecture of canine flexor tendon, and to correlate tissue structure with applied mechanical loading, five anatomical regions of flexor tendon were studied. Histologically, two prominent fibrocartilaginous areas were observed on concave aspects of the tendon. The location of the major fibrocartilaginous area at the metacarpophalangeal joint correlated well with the region predicted by biomechanical modeling to be under greatest compressive loads during standing and claw movement. Comparative biochemical analysis showed an elevated water content, a five-fold higher hexuronic acid content, and a larger hydroxylysine/hydroxyproline ratio in this region relative to that for more tendinous areas. The major glycosaminoglycan component of fibrocartilaginous areas was chondroitin sulfate, whereas in other areas dermatan sulfate and hyaluronic acid dominated. Cell density and DNA analyses indicated a slightly higher cellularity for fibrocartilaginous areas and the region of vinculum insertion. These data document the existence of discrete areas of specialization within the flexor tendon that appear to be an adaptation to nutritional and mechanical factors. PMID- 3819912 TI - Force analysis of the patellar mechanism. AB - The aim of this study is an experimental evaluation of a force analysis of the patellar mechanism based on the assumption that patellofemoral contact is frictionless. At first, the geometric characteristics of contact surfaces, a prior knowledge of which is necessary for quantitative analysis, were measured from radiographs of 42 fresh-frozen knee specimens in the flexion range 0-120 degrees. The results were then used in the analysis to predict the relations between the forces acting on the patella. For the evaluation of the analysis, the ratio of the tension in the ligamentum patellae and the rectus femoris was measured in ten specimens during simulation of two knee functions: (1) "leg raising" against a resistance; and (2) "static lifting". The effect of flexion angle on the ratio is found to be rather complex. With increasing flexion, the ratio increases initially up to 30 degrees, then decreases up to 90 degrees, and finally increases again beyond 90 degrees. The ratio is above unity up to around 45 degrees and below that in the remaining flexion range. The analysis has been found to predict not only the characteristic variation of the ratio but also its magnitude with reasonable accuracy. It has been concluded that for an accurate prediction of the patellofemoral joint reaction, the force analysis needs to be based on the geometry of the contact surfaces. This implies that the mechanical consequences of surgical procedures involving tibial tubercle relocation cannot be inferred simply on the basis of their effect on the patellar mechanism angle, but that they also require consideration of their effect on the contact geometry. PMID- 3819913 TI - Biochemical characterization of fracture callus proteoglycans. AB - The changes in proteoglycan molecules during the initial stages of fracture healing in rats were characterized. Following extraction of callus proteoglycan components with dissociative solvents, the components were purified in a cesium chloride density gradient. The recovered proteoglycans were characterized with respect to their molecular size distribution using gel filtration chromatography and a centrifugal transport methodology. During this early healing period, a decrease was observed in the relative proportion of the aggregate and in the hydrodynamic size and sedimentation coefficients of these molecules. While some molecular degradation could have occurred during the early stages of fracture healing, the dominant change of the proteoglycan molecules seemed to be disaggregation. No significant difference was observed in the proportion of aggregates reformed when exogenous hyaluronate and link glycoproteins were allowed to interact with the two corresponding monomer preparations. The molecular changes of the proteoglycan molecules seem to parallel those occurring during endochondral calcification of rat epiphyseal cartilage. PMID- 3819914 TI - Femoral anteversion: assessment based on function axes. AB - This study describes a clinically oriented anatomical assessment of anteversion on 32 cadavers ranging from 61 to 89 years. The method used a three-dimensional reference system based on functional axes of the femur. Each soft tissue-free femur was mounted on an osteometric table and aligned to its functional axes. The long axes were defined as passing from the centre of the femoral head to the femoral attachment of the posterior cruciate ligament (PCL). A line that ran through the PCL attachment (equal distal origin of this system) and was parallel to a transepicondylar line served as transverse axis. Anteversion of the femur was defined as an angle formed to the transverse axis by a line running through the centre of the femoral head through the midpoint of the narrowest segment of the femoral neck. The measurement mean for anteversion among these specimens was 7.4 degrees with a range from -10.8 degrees (retroversion) to 22.1 degrees. There was no statistical difference in mean values (p less than 0.05) between sexes or between right and left sides of the group; however, there were large variations for anteversions when each side in the same individual was compared (although there was no dominant side). Retroversions were observed in four of 32 femurs (12.5%). No correlation was found between the anteversion in these femurs and rotational geometry at the knee. We compared our data with those obtained by conventional techniques, by which anteversion for each femur was measured after the bone had been placed on a flat surface.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819915 TI - Load-displacement behavior of sacroiliac joints. AB - We measured the load-displacement behavior of both single and paired sacroiliac (SI) joints in fresh cadaver specimens obtained from eight adults between the ages of 59 and 74 years. With both ilia fixed, static test loads were applied to the center of the sacrum along and about axes parallel and normal to the superior SI endplate. Test forces up to 294 N were applied in the superior, inferior, anterior, posterior, and lateral directions. Moments up to 42 N-m were applied in flexion, extension, lateral bending, and axial torsion. Displacements of the center of the sacrum were measured 60 s after each load increment was applied, using dial gauges and an optical lever system. The tests were then repeated with only one ilium fixed. Finally, the three-dimensional location and overall geometry of each SI joint were measured. For an isolated left joint at the maximum test loads, the mean (SD) sacral displacements in the direction of the force ranged from 0.76 mm (1.41) in the medial to 2.74 mm (1.07) in the anterior direction. The mean rotations in the directions of the moments ranged from 1.40 degrees (0.71) in right lateral bending to 6.21 degrees (3.29) in clockwise axial torsion viewed from above. We also examined load-displacement behavior under larger loads. Single sacroiliac joints resisted loads from 500 to 1440 N, and from 42 to 160 N-m without overt failure. PMID- 3819916 TI - Acute stroke treated in a cerebrovascular unit. PMID- 3819917 TI - Heparin treatment of acute stroke. PMID- 3819918 TI - [87th congress of the Otorhinolaryngological Society of Japan. Sapporo, Japan, May 29-31, 1986. Abstracts]. PMID- 3819919 TI - [Evaluation of anterior rhinomanometry by a model experiment]. PMID- 3819920 TI - [A study on the readiness potential in ocular movement]. PMID- 3819921 TI - [Studies of the averaging wave-pattern of the acoustic reflex. 1. On subjects with normal hearing]. PMID- 3819922 TI - [A clinical study on noise-induced deafness--the present state and problems in the recognition of workers' accidents]. PMID- 3819923 TI - [Olfaction in laryngectomized patients--does a loss of function due to disuse occurs? ]. PMID- 3819924 TI - [Pyridine olfaction test--on the results of the test in cases of olfactory disturbance]. PMID- 3819925 TI - [Clinical study of auditory evoked brainstem response--air and bone conduction ABR obtained by stimuli of sine one waves]. PMID- 3819926 TI - [The abnormal sensation in the throat and serum ferritin]. PMID- 3819927 TI - [Evaluation of the treatment of laryngeal cancer]. PMID- 3819928 TI - [Pathophysiology of the perilymphatic fistula]. PMID- 3819929 TI - [Ultrastructural studies of the olfactory epithelium following bulbectomy: evidence of neuronal regeneration]. PMID- 3819930 TI - [Problems in the management of well differentiated thyroid cancers--4 cases of thyroid cancer showing atypical clinical pictures]. PMID- 3819931 TI - [Scanning electron microscopic study of the acinic cells of the submandibular gland in the guinea pig]. PMID- 3819932 TI - [Predominance of nasal saccade in fast eye movement]. PMID- 3819933 TI - [Assessment of eustachian tube function by measuring tubal resistance]. PMID- 3819934 TI - [Grading the malignancy of parotid gland tumors by measurement of nuclear DNA content in smears from fine needle aspirates]. PMID- 3819935 TI - [Reevaluation of the prognostic criteria of sudden deafness]. PMID- 3819936 TI - Growth hormone secretory patterns in children with short stature. AB - To assess whether growth-retarded children with a stimulated growth hormone (GH) level greater than 10 ng/mL have an abnormality in spontaneous GH secretion, we measured GH levels every half hour for 24 hours in 50 children 2.7 to 17 years of age. Growth rate was subnormal in all. Mean 24-hour GH concentration ranged from 1.2 to 7.7 ng/mL, and was significantly greater in pubertal than in prepubertal children (P less than 0.01). In both groups, GH concentration during sleep was significantly greater than during wakeful hours (P less than 0.0005); 24-hour GH concentration correlated significantly with sleep-induced GH peak. A decrease in 24-hour GH concentration and sleep-induced GH peak were noted in four pubertal children with stimulated GH less than 15 ng/mL. A progressive and significant increase in somatomedin C (SmC) level was noted with increasing age and sexual development. No correlations were found between 24-hour GH concentration and rate of growth, age, or bone age. Serum SmC values correlated significantly with age and bone age (P less than 0.01), and with 24-hour GH concentration only in prepubertal children (P less than 0.05). A strong correlation between SmC and growth rate was noted only in pubertal children (P less than 0.01). Growth velocity increased significantly during GH therapy regardless of the 24-hour GH concentration. Our results indicate that in children with growth retardation there is a wide variation in 24-hour GH concentration and a significant increase in GH concentration during puberty; the GH concentration during nocturnal sleep, rather than an entire 24-hour GH concentration, can be used for evaluation; during puberty the SmC level reflects sexual development more than GH reserve; and GH therapy appears to increase growth velocity in both non-GH-deficient and partially GH-deficient short children. PMID- 3819937 TI - Growth hormone secretory dynamics in children with precocious puberty. AB - We investigated whether an increase in growth hormone secretion contributed to the growth spurt in children with precocious puberty by measuring the 24-hour profile of serum growth hormone in 51 patients with central precocious puberty. Girls with central precocious puberty had significantly greater mean 24-hour levels of growth hormone in comparison with normal prepubertal girls (5.1 +/- 0.5 SEM vs 3.4 +/- 0.3 ng/mL, P less than 0.005). Mean 24-hour growth hormone levels did not differ significantly between boys with central precocious puberty and normal prepubertal boys (4.4 +/- 1.2 vs 3.0 +/- 0.4 ng/mL). Serum somatomedin C levels were significantly correlated with mean 24-hour growth hormone levels in the girls only. Height age advancement (expressed as height age/chronologic age) was significantly correlated with mean 24-hour growth hormone levels in both boys and girls with central precocious puberty. We conclude that spontaneous 24-hour growth hormone secretion in girls with precocious puberty is greater than that of normal prepubertal girls and may mediate at least in part the increased growth rate in this disorder. PMID- 3819938 TI - Precocious puberty after traumatic brain injury. AB - After traumatic brain injuries in 33 prepubertal children, precocious puberty was observed in seven. Precocious puberty developed significantly more frequently in girls than in boys (54.5 versus 4.5%, P less than 0.01). Six children with precocious puberty were in coma for greater than or equal to 2 weeks. Follow-up computed tomography revealed cerebral atrophy or focal encephalomalacia in all children with and 69% of children without precocious puberty. There were no striking differences in incidence of motor or cognitive deficits or posttraumatic epilepsy in children with and without precocious puberty. In four of five children, basal sex steroid levels were elevated, and the response to luteinizing hormone releasing hormone stimulation revealed a pubertal pattern after the appearance of secondary sex characteristics. PMID- 3819939 TI - An algorithmic approach to diagnosis of hypoglycemia. AB - An algorithm has been devised to facilitate the diagnostic approach to the causes of hypoglycemia. This systematic approach enables the physician to reach the final diagnosis in a logical way without subjecting the child to unnecessary and possibly hazardous investigations. The algorithm is based on the following measurements as required by each patient: concentrations of blood glucose, lactate, ketone bodies, and glucose-regulating hormones. These measurements are performed with the patient in the fasting state and after loading tests (glycerol and galactose) as needed. If indicated, an enzymatic test is performed to establish the final diagnosis. Eighteen children aged 1 month to 7 years who had persistent or recurrent hypoglycemia have been examined according to this algorithm. The correct diagnosis was arrived at in 17 patients. The diagnosis was not reached in one neonate who had glucose-6-phosphatase deficiency and initially did not have lactic acidosis; once lactic acidosis developed, his illness fitted perfectly into the algorithm. PMID- 3819940 TI - New England Maternal PKU Project: prospective study of untreated and treated pregnancies and their outcomes. AB - Four women with classic phenylketonuria (blood phenylalanine greater than 1200 mumol/L) were given a phenylalanine-restricted diet; three also received L tyrosine supplements. Biochemical measures of nutrition were normal except for iron deficiency anemia, and in one woman folate deficiency. One pregnancy in which treatment began before conception and another treated from 8 weeks gestation, both with blood phenylalanine levels maintained at 120 to 730 mumol/L, resulted in normal newborn infants whose postnatal growth and development have also been normal. A third pregnancy, treated from 6 gestational weeks, was marked by poor dietary compliance until the middle of the second trimester; fetal microcephaly was identified by ultrasonography at 28 weeks but not at 21 weeks. The child has microcephaly and motor delay. The fourth pregnancy, not treated until the third trimester, produced a child with microcephaly, mental retardation, hyperactivity, and neurologic deficits. It is likely that fetal damage from maternal phenylketonuria can be largely and perhaps entirely prevented by dietary therapy, but therapy must begin before conception for the best chance of a normal infant. PMID- 3819941 TI - Linear nevi, hemihypertrophy, connective tissue hamartomas, and unusual neoplasms in children. AB - The association of cutaneous nevi, hemihypertrophy, and connective tissue overgrowth has been described in many patients. We report long-term follow-up in two boys with such association who in addition developed testicular neoplasms. One patient also had progressive spinal cord compression as a result of stenosis of the spinal canal, and required amputation of a severely deformed limb. The importance of careful, long-term management in such patients is emphasized. PMID- 3819942 TI - Incomplete Kawasaki disease with coronary artery involvement. AB - We report four patients with Kawasaki disease in whom characteristic coronary artery abnormalities developed after illnesses that did not meet diagnostic criteria. An additional patient lacked a history of acute manifestations of Kawasaki disease, but severe Kawasaki-like arterial changes were noted at autopsy. Fever was present in four of the five patients, in three lasting from 7 to 14 days. Despite manifestation of few classic acute clinical features of Kawasaki disease, three of four patients had desquamation of the fingers and toes 10 to 14 days after onset of illness, and the fifth had desquamation several months prior to death. These patients were seen over a 2-year period during which 22 other children were seen with Kawasaki disease with coronary artery abnormalities. Thus, strict adherence to currently accepted criteria for diagnosis of Kawasaki disease may lead to failure to recognize incomplete forms of this illness, with potential sequelae of myocardial infarction or sudden death. This finding suggests that children with prolonged unexplained febrile illnesses, especially those associated with subsequent peripheral desquamation, should undergo echocardiography 3 to 4 weeks after onset of the illness. This practice would help to identify those patients with illnesses characterized by incomplete diagnostic criteria but in whom significant coronary abnormalities develop. PMID- 3819943 TI - Pediatric algorithms. PMID- 3819944 TI - On science and subspecialism. PMID- 3819945 TI - Training the pediatrician of the future. PMID- 3819946 TI - Idiopathic hemochromatosis presenting as acute hepatitis. PMID- 3819947 TI - Hemodynamic consequences of neonatal polycythemia. AB - The hemodynamic consequences of neonatal polycythemic hyperviscosity and the effects of partial exchange transfusion were evaluated in 13 infants. Mean (+/- SD) venous hematocrit was 72% +/- 2.5%. After partial exchange transfusion, whole blood viscosity at a shear rate of 11.5 sec-1 decreased from 16.2 to 8.4 centipoise. There were significant (P less than 0.05) increases in heart rate (127 +/- 7.5 to 139 +/- 7.8 beats/min), Doppler-derived cardiac index (200 +/- 35 to 263 +/- 48 ml/kg/min), left ventricular stroke volume index (1.56 +/- 0.23 to 1.89 +/- 0.33 ml/kg), systemic oxygen transport (51.4 +/- 8.4 to 57.9 +/- 11.9 ml/kg/min), and laser-Doppler peripheral (cutaneous) blood flow (+80%) after partial exchange transfusion. The increase in cardiac index probably resulted from reductions in pulmonary and systemic vascular resistance index, the latter decreasing from 0.26 to 0.19 mm Hg/ml/min/kg-1. The greater increase in cutaneous blood flow (+80%) versus cardiac index (+32%) after exchange transfusion suggests hemodynamic compromise and a redistribution of blood flow away from organs that use little oxygen during polycythemia. Our data provide a possible basis for the symptoms of neonatal polycythemia, and demonstrate the acute hemodynamic benefits of partial exchange transfusion. PMID- 3819948 TI - Serial determination of pulmonary function in infants with chronic lung disease. AB - Pulmonary function was measured in 39 infants with chronic lung disease who had required mechanical ventilation starting during the first week of life for a median of 9 days (range 1 to 46 days) and supplemental oxygen for a median of 48 days (range 28-162 days). Their mean birth weight was 1140 g (range 550 to 2325 g), and mean gestational age 29.8 weeks (range 26 to 37 weeks). Ventilation was measured by pneumotachography, esophageal pressure through a water-filled feeding tube, and functional residual capacity (FRC) by a modified nitrogen washout technique. Lung compliance, pulmonary conductance, and FRC were determined at 1, 3, 6, 12, 18, 24, and 36 months after birth. Pulmonary function was also determined in 40 normal children, ranging in age from neonates to 5 years, who served as controls. In infants with chronic lung disease, growth in weight and length followed the 10th to 25th percentiles of the normal curve. Minute ventilation and respiratory effort remained elevated throughout the follow-up. FRC per kilogram of body weight was decreased at 1, 3, and 6 months after birth, but thereafter was in the normal range. FRC increased in proportion to weight at the same rate as in the controls. Lung compliance was only half of normal at 1 month, increased with growth in close correlation with weight, and was approximately 80% of normal at the end of follow-up. Pulmonary conductance was 50% of normal at 1 month, increased little during the first 6 months, but reached 85% of normal at 3 years of age. There was no evidence of gas trapping. These results indicate that in infants with chronic lung disease after mechanical ventilation, lung volume increases normally, probably by formation of new alveoli, which also leads to improvement in lung compliance. Airway growth is slow during the first 6 months after birth, but the subsequent faster growth leads to conductance values close to normal at 3 years of age. PMID- 3819949 TI - Clinical impact of neonatal thrombocytopenia. AB - In a 1-year prospective study, the outcome in infants with a platelet count less than 100 X 10(9)/L (n = 97) was compared with the outcome in an age-, weight-, and disease-matched nonthrombocytopenic control group (n = 80). The hemostatic impact of the thrombocytopenia was assessed by modified template bleeding time, hemorrhage score, and determination of the presence and extent of intraventricular hemorrhage (IVH) in thrombocytopenic infants weighing less than 1500 at birth (n = 39) compared with all nonthrombocytopenic infants less than 1500 g (n = 122) admitted during the study period. The development outcome in infants less than 1500 g was compared at 12 months after delivery. Neonatal thrombocytopenia had a major impact on hemostatic integrity: bleeding time was inversely related to platelet count (r = -0.56, P less than 0.001) and became prolonged when the platelet count fell to less than 100 X 10(9)/L. In addition, many infants (40%) had evidence of platelet dysfunction with prolonged bleeding times despite only moderately reduced platelet counts (75 to 150 X 10(9)/L). The hemorrhage score was greater in the thrombocytopenic infants compared with the sick control infants, and increased as the platelet count fell (r = -0.58, P less than 0.001). The incidence of IVH in thrombocytopenic infants less than 1500 g was 78%, compared with 48% in the nonthrombocytopenic infants (P less than 0.01). In addition, the more severe grades of IVH were more frequent in the thrombocytopenic infants. The serious neurologic morbidity for the surviving infants less than 1500 g was 41% in the thrombocytopenic infants and 7% in the nonthrombocytopenic infants. Thus, on the basis of three indices of abnormal bleeding, thrombocytopenic infants are at greater risk for bleeding than equally sick nonthrombocytopenic infants. The thrombocytopenia itself may have contributed to the high mortality and neurologic morbidity. PMID- 3819950 TI - Decreased gas flow through pneumothoraces in neonates receiving high-frequency jet versus conventional ventilation. PMID- 3819951 TI - Prostanoids in neonates with persistent pulmonary hypertension. PMID- 3819952 TI - Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels. AB - Relations between adolescent psychosocial adjustment problems and markers of biologic development, including chronologic age, pubertal status, and serum hormone levels, were examined in 56 normal boys and 52 normal girls, ages 9 to 14 years. Adolescent psychosocial adjustment was assessed by adolescent self-ratings of various aspects of self-image (Offer Self-Image Questionnaire for Adolescents) and parent ratings of adolescent behavior problems (Child Behavior Checklist). The pubertal status measure used in the analyses was Tanner genital stage for boys and Tanner breast stage for girls. The hormone measures, determined by radioimmunoassay, were serum levels of gonadotropins (luteinizing hormone and follicle stimulating hormone), sex steroids (testosterone and estradiol), and adrenal androgens (dehydroepiandrosterone and its sulfate, and androstenedione). The testosterone/estradiol ratio also was computed. Overall, findings were stronger, more consistent, and more generalized for boys than for girls. For boys, adjustment problems typically were associated with a multivariate profile that may be characteristic for later maturers: relatively low sex steroid levels, or lower pubertal stage, and relatively high adrenal androgen (androstenedione) levels, frequently in conjunction with higher chronologic age. Univariate relations predominated for girls; that is, associated with adjustment problems for girls were relatively high levels of gonadotropins, relatively low levels of dehydroepiandrosterone sulfate, and relatively high levels of androstenedione on their own or in conjunction with lower pubertal stage. Higher levels of androstenedione, a steroid particularly responsive to stress, were associated with adjustment problems in both boys and girls. This relation may reflect the stress of later maturation, which could result from environmental factors, such as adolescent self-comparisons with same-age peers, or endogenous effects of hormones. PMID- 3819953 TI - Relationship between high school student smoking and recognition of cigarette advertisements. AB - We report the results of a study examining the level of advertisement recognition and tobacco experimentation in a group of U.S. high school students. Students who smoked as few as one cigarette per week were found to identify a preferred cigarette brand. One brand of cigarettes accounted for 76% of all preferred brands. A dose-response relationship was found between smoking level and cigarette advertisement recognition, with regular smokers recognizing 61.6% of advertisements, compared with only 33.2% for nonsmokers. These data have potential implications for youth smoking prevention programs. Future research is needed to explain this association and to establish whether cigarette advertising and adolescent smoking are causally related. PMID- 3819954 TI - Birth defects and predisposition to malignant hyperthermia. PMID- 3819955 TI - SI units and pediatric therapeutics. PMID- 3819956 TI - Identifying infants at low risk for bacterial infection. PMID- 3819957 TI - Continuous versus intermittent aminoglycoside therapy. PMID- 3819958 TI - Nephrotoxicity of vancomycin-gentamicin therapy in pediatric patients. PMID- 3819959 TI - The pediatrician and adolescent drug abuse. PMID- 3819960 TI - Manifestations of milk allergy in infancy. PMID- 3819961 TI - Continued functioning of the feeding apparatus during moulting of Boophilus microplus as an adaptation of one-host ticks. AB - Nymphs of the 1-host cattle tick Boophilus microplus remain attached to the host during moulting, but this process is not uniform throughout the tick tissues. The muscles of the pharynx and salivarium remain attached to the cuticle and are functional while the cuticle of the legs has already separated from the underlying epidermis and muscle. The nymphs continue to feed for 2 days after the moulting process in the legs has begun, and they more than double their weight in this time. Mouth-part primordia of the adults develop while the nymphs are still feeding. These adaptations could be an advantage of a 1-host feeding strategy, as they decrease the non-feeding development time spent on the host. In the 3-host tick Haemaphysalis longicornis, which moults off the host, the pharynx, salivarium and legs all begin the moulting process at the same time. PMID- 3819963 TI - Isolation of a neurotoxin from the salivary glands of female Rhipicephalus evertsi evertsi. AB - A quantitative study of the changes in the protein pattern of the salivary glands of female Rhipicephalus evertsi evertsi during the entire repletion process was undertaken. These results, in conjunction with the previously determined toxic phase, indicated the presence of a toxic protein. The development of a sensitive in vitro assay using a Xenopus nerve-muscle preparation, made it possible to identify toxic phases during feeding and to assay fractions of salivary gland extracts during toxin isolation. Sufficient amounts of electrophoretically and chromatographically homogeneous toxin could be obtained through the use of chromatofocusing, enabling its characterization with respect to molecular weight (68 kDa; determined by gel permeation chromatography), pI (6.00), and amino acid composition. The toxin was inactivated by pronase digestion as well as by antiserum. PMID- 3819962 TI - Effects of cholinergic drugs on longitudinal muscle contractions of Fasciola hepatica. AB - Acetylcholine, cholinergic agonists and acetylcholinesterase inhibitors significantly decrease the amplitude and frequency of spontaneous longitudinal muscle contractions in Fasciola hepatica. In order of their effects on the inhibition of muscle contractions, the cholinergic agonists can be ranked as nicotine greater than carbachol greater than acetylcholine. High calcium ion concentration also causes a significant inhibition of contractions. Atropine, a cholinergic antagonist that acts on muscarinic receptors, significantly increases the amplitude and frequency of spontaneous contractions and completely reverses the effects of cholinomimetic drugs, including nicotine. In adult F. hepatica, the levels of acetylcholine and its precursor choline are 3.14 +/- 0.55 and 13.75 +/- 3.72 pmol/mg wet weight, respectively. The activities of choline acetyltransferase, specific acetylcholinesterase and the nonspecific cholinesterase are 1.25 +/- 0.19, 238.0 +/- 13.0, and 83.0 +/- 33.0 nmol/hr/mg protein, respectively. PMID- 3819964 TI - Hemocyte cell surface changes in Aedes aegypti in response to microfilariae of Dirofilaria immitis. AB - This study involved the assessment of surface changes on hemocytes of Aedes aegypti black-eyed Liverpool strain in association with the melanization response against intrathoracically inoculated Dirofilaria immitis microfilariae (mff). Surface changes on hemocytes were identified using fluorescein-labeled wheat germ agglutinin (WGA). In mosquitoes eliciting a melanization response against inoculated mff, there was a 5-fold increase in the percentages of hemocytes exhibiting WGA binding compared with saline inoculated controls. Relationships of this hemocyte activation in relation to cell-mediated melanization responses of adult mosquitoes against mff are discussed. PMID- 3819965 TI - Effects of environmental calcium on fecundity and cercarial production of Biomphalaria glabrata (Say) infected with Schistosoma mansoni Sambon. AB - Biomphalaria glabrata were reared in stock culture and subjected to either 7-day or 60-day acclimation periods in complex CaCO3 media with calcium values ranging from 1.5 mg/L to 75 mg/L. Following 60-day acclimation, snails from series I were each exposed to 8 miracidia of Schistosoma mansoni. Snails of series II were each exposed to a single miracidium. Snails of both experimental regimens were observed for mortality, growth, rate of infection, and number of cercariae shed. Series I snails were also monitored for fecundity during acclimation and following miracidial exposure. Calcium levels of 1.5 and 75 mg/L resulted in significant snail mortality. Shell growth and rates of infection were positively correlated with calcium maintenance level. Snails with high fecundity prior to miracidial exposure subsequently shed more cercariae. In contrast, post-exposure (PE) fecundity of snails reared in media with up to 30 mg/L Ca++ were negatively correlated with calcium level, infection rate, and number of cercariae shed. Maximal cercarial emergence occurred at 30 mg/L Ca++. These results suggest that environmental calcium affects both the distribution patterns of snail hosts of human schistosomes and the productivity of intramolluscan schistosome infection. PMID- 3819966 TI - Proteins and antigens of merozoites and sporozoites of Eimeria bovis (Apicomplexa). AB - Proteins and antigens of first-generation merozoites and sporozoites of Eimeria bovis were examined using standard sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting and lactoperoxidase iodination procedures. SDS-PAGE gels revealed both common and unique protein bands in merozoite and sporozoite extracts, ranging in molecular weight (Mr) from 15,000 to 215,000. Nitrocellulose immunoblots of separated proteins, when probed with sera obtained from immunized calves, revealed numerous IgG-binding antigens of Mr 18,000 to 180,000 in merozoites and Mr 28,000 to approximately 118,000 in sporozoites. Although merozoite and sporozoite preparations each contained antigens of different molecular weights, 4 antigens had the same migratory distance in both preparations (Mr 58,000, 70,000, 83,000, 98,000). Of 3 types of immune sera used to probe immunoblots, serum taken from a calf that had been inoculated with oocysts of E. bovis and boosted 10 wk later by subcutaneous injection with 2 X 10(7) live merozoites emulsified in Freund's complete adjuvant consistently identified and reacted more intensely with more antigens of merozoites and sporozoites than the other immune sera tested. Autoradiographic analysis of radioiodinated parasites revealed major surface proteins on merozoites of between 15,000 and 18,000 Mr and 3 surface proteins on sporozoites of Mr 28,000, 77,000, and 183,000. All but the 183,000 protein elicited an IgG antibody response in the host. PMID- 3819967 TI - Developmental changes in Hymenolepis citelli and Hymenolepis diminuta during patency. AB - Stem cell frequency, wet weight, proglottid number, and egg production were measured in Hymenolepis citelli at specific intervals between 20 and 120 days postinfection in an effort to correlate changes in stem cell frequency to other developmental parameters. Considerable variability was seen in wet weight and proglottid number, but differences did not seem to reflect any relation between these parameters and stem cell frequency. Significant differences were observed in egg production at specific postinfection periods. These appeared to correspond to changes seen in stem cell frequency during patency. Similar changes in egg production which also correspond to measured changes in stem cell frequency were recorded for Hymenolepis diminuta. Differences were also seen in number of eggs contained within gravid proglottids at various times postinfection for both species. PMID- 3819968 TI - Expression of lectin-binding surface glycoproteins during the development of Schistosoma mansoni schistosomula. AB - Tegumental glycoproteins of Schistosoma mansoni cercariae, mechanically produced 24-hr and 48-hr schistosomula, and adult worms were radioiodinated with the Bolton-Hunter reagent, then isolated by lectin affinity chromatography. SDS-PAGE revealed Con A binding glycoproteins with apparent molecular weights of 180,000, 150,000, 43,000, and 30,000 in detergent extracts of the tegument of cercariae. These glycoproteins are retained by 24-hr mechanically produced, cultured schistosomula and are accompanied by the appearance of 2 additional labeled glycoproteins, mol. wt. 66,000 and 57,000. In 48-hr schistosomula, there is a marked increase in the relative size of the 66,000 mol. wt. peak. In contrast, the 57,000 mol. wt. glycoprotein is the major radiolabeled Con A binding component of the adult tegument; the other peaks are either reduced or absent in adults. Similar findings were obtained following affinity chromatography using immobilized Lens culinaris lectin or Ricinus communis agglutinin, and following metabolic labeling of glycoproteins with tritiated galactose. PMID- 3819969 TI - A survey in Louisiana of intestinal helminths of ponies with little exposure to anthelmintics. AB - Ponies reared with minimal or no exposure to anthelmintics were surveyed for intestinal helminths in order to estimate prevalence and intensity of parasite populations unaltered by frequent exposure to anthelmintics. Thirty-seven mixed breed ponies of varying ages were examined. Thirty-four species of nematodes and 2 species of cestodes were found. Twenty-four of the nematode species (including 1 new species) were in the subfamily Cyathostominae (small strongyles). Eighty seven percent of the total burden of adult small strongyles in the large intestine was composed of 10 species. By comparing the results of the present survey with those of recent surveys of horses from herds which had been subjected to treatments with anthelmintics, the effect of prolonged usage of anthelmintic treatment on the prevalence of individual species possibly can be estimated. The general ranking of the 10 most common cyathostome species was similar to those described in recent surveys of horses, suggesting that anthelmintic pressure does not affect the prevalence of most cyathostome species. The lack of anthelmintic treatment appeared not to affect prevalence rates for Anoplocephala perfoliata and Anoplocephala magna when compared to other studies. Conversely, prevalence rates for Strongylus spp., Triodontophorus spp., Craterostomum acuticaudatum, Oxyuris equi, and Parascaris equorum were higher than those reported for these species in recent studies of horses. PMID- 3819970 TI - Development of metacyclic forms of Trypanosoma brucei sspp. in cultures containing explants of Phormia regina Meigen. AB - When procyclic trypanosomes of Trypanosoma brucei brucei and Trypanosoma brucei rhodesiense were cultivated in Nunclon 25 cm2 flasks at 27 C in a liquid medium containing various tissue explants of Phormia regina Meigen, some of them developed into forms infective for mice. The infective stages were present at various periods of up to 29 days when the cultures were terminated. Larger numbers of explants of head-salivary glands than the other tissues used were required to produce infections. Infectivity titrations on trypanosome suspensions of T. b. brucei TRUM 252 and T. b. rhodesiense TRUM 497 indicated that only a small proportion of the populations was infective. Mice were rarely infected with trypanosomes grown in medium without explants. Only 1 mouse of the 11 inoculated developed a parasitemia from a control culture of T. b. rhodesiense TRUM 545. A few trypanosomes resembling epimastigotes and metacyclic forms were seen in stained samples of infective inocula. PMID- 3819971 TI - Further study on the potential vectors of Dirofilaria in Macon County, Alabama. PMID- 3819972 TI - A method for freeing murine plasmodia of contaminating lactate dehydrogenase elevating virus. PMID- 3819973 TI - Acquired resistance in mallard ducks (Anas platyrhynchos) to infection with Sphaeridiotrema globulus (Trematoda). PMID- 3819974 TI - Establishment of monoclonal antibodies that discriminate the antigen distribution specifically found in Anisakis larvae (type I). PMID- 3819975 TI - Adenylate cyclase activity is absent in inactive and motile sperm in the nematode parasite, Ascaris suum. PMID- 3819976 TI - Collection of fertile Ascaris suum eggs. PMID- 3819977 TI - The other side of process validation. PMID- 3819978 TI - Entrapment of bioactive compounds within native albumin beads: II. Effects of rate and extent of crosslinking on microbead properties. PMID- 3819979 TI - Entrapment of bioactive compounds within native albumin beads: III. Evaluation of parameters affecting drug release. PMID- 3819980 TI - Standard particulate sets for visual inspection systems: their preparation, evaluation, and applications. PMID- 3819981 TI - The use of consultants in the parenteral industry. PMID- 3819982 TI - Factors affecting recovery of endotoxin adsorbed to container surfaces. PMID- 3819983 TI - Extraction of bacterial endotoxin from medical devices. PMID- 3819985 TI - Papers presented at the 17th annual meeting of the American Pediatric Surgical Association. Toronto, Ontario, May 14-17, 1986. Part 2. PMID- 3819984 TI - Pediatric trauma. PMID- 3819986 TI - Are published manuscripts representative of the surgical meeting abstracts? An objective appraisal. AB - Abstracts accepted for presentation at a pediatric surgical meeting usually result in publication. This study attempts to evaluate the relationship of abstracts to the finished, published manuscript. Thirty-three papers published in the Journal of Pediatric Surgery over a 2-year period were randomly selected and compared with their original program abstracts. Only 10 of 33 (30%) had the same title and authors as their abstract. Nine manuscripts underwent revisions of their title and two had different first authors. Nine (27%) had one more author, two had 2 more authors, and 3 had one less author. Only 11 of 33 (33%) had the same data in the paper and in the abstract. Fifteen (45%) had numbers that were mathematically inconsistent with their abstracts. (Range was from 75% fewer cases to 210% more patients.) Ten papers had smaller numbers of patients or experiments while nine had larger numbers than their respective abstracts. Of the seven experimental papers, four had smaller numbers than their original abstract. The conclusions stated in the papers were similar to the program abstracts in 23 of 33 comparisons. In the remaining ten, the conclusions were not only different but rather routinely weaker than in the abstract. In no instance were the data or conclusions stronger. Two papers bore little relationship to their abstract. These facts suggest a need for change in the current evaluation process wherein a highly competitive abstract leads to a presentation, which leads to publication. At the very least, the need is shown for authors to evaluate data completely before submitting an abstract, so that the program committee actually reads the true data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819987 TI - Efficacy of emergency room thoracotomy in pediatric trauma. AB - With improved rapid transportation systems, an increasing number of children may arrive at the emergency room (ER) without detectable vital signs and may undergo vigorous resuscitation, including emergency room thoracotomy, aortic cross clamping, and open cardiac massage. Of 1,287 pediatric trauma admissions between 1980 and 1985, 101 deaths were recorded. Fifty (50%) of the deaths occurred in the ER. Thirty-three of the patients were pronounced dead with obvious irreversible injuries, while 17 (34%) with suspected thoracoabdominal injuries underwent ER thoracotomy during resuscitation. None of the 17 patients had detectable vital signs upon arrival to the ER. Fifteen patients had multisystem injuries associated with blunt trauma and two with isolated penetrating injuries. Despite maximal conventional resuscitation and ER thoracotomy, none of the 17 patients survived. In this group of pediatric blunt trauma victims who appear initially salvageable, and present in the ER with no detectable vital signs, ER resuscitative thoracotomy did not influence survival. ER thoracotomy in children, therefore, should be reserved for patients presenting with penetrating thoracic injuries or blunt injuries associated with detectable vital signs and deterioration despite maximal conventional therapy. PMID- 3819988 TI - Fifteen years' experience with penetrating trauma to the head and neck in children. AB - To determine the extent and consequences of penetrating trauma to the head and neck in children, as well as the safety and efficacy of selective management of penetrating wounds of the face and neck, we reviewed our experience with these injuries since 1970. During this interval, 45 children aged 2 to 17 years were admitted for treatment of 37 missile wounds (MW) and eight stab wounds (SW). Most patients reached the hospital within 30 minutes of injury. The greatest single number of these injuries were due to accidents; violent crimes accounted for the remainder of injuries in which a motive for attack was known. Craniotomy was performed in neurologically viable patients only; neck exploration was reserved for those patients who presented with profuse hemorrhage, an expanding or pulsatile hematoma, respiratory distress, or violation of the esophagus, trachea, or great vessels seen on fluoroscopy, endoscopy, or angiography. Overall survival was 87% (MW 84%, SW 100%). Three of the nonsurvivors presented in extremis with gunshot (GSW) wounds to the head, and died shortly thereafter, while two who presented with similar injuries survived craniotomy but died subsequently from irreversible brain damage; one presented in shock due to massive hemorrhage (internal jugular vein transection flush with the base of the skull) and exsanguinated during attempted repair. Among the 39 survivors, 15 sustained multiple wounds, but only two presented in shock, due in both instances to tension pneumothorax. Soft tissue injuries of the scalp, face, and neck accounted for 36 of the 39 nonfatal wounds; five of these involved major cervical structures, but only four required immediate exploration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819989 TI - Current indications for decortication in the treatment of empyema in children. AB - Although most children with empyema respond to antibiotics and pleural drainage, a recognizable number fail to improve. This study reviews experience with ten children over the past 7 years who have been selected for lung decortication for refractory empyema. Decortication was performed because of lack of clinical improvement despite drainage and multiple antibiotics during an average 20-day preoperative hospitalization. Responsible organisms included beta-hemolytic Streptococcus, Streptococcus pneumoniae, and Hemophilus influenzae. A computerized tomographic (CT) scan of the chest was performed in the last eight patients and showed at least a 50% limitation of lung expansion by the products of the empyema in each case. Following decortication, chest tubes were removed, antibiotics stopped, and temperature and white blood cell count returned promptly to normal. The advantages of early decortication in selected patients with empyema who do not respond to antibiotics and drainage include low morbidity, shorter hospitalization, and excellent long-term results. PMID- 3819990 TI - Surgical management of neonatal interstitial emphysema. AB - In the past 6 years, 50 patients with interstitial emphysema in our newborn nursery were treated with open operative procedures to remove interstitial air. Thirty-one were critically ill newborns with severe progressive pulmonary interstitial emphysema treated with pleurotomies. Five underwent pleurotomies on both sides, for a total of 36 operations in the 31 patients. All of the 31 patients underwent aggressive medical management to reduce airway pressure before resorting to operation. Ventilator manipulations, selective bronchial intubation, Forgerty catheter occlusion of the bronchus, and percutaneous lung needling were among the methods used to reduce emphysema in these patients. The operation for all 31 patients consisted of multiple linear pleurotomies to lyse blebs. The hilum was skeletonized to release perihilar blebs. A downhill course was reversed by the operation in over 50% of patients. The operation almost always permanently cured the tension emphysema on that side. Seventeen of the 31 patients lived. Eight of ten patients with unilateral disease lived. All of those patients who died had either very low birth weight, severe preoperative hypoxia, shock, or a combination of these problems. PMID- 3819991 TI - Long-term functional results of prosthetic airway splinting in tracheomalacia and bronchomalacia. AB - The long-term functional results of splinting a collapsing major airway with a silastic Marlex mesh prosthesis were assessed. Six patients in whom follow-up has been longer than 4 years (mean 5.3 years) were studied. The prosthetic semirigid splints had been implanted in five children with tracheomalacia and one with bronchomalacia. Mean age at the time of airway splinting was 4 years (range 6 months to 8 years). At their last clinical evaluation, all six children were leading normal active lives. Three had mild respiratory symptoms not related to the splinting. The only long-term complication was a serous effusion that developed around the splint and compressed the trachea in one child 2 years postoperatively. Tracheal fluoroscopy, barium swallow, and computed tomography scans of the trachea in five patients demonstrated satisfactory tracheal caliber without airway collapse during expiration and coughing. Pulmonary function testing showed a mild increase in airway resistance in one child who had had a tracheostomy. These results demonstrate that the application of composite synthetic graft to a segment of a malacic airway in young patients can provide long-term relief from airway collapse without compromising airway growth. PMID- 3819992 TI - Primary repair of esophageal atresia: how long a gap? AB - Primary esophagoesophagostomy is the treatment of choice for repair of esophageal atresia, particularly the more common type C atresia. Debate continues, however, regarding repair of the type A, or long-gap esophageal atresia. Since the pioneering work of Livaditis, Howard and Myers, the frequency of primary repair of long-gap atresia has increased. Interposition grafting, however, remains as the treatment for gaps longer than 6 cm or with absence of a distal intrathoracic esophageal segment. We report a case of primary esophagoesophagostomy with proximal esophagomyotomy in a 1,900-g infant with an absent distal intrathoracic esophageal segment and an eight vertebral body gap. Utilizing daily bougienage of the proximal and eventually the distal segment, a 1-cm gap was present at 6 months of age. With intraoperative fluoroscopy, the distal intra-abdominal esophageal segment was manipulated thru the esophageal hiatus. Thru an extrapleural approach with a proximal esophagomyotomy, a delayed primary anastomosis was successfully performed. She is currently 3 years old and has a normal barium swallow without stricture or gastroesophageal reflux. PMID- 3819993 TI - Surgical correction of pectus carinatum. AB - Pectus carinatum is an infrequent but eminently correctable chest wall deformity. It is encountered much less frequently than pectus excavatum. In 12 years, from 1973 to 1985, 152 pectus carinatum (16.7%) and 758 pectus excavatum deformities (83.3%) were corrected. It occurs more frequently in boys (119 patients) than girls (33 patients). The majority, 89 cases, were symmetric, while 49 were asymmetric, and 14 were mixed deformities (ipsilateral carinatum, contralateral excavatum). In almost half the patients the deformity was not identified until after the 11th birthday. A family history of chest wall deformities was present in 26%, and of scoliosis in 12%. Associated musculoskeletal abnormalities were identified in 34 patients (scoliosis 23, Poland's syndrome 4, neurofibromatosis 2, Morquio's disease 2, vertebral anomalies 1, hyperlordosis 1, and kyphosis 1). Surgical correction required bilateral resection of the third through seventh costal cartilages in 143 patients, and unilateral resection in nine patients with an isolated abnormality. A single osteotomy was used in 88 patients and a double osteotomy in 53 patients. In 11 cases no osteotomy was required. Mixed deformity with posterior angulation of the sternum was managed by osteotomy and anterior displacement. The remaining cases had sternal osteotomy and fracture of the posterior cortex to correct anterior angulation. The operation was completed with a low complication rate 3.9% (pneumothorax 4, wound infection 1, atelectasis 1, and local tissue necrosis 1). Three patients required revision with additional unilateral lower cartilage resection for persistent malformation of the costal arch. All patients ultimately had a satisfactory result. PMID- 3819994 TI - Reduction of lower esophageal sphincter pressure with Stamm gastrostomy. AB - Although recent clinical studies suggest an association between Stamm gastrostomy and gastroesophageal reflux (GER), no significant experimental data is available. This study evaluates alterations in lower esophageal sphincter (LES) pressure after Stamm gastrostomy in cats. Eight male cats (average weight 3 to 4 kg) were induced under general anesthesia using 20/mg/kg ketamine intramuscularly (IM). Esophageal manometrics were determined for each animal using a continuous perfusion catheter and recording system. Three measurements were taken for each animal. Stamm gastrostomy was then placed in the anterior wall of the stomach two thirds of the way down from the fundus. This was tacked to the anterior abdominal wall 3.0 cm lateral to the midline at the appropriate longitudinal level. Esophageal manometry was repeated after abdominal closure. The animals were awakened and returned to their cages for ad libidum feedings. The animals were reanesthetized with ketamine and manometrics repeated at 7 and 14 days. Each animal served as its own control. Five animals underwent barium esophagram 14 days postoperatively to evaluate for GER. Preoperative mean LES pressure measured 11.4 +/- 3.5 torr. This decreased to 7.8 +/- 2.8 torr immediately after Stamm gastrostomy (P less than .025). When evaluated at 1 and 2 weeks after gastrostomy, further decrease in LES pressures to 6.6 +/- 1.6 torr and 4.8 +/- 1.6 was observed (P less than .02 v preoperative). Three of five cats undergoing barium swallow demonstrated significant reflux radiographically. Stamm gastrostomy caused significant reduction of the LES pressure in all cats studied. This resulted in clinical GER as documented by barium swallow in three of five cats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819995 TI - Neuroradiologic evaluation of sacral abnormalities in imperforate anus complex. AB - Neurologic impairment and sacral spinal anomalies are a finding in children with imperforate anus. The neurologic deficits previously had been considered static rather than progressive. Recent experience at this institution has documented the frequent association of imperforate anus patients having bony sacral and other spinal deformities with progressive neurologic dysfunction. These deficits are related to underlying spinal cord anomalies, which may be amenable to neurosurgical correction. To investigate the nature and frequency of such lesions, spinal cord imaging was done in these patients. From July 1976 to June 1985, 106 patients with imperforate anus were screened with plain radiographs of the sacral spine; 37 (35%) patients had abnormalities. Of these, 26 have been evaluated with a variety of spinal cord imaging techniques, including magnetic resonance imaging (18), digital metrizamide myelotomography (14), computed tomography (10), metrizamide myelography (5), or ultrasound (4). Four patients were lost to follow-up, and seven have not yet been studied. Fifteen of the 26 patients (53%) had one or more abnormal studies. Thirteen were considered to have progressive dysfunction with operable lesions and have undergone neurosurgical correction. At follow-up, there was improved leg function in five patients and improved bladder function in two patients. No patient had additional neurologic deficits after surgery. Because of the high incidence of progressive but potentially correctable myelodysplasias in patients with coexisting anorectal and sacral anomalies, routine radiographic screening of the spine is recommended, followed by spinal cord imaging and neurosurgical evaluation if warranted. PMID- 3819996 TI - Reconstruction of rectal sphincter by transposition of gluteus muscle for fetal incontinence. AB - Many remedial operations have been described for fecal incontinence. We describe a bilateral gluteus muscle transposition to encircle the rectum with striated muscle. This procedure positions a voluntary muscle around the rectum to produce volitional rectal closure, the opposite direction pulling produces a kinking closure of the rectum, and the newly accentuated anorectal angle also facilitates continence. In 6 incontinent patients, 3 were normalized by this procedure, 1 was improved, and 2 had delayed improvement secondary to the development of a fecaloma. Gluteus muscle transposition may be a useful secondary procedure in that patient with muscle dysfunction deficiency fecal incontinence. PMID- 3819997 TI - Multiple-flap anoplasty in the treatment of rectal prolapse after pull-through operations for imperforate anus. AB - Rectal prolapse is a frequent complication after pull-through operations for high imperforate anus. Mucosal prolapse causes soiling, occasional bleeding, and pain. Simple resection of the redundant mucosa is unsatisfactory and leads to frequent recurrences or strictures. In 1982, Millard and Rowe reported a technique designed to correct rectal prolapse using two perineal flaps, thus providing a skin-lined anal canal. We have operated on two patients using the same technique. A three-flap anoplasty was used in nine other patients. With an average follow-up of 13 months, none of out patients presented recurrence of the prolapse or a significant stenosis. This procedure is safe and physiologically sound. The skin lined anal canal provides some sensation where it is lacking. The functional and esthetic results are gratifying and we are now using the three-flap anoplasty as a primary procedure in the correction of high imperforate anus. PMID- 3819998 TI - A unique teletransmission system for extended four-channel esophageal pH monitoring in infants and children. AB - A new computerized telemetry system for extended esophageal pH monitoring is prospectively evaluated and compared with other diagnostic modalities in 38 pediatric patients suspected of having gastroesophageal reflux (GER). Unique circuitry allows connection of 1.5 mm diameter antimony electrodes to a patient worn digital recorder that continuously samples pH at four levels from pharynx to distal esophagus. Ambulatory studies in a "physiologic" environment are possible and data is teletransmitted by the satellite computer to the central laboratory for analysis. Of 41 studies completed, four were lost to interpretation because of battery, electrode, or computer failure. Thirty-seven studies could be analyzed in five clinical groups: emesis and failure to thrive; status post esophageal atresia repair; apnea/bradycardia; central nervous system damage; and status post antireflux procedure. Pathologic GER was noted 14 times and an antireflux procedure was clinically required in 13 instances. In five cases the upper GI series failed to detect the GER. Twenty-three studies showed no GER, and the clinical symptoms resolved with appropriate medical therapy in 21 cases. The upper GI series demonstrated GER five times in this group. In the nine instances that esophagoscopy/biopsy was employed, the pH study findings were uniformly confirmed. This computerized system provided a technically complete and interpretable study 90% of the time. Based on patient outcome, the extended pH monitoring was 92% accurate in detecting clinically important GER with a sensitivity of 87% and specificity of 93%. The upper GI series demonstrated a 69% accuracy with a 60% sensitivity and 64% specificity (P = .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3819999 TI - External silo reduction of the unruptured giant omphalocele. AB - Construction of an external silo dressing over the intact omphalocele membrane allows complete reduction of the giant omphalocele with enlargement of the abdominal cavity before surgical intervention, so that primary closure of the abdominal wall can be achieved. Three infants with giant omphalocele containing a central liver were successfully managed by this technique avoiding the complications associated with operative silo placement or simple membrane painting. PMID- 3820000 TI - Twenty-one year experience with the pediatric gastric tube. AB - From 1964 to 1985 inclusive, gastric tubes have been constructed in 36 infants and children to replace a congenitally defective esophagus or an esophagus with acquired irreparable damage. This report reviews our entire series to date covering a 21-year experience. There were 24 boys and 12 girls ranging in age from 3 months to 17 years. Twenty-two patients were operated on because of congenital esophageal defects and 14 for acquired lesions. A proximally based antiperistaltic tube was constructed in 32 instances, and a distally based isoperistaltic tube made in four. Thirty tubes were passed retrosternally, five through the chest (four with an anastomosis) and one subcutaneously. Twenty-nine infants and children had their tube construction staged, and the remaining seven had the entire procedure done in one stage. The spleen was removed in 23 early gastric tube operations. There were 19 extratube major complications. Twenty-four gastric tube neck anastomoses leaked (66%); all but one closed spontaneously within 3 months. There were 15 esophagogastric tube neck anastomotic strictures (41%), which were dilated; nine required resection. Thirty-two of the 36 infants and children have been followed for more than 1 year. Twenty-nine are swallowing normally, one is still being dilated, and one infant still does not swallow well. Mild sacculation or tortuosity of the gastric tube has been encountered only one. Growth was slow in four until the school years. One boy had his improperly made tube eventually discarded for a colon replacement. There were three deaths (tracheostomy complication, aspiration, gastric tube ulcer hemorrhage). Despite the above problems, the eventual outcome continues to be satisfactory and satisfying.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820001 TI - Esophageal atresia: five year experience with 148 cases. AB - One hundred forty-eight infants with abnormalities of the esophagus treated over a 5-year period were reviewed: 87% comprised esophageal atresia with distal tracheoesophageal fistula. The survival rate for infants in risk group A was 100%, for risk group B, 86%, and for risk group C, 73%. There were six infants with associated anomalies incompatible with survival. Anastomotic leaks occurred in 21% of cases, strictures in 18% and recurrent tracheoesophageal fistula in 12%. The use of braided silk for the repair was associated with a high complication rate. There was a distinct advantage in delaying surgery pending improvement in aspiration pneumonia. Low birth weight was not considered a contraindication for primary repair. Emergency ligation of the fistula was considered a more appropriate procedure than gastrostomy for the infant with associated severe respiratory distress syndrome in whom mechanical ventilation was providing difficult. Congenital cardiac anomalies were the single most common cause of mortality and correction of these anomalies should be pursued aggressively. There were definite advantages of preoperative endoscopy, particularly in identifying proximal fistulae. Elective postoperative ventilatory support for infants with a very tense anastomosis was successful in preventing leaks in five infants. There were no advantages to routine gastrostomy. Severe gastroesophageal reflux and tracheomalacia demand aggressive management. Mortality was directly related to the severity of associated congenital anomalies. PMID- 3820002 TI - Livaditis myotomy in long-gap esophageal atresia. AB - During 1973 to 1983, Livaditis myotomy was performed on 12 esophageal atresia patients in whom anastomosis otherwise would have been impossible. Ten patients had the usual malformation with a distal fistula, while two had an isolated atresia. Four patients belonged to Waterston's risk group A, 4 to group B, and 4 to group C. In 11 cases anastomosis was permitted by myotomy. In one patient anastomosis was impossible even after myotomy. This baby weighed 1,380 g and she also had trisomy 18 with severe cardiac and renal anomalies leading to death. One patient had a refistula and died of pneumonia, she also had a severe congenital cardiac malformation. There were no anastomotic leakages to free pleural cavity nor complications related to the myotomy. The ten survivors were followed up for a mean period of 5.4 years (range 1.6 to 11.3 years). The subjective results at last follow-up according to the criteria of Desjardins were excellent in eight and good in two patients. Esophagograms showed no strictures, but two patients had a myotomy pouch. PMID- 3820003 TI - Intercostal pedicled flap in esophageal atresia. AB - Since 1974 we have used an intercostal pedicled flap (IPF) between the esophageal anastomosis and the sutured trachea in a single case of recurrent tracheoesophageal fistula (TEF) and in four cases of primary repair of esophageal atresia (EA) and TEF in which the distance between both ends was greater than 2.5 cm and with a certain degree of tension in the anastomotic line. Furthermore, in the last two cases reported in this article, we have been able to use the IFP in an extrapleural approach in a way not previously reported. The short-term and long-term follow-ups have been excellent without any complications relating to the esophagus itself or to the pedicle flap of intercostal muscle. The method is considered particularly useful in recurrent fistulas. PMID- 3820004 TI - Tubular musculopleural pedicle grafting of esophageal long gaps in dogs. AB - Direct anastomosis of the esophagus is the treatment of choice in patients with esophageal atresia. If, however, a long esophageal gap exists, the anastomosis is performed under tension or a staged procedure is anticipated. The aim of this study was to prove that a pedicle musculopleural graft can be used to bridge the two esophageal ends. In 14 dogs through a right thoracotomy, the periosteum of the fifth rib was mobilized and the rib was excised. An intercostal musculopleural flap was created leaving the muscle attached to its vascular pedicle posteriorly with the intercostal vessels and nerve carefully preserved. A tube-like portion including pleural and intercostal muscles was formed from the free part of the graft. A 5 cm segment of the esophagus was excised and the tubular graft was interimposed. Animals were studied 1 month postoperatively with a barium meal that showed free passage through the esophageal neolumen. Peristaltic activity was studied with strain gauges above, below, and at the grafted area. Histologic examination revealed good healing at both anastomotic sites, while esophageal squamous epithelium covered the lumen all over the graft. Survival of the musculopleural pedicle graft seems to be feasible providing that its vascular supply is preserved. It is, thus, suggested that this technique might offer an alternative method in bridging long gaps in esophageal surgery. PMID- 3820005 TI - Disorders of the esophageal motor activity in atresia of the esophagus. AB - Esophageal dysfunction has been reported after successful repair of esophageal atresia but its nature has not been clearly defined. We studied esophageal motility in 20 newborns with esophageal atresia by recording intraluminal pressure of both proximal and distal segments. The investigation was made by pressure monitoring of the upper pouch via the mouth and of the distal segment via the gastrostomy. In all cases we found motility disorders. Two patients (12.5%) showed incomplete relaxation of the upper esophageal sphincter. The resting pressure of the esophageal body in both segments was constantly positive in all cases. Lower esophageal sphincter (LES) function was normal in all but two patients (16.7%) in whom the LES pressure was reduced and one case (8.4%) with incomplete relaxation of the LES. These studies suggest that motility disorders are also present in esophageal atresia before surgery. PMID- 3820006 TI - Pulmonary agenesis with esophageal atresia and tracheoesophageal fistula. AB - A twin neonate with esophageal atresia, tracheoesophageal fistula, and agenesis of the right lung from consanguinous parents is reported. The twin brother was normal. The baby eventually made a good recovery after delayed primary esophageal anastomosis. Thirteen similar cases have been reported in the literature but all died. PMID- 3820007 TI - Early prediction of outcome following head injury in children. AB - A retrospective survey of 166 children aged 15 years or less was made in an attempt to identify which clinical features presenting in the first 24 hours after a head injury might be helpful in predicting the eventual outcome as defined by the Glasgow Outcome Scale. In 88% of the children, the trend of Glasgow Coma Scale score over the first 24 hours was useful. This included children admitted with a score of 3 or 4 and those with a score of 5 or more who did not deteriorate within 24 hours of injury. In this group only 2% of the predictions would have been inaccurate and in only 0.7% would the outcome have been worse than the prediction. The presence of both abnormal plantar and pupillary light reflexes predicted death or significant disability in 99% of cases. PMID- 3820008 TI - Partial splenic decapsulation: a simplified operation for splenic pseudocyst. AB - Splenic pseudocysts have traditionally required splenectomy because of the risks imposed by partial splenectomy or excision of the cyst lining. During the past 2 years, a 6-year-old boy and a 9-year-old girl presenting with vague upper abdominal discomfort, palpable splenomegaly, and a large unilocular sonolucent cyst within the spleen, were treated by partial splenic decapsulation with preservation of the hilar blood supply. This procedure involves mobilizing the spleen by dividing the renal, colic, and diaphragmatic attachments; decompressing the liquefied cyst contents through a thoracostomy trochar; excising the outer splenic capsule and gaining hemostasis of the splenic wall with a running interlocked silk suture; and providing external tube drainage of the left upper quadrant. During the follow-up period of 26 and 12 months, splenic size has returned to normal. Serial nuclear scan and ultrasound show a small residual crescent-shaped deformity of the functioning splenic remnant. We conclude that partial splenic decapsulation for splenic pseudocyst is simpler and safer than other preservation procedures attempted, and carries no increased risk of recurrence from leaving a portion of the pseudocyst wall. PMID- 3820009 TI - Hydatid disease of spleen treated by cyst enucleation and splenic salvage. AB - A 4-year-old boy with unilocular hydatid cysts of spleen and liver was successfully treated by enucleation of both the cysts and salvage of the spleen. The conventional surgical treatment of choice for hydatid cyst of the spleen is splenectomy. The authors demonstrate that preservation of a spleen afflicted by hydatid disease is technically feasible and is recommended as the choice of treatment to obviate the well-recognized postsplenectomy complications especially in children. PMID- 3820010 TI - Early ileostomy closure in necrotizing enterocolitis. AB - The nutritional and metabolic complications following intestinal resection and ileostomy for necrotizing enterocolitis (NEC) in low birth weight preterm infants often necessitate repeated prolonged hospitalization for salt and water imbalance and reliance on total parentaral nutrition (TPN). The traditional concerns about anesthetic and anastomotic complications delays the restoration of intestinal continuity until the infant has attained a weight of about 5 kg, but recent nutritional balance studies in our unit have shown a combination of nutrient and mineral malabsorption in neonates with ileostomies. Beginning 4 years ago, a prospective study of early closure of the ileostomy was undertaken in infants weighing as low as 2 kg to examine the effect on surgical morbidity, infant growth, and gastrointestinal function using the preclosure infant as his/her own control. Ten infants with birthweights ranging from 670 to 2,000 g developed NEC requiring ileostomy at age three days to 11 weeks. In addition to partial ileal resection, the cecum was resected in 10 patients, ascending colin in 7, transverse in 4, descending colon in 1 patient. Postoperative treatment, including short-term TPN and elemental diet, preceded closure of ileostomy at a mean age of 18 weeks (range 5 to 36 weeks). Mean weight at time of closure was 3,052 +/- 994 g. There were no short-term complications of early closure in this series, nor was there any incidence of anastomotic dysfunction, colon stricture, or recurrent NEC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820011 TI - Early closure of enterostomy after exteriorization of the small intestine for abdominal catastrophies. AB - Little has been written about the follow-up after temporary exteriorization of the small bowel for intraabdominal catastrophies in neonates and small infants. This report summarizes our results in 27 patients who had as a rule intestinal continuity restored electively within 4 weeks. There was a leakage rate of 10% and no mortality. PMID- 3820012 TI - Bowel perforation with nonoperative treatment of meconium ileus. AB - Over the last 11 years, 22 neonates were treated with water-soluble contrast enemas to relieve the obstruction of meconium ileus. Fifteen babies had a gestational age of at least 36 weeks, and 16 weighed more than 2,500 g. All presented with clinical findings of a bowel obstruction, confirmed by roentgenograms, and each eventually had high sweat chloride levels. Each neonate had from 1 to 4 water-soluble contrast enemas administered slowly by syringe over 15 to 30 minutes. Eight enemas were successful in relieving the obstruction, four newborns requiring only one enema. Fourteen were unsuccessful, three having more than one enema. Seven of these 14 had intraabdominal pathology that would have required surgery. In five babies the bowel was perforated by the enema, the colon in three, and terminal ileum in two. These perforations were all immediately recognized during the course of the enema and operated on forthwith; a stoma was made in four cases. Only one of these five babies would have required an operation because of a volvulus. There were no fluid or electrolyte disturbances caused by the contrast material, and none of the babies with perforations died. Although this enema technique was successful in one third of cases, and despite the fact that perforations ensued in one quarter of cases, the procedure still seems warranted if the following precautions are taken: establishment of proper temperature, fluid, and electrolyte balance; the radiologist is not rushed, is extremely gentle, willing to repeat the study until no further progress is evident; the surgeon is available for an immediate laparotomy should a perforation occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820013 TI - The meconium ileus equivalent following appendectomy. AB - A child with cystic fibrosis developed the meconium ileus equivalent in the postappendectomy period. This problem has not been emphasized in patients with cystic fibrosis. Operative evacuation only partially relieved the obstruction. Transient upper gastrointestinal bleeding fortuitously produced beneficial effect, which completely resolved the persisting ileus. PMID- 3820014 TI - A 7-year study of the diagnostic value of rectal mucosal acetylcholinesterase measurement in Hirschsprung's disease. AB - Over a 7-year period, 213 children were investigated for failure to pass meconium or for chronic constipation. Of these, 45 were confirmed to have Hirschsprung's disease; in this group the acetylcholinesterase activity in rectal biopsy tissue was significantly increased (P less than .001; mean 34.2, 95% confidence limits, 8.6 to 95.2) units g-1 when compared with the non-Hirschsprung's group (mean 6.6, 95% confidence limits, 2.0 to 15.9 units g-1). By expressing the acetylcholinesterase activity as a percentage of the total cholinesterase activity it is possible to compensate for evaporative weight loss and the combination of these two measurements improves the overall diagnostic value of the test. There were no false-positive and only two false-negative results. PMID- 3820015 TI - Enterocystoplasty in the management and reconstruction of the pediatric neurogenic bladder. AB - Eighteen children and young adults with neurogenic bladder underwent enterocystoplasty as part of urinary undiversion or for treatment of incontinence associated with reduced bladder compliance or detrusor sphincter dyssynergia. In 12, tubular sigmoid enterocystoplasty with transureteroureterostomy was performed with the smaller diameter ureter implanted into the bowel tenia. In two patients the ileocecal segment was used to augment the bladder, and the ureters were anastomosed to the ileum. In four patients the cecum or a patch of sigmoid colon was used to augment the bladder. Young-Dees bladder neck reconstruction was performed on eight patients at the time of surgery; one later required bladder neck reconstruction, and two later required an artificial sphincter. After a mean follow-up of 20 months, 16 of the 17 available for follow-up are continent with clean intermittent catheterization every 3 to 4 hours. Nine patients require anticholinergic or smooth muscle relaxing medication to increase functional bladder capacity. Most of the patients need chronic antimicrobial treatment to control bacteriuria. PMID- 3820016 TI - Urolithiasis in childhood: current management. AB - During the past 12 years, 62 children with urinary stones have been treated at the Children's Hospital of Philadelphia. The most common presenting symptoms were abdominal or flank pain (45%), recurrent or persistent pyuria (35%), and gross hematuria (21%). Twenty-two patients had associated congenital urologic anomalies. Infection-related struvite stones were most common and were found in 18 children, of whom 15 were found to have anatomic abnormalities. Eighteen of 28 children evaluated for a metabolic cause were found to have an abnormality, most frequently hypercalciuria. No predisposing factors could be found in 16 of the 62 patients. Forty-four (87%) children had upper urinary tract stones. Twelve of 15 bladder stones were in children with a neuropathic bladder and all were related to infection. Treatment was directed to the correction of anatomic and metabolic predisposing causes, as well as to removing the stones. Fifteen patients passed stones ranging in size from 2 to 6 mm. Forty-six surgical procedures were performed in 43 children. Pyelolithotomy and cystolithotomy were the most frequent procedures. There were three residual stones and five recurrences. Of the 29 operations for upper urinary stones reviewed, 17 might today be considered suitable for percutaneous nephrostolithotripsy or extracorporeal shockwave lithotripsy. Possible future stone management will be discussed in light of this analysis. PMID- 3820017 TI - Posterior urethral valves in the newborn: treatment and functional results. AB - Between 1977 and 1984, 30 newborn boys were diagnosed and treated with posterior urethral valves. Presenting symptoms varied but included respiratory distress, oligohydramnios, urinary ascites, abdominal mass, urinary retention, and renal insufficiency. Diagnostic modalities consisted of excretory urography and voiding cystourethrography in all patients and ultrasonography in 20 (12 prenatal). Treatment consisted of valve ablation alone in 14, vesicostomy and later valve ablation in 4 premature infants, valve ablation and later upper tract reconstruction in 8, loop ureterostomy in 2, and valve ablation and immediate reconstruction in 2. Follow-up in our patients has demonstrated that even though surgical reconstruction may be technically successful, ultimate functional outcome may be dependent upon the degree of renal impairment at presentation. PMID- 3820018 TI - Neonatal genital reconstruction. AB - It is evident from studies of boys who suffered a surgical catastrophe at a young age and were then assigned a female sex role that cultural and environmental influence are a potent determinant of a child's gender identity. It is imperative that parents have their child's sex assignment firmly fixed in their minds as early as possible. Early surgical correction of a child with ambiguous genitalia to conform to the sex of assignment will serve greatly to reinforce appropriate behavior in the parent. Such surgical intervention for diagnostic and reconstructive purposes is both desirable and safe in the first weeks of life. PMID- 3820019 TI - Penile agenesis: a report of six cases. AB - Agenesis of the penis is an extremely rare anomaly, occurring only once in 30 million births. This low incidence is responsible for the limited experience with this anomaly. There are only about 70 published cases, most reports being of one or two patients. This complex malformation requires urgent assessment at birth for several reasons: Female sex assignment is required early. Gonadectomy should be performed in the first few days of life to prevent male gender sex marking from the testosterone surge occurring between the tenth and the 60th day of life. Early gonadectomy and genital reconstruction helps the family to accept the child's altered gender and to reduce psychological problems. PMID- 3820020 TI - Complete epispadiac urethral duplication. AB - A case of complete epispadiac urethral duplication is reported. The epispadiac opening was at the base of the penis. This case is unusual because the anatomy was otherwise normal and the incontinence was intermittent. PMID- 3820021 TI - Abdominoscrotal hydrocele. AB - This report concerns the youngest case so far described in the world literature of abdominoscrotal hydrocele. Although this rare variant of hydrocele of the tunica vaginalis was first described in 1834, only five cases have been recorded in childhood to date; our case represents the sixth. PMID- 3820022 TI - Congenital nasopharyngeal teratoma: report of a case and review of the literature. AB - We report a case of congenital nasopharyngeal teratoma with cervical extension and review the literature on nasopharyngeal teratomas. PMID- 3820023 TI - Bilateral congenital posterolateral diaphragmatic hernia. AB - The 11th recorded case of bilateral congenital posterolateral diaphragmatic hernia is here presented. Left-sided diaphragmatic hernia was corrected surgically, while the baby expired because of respiratory failure on the 31st operated day. Autopsy revealed that the baby had right posterolateral diaphragmatic defect with sac. From this experience, it might be said that at surgery for left-sided hernia, right diaphragm should be examined carefully. PMID- 3820024 TI - Emergency gastrotomy: treatment of choice for iron bezoar. AB - The authors believe that gastrotomy and surgical removal of tablets is the treatment of choice in massive iron ingestion with development of an "iron bezoar" unresponsive to gastric lavage. Prompt surgical treatment in such cases may be lifesaving. PMID- 3820025 TI - Splanchnic bed vascular malformations and the development of portal hypertension. PMID- 3820026 TI - Spontaneous deep vein thrombosis in children and adolescents. PMID- 3820027 TI - The endoscopic and surgical management of pyriform sinus fistulae in infants and children. PMID- 3820028 TI - High altitude treatment of imperforate anus. PMID- 3820029 TI - Effect of continuous infusion of norepinephrine on maternal pelvic and fetal umbilical blood flow in pregnant sheep. AB - The effect of continuous maternal intravenous infusion with norepinephrine on the blood flow in the maternal internal iliac and the median uterine artery was studied in ten chronically instrumented pregnant sheep between 104 and 146 days gestation. Furthermore the effects on umbilical venous blood flow, fetal heart rate and acid-base balance were analyzed. Maternal and fetal blood flows were measured with electromagnetic flow transducers. Norepinephrine was administered to the ewe via a continuous intravenous infusion in increasing sequential doses of 15 minutes duration from 4 to 40 micrograms per minute. Variations of often considerable magnitude associated with e. g. micturition, defecation and fear of the ewe occurred in the maternal pelvic blood flow during the steady state period. The blood flow in the maternal vessels substantially decreased immediately following the onset of the norepinephrine infusion but gradually returned towards the preinfusion level despite the continued drug infusion and except one no significant changes in blood flow were found at the end of each sequential infusion period. Umbilical venous blood flow did not change. No significant changes in fetal arterial blood pressure, heart rate and acid base balance were found. It is concluded that the decrease in maternal pelvic blood flow associated with continuous norepinephrine administration gradually abates with time, possibly by the involvement of local factors such as prostaglandin formation and/or by the phenomenon of down-regulation. PMID- 3820030 TI - The concentration of bupivacaine in fetal organs during obstetrical epidural analgesia. AB - The concentration of bupivacaine in organs of non-viable human fetuses after obstetrical epidural analgesia in customary doses was investigated. The concentrations were determined with a gas chromatograph. The material consisted of a fetus who died following termination in the 24th week of pregnancy three minutes after birth without spontaneous respiration. The other fetus was born maturely in the 40th pregnancy week with anencephaly who lived 20 minutes following initial spontaneous respiration. Most noteworthy were the increased concentrations in the liver indicating the important metabolic function of the liver for the metabolism of bupivacaine in the fetus. Further a very high pulmonary concentration was found in the mature fetus. Even though blood gases analysis were not performed we conclude that: the lung is the best perfused organ after birth and onset of spontaneous respiration because of the closure of the ductus arteriosus; because of the increasing agonal respiratory acidosis, bupivacaine accumulates in the lung, the organ from which the acidosis originates. Also, the ionized form the bupivacaine is unable to leave the intracellular space. For the clinical use of epidural analgesia during delivery, these results constitute an important indication for avoiding fetal acidosis before and during the action of such analgesia. This mandates strict and continuous fetal monitoring. Our results in agreement with other authors show that during fetal acidosis and simultaneous administration of bupivacaine the fetal distress may be potentiated by an accelerated transfer of the anesthetic agent into the fetal placental space. Under normal conditions one may assume that this technique of analgesia has a positive effect on the fetus because of the improved placental perfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820031 TI - Effects of intraamniotically administered thyroxin on acceleration of fetal pulmonary maturity in preeclamptic toxemia. AB - In 18 cases of serious and fairly serious toxemic pregnancy, the authors gave 500 micrograms L-Thyroxin "Henning" intraamniotically after the laboratory evaluation demonstrated negative pulmonary maturity from an amniotic fluid sample. Maternal and fetal complications due to the drug could not be observed. Despite a 39% premature incidence, IRDS and hyaline membrane disease were not observed. The administered T4 caused a positive change in the direction of the L/S ratio and the Clements test. The other amniotic fluid parameters did not change, except the T4 level. The extremely high T4 level obtained 48 hours later gradually became normal several days later. The T4 values obtained from the blood of the mother and the newborn on the 5th postnatal day were normal. In toxemic cases where the induction of labor is vital and there is a risk of IRDS and steroid application in contraindicated, intraamniotic thyroxin is recommended as prophylaxis for IRDS. PMID- 3820032 TI - Placental transfer of parathyroid hormone. AB - We investigated the in vitro transfer of three parathyroid hormone (PTH) fragments (amino acids 35-84, 44-68 and 65-84) through human placenta at term. The perfused and transferred fragments were measured radioimmunologically and identified by three different methods: high-pressure-liquid chromatography (HPLC), preparative flat-bed electrofocusing (PEGG), and gel filtration (GF). The study demonstrated that PTH fragments traverse the human placenta. The transferred and perfused fragments were identical. We observed a significant degradation of the perfused hormone during the passage through the placenta in both fetal and maternal directions. In addition, we measured the PTH concentrations on forty samples of maternal and umbilical cord artery and vein plasma obtained immediately after delivery. A highly significant correlation of PTH concentrations in the maternal and umbilical cord vessels was observed. These findings support the contention that human placenta at term is permeable for PTH fragments. PMID- 3820033 TI - Total nitrogen and electrolyte levels in colostrum and transition human milk. AB - The objective of this research was to study the composition of human milk in terms of protein levels and levels of the electrolytes sodium, potassium, calcium, magnesium, phosphorus and chloride in colostrum 48-72 hours post-partum, and in the transition milk (96 +/- 9 hours, 120 +/- 9 hours and 144 +/- 9 hours post-partum) of mothers who had fullterm and pre-term deliveries. The mothers were kept in the hospital with the objective to control a few important lactation parameters such as exercising or resting conditions, sleep, nutrition and suckling stimulation. Only low socioeconomic level mothers took part in the study. The initial period of lactation was studied because this is the time when secretion suffers rapid changes, going from colostrum to transition milk, and then to mature milk. The results observed for the different times and for the two groups were compared both within and between groups. No significant differences were obtained for any of the comparisons, except for transitory oscillations in potassium, calcium, chloride and phosphorus levels observed within groups. In general, it can be said that there was no variation between colostrum and transition milk for the mothers who delivered at full term or pre-term. No differences were found either when the groups were compared at the different times post-partum. This means that, under the conditions used in this study, milk did not vary as its type naturally changed (from colostrum to transition milk) for the two groups and that the levels of the constituents studied also remained unchanged when studied as a function of full-term or pre-term delivery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820034 TI - Concentration of free fatty acids (FFA) in amniotic fluid and maternal and cord serum in cases of intrauterine growth retardation. AB - There were no efficacious methods of diagnosing the syndrome of intrauterine growth retardation (IUGR) before birth. Only about 50% of cases with this syndrome can be recognized by clinical examinations. The aim of our investigations was an attempt to determine free fatty acid level (FFA) in amniotic fluid as a biochemical test in prenatal diagnosis. The investigations were carried out in 49 pregnant women and their newborns in whom IUGR was diagnosed clinically. The control group consisted of 30 pregnants who had an uneventful pregnancy and normal labor. Samples of amniotic fluid were taken in the first stage of parturition (dilatation of cervical os +/- 4-5 cm) by vaginal amniocentesis or amniotomy during cesarean section. The concentration of FFA in samples of amniotic fluid and serum were determined by Ducombe's method. It was found that during pregnancy complicated by IUGR, the free fatty acid concentration in amniotic fluid was almost three times higher than in normal pregnancy (0.355 mmol/l and 0.125 mmol/l) respectively. These differences are statistically significant (t = 12.58 p less than 0.001). Thus, determination of FFA can be used as a biochemical test in prenatal diagnosis of IUGR. PMID- 3820035 TI - Abdominal electrocardiography in intrapartum fetal heart rate monitoring. AB - Abdominal fetal electrocardiography (AFECG) as a means of intrapartum fetal heart rate (FHR) monitoring was studied in 700 consecutive labors in a small hospital. Sixty-eight pregnancies were excluded from the study because of the elective cesarean section or because labor was too short for electronic monitoring. AFECG succeeded (at least 30% of fetal heart intervals obtained) throughout labor in 99 of 632 monitored labors (16%). Ultrasound was needed in six cases (1%). The rest (527) were monitored first with the use of AFECG, and later with the use of direct FECG. The mean beat-to-beat variation of FHR (differential index) during last two hours of labor measured from AFECG signal was similar to that measured from AFECG and direct FECG. Hence the same reference values of the differential indices for both methods can be used. The mean long term variation (interval index) measured from AFECG was lower than that measured from abdominal and direct FECGs consecutively. Ultrasound is rarely needed during labor, and it should be avoided except in breech presentations, in association with low placentas and twins, if recording of AFECG fails. PMID- 3820037 TI - Advances in fetal echocardiography. Proceedings of the International Workshop on Fetal Electrocardiography. Nottingham, November 25-27, 1985. PMID- 3820036 TI - RDS prevention: benefit and risk. PMID- 3820038 TI - Limitations of current fetal monitoring technology. AB - Continuous recordings with a cardiotocograph are confused with the concept of monitoring. One of the continuing problems is ensuring that recordings are properly monitored by the clinical staff. Previous simplistic attempts at producing true monitors which failed to work inhibited the development of more sophisticated approaches which modern technology now make possible. The use of computers in this field would not only reduce the monitoring load on the staff but also have advantages in data storage, data transfer and in audit. The profession has failed to demand, and the manufacturers to offer, the advantages of modern technology which could improve our level of intra-partum care. PMID- 3820039 TI - Techniques for the routine on-line processing of the fetal electrocardiogram. AB - In order to routinely monitor the fetal electrocardiogram (FECG), during labor, in an on-line real-time situation, the following processes need to be undertaken: The FECG signal must be recovered from noise. The recovered signal or waveform must be measured with a high degree of precision in order to generate the timing intervals, areas and parameters that are of interest to the clinician. The FECG and measured parameters must be presented to the clinician in a meaningful and simple format. Control of the machine and its processing should be a user friendly operation. In the current work, a system is described that uses digital filtering to recover the FECG waveform from low frequency biological noise and associated artifacts. A linear model of the FECG waveform is used to evaluate some 18 different timing intervals of the FECG. The enhanced waveform and accompanying parameters are displayed upon an intelligent graphics terminal to achieve a user friendly operation of the system by clinical staff. PMID- 3820040 TI - The fetal electrocardiogram: current clinical developments in Nottingham. AB - The fetal electrocardiogram (FECG) has been recorded from 155 women in labor using a fetal scalp electrode and a minicomputerized enhanced averaging technique. Fetal hypoxia, acidosis, and stress have been diagnosed by analysis of blood from the fetal scalp, and post delivery from full gas analysis from blood taken from the umbilical artery and vein. Umbilical venous levels of serum lactate, adrenaline, noradrenaline, potassium and hemoglobin were also determined. A P wave was seen to be present in all cases recorded. The P-R interval correlated both with fetal autonomic nervous activity, and with the R-R interval of the healthy fetus. The P-R--R-R interval correlation altered with increasing fetal acidosis. QRS complex changes were varied and not usually related to fetal condition. ST segment changes occurred with increasing fetal acidosis. T wave analysis although incomplete, has shown no obvious correlation with fetal condition. PMID- 3820041 TI - Spatial filtering of the fetal electrocardiogram. AB - One of the basic problems in the analysis of the rhythm and the shape of the fetal ECG (FECG) is the interference caused by the electrical activity of the maternal heart (MECG). Methods devised for suppressing the maternal signals in the abdominally recorded leads obviously have to rely on differences in the characteristics of both kinds of signals. In the past various differences have been employed for this purpose such as differences in wave shape, frequency content and source location. The method presented here is based on the latter principle. The electrical sources of the fetal and maternal heart are clearly separated in space. By employing multiple abdominal leads, a linear combination of the recorded signals can be formed which acts effectively as a spatial filter. As such the filtering characteristics depend exclusively on the separation inside the human body (the electrical volume conductor) and, as such, can be expected to be independent of the temporal aspects of the recorded signals. In particular, the obtained filter is unaffected by the occurrence of ectopic beats in either the fetal or the maternal heart. The determination of the required filter (weighting coefficients) is carried out by using the technique of singular value decomposition (SVD) of the data matrix representing the sampled input signals. The filter effectively suppresses the maternal component in the filter output and optimizes the fetal component. The properties of this filter are demonstrated. PMID- 3820042 TI - An adaptive on-line method for the extraction of the complete fetal electrocardiogram from cutaneous multilead recordings. AB - The detection of a fetal electrocardiogram (FECG) is described to be a so-called inverse problem. A geometric interpretation of such a problem is presented. It can be solved by determining the weights to be used in one or more weighted sums of measurement signals. A novel method is presented to determine these weights. Theoretical and experimental evidence is given that this method has the following attractive properties. Application of the method results in one or more FECG signals, free of maternal ECG (MECG) which are at the same time maximal with respect to noise. It is shown that one FECG signal does not always suffice to describe the observed electrical heart activity in a set of cutaneous electrodes, equivalently to the adult ECG (see figure 7). It is explained and experimentally verified that the application of three thoracic signals is useful to guarantee the suppression of the MECG. The positions of the abdominal electrodes then determine the obtained FECG to noise ratio, and will have no influence on the degree of MECG suppression (see figure 6). It is expected that a total of about eight measurement signals are sufficient in most cases. The method is simple to apply by medical personnel, and after a transient of about 1 s the signals with the mentioned properties are obtained (see figure 5). Further on, the weights are allowed to change in order to adapt automatically to sudden changes in the measurement signal properties (see figure 6). These may occur e. g. due to fetal movement. Application of the method requires no human interpretation or decision in order to obtain the claimed properties. PMID- 3820043 TI - The potential distribution generated by the fetal heart at the maternal abdomen. AB - The pathways along which the electrical currents generated by the fetal heart are conducted to the surface of the maternal abdomen are not known. As a consequence, in recording the fetal electrocardiogram (FECG) it is hard to predict where electrodes should be placed in order to obtain an optimal signal. The amplitude of the FECG varies with gestation, and there is a large interindividual variability in the amplitude of the FECG and in the optimal recording site among subjects within the same gestational age. Attempts have been made to explain these phenomena in terms of volume conduction. In this research the complete potential distribution on the maternal abdomen is studied in connection with the geometrical configuration of the electrical source (fetal heart) and the volume conductor (surrounding tissues). For a small group of pregnant women the abdominal FECG is recorded simultaneously in 32 leads during a period of about one minute, once every two weeks from 20 weeks of gestation onwards. A spatial filtering technique which combines information of all 32 leads is used to provide a trigger of the fetal QRS complexes. Using this trigger, an average fetal complex is constructed for each lead by time coherent averaging, after subtraction of the maternal contribution. These average fetal complexes are combined to plot the complete potential distribution generated by the fetal heart at the maternal abdomen (fetal body surface map, FBSM) at any given time instant during the fetal cardiac cycle. At these recording sessions the geometry is carefully quantified by making transverse scans every 2 cm with a compound echo scanner. The contours of fetal head and body, the placenta and the uterus are manually drawn on hardcopies of the video display images. Real time echoscopy is used to support the identification of the geometry. The contours are fed into a computer using a graphics tablet. The three dimensional surfaces of fetus, placenta and uterus are separately represented by a triangulation of the respective contour lines. Figures 5 and 6 show an example of the triangulated representation of the recorded geometry. Figure 7 shows the average fetal complexes of an individual at 26 weeks of gestation, plotted at the site where they have been recorded.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3820044 TI - Variability analysis of fetal heart rate signals as obtained from abdominal electrocardiographic recordings. AB - The present paper introduces an original method of digital signal processing for an automatic analysis of non-invasive abdominal ECG recordings on pregnant women starting from the 25th week of gestation. The procedure has been implemented on a DEC-VAX 750 digital computer at the Department of Electrical Engineering, Polytechnic of Milano and the signals are recorded at the Department of Obstetrics and Gynecology "L. Mangiagalli", University of Milano, Italy. The experimental results presented in here are still preliminary as only few cases have been considered up to now (about 20) and the goal of the paper is mainly focused on the algorithmic aspects of the whole procedure implemented in the computer and on the approach of heart rate variability (HRV) signal analysis both in the mother and in the fetus. Abdominal ECG lead processing is illustrated starting from the step of maternal (M) and fetal (F) QRS recognitions through linear digital filtering (derivative and low-pass FIR filter, Weber-Cappellini window) and weighted averaging techniques synchronized with maternal QRS's. Figure 1 a shows the original abdominal lead; figure 1 b the filtered signal for MQRS recognitions; figure 2 a the template of maternal cardiac cycle as obtained after the averaging operation synchronized with the instants of MQRS occurrence. The subtraction of the template results in the abdominal lead shown in figure 1 c in which the contribution of MECG is practically entirely reduced even in the case of MQRS and FQRS overlapping.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820045 TI - Information seeking of high- and low-anxiety subjects after receiving positive and negative self-relevant feedback. AB - The present paper reports an experiment in which subjects received fictitious intelligence test feedback that was either negatively or positively discrepant with their self-evaluation. They were then given an opportunity to choose among several articles containing information that either derogated intelligence tests (test-disparaging information) or argued for their validity (test-supporting information). The main finding of this study consists of an interaction between the personality factor anxiety and the feedback variable: High-anxiety subjects prefer test-disparaging information significantly more in the negative feedback condition than in the positive feedback condition, whereas low-anxiety subjects show no difference in preference for test-related information as a function of the feedback condition. These results are in line with past theoretical reasoning and experimental findings showing that high-anxiety subjects feel more threatened by negative self-relevant feedback than do low-anxiety subjects. PMID- 3820046 TI - An examination of the relation of individual difference variables to loneliness. AB - This study investigated the relation of five individual difference variables (extroversion, depression, self-esteem, neuroticism, and attitude toward others) to loneliness. The relative contributions of two different models that might explain these relations were examined. One model suggests that individual difference variables are related to loneliness through the mediation of social network variables; that is, individual difference variables may reduce people's motivation and/or ability to build and maintain social relationships, which in turn leads to loneliness. The second model, the cognitive bias model, states that both the individual difference variables and loneliness are influenced by the same intrapersonal, cognitive processes. Some people are prone to negative affect and tend to evaluate themselves and their relationships negatively. The relations of self-esteem, neuroticism, and depression to loneliness were hypothesized to reflect the cognitive bias model, while extroversion and attitudes toward others were hypothesized to be related to loneliness through the mediation of social network variables. Eighty-two female and 42 male adults completed measures of loneliness and the five individual difference variables, as well as an instrument assessing their social networks. The results indicated partial support for both models for each of the individual difference variables. Together, the two models did a good job of explaining the correlations of the individual difference variables and loneliness. The implications of these findings, as well as their relation to previous research, are discussed. PMID- 3820047 TI - Self-report measurement of type A behavior: toward refinement and improved prediction. AB - Self-report measures of Type A personality receive wide research usage despite mounting evidence that they are poor predictors of coronary heart disease. It was proposed that the limited prediction results in part from the failure to restrict measurement to only those Type A characteristics that are demonstrably related to excessive stress. The first study in this article reports a factor analysis of all items on the Jenkins Activity Survey (JAS), the most popular Type A questionnaire, along with 25 stress symptoms. Self-ratings were obtained from both male and female college students. Only one stress-related factor emerged including 12 JAS items out of 44. These were relevant to (a) hard-driving and competitive, (b) time-urgent, and (c) hostile/irritated characteristics. Study 2 reports correlations of +.50 and +.43 between the stress-relevant JAS items and stress for new samples of female and male college students. Study 3 considers the broader personality correlates of scores on the stress-relevant Type A items and reports markedly different patterns for male and female college students. Predicted correlations were found on new samples between these personality correlates, considered as scales, and stress-relevant Type A scores and stress. PMID- 3820048 TI - The MMPI, prototypal typology, and borderline personality disorder. AB - This study demonstrates inherent features in the DSM-III diagnostic criteria for personality disorders (i.e., overlapping diagnoses and heterogeneous symptomatology) that limit efforts to identify a sensitive and specific MMPI profile for the borderline personality disorder. A sample of 71 inpatients was administered an MMPI and a semistructured interview that systematically evaluated each of 81 symptoms for the 11 DSM-III personality disorders. Interrater reliability was substantially higher than has been obtained with unstructured interviews. The effect on the borderline MMPI profile of variation in the number of borderline symptoms and overlap with the schizotypal, histrionic, and antisocial diagnoses was demonstrated. We discuss implications with respect to a prototypal model of classification. PMID- 3820049 TI - The operating characteristics of the Millon Clinical Multiaxial Inventory. AB - The operating characteristics of the 20 scales of the Millon Clinical Multiaxial Inventory (MCMI) were analyzed with respect to the construction sample data as presented in the test manual. Sensitivity, specificity, positive predictive power, negative predictive power, and overall diagnostic power of each scale were derived. Results indicated that eight scales show excellent characteristics, nine were classified as fair, and three were determined to have poor positive predictive power for identifying the presence of a syndrome in an individual patient. Five scales had good positive predictive power for identifying the most prominent syndrome in a patient's clinical picture, eleven scales were classified as fair, and four were seen as poor on this dimension. We suggest a method for determining the utility of individual scales for different clinical populations and discuss implications of this type of analysis of the MCMI for diagnosis of the individual case. PMID- 3820050 TI - Discriminant validity of the General Behavior Inventory: an outpatient study. AB - Recent studies have provided strong support for the convergent validity of the General Behavior Inventory (GBI), a case identification inventory for chronic subsyndromal affective disorders (cyclothymia and dysthymia). Fewer data are available, however, on the ability of the GBI to distinguish chronic subsyndromal affective disorders from other forms of psychopathology. In order to address this issue, outpatients with cyclothymia (n = 9), dysthymia (n = 26), nonchronic major depression (n = 16), and nonaffective psychiatric disorders (n = 30) were compared on the GBI. Diagnoses were derived blind to GBI scores using structured diagnostic interviews and DSM-III criteria. The inventory significantly discriminated cyclothymes and dysthymes from patients with nonchronic major depressions and nonaffective disorders. Using the cutoff score that maximized GBI diagnosis concordance, the inventory correctly classified 88% of the sample. All of the cyclothymes, 92% of the dysthymes, 87% of the patients with nonaffective psychiatric disorders, and 75% of the nonchronic major depressives were correctly classified by the inventory. These data provide strong support for the discriminant validity of the GBI. PMID- 3820051 TI - The factor structure of the Millon Clinical Multiaxial Inventory (MCMI) for psychiatric inpatients. AB - This study examines the factor structure of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of psychiatric inpatients. The results are compared and contrasted with previous studies that have examined the factor structure of the MCMI. Factors identified for the inpatient sample include Interpersonal Withdrawal/Avoidance, Emotional Distress, Impulsivity/Negativism, Paranoid Distrust/Delusions, and Dependency/Submission. In general, results from this study are consistent with previous findings. However, there is evidence that the factor structure for this inpatient sample demonstrated more discrimination between symptoms and personality traits than had been demonstrated in previous studies. PMID- 3820052 TI - The development of a scale to measure cognitive distortions in bulimia. AB - The Bulimia Cognitive Distortions Scale (BCDS) was developed to measure irrational beliefs and cognitive distortions associated with bulimia. The final 25-item scale was found to have excellent internal consistency with high item to total correlations and a coefficient alpha of .97. Factor analysis revealed two clear factors measuring cognitive distortions related to automatic eating behaviors and to physical appearance. Data attesting to the convergent and divergent validity of the BCDS are also presented. With 110 subjects (55 bulimics, 55 controls), a discriminant analysis revealed the BCDS to be the only significant variable in predicting group membership, correctly classifying 93.6% of all subjects. The BCDS was also predictive of severity of bulimia as measured by the frequency of binge eating episodes. The potential of the BCDS as both a diagnostic and research instrument is discussed. PMID- 3820053 TI - Correlations of MMPI factor scales with measures of the five factor model of personality. AB - Two recent item factor analyses of the Minnesota Multiphasic Personality Inventory (MMPI) classified the resulting factors according to a conceptual scheme offered by Norman's (1963) five factor model. The present article empirically evaluates those classifications by correlating MMPI factor scales with self-report and peer rating measures of the five factor model in a sample of 153 adult men and women. Both sets of predictions were generally supported, although MMPI factors derived in a normal sample showed closer correspondences with the five normal personality dimensions. MMPI factor scales were also correlated with 18 scales measuring specific traits within the broader domains of Neuroticism, Extraversion, and Openness. The nine Costa, Zonderman, McCrae, and Williams (1985) MMPI factor scales appear to give useful global assessments of four of the five factors; other instruments are needed to provide detailed information on more specific aspects of normal personality. The use of the five factor model in routine clinical assessment is discussed. PMID- 3820054 TI - Three-compartment open model analysis of micronomicin in man. AB - The pharmacokinetics of micronomicin (MCR) as a model drug of aminoglycoside antibiotics (AGs) was studied in man by applying our results previously obtained in rats. Three-compartment open model analysis of combined serum and total body store (T.B.S.) data obtained from multiple dosing in man was done using a non linear least-squares regression program MULTI. We found large individual variations of MCR disposition in man and these variations did not appear within the serum concentration range measurable with conventional assay methods. This finding suggests that the disposition of AGs, included MCR, cannot be estimated by only plasma or serum level analyses. We conclude that the therapeutic drug monitoring of AGs by using T.B.S. data analysis should be an effective method for controlling therapy with AGs in the clinical setting. PMID- 3820055 TI - Gastrointestinal absorption of sulfaguanidine in neonatal and adult rats. AB - The pharmacokinetics of sulfaguanidine in rats was studied after its intravenous or oral administration. In adult rats, its elimination from plasma, after intravenous administration of 2.5 or 25 mg/kg doses, could be described by a two compartment open model, while its plasma concentration after oral administration of 25 mg/kg doses, agreed with the one- or two-compartment open model. Neonatal rats displayed a lower elimination of sulfaguanidine than adult rats. Comparison of the drug's gastrointestinal absorption showed that the maximum plasma concentration after oral administration was significantly higher for neonatal than for adult rats. However, there was no significant difference between the times required to reach maximum plasma concentrations. The area under the plasma concentration-time curve at 0-infinity h was significantly higher for neonatal than for adult rats. The absolute bioavailability (57.86%) in neonatal rats was approximately five times that (12.76%) in adult rats. Thus, sulfaguanidine was poorly absorbed by adult rats, but was efficiently absorbed by immature gastrointestines of neonatal rats. PMID- 3820056 TI - The mode of enhanced enteral absorption of macromolecules by lipid-surfactant mixed micelles. I. AB - The enhancement of absorption of water soluble macromolecules by lipid-surfactant mixed micelles (MM) was performed in two in vitro experimental systems using rat large intestine, which were isolated epithelial cells containing transcellular route alone and everted sac involving trans- and paracellular routes. Four kinds of fluorescein isothiocyanate-labelled dextrans (FDs) having different average molecular weights (9K-70K) were used as models of water soluble macromolecules. In the absence of MM, very poor transport of FDs was observed in both isolated epithelial cells and everted sac experiments. Linoleic acid-polyoxyethylated (60 mol) hydrogenated castor oil (HCO60) MM enhanced the transport of FDs in both systems, especially for smaller size FDs. This promotive effect by MM decreased with an increase in molecular weight of FDs in both systems. Although enhanced transport of the largest FD (molecular weight, 70K) by MM was clearly demonstrated in the everted sac, the enhanced transport of the same FD in the isolated cells was negligible. These results suggest the possibility of participation of paracellular route as well as transcellular route in the enhancing effect of MM on the large intestinal absorption of water soluble macromolecules. PMID- 3820057 TI - Response of immunoreactive antiarrhythmic peptide (IR-AAP) level associated with experimental arrhythmia in rats. AB - The change in endogenous antiarrhythmic peptide (AAP) levels in serum, heart and kidney from rats under several drug-induced arrhythmias was investigated using a sensitive and specific radioimmunoassay. The extracts from serum, heart and kidney were fractionated by Sephadex G-25 chromatography to obtain a fraction which was found at the same position as that of synthetic AAP. In serum, the immunoreactive (IR)-AAP level increased about threefold under CaCl2-, aconitine- and epinephrine-induced arrhythmias. In heart, the IR-AAP level was doubled by CaCl2, increased 1.4 times by aconitine and decreased by one third by epinephrine. The levels in serum and heart were slightly increased by ADP. The kidney IR-AAP level was not changed under these drug-induced arrhythmias. Considering the previous result that AAP could protect against CaCl2- and aconitine-induced arrhythmias but not against epinephrine-induced arrhythmia, the change in the IR-AAP level in heart coincided with the effect of AAP given to animals under arrhythmia. Quinidine, propranolol and verapamil had no effect on serum IR-AAP level. These results suggested that endogenous AAP in heart worked to suppress certain arrhythmia. PMID- 3820058 TI - Effect of metoclopramide on the absorption of cimetidine in rats. AB - Metoclopramide was found to increase the absorption rate constant (ka) of cimetidine by the duodenum and jejunum in both ligated and unligated rats. The increase of ka of cimetidine in the ligated rats cannot be interpreted in terms of an increase in the gastric emptying rate, which has been suggested to be the main effect of metoclopramide. The pH values of the stomach, duodenum and jejunum increased following the administration of metoclopramide. Atropine also increased the pH value of the duodenum, but it did not increase the ka of cimetidine. Consequently, the increase of ka of cimetidine, following administration of metoclopramide, was not due to the elevation of intestinal pH. On the other hand, metoclopramide significantly increased the blood flow by about 67.3 and 29.7% at the duodenum and jejunum, respectively, when the intestinal blood flow was measured by the hydrogen clearance method. Atropine had no effect on the intestinal blood flow. Based on these results, it was concluded that the increase of intestinal blood flow may be one of the factors for the increase of ka of cimetidine following the administration of metoclopramide. From the results of multi-line fittings of the plasma concentration data following oral, intraduodenal, intrajejunal and intraileac administrations of cimetidine with metoclopramide treatment, it was suggested that metoclopramide increased the intestinal transit time of subsequently administered drugs, as well as the gastric emptying rate. PMID- 3820059 TI - A possible contribution of phospholipids in tissue distribution of quinidine in rats. AB - The tissue distribution of quinidine was investigated at three different steady state plasma concentrations of quinidine in rats. The tissue distribution of quinidine (tissue-to-plasma concentration ratio, Ct/Cp) was studied in the liver, lung, kidney and heart and the highest distribution was found in the lung. Tissue binding characteristics of quinidine was determined in normal tissue homogenates and lipid-depleted tissue homogenates in vitro. No correlation was observed between the tissue bindings (product of association constant (K1) and number of binding sites (n), nK1) estimated in each normal tissue homogenate and the values of Ct/Cp in vivo. However, a marked decrease in the tissue binding of quinidine was observed in all lipid-depleted tissue homogenates, and the largest decrease was observed in the lung tissue. This result suggested that lipid may have an important role in the tissue binding of quinidine. However, no good relationship was observed between the values of Ct/Cp and the phospholipid contents in each tissue. In order to investigate the role of lipid in the tissue binding of quinidine, phospholipids extracted from each tissue were used for binding study. The phospholipids binding of quinidine (nK2) increased in the following order; heart less than liver less than kidney less than lung, and the plots of the values of Ct/Cp obtained in vivo against the binding ability of phospholipids (product of nK2 and the content of phospholipid in each tissue) gave a good linear relationship. Based on these observations, it was concluded that some species of phospholipids had an important and determining role in the tissue distribution of quinidine in vivo. PMID- 3820060 TI - Effects of propranolol on tissue necrosis in experimental myocardial infarction in dogs. AB - We studied the effects of propranolol on degradation of cardiac structural proteins resulting from ischemia induced by 24 h ligation of the coronary artery in dogs. Degradation of myocardial myosin heavy chain, alpha-actinin and troponin I was used as an indicator of degradation of cardiac structural proteins. In dogs with left circumflex coronary artery ligation, propranolol, given orally in the dose of 10 or 30 mg/kg, significantly reduced degradation of cardiac structural proteins. This can be supported by the facts that treatment with propranolol, 10 or 30 mg/kg, reduced release of cathepsins B, L and D from lysosome to cytosol in the ischemic tissue and that the reduced acidity of the ischemic tissue was improved by treatment with propranolol, 30 mg/kg. In conclusion, propranlol delays the necrotic development of the severely ischemic myocardial tissue as shown by reduced protein degradation. PMID- 3820061 TI - Pharmacological studies on ginger. II. Pressor action of (6)-shogaol in anesthetized rats, or hindquarters, tail and mesenteric vascular beds of rats. AB - When (6)-shogaol (0.5 mg/kg, i.v.) was administered to rats, blood pressure showed a tri-phasic response which was comprised of a rapid fall, followed by a rise and a delayed fall. The rapid fall, which followed immediately after injection of (6)-shogaol, disappeared with the use of atropine and vagotomy. The marked rise, which occurred after the rapid fall, was not affected by alpha adrenoceptor blockades, Ca antagonists and ganglion blockade. However, a combination of alpha-adrenoceptor blockade and Ca antagonist inhibited this pressor response. In hindquarters perfused with a nutrient solution, (6)-shogaol (10(-5) g)-induced peripheral pressor response was also not affected by alpha adrenoceptor blockades and Ca antagonists, but was inhibited by the combination of an alpha-adrenoceptor blockade and a Ca antagonist. Furthermore, this peripheral pressor response was eliminated by the removal of Ca ion from the perfusate. (6)-Shogaol did not exhibit a pressor response in an artery and a vein of the tail or an artery of the femur perfused with a nutrient solution. (6) Shogaol-induced peripheral pressor response in hindquarters was markedly potentiated during the perfusion of norepinephrine (5 X 10(-6) g/ml), but this potentiation was prevented by pretreatment with reserpine (5 mg/kg, i.p.). Moreover, repeated injections of (6)-shogaol caused a tachyphylaxis in mesenteric and tail vascular beds and a slight tachyphylaxis in hindquarters. PMID- 3820062 TI - Antitumor activity of a beta-1,3-glucan obtained from liquid cultured mycelium of Grifola frondosa. AB - The antitumor activity of a branched beta-1,3-glucan "grifolan LE" purified from liquid cultures of Grifola frondosa (Ohno et al. Chem. Pharm. Bull., 34, 1709 1715 (1986] was examined on an allogeneic murine tumor system. By intraperitoneal (i.p.) administration (100-200 micrograms/mouse/d X 5) at days 1 to 9 from the tumor transplantation, grifolan LE showed marked inhibitory activity on the growth of solid form sarcoma 180 in ICR mice. Significant activity was also observed in intravenous (i.v.) or intratumoral (i.t.) administrations. However, the oral (p.o.) administration of grifolan LE was not effective. I.p. administration of grifolan LE at a dose of 100 micrograms/mouse/d X 5 before the tumor transplantation showed significant inhibition of tumor growth. I.p. administration of grifolan LE at day +11 to +19 was also effective. Grifolan LE was not effective on the ascites form of sarcoma 180. The pretreatment of sarcoma 180 cell with grifolan LE in vitro did not affect tumor growth. The mice cured from the solid form of sarcoma 180 by administration of grifolan LE had the ability to reject the same tumor cell. From these results, it is suggested that the antitumor activity of grifolan LE occurred by modification of biological responses. PMID- 3820063 TI - Attributional responses of anxious individuals to different patterns of social feedback: nothing succeeds like improvement. AB - The causal attributions of socially anxious and nonanxious subjects were studied following four patterns of social feedback: consistent success, improvement, deterioration, and consistent failure. Providing anxious subjects with improving feedback produced the strongest internal attribution for positive outcomes, albeit to the unstable factor of effort. Nonanxious subjects, on the other hand, accepted greatest personal responsibility for consistent success. Socially anxious individuals also ascribed greater importance to the external factors of luck and task difficulty than did nonanxious subjects. Possible implications for treatment of socially anxious clients are discussed. PMID- 3820064 TI - Sentencing goals, causal attributions, ideology, and personality. AB - Disparity in sentencing of criminals has been related to a variety of individual difference variables. We propose a framework establishing resonances or coherent patterns among sentencing goals, causal attributions, ideology, and personality. Two studies are described, one with law and criminology students, the other with probation officers. Relations among the different types of variables reveal two resonances among both students and officers. One comprises various conservative and moralistic elements: a tough, punitive stance toward crime; belief in individual causality for crime; high scores on authoritarianism, dogmatism, and internal locus of control; lower moral stage; and political conservatism. The second comprises various liberal elements: rehabilitation, belief in economic and other external determinants of crime, higher moral stage, and belief in the powers and responsibilities of government to correct social problems. Implications of these results are discussed for individual differences in sentencing, attribution theory, and attempts to reduce disparity. PMID- 3820065 TI - Narcissism: theory and measurement. AB - Lack of a suitable measuring device hampered the empirical study of narcissism until Raskin and Hall (1979) developed the Narcissistic Personality Inventory (NPI). The NPI possesses desirable psychometric properties, and in this article I used the scale in a variety of studies. Factor analysis of the scale replicated the four-factor solution found by Emmons (1984): Leadership/Authority, Self Absorption/Self-Admiration, Superiority/Arrogance, and Exploitiveness/Entitlement. The Exploitiveness/Entitlement subscale was found to correlate with measures of pathological narcissism and affective intensity and variability. The relevance of Linville's (1982) theory of self-complexity-affect intensity for understanding aspects of narcissism is outlined. Implications of the study of narcissism for attribution theory and research are discussed. PMID- 3820066 TI - Energy, tiredness, and tension effects of a sugar snack versus moderate exercise. AB - After either eating a candy bar or walking briskly for 10 min on 12 selected days, 18 volunteers made systematic self-ratings of their energy, tiredness, and tension feelings for a fixed 2-hr period each day in the context of their normal daily activities. The snacking or walking activity was randomly selected on each test day after completion of a pretest. Results indicated that walking was associated with higher self-rated energy and lower tension significantly more than was snacking. In the walk condition reliable increases in energy and decreases in tension were observed for 2 hr. The sugar snack condition was associated with significantly higher tension after 1 hr, and a pattern of initially increased energy and reduced tiredness, followed 1 hr later by increased tiredness and reduced energy. The results partially support a general conceptual hypothesis that sugar snacking is often motivated by a low-awareness attempt to raise energy. Additionally, the results clarify an apparent conflict between neurochemical research, which indicates that sugar ingestion increases the tendency to sleep, and popular nutrition theory, which indicates that it increases tension. PMID- 3820067 TI - Emotional reactions to dramatic film stimuli: the influence of cognitive and emotional empathy. AB - The idea that empathy may best be considered a multidimensional construct, consisting of both cognitive and emotional facets, has recently been gaining in popularity. To date, however, little research explicitly based on such a view has been carried out. We conducted the present experiment to explore the different influences of cognitive and emotional empathy on two types of responses to dramatic stimuli: positive and negative emotional reactions. Consistent with a multidimensional view of empathy, the two types of empathy exhibited different effects; positive emotional reactions were affected primarily by cognitive empathy, and negative emotional reactions were most heavily influenced by emotional empathy. The results are discussed in terms of their relevance to a multidimensional approach to the study of empathic responding. PMID- 3820068 TI - Repression and the inaccessibility of affective memories. AB - The fundamental assumption that repression involves an inaccessibility to affective memories has not been directly addressed in empirical research. In the present study we examined three groups of subjects (repressors, low anxious, and high anxious) under six conditions of recall (general, happy, sad, anger, fear, and wonder). Subjects were asked to recall personal experiences from childhood and to rate their current mood and the affective intensity of the memories. The results indicated that repressors recalled significantly fewer negative memories than did low-anxious and high-anxious subjects and, furthermore, that they were substantially older at the time of the earliest negative memory recalled. Compared with low-anxious subjects, repressors also recalled fewer positive affective memories as well. This pattern of findings is consistent with the hypothesis that repression involves an inaccessibility to negative emotional memories and indicates further that repression is associated in some way with the suppression or inhibition of emotional experiences in general. The concept of repression as a process involving limited access to negative affective memories appears to be valid. PMID- 3820069 TI - Type A behavior pattern, inhibited power motivation, and activity inhibition. AB - The constructs of the Type A behavior pattern and the Inhibited Power Motive Syndrome (IPMS) have many features in common. The empirical relation between the two constructs was investigated in this study with 45 employed, male medical and surgical patients. Four different measures of the Type A pattern were examined. Results showed that, of the four measures, the Structured Interview and the Hostility Scale were related significantly to the IPMS. Systolic blood pressure reactivity was also related significantly to the IPMS. These relations could be ascribed largely to activity inhibition alone. The contribution of activity inhibition to an understanding of the biological and psychological substrates of the Type A behavior pattern is discussed. PMID- 3820070 TI - Personality and social resources in immediate and continued stress resistance among women. AB - In this study we investigated the immediate and continued impact on women of a major stressful event, the outcome of pregnancy, and the mitigating effect of self-esteem and intimacy with their spouse on their reactions. Few other studies have investigated initial reactions to crisis events. Ninety-nine Israeli women who experienced either normal delivery or pregnancy complications were interviewed at the time of the event and 3 months later. High self-esteem was found to limit feelings of depression at both times. Intimacy with spouse limited depression at the event, but not at follow-up. High self-esteem was seen as always being exploitable by women who possessed it, whereas the benefit of intimacy with spouse was seen as being dependent on situational demands and environmental constraints. Cross-cultural implications were presented. PMID- 3820071 TI - Linking person and context in the daily stress process. AB - In this study we combined daily diary data with interview data to investigate individual differences in the impact of stressful daily events on mood. Using a sample of 96 women in an urban community, we examined perceived neighborhood quality and major life events as possibly potentiating the effects of stressful daily events, and we viewed social supports as potentially buffering this daily process. Results confirmed that the presence of chronic ecologic stress (neighborhood perceptions) exacerbated the immediate effects of stressful daily events on mood and also increased the likelihood of enduring effects of daily stressors on next day's mood. Contrary to expectations, previous exposure to major life events decreased the impact of stressful daily events. The availability of social supports, although not buffering the impact of stressful daily events on mood, did mitigate the enduring effects of these events on next day's mood. This study also presents a method for analyzing daily time-series data, while correcting for potential problems of autocorrelated error terms. As such, this study represents a significant advance over previous analytic approaches to time-series data in the study of the stress process. PMID- 3820072 TI - Power and affiliation motivation, stress, and abuse in intimate relationships. AB - The associations among n Power, n Affiliation, inhibition, stressful life events, and infliction and receipt of psychological and physical abuse in intimate relationships were investigated in a sample of 48 male and 107 female college undergraduates. Results indicated that life events that were perceived as being negative were associated with both the infliction and the receipt of abuse for women but not for men. Individual personality characteristics determined the tactics used in resolving intimate interpersonal conflicts. High n Power was significantly associated with the infliction of physical abuse on their partners by men, but not by women. For women, n Affiliation and activity inhibition moderated the effect that stress has on the infliction of abuse. Highly stressed women with high n Affiliation and low activity inhibition were the most likely to inflict abuse. Length and status of relationship were also found to be related to abuse, with abuse occurring most often between more committed couples. Sex differences were found for the relation between infliction and receipt of abuse. That is, receipt of abuse was highly correlated with infliction of abuse for women but not for men, suggesting that when women strike out they are struck in return. PMID- 3820073 TI - In search of the false-uniqueness phenomenon: fear and estimates of social consensus. AB - An examination of the social perception literature yields little evidence for the false-uniqueness phenomenon (Valins & Nisbett, 1972), the perception that one's attributes are more unique than is the case. In contrast, the tendency for individuals to project their own characteristics onto other people and assume that more people are like themselves is a robust phenomenon. One reason researchers may not have found false uniqueness is that they have not looked at the accuracy of consensus estimates. A close look at the results of Tabachnik, Crocker, and Alloy (1983) and Sanders and Mullen (1983), who did assess accuracy, suggests that people possessing undesirable attributes over-estimate consensus, whereas people holding desirable attributes underestimate consensus. The latter pattern is a form of false uniqueness. In this study we looked at the accuracy of social consensus estimates in the context of psychological fears. A sample of subjects filled out an abbreviated version of a fear survey and made estimates of consensus. The results showed that both high- and low-fear respondents overestimated the incidence of high fear among their peers, but high-fear subjects were more inaccurate in their estimates. A false-uniqueness effect was found on the part of low-fear subjects, as they tended to underestimate the incidence of low fear among their peers. These findings are consistent with a motivational interpretation that emphasizes the individual's need to justify or normalize stigmatized behavior and to bolster perceived self-competence. PMID- 3820074 TI - Long-term effects of losing a spouse or child in a motor vehicle crash. AB - In this article we examine the long-term effects of the sudden, unexpected loss of a spouse or child. In the spouse study, interviews were conducted with 39 individuals who had lost a spouse in a motor vehicle crash 4 to 7 years ago and with 39 matched controls. In the parent study, interviews were conducted with 41 parents who had lost a child in a crash and with 41 matched controls. Control respondents were matched to bereaved respondents case-by-case on the basis of sex, age, income, education, and number and ages of children. Significant differences between bereaved spouses and controls were revealed on several indicators of general functioning, including depression and other psychiatric symptoms, social functioning, psychological well-being, reactivity to good events, and future worries and concerns. For the most part, these differences persisted when variables such as present family income and present marital status were statistically controlled. Comparisons between bereaved and control parents also revealed significant differences on some measures of general functioning (especially depression), but these were not as pervasive as the differences obtained in the spouse study. Responses to questions about current thoughts and feelings suggest that the deceased continued to occupy the thoughts and conversations of bereaved spouses and parents. Moreover, a large percentage of respondents (from 30% to 85%, depending on the question), continued to ruminate about the accident or what might have been done to prevent it, and they appeared to be unable to accept, resolve, or find any meaning in the loss. Taken together, the data provide little support for traditional notions of recovery from the sudden, unexpected loss of a spouse or child. PMID- 3820075 TI - Intellectual functioning and aggression. AB - In a 22-year study, data were collected on aggressiveness and intellectual functioning in more than 600 subjects, their parents, and their children. Both aggression and intellectual functioning are reasonably stable in a subject's lifetime and perpetuate themselves across generations and within marriage pairs. Aggression in childhood was shown to interfere with the development of intellectual functioning and to be predictive of poorer intellectual achievement as an adult. Early IQ was related to early subject aggression but did not predict changes in aggression after age 8. On the other hand, differences between early IQ and intellectual achievement in middle adulthood were predictable from early aggressive behavior. A dual-process model was offered to explain the relation between intellectual functioning and aggressive behavior. We hypothesized that low intelligence makes the learning of aggressive responses more likely at an early age, and this aggressive behavior makes continued intellectual development more difficult. PMID- 3820076 TI - Personality and compatibility: a prospective analysis of marital stability and marital satisfaction. AB - The antecedents of marital stability (divorce or remaining married) and marital satisfaction (within the group that remains married) were investigated with a panel of 300 couples who were followed from their engagements in the 1930s until 1980. Twenty-two of the couples broke their engagements; of the 278 couples who married, 50 got divorced at some time between 1935 and 1980. Personality characteristics (measured by acquaintance ratings made in the 1930s) were important predictors of both marital stability and marital satisfaction. The three aspects of personality most strongly related to marital outcome were the neuroticism of the husband, the neuroticism of the wife, and the impulse control of the husband. In combination, the 17 major antecedent variables were moderately predictive of a criterion variable composed of both marital stability and marital satisfaction (R = .49). The three major aspects of personality accounted for more than half of the predictable variance. The remaining variance was accounted for by attitudinal, social-environment, and sexual history variables. PMID- 3820077 TI - Peer-group affiliation and adolescent self-esteem: an integration of ego-identity and symbolic-interaction theories. AB - To evaluate expectations derived from ego-identity theory and symbolic interaction theories about the association between self-concept and peer-group affiliations in adolescence, we examined the self-esteem of 221 7th through 12th graders associated by peers with one of five major school crowds and 106 students relatively unknown by classmates and not associated with any school crowd. Among crowd members, self-esteem was directly related to the position of one's crowd in the peer-group status hierarchy (based on both peer-rated and self-perceived crowd affiliation). Outsiders' self-esteem differed in relation to the accuracy of their reflected appraisal of and the salience they attached to crowd affiliation. Crowd members as a whole exhibited higher self-esteem than outsiders as a whole. Differences, however, were mediated by crowd status, salience of crowd affiliation, and the accuracy of reflected appraisals. An adequate interpretation of the findings required an integration of Festinger's (1954, 1957) social comparisons and cognitive-dissonance theories, Cooley's (1902) notions of reflected appraisal, and Newman and Newman's (1976) extrapolations from ego-identity theory. PMID- 3820078 TI - Sexuality among Mexican Americans: a case of sexual stereotyping. AB - The purpose of this study was to establish an empirical base for the comprehensive study of sexual preferences and practices among Mexican Americans. The sample consisted of 165 Mexican-American (86 male, 79 female) and 99 Anglo (47 male, 52 female) undergraduates. The instrument used was the Sexual Knowledge and Attitude Test (SKAT; Lief & Reed, 1972). The first section of the SKAT consists of four attitudes subscales dealing with autoeroticism, abortion, heterosexual relations, and sexual myths. The second section includes 50 true false items testing knowledge of the biological, psychological, and social facts of human sexuality. The last section focuses on the respondent's sexual value system and practices. The design was a 2 (ethnicity) X 2 (gender) X 4 (religion) X 3 (socioeconomic status) incomplete factorial, in which the effect of interest was ethnicity. This effect was assessed controlling for subjects' age, gender, religious preference, and socioeconomic status. The dependent variables were subjects' sexual attitudes, knowledge, sexual value system, and sexual practices. Tests of significance were undertaken separately for each set of dependent variables, with a correspondingly reduced alpha level. Significant differences were obtained between Mexican Americans and Anglos, in attitudes, knowledge, value system, and practices, in clear support of the hypotheses. PMID- 3820079 TI - Event content in a daily survey is differentially associated with concurrent mood. AB - Daily life events were grouped according to their life content area and according to the desirability of the event as rated by the subject. Associations among event groupings and concurrently measured daily mood were examined. As in studies of major life events, some event classifications were more strongly associated with mood than were others: Specifically, desirable family-leisure events and undesirable work events were strongly related to mood. The results suggests that particular life areas deserve special attention in understanding environmental stress. PMID- 3820080 TI - Depression, self-esteem, and the absence of self-protective attributional biases. AB - Previous research has demonstrated a relation between depression and attributional style. In the present study we evaluated the extent to which self esteem may be an important determinant of attributional style. Subjects completed measures of self-esteem, depression, and anxiety and responded to the Attributional Style Questionnaire. Maximum R2 analyses revealed that for significant one-variable and multivariable regression models, self-esteem accounted for the variation in attributional style on the majority of outcome measures. Depression and anxiety added little beyond the contribution of self esteem. These findings were consistent for both positive and negative events. In addition, self-esteem accounted for variation in attributional evenhandedness. Results are discussed in terms of the role of self-esteem maintenance in attributional style. PMID- 3820081 TI - Validation of the five-factor model of personality across instruments and observers. AB - Two data sources--self-reports and peer ratings--and two instruments--adjective factors and questionnaire scales--were used to assess the five-factor model of personality. As in a previous study of self-reports (McCrae & Costa, 1985b), adjective factors of neuroticism, extraversion, openness to experience, agreeableness-antagonism, and conscientiousness-undirectedness were identified in an analysis of 738 peer ratings of 275 adult subjects. Intraclass correlations among raters, ranging from .30 to .65, and correlations between mean peer ratings and self-reports, from .25 to .62, showed substantial cross-observer agreement on all five adjective factors. Similar results were seen in analyses of scales from the NEO Personality Inventory. Items from the adjective factors were used as guides in a discussion of the nature of the five factors. These data reinforce recent appeals for the adoption of the five-factor model in personality research and assessment. PMID- 3820082 TI - Emotional states and memory biases: effects of cognitive priming and mood. AB - Recent studies have shown that naturally occurring and experimentally induced affect states enhance the accessibility to retrieval of memories of life experiences that are congruent in valence with the affect state. Previous studies have suggested that this memory bias results from the influence of affective processes on memory retrieval. In our study we manipulated mood state by having subjects read statements expressing positive or negative self-evaluative ideas or describing somatic states that often accompany positive or negative mood states. The somatic and self-evaluative statements had, in general, equally strong effects on mood state. In spite of this, however, the self-evaluative statements had a stronger impact on recall latencies for life experiences than did the somatic statements. Moreover, the impact of the self-evaluative, but not the somatic, statements on recall was found to be independent of the statements' effects on mood state. This suggests that the cognitions accompanying a mood altering experience may have a substantial effect on the capacity of the mood state to influence memory retrieval. PMID- 3820083 TI - [Pharmacognostical study on the crude drug, corni fructus "shanzhuyu"]. PMID- 3820084 TI - [Screening test for calcium antagonists in natural products. The active principles of Magnolia obovata]. PMID- 3820085 TI - [Tannins in Artemisia montana. A. princeps and related species of plant]. PMID- 3820086 TI - [Microanalysis of dihydroergotoxine by gas chromatography/selected ion monitoring (GC/SIM). Evaluation of feasibility for GC/HR-SIM in the analysis of human plasma]. PMID- 3820087 TI - [The pharmacokinetical analysis of the fate of naphtidrofuryl oxalate (LS121) in human subjects. I. Single intravenous infusion and multiple intravenous infusion]. PMID- 3820088 TI - [The pharmacokinetical analysis of the fate of naphtidrofuryl oxalate (LS121) in human subjects. II. Estimation of the first-pass effect after oral administration]. PMID- 3820089 TI - [Effect of aluminum ion on sulfisomidine absorption in rabbits]. PMID- 3820090 TI - [Pharmaceutical studies on crude drugs. I. Effect of the Zingiberaceae crude drug extracts on sulfaguanidine absorption from rat small intestine]. PMID- 3820091 TI - The determination of essential clearance, volume, and residence time parameters of recirculating metabolic systems: the reversible metabolism of methylprednisolone and methylprednisone in rabbits. AB - Methods based on moment analysis are described which permit the calculation of the fundamental parameters of reversible drug/metabolite systems. These parameters include the four essential clearances of reversible and irreversible elimination, the central and steady-state distributional volumes, and the sojourn times or turnover rates of the metabolic pair. Additional parameters unique to interconversion systems are developed which describe the properties of metabolic entrapment ("recycled fraction"), conservation ("exposure enhancement"), and equilibrium resulting from reversible metabolism ("Percent parent drug at steady state"). Parameters obtained by these methods are compared to those generated by conventional mammillary analysis. The influence of perturbation of essential parameters on the response of mammillary descriptors and the state of the interconversion system are simulated. The interconversion analysis is applied to disposition data for methylprednisolone and methylprednisone in the rabbit. Mammillary methods underestimate the metabolic clearance of these two steroids by 30%, while steroid turnover is underestimated by 100%. The steady-state volumes of distribution of the two steroids are overestimated by 10 and 61%. Additional literature data for disposition of several corticosteroids in various species and disease states are reanalyzed. Examination of cortisol/cortisone disposition in thyroid disorders reveals that mammillary methods detect the overall acceleration of steroid elimination in hyperthyroidism, but fail to reveal a 50% reduction in metabolite backconversion and decreased metabolic cycling. These moment analysis methods should facilitate characterization of the pharmacokinetics of the increasing array of reversible drug/metabolite systems. PMID- 3820092 TI - Amiodarone pharmacokinetics. I. Acute dose-dependent disposition studies in rats. AB - Single intravenous bolus doses of amiodarone hydrochloride of 30, 60, 90 and 120 mg/kg were administered to male Sprague-Dawley rats to determine the effects of dose on amiodarone pharmacokinetics. Serial blood samples and total urine were collected over 48 hr and assayed for amiodarone and desethylamiodarone by HPLC. The blood amiodarone concentration-time curves for the four doses were best described by a triexponential equation with terminal half-lives (t1/2 gamma) ranging from 17 to 20 hr. Over the dose range studied, no changes in gamma, t1/2 gamma, or central compartment volume (Vc = 1.2-1.4 L/kg) were observed. On the other hand, reductions in amiodarone clearance (CL) and steady-state volume of distribution (Vss) of 44% (17.7 to 10.0 ml/min per kg) and 50% (16.4 to 8.2 L/kg), respectively, were noted as the dose of amiodarone increased. The conversion of amiodarone to desethylamiodarone (fm) was dose-independent and amounted to approximately 10% of each amiodarone dose. No amiodarone or desethylamiodarone was detected in the urine of any of the treated animals. The blood-to-plasma concentration ratio of amiodarone was concentration-independent and therefore did not account for the dose-dependent changes in Vss and CL observed. The data suggested that the dose-dependent changes noted were due to an alteration in the volume (s) of the peripheral tissue compartment(s). PMID- 3820093 TI - Studies on the reliability of a bihyperbolic functional absorption model. I. Ring substituted anilines. AB - The present study reviews and checks the rearranged master lines of the functional bihyperbolic absorption model proposed by Pla-Delfina and Moreno, by examining the correlations between absorption rate constants experimentally found in the small intestine and in the colon of the rat, and two types of partition constants for a series of ring-substituted anilines, of low to medium molecular weight. Evidence is given which demonstrates the reliability of the bihyperbolic equation for the small intestine data, showing the importance of the type of substitution in the absorption rate of compounds; for the colonic data, the collapsed, monohyperbolic form of this equation (i.e., the Wagner-Sedman equilibrium model) applies, independent of the nature and position of the group substituents in the aniline molecule. This means that, as the bihyperbolic model equation predicts, aqueous pore diffusion is a crucial factor, as important as membrane permeation, in absorption in the small intestine, whereas in the colon only this latter route is operative. The perspectives opened by the application of the model to gastrointestinal absorption studies are also discussed. PMID- 3820094 TI - Generalizations in linear pharmacokinetics using properties of certain classes of residence time distributions. I. Log-convex drug disposition curves. AB - Introducing the phenomenological concept of a time-varying fractional rate of elimination kD(t) and applying the theory of lifetime distributions, implications of the log-convexity of drug disposition curves are examined and some important applications are described. Linear pharmacokinetic systems exhibiting a log convex impulse response and satisfying the basic conditions underlying the noncompartmental approach have the following properties: (1) The time-varying volume of distribution V(t) increases, and consequently the fractional rate of elimination kD(t) = CL/V(t) decreases monotonically. (2) The concentration-time curve and the time course of total amount of drug in the body, respectively, have an exponential tail [where V(t) approaches the equilibrium value VZ]. The relative dispersion of residence times (CV2D = VDRT/MDRT2) and the ratio Vss/VZ (Vss is the volume of distribution at steady state) act as measures of departure from pure monoexponential decay (one-compartment behaviour). The role of the latter parameters as shape parameters of the curve that characterize the distributional properties of drugs is discussed. Upper and lower bounds of the time course of drug amount in the body are derived using the parameters MDRT and CV2D or lambda Z (terminal exponential coefficient), respectively. This approach is also employed to construct upper bounds on the fractional error in AUC determination by numerical integration that is due to curve truncation. The significance of the fractional elimination rate concept as a unifying approach in interspecies pharmacokinetic scaling is pointed out. Some applications of the results are demonstrated, using digoxin data from the literature. PMID- 3820095 TI - Similarity principles and intrinsic geometries: contrasting approaches to interspecies scaling. AB - We criticize standard allometric approaches on the grounds that they emphasize scaling to one variable at a time, whereas chemically reactive hydrodynamic systems involved in pharmacokinetic phenomena are of higher dimension. We show that attempts based on mechanical similitude to set a dosage that would be equivalent across species (for example, from mouse to humans) lead to ambiguous results. Another failing of standard allometry may be its incapability to accommodate the neoteny of Homo sapiens, even though it helped discover the phenomenon. The retarded development in our species implied by neoteny can most clearly be seen in the evidence that both our brain size and our lifespan lie well above the allometric curve for Class Mammalia for these features. In contrast to allometry, which proposes a search for scaling coefficients through invariant external measurement reference frames, we propose a search for transformations of coordinate space coefficients in an intrinsic geometry for the mammalian body plan. PMID- 3820096 TI - Man versus beast: pharmacokinetic scaling in mammals. AB - Land mammals range in size from the 3-g shrew to the 3000-kg elephant. Despite this 10(6) range in weight, most land mammals have similar anatomy, physiology, biochemistry, and cellular structure. This similarity has allowed interspecies scaling of physiologic properties such as heart rate, blood flow, blood volume, organ size, and longevity. The equation that is the basis for scaling physiologic properties among mammals is the power equation Y = aWb, where Y is the physiologic variable of interest, W is body weight, and log a is the y-intercept and b is the slope obtained from the plot of log Y versus log W. Animals commonly used in preclinical drug studies (i.e., mice, rats, rabbits, monkeys, and dogs) do not eliminate drugs at the same rate that humans eliminate drugs; small mammals usually eliminate drugs faster than large mammals. Since drug elimination is intimately associated with physiologic properties that are well described among species, it seems reasonable to surmise that drug elimination can be scaled among mammals. Analysis of drug pharmacokinetics in numerous species demonstrates that drug elimination among species is predictable and, in general, obeys the power equation Y = aWb. Early papers on interspecies pharmacokinetic scaling normalized the x- and y-axes to illustrate the superimpossibility of pharmacokinetic curves from different species. More recently, the x- and y-axes have been left in the common units of concentration and time, and individual pharmacokinetic variables have been adjusted to predict pharmacokinetic profiles in an untested species, usually humans. PMID- 3820097 TI - Animal extrapolation and the challenge of human heterogeneity. AB - The capacity of animal models to predict the responses of humans to carcinogenic agents in light of the occurrence of human heterogeneity is assessed in this paper. It is widely accepted that human susceptibility to toxic substances, including carcinogens, is highly variable. At the same time, it is believed that the conventional rodent models, which are usually highly inbred and reared in standard ways, display a very homogeneous response to toxic agents, including carcinogens. The question then becomes, To which narrow band of the broad spectrum of human responses can specific animal models likely be extrapolated? First, the occurrence of human heterogeneity is examined with respect to a broad range of biological characteristics (e.g., aryl hydrocarbon hydroxylase activity, epoxide hydrase activity, glutathione S-transferase activity, beta-glucuronidase activity, debrisoquine hydroxylation, and DNA adduct formation), with particular emphasis on those which affect responses to carcinogens. Second, the occurrence of heterogeneity for selected animal models for these characteristics is assessed and the outcomes are related to the spectrum of human responses noted above. PMID- 3820098 TI - Interspecies scaling of regional drug delivery. AB - Calculation of the pharmacokinetic advantage of regional drug administration requires knowledge of the relevant intercompartment transport parameter. In a lumped model this is the blood (or plasma) flow rate for intra-arterial drug infusion or the permeability-area product for intraperitoneal or intrathecal administration. It is suggested that the perfusion of many tissues and the intrinsic permeability of the peritoneal surface or the brain-cerebrospinal fluid interface are similar among mammals. This provides a clear allometric basis for interspecies scaling based on organ size or surface areas. Intra-arterial or intrathecal treatment of the brain or meninges is a particularly interesting problem because of the relatively large brain of humans and because increased folding results in a cortical surface area that is almost proportional to brain size. Major unresolved issues remain concerning the distributed character of the processes such as streaming of drug infused into an artery and nonuniform mixing of cerebrospinal fluid. PMID- 3820099 TI - Time concepts in physics, biology, and pharmacokinetics. AB - Three major types of time relativity are discussed: physical, biological, and psychological. Physical relativity illustrates how the same distant event may occur in the past of one observer and in the future of another. Moreover, space and time variables are not viewed in isolation from one another, but rather are blended together into a static, four-dimensional "block universe." Biological relativities arise through coordinate transformations of physical time-scales such that relevant processes become invariant in space-time. Because pharmacokinetic processes are integrated through a common, highly coordinated series of systems, relations between mammalian species may be probed through empiric allometric coordinate transformations. Psychological time relativity deals with a creature's awareness of its own duration and location within a restricted range of reality; it involves the transformation of perceived sequences (stimuli) into durations. PMID- 3820100 TI - In vitro binding of chloroquine to rat muscle preparations. AB - Chloroquine (7-chloro-4-[[4-(diethylamino)-1-methylbutyl]amino]quinoline; CQ) accumulates in the insoluble fraction of rat muscle homogenates with an equilibrium distribution ratio of 7.8 L/kg. This is of a similar magnitude to muscle:plasma ratios observed in vivo. Uptake is approximately linear, even up to concentrations of free CQ greatly exceeding toxic plasma levels. Cell structural integrity is not essential for uptake, indicating that CQ is bound to tissue constituents and not trapped inside cells by an active process. At pH 7.4, binding of ionized CQ at anionic sites on tissue predominates over lipid partitioning of the un-ionized species. Binding to phospholipids is a major component of total muscle binding. PMID- 3820101 TI - Effects of combined administration of diazepam and imipramine hydrochloride in rats. AB - The effects of daily oral administration of imipramine hydrochloride (5-[3 (dimethylamino)propyl]-10,11-dihydro-5H-dibenz-[b,f]azepine monohydrochloride; 50 mg/kg) and/or diazepam (7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4 benzodiazepin-2-one ; 5 mg/kg) in a 1% aqueous solution of carboxymethylcellulose sodium salt (CMC) on the body weight, organ weights, and activities of various enzymes, including drug metabolizing enzyme systems were investigated in rats during a 15-day period. The plasma concentrations of imipramine and desipramine were also determined. In addition, the effect of a single intravenous administration of imipramine hydrochloride (5 mg/kg) on the plasma concentration time profiles of imipramine and desipramine was investigated in rats given the same drug treatments. The plasma concentration-time profiles of imipramine and desipramine were analyzed pharmacokinetically. The rats treated with imipramine hydrochloride showed a greater inhibition of body weight gain than those treated with diazepam, and those treated with imipramine hydrochloride and diazepam simultaneously showed a body weight gain similar to those treated with imipramine hydrochloride alone. No significant differences in organ weight (per 100 g of body weight) were found. The imipramine hydrochloride plus diazepam treatment group showed a greater increase in drug-metabolizing enzyme activities than the imipramine hydrochloride treatment group, but the difference was not statistically significant. However, the plasma levels of imipramine and desipramine after oral administration for 15 d suggested that the imipramine hydrochloride plus diazepam treatment group did not show increased imipramine metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820102 TI - Thermal chemistry of podophyllotoxin in ethanol and a comparison of the cytostatic activity of the thermolysis products. AB - Podophyllotoxin (1) in buffered ethanolic solution is degraded by two pathways. One leads to (a) picropodophyllin (2), which undergoes dehydration to give alpha apopicropodophyllin (5), which rearranges to give beta-apopicropodophyllin (6), (b) the ethyl ether of picropodophyllotoxin, 8, and (c) the ethyl ether of epipicropodophyllotoxin, 7. The other pathway leads directly to epipodophyllotoxin (10) and the corresponding ethyl ether, 9, and possibly, via a transient 3,4-dehydropodophyllotoxin (5'), to beta-apopicropodophyllin (6). The 1H NMR spectra of these compounds are described, their in vitro cytostatic activity compared, and their syntheses, including that of podophyllotoxin ethyl ether, reported. PMID- 3820103 TI - S-acylation of cysteine by O-acetylsalicylic anhydride: a possible mechanism for aspirin hypersensitivity? AB - In order to elucidate the possible reaction pathways for the acylation of protein by O-acetylsalicylic anhydride, the mechanism of the reaction between L-cysteine and O-acetylsalicylic anhydride was studied. O-Acetylsalicylic anhydride reacts with L-cysteine via a consecutive kinetic pathway. The thiol anion first reacts with the anhydride to form an intermediate thiol ester which then undergoes an intramolecular rearrangement to form the stable N-(O-acetylsalicyloyl)-2-amino-3 thiopropionic acid, 5. The importance of the free amino group in the intramolecular reaction was established by the observed stability of the S-(O acetylsalicyloyl) derivative of N-acetylcysteine under similar reaction conditions. The formation of the thiol ester was pH dependent, suggesting that the thiol anion was the attacking species. The acyl transfer to the adjacent amino group was catalyzed by both phosphate and acetate buffers. The results suggest that the reaction of O-acetylsalicylic anhydride with the thiol containing amino acids of a protein molecule may proceed via formation of an initial thio ester, followed by an S to N intramolecular acyl transfer to form an immunogenic amide. PMID- 3820104 TI - Methods for in vitro percutaneous absorption studies. VII: Use of excised human skin. AB - Water permeability constants (Kp) were determined with skin from human cadavers. No difference was seen in Kp values from unfrozen skin or from skin frozen for a few days. Human skin could usually be stored at -20 degrees C for up to a year with no change in water permeability, but in some cases apparent deterioration of the barrier was observed. A rapid procedure was developed for checking barrier integrity of skin in diffusion cells before a penetration study. The percent of the water dose absorbed after 20-min contact with skin correlated with water Kp values. Changes in water permeation through human skin agreed with changes in the absorption of seven test compounds of varying solubility properties (acetylsalicylic acid, benzo(a)pyrene, cortisone, DDT, nicotinic acid, propylene glycol, and testosterone). Water permeation is therefore considered to be a good indicator of potential changes in the barrier integrity of human skin. No correlation was observed in Kp values and other characteristics of the donor skin samples such as age, sex, race, and length of time before skin harvest. PMID- 3820105 TI - Permeation of mouse skin and silicone rubber membranes by phenols: relationship to in vitro partitioning. AB - A discrepancy has been noted in the relationship between the relative skin permeabilities of phenols and their lipophilicities as expressed in commonly used octanol:water partition coefficients (PCoctanol:water). The lack of correlation between partitioning and permeability is seen with the nitrophenols, particularly 4-nitrophenol. In the present study, the permeability coefficients-of 4 nitrophenol and several other phenols through skin and a model lipophilic membrane made of silicone rubber were found to be independent of concentration, ruling out concentration-dependent molecular aggregation as the cause of the partitioning-permeability incongruity. An unexpectedly low permeation rate was observed for the diffusion of 4-nitrophenol through the synthetic, silicone rubber membrane, confirming the anomalous position of this phenol in permeability relative to the octanol:water partitioning scale. However, when oil:water (o/w) partition coefficients for the phenolic compounds based on either n-hexane, CH2Cl2, CHCl3, or silicone rubber as the water immiscible phase are used, permeability coefficients for the skin and the synthetic membrane followed expected permeation-partitioning dependencies. On this basis, it appears that PCoctanol:water does not properly reflect the lipophilicity of the phenols with respect to partitioning into skin and silicone rubber during mass transfer. PMID- 3820106 TI - Determination of the dissolution rate controlling process for isomeric amides in alkane solvents. AB - The mechanisms that control the dissolution rates of chemical compounds in liquids have long been of interest to pharmaceutical scientists. Generally, control of the dissolution rate can be classified as being by interfacial reaction rate or by the rate of mass transport. Little work has been done in the area of sparingly soluble compounds dissolving in nonpolar organic solvents. In this study the dissolution of three isomers of methylacetanilide was investigated in three nonpolar organic solvents (hexane, heptane, and cyclohexane). The dissolution apparatus used a flat plate into which the nondisintegrating tablet could be placed so that dissolution occurred only from one face of the tablet. Agitation was provided by a four-bladed stirrer whose outer edge was 2 cm from the tablet surface. Dissolution data were collected only for concentrations less than 5% of the saturation solubility of the given compound in the given solvent. All dissolution profiles were linear. Dissolution rates were obtained from the slopes of these plots. Plots of In (dissolution rate) versus In (stirring speed) were also linear and yielded slopes that were close to the value of 0.50 predicted by the convective diffusion model employed. PMID- 3820107 TI - Plasma levels of the prodrug, arbaprostil, [(15R)-15-methylprostaglandin E2], and its active, antiulcer (15S) epimer in humans after single dose oral administration. AB - Arbaprostil [(15R)-15-methylprostaglandin E2] is an antiulcer prodrug being evaluated for the treatment of gastric and duodenal ulcers in humans. It epimerizes in acidic gastric fluid to produce the biologically active form, (15S) 15-methyl-PGE2, which acts directly on the gastric mucosa and possesses both gastric acid antisecretory and cytoprotective properties. Because of its local mode of action, plasma levels of the two epimers may have greater relevance to drug safety than to therapeutic efficacy. In the present study, plasma concentrations of both 15-methyl-PGE2 epimers resulting from a gastric acid antisecretory dose of arbaprostil oral solution (50 micrograms) were measured in eight male volunteers having sufficient gastric acidity for prodrug activation (pH less than 3). Arbaprostil was determined with a newly developed RIA having a sensitivity of 10 pg X mL-1. The accuracy of the RIA was confirmed by parallel analysis of plasma samples by HPLC. (15S)-15-Methyl-PGE2 was also determined by HPLC. Arbaprostil was both rapidly absorbed and eliminated (tmax of 15-30 min and plasma t1/2 of 20 min), but there was large intersubject variability in its observed maximum plasma concentration (38 to 348 pg X mL-1). The concentration of (15S)-15-methyl-PGE2 did not exceed 25 pg X mL-1 In six subjects and 50 pg X mL-1 in the remaining two subjects. The significance of these results is discussed. PMID- 3820108 TI - Comparison of ultraviolet and liquid chromatographic methods for dissolution testing of sodium phenytoin capsules. AB - An in vitro dissolution procedure for phenytoin (5,5-diphenylhydantoin) products, which utilizes a UV method of analysis, is compared with an HPLC method. The UV method is subject to interference due to inactive materials and decomposition products. One of the inactive materials was identified as the synthetic precursor, benzophenone. The decomposed and degraded capsule contained brown material probably due to alkaline hydrolysis of lactose in the capsule. Both benzophenone and the brown material had significant UV absorption in the phenytoin region. Consequently, a simple, specific, and sensitive HPLC method for dissolution testing of phenytoin has been developed. Comparison of the results of the UV and HPLC methods indicates that the UV method may result in up to 51% higher dissolution values, depending on the presence of inactive ingredients and the purity of the product. PMID- 3820109 TI - The varus components of the forefoot in flatfoot deformities. PMID- 3820110 TI - Evaluation of planovalgus foot deformities with special reference to the natural history. PMID- 3820111 TI - Biomechanics of talipes equinovalgus. PMID- 3820112 TI - Rheumatoid flatfoot. PMID- 3820113 TI - End-stage flatfoot. Diagnosis and conservative and surgical management. PMID- 3820114 TI - Treatment of flexible flatfoot. A panel discussion. PMID- 3820115 TI - Silicone elastomer implant failure. PMID- 3820116 TI - Biomechanics and surgical criteria for flexible pes valgus. PMID- 3820117 TI - Selected perspectives on a quarter century of rehabilitation engineering. PMID- 3820118 TI - Wheelchair prescription: an analysis of factors that affect mobility and performance. AB - Clearly, all considerations for wheelchair performance and their applicability to optimization of mobility are related to user position relative to the main wheel axis. It is also obvious that wheelchair performance is enhanced by a center of gravity position rearward of that which is characteristic of the generic wheelchair. The only obvious features of the generic wheelchair are excessive static stability and limitation of body motion. Perhaps at this stage the reader may be ready to accept some of the arguments presented above, but have reservations about prescribing a less stable wheelchair for the more severely disabled (e.g., quadraplegics). Consider that the reduction of rolling resistance, decrease in downhill turning tendancy, and required turning force would likely be even more important to the user with marginal physical capacity. This would appear as an attractive trade for reduction in static stability. The number of factors unfavorably affected by increased static stability would suggest the use of an anti-tipping device rather than designed static stability if this is thought to be an important consideration. PMID- 3820119 TI - Metallurgical analysis of five failed cast cobalt-chromium-molybdenum alloy hip prostheses. AB - The clinical and metallurigical characteristics of five cast cobalt-chromium molybdenum alloy femoral hip prostheses which failed in vivo were evaluated. The devices included: two of the Howmedica Muller-Charnley design, two of the Howmedica Charnley design, and one of the Zimmer Aufranc-Turner design. Fractographic analyses demonstrated that the five devices had failed by fatigue which originated on the lateral aspect. Failure occurred after an average in vivo time of 80.4 months (approximately 6.7 years). Only two of the devices had Rockwell hardness values that were within the ASTM specifications for the alloy. Upon metallurgical examination, moderate to severe levels of gas porosity, interdendritic shrinkage, and nonmetallic inclusions were found in all of the devices. As expected, extremely large grain sizes also were observed in the devices examined. These results indicate that the metallurgical flaws and defects associated with the cast cobalt-chromium-molybdenum alloys used in these devices may preclude successful longterm performance and warrant manufacturer's attention. PMID- 3820120 TI - Technological and physiological characteristics of a newly developed hand-lever drive system for wheelchairs. AB - It may be concluded that, by use of the newly developed Swing-Turn-gear system, mobility of the disabled person using wheelchairs outdoors can be improved. The qualities of the drive gear in push and pull action, the free wheel, the full selection of frequency, and the range of moving the hand levers represent important progress in wheelchair engineering research. The handrim drive is an alternative, especially for indoor use. But, for the first time, an indoor wheelchair can be offered as a combination vehicle for both indoor and outdoor use. The acceptance of the new wheelchair integrated Swing-Turn-gear is much better than the conspicuous hand-lever drive in standard outdoor wheelchairs. At present, the German wheelchair manufacturer, MEYRA Vlotho, is preparing the new hand-lever drive system for production. Initially, the drive system will be adapted to a standard indoor wheelchair made by this company. Development of a lever drive system is also in progress in the United States, which employs force transmission characteristics in one direction. PMID- 3820121 TI - A preliminary report on the use of a practical biofeedback device for gait training of above-knee amputees. AB - A new type of biofeedback device for use in gait training of above-knee amputees is described. This device provides immediate and postsession performance feedback to both patient and therapist, based on programmable thresholds of prosthetic weightbearing and hip extension angle. The device is battery powered, lightweight, and completely portable. The design of the microprocessor-based control unit and the weightbearing and hip angle sensors is presented. Initial field trials at Massachusetts General Hospital show that this device meets the clinical requirements of simplicity and good human interface. Based on this experience, design recommendations are made for a general purpose physical therapy biofeedback and data acquisition system. PMID- 3820122 TI - A variation in growth capability of myofibers shifted to incompetence as the pathogenesis of mouse muscular dystrophy. PMID- 3820123 TI - [Immuno-enhancing actions of carnosine and homocarnosine]. AB - Immuno-enhancing actions of carnosine, beta-alanine, homocarnosine, and gamma aminobutyric acid were studied in ddY mice by evaluating plaque-forming cell reaction against sheep red blood cells. Animals were administered the test agents in prior to, or simultaneously with, various treatments that are known to reduce immune function such as administration of the anti-tumor agents, mitomycin C and 5-fluorouracil, immunosuppressant cyclophosphamide, antiinflammatory agent hydrocortisone, or cancer implantation and gamma-irradiation. Experiments were performed also in aged mice with reduced immune function. The administration of these drugs showed non-specific immuno-enhancing effects under all conditions examined and on all cell groups that may have been affected by these immunosuppressive stimulus. PMID- 3820124 TI - [Effects of dithizone on the electroencephalogram recorded from the mouse hippocampus in vivo]. AB - In the present study the author examined the effects of dithizone on hippocampal and cortical EEG by power spectral analysis in the moving mouse. Following results were obtained. Administration of dithizone 100 mg/kg i. p. produced almost loss of electrical activities on EEG which began 409 sec after injection and lasted approximately up to 706 sec. In recovery period waveform showed shift to slower frequencies apparent by 60 min. Heart rate decreases were seen between 5 and 20 min after 100 mg/kg i. p. injection. Dithizone produced dose-dependent changes in hippocampal and heart rate activities. Abolished EEG by dithizone administration were immediately recovered by zinc-acetate application. Injection of vehicle had no significant effect on hippocampal and cortical EEG. PMID- 3820125 TI - Correlated biochemical and ultrastructural studies on the lung in isolated and combined acute treatment with ethanol and paraquat. PMID- 3820126 TI - Heterogeneous distribution of dextroamphetamine in rat brain after acute amphetamine administration. PMID- 3820127 TI - [Embryotoxicity of the products of the Maillard reaction. Methionine-glucose and methionine-lactose]. PMID- 3820128 TI - Adolescents and microcomputers: sex differences, proxemics, task and stimulus variables. AB - Questionnaires concerning attitudes toward use of microcomputers at home, in school, and at video arcades were administered to 879 high school students. Direct observations of adolescent proxemics and sex differences, and of various parameters of video games in 18 video arcades were made. A thorough and representative content analysis of sex bias of microcomputer software advertising brochures was carried out. Results supported previous findings of overrepresentation of masculine culture in the adolescent world of microcomputers, particularly regarding video games. Various types of computer related activity were not related to socioeconomic class of the parents or to academic grades except for use of home microcomputers, which was mildly positively related to socioeconomic class (r = .124, p less than .001). Nearly half the activity in the arcades was strictly solitary. None of the arcade video games allowed for cooperative play. Most allowed only for sequential competition (86%) or simultaneous competition (7%); as many as 7% did not provide a display of the scores for a second player. PMID- 3820129 TI - Adolescents' reactions to the evacuation of the Sinai settlements: a longitudinal study. AB - This study investigated psychological reactions of adolescents to a severe stress situation--the evacuation of the Sinai settlements. The research focused on emotional reactions of anxiety and anger to this stress situation. Two central problems were investigated: The intensity of the emotional responses of anxiety and anger of the adolescents to the stress situation, before and after the evacuation, and the impact of three intervening variables on these emotional reactions--cognitive perception of the political situation, family functioning, and personality characteristics. Data for this study were collected in a regional high school in Israel from 418 pupils in 9th through 12th grades. Seventy-eight of the pupils lived in the Yamit area. Measurements were obtained at three points in time: 6 weeks and 1 week before the evacuation and 2 months after it. The results supported the predicted trend that adolescents in the Yamit group before the evacuation would score higher on state anxiety and state anger than would those in the comparison group. Two months after the evacuation there was a significant drop in those scores. The trait measures remained stable in both groups and no significant differences were found between the two groups on these scores. Concerning the impact of the three intervening variables on the intensity of the state emotional responses, the results did not support any of the hypotheses. PMID- 3820130 TI - Jewish-Arab relations in Israel: a psychology of adolescence perspective. AB - Jewish and Arab high school seniors (61 Jewish boys and 51 Jewish girls, 57 Arab boys and 49 Arab girls) participated in a study of future orientation and described their hopes and fears for the future. The present analysis focuses on part of the data pertaining to the respondents' cross-ethnic references. More Arab than Jewish adolescents referred to the other ethnic group. The cross-ethnic references contained hope for peace and fear of war; the Arab statements, however, also showed discontent with Israeli authorities. More Arab than Jewish adolescents referred to collective issues (the people, the state, the world). The percentage of Jewish and Arab adolescents concerned with Jewish-Arab relations relative to the number addressing other aspects of collective concerns were similar (12% for Jews and 16% for Arabs). For Jews, this small number was related to adolescents' egocentrism and for Arabs, to adolescents' ethnocentrism. PMID- 3820131 TI - Young adults' caregiving and the age level of a potential recipient. AB - The hypothesis that two caregiving tendencies are affected by the age of potential recipients was investigated in two experiments. In Experiment 1, two matched groups of 40 young adults selected from 16 pairs of either facial profile drawings or age-labels (e.g., "2-year-old") those individuals that they would feel most compelled to protect (i.e., the most "defense-provoking" in each pair). Both groups tended to select younger and more elderly individuals over more middle-aged ones. In Experiment 2, two more matched groups of 40 adults rated the defense-provokingness or the cuddliness of a series of facial profile drawings showing a male at eight ages, from newborn to 70 years old. Although rated cuddliness decreased as portrayed age increased from age 6 months onward, rated defense-provokingness decreased with age from birth to 35 years, but increased thereafter. These results are generally consistent with the expectation that adults' tendency to protect or cuddle others varies in accordance with the typical neediness of individuals of different age levels for these forms of care. PMID- 3820132 TI - Internal inconsistency in the Eysenck Psychoticism Scale. PMID- 3820133 TI - The use of visual landmarks by gerbils: reaching a goal when landmarks are displaced. AB - Gerbils (Meriones unguiculatus) can specify the location of a goal by means of visual landmarks and will return to such a goal from different starting positions in the vicinity of the landmarks. To discover whether landmark-cues are used continuously during an approach to the goal, gerbils were trained to forage for sunflower seeds close to a single illuminated light-bulb on the floor of an arena. As they approached the bulb, it was switched off and another bulb in a variable position with respect to the first turned on. On 52 out of 71 trials the gerbils changed their trajectory (latency ca. 240 ms) to aim for the newly lit bulb (Fig. 1 A, B). On the remaining trials, gerbils maintained their original course towards the first bulb as though it were still lit and then paused after a longer delay before eventually changing direction (Fig. 1 C). Thus, an approach to a beacon is usually under continuous visual control. This ensures that the gerbil will reach its goal correctly despite any inaccuracies in its initial computation of its approach. When switches were made between more complex arrays of landmarks, the gerbils' behaviour was less clear-cut. Possible reasons for this difference are suggested. PMID- 3820134 TI - Control of a teleost social signal. I. Neural basis for differential expression of a color pattern. AB - Territorial male Haplochromis burtoni (Teleostei; Cichlidae) have a dark facial stripe, the 'eyebar', which can appear and disappear within seconds, independently of other coloration patterns. It is used to signal territory ownership and aggressive intent. Some males, called 'barless', have functional melanophores in the eyebar region but never display this pattern, because melanin in eyebar pigment cells is never dispersed. The eyebar melanophores are controlled by a specialized branch of the maxillary nerve. Lesioning the 'eyebar nerve' resulted in immediate melanin dispersion and consequent darkening of the eyebar pattern, and it abolished the normal paling response in all behavioral situations. Nerve lesion produced similar results in both barred and barless males, except that the coloration of the denervated eyebar in barless males was more similar to camouflage markings than to the conspicuous black eyebar used as a social signal. Electrical stimulation of the maxillary nerve produced melanin aggregation. Photoelectric recordings of this paling response revealed no differences between barred and barless males, or between the eyebar and other facial chromatophores that do not function as visual displays. Thus, the difference in the physiological state of eyebar melanophores in intact barred and barless males cannot be explained by differences in peripheral nerve anatomy or physiology. PMID- 3820135 TI - Control of a teleost social signal. II. Anatomical and physiological specializations of chromatophores. AB - A prominent dark facial stripe, the 'eyebar', is an important component of the reproductive coloration and dominance displays of 'barred' territorial male Haplochromis burtoni (Teleostei; Cichlidae). 'Barless' territorial males are identical to barred, behaviorally and morphologically, except they completely lack an eyebar during agonistic encounters with conspecifics. Both anatomical and physiological differences characterize eyebar pigment cells of barred and barless males. Melanophores and iridophores, which form a single structural and functional unit in the eyebar, contain less pigment in barless males. Physiologically, eyebar melanophores are tonically expanded in barred males, contracted in barless males. This physiological difference is correlated with a difference in the alpha adrenoceptor-mediated aggregation response of the cells in vitro: eyebar melanophores of barless males are significantly more responsive to physiological concentrations of the sympathetic neurotransmitter norepinephrine than those of barred males, and this intermorph difference appears to be unique to the eyebar color pattern. Physiological and morphological characteristics of eyebar pigment cells are functionally related. When barless males first begin to use the eyebar as a social display, the physiological state of melanophores changes from aggregation to dispersion. In subsequent weeks, additional pigment develops, which enhances conspicuousness of the display. PMID- 3820136 TI - Psychological factors and immunity. PMID- 3820137 TI - Female sexual behavior: fluctuations during the menstrual cycle. AB - This longitudinal prospective study was designed to examine the influence of menstrual cycle phase on female sexuality. Sixty-nine normally cycling women monitored their sexual behavior including both heterosexual and autosexual activities and their basal body temperature daily over two or three consecutive menstrual cycles. Temperature charts were used to ascertain five cycle phases (menstrual, postmenstrual, ovulatory, luteal and premenstrual) and data were analyzed using analyses of variance with repeated measures. The results supported a significant cyclic fluctuation in sexual behavior with both female-initiated and male-initiated sexual activities peaking in the ovulatory phase. Moreover, the findings indicated that women experienced increased sexual arousal and sexual pleasure as they progressed from the menses to the premenstruum. These data suggest that human sexual behavior may be influenced by hormonal fluctuations and cognitive factors associated with the menstrual cycle. PMID- 3820138 TI - Response to symptoms in healthy, low utilizers of the health care system. AB - From the literature, it is clear that a small proportion of people account for an inordinately high number of health care visits. Conversely, there exists a group of individuals who rarely seek professional medical intervention and, yet, who remain healthy. This study examines a sample of adults who have not received remedial treatment for any symptom in the previous year, who consider themselves as healthy and who pass a comprehensive physical examination. A gender and age balanced group of healthy low utilizers was administered the Symptom Response Questionnaire, an instrument designed to elicit response tendencies to thirteen standardized symptoms. There were significant differences between age groups in response to symptoms with the older individuals more likely to seek professional help. There were few gender differences within the healthy sample. This sample of healthy low-utilizers was not without symptoms, reporting an average of 20 symptoms occurring in the previous week as measured by the SCL-90. A clinical headache group was also administered the SRQ to provide information about their response tendencies to symptoms. This preliminary study suggests that response to illness may be significantly influenced by age and patient status and that reported gender differences in health care utilization may need to be examined more carefully. It is proposed that behavior patterns of healthy, low utilizers may have direct implications for intervention with high utilizers of the health care system. PMID- 3820139 TI - The relationship between cynical hostility and blood pressure reactivity. AB - It is hypothesized that high levels of hostility stimulate blood pressure hyperresponsivity to challenge. Seventy-six normotensive adults completed the MMPI hostility subscale, and blood pressure reactivity to, and recovery from, cold pressor and mental arithmetic stressors were measured on two occasions. Only one of twenty Pearson correlations between Cook-Medley hostility and blood pressure reactivity was significant. Analyses of variance revealed that blood pressure reactivity was influenced by sex and family history of cardiovascular disease, but neither factor interacted with hostility. There was no evidence from the present study that cynical hostility as measured by the Cook-Medley was associated with blood pressure reactivity. PMID- 3820140 TI - Life event stress and chronic difficulties in duodenal ulcer: a case control study. AB - In a sample of consecutive ulcer (DU) patients and age, sex and social class matched normal controls, the prevalence of antecedent stressful life events in the two samples was similar. Antecedent chronic difficulties often lasting years were however significantly more common in the ulcer patients. Duodenal ulcer was more common in divorced, separated or widowed subjects; this finding was explained by the fact that these subjects had more chronic difficulties which predisposed to ulcer disease. PMID- 3820141 TI - Social and psychological responses to myocardial infarction: multiple determinants of outcome at six months. AB - Thirty one married men, under 65 yr of age, who were admitted to hospital with a suspected myocardial infarction, were interviewed on four occasions over six months. The patients' social and psychological responses during the course of his rehabilitation were elicited using a semistructured interview schedule. Determinants of outcome were assessed using multiple regression analysis. Return to work, exercise, leisure and sexual activity were all strongly influenced by somatic symptoms of chest pain, breathlessness, and tiredness. Lack of depression, not smoking, and support from the family doctor were important contributors to successful rehabilitation. Cardiac damage sustained at the time of admission did not appear to have any consistent influence on outcome. Half of the smokers had not resumed their habit at six months. Fewer men were working at six months than on admission. Somatic symptoms, anxiety and depression were considerable. PMID- 3820142 TI - Combat stress reactions, post traumatic stress disorder and somatic complaints among Israeli soldiers. AB - This study examined the effect of combat stress on somatic health in a sample of 804 Israeli soldiers. Three groups of subjects were assessed: combatants who did not participate in the Lebanon War, combatants who fought and suffered from combat stress reactions, and combatants who participated in the Lebanon War but did not sustain psychiatric injury. One year following the war subjects were asked to report somatic complaints and were screened for post-traumatic stress disorder. Results indicated that participation in combat per se did not have pathogenic effects. However, combat stress reactions and post-traumatic stress disorder were found to be associated with somatic complaints. The practical and theoretical implications of these findings are discussed. PMID- 3820144 TI - Asthma in opiate addicts. AB - A case-note study of 2276 opiate addicts revealed that 112(5%) had a history of asthma and that in 31(1.4%) cases there appeared to be a definite temporal relationship between heroin abuse and the onset of asthma. This rarely-reported complication of heroin dependence has a higher incidence among female addicts (3.3%) than among male addicts (0.7%). PMID- 3820143 TI - The differential impact of diabetes type on female sexuality. AB - Although diabetes is associated with a high prevalence of erectile impairment in men, its effect on the sexuality of women remains unclear. Since diabetes consists of different disorders, diabetes type may have confounded previous studies by differentially impacting on sexual functioning and marital satisfaction. To evaluate this possibility, 35 Type I diabetic married women were compared with 42 healthy married controls and 23 Type II diabetic women with 23 controls. Assessments were made on all aspects of sexual response, activity, dysfunction and satisfaction; on cognitive and psychological dimensions of sexuality; and on marital adjustment. Results indicated that diabetes type is highly associated with sexual responsiveness and marital satisfaction. Type I diabetes was found to have little or no effect on women, while Type II diabetes had a pervasively negative impact on sexual desire, orgasmic capacity, lubrication, sexual satisfaction, sexual activity, and on the relationship with the sexual partner. PMID- 3820145 TI - The relationship between retrospective premenstrual symptom reporting and present oral contraceptive use. AB - The premenstrual assessment form (PAF) was used to assess the degree and type of premenstrual changes reported by 101 oral contraceptive users and 149 non-users (aged 18-45 yr) attending general health and gynaecology clinics. Women using oral contraceptives did not complain of fewer or less severe symptoms overall, but their severity scores on the subscales of premenstrual anxiety, fatigue, low mood, water retention, and impaired social functioning were significantly lower than those of non-users. The duration of oral contraceptive use and the type of preparation (combined or phased) taken were not related to the degree of premenstrual change reported. Complaints of symptoms beginning more than two days before menstruation were less frequently reported by pill-users (p less than 0.01) and were associated with a greater severity of all types of premenstrual change (p less than 0.0001). Women who had experienced difficulties tolerating oral contraceptives reported a greater number of moderate/severe premenstrual changes (p less than 0.0001). PMID- 3820146 TI - Type A behavior in housewives: relation to work, marital adjustment, stress, tension, health, fear-of-failure and self esteem. AB - Ninety-five housewives were administered the Framingham Type A Scale and the Jenkins Activity Survey. Information concerning various aspects of their daily lives as well as various psychological and psychosocial variables were obtained via questionnaire and interview. Type As were found to differ from Type Bs in having more stressful work-related experiences. Further, Type As reported poorer marital adjustment and tended to report more marital disharmony than did Type Bs. Type A behavior was also related to more self-reported stress, tension, and physical health problems. Finally, Type As reported lower covert self-esteem and tended to report more fear-of-failure than Type Bs. PMID- 3820147 TI - Impact of chronic pain on the spouse: marital, emotional and physical consequences. AB - The effects of chronic illness on marital relationships and the spouses' emotional and physical health were examined in chronic pain patients, their spouses, and a control sample of spouses of diabetic patients. Results indicated that pain patients and their spouses experienced considerable change in marital and sexual satisfaction. Patients with better marital adjustment also reported higher overall pain levels and had more solicitous and maritally satisfied spouses. Spouses' marital adjustment was positively associated with patients' marital satisfaction and spouses' own mood. Spouses' dysphoric mood was related to patients' negative appraisal of the pain experience, spouses' perceived lack of life control, and spouses' marital dissatisfaction. Although spouses of chronic pain patients showed no more physical symptoms than spouses of diabetics, they reported significantly more pain symptoms that were related to elevated levels of depressed mood. The results indicate that not only is chronic pain associated with problems in the marital relationship but heightened distress and physical symptoms in spouses as well. These effects are related less to the existence of a chronic pain problem per se but rather to patients' and spouses' manner of coping with the situation. PMID- 3820148 TI - Social support in women reporting dysmenorrhea. AB - Twenty-five women who reported dysmenorrhea were compared with a control group reporting no dysmenorrheic symptoms. An assessment of the structural and functional aspects of their social support system and ratings of somatic awareness and depression were made. Dysmenorrheic women reported less adequate social support than the control group. Although the two groups indicated similar numbers of individuals within their networks the dysmenorrheics reported a higher frequency of inadequate and geographically distant relationships. Somatic awareness but not depression scores were also elevated in the dysmenorrheic group. PMID- 3820149 TI - Stress, the adrenergic hypothalamovagal pathway, and chronic gastric ulceration. AB - In the rat, stress activates the hypothalamus inducing central sympathetic discharge and delivery of alpha-adrenergic stimulation to the stomach by the adrenergic hypothalamovagal pathway. This stimulation controls intragastric blood flow and 5-HT release. Administration of reserpine produces stress pharmacologically and stimulates the mentioned pathway. Six hours after intraperitoneal reserpine (5 mg/kg), gastric mucosal lesions are produced in all rats. These lesions are vascular in origin and do not require gastric acid or duodenal contents for their development. However, reflux of duodenal contents into the stomach is associated with this pathway stimulation and increases lesion severity. Stimulation of the pathway with a single intraperitoneal injection of reserpine (5 mg/kg) every 24 h for five days produces chronic gastric ulceration in 80% of rats demonstrating the relationship between stress and chronic gastric ulceration. In addition it is observed that the duration of stress in the rat determines the nature of the gastric lesion produced. PMID- 3820150 TI - Degree of life-threat and differential use of coping modes. AB - This investigation sought to determine whether medical patients facing life threatening illnesses (i.e. cancer, myocardial infarction) differed in their coping responses from medical patients facing nonlife-threatening illnesses (e.g. arthritis, dermatitis). Subjects' coping responses were measured by a Medical Coping Modes Questionnaire which was developed to measure three forms of coping: confrontation, avoidance, and acceptance-resignation. The scales were based on a 32-item questionnaire and were derived by a combination of rational and factor analytic procedures. Construct validity data gathered from patients, physicians, and significant others verified the nature of the scales. Results indicated that life-threatened patients used confrontation significantly more than did nonlife threatened patients in dealing with their illness. Acceptance-resignation was used least of all by each of the groups. Findings appear to support those theorists who conceptualize coping behavior in dealing with life-threat as being shaped more by situational context than by personal style. PMID- 3820151 TI - A global view of immunisation. PMID- 3820152 TI - Topical corticosteroids. PMID- 3820153 TI - Inappropriate prescribing in the elderly. PMID- 3820154 TI - The performance of clinics for outpatient control of anticoagulation. PMID- 3820155 TI - Hyperventilation and angina pectoris. PMID- 3820156 TI - Hypothyroidism following radioiodine treatment of thyrotoxicosis. PMID- 3820157 TI - Treatment of sexual disorder: a prophylaxis for major pathology? PMID- 3820158 TI - Who treats cancer? PMID- 3820159 TI - The future of local ethical research committees. PMID- 3820160 TI - Polycythaemia study. A project of the Royal College of Physicians Research Unit. 1. Objectives, background and design. PMID- 3820161 TI - Medicine in tropical Africa. PMID- 3820162 TI - Control of birth in rats by RU 486, an antiprogesterone compound. AB - Rats, isolated at mating (Day 1 of pregnancy), were submitted to either 8 h (8L:16D, Exp. I) or 14 h (14L:10D, Exp. II) of light daily with lights on from 12:00 h to 20:00 h and from 06:00 to 20:00 h respectively. In Exp. I, a single dose of RU 486 (10 mg in 0.2 ml ethanol) was given cutaneously at 08:00 h (Group A1), 12:00 h (Group B1), 19:00 h (Group C1) on Day 21 and at 08:00 h (Group D1) and 12:00 h (Group E1) on Day 22. In Exp. II, the same dose of RU 486 was given at 08:00 h (Group A2), 12:00 h (Group B2) and 19:00 h (Group C2) on Day 21. The solvent was given once at each of the preceding times to the control groups (T1 and T2) in both experiments. Groups T1 and T2 gave birth at two periods, the first on Day 22, the second on Day 23; the proportion of births during each of these periods depended on the light regimen (66.3% in 8L:16D; 50% in 14L:10D on Day 22). The distribution of births in Groups D1 and E1 treated on Day 22 were similar to their controls (T1). Rats treated on Day 21 (Groups A1, A2, B1, B2, C1, C2) gave birth over single periods on Day 22 after an interval correlated with the time of RU 486 administration. The earlier the treatment was given, the higher was the number of dead young and the lower the weight of live young 1 day after birth. These effects of prematurity did not impair further survival rates or weight at weaning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820163 TI - Characterization of oestrus and timed collection of oocytes in the grey short tailed opossum, Monodelphis domestica. AB - A system of test-pairing was used to detect reproductive behaviour in the grey short-tailed opossum. This enabled timing and characterization of the development of pro-oestrous and oestrous behaviour, and facilitated collection of ovulated and unovulated oocytes. Oestrus was induced 8.5 days (n = 80, 95% confidence limits 7.56-9.21) after the introduction of a male. Timed examination of the ovaries by laparotomy indicated that ovulation occurred 14-16 h after the first onset of oestrous behaviour. The development of follicles was linked to pro oestrous behaviour, and ovulation occurred in the absence of copulation. Vaginal exfoliative cytology indicated that pro-oestrous behaviour was associated with an increasing number of keratinized epithelial cells, and at the time of maximum receptivity to males, a heavy infiltration of polymorphonuclear leucocytes was seen. Oocytes were typically marsupial: large (approximately 250 microns in diameter), with a yolky vitellus and thin zona pellucida. An average of 6 oocytes were ovulated per ovary. PMID- 3820164 TI - Inequality in function of the right and left ovaries and uterine horns of the mouse. AB - Inequality in function of the left and right ovaries and uterine horns of mice was evaluated in three separate experiments. In Exp. 1, the effect of position in the reproductive tract on various reproductive characteristics was evaluated in 158 pregnant hybrid mice. Ovulation rate, number of fetuses, total fetal weight and total placental weight were higher (P less than 0.05) on the right than the left on Day 18 of pregnancy (vaginal plug = Day 1). In Exp. 2, the effect of previous sham or unilateral ovariectomy (right or left) in mated Swiss-Webster mice was compared with unoperated mated controls (N = 17-24/treatment). In control mice, ovulation rate, total fetal weight and ovarian weight were higher (P less than 0.05) on the right than left side. Surgery (sham or unilateral, ovariectomy) decreased (P less than 0.005) ovulation rates, number of fetuses, ovarian weights, total fetal weight and total placental weight on Day 18 of pregnancy. Unilateral ovariectomy decreased (P less than 0.05) ovulation rates and ovarian weights more than did sham operation. Ovulation rates were higher (P less than 0.01) when the left ovary was manipulated or removed rather than the right ovary. For Exp. 3, pairs of 8 hybrid mouse embryos each (morulae and blastocysts) were surgically transferred to the left and right uterine horns of the same (bilateral, N = 15) or different (unilateral, N = 28) Swiss-Webster recipients. In almost all incidences, embryo survival (to Day 18 of pregnancy) was twice as high (P less than 0.05) in right than left uterine horns. We conclude that the left and right ovaries and uterine horns are not equal in function in Swiss-Webster and a hybrid strain of mice. PMID- 3820165 TI - Treatment of rats with hCG induces inflammation-like changes in the testicular microcirculation. AB - Adult rats were injected subcutaneously with 50 i.u. hCG and vascular permeability was compared to that in saline-treated control rats by two independent methods. At 4 h after hCG treatment the rats were injected intra arterially (i.a.) with FITC-labelled macromolecular dextran (Mr 150,000) and the testicular microcirculation was studied in vivo by using a fluorescence microscope. Other rats were injected i.a. with a suspension of colloidal carbon and the location of leaking blood vessels was recorded in sections from the testes by light and electron microscopy. In hCG-treated animals leucocytes were found adhering to the endothelium in post-capillary venules and in these venular segments dextran was leaking into the interstitium. Carbon particles were deposited in the walls of post-capillary venules and leucocytes migrated through open interendothelial cell gaps in hCG-treated animals. In control animals leucocyte adhesion and migration were not observed, the injected dextran remained in the circulation and the blood vessels were not labelled by carbon. It is suggested that the hCG-induced increase in testicular interstitial fluid volume, like the tissue oedema in inflammation, is caused by a leucocyte-mediated increase in venular permeability. PMID- 3820166 TI - Seasonal changes in oestrogen receptor affinity in the domestic rabbit, Oryctolagus cuniculus. AB - Over the course of 1 year the Ka value of uterine oestrogen receptor for oestradiol varied 10-fold from a low of 0.259 +/- 0.065 X 10(9) M-1 in early spring to 2.21 +/- 0.21 X 10(9) M-1 in fall. There were no significant changes in receptor number. In addition, administration of oestradiol or progesterone to ovariectomized rabbits resulted in significant reductions in measureable oestrogen receptor affinity. Although these variations in oestrogen receptor Ka values parallel reproductive success in the domestic rabbit, no causal relationship has been established. PMID- 3820167 TI - Sex difference in mouse embryonic development at neurulation. AB - Sixty-seven mouse embryos from 10 litters collected on the morning of Day 9 of gestation, when neurulation is beginning, were classified according to the precise stage of development reached, and sex-chromatin analysis was performed on the yolk sac. Within litters, the least developed embryos were more likely to be female than male, while the most advanced embryos were predominantly male. Taking all embryos, the mean somite number was greater in males than females. PMID- 3820168 TI - Length of pseudopregnancy and pattern of uterine protein release as influenced by time and duration of oestrogen administration in the pig. AB - Treatment of gilts with 5 mg oestradiol benzoate on Day 9.5, 11, 12.5, 14, 15.5 or Days 14-16 resulted in an interoestrous interval of about 30 days. Administration of oestradiol benzoate daily from Days 11 to 15 or two periods of treatment on Days 11 and 14 to 16 resulted in prolonging CL function beyond 60 days from the pre-treatment oestrus. Endometrial secretory response to oestrogen stimulation, based on the ability of oestrogen to release calcium and uterine protein into the lumen appears to occur after Day 10 of the oestrous cycle. The results suggest that maintenance of prolonged CL function appears to require two periods of oestrogen stimulation. The first period occurs on Day 11 when the endometrium has become responsive to oestrogen stimulation followed by a second prolonged increase in oestrogen stimulation after Day 14. These findings accord with the normal patterns of oestrogen released by pig blastocysts during early pregnancy. PMID- 3820169 TI - Formation of the hamster zona pellucida in relation to ovarian differentiation and follicular growth. AB - Using an immunofluorescence technique on ovarian sections, zona-immunoreactive components were detected in the cytoplasm of the oocyte from the beginning of its growth, when it is surrounded by only a thin squamous follicular cell layer, up to the end of its growth. In parallel with oocyte growth, the staining intensity decreased in the ooplasm. No staining was observed in the cytoplasm of the granulosa cells during normal follicular development in adult cyclic females. However, staining of the granulosa cells was observed at some stages of follicular development in immature females. This staining was especially evident in the ovaries of immature females (22 or 26 days old) stimulated with PMSG. In addition, the staining of the granulosa cells was consistently observed in ovaries showing an abnormal histology. Increased staining of the zona at its outer and inner regions could be distinguished in normal follicles, but when staining occurred on the granulosa cells no such pattern was observed over the zona matrix. These studies indicate that the oocyte itself but not the granulosa cells elaborates the native immunogenic material of the zona pellucida. The administration of PMSG at particular stages of ovarian differentiation interferes with follicular development leading to an abnormal extracellular assembly of the zona and its degradation (phagocytosis) by the surrounding granulosa cells. PMID- 3820170 TI - Influence of adrenergic receptors on ovarian progesterone secretion in the pseudopregnant cat and oestradiol secretion in the oestrous cat. AB - The infusion of isoprenaline or propranolol into the abdominal aorta of the pseudopregnant cat caused an increase or decrease respectively in the ovarian progesterone secretion rate. These observations suggest that the sympathetic innervation of the ovary has a physiological influence on normal progesterone secretion, and this mechanism may explain stress-related increases in progesterone concentrations. The infusion of isoprenaline or propranolol after the stimulation of follicular growth had no consistent or convincing effect on oestradiol secretion. PMID- 3820171 TI - Seasonal reproduction in ewes selected on seasonal changes in wool growth. AB - Romney and Perendale ewes were selected on the amplitude of seasonal wool growth. The ewes were fed a constant plane of nutrition and run with vasectomized rams. Ovarian activity was recorded by laparoscopy during 11 months. Ewes with a low amplitude of seasonal wool growth (Group L) had a 68% higher wool growth rate in winter and a 17% lower wool growth rate in summer compared with ewes with a high amplitude (Group H). There was no difference between the groups in the date of the first mating mark. Ewes in Group L entered anoestrus significantly later than did ewes in Group H; the difference was 11 days in the mean date of the last mating mark and 17 days in the mean date of the last ovulation. A significantly higher proportion of ewes in Group L ovulated during July to November. In addition, ewes in Group L had a significantly higher proportion of multiple ovulations throughout the experiment: on average the difference between the groups was 0.21. These results show that phenotypic selection for a low amplitude of seasonal wool growth resulted in a delay in the end of the breeding season associated with an increase in ovulation rate, suggesting independent effects on the beginning and end of the breeding season. PMID- 3820172 TI - Futile substrate cycles in the glycolytic pathway of boar and rat spermatozoa and the effect of alpha-chlorohydrin. AB - In boar spermatozoa incubated with 0.1 mM-glucose about 20 nmol glucose were converted to lactate and CO2 and the rate of futile substrate cycling between glucose and glucose 6-phosphate was about 6 nmol/10(8) spermatozoa/30 min. Futile cycling was increased in the presence of 0.05 or 1 mM-alpha-chlorohydrin but not to an extent sufficient to account for the rapid decline in ATP concentration observed under these conditions. These estimates include a substantial rate of fructose formation from fructose phosphates. The addition of 10 mM-L-lactate plus 1 mM-pyruvate protected the spermatozoa against the effect of alpha-chlorohydrin and glucose on the ATP concentration but increased futile substrate cycling. Substrate cycling between fructose 6-phosphate and fructose 1,6-bisphosphate could not be measured in boar spermatozoa but in rat spermatozoa its rate (nmol/10(8) spermatozoa/30 min) was about 10 under control condition and about 25 in the presence of 1 mM-alpha-chlorohydrin. This increase was insufficient to account for the decline in ATP concentration. In both species futile substrate cycling consumed a significant proportion of the ATP synthesis during lactate production but only about 5% of that produced in the oxidation of glucose to acetyl carnitine and CO2. PMID- 3820173 TI - Influence of follicular maturation on 3-hydroxy-methylglutaryl coenzyme A reductase activity in hen granulosa cells. AB - The activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase: EC 1.1.1.34) was measured in a microsomal preparation of the granulosa of rapidly growing ovarian follicles of laying hens in the late preovulatory period (2-3 h before expected ovulation). The specific activity of the enzyme was measured in the five largest (F1-F5) preovulatory follicles, F1 being the follicle destined to ovulate first. Enzyme activity increased concomitantly with follicle size. The apparent Km of the enzyme decreased 60-80% from the smallest to the largest preovulatory follicle. There was no significant change in the Vmax during follicle development. Although our results have demonstrated the presence of HMG/CoA reductase in chicken granulosa cells and the progressive increase of its activity with follicular maturation, the quantitative significance of de-novo synthesized cholesterol as steroid hormone precursor remains to be ascertained. PMID- 3820174 TI - Increasing ovulation rate and lambing rate in sheep by treatment with a steroid enzyme inhibitor. AB - Treatment of ewes with a 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) inhibitor (Epostane) resulted in a significant increase in both ovulation rate and in the mean number of lambs per ewe lambing. The progestagen sponge plus 3 beta-HSD inhibitor treatment also caused a significant increase in oestrous cycle duration of approximately 1.5 days. Treatment of ewes with the 3 beta-HSD inhibitor caused a significant decrease in peripheral progesterone concentrations, which were reduced even further when 3 beta-HSD inhibitor treatment was given to ewes after insertion of a progestagen sponge. However, mean oestradiol concentrations were significantly higher in the two treatment groups, both at the end of the luteal phase and during the follicular phase of the oestrous cycle. These results demonstrate that ovulation rate and the production of lambs per ewe lambing can be significantly increased by 3 beta-HSD inhibitor treatment. PMID- 3820175 TI - The effects of cryopreservation and transfer on embryonic development in the common marmoset monkey, Callithrix jacchus. AB - Embryos were collected at the 4-10-cell stage from the oviducts (Day 4; Day 1 = ovulation) or as morulae (Day 7) from the uterus of marmosets and frozen in 1.5 M DMSO (Days 4 and 7) or 1.0 M-glycerol (Day 4 only), using a slow freezing and thawing technique. Of 22 Day-4 embryos frozen in DMSO, 18 were recovered and 16 of these were transferred to 10 synchronized recipients; 7 recipients became pregnant compared with all 7 control recipients receiving 10 unfrozen embryos. Fifteen frozen-thawed morulae were transferred to 9 Day-6 recipients; the pregnancy rate (55.6%) was lower than for control embryos (85.7%). Embryos frozen in glycerol suffered severe osmotic stress during glycerol addition and removal. Of 8 recipients, 3 (37.5%) became pregnant but only one fetus was carried to term. These results on embryo collection, freezing and transfer in the marmoset have important implications for developing improved methods for freezing human embryos and the breeding of endangered primates. PMID- 3820176 TI - The sensitivity of the uterus of the mouse and rat to intraluminal instillation. AB - The tissue accumulation of 125I-labelled human serum albumin 30 min after intravenous injection was used as an index of uterine vascular permeability. In ovariectomized mice, all sham and experimental instillation procedures produced a 6-10-fold increase in vascular permeability. Some effects were also manifest in the contralateral, control horn. In ovariectomized rats, instillation of saline and arachis oil increased vascular permeability 3-7-fold. After 3 or more days of progesterone treatment following oestradiol priming, fluorocarbon and arachis oil instillation produced marked vascular responses, but these were not restricted to the transient period in which the uterus would respond with decidualization. An IUD prevented the response to arachis oil instillation. These results indicate that the uterus is very sensitive to any manipulation and are consistent with decidualization representing a specialization of a normal uterine inflammatory response. PMID- 3820177 TI - Influence of melatonin on the initiation of the breeding season of the marsupial bandicoot, Isoodon macrourus. AB - Melatonin implants were administered to 6 female bandicoots during the months of May and July. These animals, together with 6 control bandicoots were housed in large outside enclosures with mature males. Births were observed in the 6 control animals from 26 July to 2 September, but no births were observed in the 6 bandicoots with melatonin implants. These results would suggest that photoperiod, which is known to influence melatonin concentrations, may be a factor in the initiation of births in the bandicoot. However, the gradual build-up of births would suggest that other factors such as temperature and rainfall may also have some influence. PMID- 3820178 TI - Effects of oestradiol and progesterone on the metabolism of [U-14C]glucose by mouse morulae and early blastocysts in vitro. AB - The addition of progesterone (10(-7) to 10(-5) M) and/or oestradiol (10(-10) M) during 24-h chase culture of pulse-labelled morulae-early blastocysts did not affect the degradation of radiolabelled glycogen or other biochemical fractions. The presence of a high concentration of progesterone (10(-5) M) during 5-h pulse culture significantly inhibited incorporation of substrate carbon from [U 14C]glucose into both the acid-soluble and acid-insoluble glycogen fractions, but had no effect on non-glycogen fractions. Catabolic utilization of glucose as estimated by the rate of carbon dioxide and lactate production was not affected by the presence of progesterone (10(-7) to 10(-5) M), oestradiol (10(-10) to 10( 8) M) or a combination of both. The results indicate that ovarian steroids at expected physiological concentrations do not directly influence embryonic energy metabolism. PMID- 3820179 TI - Comparison of two reference preparations for horse chorionic gonadotrophin in four in-vivo and in-vitro assays. AB - A number of horse chorionic gonadotrophin (CG) preparations of different purities and from diverse sources have been compared in radioimmuno-, radioreceptor, in vitro cell culture, and in-vivo assays. The relative activities of the great majority of the preparations tested were consistent in the 4 assay systems. Moreover, their relative activities in the 4 assays were consistent with those found for unfractionated plasmas. These preparations were therefore considered to represent the native form of hormone. The second International Reference Preparation (IRP2) was among the few preparations exhibiting discordant relative activities in the different assay systems. Its relative in-vivo activity was almost 50% lower than that found in the 3 other assays. This could be due to denaturation of the hormone during its preparation or to selection of isoform(s) not representative of the whole population of molecules. For standardization of horse CG preparations by in-vivo assay, IRP2 has proved to be a reliable standard. However, for the standardization of preparations by in-vitro methods, a standard giving consistent results in in-vivo and in-vitro assays must be used. The present report indicates that the NIH standard, but not IRP2, fulfils these requirements. PMID- 3820180 TI - A 'window of time' during which testosterone determines the opiatergic control of LH release in the adult male rat. AB - Male rats castrated before puberty (when 26 days of age) showed a progressively decreasing susceptibility to the inhibitory effects of morphine (5 mg/kg) upon LH secretion for up to 28 days after gonadectomy (approximately 100%, 40% and 10% inhibition at 5, 12 and 28 days after castration), but thereafter morphine again caused approximately 50% reduction in serum LH values; the minimum inhibition found at 28 days after castration (age 54 days) occurred at the time at which male rats normally reach puberty. When rats were castrated at 59 days of age, morphine maximally suppressed serum LH concentrations (to less than 70%) 2 and 5 days after castration, but had no effect thereafter. In prepubertal castrates, testosterone replacement between Days 26 and 50 of life resulted in responses to morphine similar to those found in rats castrated after puberty, i.e. serum LH levels were not reduced. Morphine significantly reduced LH levels in prepubertal castrates given testosterone after 60 days of age. Treatment with morphine consistently elevated serum prolactin concentrations (greater than 100%) in castrated rats of all ages, regardless of the time elapsed after gonadectomy. These results indicate a transient fall in the inhibitory opioidergic tone upon LH secretion as the normal age of puberty approaches, that the ability of opiates to alter LH release in adulthood may depend upon testicular steroids secreted during the peripubertal period, and that the LH responses do not reflect general changes in the neuroendocrine response to opiates after castration since the prolactin response to morphine remains intact in rats castrated before and after puberty. PMID- 3820181 TI - Radioreceptor and autoradiographic analysis of FSH, hCG and prolactin binding sites in primary to antral hamster follicles during the periovulatory period. AB - As measured by radioreceptor assays, binding sites for FSH and prolactin were present at 09:00 h on the day of pro-oestrus in Stage 1-10 follicles (primary to antral) with prolactin receptors 3-6 times higher than FSH sites in Stages 1-3 (3 layers of granulosa cells). Specific binding sites for hCG were present in Stage 1 and 2 follicles (2 layers of granulosa cells) but thereafter their distribution was erratic and they were not consistently detectable until Stage 5, when thecal cells first appeared. Using topical autoradiography, specific binding for FSH was evident in Stage 1-4 follicles (4 layers granulosa cells) whereas specific hCG binding was not. After the preovulatory gonadotrophin surges, by 21:00 h on pro oestrus, FSH receptors declined in Stages 5-10, prolactin receptors fell in Stages 8 and 10 (small and large antral follicles) and hCG receptors were reduced in Stages 7 (start of antral cavity) to 10. On the morning of oestrus, for follicles from Stage 4 onwards, receptor numbers usually returned to levels found at 09:00 h on pro-oestrus. At oestrus, the few remaining Stage 10 follicles were all atretic and contained significantly reduced FSH and prolactin receptors but numbers of hCG binding sites comparable to those at 09:00 h of pro-oestrus. These results provide evidence of gonadotrophin receptors in small primary and secondary follicles which is consistent with increased DNA synthesis in small hamster follicles on the afternoon of pro-oestrus and on the morning and afternoon of oestrus. Periovulatory changes in gonadotrophin concentrations may therefore affect early stages of folliculogenesis. PMID- 3820182 TI - Anti-progesterone monoclonal antibody affects early cleavage and implantation in the mouse by mechanisms that are influenced by genotype. AB - Pregnancy was blocked by anti-progesterone monoclonal antibody in two inbred (BALB/cJ, CBA/Ca) but to a lesser degree in an F1 hybrid (CBA/Ca male X BALB/cJ female) or an outbred (Tuck's no. 1) stock of mice when antibody was injected intraperitoneally (i.p.) at 32 h post coitum (p.c.) using a dosage of 9.5-10.9 nmol. This different antifertility effect could not be explained solely by altered tubal transport in inbred mice since the rate of transport was slightly accelerated in one stock (BALB/c) but not in another (CBA). In crossbred mice tubal transport was not significantly altered by antibody treatment. At Day 3 (54 58 h p.c.), the majority of embryos in control mice were at the 4-cell and 8-cell to morula stages in inbred and crossbred stock, respectively, but after antibody treatment they were mainly at the 4-cell stage in all 4 stocks. At Day 4 (78-82 h p.c.) the majority of embryos in control females had reached the blastocyst stage in all stocks, whereas after antibody treatment they had reached this stage in crossbred stock and relatively few had progressed so far in inbred stock. The results indicate that there are two events in early gestation which are susceptible to passive immunization with anti-progesterone monoclonal antibody. The first of these occurs during cleavage shortly after the 4-cell stage when embryo development was arrested in two inbred stocks of mice. Antibody effects on cleavage were not direct since embryos cultured in the presence of high concentrations of antibody, or antibody saturated with progesterone, continued to develop in the normal way and formed blastocysts. The second event is the onset of implantation, an effect also influenced by genotype. The decidual cell reaction induced by intraluminal oil injection was blocked by antibody injected at 8 or 32 h p.c. in BALB/c females, but only when injected at 8 h, and not at 32 h p.c., in F1 hybrid females. The results show that there is a greater resistance in two crossbred stocks compared with two inbred stocks to the effects of passive immunization against progesterone in early pregnancy. PMID- 3820183 TI - Changes in gonadotrophin concentrations are not necessarily involved in ovarian compensation after unilateral ovariectomy in sheep. AB - Ewes were unilaterally ovariectomized and/or hypophysectomized and treated with PMSG and hCG. For a given gonadotrophin treatment the ovulation rate per ewe was maintained, i.e. the ovulation rate of the remaining ovary was significantly increased (P less than 0.05), after the removal of one ovary in hypophysectomized and in pituitary-intact ewes. It is concluded that compensation of ovulation rate in the remaining ovary after unilateral ovariectomy in the sheep may be independent of feedback from the ovary and the release of gonadotrophins from the pituitary gland. PMID- 3820184 TI - Ultrastructural analysis of a local regulation of Leydig cells in the adult monkey (Macaca fascicularis) and rat. AB - Peritubular Leydig cells located in interstitial areas surrounded by tubules at nearly the same stage of spermatogenesis were analysed. Low-power electron micrographs were used for measurement of cell profile area and higher magnification views provided volume density of SER, Golgi stacks, mitochondria, and lipids. In the adult monkey, no cyclic changes were found in Leydig cells in their size or in the volume density of their organelles. In the adult rat (63 days of age), a comparison limited to stage VII-VIII and stage XI-XII peritubular Leydig cells demonstrated a significantly higher SER content (P less than 0.01) in the former, but no other differences. The study of subadult rats (45 days of age) showed that the full development of spermatogenesis was required to detect significant changes in Leydig cell SER content. The present results provide morphological evidence for an intratesticular control of the Leydig cells of the rat but not for those of the monkey. PMID- 3820185 TI - Isolation and characterization of cathepsin B from rabbit testis. AB - Cathepsin B (EC 3.4.22.1) has been purified from rabbit testes to apparent homogeneity by chromatography on DE-52, affinity chromatography on organomercurial agarose and subsequent gel filtrations on Sephadex G-75. The enzyme is composed of a single polypeptide of Mr 23,000. Thiol blocking agents and leupeptin abolished the activity of the enzyme completely. The enzyme showed maximum activity at pH 6.0 and 43 degrees C, required 2 mM-cysteine for the optimal activity and had a Km1.45 X 10(-3) M using Z-Arg-beta-naphthylamide as the substrate. However, Z-Arg-Arg-beta-naphthylamide was 12 times more sensitive as a substrate than was Z-Arg-beta-naphthylamide. Rabbit testicular cathepsin B hydrolysed intact proteins. An endogenous inhibitor isolated from the rabbit testes inhibited purified Cathepsin B. PMID- 3820186 TI - Androgen-dependence of ornithine decarboxylase in the rat epididymis. AB - Ornithine decarboxylase (ODC) activity was measured in epididymides of 45-day-old rats. Higher ODC activity was detected in the corpus and cauda than in the caput epididymidis. Bilateral castration for 7 days caused epididymal ODC to fall to undetectable values, whereas testosterone restored activity to normal values. The effect of the androgen was significantly inhibited by cyproterone acetate. The caput was more sensitive to the action of testosterone than were the corpus and caudal segments. Unilateral castration for 4 or 8 days did not affect ODC on the control or castrated side, but the activity fell in epididymides of both sides after removal of the remaining testis. These results show that epididymal ODC activity is androgen-dependent. PMID- 3820187 TI - Developmental changes in the intraplacental distribution of placental lactogen and alkaline phosphatase in the rat. AB - The junctional and labyrinth regions of the rat chorioallantoic placenta during the second half of gestation showed different patterns of development with regard to DNA, protein, placental lactogen and alkaline phosphatase content. DNA and protein measurements indicated that growth of the labyrinth region was more rapid and persisted for longer during gestation than did growth in the junctional zone. At midpregnancy the junctional zone was the main source of placental lactogen whereas by late pregnancy both regions contributed considerable amounts. On Day 20 of gestation the labyrinth region contained significantly more placental lactogen than did the junctional zone. Alkaline phosphatase activity was predominant in the labyrinth zone throughout the second half of gestation. The results indicate that the chorioallantoic placenta is composed of two functionally distinct regions. PMID- 3820188 TI - Inhibitory effects of monoclonal sperm antibodies on the fertilization of mouse oocytes in vitro and in vivo. AB - The inhibitory effects of monoclonal antibodies on the fertilization of mouse oocytes were evaluated in vitro and in vivo. Among the 40 sperm-specific monoclonal antibodies that had been examined, nine showed significant inhibition of the fertilization of mouse oocytes in vitro. MS 204 was shown to cause a high incidence of penetration of the zona pellucida of mouse eggs by multiple sperm, when the sperm concentration for insemination exceeds 1 X 10(5)/ml. This antibody prevented further penetration of the vitelline membrane by sperm. On the other hand, sperm penetration to zona was inhibited in the presence of MS 207. However, neither MS 204 nor MS 207 caused significant inhibition of penetration of zona free mouse or hamster eggs by sperm. MS 204 and MS 207 were also found to inhibit the fertilization of mouse oocytes in vivo and embryo development in vitro, when superovulated mice were injected intraperitoneally with given doses of antibodies prior to the mating. Further in vitro culture of the recovered 2-cell oocytes revealed little or no further embryo development beyond two- to four-cell stages. In the controls, greater than 80% of the retrieved oocytes were fertilized and successively developed to the blastocyst stages in vitro when the ascites fluid from NS-1 cells was administered. Two of the monoclonal antibodies generated against human sperm antigens, HS 11 and HS 63, were shown to cross-react specifically with mouse sperm acrosomal antigens and also inhibited the fertilization of mouse oocytes in vitro and in vivo. The results of this study suggest that some monoclonal antibodies to sperm acrosomal antigens exhibit strongly inhibitory effects on the in vitro and in vivo fertilization of mouse oocytes as well as subsequent development of early embryos. As a comparative control, rabbit antisera against sperm-specific enzymes, lactate dehydrogenase-X and 3-phosphoglycerate kinase-2, showed little or no inhibition on the fertilization of mouse oocytes in vitro or in vivo or the subsequent embryo development. PMID- 3820189 TI - Humoral immune responses in murine pregnancy. V. Relationship to the differential immunogenicity of placental and fetal tissues. AB - The nature of the humoral immune response induced in virgin female mice by injections of F1 placental and fetal tissues has been examined and compared to that induced by immunization with F1 adult spleen cells and by multiple allogeneic pregnancy. In a 'responder' strain mouse, as defined by the ability of multiple allogeneic pregnancy to elicit an anti-paternal humoral immune response, both F1 placental and fetal tissues induced the formation of alloantibodies primarily of the IgG1 sub-class, similar to those induced by allogeneic pregnancy, but different from those elicited by adult spleen cells. However, only the placental tissues induced alloantibodies possessing all the characteristics of those appearing in multiparous allogeneic pregnancy. In contrast, the alloantibodies induced by the injected fetal tissue possessed complement dependent cytotoxic activity, indicating that the inability of pregnancy-induced alloantibodies to mediate cytotoxicity may not be related to their restriction to the IgG1 sub-class. In a 'non-responder' mouse strain, where multiple allogeneic pregnancy does not lead to a maternal alloantibody response, F1 placental tissues, in contrast to fetal and adult tissues, failed to induce a humoral immune response. Injection of F1 placental tissue therefore elicits responses that mimic both the properties and the strain-dependent distribution of the alloantibodies identified in normal murine pregnancy. This implies that the immunogenic stimulus in pregnancy emanates from the placental rather than the fetal compartment of the allogeneic conceptus. PMID- 3820191 TI - Effect of pregnancy on the immune response of cattle to a Brucella vaccine. AB - An experiment was performed to determine whether humoral- or cell-mediated immune responses of cattle to a Brucella abortus vaccine were influenced by the stage of gestation. Heifers were vaccinated 2 mth before and 2 mth after breeding with cell envelopes of B. abortus in an oil adjuvant containing trehalose dimycolate and muramyl dipeptide. Control groups received adjuvant alone or no vaccine. Following breeding, vaccinated animals were divided into pregnant and nonpregnant subgroups. Immune responses to two outer membrane proteins were measured at monthly intervals by ELISA and lymphocyte blastogenesis tests. Skin tests were performed during the ninth month of gestation. Vaccination induced sustained immune responses, but few differences were detected between pregnant and non pregnant animals. The relative increase in IgA antibodies to group 3 protein in nonpregnant heifers exceeded that in pregnant heifers during months 4 and 6 of gestation (P less than 0.05). Dermal hypersensitivity, measured by changes in double skin thickness, was significantly greater in nonpregnant heifers to porin (P less than 0.01) and group 3 (P less than 0.05) antigens at 24 h post injection, but no significant differences in skin thicknesses or in the nature of the lesions were observed at 48 h. Animals which received adjuvant alone demonstrated negligible responses. Pregnancy had no significant effect on the responses of lymphocytes to phytohemagglutinin (PHA) or Concanavalin A (Con A). However, plasmas from nonvaccinated pregnant heifers taken during the sixth and seventh (but not eight or ninth) months of pregnancy decreased responses of normal donor cells to PHA and Con A when compared with those in autologous plasma (P less than 0.05). PMID- 3820190 TI - A search for antibodies in term maternal sera to solubilized syncytiotrophoblast surface components. A passive haemagglutination assay yields negative evidence. AB - Using a passive haemagglutination assay, agglutinins against trophoblast components were detected in term maternal sera at titres above those of non pregnant control sera. These agglutinin titres were independent of the family relationship between individual sera and trophoblast samples. They were unaffected by adsorption with excess packed fetal or paternal red blood cells or paternal lymphocytes. The agglutinins of both normal control and term maternal sera were found to elute in the macroglobulin fraction of serum having a molecular weight of greater than 350 kDa and were shown to be a component of euglobulin precipitates. The titres of the agglutinins were unaffected by adsorption using solid phase antibodies against human IgM and IgG from the sera. It was concluded that these agglutinins were not a maternal antibody response against trophoblast surface components. PMID- 3820192 TI - Immunosuppression, sialic acid, and sialyltransferase of neonatal and maternal bovine serum. AB - Serum samples of 7 cows from -10 to +10 days following parturition and of 7 calves from 0 to 20 days following birth were tested for the ability to inhibit mitogen-stimulated proliferation of lymphocytes, for cortisol and progesterone concentrations, and for sialic acid and sialyltransferase activity. Calf serum inhibited phytohemagglutinin (PHA)-stimulated proliferation of lymphocytes, with maximal inhibition at 12-24 h following birth, whereas no consistent immunosuppressive activity was detected in the maternal serum. Sialic acid was greatly elevated in calf serum (4.8 +/- 0.2 mumol/ml) relative to adult control values (1.3 +/- 0.1) and decreased continuously from day 0 to day 20. Sialic acid of maternal serum was slightly elevated prior to parturition (1.7 +/- 0.1) and increased to peak at 2.5 +/- 0.1 on day 8 following parturition. Sialyltransferase of both maternal and calf serum increased dramatically following parturition to peak at day 2. For calf serum, a moderate correlation was observed between sialic acid and cortisol concentration (r = 0.71) and between sialic acid and suppression of PHA-stimulated proliferation (r = 0.60). The results demonstrate that serum of 12-24 h-old calves is immunosuppressive in vitro, and suggest that changes in sialic metabolism may accompany cortisol related immunosuppression in these animals. PMID- 3820193 TI - Taking mortality in rheumatoid arthritis seriously--predictive markers, socioeconomic status and comorbidity. PMID- 3820194 TI - The redox state in lymphocytes from patients with rheumatoid arthritis. AB - Our study was designed to quantitate levels of NAD+, NADH, NADP(H), and ATP in peripheral blood lymphocytes with and without mitogenic stimulation from patients with rheumatoid arthritis (RA). No differences were found in patients with RA and healthy controls. Our data suggest the ability of the redox system of circulating peripheral lymphocytes to respond to mitogenic stimulation in patients with RA is not markedly impaired. PMID- 3820195 TI - Fetal wastage in patients with rheumatoid arthritis. AB - Ninety-six women with rheumatoid arthritis (RA) were found to have an abortion ratio higher than that of a comparison group (p = 0.005). This was true even before the onset of their RA (p = 0.007). The fertility rate of the patients with RA was not different from the control patients. This suggests the presence of a "rheumatoid diathesis" which long antedates the expression of the disease. PMID- 3820196 TI - Hearing and middle ear function in rheumatoid arthritis. AB - The hearing and middle ear function in 68 patients with rheumatoid arthritis were tested. Reduced middle ear compliance, presumably due to stiffening of the tympanossicular chain, was noted in 48 patients (70.50%). Conductive hearing loss and absence of the stapedius reflex, were recorded in only one patient (1.40%). In 20 patients (29.40%) a moderate (20-30 dB) high frequency sensorineural hearing loss was found. The results of loudness balance and tone decay tests and the speech discrimination scores suggested cochlear pathology in some cases. However the multiplicity of factors that might be involved in sensorineural hearing loss, and the absence of a significant relation between such a loss and the activity of the disease or drugs used in its treatment makes the postulation of a plausible explanation a difficult, still unfinished task. PMID- 3820197 TI - Patterns of in vitro aspirin hydrolysis rates in rheumatoid arthritis and systemic lupus erythematosus. AB - In previous in vitro studies of normal human blood and in vivo canine studies an intracellular erythrocyte (RBC) esterase was identified which controlled the rate of aspirin (ASA) hydrolysis and thus modulated the duration of intact ASA survival and availability for transacetylations required for some therapeutic effects. In whole blood from 30 patients with systemic lupus erythematosus (SLE), 10 normal subjects, and 40 patients with active seropositive rheumatoid arthritis (RA), there were negative correlations between the hematocrit level and the ASA half-life in vitro: r = -0.50, -0.83, and -0.61, respectively. When ASA hydrolysis rates were normalized to approximate whole blood esterase content (k/Hb [min-1 X g-1 X dl] X 10(-4) the mean rate was most rapid in patients with RA (24.2 +/- 2.8) and lowest in patients with SLE (18.6 +/- 3.1), especially in those with recently active disease. To differentiate intracellular and extracellular factors, ASA hydrolysis rates were measured in washed RBC suspensions from similar groups. The mean ASA hydrolysis rate (k/10(6) RBC X 10( 3) was significantly lower in SLE RBC (7.72 +/- 0.81). In RBC from patients with RA the average rate (8.50 +/- 0.85) lay between the SLE group and controls (9.08 +/- 1.04). Thus, an erythrocyte esterase defect in SLE patients resulted in reduced ASA hydrolyzing capacity. In blood from patients with RA a small reduction in esterase activity was compensated by extracellular factors increasing ASA accessibility to the esterase. PMID- 3820198 TI - Occurrence of rheumatoid arthritis in a nationwide series of twins. AB - The nationwide Finnish Twin Cohort was linked with the Sickness Insurance Register on the basis of the unique identification number assigned to each Finnish citizen. The study series consisted of 4137 monozygotic (MZ) and 9162 dizygotic (DZ) same-sexed twin pairs born before 1958 and alive in 1975. Altogether, 261 subjects in the series had the right to receive free medication for rheumatoid arthritis (RA) under the Sickness Insurance Act that covers the entire Finnish population. The pairwise concordance percentage for RA was 12.3 in MZ twins and 3.5 in DZ twins. The age and sex adjusted ratio of observed per expected numbers of concordant pairs (relative risk) was 8.6 for MZ pairs and 3.4 for DZ pairs. These figures are lower than those previously reported on twins but compatible with results from family studies on the genetic component of RA. PMID- 3820199 TI - The age of death of the parents of patients with rheumatoid arthritis: a preliminary study. AB - The hypothesis was tested that the shortened life expectancy of patients with rheumatoid arthritis (RA) is, partially at least, due to a familial factor which independently shortens life expectancy, whether the person has RA or not. We therefore compared the ages of death of the parents of patients with RA with the ages of the death of the parents of a control group. The parents of the patients with RA had a mean age of death of 64.76; 18.23 years versus 68.29; 18.24 years for the parents of the control group (p = 0.006). This finding is compatible with the hypothesis: whether genetic or environmental factors are involved is unknown. PMID- 3820200 TI - Arthroscopic synovectomy: a prospective study. AB - Seven patients undergoing arthroscopic synovectomy for painful knee joint synovitis with marked synovial swelling were assessed preoperatively and up to 24 months postoperatively. Six patients had rheumatoid arthritis and one psoriatic arthritis. Patients were assessed for overall disease activity and indices of synovitis and function of the knees. There was minimal or no loss of function in the operated knee at one month. Subsequent improvement was reflected in reduction of pain on walking, pain on using steps, and swelling of the knee, with improvement occurring up to 6 months and maintained at 24 months. No sustained loss of movement was observed in the operated knee and all patients had improvement in knee flexion at 24 months. Patients universally regarded the procedure as worthwhile. These results highlight the lesser morbidity of arthroscopic synovectomy compared to that known to be associated with open synovectomy. Further study is required to evaluate the longterm value of this procedure. PMID- 3820201 TI - Nailfold capillaroscopy in type I diabetics with vasculopathy and limited joint mobility. AB - The nailfold capillary pattern of 48 Type I diabetic patients with longstanding disease and of 15 normal controls was studied using the technique of widefield nailfold capillaroscopy. Twenty-six diabetic patients had documented vascular disease (retinopathy) and 27 had flexion contractures of the hand. No distinctive morphologic capillary lesions were observed in any diabetic patient, nor were any differences in capillary loop number or density found between the diabetic and control groups. While vascular disease is a prominent feature of diabetes, it is not reflected in the appearance of the nailfold capillary pattern. PMID- 3820202 TI - Polyarticular pigmented villonodular synovitis in children: evidence for a genetic contribution. AB - Pigmented villonodular synovitis rarely occurs in multiple joints, and only once has been noted in siblings. We identified this disorder in 2 generations and found evidence for its presence in a third. It occurred in 2 sibling children at multiple sites. All affected individuals also had a rare autosomal dominant disorder, the multiple lentigines syndrome. Among the developmental abnormalities in this kindred were fibrous dysplasia, hypertelorism, pectus excavatum, high arched palate, and primary lymphedema. The etiology of pigmented villonodular synovitis is uncertain, and suggested causes include trauma, inflammation, neoplasia, and repeated hemorrhage. Our observations suggest genetic factors might also be important in the development of pigmented villonodular synovitis. PMID- 3820203 TI - Chemical classification of hereditary amyloidosis in Brazilian families and identification of gene carriers. AB - Plasma prealbumin was isolated from individuals in 3 kindreds from Brazil with biopsy proven heredofamilial amyloidosis as well as from a number of asymptomatic family members. The prealbumin samples were cleaved with cyanogen bromide and the resulting peptide mixtures separated by reverse phase high performance liquid chromatography. The peptide elution pattern seen for the individuals with confirmed amyloidosis is consistent for the presence of a prealbumin variant with a methionine for valine at position 30 of the molecule. Sequence analysis of the isolated peptides confirms this observation and shows that the 3 Brazilian families investigated in our study have the same prealbumin variant as individuals with amyloidosis of Swedish/American, Portuguese and Japanese origins. PMID- 3820204 TI - Bone mass in ankylosing spondylitis. AB - To assess bone mass in ankylosing spondylitis (AS) we have measured total body calcium, bone mineral content of the lumbar spine and metacarpal indices in groups of patients with AS. Mean total body calcium was reduced by 5.3% (p less than 0.05) in 20 patients compared with controls. The mean annual loss of bone, assessed over an 18 month period in 17 patients, was 2.9% (p less than 0.001). Compared to controls, bone mineral content was increased by 28% (p less than 0.05) in 8 male patients while metacarpal indices were normal in 18 male and female patients. The results of total body calcium measurements give support to the hypothesis of a minor increase in bone turnover in AS. The increased bone mineral content in the male patients may relate to syndesmophyte formation. PMID- 3820205 TI - Severe airway obstruction caused by laryngeal rheumatoid arthritis. AB - Ankylosis of the cricoarytenoid joints due to rheumatoid arthritis (RA) may cause upper airway obstruction by fixation of the vocal cords in the midline. In early stages, this condition usually results in minor symptoms which are easily overlooked. It may, however, very rapidly, e.g., in association with an upper respiratory tract infection, become life-threatening. It is essential to diagnose this condition early to avoid emergency situations. In 5 patients with classic RA and in one patient with juvenile RA severe laryngeal obstruction was operated on using a new simple technique consisting of a mobilization of the arytenoid cartilages and laterofixation of one of the vocal cords. PMID- 3820206 TI - Stridor due to cricoarytenoid arthritis in pauciarticular onset juvenile rheumatoid arthritis. AB - A 2-year-old girl developed severe inspiratory and expiratory stridor 2 months after onset of pauciarticular juvenile rheumatoid arthritis (JRA). Direct laryngoscopy demonstrated that both vocal cords were immobile and approximated to each other in the midline secondary to arthritis of the cricoarytenoid joints. High dose corticosteroid therapy resulted in clinical and laryngoscopic improvement and tracheostomy was avoided. Cricoarytenoid arthritis can be a life threatening complication in JRA. Early institution of corticosteroids appears to be the treatment of choice. PMID- 3820207 TI - Rheumatoid-like arthritis presenting as idiopathic pulmonary hemosiderosis: a report and review of the literature. AB - Idiopathic pulmonary hemosiderosis, an unusual form of the alveolar hemorrhage syndromes, has been reported in association with several connective tissue disorders. Rheumatoid arthritis (RA), however, rarely presents in this manner. We discuss a young adult with recent onset RA following idiopathic pulmonary hemosiderosis, and review the 3 cases previously reported. PMID- 3820208 TI - Childhood eosinophilic fasciitis--progression to linear scleroderma. AB - A 2-year 10-month old girl developed eosinophilic fasciitis that resolved within one year after the administration of prednisone. She was left with changes similar to chronic linear scleroderma. Our case illustrates that eosinophilic fasciitis can occur in very young children and reinforces the hypothesis that it may be an early manifestation of scleroderma. PMID- 3820209 TI - Penicillamine associated pulmonary hemorrhage. AB - Penicillamine is the drug of choice in Wilson's disease and a therapeutic alternative in rheumatoid arthritis. Autoimmune complications associated with penicillamine include cases resembling systemic lupus erythematosus and Goodpasture's syndrome. We report a case of diffuse pulmonary hemorrhage associated with prolonged penicillamine use in a patient with Wilson's disease with evidence of circulating immune complexes and complement activation, but without serologic or morphologic evidence of systemic lupus erythematosus, Goodpasture's syndrome or renal disease. PMID- 3820210 TI - Rheumatoid synovial cyst of the hip: an unusual cause of leg swelling. PMID- 3820211 TI - Rheumatoid iliopsoas bursitis. PMID- 3820212 TI - The prevalence of ankylosing spondylitis in males and females. PMID- 3820213 TI - Experimental evidence for a proinflammatory effect of phospholipase A2 on joint tissues. PMID- 3820214 TI - Delayed appearance of salicylate in cerebrospinal fluid. PMID- 3820215 TI - Esters of N,N-disubstituted 2-hydroxyacetamides as a novel highly biolabile prodrug type for carboxylic acid agents. PMID- 3820216 TI - Quinolonecarboxylic acids. 2. Synthesis and antibacterial evaluation of 7-oxo-2,3 dihydro-7H-pyrido[1,2,3-de][1,4]benzothiazine-6-carboxylic acids. AB - A series of pyridobenzothiazine acid derivatives was synthesized and their in vitro antibacterial activity was evaluated. The 1,4-benzothiazine intermediates, which by Gould-Jacobs quinoline synthesis produced pyridobenzothiazine acids, were prepared by hydrolytic basic cleavage of substituted 2-aminobenzothiazoles and successive cyclocondensation with 1-bromo-2-chloroethane or alternatively with monochloroacetic acid, hence reduction by LiAlH4. The pyridobenzothiazine acids 10c, 30, and 31 show potent antibacterial activities against Gram-positive and Gram-negative pathogens. Structure-activity relationships are discussed. The compound 9-fluoro-10-(4-methyl-1-piperazinyl)-7-oxo-2,3-dihydro-7H-pyrido[1,2,3-d e] [1,4]benzothiazine-6-carboxylic acid (31) (MF-934) has been found to possess, together with the antibacterial activity, a weak acute toxicity and interesting pharmacokinetic characteristics in several animal species (rat, dog, monkey, man). PMID- 3820217 TI - Redox chemistry of the 9-anilinoacridine class of antitumor agents. AB - 9-Anilinoacridines bearing a 1'-NHR substituent on the anilino ring undergo facile, chemically reversible, two-electron oxidation to quinone diimines. The chemical and electrochemical oxidation of three groups of 9-anilinoacridines (1' substituted derivatives, together with 3'-substituted analogues and acridine substituted analogues of the clinical antileukemic drug amsacrine) have been studied and their redox potentials determined. For aniline-substituted derivatives, redox potentials (E1/2) correlate well with substituent electronic properties, with electron-donating substituents facilitating oxidation. Substituents in the acridine ring have little effect on redox potentials, indicating minimal transmission of electronic effects from the acridine to the aniline rings. Although the broad class of 9-anilinoacridines show biological activity over a very wide range of structural variations, a 1'-NHR substituent is a common feature of the most active derivatives. Nevertheless, no clear quantitative relationships between redox potential and biological activity could be discerned, and the relevance of this redox chemistry to the mode of action of amsacrine and other 9-anilinoacridines remains unclear. PMID- 3820218 TI - Nucleic acid related compounds. 51. Synthesis and biological properties of sugar modified analogues of the nucleoside antibiotics tubercidin, toyocamycin, sangivamycin, and formycin. AB - Treatment of 7-amino-3-beta-D-ribofuranosylpyrazolo[4,3-d]pyrimidine (formycin) with alpha-acetoxyisobutyryl bromide followed by deprotection of the resulting trans-vicinal acetoxy bromides and hydrogenolysis of the separated bromohydrins gave 2'-deoxy-(23%) and 3'-deoxyformycin (32%) after complete deprotection and purification of their hydrochloride salts. An analogous sequence gave 3' deoxytoyocamycin and/or 3'-deoxysangivamycin in approximately 80% yields from toyocamycin. Antiviral, antineoplastic, and antimetabolic effects were evaluated for the formycin compounds and 4-amino-7-beta-D-ribofuranosylpyrrolo[2,3 d]pyrimidine (tubercidin), its 5-cyano- (toyocamycin), and 5-carbamoyl (sangivamycin) antibiotic congeners in comparison with their 2'-deoxy, 3'-deoxy, and arabino analogues. In all cases, the modified-sugar compounds were less cytotoxic than the parent antibiotics. The majority also exhibited lower antiviral potency. However, the xylo-tubercidin analogue retained potent antiherpes 1 and 2 activity with decreased cytotoxicity. Labeled metabolite studies suggested that effects of these compounds on RNA and/or protein synthesis might be more significant than interference with DNA synthesis. PMID- 3820219 TI - Multisubstrate inhibitors of dopamine beta-hydroxylase. 2. Structure-activity relationships at the phenethylamine binding site. AB - 1-Aralkylimidazole-2-thiones have been shown to be potent multisubstrate inhibitors of dopamine beta-hydroxylase (DBH; EC 1.14.17.1). In the present study, a series of 1-benzylimidazole-2-thiones was prepared to explore the effects of substitution in the benzyl ring on the inhibition of DBH. A detailed structure-activity relationship for in vitro activity was discovered and this was shown by a modified Hansch analysis to correlate (r = 0.91) with four key structural features of the benzyl ring: the presence of a hydroxyl at the 4 position, molar refractivity at the 3-, 4-, and 5-positions, inductive effects of the substituents at the 3-, 4-, and 5-positions, and pi-electron density. The affinity (Kis) of eight substituted inhibitors for DBH was shown to correlate (r = 0.75) with the affinity (KD) of comparably substituted tyramines for the ternary DBH-oxygen-tyramine complex. This correlate is used to support the hypothesis that binding of inhibitor to DBH occurs in a fashion that mimics the binding of tyramine substrates. The most potent inhibitors were selected for study in vivo in the spontaneously hypertensive rat model of hypertension. The changes in vascular dopamine and norepinephrine levels that resulted from oral administration of the inhibitors corresponded to the observed reduction in mean arterial blood pressure. A divergence between in vitro potency and in vivo efficacy upon oral dosing was noted and is suggested to result from an in vivo metabolic conjugation of the phenolic group of inhibitor. PMID- 3820220 TI - Dopamine autoreceptor agonists: resolution and pharmacological activity of 2,6 diaminotetrahydrobenzothiazole and an aminothiazole analogue of apomorphine. AB - The enantiomers of the aminothiazole analogues of the known dopaminergic agonists apomorphine (1) and 2-aminohydroxytetralin (2) have been prepared. The absolute configurations of the enantiomers of 2,6-diaminotetrahydrobenzothiazole have been established by X-ray crystallographic analysis. Dopamine (DA) autoreceptor agonist activities of the compounds were evaluated. Testing revealed (-)-5, the S enantiomer, to be the most active compound tested (inhibition of GBL accelerated dopamine synthesis and inhibition of alpha-methyltyrosine-induced decline of DA). In addition (-)-5 does not exhibit stereotyped behavior, suggesting a pronounced selectivity for DA autoreceptors. PMID- 3820221 TI - Amnesia-reversal activity of a series of cyclic imides. AB - A series of dihydro-1H-pyrrolizine-3,5(2H,6H)-diones were synthesized and evaluated for their ability to reverse electroconvulsive shock (ECS) induced amnesia in mice. Among the structure-activity relationships explored were the effects of ring size, the presence of heteroatoms (sulfur) in the ring system, and the introduction of alkyl substituents. The optimal ring size for the bicyclic system was 5.5 with dihydro-1H-pyrrolizine-3,5(2H,6H)-dione (3), although some activity was present in the corresponding 5.6 [hexahydro-3,5 indolizinedione (7)] and 6.6 [tetrahydro-2H-quinolizine-4,6(3H,7H)-dione (9)] analogues. Replacement of the C-1 carbon atom in compound 3 with a sulfur [dihydropyrrolo[2,1-b]thiazole-3,5(2H,6H)-dione (10)] abolished activity, and the introduction of methyl groups resulted in poorer biological profiles except when the substitution was made at the 7a position [dihydro-7a-methyl-1H-pyrrolizine 3,5(2H,6H)-dione (4)]. In several instances, hydrolysis of the parent bicyclic compound was carried out to furnish the corresponding lactam acids, which were further derivatized. Several exhibited interesting activity, especially the 5-oxo 2-pyrrolidinepropanoic acid derivatives such as 5-oxo-2-pyrrolidinepropanoic acid (12), 5-oxo-2-pyrrolidinepropanoic acid phenylmethyl ester (17), 5-oxo-2 pyrrolidinepropanoic acid (3-chlorophenyl)methyl ester (20), N-4-pyridyl-5-oxo-2 pyrrolidinepropanoic acid amide (25), and N-(2,6-dimethylphenyl)-5-oxo-2 pyrrolidinepropanoic acid amide (27). Compound 3 (CI-911; rolziracetam) was also observed to improve performance on a delayed-response task in aged rhesus monkeys and was selected for evaluation in cognitively impaired human subjects on the basis of its biological profile and a wide margin of safety in animals. PMID- 3820222 TI - Synthesis and structure-activity relationship of 1-aryl-6,8-difluoroquinolone antibacterial agents. AB - A series of new arylfluoroquinolones has been prepared. These derivatives are characterized by having fluorine atoms at the 6- and 8-positions, substituted amino groups at the 7-position, and substituted phenyl groups at the 1-position. The in vitro antibacterial potency is greatest when the 1-substituent is 2,4 difluorophenyl and the 7-substituent is a 3-amino-1-pyrrolidinyl group. 1-(4 Fluorophenyl)-6,8-difluoro-7-piperazin-1-yl-1,4-dihydro-4-oxo quinoline-3- carboxylic acid (22) was found to possess excellent in vitro potency and in vivo efficacy. PMID- 3820224 TI - 1H NMR study of degradation mechanisms of oxacephem derivatives with various 3' substituents in alkaline solution. AB - The degradation process of oxacephems with various 3'-substituents in alkaline solution was examined by 1H NMR spectroscopy, and the structures of two types of degradation products were determined: the hydrolysis products having the cleaved beta-lactam ring and the remaining 3'-substituents, and the exo-methylene compounds having the cleaved beta-lactam ring and the expelled 3'-substituents. The oxacephems were found to decompose, giving the former compounds that subsequently decomposed to the latter compound. Although the ratios of the formation of the exo-methylene compound 15 relative to the other degradation products depended on the leavability of the 3'-substituents, there was little correlation between the relative yields and the beta-lactam reactivity. Thus, the expulsion of the leaving group at the 3'-position was concluded to be not involved in the nucleophilic attack on the beta-lactam carbonyl. PMID- 3820223 TI - Synthesis, biological evaluation, and quantitative structure-activity relationship analysis of 2-hydroxy-1H-isoindolediones as new cytostatic agents. AB - A series of 16 derivatives of 2-hydroxy-1H-isoindole-1,3-diones was designed and synthesized as potential antitumor agents. The cytostatic activity against L1210 cell growth of these compounds was studied, and their IC50 values were found to be in the range of 10(-4) to 10(-8) M. Quantitative structure-activity relationship analysis of these compounds showed that the inhibitory effect was well correlated with the electronic and the lipophilic parameters. Derivatives having a substituent with strongly electron-donating properties at the 6-position showed enhanced inhibitory activity while compounds having an electron withdrawing group at the same position showed lower activity. PMID- 3820225 TI - Heteroatom-activated beta-lactam antibiotics: considerations of differences in the biological activity of [[3(S)-(acylamino)-2-oxo-1-azetidinyl]oxy]acetic acids (oxamazins) and the corresponding sulfur analogues (thiamazins). AB - The considerable antibacterial activity of [[3(S)-(acylamino)-2-oxo-1 azetidinyl]oxy]acetic acids (oxamazins) in contrast to the lack of activity of the corresponding sulfur analogues (thiamazins) is examined in terms of physicochemical parameters, including electronegativity, IR carbonyl stretching frequencies, base hydrolysis rates, and three-dimensional molecular geometries. An X-ray structure determination of a protected thiamazin together with molecular graphics and molecular orbital calculations on model structures reveals that thiamazins would not fit as well as oxamazins in the active site of target bacterial transpeptidases. As a result of thiamazins' long N-S and S-C bond lengths, the pharmacophoric beta-lactam ring and carboxylate functionality cannot adopt the spatial relationship they have in penicillins and cephalosporins. The beta-lactam nitrogen of the monocyclic, crystalline thiamazin is 0.18 A out of the plane of its three substituents, and this distance (h) is predicted by computational chemistry methods to be higher in oxamazins. The rates of beta lactam ring opening of an oxamazin, thiamazin, and aztreonam are comparable, even though the pyramidal character and IR data both indicate the electronegative oxygen analogue has reduced amide resonance. MNDO, AM1, and MINDO/3 correctly give a twofold potential for rotation about the N-S bond in model sulfenamides, with barrier heights ranging up to 12 kcal/mol. PMID- 3820226 TI - Selective cytotoxicity of a system L specific amino acid nitrogen mustard. AB - The synthesis and characterization of DL-2-amino-7-bis[(2-chloroethyl)amino] 1,2,3,4-tetrahydro-2-naphthoic acid and DL-2-amino-5-bis[(2-chloroethyl)amino] 1,2,3,4-tetrahydro-2-napthoic+ ++ acid were accomplished. The correct assignment of the site of attachment of the bis(2-chloroethyl)amino side chain was ascertained by selective proton decoupling of the 13C NMR spectra performed on the corresponding nitrospirohydantoin precursors 2 and 3, which were obtained from the nitration of beta-tetralone hydantoin. The two target compounds 6 and 7 were designed as tumor-specific agents capable of being selectively transported into tumor cells by the leucine-preferring transport system (system L). Inhibition analysis of the initial rate of transport of the system L specific substrate 2-amino-bicyclo[2.2.1]heptane-2-carboxylic acid (BCH) by 6 and 7 indicated that the 7-substituted isomer 6 was an extremely potent competitive inhibitor of that transport system in murine L1210 leukemic cells (Ki = 0.2 microM). Evaluation of the selectivity of this compound indicated that it possessed enhanced in vitro antitumor activity and reduced myelosuppressive activity when compared to its prototype amino acid nitrogen mustard, L phenylalanine mustard (L-PAM). In addition to being more selectively toxic to tumor cells, this compound differs from L-PAM in having a 2-3-fold shorter half life (t1/2). PMID- 3820227 TI - 2-[(3-Pyridinylmethyl)thio]pyrimidine derivatives: new bronchosecretolytic agents. AB - 2-[(3-Pyridinylmethyl)thio]pyrimidine derivatives (1a-n) promote the excretion of phenol red into the mouse trachea, indicating an increased tracheobronchial secretion. Furthermore, 2-[(3-pyridinylmethyl)thio]pyrimidine (1a) (tasuldine) produces greater excretion of phenol red into the mouse trachea after systemic administration than the known bronchosecretolytic ambroxol. Compound 1a also reduces the viscosity of canine bronchial mucus. Compound 1a has been selected for clinical investigations. PMID- 3820228 TI - Functionalized DL-amino acid derivatives. Potent new agents for the treatment of epilepsy. AB - Structural analogues of the potent known anticonvulsant agent N-acetyl-DL-alanine N-benzylamide (1a) have been prepared (16 examples). The pharmacological activities of these products were evaluated in the maximal electroshock seizure (MES), the subcutaneous pentylenetetrazole seizure threshold (sc Met), and the rotorod (Tox) tests. The median effective doses (ED50) and the median toxic doses (TD50) for the most active compounds by both intraperitoneal and oral administration are reported. The most active compounds were N-acetyl-DL phenylglycine N-benzylamide (1d) and N-acetyl-DL-alanine N-m-fluorobenzylamide (1m) along with the parent compound 1a. The ED50 values in the MES test for these three compounds compared well with phenobarbital, while their high TD50 values contributed to their large protective indexes, which approached that of phenytoin. When tested against four convulsant agents, compounds 1a and 1d displayed activity profiles significantly different from those reported for conventionally used antiepileptic drugs. PMID- 3820229 TI - Hydroxamic acid inhibitors of 5-lipoxygenase. AB - The hydroxamic acid functionality can be incorporated in a variety of simple molecules to produce potent inhibitors of 5-lipoxygenase. As an example of this, the structure-activity relationships in a series of omega-phenylalkyl and omega naphthylalkyl hydroxamic acids are presented. Among the features described are the influence of hydrophobicity, aryl substitution, and modifications of the hydroxamate group on enzyme inhibitory potency. To assist in the selection of more potent hydroxamic acid inhibitors, a simple hypothesis about the nature of enzyme-inhibitor binding was devised. In this hypothesis, the structures of compounds were matched to a proposed geometry of arachidonic acid when bound to the enzyme. Compounds that match best without extending into disfavored regions were predicted to be the best inhibitors. Three series of hydroxamates selected according to this approach are described. Within these series are some of the most potent inhibitors of 5-lipoxygenase reported to date. PMID- 3820230 TI - Synthesis and antitumor activity of N-terminal proline-containing peptide (chloroethyl)nitrosoureas. AB - The N alpha-(2-chloroethyl)-N-nitrosocarbamoyl derivatives of H-Pro-Lys(X)-Pro Val-NH2 (X: tert-butyloxycarbonyl, formyl, (2-chloroethyl)nitrosocarbamoyl) were synthesized. It was found that the bis-substitution of the urea N3 in these derivatives does not decrease the antitumor activity influenced mainly by the nature of the carrier molecule as a whole. PMID- 3820231 TI - Antitumor agents. 86. Synthesis and cytotoxicity of alpha-methylene-gamma-lactone bearing purines. AB - alpha-Methylene-gamma-lactones covalently linked to adenine, hypoxanthine, and guanine were synthesized by using the convenient Reformatsky-type reaction between ethyl alpha-(bromomethyl)acrylate and the proper purine ketones. In vitro cytotoxicity data demonstrated that these compounds were active against L-1210 tissue culture cells with 3 being most potent (ED50 = 0.3 microgram/mL). PMID- 3820232 TI - Pigmentation associated with oogenesis in the biting fly Culicoides variipennis (Diptera: Ceratopogonidae): light and electron microscopy. PMID- 3820233 TI - Amblyomma calcaratum (Acari: Ixodidae), a Central and South American tick, found in Kentucky, USA. PMID- 3820234 TI - Effect of age of Boophilus microplus larvae (Acari: Ixodidae) on attachment to cattle. PMID- 3820235 TI - Redescription of Demodex nanus (Acari: Demodicidae) from Rattus norvegicus and R. rattus (Rodentia). PMID- 3820236 TI - Detoxification esterases new to California, USA, in organophosphate-resistant Culex quinquefasciatus (Diptera: Culicidae). PMID- 3820237 TI - Host-feeding patterns of the mosquito community (Diptera: Culicidae) in two Faiyum Governorate villages, Egypt. PMID- 3820238 TI - Host-feeding patterns of the mosquito community (Diptera: Culicidae) in Aswan Governorate, Egypt. PMID- 3820239 TI - Feeding of Cheyletus malaccensis (Acari: Cheyletidae) on human body fluids. PMID- 3820240 TI - Electrophoretic comparisons of isozymes from selected populations of Stomoxys calcitrans (Diptera: Muscidae). PMID- 3820241 TI - Effect of Plasmodium gallinaceum infection on the mortality and body weight of Aedes aegypti (Diptera: Culicidae). PMID- 3820242 TI - Competitive parasitism of house fly pupae (Diptera: Muscidae) by Muscidifurax zaraptor and Urolepis rufipes (Hymenoptera: Pteromalidae). PMID- 3820243 TI - Temperature and humidity effects on the life cycle of Haemaphysalis spinulosa and Rhipicephalus simus (Acari: Ixodidae). PMID- 3820244 TI - Amblyomma variegatum (Acari: Ixodidae): population dynamics and hosts used during an eradication program in Puerto Rico. PMID- 3820245 TI - Leishmaniasis in the Jordan Valley. IV. Attraction of Phlebotomus papatasi (Diptera: Psychodidae) to plants in the field. PMID- 3820246 TI - Carotid body tumor. Report of six cases and review of the literature. PMID- 3820247 TI - Non-Hodgkin's lymphomas. Management strategy and future research. PMID- 3820248 TI - [Role of sympathectomy in the treatment of causalgias]. PMID- 3820249 TI - [Central diabetes insipidus: diagnosis and treatment. Apropos of the experience of the Endocrinology Service of the Hotel-Dieu from 1976 to 1985]. PMID- 3820250 TI - [Repetitive fetal malformations]. PMID- 3820251 TI - [Sudden death during Holter monitoring]. PMID- 3820252 TI - Children intestinal intussusception. PMID- 3820253 TI - Predictive validity of the MCAT as a function of undergraduate institution. AB - The question of whether the predictive ability of the Medical College Admission Test (MCAT) differed for students from different undergraduate institutions was addressed by the authors in the study reported here. Two groups of students were studied: group 1 comprised 1,859 students who entered Jefferson Medical College of Thomas Jefferson University between 1964 and 1977, and group 2 consisted of 999 students who entered the college between 1978 and 1982. Ten undergraduate institutions with at least 20 matriculants in each group were selected for analysis. Group 1 students had taken the old version and group 2 the new version of the MCAT. Scores on the Science subtest of the old MCAT were used as the predictor for group 1, and scores on the Science Problems subtest of the new MCAT were used as the predictor for group 2. First-year and second-year medical school grade-point averages and total scores on the Part I and Part II examinations of the National Board of Medical Examiners were the performance measures used. Validity coefficients were derived of the predictive value of the MCAT scores at each of the 10 undergraduate institutions. Striking differences were found in validity coefficients among these institutions. These differences raise questions about the predictive validity of the MCAT when scores for different undergraduate institutions are combined in deriving the coefficients. Possible explanations, implications for admissions decisions and validity studies, and limitations of these findings are discussed. PMID- 3820254 TI - Performance of residents who had academic difficulties in medical school. AB - An assessment of how well graduates of one medical school performed in residency training was undertaken to assess the school's monitoring of students' performances. The minutes of the school's student progress committee for four years were reviewed to identify all students who had had academic difficulty. Seven students had been recommended for dismissal but ultimately graduated, 22 students were on academic probation for longer than one year, and 22 students were on academic probation for less than one year. The residency performance of 43 of these 51 students were compared with the performances of a randomly selected group of students who had had no academic difficulties and had graduated during the same period. Of 12 performance and knowledge items assessed by the residency directors for the studied graduates, the one dealing with quality of interaction with patients showed significant differences among the residents. The residents who had had academic difficulty had lower ratings on this item than the residents who had not had academic trouble. On all other items, those residents who had had academic difficulties received generally lower scores than the other residents, but the differences were not statistically significant. Of the seven students considered for dismissal, one had been dismissed and one had withdrawn from the residencies; the other five generally received positive ratings from their residency directors. The findings suggest that the medical school's overall monitoring of students' performance was working and confirmed the authors' opinion that each decision concerning a student with academic difficulties should be based on the student's individual situation. PMID- 3820255 TI - An inner-city clinic and house call experience for medical students. PMID- 3820256 TI - A comparison of subjective and objective measures of performance in a psychiatry clerkship. PMID- 3820257 TI - Teaching about the doctor-patient relationship in the first postgraduate year. PMID- 3820259 TI - Study of physician referral rates: more numerators in search of denominators. PMID- 3820258 TI - Use of computer simulations to teach history-taking to first-year medical students. PMID- 3820260 TI - Research and clinical care. PMID- 3820261 TI - Perspective on teaching. PMID- 3820262 TI - Association of American Medical Colleges. Annual Meeting and Annual Report, 1986. PMID- 3820263 TI - A microcomputer-based data acquisition system for a prosthetic heart valve test apparatus. AB - The hydrodynamic testing of prosthetic heart valves in the laboratory under pulsatile flow conditions remains the only way of obtaining detailed information about valve function. Test procedures have become increasingly sophisticated, with a variety of different test conditions and detailed analysis of the pressure and flow signals. A computerized data acquisition system has been developed for use with the Glasgow pulsatile flow test apparatus. The computer collects seven signals from the test rig over a period of 20 s, and calculates the average waveform for each signal. Standard parameters, such as mean pressure differences, mean flows, regurgitant volumes and energy losses, are calculated automatically. The complexity of the analysis and the need for standardized documentation makes computerization essential. The system has been used extensively for function tests on over 160 prosthetic heart valves. PMID- 3820264 TI - Cardiac gating in nuclear magnetic resonance imaging. AB - In order to obtain NMR images of the heart, and to measure blood flow by NMR, the signal acquisition must be synchronized with the patient's cardiac cycle. Some of the problems of detecting the cardiac cycle within a strong uniform magnetic field without introducing RF interference into the imaging system are discussed. Some general applications of cardiac gated NMR imaging are presented. PMID- 3820265 TI - A plethysmograph for the measurement of digital blood flow. AB - Venous occlusion plethysmography using a water-filled plethysmograph is an accurate and reliable method for the measurement of limb flow which has been used for many years. The technique has been adapted to produce a plethysmograph for the measurement of digital blood flow. The device is small, light, cheap, simple to use, and can be calibrated directly with the digit 'in situ'. It is especially suitable for the assessment of digital blood flow, since flow through a large portion of the whole digit is measured and the local temperature of the digit is accurately controlled. PMID- 3820266 TI - Computer control of a Braun Infusomat pump. AB - Machine code programs have been produced to allow a simple method of communication between a computer and the Braun Infusomat pump. Commands are set up as character strings using a high-level language and passed to a machine code program which transmits them to the pump. Messages from the pump are received under interrupt control for display by the high-level language. Any error in communication is stored in memory and the appropriate action taken by the main application program. PMID- 3820267 TI - Opsonic monoclonal antibodies against lipopolysaccharide antigens of Leptospira interrogans serovar hardjo. AB - Six monoclonal antibodies produced from mice immunised with Leptospira interrogans serovar hardjo were directed against determinants in the leptospiral lipopolysaccharide, as indicated by immunodiffusion and enzyme immunoassay (EIA), and opsonised leptospires for phagocytosis by mouse macrophages. Their specificities were studied by agglutination and EIA. Five antibodies reacted with some, but not all, members of the Sejroe and Hebdomadis serogroups, and one antibody agglutinated exclusively members of the Sejroe group thus indentifying a serogroup-specific epitope. None of the six antibodies reacted with representative serovars of any other serogroup. PMID- 3820268 TI - Instability in the faecal flora of a patient suffering from food-related irritable bowel syndrome. AB - The faecal microbial flora of a patient with severe irritable bowel syndrome related to multiple food intolerances was very variable and contained a high proportion of facultative bacteria and an unusual incidence of Clostridium species. PMID- 3820269 TI - The typing of Morganella morgani by bacteriocin production and sensitivity. AB - A typing scheme for Morganella morgani based on bacteriocin (morganocin) production and sensitivity is described. These characteristics were determined by testing 160 strains in all combinations and permitted their differentiation into 90 types. Morganocin production was induced with mitomycin C and morganocin sensitivity determined with a diluted inoculum on Lab-lemco agar at 30 degrees C. Most strains (82.5%) produced morganocins and 49 different types were defined. Most strains (97.5%) were sensitive to morganocins and usually to several different types. The scheme is more discriminating than other reported methods. The finding in an epidemiological survey of the carriage of certain strains in the bowel for several weeks suggests that in practice the method is stable and reproducible. PMID- 3820270 TI - Staphylococcal whole-cell polypeptide analysis: evaluation as a taxonomic and typing tool. AB - Whole-cell-polypeptide profiles obtained by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) were used in conjunction with the API-Staph technique to identify different strains of Staphylococcus aureus, S. epidermidis, S. saprophyticus and S. capitis. Complete concordance of results from both techniques was achieved with all strains examined. Visual analysis of the polypeptide patterns and comparison by use of the coefficient of Dice showed minor differences in band pattern between strains of the same species but each species produced a pattern distinguishable from that of any other. The results suggest that although SDS-PAGE can be used to identify staphylococcal species, this type of analysis will not readily provide the basis for a typing method. PMID- 3820271 TI - The effect of crude extracts of nine African chewing sticks on oral anaerobes. AB - Chewing sticks are widely used in Nigeria for dental and oral hygiene. In-vitro susceptibility tests were done with crude extracts from nine popular sticks on four species of Bacteroides. Serindeia warneckei chewing stick had the greatest and most consistent inhibitory effect on the four species; extracts from bark and pulp were bactericidal at concentrations of less than or equal to 1%. Extracts of other sticks, when inhibitory, were only so at higher concentrations--in the range 2-30%. All the black-pigmented oral anaerobes were very susceptible to eight of the nine chewing-stick extracts but non-pigmented anaerobes showed variable susceptibilities. PMID- 3820272 TI - Bacteraemia and seeding of capsulate Bacteroides spp. and anaerobic cocci. AB - The effect of capsulation on the ability of Bacteroides fragilis, B. asaccharolyticus and anaerobic gram-positive cocci to induce bacteraemia and seeding to various organs was investigated. The test species were injected into mice subcutaneously alone, or mixed with other aerobic or facultative organisms. Capsulate anaerobes were isolated more frequently from the blood, spleen, liver, and kidneys of infected animals than were non-capsulate organisms. After injection of single anaerobic strains, capsulate organisms were recovered from 163 (39%) of 420 animals; non-capsulate anaerobes were recovered from only 14 (3%) of 420 animals. After injection of B. fragilis mixed with aerobic or facultative organisms, the capsulate B. fragilis strain was isolated more often and for longer periods than the non-capsulate strain. Capsulate B. fragilis was also recovered more often 5 days after injection with other organisms, than when injected alone. These data demonstrate that capsulate Bacteroides spp. and anaerobic gram-positive cocci are more virulent than non-capsulate strains in single and mixed infections. PMID- 3820273 TI - Adherence of Fusobacterium necrophorum to bovine ruminal cells. AB - The adherence of Fusobacterium necrophorum to the surface of bovine ruminal epithelial cells was paralleled by the organism's haemagglutinating ability. Treatment of the bacterial cells with haemagglutinin antiserum caused a reduction in the degree of attachment. The purified haemagglutinin became bound to the membranes of ruminal epithelial cells but lost its adherence when pre-incubated with haemagglutinin antiserum. These findings suggest that the adherence of F. necrophorum to the membrane of the ruminal cells is mediated by haemagglutinin. PMID- 3820274 TI - The prolonged persistence of mycoplasmas in culture. AB - Mycoplasma fermentans organisms in medium containing 20% horse serum multiplied to 10(7)-10(10) ccu/ml within 5 days at 37 degrees C and were dead usually after 9 days. There was no growth in medium without serum, nor in such medium with the addition of cholesterol or palmitic acid or both, but in some experiments addition of bovine plasma albumin (BPA) increased the number of organisms by up to 1000-fold and some remained viable for up to 84 days. BPA and cholesterol or BPA, palmitic acid and cholesterol more often enhanced growth, in terms of the maximum number of organisms and their survival, than did the addition of BPA alone. The maximum number of organisms in such supplemented serum-free media was usually at least ten-fold less than in medium with horse serum, but some organisms remained viable for up to 131 days. Survival of Ureaplasma urealyticum was also longer in the supplemented serum-free medium than in standard horse serum medium. The possible factors affecting persistence of mycoplasmas in culture are discussed in relation to these observations. PMID- 3820276 TI - Computer modeling of the reaction between antigen and heterogeneous antibody in fixed antigen excess: a new method for measuring antibody affinity. AB - Antigen-antibody binding experiments were performed by choosing antigen excess starting conditions and then diluting both the 125I-BSA antigen and anti-BSA proportionately so that the ratio between the reactants remained constant. The fraction antigen bound was measured at each dilution. Binding data were analyzed by computer using non-linear least squares regression to determine the affinity and affinity distribution of different antisera. Early anti-BSA was found to have a unimodal distribution with a binding constant in the range of 10(6)M-1. Intermediate anti-BSA had a bimodal distribution: 1/3 high affinity (1.0 X 10(9] and 2/3 low affinity (3.4 X 10(6)M-1). Late and hyperimmune rabbit BSA antibodies had unimodal affinity distributions with binding constants varying between 1.7 and 2.9 X 10(10)M-1. Antibody affinity can be readily determined by computer analysis of binding curves obtained in constant antigen excess conditions. PMID- 3820275 TI - Preparation and immunogenicity of a bivalent cell-surface protein-polysaccharide conjugate of Vibrio cholerae. AB - Alkali-treated lipopolysaccharides (LPS) from Ogawa and Inaba serotypes of Vibrio cholerae were chemically coupled to cell-surface proteins of V. cholerae. The reaction product was eluted in the void volume when fractionated on a column of Sephacryl S-300. The material did not enter the gel when subjected to polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate (SDS-PAGE). The bivalent protein-polysaccharide conjugate was nonpyrogenic, as determined by the Limulus lysate assay. It was immunogenic and elicited, in rabbits, antibodies against both intact LPS and cell surface proteins, as determined by enzyme linked immunosorbent assay. LPS from Ogawa serotype was resolved into two major bands by SDS-PAGE and that from the Inaba serotype into one major band. Immunoblotting studies indicated that antisera to the protein polysaccharide conjugate contained antibodies to the major LPS fractions from both serotypes. Antisera to the protein-polysaccharide conjugate tested by crossed-immunoelectrophoresis produced immunoprecipitation with whole-cell sonicates of both biotypes and serotypes of V. cholerae. Such antisera also possessed agglutinating and complement-mediated bactericidal activities towards V. cholerae strains of both biotypes and serotypes. These results suggest that a bivalent cell-surface protein-polysaccharide conjugate of V. cholerae could be developed as a nonpyrogenic vaccine against cholera. PMID- 3820277 TI - Response of bacterial antigen in palmoplantar pustulosis. AB - Motilities of leukocytes in response to bacterial antigens or sera were examined in tissues from patients with palmoplantar pustulosis (PPP). Accelerated migration towards bacterial antigens was detected in the case of Staphylococcus epidermidis in 9 of 19 patients, to Propionibacterium acnes in 5 of 19, to Proteus mirabilis and Staphylococcus aureus in 3 of 19, while no acceleration was found in neutrophils from the controls. A significantly accelerated migration of normal lymphocytes in response to both patients' and control sera was nil. Inhibition of migration of guinea pig peritoneal exudate cells mixed with lymphocytes from PPP patients was detected in 12 out of 14 patients with the addition of S. epidermidis antigen and 8 of 14 with the addition of P. acnes antigen, while no such inhibition was detected in all 7 controls. The accelerated migration of neutrophils and inhibition of macrophages may participate in the development of PPP. PMID- 3820279 TI - Flux ratio of valinomycin-mediated K+ fluxes across the human red cell membrane in the presence of the protonophore CCCP. AB - The ratio of valinomycin-mediated unidirectional K+ fluxes across the human red cell membrane, has been determined in the presence of the protonophore carbonylcyanide m-chlorophenylhydrazone, CCCP, using the K+ net efflux and 42K influx. The driving force for the net efflux (Vm - EK+) has been calculated from the membrane potential, estimated by the CCCP-mediated proton distribution and the Nernst potential for potassium ions across the membrane. An apparent driving potential for the K+ net efflux has been calculated from the K+ flux ratio, determined in experiments where the valinomycin and CCCP concentrations were varied systematically. This apparent driving force, in conjunction with the actual driving force calculated on basis of the CCCP estimated membrane potential, is used to calculate a flux ratio exponent, which represents an estimate of the deviation of valinomycin-mediated K+ transport from unrestricted electrodiffusion, when protonophore is present. In the present work, the flux ratio exponent is found to be 0.90 when the CCCP concentration is 5.0 microM and above, while the exponent decreases to about 0.50 when no CCCP is present. The influence of CCCP upon the rate constants in the valinomycin transport cycle is discussed. The significance of this result is that red cell membrane potentials are overestimated, when calculated from valinomycin-mediated potassium isotope fluxes, using a constant field equation. PMID- 3820278 TI - Current-voltage relations of sodium-coupled sugar transport across the apical membrane of Necturus small intestine. AB - The current-voltage (I-V) relations of the rheogenic Na-sugar cotransport mechanism at the apical membrane of Necturus small intestine were determined from the relations between the electrical potential difference across the apical membrane, psi mc, and that across the entire epithelium, psi ms, when the latter was varied over the range +/- 200 mV, under steady conditions in the presence of galactose and after the current across the apical membrane carried by the cotransporter, ImSNa, is blocked by the addition of phloridzin to the mucosal solution. ImSNa was found to be strongly dependent upon psi mc over the range -50 mV less than psi mc less than EmSNa where EmSNa is the "zero current" or "reversal" potential. Over the range of values of psi mc encountered under physiological conditions the cotransporter may be modeled as a conductance in series with an electromotive force so that ImSNa = gmSNa (EmSNa - psi mc) where gmSNa is the contribution of this mechanism to the conductance of the apical membrane and is "near constant." In several instances ImSNa "saturated" at large hyperpolarizing or depolarizing values of psi mc. The values of EmSNa determined in the presence of 1, 5, and 15 mM galactose strongly suggest that if the Na galactose cotransporters are kinetically homogeneous, the stoichiometry of this coupled process is unity. Finally, the shapes of the observed I-V relations are consistent with the predictions of a simple kinetic model which conforms with current notions regarding the mechanico-kinetic properties of this cotransport process. PMID- 3820280 TI - Transcytosis in cultured proximal tubular cells. AB - Studies were designed to examine fluid-phase pinocytosis in proximal tubular cells. Canine proximal tubules were obtained from the band IV of Percoll gradient centrifugation of the dispersed renal cortex, and were seeded on collagen-coated polycarbonate membranes. Integrity of monolayers was confirmed by electrophysiologic measurements, and by scanning electron microscopy. At confluence cell monolayers were studied in Ussing chambers. The rate of transfer of a marker of fluid-phase pinocytosis, Lucifer Yellow CH, from the luminal to the basolateral bath was three times higher than that occurring in the opposite direction. Fluorescence microscopy demonstrated that Lucifer Yellow was trapped exclusively in the vesicular compartment. Electron microscopy of the monolayers incubated with cationized ferritin added to the luminal or to the basolateral both revealed that endocytic vesicles were formed only at the luminal surface. Luminal-to-basolateral transfer of Lucifer Yellow was almost completely blocked at 0 degrees C, and was significantly diminished by K+ depletion. Transcytosis of Lucifer Yellow was stimulated twofold by 1-oleoyl-2-acetyl-glycerol. Transfer of quin-2 acetoxymethylester across the monolayer was used as a marker of the paracellular pathway, demonstrating the lack of directional selectivity of this transport route. In summary, vectorial fluid-phase pinocytosis in proximal tubular cells represents an additional mechanism contributing to fluid transport in this segment of the nephron. PMID- 3820281 TI - Quantitative microlocalization of diffusible ions in normal and galactose cataractous rat lens by secondary ion mass spectrometry. AB - Secondary ion mass spectrometry (SIMS) is a surface analytical technique with high sensitivity for elemental detection and microlocalization capabilities within the micrometre range. Quantitative analysis of epoxy resins and gelatin have been reported (Burns-Bellhorn & File, 1979). We report here the first application of this technique to quantitative microlocalization in the context of a physiological problem--analyses of sodium, potassium and calcium in normal and galactose-induced cataract in rat lens. It is known that during the development of galactose-induced cataract the whole lens content of potassium is decreased, sodium is increased and, in late stages, calcium concentration increases. Whether these alterations in diffusible ions occur homogeneously or heterogeneously is not known. Standard curves were generated from epoxy resins containing known concentrations of sodium, potassium or calcium organometallic compounds using the Cameca IMS 300 Secondary Ion Mass Spectrometer. Normal and cataractous lenses were prepared by freezing in isopentane in a liquid nitrogen bath followed by freeze-drying at -30 degrees C. After dry embedding in epoxy resin, 10 microns thick sections of lens were pressure mounted on silicon wafers, overcoated with gold, and ion emission measured under the same instrumental conditions used to obtain the standard curves. Quantitative analysis of an area 27 microns in diameter, or a total analysed volume of 1.1 microns3, was performed by using a mechanical aperture in the ion optical system. Ion images provided qualitative microanalysis with a lateral resolution of 1 micron. Control rat lenses gave values for sodium and potassium content with a precision of +/- 17% or less. These values were compared to flame photometry and atomic absorption measurements of normal lenses and were accurate within 25%. Analysis of serum and blood also gave accurate and precise measurements of these elements. Normal rat lenses had a gradient of sodium, and, to a lesser degree, of potassium from the cortex to the nucleus. Development of galactose-induced cataract was heterogeneous by morphological criteria, beginning at the lens equator and spreading from the cortex into the nucleus. However, the loss of potassium and increase in sodium concentration occurred at early stages in both the cortex and nucleus cells, possibly because these cells are interconnected by gap junctions. There is a local alteration in elemental content prior to morphologically demonstrable cataract formation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3820282 TI - Elemental concentrations in isolated rat thymocytes prepared for cryofixation in the presence of different media. AB - Rat thymocytes were isolated in suspension and the effect of preparing the cells for cryofixation in the presence of different media on the elemental content was investigated using the technique of X-ray microanalysis. Cells prepared in the different media showed variation in the concentrations of Na, K and Cl. The isolated cells were incubated at 310 K for 1 h to allow recovery from isolation. There was a decrease in Na and Cl content after incubation. The thymocyte population was disturbed by suspension in medium containing dextran, and this resulted in a number of cells with high concentrations of Na and low concentrations of K. These cells did not take up vital dye. Thymocytes were also prepared for freezing by using high-speed centrifugation to concentrate the cells. Thymocytes prepared by this method showed values for concentrations of Na, K and Cl similar to published values for these cells using other methods of estimation. There were, however, consistent differences in Na content between the cells prepared in Hanks' balanced salt solution and those prepared in serum. Factors which affect the apparent concentration of Na and Cl in isolated cells are discussed. PMID- 3820283 TI - Selective contrast-enhancement of the cochlear duct glycocalyx after OsO4/K4Ru(CN)6 post-fixation. AB - Fixation-dependent selective contrast-enhancement of the cochlear duct (or endolymphatic) glycocalyx was observed in the guinea pig inner ear after post fixation with osmium tetroxide-potassium rutheniumcyanide. Contrast of the perilymphatic glycocalyx, however, was not significantly enhanced. The possible factors underlying this phenomenon are discussed. PMID- 3820284 TI - Beam induced mass loss in high resolution biological microanalysis. AB - Electron beam induced loss of mass from the organic matrix and from higher Z constituents of biological samples was measured by monitoring bremsstrahlung and peak changes in EDS spectra. When any effects of contamination, extraneous X rays, beam current drift, specimen drift, and specimen shrinkage were monitored and corrected for, the three types of samples gave consistent and similar results at 296 K. Bremsstrahlung losses averaged 45%, 46% and 50% respectively for muscle homogenate, salivary gland sections and albumin. Sulphur losses average 74%, 72% and 86% for the same three sample types. No other elements suffered significant losses. D1/e for bremsstrahlung averaged 0.14 C/cm2. Bremsstrahlung loss at 93 K began approximately one order of magnitude higher in dose, and the extent of loss varied. Sulphur losses, however, were greatly reduced at low temperatures. PMID- 3820285 TI - SEM low magnification stereoscopic technique for mapping surface contours: application to measurement of volume differences in human teeth due to polishing. AB - SEM stereogrammetry with a low magnification mosaic of pictures is used to measure the elevation of many individual points. This random array of elevations is then connected into a triangular mesh, from which a contour map of elevation is drawn for the entire surface. Maps of surfaces before and after removal of material are used to determine the volume removed. The method is applicable to many circumstances of wear, erosion or deformation of surfaces. It is applied here to the erosion of human teeth due to dental polishing. PMID- 3820286 TI - A simple photographic grid system for the correlative examination of cell smears by light and scanning electron microscopy. PMID- 3820287 TI - New approaches for continent ostomy construction. PMID- 3820288 TI - Obstetrical manpower in Mississippi: who will deliver the babies? PMID- 3820289 TI - Hospital credentialing. PMID- 3820290 TI - At least two nodD genes are necessary for efficient nodulation of alfalfa by Rhizobium meliloti. AB - A Rhizobium meliloti DNA region (nodD1) involved in the regulation of other early nodulation genes has been delimited by directed Tn5 mutagenesis and its nucleotide sequence has been determined. The sequence data indicate a large open reading frame with opposite polarity to nodA, -B and -C, coding for a protein of 308 (or 311) amino acid residues. Tn5 insertion within the gene caused a delay in nodulation of Medicago sativa from four to seven days. Hybridization of nodD1 to total DNA of Rhizobium meliloti revealed two additional nodD sequences (nodD2 and nodD3) and both were localized on the megaplasmid pRme41b in the vicinity of the other nod genes. Genetic and DNA hybridization data, combined with nucleotide sequencing showed that nodD2 is a functional gene, while requirement of nodD3 for efficient nodulation of M. sativa could not be detected under our experimental conditions. The nodD2 gene product consists of 310 amino acid residues and shares 86.4% homology with the nodD1 protein. Single nodD2 mutants had the same nodulation phenotype as the nodD1 mutants, while a double nodD1-nodD2 mutant exhibited a more severe delay in nodulation. These results indicate that at least two functional copies of the regulatory gene nodD are necessary for the optimal expression of nodulation genes in R. meliloti. PMID- 3820291 TI - Sequence, evolution and differential expression of the two genes encoding variant small subunits of ribulose bisphosphate carboxylase/oxygenase in Chlamydomonas reinhardtii. AB - We have sequenced the two genes for the small subunit of ribulose bisphosphate carboxylase/oxygenase (Rubisco) in Chlamydomonas reinhardtii and analyzed their expression. The two genes encode variant small subunits that differ by four amino acid residues. Both genes are expressed and each is transcribed into an RNA of distinct size. The accumulation of the two RNAs changes depending on the growth conditions, so the small subunit composition of Rubisco may be expected to differ in response to the environment. The C. reinhardtii small subunit sequence is homologous to those of vascular plants or cyanobacteria, but is longer at the amino terminus and in internal positions. The number and location of the intervening sequences in the genes from C. reinhardtii and from other plants differ. In several cases, internal length differences in the polypeptide coincide with the positions of introns in the coding sequence. Thus, changes in the exon structure of the genes during evolution may have been accompanied by substantial changes in the encoded protein. The translation and splicing signals in C. reinhardtii are similar to those of other eukaryotes, but the transcription signals are less conserved and the highly biased codon usage is very unusual. PMID- 3820292 TI - Differential localization of membrane receptor chemotaxis proteins in the Caulobacter predivisional cell. AB - The methyl-accepting chemotaxis proteins (MCPs) are membrane receptors that initiate signal transduction to the flagellar rotor upon ligand binding. The synthesis of these proteins occurs only in the Caulobacter crescentus predivisional cell coincident with the biosynthesis of the polar flagellum. Both the flagellum and the MCPs are partitioned to only one daughter cell, the swarmer cell, upon division. We report the results of experiments designed to determine the distribution of these MCPs within swarmer cells and predivisional cells. Flagellated and non-flagellated vesicles were prepared from these cells by immunoaffinity chromatography and the level of MCPs that had been labeled either in vivo or in vitro with methyl-3H was determined. Small membrane vesicles from swarmer cells contained [methyl-3H]MCPs both in the flagellated and non flagellated vesicles, which indicates that the region immediately surrounding the flagellum, as well as the rest of the surface of the swarmer cell, contains [methyl-3H]MCP. Thus, the MCPs are not specifically localized to the immediate vicinity of the flagellar rotor. The distribution of MCPs was examined in flagellated and non-flagellated vesicles isolated from predivisional cells. The analysis of small predivisional vesicles showed that the MCP content is higher in the flagellated vesicles, and analysis of large flagellated vesicles showed that the MCPs are positioned preferentially in the swarmer cell portion of the predivisional cell. This positional bias of MCPs within predivisional cells could reflect either a large compartment or membrane domain within the incipient swarmer cell, or a gradient of MCPs, with the highest concentration in the vicinity of the flagellum. PMID- 3820293 TI - Role of the N-terminal part of the coat protein in the assembly of cowpea chlorotic mottle virus. A 500 MHz proton nuclear magnetic resonance study and structural calculations. AB - The interaction of the oligonucleotides (Ap)8A and (A-T)5 with empty capsids of the coat protein of cowpea chlorotic mottle virus (CCMV) has been studied with 500 MHz 1H nuclear magnetic resonance. It is found that these oligonucleotides specifically bind to the arginine and lysine residues of the N-terminal arm of the protein. Upon this binding, immobilization of part of the N-terminal arm occurs. In addition, secondary structure predictions and energy calculations have been performed on the N-terminal arm. These calculations were carried out as a function of the charges on the arginine and lysine side-chains. For free coat protein, where the arginine and lysine side-chains are charged, the arm is found in a random-coil conformation. In the neutralized state, as for the coat protein in the virus, the arm adopts an alpha-helical conformation. The results support a previously published model for the assembly of CCMV, in which a random-coil to alpha-helix conformational transition, induced by neutralizing the arginine and lysine side-chains, plays an essential role. PMID- 3820294 TI - Computer modeling of actinomycin D interactions with double-helical DNA. AB - We have performed molecular mechanical calculations on intercalation complexes of actinomycin D with a series of base-paired hexanucleoside pentaphosphates; d(GCGCGC)2, d(GCCGGC)2, d(GCATGC)2, d(GCTAGC)2 and d(ATGCAT)2. Our results are in good agreement with previous experimental work on sequence selectivity. The results provide a rationalization for the strong preference of actinomycin D to intercalate on the 3' side of guanine residues, consistent with previously proposed models. Finally, the computed structures for d(ATGCAT)2-actinomycin D complexes have been compared with two-dimensional nuclear magnetic resonance nuclear Overhauser effect experimental results. To our knowledge, this is the first extensive comparison of molecular mechanical model structures for a drug DNA complex with experimental solution phase data. We find generally good agreement between our computational models and the experimental solution phase structures. PMID- 3820295 TI - N-hydroxyaminofluorene: a chemical probe for DNA conformation. AB - The importance of the polymorphism of DNA in the reaction with the chemical carcinogen N-hydroxyaminofluorene is studied by means of a supercoiled plasmid containing an insert of (dC-dG). Immunochemical titration and the determination of the binding spectrum of -aminofluorene adducts show that the carcinogen reacts with B-DNA but not with Z-DNA and that conformational changes of the B-DNA-Z-DNA junctions occur as a function of the superhelical density. PMID- 3820296 TI - Preliminary crystallographic study of a ribulose-1,5-bisphosphate carboxylase oxygenase from Chromatium vinosum. AB - Crystals of a ribulose-1,5-bisphosphate carboxylase-oxygenase from Chromatium vinosum were obtained with the hanging-drop vapor diffusion technique, using polyethylene glycol 4000 as precipitant. The crystal belongs to the cubic system, space group I432, with unit cell dimension a = 245.9 A. An asymmetric unit includes one-quarter (L2S2, L: large subunit, S: small subunit) of a hexadecameric molecule (L8S8, 544,000 Mr), which is located on the crystallographic point symmetry 222 or 4. The crystal diffracts to at least 3.0 A resolution. PMID- 3820297 TI - ATP binding and crossbridge structure in muscle. AB - Thick filaments extracted from insect flight muscle were used in examining whether the dependence of actin-myosin crossbridge structure on nucleotide, generally presumed to underlie the power-stroke, is exhibited by myosin alone. The strongly periodic crossbridge arrangement seen in the presence of ATP (corresponding to relaxed muscle) is reversibly lost in conditions that induce rigor in intact muscle fibres. These observations suggest that the power-stroke may involve changes in the steric relation of the myosin head to the thick as well as to the thin filament. PMID- 3820298 TI - Localization of the binding site for protein S4 on 16 S ribosomal RNA by chemical and enzymatic probing and primer extension. AB - We have examined the effect of binding ribosomal protein S4 to 16 S rRNA on the susceptibility of the RNA to a variety of chemical and enzymatic probes. We have used dimethyl sulfate to probe unpaired adenines (at N-1) and cytosines (at N-3), kethoxal to probe unpaired guanines (at N-1 and N-2) and cobra venom (V1) ribonuclease as a probe of base-paired regions of 16 S rRNA. Sites of attack by the probes were identified by primer extension using synthetic oligodeoxynucleotides. Comparison of probing results for naked and S4-bound rRNA shows: Protein S4 protects a relatively compact region of the 5' domain of 16 S rRNA from chemical and enzymatic attack. This region is bounded by nucleotides 27 to 47 and 394 to 556, and has a secondary structure characterized by the junction of five helical elements. Phylogenetically conserved irregular features (bulged nucleotides, internal loops and flanking unpaired nucleotides) and helical phosphodiester bonds of four of the helices are specifically protected in the S4 RNA complex. We conclude that this is the major, and possibly sole region of contact between 16 S rRNA and S4. Many of the S4-dependent changes mimic those observed on assembly of 16 S rRNA into 30 S ribosomal subunits. Binding of S4 causes enhanced chemical reactivity coupled with protection from V1 nuclease outside the S4 junction region in the 530, 720 and 1140 loops. We interpret these results as indicative of loss of structure, and suggest that S4 binding causes disruption of adventitious pairing in these regions, possibly by stabilizing the geometry of the RNA such that these interactions are prevented from forming. PMID- 3820299 TI - Tropomyosin crystal structure and muscle regulation. AB - The crystal structure of tropomyosin filaments has been solved to 15 A resolution by refinement of models against the diffraction data and heavy atom labeling of cysteine residues. These results confirm and extend earlier findings. The improved maps reveal the pitch of the coiled coil, the location of the cysteine residues, and the location and features of the overlapping molecular ends in the filaments. A correlation can now be made between regions of the amino acid sequence and key features of the molecule, such as contact sites in the lattice and departures from regularity along the coiled coil. The crystal shows remarkable dynamic features and the relative flexibility of different parts of the molecule as well as its anisotropic character have been determined. The structure and motions of tropomyosin in the crystal provide information on the structure of tropomyosin in muscle and its possible role in regulation. An atomic model of the molecule has been constructed, based on the low resolution X-ray results, together with the stereochemistry of alpha-helical coiled coils. In contrast to previous views, the molecule appears to display but one set of seven alpha-sites that permit weak linkages of the flexible tropomyosin filament to the actin helix. Correspondingly, we picture that in the "off" state of ATPase activity, the alpha-sites are not occupied; in the "on" state, they are only partly occupied; and in the "potentiated" state, they are more completely saturated. Control of contraction is therefore seen as a statistical mechanism requiring at least three distinct average conformations for the tropomyosin molecule on the actin helix. PMID- 3820300 TI - Construction of an atomic model for tropomyosin and implications for interactions with actin. PMID- 3820301 TI - X-ray structure and refinement of carbon-monoxy (Fe II)-myoglobin at 1.5 A resolution. AB - The structure of carbon-monoxy (Fe II) myoglobin at 260 K has been solved at a resolution of 1.5 A by X-ray diffraction and a model refined against the X-ray data by restrained least-squares. The CO ligand is disordered and distorted from the linear conformation seen in model compounds. At least two conformations, with Fe--C--O angles of 140 degrees and 120 degrees, are required to model the system. The heme pocket is significantly larger than in deoxy-myoglobin because the distal residues have relaxed around the ligand; the largest displacement occurs for the distal histidine side-chain, which moves more than 1.4 A on ligand binding. The side-chain of Arg45 (CD3) is disordered and apparently exists in two equally populated conformations. One of these does not block the motion of the distal histidine out of the binding pocket, suggesting a mechanism for ligand entry. The heme group is planar (root-mean-square deviation from planarity is 0.08 A) with no doming of the pyrrole groups. The Fe--N epsilon 2 (His93) bond length is 2.2 A and the Fe--C bond length in the CO complex is 1.9 A. The iron is the least-squares plane of the heme, and this leads to the proximal histidine moving by 0.4 A relative to its position in deoxy-myoglobin. This shift correlates with a global structural change, with the proximal part of the molecule translated towards the heme plane. PMID- 3820302 TI - Denaturation of a halophilic enzyme monitored by small-angle neutron scattering. AB - Malate dehydrogenase from Halobacterium maris mortui exists in 4 M-NaCl as a stable protein dimer, with which are associated unusually large amounts of salt and water. In 1 M-NaCl at 25 degrees C, it denatures with a time-constant of about 0.5 h-1. Small-angle neutron scattering data from the protein under these conditions were monitored regularly over more than 12 hours during denaturation. They are quantitatively consistent with a model in which the protein dimer loses its exceptional salt and water-binding properties, and dissociates into monomers that partially unfold and have the interactions with solvent expected from their relatively charged amino acid composition. The exceptional salt and water-binding by the native enzyme, therefore, is associated with the native structure of the dimer. PMID- 3820303 TI - Characterization of single crystals of the large ribosomal particles from a mutant of Bacillus stearothermophilus. AB - Single, three-dimensional crystals of 50 S ribosomal subunits, from a mutant of Bacillus stearothermophilus that lacks the protein L11, have been characterized using a synchrotron X-ray source. The crystals of the mutated particles grow under the same conditions and are isomorphous to those of the wild type of the same bacteria. They are orthorhombic, contain at least one 2-fold screw axis, and have unit cell dimensions of a = 350(+/- 10) A, b = 670(+/- 10) A, and c = 910(+/ 10) A. They diffract to 15 to 18 A resolution at 4 degrees C and are stable in the synchrotron beam for several hours. PMID- 3820304 TI - Linking-number changes in the DNA substrate during Cre-mediated loxP site specific recombination. AB - We have examined the linking-number changes that occur during phage P1 Cre mediated recombination in vitro between two loxP sites. Such recombination reactions can be divided into three types: intramolecular inversion, in which recombination occurs between two loxP sites in opposite orientations on the same DNA substrate; intramolecular excision, where recombination occurs between two loxP sites that are in the same orientation on the DNA substrate; and intermolecular recombination, which occurs between two loxP sites on separate DNA molecules. Our results indicate that inversion changes the linking number of the substrate DNA by two topological turns. With a negatively supercoiled substrate, the product is changed by +2 turns. A relaxed substrate yields products that have been changed by either +2 or -2 turns. For intermolecular reactions, the sum of the linking numbers of each of the two starting circles is equal to the linking number of the dimer circle generated by recombination, and no change occurs in linking number. For intramolecular excision reactions, the data are most consistent, with no change in linking number during recombination. These results are discussed in terms of models for alignment and synapsis of the recombining sites and the mechanism of strand exchange. PMID- 3820305 TI - Lambda repressor inactivation: properties of purified ind- proteins in the autodigestion and RecA-mediated cleavage reactions. AB - Under physiological conditions, lambda repressor can be inactivated in vivo or in vitro by RecA-mediated cleavage of the polypeptide chain. The repressor protein is thought to cleave itself, with RecA acting to stimulate autodigestion. ind- repressor mutants are resistant to RecA-mediated inactivation in vivo. In this paper, we report the purification of 15 ind- repressor proteins and the behaviors of these proteins in the RecA-mediated and autodigestion cleavage reactions. None of these proteins undergoes substantial RecA-dependent cleavage. However, eight mutant proteins autodigest at the same rate as wild-type repressor, six mutants do not autodigest or autodigest slower, and one mutant autodigests faster than wild-type. We discuss these results with respect to repressor structure and RecA binding, and suggest possible roles for the RecA protein in the cleavage reaction. PMID- 3820306 TI - A cell-cycle-dependent DNA polymerase activity that replicates intact DNA in chromatin. AB - An insoluble DNA polymerase activity that replicates the intact chromatin template at 85% of the rate found in vivo has been partially characterized. HeLa cells, encapsulated in agarose microbeads, are lysed using an isotonic salt concentration: the resulting encapsulated nuclei contain polymerase associated with a nucleoskeleton and the unbroken template. This preparation can be manipulated freely without aggregation or breaking the DNA and yet is accessible to enzymes and other probes. The major activity, which is sensitive to aphidicolin, is found only in S-phase nuclei and replicates DNA semi conservatively, forming intermediates that are ligated efficiently into larger products. PMID- 3820307 TI - Different populations of DNA polymerase alpha in HeLa cells. AB - Three different populations of HeLa DNA polymerase alpha have been distinguished using a novel preparation of chromatin isolated using an isotonic salt concentration, which contains intact DNA. One synthesizes DNA in vitro at 85% of the rate in vivo, is found only in S-phase nuclei tightly associated with the nucleoskeleton and requires unbroken DNA in the form of chromatin as a template: we assume this is the authentic S-phase activity. On incubation at 37 degrees C, this activity dissociates from the nucleoskeleton to give a soluble activity that prefers broken templates. This soluble activity is in turn heterogeneous, containing active complexes of about 0 X 75 X 10(6) and 3 X 10(6) Mr. The third activity is also soluble and released by lysing cells at any stage of the cell cycle. It, too, prefers broken templates. The authentic activity is obscured by the soluble ones if broken templates are provided. PMID- 3820309 TI - The biology and evolution of lungfishes. Based on proceedings of a symposium. Denver, Colorado, December 27, 1984. PMID- 3820308 TI - Interhead fluorescence energy transfer between probes attached to translationally equivalent sites on the regulatory light chains of scallop myosin. AB - Interhead fluorescence energy transfer studies between probes located at translationally equivalent sites on the two heads of scallop myosin indicates that the distance between such sites is no less than 50 A. Regulatory light chains, possessing either one (Mercenaria, chicken gizzard) or two (Loligo, rabbit skeletal) sulfhydryl groups, were modified either with 1,5-IAEDANS (N' iodoacetyl-N'-(1-sulfo-5-n-naphthyl)ethylenediamine), as energy transfer donor, or with IAF (5-(iodoacetamido)fluorescein) or DABMI (4 dimethylaminophenylazophenyl-4'-maleimide), as energy transfer acceptor. The sulfhydryl groups on these light chains are located at different positions within the regulatory light-chain primary sequence; this enables one to probe a variety of locations, with respect to regulatory light-chain topology, on each myosin head. These independently modified regulatory light chains were added back to desensitized scallop myosin under a variety of conditions, including biphasic re addition, the aim being to maximize the number of interhead energy transfer couples present. The efficiency of energy transfer was determined on the same samples by both steady-state and time-decay techniques. Results obtained by these two techniques were in good agreement with each other and indicated that the efficiency of energy transfer did not exceed 20% in any of the hybrids studied. Transfer efficiencies were invariant, irrespective of the presence or absence of MgATP, calcium or actin, either separately or in combination. Results using heavy meromyosin at low ionic strength were identical. It is shown that these results, in conjunction with the results of recent crosslinking studies performed on comparable myosin hybrids, may place certain restrictions on the configurations of the two heads of myosin. PMID- 3820310 TI - Distribution and innervation of short, interdigitated muscle fibers in parallel fibered muscles of the cat hindlimb. AB - The cat hindlimb contains several long, biarticular strap muscles composed of parallel muscle fascicles that attach to short tendons. Three of these muscles- sartorius, tenuissimus, and semitendinosus--were studied by dissecting individual gold-stained fibers and determining the surface distribution of acetylcholinesterase-stained end-plate zones. In each muscle, fascicles were composed of muscle fibers that ran only part of the fascicle length and tapered to end as fine strands that interdigitated with other tapering fibers within the muscle mass. Most muscle fibers measured 2-3 cm in length. Fascicles of muscle fibers were crossed by short transverse bands of endplates (1 mm wide by 1-5 mm long) that were spaced at fairly regular intervals from the origin to the insertion of the muscle. The endplate pattern suggested that the fiber fascicles were organized into multiple longitudinal strips. In the sartorius, the temporospatial distribution of electromyographic (EMG) activity evoked by stimulating fine, longitudinal branches of the parent nerve confirmed that each strip was selectively innervated by a small subset of the motor axons. These axons appeared to distribute their endings throughout the entire length of the fascicles, providing for synchronous activation of their in-series fibers. PMID- 3820311 TI - Optimal design of vertebrate and insect sarcomeres. AB - This paper offers a model for the normalized length-tension relation of a muscle fiber based upon sarcomere design. Comparison with measurements published by Gordon et al. ('66) shows an accurate fit as long as the inhomogeneity of sarcomere length in a single muscle fiber is taken into account. Sequential change of filament length and the length of the cross-bridge-free zone leads the model to suggest that most vertebrate sarcomeres tested match the condition of optimal construction for the output of mechanical energy over a full sarcomere contraction movement. Joint optimization of all three morphometric parameters suggests that a slightly better (0.3%) design is theoretically possible. However, this theoretical sarcomere, optimally designed for the conversion of energy, has a low normalized contraction velocity; it provides a poorer match to the combined functional demands of high energy output and high contraction velocity than the real sarcomeres of vertebrates. The sarcomeres in fish myotomes appear to be built suboptimally for isometric contraction, but built optimally for that shortening velocity generating maximum power. During swimming, these muscles do indeed contract concentrically only. The sarcomeres of insect asynchronous flight muscles contract only slightly. They are not built optimally for maximum output of energy across the full range of contraction encountered in vertebrate sarcomeres, but are built almost optimally for the contraction range that they do in fact employ. PMID- 3820312 TI - Lymph heart musculature in birds. AB - Development and innervation of the lymph heart musculature of chicken, emu, rhea, and duck was studied by electron microscopy at post-hatch ages from 3 days to adulthood. Development of innervation was monitored by acetylcholinesterase staining. Horseradish peroxidase was used to determine the extent of the transverse tubule network. Chickens were unusual among these birds in that lymph heart myocytes had already undergone a definitive differentiation and degeneration by 3 days. In ducks and ratite birds, lymph heart myocytes more slowly but progressively differentiate a cytomorphology that does not conform in all characteristics to cardiac or skeletal muscle and even resembles in some aspects, smooth muscle. Myofibrils become the dominant cytoplasmic structure, transverse tubules form "internal couplings" with agranular reticulum cisternae, and "external couplings" are formed between myocytes at myomyal junctions. The myomyal junctions also contain AChE-positive reaction product and some subplasmalemmal vesicles that lack a dense core. The lymph heart myocardium of ducks of 2 weeks demonstrated mitotic figures. In adult ducks the myosatellite cell numbers diminish and a characteristic pattern of myocyte degeneration appears. In juvenile ducks and ratites some myocytes differentiate to conductile cells, much as the conductile myocytes and myofibers of the blood heart. The lymph heart innervation is described, and the role of nerve in differentiation and maintenance of myocyte morphology in the lymph heart is discussed. PMID- 3820313 TI - Anatomy of the heart of the beluga whale (Delphinapterus leucas). AB - The heart of the beluga whale (Delphinapterus leucas) is described from the dissection of seven specimens. As in most whales the heart is characterized by a transverse broadness and a flatness of the ventricles from one surface to the other and by an apex formed by both ventricles. Heart size parameters are used for comparison with parameters of other marine and land mammals. The heart width index (heart height/heart circumference) averages 31.3 in comparison to 28.7 for the Weddell seal and 39.0 for the felids. The right ventricle is relatively long and narrow with a mean length index (TS/heart height) of 64.7 and a mean breadth index (TP/heart height) of 38.7. These heart parameters are discussed in functional terms. PMID- 3820314 TI - Ultrastructure of DNA-synthesizing and mitotically dividing myocytes in sinoatrial node of mouse embryonal heart. AB - Unlike the cells of the working myocardium (WM), myocytes from the sinoatrial node (SAN) of the hearts of 16- to 18-day-old mouse embryos are small and 'pale'. They contain few poorly organized myofibrils and no specific granules. The frequency of myocytes labeled with 3H-thymidine or dividing mitotically is 3-4 times lower in the SAN compared to the WM. The ultrastructure of myofibrils and other cytoplasmic organelles in DNA-synthesizing myocytes of the SAN remains practically the same as in most of its muscle cells not labeled with 3H thymidine. However in prometaphase Z-discs disappear and myofibrils break into free myofilament bundles. Intercalated discs and desmosomes persist in all mitotic phases. As a result of cytotomy, two daughter myocytes appear, while occasional acytokinetic mitoses give rise to binucleated cells of the SAN. PMID- 3820315 TI - The effect of prolonged rest on calcium exchange and contractions in rat and guinea-pig ventricular myocardium. AB - The exchange of calcium in isolated, perfused rat ventricular myocardium was measured by means of 45Ca2+ and compared with that in guinea-pig. In the rat the total exchangeable calcium pool containing 0.84 +/- 0.03 mmol/kg of wet weight (w.w.) consists of at least two fractions: excitation-dependent, beat-to-beat exchanging fraction of about 0.1 mmol/kg w.w. which is lost at rest and re-gained during post-rest contractions; a fraction containing 0.74 +/- 0.04 mmol/kg w.w. of Ca2+ exchanging both at rest and during stimulation. During prolonged rest the rat ventricular myocardium loses only 13% (0.1 mmol/kg w.w.) of its exchangeable calcium whereas in the ventricle of guinea-pig heart 72% (0.94 mmol/kg w.w.) Ca2+ is lost at rest. These differences conform to the differences in the response of the contractile force to prolonged rest: the first post-rest contraction of the rat ventricle is stronger than the steady-state beats whereas the guinea-pig ventricular muscle loses its contractility. These results are compatible with the hypothesis that the calcium fraction released from resting guinea-pig ventricle is an important component of the mechanism of the slow force-frequency relationship. PMID- 3820316 TI - The effect of phenothiazines upon maintenance of membrane integrity in the cultured myocardial cell. AB - The cultured myocardial cell provides a defined model for examining factors which are responsible for maintaining cellular viability and sarcolemmal integrity. Our data indicates that the spontaneous loss of myocyte membrane integrity is a calcium-dependent process and thus provides a method for examining the mechanism through which calcium exerts this effect. Antimyosin antibody staining and propidium iodide uptake were used to quantitate membrane integrity. The integrity of the cell membrane was inversely related to the calcium concentration in the culture medium. This loss of membrane integrity was calmodulin-dependent as demonstrated by the following: phenothiazines (trifluoperazine greater than chlorpromazine greater than promethazine) and structurally dissimilar calmodulin inhibitors prevented the formation of sarcolemmal defects at concentrations similar to those known to inhibit calmodulin; phenothiazines and calcium demonstrated a competitive interaction with respect to this effect on membrane integrity. Electron microscopy confirmed the integrity of the sarcolemma of the cells exposed to high phenothiazine concentrations although metabolic alterations occurred in these cells as evidenced by an increased membrane permeability to the low molecular weight probe propidium iodide, degenerative changes in the fine structure of the mitochondria, the accumulation of autophagic vacuoles in the cytoplasm and the loss of contractile ability. These findings indicate that calmodulin inhibitory compounds are capable of preserving the membrane integrity of cardiac myocytes, interfering with a calcium-dependent process that is associated with the spontaneous attrition of these cells in culture. Significant intracellular alterations appear at high doses of these agents even while the sarcolemma is free of gross defects. PMID- 3820317 TI - Effects of diltiazem on reperfusion-induced arrhythmias in vitro and in vivo. AB - The effects of the calcium antagonist, diltiazem, on myocardial injury during ischemia and reperfusion were studied both in vitro, in the isolated rat heart, and in vivo, in a closed-chest pig model. In the isolated rat heart, administration of diltiazem before or at the onset of ischemia resulted in a dose dependent reduction of the incidence and duration of ventricular fibrillation. This reduction was associated with a dose-dependent reduction in overflow of ATP catabolites (adenosine, inosine, hypoxanthine and xanthine). Both changes were significant at concentrations of 3 X 10(-7) M diltiazem and higher. When 3 X 10( 7) M diltiazem was administered upon reperfusion no effect on the incidence of ventricular fibrillation and on ischemia induced total purine overflow was observed. However, the duration of ventricular fibrillation and purine overflow at 5 min after reperfusion were significantly reduced. In the pig experiments all untreated animals (n = 8) showed accelerated idioventricular rhythm (AIVR) upon reperfusion which lasted for 22 +/- 5 min after which sinus rhythm returned. Only two out of five treated animals (450 micrograms/kg/2 h) had an AIVR. Upon reperfusion both groups showed a substantial rise in noradrenaline concentration in the coronary sinus blood, but after 5 min this was significantly less in the treated group. Creatine kinase-kinetics were not altered by diltiazem, but the maximum creatine kinase level was significantly reduced. Within 4 days after the acute experiment 50% of the untreated animals died suddenly, whereas no sudden deaths occurred in the diltiazem group (P less than 0.05). Seven days after the acute experiment, sustained ventricular tachycardia could be induced with programmed electrical stimulation in three out of four surviving untreated pigs. In none of the diltiazem treated pigs was ventricular tachycardia inducible. The results of this study show that the calcium antagonist diltiazem can beneficially influence the events during ischemia and during reperfusion, both in vitro and in vivo; this benefit is associated with a reduction of ATP catabolism, creatine kinase release and noradrenaline overflow. Furthermore, diltiazem reduces electrical instability in the chronic phase of myocardial infarction. PMID- 3820319 TI - DNA damage during aging of mouse myocardium. AB - It is not known if DNA lesions, such as covalently modified nucleotides, change qualitatively or quantitatively during aging of post-mitotic cells. If genetic damage accumulates faster than cellular systems can repair it, a cell will eventually become defective in maintaining homeostatis. This situation would be particularly serious for cells that do not divide after they have differentiated to their terminal forms, for example, heart muscle cells. To examine this possibility a 32P-postlabeling technique was used to measure the relative level of modified nucleotides in mouse myocardial DNA as a function of age. The postlabeling analysis indicated that a modified nucleotide changed in an age dependent manner. A nucleotide with similar chromatographic properties was induced by N-methyl-N-nitrosourea (MNU) alkylation of synthetic polydeoxynucleotides containing the base guanine but not by alkylation of synthetic DNAs lacking this base. This modified nucleotide was found to increase about 9-fold in heart DNA between 2 months and 39 months. These results suggest that the steady-state level of this type of genomic damage is greatly elevated in senescent mouse heart tissue. PMID- 3820318 TI - The role of temperature on the development of oscillatory afterpotentials and triggered activity. AB - Increasing evidence suggests that calcium dependent oscillatory afterpotentials (OAP) may play a pivotal role in the genesis of reperfusion-induced arrhythmias. Many factors may influence the vulnerability of the heart to reperfusion arrhythmias, some of which may possibly affect the development of OAP. Since intramyocardial temperature changes during ischemia and reperfusion, it may be speculated that the rapid rewarming of the ischemic area during reperfusion favors the development of associated arrhythmias. We thought it important to examine the effects of sudden changes in temperature on OAP and subsequent triggered activity. Evidence is presented that raising the bath temperature from 34 degrees C to 37 degrees C causes a transient increase above the control level of the OAP amplitude, and that if the OAP is large enough to reach the threshold a triggered rhythm ensues. These results suggest that sudden rewarming of calcium overloaded cell (as it happens during reperfusion of the ischemic myocardium) may favor the development of abnormal automaticity due to OAP. PMID- 3820320 TI - Sexual dysfunction within an adult developmental perspective. AB - The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient. PMID- 3820321 TI - Ego-dystonic homosexuality. AB - The patient coming in with a dysphoria over his or her homosexual feelings, fantasies or behavior must be given the choice of working through the homophobia or the heterophobia. With the first choice, treatment is directed toward decreasing shame over the homosexual orientation and integrating the patient's social role and personal identity. If a move toward greater heterosexuality is chosen, techniques range from psychoanalysis to time-limited psychodynamic psychotherapy to behavioral techniques. Behavioral techniques may involve in vitro or in vivo desensitization. Issues in selecting the appropriate form of therapy are sometimes subtle and complex, and ethical issues frequently beset the therapist. The patient must be kept fully informed of his or her options, and the choice and the goals of therapy must be arrived at by both patient and therapist. PMID- 3820322 TI - Sexual dysfunction and disorder patterns of husbands of working and nonworking women. AB - The sexual dysfunction and disorder patterns of 218 husbands of working and nonworking women were compared in a retrospective analysis of couples presenting for sexual and marital therapy at Masters & Johnson Institute. Results indicated that men who were married to women who were pursuing careers or to women who were employed in jobs presented only between one half and two-thirds as often with primary complaints of inhibited sexual excitement and inhibited sexual desire as husbands of unemployed women. The results are compared to findings for women in dual-earner and single-earner relationships. The findings are interpreted in terms of psychological and interpersonal stressors characterizing single-earner, conventional marital arrangements as compared with those typifying dual-earner partnerships. PMID- 3820323 TI - Treating the new American couple. AB - This paper reviews the changing models of structure and function of the American family, emphasizing that the family is evolving and developing to meet changing conditions, rather than dying. We focus on new trends in the family system, life cycle, and tasks. A common sequence of treatment for a sexual and/or marital problem is sex therapy, followed by marital therapy, followed by individual therapy for one or both partners. Upon resolution of these, the couple may be seen in marital therapy again. PMID- 3820324 TI - Sexuality of widows: a study of the sexual practices of widows during the first fourteen months of bereavement. AB - The sexual adjustment of 31 Caucasian women, ages 30-62, widowed less than 14 months was assessed using a structural interview. The relationship between the frequencies of autostimulation, coitus, sexual desire and other selected variables was analyzed. Results showed that the sexual identity and experience of each individual widow; circumstances surrounding the death of the husband, particularly whether the death was sudden or delayed; the widow's age; overall sexual satisfaction and intimacy within the marriage, as opposed to ambivalence toward the relationship; and the degree and kind of attachment to the deceased spouse; seem to be significantly associated with the sexual desires and activities of widows during the first 14 months of bereavement. PMID- 3820325 TI - A cognitive-behavioral approach to understanding and treating sexual trauma. AB - This paper presents a cognitive-behavioral model for conceptualizing and intervening in the area of sexual trauma. A central theme is understanding and modifying the process of victimization. The survivor of sexual trauma can regain a positive sexual self-esteem and view sexuality as a planful, choiceful activity which can enhance her life. PMID- 3820326 TI - The challenge of providing health care for the poor: public hospital perspective. PMID- 3820327 TI - Exploring the frontiers of magnetic resonance imaging. AB - New developments in magnetic resonance imaging are highlighted, including multiecho-multislice high-resolution imaging, special purpose coils, multiplanar imaging, thin slices, hybrid imaging processing, flow imaging, heart gating, paramagnetic contrast material, and wider application of spectroscopy. PMID- 3820328 TI - Facts about black-on-black murder. PMID- 3820329 TI - Issues and attitudes concerning combat-experienced black Vietnam veterans. AB - The therapist, whether black, white, or a member of any other ethnic group, must improve his or her objectivity and empathic accessibility by becoming knowledgeable about a minority subculture. The goal is to assist the black veteran to come to some resolution with an imperfect society and to become a legitimate, productive, contributing citizen, who happens to live in a hostile environment. PMID- 3820330 TI - Cerebrovascular disease in blacks. AB - Stroke in black Americans is an important health problem that has been understudied. A brief review of the pertinent literature and strategies for evaluating and managing patients with cerebrovascular disease are presented. PMID- 3820331 TI - Minor physical anomalies and learning disability: what is the prenatal component? AB - The authors performed a case-control study of 60 school children who were examined for a constellation of anomalies suggestive of fetal alcohol exposure. Nonretarded learning disabled children were 7.25 times (95%, confidence interval, 1.05 to 50.0) more likely than controls to have signs consistent with alcohol exposure in fetal life. These data suggest an expanded spectrum of fetal alcohol effects. Early recognition of minor physical anomalies could result in prompt evaluation and treatment of these children. PMID- 3820332 TI - Inflammatory pseudotumors of the lung: importance of recognition and differentiation from neoplastic and granulomatous processes. AB - Two cases of inflammatory pseudotumors of the lung are reported and the literature is reviewed. The lesions are commonly discovered incidently in asymptomatic young persons and are characterized by a solitary, homogeneous, well circumscribed mass composed of the major kinds of inflammatory elements in various proportions. The lesion should be differentiated from true neoplasms and common granulomas. Resection of the lesion results in permanent cure. PMID- 3820333 TI - Skin cancer in black Americans: a review of 126 cases. AB - Primary cancer of the skin is rare in blacks. The records of 126 black patients with skin cancer were reviewed. Histopathologic findings included squamous cell carcinomas (43) basal cell carcinomas (39) malignant melanomas (8) dermatofibrosarcomas (16) Bowen's disease (6) mycosis fungoides (14) and sebaceous cell carcinoma (1).There is a higher percentage of skin cancer involving covered areas in blacks than among whites. Squamous cell carcinoma was the most common skin cancer in blacks. The distribution of basal cell carcinoma in blacks was 30 percent in this series, as compared with 80 percent in whites in the 1977 to 1978 survey. The majority of patients with squamous cell carcinoma had associated predisposing conditions and lesions on non-sun-exposed skin. Sunlight and occupational chemical exposure did not appear to be associated with skin cancer in blacks in this series. PMID- 3820334 TI - Hemoglobin and MCV values in 4,074 healthy black children and adolescents. AB - Hemoglobin and mean corpuscular volume values appear to be lower among black than among white children. Blood hemoglobin concentration and red cell mean corpuscular volume were measured in 4,074 black boys and girls aged 1 through 20 years who lived near sea level. This is the largest hematologic survey of healthy American black children and adolescents to date. Children with sickle cell disease and elevated hemoglobin F were excluded from the study, but children with the traits for hemoglobin S, hemoglobin C, thalassemia, and iron deficiency were not. The 3rd and 97th percentile values reported here are close to the 95 percent confidence limits, and are adjusted for age and sex. PMID- 3820335 TI - Burkitt's lymphoma with ileocecal and subdiaphragmatic masses. AB - Approximately 25 new cases of American Burkitt's lymphoma (ABL) are diagnosed and reported yearly. Black patients presenting with ABL occur in less than 5 percent of the reported cases. A 47-year-old black man with ABL and ileocecal masses typical of the disease is presented. Symptoms, physical findings, and radiologic features of the disease are assessed. The combined modality of aggressive surgical extirpation and chemotherapy may improve remission and survival time by reduction of tumor burden. PMID- 3820336 TI - Psychosocial variables associated with the exceptional survival of patients with advanced malignant disease. AB - This study identified psychosocial variables associated with the exceptional survival of nine cancer patients diagnosed as terminal. During open-ended interviews, subjects described their behaviors and emotions following the onset of disease and articulated personal explanations for their survival. Despite the methodological limitations inherent in this type of research, the similarity of the subjects' responses was compelling.All subjects believed that there was a direct relationship between the outcomes experienced and their psychological states. They remained confident that they would not die, and asserted that these positive expectations were critical to the healing process. The report by subjects that they experienced major psychosocial changes in the months following their prognoses presents a serious challenge to the conclusions of a related study.The subjects assumed responsibility for all aspects of their lives, including recovery. Thus, medical personnel were often used as consultants. All patients established a physician relationship characterized as trusting, meaningful, and healing. They indicated an intense desire to stay alive. Unlike their attitudes before illness, once the patients were confronted with the prospect of death, life suddenly became very precious. PMID- 3820337 TI - Effects of pentachlorophenol on the in vitro and in vivo antibody response. AB - The effects of pentachlorophenol (PCP) on selected parameters reflecting immunocompetence of female B6C3F1 mice were measured following subchronic exposure (14 d) and direct exposure in culture. Daily exposure was by gastric intubation of 10, 30, or 100 mg/kg of technical-grade PCP (PCP-T), or 100 mg/kg of EC-7, a PCP preparation purified to reduce contamination (PCP-P), or 100 mg/kg of the vehicle, corn oil. There were no effects on the antibody responses of spleen-cell suspensions from either PCP-T- or PCP-P-treated mice stimulated with antigen in culture. In contrast, when mice were immunized during the exposure to PCP-T, there was a dose-related suppression of the IgM antibody response to sheep red blood cells (SRBC) measured on both d 4 (peak day) and d 5. There was no change in the antibody response of mice exposed to PCP-P. The differential activity was not observed following direct addition, since both PCP-T and PCP-P suppressed the in vitro antibody response by spleen-cell suspensions from untreated mice. The suppression was associated with a decrease in cell viability, indicating that both preparations were directly cytotoxic. These results indicate that the in vitro antibody assay will be of limited value in determining the mechanism of immunosuppression by PCP. The lack of effect on the antibody response by splenocytes from PCP-T-treated mice indicates that the dysfunction is not due to a direct suppression of the capabilities of immunocompetent cells. PMID- 3820338 TI - Acute toxicity in the guinea pig and in vitro "dioxin-like" activity of the environmental contaminant 1,2,4,5,7,8-hexachloro (9H)xanthene. AB - A number of sites in the state of Missouri have been contaminated with polychlorinated dibenzodioxins and dibenzofurans as a result of improper waste oil application for dust control. In addition to these compounds, relatively high levels of 1,2,4,5,7,8-hexachloro(9H)xanthene (1,2,4,5,7,8-HCX), a by-product of hexachlorophene manufacture, were also detected. Unlike the dibenzodioxins and dibenzofurans, no animal toxicity data are available on the chlorinated xanthenes. In view of the potential importance of this novel class of environmental contaminants, studies were conducted to examine the acute oral toxicity in guinea pigs and in vitro "dioxin-like" activity of 1,2,4,5,7,8-HCX. Animals administered a single oral dose of 0.02, 0.1, 0.5 or 2.5 mg 1,2,4,5,7,8 HCX/kg in corn oil and sacrificed 42 d later exhibited no treatment-related pathology. Guinea pigs given 12.5 mg/kg displayed mild to moderate distension and histologically observable subserosal edema of the urinary bladder, in addition to mild fatty vacuolization of pancreatic acinar cells. The alterations were considered to be of minimal toxicological significance. No compound- or dose related mortality, body weight loss, or organ weight changes were noted at any dose level. Results using an in vitro bioassay for "dioxin-like" activity confirmed preliminary data suggesting that 1,2,4,5,7,8-HCX is about 10(6) times less potent than 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) in this assay system. These findings indicate that 1,2,4,5,7,8-HCX may represent a relatively low environmental hazard compared to 2,3,7,8-TCDD. PMID- 3820339 TI - Biochemical and morphological studies on the percutaneous uptake of [14C] ethylenediamine in the rat. AB - Male Wistar rats were exposed to aqueous [14C]ethylenediamine (EDA) solutions (10, 25, or 50%) percutaneously over a 7 x 7 cm area on the back with occlusion for 24 h. For each rat dosed, three types of studies were conducted: (1) plasma kinetics, (2) material balance, and (3) histological evaluation, including autoradiography of the skin sample from the dosing area. Adequate kinetic measurements were obtained only from animals treated with 25 and 50% EDA, but not from the 10% treatment group, due to analytical limitations. The uptake of [14C]EDA percutaneously by the rat was relatively slow in comparison with uptake following peroral or endotracheal administration. The absorption of EDA by the animals was estimated to be greater than 61, 55, and 12%, respectively, for the 50, 25, and 10% treatment groups. A large portion (11-32%) of the dose was left on/in the dosing area. Urinary excretion was the predominant route for the disposition of EDA. The recovery of the administered dose was low (70-83%), possibly due to volatilization of EDA from the skin during dosing and holding. Histologic examination of skin sections (dosing areas) revealed a normal, intact epidermis in rats dosed with 10% EDA, but full-thickness epidermal necrosis in rats dosed with 25% or 50% EDA solutions. The damage of the epidermis apparently enhanced the penetration of EDA. Autoradiographic preparations revealed a concentration of the [14C]EDA radiolabel over the keratin layer and hair shafts. PMID- 3820340 TI - Effect of dermal application of phosphamidon-92 (technical) on different tissues and hematobiochemical parameters in albino rat. AB - The histological disturbances occurring from the dermal application of low, medium, and high doses of phosphamidon-92 (technical) to rats as observed by light microscope and analysis of hematobiochemical parameters of blood are presented. Groups of 10 male and 10 female albino rats (Wistar strain) were treated with the test material at dose levels of 0.48 (low), 2.2 (medium), and 3.98 (high) mg/kg X d for 3 wk, followed by a 2-wk observation period. During application, a reduction in food intake and in body weight was recorded with all three treatments. However, gain in body weight and food intake resumed during the observation period and was marked with the high-dose treatment only. Symptoms like hypersalivation and frothing were noticed in both the sexes, as well as a relative decrease in liver weight and gross pathological alterations on microscopical examination of skin, lung, kidney, and testis; significant alterations in some hematobiochemical parameters of blood were observed. PMID- 3820341 TI - Perfluorinated fatty acids alter merocyanine 540 dye binding to plasma membranes. AB - We have evaluated the effect of the perfluorinated fatty acids pentadecafluoro-n octanoic acid (PFOA) and nonadecafluoro-n-decanoic acid (NDFDA) on the ability of a human B-lymphoblastoid cell line to bind the lipid-binding, membrane impermeant, fluorescent dye merocyanine 540 (MC540). Subtoxic concentrations of perfluorinated fatty acids (0.9 mM PFOA; 0.5 mM NDFDA) greatly diminish binding of MC540 by normal plasma membranes, as determined by fluorescence flow cytometry. When perfluorinated fatty acids are added to cells at toxic or lethal concentrations (1.2 mM PFOA; 0.75 mM NDFDA), MC540 binding increases dramatically, with entrance of dye to internal membrane domains. Neither perfluorinated fatty acid molecule reduces the ability of surface immunoglobulin to migrate laterally and cap on cells. Our data suggest that perfluorinated fatty acids either interact directly with lipid binding sites for MC540, and thereby inhibit dye intercalation, or alter membrane lipid architecture and lipid packing to diminish MC540 binding. Both possibilities support a direct, physical, membrane-altering mechanism for perfluorinated fatty acid toxicity on mammalian cells. PMID- 3820342 TI - An evaluation of the safety of cefuroxime axetil during six months oral administration to beagle dogs. AB - The effects of repeated oral administration of cefuroxime axetil were assessed in Beagles. The test material, an ester, is hydrolysed following absorption from the intestine to yield the therapeutically active moiety, cefuroxime, together with acetic acid and acetaldehyde; in this study cefuroxime and unhydrolyzed cefuroxime axetil were detected in the blood. Cefuroxime axetil was administered twice daily during 27 weeks by gavage of aqueous, suspensions, total daily doses were equivalent to 100, 400 or 1600 mg cefuroxime/kg/day. Apart from three cases of intercurrent illness, unrelated to treatment, the dogs remained in good health. Effects observed in the 1600 mg/kg group included vomiting and slight suppression of body weight gain. Minor variations in haematological measurements included rather low haemoglobin levels, packed cell volumes and erythrocyte counts. Slightly smaller numbers of neutrophils were thought to reflect reduced demand on normal defensive mechanisms due to continued antibiotic treatment. Prolongation of prothrombin time and activated partial thromboplastin time is attributed to disturbance of the intestinal microbial flora and reduced synthesis of vitamin K, on which the dog is highly dependent. Cefuroxime does not have the N-methylthiotetrazole side chain thought to be responsible for inhibition by other cephalosporins of the vitamin K-dependent step in the synthesis of clotting factors. Variations in plasma chemistry included rather low levels of plasma protein. Electrophoresis showed this to be a generalised reduction; only gamma globulins were proportionally decreased and this finding, like the low neutrophil counts, is attributed to the protective action of the antibiotic. Minor metabolic adjustments to the compound are reflected in plasma levels of cholesterol and triglycerides. This spectrum of findings was seen only to a very limited extent in the 400 mg/kg group; the 100 mg/kg group was, with very few exceptions, unaffected by the treatment. Macroscopic post mortem examination and microscopic examination of tissues revealed no treatment-related features indicative of toxicity. Cefuroxime axetil was thus shown to possess very little toxicity when administered repeatedly in large doses to Beagles. The lowest dose level in this study was ten times the proposed daily clinical dose in man. PMID- 3820343 TI - Time dependent effects of selenium on cadmium-induced acute mouse testicular damage. AB - Twenty-four hr after a single subcutaneous injection of Cd (0.024 mmol/kg), the testis showed severe and widespread degeneration. The damage was accompanied by an increase of lipoperoxide and a decrease of glutathione in the testis. Se (0.048 mmol/kg) injections 2 hr before, at the same time, and 1 hr after the Cd injection, decreased the damage. In these groups, the level of glutathione and lipoperoxides was restored to the control level. With a Se injection 6 hr after the Cd injection, the preventive effect of Se was no longer found. In the testis in which Se injection alleviated the damage caused by Cd, the changes in Ca, Mg and Zn were also restored to the control level. Uptake of Cd into the testis was stimulated by the Se injection. However, the uptake still remained at a low level in the testis in which the Se preventive effect was not found. These results suggest that the preventive effect of Se against testicular Cd toxicity is dependent on the interval between Cd and Se injections. PMID- 3820344 TI - [Studies on the antigenicity of MY-5116]. AB - Antigenicity of MY-5116 was studied in the experimental animals and the following results were obtained. MY-5116 was shown to be non-immunogenic in rabbits, guinea pigs and mice when given alone as immunogen. Protein conjugate of MY-5116 induced antibody of hapten specific antibody when using guinea pigs and mice as immunizing species. However, MY-5116 was shown to be not capable of reaction with anti MY-5116-OVA antibodies. Guinea pigs had no skin contact sensitivity against MY-5116 examined by means of maximization test. In conclusion, MY-5116 lacks immunogenicity and eliciting antigenicity in this experimental conditions and this suggests that drug allergic response would either not occur or be minimal, if any, when MY-5116 is administered clinically. PMID- 3820345 TI - [Proceedings of the 13th annual meeting of the Japanese Society of Toxicological Sciences. Tokyo, July 23, 1986]. PMID- 3820346 TI - Early coverage of deep hand burns with groin flaps. AB - Deep burns of the hands require skin flap coverage in order to protect the exposed vital structures. The groin flap is a safe and effective method of obtaining early closure of these defects. We have used groin flaps to cover deep hand burn defects in nine patients. In each case, groin flaps effectively covered the various defects, such as the volar aspect of the wrist, dorsum of the hand, first web space, thumb, and fingers. PMID- 3820347 TI - Selected papers from the 1986 American Burn Association meeting. Chicago, April 9 12. PMID- 3820349 TI - Fluid retention and burn survival. AB - The relationship between retained fluid and survival has previously been reported from our burn unit. Two hundred thirty cc/kg lean body mass accurately delineated survivors from nonsurvivors. Our previous study did not account for fluid lost through the burn wound. This study was undertaken to evaluate fluid retention per square meter of body surface area which has been corrected for fluid loss from the burn wound using a formula suggested by Mason et al. Data collected from 95 adult patients with burns greater than or equal to 20% body surface area burn (mean age, 42.4 years; mean burn size, 37.7%), who were admitted to our burn unit between January 1978 and September 1985, were evaluated. All patients included in the study were adequately resuscitated and survived the initial 48 hours. A calculation of the total fluid retained during the first 48 hours postburn and estimation of fluid loss from the burn wound were made. A comparison was made between lean body retained fluid and surface area retained fluid. A positive correlation (r = 0.921; p less than 0.001) was demonstrated between these two methods of assessing fluid retention. Fluid retention determined by either method resulted in a higher correlation with survival than any single predictor (age, per cent body surface area burned) of burn survival. Surface area fluid is as accurate as lean body fluid in predicting survival. Additionally, we determined that for the first 48 hours postburn, 4,425 cc fluid retained per meter square body surface area accurately differentiated survivors from nonsurvivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820348 TI - Reversal of SAP-induced immunosuppression and SAP detection by a monoclonal antibody. AB - A murine monoclonal IgG antibody (MAb) to column-isolated trauma-induced suppressor active peptide (SAP) was produced and utilized in these studies for the further characterization of SAP. Specificity of the antibody was confirmed by enzyme-linked immunosorbent assay (ELISA), passive immunoblotting, and reversal of SAP-induced neutrophil chemotaxis inhibition. ELISA analysis revealed binding of anti-SAP MAb to a serum protein present in both whole burn and normal serum, but only to burn serum using a less than 25,000-mw serum fraction. This suggests that SAP may be an injury-induced degradation product of a greater than 25,000-mw serum protein. Immunoblotting using a less than 25,000-mw burn serum fraction demonstrated MAb binding to a single low molecular weight protein band. Using the MAb in an ELISA immunodiagnostic procedure, it appeared that SAP levels were significantly elevated in the sera of burned patients who died from their injuries compared to levels in sera of controls or patients who survived. PMID- 3820350 TI - Protein loss across burn wounds. AB - One factor contributing to negative nitrogen balance in burned patients is protein loss through the burn wound. There is, however, little information on the amount and type of protein lost by this route. This study was designed to quantitate protein loss through burn wounds. Multiple full- and partial-thickness burns on 29 patients were studied. Sampled burn sites were dried and occlusive sponge dressings (2'' X 2'') were applied and left in place for 1 hour. The central 1 square-inch portion of the dressing was then removed, rinsed in distilled water, and total protein, albumin, and globulin were measured in the water wash. Considerable protein losses were measured. These losses were greatest in the first 3 postburn days, being somewhat greater in full-thickness burns (0.98 +/- 0.82 mg/cm2/hr) compared to partial-thickness burns (0.59 +/- 0.41 mg/cm2/hr) during this period mean +/- SD). Subsequent to the first 3 postburn days, protein loss in all burn types decreased to a relatively steady rate of loss of approximately 0.25 mg/cm2/hr. Based upon these data, average daily protein losses during the first postburn week can be estimated by the following equation: 24-hour protein loss through burn surface (gm) = 1.2 X body surface area (m2) X % burn (%). On subsequent days, protein is lost at approximately half this rate. These data demonstrate significant protein losses through burn wounds greater than recent studies have considered. It is possible that inadequate nutritional replacement of these protein losses is partly responsible for the marked negative nitrogen balance of the early postburn period. PMID- 3820351 TI - Total body oxygen supply-demand balance in burned patients under enflurane anesthesia. AB - The effects of enflurane anesthesia on the oxygen supply-demand balance have been studied in nine hypermetabolic-hyperdynamic burned patients undergoing debridement and skin-grafting procedures. Mean burn size was 55% of total body surface area. The patients were without cardiac, lung, hepatic, and kidney dysfunction and were not septic. Anesthesia was induced with sodium pentothal and maintained with enflurane and nitrous oxide in oxygen. Ventilation was controlled to maintain PaCO2 within normal limits. Crystalloid solutions and blood were administered to maintain adequate heart filling pressures. Serial measurements of cardiac output, arterial and mixed venous blood gases, and oxygen content were made before, during, and after anesthesia. Following induction of anesthesia and enflurane administration, cardiac output, oxygen delivery, and oxygen consumption decreased in a parallel fashion to approximately 60% of control. These variables did not change significantly throughout the procedure and returned to control values when enflurane was discontinued. Arteriovenous oxygen content difference did not increase and metabolic acidosis did not develop, suggesting that tissue perfusion remained adequate. Under anesthesia, oxygen consumption in burned patients was similar to that observed in normal subjects, indicating that enflurane blunts the hypermetabolic effects of thermal injury. It is concluded that in burned patients enflurane decreases metabolic rate and cardiac output, and maintains an adequate oxygen supply-demand balance. PMID- 3820352 TI - Interaction of thromboxane A2 and tissue pathology during graded bacteremia. AB - The purpose of this study was to determine whether or not thromboxane A2 (TXA2) was necessary or sufficient for the development of end-organ pathology during graded bacteremia. Pulmonary artery catheters were placed in 21 adult male pigs under pentobarbital anesthesia and breathing room air. After a control period, animals were studied in four groups: Group 1, anesthesia only; Group 2, infusion of 1 X 10(9) ml Aeromonas hydrophila which was gradually increased from 0.2 ml/kg/hr to 4.0 ml/kg/hr over 4 hours; Group 3, pretreatment with SQ 29,548 (TXA2 antagonist) then Aeromonas h. infusion; Group 4, infusion of U46619 (TXA2 agonist) to pulmonary artery pressures measured in Group 2. Animals were sacrificed after 4 hours and the lungs, liver, spleen, kidneys, and heart were examined under light microscopy by a pathologist unaware of study groups. The results indicated that physiologic thromboxane A2 agonist (Group 4) was sufficient alone to cause pulmonary inflammation. Thromboxane A2 was neither necessary nor sufficient for significant renal, hepatic, pulmonary, or splenic pathology to occur in graded bacteremia, manifested in similar microanatomic abnormalities in these organs in Groups 2 and 3 and in Groups 1 and 4. Pulmonary leukocyte infiltration was significantly increased in Group 3 compared to all other groups, suggesting that TXA2 impairs inflammatory responses. PMID- 3820353 TI - Effect of early excision on patients with major thermal injury. AB - A randomized study was carried out to determine the effect on mortality of early massive excision of large burns. Fifty consecutive adult patients admitted to our hospital burn unit between December 1983 and January 1986 with 2 degrees and 3 degrees burns totaling at least 30% total body surface area (TBSA) were randomized on admission to one of two groups. The patients received either conservative therapy or early massive excision of all full-thickness burns. The two groups were similar in average size of burn but differed in their average age. In the patients with burns greater than 50% TBSA and no inhalation injury, mortality was decreased with early excision, which can be explained entirely by age differences alone. There was not a significant difference in length of stay, blood requirements, or in mortality in other groups of patients. PMID- 3820354 TI - In vivo monitoring of postburn immune response. AB - Following a severe thermal injury (30% TBSA), 50% of the burned mice died within 48 hours. The immune response of the survivors was evaluated in vivo using the popliteal lymph node assay (PLNA) for host versus graft (HVG) or graft versus host (GVH) response. Suppression of GVH reactivity was observed using isolated splenocytes from burned mice harvested on postburn days 3, 8, and 11. Lymphocyte response evaluated in the burn environment using the HVG assay was profoundly deficient on postburn days 3 and 11. Recovery of immune function as determined by measurements of both responses occurred by postburn days 14-21, and coincided with wound healing. The PLNA proved to be a sensitive measure of immune function, and allowed for the evaluation of isolated cell populations, as well as measurement of lymphocyte function in the burn environment in the presence of circulating suppressor factors. PMID- 3820355 TI - The effect of burn wound excision on measured energy expenditure and urinary nitrogen excretion. AB - The effect of wound closure on the metabolic response to burn injury is uncertain. Energy expenditures were measured in 20 patients by indirect calorimetry (MEE) and estimated initially by the Curreri formula (CEE) and subsequently by a modification of the Curreri formula (MCEE), adjusted for changes in open wound size and body weight. Urinary urea nitrogen (UUN) excretions were measured over 24 hours. Second- and third-degree burns, initially involving 31% to 74% of the body surface areas, were reduced in size to less than 15% by excisions and grafting procedures. The correlations among percentage open wounds, MEE's, CEE's, and MCEE's were low. UUN excretions were not correlated with percentage open wounds or with MEE's. Estimates of energy expenditures using the Curreri formula appear to be of limited usefulness in prescribing caloric intakes in burned patients. Serial UUN's are useful in determining protein requirements, but were not correlated with MEE's or with the extent of open wounds. PMID- 3820356 TI - Treatment of severe diarrhoeal dehydration in hospital and home by oral fluids. AB - This paper reports on 1330 infants, from birth to 24 months old, suffering from diarrhoea and moderate to severe dehydration who were hospitalized in Tehran University Hospital over a period of 11 months. Fifteen per cent of them had signs of shock and 36% had marasmus. All patients were treated orally in two phases: rehydration therapy and maintenance therapy. For rehydration, an isotonic fluid (sodium 80 mmol l-1, potassium 20 mmol l-1) was administered at a rate of 40 ml kg-1 h-1 until all signs of dehydration disappeared. Following complete hydration, the patients were discharged and maintenance therapy was performed at home, by mothers, administering Maintenance Solution (sodium 40 mmol l-1, potassium 30 mmol l-1) ad libitum. Intravenous fluids were not used, even in severe dehydration. The efficacy and safety of this regimen were confirmed by rapid and successful rehydration in 99.7% of the patients and correction of a wide variety of electrolyte abnormalities present on admission, though some relapsed. The study suggests that this protocol could be employed in varied types and severities of dehydration and electrolyte abnormalities, and could also be used in both well nourished infants and in those with severe marasmus. It also demonstrates that mothers can serve as effective health workers and can perform successful maintenance therapy. Nine per cent of treated children required readmission to hospital within 24 h of discharge and a further 8% were hospitalized elsewhere with recurrent symptoms. PMID- 3820357 TI - Incidence of shigellosis and multi-drug resistant Shigellae: a 10 year study. AB - Between 1976 and 1985 a total of 12,709 faecal samples were cultured. From these samples 760 strains (6.0%) of Shigellae were isolated. Shigella flexneri was the commonest isolate (55%), followed by S. dysenteriae (29.7%). A total of 15.7% of children under 5 years of age were positive for Shigellae. The rate of isolation was lower during the winter months than in the summer months. Only 25 strains (3.3%) were sensitive to all five antibiotics tested. A total of 617 (81.2%) were resistant to three or more antibiotics (multi-drug resistant). The minimum inhibitory concentrations (MICs) of five drugs were calculated in 100 strains. Streptomycin showed an MIC of 25 micrograms ml-1 or less for only seven strains. MICs of chloramphenicol tetracycline and ampicillin were found to be as high as 100-1000 micrograms ml-1 for the majority of strains. Sulphonamide showed an MIC of 1000 micrograms ml-1 for 93 strains. PMID- 3820358 TI - Toxoid preparation from the venom of Crotalus durissus cumanensis (South American rattle snake). AB - A new technique is described for the preparation of Crotalus venom toxoid. This method preserves the immunogenicity but eliminates the toxic effects. All the animals vaccinated with Crotalus venom toxoid survived when they were injected with raw venom. PMID- 3820359 TI - The effects of distance and season on the use of boreholes in northeastern Imo State, Nigeria. AB - A study was conducted in a rural area of northeastern Imo State to examine the effect of distance and season on the use of boreholes, provided at a borehole-to population ratio of 1 to 440. The type of water source used by households varied according to season. In the water-scarce dry season, 98% of households used borehole water: 64% as their sole source, a further 26% as their main source, and 8% as a secondary source. The use of borehole water as the main source was little influenced by distance until the household-to-borehole distance reached approximately 2 km. The situation was different in the wet season when the availability of water sources was much greater. In this season, rainwater was the main water source for 64% of households. Borehole water was the main source for only 31% of households. In the rainy season, the use of borehole water as the main source showed a significant decrease with increasing household-to-borehole distance. The provision of one borehole for 400-500 people was associated with a high rate of use as the main water source only in the dry season. However, the use of boreholes as either a main or alternative source was high in both seasons and it is possible that those households that used boreholes as an alternative source used the water for drinking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820360 TI - Alterations in nuclear matrix structure after adenovirus infection. AB - Infection of HeLa cells with adenovirus serotype 2 causes rearrangements in nuclear matrix morphology which can best be seen by gentle cell extraction and embedment-free section electron microscopy. We used these techniques to examine the nuclear matrices and cytoskeletons of cells at 6, 13, 28, and 44 h after infection. As infection progressed, chromatin condensed onto the nucleoli and the nuclear lamina. Virus-related inclusions appeared in the nucleus, where they partitioned with the nuclear matrix. These virus centers consisted of at least three distinguishable areas: amorphously dense regions, granular regions whose granulations appeared to be viral capsids, and filaments connecting these regions to each other and to the nuclear lamina. The filaments became decorated with viral capsids of two different densities, which may be empty capsid shells and capsids with DNA-protein cores. The interaction of some capsids with the filaments persisted even after lysis of the cell. We propose that granulated virus-related structures are sites of capsid assembly and storage and that the filaments may be involved in the transport of capsids and capsid intermediates. The nuclear lamina became increasingly crenated after infection, with some extensions appearing to bud off and form blebs of nuclear material in the cytoplasm. The perinuclear cytoskeleton became rearranged after infection, forming a corona of decreased filament number around the nucleus. In summary, we propose that adenovirus rearranges the nuclear matrix and cytoskeleton to support its own replication. PMID- 3820361 TI - The ureteral access system: a review of the immediate results in 43 cases. AB - The ureteral access set was used 43 times during an 18-month period between 1984 and 1985. Stones lodged throughout the ureter and in the renal pelvis were extracted with a success rate of 51 per cent. Of the upper tract strictures 92 per cent were dilated successfully. Filling defects were diagnosed in 88 per cent of the cases. Foreign bodies were retrieved, Double-J stents were placed and biopsies were successful in each case. Ureteral perforation in 28 per cent of the cases was caused by the dilator in 8 of 12 (19 per cent over-all). The technique and short-term results are discussed. Long-term followup data are not yet available. PMID- 3820362 TI - Complications of ureteroscopy in relation to experience: report of survey and author experience. AB - During the last 4 years we performed ureteroscopy for diagnostic evaluation in 20 patients and for removal of mid or distal ureteral stones in 127. All of the diagnostic studies were successful. In the stone removal cases the success rate increased from 71 per cent for the 24 procedures done during the first 2 years to 92 per cent for the 60 procedures done in the first 9 months of 1985. The rate of ureteral injury in the entire series was 2 per cent and in only 9 of the 23 failures was an open operation necessary. The benefit of experience also was evident in the results reported by 28 medical centers, with a 78 per cent success rate at the 11 centers that had performed less than 20 procedures each and an 84 per cent success rate at the 9 centers that had done more than 50. Despite early frustration with ureteroscopy, the value of mastering the technique allows the urologist to proceed endourologically with minimum morbidity and without precluding further interventional procedures. PMID- 3820363 TI - Pulsed dye laser fragmentation of ureteral calculi: initial clinical experience. AB - The pulsed dye laser, emitting at wavelengths of 504 nm. for 1 microsecond. at a frequency of 5 Hz. transmitted via a 250 mu in diameter silicon-coated quartz fiber, was passed into the ureter through the working channel of a 9.5F rigid ureteroscope. Seventeen patients with ureteral calculi too large to be extracted directly, who were unable to be treated by extracorporeal shock wave lithotripsy or who otherwise would have required transureteral or percutaneous ultrasonic stone removal, underwent attempted stone fragmentation by pulsed dye laser application. Of the 17 calculi 16 were fragmented to spontaneously passable or easily extractable fragments. There was no significant ureteral injury, thermal or otherwise, attributable to laser energy action. At 3-month followup 15 of the 17 ureters had improved and 2 showed evidence of ureterscopic injury. The mechanism of stone fragmentation by laser is small volume "shock wave" formation. PMID- 3820364 TI - Endourological management of ureteroileal anastomotic strictures: is it effective? AB - Ureteroileal stenosis represents a serious postoperative threat to the obstructed kidney and open revision in these patients often is difficult. We evaluated 9 patients with 10 ureteroileal strictures who were treated with semirigid fascial dilators (1), balloon dilation (4) or a combination of balloon dilation and percutaneous intraureteral surgery (4). All 5 patients who had semirigid fascial or balloon dilation alone had early recurrence of the strictures. However, in 4 patients dilation in conjunction with percutaneous intraureteral incision of the stricture through a flexible choledochonephroscope resulted in short-term resolution of each ureteroileal stricture. However, by 6 months these strictures had recurred in 50 per cent of the patients. PMID- 3820365 TI - The natural history of patients less than 40 years old with bladder tumors. AB - We treated 19 men and 6 women less than 40 years old with bladder tumors. The average patient age at diagnosis was 30.6 years and the mean followup was 65 months. Gross hematuria was present in 84 per cent and excretory urography showed a mass in the bladder in 44 per cent of the patients. Of 8 patients less than 30 years old 6 had papilloma and 2 had grade II to III, stage O transitional cell carcinoma. All patients with papillomas were free of disease. The pathological reports of the patients more than 30 years old revealed papilloma or grade I, stage O transitional cell carcinoma in 9, grade II to III, stage O to A papillary transitional cell carcinoma in 6 and invasive disease in 2, 1 of whom died. Of the 9 patients with papilloma or grade I, stage O disease 77 per cent are currently free of disease. Of those with grade II to III, stage O to B papillary transitional cell carcinoma only 1 is free of disease, while 6 have had resectable recurrences. One patient with grade II to III disease was lost to followup. Accordingly, all patients, regardless of age, should be treated as aggressively as necessary on the basis of the stage and grade of the tumor. PMID- 3820366 TI - Transitional cell carcinoma of the bladder in an adolescent with Turner's syndrome. AB - Primary epithelial tumors of the bladder are extremely rare in children and adolescents. We report a case of transitional cell carcinoma in an adolescent with Turner's syndrome. The patient presented with intermittent gross hematuria and mild dysuria. A mass was identified on the trigone of the bladder near the left ureteral orifice, and histological evaluation revealed grade II to III in situ papillary transitional cell carcinoma with foci of submucosal invasion. Transurethral resection of the tumor was performed, and the patient remains free of disease 2 1/2 years later. The literature on transitional cell carcinoma of the bladder in children is reviewed. PMID- 3820367 TI - The impact of cigarette smoking on stage, grade and number of recurrences of transitional cell carcinoma of the bladder. AB - The records of 386 patients with diagnosed transitional cell carcinoma of the bladder were reviewed to determine a correlation between smoking history, and stage, grade and number of recurrences of transitional cell carcinoma. A significant association was detected between smoking history and all 3 variables. Within this military population 79 per cent of the patients were noted to have a smoking history, which is higher than most previously studied groups. These data further confirm the association between cigarette smoking and transitional cell carcinoma of the bladder, and suggest that cigarette smoking within the military population may portend a much higher cancer risk in this group. PMID- 3820368 TI - Incidence, extent and location of unsuspected pelvic lymph node metastasis in patients undergoing radical cystectomy for bladder cancer. AB - Between March 1, 1983 and December 31, 1985, 18 of 130 patients (14 per cent) undergoing radical cystectomy had unsuspected metastasis. In 17 patients (94 per cent) only 1 or 2 nodes were involved. The mean size of the involved nodes was 0.81 cm. and the mean size of metastasis was 0.39 cm. In patients with 1 or 2 positive nodes metastasis was not observed above the bifurcation of the common iliac arteries or lateral to the external iliac arteries. In patients in whom the primary bladder tumor was localized clearly to 1 side of the bladder unsuspected metastasis was observed only in ipsilateral lymph nodes. In accordance with these findings, we advocate a restricted pelvic lymphadenectomy in patients in whom gross examination reveals no evidence of nodal metastasis at radical cystectomy. PMID- 3820369 TI - Impact of routine screening for adenocarcinoma of the prostate on stage distribution. AB - The impact of routine screening with digital rectal examination for carcinoma of the prostate on stage distribution of the disease was assessed in the primary treatment population of our medical center. Two, 5-year periods were compared: 1974 to 1978--before the onset of routine screening and 1979 to 1983--during the period of routine screening of this population. The clinical stage distribution of prostatic cancer before the onset of routine screening was not significantly different from national averages. Routine screening during the latter period significantly increased the percentage of patients with clinically curable carcinoma of the prostate. Pathologically, the disease was upstaged in many patients in both series. Digital rectal examination can have a significant impact on early detection of carcinoma of the prostate within a given population but it cannot be interpreted as a panacea for this disease. PMID- 3820370 TI - Adverse implications of acid phosphatase levels in the upper range of normal. AB - A retrospective review of 102 consecutive patients with surgically staged, clinically localized prostatic carcinoma was performed to determine the relationship between pre-treatment enzymatic acid phosphatase values and histopathological extent of the tumor. Of 96 patients with normal pretreatment acid phosphatase titers (thymolphthalein monophosphate substrate) 77 (80 per cent) had values in the lower and 19 (20 per cent) had values in the upper half of the normal range. Of the latter 19 patients 16 (84 per cent) had histological evidence of extraprostatic tumor extension. Similarly, 5 of 6 patients (83 per cent) with elevated pre-treatment acid phosphatase titers had extraprostatic extension and 1 had a persistent postoperative acid phosphatase elevation that normalized with megestrol acetate therapy. Thus, 22 of 25 patients (88 per cent) with acid phosphatase values in or above the upper half of the normal range had either histological or clinical evidence of extracapsular tumor extension. By contrast, 41 of the 77 patients (53 per cent) with acid phosphatase titers in the lower half of the normal range had extracapsular extension. The predictive value for extraprostatic tumor extension of an acid phosphatase level in the upper half of the normal range was 84 per cent. Furthermore, in the 96 patients with normal acid phosphatase titers the incidence of extraprostatic tumor extension was significantly greater (p less than 0.01, chi-square) in those with values in the upper rather than the lower half of the normal range. Acid phosphatase titers in the upper half of the normal range were proportionately more common among patients with high grade and high clinical stage tumors. However, among patients with low grade and low stage tumors an acid phosphatase value in the upper half of the normal range was an independent variable that correlated with the presence of extracapsular tumor extension. These results confirm previously reported adverse prognostic implications of enzymatic acid phosphatase titers in or above the upper half of the normal range. PMID- 3820371 TI - Radioimmunological imaging of metastatic prostatic cancer with 111indium-labeled monoclonal antibody PAY 276. AB - A total of 25 patients with histologically proved adenocarcinoma of the prostate, whose disease was staged clinically as D2 by appropriate radiographic and nuclear medicine studies, received increasing doses of PAY 276, an antiprostatic acid phosphatase monoclonal antibody for radioimmunological imaging. The patients were divided into 5 groups of 5. Groups 1 through 5 received an infusion of 5, 10, 20, 40 or 80 mg. monoclonal antibody, respectively, 1 mg. of which was labeled to 5 mCi. of 111indium, while stable monoclonal antibody was added to achieve the desired antibody concentration. No patient had an allergic reaction, and no significant change in serial hemoglobin levels, platelet count, chemistry profile or results of urinalyses was noted. The monoclonal antibody scan visualized at least 1 lesion in 19 of 25 patients (76 per cent): 4 in groups 1 and 2, and all 15 in groups 3 to 5. With results of conventional radiography and bone scintigraphy considered definitive for metastases, monoclonal antibody scans detected 7 of 32 metastases (21.8 per cent) in group 3 (20 mg.), 31 of 58 (53.4 per cent) in group 4 (40 mg.) and 101 of 134 (75.4 per cent) in group 5 (80 mg). In group 5 the incidence of false positive and false negative scans was 2.3 per cent (3 of 132) and 24.6 per cent (33 of 134), respectively. The detection of metastatic lesions increased as the concentration of unlabeled monoclonal antibody increased. Radioimmunological imaging of prostatic cancer with antiprostatic acid phosphatase monoclonal antibody seems to be feasible. PMID- 3820372 TI - Selective diagnostic uroradiography for trauma. AB - Fifteen years of personal experience have yielded 157 penetrating and 225 blunt urological injuries, including only 2 instances of simultaneous upper and lower tract involvement (0.5 per cent). A similar review of 2,750 cases from the urological literature has yielded only 17 patients with simultaneous upper and lower tract injuries (0.6 per cent). Blunt trauma was responsible in all but 1 of these 17 patients (95 per cent). Based upon these observations, it is suggested that comprehensive radiographic evaluation of traumatic hematuria or suspected occult urological trauma unnecessarily may be expensive and dilatory, and that evaluation may be limited routinely to the area of maximum injury. PMID- 3820373 TI - Applications of the peel-away introducer sheath. AB - The peel-away introducer sheath set, originally designed for the antegrade insertion of the silicone rubber Universal stent, also is useful for antegrade or retrograde basketing of ureteral stones, negotiation of a dilated renal pelvis and tortuous ureter with minimal trauma, retrograde flushing of ureteral stones for percutaneous extraction, removal of dislodged stents from the renal pelvis and ureteral examination with a flexible endoscope or rigid ureteropyeloscope. PMID- 3820374 TI - Use of a balanced bowel preparation solution in urological surgery. AB - A balanced bowel preparation solution was used in 25 patients undergoing cystectomy and in 31 undergoing radical retropubic prostatectomy. No significant problems occurred during the preparation, intraoperatively or postoperatively. Metronidazole and neomycin were used for antibiotic coverage. Consistent with the findings of other studies no significant physiological shifts occurred and patient acceptance was good. Savings were noted in cost, duration of hospitalization, time needed for nursing care and nutritional status. The balanced bowel preparation solution is an attractive and equally effective alternative to the standard laxative-enema bowel preparations for urological operations. PMID- 3820375 TI - The adaptation of urethral pressure profiles to detect sphincter incompetence and sphincter obstruction using a microcomputer. AB - A new system for performing urethral pressure profiles, the fluid bridge test and micturitional urethral pressure profiles has been designed based on the use of a microcomputer. The method described has not only led to major improvement in the presentation and accuracy of these tests but for the first time urethral profilometry has been adapted to detect sphincter incompetence and obstruction in 1 simple method. The fluid bridge test was performed on 46 men and 18 women. The results suggested that this test was excellent for urodynamic evaluation of retrograde ejaculation, post-prostatectomy incontinence and vesicourethral neuropathy, and its value was confirmed in women with stress incontinence. Micturitional urethral pressure profiles were performed in 38 men and 2 women. Not only was this test found to correlate well with conventional methods of detecting obstruction but it was able to diagnose urinary outflow obstruction in patients with equivocal pressure/flow studies and patients with acontractile detrusors. It also allowed diagnosis of the site of obstruction in men with vesicourethral neuropathy without the need for radiological screening. PMID- 3820376 TI - Reversal of testicular growth failure by varicocele ligation. AB - A total of 20 male patients 11 to 19 years old had a grade 2 or 3 varicocele and volume loss of the testis ipsilateral to the varicocele. None of these patients presented because of subfertility. Following varicocele ligation a significant increase in volume of the testis ipsilateral to the varicocele was observed in 16 of 20 patients. All 20 patients have been followed for 1 to 6 years. Our results suggest that a moderate to large varicocele can be responsible for testicular growth retardation and that early ligation of the varicocele may reverse this process. PMID- 3820377 TI - Right adrenal pheochromocytoma with anterolateral displacement of the inferior vena cava: skin incision and approach. AB - We report a case of a right adrenal pheochromocytoma with prominent anterolateral displacement of the inferior vena cava. A right ipsilateral anterior subcostal incision extending from the xiphoid process to the 11th intercostal space allowed for wide upward retraction of the right costal arch. This incision is useful for easy mobilization of the liver and manipulation of the inferior vena cava without thoracotomy. PMID- 3820378 TI - Simultaneous bilateral adrenal involvement by renal cell carcinoma: experience with 3 cases. AB - We report 3 cases of renal cell carcinoma and synchronous bilateral adrenal metastases discovered preoperatively with computerized tomography and other imaging techniques. Surgical treatment consisted of radical nephrectomy through a transperitoneal approach, with adjunctive lower polar resection in a patient with bilateral renal tumors, and contralateral adrenalectomy. Subsequent steroid treatment was given. PMID- 3820379 TI - Renal angiomyolipoma with arteriovenous shunting. AB - We describe a patient with arteriovenous shunting during renal arteriography who at operation was found to have an angiomyolipoma rather than renal cell carcinoma or an arteriovenous malformation. Renal angiomyolipoma should be added to the list of causes of gross hematuria with angiographically demonstrable arteriovenous shunting. PMID- 3820380 TI - Primary psoas abscess. AB - Infectious processes in the retroperitoneal space often involve the psoas muscle. These infections usually are secondary to other intra-abdominal or intrapelvic inflammatory processes but rarely they will arise primarily within the retroperitoneum. These primary infections occur most often in younger patients and usually will demonstrate a chronic illness in which the diagnosis often is missed. We describe a 22-year-old man with a 2-year history of symptoms before the diagnosis was confirmed. The clinical presentation of the process and pathophysiology are discussed briefly. PMID- 3820381 TI - Psoas muscle abscess due to Pasteurella multocida. AB - A 9-year-old girl with meningomyelocele, an ileal conduit and a living related kidney transplant presented with a progressive gait disturbance. Radiographic evaluation included a computerized tomography scan that disclosed a large right psoas muscle abscess. The abscess cavity was drained percutaneously and culture of its contents yielded Pasteurella multocida. This case illustrates an unusual presentation of a psoas muscle abscess caused by an uncommon organism that was diagnosed and treated by nonoperative methods. PMID- 3820382 TI - Nephrogenic adenoma occurring in an ileal conduit. AB - We report a case in which papillary lesions developed in an ileal conduit that had been constructed for management of nonmalignant disease. Pathological diagnosis was nephrogenic adenoma, an entity previously thought to occur only in the urothelium. The pathogenesis of this unusual tumor is discussed. PMID- 3820383 TI - Ureteral intussusception owing to a malignant ureteral polyp. AB - We report a case of ureteral intussusception owing to well differentiated transitional cell carcinoma. The occurrence and radiological features of ureteral intussusception are discussed. PMID- 3820385 TI - Bladder neck obstruction in women. AB - Bladder neck obstruction in women is rare. The symptoms are confounding and nonspecific. The diagnosis depends on demonstrating poor uroflow, a detrusor contraction of adequate magnitude and duration, and radiographic evidence of obstruction at the vesical neck. We treated successfully 3 women with vesical neck obstruction by transurethral vesical neck incision. PMID- 3820384 TI - Treatment of intractable bacterial cystitis with intermittent catheterization and antimicrobial instillation: case report. AB - Intractable bacterial cystitis associated with residual urine formation was treated successfully in 4 women by intermittent self-catheterization with instillation of an aminoglycoside directly into the bladder after other methods had failed. PMID- 3820386 TI - Bladder disruption in the premature male neonate. AB - Bladder injury in children is an unusual event that usually is associated with trauma or a surgical mishap. We describe-2 premature male neonates who were treated by minimal stimulation therapy and systemic paralyzation. Despite normal urological anatomy, each patient had a bladder rupture that we attributed to atony of the bladder coupled with the Crede maneuver, which produced high intravesical pressures. PMID- 3820387 TI - Ectopic production of human chorionic gonadotropin by poorly differentiated transitional cell tumors of the urinary tract. AB - We performed a 5-year histopathological review of 41 consecutive cases of transitional cell carcinoma. Of these cases 8 were positive for human chorionic gonadotropin immunoperoxidase tissue staining. All tumors were grade III and stages ranged from A to D. Three patients presented with gynecomastia as the clinical manifestation of elevated serum levels of beta-human chorionic gonadotropin. These findings document the association of this phenomenon with lesions of an aggressive nature. As with the loss of cell surface antigens, the appearance of human chorionic gonadotropin within the tumor cells may be further evidence of dedifferentiation. Human chorionic gonadotropin production may be a potential marker to gauge tumor response to chemotherapy and, perhaps, a predictor of future aggressiveness and over-all progression. PMID- 3820388 TI - Perforation-reconstitution of proximal urethral obliteration. AB - Post-traumatic or failed postoperative proximal urethral obliteration commonly is managed by technically demanding transpubic procedures. Five cases are reported, which were treated successfully by forceful retrograde perforation with a urethral sound guided by a finger inserted into the prostatic urethra. Temporary urethral catheterization followed by a program of daily self-dilation by catheter during maturation of the tract, with visual urethrotomy as required, facilitated healing. PMID- 3820389 TI - Hydatid cyst of testis: a case report. AB - A case of a hydatid cyst of the testis is reported that was misdiagnosed clinically as malignant tumor. Echinococcosis should be considered in the differential diagnosis of testicular masses, especially in endemic countries. PMID- 3820390 TI - Electroejaculation for recovery of semen after retroperitoneal lymph node dissection: case report. AB - Electroejaculation with a rectal probe was used successfully for semen recovery 8 years after bilateral suprarenal hilar lymph node dissection for stage IIB embryonal cell cancer. An adequate ejaculate was obtained in relation to total sperm count, motility and normal morphology. Prior use of sympathomimetic drugs, including imipramine and ephedrine, was unsuccessful in producing an ejaculation. Electrostimulation via a rectal probe seems to be a useful technique for semen recovery in the patient with anejaculation after retroperitoneal lymph node dissection. PMID- 3820391 TI - Metastatic pure choriocarcinoma of the testis in an elderly man. AB - The case described of pure choriocarcinoma of the testis is rare because of the histological type and patient age at presentation. A 63-year-old man had a 160 gm. tumor, with a necrotic, hemorrhagic appearance and sparse bright areas that consisted exclusively of syncytial and cytotrophoblastic cells. Immunocytochemical analysis revealed strong staining for human chorionic gonadotropin in the syncytiotrophoblastic cells. The specimen was moderately positive for keratin and negative for alpha-fetoprotein. PMID- 3820392 TI - Aplasia of nasal cilia with situs inversus, azoospermia and normal sperm flagella: a unique variant of the immotile cilia syndrome. AB - A 23-year-old man with situs inversus and bronchiectasis was investigated because of azoospermia. Serum levels of testosterone and pituitary gonadotropins were normal. Scrotal exploration revealed no abnormalities of the testes, epididymides or vasa deferentia. Electron microscopy of a testicular biopsy specimen revealed a normal sperm flagellum structure, including the presence of dynein arms but 2 separate biopsies of the nasal mucosa revealed complete ciliary aplasia. This case, which bears a striking resemblance to Young's syndrome (bronchiectasis and azoospermia), represents a unique variant of the immotile cilia syndrome. PMID- 3820393 TI - Intravesical alum irrigation for intractable bleeding secondary to adenocarcinoma of the prostate. AB - We report on 2 patients in whom intractable hematuria was caused by carcinoma of the prostate. Since the hematuria failed to respond to conservative measures, intravesical 1 per cent alum irrigation was used. Hematuria resolved in both patients and no toxicity was observed. Intravesical alum irrigation should be considered in any patient with significant hematuria secondary to carcinoma of the prostate in whom conservative therapy has failed. PMID- 3820394 TI - Time lapse videomicroscopic identification of Dunning R-3327 adenocarcinoma and normal rat prostate cells. AB - A method for accurate prediction of prognosis in human prostatic cancer does not exist. The limitations of pathologic grading systems may result from the failure of standard pathological examination of fixed dead tissue to accurately assess the biological behavior of live tumor cells. Many of the sublines of the Dunning R-3327 rat adenocarcinoma are histologically similar yet differ widely in their metastatic potential. The nonmetastatic G, occasionally metastatic AT-1 and AT-2, and highly metastatic AT-3 and MAT-Lu Dunning sublines, and normal dorsal prostate were grown in culture and filmed by time-lapse videomicroscopy. Cell membrane ruffling, undulation and pseudopodal extension, vectoral translation, irregularity of pathway, and overall subjective motility (gestalt) were visually graded. Intra-assay, intra-observer, and inter-observer reproducibility were 75, 80 and 75% respectively. The combination of ruffling, pseudopodal extension and vectoral translation was most successful in identifying the six sublines. To validate this technique prospectively, five tumor sublines and two normal prostates were graded by 10 observers unfamiliar with the technique. Fifty-nine percent of unknowns were correctly identified when motility profiles were compared to previously developed standards by least sum of squares analysis. We devised a new technique for characterizing the motility of living prostate cells which was more accurate in identifying normal rat prostate and the Dunning sublines than standard pathological examination. Prostatic cancer cell motility may reflect biological behavior and metastatic potential and thus contribute to the assessment of an individual patient's prognosis. PMID- 3820395 TI - Characterization of a human chorionic gonadotropin-producing testicular choriocarcinoma cell line. AB - A testicular choriocarcinoma cell line designated JHTK-1 was established in vitro from a mixed germ cell tumor xenografted into nude mice, and may prove to be the first human choriocarcinoma cell line of testicular origin in long-term culture. The cells have been kept in culture for three years and produce human chorionic gonadotropin persistently. The chromosome number distribution ranged from tetraploidy to septaploidy, and trypsin G-band karyotyping showed that all the chromosomes were of human origin. Dibutyryl cyclic adenosine monophosphate at a concentration of 1 mM caused more than 15-fold stimulation of human chorionic gonadotropin secretion with morphological alteration in JHTK-1 cells. This suggests that dibutyryl cyclic adenosine monophosphate induces the differentiation of cytotrophoblastic cells into syncytiotrophoblastic cells among JHTK-1 cells. When JHTK-1 cells were heterotransplanted into the subcutis of BALB/c nude mice, large cystic tumors were produced with histological characteristics similar to choriocarcinoma. PMID- 3820396 TI - The effect of the thromboxane A2 synthesis inhibitor OKY-046 on renal function in rabbits following release of unilateral ureteral obstruction. AB - A marked decrease in renal blood flow (RBF) and glomerular filtration rate (GFR) was found after 24, 48 and 72 hours of total unilateral ureteral obstruction (UUO) in the rabbit. Contralateral GFR showed a modest increase consistent with compensatory hypertrophy. The urinary excretion of thromboxane B2 (TxB2), the stable metabolite of the vasoconstrictor prostaglandin, thromboxane A2 (TxA2) was significantly elevated in the urine obtained following release of the obstructed ureter when compared to the TxB2 level in the urine from the contralateral kidney. Continuous infusion of OKY-046 at 100 micrograms./kg./min. over 24 hours during UUO decreased TxB2 excretion by greater than 80 per cent. However there was no significant preservation of RBF or GFR of the obstructed kidney following ureteral release despite the selective inhibition of TxA2. Moreover the increase in contralateral GFR was also abolished. Taken together with other studies these results strongly suggest that the potent vasoconstrictor TxA2 is not responsible for the rise in renal resistance that follows acute UUO. PMID- 3820397 TI - American Urological Association, Inc. Eighty-second annual meeting. May 17-21, 1987, Anaheim, California. Abstracts. PMID- 3820398 TI - The second-generation vascular surgeon. PMID- 3820399 TI - Late survival in abdominal aortic aneurysm patients: the role of selective myocardial revascularization on the basis of clinical symptoms. AB - Coronary artery disease is recognized as the major cause of perioperative and late death after abdominal aortic aneurysm (AAA) repair. Routine coronary angiography and prophylactic myocardial revascularization for all significant lesions, regardless of symptoms, have been recommended as a means of reducing this mortality risk. We have advocated a more selective approach in which coronary angiography and myocardial revascularization are performed on the basis of cardiac symptoms. Studies have shown that this selective approach is just as effective as the prophylactic approach in reducing perioperative deaths. To evaluate the effect on late survival of selective myocardial revascularization on the basis of symptoms, we reviewed the preoperative coronary status and course of 485 patients who successfully underwent AAA repair between 1980 and 1985. Late survival was evaluated by means of the Kaplan-Meier method and compared with life expectancy of an age- and sex-matched population. Late survival of the entire group of patients was no different from that of the matched population. Patients with no preoperative evidence of coronary artery disease did significantly better than expected (p = 0.05), whereas those patients with uncorrected or previously bypassed coronary disease had survival no different from that expected. When age was considered as a variable, patients in their 50s and 60s had survival significantly worse than the matched population (p less than 0.001 and p = 0.003, respectively). Patients in their 70s and 80s had survival as good as or better than the matched population, regardless of coronary status.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820400 TI - A screening sequence for vasculogenic impotence. AB - Delineation of neural, arterial, and venous components contributing to penile erectile failure is critical to proper patient selection for surgical interventions, particularly for a subset of men with impotence as the sole manifestation of pelvic arterial disease. In addition to obtaining a history and physical examination specific for disordered erectile function and vascular risk factors, we developed a sequence of testing to include noninvasive estimates of penile perfusion, pulse volume recording (PVR), and penile/brachial blood pressure indices (PBPI); somatosensory evoked potentials from dorsal penile (PEP) and posterior tibial nerve stimulation (SEP) and bulbocavernosus reflex time (BCR); stimulation of artificial erection with injection of papaverine (AE); and selective hypogastric-pudendal arteriography with patients under epidural anesthesia, and corpus cavernosography with AE. Three hundred fifty-three men complaining of impotence were screened by PVR and PBPI; among these 42 impotent men and 20 additional concurrent potent control subjects had evoked potentials and BCR measurements, and 55 men received one or more AE injections. On the basis of these results, angiographic investigation was recommended. Age and risk factors were similar in the two groups. Abnormal penile blood perfusion was associated significantly only with cigarette smoking (p less than 0.0001) or overt large vessel disease. Impotent men with (138) or without perfusion abnormalities (215) averaged 54 and 56 years of age, respectively; impotent men with normal flow patterns most commonly had treated hypertension or diabetes (79 of 215 men). Covert neurologic abnormalities were detected in 28 of 42 impotent men. Abnormal penile perfusion plus failure of AE predicted isolated ischiopudendal trunk or pudendal artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820401 TI - The risk of stroke in patients with asymptomatic carotid stenosis undergoing cardiac surgery: a follow-up study. AB - During a 7-year period, 4047 patients underwent a battery of noninvasive carotid tests before cardiac surgery. Two thirds of the patients with abnormal studies underwent carotid angiography. One hundred fifty-three patients (3.8%) had significant carotid disease, narrowing the luminal diameter by greater than 50%. The incidence of transient ischemic attack or cerebrovascular accident following cardiac surgery was 1.9% in those patients with no carotid disease and 9.2% in those patients with carotid lesions. The incidence of transient ischemic attack or cerebrovascular accident in 32 patients with inoperable (occluded) carotid vessels was 15.6% and in 121 patients with operable (stenotic) lesions was 7.4%. In the group of patients with stenosis, 57 patients underwent carotid operation with an 8.8% incidence of neurologic deficit. During the last 1 1/2 years, no patient with asymptomatic carotid stenosis underwent simultaneous carotid and coronary surgery. Four of 64 patients with combined lesions but no carotid surgery (6.3%) had a neurologic deficit, one of which was severe and permanent. The highest incidence of neurologic dysfunction occurred in patients with unilateral occlusions and contralateral stenosis. Four of 12 patients in this group had a deficit (three of seven patients underwent operation; one of five did not), one of which was permanent. The operative mortality rate after cardiac surgery was three times higher in patients with carotid disease than in those patients with normal carotid arteries. Combined carotid and coronary surgery is currently reserved for patients with neurologic symptoms and severe cardiac disease. PMID- 3820402 TI - Relief of nonhemispheric symptoms in low flow states by anterior circulation revascularization: a physiologic approach. AB - Operative intervention remains controversial for patients with transient nonhemispheric symptoms with occlusive disease of both the anterior and posterior cerebral circulations. In addition to the standard evaluation of these patients, we have used stable xenon-enhanced computed tomographic mapping of cerebral blood flow (Xe/CT CBF). This relatively new and potentially widely available CBF methodology, by measuring approximately 30,000 CBF values within each of three CT levels, provides a readily interpretable means of evaluating extremes of hemodynamic compromise within any or all vascular territories. In the past 30 months, Xe/CT CBF studies in 300 patients with occlusive vascular disease have identified nine patients with global low flow and nonhemispheric symptoms (vertigo, lightheadedness, and/or blurred vision). Blood pressures determined by ocular pneumoplethysmography of Gee were markedly abnormal with reduced ocular/brachial ratios. Each patient had a combination of both segmental carotid and vertebrobasilar occlusive disease. Each patient had a flow-augmenting procedure performed on the anterior circulation in an attempt to improve global flow: carotid endarterectomy (two patients), subclavian-external carotid bypass (one patient), and superficial temporal artery-middle cerebral artery bypass (six patients). In each case disabling transient symptoms were relieved. There were no operative deaths, but one stroke occurred, probably as a result of a brief period of postoperative hypotension. Postoperative Xe/CT CBF studies show a long-term improved global CBF in all patients. PMID- 3820403 TI - Reoperation for polytetrafluoroethylene bypass failure: the importance of distal outflow site and operative technique in determining outcome. AB - Of 724 bypasses with polytetrafluoroethylene grafts performed for critical ischemia during a 6-year period, 165 (23%) failed and necessitated reoperation for continued limb salvage. Forty-three failures occurred in 199 femoral-above knee-popliteal bypasses (F-AKP), 33 failures in 177 femoral-below-knee-popliteal bypasses (F-BKP), 52 failures in 182 femorodistal bypasses (F-D), 28 failures in 85 axillofemoral bypasses (Ax-F), and nine failures in 81 femorofemoral bypasses (F-F). Our reoperative approach consisted of dissection of the distal anastomosis, longitudinal incision in the hood of the graft directly over the anastomosis, and proximal graft thrombectomy. Intimal hyperplasia was treated by patch angioplasty, proximal or distal progression of atherosclerosis was treated by a graft extension, and thrombectomy alone was performed when no cause of graft failure was identified. More recently, a totally new bypass was constructed in 27 cases of F-BKP or F-D failures. Reoperations featuring graft salvage for failed extra-anatomic and F-AKP bypasses yielded 3-year patency rates from the time of first reoperation of 71% and 52%, respectively, whereas for F-BKP and F-D reoperations, 3-year patency rates were 13% and 15%, respectively, at 3 years. However, totally new grafts to a different outflow artery in these settings had 3 year patency rates of 48% and 39%. These data support the aggressive use of reoperation with graft salvage when F-AKP or extra-anatomic graft failure reproduces critical ischemia. Conversely, a new bypass to a virginal outflow site, preferably with autologous vein, should be performed when a polytetrafluoroethylene F-BKP or F-D bypass fails. PMID- 3820404 TI - Long-term follow-up of patients having infrainguinal bypass performed below stenotic but hemodynamically normal aortoiliac vessels. AB - Because infrainguinal bypasses performed on the basis of normal papaverine testing in patients with multilevel arterial occlusive disease are done below arteriographically diseased although hemodynamically normal vessels, there is concern about progression of suprainguinal disease compromising long-term success. This study has been done to assess the long-term results of such bypasses. Between 1979 and 1985, infrainguinal bypasses selected by papaverine testing were done on 92 limbs having hemodynamically normal inflow in the presence of arteriographically demonstrable aortoiliac stenoses of 15% to 70%. Long-term hemodynamic and clinical success rates were determined with criteria based on papaverine and noninvasive vascular testing. There was no significant difference in hemodynamic success at 48 months (by life-table analysis) (p = 0.98) when comparing limbs with less than 50% aortoiliac stenoses to limbs having 50% or greater stenoses. The difference between the mean degree of preoperative inflow stenoses for long-term hemodynamic successes (32.5% +/- 1.5%) and failures (34.6% +/- 3.0%) was not significant (p = 0.57). There was no significant difference (p = 0.98) in the number of subsequent inflow procedures required in limbs with preoperative aortoiliac stenoses of less than 50% (13.5%) vs. aortoiliac stenoses of 50% or greater (13.3%). Long-term results of infrainguinal bypass done below stenotic but hemodynamically normal aortoiliac vessels are not related to the amount of angiographically demonstrable inflow stenosis. Selection of patients for infrainguinal bypass on the basis of papaverine testing, irrespective of angiographic findings, eliminates unnecessary inflow procedures without detriment to long-term success. PMID- 3820405 TI - Correction of enhanced endothelial permeability by cessation of cholesterol feeding. AB - Changes in endothelial permeability and the transport of macromolecules may be important in the initiation and/or progression of atherosclerosis. We have previously shown, with a carotid artery preparation isolated in situ with intact adventitia, that long-term cholesterol feeding in rabbits will result in a seven- to tenfold increase in 125I albumin transport across the artery into the systemic circulation. The current studies were undertaken to determine whether this abnormality of enhanced permeability could be reversed by cessation of cholesterol feeding and correction of the hyperlipidemia. Two groups of rabbits were fed either a standard Rabbit Chow or a diet containing 1.5% cholesterol and 5.2% corn oil for 12 to 15 weeks. Another group of rabbits was given cholesterol for 12 to 15 weeks with change to standard rabbit chow for an additional 22 to 24 weeks after which albumin transport studies were then performed. Mean plasma cholesterol level after 12 to 15 weeks of cholesterol feeding was 2052 +/- 395 mg/dl. After the animals were withdrawn from the cholesterol diet for 22 to 24 weeks, the mean plasma cholesterol level decreased to 80 +/- 21 mg/dl. The mean plasma cholesterol value in chow-fed animals was 39 +/- 6 mg/dl. Perfusion studies were done with 125I-labeled albumin and plasma radioactivity served as a measure of transport across the carotid artery. The average level of albumin transport across the artery into venous blood in the cholesterol-fed animals (13,911 dpm/ml of plasma) was significantly greater than that of control animals (2049 dpm/ml of plasma).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820406 TI - Acute renal artery occlusion: when is revascularization justified? AB - Acute renal artery occlusion is an infrequently encountered entity, with a paucity of literature on which to form clinical decisions. During a 20-year period 35 patients were treated for acute renal artery occlusion as a result of embolism (13 patients), thrombosis of a stenosed vessel (16 patients), or trauma (six patients). Patients were treated operatively in 16 cases and nonoperatively in 19 cases. In patients with embolic occlusion, embolectomy was successful in the relief of hypertension but was ineffective in the restoration of renal function. In patients with thrombotic occlusion, thrombectomy and aortorenal bypass were successful in both the reduction of blood pressure and the retrieval of renal function. In this group, salvage was dependent on the presence of a reconstituted distal renal artery, irrespective of the operative delay. In patients with traumatic renal artery occlusion, return of renal function did not occur, despite reperfusion as early as 6 hours after injury. These data suggest that the period in which function of embolized or traumatized kidneys may be preserved has usually passed by the time the diagnosis of renal artery occlusion has been made. By contrast, operative therapy of thrombotic occlusion frequently results in return of renal function, irrespective of the delay in treatment. PMID- 3820407 TI - The predictability of the success of arterial reconstruction by means of transcutaneous oxygen tension measurements. AB - The cases of 100 patients with severe peripheral vascular disease were reviewed to determine whether the success or feasibility of arterial reconstruction could be correlated with the increase in transcutaneous tissue oxygen tension (tcPO2) that occurs in all persons when assuming an erect posture from the supine position. Resting supine tcPO2 levels of 20 mm Hg or less at the foot were noted in all patients in this study (normal values 60.10 +/- 6.82 mm Hg). Group I patients were defined by an increase of less than 15 mm Hg on standing, whereas group II patients showed an increase of 15 mm Hg or more. Group I patients had a supine tcPO2 value of 4.24 +/- 5.31 mm Hg, with an increase of 3.91 +/- 4.59 mm Hg on standing. The group II subjects also had a low supine tcPO2 level, 5.73 +/- 4.98 mm Hg, but the increase on standing, 36.14 +/- 11.41 mm Hg, was significantly higher (p less than 0.001). When these levels increased by less than 15 mm Hg on standing in group I (31 patients), only 29% of limbs (10 of 34) were saved or had patent grafts at 3 months and 55% of attempted vascular reconstructions (11 of 20) failed. Amputations were performed in 50% of the limbs (17 of 34). This contrasted in group II (69 patients) with a significantly higher limb salvage and graft patency rate (81%, 57 of 70 limbs), success of reconstruction (79%, 37 of 47 procedures), and a significantly lower rate of amputation (11%, 8 of 70 limbs) (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820408 TI - Reoperation for aortofemoral graft limb occlusion: optimal methods and long-term results. AB - To determine optimal methods of reoperation, experience with 157 secondary procedures for unilateral aortofemoral graft limb occlusion in 110 patients during a 16-year period was reviewed. In earlier years, inflow was reestablished by direct replacement of the graft limb or entire graft (11%); more recently, graft limb thrombectomy has been used most frequently (68%) with equal success, durability, and less morbidity. Femorofemoral grafts from the patent contralateral graft limb were employed in 18% of patients, usually those in whom thrombectomy was not attempted. Thrombolytic therapy (3%) appears to offer little advantage, is time-consuming, and occasionally causes significant complications. In addition to reestablishment of inflow, most patients also required revision of the femoral anastomosis to improve profunda femoris runoff; this was usually best accomplished by short segmental extension of the graft limb to the more distal deep femoral artery. Concomitant femoropopliteal bypass was done in 32% of patients and is indicated when preoperative angiography or specific intraoperative findings suggest inadequate profunda femoris outflow. An aggressive approach to reoperation appeared justified by long-term results (mean follow-up 37 months). Despite the need for repetitive reoperation in 26% of patients (two to five reoperations), graft limb patency was ultimately maintained in 78% and limb salvage achieved in 67% of patients, with an operative mortality rate of only 1.9%. PMID- 3820409 TI - Chronic digitalis administration alters mesenteric vascular reactivity. AB - To characterize any digitalis-induced differences in intestinal blood flow autoregulation, we studied the circulatory responses of the rat intestine in control (n = 7) and chronically digitalized (n = 7) animals. Data were generated from denervated isoperfused small intestinal preparations. Arterial pressure, venous pressure, and oxygen consumption were continuously monitored. Determinations of intestinal blood flow allowed calculation of mesenteric vascular resistance and oxygen consumption. Animals underwent stepwise reductions in arterial pressure and acute venous hypertension (10 to 15 mm Hg). There were no differences in baseline hemodynamic or metabolic parameters in control (C) or digitalized (D) animals. Blood flow and oxygen consumption were autoregulated in both C and D rats until perfusion pressure decreased below 50 mm Hg. The response to acute venous hypertension was different. In D rats, venous hypertension resulted in increased vascular resistance (millimeters of mercury per milliliter per minute per 100 gm) [0.89 +/- 0.05 to 0.97 +/- 0.07; p less than 0.05], whereas C rats demonstrated no change [0.92 +/- 0.08 to 0.95 +/- 0.09]. The decrease in oxygen consumption in D rats (-14%) was slightly but significantly greater than that observed in C rats (-9%). Digitalized rats demonstrated a heightened myogenic response to acute venous hypertension with deleterious effects on vascular resistance and oxygen consumption. This reaction was intrinsic to the mesenteric circulation and not mediated by sympathetic nerves or central reflexes. Nonocclusive mesenteric ischemia in digitalized patients may reflect a similar abnormal response to the acute increases in portal pressure accompanying cardiac failure. PMID- 3820410 TI - The effects of endothelial injury on smooth muscle cell proliferation. AB - The endothelial injury induced by the placement of a synthetic graft has been implicated as a stimulus for the development of MIH. In this study we compared the degree of EC coverage and the early SMC-PR in the arterial segments proximal and distal to 2 mm diameter PTFE grafts that had been placed in rabbit carotid arteries (n = 49). In vivo labeling with 3H-thymidine and Evans blue was carried out at intervals of 2 to 33 days after grafting. The SMC-PR was measured as the degree of 3H-labeled DNA divided by the total DNA for each segment, and the EC coverage was determined by planimetry of the area of Evans blue exclusion. There was an early rise in the SMC-PR in both arterial segments, but it was more marked in the distal segment (p less than 0.001). There was no correlation between the SMC-PR and the degree of EC coverage in either the proximal (r = 0.25) or the distal segments (r = 0.10). The data suggest that there is a greater SMC-PR at the distal end of an implanted PTFE graft. The degree of endothelial loss and its regrowth does not appear to be an important factor. PMID- 3820411 TI - Mortality of captive tortoises due to viviparous nematodes of the genus Proatractis (Family Atractidae). AB - Between September 1982 and January 1984, verminous colitis was diagnosed post mortem in eight red-footed tortoises (Geochelone carbonaria) and three leopard tortoises (Geochelone pardalis) from the reptile collection of the National Zoological Park. This represented 69% of 16 tortoise necropsy accessions for that period. Etiology was determined to be a viviparous pinworm-like nematode of the genus Proatractis (Family Atractidae). Clinical signs were either nonspecific, consisting of anorexia, lethargy, and depression, or were absent. Limited trials with piperazine citrate and fenbendazole appeared to be ineffectual against the parasite and supportive therapy was unsuccessful. Post mortem examination revealed roughening and thickening of the mucosa of the cecum and colon, and in severe cases myriads of tiny (0.5-1.0 cm) nematodes were evident on the mucosal surface. In six tortoises, worms were found also in the small intestine. Histopathologic features in severe cases included mucosal necrosis with parasites and mixed inflammatory cells extending into the tunica muscularis. Focal to diffuse lymphoplasmacytic infiltrates were present consistently in the submucosa of the cecum and colon, and similar but milder lesions occasionally occurred in the small intestine. PMID- 3820412 TI - Visceral helminth communities of sympatric mule and white-tailed deer from the Davis Mountains of Texas. AB - Hybridizing populations of mule (Odocoileus hemionus) and white-tailed deer (O. virginianus) from the Davis Mountains of Texas were examined to determine similarities in species composition of their helminth communities and if abundances of helminth species in those communities varied across host species and seasonal factors. Only three cestode and three nematode species were recovered. There were very low abundances of species and little diversity in the helminth communities of both hosts. Common helminth species were shared by both deer, and the significant variance in abundances of three of the four most common helminth species appeared to result from differences in habitat preferences of the respective hosts. Our results indicated that analyses of helminth communities of deer from this geographical area do not provide a useful quantification technique for determining deer condition, degree of hybridization, or levels of intraspecific competition. PMID- 3820413 TI - Pathogenicity of Eimeria lettyae Ruff, 1985 in the northern bobwhite (Colinus virginianus L.). AB - Sporulated oocysts of Eimeria lettyae were administered orally to 5-day-old or 18 day-old northern bobwhites (Colinus virginianus, L.). Five-day-old bobwhites were more susceptible based on higher mortality and reduced weight gain. A dose of 5 X 10(5) oocysts produced 25-43% mortality in 5-day-old bobwhites, but none in 18 day-old bobwhites. A dose of 1 X 10(6) oocysts/bobwhite produced 83-100% mortality in 5-day-old bobwhites, and 17-83% mortality in 18-day-old bobwhites. Body weight gain was reduced significantly with a dose of 1 X 10(5) oocysts or greater in 5-day-old bobwhites and with a dose of 5 X 10(5) oocysts or greater in 18-day-old bobwhites. Infection in all age groups reduced concentrations of plasma pigment and plasma protein, but did not affect packed cell volumes. No grossly visible lesions were present in the intestine although there was a shortening of the villi in the duodenum. In mature bobwhites, infection with E. lettyae did not cause mortality, but did reduce egg production and fertility. PMID- 3820414 TI - Mortality of waterfowl on a hypersaline wetland as a result of salt encrustation. AB - Approximately 300 geese, primarily lesser Canada geese (Branta canadensis parvipes) were found unable to fly or dead on a small hypersaline lake (conductivity 77,000-90,000 mumhos/cm) in western Saskatchewan in September 1985. The birds were heavily encrusted with sodium sulfate crystals. Dead birds that were necropsied had aspirated lake water and had evidence of acute muscle degeneration. The live geese (155) were captured and moved to nearby freshwater wetlands where most apparently survived. Some birds died of severe myopathy after translocation. Five northern shovelers (Anas clypeata) were found encrusted with salt and unable to fly on the lake approximately 10 days later. Salt encrustation apparently occurred when rapid cooling of the lake resulted in supersaturation and crystallization of the dissolved salt. A local resident recalled similar events occurring on the lake in autumn on at least two other occasions during the past 50 yr. PMID- 3820415 TI - Effects of fluoride emissions from a modern primary aluminum smelter on a local population of white-tailed deer (Odocoileus virginianus). AB - The influence of fluoride emissions from a modern aluminum smelter on concentrations of skeletal fluoride and dental fluorosis in a resident population of white-tailed deer was studied. The smelter was located on Mount Holly Plantation in South Carolina, and concentrations of skeletal fluoride in the deer collected at Mount Holly increased approximately five-fold 3 yr after the operation began. Increases in skeletal fluoride of less than two-fold were observed in deer obtained from Medway Plantation which has its nearest boundary 1.6 km from the smelter site. No dental fluorosis was observed in deer collected at Medway Plantation, but mild dental fluorosis was observed in a significant number of deer collected at Mount Holly Plantation. The dental fluorosis that was observed was not associated with incisor wear or with fluoride-induced molar wear. Osteofluorosis of mandibles or metacarpals was not observed in any of the deer obtained from either plantation. The data obtained from this study indicated that the presence of a modern aluminum smelter caused a detectable increase in concentration of skeletal fluoride in the resident population of white-tailed deer, but that no adverse health effects were seen. PMID- 3820416 TI - Hematologic values of the endangered San Joaquin kit fox, Vulpes macrotis mutica. AB - Between 1981 and 1982 blood samples were collected from 64 adult San Joaquin kit foxes, Vulpes macrotis mutica, in western Kern County, California. The goal of the study was to establish normal blood values for this endangered species, and to determine whether changes in them could be used to assess the possible effects of petroleum developments on these foxes. None of the values differed significantly between the sexes, or between foxes sampled in developed habitats compared with foxes sampled in undisturbed habitats. Mean values of Hb, MCH, MCHC, and WBC counts differed significantly between summer and winter. Average hematological characteristics were: RBC, 8.4 X 10(6)/microliter; Hb, 14.5 g/dl (summer), 15.6 g/dl (winter); PCV, 46.9%; MCV, 56.3 fl; MCH, 17.8 pg (summer), 18.4 pg (winter); MCHC, 31.2 g/dl (summer), 33.2 g/dl (winter); and WBC, 6,200/microliter (summer), 7,500/microliter (winter). Comparisons of hematological data for kit foxes, coyotes (Canis latrans), and wolves (Canis lupus) confirmed a previously published observation that within mammalian families RBC counts are correlated inversely with body weight, and that MCV is correlated directly with body weight. PMID- 3820417 TI - Neutralizing activity against infectious pancreatic necrosis virus in striped bass, Morone saxatilis, from the Chesapeake Bay. PMID- 3820418 TI - Plague in a free-ranging mule deer from Wyoming. PMID- 3820419 TI - Ostertagiosis in a white-tailed deer due to Ostertagia ostertagi. PMID- 3820420 TI - Clinical mange of the black bear (Ursus americanus) caused by Sarcoptes scabiei (Acarina, Sarcoptidae). PMID- 3820422 TI - Ingested lead shot in northern red-billed whistling ducks (Dendrocygna autumnalis) and northern pintails (Anas acuta) in Sinaloa, Mexico. PMID- 3820421 TI - Organochlorine residues in ducks on Playa Lakes of the Texas panhandle and eastern New Mexico. PMID- 3820423 TI - Acute myocarditis in a captive African elephant (Loxodonta africana). PMID- 3820424 TI - Quality deer serum without a centrifuge. PMID- 3820425 TI - Epizootiology of anthrax and Nyasa wildebeest in the Selous Game Reserve, Tanzania. PMID- 3820426 TI - Seroconversion rates to Jamestown Canyon virus among six populations of white tailed deer (Odocoileus virginianus) in Indiana. AB - The annual seroconversion of fawns, yearlings, and adult white-tailed deer (Odocoileus virginianus) to Jamestown Canyon virus (California group) was followed at six Indiana sites from 1981 through 1984. In all, sera from 1,642 deer (515 fawns, 618 yearlings, and 509 adults) were tested for neutralizing antibody to three California serogroup viruses: Jamestown Canyon, La Crosse, and trivittatus. Virtually all deer with specific neutralizing antibody showed evidence of a prior infection with Jamestown Canyon virus; only three deer showed evidence of a prior infection with only La Crosse virus and none showed evidence of an infection with only trivittatus virus. While there were no significant differences in antibody prevalence to Jamestown Canyon virus between yearling and adult deer at any site, fawns had significantly lower antibody prevalences than either of the two older age groups. Significant differences in antibody prevalence were found between northern versus southern populations of white tailed deer in Indiana, however, no significant differences were found among the four northern populations or between the two southern populations. The mean antibody prevalences in the two southern fawn, yearling, and adult populations were 15%, 38%, and 41% respectively, while the prevalences in the four northern fawn, yearling, and adult populations were 5%, 67%, and 67% respectively. These different prevalences (northern vs. southern) correlate with the higher Jamestown Canyon virus antibody prevalence in human residents of northern Indiana (2-15%) compared to residents of southern Indiana (less than 2%) found in other studies. The significantly lower prevalence of antibody to Jamestown Canyon virus in fawns is attributed to maternal antibody protecting them from a primary infection their first summer. Yearling deer showed high rates of seroconversion following their second summer of life. These results suggest that infection of white-tailed deer in Indiana with Jamestown Canyon virus is a common phenomenon. PMID- 3820427 TI - Antibodies to marine caliciviruses in the Steller sea lion (Eumetopias jubatus Schreber). AB - Sera from 145 Steller sea lions (76 adults, three subadults, 37 pups, and 29 fetuses) were tested for neutralizing antibodies to nine marine calicivirus serotypes. Antibodies were found to San Miguel sea lion virus (SMSV) types 1, 5, 6, 7, 8, 10 and 13, and to Tillamook (bovine) calicivirus, but no antibodies were found to the walrus calicivirus. Titers (microtiter neutralization assay) ranged from 1:20 to 1:320, with many positive reactions at the higher dilutions (greater than or equal to 1:80). Antibodies to SMSV's 5 and 10 were most common among animals sampled in Alaskan waters, while antibodies to SMSV-6 were most common among pups from the southern Oregon coast. These data provide evidence that Steller sea lions, like their California sea lion (Zalophus c. californianus Lesson) counterparts, have experienced widespread exposure to multiple serotypes of marine caliciviruses. PMID- 3820428 TI - Prevalence and distribution of serum neutralizing antibodies to Tillamook (bovine) calicivirus in selected populations of marine mammals. AB - Neutralizing antibodies to Tillamook calicivirus (TCV) were found in sera collected from California sea lions (Zalophus c. californianus Lesson) in 1983 and 1984 and in sera collected from Steller sea lions (Eumetopias jubatus Schreber) in 1976 and 1985. The combined prevalence of antibodies for these two species was 10/228 = 4.38%. Titers ranged from 1:20 (five animals), to 1:40 (four animals), to 1:80 (one animal) by standard microtiter neutralization assay. The seropositive pinnipeds were dispersed widely along the margins of the eastern Pacific rim, from the Bering Sea to the Santa Barbara Channel. Antibodies to TCV were not found in sera collected from northern fur seals (Callorhinus ursinus L.), Pacific walruses (Odobenus rosmarus divergens Illiger), seals of the family Phocidae, or several cetacean species. Tillamook calicivirus was isolated originally in 1981 from dairy calves in Oregon; the finding of neutralizing antibodies in two widely distributed species of sea lions suggests the possibility of a marine origin for this agent. PMID- 3820429 TI - Leptospires in vervet monkeys (Cercopithecus aethiops Sabaeus) on Barbados. AB - Agglutinins to Leptospira were found at titers of greater than or equal to 1:100 in 150 of 501 (29.9%) vervet monkeys (Cercopithecus aethiops sabaeus) bled within 1 mo of capture in Barbados. Including a further 34 of 145 bled within 1 yr of capture, the seropositivity prevalence was 28.5%. A further 35 monkeys (5.4%) had traces of agglutinins or gave titers of 1:50. The proportion of seropositive adults (41.5%) was more than twice that of seropositive immature monkeys (17.6%). Among adults, 49.2% of males and 35.7% of females were seropositive, while among juveniles proportions of seropositive males and females were similar (17.8% and 17.4%, respectively). Seropositivity prevalences tended to increase in proportion to rainfall. In each of 165 of the 184 positive sera, a single serogroup predominated in the serological reactions. These serogroups were Ballum (61%), Icterohaemorrhagiae (16%), Autumnalis (15%), Pyrogenes, Panama, Pomona, Tarassovi and Canicola (8% altogether). In the other 19 positive sera no single serogroup predominated. Serial bleeding showed that vervet monkeys can retain naturally acquired antibodies to Leptospira for at least 2.5 yr. The evidence suggests that vervet monkeys in Barbados are transmitting leptospiral infections among themselves independently of other groups of animals, and are not a major source of human leptospirosis. PMID- 3820430 TI - Serology and virology of the bowhead whale (Balaena mysticetus L.). AB - Sera from four bowhead whales (Balaena mysticetus L.) were examined for the presence of specific antibodies, and tissue and swab samples from six and four animals respectively were processed for isolation of viruses and for initiation of bowhead whale cell cultures. All sera were negative for antibodies to nine serovars of Leptospira interrogans and to 21 orthomyxovirus subtypes and a paramyxovirus (Newcastle disease virus). All sera were positive, however, for neutralizing antibodies to one or more calicivirus serotypes. Two untyped adenoviruses were isolated from colon samples of two different whales, but neutralizing antibodies to the agents could not be demonstrated in any sera. Three primary bowhead whale cell cultures were derived from kidney (two cultures) and testis (one culture), from three individual whales. PMID- 3820431 TI - Experimental infections of Babesia bigemina in American bison. AB - Babesia bigemina was experimentally transmitted from cattle to bison and back to cattle. One spleen-intact and two splenectomized American bison (Bison bison) inoculated with a B. bigemina stabilate exhibited clinical and hematological signs of babesiosis within 10 days of exposure. Blood from the infected bison produced disease in a splenectomized bovine steer. PMID- 3820432 TI - Laser may provide better channel, smoother lumen in future coronary arterial occlusions; full potential awaits improved technology. PMID- 3820433 TI - Calcium antagonists coming of age: heterogeneous class reveals broad therapeutic potential. PMID- 3820434 TI - Leads from the MMWR. Tuberculosis in minorities--United States. PMID- 3820435 TI - Leads from the MMWR. Use of supplements containing high-dose vitamin A--New York State, 1983-1984. PMID- 3820436 TI - Compassion. PMID- 3820437 TI - Sudden death: is there a human stress syndrome? PMID- 3820438 TI - Adverse reactions to antihypertensive drugs. PMID- 3820439 TI - Solar sneeze reflex. PMID- 3820440 TI - Aspirin in the treatment of chronic inflammatory arthritis. PMID- 3820441 TI - Sick stethoscopes modified and debugged. PMID- 3820442 TI - Silly hematurias: achtung! It's the goose step. PMID- 3820443 TI - Prevention of travelers' diarrhea by the tablet formulation of bismuth subsalicylate. AB - Within 48 hours of arrival in Mexico, 182 US students participated in a study to compare the efficacy of two dosages of bismuth subsalicylate (262 mg per tablet) as a prophylactic agent against diarrhea. The students were randomly assigned to receive two tablets (high dose) or one tablet (low dose) of bismuth subsalicylate four times daily or a placebo four times daily during a three-week period. Among these completing the trial, diarrhea (four or more unformed stools in 24 hours or three in eight hours, plus one other symptom) occurred in seven (14%) of 51 receiving the high-dose regimen compared with 15 (24%) of 63 receiving the low dose regimen and 23 (40%) of 58 in the placebo group. Protection rates were 65% for high-dose and 40% for low-dose bismuth subsalicylate. Diarrhea caused by enterotoxigenic Escherichia coli was found in one student receiving the high-dose regimen, in no students receiving the low-dose regimen, and in seven placebo treated subjects. Bismuth subsalicylate was well tolerated; the most common side effects were blackening of tongues and stools. Bismuth subsalicylate use in both dosages was associated with tinnitus at a low, clinically insignificant frequency of 1.2 days per 100 days of treatment. The dosage of two tablets of bismuth subsalicylate four times daily (2.1 g/d) appears to be a safe and effective means of reducing the occurrence of travelers' diarrhea among persons at risk for periods up to three weeks. PMID- 3820444 TI - Acellular and whole-cell pertussis vaccines in Japan. Report of a visit by US scientists. AB - Since the introduction of acellular pertussis vaccines in Japan late in 1981, more than 20 million doses have been administered, mostly to children 2 years of age and older. Clinical studies indicate that mild local and febrile reactions are less frequent after administration of acellular pertussis vaccines than after whole-cell vaccines. Serious adverse events with sequelae occurred in 2-year-old children at approximately the same low rate during the period 1975 through August 1981, when whole-cell vaccines were used, and during August 1981 through 1984, when acellular vaccines were used exclusively. Five household contact studies have yielded vaccine efficacy estimates ranging from 78% to 92% in children 1 year of age or older. In addition, there has been a continuing decrease in reported pertussis incidence from the epidemic peak in 1979. Additional data on the safety and efficacy of acellular pertussis vaccines administered to infants would be useful in consideration of acellular pertussis vaccine licensure in the United States. PMID- 3820446 TI - The years of living dangerously. PMID- 3820445 TI - Acellular and whole-cell pertussis vaccines in Japan: report of a visit by US scientists. PMID- 3820447 TI - Leads from the MMWR. Restaurant-associated botulism from mushrooms bottled in house--Vancouver, British Columbia, Canada. PMID- 3820448 TI - Leads from the MMWR. Guidelines for diabetic eye disease control--Kentucky. PMID- 3820449 TI - Leads from the MMWR. Outbreak of occupational hepatitis--Connecticut. PMID- 3820450 TI - Leads from the MMWR. An imported case of rabies in an immunized dog. PMID- 3820451 TI - Needle aspiration biopsy of the breast. PMID- 3820452 TI - The risk of breast cancer in American women. PMID- 3820453 TI - Selected sexual practices of San Francisco heterosexual men and risk of infection by the human immunodeficiency virus. PMID- 3820454 TI - Tuberculosis and the acquired immunodeficiency syndrome in prisoners. PMID- 3820455 TI - Health care in the year 2000. PMID- 3820456 TI - Standards for monitoring during anesthesia. PMID- 3820457 TI - Sudden nocturnal death in Southeast Asian refugees. PMID- 3820458 TI - The use of seat belts. PMID- 3820459 TI - Adverse reactions to antiarrhythmic drugs. PMID- 3820461 TI - The diagnosis of meningococcal meningitis. PMID- 3820460 TI - Oral desensitization for penicillin sensitivity. PMID- 3820462 TI - Bacterial vaginosis and the outcome of pregnancy. PMID- 3820463 TI - Remission of hypertension. The 'natural' history of blood pressure treatment in the Framingham Study. AB - Recent studies suggesting that adequate blood pressure control may be maintained without medication in some persons with mild hypertension have been limited by short follow-up and/or small sample size. The Framingham Heart Study provides an opportunity for long-term observation of antihypertensive medication use by a group of hypertensive subjects. While 801 (70%) of the 1138 cohort members taking such medication at two consecutive biennial examinations continued to receive medication until death or the end of observation, 242 subjects (21%) had blood pressure of at least 140/90 mm Hg and 95 subjects (8%) were normotensive at the first examination while not receiving medication. The 95 normotensive subjects had lower pretreatment blood pressure and a greater proportion with controlled blood pressure at 4, 8, and 12 years after first medication use than those in the first two groups. Eleven of these 95 subjects maintained good blood pressure control while not receiving medication for at least four years, including one subject who continued not to receive medication for 12 years. While virtually all hypertensive subjects eventually relapse, a small group may experience a period of remission of hypertension while not receiving medication. As further studies permit more specific identification of individuals who will do well while not receiving medication, guidelines for medical care of hypertensive persons will need to be updated. PMID- 3820464 TI - Falls and fractures in patients with Alzheimer-type dementia. AB - The prevention of fall-related injuries in patients with Alzheimer-type dementia (ATD) is hampered by an incomplete understanding of their causes. We studied falls and fractures in 157 ATD patients, including 117 with three-year follow-up. Initially all but one patient could walk; 31% reported falls. During follow-up, 50% either fell or became unable to walk. The fracture rate during follow-up (69/1000/y) was more than three times the age- and sex-adjusted fracture rate in the general population. Features of both ATD and comorbid conditions contributed to the risk of falls and fractures. In particular, patients who experienced toxic reactions to drugs on entry into the study were more likely to report they had fallen prior to entry (odds ratio, 4.9; 95% confidence interval, 1.78 to 13.3), and patients who wandered were more likely to sustain fractures (odds ratio, 3.6; 95% confidence interval, 1.25 to 10.4) during the follow-up period, including hip fractures for which the odds ratio of 6.9 (95% confidence interval, 1.66 to 28.6) was unexpectedly high. Preventive measures may be possible, including controlling wandering, avoiding toxic reactions to drugs, and treating comorbid illnesses. PMID- 3820465 TI - Erythrocyte reinfusion and maximal aerobic power. An examination of modifying factors. AB - Induced erythrocythemia is associated with a variable increase in maximal oxygen uptake. To examine the roles of the magnitude of change in hemoglobin concentration and the individual's initial aerobic fitness in this effect, we combined individual data from our own research and three other studies. In each study freeze-preserved erythrocytes from the product of 2 units of blood were reinfused, and maximal oxygen uptake was measured within 24 to 72 hours after reinfusion. The 30 subjects had an initial aerobic power of 36 to 88 mL of oxygen per kilogram per minute. The combined results from these studies indicate that after erythrocyte reinfusion the increase in hemoglobin concentration is fairly homogeneous (mean +/- SD, 1.36 +/- 0.6 g/dL [13.6 +/- 6 g/L]), nearly all individuals demonstrate an increase in maximal oxygen uptake (0.357 +/- 0.216 L/min), the magnitude of increase in hemoglobin concentration is not related to the magnitude of increase in maximal oxygen uptake, and the magnitude of increase in maximal oxygen uptake is related to the individual's initial aerobic fitness. Individuals with an initial aerobic fitness between 50 and 65 mL X kg-1 X min-1 experience approximately twice the increase in maximal oxygen uptake after erythrocyte reinfusion of individuals with greater fitness and also of lesser fitness. PMID- 3820466 TI - Patient dumping. Status, implications, and policy recommendations. PMID- 3820467 TI - A 73-year-old woman with abdominal pain in the right lower quadrant. PMID- 3820468 TI - Transfer of unstable patients: dumping or duty? PMID- 3820470 TI - Friable asbestos in schools must be found by May 1988, removal plan must start by 1989. PMID- 3820469 TI - Mesothelioma: has patient had contact with even small amount of asbestos? PMID- 3820471 TI - Leads from the MMWR. Demonstration to improve care practices for diabetic patients in primary care centers--Florida. PMID- 3820472 TI - Leads from the MMWR. Update: influenza activity--United States. PMID- 3820473 TI - Obesity, hypertension, and cardiovascular disease. PMID- 3820474 TI - Serum cholesterol and death from coronary heart disease. PMID- 3820475 TI - Cholesterol and exercise. PMID- 3820476 TI - Low-energy diets and prolonged QT intervals. PMID- 3820477 TI - Measuring serum cholesterol. PMID- 3820478 TI - Preventing death and injury from fires with automatic sprinklers and smoke detectors. Council on Scientific Affairs. AB - Resolution 2 (Annual Meeting 1985), which was referred to the Board of Trustees, asked the American Medical Association to urge government officials to require all new residential and nonresidential buildings to be equipped with rapid response automatic water sprinklers and smoke detectors and to require their installation in existing high-rise buildings within three years unless existing code requirements are more stringent. This response to the resolution is a summary of the literature up to June 1986. PMID- 3820479 TI - The use of literary classics in teaching medical ethics to physicians. PMID- 3820480 TI - Referral by default. The medical community and unorthodox therapy. PMID- 3820481 TI - The humanities in postgraduate training. PMID- 3820482 TI - Physicians aim to KO boxers' injuries; focus on eyes as title bout nears. PMID- 3820483 TI - Leads from the MMWR. Tuberculosis and AIDS--Connecticut. PMID- 3820484 TI - Leads from the MMWR. Survey of non-U.S. hemophilia treatment centers for HIV seroconversions following therapy with heat-treated factor concentrates. PMID- 3820485 TI - Leads from the MMWR. Outbreak of hepatitis B associated with an oral surgeon--New Hampshire. PMID- 3820486 TI - Lying to military physicians about risk factors for HIV infections. PMID- 3820487 TI - MD-MBA: a dual degree whose time has come. PMID- 3820488 TI - The age threshold for isoniazid chemotherapy. PMID- 3820489 TI - Standardization and CD-ROM. PMID- 3820490 TI - Naproxen and agranulocytosis. PMID- 3820491 TI - Catheter balloon valvuloplasty of the mitral valve in adults using a double balloon technique. Early hemodynamic results. AB - Catheter balloon valvuloplasty (CBV) using the double-balloon technique was performed on 12 symptomatic patients (mean age, 43 years) with rheumatic mitral valve stenosis. Two dilatation balloons were used in which the diameters approximately equaled the mitral valve anulus diameter as determined. After CBV, the mean mitral valve gradient decreased in all patients (mean +/- SD, 16 +/- 6 to 5 +/- 2 mm Hg), the mean left atrial pressure decreased (29 +/- 7 to 16 +/- 4 mm Hg), and the cardiac output increased (4.4 +/- 1.2 to 5.5 +/- 1.4 L/min). The mitral valve area increased from 1.0 +/- 0.3 to 2.4 +/- 0.8 cm2. Oximetry demonstrated small left to right shunts of pulmonary to systemic flow ratios of 1.4:1 and 1.3:1 in two patients. Mitral regurgitation did not increase. Gradual decreases in mean pulmonary artery pressures and pulmonary vascular resistance were recorded over the subsequent 24 hours. Our patients left the hospital two days after CBV. The New York Heart Association Functional Class improved in 11 of 12 patients. We conclude that CBV using the double-balloon technique effectively relieves mitral valve obstruction, reduces elevated pulmonary pressures, and reduces symptoms in selected adult patients with symptomatic mitral stenosis. PMID- 3820492 TI - Urinary incontinence among geriatric patients in an acute-care hospital. AB - The prevalence, time course, and factors associated with urinary incontinence were examined among 363 patients aged 65 years or older admitted to the acute medical and surgical services of a university hospital. Overall, 35% were incontinent of urine at some time during their hospital stay; incontinence was more common among women and among those older than 75 years. Indwelling catheters were used in 50% of the incontinent patients and 25% of the patients who were otherwise continent while in the hospital. Incontinence was associated with impaired cognitive and physical functioning and with treatment for urinary tract infections. In most of the patients who were incontinent while hospitalized, incontinence was a persistent phenomenon and had been present before hospitalization and was present afterward. Only 5% had "transient" or "nosocomial" incontinence. These data suggest that the acute-care hospital may provide a good opportunity for physicians to identify the often-ignored problem of incontinence, and to then initiate an appropriate diagnostic evaluation of this condition if it persists after hospital discharge. PMID- 3820493 TI - Blood pressure and metabolic effects of calcium supplementation in normotensive white and black men. AB - A randomized, double-blind, placebo-controlled trial was conducted to examine the effect of calcium supplementation on blood pressure in normotensive black (n = 21) and white (n = 54) men, aged 19 to 52 years. After a four-week baseline period of weekly blood pressure measurement, subjects were randomly assigned within racial groups to either a treatment (calcium, 1500 mg/d) or placebo group for a 12-week period. During the experimental period, multiple blood pressure measurements were taken every two weeks in both the seated and supine positions, using a random baseline sphygmomanometer. A repeated-measures analysis of covariance yielded a modest but significantly lower seated mean arterial pressure in the treatment group compared with the control group, but no differences between the races. Results were similar for supine blood pressure. Calcium supplementation, in comparison with placebo, resulted in lower mean arterial pressure in normotensive white and black men during a 12-week period. The overall blood pressure-lowering effect was not correlated with the response of serum levels of total and ionized calcium, total inorganic phosphorus, or parathyroid hormone, or overnight urinary electrolyte values. PMID- 3820494 TI - Consensus conference. Platelet transfusion therapy. PMID- 3820495 TI - Rapid eye movement sleep behavior disorder. A treatable parasomnia affecting older adults. AB - Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by intermittent loss of electromyographic atonia during REM sleep with emergence of complex and vigorous behaviors. Punching, kicking, and leaping from bed during attempted dream enactment caused repeated injury in nine of our first ten adult patients. Mean age at onset was 62 years; nine of the patients were male. All patients underwent standard polysomnographic studies with videotaping of behaviors and extensive neurologic and psychiatric evaluations. The RBD was unrelated to psychopathologic conditions but in five cases was closely linked with major neuropathologic disorders: dementia (two), olivopontocerebellar degeneration, subarachnoid hemorrhage, and the Guillain-Barre syndrome. Other common polysomnographic abnormalities were high REM density, increased stage 3/4 (slow-wave) sleep, and both periodic and aperiodic limb twitching in non-REM sleep. Eight patients had dream changes involving motor overactivity and violent confrontations of dream characters. Clonazepam induced rapid and sustained improvement of dream and sleep behavior problems in seven patients, as did desipramine hydrochloride in one patient. PMID- 3820496 TI - Ambulatory management of thromboembolic disease during pregnancy with continuous infusion of heparin. PMID- 3820497 TI - Hospital information systems. The physician's role. PMID- 3820498 TI - 'Oncolipids' offer promise as universal screening tool for cancer. PMID- 3820499 TI - Problems plaguing public hospitals: uninsured patient transfers, tight funds, mismanagement, and misperception. PMID- 3820500 TI - Leads from the MMWR. Human immunodeficiency virus infection in transfusion recipients and their family members. PMID- 3820501 TI - Leads from the MMWR. Smokeless tobacco use in rural Alaska. PMID- 3820502 TI - Body weight and longevity. PMID- 3820503 TI - Sex chromatin screening of female athletes. PMID- 3820505 TI - The treatment of recurrent corneal erosion. PMID- 3820504 TI - Severe diarrhea in pneumococcal bacteremia. PMID- 3820506 TI - Patients' understanding about drugs. PMID- 3820507 TI - The health effects of heptachlor. PMID- 3820508 TI - Prevalence of human immunodeficiency virus infection in ethnic minority homosexual/bisexual men. PMID- 3820509 TI - Public Health Service study of Reye's syndrome and medications. Report of the main study. AB - Between January 1985 and May 1986, following completion of a pilot study, a main study concerning the possible association between Reye's syndrome and salicylates was conducted. Twenty-seven patients with stage II or deeper Reye's syndrome whose diagnoses were confirmed by an expert panel and who had appropriate antecedent illnesses (chickenpox, respiratory illness, or gastrointestinal illness) prior to the onset of Reye's syndrome were compared with 140 controls matched for age, race (black or not black), and type and timing of onset of antecedent illness. Controls were selected from the same hospital, emergency room, or school as case-patients or were identified by random-digit telephone dialing. As in the pilot study, a strong statistical association with ingestion of salicylates during the antecedent illness and prior to the onset of Reye's syndrome was observed (odds ratio, 40; lower 95% confidence limit, 5.8). Analysis of the independent risk of aspirin and nonaspirin salicylates revealed a significant association with aspirin (odds ratio, 26; lower 95% confidence limit, 6.4); the independent risk of nonaspirin salicylates could not be assessed because only two cases were not exposed to aspirin. Assessment of epidemiologic issues of concern, including case-control differences in the severity of the antecedent illness, did not explain the high odds ratios that were observed. The high percentage of patients with Reye's syndrome exposed to salicylates (greater than or equal to 90%) in this and prior studies suggests that, though the reported incidence of Reye's syndrome has declined in recent years, concomitant with a decline in salicylate use among children, a majority of Reye's syndrome cases may be attributable to salicylate use. PMID- 3820510 TI - Do families get family care? AB - To determine the prevalence of family care, we measured the extent to which a subset of 732 families, from those enrolled in the Rand Health Insurance Experiment, perceive and use a single primary care physician. Although only 16.7% of these families had all members with a majority of their visits to the same physician, 45.4% identified a single primary care physician for all family members. (For older couples, this percentage reached 73.5%). An intermediate proportion of families had visits by all family members to a single physician. Children received less family care, but as families matured, family care increased for both children and parents. Our results suggest an inverse relationship between family care and education level. The availability of general family practitioners, family income, insurance coverage, and population size were not significant determinants of family care. We conclude that family members share the perception of having a single "family physician," which is reflected in their patterns of utilization. PMID- 3820511 TI - Are physicians advising smokers to quit? The patient's perspective. AB - Physicians can play an important role in smoking cessation because they have frequent contact with smokers and because most smokers believe that a physician's advice is important in the decision to quit. Therefore, to determine smokers' perceptions of physician involvement in smoking cessation, we analyzed aggregate data from two random statewide surveys of 5875 Michigan adults. Of smokers who had seen a physician in the previous year, only 44% reported that they had ever been told to quit smoking by a physician. Young male smokers were the least likely (30%) to have been told to quit. Smokers who were hypertensive, obese, diabetic, sedentary, or users of oral contraceptives were no more likely to have been told to quit than smokers without these additional cardiovascular risks. Conversely, smokers who had survived a myocardial infarction or stroke were more likely to have been told to quit than smokers who had not suffered these events (73% vs 43%). Most smokers do not perceive physicians to be even minimally involved in their efforts to quit. Physicians need to increase their efforts in counseling smokers to quit before smoking-related diseases result, especially for smokers with additional risk factors for cardiovascular disease. PMID- 3820512 TI - Colchicine in acute gout. Reassessment of risks and benefits. AB - Colchicine is an effective and relatively specific treatment for acute gout and has a long, venerable history. Serious toxic reactions to colchicine could be prevented if guidelines for its use were followed strictly, but because of its relatively infrequent use and conflicting recommendations, considerable toxic effects might occur and still be undetected by passive surveillance. A review of a teaching hospital's four years' experience showed two deaths (2% incidence) due to inappropriate use. Colchicine has the smallest benefit-to-toxicity ratio of drugs that are effective for acute gout. This article gives specific recommendations for the use of colchicine in different clinical settings. PMID- 3820513 TI - Vitamin preparations as dietary supplements and as therapeutic agents. Council on Scientific Affairs. AB - Healthy adult men and healthy adult nonpregnant, nonlactating women consuming a usual, varied diet do not need vitamin supplements. Infants may need dietary supplements at given times, as may pregnant and lactating women. Occasionally, vitamin supplements may be useful for people with unusual life styles or modified diets, including certain weight reduction regimens and strict vegetarian diets. Vitamins in therapeutic amounts may be indicated for the treatment of deficiency states, for pathologic conditions in which absorption and utilization of vitamins are reduced or requirements increased, and for certain nonnutritional disease processes. The decision to employ vitamin preparations in therapeutic amounts clearly rests with the physician. The importance of medical supervision when such amounts are administered is emphasized. Therapeutic vitamin mixtures should be so labeled and should not be used as dietary supplements. PMID- 3820515 TI - Our nation's great public hospitals. PMID- 3820514 TI - Life-threatening ventricular tachycardia and fibrillation induced by painless myocardial ischemia during exercise testing. AB - The clinical importance of myocardial ischemia without associated symptoms in patients with atherosclerotic coronary disease has not been clarified. We present three patients in whom painless cardiac ischemia was associated with the induction of cardiac arrest and/or ventricular tachycardia/fibrillation. In the two surviving patients, programmed ventricular stimulation did not induce ventricular arrhythmias. In one patient, successful coronary bypass surgery resulted in the elimination of exercise-induced painless myocardial ischemia and associated ventricular fibrillation; the other patient suffered a myocardial infarction after which ischemia and ventricular tachyarrhythmias could not be reproduced with exercise testing. We conclude that painless myocardial ischemia can cause life-threatening arrhythmias and is, therefore, a potentially lethal phenomenon. PMID- 3820516 TI - Reye's syndrome, salicylates, epidemiology, and public health policy. PMID- 3820517 TI - Disease-specific amino acid infusion (F080) in hepatic encephalopathy. PMID- 3820518 TI - Low blood selenium levels in patients with cystic fibrosis compared to controls and healthy adults. AB - Frank clinical selenium deficiency has been described in cystic fibrosis (CF), and a relative deficiency has been proposed as contributing to the pathogenesis of the disease. Because of these possibilities, we investigated the relationship between overall nutritional status in CF with measures of selenium nutriture. Fifteen stable outpatients with CF (group I) were compared to 13 age-matched controls (group II) and 27 healthy adults (group III). Whole blood, plasma, and red blood cell selenium levels were reduced by 31%, 29%, and 33%, respectively, in CF patients vs controls (all p less than 0.001). In addition, both groups I and II showed significantly lower blood selenium levels than healthy adults (p less than 0.005). Nutritional assessment revealed CF patients to be undernourished, with significant decreases in serum albumin (p less than 0.025), weight-for-height deficit (p less than 0.01), and weight-for-age (p less than 0.025) vs controls. However, only the triceps skinfold (TSF) measurement correlated significantly with selenium status (r = 0.56: p less than 0.05 for whole blood selenium vs TSF). We conclude, based on the magnitude of decrement in blood selenium, that it is unlikely that selenium plays a significant primary pathogenic role in cystic fibrosis. However, these patients are at high risk for developing clinical selenium deficiencies. The measurement of blood selenium levels using appropriate age-matched normal standards should be mandatory in all CF patients with malnutrition, or in those requiring parenteral nutritional support. PMID- 3820519 TI - Elimination kinetics of Lipofundin MCT: bolus injection and infusion compared. AB - Fifteen healthy young probands (nine males, six females) underwent an intravenous fat tolerance test (IVFTT) and, on the following day, a fat infusion lasting 6 hr. The emulsion tested was Lipofundin MCT 10%. One half of its triglyceride mass contains medium chain fatty acids. The IVFTT was started by injection of 0.1 g lipid per kg body weight into the fasting proband. Lipid elimination was estimated by measurement of light-scattering intensity of serum samples collected during a 60-min period. Individual fraction elimination rate constants covered a considerable range (K2 = 8.84 +/- 3.45%/min). The infusion test was performed at a rate of 0.1 g lipid per kg body weight and hr and lasted 6 hr. Serum triglyceride concentrations were determined enzymatically. They increased from 0.941 +/- 0.285 mmol/liter at the fasting state to a plateau level of 1.753 +/- 0.306 mmol/liter during infusion, and returned to initial levels 1 to 2 hr after the infusion was terminated. Individual triglyceride increments during infusion were significantly correlated with half-life periods of lipid elimination during IVFTT (r = 0.792, p less than 0.001). This relationship was derived using a model of the stationary state during infusion. We conclude that elimination kinetics of exogenous fat given either as bolus or infusion are ruled by the same fractional elimination rate constant K2. The IVFTT provides an estimate of the stationary triglyceride increment during a lipid infusion lasting several hr. PMID- 3820520 TI - Unstirred water layers in rabbit intestine: effects of guar gum. AB - Guar gum has been shown to affect the absorption of several different nutrients in clinical studies; however, the mechanisms for decreased absorption have not been defined. A possibility not studied with regard to guar gum, but previously demonstrated to be important in absorption, is the effect of change in the unstirred water layer. As the unstirred water layer increases in thickness, the rate of absorption decreases for certain nutrients. The effect of guar gum on the unstirred water layer in the lumen of rabbit jejunum was examined by previously described techniques. It was observed that: increases in guar gum concentration resulted in an increased thickness of the unstirred water layer; for any stir rate, the addition of guar gum increased the thickness of the unstirred water layer; and stir rate is inversely related to the thickness of the unstirred water layer. It was concluded from these results that guar gum increases the thickness of the unstirred water layer in rabbit jejunum. This mechanism may explain, in part, the reduction of the rate of absorption of certain nutrients seen following guar gum ingestion. PMID- 3820521 TI - Aminoglycoside serum concentration sampling via central venous catheters: a potential source of clinical error. AB - Two patients receiving aminoglycosides via central venous Silastic catheters were noted to have serum drug concentrations markedly divergent from expected results. Study of these patients, and of four additional patients prospectively selected for study, demonstrated that three of five patients had higher peak and/or trough aminoglycoside serum concentrations--when blood was obtained from the central venous catheter--than were contained in simultaneous samples from peripheral blood; these divergent results were noted after the catheter had been in use for more than 1 week; divergent results were not improved by additional catheter flushing prior to central venous blood sampling. These observations suggest that spurious aminoglycoside serum concentration results may sometimes be obtained when blood sampling is performed from central venous Silastic catheters, and can result in improper drug dosage alterations. It is necessary to access the timing, processing, and reliability of serum drug-monitoring practices on a routine basis to preclude such problems, and to reassess individual patient-monitoring studies which are inconsistent with anticipated results. PMID- 3820522 TI - What is subjective global assessment of nutritional status? AB - Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status based on features of the history and physical examination. Illustrative cases are presented. To clarify further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinician's SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78, 95% confidence interval 0.624 to 0.944, p less than 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible. PMID- 3820523 TI - Clinical significance of early diastolic time intervals for the evaluation of left ventricular function in patients with coronary artery disease. AB - To investigate non-invasively the diagnostic significance of diastolic properties in coronary artery disease (CAD), the following early diastolic time intervals (EDTIs): IIA-O time (from the aortic component of the second heart sound to the O point on the apexcardiogram), IIA-MVO time (from IIA to the mitral valve opening) and MVO-O time (from MVO to the O-point), were estimated in 18 patients with angina pectoris (AP) and 29 with old myocardial infarction (OMI) who were subdivided into two groups according to ejection fraction (EF): group I (OMI-I): more than 50% and group II (OMI-II): less than 50%. Seventeen patients without evidence of CAD were used as controls (N). Left ventricular pressure (LVP) and pulmonary capillary wedge pressure (PCWP) were measured simultaneously to clarify the relationship between EDTIs and early diastolic hemodynamics. IIA-O time and IIA-MVO time in AP, OMI-I and OMI-II were significantly longer than in N. This prolongation accorded with the reduction of left ventricular function. MVO-O time in AP and OMI-I also was significantly longer compared with that in N. In OMI-II, however, it was significantly shorter than in N. The prolongation of IIA-MVO time reflected impaired LV relaxation accompanied by LV dysfunction. The maintenance of low minimal LVP was the main contributor to the lengthening of MVO-O time in AP and OMI-I. Conversely, elevated minimal LVP and impaired LV relaxation resulted in the shortening of MVO-O time in OMI-II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820524 TI - Effects of preload alteration on the degree of ischemia and function of ischemic myocardium under constant mean aortic pressure, coronary perfusion pressure and heart rate in isolated perfused canine heart. AB - We examined the effects of preload alteration on global and regional (i.e., non ischemic and ischemic areas) function in the presence of regional myocardial ischemia and on the degree of ischemia using 18 isolated, metabolically supported canine left ventricles. For this purpose, cardiac output (CO), systolic segment length change (SL), myocardial CO2 tension (PmCO2) and ST level of epicardial ECG were measured at 3 levels of left ventricular end-diastolic pressure (LVEDP), i.e., approximately 7 (low LVEDP), 11 (middle LVEDP), and 16 mmHg (high LVEDP) without and with left circumflex artery (LCx) stenosis under a constant mean aortic pressure (90 mmHg), mean coronary perfusion pressure (90 mmHg) and heart rate. In the Pre-ischemic stage, CO and SL increased significantly when LVEDP was elevated in a stepwise fashion by changing the height of the reservoir connected to the left atrium. There were no significant changes in PmCO2 or ST level. On the other hand, with LCx stenosis, CO did not show a subsequent increase at higher LVEDPs (i.e., from 796 +/- 103 ml/min at middle LVEDP to 931 +/- 153 ml/min at high LVEDP). Furthermore, there was no significant SL response in the LCx area following alterations of LVEDP, although there was considerable lengthening of end-diastolic length. Both increased PmCO2 and ST level of the LCx area, following LCx stenosis, further increased significantly with elevation of LVEDP. These results suggest the possibility that considerable elevation of LVEDP worsens the degree of ischemia and does not significantly augment ischemic regional myocardial function or global function, while mild elevation of preload improves or tends to improve simultaneously regional ischemic and global functions without aggravating the ischemic injury significantly. Therefore, we conclude that the preload level is quite important in managing ischemia induced myocardial dysfunction. PMID- 3820525 TI - A case of normotensive pheochromocytoma masquerading as a dilated cardiomyopathy. AB - A case of right adrenal pheochromocytoma masquerading as a dilated cardiomyopathy is described. This patient was normotensive throughout 8 years of observation. Hyperglycemia and an abnormal glucose tolerance test were a clue to the diagnosis which was confirmed by the findings of increased plasma and urinary epinephrine and norepinephrine values. In patients with dilated cardiomyopathy the possibility of a pheochromocytoma should be considered. PMID- 3820526 TI - The 15th conference on the pathogenesis of hypertension. November 22, 1985, Osaka. Proceedings. PMID- 3820527 TI - Hypotension and hypothalamic depression produced by intracerebroventricular injections of GABA in spontaneously hypertensive rats. AB - To determine the central effects of 4-Amino-n-butyric acid (GABA), pressor and sympathetic nerve responses to electrical stimulation of the ventromedial hypothalamus were recorded following the intracerebroventricular (ICV) injection of GABA. In normotensive Wistar rats, anesthetized with urethane, ICV injections of GABA (50-200 micrograms) reduced sympathetic nerve activity, arterial blood pressure, and heart rate in a dose-dependent manner. Graded electrical stimulation of the ventromedial hypothalamus (50, 100, 150 microA) increased not only mean blood pressure but also the rate of sympathetic nerve firing, and both responses were attenuated by GABA pretreatment (100, 200 micrograms, ICV). In spontaneously hypertensive rats (SHR), ICV-injected GABA also reduced sympathetic and cardiovascular activity, but the magnitude of depressor responses was significantly larger in SHR than in normotensive Wister Kyoto controls (WKY). Pressor and sympathetic nerve responses elicited by ventromedial hypothalamic stimulation were initially larger in SHR than in WKY, but upon subsequent ICV injection of GABA, hypothalamic responsiveness in SHR was inhibited more prominently and became comparable to that in WKY. These results suggest that by depressing hypothalamic function, centrally injected GABA decreases sympathetic nerve activity to thereby lower blood pressure and heart rate, and in SHR, ICV injected GABA reversed hypothalamo-sympathetic hyperactivity and thus attenuated hypertension. PMID- 3820528 TI - Enhanced calcium-sensitivity of erythrocytes in hypertension--calcium-induced changes of erythrocyte osmotic fragility in essential hypertension. AB - To investigate the Ca-sensitivity of the erythrocyte membrane in hypertension, the changes of the osmotic fragility of erythrocytes by Ca-loading and the effects of Ca-channel blockers or calmodulin-antagonist were observed in patients with essential hypertension. Erythrocytes were obtained from untreated patients with essential hypertension and age-matched normotensive subjects. Treatment of erythrocytes with Ca-ionophore A23187 and Ca in bathing medium caused the reduction of the osmotic fragility of erythrocytes dose-dependently on Ca concentration. The degree in alteration of the osmotic fragility of erythrocytes was greater in essential hypertension than that in normotensive controls. In addition, Ca-induced changes of erythrocyte osmotic fragility was inversely correlated with the plasma renin activity in essential hypertension. In the presence of Ca-antagonists (verapamil, diltiazem) or calmodulin-antagonist (trifluoperazine), the reduction of the osmotic fragility of erythrocytes by Ca loading was inhibited, and the differences of the osmotic fragility of erythrocytes between the hypertensives and the normotensive controls were abolished by these drugs. These results suggest that the greater changes of the osmotic fragility of the erythrocytes by Ca-loading in essential hypertension might be due to the abnormality of Ca-handling of the cell membranes causing an increase in the intracellular Ca concentration, contributing at least partially to the pathogenesis of hypertension. PMID- 3820529 TI - Ventricular volume of single ventricle with or without palliation and after corrective surgery--concept of septation procedure. AB - Ventricular volume measurements of single ventricle were carried out in 20 patients with or without palliation and in 2 after total correction. In the former 20 patients, 6 had a single left ventricle and 14 a single right ventricle, anatomically. Two having total correction were associated with undivided ventricle. In the 20 patients with or without palliation, ventricular end-diastolic volume ranged from 64 to 206 (115 +/- 42) percent of the sum of the normal left and right ventricular volumes. Ejection fraction of single ventricle ranged from 0.40 to 0.64 (0.55 +/- 0.06). There was no significant difference in ventricular volume and ejection fraction between patients with a single left and right ventricle. There was high correlation of ventricular volume with pulmonary to systemic blood flow ratio (r = 0.66, p less than 0.005). This indicates that systemic-to-pulmonary shunt should increase ventricular volume of single ventricle. In two patients after total correction, total ventricular volume was 136 and 166% of the sum of the normal left and right ventricular volumes. Total ejection fraction was 0.55 and 0.33 in the first and second patient, respectively. The prosthetic ventricular septum bulged toward the right ventricle during systole and this shift made the left ventricular volume increase and ejection fraction decrease. Right-to-left ventricular volume ratio at end diastole was 0.74 and 0.67 in the first and second patient, respectively. These results suggest that 1) larger ventricular volume than the sum of the normal left and right ventricular volumes would be required for septation of single ventricle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820530 TI - Hypotensive responses to centrally administered taurine in DOCA-salt hypertensive and spontaneously hypertensive rats. AB - The present study was designed to investigate the short-term effects of intracerebroventricularly-administered taurine in DOCA-salt hypertensive (DOCA), spontaneously hypertensive (SHR) and their respective normotensive control rats anesthetized with urethane. Blood pressure, heart rate and sympathetic nerve activity were consistently decreased following the injection of taurine 150 micrograms per rat in hypertensive rats as well as in normotensive controls of the two groups. Percent changes from the baselines in blood pressure, heart rate and sympathetic nerve activity were significantly larger in DOCA-salt hypertensive rats than those in sham operated rats. In contrast, percent changes in blood pressure and sympathetic nerve activity were not significantly different between spontaneously hypertensive rats and normotensive wistar kyoto rats. These result show that the responses of blood pressure, heart rate and sympathetic nerve activity to intracerebroventricular taurine are different between spontaneously hypertensive rats and DOCA-salt hypertensive rats. It appears that augmented vasodepressor responses to taurine in DOCA-salt hypertensive rats, as compared to spontaneously hypertensive rats, are due to enhanced inhibition of the sympathetic outflow. PMID- 3820532 TI - A survey of pacemaker implantation in Japan--1985: report from the Pacemaker Committee of the Japanese Circulation Society with the Japan Society of Medical Electronics and Biological Engineering, and the Japanese Cardiac Pacing Society. PMID- 3820531 TI - Pathology of stroke. AB - Large cerebral infarctions were caused by atherosclerosis with or without thrombosis in the proximal circumflex (cortical) cerebral arteries. Hypertension, hypercholesterolemia, hypoxidosis, and vasospasm were considered to induce endothelial cell injuries, which might be the primary events not only in atherosclerosis, but also in arteriosclerosis and arteriosis formation. Morphogenesis of atherosclerosis and causes of associated thrombosis were also discussed. Small cerebral infarcts were produced not only by arteriosclerosis, arteriosis, and atherosclerosis, but also by arterionecrosis-derived microaneurysms occluded by thrombi in the distal penetrating (perforating) cerebral arteries. Pathogenesis and morphogenesis of the arterial lesions were discussed. Recent increase of the arterionecrosis occluded by thrombosis in the pathogenesis of small infarcts (lacunes) was noted. The direct cause of hypertensive cerebral hemorrhage was the rupture of arterionecrosis-derived microaneurysms in the distal penetrating cerebral arteries. The primary change of the arterionecrosis was the medial muscle cell necrosis, the causes of which were considered to be hypertension, aging, poor diet low in cholesterol, vasospasm, and the congenitally poor wall structure of the arteries. The development and healing of experimental arterionecrosis in hypertensive rats were also reported. PMID- 3820533 TI - The 10th conference on Prevention for Rheumatic Fever and Rheumatic Heart Disease. January 12, 1985, Kyoto. Proceedings. PMID- 3820534 TI - Rheumatic fever and rheumatic heart disease in Japan. AB - Rheumatic fever (RF) is the common cause of rheumatic heart disease (RHD) in the 5-30 age group and is usually preceded by group A streptococcal pharyngitis. The annual mortality caused by RF and RHD has changed remarkably in Japan between 1960 and 1981 according to the report of the Ministry of Health and Welfare. The annual incidence of RF among schoolchildren as surveyed from pediatric clinics of 20 major hospitals between 1952 and 1980 varied year by year, and is now steadily declining. Follow-up studies of 287 patients with carditis over ten years showed that cardiac murmur disappeared in 44.9% of total patients within 4 years through use of antibiotic prophylaxis. Other patients continued to have cardiac murmur 10 years after the first attack of RF. Valvular involvement due to RF was mostly confined to mitral valve and the appearance of mitral regurgitation was particularly common in schoolchildren. Survey of RHD in schoolchildren showed that mitral regurgitation was the most common anomaly, but the prevalence rate of RHD decreased from 4.6/1000 population in 1958 to 0.14/1000 population in 1981. By contrast, mitral stenosis was predominant in adults, according to the records of patients admitted in three university hospitals. Since socio-economic conditions have improved, and penicillin has been introduced to control group A streptococcus, mortality and morbidity from RF and RHD have remarkably decreased in well developed countries. These factors may have contributed predominantly to the sharp decrease in first and recurrent attack of RF in Japan. PMID- 3820535 TI - Changing pattern of rheumatic fever and streptococcal antibodies. PMID- 3820536 TI - Analysis of histopathologic findings in cases with dilated cardiomyopathy with special reference to formulating diagnostic criteria on the possibility of postmyocarditic change. AB - From our study employing serial endomyocardial biopsy in patients with acute viral or idiopathic myocarditis, we were able to construct histopathologic criteria for acute, subacute and convalescent myocarditis. We realize that it is difficult for the inexperienced observer to make an appropriate diagnosis of myocarditis or postmyocarditic changes in patients with dilated cardiomyopathy (DCM). In order to overcome this problem, each finding was graded and the scores obtained were analyzed statistically and compared with those from hypertrophic cardiomyopathy (HCM) and chronic right ventricular overloading (CRVO). The scores were obtained by summing the gradings for each of the following findings: increase of fibrocytes, increase of fibroblasts in the interstitium, hypertrophy of myocytes, fragmentation of muscle bundles, interstitial fibrosis, disarrangement of muscle bundles, abnormal branching, variation in size, increased glycogen deposition in the sarcoplasm, scarcity of myofibrils, and nuclear degeneration of myocytes and endocardial thickening. Since the increase in number of fibrocytes was considered important, its value was doubled. Scores in each group were as follows: convalescent myocarditis: 17.1 +/- 4.7 (n = 10), DCM: 13.2 +/- 3.3 (n = 47), HCM: 9.7 +/- 2.4 (n = 20), CRVO: 7.0 +/- 3.6 (n = 21). It was found that the scores for cases with myocarditis in the convalescent stage and in DCM were higher than those found for cases with either HCM and CRVO (p less than 0.05). In summary, the high score for postmyocarditis in DCM could suggest that prior myocarditis is an important causative factor of this disease. PMID- 3820537 TI - Twenty year autopsy statistics of myocarditis incidence in Japan. AB - In the annuals of autopsy records in Japan, edited by the Japanese Society of Pathology and covering 20 years, from 1958 to 1977, 377841 autopsy cases are registered with a short summary of the pathology findings. Of these, 434 cases with idiopathic, interstitial, viral, non-specific (NSM) and giant cell (GCM) myocarditis were found. The incidences of NSM and GCM were 0.11 and 0.007%, respectively. The annual incidence of NSM showed periodic fluctuations with in 5 year intervals and increased remarkably after 1974. Incidence of GCM showed a similar fluctuation but with a one to two year delay of peaks. The male to female ratio was 1.2: 1 and the age distribution had two peaked patterns for both sexes, though these peaks were scattered widely from neonate to elderly patients. The regional distribution of NSM showed a concentration in the middle portion of Honshu and its regional annual incidence had propagation waves from the central area to peripheral areas. The same tendency was observed in GCM cases. Hokkaido was characterized by a low incidence of NSM and no GCM. Complications of myocarditis included pancreatitis, pneumonitis, interstitial nephritis, meningoencephalitis, hepatitis, hepatic cirrhosis and a considerable incidence of malignancies. Antibiotics, antineoplastic agents, steroids and irradiation therapy were the main forms of treatment applied before or after the start of myocarditis. PMID- 3820538 TI - Infective endocarditis in children: a current diagnostic trend and the embolic complications. AB - Twenty-three cases of IE, of which 91% had underlying congenital heart diseases were diagnosed by positive blood culture or vegetative lesion detected by 2-D ECHO when a patient revealed clinically suspicious episodes. VSD and TOF were the most common underlying heart diseases. The vegetation was detected successfully by 2-D ECHO in 91% of the cases. The causative organisms were identified in 83% of the cases. Streptococcus viridans and Staphylococcus aureus were the two major organisms detected. Candida albicans was found in 3 postoperative and fatal cases. Embolic complications occurred in 7 cases (30.5%): five cases of pulmonary infarction and two of cerebral infarction. The overall mortality was 22%. We recommend early surgical intervention whenever a patient reveals a very large vegetation with animated movability, and emphasize the importance of a proper prophylaxic regimen. PMID- 3820539 TI - Follow up study of acquired valvular heart disease. AB - In patients with acquired valvular heart disease detected by group cardiac examinations at school, we analyzed follow-up data obtained during school days as well as after graduation from senior high school. Of the 343 patients followed up after graduation from senior high school up to an age range of 20-38 years (mean: 29.3 years), 18 (5.2%) died, 16 (4.7%) deteriorated, 159 (46.4%) remained unchanged, 40 (11.7%) improved, 18 (5.2%) spontaneously recovered and 30 (9.7%) were treated surgically. Of patients who showed spontaneous recovery after graduation from senior high school, 16 cases (8.4%) had mitral regurgitation and 2 (3.6%) had mitral stenosis-regurgitation. In some patients, the disease type changed many years after graduation from senior high school. In particular, the appearance of stenosal lesions in the mitral or aortic valve was often delayed. The mean annual death rate for patients with acquired valvular heart disease (age range: 6-38 years) between April 1962 and March 1983 was 0.65%. The rate peaked at the 15-17 years age range. In recent years, the fatality rate has been falling and no deaths are seen in younger patients. In the past, the leading cause of death in juvenile patients with acquired valvular heart disease was the recurrence of rheumatic fever. For the past ten years, however, no death attributable to the recurrence of rheumatic fever has been registered. PMID- 3820540 TI - A 13-year follow-up study of rheumatic valvular diseases. AB - A 13-year follow-up study was performed in 301 patients with rheumatic heart disease (RHD). Of these patient, 223 cases, 78 men (average age 59.3 years) and 145 women (average age 60.4 years), survived. Seventy-eight cases including 38 men (mean age of death 72.5 years) and 40 women (mean age of death 64.8 years) died. RHD consisted of 51% mitral valvular diseases, 40% combined valvular diseases and 9% aortic valvular diseases. The mean mortality for all patients with RHD was 25.9%. Seventy percent of the deaths were due to severe, chronic heart failure, sudden death and cerebral emboli. Atrial fibrillation was observed in 50% of the patients. Cerebral emboli occurred frequently in patients with mitral stenosis (MS), mitral stenoregurgitation (MSR) and combined valvular disease (CVD), which were associated with atrial fibrillation. However, cerebral emboli were rarely found in cases with MSR, CVD and aortic valvular disease with sinus rhythm. The mortality of cardiac surgery was low, 13.3%. PMID- 3820541 TI - Estimation of exercise capacity from oxygen consumption in the recovery phase of submaximal exercise. AB - We analyzed the transient response of oxygen consumption (VO2) after the sudden termination of exercise. The study population consisted of 20 male athletes (age 13 to 15.9 years) and 87 male patients, 59 of whom (age 4.8 to 17.8 years) were considered to be normal subjects, and 28 of whom (age 6 to 14.8 years) had restricted physical activity because of underlying heart diseases (restricted group). The exercise tests were performed according to Bruce's protocol and terminated at signs of exhaustion. As soon as exercise ceased, the examinee sat on a chair and took rested completely. VO2 was measured every 30 seconds throughout the test. We characterized the rate of the initial decay of the VO2 transient as the ratio of the 30 second VO2 right after the exercise to that at the end of the exercise (Irv). This index did not differ significantly among the groups. On the other hand, Exc, the Irv normalized by the end-exercise VO2, was a sensitive index for separating the restricted group from the control and athlete groups. Should the Exc remain sensitive enough to quantify exercise capacity regardless of the intensity of the exercise imposed, even the submaximal exercise test should enable us to safely evaluate the exercise capacity of patients with impaired cardiac function. PMID- 3820542 TI - Twenty-four hour ambulatory ECG monitoring of junior high school students in Miki City. AB - To evaluate incidence of serious arrhythmias among school age youths, 24-hour ambulatory ECG monitoring was performed in 100 junior high school students, including 60 subjects with some ECG abnormalities and 40 without. With this monitoring 2 cases with multifocal VPCs and 2 cases with paired VPCs or nonsustained ventricular tachycardia were found; the case with VT died suddenly after having been lost during careful follow up. It is emphasized from these results that ambulatory ECG monitoring is quite useful in selected cases in this age group and careful follow up of students with advanced grade VPCs is very important. PMID- 3820543 TI - Mass screening of blood pressure in school children: results of the Karatsu Study. AB - The purpose of this study was to determine the prevalence of persistent blood pressure elevation in school children. Mass screening of blood pressure was performed simultaneously with a cardiovascular health check in school children. Forty four hundred and eighty school children were selected as subjects for this study, consisting of 2289 first grade primary school students aged six and seven (group A), and 2191 second grade junior high school students aged thirteen and fourteen (group B). Of the 4480 students, 4031 were examined at the initial blood pressure screening. Three hundred and sixty students whose systolic and/or diastolic pressures were above the 95th percentile were recalled for a second examination. Three hundred and thirty one students were studied at the 2nd examination, and 69 students were listed for a third survey. 1.7% of the original subjects were examined at the final survey. At the first screening, mean blood pressures were 101.5 +/- 8.5/61.2 +/- 6.6 mmHg (mean +/- SD) for males and 100.3 +/- 8.3/60.9 +/- 6.5 for females in group A. In group B, blood pressures were 120.2 +/- 11.3/66.6 +/- 7.4 mmHg for males and 117.4 +/- 11.2/66.9 +/- 7.8 mmHg for females. This screening system, if incorporated into the school health program, is an effective and efficient method of screening for persistent blood pressure elevation in school children in Japan. PMID- 3820544 TI - Tracking of blood pressure, height, weight and left ventricular muscle volume in children--the Shimane Heart Study. AB - Two cohorts of Japanese children were studied longitudinally at 3-year intervals, at ages 6 and 9 years in cohort 1 and 9 and 12 years in cohort 2. There were 252 children in cohort 1 and 235 in cohort 2. The examinations performed were blood pressure, height, weight, skin fold thickness, upper arm length and circumference, ECG, VCG, M-mode echocardiography, serum cholesterol, hemoglobin and urinalysis. The subjects were divided into 5 quintile groups by their systolic blood pressure (SBP) percentiles calculated at each examination. SBP was tracked in each cohort throughout the follow-up period. Percentages remained in the highest SBP quintile group at both examinations were 43.5% (boys) and 59.1% (girls) in cohort 1, and 25.0% (boys) and 56.5% (girls) in cohort 2. The tracking of SBP was defined by body mass (height and weight) in most children. In some children, however, it was not defined by body mass tracking. Left ventricular muscle volume and its index were large in boys in the highest SBP tracking group. This indicates that the cardiac muscle is hypertrophied already, before the development of hypertension. PMID- 3820545 TI - Heart diseases discovered by mass screening in the schools of Shimane Prefecture over a period of 5 years. AB - Mass screening by ECG for heart diseases in pupils and students was performed in Shimane Prefecture; all the children had primary screening and were under the supervision of a pediatric cardiologist in all phases, from primary to precise (tertiary) examination. The precise examination was performed with 2D echo, exercise ECG and/or cardiac catheterization when indicated, and an important feature of this mass screening was the ability to carry out an accurate follow-up in all the phases from primary to precise examination. The number of subjects in the primary screening from 1980 to 1984 was 50758 primary school pupils, 44216 junior high school students and 33480 senior high school students; organic heart diseases not under the supervision of the pediatric cardiologist at the time of mass screening were found in 22 primary school pupils (0.04% of participants in the primary screening), 14 junior high school students (0.03%) and 5 senior high school students (0.01%). Clinically significant arrhythmias without underlying organic heart diseases were discovered by mass screening in 8 primary school pupils (0.02%), 13 junior high school students (0.02%) and 16 senior high school students (0.05%). PMID- 3820546 TI - [Extent of diagnosis by medical history taking, physical examination, thoracic X ray, and electrocardiography. 3. Electrocardiography, with special reference to P wave and QRS axial deviation]. PMID- 3820547 TI - [Extent of diagnosis by medical history taking, physical examination, thoracic X ray, and electrocardiography. 1. Medical history taking]. PMID- 3820549 TI - [Regional meetings of area branches of the Japanese Circulation Society. Abstracts]. PMID- 3820548 TI - [Extent of diagnosis by medical history taking, physical examination, thoracic X ray, and electrocardiography. 4. Plain chest films]. PMID- 3820550 TI - [Extent of diagnosis by medical history taking, physical examination, thoracic X ray, and electrocardiography. 2. Physical examination]. PMID- 3820551 TI - [Interrelation of administered fluid, hemodynamics and renal function during induced hypotensive anesthesia]. PMID- 3820552 TI - [Changes in the electroencephalogram after intravenous administration of diazepam -evaluation of amplitude spectra with fast Fourier transform]. PMID- 3820553 TI - [Possible participation of endogenous bursting neurons in central respiratory rhythm generation]. PMID- 3820554 TI - [Renin-angiotensin and catecholamine levels during extracorporeal circulation under balanced anesthesia in children]. PMID- 3820555 TI - [Effects of halothane and enflurane on intracranial pressure in dogs under nitrous oxide-oxygen anesthesia]. PMID- 3820556 TI - [Measurement of functional residual capacity during mechanical ventilation by multiple-breath nitrogen washout technic]. PMID- 3820557 TI - [Effects of the peripheral chemoreceptor denervation and increasing depths of halothane anesthesia on hypoxic respiratory depression]. PMID- 3820558 TI - [Effect of nitrous oxide alone or in combination with fentanyl on the spontaneous discharge of muscle nerves in the decerebrate cat]. PMID- 3820559 TI - [Changes of epidural pressure and cerebrospinal fluid pressure during abdominal surgery]. PMID- 3820560 TI - [Distance from the skin to the epidural space in the cervical, thoracic, and lumbar regions]. PMID- 3820561 TI - [Anesthesia for microlaryngosurgery with a special "J" tube]. PMID- 3820562 TI - [Humidification and heating of anesthetic gases with the semi-closed circular type anesthesia machine]. PMID- 3820563 TI - [Effect of osmolality of the irrigation fluid on water intoxication during transurethral resection of the prostate]. PMID- 3820564 TI - [Effects of acrylic bone cement following total hip replacement]. PMID- 3820565 TI - [Case report of spiral endotracheal tube obstruction during anesthesia]. PMID- 3820566 TI - [Investigation on the use of hyperbaric oxygen therapy of anoxic encephalopathy]. PMID- 3820567 TI - [Chronic intravenous toxicity studies of potassium clavulanate and BRL28500 in dogs]. AB - The chronic toxicity of potassium clavulanate (CVA-K) and BRL28500 were evaluated using dogs in 26-week intravenous administration studies followed by a 5-week off dose period. The doses for CVA-K and BRL28500 were 10, 20, 50 and 100 mg/kg (p.f.a.), and 80, 160, 320 and 800 mg/kg (p.f.a.) respectively. There were no deaths in either of the groups. For general condition, dogs dosed with CVA-K at 100 mg/kg showed reddening of the skin and mucous membranes, shaking of the head, facial oedema, a decrease in food intake and a reduction in body weight. Also some dogs of the same group showed decreased spontaneous activity, emaciation and signs of dehydration. In the BRL28500 treatment groups, there was reddening of the skin and mucous membranes, vomiting and salivation at 800 mg/kg. Urinalysis of dogs dosed with CVA-K showed occasional dark yellow coloration of the urine. There was also a very weak and equivocal response or positive reaction for protein, occult blood, and urine sugar in some animals at 100 mg/kg. Some dogs dosed with BRL28500 also showed either a very weak and equivocal response or slight positive reaction for occult blood at 320 mg/kg and above, and dark yellow coloration of the urine at 800 mg/kg. Haematological examination of the CVA-K groups showed increases in leukocyte count and platelet count at the highest dose of 100 mg/kg. No haematological abnormalities were noted in any of the BRL28500 groups. Serum biochemical studies of dogs dosed with CVA-K revealed a decrease in total protein at 50 mg/kg and above, and increases in Al-P, total bilirubin, GPT, BUN and creatinine at 100 mg/kg. In the BRL28500 treatment groups, there were increases in total cholesterol and triglyceride at 160 mg/kg and above. In dogs dosed with CVA-K there was an increase in liver weight at 100 mg/kg. Histopathological examination showed a ground glass-like appearance of the hepatocyte cytoplasm and also altered distribution of PAS positive material at 50 mg/kg and above. In the BRL28500 groups, there was an increase in liver weight at 320 mg/kg and above. There were the same ground glass-like appearance in hepatocytes and altered distribution of PAS positive material at 800 mg/kg. In view of the above results, the maximum non-effect dose levels in the present studies were considered to be 20 mg/kg for CVA-K and 80 mg/kg for BRL28500.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3820568 TI - [Transfer of fosfomycin into human burn blister fluid and its pharmacokinetic analysis]. AB - Fosfomycin (FOM) (50 mg/kg) was administered to burned patients by intravenous bolus injection. Burn blister fluid and serum were taken during 8 hours after injection, and concentrations of FOM in burn blister fluid and serum were determined by bioassay using Proteus sp. (MB-838) as the test organism. The serum concentrations of FOM were 257 +/- 34.6 micrograms/ml at 15 minutes, 222 +/- 34.8 micrograms/ml at 30 minutes, 166 +/- 34.6 micrograms/ml at 1 hour, 114 +/- 43.9 micrograms/ml at 2 hours, 79.5 +/- 34.9 micrograms/ml at 3 hours, 63 +/- 36.4 micrograms/ml at 4 hours, 44.3 +/- 27.6 micrograms/ml at 5 hours, 29.6 +/- 20.9 micrograms/ml at 6 hours and 17.9 +/- 12.8 micrograms/ml at 8 hours after the injection. FOM concentrations in burn blister fluid were 64.4 +/- 18.1 micrograms/ml at 30 minutes, 77 +/- 26.0 micrograms/ml at 1 hour, 71.6 +/- 24.7 micrograms/ml at 2 hours, 64.8 +/- 23.6 micrograms/ml at 3 hours, 43.2 +/- 8.8 micrograms/ml at 4 hours, 24.8 +/- 7.9 micrograms/ml at 6 hours and 17.9 +/- 10.5 micrograms/ml at 8 hours after the injection. The obtained data were analysed pharmacokinetically. The serum levels were analysed by a two-compartment model, and the transfer of FOM into burn blister was analysed by a modified deconvolution method. In results, Tmax and Cmax of FOM levels in burn blister fluid were calculated as 1.3 hours and 80.9 micrograms/ml, respectively. The transfer rate constant of FOM from serum to burn blister fluid (K1) and that from burn blister fluid to serum (K2) were calculated as 0.612 hr-1 and 1.10 hr-1, respectively. PMID- 3820569 TI - [Evaluation of T-2588 in the treatment of respiratory tract infection]. AB - T-2588 was used on 55 patients with respiratory tract infections and 44 cases were evaluated; 23 patients with pneumonia, 12 patients with acute bronchitis, 2 patients with chronic bronchitis, 1 patient with diffuse panbronchiolitis and 6 patients with bronchiectasis with infection. Clinical effects of T-2588 were as follows; excellent in 6 and good in 28 patients. The efficacy rate was 77.3% (34/44). Bacteriological effects of T-2588 were prominent in 8 patients infected with B. catarrhalis, H. influenzae, K. pneumoniae and E. coli, but not in a patient infected with P. putida. The elimination rate was 90.0% (9/10 strains). As side effects, stomatitis, anorexia, diarrhea X vomiting and pruritus were observed in one patient each. Abnormal laboratory findings were observed in 4 patients with elevated GOT and/or GPT. These side effects and abnormal laboratory findings were not serious. The usefulness of T-2588 was 68.2% (30/44). Therefore, T-2588 is a useful drug and its effects are promising in clinical management of respiratory tract infections. PMID- 3820570 TI - [In vitro susceptibility, of bacterial isolates from patients with respiratory tract infections, to beta-lactam antibiotics II]. AB - In vitro susceptibilities of bacterial pathogens to beta-lactam antibiotics were determined. Bacterial pathogens examined included various isolates from patients of respiratory tract infections at hospitals of Kyoto-Shiga area in 1984. Major organisms isolated from clinical specimens were Pseudomonas spp., Klebsiella spp., Haemophilus spp., Staphylococcus aureus and Streptococcus spp. An increase in the isolation frequency of Pseudomonas spp., a decrease in the isolation frequency of S. aureus, and no change in the isolation frequency of other organisms were observed between the years 1981, 1983 and 1984. Data from susceptibility tests of clinical isolates confirmed that cefazolin (CEZ), cefamandole and cefotiam (CTM) showed good antibacterial activity against S. aureus and cefmenoxime (CMX) was highly active against Streptococcus spp., but their susceptibilities to CEZ in 1984 were lower than in 1983. Susceptibilities of Klebsiella spp. to CMX, cefbuperazone, latamoxef, CTM, cefoperazone (CPZ) were better than those to other beta-lactam antibiotics tested, but there was a decline in the susceptibility to CEZ, cefmetazole and CTM. Further, CMX, CPZ and LMOX also showed good antibacterial activity against Haemophilus spp. Although gentamicin, cefsulodin, cefpiramide and piperacillin were highly active against Pseudomonas spp., resistant organisms were present for all the beta-lactam antibiotics tested. PMID- 3820571 TI - [Clinical evaluation of astromicin by intravenous drip infusion. Report I. Bacterial infections in the field of internal medicine]. AB - Intravenous drip infusion of a new aminoglycoside agent, astromicin (ASTM), was used against various infections in the field of internal medicine, and its clinical efficacy and safety were studied. Clinical effects were evaluated in 105 among 111 patients administered with ASTM. Almost all the patients were given 200 mg of ASTM twice a day by intravenous drip infusion for 60 minutes. Among 105 cases, clinical effects of ASTM were excellent in 15, good in 56, fair in 10 and poor in 24. The number of cases who were judged as excellent or good was 71, and the efficacy rate was 67.6%. Efficacy rates classified by diseases were as follows; 80% (4/5 cases) in sepsis, 55.6% (5/9 cases) in urinary tract infections, and 68.1 (62/91 cases) in respiratory tract infections (RTI). In 91 cases with RTI, clinical effects of ASTM were excellent in 14, good in 48, fair in 9 and poor in 20. The efficacy rates classified by diseases of RTI were 77.3% (34/44 cases) in pulmonary parenchyma infection and 59.6% (28/47 cases) in chronic RTI and others. As subjective and objective side effects, tinnitus and malaise were observed in 5 (4.5%) of 110 patients evaluated for side effects. But, either symptom was mild and disappeared after the end or withdrawal of administration. Slight elevations of S-GPT, BUN and others were observed in 7 cases (6.4%) as abnormal laboratory test values. Safety and efficacy of intravenous drip infusion of ASTM were confirmed. PMID- 3820572 TI - [Strain differences in granuloma formation in mice in response to mycolic acid containing glycolipids of some species of Nocardia and Rhodococcus]. PMID- 3820573 TI - Magnetocardiographic P waves in normal subjects and patients with mitral stenosis. AB - The P wave of the magnetocardiogram (MCG) was investigated in normal subjects and patients with mitral stenosis to determine its characteristics in normal conditions and left atrial overloading (LAO) and to analyze atrial activation by a magnetic field. In normal subjects, the MCG P wave was negative in left parasternal sites and positive in right lower sternal sites. The current source deduced from the MCG pattern and isomagnetic map was directed inferiorly and to the left through the entire phase of atrial activation, suggesting that in most normal cases the P wave reflects right atrial activity. In patients with mitral stenosis, a negative-positive biphasic P wave was seen more frequently than in normal subjects in left parasternal sites (p less than 0.005). In the late phase of atrial activation, the current source deduced from the isomagnetic map was shifted superiorly and to the left, suggesting an increased leftward force due to LAO. The MCG was similar in sensitivity to the ECG, for diagnosis of LAO, but in a few cases LAO could be detected from the MCG but not the ECG. These findings suggest that the MCG is clinically useful for diagnosis of LAO. PMID- 3820574 TI - The infundibular septum in normal hearts and in hearts with isolated ventricular septal defect. A comparison between Japanese and Dutch hearts. AB - The observation that subpulmonary or doubly committed subarterial ventricular septal defects occur with a high frequency among orientals as compared to westerners has led to the hypothesis that a racial difference exists with regard to normal and abnormal development of the embryonic conal septum. In an attempt to contribute to this concept we have studied 24 normal hearts and 70 hearts with a perimembranous ventricular septal defect from patients of Japanese and Dutch origin. The length of the infundibular septum and the length of the right ventricle were not statistically different between the 2 groups. These findings suggest that in normal hearts and in hearts with perimembranous ventricular septal defects no racial differences exist with respect to the role of the embryonic conal septum in contributing to the definitive infundibular septum. The results indicate that subpulmonary or doubly committed subarterial defects may have a different origin from that of the usual perimembranous defect. PMID- 3820575 TI - Heart rate at onset and termination of paroxysmal atrial fibrillation in apparently healthy subjects. AB - Eighteen paroxysms were documented on Holter electrocardiogram both at the onset and the termination of paroxysmal atrial fibrillation in 14 apparently healthy subjects. There were large inter- and intraindividual variations and no definite trend was observed in the time and duration of paroxysms. Heart rate at the onset of paroxysms was consistently higher than that at sinus rhythm immediately before atrial fibrillation started. There were 2 patterns in the sequence of heart rate during paroxysms. One was an almost constant heart rate during paroxysms, and the other was a trend toward a decrease in heart rate from the onset to the termination of paroxysms. The duration of paroxysms was within 2 hours in the former group and more than 2 hours in the latter group. There was a reverse correlation between heart rate at the termination of paroxysms and their duration. PMID- 3820576 TI - A new portable device for 24-hour recording of ambulatory intra-arterial blood pressure and heart rate in hypertensive patients. AB - A new portable device (measuring 14 X 11 X 5 cm, weighing 600 g) has been developed for recording ambulatory intra-arterial blood pressure (BP) and R-R intervals on the electrocardiogram at 10 sec intervals throughout a 24 hour period and a computer system for analysis of the 8,640 digital recordings of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR). Using this device, SBP, DBP and HR recordings were obtained in 12 normotensive patients and 37 patients with essential hypertension (of whom 19 presented in WHO Stage I and 18 in WHO Stage II). The 24-hour BP variation (SD) increased with increasing 24 hour mean BP but there was no difference of statistical significance in SD/mean among the 3 groups. There was a good correlation (r = 0.70 to 0.94) between SBP and DBP during 24 hours. The average of A in the linear regression equation, SBP = A X DBP +B, was greatest for patients with WHO Stage I and the average of 24-hour HR was highest for this group. The results suggested that these patients were in a hyperdynamic cardiac state. The new portable SBP-DBP-HR recorder is easy and simple to use and has the advantage of being low-cost, and therefore will be useful in clinical applications. PMID- 3820577 TI - Projection of death rates from ischemic heart disease in Japan, 1985-2000. AB - Death rates from all forms of ischemic heart disease and acute myocardial infarction were projected between 1985 and 2000 A.D., based on vital statistics from 1973 to 1982 and the estimated population by sex and age groups in Japan. It is predicted that the crude death rate from ischemic heart disease will increase (+1.4% per year for males and +1.8% for females), and that the age-adjusted death rate will decrease (-1.1% per year for males and -1.4% for females). The crude death rate from acute myocardial infarction is predicted to increase steadily (+2.4% per year for males and +2.2% for females), though the age-adjusted rate will decline slightly (-0.5% per year for males and -1.0% for females) throughout this period. The crude death rate from acute myocardial infarction is predicted to increase more than the rate from ischemic heart disease. It is estimated that the total number of deaths will increase from 48,000 (males and females combined) in 1982 to 72,000 in 2000 for ischemic heart disease, and from 29,600 in 1982 to 45,500 in 2000 for acute myocardial infarction. PMID- 3820578 TI - Coronary artery disease in patients aged 30 and younger. AB - Twenty-four male patients aged 18-30 (mean = 27.4) years were catheterized either after myocardial infarction (22 patients) or because of angina pectoris (2 patients). In this highly-selected group, 18 of 24 smoked but only 5 had elevated cholesterol levels. Of 14 patients with anterior myocardial infarction (AMI), 7 had a significant left anterior descending obstruction while the other 7 had nonsignificant or no coronary stenosis. In 8 patients with inferior MI (IMI), 4 had significant multivessel disease. Five of 6 patients with multivessel disease smoked while 4 had hypercholesterolemia. Risk factors were absent in 3 of 16 patients with single or no coronary lesions. We conclude that angina pectoris and inferior MI carry high risk of multivessel coronary disease; there is often one or more risk factor in this subgroup. Finally, routine catheterization in young patients with AMI is not warranted. PMID- 3820579 TI - Incidence of strokes and its prognosis in patients on maintenance hemodialysis. AB - The incidences of cerebral hemorrhage (CH), cerebral infarction (CI) and subarachnoid hemorrhage (SAH) were examined retrospectively in patients with chronic renal failure on maintenance hemodialysis, followed for 13 years in our 26 satellite dialysis centers. During 10,364 patient-years of experience (PYE), CH developed in 66, CI in 16, SAH in 3 and unclassified stroke in 5 cases. The incidence was 637 per 10(5) PYE for CH and 154 for CI, the former being approximately 5 times and the latter one third of the incidence of CH or CI in the general population in Japan. Forty-six percent of fatal CH cases died within 24 hours and 73% within 3 days after the onset, while 13% of CI deaths died within 24 hours and 26% within 3 days. These data suggest that factors such as the regular use of heparin as an anticoagulant in hemodialysis patients or other inherent factors in these patients may increase vulnerability to CH and decrease the probability of CI. PMID- 3820580 TI - Cardiovascular effects of ZSY-27 [5-methyl-6-(4-pyridinyl)-2H-1,4-thiazine-3(4H) one X hydrochloride] in the dog cross-circulated atrial preparation. AB - A new cardiotonic compound, 5-methyl-6-(4-pyridinyl)-2H-1,4-thiazine-3(4H)-one X hydrochloride (ZSY-27), was investigated in cross-circulated dog atrial muscle preparations. When ZSY-27 was intravenously administered to the donor dog, a dose dependent depressor effect with slight sinus tachycardia was induced in the donor dog. At the same time, a significant dose-dependent increase in developed tension was usually observed in an isolated atrium perfused with donor's arterial blood, but there were no significant changes in sinus cycle length and sinoatrial conduction time. The ZSY-27-induced positive inotropic effect was not significantly influenced by treatment with propranolol in doses which completely inhibited norepinephrine-induced positive chronotropic and inotropic effects. When ZSY-27 was injected into the cannulated sinus node artery of the isolated atrium, dose dependent positive chronotropic and inotropic effects were induced. The dominant increases in developed tension by ZSY-27 were similar to effects of other phosphodiesterase inhibitors, such as papaverine and aminophylline. From these results, it is concluded that ZSY-27 has non-adrenergic, cardiotonic properties with a depressor effect. PMID- 3820581 TI - Electrocardiographic masking of a myocardial infarction by a fasciculoventricular Mahaim fiber, atrioventricular reentry with anterograde conduction over a fasciculoventricular Mahaim fiber and retrograde conduction over a concealed Kent bundle. AB - An intracardiac electrophysiologic study was performed in a patient with paroxysmal tachycardia. The patient had two previous episodes of myocardial infarction, but abnormal Q waves were absent in previously obtained electrocardiograms. Electrocardiographic diagnosis of inferior and anterior infarction was made because the electrocardiogram taken on admission temporarily showed abnormal Q waves. Atrioventricular reentry with anterograde conduction over a fasciculoventricular Mahaim fiber and retrograde conduction over a concealed Kent bundle was observed during the tachycardia. It was also demonstrated that electrocardiographic masking of the Q waves was caused by conduction over a fasciculoventricular Mahaim fiber. PMID- 3820582 TI - A case of atrial septal defect complicating myocardial infarction. Severe heart failure induced by balloon occlusion of ASD. AB - A 58 year old man with an acute, extensive anterior myocardial infarction was found to also have an atrial septal defect secundum. A cardiac catheterization study showed a large left to right shunt (Qp/Qs: 6.0). Since other clinical findings were not consistent with the prolonged existence of a large shunt, we considered it to be secondary to the myocardial infarction. Balloon occlusion of the ASD was carried out to predict the hemodynamics after the surgical correction, which soon resulted in severe left ventricular failure. Therefore, an operation was not feasible in this case. PMID- 3820583 TI - Proceedings of Oji International Seminar on Ventricular Repolarization. October 6 9, 1985, Tomakomai, Japan. PMID- 3820584 TI - Direct measurement of the gap junctional conductance under the influence of Ca2+ in dissociated paired myocytes of guinea-pig. AB - A new method to measure the gap junctional conductance under the influence of a given pCa solution was described. The paired ventricular cells were enzymatically dissociated from the guinea pig and were voltage clamped. One of the pair was crushed to expose one aspect of the gap junction to the bath solution, which contained different pCa. The method disclosed a reversible effect of Ca closing the gap junctional channel. PMID- 3820585 TI - Modulation of repolarization by electrotonic interactions. AB - The expression of repolarization properties in different regions of the ventricle is a complex interaction between the spatial distribution of intrinsic properties of the cells and the spatial distribution of the coupling resistance among the cells of the cardiac syncytium. Our theoretical studies show that electrotonic modulation of repolarization among cells with intrinsically different repolarization properties can make the expressed properties of cells at a given location quite different from the intrinsic properties of these cells. These interactions are simulated both for a simple two cell system as well as for more complex geometries, showing that the spatial distribution of expressed repolarization properties is quite extensive, and, more specifically, is much more extensive than would be expected by passive electrotonic interactions. PMID- 3820587 TI - The effect of cardiac electric anisotropy on epicardial potential fields during ventricular repolarization. AB - We tried to establish whether some of the manifestations of electrical anisotropy previously observed on the canine ventricular epicardium during the spread of excitation were also present during repolarization, with the appropriate polarity. To this end we determined the potential distribution on the ventricular surface of exposed dog hearts during ventricular excitation and repolarization. The ventricles were paced by means of epicardial or intramural electrodes. During the early stages of ventricular excitation following epicardial pacing we observed typical, previously described potential patterns, with negative, elliptical equipotential lines surrounding the pacing site, and two maxima aligned along the direction of subepicardial fibers. Intramural pacing gave rise to similar patterns. The axis joining the maxima, however, was oriented along the direction of intramural fibers. The repolarization potential pattern relating to epicardial excitation exhibited some features similar to those observed during the spread of excitation, namely the presence of families of elliptical equipotential lines around the pacing site, with pairs of potential extrema along the major or minor axes of the ellipses or both. The location of the extrema and the distribution of the epicardial potential gradients during repolarization suggested the presence of anisotropic current generators mainly oriented along the direction of deep myocardial fibers, with some contribution from more superficial sources which were oriented along the direction of subepicardial fibers. Deep stimulation elicited more complicated epicardial patterns whose interpretation is still obscure. We conclude that the electrical anisotropy of the heart affects the distribution of repolarization potentials and probably the strength of electrical generators during ventricular repolarization. PMID- 3820586 TI - Determination of activation and recovery sequences and local repolarization durations from distant electrocardiographic leads. AB - Experiments using an isolated heart, perfused by a support dog were done to compare estimates of activation times, recovery times and activation recovery intervals from cardiac surface electrograms to estimates from distant electrocardiographic leads and to known features concerning normal activation and recovery sequences. The isolated heart was suspended in a tank with 600 electrodes located at sites 0.5 cm to 7.5 cm from the surface of the heart. In some experiments up to 330 electrodes, spaced 2.5 mm to 5 mm apart on a nylon matrix, were placed on the cardiac surface. Recordings were made during atrial and ventricular drives at cycle lengths of 400 msec to 700 msec. The minimum QRS and maximum T derivatives and the interval between them were taken as the estimates of activation times, recovery times and activation recovery intervals respectively. Maps of activation sequence, and the distribution of activation recovery intervals were constructed from cardiac surface data and from data recorded at various distances from the heart. Regions of earliest and latest activation and recovery times, range between the earliest and latest activation and recovery times and the average activation recovery interval could be determined from data recorded at distances from the heart comparable to the distance between the cardiac and thoracic surfaces. The results indicate that electrocardiographic signals, recorded with regionally sensitive distant leads, contain considerable detail concerning local activation and recovery sequences and the distribution of repolarization properties. This information should be useful in the evaluation of patients and in guiding drug therapy. PMID- 3820589 TI - Estimation of location and size of myocardial injury site from body surface potential distribution using ECG inverse solution. PMID- 3820588 TI - 3-dimensional computer simulation of depolarization and repolarization processes in the myocardium. AB - A computer algorithm for 3-dimensional computer simulation of electric phenomena in the human heart has been completed, in which the heart model consists of 50,000 functional cells arranged in the cubic close-packed structure and various waveforms of the action potential have been allotted to these functional cells. The present model allows one to estimate time courses of ECG, VCG, and body surface potential distribution from the P-wave up to the T-wave. It also can simulate electric phenomena in the heart with anomalies in the conduction system and the myocardium. PMID- 3820590 TI - The effect of ventricular conduction velocity on ST-segment level in acute myocardial ischemia. AB - The ECG changes in acute myocardial ischemia was studied with ST segment map pattern. Three isolated coronary perfused and isovolumetric contracting canine heart preparations were used. In each preparation, large and small sized acute ischemia was induced by 5 min occlusion of proximal and distal portion of left circumflex coronary artery. Single exponential relationship was seen between R wave amplitude and ventricular activation time (VAT) in normal and in coronary occlusion. The marked degree of delayed VAT induced lowering in R-wave amplitude. Prolongation of VAT, increasing in R-wave amplitude and ST segment elevation was shown at ischemic area. The maximum change in VAT and in R-wave amplitude was seen at center of ischemic zone. The ST segment map pattern was similar with solid angle distribution pattern, despite the slight disturbance of conduction velocity, however, marked delay over 45 msec VAT induced extremely difference of ST map from solid angle distribution map. PMID- 3820591 TI - Simulation of T wave based on cardiac model of electrical activity: effects of anisotropy of myocardium and inhomogeneity of ventricular gradient on QRS-T angle. AB - To investigate the effects of the excitation propagation and the inhomogenous distribution of action potential duration (APD) on QRS-T angle and T wave polarity, mathematical analysis and computer simulation of QRS-T wave were performed in a cardiac model of the electrical activity. A rectangular solid model with the conduction system on the subendocardial surface simulated a part of the free wall of the left ventricle. In our previous studies we assumed isotropy of the myocardium and linear ventricular gradient. In the present study, we obtained the quantitative relationship between the ventricular gradient (beta) (intramural gradient of action potential duration) and the QRS-T angle (theta) in the models with anisotropy of the myocardium and inhomogenous ventricular gradient. The directions of progress of depolarization and repolarization were different between with presence and absence of anisotropy. However, the beta theta relationship was minimally influenced by anisotopy. Furthermore, the present study demonstrated that the total T vector is determined by the difference of APD between endocardium and epicardium, and is not influenced by the inhomogeneity of APD in the middle layer of the ventricular wall. These results support the validity of our previous cardiac model in which we assumed isotropy of the myocardium and the homogenous ventricular gradient. Moreover we demonstrated that the propagation velocity and the cardiac hypertrophy may largely influence the T wave polarity by the simulation study of electrocardiograms. PMID- 3820592 TI - T wave inversion in experimental myocardial ischemia and sympathetic nerve stimulation. AB - In open-chest dogs, T wave changes were recorded following coronary occlusion and sympathetic nerve stimulation. Recording of suction electrograms was made to study their genesis. Not only after release but immediately after introduction of coronary occlusion, T wave was inverted significantly associated with QT prolongation in sites with prolonged excitation duration in suction electrogram. Sympathetic nerve stimulation also produced T inversion followed by rapid reversion to positive T wave, which was apparently analogous to ischemic changes in electrophysiological aspects. However, the underlying mechanisms were thought to be much different. PMID- 3820593 TI - On a heart-torso model to be used for electrocardiographic forward and inverse solution. PMID- 3820594 TI - Dipolarity of the T wave. PMID- 3820595 TI - [Transarterial embolization in metastatic retroperitoneal tumor]. AB - A case of retroperitoneal metastasis of a malignant testicular tumor treated by transarterial embolization (TAE) is reported. The tumor feeders were the intercostal and lumbar arteries. Improvement of the patient's condition could be obtained by TAE. It is suggested that TAE has some effectiveness for chemoresistant, radio-resistant or inoperable cases of metastatic retroperitoneal tumors. PMID- 3820596 TI - [Pleomorphic adenocarcinoma of the pancreas with extrapancreatic proliferation]. AB - Two cases of pleomorphic adenocarcinoma of the pancreas are reported. The patients were both women, aged 42 and 44, respectively. Their primary lesions had proliferated extrapancreatically and revealed a clinically specific patterns. They were differed from the general findings of pancreatic cancer. In the histological appearance, tissues such as well-differentiated adenocarcinoma and a mixture of giant cell carcinoma (osteoclastic type) and spindle cell sarcomatous type were seen, and they transferred in either. The extirpation of these tumors was possible, but they recurred in the short term and had an extremely unfavorable prognosis. PMID- 3820597 TI - [Low-grade non-Hodgkin's lymphomas--report of the Japanese Lymphoma Radiation Therapy Group (JLRTG)]. AB - The clinical features of 102 patients with low grade non-Hodgkin's lymphomas treated from 1972 to 1981 among the hospitals belonging to the JLRTG were retrospectively reviewed. According to the Rappaport classification, there were 29 cases of NPDL, 26 of NM and 47 of DWDL. The survival rate and relapse-free survival rate for all patients at 10 years were 49% and 41%, respectively. No obvious difference in survival rate was seen by histologic type, but patients with DWDL had a better relapse-free survival rate than those with NM (P less than 0.01). This study also suggested that patients with stages I and II low grade lymphomas might be treated by irradiation alone, if they are staged properly. PMID- 3820598 TI - [Needle aspiration cytology of malignant lymphoma of the thyroid]. AB - We have reviewed our experiences with needle aspiration cytology in five cases of malignant lymphoma of the thyroid. From the original cytologic reports, one case was correctly diagnosed as malignant lymphoma. Three were misdiagnosed as anaplastic carcinoma of the small-cell type, and two of these three were subsequently revised to malignant lymphoma at the second aspiration. Another patient was misdiagnosed as chronic thyroiditis at the first and second aspirations. Following the third aspiration, the condition was correctly diagnosed as malignant lymphoma. In the smears correctly diagnosed as malignant lymphoma, many malignant cells were distributed as isolated cells and showed monotonous features. Sometimes, cleaved cells or prominent nucleoli were visible. PMID- 3820599 TI - [Monoclonal antibody to human pancreatic carcinoma cells]. AB - A monoclonal antibody (MoAb, SK-930) of the IgG2a subclass to human pancreatic carcinoma cells (MIA-PaCa 2) was obtained by hybridization of spleen cells from immunized Balb/c mice with murine myeloma cells. SK-930 was investigated for reacting in indirect immunofluorescence on FACS against a panel comprising 12 types of different origin. SK-930 reacted with seven out of 11 tumor cells and with one PBL. Immunoperoxidase techniques (ABC method) showed that SK-930 antigen was present on pancreatic adenocarcinoma cells, but could not be detected on normal pancreatic tissue. Immunoprecipitation experiments and SDS-PAGE analysis revealed that SK-930 recognized 134K dalton peptide on tumor cells. These results suggest that SK-930 reacts with a novel pancreatic cancer-associated antigen. PMID- 3820600 TI - [Colon cancer with macroscopic invasion into surrounding organs]. AB - Of 195 cases of colon cancer operated on between January 1972 and April 1985, 56 (30.3%) were with macroscopic invasion into surrounding organs. Among them, 45 patients underwent combined resection of the colon and one or more adjacent organs, and in 60% of them, the tumor invasion was verified microscopically. The organ invaded most frequently was the abdominal wall (26 cases), followed by the bladder (7) and stomach (6). The operative mortality was 8.9%, and the five-year survival rate in the curative resection group was 70.9%. Even the noncurative resection group showed a significantly longer mean survival time than the nonresectable group. Combined resection should be undertaken unless the patient is seriously ill. PMID- 3820601 TI - [Basic evaluation of measurement of the serum level of squamous cell carcinoma related antigen (SCC) and its value following irradiation of cancer of the uterine cervix]. AB - The measurement of the serum level of squamous cell carcinoma-related antigen (SCC) purified from liver metastasis of cancer of the uterine cervix by an RIA kit is basically evaluated. The results of sensitivity, the recovery test, dilution test and variance test are good enough for clinical application. In gynecological disorders, the positive rate is high (62% [29/47]) in patients with cancer of the uterine cervix. Furthermore, the rate and level are related with the clinical staging. The changes of the serum SCC level in irradiated patients with cancer of the uterine cervix were a good reflection of the effectiveness of the treatment. PMID- 3820602 TI - [Follicular carcinoma in an autonomously functioning thyroid nodule]. AB - The patient was a 66-year-old man who complained of goiter. A diagnosis of functioning thyroid tumor was made because of high uptake of 131I after T3 suppression test and no response to thyrotropin releasing hormone. The tumor was removed and histologically proven to be follicular carcinoma. Twelve cases of thyroid carcinoma in autonomously functioning thyroid nodules have been reported, and the relation between carcinoma and an autonomously functioning nodule is reviewed from the literature. PMID- 3820603 TI - [Esophageal adenocarcinoma in an 81-year-old man]. AB - Adenocarcinoma of the esophagus is relatively rare. An 81-year-old man with the chief complaints of loss of appetite and general fatigue was admitted to our hospital. By X-ray and endoscopic examination, a diagnosis of esophageal carcinoma in the Ei and Ea areas was made. A biopsy specimen obtained by endoscopy showed moderately differentiated adenocarcinoma, and the tumor origin was recognized in the cardia of the stomach. Lower esophagofundectomy by left thoracolaparotomy was performed. The postoperative pathological diagnosis showed adenocarcinoma of the esophagus and the tumor expansively invading to the cardiac portion. PMID- 3820604 TI - [An autopsy case of primary hepatic malignant lymphoma and a review of 10 reported cases]. AB - Primary malignant lymphoma is an extremely rare neoplasm in the liver, with only 10 cases having been reported in the English literature. An autopsy case of primary hepatic lymphoma is presented herein. Although a few lymph nodes were slightly involved, large involvement of lymphoma was apparent in the liver. This lymphoma was classified as a diffuse large-cell (histiocytic) type. Microscopically, the PAP method for immunoglobulin showed positive staining of IgG and lambda in the lymphoma cells. PMID- 3820605 TI - [Acute squamous metaplasia of the whole lung after combined radiation and chemotherapy in advanced lung cancer]. AB - Two patients with advanced lung cancer, histologically diagnosed as adenocarcinoma and squamous cell carcinoma, respectively, were treated with a combination of radiation and anticancer drugs (aclacinomycin-A, bleomycin, mitomycin). The lung tumors responded remarkably to this combined modality. However, the patients succumbed to pneumonia-like disease, being refractory to various antimicrobial treatments. Histologic examination revealed that the outstanding squamous metaplasia developed diffusely in the terminal bronchioles and the alveoli in all lobes of the lungs. Compared with their clinical courses and the resultant detailed pathological findings, the pathogenesis of the conditions was discussed. PMID- 3820606 TI - [Carcinoma of the esophagogastric junction with extension to the cervical esophagus]. AB - A 51-year-old woman with adenocarcinoma of the esophagogastric junction (E-G J), which spread from the E-G J to the cervical esophagus, is reported. Only two cases of carcinoma in the E-G J with the extension of the tumor to the upper or middle portion of the intrathoracic esophagus have been reported in the Japanese literature in the past two decades and there have been no previous reports of E-G J carcinoma with extension to the cervical esophagus. At first, the invasion to the esophagus in our case was thought to be continuous. Histological examination, however, revealed that the tumor in the esophagus was discontinuous in some portions and that the lymph vessels were remarkably invaded. These findings suggested that the extension of the tumor to the esophagus was lymphogenous metastasis. PMID- 3820607 TI - [Antiplatelet therapy and platelet function studies in elderly patients with ischemic heart disease--evaluation of whole blood platelet aggregation]. PMID- 3820608 TI - [Significance of corticosteroid administration including bolus methylprednisolone therapy as the preconditioning of hematopoiesis in the treatment of aplastic anemia]. PMID- 3820609 TI - [Evaluation of clinical usefulness of thiamphenicol in the management of patients with polycythemia vera]. PMID- 3820610 TI - [Two cases of primary thrombocythemia in children]. PMID- 3820611 TI - [An autopsy case of acute myelofibrosis with myeloblasts showing hematological remission in the terminal stage]. PMID- 3820612 TI - [A case of multiple myeloma associated with phagocytic plasma cells and a variety of abnormal morphological features of bone marrow cells]. PMID- 3820613 TI - [Transformation from aplastic anemia to myelodysplastic syndromes--report of two cases and review of the literature]. PMID- 3820614 TI - [Successful delivery in a female with thrombotic thrombocytopenic purpura]. PMID- 3820615 TI - [Burkitt's lymphoma with an initial symptom of thyroid tumor during pregnancy]. PMID- 3820616 TI - [Eosinophilic leukemia with myelofibrosis and dysplasia terminating in marked increase of blast cells: a report of an autopsied case]. PMID- 3820617 TI - [Severe heterozygous protein C deficiency with relapsing purpura fulminance from the newborn period]. PMID- 3820618 TI - [DIC: an application of new laboratory tests]. PMID- 3820619 TI - [Clinical implications of analyses of fibrinogen and fibrin-derivatives in DIC]. PMID- 3820620 TI - [Local DIC]. PMID- 3820621 TI - [Compensated DIC]. PMID- 3820622 TI - [Liver disease and DIC]. PMID- 3820623 TI - [Is fibrin deposition in microcirculation of vital organs important as a precipitating factor in multiple organ failure in intravascular coagulation?]. PMID- 3820624 TI - [Central nervous system involvement in non-Hodgkin's lymphoma]. PMID- 3820625 TI - [Hemopoietic progenitors in patients with Wiskott-Aldrich syndrome]. PMID- 3820626 TI - [Bacteriological study on autopsy cases with hematological malignancies, particularly the increased isolation of fungus and gram-positive cocci]. PMID- 3820627 TI - [Modified VAPA therapy in children with acute nonlymphocytic leukemia]. PMID- 3820628 TI - [Positive direct antiglobulin test due to anti-C in antilymphocyte globulin following its use in a patient with aplastic anemia]. PMID- 3820629 TI - [Megakaryoblastic transformation in polycythemia vera--a case of megakaryoblastic leukemia associated with myelofibrosis and elevation of serum PDGF-like activity]. PMID- 3820630 TI - [A 14q+ marker chromosome due to t(11;14) in a case of nonsecretory plasma cell leukemia]. PMID- 3820631 TI - [Congenital factor X deficiency showing cross-reacting material negative (CRM-)]. PMID- 3820632 TI - [Kaposi's sarcoma and malignant lymphoma in AIDS]. PMID- 3820633 TI - [AIDS and neurological manifestations]. PMID- 3820634 TI - [Pathology of AIDS based on biopsy and autopsy--with special reference to target organs]. PMID- 3820635 TI - [Transmission and prevention of AIDS]. PMID- 3820636 TI - [Metabolic bone disease: morphology and biochemistry of bones]. PMID- 3820637 TI - [Metabolic bone disease: bone development and remodeling]. PMID- 3820638 TI - [Standardization of drug evaluation in the treatment of urinary tract infections]. PMID- 3820639 TI - [Trends in the development of new antibiotics for urinary tract infections]. PMID- 3820640 TI - [Combination chemotherapy in urinary tract infections]. PMID- 3820641 TI - [Clinical studies of urinary tract infections in a geriatric hospital]. PMID- 3820642 TI - [Characteristics of urinary tract infections in pediatric patients and a guide to therapy]. PMID- 3820643 TI - [Hereditary diseases associated with impaired glucose tolerance]. PMID- 3820644 TI - [Experimental models of diabetes mellitus]. PMID- 3820645 TI - [List of food items and their caloric equivalents for diabetic diet]. PMID- 3820646 TI - [List of standard body weight]. PMID- 3820648 TI - [List of hypoglycemic and other therapeutic agents used for the treatment of diabetes mellitus]. PMID- 3820647 TI - [Simple determination of blood sugar level]. PMID- 3820649 TI - [Diabetes-related clinical tests--methods and their clinical significance]. PMID- 3820650 TI - [Symptomatology of diabetes mellitus]. PMID- 3820652 TI - [Therapeutic programs for diabetic patients and short-term hospitalization for patient education]. PMID- 3820651 TI - [Various clinical conditions related to diabetes mellitus]. PMID- 3820653 TI - [Diabetic therapy--diet therapy]. PMID- 3820654 TI - [Diabetic therapy--exercise therapy]. PMID- 3820655 TI - [Diabetic therapy--oral hypoglycemic agents]. PMID- 3820657 TI - [System of diagnosis and control of diabetes mellitus]. PMID- 3820656 TI - [Determination of the efficacy (indices) of diabetic treatment]. PMID- 3820658 TI - [Self care by diabetic patients]. PMID- 3820660 TI - [Diabetic complications--description of various clinical conditions]. PMID- 3820659 TI - [Diabetic complications--a general theory]. PMID- 3820662 TI - [Diabetes mellitus: regulation of carbohydrate metabolism]. PMID- 3820661 TI - [General outline of diabetes mellitus]. PMID- 3820663 TI - [Diabetic coma]. PMID- 3820665 TI - [Abnormal glucose tolerance in various diseases]. PMID- 3820664 TI - [Clinical features of diabetes mellitus]. PMID- 3820666 TI - [Clinical MRI in disease. 1) Nervous system diseases. b. Cerebrovascular disorders]. PMID- 3820667 TI - [Clinical MRI in disease. 1) Nervous system diseases. c. Psychoneuroses]. PMID- 3820668 TI - [Clinical MRI of disease. 2) Circulation disorders. a. Myocardial infarct]. PMID- 3820670 TI - [Clinical MRI of disease. 3) Respiratory tract diseases. a. Lung cancer]. PMID- 3820669 TI - [Clinical MRI of disease. 2) Circulation disorders. b. Diseases of the great vessels]. PMID- 3820671 TI - [Clinical MRI of disease. 3) Respiratory tract diseases. b. Mediastinal tumors]. PMID- 3820672 TI - [Clinical MRI of disease. 4) Digestive system diseases. a. MRI of the gallbladder and liver cancer]. PMID- 3820673 TI - [Enhanced abdominal diagnosis using rapid MRI scans]. PMID- 3820674 TI - [Clinical MRI of disease. 4) Digestive system diseases. b. Pancreatic diseases]. PMID- 3820675 TI - [Clinical MRI of disease. 4) Digestive system diseases. c. MRI diagnosis of tumors of the large intestine]. PMID- 3820676 TI - [Clinical MRI of disease. 5) Urogenital system diseases. a. Tracer measurement by MRI. Kidney function evaluation]. PMID- 3820677 TI - [Clinical MRI of disease. 5) Urogenital system diseases. b. MRI diagnosis of kidney and urologic tumors]. PMID- 3820678 TI - [Clinical MRI of disease. 5) Urogenital system diseases. c. MRI of uterine and ovarian tumors]. PMID- 3820679 TI - [Principles of NMR and NMR whole-body imaging]. PMID- 3820680 TI - [Elimination of MRI motion artifacts and the synchronized respiration-heart beat system]. PMID- 3820682 TI - [A surface coil device and improvement of MRI resolving power]. PMID- 3820681 TI - [Contrast-enhanced MRI and contrast medium development]. PMID- 3820684 TI - [Advantages of permanent magnet MRI systems and trends in magnet development]. PMID- 3820683 TI - [MRI equipment, advances in magnet shielding systems]. PMID- 3820685 TI - [In vivo spectroscopy and chemical shift imaging]. PMID- 3820686 TI - [MRI equipment types and trends in their development. Normal conductors, permanent magnets, superconductors]. PMID- 3820688 TI - [Evaluation of the widespread use of MRI from an economic viewpoint]. PMID- 3820687 TI - [NMR blood flow measurement and NMR angiography]. PMID- 3820689 TI - [MRI of regional anatomy. Its characteristics and comparison with CT x-ray imaging. 1) Head and neck]. PMID- 3820690 TI - [MRI of regional anatomy. Its characteristics and comparison with CT x-ray imaging. 2) Thorax]. PMID- 3820691 TI - [MRI of regional anatomy. Its characteristics and comparison with CT x-ray imaging. 3) Abdomen]. PMID- 3820692 TI - [MRI of regional anatomy. Its characteristics and comparison with CT x-ray imaging. 4) Extremities]. PMID- 3820693 TI - [Clinical MRI in disease. 1) Nervous system diseases. a. CNS tumors]. PMID- 3820694 TI - [Clinical significance of serum neuron specific enolase (NSE) levels in patients with gastric and colorectal cancer]. PMID- 3820695 TI - [Biochemistry and clinical evaluation of cancer-associated carbohydrate antigens: an approach to the diagnosis using monoclonal antibody cocktails]. PMID- 3820696 TI - [Acute phase protein, especially with reference to the rapid quantitation of CRP]. PMID- 3820697 TI - [A rapid diagnosis of Campylobacter enteritis by direct smear examination]. PMID- 3820698 TI - [PACS (picture archiving and communication system)--preliminaries of medical care in the 21st century]. PMID- 3820699 TI - [Recent developments in tumor imaging using labeled anti-tumor monoclonal antibodies]. PMID- 3820700 TI - [Analysis of interdoctor variations in image reading and diagnosis dependent on image quality]. PMID- 3820701 TI - [Efficacy of the sitting position for intravenous digital subtraction angiography of the abdomen]. PMID- 3820703 TI - [Case of the month: Cavitary pulmonary sarcoidosis]. PMID- 3820702 TI - [Clinical evaluation of afterloading an Ir-192 source in the treatment of tongue cancer]. PMID- 3820704 TI - [Scintigraphy presentation. Bone scintigraphy of marble bone disease]. PMID- 3820705 TI - [Spinal arteriovenous malformation: assessment with magnetic resonance imaging and angiography]. PMID- 3820706 TI - [Gastric cancer with psammoma bodies]. PMID- 3820707 TI - [Primary lipoma and angiomyolipoma of the liver diagnosed by CT scan: report of two resected cases]. PMID- 3820708 TI - [A case of multifocal fibrosclerosis]. PMID- 3820709 TI - [High ectopic kidney: a case report]. PMID- 3820710 TI - [A report of three cases of renal cell carcinoma with multilocular cystic changes seen on CT]. PMID- 3820711 TI - [A case of retroperitoneal schwannoma preoperatively diagnosed as a non functioning adrenal tumor]. PMID- 3820712 TI - [Transcatheter splenic arterial embolization by using a balloon catheter]. PMID- 3820713 TI - [The basic introduction to MRI]. PMID- 3820714 TI - [MR imaging of cavernous hemangioma of the face and neck]. PMID- 3820715 TI - [Protruded superficial esophageal carcinoma--relation of X-ray findings to pathology and prognosis]. PMID- 3820716 TI - [X-ray diagnosis of acute gastritis]. PMID- 3820717 TI - [Intracranial hemorrhage in full-term neonates]. PMID- 3820718 TI - [Gaucher's disease]. PMID- 3820719 TI - [Bone scintigraphy of eosinophilic granuloma]. PMID- 3820721 TI - [Intracranial extension of a frontal sinus mucocele--a case report]. PMID- 3820720 TI - [A case of cavernous hemangioma of the brain with atypical radiographical findings]. PMID- 3820722 TI - [Arterial embolization of two patients with arteriovenous malformations of the extremities]. PMID- 3820723 TI - [Ulcerative colitis accompanied by ischemic colitis: a report of 2 cases]. PMID- 3820724 TI - [CT assisted nerve blocks using a guide apparatus]. PMID- 3820725 TI - [A simple and effective protection method during abdominal angiography]. PMID- 3820726 TI - [6 cases of friction melanosis with amyloid deposition and frequency of friction melanosis in general population by questionnaires]. PMID- 3820727 TI - [Sporotrichosis which showed peculiar clinical findings]. PMID- 3820728 TI - [Effects of hydrocortisone on function and structure of human skin fibroblasts in culture--especially effects on the growth, cytoskeleton and fibronectin]. PMID- 3820729 TI - [Basement membrane zone antigens during epidermal wound healing--EBA antigen, BP antigen and fibronectin]. PMID- 3820730 TI - [The 85th annual meeting of the Japanese Dermatological Association. Kyoto, May 16-18, 1986. Abstracts]. PMID- 3820731 TI - Mathematical analysis of transport phenomenon to the blood from the site of intramuscular injection with ampicillin in the rat. AB - The mathematical formula with time function of transport phenomenon is obtained by the analysis of the concentrations of ampicillin in the serum, bile and urine. This formula indicates the speed of transport of the drug, or the ratio of the vascular permeability of it for the administrated dose from the site of intramuscular injection into the blood as the time function. About 80% of ampicillin was transported into the blood through capillaries for 120 min from the beginning of intramuscular injection. PMID- 3820732 TI - Role of cholinergic mechanism in the hypoglycemic action of B. pertussis vaccine. AB - The present work aims to study the role of the cholinergic mechanism in the hypoglycemic action of B. pertussis vaccine in rats. The vaccine resembles insulin in that the hypoglycemia produced is mainly due to the increase conversion of glucose to glycogen in the liver and muscle. Both the hypoglycemia as well as glycogen deposition was partially blocked by atropine. On the other hand the vaccine potentiated the fall in the blood sugar and deposition of glycogen in the tissues produced by physostigmine. This suggests the possible involvement of the cholinergic system in the hypoglycemic action of the vaccine. PMID- 3820733 TI - Tetanus in Japan: trends of mortality, case fatality and causes of death. AB - The rapid decline of tetanus mortality in recent years, from 2.84 to 0.02 per 10(5) population during the period of 1947-1982 was largely due to the decrease in neonatal tetanus mortality which declined from 36.1 to 0 per 10(5) live birth during the same period (1947-1979). The incidence of neonatal tetanus was inversely related to the percent of babies born in medical institutions. Vaccination against tetanus contributed to the rapid decline of tetanus mortality in the 0 to 9 years old group excluding the neonates, but not necessarily in the other age groups. There was a conspicuous decline in case fatality from about 50 40% during 1940-1970 to 20% and 10% in the periods from 1971-1980 and 1981-1982, respectively. This is attributed to the recent trend of treating tetanus patients in intensive care units where even the most extremely moribund patients have come to be successfully treated in the past few decades. The causes of death of tetanus patients changed from about 1975. Respiratory insufficiency with or without pulmonary infection was predominant in the period from 1961-1974. Unexpected complications, i.e. perforation of esophageal fistula, bleeding from gastrointestinal ulcers, myocardial infarction, respiratory insufficiency due to hyalinosis of alveolar septae associated with prolonged artificial respiration etc. were the major causes of death in the years 1975-1985. PMID- 3820734 TI - Regressor serum factor-dependent nonspecific killers in tumor-bearing mice. AB - Spleen cells obtained from C3H/He or C57BL/6 mice bearing syngeneic ascitic tumor cells in the early stage of tumor progression had activity to lyse various tumor cells in vitro when serum from MM2-regressor C3H/He was added to the reaction mixture. The serum component responsible for the reaction was of non immunoglobulin nature. The serum factor-dependent cytotoxic cells were Thy-1 positive cells which were not adherent to nylon wool or Sephadex G-10 and were not natural killer cells. Allogeneic tumor cells and syngeneic tumor cells of near-tetraploid chromosomes were susceptible to such lysis whereas syngeneic near diploid cells were resistant. The serum factor was absorbed by susceptible cells and not by resistant cells. PMID- 3820735 TI - Clearance of inoculated microfilariae of Brugia malayi by monoclonal antibodies in BALB/c mice. AB - A stable and long-lasting microfilaremia was developed by intravenous injection with 2 X 10(5) microfilariae (mf) of Brugia malayi into BALB/c mice. Mf density in mice was maintained at least at 30 to 40 mf/20 microliter blood for 4 weeks, then gradually decreased as the same as in the jird. However, mf inoculated were cleared from the blood within 3 weeks in the mice which was immunized with repeated intravenous injections with live mf. The effect of mf clearance was passively transferred into the mice with inoculated microfilaremia by intravenous injection of 0.2 ml serum from the immunized mice. For the analysis of the role of anti-mf antibodies, monoclonal antibodies (MABs) against mf of B. malayi were produced. An IgG1 MAB gave a significant mf reduction in mice and it promoted in vitro adherence of normal mouse spleen cells to mf. PMID- 3820736 TI - Increased biosynthesis of alkaline phosphatase by serum, serum albumin and gamma globulin in chimpanzee liver cells in culture. PMID- 3820737 TI - Parameters used for assessment of molluscicides. PMID- 3820738 TI - [Roentgenographic estimation of the growth rate of esophageal cancers]. PMID- 3820739 TI - [Serum anti-Anisakis IgE antibody in patients with acute gastric anisakiasis]. PMID- 3820740 TI - [Experimental study on the functional activity of the reticuloendothelial system after partial hepatectomy in normal and CCL4-induced cirrhotic rats]. PMID- 3820741 TI - [Central signals of gallstones in magnetic resonance imaging]. PMID- 3820743 TI - [Clinical aspects of multidirection and multislice methods of abdominal MRI (magnetic resonance imaging)]. PMID- 3820742 TI - [Comparative study of the secretin test and pancreozymin secretin test in chronic pancreatitis]. PMID- 3820744 TI - [A case of ulcerative colitis with pyoderma gangrenosum]. PMID- 3820745 TI - [A case of large jejunal leiomyosarcoma with specific diagnostic images]. PMID- 3820746 TI - [A case of tumor thrombosis of the extrahepatic portal vein (cavernous transformation) secondary to gastric cancer]. PMID- 3820747 TI - [A case of post-operative hepatopetal mesenteric varices diagnosed by angiography]. PMID- 3820748 TI - [A case of old intrahepatic hematoma, suspected cystadenocarcinoma of the liver]. PMID- 3820749 TI - [A case of lymphangioma of the pancreas]. PMID- 3820750 TI - [Effects of a prostaglandin E1 derivative on survival of experimentally induced acute hepatic injury]. PMID- 3820751 TI - [The prevention of post-transfusional hepatitis using measurement of guanase activity]. PMID- 3820752 TI - [The esophageal mucosal hemodynamics in patients with liver cirrhosis]. PMID- 3820753 TI - [The effects of omeprazole, a proton pump inhibitor, on gastric mucosa, serum gastrin and pepsinogen activity of the rats, with special reference to neonatal development]. PMID- 3820754 TI - [Effects of prostaglandin derivatives on gastric mucus glycoproteins]. PMID- 3820755 TI - [Chemo-sensitive differences of primary, metastatic and recurrent tumors of human colorectal cancer]. PMID- 3820756 TI - [Mycobacteria in Crohn's disease]. PMID- 3820757 TI - [Healing process of experimental duodenal ulcer in rats--regeneration of intestinal epithelium from Brunner's glands]. PMID- 3820758 TI - [Clinicopathological studies on fungus infections of the digestive tract]. PMID- 3820759 TI - [Binding ratio of rat liver cells to peripheral lymphocytes in patients with liver diseases]. PMID- 3820760 TI - [A study on the serum levels of insulin-like growth factor-I (IGF-I) in patients with various chronic liver diseases]. PMID- 3820761 TI - [The incidence of palmar erythema in patients with alcoholic fatty liver--a comparative study with fatty liver of other origins]. PMID- 3820762 TI - [Release of cholecystokinin and exocrine pancreatic secretion, gallbladder contraction--establishment of a radioimmunoassay specific for CCK33]. PMID- 3820763 TI - [Effect of splanchnic lymphostasis on the pathogenesis of chronic pancreatic disorders]. PMID- 3820764 TI - [A case of kwashiorkor-like syndrome--research in lipid metabolism]. PMID- 3820765 TI - [A patient with asymptomatic primary biliary cirrhosis in association with Sjogren syndrome developing features of systemic lupus erythematosus]. PMID- 3820766 TI - [Portal thrombosis after splenectomy: hemodynamic analysis of two cases using an ultrasonic duplex system]. PMID- 3820767 TI - [Clinical significance of urinary levels of type III procollagen peptide in patients with various liver diseases and cancer of the alimentary tract]. PMID- 3820768 TI - [Simultaneous assay of serum lactate dehydrogenase activities depending on NAD (N) and thio-NAD (T), and the clinical significance of N/T values]. PMID- 3820769 TI - Mortality rate of amyotrophic lateral sclerosis in Japan: effects of marital status and social class, and geographical variation. PMID- 3820770 TI - Mitochondrial DNA polymorphism in Japanese living in Hokkaido. PMID- 3820771 TI - Cytotoxicity of lectins toward skin fibroblasts from patients with Duchenne muscular dystrophy and myotonic dystrophy. PMID- 3820772 TI - A fetal case of partial trisomy 6q(q21-qter) with renal dysplasia. PMID- 3820773 TI - [Carcinogenicity in mice by inhalation of benzotrichloride and benzoyl chloride]. AB - Benzotrichloride and benzoyl chloride are suspected to be causative agents of lung cancer and maxillary malignant lymphoma of workers employed in factories producing benzoyl chloride. The present study was undertaken to evaluate the carcinogenicity in mice of inhaling benzotrichloride and benzoyl chloride. Mice inhaled benzotrichloride and benzoyl chloride vapor for 30 min/d for 2 d/wk for 5 months, and each animal was followed for several month without subsequent exposure. Tumor developed in the lung, skin and lymphatic tissues at high incidences in mice inhaling benzotrichloride. By benzotrichloride vaporized at 50 degrees C, the incidence of pulmonary tumors was 53.1% (17/32, p less than 0.001), that of skin tumors was 25% (8/32, p less than 0.02), and that of malignant lymphoma was 25% (8/32, p less than 0.02) observed at the 10th month after exposure. These are significantly higher than that observed in control mice. In mice exposed to benzotrichloride vaporized at room temperature, the incidence of pulmonary tumors was 81.1% (30/37), that of skin tumors was 27.0% (10/37), and that of malignant lymphoma was 10.8% (4/37) observed at the 15th month after exposure. On the other hand, by benzoyl chloride vaporized at 50 degrees C, the incidence of pulmonary tumors was 10.7% (3/28) and that of skin tumors was 7.1% (2/28), but these incidences did not show any significant difference from the controls. These results suggest that the carcinogenicity of benzotrichloride is much higher than benzoyl chloride and that benzotrichloride is the primary cause of malignancies developing among workers engaged in manufacturing benzoyl chloride. PMID- 3820774 TI - [Validity of the self-assessing depression scale in industry]. PMID- 3820775 TI - [Development of the passive gas sampler for measurement of organic vapors]. PMID- 3820776 TI - [Alteration of heart rate following 1,1,1-trichloroethane inhalation]. PMID- 3820777 TI - [Erythrocyte and plasma cholinesterase activities on poisoning by disyston, fenitrothion and malathion]. PMID- 3820778 TI - [A questionnaire survey on the dissemination of personal exposure monitoring of organic solvents in Japan]. AB - A questionnaire survey on the dissemination of personal exposure monitoring of hazardous chemicals, especially organic solvents, was conducted on 404 Japanese institutions for occupational health and environment, including enterprises, national and municipal institutes, universities and colleges. Responses were received from 236 organizations. The results can be summarized as follows: Of the 236 organizations which responded, 89 (37.7%) had some experience in measuring personal exposure in workers exposed to hazardous chemicals. In 74.2% of these 89 institutions, personal exposure monitoring of organic solvents was being made. Passive dosimeter method was far more commonly employed in Japan than charcoal tube method. Personal exposure measurement is predominantly regarded to be supplementary to the general air sampling and measurement method provided for in the Working Environment Measurement Law (1975). It is considered that personal exposure monitoring would be further disseminated in Japan than today with the aim of improving the health care system for industrial workers and of elucidating epidemiologically the relationship of chemical exposure to biological effects. PMID- 3820779 TI - [Instrumentation physics in medicine: learning from the development of X-ray CT]. PMID- 3820780 TI - [Instrumentation physics in medicine: arterial blood flow and mass transport across the arterial wall--relevance to the localization of atherosclerosis]. PMID- 3820781 TI - [Instrumentation physics in medicine: blood rheology--viscosity and mechanical properties of blood cells]. PMID- 3820782 TI - [Instrumentation physics in medicine: theory of nuclear magnetic resonance and its application to in vivo measurement]. PMID- 3820783 TI - [Instrumentation physics in medicine: ELF electromagnetic field coupling to biological objects]. PMID- 3820784 TI - [Instrumentation physics in medicine: capacitance and dielectric constants]. PMID- 3820785 TI - [Instrumentation physics in medicine: measurement of the distribution of biomagnetic fields]. PMID- 3820786 TI - [Instrumentation physics in medicine: bioelectrodes]. PMID- 3820787 TI - [Instrumentation physics in medicine: thermometry by microwave radiometry]. PMID- 3820788 TI - [Instrumentation physics in medicine: non-invasive thermometry by computed tomography]. PMID- 3820789 TI - [Apparatus for measuring shoulder complex motion]. PMID- 3820790 TI - [Development of an automatic defibrillator with temporary pacing function after defibrillation]. PMID- 3820791 TI - [On the relations between the excitation fronts propagating in the heart and the equivalent dipoles]. PMID- 3820792 TI - [A medical synchronous thermographic system]. PMID- 3820793 TI - [Development of the trendgram display for fetal heart rate and studies on its changes]. PMID- 3820794 TI - [Child gait patterns on the basis of temporal and distance factors]. PMID- 3820795 TI - [Psychophysical measurement of geometrical optical illusions in various visual field conditions]. PMID- 3820796 TI - [A multivariate autoregressive model of R-R intervals and blood pressure time series]. PMID- 3820797 TI - [A photic evoked potential model expressed by second order systems with time lags]. PMID- 3820798 TI - [Studies of waveform recognition in EEG analysis]. PMID- 3820799 TI - [A method of managing data items for individual patients in a tabular database]. PMID- 3820800 TI - [A method for archiving patient data in free-sized records]. PMID- 3820801 TI - [The 70th conference of the Medico-Legal Society of Japan. Nagoya, 14-18 May 1986]. PMID- 3820802 TI - [Identification of a person by the superimposition method]. PMID- 3820804 TI - [Symposium: problems concerning compensation for traffic accidents, with special reference to injuries and fatalities]. PMID- 3820803 TI - [Toxicological examination from the medico-legal aspects]. PMID- 3820805 TI - [Report on Japan Air Lines Flight 123 crash]. PMID- 3820806 TI - [An intermediary report from the research committee on brain death of the Medico Legal Society of Japan--could brain death be regarded as somatic death?]. PMID- 3820807 TI - [Ultrastructural alterations of glomerular anionic sites in idiopathic membranous glomerulonephritis]. PMID- 3820808 TI - [Enzyme immunoassay of anti-renal basement membrane antibodies]. PMID- 3820809 TI - [Clinical significance of urinary acid-soluble protein in diabetic nephropathy]. PMID- 3820810 TI - [IgA deposits in the glomerular capillary wall in purpura nephritis]. PMID- 3820811 TI - [Coagulation-fibrinolysis system on pregnant toxicosis]. PMID- 3820812 TI - [Serum levels of malondialdehyde and antioxidant activity in patients with chronic renal failure]. PMID- 3820813 TI - [Inhibitory effects of dopamine biosynthesis on the development of spontaneous hypertension in rats]. PMID- 3820814 TI - [Glomerular lesions in primary biliary cirrhosis]. PMID- 3820815 TI - [Studies on normal renal weight and size in Japanese]. PMID- 3820816 TI - [Clinicopathological study of renal biopsy cases with predominant IgM deposition with particular reference to the disease entity, IgM nephropathy]. PMID- 3820817 TI - [An autopsy case of focal glomerulosclerosis (FGS) complicated by bilateral adrenal hemorrhage]. PMID- 3820818 TI - [A clinical study of renal cell carcinoma]. PMID- 3820819 TI - [A new C3NeF assay with zymosan-treated guinea-pig serum]. PMID- 3820820 TI - [Effect of prednisolone on blood coagulation in primary glomerular diseases]. PMID- 3820821 TI - [Hepatitis B virus-related nephropathy in adults]. PMID- 3820823 TI - [Study of circadian rhythm of urine output--study in water-free conditions]. PMID- 3820822 TI - [The effect of swimming on renal function in children with renal disease]. PMID- 3820824 TI - [Effect of continuous ambulatory peritoneal dialysis on serum aluminum concentrations]. PMID- 3820825 TI - [A case of acute renal failure caused by alcohol-induced rhabdomyolysis associated with severe abnormalities in calcium metabolism and type I renal tubular acidosis]. PMID- 3820826 TI - [Clinicopathological study of four cases of SLE nephritis in children with long term remission after 15 flare-ups]. PMID- 3820828 TI - [16th regional meeting of East and West Japan, Japanese Society of Nephrology. Abstracts]. PMID- 3820827 TI - [A maintenance hemodialysis patient with tuberous sclerosis presenting as severe hypocalcemia]. PMID- 3820829 TI - Clinical and histopathological characteristics of patients with IgA nephropathy showing massive proteinuria. PMID- 3820830 TI - Monoclonal antibody (KI-13) against glomerular cytoskeletal protein, produced by immunization with cultured mesangial cells from rabbits. PMID- 3820831 TI - Reversible renal failure in focal glomerular sclerosis. PMID- 3820832 TI - Adenine nucleotides and inorganic phosphate metabolism in experimental hydronephrotic kidneys. PMID- 3820833 TI - Acquired resistance to acute renal failure in ischemic and uranium-induced renal failure of rabbits. PMID- 3820834 TI - Ventricular arrhythmia in patients on maintenance hemodialysis. PMID- 3820835 TI - Frequency dependency of causal factors for hypertension in hemodialysis patients. PMID- 3820836 TI - Effects of oral adsorbent on experimental uremic rats. PMID- 3820837 TI - Renal adenomatosis associated with bilateral renal calculi. PMID- 3820838 TI - Monitoring the 24-hour urinary frequency in spontaneously hypertensive, and in Wistar rats: effect of alpha-blockers. PMID- 3820839 TI - [Evaluation of survival of grafted joint by bone scintigraphy: experimental studies using rat models]. PMID- 3820840 TI - [Correlation between Tl-201 myocardial scintigraphic findings and exercise induced ST depression in non-infarct-related leads in old myocardial infarction with one-vessel coronary disease]. PMID- 3820841 TI - [Enhanced binding of 131I-labeled monoclonal anti-CEA antibody to a CEA producing lung carcinoma cell line (QG56) after phorbol ester (TPA) treatment]. PMID- 3820842 TI - [Fundamental and clinical evaluation of immunoradiometric assay for TSH using monoclonal antibodies (Sucrosep)]. PMID- 3820843 TI - [Clinical experience of N-isopropyl-p-[123I] iodoamphetamine imaging in a case of brain death]. PMID- 3820844 TI - [A case of rhabdomyolysis demonstrated by 99mTc methylene diphosphonate bone scan]. PMID- 3820845 TI - [Utility of digital Tc-99m-MAA pulmonary perfusion images for estimating prognosis of dilated cardiomyopathy]. PMID- 3820846 TI - [Assessment of cardiac reserve by lung thallium-201 uptake after exercise in patients with ischemic heart disease]. PMID- 3820847 TI - [Aerosol lung inhalation scintigraphy in occupational lung disease]. PMID- 3820848 TI - [Assessment of the clinical significance of washout rate analysis by the exercise stress thallium-201 myocardial scintigram in coronary artery disease]. PMID- 3820849 TI - [Binding sites and subcellular distribution of N-isopropyl-p-(I 125)iodoamphetamine in the rat brain]. PMID- 3820850 TI - [Clinical trials of melanoma imaging with In-111-labeled monoclonal antibody 96.5]. PMID- 3820851 TI - [Radioiodinated peanut agglutinin (PNA): in vitro binding to various tumor cells]. PMID- 3820852 TI - [Measurement of regional cerebral blood flow using N-isopropyl-p-(I 123)iodoamphetamine; changes caused by auditory stimulation]. PMID- 3820853 TI - [Clinical experience with radioiodine treatment of differentiated thyroid carcinoma]. PMID- 3820854 TI - [An interesting case of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) showing an unusual accumulation pattern of 123I-N isopropyl-p-iodoamphetamine]. PMID- 3820855 TI - [Fundamental and clinical evaluation of a highly sensitive immunoradiometric assay kit (RIA-gnost TSH Ultrasensitive) for serum TSH]. PMID- 3820856 TI - A comparative study on the effects of disulfiram and beta-lactam antibiotics on the acetaldehyde-metabolizing system in rats. AB - Several beta-lactam antibiotics, especially those containing N methyltetrazolylthiomethyl groups at the 3-position of the cephalosporin nucleus, affect the alcohol-metabolizing system in rats. These effects were compared those with disulfiram, well-known as a potent inhibitor of aldehyde dehydrogenase (ALDH). Both disulfiram and antibiotics containing the N methyltetrazolylthiomethyl group inhibited both mitochondrial low Km ALDH and acetaldehyde oxidation in rat livers. The high Km ALDH and alcohol dehydrogenase activities in livers were not affected by these treatments. When ethanol was given to rats pretreated with disulfiram or these antibiotics, the blood acetaldehyde concentration increased markedly concomitant with a decrease in activity of the low Km ALDH. Administration of N-methyltetrazolethiol alone suppressed the low Km enzyme activity and also increased the blood acetaldehyde level; both effects were pronounced and observed several hours after administration. beta-Lactam antibiotics without N-methyltetrazolethiol in their molecule did not affect the liver mitochondrial enzyme activity or the blood acetaldehyde level. PMID- 3820857 TI - Effects of hypophysectomy and growth hormone treatment on sex-specific forms of cytochrome P-450 in relation to drug and steroid metabolisms in rat liver microsomes. AB - Hypophysectomy decreased the content of a male specific cytochrome P-450, P-450 male, in male rats, while it expressed P-450-male and completely depressed a female specific cytochrome P-450, P-450-female, in female rats. Intermittent injections of human growth hormone (GH), which mimic the secretion in males, restored P-450-male in hypophysectomized (Hypox) male rats and partially restored P-450-female in Hypox female rats. Continuous infusion of GH, which mimics the female secretion pattern, into Hypox male rats caused a further decrease in P-450 male content, and it caused the expression of P-450-female. In Hypox female rats, the same treatment depressed P-450-male and expressed P-450-female to the level of an intact female. These results indicate that the diurnal changes in the pattern of serum growth hormone level regulate the expression of P-450-male and P 450-female. The activities of testosterone 2 alpha- and 16 alpha-hydroxylases were closely correlated to P-450-male content with the correlation coefficients (r) of 0.955 and 0.929, respectively. Benzo(a)pyrene hydroxylation was also correlated to P-450-male content (r = 0.850). Aminopyrine N-demethylation and propoxycoumarin O-depropylation were correlated to less extents (r = 0.692 and r = 0.720), while aniline hydroxylation and O-ethylresorufin O-deethylation were not correlated to P-450-male content. These results indicate that testosterone 2 alpha- and 16 alpha-hydroxylations are closely dependent, but the metabolism of a variety of drugs are dependent to different extents on P-450-male in rat liver microsomes. PMID- 3820858 TI - Pathogenic mechanisms involved in mepirizole-induced duodenal damage in the rat. AB - Mepirizole (60 and 200 mg/kg) administered s.c. induced damage in the surface epithelial cells of the rat proximal duodenum as early as 2 hr after the treatment. 16,16-Dimethyl prostaglandin E2 (dmPGE2, 30 micrograms/kg) administered s.c. significantly protected the duodenal mucosa against mepirizole induced damage for up to 6 hr. Gastric acid secretion in acute fistula preparations was significantly reduced 1 hr after administration of mepirizole (60 and 200 mg/kg). The secretion reverted to the control level 2 hr later. In the 60 mg/kg-treated group, however, there was a significant increase in the acid output for up to 6 hr. Duodenal HCO3- secretion, stimulated with 10 mM HCl was significantly inhibited with mepirizole (60 and 200 mg/kg). Mepirizole (60 and 200 mg/kg) significantly increased the amount of acid in the duodenum for 2 to 6 hr after the treatment. dmPGE2 (30 micrograms/kg) significantly inhibited gastric acid secretion, stimulated duodenal HCO3- secretion, and reduced the increased amount of acid in the duodenum in response to mepirizole. Endogenous prostaglandin E2 and 6-keto prostaglandin F1 alpha in the duodenal mucosa were significantly reduced by mepirizole (200 mg/kg) 1 to 2 hr later. Mepirizole induced duodenal damage appears to be caused by the increased amount of acid in the duodenum. PMID- 3820859 TI - Studies on the nephrotoxicity of aminoglycoside antibiotics and protection from these effects (3). Protective effect of latamoxef against tobramycin nephrotoxicity and its protective mechanism. AB - Effect of latamoxef (LMOX) against tobramycin (TOB)-induced nephrotoxicity was studied in rats. Treatment with TOB (90 mg/kg/day, s.c.) alone resulted in marked increases in the activities of urinary enzymes such as lactate dehydrogenase, N acetyl-beta-D-glucosaminidase and lysozyme, urinary protein content and blood urea nitrogen, which peaked on the 7th or 10th day. The combination with LMOX (500, 1000 or 2000 mg/kg/day, s.c.) significantly suppressed increases in the parameters with TOB alone. The extent of this suppression roughly depended on the LMOX dosage. Although TOB alone caused pronounced histological changes such as extensive cortical proximal tubular cell necrosis, residual tubular basement membrane and cast formations in the renal cortex and medulla on the 7th day, these changes were apparently suppressed by combination with LMOX. In addition, intrarenal TOB concentrations in the rat given TOB alone were about 350, 500 and 1000 micrograms/g tissue wet weight at 3 hr, on day 3 and on day 5, respectively. On the other hand, there was a significant reduction (30-60%) in intrarenal TOB concentration by combination with LMOX. These results indicate that combination with LMOX obviously protects the rat kidney from TOB nephrotoxicity, and the protective effect may be partially due to suppression of intrarenal accumulation of TOB by LMOX. PMID- 3820860 TI - Possible mechanisms underlying the hypertensive response to clonidine in freely moving, normotensive rats. AB - Possible mechanisms underlying the hypertensive response to intracerebroventricular (i.c.v.) or intravenous (i.v.) injection of clonidine were investigated in freely moving, normotensive rats. In conscious rats, clonidine (2-20 micrograms) injected i.c.v. caused a dose-dependent and long lasting pressor response associated with bradycardia. A similarly long-lasting pressor response was induced following an initial rapid rise in mean blood pressure after i.v. bolus injections of clonidine (5-50 micrograms/kg). In pentobarbital-anesthetized rats, the prolonged pressor responses to i.v. and i.c.v. injected clonidine at high doses were significantly smaller than those in conscious rats. Low doses of clonidine caused only depressor responses which developed gradually. No significant changes in concentrations of plasma norepinephrine and epinephrine were found during the pressor period after i.c.v. injection of clonidine (20 micrograms). Systemic (2 mg/kg, i.v.) or central (100 micrograms, i.c.v.) pretreatment with phentolamine abolished only the prolonged pressor response to both i.c.v. (20 micrograms) and i.v. (50 micrograms/kg) injected clonidine. The prolonged pressor response to clonidine (20 micrograms, i.c.v.) was enhanced by pretreatment with hexamethonium (25 mg/kg, i.v.), methylatropine (1 mg/kg, i.v.) or atropine (1 mg/kg, i.v.) and it was not affected by pretreatment with saralasin (300 micrograms/kg and 25 micrograms/kg/min, i.v.), d(CH2)5Tyr(Me)-arginine-vasopressin, a vasopressin antagonist (50 micrograms/kg, i.v.) or naloxone (1 mg/kg, i.v.). Neither adrenalectomy nor adrenal demedullation had an effect on the pressor response to clonidine (20 micrograms, i.c.v.). In adrenalectomized rats, systemic pretreatment with hexamethonium (25 mg/kg, i.v.) caused a potentiation of the pressor response to clonidine (20 micrograms, i.c.v.). These results suggest that clonidine induces the pressor response through activation of central alpha adrenoceptors, probably the alpha 2 subtype, without an increase in sympatho adrenomedullary activity. It is speculated that the response may be mediated by vasoactive humoral substance(s). PMID- 3820861 TI - Taurine transport in chronically stimulated fast- and slow-twitch muscles of the rat. AB - Indirect stimulation via the sciatic nerve, 10 or 100 Hz stimulus trains of 1 sec duration, applied every 3 sec, 8 hr/day for 1-4 weeks increased taurine concentration of the extensor digitorum longus (EDL, fast-twitch) muscle of the rat. The uptake of [3H]-taurine into the EDL and tibialis anterior (TA, fast twitch) muscle was also increased by the stimulation. Concentration and uptake of taurine in the soleus muscle (SL, slow-twitch) did not change by chronic 10 Hz stimulation. Taurine concentration in the SL muscle was significantly reduced by chronic 100 Hz stimulation. This study shows that chronic nerve stimulation increases the uptake of taurine in the fast-twitch muscles, but not in the slow twitch muscle. PMID- 3820862 TI - Effects of methysergide on the cough reflex. AB - The present study had two basic purposes: to observe the effect of methysergide on the cough reflex and to investigate the effect of methysergide on the antitussive effect of dextromethorphan. Male and female cats were anesthetized with pentobarbital-Na. Respiration and cough reflex were measured using a pneumotachograph via a cannula inserted into the trachea. The cough reflex was elicited by electrical stimuli to the superior laryngeal nerve. Methysergide (3 mg) injected into the vertebral artery increased the number of coughs and respiratory frequency. Dextromethorphan in a dose of 3 mg inhibited the cough reflex. Methysergide (1 and 3 mg) reduced the antitussive effect of dextromethorphan in a dose-dependent manner, but did not inhibit the excitatory effect on respiratory frequency. These findings might indicate that the central serotonergic system has an inhibitory role on the cough reflex and may be related to the antitussive mechanisms of dextromethorphan. PMID- 3820863 TI - Clinicopathological study on hematogenous metastasis of pancreatic cancer. AB - Out of 272 pancreatic cancer patients, 94 with hematogenous metastasis were clinicopathologically analyzed. The incidence of hematogenous metastases on laparotomy was 31.3 per cent in the liver, 1.8 per cent in the lung, 1.1 per cent in the adrenal gland and 0.4 per cent in the navel, respectively. The incidence of liver metastasis, in 22.9 per cent of the patients with carcinoma of the head of the pancreas and in 47.3 per cent of those of the body and tail of the pancreas, was higher than that of carcinomas of the other digestive organs. In autopsy findings, early metastases to the liver, lung, cerebellum and ovarium were evident. A higher rate of liver metastasis with lymph node involvement in the early stage of the disease was peculiar to cases of pancreatic cancer. PMID- 3820864 TI - Plasma endotoxin levels and functions of peripheral granulocytes in surgical patients with respiratory distress syndrome. AB - Plasma endotoxin levels and granulocyte functions (chemiluminescence and chemotaxis) were determined in fifty-two patients with postoperative sepsis. Seventeen had concurrent respiratory distress syndrome (RDS group) and the remaining thirty-five were free of the syndrome (non-RDS group). The plasma endotoxin concentrations were higher in the RDS group than in the non-RDS group (p less than 0.001). All nine patients with particularly high levels (greater than 80 pg) belonged to the RDS group. We noted a positive correlation in chemiluminescence (p less than 0.001, r = 0.67) and a negative correlation in chemotactic activity (p less than 0.001, r = 0.69). To determine whether endotoxin alters normal granulocyte functions in vitro, healthy granulocytes were treated by the endotoxin (E. coli 0111:B4). There was an increase in chemiluminescence and a decrease in chemotactic activity, as observed in vivo. Furthermore, normal granulocytes chemiluminescence was increased by pretreatment of RDS plasma showing high endotoxin levels in vitro (n = 4, p less than 0.05). Thus, endotoxin in the plasma probably plays an important role in marked changes in peripheral granulocyte functions in patients with respiratory distress syndrome. PMID- 3820865 TI - Chitin is an effective material for sutures. AB - Chitin is an absorbable suture material with suitable mechanical properties. Tissue reaction is not specific and the good healing which ensued provided evidence for a satisfactory biocompatibility. Toxicity tests, including acute toxicity, pyrogenicity, mutagenicity were negative in all respects. The chitin suture was absorbed in about four months in rat muscles. The persistence of the tensile strength of the chitin was better than Dexon (TM) or catgut in bile, urine and pancreatic juice but weakening occurred early in the presence of gastric juice. Application in 132 patients proved satisfactory. Adverse effects were nil. PMID- 3820866 TI - Pulmonary function after lobectomy in children under ten years of age. AB - A long-term follow-up study on pulmonary function in twelve lobectomized children under ten years of age at the time of surgery was performed to determine the patterns of compensation. In the patients over ten years old at the time of the test performed over two years postoperatively, there was neither compensatory regeneration nor compensatory overdistension of the remaining lung tissue. However, there appeared to be an increase in the vital capacity, probably due to the growth of surrounding tissue such as thorax, respiratory muscles, and diaphragm. In contrast, the children tested under the age of eight years showed evidence of mild overdistension during the early postoperative period, but not at two years. There was no sign of overdistension in the patients over ten years of age at the time of testing. PMID- 3820867 TI - Dermatofibrosarcoma protuberans--a clinicopathological study of ten cases. AB - Dermatofibrosarcoma protuberans is a low grade soft tissue tumour of skin and frequently recurs. It is a locally invasive tumour and hence wide excision is required to minimize recurrences. Tumours of low mitotic rate, less than 5 per 10 high power fields with a lesser degree of cellularity and anaplasia tend to follow a more indolent course than those with moderate to high grades with higher mitotic rates. PMID- 3820868 TI - Primary malignant thymoma in a 6-year-old boy. AB - Although not uncommon in adults, thymomas are the least common mediastinal tumors in children. The behavior of these tumors in children is partially distinct with a much more rapid course and a poor prognosis. A symptom-free 6-year-old boy was treated for malignant thymoma detected incidentally on a chest X-ray in a school mass examination. At operation, the tumor was found to have already invaded the surrounding tissue. Complete removal at the base of the invasive tumor is the treatment of choice. PMID- 3820869 TI - Breast cancer in a man treated effectively with a large dose of tamoxifen citrate. AB - Breast cancer in males is comparatively rare. A 41-year-old man visited our hospital with a complaint of left breast tumor. Initial examination showed remarkably diffuse metastatic lesions in the lung field and small metastatic lesions in the surrounding skin. Modified radical mastectomy, including the surrounding metastatic skin lesions, and incisional biopsy of the lung were performed. Estrogen receptor was positive in both the primary breast cancer and metastatic cancer lesions in the lung. Postoperative medication of tamoxifen citrate, an estrogen receptor blocking agent, in a dose of 30 mg/day, was given together with fluorouracil, BCG, cyclophosphamide, and methotrexate. No evident change could be seen in the lung field six months after the operation. The metastatic lesions in the lung disappeared two years after the operation when the dose of tamoxifen citrate was increased to 60 mg/day. At this writing, thirty months after the operation, the patient is in good health. PMID- 3820870 TI - Latero-lateral end anastomosis for right hemicolectomy using staplers. AB - In seven patients undergoing right hemicolectomy for benign or malignant diseases, latero-lateral end anastomoses were made using stapling devices, LS (linear stapler) and GIA (gastrointestinal anastomosis). As no complications directly related to the anastomosis occurred, we conclude that anastomosis using stapling devices for right hemicolectomy is a safe and rapid procedure. PMID- 3820871 TI - [Endoscopic classification of peripheral airway lesions]. PMID- 3820872 TI - [Cutaneous delayed hypersensitivity to methyl hepatine carbonate in pulmonary tuberculosis]. PMID- 3820873 TI - [The significance of creatine kinase isozymes as biomarkers of carcinoma of the lung]. PMID- 3820874 TI - [A clinicopathological study of pneumonia in the elderly]. PMID- 3820875 TI - [Prognosis of diffuse panbronchiolitis]. PMID- 3820876 TI - [Evaluation of transtracheal aspiration in pulmonary infection of lung cancer]. PMID- 3820877 TI - [Bronchoalveolar lavage cell findings in patients with PIE syndrome--a suggestion concerning pathogenesis]. PMID- 3820878 TI - [A morphological study of bronchus-associated lymphoid tissue (BALT)]. PMID- 3820879 TI - [A case of exacerbation of chronic pulmonary disease successfully treated by extracorporeal lung assist with a membrane lung]. PMID- 3820880 TI - [A case of Cheyne-Stokes respiration--a mechanism of ventilatory control and the effect of acetazolamide]. PMID- 3820881 TI - [Biochemical analysis of a bronchogenic cyst]. PMID- 3820882 TI - [A case of aortic arch syndrome associated with liver dysfunction, pulmonary lesion and pleuropericardial effusion responsive to anti-tuberculous treatment]. PMID- 3820883 TI - [Supra-annular oblique aortic valve replacement (David procedure) in a patient with aortic stenosis]. PMID- 3820884 TI - [Modified Fontan operation after pulmonary artery banding for a single ventricle with levo-transposition of great arteries: a case report]. PMID- 3820885 TI - [Measurement of creatine-kinase isoenzymes during open heart surgery--elevation of CK-BB and organ failure]. PMID- 3820886 TI - [Concentric stent-post creeping of porcine xenografts in mitral position]. PMID- 3820887 TI - [Clinical application of transesophageal echocardiography]. PMID- 3820888 TI - [Managements of patients after application of a left ventricular assist device (LVAD)]. PMID- 3820889 TI - [One-stage revascularization surgery of coronary artery disease associated with other vascular lesions]. PMID- 3820890 TI - [A case of isolated nodular pulmonary amyloidosis]. PMID- 3820891 TI - [Dysfunction of the Bicer val mitral prosthesis--emergency operation with survival]. PMID- 3820892 TI - [A successful repair of recurrent coarctation using a heparinized shunt tube (Anthron)]. PMID- 3820893 TI - [Abstracts of papers presented at the XXVIII annual meeting of the Japan Society of Smooth Muscle Research (II). Tokyo, 26-27 June 1986]. PMID- 3820894 TI - [Clinical study of cystinuria]. PMID- 3820895 TI - [Studies on the hemodynamics of erection by electrostimulation of the cavernous nerves in the dog]. PMID- 3820896 TI - [Enhancing cytotoxic effect of calcium antagonists on anticancer agents in human renal cell carcinoma cells in vitro]. PMID- 3820897 TI - [Statistical and clinical observations on urolithiasia at the Department of Urology, Hamamatsu University School of Medicine, during the seven-year period after the opening of our clinic (November, 1977-December, 1983)]. PMID- 3820898 TI - [Magnetic resonance imaging of bladder tumors]. PMID- 3820899 TI - [Renal cell carcinoma: a clinical study of fatalities]. PMID- 3820900 TI - [Intravesical bacillus Calmette-Guerin (BCG) in the treatment of superficial bladder tumors: effect of intravesical BCG on papillary tumors]. PMID- 3820901 TI - [A case of invasive bladder carcinoma cured by combined cisplatin and radiation therapy]. PMID- 3820903 TI - Studies on the parasite fauna of Malaysia. I. A redescription of Strongylus brauni Linstow, 1897, and the establishment of a new genus, Viverrostrongylus. PMID- 3820902 TI - [Two cases of "9 + 0" immotile spermatozoa]. PMID- 3820904 TI - Morphological study of the synlophe of the intestinal nematode, Heligmonella leporis (Schulz, 1931) Durette-Desset, 1971 (Heligmonellidae: Trichostrongyloidea) from lagomorphs in Japan. PMID- 3820905 TI - Ohbayashinema abei sp. n. (Nematoda: Heligmosomidae) from the northern pika, Ochotona hyperborea Pallas, in Hokkaido, Japan. PMID- 3820906 TI - A new genus of the intestinal nematode, Lagostrongylus (Heligmonellidae) from lagomorphs: a review of related genera of subfamilies Heligmonellinae and Brevistriatinae. PMID- 3820907 TI - Echocardiographic detection of bovine cardiac diseases. PMID- 3820908 TI - Role of adherent mononuclear cells derived from adult pigs and suckling piglets in response to pokeweed mitogen-induced immunoglobulin production. PMID- 3820909 TI - The first record of Brevistriata bergerardi Durette-Desset, 1970 from an asiatic chipmunk, Tamias sibiricus lineatus Siebold, in Hokkaido, Japan. PMID- 3820910 TI - Multiplication of canine coronavirus in CRFK cells. PMID- 3820911 TI - Newcastle disease viruses isolated from racing pigeons in Japan. PMID- 3820912 TI - Plasma gastrin levels in cows at various growing stages. PMID- 3820913 TI - Developmental electroencephalogram of non-REM sleep in beagle dogs. PMID- 3820914 TI - Heterogeneity in immunologic functions among canine alveolar macrophage subfractions. PMID- 3820915 TI - Relationship between ovarian follicles and peripheral levels of sex steroid hormones during early midpregnancy in cows. PMID- 3820916 TI - Levels of serum protein, protein fractions and minerals in dairy cow with traumatic gastritis of various conditions. PMID- 3820917 TI - Immunocytochemical studies on the cytodifferentiation of the adenohypophysis of the golden hamster. PMID- 3820918 TI - Systemic proliferative vasculitis and glomerulonephritis in ICR-nude mice infected with mouse hepatitis virus. PMID- 3820919 TI - Eight calves of cervical ectopia cordis and their sternums. PMID- 3820920 TI - Clinical application of milbemycin D as a prophylactic agent against Dirofilaria immitis infection in dogs: clinical findings in dogs with shock-like reaction. PMID- 3820921 TI - Total and differential leukocyte counts of traumatic gastritis classified under three types in dairy cows. PMID- 3820922 TI - Biotyping of coagulase-positive Staphylococcus aureus and Staphylococcus intermedius strains isolated from various animals in Japan. PMID- 3820923 TI - Application of enzyme-linked immunosorbent assay (ELISA) to detection of antibodies against Tyzzer's organism (Bacillus piliformis) in mice. PMID- 3820924 TI - Correlation between the indirect hemagglutinating antibody and protection of mice against Clostridium chauvoei. PMID- 3820925 TI - Clinical application of milbemycin D as a prophylactic agent against Dirofilaria immitis infection in dogs: sensitivity for the drug in rough-coated collies. PMID- 3820926 TI - Fluorescein angiogram in diabetic dogs. PMID- 3820927 TI - Prophylactic efficacy of milbemycin D against multiple infection of Dirofilaria immitis in dogs. PMID- 3820928 TI - A case of bovine cerebral mucormycosis. PMID- 3820929 TI - Plasma concentrations of beta-carotene and vitamin A in cows with ovarian cyst. PMID- 3820930 TI - Correlations among Mg, Ca and P contents of digesta in the gastro-intestinal tract of rats. PMID- 3820931 TI - Hepatic and spinal lesions in goats chronically intoxicated with cycasin. PMID- 3820932 TI - A case of seminoma in a black swan. PMID- 3820933 TI - Guidelines for Level III perinatal centers in Kansas. PMID- 3820934 TI - Proximal tubule morphology after single nephron obstruction in the rat kidney. AB - This study examined the effects on proximal tubule morphology of blocking single nephrons with paraffin wax for one day, one week, or one month in the rat. Proximal tubule lumens were blocked with a short column of wax using micropuncture. Chronically blocked and control (normal) tubules were fixed by either intravascular or intraluminal perfusion of glutaraldehyde solution. Proximal tubule segments downstream to the wax block were examined by light and transmission electron microscopy. Intraluminal Alcian blue dye, serial sectioning, and nephron microdissection techniques were used to identify nephrons. One day after obstruction, all proximal tubule cells downstream to the block were injured. Some recovery was seen. S1 and S2 segments showed more severe damage than S3 segments. Alcian blue, which normally is excluded from cells, entered the cytoplasm of some damaged S1-S2 cells. After one week of obstruction, the tubule appeared to have reconstituted itself, but cells were less differentiated than normal. One month after obstruction, blocked tubules were atrophied. Tubule cells were simplified and were surrounded by a thickened basement membrane. The results suggest that prolonged proximal tubule blockade produces injury and atrophy of the proximal tubule probably due to ischemia and interruption of normal reabsorptive activity. PMID- 3820935 TI - Role of peritubular capillary forces in the renal action of carbonic anhydrase inhibitor. AB - Micropuncture study was performed in Munich-Wistar rats to assess peritubular capillary Starling forces in renal superficial cortex during suppression of proximal fluid reabsorption by carbonic anhydrase inhibitor. Administration of benzolamide (2 mg/kg/hr, i.v., Group 1, N = 7 rats) caused not only reduction in absolute rate of proximal fluid reabsorption (APR, from 26.7 +/- 4.0 nl/min to 17.7 +/- 3.6, P less than 0.001), but also an increase in peritubular transcapillary hydraulic-pressure difference (from 10.0 +/- 0.5 mm Hg to 15.2 +/- 0.5, P less than 0.001). In a separate group of seven rats (Group 2), these parameters did not change significantly without benzolamide treatment. In Group 1 rats, an attempt was made to nullify the benzolamide-induced reduction in the peritubular capillary net reabsorptive forces by infusing hyperoncotic high hematocrit blood. Following this treatment, while benzolamide administration was continued, values for APR returned to levels (25.6 +/- 4.8 nl/min) nearly identical to those measured prior to benzolamide administration, in association with a rise in peritubular transcapillary oncotic pressure difference. A separate group of six rats treated in a fashion identical to that of Group 1 showed continued suppression of carbonic anhydrase activity following blood infusion as indicated by low levels of whole kidney bicarbonate reabsorption rate. Peritubular capillary reabsorption coefficient was calculated based on the measured values for Starling forces in Group 1 and were unaffected throughout the study. Continued benzolamide administration alone without the treatment of hyperoncotic blood did not change APR significantly (Group 3, N = 7 rats).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820936 TI - Contraction and relaxation of cultured mesangial cells on a silicone rubber surface. AB - Glomerular mesangial cells (MC) in culture are believed to contract or relax in response to agents such as angiotensin II and cyclic AMP. However, cells grown on glass or plastic surfaces are limited in their response to vasoactive agents because of the rigid surfaces to which they adhere; thus, interpretation of a change in shape as contraction, relaxation, or detachment is difficult. We have grown MC on a flexible silicone rubber (dimethylpolysiloxane) substrate (DMPS), and studied with sequential photographs several models of cell contraction, relaxation, and detachment. When the cells contracted, the DMPS became wrinkled; when the cells relaxed, the DMPS lost wrinkles. In contrast, if the cells detached, the sheet lost wrinkles as the cells became smaller and rounder. Angiotensin II (5 X 10(-7) M), and calcium ionophore A23187 (2 X 10(-6) M) increased wrinkles in more than 30% of cells at 22 degrees C and more than 40% of the cells at 36 degrees C. The earliest effect was visible within five to 10 minutes at 22 degrees C and within one minute at 36 degrees C and increased until 40 minutes; thereafter, the cells relaxed and wrinkles were reduced. 10(-1) M Na azide prevented the increase in wrinkles produced by angiotensin II. Seventy-two percent of the angiotensin II-treated cells whose margins could be seen in their entirety, and 78% of the calcium ionophore-treated cells showed a reduction in surface area at a time when new wrinkles were appearing or wrinkles were increasing in size. Dibutyryl cyclic AMP, a known smooth muscle relaxant, produced a decrease or loss of wrinkles in 90% of the cells, and an accompanying increase in surface area. Untreated control cells, observed in conjunction with the above series, showed little change in wrinkles. Ten percent DMSO, an actin translocating agent, produced a reversible disappearance of wrinkles. These models of contraction and relaxation could be distinguished from cell detachment; EDTA, for example, in the presence of zero calcium, diminished both cell size and wrinkles, with an accompanying lifting of cells from the surface. Similar results were obtained with cytochalasin B and chlorpromazine. Thus, the silicone rubber system accurately reflects the contraction, relaxation and detachment of cultured mesangial cells in response to a variety of agents. PMID- 3820937 TI - Effect of chronic administration of different Bence Jones proteins on rat kidney. AB - The role of Bence Jones proteins (BJPs) in the genesis of the renal dysfunction that develops in patients with multiple myeloma is not clearly defined. We previously evaluated renal function and morphology in a unique strain of rats (LOU/m) bearing tumors which synthesized BJPs with isoelectric points of 5.2, 4.3 and 6.7. Myeloma cast nephropathy developed in one tumor bearing group (pI 5.2), tubular necrosis was observed in another (pI 4.3), and renal function and histology remained normal in a third group (pI 6.7). To see if these renal outcomes were a function of the BJP being excreted or other factors which could be present in the tumor bearing animals, we have examined the effect of chronic intravenous administration of these three BJPs on renal function and histology in non-tumor-bearing LOU/m rats. Urine containing the BJP was collected from tumor bearing rats, sterilized by passage through a 0.2 mu millipore filter, concentrated to 50 mg/ml, and dialyzed extensively so as to remove material with a molecular weight less than 3500. Chronic indwelling-venous catheters were placed in non-tumor-bearing LOU/m rats and these rats were given 100 mg/day for five days of one of the three BJPs. Polyfructosan clearance (Cin) was measured prior to and following the five days of BJP administration. Renal histology was examined at the completion of the second Cin. In the pI 5.2 group (N = 6), a severe distal nephron cast nephropathy occurred and Cin fell from 2.88 +/- 0.24 to 0.90 +/- 0.17 ml/min (P less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820938 TI - Utilization of alpha-ketoisocaproate for protein synthesis in uremic rats. AB - We have recently shown that the nutritional efficiency, R, of alpha ketoisocaproate (KIC) as a substitute for leucine, defined as the ratio of the dose of leucine to the dose of KIC (on a leucine-free diet) for equal growth, can be evaluated isotopically: 14C-KIC and 3H-leucine are administered p.o.; six hours later, 14C/3H in the leucine of whole body protein, divided by 14C/3H in the injectate, gives a value distinguishable from R assessed in the same animals by growth experiments. To see how chronic uremia affects R, 11/12 nephrectomized rats and sham-operated controls were fed a regular diet for 15 days and then given these isotopes p.o. Six hours later, R, measured in whole body protein, and in the protein of brain, heart, muscle, salivary gland, liver, and the kidney remnant was significantly greater than in sham-operated controls. The greatest difference (39%) was seen in liver protein and the smallest difference (19%) in muscle. Thus chronic uremia increases the efficiency, relative to leucine, with which KIC is utilized for protein synthesis in all of these organs and in the body as a whole. Possible explanations are discussed. PMID- 3820939 TI - The effects of angiotensin II and norepinephrine on afferent arterioles in the rat. AB - Perfusion-fixation and vascular casting were used to determine if angiotensin II and norepinephrine cause constriction of afferent arterioles, and if so, whether or not the constriction is principally attributable to a secondary (autoregulatory) response to elevated pressure in the renal circulation. Rats were divided into six groups, and were given five minute infusions of angiotensin II, norepinephrine, or normal saline before perfusion-fixation. Angiotensin II infusions were given to animals in Groups 1 and 2; in Group 1 the renal circulation was exposed to elevated blood pressure, but in Group 2 intrarenal pressure was maintained at normal levels by partial ligation of the aorta above the renal arteries. Groups 3 and 4 were comparable to Groups 1 and 2 respectively, except that norepinephrine was infused instead of angiotensin II. Groups 5 and 6 received infusions of normal saline instead of vasopressor substances. In Group 5, renal vessels were perfusion-fixed at elevated pressures, while in Group 6 renal vessels were perfusion-fixed at normal pressures. Scanning electron microscopy was used to examine and measure vascular casts of 40 to 50 afferent arterioles from each rat. In Groups 1 through 4, casts of afferent arterioles showed severe, focal, and irregularly distributed constriction. In Groups 5 and 6 there was no qualitative evidence of afferent arteriolar constriction or irregularities in vessel caliber. Vessel diameter measurements were significantly smaller in Groups 1 to 4 when compared to Groups 5 and 6, and arteriolar constriction in the juxtamedullary and cortical regions was quantitatively comparable in Groups 1 to 4. Arteriolar diameters in Group 5 were somewhat, but not significantly smaller than those in Group 6, suggesting that perfusion-fixation at elevated pressure alone may have made a minor contribution to afferent vasoconstriction. However, this constriction was clearly not of the same pattern or magnitude as that produced by angiotensin II or norepinephrine infusions. The results indicate that both angiotensin II and norepinephrine cause severe focal constriction of afferent arterioles, and that this constriction cannot be attributed primarily to a pressure-induced autoregulatory response in the renal vasculature. PMID- 3820940 TI - Impaired renal acidification following acute renal ischemia in the dog. AB - Transient renal tubular acidosis may complicate acute renal failure (ARF). To clarify this phenomenon, the present study examined tubular H+ ion secretory capacity in an ischemic model of ARF. Clearance studies were performed in dogs subjected to 60 minutes, unilateral renal artery clamping. The contralateral kidney served as control. One hour after release of clamp, mean glomerular filtration rate (GFR) was reduced by 50 to 70 percent in the ischemic kidney. Bicarbonate reclamation (mEq/liter GFR) was comparable in both kidneys. However, ischemia resulted in impaired distal acidification as judged by three separate maneuvers: minimal urinary pH following sulphate infusion was higher in ischemic than in control kidney (6.61 +/- 0.39 vs. 5.39 +/- 0.26, P less than 0.01), mean urine to blood PCO2 difference (U-B PCO2) was significantly lower during phosphate infusion (ischemic: 13.8 +/- 4.1 mm Hg, control: 37.2 +/- 6.8 mm Hg, P less than 0.01) and was completely abolished during isotonic NaHCO3 infusion in the ischemic kidney (-1.9 +/- 3.4 mm Hg) compared to control (40.1 +/- 14.8 mm Hg, P less than 0.05). Urinary potassium excretion was intact following ischemia and was appropriately suppressed by amiloride. Administration of 0.7 M NaHCO3 solution at a rate sufficient to produce maximally alkaline urine resulted in a similar U-B PCO2/UHCO3 relationship in both kidneys in the face of impaired distal acidification in the ischemic kidney. This suggests either that the defect may be reversed by massive bicarbonate infusion or, alternatively, that U-B PCO2 difference may be related to other factors in addition to distal H+ secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820941 TI - Successful pregnancy in primary glomerular disease. AB - The course of 66 pregnancies was studied in 48 women with primary glomerular diseases. In all cases diagnoses were established by biopsy before pregnancy. They were: membranoproliferative glomerulonephritis in 16 patients, focal glomeruloesclerosis in 13, IgA nephropathy in 10, membranous nephropathy in seven and focal glomerulonephritis in two women. The clinical status of the nephropathy before conception was that 43 had only mild renal dysfunction, five had moderate renal insufficiency, serum creatinine (1.3 to 1.9 mg%), eight women had hypertension (150/100 mm Hg) and eight had nephrotic range proteinuria. Their clinical course was compared with a control group of 36 women with primary glomerular disease who did not become pregnant, and were matched for similar age, histological type, and status of nephropathy (renal function, blood pressure and proteinuria). After one year and at the end of the five year follow-up period, the incidence of hypertension, proteinuria, and renal failure was similar in the two groups. The fetal survival rate was 92%; 51 pregnancies ended in full-term delivery, with a mean birthweight of 3,242 +/- 320 g. There were seven pre-term deliveries (2,170 +/- 135 g), three small for gestational-age (2,340 +/- 135 g), two stillbirths and three spontaneous abortions. These patients had more pre-term deliveries (10.6%) and perinatal mortality (31%) than a normal population (5.5% and 9.6%, respectively). Blood pressure increased during pregnancy in 13 women; in 10 it was reversible, and in four it persisted after delivery. Ten gravidas developed increased proteinuria (reversible in six of them) and two others developed permanent impairment of renal function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3820942 TI - Pulmonary gas exchange during hemodialysis. AB - Pulmonary gas exchange was continuously measured in 13 mechanically ventilated patients during 24 hemodialyses for acute renal failure. Minute-ventilation was maintained constant by controlled ventilation and gas exchange was continuously measured by a mass-spectrometer system. Three groups were compared: a cuprophan membrane with an acetate dialysate; a polyacrilonitrile membrane (PAN) with an acetate dialysate; and PAN with a bicarbonate dialysate. Arterial PO2 and the O2 alveolar-arterial gradient were the same regardless of the membrane used. [H+] mildly decreased with all dialysates used. Arterial PCO2 decreased only with the acetate dialysate. O2 consumption increased, up to 20 +/- 5% of the initial values during hemodialysis, and remained increased during the two hours following the hemodialysis. Respiratory exchange ratio was lower after than before the hemodialysis. IN CONCLUSION: the maintenance of a constant minute ventilation prevented hemodialysis induced hypoxemia. VO2 increased during hemodialysis. PMID- 3820943 TI - Gentamicin and phenytoin sieving through hollow-fiber polysulfone hemofilters. AB - The sieving characteristics of the prototype drugs gentamicin (poorly protein bound) and phenytoin (highly protein bound) were measured in vitro using polysulfone capillary hemofilters similar to those used in clinical continuous arteriovenous hemofiltration. Plasma water, whole plasma, and whole blood were the solvent systems used with variable drug concentrations and solvent flow rates. Our results indicate that the sieving coefficients for both drugs can be accurately defined as the concentration in the ultrafiltrate divided by the concentration in the artery. This correlates with a more rigorously derived expression by Colton and Henderson (r = 0.98, P less than 0.00001 for both drugs) and avoids the necessity of measuring venous concentrations. Drug sieving in the three solvents followed expectations from known protein-binding data and was independent of solvent flow rate. For both drugs, at higher drug concentrations sieving increased in plasma, consistent with the saturation of protein-binding sites. In whole blood, sieving fell for both drugs with increasing drug concentrations, consistent with drug compartmentalization into red blood cells. Although these sieving changes with increasing drug concentrations were statistically significant, their clinical significance is doubtful. Phenytoin sieving in plasma was increased by the addition of free fatty acids, consistent with a protein-drug displacement effect. There appears to be a real, but small, effect of protein concentration polarization, protein-membrane and drug-membrane interactions on drug sieving. Our observations are consistent with the expectation that the major determinant of drug sieving is the extent of drug protein binding. PMID- 3820944 TI - Aluminum removal by peritoneal dialysis: intravenous vs. intraperitoneal deferoxamine. AB - Aluminum removal via peritoneal dialysis was evaluated after the administration of deferoxamine in patients treated with CAPD and CCPD. The intravenous administration of deferoxamine, 40 mg/kg, led to a 730 +/- 139% increase in aluminum removal, compared to an increase of 641 +/- 178% after the drug was administered intraperitoneally. The mean dialysate: plasma concentration ratio for aluminum rose from 0.17 +/- 0.03 to 0.32 +/- 0.03 with intravenous deferoxamine administration, and from 0.19 +/- 0.05 to 0.38 +/- 0.07 with the intraperitoneal instillation of deferoxamine. In the seven patients with paired studies using both modalities of administration, there were no significant differences in the increments in plasma aluminum or in aluminum removal over a 24 hour period. In patients from whom effluent dialysate was collected for several days after the administration of deferoxamine, daily aluminum losses increased from 218 +/- 76 micrograms/24 hours before the administration of desferrioxamine to 1521 +/- 339, 1120 +/- 232, and 948 +/- 328 micrograms/24 hours over three successive days after deferoxamine. These data indicate that aluminum is effectively removed after the administration of either intravenous or intraperitoneal deferoxamine. The enhanced rate of removal of aluminum by peritoneal dialysis persists for several days after a single dose of deferoxamine. The efficacy and safety of long-term treatment with intraperitoneal deferoxamine requires further study. PMID- 3820945 TI - [Differential diagnosis of coma conditions in childhood]. PMID- 3820946 TI - [Differential diagnosis of cholestasis in early infancy based on clinical findings]. PMID- 3820947 TI - [Method for determining the micro-erythrocyte sedimentation rate and its value for the diagnosis of bacterial infections in the neonatal period]. PMID- 3820948 TI - [Glucose tolerance (1.75 g/kg oGTT) in children of diabetic mothers in the 1st to 3d years]. PMID- 3820949 TI - [Recommendations on the duration of exemption from mandatory vaccination in gastroenterologic, liver and metabolic diseases]. PMID- 3820950 TI - [Surgical treatment of recurrent goiter]. PMID- 3820951 TI - [Methods of diagnosis and treatment of left-sided varicocele]. PMID- 3820952 TI - [Diagnosis of disorders of regional blood flow in the testis using the technic of rheotesticulography]. PMID- 3820953 TI - [Classification of craniocerebral injuries]. PMID- 3820954 TI - [Endoprosthesis in fractures of the neck of the femur]. PMID- 3820955 TI - [Cytologic diagnosis of the autoimmune process in hyperplastic diseases of the thyroid gland]. PMID- 3820956 TI - [Microsurgical autotransplantation of the adrenal gland in Itsenko-Cushing disease]. PMID- 3820957 TI - [Diagnosis and surgical treatment of recurrences of hormonally-active tumors of the adrenal cortex]. PMID- 3820958 TI - [Experience with the treatment of subrenal anuria]. PMID- 3820959 TI - [Features of the surgical treatment of severe craniocerebral injuries in patients with arterial hypertension]. PMID- 3820960 TI - [Surgical treatment of fractures of the proximal end of the femur in late middle aged patients]. PMID- 3820961 TI - [Immunomorphologic and humoral changes in patients with nodular goiter and autoimmune thyroiditis]. PMID- 3820962 TI - [Complex treatment of brachio-scapular periarthrisis using laser therapy]. PMID- 3820963 TI - [Hemosorption in the complex treatment of patients with severe suppurative complications of injuries of the limb joints]. PMID- 3820964 TI - [Arthroscopy of the shoulder joint]. PMID- 3820965 TI - [Thermography in the clinical practice of maxillofacial surgery]. PMID- 3820966 TI - [Use of the technic of indirect lymphography of the neck in the clinical practice of maxillofacial surgery]. PMID- 3820967 TI - [Safety provisions for protracted orthopedic-traumatologic surgical procedures using microsurgical technics]. PMID- 3820968 TI - [Programmed anesthesiologic assistance in a first-aid hospital]. PMID- 3820969 TI - [Surgical treatment of thyrotoxic goiter]. PMID- 3820970 TI - [Agranulocytosis as a complication of mercazolyl therapy of toxic goiter patients]. PMID- 3820971 TI - [Oleogranuloma of the penis]. PMID- 3820972 TI - [Treatment of extraperitoneal rupture of the urinary bladder complicating severe associated injuries]. PMID- 3820974 TI - [Radionuclide study of muscle blood flow using 133Xe in patients with lumbar osteochondrosis]. PMID- 3820973 TI - [Replacement hormone therapy of patients after surgery for the Itsenko-Cushing syndrome]. PMID- 3820975 TI - [Penis endoprosthesis as a means of treating Peyronie's disease]. PMID- 3820976 TI - [Method of stopping bleeding from nerve trunk vessels]. PMID- 3820977 TI - [Reduction of anterior subcoracoid dislocations of the shoulder]. PMID- 3820978 TI - [Method of surgical treatment of ingrown toenails]. PMID- 3820979 TI - [Pathologically mobile kidneys]. PMID- 3820980 TI - [Angiography in the diagnosis of complications in the late period after kidney injury]. PMID- 3820981 TI - [Acute non-cardiogenic pulmonary edema in surgical patients]. PMID- 3820982 TI - [Errors and complications of lymphosorption]. PMID- 3820983 TI - [Use of a method of recording peroxide chemiluminescence in the diagnosis of protracted thrombosis in embolism of the major arteries of the extremities]. PMID- 3820984 TI - [Injury of the vertebral artery]. PMID- 3820985 TI - [Calcified hematoma of the heart]. PMID- 3820987 TI - [Clinico-morphologic parallels in the terminal stages of arterial occlusive diseases]. PMID- 3820986 TI - [Course of asymptomatic occlusive lesions of the carotid arteries]. PMID- 3820988 TI - [Clinico-angiographic parallels in patients with arteriosclerotic occlusions of the ilio-femoral segment]. PMID- 3820989 TI - [Suppurative-destructive lung diseases and current principles of their treatment]. PMID- 3820990 TI - [Causes of failure in the surgical treatment of aortoiliac occlusions]. PMID- 3820991 TI - [Possibilities of sparing the extremity in peripheral levels of arterial occlusion]. PMID- 3820992 TI - [Role of reconstruction of the deep femoral artery in the treatment of late femoro-popliteal reocclusion]. PMID- 3820993 TI - [Remote results of radical venectomy combined with correction of valvular insufficiency of the deep veins]. PMID- 3820994 TI - [Treatment of lymphedema in a controlled abacterial medium]. PMID- 3820995 TI - [Characteristics of the pathogenesis and treatment of trophic ulcers in varicose veins of the lower extremities]. PMID- 3820996 TI - [Direct roentgenocontrast lymphography in the examination of lymphovenous anastomoses]. PMID- 3820997 TI - [Effectiveness of hyperbaric oxygenation in ischemia of the lower extremities]. PMID- 3820998 TI - [Immunologic reactivity and hemostasis in the treatment of patients with chronic stenotic-occlusive angiitis]. PMID- 3820999 TI - [Surgical treatment of blood vessel injuries of rare sites]. PMID- 3821000 TI - [Surgical treatment of Peyronie's disease]. PMID- 3821001 TI - [Hormonal contraceptive agents as a risk factor in the development of acute thromboembolic diseases]. PMID- 3821002 TI - [Heart injuries]. PMID- 3821003 TI - [Surgical procedure in duodenal injuries]. PMID- 3821004 TI - [Treatment of the severe forms of acute pancreatitis by long-term regional arterial therapy]. PMID- 3821005 TI - [Occult sclerosing carcinoma of the thyroid]. PMID- 3821006 TI - [Plastic repair of the inguinal-femoral canal using Bulgarian antimicrobial mesh (BAPP) and sutures (BAPK) following Duquing and Taussig lymph node dissections]. PMID- 3821007 TI - [Skin-muscle flaps formed in the gluteal and femoral regions]. PMID- 3821008 TI - [Surgical treatment of wounds with trophic impairment in the sacral region]. PMID- 3821009 TI - [Gluteal island skin-muscle flaps for covering soft-tissue defects in the sacral and ischiatic regions]. PMID- 3821010 TI - [Clinical aspects and surgical treatment of cancer of the large intestine]. PMID- 3821011 TI - [Our experience using polytetrafluoroethylene prostheses for the vascular approach in patients on periodic hemodialysis]. PMID- 3821012 TI - [Chronic pancreatitis--achievements and problems]. PMID- 3821013 TI - [Case of an annular pancreas in an adult]. PMID- 3821014 TI - [Polycystosis of the liver with a case report]. PMID- 3821015 TI - [Duodenal stasis with a clinical manifestation of high intestinal obstruction]. PMID- 3821016 TI - [Deferred implantation of a magnetic closure device with partial reconstruction of an existing colostomy]. PMID- 3821017 TI - Alternatives method of myocardial revascularization by laser: experimental and clinical study. PMID- 3821018 TI - The effect of drugs on bilirubin-albumin binding capacity. PMID- 3821019 TI - [Experience with the anti-tuberculosis service in organizing the dispensarization of the population]. PMID- 3821020 TI - [Outcomes of infectious endocarditis]. PMID- 3821021 TI - [Cortico-pleural cancer]. PMID- 3821022 TI - [Basic principles for the treatment of local radiation injuries]. PMID- 3821023 TI - [Histamine therapy in the complex treatment of chronic urticaria]. PMID- 3821024 TI - [Treatment of food toxicoinfections of chronic alcoholics]. PMID- 3821025 TI - [A case of thrombotic thrombocytopenic purpura]. PMID- 3821026 TI - [Acute agranulocytosis in a patient with thyrotoxicosis]. PMID- 3821027 TI - [Use of entero-and hemosorption in a patients with diabetic xanthomatosis and hyperlipoproteinemia type V]. PMID- 3821028 TI - [A case of Schilder's encephalitis]. PMID- 3821029 TI - [Clinical picture and diagnosis of the gastrointestinal and abdominal form of yersiniosis]. PMID- 3821031 TI - [The problem of viral hepatitis]. PMID- 3821030 TI - [Clinical picture, pathogenesis and treatment of shock in various infectious diseases]. PMID- 3821032 TI - [Oral rehydration therapy of patients with food toxicoinfections]. PMID- 3821033 TI - [Intestinal dysbacteriosis and its clinical significance]. PMID- 3821034 TI - [Various features of the course of severe forms of botulism]. PMID- 3821035 TI - [Early differential diagnosis of salmonellosis Haifa and acute dysentery]. PMID- 3821036 TI - [Clinical picture of contemporary brucellosis caused by Br. melitensis]. PMID- 3821037 TI - [Clinical and isoenzyme characteristics of viral hepatitis complicating other diseases]. PMID- 3821038 TI - [Increase in the informative value of enzyme level indices in the differential diagnosis of viral hepatitis and mechanical jaundice]. PMID- 3821039 TI - [Differences in the mechanism of development of HBsAg-positive and HBsAg-negative forms of chronic active hepatitis]. PMID- 3821040 TI - [Changes in the isoenzyme spectrum of LDH in different forms of erysipelas]. PMID- 3821041 TI - [Enterosorption in the treatment of viral hepatitis patients]. PMID- 3821043 TI - [Contemporary clinical laboratory diagnosis]. PMID- 3821042 TI - [Condition of hemostasis in the hemorrhagic syndrome of erysipelas patients]. PMID- 3821044 TI - [Absorptive function of the small intestine in chronic opistorchiasis]. PMID- 3821045 TI - [Diagnosis of tuberculous meningitis]. PMID- 3821046 TI - Brainstem auditory evoked potentials in basilar artery occlusion. PMID- 3821047 TI - Propranolol blocks the extrasynaptic nicotinic receptors on the intramural cardiac ganglion cells. PMID- 3821048 TI - Pathological studies on the liver with extrahepatic portal obstruction. PMID- 3821049 TI - Effects of ultraviolet irradiation on cultured B-16 melanoma cells--membrane fluidity, lipid composition and phospholipase activity. PMID- 3821050 TI - Intracranial pressure measurement in newborn infants with subependymal, intraventricular hemorrhage (SEH/IVH) and/or ventriculomegaly after IVH--a preliminary report. PMID- 3821051 TI - Cloverleaf skull syndrome--a case report. PMID- 3821052 TI - Perforation of the colon by a ventriculoperitoneal shunt tube--a case report. PMID- 3821053 TI - Anticoagulant and thrombolytic therapy for cerebral embolism of cardiac origin. PMID- 3821054 TI - Increased catecholamine output in the hypertensive fawn-hooded rat. AB - The total 24 hour urinary outputs of the catecholamines norepinephrine (NE), epinephrine (E), dopamine (DA) and the DA metabolite homovanillic acid (HVA) were measured in hypertensive fawn-hooded rats and compared to the ancestral strain of normotensive Wistar rats. The hypertensive fawn-hooded rats demonstrated significantly higher urinary outputs of the catecholamines NE and DA, and of the DA metabolite HVA. Following treatment with the antihypertensive, debrisoquin sulfate, the blood pressure of the fawn-hooded rats decreased until it approached the levels observed in normotensive Wistar rats. By inhibiting sympathetic nervous activity and monoamine oxidase, the debrisoquin treatment significantly decreased the output of DA, NE and HVA but not E. The data suggest the fawn hooded rat is a model of neurogenic hypertension which is characterized by an increased sympathetic output. PMID- 3821055 TI - Sex specificity of myocardial damage in mice fed a purified diet. AB - Both sexes of BALB/c and B6C3F1 mice were divided into test groups and fed either a purified diet (AIN-76A) or a natural ingredient diet (NIH-07) containing graded levels of 2-acetylaminofluorine (2-AAF) for 90 days. A large number of dead or moribund B6C3F1 males fed the AIN diet were removed from the study prematurely. AIN-fed B6C3F1 mice removed early as well as some sacrificed at the end of the study showed myocardial damage with hemorrhage. A much smaller number of BALB/c males fed the AIN diet also exhibited these signs while none of the females from either stock were affected. Mice having these lesions were confined largely to 2 of 5 treatment groups. Increased levels of serum aspartate aminotransferase (GOT) (P less than .01) occurred in the AIN-fed B6C3F1 male mice that were sacrificed, supporting the histopathological observation of myocardial damage. There was no other significant difference in the GOT between diets or 2-AAF doses. No environmental factors could be associated with the problem and microbiological and chemical analyses of the diets showed no convincing evidence of specific pathogenic organisms or nutritional deficiencies that might have caused these lesions. Extended storage (up to 4 months) and one batch of feed in particular seemed to be associated with mice having myocardial damage. These associations were highly strain and sex dependent and suggest that great care must be taken in the manufacture and handling of the diet. Furthermore, it seems likely that the diet may be marginally adequate for some strains of mice and may require modification before it will become generally useful. PMID- 3821056 TI - Survey of genetic authenticity of commercially produced inbred rats. AB - Strain specific typing antisera (SSTA) were used to genetically monitor six inbred strains of rats from major US commercial producers. SSTA were used in both the hemagglutination test and the microcytotoxicity assay because results from a preliminary study showed that use of both tests gave more reliable results than either test used individually. Of 25 colonies tested (representing all six strains), one colony of LEW rats appeared to be contaminated genetically. PMID- 3821057 TI - Ultrastructure of proteinaceous bladder plugs in male rats. AB - Proteinaceous plugs in the bladder (bladder plugs) were found in male rats with an incidence of 14.1 to 17.8% in ages ranging from 10 weeks to 2 years. No evidence of urinary obstruction was found due to the plugs, but they appeared to irritate the bladder epithelium mechanically causing denudation. Consequently, exfoliated epithelial cells were incorporated into the plugs. Early in development, the plugs consisted of loosely organized eosinophilic masses with fine eosinophilic granules and fenestrated filaments in which eosinophilic globules were suspended. The components of plugs were similar to that contained in seminal vesicles. Subsequently, the plugs became more compact in structure with formation of densely interwoven amphophilic trabeculae containing exfoliated cells and spermatozoa. The periphery of the plugs was surrounded by exfoliated cells, cellular debris, eosinophilic granular materials and spermatozoa. Under electron microscopy, the eosinophilic granules surrounding the plugs were dense aggregates of electron-dense globules and vesicles derived from disintegrated bladder epithelium. The amphophilic trabeculae had a dense compact granular structure consisting of densely aggregated protein globules with a filamentous network. The intertrabecular proteinaceous material had a spongy like structure consisting of sparsely scattered protein globules with fine fenestrated filaments. Proteinaceous plugs having exfoliated cells and spermatozoa were found also in the male accessory sex glands. The plugs in the urinary bladder or male sex accessory glands appeared to be developed from back-flow of semen following ejaculatory disturbance. PMID- 3821058 TI - Preparation of "tissue-isolated" rat tumors for perfusion: a new surgical technique that preserves continuous blood flow. AB - A surgical technique for preparing "tissue-isolated" rat tumors for perfusion was developed that ensures continuous blood flow to the tissue. The tumor may be perfused in situ or ex vivo. Tumor venous blood flow, tumor glucose and lactic acid metabolism, as well as host animal respiration and core temperature, were unchanged during the procedure. Following addition of 14C-D-Glucose to the tumor afferent blood, all radioactivity appeared in the tumor venous blood. None appeared in the host systemic blood, indicating complete separation of tumor and host vasculature during in situ perfusion. PMID- 3821059 TI - An automatic feeder for infant rats. AB - An automatic feeder for infant rats was developed which consisted of a rectangular container in which tubes were passed through the front and back walls and sloped slightly from the back to the front. Nursing bottles were inserted into the tubes from the back until the nipples projected 5 mm from holes in the rubber stoppers which closed the tubes at the front. At the surface of the front wall around the nipples, there was material similar in feel to that of the skin and fur of mother rats. Milk was fed from a tank to the nursing bottles by a peristaltic pump. After training 3-day-old infants which were nursed by mother rats during the first three days, they found the nipples and suckled milk by themselves. At the time of weaning, the automatically-fed infants gained as much weight as the mother nursed-infants. PMID- 3821060 TI - Hand-rearing baboons for laboratory investigations. AB - To conduct laboratory studies in unsedated animals that were similar anatomically and physiologically to man, five full term baboons (four Papio cynocephalus anubis, one Papio cynocephalus cynocephalus) were hand-reared. These infants were used as unsedated animal models in short-term lung clearance studies conducted from birth to 2 years of age. The hand-rearing techniques described here encouraged the formation of an infant-human rearer bond that permitted us to control the level of expressed aggressive behavior as the infant matured. These techniques resulted in baboons which displayed subordinate behavior, showed positive reception to human contact (without evidence of negative stereotypic behavioral anomalies) and remained cooperative subjects for our investigations of short-term pulmonary clearance. The baboons generally were above average in weight in comparison to conspecifically-reared baboons of similar age, sex and species. Representative lung retention curves presented on one baboon demonstrate the feasibility of lung clearance studies in these hand-reared animals. Due to its suitability for unsedated studies, this baboon model may be considered for other types of laboratory investigations. PMID- 3821061 TI - Spontaneous transitional cell carcinoma in the urinary bladder of a strain 13 guinea pig. PMID- 3821062 TI - Ventricular septal defect in a rhesus monkey. PMID- 3821063 TI - A method for prolonged, repeated infusion of nude mice. PMID- 3821064 TI - Pharmacological characteristics of the contractile response of the vas deferens in shrews (Suncus murinus). PMID- 3821065 TI - A simple anesthetic chamber. PMID- 3821066 TI - Response of epithelial cells of the choroid plexus in the ferret model for Reye's syndrome. AB - The structural integrity of epithelial cells of the lateral choroid plexus tissues from the ferret model for Reye's syndrome was examined by transmission electron microscopy after the animals were inoculated intranasally with influenza B, were administered aspirin, and/or were fed an arginine deficient diet singly and in combination. No cellular alteration in the choroidal epithelium was caused by influenza B nor by aspirin, however, the synthetic diet produced random intercellular edema. The structural integrity of choroidal epithelial cells appeared intact after ferrets were infected with influenza B and were given aspirin in combination. Cellular changes were seen, however, after each of these agents was combined with the presentation of the arginine-deficient diet. Intracytoplasmic vacuoles were observed in tissues of the choroid plexus from animals inoculated with influenza B and fed the arginine-deficient diet. Both intercellular vacuolization and intercellular edema were seen in the choroidal epithelia after ferrets were administered aspirin and were fed the synthetic diet. Such cellular changes observed in the choroidal epithelia in response to the paired presentation of these agents were not as severe as those seen in the choroid plexuses of animals in which all three agents were given in combination. These results support the hypothesis that metabolic events that occur after the administration of these agents collectively impact on epithelial cells of the choroid plexus. PMID- 3821067 TI - Lipid microvesicles and their association with procoagulant activity in urine and glomeruli of rabbits with nephrotoxic nephritis. AB - The procoagulant activity (PCA) in urine of rabbits with nephrotoxic nephritis was characterized. Most of the PCA in urine was pelleted by centrifugation at 50,000 X g but was not pelleted together with cells and casts at 1,000 X g. PCA appeared in the void volume of a Sepharose 4B column but would not pass through a 0.2-micron filter. Ultrastructural studies using both transmission and scanning electron microscopy showed that urine PCA was associated with lipid vesicles 0.1 to 1-micron in diameter. These vesicular structures were shown to promote fibrin formation from recalcified plasma on a 0.2-micron filter surface. This microvesicular PCA was mostly Factor VII-like as judged by clotting assay using human factor-deficient plasmas. Aggregates of vesicles were present in urine as granular casts. Ultrastructural studies of rabbit kidney showed similar vesicular structures in the proximal tubular lumen and budding from glomerular epithelial cells. Fibrin was seen adjacent to both glomerular endothelial cells and epithelial cells in association with vesicular structures. We conclude that microvesicles in urine carry a procoagulant signal which is tissue factor/Factor VII-like. We speculate that these vesicles may come from the glomerulus by budding off from glomerular epithelial cells, or macrophages. PMID- 3821068 TI - Genesis of renal tubular atrophy in experimental hydronephrosis in the rat. Role of apoptosis. AB - A morphological study was undertaken to assess the role of cell deletion by apoptosis in experimental hydronephrosis. Male Sprague-Dawley rats (200 +/- 20 gm) were used. The left ureter was ligated or a sham operation was carried out. Animals were killed from 4 days to 12 weeks after operation. Two parallel studies were undertaken: one to demonstrate and quantitate specific morphological changes in the affected kidney using light and electron microscopy, and the other to measure changes in dry kidney weights. Renal tubular atrophy is an inevitable consequence of chronic occlusion of the ureter. As expected, the present study showed a progressive loss of tissue mass in the hydronephrotic kidney. This occurred from 1 week after permanent ureteric ligation, and was most rapid between 2 and 4 weeks. The tubular epithelium contained cells undergoing a distinct form of cell death termed apoptosis, characterized ultrastructurally in its early stage by the presence of rounded cells with condensed cytoplasm and condensed and marginated nuclear chromatin, and later by the presence of discrete membrane-bounded intact cellular fragments (apoptotic bodies), which were phagocytosed and digested by adjacent viable cells, or were shed into the tubular lumens. Numbers of apoptotic cells or clusters of apoptotic bodies were increased significantly in all animals with ureteric obstruction in comparison with controls. The greatest increases occurred at 2 and 4 weeks, when loss of renal mass was occurring rapidly. Diminished blood flow in hydronephrosis has been well documented by others, and therefore our results are consistent with studies which have shown mild ischemia to be the cause of tissue atrophy involving apoptosis. We conclude that cell deletion by apoptosis plays an important role in the pathogenesis of renal tubular atrophy associated with hydronephrosis. PMID- 3821069 TI - Actin isoform synthesis by cultured cardiac myocytes. Effects of doxorubicin. AB - Cultured neonatal rat myocardial cells (CMC) were incubated with 10(-10) M to 10( 5) M doxorubicin (adriamycin, ADR) and [35S]methionine to determine incorporation of radiolabeled methionine into myocardial contractile proteins. Cells were harvested after 24 hours homogenized, and subjected to centrifugation. Equivalent amounts of extracted protein were applied to 8 to 15% gradient sodium dodecylsulfate polyacrylamide gel electrophoresis. Similar aliquots were subjected to isoelectric focusing and to 2-dimensional gel electrophoresis. Electrophoretic gels were autoradiographed. Polypeptide bands on sodium dodecylsulfate polyacrylamide gel electrophoresis and autoradiograms were quantitated densitometrically. No effect of ADR on CMC actin or protein synthesis was seen from 10(-10) M to 10(-7) M ADR. ADR decreased protein synthesis in CMC by 31% at 10(-6) M and by 59% at 10(-5) M ADR. Autoradiograms of two-dimensional gels showed decreased radiolabeling of alpha-actin at 10(-6) M ADR compared to beta and gamma. Decreased CMC actin synthesis initiated at 10(-6) M ADR resulted in selective decrease in synthesis of the alpha-isoform. This in vitro observation may relate to poor contractility in ADR heart muscle disease. PMID- 3821070 TI - Characterization of nonhuman primate epidermal and dermal dendritic cells with monoclonal antibodies. A study of Langerhans cells and indeterminate cells in the rhesus monkey. AB - Epidermal dendritic cells (Langerhans cells) present cutaneously derived antigens to T cells in the skin and draining lymph nodes and therefore are important in many afferent immune responses. The role of dermal dendritic cells on the other hand is more obscure, although it has been suggested that these cells are precursor forms of Langerhans cells. Although human cutaneous dendritic cells have been previously characterized by using monoclonal antibodies, there are no reports of comparable studies in the skin of rhesus monkeys. By using an immunoperoxidase technique with light and immunoelectron microscopy, we have evaluated 29 antibodies raised against human cell surface antigens for their reactivity to dendritic cells in the skin of rhesus monkeys. This study demonstrates that many antisera to human cell surface antigens can be used to identify cutaneous dendritic cells in this species and that the cell populations so labeled are similar ultrastructurally to those in man. These observations represent the first demonstration of immunologic markers specific for epidermal Langerhans cells in animals, and are requisite for further study of dendritic cell function in nonhuman primate models of human immunopathologic diseases. PMID- 3821071 TI - Defective cytoplasmic granule formation. I. Abnormalities affecting tissue mast cells and pancreatic acinar cells of beige mice. AB - Beige mice (C57BL/6-bgJ/bgJ) express the Chediak-Higashi syndrome, a genetically determined constellation of morphologic and functional abnormalities affecting cells that synthesize cytoplasmic granules; a similar disorder also occurs in humans and several other mammalian species. We used a computer-assisted morphometric approach to identify and quantitate the effect of the beige mutation on the structure of mast cell or pancreatic acinar cell cytoplasmic granules. Beige and control mouse mast cell or pancreatic acinar cell granules exhibited periodic, multimodal distributions of equivalent volumes in which the modes fell at volumes that were integral multiples of the volume of the "unit granule," whose volume (the "unit volume" or v1) was defined by the first mode in the granule equivalent volume distribution. But the modal frequency of the C57BL/6 bgJ/bgJ mast cell granule equivalent volume distribution fell at v1, a pattern consistent with a haphazard pattern of "unit granule" fusion, whereas the corresponding modal frequency for the control mast cell granules fell at v3, a pattern consistent with a "unit addition" model of granule fusion. In addition, the unit volume of beige mouse mast cell granules was 18 times that of control mouse mast cell granules. By contrast, the unit volume of beige mouse pancreatic acinar cell granules was only slightly (23%) greater than that of control cells. C57BL/6-bgJ/bgJ and control cells did not differ significantly in total cell or nuclear volume, or in the aggregate volume of their cytoplasmic granules. However, C57BL/6-bgJ/bgJ mast cells or pancreatic acinar cells contained significantly fewer granules than did their normal counterparts. These findings are consistent with the hypothesis that the beige mutation affects the formation of unit granules and also alters the pattern of aggregation and fusion of unit granules. The data also identify quantitative differences in the expression of the beige mutation in mast cells and pancreatic acinar cells. PMID- 3821072 TI - Identification and quantitation of N-nitrosamines in human postmortem organs. AB - A gas-liquid chromatographic method for quantitative determination of six volatile N-nitrosamines in human postmortem organs (brain, liver, kidneys, and pancreas) is described. This method, which is highly sensitive and selective, makes use of two different detectors, i.e., the electron capture detector (ECD) and the thermal energy analyzer (TEA). The mean absolute percentage recoveries of N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N nitrosodipropylamine (NDPA), N-nitrosodibutylamine (NDBA), N-nitrosodipropylamine (NDPA, N-nitrosodibutylamine (NDBA), N-nitrosopiperidine (NPIP), and N nitrosopyrrolidine (NPY) were 54.7, 80.0, 79.6, 72.5, 75.5, and 79.6, respectively. N-Nitrosamines in the organ extracts were converted to their corresponding N-nitramine analogs by pertrifluoroacetic acid oxidation. These derivatives were purified by adsorption chromatography on basic alumina and then analyzed by ECD. N-Nitrosamines were analyzed without derivatization in the organ extracts with the TEA detector. The described method did not cause artifactual formation of N-nitrosomethyl-N-butylamine (NMBA) when methyl-N-butylamine was used as an internal marker of nitrosation. NDMA was found in all the organs examined, whereas NDPA was only detected in the liver of one in four subjects. NDMA was found in all brain samples, indicating that it crosses the blood-brain barrier. PMID- 3821073 TI - Spectrophotometric evaluation of carboxyhemoglobin in blood of mice after exposure to marijuana or tobacco smoke in a modified Walton horizontal smoke exposure machine. AB - Carboxyhemoglobin (COHb) values were determined in mice exposed to varying amounts of marijuana and tobacco cigarette smoke utilizing a spectrophotometric technique. Mice were exposed to smoke inhalation in a modified Walton horizontal smoke exposure machine, whereby rodents can be exposed to multiples of 1-min smoke exposure cycles. Smoke exposure was intermittent; during the first 30 sec of each 1-min cycle, the subjects were exposed to smoke diluted either 1:10 or 1:5 with air. During the second half of the cycle the animals were given fresh air. There was a positive linear relationship between COHb values obtained and the number of puffs of marijuana smoke administered via either 2, 4, 6, or 8 "puffs" of marijuana smoke. COHb levels in plasma did not increase in animals given multiple 8-puff episodes of smoke daily as long as a 60-min period was interposed between smoking episodes. COHb values in mice exposed to tobacco smoke were significantly higher than those in mice receiving equal numbers of exposures to marijuana smoke. Mean COHb values of mice receiving 8 consecutive puffs of marijuana smoke were 18.6 and 22.0% saturation, but CO was rapidly cleared from the blood. This rapid clearance suggests that the binding affinity of CO for mouse hemoglobin may be be weaker than that of human hemoglobin. Mice similarly exposed to 6 or 8 puffs of tobacco smoke had mean COHb values of 24.6 and 28.5% saturation, respectively. No acute lethal effects were observed in mice receiving multiple daily episodes of 8 puffs per episode of marijuana smoke, whereas mice exposed to a single 8-puff episode of tobacco smoke suffered about 50% acute lethal effects. PMID- 3821074 TI - HPLC determination of the metabolite 4-chloro-o-toluidine in the urine of workers occupationally exposed to chlordimeform. AB - A reversed phase HPLC method (UV detection) is described or the analysis of 4 chloro-o-toluidine in the urine of workers occupationally exposed to chlordimeform. The procedure involves extracting an alkaline hydrolysate of urine with hexane, evaporating off the solvent, and reconstituting the residue with an aqueous acetonitrile mobile phase. PMID- 3821075 TI - A polyvalent method using HPLC for screening and quantification of 12 common barbiturates in various biological materials. AB - A high-performance liquid chromatographic (HPLC) assay has been developed for the identification and quantification of 12 barbiturates at toxic and therapeutic levels in plasma, urine, gastric content, postmortem blood, and tissues. The sample preparation procedure involves a single-step extraction for plasma, urine, and gastric contents, and a supplementary back-extraction for postmortem blood and tissues. Appropriate internal standards are used for quantification. A mu Bondapak C18 column is used with a mobile phase of 40% methanol and (NH4)2HPO4 (0.05M). The barbiturates are detected at 240 and 290 nm. This method is rapid, sensitive, reproducible, relatively selective, and applicable to a great variety of biological fluids; it has been used regularly in forensic and clinical toxicological analyses. PMID- 3821076 TI - Confirmation of cocaine in human saliva after intravenous use. AB - The presence of cocaine was confirmed in the saliva of two male human subjects who had received intravenous doses of cocaine. For one subject, the saliva:plasma concentration ratios varied from 2.96 to 0.5 over time following drug administration. Correlations of saliva to plasma cocaine levels were highly significant (p less than 0.001) across doses of 15, 20, and 40 mg of intravenously administered cocaine. These findings are important in that they allow monitoring blood levels of cocaine after intravenous infusion in a non invasive manner, and could form the basis for development of a non-invasive screen for active cocaine levels in saliva. PMID- 3821077 TI - An unusually high blood cocaine concentration in a fatal case. AB - A fatal case resulting in an unusually high blood cocaine concentration is reported. Cocaine was administered intranasally, then orally. Blood concentrations of cocaine and the combination of cocaine and its metabolites were 51.7 and 85.0 mg/L, respectively. Case history, pathological findings, and tissue distribution of cocaine and its metabolites are presented. PMID- 3821078 TI - An estimation of diazinon in omental tissue. AB - A fatality in which diazinon was the suspected toxic agent was investigated. Samples of omental tissue, blood, and liver tissue were examined by gas chromatography and thin layer chromatography. Diazinon was found in the omentum (at a level of 5.1 mg/kg) and blood (in a trace amount), but no diazinon was found in the liver tissue. Methods are given for the extraction of diazinon from omental fat, the purification of these extracts by sweep co-distillation and fat precipitation, and for an estimation of the amount of diazinon present. It is not possible to determine whether the low level found arose from chronic occupational exposure, accidental dermal contact, or ingestion of a lethal dose. PMID- 3821079 TI - A rapid screening procedure for acidic and neutral drugs in blood by high resolution gas chromatography. AB - A rapid high resolution gas chromatographic method for screening acidic and neutral drugs in blood is described. The procedure involves a single extraction with ethyl acetate. Using flame ionization detection, without derivatization and with on-column methylation, more than 60 drugs of toxicologic importance are detected. PMID- 3821080 TI - Postoperative alterations in interorgan glutamine exchange in enterectomized dogs. AB - The effect of enterectomy on postoperative visceral organ glutamine exchange was studied in order to gain further understanding of the role of the intestinal tract in the altered glutamine metabolism that occurs following catabolic illness. In addition to studying glutamine, which transports 1/3 of whole blood amino acid nitrogen, we determined the fluxes of glutamate and alanine across the gastrointestinal tract, liver, and kidneys in 18 postoperative dogs. Arterial glutamine and glutamate were significantly higher in enterectomized animals than in controls. With enterectomy the gut became an organ of glutamine balance while in control dogs the GI tract consumed glutamine (0.11 +/- 0.04 vs 1.67 +/- 0.14 mumole/kg X min, P less than 0.001). The gut switched from an organ of glutamate release to one of net glutamate uptake following enterectomy and intestinal alanine release simultaneously fell by 50%. Simultaneously, the liver reduced its uptake of alanine and became an organ of glutamine release. Renal glutamine consumption was also diminished in enterectomy animals. The interorgan exchange of glutamine and other amino acids is altered by enterectomy. The increase in circulating glutamine levels in enterectomized animals suggests that the accelerated intestinal glutamine consumption that characterizes catabolic illnesses contributes to the low glutamine levels in these stress states. In addition, it becomes apparent that the gut is an important supplier of alanine to the liver, which supports gluconeogenesis. Metabolic adaptation and cooperation between organs is essential during organ absence or dysfunction if the organism is to survive critical illness. PMID- 3821081 TI - Adrenergic control of serotonin release from carcinoid tumor cells in vitro and in vivo. AB - Serotonin (5-HT)-producing human carcinoid tumors of midgut origin were transplanted to the anterior eye chamber of cyclosporine-treated rats. The release of 5-HT from in oculo transplants was studied after stimulation with adrenoceptor agonists applied locally to the eye. Chamber fluid was collected by micropuncture of the eye. 5-HT levels were determined by liquid chromatography with electrochemical detection. The release of 5-HT in cell suspensions of the same tumors was similarly studied after incubation with adrenoceptor agonists. In both experimental models activation of adrenoceptors caused release of 5-HT from carcinoid tumor cells. Individual variations in the type of response to adrenoceptor stimulation could be demonstrated for the different tumors. In two tumors there was good agreement between in vitro and in vivo findings with release of 5-HT at selective activation of beta-adrenoceptors with isoprenaline. In a third tumor there was a release of 5-HT at activation of alpha-adrenoceptors with norepinephrine in vitro. However, 5-HT release from this tumor in vivo was demonstrated at activation of beta-adrenoceptors. This finding may reflect different adrenoceptor populations on the tumor cell surface, each population activated to various degrees in the in vivo and in vitro situation. PMID- 3821082 TI - Systemic vascular effects of epinephrine administration in man. AB - Although the peripheral vascular effects of epinephrine have been characterized in animal models, similar studies have not been carried out in man. To determine the vascular effects of epinephrine the systemic circuit must be conceptually and surgically opened to allow for independent control of flow and pressure. This unique situation exists in man only while on total cardiopulmonary bypass with an external reservoir and pump interposed between the right atrium and the aorta. Under these conditions, peripheral vascular compliance, arteriolar and venous resistance, and the systemic time constant (a measure of the drainage characteristics of the vascular bed, in units of time) can be determined directly. Nine anesthetized patients undergoing normothermic cardiopulmonary bypass were studied before and during epinephrine infusion (5 micrograms/kg/min) after the aorta was cross-clamped and the heart had been isolated from the rest of the peripheral circulation. At constant blood flow epinephrine infusion increased blood pressure and reservoir volume (effectively decreasing blood volume) by an average of 360 ml. Although systemic vascular compliance decreased (due to venoconstriction), resistance to venous return decreased. Analysis of transient blood volume changes after a step change in right atrial pressure at constant blood flow revealed that blood was effectively draining from two vascular compartments with different time constants, as previously demonstrated in animal experiments. Epinephrine caused redistribution of blood flow away from the compartment with the longest time constant by constricting the arterioles leading to it. This accounts for the major increase in venous return and is almost entirely the mechanism of increased cardiac output in the normal individual after its administration, independent of its effects on the heart. In an attempt to localize the long and short time constant vascular compartments, three normal volunteers were studied. Thallium-201 whole body imaging at rest and after maximal treadmill exercise showed redistribution of blood flow away from the mesenteric bed and towards the muscle compartments. Although two similar compartment models of the circulation have been suggested by others, to our knowledge this type of analysis has not been carried out in man. PMID- 3821083 TI - Effects of Nd:YAG laser energy on the arterial wall: evaluation of a new contact delivery system. AB - Although there has been much recent interest in the application of lasers to arterial occlusive disease, a detailed understanding of the effects of laser energy on vessel walls is lacking. This study compared the effect of a conventional, non-contact delivery system of Nd:YAG laser energy to a contact system using a 600 microns, artificial sapphire tip in eight mongrel dogs. A small section of the luminal surface of the carotid and femoral arteries was exposed to 10 or 15 joules of Nd:YAG laser power and flow was restored in the vessel. The animals were sacrificed at 0, 1, 2, 4, 7, 14, 21, and 30 days and the vessels were removed. The surface area of the laser injury for each artery was quantitated by computerized planimetry and all histologic sections were examined under light microscopy by an independent observer. Transmural necrosis occurred in 64% (20/31) of the non-contact lesions versus only 29% (9/31) of the contact lesions (P less than 0.01). Both types of laser injuries followed a predictable course with initial medial necrosis followed by formation of a fibrin erythrocyte coagulum overlying the lesions at 24 hr. The usual zones of vaporization, coagulation necrosis, and thermal damage were noted with both types of delivery systems, but the contact system resulted in more intimal vaporization. Healing of all lesions was rapid with complete endothelial coverage at two weeks. Thrombosis occurred in only 1 of 32 (3%) arteries, and there were no false aneurysms. Contact delivery of Nd:YAG laser energy produces significantly less transmural injury than does non-contact.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821084 TI - Lung damage following lymph fistula preparation in sheep. AB - The effect of preparative trauma on lung microvascular permeability during lung lymph fistula preparation in sheep was investigated. Two groups of anesthetized sheep were used. In group I (controls: n = 3) the lymph fistula was prepared 3 to 4 days before the experiment. In group II (experimental group: n = 13): left atrial and lymph catheters were introduced on the day of the experiment. All animals had catheters in the aorta and pulmonary artery. The stable prostanoid metabolites thromboxane B2 (TxB2) and 6-keto-PGF1 alpha (6-keto) were measured in lymph. In group I systemic (Psa) and pulmonary pressures (Ppa) remained constant. Leukocytes and platelets were unchanged as was pulmonary lymph flow (QL) and the lymph to plasma total protein concentration ratio (L/P). In group II Psa and Ppa remained constant. All sheep developed a temporary leukopenia and thrombocytopenia. TxB2 and 6-keto were low and stable during anesthesia in group I but were elevated immediately following surgery in group II but values normalized during a 4-hr observation period. QL during the first half hour was 1.9 +/- 0.3 ml/30 min and increased over 5 hr to 3.1 +/- 0.7 ml/30 min corresponding to 60 +/- 15% over baseline (P less than 0.01). L/P did not change. These changes could be due either to changing permeability or surface area. These effects of preparative trauma indicated that the model was not in a steady state. This observation should be kept in mind when evaluating studies using the lung lymph fistula in acute experiments. PMID- 3821085 TI - The importance of gastric emptying in reflux esophagitis: an experimental research on pigs. AB - A study was conducted on pigs to evaluate the importance of gastric emptying rate in reflux esophagitis development. Gastric emptying was previously measured in 25 pigs. Then, the following operative procedures were carried out: Heller's cardiomyotomy, common bile duct ligature, cholecysto-gastric anastomosis, and extramucosal duodenal myotomy on 10 animals (group A); the same procedures except extramucosal duodenal myotomy on another 10 animals (group B); common bile duct ligature and cholecysto-gastric anastomosis on the last 5 animals (group C). Six months later, gastric emptying was measured again; whereas in group A a significant shortening of gastric emptying was found, the other 2 groups remained unchanged. Then, all the animals were sacrificed and the lower third of the esophagus was removed for histologic examination. In all the pigs undergoing cardiomyotomy (groups A and B) appearance of esophagitis was found. No signs of esophagitis were found in group C. The conclusions reached are cardiomyotomy is in all cases responsible for reflux esophagitis development; extramucosal duodenal myotomy is capable of shortening gastric emptying, but this does not affect reflux esophagitis development. PMID- 3821086 TI - Vascular reactivity in reversible experimental obstructive jaundice. AB - We studied the effect of jaundice on in vitro vascular reactivity to cumulative doses of norepinephrine (NE) by measuring the maximal response (Rmax) and the concentration of NE required to cause a 50% response (ED50) of isolated vascular smooth muscle. For this we prepared helically cut strips of thoracic aorta from bile duct ligated (BDL) rats at 1, 3, 6, 14, and 28 days postligation and compared them with those of nonoperated and sham-operated controls. From 1 to 6 days post-BDL, changes in liver blood chemistry and liver histology indicated cholestasis with necrosis. By 14 days, the tests for liver function and histology indicated a return to normal liver function and histology. In nonoperated controls, mean Rmax increased significantly from 883 +/- 67 mg of tension to 1220 +/- 68 mg of tension (P less than 0.0025) from 0 to 28 days, whereas ED50 remained unchanged. In sham-operated controls and BDL rats, an age-dependent increase in Rmax was also observed. However, in the sham groups, ED50 tended to decrease compared with nonoperated controls, indicating a surgically induced "sensitization" phenomenon of the vascular smooth muscle. In contrast, this was not seen in BDL rats since in these groups, the ED50 remained unchanged and significantly higher than in the sham groups, in both the jaundiced (1-6 days) and nonjaundiced (14-28 days) period. Furthermore, these changes occurred in the absence of any alteration in portal pressure. These changes may be important in understanding the mechanism of hypotension and shock in postoperative patients with obstructive jaundice even after the jaundice has been relieved. PMID- 3821087 TI - Reduction in myocardial acidosis using blood cardioplegia. AB - The composition of the ideal cardioplegic solution is controversial. Blood cardioplegia is an attractive alternative to standard crystalloid solutions, though its superiority in preserving myocardial metabolism has not been demonstrated. Using a new pH electrode system, this study contrasts the effects of blood and crystalloid solutions upon the generation of myocardial acidosis during global ischemia. Thirty-eight mongrel dogs underwent a 120-min period of aortic cross clamping using systemic hypothermia. To maintain myocardial temperature below 15 degrees C, 19 dogs received multiple doses of a bicarbonate containing crystalloid cardioplegic solution (Group I), while 19 dogs received multiple doses of blood cardioplegia (Group II). Myocardial pH and temperature were continuously monitored in the subendocardial region of the left ventricle. There was no difference in baseline pH between Group I (7.13 +/- 0.05) and Group II (7.17 +/- 0.05, P:NS). With systemic cooling and the initial bolus of cardioplegia, myocardial pH rose to 7.42 +/- 0.04 in Group I and 7.42 +/- 0.06 in Group II (P:NS). After 120 min of global ischemia, myocardial pH decreased to 6.61 +/- 0.05 in Group I and 7.07 +/- 0.05 in Group II (P less than 0.001). Blood cardioplegia was most effective during the first hour of aortic cross clamp when myocardial pH rose by 0.13 +/- 0.04 pH units. In contrast, myocardial pH in Group I during the first hour of global ischemia fell -0.35 +/- 0.08 pH units (P less than 0.001 compared to Group II). During the second hour of cross clamp, myocardial pH declined both in Group I (0.26 +/- 0.03 pH units) and in Group II (0.24 +/- 0.05 pH units, P:NS). However, the accumulation of hydrogen ion during the second hour was significantly greater in Group I (+128.0 +/- 21.4 nm/liter) than in Group II (+36.6 +/- 9.0 nm/liter, P less than 0.001). Thus, myocardial acidosis was reduced during the administration of blood cardioplegia when compared to a bicarbonate-buffered crystalloid solution. The salutary effects of blood cardioplegia on myocardial metabolism stem from blood's significant buffering capacity and its ability to deliver oxygen. PMID- 3821088 TI - A primate model for the evaluation of tendon adhesions. AB - A cynomologous monkey animal model was developed for future pharmacological trials to reduce tendon adhesions. When developing an animal model, similarity to human anatomy and severance of motor units from operated tendons are stressed. Differences in vincular anatomy among various laboratory animals and incomplete postoperative tendon-motor unit immobilization in previous studies tend to distort results. Peak pull-out forces were measured on the Instron tensionmeter as operated tendons that underwent surgical procedures on Zone II were removed from their sheaths and compared to controls at various times postoperatively. Increasing pull-out force was obtained in a reproducible fashion. PMID- 3821089 TI - Assessment of gastric mucosal ulceration by computerized image processing. AB - The absence of a rapid, objective, and reproducible method for assessing mucosal ulceration has long been a frustration to research in the field of gastric physiology. This study compared assessment of mucosal injury by computerized image processing with values obtained by the shed microsphere technique. An ex vivo gastric chamber model based on miniature swine was used. Five chambers were subjected to hemorrhagic shock and acid-bile solution and five chambers were maintained in normotension and exposed to normal saline (controls). After 3 hr, mucosal injury was assessed by both techniques. The chambers exposed to shock and acid-bile all developed visible ulceration ranging from 1.8 to 99.7 cm2 by computerized image processing. These values correlated well with the results obtained by the shed microsphere technique (23 to 419 mg, r = 0.99, P less than .05). No ulceration developed in the control chambers. Implementation of computerized image processing as well as its limitations is discussed. PMID- 3821090 TI - Morphology of lysolecithin-induced damage on esophageal mucosa. An experimental light and scanning electron microscopical study. AB - The morphology of the esophageal mucosal damage induced by lysolecithin was investigated in an experimental model, where an isolated segment of rabbit esophagus was purfused in situ with lysolecithin, alone or in combination with HCl. The results indicate that lysolecithin alone causes no morphological damage to the esophageal mucosa. However, when combined with HCl, lysolecithin causes widening of intercellular spaces and detachment of superficial cells leading ultimately to disclosure of denuded submucosal collagen bundles. This suggests that, in clinical situations lysolecithin refluxed from the duodenum into the stomach and further to esophagus may have importance in the pathogenesis of reflux esophagitis when gastric acid is present, too. In contrast, under unacidic conditions (i.e., in the pathogenesis of alkaline reflux esophagitis) lysolecithin seems to be of minor importance. PMID- 3821091 TI - Ultrastructural changes and enzyme activities for energy production in hearts concomitant with tumor-associated malnutrition. AB - Morphometric data on left ventricular papillary muscle structures have been determined in tumor-induced malnutrition and related to the maximum activities of key enzymes for energy production in the whole myocardium. Adult, nongrowing mice with a syngeneic sarcoma were used to represent a condition of cancer associated host tissue wasting. Hearts from mice 11 days after tumor implantation showed atrophy and a significantly reduced amount of myofibrillar, soluble, and collagen proteins than hearts from control animals. The cross-sectional area of myocardial cells was 33% smaller in tumor-bearing mice (p less than 0.025), but the total number of capillaries and the residual interstitial volume were similar in the two groups. The total number of subcellular structures per cell, such as mitochondria, myofibrils, and myosin filaments per myofiber, were significantly lower in the tumor-bearing animals (p less than 0.025). Conversely, the proportion of myofibrils was higher (p less than 0.05) in tumor-bearing animals while the proportion of mitochondria was lower. Maximum activities (Vmax) of selected regulatory key enzymes for energy production (glycogenolytic, glycolytic, and mitochondrial) were not significantly altered in hearts from tumor-bearing mice. The results support the conclusion that myocardial functional capacity is better preserved than overall structural components would imply in tumor-host associated malnutrition, which is probably secondary to deprived food intake. Teleologically, this may be a means by which functional deterioration of the heart is minimized during the induction of malnutrition. PMID- 3821092 TI - Sickle cell disease and sudden death. PMID- 3821093 TI - Should your children seek to become physicians? PMID- 3821094 TI - Macrocytic anemia. PMID- 3821095 TI - Traumatic laceration of internal mammary vessels. PMID- 3821096 TI - Asymptomatic anterior mediastinal mass. PMID- 3821097 TI - 18-Hydroxy-11-deoxycortisol: a new steroid isolated from incubations of the adrenal with 11-deoxycortisol. AB - Cortisol has been shown to be metabolized in the zona glomerulosa of the adrenal gland through the same pathway involving the cytochrome P-450, corticosterone methyl oxidase by which corticosterone is transformed to 18-hydroxycorticosterone and aldosterone. When cortisol is the precursor, 18-hydroxycortisol and 18 oxocortisol are formed. 18-Hydroxycortisol can also be made at a similar rate in the bovine zona fasciculata and reticularis as in the zona glomerulosa. We studied the possibility that the formation of 18-hydroxycortisol in the zona fasciculata and reticularis might be through a different pathway involving initial 18-hydroxylation of 11-deoxycortisol before 11 beta-hydroxylation. Rat adrenal capsules or cores were incubated with 10 micrograms of cortisol or 11 deoxycortisol and the formation of 18-hydroxycortisol was measured by radioimmunoassay. Both capsules and cores transformed 11-deoxycortisol to 18 hydroxycortisol, but cortisol was only transformed in the capsular portion. Sixty two rat adrenals were incubated with 10 mg of 11-deoxycortisol and the putative steroid, 18-hydroxy-11-deoxycortisol, was purified by TLC and HPLC and subjected to gas chromatography mass spectrometry. The mass spectra indicated that the steroid isolated was indeed 18-hydroxy-11-deoxycortisol. The function of this steroid is still unknown. PMID- 3821098 TI - A sensitive method for quantitation of steroid hydroxylase activities of individual P-450 in tissue homogenates. AB - Assay methods which allow measurements of the level of individual P-450's in a homogenate of steroidogenic tissues have been developed. The assay is based simply on the determination of the specific products of steroid monooxygenase reactions under conditions in which sufficient amounts of the purified electron donating components as well as lipids and detergents are supplemented so that the membrane-associated P-450 is able to exhibit its maximum activity. Under these conditions, an at least 10-fold increase in the NADPH-dependent monooxygenase activity of P-450 occurred as compared to that measured in the unenriched system. In addition, the present assay used ascorbate as an O2- -scavenger which effectively prevented possible inhibition caused by initiation of O2- -formation. Under the present assay conditions, nearly quantitative recovery of activities was accomplished of each purified P-450 that had been added to the homogenates as an internal standard. Furthermore, the high sensitivity of this assay allows the measurement of P-450 in small specimens (at least 100 mg of tissues), and could be used for measurements in autopsied cases or the glands of small animals. PMID- 3821099 TI - Characteristics of estrogen-2/4-hydroxylase of porcine ovarian follicles: influence of steroidal and non-steroidal agents on the activity of the enzyme in vitro. AB - The conversion of [3H]estradiol to 2-hydroxyestradiol (2-OH-E2) by homogenates of porcine ovarian follicles was assayed in vitro in the presence and absence of 10 and 100 microM concentrations of the following potential substrates or inhibitors of estrogen-2/4-hydroxylase (E-2/4-H): (1) estrogens; estrone (E1), estriol (E3) and 17 alpha-estradiol (17 alpha-E2), (2) catecholestrogens; 2-hydroxyestradiol (2-OH-E2), 4-hydroxyestradiol (4-OH-E2) and 2-hydroxyestrone (2-OH-E1); (3) 2 methoxyestradiol (2-MeO-E2); (4) halogenated estrogens; 2-bromoestradiol, (2 Bromo-E2) 4-bromoestradiol and 2,4-dibromoestradiol; (5) androgens; testosterone (T), dihydrotestosterone (DHT) and androstenedione; (6) progesterone; (7) epinephrine; (8) inhibitors of steroid aromatase; aminoglutethimide and 4 hydroxyandrostenedione and (9) SKF 525A, an inhibitor of cytochrome P-450. Progesterone and 2-Bromo-E2 were the two most effective inhibitors (2-OH-E2 formation = 4 and 5% of control at 100 microM and 29.6 and 17.4% at 10 microM of progesterone and 2-Bromo-E2, respectively). 2-MeO-E2 at 100 microM was nearly as effective as progesterone in inhibiting E-2/4-H activity but only caused about 50% inhibition at 10 microM. The three catecholestrogens reduced 2-OH-E2 formation to about the same degree (21-23% of control at 100 microM). The 2,4 dibromo-E2 was equipotent with the catecholestrogens while 4-bromo-E2 was about half as effective. The phenolic estrogens, potential substrates for the enzyme, reduced 2-OH-E2 formation to different degrees, with E3 being the most effective. Among the androgens, DHT was almost as effective an inhibitor as the catecholestrogens, T was about half as effective while androstenedione had no effect. Epinephrine and the two inhibitors of aromatase did not inhibit E-2/4-H activity. SKF 525A inhibited E-2/4-H activity but with a potency only about 1/10th that reported for liver. PMID- 3821100 TI - Differential distribution of the 5-alpha-reductase in the central nervous system of the rat and the mouse: are the white matter structures of the brain target tissue for testosterone action? AB - In the brain of several animal species testosterone is converted into a series of 5-alpha-reduced metabolites, and especially into 17-beta-hydroxy-5-alpha androstan-3-one (DHT), by the action of the enzyme 5-alpha-reductase. The formation of DHT has never been evaluated in the white matter structures of the brain, which are composed mainly of myelinated axons. The experiments here described were performed in order to study, in the rat and the mouse, the DHT forming activity of several white matter structures, in comparison with that of the cerebral cortex and of the hypothalamus. Two sampling techniques were used in the rat: microdissection under a stereo-microscope from frozen brain sections of fragments of corpus callosum, optic chiasm and cerebral cortex; fresh tissue macrodissection of subcortical white matter, cerebral cortex and hypothalamus. Only macrodissection was used in the mice. The data show that, independently from the sampling technique used, there are considerable quantitative differences in the distribution pattern of the 5-alpha-reductase activity within different brain structures. Both in the rat and in the mouse, the enzyme appears to be present in higher concentrations in the white matter structures, than in the cerebral cortex and in the hypothalamus. The present results clearly show that the subcortical white matter and the corpus callosum are at least three times as potent as the cerebral cortex in converting testosterone into DHT. An even higher 5-alpha reductase activity has been found in the optic chiasm. Further work is needed in order to understand the possible physiological role of DHT formation in the white matter structures. PMID- 3821101 TI - The influence of 4-hydroxy-4-androstene-3,17-dione on androgen metabolism and action in cultured human foreskin fibroblasts. AB - 4-hydroxy-4-androstene-3,17-dione (4-OHA) has been shown to be a potent inhibitor of aromatase activity. It is effective in the control of estrogen-dependent processes in female subjects and may potentially be useful in the treatment of estrogen-dependent processes in men. Human foreskin fibroblasts grown in cell culture provide a model to investigate the effects of 4-OHA on extraglandular aromatase activity as well as the ability of the compound to influence androgen receptor binding and the 5 alpha-reduction of testosterone (T). Initial experiments were carried out to determine the potency of 4-OHA in genital skin fibroblasts by incubating cells with 4-OHA over a range of concentrations. When aromatase activity was determined at a substrate concentration close to the apparent Km of the enzyme, a 44% inhibition of enzyme activity occurred at a mean concentration of 5 nM 4-OHA. Enzyme kinetic studies analyzed by Eadie-Hofstee plots demonstrated competitive inhibition by 4-OHA with a mean apparent Ki of 2.7 nM. When 5 alpha-reductase activity was determined in the presence of 200 nM [3H]T, in the absence or presence of 4-OHA, a 50% inhibition of enzyme activity occurred at an inhibitor concentration of 3 microM. In androgen receptor binding studies, 4-OHA possessed 1% of the affinity of dihydrotestosterone (DHT) for [3H]DHT binding sites. In summary: 4-OHA is a potent and specific inhibitor of aromatase activity in human genital skin fibroblasts, the affinity of the enzyme for 4-OHA being greater than its affinity for the substrate, androstenedione. The influence of 4-OHA on 5 alpha-reductase activity and androgen receptor binding is minimal. PMID- 3821102 TI - Equilin and equilenin biosynthesis. Stereochemistry of aromatization of 3-hydroxy 3,5,7-androstatrien-17-one by horse placenta. AB - The metabolic pathway leading to equilin and equilenin biosynthesis in the pregnant mare is different from that of estrone and estradiol and it is apparently cholesterol-independent. The precise precursors and intermediates and the stereomechanism of equine placental aromatization have not been established. [1,2-3H, 4-14C]3-Hydroxy-3,5,7-androstatrien-17-one was synthesized as a potential substrate and the 3H-distribution was analyzed by biochemical and chemical derivatization methods. The substrate was converted to equilin, equilenin and Heard's ketone by horse placental microsomes with a sp. act. of 74, 18 and 2.8 pmol/h/mg, respectively, and only to equilin by human placental microsomes with a rate of 26 pmol/h/mg. Analysis of the loss of 3H-labeling during aromatization showed the stereospecific 17 beta,2 beta-cis hydrogen elimination for equine estrogen biosynthesis both by horse and human placental microsomes. This is the same as for estrone and estradiol biosynthesis by both placentas. The biosynthesis of Heard's ketone, a non-phenolic ring-B aromatic C18 steroid, by horse placental microsomes was found to involve none of the four hydrogens at C-1 and C-2. This refutes the previous postulate that Heard's ketone arises from equilenin by reduction of the ring-A. PMID- 3821103 TI - Inhibition by hydroxymalonate of malate dependent biosynthesis of progesterone in the mitochondrial fraction of human term placenta. AB - It has been shown that the conversion of cholesterol to progesterone by human term placental mitochondria incubated in the presence of malate or fumarate was inhibited by hydroxymalonate--an inhibitor of malic enzyme. No inhibition was observed when mitochondria were incubated in the presence of citrate or isocitrate. The degree of inhibition by hydroxymalonate of partly purified NAD(P) linked malic enzyme activity was identical to that of both malate dependent pyruvate and progesterone formation by intact mitochondria. These data strongly support a previous suggestion that malic enzyme plays an important role in the malate dependent progesterone biosynthesis by human placental mitochondria. PMID- 3821104 TI - Polyamine modification in human breast tumors after short treatment with tamoxifen. AB - The authors measured estrogen receptors, and polyamine (putrescine, spermidine and spermine) in breast tumors from patients (n = 23) who had received tamoxifen for a few days (5-10) before surgery. Women undergoing mastectomy without any preoperatory treatment were selected as the control group (n = 44). As already reported about in vitro experiments, the treatment resulted in a significant lowering of the spermidine to spermine ratio. Such a modification was larger in the ER positive tumors then in the ER negative ones and it seems to be related to the regression process of the drug-responsive tumors. On the basis of the experimental data the authors suggest the development of a in vivo tamoxifen sensitivity test. PMID- 3821105 TI - Aromatase activity in microsomes from rat ventral prostate and Dunning R3327H rat prostatic adenocarcinoma. AB - We have measured aromatase activity in microsomes obtained from rat ventral prostate, using the 3H2O release method as described by Weisz. Production of 3H2O from 1 beta-[3H]androstenedione correlated with estrogen production measured by RIA and by TLC. The assay was optimized for incubation time and protein concentration, and used to determine the aromatase activity of ventral prostate microsomes from rats of varying age. Aromatase activity per mg microsomal protein increased from an average of 4 pmol/mg protein X h in 3-month old rats to 68 pmol/mg protein X h in 8-month old rats. Aromatase activity was also measured in microsomes from the Dunning R3327H rat prostatic adenocarcinoma, and was increased in tumors removed 225 days after implantation compared to tumors removed 141 days after implantation. Tumors removed 225 days after implantation from rats which had been treated with DES for 14 days displayed increased aromatase activity compared to untreated tumors. The presence of aromatase activity in the rat ventral prostate and rat prostatic adenocarcinoma would allow regulation of estrogen levels independent of circulating estrogen. Thus, in situ changes in estrogen production with age may contribute to the development of prostatic disease. PMID- 3821107 TI - Hepatic estrogen receptor in the turtle, Chrysemys picta: partial characterization, seasonal changes and pituitary dependence. AB - A hepatic estrogen receptor is described from female turtles, Chrysemys picta. The receptor adheres to DNA after incubation with [3H]estradiol and can be eluted with a linear salt gradient as a single component with an elution maximum of 0.21 M. It is steroid-specific, binding estrogens, but not androgens or progestins. Specific binding saturates between 3 and 7 nM [3H]estradiol-17 beta and Scatchard analysis gave a Kd of 2 X 10(-9) M and a maximal binding capacity of 3.02 fmol/mg protein. Hypophysectomy reduces hepatic estradiol receptor from 70 fmol/g tissue in control animals to non-detectable levels. Growth hormone replacement partially restored the receptor to 36% of control. Significant changes in receptor occur during the ovarian cycle. PMID- 3821106 TI - Analysis of the nuclear estrogen receptor from MCF-7 cells by limited proteolysis. AB - The proteolytic fragments of the nuclear estrogen receptor in the MCF-7 cell line were characterized following limited digestion with chymotrypsin and trypsin. Nuclei were isolated from cells previously exposed to 10 nM [3H]estradiol. The proteolytic digestion was performed either on the micrococcal nuclease hydrolysate or on intact nuclei. The molecular weights (Mr) were calculated from the sedimentation coefficients determined on a sucrose gradient and from the Stokes radii estimated by gel filtration. Digestion of the nuclei with micrococcal nuclease solubilized a receptor form of Mr = 151,000. This receptor form was degraded by chymotrypsin to a receptor of Mr = 33,000 and by trypsin to a receptor of Mr = 60,000. Digestion of intact nuclei with chymotrypsin solubilized a receptor form of Mr = 62,000 which dissociated in 0.4 M KCl to a receptor of Mr = 32,000. Digestion of intact nuclei with trypsin followed by micrococcal nuclease solubilized a receptor form of Mr = 75,000 which was further dissociated by 0.4 M KCl to a receptor form of Mr = 60,000. The ability of the receptor forms to bind DNA was tested using DNA-cellulose column chromatography. About 40% of the micrococcal nuclease solubilized receptor form, compared to about 7% of the chymotrypsin degraded receptor and to about 13% of the trypsin degraded receptor forms, all bound to the column and could be eluted by high salt concentrated buffer. We conclude that the nuclear estrogen receptor in the MCF-7 cell line can be partially degraded either in the micrococcal nuclease hydrolysate or in intact nuclei by chymotrypsin or trypsin generating protein moieties, probably receptor fragments of Mr = 33,000 and 60,000 respectively. Both fragments retain their estradiol binding domain and it may be hypothesized that the heavier fragment retains its chromatin binding domain. PMID- 3821108 TI - Characterization of glucocorticoid receptors in S49 mouse lymphoma cells by affinity labeling with [3H]dexamethasone 21-mesylate. AB - Glucocorticoid receptors in wild type and mutant S49 mouse lymphoma cells were affinity labeled with [3H]dexamethasone 21-mesylate and analyzed directly by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The molecular weight of receptors in cytosol from wild type cells and nuclear transfer decreased (nt-) mutants was 97,000 (97 kDa). The molecular weight of receptors in cytosol from nuclear transfer increased (nti) mutants was 48 kDa. The 97 kDa receptor in cytosol from wild type cells was digested by chymotrypsin to a 40 kDa steroid binding receptor fragment but the 48 kDa receptor in cytosol from nti mutants was resistant to digestion by chymotrypsin. In addition to the 48 kDa receptor, cytosol from nti mutants contained 40 and 18 kDa receptor fragments. Cytosol from the nt- mutants also contained 18 kDa receptor fragments. The 40 and 18 kDa receptor fragments were present in multiple subclones of a nti mutant cell line. Formation of these receptor fragments was not prevented by protease inhibitors and was not increased by extended incubation of cytosol samples. Both 48 and 40 kDa forms of the receptor, but not the 18 kDa form, could be activated and bound by DNA-cellulose. PMID- 3821109 TI - Genital fibroblasts from normal individuals and patients with androgen insensitivity: demonstration of reduced or absent levels of a specific protein (Mr approximately 41K, pI approximately 6) in receptor negative cells. AB - Genital fibroblasts were obtained from normal individuals and from patients with a variety of syndromes of defective androgenization (complete androgen insensitivity, partial androgen insensitivity, microgenitalia, hypospadias, infertility). Cells were labelled with [35S]methionine, and patterns of protein synthesis compared by two-dimensional gel electrophoresis, with isoelectrofocusing electrophoresis gels or non-equilibrated pH gradient electrophoresis (NEPHGE) gels as the first dimension. A protein (mol. wt approximately 41K, pI approximately 6) was found on NEPHGE gels to be reduced or absent in fibroblasts in which androgen receptor levels were abnormal. The protein was unaltered by prior incubation with 1-100 nM dihydrotestosterone for 48 h, and was present in cells both from normal controls, and from patients with abnormal sexual differentiation showing normal androgen receptor levels. The coincidence of low or absent 41K with low or absent androgen receptors suggested the possibility that it may constitute a steroid-binding moiety of the androgen receptor. To test this possibility cytosols from normal foreskins or normal cultured fibroblasts were adsorbed with testosterone-sepharose affinity resin to remove androgen receptors. Cytosols so treated showed levels of 41K on NEPHGE indistinguishable from those in untreated cytosols, or in cytosols treated with underivatized sepharose. We therefore conclude that the 41K protein, while an accurate marker of the presence or absence of androgen receptors over a range of clinical disorders, is neither an androgen-induced protein nor an androgen binding protein. PMID- 3821110 TI - Production of 19-hydroxy-11-deoxycorticosterone and 19-oxo-11-deoxycorticosterone from 11-deoxycorticosterone by cytochrome P-450(11)beta. AB - Incubation of 11-deoxycorticosterone with a cytochrome P-450(11)beta reconstituted system yielded, in addition to corticosterone and 18-hydroxy-11 deoxycorticosterone, a new steroid product. The retention time of the new product was identical with that of authentic 19-hydroxy-11-deoxycorticosterone on high performance liquid chromatography (HPLC). The turnover number of 19-hydroxy-11 deoxycorticosterone formation was 7.0 mol/min/mol P-450. When a large amount of cytochrome P-450(11)beta was used for the reaction and the products were analyzed by HPLC, the 19-hydroxy-11-deoxycorticosterone peak disappeared from the chromatogram and concomitantly new unidentified peaks appeared. These results suggest that 19-hydroxy-11-deoxycorticosterone was further metabolized to other steroids by cytochrome P-450(11)beta. Therefore, we next incubated 19-hydroxy-11 deoxycorticosterone with cytochrome P-450(11)beta and analyzed the reaction products by HPLC. The above-mentioned unidentified peaks appeared again in the chromatogram. The retention time of one of the peaks coincided with that of authentic 19-oxo-11-deoxycorticosterone. This peak substance was purified by repeated HPLC and subjected to mass spectrometry and 1H NMR analyses. Its field desorption mass spectrum (FD-MS) showed a M+ peak at m/e 344. The 1H NMR spectrum showed the signal of an aldehyde proton instead of those of hydroxymethyl protons at the C-19 position. These results suggest that cytochrome P-450(11)beta can catalyze the 19-hydroxylation of 11-deoxycorticosterone, and the 19-hydroxy-11 deoxycorticosterone produced is further oxidized at the C-19 position to 19-oxo 11-deoxycorticosterone. PMID- 3821111 TI - Interactions between glucocorticoid receptor-bearing chromatin and antireceptor antibody preparations. AB - Recent evidence indicates that the control of gene expression by steroid hormones is mediated by hormone-receptor complexes bound at specific chromosomal locations. The isolation of these in vivo sites of binding would be useful in an analysis of the mechanism of this control. We have therefore examined the interaction between two different antiglucocorticoid receptor antibody preparations and a defined chromatin fraction containing bound glucocorticoid receptors in order to test the feasibility of this approach. Both antibody preparations, when attached to sepharose, removed nucleosome-bound and nucleosome free receptor from solution, indicating that chromatin-bound receptor was exposed and available for reaction with antibody. The bulk of the chromatin, not containing receptor, was mainly unaffected during these reactions, showing that the antibodies exhibited significant specificity. To determine whether the nucleosome-bound receptor remained attached to the nucleosome during reaction with antibody, studies using soluble antibody were performed. One of the antibodies caused a shift in the sedimentation rate of the nucleosome-bound receptor from 11S to 11.5S, suggesting that an intact ternary complex of antibody receptor-nucleosome had formed. The other antibody produced various-sized aggregates of the free and bound receptors. Surprisingly, we found that one of the antibodies reacted strongly with free and nucleosome-bound estrogen receptors as well as glucocorticoid receptors. These studies suggest that an antibody preparation with appropriate characteristics should permit isolation of chromosomal receptor binding sites. PMID- 3821112 TI - Steroid hormone biosynthesis by a sesterterpene pathway in the rat and rabbit testis. AB - Rat and rabbit testis preparations were incubated with [4-14C]cholesterol and 23,24-dinor-[7 alpha-3H]5-cholen-3 beta-ol, the latter being a proposed intermediate in the sesterterpene pathway for steroid biosynthesis. Steroids were isolated, purified by thin-layer chromatography and crystallised to constant specific activity. It was found that rat and rabbit testis can utilise 23,24 dinor-5-cholen-3 beta-ol to produce testosterone. The tritium/carbon-14 ratios in the testosterone and androstenedione isolated indicated that these tissues differentiated between the two substrates. This finding is supported by the observation that, on stimulation with HCG, the tritium/carbon-14 ratios in the testosterone isolated were increased compared to the controls. The results of further experiments implied that, while the biosynthesis of testosterone from cholesterol occurred in the rat testis mitochondrial fraction, its biosynthesis from 23,24-dinor-5-cholen-3 beta-ol occurred in the microsomal fraction. PMID- 3821113 TI - Genetic and environmental factors in alcohol abuse and antisocial personality. AB - Previous analyses of adoptees from Lutheran Social Services of Iowa developed a multifactorial model of adoptee alcohol abuse that related abuse to three factors: biologic background of alcohol-related problems, biologic background of antisocial problems and exposure to an adoptive family where family members had alcohol-related problems. The present study examines an independently collected sample of adoptees from a different agency--the Iowa Children's and Family Services, and confirms the multifactorial model previously found in the Lutheran Social Service data. The model shows a specificity of type of inheritance and type of environmental influence: biologic family alcohol-related problems predict increased alcohol abuse in adoptee, biologic family antisocial behaviors predict increased antisocial personality diagnoses in adoptee, and environmental factors of alcohol-related problems in the adoptive family predict increased adoptee alcohol abuse. PMID- 3821114 TI - Gender roles and female drinking-driving. AB - Using roadside survey data on 2044 drivers in a southern metropolitan community, the potential of gender roles for explaining the role behavior of female drinking drivers was examined. Although female drinking drivers are like female nondrinking drivers in previous driving and drinking-driving experiences, overall they are more like male drinking drivers. Both female and male drinking drivers tend to drive in similar places and to be on the roads at similar times and days. They also carry similar numbers and types of passengers. The greater similarity of female drinking drivers to male drinking drivers than to nondrinking female drivers suggests caution in leaning too heavily on gender roles as explanations of female drinking-driving behavior. PMID- 3821115 TI - Differential referral of women and men to employee assistance programs: the role of supervisory attitudes. AB - Potential factors underlying sex differences in the referral of problem-drinking subordinates to employee assistance programs (EAPs) were explored in interviews with 120 supervisors in four organizations. Analyses of data obtained in these interviews assessed the relative ability of eight variables to predict supervisor's actual identification and referral of female and male problem drinkers. In addition to numbers of employees supervised, the supervisors' judgment of the EAP's effectiveness was the best predictor of referral and identification, regardless of the sex of the referred subordinate. Knowledge and training in the EAP was a secondary contributor to referral of men, but played no role in female referrals. When controlling for all other variables, the extent to which supervisors held an egalitarian attitude toward women's rights and roles was found to be marginally positively related to identification of female drinkers. Similarly, a less stigmatized, stereotyped view of women's use and abuse of alcohol was marginally associated with a greater likelihood of referral of a female drinker to the EAP. Neither of these attitudinal variables was related to identification or referral of male problem drinkers. PMID- 3821116 TI - Experience and change in Al-Anon family groups: adult children of alcoholics. AB - Adult children of alcoholics exhibit low self-esteem, excessive feelings of responsibility, difficulties reaching out, depression and the increased likelihood of alcoholism. This study examines how adult children of alcoholics discuss their experiences in an Al-Anon group and describes their perceptions of change in self, personal problems, relationships, spirituality, childhood and the Al-Anon program. Twelve sessions of one Al-Anon chapter were observed, Al-Anon members were interviewed and a coding system to assess the content of the meetings was developed. Improvements constituted 25% of reports, of which improvement in problems constituted 20%. Members reported positive changes in self. Changes in relationships with alcoholics were few, as were changes in perceptions of the program (members felt positively about the program from the start). Although spirituality constituted less than 4% of the reports, many interviewees found spirituality the last and, ultimately, one of the most valued components of Al-Anon. A common experience of parental alcoholism, and cognitive, affective and behavioral antidotes to prior socialization in an alcoholic family contributed to the program's perceived helpfulness. PMID- 3821117 TI - Alcohol on prime-time television. AB - Alcohol acts and scenes from a sample of 122 hours of prime-time television programs aired in the fall of 1984 were studied. Approximately 80% of the 116 episodes studied contained one or more appearances of alcohol. The appearance of alcohol on dramatic series was especially high with 9 of 10 episodes containing some verbal or visual reference to alcohol. Alcohol was ingested on 60% of all the programs. Overall, the sample contained 10.65 drinking acts per hour. Dramas, comprising 56% of the sample hours, accounted for most alcohol behavior--11 drinking acts per hour. Put in audience terms, a regular viewer of dramas would be likely to see more than 20 drink acts per evening. PMID- 3821118 TI - Treatment compliance of older alcoholics: an elder-specific approach is superior to "mainstreaming". AB - A sample of 24 alcoholics (mean age, 58.8 years) treated in typical mixed-age outpatient groups, is compared to a sample of 25 alcoholics (mean age, 60.2 years) treated in special elderly peer groups. Patients treated in the special peer group program remained in treatment significantly longer and were more likely to complete treatment than those treated in mixed-age groups. These findings support the continued development and evaluation of elder-specific treatment approaches for older alcoholics. PMID- 3821119 TI - Liquor-by-the-drink and alcohol-related traffic crashes: a natural experiment using time-series analysis. AB - A quasi-experimental study was conducted to estimate the impact of liquor-by-the drink (LBD) on alcohol-related traffic accidents in North Carolina counties. Time series analysis for the period from January 1973 through December 1982 found LBD was associated with statistically significant increases of 16 to 24% in both the number of police-reported alcohol-related accidents and in single vehicle nighttime accidents among male drivers 21 years of age and older in counties implementing LBD. No change in alcohol-related accidents was found for non-LBD counties. Single vehicle nighttime accidents involving male drivers under 21 did not change for either the experimental or comparison groups. PMID- 3821120 TI - The limitations of control-of-supply models for explaining and preventing alcoholism and drug addiction. AB - The primary approach to eliminating drug abuse in America for most of the 20th century has been to prohibit the use and sale of certain drugs and to shut down drug supply lines. Yet drug abuse persists at high levels and the use of outlawed substances is a common feature of American life from high school on. The failure of drug policies has not discouraged, but seemingly fuels, renewed efforts of the same kind. Contrasting with this focus on the inherent dangers of the substance itself, the effort to control alcohol abuse has instead focused, since the end of Prohibition, on the characteristics of the individual alcoholic. In recent years, however, the public-health model of alcohol abuse and the psychophysiological formulation of alcohol dependence have emphasized that alcoholism is a consequence of the amount of alcohol available in the society and consumed by the individual drinker. In this way, alcohol and drug dependence (or addiction) formulations have coalesced: both assume that uncontrolled use results from regular or excessive consumption of these substances. This unified model of addiction based on exposure to a substance fails to account for substantial interindividual, intraindividual and cultural variability in patterns of use. The evidence is, moreover, that control-of-supply policies will never reduce substance abuse significantly and that such policies may backfire by propagating images of substances as being inherently overpowering. PMID- 3821121 TI - Brainstem auditory evoked potentials in newly detoxified alcoholics. AB - The effects of detoxication on auditory transmission were examined using Brainstem Auditory Evoked Potentials (BAEP) in a group of alcoholics undergoing treatment and compared to nonalcoholic controls. BAEP responses, obtained at 2 click stimulation rates (11.3/sec and 31.3/sec), were examined for morphology, absolute latencies, interpeak latencies and I/V amplitude differences. All mean latency values were found comparable for the two groups. For a number of waves in each ear, data for alcoholics were significantly more variable than that of controls. A significant number of alcoholics, however, had atypical waveforms (i.e., missing components) and some, unexpected I/V amplitude differences, with the amplitude of wave I larger than that of V in comparison to controls. The clinical interpretation of evoked potential findings for individual alcoholic patients is likely to be precarious due to the observed high variability of latency and amplitude values. PMID- 3821122 TI - Tumor stabilization after hyperthermia: an important criterion of response to thermal therapy. AB - Several investigators have indicated that changes in tumor size may not occur after hyperthermia therapy even with substantial tumor cell kill, because of early edema and subsequent fibrosis of background stroma, suggesting that "tumor stabilization" might be an important benefit of thermal therapy. Recently, 9 institutions completed a national cooperative study of localized hyperthermia for patients with advanced, recurrent, or metastatic solid cancer that evaluated the potential significance of this response variable in a standardized clinical trial. Of 960 evaluable patients who completed at least one course of hyperthermia, thermoradiotherapy, or thermochemotherapy, 85 (9%) had complete responses for 1-34 months, 173 (18%) had partial responses for 1-39 months, 95 (10%) had minimal responses for 1-15 months, and 313 (33%) had disease stabilization for 1-32 months. Of 313 patients who had no change (i.e., +/- 25%) in the size of their tumors after hyperthermia, the response lasted only 1-3 months in 170 (54%) patients, a finding of questionable clinical significance. However, disease stabilization was observed for more than 3 months in 143 (46%), for more than 6 months in 67 (21%), more than 9 months in 33 (10%), and more than 12 months in 16 (5%). Disease stabilization was also associated with improved activity for 1-22 months in 79 (25%) of these patients, and improved pain for 1 22 months in 100 (32%). Disease stabilization appeared to be independent of tumor histology, location, or depth within the body, size, or minimum treatment temperature, but was somewhat more frequent after hyperthermia combination therapy. There is sufficient accumulative data to suggest that tumor stabilization after hyperthermia should not be dismissed as a placebo effect. This response variable well may be a unique and potentially important criterion of response to localized hyperthermia therapy. PMID- 3821123 TI - Diagnosis of pulmonary nodules in the cancer patient: the role for routine culture and an unusual application of the human tumor colony-forming assay. AB - Many solid tumors that occur in humans tend to metastasize to the lungs. The etiology of pulmonary nodules in cancer patients, therefore, presents a diagnostic problem that can be resolved only by histologic evaluation or resection. We present two cases of cancer patients with preoperative and intraoperative diagnoses of metastatic lung tumors. Tissue culture using the Human Tumor Colony-Forming Assay (HTCFA), a procedure that predicts chemosensitivity patterns of tumors, was employed to successfully diagnose those nodules as fungal infections. In one case, results using the HTCFA were crucial in the identification of the opportunistic organism. These cases stress the importance of routine culture of all pulmonary nodules and present an unusual but noteworthy application of the HTCFA system. PMID- 3821124 TI - Changes in survival with clinical stage I malignant melanoma. AB - Inclusion of patients referred to our cancer center following recurrence, by retracing the history and characteristics of these patients back to when they were in stage I, produced a bias that lowered the estimated disease-free survival rates. However, taking into consideration only patients referred and managed in our center when they had clinical stage I melanoma, significant differences in disease-free survival over time were revealed (P = 0.03). Thus, the estimated five-year disease-free survival rate for 86 patients treated in the period 1971 75 was 65%, whereas that from 115 patients treated in the period 1976-80 was 81%. There was no significant increase in disease-free survival for patients who had an elective node dissection in addition to wide excision. PMID- 3821125 TI - Clear cell follicular adenoma of the thyroid. AB - A rare case of follicular adenoma of the thyroid gland composed exclusively of clear cells is described. This case differs from most of the previously reported cases of clear cell thyroid neoplasm in that it was clinically and histologically benign. PMID- 3821126 TI - Response of advanced breast cancer to total endocrine ablation after exacerbation on tamoxifen: results in seven patients and possible mechanism of action. AB - Usage of tamoxifen in the treatment of advanced breast cancer is increasing and is advocated by some authors as primary therapy in all estrogen receptor positive cancer patients. Tamoxifen is an incomplete estrogen antagonist with partial estrogen agonist activity as well. Tamoxifen-induced exacerbation of breast cancer ("tamoxifen flare") is reported to occur in 4-20% or more of treated patients. Management of this condition has varied from stopping treatment to continued administration or reinstitution of tamoxifen after flare symptoms subside. Responses have occurred in some patients so treated, although the remissions do not appear durable. The seven patients with advanced breast cancer in this report experienced disease exacerbation with tamoxifen therapy. Endocrine ablation afforded all patients excellent pain relief and disease control with prolonged survival in six of the seven. There have been no studies directly examining the disease course in flare patients continuing on tamoxifen. Persistence in treating these patients with an incomplete antagonist-agonist may deprive them of full survival benefit possible through ablative procedures when used in sequential treatment. PMID- 3821127 TI - Secondary urinoma mimicking recurrent tumor as a cause of bilateral ureteral obstruction. AB - A case is reported of a previously resected adenocarcinoma of the rectum presenting with recurrent tumor in the pelvis and an abdominal mass that was found to be a large urinoma. Dialysis was discontinued after drainage of the extravasated urine, and the patient's condition became stable. A review of the literature is also discussed. PMID- 3821128 TI - Nail-bed melanoma. AB - In our series of 348 patients treated over a 10-year period, six (1.7%) had their primary lesions in the nail bed. Five of the subungual melanomas occurred in the toes and one in the thumb. Four of the lesions were of the acral lentiginous type. The delay in diagnosis was 7 months to 6 years. Four of the patients presented with advanced, neglected tumors. One had distant metastases at diagnosis. The treatment was mainly surgical. Digital amputation was carried out for local control. Five patients underwent lymph node dissection and in three of them regional metastases were found. Of the four patients with regional and distant metastases at the time of diagnosis, three died within 6 to 60 months and the fourth is alive with metastatic spread. Of the two patients with melanoma confined to the nail bed, one is free of disease 50 months following diagnosis and the other suffered from a local recurrence and has been free of disease for 30 months following wide excision and limb perfusion. PMID- 3821129 TI - Trophic role of the sympathetic innervation. PMID- 3821130 TI - [Monoclonal antibodies in diagnosis and therapy]. AB - The discovery of monoclonal antibodies has brought about a revolution in diagnostic and therapeutic. New antigens have been discovered on cell surfaces allowing the fine classification of cell lineages. Leukemia cells and tumors can now be characterized accurately. Regarding in vitro diagnostics monoclonal antibodies have allowed uniform standardization and a rational approach to hormone polymorphism. Monoclonal antibodies are now tested as pharmacological drugs. They have proved their use in the prevention and cure of rejection in bone marrow and kidney transplantation. PMID- 3821131 TI - [Pharmacological possibilities for the prevention of complications following myocardial infarction]. AB - Sudden cardiac death (SCD) due to acute myocardial infarction (AMI) is mostly the result of ventricular fibrillation (VP) which is an electrical accident appearing on the basis of electrical instability of the myocardium. In addition to the chronic electrical instability predisposing to ventricular arrhythmias the trigger effect of a precipitating factor also seems necessary which may disrupt the normal sequence of cardiac contractions. In view of this hypothesis the following strategy of therapeutic interventions aimed at preventing SCD from AMI seems to be logical: Prophylactic measures to prevent pathological processes underlying chronic electrical instability of the heart i.e. elimination of identified risk factors of ischemic heart disease. Protection from SCD due to AMI: by using drugs which could, prevent further electrical destabilization as shifts in myocardial and plasma ionic balance, in pH, in pCO2, accumulation of potentially arrhythmogenic metabolites: Inhibit the trigger effect of sudden changes: in hemodynamics, in the autonomic nervous outflow and balance. The general supportive measures include therapeutic interventions which are not directly connected with appearance of lethal arrhythmias but may indirectly contribute to their development as pain, arterial Hb desaturation, deep vein thrombosis. Some of the measures listed above are capable of limiting the size of the developing infarct, a major determinant of the future conditions of life and prognosis of the patient. In the prehospital phase of AMI when two thirds of all coronary deaths occur general supportive measures and drug treatment of life threatening arrhythmias should be applied simultaneously. Sedatives and anxiolytics, furthermore analgetics are widely used. They are however often associated with bradycardia and sometimes with hypotension. This latter is dominant in patients with inferior infarction, showing a parasympathetic hyperactivity, when atropine treatment is needed. Sympathetic hyperactivity responds to analgesia and sedation but beta blockers may be required to reduce increased MVO2. These agents belong to the group of anti-ischemic drugs. The beneficial anti-ischemic action of beta-blockers is mostly due to their negative chronotropic and inotropic effect. A direct metabolic action was shown by use as well as the presence of a positive steal phenomenon in the experimental angina model in dogs. Anti-ischemic action of coronary vasodilators. The most reliable drug for preventing or abolishing anginal attack is still the classic nitroglycerin. On the other hand persantine a potent coronary dilator failed to protect against anginal attack in man. PMID- 3821132 TI - Smooth muscle contracting lipid-soluble principles in chromatographic fractions of Ocimum gratissimum. AB - Fractions isolated from Ocimum gratissimum leaves by lipid extraction and column- and thin-layer chromatography have been shown to contain components which contract guinea pig ileum, rat colon and raise rat mean arterial blood pressure. TLC analysis indicates that these compounds are fairly polar. Analysis of one of the components by mass spectra shows the presence of an unknown with a molecular mass of at least 353 daltons containing carbon, hydrogen, oxygen and possibly nitrogen. A tentative molecular formula, as deduced from computer analysis, is either C21H37O4 or C19H35N3O3. PMID- 3821133 TI - Anti-ulcerogenic effect of banana powder (Musa sapientum var. paradisiaca) and its effect on mucosal resistance. AB - Orally administered banana pulp powder (Musa sapientum var. paradisiaca) was shown to have significant anti-ulcerogenic activity in rats subjected to aspirin, indomethacin, phenylbutazone, prednisolone and cysteamine and in guinea-pigs subjected to histamine. Banana powder not only increased mucosal thickness but also significantly increased [3H]thymidine incorporation into mucosal DNA. Relative to untreated control sections, histological studies showed that banana treatment increased staining by alcian blue in the apical cells with staining noted in the deeper layers of the mucosal glands. Banana-treated and control sections were also stained for DNA by the Feulgen reaction. The banana-treated sections showed a greater aggregation and intensity of pink spots when compared to controls. The present study suggests that banana powder treatment not only strengthens mucosal resistance against ulcerogens but also promotes healing by inducing cellular proliferation. PMID- 3821134 TI - Effects of alpha-momorcharin, beta-momorcharin and alpha-trichosanthin on lipogenesis and testicular and adrenal steroidogenesis in vitro and plasma glucose levels in vivo. AB - The effects of alpha-momorcharin, beta-momorcharin and alpha-trichosanthin on lipogenesis in isolated rat adipocytes were examined. None of the three abortifacient proteins possessed lipogenic activity. The plant proteins did not affect the plasma-glucose level in fasting mice nor did they affect luteinizing hormone-induced testosterone production in isolated rat Leydig cells or corticotropin-induced corticosterone production in isolated rat adrenal decapsular cells by the end of a 2-h incubation period. The results suggest that the functions of adipocytes, adrenal decapsular cells, Leydig cells and pancreatic beta cells were not greatly affected after short-term exposure to the abortifacient proteins. PMID- 3821135 TI - A steryl glycoside fraction with hemolytic activity from tubers of Momordica cochinchinensis. AB - A hemolytic fraction has been obtained from fresh tubers of Momordica cochinchinensis. The fraction was strongly adsorbed on DEAE-Sepharose CL6B. It did not stain with Coomassie brilliant blue in SDS-polyacrylamide gel electrophoresis and it gave no immunoprecipitin arcs in immunoelectrophoresis. The hemolytic activity of the fraction was resistant to heat and proteolytic enzymes. The behavior of the fraction in thin-layer chromatography and its positive reaction in Liebermann-Burchard test indicated that the hemolytic activity of the fraction can be attributed to a steryl glycoside(s). PMID- 3821136 TI - Effects of Olax gambecola methanol extract on smooth muscle and rat blood pressure. AB - A methanol extract of the roots of Olax gambecola induced a biphasic contractile response consisting of a transitory initial rapid contraction (Phase I), followed by a slowly developing sustained increase in basal tone (Phase II) on rat fundus, antrum, guinea pig taenia coli, rabbit jejunum and aorta. The Phase I contraction was abolished by atropine, attenuated significantly by indomethacin and potentiated by physostigmine while the Phase II response was unaffected. Hexamethonium, morphine, serotonin (5-HT) antagonists or desensitization of 5-HT receptors did not alter either the Phase I or the Phase II contractions. Calcium channel blockers and procedures affecting calcium translocation abolished the Phase I contraction while only reducing the Phase II contractions. Transmural electrical stimulation produced contractions of the fundus which were attenuated by the extract. Single bolus injections of extract produced a rapid fall in blood pressure in both normotensive and spontaneously hypertensive rats but intravenous infusion resulted in a sustained fall in blood pressure which was maintained throughout the infusion period. Chronic i.p. administration of extract to spontaneously hypertensive rats reduced blood pressure markedly but did not alter the blood pressure of normotensive animals. The hypotensive response to single bolus injections was abolished by atropine and potentiated by physostigmine. The activity profile of the extract suggests the presence of at least two active principles in the crude extract of Olax gambecola used in this study. PMID- 3821137 TI - Zoapatle. XII. In vitro effect of kaurenoic acid isolated from Montanoa frutescens and two derivatives upon human spermatozoa. AB - Zoapatle aqueous crude extract (ZACE) from Montanoa tomentosa has been used as an oral contraceptive in traditional Mexican medicine for centuries. Kaurenoic acid, as isolated from Montanoa frutescens, and the methyl esters of 15-hydroxy-dihydro kaurenoic acid and 15-keto-dihydro-kaurenoic acid were tested in vitro on human sperm motility and viability. The estimated ED50 concentrations immobilization were 374, 126 and 58 micrograms/ml, respectively using 15 X 10(6) sperms/500 microliter. Kaurenoic acid and both of its derivatives displayed only weak to negligible capacity for killing human sperms. PMID- 3821138 TI - Estrogenic and postcoital anticonceptive activity in rats of butin isolated from Butea monosperma seed. AB - Butin isolated from the seeds of Butea monosperma and administered orally to adult female rats at the doses of 5, 10 and 20 mg/rat from day 1 to day 5 of pregnancy showed anti-implantation activity in 40%, 70% and 90% of the treated animals, respectively. At lower doses, there was a dose-dependent termination of pregnancy and reduction in the number of implantation sites. In ovariectomized young female rats, the butin exhibited estrogenic activity at comparable anticonceptive doses, but was devoid of anti-estrogenic activity. Butin is a weak estrogen in that a significant uterotrophic effect was discerned even at 1/20th the anticonceptive dose. PMID- 3821139 TI - Psychopharmacologic analysis of an alleged oneirogenic plant: Calea zacatechichi. AB - Calea zacatechichi is a plant used by the Chontal Indians of Mexico to obtain divinatory messages during dreaming. At human doses, organic extracts of the plant produce the EEG and behavioral signs of somnolence and induce light sleep in cats. Large doses elicit salivation, ataxia, retching and occasional vomiting. The effects of the plant upon cingulum discharge frequency were significantly different from hallucinogenic-dissociative drugs (ketamine, quipazine, phencyclidine and SKF-10047). In human healthy volunteers, low doses of the extracts administered in a double-blind design against placebo increased reaction time and time-lapse estimation. A controlled nap sleep study in the same volunteers showed that Calea extracts increased the superficial stages of sleep and the number of spontaneous awakenings. The subjective reports of dreams were significantly higher than both placebo and diazepam, indicating an increase in hypnagogic imagery occurring during superficial sleep stages. PMID- 3821140 TI - Nigerian folk medicine: practices and beliefs of the Ondo people. AB - One hundred informants including full time/part time herbalists, old ladies, family heads and village heads were interviewed for the type of plants used in their homes for the treatment of some common diseases. Forty eight plant species were found to be used by Ondo people in folk medicine. Fourteen species were found to contain alkaloids and 34 plant species were found to have local actions. The plant parts used, their uses and biodynamic notes are given. PMID- 3821141 TI - Studies on mate drinking. AB - The habit of drinking mate is very strongly established in the Rio de la Plata region of South America. A chemical study of the commercial herbal material and of the infusion itself is described. PMID- 3821142 TI - Toxicity of plant material used as emergency food during famines in Finland. AB - The use of natural plants as emergency food in Finland and northern Europe has been described. The chemical contents of the commonly used "pettu" (pine bark), lichen (Cetraria islandica, Cladonia sp.) and water plants (Calla palustris, Menyathes trifoliata, Nymphea sp. and Nuphar luteum) are described and their toxicity after traditional pretreatments were studied in mice and rats. As 50% w/w mixture in normal food none of them were tolerated by mice. However, rats tolerated 25% of "pettu" and ash-treated C. islandica in 3-month tests rather well, although the body weight did not increase as much as in controls. At the end of experiment in the lichen group, the rats had proteinuria, and on autopsy some tubular changes were found probably due to high concentrations of lead in the lichen and kidneys. All the rhizomes studied contain toxic compounds, but they, particularly calla, would be nutritionally valuable. Boiling poorly eliminated their toxicity, but after baking at 180-200 degrees C the most toxic Nuphar and calla were well tolerated as 25% mixture during a 6-week test. It is possible that poorly selected or poorly pretreated emergency food have sometimes contributed to the death of famine victims in the olden times. Unqualified simplification of the traditional precautions for their treatment may be dangerous. PMID- 3821143 TI - Clinical comparisons of methods of myocardial protection. AB - Currently, numerous methods are in use for myocardial hypothermia as a myocardial preservation modality for cardiac operations. During cardiac ischemia we have compared myocardial surface cooling with topical cold saline (Group I, N = 9), crystalloid cardioplegia plus topical cold saline (Group II, N = 8) and cardioplegia with a specially designed cooling jacket (Group III, N = 8) in patients undergoing aortic or mitral valve replacement, or both. Temperatures were assessed and recorded continuously in standardized locations for the right and left ventricular epicardium and endocardium. In Group I the rate of cooling was significantly slower than in the other two groups. Also, excessive gradients were developed across the left and right ventricular walls. In Group II the rate and depth of cooling were adequate and initial temperature gradients were eliminated. However, over the period of ischemia, significant rewarming occurred. In Group III temperatures were reduced rapidly and uniformly and maintained at or below 10 degrees C for the duration of the ischemic period. These differences are statistically significant (p less than 0.05). For optimal myocardial hypothermia, we recommend the following: separate cannulation of the superior and inferior venae cavae with caval snares; venting of the pulmonary artery (if inadequate, pulmonary vein occlusion or direct left atrial venting); induction of myocardial hypothermia with crystalloid or cold blood cardioplegia; and maintenance of hypothermia by the cooling jacket described herein. It is also desirable to continuously monitor temperatures of the right and left ventricular endocardial and epicardial surfaces. PMID- 3821144 TI - Bronchial sleeve resection with and without pulmonary resection. AB - Sleeve resection with and without pulmonary resection is safe, effective, and appropriate treatment for a wide range of endobronchial lesions including neoplasms of low-grade malignant potential and selected cases of bronchogenic carcinoma. Sixty-three patients underwent 64 sleeve resection procedures (47 with concomitant pulmonary resection and 17 without) at the Massachusetts General Hospital between 1962 in 1986 with a 30 day mortality rate of 4.7%. Applicability of the technique for bronchial lesions which do not require concomitant pulmonary resection is emphasized. Types of disease included a heterogeneous collection of 31 benign tumors, neoplasms of low-grade malignant potential, and bronchostenosis and 33 bronchogenic carcinomas. Actuarial disease-free survival rate for the former group was 100% at 5 years. Quality of life was excellent for this group. Five-year survival rates for bronchogenic carcinoma (24 squamous cell, seven adenocarcinoma, two undifferentiated) were 58% +/- 25% (+/- standard error), 69 +/- 18%, and 38% +/- 13% in Stages I, II, and III, respectively. The 5 year survival rate of 31% +/- 16% in 14 patients selected because of decreased respiratory reserve compared with 60% +/- 14% in 19 patients for whom sleeve was the operation of choice on the sole basis of anatomic suitability. Sleeve resection is the ideal form of excisional therapy for benign endobronchial tumors, bronchostenosis, tumors of low-grade malignant potential, and for selected cases of carcinoma. PMID- 3821145 TI - Percutaneous cardiopulmonary bypass with a synchronous pulsatile pump combines effective unloading with ease of application. AB - Percutaneous total cardiopulmonary bypass offers the advantage of rapid, simple implementation without the need for thoracic incision and provides the ability to support both left and right ventricular failure as well as pulmonary insufficiency. Previous studies using roller pump percutaneous bypass were only partially successful because of the inability to effectively unload the left ventricle. In the present experiment we attempted to determine in a normal canine model whether use of synchronous pulsatile pumping for percutaneous bypass could overcome this problem. Fourteen dogs were placed on percutaneous bypass for 1 hour. A roller pump was used in seven and a synchronous pulsatile pump with an electrocardiogram triggering mechanism in the other seven. All animals were maintained on percutaneous bypass for 1 hour. In the pulsatile pump group there was a significantly greater percent decrease from baseline in tension-time index (-56.3% versus -19.1%, p less than 0.01) and in myocardial oxygen consumption ( 45.8% versus +2.1%, p less than 0.05) and a significantly greater percent increase in the endocardial/epicardial blood flow ratio (27.6% versus -6.5%, p less than 0.01) than in the roller pump group. These results show that superior unloading can be achieved by percutaneous pulsatile bypass compared with percutaneous roller pump bypass. The findings suggest that percutaneous total cardiopulmonary bypass with a synchronous pulsatile pump offers a relatively simple but effective method for providing appropriate patients with temporary hemodynamic stability before cardiac catheterization or medical or surgical revascularization. PMID- 3821146 TI - Extended aortic root replacement with aortic allografts. AB - Complex left ventricular outflow tract obstruction after operation for subaortic stenosis or with hypoplastic aortic anulus remains a challenge for pediatric cardiac surgeons. We have recently applied a new technique of extended aortic root replacement using a cryopreserved aortic allograft to treat two patients who had previously been operated on for subaortic stenosis and a third who had aortic stenosis with a hypoplastic aortic anulus. This new procedure combines the concept of aortoventriculoplasty with aortic root replacement and coronary artery reimplantation. The valved aortic homograft is used in place of an aortic valve prosthesis and the attached anterior mitral leaflet augments the interventricular septum to relieve the subvalvular left ventricular outflow tract obstruction. The coronary ostia are then reimplanted into the allograft and an anastomosis between the distal graft and the ascending aorta is completed. Allograft aortic tissue is then used to patch the right ventricular outflow tract. One patient had aortic stenosis with annular hypoplasia and did well after extended root replacement. Two patients had previous operations for subaortic stenosis before undergoing extended aortic root replacement. One required mediastinal exploration and drainage at 2 weeks for Serratia marcescens mediastinitis and bacteremia, but uncomplicated recovery followed. The other patient had complete heart block for 2 days, but normal sinus rhythm resumed and convalescence was benign. This modified technique with the aortic allograft was very helpful in treating these difficult problems, and the lack of mortality, limited morbidity, and good functional results are encouraging. PMID- 3821147 TI - Repair of ascending aortic dissection. Influence of associated aortic valve insufficiency on early and late results. AB - Operative treatment of dissections of the ascending aorta differs from that for the descending aorta, not only because of the need for cardiopulmonary bypass, but also because of the frequent occurrence of aortic valve insufficiency. To determine the early and late results of operative repair, we have reviewed the case histories of 121 consecutive patients who underwent repair of ascending aortic dissections between 1962 and 1985. Ages ranged from 16 to 79 years (mean 56 +/- 14 years); 54 patients had operation within 2 weeks of onset of symptoms (acute), and the remainder had later repair (chronic). Seventy patients (58%) had clinical evidence of aortic insufficiency at the time of admission. During repair of acute dissection, 10 patients (19%) had aortic valve resuspension and 15 patients (28%) had aortic valve replacement. During repair of chronic dissection, eight patients (12%) had resuspension and 43 patients (64%) had replacement. Overall operative mortality was 22%, significantly higher for patients with acute than for those with chronic dissections (39% versus 9%, p less than 0.01). Operative risk was similar for patients who underwent repair of ascending aortic dissections without valve resuspension or replacement (31%) versus those who had repair with aortic valve resuspension (17%) or replacement (17%). During a follow up period ranging from 1 to 208 months, aortic regurgitation developed in only two patients who did not have aortic insufficiency at the time of repair. Late aortic regurgitation necessitating reoperation developed in one of the 15 survivors who had aortic valve resuspension. Eight patients undergoing aortic valve replacement had complications of their prostheses, including one periprosthetic leak and four mechanical failures. We conclude that resuspension or replacement of the aortic valve does not increase the risk of repair of ascending aortic dissections. Selective management of aortic insufficiency (with valve repair whenever possible) yields satisfactory long-term results. PMID- 3821148 TI - Surgical repair of double-chambered right ventricle with or without ventriculotomy. AB - Double-chambered right ventricle is an uncommon congenital anomaly consisting of obstruction of the trabecular zone of the ventricle by an elevated, hypertrophied moderator band, with or without additional muscle bundles(s). During an 18 month period (August 1984 to February 1986) 12 patients underwent repair of double chambered right ventricle. Their ages ranged from 13 months to 12 years (mean 4.4 years). Associated lesions were ventricular septal defect in 11 patients (three closed spontaneously), atrial septal defect in two, left superior vena cava in three, aortic valve prolapse in one, and mild subaortic stenosis in two. Right ventricular outflow tract gradients were from 30 to 165 mm Hg (mean 77.2 +/- 37.3 mm Hg). The initial six patients (Group 1) were treated in the "classical" manner with a right ventriculotomy for muscle resection and ventricular septal defect closure (4/6). All patients survived. Five of the six required pharmacologic support for signs of mild to moderate right ventricular failure. The right ventricular outflow tract gradient postoperatively was 0 mm Hg in five patients and 25 mm Hg in one patient. Oxygen saturations were checked in the right atrium and pulmonary artery in all six patients, and one patient had a step-up of more than 10%. In the next six patients (Group 2) a previously unreported right atrial pulmonary artery approach was used to avoid a ventriculotomy. The right ventricular outflow tract gradient was 0 mm Hg in five patients and 5 mm Hg in the sixth. A ventricular septal defect was closed in four of the six patients. There were no deaths, and no patient required inotropic support. Follow-up has been from 2 to 20 months. There have been no late deaths, and all patients are asymptomatic. One patient in Group 1 still has signs of a residual ventricular septal defect at 1 year. No patient has echocardiographic evidence of right ventricular outflow tract obstruction. All patients have remained in sinus rhythm with right bundle branch block. No patient has been recatheterized. Repair of double-chambered right ventricle is easily performed without a ventriculotomy. The atrial exposure of the ventricular septal defect is excellent. The muscle bundle(s) can be visualized easily through an initial transverse pulmonary arteriotomy with completion of resection through the tricuspid valve. PMID- 3821149 TI - Bjork-Shiley and Carpentier-Edwards valves. A comparative analysis. AB - Between January 1977 and December 1982, 986 Bjork-Shiley and 744 Carpentier Edwards valves were implanted in 774 and 620 patients, respectively, at the same institution. All Bjork-Shiley patients and 57% of patients with a Carpentier Edwards valve in the mitral position received long-term anticoagulation. Mean follow-up was 3.2 years (range 0 to 8.8) in the Bjork-Shiley patients and 3.5 years (range 0 to 8.2) in the Carpentier-Edwards group. There was no significant difference between the two groups in hospital mortality (Bjork-Shiley 7.6%; Carpentier-Edwards 6.0%), overall incidence of embolism (Bjork-Shiley 1.4 per 100 patient-years; Carpentier-Edwards 1.6% py), endocarditis (Bjork-Shiley 0.6% py; Carpentier-Edwards 0.8% py), periporsthetic leak (Bjork-Shiley 1.6% py; Carpentier-Edwards 1.4% py), anticoagulant-related complications (Bjork-Shiley 0.3% py; Carpentier-Edwards 0.1% py), valve failure (Bjork-Shiley 0.78% py; Carpentier-Edwards 0.68% py), reoperation for complication (Bjork-Shiley 1.68% py; Carpentier-Edwards 1.22% py), and late mortality (Bjork-Shiley 3.1% py; Carpentier-Edwards 3.0% py). Actuarial freedom from valve-related events was similar in the two groups. In the aortic position, freedom from embolism was significantly better in the Bjork-Shiley group than the Carpentier-Edwards group (Bjork-Shiley 99% at 3 and 5 years; Carpentier-Edwards 96% and 92% at 3 and 5 years; p = 0.023). In the mitral position, the overall incidence of reoperation was higher in the Bjork-Shiley group (1.78% py) than in the Carpentier-Edwards group (0.48% py) (p = 0.004). Actuarial analysis shows this difference to be confined to the first 6 years of follow-up. The commonest indication for reoperation was valve failure in both groups. However, when analysis is confined to this indication, the difference between the reoperation incidence in the mitral position becomes insignificant (Bjork-Shiley 0.85% py; Carpentier-Edwards 0.29% py; p = 0.085). This study confirms the satisfactory performance of both the Carpentier-Edwards and Bjork-Shiley valves in the short and middle term and indicates no clear-cut advantage for either prosthesis. PMID- 3821150 TI - Enhanced myocardial protection with high-energy phosphates in St. Thomas' Hospital cardioplegic solution. Synergism of adenosine triphosphate and creatine phosphate. AB - The potential for improving myocardial protection with the high-energy phosphates adenosine triphosphate and creatine phosphate was evaluated by adding them to the St. Thomas' Hospital cardioplegic solution in the isolated, working rat heart model of cardiopulmonary bypass and ischemic arrest. Dose-response studies with an adenosine triphosphate range of 0.05 to 10.0 mmol/L showed 0.1 mmol/L to be the optimal concentration for recovery of aortic flow and cardiac output after 40 minutes of normothermic (37 degrees C) ischemic arrest (from 24.1% +/- 4.4% and 35.9% +/- 4.1% in the unmodified cardioplegia group to 62.6% +/- 4.7% and 71.0% +/- 3.0%, respectively, p less than 0.001). Adenosine triphosphate at its optimal concentration (0.1 mmol/L) also reduced creatine kinase leakage by 39% (p less than 0.001). Postischemic arrhythmias were also significantly reduced, which obviated the need for electrical defibrillation and reduced the time to return of regular rhythm from 7.9 +/- 2.0 minutes in the control group to 3.5 +/- 0.4 minutes in the adenosine triphosphate group. Under more clinically relevant conditions of hypothermic ischemia (20 degrees C, 270 minutes) with multidose (every 30 minutes) cardioplegia, adenosine triphosphate addition improved postischemic recovery of aortic flow and cardiac output from control values of 26.8% +/- 8.4% and 35.4% +/- 6.3% to 58.0% +/- 4.7% and 64.4% +/- 3.7% (p less than 0.01), respectively, and creatine kinase leakage was significantly reduced. Parallel hypothermic ischemia studies (270 minutes, 20 degrees C) using the previously demonstrated optimal creatinine phosphate concentration (10.0 mmol/L) gave nearly identical improvements in recovery and enzyme leakage. The combination of the optimal concentrations of adenosine triphosphate and creatine phosphate resulted in even greater myocardial protection; aortic flow and cardiac output improved from their control values of 26.8% +/- 8.4% and 35.4% +/- 6.3% to 79.7% +/- 1.1 and 80.7% +/- 1.0% (p less than 0.001), respectively. In conclusion, both extracellular adenosine triphosphate and creatine phosphate alone markedly improve the cardioprotective properties of the St. Thomas' Hospital cardioplegic solution during prolonged hypothermic ischemic arrest, but together they act additively to provide even greater protection. PMID- 3821151 TI - Long-term results of ventricular assist pumping in postcardiotomy cardiogenic shock. AB - Short-term survival of patients who require ventricular assist pumping for postcardiotomy cardiogenic shock has been encouraging and has provided enough survivors to allow evaluation of long-term results. We observed nine survivors, 39 to 69 years of age (mean = 54.6) for 10 to 53 months (mean = 31) after their discharge from the hospital. In three patients, the angiographic ejection fraction was normal before the operation, whereas in six patients it was moderately to severely impaired. All nine patients were in New York Heart Association Functional Class IV before operation. After operation, eight of the nine patients were in Functional Class I or II. In the remaining patient, the ejection fraction fell markedly and the postoperative functional class remained unchanged. Two patients were employed full-time and one, part-time. Five patients were retired but active and had no cardiac disability, although two of the five did have residual partial noncardiac disability. The remaining patient, a housewife, continued to have compensated congestive heart failure but was relieved of angina. During the follow-up period, five of the nine patients died suddenly after 12, 18, 25, 30, and 38 months from causes that included pulmonary embolus and probable arrhythmias. Survivors who have had ventricular assist pumping for postcardiotomy cardiogenic shock have a good chance of resuming active lives. The risk of being a "cardiac cripple" is small, as is the risk of significant noncardiac disability. PMID- 3821152 TI - Observations on flow characteristics of passive external aortic shunts. AB - Extraluminal heparin-bonded shunts have been recommended to support the distal circulation and decompress the proximal vascular bed during procedures that require interruption of flow through the thoracic aorta. Shunts that originate in either the left ventricle or the proximal aorta are generally viewed as hemodynamically similar, despite incomplete documentation of their flow characteristics. The present study was conducted to further define these hemodynamic properties. Identical extraluminal shunts were placed from the left ventricular apex and aortic arch to the distal thoracic aorta in mongrel dogs. Simultaneous pressure and Doppler flow velocities were recorded in the carotid and femoral arteries. Computer-enhanced composite waveforms were used to assist data analysis. When compared to ventricular cannulation, aortic cannulation provided improved proximal decompression and increased mean distal flow. In addition, significant diastolic flow reversal was recorded in the distal circulation when ventricular cannulation was employed. On the other hand, ventricular cannulation was associated with the preservation of pulsatile flow, whereas flow generated by aortic cannulation was linear. It is concluded that extraluminal shunts that originate in the left ventricle and the proximal aorta have distinct hemodynamic properties. These differences may be clinically important in specific situations. PMID- 3821153 TI - Primary left ventricular rhabdomyosarcoma in a child: noninvasive assessment and successful resection of a rare tumor. AB - Rhabdomyosarcoma of the heart is a rare tumor, especially in childhood and particularly in the left ventricle. A primary tumor of this type was successfully resected after echocardiographic assessment alone in a young girl exposed prenatally to diphenylhydantoin. The patient is well and free of recurrence 2 1/2 years later. PMID- 3821154 TI - Data collection by the National Center for Health Statistics. PMID- 3821155 TI - Coronary endarterectomy. PMID- 3821156 TI - Routine template bleeding time determinations before cardiac procedures. PMID- 3821157 TI - Chromosomal abnormalities in lymphogranulomatosis X (LgrX)/angioimmunoblastic lymphadenopathy (AILD). AB - Histologically, lymphogranulomatosis X (LgrX) is a Morbus Hodgkin-like disease which until now has been considered as an abnormal immune reaction or a prelymphoma. Chromosome analyses showed that LgrX and angioimmunoblastic lymphadenopathy AILD) are characterized by chromosomal aberrations. Chromosome analyses of 18 cases of LgrX with sequential banding techniques showed abnormalities in 13 out of 18 cases. They were monoclonal in 7 cases. The most frequent abnormalities were trisomies of chromosomes Nos 3 and 5 and duplication of the X-chromosome. The abnormal karyotypes always appeared with normal mitosis in single or clonal cells. They were found in unstimulated and in PHA-stimulated cultures from lymph node and peripheral blood. Thus, it can be concluded that at least some cases of LgrX are monoclonal cell proliferations. An attempt is made to define the role of chromosomal abnormalities in the development of malignant lymphomas. PMID- 3821158 TI - A transcervical surgical approach to the ventral medulla of the cat. AB - For the purpose of injection of anatomical tracers, it is desirable to have a surgical approach which provides the most direct approach to the target structure. This minimizes the amount of neural tissue that must be transgressed, and hence the leakage of tracer along the tract and the potential undesirable labelling that may result from this. In addition, visual guidance is preferable to stereotaxic guidance of injections where possible, particularly in situations where the target structure is far removed from the ear bar zero coordinate. Some of our work has necessitated small, discrete injections in the inferior olive sparing the adjacent reticular formation. The ventral transcervical approach to the medulla which was developed for this purpose is described below. It may conceivably be of use to physiologists wishing to record from ventral medullary structures. We feel it is a useful technique, but one which those with little surgical experience might not attempt. It is hoped that our description may guide others who could benefit by this approach. PMID- 3821159 TI - Long-term peripheral nerve and muscle recordings from normal and dystrophic mice. AB - A method for long-term recording of electrical activity from small mammalian nerves and muscles is described. Electrodes for stimulating and recording activity were implanted on nerves and muscles subserving ankle flexion and extension in normal and dystrophic mice. Activity was monitored on a regular basis for up to 200 days following implantation. Neural compound action potentials, compound EMG potentials and twitch tension were recorded. Shortly after implantation, evoked EMG and twitch tension declined, but recovered progressively to values measured at the time of implantation and subsequently remained steady in normal mice. However, while dystrophic mice did recover, with EMG levels reaching 50-60% of the values recorded at implantation, tension eventually dropped to 10% in flexor muscles and 25% in extensors. PMID- 3821160 TI - The PD programs: a method for the quantitative description of motor patterns. AB - We describe a family of 6 computer programs that measure, analyse and create graphic displays of complex motor patterns. The programs create lists of times at which successive bursts of impulses in different nerves started and stopped, and use these lists to calculate the periods and durations of these bursts and to calculate their phases relative to some specified frame of reference. When calculating phases, the programs take into account missing bursts or extra bursts in each reference interval. Individual programs then calculate descriptive statistics for these parameters, select lists of paired data for plotting and regression analysis, and prepare files for graphical display of statistics as boxplots. A final-program plots these files on a digital plotter. These programs are available for non-commercial use. PMID- 3821161 TI - Numerical analysis of electrotonus in multicompartmental neuron models. AB - Advances in anatomical and biophysical techniques have produced a wealth of data from certain classes of mammalian central neurons. In order to evaluate quantitatively these data and the hypotheses of neuronal function to which they lead, we have developed LADDER, a computer program for simulating neuronal electrotonus under current- or voltage-clamp conditions. This program models a neuron as an unbranched series of isopotential compartments composed of resistive and capacitive elements, i.e., a ladder network. Synaptic inputs are represented by realistic time-varying conductance changes. LADDER solves the set of simultaneous linear differential equations that describe this model by numerical integration in the time domain. Several tests confirmed the accuracy of LADDER's calculations. Simulated responses to current pulses were quantitatively similar to the charging transients that have been reported in hippocampal CA3 pyramidal neurons. These digital simulations also agreed closely with previously reported results from an analog neuronal model. In addition, transfer of synaptic charge in the model neuron, under both current- and voltage-clamp conditions, equalled theoretical predictions from two-port analyses of linear electrotonus. To illustrate the application of LADDER, we present the results of simulations involving the spread of voltage and current arising from various synaptic inputs. PMID- 3821162 TI - A technique to restrain awake rats for recording single-unit activity with glass micropipettes and conventional microdrives. AB - A technique has been developed which permits the study of single-unit activity using glass micropipettes and conventional microdrives in restrained, awake rats. A unique feature of this preparation is that the rats are kept still during electrophysiological recording by infusing a small amount of local anesthetic through a catheter chronically implanted into the epidural space of the spinal cord resulting in a temporary mid-body to hind-limb motor blockade. The animal is held in a slightly modified stereotaxic device by a bolt attached to the top of its skull. The rats are responsive to acoustic, visual, or tactile stimulation, permitting the simultaneous recording of electrophysiological activity and behavioral or electromyographical activity rostral to the level of motor blockade. By employing the epidural anesthesia the animals are healthy and mobile prior to and following each recording session and can be tested across a number of days. Single unit activity recorded from the facial motor nucleus in response to an acoustic click is presented as an example of the viability of this preparation. Therefore, this preparation seems suitable for a variety of investigations involving neurophysiological recording with glass micropipettes or the correlation of such recording with simple behaviors in awake, restrained rats. PMID- 3821163 TI - A precise and inexpensive magnetic field search coil system for measuring eye and head movements in small laboratory animals. AB - The design of a magnetic field search coil system based on the phase detection principle is described. The system was developed to record eye and head movements of small, unrestrained laboratory animals. It is compact, linear over 360 degrees, has a high resolution and allows the use of minute, commercially available search coils. Potential pitfalls and critical factors in the use of the system are discussed and original movement records are presented. PMID- 3821164 TI - A device for spike train sampling with built-in memory. AB - The described interface to a digital computer measures interspike interval durations with a resolution of 10 microseconds. A built-in first-in first-out (FIFO) memory relieves the host computer from frequent I/O intensive tasks. The internal FIFO buffer can store up to 512 data words (wordlength is 16 bit) and works on the dual-port principle. This way the acquisition of a neuronal spike train is completely independent of the computer's simultaneously ongoing data access. A simple handshake protocol between the interface and the computer prevents any overhead communication. The buffer architecture of the instrument releases the host computer from high speed I/O handling schemes like real-time, clock-controlled, polling or interrupt procedures, that would request assembly language support. The body of two software, driver routines in the BASIC and the PASCAL language is presented. A complete and detailed schematic diagram of the circuitry is included. PMID- 3821165 TI - A miniaturised roller pump. AB - A roller pump is described which is able to pump microlitre quantities of solution in either direction. It depends upon a caged roller bearing where the individual rollers press against silicon rubber tubing having an internal diameter of 0.5 mm. This assembly was housed in a cylindrical cavity shaped to produce a non-pulsatile flow. The pump is driven by a stepping motor to produce a constant flow rate. It is used to obtain small samples of bathing solution from near the surface of brain slices to monitor efflux of amino acids. PMID- 3821166 TI - A simple, sensitive method for the determination of extracellular catecholamines in the rat hypothalamus using in vivo dialysis. AB - The design, construction and characterisation of a dialysis probe suitable for perfusing any deep brain structures is described. Using high-performance liquid chromatography with electrochemical detection (HPLC-ECD) the effects of flow rate, concentration, dialysate composition and temperature on the recovery within the dialysate of authentic catecholamines are detailed. The dialysis probe was used to collect endogenous catecholamines from the anterior hypothalamus of urethane-anaesthetised rats. Following organic phase extraction of the in vivo samples, a small basal release of noradrenaline (NA) of 37 +/- 4 pg/30 min sample was found. Potassium stimulation markedly elevated the release of NA and dopamine from the anterior hypothalamus in a calcium ion and dose dependent manner. It appears therefore that the dialysis probe described here, in conjunction with HPLC-ECD, can be used to follow changes in neuronally released catecholamines within the anterior hypothalamus, providing a valuable tool to study the role of these neurotransmitters in physiological and pharmacological function. PMID- 3821167 TI - On-line analysis of rapid motion with a microcomputer. AB - A software package is described, which uses an Apple IIe computer with a digitizing board (Digisector 65) for analysing rapid motions of appendages of small insects from video images. Every 20 ms the program simultaneously analyses the position of two moving appendages after a background correction and the externally applied trigger stimulus. The data may be plotted in high-resolution plots with a matrix printer and evaluated with statistical methods. PMID- 3821168 TI - Recording electrophysiological signals from small moving animals: electrode fixation and low torque swivel for recording a weakly electric fish in a group. AB - A silicone rubber ring maintains an electrode on the electric organ of a mormyrid fish. The electrode is connected with a novel swivel, which allows free motion of the wire around its axis. The principle of the rotating contact is based on magnetic contact between a steel pin (moving) and a steel ball (fixed). Using this apparatus, a single fish within a group is recorded. The general electric activity of the group is recorded by means of two sets of fixed differential electrodes. These devices may be adapted for neuroethological studies of other small animals. PMID- 3821169 TI - Studies on tumor necrosis factor (TNF): II. Metabolic fate and distribution of human recombinant TNF. AB - We have evaluated the fate of cold and 125I- human recombinant tumor necrosis factor (RTNF) using isolated organs such as rabbit and monkey livers and rabbit kidney and lungs. We have also evaluated the body distribution of the total radioactivity after iv administration of 125I-RTNF in the rabbits. Monkey and rabbit livers play little catabolic role for RTNF. Lungs do not catabolize TNF at all, while the kidney appears to be the main catabolic organ. Accordingly, the body distribution of 125I-RTNF shows that most of the radioactivity is concentrated in the kidneys. PMID- 3821170 TI - Routine serum magnesium determination--a continuing unrecognized need. AB - Abnormalities of serum Mg may be the most underdiagnosed serum electrolyte abnormality in clinical practice today. The incidence appears to range from 12.5 to 20% on routine determination. Hypomagnesemia is found in 6.9-11% of hospitalized patients on routine determination of serum Mg. A high frequency of hypomagnesemia occurs with other common electrolyte abnormalities: hypokalemia (38-42%), hypophosphatemia (29%), hyponatremia (23%), and hypocalcemia (22%). Routine serum Mg determination would facilitate identification of hypomagnesemia which may be a more frequent contributor to digitalis toxicity than hypokalemia. Identification and treatment of patients at risk for refractory K repletion would be facilitated by routine serum Mg determination. As in our 1976 report to the 2nd International Symposium on Mg Deficiency, it is again our opinion as in 1985 that routine clinical determination of serum Mg represents a continuing unrecognized need. In our opinion routine determination of serum Mg will materially enhance the care of the patient. PMID- 3821171 TI - Effects of drugs on magnesium requirements. AB - A number of drugs can influence Mg metabolism and produce changes in serum Mg concentrations. These alterations must always be considered in the differential diagnosis of cases with Mg disturbances. Hypermagnesemia is seen, particularly after administration of Mg-containing drugs in renal insufficiency. Marked hypomagnesemia can be observed in a great number of patients, particularly in those treated with loop diuretics, osmotic substances and with antineoplastics, such as cisplatin. PMID- 3821172 TI - Magnesium intake during pregnancy. AB - The mean dietary magnesium intake of pregnant women is 35-58% of the recommended dietary allowance of 450 mg. Low-income women consumed 97-100 mg magnesium/1,000 kcal while women with higher incomes averaged 120 mg/1,000 kcal. Diets high in fat and sugar and low in whole grains, vegetables and fruits have a lower magnesium density. Magnesium content of water can also make a significant contribution to magnesium intake. Magnesium from prenatal supplements, if present, is seldom more than 100 mg. Additional supplementation is needed for adequate magnesium nutriture during pregnancy. PMID- 3821173 TI - Prevention of stress-induced damage in experimental animals and livestock by monomagnesium-L-aspartate hydrochloride. AB - Monomagnesium-L-aspartate hydrochloride (Mg-Asp. HCl) is readily absorbed from the intestine of rats because this process is not saturable. Depending upon the dose administered, Mg-Asp. HCl exhibits Ca-antagonistic effects and inhibits the release of stress hormones. Higher concentrations of Mg salts, which do not contain chloride, e.g. MgO, tend to induce hypochloremic, metabolic alkalosis and changes of urinary pH, whereas MgCl2 produces hyperchloremic acidosis under these conditions. Evidence is given that oral supplementation with Mg-Asp. HCl has beneficial effects not only in experimental animals or livestock, but also in man, e.g. on exposure to muscular stress. PMID- 3821174 TI - Magnesium and obesity: effects of treatment on magnesium and other parameters. AB - Obesity, a well-known phenomenon in Western society, is frequently associated with cardiovascular and endocrine disease. Strokes, myocardial infarction, diabetes and hyperlipidemia are classical reasons for the high mortality and morbidity of overweight people. For this reason, intensive weight-reduction programs have been proposed: low-calorie diets, total starvation, drugs and even surgery. Total starvation and some low-calorie diets are, however, also associated with sudden death, most probably of cardiac origin. Experimental data from our laboratory show that total starvation is accompanied by a severe depletion of magnesium in myocardial tissue. Protein-sparing modified low-calorie diets, however, can protect against this mineral loss even if magnesium supplementation alone cannot obtain this goal. Applying these principles in overweight man show weight reduction without mineral loss or cardiac disturbance. Surgery with 'ileal bypass' procedures gives rise to severe hypomagnesemia and hypocalcemia with tetany and spasmophilia. New procedures, derived from experimental surgery, are 'gastric bypass' and 'gastroplasty'. These methods, only applied in very obese patients (body mass index greater than 40, normal 23 27) show no change in mineral concentrations of calcium and magnesium and no clinical symptoms suggestive for mineral loss. A good, controlled weight reduction program under strict medical surveillance can, in this way, offer new perspectives in the treatment of one of our most frequent 'culture-induced' diseases. PMID- 3821175 TI - Tissue minerals of magnesium-deficient rats with thiamine deficiency and excess. AB - To clarify the influence of thiamine deficiency or a dietary excess of thiamine on the mineral balance in magnesium-deficient animals, the following six different synthetic diets were fed to Wistar rats. Group 1: thiamine and magnesium-deficient; group 2: thiamine-deficient, magnesium-deficient; group 3: thiamine-sufficient, magnesium-deficient; group 4: thiamine-sufficient, magnesium sufficient; group 5: thiamine excess, magnesium-deficient; group 6: thiamine excess, magnesium-sufficient. Rats were sacrificed after 4 weeks of these dietary regimens. In the magnesium-deficient groups, magnesium levels in serum, bone and heart decreased; calcium levels in serum and heart increased and, in contrast, calcium levels in bone decreased. These changes in mineral concentration seen in magnesium-deficient animals, as well as kidney weight changes, were alleviated significantly when the animals were also deficient in thiamine. It can be presumed that thiamine deficiency inhibits magnesium depletion and, consequently, the influence of magnesium deficiency is less significant in the thiamine- and magnesium-deficient animals. In regard to trace elements, the significant changes seen in magnesium-deficient rats were as follows: zinc in liver, muscle and blood increased and that in bone decreased. Copper in blood, kidney, muscle and heart increased and that in liver decreased. Iron in serum, liver, spleen and kidney increased and that in whole blood decreased. PMID- 3821176 TI - Effects of aging, chronic disease, and multiple supplements on magnesium requirements. AB - While the existence of age-related Mg deficiency is difficult to prove, intake of Mg by old people tends to be suboptimal, and the finding of decreased intestinal Mg absorption with progressive age provides evidence for the fact that the Mg requirement may be higher in elderly people than young adults. Chronic diseases, such as diabetes, congestive heart failure and alcoholism, common among elderly people, may further contribute to Mg depletion. A number of the drugs used in aged patients are also known to promote Mg loss. On the other hand, long-term Mg deficiency may play a role in the aging process, by affecting neurotransmitter activity, hormone synthesis and immune function, and/or may enhance cardiovascular disease, which is the most common cause of morbidity and mortality in old age. Despite this type of evidence, there is a lack of data concerning the effects of Mg supplementation in the aged. PMID- 3821177 TI - Influence of aspirin and ethanol on fecal blood levels as determined by using the HemoQuant assay. AB - We sought to determine the short-term effects of use of aspirin and ethanol on fecal occult blood levels measured with the HemoQuant assay. A factorial design was used to study 68 healthy volunteers randomized to receive various doses of aspirin, ethanol, or a combination of both for either 1 or 3 days. Fecal hemoglobin concentrations were measured before and after drug ingestions. Moderate quantities of ethanol (300 ml of 5% or 30 ml of 50% three times nightly) did not cause significant fecal blood elevation unless aspirin was administered concomitantly (P = 0.05). High-dose aspirin alone, 975 mg three times daily, induced abnormal blood loss (P less than 0.01). The highest HemoQuant levels were usually noted after concomitant administration of aspirin and ethanol at maximal doses for 3 days (P less than 0.005), some HemoQuant levels approaching 5 times the normal value. We conclude that, in a short-term analysis, social consumption of ethanol is unlikely to interfere with fecal blood testing but therapeutic doses of aspirin will. PMID- 3821178 TI - Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bismesylate. AB - Severe hypoxemia associated with chronic liver disease is an uncommon disorder most likely due to an intrapulmonary vascular abnormality that has characteristics of both ventilation-perfusion mismatching and diffusion limitation. Anatomically, the intrapulmonary vascular abnormalities can occasionally be detected by angiography. Physiologically, the gas exchange abnormalities can be substantiated by contrast-enhanced two-dimensional echocardiography. Although orthodeoxia and platypnea have frequently been found in these patients, echocardiographic data suggest that vascular abnormalities can exist in the absence of orthodeoxia. We describe 11 patients who had severe hypoxemia and chronic liver disease and review their pulmonary angiographic, contrast echocardiographic, and arterial blood gas findings. Among five of these patients who were given almitrine bismesylate, an experimental medication thought to alter ventilation-perfusion relationships in patients with chronic obstructive pulmonary disease, one had improved oxygenation. We recommend that patients with hypoxemia associated with chronic liver disease have detailed studies to rule out reversible forms of hypoxemia and that those with severe hypoxemia undergo testing to determine the existence of intrapulmonary vascular abnormalities, especially if liver transplantation is considered. PMID- 3821179 TI - Magnetic resonance imaging and clinical relationships in multiple sclerosis. AB - Magnetic resonance imaging (MRI) was done in 109 patients with suspected demyelinating disease (56 with clinical multiple sclerosis [MS] and 53 without). Of those with clinical MS, 43 (77%) had multifocal lesions of the white matter detected on MRI; 12 of the 43 also had confluent periventricular signaling. Nine patients (17%) without clinical MS had similar findings. Of the 56 patients with MS, 35 underwent both computed tomography (CT) and MRI. In this group, 80% of MRI scans showed multiple demyelinating lesions compatible with MS, as compared with 29% of the CT scans. A CT scan was "positive" more often if obtained within 1 month after an attack of MS than later. In contrast, the sensitivity of MRI or the number of lesions detected by MRI did not increase in patients with recent exacerbations. MRI was "positive" in patients with clinical MS more often than was any single evoked response study. In statistical analyses, both the sensitivity of MRI and the number of lesions were associated with the duration of MS. A pattern of confluent periventricular signaling around the lateral ventricle was associated with greater duration of MS and patient disability. PMID- 3821180 TI - Surgical technique and pitfalls of breast reconstruction immediately after mastectomy for carcinoma: initial experience. AB - Breast reconstruction immediately after mastectomy is being used with increasing frequency. In a study of the first 100 consecutive patients at our institution who underwent this procedure, with (21 patients) or without (79 patients) later nipple reconstruction, 85% responded affirmatively on a follow-up questionnaire when asked whether they would recommend the procedure to other patients. Moreover, 32% rated their cosmetic results as "perfect." No deaths occurred in the immediate postoperative period, but 13 patients had major complications--most commonly, wound infection or displacement or partial extrusion of the implant. All infections, however, occurred early in the study, and with increasing experience and improved selection of patients, the associated morbidity decreased. For the entire group, the mean duration of hospitalization was 7.8 days, similar to that for patients who undergo mastectomy without reconstruction (7.5 days). The high patient acceptance and the overall good results in this preliminary study support the use of breast reconstruction immediately after mastectomy. PMID- 3821181 TI - Breast cancer in residents of Rochester, Minnesota: incidence and survival, 1935 to 1982. AB - The incidence and survival rates for breast cancer among residents of Rochester, Minnesota, from 1975 to 1982 were compared with rates from 1935 to 1974. The age adjusted incidence rates of breast cancer, after exclusion of patients with carcinoma in situ, increased 14% between the periods 1965 to 1974 and 1975 to 1982 (from 87.2 to 99.5 per 100,000 person-years). Much of this increase was due to the greater number of patients with less advanced disease: the frequency of both regional lymph node involvement and distant metastatic disease at initial diagnosis decreased. In addition, the incidence of carcinoma in situ more than doubled between the periods 1935 to 1944 and 1975 to 1982. These increased proportions of less advanced disease coincide with increased public and physician awareness of the importance of early detection. No change was demonstrated in overall survival during the study period, perhaps because the follow-up for the final study period was shorter than that for the previous periods. When divided into subsets by staging characteristics, only patients with distant metastatic disease had statistically significant improvement in survival over time (P less than or equal to 0.01)--from a median survival of 21 months in the period 1955 to 1974 to 28 months in the period 1975 to 1982. This increased survival is probably related to advances in therapy (such as combination chemotherapy). In addition, earlier detection of distant metastatic disease in the later study periods might have produced the apparent improvement in survival in this subgroup. PMID- 3821182 TI - The pituitary gland in the Laurence-Moon syndrome. AB - The apparent hypogonadism in patients with the Laurence-Moon syndrome has been variably attributed to unresponsiveness of target organs to gonadal hormones, primary end-organ failure, hypothalamic dysfunction, or pituitary failure. We report the first immunocytologic study of the pituitary gland in this rare disorder. No morphologic abnormalities were noted. The numbers and immunoreactivities of adenohypophyseal cell types were normal. No microscopic abnormalities were evident in the hypothalamus and target organs. The results of our study are consistent with recent biochemical data that suggest that pituitary function is normal in patients with this syndrome. PMID- 3821183 TI - Renovascular hypertension: a rare cardiovascular manifestation of the Ehlers Danlos syndrome. AB - The association of the Ehlers-Danlos syndrome with many cardiovascular abnormalities is well known. To our knowledge, however, renovascular hypertension due to renal arterial aneurysms has not previously been reported in patients with this disease. We describe a patient with type IV Ehlers-Danlos syndrome who had multiple systemic and bilateral renal arterial aneurysms and hypertension. The hypertension could have been related to compression of renal tissue or arteries (or both) by the large aneurysms, associated stenoses, or small peripheral renal infarctions. A review of all patients in whom the Ehlers-Danlos syndrome had been diagnosed at our institution between 1967 and 1985 revealed that 4 of the 200 patients had hypertension. Three of these patients, and probably all four, had secondary causes of hypertension: Cushing's syndrome, renal insufficiency, or renovascular hypertension (in the present case). We conclude that hypertension is rare in patients with the Ehlers-Danlos syndrome and that, if present, it most likely is secondary hypertension. A thorough search for secondary causes of hypertension should be undertaken in these patients. PMID- 3821184 TI - In vivo brain calcium homeostasis during aging. AB - Since in vitro experiments suggest that brain calcium metabolism is altered with aging, the estimated rate of calcium uptake by the brain in vivo was determined with senescence. Calcium-45 incorporation into cortex, striatum, hippocampus, cerebellum, forebrain, midbrain and brainstem was determined in 3-, 10- and 30 month-old mice at 5 h after either an intravenous or intraperitoneal injection. Calcium uptake (brain dpm/mg protein divided by blood specific activity at 5 h) into these regions declined 19-33% at 10 months and 41-51% at 30 months. Subcellular fractionation of the cortex revealed that the decrease was similar in P1 (myelin, nuclei and tissue debris), P2 (synaptosomes, mitochondria and myelin) and S2 (microsomes, ribosomes and cytosol). Brain calcium concentrations declined with age in brain stem (-62%) and midbrain (-48%) but did not significantly vary with age in the other regions. These results support the suggestion that alterations in calcium homeostasis may underlie age-related changes in neurotransmitter metabolism. PMID- 3821186 TI - Failure in S6 protein phosphorylation by serum stimulation of senescent human diploid fibroblasts, TIG-1. AB - When quiescent young or senescent human diploid cells, TIG-1, were metabolically labeled with 32Pi and stimulated with 10% fetal bovine serum, the phosphorylation of ribosomal S6 protein was enhanced in young cells but not in senescent cells while that of some other proteins were increased in both cells. Inability to stimulate the phosphorylation of S6 protein in senescent cells after serum addition may be the primary cause of the failure of enhancement in protein synthesis followed by the block of prereplicative events dependent on protein synthesis and thus of the failure of cells to enter S phase. However, when the cell-free preparation from serum-stimulated senescent cells was incubated with [gamma-32P]ATP, S6-kinase activity was stimulated and S6 in ribosomal fraction was susceptible to phosphorylation as observed in young cells. Differences in S6 phosphorylation of senescent cells between in vivo and in vitro was discussed. PMID- 3821185 TI - Long-term mild endurance exercise effects on the age-associated evolution of hindlimb muscle characteristics in hamsters. AB - The purpose of the study was to describe the effects of long-term, mild daily exercise on age-associated neuromuscular changes in the Syrian hamster. Daily treadmill exercise (for 26 weeks) was administered throughout a portion (25-37%) of the life span (70-100 weeks), beginning at an age of 4 months, during which period body and muscle weights plateau and subsequently decline. Non-exercised (NEX) animals showed an increase in body weight (20%) until 7 months of age, which subsequently declined with the attainment of late adulthood to values not different from 4-month-old controls (Y) by 10.5 months. Gastrocnemius muscles were atrophied, showed twitch potentiation when stimulated in situ, and contained more type I fibers compared to young controls. Hamsters exercised from 4 to 10.5 months of age (EX) showed elevated body weights, and gastrocnemius muscles showed attenuated atrophy (muscle weight and fiber size), lack of twitch potentiation, and a significantly reduced PFK/CS enzyme ratio. Hamsters exercised only until 7 months were similar to NEX group by 10.5 months of age. Mild daily exercise, maintained throughout adult life into early senescence, attenuates muscle atrophy and promotes adaptive enzymatic changes in atrophying muscles. PMID- 3821187 TI - Hematopoietic stem cells in elderly people. AB - Marrow stem cells from old and young donors have often been compared by measuring concentration and numbers of CFU-S in mice. However, little information is available on hematopoietic stem cells in elderly people. This present study was undertaken to investigate age-associated changes in the concentrations of granulocyte-macrophage progenitor cell (CFU-C) and erythrocyte progenitor cell (CFU-E) in human bone marrow. We examined CFU-C from 101 subjects and CFU-E from 26 subjects by age, ranging from 28 to 95 years, and found there was no difference in the concentration of CFU-C but a slight decrease of the concentration in CFU-E in elderly subjects. PMID- 3821188 TI - Increased fatty acid uptake, a factor in increased hepatic triacylglycerol synthesis in aging rats. AB - The mechanisms responsible for the increased hepatic triacylglycerol synthesis in aging are not established. We studied [1-14C] palmitate uptake and its esterification to triacylglycerols in the isolated hepatocytes of 2-month, 10 month and 20-month-old normal rats. In all hepatocytes, palmitate uptake and its esterification were linearly related to medium palmitate concentration, but palmitate uptake and triacylglycerol synthesis by the hepatocytes of 10-month and 20-month-old rats were nearly double that observed with the cells of 2-month-old rats. These results suggest that increased fatty acid uptake by the liver cells was a contributory factor in the increased triacylglycerol synthesis observed in the liver of senescent rats. The changes in the hepatocyte leading to increased fatty acid uptake and hence increased triacylglycerol synthesis are detected as early as middle age of the rat. PMID- 3821189 TI - Culture media variation as related to in vitro aging of human fibroblasts: I. Effects on population doubling, nuclear volume and nuclear morphology. AB - The relative effect of five commonly used culture media (MEM, BME, McCoy's 5A, M199 and HMEM) on the population doubling level (PDL), nuclear volume and nuclear morphology was examined during in vitro senescence of WI-38 human fetal fibroblasts. Statistical analyses showed that cells grown in M199 had a significantly lower PDL than that of cells cultured in any other medium. The PDL in McCoy's 5A was significantly lower compared to that in BME, MEM and HMEM. Cells grown in BME, MEM and HMEM showed similar PDL. It was found that the nuclei of aged cells grown in M199 were significantly larger in volume than cells aged in any other medium. The average increases in nuclear volume of cells during aging in BME, MEM and McCoy's 5A were statistically equivalent. The increase in nuclear volume in HMEM was significantly smaller than that of cells aging in M199 and was longer than that of cells aging in BME or MEM. Linear regression analysis showed that there was a linear increase in nuclear volume as a function of PDL for cells aged in all five media. However, the rate of increase in nuclear volume with increasing PDL varied from medium to medium. There was no significant difference between media on induction of abnormal nuclear morphology as related to PDL. The relative effects of all five media were not uniform on the three cellular parameters investigated during in vitro aging of WI-38 cells. It is, therefore, suggested that one should keep this medium differential in mind to allow meaningful comparison of possible changes in various morphological parameters during in vitro senescence of diploid human fibroblasts such as WI-38. PMID- 3821190 TI - Degradation of immunoreactive albumin in young and old conscious female rats. AB - The kinetics of inactivation of plasma albumin was studied in young (3-4 months) and old (25-28 months) Sprague-Dawley female rats. Conscious, free-moving animals carrying indwelling atrial and carotid cannulas received a single injection of [125I]-albumin (rat) via the carotid cannula. Sequential blood samples were removed at intervals during the following 120 min, and total (TR) and immunoprecipitable radioactivity (IPR) were determined in the corresponding plasmas. TR disappearance curves for young and old animals were almost identical but IPR disappearance curves showed a significantly faster decline in the young rats. The absolute plasma volumes for young and old rats were (mean +/- S.E.M.), 10.8 +/- 1.1 and 14.4 +/- 1.5 ml, respectively (P less than 0.05). The IPR/TR ratio, an estimate of albumin inactivation within the plasma space, showed a monoexponential decrease in vivo with a t 1/2 of 11.4 +/- 5.1 and 39.3 +/- 10.8 h (P less than 0.05) for young and old rats, respectively. The in vitro t 1/2s for albumin were 5.25 +/- 1.02 and 3.42 +/- 0.91 days (NS) for young and old rats, respectively. It is concluded that: the rate of albumin catabolism declines with age in the female rat; albumin is mainly inactivated in the extravascular space; and total plasma volume increases significantly with age in this species. PMID- 3821191 TI - Microspectrofluorometric quantitation of autofluorescent lipopigment in the human sympathetic ganglia. AB - The age-related changes in lipopigment autofluorescence were studied by microspectrofluorometry in three different types of human neurons: the sympathetic neurons of the stellate and superior mesenteric ganglion and pyramidal neurons of the frontal cortex. The age-related increase in lipopigment autofluorescence was more rapid in stellate ganglion but similar linear increases were found also in superior mesenteric ganglion and frontal cortex. There was an age-related shift in the autofluorescence from yellow to orange in the ganglia. This may be due to the accumulation of neuromelanin in noradrenergic neurons. Lipopigments were identified in sympathetic neurons at the age of 4 months and all neurons carried pigment granules after the age of 64 years. It is concluded that lipopigment autofluorescence is a useful marker for cellular ageing in both the peripheral and the central nervous system. PMID- 3821192 TI - The effect of bleaching on the lipopigments in the human sympathetic neurons. AB - The effect of exposure to H2O2 on the lipopigments of the human sympathetic neurons was investigated by fluorescence and electron microscopy. In intact ganglia two subtypes of the lipopigment were seen: the yellow fluorescent pigment (emission maximum at 510 nm), which under the electron microscope had two components (vacuoles and osmiophilic matrix) and the orange fluorescent pigment (emission maximum at 535 nm), which in electron microscopy showed a third, highly osmiophilic component. Bleaching did not change the emission spectrum of the yellow pigment, while that of orange pigment shifted from 535 nm to 485 nm. Under electron microscopy the highly osmiophilic component disappeared in bleached orange pigment bodies. The characteristics of orange autofluorescent lipopigment are similar to those described for neuromelanin in the substantia nigra. The results suggest that neuromelanin accumulates in aging sympathetic neurons. PMID- 3821193 TI - H-2, Ah, and aging: the immune response and the inducibility of P-450 mediated monooxygenase activities, xanthine oxidase, and lipid peroxidation in H-2 congenic mice on C57BL/10, C3H, and A strain backgrounds. AB - The effects of beta-naphthoflavone (beta-NF, 80 mg/kg i.p. for 2 consecutive days) on P-450-dependent and -independent enzymes, lipid peroxidation and xanthine oxidase were investigated in 9 strains of young (3-month-old) male mice. Three H-2 congenic strains on each of three different genetic backgrounds were studied. The backgrounds were C57BL/10 (abbreviated as B10), C3H, and A strain mice. The reported longevities (weeks) as expressed in 10th decile of survivorship are significantly different among the H-2 congenic strains on each of these backgrounds: it ranges from 155 to 170 weeks in B10, from 138 to 150 in C3H and from 114 to 134 in A background mice. The inducibility of aryl hydrocarbon hydroxylase (AHH) with beta-NF was highest in B10, intermediate in C3H/He and non-inducible in other C3H mice and in all mice on the A strain background. Within the B10 background, inducibility of AHH varied widely among mice of different H-2 haplotypes: 549 +/- 34 (H-2k), 360 +/- 72 (H-2b) and 349 +/ 47 (H-2r) percent of the mean control values (n = 5; mean +/- S.D.), without change in activities of P-450-independent enzymes. In C3H mice the H-2k haplotype showed inducibility (213 +/- 34%), while other haplotypes, specifically H-2b and H-2j, did not. beta-NF increased the activities of xanthine oxidase in B10 and A background strains, without interbackground differences. Lipid peroxidation was significantly increased in A background strains and in an H-2 dependent manner. The relationship between Ah responsiveness and reported longevities of these nine strains is discussed. PMID- 3821194 TI - Effects of oltipraz, BHA, ADT and cabbage on glutathione metabolism, DNA damage and lipid peroxidation in old mice. AB - Eighteen-month-old female mice were fed defined diets for 2 weeks which contained 0.05% or 0.10% oltipraz, 0.10% anethole dithione (ADT), 0.10% butylated hydroxyanisole (BHA) or 20% lyophilized cabbage. All diets resulted in significant increases in hepatic reduced glutathione (GSH) content. Glutathione reductase and glutathione S-transferase activities were also significantly higher than the control values. All diets produced significant decreases in hepatic DNA damage (single strand breaks) and lipid peroxidation (malondialdehyde content). In general, similar effects were produced by the two dithiolthiones, oltipraz and ADT. More pronounced effects were produced by oltipraz and ADT than by BHA or cabbage in the diet. Diets high in antioxidants may be effective in retarding free radical reaction processes associated with aging and cancer. PMID- 3821195 TI - Aging in the AXC/SSh rat: characterization of moderately abundant ventral prostate proteins showing age-dependent diminution and one protein exhibiting age invariant content. AB - To determine whether prior demonstrations of age-related decrements in prostate content of minor, androgen regulated proteins represent a generalized phenomenon, we validated a denaturing polyacrylamide gel electrophoretic protocol for separation and quantification of moderately abundant ventral prostate cytoplasmic proteins. We established age-related, progressive 3- to 3.5-fold decreases in prostate content of proteins of 90, 79, 63, and 58 kDa and found that content of a 46 kDa protein was age-invariant. The amount of 90 and 46 kDa proteins was not significantly altered, whereas the level of 79, 63 and 58 kDa proteins decreased during 72 h post-orchiectomy of 3-month-old rats. Testosterone injection of intact 26-month-old rats caused an average 2-fold increase in 90, 79, 63, and 58 kDa protein content and did not affect 46 kDa protein level. Because we demonstrated the 46 kDa protein is not a secretory protein, absence of an affect of aging or testosterone on prostate content is not due to secretion mediated inaccessibility to intracellular processing. The apparent relation between age and prostate content of these proteins is not a consequence of potential age related changes in ventral prostate cell content or distribution because biochemical and histologic analyses show this does not significantly occur. Our studies establish age-related decreases in ventral prostate content of moderately abundant, androgen responsive proteins and show that content of at least one protein is age- and androgen-independent. It remains to be determined whether these findings reflect direct effects of gene regulation. PMID- 3821196 TI - Age-related changes in human platelet function in vitro. AB - Platelet aggregation and ATP release were simultaneously measured in platelet rich plasma samples obtained from humans of various age. In subjects aged over 59 years, an increase was found in platelet sensitivity to ADP and collagen as well as elevated aggregation amplitudes 5 min after induction with low concentrations of the aggregation agents. At 1 mumol/l ADP, old persons had a higher incidence of a secondary aggregation wave. Platelets from old subjects also released more ATP in response to collagen stimulation. Since no age-related changes are commonly found in the platelet count, the observed increase in platelet sensitivity to aggregation agents cannot be regarded as a mere compensatory reaction. An attempt is made to relate altered platelet function to peculiarities of lipid metabolism associated with ageing. PMID- 3821197 TI - Expression of the cell adhesion molecules N-CAM and L1 in B16 melanoma cells. AB - The cell adhesion molecules N-CAM and L1 are important for cell-cell recognition and cell migration and so may be involved in the metastatic process. We have studied the biosynthesis of N-CAM and L1 in the B16 melanoma cell lines B16-F1 and B16-F10 which differ in metastatic capacity. N-CAM was synthesised as two glycosylated polypeptides with Mr of 150,000 and 210,000; L1 was synthesised as one polypeptide with Mr of 215,000. In fetal neurons N-CAM is synthesised as a 135,000 and a 200,000 Mr polypeptide and L1 as a 200,000 Mr polypeptide. Thus, the Mr of N-CAM and L1 in tumour cells appeared to be 10,000-15,000 higher than in the normal cells. L1 was phosphorylated in the tumour cells as in neurons. The tumour cells also phosphorylated the 210,000 Mr N-CAM polypeptide, whereas no phosphorylation of the 150,000 Mr polypeptide was observed. In neuronal cells both the corresponding polypeptides are phosphorylated and thus the biosynthesis of N-CAM in tumour cells seem to differ from that in neuronal cells with regard to phosphorylation. No differences in biosynthesis of N-CAM or L1 were apparent between the two tumour cell lines, B16-F1 and B16-F10. PMID- 3821199 TI - Expression of integrated hepatitis B virus DNA in PLC/PRF/5, Hep 3B, and L6EC3 cell lines detected by in situ hybridisation. AB - The expression of the DNA of hepatitis B virus (HBV) was analysed in three cell lines (PLC/PRF/5, Hep 3B, L6EC3) which contain the HBV DNA integrated in their genome and release the viral surface antigen (HBsAg) in relation to cell growth. Using the in situ hybridisation technique and a cloned DNA probe specific for hepatitis B virus (PTKH9), the intracellular viral RNA localisation showed that for the three cell lines, HBV RNA are present in the different cell compartments according to the age of the culture. The nucleolar and nuclear localisation are visible in the early stages of the cell growth, whereas in the later stages viral RNA are found in the cytoplasm corresponding to the maximal production of the HBsAg. These observations suggest that the nucleolus is implicated in the expression of the integrated form of HBV genetic information, the regulation of which is linked to cell growth. PMID- 3821198 TI - Effect of sera from male type 2 (non-insulin-dependent) diabetics on human aortic smooth muscle cells in culture. AB - The effect of sera from male type 2 (non-insulin dependent) diabetics in variable metabolic control on the proliferation of, and on the synthesis of hyaluronic acid and collagen in human aortic smooth muscle cells (HSMCs) in culture was studied. Pooled sera from diabetics in poor metabolic control either with or without antidiabetic drugs stimulated the proliferation and hyaluronic acid synthesis of the cells more than did pooled serum from healthy controls. On the other hand, pooled serum from diabetics in good metabolic control did not have a higher stimulatory effect on the growth of HSMCs than pooled control serum. Indeed, it increased the synthesis of hyaluronic acid similarly as did the pooled serum from poorly controlled diabetics. The synthesis of collagen was not affected by pooled diabetic sera. When the effects of 14 male diabetic sera were individually measured using the same functions of HSMCs, metabolic control of diabetes did not correlate with various activities of diabetic sera on HSMCs. The results show that sera of type 2 diabetics contain factors affecting the functions of HSMCs. The activity of the factors on cell proliferation is related to some extent to the degree of glycemic control, as shown in experiments with serum pools, but experiments with individual sera show that other serum properties unrelated to the metabolic control of diabetes are also of importance. PMID- 3821201 TI - Conductivity and geometrical factors affecting volume measurements with an impedancimetric catheter. PMID- 3821200 TI - In vitro velocity measurements down stream from the Ionescu-Shiley aortic bioprosthesis in steady and pulsatile flow. PMID- 3821202 TI - Simulation of cardiac arrhythmia haemodynamics with a real-time computer model. PMID- 3821203 TI - 60 Hz ventricular fibrillation thresholds for large-surface-area electrodes. PMID- 3821204 TI - Generation of a rapid step in the temperature of a papillary muscle. PMID- 3821205 TI - Self-excited oscillations in thin-walled collapsible tubes. PMID- 3821206 TI - New probe for measurement of related values of cross-sectional area and pressure in a biological tube. PMID- 3821207 TI - Experimental modelling of biomechanical impedance characteristics. PMID- 3821208 TI - Equipment to condition inspired air over a wide temperature and humidity range for a hyperventilation challenge for asthmatics. PMID- 3821209 TI - Model for decomposition of the motor unit action potential. 1. The algorithm. PMID- 3821210 TI - Model for decomposition of the motor unit action potential. 2. Analysis of simulated motor unit action potentials. PMID- 3821211 TI - Effect of time-varying magnetic fields on the action potential in lobster giant axon. PMID- 3821212 TI - Amplifier input impedances for myoelectric control. PMID- 3821213 TI - Micropower pulse-position modulator for time-shared applications. PMID- 3821214 TI - Measurement of sensory-motor integrated function in neurological disorders: three computerised tracking tasks. PMID- 3821215 TI - Microcomputer-based system to calculate respiratory impedance from forced random noise data. PMID- 3821216 TI - Microcomputer-aided urodynamic data-acquisition and analysis system. PMID- 3821217 TI - Idea to measure diastolic arterial pressure by volume oscillometric method in human fingers. PMID- 3821218 TI - Electronic comparison of toe strengths for diagnosis of lumbar nerve root lesions. PMID- 3821219 TI - Laser He/Ne light exposure of red blood cells. PMID- 3821220 TI - Waiting for care. Queuing and resource allocation. AB - Queues arise in medical care and serve as allocators in the absence of an effective market and when resources become perceptibly constrained. This is essentially the case in all countries where money is not the means for gaining access to medical services. A study estimated that the total wait in England was 96 days for nonemergency care leading to hospitalization, including primary and specialty ambulatory care, for that one quarter of patients who had been placed on a waiting list. Of the remaining hospitalized population one half were admitted immediately and another one fourth were either booked or transferred from other hospitals. The widely accepted notion that a large majority of hospitalized patients wait a long time for care in Britain is mistaken. The emphasis on primary ambulatory care means that essentially no one has to wait for general practitioner care. The wait for elective ambulatory specialty care averaged approximately 8 weeks for all patients. Although mortality is rarely an issue for those who wait, an argument can be made that convenience and quality of life are importantly affected. PMID- 3821221 TI - The impact of a prospective payment system on psychosocial service delivery in the general hospital. PMID- 3821222 TI - Physician awareness of cost under prospective reimbursement systems. AB - The failure of some strategies to reduce physician use of costly hospital services has been attributed in part to retrospective reimbursement systems. However, anticipation of changes in the reimbursement structure has led to speculation that a different environment might lead to increased cost awareness by physicians. To measure the impact of prospective reimbursement systems on physician awareness of cost, the authors surveyed 46 medicine residents and faculty at a medical center. Data show that only 34% were able to correctly estimate common charges and 24% less common charges. In the early stages of prospective reimbursement, there has been no increased physician awareness of cost. PMID- 3821223 TI - Factors affecting the incidence of patient falls in hospitals. AB - Patient falls affect the cost and quality of patient care in hospitals. Published studies of risk factors for patient falls are inconsistent and often methodologically weak. Existing programs of patient risk assessment rely on large sets of patient characteristics, not all of which may be necessary. This article describes an information-theoretic technique that is able to identify a limited set of patient characteristics that provide most of the statistically significant information regarding risk of falls that is available in a hospital's adverse patient incident data set. Analysis of data from four hospitals with different institutional and data system characteristics revealed a consistent pattern of risk factors. PMID- 3821224 TI - The appropriateness of using a medical procedure. Is information in the medical record valid? AB - Understanding the clinical appropriateness of a procedure's use may be critical in explaining geographic variations in its use. Little is known, however, about whether data on appropriateness can be obtained from a medical record. A national panel of physicians formulated a list of 300 mutually exclusive, detailed clinical indications for performing coronary angiography. Using this list, we compared the reasons physicians perform coronary angiography as revealed in medical records with those given in interviews with the physicians who actually did the procedure. Thirty-five of 47 eligible billing entities (74%) from two Los Angeles Professional Standards Review Organization areas participated. These physicians practiced in 14 hospitals and accounted for 81% of all angiographies performed on Medicare patients in the two areas. Sixty-six records (approximately two per physician) were reviewed; physician interviews were conducted by two trained data collectors who were blinded to each other's results. Ninety-one percent agreement was reached on the specific indication for performing coronary angiography when information from the record review and interview was compared. We conclude that medical records yield valid information on why coronary angiography is performed and that they are a suitable source to use in judging the appropriateness of that use. PMID- 3821225 TI - The influence of medical school programs on physicians' attitudes toward universal access to medical care. AB - The extent to which medical education influences physicians' attitudes toward the issue of universal access to medical care was studied. Data were obtained from a survey of graduates from three medical schools with differing orientations. The first school could be described as traditional and highly research-oriented; the second as also traditional but more middle-of-the-road in its curriculum content; and the third as more social and primary care-oriented. Our results indicated that graduates from the more socially-oriented medical school were significantly more positive in their attitudes about the universality of the medical care issue than were graduates of the more traditional medical schools. The medical school effect vanished completely, however, when differences in personal characteristics among the three groups of graduates, namely, sex and interest in social sciences, were taken into account. Such findings support the hypothesis that the medical school effect can be explained to a greater extent by differences in medical student recruitment than by differences in medical school curricula. They also limit the expectations of those who advocate changes in medical curricula as a mean of inducing more favorable attitudes toward progressive medical care approaches in tomorrow's physicians. PMID- 3821226 TI - Predictors of physician prescribing change in an educational experiment to improve medication use. AB - In analyzing a university-based program to educate physicians about proper medication use, we sought to measure whether physician background characteristics and the quality or number of educational exposures influenced the rate of relinquishment of inappropriate prescribing. A sample of 435 doctors was randomized to control and experimental groups; interventions consisted of printed educational materials and face-to-face visits by clinical pharmacists. The program sought to reduce inappropriate use of three drug categories: propoxyphene, peripheral/cerebral vasodilators, and cephalexin. Outcome data included the total volume (tablets/capsules) of these drugs prescribed through Medicaid by each study physician 9 months before and after the program. We estimated average changes in prescribing levels by experimental and control physicians within each physician subgroup (e.g., board-certified versus uncertified), adjusting for prescribing level in the same 9 months of the previous year. The results indicated that the rate of prescribing change was independent of most physician background characteristics studied, including age, board certification, specialty, rural versus urban practice, intensity of previous target drug use, and size of Medicaid practice. Experimental effects were highly significant (-9% to -20%, P less than 0.025) in 11 of 14 physician subgroups. The presence of a follow-up reinforcement visit was a strong independent predictor of prescribing change (P less than 0.05). An increase from one visit to two visits was associated with an approximate doubling of the size of the program effect. However, total exposure time was not related to changes in prescribing behavior. These findings document that face to face education can be effective in improving the prescribing practices of a wide variety of physicians, and that brevity, repetition, and reinforcement of recommended practices are important components in the design of such programs. PMID- 3821227 TI - Preliminary production functions describing change in mental health status. AB - Change in mental health status is analyzed as a function of hours of professional treatment, patient attributes, treatment characteristics, and environmental factors for each of seven clusters of conditions typically seen by psychiatrists, psychologists, or social workers. One of two regression strategies was effective in characterizing the relationship between status change and the input variables for each condition cluster. In each model, initial severity was significantly associated with change in mental health status, and it captured most of the unexplained variance. Provider time was predictive of improvement for only some conditions and providers. On average, mental health services appear to make patients better, but improvement is not terribly impressive. Moreover, the marginal benefits of treatment fall off as the number of contact hours increases. PMID- 3821228 TI - Provider-oriented interventions and management of hypertension. PMID- 3821229 TI - Professional satisfaction and client outcomes. A reanalysis. PMID- 3821230 TI - [Attitudes of medical students to the profession in Vitoria-Gasteiz. Results of a questionnaire]. PMID- 3821231 TI - [Evaluation of an antiemetic regimen with a high-dose metoclopramide, dexamethasone and diphenhydramine combination in chemotherapy regimens with cisplatin]. PMID- 3821232 TI - [The medical student's attitude to the profession]. PMID- 3821233 TI - [Value of immunohistochemical methods in the diagnosis and prognosis of pituitary hormone-producing adenomas]. PMID- 3821234 TI - [Benign pleurisy caused by asbestos]. PMID- 3821235 TI - [Clinical observation and epidemiologic reasoning]. PMID- 3821236 TI - [Bilateral luxation of the shoulder and epiphyseal detachment caused by an electrical discharge]. PMID- 3821237 TI - [Cholesterol of lipoprotein fractions determined by electrophoresis]. PMID- 3821238 TI - [Stevens-Johnson syndrome in a patient treated with quinine and pyrimethamine sulfadoxine]. PMID- 3821239 TI - [Dignity before death]. PMID- 3821240 TI - [Quality of clinical assays, drug utilization and clinical pharmacology education in medicine]. PMID- 3821241 TI - [Allergic bronchopulmonary aspergillosis and cystic fibrosis]. PMID- 3821242 TI - [Anti-smoking campaign: primary care must take the first step]. PMID- 3821243 TI - [Changes in hepatic biology and hyperpotassemia caused by heparin]. PMID- 3821244 TI - [Detection and quantification of adverse reactions on the embryo and fetus]. PMID- 3821245 TI - [Septic arthritis and its early diagnosis]. PMID- 3821247 TI - [Carpal tunnel syndrome]. PMID- 3821246 TI - [Carpal tunnel syndrome in pregnancy. I. Epidemiologic study]. PMID- 3821248 TI - [Reasons in favor of using the International System of Units in medicine]. PMID- 3821249 TI - [Counting, weighing and measuring]. PMID- 3821250 TI - [Calmodulin and calcineurin]. PMID- 3821251 TI - [Intrahospital pneumonias]. PMID- 3821252 TI - [Extra-hospital Streptococcus viridans pneumonia]. PMID- 3821253 TI - [Pulmonary edema and obstruction of the upper airway]. PMID- 3821254 TI - [Polyneuritis associated with essential mixed cryoglobulinemia]. PMID- 3821255 TI - [Erythema nodosum: study of 103 cases]. PMID- 3821256 TI - [Aspiration biopsy of the cold thyroid nodule. I: Cytologic patterns]. PMID- 3821257 TI - [Fine needle aspiration biopsy of the cold thyroid nodule. II: Cytohistologic correlation, criteria for surgical intervention and its repercussion on health costs]. PMID- 3821258 TI - [Ophthalmologic manifestations of acquired immunodeficiency syndrome]. PMID- 3821259 TI - [Paraneoplastic polyarthritis. Description of 5 cases]. PMID- 3821260 TI - [The right of the patient to obtain his medical records]. PMID- 3821261 TI - [Where is rheumatic fever?]. PMID- 3821262 TI - [Membranous nephropathy in Hodgkin's disease in complete remission]. PMID- 3821263 TI - [Current status of pulmonary auscultation]. PMID- 3821264 TI - [A 31-year-old woman with episodes of headache and dyspnea]. PMID- 3821265 TI - [Lithium clearance and essential arterial hypertension]. PMID- 3821266 TI - [Ergotamine and acute renal insufficiency]. PMID- 3821267 TI - [Prostitution as a risk group in acquired immunodeficiency syndrome]. PMID- 3821268 TI - [Arginine thiazolidinecarboxylate poisoning]. PMID- 3821269 TI - [Lennert lymphoma and erythema nodosum]. PMID- 3821270 TI - [Acute benign myositis]. PMID- 3821271 TI - [Collagenous colitis in a patient with chronic renal insufficiency]. PMID- 3821272 TI - [Acute renal insufficiency and nephrotoxic substances]. PMID- 3821273 TI - [Severe bone marrow aplasia associated with thymoma. Presentation of 2 cases and review of the literature]. PMID- 3821274 TI - [Problems posed by the patient with positive serology for the HTLV-III/LAV retrovirus]. PMID- 3821275 TI - [Benign intracranial hypertension in infectious mononucleosis]. PMID- 3821276 TI - [Reversible leukopenia associated with the use of cimetidine]. PMID- 3821277 TI - [Prevalence and morbidity of HTLV-III/LAV infection in homosexuals and parenteral drug addicts (up-date 1985)]. PMID- 3821278 TI - [Bacterial meningitis in a general hospital. Etiology of 604 cases]. PMID- 3821279 TI - [Acute nephrotoxic renal insufficiency]. PMID- 3821280 TI - [Present state of antibiotic resistance of bacteria isolated from intra- and extra-hospital bacteriuria ]. PMID- 3821281 TI - [Glomerulonephritis and pulmonary hemorrhage]. PMID- 3821282 TI - [Acute poisoning in Valladolid. Epidemiological study of cases seen at the Clinical Hospital from 1978 to 1984]. PMID- 3821283 TI - [Incidence of chronic diseases and risk factors in primary care]. PMID- 3821284 TI - [Viruses and pregnancy]. PMID- 3821285 TI - [Single or combined use of dissolution therapy with biliary acids, sphincterotomy and extracorporeal shock waves. Is this the end of the surgical treatment of uncomplicated radiolucent biliary lithiasis?]. PMID- 3821286 TI - [Left hemiparalysis and buccofacial apraxia without aphasia in a right-handed man with essential thrombocythemia]. PMID- 3821287 TI - [Acute renal failure and acute toxic hepatitis after inhalation of a mixture of chlorinated solvents]. PMID- 3821288 TI - [Erythema nodosum and giant cell arteritis]. PMID- 3821289 TI - [Autoimmune Addison's disease associated with Graves-Basedow disease]. PMID- 3821290 TI - Cancer pain. PMID- 3821291 TI - A model of continuity of care for cancer patients with chronic pain. AB - A patient and family-centered, nurse-coordinated model is presented in which a collaborative approach among nurse, physician, and social worker is used. The team is based at a hospital or cancer center, but is oriented toward the community. In the model, the nurse is responsible for the day to day management of the patient's pain, and works with the patient, family, and community physicians and nurses in symptom control and supportive care. PMID- 3821292 TI - Cognitive-behavioral interventions in management of cancer pain: principles and applications. AB - Cognitive-behavioral interventions are effective for symptoms control and reduction of suffering in cancer pain patients. This article outlines the theoretical and technical principles of these nonmedical interventions and illustrates their integrated application with two case reports. PMID- 3821293 TI - Defaults, exceptions and ambiguity in a medical knowledge representation system. AB - Inheritance methods for general semantic networks which allow for exceptions are essential to representing medical knowledge in forms which are familiar to doctors. Such systems give rise to the possibility of ambiguity and problems of computational efficiency. Efficient computational methods using conventional hardware for inheritance and the detection of ambiguity in general semantic networks are described. These methods have been implemented in PROLOG in a knowledge management system which is being used in the development of intelligent drug information and medical decision support systems. PMID- 3821294 TI - Computerized analysis of antimicrobial drugs interactions in biological systems using an IBM-PC microcomputer. AB - We have developed a computer program to analyse the individual and combined effects of two treatments applied concurrently to a biological system. Analysis is done in regard to: level of significance selected for the statistical test (two-sided Student's t test); number of data available; expected combined effect resulting from addition (computed by the program); experimental hypothesis tested (synergism or antagonism). The main program gives access to eight options: input of new data; input of data from file; addition or modification to data in memory; display on monitor the results from analysis or the contents of a data file; analysis with another level of significance; printout; kinetics of interaction; end of program. The program is designed to work with an IBM-PC, Epson MX/FX 80/100 printer and Roland DXY 800 plotter. Sample runs are given. PMID- 3821295 TI - A user-oriented validation method for clinical data. AB - The patient data in hospitals is prone to many errors during computerization because of the large human element involved during the processes concerned. A user-oriented validation method, which has been found to be practical and acceptable, is suggested. A non-statistical approach is adopted in this regard. The qualitative requirements of all users for validation have been taken as the guidelines to achieve maximum user acceptability. A user-oriented data code sheet, whose format changes for different disease groups, has been devised to prevent most of the typographical errors. These code sheets have also been found to be of considerable help to doctors in keeping a check on any missed or incomplete investigations, examinations and history recording. The validation program detects all errors of a typographical nature and all commonly possible logical errors. In addition, the program outputs data values, whose accuracy is doubtful, in the form of warning messages like WARNED DATA and ERRONEOUS DATA. The data fields which do not contain any data are also output to help the clinicians to take note of investigations and clinical tests not done or whose results are awaited. The logical errors, if any, also help them in detecting and identifying atypical cases in any given disease group at the earliest possible stage of a patient's hospitalization. In this paper, the need for a user-oriented and non-statistical approach to the validation of clinical data has been discussed in detail and its advantages enumerated. PMID- 3821296 TI - Efficacy of a computerized system applied to central operating theatre for medical records collection. AB - A computer system operation is introduced, which has been in use since October 1981 at Kochi medical school as one of the integral sub-systems of the total hospital information system called IMIS. The system was designed from the beginning with the main purposes of obtaining better management of operations, and detailed medical records are included for before, during and after operations. It is shown that almost all operations except emergencies were managed using the computer system rather than the paper system. After presenting some of the results of the accumulated records we will discuss the reason for this high frequency of use of the computer system. PMID- 3821297 TI - Patient appreciations of computerized medical interviews. AB - In a research project on the automation of patient histories, 99 patients in internal medicine were questioned about their opinions on computerized medical records, after having answered an automated questionnaire. Patients were very positive on being able to express their medical complaints and the large majority found it useful (94%); 68% could express all or most of their complaints, but some of their physical complaints could not be entered (47% women against 25% men). Of the male patients 74% found the range of answers from which to choose sufficient, against 52% of the women. The printed report was positively rated, with a higher appreciation by men. PMID- 3821298 TI - Application of the microcomputer to the estimation of adult survivorship by indirect techniques. AB - This paper, the second in a series on the application of the microcomputer to the estimation of vital rates by indirect techniques, deals with the measurement of adult survivorship. Two of the most widely used techniques for the estimation of adult survivorship using indirect techniques are the Widowhood method and the Orphanhood method. A review of the Widowhood method, developed by Hill and Trussell, is given followed by a detailed description of the use of the computer program for the conditional regression variant of the method using data on age of respondents (widowed males or females). A full listing of the program, written in TRS-80 BASIC, is available on request. The program for the Orphanhood method will be given in a paper to follow. PMID- 3821299 TI - An on-line system for electrocardiogram interpretation using the Bonner program. AB - An on-line system for electrocardiogram (ECG) interpretation using the Bonner program has been developed. The system consists of a telephone network, a process computer, a host computer, a computer interface and an electrocardiograph equipped with transmitting options. The signal acquisition program offered by IBM was modified so as to be equipped with the following functions: The technician can distinguish whether the process computer is ready or not, even if he is working in an examination room which is distant from the computer room. The data received by the process computer is transferred to the host computer in real time. In cases where the host computer is unable to receive the data, the process computer restarts transmission quickly after the host computer recovers the function of receiving. The host computer interprets transferred data in real-time by the Bonner program. The interpretation report is printed in real time on a remote printer. As the result of these modifications, a series of data processing operations may be executed without intermediary operators. The printed interpretation report begins to appear about ten seconds after completion of transmission. PMID- 3821300 TI - [Follicular cyst or cancer--a clinical dilemma]. PMID- 3821301 TI - [Plasma exchange with fresh frozen plasma in the treatment of thrombotic thrombocytopenic purpura]. PMID- 3821302 TI - [Nausea after cisplatin administration can be prevented with antiemetic treatment]. PMID- 3821303 TI - [The stage of pulmonary hypoplasia is crucial for survival in congenital diaphragmatic hernia]. PMID- 3821304 TI - [Diagnosis and treatment of fetal congenital adrenal cortex hyperplasia]. PMID- 3821305 TI - [Diagnosis and treatment of venous thromboembolism in Swedish departments of internal medicine]. PMID- 3821306 TI - [Asthma--an exudative disease?]. PMID- 3821307 TI - [Continuous vector cardiography--a valuable method for description of the course in acute myocardial infarction]. PMID- 3821308 TI - [Psychological intervention after myocardial infarction--is it needed?]. PMID- 3821309 TI - [Solvents and non-Hodgkin's lymphoma--an investigation of a case of occupational disease]. PMID- 3821310 TI - [3 cases of wound formation in treatment of enuresis with home modified mats]. PMID- 3821311 TI - [Endometrial carcinoma in young women is rare]. PMID- 3821312 TI - [Thoracic disk hernia--a difficult diagnosis]. PMID- 3821313 TI - [Pneumatosis cystoides intestinalis in myeloma--an unusual cause of free gas in abdomen]. PMID- 3821314 TI - [Iatrogenic biliary tract injuries can be prevented if surgeons are more informed about risks]. PMID- 3821315 TI - [Gallbladder agenesis--underdiagnosed and difficult to separate from other biliary tract disorders]. PMID- 3821316 TI - [Biliary tract aberrations can cause problems when discovered in cholecystectomy]. PMID- 3821317 TI - [Choledochocele--a rare anomaly of unknown etiology]. PMID- 3821318 TI - [Intermittent dyspnea: problems in the differential diagnosis by digital pulmonary angiography]. PMID- 3821319 TI - [A study from 3 different health care areas: the disease panorama in emergency psychiatry is homogeneous both geographically and socially]. PMID- 3821321 TI - [Sulindac--a review of adverse effects. Liver reactions are the most characteristics]. PMID- 3821320 TI - [Emergency heart surgery in Gothenburg 1980-1984: early surgical treatment is more common in patients with severe acute heart diseases]. PMID- 3821322 TI - [Facial hemorrhage in whooping cough judged as child abuse]. PMID- 3821323 TI - [Abuse of women--care and legal follow-up]. PMID- 3821324 TI - [HIV infection and narcotic addiction]. PMID- 3821325 TI - [Radiologic diagnosis of acute abdomen in children--a review]. PMID- 3821326 TI - [Acute dissection type A--a life-threatening condition but curable]. PMID- 3821328 TI - [Prognosis in untreated abdominal aortic aneurysm is almost as bad today as 20-30 years ago]. PMID- 3821327 TI - [Thoraco-abdominal aortic aneurysm--is surgery the solution?]. PMID- 3821329 TI - [Theophyllamine and benzodiazepines--an interaction demanding attention]. PMID- 3821330 TI - [Stress fractures of the tarsal bone in physically active persons--an overlooked cause of chronic foot pain]. PMID- 3821331 TI - [Infected aortic aneurysm--a serious complication in arteriosclerosis]. PMID- 3821332 TI - [Traumatic tricuspid valve insufficiency--correct diagnosis and surgery after 46 years]. PMID- 3821333 TI - [Dyspnea with unusual heart sounds]. PMID- 3821334 TI - [Cell morphology in immunosuppressive treatment of lymphocytic myocarditis]. PMID- 3821335 TI - [Pregnancy in diabetes--screening, diagnosis, treatment and follow-up]. PMID- 3821336 TI - [Occupational musculoskeletal diseases 1980-1983--a review]. PMID- 3821337 TI - [Reinterventions following fundoplication]. PMID- 3821338 TI - [Reoperation following Nissen fundoplication]. AB - The main causes of unsatisfactory results after Nissen fundoplication can usually be explained by tactical and technical mistakes. The fixation of the stomach to the diaphragm is one case of the development of pain syndrome, telescopic phenomenon and relative or complete dispersion of fundoplication with subsequent development of a recurrent reflux oesophagitis. The fundoplication should be done only in hospitals which have experience in oesophageal and gastric surgery. The collar of fundoplication should be formed with the two sides (the anterior and the posterior) of the stomach after extensive mobilisation of the cardia region. The operation includes the obligatory fixation of the collar to the oesophagus in order to avoid complications like pain syndrome, sliding of the collar and recurrent reflux oesophagitis. PMID- 3821339 TI - [Surgical therapy of stenosing duodenal ulcer--results of an uncontrolled comparative study]. AB - In an uncontrolled trial on 77 patients we investigated the results of different surgical procedures in stenosis secondary to duodenal ulcer. The assignment to a procedure was dependent on the preference of the surgeon. The follow-up investigation after a mean observation time of 40-42 months was performed without knowledge of the surgical procedure. The postoperative mortality was 6.6% after resection, 0% after vagotomy and drainage. Postoperative sequelae were lowest in highly selective vagotomy + gastroduodenostomy (Visick I in 15 out of 17). After resection only 15 out of 33 had Visick I. The worst result was obtained after selective vagotomy and pyloric dilatation (4 out of 9 Visick IV). This procedure has been given up. PMID- 3821340 TI - [Bacteria in the gallbladder wall and gallstones--indications for cholecystectomy]. AB - After cholecystectomy the bacterial content of the bile, gallbladder wall and gallstones was studied in 40 patients. Bacteria could be found in 9 cases in the gallbladder wall, in 8 cases in the gallstones and in 3 cases in the bile. In chronic inflammatory thickened gallbladder wall bacteria were positive in 8 of 14 cases whereas in normal gallbladders bacteria were found only in 3 of 26 cases (difference statistically significant, P = 0.01). It is concluded that in gallstone disease bacteria are not only present in bile but also in the gallbladder wall and within the gallstones. As bacteria are mostly present in a gallbladder wall with chronical inflammatory changes a thickened gallbladder should be removed even in asymptomatic or slightly symptomatic cases of gallstone disease in order to prevent relapsing cholecystitis. PMID- 3821341 TI - [Technic of breast-saving surgery]. PMID- 3821342 TI - [Soft tissue coverage of compound fractures of the lower leg]. PMID- 3821343 TI - Allergic Aspergillus sinusitis: concepts in diagnosis and treatment of a new clinical entity. AB - The clinical features in 15 young adult patients with allergic Aspergillus sinusitis includes a history of asthma, recurrent nasal polyps, and radiographic evidence of pansinusitis. Multiple surgical procedures were performed on 12 patients. The histologic diagnosis is made on the mucinous material which contains eosinophils, fungal hyphae (Aspergillus species), and Charcot-Leyden crystals. Mycetomas, direct mucosal and soft tissue invasion by fungi, were not observed. Immunologic findings include an immediate cutaneous reactivity to Aspergillus in 60% of patients, total serum IgE elevation in 85%, and serum precipitins to Aspergillus in 85%. A new therapeutic protocol was devised based on the current treatment of allergic bronchopulmonary aspergillosis. Therapy includes wide local debridement, adequate sinus aeration, and the postoperative use of systemic steroids. Seven patients placed on systemic corticosteroids are asymptomatic for a mean of 14 months. Diagnosis of allergic Aspergillus sinusitis requires a high index of suspicion, a confirmatory diagnosis from the inspissated mucus, and an immunologic evaluation prior to the institution of corticosteroid therapy. PMID- 3821344 TI - Postoperative radiation of open head and neck wounds. AB - Complication rates are lower using postoperative radiation therapy and cure rates at least compatible to preoperative radiation therapy. However, one of the concerns with postoperative radiation treatment is the possibility of delay in beginning the treatment because of an unhealed surgical wound. A delay of more than 6 weeks is detrimental. In order to study the effect of radiation therapy on incompletely healed wounds, a retrospective chart review of such cases during the period 1977 to 1984 was undertaken. One hundred and eighty-five patients had planned postoperative radiation therapy, and 13 of these began radiation therapy with an unhealed wound or fistula. Six of 10 wounds closed spontaneously, 4 required surgical closure, and 3 failed to heal. Seven patients in this study died with cancer, 2 died of other causes, 3 are alive without disease, and 1 patient remains alive with disease. We conclude that giving radiation therapy to an open wound with appropriate precaution can be done without serious complications. PMID- 3821345 TI - Fulminant infections of odontogenic origin. AB - The dentition is a common source of infection in the head and neck and most odontogenic infections respond uneventfully to proper dental therapy. Some more fulminant odontogenic infections can produce complications including airway obstruction, necrotizing fasciitis, and extension of the infection to the orbits, intracranial structures, and thorax. Six such cases treated by the authors are presented and recommendations for management including aggressive antimicrobial, therapy-based bacteriology and surgical drainage and debridement are made. PMID- 3821346 TI - Airway obstruction in LeFort fractures. AB - Airway obstruction associated with fractures of the midfacial skeleton can be life-threatening if not recognized promptly and treated appropriately. One hundred seventeen patients with LeFort fractures were treated between 1978 and 1984. Of the 117 patients, 21 had a LeFort I fracture, 46 had a LeFort II fracture, 14 had a LeFort III fracture, and 36 had various combinations of the three types of LeFort fractures. Thirty-one patients (26.5%) presented with airway obstruction, decreased respiration, or both, requiring either tracheotomy or endotracheal intubation. Of the 31 patients undergoing emergent tracheotomy or endotracheal intubation, 26 (83.9%) had loss of consciousness relating to their injuries. Thirty-nine (33.3%) additional patients had an elective tracheotomy either at the time of surgical repair of their fractures or for prolonged endotracheal intubation. Age and sex of the patients played no role in the incidence of airway complications in patients with LeFort fractures. Patients with LeFort III fractures and those with associated injuries such as mandible fracture, laryngeal and pharyngeal injury, and chest or closed head injury are at greater risk for requiring emergent control of the airway. PMID- 3821347 TI - A new assay to assess steroid-hormone responsiveness in head and neck cancer. AB - A new assay has been developed to predict the effectiveness of steroid-hormone therapy in various tumors. The Biopsy Nuclear Binding assay measures the amount of biologically active receptor that binds both steroid hormone and acceptor sites in the nucleus. This assay does not measure the entire receptor population, only those that are biologically active; therefore, it should more accurately predict the response to steroid-hormone therapy. We applied this assay effectively in breast and endometrial carcinoma. Preliminary studies have shown that 40% of patients with head and neck squamous-cell carcinomas have biologically active (nuclear bound) progesterone receptors. If nuclear binding predicts a remission with hormonal therapy, then the quality of life of appropriately selected patients could greatly improve. PMID- 3821348 TI - Non-Hodgkin's lymphoma of the head and neck: the University of Iowa experience. AB - The evaluation of a patient with a mass in the head and neck may require the consideration of lymphoma in the process of differential diagnosis. Non-Hodgkin's lymphoma is a well-described heterogeneous group of lymphoid malignancies characterized by a natural history ranging from indolent to aggressive growth. Little has been written, however, concerning the specific features of this disease in the head and neck. Between 1974 and 1984, 287 patients were treated for non-Hodgkin's lymphoma presenting in the head and neck. A multivariant analysis of these cases forms the basis of this report. All case material was reviewed and classified according to the working formulation of the National Cancer Institute and the Ann Arbor Classification System for lymphomas. Sites of initial presentation, methods of diagnosis, choice of therapy and subsequent response to treatment were related to the manifestations of non-Hodgkin's lymphoma in the head and neck. Of particular interest to the head and neck surgeon is the constellation of presenting signs and symptoms which point one to the possibility of non-Hodgkin's lymphoma. PMID- 3821349 TI - Determination of obstructive site in obstructive sleep apnea. AB - Patients with obstructive sleep apnea syndrome (OSAS) may have airway obstruction at various levels, including the uvula-soft palate complex, base of tongue, and/or possibly other sites. For patients with tongue base and/or laryngeal obstruction, uvulopalatopharyngoplasty (UPPP, ppp) will not alleviate the obstruction. Prior authors have proposed that the hyoid bone position as determined by cephalometric x-rays can predict which patients have obstruction at a lower site than the soft palate. In this study, patients with obstructive sleep apnea syndrome were evaluated with polysomnographic testing, fiberoptic endoscopy, and cine-CT scans (Imatron Scanner with multiple level rapid sequence scans) in an attempt to determine precisely the site of airway obstruction. Measurements of airway size taken at the time of fiberoptic pharyngoscopy were compared with those determined by the cine-CT studies. Initial results revealed that fiberoptic pharyngoscopy in the sitting and supine positions was helpful in confirming pharyngeal airway sites with smaller diameters in awake patients. However, the cine-CT exam performed in both sleeping and awake states provided more direct data regarding the airway during sleep. We feel that with more clinical experience the cine-CT technique will prove to be the most helpful study for identification of the obstructive airway site in obstructive sleep apnea syndrome. PMID- 3821350 TI - Nasopharyngeal complications following uvulopalatopharyngoplasty. AB - This report presents our experience with nasopharyngeal complications of UPPP in 85 patients undergoing the procedure from May, 1982 to January, 1985. Three patients developed nasopharyngeal stenosis and one patient developed permanent velopharyngeal insufficiency. Surgical management in two patients with nasopharyngeal stenosis resulted in adequate nasopharyngeal airway, while one patient still has a moderate stenosis following two surgical procedures. The patient with velopharyngeal insufficiency underwent Teflon paste injection in the posterior pharyngeal wall. This resulted in complete alleviation of his nasal regurgitation. PMID- 3821351 TI - Determinants of otic capsule formation. AB - The otocyst is the epithelial anlage of the membranous labyrinth that interacts with surrounding head mesenchyme tissue during formation of the otic capsule. In vitro studies were performed to gain a better understanding of the role that epithelial-mesenchymal tissue interactions play in development of the otic capsule. Parallel series of otocyst/mesenchyme (O/M) and isolated periotic mesenchyme (M) explants provided morphological and biochemical data. The results indicate that epithelial-mesenchymal tissue interactions control development of both the otic capsule and the perilymphatic spaces. The otocyst induces cartilage differentiation in periotic mesenchyme between embryonic days 11 to 13 and organizes otic capsule morphology between embryonic days 13 to 14 in the mouse embryo. The otocyst exerts a localized repression of chondrogenesis in nearby mesenchyme during perilymphatic space formation on embryonic days 12 to 14. PMID- 3821352 TI - Neodymium-YAG laser photocoagulation of hemangiomas of the head and neck. AB - Hemangiomas of the head and neck region can be a therapeutic challenge depending on their size, flow rate, and location. The neodymium-yttrium aluminum garnet (Nd YAG) laser was used to treat 16 pediatric and adult patients with cavernous, capillary, and mixed hemangiomas as well as hypertrophic port-wine stains of the head and neck. Low-power energy and intermittent short exposure accomplished photocoagulation with minimal damage to surrounding tissue. Follow-up study in these patients has ranged from 1 to 3 years with excellent results in 14 of 16 patients. Few complications and no major morbidity or mortality occurred. Photocoagulation of hemangiomas of the head and neck using the Nd-YAG laser appears to be an exciting new therapeutic option for this difficult problem. Further clinical study and follow-up appear to be warranted. PMID- 3821353 TI - Artificial reflex arc: a potential solution for chronic aspiration. I. Neck skin stimulation triggering strap muscle contraction in the canine. AB - Aspiration can occur when the reflex of deglutition occurring in the brain stem is impaired. Surgical procedures involving the airway have so far failed to provide a long-term solution to this problem. Because the sphincteric properties of the larynx could be used to help separate the air from the food passages on a dynamic basis, we present the concept of an artificial reflex are (ARA) in the canine. The afferent limb of this system consists in a cervical cutaneous sensory surface containing the specific biologic sensors for pressure and stretch, subtended by a corresponding sensory nerve, destined to be eventually implanted into the pharynx. The efferent limb picks up the information resulting from the sensor's distention via a frequency modulator and an amplifier, prior to transmitting it to the recurrent laryngeal nerves through monopolar electrodes, resulting in synchronous glottic closure. In order to test this new concept as a pilot study, this principle was applied in three dogs by using an island of cervical skin tubed on itself and the contralateral strap muscles as effector. Inflation of a Foley catheter introduced into the lumen of this tube resulted in synchronous strap muscle contraction, following corresponding increase in the firing frequency in the subtended sensory nerve. The data obtained in this series of experiments should permit further application at the laryngeal level. PMID- 3821354 TI - Tolusa-Hunt syndrome: resolution of a 12-year course after tonsillectomy. AB - The authors review the symptoms, physical findings, possible causes, and treatment of Tolusa-Hunt syndrome (THS). The authors present a patient with THS and tonsillitis. The symptoms, except for blindness, were alleviated after tonsillectomy. Anatomical relationships of the tonsils to the cavernous sinus are demonstrated and tonsillitis as a possible trigger mechanism of THS is suggested. PMID- 3821355 TI - Limited septoplasty as treatment for recurrent epistaxis in a child with Glanzmann's thrombasthenia. AB - Recurrent epistaxis can be a serious problem in children with coagulation disorders. We present a case of severe, recurrent nosebleeds in a 3-year-10-month old boy with Glanzmann's thrombasthenia. The nature of Glanzmann's disease and medical treatment of epistaxis in children is reviewed. A method of controlling recurrent epistaxis with a very simple and limited septoplasty is described. This technique should be applicable to patients with recurrent nosebleeds and other more common coagulation disorders. PMID- 3821356 TI - Acute bilateral deafness with nephritis: a human temporal bone study. AB - Temporal bone pathology is described in a 37-year-old man who had acute, bilateral, profound sensorineural hearing loss without improvement 4 months before death. The patient had suffered from low complement nephritis, for which he had received prednisolone therapy. Autopsy revealed malignant lymphoma with non-Hodgkin's type, membranous proliferative glomerulonephritis and necrotizing vasculitis of middle and small arteries. In the temporal bone study, pathological changes were limited to the cochlear region. The vestibular structure showed no detectable pathological changes. The changes included total absence of the organ of Corti, atrophy and/or disappearance of the stria vascularis in the upper turns, collapse of Reissner's membrane in the middle turn, and new bone formation in the apical turn. PMID- 3821357 TI - Trichinosis presenting as a neck mass. AB - Trichinosis is a rare cause of a neck mass, but should be considered by the physician when contemplating a differential diagnosis. This disease is still endemic in parts of the world and is directly related to the ingestion of incompletely cooked pork. A case is presented in which a 68-year-old man was diagnosed as having a squamous cell carcinoma of the mandible only to have trichinosis diagnosed on the final pathologic report. The case presentation is followed by a historical review and discussion. PMID- 3821358 TI - Composition and supramolecular organization of the tectorial membrane. AB - We have shown that collagen accounts for approximately 40% of the total protein of the tectorial membrane (TM) of the guinea pig and have estimated several essential parameters of TM composition including dry weight, wet weight, and water content. The major collagenous protein was definitively identified as type II collagen by SDS-PAGE, CNBr peptide mapping, and immunoblot assays. Quick freeze, deep-etch electron microscopy of the guinea pig TM demonstrated a dense meshwork of fibers embedded in a complex microfibrillar matrix which may consist of proteoglycans; the larger fibers were similar in size and appearance to type II collagen fibers of elastic cartilage. Finally, the comparative free amino acid profiles of TM strongly suggest that the TM is chemically transparent with respect to endolymph. Thus, the TM appears to consist of a highly hydrated matrix mechanically stabilized by type II collagen fibers. PMID- 3821359 TI - Laser laryngoscopic management of internal laryngocele. PMID- 3821360 TI - Autologous tissue seal in myringoplasty. AB - A prospective, controlled study on the efficacy of autologous tissue seal in myringoplasty was performed. In 29 patients with dry perforations, temporalis fascia was glued with tissue seal. In 30 patients the fascia was fixed with Gelfoam balls. No significant differences in take-rate was found between these two methods. PMID- 3821361 TI - Sound detection with the cochlear implant in five ears of four children with congenital malformations of the cochlea. AB - To determine if the cochlear implant can enable sound detection in children with a congenitally deformed cochlea, we reviewed warble-tone thresholds in five ears of four children in the implant clinical trials program. Of the five ears, there were two common cavity deformities, two cochlear hypoplasias, and one incomplete partition. Four of the five ears had an auditory response to stimulation by the implant at the same level as ears deafened by other disorders. One ear that had an auditory response to stimulation also produced facial stimulation that precluded use of the implant. The one ear that did not stimulate was the incomplete partition. This ear had a very narrow internal auditory canal. Three patients are now using the implant in three ears to detect sound. Results show that a cochlear implant may enable sound detection in a patient with a malformed cochlea but that a very narrow internal auditory canal (less than 1.5 mm) detected preoperatively on radiographs may contraindicate an implant. Such anatomy suggests only a rudimentary audiovestibular nerve or no such nerve and only a facial nerve. PMID- 3821362 TI - Congenital malformations of the inner ear: histologic findings in five temporal bones. AB - The histopathologic findings in five temporal bones from three patients with congenital malformation of the inner ear are described. The external contour of the cochlea was deformed in two temporal bones, while the internal architecture was abnormal in all five temporal bones. Intracochlear abnormalities included defects in the interscalar septum, deficiencies in the modiolus, and a paucity of neural elements. Spiral ganglion cell populations varied, but were substantially diminished in all five temporal bones. Enlargement of the vestibule and semicircular canals (lateral and posterior) was seen in two temporal bones. A large vestibular aqueduct and saccular hydrops were found in one temporal bone each. An attempt was made to relate the histologic patterns of deformity to the proposed clinical classification of inner ear malformations. Radiographic abnormality of the cochlea would have been detectable in two bones (incomplete partition pattern), while two other bones would have appeared as vestibule semicircular canal syndromes. One bone would have been radiographically normal. PMID- 3821363 TI - Congenital malformations of the inner ear: a classification based on embryogenesis. AB - Approximately 20% of patients with congenital sensorineural hearing loss have radiographic abnormalities of the inner ear. A broad spectrum of anomalous patterns have been described, most of which have been lumped together under the term "Mondini's dysplasia." We feel that this grouping of many dissimilar entities under a single umbrella term is unwarranted. Based on a review of 63 patients with 98 congenitally malformed ears, we have been able to recognize a number of distinct anatomic patterns from their radiographic appearance. A remarkable similarity between these morphologies and the appearance of the inner ear at various stages of embryogenesis was found. This led us to propose a classification system based upon the theory that these deformities result from an arrest of development during varying stages of inner ear organogenesis. PMID- 3821364 TI - The ratio of lipidperoxides to superoxide dismutase activity in the skin lesions of patients with severe skin diseases: an accurate prognostic indicator. AB - We studied 35 patients with active inflammatory skin diseases, measuring the levels of lipidperoxides and of the oxygen radical scavenging enzyme superoxide dismutase (SOD) in biopsy specimens of skin lesions. Lipidperoxide levels were markedly elevated in all patients. In fifteen patients with disease that was severe and highly resistant to therapy, SOD activity was only slightly increased, in comparison with normal controls. In contrast, in the twenty patients with mild disease that responded well to therapy, SOD activity was markedly elevated. The ratio of lipidperoxide levels to SOD activity was thus an accurate prognostic indicator, being elevated only in the group not responding to treatment. These findings suggest that the severity of allergic inflammatory skin disease and/or the response to treatment may in part be governed by the degree to which the patient's SOD activity is up-regulated in response to the generation of tissue damaging substances such as lipidperoxides. Interestingly, our studies revealed the SOD activities of both normal and inflamed skin to be unexpectedly high; our data suggest that SOD plays a critical role in protecting the skin from the effects of oxygen radicals and ultraviolet light. PMID- 3821365 TI - Effects of brovincamine on the stereological parameters of corticocerebral capillaries. AB - A number of clinical studies in patients with cerebrovascular insufficiency or symptoms resulting from multiple cerebral infarctions have shown that brovincamine significantly reduces the number of ischaemic regions and the left/right asymmetry of blood flow to the hemispheres, and brings about general improvement of the microcirculation. An optical-electronic image analysis technique was used to investigate whether brovincamine (7.5 mg/kg/day orally for 4 weeks) had any effect on stereological parameters of the corticocerebral capillaries of 1-year-old and 3-year-old OFA rats (n = 20). The older group of rats was included since in man changes in capillary geometry are known to be one of the manifestations of aging. The results show that brovincamine significantly increases the efficiency of capillary clearance, which is accompanied by an increase in capillary length and capillary volume per unit volume of tissue, resulting in a shortening of the mean intercapillary diffusion paths, a rise in capillary density and an increase in capillary diffusion area. No significant difference was observable between young and old rats. The changes in both groups of animals took the same form. From the above findings it was concluded that brovincamine improves the corticocerebral microcirculation by virtue of its effect on capillary geometry. PMID- 3821366 TI - Chronic intrastriatal dopamine infusions in rats with unilateral lesions of the substantia nigra. AB - This study examined the effects of continuously supplied dopamine delivered directly into the dopamine-deficient striatum. Rats received unilateral lesions of the substantia nigra by stereotaxic administration of 6-hydroxydopamine and were tested for apomorphine-induced rotational behavior and general activity. Osmotic mini-pumps were filled with dopamine in various concentrations, implanted subcutaneously and connected to a cannula implanted directly into the striatum. The system delivered solution at a rate of .5 microliter/hr for two weeks. Dopamine in a dosage of 0.5 microgram/per hour reduced apomorphine-induced rotational behavior by a mean of 52 +/- 5.8% (mean +/- SEM, n = 20) with a maximal individual decrease of 99%. There was no change in general activity or increase in stereotyped behavior. Infusions of vehicle solutions did not decrease rotational behavior. Spread of the infused dopamine and its metabolites was estimated by adding 3H-dopamine to the pumps in tracer quantities. Radioactivity was highly concentrated at the infusion site and decreased rapidly within a few mm from the infusion site. Continuous infusion methods may eventually prove to be effective in the treatment of nigro-striatal degenerative disease. PMID- 3821367 TI - Effect of hypophysectomy, adrenalectomy, pituitary hormone secretion and gastric acid secretion on neurotensin induced gastric protection against stress gastric lesions. AB - In previous studies we have established that intracisternal (i.c.) but not peripheral (intravenous) administration of neurotensin (NT), a brain and gastrointestinal tridecapeptide, totally prevents the development of gastric lesions produced by cold-restraint stress (CRS) with food-deprived rats. In this investigation, removal of the pituitary and adrenal gland, anterior pituitary hormone secretion and gastric acid secretion were evaluated independently as potential intermediates for NT's protective effect. NT (30 micrograms) produced a significant reduction of gastric lesions incidence and severity in intact and sham-operated controls. Adrenalectomy, but not hypophysectomy totally blocked the protective effect of i.c. NT. In addition, replacement therapy with s.c. prednisone (1 mg/kg) for 5 days following adrenalectomy did not restore the protective activity of central (i.c.) NT in adrenalectomized rats. A significant reduction of serum levels of TSH, PRL and GH following i.c. NT (30 micrograms) was observed after 2h of CRS. The gastrosecretory studies revealed that i.c. NT (30 micrograms) did not affect gastric acid secretion in pylorus ligated rats. However, blockade of peripheral (gut) cholinergic (muscarinic) receptors with i.p. atropine methylbromide (1 mg/kg) significantly raised gastric pH and reduced gastric acid concentration and output. In conclusion, the results of this study indicate that the acute protective effect of brain NT appears to be mediated, at least in part, by the sympathoadrenomedullary axis, and not by the pituitary gland or substances derived from the pituitary or by inhibition of gastric acid secretion. PMID- 3821368 TI - In vivo binding of 3H-N-methylspiperone to dopamine and serotonin receptors. AB - 3H-N-methylspiperone (3H-NMSP) was used to label dopamine-2 and serotonin-2 in vivo in the mouse. The striatum/cerebellum binding ratio reached a maximum of 80 eight hours after intravenous administration of 3H-NMSP. The frontal cortex/cerebellum ratio was 5 one hour after injection. The binding of 3H-NMSP was saturable in the frontal cortex and cerebellum between doses of 10 and 1,000 micrograms/kg. Between 0.01 and 10 micrograms/kg the ratio total/nonspecific binding increased from 14 to 21. Inhibition of 3H-NMSP binding in the frontal cortex and striatum by ketanserin, a selective serotonin-2 antagonist, demonstrated that 20% of the total binding in the striatum was to serotonin-2 receptors and 91% of the total binding in the frontal cortex was to serotonin-2 receptors. Compared to 3H-spiperone, 3H-NMSP results in a much higher specific/nonspecific binding ratio in the striatum and frontal cortex and displays more than a two-fold higher brain uptake. PMID- 3821369 TI - Effects of taurine depletion on rat cardiac electrophysiology: in vivo and in vitro studies. AB - Electrocardiograms were monitored in unanesthetized rats during treatment with drinking water containing guanidinoethyl sulfonate (GES), an inhibitor of taurine transport, which depleted cardiac taurine content. Treatment led to a selective prolongation of the QT interval which was highly correlated with the degree of taurine depletion (r2 = 0.92, p less than .001). Compared to controls, the duration of ventricular muscle action potentials was significantly increased in GES-treated rats, and this accounted for the prolongation of QT intervals. Oral taurine supplements reversed GES-induced cardiac taurine depletion and the associated increased duration of action potentials and QT intervals. In vitro superfusion with 0.2-10 mM GES or taurine had no effect on action potentials of control or GES-treated rats. These data indicate that intracellular taurine may play a role in regulating myocardial action potential duration, particularly during repolarization. PMID- 3821370 TI - Naloxone, naltrexone and body temperature. AB - The temperature effects of naloxone and naltrexone (1-30 mg/kg) were examined in well habituated male rats. These drugs had a similar time course and potency, producing a dose-dependent hypothermia followed several hours later by a hyperthermia. A subsequent study found that not only did 30 mg/kg of naloxone or naltrexone produce an equivalent hypothermia but this hypothermia was just as pronounced during the dark as in the light part of the cycle. PMID- 3821371 TI - Dose response curve for the phase-shifting effect of triazolam on the mammalian circadian clock. AB - A dose response curve for the phase shifting effect of triazolam, a short-acting benzodiazepine commonly prescribed for the treatment of insomnia, on the circadian rhythm of locomotor activity was measured for the golden hamster. A single intraperitoneal injection of triazolam six hours before the onset of wheel running activity induced a dose-dependent phase advance in the rhythm. A maximum phase advance, which averaged about 100 minutes, was observed in animals injected with 0.5 to 5.0 mg of triazolam. The use of drugs which promote sleep, and induce phase shifts in a central circadian clock, could be important in the treatment of sleep disorders associated with disrupted schedules and of mental and physical disorders associated with abnormal circadian rhythmicity. PMID- 3821372 TI - Determination of serotonin in whole blood, platelet-rich plasma, platelet-poor plasma and plasma ultrafiltrate. AB - The important biogenic amine, serotonin (5HT), was determined in whole blood, platelet-rich plasma (PRP), platelet-poor plasma (PPP), and plasma ultrafiltrate after simple deproteinization. Following ion-pair chromatography on standard or narrow-bore reverse-phase columns, 5HT and the internal standard (N methylserotonin-NMS) were detected by fluorometry with absolute detection limits of 2-4 pg. Levels obtained for whole blood and PRP were in agreement with previous methods. However, mean (+/- SD) values obtained for platelet-poor plasma (PPP) of 578 +/- 277 pg/ml (N = 7) were approximately 3-fold lower than the lowest previous reports. We also report the first determination of 5HT in plasma ultrafiltrate, having observed mean levels of 387 +/- 222 pg/ml (N = 7). PMID- 3821373 TI - Quinoline and quninaldine as naturally occurring inhibitors specific for type A monoamine oxidase. AB - Type A monoamine oxidase (MAO-A) in human placental mitochondria was competitively inhibited by naturally occurring substances, quinoline and quinaldine, using kynuramine as substrate. Quinoline had a higher affinity for MAO than kynuramine. MAO-A in human brain synaptosomal mitochondria was also competitively inhibited by quinoline, while type B MAO (MAO-B) was reversibly and non-competitively inhibited by quinoline. Quinoline inhibited MAO-A much more potently than MAO-B. Of several compounds structurally similar to quinoline, isoquinoline noncompetitively inhibited MAO-A and -B activity. PMID- 3821375 TI - Spontaneous asymmetric circling behavior in hemi-parkinsonism; a human equivalent of the lesioned-circling rodent behavior. AB - When induced experimentally in rodents, hemispheric asymmetry in basal ganglia dopamine results in spontaneous asymmetric circling toward the hemisphere with the lower level of dopamine. A similar asymmetry has long been thought to exist in the brains of hemi-Parkinsonian patients. Using an electronic turn counter, we demonstrated that, like unilaterally lesioned rats, and without being aware of it, five ambulating outpatients with hemi-Parkinson's disease exhibit spontaneous rotation toward the hemisphere containing less striatal dopaminergic activity. PMID- 3821374 TI - Cardiovascular effects of cocaine in anesthetized and conscious rats. AB - This study examined the cardiovascular and respiratory effects of cocaine and procaine in anesthetized and conscious rats. Intravenous cocaine (0.16-5 mg/Kg) elicited a rapid, dose dependent increase in mean arterial pressure of relatively short duration. In pentobarbital anesthetized (65 mg/Kg, i.p.) animals, the pressor phase was generally followed by a more prolonged depressor phase. These effects on arterial pressure were generally accompanied by a significant tachypnea and at larger doses (2.5 and 5 mg/Kg, i.v.), bradycardia. Procaine (0.31 and 1.25 mg/Kg, i.v.) produced similar cardiovascular and respiratory effects (depressor phase, tachypnea) in pentobarbital anesthetized animals. In conscious-restrained animals, both cocaine and procaine (1.25 mg/kg, i.v.) produced pressor responses. The subsequent depressor response was, however, absent in both cases. The cardiovascular effects of cocaine (0.25-1 mg/Kg, i.v.) in urethane anesthetized (1.25 g/Kg, i.p.) animals were essentially similar to those observed in conscious animals. Procaine (1mg/Kg) did not produce any significant cardiovascular effects in urethane anesthetized animals, but did elicit tachypnea. Reserpine pretreatment (10 mg/Kg, i.p.) did not significantly attenuate the pressor response in urethane anesthetized animals. Phentolamine pretreatment (3 mg/Kg, i.v.) did significantly antagonize the pressor effect in urethane anesthetized animals. These results suggest that: the depressor phase is likely due to a interaction between local anesthetic activity (cocaine and procaine) and barbiturate anesthesia, the cardiovascular effects of cocaine in conscious animals are more similar to those observed in urethane anesthetized rats than in pentobarbital anesthetized rats and the pressor effect in urethane anesthetized rats is apparently due to a reserpine resistant catecholaminergic mechanism. PMID- 3821377 TI - Antagonism of morphine tolerance and dependence by metoclopramide. AB - Metoclopramide produced significant analgesic activity when tested by acetic acid induced writhing assay. Repeated injections of metoclopramide did not result in the development of tolerance to its analgesic activity. Pretreatment with metoclopramide antagonised acute morphine tolerance and suppressed the withdrawal signs (both in acute dependence type and abrupt withdrawal type). It is suggested that metoclopramide may be a useful tool in the management of morphine dependence. PMID- 3821376 TI - Effects of diazepam on cell proliferation in cerebral cortex, anterior pituitary and thymus of developing rats. AB - The effect of a single dose (5mg/kg b.w.) of diazepam on the cell proliferation in selected organs of 11-day old female Sprague-Dawley rats has been investigated. The stathmokinetic method (counting of mitoses after colchicine administration) has been used for evaluation of cell replication. The significant fall of the mitotic activity in the parietal cerebral cortex and the anterior pituitary gland was found. On the other hand, the increase of the mitotic activity in thymus was observed. The reported data, taken together with the previous observations from our and other laboratories, suggest the involvement of benzodiazepine receptor in the control of cell proliferation. PMID- 3821378 TI - Dopamine in rat adrenal glomerulosa. AB - There is increasing evidence that dopamine (DA) inhibits aldosterone production, but the source of DA for this dopaminergic influence is not known. In the present study we examined the adrenal's zona glomerulosa for the presence of DA. Rats maintained on an intake of regular food were killed by decapitation and the adrenal capsule (containing zona glomerulosa) and the remainder of the gland (containing both cortex and medulla) were examined for their content of DA and also for norepinephrine (NE) and epinephrine (E). DA was found in adrenal glomerulosa in substantial quantity, 1.92 +/- 0.17 (SEM) ng/mg wet weight, representing an approximate concentration of DA of 1-100 microM. DA in adrenal capsule represented 12.2% of the total adrenal content of DA. NE and E were also present in glomerulosa, 3.46 +/- 0.32 and 18.7 +/- 2.1 ng/mg respectively, but, unlike DA, about 98% of the total adrenal content of NE and E was contained in adrenal medulla. The NE/E ratio in capsule and medulla were similar, although slightly higher in adrenal medulla, suggesting that the medulla is the source of the NE and E found in glomerulosa. On the other hand, the DA/E ratio was several fold higher in glomerulosa than medulla--suggesting that glomerulosa DA was derived at least partially from a source other than adrenal medulla. We also found that short-term culturing of the adrenal reduced DA levels to 1/3 that observed in fresh tissue. This could explain in part why cultured glomerulosa has been shown to be more responsive to administered stimuli. In summary, the findings indicate a significant concentration of DA in adrenal glomerulosa, and suggest that the effects of DA on aldosterone production are mediated locally within the adrenal. PMID- 3821379 TI - Diazepam withdrawal as demonstrated by changes in plasma corticosterone: a role for the hippocampus. AB - Elevations in plasma corticosterone were shown to be a reliable indication of antagonist-precipitated withdrawal from diazepam in the rat. Dependence to the benzodiazepine was produced by a single daily injection for eight days at which time CGS-8216 was injected i.v. via a chronic indwelling catheter. This injection and subsequent serial blood samples were withdrawn from conscious, unrestrained animals that were placed previously in sound-attenuated one-way vision boxes. The magnitude of the hormone change was correlated with either the chronic dose of diazepam or the dose of the antagonist used to precipitate withdrawal. When CGS 8216 was administered chronically with the diazepam, antagonist-precipitated abstinence did not occur. Additional results showed that dependence could be produced by bilateral intracerebral placement of micropellets of diazepam into the dorsal and ventral hippocampus. These data show that dependence to diazepam can be demonstrated in a relatively short time using modest doses of drug, and, further, that exposure of the hippocampus, an area with a high concentration of benzodiazepine receptors, to diazepam will initiate dependence. PMID- 3821380 TI - Distribution of muscarinic receptor subtypes in rat brain as determined in binding studies with AF-DX 116 and pirenzepine. AB - In vitro competition binding experiments with the selective muscarinic antagonists AF-DX 116 and pirenzepine (PZ) vs 3H-N-methylscopolamine as radioligand revealed a characteristic distribution of muscarinic receptor subtypes in different regions of rat brain. Based on non linear least squares analysis, the binding data were compatible with the presence of three different subtypes: the M1 receptor (high affinity for PZ), the cardiac M2 receptor (high affinity for AF-DX 116) and the glandular M2 receptor (low affinity for PZ and AF DX 116). The highest proportion of M1 receptors was found in the hippocampus, whilst the cerebellum and the hypothalamus were the regions with the largest fraction of the cardiac M2 and glandular M2 receptors, respectively. In certain brain areas, depending on the relative proportions of the subtypes, flat binding curves were seen for AF-DX 116 and PZ. Based on these data, an approximate distribution pattern of the subtypes in the various brain regions is presented. PMID- 3821381 TI - Acetaldehyde binding increases the catabolism of rat serum low-density lipoproteins. AB - Acetaldehyde was found to form adducts with rat serum lipoproteins. The binding of [14C]acetaldehyde to lipoproteins was studied at low concentrations which are known to exist during ethanol oxidation. The amount of lipoprotein adducts was a linear function of acetaldehyde concentration up to 250 microM. Incubation of rat plasma low-density lipoproteins (LDL) with 200 microM acetaldehyde increased the disappearance rate of the 3H-label from the cholesterol ester moiety of LDL injected into normal rats. The data show that even low concentrations of acetaldehyde are capable of affecting LDL metabolism. These findings may provide an explanation for the low concentrations of serum LDL in alcoholics. PMID- 3821382 TI - Species differences in metabolism of ketotifen in rat, rabbit and man: demonstration of similar pathways in vivo and in cultured hepatocytes. AB - In vitro drug metabolism by cultured rat, rabbit and human adult hepatocytes has been studied, using ketotifen (ZADITEN) as a model substrate because it is biotransformed in vivo by various metabolic pathways in man and animals. The major in vivo pathways were demonstrated in vitro, namely oxidation in rat hepatocytes, oxidation, glucuronidation and sulfation in rabbit hepatocytes, reduction and glucuronidation in human hepatocytes. Human hepatocytes were the most stable in culture, displaying ketotifen biotransformation for at least one week. These results clearly demonstrated that cultured hepatocytes retain their in vivo specific drug metabolizing activities, including inter-species polymorphism, for a few days. Therefore, pure hepatocyte cultures represent a useful system suitable for drug metabolism studies. PMID- 3821383 TI - Effects of GABA natriuresis induced centrally by cholinergic stimulation. AB - Sodium and potassium excretion and urine output have been studied in rats following water loading and intracerebroventricular (i.c.v.) injection of isotonic saline (NaCl-0.15M), gamma-amino butyric acid (GABA), picrotoxin, carbachol, GABA plus picrotoxin, GABA plus carbachol and GABA plus atropine. GABA injection decreased sodium and potassium excretion. Picrotoxin or carbachol injection elicited natriuresis and kaliuresis. GABA injection decreased the effects of the carbachol and atropine injection decreased the effects of the GABA on sodium and potassium excretion. These results suggest an interaction between gabaergic and cholinergic pathways in the control of sodium and potassium excretion. PMID- 3821384 TI - Effects of 2-substituted-4-phenylquinolines on uptake of serotonin and norepinephrine by isolated brain synaptosomes. AB - In this present communication, the in vitro inhibition of the uptake of [3H]-L norepinephrine ([3H] NE) and [3H]-Serotonin ([3H] 5-HT) by eleven synthesized 2 substituted-4-phenyl quinolines were studied using rat brain synaptosomal preparations. Compounds with an open side chain were relatively weak inhibitors of the synaptosomal uptake of [3H] NE and [3H] 5HT. Compounds having a distance of three atoms between the terminal basic nitrogen of the side chain and the quinoline ring were better inhibitors of serotonin uptake than those compounds having a four-atom distance. The replacement of the side chain with a piperazine ring produced compounds which were more potent and selective inhibitors of the uptake of either [3H] 5-HT or [3H] NE. Further structure-activity relationships are also discussed. PMID- 3821385 TI - Biological effects of fish oils in relation to chronic diseases. AB - The low incidence of cardiovascular disease in Greenland Eskimos appears to be due to their high intake of seal, whale and fish. The lipids of these marine animals lower serum triglyceride and cholesterol levels and help to prevent blood clotting. The latter effect has been related to a change in the balance of prostacyclin and thromboxane as a result of replacing n-6 polyunsaturated fatty acids in the body by n-3 polyunsaturated fatty acids present in marine lipids. Dietary fish oils have also been shown to inhibit development of mammary, pancreatic, intestinal and prostatic tumors in experimental animals. This effect may likewise be due to changes in the production of prostaglandins or related compounds. The involvement of prostaglandins and leukotrienes in immune responses has led to studies on the effects of fish oil on various chronic diseases associated with abnormalities of the immune system. Some of these diseases, such as multiple sclerosis and psoriasis, are also relatively uncommon in Eskimos. Preliminary results of these studies are encouraging, but more work is required to assess the usefulness of dietary fish oils in treatment of these diseases. In addition to their apparent therapeutic value, n-3 fatty acids are considered essential dietary components since they cannot be synthesized in the body and appear necessary for normal vision and probably other body functions. PMID- 3821386 TI - Comparative study of the blood pressure effects of four different vegetable fats on young, spontaneously hypertensive rats. AB - Following the suckling period, four groups of male four-week-old spontaneously hypertensive rats (SHR) were fed semisynthetic diets with 14% (by weight) of either sunflower seed oil [46% 18:2(n-6); linoleic acid (LA)-rich], linseed oil [62.5% 18:3(n-3) + 12.9% 18:2(n-6); alpha-linolenic acid (LNA)-rich], evening primrose oil [9.2% 18:3(n-6) + 71% 18:2(n-6); gamma-linolenic acid (LNA)-rich] or hydrogenated palm kernel fat [1.5% 18:2(n-6); polyunsaturated fatty acid (PUFA) deficient], respectively, up to an age of 18 wk. All diets enriched with PUFA provoked an attenuation of hypertension development. The effect was lowest in the LA-rich group and highest in the gamma-LNA-rich group. Differences in fatty acid composition of renal phospholipids between groups reflect the fatty acids present in the respective dietary fats. Renomedullary production of PGF2 alpha was significantly reduced in alpha-LNA-rich and slightly diminished in gamma-LNA-rich fed rats. Aortic formation of 6-keto-PGF1 alpha and TXB2 was increased in animals fed the gamma-LNA-rich diet. Thus, the attenuation of hypertension development cannot be explained only by changes in prostanoid formation. Other mechanisms possibly involved should be pursued. PMID- 3821387 TI - Effects of cholestanol feeding and cholestyramine treatment on the tissue sterols in the rabbit. AB - Rabbits were fed diets enriched with cholestanol or cholesterol (3.5 g/wk) for 4 12 weeks. During cholestanol feeding, the concentration of cholestanol in blood serum, liver, heart and aorta increased 15-30 times. In serum and liver, the concentration of cholesterol also increased. Cholestanol-fed rabbits developed inflammatory changes in the liver, with proliferation of small bile ducts. Liver tests were only slightly abnormal. Morphological atherosclerosis of the aorta was only occasionally seen in rabbits receiving cholestanol for eight weeks or less. During cholesterol feeding, the amounts of cholesterol in different tissues increased dramatically, most in the aorta. Morphological atherosclerosis in the aorta was found in all rabbits fed cholesterol-enriched diets for more than four weeks. Brain cholestanol was doubled in rabbits fed cholestanol for eight weeks, whereas brain sterols did not change significantly during cholesterol feeding. After an additional regression period with cholestyramine for eight weeks, the increased content of cholestanol in the brain was unchanged in cholestanol-fed rabbits. These observations are discussed in relation to the cholestanolosis of the brain that develops in the rare inherited human disease cerebrotendinous xanthomatosis. PMID- 3821388 TI - Intestinal absorption and fecal excretion of 5,6 alpha-epoxy-5 alpha-cholesta-3 beta-ol by the male Wistar rat. AB - The intestinal absorption of 5,6 alpha-epoxy-5 alpha-cholesta-3 beta-ol, an oxysterol formed by cholesterol autoxidation, has been evaluated in the male Wistar rat. Measurement of the 14C/3H ratio in the serum (by the method of Zilversmit and Hugues) and in the feces showed that a large proportion of the epoxide was absorbed. Epoxide clearance from the blood was very rapid, but its excretion in the stool continued for several days, corresponding to the fraction of the epoxide stored in the animal. PMID- 3821389 TI - Changes in lipids in liver and serum of rats fed a histidine-excess diet or cholesterol-supplemented diets. AB - The influence of dietary excess (5%) L-histidine on serum and liver lipids was examined in rats. Feeding a histidine-excess diet for 3, 6, 14 or 30 days caused growth retardation, hepatomegaly and decreased liver lipids throughout the period of the experiment. Hypercholesterolemia was observed after feeding a histidine excess diet for 6 days; then serum cholesterol continuously increased for 30 days. Serum triglyceride on day 30 in rats fed the histidine-excess diet showed a significant decrease compared to rats fed the basal diet. Serum phospholipids of rats fed the histidine-excess diet for 7 or 14 days showed a significant increase compared to rats fed the basal diet. When rats were fed a basal, histidine-excess or cholesterol-supplemented diet (0.5% and 1.0% cholesterol) for 6 days, the distribution of serum high density (HDL), low density (LDL) and very low density lipoprotein cholesterol in rats fed the histidine-excess diet was similar to that of rats fed the basal diet, whereas LDL-cholesterol increased and HDL-cholesterol decreased in rats fed the cholesterol-supplemented diet. PMID- 3821390 TI - Regulation of cholesterol synthesis in isolated epithelial cells of human small intestine. AB - We have investigated the regulation of cholesterol synthesis in isolated human small intestine epithelial cells (enterocytes). It was established that the amount of cholesterol synthesized increased linearly with the incubation time and the number of cells in the incubation mixture; the synthesis was suppressed by 7 ketocholesterol. Cholic, dehydrocholic, chenodeoxycholic, glycocholic, taurocholic, taurochenodeoxycholic and taurodeoxycholic acids inhibited cholesterol synthesis in enterocytes to different degrees in a dose-dependent manner. Lithocholic acid enhanced the rate of cholesterol synthesis. Deoxycholic acid, methyl ester of cholic acid and cholesterol did not affect the process. No bile acids tested, with the exception of taurodeoxycholic acid, affected fatty acid synthesis in enterocytes. Most bile acids also decreased cholesterol synthesis in cultured human skin fibroblasts. The results obtained make it possible to postulate that cholesterol synthesis in human enterocytes may be subject to a complex regulation by bile acids. PMID- 3821391 TI - Spectroscopic investigations of the water pool in lecithin reverse micelles. AB - The nature of the water pool formed in the reverse micellar system, lecithin/nonpolar solvent/water, has been investigated by means of near infrared, ultraviolet, fluorescence emission and visible spectroscopic techniques. The three nonpolar solvents chosen in this study were benzene, carbon tetrachloride and cyclohexane. Near infrared spectroscopic studies revealed that the amount of water present in the bulk organic phase is negligible at all water concentrations studied in all three solvents. The results of the polarity probe and 8 anilinonaphthalene sulfonic acid (ANSA) fluorescence emission maxima studies indicate that the polarity of the water pool is much lower than that of bulk water. The difference in polarity between the water pool and bulk water decreases with increasing water concentration in benzene and carbon tetrachloride systems. However, in the cyclohexane system, at a water content of 6 moles of water per mole of lecithin, where the system is known to change from isotropic reverse micelle to anisotropic liquid crystalline state, the polarity of the water pool is found to decrease. PMID- 3821392 TI - Species differences in lipid peroxide levels in lung tissue and investigation of their determining factors. AB - Marked species differences in thiobarbituric acid reactant value (TBA value) in normal lung tissue of five species of animals were found. The order of the values was mouse greater than hamster greater than rat greater than guinea pig greater than rabbit, and the value for mice was 3.6 times higher than that for rabbit. The vitamin E (VE) and nonprotein sulfhydryls (NPSH) contents in lungs varied widely among the five animal species. Species differences were also observed on polyunsaturated fatty acid composition in lung phospholipids. The peroxidizability index (PI), which shows the relative rate of peroxidation reaction, was calculated from the composition ratio and the reactivity of each polyunsaturated fatty acid, and the PI was found to be significantly correlated to the TBA value in lungs (r = 0.853, p less than 0.001). The PI value was normalized by the contents of VE and/or NPSH. Finally, the log-value of PI, normalized by the log values of the reciprocals of VE and NPSH, log(PI/VE X NPSH), showed the highest correlation coefficient (r = 0.907, p less than 0.001). Normalization by the activities of antioxidative protective enzymes in lungs did not show any significant correlation against TBA value. These results suggest that TBA value as an index of lipid peroxides in the lungs of animals may be regulated mainly by the contents of VE and NPSH, the composition ratio and the reactivity of each polyunsaturated fatty acid in lung phospholipid fraction. PMID- 3821393 TI - A phospholipase C with a high specificity for platelet-activating factor in rabbit liver light mitochondria. AB - The light mitochondrial fraction from rabbit liver was found to catalyze the hydrolysis of platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3 phosphocholine) by the phospholipase C reaction to form 1-O-alkyl-2-acetyl glycerol and phosphocholine. The highest specific phospholipase C activity occurred in the liver and kidney. A subcellular survey showed that the enzyme was of lysosomal origin. The enzyme was solubilized with 2% Triton X-100 from rabbit liver light mitochondria and purified ca. 600- to 700-fold with a 17% yield using procedures that included hydroxyapatite, Sepharose 4B and isoelectric focusing column chromatography followed by fast protein liquid chromatography. The enzyme consists of two forms having a pl of 4.7 and 5.8. Each form was purified to a homogeneous state as judged by sodium dodecyl sulfate-polyacrylamide disc gel electrophoresis. The enzyme migrated to positions corresponding to apparent molecular weights of 33,000 and 75,000, respectively. The purified enzymes of pl 4.7 and 5.8 had pH optima of 8.2 and 8.5 and apparent Km values of 55.6 and 45.5 microM for PAF, respectively. Furthermore, their phospholipase C activity was significantly inhibited by the addition of 1 mM EDTA. EDTA-inactivated enzyme, however, recovered completely upon addition of Ca2+ to the original level. p Chloromercuribenzoate markedly inhibited enzyme activity, suggesting that phospholipase C is a -SH enzyme. The physiological role of the enzyme should be evaluated, considering its specificity for a highly potent, biologically active ether-phospholipid. PMID- 3821394 TI - Influence of dietary vitamin E, selenium and age on regional distribution of alpha-tocopherol in the rat brain. AB - Concentrations of alpha-tocopherol (alpha-T) in plasma, cerebrum, cerebellum, midbrain and brain stem and activity of selenium (Se)-dependent glutathione peroxidase (GSH-Px) in plasma were measured in 1- and 15-month-old male F344 rats fed diets containing vitamin E (E, IU/kg) and Se (ppm) in the following combinations: 30 E, 0.1 Se (control diet, minimum requirements); 200 E, 0.2 Se; 0.0 E, 0.2 Se; 200 E, 0.0 Se; 0.0 E, 0.0 Se for 8 or 20 weeks. alpha-T and GSH-Px levels in plasma were reflective of dietary treatment in young rats in which an interaction of the two nutrients was noted. A longer period of dietary vitamin E deficiency was necessary to deplete plasma alpha-T and depress GSH-Px activity significantly in the old rats. Among the brain regions of all ages, cerebrum and midbrain had the highest concentrations of alpha-T while cerebellum showed the lowest. However, cerebellum of young rats and cerebellum and brain stem of old rats had a greater alpha-T accumulation with doubly supplemented diets, whereas only cerebellum of young and old rats showed a marked increase of alpha-T with vitamin E supplementation. In old rats, vitamin E deficiency resulted in greater depletion of alpha-T in cerebellum and brain stem than cerebrum and midbrain regions. Se deficiency in brain stem of young and old rats significantly decreased alpha-T accumulation by vitamin E supplementation. Se supplementation marginally alleviates vitamin E depletion in brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821395 TI - Limitations of the method using peroxidase activity of hemoglobin for detecting lipid hydroperoxides. AB - The method using peroxidase activity of hemoglobin (Hb) for the determination of lipid peroxides was examined by using pure methyl linoleate hydroperoxides, trilinoleoylglycerol hydroperoxides and egg yolk phosphatidylcholine hydroperoxides as substrates and tetramethyl benzidine as electron donor for the peroxidase reaction of Hb. The reactivities of these substrates were quite varied. Furthermore, some electron donors were tested for peroxidase activity of Hb, but none showed a complete reduction of methyl linoleate hydroperoxides. From these results, it seems the Hb method needs to be carefully applied to biological materials that contain mixtures of different types of lipid classes. PMID- 3821396 TI - Bile lipid secretion in isolated perfused rat liver. A model for metabolic studies. AB - Isolated perfused rat liver was used to study the effects of constant taurocholate perfusion, with or without the addition of phosphatidylcholine unilamellar vesicles, upon both the bile salt-dependent and bile salt-independent secretion of bile. Taurocholate introduction increased bile flow and normalized the bile lipid secretion by restoring the bile salt-dependent secretion. At a flow rate of 30 ml/min, the liver was perfused by a single-pass method. The perfusion medium contained 17.5 microM taurocholate with or without 5.83 microM phosphatidylcholine. In light of a recent quantitative dynamic concept on the interphase partition of lipids, it was calculated that more than 99% of the taurocholate reaches the liver as monomers and/or dimers. It was also deduced that the lipids were secreted in bile as small discoidal lipoprotein structures rather than unilamellar lipoproteic vesicles. During the course of the experiments (2 hr), the excellent criteria of viability of this model make it highly suitable for the investigation of hepatic metabolism. Furthermore, the addition of phosphatidylcholine unilamellar vesicles to the perfusate constitutes a potential vector for various liposoluble molecular species. PMID- 3821397 TI - The major gangliosides of the bovine pineal body. AB - Acetone powders of fresh-frozen pineals were extracted with chloroform/methanol mixtures. By column chromatography on silicic acid, mild alkaline methanolysis, ion-exchange high performance liquid chromatography and a final thin layer chromatography on silicic acid, the major glycosphingolipids were purified from the extracts of a total of 300 bovine pineal bodies. Chromatographically purified fractions were characterized by gas chromatographic analysis. The most prominent glycosphingolipid appeared to be cerebroside. In addition, five different gangliosides were found in detectable levels. The two major gangliosides have the chromatographic and component characteristics of GD3 and GM3, with disialoganglioside predominating. Gangliosides indistinguishable from purchased standards of GM1 and GD1a were third and fourth, respectively, in amount. The fatty acid profiles of the two lactosyl gangliosides are similar and significantly different from those of the two gangliotetraose gangliosides. The fifth most prominent ganglioside, present at a level of 1.09% of total recovered ganglioside sialic acid, appears to be a novel trisialoganglioside, called GTx. This new molecule has a component ratio of gal:glc:sialic acid:amino sugar of approximately 1:2:3:1. Similarities between bovine pineal and rod outer segments are discussed. PMID- 3821398 TI - Onset and persistence of changes in intestinal transport following dietary fat manipulation. AB - In this study we determined the time-course for the onset and the loss of the effect of short-term feeding rats isocaloric semisynthetic diets containing a high content of saturated (HS) or polyunsaturated (HP) fatty acids on the jejunal and ileal uptake of medium- and long chain fatty acids, cholesterol and glucose. Animals were fed HP or HS for 3, 7 or 14 days; then the diet was switched to standard Purina rat chow for a further 3, 7 or 14 days. The uptake of medium chain fatty acids was unchanged. The differences between HP and HS in glucose uptake occurred within 3 days, but persisted for 14 days, whereas there were qualitative as well as quantitative changes in the pattern of lipid uptake: differences in uptake of stearic, oleic, linoleic and linolenic acids and cholesterol occurred after 7 days of feeding HP or HS. Jejunal uptake of linoleic acid was greater in HP than HS on day 7, but HS was greater than HP on day 14. The effect of diet on lipid uptake was similar in the jejunum and ileum. The altered uptake of stearic and oleic acids persisted after the rats were switched back to chow, whereas the uptake of the other nutrients became similar. Thus, changes in dietary content of saturated and polyunsaturated fatty acids have early effects on intestinal transport function; some of these changes persist even when animals are returned to feeding on chow; and glucose transport is rapidly altered by dietary changes, whereas lipid uptake changes only after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821399 TI - Intestinal cholesterol and oleic acid uptake from solutions supersaturated with lipids. AB - To test the role of nonmicellar phases in lipid absorption, intestinal uptake of fatty acids and cholesterol has been studied in vitro from supersaturated and micellar solutions. The micellar solubility limit at equilibrium was established for cholesterol and oleate/monoolein (2:1) at pH 6.7 with 10 mM taurocholate. Uptake by rat intestinal everted sacs was measured during incubation of 5 min. Cholesterol uptake increased linearly with the cholesterol content of micellar or supersaturated solutions up to a supersaturation of 150%. Oleate uptake, by contrast, remained essentially the same from either saturated or supersaturated (130-280%) mixtures. The difference between cholesterol and oleate uptake rates is explained by their distinct effects on micellar size, which is unchanged by cholesterol supersaturation but is increased by oleate. Solutions largely supersaturated (280%) with oleate-monoolein are polydisperse and contain viscous isotropic and paracrystalline phases similar to those observed during lipid absorption. These results suggest that, in the presence of such solutions, uptake occurs from both the micellar saturated and nonmicellar supersaturated phases. PMID- 3821400 TI - Intestinal absorption of ester and ether glycerophospholipids in guinea pig. Role of a phospholipase A2 from brush border membrane. AB - In vivo intestinal perfusion was used to follow the absorption of three different choline glycerophospholipids (CGP) in guinea pig. These included 1-[3H]palmitoyl 2-acyl-sn-glycero-3-phosphocholine (diacyl-GPC), 1-[3H]-O-hexadecyl-2-acyl-sn glycero-3-phosphocholine (alkylacyl-GPC) and 1,2-di-O-hexadecyl-sn-glycero-3 phospho-[3H]-choline (dialkyl-GPC). About 80% of diacyl-GPC was absorbed within 4 hr, compared to 60% of alkylacyl-GPC and 30% of dialkyl-GPC. The radioactivity disappearing from the perfusion fluid was recovered in intestinal lipids, mostly triacylglycerol, free fatty acid and CGP from diacyl-GPC, CGP from alkylacyl-GPC and dialkyl-GPC. These results indicated that the nonhydrolyzable substrate dialkyl-GPC was much less absorbed, whereas diacyl-GPC, which released over 80% of [3H]palmitic acid in the perfusion fluid, displayed the highest absorption rate. The intermediate picture observed for alkylacyl-GPC suggested the possible involvement of a phospholipase A2, which was detected in the entire intestinal tract. This enzyme was further found to concentrate in villus cells, where it is localized in the brush border membrane, as shown using two different subcellular fractionation procedures. These data suggest a possible role of this new enzyme in the digestion of alimentary phospholipids. PMID- 3821401 TI - Lipids from Plasmodium vinckei-infected erythrocytes and their susceptibility to oxidative damage. AB - The constituent lipids of plasma and red blood cells (RBC) from mice late in infection with the malarial parasite Plasmodium vinckei were analyzed and compared with those obtained from uninfected animals. On a dry weight basis, the total extractable lipids of RBC increased threefold during infection, while those of the plasma did not change significantly. In general, changes in individual plasma lipid constituents paralleled those found in RBC of infected mice but were of smaller magnitude. While the increase in the total lipids of parasitized RBC was largely attributable to an increase of more than fourfold in total phospholipids, a significant increase in neutral lipids was also observed. Phosphatidylcholine and phosphatidylethanolamine were the major phospholipids present within RBC, and their total and relative concentrations increased as a result of the infection. A parallel increase occurred in the ratio of unsaturated to saturated fatty acids in the parasitized RBC phospholipids. Infection was also associated with decreases in the relative amount of cholesterol present in RBC and in the ratio of cholesterol to phospholipid. Consistent with this, the fluorescence polarization of 1[4-(trimethylamino)phenyl]-6-phenylhexa-1,3,5 triene within parasitized RBC plasma membranes was decreased in comparison with its value in noninfected RBC, indicating that malarial infection decreases the "order" of membrane lipids. These modifications, in conjunction with the increased levels of vitamin E and malonyldialdehyde reported elsewhere, are important determinants of the susceptibility of the different membrane compartments within infected RBC to peroxidative damage. PMID- 3821402 TI - A micromethod for the estimation of blood dolichol. AB - A micromethod for the estimation of dolichol in blood was developed using high performance liquid chromatography. This method can be applied to whole blood or plasma. With detector sensitivity set at 0.005 Absorbance Unit Full Scale, samples as little as 50 microliter are sufficient to carry out the determination. Blood samples from the tail vein of inbred strains of C57 BL/6 NNia-1 mice 3, 6, 12 and 24 mo of age were examined. Blood dolichol levels decreased with age from 163.3 ng/ml at 6 mo to 110.1 ng/ml at 24 mo. The major dolichol homologs were C 85 (10.4%), C-90 (41.6%), C-95 (38.0%) and C-100 (8.1%). PMID- 3821403 TI - Activities of liver mitochondrial and peroxisomal fatty acid oxidation enzymes in rats fed trans fat. AB - The effect of trans fat on the activities of liver mitochondrial and peroxisomal fatty acid oxidation enzymes was examined in various strains of rats. When Wistar and Sprague-Dawley rats were fed for 30 days diets containing either olive oil or partially hydrogenated corn oil as a source of cis- or trans-octadecenoate, respectively, the activities of various enzymes of mitochondrial and peroxisomal beta-oxidation measured with cis- and trans-9-octadecenoic acid as substrates showed little dietary fat-dependent change. In Fischer 344 rats, feeding trans fat for 15 mo increased only moderately various enzymes of beta-oxidation except for carnitine acyltransferase. The rate of mitochondrial ketogenesis and the activity of carnitine acyltransferase measured with trans-9-octadecenoic acid as a substrate were about half those with the cis-counterpart. Peroxisomes oxidized trans-9-octadecenoyl-CoA at a rate comparable to the cis-counterpart. It was concluded from this study and previous ones that the difference in the geometry of dietary fatty acid had only a marginal effect in modulating the hepatic fatty acid oxidation system, in spite of marked differences in the metabolic behavior of cis- and trans fatty acid in cell-free preparations and perfused liver. PMID- 3821405 TI - Society for Magnetic Resonance Imaging. Fifth annual meeting, 28 February-4 March 1987, San Antonio, Texas. Program and abstracts. PMID- 3821404 TI - Improved enzymatic hydrolysis of conjugated bile acids. AB - The hydrolysis of conjugated bile acids by cholylglycine hydrolase (EC 3.5.1.24) using the standard procedure for a commercial enzyme preparation was found to be incomplete, as judged by the use of 24-14C-taurocholic acid as a tracer. A method is proposed that incorporates the nonionic detergent Triton X-100 into the reaction mixture to achieve almost complete hydrolysis. It is proposed that the observed enhancement of enzyme activity is due to the formation of micelles by the detergent. PMID- 3821406 TI - Effects of chronic nifedipine administration on epinephrine-induced arrhythmias during isoflurane anesthesia in dogs. PMID- 3821407 TI - [Induction doses of etomidate, althesin and midazolam in Chinese]. PMID- 3821408 TI - Epidural ketamine for postoperative pain relief. PMID- 3821409 TI - [The effect of intravenous cimetidine premedication on gastric pH]. PMID- 3821410 TI - [Postanesthetic recovery of pulmonary function]. PMID- 3821411 TI - [Clinical experience in intraoperative hemodilution and autotransfusion]. PMID- 3821412 TI - [Hyperkalemia induced by succinylcholine injection in woman with metabolic acidosis]. PMID- 3821414 TI - Three surveillance and query languages for medical care. PMID- 3821413 TI - [Common errors in computer compilation of anesthesia records]. PMID- 3821415 TI - A surgical cut into computers. PMID- 3821416 TI - Computerized management of intensive care patients. PMID- 3821417 TI - Computer records 1990. PMID- 3821419 TI - Low-priced microcomputer voice-input boards. PMID- 3821418 TI - Personal computers: a medical scientist's review. PMID- 3821420 TI - Man/microcomputer telephone communication. PMID- 3821421 TI - Programs for on-line searching. PMID- 3821422 TI - Non-narcotic analgesics today: an update on benefits and risks. Proceedings of a symposium. Yogyakarta, Indonesia, February 23-26, 1986. PMID- 3821423 TI - Adverse reaction assessment in Thailand. AB - In Thailand, 5 years ago, the Ministry of Public Health set up the National Adverse Drug Reaction Monitoring Center for collecting, analysing and compiling all evidence related to drug hazards. Between March 1983 and December 1985, 790 reports on adverse drug reactions have been received, of which 711 could be analysed. Adverse drug reactions are commonly reported with the antibiotics, other anti-infective agents, analgesics and antipyretics, and anti-inflammatory drugs. Most of the reported reactions are related to skin reactions and gastrointestinal disorders. It is unquestionable that such voluntary reporting is more useful qualitatively than quantitatively. Even though there are a lot of problems facing us in assessing adverse drug reactions, it is a necessity to have the programme running and improving as time goes by. There is an urgent need for well-trained personnel to perform such tasks. PMID- 3821424 TI - Reporting systems for rare side effects of non-narcotic analgesics in India. Problems and opportunities. AB - Soon India will launch a fully developed system to monitor adverse drug reactions. The national requirement for this project encompasses 12 regional centres; district hospitals and primary health centres will be affiliated to these. Patient investigation and referrals will be manned by completely trained medical and paramedical personnel. The system is expected to become operational by 1987. Peculiar problems arise in the scientific research of adverse drug related events in India: illiteracy, the strong influence of traditional medicine, over-the-counter drug availability, inadequate numbers of trained personnel, shifting doctor-patient relations and costs. There is an opportunity for rigorous prospective epidemiological investigation in India, since the great majority of the population depends on governmental health support. Detailed drug related events, timing of exposure and withdrawal can be accurately monitored. Various influential 'non-drug' factors relevant to the drug reaction must be considered in the assessment of any adverse drug reaction. PMID- 3821425 TI - The assessment of risks, benefits and availability of non-narcotic analgesics. A commonsense approach. AB - In Indonesia, about 50% of all available non-narcotic analgesics are marketed as single drugs and the other half comprise fixed combination products. Each country should decide through a national drug policy which drugs are to be available, but it is important such policies be flexible and cognisant of the needs of the public and of the pharmaceutical industry. A drug should not be withdrawn from the market without an objective scientific assessment of its benefit-risk ratio. However, reevaluation of some drugs marketed previously should be undertaken, including combinations of non-narcotic analgesics. Although it is often said that evaluation of drugs should be left to experts in the established drug control agencies and that the third world countries should follow their decisions, there is a good argument for the developing countries to formulate and implement their own drug policies. In evaluating a non-narcotic analgesic, efficacy and safety must be carefully considered and a drug with marginal efficacy should not be approved for use. However, a non-narcotic analgesic with superior efficacy should probably be approved for use even if there is some risk associated with usual therapeutic dosages. Commonsense reasoning demands that drugs should be for the layperson to treat common ailments, although such drugs must fulfil exacting criteria of efficacy, safety and simplicity of use. PMID- 3821426 TI - The regulatory challenge. AB - The concepts of drug regulation should ideally be derived from an appropriately defined and broadly agreed national drug and health policy, according to health needs, relevant criteria and the local circumstances. The major long term challenge emerging from these concepts is how to establish a sufficiently comprehensive and functional drug and therapeutic audit as a basis for regulatory and other decisions within the health chain that strike a balance between sociomedical and economic requirements. Such an audit involves three sequential phases: collection and compilation of all relevant facts and premises; data organisation and analyses by competent auditors and decision, implementation, and re-evaluation with subsequent adjustments. Despite extensive international and national efforts during recent years, only fragmentary solutions exist, and only in a few countries. Thus, another major challenge still remains: how to weight and integrate the sometimes quite conflicting interests and scopes of politicians, administrators, the teaching institutions, the health professions, the pharmaceutical manufacturers--and the consumers. All the partners involved have to emphasise that the problems behind the present miseries of global drug use are basically of political and economic nature, although there are considerable limitations imposed by widely varying attitudes and deficient knowledge and criteria. Thus there is a need for joint action and a strengthening of collaboration and communication combined with the best possible elements of professional skills and common sense. PMID- 3821427 TI - Post-marketing management of the use of non-narcotic analgesics. AB - While the use of non-narcotic analgesics is of considerable health benefit to people everywhere, they also represent a health problem. This problem has to do more with the risks associated with individual courses of treatment than with the commonality of those treatments. The public health challenge in post-marketing management of non-narcotic analgesic use, is to promote a pattern of use such that the risks are justifiable by the benefits and are the lowest that can be attained. To achieve such goals it is essential to have scientific knowledge about the benefits and risks and to be able to determine the quality of use in the population as to how proper it is. Current post-marketing management programmes focus largely on regulation, overlooking other equally important basic methods of public health intervention, namely education and service. If it is accepted that mass education is the key element in the proper management of non narcotic analgesic use, the present emphasis on regulation needs amendment. Such changes will take time, but it is conceivable that ultimately the management goal can be achieved with minimal regulatory intervention. PMID- 3821428 TI - Regulatory decisions and consumers. AB - Consumers expect regulatory authorities to evaluate the risks and benefits of non narcotic analgesics both before marketing and throughout their marketing life. In making their evaluation, regulatory authorities attempt to ensure that before a product is marketed it is of satisfactory quality, is efficacious, tested for likely toxicological hazards and that prescribers are provided with appropriate, objective information. After marketing of a drug, regulatory authorities use spontaneous adverse drug reaction (ADR) reporting systems as their principal monitoring technique and use the data collected to help identify risk factors for human toxicity. PMID- 3821429 TI - Regulatory decisions and the pharmaceutical industry. AB - National regulations on medicines are generally accepted as an important mechanism for ensuring that only medicines of adequate quality, safety and efficacy are available in the community. However, there are potential adverse effects of such regulations which should be kept within limits as far as possible. The recent history of non-steroidal anti-inflammatory drugs (NSAIDs) with withdrawal of 9 drugs in 6 years suggests that something is wrong with the current system and that improvements are needed. Attention is drawn to 3 key areas. Firstly, that a number of general conditions are important in the relationship between regulators and pharmaceutical companies. Secondly, the long life cycle of a medicine contains 2 phases for regulatory decisions--pre marketing and post-marketing--but there is a discrepancy in the data, criteria and standards used in each. A new medicine is licensed on the basis of a large amount of accurate, scientific laboratory and clinical data, but, of necessity, before experience is available from general field use. Hence, research continues after marketing in respect of efficacy and safety in the new situation of ordinary field use. Usually this enables refinements to be made in methods of use and sometimes very useful new formulations or dramatic new uses of the drug are discovered. Testing for efficacy is accurate and becoming further refined by measuring the quality and duration of life provided by medicines. Suspicions of rare serious reactions are easily raised by a few anecdotal reports but are much more difficult to test, as accurate data are not available.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821430 TI - Importance of valid measurements of benefit and risk. AB - Without good measurement of both the risks and benefits of drugs, perceptions are bound to be distorted. Similarly, interpretations of findings are likely to be inappropriate, thus leading to decisions by regulatory bodies that are less than optimal. When measuring health phenomena in populations, both numerators and denominators must be determined to permit calculation of prevalence (frequency at a given time), incidence (frequency of new events over a specified period of time), mortality and case-fatality rates. Attribution of an adverse drug reaction to a particular drug can be the most demanding challenge for the clinician, the scientific investigator and the regulator. Criteria that must be met to establish a link between an apparent adverse drug reaction and an incriminated product include, biological plausibility, chronological and timing relationships, specificity, and response to dechallenge and to rechallenge. Acceptable chronology requires that a drug be shown to be taken before the onset of the adverse effect, not after symptoms have appeared. The unmet challenge of measuring benefit is more difficult than the measurement of harm. The need for valid measurements of risk and benefit remains compelling and urgent. PMID- 3821431 TI - Prescription-Event Monitoring. Recent experience with 5 NSAIDs. AB - The principles and methods of Prescription-Event Monitoring (PEM) are presented and illustrated by a study of general practice notes of 55,642 patients, who were prescribed one of five non-steroidal anti-inflammatory drugs (NSAIDs). PEM showed the expected side effects and a low incidence of serious adverse reactions. The general pattern of events during and following treatment was, with few exceptions, very similar. The incidence of side effects that have led to the withdrawal of three of the drugs from the market was extremely low. Complications of peptic ulcer were uncommon and deaths from this cause were rare. No difference was apparent in the incidence of serious gastrointestinal complications during or after stopping treatment or changing to another NSAID. PMID- 3821432 TI - Post-marketing surveillance in New Zealand. AB - In early 1977, the Intensive Medicines Monitoring Programme (IMP) was instigated for selected medicines with novel chemistry or pharmacology and those expected to be widely used. Pharmacists are requested to record the patient and prescribing doctor's details along with the medicine dose and duration of the prescription. Doctors are asked to send details of any unexpected clinical events. Doctors' spontaneous returns are low and have been supplemented by regular surveys. Now a new self-carboned prescription form has recently been introduced upon which doctors indicate if events have occurred. Since trial introduction of the new system the rate of event reporting in the test areas has increased 15-fold. In view of this, the duplicate prescription system will be introduced to the whole country over the next 3 years. In the past, the IMP has been used to follow up signals of new adverse events, to establish adverse drug reaction profiles and to establish risk-benefit indications. PMID- 3821433 TI - Rare but serious risks associated with non-narcotic analgesics: clinical experience. AB - Our data show that 1% of patients who required hospital treatment did so due to severe adverse reactions to analgesics. The most frequent adverse reaction was major gastrointestinal bleeding after aspirin, indomethacin, phenylbutazone or naproxen. Thrombocytopenia, second in frequency, was also mainly a complication of aspirin treatment, as was severe vertigo and tinnitus. Allergic reactions and leucopenia or agranulocytosis occurring in single cases only were associated with the use of pyrazolones. Patients with nephropathy were usually taking phenacetin or one of the close derivatives paracetamol or bucetin. Intensive monitoring for adverse reactions to drugs in 6,000 hospitalised patients in medical wards showed that analgesics, although frequently used, did not lead to life-threatening reactions. Gastrointestinal and neurological side effects were the most commonly observed reactions and these occurred more often after aspirin, indomethacin or pentazocine than after dipyrone or tilidine. Preliminary data of an international case-control-study on agranulocytosis and aplastic anaemia suggest that the incidence of agranulocytosis was in the order of 2 to 3 per million users of analgesics per year. Agranulocytosis occurred predominantly with pyrazolones, with a mortality of 1 to 2 per 10 million users per year. A cohort study on the treatment of colic pain in general practice showed that serious events most likely due to adverse reactions to analgesics were bronchospasm, shock fragments or shock. The incidence of these serious events was about 2 in 1,000 treated cases. The relative risk was not increased by treatment with pyrazolones, opioids or other drugs. PMID- 3821434 TI - Special problems of adverse reaction assessment in Indonesia. AB - Limited experience with adverse drug reaction (ADR) monitoring in Indonesia is one of the difficulties faced in the developing programme. Problems which arise are related to data collection, quality of reporting, reaction-type reported, and assessment of cause-effect relationships, in addition to problems related to personnel and other factors. PMID- 3821435 TI - Adverse drug reaction reporting. Philippine experience. AB - For almost 20 years, the Philippine Medical Association, and specifically its Committee on Foods, Drugs and Cosmetics, has not been able to successfully gather information on adverse drug reactions (ADRs). The reporting of ADRs began in 1967, using a very comprehensive reporting form, at a time when news items of anaphylactic shock and deaths allegedly from intramuscular injections of penicillin, and subsequent litigation, were appearing. Up until 1973, when there were new initiatives, a few ADR reports were obtained mainly from hospitals who employed Philippine Medical Association committee members. Despite the issuing of directives for co-operation from hospitals, reports were not forthcoming. Involvement of hospital pharmacists and officers of specialist societies subsequent to the arrival of a World Health Organization (WHO) consultant in 1981 resulted in a simplified reporting form. Initial enthusiasm generated some ADR reports, but information was often inadequate and requests for further details were ignored. A new form entitled 'Drug Experience Reporting'--based on the USA FDA example--was introduced in 1984, when the Philippine Pediatric Society on ADR reporting also designed a project for use in hospitals. A change in doctor and patient attitudes is necessary before progress can be made, and a new strategy based on the education of doctors and medical students has been implemented. An important requirement is a mechanism to review and assess ADRs that will satisfy health authorities and maintain confidentiality. PMID- 3821436 TI - Detection of cocaine in rats from analysis of hair. PMID- 3821437 TI - A possible morphological sexual dimorphism in the human gastrocnemius muscle. PMID- 3821438 TI - A unit for 'psychopathic disorder' patients in Broadmoor Hospital. PMID- 3821439 TI - Wandering at Heathrow Airport by the mentally unwell. PMID- 3821440 TI - A biochemical hypothesis of wandering. PMID- 3821441 TI - Psychiatric court referrals in Sweden. PMID- 3821442 TI - Identification of spermatozoa through fluorescent microscopy. PMID- 3821443 TI - The West German experience in drink driver improvement courses. PMID- 3821444 TI - On the close connection between forensic medicine and pathology--a recollection. PMID- 3821445 TI - Things are not always what they seem! Joule burns in electrocution--a report of four cases. PMID- 3821446 TI - [Design principles for a multifunction programmed electrocardiostimulator]. PMID- 3821447 TI - [Optimization of the shape of implantable electrocardiostimulators]. AB - The deficiencies of current electrocardiostimulation equipment are being discussed on the basis of analysis of cases with the device implantation. The authors propose changing the shape of the electrocardiostimulator so, that the frame of the device were surrounded by soft tissue. PMID- 3821448 TI - [Current status and outlook in the further development of methods and technological resources for electrocardiostimulation]. PMID- 3821449 TI - [A basic line of automated devices for assessing the functions of the human central nervous system]. PMID- 3821450 TI - Cardiovascular responses to exercise and stress in the borderline hypertensive rat. AB - This report demonstrates the effect of voluntary exercise in attenuating increases in heart rate (HR) caused by chronic stress in an animal model of stress-induced hypertension, the borderline hypertensive rat (BHR). Exercise training also protected against the hypertensive effects of stress in 16-wk-old, but not 10-wk-old animals. In the first experiment, adult borderline hypertensive rats were subjected to 1 wk of signaled shock followed by 6 wk of signaled, unsignaled, or no shock. Half of these animals also had free access to a running wheel. Blood pressure (BP) and HR were measured before and after treatments by the tail cuff method. Exercise was found to significantly attenuate the rise in BP by 56% and HR by over 100%, as compared to non-exercised animals. In a second study, borderline hypertensive rats were subjected daily to anticipation of shock or handling for 6 wk. Half of these animals could exercise voluntarily. BP and HR, measured weekly under light ether anesthesia, increased over time due to both stressors alone. Exercise attenuated stress-induced increases in HR by 50%, but did not attenuate BP. These studies demonstrate that voluntary exercise can reliably attenuate increases in HR regardless of age or concurrent stress, but the protective effects of exercise on stress-induced hypertension may interact with the age of the subject. PMID- 3821451 TI - Effect of exercise on recovery blood pressure in normotensive and hypertensive subjects. AB - The effects of dynamic exercise on the acute recovery blood pressure (BP) were studied in normotensive and hypertensive subjects. Three groups [eight normotensives, age 19 to 29 yr (N1); eight normotensives, age 35 to 62 yr (N2); and eight hypertensives, age 44 to 57 yr (H)] were tested over three separate sessions. The first two sessions were for familiarization with the protocol and test procedures. Resting systolic BP decreased (P less than 0.01) in all groups from sessions 1 to 3: N1 = 126 to 121 mm Hg; N2 = 127 to 120; H = 155 to 142. Resting diastolic BP decreased (P less than 0.05) in the N1 and H groups from 77 to 73 and 98 to 95 mm Hg, respectively. On the third day, each subject followed the protocol of Wilcox et al. (8) of 15 min of seated rest, five 10-min periods of treadmill walking with a 3-min rest between each period, and 60 min of seated recovery. Exercise was performed at 67% of estimated maximal heart rate. In all three groups, significant (P less than 0.05) reductions in both systolic BP (N1 = -12 +/- 1; N2 = -10 +/- 2; H = -12 +/- 3) and diastolic BP (N1 = -5 +/- 2; N2 = 5 +/- 1; H = -7 +/- 2) occurred from pre-exercise rest to post-exercise rest. Systolic BP remained lower following 60-min recovery (P less than 0.02), while diastolic BP returned to pre-exercise levels in all three groups. No between group differences were observed in the magnitude of reduction of BP post exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821452 TI - Thermoregulatory responses to skin wetting during prolonged treadmill running. AB - We examined the physiological responses to skin wetting during a 120-min level treadmill run to assess whether skin wetting would reduce the dehydration and the increase in core temperature associated with prolonged exercise. Testing was conducted in an environmental chamber (T = 29.5 degrees C, wind velocity = 3 m X sec-1) under two different humidity conditions (33 or 66% relative humidity). Ten male subjects performed two runs in each humidity condition; one served as a control run. The other included spraying the body with 50 ml of water (T = 29.5 degrees C) every 10 min. Spraying had no effect on rectal temperature (Tre), heart rate, oxygen consumption, perceived exertion, sweat loss, or percent change in plasma volume in both the humid and the dry conditions. Spraying produced a significant reduction in mean skin temperature (Tsk), which increased the (Tre - Tsk) gradient. At the same time, overall skin conductance (K) was decreased, presumably as a result of cutaneous vasoconstriction due to the low Tsk. Since heat transfer from the body's core to the skin is expressed by the equation: heat transfer = K X (Tre - Tsk) the spraying had no effect on heat transfer away from the core, and Tre remained unchanged. PMID- 3821453 TI - Influence of selected carbohydrate drinks on cycling performance and glycogen use. AB - Eight well-trained male cyclists were used to determine the influence of carbohydrate feedings on exercise performance and muscle glycogen use. Two days prior to each trial, the subjects performed a 60-min "depletion ride" at 70% VO2max, which was followed by the ingestion of a high carbohydrate diet (approximately 500 g X -1). During the experimental trials, the men performed 2 h of cycling exercise and consumed 150 ml of 1 of 4 solutions at 24-min intervals. The drinks were: H2O (artificially flavored and sweetened); maltodextrin (5 g X 100 ml-1) and fructose (5 g X 100 ml-1); maltodextrin (7.7 g X 100 ml-1) and high fructose corn syrup (2.3 g X 100 ml-1); maltodextrin (3 g X 100 ml-1 and glucose (2 g X 100 ml-1). The amount of work completed during the four trials was not significantly different. Initial glycogen levels were high, and glycogen values were not significantly different at the beginning of exercise or at 90 min (185.35 +/- 3.26 and 91.93 +/- 3.39, respectively). Blood glucose was greater at 60 min in trial maltodextrin and glucose (5.70 +/- 0.36 mmoles X l-1), maltodextrin and high fructose corn syrup (6.05 +/- 0.54), and maltodextrin and fructose (6.03 +/- 0.42) compared to H2O (4.97 +/- 0.35) (P less than 0.05). Blood glucose remained elevated at 90 min during the maltodextrin and fructose and maltodextrin and high fructose corn syrup trials and at 120 min in the maltodextrin and fructose trial. No differences were observed between trials in blood lactate, serum glycerol, respiratory exchange ratio, or the subjects' perception of effort.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821454 TI - The ultraendurance triathlete: a physiological profile. AB - To better characterize the athletes who participate in ultraendurance triathlons, 14 triathletes in training for the Hawaii IRONMAN triathlon were studied. A physical and physiological profile was developed from anthropometric measurements and oxygen uptake during maximal exercise on a treadmill, cycle ergometer, and arm ergometer. A comparison of the maximal values among exercise modes and between males and females was made. A comparison of height, weight, and percent body fat of these triathletes with elite athletes from the sports of swimming, cycling, and running showed the physique of triathletes to be most similar to that of cyclists. Oxygen uptake at maximal exercise was, for males and females, respectively: 68.8 ml X kg-1 X min-1, 65.9 ml X kg-1 X min-1 on the treadmill; 66.7 ml X kg-1 X min-1, 61.6 ml X kg-1 X min-1 on the cycle ergometer; and 49.1 ml X kg-1 X min-1, 39.7 ml X kg-1 X min-1 on the arm ergometer. When comparing the highest oxygen uptake attained at maximal exercise in any one of the three exercise modes, the male triathletes are comparable to swimmers, but have a lower aerobic capacity than cyclists or distance runners. The female triathletes studied were able to attain oxygen uptake values greater than those previously reported for female athletes. PMID- 3821455 TI - Physiological responses of triathletes to maximal swimming, cycling, and running. AB - The objectives of this study were to: (a) develop a physiological profile for a group of trained triathletes and (b) determine whether multiple modes of training result in general or specific adaptations. VO2max of 13 trained triathletes (mean = 29.5 yr) was measured during treadmill running (TR), cycle ergometry (CE), and tethered swimming (TS) over a 6-wk period encompassing a half-triathlon (1.2 mile swim/56 mile bike/13.1 mile run). Most subjects performed two tests in each mode. Since test-retest reliability coefficients for TR, CE, and TS VO2max were 0.97, 0.93, and 0.97, respectively, results were averaged: formula; see text The mean TR VO2max indicated that the subjects were well-trained, but not of elite caliber. Mean CE VO2max was 95.7% of the TR value, which is greater than the value typically found in non-cyclists (88 to 92%) but less than that of highly trained cyclists (98 to 105%). Mean TS VO2max was 86.6% of the TR value. As in cyclists, this percentage is greater than that of recreational swimmers (78 to 82%) but less than that of elite swimmers (93 to 95%). Running and cycling times in the triathlon were significantly (P less than 0.01) related to the corresponding VO2max values (r = -0.68 and r = -0.78, respectively), but swimming times were not (r = -0.50). It is concluded that these triathletes were well trained in all events, but not to the same extent as athletes who train in only one sport. Running and cycling performance were associated with VO2max.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821456 TI - Strength and anaerobic responses of elite young female sprint and distance runners. AB - The purpose of this study was to assess the strength and anaerobic responses of elite young female runners, in order to determine the relationship of these characteristics to age and high proficiency in sprint events. Thirty-one national junior-level sprint and middle distance runners were evaluated for isokinetic peak torque for leg extension at velocities ranging for 30 degrees to 300 degrees X s-1, anaerobic power and capacity based on the Wingate test, and body composition based on underwater weighing. Age-related and event-related differences were noted for both the peak torque and anaerobic response measures. Peak torques were greater for the older (greater than 11.67 yr) runners and greater for the sprinters when measured at the higher testing velocities. Anaerobic power and capacity were also greater for the older runners, but event related differences only appeared when anaerobic power was adjusted for fat-free weight (adjusted anaerobic power was greater in the older sprinters). These results indicate that both age and fat-free weight influence strength and anaerobic responses in young female runners and that exceptional levels of such characteristics only appear for sprinters within the upper age groups of youth competition. PMID- 3821457 TI - Aerobic and anaerobic power of Canadian wheelchair track athletes. AB - The aerobic and anaerobic capabilities of six wheelchair track athletes were determined on a wheelchair ergometer prior to their competition in the 7th World Wheelchair Games. The sample included two male tetraplegics, one female paraplegic, and three male paraplegics, each in different competitive classifications. The evaluation of the anaerobic capabilities of the athletes involved determination of the total work accomplished during a 30-s all-out effort and the peak power output (PO) during a 5-s interval of this test. Aerobic capability was determined as the peak oxygen uptake and associated PO over a 1 min time period during a continuous progressive intensity test to exhaustion. Peak oxygen uptakes ranged from 1.00 to 3.43 1 X min-1 (16.9 to 50.7 ml X kg-1 X min-1) and aerobic PO from 19 to 120 W. Peak anaerobic PO was 21 to 70% higher (31 to 148 W) than aerobic PO, and total work in 30 s ranged from 740 to 4345 J. The male paraplegics displayed the highest values while the class 1A tetraplegic had the lowest. These laboratory findings were in general agreement with the athletes' performances in their track events. PMID- 3821458 TI - Effects of leg press training on cycling, leg press, and running peak cardiorespiratory measures. AB - Six males and seven females trained 3 d per wk (30 min at 80 to 85% heart rate reserve) for 20 wk on a leg press apparatus. A progressive exercise test was administered on a cycle ergometer, leg press apparatus, and treadmill before and after training. Before training, peak oxygen consumption (VO2, ml X kg-1 X min-1) during the leg press test was higher for the males (23.9 +/- 1.60, mean +/- SE) compared to the females (19.5 +/- 2.40, P less than or equal to 0.05). Peak VO2 during the cycling (males = 36.6 +/- 2.65, females = 28.5 +/- 2.35) and treadmill (males = 39.8 +/- 2.04, females = 33.2 +/- 2.64) tests was also different between the sexes, and 30 to 40% higher than during the leg press test (P less than or equal to 0.05). Peak heart rate (beats X min-1) was not different between the sexes (P greater than 0.05), yet was 11% lower during the leg press test (165 +/- 3.5) compared to the cycling (184 +/- 2.8) and treadmill (187 +/- 1.3) tests (P less than or equal to 0.05). After training, peak VO2 during the cycling and treadmill tests increased 10 to 15%, compared to 35% during the leg press test (P less than or equal to 0.05). The only change in peak heart rate was a 6% increase during the leg press test (P less than or equal to 0.05). Although peak VO2 on the leg press apparatus was lower than on the cycle ergometer and treadmill, leg press exercise elicited a sufficient stimulus for increasing peak VO2 on the three testing modes. PMID- 3821459 TI - The use of pulse oximeters during exercise, a measurement with unproven reliability and validity. PMID- 3821460 TI - The effects of aerobic conditioning and/or caloric restriction in overweight men and women. PMID- 3821461 TI - RARE imaging: a fast imaging method for clinical MR. AB - Based on the principles of echo imaging, we present a method to acquire sufficient data for a 256 X 256 image in from 2 to 40 s. The image contrast is dominated by the transverse relaxation time T2. Sampling all projections for 2D FT image reconstruction in one (or a few) echo trains leads to image artifacts due to the different T2 weighting of the echo. These artifacts cannot be described by a simple smearing out of the image in the phase direction. Proper distribution of the phase-encoding steps on the echoes can be used to minimize artifacts and even lead to resolution enhancement. In spite of the short data acquisition times, the signal amplitudes of structures with long T2 are nearly the same as those in a conventional 2D FT experiment. Our method, therefore, is an ideal screening technique for lesions with long T2. PMID- 3821463 TI - Fat and water separation at 0.23 T using simultaneous shift selective imaging. AB - Based on the principle of selective inversion of the fat or water signal, we have developed a method which allows the simultaneous acquisition of separated fat and water images. In combination with multiecho techniques, this allows the determination of shift selective relaxation times. A detailed analysis of the relaxation behavior of a human leg at 0.23 T shows, that T2 of fat and water can differ by a factor of two or more. We think, that the potential of MRI for differential diagnosis can be greatly enhanced using our method. PMID- 3821462 TI - Nuclear magnetic resonance study of high-energy phosphate stores in models of adriamycin cardiotoxicity. AB - Previous studies have suggested that one of the mechanisms of adriamycin (ADR) cardiomyopathy is depletion of high-energy phosphate stores (HEP). To examine this hypothesis, we used 31P nuclear magnetic resonance to assess the adenosine triphosphate-to-phosphocreatine ratio (ATP-to-PCr ratio) in Langendorff-perfused rabbit hearts. Using either an acute (5 days of therapy at 5 mg/kg/day) or chronic model (7 to 10 weeks of therapy at 1.2 or 1.5 mg/kg twice a week), we compared isovolumetric LV systolic pressure, heart rate, ATP-to-PCr ratios, and histologic lesions between the treated and control animals in each model. In the acute model, there was a significant increase in the ATP-to-PCr ratio (P less than 0.02), without significant changes in myocardial function. Despite significant hemodynamic and histologic alterations in the chronic model, compared to controls, we were unable to identify significant differences in ATP-to-PCr ratios. We conclude that there appear to be differences in energy metabolism between the acute cardiotoxicity and the chronic cardiomyopathy of ADR in the rabbit model and the mechanism of the chronic cardiomyopathy from ADR therapy does not appear to be related to progressive impairment of cellular high-energy phosphate metabolism as measured by the ATP-to-PCr ratio. PMID- 3821464 TI - Some results of high-flow-velocity NMR imaging using selection gradient. AB - A simple and new flow velocity measurement technique using conventional spin-echo sequence is proposed and its applications to a preclinical result are presented. This technique utilizes the phase velocity encoding effect due to 180 degrees rf and its corresponding selection gradient. This phase encoding and its phase velocity relations have been obtained by numerical solution of the Bloch equation. A flow velocity measurement obtained with a volunteer using this proposed technique indicates close agreement with other previously measured values. PMID- 3821465 TI - Quantitative proton chemical-shift imaging. AB - Recently W. T. Dixon (Radiology 153, 189 (1984))introduced a simple method of proton chemical-shift imaging which requires only two images, a conventional (in phase) image and an image in which fat and water protons are 180 degrees out of phase during signal acquisition, to separate the signals from fat and water protons. We have tested the application of this method to the quantitative determination of fat content and fat and water longitudinal relaxation times, and analyzed the effects of random and systematic errors. Ten phantoms were constructed with a range of fat contents (0-50% by weight) and water T1's (300 800 ms). Fat and water T1's were measured with a 0.6-T clinical imaging system in two ways: using the system as a spectrometer with all gradients off, and from least-squares fits to in-phase and out-of-phase image data made with six values of TR. The image-derived values of water T1 agreed well with spectrometer-derived values (r = 0.97) and the image derived fat fraction correlated strongly with the fat fraction by weight (r = 0.995). The effects of random and systematic errors were analyzed for a minimum data set of four images: in-phase and out-of-phase images at two values of TR. The pair of TR values which minimize the variance in water T1 were calculated, and for these pulse sequences the effects of two potential systematic errors were calculated: inhomogeneities in the main field, which will reduce the intensity in out-of-phase images compared to in-phase images even for pure water samples, and an incorrect shift of the 180 degrees pulse in the out-of-phase pulse sequence, corresponding to an inaccurate assumed chemical shift. With careful attention to such systematic effects the Dixon method is capable of producing reliable quantitative measurements. PMID- 3821466 TI - New polyvinyl alcohol gel material for MRI phantoms. AB - Nambu PVA gel which is produced by repeated freezing and thawing of PVA solution has overcome almost all of the problems which present substances have: It is close to human soft tissue in MRI parameters. MRI parameters (1H density, T1, T2) are adjustable to some extent. It has appropriate physical characteristics. The important problem with PVA gel is long-term stability. It is assumed that this problem can be solved by its periodic calibration and replacement. PMID- 3821467 TI - Sodium-23 NMR relaxation times in body fluids. AB - 23Na longitudinal and transverse NMR relaxation times were measured in human serum, plasma, cerebrospinal fluid (CSF), and solutions of plasma proteins. The magnetization decay curves could not be resolved into two exponentials. A procedure to extract quantitative information from the measured relaxation rates in such a case was developed. The relaxation times of 23Na in serum and plasma were analyzed in terms of the different contributions from free Na+, Na+ bound to small molecules, and Na+ bound to various protein fractions in these body fluids. While T1 is essentially that of free Na+ in a solution which is slightly more viscous than salt solution, T2 is influenced by binding to proteins with the largest contribution from serum albumin. The effect of binding to small molecules on T1 and T2 is negligible. From measurements of the relaxation times at several magnetic field strengths a rotational correlation time of Na+ bound to serum albumin of 16 +/- 6 ns was obtained. The fraction of bound Na+ in serum and plasma was roughly estimated as 0.02% of the total sodium. The relaxation times in cerebrospinal fluid are very similar to those of NaCl solution. PMID- 3821468 TI - Surface-coil T1 images. AB - A method for producing calculated T1 images with high signal-to-noise ratio and good spatial resolution using surface coils is presented. Separate transmit and receive rf coils with electronic decoupling are employed to insure uniform B1 excitation. The sensitivity profile of the receiver coil is normalized out of the image by the T1 calculation. T1 values determined by this method show close agreement with previously reported values. PMID- 3821469 TI - 31P NMR measurements of T2 relaxation times of ATP with surface coils: suppression of J modulation. AB - The efficiency of selective refocusing pulses to suppress J modulation of spin echoes when using the surface-coil technique has been investigated. 31P T2 values obtained for ATP by the HAHN spin-echo method remain in good agreement when the standard refocusing pulse is replaced by selective pulses based on the DANTE excitation method. PMID- 3821470 TI - An evaluation of the effect of fasting on the exercise-induced changes in pH and Pi/PCr from skeletal muscle. AB - The changes in the response of skeletal muscle to maximal dynamic exercise were investigated in going from a fasted state to a refed state by means of 31P NMR spectroscopy. It was found that in the fasted state, exercise-induced changes in Pi/PCr and in pH were both inhibited, in comparison with those in the refed state. PMID- 3821471 TI - A simple fiber optic monitor of cardiac and respiratory activity for biomedical magnetic resonance applications. AB - A fiber optic reflectometer, capable of monitoring physiological parameters in a high magnetic field without significant disturbance of either rf or static fields, is described. Both cardiac and respiration rates were monitored with this optical device while 31P NMR spectra of the liver of an anesthetized rat were acquired. PMID- 3821472 TI - Localization of unaffected spins in NMR imaging and spectroscopy (LOCUS spectroscopy). AB - A new method for the localization of NMR spectra in vivo is presented. Herein a series of selective 90 degrees pulses with different carrier frequencies in the presence of magnetic field gradients is saturating spins of unwanted regions. Only spins in the region of interest are left unaffected. The LOCUS (localization of unaffected spins) spectrum of this region is measured by a single 90 degrees excitation pulse. The FLASH imaging sequence combined with the LOCUS technique allows the identification of the region of interest. PMID- 3821473 TI - The utilization of two frequency-shifted sinc pulses for performing volume selected in vivo NMR spectroscopy. AB - A new approach to volume-selected in vivo NMR spectroscopy uses two frequency shifted sinc pulses, in conjunction with pulsed field gradients, to destroy the coherence of the unwanted signals. A hard pi/2 pulse can then be used to read the z magnetization in the region of interest. This method is independent of T2, provides complete volume selection in a single acquisition, and can be readily implemented on most high-field commercial imaging/spectroscopy systems. PMID- 3821475 TI - Effects of calcium antagonists on high-energy phosphates in ischemic rat brain measured by 31P NMR spectroscopy. AB - The effects of various calcium antagonists on the ATP, PCr, and Pi levels as well as intracellular pH in normal and ischemic rat brain were examined by 31P NMR spectroscopy using a surface coil. None of the calcium antagonists tested showed any effect in the nonischemic rat brain. However, when global ischemia was induced by cardiac arrest, the ensuring rapid decrease of ATP and PCr and concomitant increase of Pi were significantly retarded by dihydropyridine calcium antagonists, but not by verapamil. The fall in pH caused by ischemia was not affected by either drug. Barbiturates showed effects similar to calcium antagonists, whereas calcium agonists showed the opposite. These results suggest that dihydropyridine calcium antagonists, similar to barbiturates, decrease the high-energy phosphate consumption of the brain, which might be beneficial in instances where their production is severely hampered, e.g., during ischemia. PMID- 3821474 TI - Correlative study of properties of water in biological systems using ultrasound and magnetic resonance. AB - Ultrasonic and nuclear magnetic resonance properties of media rich in water are investigated. The chemical shift of the water proton in pure water, aqueous solutions of tertiary butanol, and sodium chloride is shown to be linearly correlated to the reciprocal of sound speed in these media. A new method of determining the self-diffusion coefficient of water by using acoustic nonlinearity and sound speed is proposed. The method is tested on a variety of media that include pure water, aqueous solutions of glycerol, serum albumin, egg constituents, plant tissues, frog muscle and liver, and excised human tissues. In all the cases the results are found to compare closely to diffusion coefficients measured by magnetic resonance. The results presented here indicate that the acoustic and magnetic resonance modalities, though inherently different in their origin, can provide closely related information on the properties of water. PMID- 3821476 TI - Tissue distribution and stability of metalloporphyrin MRI contrast agents. AB - Mn(III), Fe(III), and Gd(III) complexes of tetrakis(4-sulfonatophenyl)porphyrin (TPPS) and several other porphyrins were evaluated as potential MRI contrast agents. Based on consideration of relaxivity and stability properties in solution, MnTPPS was found to be the compound of choice. At pH 7 the Gd and Mn complexes significantly enhanced the water proton relaxation rate, while the relaxivity of FeTPPS exhibited a significant loss of relaxivity above pH 6 due to oxy-dimer formation. Although GdTPPS exhibited the highest relaxivity in solution, this property was rapidly lost due to dissociation of the metal ion. By contrast MnTPPS remained stable in human plasma after incubation for 9 days. Upon intravenous injection into athymic mice bearing subcutaneous human colon carcinoma xenografts, MnTPPS provided enhanced relaxation of the tissue water in several excised mouse tissues, notably kidney, liver, and tumor. The results at a fixed field (0.25 T) and relaxation dispersion studies showed decreases in water relaxation rates with time for kidney and liver, but an increase for the tumor, with a maximum near 4 days at the highest dose used. PMID- 3821477 TI - Errors in T2 estimation using multislice multiple-echo imaging. AB - Accurate T2 images calculated from multiple-echo sequences are difficult to obtain over a number of contiguous slices due to the presence of unwanted echoes that are generated at the slice edges. This problem is similar to problems encountered in single-slice imaging in the presence of rf pulse imperfections. In this paper, we use computer simulations to show that all unwanted echoes can be eliminated by defocusing them using additions to the slice-selection gradients. Accurate T2 images may then be calculated from the remaining echoes. We also present a method of experimentally displaying the slice shapes of unwanted echoes generated by a multislice imaging sequence. PMID- 3821478 TI - Localized magnetic resonance imaging with oscillating gradients. AB - Hinshaw's sensitive-point method and Macovski's post-filtering localization techniques are analyzed under very general imaging conditions. It is shown that one can obtain an expression for the FID signal induced by all resonating particles at any particular point in the imaged object. Contributors to the signal may have different relaxation behaviors, spin rates, and velocity components. In fact, in the case of flows, different nuclei contribute to the signal at different times during the observation. Localization enables us to impose local assumptions on our model rather than global ones, as is usually done in MRI. Applications to imaging slow and fast flows and in vivo spectroscopy are discussed. PMID- 3821479 TI - Small animal imaging with a clinical magnetic resonance imager. AB - Any clinical whole-body MR imager can be adapted for experimental small animal imaging. The design of an rf receiver coil and an efficient magnified imaging technique are presented. Application of this small animal imaging technique is illustrated using a study of paramagnetic contrast enhancement of a tumor in the mouse. PMID- 3821480 TI - The flip-angle effect: a method for detection of sodium-23 quadrupole splitting in tissue. AB - A method is presented for the detection of quadrupole splitting in tissue, where the spectral line splittings are typically unobservable. The method used is a study of the rate of rotation of the flip angle as a function of radiofrequency (rf) amplitude. Our results with samples of skeletal muscle and cat brain indicate the absence of quadrupole splitting. PMID- 3821481 TI - Maximum entropy method in phase-encoding NMR imaging. PMID- 3821482 TI - 31P magnetic resonance spectroscopy of mesenteric ischemia. AB - 31P magnetic resonance spectroscopy (MRS) was performed in vivo on normal and ischemic rat intestine. Within 3 min after induction of ischemia, there is a dramatic fall in adenosine triphosphate (ATP) and rise in inorganic phosphate (Pi). Our results suggest that MRS may prove useful in the early detection of mesenteric ischemia. PMID- 3821483 TI - In vivo determination of body iron stores by natural-abundance deuterium magnetic resonance spectroscopy. AB - Induction of iron overload in mice using 1% (w/w) dietary carbonyl iron resulted in marked decreases in 1H and 31P NMR relaxation times. Natural-abundance deuterium (2H) NMR spectroscopy has been used to measure 2H T1 values in vivo in the presence of body paramagnetic iron. This procedure offers a method for noninvasive determination of body iron stores. PMID- 3821484 TI - Rapid Fourier imaging using steady-state free precession. AB - Reversal of the read gradient in a SSFP imaging experiment allows a full spin echo to be collected in the interval tau between successive rf pulses. Orthogonal gradient pulses are used to dephase and subsequently rephase the transverse magnetization each tau enabling 2D or 3D Fourier techniques. The minimum data collection time per slice in the 3D technique is 3.1 s (128 X 256). For a 2D data collection, an oscillating bipolar sawtooth gradient is used to select the slice. Each phase-encode value must be averaged over an equivalent portion of the oscillating slice-selection gradient and this condition gives a minimum of 25 s for 2D data collection. Excellent slice selection is achieved with less than 5% of the signal lying outside the slice profile central lobe. Images at 0.14 T show tissue contrast may be manipulated by changing the rf pulse angle, an example of which is the presence or absence of gray/white matter contrast at rf pulse angles of 30 and 90 degrees, respectively. The pulse angle theta dependence of five samples with different values of T2/T1 was measured and numerically calculated with good agreement between theory and experiment for theta less than or equal to 90 degrees. PMID- 3821485 TI - Staphylococcus aureus meningitis: a broad-based epidemiologic study. AB - In an effort to ascertain important epidemiologic and prognostic risk factors, we analyzed 33 cases of Staphylococcus aureus meningitis occurring over an 8-year period (1976 to 1984). Staphylococcus aureus caused 6% of all bacterial meningitis at our University Hospital. Fifty percent of cases were pediatric and included 7 newborn infants, of whom 71% were either premature or had low birth weight. Major underlying diseases were: central nervous system (CNS) disorders (55%), endocarditis (21%, predominantly intravenous drug abusers), other sites of infection (27%), and prematurity (24%). Fifty-seven percent of patients were bacteremic and 41% of those had concomitant bacteriuria. Hypoglycorrhachia was present in 27% of cases, positive cerebrospinal fluid (CSF) Gram stain in 20%, disseminated intravascular coagulation (DIC) in 19%, and methicillin-resistant organisms in 18%. Cerebrospinal fluid cultures remained positive for a protracted period (mean, 6.7 days) regardless of the presence or absence of a CNS shunt. Overall mortality was 21%. Favorable outcomes were associated with the eventual presence of sterile CSF (15.4% vs. 100% mortality) and the removal of foreign bodies (10% vs. 67% mortality). Mortality was also associated (p less than 0.5) with the presence of diabetes mellitus, age greater than 60, obtundation or coma on presentation, bacteremia, or DIC. Cure correlated (p less than .05) with CNS shunt-associated infections, age less than 1, normal neurologic examinations on presentation, or the absence of DIC or bacteremia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821486 TI - The inflected noun system in Serbo-Croatian: lexical representation of morphological structure. PMID- 3821487 TI - Processing lexical ambiguity and visual word recognition in a deep orthography. PMID- 3821488 TI - The word frequency effect in lexical decision: finding a frequency-based component. PMID- 3821489 TI - The role of structural context in perception: syntax in the recognition of algebraic expressions. PMID- 3821490 TI - Analytic and holistic modes of learning family-resemblance concepts. PMID- 3821491 TI - Inheritance of attributes in natural concept conjunctions. PMID- 3821492 TI - Metamemory for narrative text. PMID- 3821493 TI - Inexpert calibration of comprehension. PMID- 3821494 TI - Problems in the classification of congenital anomalies. PMID- 3821495 TI - Developing primitive signalling behavior of students with profound mental retardation. PMID- 3821496 TI - Financing community services in the United States: results of a nationwide study. PMID- 3821497 TI - Stress, social support, and health of psychiatric technicians in a state facility. PMID- 3821498 TI - Comparison of three measures of predictor VO2 maximum test protocols of adults with mental retardation: a pilot study. PMID- 3821499 TI - The promise and problems of high technology. PMID- 3821500 TI - Interactions of preschoolers with and without handicaps in integrated and segregated settings: a longitudinal study. PMID- 3821501 TI - Morphometric study of human hepatic cell modifications induced by fenofibrate. AB - We have studied liver biopsies obtained in 12 hyperlipoproteinemic (HLP) patients (type II, 6; type IV, 6) treated with diet and fenofibrate, and in 15 patients (type II, 11; type IV, 4) receiving diet only. Electron microscopy of liver biopsies and the morphometric analysis according to the method of Weibel and Rohr showed mitrochondrial changes in patients treated with fenofibrate, these changes depending on the type of hyperlipoproteinemia. In type II HLP, we found a decreased volume of normal mitochondria (fenofibrate, 125.72 +/- 17.04 X 10(-3) cm3/cm3; diet only, 185.84 +/- 8.96 10(-3), P less than .05). In type IV HLP we found a decreased number of giant mitochondria (fenofibrate, 0.08 +/- 0.03 X 10(10) cm-3; diet only, 0.32 +/- 0.08 X 10(10) cm-3, P less than .05) and a decreased volume of altered mitochondria (fenofibrate, 6.00 +/- 1.44 X 10(-3) cm3/cm3; diet only, 13.61 +/- 1.17 X 10(-3), P less than .05). In contrast with the rodent studies, the present study shows no change in the number of volume of peroxisomes. PMID- 3821502 TI - Fluoride therapy for osteoporosis: characterization of the skeletal response by serial measurements of serum alkaline phosphatase activity. AB - Optimum use of fluoride therapy for osteoporosis requires a sensitive and convenient index of the skeletal response to fluoride. Since previous studies had shown that serum alkaline phosphatase activity (SALP) was increased in response to fluoride therapy, we examined serial measurements of SALP in 53 osteoporotics treated with 66 to 110 mg of sodium fluoride (NaF) for 12 to 91 months. SALP was increased in 87% of the subjects during therapy with fluoride. The increase in SALP was thought to reflect the osteogenic action of fluoride based on the findings that SALP correlated with both trabecular bone area (r = .81, P less than .001) and osteoid length (r = .67, P less than .01) in iliac crest biopsies, predicted increased bone density on spinal radiographs in response to fluoride therapy with an 87% accuracy, and predicted decreased back pain in response to fluoride with a 91% accuracy. In addition, the SALP response to fluoride was seen earlier than other therapeutic responses as indicated by the findings that the tau 1/2 for the SALP response (ie, time for 1/2 of the patients to show a significant response) was significantly less (1.2 +/- 0.3 yr) than that for the pain response (1.6 +/- 0.3 yr, P less than .05) or that for the radiographic response (3.7 +/- 0.5 yr, P less than .001). Although most patients responded to fluoride with an increase in SALP, evaluation of the kinetics of the SALP response to fluoride revealed marked interpatient variation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821503 TI - Substitution of mixed amino acids resembling soy protein for mixed amino acids resembling casein in the diet reduces plasma cholesterol in slowly, but not rapidly fed nor fasted baboons. AB - Studies of cholesterol and triglyceride metabolism were conducted under steady state conditions in conscious restrained female baboons to ascertain whether the cholesterol- and triglyceride-lowering effects of soy protein v casein in nonrodents can be explained by differences in amino acid composition between the two proteins and whether the lipid-lowering effects of soy protein are influenced by fasting or the rate of feeding, ie, the nutritional state. The metabolic changes underlying the changes in serum cholesterol and triglyceride concentration were also investigated. Isocaloric diets consisting of 45% mixed amino acids (soy or casein type), 50% glucose and 5% corn oil, including all nutritional requirements, were infused intraduodenally for five days. There were no differences in lipid levels between the soy and casein diets in fasting baboons (days 4 or 5) or when the daily diet (calculated to equal 24 hours of energy utilization) was given rapidly by constant intraduodenal infusion over seven hours (day 4). During rapid feeding there was, unexpectedly, no significant change in plasma cholesterol concentration, but the estimated rate of cholesterol oxidation to bile acids fell significantly by 38 +/- 6% (from 39 +/- 4 to 24 +/- 3 mg/d). Significant differences between the soy and casein diets were observed only in the fed state produced by the slow constant isocaloric intraduodenal infusions of the diets [5.8 mg mixed amino acids (soy or casein type) plus 7.2 mg glucose/min/kg body wt0.75] on day 5. These diets were calculated to equal the simultaneous rate of energy utilization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821504 TI - Metabolism of high-density lipoprotein in the hyperlipidemic, diabetic SHR/N corpulent rat. AB - The SHR/N-corpulent rat is a new genetically obese strain that is both hyperlipidemic and diabetic. The high density lipoprotein (HDL) fraction from 12 week-old obese males contained significantly greater amounts of protein (+83%), free (+72%) and esterified (+76%) cholesterol, phospholipid (+94%), and triglyceride (+78%). HDL from obese rats were also enriched in C apolipoproteins (apo C-III0 and apo C-III3) but had similar relative amounts of both apo A-I and apo E compared to HDL from their lean littermates. HDL protein turnover, measured with 125I-labeled HDL, showed that obese rats had a smaller fractional catabolic rate (FCR) than lean rats, but due to their much larger HDL pool size, they had a significantly higher rate of HDL protein catabolism (obese, 1.98 +/- 0.07 mg/whole animal/h v lean, 1.32 +/- 0.05 mg/whole animal/h). Therefore, under steady-state conditions, HDL protein production must also have been increased in the obese animals. To determine whether the increased catabolism of HDL protein was associated with increased catabolism of cholesteryl ester (CE), tissue uptake of HDL CE was measured using the nonhydrolyzable ether analogue [3H]cholesteryl linoleyl ether. After four hours 41.6 +/- 1.6% of the injected dose was cleared from the plasma of lean rats compared with 37.0 +/- 1.1% from the plasma of obese rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821505 TI - The energy cost of triglyceride-fatty acid recycling in nonobese subjects after an overnight fast and four days of starvation. AB - The basal blood glycerol concentration was determined and the rate of glycerol turnover was assessed by a nonradioactive infusion technique in six healthy nonobese adults after an overnight fast and again after four days of total starvation. Simultaneously, estimates of total energy expenditure and net fat oxidation were made from measurements of oxygen consumption, carbon dioxide production, and urinary nitrogen excretion. The data were combined to provide quantitative estimates of the activity of the triglyceride/fatty acid cycle. The basal concentration of glycerol in venous blood rose from a mean value of 54 +/- 8 mumol/L (SEM) before starvation to 154 +/- 5 mumol/L on day 4 of starvation. Glycerol turnover rates correlated well with the basal blood glycerol concentration (r = .95) and increased from a mean value of 115 +/- 17 mumol/min before starvation (equivalent to mobilization of about 3.95 kJ triglyceride/min) to 304 +/- 20 mumol/min (equivalent to mobilization of about 18.41 kJ/min). The estimated rate of net fat oxidation was 3.00 +/- 0.47 kJ/min before starvation and 4.00 +/- 0.14 kJ/min on day +4 of starvation. The rate of triglyceride energy recycling or rate of deposition of triglyceride energy into fat stores was calculated from the difference in the rate of fat energy mobilization and the rate of energy released during net fat oxidation. The values were found to be 0.94 +/- 0.26 kJ/min before starvation and 6.29 +/- 0.54 kJ/min on day +4 of starvation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821506 TI - Increased catabolism of VLDL-apolipoprotein B and synthesis of bile acids in a case of hypobetalipoproteinemia. AB - A 29-year-old man is described who has reduced concentrations of low density lipoprotein (LDL)-cholesterol seemingly due to an unusual variant of hypobetalipoproteinemia. The patient developed retinitis pigmentosa at age 14. When studied at age 28, his total cholesterol was 104 mg/dL, triglycerides 58 mg/dL, LDL-cholesterol 44 mg/dL, and HDL-cholesterol 51 mg/dL. Lipid and lipoprotein levels of his parents and sister were normal. His excretion of bile acids (13.9 mg/kg/d) was markedly elevated at about three times normal, although absorption rates of cholesterol and bile acids appeared to be in the normal range. His high excretion of bile acids equates to a threefold increase in bile acid synthesis. Isotope kinetic studies of his lipoproteins produced unexpected findings. Total production of VLDL-apolipoprotein B (apo B) was estimated to be 20.8 mg/kg/d, which was in the normal range. Synthesis of VLDL-triglycerides was also normal at 12.0 mg/kg/h. However, 75% of VLDL-apo B was removed directly from the circulation, which was much higher than values for direct removal of VLDL-apo B in control subjects. His production rate of LDL-protein (5.2 mg/kg/d) consequently was below normal, although his fractional catabolic rate for LDL (0.40 pools/d) was not distinctly elevated. These data suggest that the patient's hypobetalipoproteinemia was due to increased direct removal of VLDL remnants and not to reduced synthesis of VLDL-apo B; this abnormality may have been the result of enhanced activity of LDL receptors, which in turn was secondary to increased synthesis of bile acids. PMID- 3821507 TI - Low-density lipoprotein metabolism in cerebrotendinous xanthomatosis. AB - Cerebrotendinous xanthomatosis (CTX) is a rare disorder characterized by a defect in conversion of cholesterol into bile acids, increased plasma levels of cholestanol, and accumulations of sterols in tendons, brain, and coronary arteries. Despite the presence of tendon xanthomas, patients with CTX frequently have low levels of plasma cholesterol and low density lipoproteins (LDL). The mechanisms for a low LDL are not understood. The present study, therefore, was carried out to examine the metabolism of LDL in a 58-year-old black man with CTX. This particular patient had an LDL-cholesterol in the mid-normal range (149 +/- 6 mg/dL). Nonetheless, his fractional catabolic rate (FCR) for LDL-apolipoprotein (apo-LDL) was 0.45 pools/d, which was increased compared to 15 aged-matched men (FCR, 0.30 +/- 0.01 pools/d). His production rate for apo-LDL (18.5 mg/kg-d) also was increased compared to those of middle-aged men (13.5 +/- 2.5 mg/kg-d). Since the underlying defect in CTX can be reversed by administration of chenodeoxycholic acid (chenodiol), the patient was treated with chenodiol (250 mg 4X daily), and measurements of LDL kinetics were repeated. During chenodiol therapy, his LDL-cholesterol concentration rose significantly to 165 +/- 12 mg/dL; his FCR for apo-LDL fell to 0.29 pools/d; and his production rate of apo LDL declined to 14.4 mg/kg-d. We postulate that chenodiol suppressed the excessive synthesis of cholesterol and bile acids, which had two effects. It curtailed both the overproduction of LDL and the excessive synthesis of LDL receptors, the latter being responsible for the high FCR of apo-LDL in the untreated state. PMID- 3821508 TI - Body composition in malignant disease. AB - It has been suggested that adaptation to starvation may be impaired in patients with malignant disease and that this may contribute to the development of cancer cachexia. We have investigated this by comparing the body composition, as well as the tissue composition of weight loss, of a group of 49 patients with gastrointestinal carcinomas and 91 patients with benign gastrointestinal disease all of whom had sustained a weight loss greater than 10% of their recalled pre illness weight. Total body protein was calculated from total body nitrogen measured by in vivo neutron activation analysis which also provided absolute values of sodium, chlorine, phosphorus, and calcium. The masses of muscle and nonmuscle protein were estimated using a validated compartmental analysis. Total body fat was derived using anthropometry. Total body water was estimated from the difference between body weight and the sum of body protein, fat, and minerals. The loss of body weight incurred by patients with both benign and malignant disease was primarily muscle mass and body fat. Both groups of patients retained nonmuscle protein. All patients manifested, with increasing weight loss, a progressive loss of muscle protein, fat, and water, which must represent the tissue composition of weight loss. No significant differences between patients with benign or malignant disease were demonstrated for any of the body composition parameters measured. The results of this study do not support the hypothesis that adaptation to starvation in patients with cancer is in anyway different from that which occurs in patients with benign disease. PMID- 3821509 TI - In vitro and in vivo measurement of phagocytosis by flow cytometry. PMID- 3821510 TI - Methods for the study of receptor-mediated phagocytosis. PMID- 3821511 TI - Purification and cryopreservation of phagocytes from human blood. PMID- 3821512 TI - Suspension culture of human monocytes. PMID- 3821513 TI - Preparation and cryopreservation of cytoplasts from human phagocytes. PMID- 3821514 TI - Opsonins and dysopsonins: an overview. PMID- 3821515 TI - Phagocytosis: an overview. PMID- 3821516 TI - Tuftsin. PMID- 3821517 TI - Opsonic activity of fibronectin. PMID- 3821518 TI - NADPH oxidase from polymorphonuclear cells. PMID- 3821519 TI - NADH oxidase from guinea pig polymorphonuclear leukocytes. PMID- 3821520 TI - Cytochrome b-245. PMID- 3821521 TI - Assay of the extracellular hydrogen peroxide pool generated by phagocytes. PMID- 3821522 TI - Continuous assay for cytolytic activity. PMID- 3821523 TI - Measurement of phagocytosis and cell-mediated cytotoxicity by chemiluminescence. AB - The generation of CL by phagocytes has been shown to be a valuable tool for monitoring the activity of phagocytic cells. It has been used to investigate mechanisms by which stimulants or inhibitors act to affect the function of phagocytic cells. CL has also been used as an assay system to detect various disease states. Last, it has been shown to be a very sensitive assay system for determining the toxicity of environmental or occupational agents on phagocytic cells. PMID- 3821524 TI - Activated macrophage-mediated cytotoxicity: use of the in vitro cytotoxicity assay for study of bioenergetic and biochemical changes that develop in tumor target cells. PMID- 3821525 TI - Activation of macrophages with oxidative enzymes. PMID- 3821526 TI - Preparation and characterization of chloramines. PMID- 3821527 TI - Intracellular parasitism of macrophages in leishmaniasis: in vitro systems and their applications. PMID- 3821528 TI - Parasiticidal activity of macrophages against Plasmodium. PMID- 3821529 TI - Basic methods for the study of phagocytosis. PMID- 3821530 TI - Bioluminescence and chemiluminescence. Part B. PMID- 3821531 TI - Purification of bacterial luciferase by high-performance liquid chromatography. PMID- 3821532 TI - Bacterial luciferase 4a-hydroperoxyflavin intermediates: stabilization, isolation, and properties. PMID- 3821533 TI - Extraction of adenosine triphosphate from microbial and somatic cells. PMID- 3821534 TI - Purification and properties of lumazine proteins from Photobacterium strains. PMID- 3821535 TI - Bioluminescent assays using coimmobilized enzymes. AB - In summary the use of immobilized luciferases along with other enzymes offers a method for measuring a wide variety of metabolites or enzymes. The assays are rapid, sensitive, and specific and can be automated. It is anticipated that many more assays for different compounds will be developed in the future. PMID- 3821536 TI - Detection of bacteriurea by bioluminescence. PMID- 3821537 TI - Continuous-flow bioluminescent assays employing sepharose-immobilized enzymes. PMID- 3821538 TI - Flow systems utilizing nylon-immobilized enzymes. PMID- 3821539 TI - Bioluminescence test for genotoxic agents. PMID- 3821540 TI - Estimation of biomass in growing cell lines by adenosine triphosphate assay. PMID- 3821541 TI - Amplified bioluminescence assay using avidin-biotin technology. PMID- 3821542 TI - Enhanced chemiluminescent reactions catalyzed by horseradish peroxidase. AB - Enhancement of light emission from the horseradish peroxidase-catalyzed oxidation of diacyl hydrazides on addition of 6-hydroxybenzothiazole or phenol derivatives forms the basis of rapid, specific, and sensitive chemiluminescent assays for peroxidase. The advantages and wide applicability of the technique have been demonstrated in a range of ligand-binding assays. Careful selection of chemiluminescent reagents, enhancer, their relative proportions and reaction conditions, and more detailed knowledge of the mechanism of enhancement should enable further improvements in sensitivity and the intensity or constancy of light emission. PMID- 3821543 TI - Luminescence immunoassays for haptens and proteins. PMID- 3821544 TI - Surface chemiluminescent immunoassays of steroids. PMID- 3821545 TI - Photographic detection of chemiluminescent and bioluminescent reactions. PMID- 3821546 TI - On-line computer analysis of the kinetics of chemiluminescent reactions: application to luminescent immunoassays. PMID- 3821547 TI - Sensitive bioluminescent assay for alpha-bungarotoxin binding sites. PMID- 3821548 TI - Chemiluminescence detection system for high-performance liquid chromatography. PMID- 3821549 TI - Phagocytic leukocyte oxygenation activities and chemiluminescence: a kinetic approach to analysis. PMID- 3821550 TI - Cellular chemiluminescence associated with disease states. PMID- 3821551 TI - Commercially available firefly luciferase reagents. PMID- 3821553 TI - Characteristics of commercial radiometers. PMID- 3821552 TI - Chemiluminescent probes for singlet oxygen in biological reactions. PMID- 3821554 TI - Purification of bacterial luciferase by affinity methods. PMID- 3821555 TI - Structural and contractile proteins. Part C. The contractile apparatus and the cytoskeleton. PMID- 3821556 TI - Isolation of sea urchin egg tubulin. PMID- 3821557 TI - Direct identification of microtubule-associated proteins by selective extraction of cultured cells. PMID- 3821558 TI - Purification and assay of primate 210K microtubule-associated protein. PMID- 3821559 TI - Purification and assay of cold-stable microtubules and STOP protein. PMID- 3821560 TI - Isolation and purification of tubulin tyrosine ligase. PMID- 3821561 TI - Isolation of native, membrane-containing mitotic apparatus from sea urchin embryos. PMID- 3821563 TI - Isolation of the erythrocyte marginal band. PMID- 3821562 TI - Isolation of mitotic spindles from mammalian cells. PMID- 3821564 TI - Purification of the intestinal microvillus cytoskeletal proteins villin, fimbrin, and ezrin. PMID- 3821565 TI - Isolation of basal bodies from Chlamydomonas. PMID- 3821566 TI - Isolation of mammalian centrosomes. PMID- 3821567 TI - Isolation of Chlamydomonas flagella and flagellar axonemes. PMID- 3821568 TI - Purification of caldesmon. PMID- 3821569 TI - Isolation of intermediate filaments from neuronal tissues by cycles of assembly/disassembly. PMID- 3821570 TI - Purification of neurofilaments and their constituent polypeptides. PMID- 3821571 TI - Isolation of paired helical filaments and amyloid fibers from human brain. PMID- 3821572 TI - Isolation of nematode major sperm proteins. PMID- 3821573 TI - Purification of fodrin from mammalian brain. PMID- 3821574 TI - Antibody inhibitors of nonmuscle myosin function and assembly. PMID- 3821575 TI - Purification of isoform-selective actin antibody from polyclonal antiserum. PMID- 3821576 TI - Preparation and characterization of fluorescent analogs of tubulin. PMID- 3821577 TI - Myosin movement in vitro: a quantitative assay using oriented actin cables from Nitella. PMID- 3821578 TI - Methods to study the microtubule-neurofilament network in vitro. PMID- 3821579 TI - Quick freeze, deep etch of the cytoskeleton. PMID- 3821580 TI - Cryo-electron microscopy of unstained frozen-hydrated microtubules. PMID- 3821581 TI - X-ray diffraction of cytoskeletal fibers. PMID- 3821582 TI - Time-resolved X-ray scattering of microtubule assembly using synchrotron radiation. PMID- 3821583 TI - Reversible assembly purification of microtubules without assembly-promoting agents and further purification of tubulin, microtubule-associated proteins, and MAP fragments. PMID- 3821584 TI - Purification of severin. PMID- 3821585 TI - The modulatory effect of membrane viscosity on structural and functional properties of the anion exchange protein of human erythrocytes. AB - The sterol content of human erythrocyte membranes was modified by polyvinylpyrrolidone (PVP)-mediated enrichment or depletion of cholesterol (CHL) or incorporation of cholesteryl hemisuccinate (CHS). The effects of these modifications on osmotic fragility and anion exchange protein (AEP) disposition and function were evaluated. CHS enrichment was fast (1 hr, 37 degrees C) and led to a concentration-dependent crenation as well as a decrease in osmotic cell fragility, in parallel with increased membrane microviscosity. CHL caused similar but considerably less marked effects due to slower incorporation rates into membranes. CHS enrichment of cells induced susceptibility of AEP to trypsin, a protease which otherwise does not affect AEP in intact cells. Although transport rates of monosaccharides, nucleosides, and anions were markedly slowed down by CHS enrichment of cells in parallel with increased membrane viscosity, anion transport was the most affected. The temperature profile of anion transport in CHS-enriched cells revealed a 10-kcal/mol increase in the enthalpy of activation relative to normal cells. Anion transport measured in heteroexchange conditions (Cl in--pyruvate out) and (Cl in-sulfate out) was relatively more susceptible to CHS modification than when it was measured in homoexchange conditions (Cl in-Cl out). The results of these measurements indicate that CHS-mediated increase in membrane viscosity affects AEP translocation capacity and transmembrane disposition via changes in lipid compressibility. Specific effects of CHS on AEP function, however, could not be ruled out. PMID- 3821587 TI - Litigation is a crippling disease. PMID- 3821586 TI - Update: terminal care decisions in Michigan. PMID- 3821588 TI - Doctors, hospitals, and the new health care: a joint adventure. PMID- 3821589 TI - [Metabolic transformation of labelled exogenous fatty acids by fungal cultures of the family Entomophthoraceae]. AB - Entomophthora coronata 1932 and E. conica 1716 are quite different in their fatty acid composition and the unsaturation degree of synthesized lipids. The cultures were used as models to study metabolic transformations of exogenous 14C-labeled acetic, palmitic, stearic and oleic acids as well as to compare the activities of the synthetase and desaturase enzyme complexes. The cultures were capable of transforming exogenous acetic and fatty acids into polyunsaturated arachidonic acid. E. coronata 1932 whose lipids mainly contain fatty acids with a short chain could metabolize unsaturated oleic acid to yield polyene fatty acids. However, this culture metabolized exogenous acids at a far lower rate as compared with E. conica 1716. The high content of saturated fatty acids with a short chain in the lipids might be due to the specific action of the synthetase complex and to the low activity of the desaturation enzymes. It has been demonstrated for the first time that exogenous oleic acid is converted at a high rate by the cells into arachidonic acid, a precursor of prostaglandin compounds. PMID- 3821591 TI - [Ultrastructural and biochemical changes in Mycobacterium rubrum and Streptomyces bacillaris cells exposed to the herbicide semeron]. AB - The work was aimed at studying how the herbicide semerone affected the ultrastructure of two soil microorganisms, Mycobacterium rubrum and Streptomyces bacillaris. Depending on its concentration, the herbicide inhibited growth processes so that biomass yield decreased, cell division was interfered with, and giant and misshapen cells appeared. The herbicide taken at a concentration of 50 100 mg/ml increased the amount of membrane structures of the respiration type in some cells. This compound at a concentration of 400-500 mg/ml changed the nucleoid structure in certain cells. The decrease number of ribosomes and their peculiar distribution in the cell cytoplasm are most typical responses of the cells to the herbicide action. These responses were found in all cells at any of the tested herbicide concentrations. The results of cytological experiments are supported by statistically reliable data on the effect of the herbicide on RNA and protein synthesis. RNA synthesis is inhibited at a semerone concentration as low as 1 mg/ml, which is a very sensitive indicator of its presence in the medium. PMID- 3821590 TI - [Biological activity of a polar lipid of Clostridium butyricum spores]. AB - A fraction of polar lipids was isolated from spores of the anaerobic bacterium Clostridium butyricum 35/11 exerting a noticeable radioprotective effect. The main biological activity of spore extracts was associated with this fraction. The fraction of polar lipids inhibited autolysis of the bacterial cell walls. The fraction was found to contain a phenolic glycolipid and a peptide component. The bacteriostatic and radiotherapeutic properties of the fraction are presumed to be due to its membranotropic activity. PMID- 3821593 TI - [Structural characteristics of DNA of Bacillus thuringiensis phages]. AB - The spectral characteristics of DNA from two phages of the polylysogenic Bacillus thuringiensis subsp. galleriae culture 1-97 were studied. The typical parameters of melting and the negative reaction with formaldehyde are indicative of the double-helical structure of these DNAs. The phage DNAs differ in the molar content of nitrogen bases (32 and 38 mole% of GC) and in their distribution along the molecule. This distribution is uniform in the DNA of one phage whereas the other phage DNA is composed of heterological segments with a different nucleotide composition. PMID- 3821592 TI - [Characteristics of free water distribution in the cytoplasm of cryotolerant cells of Cryptococcus laurentii]. AB - The resistance to freezing-thawing was studied with Cryptococcus laurentii cultivated at a near-zero plus temperatures in a minimal or a rich medium. At the transition into the stationary phase, the resistance of the cells to freezing increased 20 times in the culture grown in the minimal medium and 8 times in the culture grown in the rich medium. Free water localization in the cell cytoplasm was determined by electron microscopy. In yeast cells with the maximal cryotolerance, free water was found mainly between glycogen granules. The authors discuss the role of glycogen as of a possible factor making the cells resistant to low temperatures. PMID- 3821594 TI - [Regulation of terephthalate catabolism in Rhodococcus rubropertinctus]. AB - The regulation of terephthalate catabolism was studied in Rhodococcus rubropertinctus which decomposed this synthetic monomer. The pathway (a) of terephthalate (TP) catabolism is as follows: TP----benzoate----4-hydroxybenzoate- --protocatechuate----pyrocatechol-- --cycle ortho-cleavage. The following results were obtained when studying why two other catabolic pathways were realized if benzoate and 4-hydroxybenzoate were taken as a sole carbon source, namely, (b) benzoate----pyrocatechol----cycle cleavage and (c) 4-hydroxybenzoate--- protocatechuate----cycle cleavage. TP seemed to cause the divergence of pathways (a) and (b) by repressing the system of benzoate oxidation to pyrocatechol. In pathway (c), benzoate repressed the synthesis of enzymes which catalysed protocatechuate oxidation. Pathway (b) was switched over to (a) when the strain was grown in a medium containing TP and benzoate at a benzoate concentration above 5 mM. Here, the concentration of benzoate (first exogenous and later formed from TP) played a key role. R. rubropertinctus growth in a medium with TP and glucose had diauxic characteristics. PMID- 3821595 TI - Interactive video teaching using a home microcomputer. AB - This paper describes the use of a home microcomputer to produce a highly versatile yet relatively inexpensive interactive video system. The program has been designed to introduce medical students to the examination of the mentally ill patient, but the technique is ideally suited to demonstrate examination and treatment techniques in all medical specialties. PMID- 3821596 TI - Medical students' attitude to general studies in the University of Benin, Nigeria. AB - The academic curriculum of the University of Benin includes some compulsory courses for all students in the first year of admission. These courses, referred to as general studies, cover some aspects of English language, Nigerian history and culture, humanities, science and technology. Since the introduction in 1975 of this programme in the university various views have been expressed on the necessity, effectiveness, suitability, relevance and reaction of students to the programme. This investigation was therefore carried out to find out the views of the medical students about the programme. The results show that our medical students regard the programme as useful, effective and relevant to their medical education and should be continued. They also suggested some modifications and improvement in some aspects of the programme. PMID- 3821597 TI - Attitudes to social issues in medicine: a comparison of first-year medical students with first-year students in non-medical faculties. AB - The emphasis on academic achievement in medical student selection has given rise to the fear that students entering medicine may comprise a homogeneous group with tendencies towards academic and scientific pursuits rather than humanistic and person-oriented health care. The Attitudes to Social Issues in Medicine (ATSIM) scale was administered to first-year Australian medical students and first-year students in other faculties including students with significantly lower academic performance measured by high school examination scores. The medical student group was found to be less conservative towards general social issues than students enrolled in commerce and science faculties and scored equally with arts students. Greater conservatism was, however, apparent in those areas which most closely affect the doctor's role. Medical students were less positive than other student groups in their attitudes towards increased government control of the medical profession, the contribution of allied health professionals and the importance of social aspects of illness. On attitudes to issues such as prevention and doctor patient relationships which do not challenge the knowledge base or traditional role and status of the medical profession, however, medical students demonstrate equal or greater concern compared with other student groups. PMID- 3821598 TI - Clinical relevance: an issue in biostatistical training of medical students. AB - Significant trends in teaching biostatistics to medical students include: recognition of the dependence of advancement in the medical sciences upon the quantitative sciences; integration of biostatistics and other disciplines such as epidemiology and community medicine; increased emphasis on clinical relevance through the introduction of such topics as medical decision-making, evaluation of diagnostic test, genetic counselling and evaluating health-science literature; growing emphasis on analytic skills and computer literacy as precipitated by the presence of computer-based patient and medical information systems, expert systems, imaging and signal analysis systems; the emergence of new applications of statistics in health and medicine; and changes in the learning environment, for example emphasis on small-group discussions and problem-solving sessions. The evolution and future directions of biometrical training in medicine as precipitated by these trends, and the response of course directors at the Medical University of South Carolina to the demand for a 'new' curriculum in biostatistics for medical students are described. PMID- 3821599 TI - A rationale for selecting suitable physiology topics for the basic sciences curriculum in dentistry. AB - The suitability of physiology topics taught in the first-year dental curriculum needs to be investigated in the light of the view of the present generation of clinical and preclinical teachers, and students. This was studied in the University of Malaya in order to propose a rational physiology curriculum with proper identification of priority topics. Oral physiology, blood and the cardiovascular system were found to be the most relevant for dental students. Among the systems, high and low priority topics were identified and their relative importance is discussed. PMID- 3821600 TI - Teaching primary health care: some lessons from Zimbabwe. AB - A new teaching programme for fourth-year medical students in child health in Harare, Zimbabwe is outlined. A 2-week attachment to a rural district-level hospital is intended to orient the students to primary health care and to the practice of clinical medicine in a low resource environment. The attachment has become popular with students and it is hoped that it will improve attitudes of teaching staff in the medical school towards primary health care. PMID- 3821601 TI - A reappraisal of the use of the phi-coefficient in multiple choice examinations. AB - The phi-coefficient of an item in a multiple choice question (MCQ) examination is often used to determine whether that item is suitable for re-use in future examinations. In order to be of value in this regard, the coefficient must be shown to be an objective and consistent index of the discriminating power of an MCQ item. The behaviour of the phi-coefficient (phi) was investigated in two one from-five MCQ and two true/false examinations. It is shown that the magnitude of the phi-coefficient for the items in any examination is a function not only of the discriminating power of the items, but also of the magnitude of the countermark for incorrect responses, of the proportion of 'don't know' responses in the examination, and of how the 'don't know' responses are handled in the analysis. It is further shown that the reproducibility of the phi, when calculated for any pair of randomly selected portions of a class of students, is very poor. We conclude that the error of estimation of the phi is of the same order of magnitude as the phi's normal operative range. PMID- 3821602 TI - Specialty choice of medical students in India. AB - The objectives of this study are to investigate undergraduate medical students' attitudes towards different specialties and to investigate whether there are any differences between the attitudes of students of different sex and different socio-economic background. The sample consisted of 692 final-year students from 11 medical colleges in India. Scale values were worked out to find out the actual distance between students' attitudes. Sex differences were observed in the attitude towards surgery, obstetrics and gynaecology, orthopaedics, microbiology, social and preventive medicine and anatomy. There were no statistically significant differences between the attitudes of students from different socio economic backgrounds. PMID- 3821603 TI - Orthopaedic undergraduate assessment. AB - The multiple choice, viva voce and consultant marks from 327 students in the Orthopaedic Undergraduate Course at the University of Bristol were compared. The assessments were based on 84 questions in the multiple choice questionnaire, 30 questions in the viva voce and four questions in the consultant assessment. The consultant assessment correlated least well with the other two marks. It is suggested that in short courses consultant grades be supplemented by objective examinations. PMID- 3821604 TI - The state of the world's children. PMID- 3821605 TI - A knowledge attitude and practice (KAP) study on dengue/dengue haemorrhagic fever and the Aedes mosquitoes. PMID- 3821606 TI - Coping among the non-institutionalised ill elderly. PMID- 3821607 TI - A study of patients admitted to Miri Hospital, Sarawak, by airborne medical evacuation. PMID- 3821608 TI - Analgesic nephropathy as a cause of end-stage renal disease in Malaysia. PMID- 3821609 TI - IgA nephropathy: a Malaysian experience. PMID- 3821610 TI - Pattern of bone disease in maintenance haemodialysis patients in Malaysia. PMID- 3821611 TI - 16 cases of acute renal failure due to leptospirosis. PMID- 3821612 TI - Juvenile rhegmatogenous retinal detachment in Malaysia. PMID- 3821613 TI - Teeth in osteogenesis imperfecta: a light microscopic study. PMID- 3821615 TI - Benign cystic teratoma in a two-year-old child: a case study. PMID- 3821614 TI - Barium enema reduction of intussusception in children. PMID- 3821616 TI - Neuroleptic malignant syndrome: a case report. PMID- 3821618 TI - W(h)ither medical entomology? PMID- 3821617 TI - Congenital fibrous epulis: a case report. PMID- 3821619 TI - The management of patients with poorly-controlled non-insulin dependent diabetes. PMID- 3821620 TI - Fish oils and cardiovascular disease. PMID- 3821621 TI - Tick infestation in soldiers who were bivouacked in the Perth region. AB - We report observations on infestations with the tick, Amblyomma triguttatum, in soldiers who were bivouacked in two areas near Perth; 34% of 175 persons were infested with varying stages of the ectoparasite. Most persons were infested with only one tick but some troops had multiple infestations. Local skin reactions to tick-bites were frequent; they usually developed 24-48 h after removal of the tick and may indicate delayed hypersensitivity reactions. A small number of persons developed secondary bacterial infections. Management and prevention of these infestations is reviewed briefly. PMID- 3821622 TI - Efficacy of aminohydroxypropylidene diphosphonate in the treatment of malignancy associated hypercalcaemia. AB - Two patients with symptomatic malignancy-associated hypercalcaemia were treated with intravenously-administered aminohydroxypropylidene diphosphonate (APD). Both patients demonstrated dramatic falls in serum calcium concentration, and in urinary calcium and hydroxyproline excretion that were consistent with a reduction in the rate of bone resorption. Normocalcaemia occurred by day 5 and persisted for approximately three weeks after treatment. No significant side effects were encountered. It was concluded that APD is a promising new agent in the management of hypercalcaemia that is associated with malignant disease and warrants further investigation. PMID- 3821623 TI - A case of factitious disorder presenting as plumbism. AB - The case of a young man who presented with lead poisoning is reported. This did not resolve with prolonged treatment and he had several unusual and unexplained bacteraemias. Probable sources of self-administered lead and bacteria were demonstrated and psychiatric assessment showed that the patient had a personality disorder which was consistent with a diagnosis of factitious disorder. Psychiatric management led to the termination of the self-inflicted illnesses and enabled the patient to cope with his personal and social problems. PMID- 3821624 TI - Social significance of genital tract infections in adolescent girls admitted to a juvenile remand centre. PMID- 3821625 TI - Changing patterns of ischaemic heart disease in elderly Australians. PMID- 3821626 TI - AIDS and intravenous drug abuse: risk behavior. PMID- 3821627 TI - Lead poisoning: closer liaison between medical and veterinary investigators. PMID- 3821628 TI - Morbidity patterns in Western Australia. PMID- 3821629 TI - Liposuction on trial. PMID- 3821630 TI - Electroconvulsive therapy. PMID- 3821631 TI - Vocational rehabilitation. PMID- 3821632 TI - The diagnosis of postmenopausal osteoporosis. PMID- 3821634 TI - Heed Yul Brynner. PMID- 3821633 TI - How many deaths make a holocaust? PMID- 3821635 TI - The relation of forearm mineral density to peripheral fractures in postmenopausal women. AB - Forearm bone mineral density was measured in 557 postmenopausal women from whom a history of fractures was also obtained. Known cases of osteoporosis were excluded. The mean age of the subjects was 59 years. Ninety-eight of the subjects had sustained a fracture since the menopause and 37 had done so before the menopause. There had been 188 fractures in all. The mean bone density was significantly lower in the subjects who had experienced a fracture than in those who had not experienced a fracture; this was also true of subjects who had suffered a fracture before the menopause. The lowest bone densities were observed in subjects who had suffered forearm fractures, followed by those who had suffered fractures of the rib, ankle and foot. The mean bone density in subjects with more than one fracture was significantly lower than in those with only one fracture. The difference in bone density between subjects with and without a history of fractures was most significant in the younger subjects and became progressively less significant with age. The estimated relative fracture risk was 3.1 in the group with the lowest bone densities and zero in the group with the highest bone densities. PMID- 3821636 TI - Psychiatric morbidity in patients with chronic airflow obstruction. AB - Fifty consecutive patients with chronic airflow obstruction who were admitted to a respiratory unit were assessed medically and psychiatrically. A high rate of psychiatric morbidity (58%) was detected with panic and other anxiety disorders (34%) being particularly prevalent. Various physiological and psychological reasons for the high rate of anxiety disorders are discussed. PMID- 3821637 TI - Drugs and breast-feeding. PMID- 3821638 TI - Intermittent carbamazepine intoxication possibly related to altered absorption characteristics of the drug. AB - In Australia intermittent carbamazepine intoxication that occurs around the expected time of the peak post-dose plasma drug concentrations has been seen more frequently in recent years than in the past. Reworking of pharmacokinetic data from earlier studies of the drug suggests that, between 1977 and 1980, there was a change in the absorption profile of carbamazepine in the most widely used oral Australian preparation of the drug. The drug's absorption rate increased and its peak plasma levels occurred earlier. The reason for this altered absorption profile cannot now be traced, but it seems a possible explanation for the clinical problem that has emerged subsequently in a number of patients. PMID- 3821639 TI - Aortic incompetence associated with severe rheumatoid arthritis. PMID- 3821640 TI - Monobenzone, Superfade, vitiligo and confetti-like depigmentation. AB - Three cases of cutaneous depigmentation after the application of Superfade are presented. Almost total depigmentation occurred on the dorsum of the hands with spread of confetti-like depigmentation to the arms. More distant spread occurred in two cases. Superfade contains 1.5% monobenzyl ether of hydroquinone (monobenzone). This is proposed as the cause of the depigmentation. PMID- 3821641 TI - Problems with herbal medicines. PMID- 3821642 TI - Possible contamination of a herbal product with a prohibited substance. PMID- 3821643 TI - The diagnostic dilemma of subungual melanoma. PMID- 3821644 TI - Cyclosporin A-associated proteinuria. PMID- 3821645 TI - Methylmalonic aciduria in an infant of a mother with undiagnosed pernicious anaemia. PMID- 3821646 TI - Anorexia nervosa versus biliary gastritis: the deadly potential of misdiagnosis. PMID- 3821648 TI - Postgraduate training in family practice. PMID- 3821647 TI - Effectiveness of resuscitation masks as an aid to expired air resuscitation. PMID- 3821649 TI - Bath-time itch and polycythaemia rubra vera. PMID- 3821650 TI - Benzodiazepine dependence. PMID- 3821651 TI - The psychiatric problems of life sentence prisoners. PMID- 3821652 TI - Dealing with errors of clinical judgment. PMID- 3821653 TI - Why stipendaries? PMID- 3821654 TI - Isolation and properties of a novel IgG-binding protein from streptococci of serological group U. AB - A nonimmune binding of immunoglobulin (Ig) G has been detected in streptococci of group U. The group U Fc-binding site differed from the five previously known types of staphylococcal and streptococcal Fc-binding sites by its strong affinity for murine IgG, with dissociation constants in nanomolar range for rat and mouse IgG, as well as for mouse IgG subclasses 1, 2a, 2b and 3. It also differed from other binding sites by the high sensitivity towards trypsin. The Fc-binding protein could be solubilized from the streptococci of group U with papain and purified by gel filtration on sephacryl S-200 and by subsequent affinity chromatography on human IgG-Sepharose. The purified binding protein was homogeneous on SDS-polyacrylamide gel electrophoresis and had a molecular weight of approximately 58,000 daltons. It retained its binding activities for murine IgG subclasses as revealed by western blotting. Coupled to CNBr-activated sepharose, the purified Fc-binding protein could be effectively used for the isolation of murine IgG subclasses by affinity chromatography. PMID- 3821655 TI - [Ecologo-epidemiologic reasons for the prevalence of opisthorchiasis in the Kurgan region]. PMID- 3821656 TI - [Early clinical stage of alveococcosis. Clinico-morphologic characteristics]. PMID- 3821657 TI - [Efficacy and tolerance of treatment of echinococcosis patients (Echinococcus granulosus, Echinococcus multilocularis) with mebendazole]. PMID- 3821658 TI - [Experimental therapy of alveococcosis. 10. Effect of mebendazole combined with BCG or levamisole on the course of experimental alveococcosis in the mouse]. PMID- 3821659 TI - [Results of the implementation of the interdisciplinary complex scientific program "Opisthorchiasis" in the 11th Five-year-plan]. PMID- 3821660 TI - [Various features of the biology of a northern isolate of Taeniarhynchus saginatus Coeze, 1782]. PMID- 3821661 TI - [Research on sanitary helminthology and public health, objectives and prospects for development]. PMID- 3821662 TI - [Modeling amebiasis in the adult white rat sensitized with tissue antigens]. PMID- 3821663 TI - [Mathematical analysis of the relation between the pathogenicity of natural populations of tick-borne encephalitis virus and biotic and abiotic factors]. PMID- 3821664 TI - [Approaches to regionalization of endemic territories in order to select the objectives and goals of measures to control opisthorchiasis]. PMID- 3821665 TI - [Stereologic analysis of the development of the claustrum between the 14th and 19th week of gestational age]. PMID- 3821666 TI - [Therapy of polyposis of the nasoethmoidal region using intranasal ethmoidectomy]. PMID- 3821667 TI - [Regeneration of peripheral nerves: electrophysiologic diagnosis]. PMID- 3821668 TI - [Contraception and problems with its use]. PMID- 3821669 TI - [Primary localization of a malignant lymphoma in the salivary gland--case report]. PMID- 3821671 TI - [Case report of rupture of the urethra and bladder]. PMID- 3821670 TI - [2 case reports of intra-abdominal hemorrhage caused by rupture of a Graafian follicle]. PMID- 3821672 TI - [Clinical use of radiosaturation analysis]. PMID- 3821673 TI - [Migraine--diagnostic problems]. PMID- 3821674 TI - [Permeability of cuprophane membranes to pyrogens in capillary dialyzers]. PMID- 3821675 TI - [The importance of time and space components in secondary phobic conditions]. PMID- 3821676 TI - [Advantages and inadequacies of cytohormonal analysis of the vaginal epithelium in normal and pathologic pregnancy]. PMID- 3821677 TI - [Surgical treatment of ozena]. PMID- 3821678 TI - [Trochantero-iliac coaptation in the treatment of septic complications after alloarthroplasty of the hip]. PMID- 3821679 TI - [Improving the mechanical properties of alabaster gypsum with the addition of 5% superplasticizer]. PMID- 3821680 TI - [Temporomandibular joint sounds]. PMID- 3821681 TI - [The need for thorough psycho-physiologic studies in obesity]. PMID- 3821682 TI - [The course of endocrine ophthalmopathy and effectiveness of established therapeutic measures]. PMID- 3821683 TI - [Effect of endogenous stimulated melatonin on the hypothalamo-hypophyseal system]. PMID- 3821684 TI - [Left ventricular function in acromegaly]. PMID- 3821685 TI - [Anorexia nervosa--endocrine changes]. PMID- 3821686 TI - [Coincidence of idiopathic insufficiency of the autonomic nervous system with ventricular tachycardias]. PMID- 3821687 TI - [Toxic myocardial damage in meningococcal infection]. PMID- 3821688 TI - [Methods and risks of plasmapheresis in severe courses of Guillain-Barre syndrome]. PMID- 3821689 TI - [Pathogenesis, clinical aspects and noninvasive diagnosis of acute hepatic ischemia in shock conditions]. PMID- 3821690 TI - [Electrophysiologic diagnosis of tachycardiac ventricular arrhythmias]. PMID- 3821691 TI - Norepinephrine effects on SHR muscle vessel diameters, RBC and plasma flow. AB - The distribution of blood flow through the cremaster microcirculation of pentobarbital anesthetized WKY and SHR rats was studied using fluorescence videomicroscopy and videodensitometry. The left cremaster muscle was spread over an optical port in a bath filled with modified krebs solution (pH = 7.4, 34 degrees C). The right femoral artery was cannulated with PE-10 tubing for the measurement of mean arterial blood pressure and bolus injections of indicators (DTAF-RBC's and FITC-dextran) into the aorta. The passage of indicators through the microvessels and vessel diameters were recorded on video tape during the topical application of norepinephrine (10(-10) M to 10(-6) M). Mean arterial blood pressure was 95 +/- 4 mmHg for WKY rats and 146 +/- 6 for SHR. Venular diameters were greater in WKY than in SHR. Norepinephrine decreased vessel diameters and blood flow velocity in a dose dependent manner. Mean transit time (t) for DTAF-RBC's was less than for FITC-dextran in first order arterioles for both normotensive and hypertensive animals. At high concentrations of norepinephrine differences in t for the two indicators disappeared. The t of both indicators were not different between normotensive and hypertensive animals in arterioles. However, t for both indicators were significantly increased in venules at all concentrations of norepinephrine in SHR but significantly less than in WKY. t for both indicators were increased in a dose dependent manner in both arterioles and venules. Arterioles of SHR appear to be constricted reducing the number of parallel circuits available for flow which allows passage of both RBC and plasma more directly and rapidly through shorter routes than in WKY, but restricts flow of RBC through the terminal arterioles. PMID- 3821692 TI - Hepatic microvascular regulatory mechanisms. VIII. Glucogenic responses and morphologic changes following serotonin-induced low flow. AB - Changes in blood glucose, hepatic glycogen content and distribution, the number of hepatic mast cells, and hepatic morphology were assessed over 30 min in non fasted and anesthetized Sprague-Dawley rats receiving endoportal or femoral intravenous injections of selected doses of serotonin and/or phentolamine, lodoxamide, or of Ringer's solution (control). Endoportal administration of low flow producing doses of serotonin (1.0, 10.0, 20.0 micrograms per 100 g b.w.) elevated circulating blood glucose without decreasing hepatic glycogen content when compared to control in unit dry or wet weights. Hyperglycemia was accompanied by centrilobular glycogen depletion and apparent Kupffer cell activation. However, no change in hepatocyte or endothelial cell morphology or in the number of hepatic mast cells was observed following serotonin-induced low flow. The glucotropic response to a nonhypotensive dose of serotonin (1.0 microgram per 100 g b.w.) was modified by phentolamine (100 micrograms per 100 g b.w.) but not lodoxamide (0.1 microgram per 100 g b.w.). These blockers, when given alone, stimulated centrilobular glycogen depletion without producing a net change in blood glucose or hepatic glycogen content. By contrast, injection of serotonin (10.0 micrograms per 100 g b.w.) and/or phentolamine (100 micrograms per 100 g b.w.) into the femoral vein provoked no glucogenesis or systemic hypotension. Given these results, serotonin is suggested to stimulate hyperglycemia by activating alpha-adrenergic receptors. Since centrilobular glycogen depletion proceeds with no detectable change in total hepatic glycogen content, it is postulated that hepatic glycogen catabolism and deposition occur simultaneously and at equivalent rates during conditions of serotonin-induced hyperglycemia and low flow. PMID- 3821693 TI - Microcirculatory measurements in the same conscious rats (WKY and SHR) during their first year from birth. AB - To study peripheral circulation, it is desirable to avoid anesthesia and surgical trauma to the experimental animal. The depilated auricle (external ear) of rat provides this as a model and is used to facilitate numerous analyses of age related changes in hemodynamics in the same animal. The rat is placed in a plastic tube and the right auricle is positioned on a transparent block with electronically controlled temperature using intravital microscopic techniques (transmitted light). Red blood cell (RBC) velocities and capillary diameters (phi cap, column of blood) were measured in the course of 15 months from birth (flying spot technique, angiometer or ruler). Between week 13 to week 27 from birth, RBC velocities increase significantly (p less than 0.01) to steady-state levels (WKY: 0.16 mm/s; SHR:0.19 mm/s); the velocities were higher in SHR than in WKY (about 20 to 25%). phi cap decrease from values of about 7.0 microns to 6.3 microns (p less than 0.05). RBC-velocities depend on ambient temperature and reach maximum values between 35 degrees C and 37 degrees C surface temperature. PMID- 3821694 TI - Escape of gastric submucosal arterioles from acetylcholine-induced dilatation. AB - Escape from acetylcholine-induced dilatation of gastric submucosal arterioles was studied using in vivo microscopy in rats. Acetylcholine, physostigmine and atropine were applied topically to the submucosa. Experiments were videotaped and diameter changes of the submucosal arterioles were measured with an image splitting technique on playback of the videotapes. Acetylcholine, 10(-6) M and 10(-5) M, caused prompt dilatation of arterioles in a dose-dependent manner, and the dilatation was rapidly followed by escape (return of vessel diameter toward basal diameter in spite of the continued presence of acetylcholine). The escape from acetylcholine-induced dilatation was prevented by physostigmine in a dose dependent manner, 10(-2) M completely inhibiting the escape. Physostigmine, by itself, 10(-4) M to 10(-2) M, dilated arterioles dose-dependently, and this dilatation was inhibited by atropine. These results indicate that escape of gastric submucosal arterioles from acetylcholine-induced dilatation is mediated by endogenous cholinesterase (catabolism of acetylcholine by endogenous cholinesterase), and basal arteriolar diameter may be determined, in part, by endogenous acetylcholine, this effect being modulated by endogenous cholinesterase. PMID- 3821695 TI - Compensating for biased selection in health insurance. AB - The focus of interest in HMOs is shifting from simple encouragement of their growth to the design of systems allowing for choice among alternative plans. Problems of adverse and favorable selection of enrollees may prevent effective multiple choice. A trial system, including enrollee surveys and risk pools, is proposed to create incentives for delivery systems to compete on the basis of efficiency and services rather than on selection. PMID- 3821696 TI - Beyond equity: Swedish health policy and the private sector. AB - The rapid development of private medicine in Sweden poses a challenge to that nation's traditional commitment to equity and a public system of health care. Economic constraints in public-sector spending, physician intent in private practice, popular interest in individual choice, and criticism of the public system have been the stimulus. The dominant Social Democrats will likely accept those elements of the private sector that are ideologically compatible, but resist others. PMID- 3821697 TI - Hazard pay in unsafe jobs: theory, evidence, and policy implications. AB - Critics of OSHA argue that an unregulated labor market gives firms incentives to improve working conditions. Analysis of the relation between wages and hazardous working conditions confirms that workers in hazardous jobs are paid marginally more than comparable workers in safe jobs. But hazardous occupations are concentrated in low-skill and low-pay strata. The empirical findings have important implications for "right-to-know" and related occupational health strategies. PMID- 3821698 TI - Practicing the business of medicine. PMID- 3821699 TI - Transitions in rural medicine. PMID- 3821700 TI - Diffusing the crisis in rural mental health care. PMID- 3821701 TI - Evoking the gifts. PMID- 3821702 TI - Medical education of the future. A prototype. PMID- 3821703 TI - A catalyst for cooperation. The Northern Lakes Health Care Consortium. PMID- 3821704 TI - Teen-age sexual activity in rural Minnesota. PMID- 3821705 TI - Cesarean section rates in a rural Minnesota town (1976-1984). PMID- 3821706 TI - Management of multiple trauma in a rural setting. PMID- 3821707 TI - [86th congress of the Japan Surgical Society. Tokyo, Japan. Abstracts]. PMID- 3821708 TI - [Assessment of surgical treatments of medullary thyroid carcinoma by analysis of serum calcitonin levels]. AB - In 67 patients with medullary thyroid carcinoma, serum calcitonin levels were measured before (S1) and after (S2) surgical therapy. Doubling time of serum calcitonin levels (T2) was calculated in each patient with elevated calcitonin levels after surgery. Residual tumor weight (W2) was estimated as W1S2/S1-S2) where W1 was resected tumor weight. Reduction index (alpha) is defined as S2/S1 = (1/2) alpha. alpha T2 indicates expected prolongation in survival (EPS) by surgical therapy. Expected duration of survival after surgery (EDS) is estimated as beta T2, where beta times of doubling of the residual tumor (W2) make 1000 g of tumor which would generally kill the host. Death within 3 years after surgery or recurrence within 5 years was best associated with short EPS followed by short T2 or small alpha. Postoperative calcitonin levels had a rather weak correlation with the prognosis, and preoperative calcitonin levels had almost no correlation with the prognosis during the present observation period. All 3 patients with EDS shorter than 3.9 years died within 2 years and 2 months after surgery. These parameters allow quantitative judgement of the surgical benefit and quantitative prediction of the prognosis in each individual patient. PMID- 3821709 TI - [Rupture of false aneurysm of the femoral artery caused by blunt trauma]. AB - The successful surgical repair of a ruptured false aneurysm of the left femoral artery in a 44-years-old male is presented. He was admitted to this hospital with the chief compliant of marked swelling accompanied with severe pain of the left thigh and the past history of a blunt trauma 7 years ago on the left groin? He had also severe anemia with hb 4.4 g/dl. An aneurysm measuring 15 by 8 cm was detected on the arteriogram. The aneurysm was treated by resection and implantation of Gore-Tex graft with good result. The pathological findings strikingly suggested that the false aneurysm was caused by the old blunt trauma. A false aneurysm of femoral artery caused by a blunt trauma is very rare and it's complications include acute arterial occlusion, subsequent ischemic change of lower limb and massive bleeding by the rupture. In conclusion, early diagnosis and surgical treatment are essential for a false aneurysm of femoral artery. PMID- 3821710 TI - [Analysis of lymphocyte subpopulations of the spleen in patients with gastric cancer and liver cirrhosis]. PMID- 3821711 TI - [Development of an animal model of autonomic over-activity in tetanus]. AB - Although present day progressive respiratory management has decreased the tetanus mortality rate, tetanus-related autonomic overactivity remains a lethal condition. The cause, pathophysiology, and treatment of this condition are controversial and no animal model has ever been reported. So we tried to make a rabbit model of this condition. At first we injected 30 micrograms of purified tetanus toxin intravenously. Blood pressure oscillation occurred, but the degree of oscillation was smaller than that was seen in the clinical cases. The degree of oscillation had not changed by addition of 30 micrograms purified toxin 12 hours after first injection. Secondly, 7 days before the experiment we injected 0.5 micrograms of purified tetanus toxin intravenously. On the experiment day, we injected 30 micrograms of purified toxin again. By this method there occurred blood pressure oscillation as same as that was seen in the clinical cases. But no rabbits progressed to circulatory collapse by purified toxin. Then to the last group of rabbits, we injected crude tetanus toxin for purified toxin. The degree of blood pressure oscillation was same as that of cases in which purified toxin was injected, and all rabbits progressed to circulatory collapse. PMID- 3821712 TI - [Clinical use of autologous frozen blood in the surgery of three esophageal cancer patients]. AB - Autologous frozen blood transfusion (AFBT) has advantages both of autologous and frozen blood transfusion. In AFBT there are no remarkable adverse effects which often emerge after usual heterologous blood transfusion. As a rule, four hundred milliliters of blood were drawn twice from patients and reserved as autologous frozen blood (AFB) preoperatively. It is supposed that radical operation of esophageal cancer using only AFB is difficult to perform because of various kinds of preoperative risks. In this paper three cases of radical esophageal cancer operations, in which only AFBT were used are reported. Pre- and postoperative liver functions were uneventful. RBC counts, Hb and Hct dropped after drawing blood and did not recover until the day of operation. Postoperatively, they deteriorated further but recovered to initial values without any specific treatment within 5 months after operation. Pre- and postoperative PaO2 values of AFBT were not different from those of the usual blood transfusion. Thus using only AFBT, esophageal cancer operations were performed without any disadvantageous effects. PMID- 3821713 TI - [The effect of reflux of bile juice on the development of residual stomach cancer]. AB - An experimental study was performed using an organ culture method to evaluate the effect of a duodenal juice reflux on the development of cancer in the residual stomach. The following results were as follows. An intracellular DNA levels to combine with carcinogenic agents was significantly increased in the mucosa of the residual stomach compared to the parietal mucosa in the whole stomach (control group). In the human gastric mucosa exposed to the bile acid, the intracellular DNA level to combined with carcinogenic agents was increased, and thus the effect of the bile acid as a surfactant on the experimental development of gastric cancer was suggested. An atrophic change was main feature of the residual stomach. Autoradiographic findings revealed that the proliferative zone was extended and a number of immature cells appeared which became to be target cells. Therefore, the residual stomach might provide a situation where the cancer would easily develop. PMID- 3821714 TI - [Studies on para-aortic metastatic lymph nodes in gastric cancer after endoscopic injection of activated carbon particles]. AB - When activated carbon particles are injected into the tissues, they are absorbed into the lymphatic capillary and reach to the regional lymph nodes. Utilising this property of the activated carbon, we injected small sized carbon particles (CH-44) around the gastric cancer using endoscope to examine para-aortic lymph node metastasis. Sixty eight patients with gastric cancer existing serosal invasion were subjected to extended radical gastrectomy dissecting para-aortic lymph nodes as well as regional lymph nodes. Twenty patients (29.4%) had para aortic lymph node metastasis. Cumulative 5-year survival rate of these patients after surgery was 20.0 per cent. High incidence of metastasis in para-aortic lymph nodes was found in the lymph nodes larger than 4mm in diameter, but 15.9 per cent of lymph nodes less than 2mm in diameter had metastasis. Large lymph nodes occupied almost wholly by cancer cells were stained scarcely by activated carbon particles, but lymph nodes with moderate or slight metastasis were stained black well and this method was very useful for lymph node dissection, even for micro-lymph nodes which seemed to escape from naked eye at surgery. PMID- 3821715 TI - [Therapeutic goals for fluid management in profound shock]. AB - The therapeutic goals for fluid replacement in 9 patients were studied. Five cases in sepsis, 2 in necrotizing pancreatitis and 2 in fat embolism were treated as dehydration or hypovolemia. Fluid replacement was performed with the view of obtaining the amelioration of circulation and urine output, even if CVP or PCWP had been elevated on admission. The values of CVP and PCWP, renal function and pulmonary function were assessed retrospectively. Out of 9 patients, one died of refractory shock, brain edema due to fat embolism and remaining one after recovery of shock. Out of 6 survivors, 2 showed oliguric renal failure, and 2 nonoliguric renal failure. The volume of administered fluid ranged from 5445 ml/10 hrs to 15820 ml/14 hrs and speeds of fluid administration were 545 ml/hr to 1248 ml/hr. CVP value on admission ranged from 4.0 to 22.0 cmH2O (3.0 to 16.3 mmHg), mean value 14.0 +/- 6.5 cmH2O. Through the course, the highest CVP and PCWP ranged from 12.5 to 26.5 (mean 19.8) mmHg and 14 to 36 (mean 20.9) mmHg, respectively. Out of 9 patients, 8 were suffering from respiratory distress, however, 7 recovered by PEEP except for one refractory shock. High values of CVP or PCWP could be recognized even if in hypovolemic shock and/or septic shock. Maintenance of higher values (18-20 mmHg) in CVP and/or PCWP during fluid resuscitation might be recommended because adequate fluid resuscitation could sustain the renal function, and result in good outcome. PMID- 3821716 TI - [The effect of glucagon on hepatic blood flow and ICG excretion]. AB - Loading of glucagon on mongrel dogs was performed and the following results were obtained: The effects of glucagon on hemodynamics were decrease in the vascular resistance and increase in the blood flow in the superior mesenteric artery. Therefore, the blood flow of the portal vein was also increased. In the hepatic artery, glucagon also decreased the vascular resistance, when the blood flow was initially increased and then decreased. This might be attributable to the difference in sensitivity between the vascular resistance by glucagon. While administration of glucagon increased the blood flow of the portal vein, it had less effect on the vascular resistance. Though the blood flow of the hepatic tissues by hydrogen gas clearance method correlated favorably with the hepatic inflow measured with electromagnetic flowmeter, local blood flow in the hepatic tissues was not always constant in the liver and had some difference. Concerning change in local blood flow in the hepatic tissues, in low perfusion area, the blood flow was increased by low concentration of glucagon. This change in distribution of the blood flow was presumed to be caused by the portal flow. After simultaneous loading of glucagon and ICG, glucagon accelerated excretion of ICG. After simultaneous loading of glucagon and ICG on cirrhotic and control patients, accelerated excretion of ICG with time course was observed in control group. On the other hand, slightly accelerated excretion was seen in cirrhotics. It was suggested that simultaneous loading test of glucagon and ICG may be useful as a test for dynamic ability of hepatic circulation which can not be obtained by ICG loading test. PMID- 3821717 TI - [Effects of preoperative transcatheter arterial embolization (TAE) on the liver following partial hepatectomy in rats]. AB - The safety of pre-operative transcatheter arterial embolization (TAE), especially on the relation to hepatic regeneration following partial hepatectomy, was evaluated in rats. TAE was done through a catheter cannulated into hepatic artery under laparotomy. The remarkable elevation of S-GOT and S-GPT levels were demonstrated a day after TAE, which returned to normal on third post operative day. No influence of the difference of embolized materials was seen on the changes of transaminase levels. TAE severely decreased hepatic microsomal functional mass measured by [14C]-aminopyrine breath test (ABT) and the recovery of microsomal functional mass was shown on the 14th day after TAE. Histologically, recanalization could not be revealed in embolized arterioles even on the 21st day after TAE. But trabecular pattern of hepatic lobules was preserved after TAE. The serious inhibition of DNA synthesis of regenerating liver was demonstrated when TAE was performed within 14 days prior to partial hepatectomy (p less than 0.001-0.05). The period from TAE to partial hepatectomy had a influence on the survival rate after partial hepatectomy, and when appropriate interval was taken after TAE, the survival rate increased significantly (33%-50% in 24 hours interval and 88% in 14 days interval). In conclusion, preoperative TAE remarkably suppressed hepatic regeneration after partial hepatectomy, and appropriate time when suppressed hepatic functional mass, such as microsomal functional mass measured by ABT, returned to pre TAE value was required to perform hepatectomy in safety. PMID- 3821718 TI - [A new series of monoclonal antibodies against pancreatic cancer cells]. AB - A new series of monoclonal antibodies (Span 1-7) was produced by immunizing mice with SW 1990 human pancreatic cancer cells. Span 1-4 antibodies (Ab) reacted with 4-5 of 8 pancreatic cancer cell lines tested and with 5-6 of 9 colon cancer cell lines and some lung cancer cell lines. Span 1-4 antigens (Ag) were detected not only on cell surface but also in cultured spent medium of SW 1990 cells by ELISA. They were also found in the fractions of a cesium chloride gradient of SW 1990 xenograft homogenates which have the highest molecular weight, density and carbohydrate content. Their immunoreactivity is dependent upon sialic acid because prior digestion with neuraminidase abolished their immunoreactivity. Span 5,6,7 Ab reacted with only 3 of 8 pancreatic cancer cell lines tested and did not reacted with any other cell lines such as colon cancer, lung cancer and melanoma. The epitopes which were recognized by Span 5,6,7 Ab did not contain sialic acid. These results suggest that Span 1-4 Ab has potential application in the detection of gastrointestinal cancers and that Span 5,7 may be useful to detect the origin which is unknown by using immunohistochemistry method for metastatic lesions. PMID- 3821719 TI - [Prognostic value of hormone receptor in breast cancer]. AB - The relationship of hormone receptor and postoperative prognosis was investigated in 166 patients with breast cancer who underwent curative operation and postoperative adjuvant chemotherapy. The endocrine therapy was performed only for the patients with recurrent disease. The content of estrogen receptor (ER) and progesterone receptor (PgR) were measured by binding assay using gel-filtration method. ER-positive cases accounted for 56% of 166 patients and PgR-positive ones for 36% of 124. The relapse free interval was not different between the ER positive group and ER-negative one, but the survival curve after relapse was significantly different between the both groups. There was no significant difference in the relapse free interval and the survival curve after relapse between PgR-positive group and PgR-negative one. These results suggest that the ER is a good predictor as to the response to endocrine therapy given for recurrent disease, but not as to early recurrence. PMID- 3821720 TI - Structural and functional aspects of tumor cell sialomucins. AB - Sialomucins are abundant on the surfaces of certain ascites tumor cells and have been implicated in the escape of tumors from immune destruction and metastasis. They are large, highly glycosylated glycoproteins which are rich in serine and threonine and have a variety of 0-linked oligosaccharides. The sialomucin (ASGP 1) or 13762 rat mammary adenocarcinoma ascites cells represents more than 0.5% of the total cell protein and can be isolated from cell membranes by centrifugation in 4 M guanidine hydrochloride-cesium chloride. ASGP-1 can also be isolated from membranes or cells by nonionic detergent extraction as a 1:1 complex with a second glycoprotein ASGP-2. Studies with the fluorescent lectins peanut agglutinin, which binds ASGP-1, and Concanavalin A, which binds ASGP-2, indicate that the glycoproteins are present at the cell surface as a complex. ASGP-1 is shed into cell culture medium or ascites fluid, apparently by a proteolytic cleavage mechanism. 13762 ascites cells grown in culture or as solid tumors lose their ASGP-1. The sialomucin reappears with extensive passage of the tumor cells in ascites form. Studies on the biosynthesis of ASGP-1 indicate that carbohydrate is being added over nearly the entire period of transit of ASGP-1 from the site of polypeptide synthesis to the plasma membrane. The negatively charged, rod-like structure of the sialomucins suggests that they may play a role in inhibiting recognition or binding processes necessary for the immune destruction of these tumor cells. PMID- 3821721 TI - Glycoantigen expression is regulated both temporally and spatially during development in the cellular slime molds Dictyostelium discoideum and D. mucoroides. AB - Six monoclonal antibodies were isolated which react with common antigens shared by multiple glycoconjugate species in the cellular slime mold Dictyostelium discoideum. Based on competition of antibody binding by glycopeptides and simple sugars, and inhibition of antibody binding by antigen pretreatment with Na periodate, it is argued that at least five of the six antibodies recognize epitopes which contain carbohydrate. These epitopes are consequently referred to as glycoantigens (GAs). Three of the GAs are expressed during growth and throughout the developmental cycle, but are eventually enriched in prestalk and stalk cells. The remaining three are expressed only during and/or after aggregation and are exclusively expressed or highly enriched in prespore cells and spores. These conclusions are derived from Western blot immunoanalysis of purified cell types, immunofluorescence, and EM immunocytochemistry. The two GAs found only in prespore cells appear to be exclusively enclosed within prespore vesicles. The third GA of this type, which is only enriched in prespore cells compared to prestalk cells, is also found in other vesicle types as well as on the cell surface. Two of the GAs enriched in prestalk cells are initially found in all cells of the slug. They are undetectable in spores and prominent in stalk cells. The third GA, though found in the interiors of both prestalk and prespore cells, is enriched on the cell surface of prestalk cells. The chief characteristics of expression of four of these GAs are conserved in the related species D. mucoroides. This species is characterized by continuous transdifferentiation of prespore cells into prestalk cells. This shows that the prespore cells maintain specific mechanisms for turning over their cell type specific GAs and that prestalk cells express a specific mechanism for inducing at least one of their cell-type specific GAs. These observations identify specific carbohydrate structures (as GAs) whose synthesis, subsequent localization and turnover are developmentally regulated. The exclusive association of two GAs with prespore vesicles identifies these GAs as markers for this organelle and raises questions regarding the functional significance of this association. The restricted cell surface localization of the other four GAs, together with data from cell adhesion studies, suggest the possibility of a potential role for these GAs in intercellular recognition leading to cell sorting. PMID- 3821722 TI - Possible function of carbohydrate on glycoproteins secreted by the pig uterus during pregnancy. AB - Uteroferrin is a purple iron-containing acid phosphatase secreted by the porcine uterus under the influence of the hormone, progesterone. It is synthesized by the glandular epithelial cells of the uterine endometrium and during pregnancy is taken up by specialized structures (areolae) opposite each uterine gland. Uteroferrin is then released into the fetal circulation and cleared by the liver or fetal kidney. A major role in iron transport to the fetus has been proposed. Uteroferrin, as purified from uterine secretions of pigs, possesses mainly high mannose (predominantly Man5 and Man6) chains. These oligosaccharide chains of uteroferrin appear to be responsible for its binding and uptake by reticuloendothelial cells of the fetal liver which is the major site of erythropoiesis of the fetus. Uteroferrin, although implicated in transplantal iron transport, also possesses many of the properties of a lysosomal enzyme and, when newly synthesized, carries the so-called lysosomal recognition marker, mannose 6-phosphate. The phosphate group is masked by a covering N acetylglucosamine residue, a feature which may account for its secretion rather than retention within lysosomes. Evidence is also presented that the oligosaccharide chains of newly synthesized uteroferrin are larger than those of the mature form and are trimmed after secretion. The phosphate group is also removed. It is not clear whether uteroferrin carbohydrate is implicated in the movement of the glycoprotein across the placenta as well as its uptake by the fetal liver. PMID- 3821723 TI - Isolation of the amplified dihydrofolate reductase domain from methotrexate resistant Chinese hamster ovary cells. AB - We isolated overlapping recombinant cosmids that represent the equivalent of two complete dihydrofolate reductase amplicon types from the methotrexate-resistant CHO cell line CHOC400. The type I amplicons are 260 kilobases long, are arranged in head-to-tail fashion, and represent 10 to 15% of the amplicons in the CHOC400 genome. The type II amplicons are 220 kilobases long, are arranged in head-to head and tail-to-tail configurations, and constituted the majority of the remaining amplicons in CHOC400 cells. The type II amplicon sequences are represented entirely within the type I unit. These are the first complete amplicons to be cloned from a mammalian cell line. PMID- 3821724 TI - Localization of an alpha-amanitin resistance mutation in the gene encoding the largest subunit of mouse RNA polymerase II. AB - RNA polymerase II is inhibited by the mushroom toxin alpha-amanitin. A mouse BALB/c 3T3 cell line was selected for resistance to alpha-amanitin and characterized in detail. This cell line, designated A21, was heterozygous, possessing both amanitin-sensitive and -resistant forms of RNA polymerase II; the mutant form was 500 times more resistant to alpha-amanitin than the sensitive form. By using the wild-type mouse RNA polymerase II largest subunit (RPII215) gene (J.A. Ahearn, M.S. Bartolomei, M. L. West, and J. L. Corden, submitted for publication) as the probe, RPII215 genes were isolated from an A21 genomic DNA library. The mutant allele was identified by its ability to transfer amanitin resistance in a transfection assay. Genomic reconstructions between mutant and wild-type alleles localized the mutation to a 450-base-pair fragment that included parts of exons 14 and 15. This fragment was sequenced and compared with the wild-type sequence; a single AT-to-GC transition was detected at nucleotide 6819, corresponding to an asparagine-to-aspartate substitution at amino acid 793 of the predicted protein sequence. Knowledge of the position of the A21 mutation should facilitate the study of the mechanism of alpha-amanitin resistance. Furthermore, the A21 gene will be useful for studying the phenotype of site directed mutations in the RPII215 gene. PMID- 3821725 TI - Transient response of amplified metallothionein genes in CHO cells to induction by alpha interferon. AB - Alpha interferon treatment of CHO cells elicits the rapid synthesis of many gene products, including metallothionein (MT), a protein which avidly binds heavy metals such as zinc, cadmium, and copper. Since MTs appear to have a pleiotropic role in the cell, ranging from metal detoxification to free-radical scavenging, interferon treatment may trigger a generalized defense mechanism. Activation by interferon, however, was transient, with MT mRNA being maximally detectable by a cytodot procedure within the first hour. Subsequent addition of interferon was ineffective until 7 h after the initial treatment. The action of zinc, a potent inducer of MT, however, remained independent of alpha interferon induction. The transient nature of induction by interferon was examined for altered rate of MT mRNA turnover. PMID- 3821726 TI - Metal-responsive elements act as positive modulators of human metallothionein-IIA enhancer activity. AB - The human metallothionein IIA (hMT-IIA) gene contains two enhancer elements whose activity is induced by heavy-metal ions such as Cd2+. To determine the nature of the relationship between the metal-responsive elements and the element(s) responsible for the basal activity of the enhancers, the basal-level enhancer element(s), the hMT-IIA enhancers were subjected to mutational analysis. We show that deletion of the metal-responsive elements had no effect on the basal activity of the enhancer but prevented further induction by Cd2+. On the other hand, replacement of the basal-level enhancer element with linker DNA led to inactivation of the enhancer both before and after treatment with Cd2+. Therefore, the metal-responsive elements seems to act as a positive modulator of enhancer function in the presence of heavy-metal ions. In addition to the two enhancers, the hMT-IIA promoter contained one other element, the GC box, required for its basal expression. Unlike deletion of the basal-level enhancer element, replacement of the GC box with linker DNA had no effect on the ability of the promoter to be induced by Cd2+. PMID- 3821727 TI - Firefly luciferase gene: structure and expression in mammalian cells. AB - The nucleotide sequence of the luciferase gene from the firefly Photinus pyralis was determined from the analysis of cDNA and genomic clones. The gene contains six introns, all less than 60 bases in length. The 5' end of the luciferase mRNA was determined by both S1 nuclease analysis and primer extension. Although the luciferase cDNA clone lacked the six N-terminal codons of the open reading frame, we were able to reconstruct the equivalent of a full-length cDNA using the genomic clone as a source of the missing 5' sequence. The full-length, intronless luciferase gene was inserted into mammalian expression vectors and introduced into monkey (CV-1) cells in which enzymatically active firefly luciferase was transiently expressed. In addition, cell lines stably expressing firefly luciferase were isolated. Deleting a portion of the 5'-untranslated region of the luciferase gene removed an upstream initiation (AUG) codon and resulted in a twofold increase in the level of luciferase expression. The ability of the full length luciferase gene to activate cryptic or enhancerless promoters was also greatly reduced or eliminated by this 5' deletion. Assaying the expression of luciferase provides a rapid and inexpensive method for monitoring promoter activity. Depending on the instrumentation employed to detect luciferase activity, we estimate this assay to be from 30- to 1,000-fold more sensitive than assaying chloramphenicol acetyltransferase expression. PMID- 3821728 TI - Metaphase protein phosphorylation in Xenopus laevis eggs. AB - Cytoplasmic extracts of metaphase (M-phase)-arrested Xenopus laevis eggs support nuclear envelope breakdown and chromosome condensation in vitro. Induction of nuclear breakdown is inhibited by AMPP(NH)P, a nonhydrolyzable ATP analog, but not by ATP or gamma-S-ATP, a hydrolyzable ATP analog, suggesting that protein phosphorylation may be required for M-phase nuclear events in vitro. By addition of [gamma-32P]ATP, we have identified in cytoplasmic extracts and in intact eggs at least six phosphoproteins that are present during M-phase but absent in G1/S phase. These phosphoproteins also appear in response to partially purified preparations of maturation-promoting factor. A subset of these proteins are thiophosphorylated by gamma-S-ATP under conditions that promote nuclear envelope breakdown and chromosome condensation. Each of these proteins is phosphorylated on serine and threonine, and one, a 42-kilodalton protein, is also phosphorylated on tyrosine both in extracts and in intact eggs. These results indicate that activation of protein kinases accounts for at least part of the increased phosphorylation in M-phase and that both protein-serine-threonine kinases and protein-tyrosine kinases may play a role in controlling M-phase nuclear behavior. PMID- 3821729 TI - Role of protein synthesis in decay and accumulation of mRNA during spore germination in the cellular slime mold Dictyostelium discoideum. AB - Spore germination in Dictyostelium discoideum is a particularly suitable model for studying the regulation of gene expression, since developmentally regulated changes in both protein and mRNA synthesis occur during the transition from dormant spore to amoeba. The previous isolation of three cDNA clones specific for mRNA developmentally regulated during spore germination allowed for the quantitation of the specific mRNAs during this process. The three mRNAs specific to clones pLK109, pLK229, and pRK270 have half-lives much shorter (minutes) than those of constitutive mRNAs (hours). Using spore germination as a model, we studied the roles of ribosome-mRNA interactions and protein synthesis in mRNA degradation by using antibiotics that inhibit specific reactions in protein biosynthesis. Cycloheximide inhibits the elongation step of protein synthesis. Polysomes accumulate in inhibited cells because ribosomes do not terminate normally and new ribosomes enter the polysome, eventually saturating the mRNA. Pactamycin inhibits initiation, and consequently polysomes break down in the presence of this drug. Under this condition, the mRNA is essentially free of ribosomes. pLK109, pLK229, and pRK270 mRNAs were stabilized in the presence of cycloheximide, but pactamycin had no effect on their normal decay. Since it seems likely that stability of mRNA reflects the availability of sites for inactivation by nucleases, it follows that in the presence of cycloheximide, these sites are protected, presumably by occupancy by ribosomes. No ribosomes are bound to mRNA in the presence of pactamycin, and therefore mRNA degrades at about the normal rate. The data further indicate that a labile protein is probably not involved in mRNA decay or stabilization, since protein synthesis is inhibited equally by both antibiotics. We conclude that it may be important to use more than one type of protein synthesis inhibitor to evaluate whether protein synthesis is required for mRNA decay. The effect of protein synthesis inhibition on mRNA synthesis and accumulation was also studied. mRNA synthesis continues in the presence of inhibitors, albeit at a diminished rate relative to that of the uninhibited control. PMID- 3821730 TI - Adenovirus origin of DNA replication: sequence requirements for replication in vitro. AB - The initiation of adenovirus DNA takes place at the termini of the viral genome and requires the presence of specific nucleotide sequence elements. To define the sequence organization of the viral origin, we tested a large number of deletion, insertion, and base substitution mutants for their ability to support initiation and replication in vitro. The data demonstrate that the origin consists of at least three functionally distinct domains, A, B, and C. Domain A (nucleotides 1 to 18) contains the minimal sequence sufficient for origin function. Domains B (nucleotides 19 to 40) and C (nucleotides 41 to 51) contain accessory sequences that significantly increase the activity of the minimal origin. The presence of domain B increases the efficiency of initiation by more than 10-fold in vitro, and the presence of domains B and C increases the efficiency of initiation by more than 30-fold. Mutations that alter the distance between the minimal origin and the accessory domains by one or two base pairs dramatically decrease initiation efficiency. This critical spacing requirement suggests that there are specific interactions between the factors that recognize the two regions. PMID- 3821731 TI - Sequence-specific interactions between cellular DNA-binding proteins and the adenovirus origin of DNA replication. AB - The adenovirus origin of DNA replication contains three functionally distinct sequence domains (A, B, and C) that are essential for initiation of DNA synthesis. Previous studies have shown that domain B contains the recognition site for nuclear factor I (NF-I), a cellular protein that is required for optimal initiation. In the studies reported here, we used highly purified NF-I, prepared by DNA recognition site affinity chromatography (P. J. Rosenfeld and T. J. Kelly, Jr., J. Biol. Chem. 261:1398-1408, 1986), to investigate the cellular protein requirements for initiation of viral DNA replication. Our data demonstrate that while NF-I is essential for efficient initiation in vitro, other cellular factors are required as well. A fraction derived from HeLa cell nuclear extract (BR-FT fraction) was shown to contain all the additional cellular proteins required for the complete reconstitution of the initiation reaction. Analysis of this complementing fraction by a gel electrophoresis DNA-binding assay revealed the presence of two site-specific DNA-binding proteins, ORP-A and ORP-C, that recognized sequences in domains A and C, respectively, of the viral origin. Both proteins were purified by DNA recognition site affinity chromatography, and the boundaries of their binding sites were defined by DNase I footprint analysis. Additional characterization of the recognition sequences of ORP-A, NF-I, and ORP C was accomplished by determining the affinity of the proteins for viral origins containing deletion and base substitution mutations. ORP-C recognized a sequence between nucleotides 41 and 51 of the adenovirus genome, and analysis of mutant origins indicated that efficient initiation of replication is dependent on the presence of a high-affinity ORP-C-binding site. The ORP-A recognition site was localized to the first 12 base pairs of the viral genome within the minimal origin of replication. These data provide evidence that the initiation of adenovirus DNA replication involves multiple protein-DNA interactions at the origin. PMID- 3821732 TI - Structure of the rat platelet factor 4 gene: a marker for megakaryocyte differentiation. AB - A rat platelet factor 4 (PF4) cDNA has been isolated by immunoscreening a g lambda 11 rat megakaryocyte cDNA expression library. Sequence analysis of the rat PF4 cDNA revealed that this megakaryocyte protein is composed of a leader sequence of 29 amino acid residues and a mature protein sequence of 76 amino acid residues. The structure of rat PF4 derived from its cDNA shows a marked homology with the amino acid sequence of human PF4 obtained by classical protein chemistry techniques. This observation is particularly striking with regard to the carboxy terminal region of rat and human PF4, where 28 of the last 31 C-terminal residues are identical. The rat PF4 gene was obtained from a rat genomic library by using rat PF4 cDNA as a hybridization probe. Sequence analysis showed that the gene is constructed of three exons and two short introns. The transcriptional start site is located 73 base pairs upstream of the translational start codon as judged by S1 nuclease mapping and primer extension. The 5' noncoding region of the gene also exhibited a sequence homologous to the TATA box at -31, as well as a series of direct and inverted repeat sequences and a cluster of 26 T residues at -155 to -218. This latter domain may be involved in regulating PF4 gene expression during megakaryocytopoiesis. PMID- 3821733 TI - Characterization of the rearranged tpr-met oncogene breakpoint. AB - We determined the nucleotide sequence of the rearranged trp-met genomic locus and the corresponding portions of the unrearranged tpr and met genomic fragments. The breakpoints occur at one end of a stretch of 21 A residues that follow an Alu repetitive sequence in the tpr locus and within a group of 3 A residues in the met proto-oncogene locus. We conclude that the fusion between the tpr locus on chromosome 1 and the met locus on chromosome 7 resulted from a recombination event. PMID- 3821734 TI - A 5'-flanking region of the chicken acetylcholine receptor alpha-subunit gene confers tissue specificity and developmental control of expression in transfected cells. AB - The 5' end and promoter region of the alpha-subunit gene of chicken muscle acetylcholine receptor was mapped and sequenced. It includes a TATA and a CAAT box and a potential Sp1-binding site. When inserted in front of the chloramphenicol acetyltransferase gene, this promoter (including 850 base pairs of upstream sequence) directed high transient chloramphenicol acetyltransferase expression in transfected mouse C2.7 myotubes but not in C2.7 myoblasts or nonmyogenic 3T6 cells. PMID- 3821736 TI - Signals and signal processing--IV. Antigen specific and other immune regulatory circuits and networks. Proceedings of the 4th Balaton Meeting of Signals and Signal Processing in the Immune System. 1-4 September 1985, Balatonfured, Hungary. PMID- 3821735 TI - Molecular characterization of 15 rearrangements among 90 human in vivo somatic mutants shows that deletions predominate. AB - Ninety hypoxanthine phosphoribosyltransferase-deficient mutants were isolated from lymphocytes of 31 individuals drawn from both control populations and populations exposed to low doses of ionizing radiation. Southern analysis of the DNA revealed altered hybridization patterns in 15 mutants. Of these, 14 changes consisted of deletions of 2 to 40 kilobases or more. PMID- 3821737 TI - Binding characteristics and isotype specificity of Fc receptors on K cells. PMID- 3821738 TI - The effect of Fc receptor modulation on human monocyte function. PMID- 3821739 TI - Contribution of activated C3 to lymphocyte-mediated cytolysis. PMID- 3821740 TI - Specificity of ganglioside binding to rat macrophages. AB - The binding specificity of rat alveolar macrophages (AM phi) for sheep erythrocytes (E) coated with gangliosides GM1, GM2, GM3, GD1a, GD1b or GT1b was analyzed in a rosette assay by studying the inhibitory effect of gangliosides, various carbohydrates, IgG, C3b-like C3, and fibronectin in this assay. The uptake of gangliosides by E was calculated from radioactivity measurements using 3H-labeled gangliosides. The different gangliosides were taken up by E at 37 degrees C to a similar extent. Uptake of 3H-labeled GM2 correlated linearly to its concn in the incubation medium. Erythrocytes pretreated with the same molar concn of GM2, GD1a, GD1b or GT1b were bound to AM phi to the same degree reaching a maximum of about 90% rosette forming cells. A mean of 17.8% AM phi-bound GM3 coated E. Treatment of E with asialo-GM2 (GA2) or GM1 did not induce significant rosette formation. A dose-dependent inhibition of rosette formation was observed when AM phi were preincubated at 0 degree C with GM2, GM3, GD1a, GD1b or GT1b, but not with GM1 or GA2 Of the tested carbohydrates, sialyl-lactose had a strong inhibitory effect, while lactose was completely ineffective. N-acetyl-neuraminic acid, N-glycolyl-neuraminic acid and N-acetyl-galactosamine were slightly inhibitory. A series of other carbohydrates including highly negatively charged compounds, as well as fibronectin, IgG or C3b-like C3 did not show significant inhibition. Our data indicate the expression of a receptor on rat AM phi recognizing carbohydrates containing sialic acid at or near the non-reducing terminus. PMID- 3821741 TI - Linkage of low and high affinity anti-fluorescein idiotype families. AB - Data presented in this study describes the isolation and characterization of two anti-fluorescein (F1) hybridoma proteins 3-24 and 12-40, both IgG1, kappa with a Ka = 2.8 and 3.4 X 10(6) M-1, respectively, at 37 degrees C. These clones inhibited (6.8 +/- 2.8 -20.8 +/- 0.6% at 1 microgram/well) the idiotype-anti idiotype interactions (IAII) of anti-F1 clones 3-13 and 3-17, which define a previously described low affinity idiotype family. Antibodies 3-24 and 12-40 also inhibited (45.0 +/- 3.0 and 61.3 +/- 5.6%, respectively, at 1 microgram/well) an IAII defined by a high affinity (Ka = 5.2 +/- 1.5 X 10(9) M-1 at 37 degrees C) anti-F1 clone, 4-4. Hybridoma proteins 3-13 and 3-17 possess similar affinities for F1 (Ka = 3.8 +/- 5.1 and 5.9 +/- 4.0 X 10(4) M-1) and are known to be idiotypically unrelated to clone 4-4. While 3-24 and 12-40 appeared very similar, non-identity of their active sites was established by heterologous idiotypic inhibitions, fine specificity of binding and spectral measurements (Qmax and lambda max) of bound F1. All IAII (3-13, 3-17, 9-40 and 4-4) were inhibited greater than 80% by the presence of 10(-4) M F1 or F1-BSA. In addition, four intermediate affinity (6.0 X 10(6) less than or equal to Ka less than or equal to 5.3 X 10(8) M-1) anti-F1 clones, comprising a second previously described idiotype family (designated the 9-40 family) were further analyzed. Inhibition of the 9-40 IAII by all heterologous proteins in the 9-40 family (except clone 5 27), and clones 3-24, 12-40 and 4-4 ranged from 87.7 +/- 1.3 to 95.4 +/- 1.0% at 1 microgram/well. Titration of the 9-40 IAII inhibition by antibodies 9-40, 3-24, 12-40 or 4-4 generated essentially superimposable profiles. In reciprocal inhibition experiments, using the 4-4 IAII, clones 3-24, 12-40, 9-40 and 4-4 gave distinct idiotypic titration patterns. Thus, members of the 9-40 family, 3-24 and 12-40 were more closely related to intermediate affinity clone 9-40 than high affinity clone 4-4.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3821742 TI - The asymmetric IgG non-precipitating antibody. Localization of the oligosaccharide involved, by concanavalin A interaction. AB - Binding to Con A-Sepharose 4B of the low-affinity Fab fragment from sheep IgG1 anti-Dnp non-precipitating antibody was previously determined. This communication reports the results obtained when the concanavalin A interaction with Fd' fragments and L chains from non-precipitating and precipitating antibodies was examined. When Fd' fragments and L chains from non-precipitating and precipitating antibodies were tested as inhibitors of the binding of 125I labelled concanavalin A to guinea pig erythrocytes, inhibition of such binding was only achieved by Fd' fragments from non-precipitating antibodies. Forty eight per cent of this Fd' fragment was bound by Con A-Sepharose 4B. From these results and our previous studies we conclude that mannose and/or glucose residues must be present and exposed at the Fd' fragment from the low-affinity Fab arm of sheep IgG1 anti-Dnp non-precipitating antibody. Glycosylation differences may explain the difference in precipitation behaviour of the 2 types of antibody. PMID- 3821743 TI - [Ergometry procedures independent of body weight in children with special reference to blood pressure behavior in stress]. AB - For the purpose of investigating differences in terms of gender and methodology, a group of 80 healthy children engaged in leisure-time sport activities (male: n = 50; 10.9 +/- 1.1 years; female: n = 30; 11.5 +/- 1.1 years) was divided into 3 groups, which were then subjected to different ergometric procedures. In group I, boys and girls were compared in a bicycle ergometry in an upright seated position. In group II, a bicycle ergometry in upright seated position was compared with a bicycle ergometry in a supine position. In group III, a bicycle ergometry in upright seated position was compared with a treadmill exercise. Bicycle ergometry was started at 25 W; workload was increased in steps of 25 W every 3 min until the children felt exhausted. RESULTS: No differences with respect to gender were found for maximum oxygen uptake, maximum heart rate and maximum lactate. The relevant parameters were also similar on submaximal levels of exercise intensity. All children reached a degree of thorough physical exhaustion at heart rates close to 200 X min-1. As in adults, maximum oxygen uptake decreased in the following order: treadmill exercise greater than bicycle ergometry in upright seated position greater than bicycle in supine position. Systolic and diastolic blood pressure on the various levels of exercise were lower than among adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821744 TI - [Respiratory emergency in the newborn infant: extreme laryngotracheo-esophageal cleft (esophagotrachea)]. AB - Intra vitam diagnostic procedures revealed a complete laryngo-tracheo-oesophageal cleft in a premature infant with respiratory distress. Anamnesis together with clinical and roentgenological symptoms suggested the diagnosis of oesophageal atresia or oesophago-tracheal fistula. The diagnosis of "oesophago-trachea" was finally confirmed by laryngo-tracheoscopy. The morphologic defect in this case was combined with partial supradiaphragmatic dislocation of the stomach and with intestinal malrotation. PMID- 3821745 TI - [Recommendations of the Nutrition Commission of the German Society of Pediatrics on the introduction of supplementary food in the nutrition of infants]. PMID- 3821746 TI - [Nutrition of small premature infants with FM85: energy, protein and mineral supplemented breast milk]. PMID- 3821747 TI - [Congenital hypothyroidism--a diagnosis made by abdominal x-ray?]. AB - Meteorism in a newborn may be a symptom of different diseases including hypothyroidism. It is caused by a disturbed peristalsis of the gut. Since in rare cases - as demonstrated in one infant - obligatory screening for hypothyroidism may be missed, meteorism should be considered a serious symptom and should lead to the right diagnosis before too much time is lost. PMID- 3821748 TI - [Dilatation of the sinusoids in liver tissue caused by oral contraceptives. Electron microscopy studies in 14 cases of surgical liver excision]. PMID- 3821749 TI - [Astrocytoma (infundibuloma) of the infundibulum with granular bodies]. PMID- 3821750 TI - [Morphologic consequences of prenatal anoxic damage]. PMID- 3821751 TI - [Epithelioid hemangioendothelioma of the liver]. PMID- 3821752 TI - [Morphologic lesions in paraquat poisoning]. PMID- 3821753 TI - [Nodular regenerative hyperplasia of the liver]. PMID- 3821754 TI - [Simultaneous occurrence of malignant colon teratoma and ulcerative colitis]. PMID- 3821755 TI - [Ultrastructure of skin biopsy specimens from uremic patients treated by peritoneal dialysis]. PMID- 3821756 TI - [Evolution of the hemagglutinin gene of influenza A virus H1N1-subtype (1977 1983]. AB - A scheme for evolutionary interrelations of the H1-subunits of influenza hemagglutinin genes is proposed for the natural variants of influenza A virus of the H1N1-subtype. It is based on experimental data obtained by the authors and those reported in the literature. Differences among these viral isolates in their amino acid sequences and in the reaction of hemagglutinin inhibition obtained with a set of monoclonal antibodies are compared. The distinctions in the ability of the viruses to react with several monoclonal antibodies are attributed to differences in the primary structures of their hemagglutinins. Some aspects of hemagglutinin gene evolution are discussed in relation to vaccination. PMID- 3821757 TI - [Effect of ethanol on the level of biogenic amines and activity of energy metabolism enzymes in rats subjected to extreme conditions]. PMID- 3821758 TI - [Regulation of the orientation of the IgG and IgM molecule at the interface]. AB - Pathological immunoglobulins (IgG from patients with multiple myeloma and IgM from patients with Waldenstrom macroglobulinemia) have been shown to possess hydrophylic-lipophylic balance (HLB) which differed from normal Ig HLB. HLB deficiency in pathological proteins was due to the increase of hydrophobic area at the surface of protein globe, which was the reason for different normal and abnormal Ig orientations at the aqueous NaCl solution--air interface. The normal IgG and IgM had horizontal orientation while abnormal ones had vertical orientation. Both normal and abnormal Ig changed their orientation in monolayers as a result of sodium deoxycholate processing. The change in orientation depended on protein molecules interaction with single molecules or micelles of sodium deoxycholate. PMID- 3821759 TI - [Evolution of the hemagglutinin gene of human influenza A virus H3 subtype]. AB - An evolutional tree of human influenza viruses of the H3N2-subtype is suggested on the basis of combined published primary structures of the hemagglutinin HA1 subunit. Possible differences between natural and sequenced structures are discussed. A tendency to reversions in the course of antigenic draft within the subtype has been revealed to support the hypothesis of limited antigenic evolution within a single subtype. PMID- 3821760 TI - Chromosomal aberrations induced in human cultured cells by liposome-encapsulated deoxyribonuclease I. AB - Experiments of incorporation of a nucleolytic enzyme into human cells cultured in vitro have been carried out with the aim of inducing structural chromosome variations. Human heteroploid cells, either as asynchronous populations or enriched in mitoses, and PHA-stimulated lymphocytes were used as recipients. We found that all these cells when exposed to pancreatic DNAase I encapsulated in liposomes, either of multilamellar (MLV) or of small unilamellar (SUV) type, show an incidence of chromosome damage higher than that induced by the enzyme free in the incubation buffer. Our results indicate that liposomes are suitable vehicles for the transfer of an exogenous nuclease into human cultured cells. The enzyme remains functionally active and interacts with nuclear DNA, giving rise to chromosome lesions. PMID- 3821761 TI - Cytological characterization of Chinese hamster ovary X-ray-sensitive mutant cells xrs 5 and xrs 6. I. Induction of chromosomal aberrations by X-irradiation and its modulation with 3-aminobenzamide and caffeine. AB - We have studied two X-ray-sensitive mutants xrs 5 and xrs 6 (derived from the CHO K1 cell line), known to be defective in repair of double-strand breaks, for cell killing and frequency of the chromosomal aberrations induced by X-irradiation. The survival experiments showed that mutants are very sensitive to X-rays, the D0, for the wild-type CHO-K1 was 6-fold higher than D0 value for the mutants. The modal number of chromosomes (2 n = 23) and the frequency of spontaneously occurring chromosomal aberrations were similar in all 3 cell lines. X-Irradiation of synchronized mutant cells in G1-phase significantly induced both chromosome- and chromatid-type of aberrations. The frequency of aberrations in xrs mutants was 12-fold more than in the wild-type CHO-K1 cells. X-Irradiation of G2-phase cells also yielded higher frequency of aberrations in the mutants, namely 7-8 fold in xrs 5 and about 3.5-fold in xrs 6 compared to the wild-type CHO-K1 cells. There was a good correlation between relative inability to repair of DNA double strand breaks and induction of aberrations. The effect of 3-aminobenzamide (3AB), an inhibitor of poly(ADP-ribose) synthetase on the frequency of X-ray-induced chromosomal aberrations in these 3 cell lines was also studied. 3AB potentiated the frequency of aberrations in G1 and G2 in all the cell types. In the mutants, 3AB had a potentiating effect on the frequency of X-ray-induced chromosomal aberrations only at low doses. X-Ray-induced G2 arrest and its release by caffeine was studied by cytofluorometric methods. The relative speed with which irradiated S-G2 cells progressed into mitosis in the presence of caffeine was CHO K1 greater than xrs 5 greater than xrs 6. Caffeine could counteract G2 delay induced by X-rays in CHO-K1 and xrs 5 but not in xrs 6. Large differences in potentiation by caffeine were observed among these cells subjected to X-rays and caffeine post-treatment for different durations. These responses and possible reasons for the increased radiosensitivity of xrs mutants are discussed and compared to ataxia telangiectasia (A-T) cells and a radiosensitive mutant mouse lymphoma cell line. PMID- 3821762 TI - Radiation-induced forward and reverse specific locus mutations and dominant cataract mutations in treated strain BALB/c and DBA/2 male mice. AB - Strain BALB/c and DBA/2 mice were chosen to investigate the effects of genetic background on the radiation-induced mutation rate since they exhibit differences in their radiation sensitivity. Males were exposed to 3 + 3-Gy X-irradiation and mated to untreated specific locus Test-stock females. Offspring resulting from treated spermatogonia were screened for induced specific locus forward and reverse mutations and dominant cataract mutations. Since BALB/c mice are homozygous brown and albino, specific locus forward mutations could be screened at 5 of the 7 specific loci (a, d, se, p, s), while reverse mutations could be screened at the b and c loci. Strain DBA/2 is homozygous non-agouti, brown and dilute. Therefore, specific locus forward mutations could be screened at 4 loci (c, se, p, s) and reverse mutations were screened at the a, b and d loci. Results indicate no effect of genetic background on the sensitivity to mutation induction of specific locus forward mutations, while for the dominant cataract alleles strain DBA/2 exhibited a higher mutation rate than either strain BALB/c or similarly treated (101/El X C3H/El)F1 mice. If, by confirmation, these differences should be demonstrated to be real, it is interesting that strain DBA/2 should exhibit a greater sensitivity to radiation-induced dominant mutations. First, strain DBA/2 was chosen as radiation resistant or repair competent. The observation that DBA/2 exhibited a higher sensitivity to radiation induced mutation may indicate a role for repair, albeit misrepair, in the mutation process. Second, that the effect of genotype was only observed for the mutation rate to dominant cataract alleles may reflect a difference in the spectrum of DNA alterations which result in dominant or recessive alleles. A dominant allele is more likely misinformation, such that as heterozygote it interferes with the wild-type allele. By comparison, a recessive allele may result from any DNA alteration leading to the loss of a functional gene product. One reverse mutation at each of the a and d loci was recovered in the present experiments. The similarities of the present results for radiation-induced reverse mutations with the extensive data on the spontaneous reverse mutation rates are interesting. Reverse mutations were recovered only at the a and d loci. Further, the reverse mutations recovered at the a locus were to alternate alleles (at, Aw or Asy) while true reverse mutations were apparently recovered at the d locus. PMID- 3821763 TI - Frequency of congenital defects and dominant lethals in the offspring of male mice treated with methylnitrosourea. AB - ICR strain male mice were injected intraperitoneally with daily doses of MNU (5 25 mg/kg) for 5 days and mated to untreated virgin females of the same strain on days 1-7, 8-14, 15-21 and 64-80 after the last dose. Copulations during these periods involve, respectively, spermatozoa, late spermatids, early spermatids, and spermatogonial stem cells at the time of the last treatment. The uterine contents were examined on day 18 of pregnancy for post-implantation losses (dominant lethality). Fetuses were examined for external and skeletal abnormalities. In contrast to the results reported for specific-locus mutations, MNU treatment of either postmeiotic cells or spermatogonial stem cells caused dose-dependent significant increases in the incidence of congenital defects and of dominant lethals over the control levels. The relative sensitivity of germ cells sampled on days 1-7, 8-21 and 64-80 to MNU-induced congenital defects was 1:1.6:2. For the induction of dominant lethals, the sensitivity ratio was 1:1.8:0.5. It is proposed that congenital defects in the offspring of mice following paternal treatment with MNU may represent mostly chromosomal rather than genic changes. Cleft palate was the most frequent of the external abnormalities, which were significantly induced in every treatment series; fused ribs were the most frequent of the skeletal abnormalities, which were significantly induced in the treatment series for spermatogonial stem cells. PMID- 3821764 TI - General characteristics, molecular and genetic analysis of two new UV-sensitive mutants of Chlamydomonas reinhardtii. AB - Two new UV-sensitive mutants of Chlamydomonas, UVS10 and UVS11, were isolated. Both behave as single nuclear mutations. UVS10 was mapped to linkage group I. UVS11 is a separate, unlinked mutation but has not yet been located to a specific linkage group. Both mutants are proficient in the excision of pyrimidine dimers from nuclear DNA. The survival of UV-irradiated UVS11 is increased when plated in the presence of 1.5 mM caffeine, similar to wild-type. Caffeine has no effect on the survival of UV-irradiated UVS10. UV-irradiated UVS11 frequently divides at least once before dying, in contrast to UVS10 or wild-type. UVS11 also exhibits a much increased frequency of mutation to streptomycin resistance after UV irradiation. PMID- 3821765 TI - Sister-chromatid exchanges induced by ultraviolet light in Bloom's syndrome fibroblasts. AB - The relationships between the cytotoxic effect of ultraviolet light and the UV induced sister-chromatid exchanges (SCEs) were compared among fibroblast cell strains from two unrelated Bloom's syndrome (BS) patients, one xeroderma pigmentosum (XP) patient belonging to complementation group A and two unrelated normal controls. The "net" induced SCEs as a function of UV fluence, obtained by subtracting spontaneous SCEs from observed SCEs, were much higher in both BS cells and XP group A cells than in normal cells. The relative efficiency of induced SCE, defined as the "net" induced SCEs as a function of surviving fraction after UV irradiation, was higher in BS cells than in normal and XP cells, and there was essentially no difference between XP and normal cells. These results imply that in addition to the extremely high frequency of spontaneous SCEs, the increased efficiency in UV induction of SCEs may reflect the intrinsic defect(s) in BS cells. PMID- 3821766 TI - Cytogenetic studies on rural populations exposed to pesticides. AB - The authors have carried out cytological analysis of 72 h lymphocyte cultures from peripheral blood and internal examinations of 80 workers professionally exposed to a complex of pesticides and that of 24 control persons. There was a significant increase of chromosome aberrations in relation to the duration of exposure. The additive role of alcohol consumption and smoking in evoking aberrations was also studied with inconclusive results because of the limited number of cases. Internal examinations revealed a more frequent occurrence of acute as well as chronic diseases among the workers aged 21-40 years. PMID- 3821767 TI - Mutagenicity and clastogenicity of teniposide (VM-26) in L5178Y/TK +/- -3.7.2C mouse lymphoma cells. AB - The antitumor drug teniposide (VM-26) is a potent inducer of DNA breaks (Long et al., Cancer Res., (1985) 45, 3106), but it is only weakly mutagenic at the hprt locus in CHO cells (Singh and Gupta, Cancer Res., (1983) 43, 577). In the present study, the mutagenic and clastogenic activities of teniposide were evaluated in L5178Y/TK +/- -3.7.2C mouse lymphoma cells. Although teniposide is a weak mutagen at the hprt locus, it is a potent mutagen at the tk locus, with as little as 0.5 ng/ml producing 220 TK mutants/10(6) survivors at 96% survival (background = 100/10(6) survivors). This same dose of teniposide induced 38 aberrations per 100 metaphases (background = 7/100 cells). At 7 ng/ml, teniposide induced approximately 2700 TK mutants/10(6) survivors at approximately 10% survival. At the highest dose sampled for aberration analysis (5 ng/ml), teniposide induced 44 aberrations/100 cells. Most of the aberrations were chromosomal rather than chromatid events. As expected for a compound acting primarily by a clastogenic mechanism, most of the TK mutants were small colonies. Thus, teniposide is a potent clastogen, and it is a potent mutagen at the tk locus but not at the hprt locus. These results support the hypothesis that the location of the target gene affects the ability of the assay to detect both intragenic events and events causing functional multilocus effects. Thus, a heterozygous locus (like tk) but not a functionally hemizygous locus (like hprt) may permit the detection of mutagens that act primarily by a clastogenic mechanism. Because teniposide induces topoisomerase II-associated DNA breaks, and because there is evidence that teniposide may not interact directly with DNA, we discuss the possibility that the potent clastogenic/mutagenic activity of teniposide may be mediated by topoisomerase II. PMID- 3821768 TI - The effectiveness of S9 and microsomal mix on activation of cyclophosphamide to induce genotoxicity in human lymphocytes. AB - Comparative results are presented on the effectiveness of rat-liver S9 or microsomal mix (M mix) in activating cyclophosphamide (CP) and its ability to induce a clastogenic effect in human lymphocytes in vitro. Structural chromosome changes were analysed exclusively in 1st division (M1) metaphases post-exposure. A high genotoxic response was observed for both metabolizing systems used. With an exposure of 2 h to different concentrations of S9 or M mix, the highest aberration yields were always found for the highest protein content. For CP treatment times of 1, 2 or 4 h together with S9 mix (protein content 10 mg/ml) or M mix (4 mg/ml), the latter was more efficient. With both systems, a lower clastogenic effect of CP was found at 4 h exposure than at 1 h or 2 h. Only a weak cytotoxic effect, reflected mainly by the reduction in the percentage of 3rd cycle cells (M3), and measured in terms of the proportion of M1, M2 and M3 cells, was induced by both systems. PMID- 3821769 TI - Cytogenetic studies on 1,1-dichloroethylene and its two isomers in mammalian cells in vitro and in vivo. AB - Chromosomal aberration and sister-chromatid exchange (SCE) tests in vitro on 1,1 dichloroethylene (1,1-DCE), its two isomers, cis- and trans-1,2-DCE, and two possible metabolites of 1,1-DCE, chloroacetyl chloride and chloroacetic acid, were carried out using a Chinese hamster cell line, CHL. 1,1-DCE induced chromosomal aberrations in the presence of S9 mix prepared from the rat liver, but not in the absence of S9 mix. SCEs were also slightly induced by 1,1-DCE only in the presence of S9 mix. On the other hand, two isomers and two metabolites of 1,1-DCE induced neither chromosomal aberrations nor SCEs with and without S9 mix. 1,1-DCE, however, was negative even at a sublethal dose in the micronucleus test using mouse bone marrow, fetal liver and blood. PMID- 3821770 TI - Specific targets of alkylating agents in nuclear proteins of cultured hepatocytes. AB - We have established a specific correlation between the carcinogenic potency of a series of alkylating agents, with a mechanism of reaction ranging between Ingold's SN1-SN2 (ENU greater than MNU = MNNG greater than EMS greater than DMS = MMS) (Vogel et al., 1979; Bartsch et al., 1983) and specific target sites in the amino acids of nuclear proteins of cultured hepatocytes. More potent carcinogens, that react predominantly with an Ingold's SN1 mechanism, mainly alkylate the amino group of lysine and the guanido group of arginine. Weaker carcinogens, reacting with a mechanism closely resembling an Ingold's SN2, mainly alkylate the sulfhydryl group of the cysteine and the 3 position of the imidazolic ring of histidine. A compound with an intermediate type of reactivity alkylates, to a comparable extent, all 4 of the above-described positions. Although stable DNA damage brought about by alkylating carcinogens is considered to be the most likely cause of neoplastic transformation, epigenetic modifications may also play an important role in the process, especially because of their extreme stability. We have verified the existence of a linear correlation between the Swain-Scott substrate constant (S) of each compound and the amount of alkylation produced at the specific target sites. This type of correlation could be the basis of a 'short-term' genotoxicity assay in a battery of complementary tests. PMID- 3821771 TI - Chromosome flexion: potential for assessing the state of spindle assembly. AB - A novel measurement, that of chromosome flexion, has been used to assess the degree of spindle polymerization at metaphase in human lymphocytes. It was found that this measurement showed a highly repeatable quantitative response to nocodazole exposure. Thus this measurement could be used to assess the potential for chemicals to depolymerize spindles. Under controlled conditions, individual differences were observed between the subjects which might be related to their age. However, the response to nocodazole-induced spindle depolymerization, as measured by flexion, was uniform for all subjects. 4 chemicals reported to induce aneuploidy in mammalian cells were used in a flexion assay. Only substances known to depolymerize microtubules reduced chromosome flexion. PMID- 3821772 TI - Production of sister-chromatid exchange by irradiation during the G1 stage: the probable role of 5-bromodeoxyuridine. PMID- 3821773 TI - Clastogenic evaluation of cathinone and amphetamine in somatic cells of mice. AB - Clastogenic effects of cathinone, the active principle from khat (Catha edulis) and amphetamine, a compound having similar chemical structure and pharmacological activity, have been studied on the somatic cells of mice. Both of them produced marked clastogenic activity and affected the cell proliferation in the bone marrow of mice. They induced a significant increase in the frequency of micronucleated polychromatic erythrocytes at higher doses. These results substantiate our earlier observations on the clastogenic and mitodepressive activity of cathinone on the meristematic region of Allium cepa, and indicate that cathinone may be responsible for the mutagenic effect of khat reported by other workers. The clastogenic effects of amphetamine are being reported for the first time. Further studies are required to substantiate these findings and to study whether cathinone and amphetamine produce a direct clastogenic effect or whether they act as spindle poisons. PMID- 3821774 TI - Genotoxicity of a variety of nitroarenes and other nitro compounds in DNA-repair tests with rat and mouse hepatocytes. AB - Genotoxicity of a variety of nitroarenes and other compounds was examined in DNA repair tests with rat or mouse hepatocytes. Out of 15 nitroarenes tested, 9 compounds, i.e., 1-nitropyrene, 1,3-dinitropyrene, 1,6-dinitropyrene, 1,8 dinitropyrene, 1-nitro-3-acetoxypyrene, 3-nitrofluoranthene, 2-nitrofluorene, 2,7 di-nitrofluorene and 5-nitroacenaphthene elicited positive response of DNA repair in the tests with rat and mouse hepatocytes. Among the positive chemicals, the DNA-repair level of the 3 dinitropyrene isomers was much higher than other nitroarenes. The results indicate that a number of nitroarenes are metabolically activated in the primary culture of rodent hepatocytes, and suggest potential carcinogenicity of 1-nitropyrene and 1-nitro-3-acetoxypyrene the carcinogenicity of which is either not clear or unknown. Of the other nitro compounds, 2-(2 furyl)-3-(5-nitro-2-furyl)acrylamide as well as 4-nitroquinoline 1-oxide were clearly genotoxic in the assays with hepatocytes of both species. However, 5 nitro-2-furaldehyde semicarbazone was negative in both assays with hepatocytes of 2 species. PMID- 3821775 TI - Mutagenicity of 4-hydroxynonenal in V79 Chinese hamster cells. AB - 4-Hydroxynonenal (HNE), a major product of the peroxidation of liver microsomal lipids, was examined for mutagenic activity at the hypoxanthine-guanine phosphoribosyltransferase locus in V79 Chinese hamster lung cells. At concentrations ranging from 10 to 45 microM, HNE induced a dose-dependent increase in the number of mutations to 6-thioguanine resistance, which reached the level of 4.7X baseline at the highest concentration tested. PMID- 3821777 TI - Deficiencies in the covalent binding index (CBI) for expressing in vivo binding to DNA with respect to predicting chemical carcinogenicity. A proposal for a target-organ binding index. PMID- 3821776 TI - Evidence that N-methyl-N'-nitro-N-nitrosoguanidine induces adaptive response in Bacillus thuringiensis. AB - Bacillus thuringiensis is shown to have an inducible error-free repair system for alkylation damage as found in Escherichia coli and Bacillus subtilis. Growth of cells in the presence of low concentrations of N-methyl-N'-nitro-N nitrosoguanidine (MNNG) induces an adaptive response which is characterized by an increase in resistance to killing and mutagenesis by challenge with higher concentrations of MNNG. In addition, we have noted with interest that adaptive low doses seem to produce lesions at a rate sufficient to induce an increase of mutation frequency, and inhibition of cell division. The possibility of an interaction between SOS and adaptive responses with these low doses of MNNG is discussed. PMID- 3821778 TI - Mutagenicity of some substituted 1-phenyl-3,3-dimethyltriazenes. II. Chromosomal aberrations in human peripheral lymphocytes in vitro. AB - The chromosome-breaking activity of four 1-(phenyl)-3,3-dimethyltriazenes was tested in vitro on human peripheral blood lymphocytes using S9 mix as a metabolic activation system. 1-(4-Nitrophenyl)-3,3-dimethyltriazene was the most active compound. The difference in the frequency of chromosomal aberrations in a test with and without metabolic activation was significant at the 1% level of significance. The lowest frequency of chromosomal aberrations was induced by 1-(4 methylphenyl)-3,3-dimethyltriazene which, under the conditions of this experiment, is the least stable and probably rapidly degraded to non-active compounds. The chromosomal aberrations were also induced by 1-(4-chlorophenyl) 3,3-dimethyltriazene and 1-(4-bromophenyl)-3,3-dimethyltriazene, this activity was unrelated to metabolic activation. PMID- 3821779 TI - Anaerobic metabolism of 2-amino-3-methyl-3H-imidazo[4,5-f]quinoline (IQ) by human fecal flora. AB - Incubation of the heterocyclic cooked food mutagen IQ with mixed human fecal microflora under anaerobic conditions yielded 2-amino-3,6-dihydro-3-methyl-7H imidazo[4,5-f]quinoline-7-one (2) as the major detectable metabolite. PMID- 3821780 TI - Cytogenetic effects of penicillamine. AB - Penicillamine (PA), a drug used for the treatment of rheumatoid arthritis induces sister-chromatid exchanges (SCEs) and chromosome aberrations in cultivated mammalian cells. PA in concentrations from 400 micrograms/ml upward induced SCEs and proliferative delay in human blood cultures when added for the last 24 h of the culture period. In V79 Chinese hamster cells SCE induction was found after acute exposure to PA before the addition of BrdUrd and after chronic exposure during one cell cycle in the presence of BrdUrd. The effect of PA on SCE frequencies occurred both after treatment in complete medium and in serum-free medium and was not influenced by the application of an S9 mix. The simultaneous addition of peroxidase reduced the PA-induced SCEs whereas catalase did not show any effect. Chromosome analysis in the first mitosis after PA treatment revealed a significant increase in the incidence of chromosome aberrations and endoreduplication. The results are discussed with respect to the cause and the significance of the observed effects in connection with mutagenicity testing. PMID- 3821781 TI - Induction of cytogenetic damage by modified steroidal derivatives of p-bis(2 chloroethyl)aminophenylacetic acid in human lymphocytes. AB - The effect of modified steroids, containing alkylating agents, on SCE rates and on cell kinetics in cultured human lymphocytes was studied. The homo-aza steroidal ester of p-bis(2-chloroethyl)aminophenylacetic acid (ASE) was found to be the most effective in causing markedly increased SCE rates and cell division delays. The androsterone ester of p-bis(2-chloroethyl)aminophenylacetic acid (AE CAPA) was found to be next in order of effectiveness with the lactone ester (LE CAPA), chlorambucil ester 3 beta-hydroxy-13a-amino-13,17-seco-5a-androstan-17-oic 13,17-lactam (CBC-HAAL) and chlorambucil (CBC) following. p-Bis(2 chloroethyl)aminophenylacetic acid (CAPA) had only a small effect and 3 beta hydroxy-13a-amino-13,17-seco-5a-androstan-17-oic-13,17-lactam (HAAL) had no effect at all. A correlation between potency for SCE induction, effectiveness in cell division delay and previously established antitumor activity of these drugs was observed. PMID- 3821782 TI - Sister-chromatid exchange and cell proliferation in cultured lymphocytes of passively and actively smoking restaurant personnel. AB - Sister-chromatid exchange frequencies were measured in peripheral lymphocytes of 12 cigarette smokers, 20 passive smokers, and 14 non-smokers with no regular exposure to tobacco smoke. All active and passive smokers worked as waiters and waitresses in restaurants. The passive smokers showed neither an increased mean SCE value nor an increased number of high SCE frequency cells (HFCs) when compared to non-exposed non-smokers. The incidence of SCEs and HFCs was observed to be elevated (P less than 0.01; P less than 0.05, resp.) among the active smokers. The proliferation rate of lymphocytes in whole blood cultures from the different exposure groups was also studied. The proportion of cells in first mitosis was lower and the mean replication index (RI) higher among the smokers than among non-smoker controls. However, no significant correlation was observed between the individual mean SCE and the replication index. PMID- 3821783 TI - Analysis of cytogenetic effect in human lymphocytes induced by metabolically activated 2-nitropropane. AB - Chromosome analyses were carried out in human lymphocytes treated in vitro with 2 nitropropane (2-NP) in the presence and absence of the mammalian metabolic activation system, S9 mix. Without S9 mix, only the frequency of gaps was significantly increased at 80 mM 2-NP as compared to controls. With S9 mix, the incidences of gaps and chromatid-type aberrations were significantly increased at 60 mM and 80 mM. Sister-chromatid exchanges (SCE) have been induced at concentrations as low as 7.5 mM. The present findings demonstrate that in human lymphocytes, 2-NP requires metabolic activation to express clastogenicity and SCEs. PMID- 3821784 TI - Effects of vanillin on sister-chromatid exchanges and chromosome aberrations in human lymphocytes. PMID- 3821785 TI - Recent advances in the pathogenesis of diabetic neuropathy. AB - Recent advances in the understanding of the pathogenesis of diabetic neuropathy have been made in six areas. There is support for the notion that a reduction in nerve free myoinositol may be responsible in part for the nerve conduction slowing in diabetic neuropathy. There is further evidence of microvascular abnormalities, including morphometric evidence of multifocal fiber loss and of capillary changes in biopsied sural nerve. There is evidence of endoneurial hypoxia, including the findings of reduced nerve blood flow and endoneurial oxygen tensions in chronic experimental diabetic neuropathy (EDN). The major mechanisms of resistance to ischemic conduction failure (RICF) is the marked increase in nerve energy substrates. Recent studies provide certain insights into clinical characteristics of human diabetic neuropathy (HDN), including the asymmetric pattern of HDN, the paradox between liability to pressure palsies and RICF, and insulin-related acute painful neuropathy. The suggested pathogenetic scheme incorporates the notion that once hypoxia is established, it may start a vicious cycle of further capillary damage and escalating hypoxia. PMID- 3821786 TI - Electrophysiologic studies of critically ill patients. AB - Sepsis and critical illness occur as complications of illness, injury, or surgery in approximately 5% of patients in our critical care unit. Clinical evaluation of the nervous system is difficult in this clinical setting, and electrophysiologic studies are therefore quite valuable. Electroencephalography detects encephalopathy and electromyography (EMG) and nerve conduction studies detect neuromuscular disorders at early stages of their development. Thus, septic encephalopathy occurs in almost all patients and critically ill polyneuropathy in at least 50% of such patients. The polyneuropathy is a predominantly distal axonal degeneration of motor and sensory fibers. A catabolic myopathy is also present, but is difficult to detect electrophysiologically. No defect in neuromuscular transmission has so far been demonstrated. Both the encephalopathy and polyneuropathy may be quite severe, but with vigorous management of the sepsis and critical illness complete recovery may occur in the 40% of patients who survive. PMID- 3821787 TI - Superoxide dismutases, glutathione peroxidase, and catalase in neuromuscular disease. AB - Studies in experimental muscular dystrophy indicate a possible role for anomalous redox metabolism in the genesis of these disorders, prompting a retrospective review of changes in redox-active enzymes in Duchenne muscular dystrophy (DMD). Both manganous and copper-zinc superoxide dismutase (Mn and CuZn SOD) content and glutathione peroxidase and catalase activities were measured in muscle biopsy specimens taken from normal individuals and from patients with Duchenne muscular dystrophy and other neuromuscular diseases. Muscle from patients with Duchenne dystrophy differed from the norm in that both Mn SOD and CuZn SOD were decreased and glutathione peroxidase was increased. This profile differed from that in anterior horn cell diseases in that CuZn SOD was not decreased in these disorders and from polymyositis, where CuZn SOD was decreased without an increase in glutathione peroxidase. Thus, there appears to be disease-specific changes in these enzymes in DMD. These data support the concept that changes in redox-active enzymes may be associated with the genesis of DMD. PMID- 3821788 TI - Primary segmental demyelination in the sural nerve in Cockayne's syndrome. AB - In a typical case of Cockayne's syndrome, morphometric histopathologic findings of the sural nerve were described and compared with data on two controls. The main pathologic changes of myelinated fibers were segmental demyelination and remyelination with onion bulb formation and a moderate decrease of myelinated fibers. There was no evidence of axonal atrophy in relation to myelin spiral length. In addition, no evidence of the clustered occurrence of demyelinated and remyelinated internodes was obtained on the statistical evaluation of the distribution of such internodes. Although the presence or absence of hypomyelination of a mild degree and maldevelopment of axons to be myelinated has not been clarified, our morphometric data do suggest the presence of primary segmental demyelination of the biopsied sural nerve. PMID- 3821789 TI - Remarkable resistance of the nerve to ischemia: a reply. PMID- 3821790 TI - 31P-NMR studies in patients with exertional muscle pain syndrome (EMPS) responding to verapamil. PMID- 3821791 TI - AAEE minimonograph #26: The electrodiagnosis of carpal tunnel syndrome. AB - The electrodiagnosis of carpal tunnel syndrome is reviewed, including discussions of old and new techniques of motor and sensory nerve conduction, anomalous innervation, needle electrode examination, and one method of examining a patient with suspected carpal tunnel syndrome. The results of electromyographic testing of 505 patients with carpal tunnel syndrome in Rochester, Minnesota, from 1961 to 1980 are compared with results from previous studies. In the appendixes, a method of performing median motor and sensory nerve conduction studies and Mayo Clinic normal values are provided. PMID- 3821792 TI - Comparative activity of miconazole cream and ointment in the treatment of experimental dermatophytosis in guinea pigs. PMID- 3821793 TI - Microsporum canis epidemic in laboratory mice. PMID- 3821794 TI - Hepatoerythropoietic porphyria: clinical, biochemical, and enzymatic studies in a three-generation family lineage. AB - Hepatoerythropoietic porphyria is caused by a marked deficiency in the activity of uroporphyrinogen decarboxylase, an enzyme that is essential for heme biosynthesis. It has been hypothesized that uroporphyrinogen decarboxylase deficiency is inherited as a homozygous defect in the disease. This suggestion has been supported by reports of a deficiency of the enzyme in parents of patients with the disorder. Further confirmation would be provided by demonstrating a similar uroporphyrinogen decarboxylase deficiency in the offspring of such patients. This study follows the enzymatic defect throughout three generations of a family in which a second-generation male was shown to have hepatoerythropoietic porphyria. Detailed biochemical and enzymatic analyses revealed a moderate deficiency of uroporphyrinogen decarboxylase in both the proband's parents and in his three children, all of whom were asymptomatic. The mildness of the clinical symptoms in the proband correlated with a higher level of residual enzyme activity than that in previously described patients. We conclude that clinically manifested hepatoerythropoietic porphyria results from the homozygous inheritance of a defect in the uroporphyrinogen decarboxylase gene, that the severity of clinical symptoms is probably related to the level of residual enzyme activity, and that the genetic defect of uroporphyrinogen decarboxylase in hepatoerythropoietic porphyria can be heterogeneous. PMID- 3821795 TI - The reduction in risk of ovarian cancer associated with oral-contraceptive use. AB - Although several studies have reported that the use of oral contraceptives decreases the risk of ovarian cancer, it is not clear whether the effect varies according to the oral-contraceptive formulation or the histologic type of cancer. To characterize this association more fully, we used data from a case-control study, the Cancer and Steroid Hormone Study. From 1980 to 1982, 546 women 20 to 54 years of age with ovarian cancer were enrolled from eight population-based cancer registries. The controls were 4228 women selected from the same areas. Women who had used oral contraceptives had a risk of epithelial ovarian cancer of 0.6 (95 percent confidence interval, 0.5 to 0.7) as compared with those who had never used them. This protective effect was seen in women who had used oral contraceptives for as little as three to six months, and it continued for 15 years after use ended; it was independent of the specific oral-contraceptive formulation and of the histologic type of epithelial ovarian cancer. (We could not adequately assess the association with nonepithelial ovarian cancers because of an insufficient number of cases.) We conclude that the use of oral contraceptives decreases the risk of epithelial ovarian cancer. PMID- 3821796 TI - Rapid prenatal diagnosis of sickle cell anemia by a new method of DNA analysis. AB - We have used a new method of DNA analysis for the rapid prenatal diagnosis of sickle cell anemia in two fetuses at risk for this disease. This method of detecting the sickle gene is a modification of standard restriction-enzyme techniques and requires only a small amount of DNA. The first step involves a 200,000-fold enzymatic amplification of the specific beta-globin DNA sequences that may carry the sickle mutation. This provides a sufficient quantity of DNA for the analysis. Next, a short radiolabeled synthetic DNA sequence homologous to normal beta A-globin gene sequences is hybridized to the amplified target sequences. The hybrid "duplexes" are then digested sequentially with two restriction endonucleases. The presence of beta A- or beta S-globin gene sequences in the amplified target DNA from the patient determines whether the beta A-hybridization probe anneals perfectly or with a single nucleotide mismatch. This difference affects the restriction-enzyme digestion of the DNA and the size of the resulting radiolabeled digestion products, which can be distinguished by electrophoresis followed by autoradiography. This method is sufficiently sensitive and rapid that the prenatal diagnosis of sickle cell anemia can be made on the same day that the fetal DNA is made available. It can also be applied to the diagnosis of hemoglobin C disease. PMID- 3821797 TI - Prevalence and importance of pigmented ocular fundus lesions in Gardner's syndrome. AB - We examined 134 members of 16 families with Gardner's syndrome for pigmented ocular fundus lesions. Of 41 patients with documented Gardner's syndrome, 37 (90.2 percent) had such lesions. The lesions were bilateral in 32 of the patients (78.1 percent) and in 2 of 42 controls (4.8 percent). Twenty (46.5 percent) of 43 first-degree relatives at 50 percent risk for Gardner's syndrome had bilateral pigmented fundus lesions, indicating that they had probably inherited the abnormal gene. The presence of bilateral lesions, multiple lesions (more than four), or both appeared to be a specific (specificity, 0.952) and sensitive (sensitivity, 0.780) clinical marker for Gardner's syndrome. The lesions are probably congenital; they were observed in a three-month-old baby at risk. The multiplicity of the pigmented fundus lesions and their association with diffuse disturbances of the retinal pigment epithelium in the same eye suggest a widespread expression of the abnormal gene in the retinal pigment epithelial cells. PMID- 3821798 TI - Maternal mortality in Massachusetts. Trends and prevention. AB - To identify ways in which the safety of childbirth might be increased, we investigated the causes of death among the 886 women who died during pregnancy or within 90 days post partum ("maternal deaths") in Massachusetts from 1954 through 1985. The maternal mortality rate declined from 50 per 100,000 live births in the early 1950s to the current rate of 10 per 100,000 live births. Between one third and one half of the maternal deaths were considered to have been preventable. The leading causes of maternal death from 1954 through 1957 were infection, cardiac disease, pregnancy-induced hypertension, and hemorrhage. In contrast, from 1982 through 1985 the leading causes of death were trauma (suicide, homicide, and motor vehicle accidents) and pulmonary embolus. We observed a rapid increase in the frequency of death among women who received little or no antenatal care. From 1980 through 1984 the maternal mortality rate for white women was 9.6 per 100,000 live births, whereas for nonwhites it was 35 per 100,000 live births (relative risk, 2.9; 95 percent confidence limits, 2.5 and 3.2). Fifty percent of the nonwhite women who died during pregnancy or within 90 days post partum received little or no antenatal care, in contrast to only 15 percent of the white women. These data show that the leading causes of maternal death have changed markedly in Massachusetts during the past 30 years. Although the overall maternal mortality rate has declined sharply, further improvement may occur with better antenatal care and specific efforts to prevent trauma and pulmonary embolus. PMID- 3821799 TI - Disseminated vaccinia in a military recruit with human immunodeficiency virus (HIV) disease. PMID- 3821800 TI - HIV infection and immunization against other agents. PMID- 3821802 TI - Nuclear war. PMID- 3821801 TI - Artificial intelligence in medicine. Where do we stand? PMID- 3821803 TI - Entamoeba histolytica in homosexual men. PMID- 3821804 TI - Treatment of trigeminal neuralgia. PMID- 3821805 TI - Case 11-1986: cysticercosis. PMID- 3821806 TI - Drug use among physicians and medical students. PMID- 3821807 TI - Drug dispensing for the elderly. PMID- 3821808 TI - Risk of ulcerative colitis among former and current cigarette smokers. AB - We performed a case-control study of the effect of tobacco smoking on the risk of acquiring ulcerative colitis among the 304,000 members of a health maintenance organization. Smoking histories before the date of the onset of ulcerative colitis were compared in 212 cases and an equal number of controls matched for age and sex who were selected from the enrollment file of the health maintenance organization. The relative risk of ulcerative colitis among current cigarette smokers as compared with nonsmokers was 0.6 (95 percent confidence interval, 0.4 to 1.0); however, among former cigarette smokers it was 2.0 (95 percent confidence interval, 1.1 to 3.7). These values remained after adjustment for socioeconomic factors and for coffee and alcohol consumption. The higher risk among former smokers could not be explained by postulating that smokers gave up tobacco near the time of disease onset because of early symptoms of ulcerative colitis. The relative risk of ulcerative colitis among former smokers increased in proportion to the cumulative number of cigarettes smoked before the onset of disease, suggesting a causal relationship between this exposure and disease occurrence. No difference in risk was observed among current smokers according to cumulative amount smoked. We conclude that former and current tobacco use may have opposite effects on the risk of acquiring ulcerative colitis. PMID- 3821809 TI - Decreasing risk of leukemia with prolonged follow-up after chemotherapy and radiotherapy for Hodgkin's disease. AB - Acute nonlymphocytic leukemia is a recognized complication of combined chemotherapy and radiation treatment of patients with Hodgkin's disease. Previous studies have suggested that the risk of leukemia in these patients increases with time after treatment. We analyzed the occurrence of second neoplasms among 192 patients with Hodgkin's disease who were followed for a median of over 15 years. We originally planned to identify prospectively the morphologic changes in bone marrow that precede the development of acute leukemia. All 63 patients consenting to bone marrow aspiration had normal marrow morphology, and no case of acute leukemia occurred more than 11 years after treatment. Actuarial analysis revealed that the peak onset of leukemia-related complications was between three and nine years after first treatment. We conclude that there appears to be a period of increased risk in patients treated with chemotherapy and radiation, after which the risk of secondary leukemia decreases. Patients surviving for more than 11 years after treatment appear to be at no increased risk of acute leukemia. PMID- 3821810 TI - Hypocalciuria in preeclampsia. AB - We studied 40 women in the third trimester of pregnancy to determine whether alterations in serum calcium levels or in urinary calcium excretion would distinguish patients with preeclampsia from normal pregnant women or women with other forms of gestational hypertension. Our population included 10 normal pregnant women, 5 pregnant women with transient hypertension, 6 with chronic hypertension, 7 with chronic hypertension and superimposed preeclampsia, and 12 with preeclampsia. The serum levels of ionized calcium, phosphate, and 1,25 dihydroxyvitamin D were not different among the various groups. In contrast, the mean (+/- SD) 24-hour urinary calcium excretion in the patients with preeclampsia or hypertension with superimposed preeclampsia was significantly lower (42 +/- 29 and 78 +/- 49 mg) than that in normal pregnant women (313 +/- 140 mg per 24 hours), women with transient hypertension (248 +/- 139 mg per 24 hours), or women with chronic hypertension (223 +/- 41 mg per 24 hours) (P less than 0.0001). The hypocalciuria in the women with preeclampsia was associated with a decreased fractional excretion of calcium. Although the mean creatinine clearance was reduced in the women with preeclampsia, the range of values overlapped with those in the other groups. In contrast, we observed little or no overlap with respect to calcium excretion. We conclude that preeclampsia is associated with hypocalciuria due to increased tubular reabsorption of calcium. Measurement of calcium excretion may be useful in distinguishing preeclampsia from other forms of gestational hypertension. PMID- 3821811 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12-1987. A 28-year-old woman with pain in the buttocks and leg and lesions of the sacrum and ilium. PMID- 3821812 TI - Present and future treatment of myasthenia gravis. PMID- 3821813 TI - A ban on the promotion of tobacco products. PMID- 3821814 TI - Survival and age at diagnosis in breast cancer. PMID- 3821815 TI - More on progress against cancer. PMID- 3821816 TI - "I accuse" the Journal of unfair journalism. PMID- 3821817 TI - Herpes simplex virus infections. PMID- 3821818 TI - Lead-contaminated heroin as a source of inorganic-lead intoxication. PMID- 3821819 TI - Cigarette counteradvertising for children. PMID- 3821820 TI - Primitive plaques and memory dysfunction in normal and impaired elderly persons. PMID- 3821821 TI - Subcutaneous emphysema as a complication of oxygen therapy using nasal cannulas. PMID- 3821822 TI - Replacement dose, metabolism, and bioavailability of levothyroxine in the treatment of hypothyroidism. Role of triiodothyronine in pituitary feedback in humans. AB - A change in the formulation of the levothyroxine preparation Synthroid (Flint) in 1982 prompted us to reevaluate the replacement dose of this drug in 19 patients with hypothyroidism. The dose was titrated monthly until thyrotropin levels became normal. The mean replacement dose (+/- SD) was 112 +/- 19 micrograms per day, significantly less (P less than 0.001) than the dose of an earlier formulation--169 +/- 66 micrograms per day--used in a similar study (Stock JM, et al. N Engl J Med 1974; 290:529-33). The fractional gastrointestinal absorption of a tablet of the current formulation is 81 percent, considerably higher than the earlier estimate of 48 percent. Using high-performance liquid chromatographic analysis, we found that the current tablet contains the amount of thyroxine stated by the manufacturer. By measuring the bioavailability of the earlier type of tablet in five patients, we inferred that the strength of the previous tablet had been overestimated. In the present study, the thyrotropin levels of patients on replacement therapy returned to normal when serum triiodothyronine concentrations were not significantly different from those of controls (122 vs. 115 ng per deciliter [1.87 vs. 1.77 nmol per liter]), but when serum thyroxine levels were significantly above those of controls (11.3 vs. 8.7 micrograms per deciliter [145 vs. 112 nmol per liter], P less than 0.001). These findings suggest the possibility that in humans, serum triiodothyronine may play a more important part than serum thyroxine in regulating the serum thyrotropin concentration. PMID- 3821823 TI - Measles outbreak in a fully immunized secondary-school population. AB - An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced. Serum samples from 1806 students at two secondary schools were obtained eight days after the onset of the first case. Only 4.1 percent of these students (74 of 1806) lacked detectable antibody to measles according to enzyme-linked immunosorbent assay, and more than 99 percent had records of vaccination with live measles vaccine. Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been vaccinated, contracted measles. In addition, three seronegative students seroconverted without experiencing any symptoms. We conclude that outbreaks of measles can occur in secondary schools, even when more than 99 percent of the students have been vaccinated and more than 95 percent are immune. PMID- 3821824 TI - Removal of corneal crystals by topical cysteamine in nephropathic cystinosis. AB - In patients with nephropathic cystinosis, corneal crystals develop by one year of age; they progressively accumulate and eventually cause recurrent corneal erosions and photophobia. After an in vitro study of cystinotic corneal stromal cells showed cystine depletion by cysteamine and after topical cysteamine was determined to be nontoxic in rabbits, we performed a controlled double-blind clinical trial of 10 mM cysteamine eyedrops in young patients with cystinosis, using one eye for treatment and the other as the control. Two children begun on the protocol before two years of age had a striking decrease in the number of corneal crystals in the cysteamine-treated eye within four to five months of entering the study. Cysteamine eyedrops appear to be safe and efficacious in the short-term treatment of patients with cystinosis who are under two years of age. The long-term value of such treatment and its effectiveness in older patients remain to be determined. PMID- 3821825 TI - Are the results of the extracranial-intracranial bypass trial generalizable? PMID- 3821826 TI - Open microsurgical autograft of adrenal medulla to the right caudate nucleus in two patients with intractable Parkinson's disease. AB - Recent experimental studies and one clinical case have suggested that grafting tissue from the adrenal medulla into the brain may ameliorate the signs of Parkinson's disease. We describe the treatment of two young patients (35 and 39 years old) with intractable and incapacitating Parkinson's disease, in whom fragments of the adrenal medulla were autotransplanted to the right caudate nucleus. Clinical improvement was noted in both patients at 15 and 6 days (respectively) after implantation and has continued in both. Rigidity and akinesia had virtually disappeared in the first patient at 10 months after surgery, and his tremor was greatly reduced. A similar degree of improvement was present in the second patient at three months. We conclude that autografting of the adrenal medulla to the right caudate nucleus was associated with a marked improvement in the signs of Parkinson's disease in two patients, but our results are preliminary and further work is necessary to see whether this procedure will be applicable over the long term in other types of patients with Parkinson's disease. PMID- 3821827 TI - Use of ambulatory electrocardiographic monitoring to identify high-risk patients with congenital complete heart block. AB - To define the long-term natural history of congenital complete heart block, we followed 27 patients prospectively by means of frequent ambulatory electrocardiographic (ECG) recordings for a mean (+/- SD) of 8 +/- 3 years. During that time, 8 of the 13 patients with a mean daytime heart rate below 50 bpm (Group A) had cardiac complications such as sudden death, syncope, presyncope, or excessive fatigue. Six of the eight patients had additional ECG findings that suggested an instability of the junctional escape mechanism. These findings included nocturnal junctional exit block (three patients), little or no change in the junctional rate with physical activity (three patients), and associated tachyarrhythmias (three patients). None of the 14 patients with a mean daytime heart rate of 50 bpm or more (Group B) had an adverse clinical outcome, and 5 of the 13 patients in Group A also remained well. Among the five patients in stable condition in Group A, three had no evidence of an unstable junctional mechanism. We conclude that patients with a mean daytime junctional rate below 50 bpm and other evidence of an unstable junctional escape mechanism should probably undergo prophylactic pacemaker implantation. Since junctional exit block and tachyarrhythmias sometimes appear first during follow-up, the method of risk stratification employed in this study depends on serial ambulatory ECG recordings. PMID- 3821828 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 14-1987. A 73-year-old woman with proteinuria and coronary-artery disease. PMID- 3821829 TI - Parkinson's disease--a new therapy? PMID- 3821830 TI - Television and suicide. PMID- 3821831 TI - Follow-up on Leiden trial. PMID- 3821833 TI - Case 30-1986. PMID- 3821832 TI - Asbestos in play sand. PMID- 3821834 TI - Cardioversion for intractable hiccups: a frightening cure. PMID- 3821835 TI - The house officer's changing world. PMID- 3821836 TI - The destabilization of health care. PMID- 3821837 TI - Antitrust implications of medical technology assessment. PMID- 3821838 TI - Insulin-like growth factors in pygmies. The role of puberty in determining final stature. AB - We measured the serum concentrations of insulin-like growth factors (IGF) I and II and testosterone in pygmy children, adolescents, and adults, as well as in controls, to determine more precisely the role of these factors in controlling growth. We had previously shown that growth hormone levels were normal in pygmies. Prepubertal pygmy children and controls did not differ in linear growth or in serum concentrations of IGF I and II. In pygmy adolescent boys, the mean (+/- SEM) serum concentration of IGF I was only one third that in control adolescents, who were similar to the pygmies in age and Tanner stage of development (154 +/- 22 vs. 435 +/- 37 ng per milliliter; P less than 0.01). A similar difference in IGF I concentration was observed in girls (278 +/- 18 vs. 570 +/- 25 ng per milliliter; P less than 0.01). IGF II and testosterone levels were normal in all groups. There was a significant difference in growth between controls and pygmies only during puberty. There was a marked acceleration of growth in the controls during adolescence, but such an acceleration was absent or blunted in the pygmies. These findings suggest that the short stature of adult pygmies is due primarily to a failure of growth to accelerate during puberty. We postulate that IGF I is the principal factor responsible for normal pubertal growth and that testosterone does not accelerate growth appreciably in the absence of an increase in the level of IGF I. PMID- 3821839 TI - Emergence of vancomycin resistance in coagulase-negative staphylococci. PMID- 3821840 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 15-1987. A 65-year-old woman with hypothyroidism and a rapidly enlarging goiter. PMID- 3821841 TI - Hormonal regulation of human growth. PMID- 3821842 TI - Medical malpractice and quality of care. PMID- 3821843 TI - Coffee consumption and the incidence of coronary heart disease. PMID- 3821844 TI - Low-molecular-weight heparin and deep-vein thrombosis. PMID- 3821845 TI - Transient sexual precocity resulting from gonadotropin stimulation in a young girl. PMID- 3821846 TI - Branched-chain alpha-keto acids for the diagnosis of maple-syrup-urine disease. PMID- 3821847 TI - Proper technique for using inhalers in asthma. PMID- 3821848 TI - Passive smoking on commercial airplanes. PMID- 3821849 TI - Use of smokeless tobacco in the 1986 World Series. PMID- 3821850 TI - Congress moves to bolster peer review: the Health Care Quality Improvement Act of 1986. PMID- 3821851 TI - [Separation and visualization of the multiple forms of alcohol dehydrogenase]. PMID- 3821852 TI - Influence of cooking methods on the nutritive value of turkey meat. AB - Selected culinary parts of turkey meat were subjected to a differentiated cooking method. The chemical composition and -SH group levels were studied in both raw and cooked turkey meat and indices of nutritive value were determined. The turkey meat was shown to be characterized by a high nutritive value, irrespective of any cooking method. A slightly unfavourable effect was found to be exerted on the nutritive value of meat by microwaves. Fried and roasted meat was characterized by high values of PER (3.1) and BV (83.8). Lower index values were found for microwaved meat [PER (2.8); BV (82.2)]. PMID- 3821853 TI - Kinetic description of proteolysis. Part 2. Substrate regulation of peptide bond demasking and hydrolysis. Liquid chromatography of hydrolyzates. AB - Lower peptides and amino acids in hydrolyzates of casein obtained with protosubtilin were determined using high pressure liquid chromatography (HPLC). The dependences of product concentrations in hydrolyzates produced at different substrate concentrations on the degree of hydrolysis were obtained. With an increase of the substrate concentration the real type of proteolysis changes from "zipper" to "one-by-one". This result supports the assumption that the substrate proteolysis regulation is realized through the change in the ratio of the rates of peptide bond demasking to those of peptide bond hydrolysis. PMID- 3821854 TI - AIDS registration becoming a political issue in Germany. PMID- 3821855 TI - MRC pushing for government funds for AIDS vaccine research. PMID- 3821856 TI - Interest in the human genome project reaches new heights. PMID- 3821858 TI - More compensation in Finland for nuclear accident victims. PMID- 3821857 TI - Investigations into NIH fraud allegations end with suicide. PMID- 3821859 TI - Accuracy, statistics and fraud. PMID- 3821860 TI - Divergence and directional mutation pressures. PMID- 3821861 TI - Vagaries of nomenclature. PMID- 3821862 TI - Regeneration by supernumerary axons with synaptic terminals in spinal motoneurons of cats. AB - Axons in the central nervous system (CNS) of mammals do not normally regrow if they are cut, which severely limits restoration of function after injury. We have studied the reactions of adult cat spinal alpha-motoneurons after chronic transection of their axons in the periphery by labelling single cells with horseradish peroxidase. Twelve weeks after the operation, about a third of the axotomized cells had developed a 'supernumerary' axon originating from the cell body region. These supernumerary axons had variable trajectories and termination fields in the ipsilateral spinal cord but generally anomalous projections. Ultrastructural examination shows that they give rise to boutons that form morphologically normal synaptic contacts with neuronal profiles, although they contain dense-cored vesicles not normally seen in central terminals of alpha motor axons. We conclude that axotomized neurons in the mammalian CNS may be able to form new synaptic contacts by means of supernumerary axons in the absence of local damage. PMID- 3821863 TI - Sperm sharing in Biomphalaria snails. PMID- 3821864 TI - Teacher union issues AIDS guidelines. PMID- 3821865 TI - Muscle regulation. Movement on the Aufbaubahn. PMID- 3821866 TI - Mechanism of fertilization. PMID- 3821867 TI - The mechanism of chromogranin A processing. PMID- 3821868 TI - Automated high-speed DNA sequencing. PMID- 3821869 TI - Redesigning the body plan of Drosophila by ectopic expression of the homoeotic gene Antennapedia. AB - Genetic and molecular studies on the expression of Antennapedia (Antp) have suggested that this gene specifies mainly the second thoracic segment. On the basis of our molecular analysis of dominant gain-of-function mutants we have postulated that the transformation of antennae into second legs is due to the ectopic overexpression of the Antp+ protein. This hypothesis was tested by inserting the complementary DNA encoding the normal Antp protein into a heat shock expression vector and subsequent germ-line transformation. As predicted, heat induction at defined larval stages leads to the transformation of antennae into second legs. The dorsal part of the head can also be transformed into second thoracic structures (scutum) indicating that Antp indeed specifies the second thoracic segment. By ectopic overexpression of the Antp protein the body plan of the fruit fly can be altered in a predictable way. PMID- 3821870 TI - Poly(dA).poly(dT) is a B-type double helix with a distinctively narrow minor groove. AB - The structure of poly(dA).poly(dT) currently arouses great interest, mainly because dAn.dTn stretches are associated with considerable DNA bending. Until recently the heteronomous DNA described by Arnott et al., with the poly(dA) and poly(dT) chains in A and B conformations respectively, was the only detailed model of this structure. Following our earlier studies of the interaction of DNA and monovalent ions, we examined the X-ray diffraction of the bivalent Ca2+ salt of poly(dA).poly(dT) (Ca-poly(dA).poly(dT)) and found no sign of a heteronomous structure: Ca-poly(dA).poly(dT) in fibres shows fully equivalent B-type conformations of the opposite sugar-phosphate chains. A revision of the structure of the sodium salt, Na-poly(dA).poly(dT), based on this result, yields only a slightly heteronomous structure with each chain in a B-type conformation, which is in much better agreement with the experimental data underlying the original heteronomous model. Both structures, Ca- and Na-poly(dA).poly(dT), have a minor groove narrower than that of the B form: this peculiarity seems to be very important for the interaction of poly(dA).poly(dT) and biologically significant molecules (including proteins and antibiotics). The specific base-pair positions in poly(dA).poly(dT) may account for the DNA bending adjacent to dAn.dTn tracts. PMID- 3821871 TI - Dependence of the mechanical properties of actin/alpha-actinin gels on deformation rate. AB - The cortical cytoplasm, including the cleavage furrow, is largely composed of a network of actin filaments that is rigid even as it is extensively deformed during cytokinesis. Here we address the question of how actin-filament networks such as those in the cortex can be simultaneously rigid (solid-like) and fluid like. Conventional explanations are that actin filaments rearrange by some combination of depolymerization and repolymerization; fragmentation and annealing of filaments; and inactivation and reestablishment of crosslinks between filaments. We describe the mechanical properties of a model system consisting of actin filaments and Acanthamoeba alpha-actinin, one of several actin crosslinking proteins found in amoeba and other cells. The results suggest another molecular mechanism that may account for the paradoxical mechanical properties of the cortex. When deformed rapidly, these mixtures are 40 times more rigid than actin filaments without alpha-actinin, but when deformed slowly these mixtures were indistinguishable from filaments alone. These time-dependent mechanical properties can be explained by multiple, rapidly rearranging alpha-actinin crosslinks between the actin filaments, a mechanism proposed by Frey-Wyssling to account for the behaviour of cytoplasm long before the discovery of cytoplasmic actin or alpha-actinin. If other actin-filament crosslinking proteins behave like Acanthamoeba alpha-actinin, this mechanism may explain how the cortex recoils elastically from small rapid insults but deforms extensively when minute forces are applied over long periods of time. PMID- 3821872 TI - Hyperacuity and the visual cortex. PMID- 3821873 TI - Protein transport. From organelle to organelle. PMID- 3821874 TI - Macrophage regulation of vitamin D3 metabolites. PMID- 3821875 TI - Models for the origin of influenza viruses. PMID- 3821876 TI - AIDS arrives in Soviet Union--(official) PMID- 3821878 TI - Too much panic over AIDS? PMID- 3821877 TI - Absence of both cytochrome b-245 subunits from neutrophils in X-linked chronic granulomatous disease. AB - Phagocytosis by neutrophils and other 'professional' phagocytic cells is accompanied by a microbicidal burst of non-mitochondrial respiration. Cytochrome b-245 is the only clearly defined component of this oxidase system and its absence provides the molecular basis of X-linked chronic granulomatous disease (CGD), in which a profound predisposition to infection results from complete failure of this respiratory burst. Purification of the cytochrome has proved difficult, with uniform disagreement regarding the identity of its apoprotein, descriptions of its relative molecular mass (Mr) on SDS-polyacrylamide gel electrophoresis (PAGE) ranging from 10,000 to 127,000 (10-127K). I report here that it has two subunits, a 23K protein and the previously described 76-92K glycoprotein. These subunits are closely linked and remain associated with the haem of the cytochrome through affinity and gel filtration chromatography and sucrose gradient centrifugation, and exhibit a similar distribution in a pH gradient. Neither protein was detected in the cells of five patients with X linked CGD whereas both were present in two with the form of this disease with autosomal recessive inheritance. PMID- 3821879 TI - Franco-US agreement on AIDS test within sight. PMID- 3821880 TI - Supreme Court reverses AIDS judgment. PMID- 3821881 TI - Japan's unpopular mental health laws to be revised at last. PMID- 3821882 TI - Brenner homes in on the human genome. PMID- 3821883 TI - Money to flow again at NIH, but how long will it last? PMID- 3821884 TI - More vaccine needed. PMID- 3821885 TI - Valuable libraries. PMID- 3821886 TI - Neurobiology. An eye on ancient circuits. PMID- 3821887 TI - Cloned schistosome antigens. PMID- 3821888 TI - The molecular basis for clathrin light-chain diversity. PMID- 3821889 TI - Alzheimer's disease and aluminium. PMID- 3821890 TI - Transmission dynamics of HIV infection. AB - Simple mathematical models of the transmission dynamics of human immunodeficiency virus help to clarify some of the essential relations between epidemiological factors, such as distributed incubation periods and heterogeneity in sexual activity, and the overall pattern of the AIDS epidemic. They also help to identify what kinds of epidemiological data are needed to make predictions of future trends. PMID- 3821891 TI - Clathrin light chains contain brain-specific insertion sequences and a region of homology with intermediate filaments. AB - The primary structures of four bovine clathrin light chains have been determined. Light chains LCa and LCb are homologous proteins encoded by different genes. In the brain the messenger RNA from these genes undergoes differential splicing to yield proteins having centrally inserted brain-specific sequences. A potentially alpha-helical region of the clathrin light chains shows homology with intermediate filament proteins. PMID- 3821892 TI - Ketamine-xylazine anaesthesia blocks consolidation of ocular dominance changes in kitten visual cortex. AB - In the visual cortex of mammals, response properties of single neurons can be changed by restricted visual experience during early postnatal development. Covering one eye for four to eight hours when kittens are at the peak of the sensitive period is sufficient to weaken the influence of the occluded eye on cortical neurons resulting in a noticeable shift of ocular dominance towards the open eye. The underlying changes in synaptic connections do not occur so readily when a kitten is anaesthetized and paralysed. We report here that an ocular dominance shift is prevented in alert kittens that receive repeated brief monocular exposures when these are followed by ketamine-xylazine anaesthesia. This retrograde effect on cortical plasticity suggests that the process by which synaptic activity is converted into structural changes has been disturbed. PMID- 3821893 TI - Long-distance intraretinal connections in birds. AB - Electrophysiological experiments have shown in both birds and mammals that remote parts of the retina, several millimetres apart, interact at the retinal level. The anatomical basis of this is poorly understood, although in mammals some cells in the ganglion cell layer have axons that terminate in the inner plexiform layer several millimetres from the cell body. In birds, the longest previously reported intraretinal connections were from amacrine cells, extending only a few hundred microns. But we here describe very long connections that span almost the entire extent of the retina in chicks and chick embryos. The parent cell bodies are in the inner nuclear layer of the ventral half of the retina, and they project in topographical order onto the dorsal half. They do not project to the brain. They may be involved in selective switching of attention between the upper and lower parts of the visual field, at an unprecedentedly early stage of visual processing. PMID- 3821894 TI - The v-myc oncogene is sufficient to induce growth transformation of chick neuroretina cells. AB - A number of studies have shown that full transformation of non-established rodent fibroblasts can be efficiently achieved in vitro by the concerted action of two oncogenes belonging to different complementation groups. Extension of the two genes carcinogenesis model to other differentiated cell types, presumably endowed with different controls of growth, is desirable for a better understanding of questions such as the host cell selectivity of oncogene action. A recent report claimed that cooperation between two oncogenes, v-myc and v-mil, is required to achieve transformation of chicken embryo neuroretina cells, which are characterized by a limited growth capacity in monolayer culture. Here we present evidence that the v-myc oncogene alone is sufficient to induce growth transformation of glial and neuronal precursor cell types from chick neuroretina. We also report that induction of transformation by v-myc is accompanied by faithful preservation of some of the differentiated functions of the chick cells. PMID- 3821895 TI - Mesoderm induction in early Xenopus embryos by heparin-binding growth factors. AB - In early embryonic development the basic body plan arises because cells in different regions become programmed to follow different developmental pathways. We have proposed that in the early amphibian embryo this process of regional specification arises from the action of three different inducing factors, or morphogens, but we have not until now had any idea of their chemical nature. In this paper we report that pure basic fibroblast growth factor (bFGF), at very low concentrations and with high specificity, closely mimics the effect of the ventrovegetal (VV) signal and that the transmission of the natural VV signal can be blocked by heparin, suggesting that it may be a heparin-binding factor such as bFGF. PMID- 3821896 TI - The Vatican and embryology. PMID- 3821897 TI - Protropin status questioned by FDA decision. PMID- 3821898 TI - AIDS becomes a notifiable disease in Japan despite protests. PMID- 3821899 TI - AIDS education programme in Japan. PMID- 3821900 TI - Tests for AIDS in pregnancy on offer to all. PMID- 3821901 TI - Change of heart signalled in Soviet-US health agreements. PMID- 3821902 TI - Howard Hughes Institute and tax collectors bury the hatchet. PMID- 3821903 TI - Protein structure. New light on old defects. PMID- 3821904 TI - Lung surfactant anchor. PMID- 3821905 TI - HPRT-deficient (Lesch-Nyhan) mouse embryos derived from germline colonization by cultured cells. AB - Embryonal stem (ES) cell lines, established in culture from peri-implantation mouse blastocysts, can colonize both the somatic and germ-cell lineages of chimaeric mice following injection into host blastocysts. Recently, ES cells with multiple integrations of retroviral sequences have been used to introduce these sequences into the germ-line of chimaeric mice, demonstrating an alternative to the microinjection of fertilized eggs for the production of transgenic mice. However, the properties of ES cells raise a unique possibility: that of using the techniques of somatic cell genetics to select cells with genetic modifications such as recessive mutations, and of introducing these mutations into the mouse germ line. Here we report the realization of this possibility by the selection in vitro of variant ES cells deficient in hypoxanthine guanine phosphoribosyl transferase (HPRT; EC 2.4.2.8), their use to produce germline chimaeras resulting in female offspring heterozygous for HPRT-deficiency, and the generation of HPRT deficient preimplantation embryos from these females. In human males, HPRT deficiency causes Lesch-Nyhan syndrome, which is characterized by mental retardation and self-mutilation. PMID- 3821906 TI - Possible role for fatty acyl-coenzyme A in intracellular protein transport. AB - The transport of proteins between subcellular compartments is a vectorial, energy requiring process mediated by the budding and fusion of a series of vesicular carriers. As yet, nothing is known of the chemical reactions that underlie these events, or how or in exactly what forms energy is used to sustain such movements. Here we report that fatty acyl-CoA acts as cofactor to a Golgi-associated protein factor (termed NSF) that is required for transport between cisternae of the Golgi stack in a cell-free system. This previously unsuspected connection may offer a link between the complex process of protein transport and a single, well-defined type of chemical reaction. We suggest that an ATP-dependent cycle of fatty acylation and deacylation may play an important role in driving rounds of vectorial protein transport. PMID- 3821907 TI - [Special programs for the gifted or support for the elite?]. AB - The scepticism prevailing with regard to the promotion of an elite in science- not, however, in the arts or in sports--originates from increasing mistrust vis-a vis a new power based on knowledge held by certain social classes only. It has to be removed by opening the education system, by establishing new patterns of confidence between scientists and policy-makers, and by linking knowledge and responsibility. The confusion between elite and talent is another cause of this sceptical attitude. The task of education is not, however, to promote an elite, but to promote gifted pupils. Whether gifted young people will eventually become part of an elite is another question. PMID- 3821908 TI - Auditory excitability cycles in choice reaction time and order threshold. PMID- 3821909 TI - International symposium on labeled and unlabeled antibody cancer diagnosis and therapy. Baltimore, Maryland, September 12-13, 1985. Proceedings. PMID- 3821910 TI - Evaluation of immunolocalization in gastrointestinal cancer. AB - Tumor localization by a 131I-labeled monoclonal antibody to CEA has been evaluated in a series of 50 patients with clinically suspected primary or recurrent gastrointestinal cancer. Eighty-five percent of the primary tumors were correctly detected, as were 43% of associated nodal metastases. Localization was compared with computerized tomography in the detection of recurrent disease. Each technique correctly identified 61% of the sites but missed 39%. In addition, labeled antibody localization produced a significant number of false-positive images. Radioactivity accumulated by tumors, both primary and secondary, was significantly higher than that in surrounding normal tissue (P less than .01). However, less than 0.8% of the injected radioactivity and 0.01% of the injected antibody were detectable in the tumors. Radiolabeled antibody was rapidly cleared from the circulation, and this may reflect a recipient reaction to the foreign protein. PMID- 3821911 TI - Efficacy and selectivity of vindesine monoclonal anti-carcinoembryonic antigen antibody conjugates on human tumor cell lines grown as xenografts in nude mice. AB - The therapeutic potential of immunoconjugates comprising vindesine and a monoclonal anti-CEA antibody, 11-285-14, has been evaluated in vivo using a clinically relevant targeting model system. Treatment of nude mice bearing human tumor xenografts of varying target antigen (CEA) expression has demonstrated efficacy and selectivity of conjugates of vindesine with 11-285-14 on tumor growth for tumors expressing the antigen (LS174T and BENN) but not for those lacking the antigen (COLO320DM). An effect of conjugate was seen even with xenografts that achieved a no-growth state (SKCO1) but not with CEA-expressing xenografts that were resistant to free drug (SW1116). Additionally, prolonged survival of mice bearing a lung tumor xenograft was observed after conjugate treatment. The toxicity of conjugated drug was less than that of free drug, and conjugates retained efficacy up to 5 months after preparation. PMID- 3821912 TI - Use of new heterobifunctional reagent for radiometallic labeling of antibodies. AB - A new heterobifunctional reagent, 2,6-dioxo-N-(carboxymethyl)morpholine (DCM), was synthesized, reacted with a monoclonal antibody (MAb) to human high-molecular weight, melanoma-associated antigen, and then chelated with 111In. The same MAb also was chelated with 111In with the use of the bicyclic anhydride of pentetic acid (BADTPA), a homobifunctional reagent, for comparative studies. The labeling efficiencies were similar: an average of 79% for 111In-iminodiacetic acid-MAb and an average of 75% for 111In-DTPA-MAb. However, the loss of immunoreactivity was 32.6% and 58.7% for both radiolabeled antibodies, respectively. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated a high molecular-weight polymer band only for the 111In-DTPA-MAb preparation. The results indicate that DCM likely causes less denaturation of antibody by eliminating the cross-linking reaction that is known to occur with homobifunctional chelating reagents. PMID- 3821913 TI - Human sarcoma-associated murine monoclonal antibody labeled with indium-111, gallium-67, and iodine-125. AB - Monoclonal antibody (MAb) 23H7 is a hybridoma-derived IgG that is generated following fusion of mouse myeloma cell line P3U1 and spleen cells from BALB/c mice hyperimmunized with a human fibrosarcoma. It detects a mesenchymal antigen of 23KD expressed on human sarcoma tissues and other neoplasms, including myeloid leukemias, but it rarely binds to normal tissues. The MAb 23H7 was labeled with 67Ga and 111In using the bifunctional ligand method. The 67Ga was chelated to the MAb via desferrioxamine B, while 111In was chelated via the cyclic anhydride of diethylenetriamine pentaacetic acid. Higher specific activity was obtained with 67Ga than with 111In (4.5 and 2 muCi/microgram, respectively); both gave stable complexes. When 23H7 was labeled with 125I, considerable breakdown was observed. This, together with the physical shortcomings of this isotope, emphasizes the advantages of labeling with 111In and 67Ga. The rapid blood clearance of the labeled sarcoma-associated MAb may be beneficial for early tumor uptake and for imaging shortly after injection. PMID- 3821914 TI - Radioimmunoscintigraphy and radioimmunotherapy of renal cell carcinoma xenografts. AB - From a panel of monoclonal antibodies (MAb) reactive with human renal cell carcinoma generated by this laboratory, three (designated A6H, C5H, and D5D) were selected for in vivo studies with a nude mouse xenograft model. These studies included 131I- and 111In-labeled MAb radioimmunoscintigraphy and 131I-labeled MAb radioimmunotherapy. In the imaging studies, these radiolabeled MAb allowed visualization of subcutaneous xenografts larger than 40 mg and subrenal capsule xenografts smaller than 20 mg. Comparisons of tumor to non-tumor tissue radiolabel distribution yielded unusually high ratios and depended on the MAb xenograft combination. The 111In-radiolabeled A6H showed increased accumulation in the liver compared with 131I-A6H, but this still did not necessitate background subtraction for good visualization of small, subrenal capsule renal cell carcinoma xenografts. Radioimmunotherapy studies with 131I-A6H in BALB/c nu/nu mice bearing established renal cell carcinoma xenografts showed a prolonged (greater than 90 days) regression in tumor burden and possible "cures," whereas three sets of control mice showed progressive and rapid increases in tumor size. These studies indicated that MAb, which show good tissue biodistribution and high imaging sensitivity, could also be capable of delivering effective radiotherapy to the tumor when "human equivalent" radiolabeled-MAb doses are used. PMID- 3821915 TI - Radioimmunodetection of human melanoma with indium-111-labeled monoclonal antibodies. AB - Our purpose in conducting this study was to evaluate the efficacy of an 111In labeled murine monoclonal antibody directed against a high-molecular-weight glycoprotein in localizing metastatic melanoma in 15 patients with previously documented disease and to determine the effect of antibody mass (2.5, 5.0, and 10.0 mg) on blood clearance, biodistribution, and lesion detection. Five mCi of 111In-antibody were infused over 1 hour, and patients were scanned at 24 and 72 hours after injection without computer enhancement or background subtraction techniques. No significant differences in the organ distribution, urine excretion, or plasma disappearance curves were noted at the three antibody dose levels. There were no acute reactions. The scan detected tumor in 9 of 12 (75%) patients with active disease, and 26 of 33 (79%) lesions greater than 1 cm. Patient management in 3 of 15 (20%) of patients studied was changed as a result. PMID- 3821916 TI - Radioimmunoimaging in malignant melanoma patients with the use of indium-111 labeled antimelanoma monoclonal antibody (ZME-018) to high-molecular-weight antigen. AB - Radioimmunolocalization of an 111In-labeled, mouse antimelanoma monoclonal antibody (MAb), ZME-018, was examined in 30 patients with metastatic malignant melanoma. Each patient received a single iv infusion of MAb at concentrations ranging from 0.6 to 40 mg, coupled to 5 mCi 111In by the chelating agent pentetic acid. No toxicity was observed in any patient. Total-body and region of interest scans performed at 4, 24, and 72 hours following MAb administration revealed uptake in 110 of 171 previously diagnosed metastases for a sensitivity of 64%. Nonspecific uptake of radioactivity was consistently observed in the liver and spleen, and less frequently in the bowel, testes, axillae, and bone. Sensitivity of detection increased significantly at doses of MAb above 2.5 mg, with 74% of the lesions imaging at 20 mg/5 mCi compared with 29% at 2.5 mg/5 mCi (P less than .005). Sensitivity actually decreased slightly at the 40-mg dose. There was a significant correlation between tumor uptake of MAb-111In-conjugate and increasing tumor size. Soft tissue lesions, such as skin and lymph node metastases, were imaged to a greater extent (77%) than were visceral metastases (40%). Mean plasma clearance of ZME-018 was prolonged with a half-life of 33.6 hours in patients receiving 40 mg, compared with 17.8 hours in patients given 2.5 mg (P less than .01). Urinary excretion of the isotope averaged 11.4% of the injected dose over 48 hours. Hence radioimmunolocalization of melanoma with 111In ZME-018 appeared feasible. The sensitivity of the technique varies with MAb dose, specific activity of 111In-MAb conjugate, tumor size, and disease site. PMID- 3821917 TI - Radioimmunodetection of cancer with the use of indium-111-labeled monoclonal antibodies. AB - We have infused 13 111In-labeled murine IgG monoclonal antibodies (MAb) into 73 patients who had been diagnosed as having 7 types of cancers, and 3 111In-labeled human MAb into 8 patients with breast cancer. To each patient, 1.5-5 mCi attached to a maximum of 1 mg MAb had been given in a total MAb dose of 0.5-500 mg. The most encouraging overall results have been obtained with anti-human T-cell MAb T101 (33 of 33 tumor sites imaged in 5 patients), antimelanoma MAb P96.5 (47 of 88 sites imaged in 21 patients), anti-prostate MAb PSA399 (14 of 21 sites imaged in 4 patients), and anti-colon MAb ZCE025 (16 of 26 sites imaged in 12 patients). Poor imaging results were related to lower doses, reactivity with circulating cells, and limited antigen expression in various tumor sites. The problems involved in radioimmunodetection included low extraction of MAb from the serum by the tumor that resulted in poor tumor uptake of the radiopharmaceutical, and high background activity in the liver, heart, spleen, and gastrointestinal tract that made imaging difficult in those areas. Heterogeneous antigen production leaves some tumor deposits without targets, and the immunogenicity of the MAb limits use of these agents repetitively in humans. Nevertheless, these early results are encouraging for their potential diagnostic and therapeutic applications. PMID- 3821918 TI - Enhancement of monoclonal antibody binding to melanoma with single dose radiation or hyperthermia. AB - We undertook this study to determine whether radiation (10 Gray, single dose) or water bath hyperthermia (41 degrees C, 45 min) could enhance binding of 111In labeled anti-p97a monoclonal antibody (MAb) to human melanoma tumors transplanted subcutaneously into nude mice. Sixty animals were given injections of 1-2 X 10(7) Brown C5513 melanoma cells. At 1-2 weeks postinjection, two-thirds of the mice were treated (one-third served as controls). Within 3 hours after treatment, each animal was given iv 2 muCi 111In-anti-p97a MAb. At 24 and 48 hours thereafter, whole-body scans were done with the use of a MaxiCamera 300 A/M unit, and the ratio of activity at the tumor and liver was determined. Some animals were kept for 7 days posttreatment, whereas others were taken after the 48-hour scan for determination of biodistribution of the radiolabeled complex. Enhancement of MAb binding was demonstrated by either modality, although enhancement was more consistent with radiation. The therapeutic efficacy of MAb may be enhanced with increased binding of radioactive MAb complexes through single dose radiation or hyperthermia. PMID- 3821919 TI - Therapeutic application of radiolabeled monoclonal antibody UJ13A in children with disseminated neuroblastoma. AB - Dosimetric data from UJ13A scanning studies using 131I are presented for children with stage IV neuroblastoma and primary brain tumor. The data demonstrate a large variation among patients in dose delivery to vulnerable organs and tumors. Against this background, a phase I toxicity study is under way with escalating amounts of conjugate administered to patients who have stage IV neuroblastoma. Major toxicity has been confined to bone marrow aplasia and necessitates bone marrow harvest prior to therapy. Specific problems encountered include altered kinetics during therapy following tracer studies and adequate dose delivery in large tumor masses. PMID- 3821920 TI - Comparison of L-thyroxine and a saturated solution of potassium iodide in preventing damage to the thyroid following iodine-131-labeled antibody injection. AB - Following injection of radioiodinated antibodies in diagnostic amounts, there is variable uptake of radioiodine by the thyroid. Unless preventive steps are taken, radiation damage to the gland may occur. We have evaluated the role of L thyroxine and a saturated solution of potassium iodide (SSKI) in preventing radiation damage to the thyroid glands of Sprague-Dawley adult male rats by measuring DNA strand breakage by the nucleoid sedimentation gradient method. Pretreatment with SSKI reduced DNA damage and also reduced 131I accumulation in the thyroid. Pretreatment with L-thyroxine also reduced DNA damage without significantly reducing 131I accumulation in the thyroid. The possible mechanisms of action of L-thyroxine and SSKI in preventing radiation damage to the thyroid are addressed. PMID- 3821921 TI - Beta dosimetry for radioimmunotherapy of cancer using labeled antibodies. AB - Starting with the tabulation of scaled monoenergetic electron dose point kernels F in water, according to the calculations of Berger, we have developed analytic approximations that facilitate the task for convolving F with beta spectra of specific nuclides to derive their dose point kernels J. J is well fitted by a single log-normal distribution, involving three independent parameters. For large atomic numbers, the addition of an exponential function near the origin is required. The radiation dose distribution D in a homogeneous medium of soft tissue with an activity distribution C is given by the convolution of J with C. Computer programs using fast Fourier transform techniques have been developed to evaluate the convolution efficiently. To study the perturbation of tissue inhomogeneity for D, we have used a point source of 32P and measured the increase in backscattered dose from a polystyrene/aluminum interface simulating soft tissue/bone. We have also measured the decrease in dose at a polystyrene/air interface. PMID- 3821922 TI - Radioimmunodetection of implanted tumors with gamma probe. AB - Tumor uptake of 125I- and 131I-radiolabeled anti-CEA antibodies was compared in female Swiss nude mice, each bearing a CEA-producing human colon adenocarcinoma xenografted in one flank. Counts from the tumor and contralateral flank were recorded with a manipulatable, cadmium-telluride crystal gamma detector at 24, 48, and 72 hours following injection. The animals were killed, and the tumors and other organs were removed, weighed, and then assessed in an automatic gamma counter. The cadmium-telluride counter was more efficient at counting 125I labeled antibodies than 131I antibodies. The tumor to contralateral flank ratios improved with the use of a monoclonal anti-CEA and polyclonal anti-CEA in combination compared with the single antibodies. The investigation of the external counting characteristics of the portable gamma detector demonstrated the potential of the adjunctive use of intraoperative detection with external radioimmunoscintigraphy for detection and localization of gastrointestinal tumors. PMID- 3821923 TI - Basic approach to application of chemoimmunoliposomes for cancer therapy. AB - Liposomes were coated with subunits of murine IgM monoclonal antibody and used as the carrier of an anti-cancer drug. The antibody-coated liposomes containing an anti-cancer drug (chemoimmunoliposomes, CIL) were prepared by using dactinomycin and monoclonal antibodies against a human bladder cancer or a mouse mammary cancer. These CIL exhibited antigen-specific binding to the target cancer cells, and there was more efficient killing of the target cancer cells than with free dactinomycin. In the mouse mammary cancer model, the CIL showed a therapeutic effect in both local and systemic applications. Relevance of this CIL model to cancer therapy and the problems related to its development are discussed. PMID- 3821924 TI - Serotonin autoreceptor in rat hippocampus: pharmacological characterization as a subtype of the 5-HT1 receptor. AB - The 5-hydroxytryptamine (5-HT) autoreceptors mediating inhibition of [3H]5-HT release in rat hippocampus have been characterized pharmacologically in terms of 5-HT receptor subtype by using superfused synaptosomes depolarized with 15 mM KCl. Exogenous 5-HT inhibited in a concentration-dependent way (pEC30 = 8.74) the K+-evoked release of [3H]5-HT. Methiothepin shifted the concentration-response curve of 5-HT to the right (pA2 = 8.62). The 5-HT2 receptor antagonists, ketanserin, methysergide or spiperone were ineffective against 5-HT. The 5-HT1 receptor agonist, 5-methoxy-3-[1,2,3,6-tetrahydropyridin-4-yl]-1H-indole (RU 24969) mimicked 5-HT and was equipotent as an inhibitor of the release of [3H]5 HT. In contrast, the putative 5-HT1A receptor agonist 8-hydroxy-2-(di-n propylamino)tetralin (8-OH-DPAT) was almost ineffective at 1 microM. Finally, ( )propranolol, used as a non-selective 5-HT1A/5-HT1B receptor antagonist, shifted to the right (pA2 = 7.91) the concentration-response curve of 5-HT whereas the 5 HT1C receptor antagonist mesulergine was ineffective. In conclusion, 5-HT nerve terminals of rat hippocampus possess autoreceptors which appear to belong to the 5-HT1B subtype. PMID- 3821925 TI - The direct and amplifying effects of serotonin are increased with age in the isolated perfused kidney of Wistar and spontaneously hypertensive rats. AB - Isolated kidneys of Wistar rats and spontaneously hypertensive rats (SHR) were perfused with Tyrode's solution. In 2- and 6-month old SHR, the maximal increase in perfusion pressure caused by norepinephrine was higher than in 2- and 6-month old Wistar rats, but the sensitivity, as judged from the dose of the agonist required to reach 50% of the maximal response was the same. Both the maximal response and the sensitivity to serotonin were significantly augmented in 6-month old SHR and Wistar rats when compared to the young animals. This hypersensitivity was more pronounced in SHR than in Wistar rats. Infusion of serotonin potentiated the vasoconstriction induced by a bolus of norepinephrine. This amplification, due to activation of S2-serotonergic receptors, was more pronounced in the old animals. No amplification occurred when norepinephrine was infused instead of serotonin. Tachyphylaxis to the amplifying effect of serotonin was observed and was less pronounced in kidneys from old than from young animals. The amplifying effect of serotonin was inhibited by ketanserin at concentrations which did not, or only moderately, inhibit the response to norepinephrine. PMID- 3821926 TI - On the nature of the receptor mediating the action of 5-hydroxytryptamine in potentiating responses of the mouse urinary bladder strip to electrical stimulation. AB - Superfused mouse bladder strip responded to electrical stimulation (ES) by twitch contractions. These contractions were potentiated by 5-hydroxytryptamine (5-HT; 0.03-3.0 microM). Three tryptamine analogues were tested for their ability to potentiate the responses to ES and their relative activities were compared with values in the literature. 5-Carboxamidotryptamine was more potent than 5-HT, N omega-methyl 5-HT was about equipotent, and alpha-methyl 5-HT was much less potent. Exogenous noradrenaline did not reduce the effect of 5-HT, although it reduced the response of the tissue to ES. The maximum increase in tissue tension evoked by 5-HT was unaltered by phentolamine (1 microM) or bretylium (25 microM). These results show that 5-HT did not act on the bladder by inhibiting the release of catecholamines from intrinsic nerves. The effect of 5-HT proved very resistant to attempts to block it with conventional 5-HT antagonists. Several antagonists were studied including ketanserin, methysergide, methiothepin, and MDL 72222 but even at concentrations as high as 1 microM none of them exhibited any marked inhibitory effect against the action of 5-HT. At 10 microM some compounds showed activity, but none abolished the effect except methiothepin - and its action was not surmountable by increasing the concentration of 5-HT. Thus the effect of 5-HT on the bladder was not mediated by 5-HT receptors of types 'M', 'D' or 5 HT2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821927 TI - Effects of combinations of 5-hydroxytryptamine receptor antagonists on 5-HT induced human platelet aggregation. AB - We have examined the effects of fourteen 5-HT-receptor antagonists on 5-HT induced platelet aggregation in whole blood. Two different types of inhibitory profile were obtained. The inhibitory effects of seven of the antagonists (designated type 1) could be surmounted by increasing the concentration of 5-HT; the inhibitory effects of the other antagonists (type 2) were insurmountable by 5 HT. The effects of combinations of pairs of different antagonists were investigated. The inhibitory effects of pairs of type 1 antagonists and of pairs of type 2 antagonists were additive. However, a type 1 antagonist interfered with the inhibitory effects of a type 2 antagonist. The two types of antagonist differed in the rate at which they inhibited 5-HT-induced aggregation, a type 2 antagonist exerting its effect more slowly than a type 1 antagonist. Two possible explanations of these results are considered. It is possible that there are two different types of receptors on the surface of platelets, one causing stimulation and the other causing allosteric inhibition of platelet aggregation. Alternatively, the results may stem from different rates of association and dissociation of the agents at a single 5-HT receptor. PMID- 3821928 TI - Spinal facilitation in cholinergic-sympathetic efferents by desipramine. AB - Electrodermal potentials (EDPs) evoked by electrical stimulation of the cholinergic-sympathetic system at different levels were recorded in the forepaws of anaesthetized cats and used as a measure of sudomotor activity. After pretreatment with yohimbine (0.25 mg/kg i.v.) to block alpha 2-adrenoceptors, unilateral electrical stimulation of the hypothalamus (square wave pulses 1 ms duration, 16 Hz, 2 s train length at intervals of 1 min) induced EDPs in both forepaws. Injection of the inhibitor of neuronal catecholamine reuptake, desipramine (1 mg/kg i.v.), facilitated the EDPs in both forepaws, even though access of the drug to the sweat glands was prevented by application of a tourniquet to one paw. The facilitation was abolished by injection of the specific alpha 1-adrenoceptor antagonist, prazosin (0.5 mg/kg i.v.). An equal enhancement of this effect by desipramine (1 mg/kg i.v.) and its abolition by prazosin (0.5 mg/kg i.v.) was obtained in cats with the brain stem transected at the level of the medulla oblongata and electrical stimulation of the spinal cord at C1. EDPs evoked in the right forepaw by preganglionic electrical stimulation of the right stellate ganglion were inhibited by desipramine (1 mg/kg i.v.). From these and previous results it is concluded that inhibition of neuronal reuptake of catecholamines results in facilitation of activity in sudomotor efferents. This effect is mediated by spinal alpha 1-adrenoceptors and provides an explanation of the occasional occurrence of excessive sweating in psychiatric patients treated with tricyclic antidepressants. PMID- 3821929 TI - Different changes in striatal dopamine metabolism induced by nicotine in mice kept at different ambient temperatures. Evidence for partly separate metabolic routes of dopamine derived from separate compartmentations. AB - Further information about the nicotine-induced changes in striatal dopamine metabolism in hypothermic mice was searched by measuring the contents of dopamine and its metabolites (3,4-dihydroxyphenylacetic acid, DOPAC; 3-methoxytyramine, 3 MT; and homovanillic acid, HVA) after blocking the synthesis of dopamine by alpha methyl-p-tyrosine (alpha-MT). This method gave a possibility to study the effect of nicotine on the metabolism of dopamine in two pools (the cytoplasmic "newly synthesized" dopamine and the granular dopamine). 3 mg/kg of (-)nicotine was given s.c. four times, at 110, 80, 50 and 20 min, and alpha-MT (250 mg/kg i.p.) at 60 min before sacrifice. To prevent the peripheral effects of nicotine all mice were given hexamethonium (10 mg/kg i.p.) at 140 min before sacrifice. Hexamethonium did not alter striatal dopamine metabolism. Experiments were performed at 20-22 degrees C at which temperature nicotine induced hypothermia or at 32-34 degrees C. The alpha-MT-induced proportional decrease of 3-MT content was clearly less than that of dopamine content. On the contrary the alpha-MT treatment decreased the DOPAC content proportionally more than the dopamine content. Thus DOPAC could not be solely formed from the same dopamine pool as 3 MT. These results indicate that 3-MT reflects best the metabolism of the granular dopamine and DOPAC that of the "newly-synthesized" dopamine. In hypothermic mice nicotine administration reduced the alpha-MT-induced depletion of the dopamine content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821930 TI - Modulation of uptake2 of 3H-(+/-)-isoprenaline by isoprenaline-induced depolarization of rat salivary gland cells. AB - Previous observations by Almgren and Jonason (1974) showed that propranolol is able to increase the extraneuronal accumulation of 3H-isoprenaline in rat salivary gland slices. The present experiments were carried out in order to test the hypothesis that 3H-isoprenaline, by acting on beta-adrenoceptors, might depolarize the gland cells and thereby hinder its own uptake2 and that this hindrance might be prevented by propranolol. After inhibition of catechol-O methyltransferase the extraneuronal accumulation of the 3H-catecholamine in slices of rat salivary glands was determined subsequent to 20 min of exposure of the tissue to 0.5 to 5,000 nmol/l 3H-(+/-)-isoprenaline. Expressed as a tissue/medium ratio, accumulation decreased with increasing amine concentration, although all amine concentrations were well below those saturating uptake2. The 3H-isoprenaline-induced decrease of the tissue/medium ratio was antagonized by ( )-propranolol, and increasing concentrations of the antagonist were needed to antagonize the effect of increasing concentrations of 3H-isoprenaline. In parallel experiments K+-induced (60 mmol/l) depolarization reduced the tissue/medium ratio observed for 0.5 nmol/l 3H-(+/-)-isoprenaline. Gland slices were preloaded with 3H-(+/-)-isoprenaline and then washed out for 60 min with solution not containing labelled amine. When 500 nmol/l (+/-)-isoprenaline were present in the wash-out solution, the addition of 10 mumol/l (-)-propranolol impeded the efflux of 3H-isoprenaline. In parallel experiments, K+-induced (60 mmol/l) depolarization facilitated the efflux of 3H-isoprenaline [in the presence of 10 mumol/l (-)-propranolol]. The results support the working hypothesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821931 TI - Inhibition by K+ of uptake2 of 3H-(+/-)-isoprenaline in the perfused rat heart. AB - The kinetics of the inhibitory effect of extracellular K+ on uptake2 of 3H-(+/-) isoprenaline were determined in isolated hearts obtained from reserpine pretreated rats; catechol-O-methyl transferase was inhibited. Initial rates of uptake2 of a very low concentration of 3H-(+/-)-isoprenaline (10 nmol/l) were determined in the presence of various extracellular concentrations of K+ (2.7 to 60 mmol/l). The inhibitory effect of K+ was concentration-dependent with an IC50 of about 20 mmol/l. - In these experiments KCl was added to the perfusion solution, and some hypertonicity resulted. In some experiments NaCl was added to a solution containing 5 mmol/l K+ to result in the same degree of hypertonicity as that obtained for 60 mmol/l K+; hypertonicity increased the initial rate of uptake2 of 3H-(+/-)-isoprenaline. Thus, the inhibitory effect of K+ had been slightly underestimated. In subsequent experiments the increase of the concentration of K+ in the perfusion fluid to 30 mmol/l was compensated for by a corresponding reduction of Na+. Initial rates of uptake2 of 10 nmol/l 3H-(+/-) isoprenaline were determined in the absence and presence of various concentrations of unlabelled (+/-)-isoprenaline. At 30 mmol/l K+ the IC50 (= Km for uptake2) did not significantly differ from that determined in an earlier study at 2.7 mmol/l K+ (Grohmann and Trendelenburg 1984). Finally, the Vmax for uptake2 of 3H-(+/-)-isoprenaline was determined at either 2.7 or 30 mmol/l K+. At 30 mmol/l K+ the Vmax was only about 1/4 of that observed at 2.7 mmol/l K+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821932 TI - Sodium-dependence of the potency of inhibitors of the neuronal noradrenaline carrier in the rat vas deferens. AB - Vasa deferentia obtained from reserpine-pretreated rats were incubated (monoamine oxidase and catechol-O-methyltransferase inhibited) in media containing various concentrations of 3H-(-)noradrenaline and Na+ and initial rates of the neuronal uptake of 3H-noradrenaline measured both in the absence and presence of uptake inhibitors after 1 min of incubation. When rates of uptake were determined at various 3H-noradrenaline (1.0-12.2 mumol/l) and two fixed Na+ concentrations (25 and 140 mmol/l), the inhibition of uptake produced by (+)amphetamine, ( )metaraminol, desipramine, nomifensine and cocaine was competitive with respect to 3H-noradrenaline at both Na+ concentrations. While the Ki for (+)amphetamine, (-)metaraminol desipramine and nomifensine increased when the Na+ concentration was lowered, that for cocaine decreased. When the Na+ concentration was varied (10-140 mmol/l) and the 3H-noradrenaline concentration held constant (1.2 mumol/l), (+)amphetamine, (-)metaraminol, nomifensine and desipramine acted as mixed-type inhibitors with respect to Na+, and the inhibition of uptake produced by these drugs was the more pronounced, the higher the Na+ concentration. On the other hand, cocaine was competitive with Na+ and the inhibition produced by this drug was the more pronounced, the lower the Na+ concentration. It is concluded that the inhibitors of neuronal uptake tested here act in dependence on the external Na+ concentration. Desipramine and nomifensine resemble alternative amine substrates in being more potent at high than at low Na+ concentrations. On the other hand, cocaine is more potent at low than at high Na+ concentrations. PMID- 3821933 TI - Binding of 3H-desipramine to the neuronal noradrenaline carrier of rat phaeochromocytoma cells (PC-12 cells). AB - The specific (i.e., nisoxetine-sensitive) binding of 3H-desipramine was studied in purified plasma membranes of PC-12 cells (rat phaeochromocytoma cells). 3H desipramine bound reversibly and with high affinity (KD = 4.5 nmol/l) to a single, non-interacting site (Hill coefficient = 1.04); the maximal number of binding sites (Bmax) was 19.6 pmol/mg protein. Like the uptake of noradrenaline (by uptake1), the binding of 3H-desipramine was dependent on both sodium and chloride. The stimulation of binding by chloride and sodium was characterized by a Hill coefficient of about 1 and 2, respectively. Both, chloride and sodium, slowed the rate of dissociation of bound 3H-desipramine. Increasing concentrations of sodium decreased the KD of 3H-desipramine binding without altering the Bmax. The binding of 3H-desipramine was inhibited by tricyclic antidepressants and other noradrenaline uptake blockers. There was a highly significant correlation between the potencies of a series of drugs for the inhibition of 3H-desipramine binding and for the inhibition of 3H-noradrenaline uptake into intact PC-12 cells. Both, binding of 3H-desipramine and uptake of 3H noradrenaline, were stereoselectively inhibited by the enantiomers of cocaine and oxaprotiline. However, for most of the substrates of uptake1 the IC50 for inhibition of 3H-desipramine binding was much higher than that for inhibition of 3H-noradrenaline uptake. Nevertheless, noradrenaline competitively inhibited 3H desipramine binding and unmasked dissociation of bound 3H-desipramine. Thus, 3H desipramine probably binds to the substrate recognition site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821934 TI - Effects of sodium and GTP on the binding kinetics of [3H]diprenorphine in NG 108 15 cell membranes. AB - Equilibrium binding isotherms of [3H]diprenorphine in membranes from NG 108-15 cells are consistent with a homogeneous population of binding sites. Upon addition of Na+, Mg2+ and GTP, only a 2-fold reduction in affinity with a minor decrease in the number of sites is observed. Dissociation curves of [3H]diprenorphine, however, are clearly biphasic: in the absence of Na+, Mg2+ and GTP, 80% of the bound ligand dissociates slowly with a t1/2 of 100 min, and only 20% rapidly (t1/2 4.5 min). In the presence of Mg2+, nearly all the binding is found in the slowly dissociating form. Upon the addition of either Na+ or GTP, 20 30% of the binding dissociates more rapidly. The rate constant of the rapidly dissociating form generated by Na+, however, is 2.5 times greater than that induced by the presence of GTP. Thus, the addition of both, Na+ and GTP, converts about 80% of the receptor into a very fast dissociating form (t1/2 1.7 min). Exposure of intact cells to pertussis toxin (10 ng/ml) or treatment of membranes with N-ethyl maleimide (500 microM), strongly reduces the proportion of the slowly dissociating component. Following these treatments, the effect of GTP is reduced or abolished, but that of Na+ remains unaffected. We conclude from these data that the effects of Na+ and GTP are not only distinct in site but also in mechanism of action and that there are three forms of opioid receptors that can be differentiated by their kinetic properties. The slowly dissociating receptor form requires a functional N unit. PMID- 3821935 TI - Interactions of morphine with apomorphine: behavioural and biochemical studies. AB - The interactions of morphine with the agonist at dopamine receptors apomorphine were studied on the behavioural and biochemical level. Apomorphine (0.5 mg/kg s.c.) produced stereotyped sniffing and some licking behaviour. Pretreatment with morphine enhanced licking behaviour and, in addition, produced some gnawing behaviour, a sign which is seen after a larger dose of apomorphine alone as well. This enhancement by morphine was maximal after 3.3 mg/kg i.p. and less pronounced after smaller or larger doses of morphine; naloxone (1 mg/kg i.p.) antagonized the enhancement. Morphine did not affect the decrease in the concentration of 3,4 dihydroxyphenylacetic acid (DOPAC) produced by apomorphine in striatum and nucleus accumbens. In contrast, morphine increased the concentration of 3 methoxytyramine (3-MT) in both areas after pretreatment with pargyline (75 mg/kg i.p.), suggesting that it increased the release of dopamine, which might explain the enhancement of apomorphine-induced stereotyped behaviour. The enhancement by morphine of stereotyped behaviour produced by lisuride (2 or 4 mg/kg i.p.), another agonist at dopamine receptors, was much less pronounced than on apomorphine-induced stereotypies. PMID- 3821936 TI - Effect of chronic administration of methamphetamine on the responsiveness of substantia nigra zona reticulata neurons to GABA or a GABA agonist in rats. AB - The effects of chronic administration of methamphetamine on the responsiveness of neurons of the substantia nigra zona reticulata (SNR) to gamma-aminobutyric acid (GABA) or to a GABA receptor agonist were examined. Neuronal activity was recorded from the SNR of rats that had been pretreated twice daily, for 6 consecutive days, with saline or with 5 mg/kg methamphetamine. Intravenous administration of the GABA receptor agonist, muscimol, caused a dose-dependent decrease in the unit activity of the SNR neurons and the SNR neurons became less sensitive to the depressant effects of the drug after chronic treatment with methamphetamine. Iontophoretic application, with increasing currents, of GABA produced a progressive inhibition of unit activity in control animals, an effect that was significantly reduced in rats pretreated with methamphetamine. These results support the hypothesis that long-term administration of methamphetamine increases the activity of the striatonigral GABA system and thereby reduces the sensitivity of postsynaptic GABA receptors in the SNR. PMID- 3821937 TI - Actions of the novel thromboxane A2 antagonists, ONO-1270 and ONO-3708, on smooth muscle cells of the guinea-pig basilar artery. AB - The effects of the novel thromboxane A2 (TXA2) antagonists, ONO-1270 and ONO 3708, on the electrical and mechanical responses evoked by various agents, and in particular 9,11-epithio-11,12-methano-thromboxane A2 (STA2), were investigated in the guinea-pig artery. STA2 (up to 0.3 microM), and ONO-1270 and ONO-3708 (up to 1.0 microM) did not modify the membrane potential in smooth muscle cells. Perivascular nerve stimulation induced an excitatory junction potential (e.j.p.), and with frequencies over 0.25 Hz, depression of e.j.ps occurred. STA2 (0.1 microM) and both ONO-1270 and ONO-3708 had no effect on these electrical events. STA2 (over 0.1 microM) produced phasic and tonic contractile responses, in a concentration dependent manner. Both ONO-1270 and ONO-3708 competitively inhibited the phasic contraction induced by STA2 as estimated from parallel shifts in the dose-response curve, and from the Lineweaver-Burk and Schild plots (the PA2 values were 8.22 for ONO-1270 and 8.70 for ONO-3708), but both agents inhibited non-competitively the PGF2 alpha-induced contraction. ONO-1270 and ONO 3708 (up to 0.1 microM) had no effect on contractions induced by K+ and caffeine, but did slightly inhibited contractions induced by 5-hydroxytryptamine (5-HT). Following application of indomethacin, neither agent modified the 5-HT-induced contraction. In Ca2+-free solution, 10 nM STA2 produced a phasic but not a tonic contractile response. ONO-1270 and ONO-3708 (over 1 nM) inhibited this phasic contractile response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821938 TI - Frequent stimulation of the guinea-pig myocardium raises the inotropic efficacy of tissue-bound ouabain. AB - 3H-Ouabain binding to frequently (1 Hz) stimulated papillary muscles from reserpine-pretreated guinea pigs was evaluated at ouabain concentrations of 18.5 and 200 nmol/l. Myocardial activity increased the amount of 3H-ouabain bound to the tissue in comparison with quiescent preparations. Since the shape of the time course of ouabain binding changed with frequent stimulation, a greater number of ouabain-accessible binding sites of the Na pump as induced by the rise in intracellular Na with frequent stimulation cannot be the sole mechanism of the frequency dependence. In view of their stimulatory properties on the Na pump the effects of intracellular Na and extracellular K could be equivalent. By contrast, both interventions were differently effective. The K antagonism on 3H-ouabain binding was independent from stimulation frequency. Furthermore, the shape of the time course of binding was not altered by [K]o. As evidenced by the dependence of half-times to steady-state effect on muscle diameter, the apparent rate of diffusion of ouabain was accelerated with the frequency of contractions. This acceleration could have interfered with the time course of binding at frequent stimulation. After correlating the time courses of positive inotropic effect and ouabain binding (concentration of ouabain in the medium 200 nmol/l), frequent stimulation was found to raise the inotropic efficacy of tissue-bound ouabain. The relation of excitation-dependent Na influx to the saturable, ouabain inhibited, Na pump explained the frequency dependence of the intropic efficacy of ouabain; that is, the observed change of efficacy was consistent with Na-pump saturation in dependence on intracellular Na. PMID- 3821939 TI - Mechanisms of frequency-induced potentiation of contractions in isolated rat atria. AB - Mechanisms underlying the potentiation of contractions after periods of high frequency stimulation (post-stimulation potentiation; PSP) and periods of rest (rest potentiation; RP) were investigated in isolated rat atria. Transmembrane action potentials were not changed during PSP and RP and were superimposable upon the pre-test action potentials. However, the 45Ca content of atrial strips was significantly increased during PSP, which indicates a net gain in intracellular Ca. 45Ca content was not changed during RP. PSP and RP were increased in magnitude in atria pre-treated with gallopamil (2.5 mumol/l). This effect was due to a greater depression by gallopamil of the pre-test contractions than the potentiated post-test contractions. In contrast, PSP was abolished in atria exposed to 7.5 mmol/l [Ca]o and a transient depression of the post-test contractions was seen. RP was also abolished by high Ca medium, but contractions were not depressed after periods of rest. RP, but not PSP, was unmasked when gallopamil was added to high Ca medium to decrease the size of the basal contractions. Conversely, ryanodine (100 mmol/l) abolished RP but did not affect PSP. With ryanodine present, PSP was greatly increased when the extracellular Ca concentration was increased to 5 mmol/l, whereas RP remained abolished. These results suggest that PSP may reflect an increased transsarcolemmal influx of extracellular Ca, possibly mediated through Na-Ca exchange. In contrast, the mechanism suggested for RP is a transient increase in contractile Ca resulting from an intracellular redistribution of Ca to release sites in the sarcoplasmic reticulum. PMID- 3821940 TI - Absorption, metabolism and elimination of strophanthus glycosides in man. AB - In 33 healthy male volunteers, given a single oral and intravenous dose of cymarin (k-strophanthin-alpha), k-strophanthoside (k-strophanthin-gamma) and ouabain (g-strophanthin), enteral absorption and renal excretion of these glycosides and their metabolites were investigated by radioimmunoassay and HPLC. Cymarin was absorbed at 47% of the given dose. After intravenous injection 46% and after oral administration 21% of the given dose, i.e. the total amount as detected by radioimmunoassay which consisted of the unchanged glycoside and its metabolites, were excreted by the kidneys mainly as conjugated metabolites. The half-life of elimination, calculated from the total excreted amount was 13 h (i.v.) and 23 h (p.o.), respectively. k-Strophanthoside was absorbed at 16% of the given dose. After i.v.-injection 73% of the given dose was excreted by the kidneys with a half-life of elimination of 99 h. From this total amount about 70% was excreted as the unchanged drug, the remaining 30% as various metabolites. After oral administration 11% of the given dose were excreted with a half-life of elimination of 22 h. 80% of this amount consisted mainly of conjugated k strophanthoside and conjugated metabolites as k-strophanthin-beta, cymarin, k strophanthidin, cymarol and k-strophanthidol. Only 6% was excreted as the unchanged drug. Ouabain was absorbed after oral administration to a minimum of 1.4%. Given intravenously a total renal excretion of 33% of the given dose with a half-life of elimination of 23 h was measured. Of this 80% was unchanged ouabain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3821941 TI - Actions of quinidine and apamin on after-hyperpolarization of the spike in circular smooth muscle cells of the guinea-pig ileum. AB - The effects of quinine and quinidine on membrane potential and action potential were investigated in circular smooth muscle of the guinea-pig ileum and the findings compared with the actions of apamin. In addition to results obtained from microelectrode experiments, the actions of quinidine and apamin on membrane currents were assessed using the single cell voltage clamp method. Quinine (above 0.2 mmol/l) and quinidine (above 0.08 mmol/l) depolarized the membrane, increased the membrane resistance and blocked generation of the after-hyperpolarization of the spike. Higher concentrations of both agents reduced the amplitude of the action potential and further depolarized the membrane. Quinidine and quinine possessed much the same action, with the former being more potent than the latter. Apamin, an inhibitor of the Ca-dependent K current, did not inhibit the after-hyperpolarization of the spike and had no effect on the membrane potential. In voltage clamp experiments, a depolarizing pulse (above -30 mV from -60 mV; 200 ms duration) elicited an inward current, followed by an outward current. With application of 2.5 mmol/l Mn instead of Ca, the outward current was subclassified into the Mn sensitive (Ca-dependent) and Mn resistant (voltage-dependent) K currents. Apamin (0.1 mumol/l) did not modify membrane currents evoked in the circular muscle cell, while, 0.1 mmol/l quinidine inhibited both the Ca- and voltage-dependent K outward currents, and Ca inward current. Our observation suggest that apamin-insensitive Ca-dependent K channels are present in the smooth muscle membrane and that they probably participate in the falling phase and after hyperpolarization of the action potential. PMID- 3821942 TI - The effect of aniline derivatives on absorption of fluid, glucose and sodium in isolated duodenal segments from rats. AB - Paracetamol (5-15 mmol X l-1), phenacetin (1-3 mmol X l-1) and acetanilide (5-20 mmol X l-1) enhanced fluid, glucose and sodium absorption of isolated duodenal segments from rats. In a high concentration paracetamol (30 mmol X l-1) and acetanilide (25 mmol X l-1) inhibited these parameters. The coupling coefficient of 2:1 in sodium-glucose cotransport was not changed under the influence of the aniline derivatives. Phlorizin (10(-5) mol X l-1) completely abolished the stimulatory effect of these drugs. Also in presence of 3-O-methylglucose instead of glucose in the perfusion medium a paracetamol dependent increase in fluid absorption was seen, whereas the absorption of mannitol was unchanged. The results suggest, that the increase in sodium and fluid absorption caused by aniline derivatives is due to the stimulation of active glucose transport. A cytotoxic effect may explain the decrease of absorption at high concentrations of these substances. PMID- 3821944 TI - Deutsche Gesellschaft fur Pharmakologie und Toxikologie. Abstracts, 28th spring meeting. March 10-13, 1987, Mainz. PMID- 3821943 TI - Can exercise-induced regional contractile dysfunction be prevented by selective bradycardic agents? AB - Propranolol (0.5 mg X kg-1 X 5 min-1), alinidine (1 mg X kg-1 X 5 min-1) and the benzazepinon UL-FS 49 (0.5 mg X kg-1 X 5 min-1) were investigated in a canine model of exercise-induced transient myocardial dysfunction, mimicking exercise induced functional impairment during angina pectoris in man. Each drug was infused intravenously, after two control treadmill exercise runs had shown comparable, ultrasonically assessed regional contractile dysfunction in an area supplied by a partly stenosed branch of the left coronary artery. All three drugs abolished exercise-induced regional contractile dysfunction. Propranolol and alinidine comparably decreased heart rate and positive dp/dtmax during exercise. UL-FS 49 showed a marked negative chronotropic effect without affecting positive dp/dtmax. Thus, prevention of exercise-induced regional contractile dysfunction has been shown for the first time using a selective bradycardic agent. PMID- 3821945 TI - [The heart as a mirror for nutrition]. PMID- 3821947 TI - [Occupational risk in the handling of chemotherapeutic agents]. PMID- 3821946 TI - [Transdermal administration of drugs]. PMID- 3821948 TI - [Control of pain at the deathbed by the physician]. PMID- 3821949 TI - [Intrinsic bronchial asthma]. PMID- 3821950 TI - [A simple method for the subcutaneous implantation of tablets]. PMID- 3821951 TI - [Distraction epiphysiolysis, a new method for leg lengthening and correction of standing posture]. PMID- 3821952 TI - [The quality of statistics on causes of death as recorded by the family physician]. PMID- 3821953 TI - [A different form for the certification of cause of death]. PMID- 3821955 TI - [Familial brain hemorrhage caused by cerebral amyloid angiopathy]. PMID- 3821954 TI - [Stress fractures of the femoral neck]. PMID- 3821956 TI - [INR: an internationally accepted standard for the monitoring of oral anticoagulant treatment]. PMID- 3821957 TI - [Children and tobacco]. PMID- 3821958 TI - [Analgesics in self medication and in general practice]. PMID- 3821959 TI - [The primary treatment of patients with facial clefts; advances in the last 30 years]. PMID- 3821960 TI - [Dandruff]. PMID- 3821961 TI - [The increase in body height in Dutchmen and the attraction of tennis]. PMID- 3821962 TI - [Electrocardiograms of 10 elephants and a killer whale in Harderwijk]. PMID- 3821963 TI - [A parasitic infection probably acquired through eating imported trout]. PMID- 3821965 TI - [The last judgment?]. PMID- 3821964 TI - [Scurvy in a Dutch child]. PMID- 3821966 TI - [Minor complaints: genu varum and genu valgum in children]. PMID- 3821967 TI - [Reversal of sterilization in women]. PMID- 3821968 TI - [Current legislation regarding professional practice in health care]. PMID- 3821969 TI - [Policy following review of Pap class IIIA in mass screening for cervix carcinoma]. PMID- 3821970 TI - [Organ function disorders at a distance: "where there's smoke there's fire"]. PMID- 3821971 TI - [The treatment of patients with intermittent claudication using walking exercises]. PMID- 3821972 TI - [Tanning with artificial sunlight: harmful or not? A Public Health Council report]. PMID- 3821973 TI - [Chronopharmacology]. PMID- 3821974 TI - [A gland in the neck]. PMID- 3821975 TI - [Estrogens]. PMID- 3821976 TI - [Menstruation disorders]. PMID- 3821977 TI - [Free tissue transplantation with microsurgery]. PMID- 3821978 TI - [Determining the abscence of spontaneous respirations in brain death]. PMID- 3821979 TI - [Registration of the side effects of drugs]. PMID- 3821980 TI - [Current theories on resuscitation: no practical consequences yet]. PMID- 3821981 TI - [The significance of serum ferritin determination in healthy subjects and in patients with unexplained fatigue in family practice]. PMID- 3821982 TI - [The ingrown nail]. PMID- 3821983 TI - [Wisdom tooth problems]. PMID- 3821984 TI - [The lethal heat of electric blankets]. PMID- 3821985 TI - [And then the parrot appeared]. PMID- 3821986 TI - [Serous otitis media]. PMID- 3821987 TI - [Something to think about?]. PMID- 3821988 TI - [Continuous subcutaneous insulin infusion; the first decade]. PMID- 3821990 TI - [Drugs in the treatment of rheumatoid arthritis]. PMID- 3821989 TI - [Immunosuppressive treatment in multiple sclerosis]. PMID- 3821991 TI - [The importance of the anamnesis in "summer sickness"]. PMID- 3821992 TI - [Cephalosporins]. PMID- 3821993 TI - [Growth hormone treatment in 1987]. PMID- 3821994 TI - [Can reactive arthritis be caused by Chlamydia trachomatis?]. PMID- 3821995 TI - [Trismus as a symptom]. PMID- 3821996 TI - [Minor disorders in family medicine; fluor vaginalis without infection symptoms as a complaint]. PMID- 3821997 TI - [Yoghurt orally or vaginally? The effectiveness of yoghurt in the treatment of vaginal candidiasis]. PMID- 3821998 TI - [Modification of hearing and speech through the surgical treatment of nasal speech]. PMID- 3821999 TI - [Photosensitization caused by drugs]. PMID- 3822000 TI - [Glucocorticoids in pregnancy: effect on the fetus and neonate]. PMID- 3822001 TI - [Impressive and at the same time disappointing decrease in perinatal mortality in the Netherlands]. PMID- 3822002 TI - [Treatment of hemangiomas of the skin in children]. PMID- 3822003 TI - [Is television bad for children?]. PMID- 3822004 TI - [The duty to report or register in child abuse and then what?]. PMID- 3822005 TI - [Value of the dexamethasone suppression test for diagnosis and research]. PMID- 3822006 TI - [Minor disorders; diaper rash, ammonium dermatitis?]. PMID- 3822007 TI - [The femoro-crural bypass; a worthwhile operation for preventing amputation]. PMID- 3822008 TI - [Increased use of the internal mammary artery in coronary bypass operations; experience with 382 patients]. PMID- 3822009 TI - [Medicinal interruption of pregnancy using epostane]. PMID- 3822010 TI - [Spastic paraparesis and adrenal gland insufficiency: adrenomyeloneuropathy]. PMID- 3822011 TI - [Reflux studies and changed viewpoints of the pathogenesis of vesico-ureteral reflux]. PMID- 3822012 TI - Biopsy of mammographically suspicious breast lesions. PMID- 3822013 TI - Neonatal jaundice: current concepts. PMID- 3822014 TI - Lessons of the first cocaine epidemic. PMID- 3822015 TI - Fusarium moniliforme pneumonia. PMID- 3822016 TI - [The history and problems of the concept of schizophrenia]. PMID- 3822017 TI - [Social networks and social support. A critical review]. PMID- 3822018 TI - [Diagnosis in DSM-III]. PMID- 3822019 TI - [Oneiric perception in intensively treated panplegic polyradiculitis patients]. PMID- 3822020 TI - [Bromism--an overlooked disease picture]. AB - Reports of chronic bromine intoxication have been few in recent years: possibly this condition is now being under diagnosed. A case of drug psychosis due to chronic bromide ingestion and incorrectly diagnosed as schizophrenia is reported. Specific pharmacokinetic aspects of bromide and bromo-ureide are outlined and the clinical features of chronic bromine poisoning are considered with reference to possible diagnostic errors. There are clear indications for diagnostic testing and for appropriate treatment. PMID- 3822021 TI - [Analysis of the EEG of alcoholic patients in the initial phase of abstinence]. PMID- 3822022 TI - Primary cerebral malignant lymphoma with endocrine defect. Case report and review of the literature. PMID- 3822023 TI - The clinical significance of hepatitis B virus DNA determination in a patient receiving immunosuppressive drugs. PMID- 3822024 TI - [The narrow lumbar canal. Study of a surgical series of 139 cases]. AB - Over a period of 9 years, 139 patients with a mean age of 61 years were operated upon for disorders due to narrow lumbar vertebral canal. Clinical expression varied: lumbago, movement sciatica, intermittent claudication... Importance must be attached to discordance of examination findings in apparently benign root pain (67% of cases). The two key examinations of radiologic investigation are radiculography and a CT scan. Treatment is surgical, generally by a two-stage wide laminectomy combined with abrasion of an articular facet (64%), excision of osteophytic pads (35%) and/or treatment for a soft herniated disc (26%). Recovery was obtained in 35% of cases and pronounced improvement in 49% (84% of very good and good results) as evaluated by patients and surgeons. PMID- 3822025 TI - [Vicious callus and unrecognized dislocations of the cervicothoracic junction]. AB - Five patients were treated after a period varying between 6 weeks and 18 months following original injury. The five lesions were similar in that they could not be reduced by conventional orthopedic measures and that they were fixed during dynamic review examinations using a brilliance amplifier. PMID- 3822026 TI - [Panmedullary ependymoma with complete excision in several stages. Apropos of a case]. AB - Treatment of a panmedullary ependymoma involved a three-stage operation with total excision under microscopic control and the use of the Cavitron. The patient, a 22 year old woman, presented with a three-year history, with clinical onset of staged spinal pain and cervicobrachial neuralgia, of spasmodic paraparesis with sensory and sphincter disturbances. The extent of the lesion from C3 to L2 was determined from data from conventional myelography with Iopamiron, a CT scan with intrathecal contrast and nuclear magnetic resonance imaging of sagittal and frontal sections. The tumor, a grade I ependymoma, was treated by three-stage laminectomies (L2-T12, T12-T3, T3-C3), total excision being obtained by ultrasound fragmentation (Cavitron). Gross pathology showed a heterogeneous appearance with two cysts, one capping the tumor from the bulbospinal junction to C3, the other attached to the medullary cone. Hemorrhagic cavities were noted at cervicothoracic region and multiple microcysts in the dorsal expansion. The postoperative course was uneventful with recovery of walking wearing a bivalve acrylic corset, the most disturbing functional complication being the posterior cord syndrome responsible for an ataxia. PMID- 3822027 TI - [Intraspinal epidural hematoma in the hemophiliac]. AB - The authors report a series of 11 epidural haematoma in hemophilia. Of these, one case is observed in the department of Neurosurgery at the CHRU. From this study, main points results: a mechanic etiology was found in four cases; the main clinical and radiological signs are those of epidural haematoma; the indication to operate is required and the hemophiliacs should receive a "substitutive" treatment as soon as possible. PMID- 3822028 TI - [Multiple intracranial aneurysms associated with coarctation of the aorta. Apropos of a case surgically treated under controlled hypotension]. AB - A 17 year old girl presenting with multiple intracranial aneurysms and coarctation of aorta was treated surgically under controlled hypotension. Blood pressure distal to the stenosis was monitored to avoid risk of medullary ischemia. PMID- 3822029 TI - [Multiple intracranial aneurysms. A very peculiar case of 8 sylvian aneurysms]. AB - Reports vary with respect to frequency of multiple aneurysm but they are observed in an average of 13% of intracranial aneurysm cases. Multiple aneurysms generally involve several intracranial vascular trunks but those affecting the vertebrobasilar system and middle cerebral artery are the most common combinations. It is rare for more than two lesions to be located on the trunk of a same vessel. These data emphasize the exceptional nature of the clinical case presented. The eight aneurysms detected in this patient were all situated on the left sylvian artery and its proximal collaterals. Rupture of one of the aneurysms had provoked haemorrhage into sylvian fissure. All eight aneurysms were treated by eleven clamps during the course of a one-stage operation. Full recovery, with completely normal clinical and review arteriographic results, was obtained despite the postoperative onset of a right hemiplegia with aphasia. PMID- 3822030 TI - [Dural arteriovenous fistulas of the posterior cerebral fossa and thrombosis of the lateral sinus. Discussion of their relations and treatment apropos of 2 cases]. AB - Two cases of a posterior fossa dural arteriovenous malformation associated with a lateral sinus thrombosis are reported. In the first case, a right tentorial meningioma develops at the end of the superior sagittal sinus and on the transverse sinus which are occluded. A cranial bruit, heard by the patient four months after the surgical removal of the tumour, brings up a dural fistula supplied by the occipital, middle meningeal and pharyngeal arteries and drained away by cervical and cortical veins. Many attempts of extirpation and radiological embolization stop the bruit. In the second case, an increased intracranial pressure mixes up with an aphasia. A continuous emission doppler examination and a CT scan make likely a dural fistula. The malformation, which is associated to a left sigmoid sinus thrombosis, is fed by the occipital and middle meningeal arteries and drained by cortical veins to the cavernous sinus. The occipital artery ligation and a by-pass between the lateral sinus and the internal jugular vein cure the patient with a very good patency of the venous graft that holds up two years after. A few cases of the literature show the succession of the two vascular lesions and prove the primitive occurrence, either of the sinus occlusion, or of the dural fistula. A venous thrombosis might cause a fistula by the opening of physiological shunts of the dura-mater which consequently deviates the blood into the cortical veins, brings down the increased intracranial pressure and stops the thrombosis to spread.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822031 TI - [Transplantation of fetal neurons into the spinal cord after section]. AB - The transection of spinal cord can be seen as an interruption of the continuity in between the control command and the peripheral reception. The consequence is an anarchic reorganization of the distal spinal cord often responsible of spasticity and painful rigidity. We have, in a first step, sectioned the spinal cord at lower thoracic level in adult rats. Knowing the modulatory role of aminergic neurotransmitters, we have then one week later transplanted foetal 5-HT neurons into the distal segment of the cord, in half of the transsected animals. Functional results suggest the constitution of sphincteral autonomy in the grafted animals whereas the controls showed either an acute urine retention leading to death within two to three weeks after the section, or an absence of sphincteral control. Immunocytochemical study with specific 5-HT antibodies showed adult-looking neurons extending processes towards the intermediolateral nucleus and the anterior horn. Ultrastructural immunocytochemistry disclosed afferent and efferent synapses to the grafted neurons. PMID- 3822032 TI - [Transplantation of serotonin neurons in the olfactory bulb of the adult rat]. AB - Serotonergic neurons have their perikaraya concentrated in the raphe nuclei. In the present experiment, pieces of raphe nuclei containing serotonergic neuroblasts were dissected from 14 days rat embryos, mechanically dissociated, and 1 microliter of a cell suspension containing 30,000 cells was injected slowly under stereotaxic control in the olfactory bulb of adult rats. Three weeks after transplantation, the brain of the rats were processed for immunocytochemical detection of 5-HT. In all of the grafted animals, 5-HT neurons were found in the olfactory bulb. They exhibited the morphology of adult neurons, with well developed axon and dendrites, extending far from the injection site. Ultrastructural immunocytochemistry disclosed afferent and efferent synapses to the grafted neurons. Three preliminary results indicates that the transplanted neurons have been integrated in the host's neuronal circuitry. Ongoing electrophysiological studies are now directed at investigating the functional status of these grafted neurons. PMID- 3822033 TI - [Management of cranial-injured patients in the era of the Emergency Medical Service and the scanner. Comparative epidemiologic study with a 12-year interval in the same department of neurosurgery, in the Paris region]. AB - The authors present an analysis of the different data concerning the emergencies admitted in the Neurosurgical department of Sainte-Anne Hospital in Paris, during the one year-period extending from 1st June 1983 to 1st June 1984. These data have been compared to the corresponding findings established during 1972 in the same department. Traumatology appears to be a more and more limited activity among neurosurgical emergencies: 55% of admissions in 1972, 43% in 1983-84. The main characteristics of injured patients on admission have not changed: 65% are in a coma, 1.25 are operated in emergency, age distribution and types of lesion are identical. The sorting of the patients has improved: 25% of them were operated upon in 1972, 37% in 1983-84. Conveyance of injured patients has undoubtedly improved in quality during the last years; yet the duration of transport is still important, too important, even in Paris: 2 h 30 as an average time. Another favorable factor has been the coming out of CT-Scan; it is of course of great help for diagnosis, but it must not let forget basic and fundamental therapeutic decisions. PMID- 3822035 TI - [Transfontanelle cerebral echography]. AB - Cerebral transfontanelle ultrasonography has been making many progress for ten years, with the grey scale of new echographs. We report here our experience. The technique is now standardized: we use a high resolution realtime scanner with a 5 MHz transducer placed directly over the fontanella. The flexible cable permits the examination of preterm infants in incubator. After the description of normal echoanatomy, we give examples of the most frequent pathology observed: hydrocephalus, intracranial haemorrhage, periventricular leukomalacia, corpus callosum lipoma, brains dysraphism, Dandy Walker malformation. PMID- 3822034 TI - [Surgical excision of meningioma of the posterior fossa in a dog after detection by x-ray computed tomography]. AB - Following the progressive occurrence of a central vestibular syndrome in a 9 year old female dog, the diagnosis of a compressive lesion was confirmed by cerebrospinal fluid analysis (C.S.F.) and by computerized axial tomography (C.T.). The C.T.Scan revealed a large tumor occupying two thirds of the posterior fossa on the right side. A direct surgical approach to the right side of the posterior fossa revealed a large, friable mass, consistent with a meningioma, underneath the cerebellum, over the brain stem. Microscopic surgical dissection permitted the removal of the major part of the tumor. The nature of the intracranial neoplasm was confirmed histopathologically as a meningioma. No post operative complication arose and the dog returned to normal. Three months later, clinical signs reappeared and a control C.T.Scan showed recurrence of the tumor. The dog was euthanized four months postsurgically. Intracranial tumors are common in the dog, but rarely diagnosed and operated. However, a direct surgical approach to the posterior fossa for a tentative curative removal of an intracranial tumor has never been described in a dog. The localization and description of the lesions demonstrate the utility of C.T.Scans in the canine species. Recurrence of the tumor following surgery confirms the importance of complete excision of intracranial meningiomas when possible. PMID- 3822036 TI - [Ultrasonically guided biopsy of cerebral tumors]. AB - The authors have not an installation for stereotaxic neurosurgery. In this condition they have used for 3 years real-time ultrasonography to guide the biopsy of deep-seated brain lesions. For adopting finally their method, a preliminary study of 31 patients has been performed. This method is not available for superficial lesions (two failures) which are in the blind area of the probe. In 29 cases the lesion has been clearly identified and biopsed. Histologic diagnosis has been correct in 26 cases (90 percent), incorrect in 3 cases (lesion too necrotic in 2 cases, non specific gliosis in 1 case). The simplicity of this method, its innocuity and its low cost (versus sterotaxy) and its others applications prove its high interest for neurosurgery. PMID- 3822037 TI - [Real-time ultrasonography in neurosurgery. Puncture of an intracranial hypoechogenic cavity]. AB - The authors have been using real time echography in neurosurgical procedures since 1981: either for detection of a small sub-cortical tumor during a surgical operation, either for biopsy-guidance, or for puncturing a cavity (abscess, cyst or hematoma). The imaging is performed with a CGR SONEL 100 apparatus and two different frequency transducer elements: 3.5 MHz and 5 MHz. 56 patients underwent this technique; 22 times the lesion was hypoechoic: abscess give homogeneous, round hypoechoic image, often surrounded by a fine hyperechoic line; intracerebral hematoma produces an hypoechoic image after a 10 to 15 days evolution: compared to an abscess it then has a more hyperechoic irregular wave like limit; tumoral-cyst echogenicity is very low; it can even be anechoic. If a stereotaxic structure exists, indication of real time echography must be limited to such stereotaxy contraindications: threatening intracranial hypertension, suppurated lesion, fragile patient. The technique has its limit: that is the small volume of the target-lesion (inferior to 10 mm); advantages must be emphasized: light procedure, satisfying confidence when considering the probe progression, sometimes better information than that of a CT-Scan examination especially for tumoral and cystic lesions. PMID- 3822038 TI - [Indications for desferrioxamine in patients with chronic renal insufficiency treated by dialysis]. PMID- 3822039 TI - [Electroencephalographic changes in children dialyzed according to various protocols]. AB - A study of electroencephalographic changes in six children during hemodialysis sessions was done in order to evaluate the effects of four different dialysis strategies: acetate or bicarbonate dialysates (sodium 142 mEq/1), acetate dialysate with high sodium concentration (148-150 mEq/1), and hemodiafiltration. There are basic activity alterations in all cases except during bicarbonate dialysis sessions. Alterations are, however, less pronounced during dialysis sessions with high sodium concentration dialysate. No strict concordance between clinical manifestations and electroencephalographic changes was observed. However, better tolerance of bicarbonate dialysis sessions is assessed with respect to clinical symptoms as well as electroencephalograms. PMID- 3822040 TI - [Course of the annual incidence of primary glomerulopathies in a population of 400,000 inhabitants over a 10-year period (1976-1985)]. AB - Between January 1976 and December 1985, renal biopsy was indicated in 663 adults (greater than 15 yrs) patients who were born and lived in a rural area of 400,000 inhabitants. Annual incidence (AI) was 16.5/100,000. Primary GN was diagnosed in 418 pts (63%) corresponding to a prevalence (P) for 10 yrs of 1/1000. The results have been compared for two periods: A (1976-1980) and B (1981-1985) for which the number of patients with primary GN was similar (205 vs 213, AI: 10.3 vs 10.6/100,000). Sex-ratio M/F (2.1 vs 1.8) and mean age (+/- SD) at the time of renal biopsy (45 +/- 17) were not different. P (%) among primary GN, P (nb/1000) among global population, AI (nb/100,000) and sex-ratio (A vs B) were evaluated for each histological type: lipoid nephrosis (MC and HSF): 9.8%, 0.1/1000, 1.2 vs 0.8/100,000 (ns), 1 vs 1.5 (ns). Membranous nephropathy 12.4%, 0.13/1000, 1.1 vs 1.5/100,000 (ns), 1.75 vs 0.8 (less than 0.02). IgAGN (Berger): 27%, 0.28/1000, 2.6 vs 3/100,000 (ns), 3 vs 3.3 (ns). IgAGN (Schonlein-Henoch): 5%, 0.05/1000, 0.45 vs 0.6/100,000 (ns), 3 vs 5 (ns). MPGN: 5.9%, 0.06/1000, 1 vs 0.25/100,000 (less than 0.01), 2.3 vs 1.5 (ns). Post streptococcal AGN: 2.8%, 0.03/1000, 0.55 vs 0.05/100,000 (less than 0.01). Non post-streptococcal AGN: 6.7%, 0.07/1000, 0.65 vs 0.75/100,000 (ns), 1.2 vs 0.6. Idiopathic crescentic GN: 4.7%, 0.05/1000, 0.25 vs 0.75/100,000 (less than 0.01) 1.5 vs 1.5. S and F proliferative GN: 1.9%, 0.02/1000, 0.15 vs 0.25/100,000 (ns), 2 vs 0.2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822041 TI - [Acute interstitial nephritis and uveitis in the adult: apropos of 3 cases]. AB - Acute renal failure due to tubulo-interstitial nephritis accompanied by uveitis has been observed in 3 young women (TINU syndrome). In these 3 cases, the nephropathy was preceded (1-3 months) by asthenia, anorexia, weight loss and a major inflammatory syndrome. Nonsteroidal anti-inflammatory drugs (NSAID) administration was noted. In 2 cases, uveitis appeared after the nephropathy had subsided. Renal biopsies performed in the 3 patients revealed mainly interstitial changes with mononuclear cell infiltration; immunofluorescence studies were negative. Although the severity of renal failure varied among patients, renal function recovered completely, returning to normal within 2, 3 and 24 months respectively, on corticosteroid therapy. The TINU syndrome is a rare situation compared to drug-induced acute interstitial nephritis, including NSAID related nephritis. However, the real incidence of this syndrome might be underestimated since the uveitis can appear a few weeks later and its origin may not be related to the renal episode. PMID- 3822042 TI - [Acute granulomatous interstitial nephritis and hepatitis caused by drugs. Possible role of an allopurinol-furosemide combination]. AB - Acute granulomatous interstitial nephritis and acute granulomatous hepatitis were simultaneously observed in the same patient. Clinical and anamnestic arguments suggest that allopurinol could be responsible for this double localization, but a possible part played by furosemide cannot be excluded. The patient spontaneously recovered without corticosteroid therapy. Such an acute drug induced association did not have been proved so far. PMID- 3822043 TI - [Tuberculosis in chronic hemodialysis patients]. PMID- 3822044 TI - [Tubulo-interstitial nephropathy with cortical microcysts: apropos of a case]. PMID- 3822045 TI - [Interstitial nephropathy without granulomatous lesions and renal insufficiency in sarcoidosis]. PMID- 3822046 TI - [A new case of severe allopurinol toxicity]. PMID- 3822047 TI - Rate of in vivo verapamil exchange within the hypothalamus of the cat as examined by push-pull perfusion. AB - To investigate the characteristics of the uptake within hypothalamic tissue of the Ca2+-channel blocker, verapamil, push-pull canulae were implanted bilaterally above the anterior hypothalamic-preoptic area (AH/POA) and posterior hypothalamus (PH) of the cat. The functional reactivity of these two anatomical regions was verified in the unrestrained cat, prior to a push-pull perfusion, by a micro injection of either 5-7 micrograms norepinephrine (NE) into AH/POA, or by perfusion of 50 mM Ca2+ within the PH, both of which induce a transient decline in the cat's core temperature. Verapamil was perfused in a concentration of 0.4, 2.0 or 4.0 micrograms/microliter for successive 10 and 20 min intervals within these NE and Ca2+-sensitive sites. A quantitative analysis of verapamil in each sample of perfusate was performed double-blind by HPLC-spectrophotometric detection. The results showed that the percent recovery of verapamil after the 10 min interval was always less than that after the next 20 min period of perfusion. These recovery values were independent of the site of perfusion and the concentration of verapamil. However, the mean uptake of verapamil into tissue after 10 min was significantly greater than that after the 20 min period for all concentrations tested. These results demonstrate that the hypothalamus has a time dependent characteristic to incorporate a Ca2+-channel blocker into the parenchyma. Once the point of tissue saturation is reached, a steady-state level of verapamil uptake is established. PMID- 3822048 TI - Ornithine decarboxylase activity associated with a particulate fraction of brain. AB - The enzymic decarboxylation of ornithine by adult rat brain largely occurs in the particulate fraction. The activity is primarily due to ornithine decarboxylase (ODC) as evidenced by several criteria: the concurrent production of equimolar amounts of CO2 and putrescine, the sensitivity of the reaction to difluoromethylornithine (DFMO), a specific inhibitor of ODC, the lack of major effect of two inhibitors of ornithine-2-oxo-acid transaminase, upon the DFMO sensitive component of decarboxylation, the failure to profoundly reduce decarboxylation activity in the presence of a large excess of many aminoacids which could compete for non-specific decarboxylases. The insoluble ODC activity appears largely within synaptosomal and mitochondrial-enriched morphological fractions, yet cannot be attributed to trapped soluble ODC. Particulate ODC has a pH optimum and kinetic parameters that differ from those of soluble cerebral ODC. PMID- 3822049 TI - Anticonvulsant properties of spirohydantoins derived from optical isomers of camphor. AB - Natural camphor exists as the d (+) form but the l (-) form has been synthesized. Replacement of the keto group on carbon 2 of each form with a hydantoin moiety led to only one spirohydantoin derivative. Both d and l derivatives were synthesized. Both forms and their racemic mixture were tested in vivo for toxicity and behavioral effects in mice. A dose of 100 mg/kg of the d form was not toxic: mice showed normal grooming and exploratory behavior; the l form induced hunched posture, body jerks and myoclonic manifestations followed by quiescence. The dl form showed intermediate effects. Challenge with the convulsant pentylenetetrazol (Metrazol) 2 hr after treatment with placebo or the camphor spirohydantoins produced seizure manifestations in all controls, in half of the subjects pretreated with the d-camphor derivative, in none of those pretreated with the l derivative and an intermediate response in those pretreated with racemic mixture. Thus, a spirohydantoin moiety added to camphor conferred strong anticonvulsive properties on the l form and modest ones on the d form; the d form did not seem to antagonize the l form. PMID- 3822050 TI - D-pipecolic acid inhibits ethanol tolerance in mice. AB - The effects of graded doses of D-pipecolic acid (0.005-5 micrograms/animals s.c.) on tolerance to the hypothermic effect of ethanol (4 g/kg i.p.) were investigated in mice. D-Pipecolic acid itself did not change the core temperature or the acute hypothermic response to a single dose of ethanol. Repeated D-pipecolic acid administration, however, blocked the development of tolerance to the hypothermic effect of ethanol. The development of tolerance could be observed in the control group. It is assumed that D-pipecolic acid is capable of counteracting the tolerance effect of ethanol. PMID- 3822051 TI - Protein organization of rat synaptic plasma membranes and synaptic vesicles: a one- and two-dimensional study. AB - The protein organization of rat brain synaptic plasma membranes (SPM) and synaptic vesicles (SV) was investigated by surface iodination and one- and two dimensional electrophoresis. Polypeptides of molecular weights (MWs, in Kilodaltons) 170 K, 135 K, 96-86 K, 68-64-61 K, 56 K, 52 K, 38 K, 35-33 K, and 18 K are predominantly or exclusively exposed on the extracellular side of synaptosomes. Several polypeptides of MW between 70 K and 40 K are exclusively exposed on the cytoplasmic side of SPM. The use of two-dimensional electrophoresis allowed to recognize that, for some classes of MW, there are polypeptides of nearly the same MW and different isoelectric points exposed on both sides of SPM. The synaptosomal membrane shows a predominance of acidic proteins on the extracellular side and more neutral and basic proteins on the cytoplasmic side. With respect to SPM, SV are particularly enriched with polypeptides of MW 71 K, 56 K, 39-38 K, 32 K, 16 K, and 15 K. One of them, a doublet of MW 39-38 K, is the most highly labeled species upon surface iodination and is similar, but not identical, with a doublet located on the cytoplasmic side of SPM. PMID- 3822052 TI - High performance liquid chromatography of integral glycoproteins of peripheral nerve myelin. AB - Peripheral nerve myelin contains a large quantity of integral glycoproteins, such as PO and PASII protein. The present paper reports a fast and sensitive method for separation of these glycoproteins. High performance liquid chromatography (HPLC) with TSK-GEL 3000 SW column in the presence of sodium dodecyl sulfate (SDS) or lithium dodecyl sulfate (LDS) was used. Whereas the separation of PO and PASII was inadequate with low concentrations of the detergent, better separation profiles were obtained with high concentrations (1-2%) of the detergent in 0.1 M phosphate buffer. The two glycoproteins were able to be purified by rechromatography. High concentration of the detergent presumably diminished interaction between these glycoproteins. LSD-phosphate, SDS-lithium citrate or SDS-Tris buffer as an eluent was also compared with SDS-phosphate system. This method will be applicable to the detection and purification of proteins from myelin or other organelles. PMID- 3822053 TI - [Surgical treatment of the upper third facial fractures]. PMID- 3822054 TI - [Evaluation of hypertensive intracerebral hematomas based on the study of long term outcome--part IV: Prognostic importance of the age of the patient and the laterality of the lesion in putaminal hematoma]. AB - The age of the patient and the laterality of the lesion are said to play an important role in determining surgical indications and prognosis of any neurosurgical disease. These two factors have been evaluated in 355 cases of putaminal haematoma, which were seen during the last 10 years after the introduction of the CT scan. Patients have been divided in three age groups; less than 59 years, 60-69 years and greater than 70 years, consisting of 235, 80 and 40 cases in each group respectively. Long-term outcome of three groups has been compared in both surgically and conservatively treated patients. The hematoma was situated on left side in 182 and on right side in 173 cases. 56.6% of left sided and 48.7% of right sided hematoma cases were operated. The long-term outcome of the two sides has also been compared in both surgically and conservatively treated patients. One has to be careful while considering patients of greater than 70 years of age as there is always some natural selection among these patients before they are referred to the hospital or are operated upon thereafter. One tends to be less aggressive for so old patients. Only in moderate type and operated cases the younger patients (less than 59 years) showed a better long-term outcome (ADL) than other surgically treated patients. Otherwise age did not effect the long-term outcome (ADL) in any type of putaminal haematoma. No effect of laterality was found in mild and very severe types of hematoma for the long-term outcome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822055 TI - [Effects of indirect EC/IC bypass operations on adult moyamoya patients]. AB - We have performed indirect EC/IC operations, mainly the EDAS, on 50 pediatric and 4 adult moyamoya patients. In this paper, we report on the effects of the indirect EC/IC operations performed on the 4 adult patients, three females presented with intracranial hemorrhage and a male presented with intracranial hemorrhage and a male presented with infarction. The procedures performed were 6 EDAS, one EAS and a simple hematoma removal which was revealed later to have effected as indirect EC/IC bypass surgery. The patients were all in their twenties. All the patients had pre- and postoperative angiography and the result were compared and was correlated with changes in CT and neurological signs. Case 1 had hematoma removal right after the hemorrhagic attack. Angiograms taken 10 months later showed marked revascularization of the brain through the dural arteries on the operated side. EDAS which was performed later on the other side worked well and the postoperative angiograms taken 9 months later, showed satisfactory revascularization of the operated brain with decrease in moyamoya vessels. The patient has Rt. hemiparesis but she can enjoy skiing. Case 2 had been asymptomatic preoperatively, 10 months after the initial hemorrhagic attack. Bilateral EDAS was done. Angiograms 12 months later showed marked revascularization of the brain through the EC system and marked decrease in moyamoya vessels was seen in the Rt. side in which better revascularization presented. The patient lives a normal life as a housewife.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822056 TI - [A recurrent case of TSH-PRL secreting microadenoma following hypothyroidism]. AB - A thirty-seven-year-old housewife whose chief complaints were recurrence of galactorrhea and amenorrhea three years after having a selective adenomectomy. Hormonal examination done as a result of the continuation of the endocrinism revealed a hyperprolactinemia and high level of TRH due to hypothyroidism. Serum prolactin responded to neither TSH stimulation nor L-Dopa suppression tests. In addition, serum TSH did not react to TRH test. Contrast enhancement CT showed an intrasellar enhancing mass the size of which was less than 1 cm in diameter. A unilateral septal transsphenoidal operation was performed; and a soft white yellowish mass 7 X 5 X 5 mm in size was found in the left inferolateral aspect of the pituitary gland. Histological studies of frozen sections of this revealed it to be a pituitary adenoma, with the border between tumor and normal tissue being quite distinct. Immunocytochemical diagnosis further confirmed it to be both PRL and TSH producing adenoma. Electron microscopy showed more than three different hormone-producing cells. The PRL cells contained large, and the TSH cells had small hormone granules; but some tumor cells contained secretory granules of both sizes suggesting production of both PRL and TSH in the cytoplasm. It is necessary in the management of patients like this, during the post-operative period, to adequately institute a thyroid hormone replacement therapy so as to prevent recurrence. PMID- 3822057 TI - [A case of pineal teratoma with intraventricular free fat seen in CT scan]. AB - Detection of an intraventricular or intratumoral fat-fluid level on the plain craniograms has been known as a characteristic sign indicating the presence of intracranial teratomatous tumors. On CT scans, however, only thirteen cases have been previously reported to be found an intraventricular and/or subarachnoid free fat associated with spontaneous ruptures of these tumors. We reported a case of pineal teratoma with intraventricular free-fat seen on CT scans. A nine-year-old male with precocious puberty was admitted to our hospital complaining a moderate nonpulsatile headache. Neurological examinations were normal without signs of meningeal irritation. The serum and CSF titer of HCG were raised markedly. The laboratory data of the CSF were normal and there were no pathological cells in the CSF. The CT scans revealed a large heterogeneous mass containing multiple areas of negative density in the pineal region. There were negative density droplets in the bilateral frontal horn on the same CT scans indicating a presence of free fats. At surgery, an yellowish oily material was drained from the tumor, but there was no sign of meningitis over the cortical surface of the occipital lobe. An intraventricular free fat on CT scan have been reported in fourteen cases including ours following the first case described by Fawcitt in 1976. Although most of the cases presented headache, only two cases was diagnosed clinically as chemical meningitis. Pathological changes indicating granulomatous meningitis, however, were noted in five cases, all of them presenting seizure attacks. PMID- 3822059 TI - [A large AVM extensively involving the parietal region and posterior fossa]. AB - A 47-year-old male was concerned with a large AVM involved extensively in the parietal region and the posterior fossa. Radiological examinations showed multiple radiolucencies in the parietal and occipital bone and torturous vascular nets (nidus) in those bones on the angiograms. Nidus was found also in the dura mater in the posterior fossa. Therefore, this case seemed to be an extremely rare case of calvarial AVM in the parietal region with the mixed calvarial dural AVM in the posterior fossa. His symptoms were bruit, transient hemiparesis and Gerstmann's syndrome in addition to the symptoms due to raised intracranial pressure. Favorable results of therapies could be attained by extensive exfoliation of dura mater from the cranial bone and incision of proximal dura mater in the sinus. PMID- 3822058 TI - [Traumatic anterior cerebral artery aneurysms--experiences in 4 cases and review of the literature]. AB - Five cases of traumatic anterior cerebral artery aneurysms are reported with special emphasis on the initial CT findings of these cases. One case was already reported by Endo (1974). The cases are three in children and two in adults, male four cases and female one case. Four cases had closed head injury, one open. Consciousness level on admission were diversely from clear to semicomatose. Three cases experienced rupture of aneurysms. Time of diagnosis from trauma was from two days to 34 days. Location of aneurysms were near the junction of callosomarginal artery three cases, frontopolar artery one case, and A1-A2 junction one case. Operation was performed in four cases. Results were good in three cases and fair in a case. A case of no operation had fracture of anterior skull base and died from massive nasal and oral bleeding. Autopsy showed an aneurysm of A1-A2 junction, extending to sphenoid sinus. Histological findings of aneurysmal walls were pseudoaneurysm in all cases. There were 48 cases of traumatic anterior cerebral artery aneurysms in the literature. Most of cases are near the junction of callosomarginal artery. As the etiology of the aneurysm it is said that falx cerebri damages the arterial wall. We consider tear of junction of callosomarginal artery is a important factor, since the brain can easily move at the anterior portion of falx. It is very difficult to diagnosis traumatic aneurysms before rupture. But in our three cases of traumatic anterior cerebral artery aneurysms, computed tomographies of very early stage of trauma showed interhemispherical high density area, hematoma and hemorrhage of corpus callosum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822060 TI - [A case of male cystic pituitary adenoma with hyperprolactinemia--clinical study of 6 cases of male prolactinoma]. AB - A case of male cystic prolactinoma is reported. And six cases of male prolactinoma including the present case were experienced in our department, and they were studied clinically. A 40-year-old male was admitted to our hospital with complaints of decreased libido and bitemporal visual depression. Physical examination revealed neither gynecomastia nor galactorrhea. Decreased visual acuity, bitemporal hemianopia, and pale optic disc were disclosed. On endocrinological study, high serum level of prolactin and hyposecretion of the other pituitary hormones were shown. Plain skull x-ray films showed ballooning of the sella turcica. CT scan revealed a low density area in the pituitary fossa extending to the suprasellar region. This was visualized as a homogeneous high signal intensity in the T1 weighted magnetic resonance imaging. Surgical treatment was made by transsphenoidal approach. A considerable amount of dark reddish fluid was suctioned through an incision of the thinned dura mater. Postoperative course was uneventful, and the bitemporal hemianopia was much improved. The serum level of prolactin was normalized after administration of bromocriptine. Male prolactinomas were thought to constitute 20% of all prolactinomas and male cystic prolactinoma was a rare clinical entity. Since the serum level of prolactin became to be measured routinely, six male prolactinomas have been experienced in our department. Their clinical feature were summarized as follows; Mean age of the patients was 33.2 +/- 9.8 years. Marked suprasellar extension and associated visual disturbance were common. All lesions except in the present case were solid tumor. Mean serum level of prolactin was 3398.3 +/- 2758.4 ng/ml. Pituitary apoplexy during the test of insulin, TRH and LH-RH simultaneous loading was noted in two cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822061 TI - [A case of unruptured A1 aneurysm causing ischemic compression to the medial proximal striate artery]. AB - A 58-year-old female was admitted to our hospital because of weakness of the right lower extremity and dysesthesia of the right upper extremity. From her clinical symptoms the patient was tentatively diagnosed as having a sort of cerebral infarction and treated with administration of urokinase and antiplatelet agents. However, angiographical examination revealed a unruptured aneurysm of the A1 portion of the left anterior cerebral artery. Preoperative angiogram showed that the dome of the aneurysm compressed one of the neighboring perforating artery which arose from adjacent to the neck of the aneurysm. The patient underwent neck clipping of aneurysm successfully. During the operation, the perforator was hardly adhered to the dome of the aneurysm. So, careful dissection was made only around the neck and the perforator was spared. Her symptoms were disappeared immediately after surgery. The perforator was demonstrated with better filling in the postoperative angiogram than that in the preoperative angiogram. The pathomechanisms of cerebral ischemia caused by unruptured aneurysm were reviewed on the literature. Most of the cases were caused by release of fragmental thrombi from a large aneurysm. There was a very exceptional case whose symptoms had seemed to be related to the direct compression of the neighboring perforator by the aneurysm. The compressed perforator in this case was seemed to be corresponded with the medial proximal striate artery stated by Yasargil. PMID- 3822062 TI - [An autopsy case of medulloblastoma with massive hemorrhage]. AB - Hemorrhage in medulloblastoma is reported to be extremely rare. This is an autopsy report documenting massive hemorrhage in medulloblastoma in an 11-year old girl. She had a 3-week history of headache, vomiting and a tendency to fall to the left side, and suddenly developed respiratory arrest followed by coma. At autopsy, there were marked upward herniation of the anterior vermis and left cerebellar hemisphere and downward herniation of the cerebellar tonsils. Horizontal sections through the cerebellum showed a large tumor with a hematoma involving the entire vermis and left part of the cerebellar hemisphere. The histopathological diagnosis was medulloblastoma and no significant changes of tumor vessels were observed. Upward herniation played a significant role in the hemorrhage in this particular case. The presence of upward herniation was not described in the previously reported three autopsy cases of medulloblastoma with hemorrhage. PMID- 3822063 TI - [Surgical treatment of the herniated cervical disc--a consideration on the choice of operative method following our experience with 200 patients]. AB - There is a controversy on the surgical treatment for the so-called cervical herniated disc. Recently operators choosing the anterior approach have increased in more and more. However, considering the historical view of the treatment of disc disease, it is obvious that the posterior approach is also an important method, especially in the cases combined with the stenotic cervical spinal canal. During the past five years 200 patients of cervical herniated disc disease were operated in our clinic by using our newly devised instruments and new materials. We studied the relation between the operative approach, the extent of interbody fusion and the surgical results. The social adaptation of the operated patients was also examined especially by comparing the short follow-up with the long one. Regardless of surgical approach, the percentage of the good recovery is higher (10% at the most) in the short follow-up than that in the long observation. The consequence is thought to show that the social adaptation deteriorates as the time goes on. Based on these results, the historical aspects and the technical problems of anterior and posterior approach were reviewed, focusing especially the controversial points. On the other hand, presenting our opinion on the surgical approach, we showed how the surgical problems have been solved and other complications lowered by introducing our new technique. Consequently, we stress that it is insignificant to discuss whether we should choose the anterior approach or the posterior approach. Finally, in case of criticizing the surgical results, it is reemphasized that we should think over not only the simple operative results, but also the aspect of social adaptation. PMID- 3822064 TI - [Cerebrospinal fluid concentrations of creatinine and purine metabolites determined by high performance liquid chromatography: preliminary report on head injury and stroke patients]. AB - A prospective high performance liquid chromatography (HPLC) study was performed in eighteen patients with head injury and stroke and four control volunteers to evaluate creatinine and purine metabolites concentration (adenosine, inosine, hypoxanthine, uric acid) in cerebrospinal fluid (CSF). The present HPLC method is rapid, accurate and sensitive in the same isocratic run and no specimen pretreatment of 0.02 ml CSF is necessary. The creatinine level in CSF was increased from 122 to 169 mumol/l in some patients, and was found unrelated to that of serum. The uric acid levels varied between 5.8 and 121 mumol/l and were associated with decrease in Glasgow Coma Scale score and had a critical point of 30 mumol/l. We present initial results in application of HPLC method to measure the creatinine and purine metabolites in CSF. This preliminary report presents that these high levels in CSF of head injury and stroke patients probably reflect tissue damage and an increased tissue catabolism. PMID- 3822065 TI - [Application of the RI-counting method in CSF rhinorrhea]. AB - Some diagnostic procedures for CSF rhinorrhea have been reported, but they can not always identify and localize CSF leakage. This method, using intranasal cotton pledgets after the intrathecal injection of radioisotope (111In-DTPA) is thought to be reliable, informative and innocuous for localizing the sites of CSF leakage. This technique was named RI-counting method, and applied in two cases that were difficult to diagnose especially with positional-loading. The patients were first in the supine position, then in the sitting position, after the intrathecal injection of radioisotope and the intranasal insertion of cotton pledgets. After exchanging these pledgets, the patients were set in the prone position. After measuring the radioactivity of these pledgets and of 1 ml of blood, the ratios of the radioactivity of the pledgets to that of the blood were calculated. In case 1 the ratios of the left sphenoethmoid recess and the left middle meatus were significantly higher when the patient took the prone position, but in the supine or sitting position the ratios were in the normal range. In case 2 the ratio of right olfactory cleft was significantly higher in the sitting position or neck flexion. Both cases were operated and demonstrated that the location of the CSF leakage was presumable by using RI-counting method, regarding the anatomical relationship between the intranasal sites of pledgets and the opening of the paranasal sinuses. Positional-loading seemed to be essential. We obtained 72 pledgets of patients without CSF rhinorrhea, and the ratios of radioactivity of these pledgets had a mean value (M) of 0.156 and a standard deviation (SD) of 0.107.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822066 TI - [Gliosarcoma--a case report]. AB - A 60-year-old woman was admitted to our clinic on September 29, 1983 because of a five months history of personality change and progressive left sided motor weakness. Neurological examination on admission revealed left hemiparesis and papilledema. She was severely demented. Skull X-rays were normal. CT scan showed a large right parietoccipital mass which was markedly enhanced by contrast medium. Right internal carotid angiogram showed abnormal vascular shadow, early draining veins and tumor stain in parietoccipital region. Right external carotid angiogram showed that the tumor was partly fed by the middle meningeal artery in "sunburst" pattern. The tumor was resected subtotally through right parietoccipital craniotomy on October 4, 1983. At operation, well demarcated, reddish-grey tumor attached to the dura was found. Several branches of the middle meningeal artery were penetrated into the tumor through the attachment. The tumor grossly appeared to be a meningioma in its superficial part, but demarcation was found being obscured in removing the deeper part of the tumor. PATHOLOGICAL FINDINGS: The specimens obtained from the superficial part of the tumor showed admixture of two distinctive neoplastic tissues. One was malignant mesenchymal features. Fibrosarcomatous nature was obvious, characterized by cells with moderately chromatic, fusiform nuclei arranged in parallel rows and eosinophilic fibers deeply stained in silver preparation for reticulin. The other was gliomatous tissue forming islands surrounded by the sarcomatous tissues. Both tissues were histologically malignant, as evidenced by mitotic figure, high cellularity, atypical features and variability. In deeper part, sarcomatous findings was less noticed and features of glioblastoma multiforme more prominent, characterized by marked astrocytic anaplasia, endothelial proliferation and extensive perinecrotic pseudopalisading.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822067 TI - [Agenesis of the left internal carotid artery with an ophthalmic artery arising from the posterior communicating artery]. AB - A case of agenesis of left internal carotid artery is reported. The patient is a forty one-year-old house-wife with sudden episode of headache when she had a fever. CT scan of the head showed a small high density area in the right frontotemporal subcortical region. Four vessel cerebral angiography demonstrated negative lesion except for complete absence of the left internal carotid artery. The blood supply to the left cerebral hemisphere was provided both through the tortuous anterior communicating artery and through the enlarged left posterior communicating artery. Left ophthalmic artery arose from the left posterior communicating artery. The embryological developmental process of this kind of vascular anomaly as well as the relationship between intravascular hemodynamic stress and the induction of cerebral aneurysm were discussed in detail. PMID- 3822068 TI - [Effect of tamoxifen on the treatment of pituitary adenomas with bromocriptine]. AB - Administration of 2-Br- alpha-ergocryptine (bromocriptine = CB-154) in combination with an estrogen-receptor blocking agent tamoxifen were performed in two patients with prolactinoma and non-functioning adenoma, respectively. Case 1 was a 50-year-old male with hyperprolactinemia, impaired pituitary function and visual disorders, in whom a large invasive sellar mass lesion was disclosed by CT scans, which extended supra- and parasellarly and extracranially into paranasal sinuses and pterygopalatine fossa on the left side. As the effect of bromocriptine therapy was partial in tumor size reduction and decrease of serum PRL level and it could not be gained further improvement except for the well recovered visual acuity, tamoxifen was used together with bromocriptine resulting further reduction of tumor size and normalization of serum PRL level. Unexpectedly the medication was ceased during and after a couple of bypass surgery for angina pectoris, and it was followed by elevation of serum PRL level and regrowth of the sellar tumor as well as impairment of vision. By tamoxifen therapy the visual acuity showed some improvement, but the serum PRL level and the tumor size remained as before. Then the combination therapy with bromocriptine and tamoxifen was started again. Case 2 was a 38-year-old female with three children, who had secondary amenorrhea, galactorrhea, borderline level of serum PRL with impaired pituitary function and visual disorders. Under the diagnosis of a non-functioning pituitary adenoma with supra-sellar extension, a craniotomy was done and intracapsular partial removal of the tumor was made, revealing a chromophobe adenoma in light microscopy and undifferentiated cell adenoma in electron-micrographs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822069 TI - [Removal of upper brain stem arterio-venous malformations]. PMID- 3822070 TI - [Experience with electrothrombosis of a giant aneurysm with copper wire]. AB - A 71-year-old woman with left internal carotid giant artery aneurysm was treated by copper wire electrothrombosis after craniotomy. In spite of almost obliteration of the giant aneurysm by copper wire insertion, the giant aneurysm bled and the patient died of severe subarachnoid hemorrhage. Autopsy showed massive subarachnoid clot, large intracerebral hematoma in the left frontal lobe and intraventricular hemorrhage with thrombosis in the giant aneurysm. From the autopsy findings and our experimental study, the mechanism of the aneurysmal rupture after copper wire insertion was speculated as follows. As the speed of the thrombosis formed by copper wire in the aneurysmal dome was disproportional to the blood flow, thrombosis was formed later in the most fragile part of the aneurysmal dome into which the blood flows more rapidly from the parent artery and this gives more hemodynamic stress to the aneurysmal wall. Then the aneurysm bleeds. From this result, it may be concluded that as the surgical treatment with elecrothrombosis for giant aneurysm is a very risky procedure, this procedure should be carefully chosen to obliterate the giant aneurysm. PMID- 3822071 TI - [Pseudoaneurysm of the cortical artery associated with chronic subdural hematoma- a consideration on traumatic middle cerebral artery aneurysm]. AB - A 62-year-old man was admitted to our hospital, since chronic subdural hematoma was showed after he complained of mild headache and nausea. Two years ago he had head trauma at the left parietal region after drinking. On admission there was no paresis and mild choked disc is detected. Computed tomography with contrast enhancement showed abnormal enhancement and left chronic subdural hematoma. Cerebral angiography showed an aneurysm of the angular artery. Operation was done and the aneurysm was trapped. Aneurysmal wall was histologically a pseudoaneurysm. Post-operative result was good. We considered the relationship between the cortical pseudoaneurysm and chronic subdural hematoma. We reviewed the traumatic middle cerebral artery aneurysm in the literature, 56 cases. PMID- 3822072 TI - [Preoperative embolization with gelfoam powder for intracranial meningioma causing unusual peritumoral hemorrhage--with reference to the mechanism of hemorrhage]. AB - Preoperative embolization for intracranial meningioma has been performed at many institutions and its effectiveness has been well recognized. The complications of embolization such as facial pain, fever and facial nerve palsy, et al, were mild and temporary except embolus migration into intracranial vessels, but a peritumoral hemorrhage due to preoperative embolization was extremely rare. Recently we have experienced such an unusual complication, then we describe this complication here and discuss the mechanism of hemorrhage briefly. A 73-year-old female who had the left falx meningioma underwent preoperative embolization with gelfoam powder through the transfemoral route. About 10 hours later, she developed disturbance of consciousness and right hemiplegia. At that time, CT scan showed peritumoral hemorrhage and an increase in midline shift. An emergency craniotomy was performed and total removal of the falx meningioma (Simpson grade II) and evacuation of the hematoma were done. The postoperative course was uneventful. We conclude that gelfoam powder (average particle size 40-60 mu) is a useful material for preoperative embolization but may at times cause peritumoral hemorrhage. PMID- 3822073 TI - Differences in function and structure of the capillary endothelium in the supraoptic nucleus and pituitary neural lobe of rats. Evidence for the supraoptic nucleus as an osmometer. AB - The physiology and structure of capillary endothelial cells in the hypothalamic ventromedial and supraoptic nuclei and pituitary neural lobe were evaluated with quantitative methods and compared. The capillary endothelial cells in the ventromedial nucleus were used as an index of blood-brain barrier endothelium in cerebral gray matter; this endothelium has relatively low surface area and low permeability to tracer solutes. The permeability X surface area product of endothelial cells for a neutral amino acid, 14C-alpha-aminoisobutyric acid (AIB), in the ventromedial nucleus was similar to the value for supraoptic nucleus and was several hundred times smaller than in the neural lobe. The supraoptic nuclei and neural lobe had exceptionally large capillary surface areas, but dissimilar rates of blood flow and transendothelial influx of AIB. Differences in permeability of the endothelial cells between these two structures correlated closely with their marked dissimilarities in morphology. The neural lobe endothelium had numerous fenestrations (five per capillary cross-section) and vesicular profiles (twice as many as supraoptic nucleus), two features commonly associated with high capillary permeability. The capillary endothelium of the supraoptic nucleus was that of a typical blood-brain barrier structure having intercellular junctions that appeared tight, no fenestrations, and few cytoplasmic pits and vesicles. The unusually large capillary surface area of the supraoptic nucleus and low rate of solute flux across its endothelial cells make this nucleus a unique structure in which rapid changes in tissue volume may occur in response to small perturbations in plasma osmolality. The findings implicate the supraoptic nucleus as an osmotically sensitive detector or 'osmometer' in neuroendocrine regulation of body fluid homeostasis. PMID- 3822074 TI - Rates of release of GABA and catecholamines in the mediobasal hypothalamus of ovariectomized and ovariectomized estrogen-treated rats: correlation with blood prolactin levels. AB - Push-pull cannulae were implanted into the mediobasal hypothalamus of ovariectomized (ovx) rats. After recovery animals were treated with estradiolbenzoate (E2B) or oil and they were perfused 3 days later. Only the E2B treated animals which exhibited prolactin surges in the afternoon without concomitant LH surges were used in this study. In ovx animals hypothalamic GABA release, measured in 5-min intervals, was pulsatile, with pulses occurring every 37 min. This pattern was profoundly affected by E2B treatment: the pulse frequency was significantly reduced to 1 pulse every 117 min in steroid-treated rats. No differences in overall mean GABA release rates and pulse amplitudes were observed in ovx vs. E2B-treated rats. Our earlier demonstration of the existence of a large number of estrogen-receptive, GABAergic neurons in the MBH of rats is suggestive that these neurons change their secretory pattern in response to estrogen treatment. Estrogen-induced prolactin surges were accompanied by increased hypothalamic NE release. Concomitant changes in DA or E release rates were not demonstrable since catecholamine concentrations were too low to be reliable. However, the daily overall release rates of these two catecholamines were lower in E2B-treated rats compared to ovx animals. It is concluded that the positive feedback action of estradiol on prolactin release involves a stimulatory noradrenergic mechanism and may also involve estrogen-receptive, GABAergic neurons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822076 TI - Corticosterone and growth hormone secretions during long-term thiopental anesthesia in the male rat. AB - To study the temporal correlation of secretory profiles of corticosterone (CS) and growth hormone (GH) in adult male rats in the continuous-sleep state, CS and GH concentrations were measured in blood sampled at 10-min intervals through an intracardiac cannula for 11-12 h under long-term thiopental anesthesia. The cortical electroencephalogram (EEG) was monitored to maintain stable sleep during the sampling period. Sixteen rats were subjected to the experiment. By analysis of power spectrum and least-squares methods all the time series of CS and GH concentrations in blood were revealed to have three major ultradian rhythms with periodicities of 1.5 h and its multiples. Although there were no significant positive or negative cross-correlation coefficients between the periodicities of CS and GH, a tendency was evident for GH concentrations to be high when CS concentrations were low, and CS concentrations to be high when GH concentrations were low. The results demonstrate that CS and GH secretions are able to manifest the same ultradian rhythms as those in the unanesthetized, freely moving condition even in the continuous-sleep state due to thiopental anesthesia. Combined with our previous findings, the CS, GH and sleep-wakefulness rhythms appear to be governed by separate pacemakers, although sharing the same basic ultradian rhythm. PMID- 3822075 TI - Characteristics of receptors for dopamine in the pars intermedia of the amphibian Xenopus laevis. AB - While mammalian dopamine receptors have been extensively characterized, very little attention has been given to these receptors in lower vertebrates. Dopamine is thought to be a physiologically important melanotropin release-inhibiting factor in amphibians. By administering selective dopamine receptor agonists and antagonists to superfused neurointermediate lobes of Xenopus laevis and monitoring their effect on the release of melanophore-stimulating hormone (MSH), we have examined the characteristics of the receptors involved in the dopamine induced inhibition of MSH secretion. The results show that the receptor system involved has characteristics of both classical D-2 receptors and alpha-adrenergic receptors. This is concluded from: the agonistic effect of both the D-2 receptor agonists LY-171555 and apomorphine; the antagonism of this effect, not only by the D-2 receptor antagonists sulpiride, domperidon and haloperidol, but also by the alpha-adrenergic receptor antagonist phentolamine, and the observation that the effect of adrenaline, which is extremely potent in inhibiting MSH release, could be fully blocked by D-2 receptor antagonists. Both the fact that the dopamine-induced inhibition of MSH secretion could not be blocked by haloperidol, domperidon and phentolamine, and that adrenaline-induced inhibition was hardly blocked by phentolamine, led us to suggest the possible presence of multiple receptors or receptor sites. We find no evidence for the involvement of dopamine D-1 receptors in the regulation of MSH release. The effects of dopamine agonists and antagonists were also studied in vivo by monitoring changes in pigment dispersion of dermal melanophores. The results are consistent with our in vitro findings and indicate, moreover, that in the living animals there must also be a non-catecholaminergic system involved in the inhibition of MSH release from the pars intermedia. PMID- 3822078 TI - Long-term weekly gonadal steroid treatment: effects on plasma prolactin, sexual behavior and hypothalamic-preoptic area catecholamines. AB - Treatment of intact female rats with weekly injections of estradiol benzoate followed 48 h later by progesterone reliably induced high levels of sexual behavior. After 15-20 treatments, 25% of one group of females became refractory to the sexual-activity-inducing effects of ovarian steroids. The apparent deficit in sexual behavior could not be attributed to variation in prolactin secretion, as long-term steroid treatment resulted in greatly elevated circulating prolactin levels (greater than 1 microgram/ml) which were equivalent in good sexual responders (lordosis quotient, LQ greater than or equal to 90) and sexually refractory females (LQ less than or equal to 20). In control rats, short-term steroid treatment (5 weeks) decreased dopamine (DA) and dihydroxyphenylacetic acid (Dopac) concentrations in the median eminence (ME) and induced good sexual behavior. Interestingly, a similar pattern of decreases in DA and Dopac levels of ME was observed in those long-term-treated rats displaying good sexual behavior but not in the sexually refractory females. Further, a significant increase in DA concentration in the preoptic-anterior hypothalamic area of the sexually refractory females was observed. These data are interpreted to suggest that severe and chronic elevations in circulating levels of prolactin, induced by chronic ovarian steroid treatment, are not universally associated with a disruption of sexual behavior and increased dopaminergic function in the ME, seen in females with normal sexual behavior, was conspicuously absent in female rats that became refractory to the sexual-behavior-inducing effects of ovarian steroids. PMID- 3822079 TI - Differential distribution of muscarinic cholinergic and putative nicotinic cholinergic receptors within the hypothalamo-neurohypophysial system of the rat. AB - Binding of the muscarinic cholinergic receptor probe [3H]quinuclidinylbenzilate ([3H]QNB) and the putative nicotinic receptor probe [125I]alpha-bungarotoxin ([125I]alpha BTX) to vasopressin (VP) and oxytocin (OT) neuroendocrine cells was investigated with a combination of quantitative receptor binding, autoradiography and immunocytochemistry. A single high-affinity site was labelled by [3H]QNB in the hypothalamus and pituitary (KD = 0.76-1.44 X 10(-10) M) with a mean hypothalamic density of 213 fmol/mg protein compared with only 56 fmol/mg protein in the pituitary. Analysis of autoradiographic silver grains from [3H]QNB binding revealed a relative absence of binding associated with magnocellular VP and OT cell groups in the hypothalamus. The median eminence and neural lobe of the pituitary contained low levels of [3H] QNB binding, which, however, were the highest within the hypothalamo-neurohypophysial system. The ligand [125I]alpha BTX binds with both a high and low affinity to sites within the hypothalamus and pituitary (high-affinity KD = 0.77-1.03 X 10(-10) M). In the hypothalamus the density of high-affinity binding sites (25 fmol/mg protein) is approximately 2.5 times greater than in the pituitary. In contrast to [3H]QNB, high-affinity binding of [125I]alpha BTX was found to be highly concentrated within the supraoptic nucleus, nucleus circularis, and the magnocellular areas of the paraventricular nucleus. Autoradiographic silver grains were distributed over both VP and OT immunoreactive neurons and processes. Binding within the neural lobe was very low. These data suggest that the cholinergic regulation of VP and OT release may occur via nicotinic cholinergic receptors at the level of the magnocellular cell bodies and predominantly via muscarinic cholinergic receptors within the neural lobe. PMID- 3822077 TI - Effect of prenatal alcohol exposure on sexual maturation of female rat offspring. AB - To assess sexual maturation of female offspring from alcoholic rats, vaginal opening, body weight, prolactin (PRL), luteinizing hormone (LH) and growth hormone (GH) were followed during development. The vaginal opening in the female offspring from alcohol-fed dams was delayed compared with the offspring from both pair-fed and normally fed dams. There was an increase in plasma PRL levels together with a decrease in levels of plasma LH at the time of the opening of the vagina in rats prenatally exposed to alcohol (PEA) with respect to both control groups. The increase in PRL was the only hormonal alteration which persisted into adulthood (120 days). In general, there were no changes in levels of plasma GH between experimental and control groups. These data indicate that PEA results in a modification in secretions of PRL and LH as well as in a delay in the opening of the vagina. PMID- 3822080 TI - The selective effects of metorphamide on dorsal horn neurones of the cat spinal cord. PMID- 3822081 TI - Biological activity of Leu-enkephalin containing hydrophobic moieties. AB - A series of enkephalin analogues (Tyr-Gly-Gly-Phe-Leu-C-NH-R;R=C6,C8,C10,C12 and C14; C=CH2 groups) with increasing hydrophobic character have been tested behaviourally in the analgesic hot plate and tail flick tests. The analogues were administered intraperitoneally and were found to possess anti-nociceptive activity. The results indicate that apparently there is not a direct relationship between increasing hydrophobicity and activity of the enkephalin-alkyl-amide analogues. The enkephalin analogues were found to behave in the same way as the enkephalins in producing tolerance. PMID- 3822082 TI - Local cerebral hemodynamics in albino rats in the late stages after termination of neurotization (induction of neurosis). PMID- 3822083 TI - Differentiation by dogs with ablated auditory cortex of signals modeling movement of a sound source. PMID- 3822084 TI - Comparison of reactions of neurons in various neocortical areas of rabbits to conditioned positive and inhibitory stimuli. PMID- 3822085 TI - Effect of serotonin on the development of a rat cerebral cortex tissue culture. PMID- 3822086 TI - Enhanced development of conditioned reaction during stimulation of amygdaloid complex in rats. PMID- 3822087 TI - "Training" of subicular neurons and the theta rhythm. AB - The impulse activity of subicular neurons during electrical stimulation of the dorsal hippocampus with repeated, single impulses or groups of impulses with variable interimpulse intervals was studied in acute experiments with nembutalized, immobilized cats. Sibicular neurons can be divided into two groups according to the character of responses: One group responds with phasic excitation reactions in accordance with the rhythm of excitation; the other, with inhibition. The second group of neurons in the course of stimulation reorganizes its activity and begins generating impulses that anticipate rhythmic stimulations. The extrapolating action of these neurons is observed only at interstimulus intervals corresponding to the theta rhythm. The significance of the hippocampal rhythm in memory phenomena is discussed. PMID- 3822088 TI - Spontaneous and evoked activity of neurons in deep structures of the brain during their anodal polarization. AB - The influence of anodal polarization on the spontaneous activity of neurons in the caudate nucleus, medial geniculate body, and the median center of the thalamus and on the evoked impulse activity of neurons in the medial geniculate body was investigated during auditory stimulation. The impulse activity was recorded extracellularly with glass and metallic microelectrodes. Nichrome polarizing electrodes of 0.2 mm diameter with an uninsulated tip of 0.3 mm were inserted into the foregoing structures in a packet. Current parameters evoking the reversible suppression of spontaneous and evoked neuronal activity were determined: 300-500 microA during exposure for 1-3 min at a distance of up to 3 mm from the polarizing electrode. After the cessation of polarization, a prolonged aftereffect was observed: The inhibition of evoked discharges lasted 4 10 min, and the evoked impulse responses disappeared for 5-20 min. PMID- 3822089 TI - Monoaminergic structures of the hypothalamus under chronic stress conditions. PMID- 3822090 TI - Functional state of the autonomic nervous system in patients with euthyroid and thyrotoxic goiter. PMID- 3822091 TI - Spinal leptomeningeal sarcoidosis. PMID- 3822092 TI - Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation: 15 years later. PMID- 3822093 TI - A case of persistent hypoglossal intersegmental artery: angiographic and CT study. PMID- 3822094 TI - Behcet's syndrome masquerading as tumor. PMID- 3822095 TI - Bone changes in diffuse congenital lipomatosis. PMID- 3822096 TI - Magnetic resonance imaging determination of gliomatosis cerebri. AB - Gliomatosis cerebri is a rare condition characterized by diffuse overgrowth of large portions of the brain and spinal cord by glial cells in varying stages of differentiation. The tumor process is primarily an infiltrative, rather than a destructive one. Hence, pre-operative diagnosis by traditional imaging studies, including computed tomography (CT), has been difficult. Magnetic resonance imaging (MRI), with its unique sensitivity for cerebral pathology, is an ideal modality for demonstrating this lesion. We present three cases of gliomatosis cerebri in which high-field MRI clearly delineates the extent of the pathologic process. PMID- 3822097 TI - MR imaging in infra-, para- and retrosellar mass lesions. AB - To determine its diagnostic efficacy in infra-, para- and retrosellar mass lesions magnetic resonance (MR) imaging was compared with computed tomography (CT) in 39 cases. Thirty-six lesions were imaged with a Siemens 0.5 T superconducting unit, three with a 1.5 T unit. CT scanning was performed with third generation equipment. There were 28 neoplasms including eight pituitary adenomas with infrasellar extension, four meningiomas, four extensions from regional malignancies, three chordomas, three juvenile angiofibromas, three medial temporal gliomas, and one each of neuroma, epidermoid and metastasis. Eleven non-neoplastic masses included four vascular anomalies, three cholesterol granulomas, two arachnoid cysts, one sphenoid mucocele and one mixed sclerosing bone dystrophy with mass-like thickening of basisphenoid and basiocciput. While MR and CT were equally sensitive (100%), MR was superior in further delineating and characterizing a lesion. MR showed normal or abnormal blood vessels better than CT, and revealed changes of compact bone often quite satisfactorily. Effects on the brain parenchyma or CSF and airspaces were consistently well demonstrated. Provided absence of contraindications MR should be the primary radiologic screening test in suspected mass lesions of above location. PMID- 3822098 TI - Three-dimensional computed tomographic reformations of sellar and para-sellar lesions. AB - The purpose of this study was to determine whether diagnostically useful three dimensional (3D) reformations could be obtained from unmodified high resolution pituitary CT scans. Twelve CT examinations in 9 patients in whom an enhancing tumour or extensive bone destruction was identified around the sella, were studied using 3D images obtained on soft tissue and bone thresholds. 3D images were considered superior to conventional CT sections and reformations for the assessment of the vascular relations of tumours with large supra-sellar components, and in cases of extensive bone erosion. In selected cases, 3D CT imaging may facilitate a faster and more comprehensive appraisal of high resolution CT studies by clarifying otherwise complex spatial relationships. PMID- 3822099 TI - Chronic subdural hematomas. Time-density curve and iodine concentration in enhanced CT. AB - Surgery was undertaken on 32 chronic subdural hematomas in a series of 28 patients who had preoperatively undergone delayed contrast-enhanced computed tomography (DCECT). Time-density curves on DCECT and iodine concentrations of subdural specimens revealed that chronic subdural hematomas, regardless of density, were significantly enhanced by the entrance of intravascular contrast medium into the interior of hematomas. The ingress of intravascular contrast medium into the interior of the hematomas was chemically proven and might result from a complex transcapillary shift. PMID- 3822100 TI - Chronic subdural hematoma: correlation of computerized tomography with colour. AB - The computerized tomographic and operative findings in 10 patients with chronic subdural hematoma (SDH) are reviewed. A constant correlation was found between the CT density and the colour of the hematoma evacuated thus enabling an accurate prediction of the colour of fluid one would expect to find at operation. Certain clinical features and CT appearances are highlighted to prevent the likelihood of misdiagnoses. PMID- 3822101 TI - Cryptococcus meningitis, clinical--CT scan considerations. AB - Twenty adult cases of cryptococcus meningitis and their cranial CT scan findings were reviewed. Ten patients had abnormal CT scans. The findings were hydrocephalus, gyral enhancement, focal nodules, decreased attenuation in the white matter, and patchy increased uptake of contrast. The CT scan appearance often failed to correspond with symptoms. None of the appearances was specific to the cryptococcal infection. Fourteen patients developed papilloedema during the course of the illness. The majority of the patients who developed papilloedema did not have demonstrable hydrocephalus. PMID- 3822102 TI - Anatomy and computed tomography of the normal lumbosacral plexus. AB - The main nerves of the pelvis and lower limbs arise from the lumbar and sacral plexuses. These nerves can be affected by any of a large number of pathologic processes that occur in the paravertebral and pelvic regions. Understanding of the neurological findings related to paravertebral and pelvic pathology needs complete and accurate knowledge of the anatomy of these regions. The axial transverse sections of computed tomography give perfect visualisation of the anatomy of osseous, muscular, and vascular structures of the vertebral and paravertebral area and pelvic walls. Visualisation of the nerves in this regions is much more difficult, because direct demonstration of nervous structures by computed tomography is usually impossible. To be able to identify components of the lumbosacral plexus on axial CT sections the radiologist has to know the location of the nervous structures and the relationships of these structures to vascular, muscular and osseous structures which are easily demonstrated. PMID- 3822103 TI - The absent cervical pedicle syndrome. A case report. AB - A recent case of the absent cervical pedicle syndrome is presented. Incorrect radiological interpretation resulted in inappropriate management. A review of the literature on this congenital abnormality and a complete differential diagnosis are presented. PMID- 3822104 TI - Magnetic resonance imaging of the normal carotid bifurcation. AB - A Siemens 0.5 Tesla Magnetic Resonance Imaging (MRI) system was used with the saddle head coil and transverse scout localization for imaging 10 normal cervical carotid artery bifurcations in the sagittal plane. Good to excellent visualization of the flow voids and vessel contours was accomplished in all cases. Careful technique and patient cooperation are required. PMID- 3822105 TI - Dorsal CSF space at CI-II level. Technique of cervical myelography. AB - The width of the dorsal CSF space at the CI-II lateral puncture site was measured, both in extension and in the neutral position of the head, in 60 patients undergoing cervical myelography. The sagittal diameter of the dorsal CSF space did not change in 22 patients, was larger in extension in 27 patients, and larger in the neutral position in 11 patients. In three patients with a large dorsal CSF space the change in diameter was more than 2 mm whereas in other patients the change was minimal. Lateral CI-II puncture may be performed safely both in extension and in the neutral position. Distribution of the contrast medium was more satisfactory if the head was extended. PMID- 3822106 TI - A simple method to form an open loop with the sidewinder catheter for cerebral angiography. AB - Reforming an open loop in the ascending aorta is the first step in performing selective catheterization of the aortic arch branches, using a sidewinder catheter. An alternative method for forming the open loop is described. The method is simple and safe. No failures were encountered in over 150 consecutive cases, thirty of which were by transaxillary approach. PMID- 3822107 TI - Hypertrophic anterior tubercles of C5 and C6 on CT. AB - Hypertrophy of the anterior tubercles of the transverse processes of the fifth and sixth cervical vertebrae is a rare congenital anomaly. We present the CT appearance of this unusual variant. PMID- 3822108 TI - "Distal stump" of the internal carotid artery with ascending pharyngeal artery collateralisation. A potential source for further embolic ischemia. AB - In 2 patients, clinically exhibiting recent amaurosis fugax and small cortical infarction, carotid occlusion had been shown by means of doppler ultrasound. IA DSA showed a collateral circulation within the distal carotid artery in the base of the skull via the ascending pharyngeal artery. The slowly perfused stump of a distal carotid artery is supposed to be a potential source of emboli into the retinal or intracranial territories. PMID- 3822109 TI - Basilar bifurcation aneurysm associated with bilateral internal carotid occlusion. AB - A case of subarachnoid hemorrhage from ruptured aneurysm of the basilar bifurcation associated with occlusions of both internal carotid arteries at the neck is presented. Each internal carotid artery mainly received collateral flow at the cavernous portion from the internal maxillary artery through anastomotic artery of the foramen rotundum. Posterior circulation also supplied collateral blood flow via the right posterior communicating artery. This case report suggests that hemodynamic stress may be regarded as an important factor in the formation or development of cerebral aneurysm. PMID- 3822110 TI - Anomalous origin of the posterior meningeal artery from the lateral medullary segment of the posterior inferior cerebellar artery. AB - The authors present two cases of angiographically-confirmed anomalous origin of the posterior meningeal artery (PMA) from the lateral segment of the posterior inferior cerebellar artery (PICA) and describe briefly the probable embryogenesis of this anomaly. PMID- 3822111 TI - Cranial and epidural mycetoma caused by streptomyces somaliensis. AB - The authors report a rare case of cranial and intracranial mycetoma which presented with occipital sinuses, extensive involvement of skull vault and base, an extradural granuloma and intracranial hypertension. Radiological appearances are reviewed. The computerized tomography findings are the first of their kind for this condition. The diagnosis and treatment of this disease are discussed. PMID- 3822112 TI - Recognition of gas-containing disc herniation on lateral CT-scoutview. PMID- 3822113 TI - Principles of organization of the vertebrate olfactory glomerulus: an hypothesis. PMID- 3822114 TI - The visual cortico-striato-nigral pathway in the rat. AB - The organization of the visual cortico-striato-nigral pathway in the rat has been investigated in two sets of experiments using anterograde autoradiographic tracing techniques. First, in one group of animals, injections of tritiated amino acids were placed throughout the visual cortex to demonstrate the visual corticostriatal pathway. The results indicate that visual corticostriatal fibres terminate in a distinctive clustered pattern throughout the entire length of the ipsilateral dorsomedial striatum. The projection shows a longitudinal topographic organization with cortical loci projecting onto narrow longitudinal regions of the dorsomedial striatum. In addition to the ipsilateral projection, a substantially smaller contralateral visual corticostriatal projection was also demonstrated. In the second set of experiments, the visual corticorecipient region of the striatum demonstrated in the first set of experiments was injected with tritiated amino acids to demonstrate the "visual" striatonigral projection. The results indicate that striatonigral fibres from the dorsomedial striatum project throughout the rostrocaudal extent of the ventral region of the pars reticulata. As with the visual corticostriatal pathway, the projection shows a longitudinal topographic organization with striatal loci projecting onto longitudinal regions of the ventral pars reticulata; the most rostral regions of the dorsal striatum project to the most medial regions of the ventral pars reticulata and, likewise, successively more caudal regions of the dorsal striatum project to successively more lateral regions of the ventral pars reticulata. In addition to the main projection to the ventral pars reticulata, a second smaller component of the striatonigral pathway was traced to adjacent regions of the dorsal pars reticulata and ventral pars compacta. These findings provide evidence of a visual cortico-striato-nigral pathway to both the pars reticulata and pars compacta in the rat. It is suggested that the major projection onto the ventral pars reticulata may provide an input onto nigrotectal neurons and thereby complete an indirect visual corticotectal connection mediated via links in the basal ganglia. PMID- 3822115 TI - Thyroid hormone and development of the rat hippocampus: cell acquisition in the dentate gyrus. AB - A quantitative autoradiographic histological study was carried out to examine mechanisms underlying the reduction in the rates of growth and of cell acquisition, including that of granule cells, in the dentate gyrus of hypothyroid rats. Thyroid deficiency in early life had no effect on the replication of intrinsic cells present in the polymorph and granular layers. The pyknotic index was also normal in the "proliferative zone", polymorph layer and granule cell layer, indicating that thyroid hormone had no effect on the survival of replicating, migrating or maturing granule cells. By contrast, the arrival of migrating cells from the "proliferative zone" to the granular layer was severely retarded in thyroid deficiency. This deficit was rapidly restored after a physiological dose of thyroxine given to hypothyroid rats. The present findings are consistent with our previous proposal that the role of thyroid hormone in the formation and/or the maintenance of nerve cells is related to changes in either cell migration or maturation, rather than to alterations in the replication of germinal cells. PMID- 3822116 TI - Thyroid hormone and development of the rat hippocampus: morphological alterations in granule and pyramidal cells. AB - A quantitative study of the morphogenesis of granule and pyramidal cells was performed on Golgi-Cox preparations of the developing hippocampus of normal and hypothyroid rats, and hypothyroid rats given replacement thyroxine treatment. In the normal hippocampus, the volume of the cell body and the number of branching points on the apical and on the basal dendrites of pyramidal cells increased between 6 and 10 days after birth. The pyramidal cells of Ammon's horn showed a gradation from area CA1 to area CA4 of progressive differentiation. In thyroid deficient rats, the arborization of the dendritic field of both granule and pyramidal cells was impaired, and for pyramidal cells the extent of the impairment depended on the position of the cells in the Ammon's horn, the cells of CA3-4 areas being the most affected. Treatment of hypothyroid rats with a physiological dose of thyroxine restored some of the morphological defects to normal, but others were altered beyond control levels, indicating that thyroid hormone differentially controls not only the measured indices of maturation but also that its influence depends on the position of the pyramidal cells. The observations were consistent with the concept that thyroid hormone is important in the establishment of the CA1 to CA4 gradient of pyramidal cell differentiation and in the development of the spatiotemporal relationship between pyramidal and granule cells of the hippocampus. PMID- 3822117 TI - Lesion-induced transneuronal plasticity in the adult rat hippocampus. AB - The process of reactive synaptogenesis has been demonstrated in several areas of the central nervous system, including the hippocampal dentate gyrus. After a complete unilateral entorhinal lesion, approximately 85% of the input to the outer two-thirds of the ipsilateral dentate molecular layer is lost. Bilateral fluctuations in synaptic density within non-denervated zones of the dentate molecular layer predict further alterations in neural circuitry at sites located transneuronally to the denervated dentate granule cells. Using quantitative electron microscopy, our study demonstrates a complete cycle of synapse loss and reacquisition within the ipsilateral but not contralateral CA4/hilus region of the hippocampal formation. This area is one of the terminal fields for the dentate granule cell mossy fiber axons. In addition the granule cell mossy fiber axons sprout during the postlesion time course and form a significantly increased number of new mossy fiber terminals within the ipsilateral and contralateral CA4/hilus area. Our results indicate that responses to brain injury may no longer be confined to a local denervated site, but probably include polyneuronal circuitry loops, which may encompass one or more areas of the central nervous system. Previous difficulties in providing a close behavioral or functional correlation to localized structural events may be explained by a more global brain response to an injury. PMID- 3822118 TI - The effect of 6-hydroxydopamine, reserpine and cold stress on the neuropeptide Y content of the rat central nervous system. AB - Neuropeptide Y has previously been detected in neurons throughout the rat brain and spinal cord. On histochemical grounds, the neuropeptide Y-containing cell bodies have been subdivided into two groups: those in the brain stem in which colocalization with noradrenaline and adrenaline has been demonstrated and those in other brain regions where no catecholamine coexistence is found. In this paper the regional distribution of neuropeptide Y has been investigated in the rat brain by a specific neuropeptide Y radioimmunoassay, before and after the destruction of catecholaminergic nerve terminals by the administration of intraventricular 6-hydroxydopamine. Despite massive reductions in brain catecholamines, the neuropeptide Y level was unchanged in the cerebral cortex, striatum, spinal cord and hippocampus. A minor reduction in neuropeptide Y was found in the hypothalamus. Reserpine treatment, which is known to deplete brain nerve terminal stores of catecholamines, likewise did not result in any loss of neuropeptide Y. Cold stress which increases noradrenergic turnover in the rat brain stem had no effect on neuropeptide Y levels. These results suggest that the bulk of neuropeptide Y in the rat brain and spinal cord may not be stored in catecholaminergic nerve terminals. PMID- 3822119 TI - Effect of reserpine, phenoxybenzamine and cold stress on the neuropeptide Y content of the rat peripheral nervous system. AB - The effect of reserpine treatment on the neuropeptide Y content of the rat adrenal gland, heart, kidney and vasculature was studied using a specific radioimmunoassay. One hour after reserpine administration (5 mg/kg) the neuropeptide Y concentration in the adrenal gland was significantly reduced and after 4 h a similar reduction was seen in the heart and kidney. After 48 h, neuropeptide Y concentrations were reduced in all tissues. The greatest reduction occurred in the cardiac septum (77%) and the least in the inferior vena cava (25%). Phenoxybenzamine (2 mg/kg) also caused a reduction in neuropeptide Y concentrations which was less marked than after reserpine, except in the adrenal gland where it was similar. Cold stress caused no change in neuropeptide Y concentrations. The neuropeptide Y depletion induced by reserpine was compared to that following 6-hydroxydopamine. In the heart and pial arteries both drugs caused a similar neuropeptide Y depletion whilst in the pineal gland and renal artery 6-hydroxydopamine had more effect than reserpine. The implications of these results on NPY storage sites are discussed. PMID- 3822120 TI - Concerted enhancement of calcium influx, neurotransmitter release and protein phosphorylation by a phorbol ester in cultured brain neurons. AB - We have recently shown that the phorbol ester 12-O-tetradecanoyl-phorbol-13 acetate enhances the depolarization induced, calcium dependent release of [3H]dopamine from cultured brain neurons in the rat. In the present study the effects of 12-O-tetradecanoyl-phorbol-13-acetate on the kinetic parameters of depolarization induced calcium influx and on Ca2+ dependent neurotransmitter release and protein phosphorylation were investigated. Depolarization induced neurotransmitter release from the neurons occurs in two phases: an initial, fast release and a subsequent slow release. At low extracellular Ca2+, 12-O tetradecanoyl-phorbol-13-acetate enhanced the quantity of fast release and in addition, increased the rate constant of the slow release. These effects mimicked the effects of increasing the extracellular Ca2+. Various phorbol derivatives known to activate the Ca2+ activated phospholipid dependent protein kinase (protein kinase C) were also able to enhance the stimulated release of [3H]dopamine from the neurons. 12-O-tetradecanoyl-phorbol-13-acetate induced the incorporation of 32Pi into a protein with an apparent molecular weight of 45,000 daltons regardless of depolarization or of the presence of Ca2+. In addition, 12 O-tetradecanoyl-phorbol-13-acetate induced in unstimulated neurons, Ca2+ dependent increase in the amount of 32Pi incorporated into a 43,000 dalton protein and decrease in the amount incorporated into a 55,000 dalton protein. These changes mimicked the Ca2+ dependent changes in protein phosphorylation which occur upon stimulation of the neurons. Kinetic studies of depolarization induced Ca2+ uptake by the neurons indicated that 12-O-tetradecanoyl-phorbol-13 acetate enhanced the maximal influx of Ca2+ through the voltage sensitive Ca2+ channels by 40%. The results indicate that 12-O-tetradecanoyl-phorbol-13-acetate acts primarily on the regulation of stimulated Ca2+ entry into the cells. Consequently neurotransmitter release at submaximal extracellular [Ca2+] is enhanced. PMID- 3822121 TI - Dendritic changes in the basal nucleus of Meynert and in the diagonal band nucleus in Alzheimer's disease--a quantitative Golgi investigation. AB - Golgi-impregnated reticular neurons and multipolar giant neurons, the two main classes of neurons in the basal nucleus of Meynert and in the diagonal band nucleus, were investigated morphometrically in five cases of Alzheimer's disease, and compared to controls. Both degenerative as well as regenerative neuronal changes were observed in cases of Alzheimer's disease. Degenerative changes such as irregular swellings and the fragmentation of dendrites are most pronounced on reticular neurons but can also be detected to a lesser extent on multipolar giant neurons. Regenerative changes are restricted to reticular neurons. They are characterized by the appearance of perisomatic filopodia, by an increase in the size of cell soma, by an increase in the degree of dendritic arborization and spatial extension of the dendritic tree. These regenerative changes are probably signs of a compensatory mechanism which might be induced by degeneration in this area. PMID- 3822122 TI - Nucleus basalis neuronal loss, neuritic plaques and choline acetyltransferase activity in advanced Alzheimer's disease. AB - All our advanced, severe cases of Alzheimer's disease have dramatic cholinergic cell losses in the nucleus basalis of Meynert even after correction for cell or nucleoli shrinkage. There is a good correlation between choline acetyltransferase activity and "healthy" cell number in the nucleus basalis of Meynert. Half of the Alzheimer disease cases have markedly reduced cortical choline acetyltransferase activity in spite of preserved nucleus basalis of Meynert choline acetyltransferase activity, suggesting a deficiency of cortical origin and/or of axonal transport in Alzheimer disease. The relationship between cell loss in the various sub-divisions of the nucleus basalis of Meynert and plaque counts in corresponding and non-corresponding projection areas of the cortex has also been examined. Globally, this relation appears more obvious when cell loss in a sub division of the nucleus basalis of Meynert is compared to plaque counts in its cortical projection area. However, the relation is discontinuous with few or no data to document the intermediary stages of the process, probably reflecting the severity of our Alzheimer disease cases. PMID- 3822123 TI - Fastigial nucleus modulation of medullary parasolitary neurons. AB - Input from the cerebellar fastigial nuclei to neurons at the lateral margin of the nuclei of the solitary tract, particularly to the area identified as the nucleus parasolitarius was investigated in acutely prepared, anesthetized dogs. Fastigial nucleus stimulation led to short latency excitation of nucleus parasolitarius units often followed by prolonged inhibition of spontaneous activity. Excitation from deep skeletal muscle afferents, converged on 25% of the spontaneously active units excited from the fastigial nuclei; these afferents originated primarily from the ipsilateral forelimb muscles. This study provides electrophysiological evidence for fastigial modulation of neurons previously demonstrated autoradiographically to receive presumed monosynaptic fastigial nucleus efferents. The convergence of forelimb muscle afferent information tentatively identified as being from Group Ia or Group II pressure stretch receptors suggests that the nucleus parasolitarius may be an integrative area for cerebellar, sensorimotor and/or autonomic information. PMID- 3822124 TI - Contrasting monoamine oxidase activity and tyramine induced catecholamine release in PC12 and chromaffin cells. AB - PC12 (phaeochromocytoma derived) cells possess the catecholamine synthesizing enzymes as well as the ability to store and release the catecholamines in response to K+. However, their monoamine oxidase activity and catecholamine release in response to tyramine has not been examined previously. PC12 cells have monoamine oxidase activity which oxidizes type A (noradrenaline and serotonin) and type A-B (dopamine, tyramine and kynuramine) substrates, and is selectively inhibited by clorgyline (IC50 approximately 10(-6) M). In contrast, PC12 cell monoamine oxidase hardly oxidizes phenylethylamine a type B substrate, and is relatively insensitive to inhibition by the selective monoamine oxidase type B inhibitor, 1-deprenyl (IC50 approximately 10(-6) M). By the above criteria it is apparent that the monoamine oxidase in PC12 is solely type A. The kinetics of the oxidase are similar to those of monoamine oxidase type A reported in other tissues including the adrenergic neuron, having apparent Km values of 400, 280, 170 and 227 microM for noradrenaline, dopamine, serotonin and tyramine. The apparent Km value for phenylethylamine is 235 microM. On the other hand, isolated chromaffin cells have the B form of monoamine oxidase with high affinity (Km approximately 25 microM) for phenylethylamine and low affinities for noradrenaline (Km approximately 1100 microM) and adrenaline (Km approximately 1700 microM). This enzyme form is selectively inactivated by the monoamine oxidase type B inhibitor, 1-deprenyl. In similar fashion to peripheral adrenergic neurons, PC12 cells share the capacity to express a tyramine releasable pool of catecholamines, a property entirely lacking in mature cultured chromaffin cells, even though the latter cells are capable of taking up tyramine by a cocaine sensitive process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822125 TI - Retinal topography in the optic tract of adult goldfish. AB - The present study was aimed at determining how transformations in fiber order establish a retinal topography in the optic tract of adult Carassius auratus. Horseradish peroxidase was applied to the optic nerve or retina, and the pathways of labeled axons originating from retinal annuli or wedges were analysed in reconstructed serial-sections and wholeamounts of the optic pathway. The age related fiber order of the optic tract involves a rotation of the optic pathway that begins near the chiasm, continues through the optic tract as it wraps around the brain, and extends through the brachia. The relative order of laminae, in which each lamina is composed of age-related axons, is maintained in the optic pathway. The laminae add systematically onto the optic tract in a mediolateral direction with the oldest lamina forming the medial margin. Retinal sector order in the optic tract is established by the rearrangement of axons from each lamina. These rearrangements begin at the chiasm and, in part, involve transposition of axons originating from the ventrotemporal and dorsonasal sectors of the retina. The transformations achieve a fiber order in the optic tract that is appropriate for entry into the tectum. It is proposed that the final retinal topography of the optic tract is determined by the combined influences of selective affinities along the neural axis and substrate guidance mechanisms, the latter being mediated largely by the oldest axons of the fasciculus medialis tractus opticus. PMID- 3822126 TI - Motor responses to localized electrical stimulation of the tectum in the freshwater perch (Perca fluviatilis). AB - The results of localized electrical stimulation of the teleostean tectum indicate the presence within each tectal lobe of separate motor areas mediating ipsilateral turning, contralateral turning, and rolling movements. Stimulation of caudal regions produced larger turning circles than stimulation of rostral sites. Both these sets of observations conflict with the retinotopic map. Stimulation sites connected with turning and rolling movements were mostly located in the upper layer of the tectum. Other kinds of movement including aggressive behaviour, escape movements, head dipping, and forward swimming were obtained by stimulating the deeper tectal sites and subtectal areas. These results suggest that the tectum may be differentiated into areas with specific motor functions and afferent connections. This has important consequences for studies on optic nerve regeneration and neuronal specificity. PMID- 3822127 TI - An algorithm for the generation of curvilinear wrist motion in an arbitrary plane in three-dimensional space. AB - The elements of an algorithm are presented which predicts for some simple forms (circles and ellipses) the kinematic and figural aspects of the trajectories of the human wrist when these are drawn in any arbitrary plane of free, three dimensional space. The algorithm is based on theoretical considerations and experimental data and specifies in a unique way the angular motion at the shoulder and elbow joints by utilizing a coordinate transformation, which is only approximate, between the chosen extrinsic (trajectory) and intrinsic (joint angles) parameters. A way to extend the use of this algorithm to generate any arbitrary complex movement in all possible planes of space is also suggested. PMID- 3822128 TI - Dementia of the Alzheimer type: clinical and family study of 22 twin pairs. AB - We studied 22 twin pairs in which one or both twins had dementia of the Alzheimer type (DAT). In four twins, diagnosis was confirmed by autopsy. Seven monozygotic (MZ) pairs were concordant for DAT; 10 MZ pairs were discordant. Two dizygotic (DZ) pairs were concordant for DAT, and 3 DZ pairs were discordant. The current concordance rate was 41% for MZ twins and 40% for DZ twins. The study supports the belief that, etiologically, DAT cannot be entirely accounted for by a single autosomal dominant gene. The data also suggest that in certain genetic circumstances, disease expression may be delayed in females. PMID- 3822129 TI - Benign positional vertigo: clinical and oculographic features in 240 cases. AB - We report the clinical and oculographic features in 240 patients with benign positional vertigo (BPV). In each case, after a rapid position change from the sitting to head-hanging position, a stereotyped torsional paroxysmal positional nystagmus was visually observed and recorded with electronystagmography (ENG). The mean age of onset was 54 years, with a range of 11 to 84 years. In slightly more than one-half of the cases (122/240) a likely diagnosis was determined. The most common identifiable causes were head trauma (17%) and viral neurolabyrinthitis (15%). Females outnumbered males approximately two to one in the idiopathic group. Abnormalities on bithermal caloric testing were found in 47% of patients. Only two patients, both with well-documented neurologic disorders, had central signs on ENG. Our data are consistent with a peripheral, posterior semicircular canal origin of BPV. PMID- 3822130 TI - Postprandial and orthostatic hypotension in Parkinson's disease. AB - In this study, the 24-hour pattern of blood pressure (BP), heart rate, and urinary catecholamine (CA) excretion and the response of BP and plasma CA to the tilt test have been investigated in 13 untreated patients affected by Parkinson's disease (PD) and in 11 age-matched healthy controls. Seven of the 13 PD subjects showed a fall of supine systolic BP greater than that in controls (ie, exceeding 20% of the preprandial value). A significant relationship was found in the PD group between the degree of postprandial hypotension and the 24-hour mean value of dopamine excretion. Eight PD subjects also showed orthostatic hypotension during the tilt test (performed in the morning hours) and in the postprandial phase. Basal norepinephrine plasma levels of PD patients, as well as their percentage increases on standing, were within the range of the controls. These data suggest the existence of a subtype of PD patient, characterized by a widespread impairment of cardiovascular responsiveness and bordering on syndromes of autonomic failure such as progressive autonomic failure or multiple system atrophy, or both. PMID- 3822131 TI - Orofacial motor control impairment in Parkinson's disease. AB - Motor impairments in lip, jaw, and tongue muscles in patients with idiopathic Parkinson's disease (PD) were quantified. These orofacial muscle groups are nonuniformly endowed with muscle afferents, thus permitting evaluation of the hypothesis that certain PD motor symptoms are due to aberrations in muscle afferent function. Tongue muscles, devoid of stretch reflexes, were most impaired, while jaw-closing muscles, with numerous spindles and a monosynaptic stretch reflex, manifested the least impairment. Seemingly, PD motor impairments are independent of fusimotor or muscle afferent dysfunctions. PMID- 3822132 TI - Intracerebral hemorrhage and phenylpropanolamine use. AB - Two patients developed intracerebral hemorrhage within hours from first-time ingestion of phenylpropanolamine-containing medications. One patient had marked hypertension, presented with three intracerebral hematomas, and developed a fourth hemorrhage 10 days later. Angiogram in one patient revealed "beading" of intracranial arteries, an abnormality also detected in a third patient who developed severe headache, vomiting, and acute hypertension following a single dose of phenylpropanolamine. These cases and others reported in the literature strongly suggest an association between phenylpropanolamine ingestion and hemorrhagic stroke. Direct questioning of use of this medication in cases of unexplained intracranial hemorrhage in previously healthy young individuals may reveal an unsuspected high frequency of this association. PMID- 3822133 TI - Seizure characteristics, pathology, and outcome after temporal lobectomy. AB - We analyzed the histories of 58 patients who had temporal lobectomy for seizure control. A good outcome was more likely if a definite lesion was removed. Unlike other pathologies, including nonspecific hippocampal sclerosis (NSHS), Ammon's horn sclerosis (AHS) was strongly related to a history of a prolonged childhood convulsion as the first epileptic event. Partial seizures developed at a younger age in patients with AHS than with NSHS or nonspecific changes. Epigastric rising sensations were associated with a greater chance of a good outcome than were other forms of simple partial seizure. PMID- 3822134 TI - Bipolar recording of short-latency somatosensory evoked potentials after median nerve stimulation. AB - Generators of median short-latency somatosensory evoked potentials were studied with three orthodiagonal pairs of bipolar electrodes. N11 was attributed to the dorsal root and dorsal column volleys. N13 had at least two subcomponents, generator dipoles of which are directed horizontally (N13a) and axially (N13b). N13a was generated in the lower cervical cord. N13b (bipolar) and P14 far-field (noncephalic reference) appeared to originate in the cuneate nucleus or spinocerebellar tracts as well as in the medial lemniscus. Bipolar recordings were useful in localizing cervical cord lesions, which was impossible in conventional monopolar recordings. PMID- 3822135 TI - A clinical and autopsy study of dementia in Olmsted County, Minnesota, 1980-1981. AB - The clinical records and autopsy protocols were studied from 350 cases in which an autopsy was done in Olmsted County, MN, in 1980 and 1981. Overall autopsy rate was 33.6%, and autopsy rate for those aged 60 years or more was 29%. Preselected criteria were used for diagnosis of dementia. Thirty-two demented and 68 nondemented patients had complete autopsies; all were more than 60 years old. Twenty-three of 32 (72%) demented patients had Alzheimer's disease. The frequency of cerebral infarcts among the nondemented patients was significantly higher than among the demented patients (p = 0.02). PMID- 3822136 TI - Cerebral blood flow in severity-matched Alzheimer and multi-infarct patients. AB - Cerebral blood flow was studied in patients meeting research criteria for either Alzheimer's disease or multi-infarct dementia, matched for age and severity of dementia. In both groups, mean flow was less than in age-matched normal controls, but the Alzheimer patients also had significantly lower mean flow than the multi infarct group. This result helps resolve discrepancies found in studies with inadequate control for severity. Either global flow or regional left parietal flow could be used to discriminate between these dementia categories with 87% accuracy. PMID- 3822137 TI - Incontinentia pigmenti: association with anterior horn cell degeneration. AB - Incontinentia pigmenti (IP) has been associated with CNS involvement, including seizures, retardation, motor abnormalities, and malformations in greater than 30% of patients. Motor symptoms include spasticity and hyperreflexia; however, weakness and flaccidity have also been described. Peripheral nervous system neuropathology in patients with IP has not previously been reported. The infant with IP in this report showed generalized weakness due to anterior horn cell degeneration. The neuropathologic findings in both the central and peripheral nervous systems will be reviewed and contrasted to previous reports. Patients with IP and weakness should undergo neurodiagnostic evaluation of peripheral nervous system function. PMID- 3822138 TI - Neurosarcoidosis: the long-term clinical course. AB - We reviewed 25 patients with neurosarcoidosis followed for at least 5 years or until death. Seventeen patients (68%) had a monophasic illness. Eight (32%) had a relapsing course, with recurrences similar to the original manifestations months later. Patients with cerebral manifestations or hydrocephalus were most likely to relapse. Seven of eight patients with relapsing disease had exacerbations while taking 10 mg prednisone or less. PMID- 3822139 TI - Neuronal antibodies and cognitive function in systemic lupus erythematosus. AB - The pathogenesis of neuropsychiatric lupus (NP-SLE) is unclear, but may involve vasculopathy, antibodies against nervous system tissue, or both. A major difficulty in determining the significance of antineuronal antibodies in NP-SLE has been lack of consistent clinical diagnostic approaches. By utilizing a new clinical classification of NP-SLE, neuropsychological assessments, and an assay for IgG antineuronal antibodies, we have found a significant association between antibody-positivity and cognitive impairment or nonfocal NP-SLE. These observations indicate that antineuronal antibodies may play a role in NP-SLE and emphasize the clinical importance of cognitive function in patients with SLE. PMID- 3822140 TI - Is Parkinson's disease acquired? Evidence from a geographic comparison with multiple sclerosis. AB - In the coterminous United States, MS mortality rates demonstrate a north-south gradient, which is confirmed by more sophisticated--and more expensive- prevalence studies. Mortality rates from idiopathic Parkinson's disease show a similar north-south gradient, and they correlate significantly with the MS mortality and prevalence data. This demonstration that Parkinson's disease may be place-related provides support for the hypothesis that Parkinson's disease, like MS, is an acquired, environmental illness. PMID- 3822141 TI - Kinetic predominant essential tremor: successful treatment with clonazepam. AB - Fourteen patients with marked kinetic tremors of long duration but no other major neurologic signs are described. A positive family history of essential tremor, mild postural tremor, and tremor suppression with alcohol suggest that the condition is a variant of essential tremor. Kinetic tremors had a frequency of 3.5 to 6.0 Hz and an alternating EMG pattern. Propranolol caused improvement in some patients, but clonazepam treatment resulted in tremor suppression in all patients. Kinetic tremor without cerebellar signs is a subtype of essential tremor with pharmacologic responsiveness to clonazepam. PMID- 3822142 TI - Akathisia in idiopathic Parkinson's disease. AB - Akathisia is a little-studied symptom of Parkinson's disease. Interviews of 100 patients with idiopathic Parkinson's disease indicated that 68% periodically experienced the need to move and inability to remain still, usually because of well-defined causes such as parkinsonism and sensory complaints. Twenty-six patients could not explain the inability to remain still, a state of true akathisia. This disputes the common belief that akathisia represents simply the need to move for relief of discomfort imposed by rigidity or lack of movement, and emphasizes the need to distinguish between true akathisia and other, more common causes for the need to move experienced by parkinsonian patients. PMID- 3822143 TI - Daytime intensive monitoring: comparison with prolonged intensive and ambulatory monitoring. AB - We evaluated daytime (6- to 8-hour) intensive monitoring in a consecutive series of 166 studies. Overall success rate in answering clinical questions posed by referring physicians was 67%, and attacks were recorded in 55%. Daytime intensive monitoring provides a useful, cost-effective alternative to prolonged inpatient monitoring and ambulatory monitoring. PMID- 3822144 TI - Spatial disorientation as an early symptom of Parkinson's disease. AB - In 44 consecutive outpatients with idiopathic Parkinson's disease (PD) without levodopa substitution therapy, we tested spatial orientation. Spatial orientation was impaired on the rod orientation test in 43 patients, on the line orientation test in 7 patients, and on the facial recognition test in 17 patients. There was no correlation between severity of spatial disorientation and age, length of illness, verbal WAIS score, or severity of PD. Impairment of spatial orientation is part of PD even in mild cases. PMID- 3822145 TI - Acetazolamide-responsive myotonia congenita. AB - We have studied 14 patients from a kindred with an autosomal dominant form of myotonia, with features differing from most cases of autosomal dominant or recessive myotonia congenita. All patients had painful muscle stiffness that was provoked by fasting and oral potassium administration and was relieved by carbohydrate-containing foods. Muscle biopsies showed the presence of type 1, 2A, and 2B fibers, as opposed to the absence of type 2B fibers seen in some patients with myotonia congenita. Acetazolamide was dramatically effective in alleviating myotonia in all patients and was more effective than other antimyotonic agents. PMID- 3822146 TI - Upbeat nystagmus: clinicopathologic study of two patients. AB - Two patients had upward nystagmus on forward gaze before they died with acute caudal brainstem dysfunction. Bilateral dorsal paramedian damage in the rostral medulla, involving the perihypoglossal nuclei, was probably the critical lesion responsible for upbeat nystagmus. PMID- 3822147 TI - Pentobarbital treatment of refractory status epilepticus. AB - We studied nine patients with status epilepticus refractory to standard therapy. In all patients so treated, IV pentobarbital terminated seizure activity. Mortality was high (77%) in those treated, but was attributed to underlying pathology and possibly to duration of status epilepticus. Pentobarbital therapy should be initiated within 0 to 2 hours after onset of seizures, with continuous EEG monitoring in an intensive care unit. PMID- 3822148 TI - Stroke in the Lehigh Valley: risk factors for recurrent stroke. AB - Age-specific risk of recurrent stroke for various risk factors, calculated independently, was estimated using the first year of data from the Lehigh Valley Stroke Register. The register is based on a population of more than one-half million. Among the risk factors examined, the highest overall risk of recurrent stroke, 41.4, occurred with a history of at least one transient ischemic attack (TIA). After myocardial infarction (MI), the relative risk of a recurrent stroke was 8.0, while with all other heart diseases combined it was 8.4. With diabetes, the relative risk of a recurrent stroke was 5.6; with hypertension, it was 4.5. The relative risk increased with age after TIA and MI, but not for other heart disease, diabetes, and hypertension, except in the 85+-year-old age group. PMID- 3822149 TI - Serum lipids after stroke. AB - To ascertain the appropriate time for detecting lipid abnormalities for prophylaxis, serial analyses of fasting serum lipoproteins were undertaken prospectively in men with cerebral infarction or transient ischemic attacks. Serum total cholesterol (T CHOL) and low density lipoprotein cholesterol (LDL CHOL) in cerebral infarction patients aged 50 to 69 were lowest on day 7, intermediate on day 1, and highest at 3 months, whereas very low density lipoprotein and high density lipoprotein cholesterol (HDL CHOL) changed little. The day 1 mean fasting serum HDL CHOL of cerebral infarct patients was significantly lower in subjects aged 50 to 59 than in those aged 60 to 69 (23 +/- 3 versus 42 +/- 5 mg/dl), and there was a corresponding higher ratio of T CHOL:HDL CHOL (12.7 +/- 4.5 versus 4.7 +/- 0.4, p less than 0.01). Mean HDL CHOL levels were low normal to low in patients aged 50 to 69 with transient ischemic attacks. Both serum cholesterol and triglyceride levels are initially decreased in patients aged 50 to 69 with cerebral infarction, whereas only cholesterol is decreased in patients 60 to 69 with transient ischemic attacks. Important lipoprotein abnormalities may be missed in the acute phase. PMID- 3822150 TI - Dental chair intracerebral hemorrhage. AB - A 52-year-old woman had a fatal intracerebral hemorrhage after dental manipulation. Normotensive in the past, the initial blood pressure was high but rapidly returned to normal. Necropsy showed no vascular malformation or evidence of hypertensive vascular disease. Clinical and experimental data show that stimulation of trigeminal fibers can cause important changes in blood pressure and pulse. PMID- 3822151 TI - Remote memory and neglect syndrome. AB - Three patients with right cerebral infarctions and neglect syndrome failed to recall left hemispatial remote memories, even when the imagined orientation was reversed by 180 degrees. One patient was retested 4 months later and, although improved, continued to consistently recall more right-sided items. He was tested at east and west mental orientations with his head/eyes oriented physically to each side. Recall for items imagined in left hemispace improved 26% when his head/eye orientation was physically shifted from right to left hemispace. Findings suggest that the engrams for left-sided visuospatial memories in neglect syndrome are not destroyed, but rather fail to be activated. PMID- 3822152 TI - Cognitive evoked potentials and disorders of recent memory. AB - P3 potentials evoked by spoken words were recorded from seven patients with disorders of recent memory and seven age-matched controls. Inclusion criteria included a clearly identifiable P3 to pure tone stimuli. Absence or marked decrement of P3 to word stimuli was seen in the patients even though they could perform the word task. The results are consistent with an encoding disorder and failure in elaboration of information processing. PMID- 3822153 TI - Size-dependent myelinated fiber loss in the corticospinal tract in Shy-Drager syndrome and amyotrophic lateral sclerosis. AB - Morphometric evaluation was performed on myelinated fibers of the corticospinal tract at the seventh thoracic spinal cord segment from three patients with Shy Drager syndrome (SDS), six patients with amyotrophic lateral sclerosis (ALS), and five patients with nonneurologic symptoms. In SDS, small-sized myelinated fibers were nearly completely depleted, while large-sized myelinated fibers were considerably well preserved. In ALS, on the contrary, large myelinated fibers were predominantly decreased. These results suggested that selective vulnerability of axonal loss depends on fiber size and should be considered in interpretation of pathology of corticospinal tracts. PMID- 3822154 TI - Birth injury-induced glossolaryngeal paresis. AB - Glossolaryngeal paresis followed a difficult delivery and forceps manipulation and was due to a single extracranial traumatic lesion. Although the laryngeal palsy was suspected, hypoglossal involvement was not initially apparent. Search for additional neurologic insult is warranted when a single birth injury is identified. The glossolaryngeal paresis disappeared by age 6 months. PMID- 3822155 TI - Isolated deficiency of vitamin E with progressive neurologic deterioration. AB - We studied a 19-year-old man with vitamin E deficiency without intestinal fat malabsorption. In addition to recognized neurologic complications of vitamin E deficiency, he had dystonic posturing and bradykinesia. PMID- 3822156 TI - Magnetic resonance imaging and the diagnosis of dementia. AB - We describe seven patients with clinical, laboratory, and CT evidence of primary degenerative dementia (Alzheimer's, Pick's). Magnetic resonance imaging demonstrated regions in the white matter consistent with cerebral infarction. MRI may be a sensitive way to differentiate multi-infarct dementia and primary degenerative dementia. PMID- 3822157 TI - Steroid-responsive painful ophthalmoplegia is not always Tolosa-Hunt. PMID- 3822158 TI - American Academy of Neurology. 39th annual meeting program. New York, New York, April 5-11, 1987. Abstracts. PMID- 3822159 TI - [Metabolic consequences of total gastrectomy for cancer]. PMID- 3822160 TI - [Role of surgery in benign lesions of the breast]. PMID- 3822161 TI - [Surgical treatment of acute pancreatitis. Apropos of 40 cases]. PMID- 3822162 TI - [Surgical treatment of perforated colonic diverticula. Experience in 2l cases]. PMID- 3822163 TI - [Surgical treatment of breast carcinoma]. PMID- 3822164 TI - [So-called heel test in the semeiotics of acute appendicitis]. PMID- 3822165 TI - [Short-term antibiotic prophylaxis in cholecystectomy. Our clinical experience]. PMID- 3822166 TI - [Isolation of a strain of Yersinia enterocolitica (serotype 0:9) in a case of acute appendicitis]. PMID- 3822167 TI - [Mallory-Weiss syndrome]. PMID- 3822168 TI - [Rhabdomyosarcoma of the jejunum. Clinical case]. PMID- 3822169 TI - [A case of isolated metastasis of pulmonary carcinoma to the small intestine]. PMID- 3822170 TI - [Volvulus of the gallbladder. Apropos of a case and review of the literature]. PMID- 3822171 TI - [Biliary ileus]. PMID- 3822172 TI - [Aberrant pancreas]. PMID- 3822173 TI - [Pathology of the supra-aortic blood vessels. Nosological aspects]. PMID- 3822174 TI - [Pathology of the supra-aortic blood vessels. Surgical aspects]. PMID- 3822175 TI - [Surgical therapy of portal hypertension]. PMID- 3822176 TI - [Intestinal infarct and the short intestine syndrome]. PMID- 3822177 TI - [Vascular factors in the genesis of atresia of the intestines]. PMID- 3822178 TI - [Long-term results of the treatment of cutaneous angiomas]. PMID- 3822179 TI - [Subarachnoid hemorrhage caused by the rupture of a cerebral aneurysm: when to operate?]. PMID- 3822180 TI - [Hemorrhage through Wirsung's duct]. PMID- 3822181 TI - [Vascular prostheses in periodic hemodialysis]. PMID- 3822182 TI - [Medium-term evaluation of function recovery in chronic peripheral obliterative arterial diseases]. PMID- 3822183 TI - [Surgical treatment of liver metastasis]. PMID- 3822184 TI - [Routine and selective shunt in carotid endarterectomy]. PMID- 3822185 TI - [Anastomotic pseudoaneurysms at the crural level]. PMID- 3822186 TI - [Retroperitoneal detachment of vascular prosthesis]. PMID- 3822187 TI - [Excision and reconstruction of an abnormal right hepatic artery during duodenopancreatectomy]. PMID- 3822188 TI - [Epidemiology of pulmonary embolism in general surgery]. PMID- 3822189 TI - [Calculi of the gallbladder in patients with liver cirrhosis]. PMID- 3822190 TI - [Computerized tomography study of 32 patients with disk hernia confirmed during surgical intervention]. PMID- 3822191 TI - [Hospitalization for neoplastic pathology of the colon and rectum in the Piedmont region in the 4-year period 1976-1979]. PMID- 3822192 TI - [Use of cefoperazone in peroperative prophylaxis in hepato-biliary surgery. Pharmacokinetic and clinical evaluations]. PMID- 3822193 TI - [Instrumental perforation of the esophagus]. PMID- 3822194 TI - [Esophageal bronchogenic cysts. Description of a clinical case]. PMID- 3822195 TI - [Focal nodular hyperplasia of the liver and its treatment]. PMID- 3822197 TI - [Post-resection gastric atony ]. PMID- 3822196 TI - [Malignant schwannoma of the chest wall]. PMID- 3822198 TI - [Evaluation of electromanometric tracings of the large intestine. I. Methods and results in normal subjects]. PMID- 3822199 TI - [Value of the fasting test in the diagnosis of Gilbert's syndrome]. PMID- 3822200 TI - [Hepato-biliary pathology in Crohn disease and ulcerative rectocolitis]. PMID- 3822201 TI - [Effects of normal-caffeine and decaffeinated coffee on serum levels of total gastrin (G1-34), gastrin 1-17 and pepsinogen I]. PMID- 3822202 TI - [Correlations between coffee and alcohol consumption and pancreatic pathology]. PMID- 3822203 TI - [Gastric ulcer, duodenal ulcer and major and minor blood groups. Epidemiological aspects, functional correlations, clinical implications]. PMID- 3822204 TI - [Esophageal ulcer subsequent to endoscopic sclerosis of varices. Prophylaxis and therapy with sodium alginate]. PMID- 3822205 TI - [Ranitidine and arterial hypertension]. PMID- 3822206 TI - [Seasonal therapy of duodenal ulcerative disease]. PMID- 3822207 TI - [Leiomyomas of the small intestine]. PMID- 3822208 TI - [Alcohol and dyslipidemia. Our study]. PMID- 3822209 TI - Face-to-face interactions of depressed mothers and their infants. PMID- 3822210 TI - The transmission of maternal disturbance to the infant. PMID- 3822211 TI - The depressed mother and her one-year-old infant: environment, interaction, attachment, and infant development. PMID- 3822212 TI - [Current status of the classification and clinical staging of primary and secondary tumors of the liver]. AB - Over the past few decades there has been outstanding expansion in the surgical exeresis of primary and metastatic liver tumours and particularly hepatic metastases of colorectal carcinomas. With the advance in surgical technique it becomes increasingly necessary to codify the system for the classification and clinical staging of these conditions for the purposes of correct programming of treatment and assessment of the clinical results obtained. The most commonly used systems of classification and clinical staging are analysed, in particular the classifications proposed by the American Joint Committee on Cancer and D. Manfredi for primary liver tumours and those proposed by Gennari et al and Sugerbaker et al for hepatic metastases of colorectal carcinomas. The selection criteria adopted in each system are analysed as the basis for a more thorough discussion of the problem that is felt to be fundamental for the standardisation of classification and clinical staging systems in the future. Such standardisation is essential for the assessment of the value and limitations of liver surgery in cancer. PMID- 3822213 TI - [Internal medicine evaluation of the surgical risk in cirrhosis patients]. AB - A personal case series triggers an examination of surgical risk in patients with uncomplicated cirrhosis of the liver. After a general introduction the conditions that increase surgical risk in cirrhotic patients are analysed. These include generally poor resistance, altered haemostasis, a tendency towards cholestasis, water retention and hepatic encephalopathy. The conditions most often requiring surgical treatment are then considered. They include associated pathologies (cholelithiasis, hernias, tooth extractions, bleeding haemorrhoids etc) and complications of cirrhosis variceal bleeding, intractable ascites, splenomegaly, hepatocytoma). PMID- 3822214 TI - [Role of ureaplasma in human infectious pathology]. AB - Ureaplasmas are increasingly considered responsible for a variety of genitourinary pathologies in both men and women. However a critical review of the medical literature produces some reservations about the way surveys have been conducted largely due to the inadequate application of epidemiological research techniques and the failure to adopt either a global microbiological approach or a correct antibiotic-placebo experimental trial. Despite these negative factors some interesting indications appear to emerge and it is now certain that ureaplasmas are responsible for certain forms of non-gonococcic urethritis (NGU) and chronic prostatitis. More complex and still widely debated is the question of the involvement of ureaplasmas in obstetrical, gynaecological and neonatal pathologies. Two clinical pictures, chorion-amnionitis and low birth weight are considered the most probably pathological forms caused by ureaplasmas. However further tests using analytical epidemiological methods are required for their definite recognition. PMID- 3822215 TI - [Aculeate Hymenoptera pathology. Clinical, therapeutic and preventive aspects]. AB - Dramatic cases of hymenoptera stings have been reported from various sources for several years now. According to recent statistic from North America 0.4-0.8% of the population have shown allergic reaction to these stings. There are no reliable statistics on Italy. After classifying the taxonomy of the Hymenoptera, the present report carefully analyses both the diagnostic and therapeutic aspects of these allergic responses and the preventive measures that can be used reduce the risk of hymenoptera stings. PMID- 3822216 TI - [Sliding massive hiatal hernia: diagnosis using computerized axial tomography]. AB - The radiological features of one patient, entirely asymptomatic, with a paracardiac mass in the right lower lobe, are presented. Computed tomography (TC) evaluation of the chest has shown with remarkable accuracy a massive hiatal hernia, containing the whole stomach and fatty omental tissue. This case confirms TC validity as an accurate and non invasive method in differential diagnosis of chest radiological opacities and its utility to identify seat and composition of diaphragmatic hernias. PMID- 3822217 TI - [Electrocardiographic changes in acute carbon monoxide poisoning]. AB - Various electrocardiographic alterations (variations in the repolarisation phase, disturbed conduction, arrhythmias) have been reported in acute carbon monoxide poisoning. In the 44 cases of this poisoning examined, electrocardiographic alterations are also considered in relation to the degree of poisoning (expressed as plasmatic levels of carboxyhaemoglobin-HbCO). In 68% of these cases alterations were presented by signs of subepicardiac or subendocardiac damage. Attacks of atrial fibrillation, premature beats and episodes of sinusal tachycardia were also observed. Almost all these electrocardiographic alterations were quickly reversible. It is concluded that there is no correlation between HbCO levels and electrocardiographic alterations (that were in fact more frequent in the slight poisoning cases). PMID- 3822218 TI - [Coexistence of Kaposi's sarcoma and immunoblastic lymphoma. Description of a case]. AB - A case of a patient suffering from Kaposi's sarcoma and Immunoblastic Lymphoma is described. It is emphasized that this association appears to be more than coincidental and the probability of related etiopathogenic mechanisms between the two neoplasms is suggested. PMID- 3822219 TI - [Rheumatic polymyalgia and temporal arteritis. Case contribution and bibliographic review]. AB - Polymyalgia rheumatica (PMR) is a frequent clinical syndrome in the elderly, characterised by morning aching and stiffness in the shoulder and girdle muscles associated with an elevated erythrocyte sedimentation rate and responsive to low dose corticosteroid therapy. PMR may be associated with temporal arteritis (AT), a systemic granulomatous vasculitis predominantly affecting branches of the carotid artery in patients over the age of 50. Recent studies suggest an immunological pathogenesis for PMR and TA. Personal experience on 56 cases of PMR and TA, and a survey of the literature is reported and the articular manifestations and the differential diagnosis, are underlined. Polymyalgia rheumatica and temporal arteritis. Personal experience and survey of the literature. PMID- 3822220 TI - [Chemical and cytologic tests in the differential diagnosis of ascites]. AB - The value of chemical (protein, LDH, glucose, total and differential cell count) and cytological examination of the ascitic fluid in the differential diagnosis of peritoneal ascites was assessed in a prospective study of 98 patients. The ascites caused by hepatic metastases and primary carcinoma were of the transudative type and could not be distinguished from the type caused by cirrhosis on the basis of the parameters examined. In contrast the ascites caused by peritoneal carcinosis was exudative presenting a highly significant (p less than 0.001 for all parameters) difference from the three preceding groups. However there was no clear-cut distinction between the groups: in fact cirrhosis patients may present exudative ascites (8% in the present series, 12-19% in the literature). There was a substantial decrease in ascitic fluid glucose (less than 60 mg/dl) only in peritonitis and its measurement is therefore of secondary importance. In contrast with reports by other authors the ratio between LDH and protein concentrations in the effusion and the serum was found to be insignificant. The cytological examination revealed a significantly higher total cell count in bacterial peritonitis with a prevalence of polymorphonuclear cells and in peritoneal carcinoma where mononuclear cells predominate. Finally cytology revealed malignant tumour cells in the ascitic fluid and neoplastic peritoneal effusions in 28% of the patients examined. PMID- 3822221 TI - [Tiropramide chlorhydrate in premedication for endoscopic retrograde cholangiopancreatography and its effects on the motor activity of Oddi's sphincter]. AB - The activity of tiropramide chlorhydrate in the pre-medication for the endoscopical examinations has been evaluated. In particular ERCP has been studied considering as parameters the timing of the different stages of the examination and the activity of Oddi's sphincter. At the end of endoscopy the pressure of the sphincterial region was measured a 3-way miniature catheter. Patients included in the study were divided into two different groups: group A treated with tiropramide chlorhydrate and diazepam vs group B treated only with diazepam. The group with patients pre-medicated with tiropramide chlorhydrate presented a significant reduction in the timing of the different stages of endoscopy. Endoscopy was better tolerated. Manometry showed an antispastic action of the drug without side effects. An important reduction of the degree and duration of the sphincterial phase activity, with a possible improvement of biliary defluxion into the duodenum, was observed. PMID- 3822222 TI - [Follow-up of thyroidectomized patients]. AB - The functional recovery of the patient after thyroid surgery is the primary objective but cannot always be achieved as a result of factors relating principally to the nature of the pathology treated and the extent of the thyroidectomy, though problems linked to possible damage to the recurrent nerves and altered calcium metabolism cannot be ignored. The data obtained from a large case series followed up for an appreciable time show that: Postoperative hypothyroidism is difficult to predict and very much depends on the evolution of the residual thyroid pathology. Subclinical and clinical thyroid insufficiency can be identified by correct assessment of TSH, the TRH test and the clinical picture. Substitution therapy presents no problems but should be personalized for each individual case. Injuries to the recurrent nerves constitute a major complication especially in subjects already afflicted by a monolateral lesion, a possibility that should always be investigated before surgery. The correct surgical technique will always expose and/or prepare the nerve along its entire length. Alterations to calcium metabolism are not always attributable to parathyroid lesions and are in fact almost always the expression of a complex acute deficiency picture that can be cured by correct medical treatment. PTH assays are particularly valuable for this purpose. All the above indicates the outstanding importance of follow-up of thyroidectomy patients who are otherwise destined for dysfunctions or pathologies that are not easy to cure. PMID- 3822223 TI - [Diagnostic contribution of the determination of CEA, pH, glucose and lactase dehydrogenase in the pleural fluid in patients with mesothelioma]. AB - The difficulty involved in the diagnosis of primary pleural neoplasms (mesotheliomas) in described. Personal experience with assays of certain chemicals is the pleural fluid is reported with evidence of the value of pH, glucose and CEA as indications of malignity. PMID- 3822224 TI - [Sporological diagnosis in 282 cases of suspected fungal poisoning occurring in the municipality of Trieste from 1967 to 1984]. AB - The experience of 18 years voluntary work in collaboration with the health authorities in a Centre for Toxological Studies is reported. The Centre was called upon to diagnose 282 cases of mushroom poisoning (including 262 hospital patients) in the Commune of Trieste. The identification of the fungi ingested was in all cases based on microscopic identification of the spores isolated from the stomach contents or the faeces using a rapid, original technique. The value of other diagnostic methods in use or under experimentation is discussed. Out of the 282 patients studied, 45 (16%) presented spores of highly toxic responsible for phalloid syndrome; 40 (14%) presented spores of moderately toxic fungi causing atropine, muscarine, antabuse-type, haemolytic and acre-resinoid syndromes. All other spores were from non-toxic species. The original incidence of requests for diagnosis, presumably covering all cases occurring in Trieste, was 16 +/- 11 cases with ingestion of highly toxic fungi accounting for 3 +/- 4 cases and ingestion of moderately toxic species 2 +/- 3 cases. The tendency is towards an increase in such cases. PMID- 3822225 TI - [Aspecific bronchial reactivity during pharmacologic treatment of arterial hypertension]. AB - The study of 216 hospitalised patients with essential arterial hypertension (108 males and 108 females) revealed a high percentage of essential arterial hypertension associated with other diseases, in particular chronic obstructive lung disease in males. The behaviour of bronchial hyperreactivity was studied in 10 patients by means of inhalation tests with carbachol in order to assess the extent of the condition and its response to antihypertensive treatment with alpha methyldopa. The result showed that the drug had no effect on bronchial reactivity and is therefore to be recommended even in cases where chronic aspecific lung disease is associated with arterial hypertension. PMID- 3822226 TI - [Malignant histiocytosis. Clinical contribution and review of the subject]. AB - Malignant histiocytosis (MH) is a rare and severe disease caused by malignant histiocyte degeneration in the sinuses of the reticuloendothelial system. The clinical picture presents fever, wasting, enlargement of the liver and spleen and lymphoadenopathy. Diagnosis is based on histological criteria and it may prove very difficult to differentiate between MH and malignant lymphomas, acute monocytic leukemia and the histiocytoses considered benign. The main features of the disease are described with comments on two personally experienced clinical cases. Emphasis is placed on the leukaemic aspect, the involvement of the CNS, the association, in one case, with sarcoidosis and the poor prognosis. PMID- 3822227 TI - [Carpal tunnel syndrome in polymyalgia rheumatica. Clinical and electromyographic response to systemic treatment]. AB - The association between carpal tunnel syndrome and Polymyalgia Rheumatica has already been described. As in other systemic diseases the bilaterality of the syndrome is a common finding. Surgical treatment is usually necessary in carpal tunnel syndrome. Three cases of the syndrome associated with polymyalgia rheumatica are presented. Clinical remission and normalization of the electromyographic tracing were achieved by systemic corticosteroid treatment. The relationship between these two conditions is once more confirmed. A "wait and see" period which might eventually avoid unnecessary surgical intervention is strongly recommended. PMID- 3822228 TI - Macrophages in the peripheral nervous system and astroglia in the central nervous system of rat commonly express apolipoprotein E during development but differ in their response to injury. AB - Macrophages have been identified by immunocytochemical methods in rat sciatic nerve neonatal development expressing significant amounts of apolipoprotein E (apo E). In contrast, in mature peripheral nerve apo E appears to be associated with the basal lamina. Following sciatic nerve crush apo E-immunoreactive macrophages reappear in the denervated distal stump within 3 days. In the optic nerve and spinal cord of newborn rat apo E is associated with the astroglia. During maturation of the central nervous system the number of apo E immunoreactive astrocytes significantly increases, but as a specific response to injury this protein rapidly disappears from the astroglial cell bodies. PMID- 3822229 TI - Vasopressin administration prevents functional recovery of the vasopressinergic neurosecretory system following neurohypophysectomy. AB - The rodent hypothalamic neurosecretory system normally exhibits remarkable functional and structural plasticity following injury. However, the present study describes a newly observed phenomenon in which neurohypophysectomized animals receiving chronically administered exogenous vasopressin during the post-lesion period (a treatment which insures maximal renal antidiuresis over this time frame) lose all capacity for recovery of antidiuretic function. Functional deficits are accompanied by a severe reduction in the number of neurons exhibiting immunohistochemical staining for arginine vasopressin. These data indicate that the presence of neurological stimulation signaling vasopressin release may play an important role in promoting neural regeneration of the vasopressinergic component of the neurosecretory system. PMID- 3822230 TI - Spinal afferents and cortical efferents of the anterior intralaminar nuclei: an anterograde-retrograde tracing study. AB - The topographical relations among the terminal field of spinothalamic fibers and the cells projecting upon areas 4 and 5 were studied in the anterior intralaminar nuclei of the cat. Terminals anterogradely labeled from the spinal cord and cell populations retrogradely labeled from the lateral pericruciate and anterior suprasylvian cortex were simultaneously observed by means of a multiple fluorescent tracing strategy. The present findings confirm that spinal afferents in the central lateral and paracentral nuclei overlap with the cells projecting to area 4. Further, the present data demonstrate that spinal terminals are largely segregated from the intralaminar cell population projecting to area 5. PMID- 3822231 TI - Visual and auditory evoked potentials in different areas of rat cerebral cortex. AB - Visual and auditory evoked potentials were studied in the occipital, temporal, prefrontal and cingulate areas of the rat cerebral cortex. We found that both prefrontal and cingulate areas can respond to more than one sensory modality. The latencies of the response to light and sound, though slightly longer in these associative areas than in the two primary cortical regions, were still within the range of early sensory evoked responses (i.e. less than 50 ms). PMID- 3822232 TI - Some collicular efferent neurons code saccadic eye velocity. AB - The activity of identified tecto-reticulo-spinal neurons (TRSNs) was studied in alert head-fixed cats during orienting towards moving visual stimuli. Eye movements and dorsal neck muscle activity were recorded simultaneously. Burst parameters of TRSNs showing visuomotor properties were analysed quantitatively. It could be demonstrated that some neurons generate presaccadic bursts whose instantaneous frequency profile is closely correlated with the profile of saccadic eye velocity. This correlation could be revealed only under conditions in which cats made orienting saccades to 'catch' a target moving in the preferred direction of the neuron's visual receptive field. Latency between bursts and saccades varied depending upon the degree of attention toward the target and saccade direction. PMID- 3822233 TI - An increase in the sympathoadrenal medullary function in stroke-prone spontaneously hypertensive rats under anesthetized and resting conditions. AB - Sympathoadrenal medullary functions were investigated in stroke-prone spontaneously hypertensive rats (SHR-SP) and in control normotensive Wistar-Kyoto rats (WKY) under halothane-anesthetized and resting conditions. The mean frequency of the spontaneous efferent activity of a single adrenal sympathetic nerve fiber was 1.08 +/- 0.11 impulses/s in WKY and 2.82 +/- 0.24 imp/s in SHR SP, indicating a much higher level in SHR-SP than in WKY. The secretion rates of both adrenaline and noradrenaline from the adrenal gland were higher in SHR-SP than in WKY. The secretion rates of adrenaline and noradrenaline in WKY were 16.8 +/- 3.0 and 1.70 +/- 0.09 ng/kg X min, respectively, while those in SHR-SP were 36.7 +/- 3.9 and 2.56 +/- 0.18 ng/kg X min, respectively. PMID- 3822234 TI - Stimulation by vasoactive intestinal polypeptide of muscarinic receptor-mediated catecholamine secretion from isolated guinea pig adrenal medullary cells. AB - The effects of vasoactive intestinal polypeptide (VIP) on catecholamine (CA) secretion by isolated guinea pig adrenal medullary cells were studied. VIP (1 microM) alone induced only a slight secretion of CA, but it stimulated ACh induced CA secretion. At concentrations of 0.01-1 microM, it stimulated muscarine induced CA secretion, but not nicotine-induced CA secretion. It did not affect high K+ or Ca2+ ionophore-induced CA secretion. The stimulatory effect of VIP on muscarine-induced CA secretion was observed at muscarine concentrations of 2 200 microM and was detectable after 2 min incubation. PMID- 3822235 TI - p-Chloroamphetamine releases both serotonin and dopamine into rat brain dialysates in vivo. AB - The effect of p-chloroamphetamine (PCA) on extracellular levels of endogenous 5 hydroxytryptamine (5-HT) and dopamine (DA) in the striatum and frontal cortex of the halothane-anesthetized rat was studied using an intracerebral dialysis method. PCA (5 mg/kg s.c.) induced an immediate, marked release of 5-HT into dialysates collected from the frontal cortex and striatum, an effect which lasted over 2 h. This treatment also caused a marked release of DA in the striatum. The results further emphasize the need to carefully assess the involvement of brain DA as well as 5-HT in PCA-induced behaviors. PMID- 3822236 TI - The agranular insular cortex: a site of unusually high dopamine utilisation. AB - Dopamine (DA) utilisation (expressed as homovanillic acid:DA) was compared in the medial prefrontal cortex (FCx), the agranular insular cortex (AgCx), the caudate putamen (medial, CPM and lateral, CPL divisions) and the nucleus accumbens (NAc). DA utilisation in these regions decreased in the order AgCx greater than FCx greater than CPM, CPL, NAc, whilst the concentration of DA decreased in the reverse order. Thus, although fewer DA neurones appear to innervate AgCx compared with FCx, the rate of DA utilisation/release is much greater in AgCx. It is suggested that this apparently more marked activity in DA neurones innervating AgCx may reflect a relative lack of autoreceptor control. PMID- 3822237 TI - Release of the 120 kDa component of the mouse neural cell adhesion molecule N-CAM from cell surfaces by phosphatidylinositol-specific phospholipase C. AB - To study the membrane anchoring of the 120 kDa component of the neural cell adhesion molecule N-CAM, the smallest form lacking a transmembrane domain, cultured mouse neural cells were treated with phosphatidylinositol-specific phospholipase C from Staphylococcus aureus. When live cultures of astrocytes and neurons are treated with phosphatidylinositol-specific phospholipase C, N-CAM120 is released into the supernatant. Under these conditions N-CAM140 and N-CAM180 are not released. Phospholipase C from Bacillus cereus or Clostridium perfringens does not release N-CAM120. The embryonic form of N-CAM on astrocytes migrating as a broad band between 120 and 180 kDa is also partially released by phosphatidylinositol-specific phospholipase C as a band migrating between 120 and 160 kDa. These observations suggest novel mechanisms in regulation of N-CAM120 expression on the cell surface and in modulation of N-CAM-mediated cell adhesion. PMID- 3822238 TI - Regulation of the high affinity choline transport in locust synaptosomes by adenosine triphosphate. AB - The effect of various nucleotides on the high affinity choline accumulation by synaptosomes from locusts has been studied. Extracellular adenosine triphosphate (ATP) was found to inhibit the transport of choline, whereas the accumulation of gamma-aminobutyric acid was not affected. The ATP-effect could not be mimicked by other purine derivatives, and seems not be mediated by purinergic receptors, but rather hydrolysis of the phosphate appears to be essential. PMID- 3822239 TI - Plasma extravasation in the rat urinary bladder following mechanical, electrical and chemical stimuli: evidence for a new population of chemosensitive primary sensory afferents. AB - In the skin activation of unmyelinated primary afferents produces vasodilation and plasma extravasation. Here, using Evans blue dye leakage, we have quantitatively compared the ability of mechanical, chemical and electrical stimulation of afferents to produce extravasation in the urinary bladder of anaesthetized rats. Mechanical stimulation - a series of large active contractions of vesical smooth muscle induced by maintained distension - elicited no increase in extravasation compared to controls. In contrast, a similar period of electrical stimulation of nerves supplying the bladder, or chemical stimulation with intravesical instillation of mustard oil, produced high levels of extravasation. We conclude that afferents activated during distension and micturition contractions are different from those which produce extravasation. The latter may be important in pathophysiological cases such as inflammation of the urinary bladder. PMID- 3822240 TI - Carbachol phase shifts circadian activity rhythms in ovariectomized rats. AB - Ovariectomy in the rat abolishes alpha-bungarotoxin (alpha-BTX) binding within the suprachiasmatic nucleus (SCN), a putative circadian pacemaker, and markedly reduces cholinergic activation of SCN cells. Circadian rhythms of running wheel activity were monitored continuously in intact male and female and chronically ovariectomized rats before and after intraventricular carbachol injections. Carbachol produced similar phase shifts of the free-running rhythms in all groups. The results suggest that carbachol can influence the circadian system of rats by activation of cholinergic receptor sites independent of those binding alpha-BTX within the SCN. PMID- 3822241 TI - Reduction of the volume of the sexually dimorphic nucleus of the preoptic area by in utero ethanol exposure in male rats. AB - Ethanol consumption during pregnancy has been demonstrated to result in alterations in central nervous system structure and function. Albino female rats were given either a liquid diet containing ethanol (5% w/v), a liquid diet which contained maltose-dextrin substituted isocalorically for the alcohol, or laboratory chow and water throughout pregnancy and for 14 days following birth. The volumes of the sexually dimorphic nucleus of the preoptic area (SDN-POA) and the nucleus accumbens septi (ACN) were measured in adult male rats exposed in utero and postnatally to these diets. Adult male rats exposed to ethanol in utero exhibit significantly smaller SDN-POA volumes (P less than 0.02) when compared to those of animals which received the control diets during the gestational period and postnatally. Ethanol treatment did not significantly influence the volume of the ACN. The results indicate that maternal ethanol consumption during pregnancy retards or inhibits SDN-POA development in fetal ethanol exposed male rats when compared to the nuclear volume in rats whose mothers were not exposed to ethanol during pregnancy. PMID- 3822242 TI - Does the substantia nigra have a cholinergic innervation? AB - We have studied the distribution of choline acetyltransferase-containing fibres in ferret substantia nigra using immunohistochemistry at the light microscopical level. Positive staining for choline acetyltransferase was not observed in any nigral cell bodies, but was found in a network of fine-calibre, varicose axons, more densely distributed in the zona compacta than the zona reticulata. PMID- 3822243 TI - Evidence that [3H]forskolin binding in the substantia nigra is intrinsic to a striatal-nigral projection: an autoradiographic study of rat brain. AB - The neuronal localization of binding sites for the diterpene activator of adenylate cyclase, forskolin, has been determined. Kainic or ibotenic acid lesions were administered into the caudate-putamen or substantia nigra of Sprague Dawley rats. The binding of 20 nM [3H]forskolin was examined autoradiographically and quantitated using computerized densitometry with tritium standards. Neurochemical lesions placed in the caudate-putamen markedly reduced [3H]forskolin binding in this structure and distal to the site of injection in the substantia nigra. Ibotenic acid lesions placed in the substantia nigra did not appreciably alter binding in the substantia nigra, caudate-putamen, nucleus accumbens or olfactory tubercle. These results indicate that 'forskolin identified' adenylate cyclase in the substantia nigra is located in nerve terminals from the caudate-putamen. In addition, these sites are presumably located on cell bodies or interneurons in the caudate-putamen. PMID- 3822244 TI - Postnatal changes in conduction velocity and soma action potential parameters of rat dorsal root ganglion neurones. AB - The relationship between peripheral conduction velocity and the configuration of the soma action potential was examined in rat lumbar dorsal root ganglion neurones during the first two weeks of postnatal development. The results show that the soma membrane properties of A cells change as their conduction velocity increases during myelination, but that C cells retain the same soma membrane properties they express at birth, while their conduction velocity increases only slightly. It is suggested that the relationship between primary afferent axons and their associated Schwann cells may play a role in the differentiation of soma membrane properties of sensory neurones. PMID- 3822245 TI - Role of vagal and spinal sensory pathways in diaphragmatic response to resistive loading. AB - The effects of severe inspiratory (I) or expiratory (E) resistive loads on diaphragmatic activity were studied in two groups of cats anaesthetized with sodium pentobarbital or ethylcarbamate-chloralose. In intact cats, I or E loading never changed the amplitude of integrated diaphragmatic electric myogram (EMG) measured at 1.0 s (Edi 1.0); only I loading, prolonged the duration of diaphragmatic activity (Tdi). After selective procaine block of non-volume related vagal sensory inputs, I or E loading markedly increased Edi 1.0 and changes in Tdi due to I loading persisted. After bivagotomy, which also suppressed volume related vagal feed back, Edi 1.0 increased during I or E loading but change in Tdi disappeared. Initial spinal section at C8 level only reduced changes in Tdi with inspiratory loading. Bivagotomy plus spinal section abolished all load induced changes in diaphragmatic activity. These results suggest that all vagal information from the lungs participate in the mechanism of load compensation but that spinal sensory pathways play a minor role in this response in anaesthetized cats. PMID- 3822246 TI - Picrotoxin induced epileptiform activity in amygdaloid neurons. AB - The effects of the epileptogenic agent, picrotoxin, on inhibitory postsynaptic potentials (IPSPs) were studied in the amygdala in vitro slice preparation. Picrotoxin was superfused onto the tissue and intracellular recordings were obtained from basolateral amygdaloid neurons (BLANs). Stimulation of the stria terminalis pathway evoked an excitatory postsynaptic potential (EPSP)--IPSP sequence. Depolarization of the membrane potential increased the amplitude of the IPSP, whereas hyperpolarization of the membrane potential decreased the amplitude of the IPSP. The IPSP reversed polarity at -74 mV. Application of picrotoxin reduced the IPSP and resulted in the development of paroxysmal depolarizing shifts. Picrotoxin itself had no apparent effect on the resting membrane potential or input resistance. These results indicate that epileptiform activity induced by picrotoxin in the basolateral amygdaloid neuron is of synaptic origin. PMID- 3822247 TI - Neuropeptide Y alters monoamine turnover in the rat brain. AB - The effects of intracerebroventricular administration of neuropeptide Y (NPY) on central monoamine turnover were studied in rats treated with alpha-methyl-p tyrosine (alpha-MPT). NPY decreased noradrenaline turnover in the brainstem, hypothalamus, midbrain and hippocampus. Dopamine turnover was decreased in the brainstem and striatum of NPY-treated rats. Although alpha-MPT did not seem to affect the turnover of serotonin, the concentration of this amine after the administration of NPY was higher in the brainstem, hypothalamus and striatum. Our results suggest that NPY may play a role in the modulation of monoamine turnover in the central nervous system. PMID- 3822248 TI - Calcium ions trigger the expansion in bistable myelin. AB - Ultrastructural studies of nerve myelin emphasize its static aspects. However, current work indicates that the myelin multilayer is poised for a supramolecular transition from a compact to an expanded form. In teleosts, the membrane pair becomes 27 A thicker. The trigger for this expansion is physiological levels of Ca. Varying proportions of the myelin can be trapped in the expanded state by transferring an excised specimen from Ca-containing to Ca-free medium in order to prevent expansion of the remaining compact myelin. Images of the myelin multilayer show that the expansion occurs in the aqueous spaces between lipid bilayers. Previously we demonstrated the reversal of expansion by removing Ca under special conditions. These results together lead us to suggest that myelin may expand locally in normal nerve function, while wholesale expansion may be an early step in myelin breakdown in vivo. PMID- 3822249 TI - Molecular cloning, expression and in situ hybridization of rat brain glutamic acid decarboxylase messenger RNA. AB - A cDNA library was generated in the expression vector lambda GT11 from rat brain poly(A)+ RNAs and screened with a GAD antiserum. Two clones reacted positively. One of them was shown to express a GAD activity which was specifically trapped on anti-GAD immunogel and was inhibited by gamma-acetylenic-GABA. Blot hybridization analysis of RNAs from rat brain revealed a single 4 kilobases band. Preliminary in situ hybridizations showed numerous cells labelled by the GAD probe such as the Purkinje and stellate cells in the cerebellar cortex and the cells of the reticular thalamic nucleus. PMID- 3822250 TI - Reduction of human sleep duration after bright light exposure in the morning. AB - In 8 subjects the spontaneous termination of sleep was determined after repetitive exposure to either bright or dim light, between 6.00 and 9.00 h, on 3 days preceding sleep assessment. Sleep duration was significantly shorter following bright light than following dim light. During sleep the time course of EEG energy was not affected by the light treatment. Analysis of the time course of body temperature during sleep indicated an earlier rise of body temperature following the bright light treatment. In terms of the two-process model of sleep regulation this can be interpreted as a direct effect of light on the circadian phase of the wake up threshold. PMID- 3822251 TI - A disorder of cortical GABAergic innervation in Alzheimer's disease. AB - Synaptosomal gamma-aminobutyric acid (GABA) uptake has been used as a biochemical marker for GABAergic terminals in controls and Alzheimer disease brains. Use of this marker suggests a large (ca. 70%) loss of cortical and hippocampal GABA terminals in Alzheimer brain. To explain this observation we suggest that neuron loss in this disorder occurs via a process of cortical retrograde degeneration. This scheme reconciles our findings with previous neurochemical measurements on Alzheimer disease brains and also better reconciles the biochemistry with the histology of the disorder. PMID- 3822252 TI - Oxadiazolidinones: irreversible inhibition of cholinesterases and effects on acetylcholine receptors. AB - Inhibition of four acetylcholinesterases (AChE) and a butyrylcholinesterase (BuChE) by 3-(2,3-dihydro-2,2-dimethyl-benzofuran-'7-yl)-5-methoxy-1,3,4-oxadiaz ol-2(3H)-one (DBOX) and 3-(2-methoxyphenyl)-5-methoxy-1,3,4-oxadiazol-2(3H)-one (MPOX) was measured by the Ellman spectrophotometric method. Both oxadiazolidinones inhibited AChE and BuChE irreversibly and with quasi first order kinetics. DBOX was 2-3 orders of magnitude more potent than MPOX. Housefly brain AChE and horse serum BuChE were more sensitive than AChEs of red blood cells or eel and Torpedo electric organs. Aldicarb, a carbamate anticholinesterase, which protected Torpedo AChE against irreversible phosphorylation by DFP, also protected it against irreversible inhibition by DBOX and MPOX. It is suggested that the nonesteratic oxadiazolidinones are converted to carbanillates on the surface of the enzyme, then acylate the active site of ChEs, producing carbanillated enzymes. At higher concentrations, the two oxadiazolidinones also affected the specific binding of (125I) alpha-bungarotoxin (alpha-BGT) and [3H]perhydrohistrionicotoxin (H12-HTX) to Torpedo nicotinic ACh receptors, but did not affect the specific binding of [3H]quinuclidinyl benzilate (QNB) to rat brain muscarinic ACh-receptors. PMID- 3822253 TI - Behavioral effects of cyclic dosing with methylmercury in pigeons. AB - The present experiments examined the effects of cyclic dosing with methylmercury (MeHg) on some psychological functions in pigeons. A delayed sequence discrimination task involving order competency and a feeding task involving perceptual motor skill were tested in pigeons dosed with 2.0 mg/kg, 0.5 mg/kg, or no MeHg (the control group) during cycles of brief daily MeHg exposure and extended behavioral testing. Performance in the sequence discrimination and the feeding task was affected after a cumulative dose of only 20 mg/kg in the 2.0 mg/kg group. Sequence discrimination recovered within three months after dosing when MeHg was stopped, but feeding skill did not recover over the remainder of the experiment (about 4 1/2 months later). A cumulative dose of 86 mg/kg in the 0.5 mg/kg group had no observable effect on either task. PMID- 3822254 TI - Irreversible effects of xylene on the brain after long term exposure: a quantitative study of DNA and the glial cell marker proteins S-100 and GFA. AB - Mongolian gerbils (Meriones ungiculatus) were exposed by continuous inhalation to xylene at 160 or 320 ppm for three months, followed by a four month post-exposure solvent-free period. Concentrations of the two astroglial proteins, S-100 and GFA, as well as DNA, were then determined in different regions of the gerbil central nervous system. After exposure at 320 ppm, both concentrations of GFA and S-100 were found increased in the frontal cerebral cortex, whereas in the cerebellar vermis, only the GFA concentrations were significantly increased. In the posterior cerebellar vermis increased DNA concentrations were found after exposure at both 160 and 320 ppm, indicating an increased cell density, probably due to a proliferation of cells. These results indicate that xylene is a neurotoxin, inducing signs compatible with the presence of astrogliosis in distinct regions of the gerbil brain. PMID- 3822255 TI - Neurobehavioral evaluation of soil and structural fumigators using methyl bromide and sulfuryl fluoride. AB - Neurobehavioral functions affected by methyl bromide exposure were evaluated in California structural and soil fumigators using methyl bromide and sulfuryl fluoride. Sampling data revealed that structural fumigators are exposed for up to 1.5 hrs/day to 0-2.2 ppm methyl bromide and/or 10-200 ppm sulfuryl fluoride, and soil fumigators can be exposed to 2.3 ppm methyl bromide over an 8-hr day. Subjects were grouped for statistical analysis on the basis of exposure history: Those exposed primarily (80% or more of the work period with exposure potential) to methyl bromide (N = 32), primarily to sulfuryl fluoride (24), or to a combination of methyl bromide and sulfuryl fluoride (40-60% of each) for a minimum of one year (18), and those not exposed to high concentrations of any chemicals (29 Referents). Fumigators using methyl bromide reported a significantly higher prevalence of 18 symptoms consistent with methyl bromide toxicity than did Referents. Methyl bromide fumigators did not perform as well as Referents on 23 of 27 behavioral tests (chosen to reflect methyl bromide effects), and were significantly lower on one test of finger sensitivity and one of cognitive performance. These consistent differences suggest that even the low levels of methyl bromide found in fumigation today may produce slight neurotoxic effects. found in fumigation today may produce slight neurotoxic effects. The greater number of symptoms and reduced performance on all cognitive tests in sulfuryl fluoride fumigators compared to the Reference Group plus the absence of published research on this compound suggest that the data base for sulfuryl fluoride is inadequate. PMID- 3822256 TI - 2-Deoxyglucose uptake in the developing rat brain upon pre- and postnatal exposure to trichloroethylene. AB - Trichloroethylene (TCE) is a widespread contaminant of drinking water sources. The effects of TCE on 2-deoxyglucose uptake by brain tissue were examined in pups from rat dams exposed to TCE in their drinking water. The pups were exposed throughout gestation and lactation. Deoxyglucose uptake in the cerebellum, hippocampus and whole brain of the pups during the first 21 days of life was measured using a modification of the 2-deoxy-D-glucose (2-DG) technique. We determined that TCE at a nominal concentration of 312 mg/l significantly depressed 2-DG uptake in the whole brains and cerebella of 7- to 21-day old pups. 2-DG uptake was also lower in the hippocampus of exposed pups at 7, 11 and 16 days, but returned to control levels by 21 days. No overt toxicity, such as lower body or brain weight, was observed at this exposure level. This decrease in 2-DG uptake reflects a decrease in glucose uptake and/or metabolism in the brains of animals exposed to TCE. PMID- 3822257 TI - Di-isopropyl-fluorophosphate (DFP): acute toxicity and sleep. AB - Acute administration of the organophosphate diisopropyl-fluorophosphate (DFP) produces behavioral and physiological symptoms indicative of excessive cholinergic stimulation. This behavioral toxicity was found to be incompatible with the occurrence of sleep, despite the fact that chronic administration of DFP has been shown to increase the rapid eye movement stage of sleep. DFP was found to decrease all stages of sleep and to increase wakefulness in a dose-dependent manner. Atropine sulfate, at doses of 3.0 mg/kg, was ineffective in blocking the DFP effects upon sleep. PMID- 3822258 TI - Changes in fatty acid composition in myelin lipids after 2,4 dichlorophenoxyacetic butyl ester treatment. AB - Previous studies have shown that 2,4-Dichlorophenoxyacetic butyl ester (2,4-D b.e.) causes hypomyelination in chicks born from eggs externally treated and alters the myelin chemical composition. In this paper the effect of 2,4-D b.e. on myelin phospholipid and fatty acid composition has been examined. The results of our investigations show significant variations in the phospholipid composition, with the phosphatidyl inositol content increased and sphingomyelin and phosphatidyl ethanolamine contents diminished. The fatty acid pattern of the individual myelin lipids is also significantly altered, with an important reduction of long chain fatty acids and an increase of saturated fatty acids. The observed changes in the chemical composition implicate alterations in the intrinsic properties of this membrane. PMID- 3822259 TI - Effect of perinatal methimazole exposure on enolase isozymes in the developing rat. AB - The induction of hypothyroidism by methimazole produces a delay in CNS development as well as behavioral deficits in rat pups. Methimazole (0.1 mg/ml) was administered via drinking water to dams from gestational day 17 to postnatal day 10. Rat pup body weight was reduced on postnatal day 15 (P15) and 30 (P30) while brain weight was decreased only at P15. Soluble brain protein was decreased at P15 and P30. Total enolase and neuron-specific plus hybrid enolase (NSE+H) specific activity and activity were reduced on P15, while non-neuronal enolase (NNE) activity but not specific activity was depressed. At postnatal day 30, total enolase and NSE+H activity were slightly reduced, but NNE activity and the specific activities of total enolase, NNE and NSE+H were similar to controls. The ratio of NSE+H to NNE was reduced at P15 but not P30. The alterations in enolase activity following methimazole administration suggest a delay in the development and maturation of the CNS at P15. These results provide a biochemical correlate of the developmental delays reported in hypothyroid rat pups. PMID- 3822260 TI - Damage induced by systemic kainic acid in rats is dependent upon seizure activity -a behavioral and morphological study. AB - Kainic acid (KA) was injected intraperitoneally into rats at a dose (9 mg/kg) which produced status epilepticus in approximately 50% of the animals. Rats were categorized into groups that displayed status epilepticus, partial seizures or no effect in the 4 hr following kainic acid injection. Behavioral and morphological changes were characterized for each group. Rats that were not affected by kainic acid were indistinguishable from a saline-injected control group. When sacrificed 4 hr after treatment, rats displaying partial seizures showed morphological changes similar to, but less severe than, those exhibiting status epilepticus. Additional groups were tested and sacrificed 7 days (d) after treatment. Rats from the limited seizure group showed little behavioral or morphological response, while animals from the status epilepticus group had marked behavioral deficits and severe lesions. The tissue damage and its distribution were similar to lesions observed after seizures induced by other convulsants, and in spontaneously epileptic dogs. These results suggest that the extent of damage resulting from systemic administration of KA is dependent on the extent of seizure activity, which may in turn be related to the influence of kainic acid and other excitatory amino acids on the limbic system. PMID- 3822261 TI - Triethyl and trimethyl lead: effects on behavior, CNS morphology and concentrations of lead in blood and brain of rat. AB - The dose-related behavioral effects produced by triethyl (TEL) (2.6 to 7.9 mg/kg) and trimethyl lead (TML) (8.8 to 26.2 mg/kg) were assessed 2, 7, 14, 21 and 28 days following injection. TEL, but not TML, produced dose- and time-related decreases in body weight. Both agents decreased vertical and horizontal components of motor activity 2 days postdosing; increased activity was seen consistently in TEL-exposed rats 7 to 21 days after dosing. TML increased fore- and hindlimb strength for up to 28 days postdosing. TEL had no consistent effect on this measure. Both TEL and TML decreased responsiveness to an acoustic stimulus during the first two weeks postdosing. Latency to respond to a thermal stimulus was increased 2 to 14 days after TEL with the peak change occurring from 2 to 7 days. The peak of effect following TML was two weeks postdosing. In general, there was a significant correlation between both TEL and TML-induced changes in blood and brain lead levels and decreased sensitivity to a thermal stimulus. The apparent delayed onset of TML-induced neurobehavioral effects may be related to a longer time to obtain peak blood or brain levels. Histopathological assessment of rats 7 or 28 days after TEL and TML indicated that TEL caused structural abnormalities in the hippocampus and dorsal root ganglion, while TML produced changes primarily in the spinal cord and brain stem. PMID- 3822262 TI - The effects of lead exposure on field potentials of CA3 pyramidal cells from mossy fiber stimulation in rat hippocampus. AB - Previous anatomical evidence indicates that lead (Pb) alters development of the hippocampus and electrophysiological data suggest that Pb interferes with several neuronal systems outside the hippocampus. The present research was undertaken to examine the possibility that exposure to Pb early in development induces electrophysiological alterations in field potentials of CA3 pyramidal cells. Rat pups were exposed to Pb for the first 25 days of age via maternal milk. During this period, dams were fed diets containing either 4% PbCO3 or a Na2CO3 control diet. At 39-54 days of age, 15 sec trains of 20 Hz electrical stimuli at near maximal intensities were delivered to the dentate granule cells of anaesthetized rats. No significant differences between Pb-treated and control animals were detected for the evoked responses during or after the stimulus trains. However, spreading depression was observed in a greater proportion of Pb-treated animals and more frequently within single Pb-treated animals than in controls. Repetitive bursting, which followed termination of most 20-Hz trains, was significantly longer for Pb-treated animals. The duration of single bursts and the interval between bursts in a given episode were also longer in Pb-treated animals. These data support the hypothesis that developmental Pb exposure alters the electrophysiological properties of CA3 pyramidal cells. PMID- 3822263 TI - Effects of chemicals on delayed matching in pigeons IV: Effects of trimethyltin. AB - The effects of trimethyltin on delayed matching to sample performance of male White Carneaux pigeons were studied using the delayed matching-to-sample and the reversed delayed matching-to-sample procedures. In the delayed matching-to-sample procedure, pigeons were trained to peck a red or green center key 15 times to turn it off. After a 2- or 5-sec delay, one side key was illuminated by a red color and the other by a green color. One peck on the side key whose color was the same as the center key had been, produced food. After performance had stabilized, trimethyltin was administered intramuscularly at 3 different dosages (1.0, 1.3, and 1.75 mg/kg) to 3 different groups of birds. Birds received 3 injections of the same dose with injections at least 14 days apart. Trimethyltin produced dose-dependent decreases in matching accuracy, with smaller effects on response rate. Delay duration-dependent decreases in matching accuracy were also observed, whereas effects on response rate were independent of delay duration. These behavioral effects disappeared with time in all but one animal, who was unable to perform even 89 days after trimethyltin. There was no evidence of cumulative effects of trimethyltin in the other animals. After completion of the experiments with the delayed matching-to-sample procedure, pecking the key different in color from the sample key was required for reinforcement (reversed delayed matching-to-sample). There were no differences between trimethyltin treated birds and non-treated controls in acquiring the reversal performance. PMID- 3822264 TI - Autoradiographic localization of cadmium in the rat brain. AB - Adult rats were injected intravenously with 109CdCl2 and the distribution of the isotope within the brain and neighboring nervous structures was subsequently studied by autoradiography. Cadmium accumulated in regions outside the blood brain barrier such as the choroid plexus, pineal gland and area postrema, but did not appear in the brain parenchyma. Uptake of cadmium was observed in the trigeminal ganglia close to the nerve cells and in the olfactory bulbs. In addition, cadmium accumulated in the iris, ciliary body and choroid of the eye, but not in the optic nerves. The deposition of cadmium in the olfactory bulbs may be related to the anosmia reported in workers exposed to this metal. The possible harmful effects of accumulation of cadmium in restricted regions of the brain and adjacent nervous structures are discussed. PMID- 3822265 TI - Effect of nickel and cadmium chloride on autonomic and behavioral thermoregulation in mice. AB - Male BALB/c mice were injected intraperitoneally (i.p.) with nickel chloride (0, 5, 10, and 15 mg/kg) or cadmium chloride (0, 2, 4, and 6 mg/kg) and preferred ambient temperature (Ta) and activity were measured. Both metals caused marked reductions in preferred Ta and activity within 30 min postinjection. Preferred Ta and activity were depressed for up to 90 min. In a second experiment, body temperature was measured 60 min following the injection of nickel or cadmium chloride at a Ta of 20, 30, or 35 degrees C. Nickel and cadmium caused large reductions in body temperature when injected at a Ta of 20 and 30 degrees C but produced either no effect or only a slight elevation in body temperature at a Ta of 35 degrees C. In a third experiment, metabolic rate was measured continuously for 60 min following an i.p. injection of a relatively large dose of nickel (15 mg/kg) or cadmium chloride (6 mg/kg) at a Ta of 20, 30, and 35 degrees C. Both metals caused significant reductions in metabolic rate at TaS of 20 and 30 degrees C. At a Ta of 35 degrees C, cadmium caused a slight inhibition in metabolic rate while nickel had insignificant effects. These data indicate that nickel and cadmium chloride injected i.p. produce hypothermia by reducing metabolic rate and the preferred Ta. PMID- 3822266 TI - Family-line and socioeconomic factors in fatness and obesity. PMID- 3822267 TI - The triphasics: insights for effective clinical use. AB - Three triphasic oral contraceptive preparations are currently being widely used in the United States. These are Ortho-Novum 7/7/7 (Ortho Pharmaceutical), Tri Norinyl (Syntex) and Triphasil (Wyeth). The hormone manipulation in these formulations more closely mimics the normal menstrual cycle and decreases the total amount of hormone delivered. These drugs were formulated to decrease menstrual irregularities and nuisance side effects and increase menstrual control, while maintaining efficacy and safety. This article describes these products, their mechanisms of action, efficacy and selected areas of concern for clinical practice in relation to side effects, safety and menstrual control. Findings and suggestions related to the therapeutic administration, patient use, counseling and management of these newer oral contraceptives will assist the nurse practitioner in providing optimum care to the consumer. PMID- 3822268 TI - Clinical use of 24-hour ambulatory blood pressure monitoring. AB - Knowing a patient's continuous 24-hour blood pressure measurements can be useful to the nurse practitioner in evaluating the hypertensive patient. Recent studies have demonstrated end-organ damage to have a higher degree of correlation with 24 hour blood pressure readings than with more periodic blood pressure readings. Previously, 24-hour ambulatory blood pressure determinations were evaluated primarily in research settings. The ability to obtain these readings for diagnostic information applicable to clinical situations is becoming readily available. The historical background leading to the development of the ambulatory blood pressure monitors for clinical use is reviewed. The indications for obtaining 24-hour ambulatory pressures, interpretation of specific graphs and patient outcome are explained. PMID- 3822269 TI - Preventing and diagnosing sexual abuse in children. AB - Childhood sexual-abuse occurrences are life-altering events. Children are remarkably successful at keeping the facts of sustained abuse hidden. This results in delayed therapeutic intervention, or none at all. Traditionally, evaluating the symptoms of physical and emotional trauma has been the basis of screening for sexual abuse. This article presents an alternative method. The evaluation of some basic components of psychosexual development will make more evident a child's vulnerability to and/or experience with sexual abuse. A guide to parent-child education based on these same components of psychosexual maturity is also presented as a means of prevention. Screening and education are recognized as interdependent activities within this model of care. PMID- 3822270 TI - The power of the name. PMID- 3822271 TI - Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS related complex. AB - Thirty-four children have been cared for at SUNY-Health Science Center at Brooklyn with diagnoses of either acquired immunodeficiency syndrome (AIDS) or AIDS-related complex. Reported here are descriptions of pregnancies resulting in these children. Few of the mothers (four of 32) were symptomatic; however, low birth weight (11 of 34), preterm birth (11 of 34), and premature rupture of membranes (ten of 32) were common. Of 33 patients whose mode of delivery was known, cesarean section was used in ten cases, including one elective repeat. Among mothers who had children before their affected offspring, the average birth weight of the older children significantly exceeded that of the affected (3241 +/ 508 versus 2712 +/- 722 g, P less than .05). The affected child's age at onset of symptoms did not correlate with birth weight, mode of delivery, or status of membranes at the onset of labor. PMID- 3822272 TI - Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS related complex: follow-up of mothers, children, and subsequently born siblings. AB - Although several hundred cases of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) in infants have been reported, there is little information available concerning the follow-up of mothers and these children or subsequently born children. Thirty-four children with perinatally acquired AIDS and ARC (19 AIDS; 15 ARC) have been followed at the Downstate Medical Center. Although no mother had AIDS or ARC during her pregnancy, after an average follow up (+/- SD) of 27.8 +/- 21.6 months, five had AIDS and ten had ARC. For 22 of the mothers, T4/T8 ratios were obtained; 15 of these were less than 1, and five were between 1 and 1.5. Among 11 subsequently born siblings for whom HTLV-III antibody status was known, four were positive; of these, two had ARC and one had AIDS. We conclude that the diagnosis of AIDS or ARC in a child indicates a risk for the development of illness in the mother and subsequently born siblings. PMID- 3822273 TI - How often does maternal preeclampsia-eclampsia incite thrombocytopenia in the fetus? AB - Overt thrombocytopenia (defined as a platelet count of less than 100,000/microL) was not identified at or soon after delivery in any of 262 infants of mothers with hypertension induced or exacerbated by pregnancy. The platelet counts were 100,000 to 149,000/microL in 11 (4.2%) of the offspring and 150,000/microL or higher in the rest, even though the platelet counts of the 258 mothers were less than 150,000/microL in 77 (30%), less than 100,000/microL in 51 (20%), and less than 50,000/microL in 17 (7%). Some infants of hypertensive mothers did develop overt thrombocytopenia later; however, the frequency and intensity appeared to be no greater than it was in infants with similar complications (prematurity, growth retardation, infection, and meconium aspiration) whose mothers were normotensive. We conclude that the fetus whose mother has preeclampsia-eclampsia is very unlikely to be thrombocytopenic during labor and delivery, even when the mother is thrombocytopenic. Therefore, neither cesarean delivery to avoid labor nor scalp blood platelet counts during labor need be performed. PMID- 3822274 TI - Perinatal characteristics of uncomplicated postdate pregnancies. AB - Using a regional perinatal network database of 60,456 births, a study compared 3457 postdate (42 weeks or longer) infants to a control group of 8135 infants born at 40 weeks' gestation from 1982 through 1985. Both patient groups included only uncomplicated pregnancies. Although the differences were small, women who delivered postdate infants had a lower parity, higher weight at delivery, and higher blood pressure during pregnancy than controls. The postdate infants were heavier, more likely to be delivered by forceps or cesarean section, and more likely to experience shoulder dystocia. They also had lower Apgar scores and more meconium aspiration and congenital malformations. Although the overall perinatal mortality was not statistically different, the higher perinatal morbidity in postdate infants suggests that careful attention should be paid to this high-risk problem. PMID- 3822275 TI - The Johns Hopkins Adolescent Pregnancy Program: an evaluation. AB - The obstetric component of The Johns Hopkins Adolescent Pregnancy Program is described and the pregnancy outcome for adolescents delivering between 1976 and 1981 is compared with that of similar young women who were delivered in the same facilities, by the same staff, but who received their prenatal care in other Hopkins-related programs. The adolescent program is comprehensive, providing intensive psychosocial support and patient education in addition to medical care, using a team approach coordinated by an individual case management system. Enrollees had fewer pregnancy complications and lower perinatal mortality. Between 1979 and 1981, the frequency of birth weight below 2500 g was 9.9%, and below 1500 g, 1.9% for program adolescents, compared with 16.4 and 3.9%, respectively, for controls. Younger adolescents in the program entered prenatal care significantly later than older ones. However, those aged 14 years and below had infants with the highest average birth weight and no greater risk of perinatal death than those of older adolescents. PMID- 3822276 TI - Maternal mortality in South Carolina from 1970 to 1984: an analysis. AB - Although the maternal mortality rate in South Carolina has decreased at an impressive and statistically significant rate over the past 15 years, the overall rate is still 77% higher than in the United States as a whole. Certain epidemiologic variables related to the maternal deaths were analyzed statistically for three five-year periods: 1970-1974, 1974-1979, and 1980-1984. Deaths were more frequent in older, nonwhite, single mothers. Amniotic fluid embolus and ectopic pregnancy have become the leading causes of death. Maternal mortality declined more rapidly in smaller hospitals than in larger ones, probably due to the transfer of high-risk patients. Improved obstetric techniques and practice have reduced these mortality rates thus far. If rates are to decrease still more, this trend must continue along with a sustained effort to provide comprehensive prenatal care to indigent pregnant women in a regionalized perinatal care system. PMID- 3822278 TI - Efficacy of combined administration of magnesium sulfate and ritodrine in the treatment of premature labor. AB - Seventy-four patients in preterm labor at 20-35 weeks' gestation were randomly assigned to receive ritodrine (N = 36) or ritodrine plus magnesium sulfate treatment (N = 38) for tocolysis. Ten did not complete therapy and were excluded from analysis. Nineteen of 32 patients (59%) in the ritodrine plus magnesium sulfate group were successfully treated, compared with only 11 of 32 patients (34%) in the ritodrine-only group (P less than .05). Of the 21 patients who failed to respond to the initial ritodrine treatment, 16 received intravenous magnesium sulfate supplemental therapy; 75% of this group were treated successfully. The frequency of adverse maternal and fetal side effects did not differ between the treatment groups. In the combined group compared with the ritodrine group, the dose requirements for ritodrine therapy as well as the total duration of treatment for both ritodrine and magnesium sulfate were reduced significantly. We conclude that concurrent administration of ritodrine and magnesium sulfate is more efficacious than ritodrine alone and does not appear to increase the frequency of adverse side effects. PMID- 3822277 TI - Prenatal care adequacy and the outcome of adolescent pregnancy: effects on weight gain, preterm delivery, and birth weight. AB - A prospective study of 757 adolescents who gave birth to singleton live-born infants was undertaken to assess effects of prenatal care on pregnancy outcome. The analysis indicated that the odds of low pregnancy weight gain for gestation was reduced by a factor of two (odds ratio = 0.50, P less than .05) for adolescents with adequate prenatal care; the risk of preterm delivery was reduced with both adequate (odds ratio = 0.34, P less than .01) and intermediate prenatal care (odds ratio = 0.46, P less than .05). Birth weight was increased by an average of 157 g with adequate care (P less than .05) and 107 g with intermediate care (P less than .05). After adjusting for pregnancy weight gain and preterm delivery, differences in birth weight were much smaller and no longer statistically significant, suggesting indirect effects of care on birth weight (ie, improvements in weight gain adequacy and in preterm delivery). PMID- 3822279 TI - Continuous infusion epidural analgesia with lidocaine: efficacy and influence during the second stage of labor. AB - A randomized double-blind study evaluated the analgesic efficacy and influence of maintaining a continuous epidural infusion of 0.75% lidocaine during the second stage of labor in nulliparous women. When the cervix was 8 cm or more dilated, unidentified study solution was substituted for the known 0.75% lidocaine solution and continued until delivery. The study solution for 26 patients was 0.75% lidocaine; 27 subjects received saline. During the first stage of labor, 88% of women in the lidocaine group and 81% of women in the saline group had analgesia of excellent or good quality, a nonsignificant difference. During the second stage, there was a tendency (not statistically significant) toward improved analgesia quality in the lidocaine patients, but there was no significant difference in the frequency of perineal anesthesia (23% lidocaine, 7% saline). There was no difference between the groups in the duration of the second stage of labor (73 +/- 63 versus 76 +/- 48 minutes). Operative delivery frequency was similar (31 and 37%), as were umbilical cord blood acid-base values. It is concluded that maintenance of the continuous epidural infusion of 0.75% lidocaine did not prolong the second stage of labor, but it also did not significantly differ from saline in quality of second stage analgesia or frequency of perineal anesthesia. PMID- 3822280 TI - Effect of type of anesthesia on blood loss at cesarean section. AB - Halogenated anesthetic agents have been used to supplement nitrous oxide during balanced general anesthesia for cesarean delivery to decrease maternal awareness. However, these agents can interfere with uterine contractility and hence have the potential to increase blood loss at the time of cesarean section. To ascertain the effect of the addition of halogenated anesthetic agents for cesarean section anesthesia versus conduction or a simple balanced general anesthetic, we retrospectively assessed three aspects that may reflect operative blood loss at the time of cesarean section. Significantly more women whose balanced general anesthesia for cesarean section was supplemented with a halogenated agent (usually 0.5% halothane) versus those with a conduction or balanced general anesthetic required transfusion therapy, had a postpartum hematocrit less than 30 vol% and had a decrease in the pre- to postdelivery hematocrit of at least 8 vol %. The addition of halogenated anesthetic agents to a balanced nitrous oxide anesthesia for the purpose of decreased maternal awareness must be weighed against the risk incurred from the increased requirement for blood replacement and/or from postpartum anemia. PMID- 3822281 TI - Abdominal pregnancy in the United States: frequency and maternal mortality. AB - From an analysis of 11 abdominal pregnancy-related deaths and an estimated 5221 abdominal pregnancies in the United States, we estimated that there were 10.9 abdominal pregnancies per 100,000 live births and 9.2 per 1000 ectopic pregnancies; the mortality rate was 5.1 per 1000 cases. Although the risk of having an ectopic pregnancy is rising, the risk of abdominal pregnancy, which is probably always a sequel of a missed ruptured ectopic pregnancy, is apparently declining; this may be due to improved prenatal care. However, only one of nine women who reached the hospital alive had an accurate preoperative diagnosis of abdominal pregnancy, which suggests that preventing abdominal pregnancy-related death may depend, at least in part, upon increasing physicians' awareness of its clinical features. PMID- 3822282 TI - Vacuum extraction versus forceps delivery: indications and complications, 1979 to 1984. AB - Two hundred fifty-six vacuum extractions and 300 randomly chosen forceps deliveries were analyzed retrospectively. Vacuum extraction use increased from 0.3 to 3.1%, while forceps use declined from 10.1 to 4.9% over a five-year period. No differences were found in indications for vacuum extraction and forceps, but the preapplication position differed (occiput posterior or transverse in 81.2% in the vacuum group and 27% in forceps patients). Preapplication station also differed, with 59.8% of vacuum extraction at +1 or higher stations, compared with 9% of forceps. Under these conditions we found less maternal trauma, similar failure rates (3.9 versus 2%), and no difference in maternal morbidity. There was a higher incidence of shoulder dystocia and neonatal jaundice in the vacuum group, but cephalohematoma frequency did not differ significantly (3.9% vacuum extraction, 4.3% forceps). Cosmetic injuries (ecchymoses, abrasions) were more likely with vacuum extraction than with forceps (44.1 versus 29.5%). One death occurred in each group. Vacuum extraction replaced midforceps in our institution in the study period. We consider vacuum extraction a useful technique to teach house staff in view of today's decreasing instrumental delivery rate. PMID- 3822283 TI - Trophoblastic embolization during molar evacuation: central hemodynamic observations. AB - We evaluated prospectively the extent of trophoblastic embolization and its central hemodynamic effects during and after evacuation of large molar pregnancies in six women. A pulmonary artery catheter was inserted to obtain hemodynamic measurements as well as to obtain blood samples to identify trophoblasts before, during, and six hours after evacuation. Small numbers of both multinucleated giant cells and of large mononuclear cells with abundant cytoplasm were identified in the buffy coat of blood, aspirated in two cases before evacuation and for all six cases, during evacuation. There were no significant changes in heart rate or mean systemic arterial, pulmonary arterial, central venous, and pulmonary capillary wedge pressures; or cardiac output, stroke volume, and pulmonary or systemic vascular resistance when preevacuation preanesthetic values were compared with those six hours after evacuation. However, significant decreases in heart rate, mean arterial pressure, and pulmonary vascular resistance were observed during evacuation, which returned to preevacuation levels by completion of anesthesia. PMID- 3822284 TI - DNA content in cervical neoplasia and its relationship to prognosis. AB - Aneuploidy is commonly associated with malignancy and certain premalignant conditions. Recent studies have demonstrated an association between prognosis and the presence of aneuploidy. In this study, flow cytometry was used to determine the deoxyribonucleic acid (DNA) content of tissues with cervical intraepithelial neoplasia or invasive cervical carcinoma. Of 41 evaluable patients with cervical intraepithelial neoplasia, aneuploidy was demonstrated in the specimens of three of ten patients with cervical intraepithelial neoplasia II and six of 13 with cervical intraepithelial neoplasia III. No specimens with cervical intraepithelial neoplasia I, with condylomata, or without pathologic diagnosis contained aneuploid populations. Of the 22 evaluable specimens with invasive cervical carcinoma, 13 contained aneuploid populations. In stage I cervical lesions, aneuploidy appeared to be a poor prognostic factor with an overall survival of two of five patients with aneuploid tumors versus five of five patients with diploid tumors. PMID- 3822286 TI - Ovarian cancer after hysterectomy. AB - Hysterectomy is the most common major operative procedure in the United States. The present review of 291 women with primary ovarian cancer of the epithelial cell type from the metropolitan Washington, D.C. area reveals 41 (14%) had a prior hysterectomy. The hysterectomies were performed abdominally in 80% of women at an average age of 41 years and vaginally in 20% at an average age of 46 years. The interval between hysterectomy and discovery of ovarian cancer was ten years in the vaginal group and 18 years in the abdominal group. Women who had their ovaries retained at hysterectomy and later developed invasive ovarian cancer had approximately an 80% mortality. PMID- 3822285 TI - Clinical patterns of tumor recurrence after radical hysterectomy in stage IB cervical carcinoma. AB - We reviewed the cases of 31 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma who developed recurrent disease after radical hysterectomy and pelvic lymphadenectomy between 1961 and 1982. The overall incidence of recurrence was 11.3%. Recurrence was significantly more common in patients with adenocarcinoma or adenosquamous carcinoma (17.4%) than in those with pure squamous tumors (9.2%). The median time from operation to recurrence was eight months. The median survival of patients dying of disease was 18 months. Sites of recurrence were categorized as central pelvic in 35% of cases, pelvic sidewall in 39%, and distant in 26%. Patients treated with postoperative pelvic radiotherapy for positive pelvic nodes or surgical margin involvement were more likely to develop distant recurrence. Various therapeutic modalities were used to treat recurrent disease. Twenty-two of 23 patients with central pelvic or sidewall recurrence failed radiation therapy. None of four patients with central recurrence treated by pelvic exenteration survived. No patient treated with chemotherapy survived. Overall survival for patients with recurrence was 3.2%. The dismal prognosis for this group of patients warrants evaluation of alternative treatment modalities. PMID- 3822287 TI - The appendix and its metastatic potential in epithelial ovarian cancer. AB - The role of appendectomy in the management of epithelial ovarian cancer is unknown as a staging and cytoreductive procedure. In this series, the appendix was found to have metastatic disease in 40 of 78 patients (51%) and in 40 of 57 patients (70%) with advanced disease (stage III/IV). Occult or microscopic disease was found only in two patients (5%) with grossly normal appearing appendices. The appendix as a site of metastatic ovarian cancer is common with advanced stages (stage III/IV) and rare with early disease. PMID- 3822288 TI - The low pressure urethra as a factor in failed retropubic urethropexy. AB - Eighty-six patients with preoperative and postoperative urodynamic studies who underwent modified Burch colposuspensions were divided into two groups, one with a urethral closure pressure of 20 cm H2O or lower, and one with a pressure over 20 cm H2O. The two groups were comparable except for a difference in age (53.3 versus 46.6 years; P less than .01). There were significant differences between the two groups in both preoperative and postoperative functional lengths and closure pressures (P less than .01). The low-urethral-pressure group had a 54% failure rate, compared with 18% in the group with urethral closure pressures above 20 cm H2O (P less than .0005). Low urethral pressure was found to be a significant independent risk factor for patients under the age of 50, but not independent of age in women over 50 years old. Patients under the age of 50 who have urethral closure pressures of 20 cm H2O or lower are at high risk of surgical failure when undergoing a modified Burch colposuspension (P less than .0002). These patients should not be considered appropriate candidates for this procedure. PMID- 3822289 TI - Endometriosis and mullerian anomalies. AB - Although numerous etiologies for endometriosis have been proposed, it is clear that retrograde menstruation and cell-mediated lymphocytotoxicity each play a significant role in the disease's development. A comprehensive theory of pathogenesis of endometriosis holds that development of the disorder depends upon amount of retrograde menstruation and the ability of the immune response to remove the debris. To test this theory, 64 women with mullerian anomalies and intra-abdominal surgery were evaluated for the presence or absence of endometriosis, patency of tubes, hematocolpos or hematometra, and outflow obstruction. Results demonstrated that endometriosis was present in ten of 13 women with functioning endometrium, patent tubes, and outflow obstruction, whereas it could be identified in only 16 of 43 women with no obstruction (77 versus 37%, P less than .01). Similarly, eight of nine women with hematocolpos or hematometra had endometriosis, while only 18 of 47 with functioning endometrium but no hematometra/hematocolpos had it (89 versus 38%, P less than .01). None of the eight women without endometrium had endometriosis. These data support the concept that an increase in retrograde menstruation will increase the likelihood of endometriosis. PMID- 3822290 TI - Cyclic changes of peritoneal fluid parameters in normal and infertile patients. AB - This study compared peritoneal fluid volume, macrophage count, and macrophage concentration by diagnosis and cycle week of 426 patients undergoing laparoscopy. Patient diagnosis and cycle week had no significant interaction. Peritoneal fluid volume was dependent upon cycle week and diagnostic group, but macrophage count depended only upon diagnostic group. Endometriosis was associated with a significantly elevated total number of macrophages. Postovulatory peritoneal fluid volumes were significantly higher than preovulatory values. Cyclic and postovulatory differences in peritoneal fluid volume support proposed pathophysiologic roles. PMID- 3822291 TI - Whither gynecology? PMID- 3822292 TI - A suprapubic retroperitoneal operative approach to solitary paravaginal tumors. AB - Five cases of paravaginal tumors including a neurolemmoma, neurofibroma, lipoma, and desmoid tumors are presented. These tumors were approached through a modified Cherney incision. The rectus muscle was removed from the pubic symphysis and the pubococcygeus muscle was divided. This approach allowed good visualization of the paravaginal space, reasonable blood loss, and avoidance of entry into the peritoneal cavity. Although paravaginal tumors are rare, gynecologic surgeons should be aware of the suprapubic approach to the paravaginal space. PMID- 3822293 TI - Bipolar systems--do they perform? AB - Recent reports of bipolar sterilization failures have questioned the compatibility of bipolar forceps used with different electrogenerators. Four different bipolar forceps were matched and mismatched with five generators and the electrocoagulation effect was studied by two physicians trained in the histologic evaluation of electrical injury. All bipolar systems, matched or mismatched, failed to coagulate the fallopian tube as completely as unipolar control--except for the matched Kleppinger system. Conversely, when mismatched with other generators the coagulation effect of the Kleppinger forceps fell far below that of other bipolar forceps--matched or mismatched. Each bipolar system should be compatible and its electrocoagulation effect studied before it is used for female sterilization. PMID- 3822294 TI - Who should have intravenous pyelograms before hysterectomy for benign disease? AB - A review of 493 cases was undertaken to identify which patients undergoing hysterectomy for benign disease had received a preoperative intravenous pyelogram (IVP), an abnormality identified by IVP, and intraoperative ureteral injuries. Intravenous pyelograms were performed on 299 patients (60.6%). Factors significantly associated with obtaining a preoperative IVP included an abdominal approach, uterine size of 12 weeks or greater, and uterine prolapse. Seventy seven patients (27%) had an abnormal IVP; factors likely to be associated with abnormality included uterine size of 12 weeks or larger or an adnexal mass of 4 cm or larger. Endometriosis, pelvic inflammatory disease, pelvic relaxation, and previous intra-abdominal surgery were not associated with an increased prevalence of abnormal IVP findings. Two ureteral injuries were documented, one in the IVP group (0.3%) and one in the non-IVP group (0.5%). Clinical findings may be used to select for a preoperative IVP those patients who are likely to have abnormalities of importance to the pelvic surgeon. PMID- 3822296 TI - An evaluation of two rapid bacteriuria screening procedures. AB - Two commercially available rapid bacteriuria screening procedures were evaluated for routine screening for 10(4) or more colony forming units per milliliter of pathogenic bacteria in two female patient populations. In 694 obstetric patients with 56 cases of significant bacteriuria, the sensitivity, specificity, positive predictive, and negative predictive values, respectively, were as follows: for Chemstrip LN, 69.6, 83.4, 26.9, and 96.9%; and for Bac-T-Screen, 96.4, 56.0, 16.1, and 99.4%. In 143 nonpregnant females with 32 cases of significant bacteriuria, these values were: for Chemstrip LN, 71.9, 75.7, 46.0, and 90.3%; and for Bac-T-Screen, 84.4, 65.8, 41.5, and 93.6%. These results indicate that the LN strip did not have acceptable sensitivity in either patient group. The Bac T-Screen had better sensitivity, particularly for obstetric patients; however, a high false-positive rate and high cost per test may restrict its use in those clinical settings where culture is available and cost-effective. PMID- 3822295 TI - Suprapubic versus transurethral bladder drainage after surgery for stress urinary incontinence. AB - Fifty-one patients with clinical and urodynamic diagnoses of stress urinary incontinence were randomly allocated to either suprapubic (N = 24) or transurethral (N = 27) bladder drainage after vaginal surgery for stress incontinence (revised Pereyra procedure). Postoperative use of suprapubic bladder drainage significantly reduced febrile morbidity (calculated as fever index; P less than .01) and length of hospitalization (P less than .05). Postoperative normal bladder functions resumed more quickly when suprapubic drainage was used (P less than .05), so that most patients did not need bladder catheterization upon discharge, as opposed to more than half of those with Foley catheters, who left the hospital with a catheter in place (P less than .05). We conclude that it is both beneficial and cost-effective to use suprapubic bladder drainage after a Pereyra operation for stress urinary incontinence. PMID- 3822297 TI - Effect of the Today contraceptive sponge on growth and toxic shock syndrome toxin 1 production by Staphylococcus aureus. AB - Toxic-shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus MN8 was grown in dialyzed beef heart infusion broth, or dialyzed beef heart infusion broth supplemented with 5% human blood or with 5% human semen, in the presence and absence of Today contraceptive sponges. Early growth of the organism was inhibited by the presence of the sponges in aerobic, static aerobic, and anaerobic cultures. In aerobic cultures that contained the sponge, minimal TSST-1 was detected by immunodiffusion assay, whereas in control cultures that did not contain the sponge, extensive toxin production was seen. In static and anaerobic cultures, the presence of the contraceptive sponge resulted in toxin levels less than or equal to the low levels seen in control cultures. These results suggest that Today contraceptive sponges may inhibit TSST-1 production by S aureus. PMID- 3822298 TI - Abnormal glucose screening tests in pregnancy: a risk factor for fetal macrosomia. AB - Of 2276 patients who underwent screening for gestational diabetes mellitus, 1854 (81.5%) had normal glucose screening tests after a 50-g carbohydrate load (serum glucose below 135 mg/dL). Three hundred fifty-seven patients (15.7%) had abnormal glucose screening tests and went on to complete three-hour glucose tolerance tests, of whom 176 (48.7%) were shown to be nondiabetic when further tested using a carbohydrate-loaded, 100-g glucose, three-hour glucose tolerance test. The 176 women with abnormal glucose screens but normal glucose tolerance tests were compared with the 1854 who had normal screening values. The frequency of infants weighing more than 4000 g (greater than 95th percentile at our institution) was 11.9% in the study group and 6.4% in the control group (P = .0086). When the data were corrected for other macrosomia risk factors (advanced age, high parity, obesity, white race, and prolonged gestation), there was still a significantly higher frequency of macrosomia in the study group; this fact suggests that patients with minor abnormalities of carbohydrate metabolism during pregnancy are at risk for delivering a macrosomic infant. PMID- 3822299 TI - Twins: prophylactic hospitalization and ward rest at early gestational age. AB - One hundred eighty-nine twin pregnancies were delivered at Wilford Hall United States Air Force Medical Center from July 1977 through December 1985. Among these, 57 were referred from distant bases and were excluded from further analysis. The remaining 132 pregnancies from our local population make up the study group. Sixty-seven women (51%) followed our advice to be hospitalized at or before 28 weeks' gestation for prophylactic ward rest. The remaining 65 women (49%) were not hospitalized until after 28 weeks' gestational age or until a pregnancy complication or labor occurred. Only three of 134 infants (2%) whose mothers were admitted died, versus 11 of 130 infants (8.5%) whose mothers were not admitted (P less than .03). The results suggest that prophylactic ward rest, implemented at or before 28 weeks' gestational age, may reduce perinatal mortality in this condition. PMID- 3822300 TI - Relaxin in human pregnancy serum measured with an homologous radioimmunoassay. AB - This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncomplicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels peaked at ten weeks' gestation and decreased progressively to term. Relaxin was detectable in all pregnant subjects assessed at the time of the first missed menses. The mean relaxin levels in patients having in vitro fertilization and embryo transfer who subsequently delivered a single infant were significantly higher than those in normal antenatal patients at an equivalent gestational age. Patients with twin pregnancies after in vitro fertilization and embryo transfer generally had higher levels than patients with single pregnancies. Some pregnant patients who aborted after in vitro fertilization and embryo transfer had declining levels of relaxin before 40 days postlaparoscopy. PMID- 3822301 TI - Patterns of alcohol consumption during pregnancy. AB - Alcohol consumption among 530 pregnant women was recorded retrospectively from the last menstrual period to a mean of ten gestational weeks, and thereafter prospectively to term. Fifty-five percent of women had drunk alcohol (average 66 g of ethanol) during the week when ovulation was assumed to have taken place. This was not significantly different from the figures in 100 women seeking contraception, of whom 72% drank on average 61 g of ethanol during the ovulation week. Ninety percent of women drank alcohol at least once after the diagnosis of pregnancy. Drinking more than 600 g of ethanol during the first 12 gestational weeks (about four drinks weekly) was associated with an increased frequency of preterm delivery (P less than .05), but fetal outcome was not compromised. The proportion of drinking women decreased with advancing gestational age, with only 50% drinking after 32 weeks and only 20% during the last week of gestation. Beer was most commonly consumed, followed by wine and liquor. Alcohol consumption during pregnancy ranged between 7 and 4440 g, but 90% of the subjects drank less than 1100 g (zero to two drinks per week). Thus, women tended to decrease their drinking during pregnancy. Fewer than two drinks weekly had no detectable adverse effects on the fetal outcome. PMID- 3822303 TI - Positive endocervical curettage in patients with satisfactory and unsatisfactory colposcopy: clinical implications. AB - We studied a total of 177 patients with cervical intraepithelial neoplasia or invasive carcinoma to evaluate the clinical implications of a positive endocervical curettage. All patients underwent cervical conization. One hundred and ten women had unsatisfactory colposcopy; 67 had satisfactory colposcopy. Patients with unsatisfactory colposcopy had a higher frequency of invasive lesions in the endocervix (9 versus 1.5%, P less than .05) and involvement of internal cone margins (12 versus 0%, P less than .01); they were also more likely to require additional, frequent treatment for persistent or recurrent disease (9 versus 1%, P less than .05) than patients with satisfactory colposcopy. Histologic review of the cone specimens in patients with satisfactory colposcopy revealed no lesion deeper in the endocervical canal than was predicted by colposcopic examination. These observations suggest that selected patients with positive endocervical curettage may be managed without diagnostic conization, if they had a satisfactory colposcopic examination. PMID- 3822302 TI - Pharmacokinetics of clonidine during pregnancy and nursing. AB - Pharmacokinetics of clonidine were examined in ten women during pregnancy, in nine during nursing, and in the newborns of these women. Clonidine crosses the placenta easily, and its concentrations were equal in maternal serum and umbilical cord serum. Amniotic fluid concentrations were up to four times that found in serum. Clonidine concentrations in milk were roughly twice that in maternal serum; in the serum of the newborns the concentrations were about half those of the mothers. All concentrations corresponded well to the doses of the drug. The neurologic examinations and assessments of serum electrolytes and blood glucose showed results parallel with those of newborns of nontreated mothers. PMID- 3822304 TI - Ureteral assessment after radical hysterectomy. AB - Postoperative intravenous pyelography was performed in 233 patients with stage IB cervical carcinoma treated with radical hysterectomy and pelvic lymphadenectomy between January 1962 and December 1985. Four patients developed symptoms of ureteral injury, two (0.8%) ureteral fistulae, and one (0.4%) stricture and obstruction due to recurrent carcinoma. No ureteral injuries were observed in 229 asymptomatic patients. A 5.2% incidence of transient severe ureteral dilatation occurred in asymptomatic patients, but resolved within a median of 94 days. A significant urinary tract anomaly was observed in 3.4% of preoperative pyelograms. All of these anomalies were apparent at surgery and presented no intraoperative difficulties. Three patients (1.3%) sustained intraoperative ureteral transections, which were diagnosed and repaired without sequelae. In patients with early cervical carcinoma having primary operative treatment, the role of routine preoperative and postoperative intravenous pyelography is questionable. PMID- 3822305 TI - Major morbidity after pelvic exenteration: a seven-year experience. AB - Thirty-eight patients underwent pelvic exenteration at the University of South Florida during the last seven years. The majority of the operations were performed for recurrent carcinoma of the cervix, and the operative mortality was 5.3%. Twenty-one patients developed major morbidity in the postoperative period, and 11 with complications involving the gastrointestinal or urinary tract required reoperation. Multivariate logistic regression analysis demonstrated a correlation between the amount of pelvic radiation, type of pelvic floor, type of pelvic drain, amount of blood loss, race, and the occurrence of serious postoperative morbidity. Strategies to avoid serious postoperative morbidity are discussed. PMID- 3822306 TI - Radiation therapy in the management of gestational choriocarcinoma metastatic to the central nervous system. AB - The Albert Mathieu Chorionepithelioma Registry's 1800 cases were screened, and 70 cases of trophoblastic disease involving the central nervous system were abstracted. In addition, eight patients with central nervous system trophoblastic disease from the Western Trophoblastic Disease Center, Department of Obstetrics and Gynecology, University of Southern California (USC) Medical Center, were reviewed. Eighteen patients received chemotherapy and whole-brain irradiation, 25 were treated with chemotherapy alone, and 35 received neither chemotherapy nor irradiation. In the no-treatment group (in which most patients died before therapy was begun), there were no survivors, and 74% of the deaths resulted from central nervous system causes. In the chemotherapy-alone group, 24% survived and 58% died of central nervous system causes. In the chemotherapy and irradiation group, 50% survived but none of the deaths were due to central nervous system involvement. This study suggests that radiation has a distinct therapeutic role in the treatment of central nervous system choriocarcinoma, and provides evidence that the irradiated brain tends to resist recurrent disease even in those patients for whom the outcome is fatal. PMID- 3822307 TI - Electronic fluorography for the performance of cine hysterosalpingography. AB - We used electronic fluorography to perform hysterosalpingography in 25 women with infertility or abnormal bleeding. In contrast to the conventional modality of fluoroscopy with intermittent permanent imaging, an image intensifier was used to periodically record dye injection on a moving tape (cine hysterosalpingography). The mean number of electronic fluorographs taken per patient was 10.8 +/- 3.12 (mean +/- SD). The mean radiation exposure per patient for electronic fluorography was 113.4 +/- 52 versus 112 +/- 52.4 mR when a single conventional radiographic image was taken. We conclude that electronic fluorography is a simple yet accurate radiographic method that delivers to the gonads approximately one-eleventh the dose of ionizing radiation that current standard techniques do, and should be accepted as an alternative diagnostic modality. PMID- 3822308 TI - A new valving system for removal of laser plume during pelvic CO2 laser endoscopic procedures. AB - The large volumes of laser plume and char created during carbon dioxide laser endoscopy of the pelvis present a common problem to the gynecologic surgeon. Laser plume not only interferes with the view of the surgical field but also reduces the efficiency of emitted laser energy. A valving system has been designed and clinically tested that allows easy removal of laser-created debris while simultaneously maintaining control of the pneumoperitoneum. The system also removes these gas and liquid products without contaminating the operating room environment or hospital vacuum handling systems. PMID- 3822309 TI - Microcolpohysteroscopy compared with colposcopy in the evaluation of abnormal cervical cytology. AB - Microcolpohysteroscopy allows one to observe the cervix and endocervix at magnifications of 1:1-1:150. More important, it permits examination of the squamocolumnar junction when it is obscured within the endocervix. This preliminary report compares standard colposcopy with a microcolpohysteroscopy technique in 65 patients with abnormal Papanicolaou smears. Using contact microcolpohysteroscopy, the clinician can map out geographically entire cervical intraepithelial neoplastic lesions; locate correctly the epicenter of most lesions; and in cases of inadequate colposcopy, visualize the squamocolumnar junction within the cervix. Microcolpohysteroscopy was equivalent to traditional colposcopy in detecting abnormal histology. This technique predicted lesions with viral cytopathic effects, which correlated with histology in 83% of cases. The results of this study suggest that microcolpohysteroscopy is a diagnostic tool that can precisely qualify and localize a cervical lesion. PMID- 3822310 TI - Hysteroscopic endometrial ablation with the Nd:Yag laser using a nontouch technique. AB - Thirty-six patients with menorrhagia were treated with a technique for laser destruction of the endometrium in which the end of the fiberoptic guide of the Nd:Yag laser is not allowed to come in contact with the endometrium. The results were excellent in 93.9% of the 33 patients followed over three months. Amenorrhea was achieved in 11 patients, a significantly decreased menstrual flow in 13 patients, and a decrease to a normal flow in seven patients. Failure to satisfactorily control menorrhagia occurred in two patients. The technique of not touching the endometrium caused no complications in this series and may prevent the problems of fluid overload and postoperative bleeding found when contact is made with the endometrium. PMID- 3822311 TI - Prevention of intraventricular hemorrhage in very low birth weight infants by maternally administered phenobarbital. PMID- 3822312 TI - Pneumococcal polysaccharide antibody levels in patients with term and preterm pregnancies. PMID- 3822313 TI - Measuring up: assessing safety with climate surveys. PMID- 3822314 TI - Issue of the 'living will' document affects occupational health specialists. PMID- 3822315 TI - Mobile cranes harbor high accident potential. PMID- 3822316 TI - Choosing respiratory protection requires proper hazard evaluation. PMID- 3822317 TI - Cost of health care plans tallied in survey of California employers. PMID- 3822318 TI - Patients relinquish control of medical care by participating in HMO programs. PMID- 3822319 TI - Newer heavy load lifting methods help firms reduce back injuries. PMID- 3822320 TI - Agent Orange studies are incomplete. PMID- 3822322 TI - Vibration aggravates CTS. PMID- 3822321 TI - Vitamin therapy helps fight CTS. PMID- 3822323 TI - CTS precludes simple solutions. PMID- 3822324 TI - Audiograms catch pilots' hearing loss. PMID- 3822325 TI - VDT users should get regular eye exams. PMID- 3822326 TI - [The role of various current methods of treating patients with intraocular melanoma]. PMID- 3822327 TI - [Remote results of beta-therapy of malignant neoplasms of the eyelids, conjunctiva and cornea]. PMID- 3822328 TI - [Results of the complex treatment of tumors of the eye]. PMID- 3822329 TI - [Rare vascular tumors of the orbit (hemangioendothelioma and hemangiopericytoma)]. PMID- 3822330 TI - [Rehabilitation of patients after extensive organ-sparing operations of intraocular neoplasms]. PMID- 3822331 TI - [Characteristics of the origin of pigment neoplasms of the uveal tract of the human eye]. PMID- 3822332 TI - [Clinico-angiographic characteristics of choroid melanoma and their significance in the planning of organ-sparing treatment]. PMID- 3822333 TI - [Causes of blindness and poor vision and problems of rehabilitating patients with pathology of the refractive system of the eye]. PMID- 3822334 TI - [Comparative evaluation of the effectiveness and the degree of injury in current methods of cataract extraction]. PMID- 3822335 TI - [Prognosis of vitreous body prolapse and selection of the method of cataract extraction]. PMID- 3822336 TI - [Ophthalmotonus, hydrodynamics and the anterior chamber angle in age-related cataract]. PMID- 3822337 TI - [Comparative evaluation of the effectiveness of graded and non-graded sinusotrabeculectomies in glaucoma (analysis of 500 operations)]. PMID- 3822338 TI - [Indications for surgical treatment of high progressive myopia using the intralamellar scleroplasty method]. PMID- 3822339 TI - [Results of mass screening of persons with myopia and indicators for scleroplasty]. PMID- 3822340 TI - [Ocular accommodation in binocular vision]. PMID- 3822341 TI - [Glucose level in the tears of patients with diabetes mellitus]. PMID- 3822342 TI - [A colorimetric method of diagnosis in experimental pathologic process of the cornea]. PMID- 3822343 TI - [Morphologic changes in the ciliary body after transconjunctivo-scleral coagulation using an AYG laser]. PMID- 3822344 TI - [Diagnosing residual signs after occlusion of the retinal vein and its branches in patients with hypertension]. PMID- 3822345 TI - [A Russian three-mirror gonioscope]. PMID- 3822346 TI - [Reinforcement of the sclera during surgical treatment of retinal detachment]. PMID- 3822347 TI - [Ways of further developing ophthalmoergonomics]. PMID- 3822348 TI - [Several general questions concerning the work capacity and fatigue of operators in visually demanding jobs]. PMID- 3822349 TI - [Visuo- and refractometric indices in the evaluation of visual work capacity]. PMID- 3822350 TI - [Longitudinal study of the functional status of the visual analyzer of children who began their schooling at 6-years-old]. PMID- 3822351 TI - [Assessment of visual fatigue and work capacity evaluation of electronics industry workers]. PMID- 3822352 TI - [Comparative characteristics of the functional status of the visual analyzer of men and women during the performance of precision occupational operations]. PMID- 3822353 TI - [Ergonometric characteristics of the workplace and function of the visual analyzer in sailors]. PMID- 3822354 TI - [Status of far and near muscle balance in children exposed to a visual load]. PMID- 3822355 TI - [Factors affecting the threshold of depth vision in schoolchildren and preschool children exposed to a visual load]. PMID- 3822356 TI - [A new type of ergograph and its practical application]. PMID- 3822357 TI - [Features of the state of the hemodynamics and hydrodynamics of the eyes of patients with glaucoma and glaucoma associated with macular dystrophy]. PMID- 3822358 TI - [Ophthalmotonus and the gonioscopic picture in different types of clinical refraction]. PMID- 3822359 TI - [Fusion reserves and muscular equilibrium of the eyes in older preschool children]. PMID- 3822360 TI - [Temperature of the eyeball in health and disease]. PMID- 3822361 TI - [Phonophoresis of papain and lekozim in the treatment of leukoma and opacity of the cornea]. PMID- 3822362 TI - [Dacryocystoethmoidostomy as a method of surgical treatment in chronic inflammatory diseases of the lacrimal sac]. PMID- 3822363 TI - [Efficacy of the Soviet-produced antiviral preparation acycloguanosine (acyclovir) in experimental herpes keratitis]. PMID- 3822364 TI - [Effect of aloe on the resistance of the optic nerve system of the eye]. PMID- 3822365 TI - [Various problems in postoperative management after plastic eye surgery]. PMID- 3822366 TI - [Optimization of extracapsular cataract extraction]. PMID- 3822367 TI - [Spatula-retractor for examination of the posterior chamber of the eye]. PMID- 3822369 TI - [Cataract extraction in the People's Democratic Republic of Algeria]. PMID- 3822368 TI - [Implantation of Fedorov-Zakharov model intraocular lenses]. PMID- 3822370 TI - Yesterday never happened--diagnosing and treating memory loss. PMID- 3822371 TI - Legislative roundup. The legislative year in review. By the OSMA Department of Legislation. PMID- 3822372 TI - Medical liability reform remains priority. PMID- 3822373 TI - In-flight medical kits: high costs for high risks. PMID- 3822374 TI - A glance through time. PMID- 3822375 TI - Impaired physicians. PMID- 3822376 TI - [Parthenogenetic development of murine ova activated by heat shock]. AB - The effects of heating oviducts up to 37-42 degrees on the ovulated mouse eggs have been studied. The heating of oviducts at 39.5 degrees for 7 min resulted in 85% activation. The subsequent increase in temperature did not raise the incidence of activation but led to the formation of micronuclei and other pathological changes in the pronuclei. The heating of oviducts at 39.5 degrees for 14 min demonstrated marked changes in heat resistance, which were dependent on the postovulatory age of eggs. The freshly ovulated eggs were characterized by a low resistance and were not activated by the heat shock. If the oviducts were first heated and then cooled, and again heated, most eggs were activated and their in vitro development was the best of all experimental series. The mechanisms of egg activation by heating are discussed. PMID- 3822378 TI - [Distribution of differentiation potentials and the conditions for their realization in the amphibian neuroectoderm]. AB - The X. laevis neuroectoderm (NE) at the mid and late gastrula stages is capable to form mesoderm in vitro after its separation from mesoderm. This capacity is inherent in posterior 2/3 of NE underlied by axial mesoderm in the embryo and forming deuterencephalic and trunk regions of the brain in the normal development. The archencephalic 1/3 of NE of the late gastrula, underlied in the embryo by prechordal plate, is capable of differentiation into archencephalic regions of the brain, rather than into mesoderm. For the typical differentiation of archencephalic NE to be realized, it should be surrounded by the outer ectoderm layer. In the absence of the latter, the whole explant develops into retina and brain only. Inside the closed explants, ectomesenchyme and melanophores arise and the eye material is subdivided into retina and pigmented epithelium. The archencephalic NE, dissociated to individual cells and wrapped into epidermis, forms much more ectomesenchyme and melanophores than the usual NE explants. PMID- 3822377 TI - [Permeability of the csf-brain barrier in the median eminence of rats in the perinatal period]. AB - The ultrastructure and permeability of the CSF-brain barrier in the median eminence were studied during the perinatal period in rats with electron microscopy, electron-microscopic radioautography and electron-dense markers. It was shown that the ependymal cells forming the ventral portion of the 3rd ventricle (infundibular recess) are joined by the specialized junctions. The specialized junctions are similar in ultrastructure in different parts of infundibular recess all through the perinatal period. They consist of the tight junctions which are sometimes in series with the gap junctions and adhesion zones. An electron-dense marker, La3+, injected into the cerebral ventricles, penetrates through the foetal ependymal linins both via the ependymal cells and intercellularly in all parts of the infundibular recess. In neonatal rats La3+ penetrates in the same way in the rostral part of infundibular recess only, while in the caudal part its permeability is markedly limited, apparently by the tight junctions formed de novo around the cells. 3H-dopamine, introduced into the ventricles, crosses over the ependymal linins apparently in the same way as La3+. Then the labeled dopamine is transported into the pericapillary space of the primary portal plexus and, finally, into the capillary lumen. Thus, the results obtained point to the permeability of the CSF-brain barrier in the foetal median eminence for the markers including neurohormones. In the postnatal period the permeability of the ependyma becomes limited due to the formation of the tight junctions surrounding the ependymal cells. PMID- 3822380 TI - If you want an orange, don't choose a lemon. PMID- 3822379 TI - [Mutant gene expression in murine aggregation chimeras. 7. The effect of the aphakia gene--disorder in the formation of the crystalline capsule]. AB - An analysis of aphakia (ak) gene expression in 16 day ak/ak C/C----+/+ c/c chimaeric embryos has shown, that ak gene, acting in developing lens, blocks lens cell differentiation and disturbs the formation by these cells of the extracellular matrix composing the lens capsule material. The dependence of capsule structure in chimaeras on the genotype of underlying cells indicates that lens cells are responsible for the formation of lens capsule. PMID- 3822381 TI - A computerized analysis of astigmatism after cataract surgery. AB - We have performed a computerized analysis of postoperative changes in corneal astigmatism in 203 consecutive cases of extracapsular cataract extraction with posterior chamber intraocular lens implantation performed by one surgeon. Surgical technique was standardized consisting of a 140 degree posterior limbal incision with preplaced 9-0 silk and postplaced 10-0 nylon sutures. The average postoperative astigmatism was 1.60 D and the average surgically induced change in astigmatism 0.51 D after a mean follow-up of 5.4 months. When the axis of astigmatism was considered, cataract surgery on the average initially induced 2.2 D of with-the-rule astigmatism which gradually declined, stabilizing at 0.35 D against-the-rule 19 weeks postoperatively. An analysis of the natural history of astigmatism after cataract surgery helps to optimize the timing of spectacle prescription and postoperative intervention to correct excessive astigmatism. A computerized astigmatism analysis also provides rapid feedback to guide changes in surgical technique to minimize astigmatism. PMID- 3822382 TI - A form of variable astigmatism induced by pseudopterygium. AB - Pterygium and pseudopterygium have long been known to induce astigmatism and may do so without entering the visual axis. We present a case report of a 34-year-old man with a traumatic pseudopterygium which produced a "dynamic" astigmatism, varying in different fields of gaze. Due to the pseudopterygium's attachment to the lateral canthus, it produced a tethering effect with markedly decreased vision and wrinkling of Descemet's membrane when the eye was directed away from the anchoring point. This model may apply to other ocular diseases where perilimbal attachments and adnexal adhesions to the corneal surface may occur; such connections should be looked for in cases with unexplained low levels of visual acuity. PMID- 3822383 TI - The role of subscleral Scheie procedure in glaucoma surgery. PMID- 3822384 TI - Fistulous tract after conjunctivodacryocystorhinostomy. PMID- 3822385 TI - Macular hole-induced retinal detachment: treatment with an "armed-silicone" implant. AB - Thirty-two cases of retinal detachment with macular hole have been treated by applying an explant made of a stainless steel sheet embedded in silicone. The results obtained were very encouraging, and the technique is recommended especially when a vitrectomy cannot be performed. PMID- 3822386 TI - Argon laser phototherapy of phthiriasis palpebrarum. AB - Argon laser phototherapy is an alternative new, quick, and effective method of treating phthiriasis palpebrarum in one sitting. A beam at a setting of 200 microns size, 0.1 second time, and 200 mW power is employed to destroy individual adult parasites and nits. The only drawbacks are an occasional but tolerable stinging and the slicing of the eyelash stems carrying the nit. The eyelashes regain their normal length within a few days. PMID- 3822387 TI - Single snip trabeculectomy using a specially designed punch. AB - A special trabeculectomy punch designed by one of the authors is described. The surgical technique and advantages of the punch method are discussed. PMID- 3822388 TI - Modification of the bent needle technique for anterior capsulotomy. AB - A simple modification of the bent needle cystitome allows a more precise and regular anterior capsulotomy in extracapsular cataract surgery. PMID- 3822389 TI - Diagnosis and therapeutic surgery of the uvea--Part I: Surgical technique. AB - Surgical techniques of iridocyclectomy, iridochoroidectomy, eye wall resection, eye wall biopsy, and ab interno retinochoridectomy are described. Surgical approaches to uveal neoplasms offer a new alternative for management of these disorders. Uveal and retinal biopsy expand our knowledge of pathological processes involved in tapetoretinal degeneration and uveitides. Additionally, both eye wall biopsy and resection provide tissue to confirm tumor diagnosis and malignancy. PMID- 3822390 TI - [Topographic-surgical anatomy of the pediatric pars plana]. AB - The width of the pars plana and the distances between the corneo-limbal junction and the posterior aspect of the pars plicata as well as of the ora serrata were determined by measurement in 17 autopsy eyes and additional 12 dissected autopsy eyes of premature and mature babies and infants. The data were correlated to age and length of the globe. The site of sclerotomy in transscleral lensectomy of congenital cataracts is discussed. PMID- 3822391 TI - [Clinical interpretation of retinal circulatory measurements. IV. Photocoagulation in diabetic retinopathy and venous occlusive diseases]. AB - Based on the pathomechanism of diabetic retinopathy, the effect of photocoagulation on retinal microcirculation as assessed by measurements of retinal microcirculation magnitudes is discussed. The clinico-experimental results support the opinion that an essential effect of photocoagulation is due to an improvement in the flow conditions of the noncoagulated central retinal area with regard to metabolic exchange and stasis situation by the coagulation induced occlusion of peripheral capillary areas. Further clinico-experimental measurements of retinal microcirculation magnitudes for the assessment of the behavior of microcirculation after photocoagulation in venous occlusive diseases of the retina are presented. It is shown that retinal microcirculation immediately after photocoagulation reacts by transitory instationary flow conditions; in this period it is quite possible that an additional blood flow reduction over several days will occur. In particular, the effect of photocoagulation in venous occlusive diseases with narrow arterial vessels is discussed. It is emphasized that with regard to the therapeutic effect of photocoagulation as well as to the discussion of pathomechanisms, apart from blood flow, the differentiated behavior of single retinal vascular areas, such as arteries, arterioles, capillaries, venules and veins, requires more attention. Particularly with this in mind, substantial improvements in differential diagnosis and treatment of retinal circulatory disturbances may be expected from measurements of retinal circulation magnitudes. PMID- 3822392 TI - Hemispheric retinal branch vein occlusions. AB - Nine cases of hemispheric retinal branch vein occlusion (HRBVO) are discussed retrospectively after identification from among 94 cases of branch vein occlusion. The high incidence of simple chronic glaucoma (close to that found in central vein occlusion cases), the presence of vein-vein disc collaterals and the visual prognosis make it important to distinguish HRBVO cases from other branch vein occlusions. PMID- 3822393 TI - Sclerosing orbital pseudotumor. AB - Sclerosing orbital pseudotumor is a particular type of idiopathic inflammatory process, frequently located at the orbital apex. Both from clinical and from instrumental examination the diagnosis of these forms is difficult. The ineffectiveness of steroid treatment and the progressive visual loss in these patients favors surgical exploration. We report on 5 patients who underwent exploration yielding the diagnosis of sclerosing orbital pseudotumor. Surgery allowed correct histological diagnosis and improvement of ocular symptoms. PMID- 3822394 TI - Mechanical behavior of the sclera. AB - Induced deformations, similar to the posterior pole deformations due to advanced myopia, were studied in a series of 30 rabbits. The induced deformations were produced by means of a specially designed cup. An analysis of the applicability of the shell theory is made, and it is concluded that the thin shell theory is applicable to the mechanical study of the eyes. The basic experiment consisted of introducing a controlled deformation at different pressure levels; a wide range of types of increments and times of substained deformations were studied. It is concluded that the scleral tissue is an elastic material and has a fairly high 'Creep' rate. The material properties indicate that the eye can reaccommodate induced pressure, and thus glaucoma and myopia could be present without external indications of 'high pressure' in the eye. PMID- 3822395 TI - The normal visual field on the Humphrey field analyzer. AB - To provide a bank of normal perimetric data, we tested the central and peripheral visual fields of 102 novice normal subjects using the Humphrey automated perimeter. All eyes used for visual field testing were first carefully examined to be sure that they were, indeed, normal. We calculated population means and standard deviations of each test location and for each decade for age. Average differential light sensitivity decreased with advancing age: -0.5 dB/decade at fixation, -0.6 dB/decade in the central (30-2) field, and -06. dB/decade in the peripheral (30/60-2) field. However, neither the slope nor the shape of the hill of vision changed with aging. Short-term fluctuation was not constant throughout the visual field, but instead was greater in the periphery than the center. PMID- 3822396 TI - Significance of postgamma protein fraction in tears. AB - Tear protein electrophoresis identifies three principal groups of proteins designated as fast-migrating proteins, globulins and postgamma protein fraction. Postgamma fraction represents 32% of total tear protein content and is antigenically constituted by lysozyme as a unique component. The clinical usefulness of determining tear lysozyme content by means of electrophoresis is pointed out. PMID- 3822397 TI - [Clinical interpretation of retinal circulatory measurements. II. Blood flow]. AB - Beginning as early as the mid-4th decade of life, an age-dependent reduction in retinal blood flow has to be considered an essential risk factor for disorders of retinal microcirculation. Blood flow measurements are a valuable, but not the sole criterion of microcirculatory disorders. While in retinal occlusive diseases blood flow is a valuable indicator of the severity of microcirculatory disorders, the latter can also occur in the presence of normal and elevated blood flow values. Shifts of the metabolic activity of the retina and changes in the metabolic activity of the retina and changes in the metabolic conditions have to be taken into account when a clinical interpretation is given. PMID- 3822398 TI - [Clinical interpretation of retinal circulatory measurements. III. Blood flow velocity and vessel diameter in normal persons and in patients with venous occlusive diseases]. AB - Based on results from measurements of arterial blood velocity, arterial and venous diameters of major segmental retinal vessels in normal persons and in patients with venous occlusive diseases and in continuation of the two preceding parts of this series of articles, further possibilities for the differential diagnosis of measurements of retinal microcirculation magnitudes are discussed. Whereas the measurement of blood velocity is an important criterion for the assessment of the stasis conditions and the arterial involvement in an occlusive disease, the diameters of the vessels offer essential suggestions to local regulative processes. In this connection, a dependence on pH of the contraction state of the smooth vascular musculature detected in porcine coronary arteries is presented. By its transmission to the arterial retinal vessels, it is possible to unequivocally clarify the local regulative and pathological behavior of arterial retinal vessels in terms of flow physiology. PMID- 3822399 TI - [Surgical treatment of patients with unstable hip joints as a sequela of poliomyelitis]. PMID- 3822400 TI - [Stimulation of reparative osteogenesis in experimental aseptic necrosis of the head of the femur]. PMID- 3822401 TI - [Role of functional arthrography in choosing a method of treating congenital dislocation of the femur in young children]. PMID- 3822402 TI - [Surgical treatment of young children with congenital dislocation of the hip]. PMID- 3822403 TI - [Transposition of the hip joint]. PMID- 3822404 TI - [Errors and complications in osteotomies of the hip in children and their prevention]. PMID- 3822405 TI - [Indications and principles for modeling of the femoral head in degenerative dystrophic diseases of the hip joint]. PMID- 3822406 TI - [Non-free osteoplasty in the treatment of aseptic necrosis of the head of the femur]. PMID- 3822407 TI - [Leukocytic index of poisoning in coxarthrosis patients after total endoprosthesis of the hip joint]. PMID- 3822408 TI - [Our experience with the surgical treatment of gonarthrosis]. PMID- 3822409 TI - [Thermography in the evaluation of the temperature status of the joints of patients with gonarthrosis deformans]. PMID- 3822410 TI - [Friction properties of articular cartilage and various artificial materials]. PMID- 3822411 TI - [Experience with the treatment of fracture-dislocations of the femur]. PMID- 3822412 TI - [The site of decompressive surgery in the treatment of Perthes disease in children]. PMID- 3822413 TI - [Morphologic changes in epiphyseal cartilage after local cryoexposure]. PMID- 3822414 TI - [Effect of psychological traits of children with cerebral palsy on the efficacy of orthopedic-surgical treatment]. PMID- 3822415 TI - [Bilateral posteroiliac dislocation of the hips associated with fracture of the pelvic bones]. PMID- 3822416 TI - [Fractures of the femoral component of a hip endoprosthesis]. PMID- 3822417 TI - [Compression osteosynthesis using an Ilizarov apparatus in fractures of the femur after total endoprosthesis of the hip joint]. PMID- 3822418 TI - [Modification of arthrodesis of the hip joint]. PMID- 3822419 TI - [Specific features of ball lightning lesions]. PMID- 3822420 TI - [Degenerative-dystrophic diseases of the hip joint in children and adolescents (classification, diagnosis, treatment)]. PMID- 3822421 TI - [Surgical treatment of Perthes disease]. PMID- 3822422 TI - [Errors at the preoperative stage in the treatment of patients with peripheral nerve injuries]. PMID- 3822423 TI - [Functional rehabilitation treatment in traumatic shoulder dislocation]. PMID- 3822424 TI - [Magnetotherapy in the rehabilitation treatment of patients after operations on the hand]. PMID- 3822425 TI - [Computerized tomography of the femoro-patellar articulation in the normal state and in habitual dislocation of the patella]. PMID- 3822426 TI - [Levels and methods of amputation in patients with chronic arterial ischemia]. PMID- 3822427 TI - [Surgical preparation of patients for prosthesis after amputation of the foot]. PMID- 3822428 TI - [A method of studying the biomechanical properties of soft tissues of the supporting surface of the foot]. PMID- 3822429 TI - [Active hip prosthesis]. PMID- 3822430 TI - [Use of a fixator-tie rod for stabilizing the cervical vertebrae]. PMID- 3822431 TI - [Causes of failure in dermatoplasty using the Krasovitov method in the treatment of extensive avulsion wounds]. PMID- 3822432 TI - [Treatment of patients with rupture of the tendon of the supraspinous muscle]. PMID- 3822433 TI - [Treatment of dislocations of the acromial end of the clavicle]. PMID- 3822434 TI - [A modified method of fixation of the scapula]. PMID- 3822435 TI - [Modification of the Weber method of compression osteosynthesis]. PMID- 3822436 TI - [Weber's operation in fracture of the fibular head]. PMID- 3822437 TI - [Reposition of the malleoli after compound injuries of the ankle joint]. PMID- 3822438 TI - [Prosthesis in patients with amputation stumps of the feet]. PMID- 3822439 TI - [Surgical treatment of congenital hip dislocation in children]. PMID- 3822440 TI - [Indications for conservative and surgical treatment of diaphyseal fractures of long tubular bones]. PMID- 3822441 TI - [Complications of intramedullary osteosynthesis of the tibia and their prevention]. PMID- 3822442 TI - A comparison of heat shock protein induction in HeLa cells by heat and chemical treatments. PMID- 3822443 TI - Clinical electroencephalogram (EEG) of the workers in a lead refinery. PMID- 3822444 TI - Effect of in vivo administration of thyroid hormone on phosphate uptake of brush border membrane vesicles from kidney cortex of rachitic rats. PMID- 3822445 TI - [Gliadin and gliadophins: studies of structure and mechanism of action in lymphocytes in children with celiac disease]. PMID- 3822446 TI - [Chemical and bacterial hypersensitivity in patients with varicose leg ulcers]. PMID- 3822447 TI - [Differentiation between reversible and irreversible forms of stenosis of Oddi's sphincter]. PMID- 3822449 TI - [Main aspects and perspectives of a hospital-based integrated infant- and child care service--cui bono? Cui prodest?]. PMID- 3822448 TI - [Current questions of borderline areas between psychiatry and social policy]. PMID- 3822450 TI - [Forensic implications of emergency skull radiographies]. PMID- 3822451 TI - [Significance of the abbreviation CK-MB (creatine kinase-myoglobin binding)]. PMID- 3822452 TI - [Atypical forms of Pelger-Huet anomaly]. PMID- 3822453 TI - [Why do women not produce enough children?]. PMID- 3822454 TI - [Informative morphogenetic variations in children with congenital heart defects]. PMID- 3822455 TI - [Prenatal diagnosis of two different forms of epidermolysis bullosa by fetal skin biopsy]. PMID- 3822456 TI - [Secondary plasma cell leukemia (a multi-parameter study)]. PMID- 3822457 TI - [Anatomical variations of the thenar branch of the median nerve on the basis of 237 surgical findings]. PMID- 3822458 TI - [Laser therapy of recurrent tracheal chondroma]. PMID- 3822459 TI - [Acute emphysematous cholecystitis]. PMID- 3822460 TI - [Perinatal disorders in the etiology of hypopituitarism]. PMID- 3822461 TI - [Toxocariasis: experience based on a 6-year serologic study]. PMID- 3822462 TI - [Analysis of data on a group of patients with multiple myeloma 1977-1985]. PMID- 3822463 TI - [Treatment of patients with cerebrovascular disorders by isovolemic hemodilution]. PMID- 3822464 TI - Visual assessment with low-contrast letter charts. PMID- 3822465 TI - The effect of perimetric stimulation on evoked potential distribution--a theoretical model. AB - A schematic cortical projection of the human visual field is combined with the concept of dipole planar generators to provide a theoretical model of the scalp distribution of evoked potentials from visual field stimuli. The computations illustrate the importance of gyral surfaces as the principal generators of recorded evoked potentials. Taking several zones of the visual field projection on the striate area as an example, the model is used to produce horizontal profiles of evoked potential amplitude. This indicates the limitation and possibilities of mapping the cortical projections in man and relating these to perimetric findings. PMID- 3822466 TI - Displacement thresholds for continuous oscillatory movement: the effect of oscillation waveform and temporal frequency. AB - Displacement thresholds for continuous oscillatory movement of a grating, subtending 2 cycle deg-1, were measured for square-, triangular- and sine-wave oscillation over the frequency range 1-20 Hz. Without reference lines, thresholds were highly dependent upon temporal frequency and oscillation waveform. With reference lines, thresholds were dependent upon oscillation waveform but not frequency. Greatest sensitivity was shown to square-wave oscillation and least to triangular-wave. Results are discussed in terms of velocity- and displacement analysing systems. Increasing the spatial frequency of the sinusoidally oscillating grating had little effect on displacement thresholds. PMID- 3822467 TI - The effect of optical blur on visual acuity for targets of different luminances. AB - We studied the effect of 1.25 D of optical blur on visual acuity at luminances ranging from photopic to low mesopic levels. Optical blur reduces acuity at all luminances tested, this reduction being fourfold at a high photopic level (170 cd m-2) and twofold in low mesopia (0.017 cd m-2). The reduction of visual acuity with blur at low luminances is greater than might be expected from a spatial frequency analysis of vision. PMID- 3822468 TI - Anterior chamber pachymetry during accommodation in emmetropic and myopic eyes. AB - Optical pachymetry was performed on 15 nearly emmetropic and 15 myopic subjects with accommodation fully relaxed and with 3.00 and 6.00 dioptres of stimulus to accommodation. No significant difference was found between the change in anterior chamber depth per dioptre of stimulus between the two groups. This is in agreement with theoretical considerations, which suggest that a change in the length of the vitreous does not much affect the optical efficiency of the crystalline lens. PMID- 3822469 TI - A quasi-static study of accommodation in amblyopia. AB - A method named quasi-static recording of accommodation is introduced. While accommodative stimulus (AS) is slowly changed over a wide range with a constant velocity (0.2 D s-1), accommodative response (AR) is continuously measured. AS and AR, respectively, are recorded on the abscissa and the ordinate of an x-y recorder to produce a "quasi-static" response/stimulus curve. This method was applied to 28 monocular amblyopic and formerly amblyopic subjects, and the findings were compared with those from their sound eyes. The recordings and subsequent analysis show reduced accommodative amplitude and reduced accommodative accuracy in amblyopic eyes, similar to those reported in previous static measurements of accommodation. In about a half of the amblyopic eyes, the recordings reveal that the fluctuations of accommodation are greater as the target becomes closer. Increased microfluctuation associated with a loss of sensitivity to change of contrast is discussed. This phenomenon suggests that increased microfluctuation is directly associated with reduced performance. In three recovered amblyopes, the accommodative functions were considerably reduced, while the other 10 subjects showed improved functions. It is suggested that, in some cases, the abnormal accommodation is the cause of the amblyopia. PMID- 3822470 TI - Contrast sensitivity in pseudophakia and aphakia. AB - Contrast sensitivity was measured in pseudophakic and aphakic patients. No difference could be demonstrated between the contrast sensitivities of patients with anterior chamber/iris-supported and posterior chamber intraocular lenses (IOLs). Little difference was found between pseudophakics and aphakics. Interocular contrast ratios in five pseudophakic patients with normal fellow eyes revealed a range of contrast attenuation characteristics which may be attributed to the IOL and corneal and posterior capsule transmission. PMID- 3822471 TI - The elucidation and use of the effect of near fixation in congenital nystagmus. AB - It has frequently been reported that the spontaneous ocular oscillation in congenital nystagmats is less intense for near viewing than during distance fixation. The reason for this effect was sought, and the influences of monocular adduction, convergence and accommodation acting separately and synergistically were assessed. The frequent assumption that nystagmus intensity (amplitude and frequency) is determined by convergence angle (either symmetrical or asymmetrical) was confirmed, and it was found that binocular viewing was not necessary. An identical effect on nystagmus intensity could be created for distance fixation by the use of base-out prisms, and these were prescribed for constant wear in two congenital idiopathic nystagmats. Although nystagmus intensity was constantly reduced, no concomitant increase in binocular contrast sensitivity or Snellen visual acuity occurred. PMID- 3822472 TI - A comparison of the effects of cycloplegics on accommodation ability for distance vision and on the apparent near point. AB - The relationship between distance accommodation ability and the near point of accommodation (NPA) was investigated following the instillation of a cycloplegic. A high correlation between the two parameters was found (p less than 0.001). It is suggested that the effect of a cycloplegic may be more directly assessed using distance accommodation measurement and, in the case of young children, with more ease. A limit of 0.75 D of distance accommodation ability is suggested as a threshold for satisfactory cycloplegia. PMID- 3822473 TI - Binocular colour interaction. AB - Colour filters are used to modify the performance of colour normal subjects on the 100-Hue test. A short wavelength transmission (blue/green) filter is used in front of the dominant eye, and a long wavelength transmission (red/orange) filter is placed in front of the non-dominant eye. The change induced by the filters is then assessed monocularly and binocularly in an attempt to understand the processes involved in the binocular interaction of colour. The tentative conclusion is that the visual system uses a sampling procedure to obtain the best colour discrimination possible for a given set of viewing conditions. PMID- 3822474 TI - Two simple calculating schemes for use in ophthalmic optics--I. Tracing oblique rays through systems including astigmatic surfaces. AB - A ray tracing scheme using paraxial approximations is described to allow oblique rays to be traced through lenses or optical systems in which some or all of the surfaces may be astigmatic, even at different axes. It is based on consideration of the prismatic effects introduced at each surface. A numerical example reveals some lesser known properties of the circle of least confusion of astigmatic pencils. PMID- 3822475 TI - Definitions for hydration changes of hydrogel lenses. AB - Authors of studies on the hydration characteristics of hydrogel lenses have used a variety of definitions to describe the changes observed with exposure of the lenses to different environments. This has resulted in difficulties in the interpretation of published data. In particular, the single term "percentage dehydration" has been used to denote different mathematical expressions for alterations to the lens composition. A detailed theoretical analysis of hydrogel hydration levels is presented to examine definitions for lens hydration changes, compare results obtained under different definitions and propose appropriate usage for the alternative definitions according to the aspect of lens performance under consideration. The interrelationships between the commonly used definitions of dehydration are shown to be independent of initial lens mass but dependent on initial water content. Typically, higher water content lenses undergo considerably larger mass changes than lower water content lenses, an effect that may be masked if these changes are presented as changes of water content. There are a number of clinical consequences of lens dehydration, the importance of which will vary depending on the initial lens water content. It is therefore essential when comparing different water content lenses on the basis of the extent of dehydration to do so with respect to a specific clinical consequence rather than in general terms. PMID- 3822476 TI - Convergence insufficiency in a rural population. AB - Convergence insufficiency represents a significant problem in optometric practice. The percentage of cases in a rural area was compared with that in a previous sample from an urban area, with respect to the general incidence, and the effects of age and taking of medicines as an indicator of health. The percentage of convergence insufficiency in the rural area was about half that in the urban area, and the percentage taking medicines was about two-thirds. The incidence of convergence insufficiency increased with age in both populations. When both samples were taken together, the incidence of convergence insufficiency was three times greater in those taking medicines. PMID- 3822478 TI - On the interchangeability of standard plate tests for color vision. PMID- 3822477 TI - Changes in the orientation of the axis of astigmatism associated with age. AB - A new regression equation for the change in the axis of astigmatism with age, as deduced from cross-sectional studies, is presented. Possible artefacts arising from the methods used to obtain mean prescriptions are discussed; it is shown that these may result in over-estimation of the occurrence of oblique cylinders in middle-age and that a previously demonstrated gradual change of orientation of the axis of astigmatism may have no basis in reality. The need for further longitudinal studies is emphasized. PMID- 3822479 TI - Statistical concepts in the analysis of vision and visual acuity. PMID- 3822480 TI - Satisfying the presbyopic contact lens wearer. PMID- 3822481 TI - Legislature ends 1985-86 session in wee hours. PMID- 3822482 TI - The forbidden topic: medical unemployment. PMID- 3822483 TI - Friction-free BSE. Breast self examination. PMID- 3822484 TI - Clear-cell carcinoma metastasis to thyroid tissue. PMID- 3822485 TI - Tax reform and 'the big picture' for physicians. The Health Care Group. PMID- 3822486 TI - [Current status of pediatric surgery]. PMID- 3822487 TI - [Pierre Robin syndrome]. PMID- 3822488 TI - [Is the excretory urogram indicated as a routine study in children with hypospadias?]. PMID- 3822489 TI - [Stenosing tendovaginitis--a simple diagnosis to make?]. PMID- 3822490 TI - [Phimosis--preputial adhesion, a developmental physiologic condition or is treatment required?]. PMID- 3822491 TI - A model for the study of visceral pain states: chronic inflammation of the chronic decerebrate rat urinary bladder by irritant chemicals. AB - Normal healthy visceral tissue is largely insensitive to many kinds of tissue damaging stimuli, such as cutting, crushing or burning. When inflamed, however, visceral tissue frequently and easily elicits pain. Here we have produced inflammatory responses in urinary bladders of chronically decerebrated rats with irritant chemicals, as a model of a visceral pain state. The irritants used were 25% turpentine, 2.5% mustard oil, 2% croton oil. All produced a strong inflammatory response, as judged by protein extravasation and oedema, and invasion of the tissue with leucocytes, which started within hours of treatment. The inflammatory states were associated with hyperexcitable bladder reflexes; baseline pressures were larger at given volumes, and large micturition contractions occurred at lower volumes. These changes persisted for up to 48 h after a single treatment. The behaviour of the animals and their responsiveness to noxious stimulation were also assessed. In general animals were hypersensitive to noxious stimuli applied to the tail or caudal abdomen, with small or no changes in responses to hind limb or rostral abdominal stimulation. These irritants, particularly turpentine, applied to chronic decerebrate rats may thus provide useful models for studies of the neuronal processes which contribute to visceral nociception. PMID- 3822492 TI - Stereospecific potentiation of opiate analgesia by cocaine: predominant role of noradrenaline. AB - Cocaine hydrochloride (50 mg) pellets implanted subcutaneously in male Wistar rats potentiated the analgesia of morphine, levorphanol, methadone and buprenorphine as measured by the tail-withdrawal test. Potentiated opiate analgesia was abolished by naloxone and further enhanced by desipramine and phenoxybenzamine. Yohimbine, alpha-methyl p-tyrosine, haloperidol, zimelidine, methysergide, p-chlorophenylalanine produced no significant effect on potentiated opiate analgesia. Pseudo-cocaine (dextro-cocaine), which is several-fold less potent than cocaine as an inhibitor of noradrenaline and dopamine reuptake in the CNS, had no significant effect on opiate analgesia. Analgesia produced by low doses of baclofen, a GABA agonist, was also not potentiated by cocaine. This study suggests a predominant role for noradrenaline in the stereospecific potentiation of opiate analgesia by cocaine. PMID- 3822493 TI - The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. AB - The Varni/Thompson pediatric pain questionnaire (PPQ) represents an attempt to empirically assess the complexities of pediatric chronic, recurrent pain. This initial investigation targeted chronic musculoskeletal pain in children with juvenile rheumatoid arthritis. The PPQ provides a developmental step toward the comprehensive assessment of the pain experience in children with chronic pain. Further reliability and validity studies are needed to determine the generalizability of the PPQ with larger numbers of children with a variety of acute and chronic pain experiences across a diversity of settings. PMID- 3822494 TI - Referred sensations in chronic pain patients. AB - This clinical note describes an unusual phenomenon of referred sensation reported in a sample of 98 chronic pain patients during electrical stimulation. Thirty nine percent reported a variety of sensations referred to different parts of the body. Of these, 74% reported the sensations referred to the painful region. Among the sensations were paresthesias, pain, temperature changes, and pressure or constriction. The patients who had referred sensations had lower ratings of depression and had undergone more surgical operations than those who did not report referred sensations. Three case reports of patients with phantom limb pain are presented to illustrate the vividness with which these sensations are experienced. These data suggest that deafferentation due to disease, injury or other lesions of the CNS lead to a hypersensitivity and an increased likelihood of referred pain of long duration. PMID- 3822495 TI - Intraventricular morphine administration for control of chronic cancer pain. AB - Twenty cancer patients with severe chronic pain have been treated with intraventricular morphine sulfate. Adequate pain relief until death was achieved in 10 patients; 1 patient has been treated for 9 months and is still being treated. In 2 patients, the effects of the morphine sulfate on their unilateral pelvic pain wore off after 4 and 6 months because of tumor progression. At that time, they underwent chordotomy procedures elsewhere. The treatment was discontinued in 4 patients for reasons other than inadequate pain relief, such as medical complications or resolution of pain. In 3 patients, the procedure was abandoned when emotional and psychological factors interfered with pain control. Dose requirements of intraventricular morphine sulfate varied greatly, depending on the total daily dose of systemic narcotic intake at the onset of the study. Intraventricular morphine sulfate is a feasible and reliable method to achieve pain relief in selected cancer patients with severe chronic pain when the maximum tolerated dose of systemic narcotic analgesics has become insufficient to control their pain. PMID- 3822496 TI - Intravenous lidocaine infusion--a new treatment of chronic painful diabetic neuropathy? AB - In a randomized double-blind, cross-over study the effect of intravenous lidocaine (5 mg/kg body weight) on the symptoms and signs of painful diabetic neuropathy of more than 6 months duration has been evaluated. Using a clinical symptom scale, there was significant beneficial effect 1 and 8 days after lidocaine infusion compared to after saline infusion (P less than 0.05 and P less than 0.02, respectively). The duration of the individual effect ranged from 3 to 21 days. Lidocaine infusion had no effect on the objective measurements of neuropathy. Intravenous lidocaine infusion seems to be a new alternative treatment of chronic painful diabetic neuropathy. PMID- 3822497 TI - Dercum's disease (adiposis dolorosa). Treatment of the severe pain with intravenous lidocaine. AB - Dercum's disease (adiposis dolorosa) is associated with very painful subcutaneous fatty deposits normally localized to the lower extremities in which pain treatment is usually unsuccessful. Two patients with Dercum's disease have been treated repeatedly with intravenous lidocaine for several months each time resulting in immediate pain relief for 8 and 25 days respectively. Placebo infusions did not provide pain relief. Hereafter, the patients were treated with peroral mexiletine and again had complete pain relief. We conclude that intravenous lidocaine or peroral mexiletine may be an effective analgesic treatment in patients with Dercum's disease. PMID- 3822498 TI - Dorsal horn (convergent) neurones in the intact anaesthetized arthritic rat. I. Segmental excitatory influences. AB - Recordings were made from dorsal horn neurones in intact anaesthetized rats rendered polyarthritic by s.c. injection into the base of the tail, of Mycobacterium butyricum suspended in oil; the experiments were carried out during the acute phase of the illness (3-4 weeks post inoculation) during which hyperaesthesia occurred. The majority (60.8%) of the neurones studied had properties close to those of corresponding groups of units in healthy rats. These 'typical' neurones could be subdivided into convergent (13.2%), non-noxious (34.4%) and proprioceptive (13.2%) units. By contrast, and in agreement with a previous study in the unanaesthetized spinal arthritic rat, the segmental electrophysiological characteristics of the remaining large proportion of neurones were changed both in terms of the size and distribution of their excitatory receptive fields and their responsiveness to peripheral stimuli; these were designated as 'atypical' neurones. According to their electrophysiological properties, these neurones were differentiated as atypical convergent (27.8%) and atypical non-noxious (11.4%) units. The main qualitative difference between the typical and atypical neurones was that the atypical had an additional receptive field on the oedematous ipsilateral ankle and, in several cases, showed high levels of background activity with sometimes dramatic increases. By comparison with neurones recorded in healthy rats, quantitative data revealed other modifications: typical and atypical convergent neurones and atypical non-noxious neurones had larger classical excitatory receptive fields; while C-fibre responses evoked by transcutaneous electrical stimulation were facilitated in the case of typical convergent neurones, 47% of the atypical convergent neurones had no C-fibre responses, and when present (53%) the threshold for obtaining these C fibre responses was higher with suprathreshold stimuli producing a minimal number of spikes; in these cells, gentle mechanical stimuli gave rise to high rates of firing which sometimes resulted in dramatic, long lasting after-discharges. The possibility that typical convergent, atypical convergent and atypical non-noxious neurones were derived from the homogeneous population of convergent neurones in the healthy rat is discussed; the atypical properties could be the result of a change in the characteristics of convergent neurones, resulting from arthritis. PMID- 3822499 TI - Local and remote modifications of nociceptive sensitivity during carrageenin induced inflammation in the rat. AB - The modifications of the threshold for vocalization induced by pressure on the paws (both hind paws and both forepaws) were monitored at different times (15 min 96 h) following intraplantar injection of the polysaccharide carrageenin in the rat. During the first 2 h following the carrageenin injection, a decrease in vocalization threshold was observed not only for the right, injected hind paw, but also, in some rats, on paws distant from the inflamed plantar region, especially the right forepaw. This hyperalgesic effect was suppressed by locally administered Xylocaine into the right hind paw. During the 4 days following the injection, the number of rats hyperalgesic in the injected paw progressively declined. Twenty-four hours after the carrageenin injection, only a few rats still presented a clear hyperalgesia in the non-injected paws. PMID- 3822500 TI - Collateral sprouting in skin and sensory recovery after nerve injury in man. AB - Two different modes of cutaneous sensory reinnervation are thought to be engaged following nerve injury: regenerative growth of the injured nerve and 'collateral sprouting' of neighboring intact nerves. Although both processes are well known from experimental preparations, there is little unequivocal documentation of collateral sprouting in human skin. We report here on 5 patients in whom at least partial recovery of sensation in the hand following traumatic or surgical nerve section was apparently based on collateral sprouting from nerves that had not themselves been injured. Two types of evidence are brought. In three of the cases a totally anesthetic region of skin at a distance from the site of injury was shown to recover sensitivity long before regenerating nerve fibers could have arrived, given the known rates of fiber outgrowth. In the remaining two cases, nerve blocks using local anesthetics were used to establish that the reinnervated skin was served by a nerve other than the injured one. Thus, collateral sprouting appears to contribute to cutaneous sensory recovery in man as well as in animals. PMID- 3822501 TI - Pain and personality profiles in burning mouth syndrome. AB - The McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 72 subjects with burning mouth syndrome (BMS) who were also requested to match the levels of their clinical pain to line lengths on a visual analogue scale (VAS) and to experimentally induced warm and painful thermal stimuli. The responses of 102 toothache pain subjects and 43 asymptomatic age- and sex-matched control subjects were used to compare the responses of the BMS subjects on the MPQ and MMPI, respectively. The results indicated that BMS pain is quantitatively similar to, but qualitatively different from, toothache pain, that self-reports of BMS pain appear to be valid, that when compared to the asymptomatic control subjects, BMS subjects show elevations in certain personality characteristics which are similar to those seen in other chronic pain patients, and that these personality disturbances tend to increase with increased pain. Therefore, our findings indicate that the pain of BMS is more severe than has previously been suggested and that the severity of this pain may explain some of the personality changes which occur in the BMS subjects. PMID- 3822502 TI - Psychophysical assessment of tactile, pain and thermal sensory functions in burning mouth syndrome. AB - Tactile, two-point discrimination, thermal change detection and heat pain thresholds as well as oral stereognostic ability, warmth scaling and heat pain tolerance were compared in a group of 72 subjects with burning mouth syndrome (BMS) and 43 age- and sex-matched control subjects. No differences were found between the BMS and control subjects for any of the sensory modalities tested except for heat pain tolerance. Pain tolerance was significantly decreased for the BMS subjects at the tongue tip, a site of clinical pain in approximately 85% of the subjects tested in this study, but not at the cutaneous lower lip which was a site of pain only in approximately 17% of the subjects tested in this study. In addition, no differences in heat pain tolerance were found at the cutaneous lower lip between the control subjects and the BMS subjects who reported pain on the mucosal lower lip (approximately 49% of subjects), but heat pain tolerance was significantly decreased at this site for those BMS subjects tested without pain on the mucosal lower lip (approximately 51% of subjects). These findings do not suggest a psychogenic origin for the alteration of heat pain tolerance in the BMS subjects, but suggest instead specific changes in their peripheral or central sensory functions. PMID- 3822503 TI - The development of a German language (Berne) pain questionnaire and its application in a situation causing acute pain. AB - The adjectives used in the McGill Pain Questionnaire were translated into German. Nine of the 76 adjectives could not be translated satisfactorily. Accordingly, 10 new German adjectives were added by 22 physicians and psychologists, who were also asked to judge the grouping of the words and how adequately they express pain. Concordance of grouping was reached by more than 82% of the raters. The adjectives were assigned to 20 groups. In a next step 80 subjects assessed the words in each group on a visual analogue scale (VAS) with respect to intensity: for 3 of the 20 groups we found no difference in intensity between the adjectives within a group. They were not retained in the final version tested. Additionally each group was reduced to 3 adjectives by dropping the least discriminating words of each group; 17 groups of 3 words each were retained. In a third step a comparably composed group of 82 subjects rated the words in each group on VAS with respect to intensity: for each of the 17 triads there was a significant overall difference between the 3 adjectives on the VAS. In all but 4 of the 17 triads all 3 possible pairwise differences were significant as well. In spite of the significant differences of mean values there was considerable disagreement in individual intensity rankings of the 3 adjectives within the 17 groups. The validity of the German language (Berne) pain questionnaire (BPQ) was tested together with a verbal rating scale (VRS) and a VAS in a double-blind, complete cross-over study. A low osmolar (LO), a high osmolar (conventional) (HO) compound and 0.9% NaCl (placebo) (PL) were injected intra-arterially in patients with arteriovascular disease. We expected the LO compound to cause much less pain than the HO compound. The 3 conditions HO, LO and PL had significantly different effects on all 4 scales: VAS, VRS, RaW (scale of rank of words), and NoW (scale of number of words). The pairwise comparisons of PL with HO and LO resulted in significant differences also. The square of the correlation r for VAS/VRS was 0.64, for RaW/NoW 0.61, all other possible correlations were not significant. Our conclusions are: the translation of the MPQ into German was successful, and its validity could be shown. In our experiment, it differentiated acute, short lasting pain as well as the visual analogue and the verbal rating scales. The BPQ is a tool worth being examined in the laboratory and in studies of clinical pain syndromes. PMID- 3822504 TI - Reflex sympathetic dystrophy in a patient with pre-existing torsade de pointes. AB - A case is presented of a patient with pre-existing torsade de pointes who developed reflex sympathetic dystrophy. A trial of stellate ganglion blocks with ECG monitoring was instituted and the patient obtained relief. The pathophysiology of torsade de pointes is discussed with emphasis on the role of the stellate ganglion. Recommendations for management of similar patients are made. PMID- 3822505 TI - Complex temporal changes in 5-hydroxytryptamine synthesis in the central nervous system induced by experimental polyarthritis in the rat. AB - The purpose of this study was to investigate modifications of 5-HT synthesis in a chronic pain model, the arthritic rat, at different times after the inoculation with Freund's adjuvant. This study confirms our previous findings that experimental induced polyarthritis is associated with a marked increase in free tryptophan levels in serum. During the acute phase of the disease (15-21 days after the adjuvant), the general increase in 5-HT synthesis observed in the CNS appeared to be related to an increase in tryptophan availability due to the elevation of free tryptophan in serum. During the post-acute phase of the disease (28-42 days after the adjuvant), the level of free tryptophan in the serum remained markedly increased but the levels in the CNS tended to return to normal values in all areas examined. At 42 days, 5-HT synthesis in the brain had also returned to normal values but was further increased at the spinal level. In addition, although 5-HT levels and 5-HT synthesis were increased in the dorsal as well as in the ventral part of the cord, an increase in the rate of disappearance of the amine after blockade of the decarboxylase (benserazide) was only observed in the dorsal part. This result tends to suggest that the descending serotonergic system projecting to the dorsal horn is preferentially activated during chronic pain. PMID- 3822506 TI - Analgesic efficacy in experimental and clinical pain. PMID- 3822507 TI - [Amino acids and their metabolites in Eimeria tenella (Coccidiida) oocysts]. AB - The amino acid composition of protein in the oocysts of Eimeria tenella has been studied in detail by using the new method of purification of the coccidial oocysts. 35 amino acids and their metabolites have been established for the first time at the exogenous stages of development of E. tenella. The oocyst sporulation is noted to be followed by quantitative changes of the majority of free amino acids and their metabolites. PMID- 3822508 TI - [New subspecies of black flies Chelocnetha angustitarsis zaporojae ssp. n. (Simuliidae) from the steppe zone of the Ukraine]. AB - A new subspecies of simuliids, Chelocnetha angustitarsis zaporojae Pavlichenko ssp. n., from the steppe zone of the Ukraine is described. The subspecies is characterized by a peculiar structure of genital appendages of imago and a smaller number of rays in a big flabellum of larval mandibles. PMID- 3822509 TI - [Characteristics of the localization of Ancyrocephalus paradoxus (Monogenea) on the pike perch Stizostedion lucioperca]. AB - In one summer old fishes of the pike perch, caught in the K urish Gulf of the Baltic Sea in August-September of 1984, at 100% infection with A. paradoxus 94% of monogeneans were localized under the lower anterior angle of the operculum on the lateral surface of the intergill space (isthmus). In fishes 1+ on the isthmus there were found 52%, in pike perches 2+ 42%, and in fishes 3+ 67% of worms. In older fishes (4-10+) the number of worms on the isthmus accounts for 5% of their total number while others are localized on gill filaments. Variability of sizes, chitinoid structures and microlocalization of worms depending on the age of fish were established. PMID- 3822510 TI - Environmental sodium regulates cutaneous sugar transport in a digenean fluke. AB - Glucose uptake was examined in adult specimens of Proterometra macrostoma (Trematoda: Digenea) recovered from the stomach (endoparasites) and gills (ectoparasites) of longear sunfish, Lepomis megalotis. The endoparasitic forms transported glucose directly through the external body surface by Na+ independent, facilitated diffusion, but the ectoparasites absorbed glucose by free diffusion alone. To determine how this transport function is regulated, cercariae were incubated in solutions having Na+ concentrations normally found in fish gut (50 mM) and in fresh water (0.5 mM). Glucose transport capacity was retained in 50 mM Na+, but disappeared in worms incubated for 1-3 days in 0.5 mM Na+. Returning worms from the latter solution to one containing 50 mM Na+ fully restored glucose transport within a day. By contrast, incubation up to 5 days in 0.5 mM Na+ had no effect on glucose transport in endoparasitic adults of P. macrostoma and cercariae of P. edneyi. Thus, cutaneous sugar transport function in the migrating larva of P. macrostoma is subject to indirect regulation by environmental Na+. PMID- 3822511 TI - Ovarian development of Corynosoma semerme (Acanthocephala) during experimental infections in rats. AB - The general structure and aspects of the development of the ovaries of the palaeacanthocephalan Corynosoma semerme were studied by transmission electron microscopy using worms varying in age from 18 to 90 h obtained from experimental primary infections in hydrocortisone-treated rats instead of seals, which serve as the natural definitive hosts. The observations can be interpreted to show that the immature ovaries become transformed relatively rapidly from cellular spheres to the more complex mature ovaries consisting of the supporting and oogonial syncytia and the germ-line cells. The supporting syncytium developed before the oogonial syncytium. The cytological appearance of ovaries from worms from rats was found to be similar to that of ovaries from mature worms of unknown age from naturally infected seals. Ecological evidence is considered to suggest that the rapid maturation of C. semerme in rats may also occur when the parasite becomes established in seals. PMID- 3822512 TI - Occurrence and biochemical characteristics of cestode lymphocyte mitogens. AB - The cestodes Echinococcus granulosus, Taenia multiceps, T. pisiformis, T. hydatigena, Hymenolepis diminuta, Moniezia expansa and Anoplocephala perfoliata all produced substances that stimulated thymidine incorporation by whole blood lymphocyte cultures. This mitogenic activity was demonstrated in metacestode cyst fluids, live protoscoleces and scoleces, parasite culture supernatants, and extracts of adult parasites. T. multiceps metacestode cyst fluid mitogen adhered to, but would not pass through, cellulose dialysis tubing. This adherence was reduced or prevented by D-glucose and by proteins. The mitogen was weakly anionic. With Sephadex G75 gel filtration, its elution volume was greatly decreased when the elution buffer contained 0.5 M D-glucose. Mitogenic activity was protease resistant and could be separated by gel filtration from all the cyst fluid proteins. PMID- 3822513 TI - Population dynamics in echinococcosis and cysticercosis: evaluation of the biological parameters of Taenia hydatigena and T. ovis and comparison with those of Echinococcus granulosus. AB - An evaluation has been made of the biological and epidemiological parameters that determine the basic reproductive rates of Taenia hydatigena and T. ovis. These host-parasite systems are characterized by (i) no overcrowding in either host; (ii) no parasite-induced mortality of either host; (iii) no density-dependent constraint in the definitive host, but a strong, rapidly mobilized, short-acting immunity in the intermediate host and (iv) egg production which, in the natural environment, is high enough to prevent superinfection. It is considered that tapeworms with these characteristics are more stable to fluctuations in environmental conditions and to control measures such as dog dosing, than species which have a low egg production and infectivity such as Echinococcus granulosus. Reciprocal immunity exists between T. hydatigena and T. ovis in sheep. Exposure to T. hydatigena suppresses infection by T. ovis, but not by E. granulosus. This has important epidemiological consequences where these parasites co-exist. PMID- 3822514 TI - Population dynamics in echinococcosis and cysticercosis: mathematical model of the life-cycles of Taenia hydatigena and T. ovis. AB - It is shown that under the conditions that prevailed in New Zealand in the late 1950s, Taenia hydatigena was hyperendemic, the life-cycle being regulated by a density-dependent constraint in the form of acquired immunity, and T. ovis was rare. The control measures that caused Echinococcus granulosus, which was endemic at the time, to decline towards extinction reduced T. hydatigena and T. ovis to endemic status only. A non-linear integrodifferential equation model, which was previously linearized to describe the life-cycle of E. granulosus in dogs and sheep in New Zealand, is used to describe the life-cycles of T. hydatigena and T. ovis. The model is then used to compare and contrast the population dynamics of these three species. The model is used to demonstrate that the endemic steady state is structurally unstable, and may be asymptotically unstable to small perturbations. It is also shown that despite the lower infection pressure experienced by the intermediate host in the endemic state, the numbers of larvae in sheep may be higher than in the hyperendemic state. Finally it is shown that the partial success of the control measures against T. hydatigena may have caused an increase in the numbers and prevalence of T. ovis larvae in sheep due to the reciprocal immunity between the two species. PMID- 3822515 TI - Geographic pathology of the Australasian and South-East Asian regions. PMID- 3822516 TI - Test and teach. Number fifty-four. Diagnosis: Myxoglobulosis occurring in a retention cyst type mucocele of the appendix. PMID- 3822517 TI - Test and teach. Number fifty-five. Diagnosis: Visceral leishmaniasis (kala-azar), hepatic involvement. PMID- 3822518 TI - Carcinoma of the esophagus. An autopsy study of 231 cases. AB - Autopsy findings for 231 cases of carcinoma of the esophagus are presented. Cases with tumour resection constituted 57% of the series. Residual malignancy was present in 81% of all cases. Local residual or recurrent tumour was found in 53%, lymph node metastases in 65% and visceral metastases in 54% of cases. Intrathoracic lymph node metastases were present in 41% of patients after tumour resection and were probably significant in the failure of radical surgery. Adequate clearance of intrathoracic lymph nodes during radical surgery may reduce the incidence of tumour recurrence in this group of patients. Survival was poor in patients with or without resection of the primary tumour. Less than 12% were alive 1 yr after presentation. The average duration of dysphagia at presentation was 2.5 mth. The poor survival of our patients suggests that, by the time they presented clinically, the disease was already advanced. Early disease detection is important for a chance of cure in patients with esophageal cancer. PMID- 3822519 TI - The inheritance of abnormal sialoglycoproteins found in a Gerbich negative individual. AB - The Gerbich blood group antigens are probably expressed on one or more of the minor erythrocyte (beta, beta 1, or gamma) sialoglycoproteins which are lacking in some rare individuals having the Gerbich negative phenotype. A monoclonal antibody, CMRF-10, which recognises a trypsin-sensitive site on both the beta and beta 1 sialoglycoproteins, was tested for binding to erythrocytes from a Gerbich negative individual, OM. Erythrocytes from OM bound CMRF-10 in similar amounts to normal erythrocytes even though membranes from OM were shown by sodium dodecyl sulphate-polyacrylamide gel electrophoresis to lack both the beta and gamma sialoglycoproteins found in normal red blood cells. Instead, abnormal sialoglycoproteins which migrated as two bands with apparent molecular weights within the range 29,500-32,500 daltons were identified and purified using CMRF 10. Subsequent electrophoretic analysis of OM's two children failed to reveal any abnormal sialoglycoproteins. This suggests that in this instance the Gerbich negative phenotype may result from other mechanisms, possibly defective glycosylation, rather than a crossover involving the gene coding for the primary protein structure of the sialoglycoproteins. PMID- 3822520 TI - Primary extranodal non-Hodgkin's lymphoma. AB - A total of 52 of 238 patients (22%) with non-Hodgkin's lymphoma presented with disease in a primary extranodal site. The gastrointestinal tract was the commonest site involved (50%) and diffuse large cell was the commonest histological sub-type of the lymphoma (64%). Survivorship analysis of these patients, treated predominantly with chemotherapy, suggests that long-term survival is associated with: low-grade malignancy--median survival greater than 120 months; localized disease or spread of disease confined to the regional lymph nodes--median survival 65.5 months; and the use of aggressive combination chemotherapy for intermediate grade malignancy when the disease is localized or spread is confined to the regional lymph nodes--median survival greater than 110 months. PMID- 3822521 TI - Glomerular permeability in the isolated perfused rat kidney. AB - Increased glomerular permeability to protein occurs during isolated rat kidney perfusion in the absence of ultrastructural changes in the glomerular capillary wall. The increase is greater with age, varies with strain and is reduced by amino acid supplementation of the perfusate. Glomerular permeability to protein is thus perceptibly influenced by non-pathogenic stimuli. Such phenomena, in turn, may influence glomerular function in disease or after experimental damage. PMID- 3822522 TI - Renal and urinary tract complications following the intravesical instillation of formalin. AB - The case is reported of a 10-yr-old girl who developed intractable hematuria from hemorrhagic cystitis following chemotherapy for a malignant lymphoma. Following the intravesical instillation of formalin, which controlled the hematuria, she developed oliguria attributable to ureteric stenosis and fibrotic contraction of the renal pelves. Bilateral nephrostomies were constructed, but recurrent pyelonephritis and further renal pelvic obstruction developed. A series of renal biopsies and ultimately bilateral nephrectomy revealed severe, chronic interstitial nephritis, massive renal interstitial accumulation of deposits probably containing Tamm-Horsfall protein and, in the left nephrectomy specimen, a florid interstitial chronic granulomatous inflammatory reaction. Although ureterohydronephrosis has been described by others as a complication of the intravesical instillation of formalin, fibrotic contraction of the upper urinary tract and the florid interstitial nephritis with granulomata as described herein have not previously been reported. It is proposed that vesicoureteric reflux of formalin, perhaps accompanied by intrarenal reflux, caused or contributed to these pathological changes. PMID- 3822523 TI - Epithelioid hemangioendothelioma of the liver. Report of two cases histologically mimicking veno-occlusive disease. AB - This report describes two patients with epithelioid hemangioendothelioma presenting with multiple tumour nodules in the liver, but without evidence of tumour elsewhere. One patient died in liver failure twelve months after presentation. The other patient has been well for over two years. Histologically the tumours were remarkably similar, being composed of a proliferation of primitive endothelial cells embedded in a myxohyaline stroma, infiltrating central veins, hepatic sinusoids and, to a lesser extent, terminal portal venules. In each case an initial mistaken histological diagnosis of veno occlusive disease was made. PMID- 3822524 TI - Superficial spreading malignant melanoma with neurosarcomatous metastasis. AB - A case of neurosarcomatous nodal metastasis of superficial spreading malignant melanoma, without primary site desmoplasia or sarcomatous changes, is reported. Of particular interest regarding the metastasis are: the ultrastructural demonstration of numerous cytoplasmic microtubules, absence of premelanosomes, intense immunohistochemical reaction with S-100 protein antibody, and the presence, at the light microscopic level, of extranodal fibrosis. The primary lesion shows a pre-existing benign nevus and features suggestive of lamellar fibroplasia. The origin and histogenesis of melanocytic desmoplasia, in the context of a neural crest progenitor cell, and of lamellar fibroplasia, are discussed. PMID- 3822526 TI - Clerical accuracy in the laboratory. PMID- 3822525 TI - One or two cell types in papillary carcinoma of the breast? PMID- 3822527 TI - [Role of lipid peroxidation in the pathogenesis of periodontal damage in stress]. PMID- 3822528 TI - [Interrelation of blood supply and the regional mechanical function of the myocardium in acute coronary occlusion]. PMID- 3822529 TI - [Energy expenditure in the contractile function of the myocardium in hemorrhagic shock]. PMID- 3822530 TI - [Isoptin in the prevention of post-resuscitation damage of the heart]. PMID- 3822531 TI - [Changes in microhemocirculation in various types of shock and collapse and the evaluation of their possible use as prognostic criteria]. PMID- 3822532 TI - [Oxygen tension indicator in evaluating the severity of the course and outcome of experimental shock]. PMID- 3822533 TI - [Dynamics of the accumulation of K+ and H+ in the extracellular space and myocardial contraction in ischemia]. PMID- 3822534 TI - [Adrenergic reactivity of blood vessels of the femoral artery pool in post transfusion shock]. PMID- 3822536 TI - [Role of the endocrine system in the development of hypocalcemia in shock]. PMID- 3822535 TI - [Characteristics of the sympathetic and parasympathetic mechanisms of regulating blood circulation after deep normovolemic hemodilution]. PMID- 3822538 TI - [Myocardial oxygen supply in the isolated rat heart after its perfusion with an erythrocyte suspension and Krebs' solution]. PMID- 3822537 TI - [Changes in taurine and tryptophan metabolism after combined radiation-thermal injury]. PMID- 3822539 TI - [Indicator enzyme activity in the blood serum as an index of disorders of oxygen homeostasis in emergency conditions]. PMID- 3822540 TI - [Vasoactive properties of medium molecular-weight peptides isolated from the blood of dogs with thermal burns]. PMID- 3822541 TI - [Circulating blood plasma proteins in prolonged blood loss]. PMID- 3822542 TI - [Constant potential level of the human brain in the young, mature and aged]. PMID- 3822544 TI - [Improving the method of blood reinfusion in the modeling of terminal states caused by blood loss]. PMID- 3822543 TI - [Role of bacterial pyrogen in the development of antidiuresis in fever]. PMID- 3822545 TI - [A method of detecting the ends of regenerating axons in experimental nerve injury]. PMID- 3822546 TI - [Phospholipid metabolism in subcellular structures of the rat brain during ischemia and at various periods after restoration of blood circulation]. PMID- 3822547 TI - [The male gonad in acute and chronic alcoholic intoxication. II. Spermatogenesis]. PMID- 3822548 TI - [Changes in the subendothelial layer of the main artery in the early period of experimental arteriosclerosis in rats: histologic, histochemical and ultrastructural studies]. PMID- 3822549 TI - [Neoplastic diseases in sheep in the Wielkopolska region (analysis of autopsy data of the Institute of Veterinary Hygiene in Poznan 1977-1984]. PMID- 3822550 TI - [Effect of lathyrogen on the collagen in Guerin epithelioma]. PMID- 3822551 TI - Terminal erythrohepatic protoporphyria. PMID- 3822552 TI - [The male gonad in acute and chronic alcoholic intoxication. I. Histopathologic studies]. PMID- 3822553 TI - [Trabecular carcinoma of the skin (Merkel cell carcinoma)]. PMID- 3822554 TI - [Enzinger's clear cell sarcoma. Case report]. PMID- 3822555 TI - [Evaluation of bone marrow hemosiderin in a case-load of bone marrow biopsies with special reference to situations with high iron deposits]. PMID- 3822556 TI - [Histological and chemical study of 26 cases of copper I.U.D. users]. PMID- 3822557 TI - [Early gastric cancer. Considerations on the case load at the Anatomy and Pathologic Histology Service of the Pistoia Hospital 1979-1984]. PMID- 3822558 TI - [Diffuse malignant mesothelioma of the peritoneum and exposure to asbestos]. PMID- 3822559 TI - Inverted urothelial papilloma. Report of five cases and review of the literature. PMID- 3822560 TI - [Demyelinating disease. Morphological and etiopathogenetic up-date]. PMID- 3822561 TI - [Metaplastic endometrial carcinoma. Histological review of 411 cases with a histochemical study of 30 cases]. PMID- 3822562 TI - [Estrogen and progesterone receptors in cancer of the female breast: correlation with the age of the patients, fertility status, tumor stage and grading]. PMID- 3822563 TI - [Influence of deoxycorticosterone on the biosynthesis of collagen and on the development of hepatic steatonecrotic lesions caused by carbon tetrachloride in the rat]. PMID- 3822564 TI - [Leiomyosarcoma of the bladder. Presentation of a case and review of the literature]. PMID- 3822566 TI - [Quantitative bacteriology in infections of the subglottic respiratory tract]. PMID- 3822565 TI - Oral contraception, ovarian disorders and tobacco in myocardial infarction of woman. PMID- 3822567 TI - [Hodgkin's disease in the Monfalcone area]. PMID- 3822568 TI - [Bronchocentric granulomatosis. Description of a case]. PMID- 3822569 TI - [Lennert lymphoma arising in a cystadenolymphoma]. PMID- 3822570 TI - [Lipoblastic tumor in young adults: myxoid liposarcoma or benign lipoblastoma? Presentation of a case]. PMID- 3822571 TI - Recognizing and dealing with alienated youth in clinical practice. PMID- 3822572 TI - Intra-family sexual abuse of adolescents. PMID- 3822573 TI - Working with gay and lesbian adolescents. PMID- 3822574 TI - The pediatrician's role in adolescent suicide. PMID- 3822575 TI - Physician attitudes and approaches to the problems of youth. A report from the Upper Midwest Regional Physicians Survey. PMID- 3822576 TI - Interviewing the adolescent. PMID- 3822577 TI - Sonographic examination of the brain stem area in infants. An echographic and anatomic analysis. AB - For differentiation of diseases with impaired cerebrospinal fluid circulation and pathological alterations of the midbrain an exact and reproducible sonographic visualization of the brain stem area is of paramount importance. The approach through the anterior fontanelle has proved to be insufficient to accomplish this task. Therefore, we have developed 5 standard sonographic sections enabling detailed study of the brain stem. Typical sonographic views are compared with equivalent anatomical brain sections. To date, 330 infants have been examined using this method, making evaluation of brain stem, aqueduct, fourth ventricle, basilar artery and basal cisterns possible. PMID- 3822578 TI - Central venous silastic catheters in newborns: localization by sonography and radiology. AB - The positioning of various central venous catheters in newborns including very thin silastic catheters has been checked by sonography. Even the very thin silastic catheters are easily detectable owing to their strong echoes. Diverse malpositions are presented, including non-central positioning detected by sonography. The frequency of control radiographs could be reduced. PMID- 3822579 TI - Ilio-psoas abscess: diagnosis and management. AB - The triad of fever, limp, and pain in the flank, pelvis or leg often leads to the evaluation of the hip, genitourinary or gastrointestinal system. In the past 6 years, at our hospital, five adolescents and one young adult with these symptoms have had an ilio-psoas abscess, all diagnosed by ultrasonography. Once the diagnosis was established, four patients were treated successfully by percutaneous retroperitoneal drainage guided by ultrasonography or computed tomography. Catheter drainage averaged 11 days accompanied by appropriate antibiotics. The remaining two patients had surgical transperitoneal drainage. Growth of Staphylococcus aureus, from an ilio-psoas abscess indicates that the process is primary in origin. Growth of fecal flora suggests an intra-abdominal process and warrants further investigation. Ilio-psoas abscess can be readily diagnosed by ultrasonography or computed tomography and treated by percutaneous retroperitoneal drainage. PMID- 3822580 TI - Association of congenital megacalycosis and ipsilateral segmental megaureter. AB - Four cases of congenital megacalycosis associated with ipsilateral segmental megaureter in children are presented. This association has not been emphasized, although review of the English and French literature revealed eight such cases. In all cases, the concurrent entities are unilateral, with a left-sided predominance and a male prevalence. The diagnosis of megacalycosis is presumed in four of the cases by normal function and prompt emptying of the calyceal systems on diuretic renography and/or urography. The presence of normal caliber renal pelvis interposed between the dilated collecting system and the distal dilated ureter without evidence of vesicoureteral reflux implies the coexistence of ipsilateral idiopathic megaureter. The patients usually present because of urinary tract infection and/or calculus formation, but respond well to conservative therapy. PMID- 3822581 TI - Cervical spine fractures and dislocations in children. AB - A retrospective analysis of pediatric admissions over 10 years revealed 29 patients with cervical spine injuries. Eleven patients were below 12 years of age, and 10 of these had injuries involving C1, C2, or the occipitoatlantal articulation. Eighteen patients were between 12 and 16 years of age with injuries distributed throughout the cervical spine similar to injuries in the adult population. Our results suggest that teenagers with suspected cervical injuries are best evaluated by an adult radiographic series including trauma oblique views. In younger patients, careful evaluation of occipitoatlantoaxial alignment and the prevertebral soft tissues is required for diagnosis and selection of additional imaging evaluation. PMID- 3822582 TI - Radiology and histopathology of the bent limbs in campomelic dysplasia: implications in the aetiology of the disease and review of theories. AB - The study of the bent bones in a case of campomelic dysplasia and a review of the literature suggest a repair process at the site of angulation. A theory that can explain most of the features of the disease is presented; it supposes a damage of the cartilage model at the midshaft, followed by a fracture of the thin bone collar in the earlier stage of ossification of the diaphysis. PMID- 3822583 TI - Radiological rickets in extremely low birthweight infants. AB - Forty-eight infants of birthweight less than 1000 g who survived for more than 28 days, had wrist X-rays to prospectively determine the incidence of radiological rickets. Twelve infants (25%) had normal X-rays throughout, 10 infants (21%) showed osteopenia and 26 infants (54%) had classical changes of rickets of which 8 (17% of the total) had spontaneous fractures. There was poor correlation between peak values of serum alkaline phosphatase and the radiological changes. PMID- 3822584 TI - MRI of mumps encephalitis: comparison with CT evaluation. AB - The evaluation of a patient with mumps encephalitis by computed tomography (CT) and magnetic resonance (MR) imaging is reported. Correlation of findings on MR and CT in relation to clinical symptoms is presented. MR was found to be more sensitive in the number of lesions detected (11) as compared to CT (3). Thus, it seems that MR imaging may be a sensitive diagnostic adjunct in cases of suspected viral encephalitis. PMID- 3822585 TI - Diagnosis and evaluation of esophageal atresia by direct sagittal CT. AB - Direct sagittal CT is possible in newborns because of their small body-size. With this noninvasive investigation, we were able to establish a correct diagnosis in two neonates with esophageal atresia. Moreover, the demonstration of the air filled proximal pouch and distal tracheoesophageal fistula along their whole lengths allowed exclusion of the possibility of a proximal pouch fistula and gave knowledge of the exact distance of the two segments of the esophagus needed to be bridged to allow anastomosis, thus providing additional valuable information for the surgeon preoperatively. PMID- 3822586 TI - Inflammatory fibroid polyp of the stomach in a child. AB - A large inflammatory fibroid polyp of the stomach with endo-exophylic growth is described in a 5-year-old. CT and UGI demonstrate the lesion. PMID- 3822587 TI - Perirectal mucocele after imperforate anus repair. AB - A large perirectal mucocele developed in a child over an 11-year period following repair of an imperforate anus. Renal failure and large bowel obstruction secondary to compression by the mass were the presenting symptoms. Computed tomographic evaluation of the pelvis was critical for preoperative assessment of this previously unreported complication of imperforate anus repair. PMID- 3822588 TI - Increased CT density of the liver due to cis-diaminedichloro platinum (II). AB - Unusually increased CT density of the liver parenchyma after administration of cis-diaminedichloro platinum (II) (CDDP) is presented. This patient has neither a history of blood transfusion nor of iron overload. Therefore, CDDP which includes the heavy metal, Platinum, in its molecule was considered to be the only agent responsible for increasing the CT density. PMID- 3822589 TI - Oxygen toxicity in neonatal rats: the effect of endotoxin treatment on survival during and post-O2 exposure. AB - Neonatal rats were treated with low doses of bacterial lipopolysaccharide (endotoxin) to test for a protective effect of endotoxin against O2 toxicity and the severe inhibition of normal lung development which occurs during prolonged exposure to hyperoxia. The rationale for the prophylactic use of endotoxin included its marked protective effect against pulmonary O2 toxicity in adult rats and its lung growth-promoting effect in experimental pulmonary stress models. Neonatal rats (4-5 days old) survived a 14-day exposure to greater than 95% O2 equally well whether treated with saline (39/51 = 76%) or with endotoxin (41/51 = 80%). However, during the following 24 h of gradual weaning to room air breathing, there was a marked difference in survival between the endotoxin group (32/41 = 78%) and the saline pups (14/39 = 36%) (p less than 0.001). Both groups showed inhibition of lung development (alveolarization) during O2 exposure, but endotoxin treatment compared to saline was associated with increased specific lung volume (5.33 versus 4.50 ml/100 g) (air control = 4.08), smaller mean airspace diameter (mean linear intercept = 49.0 versus 55.8 microns) (air control = 43.3), increased specific internal surface area (4393 versus 3232 cm2/100 g) (air control = 3753), and greater preservation of alveolar wall capillary patency (24.83 versus 18.52% "capillary density") (air control = 27.70%). We conclude that endotoxin treatment resulted in significant protection against O2 toxicity in neonatal rats which was manifested during readaptation to room air breathing. The protective effect was likely due to a combination of reduced inhibition of lung growth and development and reduced hyperoxic damage to the respiratory membrane of the lung. PMID- 3822590 TI - Effects of hyperoxia on the arousal response to upper airway obstruction in lambs. AB - Experiments were done to investigate the effects of increased inspired oxygen on the arousal response from sleep to upper airway obstruction in 10 newborn lambs. Each lamb was anesthetized and instrumented for recordings of electrocorticograms, electrooculogram, nuchal and diaphragm electromyograms, and measurements of systemic arterial blood pressure and oxygen saturation (fiberoptic catheter oximeter). A tracheotomy was performed and a fenestrated tracheostomy tube was placed in the trachea. A 5F balloon tipped catheter was inserted into the tube so that airflow could be obstructed by inflating the balloon. No sooner than 3 days after surgery, measurements were made during a control period and during an experimental period of upper airway obstruction; the inspired oxygen fraction was alternated hourly between 0.21 and 0.60. A total of 57 epochs of quiet sleep and 58 epochs of active sleep was obtained in eight lambs. Arousal was significantly delayed (p less than 0.005) during active sleep (21 +/- 6 s; mean +/- 1 SD) compared to quiet sleep (7 +/- 2 s) in room air. Increased inspired oxygen significantly delayed arousal (p less than 0.05) during active sleep (47 +/- 25 s), but had little effect on arousal in quiet sleep (10 +/- 4 s). These results provide evidence that arousal from active sleep following upper airway obstruction in lambs is primarily initiated by a decrease in arterial oxygen. However, arousal from quiet sleep following upper airway obstruction in lambs appears to be initiated by other stimuli. PMID- 3822591 TI - Response to resistive loading in the newborn piglet. AB - The diaphragmatic force generation and electromyographic response to long-term (1 h) inspiratory resistive loading was examined in the newborn piglet during the 3rd postnatal wk of life. Minute ventilation decreased to approximately 50% of baseline level within 5 min of imposition of a severe resistive load and remained at this level for the duration of loading. The decrease in ventilation was secondary to a fall in tidal volume at a constant frequency. There was a significant increase in central nervous system output to the diaphragm as manifested by integrated diaphragmatic electromyogram. Progressive augmentation of this index of central drive continued throughout the period of loading. Functional residual capacity fell significantly by 60 min of inspiratory resistive loading. This strategy should allow greater force generation by placing the diaphragm at a more optimal length-tension relationship. However, the force generating capability of the diaphragm was compromised as assessed by force frequency curve analysis. These results suggest that the diaphragm of the neonatal piglet fatigues during prolonged inspiratory resistive loading. PMID- 3822592 TI - The effects of dopamine infusion on regional blood flow in newborn lambs. AB - The purpose of this project was to investigate the effects of high rates of dopamine infusion on cardiac output and regional blood flow in the lamb. We studied eight unanesthetized newborn lambs (mean age 7 +/- 2 days) during a 15 min baseline period and while infusing dopamine at 5-, 20-, 80-, and 160 micrograms/kg/min. We measured cardiac output and mean aortic, pulmonary arterial and left atrial pressures, and organ blood flow using radionuclide-labeled microspheres at each rate of dopamine infusion. Cardiac output increased significantly with increasing rates of infusion up to 80 micrograms/kg/min but decreased at 160 micrograms/kg/min. Aortic, pulmonary arterial, and left atrial pressures increased at rates of infusion above 5 micrograms/kg/min. Blood flow to all organs was unchanged at the 5 micrograms/kg/min rate of infusion of dopamine while blood flow to the brain and heart increased at the 80 micrograms/kg/min rate of infusion and blood flow to the gut and kidney decreased. We conclude that dopamine is an effective inotropic agent in the newborn lamb but that an inotropic:afterload mismatch exists at high infusion rates. Despite an increase in cardiac output at low rates of infusion, dopamine did not selectively vasodilate the vascular bed of any organs tested. Furthermore, at high rates of infusion dopamine actually impaired blood flow to the gut and kidney. PMID- 3822593 TI - Plasma erythropoiesis stimulating factor(s) in neonatal mice: in vitro dose response and chromatography studies. AB - High levels of plasma erythropoiesis stimulating factor(s) (ESF) have been found in neonatal WLO-mice during rapid growth. A previous study on hypertransfused neonatal animals indicated that the high ESF could not be due to the concomitant postnatal anemia alone. The present investigation was performed to answer the question: Is the high plasma ESF in neonatal WLO-mice erythropoietin (Ep) alone, or Ep in combination with other factors? The ESF of plasma from 20-day-old animals and standard Ep were compared in a cell culture assay for ESF based on erythroid colony formation, and also by means of gel filtration chromatography and affinity chromatography. Nonfractionated plasma and standard Ep showed parallel dose response curves and additive activity in the ESF assay. After gel filtration the detectable ESF of plasma was eluted in the same position as that of standard Ep, corresponding to an estimated molecular weight range of 34-65,000 daltons. The ESF of intact plasma, fractionated plasma, and standard Ep were identically bound to and eluted from the affinity chromatography column. These results show that the ESF of plasma from 20-day-old animals can neither be separated into several factors, nor distinguished from that of standard Ep by the methods used. It is therefore concluded that the high plasma ESF found in neonatal WLO-mice probably consists of Ep alone. PMID- 3822594 TI - Maturational changes in the pharmacological characteristics and actomyosin content of canine arterial and venous tissue. AB - The purpose of this study was to compare the pharmacological characteristics and actomyosin content of arterial and venous tissue at different times during development. Rings of arteries (femoral, renal, carotid, pulmonary) and veins (saphenous, pulmonary, jugular) were obtained from 1 wk, 1 month, and adult dogs, mounted at their optimal length for force development and the contractile response to potassium chloride and phenylephrine determined. The strain at optimal length was less at all ages in pulmonary artery and pulmonary and jugular veins than in other vessels. All vessels exhibited an increase in maximum contractile response with development but the increase was greater for phenylephrine. In general, the magnitude of the maximum response of the jugular and pulmonary veins and pulmonary artery was less than other vessels at all ages. The sensitivity (half maximum response) either increased or was unchanged in arteries with development, while in the veins it either decreased or was unchanged. The relaxant effects of verapamil and isoproterenol were determined on potassium chloride contracted vessels. Arterial tissue was minimally responsive to isoproterenol at all ages while venous tissue either increased its responsiveness (saphenous, pulmonary) with development or remained highly responsive (jugular). Verapamil, unlike isoproterenol, was an effective relaxant of all vessels. The actomyosin content (mg/mm) of femoral and renal arteries and saphenous and jugular veins increased with development but this increase was accompanied by a parallel increase in total protein so that the ratio (actomyosin/total protein) was unchanged. In jugular veins from adult dogs this ratio was smaller than in arterial tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822595 TI - The role of granulocytes in the pulmonary response to group B streptococcal toxin in young lambs. AB - Marked leukopenia and sequestration of granulocytes in the lung are consistently seen in severe early onset group B streptococcal (GBS) disease in human infants. To investigate the role of granulocytes as potential mediators in the pulmonary pathophysiology of this disease, the effects of intravenously administered GBS type III toxin were studied in young lambs before and after granulocyte depletion with hydroxyurea. Granulocyte depletion markedly reduced the 4-fold increase in total lung resistance and the decrease in dynamic compliance observed after GBS toxin. Granulocyte depletion significantly attenuated the pulmonary hypertension, hypoxemia and increased minute ventilation present during the first phase of the response (0.5-1 h after GBS toxin). It did not significantly alter the increase in body temperature, the marked increase in lung lymph thromboxane B2 concentrations during the first phase or the increase in lung lymph flow and protein clearance during the second phase of the response (3.5-5 h after GBS toxin). The results indicate that granulocytes are involved as mediators of the changes in lung mechanics seen after GBS toxin infusion in young lambs. Granulocytes contribute to the pulmonary hypertension and decrease in arterial oxygenation, but other mediators appear to be responsible for the injury of the vascular endothelium. PMID- 3822596 TI - The effects of negative pressure external high frequency oscillation on cerebral blood flow and cardiac output of the monkey. AB - The cerebral and systemic hemodynamic effects of negative pressure ventilation by external high frequency oscillation, utilizing a thoracoabdominal chamber, were investigated in six healthy adult monkeys. Cardiac output and cerebral blood flow were compared on external high frequency oscillation and conventional, positive pressure, mechanical ventilation in each animal. Cardiac output was measured by thermodilution and cerebral blood flow was measured by the intraarterial Xenon133 clearance technique. Oxygen delivery and consumption and systemic and pulmonary vascular resistances were calculated. There was no significant difference between the two ventilatory modes for any of these variables. Cardiac index on conventional mechanical ventilation was 2.87 +/- 0.39 1 X min-1 X m-2 (mean +/- SD) and on external high frequency oscillation was 2.96 +/- 0.87 1 X min-1 X min 2. Cerebral blood flow was 43.9 +/- 9.1 ml X 100 g-1 X min-1 on conventional and 39.0 +/- 9.0 ml X 100 g-1 X min-1 on external high frequency ventilation. External high frequency oscillation is not associated with any adverse cardiovascular or cerebrovascular effects and could be introduced for short-term human trials. PMID- 3822597 TI - Biliary motility: postnatal changes in guinea pigs. AB - Intravital microscopy, a new in vivo technique, documented age-dependent changes in choledochoduodenal junction motility in male guinea pigs. In the guinea pig, the choledochoduodenal junction served as a pump that actively emptied its luminal contents into the duodenum. In the neonates (less than or equal to 1 wk old), this choledochoduodenal junction pump was not fully developed. Unlike the older guinea pigs, some neonates had an incompetent sphincter ductus choledochi (SDC) allowing retrograde flow of bile during ampullary contractions. While fasting, neonates had decreased frequency of SDC (1.2 +/- 0.4 contractions/min) and ampullary (0.1 +/- 0.1 contractions/min) contractions as compared to juveniles (4-6 wk old) (SDC = 6.4 +/- 1.0; ampulla = 1.2 +/- 0.2 contractions/min) and adults (greater than 1 yr old) (SDC = 6.7 +/- 1.6; 0.8 +/- 0.2 contractions/min). Following a meal (Ensure), unlike older guinea pigs, the neonate did not have a significant increased duration and decreased frequency of SDC contractions. Altered neonatal SDC motility correlated with an incompletely developed SDC including decreased muscle mass and mucosal thickness. By 4 wk of age, choledochoduodenal junction motility was similar to that of the adult. These developmental alterations in junctional motility and structure may affect the flow of bile into the duodenum contributing to physiologic cholestasis and decreased intraduodenal bile acids seen in neonates. PMID- 3822598 TI - The differential effects of leukotriene C4 and D4 on the pulmonary and systemic circulations in newborn lambs. AB - Leukotriene (LT) C4 or D4 may mediate pulmonary hypertension induced by hypoxia. LT have also been isolated from patients with persistent pulmonary hypertension of the newborn syndrome and the adult respiratory distress syndrome. To compare the effects of LTC4 and D4 on the pulmonary and systemic circulations, we performed dose-response studies on spontaneously breathing newborn lambs. To determine whether the hemodynamic effects of LT are mediated through alpha adrenergic stimulation, some lambs were pretreated with the alpha-adrenergic antagonist phentolamine mesylate before LT injection. These results were compared to the effects of pretreatment with the LT receptor antagonist FPL57231. To determine whether the LT-induced decrease in cardiac output was mediated by the decrease in heart rate, other lambs had their heart rate maintained by left atrial pacing. We found that LTC4 and D4 increased systemic arterial pressure and decreased cardiac output and heart rate. However, LTD4, but not LTC4, increased pulmonary arterial pressure. The hemodynamic effects of LTC4 and LTD4 were completely blocked by FPL57231 but not by phentolamine mesylate. Maintenance of heart rate by left atrial pacing did not alter the LT-induced decrease in cardiac output. We conclude that LTC4 and D4 have similar effects on the systemic circulation. However, LTD4 produces more pulmonary vasoconstriction. Because FPL57231 did block the pulmonary vasoconstriction caused by LT, LT antagonists may be useful in treating patients with pulmonary hypertension. PMID- 3822599 TI - Effect of therapeutic dose of indomethacin on the cerebral circulation of newborn pigs. AB - The effects of treatment with 0.2 mg/kg of indomethacin on the cerebral blood flow and cerebral oxygen consumption of hypotensive, unanesthetized, newborn pigs were investigated. Hypotension was induced by hemorrhage (30 ml/kg) which reduced mean arterial pressure from 60 to 34 mm Hg. The decline in cerebral vascular resistance that occurred with hemorrhage allowed blood flow to all brain regions and cerebral oxygen consumption to continue unchanged. Treatment with 0.2 mg of indomethacin decreased plasma 6-keto-prostaglandin F1 alpha markedly and caused a modest increase in cerebral vascular resistance from 0.75 +/- 0.07 to 0.85 +/- 0.02 mm Hg X 100 g X min/ml at 40 min posttreatment. As a result, blood flow throughout the brain fell about 20%. Similarly, cerebral oxygen consumption declined from 2.88 +/- 0.13 to 2.03 +/- 0.21 ml O2/100 g X min following treatment of hypotensive piglets with 0.2 mg/kg of indomethacin. However, all piglets were conscious 40 min after treatment. We conclude that, although 0.2 mg/kg of indomethacin affects cerebral hemodynamics of hypotensive piglets, the effects are very modest in comparison to large increases in cerebral vascular resistance, decreases in cerebral blood flow and oxygen consumption, and coma that follow treatment of hypotensive piglets with 5 mg/kg of indomethacin. PMID- 3822600 TI - Lysosomal cystine transport in cystinosis variants and their parents. AB - Children with nephropathic cystinosis store 50 to 100 times normal amounts of free cystine in many cells and display negligible lysosomal cystine transport in their leucocytes and cultured fibroblasts. A patient with intermediate (adolescent) cystinosis exhibited a similar deficiency of egress out of fibroblast lysosome-rich granular fractions. Another individual with benign (adult) cystinosis accumulated only 2.85 nmol 1/2 cystine/mg leucocyte protein, or 20-50% of the amount stored in nephropathic cystinosis leucocytes. His leucocyte granular fractions also displayed substantial residual cystine-carrying capacity, as determined by measurement of lysosomal cystine counter-transport. We conclude that the variant forms of cystinosis represent a continuum of lysosomal cystine storage, with the varied clinical presentation depending on the amount of residual cystine-carrying capacity, genetic predispositions, and differential tissue susceptibilities. PMID- 3822602 TI - The renal handling of carnitine in patients with selective tubulopathy and with Fanconi syndrome. AB - Fractional tubular reabsorption (FTR) of free and acyl carnitine was measured in 15 patients with various selective tubular transport defects and in 19 patients with more generalized tubular dysfunction (Fanconi syndrome). FTR of free carnitine was normal in all patients with a selective tubulopathy, FTR of acyl carnitine was normal in most, and plasma carnitine levels were normal without exception. In these patients, there was no evidence for the existence of a defective renal transport mechanism shared by carnitine. In the patients with Fanconi syndrome, mean FTR of free and acyl carnitine was low; their plasma carnitine levels were lowered and correlated with the FTR. In individual patients, FTR of free and acyl carnitine also correlated with the severity of the disease. In the group of Fanconi syndrome patients, FTR of free and acyl carnitine correlated linearly with that of valine. We concluded that the lowering of plasma carnitine in the patients with Fanconi syndrome was caused by excessive loss of carnitine in urine. Its pathophysiological significance remained to be established. PMID- 3822601 TI - Biliary bile acid composition of the human fetus in early gestation. AB - Using analytical techniques, which included capillary column gas-liquid chromatography and mass spectrometry, detailed bile acid profiles were obtained for 24 fetal bile samples collected after legal abortions were performed between the 14th and 20th wk of gestation. Qualitatively, the bile acid profiles of all fetal bile samples were similar. The predominant bile acids identified were chenodeoxycholic and cholic acid. The presence of small but variable amounts of deoxycholic acid and traces of lithocholic acid suggested placental transfer of these bile acids from the maternal circulation. 3 beta-Hydroxy-5-cholenoic acid was detected at higher levels than lithocholic acid. A conspicuous feature of the profiles was the presence of bile acids with hydroxyl groups at positions C-1 and C-6, and one other nuclear position of unknown origin, indicating fetal hepatic synthesis via pathways different from those normally seen in the adult. Quantitatively total biliary bile acid concentrations were extremely low (less than 0.05 mM) before wk 17 of gestation, but thereafter concentrations markedly increased reflecting a possible surge in bile acid synthesis; however, the ratio of cholic:chenodeoxycholic acids remained relatively constant over this period (mean +/- SD = 0.85 +/- 0.36) and different from that reported for the healthy newborn (ca. 2.5) and adult (ca. 1.6). These data indicate an immaturity in hepatic 12 alpha-hydroxylation of bile acids during early development and may explain why other pathways, in particular 1 beta and 6 alpha-hydroxylation, are activated at this stage of life. PMID- 3822603 TI - The American Pediatric Society and the Society for Pediatric Research. Anaheim, California, April 27-30, 1987. Program and abstracts. PMID- 3822604 TI - [Evaluation of the biochemical indicators of risk of atherosclerosis in children with simple obesity]. PMID- 3822606 TI - [Circulatory-respiratory tests as indicators of the development of the neuroautonomic system in preschool children]. PMID- 3822605 TI - [Administration of 25-hydroxyvitamin D3 for the prevention of disorders of calcium-phosphate metabolism after anticonvulsant therapy in children]. PMID- 3822607 TI - [Status of the neuroautonomic system in preschool children with symptoms of psychomotor hyperexcitability]. PMID- 3822608 TI - [Usefulness of the NBT photocolorimetric test in the diagnosis of cerebrospinal meningitis in children]. PMID- 3822609 TI - [Evaluation of head proportions in children and adolescents by the morphogram method]. PMID- 3822610 TI - [(Fra)X in male cousins with mental retardation]. PMID- 3822611 TI - [Anorexia nervosa in boys in the light of our cases]. PMID- 3822612 TI - [Physiological activity of the sympathetico-adrenal system in children]. PMID- 3822613 TI - Consensus: management of the patient with herpes simplex encephalitis. PMID- 3822614 TI - Microbiology of human and animal bite wounds in children. AB - Aspirates from bite wounds in 39 children (21 with animal bites and 18 with human bites) were cultured for aerobic and anaerobic bacteria. Aerobic bacteria only were recovered in 7 (18%) wounds, anaerobic bacteria only in 3 (8%) and mixed aerobic and anaerobic bacteria in 29 (74%). A total of 59 isolates was recovered from animal bites (2.8/specimen): 37 aerobes (1.8/specimen); and 22 anaerobes (1.0/specimen). A total of 97 isolates were recovered from human bites (5.4/specimen): 44 aerobes (2.4/specimen); and 53 anaerobes (3.0/specimen). The most frequent isolates in both types of wounds were Staphylococcus aureus, anaerobic cocci and Bacteroides spp. Present only in animal bites were Pasteurella multocida, Pseudomonas fluorescens and M-5. Present only in human bites were Group A streptococci. Eighteen beta-lactamase-producing organisms were isolated in 16 wounds. This study demonstrates the polymicrobial aerobic anaerobic nature of human and animal bite wounds. PMID- 3822615 TI - Impact of chickenpox on households of healthy children. AB - There is little information available regarding the impact of varicella among healthy children. A group of 137 households, identified by the County of Los Angeles Department of Health Services, were interviewed by telephone and yielded 247 cases of varicella. There were no hospitalizations for complications. Rates for physician visits and telephone calls to health care providers were 0.5 and 1.0 per case, respectively. School days lost by cases and work days lost by well adults in the households were 8.7 and 0.5 per case, respectively. Varicella had a measurable impact of economic significance on our survey population. Our observations need to be extended and included in cost-benefit analyses of varicella vaccine. PMID- 3822616 TI - Epidemiology and treatment of tinea capitis: ketoconazole vs. griseofulvin. AB - We studied 80 children with tinea capitis without kerion to define the epidemiology and clinical characteristics of tinea capitis and to compare the therapeutic efficacy of griseofulvin and ketoconazole for treatment of this disorder. Patients ranged in age from 2.1 to 11 years (median, 5.2 years). Trichophyton tonsurans (74%), Microsporum canis (13.5%) and Trichophyton mentagrophytes (2.7%) accounted for 90% of the infections. Pretreatment KOH slide preparations were positive in 69% of patients with alopecia and in only 29% of those with diffuse scale with little hair loss. Sixty-three patients were randomly assigned to receive ketoconazole (5 mg/kg/day) or griseofulvin (15 mg/kg/day). The treatment groups were comparable with regard to age, sex, duration of lesions prior to treatment and type of lesions. The percent of patients with positive cultures on therapy at 4, 6, 8, and 10 weeks and the mean time to a sterile culture were significantly larger (P less than 0.01) in ketoconazole (8 weeks) than in griseofulvin-treated (4 weeks) patients. The time for complete scalp clearing was significantly longer in patients who received ketoconazole (median, 108 days) compared with those who were treated with griseofulvin (median, 60 days) (P = 0.01). PMID- 3822617 TI - Outbreak of neonatal Citrobacter diversus meningitis in a suburban hospital. AB - Between February and June, 1983, four cases of Citrobacter diversus neonatal meningitis were identified at a suburban Baltimore hospital. One of the 4 infants died at age 13 months, 2 (both of whom had brain abscesses) have evidence of developmental delay and 1 appears to be normal after 33 months of follow-up. A review of microbiology records revealed that C. diversus had been present in the hospital nursery prior to identification of the first infant with meningitis, with isolation from infants born 7 months, 4 months and 4 days, respectively, before the first meningitis case. C. diversus was isolated from 21 infants born during the outbreak period and from hand or rectal cultures of 5 nursing personnel. All isolates were biotype E, with two distinct clusters of cases identified on the basis of plasmid profile and serotype. In a case-control study isolation of C. diversus was significantly associated with male sex, low birth weight and care by house pediatricians. The outbreak was controlled by stringent infection control measures and exclusion of personnel carriers. During the 24 months following the outbreak 3431 babies discharged from the nursery were cultured for C. diversus; 3 were colonized with the organism. PMID- 3822618 TI - Suppurative thrombophlebitis: a serious nosocomial infection. PMID- 3822619 TI - Alice in Wonderland syndrome, a manifestation of acute Epstein-Barr virus infection. PMID- 3822620 TI - Toxoplasma encephalitis in an infant with acquired immunodeficiency syndrome. PMID- 3822621 TI - Fulminant hepatic necrosis in an infant with perinatally acquired echovirus 21 infection. PMID- 3822622 TI - Profound hyperbilirubinemia: an unusual presentation of childhood infectious mononucleosis. PMID- 3822623 TI - Prevalence of complement deficiencies in children with systemic meningococcal infections. PMID- 3822624 TI - Absence of congenital infection and teratogenesis in three children born to mothers with blastomycosis and treated with amphotericin B during pregnancy. PMID- 3822625 TI - Risk factors for recurrent otitis media. PMID- 3822626 TI - Acyclovir treatment in a case of facial paralysis caused by herpes zoster. PMID- 3822627 TI - How endotoxin might reach the inner ear. PMID- 3822628 TI - Legionnaires' disease and children. PMID- 3822629 TI - Drug of choice for meningitis. PMID- 3822630 TI - b-CAPSA I Haemophilus influenzae, type b, capsular polysaccharide vaccine safety. AB - The b-CAPSA I capsular polysaccharide vaccine for Haemophilus influenzae type b was given to 87,541 children 2 through 5 years of age in the Kaiser Permanente Medical Care Program, and the children were then followed using a multiple modality surveillance. Phase 1 consisted of 24-hour recall of immediate side effects which were recorded on questionnaires given to families of 13,500 children. Local side effects were found to be uncommon: 2.3% had a temperature of greater than or equal to 38.3 degrees C (greater than or equal to 101 degrees F); 4.8% had local erythema, 2.9% local swelling, and 12.6% local tenderness; two children had wheezing shortly after immunization. In Phase 2, 30 days after immunization, questionnaires were mailed to parents of all 87,541 children, who were asked to respond to questions about illnesses and health care. Phase 3 consisted of active surveillance of patient health care use by physicians and nurses during the 30 days after immunization. During the 30-day reporting periods, there were 40 hospitalizations, including one for wheezing and one for febrile seizure. Of the 40 hospitalizations, only the one for wheezing was believed by the admitting physician to be probably associated with vaccine administration. Three children had seizures within 30 days of immunization. None of the seizures was believed by the reporting physician to be associated with immunization. Adverse effects of the vaccine were mild, limited to local reactions and occasional temperature elevation; bronchospasm after immunization occurred rarely. PMID- 3822631 TI - Male homosexuality: the adolescent's perspective. AB - Although homosexual activity is prevalent among US teenagers, adolescent homosexuality per se has been a poorly understood phenomenon. The purpose of this investigation is to describe the meaning and experience of homosexuality from the adolescent's perspective. Twenty-nine male teenagers, self-described as gay (79%) or bisexual (21%), volunteered to participate in a structured interview, the purpose of which was to examine the definition of homosexuality, the acquisition of a gay identity, and the impact of sexuality on family, peers, and community. The youths demonstrated well-established sexual identities by the consistency of their sexual fantasies, interests, and behaviors over time. Homosexuality was more frequently described as a general attraction to men (48%) and an indicator of positive personal attributes (33%) than as an isolated sexual behavior. The subjects reported strong negative attitudes from parents (43%) and friends (41%) toward their sexualities. Discrimination (37%), verbal abuse from peers (55%), and physical assaults (30%) were frequently cited problems. These stressors may place the boys at high risk for physical and psychosocial dysfunction. PMID- 3822632 TI - Adolescent homosexuality: psychosocial and medical implications. AB - Despite a widespread interest in the health of the gay community, the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment, education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases, running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out, and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed. PMID- 3822633 TI - Declining frequency of circumcision: implications for changes in the absolute incidence and male to female sex ratio of urinary tract infections in early infancy. AB - The results of an investigation examining the circumcision frequency rate and its effect on the incidence of urinary tract infections in a large, widely dispersed population base during the 10-year period since the 1975 report of the American Academy of Pediatrics Ad Hoc Task Force on Circumcision are reported. Our study population included the 427,698 infants born in all United States Army hospitals, worldwide, from Jan 1, 1975, through Dec 31, 1984. There was an initial plateau in the circumcision frequency rate at approximately 85% during the first 4 years of the study period. In the subsequent 6 years there was a steady, significant decrease (P less than .001) of 1.4% to 4.0% per year through 1984, when the circumcision frequency rate reached its nadir of 70.5%. There was a concomitant increase in the total number of urinary tract infections among male infants (P less than .02) as the circumcision rate declined. This increase was due to the increase in the overall number of uncircumcised boys (who had a greater than 11 fold increased infection rate compared with circumcised boys). During the first half of the study period, there was a female predominance for urinary tract infections from birth onward. As the number of circumcised boys decreased (with a resultant increase in the total number of boys with infection), the male to female ratio of urinary tract infections during the first 3 months of life reversed, reflecting a movement toward a male predominance for infection in early infancy. This is the first, well-documented report of a decreasing rate of circumcisions performed on the American male population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822635 TI - Predictors of intelligence quotient and intelligence quotient change in persons treated for phenylketonuria early in life. AB - Ninety-one individuals with phenylketonuria who were treated early in life were followed for as many as 22 years. Regression analyses were used to determine the best predictors of IQ and IQ change. Among treatment-related variables, good dietary control of the blood phenylalanine level stood out as the best predictor of IQ. Diet discontinuation and the natural (off diet) blood phenylalanine level best predicted IQ loss, suggesting that diet continuation may be important for children with natural blood phenylalanine levels greater than 18 mg/dL. PMID- 3822634 TI - Intelligence quotient scores of 4-year-old children: social-environmental risk factors. AB - Verbal IQ scores in a socially heterogeneous sample of 215 4-year-old children were highly related to a cumulative environmental risk index composed of maternal, family and cultural variables. Different combinations of equal numbers of risk factors produced similar effects on IQ, providing evidence that no single factor identified here uniquely enhances or limits early intellectual achievement and that cumulative effects from multiple risk factors increase the probability that development will be compromised. The multiple risk index predicted substantially more variance in the outcome measure than did any single risk factor alone, including socioeconomic status. High-risk children were more than 24 times as likely to have IQs below 85 than low-risk children. PMID- 3822636 TI - Measles spread in medical settings: an important focus of disease transmission? AB - During the period September 1981 to August 1985, we investigated every reported case of measles in Oklahoma to confirm the diagnosis, to determine the source, and to identify contacts to prevent spread of the disease. During this time, 33 serologically and/or epidemiologically confirmed cases were investigated. Nine (27%) persons acquired measles in a medical office or clinic waiting area. Eight of these recalled direct face-to-face contact with a source. An additional six (18%) cases were associated with exposure to these medically acquired cases, for a total of 45% that were the direct or indirect result of exposures in medical waiting rooms. The medical waiting room is a location where a reservoir of susceptible individuals may congregate, allowing for potential exposures to measles and other infectious diseases. Because many persons in these settings are too young to have received routine measles vaccination, other measures to decrease exposures in this setting may be necessary to achieve the goal of measles elimination in the United States. PMID- 3822637 TI - Guanosine triphosphate cyclohydrolase I deficiency: early diagnosis by routine urine pteridine screening. AB - A deficiency of hepatic guanosine triphosphate cyclohydrolase I is reported in a 4-month-old infant in whom positive results on a Guthrie phenylketonuria test in the neonatal period were found. Because of the significantly elevated serum phenylalanine levels a diagnosis of classical phenylketonuria was made, and dietary therapy was started. Urinary pteridine screening for cofactor variants, however, revealed extremely low levels of both neopterin and biopterin. This suggested the possibility of guanosine triphosphate cyclohydrolase I deficiency and led to additional confirmatory assays. Repeat urine, serum, and CSF pteridine profiles, combined with tetrahydrobiopterin-loading studies and the assay of guanosine triphosphate cyclohydrolase I activity in a liver biopsy, confirmed the defect. It is significant to note that the diagnosis was made before the onset of major clinical symptoms. This case illustrates the need for routine cofactor variant screening of all infants in whom hyperphenylalaninemia is diagnosed in the neonatal period. PMID- 3822638 TI - Familial Reye-like syndrome: a presentation of medium-chain acyl-coenzyme A dehydrogenase deficiency. AB - A 20-month-old girl with a family history of two siblings who died of an encephalopathy diagnosed as Reye syndrome presented to an emergency room in hypoglycemic coma and was found to have medium-chain acyl-coenzyme A dehydrogenase deficiency. The salient clinical and biochemical features of this newly described inborn error of fatty acid metabolism are described and contrasted to those of classical Reye syndrome. Important clues that should lead the clinician to suspect this disorder, methods of diagnosis, and appropriate acute and long-term therapy are also discussed. PMID- 3822639 TI - Unsuspected non-Hodgkin's lymphoma of the tonsils and adenoids in children. AB - Six children with lymphoreticular malignancy arising in the pharyngeal tonsils or adenoids are presented. Early clues to the possible malignant nature of the enlargement of tonsils and adenoids in this series include: asymmetric and persistent enlargement, the absence of such manifestations of infection as fever or pain, and the association of atypical adenopathy. Lack of clinical suspicion brings with it the risk of delayed diagnosis and possible compromise of optimal therapy. PMID- 3822640 TI - Severe renal osteodystrophy without elevated serum immunoreactive parathyroid hormone concentrations in hypomagnesemia due to renal magnesium wasting. AB - An 8 1/2-year-old girl presented with a long history of seizures, growth retardation, muscle weakness, gait disturbance, and hearing loss. Her evaluation revealed chronic moderate renal failure (serum creatinine 2.2 mg/dL), severe hypocalcemia (5 mg/dL), hyperphosphatemia (8.1 mg/dL), hypomagnesemia (1.5 mg/dL), increased urinary magnesium excretion (2 mg/kg/d), high fractional excretion of magnesium (21.7%), hypokalemia (3.2 mEq/L), and hyperkaliuria (26 mEq/L). Low circulating immunoreactive parathyroid hormone levels for the degree of the hypocalcemia (serum N-parathyroid hormone 212 pg/mL) and severe rickets without evidence of osteitis fibrosa cystica were found. The patient probably has primary renal leak hypomagnesemia (magnesuric hypomagnesemia) which caused impaired secretion of immunoreactive parathyroid hormone leading to severe hypocalcemia and calcium deficiency rickets. Treatment with magnesium and calcium supplements, calcitriol, and aluminum hydroxide resulted in marked clinical, biochemical, and radiologic improvement. Calcium deficiency rickets due to primary or secondary renal magnesium wasting in conjunction with moderate renal failure represents a largely unrecognized metabolic bone disease. PMID- 3822641 TI - Growth hormone deficiency associated with the ectrodactyly-ectodermal dysplasia clefting syndrome and isolated absent septum pellucidum. AB - Two growth hormone-deficient patients with particular developmental defects are presented. One patient had the ectrodactyly-ectodermal dysplasia-clefting syndrome with lobster-claw deformities of the hands; thin, blond, and dry hair and enamel hypoplasia; and a facial raphe on the right side of the philtrum. The other patient had isolated absence of the septum pellucidum. The facial raphe and the absent septum pellucidum are related to cleft lip and septooptic dysplasia, conditions that have been associated with growth hormone failure. The association of the ectrodactyly-ectodermal dysplasia-clefting syndrome with isolated growth hormone deficiency has not been described previously. PMID- 3822642 TI - Caustic alkali ingestions by farm children. AB - Liquid lye drain cleaners responsible for a childhood epidemic of household ingestions in the early 1970s are now marketed in drastically reduced alkali concentrations and packaged in child-resistant containers. However, farm and industrial caustic agents continue to be sold without poison prevention safeguards, as exemplified by dairy pipeline cleaners (liquid NaOH/KOH concentrations 8% to 25%) used routinely on dairy farms. In this study, the ingestion epidemiology of farm/industrial v household caustic alkali products was compared in a population that included farm children. Forty-three children were admitted from 1973 to 1983 to four rural hospitals for nonintentional caustic alkali ingestion. Farm products constituted 23% of all products and 43% of all drain/pipe cleaners ingested. Dairy pipeline cleaners were the single most common causative substance, injuring ten toddlers (mean age 1.6 years), perforating the esophagus in two. Liquid dairy pipeline cleaners were usually ingested in tiny amounts from nonchild-resistant containers or drinking glasses at evening milking time. In contrast, household drain cleaners were associated with fewer ingestions, with all serious complications related to highly concentrated products not available on the consumer market after 1975. Poison prevention strategies successfully applied in the 1970s to household drain cleaners should be redirected and modified for farm-related caustic alkali agents. Preventive measures are suggested by the highly specific pattern of injury and the small, defined population at risk. PMID- 3822643 TI - Contralateral pneumothoraces in the newborn: incidence and predisposing factors. AB - A prospective study was performed to ascertain the incidence of, and risk factors for, the development of a contralateral pneumothorax in 32 neonates with respiratory distress, without evidence of pulmonary hypoplasia, who had an initial unilateral air leak requiring pleural drainage. The mean postnatal age of occurrence of the first pneumothorax was 31.04 hours (range 0.1 to 92 hours); a subsequent contralateral pneumothorax developed in 14 infants (44%) at a mean postnatal age of 61.5 hours (range 8 to 106 hours). Thirteen of the 14 infants with a subsequent contralateral pneumothorax had pulmonary interstitial emphysema visible on the chest radiograph taken immediately after drainage of the first pneumothorax, compared with eight of the 18 infants without a contralateral pneumothorax (P less than .005). Other factors significantly associated with a contralateral pneumothorax were alveolar-arterial oxygen gradient (P less than .01) and FiO2 (P less than .005), both measured one hour after the pneumothorax, and gestational age (P less than .05). Multivariate discriminant function analysis did not usefully add to the predictive power of pulmonary interstitial emphysema alone. Infants with pulmonary interstitial emphysema at the time of an initial unilateral pneumothorax are at significant risk for the development of a contralateral pneumothorax. PMID- 3822644 TI - Rooster attacks on children. PMID- 3822645 TI - Chlorine inhalation toxicity from vapors generated by swimming pool chlorinator tablets. AB - We have presented two cases of serious respiratory injury after brief exposure to vapors from solid chlorine compounds. We could find no previous reports of such accidents and, therefore, have related these cases to alert the medical community. We would recommend that physicians caring for children include warnings about these preparations in their routine counseling of parents. PMID- 3822646 TI - Familial right thoracic stomach. PMID- 3822647 TI - Analgesic premedication in the management of ileocolic intussusception. PMID- 3822649 TI - Head Start: making a popular program work. PMID- 3822648 TI - Child sexual abuse, criminal justice, and the pediatrician. PMID- 3822650 TI - Head Start: evolution of a successful comprehensive child development program. PMID- 3822651 TI - Day care for sick children. PMID- 3822652 TI - Cardiopulmonary resuscitation: standards, guidelines, and education. PMID- 3822653 TI - American Academy of Pediatrics Committee on Adolescence: Alcohol use and abuse: a pediatric concern. PMID- 3822654 TI - American Academy of Pediatrics Committee on Adolescence: Role of the pediatrician in management of sexually transmitted diseases in children and adolescents. PMID- 3822655 TI - American Academy of Pediatrics Committee on Environmental Hazards and Committee on Accident and Poison Prevention: Statement on childhood lead poisoning. AB - Patterns of childhood lead poisoning have changed substantially in the United States. The mean blood lead level has declined, and acute intoxication with encephalopathy has become uncommon. Nonetheless, between 1976 and 1980, 780,000 children, 1 to 6 years of age, had blood lead concentrations of 30 micrograms/L or above. These levels of absorption, previously thought to be safe, are now known to cause loss of neurologic and intellectual function, even in asymptomatic children. Because this loss is largely irreversible and cannot fully be restored by medical treatment, pediatricians' efforts must be directed toward prevention. Prevention is achieved by reducing children's exposure to lead and by early detection of increased absorption. Childhood lead poisoning is now defined by the Academy as a whole blood lead concentration of 25 micrograms/L or more, together with an erythrocyte protoporphyrin level of 35 micrograms/dL or above. This definition does not require the presence of symptoms. It is identical with the new definition of the US Public Health Service. Lead poisoning in children previously was defined by a blood lead concentration of 30 micrograms/dL with an erythrocyte protoporphyrin level of 50 micrograms/dL. To prevent lead exposure in children, the Academy urges public agencies to develop safe and effective methods for the removal and proper disposal of all lead-based paint from public and private housing. Also, the Academy urges the rapid and complete removal of all lead from gasoline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822656 TI - American Academy of Pediatrics Committee on Infectious Diseases: Health guidelines for the attendance in day-care and foster care settings of children infected with human immunodeficiency virus. PMID- 3822657 TI - American Academy of Pediatrics Committee on School Health: Impedance bridge (tympanometer) as a screening device in schools. PMID- 3822658 TI - American Academy of Pediatrics Committee on Accident and Poison Prevention: Injuries related to "toy" firearms. PMID- 3822659 TI - American Academy of Pediatrics Committee on Infectious Diseases: Ribavirin therapy of respiratory syncytial virus. PMID- 3822660 TI - American Academy of Pediatrics Committee on Adolescence: Tobacco use by children and adolescents. PMID- 3822661 TI - Sudden death associated with biotinidase deficiency. PMID- 3822662 TI - Applesauce and isoniazid. PMID- 3822663 TI - Foreign body in the hard palate. PMID- 3822664 TI - Thumb-sucking debate. PMID- 3822665 TI - Statistics and sudden infant death syndrome. PMID- 3822666 TI - Why I have difficulty being enthusiastic about recommending that children wear helmets on bicycles. PMID- 3822667 TI - Pediatric brain injuries: the nature, clinical course, and early outcomes in a defined United States' population. AB - Acute brain injury is the cause of approximately 100,000 pediatric hospital admissions per year in the United States. This report examines the nature of the brain injury, clinical diagnosis, hospital course, and discharge outcome of all pediatric cases in the population of San Diego County, California, for 1981 (N = 709). Brain-injured children were identified from hospital records, death certificates, and coroners' records. Severity of injury was determined using the Abbreviated Injury Scale and the Glasgow Coma Scale. Three percent of brain injured children died at the accident site; an additional 3% died in the hospital. All in-hospital deaths occurred among the 5% of children with Glascow Coma Scale scores of 8 or less, and in this group the case fatality rate was 59%. Fractures of the skull, present in 23% of cases, seemed to be associated with excess mortality even after type of lesion was considered. Type of lesion, but not presence or absence of a skull fracture, had some predictive power for disability among survivors. Concussion was the most frequent diagnosis. Mildly brain-injured children accounted for 93% of all cases and about 90% of all hospital days. PMID- 3822668 TI - Fetal abuse and neglect: an emerging controversy. AB - Advances in fetal medicine have expanded opportunities for protection of fetal health and intrauterine management of an increasing number of fetal disorders. The legal rights and duties of parents to provide necessary medical treatment for the child may extend to the prenatal period. Resolution of the conflict between the rights of the fetus to be born healthy and the pregnant woman's right of privacy is difficult and controversial. It is suggested that intrusion into a woman's individual fundamental rights for the potential benefit of her fetus should be permissible only in narrowly defined circumstances. PMID- 3822669 TI - Is intrauterine growth retardation a risk factor for child abuse? AB - A case-control study was conducted to determine whether infants with intrauterine growth retardation are at an increased risk of child abuse. Case children were those who had been born at Yale-New Haven Hospital and were reported to the hospital's child abuse committee because they had been physically abused. For each case, one control child was chosen from the hospital's log of births and matched to the case child by age, gender, race of the mother, method of payment for the hospitalization, and the provider of the child's health care at the time of birth. Infants were defined as having intrauterine growth retardation if they had either a ponderal index or a birth weight that was less than the tenth percentile for gestational age using the Kansas City or Denver growth standards. We identified 117 case-control pairs that met those criteria. The matched odds ratios for each of the four definitions of intrauterine growth retardation were less than one, indicating that infants with intrauterine growth retardation are at a decreased risk of abuse. The matched odds ratio for a low ponderal index according to the Kansas City standard was 0.4 (95% confidence interval 0.19, 0.83). This result was not affected by such possible confounding factors as the mother's age. We conclude that infants with intrauterine growth retardation are not at an increased risk and may be at a decreased risk of physical abuse. PMID- 3822670 TI - Pneumatic otoscopy in healthy full-term infants. AB - Pneumatic otoscopy was performed on 81 healthy full-term babies during the first 72 hours of life and at routine well-baby follow-up visits. Only 14 of 115 (12%) of the eardrums visualized during the first three days of life moved briskly to insufflation as compared with 29 of 65 (44%) and 50 of 71 (71%) by 3 weeks and 10 weeks of age, respectively. A pink color was noted in 38 of 115 (33%) and redness in five of 115 (4%) of the eardrums examined during the first 72 hours of life, whereas 64 of 71 (90%) of the tympanic membranes appeared gray by age 10 weeks. Tympanic membrane dullness, decreased light reflex, and diminished translucence occurred in greater than 90% of the infants during the first three days of life and declined to 26% or less by 4 months of age. The data suggest that limited mobility, changes in color, poor luster, and relative opacity of the tympanic membrane occur in healthy neonates and may reflect physiologic changes unique to the newborn period. PMID- 3822671 TI - Digoxin inactivation by the gut flora in infancy and childhood. AB - Inactivation of digoxin by reduction of the lactone ring has recently been shown to occur in one third of adults and to be mediated by anaerobic intestinal bacteria. Children from birth through adolescence were studied to determine the pattern of development of this gut flora-mediated process. None of 36 digitalized infants 8 months of age or less excreted reduced digoxin metabolites in the urine. The adult pattern of digoxin reduction product excretion by one third of patients was observed after 16 months of age; however, high levels of digoxin reduction products such as are found in 10% of adults were not encountered in children less than 9 years of age. Even though reduced metabolites were not formed in vivo early in life, stool cultures of 20 of 73 infants younger than 8 months of age contained digoxin reduction product-forming bacteria at high concentrations, in some instances as early as the second week of life. Maturation of the gut flora with respect to digoxin metabolism appears to be a protracted process. The relative digoxin resistance of infants and children is not due to bacterial inactivation. PMID- 3822672 TI - Rheumatic fever in children and adolescents in Hawaii. AB - Case records of hospitalized children (age 4 to 18 years) with acute rheumatic fever on Oahu, HI, were reviewed for the 4-year period from Oct 1, 1980, to Sept 30, 1984. Ninety-eight cases met the modified Jones criteria. The overall incidence of rheumatic fever was 13.4 hospitalized children per 100,000 children per year and that for recurrent attacks was 2.5. Of the 98 with rheumatic fever, 73 had polyarthritis, 33 had carditis, and ten had chorea. Polynesian/part Polynesian children accounted for 76 of the 98 cases. The incidence of rheumatic fever in Hawaiian/part-Hawaiian was 18.0 and for Samoan children was 206 hospitalized children per 100,000 per year. The relative risks were 7.7 and 88 times that of the white children, respectively. Rheumatic fever continues to cause significant morbidity in children in Hawaii, especially in Polynesian children. PMID- 3822674 TI - Influenza: a shot or not? PMID- 3822673 TI - Binding effect of albumin on uptake of bilirubin by brain. AB - A mathematical model is presented to describe quantitatively the uptake of bilirubin into the brain from blood, under conditions of extensive binding to plasma proteins. The model relates bilirubin uptake to the rate constants for dissociation and association of the albumin/bilirubin complex and to the transit time of blood through brain capillaries. A rational basis is given for deciding between the total or the free bilirubin concentration as an appropriate indicator of brain exposure to the toxic effects of bilirubin. The effect of competition for binding sites by drugs such as sulfonamides on the brain uptake of bilirubin is also described quantitatively. PMID- 3822675 TI - Pediatrics and poverty. PMID- 3822676 TI - Need for large sample sizes in randomized trials. PMID- 3822677 TI - Emergency care of the child. AB - Optimal emergency care of the child requires a well-developed EMS-C system. The components are easy to identify. We need macroregions with institutions acknowledging their institutional capabilities for pediatric emergency care and supporting field triage and transfer agreements. We need highly educated and skilled prehospital care providers, from emergency medical technicians in the field to air and ground transport services with specialized pediatric transport teams. In addition to having an appropriate hospital emergency department attending physician staff, hospitals must develop networks of cooperation between emergency departments appropriate for pediatrics and children's emergency care centers. These centers strive for quality care through systematic record keeping, chart reviews, and audits identifying care deficiencies and appropriate remedies. Subsequent reviews document improved care. There are meetings of prehospital and hospital-based providers to discuss the management of challenging cases. Comprehensive pediatric emergency care involves integration of emergency stabilization patient care with community and hospital social services, patient education programs (such as Child Life), and comprehensive rehabilitation programs, as well as community accident prevention and basic life support programs. As we strive to develop optimal emergency medical services for our country to best serve our people, comprehensive emergency care of children must have separate consideration from comprehensive emergency care of adults. If we are to assure optimal outcome for the life-threatened child, we need to continuously assess regional needs and capabilities and encourage optimal involvement of health care providers and institutions. PMID- 3822678 TI - Emergency medical services for children: what is the pediatric surgeon's role? PMID- 3822679 TI - Pediatric lead poisoning in 1987: the silent epidemic continues. PMID- 3822680 TI - Bone scintigraphy in the evaluation of children with obscure skeletal pain. AB - A retrospective analysis of bone scans of 381 children with unexplained skeletal pain was made. Of these, findings are reported on 358 for whom there were sufficient clinical data. The bone scan results suggested trauma as the cause of pain in 43 patients, inflammatory disease in 73 patients, and neoplasia in ten patients. There was only one false-positive bone scan. Normal findings were obtained from 227 patients, in whom no significant skeletal disease was detected on follow-up, except for juvenile rheumatoid arthritis in 23 patients. Bone scintigraphy is, therefore, an important, noninvasive diagnostic test for evaluating children with obscure bone or joint pain. We recommend that this test be performed early in the evaluation of these children to arrive at the diagnosis expeditiously and with minimal patient discomfort and morbidity. PMID- 3822681 TI - Comparison of self-hypnosis and propranolol in the treatment of juvenile classic migraine. AB - In a prospective study we compared propranolol, placebo, and self-hypnosis in the treatment of juvenile classic migraine. Children aged 6 to 12 years with classic migraine who had no previous specific treatment were randomized into propranolol (at 3 mg/kg/d) or placebo groups for a 3-month period and then crossed over for 3 months. After this 6-month period, each child was taught self-hypnosis and used it for 3 months. Twenty-eight patients completed the entire study. The mean number of headaches per child for 3 months during the placebo period was 13.3 compared with 14.9 during the propranolol period and 5.8 during the self-hypnosis period. Statistical analysis showed a significant association between decrease in headache frequency and self-hypnosis training (P = .045). There was no significant change in subjective or objective measures of headache severity with either therapy. PMID- 3822682 TI - Propylene glycol: increased incidence of seizures in low birth weight infants. PMID- 3822683 TI - Pott puffy tumor: a serious occult infection. PMID- 3822684 TI - Tuberculosis in a day-care home. PMID- 3822685 TI - Vulnerable sibling: hyponatremia from caries prevention. PMID- 3822687 TI - Hand-powered apparatus for aspiration of meconium from the airway. PMID- 3822686 TI - Are you overlooking fractures of the mandibular condyle? AB - Fractures of mandibular condyle may be overlooked because attention is often focused on readily apparent soft tissue injury such as lacerations and abrasions. Clinical and radiographic signs are often subtle, but the injuries caused by rapid deceleration and listed in Table 2 will serve to alert the pediatrician to the possibility of such fractures. All children in these circumstances should be carefully examined for dental occlusion and the preauricular area palpated to help formulate a clinical diagnosis. Additional evidence is gained from the finding of deviation or limitation of the jaw upon opening or edema in the preauricular area. If any of these yield abnormal findings, a good quality series of mandibular radiographs will be needed to confirm the diagnosis. Overlooking a condylar fracture may commit a child to unsightly facial asymmetry, marked malocclusion, or ankylosis requiring invasive surgery for correction. Consultation with an oral and maxillofacial surgeon or other interested specialist should be sought while the patient is still in the emergency room. PMID- 3822688 TI - American Academy of Pediatrics Committee on Early Childhood, Adoption, and Dependent Care: Health care of foster children. PMID- 3822689 TI - The circumcision debate. PMID- 3822690 TI - Atherosclerosis. PMID- 3822691 TI - Phototherapy effect on the incidence of patent ductus arteriosus. PMID- 3822692 TI - [Value of the rate of malondialdehyde accumulation in erythrocytes in the diagnosis of membrane disorders in the premature infant]. PMID- 3822693 TI - [Hormonal system of growth and indices of energy supply of early premature infants during the 1st months of life]. PMID- 3822694 TI - [Various problems in the familial study of bronchial asthma]. PMID- 3822695 TI - [Rheologic characteristics of the blood of children during an attack of bronchial asthma]. PMID- 3822696 TI - [Characteristics of the state of the autonomic nervous system in children with Quincke's edema, urticaria and neurodermatitis]. PMID- 3822697 TI - [Therapeutic approaches in selective IgA deficiency in children]. PMID- 3822698 TI - [Topical problems in organizing work with children's families to protect and promote their health]. PMID- 3822699 TI - [Follow-up of children with thymomegaly]. PMID- 3822700 TI - [Clinico-experimental basis for using thymalin in thymomegaly associated with pneumonia in young children]. PMID- 3822701 TI - [Reflexotherapy in the complex treatment of bronchial asthma in children]. PMID- 3822702 TI - [Migraine in children and reflexotherapy]. PMID- 3822703 TI - [Efficacy of rehabilitation of children at local preventive health centers during "mother-child" visits]. PMID- 3822704 TI - [Role of the pediatrician in the dispensarization of children with stomatologic diseases]. PMID- 3822705 TI - [Errors in the diagnosis of acute appendicitis in newborn infants]. PMID- 3822706 TI - [Rare case of intestinal obstruction]. PMID- 3822707 TI - [Case of medical-genetic consultation for Fanconi's anemia]. PMID- 3822708 TI - [Syndrome of partial monosomy of the long arm of chromosome 16]. PMID- 3822709 TI - [Use of teonikol in bronchial asthma in children]. PMID- 3822710 TI - [Lyell's syndrome associated with agranulocytosis and thrombocytopenia]. PMID- 3822711 TI - [Association of diabetes mellitus with celiac disease: questions concerning pathogenesis and diagnosis]. PMID- 3822712 TI - [Clonorchiasis in children]. PMID- 3822713 TI - [Convulsive syndrome as a complication of puncture catheterization of the subclavian vein in children]. PMID- 3822714 TI - [Familial cardiomyopathy in osteogenesis imperfecta in children]. PMID- 3822715 TI - [Exacerbation of hereditary methemoglobinemia in twin infants]. PMID- 3822716 TI - [Case of sudden death in retropharyngeal abscess]. PMID- 3822717 TI - [Features of the physical growth of newborn children in different territories of the USSR]. PMID- 3822718 TI - [Local immunity and microflora of the alimentary canal of newborn infants in the early postnatal period]. PMID- 3822719 TI - [Purpuras fulminans: development over a 15-year period]. AB - Eighty one children were admitted in ICU between 1969 and 1983. 35% of them died. There happened in the meantime an improvement in the results (12 deaths out of 30 children admitted in hospital from 1969 to 1974, 15 deaths out of 51 children from 1975 to 1983). The improvement was obvious in the tiniest children and the less severe cases; this is mostly owing to technical progress (hemodynamic control, sedation, artificial ventilation). Corticoids and heparin were not used, or exceptionally used since 1975. Mortality in severe cases did not change. It is important to point out the fact that the four children presenting a purpura fulminans secondary to an infection with Hemophilus Influenzae died. PMID- 3822720 TI - [Malignant arterial hypertension and Ito's hypomelanosis]. AB - Hypomelanosis of Ito is a rare neurocutaneous syndrome and several abnormalities are often associated. Malignant hypertension and polycythemia are very unusual; their occurrence in a 12 year-old girl is not related to any classical etiology and their place in Ito disease is discussed. PMID- 3822721 TI - The public perception of science (2) PMID- 3822722 TI - High-resolution facial feature saliency mapping. AB - For recognition of a target there must be some form of comparison process between the image of that target and a stored representation of that target. In the case of faces there must be a very large number of such stored representations, yet human beings seem able to perform comparisons at phenomenal speed. It is possible that faces are memorized by fitting unusual features or combinations of features onto a bland prototypical face, and such a data-compression technique would help to explain our computational speed. If humans do indeed function in this fashion, it is necessary to ask just what are the features that distinguish one face from another, and also, what are the features that form the basic set of the prototypical face. The distributed apertures technique was further developed in an attempt to answer both questions. Four target faces, stored in an image processing computer, were each divided up into 162 contiguous squares that could be displayed in their correct positions in any combination of 24 or fewer squares. Each observer was required to judge which of the four target faces was displayed during a 1 s presentation, and the proportion of correct responses for each individual square was computed. The resultant response distributions, displayed as brightness maps, give a vivid impression of the relative saliency of each feature square, both for the individual targets and for all of them combined. The results, while broadly confirming previous work, contain some very interesting and surprising details about the differences between the target faces. PMID- 3822723 TI - Influences of familiarity on the processing of faces. AB - Three experiments are reported in which undergraduate subjects made simple perceptual judgements about the faces of familiar and unfamiliar academic staff. Any effects of familiarity in these tasks were assessed by comparison with performance on the two groups of faces when both sets were unfamiliar to student subjects at a different university. In experiment 1 there was no effect of familiarity of the faces on a task requiring judgements of expression, consistent with recent models of face processing in which expression analysis proceeds independently from the analysis of identity. In experiment 2 there was a significant effect of familiarity on a task in which the sex of the faces was judged. This appeared to be due to familiarity acting to facilitate only those faces whose sex was difficult to judge from the picture presented. In experiment 3, significant effects of familiarity were also observed when the task was to distinguish intact faces from jumbled faces. Although the effects of familiarity in experiments 2 and 3 were small and emerged in interactions between item sets and university, they suggest that a simple perceptual hierarchy of the kind proposed by Ellis requires some revision. PMID- 3822724 TI - Apparent height of a stereokinetic cone is decreased by departure from circularity. AB - Subjects made judgements of the comparative height of the stereokinetic cones seen for pairs of rotating figures with varying eccentricity and ellipticity. For any given eccentricity, ellipticity of the figure reduced the apparent height, with narrow ellipses seeming to be shallower. The effect is attributed to an interaction in constancy scaling. PMID- 3822725 TI - Multiple 3-D interpretations in a classic stereokinetic effect. AB - It is known that a flat ellipse rotating in the frontoparallel plane sooner or later appears as a rigid circular disc tilting in 3-D space. An experiment is reported in which prolonged exposure to the same flat pattern produces a second previously unnoticed 3-D percept: an elongated egg slanted in 3-D space, which points towards the observer and the end parts of which describe a circular trajectory in the frontal plane. It is shown that the achievement of this alternative percept is not affected by the particular shape of the ellipse, although the time needed to reach it increases with an ellipse with a 2:3 axis ratio. PMID- 3822726 TI - Subjective contours can produce stereokinetic effects. AB - When a pattern of interrupted concentric circles drawn so as to produce an anomalous contour ellipse is slowly rotated in the frontoparallel plane, the subjective figure appears first to deform and then to tilt as a ring in 3-D space over motionless circles. Also, Benussi's floating cone can be obtained by placing an eccentric gray dot upon an anomalous solid ellipse and setting this figure into rotation. These patterns provide strong evidence that subjective contours can produce stereokinetic effects as effectively as real contours can. Implications for current explanations of stereokinetic effects are presented and discussed. PMID- 3822727 TI - Briefly presented stimuli can disrupt constant suppression and binocular rivalry suppression. AB - An earlier study has shown that the intermittent suppression of one monocular stimulus by another in binocular rivalry does not occur when normally rivalrous stimuli are briefly presented. Constant suppression of stimuli presented to one eye is a common consequence of esotropia during development. A study is reported which demonstrates that constant suppression does not occur when stimuli are briefly presented. The dependence of suppression on stimulus duration is similar in both forms of suppression. PMID- 3822728 TI - Aftereffects in binocular rivalry. AB - Five experiments are reported in which the aftereffect paradigm was applied to binocular rivalry. In the first three experiments rivalry was between a vertical grating presented to the left eye and a horizontal grating presented to the right eye. In the fourth experiment the rivalry stimuli consisted of a rotating sectored disc presented to the left eye and a static concentric circular pattern presented to the right. In experiment 5 rivalry was between static radiating and circular patterns. The predominance durations were systematically influenced by direct (same eye) and indirect (interocular) adaptation in a manner similar to that seen for spatial aftereffects. Binocular adaptation produced an aftereffect that was significantly smaller than the direct aftereffect, but not significantly different from the indirect one. A model is developed to account for the results; it involves two levels of binocular interaction in addition to monocular channels. It is suggested that the site of spatial aftereffects is the same as that for binocular rivalry, rather than sequentially prior. PMID- 3822729 TI - Binocular rivalry with rotary and radial motions. AB - Binocular rivalry between a radially sectored and a concentrically circular pattern was investigated in three experiments. Motion of the circular pattern was either cyclical expansion and contraction with corresponding changes in spatial frequency (experiment 1), or outward motion with a constant linear velocity (experiment 2). When both patterns were static the circular pattern was visible for longer than the radial one. Motion of either pattern alone resulted in an increase in the predominance duration and the mean period for which the pattern was visible. This is at variance with Levelt's model of rivalry. In the third experiment, rivalry was between a static circular pattern and a radial pattern that could be rotated at different angular velocities. Again it was found that an increase in stimulus strength, as measured by predominance, led to an increase in the mean periods of visibility of the rotating pattern. PMID- 3822730 TI - Facilitatory interactions between flashed lines. AB - The detectability of pairs of flashed lines was investigated as a joint function of their separation in both space and time. In contrast to previous studies of contrast interactions as a function of either spatial or temporal separation alone, the predominant interaction is not lateral inhibition, but a delayed facilitation. A quantitative model based on probability summation between lateral inhibitory detectors does not appear able to account for these results. Two related explanations are suggested: either a motion detection system or the nonlinear 'transient' subsystem is being tapped. PMID- 3822731 TI - Perceived orientation of contour quadrangles. AB - One hundred subjects ranked the apparent tilt of ten quadrangles. A scale of perceived orientation was derived from a pair-comparison treatment of these data. The main characteristic determining estimated orientation of the quadrangles was the axis from which the sum of the squared distances to each point of the figure was minimal (the LS-axis). Judgements were also influenced by the orientation of an 'axis of balance', which ran through the centre of gravity and the lowermost apex of the quadrangle. Quadrangles with parallel LS-axes were systematically judged as differently tilted according to the difference in the orientation of their axes of balance. Both the LS-axis and the axis of balance are physical characteristics of an object that are of great importance for the optimal control of human action through vision. PMID- 3822732 TI - Spatiotemporal isosensitivity fields in the human visual system. AB - The human visual system is capable of detecting correlations, manifested perceptually as global pattern, in mathematically constrained dynamic textures. This ability has given rise to speculation that correlative mechanisms in the human visual system exist and that they have a neural basis similar to the orientationally selective structures discovered in area 17 of the mammalian visual cortex. The limits to the detection of correlation were mapped, spatially and temporally, by means of a psychophysical technique. Evidence is presented that, at least in the spatial domain, the correlation mechanism may be served by a population of such neural units. PMID- 3822733 TI - Flicker masking and developmental dyslexia. AB - Recent studies have provided evidence that dyslexic children tend to show longer visual persistence than control children when presented with low-spatial frequency grating stimuli. The possibility that this phenomenon might reflect an impairment of inhibitory Y-cell activity in the visual system of dyslexics has been investigated. A flicker masking technique was used to mask Y-cell activity selectively in a group of dyslexic boys and a group of age-matched controls. There were no overall differences in reaction times to the offsets of grating patterns of various spatial frequencies between the groups, and no differences between subgroups defined by age, degree of reading impairment, or any other criterion. The results show no evidence of abnormal Y-cell function in developmental dyslexia. PMID- 3822734 TI - The effect of line-figure information on the magnitude of the dot forms of the Poggendorff and Muller-Lyer illusions. AB - The magnitudes of the dot and line forms of the Poggendorff illusion and the Brentano version of the Muller-Lyer illusion were assessed in two groups of subjects: the informed group was given information about the implied figure configuration in the dot pattern, the uninformed group was not. The informed group produced a significantly greater dot illusion than the uninformed group, and there was no difference between the two groups in the magnitudes of the line illusions. The experiments are discussed in the context of Coren and Porac's proposal that illusion-inducing mechanisms can be divided into structural and cognitive components. The results suggest that about 64% of the magnitude of the Poggendorff illusion and about 54% of the Muller-Lyer illusion can be attributed to the involvement of cognitive factors. PMID- 3822735 TI - The basis of Stroop interference involving the multimodal correlates of auditory pitch. AB - A pure auditory tone has a range of multimodal qualities that are determined by its pitch. A reaction-time task was used to demonstrate that subjects respond immediately and automatically to these qualities. Subjects were required to press one of two keys depending on which word, from a limited set, appeared on a microcomputer screen. The words were antonyms that represented multimodal stimulus qualities, and they were assigned to alternative responses so that the two words that shared the same response were correlated in the same way with pitch. As an incidental stimulus, either a 50 Hz tone or a 5500 Hz tone accompanied the presentation of each word. Subjects were found to respond more slowly when the multimodal qualities of the tone were incongruent with the qualities represented by the test word. When the stimulus-response mapping rules were changed, however, the Stroop effect did not occur; suggesting that a polarised semantic code of the incidental tone, that embraces its multimodal features, accesses the same semantic register as the equivalent code for the test word itself. PMID- 3822736 TI - The optomotor response and induced motion of the self. AB - Although the optomotor response in animals and induced motion of the self in humans occur under very similar stimulus conditions, they have not hitherto been related. Experiments with fish are reported which support the hypothesis that the optomotor response is based on the animal's attempt to nullify the unwanted experience of its own motion that is imposed upon it. PMID- 3822737 TI - The impossibly twisted Pulfrich pendulum. AB - Two Pulfrich pendulums swinging in opposite phase present impossible twisting effects and also size-constancy effects. PMID- 3822738 TI - An analysis of the monaural displacement of sound in space. PMID- 3822739 TI - Interaction of signal discriminability and task type in vigilance decrement. PMID- 3822740 TI - Allocation of visual attention in good and poor readers. PMID- 3822741 TI - Speed of apparent motion and the wagon-wheel effect. PMID- 3822742 TI - Saccadic eye movements and the perception of visual direction. PMID- 3822743 TI - Outline- and solid-angle orientation illusions have different determinants. PMID- 3822744 TI - Relative motion: kinetic information for the order of depth at an edge. PMID- 3822745 TI - The interaction between stimulus variations and age trends in the Poggendorff illusion. PMID- 3822746 TI - Overall brightness decrease observed in the Ehrenstein illusion induced for both contrast polarities. PMID- 3822747 TI - Tonal fusion of consonant musical intervals: the oomph in Stumpf. PMID- 3822748 TI - The homogeneity effect in counting. PMID- 3822750 TI - Integration of features in depictions as a function of size. PMID- 3822749 TI - Cortical dynamics of three-dimensional form, color, and brightness perception: II. Binocular theory. PMID- 3822751 TI - Matching gaps between misaligned pointers demonstrates that lines, both transverse and parallel, enhance Poggendorff illusions. PMID- 3822752 TI - Chromatic Mach bands: behavioral evidence for lateral inhibition in human color vision. PMID- 3822753 TI - The influence of alcohol and loud music on analytic and holistic processing. PMID- 3822754 TI - A note on apparent displacement of lines and dots on oblique parallels. PMID- 3822756 TI - Neoplasia in infancy and childhood. PMID- 3822757 TI - Lymphohistiocytosis in childhood. Pathologic comparison with fatal Letterer-Siwe disease (disseminated visceral histiocytosis X). PMID- 3822755 TI - Cortical dynamics of three-dimensional form, color, and brightness perception: I. Monocular theory. PMID- 3822758 TI - Intraepithelial current flow in rat pancreatic secretory epithelia. AB - To assess the importance for transepithelial salt secretion of current flow across the baso-lateral membrane, we studied the effects of ouabain (1 mmol/l), Ba (3 mmol/l) and tetraethylammonium (TEA: 10 mmol/l) on secretion by the acinar (caerulein stimulated) and ductal (secretin stimulated) epithelia of the perfused rat pancreas. Within 10 min, ouabain caused a 79% inhibition of acinar secretion which was resolvable into two exponentials with half-times, respectively, of 0.24 min +/- 0.19 (S.D.) and 6.40 +/- 0.46 min. In contrast, it caused only a monoexponential inhibition of ductal secretion (61% in 10 min) with a half-time of 5.08 +/- 0.26 min. Ba caused a monoexponential inhibition of acinar secretion (70% in 10 min) with a half-time of 1.82 +/- 0.27 min, but it had no inhibitory effect on ductal secretion. The action of TEA was similar to that of Ba: it caused monoexponential inhibition of acinar secretion (26% in 10 min) with a half time of 1.82 +/- 0.03 min, and it too had no effect on ductal secretion. For comparison, we also studied the effect of these drugs on the more rapidly secreting rat mandibular gland (stimulated with acetylcholine). All three drugs were strongly inhibitory: within 10 min, ouabain caused a 95%, Ba an 89% and TEA an 83% inhibition. The decay curves appeared to be monoexponential with half times, respectively, of 1.49 +/- 0.12, 0.51 +/- 0.3 and 0.56 +/- 0.02 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822759 TI - Membrane potentials and intracellular chloride activity in the ciliary body of the shark. AB - We have found that membrane potential in the isolated ciliary epithelium of the shark, Squalus acanthias, is -53 mV. High extracellular potassium or ouabain (10( 5) mol X l-1) decrease the potential, and furosemide (10(-4) mol X l-1) hyperpolarizes it. There is no difference in membrane potential between the cells of the non-pigmented and pigmented layers. Intracellular chloride activity (64 mmol X l-1) was significantly higher than could be predicted from the equilibrium distribution (26 mmol X l-1) across the cell membranes. When furosemide was applied to the aqueous side of the epithelium, intracellular chloride activity decreased to 35 mmol X l-1 and approached electrochemical equilibrium. The data indicate that the ciliary epithelium possesses an active, furosemide-sensitive chloride transport mechanism which could be a Na-Cl or a 1 Na-1 K-2 Cl symport. PMID- 3822760 TI - Direct demonstration of high transepithelial chloride-conductance in normal human sweat duct which is absent in cystic fibrosis. AB - The transepithelial electrical potential difference (Vt) and the transepithelial resistance (Rt) were measured across individual microdissected sweat ducts obtained from biopsies of the scapular region of normal human volunteers and of a Cystic Fibrosis (CF) patient. During luminal and contraluminal perfusion with NaCl Ringer solution Vt and Rt were -10.7 +/- 1.1 (mV, lumen negative) and 10.9 +/- 1.7 (omega X cm2). Bilateral substitution of Cl- by gluconate increased Vt and Rt to -42.7 +/- 5.1 (mV) and 98.0 +/- 12.0 (omega X cm2), respectively. Luminal application of amiloride (10(-4) mol/l) collapsed Vt and increased Rt to 11.4 +/- 1.7 and 159.7 +/- 12.0 omega X cm2 in Cl- and gluconate Ringer respectively. These data indicate that 90% of the total transepithelial conductance is attributed to Cl- and 5% to Na+ while the remaining 5% is unaccounted for at present. In CF ducts Vt and Rt were high already in Cl- Ringer solution (-78.9 +/- 9.9 mV and 91.2 +/- 15.6 omega X cm2) and did not change significantly after replacement of Cl- by gluconate. The data demonstrate that normal human sweat duct epithelium, despite its ability to generate high electric and osmotic gradients, is a low resistance epithelium, probably because of a high Cl(-)-permeability of its cell membranes. In addition, the data demonstrate that this Cl(-)-conductance is missing in CF, in conformation of what has been postulated previously from simple potential measurements. PMID- 3822761 TI - Chloride transport in the mammalian proximal tubule. AB - Possible transport mechanisms of chloride across the mammalian proximal tubule include both active and passive components and, accordingly, transcellular and intercellular transport routes. Experiments are described in which the possibility of electroneutral anion exchange across the apical cell membrane of proximal tubule cells is evaluated. Experiments in brushborder vesicles of the rabbit kidney cortex have shown the existence of a chloride/formate exchange process. In addition, evidence is presented that formic acid is crossing the brushborder membrane of rabbit renal cortex by non-ionic diffusion. A transport schema is developed in which formate/chloride exchange and sodium/hydrogen exchange in parallel with recycling of formic acid by non-ionic diffusion can account for the electroneutral transport of sodium chloride. Perfusion studies in isolated rabbit straight and convoluted tubules show significant transport stimulation by submillimolar concentrations of formate. Thus, chloride/formate exchange is a possible mechanism for active, transcellular chloride movement across the mammalian proximal tubule. PMID- 3822762 TI - Kinetic studies of sulfate transport in basolateral membrane vesicles from rat renal cortex. AB - The kinetics of sulfate uptake were studied in basolateral membrane vesicles from rat renal cortex. Sulfate uptake exhibits a DIDS-sensitive, saturable component, and a DIDS-insensitive component, which does not saturate in the tested sulfate concentration range (up to 10 mM). Intravesicular (= trans) sulfate strongly stimulates sulfate uptake by increasing Jmax and--to a lesser degree--by decreasing apparent Km. The marked dependence of Jmax on trans-sulfate indicates that the transport system operates as an anion exchanger. Half-maximal sulfate uptake occurs at 0.08-0.14 mmol/l extravesicular sulfate. Half-maximal trans stimulation is observed at 11 mmol/l intravesicular sulfate indicating that the sulfate transporter is highly asymmetric. Lowering extravesicular pH stimulates sulfate uptake, suggesting that external protons are essential for sulfate uptake. This stimulation is mainly due to a decrease in Km. An inside positive membrane potential stimulates sulfate uptake at pHout = 8.8, but not at pHout = 6.4. These results are compatible with electrogenic sulfate transport at higher and electroneutral 2H+ -SO4(2-) cotransport at lower pH. PMID- 3822763 TI - The anion specificity of the sodium-potassium-chloride cotransporter in rabbit kidney outer medulla: studies on medullary plasma membranes. AB - Plasma membrane vesicles were isolated from rabbit kidney outer medulla and employed in sodium, rubidium, and chloride flux studies. Chloride dependence and bumetanide sensitivity of (part of) the sodium and rubidium flux indicate that this plasma membrane fraction can be used to study the properties of Na-K-2Cl cotransport system present in the luminal membrane of the medullary thick ascending limb. The anion specificity of the cotransporter was investigated by determining the effect of anion replacement on sodium fluxes. When chloride was completely replaced by bromide, iodide, nitrate, or thiocyanate only bromide could effectively substitute for chloride (90% activity), whereas sodium uptake in the presence of iodide, nitrate, and thiocyanate amounted to only 25% of the sodium uptake observed in the presence of chloride. When similar replacement experiments were performed in the presence of 10 mmol/l chloride, bromide could substitute for chloride by 110%, iodide and nitrate by 60%, and thiocyanate by 70%. In the presence of 10 mmol/l bromide iodide, nitrate, and thiocyanate were similarly effective. The effect of nitrate and chloride on sodium flux was additive. Bumetanide-sensitive chloride uptake was inhibited by nitrate, the inhibition was however only partly, amounting to 60%. The results obtained are compatible with the view that the two anion binding sites of the Na-K-2Cl cotransporter can exhibit a different substrate specificity and that the transporter in addition to a 2Cl mode can also operate in a 2Br, Cl-, A- and Br-, A- mode, A- representing iodide, nitrate, or thiocyanate. PMID- 3822765 TI - International symposium on epithelial anion transport--hormonal regulation. Frankfurt, November 18-19, 1985. Proceedings. PMID- 3822764 TI - Coupling between sodium and succinate transport across renal brush border membrane vesicles. AB - The coupling between Na+ and succinate transport through the renal brush border Na+-dicarboxylate cotransporter was examined in a vesicle preparation. Initial rates of Na+ and succinate uptake were measured simultaneously using radioactive isotopes under zero-trans (Na+ and succinate-free intravesicular solutions) and voltage-clamped conditions (p.d. = 0 mV). The coupling coefficient is defined as the ratio of the succinate-dependent Na+ flux to the Na+-dependent succinate flux. The cis Na+ and succinate concentrations were varied from 0.05-5 mM succinate and 25-150 mM Na+. The coupling coefficient was approximately 3 and was independent of the succinate and Na+ concentrations tested. These results suggest that only the free carrier and the fully loaded carrier (carrier + 3 Na+ + succinate2-) are able to cross the brush border membrane; i.e., there is little evidence of slippage in the coupling between Na+ and succinate fluxes through the membrane via this carrier. A coupling coefficient of 3 is consistent with the electrogenic nature of the Na-dicarboxylate cotransporter. PMID- 3822766 TI - Additive effects of glucagon and vasopressin on renal Mg reabsorption and urine concentrating ability in the rat. AB - Previous studies demonstrated that in rat kidney, arginine-vasopressin (AVP), glucagon (GLU), calcitonin and parathyroid hormone exert similar effects on the thick ascending limb of Henle's loop (TALH). To ascertain the physiological significance of such multiple hormonal control of TALH function, it is necessary to establish whether one hormone can exert its effect on TALH, even when other hormones are present. We therefore compared renal responses to submaximal (1 ng/min) and maximal (10 ng/min) doses of glucagon in rats deprived of endogenous AVP, GLU, calcitonin and parathyroid hormone with the responses of similar rats given a maximal dose of AVP (40 pg/min). Administration of glucagon or AVP alone reduced Mg fractional excretion, but the reduction was more marked when both hormones were given together. Consequently, their effects were additive, at submaximal and maximal doses. In the presence of AVP + glucagon, urinary osmolality was also higher than in the presence of AVP alone (Umax: 1242 +/- 49 vs. 936 +/- 50 mosmol/kg; p less than 0.001). This latter effect may indicate that AVP and glucagon also exert additive effects on Na reabsorption in the TALH. PMID- 3822767 TI - Modelling of colonic Cl- and K+ transport under resting and secreting conditions. AB - Transport of electrolytes, particularly of Cl- and K+, by the rat proximal colon was studied in vivo under conditions of high and low K+ diet and in the presence of transport inhibitors and secretagogues. The electrical parameters, PD, Isc, Rm, were monitored by direct clamping and via cable analysis. The present work reinforces own earlier work and that of others that - under control conditions - absorption of Na+ and Cl- is mainly electrically neutral. Low K+ diet reduced absorption of Na+ and Cl-, as well as secretion of K+, and increased HCO3- absorption. High K+ predominantly increased K+ secretion and reduced HCO3- absorption, these diet-induced changes being electrically neutral. Secretagogues such as PGE1 and theophylline reduced net absorption of Na+ and Cl-, increased the Isc and lowered the Rm. These effects could be reversed by the antidiarrheal drugs, loperamide and somatostatin, except the increase of K+ secretion, and reversed HCO3- transport absorption to secretion. A model consisting of absorptive columnar cells and secreting crypt cells is presented which encompasses the known and supposed aspects of colonic ion transport. PMID- 3822768 TI - The effect of inorganic phosphate on the ATP hydrolysis rate and the tension transients in chemically skinned rabbit psoas fibers. AB - The role of orthophosphate ions (Pi) in crossbridge kinetics was investigated by parallel measurements of the ATP hydrolysis rate and tension transients in maximally activated, chemically skinned rabbit psoas fibers. The hydrolysis rate of the standard activation at 20 degrees C was measured at 1.25 nmole X s-1 X m-1 X fiber-1, which corresponds to the hydrolysis of 3 moles ATP per mole of myosin head per second. The isometric tension, stiffness extrapolated to the infinite frequency, and the ATPase rate progressively decreased when increasing concentrations of Pi (0-16 mM) were added to the activating saline. The decrease was greatest with tension, followed by stiffness and the ATPase rate. Both the apparent rate constant and the magnitude parameters of exponential process (B) increased with Pi concentration resulting in a significant increase in the oscillatory power output. The effects of Pi on processes (A) and (C) were only marginal. When fibers were oscillated at 1 Hz [close to the characteristic frequency of process (A)], no significant increase in the ATP hydrolysis rate was observed. However, a small increase was noticed at 10 Hz [1%, process (B)], and at 100 Hz [6%, process (C)]. We interpret these results in terms of a crossbridge scheme which adds a branch pathway to the conventional hydrolysis cycle. In the proposed scheme, the number of crossbridges entering the branch pathway increases at higher Pi concentrations and in the presence of imposed oscillations at the proper frequency. PMID- 3822769 TI - Measurement by Quin2 of changes of the intracellular calcium concentration in strips of the rabbit ear artery and of the guinea-pig ileum. AB - Ca2+ transient and force development were investigated in smooth muscle strips of the rabbit ear artery and the longitudinal layer of the guinea-pig ileum by using the fluorescent indicator Quin2. Agonists only transiently increased the fluorescence intensity despite the enhanced contraction while excess potassium resulted in a maintained light signal. In Ca2+ free solutions the release by an agonist of Ca2+ from an intracellular store can be demonstrated. These observations illustrate the usefulness of the Ca2+ indicator Quin2 in the study of the excitation-contraction coupling in smooth muscle under various conditions. PMID- 3822770 TI - Contraluminal para-aminohippurate (PAH) transport in the proximal tubule of the rat kidney. II. Specificity: aliphatic dicarboxylic acids. AB - In order to study the specificity for contraluminal para-aminohippurate (PAH) transport, the inhibitory potency of aliphatic dicarboxylates on 3H-PAH influx, as well as the inhibitory effect on 35SO4(2-)- and 3H-succinate influx, from the interstitium into cortical tubular cells in situ has been determined. The following was found: Testing a homologous series of dicarboxylates--ranging from the 2 C oxalate to the 10 C sebacate--PAH transport was inhibited by succinate (app. Ki 1.35 mmol/l), and all longer dicarboxylates, with high potency (app. Ki 0.05--0.35 mmol/l). Sulfate transport was inhibited only by oxalate (app. Ki 1.1 mmol/l), while dicarboxylate transport was inhibited by succinate, glutarate, adipate and pimelate with decreasing potency (app. Ki 0.04, 0.24, 0.91, 4.0 mmol/l, respectively). PAH transport was inhibited by succinate and glutarate with high potency (app. Ki 1.35 and 0.05 mmol/l), by the correspondent monomethylester to a lesser extent (app. Ki 1.7 and 0.74 mmol/l), but not by the dimethylester. On the other hand, the semialdehyde of succinate with a Ki-value of 1.2 mmol/l, had the same inhibitory potency as succinate itself, while the dialdehyde of glutarate (app. Ki 1.4 mmol/l) was much less potent as glutarate. Introduction of an oxo-, methyl- or sulfhydroxyl-group group onto the 2-position of succinate, or of an oxo-group onto the 2-position of glutarate moderately augmented the inhibitory potency against PAH-uptake. However, introduction of a 2 hydroxy group onto succinate or glutarate in the L-position reduced the inhibitory potency more than in the D-position. Introduction of two methyl-, sulfhydryl- or hydroxyl-groups in the 2-3 position of succinate reduced or abolished its inhibitory potency. The introduction of a 2-amino group onto succinate or glutarate abolished its effect on PAH transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822771 TI - Relation between force and calcium ion concentration in different fibre types of the iliofibularis muscle of Xenopus laevis. AB - Calcium activated isometric force was measured in segments of single muscle fibres of the iliofibularis muscle of Xenopus laevis skinned by freeze-drying. A subdivision in five different fibre types was made, based on the location of the fibres inside the muscle, fibre diameter and a quantitative histochemical assay for succinate dehydrogenase activity. The Ca2+ sensitivity was characterized by fitting a Hill curve to the force levels reached at different Ca2+ concentrations. The parameter n of this equation indicates the steepness and pK the midpoint of this force-pCa relation. A considerable variability in the Ca2+ sensitivity characteristics was found between different fibres. The parameter n varied between 1.1 and 4.2 while pK varied between 5.5 and 6.6. The distribution of the data indicates the presence of three groups with different Ca2+ sensitivity; a group of fibres with low Ca2+ sensitivity but with considerable variation of the steepness of the Ca2+ sensitivity curves (type 1 fibres), an intermediate group (type 2, 3 and 4 fibres) with also considerable variation in steepness of the Ca2+ sensitivity curves, in which the lowest values for n are found in type 3 and 4 fibres and a group with high Ca2+ sensitivity and low n containing at least one tonic (type 5) fibre. At sub-saturating Ca2+ concentrations occasionally a transient decrease of the rate of force development was found which resembled the force oscillation reported for some mammalian muscle fibres. PMID- 3822773 TI - [CT findings and CT score in acute pancreatitis compared its with severity]. PMID- 3822774 TI - [Technic and usefulness of percutaneous transhepatic choledocholithotripsy (PTCL) using a flexible forceps]. PMID- 3822772 TI - Effects of selective cutaneous denervation on hypothalamic thermosensitivity in rats. AB - The effect of altering input from cutaneous thermoreceptors of the face and trunk on the relationship between hypothalamic temperature (Thy) and heat production (HP) was studied in three rats. The signal from cutaneous receptors was altered in two ways: by altering skin temperature (Tsk) and by sectioning nerves supplying cutaneous receptors. It was found that when Tsk was lowered in normal rats Thy threshold for thermoregulatory HP was elevated, but the slope of the relationship between Thy and HP was not significantly altered. After the spinal nerves serving the trunk skin were sectioned, the slope was reduced and the threshold was elevated markedly at both test ambient temperatures (Ta), but Ta had essentially the same effect on the Thy vs. HP relationship after cutaneous denervation as before. Clearly, eliminating input from trunk cutaneous thermoreceptors has a different effect than does lowering or raising Tsk, but thermoregulation is being achieved by the same basic mechanism before and after cutaneous denervation. After the cranial nerves supplying the skin of the face were also sectioned, there was a further elevation in the Thy threshold for HP at Ta = 25 degrees C but no change at Ta = 15 degrees C. It is concluded that cutaneous denervation does not substantially interfere with the rat's ability to regulate its body temperature, and that the reduced Thy sensitivity and increased Thy threshold exhibited after cutaneous denervation is the result of input from intact warm- and cold-thermoreceptors located in the core and in tissues intermediate to core and skin. PMID- 3822775 TI - [Embolization therapy for varicocele with special reference to its pathogenesis]. PMID- 3822776 TI - Cerebellar hemangioblastoma supplied by the artery of Davidoff and Schechter: a case report. PMID- 3822777 TI - [MRI of intracranial hemorrhage]. PMID- 3822778 TI - [Bronchial artery embolization for hemoptysis using Ivalon particles]. PMID- 3822779 TI - [Intra-arterial DSA of cerebrovascular disease using transbrachial arch injection]. PMID- 3822780 TI - [Reflux esophagitis: correlation between endoscopic and radiographic findings and quantitative changes in mucosal glycoprotein]. PMID- 3822781 TI - [Effect of misonidazole on the radiosensitivity of Ehrlich ascites tumor cells]. PMID- 3822782 TI - [Clinical trial of degradable starch microspheres (DSM) in the treatment of hepatic malignancies by intra-arterial infusion of anticancer drugs--relationship between quantity of DSM and blockade of arterial blood flow]. PMID- 3822783 TI - [Computed tomography in diffuse pulmonary diseases]. PMID- 3822784 TI - [A case of renal cell carcinoma diagnosed by percutaneous transvenous tumor biopsy]. PMID- 3822785 TI - [Computed tomography of chest wall abscess]. PMID- 3822786 TI - [Evaluation of resectability and prognosis of carcinoma of the pancreas by angiogram]. PMID- 3822787 TI - Changes in regional blood flow of normal and tumor tissues following hyperthermia and combined X-ray irradiation. PMID- 3822788 TI - [Effect of hyperthermia on mononuclear cell infiltration into tumor tissue analyzed using monoclonal antibodies]. PMID- 3822789 TI - [Effect of the hypoxic cell radiosensitizer,a dinitroimidazole derivative, on murine tumors]. PMID- 3822790 TI - [DNA adductors, a target for chemical health hazards]. PMID- 3822791 TI - [The status of occupational medicine in the Scandinavian countries]. PMID- 3822792 TI - [Combination treatment in the early stages of Parkinson's disease]. PMID- 3822793 TI - [Exercise-induced asthma in children]. PMID- 3822794 TI - [Repeated measurements in the same patient--and related problems]. PMID- 3822795 TI - [Health risks in work with video display terminals]. PMID- 3822796 TI - [Effects of solvents on the nervous system]. PMID- 3822797 TI - [Fatal accidents in Danish agriculture. 5-year notifications to the state labor supervisory board]. PMID- 3822799 TI - [Renovascular hypertension]. PMID- 3822798 TI - [Hypertension in children]. PMID- 3822801 TI - [Stochastic variable, expectation and variance--basic concepts in statistical analysis]. PMID- 3822800 TI - [Moyamoya--a cerebrovascular disease]. PMID- 3822802 TI - Sequence dependent electrophoretic mobilities and melting temperatures for A-T containing oligodeoxyribonucleotides. AB - The electrophoretic mobilities and thermal melting properties of self complementary A-T containing dodecamer oligodeoxyribonucleotides have been investigated as a function of solution conditions. The oligomers contained tracts of nonalternating A-T base pairs of 2 (d(A2T2)3), 3 (d(A3T3)2), and 6 (d(A6T6] as well as the fully alternating (d(A-T)6) sequence. The melting temperature increased with the length of the nonalternating sequence and was approximately 12 degrees C higher in the d(A6T6) sequence than in the alternating oligomer. Under denaturing conditions all oligomers had the same electrophoretic mobility on acrylamide gels. Under conditions which favor duplex formation, the oligomers exhibited significant sequence dependent mobility differences. The mobilities of two oligomers, d(A-T)6 and d(A6-T6), were approximately equal and were less than those of the other oligonucleotides. The greatest mobility was observed for d(A2T2)3. These results are best explained by a model which requires bending at a junction of two or more continuous A or T bases with another sequence. PMID- 3822804 TI - Assignment of the 13C nuclear magnetic resonance spectrum of a short DNA-duplex with 1H-detected two-dimensional heteronuclear correlation spectroscopy. AB - Proton-detected 1H-13C heteronuclear correlated spectroscopy [( 1H,13C]-COSY) was used to establish relations between the carbon-13 and proton nuclear magnetic resonance chemical shifts in the hexadeoxynucleoside pentaphosphate d-(GCATGC)2. Using the previously established sequence-specific proton NMR assignments, sequence-specific assignments were thus obtained for nearly all proton-bearing carbons. This approach offers a new criterion for distinguishing between the proton NMR lines of purines and pyrimidines, based on the different proton-carbon 13 coupling constants. Furthermore, the adenine ring carbon 2 has a unique carbon 13 chemical shift, which enables a straightforward identification of the adenine C2H resonances by [1H,13C]-COSY. PMID- 3822803 TI - Unusual features of transcribed and translated regions of the histone H4 gene family of Tetrahymena thermophila. AB - The complete DNA sequence is presented of H4-II, the second of the pair of histone H4 genes of the ciliated protozoan, Tetrahymena thermophila. Both H4 genes code for the same protein. Codon usage in these and other Tetrahymena genes is severely restricted and is similar to that in yeast. Flanking regions are AT rich (greater than or equal to 75%), relative to coding sequences (approximately 45% GC). Except for small, similarly positioned homologies, flanking sequences of the two genes are different. Canonical sequences in higher eukaryotic promoters are not obvious in these genes. Instead, short, localized, base composition eccentricities characterize the 5' flanking sequences of all Tetrahymena genes analyzed. The consensus, P yP u(A)3-4 ATGG initiates translation in these and all other known Tetrahymena genes. Nuclear transcripts and messages of both growing and starved cells begin at multiple sites, mainly at the first or second A residue following a pyrimidine. The palindrome typical of histone message 3' termini in higher organisms is not present. Downstream of both genes are sequences similar to the processing/polyadenylation signal of higher eukaryotes, although the unique 3' ends are not those predicted by the location of the signals. PMID- 3822805 TI - Anomalous structure and properties of poly (dA).poly(dT). Computer simulation of the polynucleotide structure with the spine of hydration in the minor groove. AB - The results of the search for low-energy conformations of poly(dA).poly(dT) and of the poly(dA).poly(dT) "complex" with the spine of hydration similar to that found by Dickerson and co-workers (Kopka, M.L., Fratini, A.V., Drew, H.R. and Dickerson, R.E. (1983) J. Mol. Biol. 163, 129-146) in the minor groove of the CGCGAATTCGCG crystals are described. It is shown that the existence of such a spine in the minor groove of poly(dA).poly(dT) is energetically favourable. Moreover, the spine of hydration makes the polynucleotide conformation similar to the poly(dA).poly(dT) structure in fibers and to the conformation of the central part of CGCGAATTCGCG in crystals; it also acquires features characteristic of the structure of poly(dA).poly(dT) and DNA oligo(dA)-tracts in solution. It is shown that the existence of the TpA step in conformations characteristic of the poly(dA).poly(dT) complex with the spine of hydration is energetically unfavourable (in contrast to the ApT step) and therefore this step should result in destabilization of the spine of hydration in the DNA minor groove. Thus, it appears that the spine of hydration as described by Dickerson and co-workers is unlikely to exist in the poly d(A-T).poly d(A-T) structure. The data obtained permit us to interpret a large body of experimental facts concerning the unusual structure and properties of poly(dA).poly(dT) and oligo(dA)-tracts in DNA both in fibers and in solution. The results provide evidence of the existence of the minor groove spine of hydration both in fibers and in solution on A/T tracts of DNA which do not contain the TpA step. The spine plays an active role in the formation of the anomalous conformation of these tracts. PMID- 3822806 TI - 1H and 31P NMR data of protected deoxycytidylyl-deoxyribonucleoside phosphates. PMID- 3822807 TI - Heterogeneity in the 3'-portion of Papilionaceae 5S rRNAs. The primary structure of alfalfa 5S rRNA. PMID- 3822808 TI - The nucleotide sequences of 5S ribosomal RNAs from two plants: rape and white beet. PMID- 3822809 TI - Nucleotide sequence of 5S ribosomal RNA from Rhodococcus erythropolis. PMID- 3822810 TI - The nucleotide sequences of the 5S rRNAs from the purple bacteria Ectothiorhodospira halophila and Ectothiorhodospira vacuolata. PMID- 3822811 TI - Nucleotide sequence of Physarum U6 small RNA. PMID- 3822812 TI - The final deprotection step in oligonucleotide synthesis is reduced to a mild and rapid ammonia treatment by using labile base-protecting groups. AB - Phenoxyacetyl (pac) and methoxyacetyl (mac) for adenine and guanine, isobutyryl for cytosine, were successfully applied as amino protecting groups both in phosphotriester and phosphoramidite approaches. As shown by N.M.R. and H.P.L.C. analysis, they are completely deblocked in less than four hours in 29% ammonia at room temperature allowing the preparation of modified DNA containing alkali labile bases such as saturated pyrimidines. The stability of N6-phenoxyacetyl deoxyadenosine versus depurination in acidic conditions used in the detritylation step was favorably compared with that of the classic N6-benzoyl protected adenine. PMID- 3822813 TI - Footprinting at low temperatures: evidence that ethidium and other simple intercalators can discriminate between different nucleotide sequences. AB - Footprinting experiments employing DNAase I have been performed at 4 degrees C. At this temperature several simple intercalating ligands, including both ethidium and proflavine, can be seen to induce marked changes in the pattern of cleavage. From an analysis of the changes in patterns of digestion by DNAase I we deduce that ethidium binds best to regions of mixed nucleotide sequence, especially those containing alternating purines and pyrimidines. Binding seems to be weakest to poly dA sequences which consequently appear as regions of relatively enhanced cleavage. Attempts to reproduce these changes using DNAase II as a footprinting tool were unsuccessful. PMID- 3822814 TI - Cell cycle regulated synthesis of stable mouse thymidine kinase mRNA is mediated by a sequence within the cDNA. AB - The cDNA for mouse thymidine kinase (TK) was isolated from a cDNA library in lambda-gt11 and sequenced. It was used as a probe to follow the time course of TK mRNA expression in growth stimulated mouse fibroblasts. Linked to the HSV-TK promoter the cDNA was able to transform LTK-cells to the TK+ phenotype. The transformed cells expressed the TK mRNA and enzyme activity in a growth dependent fashion suggesting that the regulatory element is localized on the cDNA. PMID- 3822815 TI - Dissociation kinetics of 19 base paired oligonucleotide-DNA duplexes containing different single mismatched base pairs. AB - The dissociation kinetics of 19 base paired oligonucleotide-DNA duplex containing a various single mismatched base pair are studied on dried agarose gels. The kinetics of the dissociation are first order under our experimental conditions. The incorporation of a single mismatched base pair destabilizes the DNA duplexes to some extent, the amount depending on the nature of the mismatched base pair. G T and G-A mismatches slightly destabilize a duplex, while A-A, T-T, C-T and C-A mismatches significantly destabilize it. The activation energy for the overall dissociation processes for these oligonucleotide-DNA duplexes containing 19 base pairs is 52 +/- 2 Kcal mol-1 as determined from the slope of Arrhenius plot. PMID- 3822816 TI - Nodulin-26, a peribacteroid membrane nodulin is expressed independently of the development of the peribacteroid compartment. AB - The peribacteroid membrane (pbm) of root nodules is derived from the plant cell plasma membrane but contains in addition several nodule-specific host proteins (nodulins). Antibodies raised against purified pbm of soybean were used to immunoprecipitate polysomes to isolate an RNA fraction that served as a template for the synthesis of a cDNA probe for screening a nodule-specific cDNA library. Clone p1B1 was found to encode a 26.5 kDa polypeptide (nodulin-26) which is immunoprecipitable specifically with the anti-pbm serum. Nodulin-26 has features of a transmembrane protein and its structure differs from that of nodulin-24 which appears to be a surface protein of pbm. The expression of these two pbm nodulins was examined in nodules induced by Bradyrhizobium japonicum Tn5 mutants that arrest nodule development at different stages of pbm biosynthesis. Nodules that do not show release of bacteria from the infection thread express nodulin-24 at a very low level. In contrast, the expression of nodulin-26 occurs fully in nodules that form infection threads only and is not affected by the release of bacteria from the threads. PMID- 3822818 TI - A rapid and simple method for the isolation of high molecular weight cellular and chromosome-specific DNA in solution without the use of organic solvents. PMID- 3822817 TI - Actinomycin D facilitates transition of AT domains in molecules of sequence (AT)nAGCT(AT)n to a DNAse I detectable alternating structure. AB - The interaction of actinomycin D with (AT)nAGCT(AT)n (where n = 2, 3, or 4) was investigated using a combination of imino proton NMR and DNAse I digestion. The stoichiometry of the interaction appears to be one:one with the actinomycin chromophore intercalated between the two GC base pairs. This binding event facilitates the conversion of the flanking repetitive AT regions to an alternating conformation characterized by induced sensitivity of the ApT sequences to attack by DNAse I. The neighboring TpA sequences do not exhibit rate changes as a function of binding of the drug. The potential relevance of such ligand induced DNA structural alterations is discussed. PMID- 3822819 TI - Structure and organization of the chicken H2B histone gene family. AB - The results of Southern blotting experiments confirm that the chicken H2B histone gene family contains eight highly homologous members. One or two more sequences which are considerably divergent from the others appear to exist in the chicken genome. Seven of the eight H2B genes have been cloned and sequenced. All seven genes fall in two histone gene clusters, but no common arrangement exists for the clusters themselves. Three different H2B protein variants are encoded by these seven genes. The nucleotide sequence homology among the genes within their coding sequences appears to exceed that required for the corresponding protein sequences, suggesting that histone H2B mRNA sequence and structure are both selected during evolution. An analysis of the 5' flanking sequence data reveals that these genes possess CCAAT and TATA boxes, elements commonly associated with genes transcribed by RNA polymerase II. In addition, these genes all share an H2B specific element of the form: ATTTGCATA. The 3' sequences of these genes contain the hyphenated symmetrical dyad homology and downstream purine-rich sequence shared by histone genes in general. PMID- 3822821 TI - Synthesis of some S-3'-deoxyadenosyl-L-homocysteine analogues. AB - Condensation of 3'-deoxy-3-deazaadenosine, 3'-deoxy-7-deazaadenosine and 3' deoxyadenosine with N,N'-bis-trifluoroacetyl-L-homocystine dimethyl ester and subsequent deprotection of the resulting N-trifluoroacetyl-S-3'-deoxyadenosyl-L homocysteine analogues afforded S-3'-deoxy-3-deazaadenosyl-L-homocysteine, S-3' deoxy-7-deazaadenosyl-L-homocysteine and S-3'-deoxyadenosyl-L-homocysteine respectively. 3'-Deoxy-3-deazaadenosine and 3'-deoxy-7-deazaadenosine were prepared by transformation of the corresponding ribonucleosides with 2 acetoxyisobutyryl bromide. 3'-Deoxy-7-deazaadenosine and 3'-deoxyadenosine were also converted into their 5'-chloro-3',5'-dideoxy derivatives which in turn were condensed with L-homocysteine sodium salt to give S-3'-deoxy-7-deazaadenosyl-L homocysteine and S-3'-deoxyadenosyl-L-homocysteine which were identical with those synthesized by condensation of the protected L-homocystine with the 3' deoxynucleosides. PMID- 3822820 TI - Chicken erythrocyte polynucleosomes which are soluble at physiological ionic strength and contain linker histones are highly enriched in beta-globin gene sequences. AB - Mature chicken erythrocyte polynucleosomes which are soluble at physiological ionic strength are enriched in beta-globin DNA sequences. Vitellogenin chromatin, which is not expressed in this tissue, is found in aggregation prone, salt insoluble chromatin. There is a direct correlation between the size of soluble fragments and the degree of globin gene enrichment, with the largest fragments being most highly enriched. The highly globin enriched (about 50 fold) polynucleosomes contain significantly elevated levels of acetylated histones H4, H2A.Z, and H2B, and ubiquitinated (prefix "u") histones H2A and H2B (with a significant relative increase of uH2B over uH2A). These polynucleosomes were complexed with histones H1 and H5 but at a lower level than that found in unfractionated chromatin. PMID- 3822822 TI - The isolation and characterisation of a new type of dimeric adenine photoproduct in UV-irradiated deoxyadenylates. AB - A new type of dimeric adenine photoproduct has been isolated from d(ApA) irradiated at 254 nm in neutral aqueous solution. It is formed in comparable amounts to another, quite distinct, adenine photoproduct first described by Porschke (J. Am. Chem. Soc. (1973), 95, 8440-8446). Results from high resolution mass spectrometry and 1H NMR indicate that the new photoproduct comprises a mixture of two stereoisomers whose formation involves covalent coupling of the adenine bases in d(ApA) and concomitant incorporation of the elements of one molecule of water. The photoproduct is degraded specifically by acid to 4,6 diamino-5-guanidinopyrimidine (DGPY) whose identity has been confirmed by independent chemical synthesis. Formation of the new photoproduct in UV irradiated d(pA)2 and poly(dA), but not poly(rA), has been demonstrated by assaying their acid hydrolysates for the presence of DGPY. The properties of the photoproduct are consistent with it being generated by the hydrolytic fission of an azetidine photoadduct in which the N(7) and C(8) atoms of the 5'-adenine in d(ApA) are linked respectively to the C(6) and C(5) positions of the 3'-adenine. PMID- 3822824 TI - Nucleotide sequence of the 3' end of the Mycoplasma strain PG50 rrnA operon. PMID- 3822823 TI - Several nodulins of soybean share structural domains but differ in their subcellular locations. AB - Four soybean cDNA nodule-specific clones encoding nodulin-23, -26b, -27 and -44 were observed to cross-hybridize under low stringency conditions. Nucleotide sequence analysis revealed that the cDNAs contain three distinct domains: two domains with 70 to 95% homology separated by a third domain unique to each cDNA. Despite a number of nucleotide insertions and deletions, the protein sequences are conserved in the two domains which correlate with the homologous nucleotide domains. The amino terminal domain of each nodulin contains putative signal sequences for membrane translocation, although only two (nodulin-23 and -44) meet all the criteria for a functional signal. Immuno-precipitation of hybrid-release translation products of the four cDNAs revealed that nodulin-23 is associated with the peribacteroid membrane while nodulin-27 is in the cytoplasmic fraction of the nodule. These four nodulins are members of a diverse family with conserved structural features and the genes encoding them appear to have recently evolved from a common ancestor. PMID- 3822825 TI - Nucleotide sequence of a cDNA encoding the ribulose-1,5-bisphosphate carboxylase/oxygenase from sunflower (Helianthus annuus). PMID- 3822826 TI - Plant small nuclear RNAs. III. The complete primary and secondary structure of broad bean U2 RNA: phylogenetic and functional implications. PMID- 3822827 TI - The nucleotide sequence of the 5S rRNA from Legionella pneumophila. PMID- 3822828 TI - Novel Alu-type repeat in artiodactyls. PMID- 3822829 TI - Interaction of nucleosome core particles with distamycin and echinomycin: analysis of the effect of DNA sequences. AB - Two fragments of Xenopus borealis DNA 135 and 189 base-pairs long were separately incorporated into nucleosome core particles by reconstitution with chicken erythrocyte histones, and incubated with echinomycin (a bis-intercalating antitumor antibiotic) or distamycin (a minor groove-binding, non-intercalating antibiotic). Controlled digestion of these defined sequence core particles using DNAase I revealed new cleavage products, indicative of a change in orientation of the DNA molecule on the surface of the nucleosome. This new rotational setting of DNA within the core particle induced by antibiotic binding appears to be practically independent of DNA sequence, although some differences were noted between the patterns of fragments observed in the various experiments, most likely reflecting the exact number and disposition of the antibiotic binding sites. PMID- 3822830 TI - Syntheses of rRNA, 5.8S, 5S and tRNA are inhibited equally by 8-methoxypsoralen phototreatment of Tetrahymena thermophila. AB - Treatment of the ciliated protozoan Tetrahymena thermophila with 8 methoxypsoralen combined with long wavelength ultraviolet irradiation (UVA, lambda approximately 360 nm) resulted in a dose dependent equal inhibition of the synthesis of rRNA, 5.8S, 5S and tRNA. Similar results were obtained with 3 carbethoxy-8-methoxypsoralen which predominantly forms DNA mono-adducts. In contrast the synthesis of tRNA in T. thermophila was much less sensitive than that of rRNA, 5.8S and 5S RNA to treatment with short wavelength ultraviolet irradiation (UVB, lambda approximately 254 nm). These results are interpreted in favor of a mechanism by which psoralen-DNA adducts (crosslinks much greater than monoadducts) inhibit RNA transcription initiation (in contrast to UVB which causes premature chain termination). Furthermore it is argued that RNA synthesis is regulated in equally sized domains regardless of the gene-size. PMID- 3822831 TI - Genetic organization of the c-sis transcription unit. AB - The structure and genetic organization of the transcription unit of the c-sis proto-oncogene was determined. Comparative nucleotide sequence analysis of the exon sequences of feline and human c-sis revealed a very high degree of homology. The cap site as well as the poly(A)-addition site of the sis transcript of each species was identified and found in similar positions. An insert of 4 amino acids was found in the deduced translational product of feline c-sis and it was located at the amino-terminus of the region that constituted the platelet-derived growth factor domain. An insert of 149 bp present at the 5' end of exon 7 of human c-sis but absent in the simian sarcoma virus v-sis oncogene was also present in the feline c-sis proto-oncogene. PMID- 3822832 TI - Comparison of the consensus sequence flanking translational start sites in Drosophila and vertebrates. AB - The previously presented consensus sequence for eukaryotic translation initiation sites by Kozak was derived substantially from vertebrate mRNA sequences. Drosophila nuclear genes exhibit a significantly different translation start consensus sequence. These differences probably do not represent mechanistic differences in translation initiation inasmuch as both taxa exhibit identical preferences and restrictions at the crucial -3 position. Using more conservative criteria for the assignment of consensus the following consensus sequences were derived: vertebrate--CANCAUG and Drosophila--CAAAACAUG. PMID- 3822833 TI - Adjustment of the tRNA population to the codon usage in chloroplasts. AB - In chloroplasts there is a correlation between the amounts of tRNAs specific for a given amino acid and the codons specifying this amino acid. Furthermore, for the amino acids coded for by more than one codon, the population of isoaccepting tRNAs is adjusted to the frequency of synonymous codons used in chloroplast protein genes. A comparison by two-dimensional gel electrophoresis of the tRNA populations extracted from chloroplasts and from chloroplast polysomes shows that all chloroplast tRNAs are involved in protein biosynthesis. PMID- 3822835 TI - A small family of nodule specific genes from soybean. AB - The primary structure of two nodule specific soybean genes are presented. The two genes code for primary products of 20.0 (nodulin 20) and 22.7 (nodulin 22) kdaltons, respectively. Both genes are related to the nodulin 23 and 44 genes. Alignment of the deduced amino acid sequences of all four genes revealed three domains of high homology interrupted by highly diverged regions due to numerous duplication and insertion events. The first conserved domain codes for a putative signal peptide, while the two others each contain four Cys residues that can be arranged in a way reminiscent of the metal binding domains present in some enzymes and in several DNA binding proteins. PMID- 3822834 TI - Structure of the human oestrogen-responsive gene pS2. AB - The human pS2 gene, whose expression is restricted to breast cancer cells, and whose transcription is induced by oestrogen in the human breast cancer cell line MCF-7, has been cloned from both placental and MCF-7 cell DNA. The exon-intron organization has been established by electron microscopy using genomic DNA-cDNA or -mRNA hybrid duplexes and by sequencing the exons and exon-intron junctions. The overall organization within and around the pS2 gene is the same in placental and MCF-7 cell DNA and the exonic sequences are identical to those previously determined from the cDNA. The 5'-flanking region of the pS2 gene is also identical (with the exception of two base transitions) in the two tissues. Thus no gene rearrangement nor sequence modification has occurred in the pS2 gene of the malignant and polyploid MCF-7 cells. A TATA-box, a CAAT-box and a GC-rich motif are present in the 5'-flanking region of the pS2 gene, but the latter motif is unusually located between the TATA-box and the capsite. No significant homology could be detected between the 5' flanking sequences of the pS2 gene and those of other oestrogen-responsive genes from different species. PMID- 3822836 TI - Oligoaminonucleoside phosphoramidates. Oligomerization of dimers of 3'-amino-3' deoxy-nucleotides (GC and CG) in aqueous solution. AB - The self-complementary 5'-phosphorylated dinucleoside 3' (N)----5' (P)-linked phosphoramidates with sequence GC (8a), CG (8b) and the tetranucleoside triphosphoramidate with sequence GCGC (10a) and CGCG (10b) have been synthesized and characterized by physicochemical and enzymatic methods. The dinucleosides 8a or 8b oligomerize in aqueous solution in the presence of a water-soluble carbodiimide. This process is efficient and regiospecific. In the case of GC it produces alternating 3' (N)----5' (P)-linked phosphoramidates up to 15 dimeric units in length with a yield in excess of 70%. The oligomerization of the CG isomer is much less efficient. The mechanism of oligomerization is discussed. PMID- 3822837 TI - Mechanistic studies on the phosphoramidite coupling reaction in oligonucleotide synthesis. I. Evidence for nucleophilic catalysis by tetrazole and rate variations with the phosphorus substituents. AB - Tetrazole catalyzed reactions of a series of phosphoramidites, 5'-O-DMTdT-3'-O P(OR1)NR2(2) (1a-h), with 3'-O-SiButPh2-6-N-benzoyl-dA (2a) in acetonitrile solution have been studied. It is found that the coupling rate depends very much on whether tetrazole is added before or after 2a, and that dialkylammonium tetrazolide salts are inhibitors. These and other facts are evidence that the reactions are subjected to nucleophilic catalysis by tetrazole, in addition to acid catalysis. The rate variations with phosphorus substituents of 1a-h are NEt2 greater than NPri2 greater than N(CH2CH2)O greater than NMePh, and OMe greater than OCH2CH2CN greater than OCHMeCH2CN greater than OCMe2CH2CN much greater than OC6H4Cl. The inhibitor properties of dialkylammonium tetrazolides have practical consequences for the efficiency of DNA syntheses, when in situ prepared phosphoramidites are used; the same would apply for segmented, simultaneous syntheses or syntheses where recycling is performed. PMID- 3822838 TI - Substrate specificity of DNA polymerases. I. Enzyme-catalysed incorporation of 5 '1-alkenyl)-2'-deoxyuridines into DNA. AB - A series of (E)-5-(1-alkenyl)-dUTPs as well as 5-vinyl-and (Z)-5-(1-propenyl) dUTP have been synthesized to study steric requirements in DNA polymerase reactions. Experiments were carried out in E. coli DNA polymerase I Klenow fragment enzyme system. Substrates were characterized by KM and Vmax-values, initial incorporation rates as well as by total extent of incorporation of the analogues into poly(dA-dT) as a template-primer. Incorporation of the analogues could be best correlated with Vmax-values as well as the very similar initial incorporation rate values. Reactivity (Vmax/KM) showed no correlation with the extent of incorporation. 5-Vinyl-dUTP proved to be as good a substrate of the enzyme as dTTP, whereas (E)-5-(1-heptenyl)-and (E)-5-(1-octenyl)-dUTPs were very poor substrates, their incorporation was strongly limited and they also proved to be very efficient inhibitors of DNA replication, as shown by Ki-values. Substrate specificity of the Klenow enzyme can be explained by the steric hindrance of C-5 substituent, by the "orientational steric substituent effect" concept. PMID- 3822839 TI - Characterization of the ternary complexes formed in the reaction of cis diamminedichloroplatinum (II), ethidium bromide and nucleic acids. AB - The purpose of this study was to characterize the ternary complexes formed in the reaction of cis-diamminedichloroplatinum (II) (cis-DDP) and nucleic acids, in the presence of the intercalating compound ethidium bromide (EtBr). In these ternary complexes, some EtBr is tightly bound to the nucleic acids. Tight binding is defined by resistance to extraction with butanol, assayed by filtration at acid pH or thin layer chromatography at basic pH. These ternary complexes are formed with double stranded but not with single stranded nucleic acids. They are not formed if cis-DDP is replaced by transdiamminedichloroplatinum(II). The amount of tightly bound EtBr depends upon the sequence of the nucleic acid, being larger with poly (dG-dC).poly(dG-dC) than with poly(dG).poly(dC). Spectroscopic results support the hypothesis that the tight binding of the dye is due to the formation of a bidentate adduct (guanine-EtBr)cis-platin. The visible spectrum of the ternary complexes is blue-shifted as compared to that of EtBr intercalated between the base pairs of unplatinated DNA and it depends upon the conformation of the ternary complex. The fluorescence quantum yield of the ternary complexes is lower than that of free EtBr in water. Tightly bound EtBr stabilizes strongly the B form versus the Z form of the ternary complex poly(dG-dC)-Pt-EtBr and slows down the transition from the B form towards the Z form. The sequence specificity of cis-DDP binding to a DNA restriction fragment in the absence or presence of EtBr is mapped by means of the 3'----5' exonuclease activity of T4 DNA polymerase. In the absence of the dye, all the d(GpG) sites and all the d(ApG) sites but one in the sequence d(TpGpApGpC) are platinated. The d(GpA) sites are not platinated. In the presence of EtBr, some new sites are detected. These results might help to explain the synergism for drugs used in combination with cis-DDP and in the design of new chemotherapeutic agents. PMID- 3822840 TI - Highly recurring sequence elements identified in eukaryotic DNAs by computer analysis are often homologous to regulatory sequences or protein binding sites. AB - We have used computer assisted dot matrix and oligonucleotide frequency analyses to identify highly recurring sequence elements of 7-11 base pairs in eukaryotic genes and viral DNAs. Such elements are found much more frequently than expected, often with an average spacing of a few hundred base pairs. Furthermore, the most abundant repetitive elements observed in the ovalbumin locus, the beta-globin gene cluster, the metallothionein gene and the viral genomes of SV40, polyoma, Herpes simplex-1 and Mouse Mammary Tumor Virus were sequences shown previously to be protein binding sites or sequences important for regulating gene expression. These sequences were present in both exons and introns as well as promoter regions. These observations suggest that such sequences are often highly overrepresented within the specific gene segments with which they are associated. Computer analysis of other genetic units, including viral genomes and oncogenes, has identified a number of highly recurring sequence elements that could serve similar regulatory or protein-binding functions. A model for the role of such reiterated sequence elements in DNA organization and function is presented. PMID- 3822841 TI - Transcription analysis of the maize chloroplast gene for the ribosomal protein S4. AB - Maize seedlings contain several RNA species complementary to the rpS4 coding strand of the maize chloroplast ribosomal protein gene rpS4. All of these have the same 5' end about 182 bp upstream of the translation start codon for the protein S4. Northern and S1 nuclease analyses of RNA isolated from seedlings at different stages of greening show that the size of the pool of rpS4 transcripts does not change significantly upon illumination of dark-grown seedlings. The rpS4 gene has also been analyzed by in vitro transcription using maize chloroplast RNA polymerase preparations. The site of initiation in vitro has been mapped by S1 nuclease analysis to the same location as the 5' terminus of in vivo transcripts. A sequence resembling other plastid promoters occurs just upstream of this initiation site. The sensitivity of in vitro transcription to DNA template superhelicity has been assessed for the rpS4 gene promoter; its negative superhelicity-transcription rate profile resembles that of rbcL. PMID- 3822842 TI - Nucleotide sequence of human rho cDNA clone 12. PMID- 3822843 TI - The nucleotide sequence of the ribosomal protein L14 gene of Xenopus laevis. PMID- 3822844 TI - Nucleotide sequence of the gene for ribosomal protein S11 in pea chloroplast DNA. PMID- 3822845 TI - Sequence of a ribulose 1,5-bisphosphate carboxylase/oxygenase cDNA from the C4 dicot Flaveria trinervia. PMID- 3822846 TI - Nucleotide sequence of the 5S rRNA from Listonella (Vibrio) aestuarianus ATCC 35048. PMID- 3822847 TI - [Malignant neoplasms and life style]. PMID- 3822848 TI - [Carcinoembryonic antigen (CEA) in the serum of patients with cancer of the colon and rectum]. PMID- 3822849 TI - [Preliminary results of the analysis of the carcinoembryonic antigen (CEA) level in the serum of patients with dysplasias and benign neoplasms of the breast]. PMID- 3822850 TI - [The organization and results of the mass screening of women for the prevention of cervical cancer in the city of Kielce]. PMID- 3822851 TI - [A case of primary melanoma of the nasal mucosa treated with high-fractionated doses of irradiation]. PMID- 3822852 TI - [Evaluation of prognostic factors in patients treated for skin cancer of the extremities (SCE)]. PMID- 3822853 TI - [Favorable use of calcitonin as an adjuvant treatment of bone metastases]. PMID- 3822854 TI - Ethchlorvynol pharmacokinetics during long-term administration in a patient with hyperlipidemia and hypothyroidism. AB - A 33-year-old obese, hypothyroid, white male with several medical problems was admitted to University Hospital in September 1984 for treatment of drug intoxication. Admitting medications included ethchlorvynol in addition to other central nervous system depressants. Initial serum concentrations were reported at 70 micrograms/ml in this somnolent yet totally conscious adult. Established therapeutic concentrations are 2-8 micrograms/ml, with toxic exceeding 20 micrograms/ml. A tolerance phenomenon seemed evident. Serum ethchlorvynol concentrations were monitored daily during early hospitalization and continued to be substantially greater than reported toxic concentrations. Kinetic values were as follows: total body clearance 9.92 ml/min, volume of distribution 68.0 liters, and half-life 78 hours. These values are unique in that they were calculated from a patient who had not suffered an acute overdose, thereby differing markedly from previously published values. The influence of hypothyroidism and hyperlipidemia on these markedly different values appears to be significant. Ethchlorvynol should probably be added to the list of drugs influenced by thyroid disease. PMID- 3822855 TI - [Evaluation of the agglutination test (AT), complement fixation test (CFT) and the antiglobulin test (AGT) in the diagnosis of swine brucellosis. III. Basic studies]. AB - In the examinations of the swine sera obtained from swines immunized s.c. with adjuvant Br.abortus S19 vaccine or Br.suis 1417 vaccine, it was found that agglutinins were present after 3 weeks, and C.F. antibodies or incomplete agglutinins normally after injections. Probably, in the first period of Brucella infection negative results of C.F.T. or AGT or both will be obtained. In the swine sera from Brucella free herds, agglutinins reacting with the Brucellognost antigen were present. The performance of mercaptoethanol test or C.F.T. lead in most cases to suitable diagnosis. In our conditions we have not obtained results which permit to classify AGT as a supplement test in serodiagnosis of swine brucellosis. PMID- 3822856 TI - [Studies on canine distemper virus. I. Virus cultivation in cell cultures]. AB - The author studied the multiplication capacity of 2 avianized strains of canine distemper virus - Onderstepoort and Lederle Encephalitis and 2 country strains - WS-66 and LL-68 in primary cell cultures of chicken embryo fibroblasts and the dog's kidney. The strain Onderstepoort multiplied and caused cytopathological changes in the cell culture of chicken embryo fibroblasts after passaging from villousallantoic membranes of chicken embryos. Maximum titer was found between the 5th and 15th passage in the cell culture and amounted to about 10(5.0) TCID50 or about 10(5.5) EID50. In all 50 passages were carried out. However, multiplication occurred, and cytopathological changes in cell culture of chicken embryo fibroblasts were caused by the strain Lederle Encephalitis only due to the application of initial adsorption and maximum inoculum by 8 successive passages. Maximum TCID50 titre occurred after 40 passages and was about 10(4.5). Both strains preserved their ability to evoke changes on villonsallantoic membranes. Studies on the effect of the inoculum size and incubation time on the virus harvest were carried out Lederle Encephalitis strain on the level of 18-20 passages. In the culture of fibroblasts the most favourable results were obtained by using 10(2.0)-10(2.5) TCID50 inoculum per 10(5.0) cells, harvested after about 96 hr of incubation. Attempts to adapt the strains Onderstepoort and Lederle Encephalitis to cell culture of the dog's kidney gave negative results. Multiplication of the country strains of canine distemper WS-66 and LL-68 was not obtained in the cell culture of the dog's kidney and in that of chicken embryo fibroblasts in the experiment conditions. PMID- 3822857 TI - [Acid-base equilibrium in experimental acid indigestion in cattle]. AB - Blood and urine acid-base parameters were investigated in 4 heifers with acid indigestion produced by intraruminal infusion of sugar in a dose of 12 g/kg b.wt. Observations were carried out for 9 days after sugar administration. It was found that rumen acidosis was accompanied by disturbances in blood acid-base balance characteristic of partially compensated metabolic acidosis. The most pronounced changes in acid-base parameters were observed within the first 24 hours after sugar infusion, i.e. during rapid increase of lactic acid levels in blood. These changes were reflected by a decrease of blood pH values to 7.138-7.275 reduction in standard bicarbonate to 12.2-17.0 mmol/l and deficiency in base excess ranging from 9.3 to 16.7 mmol/l. The maximum reduction in partial pressure of CO2 to 4.35 4.79 kPa occurred during the second day of the experiment. The duration of acid base disturbances depended on their intensity in individual animals and oscillated between 4 and 9 days after sugar administration. When acidosis subsided, acid-base balance returned to normal or showed a tendency toward blood alkalization. The observed decrease of pH values in urine to 5.42-5.74 and renal acid excretion from 170 to 299 mmol/l indicate a significant role of kidney function in the correction of metabolic acidosis. PMID- 3822858 TI - [Selected factors of metabolism in ruminants fed with increasing doses of urea in the food. I. Liver function in cows in the light of the activity of selected enzymes and the levels of indicators of protein metabolism]. AB - The authors studied the influence of urea added to diet in an amount of 150 grams daily per 1 cow on the function of the liver by means of: determination of the activity of the following enzymes: arginase, ornithin-carbamyl-transferase, leucyloaminopeptidase, gamma-glutamyl-transferase, phosphatase alkaline, determination of the level of total protein, albumins and globulins, urea, sodium and potassium in the serum of dairy cows. No significant changes were found in the activity and in the content of the above mentioned blood constituents. The dose of 150 grams of urea added to diet did not show any disturbances in protein metabolism in the liver and in the health of the cows. PMID- 3822859 TI - [Sodium and potassium levels in the soil, grass and blood serum of bulls after irrigation of the soil with sewage water]. AB - The main purpose of the studies was to find the influence of a long-term irrigation with the water of the Ner river, containing sewage on the content of sodium and potassium in soil, its vegetation and in the blood serum of the bulls fed on the hay from the meadows irrigated with this water. The soil irrigated with drain water and its vegetation were analysed and the bulls of the Black and White breed fed on the hay from the irrigated meadows were examined carefully. There were 30 bulla tested. Their initial average weight was 250 kilograms. The experiment was repeated twice. It lasted 93 days each time. The animals were divided into three groups. The animals from group 1 and 2 received the hay from the meadow irrigated with drain water. The animals from group 2 were fed on the hay from the meadow with a higher dose of irrigation. The animals from the third group were given the hay from the meadows which were not irrigated. The daily ration of food consisted of 5 kilograms of hay and 3 kilograms of dry beet pulp. The available forms of Na2O and K2O were determined in the soil on a flame photometer. Sodium and potassium in the samples of plants were determined using the atomic absorptive spectrophotometry method (AAS). Botanical and weight analyses were also done. Blood samples were taken once a month. Sodium and potassium in blood serum were determined by AAS method. The amount of sodium in the soil and hay on the meadows irrigated with drain water was significantly higher, and the amount of potassium was lower in comparison with the amount of sodium and potassium in the soil and hay on non-irrigated meadows. The content of sodium increased with the increase of the irrigation rate. According to the experimental fodder no changes were observed in the bulls' blood serum as regards the amount of sodium and potassium. PMID- 3822860 TI - [Calcium, phosphorus and magnesium levels in the soil, grass and the body of bulls after irrigation of the soil with sewage water]. AB - The aim of the studies was determination of the influence of irrigation with the water of the river Ner on the content of calcium, phosphorus and magnesium in soil, plants and organism of bulls fed on the hay grown on the irrigated soil. The soil irrigated with waste water, its vegetation and 30 bulls of the Black and White breed used in this experiment. The bulls were divided into three groups. The experiment was repeated twice and lasted 93 days each time. The animals from group I and II were given the hay from the meadows irrigated with waste water. The second group of bulls received the hay from the soil which was irrigated more intensively. The animals from group III received the hay from non-irrigated soils. The daily ration of food consisted of 5 kilograms of hay and 3 kilograms of dry beet pulp. Calcium, phosphorus and magnesium were found in the soil, in hay and in the bulls blood serum. Magnesium was found in the bull's hair. The irrigation with the Ner's water increased the amount of calcium and magnesium in the soil and its vegetation. No influence of the irrigation with waste water on the content of phosphorus in hay was observed. No definite relationship between the levels of Ca, P and Mg in food and in the bull's blood serum was observed; however, a relation between the amount of magnesium in food and in the bull's hair was found. PMID- 3822861 TI - [Effect of low temperatures on the viability of Cysticercus bovis]. AB - For investigations under laboratory conditions freezers specially prepared for this aim were used. The material for these investigations were alive Cysticercus bovis recovered from skeletal muscles of a bull infected with 500,000 eggs of Taenia saginata. The viability of C. bovis was determined on the basis of routine laboratory investigations. For investigations under conditions of an industrial cold storage plant 6 cattle carcasses intensively invaded by C. bovis were used, i.e. 5 animals infected under natural conditions and one bull specially infected with 500,000 eggs of T. saginata. The temperatures of cattle carcasses were measured with a thermograph. Every 24 hours sections of muscles were collected, from which C. bovis were recovered and examined on the viability by the above mentioned method. It was found that at low temperatures the necrobiosis time of C. bovis isolated from skeletal muscles was 15 min. at -35 degrees C and as long as 10 hours at -5 degrees C. However, C. bovis died within 72-96 hours in muscles of cattle carcasses subjected to the activity of the temperatures minus 18-19 degrees C at a relative humidity of 86-90% under conditions of an industrial cold storage plant. From the obtained results the author concluded that the regulations hitherto obligatory in Poland, concerning the treatment of cattle carcasses with C. bovis by means of cooling or freezing, should be amended. PMID- 3822863 TI - Closure of ventricular septal defect through the pulmonary artery. AB - A transpulmonary arterial approach to the closure of a high ventricular septal defect (VSD) has been used, between 1978 and 1982, in eight patients. The reasons were ease of access and the wish to overcome the problems associated with right ventriculotomy. The patients' ages ranged from three weeks to 15 months, their weight from 2.9 kg to 9 kg. The approach was used both when the VSD was an isolated anomaly and when there were major associated defects. It is in this latter group, four with aortic arch anomalies, two with additional double outlet right ventricle (DORV), that avoidance of ventriculotomy was most helpful. It was especially important in the two patients with DORV and a perimembranous, outlet subpulmonary VSD, where it was possible to close off the left ventricular outflow tract and pulmonary valve using a patch, without opening the right ventricle, which was subsequently to become the systemic ventricle. This technique obviates the need for ventriculotomy in the closure of some perimembranous outlet and doubly committed subarterial VSDs, and is the approach of choice for the closure of a perimembranous, outlet, subpulmonary VSD in DORV. PMID- 3822862 TI - Echocardiography of intracardiac filling defects in infants and children. AB - Intracardiac masses are rare in infants and children. Early detection is essential to their successful management. We present seven patients in whom echocardiography established the diagnosis and was crucial in the management. Three of the masses were primary cardiac tumors and four were thrombi. Patient 1: an infant with a calcified left ventricular fibroma. Patient 2: a neonate who presented with cyanosis due to obstruction of the right ventricular inflow tract by a fibroblastic tumor. Patient 3: an infant with a right atrial myxoma presenting as sepsis. Patient 4: a child who had a pulmonary embolus after a pulmonary valvotomy and was found to have a right ventricular thrombus. Patient 5: a child with a right atrial thrombus following a Fontan procedure for univentricular atrioventricular connection. Patient 6: a child with a left ventricular thrombus due to a dilated cardiomyopathy in association with epidermolysis bullosa. Patient 7: An infant with bilateral lobar emphysema, an aorticopulmonary window with left ventricular fibroelastosis, who developed a left ventricular thrombus. PMID- 3822864 TI - Review of 222 cases of acute rheumatic fever in southern Israel (1974-1983). PMID- 3822865 TI - Severe mitral insufficiency associated with Kawasaki's valvulitis. AB - A two-month-old male infant with Kawasaki's disease, severe mitral insufficiency, and normal coronary arteries is described. We postulate the mitral insufficiency was secondary to Kawasaki's valvulitis, and that this occurred in the absence of other forms of cardiac involvement characteristic of Kawasaki's disease. PMID- 3822866 TI - Atrioventricular septal defect after surgical resection of a subaortic shelf. AB - Left ventricular to right atrial (LV-RA) communications are rare septal defects. The majority of them are congenital in origin and acquired defects are exceedingly rare. The causes of acquired LV-RA communications include chest trauma, infective endocarditis, and valvar replacement. This report describes a case of direct LV-RA and interventricular communications occurring three months after excision of a subaortic shelf. PMID- 3822867 TI - Right atrial thrombosis: rare complication of the modified Fontan procedure. AB - A four-year-old boy with DORV and hypoplastic left ventricle underwent a modified Fontan procedure. He had a very difficult postoperative course complicated by continued pleural effusions. Eventually he died during a last ditch effort to ligate the thoracic duct at the right diaphragm. At autopsy, an obstructing giant thrombus was found in the right atrium. This rare complication probably was due to multiple factors, but we now anticoagulate all Fontan patients routinely in an effort to prevent this fatal problem. PMID- 3822868 TI - Congenital unilateral pulmonary venous atresia with pulmonary veno-occlusive disease in contralateral lung: an unusual association. AB - A patient presenting with the rare association of congenital unilateral pulmonary venous atresia in one lung and pulmonary veno-occlusive disease in the other is described. The patient first presented at the age of 3 1/2 years with anemia, hemoptysis, and pulmonary hypertension. After cardiac catheterization and angiocardiography, a diagnosis of atresia of the left pulmonary veins was made for which left pneumonectomy was done. Four years later the patient presented with right-sided congestive failure and radiologic evidence of right-sided pulmonary edema from which death resulted. At autopsy, the right lung showed changes of pulmonary veno-occlusive disease, while the major veins were not involved. PMID- 3822869 TI - Severe subaortic stenosis associated with congenital rubella syndrome: palliation by percutaneous transcatheter device occlusion of a patent ductus arteriosus. AB - Congenital rubella syndrome has been associated with several forms of congenital heart disease including left-sided obstructive lesions. This report describes a patient with severe subaortic stenosis, patent ductus arteriosus, and mild pulmonary branch stenosis, a rare condition. Palliation was achieved with percutaneous transcatheter device occlusion of the patent ductus arteriosus. PMID- 3822870 TI - PUVA carcinogenesis after ten years: prospect and retrospect. PMID- 3822871 TI - Risk evaluation of UVB therapy for psoriasis: comparison of calculated risk for UVB therapy and observed risk in PUVA-treated patients. AB - A descriptive dose-response model is presented to evaluate the long-term risk with respect to non-melanoma skin cancer associated with UVB therapy. The model is based on the results of animal dose-response studies and epidemiological data. A number of factors that influence the risk associated with therapy are evaluated: annual dose applied, solar exposure, therapeutic period, age at start of therapy. Shielding from therapeutic exposures of the skin areas that normally receive the most sun exposure could effectively reduce the risk. The model calculations were compared with observational data, as far as available. The calculated risk corresponded within the limits of statistical error with observed long-term risk of UVB therapy in Sweden; as far as there was a deviation, the model calculations tended to over-estimate the risk. A comparison of the model prognoses for UVB therapy with the observed risk among PUVA-treated patients in the USA shows a much higher observed risk for squamous cell carcinoma among the PUVA-treated patients. PMID- 3822872 TI - Atopy and photosensitivity in children. PMID- 3822873 TI - Azapropazone therapy and photosensitivity. PMID- 3822874 TI - Exanthematous drug reaction caused by 8-methoxypsoralen. PMID- 3822875 TI - Quantification of UV-induced erythema with a portable computer controlled chromameter. AB - A sensitive computer controlled tristimulus color analyzer (Minolta Chromameter II Reflectance) was used to measure UV-induced erythema quantitatively. Of the 5 available chromaticity measuring modes in the instrument, one of the values (a*) was enough to specify the erythema quickly. A comparison has been made between results using the instrument and a graded score based on visual perception of erythema. This easy to operate instrument is suitable for both clinical and field conditions. PMID- 3822876 TI - [Epidemiology and epizootiology of enteritis caused by Campylobacter jejuni and Campylobacter coli]. PMID- 3822877 TI - [Role of thermophilic strains of Campylobacter in infections of the digestive system]. PMID- 3822878 TI - [Status of the immunologic secretory system of the small intestine in children infected with Giardia intestinalis]. PMID- 3822879 TI - [Duodenal microflora in children infected with Giardia intestinalis]. PMID- 3822880 TI - [Evaluation of the effect of new fluoroderivatives of piperazinol-quinoline on clinical strains of aerobic and anaerobic bacteria]. PMID- 3822882 TI - [Role of the vascular wall in the process of hemostasis]. PMID- 3822881 TI - [A case of hypoproconvertinemia in a boy with recurrent nosebleed]. PMID- 3822883 TI - [Effect of the treatment of chronic circulatory insufficiency on the rheologic parameters of the blood]. PMID- 3822884 TI - [Effect of propranolol on the plasma lipoprotein levels with special reference to apolipoproteins B]. PMID- 3822885 TI - [Problem of the treatment of arterial embolism and thrombosis of the extremities]. PMID- 3822886 TI - [Usefulness of transcutaneous oxygen pressure determination in evaluating the pharmacologic treatment of chronic ischemia of the lower extremities]. PMID- 3822887 TI - [Fibrinolytic activity of deep and superficial crural veins]. PMID- 3822889 TI - [Vasoconstriction in the light of the laws determining the flow of fluids and the physical properties of vascular walls]. PMID- 3822888 TI - [Effect of amiodarone on selected functions of blood platelets in patients with premature ventricular excitation]. PMID- 3822890 TI - [Renal abscess]. PMID- 3822891 TI - [Renal failure in heroin addicts]. PMID- 3822892 TI - [Glucocorticosteroid receptors in peripheral blood lymphocytes in children with lipoid nephrosis]. PMID- 3822893 TI - [Treatment of renal abscesses by percutaneous puncture and drainage under ultrasonic control]. PMID- 3822894 TI - [Sporadic form of medullary cystic disease with renal atrophy in a 21-year-old male]. PMID- 3822895 TI - [Usefulness of the Cytur-Test in clinical practice]. PMID- 3822896 TI - [Hand-washing and the preparation of the surgical field. Views and controversies]. PMID- 3822897 TI - [Errors in the preoperative diagnosis of acute appendicitis in women]. PMID- 3822898 TI - [C-reactive protein as an independent indicator of bacterial infection in surgical patients]. PMID- 3822899 TI - [Advances in studies on the etiopathogenesis and therapy of ischemic heart disease]. PMID- 3822900 TI - [Therapeutic problems in torsade de pointes ventricular tachycardia]. PMID- 3822901 TI - [Disorders of myocardial blood supply in sportsmen]. PMID- 3822902 TI - [Non-invasive diagnosis of recurrent mitral stenosis]. PMID- 3822903 TI - [Echocardiographic evaluation of the regurgitant wave in complex mitral defect]. PMID- 3822904 TI - [A case of ventricular tachycardia with a triggered activity mechanism]. PMID- 3822905 TI - [Mesothelioma involving the pericardium: diagnostic difficulties]. PMID- 3822906 TI - [Economic aspects of celiac disease]. PMID- 3822907 TI - [Clinical picture and morphology of the intestinal mucosa in children with dermatitis herpetiformis]. PMID- 3822908 TI - [Difficulties in the diagnosis and treatment of ulcerative colitis in children]. PMID- 3822909 TI - [Nitrate and nitrite levels in mixtures and nutrients used in the feeding of infants]. PMID- 3822910 TI - [Echocardiographic evaluation of the left-ventricular function in diabetic and healthy children]. PMID- 3822911 TI - [Incidence of ascariasis and lambliasis in children with allergic diseases of the respiratory system]. PMID- 3822912 TI - [Induced barbiturate coma in the treatment of status epilepticus in a child]. PMID- 3822913 TI - [Can Hodgkin's disease be treated more safely? Partial downgrading of MOPP]. PMID- 3822914 TI - [Retrospective evaluation of the results of the treatment of the non-advanced form of Hodgkin's disease in children]. PMID- 3822915 TI - [Clinical pharmacology of amsacrine]. PMID- 3822916 TI - [Use of I-131-meta-iodobenzylguanidine in the treatment of malignant pheochromocytoma. Description of 2 cases]. PMID- 3822917 TI - Production, clearance, and metabolism of testosterone in men with prostatic cancer. AB - It was previously unknown whether the production and metabolism of testosterone was altered in men with prostatic cancer. We recently observed a familial influence on the plasma concentration of sex steroids in men with the cancer. We have now determined, by isotope dilution techniques, the blood testosterone production and clearance rates and testosterone metabolism to potent androgen metabolites in men with prostatic cancer, their brothers, and unrelated controls. Nineteen men had a diagnosis of prostatic cancer before age 63 (probands), 23 were brothers of these index cases, and nine controls matched for age were selected randomly from the general population. None had received endocrine therapy. The plasma content of testosterone, dihydrotestosterone, sex hormone binding globulin, apparent free testosterone concentration, follicle-stimulating hormone, and luteinizing hormone were not significantly different between the groups. The metabolic clearance rate of testosterone was significantly (P = .04) higher in probands (458 liters/day/body surface area, median) than in controls (306 liters/day/body surface area). The conversion ratios of both testosterone (1.8%) and dihydrotestosterone (16.9%) to 3 alpha-androstanediol were significantly greater (P = .04 and P = .004, respectively) in probands than in controls (0.95%, 7.8%). These results indicate that men with prostatic cancer have elevated clearance rates of testosterone and an increased conversion ratio of testosterone to its potent 5 alpha-reduced metabolites. PMID- 3822918 TI - Role of prolactin in modulating the effects of tamoxifen on growth of the Dunning R3327 rat prostate adenocarcinoma. AB - Tamoxifen (TAM) has previously been shown to inhibit growth of the Dunning R3327 rat prostate adenocarcinoma and to elevate serum prolactin levels. The purpose of this study was to determine the role of prolactin in modulating the effects of tamoxifen on growth of the R3327 prostatic adenocarcinoma. Intact and castrated Copenhagen-Fischer male rats bearing the Dunning R3327 rat prostatic tumor were divided into groups and injected sc five times per week for 16 weeks as follows: vehicle; TAM (0.5 mg/kg); haloperidol (HALO; 0.5 mg/kg); bromocriptine (CB-154; 5 mg/kg); TAM plus HALO; or TAM plus CB-154. In both intact and castrated rats, agents that either raised (HALO) or lowered (CB-154) serum prolactin had little effect on prostatic tumor growth when administered singly. In intact rats, average tumor diameter in vehicle-treated controls increased 421% 16 weeks after the start of the experiment, and treatment with TAM or TAM plus HALO reduced this tumor growth by approximately one-half. Interestingly, CB-154 administered in combination with TAM completely blocked TAM inhibition of tumor growth in intact rats. In contrast to these results in intact rats, average tumor diameter increased 129% in TAM- and 118% in TAM plus HALO-treated castrated rats and was significantly greater than the characteristic retardation of tumor growth (49% increase) that occurred in the vehicle-treated castrate controls. In addition, combined treatment of TAM plus CB-154 in castrate rats resulted in an even greater increase (188%) in average tumor diameter. The inhibitory effect of TAM on R3327 prostatic tumor growth in intact rats appears to be an indirect effect resulting from its ability to reduce serum testosterone levels. In contrast, the stimulatory effect of TAM in castrate rats appears to result directly from an estrogen-like action, which can directly enhance prostatic tumor growth in the presence of low levels of circulating androgens; this stimulatory effect of TAM is more pronounced when prolactin levels are suppressed by CB-154. Clearly, castration alone is more effective than TAM therapy alone or in combination with castration in the retardation of the growth of the androgen-dependent R3327 prostatic tumor in rats. PMID- 3822919 TI - Development of androgen resistance in mouse mammary tumor cells can be prevented by the antiandrogen flutamide. AB - As has been clearly demonstrated in prostate and breast cancer, progression to hormone insensitivity is a major problem responsible for the usually partial and short-lived response to antihormonal therapy. Preincubation of androgen-sensitive Shionogi mouse carcinoma cells for 15 days in the absence of androgens causes the development of complete resistance of cell growth to androgens. Of potentially important therapeutic significance is the finding that androgen sensitivity can be maintained not only by the androgen dihydrotestosterone (DHT) but also by incubation with the pure antiandrogen Flutamide-OH in the absence of androgens. Since androgen resistance is one of the main problems facing the treatment of prostate cancer, the possibility of avoiding or at least delaying the development of androgen resistance with a pure antiandrogen could well provide the basis for improving the success of therapy for this disease. PMID- 3822920 TI - Acute cholecystitis and liver failure after total hip replacement: a case report. PMID- 3822921 TI - Prevention of quadriceps wasting after immobilization: an evaluation of the effect of electrical stimulation. PMID- 3822922 TI - Bilateral patellar ligament rupture. A case report. AB - Patellar ligament ruptures are uncommon injuries; bilateral ruptures are rarely seen. When they do occur they are associated with chronic disease states. A case of a bilateral patellar ligament rupture secondary to trauma in a healthy man is presented. Appropriate management with aggressive surgical repair and rehabilitation are discussed. PMID- 3822924 TI - Shelling the sesamoid in the McBride procedure. AB - A method which markedly facilitates the excision of the lateral sesamoid in the McBride procedure is described. It is carried out by using an instrument commonly used in arthroscopic knee surgery. PMID- 3822923 TI - A new gait analysis system for clinical use in a rehabilitation center. AB - A semi-portable system based on a microcomputer has been developed to measure the vertical reaction forces on both feet during walking. Eight capacitive force transducers are attached to each sole of the patients' shoes. This allowed the forces to be measured for several consecutive steps during a walk of 20 sec. This article describes the principles of operation of the force transducers and the associated electronic system. It also shows data processing procedures and gives a review of the available methods of data presentation. Recordings of the walking pattern of three patients with different diagnostics are presented and discussed to demonstrate the usefulness of the new gait analysis system in a rehabilitation center. PMID- 3822925 TI - A new surgical treatment of peroneal subluxation-dislocation. A case report with a 27-year follow up. AB - A case of bilateral subluxation-dislocation of the peroneal tendons, with a 27 year follow up is presented. A new, successful surgical method of treatment was used on a college football player. Details of the operative plan are presented. PMID- 3822926 TI - Radiologic case study. Tuberculous spondylitis (Pott's disease). PMID- 3822927 TI - Kawasaki disease: a pathology survey in western Europe. AB - There is an increasing awareness that Kawasaki disease does occur outside Japan, but reliable data regarding the incidence of the disease in western Europe are lacking. Such information may be important, not only providing insight into the incidence but also indicating whether or not the pathology is comparable to that reported from Japan. For these reasons a survey has been initiated among pediatric pathologists in western Europe with the use of a questionnaire. The results show that the experience with Kawasaki disease of pediatric pathologists in western Europe is extremely limited. Only 25 cases have been reported. One may infer from these data that the incidence of Kawasaki disease in western Europe is far below that in Japan. The pathology encountered appears to be the same as that reported from Japan and the United States. This finding in particular may be important for further epidemiological studies regarding etiology and pathogenesis of Kawasaki disease. PMID- 3822928 TI - Acute form of visceral leishmaniasis in a 3-month-old infant. AB - The case of a 3-month-old infant who died with an acute form of visceral leishmaniasis is reported. The liver presented an unusual pattern with widespread patchy cellular necrosis besides marked reticulin proliferation and some fibrosis. The marked systemic histiocytic proliferation contrasted with the paucity of Leishman-Donovan bodies, responsible for the negativity of two bone marrow aspirates and a needle biopsy of the liver. Visceral leishmaniasis must be considered in the differential diagnosis of cholestatic syndromes in infancy. PMID- 3822929 TI - Diffuse meningocerebral angiodysplasia and renal agenesis: a case report. AB - A third case of meningocerebral angiodysplasia involving the cerebral cortex, with necrosis of both cortex and white matter is described in a neonate with Potter's syndrome. It is suggested that cortical vessel anomalies act as a local intracerebral shunt to produce periventricular infarction. This disorder differs from pure meningeal angiectasis without cerebral infarction and from the classic arteriovenous malformation of the central nervous system with massive systemic shunt, cardiomegaly, and neonatal cardiac failure. Meningocerebral angiodysplasia and renal agenesis appear to form a rare but distinct association. PMID- 3822930 TI - Amniotic fluid infection syndrome and abruptio placentae. AB - The incidence of amniotic fluid infection syndrome, as assessed by the presence of an acute inflammatory infiltrate of the placenta, umbilical cord, and membranes at birth, was 23.3% in pregnancies complicated by severe abruptio placentae. This was not significantly higher than that noted in uncomplicated pregnancies. These data therefore fail to support the proposal that amniotic fluid infection predisposes to placental abruption. PMID- 3822931 TI - Parathyroid peliosis: report of a case and review of the literature. AB - Peliosis most commonly affects the liver and spleen and has been associated with exogenous and endogenous steroid hormones, particularly of the anabolic type. The finding of peliosis of the parathyroid glands, as well as of the liver, in an infant with adrenogenital syndrome indicates that other organs may be affected. PMID- 3822932 TI - Perinatal mortality associated with intrauterine infection due to pseudomonads. AB - Pseudomonads are common causes of nosocomial infections but are rarely implicated in perinatal disease. In a retrospective autopsy study we found that 9% of all acute congenital bacterial infections were due to Pseudomonas species. Premature rupture of membranes occurred in half the cases and clinical maternal amnionitis in two-thirds. One case was apparently nosocomial in origin. No known risk factors were implicated in any other case. Seven infants were stillborn and two died within a few hours. Congenital pneumonia, funisitis, and chorioamnionitis were found at autopsy. Intrauterine infection due to the pseudomonads poses a serious problem that has not been previously recognized. PMID- 3822933 TI - Unusual pathologic findings in a girl with Wolf-Hirschhorn syndrome, del (4p). AB - A newborn girl with Wolf-Hirschhorn syndrome and 46, XX, del (4) (p15) de novo karyotype is described. Unusual pathologic and histologic findings were observed at autopsy in the cardiovascular, respiratory, alimentary, and urogenital systems. Of over 100 cases reported in the literature, only 18 include pathologic findings. PMID- 3822934 TI - Leiomyosarcomas in childhood: a clinical and pathologic study of 10 cases. AB - Ten children (5 males, 5 females) with leiomyosarcomas were treated at the Children's Hospital, Boston, during the 20-year period from 1963 through 1983. The patients ranged in age from 2 1/2 to 15 years, the average age at diagnosis being 10 1/2 years. The tumors originated in the following sites: stomach (4 cases), jejunum, cecum, endocervix, retroperitoneum, urinary bladder, and base of tongue (1 case each). In each case the primary tumor was surgically resectable, with the average diameter being 6.7 cm (range 2-11 cm). The tumor proved fatal for 3 of 6 children with regional or distant metastases. Three others were alive with metastatic leiomyosarcoma 6-18 years following diagnosis. A fourth death was attributed to a massive chondrosarcoma of the lumbosacral area, which developed 7 years after hysterectomy, chemotherapy, and radiation therapy for an endocervical leiomyosarcoma. While leiomyosarcomas are extremely rare in the pediatric age group (less than 2% of all soft tissue sarcomas), diagnostic features and biologic behavior appear similar to those in adults. Tumor size and mitotic counts seem to be the most important features in assessing malignant potential, but absolute minimum criteria for malignancy are not well defined. PMID- 3822935 TI - Abnormal growth of the thyroid cartilage in the DiGeorge syndrome. AB - Larynges from 17 patients with DiGeorge syndrome (DGS) and from 14 patients with tetralogy of Fallot (TOF) (11 non-DGS and 3 possible but unproven DGS) were dissected, measured, and compared to a control population of comparable body length. The patients with DGS and the 3 patients with TOF suspected of having DGS showed the following: small thyroid cartilages with increased anterior angle, abnormally short superior cornua, low ratio of mean superior cornual length to distance between superior cornual tips, and delayed time of maximal rate of increase in superior cornual length relative to increase in body length. The hypoplasia, delayed maximal growth rate and persistent fetal shape of the thyroid cartilage (predominantly a derivative of the fourth branchial arch) in DGS, indicates that the causative process in the syndrome affects not only the third and fourth branchial pouches, but also, by a contiguous field defect, other derivatives than great vessels of the fourth-sixth branchial arches. PMID- 3822936 TI - Cutaneous malignant melanoma and bilateral retinoblastomas: a case report and review of the literature. AB - Retinoblastoma survivors following successful treatment have a predilection to develop other malignant neoplasms. This report describes a patient with bilateral retinoblastomas diagnosed and treated early in life, who developed cutaneous malignant melanoma 20 years later. In our review of the literature only 5 cases with this association have been reported. We would like to report the sixth case. PMID- 3822937 TI - Acute hepatitis B in children with papular acrodermatitis. AB - Thirteen children who had repeated liver biopsies over a period of 2-16 years after the onset of papular acrodermatitis (PAC) were studied retrospectively. Six patients, rebiopsied within 36 months after the onset of PAC, had histologic evidence of chronic periportal hepatitis. However, repeated biopsies in 3 of the patients revealed a normal liver or chronic portal hepatitis. Whereas all patients had at the end of the observation markers of hepatitis B virus infection, 8 of the 10 patients studied had HBs antigenemia. These data indicate that severe active liver disease may regress without treatment in patients who have had PAC. However, the high frequency of a chronic HBsAg-carrier state among these patients suggests either an inefficient clearance of the virus or an altered immune reaction. PMID- 3822938 TI - Bronchopleural fistula in a neonate. AB - Bronchopleural fistula (BPF) produced by endotracheal suction catheter is a known cause of persistent pneumothorax in preterm infants in intensive care nurseries. This report describes the pulmonary pathology of a neonate who had sustained this injury. The observation suggests that the abnormal airflow results in severe damage of the involved lobe and an unusually mild bronchopulmonary dysplasia in the rest of the lung. This is in agreement with the fact that BPF acts as the path of least resistance for the oxygen-rich air from the ventilator. PMID- 3822939 TI - Intestinal plexuses in Crohn's disease and ulcerative colitis in children: pathologic and microdissection studies. AB - The relative fraction of neural tissue in the plane of the myenteric (Auerbach) plexus (MEP) of ileum and colon of patients with Crohn's disease and ulcerative colitis was analyzed by point-count morphometric analysis of microdissected flat mount ("circuit diagram") preparations of the plexus. Increase in the relative fraction of neural tissue (myenteric plexus hyperplasia) was seen in the MEP of some patients in both ileum and colon in both diseases. The frequency of ulceration or inflammation extending into the bowel wall deep enough to injure the various levels of the intestinal plexus system (mucosal plexus of Cajal; upper submucosal plexus of Meissner; deeper submucosal plexus of Henle; intermuscular plexus of Auerbach; outer muscular/serosal plexus of Stohr) was analyzed for small intestine, appendix, and colon for patients with both diseases. As expected, Crohn's disease tends to produce deeper intestinal wall damage in ileum versus colon, and ulcerative colitis the reverse. The effect of such injury on local and more distal motor control of the intestine and on integrative functions of the intestinal plexus system appears not to have been considered previously. Since injury deep enough to damage any given plexus necessarily damages all overlying plexus levels, analysis of such effects appears a fruitful field for study. PMID- 3822940 TI - Osteoporosis in juvenile-onset diabetes mellitus: morphometric and comparative studies. AB - Ribs and vertebrae of 8 children and young adults aged from 17 months to 24 years with juvenile-onset diabetes mellitus, 4 with diabetes secondary to cystic fibrosis and 2 with diabetes secondary to thalassemia major, were analyzed for osteoporosis by a point-count morphometric method. The mean ratio of bone spicule to marrow space in cancellous bone of ribs of patients with juvenile-onset diabetes mellitus or with diabetes mellitus secondary to cystic fibrosis or thalassemia was 55% that of 10 control patients. The lengths of the zones of proliferating and mature cartilage cells in costal epiphyses of patients with juvenile-onset diabetes mellitus were also below normal. The ratio of bone spicule to marrow space of vertebrae of the diabetic patients was not significantly different from control values. The data confirm clinical reports that osteoporosis is a regular feature of juvenile-onset diabetes mellitus and suggest that the degree of bone matrix and mineral deficiency in such patients is greater than is usually considered. PMID- 3822941 TI - Microdissection study of the incidence of branched eccrine sweat glands and the number of eccrine glands per unit area of infants' and childrens' skin. AB - That branched eccrine sweat glands occur has rarely been mentioned in the literature, and their incidence has never been determined. All eccrine glands in 0.5-cm2 pieces of anterior trunk skin of 59 children were microdissected, and the total number of glands and the number of branched eccrine glands determined. One hundred fourteen of 17,539 (0.65%) were branched, 90% in the middermis and 10% at the epidermis. The apparently normal anatomic property that almost 1% of eccrine sweat glands are branched has not hitherto been appreciated. One doubly branched gland was found. Patients with leukemia (11 in the study) possibly had more branched glands than nonleukemic patients of the same body size. The best statistical relation of the number of sweat glands per unit area of skin (GUA) to surface area (SA) or age in children was the natural logarithm of GUA versus the reciprocal of surface area: LnGUA = (0.2205 X 1/SA) + 5.42. This result is consistent with the classical proposition that there is no important degree of formation of new eccrine glands, nor of loss, after birth, the density of glands per unit area of skin reducing as SA rises with growth during childhood. PMID- 3822942 TI - Cyclopia and maternal ingestion of salicylates. AB - Salicylates are teratogens in animals, but their teratogenicity in man remains controverted. The possibility that massive oral intake in the first 3 months of pregnancy may induce malformations has not been eliminated. We report a second case of cyclopia associated with daily maternal ingestion of up to 4 g of acetylsalicylic acid in the first trimester. PMID- 3822943 TI - Meconium pleuritis: cytologic diagnosis in a neonate with perforated sigmoid colon and diaphragmatic hernia. AB - Meconium pleuritis developed in a neonate with a perforation of the sigmoid colon, through a diaphragmatic defect. The meconium released in the abdomen communicated with the right pleural space. The association of these defects is unusual, and the cytologic diagnosis of meconium pleuritis has not been previously reported. PMID- 3822944 TI - Carotid bodies in sudden infant death syndrome: a combined light microscopic, ultrastructural, and biochemical study. AB - Carotid bodies (CBs) are peripheral chemoreceptors that can undergo compensatory hypertrophy and hyperplasia in some patients with chronic hypoxemia. At the Children's Hospital morphometric and biochemical analyses were done on CBs obtained at autopsy from 89 infants in the first year of life to determine if there were statistically significant differences in sudden infant death syndrome (SIDS, n = 38) compared with an age-matched control population (n = 51). Mean combined weights of CBs from SIDS victims were greater than controls in the 1- to 4-month age interval (mean = 3.4 mg, p less than 0.075) and the 4- to 8-month interval (mean = 5.0 mg, p less than 0.098) but the differences were not statistically significant (t-test, p less than 0.05). Computerized planimetry of total surface area and area occupied by "functional" parenchyma revealed no statistically significant differences. Both groups showed an equally intense degree of cytoplasmic argyrophilia of chief cells, and electron microscopy of CBs from 5 SIDS victims was indistinguishable from controls, including overall content of dense-core neurosecretory granules. There were also no significant differences in catecholamine content using liquid chromatography with electrochemical detection (SIDS n = 29, controls n = 21). These morphometric, ultrastructural, and biochemical data are not supportive for CBs having a significant role in the pathogenesis or etiology of SIDS. PMID- 3822946 TI - Attention deficit disorder: diagnosis, prevalence, management and outcome. AB - Some of the clinical and research problems associated with so-called attention deficit disorder (ADD), minimal brain dysfunction (MBD) and hyperactivity in childhood are surveyed. It is concluded that there is no international consensus as regards diagnostic criteria, prevalence of severe disorders is in the range of 1-5% of all preschool children, management is dependent on a wide variety of treatment facilities and that outcome is relatively poor in the 5- to 10-year perspective but that it may be somewhat better if the children are followed up to adult life. PMID- 3822945 TI - Glandular schwannoma in a 17-month-old child. AB - Glandular schwannoma is an infrequent tumor, especially in the pediatric age group. We report a case in which the tumor developed in the retroperitoneum of a 17-month-old girl without stigmata of Von Recklinghausen's disease (VRD). She presented a local recurrence and bone and pulmonary metastases at 11, 23, and 30 months, respectively, after tumor resection. The pathologic findings in the original tumor did not permit us to predict its potential to metastasize. The ultrastructural characteristics of both glandular and schwannian elements are described. The rarity of this neoplasia in children and the absence of histological parameters of aggressiveness are emphasized. PMID- 3822947 TI - Chronic illness and its impact on academic achievement. AB - With chronic illness in children becoming increasingly evident, there is a need to tease out primary from secondary effects of the illness on scholastic achievement. Early multidisciplinary diagnosis of chronic illness is critical and requires a community setting with careful long-term individual follow-up and research. This will enable pediatricians and school doctors to be more helpful to the education authorities. PMID- 3822948 TI - Does television affect learning and school performance? AB - Television is ubiquitous in American households and is becoming a pervasive force in the growth and development of American children. More time is spent watching television than in formal classroom instruction. Early studies, which failed to control for IQ and socioeconomic status, showed variable effects of heavy viewing on school performance. Later, better controlled studies have consistently demonstrated a significant deleterious effect of more than 1 or 2 h/day on academic performance, particularly reading scores. Innovative school programs that teach children how to watch television critically and appropriate management strategies for parents are discussed. PMID- 3822949 TI - Educational readiness. AB - The early identification of children not yet ready to begin the formal task of classroom learning has been increasingly emphasized by educators, psychologists, pediatricians and parents. The pediatrician, as the professional concerned with monitoring children's growth and development, is uniquely suited to participate in the identification of such children. Effective participation requires recognition of the various factors influencing educational readiness, as well as the manner in which they fit together into a whole greater than the sum of its parts. Possible pediatric roles include screening children for educational readiness, as well as clinical problem-solving when issues or concerns arise. PMID- 3822950 TI - Factors associated with excessive school absence. AB - Excessive school absence is a major educational and social problem in the United States which is most pronounced in urban school systems. A case control study of excessively absent inner-city middle-school students and regular attenders failed to demonstrate any differences between groups in terms of health status, health related behaviors, or utilization of health services. These results contrast dramatically with the findings of a previous study which identified a number of educational and demographic characteristics which clearly distinguish excessively absent students from regular attenders. It is concluded that educational and demographic factors are far more important in influencing excessive absence behavior than are health-related factors. The implications of these findings for the pediatrician are discussed. PMID- 3822951 TI - Issues in the classification of children who fail in school: categorical versus descriptive approaches. AB - The classification of children who are failing in school has become a matter of national interest and concern since 1975 when the passage of PL 94-142 created a system of categories for designating the specific disorders which lead to the need for special education. This paper explores two trends in classification: namely, categorization and the descriptive approach. The benefits of categorization include the ability to create a national data base, from which epidemiologic and trend information are available; the ability to study local variation and relate this to intervention systems, and the ability to monitor the resources expended on special education. However, a number of liabilities are built into categorization system. The most serious of these is the fact that individual variation is not recognized by a categorical approach. Clinically, many multidisciplinary teams have preferred to provide parents and schools with descriptive classifications which take into account the variety of influences and symptoms at work in particular situations. Practical suggestions are offered in this paper to help pediatricians use both the categorical and descriptive approaches in helping parents as their children are diagnosed as a result of their school failure. Finally, challenges are raised to the pediatric community to help with resolving the major issues in the field, namely the variation in classification across sites and the exclusion of some children who have multiple etiologies for their school failure. PMID- 3822952 TI - Youngsters who persistently do not attend school. AB - 5% of the children attending psychiatric clinics in the UK have difficulties with school attendance and these stem from difficulties which are predominantly social (truancy) or predominantly psychological or dynamic (school refusal). Adolescents who display school refusal are three times more likely to develop neurotic difficulties in adult life, especially if marked family difficulties are persistent. Up to 20% of the senior school pupils may truant in a 2-week period and teachers report these youngsters to be more aggressive and to show more neurotic symptoms then the regular school attenders. Their peers choose them significantly less often as friends, and the marked differences in the rate of absence between schools seems related to school philosophy and the degree of school involvement in the community. Truancy can be influenced by greater vigilance in the school and by legal intervention. Although absence from school in itself does not seem to adversely influence the youngsters' adult functioning, if it is associated with conduct problems and educational retardation, long-term difficulties are common. PMID- 3822953 TI - Evaluation of school performance: dyslexia and attention deficit disorder. AB - The primary focus of the diagnostic evaluation is to determine whether the child's problems fit the criteria for a diagnostic entity. In the case of school problems, the two most common disorders to be considered are learning disability and attention deficit disorder. Historical information from parents and teachers together with psychometric data are at the core of the assessment process. Helpful insights may be gathered from the neuromaturational examination while specific laboratory measures including electrophysiological, neurochemical, neuroradiological and psychophysiological have not been shown to be helpful in distinguishing either learning disability or attention deficit disorder. The physician is urged to take a more active role in the psychometric component of the examination. Inquiry should be made about the reliability and validity of instruments used before accepting any recommendations based on a particular test. Care should also be taken to insure that the tests used in the formulation have been individually administered and that the child's performance is noted in untimed as well as timed circumstances. While a comprehensive evaluation should inquire into social, familial and medical etiologies, this should be accomplished with the knowledge that except for family history, there may be no other contributing factors that emerge. Learning disability and attention deficit disorder are high prevalence disorders. Time and energy should not be expended in searching for rare events to invoke as an explanation for these frequent occurrences. PMID- 3822954 TI - [Acquired immunodeficiency syndrome (AIDS) in the African environment]. PMID- 3822956 TI - How to get started at medical writing. PMID- 3822955 TI - Evaluation of the acute abdomen. When to consult a surgeon. PMID- 3822957 TI - Update on immunization recommendations. PMID- 3822958 TI - Patient noncompliance and overcompliance. Behavior patterns underlying a patient's failure to 'follow doctor's orders'. AB - The vicissitudes of medical treatment are affected in large part by patient compliance. Noncompliance can be caused by a variety of psychological, somatic, and socioeconomic factors. Overcompliance would seem on the surface to be less of a problem, but it too can have serious consequences in terms of treatment success. Several psychological factors account for overcompliance. The physician's best defenses against both noncompliance and overcompliance are to listen carefully to the patient for clues to one of these impending behaviors and to establish good rapport with the patient. An individualized approach is important, and in some cases participation in organized self-help groups is of benefit. PMID- 3822959 TI - Suppurative (bacterial) sinusitis. AB - Upper respiratory tract (viral) infection is the most common predisposing cause of suppurative sinusitis. Acute disease is manifested by pain, nasal discharge, systemic manifestations, and nasal obstruction. In chronic disease (greater than 3 months' duration) nasal airway obstruction and postnasal discharge may be the only symptoms. Diagnosis is made on the basis of the history and physical examination, supported by roentgenographic findings and, if necessary, cultures. Acute infection is treated with antibiotics, decongestants, and analgesics. If medical management fails, surgery is necessary. Complications of suppurative sinusitis include cellulitis, abscess, meningitis and cavernous sinus thrombosis, osteomyelitis, and oroantral fistula. PMID- 3822960 TI - The parotid lump--don't biopsy it! An approach to avoiding misadventure. AB - All lumps in the parotid region must be assumed to originate in the parotid gland. A mobile, superficial-appearing lesion cannot be assumed to be located just beneath the skin. Open incisional biopsy should never be used in approaching lumps in this region because of the danger of tumor seeding or damage to the facial nerve. The presence of a parotid lump is a definite indication for referral. Treatment by a head and neck surgeon is always done with the patient under general anesthesia. If these basic principles are followed, recurrence of mixed tumors often can be prevented. PMID- 3822962 TI - Peripheral labyrinthine causes of dizziness. AB - A patient's complaint of dizziness must be defined specifically. Many dizzy patients do not have labyrinthine or balance system disease. The patient with dysequilibrium, on the other hand, often has a balance system disease but not necessarily a labyrinthine disorder. The patient with vertigo most likely has labyrinthine disease. Vertigo is accompanied by nystagmus, which can be identified only when the examiner specifically looks for it. Although vertigo is the classic symptom of labyrinthine disease, not all labyrinthine diseases have associated vertigo. Careful history taking, physical examination, audiometry, caloric testing, electronystagmography, and radiographic studies will identify patients with labyrinthine disorders. Treatment depends on the diagnosis. Usually it is medical, but occasionally it may be surgical. Most patients have no residual problems; a few have permanent disability. PMID- 3822961 TI - Twenty questions about middle ear fluid and ventilation tubes. PMID- 3822963 TI - Patient education in primary care practice. Tips on planning a workable in-office program. AB - Patient education is an integral part of primary care practice. Physicians provide most patient education in the office setting. Good communication skills are a prerequisite for establishing a physician-patient partnership, which is key to effective patient education. A formalized plan and use of ancillary personnel should never substitute for the physician's personal communication with the patient. The office environment--including the attitudes of all personnel--sets the tone for and emphasizes the importance of patient education. The use of quality educational materials and the assistance of office personnel and allied health professionals will help the physician provide effective patient education in the office setting. Such education is one component of a quality medical care program for the entire family. PMID- 3822964 TI - Corynebacterium endocarditis. Difficult diagnosis in an elderly woman. AB - Physicians have been reminded repeatedly of the many faces of bacterial endocarditis. In this case, Corynebacterium endocarditis presented as an occult malignancy and eluded diagnosis for six months. The coryneform isolates found in cultures are often considered to be contaminants because of their ubiquitous nature, sometimes causing a delay in diagnosis. Patients with culture-negative endocarditis or Corynebacterium "contamination" should be treated as having Corynebacterium endocarditis pending results of microbiologic isolation tests. PMID- 3822965 TI - Irritable bowel syndrome. Progress in understanding and management. PMID- 3822966 TI - Key issues in nutrition. During childhood and adolescence. AB - Good nutrition is important between ages 2 and 18, because growth and maturation are taking place and because future eating habits are being established. The primary care physician can assist children and adolescents by evaluating high risk factors, such as a family history of cardiovascular disease or hypercholesterolemia, and by recommending supplemental nutrients as indicated. Possibly more important, though, is the counseling the physician can give these patients and their parents to promote a life-style that may prevent disease. PMID- 3822967 TI - Postherpetic neuralgia. Prevention and treatment. PMID- 3822968 TI - A case of chronic childhood spinal muscular atrophy. Or, how to succeed in life despite total paralysis. PMID- 3822969 TI - The fitness frenzy. PMID- 3822970 TI - Immune function in the elderly. PMID- 3822971 TI - Oral health concerns in older adults. Assessment and treatment. PMID- 3822972 TI - Neurologic examination of the elderly patient. Signs of normal aging. AB - Once the signs of normal aging are recognized, findings that indicate aging alone can be separated from those that clearly suggest a focal neurologic lesion. Using the patient's history and other data, the physician can relate the findings to the complaints. However, it behooves the physician to explain all the findings on the examination and not merely blame the aging process for every neurologic sign. PMID- 3822973 TI - The alcohol-suicide connection in late life. AB - The many losses and stresses of late life, often accompanied by feelings of loneliness and depression, make the elderly especially vulnerable to alcoholism and suicide. The elderly alcoholic is at significant risk for suicide. The major factors in geriatric alcoholism and suicide are depression (manifested by changes in sleeping and eating patterns, somatic complaints, and apathy), stress and loss, and helplessness and hopelessness. Alcoholism in the elderly can be detected and effectively treated, thus reducing the risk of suicide. Family and friends, physicians, and society all have a role in preventing alcoholism in the elderly. PMID- 3822974 TI - The carpal bones--an old mnemonic sanitized. PMID- 3822975 TI - Smokeless tobacco use. A dangerous nicotine habit. AB - Much attention has been focused on cigarette smoking and its health implications. Numerous campaigns have been launched to help people stop smoking or prevent them from starting. While smoking has been receiving this attention, use of smokeless tobacco has been increasing at an alarming rate. Smokeless tobacco exposes the user to all the nicotine effects of cigarette smoking. Oropharyngeal cancer and erosive effects on the oral structures are known hazards, but the long-term total body effects have yet to be determined. Physicians need to identify patients who use smokeless tobacco so that intervention strategies can be employed. Preventive techniques, especially those aimed at children, may be the most effective means of controlling this health threat. PMID- 3822976 TI - Recurrent psoas abscess. AB - Recurrence of a psoas abscess in exactly the same location is very unusual--in fact, we found no other reports in the literature. Laparotomy performed after the patient presented with the second abscess revealed an impacted calculus and diverticulitis of the appendix as the cause. Computed tomography was effective in establishing the diagnosis, but the question of the best method of treatment remains. Percutaneous drainage was insufficient in this case. PMID- 3822977 TI - Genotypic and phenotypic parameters of spur incidence and length in White Leghorn hens. AB - Spurs were measured on two groups of hens: at 532 days of age in six selected and three control strains (Expt. 1); and at 483 days of age in a full 3 X 3 diallel of three of the selected strains as well as two control strains and two commercial stocks (Expt. 2). There were no significant differences in length between spurs on right and left legs. Strain differences for spur incidence were large and significant, but those for length generally were not. Pooled strain estimates of heritability for spur incidence were .21 for both left and right spurs, and .40 (left) and .44 (right) for spur length (Expt. 1). General combining ability was large and highly significant for spur incidence only, and specific combining ability was not significant for either incidence or length of spurs (Expt. 2). Heterosis was not significant for spur incidence or length. Reciprocal differences were significant only for spur incidence of the crosses of strains 4 and 8. Spur length was negatively correlated phenotypically with egg production, egg weight, specific gravity, and Haugh units. Genotypically, spur length was positively correlated with part-record egg production to 273 days and negatively correlated with 450-day egg weight and specific gravity. PMID- 3822978 TI - Ahemeral light-dark cycles and intermittent photoperiod effects on laying hens. AB - To compare the effects of using continuous (C) vs. intermittent (I) photoperiods with normal (24 hr) and a long but decreasing light-dark cycle (LDLDC) on production performance and egg quality, 240 White Leghorn hens of the University of Missouri-Columbia strain were individually caged in light-controlled rooms. Treatments applied at 21 weeks of age were light-dark cycles (LDC) of 25 hr gradually reduced to 23.5 hr with C or I photoperiods, and 24-hr LDC (controls); C or I photoperiods were gradually increased from 13.75 to 16 hr for the 25- to 23.5-hr LDC, and from 13.75 to 15 hr for the 24-hr LDC. Data were obtained on hen day egg production, egg weight, egg mass, egg specific gravity, Haugh units, feed consumption, and feed efficiency. Hen-day egg production was significantly greater (P less than .01) for the combined C photoperiod treatments, while hens consumed significantly less (P less than .05) feed exposed to the combined I photoperiod treatments. Egg specific gravity was significantly better (P less than .05) for the LDLDC vs. the 24-hr LDC program with the difference being attributed to an increase (P less than .05) in initial egg specific gravity with the use of a 24-hr LDC. Egg weight, egg mass, Haugh units, and feed efficiency were not affected (P greater than .05) by LDC or photoperiod treatments. PMID- 3822979 TI - Zinc oxide to induce molt in layers. AB - The effects of the addition of Zn as ZnO to diets to induce molt were evaluated against a fasted control. Experiment 1 involved 315 Leghorn hens, 15 months old, randomly distributed among five treatments, each replicated seven times with 9 hens per replicate. Hens fasted for 10 days were compared with hens fed diets to which ZnO was added at 10,000, 5,000, or 2,500 ppm for 7, 14, or 21 days. No significant differences were observed among treatments for days to return to 50% production, hen-day and hen-housed production, egg weight, grams egg per hen-day, grams of feed per gram egg, mortality, or Haugh units during the 22-week experimental period. Experiment 2 involved 420 Leghorn hens, 18 months old, randomly distributed among five treatments, each replicated seven times with 12 hens per replicate. Treatments involved fasting for 10 days or feeding diets with 10,000, 5,000, or 2,500 ppm ZnO fed for 7, 14, or 21 days. Hens fasted and hens fed diets with 10,000 ppm ZnO at the start of the experiment ceased production in significantly less time (4.6 to 6 days) than hens fed 5,000 ppm ZnO (14.3 to 14.9 days); however, days to return to 50% production from the start of the experiment did not differ among treatments. Feed consumption and feed cost per hen day during molt were lowest (P less than .05) in the fasted hens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822980 TI - Effects of light conditioning on reproduction in partridge. AB - Reproductive response was measured in two lines of chukar partridge given conditioning light treatments of either 8 hr light:16 hr dark (8L:16D) at 50 lx or 16L:8D at .1 lx for 4, 6, or 8 weeks, respectively. Birds were recycled to lay using the same conditioning light treatments. During both lay cycles, all birds received 16L:8D at 100 lx. The results indicate that both conditioning light regimens were effective in terminating postjuvenile and postlay refractoriness. Hens given a conditioning light treatment of 8L:16D at 50 lx reached sexual maturity earlier, and produced more eggs and more viable chicks, and males maintained fertility longer, compared to birds conditioned under 16L:8D at .1 lx. Light conditioning periods of 6 and 8 weeks were superior to those of 4 weeks. For maximum reproductive performance in partridges, a short day photoperiod of 8L:16D at 50 lx is recommended for successful interruption of either postjuvenile or postlay refractoriness. PMID- 3822981 TI - Effects of type of cage partition, cage shape, and bird density on productivity and well-being of layers. AB - In Experiment 1 there were no significant differences in rate of lay, egg quality, latency to feeding, and feather condition of hens in cages with wire mesh or solid metal side partitions. Birds in cages with solid metal side partitions had significantly higher mortality (6%) and weight gain (6%) than those in cages with wire side partitions. The deep caged hens had significantly lower mortality (8%) than the shallow caged hens. Hens housed at 464 cm2 of floor area/hen had significantly higher hen-housed egg production (4.9%), lower weight gain (8%), and higher average feather scores (.8 unit) than those housed at 348 cm2. In Experiment 2 type of cage side and back partitions (wire vs. solid metal) significantly affected grams of egg per gram of feed. Birds in deep cages had significantly lower mortality (8.6%) and higher feed consumption (15.2 g/hen/day) than those in shallow cages. Hen-housed rate of lay, mortality, weight gain, feed conversion, and feather scores were significantly affected by bird density: 64.6%, 15%, 24.6%, .384% g egg/g feed, and 4.7 units, respectively, for hens with 464 cm2 floor area vs. 70.8%, 8.3%, 25.2%, .362% g egg/g feed, and 5.8 units for hens with 348 cm2. Data suggest that hens in cages with solid metal sides performed similarly to their sisters in cages with wire mesh sides and backs. PMID- 3822982 TI - Performance of White Leghorn hens in response to cage density and the introduction of cage mates. AB - Hens reared at densities of 344 and 516 cm2/bird produced significantly fewer hard-shelled (HS) and shell-less (SL) eggs than hens reared at a density of 1031 cm2/bird. Soft-shelled (SS) egg production was not affected by the density treatment. A decline in ovulation rate would account for the decrease in total hen-day production in response to the higher density treatments. To determine if the introduction of new cage mates would cause hens to lay fewer eggs with poorer shell quality, the performance of hens with visitors was compared with those with nonvisitors. Visitors were introduced monthly for 13 months. Visitors vs. nonvisitors showed no significant difference with regard to HS, SS, and SL egg production, feed efficiency, mortality, egg weight, and specific gravity. PMID- 3822983 TI - Influence of resident Salmonella on contamination of broiler flocks. AB - An epidemiological survey was made of 5329 samples from 10 poultry operations to determine the relationship between total poultry farm environment and incidences of Salmonella contamination of broiler flocks. Samples were analyzed from walls, drinkers, feeders, litter, insects, water, chicks, broilers, and feed to determine the effect of common sanitary practices on Salmonella contamination of flocks. Results indicated that although similar hygienic practices had been taken on the 10 poultry farms examined, great variation exists in Salmonella contamination among the farms. Among the sources studied, the most important source of contamination was determined to be the resident Salmonella of the flock i.e., the strain isolated on chicks' first day in the poultry house. This source was more important than Salmonella isolated during the rearing period. However, the precise conditions of Salmonella contamination in poultry flocks remain to be elucidated. PMID- 3822984 TI - Thermal transitions of natural actomyosin from poultry breast and thigh tissues. AB - Natural actomyosin was isolated from broiler breast and thigh tissues, characterized by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS PAGE), and examined for thermal transitions (Tm) during heat-induced aggregation. Electrophoresis showed some variation in the quantity of each subunit protein present between the tissue actomyosins and, with Amido Black staining, yielded actin to myosin molar ratios of 5.71 and 6.33 for breast and thigh natural actomyosins, respectively. The heat-induced initiation of protein to protein interactions occurred at 30 to 31 C for actomyosin of breast tissue and at 42 to 44 C for actomyosin of thigh tissue. Two distinct thermal transitions were found for each actomyosin. Derivative curves from the plot of differential change in optical density or absorbance (A) as a function of temperature (T) (dA/dT) between 28 C and 70 C showed Tm1 at 49.2 C and Tm2 at 60.2 C for breast actomyosin with corresponding values of Tm at 52.6 C and 57.9 C for thigh actomyosin. The interval between Tm1 and Tm2 (delta Tm) for thigh actomyosin (5.3 C) was less than that of breast actomyosin (11.0 C). This result suggests that less thermal energy is required for aggregation of actomyosin from thigh tissue. The differences in thermal characteristics between the two actomyosins may be related to differences observed in heat-processed products prepared from breast and thigh tissues. PMID- 3822985 TI - Characteristics of egg yolk phosvitin as an antioxidant for inhibiting metal catalyzed phospholipid oxidations. AB - A study was conducted to determine the antioxidant activity of phosvitin in an egg yolk phospholipid emulsion system. Various inorganic and organic metals (Fe2+, Cu2+, and hemin) in several different concentrations were added individually to the emulsions to induce lipid oxidation. Characteristics of phosvitin for inhibiting these metal-catalyzed lipid oxidations were investigated. The effect of heat treatments, both pasteurization (61.1 C, 4 min) and autoclaving (121.1 C, 10 min), on phosvitin was examined to find out if there was any effect on its antioxidant characteristics. Lipid oxidations were measured by thiobarbituric acid assays. Phosvitin effectively inhibited Fe2+ and Cu2+ catalyzed phospholipid oxidations as shown by low malondialdehyde values over the entire reaction period; however, it did not exert similar effects on the hemin catalyzed oxidation reaction. Phosvitin demonstrated higher capacity to inhibit iron catalysis of phospholipid oxidations (up to 30:1 Fe2+-to-phosvitin molar ratio) than copper catalysis (1:1 molar ratio). Pasteurization did not change the antioxidant activities of phosvitin; however, autoclaving decreased phosvitin's inhibitory capacity on iron catalysis. PMID- 3822986 TI - Growth, feed conversions, and yields of turkey parts of three strains of hen turkeys as influenced by age. AB - Effects of age on the growth, feed to gain ratios, individual part weights, and yields of hen turkeys were determined weekly from ages 12 to 21 weeks. Two hundred birds from each of three strains (A, B, and C) were processed. All three strains of hen turkeys continued to gain weight throughout the study. During the 12 to 21-week-old period birds grew from an average of 4.76 kg to 9.17 kg, while the cumulative feed to gain ratios went from 1.97 to 2.94. Strain B consistently weighed more than Strains A and C for the duration of the study. Weights of all parts increased as hens grew larger. However, the parts' proportion of total weight changed. Percentages of breast, breast muscle, and fat increase, while percentages of wing, drumstick, and skin decreased. Breast, breast muscle, and fat yields increased from 32.8 to 35.9%, 23.8 to 28.0%, and 1.7 to 5.1%, respectively. Both wing and drumstick percentages declined from approximately 14.0 to 12.0%. Thigh, thigh muscle, and shell percentages varied, but ended near their starting levels, of 14.8, 10.5, and 21.8%, respectively. At 21 weeks of age the hen turkeys were still gaining body weight. Breast weight--both actual and percentages--were still increasing. PMID- 3822987 TI - Muscle protein turnover in sex-linked dwarf and normal broiler chickens. AB - Dietary infusion of L-[U-14C]tyrosine was used to estimate the fractional protein synthesis rates (FSR) in normal and dwarf female broiler chicks. Five 2-week-old and five 3-week-old birds of each genotype were placed in individual metabolism cages and given a purified diet in agar-gel containing 2 mu Ci L-[U-14C]tyrosine for 6 hr. Birds were killed and the pectoralis major (PM) and combined gastrocnemius and peroneous longus muscles (LM) were removed for analyses. Additional groups of 4 to 5 chickens were killed 3 days before and 3 days after each infusion to determine fractional protein accretion rate (FAR) over the 6-day period. Fractional degradation rate (FDR) was obtained by difference (FDR = FSR - FAR). Protein, ribonucleic acid (RNA), and deoxyribonucleic acid (DNA) concentrations were determined to observe possible relationships between these cellular constituents and FSR. Activities of RNA and DNA were determined as units of protein synthesized per unit RNA or DNA per day. Two-week-old chicks, dwarf chicks, and the PM muscles had higher (P less than .05) FSR than 3-week-old chicks, normal chicks, and the LM, respectively. Two-week-old chicks and dwarf chicks had higher FDR than 3-week-old chicks, respectively. There was a significant decrease in RNA concentration and RNA activity from 2 to 3 weeks. The RNA activity tended to be higher in dwarf than normal birds. Concentration of RNA was higher (P less than .05) in the PM than LM. However, DNA concentration was higher (P less than .05) in the LM than PM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822988 TI - Effects of modified conventional and reverse-protein rearing dietary regimens on the performance of Leghorn hens. AB - Two commercial Leghorn genotypes were used to study the effects of rearing dietary treatments on juvenile mortality, growth, and adult performance. One control, two modified conventional, and three reverse-protein juvenile dietary regimens were compared. The two genotypes differed in egg production, age at 50% egg production, egg weight, egg specific gravity. Haugh units, and monetary returns. There was no evidence of any genotype X dietary treatment interaction. Juvenile dietary treatments had a significant (P less than .05) effect on body weights at 21 days of age that continued through the juvenile and adult periods to 490 days. Age at 50% egg production, feed efficiency, and initial egg weights were also affected. Although hens reared on one of the modified conventional and two of the reverse-protein regimens returned $.53 per bird more than the remaining three rearing dietary regimens, this difference was not significant (P greater than .05). Evidence is provided that reverse-protein juvenile dietary regimens may support adult performance that equal or surpass the performance of birds reared on conventional dietary programs. PMID- 3822989 TI - Microelements in the circulation of coccidiosis-infected chicks. AB - Four-week-old Single Comb White Leghorn male chicks were inoculated with either Eimeria acervulina, E. necatrix, E. brunetti, E. tenella, or left uninfected. On Days 1, 3, 5, 6, 7, 8, 9, 10, 14, 21, 28, and 35 after inoculation, blood was removed from five birds in each group; content of copper, zinc, and iron in plasma and total iron-binding capacity were determined. Copper content in plasma was increased during the acute phase of the infections by lower intestinal tract (E. brunetti, E. tenella) infections but not by upper tract (E. acervulina, E. necatrix) infections. Zinc content in plasma was decreased by E. acervulina and E. necatrix infections on the 7th day and was increased by E. acervulina, E. brunetti, and E. tenella infections on the 9th or 10th days. Iron content in plasma was decreased during the acute phase (Days 5 to 7) of E. acervulina, E. brunetti, and E. tenella infections. Total iron-binding capacity was decreased by acute phase E. acervulina and E. brunetti infections. Eimeria tenella infections increased total iron-binding capacity during both the acute and early recovery phases. Plasma content of all components returned to normal by the latter part of the recovery phase of the infections and remained so thereafter. Plasma trace mineral content appeared to be influenced by mineral absorption effects, by hemorrhaging, and perhaps by invasion of the bloodstream by gut bacteria as a result of mucosal damage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822990 TI - Zinc supplementation: its effect on egg production, feed conversion, fertility, and hatchability. AB - Studies were conducted over four layer years using Single Comb White Leghorn hens, 24 to 68 weeks of age, to observe the effects of zinc supplementation of a corn-soybean meal layer ration on egg production, feed conversion, fertility, and hatchability. Pullets were housed in floor pens; 20 birds per pen. New Hampshire cockerels were used as sires. Treatments were the basal corn-soy-based diet (28 or 34 ppm zinc by analysis) with the following supplemental zinc levels (as the carbonate): 0, 10, 20, or 40 ppm. Feed, water, and crushed oyster shell were supplied ad libitum in all trials. No consistent production effects due to zinc supplementation were observed. Egg production, feed intake, and feed conversion were not improved by zinc supplementation. Fertility and hatchability, likewise, were not improved by zinc supplementation. The chicks produced showed no significant differences in 3-week body weights. However, the chicks produced from hens on the 28 ppm zinc (control) diet showed an increased incidence of zinc related feather fraying. There was a significant (P less than .05) increase the first two laying trials and a numerical increase the last two trials. Thus it appears that 28 ppm of zinc, naturally supplied, is adequate for egg production, fertility, hatchability, and growth of progeny. PMID- 3822991 TI - Effects of calcium and phase-feeding phosphorus on production traits and phosphorus retention in two strains of laying hens. AB - Three levels of dietary Ca (3.0, 3.5, or 4.0%) were fed throughout a 336-day experiment to two strains of Single Comb White Leghorn hens in a factorial arrangement with three P feeding programs: .64% P fed continuously; .56, .49, and .39% P; or .64, .54, and .44% P fed when hens were 24 to 36, 36 to 52, and 52 to 72 weeks, respectively. In addition to production traits, measurements of P retention were made at 34, 42, 50, 62, and 72 weeks of age. No dietary effects were observed on production traits. Average P retention over the entire experiment was 104, 148, and 178 mg/day when hens were fed 3.0, 3.5, and 4.0% Ca, respectively. Most of the favorable effect of Ca on P retention occurred after 50 weeks of age. However, increasing dietary Ca had an adverse influence on P retention at 42 weeks, when ambient temperature was unusually hot and feed intake decreased markedly. Significant P effects were observed when hens were 42 and 72 weeks of age. At these times, hens fed .64% P retained the most P while those phase fed .56, .49, and .39% P retained at least. Retention of P tended to decline with increasing age of the hens. Overall, the hens were in a state of marginal to negative P balance at 42, 62, and 72 weeks of age even when P deposited in eggs was considered. PMID- 3822992 TI - The effect of variation of calcium intake on production performance and shell quality. AB - Two experiments were conducted to determine the effects of moderate variation of calcium intake on production performance and shell quality. In Experiment 1, birds were fed diets containing 1.5 and 5.5% calcium, respectively, in the first and second 3-day period of 10 6-day cycles. In Experiment 2, calcium concentrations alternated between 2 and 5%. In both experiments, control groups were fed a diet containing 3.5% calcium for the duration of the experiment (60 days). Birds were 28 weeks old at the beginning of Experiment 1 and 50 weeks old at the beginning of Experiment 2. Overall egg production, egg weight, egg mass, feed consumption, feed conversion, and body weight gain were consistently lower for the birds of the alternating groups than the birds of the control groups in both experiments. Shell quality as measured by shell thickness, breaking strength, specific gravity, and percent shell in most cases was significantly reduced within 24 hr of feeding the low calcium diets and improved to normal within 24 hr of feeding the high calcium diets in both experiments. These experiments suggest that calcium variation of the extent used in these experiments reduces optimum performance; shell quality is reduced within 24 hr of feeding a low calcium diet. PMID- 3822993 TI - 3'-Oxolutein, a metabolite of lutein in chickens. AB - 3'-Oxolutein (3-hydroxy-3'-oxo-beta,epsilon-carotene) was isolated using high performance liquid chromatography (HPLC) from the tissues and egg yolks of chicken fed a diet high in lutein and free of detectable 3'-oxolutein. It was identified by HPLC retention time, absorption spectrum identical to lutein and its esters, disappearance under alkaline conditions without giving rise to lutein, formation of an alkali labile palmitate, formation of a 2,4 dinitrophenylhydrazone, and reduction to lutein from which the dipalmitate was prepared. In each instance the isolated compound behaved identically with authentic 3'-oxolutein prepared by nickel peroxide oxidation of lutein. The order of ratios of lutein to 3'-oxolutein in the various tissues from laboratory and field birds was, in general, intestinal contents greater than intestinal mucosa greater than serum greater than liver approximately toe web approximately egg yolk greater than bile. This order was consistent with the hypothesis that lutein was oxidized to 3'-oxolutein in the liver, which, at least in part, was excreted via the bile into the intestinal lumen where it was diluted with dietary lutein. The remainder of the 3'-oxolutein formed in the liver presumably went into the serum where it was transported to depot sites. The ratio of lutein to 3' oxolutein in the toe webs of broilers varied with their diet and pigmentation status. Amounts of 3'-oxolutein were found in quail and turkey egg yolks. This previously unreported lutein oxidative capability of liver extends the previously known metabolic acylation and deacylation reactions in poultry. PMID- 3822994 TI - Estimation of the fractional breakdown rates of myofibrillar proteins in chickens from quantitation of 3-methylhistidine excretion. AB - The objective of this study was to estimate the fractional breakdown rate (FBR) of muscle protein in the chicken from measurements of 3-methylhistidine (3-Mehis) excretion and the amount of 3-Mehis bound in the skeletal muscle pool. Excreta were collected for a 24-hr period from six 2-week-old broiler chicks that were fed a purified diet, and 3-Mehis was quantified. The concentration of 3-Mehis was determined in the dissected tissues of skeletal muscle, heart, gizzard, intestine, crop, stomach, brain, lung, kidney, liver, skin, feathers, and skeleton. Detectable amounts of 3-Mehis were not found within serum either before or after acid hydrolysis. Heart, gizzard, intestine, crop, and stomach contained considerable amounts of 3-Mehis, but because of their small contribution to body weight, they contributed only 11% of the total body 3-Mehis. Muscle contributed 84% of the 3-Mehis in the body. Muscle protein FBR determined from 3-Mehis excretion was 5.3%/day, about half that estimated using continuous infusion methods. The difference between the two quantification methods was attributed to the slow turnover rate of actin, which contains most of the 3-Mehis. PMID- 3822995 TI - Kidney function in domestic fowl with chronic occlusion of the ureter and caudal renal vein. AB - A previously published technique for producing renal insufficiency in chicks involves ligating the caudal renal vein together with the ureter near the midpoint of the kidney. This ligation occludes the normal route (caudal renal vein) by which blood exits the medial and posterior kidney divisions. The present study was conducted to evaluate kidney function following chronic caudal renal vein and ureter occlusion. The ureters and caudal renal veins of 2 to 3-week-old chicks were clamped with hemostatic clips (Clamp Group), and kidney function evaluations were conducted when the birds reached 14 weeks of age. Plasma values [osmolality, Na, K, Ca, inorganic P (Pi)] of control, sham, and clamp groups did not differ significantly. Plasma uric acid concentrations did not differ when the control and clamp groups were compared. Clamping the ureter near the midpoint of the kidney caused a significant reduction in the number of filtering glomeruli per kidney, but due to compensatory hypertrophy the kidney weights of the groups did not differ significantly. Kidney function comparisons (urine flow rates, glomerular filtration rates, renal plasma flow rates, urine pH, fractional excretion of Na, K, Ca, Pi, and uric acid) revealed a significant reduction in Na and K excretion by the clamp group, but other renal function parameters did not differ significantly. These experiments demonstrate that chickens have a remarkable capacity to survive significant reductions in renal mass and to adapt to major disruptions of blood flow patterns. PMID- 3822996 TI - Influence of hatcher holding times on several physiological parameters associated with the immune system of chickens. AB - Two experiments were conducted with broiler chicks to study the effects of posthatch holding time in the incubator on physiological and disease parameters. In each experiment, half of the chicks were removed shortly after hatching and half of the chicks were allowed to remain in the hatcher for an additional 30 hr. Bursa weights, hematocrits, total plasma protein, and blood glucose concentrations were measured at various times up to 35 and 28 days of age in Experiments 1 and 2, respectively. In addition, chicks hatched from eggs with one of two specific gravities (less than or equal to 1.065 and greater than or equal to 1.075) were tested in the second experiment. Spleen weights, heterophil:lymphocyte ratios and the influence of an aerosol Newcastle disease Mycoplasma gallisepticum vaccine challenge were also measured in the second experiment. In Experiment 1, when chicks were held in the hatcher for an additional 30 hr, bursa weights were reduced through 8 days of age; however, they were significantly heavier by 21 days of age. In Experiment 2, both bursa and spleen weights were significantly reduced through 14 days of age when chicks were held in the incubator. Total plasma protein and glucose concentrations, hematocrits, and heterophil:lymphocyte ratios were all significantly higher for chicks held in the incubator. Chicks held in the incubator and then exposed to an aerosol vaccine challenge at 1 day of age had a significantly greater percentage of air sac lesions and the lesions were more severe at 28 days of age. Egg specific gravity had no influence on any of the parameters measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3822997 TI - The Second Amine Oxidase Workshop. Uppsala, Sweden. August 2-4, 1986. Abstracts. PMID- 3822998 TI - [Inhaled pollutants and the surfactant system of the lung]. PMID- 3822999 TI - [Geometric form of the thorax: an elliptic paraboloid]. PMID- 3823000 TI - [Sensitization to the mites Dermatophagoides pteronyssinus and farinae in patients with asthma and obstructive bronchitis]. PMID- 3823001 TI - [Tuberculous pericarditis with a 37-year history: documentation of pericardial changes by nuclear magnetic resonance tomography]. PMID- 3823002 TI - Antenatal diagnosis of a de novo paracentric inversion of chromosome 11. AB - A de novo paracentric inversion of chromosome 11 identified through antenatal diagnosis is described along with long-term follow-up information on the child and discussion of reported experiences with de novo inversions. PMID- 3823003 TI - Prenatal diagnosis of cystinosis utilizing chorionic villus sampling. AB - The prenatal diagnosis of cystinosis is currently based on the increased amount of free-cystine present in amniotic fluid cells. Amniocyte cultures must be grown for at least 2 weeks to obtain sufficient cells for such measurements. Thus, the diagnosis cannot be made until close to 20 weeks gestational age by this method. We report a case in which chorionic villi were used for direct cystine measurement resulting in the in utero diagnosis of cystinosis at 9 weeks gestational age. The diagnosis was confirmed by the study of cultured chorionic villus cells, and of the 10-week abortus. PMID- 3823004 TI - Prenatal diagnosis of severe combined immunodeficiency with defective synthesis of HLA molecules. AB - The immunodeficiency associated with a defective expression of HLA molecules is an autosomal recessive disorder leading to death during childhood. We have performed prenatal diagnosis for six fetuses at risk for this disease by membrane immunofluorescence on blood lymphocytes and monocytes, using specific monoclonal antibodies for HLA class I and II molecules. Two pregnancies have been found to be affected. The diagnosis has been confirmed on each abortus by the study of the membrane expression of HLA class I and II molecules on blood lymphocytes and monocytes, and on thymic and splenic cells. The four other cases were found to be normal both during pregnancy and after birth. The detection of the defect as early as the 20th week of gestation allows selective termination. PMID- 3823005 TI - Expression of transcobalamin II by amniocytes. AB - Children with a genetic absence of transcobalamin 2 (TC2) are clinically asymptomatic at birth but develop severe megaloblastic anemia early in life. We have examined the incorporation of [57Co]-CN-B12 in the absence of any exogenous source of TC2 in control amniotic fluid derived cells and cultured diploid fibroblasts, and in fibroblasts from a patient with TC2 deficiency. Both control fibroblasts and amniocytes incorporated labelled B12 into TC2-B12, and the proportion of labelled TC2-B12 could be increased by growing cells in the presence of chloroquine which prevents intralysosomal hydrolysis of the TC2-B12 complex. In contrast, fibroblasts from the patient with TC2 deficiency incorporated almost no label as TC2-B12. These studies suggest that TC2 deficiency either due to aberrant production of TC2 or because of the production of an abnormal TC2 which does not bind B12 can be diagnosed before birth. PMID- 3823006 TI - Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic patients. AB - The efficacy of the insulin infusion pump (CSII) in pregnancy was examined in 12 diabetic patients and compared with intermittent insulin therapy (IIT). In patients poorly controlled on IIT constant and rapid equilibrium was achieved with CSII (mean of glucose levels: CSII versus IIT = 84 versus 137 mg/dl; S.D. = 36 versus 63 mg/dl; mean amplitude of glycemic excursion (MAGE) = 65 versus 112 mg/dl. In patients well controlled on IIT, CSII led to a reduction in the variation of glucose excursions (S.D. = 29 versus 36 mg/dl; MAGE = 48 versus 76 mg/dl). CSII generally produced a reduction of 20-37 per cent of daily insulin dose (in three cases there was an increase of dose with the achievement of glycemic control). Furthermore in CSII treated-patients amniotic glucose, insulin and C-peptide concentrations were found to be in the normal range (22.1 +/- 10.1 mg/dl; 5.2 +/- 2.7 microU/ml; 1.25 +/- 0.71 ng/ml, respectively). All infants were born at or near-term, had no macrosomia or neonatal problems. It is concluded that CSII is a highly efficient way to achieve normal glucose levels in pregnancy, not only in type I, but also in type II or gestational diabetes. PMID- 3823008 TI - Borderline fasting hypertriglyceridemia: absence of excess risk of all-cause and cardiovascular disease mortality in healthy men without hypercholesterolemia. AB - The majority of prospective studies have shown no independent effect of triglyceride on the prediction of cardiovascular disease after the effects of cholesterol and other heart disease risk factors have been accounted for statistically. Because the association of borderline elevation of triglyceride levels (250-499 mg/dl) with cardiovascular risk might be obscured by its strong correlation with hypercholesterolemia, we examined the relationship in healthy men without hypercholesterolemia. In a population sample of 1,589 healthy fasting men ages 30-79 without known cardiovascular disease or categorical hypercholesterolemia, the prevalence of borderline hypertriglyceridemia was 4.2%, and was unrelated to age. There was no significant excess of borderline hypertriglyceridemia in men with systolic hypertension, or in men who reported use of antihypertensive drugs, current cigarette smoking, or a family history of heart attack before or after age 50. Only obesity, a personal history of diabetes, and fasting hyperglycemia were significantly more common in men with borderline hypertriglyceridemia. Moreover, hypertriglyceridemia was a relatively weak marker for those with diabetes or obesity, being present in only 9% of the former and 6% of the latter. A 12-year follow-up of these men showed no significant association of hypertriglyceridemia with all-cause or cardiovascular death either by univariate analysis or after adjusting for risk factors. These data support the conclusion that borderline hypertriglyceridemia is a poor marker for cardiovascular risk in healthy older men without hypercholesterolemia. PMID- 3823007 TI - Prenatal diagnosis of mosaic trisomy 9. AB - Mosaic trisomy 9 was detected in an amniotic fluid cell culture from a 40-year old woman evaluated because of advanced maternal age. After counselling, parents elected to terminate the pregnancy. On autopsy the fetus was found to have hydrocephalus and a single kidney. The diagnosis of trisomy 9 mosaicism was confirmed in cultured skin fibroblasts. This is the third reported case of trisomy 9 mosaicism diagnosed prenatally. PMID- 3823009 TI - Problems in estimating the prevalence of physical activity from national surveys. AB - Health policy in the United States has paid scant notice to physical activity until recently. This current policy focus on physical activity has revealed not only that there is less than adequate data about it but also that the single survey questions used for the purpose of measuring its prevalence should be interpreted carefully. A case in point is the example presented in this article, which gives estimates of physical activity prevalence levels for women of child bearing ages from several National Center for Health Statistics (NCHS) surveys. The amount of physical activity reported, and thus the proportion of women at risk for various diseases due to limited activity, depends on how the question is asked and the type of responses offered as options. Various questions used in three different NCHS surveys produced prevalence estimates of limited physical activity levels ranging from 3.9 to 39.1%. These findings have important implications for survey assessments of physical activity at all policy levels. PMID- 3823010 TI - Promoting health and preventing disease in health care settings: an analysis of barriers. AB - Changes in lifestyle that promote health-enhancing behaviors and inhibit health compromising behaviors have been recommended by the U.S. Surgeon General as an integral component of our general strategy for improving the health of the nation. A variety of innovations including new knowledge, new products, and new services have been developed with this recommendation in mind, and a major objective of these efforts is to identify settings for the effective diffusion and adoption of these new approaches into population groups that can make use of them. Health care settings such as hospitals, clinics, community health centers, health maintenance organizations, and private physicians' offices offer unique possibilities in this regard. Though opportunities exist for promoting health and preventing disease in other settings like schools and worksites, the primary objectives of such organizations are unrelated to health. Despite the obvious potential, however, our health care system has, in general, retained as its primary emphasis the treatment of disease rather than the enhancement of health. This article reviews the opportunities for health promotion and disease prevention in health care settings and identifies a range of barriers to such efforts. These barriers are discussed within a framework that focuses on dissemination and implementation as critical steps in the knowledge transfer process. Strategies for overcoming these barriers are described within the context of general linkage theory. PMID- 3823011 TI - Religious observance and plasma lipids and lipoproteins among 17-year-old Jewish residents of Jerusalem. AB - The association of religious observance and plasma lipids and lipoproteins was studied in a sample of 673 Jewish residents of Jerusalem ages 17-18 years. Religious observance was classified according to the parents' ranking of their perceived degree of religiosity. The study group included children whose parents were orthodox Jews who pedantically observed religious commandments, children of traditional parents who observed some of the rules, and children of nonobservant secular parents. Plasma levels of cholesterol, triglyceride, and low-density lipoprotein were higher in secular children than in the orthodox group. These associations were independent of sex, origin, social class, body mass, and season. High-density lipoprotein cholesterol was somewhat higher in the orthodox group than in the secular children although this difference was not statistically significant. Regression analysis showed that offspring's environment and parental phenotype were the most important predictors of lipid concentrations in adolescents. The association of religious observance with plasma lipids and lipoproteins, however, was independent of parental phenotype lipid values and the contribution of offspring and parents' environment. These findings are consistent with similar differences in plasma lipids described previously among the parents, as well as the lower incidence of myocardial infarction in the orthodox religious group, which has been shown in the Israeli adult population. PMID- 3823012 TI - Theory and delivery of health programming in the community: the Pawtucket Heart Health Program. AB - The Pawtucket Heart Health Program is one of the community studies examining whether population-based efforts to lower cardiovascular risk factors will reduce cardiovascular morbidity and mortality. The Pawtucket Heart Health Program intervention is based on a blend of social learning theory, community organization models, community psychology tenets, and diffusion research. This model allows for multifaceted programs that target individuals, groups, organizations, and the entire community to alter their cardiovascular risk through managing blood pressure, lowering blood cholesterol, quitting smoking, increasing fitness, and maintaining desirable weight levels. A dominant feature of the intervention is the emphasis that it places on volunteers for program delivery. The role of volunteers in providing direct services to help citizens lower their blood pressure and lose weight is highlighted to demonstrate the feasibility and effectiveness of these services. In addition, church-based programming which utilizes volunteers to manage and direct programs is also presented as an example of community-based health promotion efforts that promote collective efficacy. PMID- 3823013 TI - Acquired disorders affecting the immune system and non-Hodgkin's lymphoma. AB - A case-control study was undertaken to determine whether a prior history of a variety of acquired disorders affecting the immune system was associated with an increased risk of non-Hodgkin's lymphoma. Cases were identified over a 4-year period (1976-1979) at the Johns Hopkins Hospital and individually matched to hospital controls on age, sex, race, and year of diagnosis. For the 109 cases and matched controls who were traced and interviewed, positive associations suggesting an increase in risk were not detected. Instead, there was a suggestion of an inverse relationship. Odds ratios (ORs) were consistently less than 1 for associations between non-Hodgkin's lymphoma and several chronic infectious diseases (OR = 0.65, 95% CI = 0.35, 1.20), chronic inflammatory diseases (OR = 0.88, 95% CI = 0.43, 1.79), autoimmune disorders (OR = 0.80, 95% CI = 0.19, 3.76), and allergic disorders (OR = 0.77, 95% CI = 0.45, 1.32). A statistically significant protective association was found for surgical removal of lymphoid tissue (OR = 0.50, 95% CI = 0.27, 0.91). Adjustment for potentially confounding variables did not change these results. These findings do not support the previously anecdotally reported impression that disorders producing a chronic antigenic stimulus are associated with the development of non-Hodgkin's lymphoma. PMID- 3823014 TI - [Determination of diffusion coefficients in a solution by the transport of a solute through porous membranes]. AB - The possibility of determining the coefficients of diffusion in solution by the transport of solutes through porous polymeric membrane was studied. Reliable and reproducible results can be obtained by using nucleoporous filters with cylindrical pores. The method enables the selective determining of the diffusion coefficients of solutes being in complex mixtures, which is of special interest for biochemical research. The possibilities of the method are illustrated on the pattern of some globular proteins, polyethylene glycols and proteolytic enzymes. PMID- 3823015 TI - [Filing of microorganism strains for patent claims in the Soviet Union]. AB - The modern state of depositing microorganisms with regard to patent procedure is considered. The main stages of depositing are described. Two questions of paramount importance for depositors are examined, i.e. what kind of microorganisms should not be deposited with regard to patent procedure, who and on what terms can get samples of deposited microorganisms from the collection. A number of recommendations for researchers potential depositors of microorganisms, are given. PMID- 3823016 TI - [Comparative study of the frequency of HLA antigens in diffuse toxic goiter and autoimmune thyroiditis]. AB - Class I HLA antigens were determined in 42 patients with diffuse toxic goiter (DTG), 31 patients with autoimmune thyroiditis (AT) and in 71 donors. A degree of association of antigen and disease (R) and difference in the frequency of some HLA antigen bearing in the groups of patients and healthy persons were revealed. Positive association of DTG with antigens A1, A3, B8, haplotype A1-B8 and AT with A1 and B35 was established. The bearing of B13 antigen in DTG and A11 in AT was a protective factor in the development of the above diseases. A study of the comparative distribution of HLA antigens in DTG and AT showed immunogenetic heterogeneity of these diseases, determining perhaps difference in the immune response of DTG and AT patients. PMID- 3823017 TI - [Characteristics of the hydration status of patients with hypothyroidism]. AB - The hydratation status of 15 patients of various age groups with hypothyrosis was studied using nuclear physical methods. Their body composition was calculated. All the examinees demonstrated considerable hyperhydratation of the extracellular water sector with prevailing liquid accumulation in the interstitial space. Some changes in the infrastructure of the hydratation status including those in the nature of interrelationships of liquid media, were noted. The dependence of the hydratation status and its infrastructure in patients with hypothyrosis on age and gravity of disease but not on its duration was revealed. PMID- 3823018 TI - [Functional state of the hepato-biliary system in patients with thyroid diseases studied with radiopharmaceuticals]. AB - Function of the hepatobiliary system was studied in 33 patients with thyroid diseases (11 with diffuse euthyroid goiter, 15 with diffuse toxic goiter, of them 7 with thyrotoxicosis of a mild degree and 8 with thyrotoxicosis of an average severity, and 7 patients with primary hypothyrosis) and in 14 healthy persons of the control group by a radionuclide method using a gamma-chamber and 99mTc-HIDA, a hepatotropic radiopharmaceutical. It was established that absorptive-excretory liver function and the concentration ability of the gall bladder decreased in noticeable thyrotoxicosis and moderate hypothyrosis. Hypermotor dyskinesia of the gall bladder and hypertension of the biliary tract sphincters were revealed in more than half of the patients. Similar changes though quantitatively less pronounced were noted in the patients with euthyroid goiter. Thyrotoxicosis of a mild degree was characterized by the affection of motor function of the gall bladder (hypermotor dyskinesia) and frequent hypertension of Oddi's sphincter. Possible mechanisms of the development of the above changes were discussed. PMID- 3823019 TI - [Immediate results of parlodel treatment of patients with diffuse toxic goiter complicated by endocrine ophthalmopathy]. AB - The authors reported the results of parlodel therapy of 18 patients with diffuse toxic goiter complicated by endocrine ophthalmopathy. The patients ranged in age from 24 to 59 with a period of disease from 3 months to 10 years and more. The drug was given for 6 weeks at a dose of 2.5 mg twice a day after meals, a course dose varied from 150 to 225 mg. A radioimmunoassay was used to determine T3, T4 and TTH, the patients underwent a thorough ophthalmological examination. Six weeks after parlodel therapy was initiated, a decrease in the TTH level up to normal values was observed in parallel with the regression of clinical signs of endocrine ophthalmopathy. The use of parlodel did not change considerably the level of the thyroid hormones T3 and T4. PMID- 3823020 TI - [Combination of diabetes mellitus, optic nerve atrophy, neurosensory deafness and diabetes insipidus]. PMID- 3823021 TI - [Persistent galactorrhea-amenorrhea syndrome]. PMID- 3823022 TI - [Characteristics of thyrotoxicosis in combination with diabetes mellitus]. PMID- 3823023 TI - [Luminescence and morphometric parameters of rat thyroid cells after administration of various doses of adrenaline and immobilization stress]. AB - The thyroid status in adaptation reaction: stress and activation was studied in experiments on albino Wistar rats using morphometry and a luminescent spectral analysis. Thyroid function inhibition was obtained in stress manifesting itself in the presence of only one maximum with the wave length of 530 nm in the luminescence spectrum, low values of parameter alpha reflecting the ratio of one- and two-coil nucleic acids, a histogram of distribution with a shift to the left. Thyroid activity stimulation was detected during activation: the luminescence spectrum showed both maximums with the wave length of 530 and 640 nm, high values of parameter alpha; a histogram of distribution was almost symmetrical. PMID- 3823024 TI - [Quantitative composition and functional role of thyroid phospholipids in nodular hypothyroid goiter]. AB - Correlations between change in the composition of thyroid nodal tissue individual phospholipids and intensity of oxidizing processes under the influence of various phospholipid liposomes were studied. The thyroid phospholipid fraction level was investigated in patients with nodular goiter. A decrease in the level of sphingomyelin and phosphatidylinositide by 54%, cardiolipin by 63%, phosphatidic acid by 70%, phosphatidylserine by 46%, phosphatidylcholine by 7% and a two-fold increase in the level of phosphatidylethanolamine as compared to the control one were shown. A study of a degree of reduction of oxidation metabolism by adding phospholipid liposomes to thyroid sections showed that the tissue of a node possessed weaker oxidizing activity as compared to the control one. O2 absorption and 14CO2 excretion up to 30% were lowered in a hyperthyroid node. An activating liposome effect was noted in thyroid nodal tissue, mostly in the presence of phosphatidylserine, cardiolipin and phosphatidylinositide; the weakest effect was produced by phosphatidylethanolamine and phosphatidylserine. PMID- 3823025 TI - [Modification of the thyroidectomy operation in rats]. AB - The removal of thyroid lobes and isthmus was performed with the help of fine scissors employed in ophthalmology. The use of this instrument made it possible to considerably reduce the damage of elastic connective tissue of the trachea during operation which is of importance for the preservation of the life of experimental animals. PMID- 3823026 TI - [Simulation of thymus hypo- and hyperplasia by thymalin in guinea pigs]. AB - Potentialities of the modulation of thymus function with thymalin and the hormonal-immunological status in simulated hypo- and hyperplasia of the thymus. The advisability of the use of the drug was shown. PMID- 3823027 TI - [Effect of thymosin on the functional activity of adrenal glands in mice]. PMID- 3823028 TI - [Evaluation of the metabolizing function of the liver in thyrotoxicosis using the antipyrine test]. AB - A study was made of pharmacometabolizing liver function in 73 patients with thyrotoxicosis of various degree and duration. The antipyrine test was used to assess pharmacometabolizing liver function. In thyrotoxicosis of moderate severity and in severe forms with the period of the disease over 1 year the half life increased and antipyrine clearance decreased. Experimental and clinical studies confirmed that a course of therapy with antithyroid drugs promoted the normalization of disturbed pharmacometabolizing liver function. PMID- 3823029 TI - [Determination of the mean length-of-service and mean daily exposure to lead of workers in battery manufacture]. AB - The determination of the occupational risk at the working places by only comparing the lead concentrations determined in the air of the working environment and MAC is not sufficiently complete, if consideration is not given to the length of service of the workers in contact with that metal. The determination of the mean daily exposure is of great significance in that case as well as the number of the days during which the workers had been exposed to the noxious effect of lead. That is why, the application of the method of A. Kovacev et al., allowed the determination of the mean-length-of-service and mean daily exposure to lead of the workers from some leading occupations from an accumulator plant, being the base for prognostication of the personal risk number and the allowable length of service for the newly come to work workers in the respective accumulator production. PMID- 3823030 TI - [Hygienic evaluation of the occupational risk in working with Bulgarian bentonite raw material]. AB - The use of bentonite in various branches of industry, and first of all, in foundry workshops, grows rapidly. The literature data on health injuries by bentonite dust are rather contradictory: due primarily, to the changeable mineralogical composition of the raw material from different deposits. That requires a specific hygienic assessment of each deposit in exploitation. The authors studied the mineral composition, quantitative ratio of the mineral components and morphology of the particles from the respirable fraction of aerosol in the extraction of Bulgarian bentonite. The microscopic mineralogical analysis in phase contrast, established a basic mass of clay minerals, confirmed by the X-ray structural analysis. The free silicic oxide is presented by low temperature crystobalite and quartz, more rarely opal and chalcedony. Its quantity does not surpass 1-2%. The experimental studies on experimental animals confirmed fibrosis, degree I and II, according to Belt and King. The clinical studies on the workers established the presence of reticular changes in the lungs, type S and L, according to ILO-UC classification. The hygienic characteristic of the Bulgarian bentonite provided grounds for its broad application as a substitute for more dangerous raw materials, quartz sand in the foundries, in particular. Regardless of its advantages, bentonite is not harmless. The adherence to MAC for dustiness and periodic control of the quartz content in the raw material and aerosol in the working environment, are compulsory. PMID- 3823031 TI - [Dynamics of the recruitment phenomenon in chemical industry workers]. AB - The state of auditory function, the changes in the over-threshold tests for recruitment phenomenon respectively, characteristic for the affection of the sound-receiving links of the auditory analyzer, have dynamically been observed (at interval of 3 to 6 months) among 100 workers from chemical industry. In addition of the otorhinolaryngological examination and acoumetric study of hearing acuity, some tonal threshold and over-threshold audiometric examinations have been performed. A definite correlation has been established between the changes in the hearing function and the length of service of the workers. The data about the over-threshold studies reveal that the tests for recruitment phenomenon become more often positive in the workers, being organic solvents, paints and varnishes. The auditory disorders were observed in the region of high frequencies, being with sound-receiving character. The test of Carhardt became positive rather early, interpreted as early disorder of the processes of adaptation. The approaches of the early diagnostics of hearing disorders are presented as a result from the study. PMID- 3823032 TI - [Comparative analysis of the level and structure of morbidity with temporary loss of work capacity among the blind and seeing workers at the Uspekh enterprises]. AB - With the follow up of the dynamics of morbidity rate with temporary disability (MRTD) during the last five years, the branch of the enterprises of the Union of the Blind in Bulgaria and the Union of the Deaf in Bulgaria keeps firmly the first place according to frequency of the cases and according to the frequency of the days it is moved from seventh to fourth place in the Trade Union of the Medical Workers. In connection with that fact, our aim was a more detailed analysis of MRTD (according to index-card of SI-1) in the Uspekh enterprises for a two-year period. The comparative juxtaposition revealed a higher level of the intensive indices among the blind workers as compared with the seeing ones. Certain discrepancies in the structure of MRTD have been established, in the values of the intensive indices according to separate nosological entities in particular. The comparative analysis contributes to the establishment of a differential approach with the realization of the therapeutic-diagnostic cares of the blind and poorly seeing workers. PMID- 3823033 TI - [Toxic action of nickel when taken up by the body from the drinking water]. AB - Some aspects of the toxic effects of nickel were studied in a toxicological experiment for one year on male albino rats, administered perorally nickel in doses 0.0005, 0.005, 0.05 and 0.5 mg/kg, corresponding to 1/10 of the Soviet MAC respectively, MAC, 10 MAC and 100 MAC of nickel in potable waters, by the following indices: behaviour and general condition of the animals, body weight, weight coefficient of organs; total protein, blood sugar, glucose-6-phosphate dehydrogenase and lactate-dehydrogenase on serum; hemoglobin and erythrocytes in blood. The chronic nickel intoxication in doses of 0.5 mg/kg was established to lead to disorders in protein metabolism and reduction of body weight, in doses of 0.005, 0.05 and 0.5 mg/kg--to disorders in carbohydrate metabolism, erythrocytosis and hyperhemoglobinemia, and in doses of 0.0005 mg/kg--no changes have been established as regards all indices studied. PMID- 3823035 TI - [Natural immunity of the pupils in a secondary vocational and technical school for rubber and plastics]. AB - In connection with the reconstruction of the educational system and occupational training of the youths, the problem of the effect of the occupational factors on the organism of the juveniles is of exceptional importance. The search of early changes by the application of immunological tests in that aspect is very rational. The state of microflora of the deep layers of the skin, the microbic contamination of nasal mucosa have been studied as well as the content of complement in serum and serum immunoglobulins G, A and M and the phagocytosis in the students from SPTS. The experimental subjects have exposed to a complex of toxic-chemical substances with different intensity during their occupational training and practice. It has been established that the training under the specific conditions for mastering the specialty has led to a slight decrease of the antimicrobic resistance and reduction of the phagocytic function of leukocytes, not affecting the humoral factors of natural immunity. PMID- 3823034 TI - [Individual-based study of morbidity with temporary loss of work capacity in 1 plant over a 3-year period]. AB - The study of morbidity rate with temporary disability according to subjects, based on the Soviet experience has an approximately thirty year history in our country. Even though, numerous scientific, methodical and organizational problems with a view to the application of the method-according-to-subjects are still unsolved. The object of our study is a plant of the Union of the Blind in Bulgaria, producing cork stoppers, electrical materials and haircloth. The information derived from the patients' chart by an individual index-card, allowed a more detailed and more comprehensive analysis of the indices of the morbidity rate with temporary disability according to subjects, cases and the days lost because of temporary disability, depending on age-sex structure, occupational group, workshop, length of service and place of residence. The results obtained were compared with those supplied by the official statistics of the TIITs Gabrovo. The groups of often and continuous sick subjects (6.96%) and (8.56%) have been established for 1983, covering about 40% of the cases with temporary disability and over 60% from the labour losses for that year. Well grounded hygienic and medical-prophylactic measures are recommended on the base of the conclusions drawn. PMID- 3823036 TI - [Effect of drinking water with a high nitrate content on the body in a toxicological experiment]. AB - A chronic, four-month, toxicological experiment with albino rats was carried out with a view to study the effect of nitrates on organism. The animals, grouped into six groups, were daily intoxicated by probing with aqueous solution of sodium nitrate in concentrations of 30, 50, 100, 500 and 1000 mg/l. The toxicological studies established statistically significant changes in some integral, hematological, biochemical and pathologico-anatomical indices with the drinking of potable water with 500 and 1000 mg/l nitrates and in single cases - with 100 mg/l: body weight loss among the female animals; reduction of hemoglobin and erythrocytes; urea fluctuation (hypo- and hyperazotemia); increase of glutathione, of peroxidase activity and alkaline phosphatase; reduction of catalase activity; light parenchymal-dystrophic changes in liver and kidneys. No changes were established in methemoglobin. With a view to those results, the authors presume that no risk for organisms exists with the consumption of potable water, containing nitrates to 50 mg/l, a slight risk--up to 100 mg/l, enhanced risk--over 100 mg/l and high risk--with 500 and over 500 mg/l. PMID- 3823037 TI - [Ecological and toxicological experiments with test guppies and Daphnia in research on the effect of pesticides in water]. AB - Experiments have been carried out for the assessment of the toxic effect if some pesticides on aquatic organisms--fish groups Lebistes reticulatus and lower crustacea Daphnia magna. The following pesticides (herbicides) were studied- afalon, dimid, Lasso, patoran, propanide and Ramrod. Ramrod proved to have the highest toxicity, followed by propanide, Lasso and afalon. Dimid and patoran proved to have lower toxicity. Daphnia were established to be 10-17 times more susceptible than the fish groups. PMID- 3823038 TI - [Hygienic study and evaluation of textile materials with reduced combustibility with reference to the use of the new anti-inflammable preparations Pyrofix 2 and Torflam]. AB - The new anti-flammable preparations, proposed by the Higher Chemical Technology Institute (Sofia), were studied, namely: Pyrofix 2--for treatment of textile materials and Torflam--for production of anti-inflammable polyester fibres. The following parameters were studied: skin-irritating and skin-sensitizing effect of both preparations, skin toxic effect of Pyrofix 2 and migration of chemicals from the anti-inflammable textile materials (from the composition of the preparations used). The results obtained revealed the absence of skin-irritating and skin sensitizing effect of both preparations and cumulative dermal toxicity of Pyrofix 2. The textile materials with reduced combustibility are chemically stable and do not release compounds in the contact aqueous medium, imitating the underclothes space. Formaldehyde from recipe for the treatment of Pyrofix 2 migrates in the air environment. In conclusion, Pyrofix 2 could be applied for the final anti inflammable treatment of the textile materials for industrial needs, working garments and everyday textile (with the elimination of formaldehyde compound from the recipe). Torflam could be used in the production of anti-inflammable polyester fibres for textile materials intended for industry and everyday life without immediate contact with the skin of the consumers. PMID- 3823039 TI - [Work difficulty and the physical work capacity of female afforestation workers in forestry]. AB - The severity of labour in manual soil-preparation and planting has been studied and the physical capacity for work of the female workers--determined, who performed those basic afforestation activities in the national forestry. The severity of labour has been characterized by the values of oxygen consumption, energy-expenditure and pulse rate during work. The physical capacity for work has been determined by physical loading on the Lanoy bicycle ergometer , with submaximum degrees of loading. The maximum working capacity was calculated by the values of the pulse rate with submaximum degrees of loading according to Astrand method. The physical loading during manual soil-preparation is high (6.6 kcal/min, 27.6 kJ resp.), and that of planting--moderate. The maximum aerobic capacity of the afforestation female workers examined, was characterized by maximum oxygen consumption 2.04 dm3/min, 29.6 cm3/kg/min resp., and maximum pulse rate--177 beats/min. Energy losses during work surpassed, to a considerable degree, 30 per cent of the maximum aerobic capacity of the female afforestation workers. On the base of the results obtained, measures are proposed for the reduction of the severity of labour and for improvement of the organization of the work during the afforestation activities in national forestry. PMID- 3823040 TI - [Physical work capacity of miners]. AB - The effect of the occupational activity on the physical capacity of work is of great interest for labour physiology. In connection with that, the physical capacity for work of the miners from coal industry, at different age and with different length of service was studied. Submaximum loading of bicycle ergometer was applied--50, 100 and 150 wt. The maximum working capacity was determined by the nomogram of Astrand. The miners, aged from 21-30 (3.4 l/min maximum oxygen consumption) have the highest capacity. At the age of 31-40, it is abruptly dropped (2.54 l/min maximum oxygen consumption) anf is maintained at the same level after that age (2.49 l/min maximum oxygen consumption). The decrease of the physical capacity for work of the miners, over the age of 30, ie greater than the "normal" age decrease as well as than that of the workers from other occupations. The high physical capacity for work of the young miners (to the age of 30) allows the performance of heavy physical work (allowable energy expenditure 5.1 kcal/min, and in peak loading--8.5 Ical/min). The established decrease of the physical capacity for work after that age determines the lower allowable energy loss at work (3.8 kcal/min). The discrepancy between the real physical capacity for work of the workers between 31 and 50 years of age and corresponding allowable energy expenditure as well as the higher energy expenditure determined during work is a circumstance that requires particular attention. In fact, measures intended not to allow the exceeding of the maximum allowable loading are necessary for the older workers. PMID- 3823041 TI - [Problems of working under local muscle loading]. AB - The present labour motor activity is characterized by local loading with constant increase of the static muscular tension. The static work is the cause of reduction of capacity for work, of early advancing fatigue and various occupational diseases of the locomotory system in case of long-lasting activity. With the purpose if studying the connection between the occupational diseases of the locomotory apparatus (LMA) and the characteristics of the labour motor activity--a study on the diseases of the LMA was carried out at the Neurological Department of the Clinic of Occupational Diseases, looking for the correlation between them and the labour physiological data about the severity and tension of the motor activity and some parameters of working movements. The following main characteristics of the motor activity are indicated as risk factors of the occupational diseases--number of movements per a working shift, their velocity and duration, movements needing strength and movements with a big volume, pronounced motor monotony. The correlation between the occupational diseases of LMA, age, sex, length of service, etc. are stressed on. The problem of the optimization pf motor labour activity is discussed as a basic element of prophylaxis of overstrain and occupational diseases of the locomotory system. PMID- 3823042 TI - [Method for summing up the radio-frequency electromagnetic fields emitted by several sources]. AB - A method has been developed, included in the BSS 14525-78, for measuring and assessment of the radio-frequency electromagnetic field (EMF) at the working places. In a hygienic assessment of fields, emitted from several sources with different frequencies in one premises, it cannot be applied because of the step frequency relationship of the hygienic norms. The same difficulty is encountered in the hygienic assessment of EMF in settlements, where the summing of the from several radio television and other emitters is necessary. With the non-selective measurements of the intensities of EMF (in a broad-frequency range) in such cases, the resultant field of the working place cannot de resolve into component intensities, obtained from the separate generators and hygienic assessment of the determined value cannot be performed. The same concerns also the cases when we separately measure the radiation from each separate emitter--the summing is impossible. If the electromagnetic waves are discussed as flat waves in the free space, a system of 2m equations with 3 m unknown quantities could be worked out after several approximations, where m is the number of the emitting generators in the premises. Furthermore, if consideration is given to the technical devices for measurement of EMF (type of detector), a system of 2 m equations with so many unknown quantities, could be obtained, hence a mathematical method is proposed for its solving. The expression of the intensities of the field is approximated in a polynomial and an original algorithm is proposed for the solving of the system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823043 TI - [New epidemiological study data on the manufacture of divinyl]. AB - Complex labour-hygienic studies were carried out on the working environment in divinyl production as well as on the health state of the workers. The leading deleterious factor of the environment are the concentrations of divinyl, hydrocarbons and ammonia above the norms. The latter have been determined by stationary and personal sample collecting. More than half of the workers examined work under labour conditions characterized as "particularly unfavourable" and "dangerous". In comparison with the hygienic characteristic by the middle of 1978 1980, a considerable increase of ammonia concentrations was established. A total of 102 workers have been covered by a complete clinical-laboratory examination. The results have been statistically processed with a view to establishing the correlation between the effect of the deleterious factors of the working environment and the deviations established in the health state of the workers. The following cases could be associated with occupational risk: cases with "positive" and "very likely" chronic ischemic heart disease as well as those with arterial hypertension, gastrointestinal diseases, chronic diseases of upper respiratory pathways with loss of sense of smell to various degrees, the neurological diseases--autonomic-vasal and neurotic syndrome, the cases of contact dermatitis and anemic syndrome. PMID- 3823044 TI - [The hospital environment as a hygienic problem]. AB - The hospital environment, studied according to the parameters of microclimate, natural and artificial lighting and acoustic regime, is a factor with an effect on the disposition and healing process. Concrete data are presented, suggesting some failures in the micro-climate kept in the hospital premises studied and substantial unfavourable discrepancies in the existing standardization and the present conditions of stay. The artificial illumination is considerably diminished--20-70 lx, at a norm of 300 lx. The windows proved to be unnecessarily large, guaranteeing increased penetration of natural light but hence - creating conditions for overheating (cooling resp.) - at at a norm 1:5 to 1:4, the established light coefficient is 1:3 up to 1:2. The acoustic regime showed also some great deviations towards the increase of noise levels - at a norm of 35 dB A, the established levels are within the limits of 38 to 72 dB A. The hospital environment is obvious to need some changes that would have a favourable effect only with a strict adherence to the hygienic standardization in the course of design and building. PMID- 3823045 TI - [Changes in the peripheral blood of workers engaged in ethylbenzene-styrene and synthetic rubber and latex manufacture]. AB - A total of 67 workers were examined from the production of "Ethyl benzene styrene" and 184 workers from the production of "Synthetic rubber and latex", as well as a control group of 59 employees. The workers from the first production are exposed to the effect of styrene, ethyl benzene and toluene. The concentrations of the substances surpass MAC, with several times, at the majority of the working places. The workers with a length of service over 10 years predominate. The workers from the second production are exposed to the combined effect of styrene and divinyl, their concentrations fluctuating from 2 to 8 times over MAC. The workers with a length of service over 10 years are 71.7%. The deviations, established in the hematological indices studied are compared with the results from a study on the workers from those productions of 6 years ago. Dynamics in the changes was established among the workers from the production of "Synthetic rubber and latex", associated with the duration of occupational exposure to styrene and divinyl. In case of a shorter length of service, the deviations are functional (reduction of peroxidase activity in granulocytes), increase of hemoglobin and hematocrit, associated with the adaptive reaction of organism. Pronounced anemic syndrome was established in a considerable number (24 workers) after an exposure of 10 years as well as lymphocytosis (35 subjects) and leukopenia (9 subjects). PMID- 3823046 TI - [Experimental research on the chronic inhalational toxicity of chloracetophon]. AB - The chronic inhalational toxicity of chloracetophon was studied on 24 albino Wistar rats, with concentrations 20 mg X m-3. The animal were exposed 4 hours/daily, 5 days/weekly, for 90 days. Integral, biochemical, histological and electron-microscopic methods were used for the evaluation of the toxic effect of the preparation. The results reveal metabolic and structural alterations in the organs studied, better manifested in liver as compared with the lungs. A provisional MAC for chloracetophon is proposed on the base of the complex study carried out, being 0.1 mg X m-3. PMID- 3823047 TI - [Operations of an antituberculosis dispensary in mass preventive examinations of the population]. PMID- 3823048 TI - [Bacteriologic diagnosis of mycobacteriosis and its incidence in Latvia]. PMID- 3823049 TI - [Effectiveness of antituberculosis institutions in delivering care to pulmonologic patients]. PMID- 3823050 TI - [Detection of patients with chronic nonspecific diseases of the lungs during mass examinations of workers at machine-building factories]. PMID- 3823051 TI - [Diagnostic value of questionnaires in the epidemiologic study of chronic lung diseases]. PMID- 3823052 TI - [Postgraduate training of phthisiatrists in the Irkutsk Region]. PMID- 3823053 TI - [Features of the course of tuberculosis of the respiratory organs among persons with concurrent nonspecific pathology of the bronchopulmonary system]. PMID- 3823054 TI - [Chronic bronchitis among patients with a history of pulmonary tuberculosis]. PMID- 3823055 TI - [Scientific-technical progress and the practice of phthisiatry]. PMID- 3823056 TI - [Study of the informative value of pulmophonographic indices using the technic of linear discriminant analysis]. PMID- 3823057 TI - [Complex evaluation of the status of circulation and respiration of patients with tuberculous spondylitis]. PMID- 3823059 TI - [Tuberculous meningitis in adults at the present time]. PMID- 3823058 TI - [Asymmetry of dermatoglyphic indices and the topology of the tuberculous process in the lungs]. PMID- 3823060 TI - [Advantages and disadvantages of fibrobronchoscopy and rigid bronchoscopy in the diagnosis of lung tumors]. PMID- 3823061 TI - [Use of hemosorption in the treatment of sarcoidosis patients]. PMID- 3823062 TI - [Method of determining the extent of organ lesions in tuberculosis]. PMID- 3823063 TI - [Changes in the sputum viscosity of asthma patients exposed to different allergens]. PMID- 3823064 TI - [Assessment of the production of surfactant by type II alveolocytes during chemotherapy of experimental pulmonary tuberculosis]. PMID- 3823065 TI - [Pathomorphologic characteristics of aspergillomas of the lung]. PMID- 3823066 TI - [Tuberculosis of the breast]. PMID- 3823067 TI - [Exudative pericarditis of tuberculous etiology]. PMID- 3823068 TI - [Obliteration of the pleural cavity after complicated pneumonectomy by thoracoplasty in combination with pneumoperitoneum]. PMID- 3823069 TI - [Clinical and morphologic description of bird breeder's disease]. PMID- 3823070 TI - [Features of newly diagnosed tuberculosis of the respiratory organs in regions with a low incidence of tuberculosis]. PMID- 3823071 TI - [Use of the catalog of chemotherapeutic agents in stages of tuberculosis patient treatment]. PMID- 3823072 TI - [Causes of long-term disability and feasibility of reducing the period of invalidism in newly-diagnosed tuberculous spondylitis]. PMID- 3823073 TI - [Experience with the work of organizing the campaign against genitourinary tuberculosis in the Voroshilovgrad region]. PMID- 3823074 TI - [Rational chemotherapy of pulmonary tuberculosis in chronic alcoholic patients]. PMID- 3823075 TI - [Treatment of patients with pulmonary tuberculosis and alcoholism in a tuberculosis hospital]. PMID- 3823076 TI - [Ways of improving preventive measures in foci of tuberculous infection]. PMID- 3823077 TI - [Results of treating pulmonary tuberculosis patients with combined pathology of the gastrointestinal tract and liver]. PMID- 3823078 TI - [Use of quercetin to prevent and treat cardiovascular disorders in pulmonary tuberculosis]. PMID- 3823079 TI - [Interlobar pleurisy]. PMID- 3823080 TI - [Errors in the diagnosis of silicotuberculosis]. PMID- 3823081 TI - [Pharmacokinetics of isoniazid in patients with pulmonary tuberculosis and alcoholism]. PMID- 3823082 TI - [Effect of sodium nucleinate on the development of morphologic reactions during antibacterial therapy of experimental tuberculosis]. PMID- 3823083 TI - [Roentgenomorphologic characteristics of the course of destructive tuberculosis after exposure of the pulmonary area to a decimeter-range superhigh-frequency field (experimental study)]. PMID- 3823084 TI - [Pathomorphology of chronic inflammatory diseases of the lungs according to bronchial biopsy and bronchoalveolar lavage findings]. PMID- 3823085 TI - [Pulmonary tuberculosis in asbestosis patients]. PMID- 3823086 TI - [Classification of various forms of extrapulmonary tuberculosis]. PMID- 3823087 TI - Clinical pharmacology in psychiatry. Selectivity in Psychotropic drug action- promises or problems? Fourth International Meeting on Clinical Pharmacology in Psychiatry. Bethesda, Maryland, 5-8 September 1985. Proceedings. PMID- 3823088 TI - Possible teratogenic effects of imipramine in the rat. PMID- 3823089 TI - Pharmacokinetic considerations relevant to the pharmacodynamics of antidepressants. PMID- 3823090 TI - Molecular approach to the mechanism of action of antidepressant drugs. PMID- 3823091 TI - Neuroleptic-induced parkinsonism increases with repeated treatment in monkeys. PMID- 3823092 TI - Biochemical alterations produced by neuroleptics in man: studies of plasma homovanillic acid in schizophrenic patients. PMID- 3823093 TI - Molecular modeling in drug design. PMID- 3823094 TI - Abuse liability of triazolam: experimental measurements in animals and humans. PMID- 3823095 TI - Problems in caries surveys on children and adolescents in Finland. PMID- 3823096 TI - Social inequity in oral health--a newly awakened problem. PMID- 3823097 TI - Hazards with posterior composites. PMID- 3823098 TI - Fluoride, magnesium and dental caries. Current aspects. PMID- 3823099 TI - Chemotherapy of Streptococcus mutans. PMID- 3823100 TI - Humoral immune response to Streptococcus mutans in children. PMID- 3823101 TI - Induction of megakaryocytic colony-stimulating activity in mouse skin by inflammatory agents and tumor promoters. AB - The production of megakaryocytic colony-stimulating activity (MEG-CSA) was assayed in acetic acid extracts of skin from mice topically treated with inflammatory and tumor-promoting agents. A rapid induction of MEG-CSA was found in skin treated both with phorbol 12-myristate 13-acetate (PMA), a strong tumor promoter, and with mezerein, a weak tumor promoter, but no induction was found in untreated skin. The time course of induction of MEG-CSA following treatment of skin with PMA or mezerein was very similar to that previously demonstrated for the induction of granulocyte-macrophage colony-stimulating activity in mouse skin by these agents. The induced MEG-CSA was found in both the epidermis and the dermis. Pretreatment of the skin with beta-methasone abrogated the MEG-CSA induction. The cell number response curve suggests that the MEG-CSA acts directly on the progenitor cells of the megakaryocyte colonies. That topical administration of diterpene esters results in the rapid, local induction of MEG CSA which can be blocked by beta-methasone pretreatment suggests a mechanism for the thrombocytosis associated with some inflammatory states. The indirect action in which diterpene esters induce in certain cells the production or release of growth regulatory factors for other cell types may also aid in understanding their carcinogenic properties. PMID- 3823102 TI - The effect of low-level prenatal X-irradiation on postnatal development in the Wistar rat. AB - The objective of this investigation was to determine the effect of low-dose prenatal X-irradiation on postnatal growth and neurobehavioral development, and whether alterations would manifest at dosages lower than those which produce anatomic malformations from exposure at the most sensitive period of organogenesis. Ninety-eight Wistar strain rats were exposed to 0.1, 0.2, or 0.4 Gy X-radiation of were sham irradiated on the 9th or 17th day of gestation. A conventional teratologic evaluation was completed on half of the animals (572 fetuses). The age of appearance of four physiologic markers and of acquisition of six reflexes was observed in 372 offspring. Exposure during early organogenesis at these levels had no effect on any of these parameters. Prenatal exposure to X radiation on the 17th day of gestation at dosage levels greater than 0.1 Gy resulted in alterations in the appearance of three postnatal neurophysiologic parameters. Growth retardation throughout the postpartum period also was observed in the offspring. The induction of developmental and reflex alterations had a comparable threshold to the known threshold for anatomic malformations on the 9th day. These results indicate that all of the parameters studied had thresholds either at or above 0.2 Gy acute radiation, and that the postpartum developmental and reflex acquisition measures were not more sensitive indicators of exposure to X-radiation than growth parameters. PMID- 3823103 TI - Involvement of capsaicin-sensitive mechanism(s) in the antiulcer defence of intestinal mucosa in rats. AB - Capsaicin desensitization increases degree and incidence of indomethacin-induced intestinal ulcers in rats, suggesting the existence of a capsaicin-sensitive mechanism(s) in the protection of the intestinal mucosa against indomethacin induced ulceration. Sensory innervation thus may be involved in the pathogenesis of ulcers of the small bowel, as well as in gastric ulcers. Administration of exogenous CGRP and somatostatin, sensory neuropeptides which are depleted by capsaicin desensitization, does not afford protection toward the capsaicin induced aggravation of intestinal ulcers. The protective effect of exogenous prostaglandins toward indomethacin-induced intestinal ulceration is not mediated by capsaicin-sensitive nerve fibers. PMID- 3823104 TI - Naloxone pretreatment prevents the bloody diarrhea of canine endotoxic shock. AB - We examined the importance of timing with endorphin involvement in shock by giving the opiate receptor antagonist naloxone as a pretreatment in canine endotoxic shock. Dogs anesthetized with pentobarbital (30 mg/kg iv) were given Escherichia coli endotoxin at LD80 doses iv. Naloxone (2 mg/kg plus 2 mg/kg/hr iv, N = 10) started 15 min before endotoxin attenuated the fall in mean arterial pressure, cardiac index, and the first derivative of left ventricular pressure due to endotoxin in comparison with control animals given 0.9% NaCl (N = 10). Naloxone attenuated the endotoxin-induced decrease in superior mesenteric arterial blood flow and the increases in portal venous pressure and pulmonary arterial pressures. Moreover, naloxone pretreatment prevented the characteristic bloody diarrhea and reduced mortality. Our findings implicate endorphins acting on opiate receptors as important mediators of endotoxin-induced cardiovascular failure and bloody diarrhea in canine endotoxemia. These are early manifestations and dictate expeditious use of naloxone in endotoxic shock. PMID- 3823105 TI - Dietary induction of hepatic glucose-6-phosphate dehydrogenase, 6 phosphogluconate dehydrogenase, and malic enzyme in lean and obese female Zucker rats. AB - Responses of the hepatic lipogenic enzymes, glucose-6-phosphate dehydrogenase (G6PDH), 6-phosphogluconate dehydrogenase (6PGDH), and malic enzyme (ME) to starvation refeeding and diet shifting were determined in lean and obese female Zucker rats. Rats were either fed nonpurified diet, starved 48 hr, and then refed nonpurified diet or one of the refined carbohydrate diets containing either glucose, fructose, cornstarch, or sucrose for 72 hr, or shifted from nonpurified diet directly to one of the refined carbohydrate diets for 72 hr. Initial activities were greater in obese than lean rats for all three enzymes studied. Similar to other strains of female rats, lean Zucker rats failed to demonstrate a starve-refeed response when refed nonpurified diet. Obese female littermates showed a statistically significant increase in enzymes when refed a nonpurified diet. Both lean and obese female Zucker rats demonstrated increases in enzyme activities above controls when starved and refed any of the refined carbohydrate diets. The greatest responses were observed when female rats were starved and refed sucrose; activities increased 2.6- to 3.5-fold in lean and 3.0- to 4.3-fold in obese Zuckers. In lean females 50-70% of the starve-refeed response observed with G6PDH and ME can be accounted for by simply shifting from a nonpurified diet to the respective refined carbohydrate diet, whereas in obese females only 33-55% of the increase could be attributed to diet shifting. Plasma testosterone/estrogen ratios were consistently 1.5 times higher in obese than in lean female rats. This phenotypic difference may potentiate the heightened starve refeed overshoot response observed in obese rats. PMID- 3823106 TI - Pyridoxal phosphate concentrations determined postmortem as an indication of antemortem vitamin B-6 status. AB - In anticipation of studies relating vitamin B-6 status determined at autopsy to known pathologic causes of death, the postmortem stability of pyridoxal phosphate (PLP) in the plasma, skeletal muscle, and liver of pigs was assessed. Concentrations of plasma K, Mg, Na, and Ca also were examined for postmortem stability using the pig as an experimental model. At 1 hr after death, the mean plasma PLP concentration was essentially unchanged from that observed prior to death. Thereafter, plasma PLP concentration increased with increasing postmortem time interval and was 2.3 times greater than initial by 6 hr postmortem and 7.6 times greater than initial by 12 hr postmortem (P less than 0.01). Skeletal muscle and liver PLP content were 35% lower than initial by 6 hr postmortem (P less than 0.01). Plasma K and Mg were significantly higher by 1 hr postmortem (P less than 0.01) while plasma Na concentration was significantly lower by 1 hr postmortem (P less than 0.01). Plasma Ca concentration was not significantly different at any measured time point. Knowledge of the postmortem time interval appears to be required in order to evaluate the antemortem vitamin B-6 status using pyridoxal phosphate values derived from autopsy samples. PMID- 3823108 TI - Water-soluble prolactin receptors from porcine mammary gland. AB - Two types of prolactin receptors were identified in sow mammary gland. When light membranes were prepared on a discontinuous sucrose gradient (0.3 and 1.7 M) and then diluted and washed with 0.3 M sucrose solution, a large amount (about 50%) of receptors were released from membranes and appeared in the supernatant fraction. These two forms (hydrophobic and water-soluble) of receptors were characterized as having the same binding specificity for lactogenic hormones and a similar affinity constant for ovine prolactin (K alpha approximately 10-12 X 10(9) M-1). Polyclonal antibodies and one monoclonal (mAb M110) antibody, obtained against partially purified prolactin receptors from rabbit mammary gland, cross-reacted effectively with sow mammary receptors. They completely inhibited the specific binding of [125I]oPRL to membrane and water-soluble receptors. The present studies indicate that the two types of sow prolactin receptors could represent the same molecular entity and confirm that prolactin receptors from rabbit and sow mammary gland exhibit numerous antigenic similarities. PMID- 3823107 TI - Competitive inhibition of [3H]dexamethasone binding to mammary glucocorticoid receptor by leupeptin. AB - The inhibitory effect of leupeptin on [3H]dexamethasone binding to the glucocorticoid receptor from lactating goat mammary cytosol has been studied. Leupeptin (10 mM) caused a significant (about 35%) inhibition of [3H]dexamethasone binding to glucocorticoid receptor. Binding inhibition is further increased following filtration of unlabeled cytosolic receptor through a Bio-Gel A 0.5-m column. Binding inhibition was partially reversed by monothioglycerol at 10 mM concentration. A double reciprocal plot revealed that leupeptin appears to be a competitive inhibitor of [3H]dexamethasone binding to the glucocorticoid receptor. Low salt sucrose density gradient centrifugation revealed that the leupeptin-treated sample formed a slightly larger (approximately 9 S) receptor complex (leupeptin-free complex sediments at 8 S). PMID- 3823109 TI - Opiatergic inhibition of pulsatile luteinizing hormone release during the menstrual cycle of rhesus macaques. AB - The endogenous opioid peptides (EOPs) may inhibit the rate of hypothalamic gonadotropin-releasing hormone (GnRH) release and hence the frequency of pulsatile luteinizing hormone (LH) release, particularly in the luteal phase of the menstrual cycle. Our objectives were to compare the effects of an opiate antagonist, naloxone (NAL), on the patterns of LH, estradiol-17 beta (E2), and progesterone (P4) secretion during the follicular and luteal phases of the macaque menstrual cycle. Plasma levels of E2, P4, and bioactive LH were measured in serial, 15-min blood samples during 8-hr infusions of NAL (2 mg/hr) or saline, either on Days 5 or 6 of the follicular phase (FN and FS, n = 5 and 4, respectively) or on Days 8, 9, or 10 of the luteal phase (LN and LS, n = 5 each) of a menstrual cycle. The pulsatile parameters of each hormone were determined by PULSAR analysis and the correspondence of steroid pulses with those of LH were analyzed for each cycle stage in each animal. As expected, LH mean levels and pulse frequencies in LS monkeys were only about one-third of those values in FS animals. NAL had no effects on pulsatile LH, E2, or P4 release during the follicular phase. In contrast, luteal phase NAL infusions increased both LH mean levels and pulse frequencies to values which were indistinguishable from those in FS animals. LH pulse amplitudes did not differ among the four groups. Mean levels and pulse frequencies of P4 secretion in LS monkeys were about 4- and 14-fold greater than those values in FS animals. Mean levels and pulse amplitudes of P4 release in LN animals were greater than those values in all other groups. LH and E2 pulses were not closely correlated in follicular phase animals, and this pulse association was not altered by NAL. In FS monkeys, LH and P4 pulses were not correlated; however, NAL increased this LH-p4 pulse correspondence. LH and P4 pulses were closely correlated in luteal phase animals and this association was not affected by NAL. Our data suggest that the EOPs inhibit the frequency of pulsatile LH secretion in the presence of luteal phase levels of P4. During the midfollicular phase when LH pulses occur every 60 to 90 min, the opioid antagonist NAL alters neither the pulsatile pattern of LH release nor E2 secretion, but NAL may directly affect P4-secreting cells. PMID- 3823110 TI - Feed efficiency and norepinephrine turnover in iron deficiency. AB - Norepinephrine turnover and energetic efficiency studies were conducted in three groups of male Sprague-Dawley rats placed on low iron diets for 5 weeks on weaning. Iron-deficient rats had significant anemia (hematocrit less than 20%) and growth retardation relative to pair-fed and ad libitum fed controls who received the same diet plus weekly iron dextran injections. Energetic efficiency over a 7-day period was nearly 30% less in anemic animals. This was associated with significantly higher rates of norepinephrine turnover in brown adipose tissue (110%) and heart (330%) with significant hypertrophy in both tissues. There was no difference in body composition in ad libitum groups. Plasma triiodothyronine and thyroxine were reduced by 37% in iron deficients compared to controls. Thus 39% increase in caloric requirements in iron deficiency is associated with increased sympathetic and perhaps thermogenic activity in brown adipocytes. PMID- 3823111 TI - Potential acetylcholinesterase reactivators: pyridine and alpha-oxooxime derivatives. AB - The synthesis and pharmacological screening in vitro and in vivo of pyridine-2 carbaldoxime derivatives I and alpha-oxooximes II are described. Four compounds elicited reactivating effect on phosphorylated acetylcholinesterase comparable with that of pralidoxime used as reference substance. Among the compounds tested, interesting structures are those of oximes bearing a thioether substituent [RA 49 (Table 1) and RA 59 (Table 2)] chloro derivative of MINA [RA 55 (Table 2)] and dipyridyl glyoxime methiodide RA 56 (Table 1). PMID- 3823112 TI - [Conditions for the mercurimetric determination of the drug content of penicillins]. AB - Mercurimetric determination of penicillins includes direct titration with a solution of mercury (II) perchlorate in the medium of pyridine solvent or acetate buffer, which determines the content of decomposition products, and titration after alkaline hydrolysis, which indicates the total amount of penicillin. The determination which is indicated potentiometrically with continuous addition of the titrant, provides real and reproducible results in the titration rate of 0.6 ml/min with the initial concentration of penicillin 170 mg/30 ml and temperature 25 degrees C. Benzathine and procaine salts of benzylpenicillin and benzathine salt of phenoxymethylpenicillin were dissolved in dimethylformamide (DMF) before the titration in acetate buffer. Titrations of ampicillin, amoxycillin and azlocillin were performed in the mixture of acetate buffer and formamide which ensured real results. Hydrolysis of the lactam ring of azlocillin, mezlocillin, ticarcillin and piperacillin is quantitative in 10 min of action of NaOH (1 mol/l) which was confirmed by comparing with the enzymatic cleavage. Relative standard deviation for all penicillins was less than 1%. The accuracy of the method for the determination of penicillins was proved by comparing with the microbiological and iodometric determination. The mercurimetric determination of penicillins and their decomposition products in acetate buffer was applied to injections, tablets, capsules and dry sirup. PMID- 3823113 TI - Chromatographic isolation and mass spectrometric identification of a base-induced mebendazole fluorophor. AB - Sodium hydroxide treatment of the benzoylbenzimidazole anthelmintics mebendazole and flubendazole produces yellow solutions that possess practically no fluorescence characteristics under various conditions. However, when spotting the alkaline solutions on filter paper and examining the spots under U.V., strong bluish-white fluorescence is obtained. When pouring liquid nitrogen over the spots, a very intense bluish-white fluorescence followed by a long-lasting greenish phosphorescence is observed. These luminescence phenomena allow visualization of 1 ng of mebendazole and of 5 ng of flubendazole per spot. A preparative separation by means of column liquid chromatography was worked out for the isolation of the fluorophor in case of mebendazole. Combined spectroscopic methods indicated the formation of a primary amine function in position 2 of the imidazole nucleus by hydrolytic cleavage of the -NH-CO-bond. A discussion on the mechanism of fluorescence is given. PMID- 3823114 TI - [Radioimmunoassay of the progestagen dienogest using various methods of sample preparation of plasma]. AB - For the radioimmunological determination (RIA) of the progestagen dienogest (1, 17 alpha-Cyanomethyl-17 beta-hydroxy-estra-4,9-dien-3-one) in plasma three methods of sample preparation were tested and compared: Extraction of plasma samples with dichlormethane (I), binding of plasma dienogest to an antiserum added; removal of non-bound steroids by means of activated charcoal, extraction of dienogest using dichlormethane (II), using the RIA without extraction of plasma samples after partial precipitation of proteins by means of ammonium sulphate (III). The reliability of the dienogest-RIA is, characterized by a limit of detection of 3.2 pg (I, III) and 5 pg (II) per tube, respectively, by "within assay"- and "between-assay" variation coefficients of 3 to 5% and 3 to 9%, respectively, in parallel determinations and by a high rate of recovery of dienogest (greater than 90%) added to plasma. The application of the parallelism test method to different plasma volumes confirms the accuracy of method I and II. When method III was applied to plasma samples with low concentrations of dienogest parallelism wasn't found in all cases. PMID- 3823115 TI - [The effect of the hydrogen ion concentration on membrane transport of dissociated drugs from saturated solutions]. AB - Dissociating drugs diffuse from saturated solutions with suspended drug particles across lipophilic membranes according to zero order kinetics. The highest rate is maintained even if large fractions of the drug are dissociated due to the pH conditions of the solution. The pH range of the highest and pH-independent membrane transport corresponds with drug solubility/pH-profiles, showing the solubility of the undissociated drug. PMID- 3823116 TI - Conformation and biological activity of hydroxy-phenyl-ammonium compounds. AB - Ab initio (STO-3G) and semiempirical (NDDO) quantum chemical methods were applied to some hydroxy-phenyl-ammonium compounds to investigate their conformational structure. It is demonstrated that the theoretical conformational analysis in combination with experimentally measured activity data of a small number of compounds may serve as a useful tool to optimize the biological active conformation, which does not correspond to the blobal minimum conformation in this group of molecules. PMID- 3823117 TI - [The effect of heparin on the relative myosin content of cultured smooth muscle cells of the pig aorta]. AB - Heparin inhibits the proliferation of aortic smooth muscle cells cultured in serum containing culture medium and leads to an increase of their relative myosin content. Using plasma as medium supplement the effect of heparin is not observed. Thrombin is able to inhibit the increase of myosin content caused by heparin. Platelet mitogens are not the point of attack of heparin. The possible mechanism of action of heparin on smooth muscle cells will be discussed. PMID- 3823118 TI - [Simple photometric method for the determination of L-dopa and carbidopa in drug preparations]. PMID- 3823119 TI - Spectrophotometric determination of antimalarials using quinones. PMID- 3823120 TI - Stability-indicating assay methods for oral rehydration salts. PMID- 3823121 TI - [The effect of tensides on the structure of triglyceride suppository masses]. PMID- 3823122 TI - [The need for light protection for aqueous vitamin D solutions]. PMID- 3823123 TI - [The binding of propranolol, dihydralazine and selected metabolites to adsorbent resins for hemoperfusion]. PMID- 3823125 TI - New constituents of Zanthoxylum rigidifolium root. PMID- 3823124 TI - [Antineoplastic activity of structural analogs of geogenine with a gamma-lactone or p-quinone function]. PMID- 3823126 TI - The S-deficiency hypothesis of depression and the two-process model of sleep regulation. AB - In the S-deficiency hypothesis, the changes in sleep in depression are attributed to the deficiency of a sleep/waking dependent process (Process S) involved in sleep regulation. It is further proposed that the abnormally low level of Process S is normalized by prolonged waking, and that this normalization is the basis for the antidepressant effect of sleep deprivation. Various aspects of the hypothesis have been tested in a number of studies which are reviewed. Data from healthy elderly subjects and from depressives also indicate that the decay rate of Process S may be reduced in advanced age and depression. Napping may contribute to lowering the level of S at sleep onset. PMID- 3823127 TI - The biomagnetic inverse problem. The Biomagnetic Inverse Problem Conference. Milton Keynes, UK, April 1986. Proceedings. PMID- 3823128 TI - Analysis of magnetoencephalographic data using the homogeneous sphere model: empirical tests. AB - The external magnetic fields produced by artificial current dipoles placed in conducting-gel filled spheres, partial spheres and human skulls have been measured. Using a homogeneously conducting sphere model, the dipole parameters have been estimated. Although good quality data fitting is obtainable for a range of positions of the centre of the sphere used in the modelling, the predictions for the dipole obtained with those different assumed positions differ considerably. It is found that the most reliable method of obtaining accurate estimates of the dipole parameters is by taking an average of the predictions of several of the best-fit analyses. The information about the accuracy of the predictions that is obtainable from the fitting routine's residual error parameter is discussed. PMID- 3823129 TI - Basic mathematical and electromagnetic concepts of the biomagnetic inverse problem. AB - In this paper basic mathematical and physical concepts of the biomagnetic inverse problem are reviewed with some new approaches. The forward problem is discussed for both homogeneous and inhomogeneous media. Geselowitz' formulae and a surface integral equation are presented to handle a piecewise homogeneous conductor. The special cases of a spherically symmetric conductor and a horizontally layered medium are discussed in detail. The non-uniqueness of the solution of the magnetic inverse problem is discussed and the difficulty caused by the contribution of the electric potential to the magnetic field outside the conductor is studied. As practical methods of solving the inverse problem, a weighted least-squares search with confidence limits and the method of minimum norm estimate are discussed. PMID- 3823130 TI - Improved procedure for neuromagnetic localisation. AB - We describe an improved algorithm for localising equivalent sources of biomagnetic fields in the human brain. The algorithm is an improvement over the sphere model in that it considers two distinct surfaces: an ellipsoid, to model the region of the skull on which the sensors are placed, and a sphere as the medium in which the current dipole model is considered. This allows us to easily correct the formula of the magnetic field in order to take better account of the true position of the sensor with respect to the subject's head. PMID- 3823131 TI - The effect of torso geometry on magnetocardiographic isofield maps. AB - Using a computer model of a realistically shaped human torso with lungs and intraventricular blood masses, we have assessed how torso geometry and composition affect the extracorporal magnetic field produced by a current dipole in the centre of the ventricular mass. The magnetic induction vector B arising from the dipole has been calculated at points of a precordial measuring grid and the influence of boundaries has been assessed qualitatively, by comparing contour maps of the B component normal to the torso's frontal plane. We found that the maps reflected relatively faithfully the underlying dipolar source for the homogeneous torso and even for the torso with lungs. However, the intraventricular blood masses caused a noticeable rotation of the maps' extrema. Both lungs and blood masses tended to swing the distribution towards the distribution that would have been caused by a dipole oriented along the anatomical axis of the heart. PMID- 3823132 TI - On the accuracy of source localisation in cardiac measurements. AB - This paper describes a localisation study of the sources of bioelectrical activity in the human heart. In particular, the atrial activation (P wave) and the activation of an extra pre-excitation area in the WPW syndrome are investigated. Different models based on the current multipole expansion are used to calculate the inverse solution. A comparison between calculated results, invasive electrophysiological studies and known physiological data is performed. The best results were obtained by the current multipole model with dipole and quadrupole terms. Non-invasive localisation of cardiac electric sources can be useful in studies of arrhythmia patients in the future. PMID- 3823133 TI - Inverse problem solution in cardiomagnetism using a current multipole expansion of the primary sources. AB - The equivalent current dipole (ECD) model is only the first-order approximation in modelling the primary sources of the magnetic field of the heart. From the experimental point of view this fact is particularly evident during the onset of ventricular depolarisation. In this paper we have tried to explain the departures of the experimental maps from the dipolar pattern in terms of the second-order component of the current multipole expansion for the primary source density. The antisymmetric part of this second-order component produces the external magnetic field and is equivalent to a magnetic dipole. To a first approximation it could represent circular currents flowing within the heart. We have derived the analytical expression for the magnetic field normal to the frontal plane produced by an equivalent current dipole and by an equivalent magnetic dipole (EMD) lying in a homogeneous conducting half-space. Using this expression in a least-squares fit computer program we have obtained the appropriate set of ECD and EMD parameters producing the best matching between theoretical and experimental field distributions in normal subjects. The results are in good agreement with the anatomical features of the heart and with the electrophysiology of ventricular activation. With previous theoretical considerations they strongly suggest the presence of divergence-free circular current sources within the heart. PMID- 3823134 TI - The inverse problem in MEG studies: an instrumental and analytical perspective. AB - The present state of the art in the solution of the inverse problem by neuromagnetic measurements, as demonstrated by recent important findings, is encouraging. Nevertheless, significant instrumental and analytical problems still need to be solved, in order to significantly improve the capability of the technique. This paper is aimed at providing a perspective for these problems and their possible solutions. PMID- 3823135 TI - Biomagnetism and the biomagnetic inverse problem. PMID- 3823136 TI - The role of model and computational experiments in the biomagnetic inverse problem. AB - This is a review of the role of model and computational experiments in studies of the part of the biomagnetic inverse problem that deals with the determination of electrical sources in the body using magnetic measurements around the body. Results from modelling studies of the forward problem that are important for the inverse problem are also reviewed. An evaluation is made of the adequacy of various models of the body for use in the biomagnetic inverse problem. This evaluation indicates that simple torso models, e.g. a semi-infinite volume or sphere, are probably inadequate. The review of the modelling studies of the inverse problem includes the effects of noise, source modelling errors, body modelling errors and measurement errors on the accuracy of source localisation methods using magnetic measurements. Source modelling errors are caused by differences between an actual complex source in the body and the simple model of it used in most source localisation methods; body modelling errors are caused by differences between the actual body and a simple model of it. The review indicates that typical experimental noise will only cause significant source localisation errors for inverse solutions calculated using fewer than approximately ten measurement points; it also indicates that source modelling errors must be rather large to be detectable when typical experimental noise is present. In addition, the review indicates that many experimental measurement errors will not cause significant localisation errors. The effects of body modelling errors are largely unknown. Suggestions for further biomagnetic inverse problem research are given. These include the development of more realistic models of the body, the experimental verification of such models and source localisation methods, and the development of methods for detecting and localising distributed or multiple discrete sources. PMID- 3823137 TI - MEG source models and physiology. AB - We report in vitro experiments on the source(s) of the magnetic fields produced by the brain. Theoretical arguments suggest that the dominant sources should be dipolar and oriented parallel to the scalp. Using an isolated turtle cerebellum as a model, we find that the fields produced following dorsal stimulation are attributable to current flow perpendicular to the cerebellum surface, suggesting Purkinje cell sources. We also discuss observations of longer lasting fields associated with spreading depression induced in the cerebellum. PMID- 3823138 TI - The inverse problem: a medical perspective. AB - The techniques of magnetoencephalography (MEG) have advanced considerably recently with several major installations now being built or planned. In this paper, the present status of MEG within clinical medicine is evaluated and compared with that of other large diagnostic instruments. Deficiencies in present instruments and procedures are discussed. It is argued that in the future methods must be found of investigating sub-cortical structures which are relevant in the majority of clinically significant conditions. Some important possible lines of enquiry are indicated. PMID- 3823139 TI - Inverse problem solution in magnetisation studies. AB - Magnetic measurements of the remanent field produced by dust particles in the lungs of industrial workers have increased our knowledge of the total amount of dust, the clearance rate of this dust, and the progression of phagocytosis of the particles in the lungs. To estimate the dust load from the magnetic field measurements one has to calculate the dipole moment of the magnetised lung. We conclude from a theoretical model study that an analysis of the data that uses the dipole and quadrupole coefficients to find the origin of a multipole expansion of the field gives the most accurate results. PMID- 3823140 TI - Modelling the temporal region in patients with temporal lobe epilepsy. AB - EEG interictal epileptiform discharges in temporal lobe epilepsy are associated with magnetic fields. The maxima of magnetic spikes recorded over the spherical portions of the head appear fairly symmetric, whereas those over the lower temporal region often have irregular shapes. Furthermore, their magnitude is often unequal with the extremum over the lower temporal region usually of lower magnitude than the extremum over the upper temporal region. This lack of symmetry in shape and magnitude may be due to non-sphericity of the skull over the temporal region or to variations in conductivities of intervening tissues. We present our observation in two patients suggesting that the surface contours of the head contribute to the apparent asymmetries of the field pattern but that the head contours alone may not account for the asymmetries seen in the clinical data. PMID- 3823141 TI - Magnetic localisation of a current dipole implanted in dogs. AB - In order to evaluate the difficulty in localising a current dipole due to volume conductor current contributions to the magnetocardiogram, accuracy of depth localisation of a commercial coaxial pacemaker cable, used as a current dipole, was studied in two experimental situations: immersed in a prismatic container with NaCl solution and introduced into the lower oesophagus of dogs. Isofield contour maps were obtained by interpolation of the magnetic field measured over a plane and perpendicular to it with a third-order gradiometer coupled to a SQUID. The dipole can be accurately localised in the prismatic container. The observation of an isofield map that is symmetric about the maximum-minimum axis when the dogs are in the dorsal decubitus position with the dipole in the cephalocaudal direction implies that internal inhomogeneities in the dog's volume conductor produce no appreciable effect on the magnetic field. Nevertheless, a large distortion of the magnetic field lines is observed and can be explained by calculations using models that take into account the external boundary of the volume conductor. PMID- 3823142 TI - Novel data analysis for synchronised spontaneous neuromagnetic activity. AB - A novel approach to neuromagnetic data analysis is presented. This technique is aimed at studying synchronised spontaneous activity (SSA) and has been used to resolve two different signals from one single evoked response, providing evidence for two possibly distinct sources. The data presented are consistent with a model that permits the generators of spontaneous activity to be synchronised by sensory stimuli. PMID- 3823143 TI - Trends in computational tools for biomagnetism: from procedural codes to intelligent scientific models. AB - The nature of the available computing tools strongly influences modern scientific investigations. The sources of well known problems associated with the use of procedural computer languages are traced and their consequences investigated. The likely impact of recent quantitative and qualitative advances in software and hardware is examined with emphasis on its relevance to the biomagnetic inverse problem. Gradual changes in the use of computers, some already employed in a recent study of a specific biomagnetic inverse problem, are outlined which take into account the large investment in conventional codes. PMID- 3823144 TI - A method for combining MEG and EEG to determine the sources. AB - A three-step method is presented which combines an MEG and EEG map over the head to solve the inverse problem (to determine the sources). This method uses the feature that the MEG does not see a radial source, but only a tangential source, while the EEG sees both. A first test is also made of the method, using computer simulation, and the results presented. The purpose of the test is to see if the method is valid with noisy MEG and EEG data, and when some modelling errors are present; a single dipole source was used in a spherical head. It was found that the method works well when the RMS noise at each map location is 5% of the maximum MEG and EEG (readily attained in practice), but breaks down when the noise is 10% (quite noisy data). The modelling errors involved grid size, head radius and distance to the MEG coil, and were studied only through the first step of the method; with errors in a reasonable range, this limited test again worked well. PMID- 3823145 TI - Feasibility of the homogeneous head model in the interpretation of neuromagnetic fields. AB - During the past few years it has been demonstrated that active areas in the human brain can be located by measuring the magnetic fields arising from the electric currents in the neurons. An established model for the conductivity geometry of the head in these studies is the layerwise homogeneous sphere. If, however, the measurement grid is too large or the local radius of curvature of the head is changing rapidly in the measurement area, this simple model may become inadequate. In this paper we investigate the feasibility of replacing the conducting sphere by a homogeneous body having the shape of the brain. We show by a semi-quantitative argument that the homogeneous body model is justified. A numerical procedure for the calculation of the magnetic field is presented with examples of the accuracy that can be obtained. An example of significant differences between the predictions of the homogeneous and sphere models is discussed. PMID- 3823146 TI - Inverse solutions based on MEG and EEG applied to volume conductor analysis. AB - An inverse solution computer program, using a single current dipole in a selected volume conductor, calculates an equivalent dipole from a magneto- or electroencephalographic distribution. The program is used to evaluate several volume conductor models of the head by using one model when generating the distribution and another when calculating the equivalent dipole. Sources of errors in the equivalent dipole, namely uncertainties in the model parameters (e.g. conductivities) and noise in the MEG or EEG distribution, are investigated in the same way. A realistically shaped model of the head is introduced to investigate the extent to which sphere-shaped models can be used. PMID- 3823147 TI - Perceptions of physical therapy competencies in rheumatology. Physical therapists versus rheumatologists. AB - The purpose of this article is to report the differences in perceptions among three groups of respondents who assessed the importance of 80 competencies for entry-level physical therapists who treat patients with arthritis. Nonparametric statistics were used to analyze the responses of physical therapists and rheumatologists who completed a questionnaire regarding the competencies. I used the Kruskal-Wallis one-way analysis of variance to make group comparisons and the Mann-Whitney U test to complete pair-wise comparisons. The results revealed significant differences of opinion among the groups (p = .007) for 20 of the 80 competencies. The significant differences in opinion were among physical therapy clinical educators (n = 100), physical therapy arthritis health professionals (n = 108), and rheumatologists (n = 80). Although the results suggested that some groups perceived certain physical therapy competencies in rheumatology to be useful but not essential for the entry-level physical therapist to perform, considerable variability existed within groups. Despite the variance in opinions, teaching of these competencies should be included in the entry-level physical therapy curriculum or in clinical settings. PMID- 3823148 TI - Evaluation of joint mobilization treatment. A method. AB - The purpose of this study was to develop and test a method for evaluating the effects of joint mobilization treatment on hypomobile joints. The normal dog carpal joint was used as the experimental model. The right carpal joints of 12 dogs were immobilized for six weeks resulting in joint hypomobility. The study group was divided into Treatment (n = 6) and Control (n = 6) Groups. In each group, passive range of motion (PROM) and the following functions during gait were evaluated cinematographically before immobilization and once weekly for four weeks after immobilization: peak extension and peak flexion of the carpal joint and the amount of time required in the gait cycle to reach these peak points. Additionally, the Treatment Group was given mobilization therapy daily during the four weeks after immobilization. The model proved to be satisfactory for evaluating the effect of mobilization treatment on hypomobile joints with the Treatment Group showing improved PROM and motion during gait. The success of the method should direct further investigation of the effects of mobilization treatment on restoration of joint function. PMID- 3823149 TI - Reliability of measuring anterior laxity of the knee joint using a knee ligament arthrometer. AB - The purpose of this study was to determine examiner reliability with the use of a knee ligament arthrometer to measure the anterior-posterior (A-P) laxity of the right knee. Two clinicians performed an A-P laxity measurement on 43 healthy, male subjects. The first examiner positioned the arthrometer, recorded the subject's A-P laxity, removed the instrument, and repeated the measurement. A second examiner performed the same procedure. Subsequently, we computed interexaminer, intraexaminer, and intraclass reliability coefficients. Our results indicated relatively high reliability coefficients. We believe a clinician can use the knee ligament arthrometer to obtain objective and reliable measurements of A-P laxity of the knee. PMID- 3823150 TI - Comparison of two continuous passive motion protocols for patients with total knee implants. AB - We compared the effects of continuous passive motion (CPM) given for a minimum of 20 hours a day to Group 1 patients (n = 15) or a maximum of 5 hours a day to Group 2 patients (n = 8) who received total knee joint replacements. Four variables were analyzed on the third and sixth days after surgery: 1) range of motion, 2) edema-effusion, 3) pain, and 4) length of hospital stay. We found significant improvements in knee extension (p less [corrected] than .001) in the Group 2 patients on Day 6 after surgery. We also found a significant negative correlation between the length of hospital stay and the number of physical therapy treatments received. No between-group differences were found in measurements of 1) total knee excursion, 2) edema-effusion, 3) pain, 4) length of hospital stay, and 5) number of PT treatments received. This lack of differences implies that comparable results can be obtained by using the CPM machine either 20 hours a day or 5 hours a day. PMID- 3823151 TI - Changes in spinal mobility with increasing age in women. AB - The purpose of our study was to determine changes in spinal mobility for women aged 20 to 84 years. Anterior flexion, right and left lateral flexion, and extension were measured on 109 healthy women. The modified Schober method was used to measure anterior flexion. Standard goniometry was used to measure lateral flexion and extension. The results of the study indicated that spinal mobility decreases with advancing age. The most significant (p less than .05) differences occurred between the two youngest and the two oldest age categories. Data gathered in this study indicate that physical therapists should consider the effects of age on spinal mobility when assessing spinal range of motion. A simple, objective method for measuring spinal mobility is presented. Suggestions for future research are given. PMID- 3823152 TI - Physical therapists as double agents. Ethical dilemmas of divided loyalties. AB - Ethical dilemmas arise when physical therapists encounter conflicts between loyalty to their patients and loyalty to their employers. This type of ethical conflict is called "the dilemma of the double agent." If physical therapists perceive themselves as agents of their patients, their employment may be threatened. If physical therapists perceive themselves as agents of their employers, their patients may suffer physical or psychological harm. The double agent dilemma is illustrated in this article by a hypothetical case study derived from sports physical therapy. Three ethical theories--egoism, utilitarianism, and formalism--are used to analyze the conflict and formulate solutions. A second conflict also is raised between patient autonomy and medical paternalism. As physical therapists become more autonomous, they will assume increased responsibility. Inherent in this increased responsibility is the obligation to recognize and confront ethical dilemmas in physical therapy practice. Resolving ethical dilemmas is difficult, but use of ethical theories can help in the systematic examination of basic assumptions and principles. This article introduces therapists to three ethical theories and presents a model for ethical decision making. PMID- 3823153 TI - Interpersonal skills education in entry-level physical therapy programs. AB - The purpose of this study was to determine the current status of interpersonal skills (IPS) education in entry-level physical therapy programs with respect to content, course work requirements, and evaluation strategies. The disciplines of faculty members who teach IPS and their materials and methods also were explored. Using a 32-item questionnaire, we surveyed in 1984 all accredited baccalaureate (BS), certificate (CERT), and entry-level master's degree (MS) programs (N = 107) in physical therapy. Seventy-two responses (67.2%) were received, reflecting returns from 57 BS (64.7%), 5 CERT (83.3%), and 10 MS (76.9%) program respondents. Nearly all (97.2%, n = 70) of the respondents explicitly taught IPS in the classroom, but fewer of them evaluated learning (74.3%, n = 52). Overall, respondents teaching in MS programs consistently reported including a greater concentration of IPS content than the other two types of programs. All of the MS programs required specific IPS course work, compared with 50 (87.7%) of the BS programs and 3 (60%) of the CERT programs. Predominantly, faculty members who teach IPS are academically based physical therapists who use an extensive variety of methods and materials. PMID- 3823154 TI - Systematic clinical placement of physical therapy students. AB - The focus of this article is a description of a management information system (MIS) designed to handle the task of matching physical therapy students with clinical education facilities in fulfillment of clinical requirements of the physical therapy curriculum. The use of a specialized MIS for the assignment of physical therapy students to clinical sites has resulted in a high degree of suitable placements, pairing students' needs with the resources of clinical sites. Multiple applications of the system to the placement task also have resulted in successful matching. The clinical placement system was designed to facilitate adaptation to an automated system in the future. Applications of the proposed computer-assisted placement system and the advantages of such a system in terms of administration and research in clinical education also are presented. PMID- 3823155 TI - Problems of teaching physiology in developing countries. PMID- 3823156 TI - Teaching physiology in Africa. PMID- 3823157 TI - Hedonic reactivity to sucrose in rats: modification by pimozide. AB - Reward summation functions (RSFs) are an important way to dissociate and quantify hedonic and motor effects of neuroleptics. Previously used only with brain stimulation reinforcement, we demonstrate they will also work using sucrose solution reinforcement. Eighteen male rats were trained to lever press on a CRF schedule for 0.01 ml sucrose solution reinforcers of varying concentration (0.025, 0.05, 0.1, 0.3, 0.5, 0.7, 0.9, 1.1, 1.7, 2.3 M). Making the lever harder to press caused an increase in the asymptote of the function, demonstrating a motor effect. Quinine added to the solutions (0.05%) caused the function to shift right, demonstrating an hedonic effect. Rats injected with 0.2 mg/kg pimozide, a dopamine antagonist, then tested four hours later, showed a right shift in the function with no change in asymptote. Thus, at this dose pimozide affects hedonic and not motor substrates of the CNS. These data demonstrate the generalizability of the RSF method to reinforcers other than brain self-stimulation. PMID- 3823158 TI - Short photoperiods increase ultrasonic vocalization rates among male Syrian hamsters. AB - Two experiments investigated the effects of daylength on the emission of 35 kHz ultrasonic (US) calls among male hamsters. In Experiment 1, castrated males received Silastic implants subcutaneously that contained either low doses of testosterone in oil or oil alone; US calls were recorded when these males were paired with receptive females. Males exposed to eight hours of light per day (short photoperiod) called more often than males exposed to fourteen hours of light per day (long photoperiod). This was true whether or not they received testosterone. In Experiment 2, a similar testing and photoperiod exposure paradigm was used, but the subjects were gonadally intact. Among males exposed to short photoperiods, US call rates increased while endogenous testosterone levels decreased. In contrast, hamsters exposed to long photoperiods maintained stable calling rates and testosterone levels. These findings are related to recent studies concerning the neural mechanisms that regulate ultrasonic vocalizations and to the possible role of photoperiod in modulating conspecific aggression. PMID- 3823159 TI - The effects of repeated cycles of weight loss and regain in rats. AB - This study examined the metabolic effects of weight cycling, i.e., repeated periods of weight loss followed by regain. There were three groups of adult, male Sprague-Dawley rats: (1) Chow Controls (a normal weight control group fed chow throughout); (2) Obese Controls (animals fed a high-fat diet throughout); and (3) Obese Cycling (obese animals cycled through two bouts of caloric restriction and refeeding). The cycled animals showed significant increases in food efficiency (weight gain/kcal food intake) in the second restriction and refeeding periods compared to the first, i.e., weight loss occurred at half the rate and regain at three times the rate in the second cycle. Several physiological changes were associated with this cycling effect. At the end of the experiment, cycled animals had a four-fold increase in food efficiency compared to obese animals of the same weight who had not cycled. These data suggest that frequent dieting may make subsequent weight loss more difficult. The possible metabolic and health consequences of "yo-yo" dieting are discussed. PMID- 3823160 TI - Dose-related stimulation of feeding by systemic injections of monosodium glutamate. AB - Monosodium glutamate (MSG) is an excitotoxin capable of both stimulating and lesioning neurons in circumventricular organs (CVOs) after systemic administration. In this study, MSG and equiosmotic concentrations of NaCl were administered subcutaneously to adult rats in order to observe the effects on food and water intake. MSG (0.5, 1, 2 and 6 g/kg), but not NaCl, stimulated feeding. The magnitude of the feeding was dose-related. After the highest dose, rats consumed 4.4 g of pelleted food. Since MSG does not cross the blood-brain barrier, we conclude that feeding was stimulated by an action of glutamate on CVOs. Doses of MSG that stimulated feeding did not alter blood glucose concentration. Neonatal MSG treatment, which is known to be more damaging to circumventricular neurons than adult treatment, greatly reduced or abolished subsequent MSG-induced stimulation of feeding in adults. Both MSG and NaCl stimulated drinking. Since the magnitude of the drinking response was similar for both solutes and was directly related to the osmotic strength of the solutions, we conclude that the drinking response after MSG was mediated by cellular dehydration. PMID- 3823161 TI - Restricted feeding and circadian activity rhythms of a predatory marsupial, Dasyuroides byrnei. AB - There is considerable disagreement as to whether food availability entrains circadian activity rhythms in omnivorous laboratory rodents. However, in carnivorous mammals a restricted feeding regime could act as a zeitgeber because the predator should hold a periodism correlated to that of the prey. Nevertheless, a restricted feeding schedule does not dominate the LD cycle for entrainment of circadian activity rhythms of the nocturnal predator Dasyuroides byrnei, nor does it entrain the free-running activity rhythms in DD. Anticipatory wheel running prior to food availability was observed in most animals. Some evidence for weak coupling between LD-entrained and meal-associated oscillators was indicated by occurrences of relative coordination. This species does not appear to have a dominance hierarchy of zeitgebern different to that reported for laboratory rodents. One would have predicted that it would have been ecologically adaptive for cycles of food availability to be more important than the LD cycle in this species. PMID- 3823162 TI - Flavor-illness aversions: the role of the amygdala in the acquisition of taste potentiated odor aversions. AB - In the present experiments the role of the amygdaloid complex and its specific nuclei were tested in the conditioning of taste potentiated odor aversions. In the first experiment two groups of rats were given either large electrolytic lesions in the amygdala (AMX) or sham operations (SH). Postoperatively, these rats were trained to avoid either a taste, an odor, or a taste-odor compound using LiCl illness. Subsequent tests with odor and taste alone showed that the SH group developed strong taste and odor aversions; however, the AMX group failed to display either an odor or taste aversion. In the second experiment, another four groups of rats received either lesions in the medial and basomedial nuclei (M), central nuclei (C), lateral and basolateral (L), or sham operations (SH). The results from postoperative conditioning showed that all groups had strong taste and odor aversions, except group L which displayed a significant disruption of odor aversion learning. In conclusion, these data indicate that the amygdala is involved in the acquisition of taste, odor and potentiated odor aversions learning. Moreover, it is demonstrated that the lateral and/or basolateral nuclei are particularly involved in the development of potentiated odor aversions learning. PMID- 3823163 TI - Maternal malnutrition in the rat: effects on food intake and body weight. AB - The effects of dietary protein level on food intake and body weight were examined in adult female rats during a 35-day pre-mating period and during gestation and lactation. During the pre-mating period, no differences in daily food intake were observed among rats fed a 6% casein, 8% casein or 25% casein diet. However, during this period, rats fed the 6% casein diet gained significantly less weight than those with ad lib access to the 8% or 25% casein diets or than rats pair-fed the 25% casein diet in amounts equivalent to that consumed by rats in the 6% or 8% casein groups. Additionally, rats fed the 6% casein diet displayed decreased efficiency of energy utilization, calculated as weight gain per 100 kilocalories consumed, relative to rats fed the 8% or 25% casein diets. No differences in food intake were observed among the groups during gestation. However, rats fed the 6% casein diet gained less weight than rats fed the 8% or 25% casein diets. During lactation rats fed either the 6% or 8% casein diet consumed significantly less food than animals given the 25% casein diet ad lib. During the second week of lactation, rats receiving ad lib access to the 25% casein diet gained weight while those receiving the 6% or 8% casein diets continued to lose weight. At parturition, body weights of pups did not differ as a function of dietary condition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823164 TI - Hyperprolactinaemia alleviates behavioral alterations of rats with hereditary hypothalamic diabetes insipidus (Brattleboro strain). AB - Male rats homozygous for hereditary hypothalamic diabetes insipidus (HO) and their heterozygous (HE) and normal (NO) variants (Brattleboro rats) were made hyperprolactinaemic by homografting two adenopituitaries under the kidney capsule. The high water intake and urine output of homozygous diabetic sham operated rats (sham-HO) were similar to those of homografted HO animals. Also, hyperprolactinaemia failed to change the water intake and urine output of HE and NO rats, as compared to those of heterozygous (sham-HE) and normal (sham-NO) sham operated animals. Compared to sham-HE and sham-NO animals, sham-HO rats showed a slow acquisition of active avoidance responses, a facilitated extinction of a pole jumping avoidance behavior and a reduced retention of a passive avoidance response. However, an improved performance of acquisition and retention behaviors up to the level of sham-HEs and sham-NOs was observed in homografted HO rats. Hyperprolactinaemia resulted in a reduced responsiveness to electrical footshock in HO, HE and NO animals, and in facilitated acquisition of active avoidance responses in HE and NO rats, but it failed to affect avoidance extinction and retention in the latter variants. These results suggest that the behavioral alterations shown by homozygous diabetes insipidus rats are alleviated by hyperprolactinaemia although high levels of plasma prolactin do not interfere with the mechanisms regulating water intake and urine output. In addition, hyperprolactinaemia affects the behavior of heterozygous and normal variants of Brattleboro strain but in a selective way. PMID- 3823165 TI - Method of dynamic behavioral stage analysis (DBSAM) in the free moving mouse. AB - The process of analysis involved in DBSAM was described based on both the processing flow and the acquired model data. In the first step, the behavior of a mouse was classified into moving stage (MV), deep sleep stage (EP) and OT stage, in which the brain activity of the mouse was near the consciousness level. In the second step, the vague OT stages were classified into stages of quietness during the wakefulness state (QU) and light sleep stages (LSP) by the logical matrix. Finally, the symbol presentation for the stage-linkage of multiple stages per 1 sec was demonstrated. PMID- 3823166 TI - Coupling between feeding- and light-entrainable circadian pacemakers in the rat. AB - Activity of the rat can be entrained to LD cycles (light-entrainable rhythm = LER) and to periodic food access (feeding-entrainable rhythm = FER) and these responses appear to be mediated by separate circadian pacemaking systems. The purpose of this study was to explore interactions between these systems. In Experiment I, after entrainment of activity to a LD cycle and to restricted feeding, the LD cycle was phase delayed by 4 hr and rats were food deprived for 3 days. Delaying transients were observed in both the LER and FER although food was no longer a Zeitgeber. In Experiment II, food was scheduled at 3 different phases of the LD cycle. Food access was then phase delayed by 8 hr and rats were placed in DD. When the new food access fell into the subjective day, the phase of the LER was not affected but transients in the FER persisted for up to 18 days, 3 to 5 times longer than reported for rats with suprachiasmatic nucleus lesions. When the new food access fell into the early subjective night, the "free-running" LER was phase advanced by over 3 hr but no delaying transients in the FER were observed. When the new food access fell into the late subjective night, the LER was not phase advanced but its period remained close to 24 hr and no delaying transients in the FER were observed. In Experiment III, food was presented at two phases of the LD cycle and restricted feeding was continued in DD without phase shifts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823167 TI - Ultrasonic vocalizations and aggressive behavior in male rats. AB - The aim of the present study was to know whether 22-28-kHz vocalizations have any communicatory role in the regulation of aggressive behavior in male rats of the Wistar strain. In pairs of intact rats 22-28-kHz vocalizations showed a positive correlation with the extent of aggressive behavior. The pattern of aggressive behavior during ultrasonic vocalizations was different from that just before and just after the vocalizations. However, surgically deafened rats were less active in aggressive behavior and more active in ambulatory activity in the open field than the controls. Muted rats were not different from the controls in both aggressive behavior and ambulatory activity. The present result that the deprivation of ultrasonic signals failed to increase aggressive behavior does not support the classical hypothesis that ultrasonic vocalizations inhibit the initiation of aggressive behavior. It is concluded that ultrasounds emitted during aggressive encounters may have little communicative value in male rats. PMID- 3823168 TI - Influence of electroconvulsive shock and naloxone on acquisition and retention of a spatial navigation task in rats. AB - The effects of electroconvulsive shock (ECS) on learning and memory were examined in rats using the Morris navigation task. Rats were trained to escape from a large pool of water onto an invisible underwater platform. Application of ECS at various intervals before training (15 to 120 min) induced a significant time dependent impairment of the acquisition of escape behavior; naloxone (1 mg/kg IP 15 min before ECS) did not prevent the ECS-induced impairment. One single active escape trial preceding ECS prevented ECS-interference with the subsequent acquisition of the task. Spatial navigation in well trained animals was significantly impaired 30 and 60 min after ECS. It is concluded that ECS disturbs the disturbs the formation of a spatial memory trace more than the retrieval of a previously formed spatial trace. Release of opioid peptides do not seem to contribute substantially to the amnesic effects of ECS in the spatial navigation task. PMID- 3823169 TI - Alimentary sleep satiety in suckling rats. AB - Sleep/wake states were investigated in rat pups at 12-13 days of age following deprivation of milk and their dam for 9-12 hr. Early in the deprivation period each pup was equipped with bipolar stainless steel electrodes for electroencephalographic (EEG) and electromyographic (EMG) recordings. Four groups of pups were tested using anesthetized dams. The pups were either allowed to root in the dam's fur, but were not allowed to attach to a nipple; allowed to root after receiving a gut load of rat's milk; allowed to attach and suck a nipple without receiving milk; or allowed to attach and suck a nipple following a gut load of rat's milk. The results indicate that suckling elicits sleep, especially slow-wave sleep. Milk in the gut enhanced paradoxical sleep, primarily in the context of sucking. This experiment confirms that the types of sleep can be affected separately by specific internal and external events. The shift in the sleep/wake condition to slow-wave sleep in the suckling situation suggests one type of satiety. Furthermore, the selective enhancement of paradoxical sleep following the gut load of milk suggests postingestive satiety. PMID- 3823170 TI - Laboratory studies of eating behavior in women with bulimia. AB - This report describes a standard procedure for studying the disordered eating behavior of bulimic patients in a laboratory setting. Test meals were given to eight normal weight women with bulimia under four different conditions on non consecutive days. On day 1 they were asked to consume as much as they "would normally eat" by means of a straw from an opaque container holding 1500 g of a palatable liquid food. An eating monitor recorded the pattern of consumption. Five patients showed abnormalities of either excessive eating or acceleration of the rate of eating. On the second and third days they were given standardized amounts of an array of foods. They were instructed to eat normally on one of these days and to eat as much as they could on the other, in counterbalanced order. All patients ate to excess when they were asked, over a 28 to 90 min period, and consumed a mean of 4477 kcal (range 2083-8499 kcal) with a macronutrient composition similar to that of the typical American diet. They all vomited afterwards. On the day they were asked to eat normally, five patients overate and vomited, two ate very little, and one refused to participate. On the fourth day patients were asked to eat as much as they could of a single item, ice cream. Six patients consumed a mean of 1545 kcal (range 741-2919 kcal); one patient ate only 85 kcal; and one patient refused to participate. There were large and significant correlations among the sizes of the various meals consumed in excess.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823171 TI - Natural light exposure of young adults. AB - Bright light has a role in natural coordination of mammalian circadian and seasonal rhythms. In humans, the light intensity must probably exceed 2000 lux to be optimal. Natural light exposures of 10 healthy adults were measured over a 24 hour period, using forehead illumination transducers connected to a portable computer. The subjects varied markedly in duration and timing of exposures to light greater than 2000 lux. On average, the subjects experienced bright light for only 90 minutes per day, less than the 3-8 hours of bright light necessary to maximally synchronize human circadian rhythms. These results suggest that natural and artificial light exposure for many Americans may be suboptimal for circadian and seasonal synchronization. PMID- 3823172 TI - Olfactory and nonolfactory odor detection in pigeons: elucidation by a cardiac acceleration paradigm. AB - A technique for the Pavlovian conditioning of cardiac acceleration in response to odorants was developed and used to compare the sensitivity of pigeons to four odorants before and after resection of the olfactory nerves. This method provided quite reliable psychophysical functions yet required relatively little training time. Thresholds of normal pigeons to n-amyl acetate, n-butyl acetate, benzaldehyde and butanol were approximately 10(-4), 10(-5), 10(-3.3) and 10(-4.3) of vapor saturation, respectively. Following resection surgery, sensitivity decreased by 2 to 4 log units. When transection of the ophthalmic branch of the trigeminal nerve was combined with olfactory nerve resection, little evidence of a further decline in odor sensitivity was seen. Based on these results each of these compounds could be used, at concentrations below the postoperative threshold, to study, in isolation, both normal and reconstituting olfactory systems in the pigeon. PMID- 3823173 TI - Control of protein intake in the young rat. AB - Both adult and weanling rats are able to control their dietary intake of protein. The purposes of the current study were to determine: the precision of this ability in the weanling rat and when this ability makes its ontogenic appearance. We studied three overlapping age groups spanning the third, fourth and fifth postnatal weeks. Animals chose between two isocaloric liquid diets, one protein free and the other composed of 50% protein. The intake volume of each diet was measured daily. Three days after introduction to the diets, pups were subjected to short-term tests designed to determine their ability to distinguish between the two diets. All three age groups responded to the protein conditions. However, the youngest group displayed comparatively weaker responses characterized by a prolonged period of reduced protein intake and weaker responses to the protein conditions of the short-term test. We conclude that young rats control protein intake by the end of the third postnatal week and that this ability strengthens throughout the remainder of the weaning period. PMID- 3823174 TI - Circadian rhythms of small carnivores and the effect of restricted feeding on daily activity. AB - Restricted daily feeding can entrain an endogenous circadian clock of rodents. Carnivores have not been tested even though, unlike rodents, the availability of their foods can naturally vary with the light-dark cycle. In addition, very little is known of the characteristics of carnivore circadian rhythms in constant illumination. The locomotor activities of weasels and minks were measured on running wheels and tilt floors in LD 12:12 and constant illumination. The animals were then subjected to daily restricted feeding to determine their ability to anticipate the arrival of food. Weasels and minks anticipated food delivery but endogenous control was not unequivocally demonstrated. Anticipatory activity was suppressed during days of food excess but exhibited during days of deprivation when these conditions were presented on alternating days. The characteristics of mink activity rhythms in constant light and dark are consistent with Aschoff's rule for nocturnal animals. Free-running rhythms were not measurable for most weasels due to arhythmicity or lack of data. PMID- 3823175 TI - Influence of isolation stress and inhibited protein biosynthesis on learning and memory in goldfish. AB - Goldfish, Carassius auratus auratus L. (Pisces, Cyprinidae), were trained by different kinds of training procedures under the influence of cycloheximide or puromycin, two inhibitors of the protein biosynthesis. After active avoidance training in a shuttle box an apparent amnesia was found only when the fish were exposed to a one day lasting isolation stress prior to training. If the animals were accustomed to isolation over a period of 20 days the inhibitors did not affect memory formation. After learning by positive reinforcement (food rewarded color discrimination) in groups under stress-free conditions, neither learning nor memory formation were impaired in spite of the presence of cycloheximide. It is suggested that the amnestic effect of the inhibitors is caused by isolation treatment. Lack of the additional stress, however, leads to memory formation. PMID- 3823176 TI - Temporal and inter-task consistency of heart rate reactivity during active psychological challenge: a twin study. AB - Heart rate was monitored while 22 pairs of young male monozygotic and 29 pairs of young male dizygotic twins were exposed to a video game and a mental arithmetic task. The heart rate reactions of the monozygotic twins showed much greater concordance than those of the dizygotic twins. Analysis of the data for the 102 individuals demonstrated reliable inter-task consistency of heart rate reaction. In addition, comparison of the heart rate reactions of ten pairs of monozygotic and ten pairs of dizygotic twins who had been tested more than a year earlier and their present reactivities revealed impressive temporal consistency. PMID- 3823177 TI - Ethanol changes patterns of defensive behavior in wild rats. AB - Wild-trapped R. rattus under saline or four ethanol doses were run in tasks designed to measure a range of defensive reactions to nonpainful threat stimuli. Results suggest that at higher doses (1.2 g/kg and above) ethanol reduces defense, with effects ranging from slight reductions to near abolition, depending on the behavior measured. Low and moderate ethanol (0.3 and 0.6 g/kg) doses, however, had divergent effects, tending to enhance components of the defensive attack pattern (vocalization, jump attacks, bites), while not altering other aspects of defensiveness. This pattern of results suggest that an ethanol-based potentiation of defensive attack may be one of the factors involved in the phenomenon of aggression increases following alcohol consumption. PMID- 3823178 TI - The gonadotropic-axis involvement in the course of the filial following response in the domestic fowl chick. AB - The detachment process of the domestic chick from its mother, or any other imprinting object occurs between the sixth and tenth week after hatching. The present study (Experiment I), examines whether the detachment process parallels endocrine events that precede prepuberty. Immediately upon hatching, groups of heavy strain chicks were imprinted to a colored foam rubber ball for 72 hours. The bond between these chicks and the imprinting object was then tested, and plasma LH and testosterone were assayed once a week until the chicks were 10 weeks of age; the sexual development of chicks of the same strain was studied at the same time. At the outset of the detachment period (5-7 weeks) an increase in plasma testosterone and a decrease in plasma LH was found. In addition, the comb and testes showed a definite weight increase while the bursa of Fabricius showed a significant decline in weight. In Experiment II, the beginning of the detachment process was induced by injecting 3 to 4 week old chicks with testosterone-propionate, estradiol-benzoate and 5 alpha-dihydrotestosterone. Our evidence therefore appears to demonstrate that testosterone and its metabolites induce the detachment process by the same mechanism used to stimulate sexual behavior in juvenile chicks. PMID- 3823179 TI - Suprachiasmatic nuclei lesions do not eliminate the circadian rhythms of electrolyte excretion in the rat. AB - The 24-hour variations in 2-hour diuretic and saluretic action of furosemide (4 mg/kg) given at 8, 12, 16, 20, 24 or 4 hr and the circadian rhythms of food and water intake, urine and electrolyte excretion followed for two consecutive days at 4-hour intervals were investigated in suprachiasmatic nuclei (SCN)-lesioned or sham-operated male Wistar rats. The results showed that: a distinct 24-hour rhythm in furosemide-induced urine, sodium and chloride excretion persisted after SCN lesions, and the lesions abolished the circadian rhythms of food and water intake but only desynchronized the individual 24-hour variations in electrolyte excretion. We concluded that SCN play a role as a central synchronizer but not as a major oscillator of the circadian rhythms of electrolyte excretion in the rat. PMID- 3823180 TI - A differential sex effect of amphetamine on exploratory behavior in maturing mice. AB - The effects of amphetamine (5-20 mg/kg) were studied 60 min after injection in mice aged 2, 3, 4 and 6 weeks postpartum. Exploratory behavior as indicated by the "head poke" test was depressed at all ages, but appeared to be relatively uncomplicated by other effects at the 5 mg/kg dose. At 4 and 6 weeks control females showed significantly greater activity than males, and amphetamine produced a greater reduction for control levels than in males. PMID- 3823181 TI - Prenatal stress eliminates differential maternal attention to male offspring in Norway rats. AB - Maternal licking behavior was observed in 20 Long-Evans rat dams on two consecutive days. Stimulus pups were male and female foster pups from dams that were either housed with 5 adult males during the last trimester of pregnancy (stressed) or housed alone (unstressed). Unstressed male pups received significantly more maternal licking than their female siblings, but prenatally stressed males and females received similar levels of maternal licking, comparable to that directed to unstressed females. In a second study, urine collected from prenatally stressed male pups elicited significantly less investigation from dams in a choice test than urine from age-matched unstressed males. It is concluded that the chemosignals which stimulate dams normally to provide more maternal attention to male than female neonates are deficient in prenatally stressed males. The results raise the possibility that differential maternal care may mediate some effects of prenatal stress on behavioral development in males. PMID- 3823182 TI - Stimulus qualities of a preferred female partner and sexual behavior of old rhesus males. AB - A vaginal lavage from a preferred female sexual partner (donor) with whom old (21 27 yr) rhesus males readily copulated or a distilled water lavage was applied to the perineum of non-preferred females (N = 8) with whom old males rarely copulated. The donor and recipients were ovariectomized and were treated with estradiol benzoate (EB) before being tested. Sexual performance of the males did not differ under the two conditions of testing, but the rate of sexual solicitation by the females was significantly higher when treated with the vaginal lavage. One month later the non-preferred females were again treated with EB and paired with the old males. In these tests the preferred female was present in a cage adjacent to and in view of the test pairs. Sexual behavior was not altered significantly, but whereas these males had never threatened or aggressed their partners in previous tests, there was a significant increase in the rate at which they threatened their partners and aggression occurred for the first time. When paired with the preferred female, males ejaculated in 100% of the tests and the average ejaculation latency was less than 2.5 minutes. PMID- 3823183 TI - Methodological problems in the study of classical aversive conditioning of adrenocortical responses. AB - The present studies were conducted to demonstrate classical aversive conditioning of a corticosterone stress response in male rats. In the first experiment animals exposed to an odor which had previously preceded tube restraint stress had significantly higher plasma corticosterone levels than animals which were probed with a novel odor, or animals in which stress was followed, rather than preceded, by the odor. Careful consideration of corticosterone responses obtained on different days during training made it impossible to conclude unequivocally that learning had occurred. A second experiment was designed specifically to deal with the problems raised by the first, but we were again unable to show rigorously that learning had taken place. However, with data and paradigms comparable to our own, other researchers have prematurely concluded that aversive visceral conditioning can occur. It is suggested that the methodological considerations raised in the present studies could also be important for interpreting other experiments. Given the classical importance ascribed to learning components in many psychosomatic pathologies, future experiments are necessary to determine if stress responses can be classically conditioned, but they must be more rigorously designed than in the past. PMID- 3823184 TI - Disorganization of the rat activity rhythm by chronic treatment with methamphetamine. AB - Remarkable changes in the circadian activity rhythm of rats were observed when they were chronically treated with methamphetamine dissolved in drinking water. The circadian rhythm was phase-delayed with respect to the light-dark (LD) cycle, and showed signs of relative coordination. In some rats, the circadian organization was disturbed and two activity components appeared, with one component free-running and the other entrained by the LD cycle. After methamphetamine withdrawal, these changes disappeared rapidly but there were transient periods of 2-3 days before establishment of a stable entrainment to the LD cycle. The changes in the circadian rhythm persisted even in constant darkness (DD). The period around 24 hr in DD was significantly shorter during methamphetamine treatment than after the drug withdrawal. These results indicate that neither alteration of the sensitivity to light nor lengthening of the intrinsic period is involved in the methamphetamine induced disorganization of the circadian rhythm. Possible mechanisms are discussed in terms of a multi oscillatory system. PMID- 3823185 TI - Circannual cycles of body mass food intake and reproductive condition in male pallid bats. AB - Gonadectomy did not eliminate circannual cycles of body mass and food intake in male pallid bats maintained for up to 30 months in short or long photoperiods at a constant temperature of 23 +/- 2 degrees C. Generation and expression of circannual rhythms is independent of the annual testicular cycle. Initial peak body and testicular masses were recorded within one month of each other but the peak in food intake occurred approximately eight months after animals attained peaks in body mass. Increased metabolic efficiency appears to act independently of changes in food intake to effect seasonal increases in body mass of pallid bats. PMID- 3823186 TI - Effects of exercise-training on the thermic effect of food and body fatness of adult women. AB - Resting metabolic rate (RMR), thermic effect of food (TEF), aerobic capacity (VO2max), body fat, and food intake were measured in 10 healthy women before and after a 10 week graded exercise program of jogging. Pretraining TEF was a linear function of VO2max. Following exercise training, the women showed a significant increase (20%) in VO2max and loss (10.4%) of body fat; body weight did not change. Fat loss was directly related to changes in VO2max and RMR. The women showed a wide variation of changes in RMR (-21 to +2%) and TEF (-32 to +66%) from their pretraining levels. The changes in RMR and TEF were significantly positively correlated with improvements in VO2max. Analyses using multiple regression techniques, indicated that the changes in RMR and TEF accounted for 96.2% of the total variation in the changes of VO2max. Analyses of food intake indicated that diet composition (but not caloric intake) was highly related to the changes in VO2max, RMR, TEF and body fatness. Present results support further our hypothesis, that VO2max is an important physiological index of dietary thermogenesis and fat loss of individuals of normal body weight and fatness. Possible nutritional and physiological factors that may explain the wide variation in RMR and TEF of the women are discussed. PMID- 3823187 TI - Absolute and intensity-difference taste thresholds in the rat: evaluation of an automated multi-channel gustometer. AB - An operant conditioning procedure is described for assessing taste detection and discrimination in rats. Rats were trained to lick at a 10-barrel stimulus delivery tube for a 0.005-ml sample of a positive (S+) or negative (S-) stimulus and to switch to a water delivery tube after presentation of S+. The system is computer controlled and selection of stimuli can be made interactive with performance. After preliminary training, absolute and intensity-difference thresholds can be determined in 1-2 sessions. Mean absolute thresholds in 10 rats for NaCl, sodium-saccharin, and sucrose were 0.0049%, 0.0012%, and 0.035%, respectively. Intensity-difference thresholds (not reported previously in the rat) for NaCl and saccharin were 16.1% and 12.3%, respectively. With these procedures rats also rapidly acquired 2-tastant discriminations, including those involving taste mixtures. PMID- 3823188 TI - Drinking in the pigeon (Columba livia) in response to water deprivation and the influence of intracerebroventricular infusions of NaCl or sucrose solutions. AB - Pigeons were deprived of fluid for 24 hours then allowed access to water and a 2.7% NaCl solution, the intakes of both solutions during the subsequent 60 min were observed. In a second experiment hypertonic or isotonic solutions of NaCl or sucrose were infused ICV, starting 5 min before access to the solutions and finishing 10 min after access, and the consummatory behaviour observed. Pigeons rehydrated themselves after the period of deprivation with a volume of water equal to the weight lost during the deprivation. Pigeons never drank the hypertonic NaCl solution. ICV infusions of hypertonic or isotonic sucrose attenuated drinking in response to 24 hours water deprivation. Isotonic or hypertonic NaCl infused ICV, on the other hand, had no significant effect. Thus, in the pigeon, drinking in response to 24 hours of water deprivation appears to be controlled by one mechanism, possibly osmoreceptor in nature (with the permissive control of CSF sodium concentration), since the birds drank a volume of water equal to their weight loss and changes in CSF sodium concentration influenced drinking in a manner similar to that described previously for osmotically induced drinking in pigeons. PMID- 3823189 TI - Behavioral effects of severe and moderate early malnutrition. AB - Rats with a history of prenatal and early postnatal undernutrition (6 or 8% casein diets) were "nutritionally rehabilitated" at weaning, and were compared to well-fed animals (25% casein) at maturity. The severely-malnourished (6%) animals were hyperactive in the open field and when tested in a stabilimeter. They also appeared to be highly active during the early trials in 8-arm radial maze testing where they made more arm entries and re-entry errors than the well-fed rats. In terms of trials to criterion, however, their scores on the radial maze and on a spatial alternation task fell within normal limits. The moderately-malnourished (8%) rats tended to perform at control levels on the learning measures, but these rats were not as active as the 6% rats on the measures of activity. Brain size and weight differences among the three groups of rats also are presented and discussed. PMID- 3823190 TI - Severe early malnutrition and DRL performance in the rat. AB - Rats with a history of severe early malnutrition (6% casein) were compared to well-fed control animals on an ascending series of DRL values ranging from 5 to 60 seconds. The 6% rats who were dietarily-rehabilitated at weaning did not differ from control animals in efficiency, responses per reinforcement or response rate. In contrast, rats chronically exposed to 6% diets performed so poorly during training with continuous reinforcement that they did not advance to even the first DRL (5-sec) condition. These findings show that severely undernourished rats can perform within normal limits on even high DRL values, provided they are well trained and that they have adequate nutritional rehabilitation. PMID- 3823191 TI - A simplified method for chronic portal vein cannulation in the rat. AB - A simple technique is described for chronic cannulation and repeated blood sampling from the portal vein of the conscious undisturbed rat. The method employs a straight cannula and allows precise location of the tip. Blood flow in the portal vein is not obstructed. The present technique was used in combination with chronic cannulation of the superior vena cava. Simultaneous blood sampling from the two cannulas was successfully carried out at fifteen minute intervals over six hour periods. The system and the sampling were well tolerated by the rats. PMID- 3823192 TI - Behavioral and biochemical studies of the substrates of median raphe lesion induced hyperactivity. AB - Many authors have demonstrated that electrolytic lesions of the median raphe nucleus lead to dramatic hyperactivity, but little is known as to the neural substrates of this effect. In the current series of experiments we investigated this question by examining locomotor activity and forebrain serotonin levels after the placement of wire knife cuts in various locations around the median raphe. Activity was measured in a five minute open field test and a one hour tilt cage test. Knife cuts designed to transect the major ascending serotonergic projections of the median raphe led to a pronounced depletion of forebrain serotonin, but had no effect on locomotor activity in either testing situation. Knife cuts located antero-ventral to the median raphe, designed to interrupt raphe connections with the ventral tegmental area and interpeduncular nucleus, increased activity in the tilt cage but not in the open field test. These cuts produced only small effects on forebrain serotonin levels. Knife cuts caudal to the median raphe failed to influence forebrain serotonin levels, but produced a significant increase in both open field and tilt cage activity. The effects of the posterior and the anteroventral cuts on tilt cage locomotion were additive, suggesting that different fiber systems were damaged by the two cuts. These results demonstrate that it is possible to double dissociate changes in forebrain serotonin levels and locomotor activity with lesions in the vicinity of the median raphe and further show that ascending projections are unlikely to be the only pathways involved in the effects of median raphe lesions on locomotor behavior. PMID- 3823193 TI - Influence of intracerebroventricularly infused anions on feeding response. AB - Chloride and bicarbonate solutions of potassium, calcium, sodium, and barium were infused into the third ventricle of the rats to observe the influence of anions on feeding response. Stainless steel cannulae were chronically implanted into the anteroventral part of the third ventricle of 54 rats, which were divided in 9 equal groups. While the control group was given 10 microliters of artificial cerebrospinal fluid intraventricularly, the remaining 8 groups received the equal quantity (10 microliters) of one of the hypertonic equimolar test solutions. Chloride solutions of potassium, calcium, and barium evoked significantly (p less than 0.05) higher feeding than the control group, while none of the bicarbonate solutions influenced feeding significantly. Chloride solutions of all the 4 cations elicited significantly (p less than 0.05) higher feeding than the corresponding bicarbonate solutions in 24 hr. It was observed that though the cations differed, there was no significant difference in the responses elicited by the different chloride solutions. Similarly, various bicarbonate solutions elicited similar responses. Osmolality and pH of the infusion solution have not influenced feeding significantly. It is concluded that the anionic, but not the cationic concentration of the fluid bathing juxtacerebroventricular sensors, predominantly influence the feeding response. PMID- 3823194 TI - Short-term taste behavior and copper/vitamin B-6 nutriture in Long-Evans rats. AB - The taste behavior of rats subjected to dietary depletions of copper and/or vitamin B-6 was tested. Weanling rats were fed casein-based methionine supplemented diets according to a 2 X 2 factorial design: -Cu/-vitamin B-6; Cu/+vitamin B-6; +Cu/-vitamin B-6; +Cu/+vitamin B-6. Short-term (18 min) taste tests were conducted daily to assess the effects of the dietary treatment on taste stimuli intake behavior; body weight and ad lib food and water consumption were monitored during the study. These measures showed that dietary copper deficits had no apparent effect on growth, ingestive behavior or short-term intake of preferred taste stimuli but did cause a marginal depression in the short-term intake of quinine solution. In contrast, vitamin B-6 depleted rats reduced their ad lib consumption of food and water, failed to grow and exhibited elevated taste stimuli intake during short-term tests. PMID- 3823195 TI - Schedule-shifts, circadian rhythms and lifespan of freely-feeding and meal-fed mice. AB - Mice feeding ad lib were subjected to weekly 12-hr shifts of the daily light-dark (LD) schedule beginning at either 7, 20 or 52 weeks of age and continuing until death. Other mice were meal-fed and, from 7 weeks of age until death, experienced weekly 12-hr shifts of the LD schedule alone (with mealtime fixed) or of both the LD schedule and mealtime. Telemetered core temperature data indicated marked differences in response to the different shift conditions and suggested, in the case of meal-fed animals, involvement of a food-anticipatory rhythm. Shifting of the LD schedule had no statistically significant effect on the mean survival time of mice feeding ad lib, regardless of when shifting began. While meal-feeding in itself prolonged life, the added imposition of schedule-shifting had no statistically significant effect on mean survival time, regardless of whether the meal schedule reinforced or opposed shifts of the LD schedule. In the latter case, tenth-decile survival time may have been increased. PMID- 3823196 TI - Maternal behavior in cyclic and androgenized female rats: role of ovarian hormones. AB - A comparative study on the induction of maternal behavior (MB) in response to pups was carried out in cyclic and androgenized rats. Moreover, the effects of exposure to ovarian hormones on the induction of MB in response to pups were studied in cyclic and androgenized rats. A high percentage of androgenized and proestrus rats displayed MB after 48 hr of exposure to pups (87.9% and 87.5% respectively). Diestrus day-1 rats were significantly less maternal (37.5%). Ovariectomy did not impair MB in androgenized rats. High serum progesterone levels induced in androgenized rats by treatment with 10 I.U. of HCG (40 hours before pup presentation) or with progesterone silastic implants prevented the onset of MB. Ovariectomy performed 8 hours before HCG administration restored MB. When behavioral testing began 72 hours after HCG treatment, 75% of the rats were maternal 12 hr after exposure to pups. This rapid onset of MB in proestrus and androgenized rats appeared to be estrogen dependent. The presence of progesterone inhibited the maternal response of androgenized rats. PMID- 3823197 TI - Contrasting responses to intruders and to involuntary separation by monogamous and polygynous New World monkeys. AB - The strength and quality of the relationship between heterosexual pairmates were compared in two species of New World monkeys, the polygynous squirrel monkey (Saimiri) and the monogamous titi monkey (Callicebus). This was accomplished by measuring behavioral and adrenocortical responses to intruders and to involuntary separation from the pairmate. The species diverged sharply in their responses to these conditions. For titi monkeys, the presence of an intruder resulted in a marked increase in behavioral signs of agitation, which were more prominent in the subject of the same sex as the intruder. Most male titi monkeys showed an increase in plasma cortisol in the presence of a male intruder; this pattern was not seen in their response to a female intruder. Female titi monkeys showed no consistent pattern of adrenocortical response to intruders of either sex. For squirrel monkeys, the presence of an intruder resulted in increased frequency of displays in male subjects, but not in female subjects. Both sexes showed a reliable reduction in plasma cortisol, below basal levels, in the presence of a female intruder, whereas no effect on cortisol was produced by a male intruder. Titi monkeys, but not squirrel monkeys, responded to separation with a significant increase in plasma cortisol and in behavioral indices of agitation or distress. PMID- 3823198 TI - Effects of social partners on pituitary-adrenal activity during novelty exposure in adult female squirrel monkeys. AB - Adult female squirrel monkeys from established social groups were exposed to novel surroundings either while alone or while with an adult female partner. The partner was either familiar and judged to be affiliative with the subject, familiar and not judged to be affiliative with the subject, or unfamiliar. The females' plasma cortisol levels were higher at the end of the 25th hr of exposure than at the end of the first hr when the females were alone or with a familiar partner, but not when they were with an unfamiliar partner. In no instance were cortisol concentrations greater when females were tested alone than when they were tested in the presence of a companion. Behavioral signs of distress were greater during the first as compared to the 25th hr of exposure and showed no influence of the presence of a partner. Contact/proximity between monkeys was greater during the 25th than during the first hour of exposure in the familiar partner judged to be affiliative and in the unfamiliar partner conditions. These results contrast with those of studies investigating the disruption of the mother infant relationship in squirrel monkeys, and provide further evidence that the pituitary-adrenal system of these animals is not responsive to the disruption of adult social relationships. PMID- 3823199 TI - Ingestion of amniotic fluid enhances opiate analgesia in rats. AB - Placenta ingestion has recently been shown to enhance opiate-mediated analgesia produced by morphine injection, footshock, or vaginal/cervical stimulation. The enhancement of the effect of endogenous opiates (especially analgesia) may be one of the principal benefits to mammalian mothers of placentophagia at delivery. During labor and delivery, however, mothers also ingest amniotic fluid (AF) which, unlike placenta, becomes available during, or even before expulsion of the infant. The present experiments were undertaken to determine whether AF ingestion, too, enhances analgesia; if so, whether the effect requires ingestion of, or merely exposure to, AF; whether the effect can be produced by AF delivered directly to the stomach by tube; and whether the enhancement, if it exists, can be blocked by administering an opiate antagonist. Nulliparous Long-Evans rats were tested for analgesia using tail-flick latency. We found that rats that ingested AF after receiving a morphine injection showed significantly more analgesia than did rats that ingested a control substance; AF ingestion, alone, did not produce analgesia; ingestion of AF, rather than just smelling and seeing it, was necessary to produce analgesia enhancement; AF produced enhancement when oropharyngeal factors were eliminated by delivering it through an orogastric tube; and treatment of the rats with naltrexone blocked the enhancement of morphine-induced analgesia that results from AF ingestion. PMID- 3823200 TI - Opiate antagonists and copulatory behavior of male hamsters. AB - A possible role of endogenous opioids in male copulatory behavior was examined in six experiments which studied the effects of opiate antagonists on the copulatory behavior of male hamsters (Mesocricetus auratus). In Experiment 1, the acute administration of naloxone hydrochloride (4 mg/kg, SC) ten minutes before testing significantly decreased mount frequency, intromission frequency, and ejaculation latency. In Experiment 2 males were tested weekly for three weeks. Half of the males were injected with naloxone ten minutes before each test and half with physiological saline. Naloxone administration reduced mount frequency, and intromission frequency while increasing the postejaculatory interval and the proportion of males displaying behavioral signs of satiety. In Experiment 3 similar effects were obtained following daily administration of naltrexone hydrochloride (10 mg/kg/day SC). In Experiment 4 males were allowed to mate to satiety. Naloxone treated males were more likely to display behavioral signs of satiety during the first ten minutes of these tests. In Experiment 5 it was demonstrated that naloxone administration did not alter the duration of insertion during either intromissions or ejaculations. In Experiment 6 the administration of naloxone did not facilitate the display of copulatory behavior by sexually inactive males. Overall the results are consistent with the hypothesis that opiate antagonists alter male copulatory behavior by enhancing the impact of stimuli occurring during the sexual interaction. PMID- 3823201 TI - Relationship between behavioral and autonomic thermoregulation in the guinea pig. AB - This study was conducted to correlate the preferred thermal environment of the unrestrained guinea pig with the activity of its thermoregulatory effectors when maintained under a wide range of ambient temperatures (Ta). Eight male guinea pigs were used in a series of experiments on behavioral and autonomic thermoregulatory function. In the behavioral experiment, individual guinea pigs were placed in a temperature gradient for 90 min while their position in the gradient was noted at 5 min intervals during the last 30 min of treatment. Their position in the gradient corresponded to a preferred Ta of 30.6 +/- 3.8 (S.D.) degrees C. In the experiments to determine autonomic function, individual guinea pigs were placed in an environmental chamber thermostabilized to Ta's of 16 to 34 degrees C. Metabolic rate (MR) and evaporative water loss (EWL) were continuously monitored for 90 min. After the guinea pigs were in the chamber for 90 min their colonic temperature was measured. MR was relatively stable between Ta's of 20 to 34 degrees C. The lower critical Ta, or the Ta below which MR increased above the resting level, was 20 degrees C for the guinea pig. EWL was minimal between Ta's of 14 and 28 degrees C. Increasing Ta above 28 degrees C led to a gradual increase in EWL. Thermal conductance was minimal and stable between Ta's of 14 and 26 degrees C and increased sharply as Ta increased above 26 degrees C. Colonic temperature was maintained at 38 degrees C between Ta's of 22 to 30 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823202 TI - Menthol inhibits the perception of warmth. AB - The effect of l-menthol on the ability to perceive gradual increases in skin temperature was measured in two experiments. Experiment 1 established that suprathreshold sensations of warmth generated on the vermilion border of the lip could be significantly attenuated by exposure to menthol in concentrations of 0.2 and 2.0% (in mineral oil). Experiment 2 demonstrated that exposure to the 2.0% menthol solution caused the threshold for warmth to rise significantly whereas the threshold for heat pain was unchanged. Although masking of sensations of warmth by menthol-induced sensations of cold is discussed as a possible explanation for the results, a direct effect of the menthol molecule on warm receptors (i.e., inhibition or desensitization) is considered a more likely explanation. PMID- 3823203 TI - Performance and perception at various combinations of treadmill speed and slope. AB - Three healthy young adult males were placed on a treadmill at 5 X 5 combination of speed and slope. They were instructed that the session would end when they had climbed 300 m. The results showed that the subjects' operant choices resulted in a quasi-constant duration of sessions, i.e., they tended to walk at constant power. Such a choice could be predicted from the sum of ratings for displeasure in the chest plus displeasure in the lower limbs. It is therefore likely that this bidimensional perception was the cue for working at constant power. PMID- 3823204 TI - Effects of early postnatal gonadal steroids on the successive conditional discrimination reversal learning in the rat. AB - In the present study the existence of sex differences in the acquisition, retraining and reversal of a successive conditional discrimination learning (Experiment 1) and the role of the early postnatal gonadal steroids on these discrimination tasks (Experiment 2) were investigated. In Experiment 1 two groups of experimentally naive rats (males and females) were exposed to a black-white successive conditional discrimination task in a T-maze. No sex differences were found in the acquisition or retraining. However, in the reversal phase females made fewer errors and reached the discrimination criterion (90% of correct choices) sooner than males. In Experiment 2, the absence of sex differences in the acquisition or retraining phases and the existence of sexual dimorphism in the reversal period were confirmed. In addition, female androgenization and male orchidectomy, on day one after birth, reversed the direction of the sex differences found in the successive conditional discrimination reversal learning. PMID- 3823206 TI - Daily fluctuations in the detectability of dim lights by humans. AB - Several aspects of retinal physiology are known to vary on daily or circadian cycles, suggesting that certain aspects of visual function might also vary. We measured absolute threshold--the dimmest visual stimulus that can be reliably detected--in seven human observers at mid-day (1200-1400) and mid-night (0000 0200), by means of standard psychophysical techniques. Five of the subjects were slightly more sensitive at night: they could detect stimuli that were on the average 20% dimmer at night than during the day, and this difference was not due to changes in the criterion for detection. Three of four subjects whose thresholds were measured hourly while they remained otherwise in total darkness for greater than 24 hours showed changes in absolute visual threshold that correlated with hourly changes in body temperature. These results suggest that the ability to detect dim lights varies systematically with time of day in many human observers. PMID- 3823205 TI - Lesions of the area postrema and underlying solitary nucleus fail to attenuate the inhibition of feeding produced by systemic injections of cholecystokinin in Syrian hamsters. AB - A large body of evidence indicates that the intestinal hormone cholecystokinin (CCK) may serve as a signal for satiety. The abdominal vagus has been shown to be important for the satiety response to exogenous, and by inference, endogenous, CCK in rats and hamsters. Thus, it appears that stimulation of CCK receptors on afferent fibers of the abdominal vagus activates a gut-brain pathway to signal satiety. The present study was undertaken to further trace this viscerosensory pathway by examining food intake after administration of one of two doses (2.0 and 8.0 micrograms/kg) of CCK-octapeptide to intact hamsters and to hamsters sustaining lesions of the area postrema (AP) and underlying nucleus of the solitary tract (NST), regions containing neurons postsynaptic to vagal afferent fibers. As lesions of the AP/NST result in many alterations in ingestive behaviour and body weight regulation in rats, various aspects of feeding and drinking behaviour (spontaneous food intake, body weight maintenance, and responsiveness to a palatable drinking solution and osmotic stimulation) were also examined in lesioned hamsters. Aside from producing transient hypophagia and weight loss immediately after surgery, AP/NST lesions had no effects on these various parameters of ingestive behaviour. The lack of lesion effects on these particular parameters may be explained on the basis that hamsters are generally unresponsive to many of the stimuli for feeding and drinking which purportedly act on the vagus and/or AP/NST. Hamsters with AP/NST lesions were as responsive to the two tested doses of CCK as intact animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823207 TI - Effects of Silastic progesterone implants on activity cycles and steroid levels in ovariectomized and intact female rats. AB - We have previously shown that although Silastic implants of progesterone reduce the amount of running of animals living in activity wheels, progesterone-treated animals continue to show periodic fluctuations or peaks in activity. We hypothesized that although progesterone treatment inhibited estrous cycles, ovaries of animals treated with Silastic implants of progesterone continued to secrete estradiol in amounts adequate to stimulate moderate levels of running. In the present study we tested this hypothesis by removing ovaries from progesterone treated animals and comparing their running behavior and steroid levels to progesterone-treated animals who received sham ovariectomies. Although progesterone treatment significantly inhibited running activity, removal of ovaries in progesterone-treated animals further suppressed running activity. In addition, both estradiol and progesterone levels were significantly reduced following removal of ovaries in progesterone-treated animals. We conclude that although Silastic progesterone implants inhibit normal ovarian and estrous activity cycles, ovaries produce sufficient estradiol to stimulate running behavior. PMID- 3823208 TI - Use of hypothermia for general anesthesia in preweanling rodents. AB - Documentation and rationale are provided for the use of deep hypothermia alone for anesthesia during surgical manipulations in young preweanling rodents and moderate hypothermia as an adjunct to other anesthesia in older preweanling animals. Techniques and applications for the procedure are also described. PMID- 3823209 TI - Physiological changes during copulation in male and female stumptail macaques (Macaca arctoides). AB - Radiotelemetric recordings were made of uterine contractions in female stumptail macaques, and of heart and respiratory rate in stumptail monkeys of both sexes, before, during and after copulation. These data were fed into a multichannel recorder, along with a spoken record of behavioral changes. Males' heart and respiratory rates were raised during penile thrusting, reached a peak and then fell sharply after ejaculation. Uterine movements were similar during successive copulations. After uterine movements associated with penile thrusting prior to ejaculation a rise in contraction force occurred which lasted about 15 seconds. It is in this period, if ever, that a climax face was displayed by the female. The female's look-back and reach-back behaviors were not linked to either the pattern of uterine contractions or the occurrence of the climax face. PMID- 3823210 TI - Correction of enophthalmos and superior sulcus depression in the anophthalmic orbit: a long-term follow-up. AB - The purpose of this study was to review the long-term results in anophthalmic patients treated for enophthalmos. The patients in our series had augmentation of the volume of their orbital contents by subperiosteal placement of room temperature vulcanized silicone. From 1972 to 1985, sixty-three patients received subperiosteal placement of room-temperature vulcanized silicone for their enophthalmos. Twenty-four of these patients were seen in long-term follow-up 1 to 13 years postoperatively. Indepth follow-up evaluation showed that room temperature vulcanized silicone subperiosteal implantation for the treatment of enophthalmos and superior sulcus depression in the anophthalmic orbit is a reliable, safe procedure that is without serious complications and has excellent long-term results. PMID- 3823211 TI - The Goldman tip in secondary rhinoplasty. AB - The ingenious division and suture of the mesial crura of the lower lateral cartilages devised by Goldman has found little utilization in recent years, even by surgeons familiar and experienced with this procedure. However, in secondary rhinoplasty, many of the disadvantages inherent in the Goldman tip can be turned to the surgeon's advantage and used to correct nasal tip defects which might otherwise prove refractory to treatment. Cartilage deficit, tip asymmetry, unacceptable bifidity, excessive tip elevation, hanging columella, and insufficient bulk are readily corrected with the Goldman tip and variations on its basic theme. This report covers the authors' 20-year experience with the Goldman tip, including a recent increase in the utilization of this procedure for secondary rhinoplasty. PMID- 3823212 TI - Beneficial effects of ibuprofen on experimental microvascular free flaps: pharmacologic alteration of the no-reflow phenomenon. AB - Pharmacologic alteration of the no-reflow phenomenon was determined based on increased tolerance to ischemia in ibuprofen-treated free flaps. Sprague-Dawley rats (N = 60) were divided into control (lactated Ringer's) and treated (ibuprofen) groups and subdivided into six groups of ischemia: 1 hour, 6 hours, 8 hours, 10 hours, 12 hours, and 14 hours of ischemia. Fluorescein uptake was measured after 10, 30, and 60 minutes following microrevascularization. Dye elimination studies were done for each ischemia group that demonstrated good fluorescein uptake. All free flaps in the 1-, 6-, and 8-hour groups survived. The ibuprofen-treated 10- and 12-hour flaps all survived, whereas the 10-hour control and 14-hour ibuprofen-treated free flaps failed to survive. Despite high fluorescein uptake, the 14-hour ibuprofen-treated flaps did not eliminate the fluorescein, whereas all surviving free flaps adequately eliminated the fluorescein. Failure to eliminate dye despite adequate uptake suggested a deranged microcirculation with increasing ischemia time. By inhibiting cyclo oxygenase, nonsteroidal anti-inflammatory agents such as ibuprofen may block the untoward effects mediated by thromboxane A2, such as vasoconstriction, microvasculature thrombus formation, and intravascular sludging. These effects are theorized in part to be responsible for the failure of a free flap to survive despite revascularization. PMID- 3823213 TI - Effect of arteriovenous flow reversal on blood flow and metabolism in a skin flap. AB - Twelve pig buttock island flaps (10 X 10 cm) were studied for 6 hours after arteriovenous flow reversal at the level of the pedicle. Follow-up was 48 hours. Blood pressure, Po2, pH, and lactate were measured in flap arteries and veins. Oxygen consumption was calculated. Data indicated true flow reversal. Blood pressure and Po2 in flap veins increased to systemic arterial levels. Outflow was provided by the arterial system, demonstrating venous pressure and Po2 values. Lactate increased significantly (1.8 +/- 0.5 to 4.0 +/- 2.3 mmol/liter), while pH dropped from 7.43 +/- 0.03 to 7.11 +/- 0.02. Oxygen consumption remained below baseline. In four flaps thrombosis occurred within 6 hours; no flap survived 48 hours. The results of this study do not encourage clinical application of the concept of flow reversal. PMID- 3823214 TI - The ulnar recurrent fasciocutaneous island flap: reverse medial arm flap. AB - A new island fasciocutaneous flap raised on the inner medial surface of the upper arm has been used for reconstruction of soft-tissue defects of the elbow. The blood supply to this flap comes from the fasciocutaneous perforators of the ulnar recurrent vessels. This unique vascular arrangement allows for safe transference of the upper medial skin to the elbow region. This flap has been used to cover nine defects in eight patients, and results have been good. Except for one case of sensory disturbance, there were no complications or loss of overlying skin. It is a relatively quick and simple procedure involving only one stage that adequately corrects the skin defect around the elbow region and does not require prolonged splinting. PMID- 3823216 TI - External longitudinal splitting of the tibialis anterior muscle for coverage of compound fractures of the middle third of the tibia. AB - In this modern era, compound fractures of the middle third of the tibia are relatively common. With the advent of external fixation, these fractures can be more rapidly and effectively dealt with, and attention can be directed to immediate coverage of the exposed bone. External longitudinal splitting of the anterior tibialis muscle offers a convenient and safe method for converting the open fracture to a closed one. The uniqueness of the tibialis anterior muscle is two-fold. It is circumpennate, and it has an internal axial tendon corresponding to almost its total length. Both these features impart to it considerable strength, and the muscle splitting herewith described does not appear to impair its function. Five treated limbs, each with loss of soft tissues overlying compound mid-third tibial fractures, are presented. Rapid healing and virtual absence of bone infection was observed in all cases. PMID- 3823215 TI - The anterior tibial artery flap: anatomic study and clinical application. AB - Satisfactory replacement of skin defects over the lower leg remains a difficult problem. Various forms of coverage, including, local rotation flaps, muscle flaps, and fascial and free flaps, have their specific indications and inherent disadvantages. In this work, a new axial skin flap based on perforating vessels in the territory of the anterior tibial artery is described. A series of 50 lower leg dissections was carried out in 25 fresh cadavers after latex injection into the femoral artery. Detailed studies of the cutaneous distribution of the anterior tibial artery showed that three main arteries perfuse the anterior lateral portion of the lower leg. The superior lateral peroneal artery and the inferior lateral peroneal artery interseptal cutaneous perforators arise at an average of 25.6 and 17.2 cm from the lateral malleolus, respectively. The superior lateral peroneal artery was present in 100 percent of the specimens, whereas the inferior lateral peroneal artery was present in 70 percent of the specimens. In their course, they give several muscular branches to the peroneus longus and brevis prior to perforating the fascia and arborizing in the subcutaneous tissues of the anterolateral portion of the leg. The average external diameter was 1.6 cm for the superior and 1.4 cm for the inferior lateral peroneal artery. The superficial peroneal nerve accessory artery is the third artery which contributes to the skin of the lower leg. It arises from the superior lateral peroneal artery in 30 percent of cases, from the inferior lateral peroneal artery in 40 percent, and from both in 30 percent. The artery runs along with the superficial peroneal nerve and gives several cutaneous perforators along its descending course. Several cutaneous axial flaps can be fashioned around this anatomy. The operative technique along with demonstrative clinical cases is presented followed by pertinent discussion. PMID- 3823217 TI - Reconstruction of soft-tissue defect of the posterior heel with a lateral calcaneal artery island flap. AB - We obtained most favorable results in 11 patients with a lateral calcaneal artery island flap. It is a simple, stable, sensate, and yet safe and versatile flap to repair defects around the ankle and heel. We have also used this flap to cover defects around the medial malleolus without any delay (extended lateral calcaneal artery island flap). PMID- 3823218 TI - The peripheral nerve allograft: an assessment of regeneration in the immunosuppressed host. AB - Regeneration across the nerve allograft in the immunosuppressed host was assessed using electrical and histologic parameters. The Lewis rat (RTIl) served as the recipient animal, and ACI rats (RTIa) provided the donor nerve allografts. Hydrocortisone and azathioprine were used in various dose schedules as the immunosuppressive agents. Animals were immunosuppressed for either 30 or 100 days. Histologic and electrophysiologic measurements of nerve regeneration were assessed at 30, 100, and 180 days. The degree of nerve regeneration was similar in all experimental groups. Short-term, low-dose immunosuppression was as successful as longer-term, higher-dose immunosuppression therapy. The degree of nerve regeneration in all experimental groups was significantly better than that in the fresh, untreated nerve allograft control group (Lewis/ACI) but was not as good as that seen in the autograft control group (Lewis/Lewis). PMID- 3823219 TI - Carpal tunnel syndrome and vitamin B6. AB - We reviewed 1075 patients presenting over a 12-year period with symptoms of carpal tunnel syndrome. A total of 994 had a final diagnosis of carpal tunnel syndrome. There were 444 male and 550 female patients with a mean age of 42 years. Three-hundred and ninety-five related symptoms to their job. Surgery was performed in 27 percent of the total diagnosed cases with approximately 97 percent relief of symptoms. Satisfactory alleviation of symptoms was obtained in 14.3 percent of patients treated conservatively prior to 1980, with one or a combination of splinting anti-inflammatory agents, job or activity change, and steroid injections. In 1980, vitamin B6 (pyridoxine) was added as a method of conservative treatment. Satisfactory improvement was obtained in 68 percent of 494 patients treated with a controlled dosage (100 mg b.i.d.). While our findings were not the result of a controlled scientific study, we feel they suggest that regulated use of vitamin B6 may be helpful in treating many cases of carpal tunnel syndrome. PMID- 3823220 TI - The new rapid vertical nystagmus syndrome: preliminary report. PMID- 3823221 TI - Chronic expanding hematoma. AB - Two cases of chronic expanding hematoma are presented. Although the location and presentation vary, chronic expanding hematoma has a distinct histopathologic pattern. A diagnosis of neoplasm is suggested by its slow growth pattern. The criteria for their formation are incompletely understood, and in one case, a hematoma occurred despite apparent adequate drainage. Computed tomography is helpful in distinguishing chronic expanding hematoma from other soft-tissue masses. PMID- 3823222 TI - Upper limb salvage using a free radial forearm flap. AB - Microsurgical transfer of a skin flap salvaged from a nonreplantable upper extremity that would otherwise be discarded may provide essential soft-tissue coverage of the amputation stump, so maintaining a functional range of motion in the elbow joint. A radial forearm free flap measuring 24 cm long by 9 cm wide was salvaged from the degloved forearm skin of a patient who sustained a proximal forearm amputation that was considered unsuitable for replantation. This allowed coverage of the proximal radius and ulna, preservation of a functional elbow joint, and successful fitting of a below-elbow prosthesis. PMID- 3823223 TI - A model for planning rhinoplasty. AB - A rhinoplasty model is detailed in which nasal shape is conceived as a dynamic system, the result of powerful expansive and contractile forces, of a skin sleeve in equilibrium with a dynamic skeleton, in which the alar cartilages are external to the remaining skeleton and support a large area of lower nasal skin. In this system, changes in one region have "global" effects. Consequently, one powerful way to control nasal shape is to maintain skin sleeve size and thus maintain the preoperative nasal equilibrium. The surgeon who controls the postoperative equilibrium controls the postoperative result. PMID- 3823224 TI - Lidocaine to relieve pain with tissue expansion of the breast. PMID- 3823225 TI - Suction lipectomy of the neck. PMID- 3823226 TI - Regional aesthetic units of the face. PMID- 3823227 TI - Priority for the latissimus dorsi myocutaneous flap. PMID- 3823228 TI - Viability of temporalis myo-osseous flap. PMID- 3823229 TI - Pentoxifylline and pedicle flap survival. PMID- 3823230 TI - Autologous fat transplantation. PMID- 3823231 TI - Flexible rhombic flap. PMID- 3823232 TI - Ectopic vascularization using the inferior epigastric system. PMID- 3823234 TI - Flexible rhombic flap. PMID- 3823233 TI - On curves and spirals. PMID- 3823235 TI - Incidence of cleft lip and palate among Japanese newborns, 1982 to 1984. PMID- 3823236 TI - A forceps to mark the navel. PMID- 3823237 TI - Cigarette smoking and face lift. PMID- 3823238 TI - Growth plate transplantation. PMID- 3823239 TI - Chronic infection as a possible cause of capsular contracture. PMID- 3823240 TI - Breast encapsulation following a minor distant infection. PMID- 3823241 TI - The groin flap for immediate reconstruction. PMID- 3823243 TI - Temporal fossa bone grafts: a new technique in craniofacial surgery. AB - The calvarium has become an increasingly popular bone-graft donor site. Previously described harvesting techniques are often difficult to perform and may produce unsatisfactory bone fragments. However, full-thickness bone grafts taken from the region of the temporal fossa, beneath the temporaiis muscle, have proven to be of high quality and technically easy to obtain. In our experience with eight patients, temporal fossa bone grafts were used primarily around the orbit, including reconstruction of the orbital floor, frontal bone, and zygoma. The procedure begins with a hemicoronal or bicoronal incision; the temporalis muscle is reflected, and an underlying bone plate up to 4 X 6 cm is removed. The resulting bone graft is consistently 3 to 4 mm in thickness. The cranial defect is packed with bone debris, and the muscle is replaced. This technique has proven to be safe, technically simple, consistently productive of high-quality bone grafts, and within discernible donor-site deformity. PMID- 3823242 TI - Influence of palatal fistulas on velopharyngeal movements: a cineradiographic study. AB - Ten patients with hard palate fistulas and velopharyngeal incompetence were examined cineradiographically with lateral and frontal projections during connected speech. The purpose was to study velopharyngeal function for open versus covered fistulas. Fistula length, width, and size were measured. With an open fistula, the degree of lateral pharyngeal wall activity was significantly correlated at the 0.05 level to fistula size. There was no statistically significant correlation between fistula size and the degree of velar activity. With the fistula covered, the velopharyngeal movements improved or even normalized in all patients regardless of fistula size. These findings indicate that patients with both velopharyngeal incompetence and an additional fistula will need covering of the fistula. If velopharyngeal incompetence persists after a temporary covering of the fistula, a combination of velopharyngeal flap surgery and fistula covering ought to be performed to normalize the velopharyngeal activity and speech and resonance. PMID- 3823244 TI - Microsurgical reattachment of totally amputated ears. AB - At a time when microsurgical reattachment of amputated limbs is commonplace, successful reattachment of total ear amputations is rare. Avulsed vessels, small diameters (0.3 to 0.7 mm), and technical difficulties provide primary obstacles. Three clinical cases of ear reattachments are presented which encompass the clinical spectrum of an uncomplicated success, a salvage of an impending failure, and a late failure due to venous thrombosis. In all cases there was difficulty with identification of vessels, with differentiation of arteries from veins, and in the performance of venous anastomoses. Vein grafts were necessary in two of the three patients. Anticoagulation was essential in alleviating venous thrombosis. Medicinal leeches (Hirudo medicinalis) were used to salvage one case with venous thrombosis. Despite the technical difficulties and long operative times, successful microvascular reattachment of an amputated ear is superior to any other means of reattachment or reconstruction. PMID- 3823245 TI - Extended use of sodium tetradecyl sulfate in treatment of hemangiomas and other related conditions. AB - Sodium tetradecyl sulfate, a sclerosing agent, has been used in 18 patients in the treatment of difficult hemangiomas not amenable to surgery alone, with or without adjunctive operation, in eyelid and lip lesions, in saccular and large posterior and hypopharyngeal hemangiomas, in Klippel-Trenaunay syndrome, in variceal bleeding around a Koch ileal pouch, and as an adjunct to selective embolization in a patient with a facial A-V malformation. Sodium tetradecyl sulfate was injected intralesionally in aliquots of 0.05 to 0.1 cc at multiple sites in total doses not exceeding 2.0 to 4.0 cc. Two patients showed questionable or no improvement. The remaining 16 patients experienced modest to striking improvement with only very minimal complications in the form of superficial desquamation of skin. The conclusion is, therefore, that sodium tetradecyl sulfate, used appropriately, is a safe and frequently effective agent in the treatment of hemangiomas and a number of similar or related problems. Clinical results will be presented. PMID- 3823246 TI - Squamous cell carcinoma of the parotid gland. AB - Squamous cell carcinoma involving the parotid gland is an aggressive and rapidly advancing lesion which if not recognized and treated early will result in a high morbidity and mortality. We reviewed 30 patients with squamous cell carcinoma involving the parotid gland. Twenty-four patients had had previous epidermoid skin lesions in an area known to drain to the parotid gland and three resulted from direct extension into the gland from an overlying skin carcinoma, whereas only three were primary lesions of the gland. Patients who presented with involvement of the gland more than 4 months after excision of the skin lesion had a poor prognosis. Patients with epidermoid skin cancer in areas with a propensity to secondarily involve the parotid gland must be closely followed after treatment of the primary skin lesion. PMID- 3823247 TI - Hidradenitis suppurativa: patient satisfaction with wound healing by secondary intention. AB - Ariyan and Krizek, in 1976, reported on three patients with perineal hidradenitis suppurativa who, following excision, achieved satisfactory closure allowing spontaneous wound healing by secondary intention. We have used this approach and have considered it very satisfactory from the surgeon's point of view. We now report from the point of view of patients and review the records of 20 consecutive patients with perineal hidradenitis treated by excision and secondary healing. Surgical results and patient satisfaction were assessed 1 year following complete wound closure. All patients reported minimal inconvenience and interruption of daily activities from this method of management. Analgesic requirements were minimal, and little reinforcement was necessary to maintain vigorous wound care. Uncomplicated wound closure was uniformly achieved with unrestrictive, stable scars providing long-term relief of this disabling disease. Two patients expressed dissatisfaction as a result of a new onset of disease in previously uninvolved and therefore unresected apocrine tissue. With this exception, patient satisfaction has been great and hospitalization time and costs reduced. PMID- 3823248 TI - The vastus lateralis myocutaneous flap. AB - Four case reports of decubiti treated with vastus lateralis myocutaneous flaps are presented. The operative technique is described in detail. This method, closing the donor site primarily over Hemovac drains and eliminating the use of skin grafts, can be used to cover defects in a variety of locations. PMID- 3823249 TI - Postquadrantectomy breast deformities: classification and techniques of surgical correction. AB - The deformity which is encountered following quadrantectomy (or similar procedures such as segmentectomy or partial mastectomy) and radiation therapy is difficult to evaluate objectively, and subjective assessment of the cosmetic outcome is extremely variable. In a group of 54 patients who underwent the procedure between 1979 and 1983, the types of cosmetic changes were evaluated and classified according to morphologic criteria. Four types of deformities and their related etiopathologic factors were identified. Type I is characterized by malposition and distortion of the nipple-areola complex and is mainly due to postoperative fibrosis and scar contracture. In type II deformity, localized tissue insufficiency is observed, which may be due to skin deficiency (type IIa), subcutaneous tissue deficiency (type IIb), or both (type IIab). Type III deformity is characterized by breast retraction and shrinkage and is mainly due to the effects of radiotherapy on residual breast parenchyma. In type IV deformity, severe radiation-induced damage to the skin, nipple-areola complex, and subcutaneous and glandular tissues is present. Surgical correction of each type of deformity is discussed, and examples are reported. PMID- 3823250 TI - Reaction to injectable collagen: results in animal models and clinical use. AB - Since its commercial release, Zyderm collagen implant has been used to treat more than 200,000 subjects in the United States for soft-tissue contour defects and more than 250,000 patients internationally (including the United States). Approximately 3 percent of subjects' skin tested with Zyderm collagen experience localized hypersensitivity reactions to collagen, whereas approximately 1 percent of treated patients demonstrate symptoms of hypersensitivity at treatment sites. Of the latter treatment responses reported since the conclusion of clinical trials with Zyderm, 56 percent occurred following the first treatment, 28 percent following the second, 10 percent following the third, and 6 percent following subsequent exposures. The data indicate that most patients receive a median of three treatments (mean = 4.4) with Zyderm collagen, but most patients who are likely to develop sensitivity to Zyderm collagen appear to respond immunologically to the test implant or first treatment exposure. Examining these treatment responses, 45 percent of the patients reported an onset of symptoms within 10 days and 22 percent at more than 30 days following the last treatment with Zyderm collagen. Erythema was the sole symptom in 24 percent of cases, whereas erythema plus induration comprised an additional 42 percent. Antibodies against Zyderm collagen were detected in the sera of 88 percent of these subjects using an ELISA, but no reactivity was observed against human collagen. Sera from patients reporting only systemic symptoms were not found to have anticollagen antibodies. These data suggest that the relative risk of a hypersensitivity reaction to Zyderm collagen does not increase with multiple exposures, since patients who are going to develop an immune response to bovine collagen react with greatest frequency to initial injections of collagen. In animal models, Zyderm collagen was shown to be less immunogenic than other medical devices which are composed of bovine collagen. Specifically, comparative studies were conducted in which Zyderm collagen and hemostatic agents were implanted in the guinea pig subcutaneum: sera from animals treated with collagen-derived hemostatic devices possessed significant levels of anti-implant antibodies (titers greater than 640), whereas animals treated with Zyderm collagen mounted minimal responses (titers less than 40). Additional studies were conducted in which implant materials were compared in a guinea pig parietal (bony defect) model and in a rabbit hemostasis model: in both, Zyderm collagen demonstrated lower immunogenicity than commercial bovine collagen hemostatic agents. Histologic results from these studies showed Zyderm PMID- 3823251 TI - Reinnervation of experimental superficial wounds in rats. AB - Sensory reinnervation of a superficial skin wound in the rat was studied by labeling sensory axons with anterogradely transported wheat germ agglutinin horseradish peroxidase. Reinnervation starts after 3 days from the edge of the wound as well as from beneath the wound. About 2 weeks after the production of the wound, some hyperinnervation appears to be present, but after a few additional weeks, the innervation pattern is essentially normal. The results indicate that structural recovery of sensory axons is rapid and probably complete when skin wounds heal with no or minimal scar formation. PMID- 3823252 TI - Reverse-flow island flap: clinical report and venous drainage. AB - Twenty-two reverse-flow island flaps were transferred. These included peroneal, forearm, anterior tibial, and temporal flaps. Sixteen of 22 flaps survived completely. We encountered partial necrosis in 4 flaps and total necrosis in only 2 flaps. We credit this success to the reliability and availability of the peroneal, forearm, and temporal flaps; but we do not encourage use of the anterior tibial flap. The flaps that survived well did not show any signs of venous congestion. The advantage of the reverse-flow island flap is that it can be transferred from a proximal to a distal location. Using cadavers and fresh amputated limbs, studies on venous drainage of the reverse-flow island flap were performed. The venae comitantes had numerous venous valves and communicating branches, but more than sufficient reflux of the venous blood occurred through the valves at pressures of 90 to 105 cmH2O. We believe that the venous drainage of the reverse-flow island flap occurs as a result of reflux actions at the valve, communicating branches between the venae comitantes, and bypass vessels around the valves. PMID- 3823253 TI - Survival of transferred intestinal segments after vascular pedicle interruption. AB - Rat intestinal segments with intact vascular pedicles were transferred from the abdominal cavity into the subcutaneous space. After 30 days, the vascular pedicle was severed. The intestinal segments, now completely dependent on wound neovascularization, survived completely. We conclude that early survival of intestinal transfers requires perfusion through the vascular pedicle. With time in a favorable bed, new vessel ingrowth from the recipient wound into the intestinal segment provides adequate circulation so that the vascular pedicle can be safely divided with no ill effect or at most a minor mucosal slough which quickly heals. Further clinical opportunities are necessary to determine the time course for these phenomena in humans. PMID- 3823254 TI - End-stage reflex sympathetic dystrophy. AB - Reflex sympathetic dystrophy is an automatic dysfunction that occasionally complicates healing after trauma or surgery. The syndrome is characterized by pain, swelling, stiffness, and discoloration often out of proportion to the original injury. Early diagnosis and appropriate treatment are the most important factors in the successful outcome of this disabling condition. A case of longstanding, previously untreated reflex sympathetic dystrophy secondary to a minor injury is presented. PMID- 3823255 TI - A hemorrhagic hazard of tissue expansion. AB - A case of delayed acute hemorrhage complicating tissue expansion of the scalp is presented. The likely mechanism was erosion of an occipital artery by the edge of the expander, and the risk of a similar occurrence should be considered in all patients undergoing tissue expansion. PMID- 3823256 TI - The expandable mammary implant. AB - An expandable saline-gel implant having a detachable injection dome is described. The implant functions initially as a tissue expander. Once the correct size has been obtained, the injection dome is removed, leaving the implant in position. PMID- 3823257 TI - A different rasp for rhinoplasty. AB - A new rasp for rhinoplasty is presented. It can be dismantled and has a renewable blade that looks like the one you find in a plane. The main advantage of this rasp is that it rasps the cartilaginous septum as well as the bony part of the hump. PMID- 3823258 TI - Rhinoplasty: the importance of consistent documentation and significant long-term follow-up. PMID- 3823259 TI - Unilateral cleft lip nose. PMID- 3823260 TI - The first step in phalloplasty in female transsexuals. PMID- 3823261 TI - Decrease in globe volume. PMID- 3823262 TI - Absorption and emission spectra of fluorescein in skin. PMID- 3823263 TI - Topical anesthesia in pediatric lacerations or putting away the papoose. PMID- 3823264 TI - Fat embolism. PMID- 3823265 TI - How does skin expansion work? PMID- 3823266 TI - The executive functions of the ego. An extension of the concept of ego autonomy. PMID- 3823267 TI - On "merging" and the fantasy of merging. PMID- 3823268 TI - The empathic wall and the ecology of affect. PMID- 3823269 TI - On trauma. When is the death of a parent traumatic? PMID- 3823270 TI - Trauma in childhood. Signs and sequelae as seen in the analysis of an adolescent. PMID- 3823271 TI - Reflections on the problem of psychic trauma. PMID- 3823272 TI - Special solutions to phallic-aggressive conflicts in male twins. PMID- 3823273 TI - The female Oedipus complex and the relationship to the body. PMID- 3823274 TI - Talking with toddlers. PMID- 3823275 TI - On the concept of mourning in childhood. Reactions of a 2 1/2-year-old girl to the death of her father. PMID- 3823276 TI - Denial in adolescence. Some paradoxical aspects. PMID- 3823277 TI - A paradigm of development. The psychoanalysis of an adolescent. PMID- 3823278 TI - Reconstruction of adolescence in adult analysis. PMID- 3823279 TI - Aspects of identity development among nouveaux religious patients. PMID- 3823280 TI - Disposition and the environment. PMID- 3823281 TI - Consequences of paternal nurturing. PMID- 3823282 TI - The analyst, his theory, and the psychoanalytic process. PMID- 3823283 TI - The development of sexual identity in homosexual men. PMID- 3823284 TI - Steps in self development. PMID- 3823285 TI - Transitory symptom formation in the analysis of an obsessional character. PMID- 3823286 TI - "Lying" and "lying". A case report of a paradoxical reaction to the couch. PMID- 3823287 TI - The specter of genetic illness and its effects on development. PMID- 3823289 TI - Nursery rhymes. A developmental perspective. PMID- 3823288 TI - Psychoanalytic studies and Macbeth. Shared fantasy and reciprocal identification. PMID- 3823290 TI - The contribution of child psychoanalysis to psychoanalysis. PMID- 3823292 TI - 'Narrow localizationism' in psychiatric neuropsychology. PMID- 3823291 TI - Causal explanation in science and in psychoanalysis. Implications for writing a case study. PMID- 3823293 TI - Stressor, vulnerability and depression: a question of replication. PMID- 3823294 TI - The cerebral cortical appearance in depressed subjects. AB - This paper describes a comparison of the cerebral cortical appearance of 101 patients with a history of clinical depression and 52 control subjects. An age related increase in sulcal widening was evident in both groups. However, after controlling for age, the patients were found to differ from control subjects in two respects: they had a greater amount of sulcal widening, most noticeably in the frontal and temporal areas; and there was a positive correlation between increasing sulcal widening and increasing lateral ventricular size not found in the control subjects. Patients with a past history of treatment by electroconvulsive therapy showed more sulcal widening in the parietal and occipital areas than those not so treated. PMID- 3823295 TI - Memory selectivity and unilateral cerebral dysfunction. AB - The relative speed of recall of pleasant and unpleasant experiences was investigated in patients with unilateral temporal lobe epilepsy and after unilateral temporal lobectomy. Indications have been obtained that right, but not left, temporal lobe dysfunction may impair hedonic aspects of memory selectivity. PMID- 3823296 TI - Verbal and non-verbal recall by depressed and euthymic affective patients. AB - This study uses matched-tasks methodology in order to test memory function in depressed and euthymic patients with major affective disorder. Neither drug-free depressed patients nor lithium-treated euthymic patients show a differential deficit in verbal versus non-verbal recall. However, while euthymic patients show no memory impairment, drug-free depressives do show poor memory functioning. The results support the view that memory deficits observed in affective patients in the depressed state are transient, secondary manifestations of depression and are neither indicative of underlying organic pathology, nor of abnormal hemispheric laterality. This suggests that memory impairment in depression can be treated by treating depressive symptoms, both chemically and behaviourally. The results also support the view that prophylactic lithium treatment has no adverse effects on these memory tasks. PMID- 3823297 TI - Bulimia nervosa in the male: a report of nine cases. AB - Nine male patients with bulimia nervosa, accounting for one in 24 bulimic patients attending a clinic for eating disorders, are described. Symptomatology and demographic characteristics were similar in males and females. A history of either anorexia nervosa or obesity was always present, and a chronic course was seen in 6 patients. Five of the men showed atypical sexuality. PMID- 3823298 TI - The social desirability of the type A behaviour pattern. AB - Nearly one hundred subjects completed two Type A behaviour questionnaires twice. First, they were asked to complete them honestly, reporting accurately on their behaviour patterns. Half of the subjects were then asked to fake good, presenting themselves in a positive light, and half to fake bad, presenting themselves in a negative light. There was only a marginal difference on one questionnaire's total score, with fake good subjects having lower Type A (i.e. higher Type B scores) yet nearly every individual question revealed large significant differences. The subjects' own A/B classification did not effect the way in which they faked the questionnaires. The results are discussed in terms of the literature on faking, lay concepts of psychological phenomena and the multidimensionality of the Type A concept. PMID- 3823299 TI - Social support, self-esteem and depression. AB - A prospective study of 400 largely working-class women with children living at home has used measures of self-esteem and 'social support' to predict the risk of depression in the following year once a stressor had occurred. Actual support received at the time of any crisis in the follow-up year was also measured. Self esteem was correlated quite highly with some of the measures of support. A core tie was defined as a husband, lover or someone named as very close at first contact. Negative evaluation of self (i.e. low self-esteem), and various indices of lack of support from a core tie at the first interview, were associated with a greatly increased risk of subsequent depression once a stressor occurred. Lack of support from a core tie at the time of the crisis was particularly highly associated with an increased risk. There was also a high risk among those who were 'let down' - that is, for those who did not receive the support which they might have expected in terms of the first interview material. It is concluded that it is essential for prospective enquiries to take account of the actual mobilization of support in the follow-up period. PMID- 3823300 TI - Clinical psychiatric illness in prisoners of war of the Japanese: forty years after release. AB - Clinical psychiatric and medical assessments were carried out on a randomly selected sample of Australian prisoners of war captured by the Japanese in 1942 and a sample of combatants from Pacific theatres of war who were not captured. Prisoners of war had significantly more anxiety and depressive 'neuroses' and more major affective illness, although the latter finding was not statistically significant. The two groups did not differ in the risk of alcohol abuse and dependence. PMID- 3823301 TI - Sex therapy outcome research: a reappraisal of methodology. 1. A treatment study of male sexual dysfunction. AB - In the first section a controlled treatment study of male sexual dysfunction is described. 'Unlucky' randomization of subjects yielded treatment groups which differed with respect to variables of possible prognostic significance. Hence the results are largely uninterpretable. In the second section the predominantly negative or inconsistent findings in sex therapy outcome research are reviewed and methodological problems, such as those described in the first part, are considered as possible reasons for these negative findings. The interrelationships are explored between small treatment groups, prognostic variability, bias, power, and small expected treatment effects. A strategy for future research is proposed, with particular emphasis on the recognition and use of relevant prognostic indices. PMID- 3823302 TI - Idiot savant calendrical calculators: rules and regularities. AB - The three experiments described aimed to establish whether the achievements of idiot savant calendrical calculators were based solely on rote memory and arithmetical procedures, or whether these subjects also used rule-based strategies. It was found that, although different structural calendar regularities were tested by using differing experimental paradigms, all subjects could at least use some of the rules under investigation. The more cognitively able subjects could make use of all the three structural regularities of the calendar tested here. It was concluded that idiot savant calendrical calculators can use rule-based strategies to aid them in the calculation of the days on which past and future dates fall. PMID- 3823303 TI - Behaviour problems in severely mentally handicapped children. AB - A population study was undertaken in two health districts of children with severe mental handicap. Prevalence figures for behaviour problems are presented. A stratified random sample of 200 families was drawn from the population. Detailed structured interviews were carried out with the children's parents. The children were divided into two groups, comprising those with behaviour problems and those with no problems. There was a significant association between behaviour disorder and incontinence, lack of self-help skills, poor reading, writing and counting skills, and poor communication skills. Environmental correlates were few. There were no differences between groups in family size, birth order, age of parents, marital discord, social class or income. However, behaviour problems were more common in one-parent families. An association was found between maternal stress and problem behaviour. The possible mechanisms underlying this association are discussed. PMID- 3823304 TI - A perspective on disgust. PMID- 3823305 TI - A model for stimulus generalization in Pavlovian conditioning. PMID- 3823306 TI - Skilled actions: a task-dynamic approach. PMID- 3823307 TI - Selective attention in emotionally disturbed/behavior-disordered children. PMID- 3823308 TI - Shyness situations: perspectives of a diverse sample of shy females. PMID- 3823309 TI - Relationship of burnout among professional psychologists to professional expectations and social support. PMID- 3823310 TI - Empathy and the experiencing of loneliness. PMID- 3823311 TI - Trait-anxiety differences among medical students. PMID- 3823312 TI - Dimensionality of the short form of the Beck Depression Inventory: a study with Iranian college students. PMID- 3823313 TI - Eating, drinking, and smoking and their relationship in adult women. PMID- 3823314 TI - Older adolescents' differential expectations of infants' development. PMID- 3823315 TI - Is personality related to judgments about sexual harassment? PMID- 3823316 TI - Clusters of suicide. PMID- 3823317 TI - Assessing perceptions of self and God: comparison of prisoners and normals. PMID- 3823318 TI - Sensation seeking in a female bulimic population. PMID- 3823319 TI - Spontaneous attributions of heavy drinking by men and women who drink frequently or infrequently. PMID- 3823320 TI - Dysplasia and psychological health. PMID- 3823321 TI - Factor analysis of internal and external self-control practices for alcohol consumption. PMID- 3823322 TI - Effects of two hypnotic induction procedures on overt and subjective response to two measures of hypnotic susceptibility. PMID- 3823323 TI - The compensatory conditioned response to brain stimulation-induced feeding a preliminary study. PMID- 3823324 TI - Effect of marital discord on parental reports on the Child Behavior Checklist. PMID- 3823325 TI - Cognitive patterns of two types of aggressive felons. PMID- 3823326 TI - Psychosocial and other factors in excessive drinking of homosexuals and the general population: opinions of alcohol intervention workers in Ontario, Canada. PMID- 3823327 TI - Self-concept of lesbian and heterosexual women. PMID- 3823328 TI - Therapists' orientation and defensive styles. PMID- 3823330 TI - Suicide from the Golden Gate Bridge: do they cluster over time? PMID- 3823329 TI - Frequency of physical aggression in heterosexual and female homosexual dyads. PMID- 3823331 TI - Social and conversational skills training with long-term psychiatric inpatients. PMID- 3823332 TI - Note on the validity of the Dutch State-Trait Anxiety Inventory with surgical patients. PMID- 3823333 TI - Addressing issues in letter recognition. PMID- 3823334 TI - Routes to action in reaction time tasks. PMID- 3823335 TI - Is stimulus persistence affected by eye movements? A critique of Davidson, Fox, and Dick (1973). PMID- 3823336 TI - Separability of different negative components of the event-related potential associated with auditory stimulus processing. PMID- 3823337 TI - Maturation of startle modulation. PMID- 3823338 TI - Stimulus rise time, intensity, and bandwidth effects on acoustic startle amplitude and probability. PMID- 3823339 TI - The effects of cognitive set on the electrodermal orienting response. PMID- 3823340 TI - Predicting response to a reaction time task: heart rate reactivity compared with type A behavior. PMID- 3823341 TI - Sex differences in physiological reactions to real life stress and their relationship to psychological variables. PMID- 3823342 TI - Psychophysiological response patterns to single, double, and triple stressors. PMID- 3823343 TI - ERPs to laterally presented pictures and words in a semantic categorization task. PMID- 3823344 TI - Multiple P3s to emotional stimuli and their theoretical significance. PMID- 3823345 TI - A solution for reliable and valid reduction of ocular artifacts, applied to the P300 ERP. PMID- 3823346 TI - The correction of EOG artifacts by frequency dependent and frequency independent methods. PMID- 3823347 TI - Differences between skin resistance and skin conductance responses with respect to change over trials: a mathematical explanation. PMID- 3823348 TI - Immune function in unemployed women. AB - Immunologic effects of unemployment were prospectively studied in women over a period of 8 months. Subjects were classified into three groups depending on their employment history, and were studied concomitantly. Group A consisted of unemployed women who were recipients of traditional support from the Swedish welfare state. Group B was composed of unemployed women who were given the opportunity to participate in a psychosocial program, in addition to receiving the traditional unemployment benefits received by group A. Group C, the control, consisted of securely employed women. Phytohemagglutinin (PHA) reactivity of lymphocytes decreased significantly in both groups of unemployed women after 9 months of unemployment. The psychosocial program did not counteract this decrease. Reactivity to purified protein derivative (PPD) of tuberculin also decreased significantly in the unemployed subjects. No changes were observed in the securely employed women. There were no significant differences among the groups in T cell subpopulations, B cells, and serum cortisol. The data suggest that some aspects of the immune system may be altered at a specific time period following the loss of work. Further studies are needed to see if this effect is only temporary or more long lasting. PMID- 3823349 TI - Defense style and the perception of asthma. AB - Approximately 15% of patients with bronchial asthma are unable to sense marked changes in airway obstruction. We have investigated the hypothesis that inability to sense changes in the severity of bronchial asthma varies with insensitivity to emotional arousal, which in turn is associated with repressive defense styles. Nine asthmatic patients were studied comparing actual changes in peak flow rate using a coded peak flow meter and in arousal during a stress-inducing psycholinguistic protocol with perceived changes. Our hypotheses were confirmed. Ability to perceive changes in asthma could be predicted from performance on the psycholinguistic stress test (Spearman's rho = +0.733, p less than 0.01). Repressors performed significantly worse on the asthma perception task (Spearman's rho = -0.650, p less than 0.05). The results suggest a role for defense pathology in the psychomaintenance of asthma. PMID- 3823350 TI - A follow-up study of thirty hospitalized bulimics. AB - Thirty normal-weight female bulimics were followed up 2-5 years following hospital admission using semistructured interviews and psychometric measures. Inasmuch as bulimia was only recently designated a distinct disorder, questions have emerged with regard to its clinical course and diagnostic validity. Results of this investigation suggest that bulimia displays a chronic but tractable course in that the majority of the patients continued to report bulimic behaviors at follow-up but the symptom intensity was greatly reduced from admission. The characterization of three bulimic outcome groups suggests that the outcome pattern of this disorder is heterogeneous, with some patients becoming symptom free and others remaining severely afflicted. The durability of the symptoms and the failure of new psychiatric syndromes to emerge in the follow-up period is evidence that bulimia is a distinct diagnostic entity and not a variant of another underlying condition. The methodologic limitations of this study are addressed. PMID- 3823351 TI - Body composition, body size estimation, and attitudes towards eating in male college athletes. AB - A number of different parameters relating to eating history and body composition were examined in male college athletes during the course of an athletic season. Wrestlers, who often lose weight to meet the requirements of the sport, were compared with other athletes (swimmers, nordic skiers) who typically maintain weight during vigorous training. By the end of the athletic season, the wrestlers had reduced body weights and reported a reduction in caloric intakes. Wrestlers scored higher than swimmers and nordic skiers on scales measuring dietary restraint and attitudes towards eating (EAT). The groups differed primarily on items dealing with fluctuations in body weight and with dieting behaviors. There were no significant differences between groups on the estimates of body size and no effect of seasonal training. However, a small subsample of the wrestlers who scored high on the restraint and EAT scales also showed distortions in estimates of body size. Wrestlers may represent a population at risk for the newly reported sports-induced disturbances in eating. PMID- 3823352 TI - Effects of expectancies on women's reports of moods during the menstrual cycle. AB - Social expectancies are assumed by many researchers to influence the reporting of menstrual and premenstrual symptoms. This study investigated the role of expectancies by attempting to manipulate college women's expectancies for a negative mood-menstrual relationship and observing the effect on self-reported daily moods. One group of women viewed a videotaped lecture designed to increase expectancies for a negative mood-menstrual relationship while a second group viewed a lecture designed to decrease such expectancies. A third group was exposed to a lecture on an unrelated topic, and a fourth, blind control group was neither exposed to a lecture nor aware that the study was concerned with the menstrual cycle. Expectancies were assessed immediately before and after presentation of the lectures. In addition, all participants monitored their moods for 40 consecutive days, after which expectancies were reassessed. Results indicated that expectancies were altered in the predicted directions by the experimental manipulations, with group differences apparent even at the 40 day follow-up. Even more importantly, daily moods during the course of the menstrual cycle were also affected by the manipulations, thus supporting the importance of expectancies as a determinant of mood. PMID- 3823353 TI - A comparison of biofeedback-assisted cardiodeceleration in type A and B men: modification of stress-associated cardiopulmonary and hemodynamic adjustments. AB - The primary purpose of this experiment was to examine the cardiac effects of instructions and biofeedback to reduce heart rate during both rest and a behavioral stressor. A second purpose was to assess respiratory, hemodynamic, and metabolic function in conjunction with heart rate. A final aim was to compare the effects of biofeedback on Type A and B men. Type A subjects fell in the upper 10% of the distribution of Jenkin's Activity Survey scores and Type B subjects fell in the lower 10%. Subjects experienced one of three instructional sets during an initial session: instructions to reduce heart rate with biofeedback; instructions to reduce heart rate without biofeedback; and instructions to sit quietly. During a second session, all subjects received identical instructions prior to the behavioral stressor. Heart rate, pulmonary gas exchange, and ventilation were measured breath-by-breath. During the first session, the groups did not differ in any measured parameter, but Type As had higher heart rates than did Type Bs across all conditions. During the second session, subjects given instructions to reduce heart rate with and without biofeedback did not differ in heart rate; as expected, however, both of these groups had smaller increases in heart rate than did the control group. Interestingly, the tachycardia of the control group occurred without an increase in oxygen consumption, indicating a cardiac metabolic dissociation in this group. The modification of heart rate without a concomitant change in metabolism is important in understanding the association between cardiac and metabolic function. PMID- 3823354 TI - Models of mental health training for primary care physicians: a validation study. AB - Since the majority of persons with alcohol, drug abuse, and/or mental disorders (19%) of Americans during any 6-month period are seen exclusively within the general health sector, it is imperative to know the quality and quantity of mental health training for primary care residents. In this study, the five program training model types previously described--Consultation, Liaison, Bridge, Hybrid, Autonomous--are validated by a random sampling technique using a structured instrument to test eight hypotheses developed before data collection to preclude post hoc interpretations. Of 250 programs, 147 responded (60%): 67 Family Practice, 42 Primary Internal Medicine, and 38 Internal Medicine. Since all eight hypotheses were supported by the data, the construct validity of the program model types is significantly substantiated. Multiple discriminant analysis revealed that the relationships between twelve training program characteristics and the five program model types were such that the former could explain 57% of the variance in the latter and correctly classify 89% of the programs. PMID- 3823355 TI - Comparison of depressed and nondepressed women with severe premenstrual tension syndrome. AB - There is a need to better understand the relationship between premenstrual tension syndrome (PMS) and premenstrual depression. This research was designed to determine if severely depressed women experience a different kind of premenstrual dysfunction than nondepressed PMS patients. The nature and severity of premenstrual symptoms in both groups were evaluated and compared. The severely depressed women were found to have higher PMS scores, but did not differ from the nondepressed group in selection or ranking of symptoms. Depression appeared to influence the patient's perception and rating of symptoms, but the underlying premenstrual dysfunction was identical. PMID- 3823356 TI - Relation of family factor to treatment outcome for bulimic patients. AB - The psychotherapy of 25 normal weight bulimic adolescent and late adolescent women (age 15-32 years, mean = 21 years), was reviewed to evaluate developmental and diagnostic precursors and the outcome of psychoanalytically oriented long term therapy (mean = 33 sessions). Psychotherapy outcome was scored in these categories: bingeing and purging; food obsession; school/work satisfaction; equilibration with family of origin, and achievement of heterosexual closeness. On factor analysis, all factors loaded highly and a global outcome score was derived which was used as the dependent variable in a step-wise regression analysis with 18 family factors as independent variables. To identify family patterns that predicted degree of improvement, a multiple regression analysis was performed. Results indicated that family variables associated with maternal warmth explained an appreciable proportion of the variance in outcome. Such a finding is consistent with the formulation that patients with benign archaic maternal representations were better able than their counterparts with less benign maternal images to form a positive transference and better working alliance with the (female) therapist. PMID- 3823357 TI - Prediction of alexithymic characteristics from physiological, personality, and subjective measures. AB - Noting concerns for a comprehensive conceptualization of alexithymic characteristics, the present study examines the potential utility of considering these characteristics as manifestations of deficits in cognitive schemata. Research guided by this conceptualization has identified physiological, subjective, and personality features of alexithymic characteristics. It is reasoned that if this conceptualization has merit, it should be possible to predict the presence of alexithymic characteristics from these features. Results of the present study indicate that a combination of physiological, subjective, and personality variables significantly predicts the presence of alexithymic characteristics as measured by the Schalling-Sifneos Personality Scale. These results are discussed in terms of their implications for a more comprehensive description of alexithymia and the value of the cognitive schema conceptualization. PMID- 3823358 TI - Emotions and personality in complex partial seizures. AB - Using the emotion profile index (EPI) and the Bear and Fedio personality inventory (PI), we investigated the influence of hemispheric localization of epileptic foci on emotions and personality in 24 patients with complex partial seizure. On the EPI, left patients showed a paranoid and depressed personality and gave a negative image of themselves, whereas right patients rated themselves in a positive way. On the PI, left and right patients showed an epileptic behavioral syndrome. Left patients were more depressed, guilt-ridden and aggressive than right patients. PMID- 3823359 TI - The Schalling-Sifneos Personality Scale revised. PMID- 3823360 TI - Nurturing the biomedical research enterprise. PMID- 3823361 TI - Lack of tolerance of morphine-induced spasm of guinea pig sphincter of Oddi. AB - To determine whether guinea pigs chronically exposed to morphine would develop tolerance to the morphine-induced contraction of the sphincter of Oddi (SO), adult male guinea pigs were implanted with morphine pellets (100 mg morphine). The effect of increasing IV doses of morphine on the SO was assessed by determining the duration of which saline perfusate stopped flowing into the duodenum of morphine-treated guinea pigs (MTGP) vs nonimplanted animals (non MTGP). Isolated bovine and guinea pigs SO were also challenged with morphine. In the in vivo experiments the spasmogenic response of the SO from MTGP to morphine was greater than that of SO from non-MTGP. However, morphine had no effect on isolated SO. These results indicate that chronic morphine exposure does not result in tolerance of the SO to the spasmogenic effects of morphine. On the contrary, chronic morphine even sensitized the SO to morphine, in addition, the in vitro data indicated that morphine does not act directly on the smooth muscle of SO to cause its spasmogenic effect. PMID- 3823362 TI - [Comparative study of 2 latex tests (rubalex and rubascan) with an immunoenzyme test (enzygnost-rubella) and a hemagglutination inhibition test for the study of anti-rubella antibodies]. AB - Four different assays for detection of rubella IgG antibodies, two latex agglutination (Rubalex and Rubascan), one hemagglutination inhibition (HAI) and one enzyme-linked immunosorbent assay (ELISA IgG), were used to test 372 human serum samples. All samples were also tested with a rubella ELISA IgM test and all of them were found negative. The results obtained in 358 (96.2%) out of 372 samples tested were identical with all procedures. Inconclusive results were obtained in 14 (3.8%) specimens, in that there were positive and negative results for the different assays. These 14 specimens were sent to the Institute of Virology in Turku (Finland) and tested by using a hemolysis in gel and a non commercially-available ELISA IgG test. Results obtained with the two last tests were considered definitive. The two latex tests were found equal or better than HAI and ELISA IgG for sensitivity and specificity. Furthermore they were also cost effective and more simple to perform. PMID- 3823363 TI - [IgM ISAGA test in the diagnosis of acute acquired Toxoplasma infections]. AB - An immunoglobulin M immunosorbent agglutination assay (IgM ISAGA) was tested in 1804 outpatients' samples. The test was negative in all 1091 sera from individual negative in the total indirect immunofluorescence antibody (IFA tot) test and in the passive hemagglutination (HA) test and in 15 sera with inconclusive results in these two tests. The 698 sera positive in the IFA tot and HA tests were also tested with direct IgM enzyme-linked immunosorbent assay (IgM ELISA). The 74 sera positive in the IgM ISAGA and/or IgM ELISA were also tested in the IgM immunofluorescent (IgM IFA) test. These sera belong to 42 individuals, 26 of whom were followed for previous positive results in the IgM ELISA test. 51 samples (68.9%) were found positive in both IgM ISAGA and IgM ELISA tests. Only 13 (25.5%) of these 51 samples were found positive in the IgM IFA. 9 samples (12.2%) were positive only in the IgM ISAGA test. Conversely another 9 samples (12.2%) were positive only in the IgM ELISA test, performed on serum as well as on chromatographic IgM fraction. Finally five samples (6.7%) yielded false positive results in the IgM ELISA test, and three of them were found false positive also in the IgM IFA test. All these five samples in fact were found negative on IgM chromatographic fraction in both tests. In conclusion, IgM ISAGA appears to be more specific than direct IgM ELISA or IgM IFA test for the detection of Toxoplasma gondii IgM. Sensitivity of IgM ISAGA test seems to be as good as in the direct IgM ELISA and better than in the IgM IFA test for the diagnosis of acute acquired toxoplasma infection. PMID- 3823365 TI - [Epidemiologic surveillance of influenza in Rome 1982-1984]. AB - In the periods from July 1982 to June 1983 and July 1983 to June 1984, 31 strains of influenza virus, of which 19 A/H3N2 6 A/H1N1 and 6 type B, were isolated from 242 throat cultures obtained from patients with acute febrile respiratory disease. A seroepidemiological survey on 520 serum samples confirms significant activity of influenza viruses during the winterly period of 1983-1984. In the period July-August 1983 the evaluation of mortality from respiratory diseases presents an excess in respect of epidemic threshold probably ascribable to heat stroke. PMID- 3823364 TI - [Analysis of various lipid parameters in relation to occupational activity and smoking and alcohol drinking habits in a homogeneous population sample]. AB - The authors examine some lipidic parameters in a sample of people that represents a district in the province of Ancona (Italy). After specifying the intervals of reference, they take into consideration the subjects included in the group of study in connection with their working activity and their custom of drinking and smoking. PMID- 3823366 TI - [Determination of circulating immune complexes and complement activation in patients with urticaria-angioedema syndrome]. AB - In the present study, we examined 102 patients with chronic urticaria and angioedema. The incidence of immune complexes (CIC)-mediated chronic urticaria with complement activation (C3b+) was 11.7% (12/102 patients). The 12 patients with CIC and C3b was divided in three diagnostic groups: with drug adverse reactions; with systemic disorders; without apparent associated pathologies. On the basis of data obtained it is remarkable the necessity of a careful etiologic diagnosis in presence of CIC mediated-chronic urticaria particularly when it is associated with arthralgies and/or elevated erythrocyte sedimentation rate (ESR) because of a likely presence of a serious systemic pathology. PMID- 3823367 TI - [Monoclonal antibodies in immunohematology. Evaluation in the ABH and Lewis systems]. AB - Titration, avidity and specificity tests using anti-A, anti-B, anti-AB, anti-H, anti-Lewis a and anti-Lewis b mouse monoclonal antibodies were studied, in comparison with polyclonal sera. Monoclonal antibodies results were comparable to those obtained with polyclonal sera, any aspecific reactions have not been observed. PMID- 3823368 TI - [Correlation between plasma concentration of heparin and biological response determined by 2 APTT reagents of different sensitivities]. AB - Among 56 patients with elevated thromboembolic risk, subject to intravenous infusion of heparin, we have determined the relation between hematic concentration of heparin and activated partial thromboplastin time (APTT), surveyed by two reagents with different sensitivity. The obtained results shown a very good correspondence without significant differences between the APTT reagents used, especially inside the therapeutic range. Otherwise a good correlation is demonstrated between methods, relative to two different chromogenic substrates, applied to heparin determination. PMID- 3823369 TI - "In vitro" production of immunoglobulins and rheumatoid factor by peripheral lymphocytes of aged humans. PMID- 3823370 TI - [Urinary infections in patients in the U.S.L. 25 Val di Cornia. Percentage frequency and sensitivity to antibiotics]. AB - In order to estimate the present situation concerning bacterial resistance to a group of widely-used antibiotics, the results of several antibiograms, which were carried out from October 1984 to February 1985 on bacterial stocks isolated from urinary cultures sent to the Laboratory of Clinical Chemistry at the Campiglia Marittima Hospital U.S.L. 25 (Livorno) have been collected. The bacterial species most frequently observed are Gram-negative, namely: Escherichia coli (54%), Proteus (19%), Klebsiella (13%) and Pseudomonas (9%). E. coli turned out to be particularly sensitive to cephotaxim, phosphomicin, nalidixic acid but only slightly to gentamycin. Klebsiella was very sensitive to cephotaxim, gentamycin and amikacin, while Proteus reacted positively against cephotaxim, aztreonam and oxolinic acid. Pseudomonas was resistant to nearly every antibiotic examined, except amikacin and aztreonam. Overall analysis reveals that cephotaxim an aztreonam are the most active on E. coli, Proteus and Klebsiella, while gentamycin is only slightly. PMID- 3823371 TI - Cell survival and radiation induced chromosome aberrations. I. Derivation of formulae for the determination of transmission and survival parameters of aberrations. AB - Existing mathematical formulations to predict the frequency of radiation induced chromosome aberrations in 2nd post-irradiation division are based on the Poisson distribution [3, 4]. Meanwhile several studies have shown that intercellular distributions exist, deviating from Poisson. In the present study a modified model was developed which permits the application of empirical distributions. Transmission and survival parameters of aberrations can be iteratively computed. A general formula was derived for the calculation of cell survival from 1st to 2nd division. PMID- 3823372 TI - Cell survival and radiation induced chromosome aberrations. II. Experimental findings in human lymphocytes analysed in first and second post-irradiation metaphases. AB - Human peripheral lymphocytes were irradiated in whole blood with 0.5-4.0 Gy of 220 kVp X-rays and the frequency of chromosome aberrations was determined in 1st or 2nd division metaphases discriminated by fluorescence plus giemsa staining. Using the empirical distributions of aberrations among cells, cell survival and transmission of aberrations were investigated. Considering both daughter cells, we found that 20% of fragments and 55% of dicentrics or ring chromosomes are lost during the 1st cell division; i.e. cell survival rate from 1st to 2nd generation is mainly influenced by anaphase bridging of these two-hit aberrations. Cell survival to 2nd mitosis was calculated considering this situation and compared with the survival derived from the fraction of M 1 cells without unstable aberrations. The resulting shouldered survival curves showed significantly different slopes, indicating that cell reproductive death is overestimated in the latter approach. PMID- 3823373 TI - Photosynthetic efficiency. AB - The efficiency of photosynthesis is discussed in analogy to the solar cell. The total efficiency eta can be written as a product of factors eta i concerning different loss processes. The fraction of photon energy hv which is available for photosynthesis in the membrane, usually called the thermodynamic efficiency eta th, is calculated. An upper limit of eta th is found by means of the second law of thermodynamics. Other factors take into account losses by reflection, absorption and by various irreversible processes of the photochemical pathways. PMID- 3823374 TI - Time-resolved fluorescence of conifers exposed to environmental pollutants. AB - With regard to an early diagnosis of defects within the photosynthetic system of conifers by air pollutants, we measured the chlorophyll fluorescence from microscopic parts of individual pine and spruce needles. In particular, different spruces had been exposed before to well-defined doses and concentrations of ozone and SO2. In addition to spectral distributions and time courses of fluorescence intensity, fluorescence lifetimes were detected after picosecond laser pulse excitation. Time constants of tau 1 = (0.10 +/- 0.02) ns and tau 2 = (0.50 +/- 0.10) ns were measured for intact photosynthesis; an increase of tau 2 and a further time constant tau 3 = (2.5 +/- 0.5) ns were found, if defects within the photosynthetic system occurred. Most significant defects were so far measured after exposition to high ozone doses during longer time periods. PMID- 3823375 TI - Application of chlorophyll fluorescence in ecophysiology. AB - In vivo chlorophyll fluorescence measurements have become a valuable tool in ecophysiology. Fluorescence emission spectra are influenced by the reabsorption of the tissue and indicate the composition of the antenna system and are influenced by the chlorophyll content per leaf area. The fluorescence induction kinetics ("Kautsky effect") can be used to study photosynthetic activity. These rapid, non-destructive methods can be applied for ecophysiological field research to check the vitality of plants and to document stress effects on the photosynthetic apparatus. The Rfd-values (Rfd = fd/fs), the ratio of the fluorescence decrease (fd) to the steady state fluorescence (fs), can be taken as a rapid vitality index of the leaves and trees. We here describe fundamental chlorophyll fluorescence results of leaves which are needed for the interpretation of in vivo fluorescence signatures in stress physiology and in the forest dieback research. PMID- 3823376 TI - [Mathematical model of interphase cell death. Biophysical justification and generalization]. AB - The authors propose a biophysical justification of a radiation-induced injury and interphase death of cells. The injury to certain units of the microtrabecular network and cytoskeleton is considered to be a primary biological effect of radiation on cells. The role of these structural changes in the development of the specific radiation response is discussed. It is found possible to describe formally, by the defined parameters of the proposed model, the survival curves for not only interphase but also reproductive cell death. PMID- 3823377 TI - [Interphase death of thymus cells in combined radiation-thermal injury against a background of prophylactic administration of alpha-tocopherol and indomethacin]. AB - The administration of alpha-tocopherol prior to radiation and thermal affection enhances chromatin degradation in thymocytes, increases the number of pyknomorphic cells in the critical zone of thymus, and enhances injury to erythrocyte membranes. The preventive administration of indomethacin does not influence the interphase cell death. PMID- 3823378 TI - [Effect of the cytoplasm of irradiated cells on chromatin degradation in mouse thymocytes and hepatocytes]. AB - The addition of a cytoplasmic fraction, isolated from cells 3h after irradiation of mice, to exposed or intact thymocyte nuclei causes a 2- or 3-fold acceleration of chromatin degradation in the nuclei incubated in conditions optimum for activity of Ca2+,Mg2+-dependent endonuclease to be manifest. In contrast to thymocytes, no chromatin degradation products are found in liver cells of irradiated mice. The cytoplasmic fraction isolated from hepatocytes of irradiated animals fails to activate chromatin degradation in thymocyte nuclei. PMID- 3823379 TI - [Abscopal action of gamma radiation in the death of lymphoid cells]. AB - In the in vitro experiments with lymphoid cells Raji and X63-Ag8.653 gamma irradiated in a synthetic medium, it was shown that a cessation of division (reproductive death) and lysis (interphase death) of cells were evoked by the abscopal effect of long-lived quinoid radiotoxins enhancing the direct effect of radiation to make it not additive but synergistic: a synergism coefficient was 1.3. PMID- 3823380 TI - [Mechanism of the radiation effect at the level of the supramolecular structures of eukaryotic DNA]. AB - The methods of viscosimetry and light scattering were used to study the radiosensitivity of the supramolecular DNA (SM DNA) structure in vivo. Irreversible lesions were found in SM DNA 2 min after gamma-irradiation of rats with a dose of 10 Gy. They were associated with the damage to the RNA-lipoprotein component (a linker) and with the dissociation of SM DNA to fragments of different molecular weight, that is, 109 +/- 25 X 10(6), 51 +/- 15 X 10(6), and 47 +/- 21 X 10(6) D for liver, spleen, and thymus, respectively, which correlated with the radiosensitivity of these organs. PMID- 3823381 TI - [Proliferative activity, DNA synthesis and reproductive death of immediate and late progeny of irradiated cells]. AB - In experiments on HeLa cells a study was made of a change in the rate of DNA synthesis, proliferative activity and reproductive death of exposed cells and their descendants throughout a number of generations. The rate of DNA synthesis decreased in 4 postirradiation generations, and a maximum inhibition (by 50%) was registered 48 h following irradiation. The proliferative activity of the irradiated cell descendants markedly decreased throughout 18-20 generations resulting in an increased death rate and a loss of cells from a generation. It is suggested that even the distant descendants (18-20 generations) of expose cells exhibited some lesions which may, in time, become fatal events leading to cell death. PMID- 3823382 TI - [Effect of ionizing radiation and Fe2+-induced peroxidation on the lipid phase of erythrocyte membrane preparations]. AB - The fluorescent probes, perilene and diphenyl hexatriene, were used to study changes in the lipid phase of erythrocytic ghosts induced by ionizing radiation (100-1000 Gy) and lipid peroxidation initiated by Fe2+ (5-100 microM). Both of the factors were shown to bring about similar changes in the membrane, that is, an increase in the viscosity of the probe localization sites and a decrease in diphenyl hexatriene fluorescence intensity. During the postirradiation incubation of the exposed membranes they were additionally damaged whereas upon peroxidation, most of the changes occurred after 15-min incubation with Fe2+. PMID- 3823384 TI - [Mechanism of change in the fluorescence parameters of pyrene and diphenylhexatriene in irradiated membranes]. AB - The erythrocyte ghosts were irradiated with doses of 100 to 1000 Gy. The fluorescence intensity and the lifetime of the excited state of pyrene and diphenylhexatriene were shown to decrease. The analysis of the results obtained has demonstrated that the changes in the fluorescence parameters of these probes are related to the enhanced dynamic probe quenching, the quencher being placed in water or the water itself being a quencher. PMID- 3823383 TI - [Erythrocyte elastic and mechanical properties and mechanism of their change during irradiation]. AB - A decrease in erythrocyte deformation, which was maximum at the height of radiation sickness, was registered as early as 1-3 days following 6 Gy irradiation of rats. The aggregation of erythrocytes increased during the latent period of radiation sickness then sharply decreased. The role of the observed changes in radiation sickness then pathogenesis is discussed. It is established that they are associated with the altered fatty acid composition of the lipid phase of erythrocytic membranes, on the one hand, and with the disturbances in its ionic permeability, on the other. PMID- 3823385 TI - [Spontaneous electrical activity of the rat cerebral cortex during microwave irradiation]. AB - A study was made of changes in spontaneous electrical activity of rat brain cortex induced by a single exposure to microwave radiation (electromagnetic fields of 0.1, 1.0, 10, and 35 mW/cm2). The animals were exposed in anechoic chambers to continuous waves at 2450 MHz in conditions of continuous generation. The data obtained indicate that the EEG parameters change under the effect of microwave radiation. The technique applied permits to study the occurrence and development of the CNS reactions to microwave radiation at the time of action of the factor. PMID- 3823386 TI - [Biosynthesis of nuclear sap proteins in the thymocytes of irradiated rats]. AB - A study was made of biosynthesis of nuclear sap proteins in rat thymus cells exposed to 8 Gy gamma-radiation. Four hours following irradiation, changes were observed in the nuclear sap protein spectrum which were not associated with proteolysis. PMID- 3823387 TI - [Catecholamine content and acetylcholinesterase activity in the brain of rats exposed to lasers]. AB - The catecholamine content was quantitated and acetylcholinesterase activity determined in rat brain locally exposed to laser radiation. It was shown that the adrenaline/noradrenaline ratio changed in the tissues under study and the cholinergic system was involved in the abscopal effect of laser radiation. PMID- 3823388 TI - [Endogenous phospholipase hydrolysis in radiation injury of animals]. AB - A study was made of the free fatty acid (FFA) content of homogenates of brain, thymus, liver, kidneys, erythrocytes, small intestine mucosa, and spleen of X irradiated (7.76 Gy) rats. The increased FFA content was exhibited by all the organs under study. The increase was maximum in the thymus. Calcium ions were shown to play a defined role in the radiation enhancement of endogenous phospholipase hydrolysis. PMID- 3823389 TI - Radiology of inflammatory bowel disease. PMID- 3823390 TI - Intestinal and extraintestinal complications of inflammatory bowel disease. AB - Inflammatory bowel disease has a variety of local and systemic complications that contribute to the morbidity and mortality associated with the disease. The radiologist plays an important role in the evaluation of these complications. PMID- 3823391 TI - Toxic dilatation of the colon. AB - Toxic dilatation of the colon represents the most serious complication of colonic inflammatory diseases. It is an acute transmural extension of severe inflammation resulting in decreased tissue cohesion and an increased tendency for bowel perforation. The process is characterized by dilatation and apparent radiologic thickening and nodularity of the bowel wall. Cases of toxic megacolon without dilatation occur infrequently. PMID- 3823392 TI - Genitourinary complications of inflammatory bowel disease. AB - Inflammatory bowel disease affects the genitourinary tract not infrequently, either by way of direct extension of the gastrointestinal inflammatory process or through metabolic interrelationships between the two organ systems. The abnormalities that most frequently result include retroperitoneal abscess, ureteral obstruction, cystitis, enterovesical fistula, and urolithiasis. Some of these may be sufficiently symptomatic to draw attention to their presence, even, on occasion, overshadowing or preceding gastrointestinal disease symptoms. Other urinary lesions are clinically silent and require periodic uroradiologic evaluation for purposes of discovery. PMID- 3823393 TI - Radiologic-pathologic correlation of inflammatory bowel disease. AB - The various inflammatory bowel diseases produce a wide spectrum of mucosal and bowel wall changes. No one radiolographic sign, or even combination of signs, is completely pathognomonic. A consideration of the pathophysiology responsible for the radiographic findings is helpful as an aid to understanding and to limit reliance upon matching of nonspecific signs with specific diagnosis. Patterns of mucosal ulceration, polyp formation, and strictures in the common superficial and transmural inflammatory diseases are emphasized. PMID- 3823394 TI - Infective enterocolitides. AB - Enteric infections, which range from asymptomatic to severe illnesses, are caused by a wide variety of organisms. Radiologic studies, in correlation with clinical findings, may suggest the correct diagnosis, but laboratory examinations are usually required for definitive diagnosis. Radiologic studies can be of help in determining the extent and course of infective enterocolitides. PMID- 3823395 TI - Crohn's disease of the upper gastrointestinal tract. AB - Involvement of the upper gastrointestinal tract by Crohn's disease is being recognized with increasing frequency. Gastroduodenal disease is more common, although esophageal disease is now noted infrequently as well. There is nearly always concomitant involvement of the small bowel or colon. Initial phases of the disease are manifested as superficial inflammatory changes of the mucosa but can progress to scarring and stenosis. Optimum double-contrast technique is necessary to detect these early lesions. PMID- 3823396 TI - Imaging inflammatory bowel disease in the pediatric patient. AB - Idiopathic inflammatory bowel disease in childhood was once considered rare but is now being increasingly recognized. Although ulcerative colitis and Crohn's disease, the two most common types, have some features in common with the adult form, in all of these diseases the differential diagnoses, presentation, and therapy differ in many important ways from those in adults. Infants are also susceptible to diseases not seen in older children. These differences and the often extremely young age of the patient markedly affect the choice and performance of diagnostic imaging techniques. These techniques have to be modeled more to the individual's requirements than in adults, and infants need a different approach even from older children. PMID- 3823397 TI - [Possibilities and limitations of neuroradiologic diagnosis in detecting pituitary tumors]. PMID- 3823398 TI - [New concepts of the nature of the development and course of pulmonary edema in myocardial infarct]. PMID- 3823399 TI - [Serial computed tomographic examinations of patients with liver cirrhosis]. PMID- 3823400 TI - Pancreatic and renal size and density determined by computed tomography in patients with type 1 (insulin-dependent) diabetes. PMID- 3823401 TI - [X-ray examinations of the stomach--comparison of the findings with gastroscopy]. PMID- 3823402 TI - [Perforations occurring during administration of contrast media into the colon, a basic medical care procedure]. PMID- 3823403 TI - [Percutaneous transvasal embolization in the treatment of tumor-induced gynecologic hemorrhage--methodological aspects and results]. PMID- 3823404 TI - [Arteriography in the analysis of the causes of delayed consolidation of fractures of the lower extremity]. PMID- 3823405 TI - [Arthrographic studies of the femoropatellar joint]. PMID- 3823406 TI - [A case of local gigantism of the thumb combined with autonomic disorders]. PMID- 3823407 TI - [Effect of iodinated x-ray contrast media on human lymphocytes]. PMID- 3823408 TI - [Accumulation of contrast media in the liver during lymphography of the foot]. PMID- 3823409 TI - [Technic of patient positioning for spinal computed tomography in the diagnosis of cervical disk disease]. PMID- 3823410 TI - [Direct sagittal sections in cranial computed tomography]. PMID- 3823411 TI - Static film/screen imaging terminology: the need to standardize. AB - The lack of standardization of static film/screen imaging terminology causes confusion among people working in the field of radiology. The research presented in this article compares terminology used by a variety of radiology professionals, basic reference texts, and film companies. A survey was developed and distributed, in which 96% of the participants indicated they saw a definite need to standardize static film/screen imaging terminology. PMID- 3823412 TI - Effects of streptokinase in thrombolytic therapy: a radiology research project. AB - A radiology research project investigating the relationship between vascular endothelial injury and thrombolytic therapy using streptokinase has provided valuable data that indicates the need for a re-evaluation of such therapy and warrants further investigation in the animal laboratory. The role of the radiology research technologist in such research is explained as well. PMID- 3823413 TI - The use of transmission block in the radiation therapy portal treatment of the inguinal nodes in late stage pelvic malignancies. AB - Several pelvic malignancies in late stage have involvement of the inguinal nodes requiring radiation therapy. In recent years, our treatment plan has been changed to an opposed pelvic portal with the inguinal nodes treated in the anterior portal only by use of an anterior transmission block. This treatment technique was designed to avoid the problem of matching two radiation therapy portals. The advantages of this technique include easy treatment planning, adequate everyday set-up of the treatment portals, and no overlap by using separate pelvic fields and inguinal fields, reducing the complication rate. PMID- 3823414 TI - Hazards of ferrous materials in MRI: a case report. AB - Magnetic resonance imaging is a new technology that is free from the hazards of ionizing radiation. However, the technology utilizes intense magnetic fields and there is a risk of ferrous objects becoming projectiles if brought too close to the magnet. This case report describes an accident where a large metallic body was drawn into the bore of the magnet, seriously injuring an individual in its path. PMID- 3823415 TI - Selecting the best screen-film combination. PMID- 3823416 TI - Cancer risk in radiologic technologists: a collaborative University of Minnesota/American Registry of Radiologic Technologists Epidemiologic Study. PMID- 3823417 TI - [The morphology of generalized osteopathies]. AB - New findings in the morphology of generalized bone disorders are described in this report. The structure of the skeleton is the result of defined activity of the cellular units (osteoclasts and osteoblasts). The use of iliac crest bone biopsies and decalcified preparation procedures demonstrates the influence of cellular units on the skeleton as well as bone mineralization disturbances. The morphological results represent the basis for treatment as well as new therapeutical principles. PMID- 3823418 TI - [Common roentgen morphology of generalized osteopathies]. AB - The generalized macromorphological x-ray findings of the different kinds of osteopathy are discussed. These metabolic bone diseases include osteoporosis, osteomalacia, secondary hyperparathyroidism caused by renal osteopathy and all possible combinations. The complications caused by hormonal and metabolic bone disease are described. The pathomorphological significance and value of follow-up studies with regard to therapeutic procedures are explained. PMID- 3823419 TI - [Alcohol-induced osteopenia]. AB - There is clear evidence of a propensity to fractures and the development of osteomalacia, osteoporosis, and mixed forms in chronic alcoholics. Osteomalacia is associated with impaired vitamin D status, probably due to enzyme induction in liver and kidney and development of a secondary intestinal hyperparathyroidism. The development of osteoporosis is multifactorial, but seems to arise mainly through reduction in bone formation and reduced dietary protein and calcium intake. Low testosterone levels may also contribute to osteoporosis. PMID- 3823420 TI - [Questions from clinicians to the radiologist regarding the diagnosis of metabolic bone diseases]. AB - Macromorphological X-ray findings in metabolic bone disease can establish the diagnosis only in advanced stages. Micromorphological X-ray diagnostic procedures will support the diagnosis even at an early stage. Measurement of minerals is an adjuvant method for early diagnosis and survey of therapy in metabolic bone diseases. The measurement of calcium phosphate metabolism and description of bone histology (histomorphometry) and radiological morphology enables the type and stage of osteopathy to be diagnosed. The combination of diagnostic methods is helpful in distinguishing bone diseases with increased turnover, impaired bone modelling and absorption, disturbed mineralization and ectopic calcification. Within the metabolic osteopathies, osteoporosis is gaining importance as a socioeconomic problem; therefore, early diagnosis and treatment are of relevance. Hyper-, hypoparathyroidism and osteoidosis are curable if early diagnosed. PMID- 3823421 TI - [Thanatophoric dwarfism]. AB - The brothers and sisters described above show all the important exterior and radiological signs of thanatophoric dwarfism type I. The other described complications of pregnancy such as hydramnios, premature birth or abortion did not occur. According to present day publications a homogeneous heredity have not been noticed, so the risk of a repetition after having a child with thanatophoric dwarfism is given as 1:50 to 1:4 for healthy parents. Ultrasonic controls frequently repeated at short intervals, especially with hydramnios or an atypical development of the skeleton combined with a radiograph and - in case of doubt fetography enables a diagnosis of thanatophoric dwarfism to be made from about the 18th week of gestation. With a positive diagnosis an interruption of pregnancy is indicated because of the absolutely lethal prognosis. PMID- 3823422 TI - Primary bladder carcinoma: evaluation with MR imaging. AB - Magnetic resonance (MR) imaging was performed in 23 patients (25 tumors) with proved bladder neoplasms. MR studies were retrospectively evaluated and compared with computed tomographic (CT) and pathologic findings. Bladder neoplasms, having a signal intensity intermediate between those of urine and perivesical fat, were best seen on T1-weighted and proton-density images. MR imaging was as accurate as technically well-performed CT studies in detecting extravesical tumor extension. MR could additionally be used to assess the integrity of the bladder wall. On T2 weighted images the normal bladder wall appeared as a thin, linear, low-intensity structure. The disruption of this low-intensity line was indicative of deep muscle invasion, whereas preservation of this low intensity line implied a more localized lesion. Although chemical shift artifacts might cause apparent disruption of the bladder wall, knowledge of this artifact coupled with additional imaging along different planes helps avoid misinterpretation of this artifact as deep muscle invasion. PMID- 3823423 TI - Adrenal gland: MR imaging. AB - The authors investigated the utility of magnetic resonance (MR) imaging in identifying the normal adrenal gland in 100 patients as well as in distinguishing adrenal adenomas (n = 12) from malignant neoplasms (n = 14). The left adrenal gland was seen in 99 of 100 cases and the right in 91 of 100 cases. The adrenals were most easily seen with T1-weighted spin-echo pulse sequences. The ratio of the intensity of the adrenal mass to that of fat at 2,100/90 (repetition time msec/echo time msec) was most helpful in distinguishing adrenal adenomas from malignant neoplasms. In contrast to other studies, the adrenal mass/liver intensity ratios were not helpful. All ten lesions with adrenal mass/fat ratios at 2,100/90 of 0.8 or greater were malignant, whereas all eight adrenal masses with a ratio less than 0.6 were adrenal adenomas. However, eight (31%) of the masses (four adenomas and four malignant neoplasms) had ratios between 0.6 and 0.8. Although MR imaging has considerable potential in characterizing adrenal masses, larger studies are needed to determine its true sensitivity and specificity. PMID- 3823424 TI - Intraabdominal hematoma following orchiectomy: a potential pitfall in using CT for staging of testicular cancer. AB - Internal bleeding in patients undergoing orchiectomy for a malignant testicular tumor can cause a dissecting hematoma in the retroperitoneum. This mass may have the clinical appearance of an iliac fossa mass and may simulate metastasis on computed tomography (CT). This condition was seen in four of 486 orchiectomy patients who underwent postoperative staging with CT. One patient is described in detail. PMID- 3823425 TI - Mesoatrial shunts for Budd-Chiari syndrome and inferior vena cava thrombosis: angiographic and hemodynamic evaluations. AB - When inferior vena caval obstruction complicates the Budd-Chiari syndrome, conventional portosystemic shunts are not possible. The mesoatrial shunt has been devised to enable portal and sinusoidal decompression in these patients. Findings in 12 patients with Budd-Chiari syndrome and inferior vena caval obstruction in whom a mesoatrial shunt was performed are reported. Preoperative inferior vena cavography with pressure measurements is essential to determine the appropriate shunt procedure. Postoperatively, shunt patency is assessed with superior mesenteric arterial portography. Where possible, transvenous catheterization of the shunt is performed to confirm patency and assess hemodynamic function. PMID- 3823426 TI - Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization. AB - Over the past 7 years, eight patients with splanchnic artery aneurysms and pseudoaneurysms were studied and treated. Transcatheter embolization resulted in occlusion of the lesions in all eight patients. Potentially risky and difficult surgery was avoided completely in four patients. Three patients had elective surgery at a later date when their condition was more stable. The remaining patient had definitive surgery after embolization. Transcatheter embolization should be the initial treatment of choice in splanchnic artery aneurysms and pseudoaneurysms. PMID- 3823427 TI - MR arthrography: anatomic-pathologic investigation. AB - To enhance the efficacy of magnetic resonance (MR) imaging in evaluating articular soft-tissue structures, arthrography was performed before imaging 45 fresh cadaveric specimens. Contrast agents used were gadolinium-DTPA, 0.9% saline, diatrizoate, and air. MR imaging was performed with and without intraarticular contrast material, and specimens were subsequently sectioned in the same plane. Gd-DTPA was the most effective agent. Saline and diatrizoate exhibited equivalent signal behavior and necessitated T2-weighted sequences, while air was not useful. Depiction of normal anatomy was enhanced with MR arthrography. After surgical creation of lesions in selected specimens, subtle tears were delineated exclusively with MR arthrography, and major tears were diagnosed more confidently. Intraarticular contrast material may enhance the diagnostic capabilities of MR imaging in the setting of joint disease. PMID- 3823428 TI - Wrist: coronal and transaxial CT scanning. AB - Computed tomography (CT) of the wrist can be useful in selected clinical applications and is generally performed in the transaxial orientation. Coronal and transaxial CT scanning of the wrist were directly compared in three patients and in a normal, isolated cadaveric hand. Twenty other patients with wrist problems who underwent only transaxial or coronal CT examinations were also considered to assess the clinical indications of both techniques. A simple Lucite holder was designed and tested to simplify patient positioning with the coronal CT technique. In most clinical situations, coronal images were superior to transaxial images because the former were more detailed and easier to interpret. In some specific cases, however, especially fracture of the hamate hook and distal radioulnar subluxation, transaxial CT scanning was superior. PMID- 3823429 TI - Diverticular abscesses: percutaneous drainage. AB - Percutaneous catheter drainage was performed in 16 patients with diverticulitis complicated by abscesses. Each patient had resolution of fever within 72 hours. Eleven patients subsequently underwent simultaneous sigmoid resection and operative anastomosis 10-40 days after percutaneous drainage. One patient required a three-stage procedure after percutaneous drainage, and one patient was too unstable for operation at any time during her course and eventually died of respiratory failure. Three patients did not undergo resection after catheter drainage and have remained asymptomatic for 1-2 1/2 years. Ten of 16 patients had fistulas, eight of which closed spontaneously. Experience with percutaneous drainage of diverticular abscesses suggests that it obviates surgical abscess drainage and permits a single operation (sigmoid resection and closure) to be performed safely. Percutaneous abscess drainage has cost-saving implications, since one or two operations may be avoided in most patients, and in some high risk elderly patients all operations may be obviated. PMID- 3823430 TI - Adventitial cystic disease of the popliteal artery. AB - In a 27-year-old man with claudication, computed tomography (CT) demonstrated a popliteal cyst and an adventitial cyst of the popliteal artery. Adventitial cystic disease was unexpected because the patient had a diminished pedal pulse on plantar flexion of the foot, a physical finding suggesting popliteal artery entrapment syndrome. CT was useful in the initial examination of this young patient with suspected popliteal vascular disease because of its accuracy and noninvasiveness. PMID- 3823431 TI - Mucocutaneous and peripheral soft-tissue hemangiomas: MR imaging. AB - Hemangiomas are common congenital lesions that may have devastating sequelae. The extent and location of a lesion determines the therapeutic approach. We describe 11 patients with mucocutaneous or peripheral soft-tissue hemangiomas to illustrate the ability of magnetic resonance (MR) imaging to define clearly and noninvasively the extent and anatomic relationships of hemangiomas. The major advantage of MR imaging over computed tomography or angiography is the exquisite difference in contrast between hemangiomas and the surrounding structures on T2 weighted MR images, in which hemangiomas have a relatively intense signal. Hemangiomas demonstrated relatively low signal intensity (similar to muscle) on T1-weighted images, which were markedly inferior to T2-weighted images in defining the extent of the lesions. Phleboliths and feeding or draining vessels were rarely visible. The information obtained with MR imaging may be valuable clinically in planning surgical resection or laser therapy of aggressive lesions, in evaluating effectiveness of medical or embolic therapy, and in defining recurrence. PMID- 3823432 TI - Tumor therapy with hematoporphyrin derivative and lasers via a percutaneous fiberoptic technique: preclinical experiments. AB - Photodynamic therapy relies on uptake of a photosensitizer (hematoporphyrin derivative [HpD]) by tumor cells and subsequent interaction of the photosensitizer with penetrating light. This technique has been applied in multiple animal systems and several clinical trials. The therapeutic results in large, deep tumors are limited by poor uptake and distribution of the HpD and limited penetration of tumors by light, even at high wavelengths. In various experiments with mice, HpD was injected into tumors, and light was applied via laser fiberoptics inserted through a sheath catheter. Preliminary findings indicated that intratumoral injection enables excellent distribution of HpD in high concentrations, thus optimizing the sensitivity of the tumor cells. The sheath catheter and fiberoptics enable excellent distribution of light. Experiments with T-cell lymphomas demonstrated significant response of the tumors to the combination of intratumoral HpD and interstitial light application. PMID- 3823433 TI - CT-guided laser therapy in resistant human tumors: phase I clinical trials. AB - Photodynamic therapy was performed on ten tumors in patients who did not respond to initial therapy and for whom no additional conventional therapy was available. A sensitizing agent (hematoporphyrin derivative [HpD]) was injected directly into each tumor under computed tomographic (CT) guidance to deliver high concentrations to the tumor and to minimize systemic toxicity. Three to 6 days after the injection, a clear Teflon sheath catheter was placed into the tumor under CT guidance. The tumor was exposed to red light (630-nm wavelength) through laser fiberoptics inserted in the sheath. The initial investigation confirmed the technical feasibility of CT-guided photodynamic therapy by means of intratumoral HpD injections and laser exposure through fiberoptics inserted in sheath catheters. The toxicity from a single treatment was minor, and the tumor response was encouraging. PMID- 3823434 TI - Abscesses in Crohn disease: percutaneous drainage. AB - Fifteen patients with Crohn disease underwent percutaneous catheter drainage of related abdominal abscesses. The abscesses were located in the right lower quadrant (five patients); in the quadratus lumborum and/or iliopsoas muscles (four patients); in the left paracolic gutter (two patients); and in the right gluteal muscles, the liver, the left subphrenic space, and the pelvis (one patient each). All abscesses were evacuated successfully (n = 15 of 15), and no patient required surgery for abscess drainage. Existing fistulas closed in four of seven patients; the other three patients underwent surgery for excision of diseased bowel and enteric fistulas. No patient developed an enterocutaneous fistula as a result of catheter drainage. Percutaneous abscess drainage is effective for abscesses related to Crohn disease and should be regarded as the procedure of choice. An operation for the abscess can be avoided, and early results suggest that bowel surgery may be obviated in selected patients. PMID- 3823435 TI - Separation of the masticator space from the parapharyngeal space. AB - The separation of the masticator and parapharyngeal spaces is somewhat ambiguous. Anatomic specimens were dissected to define better the fascial layer representing the medial wall of the masticator space. A fascial layer was found extending from the medial pterygoid muscle to the skull base separating the masticator from the parapharyngeal space. The third branch of the trigeminal nerve was lateral to this fascial layer and thus passed through the masticator space. Clinical cases were reviewed. Tumors could be confidently assigned to the masticator, prestyloid, or poststyloid parapharyngeal spaces. Benign salivary gland tumors were found in the prestyloid parapharyngeal space only. PMID- 3823436 TI - The opacified maxillary sinus: CT findings in chronic sinusitis and malignant tumors. AB - To distinguish opacification owing to inflammatory conditions (sinusitis) from that caused by nasomaxillary malignancy, computed tomography scans in 24 proved cases of sinusitis or tumor were reviewed for features related to sinus size, wall thickness, and character of bone erosion. An anatomic system was defined for classifying lesions according to the surface and type of bony involvement. In 12 cases of chronic maxillary sinusitis, the involved sinus was usually small and thick walled. The nasal surface of the involved sinus usually was eroded; often the orbital surface was eroded. The erosion was, however, short, irregular, and in the region of a normal dehiscence (semilunar hiatus or infraorbital canal) in all cases. The infratemporal surface was never eroded. In 12 cases of nasomaxillary neoplasia, the sinus was enlarged, one or more walls of the involved sinus being thinned and expanded. Bone erosion was present in all cases; erosion of the infratemporal surface was specific for neoplasia and significant as the usual site of recurrence. PMID- 3823437 TI - Ranulas and their mimics: CT evaluation. AB - The spectrum of computed tomographic (CT) findings in ten patients with pathologically proved simple and diving ranulas is reviewed. These retention cysts originate within the sublingual space from obstruction of the sublingual or minor salivary glands; when they enlarge, the cysts herniate to involve the submandibular and inferior parapharyngeal spaces (the so-called diving or plunging ranula). CT findings in 38 additional patients with a variety of cystic lesions in the floor of the mouth are contrasted with findings in cases of ranulas. The relevant anatomy is reviewed. This experience indicates that a unilocular, cystic mass emanating from the sublingual space and extending into the adjacent submandibular and/or inferior parapharyngeal spaces can be considered a diving ranula in virtually all cases. A unilocular, cystic mass entirely within the sublingual space can be considered a simple ranula in most instances, although absolute distinction between a simple ranula and an epidermoid cyst cannot be made radiographically. PMID- 3823438 TI - Temporomandibular joint arthrography following surgical treatment of internal derangements. AB - Arthrograms of the temporomandibular joint were obtained in 20 symptomatic joints that had previous reconstructive arthroplasty with disk repositioning because of internal derangements. Preoperative arthrograms were available for comparison in 18 joints. Symptoms resulting in a postoperative arthrogram included pain, limited ability to open the mouth, and clicking of the joints. Postoperative arthrographic findings included limited anterior translation of the condyle (90%), irregularity in outline of the intraarticular contrast agent (60%), a conical configuration of the posterior recess (25%), decreased size of the joint (28%), anterior displacement of the meniscus (25%), and perforated meniscus (15%). Many of these findings may have resulted from fibrosis and scarring, which may be a response to intraarticular bleeding. The mechanism by which the fibrosis causes the postsurgical arthrographic features is discussed. PMID- 3823439 TI - Lumbar spine after surgery: examination with intravenous contrast-enhanced CT. AB - Computed tomography (CT) of the lumbar spine without and with intravenous administration of contrast medium was performed in 143 consecutive patients who had previously had spine surgery for disk herniation and had persistent or recurrent symptoms. Fifty-two patients underwent surgical reexploration. It was possible to make the diagnosis of normal postoperative status, disk herniation, or scarring in 31 (60%) of the 52 patients with the use of CT scans without intravenous contrast medium. CT with intravenous contrast enhancement was useful in 12 of the remaining patients (23%). Enhancement of the margins of a herniated disk occurred in 37 (71%) of the patients. There was near-homogeneous enhancement of postoperative scarring in 34 (65%) patients. Intravenous contrast medium was particularly helpful when disk herniation and scarring were both present, by delineating the margins of a herniated disk and enhancing the entire substance of the scar. In symptomatic postoperative patients, CT of the lumbar spine without intravenous contrast medium should be performed initially. If a definitive diagnosis is not established, CT with intravenous contrast enhancement should be considered. PMID- 3823440 TI - Cervical radiculopathy: value of oblique MR imaging. AB - Eighteen patients with cervical radiculopathy were entered into a prospective study to compare the accuracy of surface coil magnetic resonance (MR) imaging with that of metrizamide myelography and computed tomography (CT) with metrizamide. All MR studies included tailored axial and oblique images as well as routine sagittal images. All imaging studies were evaluated for topography and type of disease. Nine of 18 patients subsequently underwent cervical surgery with an anterior interbody approach at 11 levels. The surface coil MR findings concerning disease topography and type concurred with the surgical findings at nine of 11 levels (82%). At three levels, the oblique view added important information not available on the sagittal images or clarified changes seen on the axial images. Metrizamide myelography with CT metrizamide myelography had findings concurrent with surgical findings at ten of 11 levels (91%). PMID- 3823441 TI - Periappendiceal abscesses: percutaneous drainage. AB - Percutaneous abscess drainage was performed in 21 patients who had periappendiceal abscesses. Fifteen patients had de novo abscesses, while six patients had persistent postsurgical abscesses. Nineteen of the 21 percutaneous drainages were successful. After percutaneous abscess drainage, interval appendectomy was simple and uneventful in all 14 patients in whom it was performed; four patients had appendices removed prior to percutaneous abscess drainage, and three elderly patients have not required appendectomy (follow-up 1 1/2-3 1/2 years). Percutaneous catheter drainage of periappendiceal abscess performed with computed tomographic guidance is effective and safe. Its benefits include imaging demonstration of the abscess; avoidance of an operation for abscess drainage; temporization of extremely ill patients; simplification of appendectomy, which is made elective; obviation of all operations in selected patients (e.g., elderly or with cardiopulmonary disease); and reduction of hospital stay and cost. PMID- 3823442 TI - Cervical spine MR imaging: generating high-signal CSF in sagittal and axial images. AB - Three magnetic resonance (MR) imaging techniques were compared as to their ability to generate images with high-signal cerebrospinal fluid (CSF) to provide a high-contrast CSF-dura interface. The three techniques were CSF gating to the peripheral pulse, selective saturation recovery with gradient refocusing (SSRGR), and gradient recalled acquisition in the steady state (GRASS). In sagittal views of the cervical spine, CSF gating proved to be a reliable technique for producing images with uniform high-signal CSF in a single-section or multi-section mode. In axial views, SSRGR and GRASS techniques were more consistent than CSF gating in producing high-signal CSF images, especially in a multisection mode. Although axial image quality was nearly equivalent for SSRGR and GRASS techniques, the latter was clinically more efficient because of shorter imaging times. These methods of imaging in the cervical spine yield sufficient CSF-dura contrast and spatial resolution to be of use in the diagnosis of cervical disk disease. PMID- 3823443 TI - Intrathecal administration of nitroxides as potential contrast agents for MR imaging. AB - The diagnosis of various disorders of the cerebrospinal fluid (CSF) with magnetic resonance (MR) imaging may require the intrathecal administration of a paramagnetic contrast agent. Furthermore, the CSF route provides direct access to the brain, circumventing the blood-brain barrier. Three nitroxides, two charged and one uncharged, were administered intrathecally to dogs to assess their potential as contrast agents for MR imaging of the CSF. Nitroxide concentrations and proton T1 values were measured in samples of CSF removed at various times after nitroxide administration, and pharmacokinetic curves were constructed. The charged nitroxides had considerably longer half-lives than the uncharged compound. On in vivo MR imaging of the CSF (surrounding the upper cervical cord and brain stem) in one dog, use of a charged nitroxide as contrast agent led to considerably higher CSF signal intensity than was observed in the nonenhanced, baseline T1-weighted images. This effect was achieved at low doses (20 mumol) and sustained for at least 90 minutes. The intrathecal use of nitroxides as contrast agents for MR imaging warrants continued investigation. PMID- 3823444 TI - Adverse reactions to xenon-enhanced CT cerebral blood flow determination. AB - Fourteen institutions performed 1,830 computed tomographic (CT) cerebral blood flow (CBF) examinations with 32% inhaled stable xenon. Respiratory rate delay greater than 10 seconds occurred in 3.6% of patients, with 83% of the delays lasting 10-15 seconds. There was no incident of prolonged respiratory difficulty. Headache (0.4%), seizures (0.2%), nausea and vomiting (0.2%), and change in neurologic status (0.1%) were uncommon, and there were no transient ischemic attacks. The CT CBF method with 32% inhaled stable xenon is thus associated with an acceptably low incidence of adverse reactions. PMID- 3823445 TI - Temperature, heart rate, and blood pressure changes associated with clinical MR imaging at 1.5 T. AB - Temperature, heart rate, and blood pressure responses to high-field-strength magnetic resonance (MR) imaging were studied in 50 patients who underwent procedures at exposures to radiofrequency radiation above the present recommended whole-body average specific absorption rate (SAR) of 0.4 W/kg. Body temperature significantly increased an average of 0.2 degrees C. The highest body temperature recorded after MR imaging was 37.5 degrees C. There was no significant correlation between the change (before and after imaging) in body temperature and whole-body average SARs. Changes in skin temperatures were variable, depending on anatomic site. The largest change was 3.5 degrees C, and the highest skin temperature recorded after imaging was 35.1 degrees C. There was a modest correlation between the change in skin temperatures and whole-body average SARs. Average heart rate and average mean blood pressure measured immediately before imaging were not significantly different afterward. High-field-strength MR imaging at the whole-body average SARs of 0.42-1.2 W/kg studied was not associated with any temperature- or hemodynamic-related deleterious effects. PMID- 3823446 TI - Average radiation doses in a standard head examination for 250 CT systems. AB - Approximately 250 computed tomography (CT) systems were surveyed in a nationwide study to determine the average radiation dose resulting from a typical adult head procedure. The multiple scan average dose (MSAD) was selected as the dose descriptor. For the typical adult CT head procedure, the MSAD was generally within 2.2-6.8 rads (22-68 mGy). Variations in dose by a factor of two or more were often seen for a given manufacturer and model. These dose ranges indicate a potential to reduce dose by carefully selecting imaging techniques. Overall, variations in dose can result from differences in the user's choice of technique (desired image quality) or from actual differences in scanner performance (caused by differences in collimation, filtration, or geometry). To use CT appropriately, a facility should consider dose as well as image quality in selecting optimal techniques for typical modes of operation. PMID- 3823447 TI - Rights, roles, and relationships in radiology. AB - Traditionally, radiologists report their findings to the referring physician. When a patient who understands the reason for the diagnostic examination asks the radiologist to disclose the results, in most cases the radiologist should not decline but should answer truthfully. PMID- 3823448 TI - Improved vessel dilator for percutaneous catheterization. AB - Three commercial vessel dilators and a dilator of an improved design were tested during percutaneous catheterization in 16 mongrel dogs to evaluate arterial damage produced with their use. The results indicate that, although all dilators often produce arterial damage, the improved design produced much less damage. In addition, lesions were less severe overall. The dilator has been safely and successfully used in patients for percutaneous vessel catheterization for the past 30 years at the authors' institution. PMID- 3823449 TI - Exchange of occluded catheters with transcatheter and pericatheter maneuvers. AB - Catheter occlusion occurs frequently and in a wide variety of situations. In this report, transcatheter and pericatheter techniques are described that permit catheter exchange despite significant occlusion. Specific indications for each technique and the authors' preferences are discussed. PMID- 3823450 TI - New catheter design and placement technique for pulmonary arteriography. AB - An improved catheter for pulmonary arteriography via the antecubital approach is described. The catheter has been used successfully in 56 patients. PMID- 3823451 TI - Heating contrast media in a microwave oven. AB - Use of a conventional microwave oven to heat contrast media is described. Heating of a single 50-ml vial of contrast media in this study took an average of approximately 9 seconds. Heating rate was not affected by concentration of contrast media being heated. PMID- 3823452 TI - Dermal breast calcifications: localization with template-guided placement of skin marker. AB - Reliable localization of skin calcifications in the breast was achieved with a true tangential view obtained after superimposition of a radiopaque skin marker. The marker was placed with the aid of a localization template. This method expedited such localizations and obviated the need for repeat radiographs to achieve accurate positioning of the marker. PMID- 3823453 TI - Needle localization of occult breast lesions with a curved-end retractable wire: techniques and pitfalls. PMID- 3823454 TI - "Nutcracker" esophagus: diagnosis with radionuclide esophageal scintigraphy versus manometry. AB - "Nutcracker" esophagus is a syndrome consisting of chest pain and/or dysphagia with elevation of the mean distal esophageal contractile pressure amplitude (MDA) (greater than 120 mm Hg). Its existence as a disorder of esophageal function and the proper manometric diagnostic criteria have been debated. A correlative study of radionuclide esophageal scintigraphy (RES) and manometry was performed in 31 patients with this manometric diagnosis. RES results were abnormal in 13 of 16 (81%) patients with an MDA above 150 mm Hg, and in only three of 15 (20%) patients with an MDA below this level. There was a significant difference in RES parameters (mean transit time and percentage emptying) between these two groups. Repeat manometric and RES studies showed considerable variability, but only RES showed a significant correlation between baseline and repeat studies. RES confirms a functional disorder in a subgroup of patients with the manometric diagnosis of nutcracker esophagus and supports a change in the manometric criteria for diagnosis of this disorder to an MDA above 150 mm Hg. PMID- 3823455 TI - Peptic ulcer and gastric carcinoma: diagnosis with biphasic radiography compared with fiberoptic endoscopy. AB - The diagnostic value of biphasic radiographic examination of the stomach and duodenum was compared with that of fiberoptic endoscopy in a prospective, blinded study of 385 patients with dyspepsia. This investigation was directed at gastric malignancies and peptic ulcers. Methodologically there is no absolute standard for a study of this kind because histologic examination is useful for detection of cancer but inadequate for ulcers. As an alternative, kappa indexes and the sensitivity and specificity, as derived by Hui and Walter, were calculated and compared. For the detection of gastric carcinoma, radiographic and endoscopic findings had almost perfect agreement beyond chance. For gastric ulcers, radiography and endoscopy had substantial agreement, which became perfect if small ulcers (less than 5 mm) were excluded. For duodenal ulcers, radiography had a lower sensitivity than endoscopy; this disagreement disappeared if small ulcers were excluded. Both methods have equal merit; choice of the initial diagnostic procedure will therefore depend on cost, discomfort to the patient, and risk of complications. PMID- 3823456 TI - Suprapancreatic biliary obstruction: CT evaluation. AB - In a 5-year period, 92 patients with biliary obstruction proximal to the pancreatic segment were evaluated with computed tomography (CT). Seventy-three were judged to have technically optimal studies. Observations of the level of obstruction were compared with data from 50 percutaneous transhepatic cholangiograms; CT data enabled the level of obstruction to be correctly predicted in 46. CT enabled correct prediction of the distribution of obstructing lesions in all 18 patients with intrahepatic obstruction. Forty-four of the 73 patients had pathologic examination of the porta hepatitis. CT findings of obstructing mass and lesser omental nodes resulted in correct prediction of malignancy in 25 (92%) of 27 patients; the absence of such findings enabled correct prediction of benign disease in 13 (77%) of 17 individuals. CT is most valuable as a noninvasive means of planning surgical or radiologic drainage procedures in patients with biliary obstruction. PMID- 3823457 TI - Adult respiratory distress syndrome: acute alveolar damage. PMID- 3823458 TI - Benign thymic enlargement in adults after chemotherapy: CT demonstration. AB - Serial computed tomographic (CT) scans of 200 patients with malignant testicular teratomas were reviewed. Of the 200 patients, 120 were treated with chemotherapy for metastatic disease; 80 patients with no evidence of metastases (stage I disease) received no treatment and served as a control group. CT was performed at regular intervals for ongoing follow-up in both groups. Thymic enlargement occurred 3-14 months after initiation of treatment in 14 of the 120 patients (11.6%) who received chemotherapy but in only one patient in the control group. Histologic examination in one patient who received chemotherapy revealed that the thymic enlargement represented true hyperplasia. Thirteen of the 14 patients (93%) with thymic enlargement after chemotherapy were well and disease free on mean follow-up of 45 months, compared with 78% of the group that did not show thymic enlargement after chemotherapy (P less than .02). Rebound thymic hyperplasia in adults after chemotherapy for metastatic testicular teratoma may be a good prognostic feature and should be considered when an anterior mediastinal mass develops after chemotherapy for metastatic malignancy. PMID- 3823459 TI - Bronchoalveolar lavage: radiographic manifestations. AB - Bronchoalveolar lavage (BAL) is a safe and well-tolerated procedure in which the lower respiratory tract is sampled through infusion and subsequent aspiration of sterile saline solution. To determine the radiographic changes consequent to this procedure, 25 patients undergoing fiberoptic bronchoscopy and BAL were evaluated prospectively. After lavage, anteroposterior radiographs were obtained immediately and after 30, 90, and 240 minutes, and 24 hours. The degree and site of opacification on the radiographs was graded on a 4+ subjective scale. Sixty nine lobes were lavaged, but owing to overlap on the radiographs, 52 projected areas were evaluable for radiographic changes. Forty-seven areas of consolidation were identified on the radiographs obtained immediately after lavage. Consolidation was homogeneous and always corresponded to a projected site of lavage. There was a positive correlation between initial opacity on the radiograph and the volume of retained fluid (rs = .60, P less than .001). Consolidation cleared gradually over 24 hours. No patient had clinical pneumonitis. These benign, self-limited radiographic changes are common after BAL and may simulate pulmonary edema, aspiration, or hemorrhage. PMID- 3823460 TI - Preliminary experience with a dual cutting edge needle in thoracic percutaneous fine-needle aspiration biopsy. AB - Results of 133 thoracic percutaneous fine-needle aspiration biopsies performed with a new dual cutting edge needle were analyzed to see if it could reduce the false-negative rate for malignancy compared with that achieved with a sharply beveled spinal needle. Results of cytologic examinations were compared with those of histopathologic examinations. Cores of tissue for histopathology could be obtained in only 51 biopsies (one of which was lost). Sensitivity of cytology (vs. histopathology) was 77.8% (vs. 57.1%); specificity and positive predictive value, 100% (same); and negative predictive value, 64.3% (vs. 46.4%). In 44 of 50 biopsies, cytologic results were equal to or better than histopathologic results diagnostically. In six biopsies (including two cases of hamartoma), the histopathologic result improved upon the cytologic result. There were no biopsies for which cytologic results were negative and histopathologic results were positive for malignancy. Use of this needle did not improve the false-negative rate for malignancy, although it did allow specific diagnosis of a hamartoma in two cases. PMID- 3823461 TI - Paraspinal lipomatosis: a benign mass. AB - Paraspinal lipomatosis usually occurs in patients with steroid excess. In two patients a paraspinal mass was detected on conventional radiographs and was subsequently shown to represent benign fat deposition on computed tomography, thereby obviating further studies. Neither patient had been receiving steroids. Paraspinal lipomatosis may be the cause of a benign mass and may be considered in the differential diagnosis of this finding. PMID- 3823462 TI - Noncardiogenic pulmonary edema caused by decompression sickness: rapid resolution following hyperbaric therapy. AB - Noncardiogenic pulmonary edema is a recognized but uncommon manifestation of type 2 decompression sickness. It typically occurs within 6 hours of a dive. Because the adult respiratory distress syndrome in this setting is believed to be due to microbubbles in the pulmonary vasculature, recompression in a hyperbaric chamber has been recommended as a form of therapy. A patient developed noncardiogenic pulmonary edema following a seawater dive to 75 feet. There was complete radiologic and clinical resolution within 5 hours of hyperbaric therapy. PMID- 3823463 TI - Development and implementation of a quality assurance program for mammography. AB - As a pilot study for a national campaign to promote the use of screening mammography, the Virginia Division of the American Cancer Society conducted a breast cancer awareness project with mammography screening. An important part of the program was the development of a quality assurance program for mammography. Guidelines were established for equipment, image recorders, processing, dose, and patient positioning. A survey of information about the mammographic equipment was conducted, and the mammograms from each facility were reviewed. A total of 63 mammographic units in 56 facilities statewide were included in the month-long program during which approximately 9,000 women were screened. PMID- 3823464 TI - Punctate intranodal gold deposits simulating microcalcifications on mammograms. AB - Some axillary lymph nodes are frequently seen on mammograms. Rarely, such nodes will demonstrate opacities that appear to be multiple punctate calcific deposits. The literature is of little guidance as to the meaning of this appearance. One report indicates that breast cancers that are manifested as extensive punctate calcifications very rarely occur in this pattern in metastatically involved axillary lymph nodes. The authors suggest that such punctate densities are much more often indicative of intranodal gold deposits and that they occur almost invariably in patients with rheumatoid arthritis who have undergone prolonged chrysotherapy. This observation was confirmed in one patient and suspected in three others with similar clinical histories. PMID- 3823465 TI - MR imaging of the scrotum: normal anatomy. AB - High-resolution magnetic resonance (MR) imaging with a surface coil was utilized to evaluate the normal scrotum. Scrotal contents, spermatic canal, and inguinal regions were visualized within the same field of view. Differences in signal intensity in the testis, epididymis, tunica albuginea, fluid, fat, and spermatic cord allowed for clear delineation of these structures in detail. The high contrast and spatial resolution of MR imaging, coupled with the wide field of view and absence of ionizing radiation, make MR imaging well suited for evaluation of the scrotum. PMID- 3823466 TI - MR imaging of the scrotum: pathologic conditions. AB - The utility of high-resolution magnetic resonance (MR) imaging in studying a variety of intratesticular and extratesticular pathologic conditions was assessed. The high magnetic signal intensity of the testis provided an excellent background for visualization of intratesticular abnormalities. Except for old blood, all intratesticular processes were less intense than testis, especially on T2-weighted images. The visualization of the tunica albuginea is a distinct advantage, allowing its assessment in cases of trauma or testicular tumors. Epididymal and spermatic cord abnormalities were easily recognized. All pathologic conditions were best seen on T2-weighted images acquired in the coronal plane. Balanced images allowed for tissue characterization. PMID- 3823467 TI - Visceral sensation. PMID- 3823468 TI - Sensory innervation of reproductive organs. PMID- 3823469 TI - Neurochemistry of visceral afferent neurones. PMID- 3823470 TI - Spinal cord projections and neuropeptides in visceral afferent neurons. PMID- 3823471 TI - Somatic and visceral sensory integration in the thoracic spinal cord. PMID- 3823472 TI - Visceral inputs to sensory pathways in the spinal cord. PMID- 3823473 TI - Clinical approach to visceral sensation. PMID- 3823474 TI - Neural mechanisms of cardiac pain. PMID- 3823475 TI - Sensory-motor integration in urinary bladder function. PMID- 3823476 TI - Spinal cord integration of visceral sensory systems and sympathetic nervous system reflexes. PMID- 3823477 TI - Brainstem control of visceral afferent pathways in the spinal cord. PMID- 3823478 TI - Afferent C-fibres and visceral sensation. PMID- 3823479 TI - Brainstem integration of cardiovascular and pulmonary afferent activity. PMID- 3823480 TI - The visceral sensations--some basic mechanisms. PMID- 3823481 TI - Sensory innervation of the heart. PMID- 3823482 TI - Sensory innervation of the lungs and airways. PMID- 3823483 TI - Vagal afferent innervation of the gastrointestinal tract. PMID- 3823484 TI - Functional properties of spinal visceral afferents supplying abdominal and pelvic organs, with special emphasis on visceral nociception. PMID- 3823485 TI - [Peptidylarginine deiminase, protein-arginine deiminase and protein-L-arginine iminohydrolase]. PMID- 3823486 TI - Gastric mucus: lubricant or more? PMID- 3823487 TI - Effects of thromboxane analog U46619 on endothelial damaged canine coronary arteries in vivo. AB - We studied the effects of the thromboxane analog, U46619, infused into the left anterior descending (LAD) artery of intact dogs before and after producing endothelial denudation of the mid portion of the LAD. Proximal artery cross sectional area (CSA) decreased by 47% with 0.1 microgram/min infusion of U46619 with intact and denuded endothelium, while resting CSA reduced spontaneously following denudation. Coronary resistance vessels demonstrated a marked constrictor response to U46619 with a rise in resistance and a fall in flow and myocardial O2 consumption. U46619 produces significant narrowing of proximal epicardial coronary arteries as well as resistance coronary vessels. This effect could cause ischemia in patients with moderate coronary atherosclerosis. PMID- 3823488 TI - Radioimmunoassay for 11-dehydro-TXB2: a method for monitoring thromboxane production in vivo. AB - A radioimmunoassay was developed for 11-dehydro-TXB2, a prominent metabolite of TXB2 in blood and urine of several species. In order to reliably assay 11-dehydro TXB2, its chemical stability as well as its chromatographic properties were first examined. Since dehydrogenation at C-11 converts the thromboxane ring into the delta-lactone form of a dicarboxylic acid, which can also occur in an open form, the analysis of 11-dehydro-TXB2 may be somewhat complicated. In some chromatographic systems, the compound thus migrated with pronounced tailing, and during extraction using the common Sep-Pak procedure the two forms were partially separated. The lactone as well as the open form could be conclusively identified using mass spectrometry. The equilibrium between the two forms of 11-dehydro-TXB2 was studied in buffers of different pH and in plasma. Higher pH favoured hydrolysis into the acyclic structure. The lactonization and hydrolysis processes were also shown to be time and temperature dependent. Two different antiplasms, raised in rabbits against conjugates of 11-dehydro-TXB2 with bovine serum albumin, displayed somewhat different properties in their recognition of the two forms of 11-dehydro-TXB2. A radioimmunoassay employing these antibodies was developed. The labeled antigen was prepared by incubation of 3H-TXB2 with rabbit lung supernatant. The limit of detection was 1.5 pg. For validation of the assay, analysis of blood and urinary samples, obtained after injection of TXB2 to a human volunteer, was done. The values obtained were compatible with previous isotope studies. Results from an inhibition experiment with rabbit lung incubated in the presence or absence of indomethacin further supported the identity of the assayed substance. PMID- 3823489 TI - Pharmacology of aerosol leukotriene C4- and D4-induced alteration of pulmonary mechanics in anesthetized cynomolgus monkeys. AB - Aerosol administration of solutions of 900 micrograms/ml of leukotriene C4 (LT) or D4 to cynomolgus monkeys produced dose-dependent, equipotent increases in pulmonary resistance (Rp) and decreases in dynamic lung compliance (Cdyn). Time to peak response was, in part, related to dose and ranged from 4 to 20 min. Both LTC4 and LTD4 were less potent than histamine. Aerosol pretreatment with the cyclooxygenase inhibitor indomethacin had no significant effect on either LTC4 or LTD4 dose-response curves; however, at the highest doses of these agonists a notable, nonsignificant inhibition of effects on both Rp and Cdyn was seen. Intravenous dl-propranolol had no effect on responses to LTD4. Aerosol pretreatment with FPL 55712 significantly (P less than 0.05) inhibited airway responses to both LTC4 and D4. In contrast, an intravenous infusion of FPL 55712 failed to block the bronchospastic activity of LTD4. In conclusion, cynomolgus monkeys are responsive to aerosol administration of LTC4 and LTD4, and the pharmacology of their responses appears to resemble that of man. PMID- 3823490 TI - Coronary artery thrombosis and elevated urine immunoreactive thromboxane B2. AB - Immunoreactive thromboxane B2 (i-TXB2) was measured by radio-immunoassay (RIA) in urines collected over eight hours on the day of admission in 25 patients who were admitted with the diagnosis of myocardial infarction. In 16 of the patients myocardial infarction was confirmed by ECG and plasma enzymes. Another patient presented with pulmonary embolism and the remaining eight patients had angina pectoris. A further eight hour urine collection was obtained 24 hours later from eleven of the sixteen patients with myocardial infarction. In these eleven patients myocardial infarction was associated with five fold higher urine i-TXB2 (2.72 +/- 0.48 ng/ml) at the day of admission when compared to patients admitted under the same diagnosis but found to have angina only (0.51 +/- 0.08 ng/ml, p less than 0.001). In patients with myocardial infarction the urine i-TXB2 values were reduced 24 hours later (1.58 +/- 0.27 ng/ml, p less than 0.01). One patient was followed with urine i-TXB2 from three days prior to diagnosis of myocardial infarction and to one day prior to a second infarction. In this patient i-TXB2 was highest three days prior to infarction. We conclude that this early elevation of urine i-TXB2 three days prior to diagnosis of infarction and the increased i TXB2 in patients with myocardial infarction when compared to patients with angina suggest thromboxane is probably released from activated platelets prior to infarction. We suggest that urine i-TXB2 may be of value in the differential diagnosis between myocardial infarction and angina. PMID- 3823491 TI - ["... a God told me, what I suffer"--emancipation and method]. PMID- 3823492 TI - [Staying on track. The psychoanalytic movement and the distress of the psychoanalytic institution]. PMID- 3823493 TI - [Demise of an institution]. PMID- 3823494 TI - [Fantasy and reality in psychoanalytic institutions]. PMID- 3823495 TI - [Siegfried Bernfeld's Freud studies]. PMID- 3823496 TI - [Borderline patients]. PMID- 3823497 TI - [Statistics on the contributions of female authors to the journal Psyche]. PMID- 3823498 TI - [Clinical evaluation of serum squamous cell carcinoma-related antigen levels in patients with malignant neoplasms]. PMID- 3823499 TI - An examination of 3H and 14C hand contamination at the radioisotope laboratory of a medical school. AB - In a field of bio-medical science, low energy beta-emitting nuclides, such as 3H and 14C, are used frequently. However, contamination with those nuclides on laboratory workers is not detectable by the ordinary hand-foot-cloth monitor, if it occurs. Therefore, a new contamination check method, hand washing combined with lyophilization, was studied and feasibility of the method has been confirmed. The lyophilization step of the method takes about ten hours so it is not practical to use the method as a daily contamination check. However, it can be done at regular intervals and it will give valuable information for the maintenance of the radioisotope laboratory. PMID- 3823500 TI - [Results of various anesthesia procedures in cesarean section]. AB - Between 1979 and 1985, 1170 anaesthetics have been used for caesarean sections. The frequency of caesarean sections ranged from 11.9% to 14%. Since 1979, the use of general anaesthesia for caesarean sections has continually decreased from 76% to 11% in favour of regional anaesthesia, and the decrease in general anaesthesia has been most obvious since 1981. The sudden increase in the use of regional anaesthesia was caused by a fatal complication during general anaesthesia. Since 1982, peridural anaesthesia has been used most often (about 60%), followed by spinal anaesthesia (about 30%) and general anaesthesia (about 10%). Regarding peridural anaesthesia, in 94% of the cases the analgesic level was at T 3-8. In spinal anaesthesia, in 90% of the cases the analgesic level ranged from T 3 to T 8. In the latter, segments T 3-4 were reached more frequently. The analgesic effect of peridural anaesthesia was often regarded as being "as good" as the analgesic effect of spinal anaesthesia. A comparison of the anaesthetic techniques in emergency and nonemergency situations revealed that until 1981 in only 30% of the cases was regional anaesthesia performed. After 1981, there was an increase in regional anaesthesia to about 88%. An emergency indication for caesarean section existed in 75% of the cases. Regarding general anaesthesia, the most frequent secondary effects were said to be tachycardia, hypotension and ventricular extrasystoles. Serious complications rarely occurred; nevertheless, when they occurred, they were a threat to life under certain circumstances. Regarding regional anaesthesia, the most frequent secondary effects proved to be vomiting, hypotension and tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823501 TI - [Side effects following intravenous regional anesthesia (IVRA) on the central nervous system and heart rate]. AB - Forty patients undergoing upper limb surgery received intravenous regional anaesthesia (IVRA). Electroencephalographic (EEG) and electrocardiographic (ECG) assessments were performed the day before surgery without any premedication and postoperatively before, during and after the release of the cuff. For IVRA, vasocontrictorfree 0.5% mepivacaine solution at a dosage of 3 mg/kg body wt. was applied, followed by an additional injection of 20 ml 0.9% NaCl solution. The EEG and ECG did not show any evidence of toxical effects on brain function or cardiac rhythm. In response to the sedative property of mepivacaine stages of sleep were observed in all patients following the release of the cuff. Because of this effect on alertness, ambulant patients should not participate actively in traffic. PMID- 3823502 TI - [Emergency indications for cesarean section]. AB - It must be kept in mind that there are few situations that demand immediate surgery. Regarding indications for most caesarean sections, there is enough time for the anaesthesist to administer speedy, but nevertheless orderly premedication and judge the indications for anaesthesia. The anaesthetic technique should be determined in agreement with the obstetrician. In most hospitals, general anaesthesia can probably be performed more quickly than intrathecal or extrathecal anaesthetics. However, this article will not deal with the details involved in these methods. PMID- 3823503 TI - [Choice of anesthesia procedure in cesarean section (general versus regional)]. AB - Peripartum maternal mortality occurs in about 0.2% of patients. There are anaesthesiological causes in 5%-15%. Almost 50% of the anaesthesiologically based fatalities can be attributed to aspiration and hypoxia, frequently in combination with problems of intubation during general anaesthesia. In spite of numerous recommendations to avoid aspiration, it will never be possible to prevent hypoxaemia once and for all. In order to do as much as possible to exclude this maternal risk during a caesarean section, regional anaesthesia is being performed more often. Appropriate techniques are: lumbar (catheter), epidural, or spinal anaesthesia. Because of the large dose of the local anaesthetic necessary, caudal anaesthesia is normally excluded. The advantage of these techniques, especially with relation to the safety of the mother, can only be guaranteed for the following prerequisites: when maternal hypotension can be excluded or treated in time; when the block inadvertently spreads too high and is diagnosed in time; when intravascular injection of the local anaesthetic is avoided. Regional anaesthesia techniques do not endanger the cardiocirculation of the fetus, or its respiration, metabolism or neurological adaptability. Furthermore, these techniques are more advantageous when the developmental period is prolonged. The use of long-acting local anaesthetics is beneficial, as only a small quantity passes through the placenta and mixture with adrenaline is avoided. This is important because adrenaline may jeopardize the perfusion of the pregnant uterus because of the increased sensitivity of its alpha-receptors. For epidural anaesthesia, 0.75% bupivacaine is most frequently administered on account of the rapid onset of action and enhanced motor block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823504 TI - Proton magnetic resonance in experimental acute and chronic renal failure in rats. AB - Kidney cortical and medullary "spin-lattice" (T1) and "spin-spin" (T2) relaxation times were measured by spectroscopy in several types of experimental renal failure in rats. The T1 and the measured tissue water content were used to calculate the fraction bound (FB) and hydration fraction (HF) according to a fast proton diffusion model. The present study demonstrated the possibility to differentiate between normal and pathological renal tissue resulting from renal artery clamping (RAC), renal pedicle clamping (RPC) with or without reflow, glycerol-induced acute renal failure with or without previous dehydration, and chronic hypertensive renal failure induced by 5/6 nephrectomy and saline loading, with low (6%) or normal (21%) protein diet. Shortened T1 and prolonged T2 found in both cortex and medulla of the glycerol-induced ARF in dehydrated rats seem to represent a MR ischemic pattern. The prolongation of T1 and T2 and the increase in water content in the other groups seem to relate to different amounts of tubular obstruction and renal congestion. In summary, characteristic MR properties of different types of renal failure may provide etiological and pathogenetic diagnostic possibilities. PMID- 3823505 TI - Early renal pathophysiology in an acute model of cyclosporine nephrotoxicity in rats. AB - We have recently described a rat model of acute cyclosporine nephrotoxicity characterized by rapid onset of reproducible mild to moderate renal failure. In the present studies, we have examined early pathophysiologic events and morphologic changes in this model. Following acute intraperitoneal administration of 60 mg/kg of parenteral cyclosporine, renal blood flow (RBF) fell 24% from baseline. Intraperitoneal administration of an oral cyclosporine preparation (60 mg/kg) also reduced RBF (25%), as did administration of an equivalent volume of parenteral cremophore (23%). Renal vascular resistance (RVR) increased significantly in all these groups. In contrast, intraperitoneal administration of mineral oil or olive oil oral vehicle produced no significant change in RBF (4% fall from baseline), and RVR actually decreased in these control animals. Following 2 daily doses of these agents, RBF remained significantly lower in rats given parenteral cyclosporine (5.10 mL/min vs 8.54 mL/min in cremophore rats and 7.28 mL/min in oil control rats) and renal vascular resistance remained high. Systemic blood pressure was also significantly lower in cyclosporine-treated rats at 2 days, and GFR was depressed. Morphologic studies revealed a correlation at 2 days between tubular vacuolation and renal blood flow and renal vascular resistance in cyclosporine-treated rats. PMID- 3823506 TI - Natriuretic response to volume loading in normal and edematous dogs during lower body positive pressure. AB - The application of lower body positive pressure with military antishock trousers (MAST) to dogs in a 45 degrees head-up tilt is known to increase cardiac output and blood pressure, and to maintain life. In the present study we used MAST in an attempt to improve the natriuretic response to saline loading in normal and edematous anesthetized dogs. Twelve normal dogs were saline-loaded (7% body weight) in the supine position with and without MAST 4 days apart. The increment in UNaV without MAST was 853.3 +/- 26 mu Eq/min and averaged 870.4 +/- 33 mu Eq/min with MAST (p greater than 0.05). The dogs were then subjected to chronic thoracic caval constriction, and when ascitic were tested again. Now, the increment to acute volume loading was 87.6 +/- 12.1 mu Eq/min without MAST and 92.8 +/- 8.8 mu Eq/min with MAST (p greater than 0.05). The application of lower body positive pressure (60-80 mm Hg legs; 40-60 mm Hg abdomen) is not effective in promoting a natriuretic response to acute volume loading in either normal or edematous dogs with profound disturbances to the Starling forces over an extensive vascular territory. PMID- 3823507 TI - Improving the prognosis in acute renal and respiratory failure. AB - We have achieved smooth homeostasis in patients with acute renal and respiratory failure by means of machine-controlled, continuous ultrafiltration and simultaneous bicarbonate hemodialysis with a polysulfone, biocompatible membrane (CUPID). No adverse effects were seen, even after 22 days of continued treatment. Mortality was reduced (7/14) when compared to that of a similar group given short conventional daily acetate hemodialysis and ultrafiltration with a cuprophane membrane (12/18). PMID- 3823508 TI - Recurrent acute renal failure with interstitial nephritis due to D-penicillamine. AB - A 60-year-old man with rheumatoid arthritis, who developed acute reversible renal failure with nephrotic syndrome and tubulointerstitial nephritis in association with multiple-drug therapy, is described. The episode was ascribed to the nonsteroidal anti-inflammatory agent fenbufen, and the patient was reexposed to D penicillamine within 6 months, reproducing the same renal lesion. There was no evidence of the glomerular lesions characteristically associated with D penicillamine nephrotoxicity. D-penicillamine was the only drug therapy common to both episodes and it is concluded that it may cause tubulointerstitial nephritis with nephrotic syndrome. PMID- 3823509 TI - [Subacute osteomyelitis in young children. Study of 17 cases]. AB - Subacute osteomyelitis is characterised by absence of symptoms of generalised infection and a favourable prognosis. In the last 15 years, the authors have observed 17 such cases in children, aged between 3 months and 4 years. Three were situated in the epiphysis and 14 in the metaphyseal region. On three occasions, a tarsal bone was involved and in five cases the lesion was in the spine. The radiological signs were very characteristic and biological changes were minimal. Exploration of the site of the infection was done on ten occasions, but only on two were organisms found. Treatment was based on antibiotics active against staphylococci and drugs inhibiting prostaglandins. Only one case was treated surgically. Healing occurred eventually in all cases. PMID- 3823510 TI - [Infection following centro-medullary nailing of diaphyseal femoral and tibial fractures]. AB - The authors have treated 51 cases of infection arising after intramedullary nailing of the femur or tibia. In 3 cases amputation was required, 48 united, but 10 were still draining. The final result was obtained after an average of 15 months. An average of four procedures per patient were needed. All the cases were septic non-unions at the onset of treatment, except 18 cases which had already united. In these cases, simple removal of the femoral nail led to rapid healing. In contrast, healing was less easy to obtain in the tibia. In 33 septic non unions, 12 femoral and 21 tibial, the best results at the femoral level were obtained by retaining the nail in situ. At the tibial level, retention of the nail was rarely followed by bony union. Removal of the nail and the use of external fixation gave good results for the infection, but rarely resulted in bony union (1 case out of 14). The failures were treated by further operation of bone resection and grafting. The authors recommend, in cases of tibial septic non union after nailing that primary removal of the nail should be associated with bony resection and external fixation, followed by reconstructive grafting, either by open cancellous grafting extending to the fibula or conventional tibio fibular grafting. In 8 cases, 7 in the femur and 1 in the tibia, the infection extended throughout the entire diaphysis and in 3 of these cases, a large diaphyseal resection was required. PMID- 3823511 TI - [Progressive lengthening of the femur using Wagner's technic. Apropos of 48 cases]. AB - Forty eight progressive femoral lengthenings using the Wagner technique have been performed on patients aged between 6 and 18 years (average 12 years). The main aetiology of the shortening was congenital deformity (25 cases). The mean lengthening obtained was 5.2 cm and the greatest was 11.2 cm. Lengthening obtained was more than 20 p. 100 in six cases with an extreme of 24 p. 100. The final discrepancy was always less than 25 mm. In 6 cases this was corrected by the addition of a contralateral epiphysiodesis or tibial lengthening. Weight bearing was resumed after an average of 5-6 months. Many complications occurred. Some were minor: sepsis in the pin tracks (14 cases) or varus derotation corrected at the end of lengthening (22 cases). Some were more severe: varus deformities of more than 5 degrees (8 cases), contractures at the knee or the hip corrected by tenotomies in the course of lengthening (2 cases), subluxation of the hip or knee (5 cases), fractures, delayed unions, non-unions without infection (7 cases). The major complications were 15 severe infections, 6 of them with fractures or non-unions and 5 neurological lesions. PMID- 3823512 TI - [Osteoid osteoma of the floor of the acetabulum in children. Apropos of a case]. AB - The authors report a case of osteoid osteoma of the acetabulum in a 5 year old child. It was resected after arthrotomy by an anterior approach. The upper end of the femur was deformed and this was related to impaired growth. After the operation, the pain subsided but the deformity was still noticeable two years later. PMID- 3823513 TI - [Pseudarthrosis of the lower end of the radius due to interposition of the long extensor of the thumb]. AB - The authors describe one case of a severely displaced Smith's fracture which was originally immobilised by external fixation. Three month's later the fracture had not united and active extension of the thumb was absent. At operation, the extensor pollicis longus tendon was found to be dislocated into the fracture site. The tendon was repaired and the non-union was treated by plating. A review of the literature discovered only one other similar case. PMID- 3823514 TI - [Use of an aiming device and nail-plate osteosynthesis in rotation osteotomies of the femur neck]. AB - During the past four years, the authors have performed 16 anterior rotation osteotomies of the femoral neck in cases idiopathic necrosis of the head of the femur, using the Sugioka technique. There were a number of difficulties in obtaining the planned displacement, satisfactory apposition of the bone ends and sound fixation. An original design of aiming device was made to allow greater accuracy during the operation. Fixation was obtained by a one-piece nail-plate. The surgical technique is described fully. The results have been improved, thanks to this new technique. PMID- 3823515 TI - [Epidemiology of occupational risks: methodological problems]. AB - The main methodological problems encountered in occupational epidemiology are related to the particularity of the risk factors concerned. It is necessary to account for the "Healthy Worker Effect" in the design, analysis and interpretation of surveys since the very presence of workers at particular jobs is related to their health. In cohort studies, it is necessary to have precise knowledge of the work environment corresponding to different jobs as exposure information is generally not individual, objective and continuously recorded. In case-control studies also, information on occupational exposures is a key issue, not only from the point of view of differential bias but also because exposure that is too loosely defined leads to dilution and reduced accuracy. PMID- 3823516 TI - [Evaluation of preventive measures against occupational health hazards]. AB - The epidemiological methods which can be used to assess preventive measures against occupational health hazards are those used in the evaluation of public health interventions in general, with specific constraints. These constraints are mainly linked to the ethical aspects of intervention concerning occupational health hazards, to the long latency period of occupation related diseases, and to the complexity of the preventive actions. They probably explain in part why evaluative studies of preventive actions against occupational health hazards remain rare, and the methods used often inappropriate. Nonetheless, assessment of the efficacy of preventive measures at the workplace is necessary, and adequate methods do exist. PMID- 3823518 TI - [Epidemiology and prevention of occupational health hazards within the European Community]. AB - Since 1978 the European Community has had an action programme on safety and health at work covering all 120 million workers in the Community. On the basis of this programme, directives (instruments of Community legislations) have been adopted by the Council of Ministers and new directives are being drafted. The aim of these directives is to improve safety at work and to protect the health of workers from mechanical, physical, chemical and biological hazards. The drafting of proposals by the Commission for presentation to the Council necessitates detailed and critical examination of the scientific data available, such as epidemiological studies, statistical data and the results of experiments. Epidemiological studies of cases of mesothelioma have led us to propose more stringent limit values for crocidolite than for other asbestos fibres in the air at the place of work. At present, in order to gain a clearer idea of the carcinogenicity of the various compounds of nickel, efforts are being made to collate and update all the epidemiological studies conducted on this subject throughout the world. Finally, particular attention is being paid to the opportunities provided by the anti-poison centres for developing clinical toxicology and epidemiology. PMID- 3823517 TI - [Absenteeism as a predictor of severe morbidity. A double case-control study (myocardial infarction and industrial accident) in a large company of the Quebec Province]. AB - Are absenteeism indicators usefull as predictor of serious morbidity in a working population? To seek an answer was the objective of a double case-control study carried out in a large company (17000 workers) of Quebec Province. In the first study, 64 cases of myocardial infarction (incidence density = 1.66% +/- 0.35) were compared with 64 controls matched for sex, age and type of work. In the second one, 142 cases of labor accident were compared with 142 controls sampled in a similar way. Absenteeism frequency and length were analysed during the period of 6 to 12 years prior to the onset of the health problem. Ratios were calculated on an individual basis for all causes of absence and for sick leave; they were adjusted for length of service. A four classes interval scale was used for the comparison. An excess of absence length exists in the two studies. The excess is not significant for the myocardial infarction cases (+ 33%, with a statistical power = 51%). It is significant for the labor accident cases (+ 52%, p less than 0.01). The corresponding odds ratio calculated in reference to the lowest absence group were 2.4 (0.9-6.6) and 2.7 (1.5-4.9). The cumulative absence length can be considered as a predictor of serious disease. A conceptual framework of the relationship between absence and natural disease history is presented. The epidemiological approach to the phenomenon of absence is certainly usefull in spite of the controversy underlined by the social sciences. PMID- 3823519 TI - [Teaching of epidemiology applied to occupational health hazards]. AB - Courses offered students in occupational medicine, ergonomics, occupational hygiene are generally brief, sometimes more substantial but too theoretical and not sufficiently specific. Graduate courses are more specific, more pertinent and probably more efficient. PMID- 3823520 TI - [Mortality and occupation: theoretical problems and concrete illustrations]. AB - This article reviews the methods generally used when studying occupational mortality. First, the different schemes of collecting data are cited; secondly, all the indexes (PMR, SMR, standardisation by direct method, etc.) that can be employed in this kind of analysis are studied, and each of them is critically evaluated. Finally, in order to compare the advantages of SMR over the effects of direct standardisation, these two indexes are combined in a brief study of the most recent data in France concerning occupational mortality. In illustration, an analysis is made of the most common causes of male deaths in 1982, among farmers, engineers, artists, teachers and those in the liberal professions. PMID- 3823521 TI - [Biological aspects of occupational exposure to cadmium and several other metals]. AB - We have performed several cross-sectional epidemiological surveys among workers exposed to cadmium, mercury vapour or manganese in order to assess : their early biological or functional effects; the biological tests allowing an assessment of the amount of metal absorbed or stored in the body; the acceptable exposure levels. Studies have also been carried out among persons exposed to inorganic arsenic in order to define its inactivation mechanism and to develop a biological test of exposure. The kidney is the main critical organ following long-term exposure to cadmium. To prevent the occurrence of renal changes in the majority of male workers exposed to cadmium, its concentration in renal cortex should not exceed 215 micrograms/g (wet weight), and that in urine : 10 micrograms/g creatinine. A blood cadmium level of 1 microgram/100 ml has been suggested as maximum tolerable level for long-term exposure. Prolonged exposure to mercury vapour may lead to renal and neurological disturbances. The preclinical signs of nephrotoxicity are correlated with the amount of mercury absorbed which may be assessed by monitoring the mercury level in urine. The neurotoxic effects (particularly tremor) are mainly related to the integrated exposure (duration and intensity). A maximal permissible level of 50 micrograms Hg/g urinary creatinine is proposed to prevent the occurrence of these toxic effects. An exposure to manganese dust for 7 years on the average at a level below the maximum allowable airborne concentration (5 mg/m3) recommended by the ACGIH in the USA may still lead to a slight reduction in psychomotor and spirometric performances and interfere with calcium metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823522 TI - [Which measures are to be taken in the prevention of prematurity in working women?]. AB - The aim of this study was to determine the best preventive measures for employed pregnant women. Assuming that certain working conditions constitute a risk factor for preterm birth, should we give time off to women whose jobs are strenuous, reduce their weekly hours of work, or lengthen their antenatal maternity leave in an attempt to reduce risk of preterm birth? To answer this question, a survey carried out in 50 factories showed that a reduction of weekly working hours (routinely granted in many factories at present) appears helpful in reducing the preterm birth rate : this is also true for sick leaves granted for fatigue without pathological reason : on the other hand, the lengthening of antenatal maternity leave for fatigue, without medical reason, seems without effect. In the absence of experimental evaluation of preventive measures proposed at the end of this study, we provide a model for evaluating, theoretically, the relationship efficiency/cost/acceptability of such measures. Consequently, instead of lengthening antenatal maternity leave, we suggest prescribing 1 rest week (as sick leave) per month, beginning with the 4th month of pregnancy, for women working in strenuous conditions. PMID- 3823523 TI - [Role of epidemiology in the evaluation of carcinogenic risks in occupational environment]. AB - There are in use today tens of thousands of chemical substances whose potential carcinogenic risks are often not known. The IARC monographs on the evaluation of the carcinogenic risk for man from environmental substances have shown that, for 707 substances or exposures studied, 36 have been identified as associated with a risk of cancer and only 60 have been submitted to epidemiologic studies. Estimating the number of cancers attributable to occupational factor must be envisaged from a preventive viewpoint. If one uses an average and reasonable estimate in France of 10%, the number of cancers of occupational origin could be considered to be approximately 22,000 new cases each year. PMID- 3823524 TI - [Epidemiology of occupational respiratory diseases]. AB - In the occupational environments air pollutants may be of different natures (chemical, mineral, etc.) and forms (particles, gas, etc.). Except in some acute circumstances the respiratory diseases need several years to develop. These diseases may be specific, caused by a particular pollutant (i.e.: silicosis, asbestos) or non specific (i.e.: chronic bronchitis). Epidemiological studies are well-adapted tools for the acquisition of knowledge and understanding of the pathological processes. They may also lead to efficient preventive action, treatment or compensation. For each of these 3 points (knowledge, understanding, action) one must keep in mind specificities of the respiratory diseases which may be different from one to the other with respect to etiological factors, varieties of disordered structure and function. One also must keep in mind the specificities of the place where the studies will be conducted (large or small factories, professional groups, specific or miscellaneous hazards), the research teams with different skills and competences, the relational problems with the managers, the workers, the unions, the occupational physician, etc. Some particular comments are given about the definition of the disease, the ways of examination methods, the population to be studied and controlled, the evaluation of hazards, the relationships between disease and risk factors. PMID- 3823525 TI - [Occupational exposure to noise, hearing loss and arterial hypertension]. AB - Clinical examinations and audiograms were conducted in a group of 249 men working in a foundry of the Paris area. Before and after adjustment for age, systolic blood pressure levels were positively associated with the duration of the occupational exposure to a noise greater than 85 dBA: 127.8 mmHg in the non exposed group, 128.6 mmHg when the exposure lasted less than 10 years, 130.1 mmHg from 10 to 19 years, and 140.1 mmHg over 20 years (p less than 0.001). The odds ratio of arterial hypertension associated with an occupational exposure over 20 years was 1.6 (p less than 0.05). There was no relationship between noise-induced hearing loss and blood pressure levels. These results suggest that there may be a population at increased risk of high blood pressure. However, the causal relationship between noise exposure and high blood pressure should be confirmed. PMID- 3823526 TI - [Caloric intake and weight gain according to the shift schedule of shift workers]. AB - Survey involved 84 workers matched for age, socio-occupational and families status and divided into 3 groups : A : 27 shift workers on 3 days rotating shift, B : 47 shift workers on 5 days rotating shift, C : 20 days workers. Each subject was submitted to dietary survey by means of 24 hours recall, realised 3 times for shift workers and once for control. All workers were interviewed about caloric intake of the preceding day off caloric intake. Annual weight gain was studied through the use of occupational health service records. There was no significant difference between the 3 groups for working day caloric intake. Day-off intake was lower (p less than 0.05) in group A (day-off any day of the week). Annual weight gain was not different between the 3 groups. Shift workers with faster weight gain had a higher caloric intake on day-off and after evening meal. PMID- 3823527 TI - [Prenatal care and occupational activity]. AB - We studied the gestational age at the first prenatal visit and the number of prenatal visits by occupational activity among 1,573 women who delivered in 32 maternity units of the Belgium's French speaking region. The comparison with non working women showed that working women consulted significantly (p less than 0.01) earlier, whatever their professional activity, their parity and their social class. They consulted significantly (p less than 0.05) more frequently in terms of reaching the expected number of consultations calculated as a function of gestational age at the first visit. This difference disappeared when parity and social class were taken into account. PMID- 3823528 TI - [Female mortality and occupational activity in France (a comparison, 1975-1982)]. AB - The study of the relationship between occupation and health in 1975, indicated a high excess mortality among inactive females. The decline of mortality and the increase in the number of working women recorded recently, have not changed the thrust of the relation. The analysis of the 1982 data shows a rise in the excess mortality of inactives, caused by an increase of the selection effect. The study of the mortality taking into account the marital status shows that it is the transition to working status of many married--therefore preselected--women that has increased the differences in the state of health between active and inactive women. The excess mortality of inactive women varies with the cause of death and it appears that the selection effect is stronger when death is caused by a chronic or slowly developing disease, and weaker when it is due to an accident or a cancer. PMID- 3823529 TI - [Comparative study of spinal and general anesthesia in arthroplastic substitution of the hip]. PMID- 3823530 TI - [Peculiarities of orotracheal intubation in the pig]. PMID- 3823531 TI - [Secretion of 5-hydroxytryptamine after administration of protamine sulfate in heart surgery and carotid endarterectomy]. PMID- 3823533 TI - [Biological transport and tissue extraction of oxygen in surgical heart patients]. PMID- 3823532 TI - [Postoperative analgesia with epidural morphine chloride in upper abdominal surgery]. PMID- 3823535 TI - [Mandibular spasm and malignant hyperthermia]. PMID- 3823534 TI - [Anesthetic considerations in the cancer patient]. PMID- 3823536 TI - [Sudden death during anesthesia in a patient with a tumor of the mediastinum]. PMID- 3823537 TI - [Anesthesia in Ehlers-Danlos syndrome]. PMID- 3823538 TI - [Capnography in pediatric anesthesia for strabismus surgery]. PMID- 3823539 TI - [Use of naloxone in the therapy of septic shock]. PMID- 3823540 TI - [Placenta praevia, placenta accreta and disseminated intravascular coagulation]. PMID- 3823541 TI - [Analgesia with epidural morphine in chest injuries]. PMID- 3823542 TI - [Prevention of post-dural puncture headaches]. PMID- 3823543 TI - [Clinical use of atracurium. Technics of continuous relaxation]. PMID- 3823544 TI - [Intraspinal buprenorphine in surgical anesthesia]. PMID- 3823545 TI - [The Boyle-Davis mouth opener]. PMID- 3823546 TI - [Post-intubation subglottic hematoma]. PMID- 3823547 TI - [Cutaneous necrosis caused by extravasation of barbiturates]. PMID- 3823548 TI - [Results of a national survey on malignant hyperthermia]. PMID- 3823549 TI - [Electroclinical characteristics of seizures in the Aicardi syndrome]. AB - Electro-clinical patterns of seizures were studied in 7 infants with Aicardi Syndrome. In all 7 cases, partial seizure preceded the appearance of asymetrical spasms. Partial seizures and spasms were recorded by polygraphing tracings of long duration. There was a constant correlation between the EEG localization of partial seizures and the side of asymetrical spasms. In 6 cases, a cluster of spasms followed the partial discharge whereas in the 7th case, the partial discharge appeared in the middle of the cluster. Therefore, both partial seizure and cluster of spasms seem to be part of the same critical manifestation. The authors have recorded the same king of seizures in other malformative syndromes (lissencephaly, Bourneville disease) and compare them to those recorded in Aicardi Syndrome. In Aicardi Syndrome, this type of seizures might be in relation with the association of a corpus callosum agenesy and paraventricular heterotopies. PMID- 3823550 TI - [Comparison of the EEG and computerized tomography findings in 500 patients hospitalized in the neurology clinic of the Salpetriere]. AB - A comparative EEG and CT scan Study of 500 inpatients was performed. Patients were divided into four groups: 82 patients (16.5%) had normal EEG and CT scan; 92 patients (18.5%) had normal EEG but abnormal CT scan; 75 patients (15%) had abnormal EEG and normal CT scan; 251 patients (50%) had both EEG and pathologic CT scan alterations. Among the 500 patients, 326 EEG (65%) and 343 CT scan (69%) were abnormal. In 167 cases (33%) only one examination was abnormal. This finding may be considered as indicative of the complementary role for both techniques. For each group, the main clinical features were underlined: objective neurologic syndrome, seizures, psychiatric conditions, subjective complaint and headache. In groups with a pathologic CT scan and pathologic EEG, a percentage of 74 showed a clear neurological nosology. In 41% of these patients, lateralisation and localisation were much easier, owing to the presence of a single lesion. This study emphasised that electroencephalography is useful in temporal pathologies and in determination of the epileptic frame, whereas CT scan is useful in subcortical lesions in fronto-parietal lesions. PMID- 3823551 TI - [Transcutaneous oxygen tension and apnea during sleep stages in normal infants and infants at risk for sudden infant death syndrome]. AB - The relationship between chronic hypoxemia and sudden infant death syndrome (SIDS) has been reported by several authors. In order to study the influence of the apnea-time during a sleep state on transcutaneous oxygen tension (tcPO2), we have studied polygraphically 30 full-term infants (10 controls, 10 SIDS siblings and 10 near-miss for SIDS), aged from 5 to 13 weeks. No significant difference was observed either for apnea-time or tcPO2 between infant-groups studied in different sleep states. We could not find any correlation between apnea-time and tcPO2 in all groups of infants studied during different states of sleep. It is therefore concluded that in normal and at risk for SIDS infants, tcPO2 levels during sleep states cannot be explained only by the apnea-time. PMID- 3823552 TI - [Lateralized periodic activity and cerebral infarct]. AB - A series of EEG recordings shows the evolution of a periodic activity (PA) in a 57-year-old man with acute cerebral infarction. The complexes ranged from 100 to 150 microV, the duration was 750 msec; the periodic occurrence repeated itself every 2 sec. PA is obliterated during the onset of electroclinical seizures. The CT scan shows temporal brain infarction. PMID- 3823554 TI - [Current status and frontiers of calcium antagonists]. PMID- 3823553 TI - The effect of aging on the P3 component in different auditory paradigms. AB - Seventy-two healthy volunteers aged 24-75 years were submitted to different auditory "oddball" ERP (Event Related Potential) paradigms which included an intensity discrimination and a right/left discrimination task. In both conditions, a late positive component (P3) of the vertex potential appeared. However its latency was about 30 msec greater and its amplitude was smaller in the intensity discrimination paradigm. Moreover, P3 latency increased with age in a strictly linear fashion in the intensity discrimination paradigm, whereas in the right/left discrimination paradigm an increase of latency with age was confined to the older age-groups, which is expressed by a quadratic latency/age function. A relation was found between the subjective feeling of difficulty in performing the tasks and P3 latency in the different paradigms. PMID- 3823555 TI - [Interventricular communication in patients under 2. Evaluation of right ventricular pressure using vectorcardiography]. PMID- 3823556 TI - [Heart catheterization guided by 2-dimensional echocardiography: its importance in the Rashkind technic]. PMID- 3823557 TI - [Bicameral left heart ventricle in childhood]. PMID- 3823558 TI - [Development of a new surgical procedure for the correction of hypoplastic left heart syndrome in 2 stages]. PMID- 3823559 TI - [Anatomy of the ventricular myocardium in the ventriculoarterial junction zone. Anatomic bases for the possible role of the myocardium in the dynamics of the semilunar valves]. PMID- 3823560 TI - [Reversal of the cardiovascular effects of clonidine by alphamethyldopa]. PMID- 3823561 TI - [Spontaneous changes in the electrocardiogram in hypertrophic myocardiopathy]. PMID- 3823562 TI - [Angiosarcoma of the heart. Echocardiographic findings]. PMID- 3823563 TI - [Hypereosinophilic syndrome and endomyocardial fibrosis]. PMID- 3823565 TI - [Doppler echocardiography in tricuspid valve insufficiency]. PMID- 3823564 TI - [Doppler examination in mitral insufficiency]. PMID- 3823566 TI - [Doppler echocardiography in chronic aortic valve insufficiency]. PMID- 3823567 TI - [Usefulness of Doppler echocardiography in the evaluation of the severity of aortic valve stenosis. Correlation with the gradients of cardiac catheterization]. PMID- 3823568 TI - [Doppler examination in the evaluation of mitral valve stenosis]. PMID- 3823569 TI - [Evaluation of pulmonary arterial hypertension using pulsed Doppler]. PMID- 3823570 TI - [Study of the diastolic function of the left ventricle using ultrasonic Doppler examination]. PMID- 3823571 TI - [Usefulness of the Doppler study in congenital obstruction of left ventricular flow]. PMID- 3823572 TI - [Study of cardiac shunts using pulsed echocardiography]. PMID- 3823573 TI - [Origins and effects of turbulence of the arterial system]. PMID- 3823574 TI - [Representation of the blood flow by color-coded two-dimensional Doppler]. PMID- 3823575 TI - [Postinfarct programmed ventricular stimulation in patients under 66 years of age]. PMID- 3823576 TI - [Staphylococcal endocarditis: study of 35 cases]. PMID- 3823577 TI - [Critique on the use of electrophysiologic studies in the prevention of sudden death]. PMID- 3823578 TI - [Total hemodilution in children in corrective surgery of congenital heart disease (I). Prospective study in children with a body weight over 12 kg]. PMID- 3823579 TI - [Total hemodilution in children in corrective surgery of congenital heart disease (II). Prospective study in children with a body weight under 12 kg]. PMID- 3823580 TI - [Subclinical changes produced by prolonged treatment with amiodarone]. PMID- 3823581 TI - [Mild arterial hypertension. Usefulness of the exertion test in the evaluation of young patients]. PMID- 3823582 TI - [Percutaneous mitral valvulotomy in rheumatic mitral valve stenosis]. PMID- 3823583 TI - [Mitral valvuloplasty with a double balloon in rheumatic mitral stenosis]. PMID- 3823584 TI - [Mitral prolapse in a patient with Kearns-Sayre syndrome]. PMID- 3823585 TI - [Echocardiographic study of mobile bands within pericardial effusion. Presentation of 3 cases]. PMID- 3823586 TI - [Familial idiopathic auricular fibrillation]. PMID- 3823587 TI - [Intraventricular communication caused by a stab wound. Diagnosis by the 2 dimensional Doppler echocardiogram]. PMID- 3823588 TI - [Strategy for the prevention of ischemic heart disease. Directives from the European Society of Atherosclerosis]. PMID- 3823589 TI - [Intracellular buffering and chronic acidotic states. Findings in hypercapnic respiratory insufficiency and renal failure]. PMID- 3823590 TI - [Biological and clinical significance of plasma-cell acid phosphatase in multiple myeloma]. PMID- 3823591 TI - [Tuberous sclerosis: report of an unusual case]. PMID- 3823592 TI - [Social implications, associated pathology and therapeutic problems of obesity. A retrospective study of a population of obese patients]. PMID- 3823593 TI - [Pseudothrombophlebitic syndrome in arthropathies of the knee]. PMID- 3823594 TI - [New therapeutic trends in osteoporosis: physiopathological bases and clinical aspects]. PMID- 3823595 TI - [Current problems of cardiomyopathies of the peripartum]. PMID- 3823596 TI - Family enrichment: a rehabilitation opportunity. PMID- 3823597 TI - Rehabilitation of disabled children following spinal fusion. PMID- 3823599 TI - Late effects of polio: a shared concern. PMID- 3823598 TI - Inpatient pediatric rehabilitation: a five-year review. PMID- 3823600 TI - In vivo cholesterol synthesis by the rat digestive tract. III. Evaluation of modulating factors. AB - Sterol radioactivity was measured in the gastrointestinal tract of rats fed a semi-purified basal diet (B), either enriched with 0.5% cholesterol (CH) or containing 2% orotic acid (O). These measurements were taken after a fast of 48 h (CHF) or after fasting and 4-aminopyrazolopyrimidine (APP) treatment (CHFA); the five groups were killed 70 min after a subcutaneous injection of [1-14C]-acetate. Since these results agree with current published data, it is suggested that, although this method is not quantitative, it can give accurate estimates of the qualitative variations of cholesterogenesis in one organ. Adding cholesterol to the diet had no effect on sterogenesis in the stomach and caecum-colon. Fasting for 48 h did not affect cholesterogenesis in the caecum-colon, but stomacal sterogenesis was reduced (50%). APP treatment, which did not affect cholesterogenesis in the stomach, strongly stimulated (4-fold) cholesterogenesis in the caecum-colon. A slight decrease (30%) in intestinal cholesterogenesis was observed after a cholesterol-rich diet. This decrease occurred mainly in villus enterocytes. Fasting reduced cholesterol synthesis 2 to 4-fold mainly in the proximal intestine, while APP treatment stimulated it until a level higher than in nourished control rats. The level of cholesterogenesis was similar in all the enterocytes collected from duodenum to ileum in APP-treated rats. Since there was high mucosa cell loss (about 50%) during the 48-hour APP treatment, total intestinal cholesterogenesis in the CHFA rats was not higher than in the CH animals. Under the present physiological conditions, the feedback inhibition of intestinal cholesterogenesis by luminal bile acids was not clear, while that by luminal cholesterol or by LDL-cholesterol penetrating by specific receptors was modest over a wide range of physiological conditions. PMID- 3823601 TI - Perinatal development of the small intestine of the sheep. AB - Soon after birth, the villi in distal regions of the small intestine of the sheep rapidly decrease in size so that by day 6 the normal proximal-distal size gradient (tallest villi proximally) is established. This is the reverse of the gradient found throughout fetal life, where distal villi are taller than proximal villi. While crypt depth increases in both regions, the increase is more marked in proximal regions. The proportion of crypt cells labelled with a pulse of (3H) thymidine increases dramatically during day 1. Vacuolated cells are present in distal regions at day 2, but are absent by day 5. It is possible that the rapid loss of villus tip cells in distal regions is the means by which closure is achieved in this species. There is evidence to suggest that endogenous cortisol plays an important role in these changes. PMID- 3823602 TI - Adaptation of pancreatic lipase to the amount and nature of dietary lipids in the growing pig. AB - The purpose of the present study was to examine the adaptation of pancreatic lipase to the amount and nature of dietary lipids in the growing pig. Thirty pigs were distributed into three groups of 10 animals each. They were fed the same amount (1.5 kg/pig/day) of either diet C (3.5% lard, 3.5% sunflower oil, 67.7% starch), diet L (21% lard, 33.2% starch) or diet SO (21% sunflower oil, 33.2% starch) for 12 days. The diets were isoenergetic and isonitrogenous. Pancreas weight relative to live-weight was highest in group L. The pancreatic lipid content of the latter group exceeded that of groups C and SO by 53 and 39%, respectively. The pancreatic protein content was similar in the three groups. The specific lipase activity of pancreatic tissue (U per mg of protein) in group SO was about 1.6-fold higher than that of group L and about 3-fold higher than that of group C (31.9, 19 and 11.6, respectively). Specific amylase activity was higher in animals of group C than in those of the other two groups (C : 1689; L : 1112; SO : 984), whereas no difference was observed in chymotrypsin activity. Specific trypsin activity was lowest in group L. These results confirm the adaptation of pancreatic lipase and amylase to their respective substrates. Furthermore, it appears that lipase activity was more or less affected by the degree of unsaturation of lipids and that it was much higher for the same amount of triacylglycerols when the latter were rich in unsaturated fatty acids. The mechanisms involved have not been determined yet, but the possible physiopathological consequences of the increased pancreatic lipid content observed in pigs receiving triacylglycerol-rich diets (including especially saturated fatty acids) should be considered. PMID- 3823603 TI - Plasma free and total iodothyronine levels in the newborn lamb. Physiological considerations. AB - Neonatal changes in plasma total and free iodothyronine levels were monitored in 18 Limousin X Romanov suckling lambs (experiment 1) and 24 Limousin X Romanov animals bottle-fed in standardized conditions (experiment 2). In the two experiments, plasma free T3 levels were closely related to total T3 levels, whereas some differences could be observed between total and free plasma T4 levels. The neonatal rise in free T4 in particular was higher than that observed for total T4 levels. Consequently, the enhancement of T4 availability for T3 generating cells could partly explain the neonatal T3 surge. In addition, plasma reverse T3 levels decreased progressively during the first 48 h of life in suckling lambs. These results suggest also that hypotrophy and/or nutritional status could affect neonatal thyroid function: plasma active iodothyronine levels decreased sharply in bottle-fed lambs (birthweight : 2.29 Kg) compared to suckling ones (birthweight : 3.57 Kg), whereas reverse T3 levels increased. PMID- 3823604 TI - Immuno-neutralization of maternal plasma oestradiol stimulates fetal growth in rats. AB - On day 12 of pregnancy, 7 rats were injected with 2 ml of an anti-oestradiol antiserum a quantity capable of binding 2.4 micrograms oestradiol. Seven further (control) rats were injected with an antiserum raised against human serum globulin. After sacrifice on day 21 of pregnancy, the fetuses from treated rats showed an increase in both placental weight (0.851 +/- 0.023 g, n = 98 vs 0.752 +/- 0.019 g, n = 97) and fetal weight (4.446 +/- 0.426 g, n = 98 vs 3.403 +/- 0.211 g, n = 97). There was no significant difference in protein, DNA and RNA contents between the fetuses from treated mothers and those from control mothers. This experiment confirms that oestrogens may play a role in fetal weight gain. PMID- 3823605 TI - [In vitro study of ionophore antibiotics and various derivatives. I. Action on fermentation products in the rumen]. AB - An in vitro study was conducted to test the action of different ionophore antibiotics and some of their derivatives on the end-products of rumen fermentation. Nigericin and narasin, like monensin and lasalocid, increased the molar proportion of propionate in the V.F.A. mixture and decreased the proportion of acetate and especially that of butyrate. They had no action on total V.F.A. production. The effect observed with derivatives (lasalocid O-acetyl or nigericin O-acetyl) was generally less. Gas production, chiefly methane, decreased with the addition of antibiotics. This result agrees with the stoichiometric reactions of carbohydrate fermentation in the rumen. The amount of ammonia nitrogen fixed by bacteria was generally lowered by the addition of five antibiotics (nigericin, narasin, monensin, grisorixin and lasalocid) or two derivatives (lasalocid O acetyl and nigericin O-acetyl), indicating a decrease in bacterial synthesis. In contrast, calcimycin improved the butyrate production at the expense of propionate, and had no effect on gas composition or bacterial synthesis; X 14547 A and alborixin had only a small effect on rumen fermentations. These results, however, must be interpreted with care since the inocula used came from non adapted sheep. PMID- 3823606 TI - Antinociceptive effect of chlorphenesin carbamate in adjuvant arthritic rats. AB - The antinociceptive effect of chlorphenesin carbamate (CPC) and mephenesin were examined in adjuvant arthritic rats. In the behavioral study, CPC (100-400 mg/kg, p.o.) but not mephenesin (100-400 mg/kg, p.o.) had a dose-dependent antinociceptive effect, determined using the flexion test. In the electrophysiological study, CPC (25-50 mg/kg, i.v.) but not mephenesin (50 mg/kg, i.v.) depressed the evoked neuronal responses of nociceptive neurons in the ventrobasal thalamus (VB), while the evoked responses of non-nociceptive neurons were not depressed by either CPC (50 mg/kg, i.v.) or mephenesin (50 mg/kg, i.v.). The spontaneous firings of the VB nociceptive neurons were depressed by both CPC (50 mg/kg, i.v.) and mephenesin (50 mg/kg, i.v.). However, mephenesin (50 mg/kg, i.v.) but not CPC (50 mg/kg, i.v.) also depressed the spontaneous firings of the mesencephalic reticular formation (RF), in these adjuvant arthritic rats. These results indicate that CPC but not mephenesin, has an antinociceptive action in adjuvant arthritic rats. PMID- 3823607 TI - Lack of enhanced myelotoxicity with buthionine sulfoximine and sulfhydryl dependent anticancer agents in mice. AB - The lethal and non-lethal effects of L-buthionine-SR-Sulfoximine (BSO) with the sulfhydryl-dependent anticancer agents (SHDAA) were investigated in mice. The agents studied included carmustine (BCNU), cyclophosphamide (CTX), doxorubicin (DOX) and melphalan (LPAM). It was shown in normal mice that BSO is nontoxic when given IP or PO at a dose 5 g/kg. In pharmacodynamic studies with two different doses of BSO in CD-1 mice, the liver, kidney and heart demonstrated diurnal variations in thiol content and dose-dependent depression of tissue non-protein sulfhydryl (NPSH) levels. In acute lethal survival studies, mice treated with CTX and BSO exhibited increased lethality with seizures as a possible cause of death. This effect was not seen with BCNU, DOX and LPAM. Evaluations of organ-specific biochemical markers, showed slight elevations in LDH enzyme levels while bone marrow suppression was not enhanced using both in vivo spleen colony assay and in vitro colony forming unit myelotoxicity assays. These results show that the addition of BSO with SHDAA enhances the acute lethality of some agents such as CTX, and may also increase the non-myelosuppressive toxicities of other agents. It is recommended that BSO be used with caution in combination with SHDAA and that monitoring of hepatic enzymes be routinely performed. PMID- 3823608 TI - Benzamides and cholinesterases. AB - At certain doses metoclopramide (MT), sulpiride and bromopride produce anti cholinesterase effects as shown by studies on the serum and erythrocyte cholinesterases of the rabbit and the dog, and by those on the hypotensive effect of ACh incubated with rabbit serum in the presence or absence of MT. The anti cholinesterase effect of MT was more intensive than that of sulpiride, bromopride, procainamide or procaine, but less pronounced than that of prostigmine. PMID- 3823609 TI - Acetaminophen-induced hepatotoxicity: antagonistic action of caffeine in mice. AB - Studies of interactions in mice between acetaminophen (ACM) and caffeine (CAF) revealed that CAF given immediately after ACM antagonized the acute toxicity of ACM and reduced the severity of ACM-induced hepatic necrosis as assessed grossly and microscopically. It also attenuated the elevations of SGOT and SGPT levels following ACM administration. CAF reduced significantly the magnitude of ACM induced mobilization of cadmium from hepatic cadmium-metallothionein stores and the extent of binding of 3H-ACM to hepatic proteins. CAF did not restore hepatic GSH levels toward control values in ACM-treated mice; administration of CAF alone led to a reduction of hepatic GSH concentrations. It was concluded that the antagonistic action by CAF of ACM toxicity in mice is not mediated through a salutary effect on endogenous hepatic sulfhydryl levels. The significance of these observations was discussed in terms of possible interactions at the level of ACM and CAF biotransformation and the potential for interactions of CAF with other xenobiotics. PMID- 3823610 TI - Long-term changes in mitochondrial outer membrane enzymes and microsomal enzymes involved in drug and heme metabolism during 2-acetylaminofluorene feeding. AB - The changes in mitochondrial and microsomal enzyme activities were examined during the course of 2-acetylaminofluorene (2-AAF) hepatocarcinogenesis. 2-AAF produced the phasic changes, such as the early reduction, back to the control and the re-reduction, in mitochondrial monoamine oxidase (MAO) B and kynurenine 3 hydroxylase activities during the course of its hepatocarcinogenic activity in male Wistar rats. 2-AAF also produced decreases in microsomal cytochrome P-450 content and aminopyrine demethylase activity, while it caused an early significant increase and subsequent decrease in cytochrome b5 content in the liver. The change in microsomal protoheme content totally paralleled that of the hemeproteins. Microsomal heme oxygenase activity was significantly increased during 2-AAF feeding, while mitochondrial delta-aminolevulinic acid synthetase activity tended to decrease under the experimental conditions. These changes in mitochondrial and microsomal enzyme activities were more pronounced in the nodules and hepatomas as compared to those of the surrounding tissues. PMID- 3823611 TI - Distribution of pancreatic secretory trypsin inhibitor in various human tissues and its inactivation in the gastric mucosa. AB - Considerable amounts of immunoreactive pancreatic secretory trypsin inhibitor were detected in lung, stomach, liver, pancreas, kidney, small intestine and ovary. Immunoreactive pancreatic secretory trypsin inhibitor content of surgically removed gastric mucosa was approximately seven times higher than that of gastric mucosa obtained at autopsy. The reduction in PSTI-immunoreactivity seen in a tissue extract of fresh gastric mucosa on 24 hours' incubation represented 9% of the original immunoreactivity in 10 mM Tris-HCl buffer, pH 7.4, at 37 degrees C. While, there was a more than 80% reduction in immunoreactivity on 12 hours' incubation at 37 degrees C at pH 4.0 or under more acidic conditions. PMID- 3823612 TI - Effect of chlorinated alkanes on hepatic triglyceride secretion. AB - The effect of a series of monochloroalkanes (1-chloropropane through 1 chlorohexane) and a series of dichloroalkanes (1,2-dichloroethane through 1,5 dichloropentane) on hepatic triglyceride secretion in vivo and in vitro was investigated. It was demonstrated that a dose related decrease in hepatic triglyceride secretion is a common effect produced by both series of chlorinated alkanes. Using isolated hepatocytes a positive correlation between chlorinated alkane potency and increasing solvent lipid solubility was observed. However, this order of potency did not correlate with in vivo findings in which the less lipid soluble solvents were found to be the most potent. Possible reasons for the discrepancy between the two systems are proposed. It is suggested that the lipophilicity of the chlorinated alkanes may be important factor in solvent induced inhibition in triglyceride secretion. PMID- 3823613 TI - The effects of aging on the responsiveness of the cholinergic receptor of the longitudinal muscle of guinea-pig isolated ileum. AB - The responsiveness of the cholinergic receptor (ChR) of the longitudinal muscle of guinea-pig isolated ileum was characterized by determining the ED50 of acetylcholine (ACh) and pA2 of mepenzolate (MPZ) in tissues from animals of different ages. The ages of guinea pig were 0.75, 3, 6 and 24 months respectively. According to our data, the sensitivity of ChR decreased with age peaking around 6 months after which time there was an increase in sensitivity. There was no difference in the pA2. The results of this investigation suggest that changes in the ChR with age may have potential in the understanding of aging process and the use of age rather than the weight of animal may provide more reproducible data in studies using isolated preparations. PMID- 3823614 TI - Effects of food and gender on the pharmacokinetics of methotrexate in children. AB - The effects of food and gender on the oral absorption of methotrexate (MTX) in 16 Jordanian children were investigated. Plasma levels of MTX were measured by a fluorescence polarization immunoassay. The extent of absorption and the rate of elimination of the drug were determined in both males and females, before and after meals and data were statistically analyzed using two-way analysis of variance. The results showed great variability in individual MTX Cmax, t1/2, Kel. and AUC. Although no statistically significant differences were found in the pharmacokinetic parameters of the drug among the groups, apparent differences were observed in the mean values of these parameters. PMID- 3823615 TI - A specific radio-immunoassay (RIA) for salbutamol (albuterol) in human plasma. AB - A specific RIA method for Salbutamol (S) employing a selective extraction procedure was developed to enable the quantitation of 0.5 ng/ml of (S) in plasma from human volunteers. The specificity of the assay was confirmed by GC-MS method. PMID- 3823616 TI - Structural and functional integrity of rat liver perfused in backward and forward directions. AB - The purpose of this study was to assess if reversal of the direction of isolated rat liver perfusion would cause significant alterations in hepatic functions and structure. Five isolated rat livers were perfused forward and another five backward with oxygenated Ringer's solution for up to 90 min (hydrostatic pressure: less than or equal to 13 cm H2O; flow rate: forward 3.88 +/- 0.34 ml/min per gram and backward 3.76 +/- 0.34 ml/min per gram). At the end of the experiment, livers were perfusion-fixed for morphological examination. The following results were obtained: No significant differences were noted between the forward and backward perfusions with respect to oxygen uptake, mean bile flow (forward 0.57 +/- 0.12; backward 0.60 +/- 0.14 ml/min per gram), average bile acid excretion (forward 2.39 +/- 1.11; backward 2.83 +/- 0.94 nmol/min per gram), hydroxylation pattern of bile acids, urea synthesis, release of lactic dehydrogenase, glucose secretion, and redox ratios. Light and electron microscopy, including morphometry of parenchymal and sinusoidal areas, revealed that the backward perfusion caused a greater degree of sinusoidal distension, but no other noteworthy differences. Hepatic ultrastructure was well preserved. We conclude that reversing the direction of perfusion does not alter structure and major hepatic functions significantly. PMID- 3823617 TI - Erythrocytes as carriers for heparin. Preliminary in vitro and animal studies. AB - Encapsulation of heparin into resealed carrier erythrocytes may be useful in the prevention of thromboembolism because heparin may be released locally during retraction of fresh thrombi. Heparin encapsulation in human and canine erythrocytes was achieved by hypo-osmotic dialysis with 44% and 36% encapsulation, respectively. Encapsulated heparin did not leak from carrier erythrocytes in vitro. In vivo survival of heparin-loaded carrier erythrocytes in dogs was biphasic: After an initial phase of cell loss the carrier cells survived in circulation with a half-life of 28 h. The present results seem to warrant clinical studies with heparin-loaded carrier erythrocytes. PMID- 3823618 TI - Defined formula diets alter jejunal and colonic uptake of lipids in rabbits with intact intestinal tract and following ileal resection. AB - An in vitro technique was used to measure the jejunal and colonic uptake of fatty acids, decanol and cholesterol in sham-operated control (CONT) rabbits and in animals with a surgical resection of the distal half of the small intestine (RES). CONT and RES were fed standard Purina chow, Ensure, or Flexical HN for 2 weeks. The animals fed Ensure or Flexical HN consumed half the number of calories as the chow-fed rabbits and failed to gain weight. The mean of the jejunal dry weights were unchanged by diet or by ileal resection, although the height of the villi was lower in the animals fed the defined formula diets. Restricting chow intake to match the body weight gain of the animals fed Ensure or Flexical HN was associated with alterations in the uptake of lipids, but the pattern of changes was dissimilar to the pattern of changes observed in the resected animals or in the rabbits fed Ensure or Flexical HN. Ileal resection was associated with changes in the jejunal uptake of lipids and the influence of the defined formula diets on the uptake of short-, medium- and long-chain length fatty acids, decanol and cholesterol varied depending upon whether the animal had an intact intestinal tract or whether the animal had an ileal resection. It is concluded that the passive uptake of a homologous series of saturated fatty acids, cholesterol, and decanol into the jejunum and colon is modified by ad libitum feeding of Ensure or Flexical HN; the functional adaptation of the intestine and colon to dietary modification is influenced by the previous resection of the distal half of the small intestine; and these changes in the uptake of lipids are not explained solely by alterations in food intake, body weight gain, or intestinal morphology. PMID- 3823619 TI - Diurnal lipid and lipoprotein profiles in hypertriglyceridemic patients with bezafibrate and clofibrate. AB - Thirty hypertriglyceridemic patients were treated under metabolic ward conditions for 10 days with either placebo, clofibrate (500 mg t.i.d.) or bezafibrate (200 mg t.i.d.) in a randomized, double-blind study. In addition, patients received an isocaloric prudent diet. On day 10 a diurnal lipid and lipoprotein profile was carried out. Compliance to medication was good. Each treatment led to significant reductions of fasting triglycerides and cholesterol. Lowering of fasting and integrated diurnal triglycerides was greatest with bezafibrate. HDL-cholesterol profiles were highest with this drug. A strong correlation between fasting and diurnal triglycerides was observed. Triglyceride-lowering therapy must therefore aim at fasting triglyceride values as low as possible. PMID- 3823620 TI - The behaviour of prostanoids during the course of acute experimental pancreatitis in rats. AB - The behavior of two vasoactive prostanoids was studied in experimental acute pancreatitis (AP) in rats. The stable metabolites of prostacyclin (PGI2) and thromboxane A2 (TXA2), 6-keto-PGF1 alpha and TXB2, respectively, were measured during the course of experimental AP. Blood samples were taken at 3, 6, and 8 h after the induction of AP. In AP both plasma 6-keto-PGF1 alpha plasma TXB2 and serum TXB2 increased up to 6 h simultaneously (6-keto-PGF1 alpha from 271.1 +/- 77.2 pg/ml (mean +/- SD) to 459.4 +/- 192.6 pg/ml, plasma TXB2 from 752 +/- 350 pg/ml to 3640 +/- 2160 pg/ml and serum TXB2 from 22.3 +/- 14.8 micrograms/ml to 140.8 +/- 52.8 micrograms/ml). After 6 h 6-keto-PGF1 alpha remained elevated, whereas serum TXB2 dropped significantly. We suggest that in AP the balance of PGI2 and TXA2 is initially maintained, but later on an imbalance appears to favor vasodilatory PGI2. These agents may contribute to the regulation of the blood flow in the pancreas and thus play a role in the pathophysiology of AP. PMID- 3823621 TI - The effect of conditioned medium on fetal human liver cells in primary culture. AB - A medium conditioned by rat embryo cultures (RCM) promoted the adhesion of liver cells from human fetuses to plastic dish. Colonies were also formed in primary cultures of the same cells in the presence of RCM. The majority of the colonies formed were composed of large polygonal cells with a few colonies composed of both clear epithelial-like cells and fibroblast-like cells. RCM was superior to the rat embryo feeder layer for promotion of colony formation of cells. A number of colonies were formed from fetal human livers when a conditioned medium from human hepatoma cells (HCM) was used, but most of the colonies formed were composed of fibroblast-like cells. The cells derived from the polygonal cell colonies, which were formed in the presence of RCM, have been passaged four times and they are still growing with albumin-producing capacity. The effect of RCM was reduced by various physico-chemical treatments. PMID- 3823622 TI - Ejaculate characteristics of sheep infected with Trypanosoma brucei and T vivax: changes caused by treatment with diminazene aceturate. AB - The effect of Trypanosoma brucei and T vivax on the ejaculate of sheep and the rate of recovery with diminazene aceturate treatment was investigated. Animals were made to ejaculate once a week before infection, during infection and after treatment. Parameters studied were semen volume, semen colour, sperm motility and concentration, percentage dead spermatozoa and sperm morphology. Both infections severely affected the quality of the ejaculate although in T vivax infection there was no appreciable change in semen volume and sperm concentration. There was a reduction in sperm motility and concentration, an increase in the percentage of dead spermatozoa and in abnormal sperm morphology. Treatment led to improvement in all parameters but recovery was faster in T vivax than in T brucei infection. Ejaculate with few primary abnormalities was not obtained until 19 weeks after treatment. PMID- 3823623 TI - Bronchoalveolar lavage of the live anaesthetised sheep. AB - Segmental lavage was performed on anaesthetised adult sheep using either endoscopic catheterisation or fibreoptic bronchoscopy. Cellular and humoral data were compared with results obtained from gross lavage of whole excised lungs. Both techniques proved rapid, convenient and reproducible, providing sufficient material for qualitative and quantitative assays of respiratory cells and fluid. Although total cells per unit volume of fluid obtained by catheterisation or by bronchoscopy were decreased compared with whole lung lavage, differential cell populations, fluid recovery and immunoglobulin and complement (C3) concentrations were comparable. PMID- 3823624 TI - Lung surfactant composition in puppies dying of fading puppy complex. AB - The composition of surfactant from the lungs of neonatal puppies dying from 'fadding puppy complex' differs from that of neonates dying from other causes. Surfactant from 'fading puppies' contained significantly less phosphatidylcholine than did the surfactant from other puppies, and therefore abnormal surfactant may be implicated in fading puppy complex. Abnormal surfactant has been implicated in the pathogenesis of sudden infant death syndrome in human infants. PMID- 3823625 TI - Demonstration of antibodies to Eimeria species in lambs by an enzyme-linked immunosorbent assay. AB - Soluble extracts were prepared from sporulated oocysts, unsporulated oocysts and merozoites of Eimeria crandallis, E faurei and E ovinoidalis. They were assessed for antigenicity and specificity by ELISA using rabbit antisera to sporulated oocysts or merozoites. Antibody levels were examined in sera from colostrum deprived coccidia-free lambs, conventionally reared lambs and lambs which had received experimental infections. Maternal antibody was demonstrated in colostrum and in serum taken at 24 hours from all conventionally reared animals but not colostrum-deprived animals. Antibody levels in conventional animals dropped over the first five weeks of life and rose again during the next five weeks. Antibody was not detected in coccidia-free animals. Monospecific infections of E faurei or E ovinoidalis demonstrated antibody responses to primary and secondary infections. Some specificity of response was suggested with E faurei infection. The antigen preparations showed considerable cross-reactions between species. These serum antibody responses, although appearing too late for individual diagnosis, may assist diagnosis on a flock basis. PMID- 3823626 TI - Haematological studies on Indian pashmina goats. AB - Haematological studies were conducted on 61 clinically normal pashmina producing goats of the Cheghu breed, acclimatised to the temperate, humid climatic condition of Mukteswar, about 2400 m above sea level. The experimental goats comprised four age groups (birth to one month, six to nine months, three to five years and six to 10 years) of both sexes. The overall values, irrespective of age and sex, for the parameters examined were: red blood cells, 14.17 +/- 1.96 X 10(12) litre-1; haemoglobin, 7.46 +/- 0.79 g dl-1; packed cell volume, 0.31 +/- 0.04 litres litre-1; mean corpuscular volume, 21.62 +/- 2.46 fl; mean corpuscular haemoglobin concentration, 23.72 +/- 1.80 g dl-1; mean corpuscular haemoglobin, 5.11 +/- 0.67 pg; erythrocyte sedimentation rate, 0.00 mm at one hour; plasma protein 6.58 +/- 0.78 g dl-1; icterus index, 9.15 +/- 2.92 units; white blood cells 12.26 +/- 2.66 X 10(9) litre-1; absolute count of lymphocytes, 4.62 +/- 1.40; neutrophils, 5.91 +/- 2.84; monocytes, 0.38 +/- 0.15; eosinophils, 0.32 +/- 0.17 and basophils, 0.05 +/- 0.05 (X 10(9) litre-1). The sex of the animal did not affect the haematological parameters but the effect of age was evident. In newborn kids the haemoglobin, mean corpuscular haemoglobin and packed cell volume values were higher and the total leucocyte count was lower than in other age groups. As the kids grew older lymphocyte numbers decreased while neutrophils increased. PMID- 3823627 TI - Observations on femoral head abnormalities in broilers. AB - Detachment of the proximal femoral cartilaginous epiphysis was observed in broilers that were being down-graded at slaughter as a result of haemorrhage into thigh musculature. A traumatic aetiology is proposed with injury occurring at catching. Examination of field case material, and birds culled from a commercial flock of the same strain, revealed that physeal lesions are not infrequent in proximal femora. Clefts and areas of matrix necrosis occurred in normal and dyschondroplastic physeal cartilage. Clefts were thought to result from repetitive minor trauma insufficient to cause total detachment of the cartilaginous epiphysis. Total detachment may result from an acute traumatic episode or be a consequence of pre-existing physeal lesions. A traumatic aetiology suggests that in such cases the terms fracture separation or traumatic epiphyseolysis of the cartilaginous epiphysis are more appropriate than femoral head necrosis or degeneration. PMID- 3823629 TI - Cartilage thickness measurement in foals. AB - The talus and proximal and distal epiphysis of the humerus, radius, femur, tibia and distal metacarpus of 20 foals aged 0 to 150 days were obtained at necropsy and sawn sagittally into slabs 4 to 8 mm thick. The thickness of the cartilage (articular cartilage and unossified epiphyseal cartilage) was measured in three to five places in each slab, using a sliding calliper. In most epiphyses, the site, or sites, of thickest cartilage was constant in all foals examined. The difference between thickest and thinnest cartilage within one epiphysis was greatest in distal femora and least in distal metacarpi. The sites of most common occurrence of osteochondrosis dissecans in tali and proximal humeri concurred with the site of thickest cartilage in these bones. The most common site of equine osteochondrosis, the middle and distal thirds of the lateral trochlear ridge of femora, is not the location of thickest cartilage in this epiphysis. Haematological epiphyseal osteomyelitis in foals occurs most frequently in the areas where cartilage thickness is greatest in the medial femoral condyle, talus and distal radius. PMID- 3823628 TI - Further studies on the response to transplanted adult Ostertagia ostertagi in calves. AB - Calves infected by surgical transplantation of adult Ostertagia ostertagi had raised levels of plasma pepsinogen and those in which the largest number of worms established also had elevated plasma gastrin concentrations. Despite the elevated plasma pepsinogen values, the abomasal pH of the animals did not change significantly, and there was no significant difference in the percentage establishment of adult parasites in calves previously infected with O ostertagi third stage larvae and those which had been maintained parasite-naive before transplant. PMID- 3823630 TI - A laboratory method for studying tooth mobility of the mandibular central incisor of the sheep. AB - Linguolabially directed loads of 0.01 to 1.0 N were applied to a mandibular central incisor in each of 12 four-year-old ewes with healthy mouths. For each incisor, tooth position was monitored continuously with an ultrasonic displacement transducer. On suddenly applying a load and maintaining it for five minutes, a biphasic pattern of displacement was recorded, a phase of rapid displacement being followed by a more gradual one. A similar biphasic recovery response was seen on suddenly removing the load. These patterns are viscoelastic like. The group mean displacements showed that for all phases the responses were force-dependent, though not linearly graded. For a given load, the group mean displacements were considerably larger than those reported previously for the teeth of other animals, supporting the impression that the sheep incisor is extremely mobile. These data will provide a baseline for studies on the mobility of the teeth of sheep with inflammatory periodontal disease ('broken mouth'). PMID- 3823631 TI - Bovine ocular squamous cell carcinoma: superoxide dismutase and catalase levels. AB - Considerable evidence exists for the production of free radicals in the eye region after exposure to ultraviolet light. Failure to remove these radicals adequately may be important in the predisposition of Hereford cattle to ocular carcinoma. The levels of two enzymes, superoxide dismutase and catalase, involved in the removal of superoxide anion and hydrogen peroxide, were compared in Hereford cattle predisposed to ocular carcinoma and a resistant breed, Droughtmaster cattle. The results demonstrate comparable levels of superoxide dismutase in the two breeds in both eye tissue and erythrocytes. Catalase levels also were the same in both breeds. Increased incidence of ocular carcinoma in Herefords does not appear to be due to a deficiency in either superoxide dismutase or catalase. PMID- 3823632 TI - Red blood cell volume of the pig fetus. AB - A non-radioactive fluorescent excitation analysis technique was used to measure total red blood cell volume in 31 unanaesthetised pig fetuses in utero. Red blood cell volume (y in ml) was closely related (r = 0.94) to fetal bodyweight (x in g): where y = 2.92 + 0.0291x. Average red blood cell volume was 34 +/- 1 ml kg-1 fetal bodyweight. Average estimated (total) blood volume was 117 +/- 3 ml kg-1 fetal bodyweight. It was concluded that this non-radioactive indicator dilution measurement of red blood cell volume is a significant advance over the established 51Cr method, and that measurement of red blood cell volume may be used to estimate fetal bodyweight in utero. PMID- 3823633 TI - Deposition and clearance of radiolabelled monodisperse polystyrene spheres in the calf lung. AB - Two groups of three calves were exposed to monodisperse aerosols of radiolabelled polystyrene spheres measuring 3.3 microns in aerodynamic diameter (SD 0.3 micron). Although the spheres preferentially deposited in the trachea and major bronchi, 72 per cent of the total radioactivity deposited was found in lung tissue beyond the major bronchi. Mean alveolar deposition, estimated from the end retention value after mucociliary clearance, was 34 per cent in the group of bull calves and 52 per cent in the group of heifer calves. Alveolar deposition increased from 47 to 56 per cent (P less than 0.05) in heifer calves treated with oestradiol. Mucociliary clearance of the spheres was unaffected by repeated exposure to the experimental aerosol and the overall mean mucociliary clearance rate constant was 1.28 (+/- 0.43) h-1 (half-life 32 minutes). Clearance curve profiles tended to be characteristic for individual calves but variation in mucociliary clearance rates within calves was high and on occasions clearance rate inexplicably fell to 10 to 50 per cent of the maximum achievable value for the calf. Neither mucociliary clearance rate nor alveolar deposition was affected by a change in climate from 14 degrees C, 87 per cent relative humidity to 5 degrees C, 75 per cent relative humidity. Both alveolar deposition and mucociliary clearance of the spheres could be manipulated using a beta-adrenergic treatment. PMID- 3823634 TI - Routine electrocardiography in screening for pulmonary embolism. AB - In a group of 245 patients with clinical suspicion of pulmonary embolism we analyzed the ECG for 22 signs that have been associated with this disease. Subsequently, the patients were divided into two groups: those with confirmed embolism and those in whom embolism was not confirmed. The occurrence of the ECG signs was assessed separately for the two groups. Furthermore, we related ECG features to severity of embolism as estimated at lung scan. Tachycardia and S-T depression were the commonest findings in both groups. P-R displacement, late R in a VR, S1Q3T3, S slurred and T inversion in V1-V2 were more frequent in embolic than in nonembolic patients (p less than 0.05 or less). All the above mentioned signs were more frequent at diagnosis than at recovery in embolic patients (p less than 0.05 or less), whereas only tachycardia was more frequent at diagnosis than at control in nonembolic patients (p less than 0.001). S-T depression and T inversion in V1-V2 were also associated to severity of embolism. Since some ECG signs are very frequent or specific in pulmonary embolism, this condition should always be suspected when they are found and, particularly, when previously absent in the same patients and/or not explained by other conditions. PMID- 3823635 TI - High-dose intravenous methylprednisolone pulse therapy as initial treatment in cryptogenic fibrosing alveolitis. A pilot study. AB - Ten patients with fibrosing alveolitis were treated in a simple random design initially with either a high dose of methylprednisolone (5 patients) or a conventional dose of prednisolone (5 patients) followed by a maintenance dose of 30 mg prednisolone daily. The patients were followed for 6 weeks. No significant (p greater than 0.05) differences were observed between patients with high and low initial dose of glucocorticosteroids, as regards forced vital capacity, transfer factor for carbon monoxide or symptom scores after 3 and 6 weeks of treatment. After 6 weeks the dyspnoea score and the 67Ga uptake decreased, on average, by 74 and 85%, respectively, while forced vital capacity and transfer factor increased by 15 and 29%. PMID- 3823636 TI - Effect of dietary caffeine on airway reactivity in asthma. AB - The potential influence of dietary caffeine on bronchoprovocation challenges with carbachol was examined in 7 patients with asymptomatic asthma. In a double-blind fashion placebo or caffeine (6 mg/kg body weight; equivalent to approximately 4 cups of coffee) solved in orange juice was administered, and carbachol challenges were performed. The average peak serum concentration achieved 60 min after dosing was 7.6 +/- SD 2.1 mg/l. These caffeine levels did not produce any appreciable attenuation of the bronchoconstrictor response to carbachol inhalations. It thus appears that dietary caffeine is barely a cause of erroneous interpretations of bronchoprovocation challenges with carbachol. PMID- 3823637 TI - Inhibition of acetylcholine-induced bronchoconstriction in asthmatics by nifedipine. AB - The calcium-dependent constriction of bronchial smooth muscle cells and release of mediators derived from mast cells is important in the pathophysiology of asthma. We hypothesized that nifedipine, a slow calcium channel blocker, would inhibit or attenuate acetylcholine-induced bronchoconstriction in asthmatics. Because one consequence of mast cell activation is the release of platelet activating factor, we wondered whether thromboxane levels would be increased during acute bronchial constriction in asthmatics. Bronchoconstriction was induced in 8 asthmatics (6 men, 2 women) by acetylcholine; each subject was pretreated either with placebo or nifedipine (20 mg sublingually) on 2 separate days. Vital capacity, forced expiratory volume in 1 s, peak expiratory flow rates and oscillatory resistance were measured prior to and after the intake of placebo or nifedipine as well as after an acetylcholine challenge. Pretreatment with nifedipine significantly attenuated acetylcholine-induced changes in all four lung function parameters studied, but did not significantly influence the increase in thromboxane B2 plasma concentrations observed after the acetylcholine challenge. From these data we conclude that nifedipine inhibits the acetylcholine induced bronchoconstriction in asthmatics. This effect may be either a direct action on bronchial smooth muscle or may be due to the inhibition of mediators other than thromboxane. PMID- 3823638 TI - Gas mixing in the human upper airways. AB - The longitudinal dispersion of gas in the upper airways (oropharynx and larynx) was studied in 5 healthy subjects by measuring the response after injection of a bolus of 133Xe into the inspired airstream. The radioxenon concentration was measured during inspiration and expiration with two counter probes, one in front of the lips and one under the glottis. Assuming that the output tracer concentration follows a Gaussian distribution, the dispersion is expressed by the variance. The dispersion coefficient for the upper airways can then be readily computed with a simple mathematical model. This coefficient is found to be a function of the Peclet number. PMID- 3823639 TI - Relations between clinical signs and lung function in bronchial asthma: how is acute bronchial obstruction reflected in dyspnoea and wheezing? AB - To compare the degree of clinical manifestations and bronchial obstruction in acute asthma, we correlated lung function tests with the clinical symptoms in 33 patients during acute attacks of bronchospasm induced by specific and non specific inhalation challenge tests and compared the results with similar challenge tests in 12 healthy subjects. It could be shown that about 60% of the patients did not reveal wheezing or dyspnoea despite marked bronchial obstruction, thus indicating a poor sensitivity of clinical symptoms in relation to the objective alterations in the lung function tests. We therefore conclude that the degree of bronchospasm may be seriously underestimated if it is related only to the subjective complaints and the physical sign of expiratory wheezing. In particular, during inhalative bronchial challenge tests the asthmatic airway reaction should be carefully monitored by serial or continuous lung function tests in order to avoid major complications. PMID- 3823640 TI - [Myocardial infarction in the diabetic patient]. PMID- 3823641 TI - [Use of a personal computer as a recorder]. PMID- 3823642 TI - [Electrocardiographic evaluation of left ventricular function in acute myocardial infarction]. PMID- 3823643 TI - [Cardioangiography during intra-aortic balloon pumping for myocardial infarction with severe complications]. PMID- 3823644 TI - [Role of myocardial ischemia in exercise-induced ST elevation--quantitative analysis of stress myocardial scintigraphy in patients with anterior myocardial infarction and LAD single vessel disease]. PMID- 3823645 TI - [Spectrophotometric analysis of myocardial oxygen metabolism in perfused rat hearts]. PMID- 3823646 TI - [Long-term ambulatory monitoring of indirect arterial blood pressure using a volume-oscillometric method--monitoring of 500 cases and its analysis]. PMID- 3823647 TI - [Effect of the leukotriene antagonist ONO-RS-411 on LTD4-induced coronary spasm]. PMID- 3823648 TI - [A case of aortic stenosis with four types of gap phenomenon in A-V conduction]. PMID- 3823649 TI - Effect of expiratory glottic constriction on lung volume and pattern of breathing in adult dogs. AB - We examined the effect of laryngeal constriction on the pattern of breathing in 4 anaesthetized adult mongrel dogs. By means of a T-shaped tracheostomy tube the larynx could be repeatedly excluded or included in the breathing circuit. Marked expiratory activity of the thyroarytenoid muscle (TA), the main glottic constrictor, was induced by injection of 100-400 ml of air into the pleural space or by inhalation of histamine aerosol (2 dogs) which resulted in rapid shallow breathing. In 21 pairs of runs in the 4 dogs switching from tracheostomy breathing to oral breathing decreased mid-expiratory flow and frequency by 85 +/- 2% (P less than 0.001) and 48 +/- 4% (P less than 0.001), respectively. Although expiratory duration (TE) increased, end-expiratory lung volume also increased by 40 +/- 8 ml or 21 +/- 4% of the tidal volume (VT) during tracheostomy breathing (P less than 0.001). In contrast, VT remained unchanged (P = 0.9). Instantaneous ventilation decreased due to both the prolongation of TE and an increase in inspiratory duration. Our results indicate that laryngeal braking can be recruited in adult dogs and interacts with reflex mechanisms that modulate respiratory timing, thereby significantly influencing end-expiratory lung volume, ventilation and the pattern of breathing. Simulation of the laryngeal mechanism by expiratory resistive loading at the tracheostomy below the larynx points to a non-reflex mechanical effect of the larynx as a resistance in series. PMID- 3823650 TI - In vivo hysteresis of airspace dimensions measured by aerosol recovery. AB - In anesthetized mongrel dogs, we made measurements of single breath aerosol recovery (RC) at equal volume points on the inflation and deflation limb of the quasi-static pressure-volume (P-V) curve of the lungs. Using a 1.2 micron monodisperse aerosol, a large aerosol tidal volume (Vt), and a breathing period of 5 sec, we found that losses of particles were primarily due to sedimentation in pulmonary airspaces distal to anatomic dead space. Thus, the RC measurements could be related to a mean radius (R) of airspaces filled with aerosol over the course of the breath. Furthermore, at a given volume, differences between inflation and deflation limb RC could be attributed to differences in R for the two measurements (i.e., RI vs RD). We found that at isovolume, RC as measured from the inflation limb was larger than that measured from the deflation limb for low lung volumes (less than 0.75 TLC). However, the recoveries were similar as lung volume approached TLC (greater than 0.75 TLC). These results implied that at the same volume, RI greater than RD expect at volumes approaching TLC, i.e. a larger mean airspace dimension on the inflation limb than on the deflation limb at equal volume. The findings of this study support a model of nonuniform changes in airspace dimensions associated with in vivo inflation and deflation of the lungs. PMID- 3823651 TI - Effect of breathing dry warm air on respiratory water loss at rest and during exercise. AB - The changes in respiratory water loss with time, expressed as the mass of water vapour lost per liter BTPS of ventilation (MH2O), and expired temperature (TE), used to calculate the relative humidity (ERH), were investigated in ten normal subjects while breathing warm dry air by mouth (PIH2O = 0 kPa; TI = 30 degrees C): at rest for a period of 35 min; during 15 min light muscular exercise (50 W); at increasing work load from 50 to 100 W between the 5th and 10th min of the exercise. The data collected were compared to those obtained in room air conditions (PIH2O = 0.68-1.3 kPa) and under conditions with slightly heated inspired air (TI = 28-30 degrees C). At rest, when breathing dry warm air MH2O and ERH fell during the first 15 min, while they recovered their initial values during the last 20 min. In contrast no differences in MH2O or ERH were observed when breathing ambient warm air. At constant and moderate work load for 15 min, the respiratory water loss fell significantly (compared to the 5th min) at the 10th and the 15th min when breathing warm dry air. The added hyperpnea which was obtained by increasing work load from 50 to 100 W between the 5th and 10th min of exercise did not further reduce MH2O and ERH. The transient fall in MH2O and ERH, which lasted at least 15 min either at rest or during muscular exercise, suggested that the mechanism underlying humidification of expired gas is overwhelmed by thermal stress. Since the upper airways mucosa is unable to saturate expired gas, this also suggested that the mucosa is dehydrated and probably hyperosmotic. The progressive recovery in MH2O and ERH after 15 min of warm dry air breathing at rest, suggest operation of a slow adaptive mechanism. PMID- 3823652 TI - Acetylcholine-induced contraction in human isolated bronchial smooth muscle: role of an intracellular calcium store. AB - The aim of this study was to investigate the role played by an intracellular calcium store in human bronchoconstriction. Human isolated bronchial smooth muscle strips (5-6 mm long, 0.4-0.5 mm wide) were taken from lung specimens during pneumonectomy. Isometric contraction was recorded after stimulation by 10( 4) M acetylcholine in physiological solutions. The amplitude of acetylcholine induced contractions was measured in the presence and absence of calcium ions in the perfusing medium. When the perfusing medium was switched to a calcium-free solution the amplitude of the acetylcholine-induced contraction was measured with respect to the duration of calcium-free perfusion. The amplitude of the contraction was 82.1 +/- 11.3%, 77.2 +/- 15.4%, 63 +/- 10.6% of the maximum contraction after the strips were perfused in calcium-free solutions for 1, 3 and 5 min respectively. Several successive contractions could be elicited, and even after 20 min of calcium-free perfusion, acetylcholine was still able to elicit contractions. These results suggest that an intracellular calcium store may be involved in human bronchoconstriction. This finding may help further our understanding of the effects of calcium antagonists on human airways. PMID- 3823653 TI - Postnatal development of the lung following denervation. AB - We asked to what extent pulmonary innervation influences the postnatal development of the lung. To this end we performed cervical vagotomy and sympathectomy either on the right or on the left side in young rats and rabbits and rats after weaning. One to four weeks later we examined the lungs of the denervated side, the contralateral intact side of the same animal, and sham operated controls. Dry lung weight, lung volume and the size of subpleural alveoli were not different among the three groups. Lung mechanical properties (static and dynamic lung compliances, lung resistance, frequency dependence of compliance), measured in rabbits, were also not different among groups of lungs, suggesting that neither central nor peripheral airways were markedly affected by the denervation. The breathing pattern, measured in the rats after weaning, was characterized by a larger tidal volume in the denervated animals than in controls, as expected after the partial pulmonary afferent denervation. The absence of major structural and functional changes in the lungs of these animals suggests that an increase in the mechanical stretch to the lung above that normally occurring during resting breathing does not influence the lung structure. We conclude that pulmonary innervation does not play an important role in the postnatal development of the lung. PMID- 3823654 TI - Inhaled particle deposition and clearance from the normal respiratory tract. AB - Tracheo-bronchial and pulmonary deposited fractions of inhaled insoluble particles and their clearances rates were studied in 16 healthy non-smokers. After oral inhalation of radioactive particles (Mean Mass Aerodynamic Diameter (MMAD) = 3 microns, sigma g = 1.4 labelled with 111In) incorporated radioactivity was measured for each subject both by a gamma camera from to until the 3rd day, then from the 3rd until the 5th day first by a gamma camera and then by a low background profile scanner and from the 5th until the 35th day by a low background profile scanner alone. Clearance rates were calculated from the biological half lives of the deposited tracers. All subjects performed respiratory function tests. Experimental data were fitted to a two-compartment exponential system with two biological half lives: T1 = 76 min for 30%, T2 = 3.15 days for 40% of the deposited material. The delayed clearance phase for the remaining 30% of the deposited material approaches a constant rate. Our clearance values were compared with those of the Task Group of Lung Dynamics (T.G.L.D.) and other authors' results, especially for T1 and T2. These values are analyzed in terms of mucus velocity and mucociliary transport in distal conductive airways. Impaired transport reduces natural defenses and increases toxicological hazards. Therefore reliable techniques for detecting such impairment may be important in evaluating pulmonary involvement in environmental respiratory disease. PMID- 3823655 TI - Blockade of 'alveolar' and airway reflexes by local anesthetic aerosol in dogs. AB - To determine whether local anesthetic aerosol could selectively block a reflex thought to originate from the alveoli, two small particle bupivacaine aerosols (mass median diameters 1.0 and 1.7 micron) were administered on separate occasions to spontaneously breathing anesthetized dogs. Both aerosols resulted in a small but statistically significant increase in VT and one produced an increase in f. The pulmonary chemoreflex to right heart injection of capsaicin, the cough reflex and the Hering-Breuer inflation reflex were unaffected. The ability of a large particle aerosol (mass median diameter 4.8 micron) to block these reflexes was also assessed. This aerosol produced a progressive slowing and deepening of breathing which was maximal after 20 min of aerosol inhalation. Ten min of this aerosol attenuated the pulmonary chemoreflex and abolished the cough and inflation reflexes; 20 min abolished all reflexes. These had recovered by about 1 h after aerosol. Intravenous bupivacaine had no effect on breathing or any reflex. We conclude that a local anesthetic aerosol can block reflexes arising from the alveoli, but not selectively. PMID- 3823656 TI - Influence of muscle length on human inspiratory and limb muscle endurance. AB - The influence of muscle length on endurance of the inspiratory muscles and the flexors of the elbow was assessed in 12 healthy subjects who performed series of 18 maximal static voluntary contractions of 10 sec duration separated by rest intervals of 5 sec. Inspiratory contractions were performed at functional residual capacity (FRC) and at FRC plus half inspiratory capacity (FRC + 1/2 IC). Contractions of the flexors of the elbow were performed at 90 degrees and 45 degrees of flexion. Compared with values obtained at the control muscle length, maximal force at the short length was reduced to 78 +/- 10% for the inspiratory muscles and 74 +/- 6% for the flexors of the elbow (n.s.). For each test, indices of endurance were measured as the average (and peak) force attained in the better of the last two contractions expressed as a percentage of that in the best of the first three. For the flexors of the elbow endurance was significantly enhanced at the short length (45 degrees: 61 +/- 3.0%, mean +/- SE) compared with the control length (90 degrees: 55 +/- 2.0%, P less than 0.01). By contrast, this enhancement of endurance did not occur for the inspiratory muscles at the short length (FRC + 1/2 IC: 81 +/- 3.0%; FRC: 87 +/- 3.0%; P less than 0.02). Endurance of the inspiratory muscles was greater than that of the elbow flexors at both muscle lengths. The enhanced endurance of the elbow flexors, when tested at a short muscle length, is consistent with data obtained in isolated muscles. PMID- 3823657 TI - Effects of hypoxemia on phrenic nerve responses to static lung inflation in anesthetized dogs. AB - To study interactions between hypoxemia and lung stretch in modulating ventilatory activity, an experimental preparation was used that allows independent control of static airway pressure (Paw) and arterial PO2 in anesthetized dogs. Phrenic burst frequency (f) and integrated amplitude (Phr) were monitored while Paw was varied between 2 and 12 cm H2O at levels of PaO2 between 30 and 200 mm Hg. Experiments were repeated in intact (n = 8) and carotid denervated dogs (CBX; n = 7). In intact dogs, f decreased with increasing Paw through an effect on the expiratory duration (TE). Hypoxia increased f by decreasing both the inspiratory duration (TI) and TE. Hypoxia had no effect on the slope of the f vs Paw relationship, but attenuated the effect of Paw on TE. Phr was increased by hypoxia, but Paw had little effect. After CBX, f was still inhibited by Paw, but PaO2 had no consistent effect on f, TI or TE at any level of Paw. Phr was inhibited by hypoxia after CBX, but Paw had no effect. The results indicate that Paw and PaO2 exert additive effects on f in anesthetized dogs. Hypoxia attenuates the effect of Paw on TE, which alone would attenuate the slope of the f vs Paw relationship. However, the effect of hypoxia on TI enhances the slope of the f vs Paw relationship, restoring a parallel shift. These effects are abolished by carotid denervation. PMID- 3823658 TI - Oxygen transfer conductance of human red blood cells at varied pH and temperature. AB - The influence of temperature (varied from 37 to 7 degrees C) and of medium pH (varied from 7.7 to 7.1) on the kinetics of O2 uptake and release by human red blood cells (RBC) under stopped-flow conditions was investigated by double-beam spectrophotometry. From the rate of O2 saturation change and the mean effective PO2 difference between the medium and the Hb of RBC, the specific transfer conductance for O2, G, was calculated. The temperature coefficient, Q10, of G for O2 uptake averaged 1.17, activation energy, Ea, 2.6 kcal/mol O2; the average values for O2 release were: Q10 = 1.32, Ea = 4.8 kcal/mol O2. The G value for release of O2 from oxyhemoglobin solution, Gsol, yielded Q10 = 2.25, Ea = 13.5 kcal/mol O2. Comparison of these Q10 and Ea values with those for diffusion of O2 and hemoglobin in aqueous media leads to the conclusion that in the stopped-flow condition the conductance for O2 transfer was mainly limited by diffusion of O2 and hemoglobin in the red cell interior and by diffusion of O2 in the medium, and to a lesser degree by chemical reaction kinetics. This was further supported by the lack of dependence of O2 transfer conductance values on pH. PMID- 3823659 TI - Absence of apnea in armadillos covered by soil. AB - The armadillo Chaetophractus villosus shows a remarkable respiratory adaptation when the nostrils are completely covered by soil: it is able to maintain efficient respiratory movements with the corresponding filling of the lungs, thanks to a mechanism that allows it to use the air filling the space between the soil particles, without invasion of the nasal cavities by those particles. PMID- 3823660 TI - 5th European Conference on Sarcoidosis and other Granulomatous Disorders. Vienna, August 27th-30th, 1986. PMID- 3823661 TI - In honour of the past, present and future. PMID- 3823662 TI - Europe's contribution to the sarcoidosis movement. European Conferences on Sarcoidosis. PMID- 3823663 TI - On the role of 'habitual aborters' in the analysis of spontaneous abortion. AB - Analyses of spontaneous abortion rates often include special provisions to account for the presumed distorting effects that arise because of the presence of habitual aborters. In this paper, I establish a framework for investigating the effects of the presence in study groups of such women. I then examine the strengths and weaknesses of some of the analysis strategies in current use, both in situations where the study group is homogeneous and where there are high-risk women present. I show that the concept of habitual aborter is not useful and can be misleading, and I suggest that one take a broader view of heterogeneity. PMID- 3823664 TI - On surveillance methods for congenital malformations. AB - This paper presents an 'optimal' procedure for the use of the 'sets' method, a system proposed for surveillance of congenital malformations. Comparisons over a number of examples shows that the given procedure represents a clear improvement over the one originally proposed, and, in some conditions, is more efficient than the cusum scheme. PMID- 3823665 TI - Estimating incidence from age-specific prevalence for irreversible diseases with differential mortality. AB - We present a method for estimating incidence from age-specific prevalence data for an irreversible disease where the mortality risks may differ for persons with and without the disease. This method is an extension of previously presented methodology for estimating incidence from prevalence for a disease that does not entail differential mortality. An application to senile cataract illustrates the method. PMID- 3823666 TI - Adjustment of risk ratios in case-base studies (hybrid epidemiologic designs). AB - The recent growth of occupational epidemiology has led to a resurgence of interest in the hybrid epidemiologic study design of Kupper et al., which has come to be termed a 'case-base' or 'case-cohort' design. This paper shows how the adjustment method for the risk ratio estimate given by Kupper et al. may have substantial bias, and also shows how one must modify conventional adjustment techniques (such as the Miettinen, Woolf and Mantel-Haenszel methods) when used with hybrid designs. This paper also provides the necessary modifications for tests and confidence intervals. PMID- 3823667 TI - Sensitivity, specificity and predictive values: a graphical approach. AB - The relation between sensitivity, specificity and prevalence is illustrated by means of a graphical device, applied to two diagnostic questions on gastroenteritis in children. The relation between the predictive values and the prevalence is also illustrated graphically. PMID- 3823669 TI - A model for variability in arteriographic reading. AB - We propose a class of models for the joint cumulative distribution function (c.d.f.) of the values of two independent readings of percentage stenosis from a coronary arteriography. We show that these models are identifiable and that a certain subclass has unique consistent estimators for the parameters in question. We obtain these estimates for a data set from a substudy of the Coronary Artery Surgery Study (CASS). PMID- 3823668 TI - Some experiments with factors that might affect the response of mothers to a postal questionnaire. AB - The effects of a number of controllable factors on the response rate of mothers to a postal questionnaire were assessed by a series of experiments. In one a factorial design was used to look at seven factors with a random sample of 1600 mothers. The main findings were that the responses to questionnaires of 8, 16 or 24 pages were similar, but that rather more mothers replied when the questionnaires contained only factual questions than when they covered both facts and attitudes. Another experiment, based on a similar sample, compared the response rates when the questionnaires were sent out by a government organization or by the Institute for Social Studies in Medical Care, and found no difference. The final experiment looked at the effect of precoding the answers or asking respondents to tick boxes beside their replies and again found no difference in response rates. The overall response rate was 79 per cent, but this varied between 66 and 87 per cent in the ten randomly selected study areas--a much greater variation than that found with any of the experimental factors. PMID- 3823670 TI - Sensitivity of Fisher's exact test to minor perturbations in 2 x 2 contingency tables. AB - The two tailed Fisher's exact P value is extremely sensitive to small perturbations in 2 x 2 contingency tables. An example indicates that a 1 per cent increase in the denominator of one treatment group results in a 32 per cent drop in the exact P value, but a mere 0.1 per cent decrease in the treatment success rate. This is equivalent to the increase in significance obtained by a 20 per cent increase in the sample size of both treatments without changing the observed success rates. This drop results from small changes in the probabilities of unobserved events. A systematic evaluation of 920 pairs of similar contingency tables shows that these fluctuations occur frequently over a wide range of sample sizes and significance levels. Doubling the one tailed exact P value provides a more consistent measure of inferential strength. We discuss various chi-squared continuity corrections. PMID- 3823671 TI - Prognostic factors, models and related statistical problems in the survival of endstage renal disease patients on hemodialysis. AB - We investigate factors associated with the survival of end-stage renal disease patients on hemodialysis. A model derived for non-diabetics includes five significant prognostic factors: age at initiation of dialysis, arteriosclerotic heart disease, cerebrovascular accident, cancer and chronic obstructive pulmonary disease. For diabetics, age at initiation of dialysis was the only significant prognostic factor. We also show that a simple exponential model adequately represents hemodialysis survival data, the relationship between age and survival hazard is not log-linear and data for diabetics require independent analysis or inclusion of interaction terms. In this paper, we chose the first approach. PMID- 3823672 TI - Simultaneous non-parametric confidence intervals for survival probabilities from censored data. AB - In medical studies with censored data Kaplan and Meier's product limit estimator has frequent use as the estimate of the survival function. Simultaneous confidence intervals for the survival function at various time points constitute a useful addition to the analysis. This study compares several such methods. We consider in a simulation investigation two whole curve confidence bands and four methods based on the Bonferroni inequality. The results show that three Bonferroni-type methods are essentially equivalent, all being better than the other methods when the number of time points is small (3 or 5). PMID- 3823673 TI - Sample size requirements and the cost of a randomized clinical trial with repeated measurements. AB - This paper discusses the advantage of using repeated outcome measurements on subjects in a clinical trial. We choose the number of subjects and the number of repeated outcome measurements to minimize a given cost function so that the clinical trial has power (1-beta) for specified significance level alpha. An example illustrates the results and emphasizes the importance of study design and of critical evaluation of how one measures the study endpoint. PMID- 3823674 TI - On expert pre-assessment of prospects in clinical trials. PMID- 3823676 TI - [The unit for administration and monitoring of intensive care at the Bordet Institute]. PMID- 3823675 TI - [Idiopathic eosinophilic pneumopathies]. PMID- 3823678 TI - [ERCP in acute pancreatitis]. PMID- 3823677 TI - Use of ratings of perceived exertion for exercise prescription. PMID- 3823679 TI - [Esophagitis caused by stenosing reflux: importance of endoscopy for diagnosis and surveillance]. PMID- 3823680 TI - [Malignant lymphoma of the stomach: progress in early diagnosis]. PMID- 3823681 TI - [Variables in 246 patients with early stomach cancer and their statistical relations]. PMID- 3823683 TI - [Scientific study of the function of Oddi's sphincter and its clinical significance]. PMID- 3823682 TI - [Endometriosis of the terminal ileum: expanding the differential diagnosis of Crohn disease]. PMID- 3823684 TI - [Balloon endoscopic cytology, a possible method for early detection of esophageal cancer]. PMID- 3823685 TI - [Primary malignant melanoma of the esophagus]. PMID- 3823686 TI - [Analysis of the synovial fluid]. PMID- 3823687 TI - [Alcoholic cardiomyopathy: a comparison with dilated cardiomyopathy]. PMID- 3823688 TI - [Chronic recurrent appendicitis in childhood]. PMID- 3823689 TI - [Occurrence of the bulimia syndrome in Geneva (preliminary results)]. PMID- 3823690 TI - [Ischialgia-like symptoms, muscular atrophy and diabetes mellitus]. PMID- 3823691 TI - [A case from practice (71). Patient: Ms. H.C., born 11-13-1958, store clerk]. PMID- 3823692 TI - [Ferritin in female blood donors]. PMID- 3823693 TI - [Tachycardia, dizziness and weakness]. PMID- 3823694 TI - [The medical report for Disability Insurance]. PMID- 3823695 TI - [Sudden death in soldiers of the Swiss Army and in members of the "Youth and Sports" organization (age group 15-40 years)]. PMID- 3823696 TI - [Topicality and limits of sector work]. PMID- 3823697 TI - [Short-term therapy center of the Eaux-Vives Sector. Another look at crisis intervention]. PMID- 3823698 TI - [Crisis: a concept the psychiatry of today can't do without]. PMID- 3823699 TI - [A systems approach in social psychiatry: apropos of young psychotics]. PMID- 3823700 TI - [Approach to depression in a short-term therapy center]. PMID- 3823701 TI - [Group approaches in the Paquis sector]. PMID- 3823702 TI - [Treatment of alcoholic patients. Present trends]. PMID- 3823703 TI - [Data processing and evaluation of therapies]. PMID- 3823704 TI - [Crow-Fukase syndrome (POEMS syndrome) and osseous mastocytosis secondary to Castleman's angiofollicular lymphoid hyperplasia]. AB - In a case of Crow-Fukase (POEMS) syndrome there was a chronic, progressive, and eventually lethal polyradiculoneuropathy. In addition, adenomegaly, oedema and pleural effusions, gonadic atrophy, serum monoclonal IgA, and skin pigmentation were present. Plain x-rays and CT scan of the pelvis and lower vertebrae showed multiple poorly defined lesions. At postmortem there was no myeloma and a bone mastocytosis was found. In addition, next to T11, there was an abdominal nodule, 2 cm in diameter, with histological characteristics of Castleman's angiofollicular lymphoid hyperplasia. Immunohistochemical studies showed that plasmocytes of this lesion secreted polyclonal immunoglobulins with a high prevalence of IgA. Thus, the primary interest of this case lies in the association of bone mastocytosis with a POEMS syndrome. Also, one single localisation of Castleman angiofollicular lymphoid hyperplasia was found, assumed to be in this case the cause of the POEMS syndrome. Therefore, a minute and benign hyperplasic lesion, which was only discovered at autopsy, secreted the protein responsible for the symptoms and signs, and eventually the patient's death. PMID- 3823705 TI - [HLA and familial multiple sclerosis]. AB - Some data suggest an environmental perhaps a viral factor but also of a genetic factor in the etiology of multiple sclerosis. Among the latter is the notably increased risk for a twin when the other twin has the disease, a risk further increased if they are monozygotic. There is also a greater than chance frequency of common HLA haplotypes in 2 affected siblings. The frequency of familial forms of multiple sclerosis is estimated at approximately 6 p. 100. We have studied 14 families of which 12 included 2 members with multiple sclerosis and 2 with 3 affected members. Parental relation between patients was parent to child (7 cases), brother to sister (5 cases), sister to sister including two pairs of twins (4 cases) and cousin to cousin on the mother's side (2 cases). When compared with non-familial multiple sclerosis there were no particular features in clinical disorders or course: 4 forms were progressive, the others evolving by episodes. In 26 patients in whom HLA antigens were determined, the DR2 antigen was present 19 times, the B7 antigen 9 times and the A3 antigen 7 times. In the 8 pairs of siblings with multiple sclerosis, 2 were HLA-identical and 5 semi identical. One pair had no common haplotype. Grouping of HLA in 22 healthy members allowed 8 genealogic trees to be established. If a gene for susceptibility to multiple sclerosis exists, it is of low penetration, of dominant transmission and of limited frequency. It probably lies close to the region D of chromosome 6, because of the disequilibrium of crossed linking with A3, B7 and DR2 antigens. PMID- 3823706 TI - [Contribution of visual evoked potentials, electronystagmography and the blink reflex to the diagnosis of multiple sclerosis]. AB - One hundred and forty six cases of multiple sclerosis were investigated and classified according to McAlpine's criteria into 3 group: probable (40 cases), possible (51 cases) and definite (55 cases). In every patient visual evoked potentials, electronystagmography and blink reflex were performed in the same session. Percentages of abnormal findings were 66 p. cent for VEP, 63 p. cent for ENG and 53 p. cent for blink reflex. These 3 methods can detect subclinical lesions and in reveal new sites of demyelination. Since in only 14 cases (10%) were the results of all 3 methods normal, it is concluded that simultaneous examination by these methods can contribute to the diagnosis. PMID- 3823707 TI - [Thalamic dementia after a unilateral hemorrhagic lesion of the right pulvinar]. AB - A 68 year-old man with a history of right thalamic hemorrhage demonstrated radiologically in the pulvinar and posterior portion of the dorsomedian nucleus developed a clinical picture of severe physical sequelae associated with major affective, behavioral and psychic disorders. Affective manifestations were a permanent anxiety-depression state contrasting with indifference to his surroundings. Behavioral changes included marked apathy, inertness and hypersomnia, together with occasional clastic agitated episodes and verbal and gestural stereotypies and soliloquies. Psychic sequelae were psychotic in nature: depersonalization crises, delusions of persecution, multisensorial hallucinations and absurd acts. PMID- 3823708 TI - [Emery-Dreifuss disease or syndrome of amyotrophy with early contractures and secondary disorders of cardiac conduction with variable heredity]. AB - Emery-Dreifuss myopathy is characterized by the association of early muscle contractures, atrophy predominant on the scapulohumeroperoneal muscles, secondary cardiac conduction anomalies and an X-linked heredity. The case presented here had features corresponding to these criteria except in two respects: the patient was a female, and transmission was of the dominant autosomal type. Three similar families have been reported. This genetic heterogeneity together with doubt as to the exact nature of muscle anomalies, suggests that the syndrome should be termed amyotrophy syndrome with early contractures and secondary cardiac conduction abnormalities with a variable heredity. PMID- 3823709 TI - [Non-dominant hemisphere syndrome as a result of a right thalamic infarct: an anatomoclinical case]. AB - A 71 year old man had a massive left sensory deficit and hemiplegia, with left heminanopia, visual neglect and constructional apraxia. Moreover he experienced an extra-left arm and illusions of movements. 3 weeks later he suffered "thalamic" pain on left side; he died suddenly 6 weeks after the stroke. Post mortem examination revealed: a) a right inner temporal and occipital infarction; b) a right thalamic infarction in the thalamogeniculate and paramedian territories; c) an infarction in the adjacent right internal capsule. Considering this case and pertinent literature on clinicopathological studies of right thalamic infarction, the authors suggest that a simultaneous ischaemia of thalamogeniculate and paramedian territories should be necessary to induce somatognosic and visuospatial disturbances. PMID- 3823710 TI - [Benign intracranial hypertension and Marchiafava-Micheli disease]. AB - A 35 year-old caucasian man suffered from paroxysmal nocturnal haemoglobinuria (PNH) or Marchiafava-Micheli's disease diagnosed in 1976 and complicated by several thrombotic episodes. He developed a benign intracranial hypertension. A digitalized intravenous angiography showed occlusion of both lateral sinuses. Partial improvement followed lombo-peritoneal shunting and steroid therapy. Cerebral venous thrombosis is a well-known complication of PNH but only a few cases have been radiologically and/or pathologically proven. It usually involves the superior longitudinal sinus and/or cortical veins resulting in hemorrhagic infarction of poor outcome. Benign intracranial hypertension due to a venous occlusion is rare. In 3 published cases, as in our own, the neurologic outcome was good. Steroid therapy seems useful. The risks of anticoagulant therapy are discussed. PMID- 3823711 TI - [Ophthalmoplegia, ataxia and areflexia in frontal and pontine metastases simulating Fisher's syndrome]. AB - A patient presented with facial diplegia, occulomotor paresis, ataxia, areflexia and albuminocytologic dissociation. Such clinical features mimicked Fisher's syndrome. In fact, these signs were due to two metastases, one in the pons, the other in the right frontal lobe. PMID- 3823712 TI - [Isolated sensory deficit of 1 side of the body as a result of a hematoma of the pons]. AB - In a patient with a history of sudden onset of an isolated sensory syndrome of the right side of the body the sensory deficit was exclusively related to lemniscal sensitivity. NMR imaging showed a small hemorrhage in the left paramedian portion of the pontine tegmentum, corresponding precisely to the location of the median lemniscus. PMID- 3823713 TI - [Familial insomnia with a malignant course: a new thalamic disease]. AB - A degenerative familial disease with insomnia and autonomic disorders in a 53 years old man is reported. At post-mortem examination anterior and dorso-medial nuclei of the thalamus were atrophied. PMID- 3823714 TI - [Tactile and visual neglect. Preliminary study of 4 patients]. AB - A battery of tactile tests for the study of unilateral neglect is presented with the purpose of comparing the tactile modality to the visual modality. This was applied in 4 patients with right hemisphere lesions. In 3 patients, there was evidence of neglect in both modalities with qualitatively identical anomalies. The function of spatial manipulation involved in the tasks is stressed. In the cases where both modalities were involved a supramodal hemispatial disturbance is assumed. PMID- 3823715 TI - [Predominantly crural hemiplegia with ipsilateral ataxia caused by a meningioma of the falx cerebri]. PMID- 3823716 TI - Pseudomonas testosteroni infections: eighteen recent cases and a review of the literature. AB - Pseudomonas testosteroni has been largely overlooked as a potential pathogen in humans. Ten cases of infection due to P. testosteroni were identified at a single metropolitan hospital in Texas during a three-year period. The organism was most often found in association with anatomic abnormalities of the gastrointestinal tract (six of 10 cases); perforation of the appendix was the commonest abnormality (five cases). The infections were more often polymicrobial (seven cases) than monomicrobial (three cases) and usually involved other organisms that, like P. testosteroni, are of colonic origin. Eight additional cases of infection involving P. testosteroni were reported by other hospitals in Texas during the same period. The organism was isolated from the peritoneal cavity in five of these cases. The results of these surveys suggest that infections of humans with P. testosteroni, while not common, are not as rare as might be predicted on the basis of the number of cases reported in the literature. PMID- 3823718 TI - Training of infectious disease specialists. PMID- 3823717 TI - Esophageal tuberculosis: mimicry of gastrointestinal malignancy. AB - A case of tuberculous involvement of the esophagus was studied in an adult with mediastinal lymphadenopathy unrecognized by roentgenography of the chest. The roentgenographic and endoscopic features in this case were more consistent with malignancy than with tuberculosis. Nineteen additional cases from the English language literature were reviewed. Although esophageal tuberculosis is a rare disease, it should be strongly suspected in a patient with dysphagia who has a positive tuberculin skin test, active pulmonary disease, or mediastinal adenopathy. PMID- 3823719 TI - Role of infectious disease specialists. PMID- 3823720 TI - Esophagitis in the immunocompromised host: role of esophagoscopy in diagnosis. AB - Thirty episodes of presumed infectious esophagitis in immunocompromised patients were investigated by means of esophagoscopy. Indications for esophagoscopy included dysphagia, odynophagia, and retrosternal pain. Factors potentially predisposing patients to esophagitis included previous exposure to radiation, recent cytotoxic chemotherapy, recent antibiotic therapy, corticosteroid therapy, and neutropenia. Sixteen of the 18 barium esophagograms done before esophagoscopy was performed revealed abnormalities; in 14 cases the results were consistent with infectious esophagitis. Abnormalities were noted during 27 of 30 esophagoscopy procedures. Visual findings were consistent with candidal esophagitis in 18 cases, with viral esophagitis in four, and with both in one. Specific infectious diagnoses were established by culture or histology in 17 episodes: 12 of candidal esophagitis, two of herpes simplex esophagitis, two of concomitant candidal and herpetic esophagitis, and one of enteroviral esophagitis. Specific noninfectious diagnoses were made in two episodes, and the esophagus was found to be normal in three. No specific diagnosis was made in eight episodes although visual examination indicated the presence of esophagitis. The only postesophagoscopy complications recorded were isolated episodes of spiking fever in three patients. In this compromised-host population with presumed infectious esophagitis, esophagoscopy resulted in a rapid and specific infectious diagnosis in 57% of episodes. PMID- 3823721 TI - [Lobular carcinoma in situ of the breast. Apropos of 3 cases]. AB - The authors explain the particular nature of these multifocal tumors: absence of node involvement, difficulties of diagnosis, relatively favorable prognosis and a therapeutic dilemma: limited procedure with strict surveillance, subcutaneous bilateral mastectomy. PMID- 3823722 TI - [Early amniocentesis: accidents and incidents. Study of a series of 681 single pregnancies]. AB - The authors studied the outcome of 681 single pregnancies after amniocentesis. The advantage of this study is to determine the exact risk of this procedure, especially as far as spontaneous miscarriage is concerned. 82% of the taps are carried out between 17 and 18 weeks of amenorrhea. A maternal age over 38 years (56%) represent the essential indication. Questionable cases are presented are presented by cases of intrapartum and neonatal mortality (a case of hypotrophy with death in utero at 39 weeks; a case of per-partum death during a cesarean section). There are cases of fetal death in utero where the time between the tap and the diagnosis of fetal death exceeds 4 weeks and where there is no argument for an infectious etiology. Finally, there are several cases where the responsibility of the amniocentesis is unlikely. It often seems that the amniocentesis induces the spontaneous miscarriage of an already compromised pregnancy. Other incidents of amniocentesis are reviewed. A review of the literature has enabled us to draw certain conclusions. In light of their results and the data from the literature, the authors conclude that amniocentesis is not innocuous. At any rate, it is indicated for specific patients and these pregnancies must be considered as risk pregnancies. PMID- 3823723 TI - [Cesarean section for placenta praevia. Perinatal mortality and morbidity]. AB - The severity of placenta praevia is well known and responsible of a non negligible perinatal mortality. This study relates to 65 children born after a cesarean section for placenta praevia and analyzes the fetal complications, their frequency, their prognosis as well as the obstetrical factors connected to this problem. Mortality is 3%, prematurity remains high and so is the anemia, but hypotrophy is rare. The main complications are infection essentially due to an overlapping placenta praevia, its hemorrhagic nature and the increasing number of hemorrhagic episodes and respiratory complications (respiratory distress, inhalation of amniotic fluid and hyaline membrane disease). From these fetal data, the authors propose a method of management of low placental insertions consisting essentially of bed rest as soon as the diagnosis in made on the sonogram, and extraction at the 35th week of amenorrhea. In case of hemorrhage, extraction must be performed earlier if obstetrical conditions, maternal as well as fetal, do not permit to undertake a conservative approach aimed essentially to decrease prematurity and its consequences. PMID- 3823724 TI - [Lymphangioma of the uterus. Apropos of a case]. AB - Lymphangioma of the uterine corpus is a rare tumor and the authors report one case discovered per-operatively. A review of the literature permits to bring out its essential characteristics as far as clinic, etiopathogenesis, evolution and therapy are concerned. This completely benign tumor is more an anatomo pathological curiosity than a true gynecological problem. PMID- 3823725 TI - [Hemolytic-uremic syndrome during oral contraception]. AB - A hemolytic and uremic syndrome is described in a 41 year old woman on oral contraceptives for 18 years, only discontinued during the course of 4 normal pregnancies. A renal biopsy performed on the 20th day, after correction of the thrombopenia, confirms the typical aspect of advanced thrombotic microangiopathy. The usual etiological work-up is negative, but the search for steroidal anti hormones antibodies by radioimmuno assay is positive. The evolution is favorable with hemodialysis, perfusion of fresh plasma during the sessions, calciparin, dipyridamol and anti-hypertensive drugs with, eight months later, a creatinin clearance of 45 ml/min and important persisting ischemic lesions in a new renal biopsy. The hemolytic and uremic syndrome following oral contraceptives remains rare (about thirty cases reported in the literature) and its prognosis remains severe despite a well adjusted treatment. Prevention includes the detection of risk patients and the search for steroidal anti-hormones antibodies could certainly play a role which remains to be evaluated. PMID- 3823726 TI - [Value of promestriene in the treatment of postmenopausal urination disorders]. PMID- 3823727 TI - [Clinical and biological justifications for the use of Triella]. PMID- 3823728 TI - [Carcinoma of the adrenal cortex]. PMID- 3823729 TI - [Critical study of 120 cases of transrectal biopsy of the prostate]. PMID- 3823730 TI - [Repair of complete traumatic stricture of the bulbar and membranous urethra by termino-terminal urethroplasty]. PMID- 3823731 TI - [Primary amyloidosis of the ureter]. PMID- 3823732 TI - [Percutaneous nephrostomy]. PMID- 3823733 TI - [Incidence of Campylobacter jejuni/coli in swine and poultry. Possible relationship to human disease on the basis of characteristics of species and serotype]. PMID- 3823734 TI - [Biological characteristics of several species of Pseudomonas of different origins]. PMID- 3823736 TI - [Non-sporulated anaerobic bacteria in gynecologic pathology]. PMID- 3823735 TI - [Bacterial agents of postabortal and postpartum infections]. PMID- 3823737 TI - [Attempts to control giardiasis in 2 nurseries for preschool children]. PMID- 3823738 TI - [Antirabies therapy]. PMID- 3823739 TI - [Interaction of Leishmania donovani promastigotes with peritoneal exudate cells of mice as affected by chymotrypsin]. PMID- 3823740 TI - Trypanosoma (Herpetosoma) rangeli Tejera, 1920. Intracellular amastigote stages of reproduction in white mice. PMID- 3823741 TI - [Evaluation of the therapeutic activity of albendazole in rats experimentally infected with Strongyloides venezuelensis]. PMID- 3823742 TI - [Aggressive pulmonary paracoccidioidomycosis, stenosing endotracheitis and subacute cor pulmonale. Description of a case]. PMID- 3823743 TI - [Ocular paracoccidioidomycosis. Report of a case with posterior chorioretinitis]. PMID- 3823744 TI - [Clinical forms of paracoccidioidomycosis]. PMID- 3823745 TI - Transplantation terminology in nasal surgery. PMID- 3823746 TI - A modification of the saccharine test for nasal mucociliary clearance. AB - The saccharine test for assessing mucociliary clearance in the nose is the most practicable method. As the used sodium salt of saccharine is well water soluble, there is suspicion of interference with the very delicate two-layer-system of mucus or transport merely in the periciliary fluid, thus bringing about methodical errors. This is avoided by using inert tracers such as radioactively tagged ion exchange resin particles, which on the other hand must be observed with expensive equipment. A synthesis of both methods is demonstrated by using saccharine loaden ion exchange resin particles. The validity of the test is proven in vitro and in vivo. PMID- 3823747 TI - Measurement of nasal mucociliary transport rate in normal man. AB - After reviewing the main methods existing to calculate the rate of the mucociliary transport, the authors describe their personal technique. A 99mTechnetium Sulphur Colloid drop is deposited in the nasal fossa, which is carried away by the cilia down to the rhinopharynx and followed by a gamma camera. To calculate the transport rate, a new method of quantification has been introduced, based on the formation of a parametric image. A study was carried out in 14 males without any pathology of the upper airways, obtaining a mean velocity of 5.3 mm per min (range 3.3.-8.2). PMID- 3823748 TI - Balanced physiological saline in the treatment of chronic rhinitis. AB - The effects of a special balanced physiological saline on nasal symptoms of 93 patients with chronic rhinitis were studied. The main diagnoses of the patients were allergic rhinitis, atrophic rhinitis and ozaena, rhinitis sicca, chronic sinusitis, nasal polyposis and postoperative condition after nasal surgery. The tested solution was administered by a simple metered dose pump. 85 (91%) of the patients reported beneficial effects of the tested solution on nasal symptoms. In addition, 22 (71%) of those patients who used continuous anti-allergic medication, mainly intranasal steroids, reported that the tested solution improved the efficacy of their ordinary drug. So the tested solution proved to be beneficial in humidifying atrophic or otherwise dry mucosa, douching crusty nose and as adjuvant therapy in the treatment of allergic rhinitis. PMID- 3823749 TI - Nasal vasomotor responses in man to breath holding and hyperventilation recorded by means of intranasal balloons. AB - Nasal vasomotor responses were recorded in conscious human subjects by means of water filled balloons. Hyperventilation caused an increase in intranasal balloon pressure associated with vasodilatation whereas breath holding caused a decrease associated with vasoconstriction. The amplitude of the nasal vasomotor response was influenced by the nasal cycle with the greatest response always observed on the congested or low airflow side of the nose. The results suggest that an elevated arterial level of carbon dioxide causes a pronounced vasoconstruction of the nasal blood vessels and that this response may be clinically relevant in controlling nasal bleeding. PMID- 3823750 TI - Studies of transnasal pressure and airflow values in a Japanese population. AB - The proportions of subjects who attained transnasal pressure and flow values of different magnitudes during spontaneous nasal breathing at rest were determined. Several co-ordinate points on transnasal pressure: flow curves generated by 77 (34 M, 43 F) healthy Japanese subjects aged 15-65 years were examined. By posterior rhinomanometry the proportion approximated 100% at Brom's radii R1 and R2 and 80-90% at 0.25 l/sec flow and at 0.5 cm H2O (50 Pa) pressure when both nasal cavities were patent. When one nasal cavity was occluded the results were 100% at radius R1 and 80-90% at radius R2 and 0.5 cm H2O (50 Pa) pressure. By anterior rhinomanometry, the proportion approximated 100% at radius R1 and 0.5 cm H2O (50 Pa) pressure and was quite high at radius R2 and 1.0 cm H2O (100 Pa) pressure. Pressure and flow are more representative at points where the pressure: flow curve includes the turbulent flow component than at radius R1 and 0.5 cm H2O (50 Pa) pressure. Calculation of total nasal resistance from unilateral resistances at 1.0 cm H2O (100 Pa) appears a suitable compromise and this point is recommended for a Japanese population. PMID- 3823751 TI - Pressure-induced expansion of the maxillary sinus. A rare entity. PMID- 3823752 TI - Arhinia. PMID- 3823753 TI - [The sacrifice of pre-embryos]. PMID- 3823754 TI - XIV annual meeting, International Society for Oncodevelopmental Biology and Medicine. Helsinki, Finland, August 14-17, 1986. Program and abstracts. PMID- 3823755 TI - [Complications of arteriography--details at the time of the occurrence of side effects]. AB - Own observations and the review of the literature show that complications of arteriography may appear after some hours or some days. The causal context is given in general for complications that may be due to the puncture. This is valid, too, for renal insufficiency induced by contrast substance. Neurological symptoms appearing hours or days after cerebral angiography are more difficult to evaluate. Different influences may contribute. The information of the patient before arteriography may in some cases include complications of possible follow up treatment. PMID- 3823756 TI - [The quality of the roentgen image--a recommendation for quantifying image quality]. AB - A proposal is worked out to express x-ray image quality by means of a meaningful and practically useful numerical system. Attennations have been selected in such a manner that whole numbers of Quality Value figures ranging from -10 to +60 result in meaningful associations with radiological indications. Individual parameters are incorporated into the resulting values. A test body for determining Information Sensitivity figures is described that is practical easy built and inexpensive; its most important feature, however, is that it is reproducible and permits international comparisons. This test body provides a direct linking with the Quality Value figures. PMID- 3823757 TI - [Isolated agenesis of the right pulmonary artery with late manifestation of pulmonary artery hypertension]. AB - The case of a woman patient of 25 years of age with acute cardiac decompensation is presented. The chest x-ray as well as the lung scan showed the typical features of absence of the right pulmonary artery. The diagnosis was confirmed angiographically. The sudden and late onset of symptoms of pulmonary hypertension is a remarkable feature. PMID- 3823758 TI - [Difficulties in the diagnosis of osteoid osteoma]. AB - The difficulties arising in diagnosing osteoidosteoma are demonstrated by means of 30 surgically treated cases and the results are compared with those available from the literature. The value of bone scintigraphy and of tomography within the framework of a diagnostic concept is underlined. Diagnosis is confirmed and treatment is effected by the successful surgical removal of the nidus. PMID- 3823759 TI - [Arterial bolus dynamics of ionic and nonionic contrast media in intravenous administration]. AB - A more favourable intraarterial pattern of bolus dynamics can be expected in DSA on applying nonionic contrast media via the intravenous route, as can be concluded from the results of numerous experimental studies on the different effects of ionic and nonionic contrast media on cardiovascular function. However, bolus measurements of ionic and nonionic contrast media in intraindividual comparison of 28 patients via serio-CT did not yield any significant difference. The influences of various factors on measurement results--quantities of contrast media, time and method of measurement--are discussed as possible causes of this discrepancy. PMID- 3823760 TI - [Cystitis]. PMID- 3823761 TI - [Cystalgia and cystopathy]. PMID- 3823762 TI - [The female bladder and perineum]. PMID- 3823763 TI - [Bladder neoplasms]. PMID- 3823764 TI - [The irradiated bladder]. PMID- 3823765 TI - [Accidents in childhood, excluding injury and poisoning]. PMID- 3823766 TI - [Hyperosmolar coma in adults]. PMID- 3823767 TI - [Compressive pericardial effusion. Diagnosis and treatment]. PMID- 3823768 TI - [Treatment of cardiogenic pulmonary edema]. PMID- 3823769 TI - [Androgenic function]. PMID- 3823771 TI - [Does the "andropause" exist?]. PMID- 3823770 TI - [Androgenic and antiandrogenic drugs]. PMID- 3823772 TI - [Androgens and antiandrogens in the male]. PMID- 3823773 TI - [Androgens and behavior]. PMID- 3823774 TI - [Hormonal treatment in cancer of the prostate]. PMID- 3823775 TI - [AMP deaminase deficiency (myoadenylate deaminase). Disease or syndrome?]. AB - Two recent publications have shown the advantage of understanding the deficit in AMP desaminase in rheumatology. On this subject, the authors report 4 cases of deficit in AMP desaminase. The first one includes a semiology made of pain, and stiffening, the second case is discovered in the course of a primary muscular disease. The third case is present during the first stage of a spinal cord compression. The fourth case is a muscular deficit accompanied with a histological picture of inflammation, considered initially as a chronic polymyositis, but explained secondarily as a pseudo-polymyositis form of facio scapulo-humeral dystrophy. In this respect, the cases from the literature are divided into three groups: asymptomatic, infraclinical forms, forms occurring in the course of specific diseases (muscular diseases, spinal cord diseases, inflammations of the connective tissues, metabolic diseases), apparently isolated forms. In the latter, emerges a semiology made of pain, cramps, stiffening of the lower extremities occurring on exertion. However, the specificity of the symptoms remains to be discussed. PMID- 3823776 TI - [Bone and joint Actinomyces meyeri infections. Cervicofacial localizations excluded. Apropos of 3 cases]. AB - The authors report three observations of osseous and/or articular actinomycosis. Osseous localizations, always in contact with abscessed foci of the soft tissues, included the spine and one or several limbs. In one case there was an arthritis of the knee. Culture and typing of the responsible germ: Actinomyces meyeri, were obtained from infectious foci in the three cases. The authors insist on the rare occurrence, at the moment, of osteo-articular actinomycoses outside the maxillo facial area. Actinomyces meyeri has exceptionally been implicated. The prognosis of osteo-arthritis is similar to that of other localizations. It is usually favorable due to the great sensitivity of the germs to antibiotics, especially penicillin. PMID- 3823777 TI - [Comparative study of rheumatoid polyarthritis with and without the Gougerot Sjogren syndrome. 54 cases]. AB - Clinical, biological and evolutive profiles of rheumatoid polyarthritis (RP) associated or not with a Gougerot-Sjogren syndrome (GSS) were compared in two series of 27 patients matched according sex and age, and recruited among 158 patients examined during a period of 36 months. The GSS was defined by the presence, in addition to RP, of xerophthalmia (Schirmer and Rose Bengal tests were positive) and/or salivary glands disorders (histological abnormalities at stages III or IV of Chisholm classification). The evolution of RP and the importance of articular or extra-articular involvement of the disease are identical in both groups. Biologically, the prevalence of agglutinating rheumatoid factors, antinuclear antibodies and specific organ antibodies, is not different from one group to the other. Only the serum levels of gammaglobulins and circulating immune complexes are higher in the presence of a GSS. Finally, it was not necessary to resort more often to steroid therapy and/or immunosuppressors for RP with GSS than for isolated RP. In summary, in the same age group and same sex, RP associated to a GSS do not appear to have a fundamentally different profile, contrary to what might have been suggested by previous studies. PMID- 3823778 TI - [Pathology of the upper peroneotibial joint. History of cysts. Apropos of 4 cases]. PMID- 3823779 TI - [Multifocal hemangioendothelioma of the bone. Apropos of a case]. PMID- 3823780 TI - [Metatarsalgia, cyanosis and angiolymphoid hyperplasia with eosinophilia. Apropos of 2 unusual cases]. PMID- 3823781 TI - [Tenosynovitis of the wrist caused by atypical mycobacteria. Apropos of 2 cases]. PMID- 3823782 TI - [Epidemiological approximation on the study of goiter in the eastern Canary Islands (Grand Canary, Fuerteventura and Lanzarote)]. PMID- 3823783 TI - [Study of fluoride contamination in the natural waters of La Rioja, using a lanthanum fluoride membrane electrode]. PMID- 3823784 TI - [Mortality from cancer of the lung in Andalucia]. PMID- 3823785 TI - [Previous attempts at water purification and their application]. PMID- 3823786 TI - [Pharmacologic aspects of the use of antimicrobial agents in pediatrics]. PMID- 3823787 TI - [Treatment of sexually transmitted diseases]. PMID- 3823788 TI - Occurrence of specific phytohaemagglutinin-reactive immunoglobulins in the sera of certain individuals. Relevance to the detection of cell surface antigens on phytohaemagglutinin-stimulated cells. AB - While investigating sera for possible antibodies to TL-like determinants, multiparous sera were selected that had specific cytotoxic reactivity against phytohaemagglutinin (PHA)-activated lymphocytes of certain individuals and were negative against unstimulated T or B cells from the same donor. The reactivity patterns were not correlated to any HLA specificities. However, in an indirect immunofluorescence assay with flow cytometry, these same sera had strong specific monomorphic reactivity to PHA-activated lymphocytes from all the individuals in the panel. Unstimulated cells remained negative. In contrast, other human sera lacked reactivity with PHA-stimulated lymphocytes. The addition of PHA to fresh lymphocytes followed by incubation at 4 degrees C for 30 min resulted in the same pattern of reactive and non-reactive sera. When incubated with PHA, different cell types, including 0- erythrocytes and a murine lymphoid cell line, reacted similarly with the sera. Using plates coated directly with PHA-E, L, and P in a cell-free ELISA system. PHA-specific sera reacted specifically with PHA-coated wells. The anti-PHA activity was removed by absorption with 0- erythrocytes coated with PHA without affecting the titre of the anti-HLA antibody in the same serum. These findings suggested that IgG molecules in certain sera react directly with residual PHA bound to the cell surface and not necessarily with molecules of cellular origin induced by exposure to PHA, complicating the search for antibodies specific for T-cell activation antigens. PMID- 3823789 TI - Antigenic variants of human IgG subclasses. Restriction of murine monoclonal IgG subclass antisera. AB - A comparison of murine monoclonal IgG subclass antisera with rabbit polyclonal IgG subclass antisera restriction of the monoclonal antisera and further antigenic heterogeneity within the IgG subclasses of at least two antigenic variants of IgG1, two of IgG2, two of IgG3 and a third subtype of IgG4. PMID- 3823790 TI - Spontaneous IgA synthesis by blood mononuclear cells in alcoholic liver disease. AB - Changes in the concentration and composition of serum immunoglobulin A (IgA) and deposits of IgA in tissues are well-known characteristics of alcoholic liver disease. We investigated whether these changes also accompany IgA synthesis by peripheral blood mononuclear cells (MNC), by counting immunoglobulin-producing cells using a solid-phase enzymatic 'spot' test, and by analysis of immunoglobulin content in lysed cells with culture supernatant using conventional enzymatic methods. Patients with alcoholic liver disease exhibited a significantly higher number of spontaneously IgA-producing cells than did normal healthy controls (1.7 X 10(6) cells/blood and 0.5 X 10(6) cells/blood, respectively, P less than 0.01). The IgA content of MNC directly after isolation was also higher (38 and 13 ng/10(6) MNC, respectively, P less than 0.01), as was the IgA production during an unstimulated 6-day culture period (520 and 95 ng/10(6) MNC put into culture, respectively, P less than 0.001). The spontaneously IgA-producing cells assessed directly after isolation of mononuclear cells correlated with the IgA production during an unstimulated culture (P less than 0.01). We conclude that in alcoholic liver disease, B lymphocytes circulate which may have been activated in vivo. PMID- 3823791 TI - Generation of the antibody repertoire in individuals with multiple immunoglobulin heavy chain constant region gene deletions. AB - Antibodies against protein antigens are largely restricted to the IgG1 subclass in man, whereas anti-carbohydrate antibodies, at least in adults, are almost exclusively confined to the IgG2 subclass. In IgG2-deficient donors where the C gamma 2 gene is retained in the genome, antibodies against most polysaccharide antigens are absent. We therefore undertook a study of the antibody repertoire in 11 adult donors with immunoglobulin heavy chain constant region gene deletions, homozygous or heterozygous defects, encompassing the C gamma 2 gene. In all cases, antibodies against polysaccharide antigens were present and restricted to the remaining subclasses (IgG1 and/or IgG3). These results suggest an unrestricted use of the available VH gene repertoire in donors lacking the C gamma 2 gene, and imply that the limited antibody repertoire found in IgG2 deficient individuals with a retained C gamma 2 gene may be a consequence of an altered regulatory mechanism or a structural VH gene defect. However, furthermore, the deletion of multiple C gamma heavy chain constant region genes did not appear to decrease the IgG switch probability as such, since total serum levels of IgG appear to be normal. PMID- 3823792 TI - Long-term griseofulvin treatment for progressive systemic sclerosis. AB - Thirty-three patients with progressive systemic sclerosis (PSS) (24 women and 9 men, 27 with diffuse scleroderma and 6 with CREST syndrome) were treated with griseofulvin alone (375-500 mg/day) for 12-84 months (mean 33). Clinical and functional assessment of the results included: a self-evaluation (general status, skin toughness, cold sensitivity, dysphagia), a physical examination (fingerprint areas, chest expansion, mouth widening, grip strength) routine laboratory tests, electrocardiogram, glomerular filtration rate (GFR), esophagus and chest X-rays. After griseofulvin, a significant improvement was noted in 28/33 patients (85%) regarding subjective condition and skin thickening and elasticity, particularly in the trunk and proximal limbs (p less than 0.05 for chest expansion), and of GFR (p less than 0.01). Lung and esophageal involvement, on the whole, remained unchanged during the treatment, which does not appear to modify the progression of PSS myocardiopathy. No patient stopped using griseofulvin because of side effects. The present results show that griseofulvin is a safe drug for PSS treatment and that it can influence the skin and renal involvement. PMID- 3823793 TI - Acute pancreatitis in systemic lupus erythematosus. AB - Lethal acute pancreatitis developed in a 16-year-old Caucasian woman suffering from systemic lupus erythematosus. Until the time of onset of pancreatitis, the patient's medications included prednisone, furosemide, ethacrynic acid and chlorthalidone, all of which have been related to pancreatitis. At autopsy, no specific signs of autoimmune activity were found in the diseased pancreatic tissue. A review of the literature shows that information on the association of pancreatitis and SLE is scarce. This case illustrates the dilemma of pathogenesis and therapy of acute pancreatitis in SLE and the need for further investigation. PMID- 3823794 TI - Diffuse interstitial lung disease in rheumatoid arthritis. Views on immunological and HLA findings. AB - Immunological parameters including HLA typing were studied in 32 patients with rheumatoid arthritis (RA) associated diffuse interstitial lung disease (DILD) and in 32 age- and sex-matched RA control patients. The male RA patient group with DILD also included patients with other intrathoracic manifestations and had a higher prevalence of HLA-B8 and Dw3 than did healthy controls, thus agreeing with our earlier results that RA patients with this antigen combination are prone to multiple intrathoracic complications. Patients with DILD had higher titres of rheumatoid factor (RF) and lower complement (C4) levels than matched RA controls. The RF titre was in inverse correlation with C3 and C4 levels, suggesting that RF immune complexes may also promote rheumatoid lung disease via activation of the classical pathway of complement. PMID- 3823795 TI - Brucella arthritis. AB - Nine cases of peripheral arthritis were identified among 40 patients with brucellosis, in the endemic area of Southwestern Greece, during a 4-year prospective study. In 5 patients the joint was aspirated and the examination of the synovial fluid revealed white cell counts ranging from 4,460/mm3 to 8,800/mm3, with lymphocytic predominance. Synovial fluid cultures were positive for Brucella in 3 out of the 5 patients. These findings suggest that brucella arthritis is mainly a true septic arthritis, with characteristic joint fluid features, which distinguish it from other septic arthritides, a fact that is extremely helpful in its early diagnosis and management in an endemic area. PMID- 3823796 TI - Comparative evaluation of the effects of ultrasonic and ultraviolet irradiation on tissue regeneration. AB - Twenty rabbits were divided into two matching groups. Holes of 1 cm2 area were bored through the full thickness of the pinna of both ears in each rabbit. In group I, the right ears were irradiated with pulsed ultrasound three times/week for 18 weeks. In group II, the right ears were irradiated with ultraviolet rays using a hot quartz lamp, three times/week for 18 weeks. The left ears in all rabbits were not irradiated and acted as controls. The rate of wound healing was calculated in terms of decrease in surface area of the wounds measured with a planimeter from enlarged photographs taken from the wound edges at the end of third, fifth and seventh weeks. The results revealed that ultrasound has a better effect on promotion of tissue regeneration than ultraviolet irradiation, as evidenced by both reduction in the surface area of wounds and by histopathological examination. PMID- 3823797 TI - Incidence of hip involvement and need for total hip replacement in rheumatoid arthritis. An eight-year follow-up study. AB - In an 8-year follow-up of a prospective study of recent arthritis, 103 patients were found to have erosive and 97% seropositive rheumatoid arthritis. A 20% incidence of hip joint involvement was observed among them. Moderate radiological changes could be seen in 10%, severe destruction (Larsen 4 or 5) in 3%, and acetabular protrusion in 1% of the patients. It was estimated that the minimum annual need of total hip replacement in rheumatoid arthritis in Finland would be 470. This is about 100 per million in the overall population. At the end of the follow-up the Larsen X-ray index was highly significantly (p less than 0.001), ESR significantly (p less than 0.005), and CRP clearly (p less than 0.03) higher in the 13 patients with radiologically confirmed hip changes than in the 90 without them. Thus their hip destruction is attributable to a more severe disease condition and not to the glucocorticoids administered. Furthermore, HLA-B27 was positive in 69% of the above-mentioned 13 patients compared with 27% of the rest, and this difference (p less than 0.005) may also explain the poor prognosis for true rheumatoid arthritis patients. PMID- 3823798 TI - Relationship between some joint fluid, blood and serum variables and radiological destruction in knee joints in arthritic patients. PMID- 3823799 TI - Acute reversible renal failure following naproxen (naxyn) administration. PMID- 3823800 TI - Zinc concentrations in rheumatoid and psoriatic arthritis. Are they relevant to the inflammatory process? PMID- 3823801 TI - Creatine phosphokinase MB and lactate dehydrogenase isoenzyme 1 and 2 in polymyositis/dermatomyositis. PMID- 3823802 TI - Mortality and incidence of cancer among Swedish rubber workers, 1952-1981. AB - The mortality and incidence of cancer was studied among 8,734 workers from two Swedish rubber manufacturing companies. Mortality was investigated from 1952 to 1981 and cancer incidence from 1959 to 1980. The expected numbers of deaths were calculated from national statistics. No significant risk excesses were detected when the cohort was analyzed without consideration of employment time or latency period. However, the mortality from coronary heart disease and the incidence of lung cancer were increased when the study period was limited to greater than or equal 40 years since first employment. The standardized mortality ratio for coronary heart disease correlated positively with employment duration. The mortality from asthma, bronchitis, and emphysema was nonsignificantly increased. The incidence of bladder cancer was increased among individuals with heavy and long-term exposure in the weighing and mixing departments. Twenty-five percent of the individuals in the cohort were not Swedish citizens at the time of employment, and an analysis of the mortality and cancer incidence in this group showed a markedly increased lung cancer incidence for certain immigrant groups, probably mainly due to ethnic factors. The results indicate that ethnic factors must be considered in the analysis of occupational groups when a high proportion of the workers are immigrants. PMID- 3823803 TI - Mortality and cancer morbidity among workers in a chemical factory. AB - A retrospective cohort study was performed on a group of 664 male workers employed for at least one month during the period 1942-1979 in a chemical factory. Both established and suspected carcinogens had been handled in the plant, primarily piperazine, but also urethane, ethylene oxide, formaldehyde, and organic solvents. A significantly increased mortality, compared with the regional death rate, was observed in the cohort. The increase was mainly due to violent deaths and cardiovascular diseases. No rise in death rates was observed for asthma, bronchitis or emphysema, in spite of other evidence of a high risk of occupational asthma, due to exposure to piperazine. A statistically significant increase in cancer morbidity was observed for malignant lymphoma/myelomatosis when an induction latency time of at least 10 years was used. Furthermore, an increase in bronchial cancer was noted, but it was statistically significant only when an induction-latency time of at least 15 years was used. A case-referent study within the cohort did not reveal any significant association between any specific chemical exposure and cancer morbidity. PMID- 3823804 TI - Mortality among production workers in pulp and paper mills. AB - A cohort of 3,572 pulp and paper mill workers employed for at least one year between 1945 and 1955 was followed through 31 March 1977. Vital status was determined for 99% of the cohort. The 915 deaths observed were 79% of the number expected on the basis of comparable United States mortality rates. Statistically nonsignificant excesses of deaths due to lymphosarcoma and reticulosarcoma and to stomach cancer were observed. These findings tend to corroborate reports based on state vital statistics, and preliminary case-referent and population-based studies of workers in the pulp or paper industries. No deaths due to nasal cancer were observed, but only 0.6 were expected. When process-specific analyses were conducted, the excess risk of lymphosarcoma and reticulosarcoma was increased only for men who worked in sulfate mills. The excess risk of stomach cancer was limited to men who worked in sulfite mills. Process-specific standardized mortality ratios for these causes were highest after 20 years since first employment in the mills. PMID- 3823805 TI - Impaired odor perception in tank cleaners. AB - The olfactory perception of 20 men (tank cleaners) exposed to petroleum products (while cleaning oil tanks) was examined. Office workers and watchmen were used as referents (N = 20 + 20). They were matched with regard to sex, age, and smoking habits. Odor detection thresholds and the perceived odor intensity of four odorous stimuli, pyridine, dimethyl disulfide (DMDS), n-butanol, and heating oil vapor (gas phase of heating oil heated to +40 degrees C), were determined. The results suggested that the tank cleaners had higher absolute odor thresholds for n-butanol and oil vapor than the referents. The psychophysical function of the tank cleaners and referents differed for all the tested substances in respect to odor intensity. The tank cleaners displayed an odor deficit analogous to the hearing loss known as "loudness recruitment," ie, normal perception of strong stimuli but impaired perception of weak stimuli. This odor deficit was therefore named "odor intensity recruitment" and seems, in tank cleaners, to be associated with occupational exposure to oil vapor. PMID- 3823806 TI - Muscle activity and fatigue in the shoulder muscles of assembly-plant employees. AB - Subjects who do monotonous and repetitive work in a sitting position often complain of discomfort and soreness in the neck and shoulder regions. Twenty-five subjects had electromyographic examinations of the deltoid, infraspinatus, and trapezius muscles. The recordings were performed eight times throughout a whole workday. In a questionnaire administered before the examinations, 16% of the subjects had reported pain in the neck only, 8% pain in the shoulders only, and 48% pain in both areas. The muscle activity was analyzed by means of the amplitude distribution probability function. The results showed high static contraction levels in the deltoid, infraspinatus, and trapezius muscles and high medium contraction levels of the infraspinatus and trapezius muscles, but acceptable maximum contraction levels for all three muscles. The activity levels did not change during the day and showed no differences related to age or sex. The decrease in mean power frequency during a 2-min contraction sustained at 20% of the maximal voluntary contraction was the same in the morning and in the afternoon. Although the electrical activity in the muscles indicates a high degree of muscle activity, there was no change during the day, ie, no sign of muscle fatigue. PMID- 3823807 TI - Toxicokinetics of toluene in occupationally exposed volunteers. AB - The influence on the kinetics of toluene from long-term occupational exposure, cigarette smoking, and ethanol consumption was studied in 26 male spray painters. A group of spray painters with reported subjective symptoms such as concentration deficits, fatigue, and dizziness due to the solvent exposure did not differ in the uptake and disposition of toluene from a group of spray painters with no symptoms. In occupationally exposed workers, a tendency for an enhanced clearance of toluene from the blood was observed in relation to personal habits such as smoking and/or moderate chronic ethanol intake. Long-term occupational exposure to a mixture of organic solvents does not exert any effect on the metabolic rate of toluene as compared with that of an unexposed group. PMID- 3823808 TI - Toxicokinetics of inhaled 2-butoxyethanol (ethylene glycol monobutyl ether) in man. AB - Seven male volunteers were exposed to 2-butoxyethanol at the Swedish occupational exposure limit (20 ppm or 0.85 mmol/m3) during light physical exercise (50 W) on a bicycle ergometer. The exposure took place in an exposure chamber and lasted 2 h. Expired air was collected at regular time intervals for estimation of the respiratory uptake of the solvent. Arterialized capillary blood and urine were sampled during and after the exposure period and analyzed for 2-butoxyethanol and its metabolite butoxyacetic acid. A new sensitive method for analyzing 2 butoxyethanol in biological specimens is described. 2-Butoxyethanol was derivatized with pentafluorobenzoyl chloride and analyzed by gas chromatography with electron capture detection. The respiratory uptake of 2-butoxyethanol averaged 10.1 mumol/min or 57% of the inspired amount. The concentration in blood reached a plateau level of 7.4 mumol/l. The apparent values of elimination half time, mean residence time, total blood clearance, and steady-state volume of distribution were 40 min, 42 min, 1.2 1/min and 54 l, respectively. The amount of 2-butoxyethanol excreted in urine was less than 0.03% of the total uptake, while that of butoxyacetic acid ranged from 17 to 55%. PMID- 3823809 TI - Urinary elimination of acetone in experimental and occupational exposure. AB - Fifteen volunteers were exposed to an acetone vapor concentration of 964-8, 610 mumol/m3 (56-500 mg/m3) for 2-4 h in an exposure chamber. Ten subjects were at rest during the exposure, and five were exposed at alternate rest and light physical exercise. Subsequently 104 workers occupationally exposed to acetone were studied. The relative uptake averaged about 53%, and the ratio of the alveolar concentration to the environmental concentration averaged about 0.28. Both for the experimentally exposed subjects and the occupationally exposed workers the urinary acetone concentration showed a linear relationship to the corresponding environmental time-weighted average concentration. A linear equation also existed between urinary concentrations and the amounts of acetone absorbed. The findings enable a consideration of the urinary concentration of the unaltered acetone as an appropriate exposure indicator and the proposal of a "biological equivalent threshold" to be used in the field of biological monitoring. PMID- 3823810 TI - Measurements of extremely low-frequency magnetic fields around video display terminals. AB - The extremely low-frequency (ELF) magnetic field emissions of seven video display terminal (VDT) models were measured. A measuring coil with a linearized frequency response (50 Hz to 25 kHz) was used. The dominating ELF magnetic field around the terminals was the 50 or 60 Hz asymmetric triangular waveform from the vertical deflection coil of the cathode ray tube. At the distance of 50 cm, the magnetic field strength was still slightly higher than the background level in usual office rooms, but several orders of magnitude lower than the thresholds of known interaction mechanisms. Some recent experiments suggest that certain biological effects may occur at field strengths only a few times higher than those found at the position of VDT operators, but the significance of these effects to human health is not known. PMID- 3823811 TI - Polycyclic aromatic hydrocarbons in smokehouses. AB - The level of exposure to polycyclic aromatic hydrocarbons (PAH) from smoking kilns in Danish smokehouses was determined. Of 60 smokehouses curing fish with hot smoke from smoldering alder chips, 10 companies were selected for the analysis of workzone air. The amount of PAH, determined as the sum of 11 selected compounds, varied from 2.2 micrograms/m3 to 2,472 micrograms/m3 above the kiln doors. Samples taken approximately 2 m in front of the kiln doors contained 0 19.2 micrograms/m3. PMID- 3823812 TI - Smoking among Finnish pulp and paper workers--evaluation of its confounding effect on lung cancer and coronary heart disease rates. AB - The possible confounding caused by smoking was studied in connection with a mortality and cancer incidence study of 3,520 workers in the pulp and paper industry. A group 1,290 sawmill workers was used for comparison in addition to the expected numbers based on national statistics. A total of 801 questionnaires was sent to a representative sample of the workers, 537 to people still alive and 264 to the next-of-kin of decedents. The reply percentage was 86.6 for the former and 80.9 for the latter. The prevalence of smoking was determined for 1956 and 1981. The proportions of moderate and heavy smokers were assessed for 1981, and smoking indices were calculated for each occupational group. The estimated rate ratios for lung cancer in relation to smoking categories and the corresponding smoking-adjusted standardized incidence ratios were calculated for 1981, and they were compared with the observed standardized incidence ratios for lung cancer. The smoking habits could not explain the observed excess of lung cancer, nor the increased mortality from coronary heart disease found among the pulp and paper workers. Postal questionnaires may be a feasible tool for assessing smoking habits in retrospective cohort studies. PMID- 3823813 TI - Acetone-induced changes in the toxicokinetics of 2,5-hexanedione in rabbits. AB - Male rabbits were intravenously injected with 2,5-hexanedione or 2,5-hexanedione plus acetone. A toxicokinetic analysis showed that a two-compartment model satisfactorily described the kinetics of 2,5-hexanedione in rabbits. Simultaneous dosing with acetone altered the toxicokinetic model which best described the plasma concentration versus time data. The model-independent parameter body clearance, calculated according to the trapezoidal rule, showed a decrease in the body clearance of 2,5-hexanedione in rabbits simultaneously injected with acetone. The results suggest that toxicokinetic interference may partly explain the neurotoxic potentiation of that which occurs in 2,5-hexanedione-induced axonopathy as a response to simultaneous exposure to acetone. PMID- 3823814 TI - Testicular cancer among agricultural workers and licensed pesticide applicators in Sweden. PMID- 3823815 TI - Additional follow-up of cancer mortality among workers in a thermoelectric power plant. PMID- 3823816 TI - [Results after radical prostatectomy for prostate carcinoma]. AB - 35 of 54 patients undergoing radical prostatectomy for localized cancer were asymptomatic and the tumor had been found during a routine check-up by the family physician. In 53 of 54 patients the indication for surgery was based on a positive cytological finding in fine-needle aspiration biopsy of the suspected tumor. In all patients the carcinoma was confirmed by histological work-up of the radical prostatectomy specimen. Cytological and histological grading was identical in three quarters of all patients. However, the preoperative tumor stage (T) was confirmed histologically (pT) only in half of all the patients. The extension of the carcinoma was often underestimated at the preoperative clinical staging. After a mean observation time of close to 4 years, the survival rate in patients undergoing radical prostatectomy for localized cancer is comparable to an age and sex matched control group. Our data suggest that fine-needle aspiration biopsy of the prostate is a very reliable procedure in the diagnosis of prostatic carcinoma, provided the aspiration technique is correct and the smears are interpreted by a well-trained cytologist. Moreover, patients with localized prostate cancer seem to have an excellent chance of survival with low morbidity, provided the indication for surgery is restricted to carefully selected patients. PMID- 3823817 TI - [Significance of reciprocal ST-segment depression in the acute stage of transmural myocardial infarct]. AB - 19 patients with transitory ST-segment depression in the wall opposite the infarcted territory during acute transmural myocardial infarction (AMI) were studied. We investigated the reproducibility of this reciprocal ST depression induced by stress testing and correlated the ECG changes with coronary angiographic evaluation of arteries supplying the remote area. We tried to derive criteria for detection of simple mirror image. 3 different groups were defined according to ECG evolution: Group 1 consisted of 7 anterior and 3 inferior AMI where reciprocal ECG changes disappeared appeared within 24 to 48 hours independently of the ECG changes in the infarcted area. These ST depressions were reproduced by stress testing one to two months later, and correlated angiographically with an anatomic lesion. 7 out of 10 patients later had bypass graft surgery. Group 2 consisted of 7 patients in whom posterior wall extension of an inferior AMI made the diagnosis of anterior ischemia impossible. In another two patients (one anterior and one inferior AMI) reciprocal ST depression and infarcted area ECG changes showed a simultaneous evolution. The reciprocal ST depression could not be reproduced during stress testing and did not correlate with any angiographic lesion. It is concluded that reciprocal ST depression during the acute phase of transmural anterior or purely inferior myocardial infarction is correlated with multivessel coronary disease if their regression is not strictly simultaneous to the infarction-related ECG changes. Further investigations are indicated in these patients. PMID- 3823818 TI - [Resistance patterns in Shigella]. AB - Diarrhea is the most common health problem in travelers to tropical countries. Shigellae are not the primary cause but often provoke clinically relevant diseases that call for treatment. Therefore, we have analyzed resistance patterns in all Shigella strains isolated at this department over 1 1/2 years. Of 107 isolates 77% were resistant to tetracycline, 33% to trimethoprim sulfamethoxazole, 31% to ampicillin, and only 2% to nalidixic acid. Differences in resistance patterns for isolates of different geographical origins were marginal. The small number of strains resistant to nalidixic acid (2/107) suggests that agents inhibiting DNA gyrase may be useful for self-administered treatment during travel as well as upon return. Controlled clinical trials, however, are still lacking. PMID- 3823819 TI - [Pleuropulmonary infection caused by Mycobacterium smegmatis. Case description and literature review]. AB - The case is described of a patient with a tracheostomy subsequent to laryngectomy for carcinoma, who developed a pleuro-pulmonary infection due to Mycobacterium smegmatis complicating lipoid pneumonia after prolonged instillation of gomenol oil into the tracheostoma. The adjuvant property of lipids for the development of respiratory infections due to M. smegmatis and other rapid-growing mycobacteria is discussed in the light of the cases described in the literature. PMID- 3823820 TI - [Psychosocial events at risk]. AB - The purpose of this workshop was to draw attention to one sector of research in modern psychosomatic medicine, "life events research". Nowadays it is relatively well documented that significant life events may increase an individual's susceptibility to the development of physical or psychic illness. "Life events research" is grounded on the stress concept, and in our practice is integrated into the bio-psycho-social approach. Bereavement, problems at work, disruption of deep rooted life habits, social isolation, family problems and poor socio economic conditions are the most important of these events. Their impact depends on the real or symbolic meaning given to them, on the available coping mechanism, on the presence or absence of social support, and also on the stage in the life cycle at which the events occur. Some practical implications for the physician are discussed. PMID- 3823821 TI - [Therapeutic choices in osteoporosis]. AB - Precise methods of evaluating bone density or bone quality (SPA, DPA, QCT, histomorphometry) have shown that various treatments for osteoporosis are efficient. Some drugs stimulate bone formation (NaF), others inhibit bone resorption (estrogens, calcitonin), while calcium and vitamin D act as additives. The drug is chosen which corrects the prevailing defect, which in turn can be suspected on the basis of a precise diagnosis. The latter is established by classification of the different forms of osteoporosis, based upon pathophysiological mechanisms. Apart from post-menopausal osteoporosis, which responds to estrogens, the other forms of high turnover osteoporosis may respond to calcitonin. Osteoporosis with low turnover, or age-related osteoporosis usually respond to NaF. Cyclic treatments set out to stimulate the maximum number of multicellular units of the bone. In this period of investigation and fruitful development, empiric treatment should give way to controlled cooperative studies. PMID- 3823822 TI - [Indications for passive immunotherapy in infectious diseases]. AB - The most important indications for passive immunotherapy in the field of infectious diseases are reviewed. Intramuscular immunoglobulins are useful in prophylaxis and treatment of diseases due to bacterial exotoxins and in prophylaxis of some viral infections. However, their efficacy against bacterial infections has not been demonstrated. Intravenous immunoglobulins have theoretical advantages in these infections. The few clinical studies performed in neonates and in patients of surgical intensive care units have suggested modest benefits. However, these studies did not allow to decide whether intravenous immunoglobulins have a role in these situations. Another approach still under investigation is to administer polyclonal antibodies directed against the central part of the endotoxin, the structure of which is well preserved among gram negative bacteria. These antibodies have improved the survival of patients with gram-negative bacteremia or septic shock. When given prophylactically, they have reduced the incidence of gram-negative shock and related mortality in patients from surgical intensive care units. Further studies are in progress to determine the class and the precise specificity of these protective antibodies. PMID- 3823823 TI - [Intermittent venous claudication: a rarely diagnosed walking disability]. AB - Intermittent venous claudication occurs mostly in young, physically active people after iliac vein thrombosis. In 20 healthy volunteers and 4 patients with venous claudication, plethysmographic volume measurements of the thigh and calf were made during treadmill work (10 degrees gradient, 7 km/h). The mean volume of the calf in the 20 healthy controls decreased at the beginning of exercise, climbed again later and reached a plateau after 100 sec, indicating a balance between arterial inflow and venous drainage. In the 4 patients with status after iliac vein thrombosis the volume of the affected leg rose continuously during exercise without reaching a plateau, until leg pain forced the patient to stop. The measured volume of the affected leg at the point of pain was higher than that of the patients' contralateral leg and higher than that of the controls (p less than 0.01). Strain-gauge plethysmography during treadmill work permits non-invasive, objective diagnosis of the venous drainage abnormality that leads to intermittent venous claudication. PMID- 3823824 TI - [Dominantly inherited lower lip fistulas and facial clefts (Van der Woude syndrome). A study of 52 cases]. AB - Congenital lip pits may occur alone or in combination with oral clefts. They characteristically present as symmetric pits close to the vermilion border of the lower lip, about 0.5 cm off the midline, and are usually connected with heterotopic salivary glands; occasionally, salivation may occur. Congenital lip pits are associated with clefts of the upper lip and/or the palate in about half of the cases. Hypodontia may also be observed. Lip pits with or without clefts are found in a few dominantly inherited syndromes, in most cases involving the autosomal dominant Van der Woude syndrome. 52 carriers of the Van der Woude gene are described. In 8 cases the syndrome occurred as a fresh mutation and the other 44 cases occurred in 5 families. Penetrance was complete and expression very variable. Sex distribution was 1:1. For genetic counselling purposes it can be concluded that all carriers of the Van der Woude gene can be identified. Every symptom (pits, micro-pits, cleft, submucous clefts, uvula bifida) may represent the only manifestation of the gene. The recurrence risks for offspring of gene carriers is 50%, but the risk of severe forms of cleft is much lower. PMID- 3823825 TI - [Pseudomembranous colitis caused by the ingestion of colocynth]. AB - A 61-year-old woman presented with an acute condition involving confusion, abdominal cramps and bloody diarrhea six hours after accidental ingestion of colocynth mistaken for zucchini. Colonoscopic examination revealed pseudomembranous colitis though the patient had no condition known to be associated with pseudomembranous colitis. Within ten days the mental state returned to normal and the colitis resolved completely. It is suggested that the colitis was caused by the ingestion of colocynth. PMID- 3823826 TI - [On G. Poretti's paper "Units and dosimetry of radioactive elements"]. PMID- 3823827 TI - [Chlamydia infections in Switzerland. Comparative study of diagnostic technics]. PMID- 3823828 TI - [Blood gas and coefficient of extraction of oxygen at the level of the limbs in the horse anesthetized by halothane]. PMID- 3823829 TI - [Equine postanesthetic myopathy: production of lactates by the compressed muscles in the horse anesthetized by halothane]. PMID- 3823830 TI - [Effect of the cow trainer on the behavior of dairy cattle]. PMID- 3823831 TI - [Abstracts of dissertations of the veterinary medicine schools in Bern and Zurich 1986]. PMID- 3823832 TI - [Sports and organ function]. PMID- 3823833 TI - [Sports and the locomotor apparatus]. PMID- 3823834 TI - [Sports and prevention]. PMID- 3823835 TI - [Sports and society]. PMID- 3823836 TI - [Sports and the media]. PMID- 3823837 TI - [Sports in the family and school]. PMID- 3823838 TI - [Sports in clubs, associations and firms]. PMID- 3823839 TI - [Sports and economics]. PMID- 3823840 TI - [Sports today]. PMID- 3823841 TI - [Telemetric heart rate measurements in rhythmic sports gymnastics. A small training study]. PMID- 3823842 TI - [3 hobby athletes on Mont Blanc. A physiological performance protocol]. PMID- 3823843 TI - [Tick-borne meningoencephalitis and Lyme arthritis in the orientation run. Can ticks become a problem in sports medicine?]. PMID- 3823844 TI - [Special injuries of the semimembranous zone]. PMID- 3823845 TI - [Performance factors in the 400 m run]. PMID- 3823846 TI - [Performance control by athletes]. PMID- 3823847 TI - Dyslexia. PMID- 3823848 TI - Man's role in changing the global environment. Papers presented at an international conference. Venice, Italy, 21-26 October 1985. Part B. PMID- 3823849 TI - Efficient regulation of environmental health risks: the case of groundwater contamination in California. AB - This paper presents a method for incorporating uncertainty explicitly into risk assessment and risk management procedures and illustrates its use with an application to the case of pesticide contamination of groundwater. The analysis demonstrates the importance of incorporating uncertainty explicitly, of using consistent significance levels of risk to estimate the value of life and explore cost/risk trade-off, and illustrates the role of economic theory in coordinating interdisciplinary work in this area. PMID- 3823850 TI - Bioassay and biomonitoring assessments of contaminant mobility from dredged material. AB - The Clean Water Act in the United States requires that the environmental evaluation of dredged material prior to its discharge must include the effects of the proposed disposal environment on the bioaccumulation of contaminants in the food chain. Although the total amount of contaminated material is relatively small when the national dredging program is considered, a significant effort is expended to ensure that, through the application of predictive tests prior to dredging, the contaminated material is deposited in a manner that will result in minimum contaminant mobility. There also has been a necessity to conduct studies and develop management plans in relation to the potential movement of contaminants at disposal sites constructed before the hazardous nature of many contaminants were known. Three case studies illustrate some of the bioassay and biomonitoring procedures currently being applied by the Corps of Engineers. PMID- 3823851 TI - Anaerobic digestion of organic fraction of municipal solid wastes--digester performance. AB - The anaerobic digestion of source separated organic fraction of municipal solid wastes was studied by using a stirred 3 cubic meter working volume reactor fed on a semicontinuous basis. The behaviour and performance of the digester at various organic loading rates was illustrated with particular regard to turnover of the gas production rate during a cycle in the digester feed. PMID- 3823852 TI - International environmental problems and international organisations. AB - A cross comparison of environmental programmes of major International Organisations reveals a convergent tendency. A relatively small number of priority areas for action have been identified, in the domain of pollution prevention and control, natural resource management, and quality of life in human settlements. Policy development in each of the priority areas requires specific scientific research efforts. The dialogue between policy-makers and scientists raises some problem, relative, inter alia, to the independence of science and to the practical need to act before various environmental threats become irretrievable. A rational sharing of tasks between International Organisations could work towards greater effectiveness. PMID- 3823853 TI - Towards a scientific basis for regulating lead contamination. AB - Dangers from exposure to substances released to the environment, subsequently discovered to be hazardous, have been limited as a rule by actions taken piecemeal. Recently, more analytical techniques have been devised under the title 'Risk Analysis' or some similar name in order to produce a more scientific basis for establishing environmental regulations, but the results are often too complex to use. Their application to one substance, lead, is made practicable, although still leaving a difficult task, by making two assumptions: first, that blood lead concentration in humans may be taken to be an indicator both of total exposure and of its hazards to human health, and second, that 'threshold' values of blood lead concentration above which some action is necessary can be set and adopted. Programmes to control lead usages and pathways in order to reduce exposure in value-effective, acceptable and enforceable ways can then be devised and implemented, together with monitoring programmes to check the results and effectiveness of controls. Adopting these two assumptions offers the advantage that should later research show that threshold values have been set too low or too high, the rate of applications of all or any of the individual control programmes can be modified accordingly. The method is illustrated by using the distribution curve of blood lead concentrations now available for the general population of Great Britain. This is first used to estimate the numbers above each of the agreed threshold values: this procedure establishes the size or the importance of the problem. The effects on numbers and the sizes and speeds of the responses, of each of the different ways of controlling the different sources and pathways, are then assessed qualitatively, and their feasibility, enforceability and costs reviewed. The monitoring programme to check the effectiveness of the controls so far imposed is described. By using this procedure, lead contamination can be regulated to protect the health of the general population and the results of any or all of the regulations reviewed. One immediate consequence from its general application is to demonstrate that separate and specific measures are necessary to protect those at highest risk. One immediate advantage is that the procedure identifies those decisions that require value judgements. PMID- 3823854 TI - Decreasing lead exposure in Swedish children, 1978-84. AB - Blood-lead levels were determined, each summer during the period 1978-1984, in children from Scania in Southern Sweden. A total of 1395 determinations were made. The average blood-lead concentration was 55 (range 14-250) micrograms 1( 1). There was a statistically significant decrease over time, both in rural and urban areas, averaging about 4 micrograms 1(-1) per year. Lead exposure has thus decreased remarkably. One possible explanation is the contemporary, considerable reduction of the alkyl lead content of petrol. PMID- 3823855 TI - Lead levels in teeth of an urban Indian population. AB - The lead content of teeth of Bombay residents has been determined using differential pulse anodic stripping voltammetry. The median tooth lead concentrations for adults and children in Bombay are estimated to be 8.31 and 3.01 micrograms/g of tooth, respectively. The data indicate that the lead concentration of a tooth increases with the age of the donor. For children the tooth lead content varies with the type of tooth. Further, children living in industrial areas have a higher tooth lead content than children living in the cleaner suburbs of Greater Bombay. PMID- 3823856 TI - Determination of germanium and some other elements in hair, nail, and toenail from persons exposed and unexposed to germanium. AB - Inductively coupled atomic emission spectrometry was used for the determination of germanium in hair, nail, and toenail. The levels of germanium in three individuals administered a high concentration of a germanium preparation daily for about 12-16 months were very high: 56.4-173.7; 5.4-35.0; and 14.0-15.8 micrograms g-1 in hair, nail, and toenail, respectively. The levels for normal or unexposed persons are very low and were not detected by the method. PMID- 3823857 TI - Relationships between the prevalence of multiple sclerosis and some physical and chemical properties of soil. AB - The prevalence of multiple sclerosis (MS) and some physical and chemical properties of soil in two counties of Finland have been compared. In the county where the MS prevalence rate was significantly higher, the pH of the soil was lower, the organic carbon content higher, the concentration of soluble iron, zinc, chromium and aluminium higher and those of soluble potassium, calcium, magnesium, strontium and total selenium lower than in the county with the lower MS-prevalence rate. According to the literature, areas of a high MS prevalence correspond rather closely to the global distribution of mires, particularly to raised bogs in the northern hemisphere. PMID- 3823858 TI - The radiation exposure of black-headed gulls (Larus ridibundus) in the Ravenglass Estuary, Cumbria, U.K.: a preliminary assessment. AB - A variety of fission-product and transuranic radionuclides originating from the marine discharges from the fuel reprocessing plant at Sellafield, Cumbria are detectable in the bodies of black-headed gulls and their environment in the Ravenglass Estuary approximately 10 km to the south-west of the plant. The maximum concentrations of 95Nb, 137Cs and 239/240Pu detected in body tissues lie in the range 2 X 10(-3) to 1.5 X 10(-2) Bqg-1 wet weight. Many more radionuclides are detected in the regurgitated pellets and faeces produced by the gulls and have higher concentrations in the range 7 X 10(-3) to 1.7 Bqg-1 wet weight. The radionuclide contamination of the sediment produces a source of enhanced external gamma-ray exposure which can be measured directly. The available data on distributions and concentrations of radionuclides have been combined with simple dosimetry models to provide estimates of the radiation exposure of the birds. The total whole body dose rate to the adult birds from the contaminant radionuclides is approximately ten times that from the natural radiation background, while that to the developing eggs is approximately four times the natural background. The potential radiation exposure of the cells lining the alimentary tract could be much higher when contaminated food is in transit, but the long-term average exposure in this case is subject to uncertainty. The limited data on the effects of radiation exposure on birds do not indicate any response at dose rates below one hundred times that from the natural radiation background.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823859 TI - Highway pollution. Proceedings of the Second International Symposium. London, United Kingdom, 7-11 July 1986. PMID- 3823860 TI - Cytotoxicity of airborne particles from roadside urban gardens. AB - Airborne particles were collected in two small urban gardens along the roads with heavy traffic in Hong Kong. The chemical and physical properties of the particles of a diameter about 1 micron were analysed by a scanning electron microscope incorporated with a x-ray energy dispersive microanalyzer and an atomic absorption spectrophotometer. The cytotoxicities of particles were compared using an in vitro alveolar macrophage culture assay. It was found that both particles significantly increase (p less than 0.05) the release of lactate dehydrogenase and acid phosphatase into the medium in addition to damage the surface morphology and intracellular structures of the macrophages to a variable extent after exposure to the particles. PMID- 3823861 TI - Benthic invertebrates as indicators of urban and motorway discharges. AB - Spatial differences in the structure and composition of the invertebrate community of a suburban river (demonstrated by the use of indices) could be explained largely in terms of organic inputs but such indices were not suitable for the detection of the low level metal contamination associated with road runoff. Analysis of plant and animal tissue proved to be a more useful strategy and significant variation in metal concentrations in several organisms could be related to the chemistry of the river water and to road and urban discharges. PMID- 3823862 TI - Traffic lead pollution of some edible crops in Israel. AB - Fruit, vegetables and other crops grown in areas of heavy traffic were sampled and analysed for lead. The maximum lead content in washed vegetables was found in lettuce which contained about 0.5 mg/Kg (fresh weight). The low lead contents of the crops are partially due to the low lead contents of the soils on which they are grown. These in turn are a reflection of the lack of organic matter and clays in the soils. There appears to be no undue danger to health from eating crops tested. PMID- 3823863 TI - EEC directives on noise from motor vehicles. AB - The strategy of the EEC is to focus on two aspects of the EEC type approval procedure for motor vehicles. This is firstly to lay down limits for the permissible sound level of motor vehicles. Secondly, to set out the method of measuring the noise emitted during type-approval tests. PMID- 3823864 TI - Heavy metals in small mammals in roadside environments: implications for food chains. AB - Lead, cadmium, nickel, and zinc were measured in soil, vegetation, earthworms, small rodents, and shrews from the immediate environs of 4 highways of various traffic densities (range less than 1,000 to c.100,000 vehicles per day) and from 2 control areas. Concentrations of all elements in soil, vegetation, and earthworms varied with volume of traffic and with distance from highways. Concentrations in earthworms of all elements were especially high. Shrews had higher concentrations of lead and cadmium than other small rodents from similar areas. PMID- 3823865 TI - Heavy metal pollution in roadside urban parks and gardens in Hong Kong. AB - An ecological survey was conducted on metal contamination (including Cd, Pb, Ni, Zn, Cu, Mn and Fe) of vegetation (leaf of Bauhina variegata), surface soil (0-1 cm) and dust (from road curbs) collected at 13 urban parks near busy roads (with heavy traffic volume) in Hong Kong. Samples from roadside parks had significantly higher metal contents than the control site (away from automobile traffic). A close correlation was found between traffic volume and metal contents of leaf, soil and dust. Washing of leaf samples reduced the levels of Cu, Mn, Zn and Fe contamination and suggested that the source of heavy metal pollution was mainly due to aerial deposition from motor vehicles. PMID- 3823866 TI - Hierarchical structure in polymeric materials. AB - The diversity of monomers available for synthesis of high polymers makes it possible to prepare a wide variety of long-chain macromolecular compounds. It is instructive to consider a hierarchical organization of structure in polymers at four successive levels--the molecular, nano-, micro-, and macrolevels--and to examine how interactions at and between these various levels of structure have important and often quite specific influences. Examples are drawn from semicrystalline polymers with flexible chains, liquid-crystalline polymers composed of rigid macromolecules, and amorphous polymers. Structural hierarchies in biocomposite systems are also discussed, particularly in soft connective tissues such as tendon and intervertebral disk. PMID- 3823867 TI - Absence of significant cellular dilution during ADH-stimulated water reabsorption. AB - Water reabsorption across many "tight" urinary epithelia is driven by large transepithelial osmotic gradients and is controlled by antidiuretic hormone (ADH). Numerous investigators have concluded that ADH-induced water reabsorption causes large apparent increases in cell volume with concomitant cytoplasmic dilution. A central question in renal physiology has been how cellular homeostasis is maintained in tight urinary epithelia during antidiuresis. Previous direct measurements of cell membrane permeability to water and the present direct measurements of cell volume in collecting tubules of rabbit kidney cortex by quantitative light microscopy show that cell volume does not change significantly during transcellular water flow. Fluid transported across the epithelium accumulated in lateral and basal intercellular spaces; the effect was an increase in cell height and tubule wall thickness accompanied by maintenance of nearly constant cell volume. The stability of cell volume is a consequence of the relatively high water permeability of the blood-facing cell membrane. PMID- 3823868 TI - AIDS stresses health care in San Francisco. PMID- 3823869 TI - Four legs bad, two legs good. PMID- 3823870 TI - Seizures in drug-treated animals. PMID- 3823871 TI - A battle over NIH funds. PMID- 3823872 TI - Alcoholism and the medical cost crunch. PMID- 3823873 TI - Crises and nuclear control. PMID- 3823875 TI - France, Britain boost AIDS funds. PMID- 3823874 TI - AIDS commission bills proliferate. PMID- 3823876 TI - Manic-depression gene tied to chromosome 11. PMID- 3823877 TI - Fertility policy in China: future options. AB - A wide range of social, economic, and demographic criteria are used to evaluate China's present one-child policy and five alternative fertility policies that might guide China's population control efforts until the end of the century when the one-child policy is scheduled to be abandoned. These criteria include the policies' macrodemographic impact on total population size and population aging; their microdemographic effects on the family's ability to support the elderly, its economic capabilities, and the position of women; and their cultural acceptability to the majority Han Chinese population. The results suggest that the least desirable strategy is to retain the present policy; all the two-child alternatives perform better than the current one-child policy in achieving the policy goals considered. PMID- 3823878 TI - Chemistry of antibody binding to a protein. AB - The chemistry of antibody recognition was studied by mapping the antigenicity of the protein myohemerythrin with peptide homologs of the protein sequence. The results suggest that the entire protein surface is antigenic, but the probability of there being antibodies to a given site is influenced by local stereochemistry. Although accessible to an antibody binding domain, the least reactive positions cluster in the most tightly packed and least mobile regions and are closely associated with narrow, concave grooves in the molecular surface containing bound water molecules. The most frequently recognized sites form three-dimensional superassemblies characterized by high local mobility, convex surface shape, and often by negative electrostatic potential. PMID- 3823879 TI - Mechanisms of antibody binding to a protein. AB - The mechanisms of antibody binding to a protein were studied by an analysis of specific amino acid residues critical to nine antigenic sites on myohemerythrin. Rabbit antisera to the whole protein were assayed for binding to more than 1500 distinct peptide analogs differing from the protein sequence by single amino acid replacements. The results, combined with information from the three-dimensional crystallographic structure, were used to evaluate probable mechanisms of antibody binding at individual sites. The data from all sites examined indicate that initial binding to solvent-exposed amino acid residues may promote local side chain displacements and thereby allow the participation of other, previously buried, residues. PMID- 3823881 TI - Computing with neural networks. PMID- 3823880 TI - Aromatic cross-links in insect cuticle: detection by solid-state 13C and 15N NMR. AB - Cross-polarization magic-angle-spinning nuclear magnetic resonance spectroscopy has been used to determine insect cuticle composition and cross-link structure during sclerotization or tanning. Unsclerotized cuticle from newly ecdysed pupae of the tobacco hornworm, Manduca sexta L., had a high protein content with lesser amounts of lipid and chitin. Concentrations of chitin, protein, and catechol increased substantially as dehydration and sclerotization progressed. Analysis of intact cuticle specifically labeled with carbon-13 and nitrogen-15 revealed direct covalent linkages between ring nitrogens of protein histidyl residues and ring carbons derived from the catecholamine dopamine. This carbon-nitrogen adduct was present in chitin isolated from cuticle by alkaline extraction and is probably bound covalently to chitin. These data support the hypothesis that the stiffening of insect cuticle during sclerotization results primarily from the deposition of protein and chitin polymers and their crosslinking by quinonoid derivatives of catecholamines. PMID- 3823883 TI - NIH to restore slashed grants. PMID- 3823882 TI - Transplantation of neural tissue from fetuses. PMID- 3823884 TI - Human cancer gene sequenced. PMID- 3823885 TI - The surprising genetics of bottlenecked flies. PMID- 3823886 TI - Bottlenecked cheetahs. PMID- 3823887 TI - New understanding of Gaucher's disease. PMID- 3823888 TI - Regulation of products from biotechnology. PMID- 3823889 TI - Human retinoblastoma susceptibility gene: cloning, identification, and sequence. AB - Recent evidence indicates the existence of a genetic locus in chromosome region 13q14 that confers susceptibility to retinoblastoma, a cancer of the eye in children. A gene encoding a messenger RNA (mRNA) of 4.6 kilobases (kb), located in the proximity of esterase D, was identified as the retinoblastoma susceptibility (RB) gene on the basis of chromosomal location, homozygous deletion, and tumor-specific alterations in expression. Transcription of this gene was abnormal in six of six retinoblastomas examined: in two tumors, RB mRNA was not detectable, while four others expressed variable quantities of RB mRNA with decreased molecular size of about 4.0 kb. In contrast, full-length RB mRNA was present in human fetal retina and placenta, and in other tumors such as neuroblastoma and medulloblastoma. DNA from retinoblastoma cells had a homozygous gene deletion in one case and hemizygous deletion in another case, while the remainder were not grossly different from normal human control DNA. The gene contains at least 12 exons distributed in a region of over 100 kb. Sequence analysis of complementary DNA clones yielded a single long open reading frame that could encode a hypothetical protein of 816 amino acids. A computer-assisted search of a protein sequence database revealed no closely related proteins. Features of the predicted amino acid sequence include potential metal-binding domains similar to those found in nucleic acid-binding proteins. These results provide a framework for further study of recessive genetic mechanisms in human cancers. PMID- 3823890 TI - Nature, nurture, and behavior. PMID- 3823891 TI - Accuracy and truth. PMID- 3823892 TI - Basic research funding. PMID- 3823893 TI - Politics of the genome. PMID- 3823894 TI - Genentech sues FDA on growth hormone. PMID- 3823895 TI - The Vatican weighs in. PMID- 3823896 TI - California's debate on carcinogens. PMID- 3823897 TI - Marrow suppression hampers AZT use in AIDS victims. PMID- 3823898 TI - Mathematical model predicts AIDS spread. PMID- 3823899 TI - Model studies in molecular recognition. AB - Recognition at the molecular level is a fundamental characteristic of biochemical systems. Recent models developed in bioorganic chemistry have revealed the importance of complementarity in size, shape, and functional groups in molecular recognition. Structures that feature a cleft are particularly effective in regard to complementarity since functional groups attached to the interior of the cleft converge on substrates held inside. The molecular clefts offer the advantage of efficient construction; their surfaces can be tailored for specific applications. This article describes their use for recognition of acids, bases, amino acids, metal ions, and neutral substrates. Their ability to provide microenvironments complementary to asymmetric molecules and their future promise are discussed. PMID- 3823900 TI - Post-transcriptional control of class I MHC mRNA expression in adenovirus 12 transformed cells. AB - Expression of the class I transplantation antigens of the major histocompatibility complex (MHC) is suppressed in cells transformed by the oncogenic human adenovirus 12 (Ad12). This suppression of class I antigen expression, which contributes to the tumorigenic phenotype of the transformed cells, has also been observed in some naturally occurring cancers. In the present study, the rate of transcription initiation of class I genes was measured by a nuclear run-on assay in Ad5- and Ad12-transformed cells of three different types. The rate of transcription was the same in all three. The stability of the class I messenger RNA was also examined and found to be the same in all three cell types. The results indicate that in Ad12-transformed cells the suppression is caused by an inhibition of the post-transcriptional processing of class I MHC messenger RNA in the nucleus. PMID- 3823901 TI - Vertical distribution of an estuarine snail altered by a parasite. AB - Estuarine snails Ilyanassa obsoleta bearing larvae of the trematode Gynaecotyla adunca behave singularly in comparison with conspecifics lacking this parasite. Following high tides, and especially at night, infected snails were found stranded high on beaches and sandbars. Semiterrestrial crustaceans living well up on the shore serve as the next host, and the modified (induced) snail behavior is apparently a parasite adaptation facilitating cercarial transmission to these crustaceans. The altered behavior is unusual because of its apparent enhancement of host-to-host transmission by cercariae rather than predation, the process commonly recognized as being enhanced by parasitic modification of host behavior. PMID- 3823902 TI - NIH fraud guidelines. PMID- 3823903 TI - Nucleic acid database management. PMID- 3823904 TI - Saturated fat avoidance. PMID- 3823905 TI - OTA: property right, donor consent factors cloud "gifts" of human tissue. PMID- 3823906 TI - Chapter 11 for USA, Inc. PMID- 3823908 TI - Electrical responses of eggs to acrosomal protein similar to those induced by sperm. AB - The earliest known response of eggs to sperm in many species is a change in egg membrane potential. However, for no species is it known what components of the sperm cause the opening of the egg plasma membrane channels. Protein isolated from sperm acrosomal granules of the marine worm Urechis caused electrical responses in oocytes with the same form, amplitude, and ion dependence as the fertilization potentials induced by living sperm. Sperm initiated fertilization potentials in oocytes when sperm-oocyte fusion, but not binding, was inhibited by clamping oocyte membrane potentials to positive values. Acrosomal protein also initiated electrical responses in clamped oocytes. These results support the hypothesis that it is the sperm acrosomal protein that opens ion channels in the oocyte membrane. PMID- 3823907 TI - Human lipoprotein lipase complementary DNA sequence. AB - Lipoprotein lipase is a key enzyme of lipid metabolism that acts to hydrolyze triglycerides, providing free fatty acids for cells and affecting the maturation of circulating lipoproteins. It has been proposed that the enzyme plays a role in the development of obesity and atherosclerosis. The human enzyme has been difficult to purify and its protein sequence was heretofore undetermined. A complementary DNA for human lipoprotein lipase that codes for a mature protein of 448 amino acids has now been cloned and sequenced. Analysis of the sequence indicates that human lipoprotein lipase, hepatic lipase, and pancreatic lipase are members of a gene family. Two distinct species of lipoprotein lipase messenger RNA that arise from alternative sites of 3'-terminal polyadenylation were detected in several different tissues. PMID- 3823909 TI - Detection of Rift Valley fever viral activity in Kenya by satellite remote sensing imagery. AB - Data from the advanced very high resolution radiometer on board the National Oceanic and Atmospheric Administration's polar-orbiting meteorological satellites have been used to infer ecological parameters associated with Rift Valley fever (RVF) viral activity in Kenya. An indicator of potential viral activity was produced from satellite data for two different ecological regions in Kenya, where RVF is enzootic. The correlation between the satellite-derived green vegetation index and the ecological parameters associated with RVF virus suggested that satellite data may become a forecasting tool for RVF in Kenya and, perhaps, in other areas of sub-Saharan Africa. PMID- 3823910 TI - Pulmonary disease during the treatment of rheumatoid arthritis with low dose pulse methotrexate. AB - Methotrexate therapy has been effective in the treatment of RA with short term experience suggesting little serious adverse reactions. Our review of 168 patients receiving methotrexate has identified nine patients with probable or possible methotrexate-induced pulmonary toxicity, giving a prevalence of 5% and an incidence of 3.9 per 100 patients per year. No clinical or laboratory features showed an association that could potentially predict the development of pulmonary disease. All patients experienced complete recovery with supportive care and/or corticosteroid therapy. Clinical monitoring for this complication is warranted in all patients receiving long term methotrexate therapy for RA. PMID- 3823911 TI - Parametric images as a tool for quantitative normative evaluation. AB - Features extracted from static or dynamic scintigraphic images can be used to produce parametric or functional images. Those images typically map a dynamic parameter (temporal encoding) or a quantitative measure of the tracer distribution. In this report, we consider the cases in which the nature of the extracted feature is well suited for a quantitative normative evaluation, ie, where the values obtained can be directly or indirectly compared with expected normal values. The major difference between this approach and the more common heuristic or synoptic interpretation of "images" lies in the underlying modeling: the model "predicts" a minimal washout rate, a match between ventilation and perfusion rates in the lungs, homogeneous contraction in the left ventricle, an expected angular distribution of thallium in the myocardium, or the absence of an additional kinetic feature. The quantitative aspect of the analysis is based in all cases on an approach that overcomes or is less sensitive to morphological or structural biological variability: in some cases the patient provides the normalizing data, as in ventilation-perfusion ratios. In other cases, the model predicts homogeneous results (as in phase analysis) or a range of normal physiological values (for xenon washout). Less commonly, the analysis requires a transformation of the data, as is the case in the analysis of myocardial perfusion, which follows a polar transformation of the image, and an analysis based on angular coordinates. In a normative approach, pathology is defined as a deviation (in this case a quantitative deviation) from the norm. The next step is to model specific abnormalities: early right-sided reappearance of the bolus in a right-to-left shunt, the appearance of "abnormal" kinetic factors, or a comparison with the expected distribution of bloodflow (or location of defects) in certain coronary lesions. However, in all cases, one should note that the analysis does not compromise the major feature of "imaging," that is to recognize regional, rather than exclusively global malfunction. PMID- 3823912 TI - Bowel visualization in bone scintigraphy. PMID- 3823913 TI - Congestive heart failure with normal ejection fraction. PMID- 3823914 TI - Hepatic activity on perfusion lung images. PMID- 3823916 TI - Breast cancer. Part II. PMID- 3823915 TI - Scientific basis for adjuvant and primary (neoadjuvant) chemotherapy. AB - It can be stated as a general biological principle that there are many compelling reasons why chemotherapy should be directed at minimal tumor burdens. This is true whatever the nature of the tumor and becomes especially valid when one is dealing with tumors that are not curable when treated at the advanced stage. The patients who are likely to have the greatest benefit from adjuvant chemotherapy are, somewhat paradoxically, those who are at the least risk for recurrence following primary treatment. This is because, on the average, these patients will have the least tumor burdens. Patients who are at very high risk for relapse in breast cancer, (stage II patients with four plus positive nodes) will be the ones with the greatest subclinical burdens and may well have already crossed the threshold of curability to incurability. Directing effective chemotherapy programs at patients with lesser risk of recurrence complicates the ethical problems associated with adjuvant chemotherapy. To some degree, these ethical concerns can be assuaged by the appreciation that it is likely that protracted programs of chemotherapy (1 to 2 years) may well not be necessary. In general, curative drug programs can generally accomplish objectives with 3 to 6 months of fairly intensive treatment. Reducing the duration of adjuvant cyclophosphamide, methotrexate, fluorouracil (CMF) from 12 months to 6 months did not appear to have an adverse effect on long-term results. Factors such as dose intensity and early use of effective noncross-resistant agents may be much more important than the chronic administration of agents in suboptimal dosage. The narrower question as to whether advancing the time forward of adjuvant chemotherapy will make additional significant impact on survival cannot be answered yet but clearly is an important issue. There are several theoretical reasons why neoadjuvant treatment might be of particular benefit, and even if it ultimately transpires that breast cancer is not an ideal model disease for this approach, it does not preclude this particular technique for being effective in other types of malignancy. PMID- 3823917 TI - Average relative dose intensity and the impact on design of clinical trials. PMID- 3823918 TI - Psychological issues in breast cancer. PMID- 3823919 TI - Reducing complications of perinatal care. AB - There can be no easy formula for preventing complications in neonatal care. Everyone involved either directly or indirectly in the care of neonates has to be aware and concerned about known or potential complications. Likewise, we each need to commit to accumulating experience and disseminating information through supervision and communication, while assuming our share of responsibility in following our patients. Effort needs to be individual and collaborative with a primary goal such as that of the SGCPC: the prevention of complications of perinatal care. Recognition, communication, supervision, documentation, follow up, and research are suggested areas for attention where we all can impact on the outcome of our patients. PMID- 3823920 TI - Perinatal mortality and morbidity: the role of the anatomical pathologist. PMID- 3823921 TI - After discharge from the intensive care nursery: what then for the neonatologist? AB - The field of neonatology is expanding in many aspects. Not only is care of the neonatal patient evolving, but there now is also the need for follow-up long after the neonatal period. The neonatologist has ever increasing roles in preparing patients for discharge, communicating with all relevant follow-up care givers, updating them with advances in the field of neonatology as it relates to follow-up care, and coordinating whatever medical and developmental follow-up is necessary to guarantee that all the effort spent during an ICN stay will not be wasted by unaddressed, potentially preventable problems arising after discharge. PMID- 3823922 TI - How to treat a visiting radiology professor. PMID- 3823923 TI - Radiographic manifestations of pulmonary disease in the acquired immunodeficiency syndrome (AIDS). PMID- 3823925 TI - Central nervous system (CNS) manifestations of AIDS. PMID- 3823924 TI - Radiology of nonneoplastic gastrointestinal disorders in acquired immune deficiency syndrome. PMID- 3823926 TI - Meningeal tuberculoma. PMID- 3823927 TI - AIDS. PMID- 3823928 TI - [Effects of stimulation of the locus coeruleus on the electrical and mechanical activities of the stomach of rats]. PMID- 3823929 TI - [Periaqueductal gray matter participates in the inhibitory effect of electrical needling on the defense reaction]. PMID- 3823930 TI - [Perception threshold of sound amplitude modulation]. PMID- 3823931 TI - [Studies on the heterogeneity of spleen colony-forming cells]. PMID- 3823932 TI - [Mechanism of respiratory inhibition induced by Na-citrate injection into the carotid sinus area in rabbits]. PMID- 3823933 TI - [Origin of N2 in the cat electrocochleogram]. PMID- 3823934 TI - [Effects of 15-methyl-prostaglandin F2 alpha on uterine contraction and plasma progesterone]. PMID- 3823935 TI - [Studies on the effect of anordrin on blastocyst transfer implantation in rabbits]. PMID- 3823936 TI - [A simple method of making multibarrel microelectrodes]. PMID- 3823937 TI - 19th SMA lecture. Towards excellence in medicine. PMID- 3823938 TI - Significant lone daughters and mutations in sex linkage risk estimations--a comprehensive computer programme. PMID- 3823939 TI - Patterns of infection in oncology patients in Singapore. PMID- 3823940 TI - Alcohol-related hospitalisation in Singapore. PMID- 3823941 TI - Vaginal delivery following caesarean section. PMID- 3823942 TI - Treatment of pharyngeal gonorrhoea with extended oral ampicillin. PMID- 3823944 TI - Some aspects of sexual knowledge and sexual behaviour of local women. Results of a survey. VIII. Anal intercourse. PMID- 3823943 TI - Treatment of anorectal gonorrhoea infection in males and females with oral ampicillin. PMID- 3823945 TI - Evaluation of a low cost, macroscopic nontreponemal test for syphilis using reuseable supplies. PMID- 3823946 TI - Early hospital discharge for male patients with uncomplicated myocardial infarction. PMID- 3823947 TI - Minoxidil in the rapid control of severe hypertension. PMID- 3823948 TI - Rapidly progressive glomerulonephritis: treatment with combined immunosuppression and anticoagulation with arvin. PMID- 3823949 TI - Transient global amnesia: a report of three cases and review of the literature. PMID- 3823950 TI - Interpositional arthroplasty for true ankylosis of the temporomandibular joint--a report of two cases. PMID- 3823951 TI - Biliary ascariasis. PMID- 3823952 TI - Obturator dislocation of the hip associated with fracture shaft of femur: a case report. PMID- 3823953 TI - Infective endocarditis in Marfan's syndrome--a case report. PMID- 3823954 TI - Computed tomography diagnosis of distal radioulnar subluxation. AB - Eight patients with suspected diagnosis of distal radioulnar joint (DRUJ) subluxation underwent computed tomographic (CT) scans of the wrist. Five underwent surgery and had DRUJ subluxation or dislocation; CT scans revealed subluxation in four. Three CT criteria for the evaluation of DRUJ subluxation are discussed and compared in this manuscript. PMID- 3823955 TI - High resolution computed tomography of knee menisci. AB - Sixty four menisci in 22 patients were examined by non-contrast high resolution computed tomography (CT). Fifty four menisci were imaged on a GE 8800 CT scanner. The other 10 were imaged on a GE 9800 CT scanner. Nineteen menisci were shown to be torn on arthrography and/or arthroscopy--12 medially and 7 laterally. The remaining menisci were normal. When the meniscal CTs were reviewed collectively by three observers without knowledge of arthrographic or arthroscopic results, sensitivity was 63%, specificity was 93%, and accuracy was 84%. Although only 10 menisci were imaged on the GE 9800 scanner, the sensitivity in this subset of scans was 83%, the specificity 100%, and the accuracy was 90%. These results suggest that noncontrast CT cannot replace arthrography or arthroscopy, but it is possible that images obtained on the GE 9800 or comparable CT scanner may be accurate enough to be used for screening of meniscal tears in selected patients. PMID- 3823956 TI - Reversed calcaneal spurs in children. AB - A study of the radiographs of 18 heels in children provided additional information about the developmental variant of reversed calcaneal spurs in young patients. The variant is seen in both boys and girls. Observations are made about the incidence of this radiological appearance. PMID- 3823957 TI - The femoral head notch. AB - A notch-like defect at the vertex of the proximal femoral ossification center is a normal variant in children. This has often been mistaken for Legg-Perthes disease. This sharply defined defect is distinct from the irregular epiphyseal ossification patterns common in other areas. PMID- 3823958 TI - High signal intensity soft tissue masses on T1 weighted pulsing sequences. AB - On T1 weighted pulsing sequences, the majority of soft tissue masses are of low signal intensity and show high intensity signals on T2 weighting. There however is a subset of soft tissue masses of varied histology that shows high signal intensity on T1 weighted pulsing sequences. These masses have either fat or blood in their substance. Lipomatous and hemangiomatous lesions that did not show high signal intensity on T1 weighting were also encountered and are discussed. Present experience with MRI of soft tissue masses suggests that there is a limited spectrum of entities that produce high-signal intensity T1 weighted soft tissue masses. PMID- 3823959 TI - Sacrococcygeal chordoma. A clinicoradiological study of 60 patients. AB - Sixty patients with sacrococcygeal chordoma, who were seen at this center between 1946 and 1985, were studied with particular attention to the radiographic findings. This study was undertaken because of the large number of these cases and comparison was made between the plain films available in 39 patients and the computed tomography CT studies in 22. Bone destruction was found in 78% on plain films but in 90% on CT. A soft tissue mass was identified in plain films in 60% but in 90% on CT. Calcific debris was found in plain films in 44% but in 87% on CT. Mostly the debris consisted of coarse irregular fragments and probably represented sequestrated necrotic bone. Myelography was performed in only 15 patients. Angiography was studied in 10 cases. Of the 60 patients 88% underwent surgical resection. The tumor recurred in 80% and in only 20% was there no evidence of recurrence. Distant metastases occurred in 24% of patients. Fifty percent survived 5 years; 28% survived 10 years; mean survival 7.5 years. PMID- 3823960 TI - The carpal tunnel view: helpful adjuvant for unrecognized fractures of the carpus. AB - We present four cases of carpal bone fractures which were not recognized on standard anteroposterior (AP) and lateral views of the wrist. When there is clinical suspicion of fractures of the hook of the hamate, pisiform, or trapezium, either because of the mechanism of injury or clinical presentation, a carpal tunnel view of the wrist is often helpful to disclose previously unrecognized fractures. PMID- 3823961 TI - Autosomal dominant type of endosteal hyperostosis with unusual manifestations of sclerosis of the jaw bones. AB - We report three cases of autosomal dominant type endosteal hyperostosis which occurred in one Japanese family. A new pattern of sclerotic changes in the jaw bones is evident. In all members of the family there was a symmetrical thickening of the diaphyseal cortices of the long bones. The affected bones were only minimally widened and the epiphyses and metaphyses were spared. Endosteal sclerosis of the neurocranium was present with loss of the diploe. The sclerotic changes included enlargement and mottled sclerosis of both the maxilla and mandible, with multiple embedded teeth and odontomas. The ramus of the mandible was spared. Severe sclerosis of the jaw bones was present only in a 28-year-old woman. The 2-year-son showed only focal sclerosis in the mandible, and his grandmother had minimal changes in the skeleton. PMID- 3823962 TI - The use of computed tomography to quantitate bone formation after distraction epiphysiolysis in the rabbit. AB - A study of limb lengthening by distraction epiphysiolysis in the rabbit tibia is presented. For this purpose a special external distraction device was developed, which allowed 10 mm lengthening of the leg. Bone formation in the distraction zone was quantified by means of computed tomography. Cross-sectional scan planes at 1.5 mm separation revealed bone formation proceeding for several weeks after the end of the distraction period. A period of bone remodeling followed, resulting in the formation of a solid cortical structure, similar to the diaphysis, in the distraction zone. PMID- 3823963 TI - The computed tomographic appearances of cherubism. AB - The computed tomographic (CT) aspects of six cases of cherubism are described. Through its optimal representation of the lesions, CT enabled certain characteristics of this disease to be substantiated, namely, limitation of the process to the bones of the jaw and primarily superficial development of the mandibular lesions, coupled with an unusual mandibular condylar impairment. Moreover, the composition of this series permitted investigation of the condition in its several stages of progression. PMID- 3823964 TI - Case report 405: Ollier disease (enchondromatosis). PMID- 3823965 TI - Case report 406: Scurvy. PMID- 3823966 TI - Case report 409: Non-Hodgkin lymphoma (diffuse histiocytic or malignant lymphoma, diffuse, large cell B-cell immunophenotype). PMID- 3823967 TI - Case report 410: Hairy cell leukemia infiltrating the femora. PMID- 3823968 TI - Medical pluralism and infant mortality in a rural area of Bangladesh. AB - This paper examines some aspects of the health search behavior of parents in a rural area of Bangladesh who were unsuccessful in their attempt to save their infant's life. This issue is analyzed within the pluralist medical milieu and very high infant mortality rates prevalent in Bangladesh. There are several different medical cultures in Bangladesh each with their distinctive ideologies about disease causation and the nature of medical intervention. Practitioners of the modern cosmopolitan or western system of medicine are only one of the major types among several types of healers. The choice of a healer by the parents of infants is a complex process depending on a great variety of conditions such as the health status of the infant, relative proximity of the healer, cost of health care, transportation facilities, gender of the infant, attitude of the parents toward different systems of medicine, the past experience of the parents and the like. We posit that the choice of healer of a particular type may be related less to the traditional or modern orientation of the parents than to the severity of the infant's condition and the expectancy of cure. Thus, infants exhibiting acute symptoms of a disease may be more likely to be placed under the care of a 'western' type physician than taken for treatment to an indigenous medical practitioner. Such attitude on the part of the parents may, however, result in the loss of precious time at the most critical moments, and thus may reduce their chances of success to save their infant's life.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823969 TI - Proximity to hospital and mortality from motor vehicle traffic accidents. AB - Policy in England and Wales has encouraged the concentration of hospital accident and emergency facilities into large units with substantial catchment areas. This means that many rural areas are considerable distances from the nearest hospital providing such services. Analysis of data on mortality from motor vehicle traffic accidents for males aged 15 to 24 reveals that death rates are substantially higher in rural areas than in the cities. It is shown that geographical variations in mortality rate are related to differences in the dependence on private transport, to the social composition of the population and to proximity to hospital accident and emergency facilities. This latter result suggests that policy-makers need to pay more attention to the accessibility of accident and emergency services. PMID- 3823970 TI - Immunization against whooping cough in Salford: a spatial analysis. AB - The decline in pertussis (whooping cough) immunization in the 1970s is related to public concern about the safety of the vaccine. The debates about its safety and effectiveness and the impact of vaccination on notifications are reviewed. A study is made of spatial variations in vaccine uptake within the metropolitan district of Salford, Greater Manchester, using data available at ward level. Salford as a whole has one of the lowest rates of uptake in the North Western Regional Authority, which itself has the lowest uptake in the country. Variations from ward to ward are noted and an attempt is made to account for these using Poisson regression. Both the number of children being immunized against pertussis and the number receiving diphtheria and tetanus vaccine (but foregoing the pertussis component) are used as dependent variables. Of the explanatory variables social class proves a useful predictor. However, the analysis is an ecological one and further work is called for at the scale of individual clinics in order to investigate health worker and parental attitudes and the accessibility constraints felt by those responsible for bringing children to clinics. PMID- 3823971 TI - International perspectives on the health care crisis in the United States. AB - The American health care system is confronting a crisis: one consisting of severe problems of cost and access, and the other consisting of significant qualitative changes in structure, systemic behavior and operation. Some of these factors may be understood better in comparison with how systems in other nations have responded to similar problems. The United States had adopted solutions which are significantly different from those of other countries, including more limited government involvement in health care and planning, and the development of corporatized medicine. These solutions pose significant ethical and operational problems. PMID- 3823972 TI - Equity in the distribution of health and welfare services: can we rely on the state to reverse the 'inverse care law?'. AB - It has been suggested that the fiscal crises experienced in many industrial nations has been made worse by the drain on the state's economy of an ever growing welfare state. Proposals to decentralize funding for health and welfare services, and to rely more on local, private, and 'grass roots' services, have been received enthusiastically. The question raised in this paper is whether the shift away from provision by the state will bring about a more or less equitable distribution of resources. The paper considers the spatial distribution of treatment services for two groups of the population who have become largely dependent on the state: namely, the mentally ill and alcoholics. The results suggest that as the federal government withdraws from the provision of services, neither the states nor the localities can be relied on to guarantee a minimum level of services to the truly needy. In the case of alcoholism services there is also some question about whether 'grass-roots' provision would be sufficiently responsive to the distribution of needs. PMID- 3823973 TI - The geographical restructuring of urban hospitals: spatial dimensions of corporate strategy. AB - In response to demographic, economic and regulatory change, hospitals in the United States are increasingly adopting the diverse corporate strategies of private firms. The ability of a hospital to adopt these strategies and survive depends greatly on the nature of the hospital institution and the economic potential of its geographical market area. A typology is developed relating institutional strategies such as merger, expansion, diversification and closure to the size of the hospital and the socio-economic status of the neighborhood in which it is located. Data describing the geographical distribution, since 1967, of hospital closures, mergers and facility expansions in New York City are used to examine institutional strategies in relation to the typology. Closure has been most common among small hospitals located in low SES neighborhoods, whereas facility expansion has been most prevalent among large hospitals located in high status neighborhoods. The result is an increased concentration of patient care in large tertiary hospitals. Mergers have provided a means of not only increasing institutional size and rationalizing services, but also of establishing footholds in 'profitable' marked areas. The final section considers the role of the state in hospital restructuring. PMID- 3823974 TI - Territorial justice and primary health care: an example from London. AB - This paper is part of a larger piece of research which examines the spatial relationship between need for and provision of primary health care in London. The research reported here is concerned with empirically testing the 'inverse care law' at the DHA level. One concept that may be used to guide this analysis is 'territorial justice'. Several conceptual problems associated with the use of territorial justice are outlined. These include inadequate conceptualisation of the form of social justice assumed, of the problem of deriving need indices and of the nature of resources. A final problem is concerned with the spatial scale of the analysis. The concept of territorial justice is made operational so as to identify relatively under and overprovided DHAs. The result is that the often held assumption of a simple dichotomy of relatively underprovided inner DHAs and overprovided outer DHAs is shown not to be tenable. However, this research concentrates on the quantity of care, and does not focus on the important aspect of its quality. This preliminary analysis reveals the need for further research on this important topic. PMID- 3823976 TI - Medical geography: selected papers from the 1985 Nottingham symposium. PMID- 3823975 TI - Primary health care in the Philippines: banking on the barangays? AB - Primary health care has been hailed by some countries as the only practical means of providing any form of health care for expanding populations in poor economies. This is particularly true in Third World countries where the cost explosion of technology-oriented health care has been a major problem in extending services. Therefore, the PHC package of education, nutrition, preventive medicine and treatment of the most common diseases and injuries is sometimes regarded as the most beneficial application of scarce resources. The Philippines claims to be one of the first (perhaps the first) countries to have adopted PHC as a national strategy for health care and, since 1981, impressive achievements have been attained in this sector by contrast with reversals in many other sectors of the economy. PHC has not challenged the pre-eminence of Metro-Manila in the provision of hospital and specialist facilities but it has extended some basic care particularly to rural regions of the country. This paper reviews the background to health care in the Philippines and it then examines the implementation of PHC in Negros Oriental, where PHC has taken on the additional feature of special use of indigenous materials and resources. The administrative, financial and legal bases and some geographical facets of PHC are highlighted in this province. The campaign relies heavily on local (barangay) initiatives and community participation, in part to minimise resources which have to be devoted to health in a very troubled national economy. In spite of local skills and enthusiasm, this arguably still involves the abrogation of a degree of government responsibility for health care. As a result, the Philippines strategy may be said to be "banking on the barangays." PMID- 3823977 TI - Analysing geographic variations in mortality using Poisson regression: the example of ischaemic heart disease in England and Wales 1969-1973. AB - This paper describes how Poisson regression techniques can be used to examine the relationship between mortality and possible explanatory variables over a series of areas in cases where the number of deaths involved is relatively low. As an example an analysis is carried out on deaths from ischaemic heart disease among young adults in the county boroughs of England and Wales during 1969-1973. The results of the study indicate that the number of deaths was higher for males than females and was positively related to age, the size of the 'at risk' population and crowding, but negatively associated with water hardness and the size of the New Commonwealth population. A comparison of the Poisson and log-normal regression models clearly shows that the latter provides an inferior goodness of fit and unreliable results. It is therefore concluded that when the number of deaths is small there are both theoretical and practical advantages in using Poisson regression to analyse mortality data. PMID- 3823978 TI - Geriatric care and distributive justice: cross-national perspectives. PMID- 3823979 TI - Anticipating the needs of the U.S. aged in the 21st century: dilemmas in epidemiology, gerontology, and public policy. AB - Reductions in the prevalence of chronic disease, functional dependence, and associated social problems among aged Americans have been predicted on the basis of improving environmental and social conditions, more effective public health measures, and advances in medical care. Public policy makers have found such predictions attractive since improved health status in old age could significantly offset the increase in health care resources which would otherwise be required to meet the needs of the country's growing number of elderly. This paper reviews the epidemiologic model underlying such predictions. Key assumptions of the model are evaluated by examining the health and social well being of elderly residing in a socioeconomically advantaged community with an age structure similar to that projected for the United States in the 21st century. Despite their long-standing advantages in education, employment, income, housing, health care, and community services, these elderly experienced age adjusted rates of health and social problems comparable to those found in nationwide samples of elderly. No evidence of a compression of health problems into the final years of life could be found. Considerable diversity in problem constellations suggested a need for sophisticated packages of health and support services. These findings suggest that any significant improvements in the health status of the aged due to general improvements in living conditions or health behavior are unlikely to emerge before the proportion of aged Americans doubles in the first quarter of the 21st century. If this is so, public policy in the U.S. must be directed to expanding and improving health and social services for the elderly in the foreseeable future. Attempts to hold expenditures on the aged constant, or to reduce such expenditures, would seriously compromise the health of the nation's elderly. PMID- 3823980 TI - The social creation of dependence, dependency ratios, and the elderly in the United States: a critical analysis. AB - The paper addresses critically the issue of the age/dependency ratio in the United States. It is argued that embedded in this 'objective' statistic are struggles among specific social groups and societal contradictions which only come to the fore when its assumptions, calculations and usage are explored. Through an examination of the notion of social creation of dependency, the manner in which the dependency ratio is calculated and the relationship between the socio-economic structure and the creation of dependency, it is argued that the commonly employed statistics are based on assumptions that are supportive of existing dominant social relations. This phenomenon generates a reproduction of these relations and, at the same time, circumscribes the range of solutions to the problems. PMID- 3823981 TI - Policy intellectuals, class struggle and the construction of old age: the creation of the Social Security Act of 1935. AB - Studies in the political economy of aging criticize social policies for the aged for reinforcing class inequalities and doing little to help many aged persons, yet few use this perspective to explore policy development. Estes' critique of dominant conceptions of aging is the starting point for this study of the historical development of the U.S. Social Security Act. When the conflict between capital and labor is placed at the center of analysis, we see that conceptions of aging as inevitable physical and mental decline, and the subsequent institutionalization of retirement, emerged early in the 20th century from work place conflicts over changes in the production process and worker productivity. The Social Security Act embraced those conceptions of the 'problems' of aging most consistent with the needs of capitalist industry, and issues involving class struggles were redefined as issues of biological aging and decline. This paper explores the dynamics of this process and the role of businessmen and policy intellectuals. Understanding class struggles over the definition of problems is just as important as understanding class struggles over particular policies. Focusing on problem definitions also allows us as researchers to see how we may unwittingly reinforce the inequalities we struggle to overcome. PMID- 3823982 TI - The non-profit sector and community-based care for the elderly in the U.S.: a disappearing resource? AB - Non-profit health and social service agencies have traditionally been an extremely important element of non-institutional community-based care for the elderly in the U.S. Policy shifts, commencing in 1981, increasingly concerned with medical cost containment are challenging private non-profit sector agencies delivering care to the elderly. At issue is the ability of communities to maintain a viable service sector predicated on service needs and service accessibility, as opposed to a highly discrete, medicalized, and fragmented service delivery system that is available primarily (or only) to those who can pay. PMID- 3823983 TI - Analysing access to nursing home care. AB - The aim of this study is to investigate access to nursing home care in selected regions of Australia, Canada and the United States, and to examine the common ways in which nursing homes are used. Firstly, a review of methodological considerations in measuring access to nursing home care is made. Secondly, patient turnover patterns are interpreted with a view to showing differences in nursing home use among the countries studied; aggregate turnover rates, length of stay and outcomes are compared. Thirdly, groups of patients who differ in demographic and morbidity characteristics and in their use of nursing homes are discussed. Finally a number of distributive implications of these results are raised and a framework is outlined for considering redistributive consequences of changes in the use of nursing homes. It is concluded that the rate of flow of patients through nursing homes is as important a determinant of access to nursing home care as the level of bed provision and that adoption of this dynamic view of access indicates considerable scope for redistributing use of resources within the nursing home systems of all three countries. PMID- 3823984 TI - Distributive justice and the treatment of acute illness in nursing homes. AB - Using participant observation and interviews, this research investigated the social-cultural factors that influence decision making in the evaluation and treatment of acute illness in nursing homes. Mental status and cost of care emerged as the predominant factors that influence physicians in the decision making process. Drawing on some of the principles of distributive justice, it is argued that it is unjust to deny health care to the elderly because of their impaired mental status or a lack of financial resources. Quality of life from the patient's perspective, the patient's and their family's wishes and cultural and individual values must be considered in the decision-making process. PMID- 3823985 TI - Social policy and everyday life in nursing homes: a critical ethnography. AB - This is an ethnographic account of nursing homes in the United States. I draw connections between social policies and specific consequences for everyday life in this environment. This paper focuses on nursing assistants' wages, the economic impact of long term care on patients, the passification process of patient life, the invisibility of caring work, and the framing of everyday life into the concepts of capitalist industry. The primary data in the research are comments and conversations of nursing assistants and patients. Their standpoint, I conclude, is often opposed to the organizational logic of business that increasingly encases nursing home life. PMID- 3823986 TI - Improving care in nursing homes using community advocacy. AB - Community organizations have often focused their campaigns for social change on the health care system. While the techniques of Saul Alinsky and to a lesser extent Paulo Friere have provided the theoretical backbone for most community organizing efforts, these campaigns frequently are characterized by a rather eclectic synthesis of different methodologies. The nursing home industry has been one of the most severely publicly criticized components of the American health care system, and during the last decade consumer groups have sought to achieve fundamental improvements in the quality of life and care available to nursing home residents. However, the standard Alinsky and Friere techniques have limitations in organizing efforts directed toward nursing home reform. One case study is presented which describes a relatively successful community organizing project for better care in a San Francisco Bay Area nursing home. The organizing method used in this project was one of community advocacy. This method is described in detail, and the limitations and potentials of community advocacy are analyzed. PMID- 3823987 TI - Social insurance and the delivery of social services in France. AB - An outline of the organization of the French social insurance and the social service delivery system is given. It is shown that the social insurance system, more so than in most other welfare states, strongly reflects various class and occupational interests. Therefore, it is also more prone to conflict along class lines, while other countries' social insurance systems tend to blurr class conflict. In addition, problems due to demographic shifts and economic changes are discussed and the populations affected, particularly the aged, identified. Some of the government's strategies to ameliorate the financial problems of the social insurance system are mentioned. The social service delivery system is found to suffer from bureaucratization and inefficiency. In order to correct this and to improve the quality of services, France has begun to decentralize the social service delivery system. There is little evidence, though, that decentralization, as presently practiced, is able to significantly improve the appropriateness of social services and increase the efficiency with which they are delivered. On the contrary, the political forces opposed to an elaborate welfare state tend to be strengthened. No doubt, the aged would also be affected by such political changes. PMID- 3823988 TI - Medical care and social support for the elderly in Switzerland: imbalance and mix. AB - Medicalization refers to the current practice of providing medical solutions to broad social problems facing the old. This approach is destined to bring about serious economic and sociocultural dilemmas in the coming decades due to the aging trends in Switzerland. On the one hand, additional bed requirements will double, really jeopardizing the present federal savings policy on health and welfare. On the other side, ignoring the specific needs of nearly 20% of the population (as the 65 and over age group are expected to reach in the year 2010), will provoke unwielding social/political tensions. Assigning medical answers to social needs is both expensive and inadequate. This proposition is illustrated by two aspects of Geneva's medical care system for the aged: At the University Geriatric Hospital a large proportion of the patients are admitted for purely social reasons ('home maintenance impossible'). The long term bed stays, medically unjustified, constrains the optimal functioning of this acute care and rehabilitation hospital. The prolonged length of institutionalization reduces the capacity of the elderly out-patients to carry on autonomously. This observation is confirmed by many Swiss medical and sociological surveys which reveal that institutionalization is rarely necessary or desirable in the 10 to 20 first years of post-retirement provided there is an adequate system of social and primary care services available. The drug prescription to those 65 and over consulting at the out-patient department of the Geneva University Medical Policlinic typically amounts to excessive prescription for women and especially of psychoactive drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823989 TI - Health care of the aged in Korea. AB - Korea's population is now aging very rapidly, but the country has not yet shifted its priorities nor instituted programs to meet the needs of an aging population. While the death rate has already achieved low modern levels, there are still traces of malnutrition and other debilitative conditions among the elderly and ill health is generally believed to be an inevitable accompaniment of old age. This leads to resignation and stoicism rather than active steps to deal with the growing problems. Furthermore, care of the aged is still viewed as a private matter to be handled by the person's family and the state plays a very minor role. Medical practice is largely private with physicians drawing their financial support chiefly from fees of their patients. Only one-fourth of the elderly population is presently served to any significant degree by modern medical practitioners. The basic reason for the general lack of skilled care is economic, although folk medicine still plays a role. Only civil servants are covered by any type of health insurance and only 9% of the elderly receive any health care as social welfare recipients. Ninety-five percent of the elderly live in families, three-fourths of them with children and financially dependent upon the children. Bedfast patients are cared for by spouses or daughters-in-law. But fundamental changes are under way in the structure of families which make home care of incapacitated members impractical and burdensome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823990 TI - Population aging in the People's Republic of China. AB - This paper provides a factual assessment of China's population aging and its social and economic consequences. It is projected that China will have a substantially older population in the middle of the 21st century. Major policy implications concerning old age support and health care have been examined. PMID- 3823991 TI - Emerging trends in gerontology and geriatrics: implications for the self-care of the elderly. AB - Increases in the world's older population have posed a significant challenge to available health care resources. For many older people, informal initiatives represent a necessary, rather than an optional health care strategy in the absence of alternatives. Those individuals with the greatest health and economic dependencies are often held responsible for their reliance on subsidized long term care services. This tendency to blame the victim appears to transcend fundamental philosophic differences which have traditionally distinguished some collectivist and individualist societies. Although health care has been viewed traditionally by health professionals as their domain, self-care and lay initiatives have recently been recognized by professionals as important to the health care of different population groups including older people. The concept of self-care has been used in various ways by different people to describe a wide range of personal health behaviors encompassing lay care, self-help, enlightened consumerism, and various preventive measures as antidotes to the impairments of old age. This paper reports some of the outcomes of an international project which reviewed geriatric self-care in different countries and health care systems. Various influences on the evolution of interest in geriatric self-care were identified including: similarities and differences in health care systems: demographic changes; cohort differences; the emergence of professionals with specialized training in geriatric health care; and, the salience of biomedical models in addressing the health problems of aging. The role of professionals, especially those trained in geriatrics, is examined with an acknowledgment of the importance of a self-care strategy that is independent of professional dominance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3823992 TI - Health and the holy in African and Afro-American spirit possession. AB - The difficulty of reconciling religious and medical dimensions of ethnopsychiatric phenomena is discussed with respect to spirit possession cults. The paper documents a trend toward medicalization of the phenomenon in the Anglo American literature, and points out the lack of such a trend in the French literature. Extended discussion is presented of the Afro-Brazilian candomble, a cult not well represented in the Anglo-American literature. Case vignettes are excerpted from key informant interviews with a Brazilian psychiatrist who is also an initiated elder of the candomble. It is concluded that a balanced approach that attends to both religious and medical motives of cult participants is essential for an adequate understanding of the phenomenon, and that such an approach is intrinsic to the goals of contemporary medical anthropology. PMID- 3823993 TI - Models of stress and meanings of unemployment: reactions to job loss among technical professionals. AB - The same potentially stressful event may have different meanings to different individuals. Such variation may be explained by reference to different models of stress. Two such models, one based on the concept of person-environment 'transactions' and the other on that of a 'psychosocial transition,' are applied to studies of reactions to job loss among technical professionals. PMID- 3823994 TI - High levels of childhood rickets in rural North Yemen. AB - Despite a warm sunny climate, rickets is extremely common in children living in an isolated mountainous area of North Yemen. In a small township the overall prevalence amongst children under five years attending for vaccination was 27%. The condition was most common at the end of the first year and had disappeared by the fifth year. Marasmus was commonly associated with rickets. Children from the rural villages outside the township had significantly lower rates of rickets. Several factors may contribute to the very high rates of rickets in rural Yemen. However, lack of exposure to sunlight as a consequence of particular cultural practices is likely to be the most important. The major social and behavioural factors which restrict the young child access to sunlight are outlined, and possible remedies discussed. PMID- 3823995 TI - The treatment of musculoskeletal disorders by a Mexican bonesetter (sobador). AB - Joint and muscle pain and dysfunction are treated by massage by a practitioner in Ciudad Juarez, Chihuahua, Mexico. It has not hitherto been noted that this type of practitioner also treats with joint mobilization and manipulation. During nine months of field observations, patients were examined clinically before treatment in an effort to establish baseline measures of pain and stiffness as well as to confirm the diagnostic conclusions of the sobador. The nature of massage, mobilization and manipulation was then identified. Immediate post-treatment evaluations of range of motion together with patient reports of pain levels provided crude measures of effectiveness. The sobador is found to meet medical standards of practice for safety, efficacy, and cost containment. PMID- 3823996 TI - Ethnicity and pain: a biocultural model. AB - Zborowski's pioneering research in the 1950s noted ethnic differences in pain response. Subsequent clinical research has focused on ethnic variability in psychological, attitudinal and behavioral response but generally has ignored sociocultural influences on the perceptual component of pain. In light of Melzack and Wall's gate-control theory, it now appears that sociocultural factors may affect the psychophysiological processes of pain perception. This paper proposes that a biocultural model, which combines basic social learning and social comparison theories with certain aspects of the gate-control theory, will prove useful for studying and understanding cultural influences on human pain perception and response. PMID- 3823997 TI - Sudden infant deaths and clear weather in a subtropical environment. AB - Particulate pollution levels were found to decrease, on average, over the 10-day period preceding SIDS incidence in a study of 369 cases over 15 years in Brisbane, Australia. This unexpected association could not be explained by correlations between daily pollution levels and daily precipitation, wind velocity, air temperature or cloud. Of the meterological variables studied, which might have given rise to the particulate-SIDS associations, only visibility showed associations with SIDS incidence. Average visibility increased prior to SIDS in both summer and winter cases. It is hypothesised that these findings may be due to either direct effects of light, or due to increased outdoor exposure of infants and/or to changes in parental behaviour during clear weather. PMID- 3823998 TI - Interdisciplinary approaches in epidemic studies--II: Four geographic models of the flow of contagious disease. AB - Straightforward adaptation of geographical and regional-science models to conceptual modeling of the epidemic spread of a contagious disease is achieved by: using analogies and isomorphisms, and using as a real example the observations made during a well studied epidemic of variola minor (the mild form of smallpox), a typical contagious disease. The adaptation of the Wilson model of planning for urban development includes a static view (network) of the structure and activities of the population and of organizations (diffusion agencies such as day schools), and the dynamic view (mechanism of epidemic spread) which includes the changes with time of elements of the network brough by flow of disease. Adaptation of the Brown model of spatial diffusion yields flows of disease occurring between micro-scale units (households) of social interactions but aggregations of these units do not participate explicitly in the flows. The occurrence of successive generations of affected households is specified as well as the occurrence of definite stages of the epidemic progression. Adaptation of the Alves-Morrill model of spatial diffusion yields a network of social groups and interdependencies; a simplified network of the mechanism of spread that shows flows of disease between individuals grouped into generations of infected individuals and generations of infective individuals; and a more realistic view which shows the flows of disease between real epidemiological units such as households and school classes. Adaptation of the Morrill-Manninen model of spatial diffusion concentrates on the mechanism and parameters having the epidemic spread as output. The interdependencies between the parameters and between each parameter and the epidemic spread are represented, including feedback processes. Brown's model seems to be the best for describing the epidemic spread of contagious disease while the Morrill-Manninen model is the most promising for investigating the detailed mechanism of the spread. Since these two models complement each other, their combined use is indicated. PMID- 3823999 TI - The impact of late adolescent substance use on young adult health status and utilization of health services: a structural-equation model over four years. AB - This study examined the impact of adolescent substance use on young adult health status and health service utilization, while controlling for earlier subjective and objective health problems and seeking medical care. Data were obtained from 654 participants when they were in late adolescence and 4 years later when they were young adults. Latent-variable models were used to determine what effect, if any, adolescent drug use had on later health. A second-order factor of general drug use had a small, but significant, influence on decreasing subjective physical hardiness over the 4-year period. However, general drug use was not directly related to later physical symptomatology, subjective health problems, or health service utilization. General cigarette use and amount of cigarette smoking were significantly related to a range of health outcomes including increased psychosomatic symptoms, respiratory symptoms, reporting trouble with health, nights spent in the hospital, and health service utilization, as well as decreased subjective physical hardiness. Early cannabis use decreased later subjective physical hardiness and increased health problems experienced over the 4 years. Hard drug use was associated with increased emergency physician visits during adolescence and increased perceived trouble with health as young adults. Due to the fact that adolescent general drug use decreased subjective physical hardiness over 4 years, it is possible that continued substance use might lead to more serious objective health consequences later in life (i.e. physical symptoms). PMID- 3824000 TI - The measurement of social support in population surveys. AB - There is an increasing interest to include measures of social support in population surveys of chronic disease risk. The choice among a variety of measurement instruments, however, is difficult. We reviewed social support instruments, which were potentially applicable in population studies. Their conceptual framework, their reported predictive capacity and their psychometric properties were compiled and systematically compared. The convenience, clarity and applicability of the social support instruments were tested in a group of health care employees. Two distinct groups of instruments were identified, those describing quantitative aspects of social network and social interaction and those describing functions and adequacy of social support. The former instruments were more easily applicable, questions were more easily and quickly understood and answered. Furthermore, these instruments had been found to predict physical illness in prospective studies. Their psychometric properties, however, were unknown. Qualitative instruments, on the other hand, were found to include questions, not universally applicable to a general population. These instruments were mostly carefully tested for psychometric properties, but their illness predictive capacity was found to be less well examined. Thus, instruments which satisfied all the desirable requirements could not be identified. PMID- 3824001 TI - Treatment-seeking for depression by black and white Americans. AB - This paper examines data from a psychiatric epidemiologic survey of 3004 households in St Louis to determine whether there are distinctions between black and white Americans in their propensities to seek treatment for episodes of depression and to discover those groups least likely to seek care. The process initiated by the experiencing of unusual or distressing signs or symptoms and completed by seeking treatment for those complaints is a complex one, involving several steps. Numerous factors may affect decisions regarding treatment-seeking including characteristics of the individuals themselves, characteristics of the symptoms, and attitudes and beliefs about the causes and proper treatment of psychiatric problems or mood. We, therefore, also examine the available epidemiologic data for some clues concerning those factors which may have contributed to the observed patterns of treatment-seeking. Significantly fewer blacks meeting psychiatric criteria for a diagnosis of depression had sought professional care. Moreover, severity of the problem was significantly related to treatment-seeking among blacks and it was among those with the least severe problems that the greatest differences were found. Whites did not significantly exceed blacks in seeking care when depressive episodes were long lasting, severe or frequent. Although there was some indication that blacks may be more tolerant of depressive symptoms, a considerable proportion of blacks who felt they had a troublesome problem had never sought professional care. There was little evidence to suggest that a fear of being stigmatized prevented blacks from seeking care. However, blacks were more likely to report that fear of treatment and of being hospitalized had prevented them from seeking care. A number of hypotheses generated by the epidemiologic data are presented. Once large-scale surveys such as this have delineated the patterns of health care utilization and identified those groups at high risk of not receiving care, anthropological concepts and problem-oriented field research may be extremely useful in testing hypotheses concerning those factors underlying the observed behavioral patterns. PMID- 3824002 TI - Modeling the outcomes of nursing home care. AB - In this exploratory analysis using data on 290 patients, we use regression analysis to model patient outcomes in two Veterans Administration nursing homes. We find resource use, as measured with minutes of nursing time, to be associated with outcomes when case mix is controlled. Our results suggest that, under case based reimbursement systems, nursing homes could increase their revenues by withholding unskilled and psychosocial care and discouraging physicians' visits. Implications for nursing home policy are discussed. PMID- 3824003 TI - Health care policy and regional epidemiology: international comparisons and a case-study from The Netherlands. AB - In a number of countries, regional levels of administration have assumed responsibilities for the health care sector. This paper presents a specification of epidemiological information that could be relevant for health care policy towards and within regions, as well as a review of British and Scandinavian attempts at using routinely available mortality data for these purposes. A Dutch case study is then presented. To determine whether regional mortality data by cause of death can be used as indicators of need for health care, and consequently be used as criteria for the allocation of financial resources, the correspondence between provincial disease-specific mortality, hospital admissions and new cases of disability benefits was analyzed. the findings were not convincing: for a number of diseases a reasonable correspondence between mortality and hospital admissions could be shown; for other conditions, however, especially ischaemic heart disease, none at all. It is concluded that: in the context of the formal allocation of health care resources to administrative units, a strong confidence in mortality data by cause of death is unwarranted; in the (broader) context of developing and evaluating regional health care policy, mortality data by cause of death can be useful for providing a focus on population health status and a starting point for further studies. PMID- 3824005 TI - Rural health care: a British success or a tale of unmet need? AB - Discussion over health needs and health care in the U.K. has mainly centered on the urban area. The countryside has not been included in this debate because it is assumed that rural people are healthier than their urban counterparts and that health and social services are more effective. This paper questions these two premises and shows higher than expected levels of illness in the rural area and the health services to be largely dependent on general practice which, like all rural services, is becoming increasingly centralised and inaccessible. What is needed, it is argued, is the construction of a case for more localised care. Not that this should necessarily lead to a singularly rural type of health service, rather that patterns of provision should be adapted to local needs wherever they are situated. PMID- 3824004 TI - Breastfeeding: its relationship with postpartum amenorrhea and postpartum sexual abstinence in a Nigerian community. AB - Breastfeeding, together with its two related postpartum variables--amenorrhea and abstinence--govern both the tempo and quantum of fertility in traditional African societies. Decline in breastfeeding also implies decline in postpartum amenorrhea and abstinence practice. Changes in breastfeeding practices in tropical Africa, therefore, has fertility implications and consequences. This paper examines how breastfeeding is functionally related to postpartum amenorrhea and abstinence in Ilorin, an urban community in Nigeria. Results indicated that the effect of breastfeeding on fertility, through its relationship with postpartum abstinence, might be more important than its effect through lactational amenorrhea in this society. This is more true among women with little or no education than among women with secondary or higher education. The population or family planning implications of these relationships are discussed. PMID- 3824006 TI - Do health professionals agree on the parenting potential of pregnant women? AB - Although retrospective studies have suggested that the signs of potential parenting problems are present well before the child is born, successful prenatal screening is infrequent or absent in most clinical settings. For the most part, this lack of screening reflects the inherent difficulties in developing and using practical and reliable tools of assessment. Problems of reliability suggest that professionals from related disciplines often differ in their evaluations of clinical samples. This pilot study was designed to determine whether 12 professionals, four from each of three health disciplines concerned with child abuse detection (nursing, medicine and social work), could agree on parenting risk status of 15 pregnant women. Assessment protocols were comprised of the most frequently cited predictive signs of poor parenting. Each rater evaluated the transcript of 15 prenatal interviews. The results indicate inconsistencies in rating both among and within the professional groups. These inconsistencies extended not only to the individual criteria from which the final scores were derived, but also to the total risk status. Even though specific instructions were given for the use of risk criteria, the raters often violated the instructions for coding in favor of their own idiosyncratic judgements. PMID- 3824007 TI - The osteoporosis fracture threshold. PMID- 3824008 TI - Adenocarcinoma of the stomach: are we making any progress? AB - We studied 2,062 patients with adenocarcinoma of the stomach seen at The University of Texas M. D. Anderson Hospital and Tumor Institute between 1944 and 1984. The distribution by site was cardia 33%, antrum 31%, and body 27%; 9% of the patients had linitis plastica. The raw five-year survival rate was 12.5%; surgically treated patients with negative nodes had a five-year survival rate of 75%, compared to 19% for those with positive nodes. Forty-one percent of patients had diagnostic procedures only, 35% had a Billroth I or II gastrectomy, and 24% had total gastrectomy or radical proximal gastrectomy. In the first decade fewer than one new patient per week was registered, but this has increased to more than two during the last decade. This apparent increase is due to the 65% of patients referred for palliative chemotherapy. Improved nutritional support has made operations safer and combined with chemotherapy has provided modest progress. PMID- 3824009 TI - Prospective analysis of the effect of incidental appendectomy on infection rate after cholecystectomy. AB - I prospectively studied 100 patients to see whether "incidental appendectomy" with cholecystectomy affects wound infection rate. Randomization resulted in groups similar in age, habitus, and sex. Forty-seven patients had appendectomy. The most frequent gallbladder disease was chronic calculous cholecystitis. Positive cultures were obtained from 11% of gallbladders. The mean age of patients with gallbladder bacteria was 14.5 years older than that of the series. True pathologic changes were seen in 6% of appendices. Average operative time was extended six minutes by appendectomy. Length of postoperative hospital stay was unchanged by the addition of appendectomy. There were no infections in the patients without appendectomy and one (2%) in the group with appendectomy. The total 1% infection rate is considerably below most reported rates. There was no difference in infection rate between groups with and without appendectomy (P = .47). Unless the procedure is technically difficult, appendectomy with elective cholecystectomy does not increase the chance of infection. PMID- 3824010 TI - Retroperitoneal dissection in gynecologic surgery for benign disease. AB - In this study, the pelvic retroperitoneal anatomy was dissected during 140 consecutive exploratory laparotomies for benign gynecologic disease. In addition, 110 bilateral hypogastric artery ligations were done both to teach the technique and to attempt to determine whether such a procedure reduces blood loss in elective abdominal hysterectomy. Fifty-eight hysterectomies with hypogastric artery ligation were compared to an equal number done without bilateral hypogastric ligation. The data indicate that prophylactic hypogastric artery ligation during hysterectomy did decrease blood loss, though other variables may account for this, and that teaching retroperitoneal dissection to residents is paramount, teaching them a potentially life-saving procedure essential to gynecologic and obstetric training. Only one complication occurred in this series. PMID- 3824011 TI - Spring clip sterilization: long-term follow-up. AB - Between 1978 and 1984, 186 women had interval laparoscopic and postpartum Hulka clip sterilization at the University of Missouri Health Sciences Center. We reached 109 (58%) of these women for follow-up. All had had their sterilization procedures at least one year earlier, and the average duration of follow-up was 3 1/2 years. The procedure failed in four patients, for a failure rate of 3.7%; three of these failures occurred more than 12 months after sterilization. These data suggest that long-term (more than 12 months) follow-up studies may be necessary to document more accurately the failure rate of Hulka clip sterilization. PMID- 3824012 TI - Vascular trauma of the extremities: factors causing failure of arterial repair. AB - Vascular trauma of the extremities is a significant problem in our society as a result of vehicle accidents and violence. Excellent results of vascular repair can be expected with strict attention to bypass of all damaged vessel, proximal and distal embolectomy, regional heparinization, liberal fasciotomy, fixation of associated fractures, and soft tissue coverage of the repaired vessel. PMID- 3824013 TI - Infected abdominal aortic aneurysms. AB - We report five cases of infected abdominal aortic aneurysm managed at the St. Thomas Hospital between 1975 and 1985. Two patients died, one before operation, and another during surgical repair of aneurysmal rupture. Three patients survived, all of whom had primary repair of the aorta or in situ Dacron graft reconstruction. One patient is still living nine years after operation. The availability of organism-specific antibiotic agents has enabled us to use the in situ reconstruction method to successfully manage these patients without increased morbidity or mortality from recurrent infection. A high index of suspicion, prompt surgical resection, and aggressive specific antibiotic therapy are necessary for patient survival. PMID- 3824014 TI - Intraoperative autologous transfusion during major aortic reconstructive procedures. AB - To evaluate the benefits and disadvantages of autologous intraoperative transfusion during major aortic reconstructive procedures, we retrospectively studied 50 patients who had major aortic revascularization procedures without the use of autologous transfusion devices (group 1) and prospectively evaluated a second 50-patient cohort having similar procedures, but with the use of the autologous transfusion device for salvaging and reinfusing lost blood. Both groups were assessed for preoperative risk factors and postoperative complications. We found a somewhat lower morbidity in the autotransfusion group and more complete replacement of blood loss. Autologous transfusion accounted for approximately 75% of all transfused blood in group 2, tremendously reducing blood bank requirements. In addition to reduction of immediate postoperative morbidity, further risks associated with homologous transfusion such as hemolysis, posttransfusion hepatitis, transfusion-related acute lung injury, anaphylaxis, and transfusion-transmitted acquired immunodeficiency syndrome (AIDS) were markedly reduced or eliminated. PMID- 3824015 TI - Autologous transfusion: a community blood bank experience. AB - Interest in the use of autotransfusion has increased greatly, as can be ascertained by looking at usage patterns and literature citations when compared to recent past years. In this paper, we discuss different autotransfusion methods, as well as the clinical experience of a community blood bank over a 3 1/2-year period with predeposited autologous transfusions for elective surgical procedures. Blood collected in Adenine-Saline (AS-1) preservatives allows up to 42 days of storage in liquid state after donation. An average of 2.4 units per donor-patient were drawn, with almost two thirds of them being reinfused during or immediately after surgery. Even though the results of cost analysis and efficiency are far from optimal, autologous transfusion remains an effective albeit expensive alternative to homologous transfusion. PMID- 3824016 TI - Hydroxyurea in the treatment of polycythemia vera: a prospective study of 100 patients over a 20-year period. AB - From 1963 to 1983, I treated 100 patients with polycythemia vera, using phlebotomy and the adjunctive agent hydroxyurea. These 78 male and 22 female patients ranged in age from 24 to 88 years (mean 55.7). Duration of therapy ranged from three to 216 months (mean 64.9). The mean daily dose was 0.72 gm, and the median dose was 0.64 gm. Hydroxyurea gave adequate control of red cells, platelets, and spleen size. Cytopenia was not observed. Phlebotomy requirements were markedly reduced. Leukocyte alkaline phosphatase scores were generally lowered and several blood chemistry values returned to normal. Side effects were minimal, and there were no drug-related deaths. Infections were not a problem. Hydroxyurea, a metabolic inhibitor of desoxyribonucleic acid, does not interfere with the synthesis of ribonucleic acid or protein and is thus probably less leukemogenic than radioactive phosphorus and alkylating agents. Acute myelogenous leukemia was seen in one patient after five years of continuous hydroxyurea therapy. He had received no other myelosuppressant agent. Because hydroxyurea is safe and effective in the treatment of polycythemia vera, it should be considered as first-line therapy. It probably offers practical and theoretic advantages over present therapy particularly when the disease is not well controlled by phlebotomy alone. PMID- 3824017 TI - Increased HDL-cholesterol levels with a weight lifting program. AB - Weight training regimens are generally thought not to improve cardiovascular function or lipid parameters. To evaluate this further, we studied 25 men before and after supervised weight training three times each week for eight weeks. Mean plasma HDL-cholesterol level increased significantly with training, from 38.8 to 44.1 plasma HDL-cholesterol level increased significantly with training, from 38.8 to 44.1 mg/dl, while calculated LDL-cholesterol decreased from 132 to 121 mg/dl. Triglyceride values were unchanged. Percent fat decreased from 14% to 12.7% (P less than .05), and muscle mass increased from 32.4 kg before training to 37 kg after training (P less than .05). Maximal oxygen consumption (VO2max) increased significantly (from 45.2 to 49.2 ml/kg X min) during the eight-week period. LDL-cholesterol and triglycerides were negatively correlated with VO2max but changes in HDL-cholesterol were not accounted for by alterations in VO2max, muscle mass, or percent fat. This study suggests that weight training can be used to increase strength, alter body composition, improve plasma lipids, and enhance cardiovascular function. PMID- 3824018 TI - Correlates of medication compliance in non-insulin-dependent diabetes mellitus. AB - Maintaining compliance with medications is important in the management of patients with non-insulin-dependent diabetes mellitus. We examined correlates of medication compliance in 77 patients followed up prospectively for 24 weeks. Of the demographic, socioeconomic, and clinical variables examined, only older age and greater education were related to compliance. While statistically significant, the differences observed were small and unlikely to be useful to clinicians. Factors reflecting the process of care, including frequency of appointments, minutes spent with the provider, and patient satisfaction were not related to compliance. Symptoms associated with poor glucose control and fasting glucose levels were also not significantly related. The patient's report of his own compliance, however, was strongly associated with our independent measures of medication taking. We conclude that rather than attempting to predict compliance from sociodemographic characteristics, symptoms, or glucose values, the physician should directly inquire about medication taking in a nonthreatening manner. PMID- 3824019 TI - Professional personnel in health care among secondary school athletics in Alabama. AB - To ascertain the use of professional personnel in health care among secondary school athletics in Alabama, a survey was sent to all high schools in the state. Smaller schools (classified 1A) are located an average of 10.8 miles from the nearest medical facility, while for larger schools (classified 4A) the average is 3.2 miles. Overall, 55% have a team physician; primary care physicians represent 65.8% and orthopedists 13%. Only 40% of the team physicians conduct preseason physical examinations for the boys and 25% for the girls. Also, 65% of all the schools reported that a physician was not readily available for practice and games for boys' or girls' teams. Almost 90% of the 4A schools reported that a physician lives in the community, compared to 30% for the 1A schools. On this survey, a physician or athletic trainer outranked a medical facility or training room as being most important to their athletic program, suggesting that the greatest need in health care among high schools in Alabama is the presence of personnel trained in athletic injuries. PMID- 3824020 TI - Survey of major neurologic disorders in a biracial United States population: the Copiah County Study. AB - To determine the prevalence of frequently occurring neurologic disorders in a biracial population, a survey of households and chronic care institutions was carried out for all residents of Copiah County, Mississippi. Along with a complete census, interviews were held using extensive questions about diagnoses, signs, and symptoms of neurologic disorders. More than 97% of eligible households participated, comprising 23,842 persons (49% black, 50% white, 1% other). Persons with responses suggesting one or more of these disorders were examined by a neurologist who used defined diagnostic criteria. Age-adjusted prevalence ratios for cerebral palsy, epilepsy, stroke, and severe dementia were somewhat higher in blacks than in whites, while the age-adjusted prevalence ratio for essential tremor was slightly higher in whites. For Parkinson's disease, there was no difference in age-adjusted prevalence ratios between the races. PMID- 3824021 TI - Pregnancy outcome in mothers with cystic fibrosis: normal neonatal immune responses. AB - Although pregnancy with cystic fibrosis (CF) has been associated in previous reports with increased maternal and neonatal morbidity, this may not reflect the current outcome with intense perinatal medical support. This report describes the pregnancy and pregnancy outcome in four women with CF. Although one neonate was delivered prematurely to a mother with advanced CF, there were no developmental abnormalities. The one premature infant was appropriately developed for his gestational age. Maternal pulmonary function was not clearly influenced by pregnancy, as confirmed by similar Schwachman scores before conception and after delivery. Finally, in this series of patients the postdelivery Schwachman score could be predicted from the preconception score. PMID- 3824022 TI - Strategies for the management of recurrent furunculosis. AB - Furuncles are common infections of hair follicles. Staphylococcus aureus is frequently the causative agent, though other bacteria may also be pathogenic, especially for furuncles in the vulvovaginal area, the perirectal area, and the buttocks. A simple furuncle can be treated by incision and drainage. Systemic antibiotics are indicated in only special circumstances, and Gram stain is helpful in choosing an appropriate one. Some patients are plagued by recurrent furuncles because of follicular abnormalities, climatic conditions, colonization by pathogenic strains, reinfection, debility, or immunodeficiency. I present various strategies for treatment and prevention of recurrent furunculosis. PMID- 3824023 TI - Nonmelanomatous skin cancer: new concepts in pathogenesis. PMID- 3824024 TI - Acute renal failure, hemolytic anemia, and thrombocytopenia in poststreptococcal glomerulonephritis. AB - We have presented the case of a 13-year-old boy who had an apparent hemolytic uremic syndrome, with hemolytic anemia, thrombocytopenia, and acute renal failure. Subsequent laboratory investigations indicated poststreptococcal glomerulonephritis as the cause of renal failure. The triad of hemolytic anemia, thrombocytopenia, and renal failure has not been previously reported in a case of proven poststreptococcal glomerulonephritis. PMID- 3824025 TI - Family violence and the Kluver-Bucy syndrome. AB - The Kluver-Bucy syndrome was first observed in monkeys after experimental amputation of both temporal lobes produced dramatic behavioral changes (ie, visual agnosia, excessive oral activity, distractability, placidity or aggression, indiscriminate sexuality), and hyperphagia. Only a few cases have been reported in human beings. I have described a woman in whom the entire symptom complex developed after a gunshot to the head. PMID- 3824026 TI - Fibrinous pericarditis: an uncommon complication of acute pancreatitis. PMID- 3824027 TI - Dialysis-induced ascites treated with peritoneal dialysis. AB - Dialysis-induced ascites is an uncommon complication that occurs in some chronic hemodialysis patients. Attempts at treatment have included intensive hemofiltration, bilateral nephrectomy, severe dietary fluid and salt restriction, and renal transplantation. We have described a patient successfully treated with continuous ambulatory peritoneal dialysis, and have reviewed other reports of successful therapy with peritoneal dialysis. PMID- 3824028 TI - Extracranial manifestation of invasive pituitary adenoma. AB - An invasive pituitary adenoma caused nasal obstruction and marked visual loss due to compression of the optic chiasm. Surgical and medical treatment produced dramatic recovery of vision. Although the reason that certain prolactin-secreting adenomas behave in a locally aggressive fashion is unknown, the prognosis for invasive pituitary adenomas, in general, is relatively good. PMID- 3824029 TI - Hypertrophic pulmonary osteoarthropathy and breast cancer. AB - Hypertrophic pulmonary osteoarthropathy is an uncommon, poorly understood syndrome usually seen with bronchogenic carcinomas, and rarely with tumors metastatic to the lungs or mediastinum. In a review of the literature, we have found only 140 cases associated with nonbronchogenic intrathoracic tumors. We have reported a case associated with metastatic breast carcinoma in which surgical resection led to rapid disappearance of the syndrome and prolonged palliation for the patient. PMID- 3824030 TI - Coiling of the carotid arteries. AB - We have presented a case of extensive coiling of both common carotid arteries in which surgical reconstruction on the most severely affected side relieved symptoms of cerebrovascular insufficiency. The underlying lesion is believed to be congenital, and surgical correction is recommended in symptomatic patients. PMID- 3824031 TI - Hyperdense parapelvic cyst confused with renal tumor. AB - We have reported a case of a hyperdense parapelvic renal cyst that could not be easily differentiated from a solid tumor by multiple diagnostic studies. However, the typical findings of a hyperdense parapelvic cyst may allow less aggressive surgery. PMID- 3824032 TI - Unilateral absence of ventilation and perfusion associated with a bronchial mucous plug. AB - We have described a patient in whom loss of ventilation and perfusion of an entire lung resulted from mucous impaction of a major bronchus. Mucous plugging was associated with the combination of asthma and decreased cough effectiveness due to paraplegia. Removal of the obstruction by bronchial aspiration followed by vigorous pulmonary physical therapy resulted in return of both ventilation and perfusion to the lung and relief of dyspnea and hypoxemia. PMID- 3824033 TI - Perforated anterior duodenal ulcer: diagnosis with technetium Tc 99m DISIDA. AB - Cholescintigraphy with technetium Tc 99m DISIDA has proven to be a useful method for evaluating perforations of the hepatobiliary system. We have reported the first documented case of anterior duodenal ulcer perforation diagnosed by hepatobiliary scintigraphy. PMID- 3824034 TI - Hypocalcemic congestive heart failure. AB - We have described a patient who had congestive heart failure associated with hypocalcemia. The heart failure improved as the serum calcium increased. We conclude that severe hypocalcemia may produce congestive failure in the normal heart. PMID- 3824035 TI - Cerebral arteriovenous malformation coexistent with intracranial aneurysm and persistent trigeminal artery. AB - We have described a patient with a cerebral arteriovenous malformation coexisting with a persistent trigeminal artery and carotid artery aneurysm. This combination of cerebral vascular anomalies implies that common factors may play a role in their genesis. PMID- 3824036 TI - Concurrent community-acquired pneumonia with Legionella pneumophila and Streptococcus pneumoniae. AB - Both Streptococcus pneumoniae and Legionella pneumophila are well defined causes of community-acquired pneumonia, and may be associated with substantial mortality. Optimal therapy consists of penicillin for the former organism and erythromycin for the latter. We have presented a case of pneumonia caused by simultaneous infection with both of these agents. Organisms were recovered either from blood or lung tissue. This case carries important implications for treatment of community-acquired pneumonia, and conceivably could explain some of the mortality that continues to be seen with pneumococcal pneumonia. PMID- 3824037 TI - Atypical community-acquired pneumonia: concurrent infection with Chlamydia psittaci and Mycobacterium tuberculosis. AB - We have presented a case of combined pulmonary infection with Chlamydia psittaci and Mycobacterium tuberculosis, both documented by culture of lymph nodes and respiratory secretions. We describe it not only as an unusual occurrence, but also to illustrate the importance of a systematic and thorough diagnostic approach to every case of pneumonia. PMID- 3824038 TI - Skeletal muscle weakness resulting from quinidine ingestion. AB - We have described a patient with muscle weakness caused by ingestion of quinidine sulfate. Intrafascicular perivasculitis and rare muscle fiber regeneration were present in the muscle at biopsy. A similar clinical picture has previously been reported in patients taking other medications, but not quinidine. PMID- 3824039 TI - Surgery for cerebrovascular insufficiency. PMID- 3824040 TI - Gastric partition after reversal of jejunoileal bypass. PMID- 3824041 TI - Publish or perish. PMID- 3824042 TI - Fetal distress with hydralazine. PMID- 3824043 TI - Lupus. PMID- 3824044 TI - [Sociologic survey of the opinion of district physicians concerning ways of improving the dispensarization of the population]. PMID- 3824045 TI - [Organization and ways of further development of neonatal services]. PMID- 3824046 TI - [Current problems in the organization of rehabilitation therapy]. PMID- 3824047 TI - [Efficient location of primary therapeutic-preventive institutions in rural locales]. PMID- 3824048 TI - [Organization of patient certification in the polyclinics of a consultative diagnostic service]. PMID- 3824049 TI - [The formulation and development of the problem of public health]. PMID- 3824050 TI - [Organization of the campaign against alcohol]. PMID- 3824052 TI - [Monitoring the quality of hospital medical services]. PMID- 3824051 TI - [A single alphanumeric designation for medical records in automated systems for dispensarization of the population]. PMID- 3824053 TI - [Various organizational aspects of the postgraduate education of physicians]. PMID- 3824054 TI - [Ways of improving the 1-year specialization of surgeons in the internship]. PMID- 3824055 TI - [Strengthening the cooperation between the USSR and liberated nations in the field of public health]. PMID- 3824056 TI - [Experience with the work of the WHO project for the control non-infectious diseases]. PMID- 3824057 TI - [The team form of work organization--a reserve for promoting the health of workers]. PMID- 3824058 TI - [Role of the sanitary-epidemiologic service in formulating plans for socioeconomic development]. PMID- 3824059 TI - Experimental spinal injuries with vertical impact. AB - Fifteen fresh, intact, human male cadavers suspended head down were dropped vertically from a height of 0.9-1.5 meters. In eight specimens the heads were restrained to simulate muscle forces. The head-neck complex was oriented for maximal axial loading of the cervical and upper thoracic spine. In several cadavers, load cells were placed in cervical bodies. Head impact forces of 3,000 7,000 N in the unrestrained, and 9,800-14,600 N in the restrained, cadavers were recorded. There were more cervical and upper thoracic fractures in the restrained cadavers than in the nonrestrained subjects. The biomechanic and pathologic findings, including results of cryomicrotomography and computed tomography (CT), are discussed. PMID- 3824060 TI - Axis fractures resulting from motor vehicle accidents. The need for occupant restraints. AB - A total of 625 patients who sustained acute cervical spine fractures were evaluated by the Spinal Cord Injury Service at Barrow Neurological Institute, Phoenix, Arizona, between January 1976 and January 1984. Of them, 107 had fractures of the second cervical vertebra. In a retrospective review, motor vehicle accidents were found to be the most common mechanism of injury, resulting in 73 (68%) of the 107 axis fractures. All axis fracture types were encountered in this subgroup: hangman's (27%), Odontoid Type II (39%), Odontoid Type III (15%), and miscellaneous fractures (19%). Only one of the 30 patients with complete medical records and detailed information about the accident was wearing a seat belt. Equally remarkable is that 15 of the 30 accidents were single car mishaps, where occupant restraints might theoretically provide the most protection. Sixteen of the 30 patients were thrown from their vehicles, another five were found in the backseat, which leads to the conclusion that a significant of the driving population does not wear seat belts or shoulder restraints. Patients with axis fractures from an automobile accident had a high rate of associated severe head injuries or other cervical spine fractures, three times that of patients with C-2 fractures from other causes. Motorists who are thrown from their vehicles suffer the most severe trauma and have the highest rates of morbidity and mortality. As many as 25% to 40% of individuals who sustain high cervical fractures in motor vehicle accidents die as a result of their injuries. PMID- 3824061 TI - Posttraumatic syringomyelia: the British Columbia experience. AB - Posttraumatic syringomyelia is an uncommon late complication of spinal cord injury. This study identified nine patients with posttraumatic syringomyelia and examined initial presentation, neurologic status, ability to perform functional activities, and results of treatment. Pain and numbness were the most common presenting symptoms. Motor impairment occurred later but was more disabling. Functional abilities depended mainly on the level of the original spinal cord injury. Three patients were managed conservatively and have had no significant progression of their neurologic deficit. Six patients were managed with syringoperitoneal or syringosubarachnoid shunts. Pain improved most consistently after surgery. Motor power improved less and sensation least. Ability to perform activities of daily living did not significantly change after surgery. Posttraumatic syringomyelia remains a difficult therapeutic problem in the spinal cord-injured population. PMID- 3824062 TI - Painless compressive cervical myelopathy with false localizing sensory findings. AB - Five patients who presented with clearly defined thoracic sensory levels were found by myelography and follow-up computed tomography (CT) to have cervical spinal cord compression. None of these patients had pain or an immediate preceding history of trauma. There is currently no satisfactory explanation for the large discrepancy between the sensory level and the level of cord compression in such patients. It is crucial that the clinician recognize the possibility of a cervical cord lesion in patients with such a presentation so that appropriate radiographic studies can be performed. Failure to appreciate this syndrome could result in failure to diagnose a treatable lesion. PMID- 3824063 TI - Epidural migration of extruded cervical disc and its surgical treatment. AB - Twenty-two patients with epidural migration of cervical disc fragments were reviewed. Disc sequestrations can migrate to the anterior, posterior, and lateral aspects of the spinal canal and are divided into four types according to their localizations. Those migrating to the anterior or posterior surface of the spinal canal, causing myelopathy, were removed through either an anterior or posterior route. Removal of lateral sequestration by uncoforaminotomy provided full recovery for all patients with radiculopathy and drop-attacks. The number of disc sequestrations was not always one: three fragments were present in three patients and two fragments in five patients. Various routes combined with other approaches were indicated to eliminate completely the freely migrating disc sequestra. PMID- 3824064 TI - Erythrocyte survival following intraoperative autotransfusion in spinal surgery: an in vivo comparative study and 5-year update. AB - A 5-year prospective study of intraoperative blood transfusion in 239 patients, most of whom had major spinal surgery, has been completed. Autotransfusion is safe, practical, and it reduces donor blood requirements and total blood loss by 50%. It eliminates host versus graft reactions and disease transmission. In 33 patients having major spinal surgery, the in vivo survival of autologous, homologous, and processed red blood cells (RBC) using the Cell Saver System were compared. The RBC survival studies were performed using chromium51 isotope labeling technique. The long-term survival of processed RBCs was normal over a 30 day period. There was no significant difference in the survival rate of the three groups studied. PMID- 3824065 TI - Surgical treatment of vertebral metastasis. AB - Fifty-seven patients with spinal metastases underwent 60 operations. 36 patients were operated on by anterior approach with decompressive coporectomy and stabilization by metal and methylmetacrylate and 24 patients by laminectomy and/or stabilization by osteosynthesis. Postoperative improvement of the pain syndrome was observed after 56 operations. Neurologic signs were present in 23 patients with paraplegia (5 patients) or paraparesis (18 patients); 15 of the latter patients improved and recovered walking capacity. Two types of metastasis were distinguished: corporal metastasis, in which vertebral wedging and posterior protrusion led to neural deficit, with a good prognosis if treated by anterior surgery, and pericordal metastasis in which the cord compression is due to metastatic proliferation into the spinal canal. Results after decompressive surgery, either by posterior or anterior approaches are more doubtful. Surgery is beneficial and should be preferred to radiation when there is medullary compression by corporal metastasis and also in the presence of intense pain or potential instability of the spine. PMID- 3824066 TI - Localization of foreign bodies in the spinal canal by computer-assisted biplanar digitizer. AB - This study is a report of the use of a computer-assisted biplane digitizer to locate shotgun pellets within the spinal canal in an incompletely paralyzed patient. It was necessary to determine if one or more shotgun pellets were located within the spinal cord of the patient. Because of the profusion of pellets it was not possible to determine which, if any, of the pellets were in the spinal canal by routine roentgenograms. The problem of determining the location of each pellet with respect to the spinal cord was resolved by the use of biplane radiography in conjunction with an x-ray digitizer and a computer program. This report presents the method for localizing foreign bodies and discusses the results of the procedure. It was concluded that the described method successfully located the position of pellets with respect to the spinal column and cord. This method may be useful for locating metallic fragments that have to be surgically removed in other patients sustaining spinal cord injury secondary to single missile wounds. PMID- 3824067 TI - Compression-distraction instrumentation of unstable thoracolumbar fractures: anatomic results obtained with each type of injury and method of instrumentation. AB - The quality of the reductions achieved in a consecutive series of 55 patients with unstable thoracolumbar fractures were correlated with the method of instrumentation, the type and level of injury, the effects of laminectomy and end plate fractures, and the length of time from injury to surgery. It was found that many of these variables were associated with significant differences (less than 0.05) in the percent correction achieved in anterior compression, angle of deformity, and sagittal plane translation. Specifically: compression combined with distraction produced the best overall anatomic results, but bilateral compression and bilateral distraction were most effective for reducing flexion- distraction and flexion--axial compression (burst) fractures, respectively; two or more level laminectomies adversely affected reductions; end-plate fractures did not; the best reductions were obtained in flexion--distraction injuries; and the poorest reductions occurred in flexion--axial compression injuries, lumbar fractures, and fractures operated on 6 weeks or more after injury. PMID- 3824068 TI - Mersilene tapes as a substitute for wire in segmental spinal instrumentation for children. AB - Sublaminar wires for segmental fixation have been a useful adjunct to internal fixation of the spine. Concern over broken wires in the spinal canal or fear of cut-through in soft bone led to the use of Mersilene tape to supplement Harrington or Luque rod fixation in six scoliotic children. No problems of infection or hardware loosening were noted. Mersilene tapes for segmental fixation may be useful where there is concern for wires in the spinal canal or with patients with soft bone and flexible curves. PMID- 3824069 TI - Mechanical response of a lumbar motion segment in axial torque alone and combined with compression. AB - In the current study, a nonlinear three-dimensional finite element program has been used to analyze the response of a lumbar L2-3 motion segment subjected to axial torque alone and combined with compression. The analysis accounts both for material and geometric nonlinearities and treats the facet articulation as a general moving-contact problem. The disc nucleus has been considered as an incompressible inviscid fluid and the annulus as a composite of collagenous fibers embedded in a matrix of ground substance. The spinal ligaments have been modeled as a collection of nonlinear axial elements. Effects of loss of intradiscal pressure and removal of the facets on the joint response have been analyzed as well. Torsion is primarily resisted by the articular facets that are in contact and the disc annulus. The ligaments play an insignificant role in this respect. For the intact segment, with an increase in torque, the axis of rotation shifts posteriorly in the disc so that under maximum torque it is located posterior to the disc itself. Loss of disc pressure increases this posterior shift whereas removal of the facets decreases it. Torque, by itself, cannot cause the failure of disc fibers, but can enhance the vulnerability of those fibers located at the posterolateral and posterior locations when the torque acts in combination with other types of loading, such as flexion. The most vulnerable element of the segment in torque is the posterior bony structure. PMID- 3824070 TI - Myoelectric analysis of the paraspinal musculature in relation to automobile driving. AB - In this study, the myoelectric activity of 12 paraspinal muscles of ten men aged 18-24 was recorded to examine the effects of backrest inclination and lumbar support in relation to driving. In total, 24 test conditions were evaluated over a 3.5-hour period in a single day. These tests were then repeated, changing the sequence over the next 4 days. The results indicate a complex interaction between the thoracic and lumbar regions of the back with the lowest myoelectric activity position of 120 degrees backrest inclination, 5 cm of lumbar support, and 13.5 18.5 degrees of seat inclination. Electromyogramatic (EMG) evidence of fatigue was not identified over a 3.5-hour period. The generally low levels of EMG activity and, presumably, disc pressure present in any seating position suggest that the paraspinal muscle activity may not play the predominant role in disc herniation as it relates to automobile driving. PMID- 3824071 TI - Biomechanics of lumbosacral spinal fusion in combined compression-torsion loads. AB - The current study investigates the stabilizing effects of three different types of spinal fusion to the juxta-free motion segments and to the fused segment of the lumbosacral spine under combined compression-torsion loads. Sixteen fresh human cadaver lumbosacral spines were tested under a simulated physiologic loading condition. The relative movements of the motion segments, as well as the angular rotations and the center of rotation were then computed and analyzed. The average torsional stiffness of the unfused three-motion segment was found to be 2.35 nm/degree. After fusion, the torsional stiffness did not increase significantly. Under the compression-torsional load, the anterior and bilateral lateral fusions provided adequate stabilizing effect on the fused segment. The posterior fusion provided the least amount of stabilizing effect. These findings are similar to the results of the compression-bending experiment. Whereas the compression-bending loads produced significantly increased stress at the juxta free segments, the compression-torsional loads did not produce any significant amount of increase in torsional stress at the juxta-free segments. PMID- 3824072 TI - The rate of pseudarthrosis (surgical nonunion) in patients who are smokers and patients who are nonsmokers: a comparison study. AB - To investigate the relationship of smoking with the rate of pseudarthrosis (surgical nonunion), 50 patients, who were smokers, and 50 patients, who were not, and who had had a two-level laminectomy and fusion during 1977 and 1978 were randomly selected for this study. Most of those participating had sustained job related injuries whereas the others had no common etiology for their back dysfunction. Most of the patients were from the southeastern United States. Ages ranged from 23 to 62 years, with a mean age of 42.4 years for smokers and 42.7 years for nonsmokers. There was an equal representation of males and females, with minorities represented according to their general percentage in the population. Examination 1 to 2 years after surgery revealed that 40% (20) of the smokers had developed a pseudarthrosis, whereas among nonsmokers, the rate was 8% (4). This finding appears to be independent of age, sex, or race and was statistically significant (chi 2 = 14.035, P = .001). It was hypothesized that the higher incidence of surgical nonunion among smokers may be related to blood gas levels. Nonsmokers showed no significant deficiencies, whereas smokers showed a mean PO2 level of 78.5% (normal = 95-97) and a mean O2 saturation level of 92.9% (normal = 95 or above). Implications and suggestions for further research are also discussed. PMID- 3824073 TI - Inefficacy of routine laboratory analysis of CSF obtained during myelography for suspected disc disease. AB - The routine laboratory analysis of cerebrospinal fluid (CSF) obtained during myelography is performed in many institutions. The records of 100 consecutive patients who had myelography for suspected disc disease were reviewed retrospectively. The laboratory analysis of the CSF obtained during myelography did not benefit patient management in any instance. In one case, the CSF results adversely affected patient management. The CSF analysis did not add any information to the myelogram result. The CSF protein level did not correlate in a statistically significant way with the degree of disc protrusion seen myelographically. PMID- 3824074 TI - The injudicious laminectomy. AB - This report is an attempt to point out a hazard of what would be otherwise competent treatment of acquired spinal stenosis, namely laminectomy and facetectomy, in a small group of patients who are osteoporotic and who also have a "minor" compression fracture in the area in which the surgery is contemplated. Three patients who had such laminectomies, with disastrous results, are presented, along with one patient who, instead, had internal fixation and fusion at the time of laminectomy with an excellent result. The latter approach is recommended in such cases. PMID- 3824075 TI - Discitis causing spondylolisthesis. A case report. PMID- 3824076 TI - Efficacy of spinal manipulation/mobilization: a meta-analysis. PMID- 3824077 TI - [Magnetic resonance anatomy of the female pelvis]. PMID- 3824078 TI - [High-resolution nuclear spin tomography of the hand]. PMID- 3824079 TI - [Computed tomographic demonstration of small quantities of air in the thoracic veins after bolus administration of contrast media]. PMID- 3824080 TI - [Gamma-camera functional scintigraphy in the differential diagnosis of Basedow's disease: results in 423 patients]. PMID- 3824081 TI - The management of common bile duct stones--surgical removal or endoscopic sphincterotomy. PMID- 3824082 TI - Primary pyogenic psoas abscess. A case report. PMID- 3824083 TI - The effect of large-bore infusion tubing on rates of flow through different cannulas. PMID- 3824084 TI - Acute arterial occlusion in the limb--is embolectomy enough? PMID- 3824085 TI - The lock-in spinal brace for postoperative immobilization. A report of results in 44 patients. PMID- 3824086 TI - Myeloma update. PMID- 3824087 TI - A diazophenylthio-ether-IgG probe for analysing fibrin- and fibrinogen-related antigens. AB - A technique for identifying and quantitating fibrin- and fibrinogen-related antigens (FRAs) in serum is described. Panspecific antifibrinogen IgG is bound covalently to diazotized aminophenylthio-ether cellulose paper discs. Under conditions of antibody excess, a disc probe extracts 95% of all fibrinogen related antigen from appropriately diluted serum samples. Bound antigen is then eluted from the washed probe and electrophoresed on 4-11% gradient SDS polyacrylamide gels. Derivatives of cross-linked fibrin, non-cross-linked fibrin and fibrinogen may thus be identified by their molecular weights, and their relative concentrations determined by densitometric analysis. The total amount of FRA is estimated by a radio-immunoassay which uses labelled D-dimer as the competitive antigen. The probes can extract as little as 0.20 and 0.15 microgram/ml of D-dimer and D-monomer, respectively. Specific FRA binding was confirmed with Western blotting. Potential interfering substances do not influence antigen binding to the discs and, since complete elution of all antigens is achieved, discs may be re-used. This procedure provides estimates of the serum levels of fragments YY, DY, X, DD, Y and D. The procedure is simple to perform and, as a research tool, may help to delineate some of the features of clotting disturbances in clinical states. PMID- 3824088 TI - Low-density lipoprotein-receptor gene haplotypes in Afrikaans-speaking patients with homozygous familial hypercholesterolaemia. Further evidence in support of a founder gene. AB - Pvu II and Stu I restriction fragment length polymorphisms of the low-density lipoprotein-receptor gene were used for receptor allele haplotype analysis in 6 unrelated white Afrikaans-speaking subjects with homozygous familial hypercholesterolaemia (FH). Five patients were homozygous for P-S+, one of four possible haplotypes, and 1 patient showed compound heterozygosity for P-S+ and P+S-. The haplotype distribution in these patients differed from the calculated distribution in the general Afrikaner population at the 5-10% level of significance. These data support the founder gene hypothesis advanced to account for the high frequency of FH in the Afrikaans population. Four non-Afrikaner homozygous FH patients, also investigated in this study, manifested a variety of haplotypes in conformity with the heterogeneity underlying FH reported by others. PMID- 3824089 TI - The occurrence of Z-type diabetes (tropical pancreatic diabetes) in the South African Indian. AB - The presentation of diabetes in the young South African Indian is atypical in that insulin-dependent diabetes mellitus is rare, while non-insulin-dependent diabetes mellitus is common. In addition, youthful onset of tropical diabetic syndrome (J-type diabetes) is extremely rare. To date there appear to be no reports on a further tropical malnutrition diabetic syndrome associated with pancreatic fibrosis and calcification (Z-type diabetes). Four Indian patients with features consistent with the diagnosis of Z-type diabetes are described. All were asthenic, came from a poor socio-economic background and developed insulin requiring diabetes in their youth; 3 of the 4 patients had pancreatic calcification. PMID- 3824090 TI - Phase II of a successful university-based in vitro fertilisation programme. Changes incorporated. AB - the ultimate goal of any clinical programme treating infertility by means of in vitro fertilisation and embryo replacement is to maximise the number of patients who become pregnant in a treatment cycle. A 12% pregnancy rate was previously reported from this unit. Following the instigation of changes and further modifications, an overall success rate of 27% per patient was obtained in phase II. The reasons for this improved success are hard to pinpoint, but experience and changes in methodology probably play a role. These changes are described and the results discussed. PMID- 3824091 TI - Cholecystectomy and truncal vagotomy with pyloroplasty. The effect on duodenogastric reflux. AB - An experimental study investigated the effect of truncal vagotomy and pyloroplasty (TV + P) alone or combined with cholecystectomy on bile reflux into the stomach. The amount of bile reflux was estimated by measuring the concentration of bile phospholipids in the gastric contents. During each test, reflux was measured over a continuous period of 6 hours. TV + P alone was not invariably associated with increased reflux. When cholecystectomy was added to the TV + P the amount of bile reflux increased significantly (P less than 0.01). TV + P inhibited the production of lysolecithin from lecithin. Pathophysiologically this is important because lysolecithin is considered to be injurious to gastric mucosa. PMID- 3824092 TI - Gastric juice carcino-embryonic antigen estimation. A useful additional test in the diagnosis of gastric carcinoma? AB - There is a high incidence of gastric carcinoma in the coloured population of the Western Cape. Diagnostic tests other than barium meal examination or gastroscopy were investigated. In this study 50 patients were assessed and grouped according to the gastroscopic and histological findings. Twenty-five patients with gastric carcinoma and 25 with benign gastric ulcer and/or chronic atrophic gastritis and/or intestinal metaplasia were tabulated. The gastric juice and plasma carcino embryonic antigen (CEA) levels were evaluated and compared in the two groups. The gastric juice CEA level was more useful than the plasma CEA level as an aid in diagnosing malignant gastric lesions. No correlation was evidence between CEA values and the extent of the gastric carcinoma and or histological typing. An elevated gastric juice CEA level was an additional aid in diagnosing gastric carcinoma. Markedly elevated values may also identify the high-risk patient who is prone to develop gastric carcinoma. PMID- 3824093 TI - [Methods of breech delivery at Tygerberg Hospital]. AB - In a retrospective descriptive study, all breech deliveries in Tygerberg Hospital from 1 October 1982 until 30 September 1983 are presented. The aim of the study was to determine the status of the method of breech deliveries in this hospital. There were 358 breech deliveries, all fetuses weighing 500 g or more. Of these, 80% were live born. Caesarean section accounted for 51.5% of the live births. These results correlate well with those reported in other series. PMID- 3824094 TI - A new low-flow oxygen-conserving cannula. AB - Evaluation of a low-flow, oxygen-conserving cannula in 20 hypoxaemic patients has shown that the new device produces equivalent saturation at half and quarter the oxygen flow rate of conventional nasal cannulas, resulting in a substantial saving of oxygen. PMID- 3824095 TI - Postpartum sterilisation by the Irving technique. A report of 200 cases at Paarl Hospital, CP. AB - Sterilisation by the Irving procedure accompanying caesarean section was the favoured form of sterilisation at Paarl Hospital from 1971 to 1985. No subsequent pregnancies have been reported from the 200 cases and this success is compared with sterilisation failure rates of 1.35% with the Pomeroy method, 1.27% with the total fimbriectomy method, 0.41% with the Vienna or modified Pritchard method, and 0.89% with the Filshie-clip method: Irving sterilisation is accordingly advised as the method of choice at the time of caesarean section. PMID- 3824096 TI - Asymptomatic iatrogenic right coronary artery dissection with spontaneous resolution. A case report. AB - A young woman with angiographically normal coronary arteries had asymptomatic iatrogenic catheter-induced dissection of her right coronary artery which was managed conservatively. Because of continuing chest pain despite therapy, over a year later she again underwent selective coronary arteriography; a Softip cardiovascular catheter (Angiomedics Inc., Minneapolis) was used without complication. This may be the first report of use of this catheter after previous iatrogenic coronary artery dissection caused by a more conventional type. It is also the first time that this catheter was employed in the RSA. The use of a Softip cardiovascular catheter may significantly reduce this complication of a common coronary angiography. PMID- 3824097 TI - Exophytic renal angiomyolipoma. A case report. AB - A case of a large exophytic renal angiomyolipoma is presented. Despite the features on excretory urography suggestive of an extrarenal mass, computed tomography provided information concerning the origin and pathological nature of the lesion. PMID- 3824098 TI - Cervical osteophytes and respiratory failure. An unusual case of upper airway obstruction. AB - An unusual case is presented in which large cervical osteophytes caused upper airway obstruction. The presenting features of acute-on-chronic respiratory failure and cor pulmonale were alleviated by permanent tracheostomy. PMID- 3824099 TI - Risk factors in young Indian males with myocardial infarction. AB - Risk factors were assessed in 108 young Indian males with myocardial infarction. The mean age was 36 years (range 21-40 years). Cigarette smoking was the most common risk factor (79% of patients). Serum cholesterol levels were above 6.5 mmol/l in 50% and serum triglyceride levels were above 2.0 mmol/l in 53% of patients. High-density lipoprotein cholesterol levels below 0.83 mmol/l were found in 52% of patients. Ninety-six per cent of patients had one or more of the following risk factors: a history of cigarette smoking, hypercholesterolaemia, hypertension, and abnormal glucose tolerance. Thus, in young Indian males with myocardial infarction, one or more risk factors are usually present. PMID- 3824100 TI - Pulmonary mucormycosis. PMID- 3824101 TI - Seminal plasma zinc levels in fertile and infertile men. PMID- 3824102 TI - Essay at working out an information system for the general practice. Part 2. PMID- 3824103 TI - [Exposure tests and their evaluation in mercury exposure]. PMID- 3824104 TI - A comparative approach to disability morbidity in the deep working plant at "Vasas-Petofi" shaft of the "Mecsek" coal mines. PMID- 3824105 TI - [The status of prophylaxis in the socialist countries]. PMID- 3824106 TI - [The health budget--a component of the financing of sociocultural activities by the state budget]. PMID- 3824107 TI - Report of the Commission on the Evaluation of Pain. AB - The following is a reprint of the report to Congress transmitted by the Department of Health and Human Services in response to a provision of the Social Security Disability Benefits Reform Acto of 1984 (Public Law 98-460). It also includes some of the report's appendix material. The congressional mandate called for a study, performed in consultation with the National Academy of Sciences, of how pain is evaluated in determining disability under titles II and XVI of the Social Security Act and for recommendations on how pain should be considered in evaluating disability under these programs. In addition to several recommendations for improvements in interviewing, applications, questionnaires, and development practices in "pain" cases by including pain specialists for consultative examinations, the Commission strongly advocated experiments to determine if individuals with impairment due primarily to pain can be reactivated and vocationally rehabilitated under appropriate programs or if such individuals should be allowed disability benefits. PMID- 3824108 TI - Treatment of renal calculi with extracorporeal shockwave lithotripsy. PMID- 3824109 TI - Adhesion formation to the uterine horn of the rat in response to nylon and a new absorbable clip. AB - We have evaluated the tissue reactivity as manifested by adhesion formation to the uterine horn of the rat in response to a new absorbable surgical clip. A standard lesion on the uterine horn was created and repaired with either nylon sutures or an absorbable clip. Adhesion formation to the operative site was evaluated using a point based grading system, seven, 21 and 120 days postoperatively. A statistically significant increase in adhesion formation and their severity was seen on the uterine horns repaired with the surgical clips. The adhesions did not improve with time. In two instances, abscesses were formed around the clips. The use of the surgical clips in the peritoneal cavity needs to be investigated further. Their use in women in the reproductive age group who wish to preserve their reproductive potential is discouraged. PMID- 3824111 TI - Electric current and voltage recordings on the myocardium during electrosurgical procedures in canines. AB - Voltage and current spectra were measured with probes placed directly on the canine myocardium during transurethral resection (TUR). It was determined that three factors may be related to potential cardiac effects during electrosurgical procedures: obvious low frequency components modulated from a center frequency of the electrosurgical generator; high current density due to high power setting during TUR, and duration of application of the cutting waveform. PMID- 3824110 TI - A prospective study of intraoperative histologic antrum and corpus boundary in patients undergoing highly selective vagotomy for duodenal ulcer. AB - The results of the present study demonstrate that, at the level of the proximal branch of Crow's foot of Latarjet, parietal cells are found, and therefore, it must be sectioned when performing highly selective vagotomy. At the level of the distal branch, antral mucosa is found. At the level of the middle branch, in almost one-half of the instances, parietal cells are found, and its section must be evaluated with gastric emptying studies. PMID- 3824112 TI - Splenectomy for idiopathic thrombocytopenic purpura. AB - Over a period of 20 years, splenectomy has been performed upon 216 patients with idiopathic thrombocytopenic purpura. Splenectomy resulted in an immediate and sustained platelet response in 72 per cent of these patients. An additional 7.4 per cent of the patients had a sustained platelet count of 150,000 per cubic millimeter develop while off all drug therapy within the first postoperative year. Of the remaining patients who failed to meet these criteria, only one died of subsequent thrombocytopenic bleeding and only eight remained on any therapy with steroids or other immunosuppressive agents at last follow-up examination. PMID- 3824113 TI - Choledochoduodenostomy, transduodenal sphincteroplasty and sphincterotomy for calculi of the common bile duct. AB - The clinical features, indications and operative results in a consecutive series of 246 patients who underwent choledochoduodenostomy (CDD) and transduodenal sphincterotomy or sphincteroplasty (TDS) over a period of ten years (1972 to 1981) were reviewed. The over-all mortality for CDD was ten of 190 patients (5.3 per cent) and three of 56 patients for TDS (5.4 per cent). The over-all major morbidity rate for these procedures was 11.6 per cent for CDD and 21.4 per cent for TDS. This was not a statistically significant difference, but there were more elderly patients (more than 65 years old) in the CDD group (60.5 per cent) than in the TDS group (21.4 per cent) (p less than 0.001). The major morbidity rate associated with elective operations was 10.7 per cent for CDD and 20.0 per cent for TDS which is significant (p less than 0.05). Long term follow-up study (one to 12 years and mean of four and one-half years) revealed six patients in the CDD group with sump syndrome or cholangitis, or both, (3.3 per cent) and three patients in the TDS group had cholangitis develop (5.7 per cent). Over-all, the results compared favorably with the published results of endoscopic sphincterotomy. We conclude that CDD is the operation of choice when a permanent biliary drainage procedure is indicated and TDS should be reserved for instances of ampullary gallstone impaction. PMID- 3824114 TI - Physiopathologic role of microlithiasis in gallstone pancreatitis. AB - A study of 108 patients with acute or acute relapsing gallstone pancreatitis was carried out in order to evaluate the incidence of biliary lithiasis and microlithiasis. The severity of pancreatic damage associated with both clinical states and the physicochemical characteristics of the minute stones were also evaluated. The results suggest that the risk of acute pancreatitis is increased in patients with microlithiasis and that in patients with acute pancreatitis due to microlithiasis the lesions are more severe. These results warrant the conclusion that cholecystectomy should be performed upon all patients with echographically detected microlithiasis, even in the absence of symptoms. Early surgical treatment must be performed whenever pancreatitis develops. PMID- 3824115 TI - The significance of stable patients with sternal fractures. AB - A retrospective review of patients admitted with sternal fractures without massive trauma to the chest or hypotension was undertaken. Chest pain was present in 59 of 60 patients while external signs of bruising were noted in one-third. The standard anteroposterior (AP) roentgenogram of the chest was diagnostic in all patients. Thirty-four (56.7 per cent) patients had 51 significant noncardiac injuries, an average of 1.5 injuries per patient. Most commonly, these were orthopedic injuries, fractures of the rib and closed head injuries. Sixty-two per cent of the patients with sternal fractures had abnormal electrocardiograms (ECG) at some time, of which 34 per cent had ECG changes consistent with ischemia. The admission ECG was normal in 20 (48 per cent) patients. Three of these patients subsequently had significant ECG changes. Fractures that were comminuted or involved the sternal angle were more likely to be associated with ECG abnormalities than were simple fractures of the sternal body. Only three patients had elevated creatine phosphokinase-myocardial bond fractions. Two dimensional echocardiography and biventricular radionuclide angiocardiography were normal in 11 patients, including five patients with ECG abnormalities. There were no deaths related to the sternal fractures per se or to associated injuries. Sternal fractures result from high energy trauma and should be suspected in patients with chest pain after blunt thoracic trauma. The lateral roentgenogram of the chest is the most useful diagnostic test. There is a high incidence of associated cardiac and noncardiac injuries in these patients mandating close observation with ECG monitoring in the intensive care unit. PMID- 3824116 TI - The biopsy of impalpable lesions of the breast. AB - It is not necessary to undertake special techniques for localization if impalpable lesions of the breast are noted on mammography before biopsy. A simple technique using measurements from the nipple to locate the lesion is described. This method reduces patient discomfort by eliminating preoperative manipulation without increasing the size of the specimen needed for biopsy of the breast. Any impalpable lesion excised must be submitted to serial section after paraffin embedding and must not be submitted to frozen section. PMID- 3824117 TI - Mobilization of anterior vaginal wall and creation of a neourethral meatus for vulvectomies requiring resection of the distal part of the urethra. PMID- 3824118 TI - Simplified technique for placement of implantable vascular devices. AB - A simplified technique for insertion of an implantable vascular device is described. Use of a percutaneous technique with adherence to the steps described with reference to the site of the venipuncture, use of sterile lubricant while introducing the sheathed tapered dilator and Silastic catheter, creation of the subcutaneous pocket after adequate catheter placement and routine use of fluoroscopy helped to avoid technical intraoperative complications, as well as reduce postoperative morbidity. PMID- 3824119 TI - Transanal excision of large sessile villous adenomas using an endorectal traction flap. AB - A technique is presented herein which allows a local transanal excision of large sessile villous adenomas with minimal morbidity and excellent preservation of specimen for complete histologic analysis. This technique is particularly applicable to elderly, poor risk patients and those patients with villous adenomas which extend so low in the rectum that anterior resection would be difficult or impossible. PMID- 3824120 TI - [Combination therapy of oropharyngeal and hypopharyngeal cancer]. PMID- 3824121 TI - [Combination therapy of far advanced oropharyngeal cancer]. PMID- 3824122 TI - [Combination treatment of hypopharyngeal cancer using endoscopic laser surgery and radiation follow-up]. PMID- 3824123 TI - [Radio-hyperthermia in oro- and hypopharyngeal cancer]. PMID- 3824124 TI - [Low-dose platinum radiosensitization in ear, nose and throat tumors]. PMID- 3824125 TI - [Selective intra-arterial chemotherapy]. PMID- 3824126 TI - [Comparison of intra-arterial and systemic chemotherapy of head and neck tumors]. PMID- 3824127 TI - [Combination therapy of oropharyngeal and hypopharyngeal cancer: present status and outlook]. PMID- 3824128 TI - [Surgery of oropharyngeal cancer with special reference to radiologic and surgical combination therapy]. PMID- 3824129 TI - [Operative management of hypopharyngeal cancer]. PMID- 3824130 TI - [Percutaneous radiotherapy of oropharyngeal and hypopharyngeal cancer]. PMID- 3824131 TI - [Therapeutic results after irradiation of advanced hypopharyngeal cancer]. PMID- 3824132 TI - [Oro- and hypopharyngeal cancer: the Basle concept of therapy]. PMID- 3824133 TI - [Radical surgery following preliminary irradiation of oropharyngeal cancer]. PMID- 3824134 TI - [Surgery of the lymph drainage passages in oro- and hypopharyngeal cancer]. PMID- 3824135 TI - [Interstitial brachycurietherapy of ENT tumors]. PMID- 3824136 TI - Lateral lumbar spine roentgenograms: potential role in complications of lumbar disc surgery. AB - Penetration into the abdominal cavity with injury to visceral, vascular, or neural structures is a potentially life-threatening complication of lumbar disc exploration. In this report, we used reconstructed computed tomographic measurements of the L3-L4, L4-L5, and L5-S1 intervertebral discs to show that lateral spine roentgenograms contain an unavoidable magnification error that makes accurate measurement of minimal depth to penetration impossible. This magnification error may mislead the unwary surgeon into an overestimation of actual disc size. Moreover, the "safe distances" that have been published for the avoidance of penetration at the L3-L4, L4-L5, and L5-S1 intervertebral levels would have been excessive for 22.2%, 19.4%, and 8.3%, respectively, of the 26 patients in our study. PMID- 3824137 TI - Incidental meningiomas in autopsy study. AB - Two hundred thirty-one cases of incidental meningiomas found at autopsy at the Montefiore Medical Center during the period from 1950 to 1982 were reviewed. The prevalence of incidental meningiomas increased with age, and was highest in people 80 years of age or older. The male to female ratio was 1 to 3. The relative size of the tumors also increased with age. Multiple meningiomas were found in 8.2% of the cases; none of them had stigmata of neurofibromatosis. PMID- 3824138 TI - The perivenous technique of resection of arteriovenous malformations from vital areas of the brain. AB - A total of 17 patients with arteriovenous malformations (AVMs) in sensitive areas of the brain were operated on and the AVMs were completely resected using perivenous techniques. No patient suffered a new neurological deficit following surgery. The perivenous surgical technique is most suitable for small AVMs in sensitive cortex. It differs from the standard approach in that it places emphasis on perivenous microsurgical dissection, identification of the nidus before major arterial feeders, and early ligation of selected venous channels. Three different types of venous drainage--single, multiple, and dual--were identified. Each different type of venous drainage requires a different surgical approach for the best results. PMID- 3824139 TI - Magnetic resonance imaging in head injured patients with normal late computed tomography scans. AB - In 11 patients who had undergone blunt head injuries, computed tomography (CT) scans of the brain performed 4-24 months posttrauma were normal. The patients showed a variety of cognitive and behavioral disturbances. Magnetic resonance imaging (MRI) studies revealed abnormalities that were mainly confined to the frontal and temporal lobes. Magnetic resonance imaging revealed signals of increased intensity compatible with old contusions, loss of discrimination between gray and white matter, and irregular brain contours. It is suggested that MRI of the brain is a more sensitive technique than CT in the detection of brain lesions during the late posttraumatic period, allowing a better understanding of the patient's clinical and neurobehavioral disturbances. PMID- 3824140 TI - Effects of temporary arterial occlusion on somatosensory evoked responses in aneurysm surgery. AB - Changes in the central conduction time (CCT) during the application of temporary clips were studied in 40 patients who had undergone operations for intracranial aneurysms in relation to postoperative neurological outcome. Ten of these 40 patients (25%) showed postoperative morbidity, although promptly recoverable in 5. None of the patients whose CCTs did not change following temporary occlusion of major vessels showed any postoperative morbidity, except in one case of anterior cerebral artery aneurysm. In 6 patients, temporary vascular occlusion caused a considerable transient prolongation in CCT of up to 10 msec. Two of these 6 patients were associated with postoperative neurological deficit (which was recoverable in 1). The cortical response became flat in 15 patients. Seven of these 15 patients showed hemispheric deficits postoperatively, although recoverable in 4. There was a correlation between the change in the somatosensory evoked response and postoperative outcome. Disappearance of the N20 potential following occlusion is regarded as a danger signal, but postoperative, irrecoverable neurological deficit seems to be unlikely if its disappearance takes more than 3-4 minutes. Even if the cortical response disappears, the clinical outcome is expected to be good if the N20 potential recovers within 20 minutes after recirculation. PMID- 3824141 TI - Subdural fluid collection following craniotomy. AB - The occurrence of subdural fluid collection following craniotomy for intracranial aneurysms was studied with regard to the patient's age, preoperative grade, external decompression, incidence of the craniotomy, external drainage, and ventriculoperitoneal shunt. The following results and conclusions were obtained: Enlargement of the subdural space was observed in 76 of 147 patients (51.7%). The patient's age was the most likely causative factor in producing the lesion. Six patients required surgical management for the collection: three were for subdural hygroma and three were for chronic subdural hematoma. It is estimated that two factors, multiple craniotomy and younger age, accelerated the formation of symptomatic subdural hygromas. When the patient complains of headache or motor weakness 1 or 2 months after undergoing a craniotomy, one should suspect chronic subdural hematoma, especially in an elderly patient with ruptured aneurysm. PMID- 3824142 TI - Computer graphics in the assessment of severity of spasmodic torticollis: potential role in the evaluation of surgical treatment. AB - There is a need for objective evaluation of the effectiveness of treatment of spasmodic torticollis so that comparisons can be made between different therapies. Video tape recordings of patients undergoing surgery for spasmodic torticollis were digitized and the movement of a reference marker was tracked by computer. A graphic presentation of oscillation of the marker around a mean position was obtained. Comparison of preoperative and postoperative recordings enabled assessment of the effectiveness of surgery. The results can be tabulated, facilitating accurate documentation of large series of results in publication. This should enable easier comparison of the effectiveness of different therapies. PMID- 3824143 TI - Computed tomography and magnetic resonance imaging in spinal hydatidosis. AB - Computed tomography and magnetic resonance imaging in patients with spinal hydatidosis provide comprehensive evaluation of the actual extent of the disease. Paravertebral uncalcified cysts, hardly recognizable by conventional radiologic examinations, are clearly shown by both methods. Initial involvement of the spongy bone is evident in computed tomography scans, in contrast to what usually appears to be normal in plain films or tomograms. Occurrence of cysts within the spinal canal is revealed by both types of computed scans, with magnetic resonance imaging being able to provide further information on the involvement of the spinal cord. PMID- 3824144 TI - Definitive diagnosis of extreme lateral lumbar disc herniation. PMID- 3824145 TI - Benign osteoblastoma of the cervical vertebra. AB - A 31-year-old patient, with a relatively uncommon benign osteoblastoma of the sixth cervical vertebra, exhibited symptoms of spinal cord compression. Computed tomographic metrizamide myelography was very useful in the preoperative planning, particularly for locating the position and extent of the lesion. The tumor was totally removed via posterior and anterior approaches in a two-stage operation. Roentgenograms, taken 1 year and 6 months postoperatively, showed good bony union with no evidence of tumor recurrence. PMID- 3824146 TI - Vertebral hemangiomas presenting with neurologic symptoms. AB - Six cases of spinal hemangiomas with neurologic symptoms are reported. In three of them the diagnosis was obtained before surgery using plain x-rays and spinal computed tomography scan or biopsy. In the other cases the diagnosis was not done before surgery. In two cases preoperative embolization had minimized blood loss during surgery. Laminectomy was performed in three cases. Large removal and/or vertebrectomy was carried out in the other cases. Our results and a review of the literature about the investigations and treatment of vertebral hemangiomas led us to propose a stereotypical management of spinal hemangiomas with neurologic symptoms. PMID- 3824147 TI - Microsurgical anatomy of the brainstem surface facing an acoustic neuroma. PMID- 3824148 TI - The palmomental reflex. PMID- 3824149 TI - Pseudotumor cerebri. PMID- 3824150 TI - Trends in longevity after age 65. PMID- 3824151 TI - Profile of centenarians. PMID- 3824152 TI - Alcohol use in the United States. PMID- 3824153 TI - Regional variation in mortality from motor vehicle accidents. PMID- 3824154 TI - Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. AB - Five patients who suffered catastrophic colonic necrosis are presented. All patients were uremic and received sodium polystyrene (Kayexalate) in sorbitol enemas for the treatment of hyperkalemia shortly before the development of signs and symptoms of colonic necrosis. In all specimens extensive ischemic necrosis was present, and Kayexalate crystals were noted in the intestinal lumen. Four of the five patients eventually died. To further investigate the occurrence of colonic necrosis after the administration of Kayexalate in sorbitol enemas, a series of experiments were performed in rats. Two groups of Sprague-Dawley rats were studied. One group was made uremic by performance of bilateral nephrectomy. The other group underwent sham operation. Enemas of saline, Kayexalate alone, sorbitol alone, or Kayexalate in sorbitol were administered. In nonuremic rats, transmural necrosis was noted in seven of 10 rats receiving sorbitol enemas and in six of 10 rats receiving Kayexalate in sorbitol enemas. No significant pathologic changes were noted in the rats receiving other enemas. In uremic rats, extensive transmural necrosis was noted in all rats receiving enemas of sorbitol or Kayexalate in sorbitol. All of these 19 rats died within the period of observation compared with no deaths in 18 rats that received enemas without sorbitol (p less than 0.001). PMID- 3824155 TI - Hypercholesterolemia and early restenosis after carotid endarterectomy. AB - Cellular proliferation in response to endothelial injury has been examined extensively in experimental animals. Under certain conditions (e.g., hypercholesterolemia and hypertension), this response can be exaggerated and develop into lesions that resemble early atherosclerosis. The injury caused by endarterectomy in human beings and the repair of the arterial wall that ensues may be analogous to the animal models. Presumably, those patients with an exaggerated proliferative response manifest myointimal hyperplasia and recurrent stenosis. To determine potential causes of recurrent stenosis after carotid endarterectomy, we studied 31 patients with early restenosis (group I), 35 patients with later restenosis (group II), and compared them with a control group of 100 consecutive patients who underwent uncomplicated carotid endarterectomy (group III). The known risk factors for atherosclerosis were analyzed. There was no significant difference in the male-to-female ratio, number of cigarettes smoked, or incidence of diabetes mellitus. However, the serum cholesterol level for group I was 282 +/- 57 mg/dl (p less than 0.001 versus controls) while the serum cholesterol level in group II was not significantly elevated over that of the control group. Both groups I and II had a higher incidence of hypertension (p less than 0.005 for both versus controls). There were no differences in the severity of hypertension. The data suggest that hypercholesterolemia has a strong association with early restenosis after carotid endarterectomy but not with late recurrent disease and that hypertension, even when treated, may be associated with both early and late recurrent stenosis. PMID- 3824156 TI - The role of leukocytes in the production of oxygen-derived free radicals in acute experimental pancreatitis. AB - Oxygen-derived free radicals mediate an important step in the initiation of experimental acute pancreatitis in the ex vivo perfused canine pancreas model. In other organ systems, circulating leukocytes may serve as one source of oxygen derived free radical production. The current experiments were designed to evaluate the role of circulating leukocytes in the generation of injury in this model. Four experimental groups of animals were studied: group I consisted of controls (n = 6); group II had white blood cell (WBC) depletion (n = 4) in which the recirculating whole blood perfusate was depleted of 98% of its circulating leukocytes; group III had oleic acid infusion (FFA) alone (n = 9), which induced pancreatitis; group IV had WBC depletion and FFA (n = 6), in which oleic acid was infused after depletion of the circulating leukocytes in the perfusate. During the 4-hour perfusion period, the pancreatic preparations were monitored hourly for the development of edema, weight gain, and release of alpha-amylase into the perfusate. Animals in groups I and group II manifested no gross edema, gained minimal weight, and did not manifest hyperamylasemia. Leukocyte depletion alone had no effect. In group IV animals marked edema, significant weight gain, and hyperamylasemia developed to the same extent as in group III animals. These results demonstrate that circulating leukocytes are not essential to the development of pancreatitis in this model and suggest that another source of oxygen-derived free radicals mediates this injury. PMID- 3824157 TI - In vivo glucose absorption by neomucosa. AB - Growing neomucosa has been investigated as a means of permanently increasing intestinal absorption in the short-bowel syndrome. The purpose of this study was to quantitate in vivo glucose absorption by neomucosa and correlate this with neomucosal growth. Thirteen New Zealand White rabbits (2.3 to 3.8 kg) had 2 by 5 cm ileal defects patched with colon serosa, and there was 12 control animals. Glucose absorption was determined by measuring the appearance of radioactivity in the portal vein and vena cava after topical application of [14C]-glucose. At 2 weeks the patched defect is partially covered by a thin layer of columnar epithelial cells. Mature villi are present at 8 weeks. The maximum rate of absorption by neomucosa was significantly greater 8 weeks after patching than at 2 or 4 weeks (0.067 +/- 0.103 versus 0.020 +/- 0.004 and 0.012 +/- 0.003 microCi/min) but was significantly less than normal mucosa (0.264 +/- 0.142 microCi/min, p less than 0.05). Similarly, glucose absorption in the first 20 minutes by neomucosa was greater at 8 weeks than at 2 and 4 weeks (13.0% +/- 6.2% versus 4.7% +/- 0.5% and 6.5% +/- 1.33%, p less than 0.05). Colon serosa also absorbed significant glucose. Neomucosa absorbs glucose in vivo. The rate and amount of absorption correlate with neomucosal growth. Significant glucose absorption by colon serosa has implications for the transperitoneal delivery of nutrients. PMID- 3824158 TI - Cuff-occluded rate of rise of peripheral venous pressure: a new, highly sensitive technique for monitoring blood volume status during hemorrhage and resuscitation. AB - We investigated the cuff-occluded rate of rise of peripheral venous pressure (CORRP)--a new, nearly noninvasive peripheral hemodynamic monitoring parameter- in dogs subjected to hemorrhage and resuscitation. Twelve adult mongrel dogs under general anesthesia were subjected to hemorrhage of 30% of their estimated total blood volume (TBV) for 30 minutes; after this time the extracted blood was reinfused. Arterial pressure (AP), central venous pressure (CVP), pulmonary arterial pressure (PAP), cardiac output (CO), pulmonary venous pressure (PWP), heart rate, and CORRP were continuously monitored. A "clinically significant change" (CSC) in CORRP and CO was defined as a change that exceeded two standard deviations from the mean of five baseline measurements made before the onset of hemorrhage, whereas a CSC in PWP or CVP was conservatively defined as a change that exceeded 2 mm Hg from the average of five baseline measurements, and a CSC in PAP and AP was defined as a change that exceeded 3 mm Hg and 5 mm Hg, respectively from the average of the baseline measurements. There was no consistent change in heart rate during hemorrhage. Thus defined, a CSC in CORRP occurred after an average extraction of 9.2% +/- 4.7% TBV, whereas a CSC was not seen until an average loss of 16.5% +/- 8.1% TBV for AP, 21% +/- 13% TBV for PWP, 15.5% +/- 7% TBV for PAP, and 35% +/- 3% TBV for CVP. These average blood losses are all significantly different from the average blood loss required to effect a CSC in CORRP. The blood loss required to effect a CSC in CO averaged 9.7% +/- 6%. We conclude that in these anesthetized dogs, CORRP detected blood loss earlier than other commonly used hemodynamic parameters, including several invasive parameters such as CVP, PAP, and PWP; CORRP and CO were equivalent in their ability to detect early stages of blood loss. PMID- 3824159 TI - Supraceliac aortofemoral bypass. AB - Increasing numbers of patients with aortoiliac disease are seen with contraindications to standard infrarenal aortofemoral reconstruction. Although axillofemoral bypass is possible in these patients, the decreased patency rate associated with this operation makes alternate procedures desirable. This report details our experience with prosthetic bypass from the supraceliac aorta to the femoral arteries in seven patients with limb-threatening ischemia of the lower extremity, all of whom had undergone multiple previous aortic operations. The operations were performed through thoracoabdominal or flank incision, and the preferred graft configuration consisted of a single Dacron tube from the aorta to the left groin with a standard subcutaneous femorofemoral graft to the right groin. No surgical deaths occurred. At 3 1/2 years' mean follow-up, there has been one graft limb occlusion that resulted in amputation for an overall life table patency and limb salvage rate of 93%. We conclude that supraceliac to femoral artery bypass is a useful procedure for the treatment of patients who have had multiple previous aortic reconstructions fail. PMID- 3824160 TI - Fluorometric quantification of low-dose fluorescein delivery to predict amputation site healing. AB - This retrospective study evaluated quantification of skin fluorescein delivery by fiberoptic fluorometry as a means of predicting the healing potential of an amputation site. Fluorometry uses a dual-channel fiberoptic light guide--one channel transmits blue light to excite the fluorescein in the skin under study, and the other transmits emitted fluorescence from the skin to a photomultiplier tube where it is measured. Ten minutes after intravenous administration of sodium fluorescein (4 to 8 mg/kg), fluorometric readings were obtained at more than 100 reading sites. In the 86 cases without preoperative cellulitis at the site of amputation, preoperative fluorometry clearly distinguished between healing and nonhealing sites. Healing sites averaged 79% of the fluorescence of a healthy reference area (dye fluorescence index [DFI] = 79), while failing sites averaged only 27% (p less than 0.01 by ANOVA). In all but one case where the DFI was greater than 42, the amputation healed. In all cases where the DFI was less than 38, the amputation failed. In general, uncertainty was limited to sites with values between these limits. The technique maintained its high accuracy in patients with diabetes and for distal amputations. However, it was not accurate at sites of active cellulitis (12 cases). There were no significant adverse effects from the slow injection of the low dose of fluorescein used for this technique. We conclude that fluorometry is an effective means of predicting healing in patients undergoing amputation. PMID- 3824161 TI - Temporal efficacy of allopurinol during the induction of pancreatitis in the ex vivo perfused canine pancreas. AB - Oxygen-derived free radicals play an important role in the pathogenesis of experimental acute pancreatitis in the isolated perfused canine pancreas. We have previously found that pretreatment with allopurinol inhibits xanthine oxidase- apparently the primary source of free radical generation in this model--and prevents the initial development of pancreatitis. In these experiments, we evaluated whether allopurinol administered after the onset of pancreatitis would arrest the progression of the disease process. Edema formation, weight gain, and the release of amylase activity into the perfusate in the ex vivo perfused canine pancreas model were monitored during a 4-hour perfusion period. There were six experimental groups: Group I (control) received no treatment, group II (allopurinol alone) received only allopurinol (100 mg) at the start of perfusion, and groups III through VI were each given an infusion of 0.3 ml of oleic acid (FFA) over a 1-hour period to initiate acute pancreatitis. Group III (FFA alone) received no other treatment. In group IV (pretreatment with allopurinol), group V (concurrent treatment with allopurinol), and group VI (posttreatment with allopurinol), allopurinol (100 mg) was administered 1 hour before, concurrent with, or at the end of the FFA infusion, respectively. Pretreatment with allopurinol prevented edema formation, markedly attenuated weight gain, and the release of amylase caused by the FFA infusion. Administration of allopurinol concurrent with the FFA infusion provided only partial protection, whereas posttreatment with allopurinol failed to arrest the progression of the injury process. Therefore, the use of allopurinol to inhibit oxygen-derived free radical production from xanthine oxidase prevented the development of acute pancreatitis in this model; however, treatment with allopurinol after initiation of the disease process failed to arrest the progression of acute pancreatitis. PMID- 3824162 TI - Assessment of venous muscle pump function by ambulatory calf volume strain gauge plethysmography after surgical treatment of varicose veins: a prospective study of 21 patients. AB - A prospective study of the improvement in leg muscle pump function after radical surgery was performed for treatment of varicose veins. Venous muscle pump function was assessed in 21 patients with primary varicose veins by means of ambulatory strain gauge plethysmography immediately before surgery and 3 months and 60 months after surgical treatment of varicose veins. The physiologic documentation of the operative efficacy was provided by the mean venous reflux, which was reduced by 54% (p less than 0.001), and the mean expelled volume, which was increased by 58% (p less than 0.001). Initially, all patients had improved venous muscle pump function. This improvement was still present 60 months after surgery. At clinical assessment 3 months after surgery, it was noted that 90% of the patients were without residual varicose veins (p less than 0.01). Sixty months after surgery, 71% of the patients were without apparent varicose veins (p less than 0.05). Subjective symptoms had virtually disappeared 3 months after surgery (p less than 0.001) but were found to a variable extent in 80% of the patients at the 60-month control follow-up. It is concluded that ambulatory strain gauge plethysmography may quantitate the effect of surgery in patients with venous valvular incompetence; in addition to measurements of refilling time, it is able to measure the muscle-pump-generated expelled volume because of in place electrical calibration. PMID- 3824163 TI - Alcohol abuse and chronic pancreatitis. AB - The relationship between alcohol abuse and pancreatitis is now better defined than it once was. However, the effects of abstinence on the outcome of treatment are less clear, although it is generally assumed that abstinence is associated with a better outcome. The present study of 28 alcoholics confirms the importance of abstinence and demonstrates an important relationship between narcotic abuse and continued drinking. This suggests a profound psychosocial disturbance in a patient unlikely to benefit from surgery. These findings justify recommending other approaches to the management of patients with chronic pancreatitis who are likely to continue to drink, particularly when there is a history of significant narcotic abuse. PMID- 3824164 TI - Type IV gastric ulcer: a new hypothesis. AB - In 1965 Johnson proposed his classification for gastric ulcer, which was subsequently adopted by the majority of surgeons. However, for many years we have observed the high frequency of subcardial or juxtacardial ulcers near the esophagogastric junction, which has not been reported elsewhere. In this article we describe the characteristics of this type of gastric ulcer and propose to designate it as a type IV gastric ulcer. This nomenclature is based on its clinical and pathophysiologic features. The anatomically "high" gastric ulcer has an incidence of 27.4%; its main features include a frequent association with the type O blood group; a low basal and stimulated acid output, a high incidence of upper gastrointestinal bleeding, a slower emptying of fluids, and a high percentage of deep penetrating ulcer. PMID- 3824165 TI - Gastric duplication cyst communicating with aberrant pancreatic duct: a rare cause of recurrent acute pancreatitis. AB - An 18-year-old patient who had recurrent attacks of acute pancreatitis was found on endoscopic retrograde cholangiopancreatography to have an aberrant pancreatic duct which communicated with a juxtagastric cyst. Excision of a gastric antral duplication cyst and the aberrant pancreas was curative. Of the five previously reported cases, none of which had endoscopic retrograde cholangiopancreatography before surgery, all but one required multiple operations before the correct diagnosis was made. PMID- 3824166 TI - Axillary artery thrombosis: a complication of axillo-femoral bypass grafts. AB - We report three cases of late axillary artery thrombosis after axillofemoral bypass grafting. In each patient the artery was found to have been pulled down by the graft and angulated sharply. This is an important complication, which resulted in the loss of a limb in one patient. It is recommended that the upper anastomosis must be explored without delay. Anticoagulation or attempts to clear the thrombus with the more distal branchial artery approach are unlikely to be successful and serve only to delay definitive management. PMID- 3824167 TI - Computerized axial tomography (CT) as an aid in the diagnosis of hepatic portal venous gas: a case report. AB - The radiologic finding of hepatic portal venous gas and its surgical implications have been documented previously in the literature. More than 67 cases have been reported. Branching tubular lucencies that extend from the porta hepatis to the edge of the liver are characteristic. In general, air in the biliary tree is central in location, but the distinction may not always be clear. We present a case in which computerized axial tomography was extremely helpful in localizing extraluminal gas to the liver and differentiating between air in the biliary tree and hepatic portal venous gas. PMID- 3824168 TI - Nonoperative management of blunt abdominal trauma in childhood. PMID- 3824169 TI - Cystic tumors of the pancreas. PMID- 3824170 TI - [Value of determining glycosylated lipoproteins in the diagnosis of ischemic heart disease in diabetics]. PMID- 3824171 TI - [Limitation of the extent of a myocardial infarct by lysing the thrombus using intracoronary streptokinase]. AB - A total of 66 patients with acute myocardial infarction (MI) were examined: 39 of them received treatment with intracoronary administration of streptokinase within the first 3-20 h from the beginning of anginal pains, the other 27 patients (controls) were treated using routine methods. Occlusion of the coronary artery (CA) was found in 31 of 39 patients of the intervention group, stenosis over 75% was found in 8 patients. CA recanalization was achieved in 21 of 31 patients with CA occlusion. CA stenosis of various degree remained at the site of former occlusion in all the patients after recanalization. Repeated coronarography in 28 days showed reocclusion of the coronary artery at the site of stenosis in 20% of the cases. Blood flow restoration in the CA was often accompanied by the appearance of ventricular arrhythmias. Data on precordial ECG mapping (35 leads) showed the development of lesser size MI in the patients with the restored blood flow in the CA as compared to the group on routine therapy. PMID- 3824172 TI - [Diagnostic possibilities of MR-tomography of the adrenals of patients with essential hypertension]. AB - MR-tomography was employed for examination of 41 patients with arterial hypertension (AH). Aldosteroma was diagnosed in 11 patients, pheochromocytoma in 4 patients, paraganglioma in one patient. 25 patients with essential hypertension (EH) were entered into the comparison group and 16 healthy persons into the control group. Computerized tomography of the adrenals was performed in all the examinees. In MR-tomography normal adrenals were visualized as homogeneous formations of low intensity image surrounded by high intensity image of the retroperitoneal fat. In the patients with stage I-IIA EH adrenal shape and sizes did not differ from those in the control group. Certain enlargement and deformity of the adrenals were noted in the patients with stage IIB-III EH, especially in a malignant course of disease. Aldosteroma on MR-tomograms was visualized as an additional formation in the adrenal field, had a rounded or oval shape with regular clear contours; by intensity of image the tumor was similar to the liver. In the pheochromocytoma patients the tumor was also of a rounded shape, not always with clear borders, in one case with signs of the penetration in the vena cava inferior which was clearly visualized on the frontal sections. Paraganglioma found in one patients in the hilus of the left kidney, was of an oval shape with a high intensity signal, similar to that from the sympathetic chain. A study conducted in 3 reciprocally perpendicular planes clearly showed that the tumor adjoining the aorta was unconnected with the renal vessels. PMID- 3824173 TI - [Features of the clinical picture and diagnosis of nonspecific aorto-arteritis with lesions of the arch of the aorta]. AB - A total of 68 patients with non-specific aortoarteritis (NAA) and the involvement of the aortic arch and its branches were observed. The onset of disease in a young age, a high frequency of cerebro-ischemic disorders and involvement of the other vascular regions, late diagnosis were typical signs. Knowledge of NAA clinical peculiarities, thorough examination of patients using physical and instrumental methods turned out decisive in diagnosis. PMID- 3824174 TI - [Clinical variants of the course of chronic abdominal ischemia in mesenteric atherosclerosis]. PMID- 3824175 TI - [Quinidine therapy of paroxysmal arrhythmias]. PMID- 3824176 TI - [Prolapse of the aortic valve]. AB - Prolapse of the aortic valve (PAV) was diagnosed in 20 patients using a method of two-dimensional echocardiography. PAV primary and secondary forms were distinguished. Congenital pathology of the other cardiac valves (prolapse of the atrioventricular valves and the bicuspid aortic valve) or the aorta was observed in primary PAV. Secondary PAV was observed as a concomitant pathology in dilatation of the aortic root resulting from atherosclerosis or in an infectious process on the aortic cusps in subacute septic endocarditis. Of non-invasive diagnostic methods the most effective one was two-dimensional echocardiography which could be regarded as a verifying method in PAV. PMID- 3824177 TI - [Steroid cardiopathy]. PMID- 3824178 TI - [Infarct-like EKG in a primary tumor of the heart--rhabdomyosarcoma]. PMID- 3824179 TI - [Association of tumor of the heart with idiopathic hypertrophic subaortic stenosis]. PMID- 3824180 TI - [Possibilities and prospects for the development of rheographic methods for studying the circulatory system]. PMID- 3824181 TI - [Comparative characteristics of the structuro-functional state of the heart in patients with essential hypertension and pulmonary arterial hypertension]. AB - Heterogeneity of the structural-functional state of the right and left sides of the heart was detected in patients with essential hypertension and pulmonary arterial hypertension. Pulmonary hypertension was characterized by a raised frequency of development of asymmetric interventricular septal hypertrophy, pronounced diastolic dysfunction, considerable hypertrophy of the right ventricular anterior wall, an increased amplitude of its movement and noticeable dilatation of the right ventricular cavity. PMID- 3824182 TI - [Status of central and peripheral hemodynamics in borderline arterial hypertension]. PMID- 3824183 TI - [Correlations among various indices characterizing the psychological and somatic status of patients with essential hypertension]. AB - The interrelationships between the psychic status according to the MMPI test findings and indices of the central hemodynamics, microcirculation and working capacity were studied in 263 persons with borderline arterial hypertension and patients with essential hypertension. Significant non-linear correlations between hypochondriac, anxiety-depressive and hysteric tendencies, on the one hand, and parameters of arterial pressure, peripheral vascular resistance, cardiac output and tolerance to physical exercise, on the other hand, were revealed in essential hypertension. PMID- 3824184 TI - [Baroreflex regulation of circulation in essential hypertension patients treated with anaprilin]. AB - The effect of propranolol on the baroreceptor reflex and the main indices of the central hemodynamics in single (i. v.) and prolonged (per os) administration of the drug were studied in patients with essential hypertension. The hemodynamic effect of propranolol depended, to a large extent, on the initial value of the baroreflex and its time course during treatment. Possible mechanisms of the effect of propranolol on the baroreflex were discussed. PMID- 3824185 TI - [Evaluation of the effect of obsidan in essential hypertension patients with different types of circulation]. AB - A study of the effect of propranolol on the central hemodynamics using the polycardiographic method in 90 patients with essential hypertension showed that in 83% of them, disregarding the type of hemodynamics, beta-blocker made a negative chronotropic effect, and in 17% of the patients it increased the heart rate. In the patients with the hyperkinetic circulation the negative inotropic effect of propranolol was noted in 42% of the cases, and in the patients with the eu- and hypokinetic circulation 37.5%. However, the improvement of myocardial contractility expressed in an increase in the cardiac and stroke blood volume, the stroke and cardiac indices, and a decrease in peripheral vascular resistance were found in 24.4% of the total number of patients. PMID- 3824186 TI - [Difficulties and successes in the treatment of resistant forms of heart failure]. PMID- 3824187 TI - [Express-method of assessing the status of hypertension control]. AB - The authors describe a method for evaluating arterial hypertension control among the unorganized population visiting polyclinics and organized population taken care of at the medical centers. The method was tried in the city of Chelyabinsk as applicable to a randomized population sample of a medical territorial district and to a randomized sample (8%) of the workers from 9 shops of the steel plant. The method lies in the study of the population health status (arterial hypertension prevalence and knowledge, treatment coverage and efficacy) and of the documentation available at the treatment and prophylactic institutions concerning arterial hypertension control (coverage, registration, scope of examinations, and so forth). It is shown that the method is unsophisticated and feasible for examination of the population and documentation requires 5 days. It is suggested that the method should be used in the study of the situation concerning arterial hypertension control as well as in the study of the problems in the control of other non-infectious diseases. PMID- 3824188 TI - [Permeability of erythrocyte membranes to water in arterial hypertension. Findings from an epidemiologic study]. PMID- 3824189 TI - [Fractional composition of serum calcium in chronic heart failure]. AB - The total calcium concentration (Cat) using an atom-absorption spectrophotometer and ionized calcium concentration (Ca2+) with ionoselective electrodes were determined in the blood serum of 28 healthy persons and 159 patients with chronic cardiac insufficiency (CCI). The blood serum Cat concentration in CCI decreased clearly in parallel with its gravity. Ca2+ concentration remained within normal fluctuations shifting to their low border ("hypocalcemia within normal"). These shifts of the calciemia fractional composition were determined by a decrease in the calcium-binding capacity (CBC) of serum buffers resulting in a decreased portion of the physiologically inert nonionized (bound) fraction in Cat. Cat concentration grows with the effective treatment of CCI, perhaps as a result of the normalization of CBC. PMID- 3824190 TI - [Dynamics of respiratory function and and bicycle ergometry in the treatment of patients with chronic circulatory failure]. AB - Data are presented on external respiration at rest and during exercise (bicycle ergometry) in 20 patients with chronic circulatory insufficiency due to a variety of heart diseases, as well as variation in the above in the course of treatment with digoxin and calcium antagonist corinfar. External respiration parameters of the examined patients were compared with those of 40 apparently normal controls. Some mechanisms of action and the effects of digoxin, corinfar and combined use of the two on external respiration parameters are discussed. Evidence is obtained that digoxin and corinfar improve these parameters, particularly when used in combination, therefore combined digoxin/corinfar therapy is certainly advisable as part of combined treatment for chronic circulatory insufficiency. PMID- 3824191 TI - [Efficacy of corvaton in the long-term ambulatory treatment of heart failure in patients with rheumatic heart lesions]. AB - Corvaton treatment of 23 patients with congestive heart failure caused by rheumatic valvular heart diseases, continued for 10 mos. An increase in the stroke and minute blood volume in the chest, leg and fingers, and a decrease in the peripheral vascular resistance and systolic pressure in the pulmonary artery were noted as a result of corvaton therapy. Corvaton efficacy was assessed by change in hemodynamics for 2 h after administration of the drug at a single dose of 4 mg. A response of hemodynamics to corvaton was preserved for 10 mos. PMID- 3824192 TI - [Roentgeno-angiographic characteristics of congestive cardiomyopathy]. AB - Twenty-one patients with congestive cardiomyopathy were examined by angiographic techniques. All the patients manifested a considerable decrease in the contractile and pump functions of the myocardium. The alterations were mainly diffuse in nature. However, the intensity of the hypokinesis of the different segments of the left ventricle was dissimilar. Morphological examination according to the endomyocardial biopsy data revealed the etiological heterogeneity of the group under study, which in addition to the patients with congestive cardiomyopathy proper comprised those with inflammatory and alcoholic lesions of the myocardium. PMID- 3824193 TI - [Familial forms of hypertrophic cardiomyopathy]. AB - Consanguineous relatives of a patient with hypertrophic cardiomyopathy (HCMP) were examined. Asymmetric hypertrophy of the interventricular septum with signs of obstruction of the left ventricular outflow tract was detected in the patient's brother. Hypertrophy of the left ventricular posterior wall and Wolff Parkinson-White syndrome (WPW, type A) was detected in the patient's daughter. This case demonstrated a diversity of HCMP clinical, electrocardiographic and echocardiographic signs among the members of the same family. PMID- 3824194 TI - [Pathogenesis and diagnosis of dysovarian cardiomyopathy]. AB - Altogether 78 patients with dysovarian cardiomyopathy were examined, of them in 19 patients the FSH, LH, prolactin, estradiol and testosterone levels were studied. Function of the epiphysis was evaluated by melatonin excretion with urine in 46 patients. Correlation of the metabolism of sex hormones and function of the epiphysis was shown. It was assumed that the effect of disturbance of the metabolism of sex hormones on the myocardium was expressed in change of electrolyte metabolism. A new method was proposed for the diagnosis of dysovarian cardiomyopathy with the help of a pharmacological drug epithalamin whose administration returned the level of the gonadotropic hormones to normal and was accompanied by positive time course of a clinical picture of disease. PMID- 3824195 TI - [Status of the contractile function of the myocardium in patients with a mild form of infectious-allergic myocarditis]. AB - The authors analysed the results of echocardiography of patients with a mild ("ambulatory") form of infectious allergic myocarditis (the 1st group). Enhanced myocardial contractility was revealed in the 1st group as compared to the group of healthy persons (controls), decreased left ventricular contractility was noted in patients of the 2nd group (with dilated cardiomyopathy). A conclusion was made that a mild form of infectious allergic myocarditis was characterized by enhanced left ventricular contractility as a sign of its compensatory hyperfunction in response to myocardial damage. PMID- 3824196 TI - [Functional possibilities and physical capacity of patients with mitral lesions of the heart]. AB - A total of 231 women with mitral valvular disease at the stage of compensation were examined. An analysis of the complex of clinico-instrumental values of the functional state showed that the level of lowered physical working capacity was associated not only with disease type but also with functional reserves of the adaptation to exercise. Insufficiency of compensatory-adaptation reactions and lowered resources were revealed in the patients with a decreased tolerance to physical exercise. Among persons with low adaptation resources were mainly patients with mitral stenosis and its prevalence. Persons with high adaptation resources could do the work the energetic level of which reached a submaximum value. PMID- 3824197 TI - [Segmental contractility and geometry of the left ventricle of patients with isolated lesions of the mitral valve]. AB - Investigations showed that patients with "pure" stenosis of the left atrioventricular orifice as well as those with mitral insufficiency were characterized by left ventricular myocardial dysfunction expressed in a decrease of the index of left ventricular integral function--the ejection fraction and in change of geometry of the left ventricular cavity. Asynergy (hypokinesia) of the anterior wall segments and the posterior basal segment was revealed in patients with "pure" stenosis and "pure" mitral insufficiency. Hypokinesia in patients with primary mitral insufficiency was revealed in the anterior wall only. The above changes in the left ventricular segmental contractility can be regarded as a cause of left ventricular pump function disorder. PMID- 3824198 TI - [Clinical evaluation of changes in alimentary motivation and arterial pressure in patients with essential hypertension]. AB - A study was made of the main signs of food motivation in 132 patients with stages I-III essential hypertension on the basis of analysis of a special questionnaire: the patients were interviewed in hospital and after discharge (a total of 40-46 days) to reveal the effect of raised arterial pressure on food behavioral reactions. Clinical signs of a hypertensive crisis were noted in 87 patients, in 45 patients raised arterial pressure was not accompanied by a crisis. In 82% of the cases hypertensive reactions produced a marked effect on the manifestations of food motivation. Anorectic reactions prevailed in the first 3-6 days in 98 of 109 patients (80.7%). These reactions were pronounced and prolonged in the patients with normal body mass. During the second week hyperphagic reactions prevailed in 68% of the cases, their frequency, expression and period were greater in the patients with concomitant obesity. The revealed time course of food behavioral reactions reflected the phase of food motivation in patients with arterial hypertension: hypertensive anorexia followed by post-hypertensive hyperphagia for 2-3 weeks. PMID- 3824199 TI - [Current concepts concerning the syndrome of early ventricular repolarization]. AB - Electrocardiograms of 1000 patients examined in a polyclinic for various diseases and during prophylactic checkups, were analyzed. The syndrome of early ventricular repolarization (SEVR) was detected in 54 (5.4%) patients. According to the proposed classification scheme of SEVR one could determine its clinical value and the distribution of frequency of its variants and types. The authors put forward present-day ideas as to SEVR assumed genesis with an attempt to verify some of them. Differential-diagnostic pharmacological tests (procainamide, quinidine and propranolol) were recommended for SEVR recognition. PMID- 3824200 TI - [Relation between features of the psychoemotional status and lipid metabolism of patients with ischemic heart disease and arrhythmias]. AB - Interrelationship of the peculiarities of the psychoemotional status, the activity of lipid peroxidation and the content of blood free fatty acids were studied in 64 CHD patients with arrhythmia. It was shown that prolonged and pronounced psychoemotional strain, high levels of the activity of free radical lipid oxidation and the content of nonesterified fatty acids in the blood of CHD patients promoted the development of cardiac rhythm disturbances, particularly of ventricular extrasystoles. Patients with the psychoemotional strain syndrome demonstrated direct correlation of an induced initial hemiluminiscence flash value and the level of a psychological pattern MMPI by scales 2, 6, 7, 0, as well as close direct correlation of the concentration of free fatty acids with scales 6, 8, F and negative correlation with scale 3. The detection of the psychoemotional strain syndrome in CHD patients, especially in combination with high levels of lipid peroxidation and nonesterified fatty acids in the blood, may evidently serve an important criterion for defining patients at high risk of developing arrhythmias. PMID- 3824201 TI - [Clinical x-ray dynamics of patients with Kashin-Bek disease and in subjects at risk]. AB - During expeditions clinical and roentgenological symptoms were studied in 129 persons aged under 25 and 53 persons aged over 25 with threatened Kashin-Bek disease and afflicted with it, who were followed-up. Observation over time showed that preclinical signs in the form of x-ray morphological changes in the hand joints were the following: a niche in the fifth finger middle phalanx metaphysis or (less frequently) in the thumb ungual phalanx and foci of epiphyseal outer resorption. The initial characteristic clinical signs of the disease were deformity of the proximal interphalangeal joints of the II-V fingers and brachydactyly of the fifth finger. Early clinical and roentgenological signs of Kashin-Bek disease were specified in the time course of the study improving thus the diagnosis and follow-up of such patients. PMID- 3824202 TI - [Treatment methods in chronic bronchitis]. AB - Patients with chronic bronchitis at exacerbation and in remission were treated by immunocorrective agents. A study was made of the immune status, interferon synthesizing capacity of blood leukocytes, a clinical course of disease and their change resulting from immunocorrective therapy provided at different stages of chronic bronchitis. The authors established disorders in the immune status, a decrease in interferon synthesizing capacity of blood leukocytes which were more noticeable at exacerbation. The use of immunocorrective therapy raised the production of interferon by the patients' blood leukocytes, improved ratios between lymphocyte populations and subpopulations, considerably improved a clinical course of disease, prolonged remission, facilitated a course of exacerbations and decreased resistance to anti-bacterial therapy. PMID- 3824203 TI - [Clinical pharmacology of agents affecting the tonus of the lower esophageal sphincter]. AB - The effect of pharmacological drugs indicated for specific diseases on the lower esophageal sphincter, was studied in 195 patients. Pentagastrin increased the sphincter tone, secretin when used in peptic ulcer, did not influence the tone. Unlike atropine, a therapeutic course with pirenzepine (gastrozepin) for patients with peptic ulcer did not lower the tone of the lower esophageal sphincter. Diazepam significantly decreased indices of the sphincter tone. In the treatment of CHD patients with corinfar, a calcium antagonist, the sphincter tone was on a moderate but statistically significant decrease. Aminophylline in patients with chronic bronchitis made no effect on this index. The ratio of the sphincter tone stimulated with metoclopramide to its basal values was higher in the patients with initially lowered indices as compared to the patients in whom the initial tone was within normal. PMID- 3824204 TI - [Genesis of the cardiac pain syndrome in patients with neurocirculatory dystonia]. AB - Palpation of the chest-covering tissues was performed in 150 patients with neurocirculatory dystonia with complaints of pain in the cardiac region. In all the patients painful muscular consolidations of various size, shape and consistency were detected in the thickness of the pectoral muscles and at the sites of their transition into tendons. Direct correlation between the gravity of cardialgia and expression of the muscular pain syndrome was noted. In 98% of cases therapy aimed at the elimination of the muscular pain syndrome (repeated novocaine-hydrocortisone infiltrations) resulted in the correction or a significant decrease in a degree of cardialgia. The results obtained suggested that the cardiac pain syndrome in patients with neurocirculatory dystonia was mainly caused by local changes in the musculotendinous tissues of the chest. PMID- 3824205 TI - [Cerebral autonomic pathology in the clinical picture of internal diseases]. PMID- 3824207 TI - [Total pulmonary lavage in the treatment of alveolar proteinosis]. AB - Total pulmonary lavage through a two-lumen intubation tube is an effective method for therapy of alveolar proteinosis ensuring the removal of alveolar proteopexy and improving respiratory function. PMID- 3824206 TI - [Metabolic aspects of the differential diagnosis of chronic asthmatic bronchitis and bronchial asthma]. AB - The authors have presented an analysis of the results of a study of patients with chronic asthmatic bronchitis and bronchial asthma to detect possible qualitative differences in changes of indices that characterize the intensity of free radical oxidation and antioxidant activity. With this aim in view the level of lipid peroxidation (LPO), alpha-tocopherol content and SOD activity were determined. In patients with bronchial asthma a raised LPO level was noted in parallel with a decrease in alpha-tocopherol content and SOD activity up to the values below the normal ones. A degree of deviation of the indices from those in health depended on the gravity of a course of bronchial asthma. In patients with asthmatic bronchitis in exacerbation and remission with a raised LPO level alpha-tocopherol content and SOD activity remained within normal. These differences can be used for differential diagnosis. PMID- 3824208 TI - [Regional hemodynamic function in chronic obstructive bronchitis with arterial hypertension]. AB - The state of regional hemodynamics (pulmonary, cerebral and peripheral) was studied in patients suffering from chronic obstructive bronchitis with symptomatic "pulmonogenic" hypertension. Pronounced disorders of regional hemodynamics accompanied by pulmonary hypertension, an increase in the tone of the cerebral and peripheral vessels and their lowered blood filling in patients with a stable phase of this type of hypertension, were established. Multimodality therapy including antihypertensive drugs (Cordanum, clonidine, hydrochlorothiazide, hydrolasin) significantly improved regional hemodynamics. PMID- 3824209 TI - [Relationship of the value of excess body weight to the blood concentration of cholesterol and triglycerides and the level of the basic hormones regulating lipid metabolism in healthy men 30 to 50 years old]. AB - The basal levels of cholesterol (CS), triglycerides (TG), sugar, immunoreactive insulin (IRI), cortisol, testosterone, triiodothyronine (T3) and thyroxine (T4) were compared in 116 healthy males with risk factors of developing coronary heart disease (CHD), aged 45, engaged in administrative activities associated with stress and hypokinesia, with relation to normo-, hyperlipoproteinemia (NLP and HLP) and percentage of excessive body mass (IBM). In NLP as well as in HLP with an increase in IBM a tendency to elevated levels of CS, TG, sugar, IRI was noted, however there was no direct parallelism. In both cases the IBM value within the limits of obesity, I degree, did not influence the concentration of blood cortisol and testosterone. T3 and T4 levels were significantly decreased in males with IBM exceeding the normal one by 25%. They demonstrated the highest content of blood CS, TG and sugar on an empty stomach. PMID- 3824210 TI - [Incidence of risk factors for chronic noninfectious diseases among the population of 2 rural therapeutic districts in the Lithuanian SSR and the knowledge of the inhabitants of the presence of their risk factors]. AB - During examination of the adult population of two rural communities: 1558 inhabitants of a settlement of Salantai and 1713 inhabitants of a settlement of Merkine their arterial pressure was measured and they were interviewed. A high prevalence of risk factors of chronic noncommunicable diseases was established. Arterial hypertension was detected almost in 1/3 of the examined population, 50% of the male population smoked, 40.7% of the Salantai inhabitants and 32.2% of the Merkine inhabitants had excess body mass. The people were unaware of risk factors. Those who thought to be healthy, often had risk factors. Only 28.3% of the Salantai inhabitants and 25.5% of the Merkine inhabitants knew their arterial pressure, 74.8% and 79.3% respectively knew their height and body mass. With age the prevalence of risk factors grew and knowledge of them decreased. PMID- 3824211 TI - [Coronary artery spasm as a pathogenetic mechanism of ischemic heart disease]. AB - To study the role of the vasospastic factor in the etiology of CHD pain forms a total of 326 patients were examined using coronary angiography, of them a test with i. v. administration of ergometrine was made to 117. An analysis of the peculiarities in the CHD course showed that angina destabilization usually associated with the addition of a dynamic component, could occur in a different duration of disease. The first clinical signs of CHD in more than half of the cases in a stable and unstable course of angina developed in the marked obstructive involvement of the coronary bed. Obvious vasospastic reactions in the ergometrine test were more frequently noted with recently developed unstable angina however they could occur in a different period of disease. The data obtained indicated that in most cases two mechanisms were involved in the development of angina: fixed coronary obstruction as a morphological basis of coronary insufficiency and spasm of the coronary arteries which could be a leading factor in a number of patients or determine angina instability. PMID- 3824212 TI - [Biorhythm influence on the course of ischemic heart disease during combined treatment with molsidomine and anaprilin]. PMID- 3824213 TI - [Circadian fluctuations in the level of a number of hormones in the blood of ischemic heart disease patients]. PMID- 3824214 TI - [Assessment of the the physical loading tolerance of ischemic heart disease patients in relation to different sites of the coronary artery lesion]. AB - An analysis of physical exercise tolerance in CHD patients with the equal number of affected coronary arteries with relation to a coronary bed region involved in a pathological process, showed that its decrease was mostly pronounced in vasoconstriction of the left coronary arterial system and was determined by a decrease in the blood flow in this region. PMID- 3824215 TI - [Catecholamines and the oxygen transport system during the physical loading of patients with a history of myocardial infarct]. AB - A study of the time course of hemodynamic and oxygen load and catecholamine content in 74 patients after myocardial infarction showed that cardiac output as a pump was less effective in the persons with a higher load tolerance (over 50 W) in a high concentration of noradrenaline in the blood; a higher oxygen debt was revealed after equal exercise. The data obtained can be important for recommendation of beta-adrenoblockers to patients after myocardial infarction. PMID- 3824216 TI - [Cardiohemodynamic indices during the physical loading of patients with stenocardia of varying duration]. AB - A total of 232 CHD patients and 93 healthy persons were examined to reveal a possible role of the vasospastic and cardiohemodynamic factor in the pathogenesis of angina pectoris of various duration. Cardiohemodynamics, ECG, PCG and tetrapolar chest rheography were studied during a bicycle ergometry test. Two types of cardiohemodynamic reactions in anginal pain were defined: adequate--with low indices characterizing demand of the myocardium for oxygen and sufficient diastole (demand--supply) and inadequate--with an unusually high (1.5-3-fold above the normal) intensity of demand and supply (IDS). The adequate type prevailed in the patients with early angina pectoris and inadequate in the patients with long existing stable angina pectoris. Spontaneous improvement and improvement after administration of antianginal therapy or nitroglycerin in the patients with the adequate type resulted in pain at a higher IDS level. In the inadequate type the level of the demand and supply index did not change either in deterioration or improvement. Deterioration in such patients meant the appearance of inadequacy of demand and supply in lowered physical exercise and improvement in increased physical exercise. It has been assumed that investigation of cardiohemodynamics makes it possible to specify whether the vasospastic or cardiohemodynamic factor of inadequacy plays a leading role in the pathogenesis of coronary insufficiency in CHD patients. PMID- 3824217 TI - [Changes in the content of fibrinogen and its high-molecular derivatives as affected by the physical training of ischemic heart disease patients]. AB - Two groups of male patients with CHD were examined. The first group (30 persons) was treated with a 30-day therapeutic course of physical training on a bicycle ergometer, the second group received nitrates of prolonged action and beta blocking agents. Eleven healthy men receiving a course of physical training were entered into the control group. The content of fibrinogen, soluble fibrin and fibrinogen degradation products in the blood plasma was investigated prior to and after a therapeutic course. An analysis of the blood plasma protein spectrum was performed using gel-filtration on a chromatographic column as well as separate disk-electrophoresis of the blood plasma proteins and isolated fractions in polyacrylamide gel. Regular physical training of the CHD patients resulted in a significant decrease in the content of fibrinogen, soluble fibrin and fibrin degradation products in the blood that might be conducive to the improvement of microcirculation and hence to lessening the number of angina attacks in these patients. PMID- 3824218 TI - [Functional indices of the leukocytes in ischemic heart disease patients]. PMID- 3824219 TI - [ECG and hemodynamic changes during the bicycle ergometry of patients following aortic valve prosthesis]. AB - Interrelated ECG and hemodynamic changes were revealed in an analysis of the results of a bicycle ergometry test (BET) with the recording of ECG in 12 accepted leads and simultaneous impedance rheoplethysmography after Kubichek in 60 patients during rehabilitation for 3 yrs after aortic valve replacement. Impedance-measuring investigation of hemodynamics after physical exercise provided valuable information on causes of ECG changes. More frequent development of ischemic changes during rehabilitation and a variety of hemodynamic causes of changes in physical exercise and in the period of restitution necessitated intermittent BET in patients with a prosthesis of the aortic valve. An increase in voltage of the R wave during BET was combined in most cases with other inadequate hemodynamic reactions and was accompanied by an "ischemic" decrease in ST, and could serve as an additional criterion of threshold exercise. PMID- 3824220 TI - [Clinico-morphological comparisons in cardiogenic shock]. PMID- 3824221 TI - [Incidence of chronic high-altitude cor pulmonale in the Mongolian People's Republic]. PMID- 3824222 TI - [Characteristics of the spontaneous humoral immunity reactions to collagen type I in systemic lupus erythematosus patients]. AB - A study of the state of the humoral immunity in 36 SLE patients made it possible to detect an increase in the level of autoantibodies to type I collagen in comparison to the level of autoantibodies in healthy donors. It showed correlation with the activity of a process, its course, clinical signs of disease, progression of renal pathology and the levels of antinuclear factor and gamma globulins. PMID- 3824223 TI - [Echocardiographic study of heart function in systemic scleroderma]. AB - Echocardiographic investigation of 65 patients with systemic scleroderma showed that the left ventricular sizes and indices of central hemodynamics were frequently lowered in them; an increase in sizes was observed mainly in the patients with stage II-III of disease. In 3/4 of the same patients pericarditis was revealed; on the whole, it was detected in 26 (40%) examinees. One patient had changes which were typical of asymmetric obstructive cardiopathy. In location of the valvular apparatus signs of mitral stenosis were found in one patient, those of mitral insufficiency in one patient and those of aortic insufficiency in one patient. Signs of mitral prolapse were noted in 7 (10.9%) patients, i.e. twice more frequently than in the entire population. Echocardiography made it possible to specify the nature of cardiac pathology and brought to light some additional features of the involvement of different heart membranes in systemic scleroderma. PMID- 3824224 TI - [How to improve the diagnosis of diseases of the respiratory organs? (the experience in organizing diagnostic services at the Sverdlovsk Pulmonology Center)]. AB - The authors have summed up their 12-year experience in forming a system of organizational measures for the diagnosis of pulmonary diseases in an industrial area with the adult population of 3,616 mln. The major stages of diagnosis were studied, measures for its improvement defined, the main causes of diagnostic errors brought to light. The authors are of opinion that separate examination of patients with pulmonary pathology in different institutions is inappropriate. PMID- 3824225 TI - [Erythrocyte deformability in acute and chronic kidney failure patients]. AB - The authors presented some data on the platelet deforming ability in patients with acute and chronic renal failure treated with hemodialysis. Platelet deformity was studied by means of a proposed method of the filtration of platelet suspension through glass filtering funnels with a porous plate (GOST 9775-69). The deterioration of platelet deformity in patients with uremia and its direct correlation with a degree of nitremia were established. It was assumed that the deterioration of platelet deformity resulted in premature cell destruction and anemia development. Platelet deformity can be used as a test to characterize platelet function in patients with renal failure. The problem of the appropriateness of trental therapy was discussed. PMID- 3824226 TI - [Effect of the blood sera of patients with different pathologies on normal and leukemic cells--the precursors of granulo- and monocytopoiesis]. AB - A study was made of the effect of the blood sera of persons of the control group and patients with various diseases of the blood on normal precursor cells of granulo-monocytopoiesis (CFU-GM) and leukemic clonogenic cells. A stimulating human blood serum effect on proliferation was noted during cultivation of normal CFU-GM and leukemic clonogenic cells in the "agar drop-liquid medium" system. As a rule, the stimulating serum effect manifested itself in the presence of feeder cells or a high "spontaneous" colony formation. Human blood sera can be added to a culture medium for improving its nutritive properties. PMID- 3824227 TI - [Incretory changes in the pancreatic hormones in chronic pancreatitis]. AB - Radioimmunoassay was employed to study blood content of insulin, C-peptide and glucagon in 78 patients with chronic pancreatitis. It was revealed that during exacerbation, there was an increase in the content of insulin and glucagon and, to a lesser degree, in that of C-peptide. During remissions, part of the patients showed insular deficiency which increased with disease standing. When pancreatitis lasted from 1 to 5 years or from 5 to 10 years, diabetes mellitus was recorded in 9.4% of the patients and in 16% of the patients, respectively. PMID- 3824228 TI - Evaluation and treatment of dementia. PMID- 3824229 TI - Strategies for the pharmacological treatment of Alzheimer's disease. PMID- 3824230 TI - Alzheimer's dementia: recent developments in cholinergic pharmacology. PMID- 3824231 TI - Lacunar dementia: a form of vascular dementia. PMID- 3824232 TI - Nutritional concerns for patients with Alzheimer's disease. PMID- 3824233 TI - Caretaker coping and Alzheimer's patient decline. PMID- 3824234 TI - The role of coping behaviors for primary caregivers of Alzheimer's patients. PMID- 3824235 TI - Alzheimer's disease and exercise. PMID- 3824236 TI - The Alzheimer patient: interior design considerations. PMID- 3824237 TI - Alzheimer's disease in Texas: a public health perspective. PMID- 3824238 TI - The treating physician as an expert witness. PMID- 3824240 TI - Patient recall systems. PMID- 3824239 TI - Research, support groups aid dementia patients and families. PMID- 3824241 TI - Alzheimer's disease: changing health care priorities and legislative update. PMID- 3824242 TI - Pelvic inflammatory disease in the adolescent. PMID- 3824243 TI - Blood donor screening for AIDS: self-exclusion with bar codes. PMID- 3824244 TI - Nuclear weapons and nuclear war: implications for Texas physicians. PMID- 3824245 TI - Pelvic inflammatory disease in adolescents. PMID- 3824246 TI - Bladder cancer: management of advanced disease. PMID- 3824247 TI - Medical professional liability in Texas--a primer. PMID- 3824248 TI - [Nutrition in Switzerland]. PMID- 3824249 TI - [Diet treatment of ulcer and reflux disease]. PMID- 3824250 TI - [Diet and liver diseases]. PMID- 3824251 TI - [Nutritional treatment in chronic renal insufficiency]. PMID- 3824252 TI - [Dietary treatment of the hyperlipidemias]. PMID- 3824253 TI - [Dietary treatment of obesity]. PMID- 3824254 TI - [Cancer and vitamins]. PMID- 3824255 TI - [The influence of dietary factors on renal lithiasis]. PMID- 3824256 TI - [Genetic family counseling]. PMID- 3824257 TI - [Medical genetic principles]. PMID- 3824258 TI - [Autosomal chromosome aberrations]. PMID- 3824259 TI - [Sex chromosome abnormalities]. PMID- 3824260 TI - [Monogenic inheritance: nervous system and neuromuscular diseases]. PMID- 3824261 TI - [Important hereditary diseases of the sensory organs]. PMID- 3824262 TI - [Monogenic inheritance: bones, connective tissue, dysmorphic syndromes]. PMID- 3824263 TI - [Monogenic inheritance: metabolic disorders]. PMID- 3824264 TI - [Monogenic inheritance: the skin]. PMID- 3824265 TI - [Multifactorial inherited diseases and abnormalities]. PMID- 3824266 TI - Improving the chances of successful research funding. PMID- 3824267 TI - The small clinical trial: is there a better way? PMID- 3824268 TI - Clinical trials in acute severe asthma: are type II errors important? AB - Many studies in acute severe asthma have had low power. Fifteen randomised double blind studies investigating the treatment of acute severe asthma published during 1974-84 were analysed for power and 95% confidence limits. Twelve studies failed to detect a significant difference in bronchodilatation produced by two treatments and reported the treatments to produce equal effect. Each study had, however, less than a 60% probability of detecting a true 25% difference in bronchodilatation. PMID- 3824269 TI - Number of patients required in lung function studies. AB - Tables are presented showing estimates of the number of subjects which is required to give an 80% or 90% chance of detecting various differences in forced expiratory volume in one second, forced vital capacity, total lung capacity, transfer factor, and residual volume between the mean of two groups by means of Student's t test. PMID- 3824270 TI - A case-control study of deaths from asthma. AB - A population based case control-study was initiated in 1981 to identify risk factors for death from asthma. Over a two year period all deaths in the Auckland population possibly due to asthma, in people less than 60 years of age, were investigated. From the 47 people who died from asthma 44 who had useful reversibility of airways obstruction (records showing greater than 20% variability of peak flow or a history indicating equivalent variability of shortness of breath) before death were selected as cases for the study. Both hospital and community based controls were used. The cases were more likely than were the community controls to have had severe disease, a hospital admission or visits to a hospital emergency department in the previous year (odds ratios 4.4, 16.0, 8.5 respectively). The asthmatic patients who died were more likely than either group of controls to have had a previous life threatening asthma attack. Poor management of the disease and poor compliance on the part of the patient increased the risk of death. In addition, use of three or more types of asthma drug within the past year was associated with an increased risk of dying that was independent of disease severity. Of interest was a similarity between asthmatic patients admitted to hospital and those who died. Nevertheless, a history of a previous life threatening attack and a recent admission to hospital identified a group at high risk. PMID- 3824271 TI - Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. AB - Fifty patients with chronic obstructive lung disease were questioned about their sleep quality and their responses were compared with those of 40 similarly aged patients without symptomatic lung disease. Patients with chronic obstructive lung disease reported more difficulty in getting to sleep and staying asleep and more daytime sleepiness than the control group. More than twice as many patients (28%) as controls (10%) reported regular use of hypnotics. In a subgroup of 16 patients with chronic obstructive lung disease (mean FEV1 0.88 (SD 0.44) sleep, breathing, and oxygenation were measured to examine the relationship between night time hypoxaemia and sleep quality. Sleep architecture was disturbed in most patients, arousals occurring from three to 46 times an hour (mean 15 (SD 14)/h). Arterial hypoxaemia during sleep was common and frequently severe. The mean (SD) arterial oxygen saturation (SaO2) at the onset of sleep was 91% (7%). Nine patients spent at least 40% of cumulative sleeping time at an SaO2 of less than 90% and six of these patients spent 90% of sleeping time below this level. Only four of 15 patients did not develop arterial desaturation during sleep. The mean minimum SaO2 during episodes of desaturation was less in rapid eye movement (REM) sleep (72% (17%)) than in non-REM sleep (78% (10%), p less than 0.05). The predominant breathing abnormality associated with desaturation was hypoventilation; only one patient had obstructive sleep apnoea. Arousals were related to oxygenation during sleep such that the poorer a patient's arterial oxygenation throughout the night the more disturbed his sleep (arousals/h v SaO2 at or below which 40% of the total sleep time was spent: r = 0.71, p less than 0.01). Hypoxaemia during sleep was related to waking values of SaO2 and PaCO2 but not to other daytime measures of lung function. PMID- 3824272 TI - Value of computed tomography for selecting patients with bullous lung disease for surgery. AB - Computed tomography and lung function tests were performed on 43 patients who had evidence on the chest radiograph suggesting bullous emphysema. After computed tomography scan two groups of patients could be identified. Twenty patients had generalised emphysema, which was locally worse in the area of the suspected bulla; and 23 had well defined bullae, which were potentially operable. Results of lung function tests did not distinguish between the two groups. The volume and ventilation of the true bullae were measured by computed tomography and this confirmed that most of them did not contribute to ventilation (residual volume (RV)/total capacity (TLC) bulla = 89% (SD 10%). The patients with true bullae were considered suitable for surgery but only 12 had an operation. All the patients who underwent surgery survived and had a symptomatic improvement, which was accompanied by objective increases in spirometric volumes and by reductions in static lung volumes; there were no improvements in carbon monoxide transfer or blood gas tensions. It is concluded that computed tomography used alone can identify bullae that are amen-able to surgery and can measure their volume and ventilation. The surgical removal of such clearly identified bullae is safe and associated with symptomatic and functional improvement even when the preoperative FEV1 is less than 1 litre. This improvement is likely to be a consequence of reduction in lung volume and may not necessarily be associated with relief of compressed peribullous lung or the removal of dead space. PMID- 3824273 TI - Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions. AB - A retrospective analysis was carried out on a consecutive series of 181 percutaneous fine needle aspiration biopsies of discrete pulmonary lesions, in which the outcome was established in 95%. In primary bronchial carcinoma the technique had a sensitivity of 86%. There was no relationship between the size, location, or radiological appearance of the lesion and the incidence of false negative results. The principal reason for failure to diagnose malignancy was inadequacy of the material provided for cytological examination. For metastatic neoplasms of non-bronchial origin the procedure had a sensitivity of 42% and a significantly greater false negative rate than for primary bronchial malignancy. For the entire series 72 (40%) of the procedures failed to produce a definite diagnosis, 29 (40%) of these cases subsequently proving to be malignant. A positive diagnosis was established in only 16% of patients with benign conditions. Review of published reports and consideration of the role of this and other biopsy techniques in the investigation of discrete pulmonary lesions lead to the conclusion that needle aspiration biopsy seems particularly appropriate in the investigation of inoperable patients with probable bronchial carcinoma in whom sputum cytology and bronchoscopy do not yield a diagnosis. PMID- 3824274 TI - Chylothorax: a review of 18 cases. AB - Eighteen patients who had developed a chylothorax during a 25 year period, 1955 80, were reviewed. The chylothoraces occurred as a complication of cardiothoracic surgery in 11 patients, of whom eight were children in the first decade of life. Five cases followed operations for coarctation of the aorta and two occurred as a complication of a Blalock shunt for Fallot's tetralogy. The chylothorax was evident within 48 hours of the operation in all but two patients. In seven cases a second operation was performed to prevent further chylous leakage and in two infants the thoracic duct was ligated. The remainder of the postsurgical chylothoraces responded to either continuous drainage or repeated aspiration and a low fat diet. There were no late sequelae of chylothorax following surgery. Spontaneous chylothorax was identified in seven patients and in five of these it was bilateral. Patients with spontaneous chylothorax were all adults and, despite treatment, had a poor prognosis. Three with malignant disease and two with pulmonary lymphangioleiomyomatosis had died within two years of the appearance of the chylothorax. Two patients with chronic idiopathic chylothoraces survived for more than two years and one of these developed a secondary fibrothorax. PMID- 3824275 TI - Low cost carbon monoxide monitors in smoking assessment. PMID- 3824276 TI - Adenosine deaminase activity in tuberculous pericarditis. PMID- 3824277 TI - Pulmonary tuberous sclerosis treated with tamoxifen and progesterone. PMID- 3824278 TI - Intrathoracic desmoids: report of two cases. PMID- 3824279 TI - Bronchopleural fistula after pneumonectomy. PMID- 3824280 TI - [Rate-responsive pacing during exercise]. PMID- 3824281 TI - [Breast cancer in young women with a history of breast cancer in their mother]. PMID- 3824282 TI - [Malignant melanoma of the skin]. PMID- 3824283 TI - [Respiratory allergy in students]. PMID- 3824284 TI - [Disseminated pneumococcal infections in patients with chronic alcoholism]. PMID- 3824285 TI - [Tick-borne borreliosis. A case of chronic meningoencephalitis caused by Borrelia burgdorferi]. PMID- 3824286 TI - [Meningoradiculitis caused by Borrelia burgdorferi]. PMID- 3824287 TI - [Contrast media for magnetic resonance tomography]. PMID- 3824288 TI - [Magnetic resonance tomography. Diagnosis of tumors of the central nervous system]. PMID- 3824289 TI - [Septic severity score. A simple method for the evaluation of intensive care patients with multiple organ failure]. PMID- 3824290 TI - [Magnetic resonance tomography in the diagnosis of multiple sclerosis]. PMID- 3824291 TI - [Occupational disease notification in 1985]. PMID- 3824292 TI - [Concentration of aluminum in human milk and milk formulae. Infants at risk for poisoning?]. PMID- 3824293 TI - [Rapid detection of rubella antibodies in general practice]. PMID- 3824294 TI - [Health controls in a population community]. PMID- 3824295 TI - [Acetylsalicylic acid and Reye's syndrome]. PMID- 3824296 TI - [Risk of spontaneous abortions and abnormalities in laboratory personnel]. PMID- 3824297 TI - [Breech delivery at term]. PMID- 3824298 TI - [Cesarean section. Indications, incidence and complications]. PMID- 3824299 TI - [Venous dysfunction, chronic cutaneous changes and leg ulcers. Surgical prevention and treatment]. PMID- 3824300 TI - [Nutritional status and energy intake in patients admitted to internal medicine units]. PMID- 3824301 TI - [Functional capacity and self-care ability of the elderly in the municipality of Bergen]. PMID- 3824302 TI - [Monostotic Paget's disease]. PMID- 3824303 TI - [Toxic shock syndrome in children]. PMID- 3824304 TI - [Laser treatment of premalignant cervical diseases]. PMID- 3824305 TI - [Autotransfusion. Intraoperative autologous transfusion of washed red cells]. PMID- 3824306 TI - [Day-time neurologic care center]. PMID- 3824307 TI - [Fear of nuclear weapons in children and adolescents. A critical review of research in this field and suggestions for further research strategy]. PMID- 3824308 TI - [The Norwegian Red Cross rescue corps. A study of the organization based on records from a sampling of units]. PMID- 3824309 TI - [Acetylsalicylic acid. The dosage question]. PMID- 3824310 TI - [The alcohol withdrawal syndrome. Diagnosis and treatment]. PMID- 3824311 TI - [Soft tissue sarcomas. A retrospective study of 164 patients]. PMID- 3824312 TI - [Varicella-zoster virus infections in pregnant women and their newborn infants]. PMID- 3824313 TI - [Ectopic thyroid tissue in the head and neck]. PMID- 3824314 TI - [Acute pancreatitis. Treatment with peritoneal dialysis]. PMID- 3824315 TI - [Soft tissue sarcoma. The principles of diagnosis, examination and treatment]. PMID- 3824316 TI - [Child abuse and neglect in Ostfold. A study of the occurrence as registered by the regional health and social care services]. PMID- 3824317 TI - [Analysis of primary health care consultations. Medical and technical experiences from video tape recordings]. PMID- 3824318 TI - [Organic solvent poisoning in Trondelag]. PMID- 3824319 TI - [Solvents as the suspected cause of nervous system damage. Patients with another diagnosis]. PMID- 3824320 TI - [Occupational disease--a special disease entity?]. PMID- 3824321 TI - [Avulsion fracture of the tendon of origin of the long extensor muscle of the toe in a horse and a cat]. AB - An avulsion fracture of the tendon of origin of the extensor digitorum longus muscle is reported in a horse and a cat. This avulsion fracture was due to injury in both animals. There was a striking similarity of radiographic findings in these animals, with involvement of the lateral trochlear ridge and lateral condyle of the femur. The horse was slaughtered because of a poor prognosis as a riding-horse. Fixation of the avulsed fragment with two Kirschner wires resulted in complete recovery in the cat. PMID- 3824322 TI - [Simple surgical treatment of hip dislocation in dogs and cats using a modified toggle]. AB - Surgical treatment of dislocations of the hip by a modified toggle as described by Knowles (1953) usually results in a very rapid and permanent restauration of function to normal. An essential feature of this method is the slight surgical injury. This is achieved by using a relatively small toggle and drills with small diameter. The surgical technique and the results of treatment in 18 cats and 10 dogs are reported. PMID- 3824323 TI - [Examination and treatment of a loose medial coronoid process in dogs]. AB - An ununited medial coronoid process (MCP) is the most common developmental disturbance in the elbow joint of young dogs of large and medium-sized breeds. The clinical and radiological symptoms of ununited medial coronoid processes in thirty-nine dogs are reported, the presence of an ununited medial coronoid process being established by arthrotomy in these cases. Lameness was observed for the first time in these dogs, mainly Rottweilers, Retrievers and Berner Sennenhunde, and more often male dogs than bitches, when they were from four to six months of age. They showed lameness ranging from slight to severe, and the leg was frequently held in a position of abduction and outward rotation. The elbow joints involved often showed abnormal accumulations of fluid, hyperflexion and/or hyperextension being painful. Osteophytes, only occurring along the proximal border of the anconeal process, could be well assessed on the mediolateral radiographs. The appearance of the MCP, varying from normal to ununited, could best be evaluated in the mediolateral and anteroposterior medial oblique radiographs. These two radiographs were also of value in diagnosing an ununited anconeal process which was present at the same time as osteochondrosis of the medial condyle of the humerus in two dogs. The clinical symptoms were not associated with radiologically perceptible changes in some cases. Arthrotomy of the elbows showed that the entire apex or otherwise one or several fragments of the MCP, which are often wedged between the radius and ulna in these cases, may break off. Rapid post-operative improvement of locomotion is frequently reported. Preventive and diagnostic procedures carried out to make possible early institution of surgical treatment are discussed. PMID- 3824324 TI - [Hyperostosis of the mandibles in a West Highland white terrier]. AB - A clinical case of craniomandibular osteopathy in a 7-month-old West Highland White Terrier is reported. The literature on the pathogenesis, clinical and radiological symptoms as well as the treatment and prognosis are briefly reviewed. PMID- 3824325 TI - [Treatment of a growth plate fracture of the distal tibia in a calf]. AB - Case report of a post-partum type II epiphyseal fracture of the distal tibia in a calf. Following open reduction, the fracture was stabilised by cross-pins. A plaster of Paris cast was used as an additional support for four weeks. A clinical and radiological follow-up for five months after surgery did not reveal any complications. PMID- 3824326 TI - [Treatment possibilities of the problem hip in dogs]. AB - Problem hips are a common condition in dogs. The clinical features are extremely varied and there are several factors which have negative or positive effects on the symptoms. A problem-oriented scheme is presented as an aid in choosing a method of treatment. PMID- 3824327 TI - [Avulsion of tibial tuberosities in dogs]. AB - Whenever a young dog (up to ten months of age) is presented showing lameness of one of the hind legs, as well as a swelling in the region of the knee without perceptible crepitation, it is advisable to take X-rays immediately, rather than to wait. These X-rays severe to verify or rule out injury of the epiphysis. Attention is paid to the clinical and radiological features as well as to the pathophysiology and surgical treatment of avulsion of the tuberosity of the tibia in dogs in the present paper. PMID- 3824328 TI - [Luxation of a canine tooth with fracture of the alveolar wall of the maxilla in a dog]. AB - The method of treatment used in a case of alveolar fracture of the maxilla is reported in the present paper. Using a splint, the canine tooth was fixed at the level of the enamel-cement border of the teeth. The method employed in applying compression at the site of the fracture is reported. PMID- 3824329 TI - [Surgical treatment of a Dobermann pinscher with cervical spondylopathy]. AB - The successful treatment of a Dobermann Pinscher affected with cervical spondylopathy by decompression of the intervertebral disc involved and fusion of the adjacent vertebrae is reported. PMID- 3824330 TI - [Liability in veterinary medicine]. AB - In order to promote the optimum exercise of the profession, the occupational group developed disciplinary standards of its own. To protect itself from socially improper procedures, from default and from its consequences, society developed standards of civil law. When a veterinarian is insufficiently equipped for adequate treatment of a patient, this patient will be referred to a veterinary surgeon who has acquired the necessary accomplishments in the section concerned; high standards of attainment will be imposed on this veterinarian. The fact that the referring veterinarian and the one to whom the patient was referred each retain their own responsibilities, is illustrated in examples. All this may result in a further improvement in quality of veterinary health care in the Netherlands. PMID- 3824331 TI - [A small outbreak of salmonellosis caused by Bologna sausage]. AB - Late in August 1985, seventeen subjects in the 3-40 year range contracted salmonellosis which was associated with the consumption of fermented pork sausage prepared by a butcher. The incubation period varied from 6 to 9 hours, the attack rate was a hundred per cent; there were no deaths or complications. The pH of the incriminated sausage was 5.7 (the pH of controls ranged from 4.5 to 5.0), and the aw was 0.99 (vs. 0.92-0.97 in the controls), a colony count of thermotrophic Enterobacteriaceae was 10(7) per 1 g, including c. 10(6) of Salmonella typhimurium, c. 10(3) Staphylococcus aureus and c. 10(4) cfu of Clostridium perfringes per 1 g. These outbreaks may be prevented by ensuring good practices during production and distribution, supported by monitoring line samples by determining the pH and aw and cfu assessment of Staphylococcus aureus and thermotrophic Enterobacteriaceae. PMID- 3824332 TI - [Developments in biotechnology; implications for diagnosis in pet animals]. AB - During the past decade, a number of developments have occurred in certain fields of biotechnology, which considerably enlarged the therapeutic, preventive and diagnostic potential of human and veterinary medicine. Especially, hybridoma technology and recent developments in recombinant DNA technology, have found several applications, and they will - when used either separately or in combination - result in a considerable extension and refinement of the possibilities of diagnosis in man and animals. PMID- 3824333 TI - [Several cases of nitrite poisoning in broiler breeding hens]. AB - Because of insufficient ventilation during winter, water condensation associated with a high concentration of ammonia (70-100 ppm) in the air, occurred on several breeding farms. The ammonia became bound to the condensation water and was converted into nitrites (6000-16000 mg/l) and nitrates (1630-1700 mg/l). Ingestion by the birds resulted in acute death, probably as a result of the high nitrite concentration. The brown colour of the blood pointed to the conversion of haemoglobin to methaemoglobin and this is one of the features of nitrite poisoning. PMID- 3824334 TI - [The Dutch diploma in North America (2)]. PMID- 3824335 TI - [Heifer, parturition at a standstill]. PMID- 3824336 TI - [Specialization in veterinary medicine of farm animals?]. PMID- 3824337 TI - [Experiences with veterinary activities in developing countries]. PMID- 3824338 TI - [Host-parasite relations]. AB - Our current knowledge of the host-parasite relationship is reviewed as part of a series entitled 'Papers of yesterday and today'. A retrospective view is taken of a paper written in 1898 by Professor H. J. Hamburger, entitled 'The Current Point of View of the Theory of Natural Immunity', which is also published in a slightly abridged version in this issue of Tijdschrift voor Diergeneeskunde. A review of the history of developments in research in the field of infectious diseases since 1898 is followed by a discussion of two phenomena, colonisation resistance and immune adherence. So-called non-specific as well as specific (= immunological) defense mechanisms are then discussed. Finally, our current knowledge of the 'Biological Response Modifiers' is considered particular attention being paid to possible uses of recombinant DNA interferons and interleukins in human and veterinary medicine. PMID- 3824339 TI - [Ethical aspects of biotechnology]. AB - The relationship between man and animals usually receives little if any attention in ethics. Albert Schweitzer and his 'reverence for life' (1923) was the only exception. The rapid and recent developments of biotechnological possibilities in the field of veterinary medicine have so far not been considered from the point of view of ethics. In agreement with Schweitzer, Karl Barth (1951) stressed the principle of life which man and animals have in common. Passages in the Bible attribute one and the same 'life' ('soul') to both (Book of Proverbs 12: 10) and presuppose 'salvation' or 'preservation' of the two (Psalm 36:7c). Human responsibility in associating with this related species will therefore have to be apparent from careful maintenance of the conditions of this form of life, in research as well as in management. PMID- 3824340 TI - [Condemnation of 60 tons of South American beef]. AB - A case of inspection of sixty tons of South American beef is reported. A second assessment by the regional veterinary inspection was requested because of condemnation for spoilage. The initial decision based on inspection was maintained. In view of the type of spoilage, it is believed to be likely that this was present before the deboning of the meat. Although the level of meat hygiene is high in South America, this incident proves the necessity of careful inspection of imported meat. PMID- 3824341 TI - [Modification of wound healing with ultraviolet rays. Review of the literature]. AB - This article describes the physical aspects and biological effects of UV radiation. The clinical effects of UV waves on wound healing are discussed separately. Indications for treatment using UV waves are presented, as well as suggestions as to the best way in which treatment can be effected, and the risks which must be considered. PMID- 3824342 TI - [Physiotherapy in dogs. Initial practice results]. AB - Physical therapy in thirty-eight dogs is documented and evaluated. To begin with, the methods of physical therapy adopted in various cases in which a veterinary diagnosis was established, are reviewed. Subsequently, the results are reported and classified by veterinary diagnosis. Finally, the limitations of the present evaluation are shown as well as the possibilities of improving indications as a result of investigations, which will require a co-ordinated approach. PMID- 3824343 TI - [Acute polydipsia]. PMID- 3824344 TI - [Management of hedgehogs]. PMID- 3824345 TI - [Interruption of the sensory nerve tract in chronically lame horses]. AB - Within the framework of the series 'Papers of yesterday and today', two articles on neurotomy by Moubis (1876 and 1878) are used to evaluate the present status of neurectomy. In 1800 neurotomy was replaced by neurectomy because of the reinnervation which occurred after several weeks. On the basis of a literature review and clinical experience in the Department of Large Animal Surgery the indications, conditions, anatomy, operative techniques, complications and results of neurectomy are discussed. Post-operative neuroma formation is the most important complication following palmar digital neurectomy. The many operative techniques and modifications which have been conceived and used are the consequence of the search for technical and surgical variations for prevention of neuroma formation. The ethical aspects of the use and misuse of the neurectomised patient are discussed. The importance of the ethical appreciation of owners and the very important informative function of the veterinary surgeon are emphasised. PMID- 3824346 TI - [Quantitative study of the sensitivity of Bordetella bronchiseptica and Pasteurella multocida to sulfonamides]. AB - Information concerning the resistance to sulfonamides in the Netherlands was obtained by determining the minimal inhibitory concentrations (MIC's) of 119 strains of Bordetella bronchiseptica and 151 strains of Pasteurella multocida, obtained from pigs at five veterinary bacteriology centres, to sulfadimidine (SDM) and sulfamethoxazole (SMX). The MIC's of SDM against Su-susceptible strains were usually 4 times higher than those of SMX. About one third of B. bronchiseptica isolates were resistant (MIC greater than 64 micrograms/ml) to both sulfonamides. Approximately 7% of P. multocida isolates were resistant to SMX, and 21% to SDM. It is concluded that the use of SDM as the sulfonamide of choice for the treatment of atrophic rhinitis is questionable. PMID- 3824347 TI - [Unequal femurs]. AB - The femurs of a dog presented for lameness were found to be unequal in length. This was successfully treated by resection of the head of the femur. This patient was affected with rupture of the contralateral anterior cruciate ligament within six months. PMID- 3824349 TI - [Coughing cows]. PMID- 3824348 TI - [An unusual case of panic running by calves]. PMID- 3824350 TI - [Oropharyngeal tumors in dogs and cats: a review]. AB - The literature on canine and feline oropharyngeal tumours is reviewed. Particularly in dogs, these neoplasms are not uncommon. Papillomas, and particularly epulides, are the most common benign tumours in dogs. Four types of epulides are differentiated viz. fibromatous, ossifying, acanthomatous and giant cell epulis. Acanthomatous epulides frequently infiltrate into bone locally and are potentially capable of transforming themselves into squamous cell carcinomas. Malignant melanoma, squamous cell carcinoma and fibrosarcoma are the most important malignant neoplasms which usually show a highly malignant biological character. Benign oropharyngeal tumours are uncommon in cats. Squamous cell carcinoma is the most common feline neoplasm. Canine and feline odontogenic and bone tumours are briefly discussed, other uncommon oropharyngeal tumours being merely referred to. PMID- 3824351 TI - [5 years of monoclonal antibodies at the Central Veterinary Institute]. AB - The use of monoclonal antibodies in veterinary research during recent years opened up several new possibilities for the study of fundamental problems and the improvement or development of diagnostic techniques. At the Central Veterinary Institute (CVI), Lelystad, the Netherlands, a large number of monoclonal antibodies to various animal pathogens were prepared and used. Our recently acquired knowledge and extensive diagnostic potential in cases of infectious disease offer adequate possibilities for the improvement or development of methods to control particular forms of disease in animals. The progress made in this fields and the use of monoclonal antibodies of the CVI are briefly reviewed. PMID- 3824352 TI - [Breeding policy and pedigree dog populations]. AB - Data on the effects of selection in breeds of dogs were collected. Particularly, effects on behavioural traits, characteristics of type and movement and state of health. The data were collected by studies of the literature and discussions with dog breeders and their organisations. The data collected was used to design a model of a dog population. In this model, various genetically determined traits were introduced and the breeding policy for these traits was then discussed with experts in breeding of animals of other species. PMID- 3824353 TI - [Canine distemper: then and now]. AB - Canine distemper was known as a severe systemic infection of dogs and other carnivores for some centuries now. Symptoms of the gastrointestinal and respiratory tracts are particularly prominent. Nervous symptoms are also regularly observed. A paper on canine distemper by J.C. van der Slooten appeared in Tijdschrift voor Veeartsenijkunde en Veeteelt in 1894, in which a number of features of this disease was discussed. This paper was also published in the present issue of Tijdschrift voor Diergeneeskunde (see page 309). On the basis of this paper, several developments are described, which contributed to our current knowledge of canine distemper. Particular attention is paid to the aetiology, pathogenesis and epizootiology as well as the prevention of distemper by vaccination. PMID- 3824354 TI - [The microbiological status of dry sausage in East Netherlands]. AB - Dry fermented sausage (dfs) was the food most suspected in a number of outbreaks of salmonellosis and staphylococcal enterotoxaemia. Data on formulation and processing showed that over 75 per cent of 76 producers still manufactured dfs in a traditional manner: fermentation and drying at ambient temperature for ten days on an average, green room facilities not present. 'Modern' processes were characterised by fermentation in green rooms at elevated temperatures, thus limiting production time to six days on an average. However, precautions to prevent luxurious growth of S. aureus under these conditions were not adopted to any appreciable extent. Consequently, high S. aureus levels (greater than 10(4) cfu/g) were detected precisely in dfs from five manufacturers using rapid processes. Colony counts of Enterobacteriaceae were low in dfs (81 per cent of 151 samples less than 10(3) cfu/g), associated with relatively low pH and aw levels and a high concentration of salt. However, Salmonella was detected in 16 (11%) of the samples, both from 'traditional' and 'modern' producers. Improvement of manufacturing practices in the manufacture of dfs should be stimulated to guarantee wholesome and safe products. PMID- 3824355 TI - [Pseudotuberculosis in goats also in the Netherlands. A literature review]. AB - Pseudotuberculosis or caseous lymphadenitis in goats is marked by superficial abscesses and was recently observed in the Netherlands. The literature on this disease is reviewed, concerning the incidence, aetiology, pathogenesis, symptoms, diagnosis, therapy and preventive measures. The damage which the disease could cause to goat husbandry in the Netherlands, is discussed. Although the losses from death and diminished production will probably be small, treatment is time consuming and requires much labour. The greatest damage will possibly consist in the fact that breeders will not be able to sell their animals when caseous lymphadenitis occurs in their herd. Particularly, the export of breeding stock could be menaced by this disease. PMID- 3824356 TI - [Alder buckthorn poisoning in horses]. AB - Seven cases of poisoning in horses are reported. This was caused by ingestion of branches of the alder buckthorn (Frangula alnus (mill.) syn. Rhamnus frangula L.), which had been thrown on the pasture. The biological characteristics and the toxic action of the plant are discussed more fully. PMID- 3824357 TI - [Veterinary Chief Inspection of Public Health. Analysis of residues in slaughtering animals and fresh meat]. PMID- 3824358 TI - [Tattooing of cats]. PMID- 3824359 TI - [An unusual experience. 2 atypical cases of rabies]. PMID- 3824360 TI - [Pediatric endocrinology in a time of rapid change]. PMID- 3824361 TI - [Central precocious puberty]. AB - Precocious puberty is a stressful event for patient and environment. The diagnostic evaluation will be discussed. LHRH analogs will give a new approach in the treatment of central precocious puberty. PMID- 3824362 TI - The resolution of platelet serologic problems using Western blotting. AB - Serologic identification of anti-PLAl and other platelet specific antibodies is difficult because other platelet reactive antibodies (e.g. anti-HLA) are commonly found in the samples. We have developed and evaluated a method using Western blotting to identify platelet specific antibodies. Since anti-PLAl is the most frequently encountered antibody, we used this antibody to validate the method. The PLAl antigen was found on a 95,000 Dalton protein, confirmed as glycoprotein IIIa by two-dimensional electrophoresis. The usefulness of Western blotting in resolving difficult platelet serologic problems was compared to a radiolabeled antiglobulin test using intact platelets. Our results showed that all sera with anti-PLAl identified by serology were confirmed by Western blotting. In addition, one anti-PLAl was detectable only by the proposed method. Western blotting was also as useful as a serologic method to PLAl type platelets. HLA antibodies were not demonstrable by this technique. In summary, Western blotting is a highly specific and sensitive way of identifying anti-PLAl in a variety of clinical situations. This approach may be used to identify antibodies to other platelet specific antigens and to standardize platelet antigen typing sera. PMID- 3824363 TI - Lack of association of HLA with thyroid cancer. An effect of iodine sufficiency and safe environment? AB - We examined HLA association with differentiated thyroid carcinoma in 45 patients from Newfoundland. No association was found. This finding contrasts with the description of an association of thyroid cancer with HLA-DR1 in Italy and Hungary (iodide deficient areas) and with DR7 in the American mid-west. We suggest that iodide deficiency predisposes DR1 + individuals to thyroid cancer and that this risk is negated by iodide sufficiency unless some other risk factor supervenes. PMID- 3824364 TI - [Endangered farm animal breeds in German-speaking countries. II. Cattle]. AB - The development of farm animals since the beginning of domestication is described. Modern breeds have existed since the end of the 18th century. Different efficiency with regard to what were topical breeding aims as well as manipulations by the government led to a decrease in the variety of breeds. The reasons of preserving endangered breeds are both genetic and cultural. There are some examples of breeds that once had little attention payed to and which now have obtained economic importance again. In recent years several institutions in West Germany have tried by financial advancement and other measures for a variety of breeds to avoid further curtailment of them. PMID- 3824365 TI - [Health problems in fallow deer for meat production]. AB - Though fallow deer is considered very resistant to infectious diseases and parasites, diseases of different kind occur in enclosed pastures. Normally the diseases are the same as with wild animals or with farm ruminants. Diseases limited only to fallow deer are not known up to now. Parasitic diseases are a common problem, and prophylactic measures are necessary in all enclosed pastures to control parasites. Most losses in the enclosed pastures at the state farms of Grub and Romenthal caused by infections were due to necrobacillosis or to Coli bacteria. Because therapy is difficult or even impossible with wild animals, prophylactic measures are very important in enclosed pastures. Prophylaxis against Coli infections by improving the environment is possible only to a limited degree. Metabolic diseases and poisonings are mostly caused by wrong feeding. PMID- 3824366 TI - [Foreign-body related esophagus obstruction in a peacock (Pavo cristatus L. 1758)]. AB - A coil of metal wire was diagnosed by X-ray closely to the heartbasis in an eight year-old peacock. Described are anesthesia and successful surgical removal of the coiled wire which had partially pierced the wall of the oesophagus. Means of post surgical drug and dietetic therapy are discussed. PMID- 3824367 TI - [The effect of vitamin H substitution on the growth and condition of hooves]. AB - A long-term treatment with biotin (vitamin H) in 5 warm-blooded horses and 10 trotter horses is reported. The dose of 0.031-0.037 mg/kg body weight was well tolerated, and with a therapy period up to 10 months an improvement of the horn quality of the growing hoof could be attained as it had not been possible before with other measures. Biotin (Gabiotan) is recommendable as a therapeutic in all cases of hoof problems which are based on disturbed horn elasticity. PMID- 3824368 TI - [Clinical aspects of ovary tumors in mares]. AB - The present study comprises 31 mares, that showed a permanent unilateral enlargement of the ovary. In 29 patients the ovary in question was removed by a flanc laparotomy in the standing animal. In the histopathologic examination a granulosa cell tumor was diagnosed in 23 cases, a fibroma twice and a teratoma, hematoma, leiomyoma and a cystic ovary each once. Due to the endocrine activity of the granulosa cell tumor, the clinical picture was characterized by changed behaviour and atrophy of the contralateral ovary. Clinically the ovarial blastomas (teratoma, leiomyoma, fibroma) could not be differentiated from granulosa cell tumors. The postoperative prognosis of fertility is good. It should be noted though, that most of the mares did not foal until two years after the surgery. PMID- 3824369 TI - [Primary and secondary extrauterine pregnancy in a cat]. AB - The primary and secondary extrauterine gravidity is defined and the different types are explained. With reference to embryos found in the abdomen of a cat, four embryos in different developmental stages and mummification grades are discussed, emphasizing which of the extrauterine gravidity type is present in this clinical case. A primary abdominal pregnancy could not be proven histologically. PMID- 3824370 TI - [Differential postmortem diagnosis of rabies in cats]. AB - 300 cats, sent in for rabies diagnosis, which were obviously not infected, have been further examined with regard to their causes of disease and death. Traumata, uremia and panleucopenia have been observed most frequently. As expected, affections of the central nervous system often have been stated. The results of our investigations have been compared with autopsy statistics on rabies unsuspected cats, published in literature. Furthermore the preliminary reports have been examined and compared with the anamnesis of 214 rabies-positive cats. The information of preliminary reports on rabies-negative cats and their pathological diagnosis has been discussed in the context of differential diagnosis. PMID- 3824371 TI - [Earth currents as a cause of fry losses in a trout stock]. AB - The grounding of the mains by the energy suppliers causes sporadic alternating earth currents. From water over the housings of areator and its earth-connected guardwire such currents may occur. In a South German trout hatchery these earth currents led to losses of 30% among the influenced fry and to a 25% crippling among the surviving fry. Cause, clinical events and possible preventive measures are discussed. PMID- 3824372 TI - [The dissemination of Salmonella by meat and meat products from swine]. AB - Pork and pork products which are consumed raw, e.g. mincemeat or fresh Bologna sausage, are relatively often contaminated with salmonellae. In the average of one year we detected salmonellae in about 5% of the samples investigated. Due to seasonal and local influences up to 45% of the minced meat samples can be positive for salmonellae. In minced meat salmonellae grow only at temperatures above 7 degrees C. During frozen storage of meat for several weeks, the salmonella count decreases on an average of about 50%. A damaging of surviving salmonellae by the freezing and thawing process was not observed. On the contrary, in thawed mincemeat stored at 8 degrees C the growth of salmonellae is stimulated, i.e. they grow better than in mincemeat not frozen before. Growth of salmonellae in Bologna sausage ("frische Mettwurst") can be inhibited by adding of at least 2.5% nitrit curing salt, 0.3% glucono-delta-lactone, and lactic acid starter cultures, even if the product is stored at temperatures up to 25 degrees C. Likewise in spreadible and sliceable fermented sausage ("streichfahige und schnittfeste Rohwurst") no growth of salmonellae is to be expected, if a similar technology secures a sufficient microbiological stability during the ripening and smoking process. Therefore, the dissemination of salmonellae by pork and pork products can be avoided by technological measures, but also by a reasonable conduct of the consumer in the household. PMID- 3824373 TI - Effect of duration of stimulation on mechanical properties of trachealis muscle. AB - We have studied the effect of duration of stimulation on the dynamic behavior of isolated dog trachealis muscle tonically contracted by alternating current or carbachol. With the muscle contracted quick stretch and quick release maneuvers were performed. The force-length curves during the quick maneuvers were similar for both methods of stimulation and regardless of the duration of stimulation. This behavior is consistent with an undamped passive series elastic component. The plateaux of force preceding these quick maneuvers were also similar. Isometric stress relaxations after quick stretch were similar. However, after quick release, isometric stress recovery and isotonic shortening velocity were more rapid with alternating current stimulation than with carbachol, and both isometric stress recovery and isotonic shortening velocity decreased with increasing duration of stimulation by either means of stimulation. We conclude that the difference in velocity of shortening is not due to the different method of stimulation but rather to the duration of stimulation. Active respiratory smooth muscle may show different dynamic properties depending on the duration of stimulation but not on the differences in means of stimulation. PMID- 3824374 TI - Endotoxemia after abdominal surgery. AB - The blood level of endotoxin after operations in patients with digestive diseases, mainly liver cirrhosis and obstructive jaundice, and the complications most likely related to the presence of endotoxemia were investigated. Twenty seven patients without either liver cirrhosis or obstructive jaundice showed a minimal elevation of the endotoxin level in blood, as shown by 6.1 +/- 3.9 (mean +/- S.E.) pg/ml at the first postoperative day and there was only one anastomotic leakage. On the other hand, 18 patients with liver cirrhosis showed a notable and persistent endotoxemia after surgery. The cirrhotic patients who especially underwent splenectomy and hepatectomy showed marked elevations of endotoxin level at the first postoperative day, with values of 151.0 +/- 46.1 pg/ml and 101.3 +/- 36.2 pg/ml, respectively, and one of these patients died of hepatic failure. Thirteen patients with obstructive jaundice developed endotoxemia evidenced by the value of 21.6 +/- 4.8 pg/ml at the first day after surgery. Among these patients, two had gastrointestinal bleeding and one developed disseminated intravascular coagulation (DIC). The markedly high and persistent levels of endotoxin in patients with liver cirrhosis or obstructive jaundice may be possibly related with the development of multiple organ failure (MOF). PMID- 3824375 TI - Utility of BID administration of cimetidine for gastric ulcer: a comparison with QID administration in a double blind manner. AB - The clinical efficacy of cimetidine for gastric ulcer was compared between the standard administration methods in Japan; 200 mg four times daily and 400 mg twice daily after breakfast and at bedtime in a double blind manner. It was found that the results obtained by 200 mg twice-daily administration were almost comparable to those obtained by the four-times-daily administration without statistically significant difference for healing rate, final global improvement in subjective and objective symptoms, incidence of adverse reactions and effects on laboratory tests. These findings resulted in that the twice-daily administration of cimetidine provides convenience for patients. PMID- 3824376 TI - Angiocardiographic estimation of left ventricular mass in normal infants and children. AB - Left ventricular mass data were obtained from biplane cineangiocardiograms in 37 normal infants and children. Left ventricular mass calculated by using thickness of anterior wall (left ventricular mass-anterior) and posterior wall (left ventricular mass-posterior) of the free left ventricular wall were studied in relation to body surface area and left ventricular end-diastolic volume. Both of left ventricular mass-anterior and mass-posterior were expressed as a function of body surface area with exponential relationship; left ventricular mass-anterior = 68.5 (body surface area) g (r = 0.98, p less than 0.01), left ventricular mass posterior = 84.6 (body surface area) g (r = 0.97, p less than 0.01). Left ventricular mass-anterior/left ventricular end-diastolic volume averaged 0.73 +/- 0.01 g/ml, and left ventricular mass-posterior/left ventricular end-diastolic volume 0.89 +/- 0.02 g/ml, respectively. Thus, left ventricular mass can be predicted from body surface area by using the exponential equations. In addition, normal values for left ventricular mass-posterior must be discriminated from those for left ventricular mass-anterior. PMID- 3824377 TI - A case of a newborn infant with Hb M Iwate. AB - Hemoglobin of a newborn infant who was suspected to hereditarily have Hb M Iwate was examined. The infant hemolysate was separated into five fractions by column chromatography on Amberlite CG-50, and two of these fractions showed absorption spectra corresponding with that of Hb M Iwate. Five bands were found after the isoelectric focusing of the hemolysate, and two of these bands were brown. The two Hb M fractions obtained by column chromatography was focused to the positions of the brown bands. One of these Hbs M corresponded with Hb M Iwate (alpha M2 beta 2) from an adult carrier of this trait, but the other was not found in adult hemolysates. The latter species of Hb M was shown to be composed of the abnormal alpha chain and the normal gamma chain (alpha M2 gamma 2) by chain analysis, and was assumed to be specific for infants. A quantitative estimation of the hemoglobins in the infant hemolysate showed that there was no difference between the relative quantities of the fetal and adult forms of Hb M Iwate. PMID- 3824378 TI - Heat and chemical stability of blood group-specific immunoglobulins in the state of immunecomplex. AB - Immune agglutinin or precipitin loses its reactivity with the corresponding antigen by heating or some chemicals. A. Se group saliva or M group blood stain was sensitized with human IgM anti-A or rabbit IgG anti-M serum, respectively. After being washed with saline, the stains were heated or treated with formalin or 2-mercaptoethanol (2-ME) of various concentrations. The immunoreactivity of the antibodies in the state of immunecomplex was examined by the mixed agglutination or elution test, indicating IgM and IgG antibodies in the state of immunecomplex were proof against heating up to 150 degrees C for 10 min and against formalin and 2-ME of high concentrations. It is considered that IgM and IgG acquire a new property of heat and chemical stability by formation of immunecomplex although they are substantially heat and chemical labile. PMID- 3824379 TI - Age- and sex-related profiles of serum primary and total bile acids in infants, children and adults. AB - The relation of age and sex to serum primary (PBA) and total bile acid (TBA) concentrations was evaluated by an enzymatic fluorometric microassay in healthy infants, children and adults. TBA concentrations were the highest in the 6-day old group and 1-month-old group and seemed to switch to almost normal adult levels by the age of 4-6 years, which persisted throughout life, while PBA concentrations were predominant over a period of 3 days to 3 months after birth. No sex-related differences were observed from neonates to very old persons for any of serum bile acids. These results show that the bile acid metabolism in the liver and the enterohepatic circulation of bile acids are usually matured in infancy and that aging and sex may insignificantly affect serum bile acid metabolic profiles. PMID- 3824380 TI - Physiologically based pharmacokinetics and the risk assessment process for methylene chloride. AB - Methylene chloride (dichloromethane, DCM) is metabolized by two pathways: one dependent on oxidation by mixed function oxidases (MFO) and the other dependent on glutathione S-transferases (GST). A physiologically based pharmacokinetic (PB PK) model based on knowledge of these pathways was used to describe the metabolism of DCM in four mammalian species (mouse, rat, hamster, and humans). Kinetic constants for the model were derived from in vivo experiments or the literature. The model was constructed to distinguish contributions from the two pathways of metabolism in lung and liver tissue, and to permit extrapolation from rodents to humans. Model validation was conducted by comparing predicted blood concentration time-course data in rats, mice, and humans with experimental data from these species. The tumor incidence in two chronic studies of DCM toxicity in mice was correlated with various measures of target tissue dose calculated with the PB-PK model. Tumor incidence correlated well with tissue AUC (area under the concentration/time curve) and amount of DCM metabolized by the GST pathway. However, tumor incidence did not correlate with the amount of DCM metabolized by the MFO pathway. Because of its low chemical reactivity, DCM is unlikely to be directly involved in carcinogenesis. Consequently, metabolism of DCM by GST appears to be important in carcinogenesis. The PB-PK model was used to estimate target doses of presumed toxic chemical species in humans exposed to DCM by inhalation or by drinking water. Target tissue doses in humans exposed to low concentrations of DCM are 140- to 170-fold lower (inhalation) or 50- to 210-fold lower (drinking water) than would be expected from the linear extrapolation and body surface area factors which have been used in conventional risk assessment methods (D. V. Singh, H. L. Spitzer, and P. D. White (1985). Addendum to the Health Assessment Document for Dichloromethane (Methylene Chloride). EPA/600/8 82/004F). The PB-BK analysis thus suggests that conventional risk analyses greatly overestimate the risk in humans exposed to low concentrations of DCM. PB PK considerations provide a scientific basis for risk assessment, improve experimental design in chronic studies, and structure collection of quantitative metabolic constants required for risk assessment. PMID- 3824381 TI - Paraquat-induced, dose-dependent conditioned taste aversions and weight loss mediated by the area postrema. AB - Paraquat's (PQ) effect on feeding behavior in the rat was examined using a conditioned taste aversion (CTA) paradigm. CTA is a learned avoidance of tastes closely associated with prior illness. Male Sprague-Dawley rats trained to drink an instant breakfast solution were subsequently offered a novel-flavored solution and consumption was measured over 30 min. Following consumption of the novel solution, PQ (0.48-48.0 mumol/kg) was injected subcutaneously. Peak blood PQ concentrations were measured by serially sampling blood (0.15 ml) from an indwelling jugular cannula between 10 and 35 min after injection. Two days later, the rats were offered the same novel-flavored solution. Paraquat produced dose dependent avoidance of the novel solution when injected subcutaneously. A PQ dosage of 2.7 mumol/kg or less did not alter consumption. The ED50 for CTA production of 13.0 mumol/kg was determined by log-probit analysis. The minimum effective dosage was 4.2 micron/kg. The doses examined did not produce overt clinical or histological signs of toxicity. Peak blood paraquat concentration was linearly related (r = 0.995) to dosage. Additionally when administered by gavage CTAs occurred only with a much larger PQ dosage (480 mumol/kg). Thermal lesions of a hindbrain circumventricular organ, the area postrema (AP), prevented PQ induced CTAs despite repeated PQ injections. Additionally, weight loss following PQ exposure was also attenuated by AP lesions. CTAs were induced in these same AP lesioned rats by oral administration of copper sulfate. This substance conditions taste aversions by activating vagal afferent neurons. The fact that copper sulfate-induced aversions were not blocked by lesions of the area posterema indicates that the lesioned rats are capable of forming CTAs when treated with a toxicant which does not act via the AP. These data indicate that PQ produces CTAs in a dose-dependent manner. Furthermore, PQ-induced CTAs and weight loss are mediated by the AP. The AP may contain receptors which detect xenobiotics, enabling animals to avoid future contact with these compounds. PMID- 3824382 TI - Changes in physicochemical properties of mitochondrial membranes during the formation process of megamitochondria induced by hydrazine. AB - Changes in some biochemical and physico-chemical properties of rat liver mitochondrial membranes during the formation process of megamitochondria induced by hydrazine were analyzed. Hepatic mitochondria obtained from rats placed on a 1% hydrazine diet for 3 days became slightly enlarged and sometimes elongated, while they became gigantic after 7 days of hydrazine intoxication. Changes were observed in mitochondria from rats treated with hydrazine for 3 days. Total amounts of phospholipids extracted from mitochondria and submitochondrial fractions were increased. Among phospholipid species, relative amounts of acidic phospholipids were increased. Contents of Ca2+ in mitochondria were increased. Differential scanning calorimetric analysis of mitochondria, especially that of the outer membrane fraction, showed that the thermotropic lipid phase transition temperatures were elevated accompanying the broadening of thermograms and the increase in transition enthalpy. Contents of water in mitochondria were increased significantly with the ratio of freezable water to unfreezable water unchanged. Among the changes observed was that the total amount of phospholipids (except for that of the outer membrane fraction) and the contents of water and Ca2+ nearly returned to normal in megamitochondria after 7 days of hydrazine intoxication. Relative amounts of phospholipids and thermotropic lipid phase transition temperatures of megamitochondria did not return to normal levels and yet changes were smaller than those obtained from 3 days of hydrazine intoxication. The fluidity of mitochondrial membranes was not affected by hydrazine treatment. These data would suggest that hydrazine-induced megamitochondrial formation is not due simply to the swelling of mitochondria, but might be due to the fusion of adjacent mitochondria by Ca2+-acidic phospholipid interactions, and once megamitochondria are formed the mitochondrial membranes are stabilized. PMID- 3824383 TI - Triphenyl phosphite: in vivo and in vitro inhibition of rat neurotoxic esterase. AB - Organophosphorus compounds which, after acute administration, inhibit neurotoxic esterase (NTE) by greater than or equal to 65% and undergo a subsequent "aging" reaction, produce a delayed neuropathy characterized by degeneration of large and long nerve fibers (OPIDN). The present studies examine in detail the NTE inhibiting properties of triphenyl phosphite (TPP), a plasticizer which produces ataxia and degeneration of the spinal cord in animals. A neurotoxic dosing regimen (1184 mg/kg/week, sc, for 2 weeks) inhibited both brain and spinal cord NTE (less than or equal to 40%) only marginally 4 and 48 hr postdosing. By contrast, TPP was shown in vitro to be a potent (150 = 0.98 microM) inhibitor of rat brain NTE relative to Mipafox or diisopropyl phosphorofluoridate. Compounds structurally related to TPP (i.e., triphenyl phosphate, triphenyl phosphine, trimethyl phosphite, and phenol) failed to inhibit NTE in vitro at less than 10 microM concentrations. Close examination of the TPP inhibition of NTE showed a nonlinear relationship between the duration of incubation time and loss of log(NTE activity). Preincubation of 10 microM TPP in buffer (37 degrees C) resulted in a time-dependent loss of TPP's ability to inhibit NTE. In summary, TPP is a powerful NTE inhibitor in vitro, but only a marginal NTE inhibitor after in vivo administration. These results raise questions as to the causal events mediating TPP-induced neuropathy in the rat. PMID- 3824384 TI - Induction of hepatic metallothionein by alcohols: evidence for an indirect mechanism. AB - The purpose of the present study was to determine the ability of various short chain alcohols to induce metallothionein (MT) in the liver and to determine whether the induction results from a direct action of alcohol on liver or an indirect action mediated by zinc, glucocorticoids, or catecholamines. Mice were administered alcohol by gavage and hepatic MT was quantitated by the Cd hemoglobin radioassay. Ethanol, methanol, isopropanol, and propanol increased MT content to seven to nine times that of control liver. In vitro, ethanol did not increase MT concentrations in rat hepatocyte cultures, indicating that the in vivo induction is not a direct effect of ethanol on the liver. Adrenergic blocking agents did not reduce the MT content of ethanol-treated mice, indicating that catecholamines are probably not involved in the MT induction. Corticosterone and zinc concentrations in plasma were increased in mice 1 hr after ethanol treatment. Corticosterone, given in vivo, was a less effective inducer of MT than was ethanol treatment. In conclusion, hepatic MT was increased by several alcohols, the induction was not due to direct action of alcohol on the liver, and while the mechanism of alcohol induction of MT is unclear, it may be due to an alteration in zinc and glucocorticoid homeostasis. PMID- 3824385 TI - Acute cardiovascular and pulmonary effects of intravenous and aerosolized amiloride in the dog. AB - Active Na+ absorption by the epithelia that line the airways can drive volume from the airway surface. Exposure of the lumen-facing surface of airway epithelia to amiloride inhibits Na+ transport. Consequently, aerosolized amiloride may help hydrate the desiccated surface liquid that characterizes lung diseases such as cystic fibrosis. We studied the acute cardiovascular and pulmonary effects of amiloride in anesthetized dogs. Intravenous amiloride reduced blood pressure and increased ventilation frequency and airways resistance of the dog. The effects were dose-related (ED50 = 1.3 X 10(-6) mol/kg), resembled those of injected histamine, and were antagonized by methapyrilene. These results were compatible with the release of endogenous histamine by amiloride, but the graded dose-effect relationship for amiloride differed from the quantal relationship induced by the prototypical releaser, 48/80. Aerosolization of a Ringer's solution that was nearly saturated with amiloride deposited, in upper airway surface liquid, drug concentrations which in previous studies, were sufficient to inhibit Na+ transport by canine airways (ED50 approximately 10(-6) M). Cardiovascular function, airways resistance, and indices of pulmonary tissue water, gas exchange, and perfusion were not affected. Since circulating amiloride after aerosolization was estimated to fall below the concentration that induced vasodepression and correct circled bronchoconstriction after intravenous injection, we conclude that the potency of aerosolized amiloride to induce acute effects in tissues other than airway epithelia is no greater than that of intravenous drug. PMID- 3824386 TI - Utilization of methionine as a sulfhydryl source for metallothionein synthesis in rat primary hepatocyte cultures. AB - Metallothioneins (MT) contain a high concentration of cysteine which bind heavy metals. Exposure of liver cells to metals induces the synthesis of MT and thus causes the cells to draw upon their sulfhydryl (SH) pools. The utilization of methionine as compared with that of cysteine as a source of SH for the synthesis of MT has not been shown. Therefore, studies were designed to determine whether methionine, in addition to cysteine, serves as an SH donor for Zn-induced synthesis of MT in rat hepatocyte cultures. Hepatocytes were able to synthesize only low levels of MT when the concentration of both amino acids was extremely low; however, when either of the amino acids was present at a high concentration, production of MT was independent of the other amino acid concentration. Subsequently, induction of MT was compared in four media: complete (0.5 mM methionine, 0.5 mM cysteine), Met (0.5 mM methionine), Cys (0.5 mM cysteine), and SH free (-SH). Somewhat higher concentrations of MT were produced by the hepatocytes in the Met than in the Cys media and no differences were observed between the Met and the complete media. By contrast, GSH synthesis was much more dependent on methionine than on cysteine for its synthesis. Incorporation studies with 35S-labeled cysteine and methionine indicated that lower concentrations of MT found in hepatocytes in the Cys media may be due to less accumulation of cysteine by the hepatocytes. Cellular accumulation of cysteine was initially rapid and then reached a plateau, whereas the rate for methionine accumulation was more constant and eventually obtained higher cellular levels. To provide additional evidence for the role of methionine in MT production, a known inhibitor of the cystathionine pathway, DL-propargylglycine (PPG), was added to each of the four media. Reductions in MT levels were not observed in the cells cultured in the complete and Cys media; however, a 95% reduction was observed in the cells cultured in the Met media. In summary, the present results suggest that both cysteine and methionine can serve as a SH source for MT synthesis, and that the availability of SH in most culture mediums would not limit the synthesis of MT. Whereas methionine is a much better SH source than cysteine for GSH synthesis in hepatocyte cultures, it is only slightly better for MT synthesis. PMID- 3824387 TI - Age-related differences in susceptibility to renal ischemia in rats. AB - These experiments were designed to determine the influence of age on the response of the kidney to ischemia. Renal ischemia was induced in female Fischer-344 rats, 3-4 or 37-38 months old, by renal arterial and venous occlusion followed by 0, 1, 24, or 96 hr of reflow. Age-matched controls were sham operated but were not subjected to ischemia. A transient postischemic increase in blood urea nitrogen (BUN) and serum creatinine was observed in young rats. In old rats, BUN and serum creatinine remained markedly elevated through 96 hr postischemia. In vitro renal cortical slice accumulation of organic ions was inhibited to a greater extent in old rats than in young rats 96 hr postischemia. Histologically, renal tubular damage was more severe in old than in young rats 24 and 96 hr postischemia. Tubular regenerative activity was similar in old and young rats at 96 hr, but restoration of tubular architecture was more complete in young rats. Organic ion accumulation by renal cortical slices from naive old rats was inhibited by in vitro anoxia (treatment with 100% N2) to a greater extent than tissue from young rats. These data suggest that old rats are more susceptible to renal ischemia than are young rats and these differences in susceptibility may reflect intrinsic age-related differences in basal renal metabolism. PMID- 3824388 TI - Effect of dose on the absorption and excretion of [14C]benzene administered orally or by inhalation in rats and mice. AB - The effect of dose on the absorption and excretion of [14C]benzene was studied using 13-week old male F344/N rats, Sprague-Dawley rats, and B6C3F1 mice. Gastrointestinal absorption of benzene administered by gavage was greater than 97% in these species for doses between 0.5 and 150 mg benzene/kg body wt. At oral doses below 15 mg/kg, greater than 90% of the 14C excreted was in the urine as nonethylacetate extractable material. Above 15 mg/kg, in both rats and mice, an increasing percentage of the administered benzene was exhaled unmetabolized, suggesting saturation of metabolic pathways. Above 50 mg/kg, total metabolites (as determined by 14C in the urine, feces, and carcass after 2 days) were not linearly related to administered dose. Total metabolites per unit body weight was equal in F344/N rats and B6C3F1 mice at gavage doses up to 50 mg/kg; however, total metabolites in mice did not increase at higher doses. For inhalation exposures, the percentage of inhaled benzene that was absorbed and retained during a 6-hr exposure decreased from 33 +/- 6% (mean +/- standard deviation) to 15 +/- 9% in rats, and from 50 +/- 15 to 10 +/- 2% in mice as the exposure concentration was increased from approximately 26 to 2600 micrograms/liter (10 to 1000 ppm at 615 Torr, 23 degrees C). Total metabolite formation was exponentially related to the benzene exposure concentration with one-half the maximal amount of metabolite formation occurring at 220 micrograms/liter (84 ppm) for B6C3F1 mice and 650 micrograms/liter (250 ppm) for F344/N rats. Total metabolites were higher in mice than in rats at any of the vapor concentrations used due mainly to the higher amount inhaled by mice. Saturation of overall metabolism in mice but not in rats at high doses by both routes of administration indicates species differences in metabolism of benzene. PMID- 3824389 TI - Circadian alterations in prolactin, corticosterone, and thyroid hormone levels and down-regulation of prolactin receptor activity by 2,3,7,8-tetrachlorodibenzo p-dioxin. AB - Studies were initiated to determine whether 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) affects circadian rhythms of serum prolactin (PRL), corticosterone, thyroxine (T4), and triiodothyronine (T3) in male Sprague-Dawley rats. In addition, the effects of TCDD on PRL receptor activity, as assessed by the ability of PRL to induce ornithine decarboxylase (ODC), were determined. The earliest effect detected following TCDD administration was a significant decrease in the serum PRL concentration compared with that of pair-fed controls within 4 hr (p less than 0.05). This was followed by a significant decrease in serum T4 by 6 hr (p less than 0.05). By 8 hr the serum peak of corticosterone was shifted to 2 hr later in the TCDD-treated rats. This temporal sequence of hormonal changes suggests that the earlier alteration in PRL may be involved in the later alterations in the concentrations of serum T4 and corticosterone. The serum PRL concentration 7 days after TCDD administration was significantly higher (p less than 0.05) in TCDD-treated animals compared with that in pair-fed controls (mean of 20.5 +/- 3.7 vs 13.6 +/- 1.8 ng/ml serum, p less than 0.05, respectively). The elevation of ODC activity in response to PRL, 2 days after TCDD, was decreased in the order of thymus greater than adrenal greater than spleen greater than heart greater than kidney greater than liver. By 7 days, liver ODC activity in response to PRL was only 12% that detected in pair-fed controls. Liver ODC activity in response to dexamethasone and aminophylline was decreased to 25 and 22% of pair fed controls, respectively, by 7 days after TCDD administration. However, in kidney, TCDD-treated rats had an increased ODC response to aminophylline to 191% of pair-fed controls by Day 7. These results suggest that the ability of TCDD to alter receptor coupling or the receptor number for diverse hormones may play a role in TCDD toxicity. PMID- 3824390 TI - dl- versus meso-3,4-dimethyl-2,5-hexanedione: a morphometric study of the proximo distal distribution of axonal swellings in the anterior root of the rat. AB - The neurotoxicity of the dl and meso diastereomers of the gamma-diketone 3,4 dimethyl-2,5-hexanedione (DMHD) was studied to determine if the difference in rates of pyrrole derivatization would influence the clinical and morphological appearance of the neuropathy associated with these gamma-diketones. Two groups of rats received 0.2 mmol/kg/day intraperitoneal injections of their respective diastereomer, and two groups of control rats received comparable volumes of water. The dl-DMHD treated group reached the clinical end-point of hindlimb paralysis in a period of time threefold shorter than the meso-DMHD treated group, paralleling the in vitro kinetics of pyrrole formation with a model amine. A computerized morphometric analysis of cross-sectional axonal areas along the lengths of L4 and L5 anterior roots revealed that the dl-DMHD treated rats had axonal swellings more proximal and of smaller caliber than the meso-DMHD treated rats. 14C-labeled dl and meso diastereomers were synthesized and used to determine relative ability of the diastereomers to gain access to the nervous system. There was approximately 25% more dl-DMHD in the brain after 2 hr. The brain:serum ratios of the diastereomers, however, were equivalent. The more distal location of the neurofilament-filled swellings after meso-DMHD intoxication corroborates previous findings regarding toxicant potency and location of axonal swellings and suggests that the rate of neurofilament crosslinking determines the location of swellings along the length of the axon in the neurofilamentous axonopathies. PMID- 3824392 TI - Dimethylformamide (DMF) hepatotoxicity. AB - Scattered case reports of accidental exposure and a few epidemiological studies have indicated that the liver is the main target organ following acute and chronic exposure to dimethylformamide (DMF). This has been confirmed in several animal species. In humans, ethanol intolerance is one of the earliest manifestations of (excessive) exposure to DMF, followed at higher exposure levels by various complaints (nausea, vomiting, abdominal pain) and the release of liver cytolytic enzymes in the plasma. The metabolic pathway of DMF has been recently clarified, but the primary cellular lesion responsible for its hepatotoxicity is still unknown. PMID- 3824391 TI - Hyperbaric oxygen accelerates the neurotoxicity of 2,5-hexanedione. AB - The molecular pathogenesis of n-hexane neurotoxicity has been postulated to proceed as follows: The gamma-diketone metabolite, 2,5-hexanedione (HD), reacts with lysyl-amino groups on neurofilaments to form imines. The imines cyclize to form pyrroles. The pyrroles autoxidize, resulting in covalent protein-protein crosslinking within or between neurofilaments. A resultant impairment of neurofilament transport is proposed to lead to neurofilament-filled axonal swellings. This experiment was designed to test whether oxidation is a necessary pathogenetic step in vivo by comparing time of onset of paralysis of an HD treated group of rats to that of a group receiving HD plus oxygen under high pressure (OHP). The group of rats receiving the hyperbaric oxygen treatment reached the endpoint of hindlimb paralysis significantly sooner than the group receiving none. The fact that OHP does accelerate HD neuropathy points towards an oxidative step in the molecular pathogenesis of gamma-diketone neuropathy. PMID- 3824393 TI - Induced synthesis of metallothionein by ascorbic acid in mouse liver. AB - The concentration of metallothionein in mouse tissues after administration of ascorbic acid was determined by the Cd-hem method. The concentration of metallothionein in the liver was increased significantly after an intraperitoneal injection of L-ascorbic acid at the dose of 1000 mg/kg. A simultaneous injection of cycloheximide inhibited the increase of the metallothionein concentration. Mortality of mice injected with a lethal dose of cadmium was decreased significantly by the pre-injection of L-ascorbic acid. All of these results indicate that metallothionein is induced in the liver after the administration of ascorbic acid. PMID- 3824394 TI - A quantitative evaluation of the neurotoxic effect of silver on the volumes of the components of the developing rat hippocampus. AB - The volumes of the components of the hippocampus of rats subjected to subcutaneous injections of silver during the first 4 postnatal weeks were compared to those of littermate controls. Of the 14 components measured, only the pyramidal cell layer was found to be significantly smaller in the treated animals. These findings indicate that the perikaria of the pyramidal cells are either the first elements in the developing hippocampus to show signs of silver toxicity or that they are the selective sites of silver neurotoxicity. The volumetric approach is shown to be a sensitive means by which small localized neurotoxic effects can be detected. PMID- 3824395 TI - Teratogenic evaluation of triclabendazole in rats. AB - Triclabendazole, a new benzimidazole anthelmintic, was administered by gavage to pregnant rats at 0 (control), 10, 25, 50, 100 or 200 mg/kg on days 8 through 15 of pregnancy. The dams were killed on day 21 of pregnancy, and the fetuses were examined by routine teratological methods. As the results, no increase in the incidence of resorptions was observed even at 200 mg/kg corresponding to 20 times the recommended therapeutic dose. There was a dose-related decrease in fetal body weights which was statistically significant at 100 mg/kg or more. Examinations of the fetuses revealed no significant increase in the incidences of gross, skeletal and internal malformations at any dose in comparison with the controls. Thus, no evidence of embryocidal and teratogenic effects was observed with this anthelmintic in rats. PMID- 3824396 TI - Formation and accumulation of O6-ethylguanine in DNA of enriched populations of Clara cells, alveolar type II cells, and macrophages of hamsters exposed to diethylnitrosamine. AB - The concentration of O6-ethylguanine (O6EG) in DNA of enriched populations of hamster Clara cells, alveolar type II cells, and macrophages was determined following acute diethylnitrosamine (DEN) exposure, 100 and 200 mg/kg body wt, and during subchronic DEN exposure, 20 mg/kg body wt, 2 times/week. Pulmonary cells were separated by centrifugal elutriation. DNA was collected on polycarbonate filters and hydrolyzed by mild acid. Purines bases were separated by high pressure liquid chromatography, and O6EG was quantitated by optical methods. O6EG levels in DNA of Clara cell-enriched populations were found to be higher than O6EG levels in DNA of alveolar type II cell-enriched populations and macrophages following acute DEN treatment. In Clara cell-enriched populations, O6EG levels found after 200 mg/kg body wt dose were approximately 50% the levels found after the 100 mg/kg body wt dose, and O6EG levels found at 24 h post-treatment were approximately 50% the levels found at 12 h post-treatment for both the 100 and 200 mg/kg body wt doses. O6EG accumulated in DNA of Clara cell-enriched populations during subchronic DEN exposure. The differential distribution of O6EG in target and non-target cell populations suggests the involvement of this promutagenic base in the initiation process of DEN pulmonary carcinogenesis. PMID- 3824397 TI - Effects of prenatal and postnatal exposure to gentamicin on renal differentiation in the rat. AB - Pregnant rats were injected daily, from the 10th day of gestation to term, with 75 mg/kg of gentamicin. They gave birth about 15 h later than control pregnant rats injected with saline to pups with various degrees of growth retardation. In pups born of gentamicin-treated mothers, the number of nephrons present at birth, as well as the final number of nephrons, were reduced by at least 20%. Observation of the kidneys by light microscopy showed focal tubular lesions on the mature nephrons. The intrarenal concentration of gentamicin was higher in the severely growth retarded pups than in the others. In another series of experiments, rats were given 75 mg/kg of gentamicin daily from days 1 to 13 after birth. Although under these conditions the concentration of gentamicin reached in the postnatal kidney was higher than that reached after exposure in utero, no reduction of the final number of nephrons was observed. It is concluded that administration of gentamicin to pregnant rats caused focal tubular lesions in the developing kidney and a reduced rate of early nephrogenesis. The latter was probably due to growth retardation, though a more direct effect of gentamicin on early nephrogenesis may also have been involved. PMID- 3824398 TI - Effect of tridiphane on reproductive parameters in Fischer 344 rats. AB - Reproductive parameters in Fischer 344 rats were evaluated following dietary administration of tridiphane for 2 successive generations. Male and female rats in the fO generation were maintained on test diets formulated to provide 0, 1, 5, or 30 mg tridiphane/kg per day for 104 days starting at 6 weeks of age. The rats were allowed to mate twice to produce the f1a and f1b litters. Offspring from the f1b litters were maintained on test diets for 125 days and then mated to produce the f2a and f2b litters. Reproductive parameters including fertility, litter size and growth and survival of the pups were monitored. Selected weanlings were examined for gross and histologic lesions. Treatment related effects in the f0 adults were limited to the 30 mg/kg dose group and consisted of increases in relative liver weights in both sexes and depressed body weights in females. Liver weight relative to body weight was elevated in weanlings of both sexes in the f1a (30 mg/kg) litters but only in male offspring in the f1b litters. In the f1 adult females from the 30 mg/kg per day group, body weights were depressed throughout the 125-day treatment period and during lactation of both the f2a and the f2b litters. In the second generation, only male weanlings from the f2a litters, 5 mg/kg per day group had elevated (relative) liver weights. No consistent adverse effects on reproduction, fertility, or neonatal growth or survival were observed in either the f1 or f2 generations, and gross and histological examination of livers from weanlings did not reveal any treatment related lesions. PMID- 3824399 TI - Myotoxic activity of phospholipases A2 isolated from cobra venoms: neutralization by polyvalent antivenoms. AB - Phospholipases A2 which produce myonecrosis when injected i.m. into mice were isolated from venoms of Naja nigricollis, N.h.haje and N.nivea by gel filtration, ion-exchange chromatography on SP-Sephadex C-25 and CM-cellulose and by hydrophobic interaction chromatography on Phenyl-Sepharose CL-4B. Basic polypeptides of the cardio/cytotoxin-type were essentially free of myotoxic activity. Polyvalent antivenoms were tested for their ability to neutralize the myotoxic activity of the phospholipases A2 when mixed with them prior to injection. Antivenoms from Behringwerke (Orient, Central Africa, North Africa) and from the South African Institute for Medical Research, but not habu (Trimeresurus flavoviridis) monovalent antivenom, neutralized the myotoxic activity of the phospholipases A2. PMID- 3824400 TI - Vasoconstrictor components in the Arabian Gulf catfish (Arius thalassinus, Ruppell) proteinaceous skin secretion. AB - The Arabian Gulf catfish (Arius thalassinus, Ruppell) produces toxic substances from its skin and from venom glands located near the base of the pectoral fins. Investigation of the pharmacological properties of the skin toxin have previously shown cholinergic vasoconstrictor activity in umbilical arteries. Cholinergic vasoconstriction was confirmed in sheep renal arteries. This activity was partially blocked by atropine, while most of the residual contraction was eliminated by simultaneous addition of indomethacin. Skin toxin treatment of arterial specimens caused a release of prostaglandin (PGE2, TXB2 and 6-keto-PGF1 alpha) into the organ bath. Prostaglandin release was blocked by pretreatment with indomethacin. Heat denaturation of skin toxin caused a loss of only the indomethacin-sensitive muscle contraction activity; most of the residual activity was blocked by atropine. PMID- 3824401 TI - Hemolytic, lethal and edema-forming activities of the skin secretion from the oriental catfish (Plotosus lineatus). AB - The crude extract from the skin secretion of the oriental catfish, Plotosus lineatus, contained at least one hemolysin, two lethal factors and two edema forming factors; the lethal and edema-forming factors seem to be identical. The molecular weights of the hemolysin and the lethal factors (edema-forming factors) were estimated to be 180,000 and 12,000, respectively. Peculiar secretory cells, which resembled the venom glandular cells of the dorsal and pectoral stings, were observed in the epidermis. PMID- 3824402 TI - Effects of habu (Trimeresurus flavoviridis) venom on isolated and perfused hearts of rats. AB - Crude habu venom decreased coronary perfusion pressure and produced a small increase in myocardial tension of isolated and perfused rat hearts. Indomethacin infusion depressed the fall in perfusion pressure caused by the venom, without affecting the increase in tension. Heated venom decreased perfusion pressure, but did not increase myocardial tension. These results suggest that crude habu venom has coronary vasodilating and positive inotropic effects, possibly through actions of a phospholipase A2 and a heat-labile component, respectively. PMID- 3824403 TI - Red tide (Ptychodiscus brevis) toxin aerosols: a review. AB - Advances in knowledge concerning red tide toxin aerosols (airborne) of the Florida red tide organism, Ptychodiscus brevis, have not kept pace with information about waterborne toxins. This review provides a summary of current knowledge regarding the characterization, effect and production of red tide toxin aerosols. Insight into the chemical characterization and toxic effects of aerosolized toxins is provided from investigations of toxins extracted from natural blooms, as well as from laboratory cultures, of P. brevis. This information is used in conjunction with the few studies that have been performed on toxin aerosols to consider toxic effects. The production of aerosolized toxins is considered through studies of jet drop aerosol formation from bursting bubbles. Existing information suggests that aerosolized red tide toxins may be the same chemicals as those extracted from laboratory cultures, with one of the toxins having a greater respiratory effect than others. PMID- 3824404 TI - Scombroid poisoning: mini-review with case histories. AB - Scombroid poisoning has become an almost world-wide medical problem. It is probably the most common cause of fish poisoning, although frequently misdiagnosed as "Salmonella infection'. While there remains some question as to the definitive etiology, there is little doubt that the poisoning is caused by the ingestion of certain mackerel-like fishes whose tissues have undergone a number of changes provoked by bacteria, and involving the conversion of histidine to histamine, potentiated by diamines. Improper storage of the fishes, usually at temperatures above 20 degrees C, appears to be the most important predisposing factor. The organisms most commonly involved are Proteus sp., Clostridium sp., Escherichia sp., Salmonella sp. and Shigella sp. Twenty-five cases of scombroid poisoning are presented. The clinical manifestations were very similar in most cases, consisting of: alterations in taste; anxiety; hyperemia, particularly of the face and neck; nausea; pruritus; headache; certain other symptoms and signs. Most patients responded to antihistamitics, and all cases were self-limiting. PMID- 3824405 TI - Structure-function relationships of 12,13-epoxytrichothecene mycotoxins in cell culture: comparison to whole animal lethality. AB - Nineteen 12,13-epoxytrichothecene mycotoxins were tested for their relative capabilities to inhibit protein synthesis in Vero cells and rat spleen lymphocytes. Although the lymphocytes were generally more sensitive to the mycotoxins, good correlation existed between the relative potencies of the various trichothecenes in the two cell systems. The most potent mycotoxins (T-2, verrucarin A and roridin A) have acetyl side groups on, or a hydrocarbon chain between, carbons 4 and 15 of the basic ring structure. Loss of side groups from either of these positions or an isovaleryl group at carbon 8 resulted in reduced protein synthesis inhibition (T-2 to HT-2, neosolaniol or diacetoxyscirpenol). Any combination of loss from all three positions (T-2 triol, T-2 tetraol, 15 monoacetyl DAS, scirpentriol, fusarenon X and deoxynivalenol) further weakens their effect. Reduction of the hydroxyl groups to hydroxides, forming verrucarol and deoxyverrucarol, reduced their effectiveness by over a thousand-fold compared to the most potent mycotoxins. Addition of side groups resulted in reduced effectiveness only when an acetyl group was added to the carbon 3 position of T-2 (acetyl T-2) and deoxynivalenol (3-acetyl deoxynivalenol) or on substitution of an epoxide across the 9,10 carbons of diacetoxyscirpenol (beta-epoxide DAS). Effects of combining these and other mycotoxins were additive and showed no synergism or competition for binding to the active site. When in vitro effects of the mycotoxins were compared with results from whole animal lethality tests, several of the trichothecenes were weak inhibitors of protein synthesis in vitro but had in vivo toxicities similar to that of T-2 toxin. Thus, the in vitro cell response of a given trichothecene is not always an accurate predictor of toxicity in whole animals. PMID- 3824406 TI - An isoelectric focusing study of seasonal variation in rattlesnake venom proteins. AB - Adult specimens of seven southern Pacific rattlesnakes (Crotalus viridis helleri), four northern black-tailed rattlesnakes (Crotalus molossus molossus), and six western diamondback rattlesnakes (Crotalus atrox) were housed under controlled light and temperature and milked of venom monthly for 20 months. Ambient conditions were modelled to simulate seasonal change. Weighed amounts of lyophilized venom from each snake were compared chronologically for variation in isoelectric focusing patterns, using natural and immobilized gradients. No variation in patterns was evident over this time period for any individual snake. However, intraspecific differences were obvious in the venom samples. The pattern seems indicative of a species, however, concentration of various protein constituents seems individual and genetically "fingerprinted'. Unlike other physiological functions that demonstrate cyclicity in response to temperature and photoperiod, concentration ratios of venom components appear to be constant regardless of external cues. These findings may further emphasize the medical importance of treating snakebite victims symptomatically as individuals. A variation exists in the components of venoms of any given species, as well as in the physiological sensitivities of humans to a venom. PMID- 3824407 TI - The need to assess the safety of commercial and consumer products. PMID- 3824408 TI - What we have learned from phalloidin. AB - In contrast to popular opinion phallotoxins do not play a role in poisoning with Amanita phalloides when the fungi are ingested orally. All toxic properties of this mushroom are due to amatoxins which, in contrast to the phallotoxins, are absorbed upon ingestion. Nearly all experiments on intact animals were performed by parenteral injection of phalloidin and therefore, most of these are unsuitable for practical consideration. In the present survey, however, a series of important findings are discussed, which provide insight into various functions of liver cells. When present in the blood, phalloidin and other phallotoxins are selectively taken up by hepatocytes. No other types of cells are sensitive to the toxin. No extrahepatic tissue is primarily impaired by phalloidin. Phalloidin cannot be degraded by peptidases or by proteases occurring in animals. Phalloidin is therefore a useful model substance for studies on the uptake of cyclopeptides by liver cells. The carrier system responsible for the active uptake of phalloidin can also translocate antamanide and several cyclic modifications of somatostatin. Phallotoxins bind with high affinity to microfilamentous structures, in particular to F-actin [Govindan et al., Naturwissenschaften, 59 (1972) 521-522] whereas phallotoxins are not bound to the monomer (G-actin). With respect to the strong organotropism of phallotoxins, intravenously injected phalloidin binds preferentially to microfilamentous F-actin of hepatocytes. Phalloidin is therefore a tool for inactivation of microfilamentous functions specifically in liver cells, and is suitable as a prototype of a cholestatic agent. In perfused livers arrest of bile flow is the earliest effect seen after addition of the toxin. In cells from other tissues phalloidin is only toxic when applied by intracellular microinjection. Phalloidin poisoning has been often used as a model for liver damage in the testing of hepatoprotective drugs. This substance is, however, not useful for such studies since the mechanism of phalloidin poisoning is too specific for interpretation in the sense of general liver protection. PMID- 3824409 TI - Mutagenicity of the C-nitroso analog of fenitrothion. AB - The chemicals fenitrothion, nitroso fenitrothion, amino fenitrothion and 3-methyl 4-nitrophenol were tested for mutagenicity to Salmonella typhimurium strains TA98 and TA100, both in the presence and absence of rat liver S-9 mix. The strong mutagenicity of nitroso fenitrothion to both strains either in the presence or absence of S-9 mix contrasted with the observation that fenitrothion displayed no mutagenicity in these tester strains. The results suggest that the normal nitroreductases present in TA98 and TA100 cannot metabolize fenitrothion to a mutagenic metabolite. This inability of the tester strains to effect partial nitroreduction results in the failure of this screening system to predict the potential genotoxicity of this pesticide. PMID- 3824410 TI - Effects of chlordimeform on heart rate and body temperature of unanesthetized, unrestrained rats. AB - Heart rate (HR) and body core temperature (Tco) were monitored in unanesthetized, unrestrained adult Sprague-Dawley rats following intraperitoneal administration of 0, 10, 30, or 60 mg/kg of the pesticide chlordimeform (CDM). Significant non dose-related decreases were observed in both HR and Tco in all treated groups. Although similar in character, the HR response observed in the present study was of a lesser magnitude than that which was reported in previous studies from this laboratory using anesthetized animals in which Tco was maintained at control levels. It is proposed that the attenuation of the toxic response seen in the present study may be causally related to the concomitant decrease in Tco. PMID- 3824411 TI - Biochemical and immunological effects of aflatoxins in rabbits. AB - Aflatoxicosis caused impairment of specific and nonspecific immune responses to varying degrees in rabbits. However, the impairment was of lesser extent as compared to the earlier reports in other laboratory animals. The nonspecific response, as determined by phagocytic index was 60% of the control in test rabbits. Aflatoxicosis caused a decrease in protein content (22%), alkaline phosphatase activity (75%) and an increase (1.5-3 times) in the level of cholesterol, total lipids and acid phosphatase activity in test rabbits sera. The changes were statistically significant (P less than 0.05) in test rabbits. The test rabbits had a tendency to recover from the effects of aflatoxicosis after 3 4 weeks. PMID- 3824412 TI - Menadione causes selective toxicity to periportal regions of the liver lobule. AB - Infusion of increasing concentrations (0.2-1 mM) of the quinone, menadione, caused step-wise increases in oxygen uptake in perfused livers from fasted rats presumably due to oxygen-dependent redox cycling. Maximal increases in oxygen uptake of about 40 mumol/g/h were observed with 0.8 to 1.0 mM menadione. This increase in oxygen uptake was confined to periportal areas of the liver lobule suggesting that redox cycling due to menadione occurs exclusively in cells localized around the portal triad. After 60 min of infusion of menadione (1 mM), lactate dehydrogenase was released from the liver at rates between 60 to 70 U/g/h. Under these conditions, trypan blue was taken up by virtually all hepatocytes in periportal regions of the liver lobule. In contrast, dye was not taken up by cells in pericentral areas. It is concluded that menadione is selectively toxic to hepatocytes located in oxygen-rich periportal regions of the liver lobule. PMID- 3824413 TI - Effect of four synthetic antioxidants on the formation of ethylene from methional in rat liver microsomes. AB - Four commonly used food antioxidants, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), propyl gallate and octyl gallate, were tested for their ability to inhibit the formation of ethylene from methional in NADPH-oxidizing rat liver microsomes. It is assumed that the action of the antioxidants on ethylene formation reflects their free radical scavenging activity. Only propyl gallate and octyl gallate are efficient inhibitors of ethylene formation. BHT is inhibitory only at very high concentrations, and BHA tends to increase ethylene formation. It is concluded that gallic acid ester antioxidants may possess a protective potential during chemical-induced microsomal oxidations. PMID- 3824414 TI - Effect of chromate ion on the membrane of established human cells as measured by uptake of a permeant lipophilic cation. AB - Cells from the established human cell line NHIK3025 concentrate the permeant lipophilic cation triphenylmethylphosphonium (TPMP+) against a concentration gradient, indicating the existence of an electrical potential across the cell membrane (interior negative). Cells exposed to potassium chromate or dichromate (7.7 mumol Cr/l) for 2 h subsequently showed reduced uptake of TPMP+, whereas similar exposure to a trivalent chromium salt (7.7 mumol/l chromic chloride) had similar uptake of TPMP+ as control cells. These preliminary results suggest that a primary effect of chromate on these cells is to reduce the electrical potential across the cell membrane. PMID- 3824415 TI - Microsomal phospholipase A2 is activated by surfactant toxins in 3T3 mouse fibroblasts. AB - In 3T3 mouse fibroblasts that were treated by surfactant toxins such as staphylococcal delta toxin, melittin from bee venom and lysolecithin, microsomal phospholipase A2 (PLA2) was activated. However, these toxins did not activate PLA2 when added to cell-free homogenates or microsomal preparations. The maximal activation was achieved at 1 mM Ca2+ pH 8.5. The microsomal PLA2 stimulated by these toxins had a high fatty acid specificity (C-2 position) toward arachidonic acid. PMID- 3824416 TI - Effects of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) on the levels of glutathione and lipid peroxidation and the activity of glutathione reductase in liver and lung. AB - After subcutaneous injection of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) to rats, glutathione reductase activity in lung and liver diminished rapidly. The restoration of enzyme activity occurred more slowly in the lung than in the liver. The pattern for the time-course of total glutathione (GSH) levels was similar between lung and liver, except for a marked depression of hepatic levels 6 h after drug administration. The level of malondialdehyde (MDA) in lung was not affected by BCNU throughout the experimental period (3 days). However, the level in liver had increased significantly by 6 h after drug administration. These observations indicate that lipid peroxidation in lung was not induced by BCNU even when glutathione reductase activity was markedly diminished. In contrast, the lipid peroxidation in liver was induced by BCNU and was preceded by an early marked depression in total GSH. PMID- 3824417 TI - Study of mutagenic activity of troxerutin, a flavonoid derivative. AB - Troxerutin, a flavonoid derivative, used in vascular diseases was studied in 4 mutagenicity tests: the Ames test, the point mutation test (V79/HPRT), the in vitro metaphase analysis in human lymphocytes and the micronucleus test in mice. The aglycone trihydroxyethylquercetin (THEQ) and quercetin were studied too. Troxerutin was not mutagenic, whereas quercetin was positive in the Ames test, V79 cells and in vitro metaphase analysis. THEQ was negative in the Ames test. The substitution of quercetin with hydroxyethyl groups in 7,3' and 4' positions abolished mutagenic activity of quercetin. PMID- 3824418 TI - Comparison of the effects of ethanol and 4-methylpyrazole on the pharmacokinetics and toxicity of ethylene glycol in the dog. AB - The purpose of this investigation was to compare the effects of ethanol and 4 methylpyrazole (4MP) on the toxicity and pharmacokinetics of ethylene glycol (EG) in the dog. All dogs received 173 mmol/kg EG, p.o. Dogs were randomly assigned to 3 groups: EG-treated only, EG + ethanol (19.3 mmol/kg, i.v. 3, 7, 14 and 24 h after EG) and EG + 4MP (0.24 mmol/kg, i.v. 3 h after EG, 0.18 mmol/kg at 24 h and 0.06 mmol/kg at 36 h). EG produced a rapid onset of metabolic acidosis (within 3 h) and acute oliguric renal failure (after 48 h), whereas administration of ethanol or 4MP greatly attenuated acidosis and prevented renal toxicity. The administration of ethanol, however, severely increased the central nervous system (CNS) depression that existed after ingestion of EG. The half-life of FG in serum was 10.8 +/- 0.7 h in the EG-only treatment group, 6.8 +/- 0.7 (P less than 0.05) in the EG + ethanol group and 9.8 +/- 0.9 h in the EG + 4MP group. Approx. 10% and 48% of the dose of EG was excreted unchanged in the urine at the 0-3 and 3-72 h periods, respectively. Treatment with 4MP increased the amount of EG excreted in the urine (71% from 3-72 h), whereas ethanol did not (51%). However, both ethanol and 4MP increased the rate constant of EG excretion into urine approx. 70%. These data demonstrate the utility of 4MP over ethanol for the treatment of EG-induced toxicity in dogs and indicate that ethanol and 4MP cause an increase in the rate constant of EG excretion in the urine and not a prolongation in EG half-life. PMID- 3824419 TI - Protection by parenteral iron administration against the inhalation toxicity of beryllium sulfate. AB - Animals exposed to an aerosol of BeSO4 showed a significant reduction in mortality with iron treatment. Rats were exposed for 2 h in a nose-only inhalation chamber for 14 days to an aerosol of 2.59 micrograms/Be/l. The cumulative mortality of animals concurrently treated with iron salt was significantly reduced (P less than 0.05) compared to animals which had not received iron treatment. PMID- 3824420 TI - The role of traditional fertility regulation in Sri Lanka. AB - Among the countries of South Asia, Sri Lanka, with a birth rate of 26 per 1,000, has achieved by far the lowest fertility level. The research reported here shows that at least half of all fertility control there is still practiced by means other than those offered by the national family planning program. This paper reports on an investigation carried out by the Sri Lankan Department of Census and Statistics, employing a micro-approach to demographic research, on the levels of "traditional" methods of family planning and attitudes toward the practice of both modern and traditional contraception. It is shown that knowledge of rhythm was diffused throughout society as the cost of raising children increased during a period when other methods of family planning were not easily accessible. These traditional methods were employed efficiently and their high level of continued use arises from strong cultural resistance to the pill and IUD, based upon local interpretations of how these methods function. Thus, any programmatic effort to reduce dependence on traditional family planning might well result in higher fertility levels. In addition, low fertility among Indian Tamil workers on the Tea Estates, as early as the 1950s, probably resulted from a desire (manifested by lower levels of sexual activity and some abortion) to avoid frequent pregnancies, since pregnancy interrupts work that the female Estate workers cannot afford to miss. PMID- 3824421 TI - Infant mortality trends and differentials in Nepal. AB - Infant mortality trends and differentials are estimated from the 1981 Nepal Contraceptive Prevalence Survey (NCPS) and compared with similar estimates from the 1976 Nepal Fertility Survey (NFS) and the 1981 Census of Nepal. The analysis indicates that infant mortality rates derived directly from the NFS maternity histories are the most accurate. Infant mortality rates derived directly from the NCPS maternity histories are severely underestimated and yield a strongly biased trend that is the reverse of the true downward trend. Indirect estimates of infant mortality trends derived from child survivorship data do not result in a consistent pattern. Infant mortality differentials, when expressed in relative rather than absolute terms, are generally consistent with findings from earlier studies. Possible reasons for data quality differences among the three data sources are discussed. PMID- 3824422 TI - Periodic abstinence in the Philippines: new findings from a national survey. AB - This paper presents the main survey findings from a nationally representative sample of 607 users of periodic abstinence methods in the Philippines in 1984. The survey was conducted because of the widespread popularity of periodic abstinence in the Philippines and a lack of detailed knowledge about how the method is understood and practiced in the Philippines. Findings are presented on the prevalence of the different types of periodic abstinence methods, the nature of their use, knowledge about the various periodic abstinence methods, instruction received, perceived advantages and disadvantages, the husband's role, and the use-effectiveness of periodic abstinence both with and without backup methods. The implications of these findings for program management and for future research are also discussed. PMID- 3824424 TI - Effect of family planning availability and accessibility on contraceptive use in Nepal. AB - This study examines the importance of availability and accessibility of family planning services in relation to current contraceptive use in Nepal. The proportion of women who knew of a family planning services outlet in Nepal increased sharply between 1976 and 1981, from 6 percent to 33 percent. The Contraceptive Prevalence Survey data of 1981 indicate that an inverse relationship exists between the prevalence of current contraceptive use and travel time to an outlet. Unfortunately, a majority of current users in Nepal still need more than one hour to reach an outlet. The effects of education and place of residence on contraceptive use become weaker when the analysis is confined to women who have access to an outlet within a half-hour's travel time. PMID- 3824423 TI - Fertility determinants in Puerto Rico. AB - This paper examines the proximate determinants of fertility in Puerto Rico using data from a 1982 island-wide study. Contraceptive use was found to be the primary direct determinant of fertility in Puerto Rico, both for the total population and for each level of education studied. Female sterilization is the most prevalent method of contraception used in Puerto Rico at each educational level. Marriage is also important in Puerto Rico and is the only proximate determinant that varies across education groups. Late age at first marriage, in addition to high contraceptive use, accounts for the below-replacement fertility of women who have more than a high school education. In contrast, women who have not completed high school tend to marry early and not practice contraception for birth-spacing purposes. This study shows the advantages of analyzing fertility determinants at the population subgroup level (i.e., women of various educational attainment levels) so that the fertility of the total population can be better understood. PMID- 3824425 TI - Carbamazepine-danazol drug interaction: its mechanism examined by a stable isotope technique. AB - Carbamazepine (CBZ) labeled with 15N was used to investigate the mechanism of its pharmacokinetic interaction with the antiestrogenic steroid danazol during treatment of a patient with epilepsy. Danazol led to a pronounced inhibition of CBZ metabolism. During danazol coadministration, CBZ elimination half-life increased from a pretreatment value of 11 to 24.3 h. Carbamazepine plasma clearance decreased from 57.7 to 23.2 ml/h/kg. Kinetic analysis of the plasma concentration-time curves and urinary excretion of [15N]trans-CBZ-diol revealed that danazol inhibited the epoxide-trans-diol pathway of carbamazepine metabolism. Observations in five other female patients confirm that the steady state plasma concentrations of UCBZ increase between 50 and 100% during coadministration of danazol. PMID- 3824426 TI - Interference with oral theophylline absorption by continuous nasogastric feedings. AB - Continuous enteral feedings through a nasogastric tube is the preferred route of nutritional support for malnourished patients with inadequate spontaneous oral intake. However, in patients also receiving oral medications, the use of continuous nasogastric feedings may cause malabsorption of the drugs and consequently increase the risk of an inadequate clinical response. We report a case of an elderly patient with subtherapeutic theophylline serum concentrations and recurrent bronchospasm while receiving oral theophylline and continuous enteral feedings. PMID- 3824427 TI - The disposition of theophylline in blood in chronic obstructive lung disease. AB - In 42 subjects with chronic obstructive lung disease receiving chronic oral theophylline therapy, the venous whole blood theophylline concentration was closely related to the total plasma theophylline concentrations (r = 0.976, p less than 0.001). The blood/plasma concentration ratio was 0.85 +/- 0.13 and was not related to the haematocrit or the free fraction of theophylline in plasma. The red blood cell theophylline concentration was closely related and numerically similar to the free plasma concentration. This indicates that the free plasma concentration is the most important determinant of red blood cell concentration, and that binding of drug by red blood cells or active uptake into erythrocytes is unlikely to occur. Whole blood concentration can be used to predict plasma theophylline concentration in subjects with obstructive lung disease in situations where preparation of plasma is inconvenient. The therapeutic range for whole blood concentration is approximately 8.5-17 mg/L. PMID- 3824428 TI - Phenytoin clearances in a compliant population: description and application. AB - The saturable elimination kinetics of phenytoin (PHT) makes accurate dosing difficult. A simple equation has been derived to predict dosing requirements if one dose--steady-state serum concentration pair is known [new dose = first dose X Cpss (desired)0.2 X Cpss (achieved)-0.2]. This equation is based on an exponential relation between 177 pairs of PHT clearance and steady-state serum concentrations from 59 compliant patients. To evaluate this population clearance method (PCM), patients were drawn from two independent populations (Minnesota and Iowa, U.S.A.). Predicted doses obtained from PCM were compared with predictions from Bayesian, average Vmax, and average Km methods. The Bayesian method was the most precise and least biased of all methods, under- and overpredicting doses in equal frequency. PCM was biased to produce underpredictions. However, clinically achievable doses can be obtained by consistently rounding the calculated dose upward. The mean underprediction for the Bayesian method was 6 mg, for PCM 46 mg, for average Vmax 21 mg, and for average Km 11 mg. PCM is relatively precise, somewhat biased, and very easy to use. PMID- 3824429 TI - Pharmacokinetics, metabolism, and renal excretion of sulfadimidine and its N4 acetyl and hydroxy metabolites in humans. AB - Sulfadimidine is acetylated and hydroxylated in humans. The hydroxylation pathways account for 10-20% of the dose, leaving the acetylation as the major metabolic pathway. The hydroxylation pathways are independent of the acetylator phenotype. The plasma concentration-time curve of sulfadimidine in fast acetylators is biphasic, with half-lives of 1.7 and 5.4 h, whereas that in slow acetylators is monophasic, with a half-life of 7.6 h. Hydroxylation of a methyl group in sulfadimidine lowers the protein binding from 90 to 60%, while acetylation does not affect the protein binding. Methyl hydroxylation markedly increases the renal clearance. PMID- 3824430 TI - Netilmicin in gram-negative sepsis: comparative abilities of a dosage nomogram and clinical microbiologists to predict the preferred individual dose. AB - The preferred dose of netilmicin was determined in each of 39 patients with severe gram-negative sepsis treated at two centres. The dose was based upon the attainment of recommended serum concentrations. Patient age varied from 18 to 87 years (mean 58), estimated creatinine clearance from 20 to 150 ml/min (mean 71), and the preferred dose from 100 to 750 mg/24 h. The dose generated by a nomogram for netilmicin was compared in retrospect with the initial dose assigned to each patient by the clinical microbiologist concerned. With respect to the preferred dose, the nomogram underdosed, on the average, by 40 mg/24 h, and the microbiologists, by 30 mg/24 h. The correlation with the preferred dose was stronger for the nomogram dose (r = 0.66; p less than 0.001, 37 df) than for the microbiologists' dose (r = 0.47; p less than 0.005, 37 df) but there was no significant difference between the two in the frequency with which they predicted the preferred dose to within 50 mg/24 h (nomogram 19/39; microbiologists 16/39). The prescription of a fixed dose of 450 mg/day to all patients would have had a similar success rate (15/39). The performance of the nomogram was better in patients with serum creatinine concentrations of greater than or equal to 100 microM (r = 0.82; p less than 0.001, 13 df; 10/15 within 50 mg/24 h of preferred dose) than in those with creatinine concentrations less than 100 microM (r = 0.55; p less than 0.01, 22 df; 9/24 within 50 mg/24 h of preferred dose). PMID- 3824431 TI - Umbilical versus peripheral tobramycin administration. AB - This study evaluated the disposition of tobramycin (T) after umbilical artery catheter (UAC), intravenous (i.v.), and intramuscular administration to a group of 12 premature neonates. Patients varied in gestational age (31-42 weeks) and weight (1.76-3.98 kg). Each neonate received a 2 mg/kg dose of T at 12-h intervals for 2-15 days. Multiple blood samples after the first and last doses of T, as well as daily measurements, were made during the course of therapy. Analysis of drug concentration data revealed a biphasic distribution of T, which required a two-compartment model for description. Mean values for the alpha and beta elimination phases, t1/2 beta, Vc, and Vdss after the first dose of T were 7.604 h-1, 0.087 h-1, 11.18 h, 0.214 L/kg, and 0.645 L/kg, respectively. Average drug clearance (ClT) increased during therapy from 71 to 103 ml/min, associated with an increase in the renal function of patients. Serum concentrations of T were out of the therapeutic range in 50% of study patients. The variability of drug clearance in the neonate requires the measurement of T concentration in order to ensure safe and effective therapy. PMID- 3824432 TI - Matched case-control study of adjusted versus nonadjusted gentamicin dosing in perforated and gangrenous appendicitis. AB - A matched case-control study of the efficacy of gentamicin dosage adjustment through the use of pharmacokinetic analysis of serum drug concentrations in patients treated by appendectomy for perforated or gangrenous appendicitis was performed. Two groups of patients were compared. In one group gentamicin was initiated preoperatively at 1.5 mg/kg Intravenous Piggy Back (IVPB) every 8 h. Postoperatively, serum levels were obtained to maintain peak concentrations within a range of 6-8 micrograms/ml. The comparison group was given gentamicin without measurement of drug levels. Both groups received clindamycin 600 mg IVPB every six h. Matched cases and control subjects were compared, controlling for pathologic state of the appendicitis, age, and sex. The patients were predominantly young men with normal renal function. More patients in the nonadjusted group had infectious complications than in the dose-adjusted group. There were seven failures (11.3%) in the nonadjusted group compared with only one failure (1.6%) in the dose-adjusted group, a significant difference (p = 0.03). Among the nonadjusted group, the complications were four abdominal abscesses, two wound infections, and one persistent high fever. There was no evidence of nephrotoxicity in either group. Our recommendations are that patients who are to undergo appendectomy for perforated/gangrenous appendicitis should be treated with clindamycin and gentamicin at a dose of 1.5 mg/kg. With normal renal function, an interval of 8 h is appropriate. Serum gentamicin levels should be obtained and the dose adjusted to maintain peak concentrations of 6-8 micrograms/ml. PMID- 3824433 TI - Enantioselective analysis of chloroquine and desethylchloroquine after oral administration of racemic chloroquine. AB - An enantioselective high-performance liquid chromatographic method for chloroquine and desethylchloroquine was developed using a chiral alpha 1-acid glycoprotein column. This method was used to determine concentrations of chloroquine and desethylchloroquine enantiomers in plasma and urine from volunteers given single oral doses of racemic chloroquine. The disposition of the enantiomers was different. The renal clearance of the chloroquine enantiomers was indicative of stereoselective renal secretion of the drug, and evidence for stereoselective metabolism also was found. PMID- 3824434 TI - Improved chromatography of cyclosporine. AB - A fast liquid chromatographic procedure for the measurement of whole-blood cyclosporine concentration is described. A sample preparation using solid-phase extraction requires 5.5 min of technical effort per sample. Chromatographic development is complete in 6 min. The results of this procedure correlate with those of a previously validated procedure. The slope of the correlation equation is 1.04, the gamma-intercept is -17, and the correlation coefficient is 0.99. Reproducibility of the procedure at midtherapeutic concentration is 5.5%, and sensitivity is 25 ng/ml. No chemical interference was observed from 33 drugs commonly co-administered during immunosuppression. PMID- 3824435 TI - Quantitative liquid chromatographic determination of sotalol in human plasma. AB - The analysis of sotalol by a simple and sensitive liquid chromatographic assay is described. Sample preparation involves an extraction by chloroform and isoamyl alcohol (3:1, vol/vol) at pH 9.0 followed by back extraction into 0.05 M sulfuric acid. Analyses are carried out on a reversed-phase chromatographic system using an octadecylsilane stationary phase and a water-methanol-acetic acid methanesulfonic acid (91.00:8.50:0.50:0.025, vol/vol/vol/vol) mobile phase adjusted at pH 3.3. Sotalol is quantified on the basis of ultraviolet absorption at 235 nm. The precision of the method ranged from 6.3% at 0.16 microM (50 ng/ml) to 3.3% at 5.18 microM (1,600 ng/ml). The limit of quantification was established 0.08 microM (25 ng/ml). This assay provides a suitable method for pharmacokinetic studies. PMID- 3824436 TI - Preparation of serum and plasma samples for determination of tricyclic antidepressants: effects of blood collection tubes and storage. AB - The effects were tested of eight common types of blood collection tubes and two types of "plasma separators" on the stability of the tricyclic antidepressants amitriptyline, imipramine, clomipramine, and their monodemethylated metabolites in venous blood samples. Although EDTA-containing Venoject lavender and Vacutainer lavender tubes seemed to give the most stable plasma samples, and Venoject red the most stable serum samples, the differences were too small to have practical consequences. Vacutainer royal blue collection tubes gave significant losses of greater than 20% of some of the substances. The tubes with serum separator gel or filter proved unsuitable, since they were responsible for losses of greater than 40%. The losses were not caused by redistribution between blood cells and plasma but occurred mainly as a result of contact between the contents and the caps of the tubes. Experiments with freezing, thawing, and storage of samples showed that freshly sampled blood could be stored at room temperature for 24 h in Venoject green tubes without significant losses. Serum samples could be stored at refrigerator temperature for 4 weeks without important losses. Freezing, thawing, and storage at -20 degrees C did not influence the serum or plasma concentrations. PMID- 3824437 TI - Protein binding of ceftriaxone: comparison of three techniques of determination and the effect of 2-hydroxybenzoylglycine, a drug-binding inhibitor in uremia. AB - Ceftriaxone is a third-generation cephalosporin exhibiting a long half-life and a concentration-dependent protein binding. This study compared three techniques of protein binding determination (equilibrium dialysis chamber, ultrafiltration cones (Centriflo), and ultrafiltration (Centrifree micro-partition system) on human plasma and serum at ceftriaxone concentrations achieved clinically. A second objective was to determine the effect of 2-hydroxybenzoylglycine (HBG) on the protein binding of ceftriaxone. High performance liquid chromatography (HPLC) and liquid scintillation counting assays were used. Equilibrium dialysis was rotated for 12 h. The supplier's recommendations were followed for ultrafiltration techniques. The plasma protein binding of ceftriaxone, as determined by equilibrium dialysis and assayed by HPLC, decreased from 98.6 to 73.5% for drug concentrations varying from 25 to 400 micrograms/ml. Somewhat lower values were obtained with Centrifree, the binding fell from 92.1 to 73.5% for the same concentration range. Serum protein binding was similar to results obtained with plasma samples. Centriflo cones yielded more inconsistent results. A significant difference was seen between the three techniques (p less than 0.0001, three-way analysis of variance). The addition of HBG, a compound that inhibits drug binding in uremia, resulted in ceftriaxone binding defects similar to those seen in uremic serum. Although equilibrium dialysis remains a classic method of protein binding determination, Centrifree appears to be a better system. PMID- 3824438 TI - [Altered time perspective]. PMID- 3824439 TI - [Length of stay in nursing homes. Arrangements in short- and long-term stays]. AB - For general and specific planning purposes in nursing homes it is necessary to know the number of beds available for the different groups of patients. The length of stay of patients, however, varies substantially. This makes it difficult to calculate the numbers and types of beds which will be available at any given moment. By drawing the dividing line between a short and a long stay at six months we are able to discuss factors concerning length of stay more lucidly. According to this criterion, 64.9% of the somatic patients discharged in 1984 were short-stay patients, compared with 31.3% short-stay psychogeriatric patients. The total number of beds needed for short-stay patients in 1984 amounted to 34.4% of the total number of beds available for somatic patients and 12.5% of the beds available for psychogeriatric patients. The precise figures vary considerably between nursing homes. This variation is greater for somatic than for psychogeriatric patients. PMID- 3824440 TI - [The perpetrator lies in the cemetery. Regarding the report "Costs of aging for the Ministry of Health and Welfare"]. AB - The Dutch government is concerned about the aging of the population, especially in relation to the increase of the costs of care. After the government report 'Care of the elderly' now a report is presented dealing with the expected increase of costs in health care and welfare because of the aging of the population. The report has an informal status. Its objective is to develop alternatives and to offer choices in controlling the increase of costs. It is calculated that the public costs of 'care' will increase with 1.4 billion guilders in the next four years due to the aging of the population. To reduce these costs the following options are presented: substitution-policy of hospital care by primary care, improvement of productivity and personal contribution by care-users. The disadvantages of these options are not explored, although they are well known. The relationship between the expected cost-increase and societal developments is mentioned, but not analysed. The report as it is written now does not explore in depth the developments in changes of consumer behaviour in relation to aging. Therefore it does not offer real alternatives. PMID- 3824442 TI - Investigational surgery of the canine frontal sinus. PMID- 3824441 TI - [Epilepsy in the 3d stage of life. An overview]. AB - Well known, but also less frequent or deviant features of epilepsy of late onset (beginning after 60) are discussed. Main groups of disturbances causing or resulting in seizures and related to epilepsy are mentioned. Diagnostic tools are given and guidelines with special points of attention are considered. PMID- 3824443 TI - Intracranial complications of sinus and otologic infections. PMID- 3824444 TI - Fibromyxoma of the frontal sinus. PMID- 3824445 TI - Transthoracic ligation to control chylous fistula--a therapeutic alternative. PMID- 3824446 TI - Diagnosis and management of perilymph fistula in patients with preexisting hearing loss. PMID- 3824447 TI - Otologic disturbance due to AIDS. PMID- 3824448 TI - Sudden hearing loss. PMID- 3824449 TI - Neurilemmoma of the hypoglossal nerve. PMID- 3824450 TI - Lip reconstruction: Karapandzic flap revisited. PMID- 3824451 TI - Surgery of the latent image: creative clinical photography. PMID- 3824452 TI - Occult neck disease in stage I anterior lingual cancer. PMID- 3824453 TI - Tympanic injury and cardiopulmonary resuscitation. PMID- 3824454 TI - Tear function in cystic fibrosis. PMID- 3824455 TI - Clinical applications of digital image processing. PMID- 3824456 TI - Recent advances in the diagnosis of orbital tumors. PMID- 3824457 TI - Management of patients at risk of vascular accidents. PMID- 3824458 TI - Differentiation between acute ophthalmic and central retinal artery obstructions. PMID- 3824459 TI - Laser photocoagulation for retinal vein obstruction. PMID- 3824460 TI - Spontaneous separation of a premacular membrane. PMID- 3824461 TI - Diagnosis and treatment of Eales' disease. PMID- 3824462 TI - The treatment of proliferative sickle retinopathy using 360 degree scatter photocoagulation. PMID- 3824463 TI - Unoperated persistent hyperplastic primary vitreous. PMID- 3824464 TI - An improved fascia lata sling procedure for blepharoptosis. PMID- 3824465 TI - Eyelid tattooing. PMID- 3824466 TI - Survey of lesions of the caruncle. PMID- 3824467 TI - Management of patients with superior oblique palsy. PMID- 3824468 TI - A comparison of the refractive errors in high risk infants with ROP to those without ROP. PMID- 3824469 TI - Subcutaneous abscess following steroid injection of chalazia. PMID- 3824471 TI - Exercise and circulating hematopoietic progenitor cells (CFU-GM) in humans. AB - In order to determine whether the rise in blood circulating committed hematopoeitic progenitor cells (CFU-GM) was sustained long enough after exercise to be a practical adjunct to increasing stem cell yields by hemapheresis, the authors evaluated two exercise protocols in 15 normal donors. Immediately after a brief period of intense exercise, there was a significant increase in the absolute number of blood CFU-GM from 164 +/- 27 to 240 +/- 46 per ml. However, all values returned to baseline within 15 minutes. Prolonging the exercise did not enhance either the circulating CFU-GM concentration or the duration of the rise. If blood hematopoietic stem cells respond to exercise similarly, such a transient increase would not appear to be of use in stem cell harvesting. PMID- 3824470 TI - Comparison of a manual hexadimethrine bromide-antiglobulin test with saline- and albumin-antiglobulin tests for pretransfusion testing. AB - A prospective double-blind study compared a manual hexadimethrine bromide (Polybrene) antiglobulin antibody detection test (P-AHG) and crossmatch with the albumin-antiglobulin antibody detection test and saline-antiglobulin crossmatch routinely used in our laboratory. A total of 10,084 pretransfusion blood samples from approximately 6000 patients were tested. The P-AHG method detected 153 of 157 alloantibodies for which antigen-negative, crossmatch-compatible blood is routinely provided. All four antibodies not detected were anti-K. The routine techniques detected 147 of the 157 alloantibodies. The P-AHG method detected only 36 percent of the alloantibodies for which crossmatch-compatible blood is routinely provided without determination of the antigen status of the donor unit's red cells (e.g., anti-Lea), whereas the routine method detected 91 percent of such antibodies. Eighty-six percent of the 189 alloantibodies detected by the Polybrene technique were found before the addition of antiglobulin. The manual Polybrene test is a rapid and sensitive technique; it may be used without an antiglobulin phase as a routine crossmatch procedure when accompanied by a sensitive antibody detection test that includes antiglobulin and an additional test to ensure ABO compatibility. PMID- 3824472 TI - A technique to reduce lymphocyte contamination of plateletapheresis products collected with a centrifugal blood cell separator. AB - It is desirable to minimize the contamination of plateletapheresis products by lymphocytes because of the role these cells may play in febrile nonhemolytic transfusion reactions, alloimmunization, platelet deterioration during storage and also to reduce donor lymphocyte loss. This study attempted to determine whether lymphocyte contamination could be reduced by rapidly depleting plasma from the separation chamber at selected intervals during plateletapheresis with a blood cell separator (CS-3000, Fenwal). Donors who provided platelet components with more than 0.10 X 10(9) lymphocytes without rapid depletion underwent a second plateletapheresis procedure in which the rapid depletion technique was used. The plasma pump was reprogrammed to remove rapidly 12 ml of plasma from the separation chamber (pump speed 48 ml/min) immediately after the plasma pump reversal. All other collection techniques were identical for all procedures. Significantly fewer lymphocytes were collected in those procedures in which rapid depletion was used (mean, 0.187 X 10(9] than when it was not used (mean, 0.331 X 10(9] (p = 0.001, n = 30). There was no effect on platelet yield, efficiency of platelet collection, processing time, or total collection time. This procedure provides a product that should be considered for routine use. PMID- 3824473 TI - Effective leukocyte removal from platelet preparations by centrifugation in a new pooling bag. AB - A pooling bag (Leukotrap, Cutter Laboratories, Berkeley, CA) with a protruding pocket at the bottom into which heavier cellular elements are collected after centrifugation at 390 X g for 10 minutes, was studied. The tab is clamped before transfusion. Varying numbers of platelet concentrates (PC) that had been stored for different durations were pooled and centrifuged in the bags. When 4 or more units of PC were studied, the results were independent of the number of units and the duration of storage. Approximately 90 percent of the contaminating leukocytes (WBC) were removed with a platelet loss of less than 10 percent. Similar results were obtained with single-donor platelets (WBCs decreased 93%; range, 77-99%; n = 12). Posttransfusion increments were similar to those with unmodified platelets; in four patients, febrile platelet transfusion reactions were eliminated by the WBC removal. Thus, the bags represent a simple, reproducible, and effective means of reducing WBC and red cell contamination of platelet preparations with acceptable platelet losses. PMID- 3824474 TI - Studies on granulocyte preservation. III. Effect of agitation on granulocyte concentrates. AB - The effect of agitation on granulocyte storage was examined. Granulocyte concentrates were obtained as buffy coats from fresh blood by centrifugation and stored for up to 48 hours at 22 degrees C with or without horizontal agitation (80 rpm). The cell counts, mean cell volumes, morphologic changes, phagocytosis, and bactericidal activity of the stored granulocytes did not differ significantly. However, chemotaxis was maintained better in granulocytes that were agitated. At 48 hours, the ability of unagitated cells to adhere to both immunoglobulin-coated and uncoated glass surfaces increased, and clumps were observed on the surfaces. These results seem to be related to the decrease in chemotaxis. The pH of unagitated sedimented cells was more acid. To avoid the decrease of this local pH, stored granulocytes need gentle agitation. PMID- 3824475 TI - Oxidative product formation in irradiated neutrophils. A flow cytometric analysis. AB - The effect of irradiation on neutrophil oxidative function was evaluated using a flow cytometric assay of intracellular hydrogen peroxide (H2O2) production. This assay quantitates the H2O2-dependent conversion of the nonfluorescent compound, 2'-7'-dichlorofluorescein (DCFH), into fluorescent 2'-7'-dichlorofluorescein (DCF) on a single-cell basis. Intracellular H2O2 production in response to stimulation with phorbol myristate acetate was not affected by neutrophil irradiation at doses up to 2500 rad. In addition, irradiation of intracellular DCFH and aqueous 2'-7'-dichlorofluorescein diacetate (DCFH-DA) resulted in DCF production, which suggested that oxidative molecules produced by aqueous radiolysis were detected by this assay. This study indicates that radiation doses of 1500 to 2500 rad, which are sufficient to prevent induction of graft-versus host disease by transfused blood components, are not deleterious to neutrophil oxidative metabolism. PMID- 3824476 TI - Chromatographic removal of hepatitis B virus from a factor IX concentrate. Experimental studies in chimpanzees. AB - Non-A, non-B hepatitis virus can be removed from a factor IX concentrate by a hydrophobic chromatographic step added to the ordinary fractionation process. The efficacy of this procedure for removal of hepatitis B virus (HBV) was evaluated in chimpanzees. A well-defined hepatitis B virus (HBV) inoculum was added to a factor IX preparation and this preparation was subjected to chromatography with octanohydrazide-Sepharose 4B at a high salt concentration and then injected intravenously into two chimpanzees. A control chimpanzee was inoculated with the part of the factor IX/HBV preparation that had not been chromatographed. The two chimpanzees that received the treated material remained free of any serologic or biochemical evidence of hepatitis B infection during a 12-month follow-up, whereas the control chimpanzee had hepatitis B. After a later HBV challenge, the two healthy animals also had hepatitis B. The hydrophobic binding procedure seems to be useful for the adsorption of viral agents in blood components. PMID- 3824477 TI - Effects of AS-3 nutrient-additive solution on 42 and 49 days of storage of red cells. AB - Storage of red blood cells in a nutrient-additive solution, AS-3 (Nutricel, Cutter Biological, Berkeley, CA), was evaluated after 42 and 49 days of storage by in vitro measurements of hemolysis, adenosine triphosphate (ATP) levels, glucose levels and other constituents, and in vivo study of 24-hour survival of autologous, reinfused red cells labeled with 51Cr with and without 125I human serum albumin. Two laboratories conducted the studies independently. After 42 days of storage, hemolysis was within an acceptable range (0.72 +/- 0.4% and 1 +/ 0.2%), ATP decreased to 61 percent and 56 percent in the two laboratories, and 24-hour survivals were 85.1 +/- 8.3 percent for single-label cells in one laboratory and 82.8 +/- 10 percent (single-label cells) and 84.1 +/- 13.1 percent (double-label cells) in the second laboratory. Thus, results for single- and double-label cells were similar. After 49 days of storage, ATP fell to 45 and 46 percent in the two laboratories. Twenty-four-hour recovery fell to 69.4 +/- 7.4 percent with single-label cells and to 68.2 +/- 6.7 percent with double-label cells in one laboratory. In the other laboratory, a paired study comparing AS-3 with the already approved AS-1 solution (Adsol; Fenwal Laboratories, Deerfield, IL) showed nearly identical 24-hour survivals of 71.9 +/- 8.8 percent in Nutricel and 71.8 +/- 6.5 percent in Adsol. These studies demonstrate the excellent viability of the new solution after 42 days of study. At 49 days of study, viability decreased significantly and was comparable in the two nutrient-additive solutions studied. The value of paired comparison study is demonstrated by the latter results. PMID- 3824478 TI - The effects of plastic bag extracts prepared in either mouse serum or phosphate buffered saline with ethanol on mouse splenic cells. AB - Chemicals leached from plastic blood bags are potentially immunogenic when introduced parenterally into humans. The experiments reported here represent an attempt to sensitize B6C3F1 mice to parenteral injections of solutions used to extract potentially immunogenic material from plastic blood bags. Mice were given intraperitoneal injections: blood bag extracts prepared from phosphate-buffered saline and ethanol; mouse red cells stored in extract solution; or blood bag extracts prepared from mouse serum. None elicited a significant in vitro immunologic reaction as determined by 3H-thymidine or 3H-leucine uptake into spleen cells. In contrast, intraperitoneal injections in mice of large amounts (0.5 ml) of the phosphate-buffered saline and ethanol extracts decreased spleen cellularity to 59 percent of the control value and reduced spleen cell blastogenic activity in vitro. When solutions of either mouse serum extract or mouse cells stored in extract were given intraperitoneally to mice, no spleen toxicity or increased blastogenic activity was observed. In addition, the extracts obtained from plastic blood bags by using either allogenic serum or buffered saline and ethanol did not elicit an immunologic response when they were administered parenterally to mice. PMID- 3824479 TI - The association of anti-P and early abortion. AB - The current report details the serologic findings in a case reported previously of a P1k woman, para 0 gravida 13, who was treated during her fourteenth pregnancy with plasmapheresis to reduce the anti-P titer. These studies suggest that anti-P can induce early abortion in Pk women and that the abortions are immunologically mediated. Further, this case supports the disputed proposal that the anti-P component of anti-PP1Pk is responsible for pregnancy loss in p women. PMID- 3824481 TI - Temporary deferral and donor return. AB - Deferral from donation is usually for conditions that make the donor only temporarily unable to give. Based on questionnaires given to 1247 donors with subsequent follow-up of their donation records for 6 months, permanent psychological effects of deferral are suggested. Only one of 36 deferred first time donors (2.8%) compared with 27.3 percent of those who were not deferred returned for a second donation during the next 6 months. Among most first-time donors, temporary deferral may be interpreted psychologically as providing a permanent excuse for not donating. PMID- 3824480 TI - Use of a pneumatic tube system for delivery of blood bank products and specimens. AB - This study evaluated the effect of pneumatic tube transport on blood bank specimens and products. No important differences were found between aliquots transported in the tube system and those stored in the laboratory as controls. ABO, Rh, antibody detection or identification, direct antiglobulin testing, and elution were studied. Further, no differences in plasma hemoglobin and potassium concentration were found between units of whole blood and packed cells handled in either manner. Platelet counts in platelet concentrates were not decreased and coagulation factor levels in units of fresh-frozen plasma and cryoprecipitate did not decrease after pneumatic transport. The system tested is currently providing expeditious transport of specimens and blood between blood banks and patient care areas. PMID- 3824482 TI - Preparation of leukocyte-depleted red cells. PMID- 3824483 TI - Leach type Ge--red cells and elliptocytosis. PMID- 3824484 TI - HLA antigens on red cells. PMID- 3824485 TI - Effect of beta-propiolactone on human red cell antigens and antibodies. PMID- 3824486 TI - Risk of human immunodeficiency virus infection in multiple transfused patients. PMID- 3824487 TI - Proceedings of the Eleventh International Congress of the Transplantation Society. August 3-8, 1986, Helsinki, Finland. PMID- 3824488 TI - Specific immunosuppression. PMID- 3824489 TI - The immunoglobulin gene superfamily and human disease. PMID- 3824490 TI - Effect of sequential grafting of antigenetically different allografts on the immune response of the host. PMID- 3824491 TI - In vivo macrophage-directed lymphocyte traffic requires macrophage activation. AB - Lymphocytes are attracted to activated macrophages in tissue. In the absence of exogenous activators, only syngeneic macrophages can become sufficiently activated, to produce lymphocyte attractants. Allogeneic macrophages require exogenous activation to accomplish lymphocyte recruitment. It is likely that graft rejection is initiated by a nonspecific inflammatory reaction within the graft. Once host macrophages have entered the graft they may be activated by the inflammatory process to produce lymphocyte attractants. As lymphocytes are called to the graft, those recognizing donor determinants may expand to effect graft loss. PMID- 3824492 TI - Regulation of alloantigen expression in different tissues. PMID- 3824493 TI - A perspective on long-term outcome in organ transplantation. PMID- 3824494 TI - The highly sensitized patient: etiology, impact, and management. PMID- 3824495 TI - Southern blot analysis of HLA class II beta genes in relation to HLA-D, DR specificities. PMID- 3824496 TI - Evidence for a lymphocyte activation determinant coded by the HLA region different from HLA-DR, DQ, and DP. PMID- 3824497 TI - Allotransplantation of cultured retinal epithelium to Bruch's membrane in the rabbit eye. PMID- 3824498 TI - Distribution of 3H-cyclosporine A in mice by autoradiography. PMID- 3824499 TI - Cyclosporine A--calcium channels interaction: a possible mechanism for nephrotoxicity. AB - Rabbit PTC concentrated CsA rapidly and reached saturation by two to three minutes. CsA uptake was temperature dependent but was not altered by replacement of uptake medium Na with K or mannitol, changes in extracellular pH, and the presence of metabolic inhibitors or organic anions and cations. The organic Ca channel blockers verapamil and diltiazem and the inorganic Ca channel blocker cadmium caused significant inhibition in both Ca and CsA uptake by PTC. Other Ca transport modulators, ruthenium red and trifluoroperazine, decreased PTC Ca uptake, and A23187 increased PTC Ca uptake, but they were all without effect on CsA uptake. We propose that the CsA uptake pathway through PTC is situated at or close to Ca channels so that changes induced by Ca channel blockers also affect transit of CsA through the CsA "passageway." The close spatial relationship between CsA and Ca channels also raises the possibility that CsA uptake may intiate Ca channel-related activities, thereby leading to a cascade of Ca dependent processes and causing nephrotoxicity. A hypothesis is depicted in Fig 1. PMID- 3824500 TI - Effectiveness of urokinase and verapamil for 120- and 144-hour simple surface cooling preservation of canine kidneys. PMID- 3824501 TI - Acute nephrotoxicity following intravenous cyclosporine. PMID- 3824502 TI - Fish oil vehicle for cyclosporine lowers renal thromboxanes and reduces experimental nephrotoxicity. PMID- 3824503 TI - Prevention of sensitization by transfusion with antibody-coated blood cells: specificity of suppression and transfer with serum or spleen cells. PMID- 3824504 TI - Organ transplantation in the United States: recommendations of the Task Force. PMID- 3824505 TI - Organ donation in blacks: a community approach. AB - Our intent is to educate the black community about the dangers of hypertension and the need for kidney organ donors in a population that is uniquely affected by renal failure. The desired goal then is to stimulate the black community to: have annual blood pressure checks so that an early diagnosis of high blood pressure (hypertension) can be made and early treatment can be received; and become better informed about the "Gift of Life" concept and have family meetings in which donating organs after death is strongly considered. The adoption of these recommendations will likely result in a decrease in the incidence of renal disease, since the leading cause of renal disease in blacks is hypertension. This silent unrecognized killer produces renal failure in blacks 17 times more often than in whites. We expect that increasing the number of black organ donors will result in an improved success rate in black recipients of transplants from recently decreased persons. It is clear that the black community can play a major role in elucidating and, perhaps, eradicating this serious medical problem. PMID- 3824506 TI - Is cyclosporine-induced chronic nephrotoxicity inevitable? PMID- 3824507 TI - Proceedings of the Eleventh International Congress of the Transplantation Society. August 3-8, 1986, Helsinki, Finland. PMID- 3824508 TI - An integrated approach to safeguarding mental health. PMID- 3824509 TI - Drug allocation and distribution. Standardized supply of essential drugs in Ghana -3. PMID- 3824510 TI - Ketamine: parenteral anaesthesia for tonsillectomy. PMID- 3824511 TI - Management of blunt pancreatic and duodenal injuries. PMID- 3824512 TI - Management of empyema and bronchopleural fistula. Experience with Eloesser window. PMID- 3824513 TI - ECHO (Equipment to Charity Hospitals Overseas) in the tropics. PMID- 3824514 TI - Technique of caesarean section. PMID- 3824515 TI - Management of breech presentations in developing country hospitals. PMID- 3824516 TI - Distance teaching using self-marking multiple choice questions. PMID- 3824517 TI - Primary health: handle with care. PMID- 3824518 TI - Significance of Staph. saprophyticus as a uropathogen in adult Saudi females. PMID- 3824519 TI - Management of renal failure in Yaounde. First 18 months' experience. PMID- 3824520 TI - [Sensitivity of the proliferation of normal and tumor cells to cytochalasin D]. AB - The effect of cytochalasin D, which is known to disrupt specifically actin cytoskeleton, on DNA replication was studied. The incubation of cultured mouse embryonic fibroblasts (MEF), cells of Balb/3T3 line and cells of minimally transformed clones 12 MC and 6 st/T CAK-7 line with cytochalasin D leads to inhibition of DNA synthesis. A complete inhibition of labeled index in MEF culture was observed after an 8 day incubation in cytochalasin D. Part of cells of clones 12 MC and 6 st/T were insensitive to cytochalasin D and continued to enter to S-phase even after a 10 day incubation. The transfer of cells into a fresh medium leads to a rapid restoration of DNA synthesis. Strongly transformed L cells were almost insensitive to cytochalasin D. Thus, the reorganization of actin cytoskeleton caused by cytochalasin D can inhibit the cycle of normal and minimally transformed cells. In the course of neoplastic progression, in the transformed cells there is a loss of dependence of cell proliferation on microfilament system. PMID- 3824521 TI - [Analysis of macrophage heterogeneity by their phagocytic activity]. AB - Heterogeneity of resident peritoneal macrophages was studied as revealed by their phagocytosis and binding of sheep erythrocytes opsonized by specific rabbit IgG. It has been shown that the macrophage heterogeneity is due to the presence of active and inactive cellular subpopulations. A mathematical model, based on the Poisson fitting of experimental histograms, was elaborated for the analysis of subpopulation composition of macrophage pool in the test of rosette formation and phagocytosis. The validity of the model was supported by physicochemical isolation of the macrophage subpopulation which was inactive in erythrocyte binding. The macrophage pool was separated into fractions by absorption--elution at different temperatures. Active and inactive macrophage subpopulations were found in all the fractions but in different ratios. PMID- 3824522 TI - [Characteristics of the morphology and mitotic condensation of human Y chromosomes with structural rearrangements]. AB - Parameters of the length and mitotic condensation were investigated in the following cases of Y-chromosome aberrations: isodicentric Y(q), Y-chromosome without heterochromatic block, and Y-chromosome with satellites. In the Ydic we revealed some differences between f-block, that is located near the inactive kinetochore, and the block near the active centromere. Satellites exert no influence on the mitotic function of Y chromosome, presumably owing to the presence of C-heterochromatic material. With the absence of heterochromatic region, a decline in condensation of the non-fluorescent segment was observed in addition to a simultaneous increase in its length. The mechanism of functioning of the structural heterochromatin is discussed. PMID- 3824523 TI - [Genetic transformation of somatic cells. X. Morphological transformation and changes in the growth characteristics of NIH 3T3 cells administered the oncogene v-myc]. AB - Transfection of the plasmid containing the cloned gag-myc part of retrovirus MC 29 into mouse NIH 3T3 cells induces focuses of morphological transformation. Isolated morphological transformants have a decreased dependence on serum growth factors, a higher saturation density in monolayer, and an increased cloning efficiency on the glass and in agar. Induced traits are stably inherited, and may constitute the direct consequence of stable maintenance and expression of transfected oncogens. PMID- 3824524 TI - [For the reproductive death of a cell, damage to a single chromosome is sufficient]. AB - The Chinese hamster cells V-79 were treated with BUdR during one cell cycle; after that the cells were grown in the medium without BUdR and were irradiated by longwave-UV-light at different time. The cell survival after photolysis was compared with the percentage of metaphase plates with different number of chromosomes containing BUdR. It is concluded that for cell inactivation the presence of only one destroyed chromosome (or its part) is enough. PMID- 3824525 TI - [Changes in the ultraviolet fluorescence and the size of Ehrlich ascites carcinoma cells in the 1st hours after X-ray irradiation]. AB - Using the Ehrlich ascite carcinoma cells, a decrease in ultraviolet fluorescence (UVF) was demonstrated one hour following a 10 Gy X-irradiation, and an increase in UVF 5 hours following the same irradiation. The same changes were demonstrated for cell turbidity. Association between the optical changes and those in cell radius and membrane protein state is discussed. PMID- 3824526 TI - [Isolation and characteristics of a new strain of diploid cells from human embryonic lung tissue]. AB - A new strain of the embryonic human fibroblasts L-68 was obtained and thoroughly characterized. It completely met all the requirements of the International Committee on the Cells Cultures. This strain can be recommended as a substrate for production of viral vaccines, diagnostic preparations and for research purposes. PMID- 3824527 TI - [Determination of the heparin content in basophilic granulocytes by cytophotometry]. AB - A method for estimating heparin content in basophilic leucocytes by means of cytophotometry of alcian blue--heparin complex is proposed. Its application for measuring heparin amounts in basophils of healthy donors and of patients with allergies is demonstrated. PMID- 3824528 TI - Topical administration of tetrasodium-meso-tetraphenyl-porphinesulfonate (TPPS): correlation between drug penetration and depth of necrosis in skin of nude mice following red light irradiation. AB - The main side effect in photodynamic therapy is photosensitization of the patient's skin following systemic administration of the photosensitizing agent. In the case of superficial lesions, this problem can be avoided by topically applying the drug: in this way a local treatment can be performed. We tested the photosensitizing properties of a 2% solution of TPPS (tetrasodium tetraphenylporphinesulfonate) in a vehicle containing a penetration enhancer, Azone, on skin of nude mice. An aliquot of 0.1 ml/cm2 of the solution was painted on the skin overlying an s.c. implanted NMU-1 tumor. Subsequently, animals were sacrificed at different times after application. Fluorescence microscopy revealed that TPPS penetration depth was related to time elapsed after application and to painting modalities. Solution penetration was enhanced by wiping with ether immediately before painting. Irradiation at 80 mW/cm2 for 20 min with a dye laser emitting at 640 nm, 4 h after TPPS application, produced necrosis of the upper skin layers, up to 0.2 mm in depth. These findings suggest that topical TPPS administration, followed by laser irradiation, may be a suitable treatment modality for skin lesions involving epithelial layers, even though several aspects of this metodology need further investigation. PMID- 3824529 TI - Topical administration of tetrasodium-meso-tetraphenylporphinesulfonate (TPPS) and red light irradiation for the treatment of superficial neoplastic lesions. AB - In photodynamic therapy, systemic administration of photosensitizing agents induces cutaneous photosensitization in patients. This side-effect can be avoided by topical administration of the agents when only surface lesions are involved. A hydroalcoholic solution of tetrasodium-meso-tetraphenylporphinesulfonate (TPPS) containing Azone, a percutaneous penetration enhancer, was investigated to evaluate its photosensitizing potential in the treatment of 33 primary and recurrent neoplastic lesions of the skin. A complete remission was obtained of lesions with clinical thickness of less than 2 mm. Treatment effectiveness depends on both light and drug penetration through skin. Further studies are in progress to optimize treatment parameters. PMID- 3824530 TI - Adenine and pyridine nucleotides in the red blood cells of subjects with solid tumors. AB - The concentration of adenine (ATP, ADP, AMP) and pyridine (NADP+, NADPH, NAD+, NADH) nucleotides in the erythrocytes of subjects affected by solid tumors was evaluated using a method which allows their simultaneous extraction and reverse phase high-performance liquid chromatographic analysis. The results showed a lower level of ATP in the erythrocytes of subjects affected by solid tumors, whereas no significant modifications were observed in the other compounds. In fact, the mean value of ATP in these subjects was 27% lower than that of normal adults. This fact is discussed in relation to other enzymatic and metabolic modifications previously observed in red blood cells. PMID- 3824531 TI - Prognostic factors in advanced metastatic and recurrent melanoma treated with DTIC. AB - Thirty-five patients with recurrent and 25 patients with metastatic malignant melanoma after previous radical locoregional surgery were treated with DTIC at the Institute of Oncology in Krakow between 1976 and 1981. Complete and partial remissions were observed in 19/60, i.e., in 31% of the patients. Our results show an advantage for patients with locoregional recurrence, soft-tissue and lung metastases, provided that the largest deposit is no larger than 5 cm in diameter. There is little chance of remission in patients with liver and bone metastases. PMID- 3824532 TI - Prognosis for localized cutaneous melanoma treated with wide excision only, with special reference to development of regional node metastases. AB - A consecutive series of 564 patients with localized (Stage I) melanoma treated by wide excision only were followed for at least 5 years. The median tumor thickness was 1.50 mm, and 30% were ulcerated. The female/male ratio was 54/46. The overall survival rates were 80% at 5 years and 73% at 10 years. The survival rates were statistically significantly better for females, even when tumor thickness and ulceration were taken into consideration. Twenty percent developed regional node metastases after an average remission period of 13 months. The actuarial survival rates after node dissection were 32% at 5 years and 27% at 10 years. A subgroup with an exceptionally poor prognosis and a high rate of regional node dissemination was looked for. Only 26% of the intermediate thickness group (1.50 3.99 mm, Breslow) developed nodal metastasis, whereas patients with thick lesions (greater than 4 mm) had a metastasis rate of 43%. Patients with thick lesions may therefore benefit more from elective node dissection than patients with lesions of intermediate thickness. Patient characteristics, e.g., sex and tumor characteristics (ulceration), may prove to be of importance in a prospective trial on elective node dissection. PMID- 3824533 TI - Sequential treatment with interferon and chemotherapy of metastatic malignant melanoma. Total remission of cutaneous and visceral metastasis, but not of cerebral metastasis. AB - A woman 35 years of age suffering from cutaneous and visceral metastatic melanoma was treated with recombinant Interferon alpha 2b (rIFN alpha 2b) subcutaneously 3 X 10(6) U/m2 3 times a week for 3 months with no apparent effect on the course of the illness. Two months after IFN therapy the patient developed cerebral metastasis. A cycle of carmustine, 100 mg/day for 3 days, was given, and complete disappearance of the cutaneous and visceral, but not of the cerebral manifestations was observed. Two consolidation cycles based on vincristine, dacarbazine and lomustine were then administered. The patient died 26 months after beginning treatment with IFN and 18 months after chemotherapy for the cerebral metastasis. No trace of tumor at the cutaneous or visceral level was found at autopsy. PMID- 3824534 TI - Significance of ferritin as a marker in head and neck malignancies. AB - The efficiency of the combination of two tumor-associated antigens in recognising head and neck cancer was evaluated. The markers studied were CEA and ferritin by radioimmunoassay. CEA was estimated in 22 controls and 41 head and neck cancer patients. There was no difference in CEA values of controls and head and neck cancer patients, suggesting that CEA was not specific for head and neck malignancies. We measured serum ferritin in 27 controls and 58 patients with head and neck cancer. The mean ferritin level was significantly higher in patients (P less than 0.001) than in normal subjects. The ferritin level in patients with no evidence of clinical disease 8 months after treatment showed approximately normal levels, whereas the levels showed a tendency to increase or remain at high levels in patients with a poor prognosis, giving support to the contention that ferritin may prove to be a valuable adjunct in head and neck cancer. PMID- 3824535 TI - Blue nevus of the endocervix. A study of five cases. AB - The pathologic and immunohistochemical features of 5 cases of blue nevus of the endocervix are presented: 4 of them were studied ultrastructurally. The lesions were incidentaly discovered at microscopic examination and showed pigmented dendritic cells in the cervical stroma. Immunocytochemical examination showed all cases to be positive for S-100 protein. Ultrastructurally they contained melanosomes, were surrounded by a basement membrane, and displayed occasional desmosome-like devices. Histogenesis is discussed, and support for a schwannian origin is presented. PMID- 3824536 TI - Hemothorax in congenital neuroblastoma. AB - The authors report a case of massive left hemothorax in a 15-day-old baby girl, caused by the rupture of a thoracic neuroblastoma. PMID- 3824537 TI - [Subvalvular aortic stenosis (apropos of 50 cases: diagnostic factors)]. PMID- 3824538 TI - [Nonobstructive cardiomyopathies (apropos of 40 cases)]. PMID- 3824539 TI - [Specific problems of cancer of the rectum, upper tumors of the ampulla excluded (apropos of 60 cases)]. PMID- 3824540 TI - [Primary congenital glaucoma and heredity]. PMID- 3824541 TI - [Urinary retention revealing asymptomatic herniated disk. Value of urodynamic exploration]. PMID- 3824542 TI - [Injuries of the duodenum in contusions of the abdomen (apropos of 5 cases)]. PMID- 3824543 TI - [Pseudotumorous chorioretinitis in adolescents. Clinical case report: apropos of a case of ocular toxocariasis and review of the literature]. PMID- 3824545 TI - [Wolfram syndrome (apropos of a case)]. PMID- 3824544 TI - [A variant of Dandy-Walker malformation associated with agenesis of the corpus callosum]. PMID- 3824546 TI - [Dacryocystorhinostomy in diabetics]. PMID- 3824547 TI - [Value of the ultrasensitive assay of TSH in the diagnosis of hyperthyroidism]. PMID- 3824548 TI - [The psoas bladder. Apropos of 14 cases]. PMID- 3824549 TI - [Initial bone metastases: clinical, radiological and etiological aspects. Apropos of a series of 39 cases]. PMID- 3824550 TI - [Urethral stenosis. Apropos of 71 cases]. PMID- 3824551 TI - [Chronic bronchitis in Tunisia: epidemiological aspects]. PMID- 3824552 TI - [Evaluation of the activities of an intensive care unit in Tunisia during 1-year period: maintenance and management problems]. PMID- 3824553 TI - [Inducible resistance and beta-lactams]. PMID- 3824554 TI - [Scanning electron microscopy in the study of the growth of urinary calculi]. PMID- 3824555 TI - [Evaluation of the efficacy of medical treatment, especially anticoagulant treatment, in arteriopathies of the lower limbs. Apropos of 41 cases]. PMID- 3824556 TI - Effect of Ascaris lumbricoides on zinc level in blood and urine. PMID- 3824557 TI - Acellular scanning electron microscopy of spicular renal amyloidosis. AB - Two human renal biopsies containing glomerular amyloid deposits organized into spicular formations (spicular amyloid) were studied by scanning electron microscopy following removal of the cellular components (acellular SEM). Following SEM studies, portions of the same acellular tissue were embedded in paraffin and plastic for light microscopy and transmission electron microscopy, respectively. Spicular deposits by acellular SEM appear as tapering conical formations interconnected by a delicate branching network of fibrils, which imparts a higher degree of organization than previously appreciated by two dimensional LM and TEM. Silver stains of paraffin- and plastic-embedded acellular tissue showed persistence of argyrophilia in spicular deposits, while acellular TEM showed that the spicules appeared comprised "purely" of amyloid fibrils without visible contaminating material. We conclude that the argyrophilia of spicular amyloid is an inherent feature of the parallel organization of fibrils rather than a result of incorporation of glomerular basement membrane or cell components and that spicular amyloid deposits have a higher degree of organization than is apparent by two-dimensional studies. PMID- 3824559 TI - Application of pop-off method to bone marrow and peripheral blood specimens for purposes of electron microscopy. AB - In this paper, we describe a pop-off method applicable to the hematological field. Bone marrow or peripheral blood specimens from patients were placed on a clean glass slide and fixed immediately in 2% glutaraldehyde solution for 10 minutes. For the DAB reaction, the slide was immersed in the DAB reagent for 30 minutes, and post fixed with 1% OsO4 solution for 1 hour. Specimens on the slide were washed with buffer solution, dehydrated and polymerized directly on the slide. A gelatin capsule filled with Epon mixed monomer was then reversed over the specimen. After polymerization was completed, the specimen was popped off from the slide to the capsule and trimmed carefully to prepare for ultrathin sectioning. This method allows the entire sequence of tissue preparation to be carried out on the slide, from fixation to embedding, and even, especially in scanty specimens, including the DAB reaction. Electron microscopic findings in specimens prepared by this technique show excellent preservation and the absence of specific artifacts. PMID- 3824558 TI - Amianthoid fibres in muscle tissue associated with temporomandibular joint ankylosis. AB - The masseter and temporalis muscles were studied ultrastructurally in 3 patients having extra and intra-articular ankylosis of the TMJ. Amianthoid fibres (thick collagen fibres) varying from 280-430 nm in diameter were found in the connective tissue of both muscles. These fibres appeared to form by fusion of collagen fibrils of normal thickness rather than representing an active dynamic process. The presence of amianthoid fibres in these muscles may account for the restricted mouth opening associated with TMJ ankylosis and could be of some value in future management of this condition. PMID- 3824560 TI - Abdominal wall tumor. Ultrastructural pathology. PMID- 3824561 TI - Ciliated cells in the main excretory duct of the submandibular gland in obstructive sialadenitis: a SEM and TEM study. AB - The epithelium of the main excretory duct of the submandibular gland in five cases of obstructive sialadenitis was studied by TEM and SEM. In three cases we found a considerable increase in goblet and ciliated cells. As well as normal cilia, different kinds of ciliary anomalies, especially compound cilia, were noticed. Images of centriole formation and of ciliogenesis, both normal and abnormal, were also observed. Several hypotheses concerning the mode of formation of the compound cilia are discussed. PMID- 3824562 TI - Benign recurrent cholestasis: a light and electron microscopic study with emphasis on sinusoidal cells. AB - A liver biopsy was performed on a patient with benign recurrent cholestasis. Cholestasis was mainly centrolobular with infiltration by sinusoidal macrophages. There was no necrosis. All the classic and specific ultrastructural criteria of cholestasis were observed in hepatocytes under electron microscopy. Perfusion fixation of the biopsy allowed in addition a good visualization of sinusoids and sinusoidal cells. Numerous macrophages (Kupffer cells) with intense phagocytic activity were present in the lumen; some formed the sinusoidal barrier or were infiltrated in the Disse space. Endothelial cells contained numerous dense bodies and had few fenestrae. Cellular debris of hepatocytic origin which were not phagocytized in the Disse space were extruded in the lumen either through enlarged endothelial pores or by progressive invagination in the endothelial wall followed by outpouching in the sinusoid. In an enlarged Disse space containing amorphous material and collagen fibrils some perisinusoidal cells were transitional cells. These results indicate that pure cholestasis leads not only to hepatocyte injury with intense phagocytic activity but also to some degree of sinusoidal cell damage and extracellular matrix changes. PMID- 3824563 TI - Granular cell myoma and schwannoma: fine structural and immunohistochemical study. AB - We present the histological, ultrastructural, and immunohistochemical findings of two granular cell tumors of different histogenesis: a mediastinal granular cell schwannoma, and an uterine granular cell leiomyoma. Ultrastructurally the mediastinal tumor showed granular cell changes of the Schwann cells which were reactive for S-100 protein and Leu 7 antigen, but not for actin, desmin, CEA, EMA, or cytokeratin. Ultrastructural study of the uterine lesion demonstrated smooth muscle cells with only a few "autophagic" facuoles to cells nearly replaced by lysosomes. Immunohistochemically this tumor showed reactivity for actin, desmin, and Leu 7 antigen, but was S-100 protein, CEA, EMA, and cytokeratin negative. PMID- 3824565 TI - Squamous cell carcinoma with anemone cell features. AB - A tumor from a 52-year-old Albino male had the ultrastructural features of an anemone cell tumor. Evidence of squamous differentiation was seen by electron microscopy and immunohistochemistry. "Anemone cell" tumors have been shown to be classifiable as either carcinomas or lymphomas; the term therefore does not describe a discrete entity or constitute a definitive diagnosis. Treatment with radiotherapy was successful in this case, while chemotherapy appeared to have little effect. PMID- 3824564 TI - Melanotic schwannoma coexpression of vimentin and glial fibrillary acidic protein. AB - A 35-year-old man was operated for a thoracic wall tumor which bulged into the pleural cavity. Histologic examination showed a spindle cell tumor with numerous psammoma bodies and a heavy melanin pigmentation. Electron microscopy revealed melanosomes and a continuous basal lamina surrounding all tumor cells, compatible with the diagnosis of a melanotic schwannoma. The tumor cells were S-100 protein positive, and there was an abundant pericellular laminin-positivity. Practically all tumor cells were vimentin-positive, while cytokeratin, desmin and neurofilaments were absent. Glial fibrillary acidic protein was found in single tumor cells, suggesting the presence of focal glial differentiation in melanotic schwannoma. PMID- 3824566 TI - EM diversity of neuroendocrine (Merkel) cells of the human skin. AB - Ultrastructural differences in size of granules of adjacent Merkel cells belonging to normal skin of three patients are demonstrated. The differences, apparent on simple examination of micrographs, were confirmed using morphometric and statistical analysis. Differences are statistically significant (p less than or equal to 0.001) for maximum diameter and granular area. The existence of a NE (Merkel) cells system or population in the skin similar to that observed in diverse epithelial sheets of the human body, is suggested. PMID- 3824567 TI - Ultrastructural appearance of amyloid. PMID- 3824568 TI - A urinary bladder tumor in a 65-year-old man. PMID- 3824569 TI - [The thymus gland and thymus hormones]. PMID- 3824570 TI - [Acute acalcular cholecystitis]. PMID- 3824571 TI - [Infantile hypertrophic pyloric stenosis. Symptoms, treatment, complications and late results]. PMID- 3824572 TI - [Indications for preventive human tetanus immune globulins]. PMID- 3824573 TI - [Frontal osteomyelitis as a complication of frontal sinusitis]. PMID- 3824574 TI - [The trigger phenomenon in fingers without an actual trigger finger]. PMID- 3824575 TI - [Dysphagia caused by achalasia of the cricopharyngeal muscle treated with myotomy]. PMID- 3824576 TI - [Anaphylactic shock following intravenous atracurium (Tracrium) during anesthesia]. PMID- 3824577 TI - [Sickness impact profile (SIP). A method of assessing health]. PMID- 3824578 TI - [Obstructive pulmonary disease in farmers]. PMID- 3824580 TI - [The expectations of female and male medical students regarding the curriculum and their careers]. PMID- 3824579 TI - [Occurrence of silico-tuberculosis among foundry workers]. PMID- 3824581 TI - [Danish skiing injuries. Causes and social consequences]. PMID- 3824582 TI - [Colorectal cancer in Denmark 1943-1982. Cancer statistics no. 16]. PMID- 3824583 TI - [Percutaneous removal of kidney stones]. PMID- 3824584 TI - [Renal calculi in the county of Copenhagen. A 5-year follow-up study nephrolithiasis patients]. PMID- 3824585 TI - [Ventricular arrhythmias after transthoracic electrical accidents]. PMID- 3824586 TI - [Rhinitis and allergens in Saudi Arabia]. PMID- 3824587 TI - [Occupational toxic encephalopathy. Therapeutic requirements 2 years after diagnosis]. PMID- 3824588 TI - [The importance of an empty pleural cavity in the treatment of pleural effusion]. PMID- 3824589 TI - [Acute interhemispherical hematoma]. PMID- 3824590 TI - [Risk factors in breast cancer?]. PMID- 3824591 TI - [Whooping cough and families with infants and small children]. PMID- 3824592 TI - [Nicardipine. A new calcium antagonist]. PMID- 3824593 TI - [Renal calculi in the county of Copenhagen. Epidemiological conditions in a hospital case load]. PMID- 3824594 TI - [Container accidents]. PMID- 3824595 TI - [Integration of mentally handicapped pupils in normal schools with particular attention to assessment by their families]. PMID- 3824596 TI - [Cancer epidemiology in Denmark. Cancer statistics no. 17]. PMID- 3824597 TI - [Anesthesia and myocardial infarction]. PMID- 3824598 TI - [Emergency medical treatment of severe or symptom-producing hypercalcemia]. PMID- 3824599 TI - [Non-ossifying fibroma]. PMID- 3824600 TI - [Late complications of the termination of pregnancy in the 2d trimester]. PMID- 3824601 TI - [Monoamniotic twins]. PMID- 3824602 TI - [Pleural empyema. 95 cases treated at a thoracic surgery department]. PMID- 3824603 TI - [Non-traumatic osteolysis of the lateral end of the clavicle]. PMID- 3824604 TI - [Valgus deformity after fracture of the proximal tibial metaphysis in children]. PMID- 3824605 TI - [Juvenile Bechterew's disease]. PMID- 3824606 TI - [Avulsion of the Achilles tendon after a single steroid injection]. PMID- 3824607 TI - [Rupture of the patellar ligament after steroid infiltration]. PMID- 3824608 TI - [Circulatory collapse during surgery due to an undiagnosed asymptomatic pheochromocytoma]. PMID- 3824609 TI - [Self-reported health and use of medicines among school children]. PMID- 3824610 TI - [Life style and health among schoolchildren]. PMID- 3824611 TI - [Forensic examination for the presence of narcotics in the vagina/rectum]. PMID- 3824612 TI - [Health risks of dry cleaning]. PMID- 3824613 TI - [Infant feeding during the first year of life. The significance of breast milk in the prevention of allergy]. PMID- 3824614 TI - [Immunity to tetanus and diphtheria in children aged 8 to 11]. PMID- 3824615 TI - [Local anesthetics with added adrenaline during halothane anesthesia. Assessment of the risk of necrosis and systemic side effects when these preparations are employed peripherally]. PMID- 3824616 TI - [Postoperative hypoxemia]. PMID- 3824617 TI - [Regional intravenous anesthesia and ambulatory hand surgery]. PMID- 3824618 TI - [Arthroscopic removal of loose body]. PMID- 3824619 TI - [Follow-up studies of patients with hematuria]. PMID- 3824620 TI - [An unusual complication of total hip arthroplasty]. PMID- 3824621 TI - [Pseudoleukocytosis due to cryoglobulinemia]. PMID- 3824622 TI - [Sinoatrial block, hyponatremia and urticaria caused by carbamazepine]. PMID- 3824623 TI - [Retroperitoneal hematoma with femoral neuropathy during anticoagulant treatment]. PMID- 3824624 TI - [Nitrendipine (Baypress). A calcium channel blocker with prolonged action in the treatment of hypertension]. PMID- 3824625 TI - [Problems with defaulting in multipractice investigations]. PMID- 3824626 TI - [The drinking patterns in men and women and their social, psychological and somatic conditions. A study of patients admitted over a one-year period to a special psychiatric department for young alcohol and drug addicts]. PMID- 3824627 TI - [Smoking habits and attitude to smoking of school children in a sociological perspective]. PMID- 3824628 TI - [Health behavior among Danish school children 1984-1985]. PMID- 3824629 TI - [Sports injury pattern and treatment model at the Danish National Games in Odense in 1985]. PMID- 3824630 TI - [Incidence of hysterectomy in young women with neurological symptoms]. PMID- 3824631 TI - [Prevention of infections with antibiotics in leg amputations for ischemia]. PMID- 3824632 TI - [Laser surgery and other forms of laser treatment. Present and future possibilities]. PMID- 3824633 TI - [AIDS and Kaposi's sarcoma]. PMID- 3824634 TI - [Acute cannabis poisoning]. PMID- 3824635 TI - [The carpal tunnel syndrome. A review with results of a 2-year neurological and neurophysiological follow-up study]. PMID- 3824636 TI - [Balloon dilatation of muscular esophageal disorders]. PMID- 3824637 TI - [Jejunum biopsy obtained via a duodenoscopy]. PMID- 3824638 TI - [Characteristics of children consuming alcohol frequently]. PMID- 3824639 TI - [Toxic encephalopathy and sperm quality among flexoprinters]. PMID- 3824640 TI - [Testing of toilet detergents for skin irritation. Clinical readings and measurement of blood circulation by laser Doppler technic]. PMID- 3824641 TI - [The pattern of injuries in Danish championship volleyball]. PMID- 3824642 TI - [Jumper's knee]. PMID- 3824643 TI - [Hereditary angioedema]. PMID- 3824644 TI - [The supracapsular nerve compression syndrome. An overlooked cause of shoulder pain?]. PMID- 3824645 TI - [The first operation for lumbar disk prolapse]. PMID- 3824646 TI - [An occurrence study of diabetes mellitus treated with insulin and tablets in a well-defined geographical area in Denmark]. PMID- 3824647 TI - [Herpes genitalis. A retrospective study]. PMID- 3824648 TI - [Does non-ionizing radiation influence fetal development?]. PMID- 3824649 TI - [The courses of C-reactive protein and sedimentation rate in acute salpingitis. A prospective study]. PMID- 3824650 TI - [C-reactive protein (CRP) for the demonstration of postoperative complications of abdominal hysterectomy]. PMID- 3824651 TI - [Treatment of septic bursitis]. PMID- 3824652 TI - [Right-sided ureteral obstruction caused by periappendicular abscess]. PMID- 3824654 TI - [A body-weight reducing powder and cardiac risk]. PMID- 3824653 TI - [Primary vaginal dysplasia]. PMID- 3824655 TI - [Penicillin versus ampicillin]. PMID- 3824656 TI - [Acute admissions to the Copenhagen Municipal Welfare Home in Sundholm]. PMID- 3824657 TI - [Examination prior to referral. An experimental project in community psychiatric service in North Jutland]. PMID- 3824658 TI - [Attitudes of parturient women to cardiotocographic monitoring during delivery]. PMID- 3824659 TI - [Attempted suicide by injuries in the area of the wrist]. PMID- 3824660 TI - [Lumbar corset treatment]. PMID- 3824661 TI - [Diagnosis of intracranial germinomas]. PMID- 3824662 TI - [Generalized congenital skeletal dysplasias in the county of Funen. A clinical, radiological and epidemiological study]. PMID- 3824664 TI - [Urogenital tuberculosis in a urological department]. PMID- 3824663 TI - [High tibial osteotomy in the treatment of primary gonarthrosis]. PMID- 3824665 TI - [Inguinal herniotomies. Results of 888 herniotomies done by various surgical methods]. PMID- 3824666 TI - [Hemospermia and hypertension]. PMID- 3824667 TI - [Madura foot]. PMID- 3824668 TI - [Aplasia of the gallbladder]. PMID- 3824669 TI - [Lymphangioma of the mesentery as the cause of intestinal obstruction]. PMID- 3824670 TI - [Sensory nerve compression syndromes]. PMID- 3824671 TI - [Myofascial pain syndrome]. PMID- 3824672 TI - [Simultaneous occurrence of a stone in an inflamed Meckel's diverticulum and gallstone ileus]. PMID- 3824673 TI - [Regional variations in health care activities. A classical research field in new development]. PMID- 3824674 TI - [The prevalence of women with hysterectomies among the Danish population in 1983]. PMID- 3824675 TI - [Psychodynamic milieu therapy. Experience with adults psychotic since childhood]. PMID- 3824678 TI - High spatial resolution analysis using parallel detection eels. AB - The application of parallel detection electron energy loss spectroscopy to the characterization of small particles or interfaces is demonstrated. Data are presented that show variations of low energy loss plasmons, Al L23 edge near edge fine structure, and oxygen concentration with spatial resolution better than 10 nm. The use of this technique for chemical and electronic structure measurements from very small specimen volumes is discussed. PMID- 3824677 TI - Atomic structure and properties of small particles. Arizona, USA, 7-11 January 1986. Papers. PMID- 3824676 TI - [Occupational and ergonomic evaluation of Cellastic floor carpeting]. PMID- 3824679 TI - Criteria for the comparison of electron microscopical 3D reconstructions of individual particles. AB - Similarity criteria for electron microscopical 3D reconstructions can be defined in different ways. It is shown that the choice of the zero level in 3D reconstructions plays an important role, (a) for the discrimination of stained versus non-stained structural parts ("discrimination level"), and (b) for the physical definition of the signal ("zero potential level"). Of special interest are further structural features (artifacts) introduced by the reconstruction method chosen (single axis tilting in our papers). A crude estimate of the zero potential level is only possible if we neglect electron scattering from light atoms (concept of the "holey stain structure"). We calculate for the reconstructions of stained ribosome particles (W. Hoppe and H. Oettl and H. Tietz, J. Mol. Biol., in press) a signal-to-noise ratio of the order 3:1 (smaller by a factor of ca. 3 than the ratio calculated from electron noise). This explains why structural details can be recognized in single-particle reconstructions and why averages over only a few particles can already lead to consistent results. An analysis of the contrast decrease along the optical axis shows that this result is only true for strongly stained structural parts; averaging over large numbers of particles is required for the structural study of weakly stained parts. Possibilities of pattern recognition are discussed. The structural feature complementarity is explained by means of a model example; it can drastically reduce cross-correlation coefficients. PMID- 3824680 TI - Improvement in high resolution image quality of radiation-sensitive specimens achieved with reduced spot size of the electron beam. AB - High resolution images of thin paraffin crystals and of purple membrane (i.e., crystalline bacteriorhodopsin) have been recorded with illumination spots that are confined to a size of 1000 to 2000 A. Images recorded in this way show three to five times greater contrast than do images which are recorded with more conventional flood-beam (ca. 3 micron diameter) illumination. In addition, optical diffraction patterns of small areas of such images show much better preservation of contrast in all directions than is normally the case. Both effects substantiate the idea that beam-induced movement of radiation-sensitive organic specimens has been a major factor which has caused low dose images to be greatly inferior in their quality compared to electron diffraction patterns of the same type of specimens. In spite of the marked improvement that is obtained, we often observe an unexplained degree of contrast variation within the small illuminated area, demonstrating that even further improvement in the quality of low dose images should be possible. PMID- 3824681 TI - Electron energy loss analysis of near-trace-element concentrations of calcium. AB - The quantitation of near-trace-element concentrations of calcium (25 ppm atomic fraction) with electron energy loss spectroscopy (EELS) is demonstrated. The data collection, with an energy-stabilized parallel recording spectrometer, subsequent signal processing, and quantitation procedures are described. The quantitative results obtained with EELS, in the biologically relevant range of 1 to 100 mmol/kg, are directly compared with simultaneously collected and previously validated energy-dispersive X-ray spectroscopy (EPMA). The experimentally determined sensitivity of EELS for Ca detection is five-fold better than for EPMA, and the theoretically attainable sensitivity of EELS is ten-fold better than for EPMA. However, the attainment of this sensitivity with EELS is technically more difficult and limited by specimen thickness. The sensitivity of EELS experimentally demonstrated in this study permits the detection of three calcium atoms in a 10 nm diameter spot of an organic matrix, with a field emission-gun-equipped scanning transmission electron microscope. PMID- 3824682 TI - Geometric and intensity distortion in echography. AB - Anatomic structures possessing varying sonic propagation velocities refract ultrasonic beams and create distortions in the sonographic image. The distortions consist of inaccurate positioning of echogenic locations (geometric distortions) and of inaccurate display of ultrasonic intensities (intensity distortions). Artifacts of both types occur in the region distal to a structure of circular cross section with an internal sonic propagation velocity lower than that of its surroundings. In an attempt to better understand these distortions, a model is developed from first principles of the production of sonograms of such a region. Assuming a uniform ultrasonic beam and uniform echogenicity of the surrounding tissue, a mathematical expression has been derived for the intensity of the sound arriving at each point and returning to the transducer. Computer simulations of the resulting sonographic image are provided for visualization. In spite of many simplifying assumptions, this model is shown to be consistent with several known artifacts, and provides insight into the mechanisms of their production. PMID- 3824683 TI - [Alloplastic replacement of the anterior cruciate ligament by a polytetrafluoroethylene ligament. Animal experiment study]. AB - 4 sheep knees received an implant of polytetrafluorethylene. 18 month after implantation the clinical and histological investigation showed two cases of anterior instability and rupture of parts of the prosthesis. We sw severe degenerative lesions intraarticular with chronic inflammation characterized by the proliferation of immature fibroblasts, the accumulation of macrophages and the formation of multinucleated giant cells. The transfer of our results to the human knee is discussed. PMID- 3824684 TI - [The radiologic Lachman test--a simple and sure method for the detection of damage to the cruciate ligament]. AB - The Lachman test, a method allowing to verify a lesion of the anterior cruciate ligament, is not yet generally known, but it is considered to be the only test which provides clear evidence. A radiological check of this test performed by us with a special holding device proved its high qualitative and quantitative value. The possibility to diagnose also lesions of the posterior cruciate ligament could be demonstrated. A special template has been developed for a rapid reading of the test results. The test is particularly suited for the examination of fresh lesions of the knee joint without anesthesia, for the follow-up of surgical transposition of ligaments, and for the elaboration of medical expert opinions. PMID- 3824685 TI - [Calculation of the true angle in malposition of the skeletal system using electronic data processing. Retrospective study of 53 axis deviations in healed femoral fractures]. AB - Under standard conditions deformations in the skeletal system are diagnosed by two X-ray photographs whose planes of projection form a right angle. The degree of deviation from the axis is measured directly on the X-ray photograph with a protractor. The analysis of the position of the axis of a tabular bone is carried out by determining the varus/valgus or ante/recurvation deformities resp. in the a.-p. and lateral rays. The degree of deformation is expressed through the supplementary angle. We asked ourselves whether a diagnostic procedure using X rays taken in two planes is suitable for substantiating the evidence of a deformation of the axis. Example: If a fracture of the lower leg shows a varus deformity of 20 degrees in the a.-p. and a normal position of the axis in the lateral photograph, the actual angle is 20 degrees. This situation is an expection in that most cases the defect of the axis is a so-called combined defect (dislocation from the axis in both planes). In this case it can maintained that the measurable angle of deviation in the a. -p. and lateral X-ray photographs is smaller than the angle that is actually included by both fragments. We call this angle true angle. If you think of a fractured tubular bone as a cylinder it can be shown in a diagram that its deformation can only occur in one plane (Figure 1). Only from the perspective of a ray falling vertically on the curve k we would be able to determine the true angle directly from the photograph with a protractor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3824686 TI - [Initial experience using the dynamic hip screw in osteosynthesis of femoral neck fractures]. AB - We report about our first experience in 16 patients with femoral neck fractures, operated upon with the dynamic hip screw. All fractures united within three to six months, early avascular necrosis did not occur. In the concept of treatment of femoral neck fractures osteosynthesis with dynamic hip screw has some advantage, especially compared with the AO-nail plate: Easy correction of the guide wire position, sufficient impaction of the fragments by using the compression screw, low risk of penetration into the acetabulum during fracture healing with shortening of the femoral neck. PMID- 3824687 TI - [Indications for open Ender nailing]. AB - In some sub- or pertrochanteric fractures of femur it is sometimes most difficult or even impossible to carry out an closed reduction on the extension table. In these cases an open reduction has to be performed. When such an open reduction is necessary, this should not give reason to dispense with the advantages offered by the Ender nailing method and select another technique of osteosynthesis. An early mobilisation, which is of particular importance to old patients, can be achieved best by the aforementioned osteosynthesis. PMID- 3824688 TI - [Follow-up results of 102 tibial shaft fractures stabilized by dynamic compression plate osteosynthesis]. AB - From 1978 to 1982, 102 tibial shaft fractures in 100 patients were treated with a dynamic compression plate in our trauma center. Only 61 fractures were operated upon primarily. 84 fractures were followed for an average of 19,8 months. The mean hospital stay was 21.5 days. Postoperative minor would problems were present in ten fractures. The infection rate was 1.2% and non-union developed in 1.2%. In six fractures a second stabilisation was necessary. 88.1% of the patients had a good end result. The plate osteosynthesis of closed and first degree open tibial shaft fractures proved to be a reliable treatment procedure, when it is made by expert surgeons and in accordance with the AO-principles of fracture treatment. PMID- 3824689 TI - [Claw plates--new implants for para-articular osteosynthesis]. AB - The claw plate types used by us are manufactured according to the same principle. These plates are mostly applied in the treatment of multiple fragment fractures and in the fixation of osteotomies. A strong fixation of the plate, also to little fragments close to the joint, is achieved by the claws and one screw. The plates may be used for neutralization or as a support, distance piece, or compression plate. The shape of the variable plate as well as the claws can be formed. The masses of the maximum and minimum plate are adapted to the different sizes of bones. No special instrument is needed to insert the claw plate, and the region around the joint can be laid open in a sparing manner. Regarding the experience accumulated during ten years and the good results obtained, we are of the opinion that claw plates can be used successfully to complete the methods applied hitherto in the treatment of joint-near fractures of all long bones except the femur. PMID- 3824690 TI - [Static equilibrium and function of the spine]. AB - The erect posture of man is not due to a static rigidity of the vertebral column, but to an extremely dynamic function of the whole locomotor system of the trunk, especially the multiple biomechanical and functional possibilities of the vertebral column. Vertebrae intervertebral disks, ligaments (vertebral motor segment; Junghanns, 1966), back muscles, and the adjacent organ systems have to be considered as a functional unit. The erect posture is one of the most decisive acquisitions in the phylogenetic development of man. The vertebral column starts its adaption to this condition already during the last embryonal months by rearranging the small lumbar vertebral joints, beginning with the transition between thoracic and lumbar spine. In many cases this adaption is not finished and remains incomplete in the region of transition between lumbar and sacral spine. Only the erect posture has released the hands and made possible the use of tools and the evolutionary progress of the brain which is closely connected to this ability. This most recent phylogenetic adaption of a particularly loaded region has produced a weak point in the construction of our bodies. This is the price we have to pay for our erect posture which has been essential to the development of the specific human way of life, i.e. the formation of language and culture. PMID- 3824691 TI - [Conservative functional treatment of fractures of the thoracic and lumbar vertebrae]. AB - The treatment of fractures of the thoracic and lumbar vertebraes is determined by the (primary) stability or instability of the injury. "Stable" vertebral injuries are defined to affect the firmness of the vertebral column only slightly or not at all. Thus an early mobilization is generally possible without essential losses in shape and function. The dynamic functional treatment of vertebral fractures developed by Magnus and repeatedly modified later on has, together with a physiotherapeutical program containing 13 points, proved successful in the treatment of "stable" fractures of the thoracic and lumbar vertebraes. PMID- 3824692 TI - [Fractures of the cervical spine]. AB - A gentle traction is often sufficient to repose unstable lesions of the cervical spine, when a retention by means of conservative methods is not possible. Therefore a ventral, intracorporal fusion with autologous, corticospongious chip material combined with a plate fixation is an adequate solution to obtain a stable, movable blocking of the lower six cervical vertebrae. In case of a completely ruptured dorsal ligamentous apparatus, a ventral bone-chip blocking is generally insufficient. Ventral spondylodesis should be combined with a dorsal traction belt in these cases. Fresh, instable fractures of the odontoid process can be stabilized for exercise by means of two traction screws fastened from the front side. However, the best method to treat a pseudarthrosis of the odontoid process is a fusion performed from the dorsal side. PMID- 3824693 TI - [Salmonella osteomyelitis (Salmonella infection with manifestation in the tibia]. AB - A report is given of a special form of osteomyelitis the infection of the bone marrow caused by salmonellae. At the same time the development of infection and the attendant disease, which lead to this infection are dealt with. By means of an almost classical medical case the form of the disease is discussed. PMID- 3824694 TI - Identification of marker chromosomes in bladder tumor. AB - Sequential staining with Giemsa and quinacrine mustard on direct cytogenetic preparations was employed to characterize the karyotype of five bladder tumors of different stage and grade (TNM classification). The use of QFQ-banding allowed: the characterization of 2 euploid and 1 pseudodiploid cases, and the identification, in the two hyperdiploid cases, of a number of rearranged chromosomes otherwise morphologically indistinguishable from the normal ones. The importance of banding technique on direct cytogenetic preparations is stressed. PMID- 3824695 TI - Prostaglandins in urology. AB - This article gives a review of the current place of the different prostaglandins in the urogenital tract and urological pathology. Clinical as well as experimental data are analyzed. The conclusion is that prostaglandins play an important role in the physiology and pathophysiology of each organ of the urogenital tract although no direct clinical applications of prostaglandins or prostaglandin-inhibitors result from our current knowledge and experiences with these substances. PMID- 3824696 TI - Anal electrostimulation in urinary incontinence. Technical description of a new device. AB - A new electrical anal stimulator has been developed to treat urinary incontinence. The device is automatic and fully integrated with both battery and electronics in the plug. Shape, plastic material, electrodes, electrical parameters and electronic circuits have been carefully selected for optimal acceptability and therapeutic effect. A pilot study was performed in 24 women with stress, motor urge and mixed stress and motor urge incontinence where traditional incontinence therapy had failed. When the stimulator had been used for an average of 3.5 months, 25% were continent, 54% much improved and 21% without any effect of the treatment. Improved incontinence status was verified by positive changes in the urodynamic parameters in some of the patients after the treatment. No serious side effects have been observed. The present device is simple to handle for the patient and has satisfactory technical and mechanical properties. The preliminary clinical results are promising. PMID- 3824697 TI - A critical evaluation of the urinary inhibiting activity in idiopathic calcium oxalate nephrolithiasis. AB - In order to obtain new insights into the relevance of inhibitors in whole urine by focusing on their reciprocal interactions, a statistical approach was followed in 35 controls and 27 calcium oxalate (CaOx) recurrent idiopathic stone formers. The inhibiting activity of CaOx crystal growth and the most widely accepted inhibitors (glycosaminoglycans, citrate, magnesium, pyrophosphate), stone constituents (calcium, oxalate, phosphate, urate) and other normal urinary substances were evaluated. It was seen that the inhibitors played a very small role in total inhibiting activity. On the other hand, considering other normal urinary constituents, almost all the inhibiting power of urine on crystal growth could be explained. PMID- 3824698 TI - Influence of thromboxane A2 inhibition on the development of hydronephrotic atrophy. AB - The development of hydronephrotic atrophy as measured by dry and wet weight in relation to wholebody weight, in rats after complete unilateral ureteral obstruction could be influenced by oral administration of OKY 1581, an inhibitor of thromboxane A2 synthesis. The data are consistent with the thesis that preglomerular thromboxane A2-mediated active vasoconstriction is involved, most likely by ischemia, in the development of hydronephrotic atrophy, at least in the renal cortex. PMID- 3824699 TI - Chronic incomplete obstruction of the ureter: a new experimental model. AB - To produce a chronic moderate hydronephrosis in dog, a method of partial ureteral occlusion using a specially designed polypropylene obturator was developed. In 11 of 14 dogs undergoing this procedure, excretory urography constantly revealed a moderate degree of hydronephrosis persisting for 7 weeks. Combination of this method in one ureter with the vaginal-cuff cutaneous ureterostomy, previously reported, in the contralateral ureter is a useful model for split renal function study of unilateral chronic hydronephrosis or obstructive nephropathy analogous to that of clinical case. PMID- 3824700 TI - A new technique for the repair of pediatric hydroceles. AB - The major difficulties encountered in the surgical correction of pediatric communicating hydroceles are separating the hernial sac from the spermatic vessels and vas, and identifying the anatomical location of the internal inguinal ring. The passage of a pediatric Foley catheter through the hernial sac via a high scrotal incision greatly expedites this surgery. Herein, we describe a new surgical technique and discuss its merits. PMID- 3824701 TI - Use and maintenance of percutaneous nephrostomy. AB - Percutaneous nephrostomy has been used for the diagnosis and treatment of 64 patients. There have been no unsuccessful attempts at nephrostomy placement and no major complications were noted. This procedure can be accomplished readily and safely, reliably and effectively for short- and long-term urinary diversion in various urologic conditions in children and adults. Catheter care is described, and use of the nephrostomy tract for various urological problems is discussed. PMID- 3824702 TI - Nosocomial urinary tract infections: etiology and prevention. AB - Nosocomial urinary tract infections arise mainly after transurethral diagnostic or therapeutic operations and are favored by the raised susceptibility of many hospitalized patients to infection. Besides strict establishment of the indication, attention must be paid above all to proper performance of the catheterization. Standardization disposable sets are helpful in this regard. Choice of the suitable catheter type depends on the requirements of the application, the duration of drainage and on the anatomical conditions. Use of a closed urine drainage system must be part of the clinical standard today as well as mastery of daily catheter hygiene. Under observation of the contraindications, advantage should be taken of suprapubic catheter drainage. PMID- 3824703 TI - Giant hydroureteronephrosis. Case report and review of the literature. AB - A case of giant hydroureteronephrosis in a man is reported. Diagnostic evaluation included ultrasound, urethrocystoscopy and percutaneous puncture to assess the outline of the urinary tract and to locate a suspected ectopic ureteral orifice. Standard treatment usually consists of primary nephroureterectomy. A review of the literature with respect to etiology, diagnostic criteria and treatment modalities is presented. PMID- 3824704 TI - Fatal outcome of intravesical formalin instillation, with changes mimicking renal tuberculosis. AB - Intravesical formalin instillation has been performed in a patient with massive bladder hemorrhage secondary to radiation cystitis. Stricture formation at the level of the calyceal infundibula occurred, as well as retroperitoneal and ureteric fibrosis. The literature concerning formalin therapy is reviewed. PMID- 3824705 TI - Labial adhesions in a diabetic woman. AB - This paper reports a 72-year-old woman with labial adhesions, who complained of difficulty in urination and terminal dribbling. The adhesions were surgically dissected with success. Diabetes mellitus in addition to poor perineal hygiene seem to have made her susceptible to the recurrent vulvitis which led to labial adhesions. This case implies the significance of detecting diabetes mellitus as a contributory factor for labial adhesions. PMID- 3824706 TI - Prostatic tumors with penile secondaries. Review of the literature with a case report. AB - 73 cases of penile metastatic tumors secondary to prostatic cancer have been collected from the literature (including a personal case) and have been thoroughly reviewed. PMID- 3824707 TI - Myocardial tissue characterization using pattern recognition procedures on backscattered ultrasonic signals. AB - Pattern recognition techniques were applied to backscattered signals obtained in vitro from normal and abnormal canine and human heart samples. Orthogonal transforms, in conjunction with the variance criterion, comprised the feature extractors. The minimum-distance (MD) and nearest-neighbor (NN) rules were used as classification. When the MD rule was used, the magnitude of the DFT gave the best performance for both canine and human samples. When the NN rule was used, all the transforms performed comparably. The classification performances were improved for both species when the NN rule was used with feature extractors containing phase information. PMID- 3824708 TI - Multifrequency holography using backpropagation. AB - The technique of wavefield backpropagation has been used quite extensively in the literature. We report on an analytical study of the resolution properties of this technique. Backpropagation as a form of holographic reconstruction suffers from poor axial resolution. We derive expressions for both the axial and the lateral resolutions. We also show that the axial resolution can be substantially improved by the use of multiple frequencies. We derive an expression relating the resolution and bandwidth. PMID- 3824709 TI - Compensatory renal growth: interactions of nephrectomy serum and urine antisera leading to a new theory of renal growth regulation. AB - Compensatory renal growth is mediated by a substance(s) found in the serum and in urine called renotropin. The interaction of nephrectomy serum and urine antisera upon compensatory renal growth was investigated by administering rat uninephrectomy serum and sham serum and urine to rabbits. The rabbit antisera was given intravenously to uninephrectomy and sham operated rats and kidney weight/body weight ratios were calculated. Antisera against sham serum and urine induced kidney growth as well as antisera against uninephrectomy serum and urine given to sham animals. These results suggest the presence of a circulating antigenic inhibitor to kidney growth and suggest that renotropin is made up of a inhibitory as well as a stimulatory substance. PMID- 3824710 TI - Absorption of Adriamycin into the systemic circulation after intravesical instillation with or without Tween 80 in the rat. AB - The absorption of Adriamycin (ADM) into the systemic circulation after intravesical administration, using an experimental model in the rat, was closely related to the volume of the instilled solution and the concentration of the drug. The post instillation plasma concentration of ADM was increased after addition of Tween 80 to the instilled solution but the magnitude of the absorption was still discreet and, from a clinical point of view, negligible. PMID- 3824711 TI - Scanning electron microscopy of changes in the urinary bladder in dogs treated with N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN). AB - The fine structures of the bladder mucosa during BBN carcinogenesis and of bladder tumors induced by BBN in dogs were examined by scanning electron microscopy. Normal dog bladder mucosa was covered with polygonal superficial cells with peaked microridges, but no microvilli. Microridges and uniform microvilli were observed in hyperplastic mucosa. In low grade papillary tumors induced by low doses of BBN, pleomorphic microvilli predominated. In dogs which received high doses of BBN, bizarre pleomorphic microvilli and blebs were observed in papillary lesions, whereas bumpy surfaces with thick short microvilli were observed in non-papillary lesions. These sequential changes which were observed in dog bladder mucosa during BBN carcinogenesis parallelled the changes that occurred in the process of chemical carcinogenesis in rodents, and dog bladder tumors were similar to those of rodents and of human bladder cancers. PMID- 3824712 TI - Neoplastic invasion of the connective stalks in transitional cell papillary tumors (TCPT) of the bladder. AB - Neoplastic invasion into the connective stalks of transitional cell papillary tumors of the bladder was assessed in TUR specimens from new cases. There were 21 G1 cases, none of which showed invasion of the connective tissue stalk; this compared with definite invasion in 19 of 77 G2 cases (25%) and in 16 of 17 G3 cases (94%). During a 5 year follow-up period more of the stalk invasive cases had an unfavorable course (fatal outcome or total cystectomy) than of the stalk non-invasive cases; this was statistically significant (p less than 0.01) for the whole group of patients and for the smaller group of patients with G2 tumors (p less than 0.05). PMID- 3824713 TI - The innervation of the external urethral sphincter; an ultrastructural study in male human subjects. AB - Innervation of the external urethral sphincter (EUS) was studied in male human subjects. In the region of EUS at the distal end of prostatic urethra, a large axon bundle surrounded by perineurium was evident in the intramural connective tissue gap. Because of the presence of dense core vesicles, the small nonmyelinated axon profiles in the bundle were considered to be adrenergic. After ramifications to smooth musculature, the axons were traced to the EUS. In the EUS, axon bundles containing many non-myelinated axons were recognized as a sole autonomic nerve among the striated muscle cells. A single or at most two or three axons were surrounded by a Schwann cell, and some possessed dense core vesicles which suggested an adrenergic function. These autonomic adrenergic nerve ends formed surface junctions with the striated muscle of EUS. The clinical relevance of these data are discussed. PMID- 3824714 TI - Endotoxemia and bacteremia in patients following ultrasonic lithotripsy. AB - The incidence of endotoxemia was studied in 17 patients who underwent ultrasonic lithotripsy (USL), and compared with the incidence in 11 patients who underwent transurethral resection (TUR) and in 8 patients who underwent other operations. Fourteen of 17 patients (82%) who underwent ultrasonic lithotripsy had endotoxemia. The incidence of endotoxemia after USL was significantly higher than that after TUR (9%) or after other operations (12.5%). Only 2 of the 17 patients (12%) who underwent USL had bacteremia. The organisms isolated were P. mirabilis and S. sanguis, respectively. Six of the 14 patients with endotoxemia after USL suffered high fever. These data suggest that endotoxemia is a factor which causes high fever after USL. PMID- 3824715 TI - Tissue effects of an ultrasonic scalpel for clinical surgical use. AB - The effects of a new ultrasonic scalpel were studied in laboratory animals. Tissue heat conduction from the tip of the ultrasonic blade was measured. Tissue damage was assessed by light microscopy of histochemically stained sections. The ultrasonic scalpel incised nonfibrous tissue effectively, with minimal heat conduction, and the incisions healed with no evidence of fibrosis nor of tissue destruction. PMID- 3824716 TI - The in vitro assessment of a collagen/vicryl (polyglactin) composite film together with candidate suture materials for use in urinary tract surgery. I. Physical testing. AB - A Vicryl (Polyglactin)/Collagen composite membrane has been developed for potential use in urinary tract surgery. The compatability of this membrane, together with its two individual components, collagen film and vicryl mesh, has been tested over a three week period in urine obtained from both healthy and from stone forming patients. The rate of degradation as indicated by changes in the mechanical strength was determined at regular intervals. In addition, absorbable suture materials such as plain catgut, chromic catgut, and vicryl were similarly tested; in the latter case, the breaking stress, and actual loss of weight of the material were compared. The whole series of experiments were then repeated in urine obtained from rabbits, the animal chosen for any future in vivo studies. PMID- 3824717 TI - Early experience with Walsh technique of radical retropubic prostatectomy. AB - We analyzed the operative experience and postoperative and late complications of pelvic lymphadenectomy and radical retropubic prostatectomy in 27 consecutive cases in which the modifications of prostatectomy described by Walsh were employed, and compared the results with those of 29 cases performed in the preceding three years when the Campbell technique of prostatectomy was employed. The mean operative time, mean blood loss, and incidences of early postoperative complications and incontinence were less for patients treated with the Walsh technique than with the Campbell technique. After surgery 85 per cent of evaluable patients remained potent with the Walsh technique compared with 16 per cent of patients treated with the Campbell technique. Although other factors besides operative approach may have biased our results, we are persuaded that the innovations of radical retropubic prostatectomy detailed by Walsh constitute important advances in surgical technique, and we now use this procedure in all suitable patients electing treatment by radical prostatectomy for localized prostatic cancer. PMID- 3824718 TI - ESWL: a look from different angles. AB - Rapid and accurate stone positioning prior to shock wave administration is the key to efficient extracorporeal shock wave lithotripsy (ESWL). On the Dornier HM 3 machine, the operator uses the control panel to move the stone image along the x, y, or z axis, but many operators are uncertain about the direction and speed of the target when the control buttons are activated. Since knowledgeable, full use of ESWL controls probably results in reduced positioning time and x-ray exposure, the angles and relative velocities from simple and complex maneuvers are presented as a didactic aid. PMID- 3824719 TI - Screening assessment of penile tumescence and rigidity. Clinical test of Snap Gauge. AB - A study was conducted to investigate the clinical usefulness of the Snap-Gauge, a device intended to provide an economical alternative to complete nocturnal penile tumescence (NPT) recording. Twenty-one patients were assessed using the Snap Gauge either during NPT recording or during the corporeal calibration test (CCT), or both. Patient acceptance of the device was excellent. The results indicate a fair degree of consistency between the Snap-Gauge and CCT measurements. The Snap Gauge and NPT findings were less consistent. The results suggest that the Snap Gauge is a reliable and useful screening device for assessing impotent patients. However, it is not an adequate substitute for a more complete NPT monitoring with polysomnographic recording. PMID- 3824720 TI - Pattern of care and follow-up of stages A1, B1 prostatic cancers from multicenter group, the National Prostatic Cancer Treatment Group (NPCTG). AB - In 1981, the National Prostatic Cancer Treatment Group began an open survey of available A1, B1 prostatic adenocarcinomas to determine outcome and clinical characteristics. Their report as of September, 1985, summarizes the outcome and important features of the survey. The majority of A1 cases had a low tumor grade I and were followed. Stage B1 received surgery or radiation generally. The B1 tumor grade was approximately one-third grade I, II, or III-IV. Presently, symptoms differ, as would be expected. Follow-up data to date have indicated no major changes. In some of the special study cases (12/52), the stage was changed as a result of the central laboratory review. PMID- 3824721 TI - Blood loss in prostatectomy. Comparison between injected and noninjected prostates. AB - A prospective study was done during 100 open prostatectomies, measuring the blood loss by a simple photometric method as suggested by Jansen. Fifty patients were injected with 5% phenol into the prostate, preoperatively. The blood loss in the injected group was significantly less when compared with the noninjected group. During the postoperative period none of the injected group of patients required blood transfusion whereas 6 patients in the noninjected group needed transfusion (12%). It is concluded that injection of prostate preoperatively has the significant advantage of minimizing blood loss, and therefore preoperative ABO-Rh typing and antibody screen will suffice when the prostate is injected with phenol. PMID- 3824722 TI - Vaginal construction. AB - Construction of the vagina was performed in 5 46 XY, phenotypic female children, by utilizing a vascularized segment of ileum, which is folded and converted into a pouch, then placed between the rectum and bladder, and transplanted to the perineum. The neovaginal opening remained patent in all, mucus discharge decreased with time, and one teenager experienced a satisfactory sexual relationship. PMID- 3824723 TI - Repair of hypospadias using new mouth-controlled microscope. AB - The use of optical magnification (loupes) to repair hypospadiac anomalies in children is well known. A mouth-controlled operating room microscope (Zeiss OPMI 6CH Contraves Stand) became available that has been utilized in 34 cases of hypospadias repair which included 13 flip-flap, 4 MAGPI, 14 Hodgson XX (modified Asopa), and 3 other procedures. Other results show that in 2 patients fistula developed and in 1 meatal stenosis. Based on our experience, we believe this new microscope compares favorably with previous results and allows the surgeon to use small sutures with great accuracy. PMID- 3824724 TI - Needle biopsy of testes: a safe outpatient procedure. AB - A total of 287 testes biopsies were performed in the office under local anesthesia, using a modified needle and technique to collect the tissue which was then fixed in Bouin's solution. Adequate tissue was obtained in all specimens for histopathologic diagnosis. In 3 patients small hematomas developed and were treated conservatively. Five patients complained of orchialgia, but none required narcotic analgesia. No sperm antibodies, extravasation, or serious complications were encountered. We believe this technique is safe, simple, and cost-effective. PMID- 3824726 TI - Flexible ureteropyeloscopy with modular, "disposable" endoscope. AB - A flexible modular ureteropyeloscope has been utilized in 36 patients. The flexible tips of this instrument can be replaced and have been available in sizes 6.0F, 8.5F, and 11.0F. The instrument was passed successfully into the ureter in 37 of 38 patients. The most frequent indications were surveillance for fragments after lithotripsy and for diagnosis of radiographic abnormalities in the upper tracts. The high success rate in these patients supports wider application of these techniques and indicates the potential for therapeutic procedures through flexible ureteroscopes. PMID- 3824725 TI - Serious complications associated with percutaneous nephrolithotomy. AB - Serious complications occurred in 2 patients after percutaneous removal of renal calculi. The first was in a patient, who was referred to our institution, with ureteropelvic atresia following three unsuccessful percutaneous attempts to remove an upper ureteral stone which was removed by ureterolithotomy. The second was in one of our patients in whom serious bleeding developed three days postoperatively that was managed with Foley balloon tamponade followed by selective upper pole renal artery branch embolization. PMID- 3824727 TI - Bilateral ureteral endometriosis with end-stage renal failure. AB - Only 16 cases of bilateral ureteral endometriosis have been reported to date. A contiguous spread of the disease is generally thought to be the mechanism of ureteral involvement. We report a case in which the left ureter contains both intrinsic and separated extrinsic forms and the right one an extrinsic form of endometriosis, giving us the opportunity to discuss the different pathogenetic mechanisms and to suggest that dissemination of endometriosis by lymphatic pathways is the most probable explanation. PMID- 3824728 TI - Polyorchidism. AB - We report on a histologically proved case of polyorchidism. This rare condition is most often discovered in young males undergoing inguinal hernia repair. In 50 per cent of cases the patients are between fifteen and twenty-five years old. In more than 60 per cent of cases, polyorchidism is discovered on the left side, and 30 per cent are associated with an ipsilateral inguinal hernia. In 7.1 per cent of cases malignant degeneration and/or transformation occurs. Association with true cryptorchidism is still dubious. Management consists of recognition, multiple biopsies, and surgical excision. PMID- 3824729 TI - Primary retroperitoneal teratoma in adults. AB - We report on a case of primary monodermal retroperitoneal teratoma composed solely of thyroid tissue. The CT scan appearance of such a tumor is presented. PMID- 3824730 TI - Spontaneous rupture of ureter. AB - A patient with spontaneous ureteral rupture in the absence of obstruction or calculus disease is presented. In addition to ureteral rupture this patient also had a penile squamous cell carcinoma and infected inguinal lymph nodes. A review of the literature discloses that all reported cases with spontaneous rupture of the ureter had an underlying process leading to that rupture. It is considered, therefore, that rupture of the ureter should be designated as "traumatic" or "nontraumatic." The term "spontaneous," implying a primary event, is a misnomer. No such case has been reported occurring in an otherwise healthy individual. PMID- 3824732 TI - Rapid hydrodistention of ureter. An adjuvant to ureteroscopy. PMID- 3824731 TI - Utricular papilloma. AB - A benign prostatic utricular papilloma was found in a twenty-seven-year-old man complaining of urethral bleeding and intermittent hematuria after sexual intercourse. Local endoscopic resection was performed. Since the natural history of this lesion is not known, follow-up cystourethroscopy will be performed. PMID- 3824733 TI - Percutaneous technique for enlargement of cystostomy tract. PMID- 3824734 TI - How to enlarge image of cystoscopic telescopes with Endo-Loupe. PMID- 3824735 TI - Quantitative morphometry measurements of transitional cell bladder cancer nuclei as indicator of tumor aggression. AB - Superficial transitional cell carcinomas of the urinary bladder in 30 patients were studied by quantitative morphometry of the initial and subsequent tumor occurrences. Nuclear histograms were constructed and demonstrated narrow base and single modal peak in 9 of 10 patients not exhibiting tumor recurrence or invasion. In contrast, broad-based multimodal nuclear histograms were present in 15 of 20 patients in whom tumor invasion of carcinoma in situ subsequently developed. Nuclear histograms may provide an accurate means of determining invasive/recurrence potential of transitional cell carcinoma. PMID- 3824736 TI - Prostate carcinoma metastatic to ureter. AB - Since carcinoma of the prostate usually metastasizes to pelvic lymph nodes or to bone or by direct extension, a discrete metastatic papillary lesion involving the ureter is unusual. We report such a case in a fifty-three-year-old man. Review of the literature has identified 11 other cases of carcinoma of the prostate metastatic to the ureter. None of the previously reported cases, however, described a discrete papillary intraluminal tumor in which there was no direct extension outside the ureteral wall. In addition, small foci of tumor were within intraluminal lymphatics as well as within the ureterovesical resection margin. These findings together with immunoperoxidase results confirm the unusual behavior and presentation of metastatic prostate carcinoma involving the ureter. Later a bladder tumor developed and histology again revealed metastatic prostate carcinoma. PMID- 3824737 TI - Mechanism of continence after modified Pereyra bladder neck suspension. Prospective urodynamic study. AB - Twenty females with genuine stress urinary incontinence who underwent modified Pereyra bladder neck suspension were urodynamically studied pre- and postoperatively in an attempt to determine the mechanism by which continence was restored. Detailed analysis demonstrated no significant change comparing the pre- and postoperative cystometry findings, uroflow parameters, maximal voiding pressure, urethral resistance, maximal urethral closure pressure, or functional urethral length. The only significant change identified as a result of the surgical procedure was an alteration of proximal urethral pressure transmission during stress from negative to positive gradients. It is concluded that the modified Pereyra bladder neck suspension restores continence by restoring proper urethral support with restoration of positive pressure transmission to the proximal urethra without causing outflow obstruction, changing functional length, or altering maximal urethral closure pressure. PMID- 3824738 TI - Technical and anatomic factors in filling of distal portion of internal pudendal artery during arteriography. AB - Left and right internal pudendal arteriography was performed in 9 nonimpotent male patients (mean age 29 years) who had normal erections. Filling of distal branches of the internal pudendal artery and inter-pudendal anastomoses was improved by superselective catheterization of the anterior trunk of the internal iliac artery or an ischiopudendal trunk, and by the choice of hyperosmolar contrast medium. In the 5 cases where these conditions were fulfilled, filling of the distal branches of internal pudendal arteries was always symmetrical, or showed bifid artery with bilateral distribution on one side, except for the dorsal artery of the penis which appeared to be single in 2 cases. Interdependence between the two internal pudendal arteries was noted in 7 of 9 patients, through either direct anastomosis (7 cases) or bilaterally distributed deep artery of penis (2 cases). PMID- 3824740 TI - A potential problem with Double-J catheter. PMID- 3824739 TI - Nephrogenic adenoma of bladder. PMID- 3824741 TI - [Single-pulse laser iridectomy in the treatment of postoperative pupil block]. PMID- 3824742 TI - [Method of treating open-angle glaucoma--trabeculocryopexy]. PMID- 3824743 TI - [Efficacy of epinephrine dipivalate in the treatment of glaucoma]. PMID- 3824744 TI - [Ophthalmotonus and the gonioscopic picture in progressive and stable myopia]. PMID- 3824745 TI - [Current methods of surgical prevention and correction of progressive myopia]. PMID- 3824746 TI - [Intraocular correction of high myopia]. PMID- 3824747 TI - [Dispensary monitoring of patients with eye diseases]. PMID- 3824748 TI - [Endothelial microscopy of the dynamics of the cornea of patients with artiphakia following extracapsular cataract extraction]. PMID- 3824749 TI - [Microcirculation of the iris during YAG-laser dissection of the posterior capsule of the lens in patients with artificial lens implants using a neodynium laser on aluminum-yttrium garnet]. PMID- 3824750 TI - [Surgical tactics in esotropia associated with unilateral hyperfunction of the inferior oblique muscle]. PMID- 3824751 TI - [Use of taufon in pigmented dystrophy of the retina]. PMID- 3824752 TI - [Dilatation of the retinal vessels caused by styrene and tetrachloroethylene vapors]. PMID- 3824753 TI - [Effect of the preparation lekozim on the condition of the crystalline lens]. PMID- 3824754 TI - [Diagnostic value of computerized tomography in the posttraumatic surgery of complicated eye injuries]. PMID- 3824755 TI - [Computer tomography in the diagnosis of traumatic hemophthalmos]. PMID- 3824756 TI - [Ambulatory cataract surgery]. PMID- 3824757 TI - [Laser retinometry in the presence of refraction abnormalities]. PMID- 3824758 TI - [Ocular symptoms in the diagnosis of hemorrhages into a pituitary adenoma]. PMID- 3824759 TI - [Pathomorphology of the eyes in generalized herpetic infection of newborn infants]. PMID- 3824760 TI - [Various up-to-date methods of preventing progression of incipient myopia in schoolchildren]. PMID- 3824761 TI - [Tactics for extricating a fishing hook from the eye and its adnexa]. PMID- 3824762 TI - [A case of favorable outcome of perforation of the cornea in Stevens-Johnson syndrome]. PMID- 3824763 TI - [Intraocular localization of Hypoderma bovis]. PMID- 3824764 TI - [Glaucoma and ocular hypertension: study of homeostatic mechanisms]. PMID- 3824765 TI - [Continuity of the joint care provided by ophthalmologists and pediatricians during general annual preventive examinations]. PMID- 3824766 TI - [Diagnosis and surgical treatment of duodenal ulcers penetrating the common bile duct]. PMID- 3824767 TI - [Use of extraorganic detoxication in acute surgical diseases]. PMID- 3824768 TI - [Methods of improving the surgical treatment of complicated forms of chronic venous insufficiency of the lower extremities]. PMID- 3824769 TI - [Use of lasers in the treatment of bile duct obstruction of benign origin]. AB - A comparison of effects of surgical treatment of two groups of patients with obstruction of bile ducts of benign genesis was made. In the 1st group (91 patients) the intravenous laser irradiation of blood was used. In the 2nd group (93 patients) the laser irradiation was not performed. The authors consider that the intravenous laser irradiation of blood in the surgical treatment of patients with obstruction of bile ducts of non-tumor etiology contributes to reduction of the amount of complications and less lethality rate. PMID- 3824770 TI - [Economic substantiation of the expediency of simultaneous operations]. PMID- 3824771 TI - [Diagnostic errors and differential diagnosis of kidney abnormalities and surgical diseases of the organs of the abdominal cavity]. PMID- 3824772 TI - [Acute appendicitis and ovarian apoplexy]. PMID- 3824773 TI - [Rare complication after implantation of an electrocardiostimulator]. PMID- 3824774 TI - [Causes of death after operations for patent ductus arteriosus]. PMID- 3824775 TI - [A method of transjugular catheterization of the thoracic duct with formation of lymphovenous anastomosis]. PMID- 3824776 TI - [A self-fixing synthetic blood vessel endoprosthesis]. PMID- 3824777 TI - [Equipment for roentgen-endobiliary procedures]. AB - Based on his experience with 170 cholangiographies performed with using transhepatic access and curative measures in the course of cholagiographies the author gives recommendations on modelling certain devices. Characteristics of catheters and endoprostheses for a simple percutaneous external bile elimination, bougieurage and endoprosthesis of dilated bile ducts are given. PMID- 3824778 TI - [Computerized tomography in the diagnosis of subdiaphragmatic abscess]. AB - Examination of 49 patients suspected of the presence of a suppurative process in the subdiaphragmatic space was performed. The use of computed tomography allowed the author to exclude the subdiaphragmatic abscess in 22 (44.9%) of the patients, in the others the exact localization of the abscess, its size and relationships with the neighbouring organs were determined. Results of the computed tomography were of great importance in choice of the surgical tactics for treatment of the patients. PMID- 3824779 TI - [Rare forms of acute intestinal obstruction]. AB - The article analyzes 31 cases of rare forms of acute intestinal obstruction (nodulation and invagination of the intestine, obturation of the small intestine by bile stones and bezoars). Their incidence as compared with all the cases of intestinal obstruction of non-tumor etiology was from 1.0 to 3.3%. These diseases are difficult for diagnosis prior to operation and have different clinical manifestations. The surgeon's tactics should be differentiated and dependent on intraoperative findings. The syndrome diagnosis (intestinal obstruction, peritonitis) and early operation in such diseases are thought to be the correct tactics. PMID- 3824780 TI - [Transhepatic drainage in focal liver diseases complicated by mechanical jaundice]. AB - Results of using transhepatic drains in 43 patients with focal alterations of the liver complicated by a mechanical jaundice are described (55 operations). Transhepatic drains allowed widening the degree of surgical interventions in this group of patients. Risk of the operative interventions and lethality among these critical patients which were earlier thought to be inoperable became lower due to stage operations using the transhepatic drains. PMID- 3824781 TI - [Selection of the method of ureterotomy in ureteral calculi]. AB - A comparative assessment of longitudinal and transverse ureterotomies in experiments and clinic has shown the transverse ureterotomy to be a more physiological method. The observation of the patients in dynamics has revealed an earlier and more valuable recovery of the ureter functioning than after longitudinal ureterotomy. PMID- 3824782 TI - [Indications for preventive regional lymphadenectomy in primary melanoma of the skin of the trunk]. AB - A retrospective analysis of clinico-morphological data of 222 patients with primary cutaneous melanoma of the trunk was made. General results of 5-year survival of the patients after a radical surgical treatment was 56.3 +/- 3.3%. Five clinico-morphological risk factors of the regional metastazing of the primary cutaneous melanoma of the trunk were established. Prophylactic regional lymphadenectomy along with a wide dissection of the primary tumor is recommended by the authors for patients with primary melanomas of the trunk skin having 3 and more risk factors of regional metastazing. PMID- 3824783 TI - [Surgical correction of disorders of the musculo-venous pump of the foot in patients with varicose veins]. AB - An analysis of complex examinations and operative treatment of 106 patients with varicose disease having a varicose dilatation of the foot veins was performed. Technical methods of the operative correction of the alterations of foot hemodynamics described in the article are able to liquidate clinical manifestations of the submalleolar venous insufficiency and thus to obtain better functional results in treatment of patients with varicose disease. PMID- 3824784 TI - [Endoscopic correction of crural venous blood flow]. AB - A technique of subfascial electrocoagulation of the communicating shin veins through an endoscope in 53 patients with varicose dilatation of the lower extremity veins and postthrombophlebitis syndrome is described. The technique is not complicated and gives good cosmetic results. PMID- 3824785 TI - [Possibilities of early roentgenologic diagnosis of surgical infection of soft tissues]. AB - Findings of clinico-roentgenological examinations of 23 patients with an early stage of the surgical infection of soft tissues (necrotic cellulitis, fasciitis) developing without gas formation are described. Typical roentgenological symptoms were found. It was established that roentgenological symptoms often leave behind the wide clinical picture. It helps to begin timely curative measures. PMID- 3824786 TI - [Cryoprocedures in the treatment of suppurative wounds]. AB - An analysis of results of treatment of 135 patients with purulent wounds and acute pyonecrotic injuries of soft tissues has shown the application of cryoprocedures especially when combined with the laser irradiation to promote earlier cleaning of the wound from necrotic tissues, early appearance of granulations, quicker healing the wounds and medical rehabilitation of the patients. PMID- 3824787 TI - [Vacuum therapy in the treatment of suppurative lactation mastitis]. AB - An analysis of results of treatment of 299 patients with acute purulent lactation mastitis has shown the use of vacuum therapy by the authors' method to result in a considerably shorter time of healing the wounds, in quicker detoxication of the organism. It controls pyo-septic complications, normalizes immune processes. The method is simple and may be used at any surgical department. PMID- 3824788 TI - [Surgical debridement of bone cavities in the complex treatment of chronic osteomyelitis in children]. AB - The authors propose fulfilling radical necrectomy in chronic osteomyelitis with special instruments which is responsible for sparing character of the surgery. The sparing tactics in radical necrectomy was used in 173 patients. The method described when combined with autoplasty of osseous cavities by the prepared spongiosis with the bone marrow after radical sanitation resulted in recovery of 96.5% of the patients. PMID- 3824789 TI - [Treatment of acute peritonitis of appendicular origin]. PMID- 3824790 TI - [Surgical tactics in inflammatory pseudotumors of the ileocecal segment of the intestine]. PMID- 3824791 TI - [A rare cause of hemopneumothorax]. PMID- 3824792 TI - [A restoration bandage for one-half of the chest wall]. PMID- 3824793 TI - [Compensatory potential of patients with coxarthrosis]. PMID- 3824794 TI - [Cholelithiasis and hepatic insufficiency]. AB - During the recent years 202 patients with cholelithic disease and its complications have been treated in the clinic. In 135 patients admitted to the hospital an attack of severe pains was followed by jaundice and symptoms of hepatic insufficiency (HI). A compensated stage of HI was diagnosed in 68 (50.4%) patients, subcompensated stage--in 38 (28.1%), decompensated--in 25 (18.5%) and terminal stage of HI--in 4 patients (3%). The operative treatment was used in 142 patients (70.3%). The operation of choice was cholecystectomy. An intervention on the common bile duct was performed in 59 patients (41.5%). Operations were performed on 42 patients with the compensated stage of HI (one of them died), in 17 patients with the subcompensated stage (one patient died), in 16 patients with the decompensated stage (three patients died); with the terminal stage there were 4 patients operated upon. Two of them died. PMID- 3824795 TI - [Experience with extracorporeal use of xenospleen in patients with traumatic shock]. AB - The article presents results of using the extracorporal connection with the donor (porcine) spleen (ECCDS) for the treatment of 14 patients with critical mechanical traumas and their complications. An experience with 30 ECCDS-s has shown them to possess a pronounced detoxicating and immunomodulatory effect followed by a positive clinical result. In 6 cases of ECCDS a temporary chill was noted. There were no other complications. PMID- 3824796 TI - [Extracorporeal perfusion of the xenospleen in the treatment of suppurative surgical diseases]. AB - Extracorporal perfusion of the porcine xenospleen was used by the authors in 5 patients with purulent surgical diseases complicated by a septic reaction. Recovery was noted in 2 patients. In one of the patients the extracorporal perfusion of the xenospleen was used in a systemic lupus erythematosus complicated by vasculitic destruction of soft tissues with septic reaction. The effect was positive. The extracorporal perfusion of the porcine xenospleen is considered by the authors to be an effective method of detoxication of organism of patients with septic complications. PMID- 3824798 TI - [Topographico-anatomical substantiation of the method of long-term conduction anesthesia of the upper extremity]. PMID- 3824797 TI - [Functional status of the liver in patients with morbid obesity after combined anesthesia with ketalar and neuroleptanalgesia]. AB - Combined anesthesia with Ketalar and standard neuroleptanalgesia were used in obese patients with high risk of the development of hepatic insufficiency in operations of jejunoileoshunts. The investigation has shown the both kinds of intravenous anesthesia to be quite acceptable for this category of patients. PMID- 3824799 TI - [Results of the surgical treatment of congenital heart defects using profound non perfusion hypothermic protection]. AB - Results of the surgical treatment of congenital heart diseases under conditions of non-perfusion profound (26-25 degrees C) hypothermal protection in 192 patients with the hospital lethality 9.4% are described. The results obtained show that profound hypothermia is an effective method of performing operations on the open heart. PMID- 3824800 TI - [Immediate and long-term results of pulmonary resection in bronchiectasis]. AB - Under analysis were the nearest results of resection of the lungs for bronchoectasias in 360 patients aged from 5 to 68. Favorable nearest results were noted in 96.4% of the patients operated upon, with no lethal outcomes. Pleural complications met in 11% of the cases proved to be consequences of inadequate hermetic quality of the pulmonary and bronchial sutures. Remote results from 1 to 10 years were studied in 267 patients. Complete recovery was achieved in 29.9%, considerable improvement in 53.2%, the condition failed to change in 13.8%, aggravation was noted in 3.1%. Best results were obtained after operations performed at the age of 5-10 years, radical treatment in unilateral and bilateral bronchoectasias. Long-term results of the operations were influenced by pleuropulmonary complications, not treated chronical bronchitis, emphysematous alterations in the residual portions of the lungs. PMID- 3824801 TI - [Causes, diagnosis and treatment of the "postcholecystectomy syndrome"]. AB - On the basis of clinical examinations and treatment of 174 patients the authors substantiate the importance of using special and instrumental means of diagnosis as well as the expediency of exploratory laparotomy for establishing the real cause of the disease. The efficiency of selective vagotomy in persistent spasm of the major duodenal papilla is shown. PMID- 3824802 TI - [Endoscopic removal of small intestinal polyps in total polyposis of the digestive tract]. AB - In patients with proliferative and mixed forms of total polyposis of the digestive tract the intestinal polyps are mainly localized in the duodenum, with hamartomal polyposis--in the jejunum and ileus. The endoscopic polypectomy from the small intestine may be performed intraoperatively and during endoscopy under narcosis. 174 polyps with the diameter of 0.5-5 cm were removed in 27 patients. There were 3 complications (bleedings) after polypectomy. PMID- 3824803 TI - [Immunologic status and leukocyte function of patients with suppurative lactational mastitis]. AB - In patients with a severe course of suppurative lactation mastitis there develops a relative deficiency in the cellular and humoral links of immunity. The compensatory activation of factors of nonspecific antiinflammatory resistance of the organism fails to exert a substantial positive effect on the development of the destructive process in these patients. On the basis of the data obtained, in order to improve results of the surgical treatment of patients with suppurative lactation mastitis means of the cellular anti-infection therapy, transfusions of donor leukocyte masses in particular, must be included in the complex of curative measures in the postoperative period. PMID- 3824804 TI - [Radical-preventive surgery in cavernous tuberculosis of the kidneys]. AB - On the model of focal-caseous tuberculosis of kidneys in 210 rabbits it was proved that effects of antibacterial drugs in any concentration have their limits and fail to liquidate the cavernous injuries of the renal parenchyma. The investigation of long-term results of the conservative treatment of 153 patients with the cavernous tuberculosis of kidneys has completely confirmed the conclusions of experimental investigations. An analysis of long-term results of organ-preserving focal operations in experiments and clinic gave a substantial support to a real possibility to cure the pathological process. The author points to an importance to revise the idea of the leading role of the conservative antibacterial therapy in favor of wider using radical-prophylactic operations in limited cavernous tuberculosis of kidneys. PMID- 3824805 TI - [Musculo-venous "pump" of the foot in patients with varicose disease]. AB - Methods of rheovasography, phlebotonometry and phlebography of the foot were used for studying the musculo-venous "pump" of the foot in 75 patients with varicose disease. It was found that the latter is responsible for up to 30% of the venous return of blood from lower extremities in walking. Dysfunction of the foot musculo-venous "pump" makes its appearance in patients with varicose disease at the decompensation stage with complicated course of the disease. The preoperative examination of the patients must establish the functional state of this structure, the correction of the alterations found being included in the operation volume. PMID- 3824806 TI - [Prolonged dopmin infusion in severe respiratory insufficiency in newborn infants]. AB - An effective use of continuous infusion of Dopmin in dose of 2-3 mkg/(kg/min) is described. Dopmin was used in 13 newborns with severe respiratory insufficiency due to postasphyxial syndrome, disease of hyaline membranes and congenital diaphragmal hernia. Continuous infusion of microdoses of Dopmin with artificial ventilation of lungs against the background of a decreased respiratory insufficiency according to clinico-laboratory evidence resulted in decreased value of bloodflow shunt from right to left and oxygen concentration in the inhaled mixture to 45%. PMID- 3824808 TI - [Treatment tactics for diseases of the scrotal organs in children]. AB - An analysis of results of treatment of 163 children with acute diseases of the scrotum organs for five years has been made. The authors consider that urgent surgery for acute diseases parallel with establishing more precise localization of the process is a good pathogenetic treatment, prevents the appearance of disturbances of all the testicle functions, first of all the spermatogenic function, excludes an obliteration of the deferent duct, considerably shortens staying at the hospital and is not followed by complications. PMID- 3824807 TI - [Long-term results of splenectomy in children with closed injuries of the spleen]. AB - Under study were indices of the immune reactivity and infectious morbidity in 30 persons subjected to splenectomy in childhood for traumatic rupture of the spleen. They were shown to have lower resistance to infections. Children after splenectomy need a continuous dispensary observation. Prophylactic measures require further development. The most perspective method of preserving the functioning splenic tissue in the organism after trauma of the organ is thought to be autotransplantation of the splenic pulp. PMID- 3824809 TI - [Prognostic value of functional methods of studying respiration and circulation in lung cancer surgery]. AB - The method of stepwise regression analysis with the help of computer was used for a retrospective analysis of the prognostic value of indicators of the external ventilation and central hemodynamics (with special reference to age and volume of surgery) in 104 men with lung cancer. It was found that an analysis of these factors is enough for predetermination of duration of the postoperative period in its not complicated course. The priority of the estimation of the adaptive abilities of the circulation for such prognosis has been shown. The value of the method of integral rheography and the system of estimation of the indicators of central hemodynamics developed on its basis has been confirmed. PMID- 3824810 TI - [Torsion of the greater omentum in a child]. PMID- 3824811 TI - [Suppurating congenital cyst of the head of the pancreas in a child]. PMID- 3824812 TI - [Method of plastic repair of the palate with a skin flap on an isolated soft tissue pedicle]. PMID- 3824813 TI - [Therapeutic-decompression Y-shaped stoma during intestinal resection]. PMID- 3824814 TI - [Method of cutaneous plastic repair for scalped fingers]. PMID- 3824815 TI - [Analysis of the surgical treatment of inguinal hernias]. PMID- 3824816 TI - [Analysis of the results of treating patients with perforated ulcers of the stomach and duodenum]. PMID- 3824817 TI - [Preventive preoperative use of kanamycin and cefazolin in patients with acute intestinal obstruction]. PMID- 3824818 TI - The cutaneous histology of dermatomyositis in collie dogs. AB - Cutaneous lesions of 36 collie dogs affected with dermatomyositis were reviewed. The most common histologic features were follicular atrophy and perifollicular inflammation in 30 dogs, which correlated with alopecia clinically. Other less common findings included formation of colloid bodies, basal cell vacuolation, and subepidermal vesiculation. Results indicated that the most diagnostic cutaneous histologic features of dermatomyositis may be follicular atrophy and inflammation. PMID- 3824819 TI - Multifocal retinitis in New Zealand sheep dogs. AB - Thirty-nine percent of 1,448 working sheep dogs were affected with varying degrees of multifocal retinal disease on ophthalmoscopic examination. Lesions consisted of localized areas of hyperreflexia in the tapetal fundus, often associated with hyperpigmentation. Severely affected animals had widespread hyperreflexia with retinal vascular attenuation. Only 6% of 125 New Zealand dogs raised in urban environment were similarly affected. Both eyes of 70 dogs from New Zealand were examined histologically. Forty-seven of 70 dogs had ocular inflammatory disease. Ten other dogs had noninflammatory eye disease, and 13 dogs had normal eyes. Histologically, eyes with inflammatory disease were divided into three categories: Dogs 3 years of age or less with active inflammatory disease of the retina, uvea, and vitreous. Four dogs in this group had migrating nematode larvae identified morphologically as genus Toxocara. Diffuse retinitis and retinal atrophy in conjunction with localized retinal necrosis and choroidal fibrosis. Dogs in this category were severely, clinically affected. Chronic, low grade retinitis with variable retinal atrophy. Most dogs in this category were over 3 years of age, and many were visually functional. The existence of a definable spectrum of morphological changes associated with inflammation, suggests that Toxocara sp. ocular larva migrans may be the cause of a highly prevalent, potentially blinding syndrome of working sheep dogs in New Zealand. PMID- 3824820 TI - Ultrastructural and clinicopathological studies on the toxicity of cationic acrylamide-based flocculant to rainbow trout. AB - Rainbow trout (Salmo gairdneri) of two age groups were exposed to a cationic acrylamide-based flocculant at various concentrations in static bioassay chambers. At lethal concentrations the flocculant produced severe gill alterations in all fish. The principal alterations were necrosis and separation of the respiratory epithelial cells covering secondary lamellae. Many necrotic chloride cells were also seen, their apical plasma membrane was destroyed, and mitochondria were swollen with separated cristae. An influx of a large amount of fluid into the interstitial spaces caused partial or complete separation of subepithelial spaces from the covering epithelial cells and basement membranes of underlying blood vessels. Clinicopathological alterations included marked decreases in blood pH, partial pressure of oxygen, bicarbonate and plasma sodium, and chloride concentrations. Hematocrit, total protein, and blood glucose were increased. Fish exposed to sublethal concentrations had gill alterations characterized by hypercellularity and thickening of the secondary lamellae. These were due to undifferentiated cell proliferation and macrophage and lymphocyte infiltration between the covering epithelial cells and the underlying blood vessels. Macrophages and undifferentiated cells had large phagolysosomes containing cytoplasmic organelles, an indication of cell injury and increased turnover. PMID- 3824821 TI - Equine basal cell tumors. AB - Basal cell tumors from 11 horses were examined histologically. Distinct patterns identified in the order of frequency are adenoid (six), solid (three), and medusoid (two). A minor component of most of these neoplasms was a ribbon pattern and cystic spaces. Hyalinized connective tissue and clear cells reminiscent of hair follicle glassy membranes and outer root sheath were present in a solid and the medusoid tumors. Heavy melanin pigmentation was present in one solid basal cell tumor. In eight cases for which information was available, the tumors had not recurred 3 to 8 years after excision. PMID- 3824822 TI - Idiopathic periadnexal multinodular granulomatous dermatitis in twenty-two dogs. AB - A distinctive periadnexal multinodular granulomatous dermatitis of unknown cause was diagnosed over a 6-year period in 22 dogs (13 males and nine females) aged 8 months to 10 years, purebred as well as mixed-breed. Nodules, usually more than two, started on the face and were often unaccompanied by signs of irritation. All dogs were otherwise healthy except a Viszla with bilateral anterior uveitis and a Basset hound with nasal congestion and sneezing. Microscopically, cutaneous lesions occurred in a periadnexal pattern, replaced sebaceous glands, coalesced, and extended into the subcutis and in more advanced cases through the panniculus carnosus. Infectious agents were not demonstrated by aerobic, anaerobic, or fungus cultures or by light or electron microscopy, nor were ectoparasites seen. Immunofluorescence and peroxidase-antiperoxidase techniques gave negative results for intraepidermal and basement membrane deposits of IgA, IgG, IgM, and C3. Lesions were unresponsive to a variety of antibiotics; they regressed spontaneously in two untreated dogs and rapidly in dogs given only corticosteroid therapy. Continuous low-dose corticosteroids were necessary in a few dogs to prevent recurrence. PMID- 3824823 TI - Spontaneous tumors of the meninges in rats. AB - Histologic brain sections from 107 rats reported to have granular cell tumors or meningiomas in 2-year carcinogenicity studies conducted by the National Toxicology Program (NTP) or the National Cancer Institute (NCI) were reexamined microscopically. There were 62 rats with granular cell tumors, 26 with benign meningiomas, and 19 with meningeal sarcomas. Granular cell tumors were compatible with previous descriptions of this tumor. Meningeal sarcomas were subclassified into nine spindle cell sarcomas and ten fibrosarcomas. Among the rats with benign meningiomas, five were typical meningiomas (three fibroblastic meningiomas, and two meningothelial meningiomas) and 21 were meningothelial meningiomas containing cells with granules identical to those in granular cell tumors. There was a transition from epithelial-like cells of the meningothelial meningiomas to granular cells in these 21 cases. Based upon anatomic location, cytomorphologic similarities, and the occurrence of transitional or mixed forms of meningothelial meningiomas and granular cell tumors, it is suggested that these two tumors are related and may both originate from a common progenitor meningothelial arachnoid cell. PMID- 3824824 TI - Hematomas in the thymus in dogs. AB - Twenty dogs with a hematoma of the thymus are described. In four dogs the cause of the hematoma was a ruptured dissecting aneurysm of the aorta and in three cases the dogs had been hit by cars. In seven dogs the necks were overstretched by different factors. One dog was hit by a stone. In two dogs no anamnestic data were available, and in the last three cases, according to owner's statements, no trauma had occurred before the first signs. Thymic hemorrhages in the dog should not be considered to be a circumscribed pathogenetic entity. Indications are offered that trauma, or even commonly occurring microtrauma, can be involved in the pathogenesis of the hematomas in the thymus. PMID- 3824825 TI - Early changes of osteochondrosis in medial femoral condyles from rats. AB - Osteochondrosis developed from the early growing process of articular cartilage at the caudal-central region of the medial femoral condyle in rats. Articular cartilage was thick at the region. Mineralization of the matrix in the thick deep zone was incomplete and major parts remained unmineralized. Cavity formation in the mineralized matrix resulting in osteochondrotic lesions was present in the deep zone at 6 weeks of age and was followed by an appearance of viable chondrocytes around it. Osteochondrotic lesions were present from the age of 10 weeks for females and 12 weeks for males. Cavities were expanded and increased in number, and eosinophilic necrotic foci were additionally seen. These changes were extended throughout the deep zone, and viable chondrocytes were also increased in number. The thick deep zone was retained and had no detectable invasions of blood vessels from the subchondral bone. At 20 weeks of age, necrotic areas containing large clefts were present in the basal layer of the thick deep zone and fibrotic lesions were seen beneath them. In normal cases, invasions of blood vessels were seen in the basal layer of the deep zone and also in the cavities of the cartilage; the deep zone was markedly thinned at 20 weeks of age. PMID- 3824826 TI - Prolonged viral antigen retention in the brain of a gnotobiotic dog experimentally infected with canine distemper virus. PMID- 3824827 TI - An epizootic of endometritis in gilts. PMID- 3824828 TI - Hepatic vascular neoplasms in a colony of ferrets. PMID- 3824829 TI - Early season parasitic gastroenteritis in calves and its prevention with ivermectin. AB - In a two-year trial involving successive batches of 36 autumn-born steers on two adjacent sites in Hertfordshire, calves treated with ivermectin at three and eight weeks after turn out contaminated pastures much less than untreated control animals. Each year dry summers prevented the larval challenge on the control pastures from building up to high levels until about the time of autumn housing. Atypical outbreaks of parasitic gastroenteritis were recorded in May and June of the second year in both groups of control calves. Clinical and parasitological aspects of these outbreaks are discussed in the context of the epidemiology of the disease. It is concluded that the application of measures to control gastroenteritis can bring benefits in the early part of the grazing season as well as later in the year. PMID- 3824830 TI - Oestrus prediction in dairy cows using an ELISA progesterone test. AB - The commercially available test kit for assaying milk progesterone was used in the practice laboratory on samples taken daily from cows 17 to 24 days after service. Improved oestrus detection rates and accuracy were achieved by predicting the onset of oestrus. Similar results were obtained by sampling on days 18, 20, 22 and 24 or on days 19, 21 and 23 after service. Calving to conception intervals improved from 115 to 84 days in one herd and from 85 to 74 days in another and the potential economic benefits in these two herds outweighed the costs by 7.4:1 and 3.4:1, respectively. PMID- 3824831 TI - Atlanto-occipital fusion and ataxia in the calf. AB - Atlanto-occipital fusion is a rare bony anomaly due to the failure of the developing arches of the first cervical vertebra to separate from the occiput. It may be associated with compressive myelopathy and must therefore be considered in the differential diagnosis of ataxia in the young animal. This report reviews the embryological development of the region and reports the findings in two cases of fusion in the calf. PMID- 3824832 TI - Efficacy of 1 alpha hydroxyvitamin D3 in the prevention of bovine parturient paresis. AB - One hundred and seventeen Israeli-Friesian cows from herds with a milk fever incidence of more than 15 per cent were injected intramuscularly with either 350 micrograms 1 alpha hydroxyvitamin D3 (1 alpha OHD3) in propylene glycol or with the vehicle alone, close to calving. If parturition had not occurred within 72 hours a second injection was administered; parturition was induced two days after the second injection if necessary. There were 10 cases of milk fever among 57 control cows as opposed to two cases among the 60 animals treated with 1 alpha OHD3. In an attempt to prolong the effect of the drug, Israeli-Friesian cows were injected intramuscularly with 350 micrograms 1 alpha OHD3 in either 10 ml propylene glycol or arachis oil. 1 alpha OHD3 in arachis oil did not prolong the effect of the drug. 1 alpha OHD3 in propylene glycol increased plasma calcium concentrations more rapidly than when the drug was administered in oil. Additional cows of the same breed and age were injected intramuscularly with 350 micrograms 1 alpha OHD3 in propylene glycol. Five of the animals received a second dose four days, and five received a second dose five days after the first injection. Five animals served as uninjected controls. The plasma calcium levels of the injected cows were significantly higher (P less than 0.01) than those of the controls from the second until the 14th day after the first injection. Based on these results 451 Israeli-Friesian cows from herds with a milk fever incidence of more than 15 per cent were injected intramuscularly with 1 alpha OHD3 close to calving.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3824833 TI - Oral dermatophilosis in imported cattle in Nigeria. PMID- 3824834 TI - Copper serum values. PMID- 3824835 TI - Indiscriminate dog breeding and dealing. PMID- 3824836 TI - Methiocarb poisoning in a horse. PMID- 3824837 TI - Selenium and weak calf syndrome. PMID- 3824838 TI - Piperazine toxicity in a kitten. PMID- 3824839 TI - Treatment of Candida krusei mastitis with sulphamethoxypyridazine. PMID- 3824840 TI - Preliminary results of treatment and endocrinology of chronic endometritis in the dairy cow. AB - Cows with chronic endometritis were treated by using uterine irrigation, prostaglandin or oestradiol benzoate. An attempt was made to relate the success of treatment to the nature of the discharge. No statistically significant differences were demonstrated between the different treatments, nor did the severity of the disease as judged by the amount of pus in the discharge affect the success of treatment. Progesterone and in some cases a metabolite of prostaglandin were measured in a milk sample taken at the time of treatment. Increased prostaglandin concentrations were found in 69 of 71 samples examined but they were not correlated with the progesterone concentrations. These measurements from cases of endometritis were higher than those from normal cows in the immediate post partum period and during established oestrous cycles. Treatment with prostaglandin when the concentration of progesterone was high was not more effective than when progesterone concentrations were low. Treatment had less influence on the subsequent fertility of the cow than other factors investigated; in particular, the sooner after calving the cow was treated the greater was the chance of success. This was thought to be due, at least in part, to the high rate of spontaneous recovery. Before treatment can be evaluated effectively a method must be found to identify persistent cases. PMID- 3824841 TI - An evaluation of the efficacy of netobimin against Dicrocoelium dendriticum in sheep. AB - A trial was carried out to assess the efficacy of a nitrophenylguanidine compound, netobimin against Dicrocoelium dendriticum in naturally infected sheep. At a dose rate of 20 mg/kg bodyweight administered orally the drug was highly effective, producing a mean reduction of 98.9 per cent in the fluke burdens of treated animals compared with untreated controls. No side effects were observed in the treated sheep. PMID- 3824842 TI - Continuing presence of rinderpest virus as a threat in East Africa, 1983-1985. AB - The re-emergence of rinderpest virus in East Africa in 1979 caused widespread outbreaks of disease and subclinical infection throughout the region until mid 1983. Subsequent massive emergency vaccination campaigns have been successful in eliminating clinical rinderpest from Tanzania and preventing its spread southwards. Unfortunately the virus is still endemic in north-eastern Uganda and has recently caused epidemic outbreaks with high mortality in cattle in that country. In Kenya, buffaloes (Syncerus caffer) in and around the Masai Mara game reserve have developed antibodies to rinderpest virus as recently as late 1984. Although there have been no outbreaks of clinical disease in Tanzania or Kenya from April 1983 to the end of 1985 this serological evidence plus the increasing incidence of clinical outbreaks in Uganda indicate that rinderpest virus still threatens East Africa. The substantial aid which has been provided to the region for rinderpest control must be maintained. PMID- 3824843 TI - Effect of heat treatment on the surface antigens of Haemophilus pleuropneumoniae. AB - Coagglutination and ring precipitation tests were used to study the effect of heat on the surface antigens of Haemophilus pleuropneumoniae strains employing the reference strains belonging to serotypes 1 to 7 and field isolates belonging to serotypes 1, 2, 3, 5, 6 and 7. By immunising rabbits with formalin-fixed whole cell suspension, antibodies were obtained which sensitised Cowan I Staphylococcus aureus to coagglutinate antigen preparations which had not been heated, or heated at 56 degrees C, or boiled or autoclaved. Similar positive reactions were obtained with the ring precipitation test. Heating the cultures at 56 degrees C for one hour was best for exposing the most potent serotype-specific antigens in all the strains studied. All the reference strains and most of the field isolates possessed the thermostable type specific antigens which could withstand autoclaving for one hour. However, many field isolates belonging to serotype 1 did not possess this antigen. The apparent antigenic heterogeneity of serotype 1 strains based on the presence or absence of these thermostable antigens could be valuable in epidemiological investigations. It was shown that most potent serotype-specific antigens are present as freely diffusible material on the surface layer of the bacterial cells, which could easily be removed by washing in saline solution. Well washed bacterial cells devoid of surface materials are poor antigens. It is recommended that test strains should not be heated above 56 degrees C for serotyping because higher temperatures are liable to destroy the capsular antigen of some strains and render the culture untypeable. PMID- 3824844 TI - Prevalence of Toxocara species eggs in the soil of five east London parks. PMID- 3824845 TI - Piperazine toxicity. PMID- 3824846 TI - Unilateral pupillary dilation after Saffan. PMID- 3824847 TI - Control of antibiotics. PMID- 3824848 TI - Isolation of Acholeplasma oculi from calves. PMID- 3824849 TI - Oestrone sulphate for pregnancy diagnosis in sows. PMID- 3824850 TI - Prevalence of bovine virus diarrhoea virus viraemia. PMID- 3824851 TI - Farm casualties: unnecessary suffering. PMID- 3824852 TI - Bovine somatotrophin. PMID- 3824853 TI - Many causes of calf scours. PMID- 3824854 TI - Cost-effective meat inspection. PMID- 3824855 TI - Transfer of frozen-thawed embryos in sheep. AB - Embryos collected from ewes six days after oestrus were frozen in straws using ethylene-glycol as a cryoprotectant. The efficiency of the simplified freezing and thawing procedure was assessed after transfer, which resulted in an overall survival rate of 58.3 per cent. Forty-two lambs were born from 72 frozen embryos which had been transferred without any attempt to evaluate them after the thawing and sucrose dilution process. PMID- 3824856 TI - Evaluation for veterinary use of the Chiltern box: a device for home electrocardiographic monitoring. AB - The Chiltern Box is a small electrocardiograph designed for home monitoring of human patients. Its veterinary application has been investigated in the dog, the cat and the horse. It has been useful in the diagnosis of previously undiagnosed dysrhythmias in dogs showing signs of exercise intolerance and syncope. PMID- 3824857 TI - Detection of Fasciola gigantica eggs in faeces: a comparison of methods. PMID- 3824858 TI - An outbreak of selenium responsive unthriftiness in farmed red deer (Cervus elaphus). PMID- 3824859 TI - Trypanosoma evansi infection in pigs in India. PMID- 3824860 TI - Louping ill virus vaccination of dogs. PMID- 3824861 TI - Intestinal anastomosis. PMID- 3824862 TI - Breeding out canine tumours. PMID- 3824863 TI - Fly catching in the cavalier King Charles spaniel. PMID- 3824864 TI - Urine sampling in the bitch. PMID- 3824865 TI - Ministry animal health schemes. PMID- 3824866 TI - Embryo transfer. PMID- 3824867 TI - Transport of ill calves. PMID- 3824868 TI - Quantifiable morphologic evaluation of paraquat pulmonary toxicity in rats. AB - The intent of this study was to detect paraquat (PQ)-induced, dose-dependent variations, in rat lungs, by analyzing several quantifiable morphologic parameters. Male Wistar rats (6-week old) received single doses (0, 7, 10, 25 or 40 mg/kg body weight) of PQ dichloride by sc injection. The parameters examined were number of alveolar type II cells, number of intra-alveolar free cells, total number of cells constituting the pulmonary interstitium, and alveolar wall thickness. Our maximum dose produced a marked decrease, 3 days post-injection, in the number of alveolar type II cells in contrast to the observed increases in all other dosage groups. These increases in other groups were inversely proportional to the increasing PQ dosages. All rats that received the maximum dose died within 4 days after injection and therefore could not be compared to the control group for our parameters after 6 days. After 9 days, the number of type II cells had decreased significantly in the 25 mg/kg group. The two highest dosage groups, on the third day, had significantly more intra-alveolar free cells. The total number of cells constituting the pulmonary interstitium in all groups increased in proportion to the increasing dosages from 3 to 9 days post-injection. In the 10 and 25 mg/kg groups, alveolar wall thickness was notably increased from days 6 to 9. PQ dosing produced dose-dependent variations in all of the parameters examined. This model of PQ-induced pulmonary toxicity may be useful in evaluating prophylactic or therapeutic agents. PMID- 3824869 TI - The toxicity of Azadirachta indica leaves in goats and guinea pigs. AB - The effects produced by the administration of aqueous suspensions of the green or dried leaves of Azadirachta indica, a common tropical plant, were investigated in goats and guinea pigs. At doses of 50 or 200 mg/kg given orally over a period of up to eight weeks, the plant produced a progressive decrease in body weight, weakness, inappetence, and loss of condition. There were also decreases in heart, pulse and respiratory rates. Diarrhea was observed in animals given the fresh leaves. In goats, the higher doses of the plant leaves produced tremors and ataxia during the last few days of treatment. No statistically significant hematological changes were observed after dosing the animals with A indica leaves, although there was a tendency towards lowered erythrocyte counts, packed cell volume and hemoglobin concentration. The treatments caused significant rises in the plasma activity of aspartate transferase, sorbitol dehydrogenase, and concentrations of cholesterol, urea, creatinine and potassium. No significant changes in the plasma concentration of sodium, chloride or bilirubin were detected. On necropsy of treated goats there were areas of hemorrhagic erosions. The hearts appeared flappy and in some animals there were hydropericarium. Histopathologically, there was evidence of various degrees of hemorrhage, congestion, and degeneration in the liver, kidney, lung, duodenum and brain. Degeneration of the seminiferous tubules was also seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3824870 TI - The effect of activity state upon the production of lethalities due to the inhalation of the toxic pyrolysis products of polyacrylonitrile. AB - Hydrogen cyanide is known to be produced upon the pyrolysis of the synthetic material polyacrylonitrile. Cyanide inhibits phosphorylation reactions, therefore, decreasing the amount of high energy bonds available for metabolic use. Since the energy requirements, as well as the respiratory minute volume, for an individual decrease with decreasing activity, it was of interest to investigate whether diminished physical activity would decrease the lethal potential of the pyrolysis products of polyacrylonitrile. In order to produce wide variations in physical activity, male ICR mice were pretreated with either 8.6 mg/kg dextroamphetamine sulfate ip 30 min prior to challenge, 75 mg/kg sodium pentobarbital ip 15 min prior to challenge, or 10 ml/kg of 70 proof ethyl alcohol ip 15 min prior to challenge. Control animals received injections of 10 ml/kg normal saline ip 15 min prior to challenge. Animals were subsequently challenged with the cooled/filtered smoke from the pyrolysis of polyacrylonitrile fibers at 660 C. Increased physical activity decreased the exposure time necessary to produce death. Animals pretreated with amphetamine appear to die more rapidly than control animals due to an increase in respiratory minute volume. Animals pretreated with sodium pentobarbital or ethanol appear to survive through long periods of exposure to the toxic gases due to both a decrease in minute volume and a decrease in energy utilization. PMID- 3824871 TI - Toxicity of polycyclic aromatic hydrocarbons. II. Effect of NO2-nitrated phenanthrene and pyrene on blood chemistry in rats. AB - Male Sprague-Dawley rats were treated with a single ip injection of dimethyl sulfoxide (DMSO), phenanthrene, nitrated products of phenanthrene, pyrene, or nitrated products of pyrene. Phenanthrene, pyrene and their nitrated products were dissolved in DMSO. Phenanthrene produced a significant elevation of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels relative to DMSO-injected rats 24 hr after injection. Gamma-glutamyl transpeptidase (GGTP) levels were significantly increased for groups treated with phenanthrene when compared with the DMSO group 72 hr after injection. Nitrated products of phenanthrene produced a significant elevation of serum AST, ALT, sorbitol dehydrogenase (SDH), and GGTP levels when compared with groups treated with DMSO and phenanthrene 24 hr after injection. Four of six rats in the nitrated phenanthrene treatment group died between 48 and 72 hr after the injection. Injection of pyrene caused no significant increases in serum enzyme activities. Significant changes in the serum AST, SDH and LDH levels were observed with the nitrated products of pyrene at 24 hr. Only SDH levels were significantly different when pyrene and its nitrated products were compared. No significant differences were detected at 72 hr with the nitrated products of pyrene. As supported by serum chemistry, this study suggests that the products of the reaction of NO2 with two model polynuclear aromatic hydrocarbons (PAH) are hepatotoxic. Both pyrene and phenanthrene form nitrated products that are more toxic than the parent PAH, but the nitrated products of phenanthrene appear to be more toxic than the nitration products of pyrene. PMID- 3824872 TI - Formaldehyde: toxicology and hazards. AB - The widespread use of formaldehyde-based resins had led to the observation of consumer annoyance and health problems associated with its release. Formaldehyde vapor now is known to off-gas from many of these products. Vapor exposure of humans results in symptoms of eye and upper respiratory tract irritation. Inhaled formaldehyde also produces nasal carcinomas in rats and mice (following exposure to 14.1 ppm in mice and 5.6 ppm in rats for 6 hr/day, 5 days/week for 24 mo). These findings resulted in intensified concern over the amount of formaldehyde released into the indoor environment from various laboratory and consumer products. PMID- 3824873 TI - Characterization of experimentally induced equine leukoencephalomalacia (ELEM) in ponies (Equus caballus): preliminary report. AB - An isolate of Fusarium moniliforme (M-1225 Cairo #1) was cultured on autoclaved corn and fed daily to 5 ponies at a rate of 2.5 g corn/kg body wt. One pony developed clinical signs of toxicity after 28 days and was sacrificed. The remaining 4 ponies developed no clinical sign of toxicity even after extended exposure. Hematology, serum chemistry, cerebrospinal fluid (CSF), and liver and brain pathology were evaluated as possible diagnostic and prognostic indicators. Hematology was not informative. Aspartate aminotransferase and gamma glutamyltranspeptidase activities were elevated only in the clinically positive pony. CSF was most informative. Elevated myelin basic protein levels (greater than 14 ng/ml; normal less than 2.0 ng/ml) and cytologic changes consistent with chronic inflammation were observed in the clinically positive pony. Chronic inflammation was also seen in one clinically normal pony. Cytoplasmic vacuolation and clumping were observed in the hepatocytes of all ponies. Brain pathology was consistent with ELEM in the clinically positive pony. PMID- 3824874 TI - The clinical relevance of the LD50. PMID- 3824875 TI - Incidence of ethylene glycol intoxication in dogs and cats seen at Colorado State University Veterinary Teaching Hospital. AB - The number of cases of ethylene glycol intoxication in dogs and cats seen at the Colorado State University Veterinary Teaching Hospital between 1979 and 1986 was compared with the number of cases of rodenticide, insecticide, herbicide, simple organic compound and food poisonings for the same time period. Of 104 intoxications, ethylene glycol (30/104), rodenticide (53/104), and food poisonings (6/104), were major contributors. Case-fatality rates were 43.3%, 11.3% and 16.7% respectively. Data available from records of ethylene glycol intoxication in dogs and cats occurring between 1968 and 1986 facilitated description of cases by sex, age and season. Of the 60 cases, dogs (35/60) and cats (25/60) yielded uneven or skewed distributions when considering sex, age and/or season of intoxication. PMID- 3824876 TI - Death camas poisoning in sheep: a case report. AB - Approximately 250 sheep were poisoned and died from ingesting death camas (Zygadenus paniculatus) within a 2-day period on a foothill range in southeastern Idaho. Sixty to 70% of the poisoned sheep were 80-90 lb lambs and the rest were mature ewes. Poisonings were confirmed by field investigation, microhistological analysis of plant fragments from rumen contents of dead sheep, clinical signs, gross and microscopic analysis of tissues, and by experimentally feeding death camas collected on the poisoning site to 3 ewes at the Poisonous Plant Research Laboratory at Logan, UT. Clinical signs and gross and microscopic analysis of tissues were similar in ewes from the field investigation to those in ewes experimentally fed death camas. Ataxia, muscular weakness, trembling, incoordination, discharge of frothy saliva from the mouth and nose, vomition, dyspnea, collapse and death were the most common clinical signs. Gross changes included severe pulmonary congestion and subcutaneous hemorrhage. Microscopic lesions were those of severe pulmonary congestion. PMID- 3824877 TI - Rapid death resulting from mesoridazine overdose. AB - A 23-year-old mentally retarded woman was brought to the emergency department 2 2.5 hr after ingesting an unknown quantity of mesoridazine. She was lethargic and somewhat uncooperative, but did answer questions. Her ECG was normal. She was treated with gastric lavage, 50 g activated charcoal, and 10 oz magnesium citrate solution. Her condition continued to decline until, at 2 hr after arrival, she was comatose and becoming increasingly hypotensive. Her ECG showed long runs of markedly widened QRS complexes. The patient was given an iv infusion of dobutamine to maintain blood pressure. She suffered a convulsion, loss of blood pressure, and developed ventricular tachycardia which progressed to ventricular fibrillation unresponsive to electrical cardioversion, pacing, and vigorous prolonged CPR. She was pronounced dead 6-6.5 hr after the ingestion. Antemortem blood level of mesoridazine was 16 micrograms/ml and no other drugs were detected. While sudden deaths have been reported with therapeutic doses of mesoridazine and its parent thioridazine, deaths are uncommon in overdose. Rapid death seen in this case emphasizes the importance of close monitoring and aggressive treatment of phenothiazine overdoses. PMID- 3824878 TI - The role of the poison center in veterinary poisonings: a survey. AB - The number of veterinary poisonings presented to this poison center has grown to over 1200 cases annually. To make sure that the poison center is working cooperatively with local veterinarians, a survey was sent out to 237 veterinary clinics state-wide. Of particular interest was whether the poison center had a role to play in the treatment of minor poisonings in companion animals. The results of 77 returned surveys indicate that the poison center is currently a major source of poison information and 95% of responders were satisfied with the information received; 73% felt that all minor ingestions should be handled in the home whenever possible, and 70% felt it would be appropriate for poison center staff to perform this function. This survey indicates that the poison center can play a significant role in the treatment of poisonings in small companion animals. PMID- 3824879 TI - Urine spot test as guide to treatment in acute pentavalent arsenic ingestion. PMID- 3824881 TI - Volume of a swallow: role of orifice size and viscosity. AB - Following approval by an Institutional Review Board and a pilot study with adults, children aged 24 months to 71 months were encouraged to drink from a 28 fl oz flexible, plastic bottle with either a small diameter orifice (7 mm) or large diameter orifice (28 mm). The bottles contained either a low viscosity, an intermediate viscosity, or a higher viscosity liquid. Approximately 24 children evaluated each orifice/viscosity combination. The results, expressed as ml/swallow/kg body weight, showed that reducing orifice diameter reduced the volume of a swallow for the low viscosity liquid but did not appear to affect swallow volume for the intermediate or higher viscosity liquids. Additionally, swallow volume was found to be inversely related to viscosity of the test liquid. PMID- 3824880 TI - An analysis of arsenic exposures referred to the Blodgett Regional Poison Center. AB - Fifty-seven cases of acute arsenic exposure were referred to Blodgett Regional Poison Center from January 1985 through December 1985. We will summarize epidemiologic aspects, laboratory values and the types of arsenicals involved. Cases predominantly involved children ingesting sodium arsenate in the form of ant poison. A great majority were accidental exposures related to the home use of ant killers in contrast to previous reports of homicidal or industrial poisoning. Initial urine arsenic levels, symptoms and therapy will be included. Most cases were reported within hours with patients being asymptomatic or with relatively few complaints. The current Blodgett Regional Poison Center Arsenic Protocol and instructions for the preparation of D-penicillamine suspension adapted from the Blodgett Pharmacy Department will be included. Conclusions, outcomes and recommendations are discussed. PMID- 3824882 TI - Acute blasticidin S poisoning. AB - Blasticidin S is an effective fungicidal aminocylonucleoside antibiotic against a rice blast disease. We presented the first 4 reported cases of acute poisoning from ingesting blasticidin S for suicidal attempts. Three of the patients were fatal. The symptoms observed in the patients included vomiting immediately after ingestion and severe, persistent, watery diarrhea. The toxic effects of blasticidin S were noted in ectodermal tissues including the skin, conjunctiva, cornea, and intestine. Massive loss of intestinal fluid resulted in progressively pronounced hypotension associated with tachycardia. The treatment of choice for the poisoning consists of intravenous fluid administration and the management of body water and electrolyte balance. PMID- 3824883 TI - A retrospective review of plant exposures as reported to the Hennepin Regional Poison Center in 1985. PMID- 3824884 TI - [Tactics in roentgenoendoscopic examination of ulcers of the stomach and duodenum]. PMID- 3824885 TI - [Roentgenoanatomic features of the duodenum and major duodenal papilla in cholepneumoduodenography]. PMID- 3824886 TI - [Pancreatocholecystography after pancreatoduodenal resection]. PMID- 3824887 TI - [Roentgenologic diagnosis of lung lesions in Wegener's granulomatosis]. PMID- 3824888 TI - [Complex phlebography in the diagnosis of pathologic changes in varicose veins of the lower extremities]. PMID- 3824889 TI - [Radionuclide and roentgenologic diagnosis of compensatory-adaptive changes in the solitary healthy and hydronephrotic kidney]. PMID- 3824890 TI - [Indicator of the blurring effect in longitudinal tomography]. PMID- 3824891 TI - [Roentgenologic characteristics of generalized osteopenia of various etiologies]. PMID- 3824892 TI - [Interpretation of roentgenograms using digital computers]. PMID- 3824893 TI - [Use of electroroentgenography at a traumatology center]. PMID- 3824894 TI - [Roentgenologic diagnosis of diabetic osteoarthropathy]. PMID- 3824895 TI - [Roentgenologic semeiotics of joint lesions in psoriasis]. PMID- 3824896 TI - [Clinico-roentgenologic semeiotics of metastases of malignant neoplasms to the bones]. PMID- 3824897 TI - [Epidurography as a method of topical diagnosis of hernia of the lumbar intervertebral disks]. PMID- 3824898 TI - [A program for quality control in roentgenology]. PMID- 3824899 TI - [A case of intrapulmonary sequestration]. PMID- 3824900 TI - [Giant synovial cyst of the popliteal region]. PMID- 3824901 TI - Alveolar macrophage characteristics: effect of repeated lavages on cell activity. AB - The effect of frequently repeated lavages on phenotypic and functional characteristics of alveolar macrophages (AM) from calves was studied. Following an interval of 48 h the proportion of AM expressing an Ia-like antigen increased from 10.3 +/- 1.9 to 21.3 +/- 3.2 (p less than 0.01). These cells exhibited a significant increase in antibody dependent cellular cytotoxicity (ADCC) (from 37.8 +/- 5.3% to 59.2 +/- 5.2%, p less than 0.01), whereas decreases in O2(-) generation (from 28.0 +/- 1.8 to 19.7 +/- 1.1 nmol/5 X 10(5) cells/h) as well as in the intracellular rho-glucuronidase-content occurred. Small changes were also noted in ectoenzyme activities, PGE2- and interleukin 1-generation, whereas IgG Fc-mediated phagocytosis was unaffected. By extending the lavage interval to six days, these dramatic changes were avoided, although a marginal effect was still seen on ADCC, binding of IgG- and C3b-sensitized particles as well as on ectoenzymes. After even longer intervals no effects were discernable. We conclude that it should be possible to perform repeated evaluations of AM phenotype and functional activities during immune and inflammatory processes in the same animal using a lavage-schedule of 6 days intervals, without adversely affecting the composition of the AM-population or cell activities. PMID- 3824902 TI - Detection of serum antibodies against Ehrlichia risticii in Potomac horse fever by enzyme-linked immunosorbent assay. AB - An indirect enzyme-linked immunosorbent assay (ELISA) was developed which was specific and sensitive in detecting antibodies to Ehrlichia risticii in Potomac horse fever (PHF). The ELISA antibody titers were correlated with the indirect fluorescent antibody (IFA) titers. E. risticii propagated in human histiocyte culture was purified on renografin gradient and the band of the organisms at a density of 1.182 g/ml was used as antigen. ELISA antibody titers were determined through computer assisted analysis, the observed antibody titers were derived by serial serum dilutions and using a resultant standard curve the predicted antibody titers were obtained from a single serum dilution. The standard curve had a correlation coefficient of 0.8975. The observed and predicted antibody titers were in good agreement, as the respective titers fell within a two-fold range. There was a good correlation between ELISA and IFA test results, but the ELISA titers were several times higher. In experimental infections of horses produced with the infected equine whole blood and the Ehrlichia infected macrophage culture, the antibodies were first detected in two weeks and one week postinoculation (PI), respectively. In both cases the titers reached a peak in about 4 weeks PI with a mean titer of 1:16558 and 1:4030, respectively. The antibody titers of the convalescent sera of field cases of PHF were comparatively lower than the experimentally infected horses. PMID- 3824903 TI - The use of differential staining of sister chromatid to estimate the in vitro effect of human alpha interferon on cell division in normal and tumour cells. AB - Concentration of 10, 100 and 1000 I.U./ml of human leukocyte alpha interferon (IFN) were added into peripheral human blood (PBL) cultures and in KB cell cultures in the presence of 5-bromdeoxyuridine (BrdU) at 10 micrograms/ml. After 72 hours the differential staining of sister chromatid (harlequin) technique was applied in order to differentiate among the metaphases of successive cell generations occurring in the presence of IFN. The frequency of the first (M1), second (M2) and third (M3) metaphases was recorded and the replication index (RI) as well as the average generation time (AGT) was calculated for untreated controls and for each of the IFN concentrations used, both in the blood cultures and in the KB cells. In the PBL cultures a clear dose-related inhibitory effect of IFN on cell division was observed, the RI values being lessened whereas the AGT concomitantly increased by increasing the IFN concentrations. An increase in M1 metaphase frequency was observed concomitantly with a diminished number of M3 cells. In KB cells the division kinetics was not influenced by IFN as indicated by similar RI and AGT values observed in controls and in IFN treated cells. However, the frequencies of both M1 and M3 cells were slightly diminished concomitantly with a discrete augmentation of M2 cell number. The differential staining of sister chromatid thus proved a highly useful technique to investigate the different sensitivity of the normal and malignant cells to the growth inhibitory effect induced by alpha IFN in vitro. PMID- 3824904 TI - Effect of heating and adsorption of complement on the antiviral activity of normal sera against inhibitor-resistant influenza virus. PMID- 3824905 TI - Molecular characterization of the genomic S RNA segment from lymphocytic choriomeningitis virus. AB - We have used cDNA clones derived from the genomic S RNA segment of lymphocytic choriomeningitis virus (LCMV), Armstrong strain, as hybridization probes to monitor virus gene expression during acute infections. Our results with strand specific probes confirm the ambisense character of the LCMV S RNA segment and document the presence of both genomic sense and genomic complementary sense RNA species over the time course of infection. We have used nucleotide sequence information to predict primary amino acid sequences for the major viral structural proteins, nucleoprotein (NP) and glycoprotein (GP-C). Antibodies raised against synthetic peptides derived from these predicted protein sequences have indicated that the gene order for the S segment is 3' NP----5' GP-C and provided direct demonstration that the GP-1 portion of the GP-C precursor is encoded nearest the 5' end of the S segment. Comparison of the predicted amino acid sequences for NP and GP-C between the Armstrong CA-1371 strain and the WE strain shows over 90% amino acid identity. This suggests that significant differences described for the pathogenic potential of the Arm and WE strains in C3H mice reside in one or a very few critical amino acid changes. PMID- 3824906 TI - F1 polypeptides of two canine distemper virus strains: variation in the conserved N-terminal hydrophobic region. AB - The fusion protein of canine distemper virus was isolated by immunoadsorption from two virus strains, the rapidly growing Onderstepoort strain (forming large plaques) and the Convac vaccine strain (forming microplaques). The F1 subunits of the two fusion proteins were purified by preparative polyacrylamide gel electrophoresis. Direct amino acid sequence analysis revealed that 36-residue N terminal regions of the proteins from the two strains are identical except at position 9, where Ala in the Convac strain is substituted by Val in the Onderstepoort strain. The two sequences show high homology with the previously determined N-terminal sequence of the F1 polypeptide of measles virus, and moderate homology with corresponding sequences of five paramyxoviruses, emphasizing the occurrence of an extensive conservation of these structures. PMID- 3824907 TI - Viral RNAs synthesized in cells infected with Germiston Bunyavirus. AB - A rapidly growing strain of Germiston virus was used to study intracellular viral RNA synthesis in BHK cells. The RNAs were separated by electrophoresis into seven bands which fell into three size classes: large (bands L1 and L2), medium (bands M1 and M2), and small (bands S1, S2, and S3). Blot hybridisation established that bands L1, M1, and S1 contained the negative-sense genomic RNAs, while bands L2, M2, S2, and S3 contained positive-sense RNAs complementary to the genomic RNAs within the same size class. After glyoxal treatment the RNAs separated into a large, a medium, and two small bands, indicating that the positive-sense RNAs originally present in bands L2, M2, and S2 are similar in size to their genomic RNAs, while the RNA in S3 is shorter than the small genomic segment. These results suggest that band S2 contains the replicative intermediate RNA and band S3 the messenger RNA of the small genomic segment and also that bands L2 and M2 contain both replicative intermediate and messenger RNAs. Long after virus development had ceased in the infected cells the amounts of RNAs in bands L1, M1, S1, and S2 remained the same, those in bands L2 and M2 were reduced, while only trace amounts of RNAs were observed in band S3, suggesting that the genomic RNAs and the replicative intermediate RNAs form ribonuclease-resistant ribonucleoprotein complexes while the messenger RNAs do not form such complexes. Synthesis of RNA in the infected cells was first evident in bands S3 and M2, after which synthesis was soon observed in all seven bands reaching a maximum rate at the logarithmic phase of growth, suggesting that the pattern of Germiston virus development resembles that of other negative-strand RNA viruses. The presence of defective-interfering particles was indicated by the observation that purified virus preparations contained a minor RNA component originating from the large RNA segment. PMID- 3824908 TI - The measles virus matrix gene and gene product defined by in vitro and in vivo expression. AB - Sequence analysis of full-length cDNA clones of the measles virus matrix gene revealed three possible open reading frames: M, X1, and X2. The M reading frame differed from the reported sequence by a single nucleotide corresponding to a conservative lysine to arginine amino acid substitution near the carboxy-terminus conserved among the M proteins of paramyxoviruses. The putative X reading frames contained no translational termination codon due to a frame-shift mutation. The protein-coding potential of these reading frames was examined by in vitro translation and DNA-mediated gene transfer into primate cells. The M reading frame produced a 38,000 Mr protein indistinguishable from the M protein in measles virus-infected cells. This protein was not phosphorylated nor processed post-translationally in vivo. The putative X1 and X2 reading frames could be translated into proteins when placed near the 5' terminus of the RNA. The resulting proteins were heterogeneous due to the lack of a termination codon. Translation from the putative X reading frames was adversely affected by an upstream AUG codon and these reading frames were unable to synthesize proteins in their normal 3' locations. At least 146 nucleotides of these 3'-untranslated sequences could be deleted without affecting the expression of M protein in vitro or in vivo. Thus despite the multiple open reading frames, the measles virus M gene is functionally monocistronic. PMID- 3824909 TI - In vitro identification of a B19 parvovirus promoter. AB - The nucleotide sequence of the B19-Wi isolate of human parvovirus was determined and compared throughout the open reading frames and putative transcription signals with the sequence of the closely related B19-Au isolate. In vitro run off transcription assays, using B19-Wi DNA as the template, indicated that there is a strong promoter between m.u. 5 and 7. Deletion clones show that a region between nt 258 and 321 is necessary for in vitro transcriptional activity. Primer extension studies identified the start site at 31-32 nucleotides downstream of the sequence TATATATA. The strength of this left-hand promoter is unusual among parvovirus promoters characterized to date, and the possibility of an upstream enhancer element is discussed. PMID- 3824910 TI - A transcriptional promoter of the human parvovirus B19 active in vitro and in vivo. AB - The human parvovirus B19 causes aplastic crises in sickle cell anemia patients and the disease erythema infectiosum. So far, it has not been possible to grow B19 virus in cultured cells. Here we report the use of in vitro transcription in HeLa cell extracts and transient expression of cloned DNA transfected into HeLa cells to detect and map a strong transcriptional promoter on the B19 genome. The promoter is located near the left end of the B19 genome, at position 6 map units in the clone pYT103 (approximately 280 bp upstream of the first HindIII site), and directs transcription to the right. These results suggest that the strictly limited host range of B19 does not operate at the level of transcription from the promoter at the left end of the genome. PMID- 3824911 TI - Recombinant human interferons inhibit replication of Mason-Pfizer monkey virus in primate cells. AB - Pretreatment of Mason-Pfizer monkey virus-infected human embryonic kidney cells with either of the cloned human interferons, A or A/D, reduces the release of infectious virus particles to the same extent (greater than 97%) as determined by 125I-protein A binding radioimmune assay. While interferon A has no significant effect on the release of infectious viruses from a Mason-Pfizer monkey virus infected monkey cell line consistent with the species specificity of this group of compounds, human interferon A/D can block the release of virions from the same monkey cell line. This block appears to be at the level of viral particle release from the cells since both labeling with radioactive precursors and electron microscopic observations show few extracellular particles but normal levels of intracytoplasmic A particles. The results show that cloned human interferon A/D can block the replication of an immunosuppressive retrovirus in primate cells and raise the possibility of testing the efficacy of this interferon in primate model systems. PMID- 3824912 TI - [One-dimensional echocardiography during Valsalva's maneuver: I. Changes in the size of the left atrium and heart rate in healthy young persons and athletes]. PMID- 3824913 TI - [One-dimensional echocardiography in Valsalva's maneuver: II. Changes in the size of the left atrium and heart rate in patients after acute myocardial infarct]. PMID- 3824914 TI - [Left ventricular function in cardiogenic shock: is the size of the infarct more important or the kinetics of the "unaffected" heart muscle?]. PMID- 3824915 TI - [Isopotential mapping of the body surface in myocardial infarct complicated by right bundle-branch block]. PMID- 3824916 TI - [Monitoring the therapy of patients with manifest hypertension using an isometric loading test]. PMID- 3824917 TI - [Personal experience with the long-term administration of verapamil in hypertrophic cardiomyopathies]. PMID- 3824918 TI - [Does verapamil affect the thickness of the cardiac muscle in hypertrophic cardiomyopathy?]. PMID- 3824919 TI - [The bradycardia-tachycardia syndrome]. PMID- 3824920 TI - [Comparison of anti-angina agents using bicycle ergometry]. PMID- 3824921 TI - [Electrophysiology of cardiac rhythm disorders. II. Conditions affecting the electrical properties of cardiac fibers]. PMID- 3824922 TI - [Internal medicine after the 17th congress of the Czechoslovak Communist Party]. PMID- 3824923 TI - [Contrast echocardiography in persons with normal echocardiographic findings: possibilities of detecting patent foramen ovale]. PMID- 3824924 TI - [The bundle of His electrogram and programmed ventricular stimulation in the diagnosis of arrhythmic syncope]. PMID- 3824925 TI - [Risks in arterial hypertension]. PMID- 3824926 TI - [The effect of trifluoperazine on calcium absorption in the intestines measured by the oral calcium tolerance test]. PMID- 3824927 TI - [The polyglandular autoimmune endocrine syndrome. Does autoimmune hypophysitis exist?]. PMID- 3824928 TI - [Is it possible to non-invasively detect an occluded coronary artery in acute myocardial infarct? Comparison of EKG and echocardiography with coronarography or autopsy]. PMID- 3824929 TI - [Determination of trisodium citrate in acid glucose-citrate preservation solutions used in the transfusion service]. PMID- 3824930 TI - [Classification of myocardial infarcts and their prognosis]. PMID- 3824931 TI - [Electrophysiologic disorders of cardiac rhythm. III. Mechanisms of arrhythmia onset]. PMID- 3824932 TI - [Determination of zinc in body fluids, evaluation of the results and its significance in internal medicine]. PMID- 3824933 TI - [Lipid and apolipoprotein levels in health and disease]. PMID- 3824934 TI - [The effect of a 100 kilometer run on total cholesterol, HDL-cholesterol, triglyceride and lipoprotein levels]. PMID- 3824935 TI - [Determination of apolipoproteins in the study of clinical atherosclerosis]. PMID- 3824936 TI - [Excretion of proteoglycan degradation products in the urine in patients with rheumatoid arthritis and osteoarthrosis]. PMID- 3824937 TI - [Vitamin B12 during regular dialysis therapy]. PMID- 3824938 TI - [Platelet transfusion therapy]. PMID- 3824940 TI - [Electrophysiologic disorders of heart rhythm. IV. Clinical classification of arrhythmias]. PMID- 3824939 TI - [Etiopathogenic mechanisms in the development of insulin-dependent diabetes mellitus]. PMID- 3824941 TI - [Lyme disease--a new nosologic unit]. PMID- 3824942 TI - [Clinical significance of the delta antigen and its antibodies]. PMID- 3824943 TI - [Experience with the organization of correspondence instruction in functional diagnosis for military physicians (Part 3)]. PMID- 3824944 TI - [Clinical interpretation of echocardiographic findings in ischemic heart disease]. PMID- 3824945 TI - [Tasks for further improving and refining the work of maintaining and promoting the health of military personnel]. PMID- 3824946 TI - [Post-resuscitation syndrome after a myocardial infarct]. PMID- 3824947 TI - [Clinical picture and diagnosis of thromboembolism of the pulmonary artery]. PMID- 3824948 TI - [Preventive efficacy of thymalin in combination with vaccine preparations]. PMID- 3824949 TI - [Assessment of adaptation to high altitudes using statistical heart rate indices]. PMID- 3824950 TI - [Diagnosis of coronary insufficiency in flight crews]. PMID- 3824951 TI - [Features of the dispensarization of ships' officers]. PMID- 3824952 TI - [Storage of medical equipment]. PMID- 3824953 TI - [Comparative evaluation of the ultrasonic and roentgenologic methods of examination in the diagnosis of post-infarct aneurysms of the heart]. PMID- 3824954 TI - [Rehabilitation of patients with inflammatory diseases of the joints]. PMID- 3824956 TI - [Treatment of essential hypertension stages I and II]. PMID- 3824955 TI - [A typical course of thyrotoxicosis]. PMID- 3824957 TI - [Differential diagnosis of neurocirculatory dystonia and essential hypertension]. PMID- 3824958 TI - [Blood pressure dynamics of tank crew members during occupational stress]. PMID- 3824959 TI - [Experience with promoting and supporting a healthy life style in the garrison]. PMID- 3824960 TI - [Experience with the use of Holter monitoring of ischemic heart disease patients using the Soviet cardiocomplex "Lenta-MT"]. PMID- 3824961 TI - [Relation between the personality traits of athletes and the quality of their parachute jumps]. PMID- 3824962 TI - [Efficacy of antianginal therapy taking into account the correction of microcirculatory disorders of patients with stenocardia]. PMID- 3824963 TI - [A case of sudden death as a result of an overdose of berotek]. PMID- 3824964 TI - [Features of the plaque-formation reaction in servicemen in their initial period of service]. PMID- 3824965 TI - [Effect of health resort-climate therapy on the contractile capacity of the myocardium of ischemic heart disease patients]. PMID- 3824966 TI - [Method of physician monitoring of the status of the cardiovascular system of servicemen during training for battle]. PMID- 3824967 TI - [Changes in immunoglobulin concentrations in acute myocardial infarct]. PMID- 3824968 TI - [Organizational problems of certifying medical personnel for a trained category]. PMID- 3824969 TI - [Use of dosimeters for the triage of radiation injury victims]. PMID- 3824970 TI - [Temporary prosthesis of the major vessels of the extremities]. PMID- 3824971 TI - [Contactless method of crushing kidney and ureteral stones (experimental research)]. PMID- 3824973 TI - [Fundamental principles of the action of physical treatment methods in diseases of an inflammatory and dystrophic nature]. PMID- 3824972 TI - [Diagnostic difficulties and the characteristics of the therapeutic approach in combined bronchial asthma and ischemic heart disease]. PMID- 3824974 TI - [With perserverance let us raise political knowledge]. PMID- 3824975 TI - [Prevention of influenza and other acute respiratory diseases among the troops]. PMID- 3824976 TI - [Improved sanitary inspection of the conditions of military work]. PMID- 3824977 TI - [Sterilization of surgical materials and the hand scrubbing of the surgeon using pervomur on a hospital ship]. PMID- 3824978 TI - [Increased effectiveness of the dynamic medical control over flight personnel]. PMID- 3824979 TI - [Experience in treating sepsis in surgery patients]. PMID- 3824980 TI - [Diagnostic characteristics of chronic subdural hematomas]. PMID- 3824981 TI - [Diagnosis and prognosis of the course of acute glomerulonephritis]. PMID- 3824982 TI - [Clinical and treatment characteristics of chronic pyococcal skin ulcers of the lower extremities]. PMID- 3824983 TI - [Medical control over exercises in physical training and sports in a military unit]. PMID- 3824984 TI - [Experience in conducting anti-alcohol measures in aviation units]. PMID- 3824985 TI - [With an initiator of competition]. PMID- 3824986 TI - [Arterial shunting using temporary combined prostheses]. PMID- 3824987 TI - [Multichannel device for water research using membrane filters]. PMID- 3824988 TI - [The determinism theory of medicine]. PMID- 3824989 TI - [Basic research in the development of health resort treatment and physiotherapy]. PMID- 3824990 TI - [The mechanism of action of pulsatile microwaves on excitable structures]. PMID- 3824991 TI - [Development of burst activity in cerebellar Purkinje cells in response to decimeter waves]. PMID- 3824992 TI - [Effect of microwaves on recovery of disrupted motor functions of the brain (experimental study)]. PMID- 3824993 TI - [Effect of decimeter waves on glucocorticoid reception in the liver of the rat]. PMID- 3824994 TI - [Pulsatile magnetic fields in the treatment of patients with neurological syndromes of cervical osteochondrosis]. PMID- 3824996 TI - [Current status of the sanitary-bacteriologic evaluation of therapeutic muds]. PMID- 3824995 TI - [Principles for formulation of a new All-Union State Standard for therapeutic mineral drinking waters and therapeutic table waters]. PMID- 3824997 TI - [Acupuncture stimulation of points on the concha auriculae in patients with essential hypertension and the hyperkinetic type of circulation]. PMID- 3824998 TI - [Microcirculatory indices in the conjunctiva of patients with chronic ischemic heart disease in response to laser exposure of biologically active points]. PMID- 3824999 TI - [Motor regimen of patients with chronic nonspecific diseases of the lungs during the ambulatory stage of treatment]. PMID- 3825000 TI - [Effect of Naftusia mineral water on the acid- and gastrin-secretory response of the stomach]. PMID- 3825001 TI - [Diadynamomud and radon baths in the treatment of patients with neurologic manifestations of spinal osteochondrosis]. PMID- 3825002 TI - [Use of sinusoidally modulated currents in the treatment of neuritis of the facial nerve and postneuritic contractures of the facial muscles]. PMID- 3825003 TI - [Methodology of improving the teaching of exercise therapy to interns]. PMID- 3825004 TI - [Immunoblastic lymphosarcoma of the stomach (2 cases)]. PMID- 3825005 TI - [A complex vaccine in the prevention of staphylococcal, Pseudomonas aeruginosa and Proteus infections in esophageal cancer patients]. AB - An analysis of clinico-immunological data has demonstrated a considerable decline in non-specific and specific defences against such major factors of hospital infection in esophageal cancer patients as staphylococcal, blue pus and Proteus bacilli. Immunization with a complex vaccine including concentrated staphylococcal anatoxin, blue pus and Proteus vaccines was shown to stimulate the said factors of anti-infectious immunity and to be followed by a 4.7-fold decrease in the incidence of postoperative pyo-inflammatory complications. The said vaccine may be recommended for prevention of infectious complications in cancer patients since its administration is followed by a low-level reaction matched by a marked increase in immunologic vigor. PMID- 3825006 TI - [Radiation treatment of esophageal cancer patients]. AB - The data on 216 cases of cancer of the thoracic part of the esophagus treated by radiation are presented. The course of treatment was completed in 169 patients only. Two modalities of Co-60 teletherapy were employed. Complete regression of tumor was slightly more frequent in patients who were exposed to split-course radiation at two weeks' intervals than in those receiving a continuous course (22 +/- 4 and 33 +/- 6%, respectively). A five-year disease-free survival after a full course totalling a NSD of 60-70 Gy was registered in 14%. PMID- 3825007 TI - [Method for the experimental study of factors modifying carcinogenesis]. AB - Research in factors modifying carcinogenesis is closely associated with studies on complex multifactorial systems. Mathematical methods of planning multifactorial experiments should be used which assures a higher reliability of the results and elicits additional information. An analysis of the data on the modifying effect of aniline, sodium alkylsulfate and lead nitrite on nitrosomethylamine-induced carcinogenesis carried out on the basis of the newly developed method showed its advantages over the existing ones. PMID- 3825008 TI - [Enhancement of the selectivity of the action of the cytostatics cyclophosphane and 5-fluorouracil by using an extract of the Baikal skullcap in an experiment]. AB - In experiments with murine and rat transplantable tumors, Scutellaria baicalensis Georgii extract treatment was shown to ameliorate cyclophosphamide and 5 fluorouracil-induced myelotoxicity and to decrease tumor cell viability. This was partly attributed to a pronounced antistressor action of the extract and its normalizing effect on some homeostatic parameters. PMID- 3825010 TI - [Suitability of fiberscopy of the upper respiratory tracts during esophagogastroduodenoscopy and bronchoscopy]. AB - Prophylactic fibroscopic examination of the upper respiratory tract was carried out in 1,201 patients, 1,038 of them being simultaneously subjected to fiber esophagogastroduodenoscopy and 163--to fiber bronchoscopy. Specimens for cytomorphologic examination were taken from 393 cases. In 18.2%, various pathology of the upper respiratory tract was found, including inflammation in 9.7%. The group at high risk for cancer included 2.9% of examinees. Malignancies were detected in 0.08%. PMID- 3825009 TI - [Analgesic therapy of cancer outpatients]. AB - The results of treatment of 164 out-patients with far advanced malignancies for chronic pain syndrome are discussed. It was found that subarachnoid, peridural and sacral blocks with alcohol, phenol glycerine and carbolic acid can relieve pain for a long time, improve general condition and save narcotic analgetics. The most effective proved to be peridural block by phenolglycerine which induced analgesia in 67% of cases and maintained it for 45 days. PMID- 3825011 TI - [Means of improving the diagnosis of cancer of the large intestine]. AB - Problems of perfecting diagnosis of colorectal cancers are discussed with a view to identification of follow-up groups and improvement in methods for X-ray examination and subsequent diagnostic procedures. Double-contrast enema examination should be preferred in those at high risk for cancer of the large bowel. Follow-up groups were identified on the basis of risk factors. Patients' preparation for double-contrast enema including saline and contact purgatives, residue-free diet and hydration is described. The composition of a high-contrast barium suspension is given. The method of primary double-contrast enema, the required projections and other roentgenologic technicalities, which ensure the diagnostic value of the procedure are discussed. Complex syndrome-based roentgeno endoscopic examination programs are suggested. PMID- 3825012 TI - [A computer-assisted method of evaluating the actual nutrition of patients with ischemic heart disease during their clinical observation]. AB - The questionnaire method was used for the study of the actual nutrition of coronary patients after their discharge from the Clinic for Dietotherapy, during dispensary follow-up. The chemical composition of their diets was evaluated with computer, taking into consideration the losses during food preparing, and compared with the diets recommended. Certain variations in the chemical formula of the patients' home diets were revealed using this method. It is stressed that the dietetic recommendations given to coronary patients should be followed, while their physicians should thoroughly control their adherence to the diet. PMID- 3825013 TI - [Effect of carbohydrate load on the structuro-functional organization of cell membranes in patients with hypertension]. AB - Carbohydrate load induces in patients with essential hypertension reduction of the phospholipid fraction in the system blood plasma--surface-deep phospholipid pool of erythrocytic membranes, and the lowering of the levels of polyenic and dienic fatty acids. PMID- 3825014 TI - [Clinical characteristics of food motivation in patients with alimentary obesity]. AB - Characteristics of food behavioral reactions were studied in 159 patients with alimentary obesity, basing on the analysis of a specially developed questionnaire which helped elucidating the features of food motivation (FM) during 8-12 months. Three groups of patients were distinguished (with high, low and normal FM) in relation to the character, degree and duration of changes in the patients' behavioral reactions. The main manifestations of high (109 patients, 68.7% cases) and low (18 patients, 11.2% cases) FM were specified. Thirty two (20.1%) patients with normal FM in their catamnesis showed distinct hyperphagic behavior that, together with other features of FM, was considered as the state of a stable remission of high FM. Two types of high FM were differentiated which should be taken into account in the administration of effective therapy to patients with alimentary obesity. PMID- 3825015 TI - [Value of the alimentary factor in the prevention of iron deficiency conditions in young children]. AB - On the basis of the clinicophysiological and biochemical-hematologic investigations it was established that the feeding of infants with the adapted mixture "Malysh" did not prevent the development of latent iron deficiency in them. This was the reason for the enrichment of the mixture with hemopoietic substances. Five formulas of the mixture with varying compositions of hemopoietic factors enabled the authors to establish the optimum variant of the ratio of these ingredients in the adapted milk mixture. The use of the adapted mixtures enriched with hemopoietic substances promotes the prevention of iron deficiency that is confirmed by the increase of the hemoglobin stock and iron reserves in the child's body. The levels of blood hemoglobin and serum ferritin serve as informative values evidencing the effectiveness of using food enriched with hemopoietic factors. PMID- 3825016 TI - [Effect of alimentary alpha-tocopherol deficiency on the fatty acid composition of phospholipids in the subcellular membranes of the liver cells and high density lipoproteins in the blood plasma]. AB - In experiments on rats a positive correlation was demonstrated between the changes in the fatty-acid composition of hepatocytic intracellular membrane phospholipids and blood plasma high density lipoproteins. The data obtained evidence the existence in the blood of several mechanisms of alpha-tocopherol deficiency action on hepatocytic phospholipids and blood plasma protein-lipid complexes. PMID- 3825017 TI - [Specific immunosuppression after peroral administration of antibodies]. AB - The influence of immunization of lactating female rats with sheep red blood cells on the primary immune response of their progeny, and oral administration of heterologous antibodies, on the immune response of suckling rats was studied in experiments on 52 August rats. It was shown that oral antibody administration with breast milk and feeding with heterologous serum resulted in a drastic suppression of the splenic antibody-producing cells and in a fall of the humoral antibody titre in the suckling rats. The immunosuppression was reversible and could not be adoptively transferred. It is concluded that the antibodies entering the newborns' body with the mother's milk not only provide the passive immunity but also produce a regulatory effect on the immune system. PMID- 3825018 TI - [Bile secretion in dogs after intravenous administration of glucose]. AB - The effect of drop infusions of 10% glucose solution for parenteral nutrition, in a dose of 2 g/kg, on bile secretion was studied in experiments on dogs with chronic gallbladder-duodenal fistulas. It was demonstrated that the infusion of hypertonic glucose solution inhibits bile production quantitatively and qualitatively. PMID- 3825019 TI - [Protein assimilation and acid proteinases in the postnatal gastrointestinal tract in experimental studies]. AB - Proximal-distant gradient of the lysosomal proteinase activity distribution is observed in the mammals at the postnatal period of development. In various species of mammals the proximal-distal gradient of the lysosomal proteinase distribution is attended by the shift of the final stages of the intestinal digestion to the distal part of the small intestine. These features are typical of the protein digestion in the mammals at the postnatal period of development. The protein digestion in adult mammals is characterized by a uniform distribution of lysosomal proteinases between the small intestine parts and by the completion of the protein intestinal digestion in the proximal part of the small intestine. PMID- 3825021 TI - [Proteinization and biotransformation of pantothenic acid in the liver during the activation of lipogenesis]. AB - White female rats received a balanced synthetic ration (control) or a ration devoid of pantothenic acid (PAA) during 3 weeks. After 36-hour fasting adaptive hyperlipogenesis was induced by feeding the animals with a high-carbohydrate ration, then [114-C]-PAA (sodium salt, 182 nmol/kg) was administered with intervals of 3, 6, 24 hours up to 1 hour before decapitation. Radioactivity of the rats' boiled liver extracts depended on the hyperlipogenesis stage, its level rose progressively, in the control and reached the maximum in PAA-deficient animals by hour 6 after the feeding resumption. The PAA-deficient animals possessed a high PAA-accumulating capacity of the liver and cytosole of the liver including non-covalent radionuclide binding by protein complexes. CoA synthesizing capacity of the liver in the control animals, evaluated by the biotransformation of the labeled vitamin with CoA precursors of CoA, was intensified with the lipogenesis activation; in vitamin-deficiency CoA biosynthesis was accelerated more than two-fold as compared to the control at the initial and extended periods of hyperlipogenesis (3.6 h). The differences in proteinization and biotransformation of PAA in the liver of control and PAA deficient animals disappeared by 25 h of adaptive hyperlipogenesis. PMID- 3825020 TI - [Acceleration of the accumulation of the products of lipid peroxidation and reduction of the cardiac fibrillation threshold in vitamin E deficiency]. AB - A typical decrease in the blood serum alpha-tocopherol level and red blood cell hemolytic stability was recorded in rats given vitamin E-deficient diet during 2 months. Malonic dialdehyde (MDA) concentration in the skeletal muscles rose 4.5 fold, and in the myocardium, 1.6-fold as compared to the control. During aerobic incubation of heart homogenates of the experimental animals the MDA accumulation rate increased significantly, while that of the skeletal muscle homogenates was little changed. Vitamin E-deficiency induced no essential impairment of the myocardial contractility, however, the fibrillation electric threshold was decreased. The role of vitamin E-deficiency and lipid peroxidation activation in the growth of heart injury due to the factors inducing arrhythmia and fibrillation has been discussed. PMID- 3825022 TI - [Effect of methionine on the toxic effect of the pesticide rogor]. AB - Oral administration of methionine in a dose of 250 mg/kg during the priming of rats with rogor (11.5 mg/kg) decreases its toxic effect. PMID- 3825023 TI - [Characteristics of lipids of various species of small fish]. AB - Fractional and fatty-acid lipid composition studied in some new species of small industrial fish was shown to be specific and typical for hydrodionts: comparatively high nonsaturation of fatty acids, essential amount of polyenic acids with 20 and 22 carbon atoms. The main lipid fractions were presented by triglycerides and phospholipids. The new small fish species studied can serve as an additional source of biologically valuable fatty components in the nutrition of the population. PMID- 3825024 TI - [Biological variability and accuracy in determining macro- and microelements in fish]. AB - The statistical analysis of 911 personal observations and literature findings on the mean content of ash, sodium, potassium, calcium, magnesium, iron, zinc, copper and manganese in different species of fish has brought to the conclusion on the absence of any reliable interspecies differences in the content of macro- and trace elements in fish muscle tissue (except for sodium and zinc). The evaluation of the analytical accuracy in the assessment and biological variability of the mineral composition of the fish muscles has shown that the values of both these components are comparable and should be taken into account in the development of new tables on the chemical composition of food products. PMID- 3825025 TI - [The socialist life style as a civilization of a historically new type]. PMID- 3825026 TI - [Clinical evaluation of the results of the occupational screening of miners]. PMID- 3825027 TI - [Gastric secretory function of workers in contact with the methyl ester of methacrylic acid]. PMID- 3825028 TI - [Dietetic nutrition at industrial plants]. PMID- 3825029 TI - [Morphological characteristics of lung cancer]. PMID- 3825030 TI - [Effect of the antitumor antibiotic preparation 6 on macrophage function in an experiment]. PMID- 3825031 TI - [Lipid peroxidation and metabolism in viral hepatitis B and liver cirrhosis]. PMID- 3825032 TI - [Endogenous infection in viral hepatitis]. PMID- 3825033 TI - [Effect of combined treatment on the hematological and cytochemical indices of chronic bronchitis patients]. PMID- 3825034 TI - [Case of metastasizing carcinoid of the bronchus]. PMID- 3825035 TI - [Effect of ultrasonic inhalation of antitubercular preparations on the hemodynamics of the greater and lesser circulations in tuberculosis patients]. PMID- 3825036 TI - [Determination of the leukocytic intoxication index in pulmonary tuberculosis patients]. PMID- 3825037 TI - [Immunological characteristics of the side-effects of antibacterial preparations in pulmonary tuberculosis patients]. PMID- 3825038 TI - [Kidney function in chronic bronchitis patients]. PMID- 3825039 TI - [Clinico-anatomical characteristics of Goodpasture's syndrome]. PMID- 3825040 TI - [Recovery of work activity in glomerulonephritis patients at sanatoria on the southern coast of the Crimea]. PMID- 3825041 TI - [Correction of disorders of somatosexual development]. PMID- 3825042 TI - [Dynamics of the electrolyte and trace element composition of digestive gland secretions in chronic organic diseases of digestion]. PMID- 3825043 TI - [Prevention of the aspiration syndrome (a review of the literature)]. PMID- 3825044 TI - [Diaphragmatic flutter in a female patient after selective proximal vagotomy]. PMID- 3825045 TI - [Microcirculatory bed of the duodenal mucosa in selective proximal vagotomy]. PMID- 3825047 TI - [Combined treatment of patients with duodenogastric reflux]. PMID- 3825046 TI - [Intestinal function following different types of vagotomy]. PMID- 3825048 TI - [Blood antigen systems of patients with ischemic heart disease]. PMID- 3825049 TI - [Effect of nitrosorbide on the hemodynamics under physical loading in patients with ischemic heart disease]. PMID- 3825050 TI - [Use of thermography in the diagnosis of myocardial infarct]. PMID- 3825051 TI - [Myocardial function of pregnant patients with mitral stenosis]. PMID- 3825052 TI - [Thrombocyte reactivity of patients with hypertension and coronary atherosclerosis]. PMID- 3825053 TI - [Pathogenesis of arterial hypertension in bronchial obstruction]. PMID- 3825054 TI - [Spirometric bicycle ergometry indices of patients with dilated cardiomyopathy]. PMID- 3825055 TI - [Hemostatic disorders in chronic suppurative-septic diseases and principles of their correction]. PMID- 3825056 TI - [Parvovirus-like particles in the blood serum of a female patient with paroxysmal nocturnal hemoglobinuria]. PMID- 3825057 TI - [Importance of electroneuromyographic study for the diagnosis and treatment of injuries to the nerve trunks of the extremities]. PMID- 3825058 TI - [Acid-base equilibrium and the electrolyte content of the blood plasma in patients with disseminated sclerosis]. PMID- 3825059 TI - [Complexes of significant biosocial and social factors in the treatment of schizophrenia]. PMID- 3825060 TI - [2 cases of mastocytoma]. PMID- 3825061 TI - [Social questions of the development of modern medicine and public health]. PMID- 3825062 TI - [Differential diagnosis of opisthorchiasis]. PMID- 3825063 TI - [Typhoid fever relapses with exacerbation of cholecystitis]. PMID- 3825064 TI - [Comparative characteristics of the efficacy of chlorine-active and surface active antimicrobial agents]. PMID- 3825065 TI - [Side effects during treatment with peripheral vasodilators]. PMID- 3825066 TI - [Clinico-pathomorphological criteria for the diagnosis of coronary heart disease in coronary artery dilatation]. PMID- 3825067 TI - [Clinical variants of subcompensated cerebrovascular insufficiency]. PMID- 3825068 TI - [Central hemodynamics of patients with initial dyscirculatory encephalopathy in middle and old age]. PMID- 3825069 TI - [Central hemodynamic function of hypertension patients with combined alimentary obesity based on radiocardiographic data]. PMID- 3825070 TI - [Blood serum proteinase inhibitors in joint diseases]. PMID- 3825071 TI - [Fibrin-fibrinogen degradation products in the blood plasma in complicated peptic ulcer and pancreatitis]. PMID- 3825072 TI - [Importance of scanning in the diagnosis of liver and spleen lesions in lymphogranulomatosis patients following radiation therapy]. PMID- 3825073 TI - [X-ray diagnosis of diaphragmatic hiatal hernias]. PMID- 3825074 TI - [The problem of thyroid cancer in the Carpathian Mountain region]. PMID- 3825075 TI - [Functional indices of the thyroid and testes in disorders of somatosexual development]. PMID- 3825076 TI - [Hypogonadism and mental disorders as the 1st manifestations of hypopituitarism]. PMID- 3825077 TI - [Substernal goiter combined with aortic aneurysm]. PMID- 3825078 TI - [Diagnosis of thymic tumors]. PMID- 3825079 TI - [Hemodynamics of the greater and lesser circulations in patients with destructive pulmonary tuberculosis]. PMID- 3825080 TI - [X-ray and morphological comparisons of the cranial sutures]. PMID- 3825081 TI - [Recurrent Lyell's syndrome]. PMID- 3825082 TI - [Use of polyrheography and infrared thermography in the diagnosis of autonomic vascular dystonia]. PMID- 3825083 TI - [Polyamine studies of schizophrenia patients]. PMID- 3825084 TI - [Use of discriminant analysis in the diagnosis of disseminated sclerosis]. PMID- 3825085 TI - [Pharmacotherapy in geriatrics]. PMID- 3825086 TI - [Automatic control and the optimization of the current working capacity of the operators of production process systems]. PMID- 3825087 TI - [Prevention of industrial traumatism as a social hygiene problem]. PMID- 3825088 TI - [Operative assessment of the influenza situation based on a complex accounting of standardized indices of incidence and data on rapid diagnosis]. AB - The paper described a method allowing most objective and operative evaluation of the influenza situation in the autumn-winter period, the detection of the onset of influenza epidemic in a given population area, and characterization of the intensity of the epidemic. The development of a more accurate method of operative evaluation of the influenza situation is necessary because influenza is one of widely prevalent virus diseases which still plays a significant role in human pathology and simultaneously takes away from productive labor tremendous numbers of workers. Follow-up of the incidence levels is based on the idea of comparison of the actual data with standardized parameters. These parameters (incidence at the start week, the pace of epidemic increase, the critical seasonal coefficient) are calculated by weekly data of the basic period for a number of years for each town under study on the basis of comparison with the mean minimal level of influenza and ARD incidence (summer normal level) and also the use of mathematical statistics apparatus. To establish epidemiologically unfavourable situation it is necessary that operatively estimated current parameters (analogous with pre-calculated standardized ones) be equal to or exceeding the standardized parameters. The methods of rapid diagnosis are used additionally for identification of the etiology of the starting outbreak or epidemic. The use of the developed methods is exemplified in the paper by practical estimates of the influenza situation in Moscow in the seasons of 1983-1984 and 1984-1985. PMID- 3825089 TI - [Biological consequences of breaks and reunions of disulfide bonds in influenza virus proteins]. AB - Consequences of chemical breakage of native disulphide bonds in influenza virus neuraminidase and hemagglutinin glycoproteins induced by mercaptoethanol treatment were studied. Under conditions of blocked reoxidation of thiol groups, this treatment led to significant inhibition of hemagglutinating activity and infectivity of virus particles, and to a lesser inhibition of neuraminidase activity, as well as to promotion of endogenous proteolytic activity. Analysis of virus particles proteins by polyacrylamide gel electrophoresis indicated association of these biological effects with breakage of disulphide bridges, mainly in hemagglutinin glycoproteins. Under certain conditions, the proteins were capable of reformation of disulphide bridges as manifested in restoration of virion biological activity and electrophoretic characteristics of proteins. PMID- 3825090 TI - [Effective stabilizer for preparing antibody erythrocyte diagnostic agents for influenza A and B viruses]. AB - A method for preparation of erythrocyte antibody diagnosticums capable of differentiating in PHA test the type and subtype appurtenance of influenza virus strains was developed on the basis of amidol sensitization of erythrocytes with immunoglobulin preparations and the use as a stabilizing agent of nonionic detergent triton X-100. The method is simple, highly sensitive, reproducible, and may be used at virological laboratories of practical health institutions. PMID- 3825091 TI - [Characteristics of viral progeny in abortive influenza infection]. PMID- 3825092 TI - [Comparative study of the sensitivity of the serological methods used in detecting mumps virus antibodies]. AB - Six different methods were used for examinations for the presence of antibodies to mumps virus in 43 sera of donors varying in ages from 18 to 58 years. Judging by the percentage of positive results, most sensitive tests included: radial hemolysis (95.3), neutralization (88.4-81.4), immunofluorescence (83.7). Comparison of the results obtained in these tests revealed high correlation coefficients of antibody titres. The lowest number of positive results was obtained in lectin-neuraminidase test and hemagglutination-inhibition test (51.2% and 32.6%, respectively). PMID- 3825093 TI - [Effect of the size of the continuous poly(G) site in poly (G, A).poly (C) complexes on their interferon-inducing activity and their capacity to stimulate the development of immunity]. AB - It was established that the level of interferon-inducing activity of poly(G90A1).poly(C) complex in cell cultures and in mice was comparable to that of poly(G).poly(C). As the size of the continuous sites of poly(G) in the purine strand in poly(G, A).poly(C) complexes decreased to 60 and 28 nucleotides, the interferon-inducing activity decreased progressively, was still marked, or approached the zero at G:A ratios equal to 17:1 or 10:1, respectively. All this indicates that the cell receptors responsible for switching on of the induction mechanisms for interferon synthesis still recognize the stimulus 17 and possibly less so stimulus 10 of successively located guanosine nucleotides complementary to poly(C) and provide for the highest interferon production level when their number is equal to or exceeds 90-100. With the exception of poly(G10A1).poly(C) in which the interferon-inducing activity did not exceed its detection threshold, all complexes enhanced noticeably or markedly specific immune response in mice to tick-borne encephalitis after immunization with inactivated unadsorbed tissue culture vaccine against this infection. The level of this immunostimulating activity correlated irregularly with the intensity of their interferon-inducing activity. PMID- 3825094 TI - [Nucleolus-forming regions in the chromosomes in continuous cell cultures]. AB - Localization of nucleoli-forming (NF) areas in chromosomes of continuous cell cultures of African green monkey kidney Vero, CV-1, GMK, BGM, BS-C-1. Macaca rhesus kidney LLC-MK2, dog kidney MDCK, pig kidney SPEV, PK-15 was studied. The NF-areas in chromosomes of African green monkey, M. rhesus, and pig cell cultures were shown to be localized in sites of secondary chromosomal stangulation, and there was also a definite correlation between the intensity of staining of NF areas and sizes of the zone of secondary strangulation. In chromosomes of MDCK cell line, NF-areas are located in telomere ends of six-nine chromosomes, and association of two chromosomes by NF-areas was observed. The possibility of using the method of identification of nucleoi-forming areas for the evaluation of productivity of continuous cell cultures is discussed. PMID- 3825095 TI - [RAMT cell line as a substrate for the propagation of vaccinal viral strains]. AB - Properties of the PAMT cell line which are deficient in hypoxanthine guanyl phosphoribosiltransferase were studied. The PAMT cell line derived from African green monkey kidney tissue may be identified by selective nutrient media, contains no contaminants, is not tumorigenic, is susceptible to a wide range of viruses. Titres of poliomyelitis, tick-borne encephalitis, and carnivore plague viruses were similar in cell cultures grown in the medium with 10% serum and in those adapted to growth in the medium containing 1% serum. The properties of PAMT cell line allow it to be used in manufacture of killed virus vaccines. PMID- 3825096 TI - [Inhibitory action of remantadine and ribavirin on chronic influenza infection in tissue cultures]. PMID- 3825097 TI - [Viruses encountered in cell cultures of animal origin]. PMID- 3825098 TI - [Use of passive hemagglutination for control of the surface antigen of hepatitis B virus and its antibodies]. PMID- 3825100 TI - Matters gaseous. PMID- 3825099 TI - [Viral hepatitis B and immunodeficiency]. PMID- 3825101 TI - Heparin added to infused fluids. PMID- 3825102 TI - Elderly patients with dementia. PMID- 3825103 TI - Fecal occult blood screening and evaluation for a positive test. PMID- 3825104 TI - A practitioner's guide to treatment selection in psychiatry. PMID- 3825105 TI - The distribution of services to the underserved. A comparison of minority and majority medical graduates in California. AB - We assessed the belief that minority physicians are more likely to serve traditionally underserved minority populations by examining the medical practice profiles of minority and majority physicians who graduated from seven California medical schools in 1974 and 1975. The results indicate that minority graduates are more likely to locate their practices in areas with health care personnel shortages (53%) than are majority graduates (26%). Minority physicians had a higher proportion of Medicaid or Medi-Cal patients, and they saw a greater percentage of minority patients (60%) than did majority physicians (21%). We conclude that minority graduates of US medical schools, at least those from California, serve traditionally underserved populations to a greater degree than do their majority graduate colleagues. These findings lend strong support to the contention that aggressive affirmative action programs by medical school admission committees serve the important utility function of improving the distribution of medical services. PMID- 3825106 TI - Nora's 'living will'. PMID- 3825107 TI - Increased vertebral bone mineral in response to reduced exercise in amenorrheic runners. AB - Seven female runners found to have exercise-induced amenorrhea and decreased bone mineral were reevaluated after 15 months. During the 15-month period, four runners took supplemental calcium and reduced their weekly running distance by 43%, resulting in an average 5% increase in body weight, increased estradiol levels and eumenorrhea. Bone mineral content increased from 1.003+/-0.097 to 1.070+/-0.089 grams per cm.(2) Three runners continued to have amenorrhea, with no change in running distance or body weight. Estradiol levels remained abnormally low and there was no significant change in the bone mineral content, although all three took supplemental calcium. We found that early osteopenia associated with exercise-induced menstrual dysfunction improved when runners reduced their running distance, gained weight and became eumenorrheic. PMID- 3825108 TI - Iodine absorption after topical administration. AB - Absorption from povidone-iodine preparations after topical administration has been reported to be negligible, but an elderly woman had increased serum iodine levels with possible metabolic complications after povidone-iodine solution was applied to decubitus ulcers. PMID- 3825109 TI - Visual hallucinations. Clinical occurrence and use in differential diagnosis. AB - Visual hallucinations occur in diverse clinical circumstances including ophthalmologic diseases, neurologic disorders, toxic and metabolic disorders and idiopathic psychiatric illnesses. Their content, duration and timing relate to their cause and provide useful differential diagnostic information. Hallucinations must be distinguished from delusions and confabulation. A systematic approach to differentiating among hallucinatory syndromes may improve diagnostic accuracy. PMID- 3825110 TI - Occult carbon monoxide poisoning. AB - A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells. PMID- 3825112 TI - Diet and cancer--should we change what we eat? PMID- 3825111 TI - Gastrointestinal manifestations of the acquired immunodeficiency syndrome. AB - In addition to abnormalities in systemic immune function, patients with the acquired immunodeficiency syndrome (AIDS) and the pre-AIDS syndromes have significant abnormalities in the distribution of T-cell subsets in the intestinal tract. Such immune deficits predispose such patients to opportunistic infections and tumors, many of which involve the gastrointestinal tract. For example, Candida albicans often causes stomatitis and esophagitis. Intestinal infections with parasites (Cryptosporidium, Isospora belli, Microsporidia) or bacteria (Mycobacterium avium-intracellulare) are associated with severe diarrhea and malabsorption, whereas viruses like cytomegalovirus and herpes simplex virus cause mucosal ulcerations. Clinically debilitating chronic diarrhea develops in many AIDS patients for which no clear cause can be identified. Enteric pathogens like Salmonella and Campylobacter can be associated with bacteremias. Kaposi's sarcoma and lymphoma involving the intestinal tract are now well-recognized complications of AIDS. Although AIDS is not associated with a pathognomonic liver lesion, opportunistic infections and Kaposi's sarcoma or lymphoma may involve the liver. PMID- 3825113 TI - Psittacosis. PMID- 3825114 TI - Nine episodes of infective endocarditis in one patient--a new record. PMID- 3825115 TI - Use of botulinum toxin. PMID- 3825116 TI - Nonindigents in the AHCCCS Plan. PMID- 3825117 TI - Postdefibrillation idioventricular rhythm--a salvageable condition. AB - While patients who present with a pulseless idioventricular rhythm have a dismal prognosis, such a rhythm following electrical defibrillation from ventricular fibrillation (VF) may have an entirely different clinical significance. By reviewing the cases of 100 consecutive patients with prehospital ventricular fibrillation, we found the following: Subsequent development of field pulses, survival to hospital admission and hospital discharge in 49 patients who initially had pulseless idioventricular rhythm following defibrillation were statistically significantly worse (P<.05) than for 20 patients successfully defibrillated into any other organized rhythm. They were statistically significantly better, however, than for 25 patients who failed to achieve any organized rhythm in the field. Outcomes were statistically no different in 40 patients who received standard advanced cardiac life support drug therapy for pulseless idioventricular rhythm after defibrillation than in 9 patients who spontaneously progressed to another rhythm before drug therapy could be given. These findings suggest that pulseless idioventricular rhythm may be a transient recovery rhythm following defibrillation from prehospital VF, that it can in this circumstance be associated with a good outcome in a reasonable number of patients and that a short trial of cardiopulmonary resuscitation only, without immediate drug therapy, may be appropriate in these patients. PMID- 3825118 TI - Cheyletiella blakei, an ectoparasite of cats, as cause of cryptic arthropod infestations affecting humans. AB - Cheyletiella blakei, an ectoparasitic mite of domestic cats, can cause an extremely annoying, persistent and pruritic dermatosis of obscure origin (cryptic infestation) in susceptible persons having close contact with infested cats. Although the prevalence of cheyletiellosis in humans and cats appears to be low, evidence of its occurrence in California is increasing. Cheyletiellosis is often underdiagnosed in both its natural host and in humans. The small size of the mite, lack of publicity about the disease, frequent absence of symptoms in infested cats and failure to recover the mite from humans contribute to its delayed recognition. When C blakei or other mites are suspected of being the cause of a dermatosis, medical entomologists may help to hasten the diagnosis by examining the patient's physical surroundings, potential vertebrate hosts and other sources for the presence of mites. After C blakei has been eliminated from cats with an appropriate pesticide, the disease in humans is self-limiting. PMID- 3825119 TI - A program to provide hepatitis B immunoprophylaxis to infants born to HBsAg positive Asian and Pacific Island women. AB - Between January 1, 1984, and December 31, 1985, there were 545 women from Asia and the Pacific Islands who gave birth to a total of 572 infants at Highland General Hospital in Oakland, California (accounting for 20% of all deliveries at that hospital). For countries having more than ten women giving birth during the study period, the percentage of women screened prenatally for HBs antigen (Ag) ranged from a high of 100% (Laos) to a low of 54% (Philippines). HBsAg-positivity rates ranged from a high of 21% (Tonga) to a low of 0% (India). A total of 52 infants was born to 49 HBsAg-positive mothers, and 40 (77%) of the infants received hepatitis B immune globulin (HBIG) within 12 hours of birth. While 80% of the infants received HBIG and at least one dose of hepatitis B vaccine, only 35% received the recommended schedule of HBIG and three doses of vaccine. PMID- 3825120 TI - Issues in Latino health care. PMID- 3825121 TI - What about 'private practice'? PMID- 3825122 TI - Is there an exercise RDA for health? PMID- 3825123 TI - Cardiac failure in the peripartum period due to myopathy of unknown cause. PMID- 3825124 TI - Stress-induced cessation of lactation. PMID- 3825125 TI - Peripartum cardiomyopathy--successful treatment with cardiac transplantation. PMID- 3825126 TI - Lysosomotropic agents in AIDS treatment. PMID- 3825127 TI - Concept of cognitive versus procedural. PMID- 3825128 TI - Greater awareness of sulfite allergy needed. PMID- 3825129 TI - Practical management of common AIDS-related medical problems. PMID- 3825130 TI - Double vision in a patient with lymphoma. PMID- 3825131 TI - Factors associated with pedestrian-vehicle collision injuries and fatalities. AB - Data from Washington State police records of pedestrian-vehicle collisions were used to tabulate injury and fatality rates for 1981 to 1983 and to investigate event characteristics associated with the occurrence of fatalities. Case-fatality rates are seen to be relatively higher when there is decreased visibility due to fog, lack of lighting or dark color of pedestrian clothing. Fatality rates from death certificate data for the same time period were compared with the police reported rates. For children younger than 5 years, fewer cases of pedestrian death are reported by police than by death certificate, because a large proportion of fatal injuries (27%) is not traffic related or occurs at home (46%) in the garage or driveway. PMID- 3825133 TI - [Why do patients with hypertension fail to take advantage of medical services?]. PMID- 3825132 TI - Rising malpractice premiums and obstetric practice patterns. The impact on family physicians in Washington State. AB - All 853 active members of the Washington Academy of Family Practice were surveyed in the summer of 1985 to determine the impact of rising malpractice premiums on patterns of obstetric practice. Of the 685 physicians who responded, 61% are currently practicing obstetrics. The median number of deliveries per year was 29, with a range of 1 to 130 deliveries per physician. Younger physicians, rural physicians and those in group practice were more likely to practice obstetrics than older, urban physicians in solo practice. Of the 266 respondents not currently practicing obstetrics, 77% had discontinued obstetric practice within the past five years-half because of issues related to professional liability. Of those practicing obstetrics, 50% stated that they would cease obstetric practice if malpractice premiums rose to $12,000. PMID- 3825134 TI - [Clinical experiences with the surgical treatment of aorto-iliac occlusion]. PMID- 3825135 TI - [Histoclinical evaluation of cervical polyps]. PMID- 3825136 TI - [Psychosocial risk factors and their significance in the etiology of tuberculosis]. PMID- 3825137 TI - [Biological aspects of therapeutic procedures in conservative dentistry]. PMID- 3825139 TI - [A case of calculus of the palatine tonsil]. PMID- 3825138 TI - [Post-traumatic acute pancreatitis complicated by a cyst]. PMID- 3825140 TI - [Saltpeter poisoning]. PMID- 3825141 TI - [Current aspects of the diagnosis and treatment of obesity]. PMID- 3825142 TI - [Calcinosis of the mitral ring]. PMID- 3825143 TI - [Early complications of thyroidectomy in patients with increased surgical risk]. PMID- 3825144 TI - [The course of labor in women after psychopreventive prenatal care]. PMID- 3825145 TI - [Microflora and bile acids in the duodenal juice in children with lambliasis]. PMID- 3825146 TI - [Retained teeth]. PMID- 3825147 TI - [Complications of gastric lymphoma]. PMID- 3825148 TI - [Pancreatic pseudocysts in children]. PMID- 3825149 TI - [Polycystic renal dysplasia coexistent with extensive congenital hydronephrosis in a newborn infant]. PMID- 3825150 TI - [Sporadic ornithosis in a parrot breeder]. PMID- 3825151 TI - [A case of multiple sclerosis with atrophy of the occipital lobes]. PMID- 3825152 TI - [Etiology and treatment of post-traumatic torticollis]. PMID- 3825153 TI - [Clinical significance and treatment of supraventricular paroxysmal tachycardia]. PMID- 3825154 TI - [Liver resection of hematogenous and infiltrating metastases]. AB - Of a total of 245 resections for hepatic metastases 124 operations were performed for hematogenic metastases and 36 for infiltrating metastases in continuity with the primary tumour. This group of so-called "major hepatic resections" is analysed. The series comprises 83 male and 77 female patients, mean age 62.2 years. There were 85 resections of the right lobe (39 of those with intrahepatic extension to the left), 45 right) and 30 atypical hepatectomies (at least bisegmentectomies). Hematogenic hepatic metastases: 80 resections of hepatic metastases following colorectal carcinoma, 15 following cancer of the stomach and esophagus, 12 after non-gastrointestinal malignant tumours, 4 resections after unknown primary cancer (44% solitary, 32% monolobar multiple, and 24% bilateral metastases); synchronous operations were performed in 32% of the patients, in 19% so-called interval surgery (mean 7.4 weeks), and in 49% metachrone surgery (mean 30 weeks). During 1983 and 1985 our morbidity rate amounted to 10% and the letality rate to 7%, as compared to 17% morbidity and 15% letality in the period 1965-1983. In both periods, septic postoperative complications outnumbered all other causes. The mean survival rate after colorectal carcinoma was 20 months, after non-gastro-intestinal malignant growth 19 months, after carcinoma of the stomach as well as after malignant biliary tract diseases 5 months. The three year survival rate of colorectal carcinoma amounts to 30%, the five year survival rate to 15% including all metastatic stages. The results of interval and metachrone resections in forms of survival rates are clearly better than the results of synchronous resections with a mean survival time of five months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825155 TI - [Autologous venous bypass in the therapy of arterial occlusive disease of the femoropopliteal area: long-term results]. AB - The outcome of 532 femoro-popliteal vein grafts performed electively during the years 1970 to 1985 for obliterative arterial disease, was analyzed using the documentation-system of the Austrian Society for Vascular Surgery, as well as SAS and BMDP-software on an IBM 4381 computer of the Medical Faculty. The probability of function was estimated according to the Kaplan-Meier method, statistical differences were checked with Breslow's and Mantel's test, the proportional hazards regression model (Cox) was used to elucidate the influence of different risk factors on each own and in combination of each other. In the univariate analysis, the preoperative clinical status was found to be of prognostic significance, but technical details such as intraoperative as well as postoperative arteriography or site of the distal anastomosis were not important. A postoperative coumarine treatment had no demonstrable impact on graft function, but positively influenced the probability of patient survival. Taking into account the factors found to be of significance in the univariate analysis (e.g. set of factors: site of distal anastomosis, diabetic state and smoking habits) were analyzed using the proportional hazards regression model but were found of no major influence. The factors preoperative clinical status, patients age, and coumarine therapy significantly influenced the probability of patient survival, but diabetes mellitus and smoking were found to be not important. PMID- 3825156 TI - [Parathyroidectomy and autotransplantation]. AB - Total parathyroidectomy, immediate heterotopic autotransplantation and cryopreservation of parathyroid tissue was introduced in the surgical treatment of drug-resistant renal hyperparathyroidism (rHPT) in 1980 and was performed in 36 patients. During 34 initial bilateral cervical explorations including transcervical thymectomy 142 glands were removed (orthotopic localization: 84%; heterotopic localization: 16%). Supernumerary glands were found in 6 patients (18%; thymus: 3; cervical fatty tissue: 4). The elevated parathyroid metabolism was successfully corrected, in all, but one patient in whom only three glands were removed. Biochemical and clinical follow-up examinations showed a restitution of the symptoms in 88% 3 to 79 months postoperatively. Graft dependent recurrence of rHPT was diagnosed in one patient. Normocalcemia was reestablished by partially excising the grafted tissue under local anesthesia. Graft-dependent hypoparathyroidism was suspected in one patient because of low levels of serum calcium and parathyroid hormone. Late graft failure was not observed during the follow-up period. None of the patients required delayed autotransplantation of cryopreserved tissue. PMID- 3825157 TI - [Status and tasks of biometry in clinical and experimental research]. AB - The paper starts with reflections on the role of biometry in clinical research. Factors which might influence the efficacy of biostatistical consulting of clinicians are dealt with. Primarily, advantages and disadvantages of various behavioral patterns between the medical investigator and the biometrician are discussed. The recruitment and training of new biometricians, organizational structures and material foundations of clinical biometry are regarded as further factors influencing a constructive working practice. The paper ends with considerations on the future of the discipline. PMID- 3825158 TI - [Consequences of after-care in colorectal cancer]. AB - Results of a computer supported follow-up-program on patients with colorectal cancer are presented. Between 1978 and 1985 1024 patients underwent these program, the drop-out-rate was 18%. 231 recurrences in 137 patients were discovered (40% local recurrence, 30% liver metastases and 30% others). 54% of patients with local recurrence and 43% with liver metastases were free of symptoms. Radical surgery was performed in 47% of local recurrences and in 24% of liver metastases. The three year survival rate after radical surgery for recurrence amounted to 28% for local recurrences and to 31% for liver metastases. PMID- 3825159 TI - [Value of the oral glucose tolerance test]. AB - Although there has been repeated criticism regarding the Oral Glucose Tolerance Test (OGTT), we still do not know an alternative procedure with a better evaluability than the OGTT which can be carried out as easily as that. Radioimmunological tests to determine insulin as well as C peptides will not be able to give a definite distinction between a marginal "diabetic" and an "eumetabolic", nor will the OGTT. Considering certain criteria when carrying out and analyzing the OGTT, however, it might as well be possible to restrict the area of "disturbed glucose tolerances". PMID- 3825160 TI - [Pharmacologic modification of diastolic ventricular function in patients with coronary heart disease]. AB - The influence of 2 different cardiac pharmaceutics on the diastolic ventricular function (VF) in patients with ischaemic heart disease was examined. Diltiazem, a calcium antagonist, and k-strophanthine led to a reduction of time constant T of the isovolumic relaxation from 49 +/- 9 to 39 +/- 7 msec (p less than 0.005), to an increase of the quotient dt/T from 2.4 +/- 0.5 to 3.0 +/- 0.6 msec (p less than 0.01), to an increase of the peak filling rate (PFR) from 2.08 +/- 0.65 EDV/sec to 2.34 +/- 0.67 EDV/sec (p less than 0.001), to an increase of the filling fraction (FF) from 30 +/- 12% to 33 +/- 15% (p less than 0.001). The ejection fraction (EF) and the maximum rise of pressure dp/dt did not change significantly. After k-strophanthine T was reduced from 49 +/- 7 to 46 +/- 11 msec (p less than 0.05). The increase of dt/T from 2.5 +/- 0.4 to 2.7 +/- 0.4 msec was not significant. The PFR with 2.16 +/- 0.7 and 2.08 +/- 0.8 EDV/sec and the FF with 32 +/- 14 and 34 +/- 18% did not show any significant changes. The EF rose from 52 +/- 15 to 55 +/- 16 (p less than 0.05) and dp/dt rose from 1855 +/- 468 to 2124 +/- 591 (p less than 0.05). Diltiazem improves the diastolic VF without deteriorating the systolic VF in patients with ischaemic heart disease. K strophanthine improves the systolic VF and the velocity of the isovolumic relaxation. The other variables of the diastolic VF did not show any directed changes. PMID- 3825161 TI - [Antithrombin III, the most important inhibitor of hemostasis. Physiology and clinical aspects]. AB - The physiologic regulation of hemostasis is the result of several factors including antithrombin III as the most important one. Deficiencies of antithrombin III lead to an increased risk of thromboembolic diseases. PMID- 3825162 TI - [Effect of diet and exercise therapy on body weight, performance and lipid metabolism of post-infarct patients during a 4-week rehabilitation program]. AB - From a total of 130 male patients following myocardial infarction a symptom limited stress cycling ergometer was carried out at the beginning as well as at the end of a 4-week rehabilitation, as well as controls of body weight, the Broca Index, and Triglyzeride, Cholesterol, HDL-Cholesterol, LDL-Cholesterol and VLDL Cholesterol fractions. With regard to the Broca-Index, the patients received respectively a 1600 Kcal normal diet (Broca-Index 1.00, n = 34), a 1100 Kcal reductional diet (Broca-Index 1.20, n = 67) and a 600 Kcal reductional diet (Broca-Index 1.32, n = 29). During the whole duration of their stay, the patients underwent a program of physical exercise related to their personal physical performance, which consisted of gymnastic, cycle training, swimming (facultative) and physical training. The improvements of the physical performance were statistically significant, and consisted of 19.4% (normal diet), 18.2% (1100 Kcal diet), namely 11.3% in the 600 Kcal diet group. Weight, Broca-Index and parameters of fat-metabolism remained unchanged under a normal diet. In both reductional diet groups a significant reduction of weight and Broca-Index as well as all blood-fat-metabolism parameters were noted, with the exception of the HDL Cholesterol fraction, which remained unchanged. Statistical significant correlations between weight reduction, namely increases of physical performance and parameters of blood-fat-metabolism were only noted in cases of a 600 Kcal diet. The noted changes in weight, physical performance and blood-fat-metabolism can be considered as a reduction of the cardiovascular risk profile. PMID- 3825163 TI - [Successful treatment of autoimmune hemolytic anemia with cyclosporin A]. AB - A sixty-year-old patient suffering from an idiopathic immunohemolytic anemia was treated by 3 plasma exchanges (with 31 exchange-volume) and following by Ciclosporin A (3 mg/kg body weight) after the monotherapy of prednisone has been unsuccessful. Ciclosporin A promptly effected a continuous remission of the autoimmune hemolysis. The mode of action of Ciclosporin A in immunhemolytic anemia depending on incomplete warm-auto-antibodies is discussed. PMID- 3825164 TI - [Use of a personal computer system at a cardio-pulmonary function laboratory for text processing, graphics and statistics]. AB - To improve the off-line data processing a personal-computer-system was set up, including a HP-85A desk-computer with a dual-disc-drive, a plotter, a printer and a digitizer (graphical tablet). The application of the personal-computer-system is focused on the work up of medical reports and records, transformation of physiologic data into graphics (ergometric stress testing, myocardial function curve, lung mechanics) and on speeding up the flow and distribution of information. Further applications include a literature storage and retrieving system, the quantitative analysis of left ventricular wall motion by two dimensional echocardiography and a graphic aided system for medical statistics. Hopefully the data processing at a cardio-pulmonary function laboratory will lead to a better definition of diseased states in quantitative terms and by this support the rational basis for medical intervention. Slow communication of medical information is a critical factor in the practice of high quality medical care (cost/efficiency). PMID- 3825165 TI - [Effect of endoscopic hemostasis using an electrohydrothermic probe on the course of hemorrhaging stomach and duodenal ulcers]. AB - This is a report on the application of the EHT-probe in 94 patients with bleeding ulcers (stomach and duodenum) during a period of three years (1981-1983). The effect upon the course of disease and mortality is discussed. A permanent termination of bleeding could be achieved in 71% of cases (59 patients of a total of 94 patients). The data are compared with a former period (1978-1980) without the possibility for endocopic treatment of bleeding ulcers. By using the EHT probe less emergency operations were performed (19.1% compared to 36.4 during the earlier period). The over-all mortality decreased from 27.3% (1978-1980) to 17.7% (1981-1983). These favourable results are promoting the active intervention by endoscopic treatment with a electro-hydrothermic probe. PMID- 3825166 TI - [Possibilities for treating tumor patients at a general internal medicine department]. AB - The first medical department of the Poliklinik is part of a community hospital in Vienna. Out of 1500 patients admitted every year, in about 65 cases a malignant disorder is diagnosed for the first time. Recent developments in chemotherapy of solid tumors and hematologic disorders suggest the necessity to establish a specially trained oncologic working group. In this study the patient material of two years (1982-1984) is analysed. The importance of an oncologic working group integrated to the staff members of the general department of internal medicine is discussed. It is pointed out, that in about 30% of cancer patients no specific therapy was initiated due to the far advanced stage of disease and/or due to the elderly patients. Future developments should include a more intensive cooperation with the surgical departments in order to establish a careful follow-up of patients after surgical intervention and to ensure a chemotherapeutic treatment at an earlier stage of disease. PMID- 3825167 TI - [Syncope, introduction of a diagnostic program for rational assessment]. AB - The possibilities and problems of the diagnostic procedure to evaluate a patients presenting with a syncope of unknown origin are discussed. With awareness of the cost/efficiency ratio the presented scheme of investigation should identify casual factors of the long term prognosis of patients. PMID- 3825168 TI - [The significance of arterial hypertonia and cerebral vessel wall changes within the scope of hemorheologic changes in ischemic insult]. AB - The frequency of vascular risk factors and of hemorheologic alterations has been investigated in 163 patients with ischaemic cerebrovascular disease and was related to angiographical findings. Hemorheologic abnormalities were observed in 57% of the patients but lesions of the cerebral vessel walls displayed by angiography were present in 85%. The leading risk factor was hypertension which was diagnosed in 42% of the patients, however, their hemorheologic profile did not differ significantly from the normotensive stroke patients. Indeed, the frequency of hypertension was significantly higher in patients with severe vessel wall lesions. The important role of hemorheologic disturbances seems to be the deterioration of the hemodynamic situation provoked by vessel wall lesions. PMID- 3825169 TI - [Hemorheologic therapy applications in coronary heart disease]. AB - A significant correlation was found between heightened plasma viscosity and increased red blood cell aggregation and the severity of coronary artery disease. At low shear rates and exhausted vasomotion these rheological factors can cause a reversible loss of fluidity. The reduced fluidity may induce a limitation in microcirculatory flow due to the viscus resistance. Rheological treatments aim at restoration of impaired perfusion by decreasing plasma viscosity and thus diminishing red blood cell aggregation. Further therapeutic measures tend to improve red blood cell deformability. Because of limited coronary reserve in coronary artery disease hemodilution therapy is contraindicated except the cases with polyglobulia. Thrombolytic therapy in acute myocardial infarction causes a significant reduction of plasma viscosity and red cell aggregation for at least 72 hours. This improvement in blood fluidity may beneficially influence the reperfusion of ischemic areas. A therapy with orally active hemorheological drugs (pentoxifylline and buflomedil) can be discussed as an additive treatment in severe angina pectoris refractory to specific medical therapy, since these drugs increase fluidity and inhibit platelet aggregation. The defibrination may cause thrombotic and bleeding complications in the early phase of treatment. Coronary small vessel disease represents a rare type of coronary heart disease. This disease is defined by normal epicardial coronaries and reduced coronary artery reserve. In disorders of coronary microcirculation with abnormal rheology (Waldenstrom's macroglobulinemia) rheological treatment is a rational and causal therapy. PMID- 3825170 TI - Changes in blood filterability in cerebrovascular accidents. AB - Patients with acute cerebrovascular accidents (CVA) exhibit pathological changes of various hemorheological factors in dependence of severity of the clinical condition. Increase in hematocrit, rise in blood viscosity and impairment of red cell deformability together with increase in plasma proteins, especially of fibrinogen and inflammatory proteins, leukocytosis, hemoconcentration and presence of various risk factors affect cerebral blood flow on microcirculatory level and produce a prethrombotic situation. Deteriorated blood filterability may be regarded as an indicator of severity and prognosis of CVA. Studies of red cell filterability in 100 patients with severe recent CVA and 52 patients with moderate CVA showed in comparison to matching controls a progressing deterioration of filtration up to day 8 whereafter an improvement started in recovering patients. Febrile patients presented clearly more filterability deterioration than non-febrile subjects. Hyperviscosity states seem to respond best to normovolemic hemodilution, whereas red cell deformability and aggregation can be approached by various drugs such as pentoxifylline, piracetam etc. Follow up of blood filtration in CVA patients is of significant prognostic value. PMID- 3825171 TI - [The course of hemorheologic parameters in acute cerebral ischemia]. AB - In 74 patients with acute cerebral ischaemia determinations of hemorheologic parameters including hematocrit, red cell filtration, platelet aggregation, fibrinogen and blood viscosity were carried out and performed at first within three hours following the acute event and before treatment was started. Control measurements were performed 7, 14, 28 days and 6 months later. In the acute phase all parameters measured were significantly increased and in the following 6 months hematocrit and fibrinogen were responsible for the then still increased blood viscosity. PMID- 3825172 TI - [Hemorheologic findings in diabetes and their clinical relevance]. AB - Diabetics mostly display a deterioration of blood flow properties. Studies of various hemorheological factors in 163 diabetics (96 females, 67 males; 52 subjects with uncomplicated and 49 with proliferative retinopathy) disclosed in comparison to 79 matched controls: Concentrations of macromolecular proteins, especially of fibrinogen, were raised independently of actual diabetic metabolic situation; this was linked with an increase in plasma viscosity and in erythrocyte aggregation, specially pronounced in patients with renal affection. Erythrocyte flexibility assessed by filtration testing was deteriorated in dependence of metabolic control, impairment increasing in patients with progressing diabetic proliferative retinopathy. Duration of diabetes, type of diabetes and of treatment exert only indirect influence on blood rheology. Risk factors such as hypertension, arteriosclerosis and smoking have an aggravating effect. The complex disturbances of blood fluidity can contribute to the development of microcirculatory blood flow disorders, whereby, of course platelet hyperreactivity and hypercoagulation come into play, too. Especially a good diabetes control is a premise for an efficient blood flow promoting rheologic therapy. PMID- 3825173 TI - Relationship between paracetamol binding to and its oxidation by two cytochromes P-450 isozymes--a proton nuclear magnetic resonance and spectrophotometric study. AB - From the hepatic cytochrome P-450 isozymes b and c isolated from rats treated with phenobarbital and 3-methylcholanthrene respectively, only cytochrome P-450c was found to be active in the oxidation of paracetamol, in the presence of glutathione ultimately leading to the formation of the 3-glutathionyl conjugate. Paracetamol interacted with both cytochrome P-450b and c, as shown by difference spectrophotometry. Cytochrome P-450b was found to have a higher affinity for paracetamol than cytochrome P-450c and demonstrated a type I spectral change, whereas in the case of cytochrome P-450c a reverse type I spectral change was observed. Proton n.m.r. longitudinal relaxation rate measurements revealed that in the case of cytochrome P-450c, paracetamol was orientated with its phenolic hydroxyl group in closest proximity to the central haem iron ion. In the case of cytochrome P-450b, the acetylamino group of paracetamol most closely approached the haem iron ion. PMID- 3825174 TI - Biotransformation of methyl parathion by human foetal liver glutathione S transferases: an in vitro study. AB - The role of human foetal liver glutathione S-transferases in the detoxification of methyl parathion was investigated. Glutathione S-transferases were partially purified by affinity chromatography utilizing reduced glutathione as the ligand coupled to epoxy-activated Sepharose 4B. This resulted in the isolation of material with an average activity (mean +/- S.E.) of 58.90 +/- 4.83 mumol 1 chloro-2,4-dinitrobenzene conjugate formed/min per mg, representing a purification of 70-fold. These partially purified foetal liver transferases catalysed the metabolism of methyl parathion exclusively to desmethyl parathion via O-dealkylation. High-performance liquid chromatography, radiometric analysis of the enzymic reaction, and co-chromatography with reference standard on thin layer chromatography confirmed the sole metabolite as desmethyl parathion. The range of foetal liver activity towards methyl parathion was from 30 to 122 nmol desmethyl parathion formed/min per mg. Analysis of the kinetic parameters of three partially purified foetal liver preparations with gestational ages of 14, 16 and 21 weeks resulted in Km values for methyl parathion of 0.24, 0.38 and 0.86 mM, respectively; whereas, the Km values assessed for glutathione were 0.20, 0.10 and 0.18 mM. The ability of human foetal liver glutathione S-transferases to catalyse the metabolism of methyl parathion exclusively to desmethyl parathion via O-dealkylation represents a major qualitative biochemical difference from the rat-liver isozymes. PMID- 3825175 TI - Reaction of 1-amino- and 1-chlorophthalazine with mammalian molybdenum hydroxylases in vitro. AB - 1-Amino- and 1-chlorophthalazine were tested for possible substrate activity with partially purified rabbit-liver aldehyde oxidase and bovine-milk xanthine oxidase. 1-Chlorophthalazine was a more efficient substrate than the parent compound, phthalazine, with either aldehyde oxidase or xanthine oxidase. The oxidation product of 1-chlorophthalazine was identified as 4-chloro-1-(2H) phthalazinone on the basis of chromatographic, infra-red and mass-spectral data. 1-Aminophthalazine was oxidized by aldehyde oxidase to 4-amino-1-(2H) phthalazinone but was a competitive inhibitor of xanthine oxidase. Kinetic studies at different pH values indicated that, in each case, it is the unprotonated form of 1-aminophthalazine that reacts with the molybdenum hydroxylases. PMID- 3825176 TI - Effect of structural alterations on the biotransformation rate of glucocorticosteroids in rat and human liver. AB - The effect of structural alterations on the biotransformation rate of glucocorticosteroids (GCS) by rat- and human-liver 9000 g supernatant fraction was studied. Insertion of a 16 alpha-hydroxy group in the prednisolone molecule (16 alpha-hydroxyprednisolone) was found to decrease the rate of biotransformation. Substitution of the 16 alpha,17 alpha-hydroxy groups with a symmetric acetal (in, for example, desonide) or especially a non-symmetric acetal (in, for example, budesonide), enhanced the biotransformation rate several-fold, particularly in human liver. Differences in the rates of metabolism in rat and human liver were observed. Hydrogenation of the 1,2-double bond in prednisolone and budesonide (hydrocortisone and 1,2-dihydrobudesonide) enhanced the biotransformation rate nine-fold in rat liver but only two-fold in human liver. Fluorination of the steroid nucleus in 6 alpha- and 9 alpha-positions enhanced the biotransformation rate several-fold in human liver, but in rat liver fluorination marginally decreased the rate of biotransformation. These in vitro results correlate well with available data on the first-pass liver metabolism of the studied GCS. This indicates that in vitro data can be useful in predicting oral bioavailability of GCS. PMID- 3825177 TI - Disposition of new sulphur-containing 2-(chloroethyl)nitrosoureas in rats. AB - N'-(2-Chloroethyl)-N-[2-(methylsulphinyl) ethyl] and N'-(2-chloroethyl)-N-[2 (methylsulphonyl) ethyl]-N and N'-nitrosoureas (CMSOEN1, CMSO2EN1, CMSOEN2 and CMSO2EN2) are new nitrosoureas derived from cysteamine. Two of them (CMSOEN2 and CMSO2EN2) have shown excellent efficacy against several murine tumours. The inactive agents (CMSOEN1 and CMSO2EN1) display low alkylating activity but high carbamoylating activity. In contrast, the active agents (CMSOEN2 and CMSO2EN2) are strong alkylating agents but relatively weak carbamoylators. The disposition of CMSOEN2 and CMSO2EN2 was studied in rat, using two differently labelled species of each compound, administered i.v. (60 mumol/kg). Plasma disappearance, tissue distribution (with the exception of the brain) and elimination of radioactivity are similar for the two compounds similarly labelled. In contrast, these parameters are strongly influenced by the label position used. Plasma disappearance of unchanged CMSOEN2 and CMSO2EN2 follows a first-order kinetic process with the same half-life for both compounds (30-31 min). More unchanged CMSO2EN2 is found in brain compared to its congener (55 nmol/g and 37 nmol/g respectively at five minutes). This is most likely the consequence of the higher lipophilic character of the former compound. The breakdown product 2 chloroethanol was identified in plasma. PMID- 3825178 TI - Sex differences in the production of methaemoglobinaemia by 4-aminopropiophenone. AB - A methaemoglobin former, 4-aminopropiophenone (p-aminopropiophenone, PAPP), which is active only after metabolic activation in vivo, exhibits a sex difference in male Beagle dogs and bitches. Bitches produced more methaemoglobin for a given dose of PAPP than male dogs. The probable reason for this difference was a lower rate of N-hydroxylation in male dogs. PMID- 3825179 TI - The metabolism of [14C]N-ethoxycarbonyl-3-morpholinosydnonimine (molsidomine) in man. AB - [14C]-N-Ethoxycarbonyl-3-morpholinosydnonimine (molsidomine, Corvaton) was administered orally at a dose of 2 mg per subject to eight healthy male volunteers. Maximal plasma concentrations of total radioactivity of 32.4 +/- 6.4 ng equiv./ml (mean +/- S.D.) were detected compared with maximum plasma concentrations of 14.1 +/- 5.9 ng/ml (mean +/- S.D.) of molsidomine. In both cases these were attained at 0.5 h after dosing. From the peak, concentrations of parent drug fell rapidly with a half-life of 1.25 +/- 0.38 h (mean +/- S.D.). In contrast, total radioactivity declined more slowly with a terminal half-life of 138 +/- 42.7 h (mean +/- S.D.). The bulk of the radiolabel was rapidly excreted as metabolites in the urine, with over 85% of the dose recovered in the first 24 h. The main urinary radiolabelled metabolites appeared, from chromatographic evidence, to be similar to those previously identified in animals, namely N morpholinosydnonimine, N-cyanomethylamino-N-(2'-hydroxyethyl)glycine and (N cyanomethylenamino-2-aminoethoxy)-acetic acid. PMID- 3825181 TI - [Special problems of physical therapy in the aged]. PMID- 3825180 TI - [Peculiarities of the functional parameters of performance in late ontogenesis]. AB - The age parameters of physiological characteristic values of the capability of 647 persons doing non-mechanised work in agriculture and of 799 practically healthy machine operators and female machine sewers were determined. Data on the adaptabilities of physiological functions were obtained that are responsible for the activity at physical work. The functional importance of changes of the organism in ontogenesis for maintaining the occupational capability is reviewed. It was found that the nervous system and the muscular system as well as the cardiovascular system restrict the job opportunities of age workers. With self determined pace and rhythm of work the nervous and muscular system of aged people shows long-term capability. PMID- 3825182 TI - [Management of young and middle-aged psychiatric patients in general nursing homes]. AB - The author discusses the international tendency of increasing admission of psychic sick persons of young and medium age to general nursing centres. He modifies the aim of the care for these patients in these centres and points out the specialties of intercourse with that social group (specific behaviour, therapeutic techniques). There are discussed open problems such as cooperation with special psychiatric clinics, possible forming of general nursing centres, quantitative and qualitative stabilization of the members of the staff and scientific questions connect with concentration psychic sick persons in general nursing centres. PMID- 3825183 TI - [Determination of biologic aging within the scope of the Halberstadt Gerontologic Study. 4. Some theoretical and methodologic considerations on the future development of assessment tests]. AB - With regard to the test-set developed by RIES and co-workers for the purpose of determination of the biological age the authors again refer to the necessity of a corresponding catalogue of methods with a view to the measurement of work capacity and of health condition at the age. Theoretic problems concerning the examination of functional parameters are discussed. Proposals to a theory-related continued development of work capacity and of health condition are presented, especially to master common problems of daily life at the age. PMID- 3825184 TI - Progredient subclinical changes of the behaviour. AB - The author describes serious subclinical deviations of behaviour in longevity (80 90 years) in connection with 36 cases of a homogenous group of aged persons. In 4 cases she observed normal behaviour, in 13 cases the syndrome of loss of prestige, in 7 cases milder anomalies of the behaviour, in 12 cases grave deviations. The matter of the present article is to review the graver subclinical anomalies. They include unjustified intermittent depression, pathological avarice, forgetfulness regarding the daily routine (putting away articles for personal use, etc.). At the same time there is the maintained interest in and knowledge of the domain of sciences, music, latest scientific results; but also temporary uncritical behaviour, rages in consequence of which the aged person becomes amnesic before long. The deviations described are of temporary character at first (in cerebral, vascular decompensation, exhaustion). When anatomic alterations develop in the neurocytes, they will become manifest. PMID- 3825185 TI - [Professional activity in retirement--a sociologic study of employment in agriculture and trade in the Schwerin district]. AB - Basic principles on employment at the age of retirement having been explained beforehand the results of interviews with 700 employers concerning motivation and conditions in relevance are recorded. The employment rate in the age-group under consideration is discussed as dependent on the historical level of the society, the conclusions aiming at goals to be fulfilled in enterprises as well as in the society as a whole. PMID- 3825186 TI - [Criteria for determining the need for social health care]. PMID- 3825187 TI - [Effectiveness of retirement and nursing homes in the complex management of elderly citizens in neighboring residential areas]. PMID- 3825188 TI - [Aspects of the detection of psychological stress conditions in the elderly]. PMID- 3825189 TI - The application of protein concentrates from locally available legumes in the development of weaning foods. AB - The effect of mixing different sources of vegetable proteins from legumes in the preparation of infant weaning foods was investigated. Melon, cowpea and soya as sole protein sources or as a mixture were fed to 60 albino rats. A milk powder based commercial product (Cerelac) was used as control diet. The mixture of the vegetable protein diet compared favorably with the control diet in terms of growth rate, protein efficiency ratio (PER) and net protein ratio (NPR) and also ensured optimum nitrogen content in liver, kidney and muscle tissues. In contrast the use of individual protein sources failed to support satisfactory growth and were inferior to those in animals fed with the control or mixed diets. It was thus concluded that in the developing countries an application of such a mixture of vegetable proteins may be suitable in the preparation of weaning foods. PMID- 3825190 TI - Effect of carbon and nitrogen sources on the chemical composition of lipids of Rhizopus delemar. AB - Soy bean extract with glucose or oleic acid in the growth medium of Rhizopus delemar affected the production of higher values of biomass, total lipids and total glycerides than when ammonium nitrate was used as a source of nitrogen. The highest amounts of biomass (12.35 g/l) and total lipids (310 mg/g dry biomass) were attained in glucose-grown mycelia. The high proportions of total glycerides and unsaturated fatty acids in lipids of Rhizopus delemar suggest the utilization of such lipid material for nutritional and industrial purposes. PMID- 3825191 TI - Effect of proteins on availability of zinc. II. Bioavailability of zinc from casein and whey protein--retention study in young rats. AB - The availability of zinc from two semi-synthetic diets with isolated whey protein (Wp D) or with isolated casein (Cas D) as protein component (20% W/W) was compared in a 21-day study with growing male rats (initial weight 40 g; 14 animals/group). Zinc concentration in both diets (18 ppm) was adequate to meet the requirements of the animals fed ad libitum. For radiolabeling approximately 13 micrograms 65Zn (= 4 microCi) was given daily by intragastric intubation to each animal. The investigation was designed primarily as a retention study, but also general parameters like weight development, food and water intake, organ weights etc. were registered and the activity of alkaline phosphatase was determined in serum and femur tissue. A significantly higher percentage of 65Zn was retained in the whole body from the Wp D (36.5%) than from the Cas D (31.6%) during the experimental period. The same is valid for the percentage retention of 65Zn in the femur and for the 65Zn concentration in femur and hair as well as for the total zinc concentration (65Zn and non-labeled zinc) of the femur. The other parameters determined were not unequivocally influenced by the protein component of the diet. The study clearly demonstrated that the availability of zinc by the growing rat was better from a diet with whey protein than from one with casein as the protein component. The reason on this phenomenon has to be elucidated by further investigations. PMID- 3825192 TI - [A stepwise method of evaluating sugar substitutes--a preliminary study using enzymes. 3. Carbohydrases from the human jejunal mucosa]. AB - Mixed carbohydrases from human jejunal mucosa were characterized by Michaelis constants and maximal velocities of hydrolysis of 15 disaccharides and disaccharide alcohols, mainly of the glucosylfructose series. The presumed fate of such substances after oral ingestion may be foreseen from the km and vmax data. There is principal agreement that wholesomeness in man and animals as well as energetic utilization of disaccharides and split products correlate well with the enzymological data. Therefore the metabolic fate of sugar substitutes in the human body is partially predictable from such enzymic studies. PMID- 3825193 TI - [Occupational rehabilitation in the agriculture, forestry and farming industries exemplified by the Potsdam district]. PMID- 3825194 TI - [Exposure to dust in plant production]. PMID- 3825195 TI - [General practice evaluation of a psychologico-neurological questionnaire and special psychological follow-up studies in patients exposed to carbon disulfide]. PMID- 3825196 TI - [Physical exertion in the agriculture, forestry and farming industries]. PMID- 3825197 TI - [Use of Fourier analysis in the evaluation of whole and partial body vibration measurements]. PMID- 3825198 TI - [Occupational health measurements on mobile industrial machines using microcomputers]. PMID- 3825199 TI - [Analysis and evaluation of irritating factors acting on the respiratory tract at swine-breeding facilities]. PMID- 3825200 TI - [The European Section of the International Society of Rural Medicine and occupational medicine monitoring of workers in agriculture in East Germany]. PMID- 3825201 TI - [Sample recordings of heart rate in occupational physiologic studies]. PMID- 3825202 TI - [Determination of the size of the study sample in a survey for evaluating physical work load]. PMID- 3825203 TI - [Results of occupational physiologic studies in the pruning fruit trees using pneumatic shears]. PMID- 3825204 TI - [A system for establishing safety coefficients in determining maximum allowable concentrations of volatile substances in the air at the work site]. PMID- 3825205 TI - [Changes in intercellular contact as a parameter of hepatotoxicity of industrial substances]. PMID- 3825206 TI - [Effect of selected solvents on osmotic hemolysis of human erythrocytes]. PMID- 3825207 TI - [Measuring reaction time as a method for assessing the central nervous system stress effect caused by the inhalation of industrial solvents]. PMID- 3825208 TI - [Dose-response relations of dust exposure and lung function in foundry workers]. PMID- 3825209 TI - [Immunologic and clastogenic changes in benzene-exposed workers]. PMID- 3825210 TI - [Results of experimental gerontology with respect to biological age]. AB - Biological age may be defined as the state of the organism as a whole which is characteristic of the respective chronological age. Objective estimates of biological age are usually obtained by multiple regression analysis of a greater number of age parameters. However, this procedure should be based on a firm knowledge of the regularities of multicellular ageing. By means of a long-term study in male rats regularities of biological ageing have been demonstrated using multiple regression analysis, factor analysis and discriminant analysis. The multiple regression model pointed to an exponential relation between chronological and biological age. By factor analysis it has been shown that the change of the parameters represents to various extents primary ageing and system specific secondary ageing. The results of discriminant analysis reveal a change in the ageing pattern during senescence. Consequently, test batteries for the objectivation of influences on the rate of ageing should be adapted to the respective phase of ageing in order to obtain maximum sensitivity. PMID- 3825211 TI - [Thrombocyte substitution. I. Indications and clinical use of thrombocyte transfusion]. AB - The clinical use of the transfusion of thrombocytes, its indication and problems in the long-term substitution of thrombocytes are explained. Out of the side effects the alloimmunisation against antigens of the HLA-system in the long-term substitution is of greatest importance. A substitution of thrombocytes is indicated in the disturbances of formation. The substitution shall be performed prophylactically in the acute leukaemia and aplasing therapy. When an increased destruction of thrombocytes is existing, other therapy principles are important. Recommendations are given for the prophylactic substitution of thrombocytes. The analysis of the transfusion of 320 concentrates of thrombocytes is reported. PMID- 3825212 TI - [Behavior of so-called cardiovascular risk factors in general practice cardiac therapy--results of selected biochemical parameters of probands with suspect cardiovascular findings in a follow-up program of a 5-year intervention study]. AB - Based on a population of defined territories of 280,000 inhabitants, heart patients, morphologically defined by roentgenological findings, were detected, and a representative sample was controlled with differing intervention under conditions of practice in a follow-up-programme of five years. Out of this programme the developments of some so-called (biochemical) risk factors belonging to the metabolical syndrome were evaluated and interpreted in their relation to cardiovascular diseases. The parameters investigated such as lipoprotein flocculation reaction, serum cholesterol, blood glucose and uric acid revealed increases of mean values as well as differences between the sexes and certain age groups during the time of observation. Causal therapeutic measures are discussed as causes of these developments. Significant differences in the cross section analysis which were also established could be confirmed in a longitudinal observation, and their relevance to cardiovascular diseases could thus be verified. PMID- 3825213 TI - [Behavior of contractile and functional cardiac parameters of patients in the early stage of type I diabetes mellitus]. AB - The echocardiographically obtained data for contractility and function of the heart showed that patients with type I diabetes mellitus known up to 1 year at the age of 29 +/- 7 years showed more unfavourable parameters concerning the contraction fraction of the two chambers and the ejection fraction of the left ventricle and had also a larger diastolic diameter of the posterior wall, those patients were compared with persons with healthy metabolism aged 43 +/- 2 years. Since the two groups did not show any evidences as to cardiovascular diseases, the echocardiographic results might be explained as early symptoms of a diabetic cardiopathy. PMID- 3825214 TI - Contribution of pancreatic edema and short-term ischemia to experimental acute pancreatitis in the rat. I. Procedure and pathomorphological investigations. AB - For experimental analysis of pathogenesis of acute pancreatitis a suitable animal model is necessary. The pancreatic (juice) edema and an alteration of cellular energy metabolism are important pathogenetic factors. A partial intrapancreatic edema was induced by stimulating secretion against permanent or temporary obstruction by ductal ligation. Short-term ischemia was used as tool for alteration of cellular energy metabolism. 24 h postoperatively morphological changes were macro- and microscopically investigated. The data show a correlation between duration of ischemia (10-30 min) and the frequency of acute pancreatitis at preexisting juice edema (44-68 percent). With increasing ischemia the morphological alterations (e.g.: necroses of adipose tissue) were enhanced, too. A hemorrhagic necrotizing pancreatitis was rarely observed. In comparison to other experimental models the presented one is characterized by a mostly moderate and light course of acute pancreatitis offering a good tool for elucidation of the very first stages of the pathogenesis. PMID- 3825215 TI - [Determination of the sensitivity of lymphocytes to glucocorticoids- differentiation in high, normal and low responders]. PMID- 3825216 TI - [Differentiated pharmacologic modification of cytotoxic effector mechanisms]. PMID- 3825217 TI - [Clubbed fingers--a symptom]. PMID- 3825218 TI - [Decrease in immunoreactivity in melanoma. Analysis of DNCB tests in the literature]. AB - It is generally accepted that cell mediated immunity is impaired in melanoma patients. Several studies, however, could not confirm this thesis, especially in early malignancy. Therefore, it was the aim of our study to evaluate the results of the DNCB skin tests in melanoma patients of the literature. DNCB sensitization lineally decreased with increasing tumor progression. The difference of the sensitization rates between controls and stage I patients and between melanoma stage I and stage II was significant (p less than 0.001). The difference between stage II patients and stage III melanoma was apparent; statistical analysis, however, could not be done, because the results of three out of six evaluated studies where contradictory. The results confirm the thesis of impaired delayed type immunity in the course of tumor progression and support the therapeutic approaches of immune modulation in tumor patients: BCG vaccination, DNCB sensitization, interferon application. PMID- 3825219 TI - [Malignant melanoma of the breast]. PMID- 3825220 TI - [Dysplastic nevus syndrome]. AB - We report on 3 families showing increased occurrence of malignant melanoma (MM). As the patients suffering from MM also revealed great numbers of nevi, we suspected dysplastic naevus syndrome. PMID- 3825221 TI - [Clinicopathogenetic significance of K and NK blood lymphocytes in psoriasis]. AB - The activity of killer lymphocytes and natural killer cells was impaired in the peripheral blood especially of such patients whose psoriasis was progressive or resistant to therapy. PMID- 3825222 TI - [Morphologic and lipid chemistry findings in atherosclerotic femoral arteries]. AB - During autopsies of 34 individuals, 110 specimens were taken from femoral arteries and examined by microscopy and lipid chemical analyses. Five types of lesions were differentiated: 1. normal intima, 2. diffuse intimal hyperplasia, 3. fatty streaks, 4. fibrous plaques, 5. atheromatous lesions. Since studies on femoral arteries have not been performed so far, our results were compared with known results from aortas and coronary arteries. However, no essential differences were found by comparing morphologic results and lipid compositions. Esterified and free cholesterol increased approximately 30-fold, phospholipids approximately 6.5-fold, with progressing atherosclerosis. The intima of a 40-year old alcoholic was found to have an extremely low level of cholesterol esters, while the other findings were not changed. PMID- 3825223 TI - [Experience with VVI, QT time and activity-controlled pacemaker systems in patients with tranvenous ablation of atrioventricular conduction]. AB - In 36 patients with atrial flutter, atrial fibrillation or supraventricular tachycardia, refractory to medical treatment, who underwent interruption of atrioventricular conduction by means of an electrode-catheter, i.e. His bundle ablation, various pacemakers were studied. In 22 patients (group I) a heart rate programmable VVI-pacemaker was implanted, in 7 patients (group II) an activity mode pacemaker (Activitrax 8400, Fa. Medtronic) and in 7 patients (group III) a QT-mode pacemaker (Quintech 911, Fa. Vitatron). To study physical work capacity, exercise testing was performed using a bicycle ergometer in group I and group III and a treadmill in group II. Sixteen patients with VVI-mode pacing (72.7%) complained of shortness of breath during exercise in normal daily life, in comparison to only 2 patients in group II (28.6%) and 3 patients in group III (42.9%). The exercise test revealed a normal physical work capacity in only 3 out of 22 patients (13.6%) with a VVI-pacemaker, but a normal physical work capacity in all patients with activity-mode or QT-mode pacing. Heart rate during stress test in patients with an Activitrax-pacemaker increased more rapidly than in patients with a Quintech-pacemaker and also dropped more quickly in the Activitrax-group than in the Quintech-group after cessation of the stress test. It is important to note that pacemaker reprogramming was necessary in 1 out of 7 patients (14.3%) with activity-mode pacing and in 4 out of 7 patients (57.1%) with QT-mode pacing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825224 TI - [QT time and the ventricular refractory period in programmed electrical stimulation of the heart in patients with ventricular and supraventricular tachycardias--effect of sotalol]. AB - The QT-interval in the surface electrocardiogram (usually lead II) and the effective refractory period of the right ventricle (ERP-V) were investigated in 16 patients with documented supraventricular tachycardia (SVT) and in 18 patients with documented ventricular tachycardia (VT) during basic pacing (QT1) and programmed stimulation of the right ventricular apex (QT2) (single-test stimulation at 3 different rates, BCL: 600 ms, 500 ms, 430 ms). The effects of intravenous and oral Sotalol were analysed in the SVT-group. An increase in heart rate was followed by a significant decrease of the QT-intervals and ERP-V in both groups. The QT-intervals and the ERP-V were statistically significantly prolonged by intravenous Sotalol. The VT-group showed a statistically significant longer shortest QT2-interval during programmed stimulation, which can be explained by a greater dispersion of action potentials leading to an inhomogenous ventricular recovery process, which may represent the electrical substrate for the arrhythmia. PMID- 3825225 TI - [Peripheral hemodynamics and metabolic parameters influenced by amrinone at rest and following handgrip stress]. AB - Peripheral hemodynamics and metabolic parameters were studied in 12 healthy volunteers (mean = 24.6 years) and in 12 patients with coronary artery disease (mean = 51.1 years) at rest and after isometric handgrip exercise both before and after application of amrinone (1.5 mg/kg body weight i.v.). Amrinone produced a significant decrease in diastolic blood pressure during handgrip in patients and in volunteers by 10%. Heart rate increased by 4 to 8%. After application of amrinone there was a pronounced increase in forearm blood flow at rest by 50% and after handgrip by 30%. Amrinone is an effective vasodilator without altering systolic and mean arterial blood pressure or heart rate strongly. Amrinone did not influence metabolic parameters. PMID- 3825226 TI - [Electrophysiologic effects of diprafenone in supraventricular and ventricular tachycardia]. AB - The electrophysiologic effects of diprafenone were evaluated in 31 patients (9 X AV nodal reentrant tachycardia, 9 X Wolff-Parkinson-White syndrome, 4 X paroxysmal atrial fibrillation, 10 X recurrent ventricular tachycardia). Electrophysiologic studies were performed before and after intravenous infusion of 1.5 mg/kg body weight diprafenone in a period of 10 minutes. Diprafenone prolonged the mean RR interval during sinus rhythm from 690 +/- 109 ms to 789 +/- 93 ms and the maximal sinus node recovery time from 1081 +/- 216 ms to 1300 +/- 398 ms (p less than 0.001). The effective refractory period of the right atrium increased from 195 +/- 22 ms to 210 +/- 28 ms (p less than 0.01) and of the right ventricle from 220 +/- 20 ms to 235 +/- 20 ms (p less than 0.001). Diprafenone produced a prolongation of the antegrade effective refractory period of the AV node from 260 +/- 35 ms to 294 +/- 39 ms (p less than 0.01) and of the retrograde effective refractory period from 265 +/- 76 ms to 400 +/- 130 ms (p less than 0.001). The effective refractory periods of the Kent bundle increased: antegrade from 299 +/- 45 ms to 413 +/- 133 ms, retrograde from 252 +/- 33 ms to 286 +/- 169 ms (p less than 0.05). Suppression of inducibility was observed in 12 of 17 patients with supraventricular reentrant tachycardia, in 5 of 8 patients with atrial fibrillation and in 7 of 10 patients with recurrent ventricular tachycardia. The rate of supraventricular tachycardias decreased under the influence of the substance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825227 TI - [Therapy of severe propafenone poisoning--an attempt at elimination by hemoperfusion]. AB - After suicidal ingestion of 9 g Propafenone, a 31-year-old woman showed unconsciousness, cerebral convulsions, respiratory depression, sinus arrest, ventricular tachycardia and recurrent atrioventricular block. The maximum Propafenone plasma level was 4,702 ng/ml. Only 67.2 mg of Propafenone were eliminated within 4 h of hemoperfusion. Successful therapy could be achieved by symptomatic intensive care treatment. Additionally, 2 X 25 ml of 20%-saline solution were infused. In this case no efficacy of hemoperfusion in the treatment of Propafenone intoxication could be documented. PMID- 3825228 TI - [Ischemic disorders of cardiac rhythm: effects of the autonomic nervous system on electrophysiologic findings and pharmacotherapy]. AB - The time course and frequency of ventricular arrhythmias in myocardial ischemia and myocardial necrosis are influenced by a great number of different factors. The most important are: size and localization of the ischemic area, mode of coronary artery occlusion (one stage occlusion, phasic, protracted or gradual occlusion), intermittent reperfusions, and influence of the autonomic nervous system. Autonomic factors influence both the mechanisms of arrhythmias and the results of pharmacological interventions. An increased sympathetic tone causes both in reversible myocardial ischemia and in partially irreversible myocardial necrosis a significant increase in incidence and severity of arrhythmias. The underlying mechanism of action is complex and includes enhanced automaticity, an increase in ischaemia-induced prolongation of conduction while the frequency of bidirectional conduction blockades is reduced, and an increase in dispersion of repolarization. Due to these various factors the preconditions for reentry are favourable. Vagal effects consist in an increase or decrease of frequency-related arrhythmias. Furthermore, indirect antifibrillatory effects are apparent due to an antagonism of sympathetic actions. The significance of autonomic factors for arrhythmogenesis following "early" reperfusion (i.e. arrhythmias occurring immediately after release of short-term coronary artery obstruction) has not yet been established. Reports in the literature suggesting antifibrillatory actions of sympathicolytics have not yet been confirmed. The results of antiarrhythmic pharmacotherapy are also influenced by autonomic factors, particularly increased sympathetic activity. At the very onset of acute myocardial ischemia, when sympathetic tone is markedly increased in most patients, class I antiarrhythmic agents, particularly those which cause a significant conduction delay display only weak antiarrhythmic effects or even no effectiveness at all. The frequency of ventricular fibrillation is not diminished. Various agents even produce significant arrhythmogenic effects. The electrophysiological mechanism of action is based on a further increase in ischemia-induced prolongation of conduction and in dispersion of conduction times. By contrast, beta-sympathicolytics, class III antiarrhythmic agents (d-Sotalol type) and calcium antagonists (Verapamil type) (the latter only at high doses) cause a decrease in ischemia-induced prolongation of conduction and in dispersion of conduction times thereby reducing the incidence of early ventricular fibrillation. In the stage of manifest necrosis the order of relative potency is reversed if the sympathetic tone is low.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3825229 TI - [Diseases of the central nervous system and cardiac arrhythmias]. AB - Diseases of the central nervous system can result in various cardiac arrhythmias. In some neuromuscular disorders, a distinctive morphologic correlate of such arrhythmias can be found as a secondary cardiomyopathy. In other intracranial diseases, in particular subarachnoid and intracerebral hemorrhages, the lack of gross alterations of cardiac morphology suggests some "functional" nature of rhythm disturbances. Lesions of the autonomic regulatory centres frequently cause (unilateral) autonomic imbalance that is projected to the heart according to its asymmetric peripheral sympathetic innervation. The resultant propensity for sympathetically mediated arrhythmias is frequently reflected in prolongation of the QT interval and can be accentuated by simultaneous vagal discharge as well as catecholamine-mediated disseminated myocardial necroses. It is, however, unlikely that such neurogenic arrhythmias bear any independent prognostic significance; on the contrary, prognosis is usually determined by the severity of the underlying neurologic disease and its complications. PMID- 3825230 TI - [Pathophysiology of reperfusion]. AB - We investigated the influence of time after coronary occlusion, of myocardial O2 demand, and of collateral blood flow upon the amount of myocardium that can be salvaged by reperfusion. These studies were carried out in species of mammalian heart that differed widely in the availability of collateral blood flow and in MVO2, i.e. dogs, pigs, cats, rabbits, guinea pigs, and rats. In canines, we increased MVO2 before coronary occlusion by bilateral vagotomy. We found that hearts with measurable collateral blood flow had a markedly increased tolerance toward ischemia and vice versa. Ranking the species from high to low collateral flow (guinea pig, cat, dog, pig, rat) displays the same order when ranked for infarction. In the guinea pig, collateral blood flow was so high that we were unable to produce infarction by coronary ligation. The infarction process was the most rapid in pigs (= 45 min after occlusion) and rats (= 20-45 min after coronary occlusion). Increasing the MVO2 by vagolytic tachycardia markedly decreased the tolerance toward ischemia in the canine heart. We conclude from our experiments that reperfusion is the most powerful intervention to salvage ischemic myocardium, provided it is carried out within the period of reversible ischemic injury. With very low collateral blood flow (as expected to be present in young men with no previous manifestation of ischemic heart disease) this interval of reversibility may be about one hour after coronary occlusion and it is probably shorter in the presence of tachycardia and reduced perfusion pressure. PMID- 3825231 TI - [Intravenous thrombolysis in acute myocardial infarct]. AB - In two large randomized studies (ISAM and GISSI) a reduction in hospital mortality of about 15% was observed in patients treated within 6 hours after the onset of symptoms of myocardial infarction with a 1 hour intravenous infusion of 1.5 million U of streptokinase. In GISSI, early treatment within 1 hour from symptom onset reduced in-hospital mortality by about 47% (p = 0.0001). In spite of a significant limitation of infarct size by intravenous streptokinase in ISAM there was only a trend to a lower long-term mortality in patients with inferior myocardial infarction (10.2% versus 14.2% placebo), while in patients with anterior myocardial infarction long-term mortality was slightly higher in streptokinase-treated patients (19.0% versus 17.7%). Long-term mortality after hospital discharge strikingly increased in streptokinase patients, who had suffered a large anterior wall infarction (21.1% versus 6.9% placebo, p less than 0.007). An increased risk of dying cumulated in patients with rapid reperfusion, i.e. MB-CK peaking within 9 hours after the start of treatment. The potentially unstable situation in streptokinase-treated survivors of acute myocardial infarction suggests the need for additional mechanical or surgical interventions. Randomized prospective trials with sufficient statistical power are needed to ascertain the true impact of such "definite treatment". PMID- 3825232 TI - [Suitability of various kinds of sports and exercises for the elderly]. AB - This study is based on the experience of a two-year training course with fifty adults between the ages of sixty and eighty-six. 5,000 scientific publications were evaluated. The following sports were examined: callisthenics, hiking, golf, skittles, bowling, curling, games, jogging, cycling, rowing, swimming, alpine skiing, long-distance skiing, dancing, and tennis. The sports will be judged as to their suitability from four standpoints: improvement of physical fitness and motor skills, increase in well-being and maintaining mobility. With each sport conclusions will be drawn as to the method of physical education for different groups: senior sportsmen, older people doing sports only occasionally and older beginners. PMID- 3825233 TI - [Physical inactivity in the aged: an analysis of individual reasons]. AB - On the basis of interview data (n = 20) reasons given by 60-75 year-olds for physical inactivity are analysed. 6 specific motives are pointed out which can be summarized in two motive classes: an inefficient expense-effect relation and low importance of physical activity. The results show that older persons are not motivated for physical activity if sport-related motives are completely missing or if uncontrollable barriers impede sport-related motives. PMID- 3825234 TI - [Swimming performance in the aged]. AB - The deterioration of performance caused by aging was examined in 3,469 swimmers divided into 9 age groups and 4 styles of swimming. Comparisons using cross and longitudinal sections show that older swimmers become progressively slower, and the reduction of speed in all styles of swimming follows a quadratic trend. The losses of efficiency increase with age group, being by far the most in back stroke and the least in crawl swimming. The combined longitudinal and cross sectional comparisons confirm this result, but not without any exception, for very often no statistically significant differences could be recognized between adjacent age groups. The interindividual comparison shows that it is also possible to maintain or even improve the efficiency over 10 to 12 years, even in the fifth or sixth decade of age, if the intensity and volume of training can be increased. The curve comprising reductions in the later stages of life may additionally be caused by the smaller number of persons per group and the deficient homogeneity within these groups. In addition to this, the tendency towards higher losses in older age groups is not significant, if only the best competitors of each age group are compared. PMID- 3825235 TI - [Heart rate and contractile reserve of the aging heart]. AB - In standardized experiments on both conscious and anaesthetized young (n = 11) and old (n = 7) dogs differences in haemodynamics, contractility and myocardial oxygen consumption correlated to age were evaluated. Under resting conditions no significant differences were observed. Following stimulation with catecholamines young (n = 6), and old (n = 6) dogs displayed an almost parallel increase in (dp/dt) max. After administration of orciprenalin, the maximum increase in heart rate was similar in both groups of animals; however, a significant difference in the maximum heart rate following atropine was observed, which was significantly lower in old than in young animals. The decreased performance of the aged myocardium does not appear to be predominantly due to an age-dependent reduction of the contractility reserve. It could result from a deficient sympathetic stimulation of the heart. PMID- 3825236 TI - [Elderly automobile drivers--a problem with a future?]. AB - In the Federal Republic of Germany, the accident involvement of elderly drivers to date is low, corresponding to their low traffic participation. With a definite increase in the number of elderly drivers in the near future frequent adverse effects on traffic safety are expected. Particularly age changes in vision and reaction ability are considered to be important. Compared to a representative sample of different age groups, the elderly drivers themselves viewed an increasing number of elderly motorists far more positively. There is such a gap between the negative extraneous viewpoint and the elderly drivers' lack of self criticism that a conflict between the generations affecting traffic safety will be produced. PMID- 3825237 TI - [The lens of the eye and its relation to the lymphatic system]. AB - On the basis of well-tried methods of investigation with vital dyes (patent blue violet and Japanese ink) and in combination with the drug (Conjunctisan A), the natural pathways of resorption through the lymphatics of the eye in the mouse, were displayed and this permitted the transport mechanisms to be followed. It was possible gradually to understand the morphology of the lymphatic drainage and, in this way evidence was produced regarding the relationships of the lymphatic system and the regional lymph nodes. PMID- 3825238 TI - [Angiostrongylus vasorum (Nematoda) and its migration in the small intestine (duodenum) of a dog]. AB - Larvae of Angiostrongylus vasorum in the third stage of its migration through the wall of the duodenum are demonstrated histologically. Greatly dilated lymph capillaries are found here, particularly in the inner circular muscle layer. PMID- 3825239 TI - [Effect of ganglionic blockade and subsequent i.v. infusion of catecholamines and angiotensin II on the formation and transport of lymph. Studies in anesthesized dogs and a review of the literature]. AB - The effect of ganglionic blockade (GB) and subsequent i.v. infusion of adrenaline (AD), noradrenaline (NA), isoproterenol (IP), and angiotensin II (AII) on thoracic duct lymph flow (LF) and transcapillary escape rate of plasma proteins (FER) was studied in anaesthetized (Nembutal), paralyzed (pancuronium), and artificially ventilated dogs. The carotid artery, the external jugular vein, and the thoracic duct were cannulated. Following a control period, GB was performed by pentolinium tartrate and thereafter the other drugs were infused in a random sequence for 30-60 min with 1 h intervals. Mean arterial blood pressure was decreased from 125 to 90 mmHg by GB, it was increased by 36 mmHg by AD, 41 mmHg by NA, and 44 mmHg by AII, and was decreased by 27 mmHg by IP. LF was about 38 microliter/min/kg before GB and was not changed systematically by GB, because either the sympathetic tone was rather weak or the intrinsic contractions and the tone of lymphatics were reduced by GB. FER was not affected by GB. LF increased by 9 microliter/min/kg (control 36 microliter/min/kg) during AII infusion, probably due to increased lymph formation; the latter can be concluded from the 68% increase in FER. NA raised LF by 15 microliter/min/kg (control 44 microliter/min/kg) probably due to alpha-adrenergic stimulation of the intrinsic contractions of lymphatics; lymph formation seemed not to be affected because FER was not changed systematically. AD enhanced LF by 29 microliters/min/kg (control 39 microliters/min/kg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825240 TI - [Lymphangiomotoricity and tissue pressure]. AB - In the lymphangiomotor system, during manual lymph drainage (ML) there is an increase of lymphatic pressure, a decrease of the amplitude and an increase in frequency and hypertensive lymph stasis in too intensive ML. In the interstitial fluid, the pressure is always negative under physiological conditions and becomes positive when increased proteins are present. A positive IFP can be reduced a) by compression therapy b) by manual lymphatic drainage c) most effective by the combination of a) and b) Since the IFP increases again after discontinuation of one of these therapies, compression therapy is indispensable as chronic treatment. PMID- 3825241 TI - [Effect of manual lymph drainage on the autonomic nervous system]. AB - Biotonometry according to Rilling enables determination of HR and HC in healthy subjects. These two parameters hardly change during the day (diurnal profiles). In healthy 18 to 21 year old women and men, HR is 7 to 8 kOhm and HC 0.15 to 0.25 microfarad. In healthy subjects, HR increases and HC decreases during ML according to Dr. Vodder. In patients with phlebedema, local ML carried out several times brought about an increase in the level of the HR curve. Similarly to Kracmar, Hauswirth and Rilling, we conclude that there is a transition from a sympathotonic or normotonic reaction situation into a parasympathotonic reaction situation after carrying out ML. These results of experimental investigations thus confirm the clinical observations according to which a vagotonic reaction situation arises during ML (Wittlinger and Wittlinger). PMID- 3825242 TI - [Value of lymphography in the preoperative diagnosis of gynecologic cancers]. AB - In advanced tumors, the imaging techniques such as ultrasound, computer tomography or magnetic resonance imaging are at the forefront. In order to plan surgical procedure, lymphography is indicated as a supplementary diagnostic measure mainly in tumors of the corpus and the cervix uteri, especially in the early and middle stages. In tumors of the ovary, the vagina and the vulva, diagnostic assistance in deciding on therapy is to be expected only in occasional cases. The indication for lymphography should not only be established in relation to the tumor stage, but also tumor grading, since a very much higher local regional metastatic spreading is to be reckoned with in increasing grading, so that the choice of therapeutic procedure is crucially affected. In using preoperative diagnostic measures, the postoperative morphological follow-up should be considered: Examinability of the removed lymph nodes, especially in preoperative suspicion of metastases. Behavior of the lymph nodes in the post therapeutic phase with consideration of recurrence diagnostics. Planning of radiotherapeutic target volume considering collateral circulations and atypical lymphatics. PMID- 3825243 TI - [Additional images and subsequent palpation--indispensable conditions for efficient diagnosis using mammography]. AB - As adjuvant to standard two-view mammography with craniocaudad and oblique projection additional mammographic views are required to definitely establish a diagnosis in about 30% of patients. These are further views of the entire breast in other planes, repetition of standard mammographic projections, special views of parts of the breast and of the axillary region and tangential spot films. In case of nonpalpable mammographic abnormalities additional views help to study the constancy of the findings (superimposition effect?), the diagnostic significance (occult carcinoma?, parenchymal asymmetry?, benign or malignant microcalcification?) and to determine the topographical position of the lesion. Not uncommonly palpatory findings can be picked up mammographically only by special views, often they require further views in other planes for better delineation of the lesion. The important correlation of palpatory and mammographic findings is frequently possibly only with tangential spot films. Only personal physical examination by the mammographist will ensure the appropriate use of additional mammographic views. This concomitant palpation should be carried out immediately before mammography and especially after completion of mammography while viewing the mammographic images. Additional mammographic views make it possible to improve the diagnostic accuracy of numerous malignant and benign lesions of the breast and of the axilla. Conclusive proof of the benignity of a lesion and thus prevention of an unnecessary biopsy is mostly only possible by means of additional special views. This includes superimposition effects, tumorlike asymmetry, lipomas, fibroadenolipomas and oil cysts all of which amount to 12% of all patients in our material. PMID- 3825244 TI - [Assessment of a patient with idiopathic edema]. AB - In view of the difficulties in diagnosis and the necessity of meticulous whole day therapy supervised in detail by the physician over many weeks and which the patient could only bear with difficulty, inpatient treatment in a hospital specializing in edema nosology is always indispensable in such cases. On the other hand, the diagnosis developed by Dr. H. is wrong, and the therapy suggested is also ineffective and harmful. PMID- 3825247 TI - Peer review's data capability is important policing tool. PMID- 3825246 TI - Innovation and cooperation enhance policing mechanism. PMID- 3825245 TI - [A new development: a brassiere for patients with breast amputation]. PMID- 3825248 TI - [Epithelial membrane markers. Evaluation, presentation of one's own monoclonal antibodies and range of application in histopathology]. PMID- 3825249 TI - [Proliferation marker Ki-67: correlation with histological diagnosis, neoplasm grading and clinical course]. PMID- 3825250 TI - [Comparative flow cytometry analysis of DNA and CEA in stomach carcinoma]. PMID- 3825251 TI - [Biosynthesis and secretion of CEA by colon carcinoma cells-- ultrastructural and immunocytochemical studies with the protein-A-gold method]. PMID- 3825252 TI - [Immunohistochemical characterization of renal cell carcinomas]. PMID- 3825253 TI - [Significance of immunohistology in the diagnosis, prognosis and therapy planning for malignant thyroid tumors]. PMID- 3825254 TI - [Immunohistochemical demonstration of binding sites for peanut lectin (PNA) in prostatic carcinoma before and after antiandrogenic treatment]. PMID- 3825255 TI - [Morphological studies of tbe epidermal growth factor receptor. Analysis of human tumors and tumor transplants in athymic mice with special reference to salivary gland tumors]. PMID- 3825256 TI - [Expression of ABH-and Lewis antigens in the salivary glands--immunohistochemical studies]. PMID- 3825257 TI - [GFAP in brain tumors]. PMID- 3825258 TI - [Characterization of CEA antibodies used in immunochemistry by protein blotting and absorption]. PMID- 3825259 TI - [Humoral immunoregulatory factors in normal and complicated pregnancy]. PMID- 3825260 TI - [Mechanisms of the development of gametopathy]. PMID- 3825261 TI - [The activity--rest cycle of the human fetus according to changes in heart rate and motor activity]. PMID- 3825262 TI - [Prospects for the growth of research in obstetrics and gynecology in the 10th five-year-plan]. PMID- 3825263 TI - [Structure of the sleep of newborn infants as an index if degree of maturity and lesions of the central nervous system in different forms of perinatal pathology]. PMID- 3825264 TI - [15 year experience using prolonged peridural analgesia in labor]. PMID- 3825265 TI - [The pathogenesis of uterine myomas]. PMID- 3825266 TI - [Features of the adaptation of newborn infants with diabetic mothers]. PMID- 3825267 TI - [Clinico-laboratory evaluation of disorders of the generative function of men in infertile marriages]. PMID- 3825268 TI - [Multidimensional analysis of clinical data]. PMID- 3825269 TI - [Principal directions in the research work of the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences of the USSR]. PMID- 3825270 TI - [Medico-biological evaluation of the quality and prospects for the use of various proteins from sea products]. PMID- 3825271 TI - [The basis for a rational nutrition of sportsmen]. PMID- 3825272 TI - [A problem of interaction between vitamin A and xenobiotics]. PMID- 3825273 TI - [Absorption of nutrients as a key step of assimilation]. PMID- 3825275 TI - [Current principles of diet therapy of metabolic diseases]. PMID- 3825274 TI - [The role of vitamins K and E in the regulation of biomembrane structure]. PMID- 3825276 TI - [Protective effect of phosphocreatine on the myocardium (experimental study)]. PMID- 3825277 TI - [Various aspects of protective effect of exogenous phosphocreatine on the ischemic myocardium]. PMID- 3825278 TI - [Detection of antibodies against nerve tissue proteins in the serum of patients with slow infections of the central nervous system]. PMID- 3825279 TI - [Population aspects of Shigella interaction with the mucosa of explanted fragments of the human fetal intestine]. PMID- 3825280 TI - [Polarographic determination of oxygen tension in the skin of vitiligo patients]. PMID- 3825281 TI - [Characteristics of psychovegetative relations in neurodermatitis patients]. PMID- 3825282 TI - [Treatment of urogenital chlamydiosis and ureaplasmosis with erycycline combined with diucifon (clinico-electron-microscopy study)]. PMID- 3825283 TI - [Skin test with autolymphocytes in syphilis patients]. PMID- 3825284 TI - [Experience with the pyridoxal phosphate treatment of eczema patients]. PMID- 3825285 TI - [Erythematosus-carcinoma]. PMID- 3825286 TI - [Allergic mechanisms of skin damage in neurodermatitis and eczema]. PMID- 3825288 TI - [The preparation "Glutamevit" in dermatovenereologic clinical practice]. PMID- 3825287 TI - [Skin lesions in multiple myeloma]. PMID- 3825289 TI - [The Bloch-Sulzberger syndrome]. PMID- 3825290 TI - [Pathogenesis of Manganotti's abrasive precancerous cheilitis]. PMID- 3825291 TI - [Zoonotic microsporia of the scalp in a 2-week-old infant]. PMID- 3825292 TI - [Treatment of anorectal gonorrhea with preparations of penicillin and levomycetin]. PMID- 3825293 TI - [Results of treating trichomoniasis in women with tinidazole]. PMID- 3825294 TI - [Inguinal lymphogranulomatosis (lymphogranuloma venereum)]. PMID- 3825295 TI - [Role of alcohol in the development and course of skin diseases]. PMID- 3825296 TI - [Spectrum of phospholipids in the plasma and erythrocytes of psoriasis patients]. PMID- 3825297 TI - [Principles of the hydrolysis of bound purine and pyrimidine bases in foods and program-controlled calculation of nucleic acid content]. AB - In order to determine the amount of combined purine and pyrimidine bases in foods we investigated the chemical fundamentals of their hydrolytic digestion it was demonstrated that the digestion mixture used, containing trifluoracetic- and formic acids, protected the purine bases during hydrolysis from oxidative degradation due to carbon monoxide formation. Further, a time-saving computer program was developed and presented. This program allows, depending on the purine composition, the calculation of the corresponding nucleic acids, the nucleotides and the purine-nitrogen-content of the food. PMID- 3825298 TI - [Prevention: local action--national coordination? Autumn meeting 1986]. PMID- 3825299 TI - [Effect of the anti-siphon device (ASD) on the function of various hydrocephalus drainage systems in the child]. AB - Flow rate studies on various membrane and slit valve shunt combinations in the upright (hanging) position were carried out to compare their function with and without an Anti-Siphon-Device (ASD) in relationship to various proximal pressures and various distal catheter lengths. Advantages and disadvantages of the numerous valve types and shunt combinations and the optimal position of the ASD are established. The necessity of an ASD in every shunt is experimentally verified and theoretically discussed. PMID- 3825300 TI - Duodenal duplication--3 new cases. AB - Duplications can occur anywhere in the alimentary tract from mouth to anus. There may be multiple duplications in about 15% of cases. The most common site is in the distal ileum, in over 50% of cases. Duodenal duplications are rare, and occur in only 5-10% of the total in recent reviews (3, 5, 7). Three cases of this very uncommon abnormality are reported. PMID- 3825301 TI - [Vascular supply of the rectum in anal atresia. Angiography studies in newborn swine]. AB - In 15 piglets with anorectal malformations (high and low anomalies) we performed angiographies of the pelvic arterial system. 3 healthy animals were used as control group. None of the animals had isolated rectal atresia which is assumed to be due to vascular disorders. In all animals we could demonstrate normal superior and inferior rectal arteries. Thus our results support the hypothesis that anorectal malformations, with the exception of isolated rectal atresia, are not associated with vascular malperfusion during embryogenesis. PMID- 3825302 TI - Fourth pharyngeal pouch remnant presented as a neck mass. PMID- 3825303 TI - Hydatic cyst in the thyroid and submandibular salivary glands in a child. AB - A case of hydatic cyst of the thyroid and submandibular salivary glands was presented. The epidemiology, pathogenesis, clinical features of the cervical hydatic cysts and treatment of this rare combination of the hydatid disease were discussed. PMID- 3825304 TI - Peutz-Jeghers syndrome: a clinical study of a large family in two generations. AB - A family group of 15 cases in two generations with Peutz-Jeghers syndrome has been studied and a review of the history and features of the syndrome is presented. This syndrome was detected in 10 of 15 family members in two generations. One family member underwent repeated surgery after small bowel obstruction was diagnosed. In addition, multiple polyps were removed from the rectum. Rectal bleeding dominated the clinical picture in two patients. Five of the family members had small bowel polyps, five of the siblings had polyps in the colon. Colonic polyp was also found in one patient who had a small bowel polyp. Four of the ten affected family members in two generations had mucocutaneous pigmentation. One of the siblings had died during the early postoperative period. PMID- 3825305 TI - Non-iatrogenic deep vein thrombosis of lower extremities in children. AB - Non-iatrogenic ileo-femoral vein thrombosis is rarely encountered in childhood. Six children with postphlebitic leg following venous thrombosis are presented. Venous thrombosis occurred following peritonitis, osteomyelitis and scarlet fever. None of the patients had history of trauma or intravenous treatment. Based on world literature and our experience, the main clinical and radiological manifestations of this rare entity are summarised. Early detection and aggressive anti-coagulant therapy of deep vein thrombosis may probably prevent post thrombotic syndrome--a major disabling condition in children. PMID- 3825306 TI - [Incidence of psychiatric symptoms in 4- to 8-year-old children with unintelligible speech]. AB - Twenty-four children between 4 years 5 months and 8 years of age with unintelligible spontaneous speech and at least average nonverbal intelligence were evaluated over a period of several hours. Nine of the children (37%) were found to have a psychiatric disorder, either a disturbance of emotions specific to childhood (ICD code 313) or a hyperkinetic syndrome (ICD code 314). No relationship was found between the presence of such a disorder and the severity of the speech/language disorder. PMID- 3825307 TI - [Child and adolescent psychiatric classification in an unselected sample--a comparison of MAS and DSM-III]. AB - As part of an epidemiological study, the diagnoses of children with psychiatric disorders at age 13 were determined according to the criteria of both the ICD-9 oriented Multi-Axial Classification Scheme (MAS) and the Diagnostic and Statistical Manual, 3rd ed. (DSM-III). A comparison of the diagnosis pairs showed that in most cases (76%) comparable diagnostic categories had been selected. Discrepancies were found mainly in the use of the diagnoses "conduct disorder" (ICD, DSM-III: 312) and "age-specific emotional disorder" (ICD, DSM-III: 313). Severity of disorder had little impact on the extent of agreement between the two classification procedures. In an additional analysis the comparability of the threshold values used in the case definition criteria in the two systems was examined. The DSM-III criteria yielded 11 more cases of psychiatric disorder than the MAS criteria, 10 of these with the diagnosis of "attentional deficit" (ICD, DSM-III: 314). PMID- 3825308 TI - [Critical remarks and new aspects in the differential diagnosis of specific reading disability]. PMID- 3825309 TI - [Religious aspects in child psychiatry. A taboo topic?]. AB - The recent child psychiatric literature in which religious concerns play a central role is reviewed. The paucity of such publications during the past 20 years suggests that religion is taboo in the field of child psychiatry. PMID- 3825310 TI - [Psychosomatic aspects of diabetes mellitus in adolescence--a case report]. AB - A case is reported of a 15-year-old girl with insulin-dependent diabetes mellitus and neurotic development. Emphasis is placed on psychosomatic considerations in the discussion of the disease in general and of crisis management and course of treatment in this particular case. PMID- 3825311 TI - [Sex differences in the physical dependence on barbital in rats]. AB - Sex differences in physical dependence on barbital (BAR), which is not readily metabolized in rats, were studied by the drug-admixed food method. The concentration of BAR in the food was gradually increased from 1 and 2 up to 6 and 8 mg/g food concurrently available to each rat over a period of 36 days in both male and female Sprague-Dawley rats. Sedation and muscle relaxation were observed in males at the 4 and 6 mg/g condition and to a greater degree at 6 and 8 mg/g of food. This effect was seen only at the highest drug concentration, 6 and 8 mg/g food, in females. Physical dependence was assessed in both sexes after substitution of normal food for the BAR-admixed food. Various signs of BAR withdrawal were observed including vocalization, irritability, muscle rigidity, tremors and convulsions. The incidence of convulsions was 76.9% in females and 45.5% in males, respectively. Maximum weight loss was 15.4% in females and 12.1% in males. However, brain BAR concentrations in the male rats were higher than that in the female rats 9 hours before onset of withdrawal and at all later time points tested. Thus, we have demonstrated that weak sex differences in physical dependence on BAR exist and suggest that this difference resulted from a difference in CNS sensitivity to BAR. PMID- 3825312 TI - Polymorphism of EsD by isoelectric focusing: phenotyping in human tissues, dental pulps, hair roots, and semen. AB - The polymorphism of EsD was investigated in tissues of various human organs, dental pulps, hair roots, and seminal stains by isoelectric focusing. The method yielded an excellent resolution of the isoenzyme components. The time limits of determination were: in organ tissues 3 weeks, in dental pulps 1 week, and in hair roots several days. The 7-1 type was less stable than the common types. Phenotyping was possible from fresh semen samples, but was unsuccessful from dried seminal stains after storage. The results show that the EsD typing by isoelectric focusing is of practical use for medicolegal individualization of organs, teeth, and hairs. PMID- 3825313 TI - A sequence of tests of minute human blood stains for human origin identification and ABO blood grouping. AB - A series of examinations is presented for human origin identification and ABO blood grouping of doubtful minute human blood stains. A blood-stained thread (0.5 cm in length) was first tested to identify human origin by microprecipitation method and then the ABO blood type was determined by both a modified absorption elution test and a modified mixed agglutination. In the continuous tests, the maximum limits of positive reactions of the microprecipitation method, the modified absorption-elution test, and the modified mixed agglutination were 1:640, 1:160, and 1:2,560 diluted blood, respectively. A and B agglutinogens were more sensitively determined than H agglutinogen. Hemagglutinogens of blood stains on cotton threads were more easily detected than those of polyester ones. PMID- 3825315 TI - [Atypical bullet entry injuries. A case report and experimental contribution]. AB - In order to elucidate the contradictory findings in cases of suicide or homicide with firearms, firing tests were performed with various weapons shot at textile samples, block gelatine, animal and human skin, and pigs' heads. Ricochets were produced at different angles of incidence and bullets were shot through various materials introduced between the target and muzzle. The morphology and emission spectrum analyses of the entry holes were investigated, and the projectiles were collected and inspected. The morphological and chemical alterations observed at the entry holes were classified and discussed. PMID- 3825314 TI - [Pathologico-anatomic findings in sudden, unexpected death in children and adults with influenza A infection]. AB - The following observations resulted from studies on forensic autopsy cases: In 76% of the adults and 55% of the infants the cases of unexpected sudden death without morphologically verifiable causes of death showed virologic evidence of recent influenza-A (H3N2)-infection. The pathologic findings corresponded with the findings in lethal infections with influenza-A viruses. Investigation of cases of sudden and unexpected death should always include virologic serum tests. The demonstration of IgM antibodies against influenza-A virus confirms that there was a recent infection. Death from influenza-A infections occurs also in the interepidemic periods. PMID- 3825316 TI - [Reproduction of atypical bullet exit wounds]. AB - Contradictory findings from experiments designed for the reconstruction of the circumstances in crimes committed with firearms induced us to systematically investigate the conditions leading to the occurrence of non-typical bullet exit wounds. For this purpose, skin samples and pig heads were fired at with different types of small arms and, on the exit side, the skin was brought into contact with various materials. The bullet exits were investigated morphologically and by means of emission spectrum analysis. The results from these investigations are classified and discussed. PMID- 3825317 TI - [Postmortem transport of gastric contents?]. AB - For the determination of the time since death, the distribution of the last meal in the stomach and small bowel may be of great importance. It may be even more difficult to estimate the time if there is a possibility that postmortem peristaltic emptying of the gastric content occurs, as has been claimed. Radiological control immediately after death by means of applying barium sulfate to the stomach, however, revealed no evidence of peristaltic emptying of the gastric content after death. PMID- 3825318 TI - [Aspects of brain death]. AB - The different aspects of brain death are discussed. It is pointed out that the diagnosis of poisoning as the cause of brain death can be checked by toxicological examination of brain tissue and of blood in the sinus of the dura mater, since the metabolism in the brain and sinus blood is markedly reduced while drugs and toxic substances continue to be broken down in the other organs. Particular importance attaches to this difference in the case of crimes of violence creating conditions that predispose to brain death when the significance of a further violent act, e.g. stabbing with resultant haemorrhage, has to be assessed. The simple vital reaction of bleeding does not of itself constitute proof in such a situation, unless it is possible to say with a good degree of certainty that brain death did not occur at the moment when the victim was stabbed. It may, however, be possible to state that brain death that could have been caused by violence has not yet occurred if complex vital reactions, such as inflammation of a wound, are seen. PMID- 3825319 TI - [Priority of multiple gunshot injuries of the skull]. AB - In accordance with Puppe's rule, the analysis of skull fractures may provide evidence on the sequence in which multiple blunt injuries of the skull occurred. In cases of multiple gunshot wounds of the skull determination of the sequence in which the gunshot wounds took place is much more difficult. In some cases, however, analysis of the skull fractures here can also allow the order in which gunshot wounds occurred to be established. PMID- 3825320 TI - [Determination of age based on the skeleton]. AB - A skeleton is reported that was found 40-100 cm under the surface of the earth; the light, porous bones had partially fallen to pieces. The most remarkable point was the discrepancy between the age of the bone and that of the teeth: based on the bones, the age of the living human being was about 30-40 years; on the basis of the teeth, however, the person was much older. The matter was cleared up with the help of a neck chain that was a precursor to the torques worn by the Celts; thus the skeleton was about 2500 years old. As the teeth were worn down much more through more use in prehistoric times than they are today, the age of the living person is likely to be the bone age, which was about 35 years. PMID- 3825321 TI - [Effect of gold (III) on prostaglandin E2-stimulated adenyl cyclase in chick fibroblasts and osteoblasts]. AB - Gold (III) (Au(III) up to 0.25 microM increased prostaglandin E2-sensitive chick osteoblast and fibroblast adenylate cyclase activity without affecting 5' guanylylimidodiphosphate-stimulated enzyme activity. Au (III) at 5-50 microM inhibited hormone- and nucleotide-mediated activation of adenylate cyclase. This process is time-dependent, irreversible and can not be explained by desensitivation of the PGE2-receptor. Basal adenylate cyclase activity was not influenced by Au (III) in the given concentrations. Pretreatment of membranes with 5'-guanylylimidodiphosphate prior to incubation with Au (III) prevented the inhibitory effect of Au (III) on adenylate cyclase, similar to the incubation experiments with NEM instead of Au (III). Our data suggest that Au (III) at low concentrations unspecifically stimulates PGE2-sensitive adenylate cyclase by binding to sulfhydryl groups of the receptor protein and that Au (III) at high concentrations specifically inhibits PGE2-sensitive adenylate cyclase by binding to sulfhydryl groups of the N-Protein and/or of the catalytic unit. PMID- 3825322 TI - Computed axial tomography of brain in neuro-ocular Behcet's syndrome. AB - The case history of a 34-year-old male with a neuro-ocular Behcet and left sided hemiparesis is reported. On computerized tomography (CT) of the brain using contrast medium a homogeneous enhancement was seen. This conforms with the very few similar reported cases of Behcet's syndrome and is in discordance with the CT findings in cases of cerebral stroke. We conclude, therefore, that the appearance of a homogeneous enhancement on contrast CT can be of diagnostic value in neuro Behcet. PMID- 3825323 TI - [Effect of superoxide dismutase on an arthritis model in the rabbit. A scanning electron microscopy study]. AB - The effect of superoxide dismutase (SOD) was studied in an experimental arthrosis model (fixation arthrosis in rabbits). Out of a total of 40 animals, 20 of which were to be treated with SOD and 20 with placebos, 5 animals each were given padded stiffened bandages to immobilize their right knee joints for 1 week, 2 weeks, 3 weeks and 4 weeks respectively. After removing the bandage and a two week recovery period the SOD or placebo treatment respectively was begun. During this period the animals were allowed to move freely. In 20 animals 0.5 mg SOD in 0.2 ml of a 0.5% xylocaine solution were applied intraarticularly in both popliteal spaces once a week for a total of 4 weeks. 20 control animals likewise received 0.2 ml of a 0.5% xylocaine solution (placebo) in both popliteal spaces in the same time intervals. After treatment the animals were killed and examined. A further 5 animals were not given a stiffened bandage, but for 4 weeks they received intraarticular injections once a week of 0.2 ml of a 0.9% saline to act as controls. The evaluation of the changes in the joints was by histological examination and examination by scanning electron microscope. In comparison to the placebo treatment the SOD treatment in this animal experiment did not lead to a significant change in the arthrotic process. PMID- 3825324 TI - Mitral valve replacement for lupus valvulitis. AB - This paper describes a 47-years old patient with the history of lupus valvulitis for six and a half years, who had implantation of a Starr-Edwards prosthesis for a mitral insufficiency four years ago. This case represents the longest survival reported so far after mitral valve replacement for lupus valvulitis. PMID- 3825325 TI - [Is the gallbladder a shock organ?]. AB - Detrimental effect of shock on gallbladder is a rare complication which may occur in the wake of trauma or surgery. Sex ratio, incidence, lethality, and possible pathophysiological processes are stated and discussed. The incidence of posttraumatic cholecystitis appeared to be higher among patients in the second to fourth decades of age, while postoperative cholecystitis was more often recorded from patients in the fifth to seventh decades of age. The aetiology is still unknown and may be of multifactorial nature. This cannot be conclusively elucidated from one individual case. Early detection of the complication and early operation may widely protect the patient from more severity. PMID- 3825326 TI - [Gallbladder perforation in an autopsy sample]. AB - Evaluation of 135 post-mortem reports over a period from 1953 to 1985 showed that 107 patients without adequate therapy for peritonitis had died of gallbladder perforation within 32 hours from surgery. Another 28 had died of gallbladder perforation following cholecystectomy. Forty patients had been hospitalised in moribund condition and died within 24 hours from admission. Three patients died of the consequences of undetected postoperative or posttraumatic cholecystitis, while another five died following appendectomy or herniotomy, after destructive cholecystitis in them had escaped detection. Cholecystectomy was performed on 28 patients for perforated destructive cholecystitis, and 25 of these died of peritonitis within 32 hours. Bronchopneumonia was the major cause of death of two patients and purulent cholangitis in a third case. Once early operation for acute cholecystitis had been introduced in 1965, no single patient was recordable from the post-mortem documentation who had died of the sequels of untreated gallbladder perforation below the age of 60. PMID- 3825327 TI - [Early diagnosis of diffuse peritonitis]. AB - Treatment for diffuse peritonitis was applied to 62 patients at the Surgical Clinic of Munster University, between 1983 and mid-1985. Mortality accounted for 46.8 per cent. Therapeutic approaches depended on both clinical patterns and intraoperative findings. Repetitive laparotomy with abdominal lavage and generous drainage was predominant. Only five cases were given treatment with opened abdominal cavity. With early diagnosis and immediate laparotomy, 17.7 per cent of all patients were cured, and no further operation was required. A second operation was necessary for 19.3 per cent, and several laparotomies were needed by another 16.1 per cent. Twenty of the above 62 patients (32.3 per cent) died in spite of several laparotomies. Nine patients (14.5 per cent) had been received in moribund and thus inoperable condition. The mean interval between first and second laparotomies was 5.3 days. Repeated abdominal lavage became necessary in cases in which the start of therapeutic action was delayed to 6.4 days on average. This interval had been 8.3 days for patients who died despite repeated surgery. Early diagnosis was found to be the decisive prerequisite to lower peritonitis lethality. Clinical parameters in conjunction with routine laboratory checks have proved to be sufficient for adequate diagnosis in 95 per cent of all cases. High-risk patients have to be identified long time in advance. They require early surgery and intensive postoperative supervision and monitoring, if the fatal vicious circle of peritonitis is to be overcome. PMID- 3825328 TI - [Peritoneal lavage as a standard therapeutic principle in diffuse purulent peritonitis]. AB - Programmed peritoneal lavage was performed on 72 patients with diffuse purulent peritonitis. The intervals up to planned relaparotomy were one to two days. An average of 4.2 lavages was conducted. The abdominal cavity was provisionally closed. Eleven of 34 patients with incurable trias survived. Histological and bacteriological follow-up checks produced evidence to rapid healing of peritonitis in the course of the lavage programme. PMID- 3825329 TI - [Therapeutic possibilities in adhesions]. AB - Laparotomy was performed on 36 patients with persistent "adhesion complaints". Good therapeutic success was obtained from detachment of omental adhesions on the abdominal wall and of omental cords from the minor pelvis as well as from adhesiolysis in the hypogastric region. No peritoneal adhesions at all were recorded from nine patients, although they had undergone several operations before. Complaints were removed from one third of all patients, while nearly 20 per cent were improved. One death occurred, following exploratory laparotomy, due to stress-induced ulcer perforation. No peritoneal adhesion had been present in that case. No complications at all were experienced with any of the other patients. PMID- 3825330 TI - [Misinterpretation of roentgenologically visible stenoses of the large intestine]. PMID- 3825331 TI - [Acute pelveoperitonitis with an IUD in place]. AB - Pelvic inflammatory diseases observed within 5 years in the department of obstetrics and gynaecology of the University of Szeged and caused by intrauterine conception have been studied retrospectively. The cases were 78 times mild and 53 times severe. Mostly the symptoms could be observed following long-time use. Treatment was a combination of chloramphenicol and gentamycine with addition of metronidazole. If there was no remission colpotomy and drainage were performed. If this manoever was not successfull laparotomy (salpingoophorectomy, hysterectomy) was necessary. Intraperitoneal lavage with antibiotics was done by means of a drain. The authors are of the opinion, that insertion of IUD is allowed only in cases of negative gynaecological findings. Continuous supervision is compulsory. In cases of minimal complaints removal of IUD has to be considered. PMID- 3825332 TI - [Effect of local estriol therapy on the urethral pressure profile in the postmenopausal period]. AB - Measurements of the pressure in the urethra were performed under standardized conditions with the aid of perfused catheters in 20 fertile and 20 postmenopausal women, from it 12 women after local estrogen therapy by means of Ostriol-Ovula. Hormone-cytological swabs from the urethra, vagina and from the urinary cells were done. Proliferation of the urogenital epithelialia under the estriol-therapy and an ascent of the MUP and MUCP in the urethra pressure profile under resting conditions could be achieved. The maximum of the pressure profile could be displaced proximaly. In the urethra pressure profile the distal pressure transmission increased. Estriol therapy was without secondary effects and is suitable for the conservative therapy of the stress incontinence type I to III. PMID- 3825333 TI - [Incidence and pregnancy rates in various causes of sterility]. AB - A precise diagnostic procedure could be done in 1,450 sterile couples in the years 1975 to 1982. The prevailing cause of sterility was female in 67 per cent, male in 22 per cent and both female and male in 11 per cent. Pregnancy rate over all was 35 per cent and after therapy 45 per cent. There was a distinct correlation between pregnancy rate, age of the patient and duration of desire for child. 73 per cent of all conceptions occurred in female sterility; 77 per cent of it in ovarian sterility. Simple therapeutic methods like gestagens or clomiphene and conversational therapy achieved the highest pregnancy rate. Only a little proportion of the pregnancy rate could be obtained by highly specialized measurements like FSH/HCG (7 per cent) or operative interventions (8 per cent). In cases of male reasons only 8 per cent of all pregnancies could be attained. 62 per cent of all pregnancies supervised were live births. Because highly specialized methods are not able to influence the rate of conceptions over all embryo transfer will be more and more the alternative method in cases of sterile couples treated without success till now. PMID- 3825334 TI - [Principles of the prevention, early detection, treatment and aftercare of cervix cancer]. AB - The WHO classification of epithelial tumors of the uterine cervix is recommended. Cytology is more suitable as colposcopy as screening method. The best method for diagnosis is cone biopsy. Dysplasia and carcinoma in situ may be treated stepwise, whereas invasive carcinoma must be operated on radically by abdominal route or irradiated. PMID- 3825335 TI - [Sexuality and urinary incontinence]. AB - In an attempt to investigate correlations between sexuality and urinary incontinence (UI), fifty-one women with stress incontinence (18), urge incontinence (12), or combined stress/urge incontinence (21) were interviewed on their sexual behaviours, prior to and after development of UI. The results were compared with data on the average female population in the GDR. Women with subsequent UI were found to have perceived cohabitarche as extremely beautiful or disgusting or anorgastic with significantly higher frequency, as compared to the general female population. The average number of sexual partners and frequency of cohabitations had been higher with women in whom UI was to develop later on. Their sexual behaviours did not come closer to those of the general female population until UI was growing manifest. While marital problems were quoted as causes of UI by 39 per cent of the interviewers, only 14 per cent gave a negative assessment of their present partnerships. Reduced sexual relationships were often (47 per cent) offset by vicarious sexual activities. These women were more often than others suspected of trying to find a pretext for evading sexual intercourse on grounds of marital problems. Yet, one third of women with UI said that during orgasm they would strongly press downward, which might result in additional strain on the pelvic floor. In other words, sexual disorders and UI appeared to favour each other. Hence, psychosomatic and sexological investigations on interhuman relations should be adopted as part of comprehensive therapeutic planning to cope with urinary incontinence. PMID- 3825336 TI - [Urodynamic and roentgenologic findings before and following complex physical therapy of urinary incontinence in the female]. AB - In 42 patients complaints following therapy have been correlated to the pretherapeutic urodynamic findings and in 58 patients pre- and posttherapeutic urometric and X-ray findings have been compared independent from subjective result in oder to have objective parameters for the effectivity of conservative treatment of urinary incontinence. The best results could be achieved, if in the starting urometry the pressure transmission was bad and the dosing pressure of the urethra in rest adequate to the age. In analogy about identic urethral closing pressure in rest, but significant increase of the functional urethral length and a better pressure transmission in a sitting position could be found. Good results of conservative treatment on urge incontinence symptomatology could be derived from increasing bladder capacity and compliance. Against it a posttherapeutic increase of urinary incontinence signs by training-effects of exercise therapy has to be stated in the comparison of X-rays. Altogether the high rate of 63 per cent curing and 20 per cent improvement could not be detached sufficiently by urometric and radiography findings. This discrepancy has been discussed. PMID- 3825337 TI - [Results of electrical sensitivity tests of the urethra and vagina in functional urinary incontinence]. AB - Urethral and vaginal sensibility has been tested in 90 patients with urinary incontinence by means of urethral catheter and vaginal electrodes. Monophasic rectangular impulses with a frequency of 2 Hz, a duration of 2 msec and a variable intensity were used. The urethral sensibility threshold was 10.5 mA in patients with urge incontinence and 14.8 mA with stress incontinence. The vaginal sensibility threshold was by 20 mA higher and correlated well with the urethral one in its differentation of stress and urge incontinence. Because the big scattering of the values there was no statistical significance. Therefore this method is only valid to clarify patients complaints and to define impulse parameters for therapeutic intravaginal electric stimulation. PMID- 3825338 TI - [Leiomyosarcoma of the urethrovesicovaginal septum]. AB - Case report on a leiomyosarcoma situated within the septum urethrovesicovaginale. The patients has been operated before on three times because of a leiomyofibroma at the same place. The histologic diagnose is based on morphologic and immunhistochemisch findings. The patient was treated with an exstirpation of the tumour only. Principal considerations about the radicality of the tumour therapy are deduced from. PMID- 3825339 TI - [Pathogenesis and control of infectious diseases caused by factors in animal production]. PMID- 3825340 TI - [Effect of oral vitamin E administration on parameters of resistance to infection in swine in the early fattening stage]. PMID- 3825341 TI - [Multiplication of the pathogen of avian infectious anemia (CCA) in chick embryos]. PMID- 3825342 TI - Comparative isolation and characterization of secretory IgA immunoglobulin from sow milk. PMID- 3825343 TI - [Frequency of infection with Campylobacter jejuni/coli and the occurrence of IgG, IgM and complement-fixing antibodies against the agent in workers in poultry abattoirs in Santiago, Chile]. PMID- 3825344 TI - Quantitative analysis of immunoglobulins G1 and G2 in blood samples of cattle persistently infected with bovine virus diarrhoea virus. PMID- 3825345 TI - [Effect of corticosteroid hormones on the lymphoid system of vertebrates]. AB - Studies have been made on cellular mechanisms of changes in the lymphatic organs of some vertebrates after the effect of hydrocortisone. The latter in a dose 100 mg/kg of the body mass significantly decreases the activity of the thymus in the tortoise Testudo horsfieldi, albino mice and frogs. The decrease in lymphopoiesis was also observed in the spleen and bone marrow. The duration of the latent period for the reaction of the lymphatic system is species specific. It amounts to 1-3 days in rats and mice, 3-5 days--in frogs and 5-10 days in tortoises. Possible mechanisms of these effects are discussed. PMID- 3825346 TI - [The phenomenon of the replication of ontogenetic immaturity in adult cats caused by the cerebrospinal fluid of kittens]. AB - Studies have been made on the electrical activity of muscles in the hindlimbs in kittens and adult cats before and after injection the liquor from 10-, 21-day and 1-month kittens into the lumbar part of the spinal cord. Analysis was made of the EMG at rest and that of the evoked reactions. It was shown that EMG of adult cats after injection of kitten liquor attained the pattern typical of the donor. The data obtained indicate the presence in kitten liquor of biologically active substances which account for the level of regulatory relationships. Transfer of these substances to adult animals results in the formation of a new level of coordinations of movements which corresponds to immature organism. PMID- 3825347 TI - [Changes in the organic matrix composition of the solid tissues in chick embryogenesis]. AB - Biochemical studies have been made on the dynamics of organic matrix of the bone tissue and on its calcification during embryogenesis of chicks. Carbohydrate composition of non-collagen proteins and the degree of mineralization of the bone tissue, as well as utilization of carbohydrates and mineral substances from the egg shell were investigated at various stages of embryonic development. The role of carbohydrates in bone histogenesis and its mineralization is discussed. PMID- 3825348 TI - [Radial distribution of digestive enzymes in the small intestine of rats and chicks]. PMID- 3825349 TI - [Effect of scientific progress on the improvement of the teaching of microbiology, virology and immunology]. PMID- 3825350 TI - [Ability of Citrobacter freundii strains isolated in acute intestinal infections to produce LT-enterotoxin]. AB - C. freundii enteropathogenic strains were found to be capable of producing choleroform thermolabile enterotoxin. Thus, in the study of 96 C. freundii strains 38 enterotoxin-producing cultures (39.5%) were revealed by means of the molecular-biological techniques and 29 such cultures (30.0%), by means of the radioimmunoassay (RIA). 100% coincidence was noted in the results of tests for enterotoxigenicity, made by means of RIA or hybridization techniques with the use of the LT-probe containing a cloned fragment with the gene coding the synthesis of LT-enterotoxin in enterotoxigenic Escherichia coli. At the same time only 29 out of 38 Citrobacter strains found to be positive in the hybridization tests, yielded the positive result when tested in RIA for the presence of LT enterotoxin. This fact should be taken into consideration in the determination of enterotoxin-producing cultures isolated in acute enteric infections, as the method of genetic probing is capable of bringing out the genetic information in bacteria even in the absence of its phenotypical expression. PMID- 3825351 TI - [Microflora of the upper respiratory tract in young children under normal conditions and in respiratory tract diseases. Microbial count of the upper respiratory tract in healthy children and in children with pneumonia]. AB - The results of the inoculation of material taken from the anterior section of the nasal cavity and from the pharyngeal mucosa of 50 healthy young children and 298 acute pneumonia patients were analyzed. 23 microbial species were isolated. In the samples taken from the anterior section of the nasal cavity, monocultures were detected in 86 samples and 54 variants of associations including 2-4 species, in 139 samples. In the samples taken from the pharynx, monocultures were detected in 59 samples and 180 variants of associations including 2-6 species, in 282 samples. Differences in the contamination of the nasal cavity and the pharynx in healthy children and in pneumonia patients were revealed. These differences were manifested in the structure of the microflora (monocultures, associations, their composition), the assortment of microbial species and their concentration. In young children with pneumonia the microflora of the upper respiratory tract was found to reflect the severity of acute pneumonia and the intensity of the pathological process in the lungs (uncomplicated, pyodestructive pneumonia, pyodestructive pneumonia with fatal termination, acute purulent pleurisy). PMID- 3825353 TI - [Characteristics of microbial associations represented by the Enterobacteriaceae family isolated from the feces of healthy children and children with salmonellosis]. AB - Associations formed by microorganisms of the family Enterobacteriaceae in feces have been studied using the principles of ecological investigation. The study has revealed that the associations isolated from children with salmonellosis sharply differ from those isolated from healthy children in the number of species and in the variety of their combinations, as well as in changes in the proportion of different species, observed in multiple investigations. PMID- 3825352 TI - [Detection of enterotoxigenic enterobacteria with adhesion antigens in acute intestinal diseases]. AB - As revealed in this study, 56.8 +/- 4.3% of children under 1 year, suffering from acute intestinal diseases of unknown (i.e. not determined by common bacteriological methods) etiology, show the presence of enterobacteria capable of the combined synthesis of enterotoxins and adhesion antigens. No such cultures are isolated from healthy children. In cases of diarrhea of domestic animals (piglets and calves), frequent isolation of enterobacteria characterized by both, toxigenicity and capacity for producing adhesion antigens (50.6 +/- 4.8% and 42.9 +/- 4.8% respectively), is noted. PMID- 3825354 TI - [Serological surveillance of diphtheria]. AB - The serological method (indirect hemagglutination test) has been used in the surveillance of diphtheria infection. The structure of immunity to diphtheria in the population of the region has been studied. The possibility of increasing intervals between booster immunizations has been confirmed. The introduction of planned booster immunizations of the adult population with diphtheria toxoid is proposed. PMID- 3825355 TI - [Epidemiological danger of patients with pulmonary tuberculosis and alcoholism refusing treatment]. AB - The comparative evaluation of the epidemiological danger of alcohol-addicted persons with pulmonary tuberculosis who evaded treatment (the test group of 133 persons) and that of tuberculosis patients receiving adequate treatment under hospital conditions (the control group of 162 patients) was made. The morbidity level among relations having contacts with the patients evading treatment exceeded the morbidity level in the families of tuberculosis patients undergoing adequate treatment 4.5-fold for adults and 3.4-fold for children and adolescents, the contamination level in the latter group being twice as high. Although no cases of the disease were registered in the foci of infection where sick persons evading treatment had low bacterial discharge, still the elevated level of infection among children and adolescents in these foci as compared with the foci where tuberculosis patients did not evade treatment (35.0% and 21.7% respectively) indicated that the foci of infection where such aggravating factors as alcohol addiction in the source of infection was present were rightly considered to be epidemiologically most dangerous. Persons suffering with both tuberculosis and alcoholism should be subjected to compulsory hospitalization as early as possible. PMID- 3825356 TI - [The rate of detection of hepatitis B markers in persons with chronic alcoholism]. AB - A total of 707 males suffering from chronic alcoholism and 447 male donors not abusing alcohol have been surveyed in different regions of the USSR. The presence of HBsAg, as well as anti-HBs and anti-HBc antibodies, has been determined by the enzyme immunoassay. The survey has revealed a high rate of hepatitis B virus infection in chronic alcoholics in comparison with the control group, which gives grounds for including such persons into a high risk group with respect to viral hepatitis B infection. PMID- 3825357 TI - [Immunobiological characteristics of impurities in corpuscular influenza vaccines]. AB - Admixtures of free antigens have been shown to play the main role in the anaphylactogenic danger of vaccines. The immunogenic and anaphylactogenic action of such antigenic admixtures in corpuscular influenza vaccine can be observed after the immunization of animals in 2 or 3 injections. Host antigens incorporated into viral particles induce no anaphylactic reaction in guinea pigs after their immunization in 3 injections. PMID- 3825358 TI - [Hemagglutinating test for HBsAg and antibodies in epidemiological practice]. AB - The use of Alsever's solution has abolished the necessity for taking intravenous blood and made it possible to divide the determination of HBsAg and antibodies to this antigen into two stages. The combined determination of HBsAg and its antibodies by the third-generation techniques improves the quality of the epidemiological survey of hepatitis B cases and the epidemiological observation of risk groups. PMID- 3825359 TI - [Possibility of inactivation by formalin of staphylococcal protein A at different stages of its production]. AB - The possibility of the formalin inactivation of material containing staphylococcal protein A in the process of obtaining the preparation has been studied. The inactivation of the material with formalin at a concentration of 5% (from the volume of the material) for 1 hour has been shown to ensure a complete bacteriostatic effect and the stability of the initial biological activity of staphylococcal protein A. PMID- 3825360 TI - [Neurologic characteristics of patients with flat EEG's and EEG's with predominant low-frequency beta activity]. AB - The authors analyzed clinical manifestations and reactive changes in the EEG in response to eye opening and light flickering in 3 groups of patients selected according to the parameters of baseline EEGs: Group I (control) (n = 20) was characterised by normal EEG; Group II (n = 50) by domination in the EEG of beta activity of low frequency; Group III (49 patients) by a "flat" curve. It was found that micro-symptoms of organic lesion of the CNS were observed in 15% of the Group I patients, in 36% of the Group II patients, and in 61.2% of Group III patients. In Group II neurotic and neurosis-like manifestations of a hysterical type were observed in 34% of the patients while 38% of the patients in Group III presented anxiety-depressive states. The groups studied also showed significant differences in reactive shifts in the EEG. A scheme of identification of different EEG-syndrome complexes may prove useful in clinical electroencephalography. PMID- 3825361 TI - [Features of the effect of the sera of patients with hepatocerebral dystrophy on nerve tissue in vivo and in vitro]. AB - Electron microscopy of normal rabbit brain, conducted after the animals had been given intracerebral injection of serum obtained from patients with hepatocerebral dystrophy revealed some peculiarities of the damaging effect of such serum on the brain. Incubation of neural tissue culture with such serum resulted in appearance of hypertrophic astrocytes, type II Alzheimer's cells and Opalski's cells combined with the intact synthesis of an astrocyte specific antigen--an acid protein of astrocytic fibrility--detected by Coons' immunofluorescent test. PMID- 3825362 TI - [Complex use of functional bioregulation and galanthamine in spastic forms of infantile cerebral palsy]. AB - The authors describe a method of restorative therapy including functional bioregulation combined with the administration of galanthamine in children with spastic forms of infantile cerebral paralysis. A course of 15 biotraining sessions combined with galanthamine administration brings about a considerable improvement in both clinical and electrophysiological parameters. The initial values of the bioelectrical activity of the studied muscles have been found to be of a prognostic value with regard to the possible therapeutic effect. PMID- 3825364 TI - [Thrombolytic therapy with streptodekase in ischemic strokes]. AB - Thrombolytic agents previously employed in the treatment of ischemic stroke were associated with adverse side-effects and hemorrhagic complications. The use of streptodekase (S), a Soviet trombolytic drug, which is a long-acting immobilized ensyme proved to be highly effective. The efficacy of S in ischemic stroke was not investigated. The authors report the use of S within the first 6-8 hours after an ischemic stroke in thrombosis of the main stem of the middle meningeal artery in one case and of the vertebral and main arteries with the development of the locked-in syndrome in the other. In both cases the administration of S led to thrombolysis and restoration of the blood flow. The authors discuss the results of the use of S and indicate the necessity of the earliest possible administration of the drug with regard to a high sensitivity of the brain to ischemic lesions. PMID- 3825363 TI - [Functional tests in the diagnosis of cerebral dystonic venous disorders]. AB - The authors conducted rheographic and opthalmoretinal studies of 85 patients with cerebral venous dystonias and of 20 control patients using functional loads (-30 degrees head-down tilt). In the control subjects the diastolic pressure in the central retinal vein (CRV) in head-down tilt test was 10.1 +/- 0.3 mm Hg, showing no significant difference from the initial level (9.0 +/- 0.4 mm Hg), p greater than 0.05. The patients with cerebral venous dystonias presented a significant increase in the diastolic pressure in the CRV by 4.9 +/- 0.2 mm Hg, p less than 0.001, which is indicative of a compromised intracranial venous pressure. PMID- 3825365 TI - [Status of deep muscle sensitivity and its role in the pathogenesis and course of lumbar osteochondrosis]. AB - A study of the duration of a simple motor response to a passive displacement of a finger in 67 patients with lumbar osteochondrosis revealed 11 patients in whom parameters of this response were asymmetrical. Clinically these patients were characterized by a more severe course, frequent exacerbations, and an early development of the disease and hereditary predisposition to it. Sharp awkward movements were the most frequent provoking factor. PMID- 3825366 TI - [Use of the concept of determinant structures in the practice of reflexotherapy]. AB - The author developed a method of identifying acupuncture points which are most suitable for pressure impact in different patterns of neurodynamic changes. A total of 130 patients with different neurogenic syndromes were treated with the help of the above method. Comparison of the results obtained in these patients as against a control group demonstrated the efficiency of the considered method. It is suggested that the effect of acupuncture is determined by its impact on the generator of the pathological stimulation. PMID- 3825367 TI - [The initial request for medical care for epileptic seizures]. AB - The author has analyzed the pattern of primary application for medical care in 119 patients who developed epileptic attacks for the first time in their lives. Early or late application for care depends on a number of factors shaping the patients' attitude toward the newly developed pathological condition. The earliest presentation was characteristic for patients aged 20-30 years in whom the disease onset was manifested in the form of convulsive generalized paroxysms, particularly in combination with aura and with a history of neurological disturbances. Workers and married people tended to present earlier. The author recommends that the above factors be taken into consideration in selecting therapeutic/rehabilitative measures. PMID- 3825368 TI - [Status of local cerebral blood flow in experimental animals after transfusions of cerebrospinal fluid from patients with cerebro-subarachnoid hemorrhage and epileptic patients]. AB - Acute and chronic rabbit experiments (n = 35) have demonstrated the changes of the local cerebral bloodflow in the frontal, parietal, and temporal lobes of the brain of animals transfused (through cannules implanted into the lateral ventricles) 0.6 ml of the patients' liquor. Transfusion of the CSF from epileptics resulted in a drastic increase of the local cerebral bloodflow, whereas transfusions of the CSF from patients with cerebro-subarachnoidal hemorrhages lead to decrease of the bloodflow intensity. These changes were recorded in 5 min after the transfusion and persisted for 3 h, their degree correlating with the disease severity. The observed responses were more intensive than those to transfusions of artificial liquor or convalescent CSF. PMID- 3825369 TI - [Electroencephalographic characteristics of intellectual activity in astheno adynamic subdepressions]. AB - While performing associative verbal and arithmetic tasks patients with atypical subclinical astheno-adynamic subdepression with the predominance of asthenia-like thought disturbances presented characteristic disorders of reactive changes in several EEG factors. They appear to reflect non-reactivity and functional dissociation of the processes of activation, hyperactivity of the processes of cortical excitation, general blending of interzonal differences, elevated reactivity of the right hemisphere and parietal lobes of the brain. PMID- 3825370 TI - [Disorders of self perception and feeding behavior in patients with the syndrome of anorexia nervosa (clinico-psychological analysis)]. AB - An experimental psychological examination involved 87 patients with anorexia nervosa of different nosological origin. Patients with anorexia nervosa as part of borderline disease and schizophrenia presented specific characteristics of perception of their own appearance and of feeding habits. Patients with anorexia nervosa combined with borderline mental diseases showed close relationship between the orientation and degree of distortion of perception of the size of their own body and the nature of emotional value judgements. In schizophrenic patients with symptoms of anorexia nervosa this interrelationship was either absent or paradoxical in nature. All patients presented marked changes in the structure of feeding habits which were specific in each nosological group (lack of substitution effect, etc.). The results obtained served as a basis for appropriate psycho-corrective measures. PMID- 3825371 TI - [Comparative analysis of disorders of positive emotions in schizophrenic patients with defect traits and patients with endogenous depression]. AB - The hypothesis concerning a non-homogeneous disorder of the emotional sphere in schizophrenic patients has been experimentally tested. It has been demonstrated that signs of emotional depletion and depression in schizophrenic patients were predominantly expressed in deficiency of positive emotions whereas negative ones were relatively intact. Defect of positive emotions in these patients is manifested in diminution of the accuracy of assessing one's own emotions and emotiogenic situations of a positive nature and in a reduced impact of positive emotions on one's activities. In contrast to schizophrenics, emotion-related changes in patients with endogenic depressions (MDP, cyclothymia) were characterized by a predominant impairment of negative emotions. The results of the study are interpreted as signs of "deficit of positive emotions" specific of schizophrenic patients with emotional defect. PMID- 3825372 TI - [Clinico-psychological features of patients with favorable outcomes of slowly progressive juvenile schizophrenia]. AB - A follow-up study of patients with favourable outcomes of juvenile slowly progressing schizophrenia at the level of clinical cure (n = 84) revealed a number of clinical characteristics in the pattern of personality changes which correlated with a high level of the patients' social and occupational adaptation. The authors also determined external factors contributing to the achievement and stabilization of the "clinical cure" status. An experimental and psychological examination of these patients revealed finer mechanisms contributing to their social adaptation. These are high motivation of activities, compliance with social norms, a high level of voluntary regulation of activity and self regulation, as well as the ability to overcome autistic trends in situations of interpersonal activities and cooperation. PMID- 3825373 TI - [Study of the emotional range of schizophrenic patients in a model of emotion recognition through nonverbal expression]. AB - Emotional characteristics of schizophrenic patients have been studied using an experimental model of emotion recognition. It has been shown that with further emotional depression and depletion schizophrenics show a deterioration of the accuracy of recognizing nonverbally expressed (by gestures, postures, or mimics) emotions and an increased tendency for non-emotional interpretations. The study has revealed a complex nonuniform nature of these changes, their dependence on the degree of the situation recognizability, on the channel of emotional information transmission, as well as on the sign, modality, and intensity of emotion expression by another man. The results obtained are interpreted as a sign of empathy diminution, of an increase in emotional "dullness" in intercourse, and of "glass and wood" symptom in patients with schizophrenia. PMID- 3825374 TI - [Psychological mechanisms of thought disorders in psychopathies]. AB - The author studied patho-psychological cognitive disturbances in psychopathic patients. It is hypothesized that psychological mechanisms of cognitive deficit in psychopathic patients include insufficient orderliness and hierarchic instability of semantic formations. PMID- 3825375 TI - [Effect of vascular pathology on the clinical picture of schizophrenia]. AB - The author studies 109 patients with schizophrenia combined with cerebrovascular pathology (vegetovascular crises, essential hypertension, cerebral atherosclerosis). The effect of vascular disorders on the clinical picture and course of different forms of schizophrenia was found to be heterogeneous, being dependent on the severity of vascular disease, as well as the type of the course and progression of the schizophrenic process. Changes in the psychopathological structure of schizophrenic manifestations were the greatest in patients with periodic, shift-like, and slowly progressive schizophrenia. PMID- 3825376 TI - [Attitude of hysterical patients to an experimental situation]. AB - The article analyses the way in which hysterical patients' attitude to an experimental situation affects the results of an experiment. It has been assumed that depending on the nature of an experiment and the motivational content of the stimulating material the patients' attitude toward the experiment will also change. Comparison of the above attitudes in different variants of technique denoted as "the level of claims" has made it possible to characterize the specificity of hysterical patients' motivation expressed in excessively high claims and maintenance of inadequate self-assessment. The data obtained in the course of the experiment allow certain conclusions while determining the means to study the psychological syndrome in this group of patients. PMID- 3825377 TI - [Disadaptation of students with borderline mental disorders]. AB - A clinico-epidemiological study was devoted to psychopathies and neuroses in students. Students from different institutes showed significantly different borderline psychotic disorders. Initial disturbances, as well as the underlying causes of neuroses and psychopathy were analyzed. PMID- 3825378 TI - [Features of quarrelsome behavior in litigious-paranoid personality developing in advanced age]. AB - Quarrelsome behaviour was studied in 48 patients with a litigious-paranoid personality first developing in old age. It was shown that age factors had a great bearing on clinical manifestations of personality in the second half of life. PMID- 3825379 TI - [Psycholinguistic analysis of the speech of senile dementia patients]. AB - The author has studied 17 patients with senile dementia and its combination (in case of an underlying atrophic process) with cerebral atherosclerosis but without local pathomorphological changes. It has been found that in senile dementia the multilevel and multiaspect functional system of speech is impaired at both, a lower, phonetic, and higher speech (a phonological analysis) levels. Other findings with regard to the speech level include disturbances of programming a speech statement or internal speech (dynamic aphasia), impairment of grammatical structuring and damaged lexical choice. The above disturbances (above all programming of the internal speech) are linked with intellectual deviations and are secondary to atrophy of the frontal lobes. PMID- 3825380 TI - [Activation of lipid peroxidation in the bodies of schizophrenic and manic depressive patients]. AB - The intensity of lipid peroxidation was studied in schizophrenic and manic depressive patients. Peroxidation was found to be activated in these diseases as assessed by the content of peroxidation products in the lipid fraction of blood plasma. Manic-depressive patients showed a significant decrease in the intensity of peroxidation processes with improvement in the clinical symptoms of the disease. PMID- 3825381 TI - [Concentration of neuron- and non-neuron-specific enolase isoenzymes in different structures of the brains of mentally healthy subjects and schizophrenic patients]. AB - Using immunoenzymic assays, the authors studied concentrations of two isoforms of the glycolytic enzyme enolase (neurospecific, NSE, and non-neurospecific, NNE) in different structures of the postmortem brain in mentally normal people (n = 15) and in schizophrenics (n = 9). In schizophrenic patients NSE concentrations were increased by 70% (p less than 0.001) in the sensory cortex and reduced by the same magnitude in the thalamus. Insignificant changes in their levels (by 15-20%, p less than 0.05) were also discovered in the temporal cortex (elevation), lymbic cortex and the hippocampus (decrease). Cerebral values of NNE in schizophrenic patients were virtually unaltered; a certain augmentation was detected only in the hippocampus. It is supposed that marked changes in NSE concentrations in the sensory cortex and in the thalamus are probably related to the pathological processes occurring in the neural tissue in schizophrenia. PMID- 3825382 TI - [Cerebral hemodynamics in stenoses of the internal carotid artery]. AB - The cerebral hemodynamics was studied in 51 patients with varying severity of stenoses of the internal carotid artery (ICA) expressed in transient disorders of the cerebral blood flow or ischemic strokes. To study the cerebral blood flow (CBF), the authors used the 133Xe-inhalational method; in their analysis they also considered the findings of clinical, angiographic and computer-aided tomographic examinations, as well as the rheological parameters of the blood. It has been established that the main characteristics of the cerebral hemodynamics in patients with ICA stenoses are a moderate diffuse reduction of the CBF in both hemispheres of the brain without a clear-cut interhemispherical asymmetry, the absence of the dependence of the CBF on the degree of ICA stenoses, inverse correlation between the degree of the total narrowing of the lumen of all main arteries of the head and parameters of the CBF, as well as a sharper decrease in the CBF in cases where the total stenosis of the main arteries of the head exceeds 40%. The article deals with the pathogenesis of cerebral circulation impairments in ICA stenoses and the selection of the tactics of treating patients. PMID- 3825383 TI - [Role of the structuro-functional disorganization of cell membranes in the pathogenesis of strokes]. AB - The authors determined the levels of lipoperoxides and activities of endogenic phospholipases in red cell membranes and cerebrospinal fluid in 101 patients with ischemic and 35 patients with hemorrhagic strokes. The authors established increases in the activities of endogenic phospholipases and of processes of peroxidation of membrane lipids which correlated with the severity and outcome of cerebral strokes. It has been proved that the parameters of activity of membrane destructive processes may serve as criteria characterizing the severity and predicting the outcome of acute cerebral circulation impairments. PMID- 3825384 TI - [Diagnostic and prognostic role of organ-specific plasma enzymes in the acute period of cerebral circulatory disorders]. AB - Sixty-two patients with ischemic stroke were studied over time (1st-12th day) for the activity of enzymes and isoenzymes of energy metabolism (CPK, LDH, SDH). It has been shown that the brain-specific CPK BB-isoenzyme may serve as a marker of the severity and extension of brain damage while the aerobic LDH fractions may be useful in evaluation of the reversibility of hypoxic changes in the brain. The authors consider the employment of the studied enzymes for the prognosis of vascular and tissue damage. PMID- 3825385 TI - [Methods of angiography and cerebral blood flow determination in evaluating the status of the collateral circulation]. AB - It is a known fact that the value of the cerebral blood flow (CBF) in the hemisphere where the internal carotid artery (ICA) is occluded may serve as a quantitative parameter of the collateral blood supply (CBS). Comparison of the findings obtained by cerebral panangiography (CPAG) versus inhalational studies of the CBF in 38 patients with occluded ICA has demonstrated that although CPAG is quite adequate for assessing the status of the collateral blood circulation routes, a more optimal method for evaluating the status of the CBS is measurement of the CBF since in at least half the cases CPAG yields inaccurate information about the CBS in patients with impaired cerebral blood circulation. The studied methods are not competitive but should be used in conjunction for obtaining the most complete information about the cerebral hemodynamics which is particularly important to consider in making decisions about the advisability of surgical intervention. PMID- 3825386 TI - [Diagnostic value of cerebrospinal fluid spectrophotometry in acute cerebral circulatory disorders]. AB - The direct spectrophotometry of the cerebrospinal fluid (CSF) is recommended as an auxiliary method for differential diagnosis in patients with acute cerebrovascular disorders. Using both literature data and their own findings the authors have developed the scheme of spectrophotometry of the CSF which includes measuring the optic density in 265, 280, 365, 400, 415, 450, 460, 530 and 540 nm. This measuring in 9 ranges makes it possible to identify the character of the illness without analyzing the optic density in the full spectrum of ultraviolet and visible light. PMID- 3825387 TI - [The role of carotenoids in the development of compensatory reactions of the body to hypoxia]. AB - As a result of the examination of 76 patients with atherosclerosis (57 with ischemic stroke and 19 with chronic cerebrovascular insufficiency) the authors have established a definite correlation between the blood levels of carotinoids and the degree of hypoxia and cerebral ischemia, as well as between pigment concentrations and the oxygen consumption by tissues which indicates an active participation of carotinoids in the processes of body adaptation to hypoxia. The necessity of the drug correction of carotinoid concentrations in patients with ischemic vascular lesions of the brain is justified. PMID- 3825388 TI - [Pharmacodynamic action of cavinton on regional volume blood flow, central hemodynamics and the bioelectric activity of the brain in the acute stage of a cerebral infarct]. AB - Forty-two patients with acute cerebral infarction were studied for the regional volumetric cerebral blood flow (rVCBF) and central hemodynamics (by integral rheography of the body) before and after the intravenous administration of 10 or 20 mg of cavinton (vinpocetine). It was found that in the absence of changes in the central hemodynamics an increase in the cerebral blood flow was the predominant characteristic, but parodoxical reactions were occasionally observed in the acute period of an extensive hemispherical infarct. The findings of quantitative frequency analysis of the EEG conducted in 40 patients correlated with the results of the study of the blood flow and indicated a more favourable prognosis in brain stem infarction or mild cortical infarction. Treatment of extensive cortical infarction was associated with cases of parodoxical deterioration of brain function which should be taken into account in prescribing cavinton to patients during the acute stage of cerebral infarction. PMID- 3825389 TI - [Features of the ultrastructure of the brain tissue of Meriones unguiculatus after cerebral ischemia and postischemic recirculation]. AB - The authors studied the ultrastructure of the brain tissue in "symptom negative" clawed jirds (M. unguiculatus) in the presence of permanent and transient circulatory ischemia caused by ligation of the right common carotid artery and by a 3-minute occlusion of the left common carotid artery which was unattended by any clinical manifestations signifying cerebral ischemia. The formation of oedema and dystrophic changes in the right hemisphere differed from that in the left one. Permanent ischemia was associated with the typical picture of hypoxic damage to the neural tissue with the development of cytotoxic oedema. Transient ischemia was predominantly characterized by an impairment of the blood-brain barrier with the development of marked vasogenic oedema. The study made it possible to closely follow the differences in the formation of an early stage of brain damage in permanent and transient ischemia and to establish the possibility of the damaging effect of blood recirculation in the hemisphere previously affected with ischemia. PMID- 3825390 TI - [Features of the regulation of autonomic nervous system functions in various paroxysmal states of cerebral origin]. AB - The authors studied a total of 218 patients with such pathological states as neuroses with vegetovascular crises, the hypothalamic syndrome, temporal epilepsy, and neurogenic syncopes (four groups). Clinical peculiarities of psychovegetative manifestations and the status of autonomic regulation were analyzed in the above groups. The authors consider the role of a number of factors exercising influence on the organization of the functional regulation of the autonomic nervous system, the degree of changes in the psychological sphere, the nature of the pathological process, the level of damage to the cerebral structures, and the status of the initial vegetative tonus. It has been established that each of the above factors has different significance with regard to the formation of the adaptive behaviour of patients. PMID- 3825391 TI - [Clinico-morphologic aspects of the active skin points of the upper extremities and their importance in reflexotherapy]. AB - Using an acoustic apparatus designed by G. N. Novinsky the authors studied the morphological structure of the skin in the area of active points on the arm. The authors also used micro-macroscopic preparation after V. P. Vorobiev with the subsequent histological investigation of the sites where these points were distributed. There was a considerable amount of friable connective tissue in the area of the active points which was distributed in the form of meshwork in some areas. The data obtained make it possible to specify the topography of the distribution of active points which is of great practical value for improving the efficacy of acupuncture. PMID- 3825392 TI - [Complex system of differentiated prediction of strokes]. AB - On the basis of the data on 2287 patients with cerebral strokes (CS) and 800 individuals without this disease, and using discriminant and probability methods, the authors have identified 158 supposed risk factors (RF) of CS development. They have also established the specificity of RFs which depends on the nature of CS, as well as ascertained the dependence of informative value of these factors on the size of samples and the degree of percentage reflection by the main demographic indicators of the studied population. RFs are classified as controllable and uncontrollable. The authors have selected 50 risk factors with 2 5 gradations ranging from the normal to the maximal pathology and reflecting various aspects of CS etiopathogenesis. This work has resulted in the creating of a mathematical model of SC development. On the basis of this model and using the Bayes' theorem the authors have developed a system intended for predicting CS and its nature by 50, 25, and 15 RFs which is implemented by means of universal, micro- or minicomputers and tables which make it possible to predict with a 88.8% accuracy the development of CS as well as to determine the most rational individual prophylaxis of threatening stroke which is achieved through an accurate balancing in the system of controllable and uncontrollable RFs. PMID- 3825393 TI - [Complex treatment and follow-up of the dynamics of the recovery process in injuries of the nerve trunks of the extremities at polyclinics]. AB - On the basis of the experience with the treatment and monitoring of the time course of the restorative process in 578 patients with damaged nervous stems of the extremities treated at the rehabilitative department of polyclinic No. 51 in Leningrad, the authors propose a therapeutic and diagnostic complex adapted to both different stages of the recovery period of the neuromuscular apparatus and conditions of the rehabilitative department of the polyclinic, which has been in use since 1979. PMID- 3825394 TI - [Prognostic value of the motivational characteristics of schizophrenic patients]. AB - The authors present the results of experimental psychological examination of 132 patients with paranoid continuously progressive schizophrenia. The authors also validate the introduction of a psychological criterion into rehabilitative work with schizophrenic patients under conditions of industrial production, describe the motivational components of activity in experimental conditions and at an industrial enterprise. The data are considered differentially in relation to the type of remission (apatho-abulic and paranoid types). Recommendations on psychocorrective work in a rehabilitative team are given. PMID- 3825395 TI - [Clinico-dynamic aspects of long-term remissions in schizophrenia]. AB - The authors studied 56 patients with paroxysmal schizophrenia who had remissions lasting over 10 years. Three variants of such long remissions were identified: with a negative time-course characterized by a gradual decrease in their quality and the presence of signs of slow progression of the disease; with a positive time-course characterized by an elevation in their levels, a gradual reduction of positive symptomatology and stabilization of the patient's status; stationary remissions with an unaltered clinical picture throughout their course. The time course of prolonged remissions correlated with the regularities of the course of the endogenic process on the whole. Sociotherapeutic recommendations are presented for each of the identified variants. PMID- 3825396 TI - [Dynamics of remissions and readaptation of patients with paroxysmal schizophrenia (according to the results of a clinico-follow-up study)]. AB - One hundred and ten patients were followed up for 10-15 years after a manifest attack, using a special programme designed for investigating patients' social and occupational readaptation. The authors revealed fairly high readaptive possibilities of patients with paroxysmal schizophrenia and determined possibilities of compensation in patients with various clinical types of remissions, with regard to the number of previous attacks. It was found that patients with sthenic and thymopathic types of remissions had the best readaptive potentials. PMID- 3825397 TI - [Disorder of selective attention in patients with late-manifesting schizophrenia with a syndrome of involutional paranoia]. AB - Selective attention was studied by registering cortical evoked potentials to acoustic stimuli in mental patients and mentally healthy subjects of old age. Disorder of selective attention in the patients was manifested in an impaired ability of the higher portions of the central nervous system to differentiate between essential and non-essential external stimuli as well as in a weakened inhibition of irrelevant information. PMID- 3825398 TI - [The role of the self-consciousness of schizophrenic patients in the socio vocational readaptation]. AB - Using clinical and special medico-psychological methods, the authors studied 154 patients with schizophrenia with different rates of the disease progression and at different stages of the disease. The authors studied the condition of the patients' self-consciousness in relation to the possibilities of their social and occupational readaptation. It has been established that the working ability of patients depends on a number of factors, including their profession and working conditions, the influence of the family, the degree of progression of the schizophrenic process and the severity of negative symptoms. At the same time the level of patients' self-consciousness exerts a considerable influence on their social and occupational readaptation which should be taken into account in developing rehabilitative measures and in the course of expert medical examination of working capacity in such patients. PMID- 3825399 TI - [Family background of schizophrenic patients displaying acute delusional and hallucinatory psychoses]. AB - The authors studied the characteristics of the hereditary aggravation in probands with schizophrenia first manifested with acute delirious or acute verbal hallucinosis. They also considered the incidence of manifest and latent forms of schizophrenia and the rate of personality anomalies in families of probands with the differentiation of schizoid anomalies by the predominance of sthenic and asthenic features. The frequency of coincidence of the patterns of schizophrenic process among relatives was determined and the data obtained were compared with those in probands from each group. The comparative analysis has shown that the familial background of the studied group of probands reflects the following regularities characteristic of schizophrenia; an increase in the frequency of psychoses of the schizophrenic spectrum as against that in the general population, accumulation of homonomous types of the schizophrenia course and the presence in relatives of abnormalities of the schizophrenic nature. This justifies the referral of the studied forms of psychoses to schizophrenic diseases. PMID- 3825400 TI - Molecular forms of alkaline phosphatase in particular segments of the small intestine of adult rat. Separation of three enzyme forms from jejunum. AB - Rat duodenum and jejunum were found to contain three forms of alkaline phosphatase, F1, F2 and F3, and ileum two forms of this enzyme, F1 and F2. The procedure for separation of phosphatase F1, F2 and F3 from jejunum is presented. PMID- 3825401 TI - The cordycepin analogue of 2,5A and its threo isomer. Chemical synthesis, conformation and biological activity. AB - A new synthesis of the cordycepin analogue of 2,5A and its threo isomer is reported along with an assessment of their conformations by circular dichroism spectroscopy. Evidence is also presented showing that these compounds are stable against 2,5A-specific phosphodiesterase and are not able to activate the 2,5A dependent endoribonuclease, possibly due to a reduced binding to the latter enzyme as compared to that of 2,5A. PMID- 3825402 TI - Cation binding to parvalbumin studied by 113Cd and 23Na NMR. Peak assignment of rabbit (pI 5.5) parvalbumin. AB - Cation binding to three apoparvalbumins was studied by means of 113Cd NMR. The 3 parvalbumins that were investigated were carp pI 4.25, rabbit pI 5.5 and pike pI 5.0. The results showed that Cd2+ ions bind to the EF and CD sites of carp apoparvalbumin pI 4.25 with about the same affinity. For rabbit (pI 5.5) apoparvalbumin, Cd2+ binds preferentially to the EF site, while for pike (pI 5.0) apoparvalbumin, it was the CD site that exhibited somewhat higher affinity for Cd2+. The effect of Mn2+ on the 113Cd signals of rabbit parvalbumin was used to assign the 113Cd NMR signals to the EF and CD sites. The Mn2+ paramagnetic effect on rabbit and pike parvalbumins differed from that obtained for carp parvalbumin. This is in agreement with the assumption that the beta-lineage parvalbumins possess a third external site of higher affinity than the alpha-lineage parvalbumins. Furthermore, 23Na NMR was used to study Na+-Mg2+ competition in the native carp (pI 4.25) parvalbumin. The results showed that Na+ and Mg2+ compete for the same site, the third external site. PMID- 3825403 TI - Synthesis of trifluoromethylisoxazoloazines. AB - When reacted with mixtures of phosphorus pentoxide, aniline, and triethylamine hydrochloride, 5-acetamidoisoxazoles (2 and 3) gave isoxazolo[5,4-d]pyrimidines (4 and 7, respectively). The same reagent and cyclohexanone were used to prepare the isoxazoloquinoline 8. PMID- 3825404 TI - Reactions of 5-bromo substituted pyrimidine nucleosides with aqueous alkalies: kinetics and mechanisms. AB - Kinetics for the parallel and consecutive steps of the reactions of 5 bromocytidine, 5-bromouridine and its 5'-O-methyl and 2',3'-O-isopropylidene derivatives with aqueous alkalies were studied by LC. The mechanisms of the partial reactions involved are discussed. PMID- 3825405 TI - X-ray analysis of Ca2+ antagonists: 3,5-bis-(methoxycarbonyl)-2,6-dimethyl-4-(2 aminophenyl)-1,4- dihydropyridine hydrate. PMID- 3825406 TI - Elective induction of labour in the obstetrical practice. AB - Maternal and foetal results of 2020 elective inductions of labour are presented, compared with those of 2750 pregnancies in which labour was not induced during the 40th week of gestation, awaiting for its spontaneous onset. The morbidity, mortality, and the frequency of obstetric operations during labour were compared. In all the parameters compared, there were better results in the electively induced group. The author attributed this difference to the establishment of careful selection criteria for elective induction. These criteria are: reliable estimate of gestational age, mature foetus over 3000 g of body weight, ripe cervix, proven myometrial sensitivity to oxytocin. Following these rules, the elective induction of labour can be a valuable and safe method of prevention of maternal and foetal complications. PMID- 3825408 TI - Surgical management of complaints due to independent bone fragments in Osgood Schlatter disease (apophysitis of the tuberosity of the tibia). AB - The surgical treatment of complaints due to independent bone parts in Osgood Schlatter disease is described. Operations inducing the removal of the independent bone piece, the abrasion of the exostosis and the excision of inflamed connective tissue in their environment, were performed in 21 cases. By the intervention all patients could be relieved from their complaints. The pains are supposed to be due to inflammation caused by irritation on the surrounding region. PMID- 3825407 TI - Termination of normal and pathological pregnancy with Sulprostone. AB - 262 patients with normal pregnancy in the first and second trimester and 55 patients with pathological pregnancy (missed abortion, intrauterine death of the foetus, molar pregnancy) were successfully treated with the PGE2 analogue Sulprostone (Schering A. G.). The drug was administered intramuscularly in the first trimester of normal and pathological pregnancy and by constant intravenous drop infusion for induction of abortion in the second and third trimesters of pregnancy. In case of 38 patients Sulprostone was injected intramural-cervically for cervical dilatation. The efficacy was high and the incidence of side-effects was low and more acceptable in all groups compared with that after natural prostaglandins. On the basis of the results presented, the authors recommend for pregnancy termination with Sulprostone the intramuscular route in the first trimester of normal and pathological pregnancy and intravenous infusion in the second and third trimesters. PMID- 3825409 TI - Axial and random skin flaps. AB - Skin replacement by using pedicle flaps has undergone a change in attitudes during the recent 20 years. The most important results have been collected on the basis of literary data which, in our opinion, served as bases for the changes most decisively influencing flap grafting. A better understanding of the structure and blood supply of the skin and of the subcutaneous tissues led to the discovery and extensive use of regional pedicle grafts. By differentiating between axial and random flaps, various types of flaps with different biological behaviours could be classified. In possession of our current knowledge the method using surgical tube flap is considered to be outdated not playing any more a role in circular reconstruction. The axial skin flap does not need delay procedures, since on transferring the flap its blood supply remains unchanged. Only the transplanted random flap should be delayed or if it is larger than usual, an independent random flap should be used. Reduction of the pedicle of the axial skin flap has led to the discovery of the island flap, which can also be applied for regional, but--by using the microvascular method--also for distant replacement. The conception of musculocutaneous skin flaps has been based on these experimental and clinical results. PMID- 3825410 TI - A modification of the Visick grading for the evaluation of duodenal ulcer operations. AB - A series of 150 patients with duodenal ulcer, treated by means of a highly selective vagotomy, is presented. The clinical follow-up of 100 patients, treated for more than three years, was assessed according to the Visick classification. A thirteen percent recurrence rate was noted in this series. Recurrences could either be cured easily by medical treatment or induce long lasting medication or operative intervention. A subdivision of the Visick 4 class of patients is proposed in this study, taking into account this quite different evolution of ulcer recurrences after highly selective vagotomy. PMID- 3825411 TI - [Hyperselective vagotomy in the surgical treatment of duodenal ulcers]. AB - The results of hyperselective vagotomy for duodenal ulcer in 181 patients were evaluated 0.5-8.5 years after operation. The overall recurrence rate was 12.7%. The functional results were excellent in 151 patients (83.4%). PMID- 3825412 TI - [Whole bowel irrigation as preparation for colorectal surgery]. AB - One hundred consecutive patients underwent a whole gut irrigation as preoperative care for surgery of the large intestine. The solution used was balanced for isotonicity with mineral salts and polyethylene glycol. The procedure was quite well tolerated by the patients, also by the elderly. Only slight changes in body weight or in serum ionic concentrations were noted. In 88% of the patients the preparation was considered to be good or excellent by the operating surgeon. There was a tendency for low rate postoperative infections. PMID- 3825413 TI - [Pyostercoral peritonitis of diverticular origin. Retrospective analysis of 22 cases]. AB - Twenty-two cases of diverticulitis with perforation and peritonity have been treated whether by colostomy (13 cases) or primary resection (9 cases). Primary resection reduces mortality and morbidity of the emergency operation and the combined mortality and morbidity of all operative procedures. PMID- 3825414 TI - [A gallbladder filled with barium sulfate: an enigma]. AB - We report an unusual observation in a 60-year-old patient with a Ba-sulfate filled gallbladder. A thorough search of the literature failed to disclose a similar case. Several hypotheses are proposed. We could not find a satisfactory explanation for this phenomenon. PMID- 3825415 TI - Morphological changes in femoropopliteal venous grafts. AB - Morphological examination of specimens obtained from 82 venous grafts implanted into the femoropopliteal section were done. Intimal oedema, necrosis of single smooth muscle cells and partial exfoliation of the endothelium with as occurrence of parietal thrombi may lead to early graft impatency. The late cause of stenosed inner diameter below 4 mm in the venous graft was in 14,6% the hyperplasia of the smooth muscle cells and collagen and elastin fibres in the intima, whereas in 4,9% the changes were defined as graft atherosclerosis. PMID- 3825416 TI - [Brachial plexus block and locoregional anesthesia of the upper limb. Apropos of 50 cases]. AB - The authors report their experience about 50 cases of supra clavicular plexus block realised by Kulenkampff method. The anesthesia obtained has been complete in 84% of cases and in the 16% remaining general anesthesia was necessary to permit surgery. A case of late moderate pleural detachment and a case of post anesthesia paresthesia both spontaneously resolving were registered. Actually the adoption of perivascular techniques of brachial plexus anesthesia (interscalenic, supraclavicular, axillary) have greatly improved the performance of this variety of upper limb locoregional anesthesia, thus reducing the percentage of failure and eliminating or reducing the risk of pneumothorax. Locoregional anesthesia of the upper limb should constitute a daily method in the surgery of upper limb and not a technic subordinated to the contra-indications of general anesthesia. PMID- 3825417 TI - Diagnosis and treatment of unstable fractures of the pelvic ring. AB - The operative treatment of unstable fractures of the pelvic ring has gained upon the conservative treatment during the last years. The anatomical reconstruction and the stability of the bony structures allow a rapid postoperative mobilization and avoid the complications due to a difficult nursing and a long-time bedrest. The operative management could significantly diminish the mortality and morbidity in multitraumatized patients. The most recent classification of fractures of the pelvic ring pays great attention to the trauma mechanism and the degree of instability. Also in diagnostic procedures the surgeon pays attention to the stability of the dorsal pelvic ring. The value of CT-images is greater than the conventional roentgenograms in evaluating fracture form, dislocation and instability. A primary operative treatment is only necessary in certain emergency situations. All other operations can be carried out secondarily on the stable and well prepared patient. The external fixation is a simple procedure in emergency situations. In secondary operations we have the choice between the plate osteosynthesis on the ventral pelvic ring and a plate osteosynthesis or a transarticular arthrodesis on the dorsal pelvic ring. 53 of 62 patients with unstable fractures of the pelvic ring were operated upon in the Department of Traumatology of the University Clinic of Essen. The postoperative complications are reviewed and discussed. The invalidity in patients with fractures of the pelvic ring is more dependent on the lesions of the intra- or extrapelvic structures accompanying the fractures, than on the fractures themselves. PMID- 3825418 TI - [CT diagnosis of recurrent rectal carcinoma following surgery]. AB - It is well known that CT-scan imaging is very useful for diagnosing recurrence of a rectal carcinoma after surgical resection. According to this technique of investigation, more than 95% of recurrences are discovered and their size and pattern can be accurately defined. Furthermore, in case a postoperative fibrosis may be confused with a true recurrence, it is possible to punction percutaneously the mass with the help and guidance of the CT-scan. These findings were assessed and confirmed in 43 patients in the present retrospective study. PMID- 3825420 TI - [Breast implants: choice of prosthesis]. PMID- 3825419 TI - [Conservative treatment of small cancers located in the lower part of the rectum]. AB - This paper presents the experience of the "Institut Jules Bordet" in the treatment of small carcinomas located in the lower part of the rectum by transanal endoresection. This surgical procedure includes of a total resection of the tumor surrounded by normal tissue. It allows a detailed pathological study of the resected specimens and does not exclude the possibility of either a second surgical resection or an adjuvant radiotherapy. A better knowledge of the rectal cancer prognostic factors and a close cooperation between surgeon and pathologist spare a few patients a permanent colostomy and give them the same hope of cure as the more mutilation radical surgery. PMID- 3825421 TI - [Analysis of 66 cases of Baker's colorectal lateroterminal anastomosis]. PMID- 3825422 TI - [Functional subvesical obstruction. I. Detrusor-sphincter dyssynergia]. PMID- 3825423 TI - [Correction of tricuspid atresia using the modified Fontan operation]. PMID- 3825424 TI - [Retrosternal coloplasty in the treatment of post-corrosive esophageal stricture]. PMID- 3825425 TI - [Open and closed injuries of the abdominal organs based on our data]. PMID- 3825426 TI - [Crohn's disease (experience with surgical treatment)]. PMID- 3825427 TI - [The importance of lumbar sympathectomy in the treatment of peripheral arterial diseases of the lower extremities]. PMID- 3825428 TI - [Diagnosis and therapy of open injuries of the heart--personal experience]. PMID- 3825429 TI - [Pneumatosis cystoides intestinorum et mesenterii. Case report]. PMID- 3825430 TI - [Post-resection problems and their treatment]. PMID- 3825431 TI - [Trypsin inhibition by pectin. Some observations]. PMID- 3825432 TI - The effect of external sodium on the contracture responses of pacemaker preparations of Leptodactylus insularis. PMID- 3825433 TI - [Variation factors in the hematocrit and the number of red cells in the Zaian sheep breed from Morocco]. PMID- 3825434 TI - [Energy value of cassava leaves in the feeding of chickens]. PMID- 3825436 TI - Paraneoplasia--tumor products as signals. PMID- 3825435 TI - [Sarcoptic scabies in capybaras (Hydrochoerus hidrochaeris L.). Study under scanning electron microscopy]. PMID- 3825437 TI - Systemic complications of streptococcal scarlet fever: two case reports and a review of the literature. PMID- 3825438 TI - Primary neuroendocrine carcinoma of the skin or Merkel cell carcinoma. Report of a case and review of the literature. PMID- 3825439 TI - The evaluation of asymptomatic microscopic haematuria. PMID- 3825440 TI - Drugs recently released in Belgium. Digoxin antibodies, alpha-2b interferon, mesalazine. PMID- 3825441 TI - Stimulation of thyroidal iodothyronine 5'-monodeiodinase by long-acting thyroid stimulator (LATS). AB - To evaluate the effect of long-acting thyroid stimulator (LATS) on thyroid iodothyronine monodeiodinating activity, we have studied the in vitro conversion of T4 to T3 by mouse thyroid homogenate comparing tissue from LATS treated (0.1 ml LATS(+) serum, ip, for 3 days) with tissues from LATS(-) Graves' disease patients' serum or normal serum treated controls. Five out of seven LATS(+) sera were shown to stimulate the T4 5'-deiodinase significantly in mouse thyroid. There was no significant correlation between LATS titre and deiodinase activities in the different sera tested. To compare the effect of LATS and TSH (0.2 IU, ip daily), studies were carried out from 12 to 72 h. LATS had a similar latency of 12 h on the stimulation of thyroid deiodinase compared to TSH as reported earlier. However, the conversion activities reached a plateau by 12 h after LATS treatment, while it continued to rise upon daily TSH injection from 24 to 72 h. In addition, TSH caused a marked reduction of thyroid protein and an early peaking in serum T3 and T4 at 12 h, whereas LATS caused no detectable change in thyroid protein and a gradual rise in circulating T3 and T4. The kinetic analysis indicated that LATS-mediated stimulation of T4 5'-deiodinase was, similar to TSH, associated with an increase in maximum velocity (Vmax were 139, 208 and 505 pmol/mg protein/30 min respectively in control, LATS and TSH-treated animals) without a demonstrable change in the apparent Km (approximately 2.0 microM for T4). The present study demonstrated that some LATS-rich sera stimulate thyroid T4 to T3 conversion in mouse. It provides an insight into the mechanism of increased T3 secretion from Graves' thyroid glands. PMID- 3825442 TI - Plasma arginine vasopressin during neck suction in upright sitting man. AB - In order to examine the influence of carotid baroreceptor stimulation on arginine vasopressin secretion, 8 normal healthy males were subjected to static neck suction of -3.3 kPa for 20 min in the upright sitting position after overnight food and fluid restriction. The plasma concentration of arginine vasopressin did not change significantly during neck suction. However, in 3 subjects the termination of neck suction induced large increases in plasma arginine vasopressin from 1.8 to 63.7 ng/l, from 0.7 to 34.3 ng/l and from 2.1 to 19.0 ng/l, respectively. Two subjects experienced symptoms such as nausea and paleness during neck suction. Systolic arterial pressure increased slightly but significantly during neck suction from 15.3 +/- 0.3 to 15.7 +/- 0.4 kPa (N = 7, P less than 0.05), whereas mean arterial pressure, diastolic arterial pressure, central venous pressure, heart rate, plasma osmolality, plasma sodium and potassium were unchanged. Haemoglobin concentration in blood and haematocrit increased significantly during and after neck suction, whereas plasma volume decreased. We conclude that neck suction with a negative pressure of 3.3 kPa in upright sitting man does not significantly affect plasma arginine vasopressin. However, termination of the stimulation induces large increases in some subjects. This may be explained by a direct effect on the vagus nerve or by a selective deloading of carotid baroreceptors. PMID- 3825443 TI - The effect of vincristine on parathyroid hormone release and on the parathyroid cell microtubular structures in the intact rat. AB - The effect of vincristine on immunoreactive parathyroid hormone (iPTH) release and parathyroid cell microtubular structures was evaluated in intact, unanaesthetized, and unrestrained rats with indwelling catheters. In overnight fasted rats, blood samples were collected before and at 30, 60 and 120 min after iv vincristine administration in low dosage (0.15 mg/kg) or in higher dosage (0.5 mg/kg) or vehicle (controls) for serum iPTH and calcium determinations. Mean baseline serum iPTH and calcium concentrations were similar in the vincristine treated and the control rat. Following the low dose vincristine treatment, serum iPTH slightly but significantly declined to 89 +/- 5% at 30 min and remained at this low level at 60 and 120 min as compared to those observed in control rat. Similarly, iPTH concentrations after higher doses of vincristine were also significantly decreased to 87 +/- 4% at 30 min and to 83 +/- 4% at 60 min, and 86 +/- 7% at 120 min as compared to those observed in the control rat. Serum calcium concentrations were similar in the vincristine-treated and control rats. In the next study, each of the rats received vincristine and vehicle in a random order, 10 days apart. In this study also, mean serum iPTH significantly declined to 85 +/- 7% at 60 and 120 min during vincristine treatment as compared with those observed during the vehicle treatment in the same rats. Parathyroid glands were removed from rats between 60 and 120 min after vincristine or vehicle treatments for electron microscopy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825444 TI - Biological activities of human growth hormone and its derivatives estimated by measuring DNA synthesis in Nb2 node rat lymphoma cells. AB - Nb2 cell is a rat lymphoma cell line that responds to lactogens such as prolactin and human growth hormone (hGH) with an increased rate of proliferation. We explored the relationship between the biochemical events induced by hGH and its derivatives and their receptor binding activities. hGH stimulated RNA, DNA and protein synthesis of Nb2 cells as a function of time. Stimulation of RNA and protein was maximal at 2-3 h and 12 h, respectively, after the addition of hGH. DNA synthesis, measured by the rate of [3H]thymidine incorporation, reached a maximum after 18-h incubation with hGH. Stimulation of DNA synthesis was elicited by hGH in a dose-dependent manner between 0.45 and 45 pmol/l. The activity of the 20 K hGH variant in stimulating DNA synthesis was approx 30% of that of hGH. In contrast, S1-hGH, which lacks a sequence of ten amino acids (140-149) of hGH, showed a 3.2-fold greater activity than hGH. F1 (amino-terminal sequence 1-134 of hGH) was only 0.06% as active as hGH, and the activity of F2 (C-terminal 42 amino acid residue of hGH) was less than 0.01%. Both fragment 1-15 and 32-46 were without effect. The relative potencies of these hGH derivatives in stimulating DNA synthesis were similar to their relative abilities to inhibit [125I]hGH binding to lactogenic receptors on Nb2 cell. Nb2 cells provide a suitable model to study the relationship between receptor binding and the biochemical events induced by lactogens. PMID- 3825445 TI - [What can be expected of the activity index proposed in Crohn's disease?]. PMID- 3825446 TI - [Proposal for a simplified activity index for Crohn's disease]. PMID- 3825447 TI - [Propranolol and portal hypertension in cirrhotic patients. Manometric and hemodynamic studies]. PMID- 3825448 TI - [Adaptation of the small intestine to extensive resection and its regulatory mechanisms: hormonal hypothesis]. PMID- 3825449 TI - [Arterial computed tomography in focal lesions of the liver]. PMID- 3825450 TI - [Effects of uremic sera from bilaterally nephrectomized rabbits on mouse hematopoietic progenitor cells]. PMID- 3825451 TI - [Simultaneous assessment of the complement-sensitive cells of red cells and reticulocytes in paroxysmal nocturnal hemoglobinuria by complement lysis sensitivity test]. PMID- 3825452 TI - [A case report of beta-thalassemia minor with marked erythrocytosis]. PMID- 3825453 TI - [Purification of human transcobalamin II, saliva R and the production of antibodies against their proteins]. PMID- 3825454 TI - [Surface antigens of several human nonlymphocytic leukemic cell lines and leukemic colony forming units]. PMID- 3825455 TI - [Primary relapse in patients with acute leukemia after an initial 5-year period of complete remission]. PMID- 3825456 TI - [Relationship of bone marrow dose to eosinophilia following radiotherapy: a study of patients with breast, lung, cervical, and ovarian cancer]. PMID- 3825457 TI - [Chromosome abnormalities in patients with myelodysplastic syndrome and its prognostic implication]. PMID- 3825458 TI - [Chemotherapy for advanced diffuse non-Hodgkin's lymphoma with non-cross resistant alternating AVCP/EMLP regimens]. PMID- 3825459 TI - [Delta agent in hemophiliacs in Japan--with special reference to hepatitis B virus and HTLV-III/LAV]. PMID- 3825460 TI - Statistical mixture decomposition as a method for type analysis of learning curves. AB - A method for type analysis of learning curves, based on the statistical mixture decomposition, is described. Some critical points in current data-analytic techniques are discussed. The mathematical rationale of the new method is outlined in a brief sketch. The possibilities of the method are documented by two examples. In the first study, done on simulated lata of a known structure (N = 200, 2 classes), it was possible to distinguish, with an average performance of 82%, between two types, and to reproduce their original curves. In the second study data from experiments in classical eye-lid conditioning in man were analysed (N = 80). The decomposition procedure resulted into the classification into four groups, with pronounced inter-class differences in the course of respective learning curves. The variety of class curves ranges from a group with only few CRs (C1, N = 26), through a group with an initial increase and final decrease in CR frequency (C2, N = 16), a group with an apparently biphasic course of CR frequency (C3, N = 20), to a group with a rapid increase of CR and then stable course of CR frequency (C4, N = 18). The results are consistent with earlier findings concerning the existence of distinct types of learning curves. The problem of interpretation is briefly discussed. The method can be applied principally to any problems, where different types of time development trends of an alternative response are to be distinguished. PMID- 3825461 TI - Influence of amphetamine-induced changes in the behavior of adult "aunts" on development and long term behavioral patterns of rats. AB - Infant rats of the Wistar strain were kept either with their mother or with both the mother and the "aunt"--an adult virgin female during the suckling period. One group of aunts was injected regularly with amphetamine in the dose of 3 mg/kg b.w. (the AA group), another group with saline (the SA group). Control (CO) pups were reared by their mother only. Both acute and long term consequences of aunt rearing on behavioral development and growth rate were observed. On Days 25 and 28 the SA pups displayed an increased exploratory activity level and more contacts with the litter-mate in the test of paired interactions when compared with both the AA and CO groups. The lowest frequency of exploratory, of manipulatory and social activities were recorded for the AA pups. In adulthood, both the aunt-reared groups of male rats exhibited higher activity level in a novel environment than the CO males. However, while in the CO and the SA males the activity level tended to habituate over the repeated tests, in the AA it persisted on a high level. The difference among females was not significant. Growth rate was retarded in the AA male and female rats. PMID- 3825462 TI - Responses in the thalamus and striopallidar nuclei of the human brain to angular orientations of visual stimuli. PMID- 3825463 TI - Visceral orienting reflexes as significant components of psychophysiologic personality assessment. Addendum. PMID- 3825464 TI - Sinus arrhythmia differs in persons with high and low reactivity. PMID- 3825465 TI - The menstrual cycle in women following surgery for intracranial tumours. PMID- 3825466 TI - Changes in the diameter of erythrocytes and their spheroidisation in mental illness. PMID- 3825467 TI - Behaviour of genetically hypertensive rats in an animal model of depression and in an animal model of anxiety. PMID- 3825468 TI - Psychophysiological reactivity testing for the investigation of cardiovascular diseases. Report of a CIANS Working Group concerning standardisation of procedures, and the need for collaborative studies on transcultural validation. PMID- 3825469 TI - 28th Psychopharmacology Meeting. Jesenik Spa, January 1986. Abstracts. PMID- 3825470 TI - Continuous measurement of oxygen uptake. Evaluation of the Engstrom metabolic computer and clinical experiences. AB - A new system for continuous measurement of oxygen uptake was tested. The tidal volumes delivered by the system, the accuracy of the oxygen sensor cell, measurement of the oxygen uptake at different inspired oxygen concentrations, and comparative tests of oxygen uptake using the Fick principle were studied. Judging from our results, even thorough maintenance could not entirely prevent leakages. Due to a construction error, there was a large increase in measured oxygen uptake if inspired oxygen concentration was increased. While carbon-dioxide output was constant, this led to respiratory quotients of less than 0.5. By modifying the system with a mixing chamber for the inspiratory gas, new tubing to the oxygen sensor cell and changes in the computer software, these errors have been corrected in the meantime. In comparative tests of oxygen uptake using the Fick principle (cardiac output and arteriovenous oxygen content difference), we found a mean difference between EMC and the Fick principle of about 6.6% (P less than or equal to 0.001, r = 0.91) with nearly identical standard deviations for both values. Our experience indicates that the EMC is suitable for continuous measurements of oxygen uptake. Additional technical improvements seem to be possible. PMID- 3825471 TI - Granulocyte microbicidal function in patients undergoing major abdominal surgery under balanced anaesthesia. AB - Granulocyte microbicidal functions were studied in 11 major abdominal surgery patients with the luminol-enhanced chemiluminescence method. The responses of granulocytes in phagocytosis of zymosan, S. aureus and E. coli and responses to N formylmethionyl-leucylphenylalanine (FMLP) were unaffected by surgery. The percentage of high-peroxidase-activity cells among neutrophils was increased on postoperative days 1 (P less than 0.01) and 3-4 (P less than 0.05). We propose that microbicidal-related oxidative phagocytic functions of granulocytes are well maintained after major abdominal surgery under balanced anaesthesia. PMID- 3825472 TI - Constitutional factors promoting development of atelectasis during anaesthesia. AB - The extent of atelectasis was correlated to constitutional factors in 38 patients who underwent computed tomography prior to and during general anaesthesia with halothane. All patients but two developed atelectasis in dependent regions of both lungs immediately after induction of anaesthesia prior to surgery. The transverse area of the densities ranged from 0 to 27 cm2, and there were no significant differences between patients of different age or sex, or with different smoking habits. A significant linear regression was found between Broca's index weight (kg)/height (cm)-100 and the area of the densities, and also between an index describing the shape of the thorax and the density area. Thus, patients who were overweight and/or had a low and wide thorax tended to develop more extensive atelectasis during anaesthesia. This finding might partly explain why overweight patients develop postoperative pulmonary complications more often than non-obese patients. PMID- 3825473 TI - Concentrations of thiopentone in mature breast milk and colostrum following an induction dose. AB - In two groups of eight patients, concentrations of thiopentone in mature breast milk and colostrum following anaesthesia induction with 5.4 and 5.0 mg kg-1 b.w. (mean), respectively, were measured in the first 36 h postoperatively. Blood concentrations were measured simultaneously. The maximal concentrations were: in mature breast milk, 3.4 +/- 0.68 mumol l-1 (mean +/- s.e. mean) (0.090 mg 100 ml 1), and in colostrum, 1.3 +/- 0.5 mumol l-1 (0.034 mg 100 ml-1). The milk/plasma ratio was less than 1.0 in both groups. The above concentrations may be regarded as negligible and therefore non-toxic for the nursing infant. PMID- 3825474 TI - Evaluation of the usefulness of enzymatic diagnosis of myocardial infarction in patients with acute arterial occlusion of the lower extremities. AB - The serum activities of aspartate aminotransferase, lactate dehydrogenase, creatine kinase and estimated creatine kinase isoenzyme MB (CK-B) were investigated in 12 patients before and after revascularization of ischaemic lower extremities. All patients suffered from sudden lower limb arterial occlusion and underwent embolectomy through a small arteriotomy in the groin. The median serum activity of all four enzymes was elevated before surgery and further increased during the first 24-48 h after revascularization. Median serum activity of aspartate aminotransferase, creatine kinase and lactate dehydrogenase were continuously elevated 7 days after the operation. A high relative CK-B activity coincided in one patient with the development of electrocardiographic evidence of acute myocardial infarction. It is concluded that any of these four enzymes should be used with caution in the diagnosis of acute myocardial infarction before, during or after operation in patients who have sustained prolonged ischaemia of the lower extremities. PMID- 3825475 TI - Cardiovascular reactions to intramedullary reaming of long bones in dogs. AB - The cardiovascular reactions to reaming of the medullary cavity of the femoral bones in dogs were studied. Intramedullary reaming caused marked reductions in systemic and pulmonary artery blood pressure. Cardiac output was maintained, while total peripheral resistance was reduced. The haemodynamic changes were transient, and it is suggested that they were caused by a neurally transmitted reflex mechanism. PMID- 3825476 TI - Effects of prenalterol on central hemodynamics and myocardial metabolism in experimental propoxyphene-induced shock. AB - The hemodynamic and cardiometabolic effects of prenalterol were evaluated in propoxyphene-induced circulatory shock in 10 pentobarbital-anesthetized pigs. Circulatory shock (i.e. a systolic arterial blood pressure below 60 mmHg (8 kPa) and/or a cardiac index of less than 2.0 1 X min-1 X m-2) was induced by intravenous propoxyphene chloride 15 mg X min-1. Circulatory shock occurred after 26 +/- 3 mg X kg-1 of propoxyphene. During continuous infusion of propoxyphene, consecutive doses of prenalterol 0.5, 1.0, 2.0 and 4.0 mg i.v. were injected with an interval between increments of 8 min. The maximum effect of prenalterol was seen following the 2 mg dose. Increases were observed in mean arterial blood pressure, cardiac index, stroke volume index, left ventricular stroke work index, right ventricular stroke work index, maximum rate of rise of ventricular pressure, and total body oxygen consumption. Decreases were observed in pulmonary artery occlusion pressure, mean right atrial pressure and systemic vascular resistance, whereas heart rate and pulmonary vascular resistance remained unchanged. The cardiometabolic parameters: coronary sinus flow, coronary vascular resistance, myocardial oxygen consumption and extraction, remained low. Due to profound vasodilation, normal perfusion pressures were not reestablished. In conclusion, prenalterol improved cardiac performance by a significant positive inotropic action. However, pure inotropic stimulation was not sufficient to counteract the circulatory shock state during severe propoxyphene intoxication. PMID- 3825477 TI - Hypoxia-induced vasoconstriction in human lung exposed to enflurane anaesthesia. AB - The degree of hypoxic pulmonary vasoconstriction was studied in eight subjects during enflurane anaesthesia and was compared with that during intravenous pentobarbital anaesthesia in the same subjects. The lungs were ventilated separately with the aid of a double-lumen endobronchial catheter. After preoxygenation of both lungs for 30 min, during intravenous anaesthesia, the right lung (test lung) was rendered hypoxic by ventilation with 6% O2 in nitrogen. The left lung (control lung) was ventilated continuously with 100% oxygen. Cardiac output (QT) was determined by thermodilution, and the distribution of blood flow between the lungs was assessed from the elimination of a continuously infused, poorly soluble inert gas (SF6). The hypoxic challenge resulted in a reduction of the distribution of perfusion to the test lung from 57% to 36% of QT. Mean pulmonary arterial pressure increased by 37% and pulmonary vascular resistance of the test lung doubled. Arterial oxygen tension decreased from 45.9 to 9.5 kPa. Administration of enflurane to an end-tidal concentration of 2% to both lungs caused no significant change in the distribution of the pulmonary blood flow, PVR, or any other circulatory variable. The arterial blood gases remained unaltered. When the hypoxic challenge was discontinued, all variables returned towards control values. The findings suggest that the inhalational anaesthetic enflurane does not reduce the hypoxic vasoconstrictor response in the human lung. PMID- 3825478 TI - Influence of cigarette smoking on the risk of acid pulmonary aspiration. AB - Twenty-five non-smokers and 35 smokers who had abstained overnight from cigarette smoking and were undergoing minor elective orthopaedic surgery were studied in order to compare gastric volume and pH. There was no significant difference in aspirated volume and pH both just after intubation and prior to extubation between the two groups, thus indicating that habitual smokers undergoing elective surgery in general anaesthesia do not have increased risk of acid pulmonary aspiration compared with non-smokers. PMID- 3825479 TI - Heating efficacy of external heat supply during and after open-heart surgery with hypothermia. AB - Heat balance after cardiac surgery with hypothermic cardiopulmonary bypass (CPB) was studied in 156 patients. In spite of rewarming during CPB there was residual hypothermia at the end of operation. This heat deficit could not be prevented by intraoperative use of a heating mattress at 38 degrees C and/or heated (39 degrees C) humidified inspired gases. Postoperatively, in four groups of patients, the core and finger skin temperatures were recorded and the mean skin and mean body temperatures and heat balance were calculated. Heating of humidified inspired gases (n = 22) gave little improvement in the time course of the temperatures and heat balance as compared with that in a control group with no external warming postoperatively (n = 49). A thermal ceiling (a low temperature radiator suspended above the bed and providing radiant heat (n = 35] significantly increased the measured temperatures, which were restored to normal earlier than those in the controls. Also, with this radiant heat postoperative shivering was almost abolished. With a combination of radiant heat and heated, humidified gases (n = 50), the postoperative heat balance was improved somewhat further. For patients treated with radiant heat, postoperative rewarming was accomplished in a shorter time and almost without active endogenous muscular thermogenesis, as was evident by the great reduction in postoperative shivering. PMID- 3825480 TI - In vitro effect of etomidate and thiopental on granulocyte migration. AB - An increased mortality has been reported during long-term etomidate infusion. Inhibition of adrenal corticosteroid synthesis has been incriminated - but other factors related to host defence cannot be excluded. Using an under-agarose assay, we investigated the effect of etomidate on in vitro granulocyte migration. Unlike thiopental (50 micrograms/ml), etomidate (4-32 micrograms/ml) did not affect either spontaneous or directed migration. Impaired granulocyte migration is an unlikely cause of morbidity during long-term etomidate infusion. PMID- 3825481 TI - Evaluation of epidural needles. AB - Eight different epidural needles (Tuohy Everett, Pitkin, Braun Perifix and Portex in 16-gauge, and Becton Dickinson Crawford, Becton Dickinson B-D, Monoject and Portex in 18-gauge) were evaluated using a scanning electron microscope and spectral x-ray analysis. Differences were noted in the metal composition, between disposable and reusable needles with respect to molybdenum content. The inner surface of the 18-gauge Crawford needle was found to be the smoothest and it also had the best clearance between the needle and stilette. The Portex 16-gauge had the best needle/stilette fit at its bevel. The hardness of the metal was found to be satisfactory in all the needles. PMID- 3825482 TI - Developmental stages in permanent porcine enamel. AB - Developing permanent teeth of different ages were obtained from Danish Landrace pigs. Visibly distinct zones on their enamel surfaces were shown to correspond to changes in chemical composition previously reported for other species. The time of appearance, rate of progress and duration of each stage was determined for each tooth type. PMID- 3825483 TI - Cell proliferation in synovial membrane of young mice. AB - The labelling index (LI) of the synoviocytes of the lining-layer cells and of the underlying connective-tissue cells was determined in the synovial membrane of 5-, 10-, 21-, 30-, and 55 day-old mice, following a pulse labelling with [3H] thymidine. Both the synoviocytes and underlying connective-tissue cells incorporated [3H]-thymidine within 1 h after injection. No significant difference was observed between the LI of these two regions of the synovial membrane. The results indicate that synoviocytes are capable of cell division even in non pathological conditions. PMID- 3825485 TI - Comparative anatomical study of the carotid circulation in gundis, with implications for their evolutionary history. AB - The carotid circulation pattern in gundis (Ctenodactylidae) is examined and compared with that of typical members of the classical rodent suborders. On this basis their probable phylogenetic relationships and systematic position are discussed. Together with other recent investigations, the unique pattern of cephalic arterial supply emphasizes the isolated position of the ctenodactylids. PMID- 3825484 TI - [Histochemical and ultrastructural data on the adrenergic and cholinergic innervation of the epididymis in the mouse]. AB - The adrenergic and cholinergic innervation of the epididymal duct in the mouse has been investigated using histochemical methods and electron microscopy. This study demonstrates that the epididymal innervation of the mouse does not really differ from that of other mammals. Cholinergic nerves are mainly vascular, even in the cauda where cholinesterase activity is increased within the tubular musculature. Catecholamine fibres ensure the motricity of the wall of the canalicular system, particularly the terminal segment where the smooth muscle fibres are specifically differentiated. PMID- 3825486 TI - Quantitative topochemistry of rat liver enzymes during postnatal development in relation to activity-rest cycle. AB - A quantitative histochemical method (Trident) has been adapted to measure the activities of 4 enzymes, succinate dehydrogenase (SD), isocitrate dehydrogenase (ICD), glucose-6-phosphate dehydrogenase (G6PD) and 6-phosphogluconate dehydrogenase (6-PGD), within the liver acini of the rat during the postnatal developmental period. Quantitative changes of these enzymes in livers of rats of 25 g and 50 g body weight were studied, with particular emphasis on the activity rest cycle. The results indicate a time-dependent heterogeneous distribution of enzymes along the acinar zones and the pattern of localization is age-dependent. When the mean enzyme activity from each group in relation to the time of the day are compared, a mirror image of each other could be seen. In general, a high enzyme activity has been observed during the resting phase in 25-g rats and low in 50-g rats. During the developmental period, the mean ICD activity is diminished, whereas G6PD and 6-PGD are augmented, and SD activity remains unchanged. PMID- 3825487 TI - The articular disc of the wrist. Limits and relations. AB - The relationship between the discus articularis and its contiguous structures has been analyzed in 18 serially sectioned fetal hands. From this study, it can be concluded that these elements do not seem to be an extensive fibrous system emerging from the radius and reaching the metacarpal V, as it has been said, but a complex of clearly differentiated structures, of which further morphological details are given. PMID- 3825488 TI - The lamina cribrosa in the eyes of rats, hamsters, gerbils and guinea pigs. AB - The scleral lamina cribrosa in the eyes of adult rats, hamsters, gerbils and guinea pigs was examined by ordinary histology and by scanning electron microscopy after soft tissue digestion. The complexity of the lamina, when mounted for scanning electron microscopy, was graded on a scale of 0 to 4.5 by three independent observers under X 60 magnification in a stereo microscope. The observers were unaware of the species and were offered the 44 specimens twice in random order. The average variance attributable to an observer was 22 +/- 3% (SE) of the total variance of the gradings. The rat eyes had the least developed lamina cribrosa, with only 1-2 layers of sparse connective tissue. The mean complexity grading of 12 rat eyes was 1.6 +/- 0.15. The lamina cribrosa of the eyes of gerbils and guinea pigs was much more developed with at least 3 layers of abundant connective tissue, the mean grades of complexity being 3.4 +/- 0.09 and 3.5 +/- 0.15, respectively, in 12 eyes of each species. The lamina cribrosa in the hamster eyes was somewhat more developed than that of the rat, but much less than that of the gerbil and guinea pig. The mean grade of complexity was 2.4 +/- 0.14 in 8 eyes. In 6 pairs of rat eyes there was no correlation in grade of laminar complexity between the two eyes of the same animal. The present study makes the rat eye a candidate for experiments where a possible influence of the lamina cribrosa as such is undesired. PMID- 3825489 TI - A new bony canal on the clival surface of the occipital bone. AB - Three cases of a bony canal have been found in 100 adult cranial bases on the lower half of the clival surface. The possible content, nature and significance of this canal are discussed and the term 'inferior median clival canal' assigned to this variety. PMID- 3825490 TI - Ultrastructure of muscle satellite cells in hypersomatotropic rats. AB - Female Wistar-Furth rats were injected at one week of age with cells from either the GH1 or GH3 rat pituitary cell lines. Controls were injected with vehicle. Rats were killed at 11 weeks of age and satellite cells in the soleus and extensor digitorum longus (EDL) muscles were examined using transmission electron microscopy. Satellite cells in both the soleus and EDL muscles of rats with tumours which secreted growth hormone generally appeared to be metabolically more active than those cells seen in the muscles of control rats. The source of pituitary cell line did not appear to influence satellite cell ultrastructure. In rare instances, myofibers of tumor-bearing rats appeared to extend cytoplasmic projections around satellite cells as if to engulf the latter. There was no evidence of a pathological condition. Since only one time frame was observed, the effects of prolonged exposure to elevated blood growth hormone levels on satellite cells are not known. PMID- 3825491 TI - Increase in cholesterol in the apical plasma membrane of uterine epithelial cells during early pregnancy in the rat. AB - Freeze-fracture cytochemistry with the cholesterol-binding antibiotic filipin has been used to examine the plasma membrane of uterine epithelial cells at different stages of pregnancy in the rat. We find many more filipin-induced lesions on day 6 of pregnancy than on day 1 and suggest that this indicates a higher cholesterol content at this time. Since day 6 of pregnancy is the time at which blastocysts implant in the rat uterus, we consider the possible significance of an increased cholesterol content for implantation. PMID- 3825492 TI - The C3-F gene in patients with intracranial saccular aneurysms. AB - The C3-F gene has previously been found associated with atherosclerotic vascular diseases. The occurrence of the C3-F gene was therefore investigated in a group of 110 hospitalized patients with intracranial saccular aneurysms. The C3-F gene occurred equally often in patients and controls. In patients with a ruptured aneurysm, however, the C3-F gene frequency was significantly increased in subjects aged 40-49 years followed by a marked and statistically significant decline with increasing age. The findings suggest that the C3-F gene may be a risk factor for early aneurysm rupture. PMID- 3825493 TI - Automatic analysis of static charge sensitive bed (SCSB) recordings in the evaluation of sleep-related apneas. AB - An automatic analysis of Static Charge Sensitive Bed (SCSB) recordings was evaluated in the detecting periodic apneas during sleep. The results of over night SCSB recordings, on body movements and respiratory movements, were compared with the visually evaluated polygraphic recordings during daytime sleep. Twenty one patients with obstructive sleep apnea syndrome and 18 controls were studied. The periodic breathing pattern seen in all daytime recordings, was also seen in all output graphs of the over-night SCSB analyses. The automatic analyses revealed periodic breathing in 2 control subjects. The amount was, however, small (less than 4% of the recording time) compared with the high amount observed in the patients with obstructive sleep apneas (mean 42.9% of the recording time). The high sensitivity, easy use, and low cost of the automatic SCSB method make it suitable for the quantification of the periodic breathing during night and for the screening of sleep apneas. PMID- 3825494 TI - Is there a transitional zone between brain infarcts and the surrounding brain? A histological study. AB - Twenty-eight recent brain infarcts were studied histologically for the presence of zones of partial tissue destruction between the infarct border and the surrounding normal brain. Such transitional zones have been demonstrated in animals and might be suspected in humans from the broad zones of reduced blood flow that have been demonstrated around brain infarcts. Necrotic neurons were observed outside the infarct borders in 20 of 28 cases. However, the width of the peri-infarct border zone was less than 5 mm in 17 of 20 cases and between 7 and 10 mm in 2 cases. Only one section from one case showed necrotic neurons more than 20 mm from the infarct border. It is concluded that the large majority of the brain infarcts in man are sharply delimited and that the broad zones of reduced flow around the infarcts may be due to functional inactivity following partial denervation of the cortex rather than to true ischemia. PMID- 3825495 TI - A Swedish county with unexpectedly high utilization of anti-parkinsonian drugs. AB - This report is based on the use of L-dopa-containing drugs within 24 Swedish counties in the period 1977-1984. The mean utilization of these drugs in Sweden in 1984 was 1.46 defined daily doses (DDD)/day X 10(3) inhabitants (inh). As Parkinson's disease is virtually the only condition for which these drugs are prescribed, it seems highly probable that the determining factor for their use today is the prevalence of the disease. The exceptionally high utilization (2.34 DDD/day X 10(3) inh) of L-dopa-containing drugs in the county of Gavleborg, warranted further analyses of subareas in this particular county. The use is discussed in relation to environmental factors. PMID- 3825496 TI - Effect of tourniquet-induced ischemia on cutaneous thermal thresholds. AB - The effect of tourniquet-induced ischemia on human thermal thresholds was studied. After the development of the A-fibre block (= a sharp elevation of cool threshold) the heat-pain threshold was still uninfluenced. This result supports previous evidence indicating that C-fibres mediate the liminal heat pain sensation. Thus, the quantitative determination of cutaneous heat pain thresholds provides a rather selective method for testing C-fibre mediated pain sensitivity, at least when a contact thermostimulator with a slow or moderate rise of stimulus temperature is used. The second aim of this study was to examine whether ischemia or mechanical pressure is the cause of the tourniquet-induced block of A-fibres. This was studied by varying the mechanical pressure and the amount of ischemia. With increased ischemia (with muscle work) the A-fibre block (increased cool threshold) came earlier, but this finding was not significant. PMID- 3825497 TI - Prognostic indicators in multiple sclerosis. AB - The influence of sex, age at onset, course of the disease and initial symptomatology on the mortality of patients with multiple sclerosis is analysed. A sample of 1926 patients was followed up prospectively over 4.9 years. Both, the mortality ratio (number of observed to expected deaths) and the excess death rate are calculated. Whereas the mortality ratio as a parameter of overall mortality is influenced by a variety of factors, such as age and sex; the excess death rate represents the number of extra deaths per 1000 exposed to risk in an indicated year and is, therefore, a parameter of the mortality which is attributed to MS. The excess death rate was comparable for the sexes, it was slightly higher for patients with a higher age at onset and it was clearly higher for the progressive course. Patients with initial diplopia and sensory signs and symptoms had the lowest excess death rate, whereas patients with pareses, cerebral and sphincter disturbances at onset showed the highest excess death rate. PMID- 3825498 TI - Alzheimer's disease: maintenance of neuronal and synaptic densities in frontal cortical layers II and III. AB - Neuronal loss and alterations of the cortical neuropil were previously described on necropsic material from patients with senile dementia of the Alzheimer type, and the results compared to age-matched case controls. In frontal cortex biopsic material from our patients with Alzheimer's disease, the numerical densities of neurons and synapses were not significantly different from controls, indicating that changes in the highest cognitive functions might not depend on a generalized loss of neurons and synapses and that quantitative morphological differences may exist between Alzheimer's disease and senile dementia of the Alzheimer type. PMID- 3825499 TI - Epilepsy in the elderly: prognosis. AB - 251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy. PMID- 3825500 TI - Immunological and genetic studies in primary generalized corticoreticular epilepsy. AB - Serum immunoglobulin and HLA investigations were carried out in 21 probands with primary generalized corticoreticular epilepsy (PGCE) and in 26 of their first degree relatives. The mean serum levels of IgG, IgA and IgM in the epileptic probands were not significantly different from controls. In the relatives, however, the mean serum levels of IgA and IgM were significantly decreased as compared to controls. With respect to HLA investigations, the frequencies of 63 HLA specificities determined and of 5 most commonly occurring haplotypes were not significantly different in the experimental groups as compared to controls. These findings are in agreement with a previous HLA investigation of PGCE but are in contrast with a similar study of partial epilepsy. It is suggested that the contrasting HLA findings between PGCE and partial epilepsy may reflect underlying differences in the etiology of these disorders. PMID- 3825501 TI - Plasma cells in cerebrospinal fluid and multiple sclerosis: diagnostic yield and clinicobiological correlations. AB - Cerebrospinal fluid (CSF) cytocentrifugation was performed for plasma cells' demonstration in parallel with white cell count (WCC) and quantitative protein assays. Over a 5-year period, 154 consecutive multiple sclerosis (MS) patients were studied and compared to 28 other inflammatory neurological disease, 85 non inflammatory neurological disease and 29 non-neurological disease cases. CSF cytology was easy to perform, gave definitive results within 2 h and was abnormal in 80 MS patients, 26 of whom had a normal WCC. Its sensitivity in MS was 0.57, i.e. higher than for WCC (0.45) but lower than for IgG index (0.70) and IgG synthesis rate (0.71). Its specificity was 0.86, not significantly different from specificity of WCC, IgG index and IgG synthesis rate. Plasma cells demonstration in MS CSF was neither a disease activity nor a prognosis marker. It was significantly correlated with pleiocytosis and intrathecal IgG synthesis. If these morphologically defined plasma cells are actual B cells, they could represent circulating individuals of the lymphocyte clones active in MS plaques and have a pathogenetic significance. PMID- 3825502 TI - Clinical and muscle biopsy findings in malignant hyperthermia susceptibility. AB - Patients (155) were investigated for malignant hyperthermia susceptibility (MHS), by in vitro testing of muscle taken from the vastus medialis muscle. Histopathological and histochemical investigation of muscle was also performed. Ultrastructural investigation was performed in 13 MHS patients; 90% of the patients replied to a questionnaire concerning present or previous neuromuscular symptoms. The majority of MHS and MH negative (MHN) patients had no or only minor histopathological and histochemical abnormalities. Core-targetoid fibres were the only potentially important abnormalities found in MHS patients. There were no differences in neuromuscular symptoms between MHS, MHN and control patients, and most patients in both the MHS and MHN group were normal on clinical examination. PMID- 3825503 TI - Familial combined deficiency of muscle carnitine and carnitine palmityl transferase (CPT). AB - Two patients, brother and sister, aged 19 and 16, with combined, partial deficiency of carnitine palmityltransferase (CPT) are reported. Both patients had recurrent exercise-related myoglobinuria. The brother had also experienced an episode of transient renal failure associated with myoglobinuria. Both had elevated CK and myoglobin in plasma between attacks. There was a normal production of lactate in ischaemic forearm exercise, but elevated levels of NH3, resulting in an increased NH3/lactate ratio; 48-h fasting caused no significant changes in cholesterol, triglycerides or glucose, no rise of CK, and a normal ketogenic response, indicating no hepatic enzyme deficiency. Muscle biopsy showed slight changes of myopathy in both patients, with scattered atrophic fibres, but no lipid accumulation or other specific changes. Biochemical analysis of muscle tissue revealed a reduction of carnitine to 48% and 40% and a reduction of CPT to 55% and 59% of normal values, which is similar to the findings in the only previous report of combined partial carnitine and CPT deficiency. The heterogeneity of the laboratory findings in CPT deficiencies and the value of the various diagnostic procedures in metabolic myopathies are discussed. PMID- 3825504 TI - Plasma exchange in myasthenia gravis: effect on anti-AChR antibodies and other autoantibodies. AB - Plasma exchange (PE) was performed in 6 patients with myasthenia gravis (MG). Acetylcholine receptor (AChR) antibodies and other MG-correlated antibodies were quantified each day before, during and after PE. The antibody concentrations decreased during PE with a consisting increase between two exchanges. Repeated PE induced a transient decline in the AChR antibody concentration. The clinical improvement was maximal during the week after PE and correlated in time with increasing concentrations of AChR antibodies. PMID- 3825505 TI - Resistance to hypoglycemia of cerebellar transplants in the rat forebrain. AB - Prolonged insulin-induced hypoglycemia causes widespread loss of neurons and permanent brain damage with irreversible coma. Although the deprivation of carbohydrate stores affects all brain regions, the breakdown of energy metabolism and cessation of protein synthesis occur predominantly in the cerebral cortex, caudoputamen and hippocampus. The cerebellum, brain stem and hypothalamus are largely resistant. Following transplantation of the cerebellar anlage of rat fetuses (day 15 of gestation) into the caudoputamen of adult rats, the grafts were allowed to differentiate for a period of 8 weeks. The host animals were then subjected to 30 min of severe hypoglycemia with isoelectric EEG ('coma'). In contrast to the surrounding vulnerable brain structures, protein synthesis was fully preserved within the cerebellar transplant. Grafting of fetal forebrain cortex to the same location did not result in escape from hypoglycemic cell injury. This indicates that resistance to hypoglycemia is part of the programmed differentiation of the cerebellum and develops irrespective of its location and functional integration within the nervous system. PMID- 3825506 TI - Stimulation of astrocytes affects cytotoxic brain edema. AB - Cytotoxic brain edema has been produced in rats by subacute intoxication with triethyltin (TET). Some animals were allowed to recover spontaneously, others were post-treated with an extract of Ginkgo biloba (EGB) for 1 to 4 weeks, beginning 3 days after intoxication was stopped. The time course of the resolution of the edema was studied biochemically and morphologically by light microscopy, histochemistry and electron microscopy (EM). Morphometric evaluation showed that the spontaneous reabsorption of TET-induced edema was very slow: it was evident only 2 weeks after ending TET administration and it required more than 4 weeks to be completed. EGB therapy markedly decreased the vacuolation, as well as the abnormal levels of water and sodium contents, 1 week after beginning the treatment. Less influence of EGB was observed at the later stages. During spontaneous recovery, astroglial cells in the edematous white matter of TET intoxicated animals showed short and swollen processes containing few organelles, low levels of NADH- and NADPH-tetrazolium reductase activities and glial fibrillary acidic protein (GFAP)-immunofluorescence for about 2 weeks. During EGB therapy the astrocytes regained their cellular processes, containing intense oxidative enzyme activities and GFAP-immunofluorescence as early as after 1 week of treatment. In the EM, astrocytes often appeared hypertrophic, surrounding myelin vacuoles and displaying phagocytosis of myelin debris. We conclude that EGB can accelerate the reabsorption of TET-induced cerebral edema and improve the astroglial reaction. PMID- 3825507 TI - Ganglioside GM1, a molecular target for immunological and toxic attacks: similarity of neuropathological lesions induced by ganglioside-antiserum and cholera toxin. AB - Ganglioside-antisera, the ganglioside GM1-ligands, cholera toxin (CT), and CT subunit B, respectively, were injected into the lumbosacral subarachnoid space of normal rats. The cytotoxic effects of the injected compounds on the peripheral and central nervous system were investigated by light and electron microscopy; the severity of CNS lesions was evaluated by quantitation of macrophages containing debris. In contrast to control sera and GM2-antiserum, antisera against a mixture of the major brain gangliosides GM1, GD1a, GD1b, and GT1b (MaBG) or against GM1 induced demyelination in spinal roots and spinal cord, as well as alterations of astroglia. CT induced the same cytotoxic effects as MaBG- and GM1-antisera, whereas CT subunit B was without effect. The ineffectiveness of GM2-antiserum is obviously due to the very low concentration of the specific binding target, GM2, on cell surfaces; that of CT subunit B to the lack of the cytotoxic operator, subunit A. Our results indicate that a similar pattern of neuropathological lesions may be effected by different cytotoxic mechanisms through attachment of the cytotoxic agent onto the cell surface via a common target molecule, and further substantiate the role of GM1-antibodies in the pathogenesis of demyelination. PMID- 3825508 TI - Canine distemper virus clearance in chronic inflammatory demyelination. AB - The distribution of canine distemper virus (CDV) antigen was examined in the brains of 14 dogs with chronic nervous distemper using a monoclonal antibody against a major viral protein. In ten of these dogs, neutralizing anti-CDV antibody titers were determined in serum and unconcentrated cerebrospinal fluid (CSF). In 19% of the inflammatory demyelinating lesions, large amounts of CDV antigen were found; in 34% of these lesions only residual traces of virus were seen and in almost half of the lesions (47%) no CDV could be demonstrated. In four dogs neutralizing antibodies were found in the serum only; in one dog in the CSF only and in 5 dogs both in serum and CSF. Because of the correlation between the presence of inflammation, intrathecal antiviral antibodies and disappearance of CDV from the lesions, it was concluded that the inflammatory response in distemper is associated with viral clearance from the lesions. Associated immune mediated cytotoxic reactions could explain exacerbation of the initial virus induced demyelinating lesions. Despite the presence of an apparently effective intrathecal antiviral immune response, fresh non-inflammatory lesions as a result of viral replication and spread in the white matter coexisted with inflammatory ones in which viral clearance had taken place. The role and mechanism of such virus persistence are discussed. PMID- 3825509 TI - Some problems of the systemic degeneration and atrophies. AB - Report on a family of three brothers in which the prevailing features of the clinical findings were those of Friedreich's "heredo-tabes". Histologically besides the degeneration of the peripheral proprioceptive neurone and of the ventral spinocerebellar tract, several other systems proved affected. For similar categories of cases, it does not seem useful to introduce a complicated terminology, and the a potiori denomination of the classical syndrome should be retained. Yet, both the clinical and the pathological examinations have to seek carefully in every individual case for the presence of pathological features which do not belong to the basic syndrome, and note them in the characterisation of the case. Although in systemic degeneration it is the most distal part of the neuronal unit where degeneration starts, the source of it lies in the originating nerve cell. For the pseudosystem-degenerations in the sense of Seitelberger this holds true only exceptionally, if at all. PMID- 3825510 TI - Intraendothelial accumulation of calcium in the hippocampus and thalamus of rats after systemic kainic acid administration. AB - The accumulation of calcium in the hippocampal and thalamic vascular endothelium and the perivascular space was detected histochemically by means of the pyroantimonate technique 30, 60 and 120 min after systemic kainic acid administration. An increased number of calcium pyroantimonate deposits was found in the endothelial mitochondria 60 min after kainate injection. The mitochondria were swollen at this time and vacuoles containing deposits were observed. After 120 min a pronounced perivascular glial swelling was conspicuous, besides the numerous endothelial mitochondrial deposits. The swollen glial processes contained a large number of pyroantimonate deposits. It seems likely that the transendothelial calcium transport processes are accompanied by intraendothelial calcium accumulation and mitochondrial calcium sequestration. PMID- 3825511 TI - Periodic acid-Schiff (PAS)-positive, granular structures increase in the brain of senescence accelerated mouse (SAM). AB - Abnormal granular structures, which stained positively with periodic acid-Schiff (PAS-positive granular structures; PGS), were observed in the brain of senescence accelerated mouse (SAM). They were small, round to ovoid, homogeneous structures measuring up to 5 microns in diameter and usually grouped in clusters. PGS were localized in the hippocampus, piriform cortices, olfactory tubercle, nucleus of the trapezoid body, and cerebellar cortices. Quantitative analysis revealed that PGS remarkably increased in the hippocampus of SAM-P/8, a substrain of SAM, with advancing age, although a few PGS also appeared in the aged control mice, SAM-R/1 and DDD. Their histochemical nature, morphological features and distribution pattern were different from those of corpora amylacea and other similar bodies. A close anatomical relationship between PGS and glial fibrillary acidic protein positive astrocytes was inferred from immunohistochemical studies. PGS is considered to be one of the morphological manifestations of senescence in mice brains, and are found to occur more numerously in the brains of learning or memory deficit mice, SAM-P/8. PMID- 3825512 TI - Small size of orthogonal array in muscle plasma membrane of Fukuyama type congenital muscular dystrophy. AB - Freeze fracture analysis was carried out on the density of orthogonal array subunit particles in the plasma membrane of skeletal muscle of six patients with Fukuyama type congenital muscular dystrophy and seven control cases. The group mean density of orthogonal array subunit particles per one orthogonal array was significantly lower in the plasma membrane of Fukuyama patients. The results suggested the possible impairment of orthogonal array function in the plasma membrane of muscle fibers in congenital muscular dystrophy of the Fukuyama type. PMID- 3825513 TI - Cerebral Paecilomyces javanicus infection. An ultrastructural study. AB - A 41-year-old diabetic woman developed Paecilomyces javanicus endocarditis and subsequent cerebral fungal embolism and vasculitis with massive infarction and hemorrhage 6 years after a mitral valve replacement with porcine heterograft. The organism was identified by the culture from the infected brain tissue and aortic valve. Cerebral infection due to fungus Paecilomyces is rare. This report documents the cerebral manifestations of fungus Paecilomyces javanicus and describes for the first time the ultrastructure of such an organism obtained from the infected tissue. Their ultrastructural findings, similar to those described in Paecilomyces farinosus derived from culture, include a double-layered cell wall, a triple unit plasma membrane, abundant cytoplasmic lipid droplets, vacuoles, membranous profiles and septal formation. This report further demonstrates hyphae with packed 50A filaments and granulofibrillary material and features suggestive of intrahyphal hyphae, not previously described in fungus Paecilomyces. PMID- 3825514 TI - Pleocore disease. Multi-minicore disease and focal loss of cross striations. AB - We report clinical and morphological data on seven patients with a congenital myopathy as well as data concerning five parents. Classical myopathies such as rod disease, centronuclear myopathy or central core disease could be ruled out. Structural abnormalities of intracellular organelles or particulate inclusions were rare and insignificant. The most prominent and constant features were minicores and focal loss of cross striations, associated with a prevalence of type 1 fibres, increasing with the age at time of biopsy. A carrier state could not be defined in the five examined parents neither on clinical nor on morphological grounds. Although our group of patients could not clinically be distinguished from other congenital myopathies, the combination of the lesions allow their individualization as a subgroup of multicore or minicore disease under the already proposed denomination of pleocore disease [Martin and Busch, abstract in Zentralbl Allg Pathol 124:156 (1980)]. PMID- 3825515 TI - Acute painful diabetic neuropathy precipitated by strict glycaemic control. AB - A case of acute painful diabetic neuropathy that followed the establishment of strict glycaemic control using continuous subcutaneous insulin infusion is described. Sural nerve biopsy shortly after the onset of the acute painful syndrome showed no evidence of active nerve fibre degeneration; instead, the appearances were those of a chronic neuropathy with prominent regenerative activity. The suggestion is made that adequate diabetic control promoted regeneration and that the pain may have been related to the ectopic generation of impulses in regenerating axon sprouts. PMID- 3825516 TI - Structural alterations of the intramuscular nerves and junctional region in extraocular muscles of C57BL/Ks (db/db) diabetic mice. AB - The extraocular muscles of the C57BL/Ks (db/db) diabetic mutant mouse were examined by electron microscopy. The intramuscular myelinated nerves and the junctional apparatus of the singly and multiply innervated muscle fibers were found to exhibit various anomalies. Lamellated inclusion bodies were found in many of the Schwann cells of the myelinated nerve fibers; intra-axonal inclusion bodies resembling polyglucosan bodies were also observed. Junctional abnormalities consisted of various types of inclusion bodies within the junctional sarcoplasm and within sole-plate nuclei; in addition, hypertrophied endplates were observed and often penetrated by networks of axonal terminal branches. At times, pseudopod-like extensions of the junctional sarcoplasm encompassed and made protracted synaptic contacts with the incoming axons. PMID- 3825517 TI - Primary rhabdomyosarcoma combined with chronic paragonimiasis in the cerebrum: a necropsy case and review of the literature. AB - A necropsy case of a primary rhabdomyosarcoma with chronic paragonimiasis in the cerebrum of a 68-year-old man is reported. The clinical data showed a right hemiplegia and dysarthria which became lethal in 6 months even though operation and radiation therapy were performed. Computed tomography revealed a large low density area associated with the peripheral enhancement in the left basal ganglia, and multiple conglomerated calcified masses in the left temporal and occipital lobes. Biopsied and necropsied materials of the tumor in the basal ganglia was reddish brown in color and histologically was composed of purely mesenchymal derivatives with both embryonal and mature striated muscle cells but neither neuronal nor glial elements. Some of the tumor cells with extending slender cytoplasms showed obvious cross striations at the light and electron microscope levels and immunohistochemical reactivity for myoglobin. All tumor cells were also positive for vimentin, but not for glial fibrillary acidic protein. The clinical and necropsy findings revealed no primary lesion anywhere but in the brain. In addition, numerous dead oval eggs of Paragonimus westermani were found in many cystoid lesions encapsulated by thick connective tissues with calcification and/or ossification. Clinicopathological features of 24 cases of primary rhabdomyosarcoma of the central nervous system reported in the literature are reviewed briefly. The histogenesis of this tumor are discussed together with comments on cerebral paragonimiasis. PMID- 3825518 TI - Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots. Comparison between ventral and dorsal roots and between growing and mature rats. AB - The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8 week-old (growing) rats than in 26- and 45-week-old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath. PMID- 3825519 TI - Neoplastic angioendotheliosis is, in fact, intravascular malignant lymphoma. PMID- 3825520 TI - Infertility in women participating in a screening program for cervical cancer in Helsinki. AB - The purpose of the present study was to establish the occurrence of infertility in Finnish women aged 30, 35 and 40 years. The study is based on an interview by questionnaire carried out on women participating in screening for cancer by Pap smear. The participation rate is generally about 60%. A total of 4,879 women were interviewed between May 1981 and April 1982. 149 incomplete replies were discarded and an additional 528 women not at risk of conception were excluded. The final analysis included 4,202 women. Actual infertility, i.e., failure to establish pregnancy at the time of interview, occurred in 438 women (10.4%). The overall infertility rate was 15.4%. The primary infertility rate (5%) seems to be similar in all the age groups interviewed. Secondary infertility increased among women aged 30-40 years, from 4.1 to 9.9%. Actual infertility increased highly significantly between the age groups 30 and 40 years. A limited number of women are permanently infertile, but the percentage of those who at some point in their lives are involuntarily childless is higher. PMID- 3825521 TI - Effects of physical exercise on the serum concentration of melatonin in female runners. AB - The serum melatonin concentration was measured in 11 runners before and after a long-distance race, and during one menstrual cycle of another 11 runners who were performing a strenuous training programme, and in their 12 control subjects. The concentration of melatonin was significantly increased (p less than 0.05) after the competition, whereas during one menstrual cycle of female runners it did not differ from the corresponding concentrations of non-athletes. Training did not cause any chronic changes in melatonin secretion, and the serum melatonin increases following the physical exercise remained clearly below the nocturnal level. Hence, the antigonadotropic effect of endurance running activity is very likely not a melatonin-associated phenomenon. PMID- 3825522 TI - Intestinal bypass operation and pregnancy outcome. AB - With the aid of the national Medical Birth Registries and Discharge Registries in Denmark and Sweden it was possible to identify and study delivery outcome in 77 women who, prior to pregnancy, had undergone an intestinal bypass operation for obesity. Analysis of birth weight and pregnancy length distribution showed that infants borne by these women had an increased rate of low birth weight, short gestation, and also growth retardation. There were no distinct differences between those infants that were conceived less than 24 months or more than 24 months after operation. Only two infants had congenital malformations, none died perinatally. PMID- 3825523 TI - Reactivity of non-stress tests and its relationship to outcome in infants born prior to the 33rd week of gestation. AB - In order to evaluate the significance of the non-stress test (NST) in the immature fetus, 60 patients who gave birth between the 26th and 33rd week of gestation were studied. They were grouped according to reactivity of the last non stress test performed 24 hours prior to delivery. Twenty-eight (47%) of the patients were reactive, 10 (17%) non-reactive, and 22 (37%) non-reactive with decelerations on the last NST. The one-year mortality rates were significantly higher in those non-reactive with decelerations (41%) and in those non-reactive (30%), than in the reactive group (7%) (p less than 0.001, p less than 0.05). The results suggest that reactive non-stress tests and those that are non-reactive with decelerations predicted the fetal outcome similarly to the same findings in term pregnancies. Non-reactive non-stress tests without decelerations were associated with poor outcome in fetuses with a gestational age of more than 29 weeks. Conversely, in more immature fetuses, nonreactive patterns occurred in patients with favorable outcome. The clinical implications of these findings are discussed. PMID- 3825524 TI - Inhibition by plant herb extracts of steroid bindings in uterus, liver and serum of the rabbit. AB - To assess the action of herb extracts, glycyrrhizin and paeoniflorin, upon steroids, their binding to several classes of intracellular and serum steroid binding proteins was studied in the rabbit. Glycyrrhizin and paeoniflorin exhibited similar binding behaviors. They bound minimally to estrogen and androgen receptors, but not to the progesterone receptor in uterine cytosol, and exhibited a moderate binding activity to glucocorticoid receptors in liver cytosol. They also exhibited weak binding activity to both cortico-steroid binding globulin and sex-hormone-binding globulin. PMID- 3825525 TI - Commissurotomy and pregnancy. A study of 245 cases. AB - We present a retrospective study of 245 pregnancies in 157 women who had undergone commissurotomy (closed surgery) and whose delivery was assisted at the Maternity La Paz (Madrid, Spain) between 1965 and 1981. There was a statistically significant increase in the rate of fetal complications (perinatal mortality, 44.3 per 1,000; pre-term 8.5%; intra-uterine growth retardation, 17.3%; low weight, 12.5%) and maternal mortality. The most frequent and severe maternal complication was congestive heart failure which was more common among primigravidas and was of statistical significance. In patients with atrial fibrillation or heart failure during pregnancy or puerperium, the results were even more remarkable. There were no complications in patients who underwent commissurotomy during pregnancy. Preterm delivery was three times more common in patients undergoing digitalis therapy. PMID- 3825526 TI - Fetal heart rate changes and uterine activity during coitus. AB - Fetal heart rate and uterine activity were monitored during sexual intercourse in three otherwise normal gravid women at varying gestational ages. Increased uterine activity and a variety of fetal heart rate changes, some of which are traditionally identified as ominous, were seen in most instances immediately following orgasm. An increase in fetal activity was also commonly reported by the mothers. It is postulated that coitus is equivalent to an unmonitored contraction stress test. PMID- 3825527 TI - Moderate alcohol consumption--need for intervention programs in pregnancy? AB - Consumption of alcohol was investigated in two groups of pregnant women: an intervention group (n = 58) (two structured interviews during pregnancy including counseling focused on reduction of alcohol consumption and potential benefits to the fetus, and interview after delivery), and a control group (n = 74) (interview after delivery). Prepregnancy 80% of the women were light or moderate alcohol consumers, and 20% teetotalers. Pregnancy considerably reduced alcohol consumption in both groups. 66% abstained from alcohol during pregnancy, and use of liquor nearly ceased. The changes in alcohol consumption occurred independently to the intervention program. Strategy for reducing alcohol consumption during pregnancy should include a structured alcohol anamnesis at the first ante-natal visit, accompanied by counseling focused on reduction of alcohol consumption. More extensive intervention programs may be reserved for pregnancies at higher risk (high-consumers, abusers). PMID- 3825528 TI - Cesarean section and perinatal mortality in Sweden in 1981. AB - During the years 1973-81, the cesarean section (CS) birth rate increased from 5.5% to 12.4% in Sweden. During the same time, perinatal mortality declined from 12 to 7.1 per thousand children. The rates of CS and perinatal mortality, however, cannot be presented as reciprocally dependent variables without taking into consideration many of the other factors that have been at work during the same decade, e.g. improved results of the neonatologists in the lower weight groups, electronic fetal monitoring, use of steroids, introduction of tocolytic agents. The present study revealed that the incidence of CS could vary between 8% and 19% between different obstetric departments in Sweden during 1981. Despite this great difference in CS rate, no difference was noted in the rates of asphyxia or perinatal mortality. It is concluded that in the present study we have seen no indication that a marked increase in the CS rate would improve our present perinatal survival data and furthermore it still remains unproven that CS and perinatal mortality rates necessarily have a reciprocal relationship. PMID- 3825529 TI - Ectopic pregnancy combined with intra-uterine twin pregnancy. PMID- 3825530 TI - Plexiform leiomyoma in endometrial curettings. AB - A tumor found in endometrial curettings of a 35-year-old woman was originally interpreted as malignant. Review of the slides and additional curettings revealed that the tumor was in reality a plexiform leiomyoma. Attention is drawn to the fact that this rare tumor may be present in endometrial curettings. PMID- 3825531 TI - A quantitative and histological study on pulmonary effects of asbestos exposure in general autopsied lungs. AB - We demonstrated the distribution of asbestos bodies (ABs) in the lungs of 656 consecutive autopsy cases by KOH digestion method. Nine patients including one case with asbestosis had more than a thousand ABs. These patients were all blue collar workers except the two cases without occupational history. The tissue sections for these patients revealed the constant presence of more than one or two ABs. In addition, five of these subjects had parenchymal and/or peribronchiolar fibrosis. On the basis of the result of AB counts, we selected 17 subjects for enumeration and typing of asbestos fibers (AFs). The number of AFs roughly correlated with that of ABs. However, the ratio of AFs to ABs ranged from 13 to 3,700. The fiber types in our selected subjects were almost always amphibole (crocidolite, amosite). These findings indicate that modest or secondary exposure to asbestos causes virtual asbestosis to several subjects among the general population. PMID- 3825532 TI - Focal palisading granuloma in the prostate and bladder. A clinicopathologic study of 88 total cystectomy specimens. AB - In close inspection of 88 total cystectomy specimens, 20 were found to have rheumatoid nodule-like lesions known as "focal palisading granulomas". Nineteen of these nodules were from patients with a history of previous transurethral resection (TUR). Such granulomas were identified in the prostate in 3, in the bladder in 13, and in both prostate and bladder in another 3. The remaining one patient had undergone a cold cup biopsy followed by electric coagulation. The granulomas were characterized microscopically by the presence of central necrosis surrounded by palisading histiocytes and fibroblasts, and were situated in areas of the previous TUR. There were no granulomas in 20 other patients with no history of previous TUR and other surgical procedures. The lesions were commonly seen in the superficial zone of the bladder wall and in the prostate and, as proved by serial sections, opened onto the mucosal surface of the bladder and urethra, respectively. The observation confirmed that the focal palisading granulomas occurred not only in the prostate but also in the bladder, and seemed to be closely related to surgical procedures, especially to the electrocauterizing process, in both the bladder and prostate. PMID- 3825533 TI - Flow loaded canine carotid artery. I. A morphometric study of microfilament bundles in endothelial cells. AB - To estimate microfilament bundles in the endothelial cells of flow loaded arteries quantitatively, blood flow change was produced in the common carotid arteries of eleven female beagle dogs (1-2 years of age, 8-10 kg) employing the arteriovenous shunt method between the common carotid artery and external jugular vein. After 1 week, the amount of microfilament bundles was measured with a point counting method on transmission electron microscopical photographs. In the arteries loaded by highly elevated blood flow, the average thickness of microfilament bundles increased over 0.1 mu m (non-operative control: 0.01-0.02 mu m) and the average longitudinal cut area of a microfilament bundle grew over 0.7 mu m2 (non-operative control: 0.2 mu m2). The number of bundles increased over 1.0 piece (non-operative control: 0.2 pieces) per unit length (mu m) in transverse section and increased over 0.5 pieces (non-operative control: 0.2 pieces) in longitudinal section. The average thickness of the bundles significantly correlated to the blood flow increase ratio (the ratio of the blood flow rate of the final measurement to that before anastomosis). We consider that the microfilament bundles are the structure developed to combat the wall shear stress induced by the elevated blood flow. PMID- 3825534 TI - Vascular connective tissue changes in experimental portacaval anastomosis. AB - Hepatic vascular changes are generally associated to fibrotic lesions of the liver but their role in the development and extension of fibrosis is not well known. By performing a portacaval anastomosis in rats, a proliferation of hepatic vessels was attained progressively, comparable to proliferations seen in cirrhosis and schistosomiasis. Such a modification of the hepatic vasculature was accompanied by changes in the connective matrix of the liver, mainly related to the vascular walls. Moreover, sinusoidal capillarization was detected at the electron microscopical level whereas no alterations could be seen neither in the distribution nor in the quality of the connective matrix proteins with immunofluorescence technique. The only modification detected by light microscopy, at this zone, was the shrinked aspect of reticulin fibers which could be related to the important liver atrophy provoked by the anastomosis. It can be assumed that in liver pathology, selective changes occur in the connective matrix components depending on the type of injury. Necrotic and inflammatory processes lead mainly to the deposition of interstitial collagens and associated proteins, related to a diffuse stroma reaction resultant from activation of specific cell populations whereas in portacaval anastomosis, a selective increase of vascular connective matrix (mainly basement membrane components) occurs as a direct consequence of vessel proliferation. PMID- 3825535 TI - Heterotransplantation of ovarian serous adenocarcinoma with functioning stroma to nude mice. Disappearance of functioning stroma in transplanted tumor. AB - Serous adenocarcinoma of the ovary with estrogen and alpha-fetoprotein (AFP) production was serially heterotransplanted into nude mice. The original tumor presented marked luteinization of stromal cells with elevated urine levels of estrogen before the operation. Estrogen levels reduced to the normal level shortly after the operation. Histologic features of the original tumor were basically retained in the transplanted tumor, but no luteinization of stromal cells was observed and serum estrogen levels in nude mice were elevated. Immunohistochemically, AFP was found to be positive in some tumor cells of transplanted tumor, but serum AFP levels were not elevated. PMID- 3825536 TI - Squamous cell carcinoma of the gallbladder associated with squamous metaplasia and adenocarcinoma in situ of the mucosal columnar epithelium. AB - A case of well-differentiated squamous cell carcinoma of the gallbladder is presented. Unlike most previously reported cases, the tumor developed in association with squamous metaplasia as well as dysplastic and in situ adenocarcinomatous changes of the gallbladder epithelium. The significance of these lesions is discussed in relation to the histogenesis of squamous cell carcinoma or adenosquamous carcinoma of this organ. PMID- 3825537 TI - Ciliated-cell adenocarcinoma of the pancreas. AB - An autopsy case of ciliated-cell adenocarcinoma of the pancreas was reported. A 65-year-old man, who had undergone subtotal gastrectomy because of advanced gastric carcinoma 6 years previously, died of obstructive jaundice. The autopsy revealed a primary tumor in the head of the pancreas and multiple metastatic foci in the liver, lungs, and regional lymph nodes. Histologically, the pancreatic tumor was moderately differentiated papillary adenocarcinoma with well developed cilia. The metastatic tumor also showed similar histology. Histologic and ultrastructural features of the tumor were described in detail and the cytogenesis of ciliated-cell adenocarcinoma was briefly discussed. PMID- 3825538 TI - Adenoid squamous cell carcinoma of the skin overlying the right breast. An autopsy case clinically manifested with rapid growth and widely spreading metastases. AB - An autopsy case of a 62-year-old woman with a poorly differentiated, aggressive form of adenoid squamous cell carcinoma arising in the skin overlying the right breast was studied. The tumor, 9 X 8 cm in diameter, had rapidly enlarged since one year before admission from a verrucous lesion of 20 years duration. The histologic features of the tumor showed a well-differentiated squamous cell carcinoma mainly in the superficial areas, which transformed into, with a zone of transition in between, an alveolar or adenoid structure in the deep invading portion. The adenoid tumor cells exhibited an undifferentiated appearance with prominent nucleoli and frequent mitotic figures. These cells partly showed dyskeratotic or acantholytic features. Mucin was negative. The patient died at 8 months after the operation. Autopsy revealed widely spreading metastases in which an adenoid structure was outstanding. These unusual pathological features and an aggressive behavior of this tumor, which were hitherto rarely described for adenoid squamous cell carcinoma, seemed to be a poorly differentiated variant of the tumor. This malignant transformation might be derived from loss of cohesion of the pre-existing usual well-differentiated squamous cell carcinoma in the basal and parabasal layers, inparting marked invasiveness of these cells into the supporting connective tissue. PMID- 3825539 TI - Relationship between cytogenetic findings and histopathology in non-Hodgkin lymphoma. AB - The cytogenetic findings in 70 patients with non-Hodgkin lymphoma have been correlated with tumor histopathology according to the Kiel classification. Certain chromosome aberrations displayed a nonrandom association with the grade of malignancy: 4 lymphomas out of 6 with 1p+, 5 out of 7 with del(6)(q15), 7 out of 11 with 14q+, and 5 out of 8 with +18 belonged to the high grade malignancy group, whereas 9 lymphomas out of 10 with t(14;18) were low grade malignant. Two aberration types were closely associated with specific histopathologic subtypes: t(14;18) occurred in 7 cases out of 10 in centroblastic/centrocytic (cb/cc) follicular lymphomas, and 5 cases out of 6 with i(17q) were cb or cb/cc. Although less striking, there was a tendency for del(6)(q15) to occur in cb or cb/cc lymphomas (4 cases out of 7), in contrast to only 1 case out of 5 with the more distal deletion del(6)(q21). PMID- 3825540 TI - Two cases of congenital vascular malformations proved by post-mortem arteriography. Case reports. AB - Post-mortem arteriography, properly carried out, visualizes the whole extent of the arterial vascular system. The intimate relationship of parenchymatous organs to their arterial supply makes it possible to identify and localize the individual structure, even where there are abnormalities. Arteriography has never been methodically applied to post-mortem examinations of fetuses and perinates. Two cases selected from a material of 100 consecutive fetuses and perinates thus examined document that even though the external appearance of fetuses and perinates is normal, there may be severe internal congenital malformations. PMID- 3825541 TI - Tumours in Iceland. Hodgkin's disease and non-Hodgkin's malignant lymphomas. A histological classification and epidemiological considerations. AB - All cases of biopsy-proven Hodgkin's disease and non-Hodgkin's lymphomas submitted for histological diagnosis in Iceland during 1955-1982 and available for review were typed histologically, using the World Health Organization Classification for cases of Hodgkin's disease and the "International Working Formulation" for cases of non-Hodgkin's lymphoma. A total of 92 cases of Hodgkin's disease were classified with a male-to-female ratio of 1.96. The largest subgroups were those of nodular sclerosis (42%) and mixed cellularity (32%). A prominent peak in the incidence was found in the 21-30 years age group. The incidence and subtypes of Hodgkin's disease in Iceland appears similar to those found in other Western countries. A total of 90 cases of non-Hodgkin's lymphomas were classified with a male-to-female ratio of 1.5. A high incidence of large cell lymphomas was found, especially of the immunoblastic type (35%), while in other respects the distribution of subtypes appeared similar to what has been found in studies from other Western countries. The incidence of non-Hodgkin's lymphomas in Iceland is low during childhood and young adulthood but rises sharply after age 50 and the overall incidence is similar to that found in other European countries. PMID- 3825542 TI - Parietal cell density before and after parietal cell vagotomy in duodenal ulcer patients. AB - Parietal cell density, mucosal height, grade of gastritis and pentagastrin stimulated acid production were assessed before and three months after parietal cell vagotomy (PCV) in 14 patients with duodenal ulcer. Parietal cell density was found to be unaltered after vagotomy and there was no difference in the parietal cell count in the neck and base of the glands. Both the basal acid production and the pentagastrin-stimulated acid secretion were significantly reduced after PCV. No correlation could be shown between the stimulated acid production and the parietal cell count, either pre- or postoperatively. (r = 0.14 and r = 0.19). Mucosal height and grade of gastritic changes remained unchanged. It is concluded that PCV in duodenal ulcer patients causes no change in parietal cell density assessed at three months post-operatively. Vagotomy causes no mucosal atrophy or gastritic changes within this period. PMID- 3825544 TI - Ultrastructure of the small intestinal mucosa in progressive systemic sclerosis (PSS). AB - The present study deals with ultrastructural changes of jejunal absorptive epithelium in mucosal biopsy specimens from eleven patients with progressive systemic sclerosis (PSS). Epithelial cells showed cytoplasmic condensations with cholesterol clefts and fat droplets. Intercellular spaces of the epithelium were dilated with deposits of fat droplets, while tight junctions and villi preserved their normal structures. Goblet cells and entero-endocrine cells showed no changes. In the lamina propria, fat droplets were observed as well. Vessels were strongly dilated and in 2 patients contained conglomerates of thrombocytes. Perivascular cell infiltrates consisted of lymphocytes, macrophages and mast cells, while plasma cells were scarcely seen; in 2 patients, plasma cells were abundant. Collagen fibrils, elastic fibres, and nerves showed no definite changes. The findings of epithelial cell degeneration and fat droplet deposits indicate dysfunction of jejunal absorptive epithelial cells in PSS. PMID- 3825545 TI - Primary carcinoma of the upper urinary tract. AB - Thirty-seven patients with upper urinary tract tumours were evaluated for grade, stage, histological type, location, presence or absence of vascular invasion, abnormalities in the urothelium adjacent to the tumours, tumour multiplicity and patient survival. A good correlation between tumour grade and stage was found in the transitional cell tumours. Squamous cell carcinomas and adenocarcinomas were high-stage tumours. Vascular invasion was present in most high-grade tumours, squamous cell carcinoma and adenocarcinomas. Four patients had multifocal tumours of both pelvis and ureter. Three developed ureteric stump carcinomas and 13 had further development of bladder carcinomas. The cumulative 5 and 10 year survival rates were 43 and 23% respectively. PMID- 3825543 TI - Parietal cell density in duodenal ulcer patients after short-term treatment with cimetidine and antacids. AB - In a prospective study, 20 patients with endoscopically proven duodenal ulcers were randomised to be treated with cimetidine 1 g daily or with antacids 350 mmol daily. The duration of treatment was 30 days, but this was extended to three months in 3 patients in the cimetidine group and 4 patients in the antacid group. A morphological study of biopsies taken via a gastroscope from the corpus mucosa showed no change in mucosal height, parietal cell density per unit volume or changes in cellular infiltration after 30 and 90 days treatment in the two groups. Neither H-2 receptor blockers nor antacids alter mucosal height or parietal cell density. Treatment was not found to induce gastritic changes in the mucosa. PMID- 3825546 TI - [Isolation of amobarbital from human liver by means of various column chromatography purification methods]. PMID- 3825547 TI - [Surface properties of emulsifiers. I. Study of w/o emulsifiers]. PMID- 3825548 TI - [Rheologic study of hydrogels of cellulose ethers. III. Analysis of the viscoelastic properties]. PMID- 3825549 TI - Variation in the content and the composition of the essential oils in flower heads of Matricaria chamomilla L. during its ontogenetical development. PMID- 3825550 TI - The effect of alpha and beta adrenergic blockade on Ni induced coronary spasm in scalded rats. AB - After 20% total body surface scalding inducing 3d degree burn in rats the following parameters were studied in ebb and flow phases, as well as in burn disease, 2 hours, 2 and 7 days postburn: atomic absorption spectrophotometric study of the serum and myocardial Ni levels; the effect of Ni ions (10(-8)-10(-4) M/l) in vitro on total coronary resistance in the isolated perfused rat heart; the effect of alpha and beta adrenergic blocking agents (phenoxibenzamine, oxprenolol) on Ni-induced coronary vasoconstriction; electron cytochemical study of the ultrastructural changes of the myocardium 7 days after scalding. It was found that: During the first 2-3 hours after scalding or bleeding there was a significant elevation of serum Ni level which levelled off by the end of the first week. Total coronary resistance (TCR) increasing effect of Ni ions was significantly augmented during the first 2-3 hours after burn and bleeding (ebb phase). In the scalded group it decreased to the control value by the 2-3d day (flow phase) and increased again a week later (burn disease). In the scalded groups in vivo pretreatment with oxprenolol (10(-4) g/kg) completely inhibited the Ni induced coronary spasm. PBZ treatment in vitro (10(-5) M/l) had similar effect in the three postburn periods tested. Ultrastructural changes and intracellular Ni-dimetilglyoxim complexes could be detected. Oxprenolol treatment continuously applied from the 4th day postburn (2 X 0.5 mg/kg) prevented the development of myocardial damage, while the electron dense complexes containing Ni were still detectable. In view of our previous data we assume that the endogenous Ni increase in the serum after burn may be cardiopathogenic. The phasic changes of the sensitivity of the coronary vessels to Ni ion and the similarity of the effects of alpha and beta adrenergic blocking agents may be explained by the alterations in the neuroendocrine system and metabolic disturbances. PMID- 3825551 TI - Preparation and P content of non-pregnant and pregnant human uterine myosin. AB - Myosin content and phosphorus (P) concentration of myosin preparations were measured in non-pregnant and pregnant human myometrial tissue specimens. It was found that the amount of myosin gained from 1 g of minced myometrial tissue is 0.5 mg in the early follicular phase of the menstrual cycle, 0.6-0.7 mg in the late luteal phase, and 6-7 mg during pregnancy. Considering the different functional stages of the myosin sources and the performance characteristics of the methods, the estimated myosin content of non-pregnant myometrium is 1.0-1.5 mg, while 10-15 mg in pregnant myometrial tissue. A considerable amount of P is bound to the preparations. It is the smallest in the post-menstrual period and increases towards the end of the cycle. The largest amount of P is gained from fresh pregnant uterine samples. Analysis of the alkaline hydrolysate showed that the phosphate group was bound to amino acids, in the largest amount to arginine, less to histidine and the smallest amount to lysine and serine. As a function of the duration of storage, especially the P-Arg concentration was decreasing. The prolonged hydrolysis time decreases again the concentration of P-Arg with a consecutive increase of No. 1 and 2 P-containing peaks in the chromatographic profile of alkaline hydrolysate. PMID- 3825552 TI - Acidic acetone extract from pregnant sow ovaries is a rich source of substances affecting uterine contractility in vitro. AB - Acidic acetone extract of pregnant sow ovaries was subjected to Sephadex G-25 chromatography. The solution coming from column was analysed for UV absorption, molecular weight, and also for its biological effect on a myometrium strip in vitro. This biodetection system has made it possible continuously to determine the biologically active fractions eluted from the Sephadex G-25 column. The reference materials to calibrate the Sephadex G-25 column were Blue dextran and acetone, while for calibration of the biodetection system, synthetic oxytocin was used. The extract of ovaries of pregnant sows was separated chromatographically into 8 different, biologically active fractions with distinct UV absorption and molecular weight. One of these fractions showed elution characteristics and biological effect similar to those of synthetic oxytocin in the same biodetection system. The results indicated that acidic acetone extract originating from ovaries of pregnant sows is a rich source of biologically active substances with effects on the myometrium strips in pregnancy. Partial identification of oxytocin like substances in the ovarian extract verified the effectiveness of the biodetection system in the first steps of research to obtain new, biologically active substances from different unpurified extracts. PMID- 3825553 TI - Unilateral vagotomy inhibits compensatory kidney growth after unilateral nephrectomy in rats. AB - The effect of unilateral vagotomy on compensatory renal growth that follows unilateral nephrectomy was studied. Unilateral vagotomy inhibited the usual compensatory growth of the remaining kidney. Unilateral vagotomy did not effect kidney weight in animals with two kidneys. Data indicate that the vagus nerve is involved in the development of compensatory kidney hypertrophy. PMID- 3825554 TI - Changes in avoidance behaviour following ethanol treatment in rats of different ages. AB - Avoidance learning and pain sensitivity were studied in rats after chronic ethanol administration (1.1 to 1.7 g per kg b.w. in drinking water) at prenatal, adolescent and adult ages. The behavioural reactions were tested in adulthood by studying passive and active avoidance learning and the threshold of pain sensitivity to electric tail shock. Chronic ethanol consumption led to an impairment of avoidance learning and to hyperalgesia in each experimental series, although the alterations were greater in the prenatally treated groups. The experimental observations are discussed in the light of fetal alcohol syndrome. PMID- 3825555 TI - Effect of theophylline treatment on the functional hyperaemic and hypoxic responses of cerebrocortical microcirculation. AB - The purpose of the present study was to elucidate the importance of extracellular adenosine (ADO) in the regulation of cerebrocortical microcirculation during rest, hypoxia, and brain activation. Cerebrocortical microcirculation and fluorescence of reduced nicotinamide adenine dinucleotide (NADH) were measured by surface fluororeflectometry through a cranial window. Arterial hypoxia and brain activation were produced by respirating the animals with a gas mixture containing 6-7% O2 and by injecting 4-6 mg/kg metrazol into the lingual artery, respectively. These reactions were used as test before and after theophylline (THEO) treatment. In some of the experiments only the cortical area beneath the cranial window was treated with THEO (10(-4) M), in others 2 X 10(-4) mol/kg THEO was injected intraperitoneally. Potency of THEO in antagonizing the cerebral blood flow (CBF) increasing effect of topically applied ADO was also tested. It was found that superfusion of the brain cortex with artificial cerebrospinal fluid (mock CSF) containing 10(-4) M THEO does not alter resting CBF, but inhibits the CBF increasing effect of 10(-6) M and 10(-5) M ADO by approximately 70% and 40%, respectively. Intraperitoneally injected THEO increased CBF by approximately 60%, which has been attributed mostly to its action on the systemic circulation. Under control conditions, arterial hypoxia and epileptic seizures increased CBF by approximately 150% and 300%, respectively. Since neither topical nor systemic THEO treatment altered the vasodilatory and CBF increasing potency of arterial hypoxia and attenuated these effects of epilepsy slightly, it was concluded that extracellular ADO is not a critical factor in the regulation of cerebrocortical microcirculation. PMID- 3825556 TI - Influence of a single neonatal melatonin treatment on the basal and thyrotropin or melatonin modified blood thyroxine level of adult rats. AB - Neonatal melatonin treatment caused a significant increase in thyroxine (T4) level at one month of age. Preexposure to melatonin in neonatal age and reexposure after one month accounted for a still greater increase in T4 production. Rats neonatally exposed to melatonin did not respond to TSH at one month of age. PMID- 3825557 TI - The effect of rate, paired pacing and calcium on the length-tension relations in the rabbit papillary muscle. AB - The effect of sustained paired pacing, extracellular Ca2+ concentration and of the rate of steady-state single pacing on the length-tension relations in the isolated papillary muscles of right ventricles of rabbit hearts was investigated. We found that full range change of contractile force (CF, from close to zero to maximal) may be obtained by means of the change of the resting muscle length by 10-15% of Lmax (the length at which CF is maximal). This change brings about the shift of the thin filaments of the sarcomeres along the thick ones by one sixth of their length. The only effect of all the applied interventions could be reproduced by multiplying CF at each length step by some coefficient. Neither of them did change the basic pattern of length-tension relations. These results are compatible with the hypothesis that the basic mechanism of length-tension relations is the change of sensitivity of contractile system to the sarcoplasmic Ca2+ concentration. PMID- 3825558 TI - Excitation-dependent relaxation in the cardiac muscle. AB - Isolated trabeculae of rabbit and guinea pig atrium exposed to low-sodium solution developed after-contractions and increased diastolic tension when rhythmic steady-state stimulation was stopped. Single excitation applied during rest or at the peak of after-contraction brought the resting tension to the low, control level. Tension of isolated cat papillary muscle increased due to action of 17 mmol of caffeine applied during rest was reduced during rhythmic post-rest stimulation. Early extra-excitation potentiated relaxation of atrial muscle exposed to low-sodium solution. It is concluded that relaxing factor of cardiac muscle is activated by excitation of the cell. PMID- 3825559 TI - Normal electrocardiogram in guinea pig. AB - For establishing normal mean values of the parameters of the electrocardiographic curve and their standard deviations 50 male guinea pigs were studied. The directions of temporary vectors of atrial (AP) and ventricular (AQRS) depolarization times, and ventricular repolarization time (AT) were determined, and the position of the heart was evaluated. In all animals limb leads I, II, III, aVR, aVL, aVF were used, and in 38 animals additionally the precordial leads V1, V2, V3, V4, V5, V6 were applied. The investigations were done by a non invasive method with a specially designed plate making possible immobilization of the animals in supine position under general anaesthesia with urethane. In 10% of the animals abnormalities were detected in the ECG curve and these guinea pigs were eliminated from further analysis. The investigations showed that, after consideration given to the differences in the ECG curves in relation to man, guinea pigs might be used for preclinical cardiological studies. PMID- 3825560 TI - Stimulation of the arterial chemoreceptors is responsible for the ouabain induced hyperventilation in rats. PMID- 3825561 TI - [The 3d Congress of the Federation Internationale d'Epidemiologie Psychiatrique. Cooperation between clinicians and epidemiologists. Brussels, 9-11 September 1985. Proceedings]. PMID- 3825562 TI - [Mortality in patients attending a psychiatric service]. AB - This study followed during 10 years 322 Belgian patients aged between 20 and 39 years living in the district of Anderlecht and who had presented themselves for the first time to the psychosocial sector of this district between 1970 and 1973. Fifteen deaths were observed, 10 of which were among the under 30's. The S.M.R. observed (5.27) is similar to the results obtained in other international studies. The survival curves (Kaplan-Meier method) confirm the more considerable excess of mortality during the first years of the follow-up. The decreased sample was matched to a control sample of patients frequenting the centre and compared by the Mac Nemar test. There was very little difference between the two samples. The deceased had however rarely moved house during their follow-up and had accumulated a series of risk factors from the beginning. PMID- 3825563 TI - Suicide in psychiatric and non-psychiatric populations. AB - An analysis of all 776 suicides reported in Monroe County, New York, from 1966 through 1975 showed that psychiatric patients differ in systematic ways from other individuals who commit suicide. Forty-three percent of the total suicides were committed by patients with recorded contacts in the Monroe County Psychiatric Case Register. While suicide rates by age and sex for the overall population were similar to those reported previously, rates for the subgroup of psychiatric patients yielded little variation by age or sex. PMID- 3825565 TI - [High-risk suicide attempts: intent and severity]. AB - This study of 764 suicide attempts has for objective to define the factors which distinguish the "high-risk" group from other groups. The "high-risk" group is composed of people having scored more than 10 on Pierce's Intent Scale and more than 45 on the Weissman scale. Results show that the intensity and form of depressive symptomatology and some representations of death and age distinguish this group (n = 80) and that previous suicidal attempts, alcohol intake, chronic alcoholism and recent events have no statistical value. PMID- 3825564 TI - [Suicide: study of events related to patterns of mental functioning of certain subjects at high risk for suicide. Data from the emergency service of a general hospital]. AB - The events implicated during a suicidal crisis reveal different depressive patterns sometimes unknown before the suicide: pathological idealisation, pathology of mourning, suicidal identification, Tellenbach's melancholic personality, non-acceptance of growing old, anaclitic depression produce a large number of serious suicides, often facilitated by alcohol intoxication. The mechanisms of violence which persist after the suicidal act and the imaginary position of the person in relation to death are also important risk factors. PMID- 3825566 TI - Current trends in the methodology of classification. AB - Classification is a fundamental cognitive activity of ordering the objects of the external and the internal (phenomenological) world into sets on the basis of their relationships. The strategies employed vary from the search of "focal essences" identifying natural classes to the purely statistical approach of numerical taxonomy. Medical classifications are eclectic and pragmatic, without clear predominance of any single strategy. In addition to having its share of the general problems of medical taxonomies, classification in psychiatry has to face the dilemma of classifying diseases or people and their problems. The implications of this for the 10th revision of ICD are examined, and criteria for a good classification are tentatively laid down. PMID- 3825567 TI - Teaching methods for use by psychiatrists in primary care settings. AB - If psychiatrists are to be effective teachers in primary care settings, they must use methods which entail active participation by general practitioners, use a taxonomy which is appropriate to the kinds of psychological illnesses seen by general practitioners, and be aware of the importance of somatic presentations of neurotic illness. Examples are given of three teaching methods using television equipment which promote active participation by the general practitioners. PMID- 3825568 TI - Routine information systems in psychiatry. AB - Studies using data from routine psychiatric information systems must be interpreted in the light of the biases that can arise from their use. Data on utilisation of services is most commonly available but subject to the influence of enabling factors. Direct measures of quality are usually missing from routine systems. The results of a study of equity, performance and the influence of resource supply in general hospital psychiatry are summarised. PMID- 3825569 TI - [Theoretical and practical problems in the measurement of the mental health of populations. Quebec health survey]. AB - The authors present the process of setting up a mental health inquiry. The "Enquete Sante Quebec" was conducted at the request of the Ministry of Social Affairs in order to identify the problems, needs and priority intervention sectors in the health field. The inquiry was carried out on a large scale at the pilot stage, collecting information on 4,000 people in rural and urban areas. The principal options chosen are briefly discussed: type of mental health to be measured, sample methods, choice of instruments, validation work and some results. PMID- 3825570 TI - [Construction of questionnaires for the study of psychological components in the etiology of somatic diseases. The example of prematurity]. AB - A study whose aim was to define the role of psychological factors in prematurity etiology has led us to develop a methodology for evaluation of personality which could have a connection with the occurrence of a premature birth. The proposed method--interviews based on free association followed by the construction of questionnaires serving as a base for an epidemiological study--seem to us applicable in order to show the psychological components which intervene in the occurrence of a somatic illness. PMID- 3825571 TI - [Multicenter study of patients treated in a community psychiatric health service]. AB - Research on the characteristics and modalities of treatment was conducted in several diversified fields of psychiatry. The first results have allowed us to establish a sociodemographic profile of the patients in relation to their reference population, which itself is rather like the french population. The essential differences were found in the matrimonial status and the socioprofessional categories. The most represented diagnostic categories were studied according to sex. The different types of treatment were defined as hospital, outpatient consultations and mixed. The study of the duration of treatment has shown the importance of single consultations and long periods of treatment of at least 2 years. PMID- 3825572 TI - [Usefulness of self-assessment scales for anxiety and depression in internal medicine]. AB - The rating scales and questionnaires of quantitative psychopathology constitute an aid for the resident physician in the recognition of depressive and anxiety disorders in medical wards. The specific interest of these scales is more in the symptomatic intensity than in the diagnosis. A structured questionnaire leading to a DSM-III diagnosis of mood disorders shows the differences of these two approaches. Analyses of the results of two new self-assessment scales for depression compared to those of a diagnostic instrument permit to appreciate the respective prevalence of mood disorders and the intensity of depressive symptomatology. PMID- 3825573 TI - Examining the relationship between clinical concepts of personality disorder and dimensional measures of normal personality. AB - Psychiatric epidemiologists acknowledge the value of combining psychometric and clinical diagnostic approaches. However, in the description of personality disorders, the approaches have developed independently of one another. In two recent studies, the Socialization scale of the California Psychological Inventory and the E and N scales of the Eysenck Personality Inventory were found to be compatible with broad clinical concepts of personality disorder. It is suggested that these scales could be employed in epidemiological studies as screening tests. PMID- 3825574 TI - [Epidemiological knowledge and clinical truth: objectivity and clinical practice]. AB - The authors analyse the difficulties of the knowledge given by epidemiological studies from the clinician's point of view. They propose three arguments to define the aid epidemiology can bring to clinicians: to give rise to hypotheses from clinical experience, validate some epidemiological results, and reflect on the integration of predictive knowledge in clinical practice. These arguments are illustrated by examples taken from the authors work and propositions of epidemiological studies of which the aim and the problematic could emanate from observation and clinical experiences. PMID- 3825575 TI - Comprehensive mental health services: who needs them? AB - In 1980 the agency "Psychosocial Services" was founded in Vienna, Austria to set up and to operate comprehensive outpatient services, with responsibility to the total population of the city of 1.53 millions. Vienna has been divided into eight catchment areas. 11.076 patients have been in contact with the eight outpatient departments until the end of 1984 (0.72% of the total population). Data show high numbers of alcoholic, neurotic and schizophrenic patients. Number of patients indicates a need of some minimum equipment of the city with regionalized outpatient services. 50% of all the patients have never been under inpatient precare when they contact the outpatient departments. PMID- 3825576 TI - A Spanish experience of DSM III in a Consultation-Liaison psychiatric service. AB - The authors applied the DSM III diagnosis to 500 patients seen at a Consultation Liaison psychiatric service. Compared with similar American studies there was a lower frequency of adjustment and somatoform disorders and a higher proportion of drug abuse cases. Several possible reasons for these differences are mentioned. Although the use of DSM III has clear advantages in a General Hospital context, important difficulties were found: the use of some diagnostic criteria, the absence of a code to relate Axes I and III, the poor systemization of scores in social Axes IV and V and the lack of a specific category for attempted suicide are but a few of the difficulties encountered. Finally, some modifications of DSM III are suggested in order to improve its clinical usefulness. PMID- 3825577 TI - Immunoglobulin and C3 abnormalities in acute psychiatric disorders. AB - In a prospective study of 54 patients with acute psychiatric disorders, elevated absolute concentrations of immunoglobulin G (IgG), IgM and complement factor C3 were found in the cerebrospinal fluid (CSF) in seven (P less than 0.001), eight (P less than 0.01) and in four patients, respectively, and in serum in seven, 19 and 17 patients (P less than 0.001 in all), respectively, quantified by automated immunoprecipitin nephelometry in unconcentrated CSF and serum and compared with neurological controls with peripheral neurological symptoms. Elevation of the IgG index was observed in seven patients (P less than 0.001) and CSF/S albumin ratio in four patients (P less than 0.05). The presence of oligoclonal IgG bands was found in 22 patients (P less than 0.001). The results suggest that viral infections, inflammatory and autoimmune processes may have significance in the etiopathogenesis of acute psychiatric disorders. PMID- 3825578 TI - Immigration and major affective disorder. AB - We studied bipolar (ever manic; n = 297) primary unipolar (never secondary; n = 328), and secondary unipolar (n = 241) RDC major affective disorder patients in the NIMH--CRB Collaborative Study of the Psychobiology of Depression--Clinical. We examined rates of immigration, for patients and their parents, in these three diagnostic groups. Primary patients had a twofold increase in the odds in favor of immigration, compared to secondary patients. The difference persisted when proband age was statistically controlled, and could not be accounted for by any difference in sex ratios between groups. Previous findings of an increased rate of immigration in bipolar patients could not be replicated. PMID- 3825579 TI - Psychiatric diagnostic categories in Saudi Arabia. AB - This study involves 324 new cases referred to the Psychiatric Department of King Faisal University, Dammam, Saudi Arabia, over a period of 6 months. Men outnumbered women, which is in contrast to most Western studies. There was a preponderance in the younger age groups. The interaction of cultural factors and the rapid urbanization of the Saudi society may to some extent explain the pattern. PMID- 3825580 TI - Comparison between the Brief Psychiatric Rating Scale and the Manchester Scale for the rating of schizophrenic symptoms. AB - A reliability study was carried out to compare the short Manchester Scale (MS) to the longer Brief Psychiatric Rating Scale (BPRS), to see if similar items scored the same aspect of pathology and to find the sources of error. The raters were a psychiatrist and a psychologist cum medical student; they had recently arrived in Britain, came from different cultures and had not used the scale previously. Comparisons between the scales were made by interviewing the patients separately and together using either one or both scales. The items on the MS showed a higher interrater reliability as compared to the BPRS, both with independent and simultaneous ratings. Items based on observation only correlated poorly as compared to items based on verbal report. Lower between-scale correlations for delusions and affect were observed even where the same rater used the two scales, suggesting that the scales have different meanings for these items. The MS is a suitable alternative to the BPRS for quantifying schizophrenic symptoms. PMID- 3825581 TI - Premenstrual changes and changes in gonadal hormones. AB - Changes in plasma levels of estradiol and progesterone and their temporal relationship with changes in mood and behavior were studied along the menstrual cycle in 17 normal women with a wide range of severity and types of premenstrual changes (PMC). Emphasizing changes in hormonal levels over time as well as their rates of change, selective clinical features of premenstrual changes were found to be positively associated with peak levels of progesterone, its rate of decrease over time, and the ratio between the rates of decrease-over-time of progesterone and estradiol levels. A time-lag of 4-7 days between changes in plasma levels of progesterone and changes in clinical features was also found. Rate of change of estradiol was somewhat associated with clinical PMC. It is suggested that the association between gonadal hormones, other biological changes, and mood should be further studied as a diversified, dynamic, time related process. PMID- 3825582 TI - Female alcoholics. II. Factors associated with psycho-social outcome 3-10 years after treatment. AB - In a follow-up study of 44 female alcoholics, different aspects of outcome were studied. These were alcohol consumption, the use of drugs and psycho-social functioning. Also studied was a sumscore of these items called total outcome score. Childhood experiences such as having had a mentally disturbed father, a violent mother and/or unstable childhood environment were associated with a poor total outcome score. The same was true for alcohol abuse and violence in partner during follow-up period. Those women who had had their children removed from the home by the social authorities during follow-up period, also had a poor outcome. Destructive patterns of interaction experienced in family of origin may repeat themselves in adult life in relationship with partner and children. The successful treatment of female alcoholics would require modification of these behavioral patterns as well as drinking behaviour. PMID- 3825583 TI - Low prevalence of mitral valve prolapse in bipolar affective disorder. AB - The authors report the prevalence of mitral valve prolapse in bipolar affective disorder. 22 bipolar patients (13 men and 9 women; age 17-75 years, mean 42.3) were selected at random from 41 bipolar patients for echocardiographic examination. Diagnosis of mitral valve prolapse was made if prolapsus of the anterior or posterior valve to the left atrium was seen in the two-dimensional echocardiography and if mid-to late-systolic posterior motion of the mitral valve was greater than 2 mm in M-mode echocardiography. Of the 22 bipolar patients, only two had mitral valve prolapse. This rate does not differ significantly from the 5% rate found in the general population. PMID- 3825584 TI - [Thyrotropin secretion in patients with euthyroid autonomous thyroid nodules]. PMID- 3825585 TI - [Peripheral metabolism of thyroxine and triiodothyronine in patients with euthyroid autonomous thyroid nodules]. PMID- 3825586 TI - Some morphological characteristics of large sulci situated on the outer side of grivet monkey cerebral hemisphere. PMID- 3825587 TI - [Manifestations of cardiac arrhythmia in halothane anesthesia in asthmatic patients treated with theophylline]. PMID- 3825589 TI - Cardiopathic and electrocardiographic changes in multiple lentigines syndrome. PMID- 3825588 TI - [The effect of the rhythm of food intake on productivity in heavy industry]. PMID- 3825590 TI - [Familial incidence of mitral valve prolapse in elementary school students]. PMID- 3825591 TI - Hyperreactivity of lymphocytes to streptolysin O and lack of plasma inhibitory factor (s) in patients with mucocutaneous lymphnode syndrome. AB - Lymphocyte activation by streptolysin O (SLO) and factors in the plasma which inhibit the response to SLO were examined in 19 patients with mucocutaneous lymphnode syndrome (MCLS), 54 age-matched (6 months-6 years) normal children, 41 normal children older than 6 years and 10 normal adults. In normal children younger than 6 years, the response to SLO was weak and in many cases no response was seen. On the other hand, in the patients with MCLS, the response of lymphocytes to SLO was high and comparable to the response in adults and children older than 6 years. The DNA synthesis of lymphocytes stimulated by SLO was inhibited almost completely by autologous or allogeneic plasma of many of the normal children and adults. The plasma of patients with MCLS did not inhibit, but rather enhanced the response to SLO. These results suggest that the increased response of lymphocytes to SLO and the lack of plasma inhibitory factors in patients with MCLS may be due to the immune response to the pathogen of MCLS, as yet undiscovered. PMID- 3825592 TI - Injurious effects of ethanol on rat Kupffer cells. AB - The effects of ethanol on rat Kupffer cells were studied functionally and morphologically. Eight g ethanol per kg body weight per day was intragastrically administered to rats for 7 days. An isocaloric glucose solution was administered to control rats. The phagocytic activity of the reticuloendothelial system was measured by the carbon clearance method (57 mg carbon particles per kg body weight) on the 7th day. Kupffer cells having phagocytized carbon particles were counted under the light microscope. Kupffer cells were also observed by scanning electron microscopy. Both the carbon clearance and Kupffer cell number were lower in ethanol-administered rats (32 +/- 8 X 10(-4) mg/ml; 0.6 +/- 0.3/0.01 mm2 liver lobule) as compared to control rats (63 +/- 15; 3.1 +/- 1.0). Microvilli and filopodia of Kupffer cells were fewer in ethanol-administered rats than in control rats. Carbon clearance correlated with Kupffer cell number per 0.01 mm2 liver lobule and liver weight. These results suggest that the decrease in carbon clearance induced by ethanol is due mainly to the decrease in Kupffer cell number and partly to the decrease in Kupffer cell activity as demonstrated by the disappearance of microvilli and filopodia. PMID- 3825593 TI - Fluorescence and electron microscopic study of intracellular F-actin in concanavalin A-treated and cytochalasin B-treated Ehrlich ascites tumor cells. AB - To investigate the involvement of actin filaments in concanavalin A (Con A) induced cap formation and cytochalasin B (CB)-induced zeiotic knob migration, the distribution of F-actin was studied in Con A-treated and CB-treated Ehrlich ascites tumor cells (EATC) by fluorescence microscopy using heavy meromyosin conjugated with a fluorescent dye, N-(7-dimethylamino-4-methylcoumarinyl) maleimide, (DACM-HMM). In non-treated cells, the diffuse fluorescence of DACM-HMM was observed in the cytoplasm, particularly intensely under the plasma membrane and around the nucleus. In Con A- and CB-treated cells, the fluorescence was seen at Con A-induced-capped and CB-induced-knob-accumulated regions. This fluorescence was more intense in CB-treated cells. To study the actin filaments in these fluorescent regions more clearly, the soluble components of the cells were eliminated by treatment with Triton X-100 or saponin solution containing a low concentration of glutaraldehyde, and the detergent-treated and saponin treated cells were observed under a transmission electron microscope. Concentrated actin filaments were observed directly beneath the Con A-induced capping area and CB-induced zeiotic knob-accumulation area. The area of concentrated actin filaments appeared to correspond to the electron dense area observed in the identical region in the cells fixed without detergent treatment. More actin filaments were observed in CB-treated cells than in Con A-treated ones. PMID- 3825594 TI - Role of ammonia in the pathogenesis of brain edema. AB - The role of hyperammonemia in the pathogenesis of cerebral edema was investigated using mongrel dogs to develop a treatment for cerebral edema in acute hepatic failure. Intravenous infusion of ammonium acetate alone into dogs did not induce brain edema, although blood ammonia reached unphysiologically high levels. However, ammonium acetate infusion during mannitol-induced reversible (osmotic) opening of the blood-brain barrier (BBB) effectively induced cytotoxic brain edema. Pretreatment with a branched-chain amino acid (BCAA; valine, leucine and isoleucine) solution prevented an increase in intracranial pressure (ICP) and brain water content, and caused a decrease in brain ammonia content and an increase in brain BCAA and glutamic acid. The results suggest that ammonia plays an important role in the pathogenesis of cerebral edema during acute hepatic failure and that BCAAs accelerate ammonia detoxification in the brain. PMID- 3825595 TI - [Study of esophageal function. Which methods to choose?]. PMID- 3825596 TI - [A trainee register book and post-graduate education in Portugal in the 80's]. PMID- 3825598 TI - [Serum levels of selenium in the Portuguese population--the highest in Europe]. PMID- 3825597 TI - [Value of manometry of the esophagus in the diagnosis of achalasia]. PMID- 3825599 TI - [Membranoproliferative glomerulonephritis. Anatomo-clinical review of 17 cases]. PMID- 3825600 TI - [Swyer-James-MacLeod syndrome--clinico-radiologic aspects apropos of a clinical case]. PMID- 3825602 TI - [A trainee register book (corrected and issued with original paging in Acta Med Port 1986 Jul-Aug;7(4))]. PMID- 3825601 TI - [Erythrocyte senescence: lipo-protein interactions of the erythrocyte membrane]. PMID- 3825603 TI - [The case against tobacco. Tobacco and health in Portugal]. PMID- 3825604 TI - [Serum aluminum concentration and the deferoxamine test in a group of patients under chronic hemodialysis]. PMID- 3825605 TI - [Chronic complications of diabetes. II]. PMID- 3825606 TI - Percutaneous thermocoagulation for sphenopalatine ganglion neuralgia. AB - The authors describe percutaneous radiofrequency (rf) thermocoagulation of the sphenopalatine ganglion used to treat seven patients with sphenopalatine ganglion neuralgia. The procedure was effective in relieving pain, without significant side-effects. All the patients have actually been free of pain during a follow-up of 6-28 months. The surgical technique and the rationale for its use are pointed out. PMID- 3825607 TI - Phenytoin plasma levels after intraoperative administration, for the prevention of post-craniotomy seizures. AB - Since in a previous study (preliminary report) (18) the iv. administration of 15 mg X kg-1 of phenytoin (PNT) over 30 min in men produced toxic levels (25 micrograms/ml), a smaller iv. dose of 7 mg X kg-1 was given during anaesthesia to 80 patients under going craniotomy, for the prevention of post-operative seizures. Plasma PNT concentrations were studied in 22 patients before its iv. infusion 20 min, 40 min, and 1, 2, 3, 5, 8 and 12 hours later. Mean serum phenytoin levels were 9.3, 31.9, 27.8, 25.5, 19.4, 17.2, 15.4 and 19.2 micrograms/ml respectively. In this study it appeared that although the initial dose was 50% smaller than before, toxic levels were still encountered one hour after PNT administration (therapeutic range 10-25 micrograms/ml). Bearing in mind that in both our studies PNT appeared to have approximately the same efficacy in seizure prevention (from 95-97%), we suggest, that 7-10 mg X kg-1 would be adequate if administered as an intraoperative iv. infusion over an hour and that whenever possible serial serum levels should be monitored. PMID- 3825608 TI - Per-operative angiography--a useful tool in cerebral aneurysm surgery? AB - The value of per-operative angiography in elective surgery for aneurysms in the anterior cerebral circulation is evaluated. A progressive decrease in the number of difficulties was observed and was correlated with the introduction and refinements of microsurgery. From 1980-1983 approximately 5-8% of the angiograms revealed technical details which, as elucidated in the Discussion, did not always seem to require surgical correction. No case of an aneurysm neck remaining patent was encountered during this period. Similarly, main arterial branches were found to be occluded on only a few occasions, whereas significant unoccluded remnants of the base of the aneurysm occurred in roughly 5% of the cases despite modern microsurgery. It is felt by the authors that angiographic control of the operative result is no longer required in every aneurysm case because of the options for adequate visual control offered by the microtechnique. With this background it is concluded that, despite the optimal technical conditions available, per-operative angiography cannot be universally recommended in aneurysm surgery because of the inherent complexity of the procedure. Instead, post-operative angiography is more appropriate as a routine procedure for follow up of a variety of selected cases in which visual control was unsatisfactory. PMID- 3825609 TI - Comparative study of clinical and surgical findings and cortical somatosensory evoked potentials in patients with lumbar spinal stenosis and disc protrusion. AB - This paper is dealing with a comparative study of clinico-surgical findings and cortical somatosensory evoked potentials (CSEP's) recordings after stimulation of the right and left common peroneal nerve behind the fibula head, in twenty five patients suffering from lumbar spinal stenosis and disc prolapse. In all instances, the latencies of the first positive wave (the waveform also, when the latency was not discrete) were evaluated. The neurophysiological findings were verified by surgery. In combination with other roots, L3 root was affected in 1 patient, L4 in 6, L5 in 13 and S1 in 11. L5 was affected alone in 11 and L5 and S1 were impaired in combination in 11 patients. Seven patients presented sural atrophy. The results of the neurophysiological study are described below: There was delayed response on both sides in six patients, while in ten patients delayed response was found on one (affected) side, inconclusive responses in seven and in two normal. Myelography and CT Scan were performed pre-operatively to ascertain disc protrusion and establish stenosis criteria. The surgical findings were: clear disc protrusion in 4 patients, stenosis in one and combined lesions in 20 (including central disc protrusion in seven). Sixteen patients out of twenty-five had a follow up neurophysiological evaluation in addition to the clinical follow up examination. In thirteen of the above patients, (taken with the clinical progress) the re-examination gave improved neurophysiological data both as regards latency and P1 waveform. It was obvious that high value latencies were associated with long standing clinical symptoms while at the same time root compression involved more than one level. Regarding the neurophysiological data and the surgical findings, it was found that in the majority of the cases (92%) these two parameters matched together, so that in such cases a possible prediction of the operative outcome can be given. PMID- 3825610 TI - The lateral microsurgical approach to the "extracanalicular" lumbar disc herniation. I: A technical note. AB - The main aim in the surgery of the canalicular and extracanalicular lumbar disc herniation is to remove safely the hidden fragment without complete destruction of the normal facet joint, without damage to the nerve root and with minimal compromise of the stability of the spinal column. This report describes a lateral approach for operations of extracanalicular lumbar disc herniations in which full visual control allows a decompression of the respective spinal nerve or ganglion and removal of the herniated disc. With this approach, there is minimal resection of bone and facet joint and minimal risk of injury to neural structures. If necessary, this approach can easily be combined with the classical interlaminar exposure. PMID- 3825611 TI - Subtotal cervical body replacement by C-shaped iliac crest graft. Technical note. AB - A method for subtotal cervical vertebral body replacement in cases of tear drop fractures or burst compression fractures is presented, using a C-shaped iliac crest graft in combination with the trapezial osteosynthetic plate technique according to Caspar. PMID- 3825612 TI - Continuous spinal drainage of high viscosity C.S.F. using IVAC system--technical note. AB - In cases which need temporary external CSF drainage increased CSF protein levels with high viscosity of the fluid may cause a failure of the commonly used gravity dependent drainage systems. A possible solution to this problem using the vacuum effect of an IVAC system is proposed and its usefulness demonstrated. PMID- 3825613 TI - "Cross-over" duplication of middle cerebral artery, agenesis of internal carotid artery and saccular aneurysms. AB - The authors describe a patient with anomalous branches of the left internal carotid artery, "cross-over" duplication of its middle cerebral artery and agenesis of the contra-lateral internal carotid artery associated with two aneurysms successfully clipped. Pertinent literature is reviewed. PMID- 3825614 TI - Radioimmunoassay of thromboxane B2 in the prevention and treatment of the ischemic cerebrovascular diseases. PMID- 3825615 TI - Cervical SEPs from radicular (digital) upper limb nerves stimulation. PMID- 3825616 TI - Visual evoked potentials in chronic alcoholics. PMID- 3825617 TI - Risk of multiple sclerosis in optic neuritis. A prospective study. PMID- 3825618 TI - Hereditary progressive dystonia with marked diurnal fluctuation in a family with pigmentary retinopathy. PMID- 3825619 TI - Familial parkinsonism. PMID- 3825620 TI - Supratentorial haemangioblastomas. Report of two cases. PMID- 3825621 TI - Meningioma of the free edge of the tentorium cerebelli. Case report. PMID- 3825622 TI - [Correlation between competency in skiing and personality traits]. PMID- 3825623 TI - [Family factors and the course of schizophrenia]. PMID- 3825624 TI - [Diagnostic criteria of endogenous depression. A comparative study]. PMID- 3825625 TI - [Water intoxication in psychiatry (review apropos of 2 cases)]. PMID- 3825626 TI - [Risk of losing a kidney]. PMID- 3825627 TI - [Heterogeneous nucleation of calcium oxalate by the action of uric acid]. PMID- 3825628 TI - [Isolated bladder carcinoma in situ]. PMID- 3825629 TI - [Total cystectomy: complications and results]. PMID- 3825630 TI - [Surgical treatment of the obstruction of the pyeloureteral junction]. PMID- 3825631 TI - [Chronic severe cystopathy caused by mycoplasmas]. PMID- 3825632 TI - [Retrovesical hydatic cyst with spontaneous fistulization to the sigmoid]. PMID- 3825633 TI - [Litholysis of cystine calculi by continuous irrigation with acetylcysteine]. PMID- 3825634 TI - [Direct ureteroscopic lithotomy]. PMID- 3825635 TI - [Nuclear magnetic resonance. Diagnosis between parietal invasiveness and partial post-cystectomy fibrosis]. PMID- 3825637 TI - [Inverted Y ureteral duplication: versus cranial blind bifid ureter]. PMID- 3825636 TI - [Leiomyoma of the epididymis]. PMID- 3825638 TI - [Renal arterial thrombosis. Resolution with medical treatment]. PMID- 3825639 TI - [Neoplasms of the prostate, stages A2, B2 and C: experience in treatment with radiotherapy]. PMID- 3825640 TI - [Clinical and structural study of retroperitoneal fibrosis]. PMID- 3825641 TI - [Infection and lithiasis]. PMID- 3825642 TI - [Urinary lipids and bladder carcinoma. A new biological marker]. PMID- 3825643 TI - [Coagulation disorders in prostatic carcinoma]. PMID- 3825644 TI - [Plasma changes caused by estrogens in the vascular risk of prostatic carcinoma over a 3-year period]. PMID- 3825645 TI - [Prognostic value of serum prolactin in the treatment of prostatic cancer]. PMID- 3825646 TI - [Uretero-vesical metastasis of renal adenocarcinoma]. PMID- 3825647 TI - [Pyogenic abscesses of the psoas muscle]. PMID- 3825649 TI - [Treatment of stenosis of the anterior urethra in a single stage]. PMID- 3825648 TI - [Treatment of intractable bladder hemorrhage]. PMID- 3825650 TI - [2 new technics in the surgery of hypospadias]. PMID- 3825651 TI - [Instability of the detrusor muscle. Treatment with oxybutynin chloride (ditropan)]. PMID- 3825652 TI - [Congenital cysts of the prostatic utricle]. PMID- 3825653 TI - [Blind-end double ureter. Presentation of a case]. PMID- 3825654 TI - [Inverted papilloma of the urothelium. 2 new cases]. PMID- 3825655 TI - [Lymphatic metastases in carcinoma of the bladder: value of the radical excision of the pelvis]. PMID- 3825656 TI - [Bladder hernias]. PMID- 3825657 TI - [Bladder exstrophy in adult males without adenocarcinoma. A case]. PMID- 3825658 TI - [Bilateral renal angiomyolipoma. Hematuria. Treatment by selective arterial embolization]. PMID- 3825659 TI - Formal operations, the imaginary audience and the personal fable. AB - One hundred twenty-nine 6th, 8th, 10th/11th, and 12th graders were administered Enright, Lapsley, and Shukla's Adolescent Egocentrism Scale (AES) and How Is Your Logic?, a Piagetian-based, group-administered, written test of cognitive development. A series of ANOVAs on four scales of the AES (imaginary audience, personal fable, self-in-general, nonsocial) provided partial support for Inhelder and Piaget's, and Elkind's views that adolescent egocentrism is a function of beginning formal operations. Discussion focused on the difficulty of assessing the true thoughts/feelings of persons who are worried how they will appear to others. PMID- 3825660 TI - Informal control networks and adolescent orientations toward alcohol use. AB - Utilizing panel data obtained from 345 high school sophomores, juniors, and seniors in a medium-sized community in the Pacific Northwest, this study investigated the roles parental and peer informal control structures play in predicting adolescent alcohol use and abuse. The findings suggest that the "youth world" and "adult world" control structures are predictive of adolescents' orientations toward alcohol, though generally in different directions. While the adult-world predictors tended to constrain use and abuse, those of the youth world promoted use and discouraged abstinence. Further, changes occurred in the relative importance of the parental and peer predictors across time. PMID- 3825661 TI - Late adolescents' identity formation: individuation from the family of origin. AB - This study explored the relationships between late adolescents' self-reported ego identity and individuation from their family of origin. Individuation was defined as adolescents' subjective perceptions of how psychologically enmeshed they were in the transactional processes of fusion and triangulation within their family of origin. The results indicated a significant relationship between adolescents' perceived involvement in their family's patterns of fusion and triangulation and the total score, and three of the five subscale scores, from the identity measure. The implications of the findings and directions for future research are discussed. PMID- 3825662 TI - The relationship of television viewing to physical fitness and obesity. AB - The purpose of this study was to determine the extent to which light, moderate, and heavy television viewing relates to multiple measures of obesity and physical fitness among 379 high school males. The Body Mass Index and Tucker's Perceived Somatotype Scale were employed to assess obesity; physical fitness was measured by six tests: pushups, pullups, sidestep, long jump, situps, and jog-walk. Results showed that light television viewers scored significantly better than heavy viewers on a composite fitness index and on pushups, pullups, sidestep, situps, and jog-walk considered individually. Similarly, light viewers performed better than moderate viewers on the composite fitness measure and on pushups, pullups, and jog-walk. Light viewers displayed a strong tendency toward better fitness than moderate viewers on the long jump, situps, and sidestep tests, although statistical significance was not attained. Light viewers were not significantly less obese than moderate or heavy viewers. Statistical control of the demographic variables, applied simultaneously, had little influence on the associations found in this study. The findings indicate that for purposes of good physical fitness, television viewing should be limited to one hour or less per day. PMID- 3825663 TI - Child/pet maltreatment: adolescents' ratings of parent and owner behaviors. AB - This study investigated adolescents' ratings of various forms of child and pet maltreatment. Participants (N = 614) rated the seriousness of 20 vignettes (10 focusing on abuse; 10 focusing on neglect) on the potential harm each had to a child's or pet's welfare. Two instruments were administered. Half the adolescents completed the child maltreatment instrument first, while the rest completed the pet maltreatment instrument. Six weeks later all participants were administered the alternative instrument. Surveys were identical except that in one the victim was a three-year-old child and in the other it was a one-year-old pet dog. Results indicated adolescents were: highly critical of parental and owner acts which constitute maltreatment, more disapproving of abusive than neglectful acts, less tolerant of inappropriate actions directed toward a child than toward a pet, and more tolerant of the use of physical force toward a child if they had at some time been the person primarily responsible for the care of a pet. PMID- 3825664 TI - Jungian feminine psychology and adolescent prostitutes. AB - This paper explores Jungian feminine psychology and its application in the treatment of adolescent prostitutes. Wolff's (1956) work on feminine functions and Leonard's (1982) work with father-daughter wounds are discussed, and techniques for applying these concepts with adolescent prostitutes are explored. PMID- 3825665 TI - Family functioning and the adolescent mother: a systems approach. AB - This study examines unwanted adolescent pregnancy and early childbearing within the context of the family system. Fifty pregnant adolescents and their families were interviewed prenatally and again during the postpartum period. Utilizing the concepts of structural family theory and therapy as described by Minuchin, certain characteristics of family style and structure of organization were rated. These family variables were then related to aspects of the adolescent mother's adaptation postpartum. Boundaries, in terms of degree of intrusiveness and differentiation, were related to such variables as whether the adolescent is maintained in the household and to her continuing relationship with the baby's father. Similarly, the family's style of dealing with conflict was related to the relationship between the adolescent parents, among other outcome variables. Implications of the findings both for working with these families and for further research are discussed, and issues are raised about hypothesized relationships between independent and dependent variables which were not borne out. PMID- 3825666 TI - Enhancement of self-esteem among female adolescent incest victims: a controlled comparison. AB - A therapeutic intervention consisting of homogeneous group therapy and sexual education with same-sex therapist/clients was instituted with 15 female incest victims, compared to a matched control group; all the subjects had experienced intrafamilial incest and were court-placed in a Southern California resident facility. A series of behavioral markers and changes in self-esteem are reported by use of pre- and posttests of the Coopersmith Self-Esteem Inventory, behavioral observations by resident professionals, and checklists/daily behavior logs. The latter were evaluated for signs of further victimization of both groups. Findings show that female incest victims in the experimental group showed a significant increase in positive self-esteem as measured by the inventory, and developed a significantly increased knowledge of human sexuality, birth control, and venereal disease when compared to the control group. PMID- 3825667 TI - Projective-cognitive assessment of thoughts and feelings and their relationship to adaptive behavior in a dental situation. AB - The purpose of this study is to examine the interrelationships among coping statements, a self-report measure of anxiety and maladaptive overt behavior in a real-life stressful situation. Measures of these variables (interviews using TAT like cards, State-Trait Anxiety Inventory for Children, Behavior Profile Rating Scale) were taken from 23 adolescents prior to and during their dental visit. Results indicated that as disruptive "in-chair" overt behavior increased, so did the percentage of coping statements. In addition, as self-report levels of anxiety increased, the percentage of coping statements significantly decreased. Interestingly, there was no significant relationship between self-report levels of anxiety and disruptive in-chair behavior. It was also noted that the subjects' self-report levels of anxiety significantly decreased following their opportunity to verbalize their coping/noncoping statements via the TAT-like procedure. The implications of these interrelationships to cognitive-behavioral theory are discussed. PMID- 3825668 TI - Standing out from the crowd: personalization of graduation attire. AB - During 1982 and 1983 college commencement ceremonies, a tally was made of students who displayed personal adornment in addition to their traditional academic garb. Degree conferred, sex of recipient, and year of graduation were related to the frequency and forms (political and nonpolitical) of adornment. Bachelor of Arts candidates were more likely to be adorned than were Bachelor of Science candidates, women were more likely to be adorned than were men, and 1982 graduates were more likely to be adorned than were 1983 graduates. The wearing of antinuclear protest ribbons varied as a function of degree but not as a function of sex, and the wearing of nonpolitical forms of adornment varied as a function of sex but not as a function of degree. Results indicate that personalization of graduation attire follows patterns reported in studies of secular dress and adornment. This correspondence between everyday and ritual clothing expressions suggests that the graduation ceremony may be a useful microcosm for future field studies of adolescents' attitudes and social differentiation. PMID- 3825669 TI - Effects of maternal employment on sex role orientation of adolescents. AB - Sex role orientation was determined for 352 high school seniors in Plano, Texas. Using maternal employment status as the independent variable, students were divided into groups according to full-time employed mothers or full-time homemaker mothers. Results of the three-part instrument indicated that adolescents of employed mothers had a more liberal sex role orientation and attitude toward division of household tasks than adolescents of homemaker mothers. Mean scores from two sections of the instrument indicated nontraditional attitudes. Results indicated that maternal happiness with employment did not affect male and female sex role orientation. PMID- 3825670 TI - Patterns of alcohol use among rural and small-town adolescents. AB - Much research has indicated that age, gender, grade in school, religiosity, socioeconomic status, and involvement in extracurricular activities are all related to adolescent alcohol use. However, most of such research focuses on urban youth. The present study examines patterns of rural adolescent alcohol use and factors associated with such use. The Student Alcohol Inventory was administered to 650 students in grades 7-12 in a small, middle-Atlantic town and surrounding county. The survey contained sections addressing demographic data, attitudes regarding students' alcohol use, and their parents' use. Along with standard SES measures, items were included on unemployment and receipt of government assistance. The dependent variables included age at first drink, frequency of drinking, amount of drinking, and a composite heavy-drinking index. Eighty-three percent of the respondents indicated that they had drunk alcohol and 57% had had their first drink by age 12. Gender and grade in school were significant predictors of alcohol use for all four dependent variables. Time spent in social activities was significant in predicting all but age at first drink. Religiosity was a significant predictor for only one dependent variable- age at first drink. The SES measures were also weak predictors of drinking behavior. Policy implications and directions for future research are discussed. PMID- 3825671 TI - A measurement of the process of adolescence: standardization and interpretation. AB - The Objective Measure of Ego Identity Status (Adams, Shea, & Fitch, 1979) was administered to 350 adolescents (12 to 18 years old) to test the Eriksonian theory of a developmental continuum from role diffusion to identity achievement. The results offer construct validity for the dynamic process proposed by Blos and Erikson, but do not support the categorization procedure as set forth by Adams, Shea, and Fitch. The OMEIS questionnaire lends itself to a qualitative and dynamic interpretation rather than to a quantitative and normative approach. It is suggested that the dynamic interpretation is more sensitive to the psychological reality of the developmental process. PMID- 3825672 TI - A large-scale comparison of perspectives on parenting between teenage runaways and nonrunaways. AB - Teenage runaways were compared to teenage nonrunaways concerning their views on parenting behaviors. In ratings of reasons for running away, the runaways emphasized typical teenage issues such as differences in values from parents and rebellion. On the other hand, nonrunaways gave highest ratings to more dramatic issues such as parental abuse and drug use. Runaways were less likely to want to have children than nonrunaways and, if they did have children, runaways anticipated being very different with their children than their parents had been with them (e.g., more involved and open). Nonrunaways generally expected to be about the same as their parents had been. Suggestions for treatment, based on the findings, are offered. PMID- 3825673 TI - Loneliness: counseling adolescents. AB - This paper discusses the related concepts of loneliness and the guidance counseling of adolescents. Part One argues that the fear of loneliness and the accompanying need to avoid it constitutes a universal motivational principle in all human beings, and that it is especially acute during adolescence. Part Two shows how loneliness may serve the counselor as a basis for understanding and interpreting much of adolescent behavior. Part Three proposes some therapeutic principles and procedures designed to alleviate the sense of loneliness and isolation so prevalent among contemporary adolescents. PMID- 3825674 TI - The drug abuse-delinquency connection revisited. AB - Ninety-one delinquent adolescents were interviewed with respect to their personal and family drug use and criminal behavior. No significant gender differences with respect to drug use were found. Females, however, committed more crimes against property than did males. The drug use-delinquency association was explored and findings indicated that subjects saw a stronger causal relationship between drug use and subsequent criminal behavior than was found in the current study or past research. A multifactorial association between drug abuse and delinquency behaviors as part of a spectrum of sociopathic personality development was supported. PMID- 3825675 TI - Health needs and concerns of male adolescents. AB - Lifestyle factors established within the family help determine health-care functioning. Adolescents first may be challenged to meet their own health needs as freshmen in college. A 153-item questionnaire was utilized to examine concerns in the areas of alcohol and other drug use, auto safety, weight and dieting, smoking, sexuality, coping and stress, and selection and utilization of health care services. One hundred fifty-nine male college students responded. Major problems with alcohol use, auto safety, weight control, stress and sexuality were identified. Positive lifestyle factors that were strongly supported included regular exercise, nonsmoking, regular medical and dental checkups, and the development of some support systems to cope with stress. Health-care services designated by respondents to meet their own needs were significantly different from those services they pointed out as needed for their peers. PMID- 3825676 TI - Parental preferences regarding sex education topics for sixth graders. AB - The purpose of this study was to ascertain which sex education topics parents of preadolescents regarded as appropriate for their children. The sample was comprised of 146 respondents randomly selected from a class list of sixth graders in a suburban school district. A mailed, self-administered questionnaire listing 48 possible topics was used to elicit parental response. Pretesting found the questionnaire to be highly reliable (Cronbach's alpha = .95). Overall, parents strongly supported the inclusion of a broad range of sex education topics regardless of parental age, sex, marital status, income, education, or child's sex. Moreover, parents were largely in agreement with the inclusion of sensitive topics in addition to those which were more physiological or behavioral. Catholics more often than Protestants agreed with the inclusion of birth control, abortion, and sterilization even after controlling for income and education. Thus, the findings suggest that parents of sixth graders find a broad sex education program in the school appropriate. To this end, school officials and sex educators should not overlook the needs of preadolescents for sex education solely on the basis of perceived parental opposition. PMID- 3825678 TI - The molecular and cellular biology of fertilization. Proceedings of the 75th anniversary symposium. June 20-22, 1984, Davis, California. PMID- 3825677 TI - Family life education in Chicago schools: a study of programs implemented by nonschool agencies. AB - Although nonschool agencies provide important complementary courses on family life education (FLE) in public and private schools, little is known about the scope and content of such curricula. This paper describes a study documenting the types of school-based family life education programs implemented by nonschool agencies in Chicago. Semistructured telephone interviews were conducted with professionals from 26 health care and social service agencies, identified as offering FLE courses in the metropolitan area. The surveyed organizations provided FLE programs in almost 100 public and private schools in Chicago during the 1982-83 and 1983-84 school years. Most programs were relatively short, utilized few interactive teaching techniques (e.g., role-playing, exercises), covered a wide variety of topics, and were integrated into other curricula units rather than implemented as separate courses. Agency personnel covered topics viewed as important by school administrators and teachers, most notably information on contraception and sexual decision making. PMID- 3825679 TI - The cortical endoplasmic reticulum and its possible role in activation of Discoglossus pictis (Anura) eggs. AB - The role of endoplasmic reticulum was investigated in the egg of Discoglossus pictus; recent findings suggest that this organelle is the source of Ca2+ sequestration and release at activation. In the egg of Discoglossus the dimple is the only site where sperm-egg fusion occurs. Microvilli containing microfilament bundles penetrate into the dimple cytoplasm and thus define a cortical layer containing cortical granules, tubular cisternae 35 nm thick and vacuoles. In the underlying cytoplasm are clusters of small cisternae and mitochondria. In the region of the egg cortex outside of the dimple, clusters of cisternae, some vacuoles and a heterogeneous population of small granules are found. In eggs activated by pricking contraction starts from the site of pricking and travels to the antipode. Sections of eggs, fixed 20 to 60 s following fertilization or pricking, show that the tubular cisternae have disappeared and the clusters of cisternae have opened to give rise to longer cisternae arranged in chains. These chains pile up below the vacuoles which are now flat and long because of multiple fusion. A network of cisternae is thus formed whose constituents lean against the microfilament bundles and within 5 min from activation approach the plasma membrane. The flattened vacuoles and the cortical granules are exocytozed. Some cisternae fuse with the microvillar membrane thus participating in microvilli elongation. The microfilament rootlets grandually rearrange and become shorter. In the cortex outside the dimple the cisternae clusters do not open, whereas exocytosis of granules occurs. In eggs treated with A23187, vacuoles and cortical granules undergo exocytosis; however a cisternal network is not formed. The possible stimuli that cause the cisternae network to form at activation only in the dimple and in a matter of seconds are discussed. Our observations, namely exocytosis, formation of cortical wave of contraction and changes in the cytoskeleton organization at activation are consistent with an increase of free Ca2+. Vacuoles and cisternae appear to be good candidates for the sequestration and release of Ca2+ as well an important source for the increase in total plasma membrane at activation. PMID- 3825680 TI - Urodele egg jelly and fertilization. AB - Fertilization of urodele amphibians is physiologically polyspermic. These amphibians lack sperm entry blocking mechanisms at the egg surface, such as a cortical reaction or a membrane depolarization. Although, egg jelly is necessary for sperm capacitation, a late block to sperm entry does occur about 30 min after fertilization at a precise interface between jelly layers. The jelly is secreted by oviductal cells. In order to investigate its role in fertilization, we studied some biochemical properties of the oviductal secretions of eight species. In double diffusion experiments on agarose plates, some components secreted by the anterior and the middle parts of the oviduct interacted together and formed precipitin lines. This reaction might be responsible for the formation of the dense zone that delimits the capsular chamber. A hemagglutinating activity was found in the anterior or in the posterior part of the oviduct depending on the species. A 18K or 26K lectin was purified respectively from the oviduct of Ambystoma mexicanum and Pleurodeles waltl. In both species, the site where the late block to sperm entry is operative was spatially related to the location of the lectin in the jelly. However, sperm in contact with the purified lectins did not undergo any visible morphological change. PMID- 3825681 TI - Induction of the acrosomal reaction in sperm from the white sturgeon, Acipenser transmontanus. AB - Sperm from the white sturgeon, Acipenser transmontanus possess an acrosome while the eggs possess numerous micropyles. The sperm undergo an acrosome reaction that includes exocytosis and process formation. This acrosomal reaction can be induced in freshwater with ionophore A23187, high pH, high Ca++, or egg water. In addition, this event is dependent on extracellular Ca++ and Mg++. Upon immersion of eggs in freshwater, a water-soluble jelly layer hydrates and forms a highly adhesive coating surrounding the eggs. Jelly release and hydration appears dependent on both a trypsin-like protease and Ca++ and Mg++ ions. Isolated egg jelly (110,000 dalton glycoprotein) does not possess acrosome reaction inducing activity. The acrosome reaction inducing activity in egg water resides in a water soluble 66,000 dalton glycoprotein. Egg water appears species specific in its ability to elicit a response. Prior to freshwater exposure, the egg envelope possesses a water-insoluble glycoprotein with a molecular weight of 70,000 daltons. When isolated from polyacrylamide gels, the 70,000 dalton component induces acrosome reactions in a species specific manner. Following freshwater exposure, the egg envelope possesses the water-soluble 66,000 dalton glycoprotein in addition to the 70,000 dalton component. The 70,000-66,000 dalton conversion can be blocked by incubating eggs in freshwater containing inhibitors of trypsin like proteases. Both the 66,000 dalton and 70,000 dalton glycoproteins originate and reside in layer three of the egg envelope. PMID- 3825682 TI - Sperm glycosidase as a plausible mediator of sperm binding to the vitelline envelope in Ascidians. AB - In the Ascidian, Ciona intestinalis, sperm alpha-L-fucosidase is concluded to be a recognition protein for the sperm receptor in the vitelline envelope. The spermatozoa bind to the vitelline envelope probably by forming rather stable substrate (alpha-L-fucoside)-enzyme complex at many spots. Experimental evidence indicates a good correspondence in the properties between receptor binding activity and alpha-L-fucosidase activity such as the effects of saccharides, of pH and of monoclonal antibodies raised against sperm alpha-L-fucosidase, and locus in the sperm. A general mechanism involving an enzyme as a recognition protein for the cell to cell binding is also discussed in relation to the molecular evolution of the recognition proteins. PMID- 3825683 TI - Characterization of the Strongylocentrotus purpuratus egg cell surface receptor for sperm. AB - In earlier studies from our laboratory, the intact sperm receptor was partially purified from Strongylocentrotus purpuratus crude egg membranes, but due to its insolubility, it was not possible to purify it to homogeneity. Nonetheless, this receptor preparation bound with species specificity to acrosome-reacted sperm, thereby inhibiting fertilization. Antibodies against the partially pure receptor inhibited fertilization in S. purpuratus (but not Arbacia punctulata) by coating the egg surface, indicating the presence of binding sites that can be species specifically recognized by both sperm and antibody molecules. Recently we were able to further purify and characterize the receptor from S. purpuratus eggs. Chaotropic agent solubilization of the receptor prepared from crude egg membranes yielded a very high molecular weight glycoconjugate that had many of the properties of a proteoglycan. The receptor interacted with binding in an in vitro assay and bound with species specificity to acrosome-reacted sperm to inhibit fertilization. Unfortunately, this receptor preparation was soluble only in certain chaotropic agents. Exhaustive Pronase digestion of the intact receptor yielded a soluble high-molecular-weight (greater than 10(6)) polysaccharide that was virtually devoid of protein. This glycosaminoglycan-like fragment was highly sulfated, and contained fucose, galactosamine, and iduronic acid. The fragment inhibited fertilization, but did not do so with species specificity. Recently, soluble molecules with receptor activity were generated by treating intact dejellied eggs with trypsin. These proteolytically derived molecules contained (on a weight basis) approximately equal amounts of protein and carbohydrate. Importantly, they inhibited fertilization with species specificity. The results suggested that the binding activity was conferred by the polysaccharide component of the receptor and that the intact receptor and the tryptic fragments contained structural elements in the polypeptide chain necessary for species recognition. PMID- 3825684 TI - Effects of anti-zona pellucida monoclonal antibodies on fertilization and early development. AB - The murine zona pellucida surrounds the growing oocyte, ovulated egg and dividing embryo. It is comprised of three sulfated glycoproteins designated ZP-1, ZP-2, and ZP-3 which have molecular weights of 185,000, 140,000 and 83,000 daltons respectively. We have isolated a series of cell lines that produce monoclonal antibodies to ZP-2 and to ZP-3. These immunogical probes indicate that the extracellular matrix proteins of the zona pellucida are found uniquely in the ovary where they surround maturing oocytes. We have demonstrated that passive immunization with antibodies specific either for ZP-2 or ZP-3 inhibit in vivo and in vitro fertilization. This effect is observed with ng/ml quantities of antibody. It appears that the antibodies do not preclude sperm binding but rather prevent sperm penetration of the zona by steric hinderance. Although long-term, the contraceptive effect is fully reversible and this reversibility is associated with loss of antibody from the zona pellucida surrounding intra-ovarian oocytes. Antibodies to ZP-2 or ZP-3 had no other adverse effect on in vivo or in vitro preimplantation development. PMID- 3825685 TI - Pathways to immunocontraception: biochemical and immunological properties of glycoprotein antigens of the porcine zona pellucida. AB - The zona pellucida (ZP) is an extracellular coat which surrounds the mammalian oocyte and whose macromolecular composition is unique for each species. Two dimensional gel electrophoresis of porcine ZP under reducing conditions resolves four major acidic, charge-heterogeneous glycoproteins with apparent molecular weights of 82,000 (ZP1), 61,000 (ZP2), 55,000 (ZP3) and 21,000 (ZP4). Fractionation of heat-solubilized porcine ZP under nondissociative, nonreducing conditions resulted in a preparation, termed purified pig zona antigen (PPZA), substantially enriched in ZP3 and lacking ZP1 and ZP2. PPZA was highly immunogenic in both rabbit and squirrel monkey. Anti-PPZA sera exhibited contraceptive potential as assessed by in vitro inhibition of homologous sperm zona binding following antibody treatment of human, pig and squirrel monkey oocytes. Alternatively, fractionation of sodium dodecyl sulfate (SDS)-dissociated porcine ZP under nonreducing conditions resulted in isolation of two electrophoretically homogeneous antigens with apparent molecular weights of 82,000 (82K antigen) and 55,000 (55K antigen) as judged by nonreducing SDS polyacrylamide gel electrophoresis. The 82K antigen exhibited an estimated molecular weight of 345,000 by gel filtration chromatography in nondissociative solvent and was comprised of ZP1 and disulfide-linked heterodimers of ZP2+ZP4 and ZP3+ZP4. The 55K antigen was comprised of ZP3 which was highly aggregated in nondissociative solvent. Each antigen had a characteristic carbohydrate composition and proved to be immunogenic in the rabbit. The effects of active heteroimmunization of squirrel monkeys with 55K antigen on fertility are under investigation. PMID- 3825686 TI - Immunological identification of sperm antigens that participate in fertilization. AB - Using monoclonal antibodies (mAbs) as probes for specific components of the spermatozoon, we have initiated an investigation aimed at identifying those sperm components that participate in the events of gamete interaction. We intend to exploit these mAbs not only for identifying functional sperm components, but also for defining the constituents of discrete domains that comprise the structure of this highly differentiated cell. Among the large group of anti-sperm mAbs that we have generated, we have focused to date upon two categories. The first category consists of mAbs that localize to the acrosomal crescent, a restricted region of plasma membrane overlying the acrosome. Within this category, the mAbs share many similarities with regard to subclass, species and tissue cross-reactivity, and antigen solubility, in addition to cellular distribution. Nevertheless, despite these similarities, some mAbs in this category (e.g., M42) inhibit fertilization, whereas others (e.g., M41) are non-inhibitory. The block to fertilization observed in the presence of M42 is dependent upon the zona pellucida surrounding the egg. The specific event prevented by M42 appears to be the induction of the acrosome reaction at its physiological site, the surface of the zona pellucida. The sperm components recognized specifically by M42 are a cluster of high molecular weight moieties, ranging from approximately 220,000 to 240,000. The mAbs described in the second category display common localization at the equatorial segment of the sperm head. The pair of mAbs discussed from this category, M2 and M29, again bear considerable similarity to each other, yet differ significantly in their ability to inhibit fertilization. M2 does not inhibit, whereas M29 causes a marked inhibition of fertilization. With M29, however, the block to fertilization is independent of the zona pellucida. The M29 mAb interferes with sperm interaction with the egg plasma membrane subsequent to sperm attachment; since M29 does not prevent sperm binding to the egg plasma membrane, the specific event affacted, in all likelihood, is gamete membrane fusion. M29 recognizes a single sperm component, with subunit molecular weight of approx. 40,000. A variety of experiments are underway currently, both to characterize the antigens recognized by these mAbs further as well as to identify additional sperm components that participate in the fertilization process. PMID- 3825687 TI - Overview of morphological changes in Parkinson's disease. PMID- 3825688 TI - Parkinson's disease. Proceedings of the VIII International Symposium on Parkinson's Disease. New York City, June 9-12, 1985. PMID- 3825689 TI - MRI study on Parkinson's disease in relation to the severity of the disease. PMID- 3825690 TI - "Pure akinesia" and the later added supranuclear ophthalmoplegia. PMID- 3825691 TI - Juvenile onset Parkinson's disease. PMID- 3825692 TI - Effects of tyrosine administration on plasma biopterin in patients with juvenile parkinsonism and their relatives. PMID- 3825693 TI - Biosynthesis of tetrahydrobiopterin in parkinsonian human brain. PMID- 3825694 TI - Hereditary progressive dystonia with marked diurnal fluctuation: clinicopathophysiological identification in reference to juvenile Parkinson's disease. PMID- 3825695 TI - Long-term course in Parkinson's syndrome and cerebral polypathy (Parkinson plus). PMID- 3825696 TI - Cerebrospinal fluid arginine vasopressin in Parkinson's disease, dementia, and other degenerative disorders. PMID- 3825697 TI - Amino acid abnormalities in cerebrospinal fluid and blood serum of patients with Parkinson's disease, other heredodegenerative disorders and head injuries. PMID- 3825698 TI - Serum norepinephrine response to standing in patients with Parkinson's disease. PMID- 3825699 TI - Parasympathetic assessment in Parkinson's disease. AB - There is little evidence of autonomic dysfunction in PD, although autonomic disturbance was included in the original description by J. Parkinson. In addition, there are no data for de novo PD patients. We selected 14 de novo parkinsonians (seven men and seven women), aged 62.7 +/- 8.2 years, with mild disease (stage 1 through 2 on the Hoehn and Yahr's scale), without history of diabetes, heart disease, or alcoholism, and without neuropathy or orthostatic hypotension. Fourteen age- and sex-matched normal persons were controls. We found a highly significant difference in the respiratory sinus arrhythmias during deep breathing (p less than 0.01); the basal heart rate, the respiratory sinus arrhythmias during quiet breathing, and the Valsalva ratios did not differ statistically, however. In the absence of neuropathy and orthostatic hypotension and in the presence of normal Valsalva ratios, we believe that the abnormality found by us may apply only to parasympathetic dysfunction, perhaps at a central level. In addition, the abnormality seems to be independent of stage and therapy. PMID- 3825700 TI - Breathing in Parkinson's disease. PMID- 3825701 TI - Sleep apnea in idiopathic and postencephalitic parkinsonism. PMID- 3825702 TI - Early onset Parkinson's disease and childhood environment. PMID- 3825703 TI - Genetics of Parkinson's disease. AB - The hypothesis that heredity plays an important role in the etiology of PD has long seemed attractive. It was initially suggested by positive family histories and later by reports of kindreds of "parkinsonism." It was reinforced by the first systematic family study of PD conducted a half-century ago by Mjones. However, closer study of the clinical data indicates that familial aggregations of parkinsonism have reflected various other disorders, notably OPCA and other forms of multiple system atrophy. Case control studies have failed to document a prevalence of PD among first-degree relatives of index cases significantly exceeding that found in control groups. More recently, the concordance rate for PD among monozygotic twins has been found to be unexpectedly low and not significantly different from that among dizygotic twins or the prevalence among first-degree relatives. Thus, the best available data do not support a role of heredity in the etiology of PD. A nonhereditary, possibly congenital genetic defect is, however, not excluded. PMID- 3825704 TI - Family history of tremor in Parkinson's disease compared with those of controls and patients with idiopathic dystonia. PMID- 3825705 TI - Quantitative study of "on-off" fluctuations in the ocular motor system in Parkinson's disease. PMID- 3825706 TI - Oral sensorimotor defects in patients with Parkinson's disease. PMID- 3825707 TI - Sensorimotor disturbances in Parkinson's disease: index finger test. PMID- 3825708 TI - Relationships among pain, depression, and sleep alterations in Parkinson's disease. PMID- 3825709 TI - Assessment of rest tremor in Parkinson's disease. PMID- 3825710 TI - Clinical and radiographic features of scoliosis in Parkinson's disease. PMID- 3825711 TI - Foot dystonia in Parkinson's disease: clinical phenomenology and neuropharmacology. PMID- 3825712 TI - Disturbance of two simultaneous motor acts in patients with parkinsonism and cerebellar ataxia. AB - Parkinsonian patients showed great difficulty in performing two motor acts in space and time although each single motor act was relatively well performed. In contrast, patients with cerebellar ataxia had no more difficulty in performing two motor acts than did normal subjects although they performed each motor act clumsily. The results suggest that parkinsonian patients use special strategies of motor performance, requiring higher levels of brain function such as attention, strong effort, and feedback, and that abnormality of basal ganglia uses higher levels of brain function for motor performance. PMID- 3825714 TI - Coordination of manual, postural, and locomotor movements during simple goal directed motor tasks in parkinsonian off and on states. PMID- 3825713 TI - Postural adjustments associated with rapid voluntary arm movements in patients with Parkinson's disease. AB - To determine the extent to which deficits in coordination between posture and movement are influenced by postural disorders, postural adjustments associated with rapid voluntary arm movement were studied in PD patients and controls. EMG activity in postural muscles of the lower limbs and the trunk and local anteroposterior accelerations of the upper part of the leg were recorded in subjects who rapidly raised their arms to a horizontal position in response to a visual signal. The arm movement was characterized electromyographically by EMG activity from the deltoid muscle (anterior portion) and kinetically by acceleration of the arm. Study of characteristics of voluntary movement showed a nonsignificant increase in RT (simple-reaction time task) and an important increase in MT. There were important differences between PD patients and control subjects with regard to postural adjustments. Timing between voluntary movement and postural movement was anticipatory in 5% of PD patients, whereas it was anticipatory in 100% of control subjects. In PD patients, organization of early postural adjustments was not specific to voluntary movement; in control subjects, organization of early postural adjustments was specific to the forthcoming movement. Last, a possible functional relation between the "quality" of postural adjustments and a reduction in motor performance of normal subjects is suggested. PMID- 3825715 TI - Dementia of Parkinson's disease. PMID- 3825716 TI - Intellectual impairment in Parkinson's disease. PMID- 3825717 TI - Psychometric findings in clinical subtypes of Parkinson's disease. PMID- 3825718 TI - Predictive factors for cognitive deterioration and dementia in Parkinson's disease. PMID- 3825719 TI - Behavioral indicators of hallucinosis in levodopa-treated Parkinson's disease. PMID- 3825720 TI - Neuropsychological profile of primary parkinsonism among Filipinos. AB - In summary then, the neuropsychological profile of Filipino parkinsonians reveals deficits in visuospatial processing, social judgment, attention and mental tracking, recent memory and word retrieval, aside from predicted difficulty in fine motor activities which would result in a deterioration of their penmanship. The frequency of dementia with this sample is comparable to that reported in other studies. Possibly due to the small sample size, no significant correlations were obtained between the severity of illness and dementia. Why two of the ten subjects seen for follow-up improved their scores on neuropsychological testing cannot be ascertained at this time. However, it underscores the importance of long-term monitoring to gain a better understanding of the relationship between Parkinson's disease and higher mental processes. We intend to continue conducting follow-up studies and hope that, with a larger sample, we can establish trends that will assist us in the holistic management of this condition. PMID- 3825721 TI - Possible involvement of attention processes in Parkinson's disease. PMID- 3825722 TI - Depression and cognitive changes in Parkinson's disease: a review. PMID- 3825723 TI - Dexamethasone suppression test in Parkinson's disease. PMID- 3825724 TI - Mental depression in untreated Parkinson's disease of recent onset. PMID- 3825725 TI - Concept of bradyphrenia: a neuropsychiatric approach. PMID- 3825726 TI - Parkinson's disease: progression and mortality. AB - Patients with Parkinson's disease were compared during two 15-year periods before and after the introduction of levodopa. With levodopa treatment: The duration of illness at each stage of severity was 3 to 5 years longer; at every duration of illness, death and disability were reduced 1.5- to 3-fold, except in patients whose treatment had been delayed; abnormal involuntary movements that interfered with function occurred in 24% of patients; severe fluctuations that required rescheduling of activities occurred in 29% of patients; severe AIMs and fluctuations were rare during the first 3 years of treatment, but remained constant thereafter, without progressive increase; prevalence of severe fluctuations was related only to age of onset of disease: If under 50, severe fluctuations developed in 66%, if age 50 to 59 at onset, they developed in 30%, if over age 60, in only 6%; average age at death was 6 years older; and observed/expected mortality was 1.2, not significantly different from the unaffected population. PMID- 3825727 TI - Sixteen-year follow-up of 100 patients begun on levodopa in 1968: emerging problems. PMID- 3825728 TI - Pharmacokinetics of levodopa and motor fluctuations. PMID- 3825729 TI - Individual levodopa therapy in Parkinson's disease. PMID- 3825730 TI - Biochemical effects of chronic L-dopa treatment in rats: implications for emergence of tolerance phenomena in patients with Parkinson's disease. PMID- 3825731 TI - Low-dosage treatment in de novo patients with Parkinson's disease: a prospective study. AB - In 68 younger de novo patients with the hypokinetic-rigid type of PD the action of bromocriptine, Sinemet, a combination of these drugs, and orphenadrine with additional bromocriptine or Sinemet medication was investigated over at least a 6 year period. The favorable reaction on Sinemet medication was complicated by the occurrence of dyskinesias in the majority of cases as contrasted with the bromocriptine group. Dyskinesias were mild and not prominent in the combined group. In the sixth year, it appeared necessary to increase the dosage in the first three groups. Temporary complete replacement after 5 years of Sinemet by bromocriptine caused a clinical deterioration, whereas the dyskinesias did not (completely) disappear. Both drugs markedly improved the hypokinesia in the orphenadrine group. The results in the old-age category (60 patients) without high vascular risk were comparable with those of the young patients. The same applied for those PD patients with high vascular risk, in whom the cerebral circulation could be restored. The final conclusion of this study can be formulated as follows: Primary multitherapy with low dosage bromocriptine and a levodopa preparation may be the therapy of choice. In case of high vascular risk, improvement of the cerebral circulation may be as important as treatment with anti-parkinsonian drugs. PMID- 3825732 TI - Pergolide mesylate: four years experience in Parkinson's disease. PMID- 3825733 TI - Parenteral administration of lisuride in Parkinson's disease. PMID- 3825734 TI - Comparison of efficacy of lisuride hydrogen maleate with increased doses of levodopa in parkinsonian patients. PMID- 3825735 TI - Terguride: partial dopamine agonist in the treatment of Parkinson's disease. AB - In an open trial, 15 patients with PD (mostly stage V) were treated with the partial DA agonist, terguride, a derivative of lisuride. To the basic therapy, consisting of L-dopa plus benserazide and amantadine, a slowly increasing dosage of TDHL up to a maximum of 1.5 mg/day t.i.d. was added. There were 3 drop-outs; 12 patients completed the trial which lasted for 12 weeks. At this time a significant improvement in total score, bradykinesia, and functional score was seen, as well as a marked improvement in tremors score in the patients who showed this symptom (Columbia Rating Scale). As side-effects, dyskinesias occurred in two patients, psychotic symptoms in one, and marked orthostatic symptoms in one patient. No significant differences before and after 12 weeks TDHL treatment were found in the concentrations of noradrenaline, adrenaline, serotonin, and 5 hydroxy-indole-acetic-acid in plasma. It is concluded that TDHL is effective even in advanced stages of PD, and it is speculated that partial DA agonists may become important in the treatment of PD and might possibly have an advantage over "classical" DA agonists. PMID- 3825736 TI - Therapeutic experiences with an abeorphine derivative in Parkinson's disease. AB - Marked improvement of the clinical state owing to CI 201-678 treatment was seen in six patients; no definite improvement was achieved in three patients. Daily fluctuations were improved in two patients. CI 201-678 demonstrated a good effect against rigidity, impairment of gait and posture, as well as impaired self-care, although daily levodopa dosage was concomitantly reduced. In two patients, CI 201 678 was discontinued because of side-effects, while one patient stopped treatment for reasons not related to the drug. In contrast to apomorphine and other dopamimetic substances, the emetic side-effect of CI 201-678 is minimal (nausea in one patient). no arterial hypotension was not seen. It has to be mentioned that the two drug-related drop-outs were receiving CI 201-678 in a rapidly increasing dosage. It is likely that the side-effects would have been less pronounced if the dosage had been more slowly increased. However, the preliminary results indicate that CI 201-678 is a promising substance for the treatment of patients with predominant rigid-akinetic symptomatology, in combination with levodopa therapy or in the place of levodopa. PMID- 3825737 TI - GABA-dopamine relationship in Parkinson's disease striatum. PMID- 3825738 TI - Antagonism of histamine and leukotrienes by azelastine in isolated guinea pig ileum. AB - The effects of azelastine on histamine- and leukotriene C4 and D4 (LTC4, LTD4) induced contractile responses in isolated guinea pig ileum were investigated. Following a 2-min contact with the ileum, azelastine produced competitive antagonism of histamine (pA2 = 8.24). Following a 15-min contact, azelastine at 2.5 X 10(-9) M exerted competitive antagonism, but at higher concentrations (10, 40 and 160 X 10(-9) M) it not only shifted histamine concentration-effect curves to the right but also suppressed its maximum. Thus, azelastine exerts a dual (competitive/noncompetitive) antagonism of histamine depending upon the concentration and duration of contact. Azelastine and FPL 55712 (a known LT receptor antagonist) produced concentration-dependent antagonism of LTC4 and LTD4. Azelastine and compound FPL 55712 also exerted concentration-dependent reversal (relaxation) of pre-existing LTC4-induced contractions. In conclusion, the potent H1-histamine and leukotriene receptor blocking activities of azelastine may contribute to its antiasthmatic/antiallergic activities. PMID- 3825739 TI - 3H-tiotidine binding to guinea-pig cortical and striatal membranes. AB - 3H-Tiotidine has been identified as a suitable radioligand for the H2-receptor. We have confirmed and extended structure-binding affinity studies in the guinea pig cortex, and established a structure-binding affinity relationship consistent with the H2-receptor in guinea-pig striatum. Cimetidine-displaceable 3H-tiotidine binding was observed also in the nucleus accumbens. PMID- 3825740 TI - Potential therapeutic efficacy of inhibitors of human phospholipase A2 in septic shock. AB - Soluble phospholipase A2 has been implicated in the pathogenesis of local and systemic inflammatory reactions. Elevated levels of circulating phospholipase A2 (PLA2) correlate with the severity of circulatory collapse and pulmonary dysfunction in gram-negative septic shock. Characterization of septic shock serum PLA2 revealed a calcium-dependent enzyme with absolute 2-acyl specificity with a pH optimum of 7.5. We tested a number of therapeutic agents for their ability to inhibit PLA2 from human septic shock serum. Chloroquine, chlorpromazine, dexamethasone base, dexamethasone sodium phosphate, indomethacin, lidocaine, oleic acid, palmitic acid, promethazine, trans-retinoic acid, rutin and dl-alpha tocopherol were all studied over the range of 10(-2) to 10(-7) M. All agents, with the sole exception of dexamethasone base, inhibited PLA2 activity at concentrations greater than 10(-3) M. PLA2 inhibition by dexamethasone sodium phosphate was factitious, due to the formation of calcium-phosphate complexes. Of the 11 agents studied, chlorpromazine was the most effective, with an IC50 of 7.5 X 10(-5) M, a membrane concentration achievable within its therapeutic range. Inhibition was non-competitive with an apparent Ki of 5 nM. Since serum PLA2 levels correlate with mortality in both experimental endotoxemia and clinical gram-negative septic shock, and chlorpromazine was previously shown to improve survival in these conditions, we postulate that its therapeutic efficacy resides at least in part in its PLA2-inhibitory activity. PMID- 3825741 TI - Free radical production at the site of an acute inflammatory reaction as measured by chemiluminescence. AB - A foot-pad oedema model was used to investigate the presence of free radicals using a chemiluminescence method. This model is an example of a cell mediated hypersensitivity reaction. Male rats were inoculated in the scruff with Freund's Complete Adjuvant (FCA) on Day 0 and then challenged 6 days later with FCA in one hind paw. An acute inflammatory reaction was initiated over the following 96 hours and within 4 hours of induction, reactive oxygen species were detected in the inflamed tissue. A peak of chemiluminescence activity was seen 8 hours after the induction of the inflammatory reaction, well before maximum oedema was observed. Using mannitol, catalase and DABCO to elucidate the nature of the reactive oxygen species it was found that hydroxyl radicals, hydrogen peroxide and singlet oxygen all contributed to this burst of oxidative activity and are therefore probably involved with the process of lipid peroxidation and the severity of an inflammatory reaction. PMID- 3825742 TI - Copper and zinc status during acute inflammation: studies on blood, liver and kidneys metal levels in normal and inflamed rats. AB - The concentrations of copper and zinc in plasma, blood cells, liver and kidneys were determined in a study performed on normal female rats, and in female rats with carrageenan induced pleurisy. In the normal rat, the total amount of both metals increases, from 51 to 79 days of age, in all the compartments examined. This increase was mostly, and in some case exclusively, dependent upon the growth of the animal, although high individual and day to day variations in both copper and zinc values were observed in all the compartments studied. In the blood of inflamed rats a statistically significant increase in copper was measured during the crucial hours of the experiment (i.e. from 6 to 72 h); over 90% of the increase found was attributable to variations in plasma copper concentration values. In the liver of inflamed rats a statistically significant increase in zinc was measured at 6, 22 and 48 h after the carrageenan injection. The induction of the acute non-infective inflammatory process did not cause quantitative changes of both copper and zinc in all the other compartments considered in the present study. These results seem to suggest that, during acute inflammation, the organism increases its requirement for copper and zinc, and that this demand is fulfilled by enhanced intestinal absorption and/or decreased intestinal excretion of both metals. PMID- 3825743 TI - Sustained release of a corticosteroid using polymeric implants. AB - An effective sustained release method of drug administration, using methylprednisolone incorporated into acrylic bone cement, has been developed. The effect of this form of treatment on peripheral blood leukocytes, lymphoid tissue weight and the inflammatory response has been evaluated. This mode of methylprednisolone administration was compared with conventional systemic therapy and was found to produce rapid and prolonged pharmacological effects at very low plasma levels of drug. A dose response relationship was established and we determined that, for a given quantity of drug, the level and duration of suppression was greater using sustained release therapy. The inflammatory response was also depressed using this mode of administration. These results, coupled with the commercial availability and existing clinical approval of SIMPLEX P bone cement, suggest that further development may lead to useful clinical protocols. PMID- 3825744 TI - Abnormal populations of activated lymphocytes in the rheumatoid one-way MLR. PMID- 3825745 TI - DNA-binding antibodies derived from autoimmune MRL mice fail to induce clinical changes when administered to healthy animals. PMID- 3825746 TI - Effect of (chloro-4-phenyl) thiomethylene bisphosphonic acid (SR 41319) on the autoimmune disease activity in MRL/l mice. AB - MRL - lpr/lpr (MRL/l) mice spontaneously develop an autoimmune pathology including arthritic lesions. SR 41319, a bisphosphonate, having previously shown to be active in in vitro and in vivo models of arthritis, the aim of this study was to search for its possible effect on the pathology of the MRL/l mice. Results showed that SR 41319 reduced the severity of the disease in its early stages and increased mean life span. Further investigation would be necessary to define the effect of the drug during later stages when major changes in immune status occurred. PMID- 3825748 TI - Suppression of collagen-induced arthritis with pergastrically or intravenously administered type II collagen. PMID- 3825747 TI - Disease modifying activity of HWA 486 on the development of SLE in MRL/1-mice. PMID- 3825749 TI - Local cell populations in experimental arthritides. PMID- 3825750 TI - The role of antigen electric charge in the development of chronic arthritis. PMID- 3825751 TI - Specific localization of IgG isolated from inflamed synovial tissue. PMID- 3825752 TI - Magnesium-deficient hairless rat: spleen cells mitogenic responses and variations in hormonal status. AB - Hairless rats with dermatosis induced with a poor magnesium diet were previously shown to bear biochemical and immunological abnormalities. It was therefore felt of interest to investigate the spleen cells proliferative responses from these rats, both in the rash and the remission phases, when testosterone and parathormone plasma levels were also determined. Results showed that proliferative responses to mitogens and PTH levels were inversely related to the intensity of the dermatosis, whereas testosterone levels were more or less decreased. The role of 1.25 dihydroxyvitamin D3 in these modifications is questionable. PMID- 3825753 TI - In vitro and in vivo migratory response of connective tissue mast cells to inflammatory mediators. PMID- 3825754 TI - Stimulatory effect of hr tumor necrosis factor on TxB2 release by polymorphonuclears and macrophages. PMID- 3825755 TI - Selective lymphocyte killing by reactive oxygen species (ROS). PMID- 3825756 TI - In the croton oil ear test the effects of non steroidal antiinflammatory drug (NSAIDs) are dependent on the dose of the irritant. PMID- 3825757 TI - Comparison of the systemic inhibition of thromboxane synthesis, anti-inflammatory activity and gastro-intestinal toxicity of non-steroidal anti-inflammatory drugs in the rat. PMID- 3825758 TI - Inhibition of gingivitis by topical application of ebselen and rosmarinic acid. PMID- 3825759 TI - [Alteration of diffusion velocity of fluorescein-Na in dependence on vitreous liquefaction]. PMID- 3825760 TI - [Reliability of optic disc measurement with computerized stereoscopic video image analyzer]. PMID- 3825761 TI - [Elastic fibers in the human ciliary bodies]. PMID- 3825762 TI - [Adjustment of optical interpupillary distance in aphakic spectacles for distant vision]. PMID- 3825763 TI - [Role of sympathetic nerve in lacrimal secretion. I. Histochemical and electron microscopic study in the distribution of noradrenergic nerves in the lacrimal gland of the albino rabbit]. PMID- 3825764 TI - [Effects of cigarette smoking on choroidal circulation. III. Chronic phase]. PMID- 3825765 TI - [Anti-lens crystallin antibodies in human sera. I. Reciprocal change with age]. PMID- 3825766 TI - [Botulinum A toxin (Oculinum) in the treatment of strabismus in adults]. PMID- 3825767 TI - [Binocular interaction in visual evoked potential elicited by stereoscopic stimulus. The effect of interocular luminosity difference]. PMID- 3825768 TI - [Electrical activities of the superior colliculus neurons responding to visual stimuli and passive eye movement in the cat. Responses to the combined stimulation and relationship of them]. PMID- 3825769 TI - [Measurement of contrast sensitivity function using the pattern reversal VER]. PMID- 3825771 TI - [Study on characteristics of electrically evoked response (EER) in the rabbit eyes]. PMID- 3825770 TI - [Correlation between foveal dysfunction and retinal nerve fiber atrophy in early to middle stage of glaucoma]. PMID- 3825772 TI - [Histopathological study of choroidal vasculature in spontaneously hypertensive rats. 1. Progress of pathologic changes]. PMID- 3825773 TI - [A comparative study of the effects of photocoagulation with krypton lasers in the parfocal or defocal systems]. PMID- 3825774 TI - [Dynamic topography of the brainstem potentials of visual sensorial and motor functions]. PMID- 3825775 TI - [Effect of anterior chamber retaining materials on corneal endothelial function]. PMID- 3825776 TI - [New chart for training in dysopia]. PMID- 3825777 TI - [Characteristics of glaucomatous visual field regression]. PMID- 3825778 TI - [The visual field in psychogenic disorders]. PMID- 3825779 TI - [A study of the occipital convex charge in dynamic topography of VEP]. PMID- 3825780 TI - [Differences in calcium-induced opacification between alpha, beta, and gamma crystallin solutions]. PMID- 3825781 TI - [F-actin in wound healing of the rabbit corneal endothelium]. PMID- 3825782 TI - [Changes in cortisol levels of the blood and tissues of the eye after intravenous administration (the second report)]. PMID- 3825783 TI - [Clinical application of time-dependent perimetry (3). Aging of retinal function]. PMID- 3825784 TI - [Clinical application of time-dependent perimetry (4). Double flash resolution and critical fusion frequency as a function of stimulus intensity]. PMID- 3825785 TI - [Variability of VEPs to the stimulation of retinal disparity in the central and occipital zones]. PMID- 3825786 TI - [Enhancement of evoked potentials by saccadic eye movements--effects of stimulus energy]. PMID- 3825787 TI - [Experimental study on the proliferation of cells over plastic lens implants with or without glow discharge treatment]. PMID- 3825788 TI - [Choroidal circulation in ocular contusion. III. Retinochoroidal degeneration]. PMID- 3825790 TI - [Studies on the pathogenesis of nystagmus: Part 1. A new technic for measurement of abnormal head postures in three-dimensional space]. PMID- 3825789 TI - [Cone dark adaptation in Harada's disease]. PMID- 3825791 TI - [Chemotactic factor to polymorphonuclear leukocytes in the human lens. 7. Chemotactic factor leaked through the lens capsule]. PMID- 3825792 TI - [The simultaneous operation of the three rectus muscles of one eye]. PMID- 3825793 TI - [Residual ethylene oxide gas in the intraocular lens]. PMID- 3825795 TI - [Aging changes in the corneal endothelium after anterio-posterior radial keratotomy]. PMID- 3825794 TI - [Changes in angle width induced by pilocarpine]. PMID- 3825796 TI - [Preoperative prismatic correction in patients with strabismus convergence concomitants]. PMID- 3825797 TI - [Drugs and female bladder retention]. PMID- 3825798 TI - [Post-partum urinary retention]. PMID- 3825799 TI - Puerperal urinary retention. PMID- 3825800 TI - [[The solution to a problem of urinary retention is sometimes closer than you think!]. PMID- 3825801 TI - [Bladder retention and urinary tract blockage caused by certain prolapse. Effect of an intravaginal supporting device]. PMID- 3825802 TI - [Urinary retention in elderly women]. PMID- 3825803 TI - [Psychogenic urinary retention. Comparison with other psychogenic sphincter disorders]. PMID- 3825804 TI - Insufficient detrusor function--megavessie. PMID- 3825805 TI - [Parietal measurements of the bladder in experimental retention]. PMID- 3825806 TI - [Modifications in the autonomic innervation of the bladder in experimental retention]. PMID- 3825807 TI - Extramedullary plasmacytoma of the bladder. PMID- 3825808 TI - Uretero-cysto-neostomy by the "du pantalon" technique in the treatment of primary obstructed megaureter (POM). PMID- 3825809 TI - Simple vesico-vaginal fistula (VVF) following gynaecological procedures for benign conditions. Value of cystoscopic fulguration and prolonged bladder catheterisation in their management. PMID- 3825810 TI - [Radical orchidofuniculectomy with extensive lymph node dissection]. PMID- 3825811 TI - Antidiuretic approach with DDAVP for nocturnal enuresis. PMID- 3825812 TI - [Cryoprostatectomy--practice and problems]. AB - We reviewed 479 cases of cryoprostatectomy, 361 of which were performed using the 1-or 2-stage refreezing method, and 118 cases which were done by freezing only once. The refreezing methods gave better clinical and radiographic results as compared with the once-freezing method. As complications were seen in 20% of the cases in which the refreezing method was used and 10% of those in which the once freezing method was used. Sonographic control was useful for the prevention of complications. PMID- 3825813 TI - [Studies on multiple mucosal biopsy in patients with bladder cancer. 2. Evaluation on the relationship between the results of multiple mucosal biopsy and recurrence, and the clinical course of cases with carcinoma in situ and micro invasion of carcinoma in situ]. AB - The predictive value of grade, number of tumor and histology of mucosal biopsy for tumor recurrence, the course of carcinoma in situ and microinvasion of carcinoma in situ were examined. The Kaplan-Meier's method was used for the estimation of the recurrence-free rate in the patients who had undergone transurethral resection (TUR) and the logrank test for testing the significance of difference in recurrence-free rate. The 5-year recurrence-free rate was 32.2%. The recurrence-free rate was 51.0% after 40 months postoperatively in patients with a single tumor, 12.8% after 42 months postoperatively in those with multiple tumors. The patients with a single tumor had a significantly higher recurrence free rate than those with multiple tumors (P less than 0.001). The recurrence free rate was analyzed according to the grade of main tumor, but significantly difference was not present. The recurrence-free rate was 44.4% after 42 months postoperatively in patients with normal histology of mucosal biopsy and 9.5% after 34 months postoperatively in those with abnormal histology. The patients showing normal histology in mucosal biopsy had a significantly higher recurrence free rate than those with abnormal findings (P less than 0.001). the recurrence free rate at the same area of biopsy site was analyzed according to the histologies of 537 mucosal biopsies. The recurrence-free rate was 76.7% after 42 months post operatively in areas with a normal biopsy, 44.3% after 35 months postoperatively in those with abnormal histology and the difference was statistically significant (P less than 0.001). Of the 15 patients found to have carcinoma in situ, 4 were primary carcinoma in situ, 6 were associated with superficial papillary tumors and 5 were associated with invasive tumors. Thirteen of the 15 patients were alive and free of disease 18 to 42 months later. Two patients associated with invasive tumor died 5 and 18 months after transcatheter embolization of internal iliac arteries. Of the 13 patients who were found to have microinvasion of carcinoma in situ, 4 were not associated with visible tumor, 6 were associated with superficial papillary tumor and 3 were associated with invasive tumors. Nine of the 13 patients are alive and free of disease 7 to 53 months later. A patient without any visible tumor who was treated with TUR and intravesical chemotherapy died and three patients with invasive tumor died irrespective of the mode of treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3825814 TI - [Studies on multiple mucosal biopsy in patients with bladder cancer. 3. Evaluation of ABH antigenicity in specimens of multiple mucosal biopsy and transitional cell carcinoma of the bladder]. AB - Eighty-nine patients with bladder cancer underwent multiple mucosal biopsies of the bladder mucosa 129 times between April 1980 and June 1983. In total there were 126 tumor specimens and 723 mucosal biopsies. Blood group antigens (BGA) were detected by means of the specific red cell adherence (SRCA) test in blood group A, AB, and B patients and direct immunoperoxidase method in blood group O patients. Histological abnormalities in this paper indicate transitional cell carcinoma, microinvasion of carcinoma in situ, carcinoma in situ, dysplasia and hyperplasia. The Kaplan-Meier's method was used for the estimation of recurrence free rate and logrank test for testing the significance of difference in recurrence-free rate. The BGA-positive rate in mucosal biopsies was 17% for microinvasion of carcinoma in situ, 29% for carcinoma in situ, 47% for transitional cell carcinoma, 35% for dysplasia, 71% for hyperplasia, 100% for squamous metaplasia, 87% for proliferative cystitis and 77% for normal epithelium. Of histological findings, microinvasion of carcinoma in situ, carcinoma in situ, transitional cell carcinoma and dysplasia showed a significantly lower BGA-positive rate than proliferative cystitis and normal epithelium (P less than 0.001). The BGA-positive rate of main tumor was 61% in G1 tumors, 23% in G2 tumors and 21% in G3 tumors. The BGA-positive rate was shown to be decreasing with the increase in the histological grade of main tumor, and this reciprocal relationship was statistically significant (P less than 0.005). No statistical correlation between BGA in tumors and histological stage was found. The frequency of histological abnormalities in mucosal biopsy was 5.2% in patients with BGA-positive tumors, 21.2% in those with BGA-negative tumors, the difference being statistically significant (P less than 0.001). The 5-year recurrence-free rate after transurethral resection (TUR) was 57.3% in patients with BGA-positive tumors, 18.2% in those with BGA-negative tumors, the difference between the 2 groups being significant (P less than 0.001). PMID- 3825815 TI - [Studies on multiple mucosal biopsy in patients with bladder cancer. 4. Evaluation of Thomsen-Friedenreich antigen in multiple mucosal biopsy and transitional cell carcinoma of the bladder]. AB - The significance of Thomsen-Friedenreich antigen (T-Ag) in bladder carcinomas and multiple mucosal biopsies was studied. The T-antigen, a precursor of MN blood group antigen, is not found in normal cells, in which T-antigen is cryptic (cryptic T-Ag) but can be unmasked with neuraminidase digestion. Specimens of 27 main tumors and 201 mucosal biopsies from 28 patients with carcinoma in situ or microinvasion of carcinoma in situ were examined for the expression of T-antigen by Avidin-Biotin-Peroxidase Complex (ABC) method with peanut agglutinin (PNA). The T-Ag-positive rate was 22% for G2 tumors, 56% for G3 tumors, while cryptic T Ag-positive rate was 86% for G2 tumors and 50% for G3 tumors. The correlation between T-antigen, cryptic T-antigen and histologic grade was not statistically significant. The T-Ag-positive rate in mucosal biopsies was 43% in microinvasion of carcinoma in situ, 11% in carcinoma in situ, 17% in transitional cell carcinoma, 8% in dysplasia, 33% in squamous metaplasia, 33% in proliferative cystitis and 13% in normal epithelium. Of histological findings, microinvasion of carcinoma in situ showed a significantly higher T-Ag-positive rate than carcinoma in situ and normal epithelium (P less than 0.005, P less than 0.001). The cryptic T-Ag-positive rate in mucosal biopsies was 38% in microinvasion of carcinoma in situ, 74% in carcinoma in situ, 100% in transitional cell carcinoma, 82% in dysplasia, 100% in squamous metaplasia, 100% in proliferative cystitis and 96% in normal epithelium. Of the histological findings, carcinoma in situ, proliferactive cystitis and normal epithelium showed a significantly higher cryptic T-Ag-positive rate than microinvasion of carcinoma in situ (P less than 0.025, P less than 0.05, P less than 0.001). Microinvasion of carcinoma in situ expressed the T-Ag (43%), the cryptic T-Ag (21%) and lacked the cryptic T-Ag (36%). Microinvasion of carcinoma in situ showed statistically significant difference in the mode of T-Ag and cryptic T-Ag expression than other histological types in mucosal biopsies, including carcinoma in situ (P less than 0.001).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3825816 TI - [Purification of the human prostate androgen receptor. I. Purification of the androgen receptor by affinity chromatography]. AB - The androgen receptor (AR) was purified to establish a new method for measuring AR after producing the antibody for the purified AR. AR was purified from 1,700 g of benign prostatic hypertrophic tissue by combining affinity chromatography of heparin Sepharose CL-6B and of 17 alpha-carboxy-hexamethyl-17-hydroxy-4 androstane-3-one Sepharose 4B. The final purification fraction had the high affinity, low capacity binding to 3H-R 1881 in the presence of 1,000-fold molar excess of triamcinolone acetonide with a dissociation constant of 2.3 nM, showing the binding specificity of AR. Polyacrylamide gel electrophoresis did not reveal any albumin or TeBG mixed in the final purification fraction. These results showed that AR was partially purified, even though the degree of purification was low, around 38 fold calculated by the binding capacity per mg protein. PMID- 3825817 TI - [Purification of the human prostate androgen receptor. II. Characterization of the human prostate androgen receptor]. AB - For improved purification of human prostate androgen receptors (AR), the effect of molybdate, NaSCN and heparin on the binding capacity of human prostate cytosol AR was investigated. When 10 mM of molybdate in final concentration was added to cytosol, the increase in the maximum binding sites of AR to 3H-R1881 was approximately 60%, while the dissociation constant was rather increased. With sucrose density gradient centrifugation, the cytosol with molybdate added showed a constant peak of 8 approximately 9 S. However, cytosol not enriched with molybdate did not show any significant peak. These results constitute evidence that molybdate has a stabilizing effect of the AR. When 0.1 approximately 0.5 M of NaSCN was added to the cytosol, the dissociation as well as the association of the 3H-R1881-AR complex showed a tendency to accelerate. However, at a concentration of 0.3M and over NaSCN, the binding capacity of the AR rapidly disappeared. When the NaSCN was removed with gel filtration, the binding capacity of the AR recovered partially. The effect of NaSCN on the AR was therefore different from that on the estrogen receptors. Four mg/ml of heparin accelerated the dissociation of the 3H-R1881-AR complex. Furthermore, with the addition of 4 mg/ml of heparin, the maximum binding sites of AR decreased to 56%. The above results make it clear that molybdate, NaSCN and heparin have various effects on human prostate cytosol AR, which might be applied to the purification of AR. PMID- 3825818 TI - [Purification of the human prostate androgen receptor. III. Purification of the androgen receptor and characterization of the purified androgen receptor]. AB - With 855 g of benign prostatic hypertrophic tissue as starting material, the androgen receptor (AR) was purified by combining the affinity chromatography of heparin Sepharose CL-6B and of R1881-carboxymethyloxime-albumin Sepharose 4B. The final purificationfraction had high-affinity, low-capacity binding to 3H-R1881 in the presence of 1,000-fold molar excess of triamicinolone acetonide (TA) with a dissociation constant of 2.4 nM. When the relative binding affinity was being assessed, the binding of the final purification fraction to 3H-R 1881 was not suppressed by estradiol or TA and revealed the binding specificity of the AR. Polyacrylamide gel electrophoresis showed no albumin or TeBG mixed in the final purification fraction. These results give evidence that the AR had been purified and that, in comparison with the original cytosol, the degree of purification was approximately 2,360 fold. The molecular weight of the purified AR was 32,000 as calculated by high performance liquid chromatography. The fact the antiserum from rabbit immunized with the purified AR showed a reaction against the purified AR leads us to believe that antibodies for the AR were successfully produced. Further immunological study on AR measurement is considered to be of great importance. PMID- 3825819 TI - [5 cases of renal pelvis and ureteral tumor]. AB - The clinical results of three renal pelvic tumors and two ureteral tumors, experienced at Shimizu City Hospital between 1983 and 1985 are reviewed. The average age of the 5 patients was 56.8 years. The ratio of men to women was 4 to 1. The right side was involved in 4 cases and the left side in 1 case. The initial symptom was gross hematuria in all cases. Results of urinary cytology were positive in 3 cases. The prognosis of the patients with a high grade and high stage tumor was poor. PMID- 3825820 TI - [Malignant peritoneal mesothelioma of the prostate: a case report]. AB - A case of malignant peritoneal mesothelioma of prostate in a 52-year-old male is reported. He was admitted to the hospital with the complaint of perineal pain. The prostate was enlarged markedly, elastic soft and severely tender. CT scan and some examinations suggested the possibility of prostatic malignancy. The histological findings of the needle biopsy specimen revealed peritoneal mesothelioma. Complete pelvic exenteration was performed, because of direct invasions to the urinary bladder and the rectal anterior wall. The final pathological diagnosis revealed malignant fibrous peritoneal mesothelioma with solitary type of the rectovesical recess. At three months after the operation, the patient died of local resurrence and multiple metastasis to liver and lung. Only three cases of peritoneal mesothelioma, with solitary type, of rectovesical recess or retrovesical space have so far been reported in Japan. PMID- 3825821 TI - [The treatment of an impotent male with venous leakage]. AB - The intracavernous pressure to produce a passive erection was recorded in a 40 year-old man suffering from impotence. The patient had passive erection with a flow of 160 ml/min. The flow needed to maintain erection was 40 ml/min. The pressure in the flaccid state was 15 mmHg, and 151 mmHg in the state of erection. In the state of erection, the perfused liquid was demonstrated to escape through the deep dorsal vein of the penis. No other causes of impotence were revealed, and we diagnosed his erectile failure to be due to venous leakage. We performed ligation of this vein. After the operation, nocternal penile tumescence was improved. His potency recovered completely, and no complication was noted. PMID- 3825822 TI - [Epidemiologic and therapeutic study on gonococcal infections--clinical efficacy of norfloxacin]. AB - We studied the basic and clinical effects of norfloxacin (NFLX) in 120 patients with gonococcal infections (110 men with urethritis and 10 women with cervicitis) -all residents at Sapporo City; and epidemiologically analyzed the sources of their infections. The male patients were between 16 and 67 years old and the female patients were between 20 and 61 years old, with a peak in the early 20s both for sexes. 70.6% of the male patients in their 10s were infected from their girl friends or so-called pick-up friends and 50% of the female patients from their husbands. The other half of the female were workers serving at so-called special massage parlors. The minimum inhibitory concentration (MIC) of NFLX against N. gonorrhoeae distributed was 0.0125 approximately 3.13 micrograms/ml, with a peak at 0.025 micrograms/ml. NFLX inhibited 93.3% of the clinical strains of this species at less than 0.1 microgram/ml and 96.2% at less than 1 microgram/ml, where the inoculation was 10(6) CFU/ml. Twenty one (20.2%) of the 104 N. gonorrhoeae strains were penicillinase-producing one (PPNG). NFLX inhibited 18 of these PPNG (85.7%) at less than 0.1 microgram/ml and the other 3 strains at 1.56 approximately 3.13 micrograms/ml. Oral administration of 200 mg NFLX showed the average peak serum level of 0.72 micrograms/microliter in 2 hours and the average peak level in the urethral secretions of 0.5 micrograms/ml in one hour. These two concentrations of NFLX covered 95.2% of the MIC distribution against N. gonorrhoeae. The clinical efficacy of 600 mg NFLX (peros) was 97.4 and 93.1% for a 3-and 7-day treatment for male urethritis; and 100% for both 3-and 7 day treatment for female cervicitis. Complicated urethritis with C. trachomatis was noticed in 32.7% of the male urethritis and in 20% of the female cervicitis cases. Urethral secretions among about half of these patients were observed even after treatment with NFLX. As a subsequent treatment, another effective chemotherapeutic is required against C. trachomatis. No adverse reactions were detected with NFLX. All the above results demonstrate that NFLX is a highly effective and safe chemotherapeutic agent for treatment of gonorrhoea. PMID- 3825823 TI - [Clinical effects of estramustine phosphate disodium (Estracyt) on prostatic cancer]. AB - Estramustine phosphate disodium (Estracyt) was used in the treatment of 40 patients with prostatic carcinoma. Of these 20 patients 18 were treated with Estracyt as primary treatment and 22 had been treated with diethyl stilbestrol dephosphate and/or bilateral orchiectomy for more than 4 months before the Estracyt treatment. The drug was given orally in a dose of 560 mg/day in 2 divided oral doses. The clinical evaluation was done after 3 months treatment. The response in subjective symptoms and objective signs were documented and evaluated according to 5 criteria. In this study, Estracyt showed 80% improvement of dysuria, 60% of nykturia, 35% of pain and 55% of general condition. In objective signs, it showed 52.5% improvement of size of the prostate, 42.5% of consistency and 70% of residual urine. It would be emphasized that Estracyt had almost equal efficacy in both the primary treatment group and secondary treatment group. As side effects of this drug, gynecomastia, gastro-intestinal disturbance, angina pectoris like chest pain were observed. PMID- 3825824 TI - [Renal oxalate excretion following oral oxalate load in patients with urinary calculus disease and healthy controls]. AB - Oral oxalate loading using sodium oxalate or a vegetable juice was done to evaluate the intestinal absorption of exogenous oxalate in 30 patients with renal stones and 13 healthy controls. Fifteen calcium oxalate stone formers, 7 non oxalate stone formers and 10 healthy volunteers were given an oral loading of sodium oxalate (500 mg). Urinary oxalate increased promptly, reaching a peak value within 4 to 8 hours after administration of a synthetic oxalate orally in a fasting state. In calcium oxalate stone formers, the mean increment of urinary oxalate and the bioavailability following oral sodium oxalate load were significantly higher than in the healthy controls and non-oxalate stone formers. Furthermore, intestinal hyperabsorption of oxalate in our criterion was defined in six patients with calcium oxalate stones (40%). On the other hand, eight calcium oxalate stone formers and three healthy controls were given vegetable juice. Urinary oxalate was increased only slightly after the ingestion, and there was no difference between calcium oxalate stone formers and normal controls. These results suggest that a certain hyperoxaluria might be induced by intestinal absorption of exogenous oxalate, and that the hyperabsorption might indicate a possible risk factor for calcium oxalate stone formation. PMID- 3825825 TI - [Antiemetic efficacy of high-dose hydrocortisone in patients receiving cisplatin therapy]. AB - The effect of high-dose hydrocortisone on the emesis of patients treated with cisplatin was examined by controlled trial on 37 patients and 52 courses of chemotherapy with cisplatin combined with other cytotoxic drugs. Patients received either high-dose hydrocortisone or standard-dose of conventional antiemetics 30 minutes before chemotherapy, 4 hours after chemotherapy, and an additional dose was followed 8 hours after chemotherapy in some instances. Hydrocortisone in a dosage of 900-1,800 mg reduced cisplatin-induced nausea, vomiting and anorexia significantly when the dose of cisplatin was less than 20 mg/m2. At the dose of 1,500-2,400 mg, hydrocortisone had no efficacy for the gastro-intestinal toxicity when 30-40 mg/m2 of cisplatin was administered. After the high-dose hydrocortisone treatment for five days successively, the serum immunoglobulin level was lowered significantly. This study showed that high-dose hydrocortisone treatment was effective as an antiemetic in patients given a relatively low dose of cisplatin. However, prolonged use of high-dose steroids should be avoided. Other effective antiemetics such as metoclopramide with concomitant use of hydrocortisone would be helpful. PMID- 3825826 TI - [Study of sperm fertilizing ability in male infertility using the zona free hamster egg penetration assay]. AB - Zona free hamster egg-sperm penetration assay (SPA) was performed on 50 normal fertile men and 58 infertile men. The median penetrating rate was 68% (13%-100%) for the fertile men and 11% (0-100%) for the infertile men. These existed no clear relationship between SPA and any other sperm parameters. SPA showed the best diagnostic rate (72.4%) for male infertility, which was evaluated by the 95% specificity threshold values of normal males. Therefore, SPA is best correlated with male impregnating ability. On the contrary, the infertile diagnostic rate of sperm density was relatively low (36.8%). SPA was also carried out on male partners of unexplained infertility couples, and 8 out of 36 (22%) showed decreased sperm penetration rate (less than 10%). In these couples, the deterioration of fertilizing ability was thought to be one of the causative factors of infertility. PMID- 3825827 TI - [A study of functional recovery of urination and defecation by modified sero muscular ileal flap fixation to the bladder in patients with neurogenic bladder]. AB - Between 1978 and 1985, 72 patients with urinary and defecatory dysfunction due to neurogenic bladder associated with myelodysplasia (57), spinal cord injury (11), and other causes (4) were treated with modified sero-muscular ileal flap fixation to the bladder (modified IFFB). They were followed from 1 to 88 months (mean: 36.3 months). This operative procedure was attempted to recover urinary and defecatory function. Sixty-four patients underwent urodynamic studies before and after the modified IFFB. On urodynamic evaluation, bladder capacity was not decreased, voiding time was diminished, and average urine flow rate was significantly improved after the modified IFFB. Patients who were followed at least 6 months after the modified IFFB showed the following results. Urinary substitute sensation appeared in 57 out of 59 patients (96.6%) and fecal substitute sensation in 34 (57.6%). Urinary incontinence improved in 38 out of 42 patients (90.5%), disappearing completely in 19 (45.2%). Constipation improved in 26 of 59 patients (44.1%). The upper urinary tract improved in 22 renal units, remained unchanged in 90 renal units, and deteriorated in 6 of the 118 renal units. Operative complications were encountered in 6 out of 72 patients (8.3%). The modified IFFB procedure does not appear to be suitable for the low compliance bladders with high grade VUR or for young women who desire pregnancy in the future. PMID- 3825828 TI - [Recent progress and problems in bladder-sparing operations in bladder tumors]. AB - Retrospective analysis of the bladder tumor patients was performed to reveal the clinical results of partial cystectomy or transurethral resection (TUR). The observed 3-, 5-, 10-year survival rates after 143 partial cystectomies indicated for the first tumors were 66.2%, 57.1% and 41.5% respectively. To obtain satisfactory results, however, the operation should be indicated for pT2 or G0 G1. Some of the G2 tumors could also be the candidates for this procedure, but the stage of the disease must be below T2. At present, all these tumors could be well controlled by TUR, and this statement was confirmed by the study of clinical results obtained by TUR. The analysis also revealed a poor outcome in 6% of the low grade or low stage tumors and it increased to 25% in high grade and pT2. The complete cure of the high stage or high grade tumor is still difficult, but to improve the survival rate, radical surgery should be employed more positively instead of partial cystectomy. The reasons for this conclusion are also discussed. PMID- 3825829 TI - [Combination chemotherapy of advanced bladder cancer]. AB - Patients with carcinoma of the urinary bladder have a poor prognosis. When distant metastasis develops, such patients seldom survive for more than several months. For them, surgery and/or radiotherapy are of little value, and systemic chemotherapy has been thought to be the most useful treatment. Forty-six patients with advanced transitional cell carcinoma, including bladder cancer, (33 bladder, 9 ureter, 4 renal pelvis cases) were treated by a three drug combination chemotherapy, using two protocols (protocol I: adriamycin + cyclophosphamide + 5 fluorouracil, protocol II: adriamycin + cyclophosphamide + cis-platinum). Protocol I induced responses in 5 of the 24 patients (21%, 1 complete response, 4 partial responses), and protocol II in 7 of the 22 patients (32%, 1 complete response, 6 partial responses). The overall response rate was 26%. The durations of response (median duration 5.1 months) and of survival (median duration 11.3 months) in all responders were relatively short. The three-combination chemotherapy, especially protocol II, was effective against transitional cell carcinoma of the urinary tract, but the results were not satisfactory. PMID- 3825830 TI - [Results of the multidisciplinary treatment of invasive bladder cancer]. AB - Of the 843 patients with bladder cancer treated at Kyoto University between 1965 and 1984, 156 patients (18.6%) received total cystectomy. Between 1980 and 1984, 60 patients underwent multidisciplinary treatment with 4,000 or 2,400 rad adjuvant preoperative radiation therapy to the whole pelvis followed by radical cystectomy with or without postoperative adjuvant chemotherapy. The 5-year survival rate for the 65 patients with pelvic lymphadenectomy was 66% and that for the 40 patients without lymphadenectomy or only biopsy was 35%. The 5-year survival rate after radical cystectomy for 20 bladder cancer patients with regional lymph node metastasis was 11% and 73% for 59 patients without lymph node metastasis (p less than 0.001). The survival rate of multidisciplinary treatment protocol for muscle invasive bladder cancer was 55% a significantly (p less than 0.05) improved survival compared to the historical control. For analysis, the patients were divided into 2 categories according to histological criteria for evaluation of therapeutic effects for preoperative radiation by Ohoshi and Shimosato. The two groups were non-responder: grade I and IIa changes and responder: grade IIb, III and IV. Survival for responders and non-responders revealed significant differences (p less than 0.05), 87% for 28 responders and 48% for 24 non-responders. PMID- 3825831 TI - [Photodynamic therapy of superficial bladder tumors]. AB - Photodynamic therapy (PDT), using hematoporphyrin derivative (HPD) and the red light (wavelength 630 nm) of an argon-dye laser as the source of excitation energy was performed on 46 patients with superficial bladder tumors. Two methods of laser irradiation, (1) focal PDT using a 400 micron quartz fiber through a cystourethroscope in 22 patients with superficial bladder tumors and (2) whole bladder wall total PDT using a motor-driven laser light scattering device in 24 patients with multifocal carcinoma in situ and/or dysplasia of bladder mucosa associated with multicentric concurrent superficial tumors, were used. The patients in (2) had been referred for total cystectomy, and 19 of these 24 patients had a history of several transurethral resections, hyperthermia and/or instillation therapy. HPD 2-4 mg/kg was i.v. injected 48 to 72 hours before PDT. Judging from the results of 60 protrusions treated by focal PDT, the light power should be 200 mW/cm2 for 5-10 minutes or more and the total light energy should be 100 J/cm2 or more in tumors up to 2 cm in size. With focal PDT, 4 of the 22 patients had no recurrence with the mean tumor free time of 20.8 months. In 6 of the 24 patients treated with total PDT using 10, 20 or 30 J/cm2 of light energy, there was no recurrence with a mean tumor-free time of 7.5 months and there was no significant relationship between the recurrence rate and total light energy used. PMID- 3825832 TI - [Chemosensitivity test for bladder cancer in a nude-mice experimental system]. AB - The in vivo chemosensitivity test for bladder cancer, using the human bladder cancer xenografts (BT-8 and BT-11 strains) in nude mice (BALB/c) and the BBN-BT-1 bladder cancer strain in BALB/c hetero-mouse which was induced by peroral long period administration of N-butyl-N-(4-hydroxybutyl) nitrosamine and transplantable into the subcutaneous of mouse, were examined especially in respect to the difference of chemosensitivity between young and old straining and the prospective propriety for clinical application. The subrenal capsule assay (SRC), was also compared with subcutaneous transplantation. Cis diamminedichloroplatinum (II) and 5-FU were effective for all three strains and adriamycin and cyclophosphamide were effective for the BT-8 and BT-11 strains. Bleomycin, peplomycin and vinca alkaloids were more effective for the BT-11 strain than the BT-8 strain. The chemosensitivity of several anti-cancer drugs for the young BT-8 and BT-11 strains was almost equal to that of the old. A 68 year-old male with bladder cancer metastasized to lung and lymph nodes, whose primary tumor was transplanted to mice and established as the BT-11 strain in 1980, was treated with the VPM-CisCF combination chemotherapy which was evaluated as an effective therapy for this strain experimentally, and responded well to this therapy. As in this case, the results of nude mice experiments are valuable in clinical application. The chemosensitivity test in vivo for individual primary tumors should be done by SRC, and in SRC nude mice should be used instead of conventional mice until immunoreactive rejection can be prevented. PMID- 3825833 TI - [An in vitro chemosensitivity study using human tumor clonogenic assay in urologic malignancies]. AB - A soft agar colony formation assay, so called human tumor clonogenic assay (HTC assay) similar to that originally described by Salmon and colleagues, was utilized to measure the sensitivity of a total of 85 urologic malignancies including 36 urothelial cell carcinomas, 41 renal cell carcinomas, 5 testicular tumors, and 3 Wilms' tumors to anticancer drugs. In addition, the results obtained were compared with those of a novel dye exclusion method (NDE assay) described by Weisenthal and colleagues. The NDE assay was utilized to measure the sensitivity of a total of 63 urologic malignancies including 28 urothelial cell carcinomas, 25 renal cell carcinomas, 6 testicular tumors, and 4 Wilms' tumors to anticancer agents. In both assay series, the concentration of anticancer drugs tested was approximately one tenth of the maximum serum level achievable after single bolus injection. The colony forming rate inhibition of 70% or more in the HTC assay and the cell survival rate of 30% or less in the NDE assay were defined as "sensitive." Sixteen of the 36 urothelial cell carcinomas, 11 of the 41 renal cell carcinomas, and 1 of the 5 testicular tumors had both more than 30 colonies grown in control plates and enough cells in the specimens to provide at least one drug sensitivity testing. In urothelial cell carcinomas, 3 out of 13 tumors were "sensitive" to adriamycin, 3 out of 16 to cis-platinum, and 4 out of 15 to carboquone. In renal cell carcinomas, 2 out of 9 tumors were "sensitive" to adriamycin, 4 out of 11 to vinblastine, and none of 4 to Interferon alpha.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825834 TI - [Factors modifying late bronchial response in the bronchial provocation test in asthmatic children]. AB - When the test of bronchial provocation with inhalant allergens is performed in atopic asthmatics, we may find an immediate response (IR), a late response (LR) or a dual response (IR-LR). The immediate response occurs between 10 to 30 minutes after the allergenic exposition and it is resolved spontaneously in about one to two hours. A proportion of these patients, estimated around 47-73% presented a LR. The LR is manifested 3 or 5 hours after the inhalation test, maximum at 6-12 hours and may persist until 24 hours. The late response serves as a clinical model of asthma because the bronchial response is more prolonged and severe than the immediate response. This is best controlled with corticosteroids while bronchial reversibility is difficult with sympathomimetics only, a fact commonly observed in the natural course of asthma. The early response was observed to be in relation with multiple factors more predictable than the late response. The object of this work was to evaluate if the LR was related with factors such as the degree of obstruction previous to the test, the intensity of immediate bronchial response and the maximum dose of inhaled allergen. The present study was performed in 34 children of both sexes with ages ranging between 6 and 14 years, diagnosed with bronchial asthma caused by Dermatophagoides (26 patients), and Alternaria (8 patients) through the score of Foucard with positive bronchial provocation test with the allergen. The BPT was performed according to the method described for Cockcroft, utilizing a continuous pressured nebulizer, inhaling for two minutes at current volume. We employed the De Villbis 646 model nebulizer with flow of air at 6 l/min and output at 0.13 0.16 ml/min. The inhaled concentrations of allergen progressively increased by ten fold, in Dermatophagoides 0.01; 0.1; 1 and 10 BU/ml, and for Alternaria 1/1,000,000, 1/100,000 and 1/10,000 P/V. Ten minutes after each dose a spirometric function with pneumoscreen Jaeger was performed. If the FEV1 was decreased by 20% from the control value, we considered the IR positive. The late response was evaluated through an hourly control of the peak respiratory flow rate (PEFR) with a Mini Wright within a 24 hours period after the test, respecting nocturnal sleep. We considered positive (LR) if PEFR fall was equal or superior to 40% of the basal value and the presence of bronchial symptoms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3825835 TI - Local and serum IgE in patients affected by otitis media with effusion. AB - Various mechanisms intervene in the etiopathogenesis of otitis media with effusion (OME), but to date it is not clear which mechanism is the most important. We studied twenty children affected with persistent otitis media with effusion (OME) inspite of the indicated treatments, and the possible incidence of atopic features, total serum IgE and in effusion, obtained by myringotomy and aspiration were evaluated. In order to evaluate the presence of atopy, an allergic history and skin tests against the different suspected allergens (inhalants and foods) were realized. PMID- 3825836 TI - [Parallelism between the kinetics of cross-reaction responses (anti-TNP and anti DNP) and differences from the anti-LPS response when challenged with TNP-LPS immunization]. AB - The multi-functionality of a given antibody, even monoclonal antibody has recently been shown; this raises the possibility that the specificity of an antiserum be due to a population phenomena; i.e., the specificity would be the net result of the affinity of the various antibodies to the same hapten or antigenic determinant. We have shown in many reports, that prolonged and persistent immunization eventually leads to the exhaustion of the response, and this response ceases upon discontinuation of the antigen stimulation. We have therefore postulated the existence of an immunological equilibrium or antigen dependent immunologic homeostasis, which can be set at different levels and this explains the formation or lack of formation of autoantibodies. This is why we considered it interesting to study the kinetics of the anti-TNP antibody response triggered by persistent and long-lasting immunization of rabbits with TNP-LPS; it was also interesting to study the antibody response to LPS (the latter being a component of the conjugate) and the antibody response to the TNP-cross-reacting DNP and MNP haptens. A group consisting of 6 big albino rabbits was persistently immunized with TNP-LPS (200 micrograms) 3 times per week for 14 weeks and, thereafter, with 2 mg 3 times per week for 26 weeks. Serum anti-TNP and anti-LPS antibodies were titrated respectively with the TNP-Srbc and LPS-Srbc conjugates. Anti-TNP antibodies were titrated before and after absorption of serum with the TNP-EH, DNP-EH and MNP-EH conjugates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825837 TI - Sensitivity to Parietaria officinalis and Parietaria judaica pollen allergens in a Spanish population. AB - To investigate the biological activity of P. judaica and P. officinalis allergen preparations, 36 Spanish patients were included in a biological standardization (BS) trial. For both species the concentration corresponding to 1000 biological units/ml (BU/ml) was found to be about 2 micrograms dry weight/ml (d.w./ml). The allergenic activity per microgram d.w. was about the same as reported for other important weed pollen extracts. The physico-chemical and immunological properties of the purified Parietaria judaica and Parietaria officinalis pollen allergen preparations used for biological standardization were investigated. The protein content was determined to 38% and 23% for P. judaica and P. officinalis respectively, while the carbohydrate content was 25% in both weed preparations. More than 40 antigens and at least 10 different allergens were detected by crossed immuno electrophoresis/crossed radio immunoelectrophoresis (CIE/CRIE) analyses. SDS-gPAGE followed by electroblotting showed important allergens between 10,000 and 75,000 d for both species. The crossreactivity as measured by skin prick test, RAST and CRIE was high. PMID- 3825838 TI - Wheezy bronchitis: results of treatment with ketotifen. AB - The authors consider that infants and young children with recurrent obstructive bronchitis require systematic follow-up care and treatment. To evaluate the severity of the disease, a rating scale was developed. Using this criteria, the severity of the disease in 132 infants and young children was evaluated. The patients were divided into a group of more severely ill and a group of less severely ill patients. The members of the more severely ill group were given long term prophylactic treatment with ketotifen at a dose of 0.5 to 1.0 mg twice daily, in addition to standard symptomatic medication. Treatment with ketotifen afforded a decrease, although insignificant, in the number of coughing attacks, a significant decrease in the number of episodes of dyspnoea (p less than 0.025) and a significant decrease in the number of episodes of airway obstruction (p less than 0.0005). The authors conclude that patients with recurrent severe obstructive bronchitis should be given prophylactic treatment with ketotifen either during autumn and winter or throughout the year, depending on the severity of the symptoms. PMID- 3825840 TI - The new tax law and the deductibility of dues and educational expenses. PMID- 3825839 TI - [Ultrastructural changes in the human nasal respiratory epithelium in hypersensitivity reactions]. AB - In immunoallergic syndromes, the structure of normal respiratory nasal mucous membrane is modified. The epithelial lining (which is responsible for the effectiveness of the mucociliary synergy), is secondarily affected. Its modifications depend, generally, on the severity and chronicity of the clinical case. Normal and pathologic material obtained from inferior turbinate bone (of similar structure and response to the rest of the respiratory nasal mucous membrane) were studied through transmission and scanning electron microscopies, employing both methods as complementary analysis. In normal cases, the presence of different kinds of cells was confirmed. Some additional characteristics about intercellular spaces and junctions as well as the possible role of the above mentioned structures in transudation were also described. In pathologic cases, increasing lesion staging grades could be determined. In the first stage, structural alterations could not be observed despite the existence of functional disturbances (i.e. ciliary dyskinesia and non-synergic motility). In an advanced stage, ciliary abnormalities could be observed with abnormalities in the number, morphology, spatial orientation and distortion in the number of different cell types. With cellular linkage affectation, the severity of the lesion increased and the cells were easily desquamated, giving rise to intercellular spaces which communicated freely with the organ lumen. Finally, in the most severe cases, the epithelial lining was diminished to a monolayer, with complete cellular dissociation and lack of differentiation. This cellular disarrangement allowed free passage of substances in both directions through the monolayer. PMID- 3825841 TI - Psychologic implications of AIDS. AB - Eleven patients with AIDS were seen by a psychiatric consultation service over a four-year period. Psychologic issues identified in these patients included changes in body image, feelings of helplessness and isolation, sexual concerns and the grief process. Management should be aimed toward maintaining a nonjudgmental stance, providing liaison with other caregivers and securing appropriate information and grief counseling for patients, with provision for the patient's loved ones. PMID- 3825842 TI - Septic emboli. PMID- 3825843 TI - When schizophrenia complicates medical care. AB - Schizophrenia may complicate effective treatment of medical problems. For example, the patient may refuse treatment or may not be competent to give informed consent. When possible, acute psychosis should be treated first; the patient may then cooperate with medical treatment. The patient's ability to give informed consent is important. PMID- 3825844 TI - Evaluating adolescents with fatigue. AB - Although most adolescents who complain of fatigue do not have a serious medical illness, the complaint cannot be dismissed without further investigation. If the diagnosis remains uncertain after a careful history and a thorough physical examination, laboratory tests, including complete blood count, erythrocyte sedimentation rate, urinalysis and an Epstein-Barr antibody profile, may be considered next. If the etiology is still unclear, sequential visits often provide clues for the physician and reassurance for the family. PMID- 3825845 TI - Behavioral complications of alcoholism. AB - Behavioral complications of alcoholism are frequently found in young alcoholics before medical complications develop. The antisocial alcoholic is at high risk of behavioral complications, including aggressive, violent behavior and accidental injury. Because of the markedly increased risk of trauma in alcoholism, the family physician should investigate the possible role of alcohol or other drug use in any patient with an injury. PMID- 3825846 TI - Computed tomography in childhood intracranial infections. AB - Delay in treatment or inadequate therapy with inappropriate antibiotics can result in a progressive cycle of inflammation, edema and infarction in children with bacterial meningitis. Early use of computed tomographic (CT) scanning and effective antibiotic therapy may significantly alter both the initial and long term clinical courses. CT scanning also facilitates the early detection and treatment of suppurative intracranial complications. PMID- 3825847 TI - Pelvic diastasis in pregnancy. PMID- 3825848 TI - Occlusive dressings. AB - Occlusive dressings reduce or eliminate wound pain, increase the speed of reepithelialization in acute wounds and stimulate debridement and healing of chronic ulcers. During the first 10 to 14 days, a large amount of fluid may accumulate under the dressing, but this fluid is seldom the result of infection. Films, foams, hydrocolloids and hydrogels have different properties that commend them in different settings. PMID- 3825849 TI - Foodborne disease: an increasing problem. PMID- 3825850 TI - AIDS and public health: time for reason. PMID- 3825851 TI - Screening mammography. PMID- 3825852 TI - Understanding family behavior. AB - Understanding family behavior is not particularly difficult. However, it does require a broadening of orientation from individuals to families and from dyadic relationships to family system interactions. Physicians who make this adjustment in their diagnostic and therapeutic focus find that it gives them a better perspective on many health problems that might otherwise defy understanding and resolution. PMID- 3825853 TI - Mitral valve prolapse in children. AB - Mitral valve prolapse is extremely common in children. It is diagnosed by the presence of a nonejection click with or without an associated murmur. In isolated mitral valve prolapse, the prognosis is excellent, but regular office visits are necessary for cardiac status review and infective endocarditis prophylaxis. Patients with significant dysrhythmias represent a small subset with an unknown long-term prognosis. PMID- 3825854 TI - An integrated mechanism for systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy based on echocardiographic observations. AB - Although many mechanisms have been proposed to explain systolic anterior motion (SAM) of the mitral valve in hypertrophic cardiomyopathy, the precise mechanism of its onset and cessation remain undefined. The Venturi theory, based on increased flow velocity in a narrowed outflow tract, is widely accepted but fails to explain several important characteristics of SAM. It also neglects the potential role of drag forces generated by interposition of the leaflets into the path of ejection and of factors that would decrease the effectiveness of papillary muscle restraint. In order to obtain further insight into the mechanism of SAM, a detailed geometric study of the left ventricle and mitral apparatus was performed with cross-sectional echocardiography in three equal-sized groups of patients with hypertrophic cardiomyopathy and SAM, patients with hypertrophy and no anterior motion, and normal control subjects. A salient finding was that SAM began prior to ejection in patients with hypertrophic cardiomyopathy, which cannot be explained by the Venturi theory. Further, SAM began and was most prominent in the central portion of the leaflet as opposed to its lateral edges; this finding is not predicted by the Venturi mechanism. In addition to outflow tract narrowing, other structural changes unique to patients with SAM included anterior and inward displacement of the papillary muscles, anterior displacement of the mitral leaflets, and elongation of the mitral leaflets, which were, on the average, 1.5 to 1.7 cm longer than in the other subjects (p less than 0.0001). On the basis of these observations, an integrated mechanism for the initiation and resolution of SAM is proposed that would explain observed features such as onset before ejection and central prominence. This mechanism combines the effects of outflow tract narrowing with those of papillary muscle displacement. In particular, anterior and inward displacement of the papillary muscles can be predicted to alter the effectiveness of chordal support so that the central leaflet portions become relatively slack and are more readily displaced anteriorly. The altered distribution of chordal tension can also be predicted to orient the distal leaflets upward into the outflow tract at the onset of systole, prior to aortic valve opening, so that ventricular ejection will actually drag the interposed leaflets anteriorly. The resolution of SAM can be understood in terms of a reverse Venturi effect created by mitral regurgitation, as well as continued traction of the centrally displaced papillary muscles on the lateral leaflet margins.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3825855 TI - Comparison of electrocardiography and thallium-201 myocardial scintigraphy for the detection of ergonovine-induced coronary artery spasm: angiographic correlation. AB - This study was performed to determine the sensitivity of thallium imaging vs ECG monitoring for detecting coronary artery spasm noninvasively following intravenous ergonovine administration as compared to simultaneous coronary angiography. Thirty-two patients with insignificant coronary artery disease and chest pain underwent 12-lead ECG monitoring, thallium imaging, and coronary arteriography following the administration of 0.05, 0.1, 0.2, and 0.3 mg of ergonovine given 5 minutes apart or until chest pain occurred. One minute following the last dose of ergonovine, 2.5 mCi of thallium-201 was injected intravenously, and a final ECG was recorded and repeat coronary arteriography performed. Within 10 minutes following the injection of thallium, imaging was performed in the 40-degree and 70-degree left anterior oblique and anterior projections. The ECG, thallium study, and coronary arteriogram were read blindly and results were compared. The ECG, angiogram, and thallium study were read as positive if the following occurred, respectively: greater than or equal to 1 mm ST segment elevation, depression, or T wave reversal; greater than 50% vessel narrowing,; and reversible perfusion defect. Five patients were excluded from analysis because of either catheter-induced spasm, suboptimal thallium studies, or protocol violations. Of the 27 patients included for analysis, six had chest pain, five had a positive angiogram, five had a positive thallium study, and one had a positive ECG. The sensitivity of thallium vs ECG monitoring was 80% vs 25%, and the accuracy was 92% vs 80%. We conclude that thallium imaging greatly increases the noninvasive detection of ergonovine-induced coronary spasm as compared with the ECG with no loss of accuracy. PMID- 3825856 TI - Association between time of increased fibrinopeptide A levels in plasma and episodes of spontaneous angina: a controlled prospective study. AB - Thirty-seven patients affected by spontaneous angina and 15 comparable control subjects were enrolled in a 12-month prospective study to evaluate the relationship between blood clotting activation (assessed by fibrinopeptide A [FPA] plasma concentration) and the occurrence of myocardial ischemic attacks. FPA measurements and clinical examinations in patients were performed every 2 weeks. In control subjects blood sampling was performed every 4 weeks. Data from 28 patients who completed the study and from the 15 control subjects were analyzed. The clinical activity of angina was divided into three classes (asymptomatic, mildly symptomatic, and severely symptomatic) on the basis of the number and time-concentration of the ischemic attacks and ECG changes during the 15 days preceding each clinical examination. In all but one patient, a cyclic pattern of activity of coronary artery disease was observed. During follow-up studies, 624 FPA measurements were performed in patients and 173 in control subjects. Mean values were 4.68 +/- 4.53 and 1.32 +/- 0.60 ng/ml, respectively (p less than 0.001). FPA levels differed markedly in relation to the activity of angina. A relationship between FPA levels and activity of disease (r = 0.54, p less than 0.01) was found in time course. Bolus heparin administration (100 IU/kg) during the active phase of angina sharply but incompletely lowered FPA plasma levels, indicating thrombin formation both intravascularly and extravascularly. Present results indicate that a marked blood clotting activation occurs simultaneously with the outbursts of clinical activity of spontaneous angina. PMID- 3825857 TI - Adverse effects of circumflex coronary artery occlusion on blood flow to remote myocardium supplied by a stenosed left anterior descending coronary artery in anesthetized open-chest dogs. AB - Left anterior descending coronary artery occlusion in open-chest dogs causes a decrease in endocardial blood flow to the remote posterior bed supplied by a stenosed left circumflex coronary artery. To determine if "remote" myocardial ischemia also occurred in the anterior bed after circumflex occlusion, myocardial blood flow (radiolabeled microspheres) and hemodynamics were measured before and after circumflex occlusion in the presence of a stenosed left anterior descending artery (gradient: 28 +/- 2 mm Hg) in 10 open-chest dogs. Aortic pressure fell from 108 +/- 3 to 100 +/- 3 mm Hg (p = 0.02) and mean distal left anterior descending coronary artery pressure fell from 81 +/- 4 to 69 +/- 5 mm Hg (p = 0.02) after circumflex occlusion. Transmural flow to normal myocardium supplied by unstenosed and unoccluded coronary arteries increased from 0.69 +/- 0.04 to 0.84 +/- 0.04 ml/min/gm (p less than 0.0001) after circumflex occlusion. Although epicardial flow to the remote anterior bed supplied by the stenosed left anterior descending coronary artery increased after left circumflex occlusion (0.61 +/- 0.03 to 0.73 +/- 0.04 ml/min/gm, p = 0.004), remote anterior bed endocardial flow did not increase, and the remote bed endocardial:epicardial blood flow ratio decreased from 0.98 +/- 0.06 to 0.78 +/- 0.10 (p less than 0.05). Therefore, in this model, remote anterior bed ischemia, relative to the normal myocardial flow response, developed when the left circumflex coronary artery was occluded in the presence of the stenosed left anterior descending coronary artery. PMID- 3825858 TI - Left ventricular wall motion at rest in patients with organic coronary artery disease vs coronary spasm. AB - Left ventricular ejection fractions and regional ejection changes obtained from left ventriculograms at rest were analyzed in 15 normal subjects, in 17 patients with isolated, organic left anterior descending coronary artery disease, and in 11 patients with isolated left anterior descending coronary artery spasm. Patients with coronary artery spasm did not have significant organic lesions at the site of spasm. All patients with organic coronary artery disease and coronary artery spasm had a history of angina pectoris without myocardial infarction. No significant differences in ejection fraction were observed among the three groups. The regional ejection change of the anterolateral and apical wall supplied by the left anterior descending coronary artery was significantly decreased in patients with organic coronary artery disease compared with those in normal subjects (anterolateral 39.5 +/- 10.3% vs 48.4 +/- 7.7%, p less than 0.05; apical 48.4 +/- 8.8% vs 55.6 +/- 7.8%, p less than 0.05). However, the anterolateral and apical wall motion was not impaired in patients with coronary artery spasm. Thus, patients with organic coronary artery disease had impairment of left ventricular wall motion, while those with coronary artery spasm did not, although both groups of patients had symptoms of angina. These results suggest that patients with organic coronary artery disease may have had coronary blood flow disturbances through stenosed vessels and chronic active ischemia that produced left ventricular impairment. PMID- 3825859 TI - Aerobic responses to low level exercise testing following an acute myocardial infarction. AB - Thirty-four patients who had recently sustained an acute myocardial infarction performed low-level exercise testing with analysis of expired gas 7.1 +/- 2.6 days after the event. They were classified as finishers (F) and nonfinishers (NF) of the low-level protocol. The ejection fraction in the NF was 39 +/- 14% vs 56 +/- 17% in the F (p less than 0.01), and the NF had 2.6 +/- 0.8 vessels stenosed vs 1.8 +/- 0.9 vessels stenosed in the F (p less than .05). Ten normal subjects also performed the exercise test. At the same workload, patients with recent myocardial infarction had significantly lower oxygen consumption (NF less than F), significantly higher minute ventilation (NF greater than F), ventilatory equivalent for oxygen (NF greater than F), and higher respiratory exchange ratio (NF greater than F) than did normal subjects. The heart rate responses were higher in the post infarction patients than in normal subjects. The oxygen pulse was significantly lower in the cardiac patients compared to normals. These findings suggest that during the early recovery phase from an acute myocardial infarction, patients, particularly the NF, utilize less oxygen at submaximal work loads than do normal subjects. This suggests that in these patients part of the energy requirements for exercise are met anaerobically. This could be due to abnormal extraction of oxygen by the working muscles or as a result of poor delivery of oxygen due to abnormal left ventricular function. PMID- 3825860 TI - Ventricular arrhythmias in dilated cardiomyopathy: efficacy of amiodarone. AB - Sixty-five patients with dilated cardiomyopathy were studied by means of 24-hour ECG monitoring. Ventricular arrhythmias were present in 62 (95.4%), of whom 52 (80%) showed a complex form (multiform ventricular extrasystoles, pairs, and ventricular tachycardia). Forty-one patients, presenting with complex ventricular arrhythmias, received antiarrhythmic treatment with amiodarone (600 mg/day in the first week, 400 mg/day in the second week, and 200 to 400 mg/day chronically), and were then controlled with periodic 24-hour ambulatory monitoring. A significant reduction in the number of ventricular extrasystoles was seen in over 70% of patients during a 3-year period. There was also a significant decrease in the incidence of complex ventricular arrhythmias (particularly of ventricular tachycardia). Adverse effects were noted in 23 patients, but only four had to stop treatment. During the follow-up period, 19 patients died: 14 of heart failure, four of sudden death, and one of a noncardiac cause; all patients who died suddenly were not treated with amiodarone (p = 0.022). Complex ventricular arrhythmias are frequent in dilated cardiomyopathy and it is suggested that amiodarone is effective in short- and long-term control of these arrhythmias. PMID- 3825861 TI - Clinical, histochemical, and ultrastructural correlation in septal endomyocardial biopsies from chronic chagasic patients: detection of early myocardial damage. AB - In order to recognize early signs of myocardial damage, histologic, histochemical, and ultrastructural studies were performed on septal endomyocardial biopsy tissue obtained from 79 chronic chagasic patients and from 18 patients with atypical chest pain (control group). Abnormal biopsy findings were recognized in 9 of 16 (60%) chagasic patients with no clinical evidence of myocardial damage. In cases of segmental asynergy only, biopsies were abnormal in 18 of 19 patients. When signs of advanced myocardial damage were evidenced by clinical examination or ECGs, all biopsies were abnormal. Mitochondrial, nuclear, and cell membrane irregularities were consistent findings. A peculiar dilatation and filling of the T tubule system with a glycoprotein-like substance and a remarkable increase in monoamine oxidase activity were observed early in the disease and progressed in magnitude and frequency as myocardial damage became more evident by other diagnostic methods. Septal endomyocardial biopsy is a sensitive method for detection of early myocardial damage in chronic chagasic patients. Based on these findings, a modification of the currently used classification is proposed. PMID- 3825862 TI - Validation of in vivo two-dimensional echocardiographic dimension measurements using myocardial mass estimates in dogs. AB - The accuracy of in vivo measurements of left ventricular wall thickness and chamber size by means of two-dimensional echocardiography was investigated by comparing left ventricular mass estimates obtained at end diastole in 15 closed chest dogs with a wide range of left ventricular weights. The systolic and diastolic echocardiographic mass estimates were compared with the actual weights of the freshly excised, stripped left ventricles immediately following death. The mean +/- SD of the weighed mass of the excised ventricles was 104 +/- 25 gm. The mean predicted left ventricular mass with the use of the cylinder-ellipse geometric model and gross anatomic sections corresponding to the echocardiographic imaging planes was 106 +/- 26 gm (r = 0.97 compared to the actual weight). The mean echocardiographic estimate of left ventricular mass at end diastolic was 107 +/- 24 gm (r = 0.98 compared to the weight) and 105 +/- 26 gm at end systole (r = 0.95 compared to the weight). The correlation between the echocardiographic mass estimate at end diastole and the echo mass estimate at end systole was 0.95. Regression analysis failed to demonstrate a significant over- or underestimation of the actual weight by the calculated mass with the use of either the gross anatomic or the in vivo echocardiographic dimension measurements. PMID- 3825863 TI - The influence of age and gender on left ventricular response to supine exercise in asymptomatic normal subjects. AB - The performance of normal subjects during radionuclide ventriculography has been related to age, but the combined effects of age and sex on exercise ventricular function are not well described. We studied 55 normal volunteers, 27 men (age = 30 +/- 10 years) and 28 women (age = 33 +/- 14 years), free of chest pain syndromes, during supine rest/exercise radionuclide ventriculography performed to fatigue. Resting left ventricular ejection fraction did not differ between male and female subjects (64 +/- 5.4 vs 64 +/- 6.1; p = NS). Both the peak left ventricular ejection fraction (78 +/- 4.4 vs 72 +/- 9.2; p less than 0.001) and the change in ejection fraction with exercise (14 +/- 4.0 vs 7.9 +/- 7.0; p less than 0.001) were significantly greater in men compared to respective values in women. Regression analysis showed that sex (r = 0.51; p less than 0.001) but not age (r = -0.18; p = 0.19) was a significant predictor of change in ejection fraction with exercise. Data on left ventricular volume response to exercise, available in 43 subjects, revealed that men had a greater percentage of decline in end-systolic volume with exercise than women (-47 +/- 15 vs -24 +/- 26; p less than 0.001). It is concluded that sex exerts a significant influence on normal left ventricular response to fatigue-limited supine exercise and that the gender difference is mediated, in part, by left ventricular end-systolic volume response to exercise. PMID- 3825864 TI - The value of mixed venous oxygen saturation as a therapeutic indicator in the treatment of advanced congestive heart failure. AB - This retrospective study attempted to determine if the mixed venous oxygen saturation (SVO2) is an appropriate therapeutic monitoring parameter in assessing the effectiveness of dobutamine administration in patients with advanced congestive heart failure (CHF). Twelve patients (mean age 56.7 +/- 3.2 years, SEM) with New York Heart Association functional class III or IV (11 patients) received increasing doses of dobutamine with hemodynamic and SVO2 determinations. Dose-dependent hemodynamic improvements occurred with dobutamine administration. The correlation between cardiac output (CO) and SVO2 was poor (r2 = 0.37). One subset of patients (seven patients) had a good correlation (r2 greater than or equal to 0.7), whereas a second subset (five patients) had a weak correlation (r2 less than 0.7) between CO and SVO2. The baseline hemodynamic profile of the latter group demonstrates a trend toward a more seriously ill subset of patients compared to the former group. A parallel relationship between CO and SVO2 may not occur in seriously ill CHF patients. One possible explanation may be a changing oxygen consumption rate in the seriously ill patient, resulting in changes in CO without concomitant changes in SVO2. PMID- 3825865 TI - Doppler echocardiographic observations of pulmonary and transvalvular velocity changes after birth and during the early neonatal period. AB - To evaluate the qualitative and quantitative changes in Doppler velocities in the normal fetus and newborn, 61 echo Doppler studies were performed in 18 neonates, nine of whom were also studied as fetuses. Four studies were inadequate in fetuses (one pulmonary artery, two mitral, and one tricuspid) and some post natal studies were inadequate due to inability to separate atrioventricular valve E and A velocity component waveforms (one tricuspid, three mitral). Heart rates for fetuses and newborns more than 24 hours of age and less than 24 hours of age were similar. Pulmonary artery diastolic velocities consistent with patent ductus arteriosus were present in 11 of 12 examinations at less than 6 hours of age, in 5 of 13 examined at 6 to 24 hours of age, and in 2 of 27 examined after 24 hours of age. Pulmonary artery times to peak velocity were similar in fetuses, m = 46, SD = 3 msec, and in neonates less than 6 hours of age, m = 51, SD = 13 msec, but lengthened significantly, p less than 0.05, at 6 to 24 hours (m = 69, SD = 14 msec). These changes are probably due to the dramatic changes in pulmonary vascular pressure that occur after birth. Data from 6 to 24 hours and greater than 24 hours (m = 78, SD = 13 msec) were similar. Significant differences existed for transmitral valve E/A ratios, which increased from m = 0.85 in utero to m = 1.17 (p less than 0.05) after birth, with no significant change thereafter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825866 TI - A pulsed Doppler echocardiographic study of the postnatal changes in pulmonary artery and ascending aortic flow in normal term newborn infants. AB - Postnatal circulatory adaptations were studied with Doppler echocardiographic measures of flow velocity in the main pulmonary artery (PA) and ascending aorta (Ao) in 45 normal full-term neonates at 5 hours and at 27 hours after birth. PA flow velocity integral (FVI) was measured as the area under the systolic flow velocity curve and reflected total systemic flow in the presence of a left-to right shunt through the ductus arteriosus. This index increased from 5 and 27 hours age, while Ao FVI, reflecting total pulmonary flow, remained unchanged. Evidence of a left-to-right ductal shunt demonstrated as diastolic retrograde flow in the main PA was detected in 42 neonates at 5 hours and in only four subjects after 27 hours of age, indicating a patent ductus arteriosus at 5 hours of age and its subsequent closure. In the PA, acceleration time (AT) increased while pre-ejection period to ejection time ratio (PEP/ET) decreased from 5 to 27 hours of age, reflecting the physiologic fall in PA pressure. In the Ao, FVI, AT, and PEP/ET remained unchanged, suggesting little change in left ventricular function. PMID- 3825867 TI - Comparison of late clinical status between patients with different hemodynamic findings after repair of tetralogy of Fallot. AB - Long-term results and postoperative hemodynamic findings were reviewed in 144 cases of tetralogy of Fallot. A correlation was found between the late clinical status of patients and the postoperative hemodynamic findings. The mortality in our series of patients followed for 10 years was 6.25%. Each of the deaths occurred in the group with unsatisfactory postoperative hemodynamic findings. An ideal late clinical result can be anticipated in most patients with excellent or satisfactory postoperative hemodynamic findings. The greater the deviation from normal hemodynamic findings, the worse the prognosis. From the excellent group to the unsatisfactory group, the incidence of late ideal result decreased from 95% to 61.1%, while the incidence of poor result increased from 0% to 27.8%. Among various factors in patients in the unsatisfactory hemodynamic group, right ventricular outflow tract obstruction seems to have the worst late result. A large right ventricular-pulmonary artery pressure gradient was noted in three of four who died suddenly. The late result of patients with a small shunt (pulmonary blood flow/systemic blood flow less than 2) seems acceptable; the decision to reoperate in these patients should be made very cautiously. PMID- 3825868 TI - Sudden death risk in overt coronary heart disease: the Framingham Study. AB - Over 30 years of surveillance of 5127 subjects free of CHD, 760 men and 574 women developed overt CHD, and there were 160 sudden deaths in men and 73 in women. Among those who sustained clinically manifest CHD, the sudden death risk was increased 6.7 times that of those without an interim event. Although the relative risk was comparable in the two sexes, CHD did not eliminate the female advantage over men. Myocardial infarction imposed a greater sudden death risk than angina pectoris, and silent infarctions were as dangerous as symptomatic infarctions. Onset of CHD put young and old at equal risk of sudden death. Some 40% of sudden deaths occurred in the 4% of the general population with overt CHD. The proportion of coronary attacks presenting as sudden death increased from 13% at ages 35 to 64 years to 20% at ages 65 to 94 years. The fraction of CHD deaths classified as sudden deaths was lower in those with than without interim CHD. In those with established CHD, factors reflecting ischemic myocardial damage and cardiac failure were the chief predictors of sudden death. The proportion of CHD deaths presenting as sudden deaths has not declined in subjects with prior CHD over three decades, despite a national decline in the overall CHD mortality rate. PMID- 3825869 TI - Acute myocardial infarction in the United States, 1970-1983. PMID- 3825870 TI - Socioeconomic status, ethnic origin, and risk factors for coronary heart disease in children. AB - The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma lipids, body mass index, and physical fitness were measured. In a random subsample of 353 subjects, a 24-hour dietary recall interview was performed. White children in the lower socioeconomic area had the most unfavorable risk factor profile. Differences between the groups in mean level of plasma total cholesterol primarily were associated with factors related to area of residence. Children in a lower socioeconomic environment may be considered to be candidates for especially intensive intervention strategies for the primary prevention of CHD. PMID- 3825871 TI - Transfemoral embolectomy for massive pulmonary embolus and associated myocardial infarction. PMID- 3825872 TI - Successful cardiopulmonary resuscitation in a patient with rare sinus node artery anomaly. PMID- 3825873 TI - Consecutive ST segment depression and elevation in the same electrocardiographic leads during an asymptomatic exercise treadmill test. PMID- 3825874 TI - Single coronary artery complicating repair of pulmonic stenosis. PMID- 3825875 TI - Familial form of arrhythmogenic right ventricular dysplasia. PMID- 3825876 TI - Echocardiographic detection of dynamic intracavitary echoes and right atrial thrombus. PMID- 3825877 TI - Swallow syncope in an otherwise healthy young man. PMID- 3825878 TI - Two-dimensional echocardiographic features of pulmonary artery vegetation. PMID- 3825879 TI - High degree atrioventricular block in a marathoner with 5-year follow-up. PMID- 3825880 TI - Progression of complete heart block to isolated infra-Hisian block following penetrating cardiac trauma. PMID- 3825881 TI - Distribution of propafenone and its active metabolite, 5-hydroxypropafenone, in human tissues. PMID- 3825882 TI - Pericardial constraint in chronic heart failure. PMID- 3825883 TI - Self-help for the athlete. Part 3. Contributions to an athletic program. PMID- 3825884 TI - Incontinence: explaining its causes and remedies. PMID- 3825885 TI - Incidence of acute myocardial infarction in patients with exercise-induced silent myocardial ischemia. AB - Fifty-five patients with angiographically proved coronary artery disease (CAD) underwent Bruce protocol exercise stress testing with thallium-201 imaging. Twenty-seven patients (group I) showed myocardial hypoperfusion without angina pectoris during stress, which normalized at rest, and 28 patients (group II) had a similar pattern of reversible myocardial hypoperfusion but also had angina during stress. Patients were followed for at least 30 months. Six patients in group I had an acute myocardial infarction (AMI), 3 of whom died, and only 1 patient in group II had an AMI (p = 0.05), and did not die. Silent myocardial ischemia uncovered during exercise stress thallium testing may predispose to subsequent AMI. The presence of silent myocardial ischemia identified in this manner is of prognostic value, independent of angiographic variables such as extent of CAD and left ventricular ejection fraction. PMID- 3825886 TI - Prediction of infarct coronary artery recanalization after intravenous thrombolytic therapy. AB - Clinical assessment of patients with evolving acute myocardial infarction may suggest recanalization of the infarct coronary artery if chest pain, electrocardiographic ST-segment elevation and reperfusion arrhythmia are diminished. These 3 criteria, however, have not been correlated with immediate coronary angiography. Determination of which patients will achieve myocardial reperfusion after intravenous fibrinolytic therapy would allow for appropriate triage; those in whom it fails may be considered for mechanical or surgical recanalization. Fifty-six patients were studied: 28 received intravenous streptokinase and 28 intravenous recombinant tissue-type plasminogen activator. None of these clinical criteria, considered separately, was predictive of infarct artery recanalization status. Using the presence or absence of all 3 criteria, the specificity and predictive value increased to 100%. However, only 9% of patients in the series had all 3 criteria present (all had a patent infarct artery) and 34% had no criteria present (all had an occluded vessel). Noninvasive clinical markers are simple and practical, but only concordance of all 3 major criteria, when present, accurately predicts results of thrombolytic therapy. PMID- 3825887 TI - Left ventricular wall motion with and without Q-wave disappearance after acute myocardial infarction. AB - Since post-acute myocardial infarction (AMI) Q waves may disappear independent of reinfarction or development of left bundle branch block, the relation between the presence of Q waves and segmental asynergy was assessed in 58 patients with initial Q waves after first AMI. Two-dimensional (2-D) echocardiograms and electrocardiograms were recorded 1 year later. By electrocardiography, 28 had anterior and 25 inferior AMI. At 1 year Q waves had disappeared in 12 of 53 patients (23%): 5 with anterior and 7 with inferior AMI. Segmental asynergy, however, was present in 9 of these 12 patients, although dyskinesia was absent. Presence of Q waves at 1 year (41 patients) was always associated with segmental asynergy. Wall motion score, based on degree of segmental asynergy, was higher in the 41 patients with Q waves compared with patients in whom Q waves disappeared (7.8 +/- 4.4 vs 2.7 +/- 1.9, p less than 0.001). In patients with anterior AMI the number of Q waves at 1 year and the grade of asynergy were correlated. Segmental dyskinesia was rare in patients with inferior AMI (1 of 25) but was common in those with anterior AMI (18 of 28), and was consistently present in patients with more than 2 anterior Q waves. PMID- 3825888 TI - Usefulness of recanalization to luminal diameter of 0.6 millimeter or more with intracoronary streptokinase during acute myocardial infarction in predicting "normal" perfusion status, continued arterial patency and survival at one year. AB - To determine whether arteriographic dimensions of the acutely recanalized coronary lumen provide information about regional perfusion or clinical outcome, quantitative arteriography was used to measure minimum luminal diameter achieved with intracoronary streptokinase administration in 44 patients with acute myocardial infarction (AMI). Degree of coronary reperfusion was independently assessed visually using the criteria applied in the multicenter Thrombolysis in Myocardial Infarction study. Minimum diameter and qualitative reperfusion grade were both assessed from 172 coronary injections during thrombolysis. Partial perfusion (grade 1 or 2) was seen in 95 of 135 injections (70%) in which the minimum diameter was less than 0.6 mm and complete perfusion (grade 3) was seen in 35 of 37 injections (95%) in which it was 0.6 mm or more (p less than 0.001). Repeat cardiac catheterization was performed at 5.5 +/- 4.9 weeks after AMI (n = 20). When vessels were opened acutely to a minimum diameter of less than 0.6 mm, 5 of 12 vessels (42%) were reoccluded at the time of restudy and 8 of 29 patients (28%) died within 12 months. By contrast, 0 of 8 vessels (0%) were reoccluded when the artery was opened to a diameter of at least 0.6 mm (difference not significant), and only 1 of 15 patients (7%) died (p less than 0.05). Of the patients with grade 1 o r 2 perfusion at the end of the thrombolytic infusion, 7 of 19 (37%) died within 12 months and 2 of 4 vessels (50%) reoccluded; of the patients with grade 3 perfusion, 2 of 25 (8%) died (p less than 0.05) and 2 of 16 vessels (13%) reoccluded (difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825889 TI - Endorphins are related to pain perception in coronary artery disease. AB - Plasma beta-endorphin levels were measured by radioimmunoassay before and after exercise in 25 patients with coronary artery disease. Eighteen patients were men and 7 were women; age range was 36 to 75 years (mean 60). All patients had angina pectoris, a positive treadmill test response or positive exercise radionuclide findings. The mean preexercise plasma endorphin level was 4.9 +/- 3.0 pmol/liter (range 0.7 to 13.5). The mean postexercise plasma endorphin level of 6.6 +/- 4.6 mol/liter (range 0 to 19.5) was significantly higher (p less than 0.05). A significant positive correlation was seen between postexercise endorphin levels and time to onset of angina (r = 0.4, p = 0.03). There were negative correlations between postexercise endorphin levels and occurrence (r = -0.4, p = 0.04) and duration of angina (r = -0.4, p = 0.05). No association was found for maximal heart rate-blood pressure product, workload, time to ST-segment depression or stress ejection fraction. A positive correlation was found between rest left ventricular ejection fraction and postexercise endorphin levels (r = 0.5, p = 0.02). In conclusion, in patients with exercise-induced myocardial ischemia, plasma beta-endorphin levels are increased after exercise; postexercise endorphin levels are related to timing and occurrence (presence or absence) of angina; and endorphins may alter the perception of pain caused by myocardial ischemia. PMID- 3825890 TI - Role of exercise thallium-201 myocardial perfusion scintigraphy in predicting prognosis in suspected coronary artery disease. AB - While exercise thallium imaging has improved sensitivity and specificity for detection of coronary artery disease (CAD), its predictive value for morbid cardiac events is unclear. Of 532 consecutive patients who underwent exercise thallium imaging, follow-up was complete in 515 (97%) after an average of 36 months (range 31 to 48). Two hundred six patients had an abnormal exercise thallium response and 309 had a normal response. Twenty morbid cardiac events occurred (13 deaths and 7 acute myocardial infarctions [AMI]). Of the 13 patients who died, 12 had abnormal thallium results. Overall, 5.8% of the patients with abnormal thallium results died, in contrast to 0.3% of patients with normal results. Of the 7 patients who had a nonfatal AMI, 3 had abnormal exercise thallium results. Moreover, similar proportions of patients (1.4% and 1.3%) with normal and abnormal exercise thallium results had nonfatal AMI. Presence or absence of pathologic Q waves and inclusion of exercise electrocardiographic results did not significantly alter the results. Thus, although a normal exercise thallium response significantly reduces the likelihood of cardiovascular death, its predictive value for nonfatal AMI is limited. Moreover, the relatively low event rate for patients with a positive exercise thallium response further limits its prognostic value. PMID- 3825891 TI - Comparison of the high-dose dipyridamole-echocardiography test and exercise two dimensional echocardiography for diagnosis of coronary artery disease. AB - Fifty-five patients with effort angina pectoris and technically satisfactory baseline echocardiograms performed a supine exercise-echocardiography test (EET) and a high-dose dipyridamole-echocardiography test (DET, up to 0.84 mg/kg of intravenous dipyridamole in 10 minutes). All underwent coronary arteriography, which showed that at least 1 major artery had more than 70% stenosis in 34 patients. For each patient, the same physician performed both tests, with the same echocardiographic equipment. Detection of new onset or worsening regional asynergy was the only criterion of positivity for both tests. DET yielded interpretable studies in all 55 patients (100%); EET yielded only 40 such studies (73%) (p less than 0.01). In the 40 patients in whom both tests were interpretable, DET showed, compared with EET, a similar sensitivity (72% vs 76%) and specificity (100% vs 87%) (difference not significant for both) for detecting angiographically assessed coronary artery disease. In the 16 patients in whom both DET and EET yielded positive responses for ischemia, the same myocardial region showed reversible asynergy. Thus, independent of all factors that can affect the performance of each test (operator, patient and instrumentation), DET was significantly more feasible than EET, with comparable sensitivity and specificity. Dipyridamole provokes asynergy in the same regions that show ischemia during exercise. PMID- 3825892 TI - Asymmetric distribution of left ventricular asynergy in coronary artery disease and its relation to coronary stenoses. AB - In 100 patients with coronary artery disease (CAD), the prevalence and severity of asynergy was determined for 9 left ventricular (LV) segments by both radionuclide and contrast angiography. The anterior, septal and lateral LV walls had significantly more prevalent and more severe asynergy in the medial segments than in the basal segments. In contrast, the inferior LV wall exhibited equally severe asynergy in both the medial and basal segments. In general, asynergy was most severe in the apical, medial septal, medial inferior and basal inferior LV segments. This asymmetric distribution of LV asynergy could not be explained by the distribution of occlusions or significant stenoses in the arterial tree, which were relatively uniformly distributed among the left anterior descending (32%), left circumflex (29%) and right (26%) coronary arteries. It is postulated instead that the asymmetric distribution of LV asynergy results from asymmetry of the coronary arterial tree supplying the left ventricle and that the prevalence of asynergy in an LV segment is directly related to its vascular distance from the coronary ostia. Unlike the relatively direct supply of the left anterior descending and circumflex arteries to the basal segments of the anterior, septal and lateral LV walls, the arterial supply to the basal inferior wall begins only after the right or dominant circumflex artery has traversed the length of the atrioventricular groove, significantly increasing its susceptibility to the pressure attenuation and occlusive jeopardy of more proximal stenoses. PMID- 3825893 TI - Usefulness of radionuclide ventriculography in assessment of coronary artery spasm. AB - Provocative tests that permit detection of coronary artery spasm are widely used in patients with ischemic syndromes. To assess the usefulness of radionuclide ventriculography combined with provocative tests for diagnosis of coronary spasm, the left ventricular (LV) response to exercise, hyperventilation and a cold pressor test was determined in 3 groups. Group I included 10 normal subjects; group II, 49 patients with typical effort angina and fixed obstructive coronary artery disease at catheterization; and group III, 19 patients suspected of having vasospastic angina based on clinical and electrocardiographic findings, each of whom had normal coronary angiographic findings. In group I, LV ejection fraction (EF) increased during hyperventilation and exercise testing in 9 of 10 subjects (90%) and failed to decrease 5% in 9 of 10 subjects (90%) during cold testing. In contrast, while 18 of 49 patients (37%) of group II showed LV dysfunction with cold testing and 8% with hyperventilation, all showed abnormal LV function during exercise. Finally, in group III, LVEF increased during exercise, mimicking the response in normal group, while dysfunction was present in 14 of 19 (74%) during hyperventilation and in 17 of 19 (89%) during cold testing. When results of hyperventilation and cold testing were combined, abnormal responses were present in all patients. Thus, radionuclide ventriculography, when performed in association with 3 forms of stress--exercise, hyperventilation and cold testing- allows accurate identification of patients likely to have coronary spasm. PMID- 3825894 TI - Prospective comparison of right and left ventricular stimulation for induction of sustained ventricular tachycardia. AB - Thirty-eight patients who had sustained monomorphic ventricular tachycardia (VT) or sudden cardiac death underwent programmed ventricular stimulation. To assess the relative efficacy of right and left ventricular (RV and LV) stimulation, a tandem protocol with 1 to 4 extrastimuli and burst pacing was used. Each step of the protocol was performed in a rotating sequence at the RV apex, basal RV septum and LV apex. Sustained VT was induced from the RV apex in 26 patients, right ventricle (either site) in 27, and LV apex in 24, and spontaneous VT was reproduced from those sites in 11, 14 and 12 patients, respectively. In the 23 patients who had sustained VT induced from both ventricles, RV stimulation always required fewer or the same number of extrastimuli for induction. At every stage of the protocol, the cumulative yield of sustained VT was consistently greater from the right ventricle than from the left ventricle. After delivering 4 extrastimuli and burst pacing, LV stimulation only increased the yield of sustained VT by 1 patient, and spontaneous VT by 3 patients. Inducibility or noninducibility in the right ventricle generally predicted the same outcome in the left ventricle. Previously undocumented VT or ventricular fibrillation was induced from the right ventricle in 19 patients and from the left ventricle in 13. Thus, LV stimulation was less efficacious than RV stimulation. LV stimulation increased the yield over RV stimulation only minimally and did not reduce the number of extrastimuli required to induce sustained VT. PMID- 3825895 TI - Noninvasive electrophysiologic study using standard permanent pacemakers in patients with spontaneous sustained ventricular tachycardia or ventricular fibrillation. AB - Permanent pacemakers capable of noninvasive electrophysiologic testing were used to study and treat 26 patients with spontaneous sustained ventricular tachycardia (VT) or fibrillation (VF). One hundred nine episodes of sustained VT or VF were induced in these patients. In 8 patients spontaneous VT was reverted by noninvasive means. Drug changes based on noninvasive testing were made in 12 patients. In the 1- to 67-month follow-up period, drug therapy based on noninvasive electrophysiologic testing was predictive of outcome in patients with spontaneous arrhythmias. Thus, noninvasive electrophysiologic testing using permanent pacemakers is a useful method for studying and treating patients with recurrent sustained ventricular arrhythmias. PMID- 3825896 TI - Independent value of signal-averaged electrocardiography and left ventricular function in identifying patients with sustained ventricular tachycardia with coronary artery disease. AB - To determine if the signal-averaged electrocardiographic detection of late potentials is an independent marker of sustained ventricular tachycardia (VT) in patients with documented chronic coronary artery disease (CAD), 57 patients underwent signal-averaged electrocardiography. Mean ejection fraction was 47 +/- 13% in the 14 patients with sustained VT and 56 +/- 19% in the 43 patients without VT (difference not significant). The sensitivity, specificity and accuracy of late potentials for detecting patients with VT were 64% (9 of 14), 79% (34 of 43), and 75% (43 of 57), respectively. Univariate analysis and stepwise logistic regression of angiographic and electrocardiographic variables identified late potentials as an independent marker of the patient with sustained VT. The odds ratio for late potentials to detect patients with prior sustained VT was 2.6. Six-month follow-up revealed a cardiac mortality rate of 11% and an arrhythmia event rate of 22% in patients with late potentials vs a cardiac mortality rate of 3% and an arrhythmia event rate of 13% in patients without late potentials. Thus, signal-averaged electrocardiographic detection of late potentials is useful in identifying patients with prior sustained VT independent of left ventricular function. PMID- 3825897 TI - Programmed electrical stimulation in healed myocardial infarction using a standardized ventricular stimulation protocol. AB - The diagnostic accuracy of programmed electrical stimulation was prospectively assessed in 111 patients with myocardial infarction (MI) with or without a history of spontaneous ventricular arrhythmias. In 29 patients neither ventricular tachycardia (VT) nor episodes of 10 premature ventricular depolarizations per hour was documented. Fifty patients had documented nonsustained VT and 32 had sustained monomorphic VT. One and 2 extrastimuli (twice diastolic threshold, 2 ms in duration) were given during sinus rhythm and ventricular pacing at 100, 120 and 140 beats/min in the right ventricular apex (part I). When this protocol failed to induce a sustained monomorphic VT, a third extrastimulus was introduced (part II). Repetitive ventricular responses were induced in all patients, and in 15 (14%) polymorphic ventricular arrhythmias requiring DC shock were induced. Incidence of initiation of sustained monomorphic VT and polymorphic ventricular arrhythmias requiring DC shock was related to the clinical arrhythmia and the stimulation protocol. In patients with documented sustained monomorphic VT, a third extrastimulus only increased the incidence of sustained monomorphic VT (68% to 94%), whereas in patients with documented nonsustained VT and without VT the incidence of both polymorphic and monomorphic arrhythmias increased by 7 to 12%. Sustained monomorphic VTs induced in patients without such a history were faster (p less than 0.01), depended on site of MI (p less than 0.05) and were more often preceded by nonsustained polymorphic VT (p less than 0.01) than in patients with documented sustained monomorphic VT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825898 TI - Correlation between signal-averaged electrocardiogram and programmed stimulation in patients with and without spontaneous ventricular tachyarrhythmias. AB - This study examined the incidence of delayed ventricular activation on signal averaged electrocardiograms and the incidence of inducible sustained ventricular tachycardia (VT) at programmed stimulation (1 or 2 extrastimuli) in patients with and patients without spontaneous ventricular tachyarrhythmias. The correlation between delayed ventricular activation and inducible VT was investigated in 371 patients with acute myocardial infarction (AMI). In 32 patients with no ventricular disease and no spontaneous arrhythmias (group I), ventricular activation time averaged 115 +/- 2 ms, compared with 166 +/- 3 ms (p less than 0.001) for 65 patients with spontaneous ventricular tachyarrhythmias late after AMI (group II). In AMI patients with no spontaneous arrhythmias, ventricular activation time averaged 133 +/- 2 ms for 306 patients studied 1 to 4 weeks after AMI (group III) and 130 +/- 2 ms for 67 patients studied 3 to 12 months after AMI (group IV). The values for group III and group IV patients were each significantly higher than for group I (p less than 0.001), but lower than that for group II (p less than 0.001). The incidence of delayed ventricular activation was 89% for group II, 26% for group III and 18% for group IV. Sustained VT was not inducible in group I patients, but was inducible in 78% of group II (p less than 0.001 vs group I) and 20% of group III (p less than 0.05 vs group I; p less than 0.001 vs group II) (group IV was not studied).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825899 TI - Effect of excision of ventricular myocardium on delayed potentials detected by the signal-averaged electrocardiogram in patients with ventricular tachycardia. AB - The ability of surgical excision of electrically abnormal ventricular myocardium to either abolish delayed potentials or modify their timing was investigated in 21 patients with spontaneous ventricular tachycardia (VT) late after myocardial infarction. This study also examined whether modification of delayed potentials after surgery was associated with loss of ability to induce VT or improvement in left ventricular function. Signal averaging of the electrocardiogram (ECG), programmed stimulation and radionuclide ventriculography were performed preoperatively and were repeated 10 to 14 days postoperatively. At preoperative investigation, all patients had delayed potentials on the signal-averaged ECG and inducible VT at programmed stimulation. In 7 patients (33%), delayed potentials were abolished by surgery, exceeding the baseline variability of 8.5% for detection of delayed potentials. VT was no longer inducible postoperatively in 16 patients (76%), including the 7 in whom delayed potentials were no longer detectable. In the patients in whom VT was no longer inducible, mean ventricular activation time decreased from 178 ms preoperatively to 151 ms postoperatively (standard error of the mean difference = 6 ms, p less than 0.001). In the 5 patients with inducible VT postoperatively, no significant change in mean ventricular activation time was seen, 181 vs 171 ms (standard error of mean difference = 9 ms). Reductions in ventricular activation time were not associated with an improvement in left ventricular ejection fraction unless aneurysmectomy was performed in addition to excision of electrically abnormal myocardium. Thus, the signal-averaged ECG may have a role in assessing the efficacy of antiarrhythmic surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825900 TI - Holter detection of cardiac arrhythmias in intracranial subarachnoid hemorrhage. AB - To determine the frequency and severity of cardiac arrhythmias in intracranial subarachnoid hemorrhage, 120 nonselected patients were prospectively studied by 24-hour Holter monitoring. Arrhythmias were found in 96 of 107 patients (90%) with adequate Holter recording: ventricular premature complexes in 49, nonsustained ventricular tachycardia in 5, supraventricular premature complexes in 29, paroxysmal supraventricular tachycardia or atrial fibrillation in 9, sinoatrial block and arrest in 29, second-degree atrioventricular block in 1, atrioventricular dissociation in 4 and idioventricular rhythm in 2. Life threatening ventricular arrhythmias (torsades de pointes-type ventricular tachycardia) occurred in 4 patients, degenerating into either ventricular flutter or fibrillation in 2. ST-segment changes suggestive of acute transitory myocardial ischemia were found in 8 patients (1.5 mm or more of ST depression in 7 patients and 1.5 mm or more of ST elevation in 1 patient). The frequency and severity of arrhythmias were significantly higher in patients studied within 48 hours of subarachnoid hemorrhage; serious ventricular arrhythmias were associated with QTc prolongation more than 550 ms and with hypokalemia less than 3.5 mEq/liter. No correlation was found between age, clinical condition, site and extent of subarachnoid hemorrhage and either the occurrence or severity of arrhythmias. The results of our study indicate an extremely high incidence of arrhythmias, sometimes serious, in subarachnoid hemorrhage, especially in the first 48 hours after hemorrhage. Continuous electrocardiographic monitoring is therefore mandatory. PMID- 3825901 TI - Frequency, diagnosis and clinical characteristics of patients with multiple accessory atrioventricular pathways. AB - Multiple accessory atrioventricular (AV) pathways were documented in 52 of 388 patients (13%) who underwent detailed electrophysiologic evaluation. Multiple AV pathways were identified during intraoperative mapping or electrophysiologic study by different patterns of ventricular preexcitation during atrial fibrillation, flutter or atrial pacing with different delta-wave morphologic and ventricular activation patterns; different sites of atrial activation during right ventricular pacing or orthodromic reciprocating tachycardia; or preexcited reciprocating tachycardia using a second pathway as the retrograde limb of the tachycardia. A logistic model was used to determine which clinical, electrocardiographic and electrophysiologic variables were associated with multiple AV pathways. Right free-wall and posteroseptal accessory AV pathways were more common in patients with multiple AV pathways and were frequently associated. Multivariate logistic regression identified Ebstein's anomaly, and a history of preexcited reciprocating tachycardia as significant variables (p less than 0.0001). Pathway location was not subjected to statistical analysis because of confounding variables. PMID- 3825902 TI - Simultaneous right atrial appendage sensing with a target tip, a solid tip and J orthogonal electrodes. AB - To compare the sensing characteristics of a solid tip, target tip (Medtronic) and orthogonal electrodes within the right atrial appendage, atrial electrograms were simultaneously recorded from 2 pacing leads in 11 patients. No significant differences were noted between atrial electrograms derived from target tip or a solid tip electrode in contact with atrial myocardium. Mean values for P-wave amplitudes of 3.0 vs 3.1 mV and slew rates 0.4 V/s vs 0.6 V/s, and QRS amplitudes of 1.0 vs 1.2 mV and slew rates 0.4 vs 0.2 V/s were obtained. The frequency content was also similar, with spectral maxima at 8 vs 9 Hz (P wave) and 7 vs 6 Hz (QRS). In contrast, atrial electrocardiograms derived from the orthogonal electrodes were significantly different: P-wave amplitude of 6.1 mV (p less than 0.025) and slew rate of 1 V/s and QRS of 0.13 mV and slew rate of 0.04 V/s. Spectral analysis was also dissimilar with maxima at 34 Hz (P wave) and 3 Hz (QRS). Orthogonal noncontacting sensing electrodes positioned within the atrial appendage offer substantially better electrographic P-wave amplitude detection and QRS rejection than contacting tip electrodes. These leads yield a significant improvement when discriminate atrial sensing is required. PMID- 3825903 TI - Effects of intravenous verapamil administration on left ventricular diastolic function in systemic hypertension. AB - The effects of intravenous verapamil administration (0.1 mg/kg as a bolus followed by an infusion of 0.007 mg/kg/min) were studied using high-temporal resolution radionuclide angiography in 27 patients with hypertension. Verapamil administration increased heart rate from 69 +/- 11 to 75 +/- 12 beats/min (p less than 0.001) and decreased systolic, diastolic and mean blood pressures (BPs) from 155 +/- 21/102 +/- 12 mm Hg (mean 119 +/- 14) to 142 +/- 19/95 +/- 12 mm Hg (mean 109 +/- 13) (p less than 0.001 for all). Ejection fraction decreased significantly (from 65 +/- 10% to 60 +/- 11%, p less than 0.005); peak filling rate, however, increased significantly only in patients in whom it was subnormal in the basal study (from 2.2 +/- 0.4 to 3.0 +/- 0.6 end-diastolic counts/s, p less than 0.001). These latter patients had significantly higher values of left ventricular (LV) mass index than patients with normal or increased peak filling rate (129 +/- 22 vs 112 +/- 22 g/m2, respectively, p less than 0.05). The isovolumic relaxation period changes were inversely related to the baseline values (r = 0.83, p less than 0.001). In the subgroup of patients in whom isovolumic relaxation period lengthened, time to end systole decreased (from 360 +/- 31 to 329 +/- 30 ms, p less than 0.025) and time to onset of rapid filling increased (from 420 +/- 31 to 451 +/- 34 ms, p less than 0.025), whereas these 2 intervals had opposite patterns in patients in whom isovolumic relaxation period decreased or did not change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825904 TI - Clinical determinants of mortality in chronic congestive heart failure secondary to idiopathic dilated or to ischemic cardiomyopathy. AB - To determine which of the many clinical parameters routinely collected influence mortality in patients with congestive heart failure (CHF), 201 patients with idiopathic or ischemic dilated cardiomyopathy were prospectively followed for a 28-month study period. Mean age of the study group was 62 +/- 10 years, 60% had ischemic cardiomyopathy, and two-thirds were in New York Heart Association functional class II or III. Fifteen clinical variables were analyzed using a Cox proportional hazards model, while individual variables also were calculated for independent prognostic significance. There were 85 deaths, 26 (31%) of which were sudden cardiac deaths. Three characteristics at the study entry independently predicted an increased mortality risk: left ventricular ejection fraction, maximal oxygen uptake and ischemic cardiomyopathy. A Cox proportional hazards model showed that the combination of VO2max, S3 and the diagnosis of ischemic cardiomyopathy provided the best estimates of risk for an early death. Mortality for the low-risk group was only 5% at 6 months and 10% at 1 year. In contrast, in patients with an S3, ischemic cardiomyopathy and low maximal oxygen uptake, 6 month mortality was 24% and 36% at 1 year (p less than 0.001). Thus, these patients at high risk with left ventricular dysfunction associated with ischemic heart disease, a decreasing exercise tolerance and the development of an S3 should be strongly considered for an interventional trial with the aim of decreasing mortality. PMID- 3825905 TI - Perioperative acute myocardial infarction after valve replacement. AB - The incidence of fatal acute myocardial infarction (AMI) after valve replacement has decreased with use of cold potassium-induced cardioplegia. Despite this method of myocardial preservation, 12 of 662 consecutive patients submitted to valve replacement had this complication. This study retrospectively analyzes, in those 12 patients, the etiologic profile of fatal perioperative AMI, together with its morphologic aspects. The clinical picture in 11 patients was a refractory low cardiac output state. In only 3 cases was AMI diagnosis confirmed during life. Six patients either had a technical complication or a coronary embolus; in these patients AMI was localized in the vascular bed of a single occluded coronary artery, and its morphologic picture resembled that of usual AMI. The 6 other patients did not have a defined cause for AMI and coronary occlusion was not present. In 4 such patients, there was massive circumferential necrosis, mainly in the subendocardium; comparatively, there was a greater prevalence of hemorrhage, contraction bands and necrosis of the layer of subendocardial cells adjacent to the left ventricular cavity. The findings for this group suggest myocardial necrosis due to cell damage during cardiopulmonary bypass; no predisposing factor for perioperative AMI was identified. PMID- 3825906 TI - Hemodynamic evaluation of porcine bioprostheses in the mitral position by Doppler echocardiography. AB - Twenty-four patients with porcine bioprostheses in the mitral position were studied by Doppler echocardiography followed by cardiac catheterization within 24 hours. Doppler mean diastolic mitral valve gradient was calculated by a 3-point method and mitral valve area was determined by the pressure half-time method. Data from Doppler echocardiography and cardiac catheterization were compared. There was a strong correlation between Doppler echocardiography and catheterization-determined mean diastolic gradient: r = 0.9, standard error of estimate (SEE) = 1.4 mm/Hg (regression equation y = 0.63x + 1.41), p less than 0.001. There was also a strong correlation between Doppler echocardiography and catheterization-determined mitral valve area: r = 0.86, SEE = 0.18 cm2 (regression equation y = 0.64x + 0.52), p less than 0.001. Fourteen patients whose valvular function was considered normal by clinical evaluation had Doppler calculated mean diastolic gradients of 4.5 to 9.5 mm Hg (mean 6.5 +/- 1.4); the Doppler-determined valve area was 1.15 to 2.0 cm2 (mean 1.54 +/- 0.3). Ten patients had a malfunctioning bioprosthesis, 7 had severe mitral regurgitation and 3 had stenosis. Valvular malfunction in all 10 patients was detected by Doppler echocardiography and confirmed by catheterization and angiocardiography. Nine patients underwent reoperation. Doppler hemodynamic evaluation of porcine bioprostheses in the mitral position provided noninvasive information comparable to that obtained by cardiac catheterization. PMID- 3825907 TI - Effects of exercise and nitroprusside on left ventricular ejection dynamics in idiopathic dilated cardiomyopathy. AB - To characterize the abnormal pattern of instantaneous left ventricular (LV) ejection in heart failure, proximal aortic pressure, flow, acceleration, power and dW/dt were measured at rest and during supine bicycle exercise using high fidelity, catheter-mounted pressure and velocity sensors in 16 patients with idiopathic dilated cardiomyopathy (IDC) and 11 normal control subjects. In patients with IDC, peak flow was lower than normal both at rest (454 +/- 155 vs 649 +/- 168 ml/s, p less than 0.01) and during exercise (569 +/- 213 vs 916 +/- 329 ml/s, p less than 0.01). Peak acceleration, power and dW/dt were also significantly reduced in patients with IDC at rest and during exercise. Time to peak flow (as a fraction of LV ejection time) was consistently prolonged in patients with IDC (rest, 0.40 +/- 0.08 vs 0.29 +/- 0.04; exercise, 0.36 +/- 0.06 vs 0.28 +/- 0.04, both p less than 0.01). Exercise-induced increments in peak flow, power and dW/dt were significantly blunted in patients with IDC. Studies during pacing tachycardia and nitroprusside administration failed to reproduce the abnormalities during exercise in patients with IDC. Thus, the instantaneous flow pulse in heart failure is both diminished in magnitude (decreased stroke volume and peak flow) and abnormal in shape (decrease peak acceleration and delayed time to peak flow). Exercise stress in IDC results in abnormalities of LV performance that can be detected using instantaneous ejection information. These abnormalities are unlikely to be explained by changes in heart rate or loading conditions. PMID- 3825908 TI - Progressive atrioventricular valvular regurgitation in single ventricle. AB - The hemodynamic status of the patient with single ventricle is not static. This study describes the rapid development of mechanical malfunction of the atrioventricular (AV) valve in a subset of patients with single ventricle. Eighty patients with single ventricle were reviewed. Eight patients with single ventricle and single AV valve were observed to have moderate to severe AV valvular regurgitation. Patient age when AV regurgitation was first detected was 22 months to 35 years (median 15 years). Clinically, all patients were symptomatic and had severe congestive heart failure. All patients underwent cardiac catheterization, which revealed moderate to severe AV regurgitation; 7 of 8 patients had well preserved ventricular function. Earlier catheterization revealed no significant AV regurgitation. Four patients underwent surgery: 2 had AV valve replacement with the Fontan procedure and 2 had Carpentier ring placement (1 with the Fontan procedure). The 3 survivors were in improved clinical condition. At surgery 1 patient had an abnormal AV valve with 4 leaflets, and the other 3 had myxomatous degeneration of the AV valve. Thus, AV regurgitation is a significant and specific complication that occurs in patients with single ventricle and single AV valve. If recognized before development of eventual myocardial dysfunction, surgical management should be considered. PMID- 3825909 TI - Influence of exercise on coronary sinus blood flow determinations. AB - Consecutively measured values of coronary sinus blood flow were compared to assess the reproducibility of the coronary sinus thermodilution technique. Values measured at rest and during exercise were evaluated and the influence of the respiratory cycle on reproducibility was studied. Correlation of consecutive values revealed a coefficient of 0.94 at rest and 0.93 during exercise. Differences between mean values of consecutive measurements were nonsignificant. A comparison of the coefficients of variation at rest (8.50 +/- 7.09) and exercise (8.02 +/- 4.75) revealed no significant difference. Variation about mean coronary sinus blood flow due to inspiration and expiration was similar at rest and during exercise (42% and 37%, respectively). Provided that critical variables are closely monitored, the coronary sinus thermodilution technique is a highly reproducible technique in a clinically feasible setting. PMID- 3825910 TI - Evaluation of pulmonary artery pressure and resistance by pulsed Doppler echocardiography. AB - Pulsed Doppler echocardiography was used to examine the relation between pulmonary valve motion and pulmonary artery (PA) flow velocity patterns in 39 adults. In 16 patients with normal PA pressure (mean pressure less than 20 mm Hg), PA flow velocity accelerated slowly to a peak flow velocity at midsystole (time to peak flow velocity, or acceleration time = 134 +/- 20 ms [mean +/- standard deviation]), followed by a slow deceleration to the end of ejection, producing a "dome-like" appearance. In contrast, in 23 patients with elevated PA pressure (mean pressure 20 mm Hg or more), flow velocity accelerated rapidly to a peak flow velocity in early systole (acceleration time = 88 +/- 25 ms, p less than 0.01), followed by rapid flow velocity deceleration to a nadir in midsystole. In 13 of these patients, a transient increase in flow velocity occurred in late systole, producing a "spike and dome" appearance. In patients with an acceleration time of 120 ms or less, there was a negative linear correlation with mean PA pressure, expressed by the equation: mean PA pressure = 90 - (0.62 X acceleration time). The standard error of the estimate was 8.3 mm Hg. A similar negative linear correlation was found between PA acceleration time and total pulmonary resistance. Using a PA acceleration time of 100 ms or less resulted in a 78% sensitivity and a 100% specificity for detection of elevated PA pressure. Although this Doppler method cannot precisely estimate PA pressure, it can be helpful in separating patients with normal pressure from those with elevated PA pressure. PMID- 3825911 TI - Relation of oxygen uptake to work rate in normal men and men with circulatory disorders. AB - The relation between the increase in oxygen uptake (VO2) and increase in work rate (WR) between unloaded pedaling and maximal work during incremental cycle ergometer exercise was studied in normal men, men with uncomplicated systemic hypertension and ambulatory men with various cardiovascular diseases. The postulation was that impaired peripheral oxygen delivery would reduce the ratio of the oxygen utilized relative to work performed. The ratio of increase in VO2 to increase in WR (delta VO2/delta WR) was relatively constant: 10.29 +/- 1.01 ml/min/W in normal men (n = 54) for exercise 6 to 14 minutes in duration with uniform work increments of 15, 20, 25 or 30 W/min, regardless of age. The value in men with uncomplicated systemic hypertension (n = 24) was not significantly different from that of normal men. However, more than half of the men with peripheral vascular disease (n = 7) or pulmonary vascular disease (n = 5) or men who had electrocardiographic abnormalities during exercise (n = 39) had a significantly lower delta VO2/delta WR, 8.29 +/- 1.17 ml/min/W (p less than 0.05) especially evident as maximal work rates were approached. Thus, delta VO2/delta WR during incremental exercise testing is predictable for normal men and a reduction in this ratio indicates cardiovascular dysfunction. PMID- 3825912 TI - Pharmacodynamics of 3-hydroxyquinidine alone and in combination with quinidine in healthy persons. AB - The relation between serum concentration of 3-hydroxyquinidine (3-OHQ), a major metabolite of quinidine in humans, and the pharmacologic effect alone and in combination with the parent drug was studied. The heart rate-corrected, computer averaged QT interval (QTc) was used as the pharmacologic endpoint. In a randomized, double-blind study, 5 healthy subjects received, on 3 separate days 1 week apart, either (1) 300 to 400 mg 3-OHQ orally or (2) 150 mg quinidine base intravenously or (3) a combination in the same doses. Blood samples and electrocardiographic recordings were obtained over the following 10 hours. Serum concentrations of 3-OHQ and quinidine were determined by high-pressure liquid chromatography and the free fraction by ultrafiltration. Peak concentrations of 3 OHQ varied between 1,362 and 3,480 ng/ml after oral 3-OHQ ingestion, but were negligible after intravenous quinidine infusion. The free fraction was 49% +/- 4.8 (mean +/- standard deviation) for 3-OHQ and 20% +/- 4.3 for quinidine. In all 5 subjects a statistically significant correlation was found between serum concentration and QTc prolongation for both quinidine and 3-OHQ (largest p value less than 0.025). The mean slope of the regression line was 0.0184 +/- 0.0128 for 3-OHQ and 0.0297 +/- 0.0111 for quinidine. Multiple linear regression revealed in each subject a significant additive effect of 3-OHQ when administered together with quinidine (largest p value less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825913 TI - Left ventricular function during alcohol intoxication and autonomic nervous blockade. AB - Eight healthy young subjects (6 men, 2 women) entered a controlled investigation of left ventricular (LV) function during alcohol intoxication and autonomic nervous blockade. Radionuclide cardiography was performed at rest and during upright 50% submaximal bicycle exercise. During alcohol intoxication alone (serum ethanol 30 mmol/liter), heart rate at rest increased by 11% (p less than 0.05) and LV ejection fraction (EF) decreased by 6% because of end-systolic dilation. No significant alcohol-induced hemodynamic changes were observed during exercise. Plasma norepinephrine concentration increased by 29% (p less than 0.05), whereas plasma epinephrine concentration did not change. During subsequent autonomic nervous blockade with intravenous metoprolol and atropine infusion, heart rate at rest further increased and systolic blood pressure decreased. These changes were not, however, significantly different from those of a control experiment in which a nonalcoholic isocaloric drink was substituted for alcohol. Plasma norepinephrine levels at rest and during exercise were 25% and 32% higher (both p less than 0.05), respectively, than those during control conditions. Plasma epinephrine concentrations did not change. These findings suggest that alcohol intoxication has a depressant effect on LV function at rest that stimulates autonomic nervous blockade. The increased sympathetic nervous activity during exercise appears to be a toxic rather than a compensatory effect of alcohol. PMID- 3825914 TI - The systematic practice of preventive cardiology. PMID- 3825915 TI - Risk stratification in stable angina pectoris. PMID- 3825916 TI - Identification of risk factors for development of acute myocardial infarction or life-threatening ventricular arrhythmia in unstable angina pectoris. PMID- 3825917 TI - Doppler echocardiographic documentation of diastolic pulmonary artery forward flow. PMID- 3825918 TI - Left coronary artery to right ventricular fistula after total repair for tetralogy of Fallot. PMID- 3825919 TI - Time variability of cardiac output and stroke volume in persons without cardiac disease. PMID- 3825920 TI - Identification of dissection or aneurysm of the descending thoracic aorta by conventional and transesophageal two-dimensional echocardiography. PMID- 3825921 TI - Fast foods and quick plaques. PMID- 3825923 TI - Hypercalcemia and J waves. PMID- 3825922 TI - Coronary reperfusion catheter technique. PMID- 3825924 TI - Sinus venosus interatrial communication and sinus node problems. PMID- 3825925 TI - A symposium: The concept of the total ischemic burden. September 14, 1986, Washington, DC. PMID- 3825926 TI - Circadian rhythms and coronary artery disease. AB - Circadian variations have long been observed in several metabolic functions, many of which are directly or indirectly related to the cardiovascular system and its pathophysiology. Recent reports linking circadian patterns to the development of symptomatic and asymptomatic myocardial ischemia, sudden cardiac death and myocardial infarction raise important questions concerning the mechanisms of myocardial ischemic activity in patients with coronary artery disease, and they have implications for prognosis, therapy and further research. PMID- 3825927 TI - Holter monitoring in assessment of angina pectoris. AB - Holter monitoring of ST-segment changes is a unique method of studying the character of transient myocardial ischemia that occurs during ordinary daily life. The electrocardiographic signal is a reliable marker of ischemia in defined populations of patients with angina and coronary disease, but should be interpreted with caution outside of these groups. Detailed studies in patients with chronic stable angina have shown that transient ischemia is frequently silent and prolonged, and may occur without evidence of physical exertion. Analysis of underlying changes in regional myocardial perfusion using rubidium-82 and positron tomography has shown that a decrease in myocardial perfusion (supply) is involved in the genesis of many episodes of ischemia during daily life. Clinical trials have shown that drugs that affect demand and supply are efficacious against both painful and painless ischemia and that combinations of agents can provide useful benefits. There is, however, marked natural variability in disease activity despite "stable" symptoms, which must be taken into account in individual patient assessment and the rational design of clinical trials. Ambulatory monitoring permits quantitation of previously unrecognized myocardial ischemia, and treatment can thus be assessed in terms of ischemic activity during everyday life rather than on data obtained during brief hospital visits. An active approach to the detection and monitoring of transient ischemia with and without pain will be necessary if prospective clinical research shows that treatment of silent myocardial ischemia can prevent myocardial damage and improve prognosis. PMID- 3825928 TI - Total ischemic burden: pathophysiology and prognosis. AB - Myocardial ischemia is caused by decreased supply (primary ischemia), increased demand (secondary ischemia) or a combination of the two (mixed ischemia). The sum of all episodes--with or without pain--constitutes the total ischemic burden. During out-of-hospital activities, many episodes occur at lower than expected heart rates, suggesting that a vasoconstrictive component is involved in the genesis of such episodes. These silent attacks may be even more important clinically than painful attacks. It has been suggested that silent myocardial ischemia has an adverse impact on prognosis in patients with totally asymptomatic ischemia or asymptomatic postinfarction ischemia. Further, it has been shown that there is a direct relation between the duration and frequency of silent myocardial ischemia and subsequent cardiac events in patients with unstable angina. Therefore, aggressive therapy may be warranted in certain groups of patients in whom silent myocardial ischemia constitutes a significant part of the total ischemic burden. PMID- 3825929 TI - Management of the total ischemic burden in angina pectoris. AB - Recent reports suggest that neither the severity nor control of angina influences prognosis in patients with coronary heart disease. One possible explanation for such findings is that episodes of angina are only a small fraction of the daily ischemic episodes occurring in these patients. Silent episodes represent most of the ischemic burden in many patients with coronary disease who have positive exercise test results despite the absence of pain. Silent episodes also represent most of the ischemic burden in patients with either stable or unstable angina. Since silent episodes may have prognostic significance, a major goal of therapy should be the modification of both silent and painful ischemic episodes. Currently available pharmacotherapy has the potential to reduce the total ischemic burden caused by both painful and painless attacks and, thereby, alter prognosis. PMID- 3825930 TI - Significance of silent myocardial ischemia during exercise testing in patients with coronary artery disease. AB - To evaluate the significance of ischemic ST-segment depression without associated chest pain during exercise testing, data were analyzed from 2,982 patients from the Coronary Artery Surgery Study (CASS) registry who underwent coronary arteriography and exercise testing and were followed up for 7 years. Patients with proved coronary artery disease (CAD) (at least 70% diameter narrowing) were grouped according to whether they had at least 1 mm of ST-segment depression or anginal chest pain during exercise testing. Four hundred twenty-four had ischemic ST depression without angina (group 1); 232 had angina but no ischemic ST depression (group 2); 456 had both ischemic ST depression and angina (group 3); and 471 had neither ischemic ST depression nor angina (group 4). Sixty-three percent of patients in group 1 and 55% in group 2 had multivessel CAD (difference not significant). The 7-year survival rates were similar for patients in groups 1 (76%), 2 (77%), and 3 (78%), but were significantly better for patients in group 4 (88%, p less than 0.001). Among group 1 patients, survival was related to severity of CAD (p less than 0.001). The 7-year survival rate in group 1 was significantly worse than that in a separate group of 282 patients with ischemic ST depression without angina during exercise testing who had no CAD (95% survival, p less than 0.001). Thus, in patients with silent myocardial ischemia during exercise testing, the extent of CAD and the 7-year survival rate are similar to those of patients with angina during exercise testing. Prognosis is determined primarily by the severity of CAD. In patients without CAD, the survival rate is excellent. PMID- 3825931 TI - An angiographic and functional comparison of patients with silent and symptomatic treadmill ischemia early after myocardial infarction. AB - Sixty consecutive patients were studied who had positive responses to Naughton exercise treadmill testing (at least 1.5 mm of ST-segment shift in at least 2 leads or thallium reperfusion abnormalities) with or without symptoms of angina 11 +/- 1 days after acute myocardial infarction (AMI). All patients had undergone coronary angiography 24 +/- 4 days after infarction. Thirty-eight patients (63%) had no treadmill angina (silent ischemia, group I) and 22 patients had typical treadmill angina (symptomatic ischemia, group II). Use of beta-blocking drugs, calcium antagonists and nitrates at the time of exercise testing did not differ in the 2 groups. All 9 patients with diabetes mellitus were in the asymptomatic group (p less than 0.40) and group I had a greater proportion of inferior wall AMI (30 of 38) than group II (11 of 22, p = 0.02). Total exercise treadmill test duration (group I 422 +/- 31 seconds, group II 400 +/- 46 seconds) and rate pressure product were not different in the 2 groups. The number of patients unable to exercise 5 minutes (12 in group I and 7 in group II), the number with diffuse electrocardiographic changes (9 in group I and 7 in group II), and the number with inadequate blood pressure response (8 in group I and 4 in group II) were also similar. At coronary arteriography the mean number of arteries with at least 70% diameter stenosis was 2.0 +/- 0.2 in group I and 2.2 +/- 0.2 in group II (difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825932 TI - Demonstration of exercise-induced painless myocardial ischemia in survivors of out-of-hospital ventricular fibrillation. AB - To ascertain if myocardial ischemia is the mechanism of out-of-hospital ventricular fibrillation (VF), left ventricular (LV) function was assessed at rest and during submaximal exercise in 15 patients who survived out-of-hospital VF. They were separated into asymptomatic (9 patients, group A) and symptomatic (6 patients, group S) groups for a history of angina or myocardial infarction. Both groups had significant (at least 70% diameter stenosis) coronary artery disease. At catheterization no patient had angina during exercise, but 12 of 15 had ST depression or increased ST depression (group A, 1.9 +/- 1.4 mm; group S, 1.1 +/- 1.2 mm) and 11 had abnormal wall motion. From rest to exercise, patients in group S had increased LV end-diastolic pressure (from 21 +/- 9 to 37 +/- 11 mm Hg, p = 0.009) and volume (from 100 +/- 25 to 107 +/- 26 ml/m2, p = 0.006), with no significant change in LV ejection fraction (from 40 +/- 13 to 42 +/- 12%). In group A LV end-diastolic pressure increased from 19 +/- 4 to 31 +/- 8 mm Hg (p = 0.001), but neither end-diastolic volume nor ejection fraction changed significantly (from 83 +/- 13 to 92 +/- 23 ml/m2 and from 55 +/- 13% to 46 +/- 13%, respectively). Thus, patients with coronary artery disease who survive out of-hospital VF may have evidence of myocardial ischemia during exercise without pain. Painless ischemia may have a role in out-of-hospital VF. PMID- 3825933 TI - Characteristics of silent myocardial ischemia during out-of-hospital activities in asymptomatic angiographically documented coronary artery disease. AB - Ambulatory electrocardiographic monitoring is useful in documenting characteristics of both painful and silent myocardial ischemia occurring during out-of-hospital activities in patients with angina and coronary artery disease (CAD), but few data are available concerning silent myocardial ischemia during ambulatory electrocardiographic monitoring in asymptomatic patients with CAD. Accordingly, 480 hours of ambulatory electrocardiographic monitoring were recorded in 10 asymptomatic patients with CAD not receiving cardiac drugs (48 hours/patient). All 10 patients had silent myocardial ischemia on treadmill exercise testing, with initial ST-segment depression at 2 to 6 minutes in 7 patients and more than 6 minutes in 3 patients. During ambulatory electrocardiographic monitoring, 64 episodes of silent myocardial ischemia (1 mm of ST-segment depression for at least 1 minute) were recorded, ranging from 1 to 17 episodes/patient/48 hours. Of the 64 silent myocardial ischemic episodes, 30 (47%) occurred between 6 am and noon. Duration of silent myocardial ischemia was 798 minutes (range 1 to 80). ST-segment depression ranged from 1 to 4.5 mm. Heart rate at onset of the episodes on ambulatory electrocardiographic monitoring ranged from 65 to 150 beats/min (mean 98), which was significantly less than that during treadmill exercise testing in the same patients (mean 120). At cardiac catheterization, 7 patients had 2- or 3-vessel CAD and 3 had 1-vessel CAD. Thus, silent myocardial ischemia is common during daily life in asymptomatic CAD patients with positive treadmill exercise tests. PMID- 3825934 TI - Magnitude and determinants of coronary artery disease in juvenile-onset, insulin dependent diabetes mellitus. AB - The risk of premature coronary artery disease (CAD) and its determinants were investigated in a cohort of 292 patients with juvenile-onset, insulin-dependent diabetes mellitus (IDDM) who were followed for 20 to 40 years. Although patients with juvenile-onset IDDM had an extremely high risk of premature CAD, the earliest deaths due to CAD did not occur until late in the third decade of life. After age 30 years, the mortality rate due to CAD increased rapidly, equally in men and women, and particularly among persons with renal complications. By age 55 years the cumulative mortality rate due to CAD was 35 +/- 5%. This was far higher than the corresponding rate for nondiabetic persons in the Framingham Heart Study, 8% for men and 4% for women. Angina and acute nonfatal myocardial infarction followed a similar pattern, as did asymptomatic CAD detected by stress test, so that their combined prevalence rate was 33% among survivors aged 45 to 59 years. Age at onset of IDDM and the presence of eye complications did not contribute to risk of premature CAD. This pattern suggests that juvenile-onset diabetes and its renal complications are modifiers of the natural history of atherosclerosis in that although they profoundly accelerate progression of early atherosclerotic lesions to very severe CAD, they may not contribute to initiation of atherosclerosis. PMID- 3825935 TI - Duration of effects and tolerance of slow-release isosorbide-5-mononitrate for angina pectoris. AB - Isosorbide-5-mononitrate (IS-5MN) is an active metabolite of isosorbide dinitrate, but unlike its parent compound, is nearly 100% bioavailable after oral administration. Once-a-day therapy with a slow-release formulation of IS-5MN is used widely in Europe for 24-hour prophylaxis of angina pectoris. In a randomized, crossover, double-blind, placebo-controlled study, the duration of effects of 50 and 100 mg of slow-release IS-5MN were evaluated after the first dose and after once-a-day therapy for 1 week in 9 patients with stable angina pectoris. Compared with placebo values, standing blood pressure decreased (p less than 0.001) and exercise time to the onset of angina and total exercise duration increased (p less than 0.008 and p less than 0.003) at 4 hours, but not at 20 or 24 hours after first dose of 50 and 100 mg of slow-release IS-5MN. After once-a day therapy for 1 week, no improvement in exercise duration or reduction in ST segment depression was seen after 50 or 100 mg of slow-release IS-5MN at 4, 20 or 24 hours despite high plasma IS-5MN concentrations. Thus, despite therapeutic plasma concentrations, 50 and 100 mg of slow-release IS-5MN did not exert antianginal or anti-ischemic effects at 20 and 24 hours after the first dose and at 4, 20 and 24 hours after sustained once-a-day therapy for 1 week. PMID- 3825936 TI - Usefulness of ST deviation induced by prolonged hyperventilation as a predictor of cardiac death in angina pectoris. AB - One hundred ninety patients with chronic angina for an average of 2 years were followed. Forty-seven had at least 1 mm of ST deviation in response to provocation of coronary vasoconstriction by prolonged hyperventilation (group I); 143 had no ST deviation (group II). The angiographic response to this test was studied in 21 patients from group I, and revealed 25 to 100% diameter reduction; in group II 9 patients showed a 5 to 14% diameter reduction. In group I, 15 patients (32%) died (hazard rate = 0.17 deaths/patients X years) vs 18 (13%) in group II (hazard rate = 0.06) (p less than 0.01). Seven patients in group I (15%) and 3 in group 2 (2%) died while waiting for surgery (p less than 0.01). All patients who died had coronary stenoses of at least 70%. A Cox regression analysis, using 24 variables (invasive and noninvasive), showed a positive hyperventilation test (ST deviation at least 1 mm), low ejection fraction and systolic blood pressure of at least 160 mm Hg to be independent predictors of death (p less than 0.05). Considering only deaths in non-operated patients (patients waiting for surgery and patients not planned to undergo operation), a rate-pressure product/100 of 150 or less at exercise stress testing, left ventricular end-diastolic pressure of 15 mm Hg or more and duration of angina less than 1 year were also independent predictors of death. Thus, the hyperventilation test may be useful for identifying angina patients who are at high risk of cardiac death due to dynamic coronary obstructions. PMID- 3825937 TI - Acute hemodynamic effects of intravenous nicardipine in patients treated chronically with propranolol for coronary artery disease. AB - Intravenous nicardipine, 5 mg, was infused over 5 minutes in 2 comparable groups of 8 patients with chronic coronary artery disease but no clinical signs of heart failure. Eight patients had received no previous treatment and served as a control group; 8 other patients had received long-term treatment with large doses of propranolol. The hemodynamic responses to nifedipine were similar in the 2 groups, but was greater in patients taking propranolol. At 10 minutes, systemic vascular resistance decreased by 47% in patients taking propranolol and by 39% in the control group; mean aortic pressures decreased by 25% and 10%; heart rate increased by 23% and 19%; and cardiac index increased by 45% in both groups. At 20 minutes, left ventricular end-systolic volume index decreased by 20% in patients taking propranolol and 15% in the control patients; angiographic stroke index increased by 19% and 8%; left ventricular ejection fraction increased by 22% and 11%; and mean circumferential fiber velocity increased by 46% and 32%. Intravenous nicardipine infusion (5 mg) did not induce negative inotropic effects in patients with chronic coronary heart disease, and no evidence of congestive heart failure was seen, even in patients receiving large doses of propranolol. Nicardipine counteracted the potential deleterious effects of propranolol; increased peripheral vascular resistance and left ventricular stroke work and decreased cardiac output. PMID- 3825938 TI - Electrocardiographic evolution of posterior acute myocardial infarction: importance of early precordial ST-segment depression. AB - Precordial ST-segment depression is typically observed in anterior non-Q-wave acute myocardial infarction (AMI), and is generally not regarded as an indication for acute thrombolytic therapy. Of 544 patients with creatine kinase (CK)-MB confirmed non-Q-wave AMI randomized to the prospective multicenter Diltiazem Reinfarction Study, 50 patients (9.2%) had isolated precordial ST-segment depression of 1 mm or more in 2 or more contiguous precordial electrocardiographic leads (V1-V4). Serial electrocardiograms recorded at study entry (mean 50.5 hours after onset of chest pain), on study day 2, study day 3 and at predischarge showed that in 23 of 50 patients (40%) electrocardiographic evidence of posterior AMI evolved, defined as an R wave of 0.04 second or more in lead V1 and an R:S greater than or equal to 1 in lead V2. In 18 of these 23 patients (78%), posterior AMI had evolved by study day 3, and none had an abnormal reelevation of CK-MB (every 12-hour sampling) for up to 14 days of hospitalization. Compared with the remaining 27 patients who had electrocardiographic features of anterior non-Q-wave AMI only, the 23 with initial precordial ST segment depression in whom posterior AMI developed had significantly higher mean peak CK values (1,051 +/- 172 vs 663 +/- 89 IU, p less than 0.009) and greater mean precordial ST-segment depression in lead V1 (0.28 vs + 0.19 mm, p = 0.01), in lead V2 (1.3 vs 0.26 mm, p = 0.003) and in lead V3 (2.0 vs 0.93 mm, p = 0.0004).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825939 TI - Recurrent early ischemic events after thrombolysis for acute myocardial infarction. AB - Myocardium salvaged by early thrombolysis and then perfused through a residual stenosis may be at risk for ischemic events. To investigate this possibility, the short-term (2-week) clinical course of 81 consecutive patients managed within a randomized intracoronary thrombolysis trial was reviewed. All patients underwent coronary angiography within 5 hours of symptoms of acute myocardial infarction and were stratified into the following 3 outcome groups: patients with initially subtotal occlusion (subtotal group, n = 17), those with initial total occlusion and infarct artery reperfusion (reperfused group, n = 24) and those with continued infarct artery occlusion (occluded group, n = 40). Recurrent ischemic events were defined as spontaneous typical angina, provokable angina on predischarge exercise testing, and reinfarction. Eleven of 17 patients (65%) in the subtotal and 11 of 23 patients (48%) in the reperfused groups had an ischemic event (difference not significant). In contrast, 4 of 37 patients (11%) with occlusion had an ischemic event (p less than 0.01 compared with patients in the subtotal or reperfused groups). Four patients were excluded because of early (within 72 hours) elective coronary bypass surgery or death from pump failure. To eliminate the impact of multivessel coronary artery disease (CAD), 39 patients with 1-vessel CAD were analyzed separately. Five of 9 patients (56%) in the subtotal group, 3 of 10 (30%) in the reperfused group and only 2 of 20 (10%) in the occluded group had an ischemic event. These observations suggest the need for a more definitive revascularization strategy for acute myocardial infarction. PMID- 3825940 TI - Comparison of monoplane and biplane assessment of regional left ventricular wall motion after thrombolytic therapy for acute myocardial infarction. AB - Regional left ventricular (LV) function was assessed using serial biplane orthogonal LV angiograms recorded before and after reperfusion therapy for acute myocardial infarction (AMI) in 24 patients. Improvement in regional LV function was seen in only 5 patients after reperfusion therapy when only the right anterior oblique view was analyzed; improvement in regional wall motion was seen in 14 when biplane views were analyzed. Biplane analysis was particularly important in the 12 patients with right coronary artery occlusion, among whom the right anterior oblique view showed improvement in only 1 patient but the left anterior oblique view showed improvement in 6 patients (p less than 0.05). Biplane analysis is more sensitive than monoplane right anterior oblique analysis alone for detecting improvement in LV function after reperfusion therapy for AMI. However, both views are complementary, adding information about regional function not revealed by either view alone. PMID- 3825942 TI - Role of invasive electrophysiologic testing in patients with symptomatic bundle branch block. AB - Electrophysiologic testing was performed in 112 symptomatic patients with bundle branch block. Abnormalities included HV interval 70 ms or longer (35 patients), infra-Hisian block with atrial pacing (6 patients) and sinus node dysfunction (23 patients). Inducible ventricular tachycardia occurred in 47 patients (42%). Therapy was based on the electrophysiologic test result: group I--16 patients with no therapy (normal study results); group II--34 patients with permanent pacing alone; group III--39 patients with antiarrhythmic therapy alone; and group IV--21 patients with both antiarrhythmic therapy and permanent pacing. Cumulative 4-year survival rates were 83% in group I, 84% in group II, 63% in group III and 84% in group IV (mean follow-up 2.5 years). Recurrent syncope occurred in 19% of group I, 6% of group II, 33% of group III and 19% of group IV. In symptomatic patients with bundle branch block and normal electrophysiologic test results, prognosis is good without treatment. In patients undergoing permanent pacing based on electrophysiologic testing, survival is good and rate of symptom recurrence is low. Electrophysiologic testing identifies patients with inducible ventricular tachycardia for whom antiarrhythmic therapy is indicated but who nevertheless have a poor prognosis. PMID- 3825941 TI - Frequency and size of coronary arterial aneurysm at necropsy in Kawasaki disease. AB - The diameter of the largest coronary arterial aneurysm was examined in 61 autopsied children with Kawasaki disease. Thirty children died during the acute stage: The largest diameter of the coronary aneurysm was 6 mm or more in 23 who died of coronary heart disease and 4.5 mm or less in 7 who died of myocarditis. Thirty-one children died during the healed stage: The diameter of the largest coronary aneurysm was 8 mm or more in 26, to 8 mm in 3, and 2.5 mm or less (normal) in 2. Two patients without coronary aneurysms died of bacterial infections or accidents. Twenty-nine patients with a coronary aneurysm 6 mm or more in diameter died of coronary heart disease. Twenty-three of 26 children with a coronary aneurysm 8 mm or larger had multivessel coronary aneurysms. PMID- 3825943 TI - Evaluation of pacemaker pulse generator and patient longevity in patients aged 1 day to 20 years. AB - The longevity of pediatric patients requiring pacemakers and the survival rates of the implanted generators were evaluated. From January 1970 to December 1985, 96 patients aged 1 day to 20 years underwent 162 pulse generator implantation procedures. Indication for initial implantation was surgically induced heart block in 52 patients, sick sinus syndrome in 20, congenital complete heart block with symptoms of low cardiac output in 19 and tachydysrhythmia control in 5. Modal age at initial implantation was less than 1 year; median age was 5 years. During this period 90 generators were removed from service: 49 (54%) because of generator failure, 22 (24%) because the patient died, 12 (13%) because of elective upgrade at the time of lead failure or cardiac surgery, 5 (6%) because of generator pocket infection and 2 (2%) because of manufacturer's recall. Pulse generators were separated into 4 groups based upon generator technology. Group I (n = 16) were asynchronous units with mercury-zinc batteries; group II (n = 18) were single-chamber demand units with mercury-zinc batteries; group III (n = 14) were single-chamber demand units with rechargeable batteries; and group IV (n = 114) were single- or dual-chamber demand units with lithium batteries. Patient survival rate was 84% at 6 months and 70% by 109 months. There was no further decrease to the end of the study period. Six-month generator survival rate was 82% for all groups, mostly a reflection of patient deaths.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825944 TI - Prevalence of ischemia by quantitative thallium-201 scintigraphy in patients with ventricular tachycardia or fibrillation inducible by programmed stimulation. AB - The prevalence of exercise-induced ischemia was determined by thallium-201 (TI 201) scintigraphic criteria in patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) inducible by programmed electrical stimulation. Thirty-eight patients (age 57 +/- 19 years), of whom 87% had angiographic coronary artery disease, underwent quantitative TI-201 exercise scintigraphy within 14 days of invasive electrophysiologic testing. The mean rest ejection fraction was 38 +/- 9%. Eighty percent of patients had 1 or more regions with akinetic or dyskinetic wall motion. Thallium-201 scan segments were scored as normal or containing redistribution defects or mild or severe persistent defects. Only 4 patients (10%) had only redistribution defects and 9 (24%) had both redistribution defects and persistent defects; 32 of 38 patients (84%) had 1 or more persistent defects, of which 26 had at least 1 severe, persistent defect (more than 50% reduction in TI-201 activity). Patients with and without exercise induced VT had a similar prevalence of redistribution. Redistribution defect prevalence was similar in patients with polymorphic VT (3 of 13) and monomorphic VT (10 of 25) during programmed electrical stimulation (difference not significant). Thus, patients with VT or VF induced by programmed ventricular stimulation have extensive TI-201 scintigraphic abnormalities on exercise scintigrams, predominantly those suggesting scar, with associated severe regional wall motion abnormalities at rest. The scintigraphic prevalence of exercise induced ischemia is low and TI-201 redistribution and exercise ST depression are observed with equal frequency in patients with and those without VT induced during exercise. PMID- 3825945 TI - Amiodarone-induced thyroid gland dysfunction. AB - Of a population of 400 patients treated with amiodarone, 97 underwent thyroid function evaluation. Of these, 20 patients proved to be thyrotoxic and 16 hypothyroid. In thyrotoxic patients, symptoms developed 2 to 36 months after starting treatment with amiodarone, the most specific laboratory finding being a high total T3 (TT3). No antithyroid treatment proved useful. Thyroid function returned to normal 3 to 7 months after stopping amiodarone therapy. In the hypothyroid group, a high thyroid-stimulating hormone was the most specific laboratory finding. These patients were treated with substitute therapy with or without withdrawal of amiodarone. The iodine content of the thyroid gland in part of this population taking amiodarone was measured by in vivo x-ray fluorescence. Patients in whom thyrotoxicosis developed showed especially high iodine contents. During treatment with amiodarone, patients at high risk of thyrotoxicosis were recognized by increasing TT3 values and higher iodine thyroid levels. A reduction in maintenance dose should be considered in this specific population. PMID- 3825946 TI - Echocardiographically determined left ventricular structural and functional correlates of complex or frequent ventricular arrhythmias on one-hour ambulatory electrocardiographic monitoring. AB - The associations between 6 echocardiographic measurements and ventricular arrhythmias on 1-hour ambulatory electrocardiograms were evaluated in 3,348 subjects of the Framingham Heart Study who were free of symptomatic coronary artery disease, congestive heart failure and valvular heart disease and were not receiving diuretic drugs or other blood pressure or cardiac medications. Age adjusted estimates of association between echocardiographic measurements of left ventricular (LV) structure and function and complex or frequent (Lown grade 2 or greater) ventricular arrhythmia were computed using logistic regression. In this bivariate model only LV internal diameter (systolic and diastolic) and fractional shortening were associated with arrhythmia in both sexes (p less than 0.01). When all variables were entered into a multivariate model, only age and systolic LV internal diameter remained independently associated with arrhythmia (p less than 0.001). Thus, LV chamber size and function are important predictors of risk for ventricular arrhythmia. Systolic LV internal diameter, which reflects both functional and structural information, is the only measurement independently predictive of arrhythmia risk in persons free of apparent heart disease. PMID- 3825947 TI - Value of electrophysiologic testing in patients with nonsustained ventricular tachycardia. AB - This study was undertaken to determine the value of electrophysiologic testing in 61 patients with nonsustained ventricular tachycardia (VT) (3 or more beats) on ambulatory monitoring and no history of sustained ventricular arrhythmia. The study group consisted of 38 patients with coronary artery disease (CAD), 9 with idiopathic dilated cardiomyopathy and 14 with a normal heart. Nonsustained VT (at least 3 but not more than 15 beats) was induced in 46%, sustained VT (more than 15 beats) in 15% and no VT in 39%. Sustained VT was induced more frequently in the presence of left ventricular dysfunction (p = 0.005) but was not related to the presence of CAD. Over a mean follow-up of 26 months, 10 patients died from cardiac causes (4 suddenly), including 1 patient with inducible sustained VT, 2 with nonsustained VT and 7 with no inducible VT. Inducibility was not related to survival, either as a single variable or when combined with CAD, left ventricular dysfunction or recent myocardial infarction. Left ventricular function alone was a good predictor of outcome. Of 46 patients with an ejection fraction of 35% more or in New York Heart Association functional class I or II, 3 (7%) died from cardiac causes, compared with 7 of 13 patients (54%) with an ejection fraction of less than 35% or in functional class III or IV (p = 0.0001). Thus, in patients with nonsustained VT, the incidence of sustained VT during electrophysiologic testing is low and is related to the degree of left ventricular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825948 TI - A study of modulated ventricular parasystole by programmed stimulation. AB - To analyze the phase-dependent sensitivity of the parasystolic pacemaker to nonparasystolic beats, 11 patients with modulated ventricular parasystole were studied using the ventricular extrastimulus method. The intrinsic parasystolic cycle lengths ranged from 1,100 to 1,800 ms. Premature stimuli altered the duration of the parasystolic cycle lengths by amounts that depended on timing of the test impulses within the parasystolic cycles. Premature impulses delivered during the first part of the parasystolic cycles prolonged the parasystolic cycle lengths to 107 to 151% of the intrinsic parasystolic cycle lengths and impulses applied during the second part abbreviated them to 70 to 81% of the intrinsic parasystolic cycle lengths. In 10 patients the accelerating effects were of greater magnitude than the decelerating effects. Transition from the accelerating to slowing phases was progressive or unstable in 9 patients and abrupt in 2. Changes induced by individual stimuli were short-lived and the parasystolic pacemakers returned immediately to their original rates. In 1 patient the biphasic sensitivity of parasystole to premature stimuli was shown to sustain for 21 days. PMID- 3825949 TI - Supernormal conduction in accessory atrioventricular connections. AB - Prospective electrophysiologic evaluation of 74 patients with ventricular preexcitation revealed 4 patients who had supernormal anterograde conduction over an accessory atrioventricular pathway. In each patient, anterograde conduction over the accessory pathway was present at relatively slow sinus rates, but the accessory pathway anterograde effective refractory period was substantially prolonged. During premature atrial stimulation, a "window" of supernormal conduction was identified at which closely coupled atrial extrastimuli conducted over the accessory pathway, whereas longer premature intervals resulted in accessory pathway block. Causes other than supernormal conduction to explain this phenomenon, for example, phase 4 block, were unlikely in each case. Although the mechanism of supernormal conduction in humans is unknown, the electrophysiologic findings in our patients are similar to those reported in patients with supernormal conduction in the His-Purkinje system. PMID- 3825950 TI - Diseases and drugs causing prolongation of the QT interval. AB - The prolonged QT interval and its association with diseases and drugs was studied on the basis of computerized electrocardiograms recorded in the region of the Kuopio University Central Hospital, East Finland. Altogether, 33,655 persons in whom at least 1 electrocardiogram was recorded from 1975 to 1983 were found. The study population consisted of 183 persons with prolonged QT intervals (at least 470 ms) and 187 with normal QTc intervals (440 ms or less), aged 45 to 64 years. These subjects were selected from 14,990 persons eligible. No difference in the prevalence of diseases affecting the QTc interval was found between those with long QTc intervals and those with normal QTc intervals. No difference between the groups was found in use of quinidine, procainamide or disopyramide. When the comparison was made on the basis of all group 1A antiarrhythmic drugs (quinidine, procainamide and disopyramide combined), persons with prolonged QTc intervals used these drugs more often than did those with normal QTc intervals (p = 0.031). Use of sotalol was significantly more common (p less than 0.001) in subjects with long QTc intervals. The mortality rate was also higher in persons with prolonged QTc interval (p less than 0.001), and most deaths during follow-up were due to coronary artery disease. PMID- 3825951 TI - Cryosurgical versus catheter ablation of the atrioventricular junction. AB - Results of catheter ablation of the atrioventricular (AV) junction in 41 patients were compared with results of cryosurgical ablation in 42 patients. Mean follow up was 29 months among patients who underwent catheter ablation and 53 months among those who underwent cryosurgical ablation. In both groups complete heart block was produced in most patients (88% in the catheter ablation group, 86% in the cryosurgery group), and similar proportions of patients continued to receive antiarrhythmic drugs (27% in the catheter ablation group, 36% in the cryosurgery group). However, the short-term morbidity rate was significantly lower among patients who underwent catheter ablation (12% vs 42%) (p = 0.004). Long-term mortality and morbidity rates were not significantly different; most deaths were related to underlying cardiopulmonary disease and morbidity to problems with permanent pacemakers. Both catheter ablation and cryosurgical ablation of the AV junction are effective in creating complete AV block and controlling supraventricular tachycardia in medically refractory patients. Because catheter ablation is associated with lower short-term morbidity and avoids the need for a major surgical procedure, it is preferable to cryosurgical ablation of the AV junction when permanent abolition of AV conduction is necessary. PMID- 3825952 TI - Exercise-induced arrhythmias in diuretic-treated patients with uncomplicated systemic hypertension. AB - Although hypertensive patients have been shown to have a higher prevalence of arrhythmias during ambulatory monitoring when treated with diuretic drugs than when untreated, the effects of maximal aerobic stress on arrhythmia frequency in such patients is unknown. The incidence of arrhythmias during graded maximal treadmill exercise in a group of 68 subjects with mild, clinically uncomplicated systemic hypertension treated chronically with diuretics alone for a median of 4.5 years was compared with that in an age-matched normotensive control group. The prevalence of exercise-induced arrhythmias was higher in the group treated with diuretics than in the control group, 57% vs 38% (p less than 0.05). This difference was entirely due to the higher incidence of isolated atrial or ventricular premature complexes in the diuretic-treated patients, 44% vs 26% (p less than 0.05). There was no difference in the incidence of frequent (more than 10% of beats) or complex supraventricular or ventricular premature complexes between the diuretic-treated and control groups. Within the diuretic group, no difference in the incidence of simple or complex arrhythmia was found between men and women, between those with and those without rest or exercise-induced electrocardiographic abnormalities or between those with a serum potassium level of less than 3.7 mEq/liter vs those with a level of 3.7 mEq/liter or greater. Thus, patients with uncomplicated hypertension treated with chronic diuretic monotherapy do not appear to be at increased risk for major arrhythmias during aerobic exercise. PMID- 3825953 TI - Lack of evidence of low ionized calcium levels in systemic hypertension. AB - An epidemiologic screening survey was conducted in 325 male industrial workers to investigate the relation between serum total and ionized calcium concentrations and blood pressure. No relation was found. Previous reports of lower serum ionized calcium levels in hypertensive patients may be related to methodologic deficiencies both in the selection of subjects and in ionized calcium measurement. These data do not support the concept that increased blood pressure levels are related to calcium deficiency or to abnormal plasma calcium homeostasis. PMID- 3825954 TI - Oscillatory hyperventilation in severe congestive heart failure secondary to idiopathic dilated cardiomyopathy or to ischemic cardiomyopathy. AB - Thirty-one subjects with chronic congestive heart failure (CHF) were separated into 3 groups according to ventilatory patterns during graded exercise: Group 1- oscillators (n = 6); group 2-intermediate oscillators (n = 14); and group 3- nonoscillators (n = 11). Group 1 patients showed cyclic fluctuations in minute ventilation (change of 30 to 40 liters/min) and arterial PO2 (change of 38.0 +/- 4.1 mm Hg) and PCO2 (change of 11 +/- 2.8 mm Hg). The nadir in arterial PO2 occurred at times when wasted ventilatory effort was maximal. The amplitude of ventilatory oscillations in group 1 patients increased in the transition from rest to light exercise and damped with heavy exercise. There was no evidence of alveolar hypoventilation at the nadirs of minute ventilation; arterial PCO2 was always 40 mm Hg or less. Substantial hyperventilation (ventilatory equivalent for CO2 twice normal) occurred with maximal minute ventilation in group 1 patients. Oscillatory hyperventilation correlated with severity of CHF. Maximal oxygen uptake was significantly lower in group 1 (11.7 +/- 1.1 ml/kg/min) than group 3 (17.9 +/- 1.8 ml/kg/min) (p less than 0.05). Oscillatory hyperventilation during exercise may accompany severe CHF and compounds the inadequate delivery of oxygen by the failing heart. PMID- 3825956 TI - Silent myocardial ischemia, arrhythmias and sudden death: are they related? PMID- 3825957 TI - Atypical ventricular tachycardia or motion artifact? PMID- 3825955 TI - Plasma norepinephrine levels in infants and children with congestive heart failure. AB - To characterize the sympathetic nervous system response to congestive heart failure (CHF) in infants and children, plasma catecholamine levels were measured in 102 subjects undergoing routine cardiac catheterization (mean age 3.3 years, range 0.1 to 14.7), including 61 with left-to-right shunts. Plasma norepinephrine levels were significantly higher (p less than 0.0001) in children with CHF than in those without CHF. A highly significant association (p less than 0.0001) was found between the level of plasma norepinephrine and severity of CHF symptoms. This relation was found for CHF secondary to lesions producing a left-to-right shunt and CHF resulting from primary myocardial dysfunction. In congenital lesions with a left-to-right shunt, plasma norepinephrine levels correlated well with size of the shunt (Qp/Qs) (r = 0.75, p less than 0.001) and degree of pulmonary arterial hypertension (r = 0.70, p less than 0.001). Elevation of plasma norepinephrine concentrations in infants and children are seen with severe CHF regardless of its origin. PMID- 3825958 TI - Pericarditis in acute myocardial infarction. PMID- 3825959 TI - Circular polysomes predominate on the rough endoplasmic reticulum of somatotropes and mammotropes in the rat anterior pituitary. AB - We have studied the shape and size distribution of membrane-bound polysomes in somatotropes and mammotropes, which are the sources, respectively, of growth hormone and of prolactin in the rat pituitary. The observations were made in conventional electron micrographs of these cells in situ, where occasional surface or en face views of the rough endoplasmic reticulum allow the polysomes to be seen as rows of ribosomes arranged in distinctive patterns on the membranes. It is possible by this means to characterize the shape and number of ribosomes for the total population of bound polysomes in the respective cell types. The great majority of membrane-bound polysomes in these two cell types (81% in somatotropes, 78% in mammotropes) have an approximately circular shape and contain an average of 6.8 (somatotropes) or 6.5 (mammotropes) ribosomes, which is an appropriate size for translation of the polypeptide hormones produced by these cells. About 17% of the membrane-bound polysomes in somatotropes and 20% in mammotropes have a spiral shape, resembling somewhat the letter "G," and contain about eight to nine ribosomes in both cell types. The preponderance of circular polysomes on the rough endoplasmic reticulum of somatotropes and mammotropes suggests the possibility that ribosomes (or the 40S ribosomal subunit) may recycle on the polysome after the translation of growth hormone or of prolactin. PMID- 3825960 TI - Histochemical evaluation of glycoconjugates in the male reproductive tract with lectin-horseradish peroxidase conjugates: I. Staining of principal cells and spermatozoa in the mouse. AB - Several glycoconjugates are thought to bind spermatozoa as they pass through reproductive ducts. Paraffin sections of testis, ductuli efferentes, epididymis, and vas deferens of male mice were stained with ten different lectin-horseradish peroxidase conjugates to localize possible sites of synthesis and secretion of such glycoconjugates, based on the carbohydrate moieties in their constituent oligosaccharide side chains. Principal (columnar) cells lining the efferent ducts, germinal epithelium, and developing and maturing spermatozoa were examined with light microscopy. Staining of the Golgi and apical zones of cells was interpreted as evidence for synthesis and secretion of glycoconjugates. Principal cells synthesized and secreted glycoconjugates with sugar moieties as follows: sialic acid, all regions of the efferent ducts examined; the terminal disaccharide D-galactose- (beta 1----3) -N-acetyl-D-galactosamine, all regions of ducts except epididymis I; terminal alpha-D-galactosamine, some cells in epididymis III-V; N-acetyl-D-galactosamine, ductuli efferentes, epididymis I, II, and some cells in epididymis III-V; alpha-L-fucose, ductuli efferentes, vas deferens, and all regions of the epididymis except IV; N-glycosidic side chains, ductuli efferentes, vas deferens, and epididymis I, IV, and V. All of these sugar residues as well as N-acetyl-D-glucosamine were associated with the acrosomes and tails of spermatozoa throughout the ducts except for alpha-N-acetyl-D galactosamine in epididymis I, and all occurred during one or more stages of spermiogenesis. The synthesis and secretion of glycoconjugates that bind to spermatozoa appear to involve more regions of the primary reproductive structures than was believed previously. PMID- 3825961 TI - Histochemical evaluation of glycoconjugates in the male reproductive tract with lectin-horseradish peroxidase conjugates: II. Staining of ciliated cells, basal cells, flask cells, and clear cells in the mouse. AB - Efferent reproductive ducts of male mice, including ductuli efferentes, epididymis, and vas deferens, were fixed and embedded in paraffin, and sections were stained with a battery of lectin-horseradish peroxidase conjugates to localize specific sugars or sugar sequences in glycoconjugates. Cilia and the apical surfaces of ciliated cells in the ductuli efferentes stained intensely with lectin specific for sialic acid and terminal alpha-N-acetyl-D-galactosamine. Flask cells and clear cells in the epididymis reacted positively and similarly with most lectins used, providing evidence that these cell types are related. In contrast, disparities in lectin staining suggest that flask cells and clear cells are a cell type distinct from principal cells. Basal cells were not present in the ductuli efferentes but formed a continuous layer in the epididymis and vas deferens. Basal cells contained oligosaccharides terminated by sialic acid and alpha-D-galactose and varying amounts of terminal beta-D-galactose and alpha-N acetyl-D-galactosamine. Basal cells also stained variably with lectins specific for the core region of complex type N-glycosidic side chains. The basal cells varied structurally, having long spinous apical processes approaching or reaching the lumen in region I of the epididymis and being low cuboidal or squamoid and lacking apical processes in epididymal regions II-V and in the vas deferens. The contiguous nature of the basal cells and the presence of glycoconjugates bearing terminal alpha-galactosyl residues in all basal cells suggest a possible role for these cells in a regulatory influence on transepithelial movement of fluid and/or ions in the epididymis and vas deferens. PMID- 3825962 TI - Thalamic arterial pattern: an endocast and scanning electron microscopic study in normotensive male rats. AB - Rat cerebral vasculature serves as a model for study of the pathophysiology of stroke in humans. Human thalamic arteries show a high incidence of stroke. The objective is to describe the thalamic arterial vascular pattern in normotensive male rats as the initial step for quantitative histochemical studies of enzyme activities in the walls of these vessels. Intracardiac injections of methyl methacrylate monomer provide detailed vascular endocasts. The thalamic vascular bed defined by in situ dissection, serial reconstruction, and light and scanning electron microscopy of endocasts contained four groups of vessel: ventral medial thalamic arteries, thalamic branches from the posterior cerebral artery, and ventral lateral and ventral anterior thalamic arteries. Thalamic vessels are muscular arterioles that, after three to four bipinnate branches, feed into a continuous capillary bed (no loops). The parent vessels and their subsequent branches have been evaluated in terms of their mean internal diameters, mean interbranch intervals, and branch angles. The arterial patterns to rat and human thalami are very similar, with the exception of the anterior choroidal artery which is missing in the rat. The branches supplying the thalamus in both the rat and human are closely associated with the circle of Willis; however, the constituent parts of the circle in rat vary from the pattern in human brain. The rat thalamic arteries show morphological features similar to those seen in the stroke-prone ganglionic arteries in the human basal ganglia. PMID- 3825963 TI - Dynamic histology of the antral epithelium in the mouse stomach: V. Proliferation gradient from the gland base to the isthmus at various times of day. AB - The surface epithelium of the mouse pyloric antrum invaginates into blind-ended tubules whose proliferative activity was investigated by using light microscopy and 3H-thymidine radioautography. Adult, male, CD1 mice were habituated to 12 hr of light (0600-1800 hr) alternating with 12 hr of darkness. Groups of four were given an injection of 40 mu Ci of 3H-thymidine per animal and killed 1 hr later at 0600, 1200, 1800, and 2400 hr. The glands at the base of the tubules and the adjacent isthmi were serially cross-sectioned, and 0.5-micron-thick sections were prepared for radioautography. By using morphological criteria, glands were divided into five levels from their base to the isthmus (which was considered as being a sixth level). Proliferative activity was estimated by measuring the proportion of cells incorporating 3H-thymidine (labeling index) and the proportion of cells undergoing mitosis (mitotic index). The labeling index was found to decrease gradually from a high value in the isthmus to a relatively low one in the gland base; and this was observed at four times of the day. Similar gradients were observed in the mitotic index. Moreover, significant circadian variation was disclosed at most levels by comparing either labeling or mitotic index at four different times of the day. The labeling index tended to peak at the transition from dark to light (0600 hr) and drop at the transition from light to dark (1800 hr).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825964 TI - Comparative study of cytoplasmic elimination in spermatids of selected mammalian species. AB - In the transformation of a spermatid into a spermatozoon, cytoplasmic loss occurs, allowing the sperm to swim unhindered. Cytoplasmic loss takes place via elimination of the residual body and through structures known as tubulobulbar complexes. A determination of cytoplasmic loss in several species was undertaken by using high-resolution electron microscopic morphometric techniques. During the period that tubulobulbar complexes are present, an average 53% cytoplasmic loss was recorded for five species (guinea pig, 48.8 +/- 6.2% (SEM); monkey, 60.3 +/- 4.3%; opossum, 54.5 +/- 4.4%; rabbit, 46.9 +/- 2.7%; and rat, 55.7 +/- 4.9%), whereas there was essentially no loss or gain in cytoplasm during the same period for round spermatids. Surprisingly, during spermatid elongation an approximate 36% loss of cytoplasm was also recorded for five species (guinea pig, 50.1 +/- 6.3%; monkey, 30.0 +/- 15.4%; opossum, 25.4 +/- 9.0%; rabbit, 42.4 +/- 8.6%; and rat, 34.9 +/- 11.9%), which is only partially (approximately 60%) accounted for by fluid pumping from the nucleus during nuclear condensation. A densification of the cytoplasm of elongate spermatids, as compared with round spermatids, suggests fluid is also pumped from the elongating spermatid cytoplasm. Fluid loss from germ cells may contribute to the seminiferous tubule fluid, a fluid previously thought to be solely of Sertoli-cell origin. PMID- 3825965 TI - Presence of alpha-melanocyte-stimulating hormone in bovine pituitary intraglandular colloid of intermediate lobe origin. AB - Alpha-melanocyte-stimulating hormone (alpha-MSH), one of several peptide hormones originating in the intermediate lobe of the pituitary as proopiomelanocortin, was discovered in bovine pituitary intraglandular colloid by using radioimmunoassay. The quantity of alpha-MSH varied from 5 to 368 micrograms/mg protein in the three pools. The importance of this finding is discussed in light of the possibility that the colloid is a transport medium for alpha-MSH and other intermediate lobe hormones. PMID- 3825966 TI - Ultrastructural demonstration of exocytosis in intact and saponin-permeabilized cultured bovine chromaffin cells. AB - Exocytosis is the release of intracellular vesicular contents directly to the cell exterior after fusion of the vesicular and plasma membranes. It is generally accepted as the process by which transmitters and hormones are released from neurons and neurosecretory cells. There is overwhelming biochemical evidence that exocytosis is the mechanism by which catecholamines are released from adrenal chromaffin cells. With the exception of the hamster, however, there is little ultrastructural evidence to support such a mechanism. We have used a modified in vitro tannic-acid method to visualize exocytosis by transmission electron microscopy in intact and saponin-permeabilized bovine chromaffin cells. When cells are exposed to tannic-acid-containing medium, the content of vesicles involved in exocytosis is coagulated in situ as the vesicle opens to the exterior. Numerous exocytotic profiles were observed. The exposed vesicle contents appeared more granular than those of vesicles in the cell interior. Tannic acid also made the plasma membrane more distinct. Small holes were apparent in the plasma membrane of saponin-treated cells, with little disruption of underlying cytoplasmic structure. Furthermore, when these cells were stimulated with calcium, exocytosis was evident only at regions of intact plasma membrane, not at the holes. Parallel measurements of secretion showed no secretion in the presence of tannic acid. Pretreatment with tannic acid prevented subsequent secretion by intact cells and markedly reduced that of permeabilized cells, indicating a probable change in the nature of the plasma membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3825967 TI - Restricted growth at the frontonasal suture: alterations in craniofacial growth in rabbits. AB - Apposition of bone at the sutural margin is generally thought to be a compensatory adjustment to growing soft-tissue organs such as the brain or eyes within the skull. The frontonasal suture which is located at the interface between the cranial and facial skeletons is a site of extremely active growth in the young rabbit. Recently, we showed that premature closure of a cranial suture, the coronal suture, can alter the growth not only at the adjacent frontonasal suture but also of the basicranium and midface. This study examines the effects of restricted growth at the frontonasal suture on both growth at adjacent cranial sutures and linear growth of the basicranium and midface. Thirty newborn New Zealand White rabbits were subdivided into experimental and sham-treated groups of equal size and distribution for sex and birth weight. At 9 days of age, the frontonasal suture of each experimental animal was immobilized by bilateral application of methyl-cyanoacrylate adhesive across the frontonasal suture. Growth and morphometric changes were monitored by radiocephalometric methods through 120 days of age by bilateral implantation of radiopague markers on each side of frontonasal, coronal, and anterior lambdoid sutures. Results indicate that restricted growth at the frontonasal suture results not only in a significant shortening of the midface but also in significant decreases in growth at the coronal and internasal sutures. Growth at the interfrontal and sagittal sutures is increased. Furthermore, growth at the anterior portion of the nasal bones is significantly increased, thereby offsetting a portion of the decreased nasal bone length resulting from frontonasal restriction. PMID- 3825968 TI - Adverse reactions in the use of hypnosis. PMID- 3825969 TI - Impact of stage hypnosis. PMID- 3825970 TI - Potential deleterious effects of hypnosis in the clinical setting. PMID- 3825971 TI - Hypnosis complications: six cases. PMID- 3825972 TI - Complications following hypnosis in a psychotic patient with sexual dysfunction treated by a lay hypnotist. PMID- 3825973 TI - Spontaneous trance as a possible cause for persistent symptoms in the medically ill. PMID- 3825974 TI - Hypnosis and memory: the effects of emotional arousal. PMID- 3825975 TI - Applications of hypnosis in the treatment of anorexia nervosa. PMID- 3825976 TI - How hypnosis may potentiate psychotherapy. PMID- 3825977 TI - Hypnotherapy in the control of cataplexy in a narcoleptic subject. PMID- 3825978 TI - Vitamin requirements of the elderly. AB - In general, low dietary intakes can account for much of poor vitamin nutriture reported among various elderly populations. Despite problems in assessing vitamin nutriture in the elderly, the 1980 RDAs for thiamin, riboflavin, and ascorbic acid seem appropriate for those populations. However, RDAs for vitamin A and folate may be too high and the RDAs for vitamin D, vitamin B-6, and vitamin B-12 may be too low, due to specified age-related changes in the metabolism of these vitamins. For vitamin E, vitamin K, niacin, biotin, and pantothenic acid, the data is conflicting and/or insufficient to make a judgment about the appropriateness of the RDAs or to estimate safe and adequate daily intakes for the elderly. PMID- 3825979 TI - Body composition of Peruvian children with short stature and high weight-for height. I. Total body-water measurements and their prediction from anthropometric values. AB - Total body water (TBW) was measured by 18O dilution in 139 undernourished, preschool Peruvian children with high weight-for-height. Values for TBW as a percent of body weight were relatively high, averaging 67.4 +/- 6.4%. Depending upon the method of calculation, mean values for the sample population for percent fat ranged from 9.4-18.5%. Regression of TBW on lean body mass suggested that hydration of the fat-free body was higher than for normally nourished children of comparable age. Thus, the increased weight-for-height in these children did not result from increased fat tissue, but from increased hydration of the fat-free body. TBW was most highly correlated with height and weight, both with r = 0.95. Equations predicting TBW from either height or weight were significantly different from those developed by other investigators to predict TBW for normal, well-nourished American children. PMID- 3825980 TI - Determination of energy expenditure during heavy exercise, normal daily activity, and sleep using the doubly-labelled-water (2H2 18O) method. AB - Energy expenditure of four subjects was measured by the doubly-labelled-water (2H2 18O) method to determine if energy expenditure could be determined over short periods. Three subjects were studied while they performed 8 h of heavy exercise in a laboratory environment. Urine and blood samples were taken before and after exercise. Estimated energy expended during 8 h of high-intensity exercise (55% VO2 max) for three subjects was 757 +/- 118 kcal/h by the doubly labelled-water method using urine and a two-point calculation, which compared favorably with 735 +/- 82 kcal/h obtained by respiratory gas exchange. For the fourth subject, daytime, nighttime, and daily energy expenditure was calculated by both the two-pair method and decay-curve analysis of urine and saliva samples collected in the morning and at night. Daytime and nighttime energy expenditures differed significantly (p less than 0.05). PMID- 3825981 TI - Habitual daily energy expenditure and activity levels of lean and adult-onset and child-onset obese women. AB - The energy expenditure (EE) of eight lean, eight adult-onset obese (AOO), and eight child-onset obese (COO) women was determined over three 24-h periods by the factorial method, modified by subject-keypunched and mechanically recorded activity diaries. Mean daily EE was significantly higher in the pooled obese women (2472 +/- 488 kcal) than in lean women (1979 +/- 302 kcal) due to higher energy costs of sedentary and light activity in the obese. EE during moderate-to strenuous activity was similar between groups because lean women performed these activities more vigorously. AOO and COO differed significantly in neither mean EE nor habitual activity. Fat-free mass (FFM) was a better predictor than body weight of both mean daily EE and the energy cost of activity. These data indicate that EE is positively related to obesity. Obese women tend to limit possible EE by reducing the vigorousness of weight-supported activity. PMID- 3825982 TI - Variations of phylloquinone concentration in human milk at various stages of lactation and in cow's milk at various seasons. AB - An improved high-performance liquid chromatographic method was used to measure phylloquinone concentrations in human and cow's milk. Concentrations in human milk obtained serially from 10 mothers 3, 8, and 21 days after delivery were found to increase during the course of lactation. No correlation was found between phylloquinone concentration and lipids but a significant negative correlation was observed between phylloquinone and cholesterol concentrations. Determinations in cow's milk showed increased levels during the summer months. Also, levels in cow's milk were significantly higher than in human milk. Notwithstanding marked individual variations in human milk, phylloquinone concentrations in cow's milk always proved higher than in human milk. Results prompt the necessity of protecting breast-fed infants by applying relevant prophylactics measures. PMID- 3825983 TI - Aspirin as a promoter of ephedrine-induced thermogenesis: potential use in the treatment of obesity. AB - Chronic administration of aspirin to obese mice had no effect on energy balance and body composition. In contrast, ephedrine increased energy expenditure by 9% and reduced body weight and body fat by 18% and 50%, respectively: obesity, however, was reduced but not reversed. In the presence of both ephedrine and aspirin, increase in energy expenditure found during treatment with ephedrine alone was doubled, and the obese group lost greater than 75% of body fat: obesity was reversed. These studies indicate that although aspirin administered alone has no influence on energy balance it can markedly potentiate thermogenic properties of ephedrine, effects which led to a normalization of body composition of the obese to that of the lean. Such ephedrine-aspirin mixtures, often found in over the-counter preparations for asthma and bronchial disorders, could be put to new use as aids for treatment of human obesity. PMID- 3825984 TI - Food consumption patterns of Canadian preschool children in relation to zinc and growth status. AB - Hair and serum zinc and copper, growth percentiles, and dietary intakes, based on 3-day weighed food records, were determined for 106 Canadian preschool children (62 M, 44 F) aged 4-5 yr. Mean (+/- SD) hair zinc levels were (M) 103 +/- 35 micrograms/g vs (F) 129 +/- 34 micrograms/g, p less than 0.001, and median hair copper level was 12.4 micrograms/g (M + F). Mean serum zinc and copper were 111 +/- 13 micrograms/dL (M + F) and 122 +/- 21 micrograms/dL (M + F), respectively. Males with low hair zinc (less than 70 micrograms/g) had a lower mean height-for age percentile (42 +/- 29 vs 58 +/- 25%, p less than 0.05), even when adjusted for midparent height. Males with hair zinc less than 70 micrograms/g and/or height-for-age less than 15% consumed less meat, poultry, and fish and received similar average zinc intakes but higher calcium intakes than males with hair zinc greater than or equal to 70 micrograms/g and/or height-for-age greater than or equal to 15%. Suboptimal zinc nutriture was associated with lower intakes of readily available zinc from flesh foods and higher intakes of calcium. PMID- 3825985 TI - Distribution of selenium in human milk. AB - The present studies were designed to characterize selenium distribution in human milk. These studies reveal that most selenium in human milk is protein bound. Percentage dialyzable selenium varied proportionally with total selenium content of milk but not with stage of lactation. Neither rate of freezing nor frozen storage of samples for one month influenced distribution profiles. At least nine selenoproteins were detected in dialyzed milk samples following molecular sieve (Sephadex) chromatography. Glutathione peroxidase accounted for approximately 15 30% of selenium found in milk. Approximately half of peroxidase activity in human milk was associated with selenium dependent glutathione peroxidase activity. PMID- 3825986 TI - A comparison of nutrient-based and exchange-group methods of diet instruction for patients with noninsulin-dependent diabetes. AB - This study compared effectiveness of nutrient-based (Diet Guide) vs food-group (Exchange Lists) methods of diabetic diet evaluation in improving dietary compliance, glycemic control, and biochemical indicators of heart disease risk. Eighty-three persons with noninsulin-dependent diabetes were taught one of two diet-planning methods in a 3-session workshop. Both methods led to reductions in energy intake and percent of calories from fat and saturated fatty acids in 6 mo postworkshop. Reductions in fat intake were greater and more long lasting for persons using Diet Guide than using Exchange Lists method of diet planning. Despite dietary changes, neither diet-planning method led to significant decreases in weight or skinfold thickness. Few differences were seen in clinical measurements pre- and 6 mo postworkshop. Total and LDL cholesterol values were lower than preworkshop values for men in both groups. Suggestions are given for improving effectiveness of both diet-planning methods. PMID- 3825987 TI - Bone mineral, serum calcium, and dietary intakes of mother/daughter pairs. PMID- 3825989 TI - Cisplatin plus VP16-213 in refractory ovarian carcinoma. AB - Twenty-five patients with FIGO stage III and IV ovarian carcinoma were treated with cisplatin plus VP16-213 chemotherapy as the second, third, or fourth line of therapy. There were two (8%) partial responses, 18 with stable disease and five with progression of disease. Neurotoxicity was observed in all patients, with two patients developing severe paresthesias and difficulty in walking. PMID- 3825988 TI - The influence of hematogenous and serosal metastases on advanced (FIGO IIA-IVB) squamous cell carcinoma of the cervix. AB - Of 120 patients with FIGO stage IIA-IVB squamous cell carcinoma of the cervix treated with standard radiotherapeutic techniques, 41 (34.2%) relapsed with hematogenous or serosal metastases. Development of such metastases was individually associated with patient age less than or equal to 55, bilateral bulky parametrial extension, and histologically positive paraaortic nodes. Poor histologic differentiation exerted significant negative influence only in patients age less than or equal to 55. Neither surgical staging nor vascular injury predisposed to hematogenous dissemination. Radiotherapy techniques differed only in increased time to completion, from 84 to 100 days in clinical IIB and IIIB patients developing metastases. Local or regional pelvic recurrences, although associated with an increase in hematogenous or serosal metastases, were not accompanied by concomitant relapse in extrapelvic nodes. Twenty-six of 41 metastases were limited to single organ systems, with pulmonary sites most common (43.9%). A direct (non-nodal) route of hematogenous dissemination of 31% was documented within clinical stages IIA and IIB. One hundred percent concordance between bilateral bulky parametrial involvement and positive pretreatment paraaortic nodes occurred in clinical stage IIIB and IVA patients with metastatic relapse. Our data from the period 1976-1985 do not substantially differ from earlier reports on the incidence or distribution of hematogenous or serosal metastases, despite our implementation of contemporary local/regional radiotherapy prescriptions. The potential for hematogenous and serosal metastases in high-risk patients with advanced squamous cervical carcinoma merits consideration of alternative treatment protocols and precise definition of the role of pretreatment surgical staging procedures. PMID- 3825990 TI - A phase II study of AMSA in head and neck cancer. AB - AMSA was given to 22 evaluable patients with advanced head and neck cancer with measurable lesions. The starting dose was 90-120 mg/m2 by i.v. infusion over 45 min every 3 weeks. The dose of AMSA was escalated by 30 mg/m2 in absence of bone marrow toxicity. At least two cycles were given prior to the evaluation of response. Only one patient with oropharyngeal cancer achieved a partial response, lasting for 20 weeks. Toxicity was mild and mainly hematological. We conclude that AMSA given at this dose and schedule has little activity in head and neck cancer. PMID- 3825991 TI - Treatment of advanced colorectal carcinoma with actinomycin D, vincristine, methyl-CCNU, and methotrexate. AB - Twenty patients with advanced colorectal carcinoma were treated with combination chemotherapy consisting of actinomycin D, vincristine, methyl-CCNU, and methotrexate. Fourteen patients had received prior chemotherapy with 5 fluorouracil (5-FU). No complete responses and only one partial response were observed for an overall response rate of 5%. The combination of actinomycin D, vincristine, methyl-CCNU, and methotrexate at the doses and schedule used was of no value in the treatment of patients with metastatic colorectal carcinoma. PMID- 3825992 TI - 5-Fluorouracil and high-dose folic acid treatment for metastatic colon cancer. AB - Twenty-two patients with metastatic colorectal cancer were treated with a regimen of 5-fluorouracil 600 mg/m2 (maximum, 1.0 g) i.v./week and folic acid 140 mg/m2 i.v. given 1 h prior to the 5-FU. This study was undertaken in an attempt to confirm the in vitro finding that inhibition of thymidylate synthetase by 5 fluorouracil is prolonged by the presence of folates. There were four partial responses (18%) with mean duration 4 months. Dose-limiting toxicity was enteritis, seen in 12 patients (58%), and causing hospitalization in seven patients. Enteritis was shown to be due to the folic acid in most patients. Two patients died from leukopenia, enteritis, and sepsis. Mean serum folate levels at the time of 5-FU injection were 36 microM. This regimen is no more effective than 5-FU alone and has significantly more serious toxicity. Further investigation of this regimen is not recommended. PMID- 3825993 TI - Is preoperative computed tomography necessary in the management of patients treated for carcinoma of the prostate by 125iodine interstitial implantation and bilateral pelvic lymphadenectomy? AB - We have evaluated the impact of preoperative pelvic computed tomography (PCT) on the management of 145 patients with adenocarcinoma of the prostate. Our preoperative interpretations were correct in 47 (76%) of the 62 cases with PCT. Twenty-six percent of the 62 patients had microscopically positive lymph nodes, and, of this subgroup, only 50% remain disease-free, at risk for 1 to 7 1/2 years. In contrast, 93% of the subgroup with microscopically negative lymph nodes are free of disease. Of the 83 patients who did not have PCT preoperatively, 18 patients (22%) had microscopically positive lymph nodes and 33% are disease-free; 65 patients (78%) had microscopically negative lymph nodes, and 90% are disease free, followed for 1 1/2 to 9 years. Thus, there is no significant difference in percent nodal positivity, or disease-free survivals, when comparing the PCT and non-PCT groups, subdivided according to nodal status. We believe that preoperative PCT is an important screening tool, and will provide correct pathological correlations in the majority of cases. However, on the basis of the information derived from this study, the preoperative clinical assessment patients fared no differently from the preoperative PCT patients, thus suggesting that PCT may not be indicated routinely, but should be reserved for questionable situations. PMID- 3825994 TI - Adjuvant chemotherapy in males with cancer of the breast. AB - Analysis of recurrence rates in male breast cancer (MBC) has suggested that tumor size and degree of axillary lymph node involvement carry the same prognostic implications as for breast cancer in women. A similar spectrum of antineoplastic agents appears active in both females and males. Based on reports of active adjuvant chemotherapy of women with breast cancer, we initiated a trial of adjuvant chemotherapy of MBC in July 1974. Twenty-four patients have been treated with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). All patients had nodal involvement (median three nodes positive; seven patients had a single positive lymph node). All patients began adjuvant therapy within 4 weeks of either a radical or modified radical mastectomy. No postoperative radiotherapy was given. Median potential follow-up is 46 months. Four patients have recurred, one each at 15, 45, 61, and 65 months following mastectomy; two are dead of metastatic disease. The five-year survival rate projected by actuarial means is in excess of 80% (95% confidence interval: 74-100%). Based on these data, this treatment is highly encouraging when compared to other forms of treatment reported in the literature in which 5-year disease-free survival rates are less than 30%. We conclude that adjuvant therapy of MBC with a CMF regimen is feasible and may be associated with substantial improvement in disease-free survival and overall survival. PMID- 3825995 TI - Assessment of malignancy potential in mammary carcinoma in elderly patients. AB - Tumors of 89 women, aged 75 or above, that were operated on for primary mammary carcinoma were analyzed with regard to histologic type and differentiation, estrogen receptor (ER) content, and nuclear DNA distribution pattern. The majority of the tumors were invasive ductal carcinomas but a relatively high frequency of papillary and colloid carcinomas was also found. The cancers were predominantly ER-positive (87%) and diploid (70%), indicating a favorable response to anti-estrogens and slow tumor growth. Despite these characteristics, the prognosis of elderly women with mammary carcinoma is no better than that of other age groups, as shown in previous studies. Nonsurgical treatment is often preferable in very old patients. Analysis of DNA profile can provide additional information and prognostic guidance when selecting patients for endocrine therapy. PMID- 3825997 TI - The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett's esophagus. AB - The authors assessed the relationship between dysplasia in Barrett's esophagus and invasive adenocarcinoma in a study of both endoscopic biopsy specimens and esophagectomy specimens. They reviewed the pathologic findings and clinical follow-up of 14 patients with dysplasia in Barrett's mucosa in endoscopic biopsy specimens. They also studied systematically the histopathologic features of the Barrett's mucosa in 43 esophagectomy specimens resected for Barrett's carcinoma. In the biopsy specimens, dysplasia occurred in distinctive-type Barrett's mucosa of 13 patients (93%) but in cardiac-type mucosa of only 3 (21%). Six patients had high-grade dysplasia; five underwent esophagectomy and three of these were found to have superficially invasive adenocarcinoma. The other patient with high-grade dysplasia as well as eight patients with intermediate- or low-grade dysplasia are not known to have carcinoma on available follow-up. In the study of resection specimens, high-grade dysplasia was strongly associated with adjoining invasive adenocarcinoma, because 84% of areas with invasion had high-grade dysplasia and 92% of areas with high-grade dysplasia showed invasion. The authors' findings suggest that the dysplasia-carcinoma sequence most commonly occurs in Barrett's mucosa of the distinctive type; high-grade dysplasia in Barrett's mucosa is a marker indicating high probability of invasive carcinoma; the presence of high grade dysplasia in biopsy specimens of Barrett's mucosa is an indication for esophagectomy in suitable surgical candidates. PMID- 3825996 TI - Prognostic factors in early carcinoma of the endometrium. AB - Two hundred forty-one patients with clinical-pathological Stage I and 58 patients with clinical-pathological Stage II carcinoma of the endometrium treated between January 1959 and December 1983 at the Ottawa General Hospital were analyzed. The adjusted survival rate at 5 years was 92% in patients with Stage I and 66% in patients with Stage II. In patients with Stage I, the most important prognostic factors were the histological grade of the tumor and the depth of myometrial invasion. In patients with Stage II, the single most important prognostic factor was the clinical extent of the disease. Grade and depth of myometrial invasion were also significant prognostic factors, particularly in patients with pathological Stage II. Combined surgery and radiation therapy was clearly superior to surgery alone in patients with Stage II but not in patients with Stage I, although, with long-term follow-up, our results may suggest improved survival in these patients as well. PMID- 3825998 TI - Multiparameter flow cytometric analysis of colon polyps. AB - Sixty-eight colonic polyps of various histologic types were studied using retrospective flow cytometric (FCM) DNA analysis to determine the prevalence of aneuploid cell populations and whether they were associated with any particular histologic features. Overall, 13 of 68 polyps (19%) contained DNA-aneuploid cells, including 3 of 9 villous and 4 of 10 villoglandular polyps with histologic features of carcinoma in situ (CIS), 4 of 11 villous and 1 of 18 villoglandular polyps without CIS, and 1 of 12 adenomatous polyps. Eight hyperplastic polyps were diploid. These results show retrospective FCM analysis can detect DNA aneuploidy in polyps; DNA aneuploidy may occur before histologic evidence of invasive carcinoma; and this change is more frequent in types of polyps thought to have increased malignant potential (i.e., those with villous morphology and/or CIS). PMID- 3825999 TI - Histologic classification and staging of multiple myeloma. A retrospective and prospective study of 674 cases. AB - Bone marrow biopsies of 674 patients with multiple myeloma (MM) were processed for diagnostic evaluation. Histologic variables were correlated with the clinical features to determine factors of value in predicting prognosis. Four of these were used to classify MM into six histologic types: Marschalko type; small cell type; cleaved type; polymorphous type; asynchronous type; and blastic type. These six types were subsequently combined into three prognostic grades: low, intermediate, and high, analogous to the malignant lymphomas. The quantity of plasma cell burden in the biopsy proved to be a useful criterion for histologic staging of MM, supplementing any clinical staging system in use. Both these parameters, grade and stage, provide information required for decisions on treatment modalities, while the effects of therapy can be monitored by sequential biopsies. PMID- 3826000 TI - Analysis of intestinal lymphocyte subpopulations in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. AB - Lymphocyte subpopulations in the intestinal tissues of seven patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) were studied by immunohistologic technics at two different locations, the small bowel and the rectum. Intraepithelial and lamina propria lymphocyte subsets stained with monoclonal antibodies T11, T4, T8, and B1 were enumerated in the patients and different normal and patient control groups. Intraepithelial T11+ cells were decreased (P less than 0.05) in the small bowel of AIDS and ARC patients, primarily because of the near complete absence of T4+ lymphocytes. In the lamina propria of these patients, a depletion of T4+ cells (P less than 0.05), an increase in T8+ cells (P less than 0.05), and a reversal of the T4/T8 ratio were observed (e.g., the small bowel ratio was 0.1 +/- 0.02 vs. the normal ratio of 2.3 +/- 0.2 and the rectal ratios were 0.2 +/- 0.06 vs. normal 2.6 +/- 0.3). The T-lymphocytes in the intestine of AIDS and ARC patients did not express the receptor for interleukin-2 (IL-2). A near complete absence of T4+ lymphocytes was also seen in lymphoid follicles in the rectum. B1+ cells were not depleted. The reversal of the T4/T8 ratio, which is a hallmark of AIDS, occurs not only in the circulation but also in the gastrointestinal tissues of patients with AIDS and ARC. PMID- 3826002 TI - Factor IX metal ion-dependent antigen assays for measurement of warfarin effect. AB - Factor IX metal ion-dependent antigen was assayed using monoclonal antibodies in 521 samples obtained after prothrombin time testing in patients treated with warfarin. Factor IX metal ion-dependent antigen was less than measured Factor IX clotting activity and less than total Factor IX antigen adsorbable to aluminium hydroxide, suggesting that the metal ion-dependent antigen assay measures a subpopulation of circulating Factor IX in patients treated with oral anticoagulants. There was a graded decrease of Factor IX metal ion-dependent antigen as prothrombin times increased in patient samples. In two hospitals, the median prothrombin times and Factor IX antigen levels were 19 and 20 seconds and 0.10 and 0.11 U/mL (kU/L), respectively. This study shows that immunoassays measure the biologic effect of warfarin and provide information that may supplement the prothrombin time test for patient monitoring. Factor IX metal ion dependent antigen assays may be useful in efforts to standardize laboratory tests for warfarin effect. PMID- 3826001 TI - Automated platelet-sizing parameters on a normal population. AB - The quantitation of platelets in peripheral blood is a well-recognized tool. However, other platelet parameters that recently have become available on a routine basis with the introduction of automated cell sizers may become increasingly important in evaluating the integrity of the thrombocytic function. These parameters include mean platelet volume (MPV) and platelet-crit (PCT). This study established reliable reference ranges for these platelet parameters while taking into consideration the effects of age and sex in a study population of 447 normal persons. There was an inverse, nonlinear relationship between MPV and platelet count, with no statistical difference (P greater than 0.05) seen between males and females. Platelet-crit showed no variation with respect to age or sex, however, a direct, linear relationship was suggested between PCT and platelet count. These relationships provide a better understanding of these platelet parameters and may contribute to their use as helpful diagnostic aids. PMID- 3826003 TI - Persistence of partial mole. AB - Between January 1979 and August 1984, 8 of 81 patients with partial molar pregnancy who were followed at the New England Trophoblastic Disease Center had persistent trophoblastic tumor develop. No significant clinical differences were noted between such patients and others whose partial moles did not persist. On microscopic examination, none of the initial molar specimens manifested an unusual degree of trophoblastic proliferation or atypia. In six patients, curettage immediately preceding the initiation of treatment for persistent disease revealed viable molar tissue. In four, this was associated with trophoblastic hyperplasia and atypia. All patients who had persistent gestational trophoblastic tumor achieved remission with single-agent chemotherapy. Monitoring of serum human chorionic gonadotropin levels after partial molar pregnancy is recommended to detect persistent disease and effect prompt therapy. PMID- 3826004 TI - Neonatal pulmonary microaggregates and thrombi. Lack of correlation with blood transfusion. AB - A retrospective review of 36 neonatal autopsies was undertaken to determine whether blood transfusion was related to pulmonary arterial thrombi at autopsy. The number of transfusions and amount transfused were compared with an estimate of the number of thrombi in the pulmonary arterial tree, determined by a point counting method. No relation was found between these quantities, nor were thrombi related to infection or bronchopulmonary dysplasia. PMID- 3826005 TI - Screening for alpha-thalassemia in neonates. Routine erythrocyte measurements. AB - Alpha-thalassemia can be diagnosed in the neonate based on the level of Bart's Hemoglobin (HbB) in cord blood. This level corresponds to the degree of alpha gene deletion. Thus, the extent of the alpha-thalassemia carrier state can be determined. This is important for genetic counseling. Because HbB is present only until a child is six months of age, and the hematologic manifestations of the carrier state may be mild, early detection is important. This study identified a logarithmic relationship between the mean corpuscular volume (MCV) and HbB. Additionally, a discrimination level of 93.5 fL. was calculated to screen for neonates that required evaluation with hemoglobin electrophoresis to identify two and possibly three-gene deletion alpha-thalassemia. The red blood cell indices were found not to be useful in identifying patients with a one-gene deletion alpha-thalassemia. PMID- 3826006 TI - Comparison of bleeding times performed on the arm and the leg. AB - The standardized bleeding time (SBT) is used to assess hemostatic function in patients suspected of having coagulation disorders. Because injury to the arm or the presence of intravascular cannulae often preclude the determination of SBTs on the upper extremity, the authors compared the SBT on the arm with the bleeding time on the leg to ascertain the efficacy of the lower extremity for this test. Thirty healthy volunteers were enrolled in the study. Bleeding times were performed on the forearm and on the medial aspect of the calf. The subjects then ingested 650 mg of aspirin, and the tests were repeated two hours later on the contralateral extremities. The mean preaspirin SBT (5.6 +/- 1.7 minutes did not differ significantly from the mean bleeding time on the leg (5.8 +/- 2.3 minutes) (P greater than 0.50), nor was there a significant difference between the mean postaspirin bleeding time on the arm (10.2 +/- 4.3 minutes) and that on the leg (9.9 +/- 3.7 minutes) (P greater than 0.50). On the basis of this study, the authors conclude that the arm and leg are equally reliable sites for determining bleeding times in normal persons and are equally sensitive for detection of aspirin-induced prolongation of bleeding. PMID- 3826007 TI - Problems encountered in using Cefinase disks to predict in vitro penicillin susceptibility of coagulase-negative staphylococci. AB - The value of Cefinase (BBL Microbiology Systems, Cockeysville, M.D.) disks in predicting penicillin responses of coagulase-negative staphylococci was studied with the use of clinical isolates. The beta-lactamase activity of each isolate was determined both before and after enzyme induction for 18-24 hours with a 5 micrograms methicillin disk. Penicillin responses were determined in microdilution minimum inhibitory concentration (MIC) panels after 18 hours of incubation at 35 degrees C. Of 485 isolates tested, 338 (70%) were beta-lactamase positive, 168 (35%) before and 170 (35%) after induction. Only two (0.6%) of these isolates had a penicillin MIC of less than or equal to 0.12 microgram/mL (less than or equal to 0.12 mg/L). Of the 147 Cefinase-negative isolates, penicillin MICs of 0.12 microgram/mL or less (less than or equal to 0.12 mg/L) and 0.25 microgram/mL or more (greater than or equal to 0.25 mg/L) were obtained from 110 (75%) and 37 (25%), respectively. Although Staphylococcus saprophyticus accounted for only 30 (6%) of the total isolates, 54% of the organisms that were beta-lactamase negative with penicillin MICs of greater than or equal to 0.25 microgram/mL (greater than or equal to 0.25 mg/L) belonged to that species. A positive Cefinase test accurately predicted elevated penicillin MICs, but a negative test, especially with S. saprophyticus, was of less value. PMID- 3826008 TI - Education in laboratory management for pathology residents. AB - In addition to clinical expertise, pathologists are required to have a background in areas of management, administration, and computer operations. During their training, it is imperative that pathology residents have exposure to the subject of modern laboratory management. The authors feel that a rotation in administration is not adequate to give the necessary training but that a formal program is needed to achieve this goal. They have developed a course in laboratory management that uses the available resources of their own department and hospital to meet these needs. PMID- 3826009 TI - Primary amyloidosis with diffuse splenic infiltration presenting as fulminant pneumococcal sepsis. AB - This case illustrates a unique clinical presentation of primary systemic amyloidosis, namely, overwhelming pneumococcal sepsis. Although there exists a well-established association between hyposplenism and overwhelming bacterial infection, amyloid replacement of the spleen as a primary cause of the hyposplenism has not been reported. Functional hyposplenism in regard to the effect of the spleen on erythrocytes has been reported in cases of diffuse splenic amyloid infiltration. The patient described had a fulminant course and associated disseminated intravascular coagulation, two clinical features more commonly seen in pneumococcemia occurring in asplenic patients as opposed to patients with normal splenic function. He had no predisposing factors, other than amyloid replacement of the spleen, to account for the development of overwhelming pneumococcemia. The immunologic function of the spleen in protection against overwhelming bacterial infection is briefly discussed. PMID- 3826010 TI - Native-valve endocarditis caused by Staphylococcus epidermidis. A histologically confirmed case. AB - Staphylococcus epidermidis is among the most common organisms isolated from blood cultures. Conversely, it is rarely a well-documented cause of natural-valve endocarditis. However, several authors have reported series of patients with the clinical picture of endocarditis and S. epidermidis bacteremia. Most of these cases have not been confirmed by examination of the valve. The authors present a case of natural-valve endocarditis caused by S. epidermidis with pathologic documentation of the offending agent. PMID- 3826011 TI - Differential diagnosis of hemangioendothelioma. PMID- 3826012 TI - Biochemical screening in urinalysis. PMID- 3826013 TI - Hematologic parameters and leukocyte histogram patterns in infectious mononucleosis. AB - Blood samples from 60 patients with serologically positive infectious mononucleosis were analyzed on the Coulter S-Plus IV. Hemoglobins and platelet counts were essentially normal, and leukocyte counts were elevated in less than half the cases. Reactive lymphocytes were present on blood smears from all patients. The S-Plus IV automated three-part leukocyte differentials showed significantly lower numbers of lymphocytes and more mononuclears and granulocytes than manual microscopic differentials. On the leukocyte histograms, lymphocyte peaks were consistently wider than normal and asymmetrical. The instrument generated R2 flags on 43 of 60 (72%) of the samples. Using a combination of "R" flags, mononuclear backlighting, and "H" flags, the Coulter S-Plus IV identified 59 of 60 infectious mononucleosis samples as requiring further review. PMID- 3826014 TI - A plasma protein C activity assay suitable for a clinical laboratory. Its use to measure activity in hereditary and acquired deficiency states. AB - The authors describe the technic and standardization of an assay to measure plasma protein C activity feasible for clinical laboratory use. It is modified from an assay of Francis and Patch (Thromb Res 1983; 32:605-613) to enhance protein C recovery in the barium citrate eluate, to eliminate the steps of addition and neutralization of heparin, and to use only commercially available reagents. The normal range for plasma protein C in the assay is 72-130% (+/- 2 SD) (0.7-1.30). Hepatocellular disease lengthening the prothrombin time by 3-4 seconds was associated with plasma protein C activity of 25% (0.25) to 35% (0.35). Although the assay is thought to accurately measure protein C activity in patients taking warfarin, one cannot evaluate such patients for hereditary functional protein C deficiency because treatment with warfarin will itself reduce the ratio of protein C activity to antigen. The assay can be used in a patient receiving heparin if the heparin is removed as described. PMID- 3826015 TI - Red blood cell zinc protoporphyrin to evaluate anemia risk in deferred blood donors. AB - A large proportion of potential blood donors who are deferred are inappropriate to be donors because of unreliable predonation anemia screening methods. In this study, venous hemoglobin concentrations were within acceptable limits in 71% of 275 anemia deferrals. Red blood cell zinc protoporphyrin (RBC ZP) was evaluated as a screening test to improve the accuracy of detecting anemia in prospective blood donors. The frequency of abnormally low venous hemoglobin concentrations in anemia deferrals having fingerstick capillary microhematocrit (MH) values within 3% of the minimum requirement, together with normal RBC ZP levels (less than 53 micrograms/dL [0.943 mumol/L] RBC), was 2%, and not significantly different from the prevalence of venous anemia observed in eligible blood donors. Anemia deferrals with elevated RBC ZP results had a significantly increased rate of iron depletion and anemia. Capillary RBC ZP measurements in combination with the MH test have the potential to safely decrease inappropriate anemia deferrals. PMID- 3826016 TI - Comparison of cyclosporine determinations in whole blood by three different methods. HPLC, 125I RIA and 3H RIA. AB - The authors have analyzed and compared the cyclosporine concentrations in whole blood specimens from pediatric renal transplant patients using three different methods: high-performance liquid chromatography (HPLC) (5u C18 reverse-phase column), 3H radioimmunoassay (RIA) (Sandoz, E. Hanover, NJ), and 125I RIA (substituted 3H-tracer in Sandoz Kit with 125I tracer made by Immuno Nuclear Corporation, Stillwater, MN). Results obtained by the 125I RIA correlated well with results obtained by the 3H RIA. Both RIA methods had similar correlation with the HPLC method. The 125I RIA method showed higher sensitivity and greater precision than the 3H RIA method. The authors conclude that the 125I RIA method can be used for cyclosporine determination in whole blood specimens. The use of the 125I RIA provides a simple and rapid method with higher counting efficiency and less background quenching than the 3H RIA method, which requires cumbersome liquid scintillation counting procedures. PMID- 3826017 TI - Disseminated extraintestinal isosporiasis in a patient with acquired immune deficiency syndrome. AB - This report describes a 38-year-old male homosexual with acquired immune deficiency syndrome (AIDS) and a history of Isospora belli infestation treated with trimethoprim-sulfamethoxazole. At autopsy, intracellular and extracellular I. belli organisms were identified in the mucosa and lamina propria of small and large intestine as well as in mesenteric and tracheobronchial lymph nodes, where an associated granulomatous reaction was also present. Until now, Isosporiasis has been observed as intracellular parasites restricted to the columnar cells of the intestinal mucosa in humans hosts. This is, to the authors' knowledge, the first time that this protozoa has been observed invading beyond the intestinal wall. This patient's autopsy also demonstrated intestinal ulcerations proven microscopically to be caused by cytomegalovirus (CMV). In patients with AIDS and CMV enterocolitis, the authors have observed an unusual frequency of extraintestinal disseminated disease by microorganisms heretofore typically restricted to the intestinal mucosa (i.e., bacteremias resulting from Shigella species). The authors propose that, in AIDS patients, the profound immunodeficient state, possibly in conjunction with CMV-induced intestinal mucosal ulcerations, promotes access of other intestinal microorganisms, including I. belli, into lymphatic and vascular spaces, culminating in lymphohematogenous dissemination of their intestinal infestations. PMID- 3826018 TI - Regional heparinization facilitates safe hemodialysis and/or hemofiltration in the critically ill patient. PMID- 3826019 TI - Parasitic points. PMID- 3826020 TI - A comparison by race/ethnicity of narcotic addict crime rates in Baltimore, New York, and Philadelphia. AB - In an effort to provide timely information concerning the criminal activities of narcotic addicts in three different metropolitan areas, male narcotic addicts attending methadone maintenance/detoxification centers in Baltimore, Philadelphia, and New York City participated in extensive, confidential interviews conducted between May 1983 and April 1984. The information obtained focused on the amounts and types of crimes committed during the addict's longest period of active addiction to opiates, their derivatives and synthetics, as well as his first period of nonaddiction. Crimes committed were placed in one of five categories as follows: Theft, Violence, Drug Sales, Deception/Forgery, and Other. Several different measures of criminal activity were utilized, all embodying the concept of crime-days per year at risk. Such crime-days measures involve annualizing, i.e., the number of crime-days accumulated by each subject in each category during a specified time at large in the community is expressed as crime days per year at risk by taking the ratio of crime-days to total days at large and multiplying by 365. Addicts were compared by race/ethnicity (Black, White, and Hispanic) within cities as well as by race/ethnicity across cities using one way analysis of variance procedures. Addict crime rates were also compared for the period of active addiction and nonaddiction. Several mean differences by race/ethnicity within city, as well as by race across cities, were noted. Moreover, crime rates tended to be higher during the period of active addiction. In this sense, then, drugs may be said to "drive" crime. PMID- 3826021 TI - Sex differences in opioid addiction careers. AB - Differences between the opioid addiction careers of 84 female and 91 male addicts were examined longitudinally. Data were collected from clients participating in methadone maintenance treatment programs between 1969 and 1972 as part of the Drug Abuse Reporting Program (DARP). Clients were interviewed prior to and during treatment, as well as 6 and 12 years after treatment. No differences between male and female addicts were found for demographic characteristics or treatment histories. Further, differences in behavioral outcomes for criminality and employment found at 12-year follow-up were shown to be a function of pretreatment differences, and were not related to differential treatment effects. Males and females did differ, however, in psychological status at 12-year follow-up, and in their reasons for quitting drug use and entering treatments. These differences, along with significantly greater financial and medical needs for females, indicate systematic long-term differences between female and male addiction careers which should be considered in prevention and treatment of opioid addiction. PMID- 3826023 TI - Drugs and personality: dependence of findings on method. AB - Past studies on relationships between drug use and personality are open to criticism on theoretical and methodological grounds. Properly conducted research may show relationships that have been previously undiscovered. The present studies examined 45 carefully selected, noninstitutionalized men in four matched groups of heavy, chronic drug users and a nonuser comparison group. A variety of instruments, all of which presumably measure the propensity to seek novel and varied sensations, were administered. When used to evaluate hypotheses derived from Optimal Level of Arousal (OLA) theory, data from this study showed an association between the trait measured and drug(s) of choice among men committed to the heavy, chronic use of particular substances. However, the association was not that anticipated by OLA theory. Instead, it appeared that, among heavy, chronic users, drug preference and sensation seeking are related to extraversion and introversion. The findings were consistent with a theory of psychological individuation that was developed from thorough clinical assessment of every individual in the research program. PMID- 3826022 TI - Estimated intelligence and long-term outcomes of opioid addicts. AB - This study estimated intellectual functioning based upon a demographic profile (DP) for Wechsler Adult Intelligence Scale-Revised (WAIS-R) Full Scale IQ in order to determine its relationship with variables representing initiation, continuation, relapse, and cessation of daily opioid use. The DP Estimated IQs were used to describe a large former opioid addict sample from the 12-year follow up study of the Drug Abuse Reporting Program (DARP). Results were compared with those from previous studies using meta-analysis. In addition, a correlational analysis was performed. Average DP Estimated IQs for the DARP sample were comparable to mean IQs for both the WAIS-R standardization sample and previous studies. DP Estimated IQ was significantly related to length of addiction career; the higher the estimated IQ, the shorter the career. Other more complex relationships were found for variables used to represent intraindividual factors such as satisfaction with self or family, interpersonal factors such as family or peer influences, and other variables of interest. PMID- 3826024 TI - Psychosocial adjustment, modality choice, and outcome in naltrexone versus methadone treatment. AB - Thirty naltrexone and 30 methadone patients in outpatient opiate addiction treatment were compared on pretreatment psychosocial adjustment and on short-term outcome in terms of drug abuse and retention. Also, the relationship between pretreatment psychosocial adjustment and outcome for the total sample was assessed. The naltrexone and methadone groups were generally not significantly different in pretreatment psychosocial adjustment. The two groups differed significantly in retention, but not in drug abuse outcome. Pretreatment drug abuse was significantly related to drug abuse outcome. No aspect of pretreatment psychosocial functioning was related to retention outcome. Treatment and research implications are discussed. PMID- 3826025 TI - Drinking locations and frequency of drunkenness among Mississippi DUI offenders. AB - Using data collected from convicted drunken drivers, relationships between self reported frequency of drunkenness, frequency of drinking in seven types of drinking places, and sociodemographic characteristics are examined. Drunk drivers who are young, White, and who infrequently attend worship services are more likely than others to report a high frequency of drunkenness. Self-reported frequency of drunkenness is found to be more strongly related to drinking locations than to sociodemographic characteristics, however. The best predictors of the frequency of drunkenness are the frequency of drinking in automobiles and the frequency of drinking in bars or lounges. These relationships remain strong after the effects of sociodemographic characteristics have been controlled. The findings suggest that drunk drivers who drink in automobiles may represent an especially dangerous subgroup, and that policy makers need to give careful consideration to countermeasures designed to curtail drinking in automobiles. PMID- 3826026 TI - Inconsistent responses to questions about alcohol consumption in specified settings. AB - In a 1979 national survey of drinking practices, a sizable number of respondents gave the inconsistent information that they drank more alcoholic beverages in bars and at parties than they drank overall. The percentage of respondents making such errors was too large to dismiss, and instead, it raised the possibility that the mention of specific contexts in questionnaire items produces response distortions. This suggests that caution should be used in the interpretation of survey data about drinking in specified contexts. PMID- 3826027 TI - Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. AB - Campylobacter pyloridis was ingested by a volunteer who had a histologically normal gastric mucosa and fasting gastric pH recordings of less than 2. Three days later he developed moderate to severe attacks of epigastric pain. On the 5th day after ingestion C. pyloridis was cultured from antral biopsies which showed histological acute gastritis. However, fundal histology and fasting gastric pH were normal. On the 8th day fasting gastric pH rose to 7.6. On day 11 C. pyloridis was cultured from both antral and fundal biopsies which showed histological gastritis. Doxycycline was taken for 28 days but infection and gastritis persisted. Bismuth subsalicylate was taken for 28 days and final biopsies, taken 1 wk after stopping therapy, were culture negative. Histology showed a minimal residual chronic gastritis. C. pyloridis can cause an acute upper gastrointestinal illness associated with histological gastritis and an increase in fasting gastric pH. PMID- 3826028 TI - Long-term follow-up of symptomatic status of patients with noncardiac chest pain: is diagnosis of esophageal etiology helpful? AB - Questionnaires were sent to 119 patients with noncardiac chest pain, all of whom had previous detailed esophageal evaluations in which 63 were diagnosed as having pain from the esophagus. Mean follow-up period was 21.8 months. Patients diagnosed as having an esophageal etiology of their noncardiac chest pain usually continued to have recurrent pain. Furthermore, a specific diagnosis did not significantly increase the likelihood of pain resolution. However, patients who understood that the esophagus was the source of their pain were significantly less likely to feel disabled by their pain and to require continued physician evaluation. This finding was independent of any treatment program. This study emphasizes the importance of a careful evaluation of the esophagus as a potential source of pain and clearly communicating this information to the patient. PMID- 3826029 TI - The liver in acquired immune deficiency syndrome: emphasis on patients with intravenous drug abuse. AB - To assess the spectrum of hepatic abnormalities in acquired immune deficiency syndrome (AIDS), we reviewed clinical, biochemical, and pathological material in 32 patients with AIDS. Eight-four percent of AIDS cases had a history of intravenous drug abuse. Ninety percent of AIDS patients has some liver biochemical abnormality at the first presentation of illness. During the course of AIDS, significant (p less than 0.05, paired Student's t test) rises in alkaline phosphatase and bilirubin occurred, without rises in aminotransferases. Mean abnormalities were mild, reflecting approximately 2-fold increases over baseline. Liver failure was not believed to contribute to the death of any AIDS patient. Pathological findings in AIDS included specific infectious diagnosis in 26%, granulomas in 16%, hemosiderosis in 26%, nonspecific abnormalities in 39%, cirrhosis in 23%, and chronic active hepatitis in 3%. AIDS cases were also compared to 10 selected age, sex, and epidemiologically similar non-AIDS patients. Although granulomas or infections were not seen in our comparison group, only the incidence of chronic active hepatitis was significantly different between the groups. If only those with intravenous drug abuse were studied, then none of 24 AIDS patients versus four of eight non-AIDS cases (p less than 0.005) had chronic active hepatitis. AIDS patients with specific hepatic infections tended to have a higher alkaline phosphatase and aspartate aminotransferase (p less than 0.05) than noninfected cases. However, substantial overlap existed, and no difference in hepatomegaly was noted. Ninety percent of AIDS patients were ingesting at least one potentially hepatotoxic drug. We conclude that AIDS patients have a high incidence of underlying hepatic abnormalities. However, clinical and biochemical abnormalities are similar in our selected liver biopsy patients with intravenous drug abuse with or without AIDS. As expected, AIDS patients have a higher incidence of hepatic granulomas and infections, but these patients were not clearly distinguishable from other AIDS cases. Histological examination showed a wide array of changes by light microscopy, but no specific lesion of AIDS was noted. The low incidence of chronic active hepatitis in this AIDS population may imply that the altered T lymphocyte function in AIDS could influence the course of liver disease in these patients. PMID- 3826030 TI - Stainable iron in gastric and duodenal mucosa of primary hemochromatosis patients and alcoholics. AB - The presence of iron in gastric and duodenal mucosa was investigated with Perl's stain in endoscopic biopsies from 13 patients with overt primary hemochromatosis, 10 chronic heavy alcohol abusers, and 10 patients with nonulcer dyspepsia. In the primary hemochromatosis patients marked iron deposition was found in cells at the base of glands in the gastric body and antrum in nine cases, and in crypt cells and Brunner gland cells of the duodenum in six. Iron was detected in the lamina propria of the stomach in five and duodenum in four cases. A similar distribution of iron overload, usually of lesser degree, was also observed in five alcoholics. Serum ferritin levels and the degree of gastric and/or duodenal iron deposits did not correlate in either hemochromatosis patients or alcoholics. No gastric or duodenal siderosis was observed in nonulcer dyspepsia cases. The absence of gastric and duodenal stainable iron in some hemochromatosis patients and its presence in some alcoholics suggests that the diagnostic value of upper gastrointestinal biopsy in primary hemochromatosis is limited. PMID- 3826031 TI - Incomplete small bowel obstruction by the Garren-Edwards gastric bubble necessitating surgical intervention. AB - A 39-yr-old woman was treated with Garren-Edwards gastric bubble, a new nonsurgical device for the treatment of obesity. The patient did well for 31/2 months before presenting with a partial small bowel obstruction caused by a spontaneously deflated bubble. After several days of observation and therapeutic maneuvers, a partially deflated bubble was removed surgically. Although the patient had had previous abdominal surgery, she had no adhesions that were considered contributory to the obstructive process at surgery; the deflated bubble did not deflate enough to traverse the distal ileum. This case represents the first case of bowel obstruction by this device in a patient with a "normal" intestinal tract. Patients considering placement of a Garren-Edwards gastric bubble must be fully informed of this potential complication even when there has been no prior abdominal surgery. PMID- 3826032 TI - Recurrent pancreatitis caused by a calcified ascaris in the duct of Wirsung. AB - A case report of recurrent pancreatitis in a 20-yr-old woman due to an impacted calcified Ascaris remnant within the duct of Wirsung is presented. Endoscopic retrograde cholangiography identified a filling defect in the proximal main pancreatic duct. Transampullary endoscopic retrieval failed to extract the calculus and operative intervention was required to remove the calcified worm remnant. PMID- 3826033 TI - Obstructing pseudocyst of the duct of Santorini in pancreas divisum. AB - Pancreas divisum is a pancreatic duct anomaly that occurs due to failure of fusion of the dorsal and ventral ducts. While recognition of this anomaly is increasing due to more aggressive endoscopic retrograde cholangiopancreatography, its significance remains unclear. A patient with chronic pancreatitis and a history of alcohol abuse was noted to have pancreas divisum. At surgical exploration, intraoperative pancreatography revealed an obstructing pseudocyst of the duct of Santorini. Extended sphincteroplasty and cystduodenostomy as well as Roux-en-Y pancreatojejunostomy were necessary to insure adequate accessory duct drainage. Surgical therapy of pancreas divisum in chronic pancreatitis should be designed to correct existing pancreatic duct obstruction. PMID- 3826034 TI - Bile peritonitis and hemobilia after percutaneous liver biopsy: endoscopic retrograde cholangiopancreatography demonstration of bile leak. AB - A 29-yr-old woman developed portal hypertension secondary to congenital intrahepatic multiple microhamartomata. Percutaneous liver biopsy was complicated by both bile peritonitis and hemobilia. Endoscopic retrograde cholangiopancreatography was used to demonstrate the bile leak. Abdominal paracentesis failed to control the leak, which was managed by surgery. Endoscopic drainage by nasobiliary intubation with suction might have avoided surgery. PMID- 3826035 TI - Choledochoduodenal fistula: a rare complication of peptic ulcer disease. AB - Choledochoduodenal fistula is a rare complication of peptic ulcer disease. Many cases are asymptomatic and incidentally diagnosed. Treatment is controversial and ranges from medical treatment of peptic ulcer disease alone, to vagotomy with antrectomy or gastroenterostomy. Common bile duct exploration and reconstruction are reserved for cases with biliary stricture. PMID- 3826036 TI - Reversible aperistalsis as a complication of gastroesophageal reflux disease. AB - A case of an acquired scleroderma-like aperistalsis of the esophagus caused by gastroesophageal reflux disease and reversed by correction of the reflux and healing of the esophagitis is presented. This abnormality appears to be a more extreme example of an increasingly reported complication of gastroesophageal reflux, reversible esophageal motility changes. PMID- 3826037 TI - Aseptic meningitis due to echovirus 4 in Panama City, Republic of Panama. AB - Between September 23 and November 30, 1981, 1,032 children from Panama City, Republic of Panama were hospitalized with aseptic meningitis. Forty-four per cent of the cases were in the age group 5-9 years old; the disease was mild and self limiting with an average hospital stay of five days. Echovirus 4 isolates were obtained from 48 of 160 patients. To identify risk factors associated with the epidemic, the authors randomly selected 10 per cent of hospitalized cases and conducted a family-based seroepidemiologic study. The closest neighboring house with at least one child younger than 15 years was similarly studied as a control. In total, 182 households and 1,083 of 1,177 residents were included. No risk factors ascertained by the study were associated with aseptic meningitis; however, several factors were related to recent echovirus 4 infection. Overall, 56 per cent of cases had echovirus 4 antibody, as did 29 per cent of their family members and 19 per cent of control family members. Children who attended kindergarten or primary school were more likely to have antibody than other household members and, within case families, individuals involved in child-care had an excess risk for infection. PMID- 3826038 TI - Influenza B virus reinfection. AB - Four outbreaks of influenza B infection occurred in Houston, Texas in the years 1976-1984. In the Houston Family Study, age-related infection and illness rates in the recent two epidemics resembled those reported previously. A total of 118 persons, including 35 children followed from birth, were followed longitudinally through this entire period and 331 persons were studied through at least two outbreaks. Fifty-nine (88%) of 67 children studied for four outbreaks were infected and 25% had a second infection; about half of the adults had one infection but only one of 51 was reinfected. Infection rates were proportionally lower for those followed through 2-3 outbreaks. Those with documented infection were protected decreasingly over time against reinfection and associated illness in subsequent epidemics. Such protection decreased in efficacy from 65% after 2-3 years, to 46% after 4-5 years, and to no protection after seven years. PMID- 3826040 TI - Protection against ischemic heart disease in the Belgian Physical Fitness Study: physical fitness rather than physical activity? AB - Occupational and leisure time physical activity and conventional risk factors were determined in the Belgian Physical Fitness Study, a prospective study of 2,363 healthy male factory workers who were aged 40-55 years at entry in 1976 1978 and who were followed for five years. Physical fitness, defined as the interpolated physical working capacity at heart rate 150 beats per minute, was measured in 2,109 subjects. In this subgroup, there were 31 myocardial infarctions and sudden deaths. Smoking, physical fitness, and high density lipoprotein cholesterol (HDL cholesterol) were independent risk indicators for subsequent ischemic heart disease, while both physical activity scores were not. It is concluded that in this healthy, predominantly sedentary population, the fitness level, but not the physical activity pattern, is an independent protective factor against ischemic heart disease. PMID- 3826039 TI - Smoking, physical activity, and other predictors of endurance and heart rate response to exercise in asymptomatic hypercholesterolemic men. The Lipid Research Clinics Coronary Primary Prevention Trial. AB - The association of known coronary risk factors with progressive submaximal treadmill exercise tolerance test performance was studied in 6,238 asymptomatic white 34-60-year-old hypercholesterolemic men screened between 1973 and 1976 for the Lipid Research Clinics Coronary Primary Prevention Trial. Cigarette smoking and habitual physical inactivity were each associated with a doubling of the rate of symptom-related discontinuation of the exercise test; the tests of sedentary smokers were discontinued at four times the rate observed for active nonsmokers. Smaller increases in heart rate were observed during exercise testing in physically active men and in smokers than in their sedentary and nonsmoking counterparts. Thus, smoking, like habitual physical activity, reduced the heart rate required to sustain a given external workload. However, the heart rates of smokers tended to remain elevated after exercise, while those of physically active men returned more rapidly toward resting levels. Age, Quetelet index, and low plasma levels of high density lipoprotein cholesterol were also strong predictors of decreased endurance, while resting heart rate and blood pressure levels were significant predictors of heart rate response. Comparison of these results with those previously reported for ischemic electrocardiographic changes in this cohort suggests that coronary risk factors may selectively influence specific aspects of exercise tolerance test performance. PMID- 3826041 TI - The Tromso Heart Study: food habits, serum total cholesterol, HDL cholesterol, and triglycerides. AB - Associations between food habits and total serum cholesterol, high density lipoprotein (HDL) cholesterol, and serum triglycerides were examined in 7,410 men and 7,257 women in Tromso, Norway, following a screening in 1979-1980. High body mass index was associated with high serum cholesterol, high triglycerides, and low HDL cholesterol. Positive associations were observed between high serum cholesterol and high coffee consumption, use of butter or hard margarine, not selecting low-fat milk, and low bread consumption. The HDL cholesterol level was virtually independent of the dietary items recorded. Use of low-fat milk and frequent use of fish dishes for dinner seemed to be related to low serum triglyceride levels. PMID- 3826042 TI - An outbreak of recurrent acute and chronic hypersensitivity pneumonitis in office workers. AB - Three episodes of an acute, flu-like illness, one studied in detail, were associated with manipulations on the central air handling system of an office building in Tennessee in the summer and early fall of 1981. Symptoms were compatible with acute hypersensitivity pneumonitis, although the time of onset revealed a biphasic epidemic curve. Breathing air not supplied through the central air handling system protected against disease. Ill persons had significantly more precipitins to agents cultured from the building than did controls. Symptoms suggestive of chronic hypersensitivity pneumonitis were also found. Chronic disease was associated with the presence of humidifiers at home, asthma, and longer work in the building. Acute disease occurred less frequently in smokers and persons who had previously worked in the building before 1976. Persons with acute disease were more likely to have chronic disease. No single etiologic agent could be identified. Because of difficulties with demonstrating safety for reoccupancy, the building was vacated and remains empty at this time. PMID- 3826043 TI - A community hospital outbreak of legionellosis. Transmission by potable hot water. AB - Seven cases of nosocomial legionellosis occurred between February and September 1982 in a small community hospital in Upstate New York. All seven were cases of Legionella pneumophila serogroup 1; six were hospital patients and one a hospital employee. None of the cases died. During the peak of the outbreak, the incidence of nosocomial legionellosis was 1.2 cases per 100 patient discharges. An epidemiologic comparison of the six patient cases with 21 matched patient controls suggested that longer hospital stay (chi 1(2) = 24.2, p less than 0.001) and the proximity of patients' rooms to ward showers (chi 1(2) = 4.4, p less than 0.04) were significant risk factors for acquiring legionellosis. An environmental investigation demonstrated that the ward showers and the hospital hot water system were contaminated with L. pneumophila serogroup 1. Monoclonal antibody subtyping performed on isolates obtained during the outbreak investigation confirmed that the hot water system and patient isolates had an identical pattern of reactivity. The outbreak demonstrates that legionellosis can be a significant cause of nosocomial pneumonia in a community hospital and that transmission can occur from contaminated potable hot water sources, potentially via shower aerosols. PMID- 3826044 TI - Reproducibility of reports of frequency of food use in the Tecumseh Diet Methodology Study. AB - Frequency reports in 1967-1969 for 83 foods were compared to frequency reports for the same foods asked retrospectively in 1982-1983 about use in 1967-1969 for 1,184 respondents aged 45-64 in the Tecumseh Community Health Study cohort. Food frequency reports of the current (1982-1983) diet were also compared to baseline reports to indicate diet stability and to retrospective reports to indicate the influence of current diet on retrospective reporting. Comparisons were also made for 13 food groups and vitamin A and C indices. Short-term reproducibility of seven foods, measured by two reports 1-3 weeks apart in 1967-1969, was compared to long-term reproducibility for the same foods. Short-term reproducibility was consistently greater than long-term. Reproducibility was associated positively with stability of use. For the two nutrient indices and nine of the ten food groups examined, mean intake estimated from the retrospective report differed significantly from mean intake from the baseline report. Agreement between retrospective and current reports exceeded agreement between retrospective and baseline reports, indicating that retrospective reports were greatly influenced by current behavior; yet, the retrospective reports were better indicators of baseline consumption than were the current reports. While misclassification from use of the retrospective report to measure baseline consumption was large, risk differences may still be detected with usual sample sizes. PMID- 3826045 TI - Comparing new and old screening tests when a reference procedure cannot be performed on all screenees. Example of automated cytometry for early detection of cervical cancer. AB - Direct determination of the sensitivity and specificity of a screening test requires use of a reference procedure (such as biopsy with histopathologic analysis) that provides an estimate of true disease status. The authors present a method for comparing the accuracy of a new screening test to an old one in situations when it is not feasible to apply the reference procedure to all screenees. This method requires that only those persons who test positive on old or new screening tests be further evaluated with the reference procedure. Ratios of sensitivities and specificities are derived for rapid comparison of the two screening tests. It is shown that McNemar's test can be used for significance testing of the differences in sensitivities and specificities between two screening tests. The required sample size for a study that compares the two tests is determined. PMID- 3826046 TI - Partitioning the variability of fasting plasma glucose levels in pedigrees. Genetic and environmental factors. AB - Fasting plasma glucose measurements made in 1972-1977 on normoglycemic individuals in three-generation Caucasian pedigrees from Rochester, Minnesota were analyzed. The authors determined the contributions of polygenic loci and environmental factors to fasting plasma glucose variability in these pedigrees. To that end, fasting plasma glucose measurements were normalized by an inverse normal scores transformation and then regressed separately for males and females on measured concomitants including age, body mass index (weight/height2), season of measurement, sex hormone use, and diuretic use. The authors found that 27.7% of the variability in normalized fasting plasma glucose in these pedigrees is explained by these measured concomitants. Subsequent variance components analysis suggested that unmeasured polygenic loci and unmeasured shared environmental factors together account for at least an additional 36.7% of the variability in normalized fasting plasma glucose, with genes alone accounting for at least 27.3%. These results are consistent with the known familiality of diabetes, for which fasting plasma glucose level is an important predictor. Further, these familial factors provide an explanation for at least half the variability in normalized fasting plasma glucose which remains after regression on known concomitants. PMID- 3826047 TI - A mathematical model for the rural amplification of Murray Valley encephalitis virus in southern Australia. AB - The exacerbation of epidemics of Murray Valley encephalitis in southern Australia during 1951 and 1974 was studied retrospectively to determine when viral introduction may have occurred. Data from studies spanning over 30 years were utilized 1) to determine the number of infective Culex annulirostris necessary to cause one clinical case, based on known host-feeding patterns and the subclinical infection rate in man, and 2), using mathematical modeling, to calculate the likely duration of the rural amplification phase. Generalized tables were generated which demonstrated that mosquito longevity, extrinsic incubation period, and duration of the feeding cycle were the most important variables predisposing rapid amplification. Although Murray Valley encephalitis transmission may still occur during adverse conditions when the reproduction rate Z less than 1.0, subtraction of the durations of incubation in man prior to clinical onset and the most likely rural amplification period from the dates of onset of clinical infections during January 1951 and 1974 suggested that amplification commenced around October 9-30 and that any Murray Valley encephalitis introduction had occurred by then. Examination of bird and mosquito dispersal prior to this time suggests that long-range dissemination of the virus from endemic northern Australia was unlikely. PMID- 3826049 TI - Polychotomous logistic regression methods for matched case-control studies with multiple case or control groups. AB - Two statistical methods, a polychotomous and pairwise approach, are presented to derive estimates of the relative odds in a matched case-control design when multiple case or control groups are used. Test statistics are derived to determine if the relative odds between groups are different. The polychotomous method is limited to case-control sets, i.e., where data are available on all members of a matched set. In contrast, the pairwise method makes use of data from both complete and incomplete sets. Nonetheless, efficiency calculations show that the polychotomous logistic regression model is more efficient even when 40 per cent of the case-control sets are incomplete. An example using a single dichotomous variable is provided. PMID- 3826048 TI - Multivariate analysis of lipoprotein cholesterol fractions. AB - Intervention and prevention of multifactorial diseases such as coronary heart disease can be effective only when the joint effects of multiple risk factors are known. This process is facilitated by multivariate analysis of correlated risk factors, such as the serum cholesterol fractions, high density lipoprotein (HDL), low density lipoprotein (LDL), and very low density lipoprotein (VLDL). Whereas evidence for genetic covariation provides focus for further refined biochemical analysis, covariation among environmental factors can point to efficacious intervention strategies. To assess sources of variation and covariation among HDL, LDL, and VLDL, a multivariate path model was developed and applied to family data. Phenotypic variance is due primarily to specific environmental influences with substantial genetic influences, with the common family environment contributing less than 10% of the variance. There are genetic correlations of 0.22 for HDL-VLDL and 0.35 for VLDL-LDL, consistent with the known inverse associations of HDL and VLDL and the precursor-product relationship between VLDL and LDL, whereas there is no evidence for a direct HDL-LDL genetic relationship. Strong specific environmental correlations are found between HDL and VLDL (-0.35 in children and -0.50 in adults). Thus, intervention focused primarily on one fraction (e.g., triglycerides and VLDL) might beneficially affect levels of both lipoproteins (e.g., lowering VLDL cholesterol and elevating HDL cholesterol). Multivariate analysis can facilitate understanding of the linked effects of intervention on lipoprotein cholesterols, and, hence, should benefit approaches to maximize the effects of lipoprotein cholesterol intervention on coronary heart disease morbidity and mortality. PMID- 3826050 TI - Statistical modelling of lung cancer and laryngeal cancer incidence in Scotland, 1960-1979. AB - The ratio of cancer occurrence among smokers compared to nonsmokers has been generally reported to be greatest for carcinomas arising in the lung and larynx. This report presents the results of an investigation into mechanisms underlying the temporal trends in the incidence of these two forms of cancer in Scotland over the 20-year period, 1960-1979. The purpose of the study was to establish the independent effects of age, calendar time, and birth cohort on the observed pattern of incidence by adopting an alternative approach to this classical problem which can be employed when data are available as individual records. The most economic model found to explain the data involved the independent effects of site, sex, and age and different cohort effects in each sex. The cohort effect was more pronounced in men than women in older cohorts but, conversely, stronger in women than in men in younger cohorts, i.e., among those born most recently. This observation accords with the observed increase in the use of cigarettes in young women relative to young men. There appeared to be a small effect of calendar time which was the same in both sexes and both sites, although this main effect, it must be emphasized, could be eliminated from the model on statistical grounds. The effect can be interpreted to indicate the increase in the coverage of cancer registration in Scotland which has taken place since 1960. These results indicate that lung cancer risk in Scottish males will continue to fall, with the risk in women lagging 20 years behind, although the levels in women will probably not reach those attained by men. PMID- 3826051 TI - Comparing mortality in an occupational cohort with incidence rates of the general population--the bias introduced through the use of five-year age intervals. AB - The use of five-year age intervals will introduce a bias when mortality or morbidity rates for a cohort are compared with incidence rates from the general population. In a cohort of Swedish machining workers, the expected mortality and morbidity rates from cancer were reduced by about 5 per cent when one-year age intervals were used instead of five-year age intervals. PMID- 3826052 TI - Historical interpretations of the decline of tuberculosis mortality. PMID- 3826053 TI - Re: "A study of the effect of weight and dietary fat on breast cancer survival time". PMID- 3826054 TI - Prothrombin "Mexico City," an asymptomatic autosomal dominant prothrombin variant. AB - A functionally normal but structurally abnormal prothrombin variant was found in a Mexican family. Immunoisoelectricfocusing studies revealed that this variant has a more acidic isoelectric point (4.01) than normal prothrombin (4.29), but it proved to have a normal molecular weight as assessed by sodium-dodecyl-sulphate polyacrylamide gel electrophoresis. Two-dimensional immunoelectrophoresis studies showed an abnormal cleavage of the prothrombin molecule by factor Xa and Echis carinatus venom as well, despite the fact that both yield functionally normal thrombin molecules. Finally, the ability of the molecule to bind calcium ions as well as its overall antigenic structure were investigated and found to be normal. These results taken together suggest a simple (substitution or translocation) mutation at the fragment 2 level. Since this prothrombin variant is different from others described previously, the name "Mexico City" is proposed to identify it. PMID- 3826055 TI - Effectiveness of oral iron chelators assayed in the rat. AB - A 4-hour in vivo test for iron chelator activity in the rat is described. The amount of radioiron in the gut and urine that results from chelator-induced excretion of previously injected radioiron labelled ferritin is measured. Hepatocyte localization and desferrioxamine-induced radioiron mobilization from in vitro tagged homologous ferritin is shown to be similar to that from in vivo tagged ferritin. Non-homologous ferritin preparations labelled in vitro proved unsatisfactory. Radioiron mobilization by chelator occurred regardless of the iron status of the animal. Employing this measurement, the effectiveness of three iron chelators, pyridoxal isonicotinoyl hydrazone, the dimethyl ester of ethylene diamine-N, N'-dis (3-hydroxyphenyl acetic acid), and the dimethyl ester N, N'-di (3-hydroxybenzyl) ethylene-1, ethylene-1, 2-diamine-N, N'-diacetic acid, given orally was determined. All three chelators, when given in comparable dosage, induced iron excretion similar in amount to that observed with parenteral desferrioxamine. In addition, pyridoxal isonicotinoyl hydrazone administered in the diet over a period of 4 weeks was shown to reduce hepatic and splenic iron of normal animals by about one third, providing further validation of this method of evaluating chelator effectiveness. PMID- 3826056 TI - Combination of three alpha-globin gene loci deletions and hemoglobin New York results in a severe hemoglobin H syndrome. AB - A chinese patient with hemoglobin (Hb) H and Hb New York is described. Unlike classical Hb H disease, the additional beta New York chain defect resulted in a more marked alpha/beta-globin chain imbalance in this patient with only one alpha gene, accounting for her severe anemia (3.4-6.8 g/dl) during the steady state. PMID- 3826057 TI - Cyclosporin treatment for aplastic anemia: a case report demonstrating a second response to second exposure to cyclosporin. AB - Cyclosporin has been used in the treatment of aplastic anemia, often in combination with other drugs, making it difficult to make a clear distinction between the effects of cyclosporin and those of other treatments. This report demonstrates a clear response of a patient with aplastic anemia to single drug cyclosporin therapy. PMID- 3826058 TI - Lymphoid blastic crisis in Ph-negative chronic myeloid leukemia. PMID- 3826059 TI - Steroid-responsive nephrotic syndrome of childhood: a long-term study of clinical course, histopathology, efficacy of cyclophosphamide therapy, and effects on growth. AB - The long-term clinical course of 60 children with steroid-responsive nephrotic syndrome, observed for a minimum of 10 years from onset, was studied (mean 14.5 +/- 0.5 years). Four children had only a single episode, seven children experienced only one to three relapses early in their course, and the remaining 49 patients (82%) experienced frequently relapsing steroid-dependent disease. Nearly half of these (47%) continued to relapse into their late teens and early twenties. All 20 children treated with cyclophosphamide because of steroid induced side effects developed complete remissions of the nephrotic syndrome. These were sustained in 70% for 9.1 +/- 0.6 years, with a reduction of disease severity in the remaining 30%. In contrast, only 48% of patients treated with prednisone alone were in remission at last follow-up (P = .06). Ten of the children treated with cyclophosphamide had the minimal change lesion prior to therapy; 90% of these had permanent remissions. Only 50% of the six children with focal glomerulosclerosis and four children with mesangial proliferation have had permanent remissions. None of the patients developed renal insufficiency. Children treated with prednisone alone were -0.93 +/- 0.3 SD below the mean for height at last follow-up. Cyclophosphamide treatment was associated with an increase in height SD scores from -0.84 +/- 0.4 to -0.28 +/- 0.3. Children with severe growth impairment demonstrated dramatic catch-up growth when treated with cyclophosphamide with SD scores increasing from -2.29 +/- 0.8 to -0.43 +/- 0.6 (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826060 TI - Differences between membranoproliferative glomerulonephritis types I and III in clinical presentation, glomerular morphology, and complement perturbation. AB - Data for 26 patients with membranoproliferative glomerulonephritis, type I (MPGN I) and 22 with membranoproliferative glomerulonephritis, type III (MPGN III), as distinguished by glomerular ultrastructure, were analyzed to determine differences in presentation, complement perturbation, and glomerular morphology by light microscopy. MPGN III was detected with greater frequency by the chance discovery of hematuria and proteinuria in the otherwise healthy individual (MPGN III, 63%; MPGN I, 30%; P = .01) and never, in the absence of renal failure, presented with systemic symptoms such as ease of fatigue, weight loss, and pallor, as may patients with MPGN I. The more frequent detection of MPGN III by chance is evidence that its onset is insidious and that for long periods it produces no symptoms or signs. Glomerular proliferation is also less than in MPGN I. Further, in MPGN III, the complement perturbation and glomerular immunofluorescence give no evidence of classical pathway activation, for which there is abundant evidence in MPGN I. Even with severe hypocomplementemia in MPGN III, C3 nephritic factor, another cause of hypocomplementemia, is rarely detectable and then in very low concentration. The cause of the complement perturbation in MPGN III has so far escaped identification. Although these observations give evidence that MPGN III is distinct from MPGN I, there is compelling evidence from other studies that a predisposition to both types is inherited and that similar genetic factors are operative in the two types. Because their genetic basis appears to be the same, it must be concluded that despite their differences, types I and III are variants of the same disease. PMID- 3826061 TI - Identification of fragments of proximal and distal tubular cells in the urine of patients under cytostatic treatment by immunoelectron microscopy with monoclonal antibodies. AB - In an attempt to identify the origin of cellular fragments released in the urine of patients treated with potentially nephrotoxic drugs such as cytostatics, two monoclonal antibodies were applied: monoclonal antibody PM II 9 C2, directed against an antigen in distal tubular cells; and monoclonal antibody PM II 39 H11 specific for an antigen in proximal tubular cells. The specificities of both monoclonal antibodies were elaborated in the indirect as well as in the direct immunofluorescence technique. Both antibodies were then used to identify cellular fragments obtained from the urine of patients treated with cytostatic drugs by ultracentrifugation. By application of the indirect immunogold method, it was shown that material of proximal as well as distal tubular origin was shed by the damaged cells. Whereas the proximal tubular antigenic epitope recognized by PM II 39 H11 was always found in large irregular complexes of debris-containing vesicles, the distal tubular antigenic epitope recognized by PM II 9 C2 was always found associated with filament-like regular structures. This is the first report in which excretion of components of distal tubular cells is demonstrated as a consequence of the nephrotoxic side effects of cytostatic treatment. With the help of monoclonal antibodies, it has now become possible to identify and to investigate the damage inflicted on the distal part of the tubule system in addition to the well-documented proximal tubular damage. PMID- 3826062 TI - Renal involvement in juvenile chronic arthritis: clinical and pathologic features. AB - Over an 18-year period, renal involvement was diagnosed in 13 patients, who represent 1% of the total juvenile chronic arthritis population referred to us. All had severe arthritis. This study illustrates the importance of renal biopsy and indicates that renal involvement in juvenile chronic arthritis is a heterogeneous group of diseases, with a variety of causes. In eight patients with nephrotic syndrome, renal biopsy revealed amyloidosis. One rapidly died of diffuse amyloidosis and infection. The other seven received chlorambucil. Disappearance of proteinuria was noted in three of them. Four patients have persistent proteinuria but normal serum creatinine. It is suggested that, despite the long-term oncogenic risk of the drug, chlorambucil may be beneficial in patients with amyloid deposits. In one patient, the nephrotic syndrome was attributed to systemic lupus erythematosus, and in another, the chance association of an arthritis and nephrotic syndrome with minimal glomerular changes was considered. Although drug responsibility is difficult to determine in these patients receiving several medications in association, the renal involvement presented by the remaining three patients was probably related to drug(s). Moreover, it is possible that the effect of the association of medications is deleterious to the kidney. Drug-induced nephropathy is usually reversible when drugs are stopped. Unfortunately, because of persistent joint pain, these patients will continue to require pain-relieving drugs over prolonged periods. PMID- 3826063 TI - Familial adult glomerulocystic kidney disease. AB - During an evaluation for nephrotic syndrome, a 20-year-old woman was found by ultrasonographic examination to have large kidneys with multiple renal cysts suggestive of polycystic kidney disease. A subsequent renal biopsy revealed membranous glomerulopathy due to systemic lupus erythematosus, as well as the unexpected finding of glomerulocystic kidney disease (GCKD), an uncommon disorder previously reported to occur primarily in infants and children. No evidence of renal dysplasia was present and no cysts were found in any abdominal or pelvic organs. Other than one bifid renal pelvis, no significant congenital anomalies or structural chromosomal abnormalities were present. Ultrasonographic evaluation of the patient's family revealed similar-appearing cortical cysts in several members, all of whom had no clinical evidence of renal dysfunction. The pattern of involvement was compatible with autosomal dominant inheritance. Follow-up ultrasonograms of the patient and affected family members 1 year after the initial study showed enlargement of the cysts with development of additional cysts in two individuals and no change in the other family members. Although renal failure was present and progressed in our patient, renal function remained normal in all affected family members 1 year after detection of the renal cysts. This patient and her family provide additional insight into the inheritance and natural history of GCKD and demonstrate that this condition should be considered in the evaluation of multicystic renal disease in adults. In contrast to several previously reported cases, it appears that GCKD may be associated with normal renal function for many years. PMID- 3826064 TI - Renal adenocarcinoma and acquired cystic disease in chronic hemodialysis patients. AB - Three chronic hemodialysis patients developed renal cell adenocarcinoma with evidence of acquired cystic disease in two. The incidence of renal cancer in this study population of 0.27% per year is 50 times greater than that expected in general. The cancers appeared to develop at different rates. In one patient examined by serial computed tomography (CT) over 2.5 years, the tumor progressed rapidly. In the other two patients, the process was more idolent. On the basis of our experience, we recommend that dialysis patients be screened for acquired cystic kidney disease (ACKD) and renal tumors by sonography or CT. Patients with ACKD should be observed at regular intervals by CT for the development of possible tumor. PMID- 3826065 TI - The kidney in hypergammaglobulinemic purpura. AB - A 25-year-old woman with long-standing hypergammaglobulinemic purpura developed distal renal tubular acidosis and a urine-concentrating defect. The acidification defect was characterized as suggestive of impaired distal proton secretion by infusion of neutral phosphate. The concentrating defect was a form of acquired nephrogenic diabetes insipidus. On renal biopsy, IgM mesangial nephropathy was found along with multiple large hyaline tubular casts. The renal findings in hypergammaglobulinemic purpura are reviewed. PMID- 3826066 TI - Renal disease and syphilis: a report of nephrotic syndrome with minimal change disease. AB - A case of nephrotic syndrome and acute renal failure in a 74-year-old man with latent syphilis is described. A renal biopsy demonstrated focal global sclerosis in three of nine glomeruli, however, the remaining glomeruli revealed typical lesions of minimal change disease. Previous reports of renal involvement in syphilis have described membranous glomerulonephritis, mesangial and endothelial cell proliferative glomerulonephritis, and, recently, rapidly progressive glomerulonephritis. The proteinuria and renal failure resolved after penicillin therapy alone. This response strongly suggested that there was a causal relationship between the syphilis and the nephrotic syndrome. This is the first report of such a relationship. PMID- 3826067 TI - The American Journal of Kidney Diseases adopts Systeme International units. PMID- 3826068 TI - Analysis of risk factors for patient and renal survival in crescentic glomerulonephritis. AB - A series of 57 patients with crescentic glomerulonephritis was studied retrospectively to estimate patient and renal survival and to analyze the variables that affect these end points. Renal survival was 47% at 6 months for patients with idiopathic rapidly progressive glomerulonephritis and 33% for patients with antiglomerular basement membrane disease. Most patients in these two groups presented with advanced renal insufficiency. Renal survival rates for patients with systemic illness, with or without a tissue diagnosis of vasculitis, were 93% and 100%, respectively, at 1 year. These patients had better renal function at presentation. Overall, patient survival at 5 years was 61%, and there were no significant differences among the groups. A systematic analysis of clinical, immunopathologic, and laboratory variables showed that the initial serum creatinine level and oliguria and the patient's age and oliguria were the most important indicators of renal and patient survival, respectively. Virtually all patients with a creatinine level greater than 6.0 mg/dL lost their kidneys. Five-year survival for patients greater than 60 years old was 31%, compared with 83% for those less than or equal to 60 years. Moderate-to-severe tubulointerstitial inflammation indicated worse patient and renal survival, and 24-hour urine protein excretion greater than 3 g was related to shorter renal survival. We have identified and ranked a number of variables that affect patient or renal survival in crescentic glomerulonephritis. These findings may be of help in the decision-making process of patient management and analysis of treatment modalities. PMID- 3826069 TI - Calcium carbonate is an effective phosphorus binder in children with chronic renal failure. AB - We evaluated the effectiveness of calcium carbonate as a phosphate binder in 19 children with chronic renal failure; ten children were undergoing dialysis therapy (eight maintained by CAPD and two by hemodialysis). Twelve children had previously received aluminum hydroxide, while calcium carbonate was the primary phosphate binder used in seven children. Among all the children, the serum phosphorus level on no phosphate binder was 7.4 +/- 0.9 mg/dL, which decreased significantly (P less than .001) to 5.9 +/- 0.8 mg/dL during calcium carbonate therapy, while the serum calcium, bicarbonate, and creatinine were unchanged. The reduction in the serum phosphorus level occurred while dietary intake of calcium and phosphorus were unchanged, as demonstrated by three-day dietary records. The dose of calcium carbonate required to maintain the serum phosphorus in the normal range varied from 600 mg to 15 g/d (mean 7.4 g/d). Among the 12 children and four others who had received aluminum hydroxide, serum aluminum levels fell from 108.8 +/- 121.8 ng/mL to 36.1 +/- 29.1 ng/mL after aluminum hydroxide was stopped (P less than .05). Serum alkaline phosphatase and parathyroid hormone (PTH) levels during aluminum hydroxide therapy were similar to levels obtained during calcium carbonate therapy, while PTH levels fell in children treated initially with calcium carbonate. All the children have been observed for a mean of 12.0 months (range 4 months to 3 1/2 years). Hypercalcemia occurred in seven children, usually when vitamin D therapy was initiated or the dose changed. Hypercalcemia resolved with adjustment of the vitamin D or calcium carbonate dose in all but one patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826070 TI - Erythrocyte sodium and potassium in patients on peritoneal dialysis. AB - Intracellular sodium and potassium concentrations were determined on erythrocytes obtained, before and after treatment, from patients with end-stage renal disease undergoing 48-hour intermittent peritoneal dialysis. Erythrocyte sodium increased from 7.5 +/- 0.3 to 8.6 +/- 0.4 mmol/L cells with a mean of 1.1 +/- 0.1 mmol/L cells (P less than .001), but erythrocyte potassium and cellular water content were virtually unchanged. Plasma potassium decreased during dialysis from 4.2 +/- 0.2 to 3.3 +/- 0.1 mEq/L (P less than .001). The increase in red-cell sodium correlated with this decrease in plasma potassium (r = .51, P less than .01). In contrast, erythrocyte sodium and potassium in undialyzed control patients with chronic renal failure did not change over a similar period, and plasma potassium was unchanged (4.3 +/- 0.1 mEq/L before and 4.3 +/- 0.2 mEq/L after 48 hours). Incubation of postdialysis erythrocytes from the dialysis patients in their own plasma at varying potassium concentrations showed that the rise in cell sodium was blunted as the plasma potassium was increased from 3.2 +/- 0.1 to 4.5 +/- 0.2 mEq/L. These results suggest that unlike hemodialysis, which is not associated with short-term changes in red-cell electrolytes, intermittent peritoneal dialysis results in a reversible increase in erythrocyte sodium. This change appears to be causally related to the decrease in extracellular potassium concentration. PMID- 3826071 TI - Microcytic anemia in dialysis patients: reversible marker of aluminum toxicity. AB - Improvement of microcytic anemia after deferoxamine treatment is described in eight long-term dialysis patients with high serum aluminum concentration and other clinical signs of aluminum toxicity. Hematocrit increase of 3 to 19 vol% was associated with correction of microcytosis, significant reduction in abnormal levels of free erythrocyte protoporphyrins, and amelioration of the bone-related symptoms and neurologic signs of aluminum intoxication. Increase in hematocrit, reversal of microcytosis, and reduction in protoporphyrin levels all correlated with the aluminum burden as indicated by the pretreatment serum aluminum levels and by the peak serum aluminum levels during mobilization with deferoxamine. Furthermore, deferoxamine resulted in marked improvement in anemia despite significant reduction in serum ferritin levels. This reversal of microcytosis with deferoxamine provides objective evidence verifying the toxicity of aluminum, and suggests that microcytosis may be an easily detected marker for both clinical diagnosis as well as response to treatment in some cases of aluminum intoxication. PMID- 3826072 TI - Congo red-negative amyloidosis-like glomerulopathy: report of a case. AB - An elderly patient who had nephrotic syndrome for many years was found to have mesangial expansion and thickening of the glomerular capillary basement membranes (GBMs) on light microscopy. Electron microscopy (EM) showed tubular structures measuring 24 to 27 nm in the mesangium and the subepithelial areas. Congo red staining for amyloid was negative. This case represents another instance of congo red-negative amyloidosis-like glomerulopathy. PMID- 3826073 TI - Severe metabolic alkalosis complicating regional citrate hemodialysis. AB - Regional citrate hemodialysis has been effectively used as an alternative to heparin anticoagulation during dialysis of patients at increased risk for bleeding. Few complications have been noted; however, we report the occurrence of severe metabolic alkalosis in two patients requiring high infusion rates of citrate during hemodialysis while being mechanically ventilated. Careful monitoring of acid-base status is mandatory in this setting, and reduction of citrate dose may be advisable. PMID- 3826074 TI - Plasmapheresis and antiplatelet agents in the treatment of the hemolytic uremic syndrome secondary to mitomycin. PMID- 3826075 TI - Benign intracranial hypertension: a complication of subclavian vein catheterization and arteriovenous fistula. PMID- 3826076 TI - Cancer and other causes of death among Wisconsin farmers. AB - Computerized mortality listings for Wisconsin for 1968-1976 were used in proportional mortality ratio (PMR) and proportional cancer mortality ratio (PCMR) analyses to evaluate mortality patterns among Wisconsin farmers. Examination of PCMR trends by per capita county level of agricultural production was limited to the youngest birth cohort (1905-1958) and cancer sites associated with farming exposures in either the present or previous analyses. Among all Wisconsin farmers, significantly decreased PMRs were seen for tobacco- and alcohol-related causes of death, while excesses occurred for accidental causes, asthma, and cancer of the stomach, prostate, eye, and lymphatic and hematopoietic systems. Elevated PCMR's for leukemia and all lymphopoietic cancer and cancers of the stomach, rectum, eye occurred in farmers born 1905-1958, while deficits were observed for cancer of the pancreas and the category, "all other cancers." Increases in PCMR's with level of various agricultural activities were largely associated with cancers of other lymphatic tissue (2/3 of which were multiple myeloma) and the rectum. Certain agricultural exposures were also positively associated with deaths due to cancers of the prostate, brain, lymphosarcoma and reticulosarcoma, and all lymphopoietic cancers. No positive PCMR gradients were observed for leukemia and malignancies of the stomach and eye. Modern chemical practices in farming may account for some of the patterns noted. PMID- 3826077 TI - Occupational exposure to lead and blood pressure: a study in 105 workers. AB - A group of workers, occupationally exposed to lead and cadmium compounds (n = 53), was compared to a group of workers not exposed to these metals (n = 52). The average values of systolic, diastolic, and mean blood pressure were found to be higher in the exposed group (p less than 0.05). In contrast with the correlation between CdU and blood pressure, the correlation between PbB and systolic and mean blood pressure remained statistically significant after controlling for age and pulse rate (r = 0.22, p less than 0.05). The prevalence of potential hypertension (defined as systolic blood pressure greater than or equal to 160 mm Hg and/or diastolic blood pressure greater than or equal to 95 mm Hg and/or under treatment for hypertension) was higher in the exposed group, but the observed relative risk was not statistically significant: relative risk = 1.91 (95% confidence limits, 0.90-4.05). Furthermore, a significant correlation between PbB and Hgb (r = 0.28, p = 0.004) was observed. Differences in kidney function, as assessed in this study, were not detected. PMID- 3826078 TI - Cancer incidence and mortality among workers exposed to acrylonitrile. AB - A cohort of 1,083 male employees who had potential for exposure to acrylonitrile between 1944 and 1970 at a Du Pont textile fibers plant were followed through 1981 for mortality and through 1983 for cancer incidence. In total, the 21 cancer deaths were fewer than expected based on either Du Pont or U.S. rates. No significant excesses were seen by primary site. In all, 37 cancer cases occurred as compared with 36.5 expected based on company rates. Five lung cancer cases were observed and 6.9 expected. There were 5 prostate cancer cases as compared with 1.9 expected. Of these, 4 occurred among wage employees during the 1975-1983 period, compared to 0.9 expected. This excess was statistically significant. PMID- 3826079 TI - Texaco mortality study: III. A cohort study of producing and pipeline workers. AB - While there have been numerous epidemiology studies of refinery workers, no studies have been done on producing and pipeline workers. This is a retrospective follow-up study of all persons who were employed for at least 6 months at a Texaco producing or pipeline location and who worked at some time during the period 1946-1980. Of the 11,098 white men in the cohort, 8,964 were alive, 1,886 were known to be dead, and the vital status of the remaining 248 as of December 31, 1980 was unknown. The standardized mortality ratio (SMR) of 63 for all causes was significantly low, on the basis of 2,976 expected deaths. Statistically significant deficits also were seen for all major causes of death. Mortality patterns were also examined for the major job categories in these departments. Similar patterns of mortality were seen, although there was a significant excess of thyroid cancer in those employed as pumper-gaugers. However, it was based on only four cases. PMID- 3826080 TI - Semiconductor manufacturing: an introduction to processes and hazards. AB - Recent studies suggest that semiconductor workers have an increased incidence of work-related illness. Semiconductor manufacturing is a chemically intensive industry involving many potentially hazardous operations. As this industry moves into new geographic areas, health care professionals will be asked to evaluate medical or workplace conditions associated with unfamiliar and complex production processes. This paper provides an overview of semiconductor manufacturing processes for these health practitioners. Each step of device fabrication is detailed with its attendant chemical and physical hazards. Broader concepts of industrial control technology, clean room ventilation, and ergonomics are explained. The hazards are tabulated to allow rapid assessment of the risks inherent to each processing step. References have been chosen to guide the reader to more indepth information. PMID- 3826082 TI - Psychological performance in relation to central and peripheral nerve conduction in workers exposed to lead, zinc, and copper. PMID- 3826081 TI - Behavioral changes during exposure to 1,1,1-trichloroethane: time-course and relationship to blood solvent levels. AB - We report the results of an exposure chamber study in which volunteers were exposed to 0, 950 mg.m-3 (175 ppm) and 1,990 mg.m-3 (350 ppm) of 1,1,1 trichloroethane for 3.5 hours. The time-course of the behavioral changes and the relationship to blood concentrations of 1,1,1-trichloroethane were investigated. A pattern of performance deficits consistent with earlier work was found for some of the tests of psychomotor performance. The time-course of these appeared to be rapid, occurring in some cases within 20 minutes of exposure. For those tasks shown to be sensitive to 1,1,1-trichloroethane exposure, the development of performance changes followed the time-course of blood solvent levels. Two behavioral tests not previously used in this type of work were also employed. One was concerned with the distractability of attention and concentration (the Stroop test), and the other was concerned with analysing grammatical statements (the syntactic reasoning test). Different effects were found. In the Stroop test, enhanced performance was observed following exposure; however, the syntactic reasoning test was found to be resistant to solvent effects. Measures of short term subjective well-being were not affected by exposure. It is suggested that the observations of time-course effects in performance and their relationship to change in blood solvent levels have implications for psychological test selection and for study designs for examining field exposure. PMID- 3826083 TI - Monitoring waste in an intravenous admixture program. AB - A method for collecting and analyzing data on i.v. admixture waste is described, and examples of the use of these data to reduce waste are presented. In 1984, a pharmacy department serving 580 hospital beds projected annual expense for waste of i.v. products to be nearly $30,000. Five major changes were implemented to reduce waste. Modification of expiration dating policies for cefoxitin and tobramycin substantially reduced waste. After an operating room pharmacy satellite was opened, decreased waste of dobutamine, dopamine, nitroglycerin, and nitroprusside was estimated to save $1000 per year. Changing times of batch processing of i.v. admixtures resulted in cost savings that were not significantly different for three-month periods before and after the change. The method of identifying small-volume injections (SVIs) to be manufactured was improved, and SVIs of expensive drugs were prepared every 12, instead of 24, hours; these changes resulted in reduction of one technician full-time equivalent but little change in the percentage or cost of SVIs wasted. Decentralized pharmacists were asked to order certain items on an as-needed basis; this did not affect costs or waste. From 1984 to 1985, total costs associated with waste decreased an estimated $11,000, or 27.5%. This department's attempt to change i.v. admixture procedures based on timely data has resulted in substantial reductions in the cost of waste. PMID- 3826084 TI - Rapid colorimetric assay for gentamicin injection. AB - A rapid colorimetric method for determining gentamicin concentration in commercial preparations of gentamicin sulfate injection was developed. Methods currently available for measuring gentamicin concentration via its colored complex with cupric ions in alkaline solution were modified to reduce the time required for a single analysis. The alkaline copper tartrate (ACT) reagent solution was prepared such that each milliliter contained 100 mumol cupric sulfate, 210 mumol potassium sodium tartrate, and 1.25 mmol sodium hydroxide. The assay involves mixing 0.3 mL gentamicin sulfate injection 40 mg/mL (of gentamicin), 1.0 mL ACT reagent, and 0.7 mL water; the absorbance of the resulting solution at 560 nm was used to calculate the gentamicin concentration in the sample. For injections containing 10 mg/mL of gentamicin, the amount of the injection was increased to 0.5 mL and water decreased to 0.5 mL. The concentration of gentamicin in samples representing 11 lots of gentamicin sulfate injection 40 mg/mL and 8 lots of gentamicin sulfate injection 10 mg/mL was determined. The specificity, reproducibility, and accuracy of the assay were assessed. The colored complex was stable for at least two hours. Gentamicin concentration ranged from 93.7 to 108% and from 95 to 109% of the stated label value of the 40 mg/mL and the 10 mg/mL injections, respectively. No components of the preservative system present in the injections interfered with the assay. Since other aminoglycosides produced a colored complex, the assay is not specific for gentamicin. The assay was accurate and reproducible over the range of 4-20 mg of gentamicin. This rapid and accurate assay can be easily applied in the hospital pharmacy setting. PMID- 3826085 TI - Clinical limitations of in vitro testing of microorganism susceptibility. AB - General concepts in evaluating the clinical importance of discrepancies between in vitro susceptibility tests of microorganisms and in vivo results are reviewed, and four problematic antibacterial-bacterial combinations are discussed. The three most common in vitro testing systems--agar disk diffusion, agar dilution, and broth dilution--are designed to detect the minimum inhibitory concentration (MIC) of an antimicrobial agent. However, agar and broth systems cannot include all of the biologic variables found within the human body. Factors affecting the reliability of in vitro testing systems include the limitations in interpreting MIC data, because in vitro test conditions cannot duplicate the host environment; the variability of testing media (e.g., acidic versus alkaline, differences in cation content); and the limiting effect of protein binding on an antimicrobial agent. In vitro testing systems do not consider the pharmacokinetics of the antimicrobial agent or the postantibiotic effect, whereby microbial growth is suppressed even when the antibiotic concentration falls below the MIC. The variability in drug distribution to infection sites within the body is also not considered. The following antimicrobial agent-bacterial combinations present specific problems to the clinician: trimethoprim-sulfamethoxazole and Group D enterococcus, cephalosporins and methicillin-resistant Staphylococcus aureus, aminoglycosides and Staph. aureus, and aminoglycosides and Pseudomonas aeruginosa. Despite the limitations of currently available systems, in vitro testing of the susceptibility of microorganisms can be an invaluable tool in selecting antimicrobial therapy when it is used in conjunction with data regarding the clinical course of the infected patient. PMID- 3826086 TI - Business looks at health. PMID- 3826087 TI - Pharmacy medication refill clinic decreases waiting time for patients. PMID- 3826088 TI - Compatibility of morphine sulfate injections and prochlorperazine edisylate injections. PMID- 3826089 TI - Preparing and administering cefazolin sodium small-volume injections. PMID- 3826090 TI - Questioning the proof for effectiveness of pharmacist intervention in blood pressure control. PMID- 3826091 TI - Rational formulary selection of antimicrobials. PMID- 3826092 TI - Experiences of the Texas PRO. PMID- 3826093 TI - PRO experiences at a Florida community hospital. PMID- 3826094 TI - PRO experiences at the University of Wisconsin Hospital and Clinics. PMID- 3826095 TI - Institution-specific versus published in vitro antimicrobial susceptibility data in making formulary decisions. AB - The results of susceptibility testing of 549 isolates of gram-negative organisms to 17 antimicrobial agents were compared with published reports of the sensitivity of those organisms to those agents. All gram-negative bacilli isolated from cultures obtained from hospitalized patients during a three-month period were preserved for antimicrobial sensitivity testing. Standard Kirby-Bauer disk diffusion susceptibility tests were performed using 17 broad-spectrum antimicrobial agents that either were included in the hospital formulary or were being considered for inclusion. Organisms were recorded as being sensitive or resistant to each drug, and the results were compared with the published results of in vitro sensitivity studies. When the results of actual antimicrobial sensitivity testing varied from published results, the discordant results were assigned a ranking of 1 to 4 based on the percentage difference. In 34 of 77 drug organism pairs tested, the results of susceptibility testing differed by more than 10% cumulative susceptibility from published values; 26 of these represented instances in which the results of actual testing were at least 10% less than published values. For seven of the antimicrobial agents that were being considered for inclusion in the hospital formulary, results indicating unexpectedly suboptimal activity against institutional pathogens were a determinant in eliminating the agents from further consideration. In vitro testing of antimicrobial susceptibility of local pathogens can be a better method of predicting the susceptibility of such pathogens to new antimicrobial agents than relying on published susceptibility data. Pharmacy and therapeutics committees should consider testing prevalent institutional pathogens for susceptibility to all antimicrobial agents that are proposed additions to the formulary. PMID- 3826096 TI - Therapy of hypercalcemia of malignancy. AB - An appreciation of the pathogenesis of the hypercalcemia of malignancy is essential to its management. At the outset, since most patients with symptomatic hypercalcemia of malignancy are dehydrated, infusion of 2 to 3 liters of saline per day will at least partially reduce serum calcium levels. Induction of calciuresis by infusing larger volumes of saline simultaneously with parenteral administration of furosemide may reduce the serum calcium concentration to normal in the short term. Of major importance in long-term therapy, however, are drugs that inhibit bone resorption, a major cause of hypercalcemia. These include calcitonin, plicamycin, glucocorticoids, prostaglandin synthetase inhibitors, and the diphosphonates. These agents may provide long-term control of hypercalcemia in many patients. Reduction of intestinal calcium absorption by dietary means or by glucocorticoid therapy is often effective in the rare subset of patients with increased serum levels of 1,25-dihydroxyvitamin D. Oral and intravenous phosphorus therapy may be effective via unknown mechanisms in some patients. The diphosphonates, in particular, should greatly facilitate management of both acute and chronic hypercalcemia of malignancy. Daily intravenous infusion of etidronate disodium (etidronate) with saline over a period of three to six days, for example, appears to be a safe and effective means of restoring serum calcium concentrations to the normal range. Study results have shown that more than 90 percent of patients have a response to etidronate. Oral administration of the drug has been demonstrated to maintain normal serum calcium concentrations. PMID- 3826097 TI - Indwelling urinary catheters in the elderly. Relation of "catheter life" to formation of encrustations in patients with and without blocked catheters. AB - In order to define the natural history of indwelling urinary catheters in the elderly, 50 patients aged 65 years or older were followed. Their catheters had been in place for a mean of 33.2 days. When removed, 40.4 percent were blocked or showed poor flow. After the catheters were changed, the 14-day "catheter life" was 78 percent. About half the population had blocked catheters. They had a 14 day "catheter life" of only 31.8 percent (p = less than 0.01). Patients with blocked catheters ("blockers") excreted more alkaline urine, calcium, protein, and mucin than patients without blocked catheters ("nonblockers"), but urea splitting bacteria were no more frequent. The mortality was not significantly different. Flow of water through catheters was closely related to extent of encrustations. Encrustations formed uniformly throughout the catheter lumen except when the tip was obstructed. The distribution and number of species of microorganisms (three and a half per specimen) were virtually identical in catheter and bladder urine, but the counts in the catheter urine were more frequently greater than 100,000 cfu/ml (p = less than 0.01). Patients with blocked catheters appear to be metabolically different from patients without blocked catheters and should have their catheters changed at seven to 10 days to avoid obstruction. PMID- 3826098 TI - Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. AB - To quantify the consequences of asymptomatic hyperuricemia, this study examined rates for a first episode of gouty arthritis based on 30,147 human-years of prospective observation. A cohort of 2,046 initially healthy men in the Normative Aging Study was followed for 14.9 years with serial examinations and measurement of urate levels. With prior serum urate levels of 9 mg/dl or more, the annual incidence rate of gouty arthritis was 4.9 percent, compared with 0.5 percent for urate levels of 7.0 to 8.9 mg/dl and 0.1 percent for urate levels below 7.0 mg/dl. With urate levels of 9 mg/dl or higher, cumulative incidence of gouty arthritis reached 22 percent after five years. Incidence rates were three times higher for hypertensive patients than for normotensive patients (p less than 0.01). The strongest predictors of gout in a proportional hazards model were age, body mass index, hypertension, and cholesterol level, and alcohol intake. When the serum urate level became a factor in the model, none of these variables retained independent predictive power. At the final examination, only 0.7 percent of participants had a serum creatinine level of 2.0 mg/dl or more, with no evidence of renal deterioration attributable to hyperuricemia. These data support conservative management of asymptomatic hyperuricemia. PMID- 3826100 TI - Right middle lobe syndrome progressing to death in a 77-year-old woman. PMID- 3826099 TI - Chloroquine neuromyotoxicity. Clinical and pathologic perspective. AB - Six cases of toxic myopathy and/or neuropathy with chloroquine and/or hydroxychloroquine therapy are described. Two patients had unique clinical and pathologic evidence of cardiomyopathy secondary to chloroquine or hydroxychloroquine therapy. One patient had polyneuropathy secondary to chloroquine toxicity. This may be the first documentation of several features of chloroquine/hydroxychloroquine toxicity: morphologic changes in human peripheral nerve in chloroquine toxicity; chloroquine/hydroxychloroquine cardiomyopathy diagnosed by endomyocardial biopsy; and hydroxychloroquine myotoxicity. Chloroquine is a neuromyotoxin that affects nerves and cardiac and skeletal muscles. Discontinuation of chloroquine and hydroxychloroquine resulted in marked improvement in most cases. The reversibility of the symptoms emphasizes the importance of recognizing potential signs of nerve, muscle, and cardiac toxicity in patients being treated with chloroquine or hydroxychloroquine. PMID- 3826101 TI - Diagnosis. PMID- 3826102 TI - Differences in ambulatory test ordering in England and America. Role of doctors' beliefs and attitudes. AB - Forty-five American and English doctors were surveyed to determine whether differences in their beliefs about the incidence and morbidity of complications and the role of testing for patients with chronic hypertension could be contributing to the large cross-national differences previously demonstrated in ambulatory test use for such patients. For each of nine tests, the number the English doctors thought they "should order" was significantly less than that of the American group. English doctors also estimated a lower incidence for each of seven possible complications of hypertension, but there was no difference in perceived morbidity of the complications. Both groups thought results from testing would alter therapy for only a small proportion of patients; however, the English estimate was significantly smaller than the American (16 percent versus 27 percent: p less than 0.05). The reasons given for testing were very similar in the two countries except that American doctors ranked as more important the reason that patients used the quantity of test ordering as an indicator of quality care. These results suggest that differences in ambulatory test use are consistent with physicians' beliefs about the number of tests they should be ordering, disease incidence, the likelihood that testing will affect patient care, and patient expectations. Further study should be directed toward understanding the contributions that differences in physician beliefs about the natural histories of diseases and patient expectations make to variations in test ordering. PMID- 3826103 TI - Organizational aspects of physician joint ventures. AB - This article describes organizational forms of physician joint ventures. Four models are described that typify physician involvement in health care joint ventures: limited partnership syndication, venture capital company, provider network, and alternative delivery system. Important practical issues are discussed. PMID- 3826104 TI - Geriatric practice. Taking up where primary care leaves off. PMID- 3826105 TI - Prophylaxis of endocarditis. Comparison of the new regimens. PMID- 3826106 TI - Recurrent factitious hypercalcemia. AB - Severe hypercalcemia recurred three times during an observation period of 15 years in a woman with anorexia nervosa. The patient displayed a factitious cheese alkalosis syndrome similar to the iatrogenic milk-alkali syndrome. PMID- 3826107 TI - Cecal perforation following fiberoptic flexible sigmoidoscopy. AB - The superiority of flexible to rigid sigmoidoscopy is resulting in its increasing utilization by primary care physicians. The procedure is relatively risk-free, but complications including perforations may occur. An unusual case of cecal perforation as a result of flexible sigmoidoscopy is presented in order to draw attention to this complication. PMID- 3826108 TI - Long-term survival in acute arsenic encephalopathy. Follow-up using newer measures of electrophysiologic parameters. AB - A 20-year-old man survived acute massive arsenic ingestion. The resultant severe encephalopathy and peripheral neuropathy showed limited long-term recovery over the following two years. The patient's clinical course was followed using visual and auditory evoked potentials, computed tomography, electroencephalography, and electromyography. PMID- 3826109 TI - Angioimmunoblastic lymphadenopathy with malignant transformation during long-term remission of ocular melanoma. AB - A 52-year-old woman presented with angioimmunoblastic lymphadenopathy five years after undergoing enucleation for ocular melanoma. She was first treated by corticotherapy and azathioprine and had two successive remissions over an 18 month period. Lymph node biopsy performed when lymphadenopathy relapsed for the second time showed focal malignant transformation of angioimmunoblastic lymphadenopathy. Intensive polychemotherapy induced a complete remission. Three months after completion of chemotherapy, the patient presented with hepatic metastases from her melanoma and died shortly thereafter. This is believed to be the first documented association between angioimmunoblastic lymphadenopathy and melanoma. Issues regarding the relationship between angioimmunoblastic lymphadenopathy and nonlymphoid malignancies are raised. PMID- 3826111 TI - Left anterior fascicular block and masking of inferior wall infarction. AB - A case of inferior wall myocardial infarction that was obscured by left anterior hemiblock is presented. This report illustrates that changes in the sequence of electrical activation of the left ventricle resulting from this conduction disturbance may lead to a missed electrocardiographic diagnosis. PMID- 3826110 TI - Rapid response to acyclovir in herpes zoster-associated encephalitis. AB - A previously healthy patient became acutely encephalopathic, with complete disorientation and amnesia, several days after the onset of thoracic herpes zoster. She had transiently abnormal electroencephalographic results, abnormalities on radionuclide brain scanning, and cerebrospinal fluid pleocytosis. There was no evidence of a toxic/metabolic encephalopathy except for a mildly elevated ammonia level. Intravenously administered acyclovir (30 mg/kg per day) induced a dramatic response, with complete resolution of the encephalopathy within 72 hours and normalization of the electroencephalographic results. The scant clinical experience with the successful use of acyclovir in the treatment of herpes zoster-associated encephalitis is reviewed. PMID- 3826112 TI - Prinzmetal's angina during 5-fluorouracil chemotherapy. AB - Variant angina developed during intravenous 5-fluorouracil therapy in a patient without prior history of angina pectoris. Ambulatory electrocardiography demonstrated S-T segment elevation and ventricular ectopy during pain, whereas no symptoms or S-T segment changes occurred during placebo therapy. Prophylaxis with both nifedipine and diltiazem was successful in preventing recurrence. It is believed that 5-fluorouracil induced coronary vasospasm and that this was prevented by prophylactic calcium antagonist therapy. Drug-induced coronary artery spasm may be the cause of 5-fluorouracil-associated chest pain. PMID- 3826113 TI - Hypoproteinemic alkalosis. PMID- 3826114 TI - Chemical meningitis following epidural injections of corticosteroids. PMID- 3826115 TI - Acquired immune deficiency syndrome in homosexual men with Hodgkin's disease. PMID- 3826116 TI - Variable prognosis of mitral valve prolapse. PMID- 3826117 TI - Cerebral dysfunction and respiratory alkalosis during peritoneal dialysis with D lactate-containing dialysis fluids. PMID- 3826118 TI - Lyme carditis. PMID- 3826119 TI - Colonic vascular invasion as a possible route of extraintestinal cryptosporidiosis. PMID- 3826120 TI - Commencement of normal menstrual cycles after 17 years in a patient with Sheehan's syndrome. PMID- 3826121 TI - Fever in hospitalized patients. With special reference to the medical service. AB - Fever (oral temperature of 38 degrees C or more on two or more consecutive days) during the hospital stay of 4,065 patients admitted to Grady Memorial Hospital during an 11-week period was studied. At least one episode of fever occurred in 1,194 patients (29 percent). Rates of fever were highest on medical and surgical services. Review of 341 episodes of fever in 302 patients on the medical service identified a single potential cause in 56 percent. Multiple factors were present in 26 percent, and no potential causes were found in 18 percent. Of 390 factors identified, 44 percent were community-acquired infections, 9 percent were nosocomial infections, 20 percent possibly involved infection, and 26 percent were noninfectious processes. Fever is a frequent finding in hospitalized patients. Both infectious and noninfectious processes play important roles. Determining the cause of fever is complicated by the multiplicity of possible causes. PMID- 3826122 TI - Intestinal spirochetosis in homosexual men. AB - Previous studies have demonstrated intestinal spirochetosis in rectal biopsy specimens from 2 to 7 percent of heterosexual and 36 percent of homosexual patients, but the role of intestinal spirochetosis in the pathogenesis of intestinal disease remains unclear. To assess the clinical, histologic, and microbiologic correlates of intestinal spirochetosis in a high-risk group, rectal biopsy specimens from 130 homosexual men, 92 percent of whom had intestinal symptoms, were evaluated. All men were extensively evaluated for rectal and enteric pathogens. Intestinal spirochetosis was identified in rectal biopsy specimens from 39 (30 percent) men; 15 percent of biopsy specimens revealed intestinal spirochetosis on hematoxylin and eosin plus alcian blue staining, and positive results were found in 30 percent on silver staining. No rectal biopsy specimens from 79 control patients with a variety of gastrointestinal symptoms demonstrated evidence of spirochetosis on hematoxylin and eosin, alcian blue, or silver staining (p less than 0.0001). Fifty-six percent of rectal biopsy specimens from men with intestinal spirochetosis were normal, and no specific histologic abnormality was correlated with intestinal spirochetosis. There were no differences in the presence of or type of intestinal symptoms, sigmoidoscopic appearance of the mucosa, type of sexual practice, or prior antibiotic use in men with and without spirochetosis. Other intestinal pathogens were frequent in both groups, and only rectal gonorrhea was significantly associated with intestinal spirochetosis. It is concluded that homosexual men with intestinal symptoms have an increased prevalence of spirochetosis, often in association with Neisseria gonorrhoeae. Independent association of spirochetosis with clinical or histologic findings could not be demonstrated. PMID- 3826123 TI - DF-2 bacteremia following cat bites. Report of two cases. AB - DF-2 is a recently described gram-negative bacillus known to be part of the normal flora of dogs. A variety of serious infections (bacteremia, endocarditis, meningitis, cellulitis) caused by DF-2 have occurred following dog bites. Asplenic patients appear to be especially susceptible to DF-2 infection. Two cases of DF-2 bacteremia occurring after domestic cat bites are reported. Sepsis and meningitis developed in an asplenic patient, and an immunocompetent patient presented with primary cellulitis. Both patients responded promptly to parenteral antibiotic therapy. DF-2 must now be considered along with Pasteurella multocida in the differential of cellulitis or sepsis following bites or scratches from domestic cats. PMID- 3826124 TI - Recurrent Streptococcus mutans endocarditis. AB - Recurrent bacterial endocarditis is associated with several risk factors including parenteral drug abuse, past valvular heart disease, and periodontitis. Recurrence rates vary from 2 to 18 percent for a single recurrence, and 1 to 5 percent for two recurrences. An unusual case study of a patient experiencing three episodes of bacterial endocarditis following dental work is described. The episodes occurred at least one year apart and were characterized by biochemically identical strains of Streptococcus mutans. PMID- 3826125 TI - Hemolytic anemia following intravenous gamma globulin administration. AB - A young homosexual man with immune thrombocytopenia recently had transient intravascular hemolysis during intravenous gamma globulin treatment. The hemolysis, manifested by a sharp decrease in hemoglobin and by a direct Coombs' test with a positive result, was mediated by anti-A antibody present in the gamma globulin preparation. In view of the increasing use of intravenous gamma globulin in the treatment of patients with immune cytopenia, this problem may result in crossmatching difficulties and should be recognized as a potential complication of therapy. PMID- 3826126 TI - Family outbreak of fatal Yersinia enterocolitica pharyngitis. AB - A family outbreak of fatal Yersinia enterocolitica pharyngitis is reported. Two members of a family were hospitalized for pharyngitis and posed a diagnostic dilemma until cultures of throat, blood, and stool revealed Y. enterocolitica. Neither patient responded to erythromycin therapy. The first patient died, and her husband's life-threatening illness seemed to respond to aminoglycoside and trimethoprim/sulfamethoxazole therapy. Y. enterocolitica should be considered as an etiologic agent in the differential diagnosis of a patient with pharyngitis whose condition deteriorates during erythromycin or penicillin therapy. PMID- 3826127 TI - Corynebacterium hemolyticum bacteremia with fatal neurologic complication in an intravenous drug addict. AB - A 50-year-old intravenous drug user presented with clinical features suggestive of mitral valve endocarditis. Blood culture specimens grew Corynebacterium hemolyticum. Despite treatment with penicillin, he died from a neurologic complication. Recognition of the pathogenic potential of nondiphtherial coryneforms in non-immunocompromised hosts is important. PMID- 3826128 TI - Hemophagocytosis secondary to Mycoplasma pneumoniae infection. AB - A patient with hemophagocytosis secondary to Mycoplasma pneumoniae is described. This adds another entity to the already protean manifestations of M. pneumoniae infection. PMID- 3826129 TI - Inherited deficiency of properdin and C2 in a patient with recurrent bacteremia. AB - A nine-year-old white boy with recurrent pneumococcal bacteremia is described. His serum had no hemolytic activity in either the classic or alternative complement pathways. Absence of classic pathway activity was secondary to a homozygous deficiency of C2. The parents had half-normal levels of C2, compatible with an autosomal recessive mode of inheritance. Measurement of serum properdin levels by radial immunodiffusion and enzyme-linked immunoabsorbent assay revealed a profound deficiency in the patient, normal levels in the father, and half normal levels in the mother, suggesting X-linked inheritance of the deficiency. Addition of purified properdin to the patient's serum fully reconstituted the alternative pathway function. This patient's unique combination of inherited deficiencies of properdin and C2 is a likely explanation for his susceptibility to bacterial infection. PMID- 3826130 TI - Persistent adrenal insufficiency secondary to low-dose ketoconazole therapy. AB - Persistent adrenal insufficiency secondary to ketoconazole therapy has not previously been documented. A case of adrenocortical insufficiency secondary to low-dose (400 mg per day) ketoconazole therapy for blastomycosis is described. Symptomatic adrenal insufficiency was documented on endocrine testing, required physiologic replacement doses of glucocorticoids, and has not been reversible in two years of follow-up. Thus, adrenal insufficiency may be caused by low-dose ketoconazole therapy, and such adrenal insufficiency may have a prolonged course. PMID- 3826131 TI - Complications related to subclavian catheters for hemodialysis. Report and review. AB - Personal experience with subclavian vein cannulations for hemodialysis are given, and the pertinent literature on the subject is reviewed. Two hundred subclavian dialysis catheters were placed in 148 patients who kept them in place for a total of 2,798 days. Immediate complications were two pneumothoraxes and two hemothoraxes due to subclavian artery puncture. Seventeen cases of bacteremia were related to subclavian catheter infections. In 1 case, a complication of sepsis was a vertebral osteomyelitis. Clinical evidences of subclavian vein thrombosis occurred in 5 cases. Life-threatening complications were met in 2 cases: 1 with pericardial tamponade due to right atrium perforation and 1 with mediastinal hematoma and right hemothorax due to superior vena cava perforation. Review of the literature indicates that pneumothoraxes and/or hemothoraxes occurred in 1.7% of the catheter insertions and that sepsis related to subclavian dialysis catheters occurred in 8.9% of the patients. As systematically investigated subclavian vein thrombosis involved at least 50% of the patients. Our 2 personal cases of life-threatening complications and 14 similar cases of the literature were analyzed: left subclavian catheters were associated with superior vena cava perforation with right hemothorax or mediastinal hematoma, while right subclavian catheters gave atrial perforation with pericardial tamponade. Death occurred in 3 of 16 cases, and emergency surgery was required in 5 of 16 cases. Taking into account all these complications, recommendations are made for the use of subclavian dialysis catheters. PMID- 3826132 TI - Progression of minimal-change glomerulopathy to focal glomerulosclerosis in a patient with fenoprofen nephropathy. AB - We report a patient who presented with the classical features of fenoprofen induced nephropathy. Initial response to a cessation of the drug and prednisone therapy was recovery of renal function, but proteinuria persisted. One year later, he experienced recurrence of the nephrotic syndrome with sustained renal failure. A clear progression from minimal-change lesions to focal glomerulosclerosis was shown in sequential renal biopsies. Not previously reported, this evolution is suggestive of the possibility that fenoprofen nephropathy may lead to chronic renal failure. PMID- 3826133 TI - Priapism and dialysis. AB - Ninety-three dialysis units located in the tri-state area were surveyed for the prevalence of priapism. Seventeen of 3,337 male patients experienced an episode of priapism. All of these episodes occurred either during or 2-7 h after dialysis, suggesting a cause-and-effect relationship. The use of heparin during dialysis seemed to play a role in its induction; none of the patients on peritoneal dialysis experienced priapism, and heparin was not used in their exchanges. Eleven of 17 patients also received androgen therapy which might have been a contributing factor. Additional considerations included dialysis-induced hypoxemia and acidosis which have been known to precipitate priapism in patients with sickle cell disease or trait. In our study, 2 of 10 patients, including our case report, were black males with sickle cell trait. The calculated prevalence in the male population is 1:196, and in blacks and Caucasians 1:128 and 1:293, respectively. Except for 2 cases of sickle cell trait in the 10 black males, no particular subpopulation at risk was identified. In view of the absence of a proven etiologic agent and the relatively low prevalence of priapism we do not recommend changes in dialysate, anticoagulant, or the use of androgen therapy. PMID- 3826134 TI - Influence of the uremic state on the development of malignancy. An experimental study in the rat. AB - The effect of chronic uremia on the development of subcutaneously injected malignant tumoral cells was evaluated in 213 male Wistar AG rats made chronically uremic by simultaneous right nephrectomy and partial ligation of the left renal artery. The tumoral cells injected were stemming from a parental rhabdomyosarcoma (9-4/0) induced by intramuscular injection of 20 mg of colloidal nickel suspended in oil to a male Wistar rat. 54 sham-operated rats and 43 nonoperated animals served as control-groups. Renal function and tumoral growth were checked weekly up to the 60th postoperative day, at which time the surviving rats were sacrificed and submitted to autopsy. At day 15 after cell grafting, a tumoral lump could be felt by finger touch in 68% of the uremic rats, but in only 11% of the sham-operated and 14% of the nonoperated controls (p less than 0.0001). Throughout the study, the tumoral lumps which developed in the uremic animals were of significantly larger size than in the nonuremic controls. Pulmonary tumoral metastases were evidenced at autopsy in 95% of the uremic rats, but in only 50% of the sham-operated and in 54% of the nonoperated controls (p less than 0.005). These results indicate an apparently accelerating and amplifying effect of uremia on the development of a malignant tumor in the rat, for which a decrease in cell-mediated immunity associated with the uremic state still remains a questionable hypothesis. PMID- 3826135 TI - Effect of chronic renal failure on heart. Role of secondary hyperparathyroidism. AB - This study examined the effects of chronic renal failure in rats with and without parathyroid glands on myocardial energy production, transfer and utilization as well as on cardiac index. Chronic renal failure was produced by 7/8 nephrectomy in rats weighing between 240 and 350 g with intact parathyroid glands (CRF control) and in parathyroidectomized (CRF-PTX) rats maintained normocalcemic. The data were compared to results obtained in intact rats and in normocalcemic parathyroidectomized rats with normal renal function. There were significant (p less than 0.01) decrements in myocardial content of ATP and creatine phosphate, mitochondrial oxygen consumption, and in the activity of both mitochondrial and myofibrillar creatine phosphokinase in CRF-control rats as compared to normal animals. The myocardial calcium content and the 45Ca uptake in CRF-control rats were significantly (p less than 0.01) higher than in normal rats. In CRF-PTX animals, the myocardial content of ATP, mitochondrial oxygen consumption, 45Ca uptake and calcium content were normal, but PTX did not normalize the activity of mitochondrial and myofibrillar creatine phosphokinase. Parathyroidectomy in rats with normal renal function was associated with a significant reduction in the activity of creatine phosphokinase of myocardial mitochondria and myofibrils. There was a significant (p less than 0.01) decrease in cardiac index in CRF control rats as compared to normal animals, and cardiac index did not return to normal in CRF-PTX rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826136 TI - Quiz of the month: Salt-retaining post-streptococcal glomerulonephritis. PMID- 3826137 TI - Postpartum renal failure in a patient with membranoproliferative glomerulonephritis type II. AB - The previously reported detrimental effects of pregnancy on the course of membranoproliferative glomerulonephritis type II (MPGN type II) are limited and are usually considered to be mild. Based on these reports, a 19-year-old female with the diagnosis of MPGN type II who had stable renal function (creatinine 0.9 mg/dl) and a mild nephrotic syndrome with hypertension for 5 years of close follow-up was advised to complete her pregnancy. After a full-term pregnancy, complicated only by moderate nephrotic syndrome, a healthy female infant was born. Two weeks after delivery, the patient presented with acute renal failure and malignant hypertension, without evidence of hemolysis of hepatic failure. Immunologic parameters, including, C3, C4, antinuclear antibodies, circulating immune complexes as well as antibodies to glomerular basement membrane antigen and tubular basement membrane antigen were negative. Peritoneal dialysis was initiated and a renal biopsy was performed which showed MPGN type II with 50% crescents. Despite pulse therapy with methylprednisolone, renal function did not improve, resulting in the need for chronic dialysis. Although no specific nephritogenic mechanism was shown, the course of this patient should be considered when counseling female patients with MPGN type II, regarding the possibility of pregnancy exacerbating their disease, or resulting in rapidly progressive renal failure. PMID- 3826138 TI - Membranoproliferative glomerulonephritis associated with pulmonary sarcoidosis. AB - A 34-year-old woman with pulmonary and ganglionary sarcoidosis developed a nephritic syndrome. The renal biopsy demonstrated a type-1 membranoproliferative glomerulonephritis. Clinical and histological remission of the renal disease following indomethacin treatment was associated with the remission of sarcoidosis. Prior reports have emphasized the association of a membranous glomerulonephritis with sarcoidosis. Temporal sequence of events and biological data suggest that hypocomplementemic membranoproliferative glomerulonephritis may be linked to sarcoidosis. The role of immune complexes in the pathogenesis of the 2 diseases is also discussed. PMID- 3826139 TI - Hypercalcemia in a dialysis patient. PMID- 3826140 TI - Nephrotic syndrome due to glomerulonephritis and acute renal failure due to hypovolemic shock. PMID- 3826141 TI - Increased serum IgE levels in patients with lupus nephritis. PMID- 3826142 TI - Calcium and hypertension. The first Siena Seminars on Mineral Metabolism. Siena, Italy, March 15-16, 1985. Proceedings. PMID- 3826143 TI - Relationship between calcium and blood pressure. PMID- 3826144 TI - Comparative effects on blood pressure of different calcium-blocking agents. PMID- 3826145 TI - Slow-release nifedipine associated with muzolimine in the treatment of mild to moderate essential hypertension. PMID- 3826146 TI - Renal handling of phosphate in patients with primary and secondary hypertension. PMID- 3826147 TI - Evaluation of calcium and phosphate metabolism in patients affected by essential hypertension and calcium nephrolithiasis. PMID- 3826148 TI - Cardiac and peripheral vascular actions by Ca++ and Mg++. PMID- 3826149 TI - Calcium metabolism and arterial blood pressure in a healthy population sample and in hypertensive men. PMID- 3826150 TI - Calcium phosphate and blood pressure: their relationships in a geriatric population. PMID- 3826151 TI - Effects of nitrendipine in patients with chronic renal failure. PMID- 3826152 TI - Arterial hypertension and primary hyperparathyroidism. Incidence and follow-up after parathyroidectomy. PMID- 3826153 TI - Intracellular free Ca++ and Na+ in primary hypertension in arterial smooth muscle and in red blood cells. PMID- 3826154 TI - Free calcium concentration in platelets of patients with essential hypertension. PMID- 3826155 TI - Platelet intracellular free calcium during dynamic exercise. PMID- 3826156 TI - Pharmacokinetics and metabolism of calcium-blocking agents nifedipine, nitrendipine, and nimodipine. PMID- 3826157 TI - Calcium channel blockers and peripheral arterial flow in normal and in hypertensive subjects. PMID- 3826158 TI - Hemodynamic effects of acute administration of slow-release nifedipine in elderly patients with systolic hypertension. PMID- 3826159 TI - Psychological characteristics of in vitro fertilization participants. AB - Psychological characteristics of couples attending an in vitro fertilization clinic were examined. Participants completed measures of personality, family environment, life quality, coping, and emotional status. Couples seeking in vitro fertilization exhibited specific personality traits and cohesive, supportive relationships. Unexpectedly, they reported good quality of life and freedom from anxiety and depression. PMID- 3826160 TI - Detecting changes in functional ability in women with premenstrual syndrome. AB - There has been a lack of objective assessment of the disruptive effect that the symptomatology of premenstrual syndrome has on the functional performance of affected women. This study assessed the functional performance of women with premenstrual syndrome at four phases of the menstrual cycle. Twelve women with premenstrual syndrome and nine asymptomatic women were tested on four functional instruments at the menstrual, early follicular, early luteal, and late luteal phases. Two tests of a paper-and-pencil type measured perceptual parameters, and two tests involving manipulation of objects measured manual dexterity. Mean performance on the Crawford Small Parts Dexterity Test--Part II, which tests fine motor function, was better at the late luteal testing, compared to the early follicular testing, in asymptomatic women but was worse in the women with premenstrual syndrome. This difference was statistically significant (p = 0.015). No significant differences between groups in performance changes were observed for the other functional tests. The Crawford Small Parts Dexterity Test-Part II is an objective measure that is potentially valuable in therapeutic trials involving patients with premenstrual syndrome. PMID- 3826161 TI - Human chorionic gonadotropin increase in normal early pregnancy. AB - Serial determinations of human chorionic gonadotropin have been used in evaluating early pregnancies. This has been based on linear regression of logarithm-transformed hCG levels. However, these levels are changing in a curvilinear fashion as pregnancy advances. Consequently the simple linear model does not provide a good fit to the data. To define more precisely the normal values for hCG increase, serial determinations were performed on serum samples obtained from 29 patients who were carrying normally advancing pregnancies. Gestational age was established with basal body temperature records. Three gestational age periods were identified each with a linear increase in hCG. This was translated into hCG doubling times and percentage increase over time. These tables may be used to determine if an early pregnancy is advancing normally. PMID- 3826162 TI - Prevalence of antibody to Chlamydia trachomatis in spontaneous abortion and infertility. AB - A higher prevalence of Chlamydia trachomatis antibody occurred in 57.6% of women with recurrent abortion, but not in their male partners, compared to 33.7% of normal pregnant women (p less than 0.01) and 44.2% of infertile women (NS). The mean titer for the recurrent abortion group was not significantly elevated, compared to controls. Women with blocked fallopian tubes had the highest prevalence of elevated titers (p less than 0.01) and the highest mean titer (p less than 0.001). Despite multiple testing, no women or men were chlamydia culture-positive. The lack of isolation among patients with antibody could be due to cryptic infection at a site not amenable to culture or to inhibition by secretory IgA. There could also be nonspecific stimulation of chlamydial antibody caused by other infections such as mycoplasma. The presence, though at a low level, of antibody in culture-negative patients suggests chlamydia may not be directly associated with recurrent abortion but reflect previous exposure to chlamydia or an altered immune system. PMID- 3826163 TI - Infertility surgery for pelvic inflammatory disease: success rates after salpingolysis and salpingostomy. AB - Eighty-seven patients with infertility due to pelvic inflammatory disease were retrospectively studied to determine pregnancy rates after infertility surgery. Patients were divided into two groups on the basis of the type of surgical procedure: group 1, lysis of adhesions only (22 patients); group 2, terminal salpingostomy with lysis of adhesions (65 patients). A significantly greater number of patients in group 1 (nine of 22, 41%) than in group 2 (12 of 65, 18%) (p less than 0.05) achieved intrauterine pregnancy. The incidence of ectopic pregnancy was 23% in group 1 (five of 22) and 9% in group 2 (six of 65) (p = 0.12). Almost all pregnancies that were conceived more than 16 months after operation were ectopic gestations. Patients were classified according to severity of disease on the basis of several factors. Although few patients with severe pelvic inflammatory disease conceived after operation, the effect of disease severity on the likelihood of successful operation was not statistically significant. PMID- 3826164 TI - Temporal variation in rates of cesarean section for dystocia: does "convenience" play a role? AB - The purpose of this study is to test the hypothesis that convenience for the physician plays a role in the rate of cesarean section performed because of dystocia. Three time periods were defined (night, 12 midnight to 7:59 AM; day, 8 AM to 5:59 PM; evening, 6 PM to 11:59 PM) based on the work commitments and daily routines of the obstetrician. Rates of cesarean section for dystocia were determined for each of the three time periods. An evening peak in the cesarean section rate is partially but not entirely explained by an evening increase in the proportion of patients in prolonged labor. When patients were stratified according to labor duration (less than 12, 12 to 15, and greater than 16 hours), a persistent evening excess in the rate of cesarean section for dystocia was observed for patients whose labor duration was less than 16 hours. Although this is interpreted as being consistent with the hypothesis of physician convenience, the magnitude of this effect on the overall rate of cesarean section for dystocia is small. PMID- 3826165 TI - Maternal age and primary cesarean section rates: a multivariate analysis. AB - To study the effect of maternal age on primary cesarean section rates, 3458 consecutive deliveries were analyzed. The cesarean section rates in primiparous women less than 25, 25 to 34, and over 34 years of age were 13.1%, 18.5%, and 28.2%, respectively. A similarly dramatic rise with advancing maternal age was seen in multiparous women with rates of 3.4%, 4.7%, and 10.1%, respectively, in the three age groups. The strong association between cesarean section and maternal age persisted after multivariate adjustment for induction of labor, epidural anesthesia, meconium-stained amniotic fluid, and fetal distress, and thus these factors do not explain the relationship. PMID- 3826166 TI - Congenital heart disease in pregnancy: short- and long-term implications. AB - One hundred forty-four pregnancies that occurred in 74 patients with congenital heart disease at the Toronto General Hospital between 1975 and 1986 were reviewed. The patients were divided into two groups, those with acyanotic lesions and those with cyanotic lesions. Maternal and fetal outcomes in these two groups were compared. Patients with cyanotic lesions developed significantly more congestive heart failure and deteriorated more often in functional cardiac status than those with acyanotic lesions (p less than 0.005). Women with obstructive lesions had a higher incidence of pregnancy-induced hypertension than our general population (p less than 0.005). There was one maternal death in the puerperium in a woman with Eisenmenger's syndrome. Preterm births were more frequent in the cyanotic group (p less than 0.01) as were small for gestational age infants (p less than 0.005). In the cyanotic group the mean birth weight was 900 gm less than that in the acyanotic group (p less than 0.005). The major benefits of corrective cardiac surgery were in the cyanotic group and consisted of fewer spontaneous abortions (p less than 0.01) and small for gestational age infants (p less than 0.02) and more term births (p less than 0.01). Long-term follow-up revealed that 19.2% of women with acyanotic lesions had significant cardiac developments, compared with 90% in the cyanotic group (p less than 0.005). One of 87 infants (1.1%) had congenital heart disease and two had Marfan's syndrome. PMID- 3826167 TI - External vibratory acoustic stimulation near term: fetal heart rate and heart rate variability responses. AB - Twenty-five pregnant women between 36 and 40 weeks' gestational age were studied to examine effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate and fetal heart rate variability. There was an immediate significant increase in the basal heart rate, which persisted for 1 hour after the stimulus, compared to that of the control subjects. There was also a significant increase in the total time during which accelerations occurred for the first 20 minutes after the stimulus. There were no changes in computer derived indices of fetal heart rate variability. Maternal blood pressure and heart rate were not altered following vibratory acoustic stimulus. We hypothesize that external vibratory acoustic stimulus causes a change from a state of sleep to a state of wakefulness in near term healthy fetuses. PMID- 3826168 TI - Psychological adaptation to pregnancy in childless women more than 35 years of age. AB - Forty-five pregnant childless women with a mean age of 36.6 years (+/- 1.7) were compared with 42 nulliparous pregnant women with a mean age of 26.7 years (+/- 2.8). Initial interviews determined the basic demographic data, the reasons for delaying pregnancy, attitudes to pregnancy, and plans concerning careers. Psychological tests were given to measure anxiety, depression, anger, marital intimacy, sense of autonomy, and role expectations. These psychological tests were applied to all patients at 12 to 16 weeks' gestation and again at 28 to 32 weeks' gestation. The demographic information from the two groups was remarkably similar. Although their ages differed by 10 years, their career goals, their family incomes, reasons for delaying pregnancy, and reasons for now getting pregnant revealed minimal differences. The Maffer Feminine Identity Scale revealed that the younger women held more traditional attitudes toward a woman's roles than the older group. The Sociotrophy-Autonomy Scale indicated that the older women were more independent than the younger pregnant patients. The Symptom Checklist indicated that the older group were less troubled by pregnancy than the control group, and although their level of distress increased as the pregnancy progressed, they remained better adjusted as they entered the last trimester of their pregnancies. PMID- 3826169 TI - Shoulder dystocia: predictors and outcome. A five-year review. AB - Shoulder dystocia is an uncommon complication of delivery with a high morbidity rate. Ninety-one cases were coded for shoulder dystocia at the Toronto General Hospital from 1980 through 1985. True shoulder dystocia was found in 24 cases, an incidence of 0.23%. There was no significant difference in average weight and percentage of macrosomia between cases of true shoulder dystocia and those merely coded as such. True shoulder dystocia was associated with a neonatal morbidity rate of 42%, consisting of a respiratory arrest and neurological and orthopedic damage. Fundal pressure, in the absence of other maneuvers, resulted in a 77% complication rate and was strongly associated with orthopedic and neurologic damage. Delivery of the posterior shoulder and the corkscrew maneuver were associated with good fetal outcome. PMID- 3826170 TI - The effect of hydralazine on placental perfusion in the spontaneously hypertensive rat. AB - Intravenous hydralazine was administered to 16 spontaneously hypertensive rats on day 21 of gestation. The radioactive labeled microsphere technique was used to assess the change in organ perfusion produced by the drug. Vascular resistance to most organs was decreased, except to the placentas, stomach, and cecum, where it increased by 43%, 104%, and 44%, respectively. Blood flow to the organs was redistributed, and although it was increased to the lungs, kidneys, liver, and adrenals, it was significantly reduced to the spleen, stomach, placentas, cecum, large intestine, and pancreas. The effect of hydralazine on placental perfusion was opposite to the effect on the uterus (myometrium). Patients with the highest blood pressures tend to have the poorest placental perfusion. Intravenous hydralazine should be used cautiously in these patients. PMID- 3826171 TI - Fetal oxygen extraction: comparison of the human and sheep. AB - To estimate fetal oxygen extraction in the human, the inverse, linear relationship between umbilical arterial PO2 and oxygen extraction was calculated from measurements made on cord blood samples obtained after vaginal (n = 12) and cesarean (n = 16) delivery and used to predict oxygen extraction in utero. Comparisons with similar data from fetal lambs in utero and during labor and delivery indicate that extraction in the human and sheep fetus is 47% and 27%, respectively, at PaO2 = 20 mm Hg. For the human fetus to have extraction similar to that in the fetal lamb, vascular PO2 would have to be substantially higher. This would lead to a higher umbilical venous oxygen content in the human, compensating for the lower umbilical blood flow and yielding a rate of oxygen delivery comparable with that observed in the fetal sheep. These data indicate that there may be significant quantitative differences in the fetal oxygen delivery systems in the human and sheep. PMID- 3826172 TI - Endometrial carcinoma occurring in patients under the age of 45 years. AB - Endometrial adenocarcinoma is frequently unsuspected in women under the age of 45 years by the gynecologist or the pathologist, but it does occur. Twenty-seven cases of endometrial adenocarcinoma in this age group, from 1980 to 1985, were reviewed clinically and pathologically. Five cases were excluded by histologic examination. Obesity and abnormal vaginal bleeding were shown to be risk factors. Endometrial screening is to be encouraged. This cancer may arise de novo rather than from a premalignant precursor. Implications of this neoplasm for the premenopausal woman are considered. PMID- 3826173 TI - Laser surgery for vulvar intraepithelial neoplasia: principles and results. AB - Twenty-nine patients with grade 3 vulvar intraepithelial neoplasia were treated with the carbon dioxide laser while they were under anesthesia. Superficial lesions in nonhairy areas were vaporized to less than 1 mm, but lesions extending onto hairy areas were vaporized to 3 mm to destroy disease in skin appendages. Eighty-three percent of lesions involved nonhairy areas alone. Seventy-two percent of cases were cured by one laser application, 25% by two, and one case by three. Two patients had permanent hair loss after healing. The laser is an appropriate modality for lesions in nonhairy areas but scalpel excision is probably better for vulvar intraepithelial neoplasia in hairy areas. PMID- 3826174 TI - Chorioamnionitis: its association with pregnancy outcome and microbial infection. AB - In a study of 33 cases of perinatal death, chorioamnionitis was observed in 57.6% compared with 5% of 20 control cases (p less than 0.001) and in 70.8% of cases with no morphologic cause compared with 22.2% of cases with a defined cause of death (p less than 0.01). Chorioamnionitis was significantly associated with previous gestations (p less than 0.01), prolonged rupture of the membranes (p less than 0.001), prematurity (20 to 27 weeks' gestation) (p less than 0.001), and low birth weight (less than or equal to 1000 gm) (p less than 0.001) but not with elevated maternal white blood cell count or pyrexia. Overall, in patients with chorioamnionitis, the perinatal death rate was higher (p less than 0.01); more stillbirths occurred compared with early neonatal deaths (p less than 0.05), and there was a higher incidence of deaths with no defined cause (p less than 0.01) compared with cases without chorioamnionitis. Ureaplasma urealyticum or pathogenic bacteria were isolated more frequently from villous tissue of placentas from cases with chorioamnionitis (p less than 0.01) but not Mycoplasma hominis, Chlamydia trachomatis, or viruses. Furthermore, there was a higher prevalence of both elevated fetal antibody titer to U. urealyticum (p less than 0.025) and fetal titer fourfold above maternal titers (p less than 0.05) in cases with chorioamnionitis. The antibody responses and presence of microorganisms suggest that chorioamnionitis is associated with intrauterine infection and an associated increase in perinatal morbidity and mortality. PMID- 3826175 TI - Massive genital and vaginal vault prolapse treated by abdominal-vaginal sacropexy with use of Marlex mesh: review of the literature. AB - Two patients with massive procidentia and 13 patients with posthysterectomy vaginal vault prolapse underwent surgical procedures at Mount Sinai Hospital, Toronto, between May 1978 and February 1986. The standard procedure consisted of an abdominal sacropexy, with use of Marlex mesh to anchor the vaginal vault to the sacral promontory and retroperitonealization of the mesh. In 11 of the 15 patients, one or more concurrent procedures were performed at the same time. There were no intraoperative complications. One serious postoperative complication occurred, and one patient developed recurrent vault prolapse. Follow up has been from 3 to 93 months with an average of 28 months. In 14 patients (93.3%) subjective and objective improvement was achieved. A review of the literature is presented. PMID- 3826176 TI - Differing concentrations of human chorionic gonadotropin and prolactin in the cyst fluid of hydatidiform mole and in amniotic fluid. AB - The concentrations of human chorionic gonadotropin and prolactin in the cyst fluid of molar tissue were compared with that of normal amniotic fluid. Molar fluid was aspirated from the vesicles of molar tissue in eight women (duration of amenorrhea 14.1 +/- 1 week, mean +/- SEM). Amniotic fluid was obtained at amniocentesis in 24 women (mean duration of amenorrhea 15.9 +/- 0.2 week). Hormones were measured by specific radioimmunoassay. The concentrations (mean +/- SEM) of human chorionic gonadotropin in molar fluid and amniotic fluid were 581,829 +/- 112,581 and 3187 +/- 505 mlU/ml (p less than 0.001), respectively. For prolactin the levels in molar fluid and amniotic fluid were 44 +/- 24 and 1962 +/- 313 ng/ml (p less than 0.001), respectively. These data demonstrate that molar fluid contains 182-fold higher levels of human chorionic gonadotropin and 45-fold lower levels of prolactin than amniotic fluid obtained from normal pregnant women with a similar duration of amenorrhea. In addition to altered endocrine function of the trophoblast, there may be altered prolactin secretion from the decidua in molar pregnancy as compared with normal pregnancy. Further research is required to evaluate prolactin production from decidua of molar pregnancy. PMID- 3826177 TI - Postmenopausal estrogen and androgen replacement and lipoprotein lipid concentrations. AB - The effect of a combined estrogen-androgen drug on the lipoprotein lipid profile of women who received it parenterally as long-term postmenopausal replacement therapy was compared to that of women who had been receiving estrogen alone parenterally and to untreated surgically menopausal women. Plasma estradiol, testosterone, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins were measured at baseline (55 days after injection) and then on days 2, 4, 8, 15, 21, and 28 after injection. The plasma estradiol levels were greater in the two hormone-treated groups compared with the control group (p less than 0.01), and plasma testosterone levels of the combined group exceeded those of the other two groups (p less than 0.01) and remained above the normal female range for the duration of the study. There were no between-group differences in total cholesterol, triglycerides, high-density lipoprotein, or low density lipoprotein values. Neither was the low-density/high-density lipoprotein ratio significantly different between groups at any of the test times. Therefore, the addition of testosterone to a long-term parenteral estrogen replacement regimen did not induce an increased atherogenic lipid profile compared with that produced by the parenteral administration of estrogen alone. PMID- 3826178 TI - Psychosis and pregnancy: some new ethical and legal dilemmas for the physician. AB - Physicians who treat women of childbearing age may encounter the presentation of psychosis in a pregnant woman that presents special problems in diagnosis and treatment, particularly ethical and legal considerations that center on the rights of the mother as well as the continually evolving definition of fetal rights. This article represents a collaborative effort to address these considerations. Representative case material from the treatment of a psychotic pregnant patient is presented with a focus on the nature of the contractual relationship of the treating physician with the mother and fetus. PMID- 3826179 TI - Characteristics of menopausal women seeking assistance. AB - Using a questionnaire approach, we have determined the demographic, social, and clinical characteristics of the first 100 participants attending our menopause clinic. Of the respondents, 79% reported onset of significant physical symptoms and 63% significant emotional symptoms during the menopause. Among the participants, 65% had varying degrees of depression as determined by the Zung self-rating depression scale. This seemed to be more prevalent in patients with previous pelvic operations. Only half the women were on a regimen of estrogen replacement therapy, and most were receiving estrogen in an unopposed fashion. In our menopause clinic, more than half the women were over their ideal body weight, which is in contrast to the popular misconception that only thin women develop menopausal symptoms. Data from our patients suggest the need for multidisciplinary menopause clinics to adequately address the physical and emotional problems of menopausal women. PMID- 3826180 TI - Tocolysis with oral magnesium. AB - Seventeen patients in whom uterine activity responded favorably to parenteral magnesium sulfate were given oral magnesium gluconate for continued tocolysis. The mean serum magnesium level before therapy was 1.44 +/- 0.22 mg/100 ml, whereas 2 hours after initiation of oral magnesium it was 2.16 +/- 0.32 mg/100 ml (p less than 0.05). One patient had nausea without vomiting or diarrhea. These data suggest that magnesium ingested orally can raise the serum magnesium level significantly. PMID- 3826181 TI - Maternal hypothermia: an unusual complication of magnesium sulfate therapy. AB - Reported is a case of maternal hypothermia associated with magnesium sulfate therapy for treatment of preterm labor. Hypothermia was accompanied by fetal and maternal bradycardia. After discontinuation of magnesium sulfate infusion, maternal temperature, pulse, and fetal heart rate gradually returned to normal. No adverse effects were noted on either maternal or fetal outcome. PMID- 3826182 TI - Plasma progesterone concentration in women with and without adenocarcinoma of the endometrium. AB - In the search for the postulated but elusive "estrogenic bias" in patients developing endometrial cancer, several authors have suggested lack of progesterone as the common denominator. In this study 21 patients at the time of diagnosis of Stage I disease are compared to stringently matched healthy control subjects. No significant difference was found in plasma progesterone concentrations between the two groups. These results, in conjunction with other calculated estrogenic indices based on these patients, provide no evidence of lack of progesterone at the onset of clinical disease. However, the effects of long-term progesterone lack related to chronic anovulation are not excluded by these findings. PMID- 3826183 TI - Ureteral obstruction as a complication of the Burch colposuspension procedure: case report. AB - Major complications of the Burch procedure for stress urinary incontinence are rare. Inadvertent kinking of the ureter during this procedure has been described only once previously in the literature. We present a second such case, hoping to draw attention to this rare but significant complication. PMID- 3826184 TI - C-reactive protein: a limited test for managing patients with preterm labor or preterm rupture of membranes? AB - C-reactive protein has been used to identify patients at high risk for infectious morbidity with preterm labor or preterm rupture of membranes. In this article we report on 104 patients with preterm labor symptoms (n = 45) or preterm rupture of the membranes (n = 59) and serial evaluations of C-reactive protein measured by latex agglutination and laser nephelometry. The simple, inexpensive latex method appears comparable to the laser method in predicting infectious morbidity and can be used clinically. Elevated C-reactive protein values before delivery predict infectious morbidity in only 8% to 29% of patients, and up to 18% of patients with serious infections may be misdiagnosed as having normal C-reactive protein values before delivery. PMID- 3826185 TI - Comparison of phospholipids in vaginal and amniocentesis specimens of patients with premature rupture of membranes. AB - Amniotic fluid was obtained from the vaginal pool and by transabdominal amniocentesis in 28 patients who were admitted to the hospital between 26 and 35 weeks' gestation with premature rupture of the membranes. Phospholipid profiles were obtained on all specimens with the use of high-performance liquid chromatography. The lecithin/sphingomyelin ratio, phosphatidylglycerol, phosphatidylinositol, phosphatidylethanolamine, phosphatidylserine, and lysolecithin were all analyzed to determine the effect of vaginal contamination. With the use of a paired t test, only lysolecithin was shown to be significantly affected by vaginal contamination (p less than 0.05). As determined by high performance liquid chromatography, evaluation of phospholipids in vaginal fluid of patients with premature rupture of the membranes appears to be an accurate and reliable method for predicting fetal lung maturity. PMID- 3826186 TI - Delivery of fertility control services by male and female obstetrician gynecologists. AB - Sex differences in the delivery of fertility control services were explored in a national survey of 1420 recently trained obstetrician-gynecologists in active practice. Women were found to be more likely than men to provide abortion services but less likely than men to provide amniocentesis and certain infertility services. Women were found to contribute less than their proportionate share of two services for which volume was measured: artificial inseminations and sterilizations. Physician gender, however, was a less important predictor of volume of sterilizations delivered than were a set of practice related variables. Overall our findings suggest that the increased representation of women among obstetrician-gynecologists could influence the delivery of a few specific services. PMID- 3826187 TI - Effect of naloxone on fetal behavior near term. AB - Fetal behavior was studied after intravenous administration of either 0.4 mg of naloxone or an equal volume of saline solution in 54 healthy pregnant women near term. The number, duration, and amplitude of fetal heart rate accelerations increased after naloxone injection. The incidence of both gross fetal body movements and fetal breathing movements increased, especially in the first hour after naloxone administration. The distribution of fetal behavioral states was modified with a prevalence of active sleep and active awake states compared to the quiet sleep state. These data suggest that endorphins could be involved in the modulation of fetal behavior. PMID- 3826188 TI - Immunocytochemistry of human chorionic gonadotropin in human chorionic villi. AB - The immunocytochemical localization of human chorionic gonadotropin was investigated in chorionic villi from the seventh to twelfth week of gestation. By the light microscopic peroxidase-antiperoxidase technique, positive reactions of human chorionic gonadotropin were found exclusively in the syncytiotrophoblast. Immunoelectron microscopy by means of the protein A-gold technique reveals localization of the immunoreactive gold particles in two kinds of membrane-bound granular inclusions in this cell; one type is granules of 200 to 300 nm in diameter with moderate electron density and the other is large electron-dense bodies of 500 to 1000 nm. The former seems to be Golgi-derived secretory granules that play a role in the release of human chorionic gonadotropin from the syncytiotrophoblast. Although the origin of the latter is still uncertain, a certain amount of this hormone might be stored or treated by lysosomal digestion in the large bodies during these stages. PMID- 3826189 TI - Nonsurgical therapy to preserve oviduct function in patients with tubal pregnancies. AB - Surgical treatment for tubal pregnancies greatly impairs the subsequent fertility of patients because of salpingectomy and its complicated adhesions. Nonsurgical methotrexate therapy was developed to avoid such complications. Although early detection was of prime importance, resolution of ectopic pregnancy was obtained in 22 patients (95.7%) with methotrexate administration alone. Patency of the oviducts was evaluated with hysterosalpingography and/or laparoscopy in 19 patients after termination of methotrexate treatment. In 10 of 19 patients (52.6%), complete patency of the involved oviduct confirmed the validity of this regimen. Severe side effects were not observed in any of the 23 patients. PMID- 3826190 TI - Position statement on gestational diabetes mellitus. Formulated by the American Diabetes Association, Inc. PMID- 3826191 TI - Infectious morbidity in gynecologic cancer. AB - A retrospective investigation of infectious morbidity in gynecologic oncology patients documented that 54 (11%) of 494 patients and 68 (6%) of 1204 patient admissions were complicated by a serious infection. The highest rate of infectious morbidity by admission was 21%, occurring in patients admitted for cancer of the vulva. The highest surgical infectious morbidity, 22%, occurred in patients admitted for cervical cancer. Important factors in determining infection risk include multiple host factors, radical surgical procedures, factors inherent in the tumor itself, and additional irradiation and chemotherapy. These serious polymicrobial infections dictate intelligent selection of antimicrobials and appropriate monitoring to anticipate complications inherent in antimicrobial therapy. beta-Lactamase induction, superinfection, nephrotoxicity, and necrotizing enterocolitis are documented problems in these patients. PMID- 3826192 TI - Surveillance of twin pregnancy with umbilical arterial velocimetry. PMID- 3826193 TI - Additional statistical analysis of antenatal phenobarbital for prevention of neonatal intracerebral hemorrhage. PMID- 3826194 TI - Intrapartum fetal heart rate monitoring. PMID- 3826195 TI - Transcervical chorionic villus sampling. PMID- 3826196 TI - Prevention of preterm birth by ambulatory assessment of uterine activity: a randomized study. AB - Tocodynamometry, used on an ambulatory basis, has been shown to detect uterine activity. The objective of this study was to assess the effectiveness of ambulatory tocodynamometry in the early identification of preterm labor. In this investigation 67 women at risk for preterm labor were randomly divided into two groups: 34 received a uterine activity monitor while 33 patients used palpation. Approximately two thirds of the study sample developed preterm labor. Upon diagnosis of preterm labor, parturients in the control group had cervical dilatation of less than 3 cm (p less than 0.001) and effacement of greater than 50% more often than the monitored group (p less than 0.01). As a result there was a significant decrease in the number of patients who responded to tocolytic therapy in the unmonitored group. Among those with preterm labor the time gained in utero was greater in the monitored group (8.2 +/- 2.7 weeks) compared to the control group (4.2 +/- 2.9 weeks) (p less than 0.05). Subsequently 29 of 34 monitored patients attained term (36 completed gestational weeks) versus only 18 of the 33 patients in the unmonitored group (p less than 0.01). Although the sample size is relatively small, uterine activity monitoring in these very high risk patients resulted in an increased number of suitable candidates for tocolysis and allowed a significantly greater percentage of women to reach term. PMID- 3826197 TI - Braxton Hicks' contractions and motor behavior in the near-term human fetus. AB - The transient relationship between Braxton Hicks' contractions and fetal motor behavior was studied in 14 healthy nulliparous women near term. Two-hour recordings of fetal heart rate and uterine contractions and of real-time scanning for fetal body movements, breathing, and eye movements were made. The recordings were divided into state 1F and non-state 1F. Braxton Hicks' contractions were not influenced by fetal behavioral states and state changes were not related to these contractions. Fetal body movements did not stimulate contractions, but contractions coincided with a specific clustering of body movements during the ascending part of contractions. Breathing was clustered during the descending part of short-lasting contractions but decreased gradually during the long lasting ones. Heart rate variation was increased during contractions. PMID- 3826198 TI - (Sub)specialization in obstetrics and gynecology: results of a survey by the American Board of Obstetrics and Gynecology. AB - Survey of department chairmen (n = 113) and former fellows (n = 599) revealed that from 1974 to 1984 the mean number of full-time faculty doubled and the increase was in subspecialists (5.1 per department). More than 60% of departments report trained subspecialists in three areas and 92.9% in one or more areas. Twenty-two chairmen report zero laboratory research funding. Of former fellows, 82% are certified in obstetrics and gynecology; 44% are certified in a subspecialty; 86.3% have passed the subspecialty written examination. Employment is full-time faculty for 60.8% and full-time private practice for 16.1%. They devote 49.1% of professional time to the subspecialty and 15.9% to research, most of which is clinical; 56.6% spend no time in laboratory research. While 40.3% have submitted no research grant applications since completion of fellowship, of all grants submitted to the federal government, 63.5% were approved and 34.5% were funded. The mean number of papers published since fellowship is 7.8. The number of fellows graduating may meet estimated need. The initial objectives of this new certification are being achieved. PMID- 3826199 TI - The diagnostic value of hysterosalpingography and hysteroscopy in infertility investigation. AB - Four hundred infertile patients had hysterosalpingography and hysteroscopy as part of their infertility workup. A comparison between the findings of these two procedures was carried out to study their diagnostic value in female infertility investigation. It was found that hysterosalpingography was as accurate as hysteroscopy in the diagnosis of normal or abnormal uterine cavities while the nature of the intrauterine filling defects was accurately revealed by hysteroscopy only. It is concluded that hysterosalpingography is an important screening procedure for the diagnosis of normal or abnormal uterine cavities and that hysteroscopy should be reserved only for the confirmation and treatment of intrauterine anomalies discovered by hysterosalpingography. Therefore we look at the two procedures, hysterosalpingography and hysteroscopy, as complementary techniques. PMID- 3826200 TI - Treatment of menopausal hot flashes with transdermal administration of clonidine. AB - A randomized prospective double-blind study was performed to evaluate the efficacy of a transdermal therapeutic system delivering clonidine in the treatment of menopausal hot flashes. Frequency, severity and duration of the flushing attacks before and during the 8-week treatment period were evaluated. The reduction in the number of hot flashes was highly significant in patients receiving the clonidine transdermal therapeutic system. On subjective comparison of flushing attacks before and during treatment, of the 15 patients who received the clonidine transdermal therapeutic system, 80% reported fewer hot flashes; 73% a decrease in severity; and 67% a decrease in duration. Among the 14 patients who were treated with placebo only, 36% reported fewer hot flashes; 29% a decrease in severity; and 21%, shorter duration (frequency, p less than 0.04; severity, p less than 0.04; and duration, p less than 0.03). Reported side effects were minimal, and no significant effect was observed on blood pressure or pulse rate. Transdermal clonidine therapy had no effect on the pulsatile luteinizing hormone secretion. PMID- 3826201 TI - Vaginal birth after two or more previous cesarean sections. AB - The recommendation from the American College of Obstetricians and Gynecologists is to allow vaginal delivery after one cesarean section. This report is an update of our experience of 57 women with two or more cesarean sections who were allowed to labor. PMID- 3826202 TI - Fetal diaphragmatic hernia: ultrasound diagnosis and clinical outcome in 19 cases. AB - Nineteen cases of congenital diaphragmatic hernia diagnosed in utero are reported with emphasis on sonographic findings, associated congenital and karyotypic abnormalities, the presence or absence of polyhydramnios, and clinical outcome. The survival of these infants was very poor despite accurate prenatal diagnosis, maximal surgical and medical treatment and maximal postnatal care. The overall survival rate was 10.5%, and for fetuses who lived beyond delivery the survival rate was 20%. PMID- 3826203 TI - A viable pregnancy in a patient with myositis ossificans progressiva. AB - Myositis ossificans progressiva is a rare autosomal dominant disorder characterized by a progressive ectopic ossification of the connective tissue of the voluntary muscles and ligaments with associated debilitation and characteristic skeletal malformations. There have been less than 600 cases in the literature. This is the first reported case of a viable pregnancy in a patient with myositis ossificans progressiva. PMID- 3826204 TI - Atraumatic removal of secretions from the prepubertal vagina. AB - Adequate vaginal secretions for laboratory tests are difficult to obtain from the prepubertal girl. A simple atraumatic technique for obtaining several milliliters of vaginal secretions is described. This is extremely useful for the clinician evaluating the child with vulvovaginitis and/or possible sexual abuse. PMID- 3826205 TI - Preliminary report on the use of tamoxifen in the treatment of endometriosis. AB - Tamoxifen, an antiestrogen, was used in the treatment of two women with a long standing history of endometriosis. After a 6-month period of treatment, both patients were symptom free and both showed a marked decrease in the size of their endometriotic lesions. It was significant that ovulation was documented in both patients while receiving the treatment regimen. The use of tamoxifen as an alternative modality in the treatment of endometriosis, especially for women desiring to conceive, is discussed. PMID- 3826207 TI - Reassessment of White's classification and Pedersen's prognostically bad signs of diabetic pregnancies in insulin-dependent diabetic pregnancies. AB - The classification systems developed over 20 years ago by White and Pedersen identified diabetic pregnancies at increased risk for perinatal mortality. To assess whether these same criteria would currently be valid, 199 diabetic pregnancies with deliveries from 1977 to 1983 were reviewed. Perinatal mortality rates for White's Classes B gestational (n = 72), B (n = 27), C (n = 67), and D + F + R (n = 33) were 2.9%, 11.1%, 14.9%, and 21.1%, respectively (p less than 0.05). White's classes were also predictive of pulmonary morbidity (12.5%, 18.5%, 22.4%, and 42.4%, respectively). The presence of one or more of the prognostically bad signs of pregnancy (n = 76) increased the perinatal mortality rate to 17.1% versus 7.3% among insulin-dependent diabetic pregnancies without prognostically bad signs (p less than 0.05). The presence of any prognostically bad signs of pregnancy was also predictive of pulmonary morbidity in general (31.6% versus 16.3%, respectively) and hyaline membrane disease in particular (13.2% versus 4.1%, respectively). Thus with use of modern obstetric management and medical care of the pregnant diabetic patient, both White's classification and Pedersen's prognostically bad signs of pregnancy continue to be predictive of perinatal mortality. PMID- 3826206 TI - The effect of low-dose oral contraceptives on cardiorespiratory function, coagulation, and lipids in exercising young women: a preliminary report. AB - A study was undertaken to determine whether low-dose oral contraceptive usage would negate the beneficial effect of exercise on cardiorespiratory fitness, lipid and lipoprotein levels, and coagulation. Twelve exercising women were randomly allocated to groups of either oral contraceptive users or non-oral contraceptive users. When compared with results in the control group, maximal oxygen uptake (ml/kg1 X min1) decreased significantly in the oral contraceptive users during the 6-month period of observation. This was associated with an 8% decrease in both the oxygen uptake (2.34 to 2.17 L/min) and the oxygen pulse (12.1 +/- 3.2 to 11.2 +/- 2.2 ml/beat). The serum cholesterol, triglycerides, high-density lipoprotein/cholesterol, and high-density lipoprotein subfractions 2a and 2b levels were not altered. A significant increase in plasminogen activity was found in the oral contraceptive users: values increased from a coherent time average of 3.8 +/- 0.5 U/ml at baseline to 5.7 +/- 0.7 U/ml at 6 months; values returned to baseline levels 1 month after stopping the oral contraceptives (coherent time average of 3.9 +/- 0.6 U/ml; p less than 0.0001). No other significant changes were noted in the coagulation and anticoagulation factors studied. Low-dose oral contraceptive usage is associated with a decrease in functional aerobic capacity, but it does not impinge on the hemostatic mechanism or lipid-lipoprotein metabolism. PMID- 3826208 TI - Legal abortion mortality in the United States: 1972 to 1982. AB - Between 1972 and 1982, 186 women died as a result of legal abortion in the United States. The overall death rate resulting from legal abortion dropped nearly fivefold, from 4.1 per 100,000 abortions in 1972 to 0.8 in 1982. Women who were older, black, of high parity, and had abortions at a later gestational age were at increased risk of death throughout the 11 years of surveillance. During this period, the death rate decreased for abortions at all stages of gestation; the greatest decrease was with abortions performed during the second trimester. For the entire interval, mortality rates were highest for abortions performed by hysterotomy or hysterectomy and lowest for abortions performed by curettage. Before 1977, the most common causes of abortion-related death were infection, hemorrhage, and general anesthesia complications, respectively. Thereafter, hemorrhage became the most common cause of abortion-related death, followed in number by general anesthesia complications. Our findings suggest that there has been a marked decrease in septic legal abortion deaths, but potentially preventable deaths from general anesthesia and hemorrhage remain an important concern. Use of general anesthetics during first-trimester abortions should be carefully reviewed. PMID- 3826209 TI - Successful pregnancy outcome after cervical dilation with multiple laminaria tents in preparation for second-trimester elective abortion: a report of two cases. AB - Two patients at 22 weeks' gestation underwent extensive cervical dilation with laminaria tents for elective abortion but continued their pregnancies instead. Both had normal deliveries. For the unusual patient who chooses not to carry out an abortion initiated with cervical dilation, successful pregnancy is possible and therapeutic intervention such as cervical cerclage seems inadvisable. PMID- 3826210 TI - Long-term observations of cervical cancer. AB - A consecutive series of approximately 1100 patients, treated for cancer of the cervix over a span of 45 years, presents an increasingly favorable stage distribution. Emergence of exfoliative cytology as a diagnostic technique accelerates allocation of new patients to Stage I. Cumulative rates of dying from cervical cancer equate improved survival in terms of differences in prognosis and in effectiveness of treatment. Long-term observations bring into focus interval changes affecting the reservoir of individuals remaining at risk, which is maintained in accordance with rates of new patient inflow, as well as withdrawal for all categories of attrition. The several factors determining that balance, including age at diagnosis of cervical cancer, do not fall equally on all clinical stages. Age, a dominant factor determining incidence of second primary malignancies, may also have significance in unraveling the obscure etiology of corporeal malignancies evolving among patients irradiated in the treatment of cervical cancer. PMID- 3826211 TI - The value of endocervical curettage in the management of the patient with abnormal cervical cytologic findings. AB - Patients with adequate colposcopic examinations and dysplasia on the endocervical curettage specimen usually undergo further diagnostic evaluation. This study evaluated 712 patients and found the frequency of positive endocervical curettage specimens to be 17.6%. Cervical conization or hysterectomy specimens were examined in 66 cases with a positive endocervical curettage. Of these, 69.7% had histologic evidence of discontinuous dysplasia in the endocervical canal. The endocervical curettage specimens were grouped by the percentage of endocervical epithelium that was dysplastic: group 1, less than 10%; group 2, 10% to 50%; group 3, greater than 50%. Confirmed histologic endocervical involvement was 80%, 56%, and 60%, respectively. The involvement of the endocervical canal also increased with increasing grade of cervical intraepithelial neoplasia. Of the 66 cases examined with positive endocervical curettage specimens, 62.1% had grade 3 cervical intraepithelial neoplasia on the ectocervix. Seven patients had positive endocervical margins, with six of these occurring in grade 3 cervical intraepithelial neoplasia lesions. Two unsuspected cases of cervical malignancy were identified by endocervical curettage. PMID- 3826212 TI - Atypia in cervical cytology as a risk factor for intraepithelial neoplasia. AB - All Papanicolaou smears obtained during the years 1977 to 1982 were reported by a descriptive cytologic interpretation instead of a numerical report. All smears showing "atypia" were reviewed and found to fall into one of three categories: inflammatory atypia, squamous atypia, and endocervical atypia. Patients with the latter two categories and those with persistent inflammatory atypia after specific therapy underwent colposcopy and directed biopsies if indicated. Colposcopically directed biopsies revealed that 29% of patients with atypical Papanicolaou smears had underlying cervical intraepithelial neoplasia. There was no statistically significant difference in the incidence of underlying cervical intraepithelial neoplasia among patients in each of the three categories of atypia. Of those with intraepithelial neoplasia, 35% had lesions of greater severity than grade 1 cervical intraepithelial neoplasia. We conclude that all patients with squamous, endocervical, and persistent inflammatory atypia on Papanicolaou smear should undergo colposcopic evaluation to rule out intraepithelial neoplasia. PMID- 3826213 TI - Treatment of acute intrapartum fetal distress by beta 2-sympathomimetics. AB - Patients with a diagnosis of severe intrapartum fetal distress by fetal heart rate and capillary blood pH monitoring received beta 2-sympathomimetics to inhibit uterine contractions (tocolysis) while the obstetric team was preparing to deliver the fetus. Fetal heart rate and acidosis significantly improved after tocolysis; these fetuses were subsequently delivered in very good metabolic and clinical condition. The favorable effect of tocolysis on fetal homeostasis is attributed to the suppression of the ischemic effect of contractions on the placental circulation. The few fetuses having an extremely compromised placental function showed no improvement in heart rate or acidosis with tocolysis and were immediately delivered. Considering the mild side effects observed, the lack of maternal complications, and the remarkable perinatal outcome obtained, we recommend using tocolysis before delivering distressed fetuses. PMID- 3826214 TI - Upper airway obstruction as a cause of pulmonary edema during late pregnancy. AB - We describe a 35-year-old woman who developed pulmonary edema at 38 weeks of pregnancy as a result of upper airway obstruction caused by a progressively enlarging euthyroid goiter. PMID- 3826215 TI - Symphysis-fundus height, maternal height, labor pattern, and mode of delivery. AB - Fetal growth was monitored with use of symphysis-fundus charts in 920 consecutive term singleton pregnancies with cephalic presentation. There were 402 primigravid and 518 multigravid patients. The symphysis-fundus charts were divided into four zones and the patients allocated into groups according to the zone of the last symphysis-fundus height measurement before the onset of labor. A highly significant increase was noted in the incidence of abnormal labor and operative delivery in group A primigravid women (symphysis-fundus height above the ninetieth centile), which was even more pronounced when the effect of epidural analgesia was excluded. Conversely, there was a significant progressive increase in the proportion of operative deliveries for fetal distress from group A through group D (symphysis-fundus height below the tenth centile). Similar trends were significant but less pronounced among multigravid women. The relationship between maternal height, symphysis-fundus height, and operative delivery for dystocia in primigravid women was examined. High operative delivery rates were present in group A primigravid patients regardless of maternal height. In groups B and C, however, increased maternal height was associated with lower operative delivery rates. PMID- 3826216 TI - Adjuvant therapy for stage I uterine sarcoma. AB - A retrospective evaluation of adjuvant therapy in 64 patients with Stage I sarcoma was undertaken. A combination of operation and adjuvant radiation was compared with operation alone. A decreased recurrence of both pelvic and distant tumor was noted for endometrial sarcoma but not for leiomyosarcoma treated with adjuvant radiation. A Cox regression analysis showed a trend for improved survival, but the results were not statistically significant. Survival after vaginal cuff recurrence and treatment with radiation therapy (two patients) or combined radiation and chemotherapy (one patient) is reported. Seven patients received adjuvant chemotherapy with Adriamycin-based regimens. Chemotherapy alone did not statistically decrease recurrence in this small sample. PMID- 3826217 TI - Clinicopathologic study of eight cases of uterine body cancers associated with endometriosis interna (uterine adenomyosis). AB - Among 30 cases of uterine body cancers, in eight cases (Stage IA, two cases; Stage IB, six cases) uterine adenomyosis was demonstrated microscopically. The age range was from 46 to 66 years with a median of 56. When these eight cases were compared with the 12 cases of Stage I endometrial cancer without adenomyosis, there was no difference in either menstrual history or family history, although past histories of hypertension and diabetes mellitus were found in these eight cases. The mean obesity index was 127 in eight cases and 116 in 12 cases. Seven of these eight cases were pure tubular adenocarcinoma. From the standpoint of early myometrial infiltration of the endometrial cancer, these eight cases not only provided a good model to survey early endometrial cancer but also suggested a common stimulus, such as estrogen, in both endometrial cancer and uterine adenomyosis. PMID- 3826218 TI - Luteal function in ectopic pregnancy. AB - Human chorionic gonadotropin, estradiol, progesterone, and 17-hydroxyprogesterone have been measured in the serum of 46 patients with ectopic pregnancy. All these hormones were significantly lower than in normal pregnancy. Unruptured ectopic pregnancy differed from the ruptured state by a lower serum human chorionic gonadotropin concentration, a slower human chorionic gonadotropin increment, a higher incidence of metrorrhagia, and an earlier diagnosis. The concentration of estradiol, progesterone, and 17-hydroxyprogesterone in the serum of patients with ectopic pregnancy was lower than could be expected from the decrease of human chorionic gonadotropin, often lower than in a normal luteal phase. It is suggested that, as long as ultrasonography fails to show an intrauterine pregnancy, the simultaneous determination of serum human chorionic gonadotropin and progesterone could aid in the early diagnosis of ectopic pregnancy and in the improvement of subsequent fertility; to that regard any progesterone level below 15 ng/ml in the presence of detectable amounts of human chorionic gonadotropin is highly suggestive of either a threatened abortion or an ectopic pregnancy, whatever the gestational age. PMID- 3826219 TI - Fetal cardiac tumor: a prenatal echocardiographic marker for tuberous sclerosis. AB - Auscultation of a fetal bradyarrhythmia led to the prenatal echocardiographic detection of an intracardiac tumor. After birth the diagnosis of tuberous sclerosis was established. Therapeutic implications for current and future pregnancies, when a fetal cardiac tumor is found, are discussed. PMID- 3826220 TI - Electromyographic observations on the human cervix during labor. AB - The activity of smooth muscles in the cervix is one of the relevant factors for its dilatation during labor, but in humans it has not yet been sufficiently studied. Muscular activity may be observed by measuring electromyographic phenomena. In 60 parturient women of different parity and with various degrees of cervical ripeness at the onset of labor, the cervical electromyographic activity was measured through the entire course of labor in synchronization with uterine pressure measurements and also in 30 cases in synchronization with measurements of the uterine corpus electromyographic activity. The conditions necessary for successful measurements are described. The intensity of the cervical electromyographic activity was found to decrease with the level of cervical ripeness and with parity. When measured in the longitudinal direction, the cervical electromyographic activity resembled that of the uterine corpus, but when picked up from the circular lead, in a few cases of unripe cervices it differed from the electromyographic activity of the uterine corpus. PMID- 3826221 TI - Significant bacteremia associated with replacement of intrauterine contraceptive device. AB - Blood culture samples were taken from 23 women at different stages when an intrauterine contraceptive device was replaced. Transient bacteremia resulting from vaginal organisms was found in 13% of women 4 to 6 minutes after insertion of the new device. Previous reports have failed to demonstrate bacteremia associated with either first insertion or removal of intrauterine contraceptive device. Our results show that replacement of an intrauterine contraceptive device, a more traumatic procedure, causes significant bacteremia, and chemoprophylaxis should be given to patients in the groups at risk. PMID- 3826222 TI - Measurement of antibody to Mycoplasma hominis by an enzyme-linked immunoassay and detection of class-specific antibody responses in women with postpartum fever. AB - The standard conditions for detection of human IgG, IgM, and IgA antibodies to Mycoplasma hominis by an enzyme-linked immunosorbent assay (ELISA) were established with the use of a cell lysate antigen and alkaline phosphatase conjugates. Antigen was used at a concentration of 10 micrograms of protein per milliliter, sera were diluted 1:200, and conjugates were diluted 1:500. Agreement between cultured isolation of M. hominis from the lower genital tract and presence of antibody in 207 women was 71%, 82%, and 86% for IgG, IgM, and IgA, respectively. When the ELISA was compared with the mycoplasmacidal assay, an overall agreement of 81% occurred, with the majority of the discrepancies occurring in the ELISA-positive and mycoplasmacidal-negative category. A linear relationship between end point titer and the A400 value (ELISA or absorbance value at 400 nm) at a standard serum dilution was demonstrated for the IgG, IgM, and IgA classes. Although the ELISA was relatively independent of antigen heterogeneity, no single strain detected more than 87% of positive sera, thus suggesting that optimum detection of antibody to M. hominis by the ELISA will require use of antigen pools derived from multiple strains of M. hominis. PMID- 3826223 TI - Circannual rhythms in steroid receptor concentration in gynecologic and breast cancers. AB - Both estrogen and progestin receptor concentrations vary in a predictive temporal pattern for breast cancer; in epithelial ovarian cancer a temporal rhythmic pattern is suggested for estrogen receptor concentration only. No pattern for either receptor is seen for endometrial cancer. PMID- 3826224 TI - An improved human tumor stem cell assay in ovarian cancer. AB - To evaluate the effect of improved growth rates of ovarian cancers in the human tumor stem cell assay and its value in predicting clinical chemotherapy response, we studied 59 assays in 54 patients. A total of 81.6% of solid specimens and 85.7% of ascites specimens were successfully cultured and yielded an overall growth rate of 82.9%. Simultaneous primary and metastatic cultures were concordant for chemosensitivity in 80% (n = 16). The patients were evaluated for previous chemotherapy, residual volume of tumor, histologic type, and grade, and these were not statistically different between clinical responders and nonresponders. In vivo-in vitro correlations were made in 27 patients and yielded a predictive response of 13% and predictive resistance of 86% at 70% colony inhibition and 31% and 71% at 50% colony inhibition. Improved growth rates therefore did not result in better predictive correlations. The reported experience in ovarian cancer is summarized and the current status of the human tumor stem cell assay is reviewed. PMID- 3826225 TI - Effects of maternal anemia on cardiac output, systemic oxygen consumption, and regional blood flow in pregnant sheep. AB - We measured regional blood flows and cardiac output and calculated regional oxygen deliveries (blood flow X arterial blood oxygen concentration) and systemic oxygen delivery, oxygen extraction, and oxygen consumption as maternal hematocrit was varied randomly between 31% and 8% by exchange transfusion with plasma or packed sheep red blood cells. We observed three patterns of response: In the heart, brain, and adrenal glands, oxygen delivery was constant or nearly constant over the range of hematocrits studied; in the kidneys, splanchnic organs, and uteroplacental tissues, oxygen delivery was a linear function of hematocrit; in the carcass tissues, oxygen delivery decreased slowly as hematocrits were reduced from 31% to 15% and dropped rapidly at hematocrits less than or equal to 15%. Systemic oxygen consumption was maintained at normal levels, despite reductions in hematocrit to about 15%, because oxygen extraction increased as compensation. At lower hematocrits, systemic oxygen consumption fell in association with a metabolic acidemia, suggesting that, with this severity of acute anemia, oxygen supply to some tissues in the pregnant sheep was inadequate for tissue metabolic demands. PMID- 3826227 TI - Mulleriosis instead of endometriosis. PMID- 3826226 TI - Myocardial adenylate cyclase activity in ritodrine-treated pregnant rabbits. AB - To determine whether prolonged exposure to ritodrine results in down-regulation of myocardial adenylate cyclase activity during pregnancy, New Zealand White rabbits with time-dated pregnancies were randomly assigned to a sham-operated control group and to a ritodrine-treated group. Starting at 22 days' gestation (term 31 days), animals received either intravenous ritodrine intermittently or the equivalent volume of vehicle for 3 days. Adenylate cyclase activity was determined in a plasma membrane fraction obtained from ventricular tissue. There was no difference in the basal activity or the basal and guanosine triphosphate activity between the two groups. L-Isoproterenol-dependent stimulation required the presence of guanosine triphosphate. Both maximal and 50% enzymatic stimulation were equivalent in both groups. Furthermore, sodium fluoride dependent stimulation was similar in both groups. Finally, adenylate cyclase activity in the presence of forskolin and manganese chloride was similar in both groups. From the above, we conclude that intermittent systemic infusions of ritodrine to pregnant rabbits did not result in down-regulation of myocardial adenylate cyclase activity. PMID- 3826228 TI - Nurse-midwifery care and improved outcomes. PMID- 3826229 TI - Abdominal pelvic pain syndrome: fact or fiction. PMID- 3826230 TI - Use of midforceps and associated risk. PMID- 3826231 TI - Kell sensitization in pregnancy. PMID- 3826232 TI - Incidence, risk factors, and morphology in operating microscope light retinopathy. AB - A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04). PMID- 3826233 TI - Centering corneal surgical procedures. AB - Currently used methods for centering corneal surgical procedures emphasize the visual axis of the eye but do not define it properly. We obtained the best optical result by centering the surgical procedure on the line of sight and entrance pupil of the eye, not on the visual axis. We found an error of 0.5 to 0.8 mm in currently used methods of marking the visual axis, which arose from the use of the corneal light reflex as a sighting point or from inadvertent monocular sighting in techniques requiring binocular sighting. Proper centering requires the patient to fixate on a point that is coaxial with the surgeon's sighting eye, and the cornea is marked at the point in line with the center of the patient's entrance pupil, ignoring the corneal light reflex. PMID- 3826234 TI - Vitreous opacification after cataract extraction. AB - We performed pars plana vitrectomies on a consecutive series of 24 eyes in which nonhemorrhagic vitreous opacification was responsible for loss of visual acuity after cataract extraction. Twelve eyes were aphakic and the remainder were pseudophakic. Preoperative fluorescein angiograms were performed in 20 cases, and the results of all studies were within normal limits. Postoperatively, a restoration of clear media and an improvement in visual acuity occurred in all cases. Visual acuity was 20/20 or better postoperatively in 15 of 24 cases, and 22 of 24 achieved 20/30 or better. The remaining two cases improved to 20/40 and 20/50 from a preoperative level of 20/200 and 20/400, respectively. In carefully selected cases vitrectomy techniques provide an effective means of managing this syndrome. PMID- 3826235 TI - Acute bilateral posterior angiopathy with influenza A viral infection. AB - We studied an unusual case of an acute bilateral posterior angiopathy with a secondary maculopathy and papillitis that resulted in a severe reduction of visual acuity which resolved spontaneously within several days. The clinical appearance and subsequent viral titers suggested influenza A as a specific cause. PMID- 3826236 TI - "En bloc" excision of diabetic membranes. AB - We treated 16 eyes with diabetic tractional retinal detachment with a new method of surgical dissection whereby diabetic preretinal membranes and adherent posterior hyaloid were excised and removed as a single unit. This method differs from previously reported methods of diabetic membrane dissection by utilizing the posterior hyaloid to lift and immobilize the membrane as the membrane is excised with horizontally cutting scissors. The preservation of the posterior hyaloid facilitates the separation of the membrane from the retina. Fibrovascular proliferation was more completely removed and bleeding was less than with membrane sectioning techniques. The major surgical complication was posterior retinal break (seven eyes), but with near complete relief of traction all breaks were successfully treated with gas tamponade and laser photocoagulation. Thirteen retinas were completely reattached with a minimum follow-up of four months. One eye developed an extramacular tractional retinal detachment, and two eyes developed peripheral (retrolenticular) fibrovascular proliferation. Eleven eyes had 5/200 or better visual acuity. PMID- 3826237 TI - Ocular manifestations of preeclampsia. AB - We performed a prospective, controlled, masked study designed to evaluate the ocular manifestations of preeclampsia in 56 patients, including 25 control, 17 mild preeclamptic, and 14 severe preeclamptic patients. There was a statistically significant correlation between the reduction in arteriole to vein ratio and a diagnosis of severe preeclampsia (r = -.32, P = .004). There was also a significant correlation between the number of focal constrictions and a diagnosis of severe preeclampsia (r = .34, P = .005). The arteriole to vein ratio and number of focal constrictions did not differ significantly between normal and mild preeclamptic patients. None of the patients showed background changes of hemorrhages, cotton-wool spots, and exudates, or evidence of choroidal ischemia (including Elschnig's spots and retinal detachment). In contrast to previous reports, the role of the ophthalmologist in the diagnosis and management of preeclampsia appears to be limited. PMID- 3826238 TI - Contracting with managed health care plans in the present health care environment. PMID- 3826239 TI - Interface hematoma after epikeratophakia. PMID- 3826241 TI - Spontaneous unscrewing of a Cardona keratoprosthesis. PMID- 3826240 TI - 30-year follow-up of posterior radial keratotomy. PMID- 3826242 TI - Conjunctival vascular changes in AIDS and AIDS-related complex. PMID- 3826243 TI - Corneal abrasion resulting from a unit dose artificial tear dispenser. PMID- 3826244 TI - Corneal ulcer resulting from dental instrument injury. PMID- 3826245 TI - A supplemental labeling system for topical medications. PMID- 3826246 TI - Externalized silicone tube in single canalicular intubation. PMID- 3826247 TI - Eschar-induced eyelid perforation. PMID- 3826248 TI - The use of the red Amsler grid and red-green lenses in detecting spurious paracentral visual field defects. PMID- 3826249 TI - Spontaneous resolution of herpes simplex blepharoconjunctivitis in children. PMID- 3826250 TI - Compliance and results of treatment for amblyopia in children more than 8 years old. PMID- 3826251 TI - Hyperoxemic retinal necrosis in the premature neonate. PMID- 3826252 TI - Transmission electron microscopic observations of vitreous abnormalities in retinitis pigmentosa. PMID- 3826253 TI - Refractive surgery. PMID- 3826254 TI - The nationwide study of epikeratophakia for aphakia in adults. AB - In the nationwide study of epikeratophakia, 154 ophthalmic surgeons who had attended a training course performed 519 procedures for the correction of aphakia in adults: 310 of the eyes had 30 or more days of follow-up after suture removal. Of 229 eyes, 172 (75%) were within 3 diopters of emmetropia after surgery. Of 259 eyes, 245 (95%) demonstrated improved uncorrected visual acuity; 138 (53%) improved by four or more Snellen lines. Of 265 eyes, 209 (78%) achieved within two lines or improved their best corrected visual acuity. Of the 119 patients who achieved or improved their preoperative best corrected visual acuity, 110 (92%) were within two Snellen lines or better by 30 to 60 days after suture removal. Of the 127 patients with more than three months of follow-up after suture removal, 124 (98%) of those between 18 and 70 years of age but only 13 of 23 (54%) of those between 81 and 87 years of age achieved within two lines or better of their best corrected visual acuity. Corneal astigmatism measured by keratometry changed from a preoperative mean (+/- S.D.) of 2.1 +/- 1.8 diopters to a postoperative mean of 2.7 +/- 2.6 diopters. Of the 519 tissue lenses, 22 (4%) were removed, and one third of these patients underwent a second, successful epikeratophakia procedure. PMID- 3826255 TI - The nationwide study of epikeratophakia for aphakia in children. AB - In the nationwide study of epikeratophakia, 97 surgeons performed a total of 335 procedures in 314 eyes for the correction of aphakia in children under the age of 8 years 1 month. Fifteen children underwent bilateral surgery. Thirty-six tissue lenses were removed and 21 of these eyes underwent a second epikeratophakia procedure. Overall, the success rate for procedures was 89%, and with repeated surgery it was 95% for eyes. Seventy-three percent of the patients were within 3 diopters of emmetropia after surgery. Visual acuity results in patients able to provide verbal responses to the illiterate E, Allen card, or Snellen line chart testing showed improvement in most cases. The safety of epikeratophakia makes it a desirable option for the correction of aphakia in children who are spectacle or contact-lens intolerant, and the permanence of the correction eliminates the problem of optical noncompliance. PMID- 3826256 TI - The nationwide study of epikeratophakia for myopia. AB - In the nationwide study of epikeratophakia, 116 ophthalmic surgeons performed 352 procedures for the correction of myopia; 256 of the eyes had 30 or more days of follow-up after suture removal. Of 204 eyes, 153 (75%) were within 30% of emmetropia after surgery. Of 208 eyes, 202 (97%) had postoperative best corrected visual acuity within two Snellen lines or better of their preoperative visual acuity. All but one patient improved uncorrected visual acuity. Of the 120 patients who equaled or improved their preoperative best corrected visual acuity, 116 (97%) were within two Snellen lines of their preoperative measurement between 30 and 60 days after suture removal. Corneal astigmatism changed from a preoperative mean (+/- S.D.) of 1.4 +/- 0.8 diopters to a postoperative mean of 2.6 +/- 2.1 diopters. Of 352 tissue lenses, 36 (10%) were removed, largely as a result of inaccurate power, decay, or failure to reepithelialize, and 17 of these eyes underwent a second successful epikeratophakia procedure. PMID- 3826257 TI - Secondary intraocular lens implantation vs epikeratophakia for the treatment of aphakia. AB - We analyzed retrospectively the results of 30 consecutive secondary intraocular lens implantations and 30 epikeratophakia procedures performed by one surgeon for adult aphakia. Specific indications for epikeratophakia were criteria that excluded patients as candidates for intraocular implants. Follow-up of all patients was at least six months. Preoperative and postoperative uncorrected and best corrected visual acuity and endothelial cell counts, as well as power predictability and complications rates, were compared. Preliminary results indicated that postoperative visual acuity, power predictability, and endothelial cell counts were comparable for the two groups. There were, however, fewer sight threatening complications associated with epikeratophakia, and complications in these patients were successfully reversed by removal and replacement of the lenticule. PMID- 3826258 TI - A consecutive series (1982-1985) of radial keratotomies performed with the diamond blade. AB - The refractive and visual results of a consecutive series of diamond knife radial keratotomy procedures were evaluated at one year after surgery as part of an ongoing prospective study of radial keratotomy. Of the 972 procedures performed, 656 eyes (67.5%) were examined one year or more after surgery. The average amount of preoperative myopia was 4.4 diopters with a range of 0.6 to 11.9 diopters; 638 (97%) of the eyes had a preoperative uncorrected visual acuity of 20/100 or worse. The mean change in spherical equivalent after one year was 4.5 diopters. One year after surgery, 496 (76%) of the eyes were within 1 diopter of emmetropia; 310 (47%) had uncorrected distance visual acuity of 20/20 or better, 579 (88%) were 20/40 or better, and all but one eye had uncorrected visual acuity improved by at least two Snellen lines. Evaluation of refractive and visual results at the final available examination of those eyes not examined one year after surgery showed that 256 (81%) of the eyes were within 1 diopter of emmetropia; 176 (56%) had uncorrected distance visual acuity of 20/20 or better, and 287 (91%) were 20/40 or better. PMID- 3826259 TI - Repeated radial keratotomy in the prospective evaluation of radial keratotomy study. AB - In the Prospective Evaluation of Radial Keratotomy study, 59 patients received a repeated radial keratotomy in which the eight additional incisions were centered between the eight initial incisions. Other aspects of the surgical technique remained the same. The average length of follow-up after the reoperation was 26 months, and ranged from 11 to 42 months. After the reoperation, 45 patients (77%) had a decrease in myopia of 0.50 diopters or more, 12 patients (20%) changed by less than 0.50 diopters, and two patients (3%) had an increase in myopia. Thirty patients (51%) remained undercorrected by more than 1.00 diopter, 27 patients (46%) were between +0.12 and -1.00 diopter, and two patients (3%) were overcorrected by more than 1.00 diopter. There was no relationship between the change in refractive error after the reoperation and any patient characteristics or surgical factors. After the reoperation, the uncorrected visual acuity increased by two to nine Snellen lines for 45 patients (76%), changed one line or less for 13 patients (22%), and decreased three lines for one patient (2%). PMID- 3826261 TI - Ultrastructural comparison of conventional surgical and argon fluoride excimer laser keratectomy. AB - We used scanning electron microscopy to examine the structure of the surfaces created during keratectomy procedures carried out by conventional surgery and ablation by an excimer laser. The walls and the floor of the surgical site were rough with undulations greater than 10 micron in size, caused by broken lamellae and ruptured cells. In contrast, the surfaces produced by the excimer laser were smooth with perturbations of 1 micron or less and were sealed with a pseudomembrane. This smooth, sealed surface produced by the laser is probably responsible for the transparency of the healed cornea in contrast to the scarring produced when a conventional surgical keratotomy heals. PMID- 3826260 TI - An ultrastructural and histochemical study of long-term wound healing after radial keratotomy. AB - Using correlative microscopy and plant lectins conjugated to fluorescent dyes, we studied two human corneal specimens obtained 66 and 70 months after radial keratotomy. In one case a second radial keratotomy had been performed 11 months before we obtained the corneal specimen, which allowed us to compare wounds 11 and 66 months old in the same specimen. The 11-month-old incisions demonstrated morphologic features consistent with incomplete wound healing, whereas the incisions examined 66 and 70 months postoperatively demonstrated complete wound healing. A different lectin binding pattern of wheat germ agglutinin and concanavalin-A was observed in the 11-month-old wounds, compared with the 66 month-old wounds. Published and unpublished morphologic studies of 17 human keratotomy specimens have demonstrated incomplete wound healing up to 47 months postoperatively. The present study documents complete corneal wound healing 66 months after radial keratotomy. PMID- 3826262 TI - Corneal wound healing after excimer laser keratotomy in a human eye. AB - A pulsed excimer argon-fluorine laser was used to produce corneal incisions in vivo in a human cornea. Fourteen days after the laser surgery, the incisions were examined by light and transmission electron microscopy. There was good initial healing, with no inflammatory or immune reactions in the incisions. PMID- 3826263 TI - Epikeratophakia in aphakic children. PMID- 3826264 TI - Color vision and contrast sensitivity testing after radial keratotomy. PMID- 3826265 TI - Refractive surgery with the excimer laser. PMID- 3826266 TI - Dynamics of the ultraviolet laser ablation of corneal tissue. PMID- 3826267 TI - An ophthalmic excimer laser for corneal surgery. PMID- 3826268 TI - A rotating slit delivery system for excimer laser refractive keratoplasty. PMID- 3826269 TI - The effects of body mechanics instruction on work performance. AB - Thirty food service workers were randomly assigned to two groups; one group received body mechanics instruction while the other did not. The application of the instruction was measured by evaluating the subjects' use of body mechanics on a novel lifting and lowering task and during performance on the job. Results indicated that the group which received instruction performed significantly better on the novel task than the group that received no instruction. However, no significant difference between groups was found in performance in the work environment. The role of the occupational therapist in a work-related safety program is also discussed. PMID- 3826270 TI - Role conflict in occupational therapy student parents. AB - Surveys were conducted of occupational therapy curricula and of student parents who had a child or children less than 18 years old living with them. This was done to gather demographic data, to assess students' level of involvement in student and professional activities, to examine extent and sources of role conflict and potential support systems, and to identify curricular modifications that might be helpful in attracting and retaining these students. Of 5165 occupational therapy students, 8.2% were identified as being parents of children less than 18 years old who were living with them. The curricula survey indicated a generally positive attitude towards these nontraditional students. Both the curricula respondents and student respondents indicated that additional resources in the areas of financial support, child care, support groups, and flexible part time enrollment were needed. Students' responses to the 15 role conflict situations revealed many good problem solving skills and adaptations. PMID- 3826271 TI - Sequential levels in the visual-motor development of a child with cerebral palsy. AB - This case report has described an occupational therapy program for the treatment of a subject with visual-motor problems related to the total pattern of motor dysfunction in cerebral palsy. The intervention plan used visual stimulation activities that were developmentally and functionally appropriate and contributed to observable and measurable improvement within 1 year. Further research on this developmentally referenced instrument will include an interrater reliability study. PMID- 3826272 TI - Assertiveness training for occupational therapists. PMID- 3826273 TI - Active-passive paradigm in assessing CCTV-aided reading. AB - Six male and seven female English-speaking university students, with corrected vision of 20/20 (6/6), were trained using the closed circuit television system (CCTV) as a reading aid. This was an attempt to identify the essential factors in CCTV-aided reading. Active and passive observers were trained in pairs, with the passive observer being the yoked control of the active observer. The control participants were trained alone using the same reading material without the use of a CCTV. All participants used material from the Thurstone Reading Kit throughout the five training sessions and were given a pre- and postreading test to assess the increase in reading speed measured in words per minute (WPM). The active observers increased their reading speed to a greater extent than the passive observers, and the passive observers to a greater extent than the control participants. Suggestions are made pertaining to future experimentation and use of the CCTV. PMID- 3826275 TI - Visual field loss with colored hydrogel lenses. AB - The visual fields of 10 healthy myopic patients were compared using hydrogel lenses with a clear pupil and an opaque colored portion covering the iris and clear hydrogel lenses. Significant (greater than 10 degrees) field loss was found in all cases when the midperipherally colored lenses were worn. Patients interested in these lenses should be advised of this slight reduction of peripheral vision before fitting. PMID- 3826274 TI - New clinical color threshold test for eye disease. AB - Selective loss of sensitivity to blue light, when it is detected by the short wavelength-sensitive cones (B cones), is a common early sign of many retinal and visual pathway disorders. A reliable clinical test is needed to allow detection of this defect. We describe a new, simple forced-choice clinical test of B cone function which is brief, reliable, and free of patient criteria for seeing. Test results are relatively unaltered by up to 2 D of uncorrected refractive error and the usual small fixation changes the patient makes during the test. A comparison of three different test results, all obtained within 5 min, allows measurement of R and/or G cone function free of age and individual differences caused by yellowing of the ocular media in the B cone test result. The test has been used to demonstrate B cone sensitivity losses related to the severity of retinopathy in 60 diabetics, as well as selective B cone loss in glaucoma and ocular hypertension. PMID- 3826276 TI - Are stereoacuity and binocular rivalry related? AB - Several lines of evidence suggest that the processes of excitation and inhibition associated with good stereoacuity may also underlie binocular rivalry, implying that performance on these two tasks could be related. To test this possibility, we measured stereoacuity and rivalry under similar stimulus conditions in 40 observers. To estimate stereoacuity, a two-alternative, forced-choice procedure was used, wherein observers determined which of two sinusoidal grating patterns appeared displaced in depth. To measure rivalry, observers reported the occurrences of exclusive right- and left-eye dominance; dominance durations and alternation rates were recorded. The results showed that stereoacuity was significantly correlated with binocular rivalry, suggesting that stereoacuity and rivalry may share, at least in part, common neural mechanisms. PMID- 3826278 TI - Analysis of the corneal endothelium in keratoconus. AB - The corneal endothelium in nine cases of keratoconus (18 eyes) was analyzed quantitatively for mean cell area and standard deviation (SD) of cell area to determine the presence of polymegathism. Four of the subjects were veteran wearers of rigid contact lenses and five of the subjects had not worn contact lenses previously. The subjects were matched for age, sex, and contact lens history with a group of normals. The endothelium in eyes with keratoconus did not show a significant increase in the extent of polymegathism as compared with controls. There was no significant difference in mean cell area between the study group and the control group. These results suggest that polymegathism in keratoconic patients may be related to contact lens wear. PMID- 3826277 TI - Tonic accommodation, cognitive demand, and ciliary muscle innervation. AB - An infrared optometer was used to investigate the relation between cognitive induced shifts in tonic accommodation (TA) and ciliary muscle innervation. Twenty emmetropic men volunteers took part in a double-masked protocol which involved high (a reverse counting task) and low levels of mental load and blocking of sympathetic innervation of the ciliary muscle with the nonselective beta receptor antagonist timolol maleate (0.5%). The high level of cognitive demand induced shifts in TA of up to +1 D. There was no clear reason why large differences in intersubject susceptibility to these shifts occurred. The effect of beta antagonism on these shifts was insignificant for subjects having initial TA values less than 1.2 D. However, sympathetic antagonism induced significant increases in cognitive shifts for the remaining subjects. The inference is that cognitive induced shifts in TA are predominantly parasympathetic mediated although a sympathetic attenuation may occur at higher levels of TA. PMID- 3826279 TI - Diurnal variation of intraocular pressure and the overriding effects of sleep. AB - Intraocular pressure (IOP) was recorded regularly over a 24-h period in 13 normal subjects. All subjects showed a dramatic rise in IOP after sleep, ranging from 37 to 248%. In a second experiment, IOP decreased when 15 subjects remained upright and awake throughout the night. When sleep was not permitted IOP was lowest at 3:00 a.m. (0300); when six of these subjects were permitted to sleep from 0600 to 0800, they showed a rapid and significant increase in IOP of up to 150%, whereas the remaining nine subjects showed (posturally induced) increases of up to 38%. PMID- 3826280 TI - Biofeedback training of visual acuity and myopia: a pilot study. AB - Biofeedback training of accommodation was performed with nine subjects using the Accommotrac Vision Trainer to attempt to improve visual acuity (VA) and reduce myopia. A single-subject research design was used. Improvements in VA were seen with some subjects, but it is not clear whether the improvements were due to the biofeedback training alone, or to a learning effect observed during repeated measurements of VA. There was no change in refractive error. Implications for future research are discussed. PMID- 3826281 TI - Cataracts, chronic uveitis, and retinal vasculitis in Behcet's disease. AB - A 13-year-old Iranian male presented with the diagnosis of Behcet's disease, a systemic disease accompanied by significant anterior and posterior segment inflammation. He had had bilateral lensectomies, which necessitated aphakic soft contact lens fitting. Such optical enhancement of the patient's visual performance in Behcet's disease is an essential part of the overall patient management. PMID- 3826282 TI - Blinking patterns in soft contact lens wearers can be altered with training. AB - The blinking patterns of 15 soft contact lens wearers were recorded with a concealed video camera. Each of 20 consecutive blinks were graded, during slow motion replay of the video, as either complete, incomplete, forced, or twitch. Ten of these subjects were instructed to perform blinking exercises for a period of 2 weeks and the remaining 5 subjects acted as controls. After these exercises all the experimental group displayed an increased frequency of complete blinks, whereas the blinking patterns of the control group remained unchanged. Blinking exercises are likely to alleviate many of the signs and symptoms associated with incomplete blinking amongst contact lens wearers. PMID- 3826283 TI - Validity of optical pachometry measurements made with contact lenses in situ. AB - Traditionally changes in corneal thickness associated with contact lens wear have been measured with optical pachometers after the lenses are removed from the cornea. In studies of corneal response to the extended wearing of hydrogel and silicone elastomer contact lenses, optical pachometry measurements may be improved by uninterrupted lens wear during the measurements. Using four flexible lens types differing in design and thickness, a single observer made pachometric measurements both with and without the lenses in place on eight subjects. This study demonstrates that valid and reliable measures of corneal thickness may be made without removing flexible lenses from the eye. PMID- 3826284 TI - Does a small field of view degrade stereoacuity? AB - It was reported, in 1968, that stereoacuity became worse as the binocular field of view was reduced. Reported here are attempts to replicate this finding with a different stereoacuity test and with a simulation of the original test. Results suggest that the phenomenon is idiosyncratic because most subjects showed no loss in stereoacuity with the smallest field of view used in the original investigations (3.8 degrees). The greatest decrease in stereoacuity in this sample of nine subjects was 6 sec arc. These results are compared with those found in the original investigations and differences discussed. PMID- 3826285 TI - Simple pointspread retinoscope suitable for vision screening. AB - A simple pointspread retinoscope and method of retinoscopy are described which use optical principles similar to those of photoretinoscopy or static photographic skiascopy. In this instrument the degree of defocus of an eye is estimated from the disappearance of the bright fundal reflex or "crescent" in the eye of the subject when the distance between the light source and the eye of the observer is increased systematically. The instrument is particularly suitable for large scale screening efforts because it is easy to use and can be constructed from inexpensive materials. The pointspread retinoscope was calibrated against an artificial eye of known defocus. Additionally, results from pointspread retinoscopy were compared against meridional photorefractive data from a sample of infants and young children, and a significant correlation was found to exist between measurements made by the two methods. PMID- 3826286 TI - In vivo effects of thimerosal on the rabbit corneal endothelium: an ultrastructural study. AB - To assess ultrastructural alterations to the corneal endothelium, eye drops containing vehicle alone or vehicle plus 0.004% thimerosal with or without 0.1% disodium ethylenediaminetetraacetate (Na2EDTA) were administered hourly over a 2 day period to rabbit corneas in vivo. Twenty of the corneas received a 5-mm keratectomy that removed epithelium and superficial stroma and 10 corneas were left intact. The vehicle alone had no effect on the endothelium of normal corneas. Thimerosal drops with or without Na2EDTA caused some clarification of the cytoplasm and dilatation of the endoplasmic reticulum of endothelial cells. The mitochondria had dilated cristae and membrane condensations. After keratectomy and vehicle only drops, the central endothelium showed a marked increase in microvilli and mitochondrial changes. Addition of either thimerosal or thimerosal plus Na2EDTA resulted in a slight decrease in membrane activity but an increase in intracellular edema and dilatation and damage to organelles. The peripheral areas were less affected than the center. Although the endothelium was stressed, most changes were considered reversible. PMID- 3826287 TI - Normative contrast sensitivity functions: the problem of comparison. AB - Sixty college age observers who were prescreened for 6/6 (20/20) acuity were examined twice on an automated contrast sensitivity system. A significant practice effect was evident in the obtained contrast sensitivity functions (CSF's). In addition, marked differences were found between the contrast sensitivity scores in the present work and the normative CSF reported by other investigators using similar methods. Implications for the rapid assessment of CSF in applied settings and for the use of published CSF norms are discussed. PMID- 3826288 TI - Relation between refraction, education, occupation, and age among 26- and 46-year old Finns. AB - Refraction of four hundred sixty-six 26- and 46-year-old Finns revealed that the mean refraction of 26-year-olds was about 1 D more myopic than that of 46-year olds. Myopic refraction was related to education and occupation. The means of refraction were +0.54 D for those whose education was elementary only and -0.70 D for those with secondary and higher education. Those in managerial positions had a mean refraction of -0.49 D, whereas the unskilled or semiskilled in manufacturing or the service trades had a mean refraction of +0.49 D, and farmers and agricultural workers had +0.33 D. The mean astigmatism of the myopes was +0.74 D and that of the nonmyopes +0.51 D. Both the myopic and hyperopic showed more astigmatism than the emmetropic. The estimated proportion of "late myopia" was 25 to 34% of the myopes at the age of 26 years. Present myopia was higher the earlier the first spectacles were received. PMID- 3826289 TI - Branch retinal artery occlusion and carotid artery stenosis. AB - A patient who presented with a branch retinal artery occlusion (BRAO) of the left eye was discovered to have severe carotid artery stenosis bilaterally. A case report and a discussion of the optometrist's role in diagnosis and management of retinal artery occlusion and carotid stenosis are presented. PMID- 3826290 TI - Axial length elongation, not corneal curvature, as a basis of adult onset myopia. AB - Adult-onset myopia is most often reported in college age individuals. Its prevalence and the refractive component(s) responsible are essentially unknown; some recent studies implicate corneal curvature. Here I present a single case of adult-onset myopia over a period of 23 years in which axial elongation, and not steepening corneal curvature, is suggested as the most likely basis for the 4.50 D increase in refractive error. PMID- 3826291 TI - Analysis of blink-induced vertical motion of contact lenses. AB - This report discusses blink-induced vertical motion of contact lenses as measured with a slit lamp. The motion seen this way represents the displacement of the lens from its position just before a blink to its position immediately after the blink. Motion amplitudes reported in the literature will be discussed in the context of a hypothesis which seeks to account for lens motion by taking into consideration the post-lens tear film characteristics, the diameter of the lens, and the geometry of the anterior segment of the eye. PMID- 3826292 TI - Botulinum toxin and its uses in the treatment of ocular disorders. AB - The recent utilization of type A botulinum toxin in clinical ophthalmology makes it important for all health professionals involved in eye care to understand the action of this "non-surgical" tool. This paper summarizes the present knowledge concerning the chemistry, toxicology, and pathophysiology of the toxin. It also discusses the indications, contraindications, safety, and efficacy of this use of botulinum toxin. PMID- 3826293 TI - Efficacy of computerized vergence therapy. AB - The purpose of this study was to determine the efficacy of computerized fusional vergence therapy and the effect of two different vergence training velocities. Six subjects received positive vergence training using a slow vergence training rate (0.75 delta/s) and six subjects received positive vergence training using a fast vergence training rate (5.00 delta/s). Six subjects served as controls and did not receive therapy. The duration of therapy was 80 min over a period of 4 weeks. All training activities were monitored. All vergence evaluations were double masked. Subjects using a slow training rate showed significant increases in positive vergence ranges as measured with the major amblyoscope, whereas subjects training with fast rates did not. We conclude that vergence therapy using a computerized video display is an effective technique for increasing the amplitudes of positive fusional vergence and that slower rates are more productive than faster rates. PMID- 3826294 TI - Optics of progressive addition lenses. AB - The optical characteristics of the major progressive addition lenses were measured using an automated lensometer with a specially designed lens holder to simulate eye rotation. Measurements were made every 3 degrees (about 1.5 mm) and graphs of isospherical equivalent lines and isocylinder lines were developed. Generally the near zone of these lenses is narrower and lower than in bifocal or trifocal lenses. Distinct differences exist between the various progressive lenses. The width of the near zone, rate of power progression, amount of unwanted cylinder (level with the distance center), and clarity of the distance zone are compared for the various lenses. The optical measurements demonstrate an apparent trade-off between the size of the cylinder-free area of the lens and the amount of the cylinder. PMID- 3826295 TI - Glomerular epithelial abnormalities associated with the onset of proteinuria in aminonucleoside nephrosis. AB - A sequential ultrastructural study has been made of glomerular podocytic epithelium before and after the onset of proteinuria induced by daily subcutaneous injections of low doses of puromycin aminonucleoside (PAN). At 4 days, before the onset of proteinuria, the principal change was extensive replacement of podocytic foot processes by broad expanses of epithelial cytoplasm. At 5 days, when proteinuria had developed, the epithelial cells showed in addition multiple cytoplasmic droplets, many large balloon like vacuoles, some of which were ruptured, and many foci of epithelial detachment from the glomerular basement membrane (GBM). Of particular significance, the onset of proteinuria coincided precisely with the development of areas of epithelial detachment that led to direct continuity between externally denuded GBM and the urinary space. It seems likely that these areas are the primary sites of protein leakage across the GBM in this experimental model. PMID- 3826296 TI - Murine autoimmune oophoritis, epididymoorchitis, and gastritis induced by day 3 thymectomy. Autoantibodies. AB - In adult mice thymectomized at age 3 days (D3TX), increased incidences and/or levels of organ-specific antibodies to oocytes and/or zona pellucida, to testicular cell-sperm-differentiation antigens (TSDA), and to gastric parietal cells were detected, and these correlated significantly with oophoritis, orchitis (not epididymovasitis), and gastritis, respectively. The autoantibodies occurred in mice with the corresponding endogenous antigens. Thus, anti-oocyte/zona antibodies were detected in female, anti-TSDA antibodies in male, and anti parietal cell antibodies in both sexes. Anti-oocyte/zona antibodies were first detected at age 5-6 weeks and were absent by 25 weeks. Serum antizona antibodies, but not anti-oocyte antibodies, inhibited mouse fertilization in vitro. In contrast, antibodies to sperm acrosome and antibodies to sperm surface did not correlate with testicular or epididymal disease. Moreover, both male and female mice had increased levels of anti-sperm surface antibodies, indicating that the sperm antigens detected may not be organ-specific. In addition, sera from 5-10% of D3TX mice reacted with a wide spectrum of epididymal and testicular antigens with defined cellular locations but of yet unknown specificity. Although the incidence of antibodies to cytoskeletal antigens was not significantly elevated after D3TX, anti-nuclear antibodies were more frequently detected in (SWR/J X A/J) F1 (SWRAF1) and (C57 BL/6J X A/J) F1 (B6AF1) mice after D3TX. PMID- 3826297 TI - Glomerular epithelial cell function and pathology following extreme ablation of renal mass. AB - The role of the pathologic features and dysfunction of glomerular epithelial cells (GECs) in the pathogenesis of glomerular scarring was studied in the remnant kidney model (RK) (1 and 5/6 nephrectomy) in rats. Three weeks after surgery serum creatinine was greater in the RK than either sham-operation controls (SHAM) or spontaneously hypertensive rats (SHRs). Blood pressure was higher in the RK (181 +/- 26 mm Hg) than in SHAM (129 +/- 17, P less than 0.05) but not SHR (195 +/- 15, P less than 0.05). GEC endocytosis, assessed by protamine heparin aggregate (PHA) disappearance (10), was not different from that in SHAM. Glomerular damage was greater in RK (glomerular damage index, 30 +/- 18) than in SHAM animals (4 +/- 3, P less than 0.05) and SHR (0, P less than 0.05), and 2 of 11 RK animals had fibrinoid necrosis and thrombosis of arterioles and glomeruli. Segmental sclerosis occurred in only 1 RK animal (0.6% of glomeruli). Six weeks after surgery serum creatinine and urinary protein excretion remained higher in the RK than in the SHAM animals. Blood pressure was higher in RK (158 +/- 34 mm Hg) than in SHAM animals (144 +/- 24), but the difference was not significant. PHA disappeared from the glomerulus at a slower rate in RK than in SHAM animals (outside the 95% confidence limits of SHAM). Glomerular pathology was more widespread in RK than in SHAM animals (glomerular damage index, 73 +/- 62 versus 3 +/- 8, P less than 0.05), and 4 of 11 animals had acute hypertensive injury in arterioles and glomeruli. Segmental glomerular sclerosis was only seen in the animals with necrotic glomeruli. GEC dysfunction is not demonstrable until long after proteinuria and hypertension are established, and it only occurs in the context of severe, acute glomerular injury when the epithelial cells separate from the capillary wall and undergo severe degenerative changes and necrosis. The acute glomerular and vascular lesions in the RK model are morphologically similar to malignant nephrosclerosis in humans. Segmental glomerular sclerosis occurs only after proteinuria is well established in the context of severe glomerular injury, and it appears to represent, at least partially, progression of more proximate glomerular capillary injury. PMID- 3826298 TI - The interactions between asbestos fibers and metaphase chromosomes of rat pleural mesothelial cells in culture. A scanning and transmission electron microscopic study. AB - Rat pleural mesothelial cells (PMCs) in culture at the exponential growing phase were exposed to 5 micrograms/ml of chrysotile (CH) or crocidolite (CR) asbestos fibers: the cells and their chromosomes were studied 48 hours thereafter by light, scanning, and transmission electron microscopy (LM, SEM, TEM). PMCs phagocytized both CH and CR. Mild vacuolar cytoplasmic changes by LM and a few small surface blebbings by SEM were present, mainly in cells treated with CH. Metaphase chromosomes were well separated and retained surface details by SEM in the control group. Chromosomes were frequently entangled with, adherent to, and severed or pierced by long and thin curvilinear CH with occasional chromatin fibers threading over the partly severed asbestos. Similar chromosomal changes were much less frequently found in CR-treated cells; TEM confirmed the same findings. CH and CR have different physicochemical properties and also appear to have direct, intricate, but different interactions with chromosomes, as well as the cytoplasm, of PMCs. PMID- 3826299 TI - Abrogation of adriamycin-induced cardiotoxicity by selenium in rabbits. AB - Adriamycin-induced cardiomyopathy in rabbits was produced by intravenous injections of the drug with a short therapeutic schedule (3 mg/kg body wt administered as four intermittent doses). Animals receiving selenium supplementation of Adriamycin showed preservation of the normal pattern of the heart histologic picture. The protective effect of selenium was accompanied by increased selenium levels in the plasma and the heart muscle. An eventual interaction between the antitumor effect of Adriamycin and the protective effect of selenium was ruled out by in vitro experiments using the L1210 cell line. Selenium did not abrogate the antiproliferative effect of Adriamycin when the cells were treated simultaneously with both agents. The results from this study indicate that Adriamycin-induced cardiotoxicity could be prevented by selenium if the animals were pretreated with selenium, rather than simultaneous administration of both agents. The mechanism of this effect is not entirely understood. PMID- 3826300 TI - Ultrastructure of the rat pancreas after experimental duct ligation. I. The role of apoptosis and intraepithelial macrophages in acinar cell deletion. AB - After ligation of the rat pancreas, acinar cells disappeared from the distal gland within 5 days. Necrosis was responsible for minor cell loss during the first 24 hours, but most of the acinar cells were deleted by apoptosis. This distinctive form of cell death, which has been implicated in atrophy of other tissues, was characterized by cellular condensation followed by surface budding to produce membrane-bounded apoptotic bodies. Most of these were ingested and degraded by mononuclear phagocytes resident within the epithelium and a few by adjoining acinar cells. As atrophy progressed, the phagocytes increased in number through division and immigration of monocytes. The apoptotic deletion of acinar cells was characteristically effected without basement membrane disruption and was accompanied by simultaneous duct cell proliferation. The consequent rapid glandular remodeling resulted in reduction of the lobules to clusters of ductules in a collagenous stroma. PMID- 3826302 TI - Antigen-induced, IgE-mediated degranulation of cloned immature mast cells derived from normal mice. AB - Cloned, immature mast cells derived from normal mice were passively sensitized with mouse monoclonal IgE antibodies with specificity for DNP, and then stimulated to degranulate with DNP35-HSA. Cells were fixed for transmission electron microscopy or recovered for quantitation of histamine release at various intervals up to 30 minutes after antigen challenge. The cloned mast cells rapidly extruded the contents of their immature granules (dense progranular material and membrane-bound vesicles) to the exterior via multiple openings in the plasma membrane. Degranulation was associated with striking activation of the cell surface, characterized initially by elongation of surface processes, as well as by close approximation of strands of rough endoplasmic reticulum to the cell surface and by the development of coated pits. At later times after stimulation, degranulated mast cells had released nearly all of their granules and exhibited angular surfaces lacking elongated processes. These findings demonstrate for the first time that cloned, immature mast cells, like their mature counterparts, can undergo classic morphologic release reactions involving exocytosis of granules. PMID- 3826303 TI - Syphilis in the Syrian hamster. A model of human venereal and congenital syphilis. PMID- 3826301 TI - Monocyte chemoattractants in pigeon aortic atherosclerosis. AB - Atherosclerosis occurs in the aorta of White Carneau pigeons proximal to the celiac bifurcation, where monocyte adhesion and migration into lesions have been demonstrated. This study documents chemoattractants that might be responsible for monocyte adherence and migration. Ten-week-old pigeons were fed either a cholesterol-free (normal) diet or a 0.4% cholesterol diet for 12 or 24 weeks. Birds with a normal diet did not have lesions in the lesion-prone area of the aorta, whereas birds fed a cholesterol-containing diet had simple intimal foam cell lesions (12 weeks) or foam-cell lesions complicated with extracellular lipid and fibrillar matrix material (24 weeks). Plasma cholesterol levels in birds on the cholesterol-containing diet were 780-1080 mg/dl versus 140-240 mg/dl in the normal diet control group(s) at necropsy. To assay for chemoattractants, tissue was collected from lesion-prone and nonsusceptible (nonlesion) areas of the aortas. Samples from the two types of regions were separately pooled, then homogenized and tested for chemoattractant activity for pigeon peripheral blood monocytes. Monocyte chemoattractants were demonstrated in lesion area homogenates from pigeons fed cholesterol for 12 or 24 weeks and also in analogous homogenates from pigeons fed a normal diet. Monocyte migration to lesion-prone homogenates was significantly greater than that to nonlesion area homogenates. The chemoattractants in homogenates were monocyte-specific. The chemoattractant activity in the birds fed cholesterol for 12 weeks was confined to the aqueous phase of lipid extracts. This activity was abolished by pronase but unaffected by heat (100 C, 30 minutes), which indicated that the chemoattractant(s) in these homogenates was heat-stable protein(s). Activity in lipid extracts of lesion area homogenates from birds fed a cholesterol-containing diet for 24 weeks was found in both the aqueous and organic phases, suggesting that these samples contained lipid as well as proteinaceous chemoattractants. PMID- 3826304 TI - Evaluation of imminent danger for suicide among youth. AB - Problems with current strategies for assessing suicide risk are discussed and a two-tier method for evaluating imminent danger among adolescents is proposed. First, statistically-based data on suicide risk factors are collected; second, coping ability is assessed by having youths promise in writing not to try suicide, compliment themselves and others, assess their feelings; and develop a plan for dealing with suicidal circumstances. PMID- 3826305 TI - A cautionary note on the application of family therapy principles to organizational consultation. AB - Family therapy principles only partly apply to organizations. Although families and organizations are alike in some ways, they differ in goals, rules for participation, and membership. Family therapists can use organizational consultation to cross-validate systemic theories, increase nonclinical income, and influence organizations. They will succeed only to the extent that they advance organizational goals. PMID- 3826306 TI - The effects of day care participation on parent-infant interaction at home. AB - This study assessed how parents who placed their children in a model infant and toddler center were, over time, influenced by three salient features of the center: its child-centered focus, its social orientation, and its support for men in nurturing roles. PMID- 3826307 TI - The early developmental context of twinship: some limitations of the equal environments hypothesis. AB - Using questionnaires distributed to mothers, the characteristics of early development in twinship were investigated. Results indicated twinship to be an at risk situation with neonatal complications and within-pair differences in the attainment of developmental milestones. The implications of these differences raise questions about the accuracy of the equal environments hypothesis. PMID- 3826308 TI - Are seclusion rooms needed on child psychiatric units? AB - The prevailing assumption of the need for seclusion rooms in child psychiatric inpatient units is questioned and the experience of such a unit that operated with no seclusion room is described. PMID- 3826309 TI - Long term effects of a systems-oriented school prevention program. AB - This study documents three-year effects of a grade school systems-oriented primary prevention program based on the Yale Child Study Center model. Follow-up indicated that children receiving the intervention performed significantly better on various indices, mainly academic. Implications of these findings are discussed. PMID- 3826310 TI - An evaluation of consumer satisfaction in a child psychiatric service: viewpoints of patients and parents. AB - A consumer satisfaction questionnaire was mailed to 377 former patients and to parents of former patients of a child and adolescent psychiatric service. The 124 respondents indicated moderate to good levels of satisfaction with the service. A majority of both adolescents and parents had found individual therapy the most helpful treatment. PMID- 3826311 TI - Scheduled appointments and patient-staff compliance. AB - Studies of medication compliance have focused primarily on patient resistance to treatment, medication side effects, or the complexity of the medication regimen. This study of patient visits in a large psychiatric clinic found that, because of failure to schedule appointments or to notify receptionists of rescheduled appointments, physician noncompliance was as important as patient failure. PMID- 3826312 TI - On infant day care. PMID- 3826313 TI - Maternal emotional responses to preterm birth. AB - Mothers of 144 preterm infants with varying degrees of neonatal illness were interviewed prior to their infants' discharge from neonatal intensive care. Their major concerns were for the infants' survival rather than their own welfare. Husbands, parents, and, for members, church were seen as the major sources of support. PMID- 3826315 TI - Similarity of monozygotic and dizygotic child twins in level and lability of subclinically depressed mood. AB - Twenty child monozygotic twin-pairs were compared to 21 child dizygotic twin pairs on similarity of level and lability of subclinically depressed mood. Mood was assessed by self, parent, and teacher ratings. Estimates of genetic variance were statistically significant for about half of the measures of both level and lability of depression. PMID- 3826314 TI - Persistence of hyperactivity symptoms from childhood to adolescence and associated outcomes. AB - Hyperactive boys and matched controls from a large-scale epidemiological study, followed for at least three years to age 12, were compared on parent and teacher reports and assessments of attention, achievement, and intellectual functioning. Three outcome groups, based on presence or absence of hyperactivity symptoms, were derived and compared to the DSM-III description of ADD-H. Problem-free adolescents who were hyperactive in childhood were found to be more mature cognitively and behaviorally than those whose problems persisted. PMID- 3826316 TI - Prevention: a word whose time has come. AB - Prevention is a cherished mental health concept, increasingly honored more in word than deed. It is suggested that secondary and tertiary prevention constitute contradictions in terms and that--while the services they embody may be vital- they are not prevention. PMID- 3826317 TI - The context of suicide. AB - An analysis of eight cases of female suicide, drawn from Terman's Genetic Study of Genius sample, found little foreshadowing of suicide in the subjects' childhood and adolescence, absence of paternal involvement and concomitantly strong maternal influence, somatization of problems, perceived lack of accomplishment, and diminished sense of self-esteem in adulthood. Comparisons with male suicides in the Terman sample are discussed. PMID- 3826319 TI - Brief therapy in the age of Reagapeutics. AB - American society is eager to embrace brief therapy as one answer to skyrocketing bills and the limited supply of mental health care providers. In the new healing philosophy of "Reagapeutics," brief therapy symbolizes our increasing sense of futurelessness in the nuclear era, our impatience in this age of haste, and our intolerance for dependency. PMID- 3826318 TI - Ecological observation of emotionally and behaviorally disordered students: an alternative method. AB - An ecological approach to the assessment of emotionally and behaviorally disordered students and their school environments is described and an argument presented for the appropriateness of this approach in educational settings. The usefulness of problem behavior analysis (PROBA) as a specific observational method for assessing interactions of child and environment is illustrated by selected case examples. PMID- 3826320 TI - Preventive intervention with children of hospitalized psychiatric patients. AB - Indications for preventive intervention with children of hospitalized psychiatric patients are discussed and the clinical findings of a pilot study are presented. Reactive disorders are examined and two profiles of vulnerability proposed. Findings underscore the need to integrate preventive intervention with these children into routine hospital practice. PMID- 3826321 TI - Family adjustment to pediatric ambulatory dialysis. AB - Continuous ambulatory peritoneal dialysis has recently been a successful medical treatment for children with end-stage renal disease. The psychosocial issues for families and patients are considered within the context of the child's developmental stage (infants and toddlers, school age, and adolescence). The parent's conflicting duties as both a provider of medical care and a parent often lead to disturbances in family relationships. PMID- 3826322 TI - Incest: socialization within a treatment program. AB - The process of socialization in a mental health program for incestuous families is described. Treatment is viewed as a means of transmission of new knowledge- about what incest is, why it occurred, what should be done about it--from those who "know" to those who do not. Cultural mechanisms used to socialize participants to the predominant values of the treatment community are analyzed. PMID- 3826323 TI - Normal and pathological human gait analysis using miniature triaxial shoe-borne load cells. AB - Miniature triaxial shoe-borne load cells are used to analyze the normal and a below knee amputee's gait. The gait of an amputee is studied from first step on a temporary pylon to a final "normal" gait on a permanent prosthesis. The amputee's gait is compared to that of the normal subject. The load cells are an effective method of analyzing normal and abnormal gait. For an amputee, it is possible to identify misalignments from the output of the various load cells. This method may also be useful for identifying and correcting problems in the painful below knee stump. These load cells are further used to compute the center of pressure of a normal subject and a below knee amputee. Analysis of the resulting patterns has been found to be extremely useful as a measure of the subject's functional mobility. PMID- 3826324 TI - Contrasting perceptions of distress by research personnel and their spinal cord injured subjects. AB - Theoretical approaches to the understanding of psychological adjustment in spinal cord injury have recently experienced a re-examination which seriously questions the traditional "stage theory" of adjustment. Despite limited empirical validation at best, the stage theory has not only enjoyed an unchallenged popularity amongst rehabilitation professionals but often has been imposed upon new SCI patients as a necessary criterion for hospital discharge. Experienced professionals have also been shown to exaggerate the distress of their SCI patients and these misperceptions tend to progressively worsen with length of clinical experience. The present study replicated and extended this tendency amongst research personnel and their SCI subjects. Staff members tended to over estimate depression, anxiety, and social discomfort while under-estimating the optimism of their SCI subjects. Recommendations are made for the use of a questionnaire to measure their distress. Also, suggestions are made regarding the potential clinical utility of assessing the contrasting perceptions of distress by SCI patients and significant people in their rehabilitation and social environments. PMID- 3826325 TI - Detecting sincerity of effort when measuring grip strength. AB - The purpose of the present study was to determine whether sincere and faked grip strength measurements could be distinguished from one another by the patterns of measurements obtained for the five handle (hand size) positions of the Jamar dynamometer. Healthy subjects were instructed on different trials to give a sincere, maximal effort or to fake weakness of grip. Results were that the patterns did differ for sincere and fake trials, but not as strongly as expected. The recommendation is made that further research be done using patients with upper extremity injury. PMID- 3826326 TI - Evidence of spinal tuberculosis at the beginning of the fourth millennium BC from Arene Candide cave (Liguria, Italy). AB - This paper describes tuberculosislike lesions affecting the spine of Neolithic skeleton found in Arene Candide cave (Liguria, Italy) and representing one of the earliest cases of this disease in Europe. The burial is attributed to middle Neolithic (square-mouthed pottery culture) whose layers date, by 14C, to the first half of the fourth millennium BC. The skeleton, well preserved in the postcranial portion, belongs to a male aged about 15 years having a very light body build. Resorptive lesions localized to the lower thoracic and upper lumbar vertebral bodies, collapse and angular kyphosis, resulting from complete destruction of T11 and T12 and partial destruction of T10 and L1, are the main pathologic features. The morphology of the lesions, sites involved, and age of the specimen are consistent with a diagnosis of tuberculous spondylitis (Pott's disease). The extreme gracility of the skeleton, along with other signs of stress (Harris lines, enamel hypoplasia) suffered during the last years of life, and the limited bony regeneration point to a disease process in its late phase having arisen at the beginning of adolescence. The funerary ritual suggests that the social integration of this adolescent was not prevented by the severe infirmity. PMID- 3826327 TI - Longitudinal study of dental arch relationships in Australian aboriginals with reference to alternate intercuspation. AB - The patterns of age change in dental arch breadths and depths were studied longitudinally in Australian Aboriginals, 92 males and 68 females. Three types of change in relative arch dimensions were recognized: a divergent pattern in which the differences between maxillary and mandibular dimensions increased with age, a convergent pattern in which the differences decreased, and a parallel pattern in which the arch differences remained metrically stable. The feature that best distinguished the Aboriginals from Caucasian groups was the high frequency of subjects, 71% of males and 40% of females, who showed a divergent growth pattern. The association between divergent growth in arch breadths and the development of alternate intercuspation, which is characterized by an inability to occlude the teeth on both sides of the arch at the same time, is discussed. PMID- 3826328 TI - Principal components analysis of physical growth in savannah baboons. AB - Morphometric data collected from 118 male and 169 female savannah baboons (Papio cynocephalus anubis) aged between birth and 5.5 years were analyzed to describe the morphology and physical growth of this species. Measurements included weight, crown-rump length, triceps circumference, and skinfolds at the neck, subscapular, suprailiac, and triceps anatomical sites. Principal components analyses were applied to the data to provide multivariate assessments of morphological patterning among the variables. These analyses resulted in the extraction of two unrotated orthogonal components that accounted for 88% of the overall sample variation. The first component accounted for 77% of the variation and represents an axis of overall body size. The second component represents an axis of shape variation that contrasts body size with fat patterning, and was interpreted as a measure of body leanness. Individual component scores were computed for determining age, gender, and age-by-gender interaction effects. Both components were found to be age dependent for both genders. Males and females shared similar age patterning along the two components; however, gender differences did occur in patterning along the two components; however, gender differences did occur in respect to leanness. The multivariate measure of overall body size increased for both genders similarly with advancing age. Age patterning along the leanness component was described as a decrease from birth to 1 year, followed by an increase in leanness in older ages. Females had a delayed and significantly less intense increase in leanness relative to males. PMID- 3826329 TI - Effects of maternal food restriction during lactation on craniofacial growth in weanling rats. AB - Adult Holtzman rats were submitted during suckling period to a food restriction with or without protein or carbohydrate restoration. Twenty-one-day-old weanling pups were compared with controls of 9, 13, 17, and 21 days of age. Lateral craniofacial roentgenographies were taken. The length in midsagittal plane of each bone and its angle with respect to the vestibular line were measured in males. In females, the brain and the left masseter muscle were weighed, and the muscle/brain ratios (neuromuscular index) were calculated. Food restriction altered skull size and shape. Size changes were due to arrested lengths in all studied skull bones. Shape variation was evident by orthocephalization changes, reflected in angulation changes of bones belonging to the frontoethmofacial (frontal, nasal, and maxillary bones) and to the occipitointerparietal (interparietal bone) complexes. Partial restorations by both protein or carbohydrate supplementation were found. Nutritional stresses during lactation affected orthocephalization through an altered growth ratio between two soft tissues functionally associated to the craniofacial complex: brain and masticatory muscles. PMID- 3826330 TI - Prevalence and age at development of enamel hypoplasias in Mexican children. AB - Enamel hypoplasias, deficiencies in enamel thickness resulting from disturbances during the secretory phase of enamel development, are generally believed to result from nonspecific metabolic and nutritional disruptions. However, data are scare on the prevalence and chronological distributions. of hypoplasias in populations experiencing mild to moderate malnutrition. The purpose of this article is to present baseline data on the prevalences and chronological distributions of enamel hypoplasias, by sex and for all deciduous and permanent anterior teeth, in 300 5 to 15-year-old rural Mexican children. Identification of hypoplasias was aided by comparison to a published standard (Federation Dentaire Internationale: Int. Dent. J. 32(2):159-167, 1982). The location of defects, by transverse sixths of tooth crowns, was used to construct distributions of defects by age at development. One or more hypoplasias were detected in 46.7% (95% CI = 40.9-52.5%) of children. Among the unworn and completely erupted teeth, the highest prevalence of defects was found on the permanent maxillary central incisors (44.4% with one or more hypoplasias), followed by the permanent maxillary canine (28.0%) and the remaining permanent teeth (26.2 to 22.2%) Only 6.1% of the completely erupted and unworn deciduous teeth were hypoplastic. The prevalence of enamel defects on the permanent teeth was up to tenfold greater than that found in studies of less marginal populations that used the FDI method. The prevalence of defects in transverse zones suggests a peak frequency of hypoplasias during the second and third years for the permanent teeth, corresponding to the age at weaning in this group. In the deciduous teeth, a smaller peak occurs between 30 and 40 weeks post gestation. The frequency of defects after three years of age is slightly higher in females than males, suggesting a sex difference in access to critical resources. PMID- 3826331 TI - Sibling similarity in development of covariation among physical traits in early childhood. AB - We studied the sibling similarity in development of covariation among body size characters (body weight (W), body length (S) and head circumference (HC) in Tel Aviv infants from birth up to 2 years of age. We investigated the effects of parental geographic origin, profession, age, current residence, and of family size. Multiple regression analysis with "dummy" procedure established that none of these variables had any significant effect on the aforementioned anthropometric traits. The matrices of phenotypic and genetic correlations, based on sibling similarity data, among age-specific W, S, and HC (measured for 12 different ages) were subjected to principal component analysis in order to elucidate patterns over the age groups. The patterns of both analyses, phenotypic and genetic, were quite similar: one factor in each (first genetic and second phenotypic) had a high positive correlation with early, first 2-3 months of life, W, S, and HC. Three other extracted factors correlated strongly, each with late W, S, and HC, respectively. The results of additional principal component analyses of age-specific W, S, and HC matrices separately, indicate the possibility of existence of two genetic subsystems, the first determining early postnatal stages of human ontogeny, and the second, later phases of child development. PMID- 3826332 TI - Relative lower extremity length in Mexican American and in American black and white youth. AB - Stature, sitting height, estimated leg (subischial) length and the sitting height/stature ratio are compared in Mexican American, American White and American Black boys 9 through 14 years of age and girls 12 through 17 years of age. Mexican American youth are shorter in stature and have absolutely shorter lower extremities. The sitting height of Mexican American youth is similar to that of Black youth and shorter than that of White youth. The sitting height/stature ratio is virtually identical in Mexican American and White youth, indicating similar proportions of lower extremities to stature. In contrast, Black youth have absolutely and relatively longer lower extremities than Mexican American and White youth. These results would thus seem to suggest that reference data for the body mass index (BMI) based on American White youth can be used with Mexican American youth, while race-specific values may be necessary for American Black youth. However, ethnic variation in physique, perhaps frame size, may be a factor which should be more systematically considered in evaluating the utility of the body mass index. PMID- 3826333 TI - Gene differentiation at the ABO locus in twenty castes and twenty-two tribes of Andhra Pradesh, India. AB - Using gene frequency data for the ABO locus so far available, gene differentiation and gene identity between 20 castes and 22 tribes of Andhra Pradesh were determined. The interpopulation gene diversity is 1.4 and 1.6% of total genic variation in castes and tribes, respectively. Difficulties in interpreting genetic diversity using just one genetic system is discussed. PMID- 3826334 TI - Proceedings of fifty-sixth annual meeting of the American Association of Physical Anthropologists. New York City, April 2-5, 1987. PMID- 3826335 TI - Interactions of inhibitors on anion transporter of human erythrocyte. AB - Chloride tracer efflux was measured from intact human erythrocytes into media containing different chloride concentrations and different concentrations of the inhibitors 4,4'-dinitrostilbene-2-2'-disulfonate (DNDS), N-(4-azido-2 nitrophenyl)-2-aminoethylsulfonate (NAP-taurine), phloretin, and sulfate. The data were analyzed to test whether these inhibitors were mutually exclusive with each other or whether they could bind at the same time. Under the assumption that mutual exclusiveness is due to steric interference, the data can be used to map out the protein surface near the outward-facing anion binding-transport site. It is concluded that there are separate domains for NAP taurine and phloretin that do not overlap with each other or with the chloride binding site. These two domains do, however, overlap with the binding domain for DNDS that, in addition, excludes the binding of chloride and sulfate. PMID- 3826336 TI - Origin and propagation of electrical slow waves in circular muscle of canine proximal colon. AB - Experiments to determine the site of slow-wave origin and the mechanism of propagation were performed on muscles of the canine proximal colon. Cells along the submucosal border of the circular layer had resting membrane potentials (RMP) averaging -78 mV, and slow waves, 40 mV in amplitude. The RMP of cells through the thickness of the circular layer decreased exponentially with distance from the submucosal border, such that RMPs of circular cells at the myenteric border were only -43 mV. Slow waves decreased in amplitude through the thickness such that slow waves could not be detected adjacent to the myenteric border. When a thin strip of muscle along the submucosal border was removed, slow waves were not recorded from the bulk of the circular layer and could not be evoked by acetylcholine. Slow waves were still present in the excised strip. Experiments to determine the rate of slow-wave propagation were also performed. Two cells were impaled, one at the submucosal surface, and another at some distance through the circular layer. Slow waves occurred nearly simultaneously at both sites. What latency was observed could be explained on the basis of electrotonic conduction. The results support the hypothesis that in the canine proximal colon slow waves are generated at the extreme submucosal surface of the circular layer. The bulk of the circular layer does not possess either pacemaker or regenerative mechanisms, and slow waves propagate passively toward the myenteric border. The cable properties of the circular muscle syncytium furnish a barrier to invasion of the longitudinal layer by the slow wave event. PMID- 3826337 TI - Negative inotropic effect of extracellular calcium buffering in cardiac muscle. AB - Heart muscle contracts more vigorously when calcium levels are raised. A transient depletion of calcium from restricted extracellular spaces occurs with each contraction. We decided to maintain the concentration of this ion at a constant level by using an external calcium buffering system. It was found that buffering calcium at a millimolar level (using citrate as a buffer) caused a decrease, rather than an increase in the strength of contraction. The mean reduction in peak tension was by 27% in guinea pig and by 50.5% in frog atrium. This finding is analyzed; its most plausible explanation is the hypothesis that the buffer dissipates a calcium inhomogeneity, consisting of a higher calcium concentration adjacent to the membrane. Alternative interpretations such as intracellular acidosis, were tested experimentally and ruled out. PMID- 3826338 TI - High-speed ultrasensitive instrumentation for myofibril mechanics measurements. AB - A novel instrument for measuring the mechanics of a single myofibril is described. The principle of the transducer operation is to attach a myofibril to a very fine wire suspended in a magnetic field. Feedback circuits pass current through the wire to maintain the length constant when the myofibril contracts. The wire position is measured optoelectronically at a resolution below 1 A. The myofibril measurement system consists of two independent transducers and is capable of resolving tension down to 0.5 ng/square root Hz and controlling the myofibril length with a 10-microseconds rise time. Optical and electronic designs of the system and calibration and adjustment procedures are described. Experimental chamber design, a flow controller, and an environmental noise cancellation scheme are also discussed. PMID- 3826339 TI - Triiodothyronine stimulates cartilage growth and maturation by different mechanisms. AB - The mechanisms by which triiodothyronine (T3) stimulates growth and maturation of growth-plate cartilage in vitro were studied by incubating embryonic chick pelvic cartilages in serum-free medium in the presence and absence of T3 for 3 days. To determine whether T3 might stimulate production of somatomedins by the cartilage, medium from cartilage incubated with and without T3 was assayed for somatomedin C (Sm-C) by radioimmunoassay. No difference in Sm-C content was found. However, cartilage incubated with T3 and increasing amounts of human Sm-C (0.5-20 ng/ml) weighed more and had greater amounts of glycosaminoglycan than cartilage incubated in the same concentrations of Sm-C without T3, suggesting that T3 enhances the growth effect of somatomedin. We added a monoclonal antibody to Sm-C (anti-Sm-C) to the organ culture to determine whether T3's stimulatory effect on cartilage growth could be blocked. The anti-Sm-C inhibited growth of cartilage incubated in medium alone and blocked the growth response to T3. By using alkaline phosphatase as a biochemical marker to follow maturation, we found that T3 stimulated a 57% increase in alkaline phosphatase activity above cartilage incubated in medium alone and that anti-Sm-C did not inhibit T3's stimulatory effect on alkaline phosphatase activity. We propose two different mechanisms by which T3 affects growth-plate cartilage: T3 promotes cartilage growth primarily through enhancing the effect of somatomedin, and T3 stimulates cartilage maturation possibly by accelerating the normal process of cartilage differentiation from proliferative to hypertrophic chondrocytes. PMID- 3826340 TI - Lipolytic response to glucose infusion in human subjects. AB - We have determined the effect of various rates of glucose infusion on the rates of release of glycerol (Ra glycerol), free fatty acids (Ra FFA), and on energy metabolism in normal human volunteers. Plasma kinetics were determined with use of the stable isotopic tracers D-5-glycerol and [1-13C]palmitate, and energy metabolism was determined by indirect calorimetry. The effect of glucose infusion on Ra glycerol and Ra FFA was dose-dependent. At an infusion rate of 1 mg X kg-1 X min-1, no effect on either kinetic factor was noted. At 4 mg X kg-1 X min-1, both Ra glycerol and Ra FFA were suppressed; at 8 mg X kg-1 X min-1, Ra FFA was even more depressed, but Ra glycerol was similar to the value during the 4 mg X kg-1 X min-1 infusion. At all infusion rates tested, the amount of potential energy available from the sum of the glucose infusion and endogenously mobilized fat was always greater than when no glucose was infused. Glucose decreased fat mobilization by both inhibiting lipolysis and stimulating reesterification, thus causing a significant increase in triglyceride-fatty acid substrate cycling within the adipose tissue. PMID- 3826341 TI - Effect of warm or cold exposure on GDP binding and uncoupling protein in rat brown fat. AB - The effects of acute and chronic exposure to different environmental temperatures on the total tissue cytochrome oxidase activity, level of mitochondrial GDP binding, and specific mitochondrial concentration of uncoupling protein have been investigated in rat brown adipose tissue, a radioimmunoassay being used to measure uncoupling protein. Acclimation at different temperatures for 3 wk produced parallel changes in GDP binding, the concentration of uncoupling protein, and the activity of cytochrome oxidase, each parameter rising with decreasing temperature between thermoneutrality (29 degrees C) and 4 degrees C. Acute exposure of warm-acclimated (29 degrees C) rats to the cold (4 degrees C) led to a rapid increase in GDP binding without any alteration in the amount of uncoupling protein. The increase in binding was accompanied by an increase in the rate of acetate-induced swelling of the mitochondria. The concentration of uncoupling protein in warm-acclimated rats was significantly raised only after 48 h exposure to cold. When cold-acclimated rats were exposed acutely to the warm, there was a rapid decrease in GDP binding without any alteration in the amount of uncoupling protein. It is concluded that after alterations in environmental temperature the concentration of uncoupling protein in brown adipose tissue mitochondria changes much more slowly than GDP binding and that binding can therefore be dissociated from the amount of the protein. PMID- 3826342 TI - Thyroid function and cold acclimation in the hamster, Mesocricetus auratus. AB - Basal metabolic rate (BMR), thyroxine utilization rate (T4U), and triiodothyronine utilization rate (T3U) were measured in cold-acclimated (CA) and room temperature-acclimated (RA) male golden hamsters, Mesocricetus auratus. Hormone utilization rates were calculated via the plasma disappearance technique using 125I-labeled hormones and measuring serum hormone levels via radioimmunoassay. BMR showed a significant 28% increase with cold acclimation from 4.50 +/- 0.05 to 5.77 +/- 0.10 ml O2 X h-1 X g-2/3. The same cold exposure also produced a 32% increase in T4U (10.75 +/- 0.51 vs. 14.19 +/- 0.75 ng X day-1 X g-2/3), and a 204% increase in T3U (5.51 +/- 0.53 vs. 16.77 +/- 1.35). The much greater increase in T3U implies that previous assessments of the relationship between cold acclimation and thyroid function may have been underestimated and that cold exposure induces both quantitative and qualitative changes in thyroid function. It is concluded that in the cold-acclimated state, T3U more accurately reflects thyroid function than does T4U. A mechanism for the cold-induced change in BMR is proposed, for which alterations in four aspects of thyroid function are required: a decrease in plasma T4 binding, an elevation of the pituitary T4 "set point," a preferential shift in deiodinase activity from reverse T3 to T3 production, and an increase in the thyroidal secretion of T3. PMID- 3826343 TI - Secretory pattern of canine growth hormone. AB - Our aim was to define the secretory pattern of growth hormone (GH) under basal conditions in fasted, conscious, male dogs accustomed to handling. Blood samples were withdrawn from a cephalic vein at 15-min intervals. In this way, any ultradian rhythms, if present, could be detected within the frequency range of 0.042-2 cycles/h. In addition, samples were drawn at either 1- or 2.5-min intervals for 2.5 or 5 h to determine whether frequency components greater than 2 cycles/h were present. GH was measured by radioimmunoassay and the raw data were submitted to time series analysis employing power spectral estimation by means of fast Fourier transformation techniques. Peak plasma levels were up to 12 times higher than the baseline concentration of approximately 1 ng/ml. Spectral analysis revealed an endogenous frequency of 0.22 cycles/h, i.e., a periodicity of 4.5 h/cycle. The results indicate that under basal conditions the secretory bursts of canine GH are limited to one peak every 4.5 h. PMID- 3826344 TI - Vascular reactivity in experimental portal hypertension. AB - Portal hypertension (PHT) is known to be associated with a hyperdynamic circulation, yet the pathogenesis of both remains unclear. Therefore, we have studied serially the relationship between portal pressure and in vitro peripheral vascular responsiveness in an animal model of presinusoidal PHT. In rats with partial portal vein stenosis (PPVS) or sham-operated (SO) controls, we studied contractile responses to cumulative doses of norepinephrine (NE) and to a single dose of 0.8 microM NE of 20-mm helically cut strips of thoracic aorta. At both 2 and 10 days postoperatively, the portal pressures (mean intrasplenic pressure) in PPVS, 14.3 +/- 1.5 mmHg and 14.1 +/- 1.3 mmHg were significantly elevated compared with SO controls, 7.6 +/- 0.6 mmHg (P less than 0.005) and 9.7 +/- 0.5 mmHg (P less than 0.01), respectively. Yet, there was no significant differences between the two groups in the Rmax and ED50 of the contractile response curves to cumulative doses of NE as well as in the fast (phase 1) and slow phase (phase 2) of the contraction to 0.8 microM NE. In contrast, at 21 days, portal pressure in the PPVS rats fell to 11.0 +/- 0.7 mmHg but remained significantly higher than that of the SO controls, 8.2 +/- 1.0 mmHg (P less than 0.05). This occurred in conjunction with a significant decrease in Rmax [698 +/- 87 mg (PPVS) vs. 1148 +/ 92 mg (SO); P less than 0.005] but no significant change in ED50, indicating a decreased sensitivity to NE due to an alteration in alpha-adrenoreceptor function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826346 TI - Intestinal blood flow and oxygen uptake in the neonatal piglet during reduced perfusion pressure. AB - The effect of reduced perfusion pressure on neonatal intestinal blood flow, vascular resistance, arterio-venous oxygen content (a-v O2), and oxygen uptake was studied in nine fasted newborn piglets, aged 5-6 days. Successive reductions of intestinal perfusion pressure were achieved by a clamp on the thoracic aorta. Intestinal blood flow decreased after each reduction of perfusion pressure. Intestinal vascular resistance increased and Gf, a measure of flow control, was negative after all but the final, most severe reduction of perfusion pressure. However, intestinal a-v O2 increased after each pressure reduction and intestinal oxygen uptake was thus maintained at greater than or equal to 95% of its baseline value until perfusion pressure was reduced to less than or equal to 70% of its base-line value. The neonatal intestine maintains tissue oxygen uptake during moderate hypotension, and this is accomplished by regulation of a-v O2, rather than by regulation of blood flow. PMID- 3826345 TI - Effects of Na+ replacement and amiloride on ursodeoxycholic acid-stimulated choleresis and biliary bicarbonate secretion. AB - In these studies, we have tested the hypothesis that bile acid-dependent bile formation is attributable, in part, to the stimulation of active bicarbonate secretion and have further explored the cellular mechanism(s) possibly involved in this process using the isolated perfused rat liver. Under control conditions, ursodeoxycholic acid (UDCA) infusion (3 mumol/min X 20 min) produced a 3.7-fold increase in bile flow and a 7.4-fold increase in HCO3- output. Amiloride (an inhibitor of Na+-H+ exchange) decreased UDCA-stimulated bile flow by 20.6% and decreased biliary HCO3- output by 24.9% but increased biliary UDCA output by 42.9%. Thus amiloride decreased UDCA choleretic efficiency (microliter UDCA stimulated bile/mumol UDCA output) by 45% and UDCA-stimulated increase in HCO3- output per unit UDCA secreted by 48%. Substitution of Li+ for Na+ in perfusate virtually abolished (greater than 95% decrease) both the UDCA choleresis and increase in biliary HCO3- output but modestly decreased (39.6%) biliary bile acid output. Li+ substitution thus decreased UDCA choleretic efficiency by 98% and the UDCA-stimulated increase in HCO3- output by 96%. Amiloride had no effect and Li+ substitution produced a modest decrease in basal bile flow (26.0%) and HCO-3 output (33.5%). Neither amiloride nor Li+ substitution significantly affected UDCA uptake by cultured hepatocytes or by perfused liver. Amiloride (1 mM) also decreased taurocholate (TC)-stimulated choleresis by 48.5%, biliary TC output by 7.2%, and the choleretic efficiency of TC by 45%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826347 TI - Effect of central administration of motilin on migrating complexes in the dog. AB - The effects of intravenous, intrathecal, and intracerebroventricular injection of motilin on the interdigestive myoelectric (MMC) activity of the stomach and small intestine were examined in conscious dogs. To monitor electrical activity, electrodes were implanted on the stomach and small bowel. To inject motilin into the central nervous system, catheters were chronically positioned in the intrathecal space at the lumbar level and in one of the lateral cerebral ventricles. In all dogs, intravenous injection of motilin caused a transient increase in the plasma concentration of motilin and initiated gastric MMCs, which propagated aborally to the ileum. Intrathecal and intracerebroventricular injections of motilin did not affect plasma motilin levels and did not induce MMCs. These data suggest that initiation of MMCs after intravenous injections of motilin occurs through receptors for motilin possibly located outside the central nervous system. These data also suggest the hypothesis that initiation of naturally occurring MMCs in the dog may not be dependent on endogenous release of motilin from the central nervous system. PMID- 3826348 TI - Mechanisms involved in ketone body release by rat liver cells: influence of pH and bicarbonate. AB - The aim of the present work is to study the intra- and extracellular concentration gradient of ketone bodies across the hepatic cell membrane, ketone bodies released by liver cells, and the effects of changes in acid-base status on these processes. Ketone bodies appeared to be released by liver cells against a concentration gradient both in vivo and in vitro (ratio intra- to extracellular, acetoacetate approximately 0.5, 3-hydroxybutyrate approximately 0.8). In vitro, a decrease in external pH and bicarbonate gradient was associated with a reduction of ketone body gradients and efflux rates. Analysis of the distribution ratio of ketone bodies as a function of delta pH across the cell membrane indicates that additional factors must be invoked to account for the observed distribution ratios. These data along with measurements of ketone body efflux are consistent with the existence of a system promoting the efflux of ketone bodies from liver cells, which is trans-stimulated by external bicarbonate. In vivo, ketogenesis was also inhibited by acidosis, and slightly enhanced by bicarbonate infusion, although this was not solely due to effects on transfer across the cell membrane. The study indicates that the hepatic release of ketone bodies might be auto limited by ketoacidosis. PMID- 3826349 TI - Hypercholeresis induced by norchenodeoxycholate in biliary fistula rodent. AB - The biliary recovery and effect on bile flow and biliary bicarbonate secretion of infused norchenodeoxycholate (nor-CDC), the synthetically prepared C23 homologue of chenodeoxycholate (CDC), were defined in the anesthetized biliary fistula hamster, rat, and guinea pig and compared with those of its taurine conjugate as well as those of the natural C24 bile acid, CDC. In the hamster and rat, nor-CDC was recovered slowly in bile in contrast to its taurine conjugate or CDC. Hepatic biotransformation of nor-CDC was complex. Little amidation with glycine or taurine occurred and the compound was recovered in bile in unchanged form, in the form of hydroxylated derivatives as well as glucuronates and sulfates, the proportion varying in the different species. In contrast, CDC was efficiently amidated with glycine or taurine. The taurine conjugate of nor-CDC was secreted largely unchanged. Nor-CDC infusion caused a striking hypercholeresis in the hamster (108 microliters bile/mumol bile acid in bile) and in the rat (220 microliters/mumol); these values for bile acid-dependent flow far exceed those reported for any other natural bile acid to date in these species. The induced hypercholeresis was of canalicular origin and was accompanied by an enrichment in bicarbonate ion concentration as well as increased bicarbonate output. The taurine conjugate of nor-CDC did not display hypercholeretic properties in the hamster. In the guinea pig, whose native bile is bicarbonate-rich relative to other species, nor-CDC was only mildly hypercholeretic relative to CDC and caused no change in bicarbonate concentration. Thus shortening the side chain of a natural dihydroxy bile acid by a single carbon atom formed a compound that underwent a different hepatic biotransformation than that of most natural bile acids and induced a bicarbonate-rich canalicular choleresis far greater than that which can be explained by current theories of bile formation. PMID- 3826350 TI - Folate transport by human intestinal brush-border membrane vesicles. AB - Transport of folic acid (Pte-Glu) across the brush-border membrane of human intestine was studied using brush-border membrane vesicle (BBMV) technique. The transport of Pte-Glu was higher in BBMV prepared from the jejunum than those prepared from the ileum (0.70 +/- 0.05 and 0.14 +/- 0.02 pmol X mg protein-1 X 10 s-1, respectively). The transport of Pte-Glu appeared to be carrier mediated and was pH dependent and increased with decreasing incubation buffer pH; saturable (Kt = 1.69 microM, Vmax = 4.72 pmol X mg protein-1 X 10 s-1); inhibited in a competitive manner by the structural analogues 5-methyltetrahydrofolate, methotrexate, and 5-formyltetrahydrofolate (Ki = 2.2, 1.4 and 1.4 microM, respectively); not affected by inducing a relatively positive or negative intravesicular compartment; independent of Na+ gradient; and inhibited by 4,4' diisothiocyanatostlibene-2,2'-disulfonic acid (DIDS), an anion exchange inhibitor. The increase in Pte-Glu transport on decreasing incubation buffer pH appeared to be in part mediated through a direct effect of acidic pH on the transport carrier and in part through the pH gradient imposed by activating Pte Glu-:OH- exchange and/or Pte-Glu-:H+ co-transport mechanisms. The important role of an acidic extravesicular environment in Pte-Glu transport is consistent with a role for the intestinal surface acid microclimate in folate transport. These results demonstrate that Pte-Glu transport in human BBMV occurs by a carrier mediated system that is similar to that described for rat and rabbit intestinal BBMV. PMID- 3826351 TI - Quantitative assessment of villous motility. AB - A videomicroscopic method was used to quantitatively analyze villous motility in the dog small intestine. The frequency and duration of villous contractions (retractions) were measured in the duodenum, midjejunum, and distal ileum under controlled conditions. A pronounced gradient of villous motility was evident along the bowel. The duodenum exhibited the highest frequency (7.3 +/- 0.1/min) and longest duration (2.6 +/- 0.1 s) of contraction; the jejunum exhibited an intermediate frequency and duration of contraction (4.0 +/- 0.1/min, 2.1 +/- 0.1 s), and the lowest values were measured in the ileum (2.0 +/- 0.1/min and 1.8 +/- 0.1 s). In contrast to the retraction movements, the frequency of pendular villous movements (whipping, swaying movements without shortening) was highest in the jejunum and lowest in the duodenum. The frequency and duration of villous contractions (retractions) remained relatively constant over a 2-h observation period. Reducing mucosal surface temperature from 38 to 30 degrees C caused the frequency of contraction to fall by 33% and the duration to increase by 106%. Varying the suffusate pH within the physiological range of 5.0-7.4 produced no significant effects on jejunal villous motility. Suffusion with glucose (140 and 280 mM) failed to alter villous motility. However, amino acid (15 and 30 mM) and fatty acid (10 mM) solutions significantly increased contraction frequency by 30 50% and 90%, respectively. The videomicroscopic method provides useful quantitative information, which should extend current knowledge regarding the regulation and physiological importance of villous motility. PMID- 3826352 TI - Hyperglucagonemia and hyperkinetic circulation after portocaval shunt in the rat. AB - The study was aimed at investigating whether increased portal venous inflow (PVI) after portocaval shunt (PCS) in the rat is the result of selective splanchnic vasodilatation or whether it is part of a generalized circulatory disturbance. Rats with PCS (n = 9) and sham-operated controls (n = 8) were studied 2 wk after surgery by measuring cardiac output (CO), PVI, and hepatic artery flow (HAF) with radioactive microspheres. Plasma glucagon (GL) was measured by radioimmunoassay. PCS rats had increased CO (46.2 +/- 2.8 vs. 28.2 +/- 1.7 ml X min-1 X 100 g-1, P less than 0.001) and reduced arterial pressure and total peripheral resistance. PVI was markedly increased (7.7 +/- 0.7 vs. 4.3 +/- 0.2 ml X min-1 X 100 g-1, P less than 0.001), but this appeared to be part of a generalized circulatory disturbance, since when PVI is expressed as percent of CO no difference is observed between PCS and sham-operated rats (17.0 +/- 1.5 vs. 15.8 +/- 1.3%, NS), indicating the absence of a preferential splanchnic vasodilatation. GL increased after PCS (548 +/- 130 vs. 156 +/- 23 pg/ml, P less than 0.005), and significant correlations were observed between GL and CO (r = 0.787, P less than 0.001) and between GL and PVI (r = 0.806, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826353 TI - A high linoleic acid diet diminishes enhanced intestinal uptake of sugars in diabetic rats. AB - Intestinal absorption is altered in rats by diabetes and by dietary manipulation. For 5 wk rats were fed chow (C) or semisynthetic diets containing isocaloric amounts of a high content of either polyunsaturated (P) or saturated (S) fatty acids; then half were rendered hyperglycemic with streptozotocin while the remaining half served as nondiabetic controls. Studies were performed after a total of 8 wk on C, P, or S. Jejunal villous surface area was greater in diabetic rats than in control rats fed C or S, whereas the jejunal mucosal surface area was significantly greater in diabetic animals than in control animals only when they were fed S. Ileal mucosal surface area was similar in diabetic and in control rats fed C, S, or P; although ileal villous surface area was greater in diabetic than in control rats only when they were fed C. The jejunal and ileal uptake of varying concentrations of glucose and galactose was higher in diabetic rats than controls fed C or S. In contrast, the enhanced uptake of these sugars was reduced or normalized in diabetic rats fed P. The jejunal brush-border membrane (BBM) content of phospholipids was higher in diabetic than in control rats fed chow, but there was no difference in diabetic vs. control animals fed P or S in BBM total free fatty acids, phospholipids, or cholesterol. Thus feeding a high linoleic acid diet diminishes the enhanced intestinal uptake of glucose and galactose in diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826355 TI - The American Physiological Society in its centenary year. PMID- 3826354 TI - CCK-5: sequence analysis of a small cholecystokinin from canine brain and intestine. AB - The purpose of this study is to purify and to characterize chemically cholecystokinin (CCK)-like peptides present in brain and gut extracts that elute from gel filtration after the octapeptide. Canine small intestinal mucosa and brain were boiled in water and then extracted in cold trifluoroacetic acid, and cholecystokinin-like immunoreactivity was determined by carboxyl-terminal specific radioimmunoassay. Gel permeation chromatography on Sephadex G-50 revealed a form of CCK apparently smaller than CCK-8. This peptide was purified by immunoaffinity chromatography and three successive reverse phase high performance liquid chromatography steps. Microsequence analysis showed that the amino terminal primary sequence of this small CCK was Gly-Trp-Met-Asp. Immunochemical and chromatographic analysis indicated that the carboxyl-terminal residue was Phe-NH2 and thus the full sequence is Gly-Trp-Met-Asp-Phe-NH2. An antibody that recognizes synthetic CCK-8, CCK-5, and CCK-4 equally did not reveal the presence of significant amounts of CCK-4. These results indicate that CCK-5 is the major CCK form smaller than the octapeptide present in brain (19% of total CCK immunoreactivity) and small intestine (7% of total). This finding, coupled with the demonstration by others that CCK-5 interacts with high-affinity brain CCK receptors, indicates that CCK-5 may play a physiological role in brain function. PMID- 3826356 TI - Cell volume, K transport, and cell density in human erythrocytes. AB - We report here studies on the regulation of cell volume and K transport in human erythrocytes separated according to density. When cell volume was increased (isosmotic swelling, nystatin technique), erythrocytes of the least dense but not of the densest fraction shrunk back toward their original volume. This process was due to a ouabain (0.1 mM) and bumetanide (0.01 mM) (OB)-resistant K loss. OB resistant K+ efflux from the least dense fraction was stimulated by hypotonic swelling and had a bell-shaped dependence on pH (pH optimum 6.75-7.0). These pH and volume effects were not evident in the densest fraction. The swelling-induced K+ efflux from the least dense fraction was inhibited when chloride was substituted by nitrate, thiocyanate, and acetate, whereas it was stimulated by bromide. Increasing cell Mg2+ content also markedly inhibited K+ efflux from isosmotically swollen cells. N-ethylmaleimide (NEM, 1 mM) greatly increased OB resistant K+ efflux from the least dense fraction but not from the densest fraction. These data reveal the presence, in the lease dense fraction of normal human erythrocytes, of a pathway for K+ transport that is dependent on volume, pH, and chloride, is inhibited by internal Mg2+, and possibly plays a role in determining the erythrocyte water and cation content. PMID- 3826357 TI - Tissue distribution of rat S100 alpha and S100 beta and S100-binding proteins. AB - To understand the physiological role of the calcium-binding proteins S100 alpha and S100 beta, it is necessary to determine the distribution of these proteins and detect their intracellular targets in various tissues. The distribution of immunoreactive S100 alpha and S100 beta in various rat tissues was examined by radioimmunoassay. All tissues examined contained detectable S100, but the S100 beta/S100 alpha ratio in each tissue differed. Brain, adipose, and testes contained 18- to 40-fold more S100 beta than S100 alpha; skin and liver contained approximately equivalent amounts and kidney, spleen, and heart contained 8- to 75 fold more S100 alpha than S100 beta. Analysis of S100-binding proteins by gel overlay showed that each tissue possessed its own complement of binding proteins. The S100 beta-binding profile was indistinguishable from the S100 alpha-binding profile and both of these profiles were distinct from the calmodulin-binding profile. These observations suggest that the differential distribution and quantity of the individual S100 polypeptides and their binding proteins in various tissues may be important factors in determining S100 function. PMID- 3826358 TI - Interaction of two electrical pacemakers in muscularis of canine proximal colon. AB - Experiments were performed to determine the source of the 20 cycles/min electrical oscillation commonly seen in colonic electrical records, the influence of the 20 cycles/min rhythm on the circular and longitudinal muscle layers, and the interactions between the 20 cycles/min rhythm and slow waves in circular muscle cells. Cross-sectional muscle preparations of the canine proximal colon were used to allow impalement of cells at any point through the thickness of the muscularis. Intracellular recordings from circular muscle cells clearly showed the two characteristic pacemaker frequencies in the colon (6 cycles/min slow waves; 20 cycles/min oscillations). The 20 cycles/min oscillations were recorded from longitudinal and circular muscle cells. Their amplitudes were greatest at the myenteric border. In the longitudinal layer the 20 cycles/min events initiated action potentials; in circular muscle the 20 cycles/min events summed with slow waves. Simultaneous recordings from circular and longitudinal cells across the myenteric border demonstrated that events in the two layers were usually in phase, suggesting that the two layers are electrically coupled and are paced by a common pacemaker. The amplitude of the 20 cycles/min events decayed with distance from the myenteric border in both circular and longitudinal muscles. The data demonstrate that two discrete populations of pacemaker cells generate the spontaneous electrical activity in the colon. Both events appear to passively spread through the circular muscle. It is the summation of these events that appears to serve as the signal for excitation-contraction coupling in circular muscle. PMID- 3826359 TI - Cell volume regulation in hemoglobin CC and AA erythrocytes. AB - Swelling hemoglobin CC erythrocytes stimulates a ouabain-insensitive K flux that restores original cell volume. This volume regulatory pathway was characterized for its anion dependence, sensitivity to loop diuretics, and requirement for Na. The swelling-induced K flux was eliminated if intracellular chloride was replaced by nitrate and both swelling-activated K influx and efflux were partially inhibited by 1 mM furosemide or bumetanide. K influx in swollen hemoglobin CC cells was not diminished when Na in the incubation medium was replaced with choline, indicating Na independence of the swelling-induced flux. Identical experiments with hemoglobin AA cells also demonstrated a swelling-induced increase in K flux, but the magnitude and duration of this increase were considerably less than that seen with hemoglobin CC cells. The increased K flux in hemoglobin AA cells was likewise sensitive to anion replacement and to loop diuretics and did not require the presence of Na. These data indicate that a volume-activated K pathway with similar transport characteristics exists in both hemoglobin CC and AA red cells. PMID- 3826360 TI - Portal copper transport in rats by albumin. AB - The distribution of newly absorbed copper among serum proteins obtained from the portal circulation of rats was examined by conventional and high-performance gel filtration chromatography, affinity chromatography, and Western blotting. Within 10-30 min after being administered by gavage or directly into the intestine, 67Cu and 64Cu, respectively, were recovered in the albumin fraction. By 8 h after administration of the radionuclides, virtually all of the radioactivity was found with ceruloplasmin. Affigel blue fractionation and subsequent Superose-6 chromatography further demonstrated that all of the copper in the albumin containing fractions was in fact bound to this protein rather than high molecular weight moieties. Vascular perfusion of the isolated rat intestine, where 64Cu was infused into the lumen, showed that newly absorbed 64Cu in the vascular perfusate collected from the cannulated portal vein was associated with albumin. Uptake of radioactivity by isolated rat liver parenchymal cells from medium containing rat serum with 67Cu bound to albumin was demonstrated. In vitro binding of 64Cu to serum proteins that were transferred to nitrocellulose by Western blotting techniques showed that albumin is essentially the only protein that binds appreciable amounts of copper. The data suggest that albumin is the plasma protein that is responsible for the initial transport of copper after absorption. PMID- 3826361 TI - Relationship between plasma and platelet epinephrine concentrations in humans. AB - Nine healthy humans received sequential 80-min infusions of saline and epinephrine (EPI) at 0.55 and 2.75 micrograms X min-1 X m-2 to determine whether increases in arterialized venous plasma EPI within the physiological range affect platelet EPI levels. The platelet EPI concentration was significantly higher than basal levels only during the 2.75 micrograms X min-1 X m-2 EPI infusion (P less than 0.02). To assess the role of platelets in EPI clearance from plasma, four human subjects underwent a 2.75 micrograms X min-1 X m-2 EPI infusion during beta adrenergic blockade with propranolol. Propranolol decreased plasma EPI clearance (P less than 0.01) and increased both the plasma and platelet EPI concentrations (P less than 0.01) during the EPI infusion. To determine the changes in plasma and platelet EPI during and after EPI infusion, seven subjects received an 80-min EPI infusion at 2.75 micrograms X min-1 X m-2. After discontinuation of the EPI infusion, plasma EPI levels returned to base line within 30 min, whereas platelet EPI levels were significantly elevated above base line for 120 min (P less than 0.02 vs. base line). Platelets concentrate EPI during increases in plasma EPI, which are similar to the plasma levels seen in physiological and pathophysiological states in humans. The accumulation of catecholamines by platelets may be an additional mechanism in the regulation of plasma catecholamine levels in humans. PMID- 3826362 TI - A model-free approach to estimation of relative potency in dose-response curve analysis. AB - We have developed a new, general approach to analysis of dose-response curves from bioassay, immunoassay (including radioimmunoassay, immunoradiouretic assay, enzyme-linked immunosorbent assay), and other experimental procedures. It provides a test for parallelism, similarity of shape, and a measure of relative potency for any set of two or more curves. The method uses a constrained smoothing spline function to estimate the curve shape, together with a nonlinear least-squares fitting technique to estimate parameters for relative potency and slope. The use of "constrained splines" permits the analysis of nonlinear dose response curves that cannot be described by a simple model or equation such as the symmetric four-parameter logistic. A microcomputer program is used for the analysis, providing relative potencies and their SE and evaluation of goodness of fit. PMID- 3826363 TI - Effect of fetal growth on maternal protein metabolism in postabsorptive rat. AB - Rates of protein synthesis were measured in whole fetuses and maternal tissues at 17 and 20 days of gestation in postabsorptive rats using continuous infusion of L [1-14C]leucine. Fetal protein degradation rates were derived from the fractional rates of synthesis and growth. Whole-body (plasma) leucine kinetics in the mother showed a significant reduction of the fraction of plasma leucine oxidized in the mothers bearing older fetuses, a slight increase in the plasma flux, with total leucine oxidation and incorporation into protein remaining similar at the two gestational ages. Estimates of fractional protein synthesis in maternal tissues revealed an increase in placental and hepatic rates at 20 days of gestation, whereas the fractional synthetic rate in muscle remained unchanged. A model for estimation of the redistribution of leucine between plasma and tissues is described in detail. This model revealed a more efficient utilization of leucine in fetal protein synthesis in comparison with other maternal tissues, a greater dependency of the fetus on plasma supply of leucine, and a significant increase (2-fold) in the release of leucine from maternal muscle as the fetal requirements increased proportionately with its size. The latter conclusion, supported by nitrogen analysis and the ratio of bound-to-free leucine in maternal tissues, confirms the importance of maternal stores in maintaining the homeostasis of essential amino acids during late pregnancy. PMID- 3826364 TI - Regression of brown adipose tissue mitochondrial function and structure in neonatal goats. AB - Rapidly regressing perirenal brown adipose tissue (BAT) of neonatal goats was studied to correlate changes in mitochondrial metabolism and thermogenic capacity with changes in mitochondrial structure. The alpha-glycerophosphate shuttle activity of perirenal BAT mitochondria declined 60% from birth to 6 days of age. Oxygen consumption and thermogenic capacity measured by ion conductance peaked at birth and declined to low levels at 6 days. Sample electron micrographs of perirenal BAT showed intact electron-dense mitochondria with many cristae and little matrix area at 2 days. However, by 6 days the mitochondria were very relaxed with large matrix area, few cristae, and observable degradation. These results indicate that the morphological changes exhibited by rapidly regressing goat's perirenal BAT in the 1st wk postpartum are accompanied by dramatic alterations in BAT mitochondrial function. PMID- 3826365 TI - Alanine uptake by liver at midpregnancy in rats. AB - The participation of the liver to the increase in alanine utilization seen at midpregnancy was studied in 9- and 12-day pregnant rats. Liver fractional extraction of alanine was assessed in vivo from the changes in concentration in afferent and efferent vessels. Hepatic active transport of alanine was determined in vitro using isolated plasma-membrane vesicles. Compared with nonpregnant controls, alanine fractional extraction was significantly increased on day 12 but not on day 9 of pregnancy. Vesicles isolated from 9- and 12-day pregnant animals had a greater capacity for Na+-dependent transport than those from controls. Eadie-Hofstee plotting showed that this increase was due to an increase in Vmax with no change in Km. Both A and ASC systems contributed to the Vmax increase. These results indicate that, although by day 9 the liver has developed an increased capacity for alanine uptake, the actual extraction is seen only by day 12 of pregnancy. At this stage the liver participates actively in the turnover of alanine and the development of hypoalaninemia. PMID- 3826366 TI - Nuclear triiodothyronine receptor binding characteristics and occupancy in obese (ob/ob) mice. AB - Obese (ob/ob) mice exhibit reduced adaptive thermogenesis associated with an impairment of thyroid hormone action. The mechanism underlying the latter defect was investigated by comparing the binding characteristics and occupancy of solubilized nuclear 3,5,3'-triiodothyronine (T3) receptors from livers of lean and obese mice. Scatchard analysis showed minimal differences in Bmax and Kd between phenotypes at both 4 and 8-10 wk of age, indicating that reduced hepatic thyroid hormone expression in obese mice is not caused by alterations in nuclear receptor concentration or affinity. In contrast, nuclear T3 receptor occupancy (endogenous T3 associated with the specific receptor divided by Bmax) was 14 and 23% lower in 4- and 8- to 10-wk-old obese mice, respectively. Together with reported changes in hepatic thyroid hormone-sensitive enzymes, these data are consistent with a diminished nuclear T3 signal initiating thyroid hormone action in obese mice. Decreased nuclear T3 receptor occupancy may be secondary to a low transport of plasma T3 to the nuclear pool. In conclusion, impaired hepatic thyroid hormone action in obese mice is mediated in part at least by a reduction in nuclear T3 receptor occupancy. PMID- 3826368 TI - Lactate production cannot be measured with tracer techniques. PMID- 3826367 TI - Validation of a new method for determination of free fatty acid turnover. AB - The accuracy of tracer methods for estimating free fatty acid (FFA) rate of appearance (Ra), either under steady-state conditions or under non-steady-state conditions, has not been previously investigated. In the present study, endogenous lipolysis (traced with 14C palmitate) was suppressed in six mongrel dogs with a high-carbohydrate meal 10 h before the experiment, together with infusions of glucose, propranolol, and nicotinic acid during the experimental period. Both steady-state and non-steady-state equations were used to determine oleate Ra ([3H]oleate) before, during, and after a stepwise infusion of an oleic acid emulsion. Palmitate Ra did not change during the experiment. Steady-state equations gave the best estimates of oleate inflow approximately 93% of the known oleate infusion rate overall, while errors in tracer estimates of inflow were obtained when non-steady-state equations were used. The metabolic clearance rate of oleate was inversely related to plasma concentration (P less than 0.01). In conclusion, accurate estimates of FFA inflow were obtained when steady-state equations were used, even under conditions of abrupt and recent changes in Ra. Non-steady-state equations, in contrast, may provide erroneous estimates of inflow. The decrease in metabolic clearance rate during exogenous infusion of oleate suggests that FFA transport may follow second-order kinetics. PMID- 3826369 TI - Small intestinal motility in fasted and postprandial states: effect of transient vagosympathetic blockade. AB - We investigated vagal control of the migrating myoelectric complex (MMC) and postprandial pattern of the canine small intestine. Gastric and small intestinal motility were monitored in six conscious dogs. The vagosympathetic nerves, previously isolated in bilateral skin loops, were blocked by cooling. To feed, a meat-based liquid food was infused by tube into the gastric fundus. MMC phases I, II, III, and IV were observed in the fasted state. On feeding, the fed pattern appeared quickly in the proximal small bowel but was delayed distally. Vagal blockade abolished all gastric contractions and spiking activity as well as the small bowel fed pattern. During vagal blockade, the small bowel exhibited MMC like migrating bursts of spikes in both the fasted and fed states. The migration and cycling of these bursts were not significantly different from the MMC, but the duodenal and jejunal phase II was absent or shortened. On termination of vagal blockade, normal fasting or fed activity reappeared but with a delay in the fed pattern distally. We conclude: the ileum is the least sensitive to vagal blockade; the fasting vagal influence is exerted primarily on phases I and II of the duodenal and jejunal MMC; the fed pattern throughout the entire small bowel is normally dependent upon vagal integrity; the phase III-like bursts of activity seen during vagal blockade likely represents the intrinsic small bowel MMC, which is vagally independent. PMID- 3826370 TI - Distribution and monomer activity of cholesterol in micellar bile salt: effect of cholesterol level. AB - Despite the fact that uptake of cholesterol by the enterocyte occurs as a monomer from the intermicellar aqueous phase in equilibrium with micelle, the cholesterol monomer concentration in the aqueous phase and the partition coefficient between intermicellar aqueous phase and micellar aggregate have not been clarified. The present study deals with the distribution of cholesterol and monomer activity in constant bile salt-fatty acid micellar solutions with different cholesterol concentrations. In addition, uptake of cholesterol from these micellar solutions into rat jejunum was studied using everted sacs. Cholesterol monomer concentration in the aqueous phase increased linearly with the concentration of cholesterol in the micellar solution. Partition coefficient of cholesterol between the aqueous phase surrounding micelle and micellar aggregate was essentially constant at any cholesterol level (K = 3 X 10(-2)). Cholesterol monomer activities were linearly proportional to the cholesterol concentrations in the micellar solutions and correlated well with the rate of cholesterol uptake. It is concluded from these experiments that a partitioning phenomenon determines cholesterol monomer concentrations in the intermicellar aqueous phase from which the cholesterol is absorbed. After disappearance of the cholesterol monomers from the aqueous phase, these monomers are replaced by a shift of monomers from the intramicelle to intermicellar aqueous phase, under constant partition coefficient between extra- and intramicelle. The bile salt micelle provides a huge reservoir for partitioning of cholesterol monomers. PMID- 3826371 TI - Kinetic evidence for separate systems in transport of D- and L-methionine by rat small intestine. AB - The kinetics of D- and L-methionine uptake by rings of everted intestine in vitro are consistent with a saturable Michaelis-Menten component (Km = 11.7 and 1.7 mM; Vmax = 0.53 and 0.74 mumol X g-1 X min-1 for D- and L-methionine, respectively) plus a linear, diffusional one. All the data could be fit with a diffusion constant (Kd = 3.2 microliters X g-1 X min-1), which was essentially the same, independent of whether it was estimated by iteration or by using the extracellular marker, inulin. Similar results were obtained from in vivo perfusion experiments, except that the diffusional term was negligible. D Methionine was found to inhibit L-methionine uptake by intestinal rings according to fully noncompetitive kinetics (Ki = 45 mM). Another set of experiments with jejunal brush-border membrane vesicles showed that D-methionine uptake is dependent on a Na+ gradient and is significantly inhibited by L-methionine and L proline, but not by beta-alanine and alpha-methylaminoisobutyric acid. Our results indicate that, in rat jejunum, D-methionine is taken up through a Na+ dependent pathway distinct from the neutral amino acid (L-methionine) carrier and from the imino acid (L-proline, alpha-methylaminoisobutyric acid, beta-alanine) carrier. PMID- 3826372 TI - Quantitative assessment of luminal stirring in the perfused small intestine of the rat. AB - We measured the resistance (RL) to CO absorption that resulted from poor luminal stirring in the constantly perfused rat jejunum. RL or calculated unstirred layer thickness was greater for 30-cm than 10-cm long segments, indicating lack of a uniform thickness of unstirred layer. The possibility that laminar flow existed in the gut was first tested by calculating expected CO absorptions from fluid moving with laminar flow. These values agreed closely with observed absorption rates. Laminar flow also was supported by the observation that CO absorption was independent of perfusate viscosity. Lastly, after sudden addition of phenolsulfonphthalein (PSP) to the perfusate, PSP outflow concentration was similar in tygon tubing (which has laminar flow) and a gut segment of comparable dimension. We conclude that flow in the perfused gut is laminar and that this laminar flow has many implications for studies carried out with the constant perfusion technique. PMID- 3826373 TI - Effect of morphine on electrophysiological properties of circular and longitudinal muscles. AB - We have measured the effects of morphine on the intracellular electrophysiological properties of smooth muscle cells from the circular and longitudinal muscle layers of the canine jejunum. Morphine hyperpolarized the circular muscle membrane by approximately 12 mV and increased the electrical control activity (ECA) amplitude and dV/dt. Morphine had no significant effect on the electrical properties of the longitudinal muscle cells. The morphine-induced hyperpolarization of the circular muscle membrane was blocked by tetrodotoxin (TTX) and naloxone, but not by atropine and hexamethonium, propranolol, or phentolamine. Morphine significantly increased the slope of the resting membrane potential vs. the log of the potassium concentration in bathing medium from 38 to 50 mV/decade. The sodium permeability to potassium permeability ratio, calculated from the Goldman constant field equation, was reduced by morphine from 0.13 to 0.07 at mM of K+. The above results suggest that when measured by intracellular techniques, morphine hyperpolarizes the circular muscle membrane by release of a nonadrenergic, noncholinergic neurotransmitter. The mechanism of this hyperpolarization is consistent with an increase in potassium conductance. PMID- 3826374 TI - Bile acid inhibition of taurocholate uptake by rat hepatocytes: role of OH groups. AB - To define further the structural specificity of the taurocholate uptake site, we studied the ability of a variety of taurine-conjugated bile acids with differing hydroxyl substituents on the sterol moiety to inhibit [14C]taurocholate uptake. Rat hepatocytes isolated by collagenase perfusion were incubated in a tris(hydroxymethyl)aminomethane-phosphate buffer containing [14C]taurocholate (2.5-100 microM) in the presence or absence of inhibitor bile acid. Stronger inhibitors were studied at a fixed concentration of 5 microM, weaker ones at 25 microM. Initial uptake velocity was measured by sedimenting an aliquot of cells through silicone oil into 3 N KOH every 15 s for 1 min. Uptake velocity (nmol X mg protein-1 X min-1) could then be related to taurocholate concentration and a Vmax and Km could be determined by applying a nonlinear least squares fit to the data obtained with or without inhibitor. The kinetic parameters allowed the determination of the type of inhibition and of inhibition constants (Ki) of the various test bile acids. The data indicate that bile acids containing a 6- or 7 OH group exhibit competitive inhibition, whereas bile acids with no 6- or 7-OH group exhibit noncompetitive inhibition. Of the compounds exhibiting competitive inhibition, Ki varied with the number of hydroxyl groups on the sterol moiety. We conclude that the presence or absence of a 6- or 7-OH group dictates the mechanism of inhibition; the number of hydroxyl substituents determines the potency of competitive inhibition. PMID- 3826375 TI - Sensitivities of human jejunum, ileum, proximal colon, and gallbladder to cholecystokinin octapeptide. AB - We compared in humans simultaneous motor responses of the jejunum, ileum, proximal colon, and gallbladder (GB) to intravenous cholecystokinin octapeptide (CCK-OP). To gauge the physiological relevance of the doses of CCK-OP, intestinal motility and GB contraction were also quantified after a fatty meal. Eight healthy volunteers participated in both experiments. Six graded, 30-min intravenous infusions had a mean range of 2.2 to 73.2 pmol X kg-1 X h-1 of CCK OP; these spanned from subphysiological (negligible contraction of GB) to pharmacological (producing intestinal symptoms and a 70-99% contraction of GB) levels. CCK-OP inhibited interdigestive cycles of motility, though in some persons fasting patterns persisted with doses of CCK-OP, which produced up to 50% reduction in GB volume. Motility indices of the ileum and proximal colon responded to CCK-OP by decreasing initially but then increasing with larger doses; motility of the jejunum increased gradually at all doses. Judged by the gallbladder's response to food (reduction in volume down from 74 to 29% of original volume), the physiological range of infused CCK-OP was approximately 5 16 pmol X kg-1 X h-1. Within this range of doses of CCK-OP, motility of the jejunum increased, whereas motility of the proximal colon was reduced. These data are consistent with CCK being a "physiological" mediator of intestinal motility in humans; responses of the intestine to the peptide appear to vary regionally. PMID- 3826376 TI - Effects of ion substitution on transport and choleretic effect of ouabain. AB - The role of inorganic ions in hepatic transport and choleretic effect of ouabain was studied in isolated perfused rat liver to verify whether Na+-coupled ouabain uptake into hepatocytes is responsible for the choleretic effect. Hepatic uptake and clearance of ouabain were not significantly affected when perfusate Na+ was replaced by Li+ or choline+, chloride by nitrate or isethionate, or bicarbonate by tricine. However, these ion substitutions, with the exception of Li+, significantly reduced ouabain-induced choleresis and biliary electrolyte excretion. When ouabain was infused at different rates followed by perfusion without ouabain, changes in bile flow paralleled biliary excretion of ouabain rather than hepatic uptake. These results indicate that hepatic uptake of ouabain is not Na+ dependent and that the osmotic effect of biliary excreted ouabain is responsible for its choleretic effect. A part of the choleretic effect (30%) must also involve other mechanisms, since a permeable anion-like nitrate failed to substitute for perfusate chloride. Results of infusion studies also showed that ouabain was concentrated in liver (liver/perfusate = 30) and in bile (bile/liver = 15), indicating that ouabain is transported against its concentration gradient across both sinusoidal and canalicular membranes. PMID- 3826377 TI - Partial characterization of a nonmicellar system of cholesterol solubilization in bile. AB - We have shown that there were two distinctly separate cholesterol-containing fractions in human hepatic and gallbladder bile. In addition to mixed micelles that were composed of bile salts, cholesterol, and phospholipids and measured at approximately 25 A by quasi-elastic light scattering spectroscopy, there was a nonmicellar fraction made up of cholesterol and phospholipids with no, or only trace amount of bile salts. This fraction had a mean hydrodynamic radius of 600 A. When studied with electron microscopy, the fraction consisted of particle spherical in shape that measured 900-1,300 A in diameter and were monodisperse. This form of cholesterol had a low buoyant density of less than 1.05 g/ml by density gradient ultracentrifugation and eluted as a macromolecular aggregate (mol wt greater than 200,000) employing Sephadex G-75 chromatography. The quantity of nonmicellar cholesterol in bile correlated positively with the cholesterol saturation index (r = 0.649; P less than 0.001) and inversely with relative bile salt concentration (r = -0.572, P less than or equal to 0.03) and total lipid concentration (r = -0.844, P less than 0.0001). In vitro and in vivo addition of bile salts resulted in a shift of nonmicellar cholesterol to micellar cholesterol. In hepatic bile, nonmicellar cholesterol was the predominant and sometimes the exclusive form of cholesterol transport. When nucleation experiments were performed on gallbladder bile samples, the cholesterol that had nucleated were almost exclusively derived from the nonmicellar fraction. PMID- 3826378 TI - Intraluminal calcium modulates lipid dynamics of rat intestinal brush-border membranes. AB - The present investigations were performed to evaluate whether calcium modulates the physical state and lipid composition of rat enterocyte plasma membranes in vivo. Ca2+ [CaCl2 (50 mM) in NaCl] or NaCl (vehicle control) was administered to rats by intraluminal (gavage) or intraperitoneal routes. Sixty minutes later, brush-border (BBM) and basolateral membranes (BLM) were prepared from the proximal small intestine. By use of the fluorophores, DL-2-(9-anthroyl)-stearic acid (2-AS), DL-12-(9-anthroyl)-stearic acid (12-AS), and 1,6-diphenyl-1,3,5 hexatriene (DPH), steady-state fluorescence polarization studies demonstrated that intraluminal calcium decreased the fluidity of BBM but not BLM compared with their respective vehicle controls. These alterations in fluidity could, at least in part, be attributed to the concomitant increase in sphingomyelin content and the sphingomyelin/lecithin ratio (mol/mol) observed in the BBM prepared from calcium-gavaged rats. To evaluate the mechanism for these lipid alterations, enzyme activities involved in sphingomyelin synthesis and degradation were measured and revealed an increase in sphingomyelin synthase and a decrease in sphingomyelinase in BBM prepared from calcium-gavaged rats. In contrast, intraperitoneal administration of calcium failed to influence membrane fluidity, lipid composition, or these enzymatic activities in either BBM or BLM. PMID- 3826379 TI - Does aspirin damage canine gastric mucosa by reducing its surface hydrophobicity? AB - Intraluminally administered aspirin disrupts the gastric mucosal barrier in a pH dependent manner and may do so by compromising the hydrophobic or nonwettable lining to the stomach. We examined the pH dependence and time-course of aspirin's effects on barrier integrity by measuring the aspirin-induced changes in surface wettability, potential difference (PD), and electrical resistance (R) of canine gastric mucosa mounted in Ussing chambers. Luminal surface hydrophobicity, as determined by contact angle (CA) measurements, and PD were reduced by acidic aspirin solutions but were not reduced by acidic solutions without aspirin (pH 2.6) or by aspirin solutions that were neutral or only mildly acidic (pH greater than 4.0). Significant reductions in CA were correlated well with the proportion of aspirin in its lipid-soluble undissociated form (r = 0.93, P less than 0.001). Acidified-aspirin solutions significantly reduced CA and PD after a 2.5-min incubation period. Significant reductions in R occurred 25 min after exposure to acidified aspirin. Morphological damage to the gastric epithelium was not apparent after a 5-min exposure to acidified aspirin but was conspicuous 30 min after aspirin treatment. Aspirin-induced reductions in CA were highly associated with decreases in mucosal PD in both the pH and time-dependent studies (r = 0.93 and r = 0.99, respectively, P less than 0.001). These data support the hypothesis that the undissociated form of aspirin compromises the protective nonwettable lining of the stomach and in doing so, disrupts the gastric mucosal barrier. PMID- 3826380 TI - Simultaneous measurements of 22Na and 36Cl in aqueous samples: a comparison of three different methods. AB - We have critically analyzed three methods that measure the combined presence of 36Cl and 22Na in aqueous samples. These were a sequential method, a dual-label spectral analysis method (Beckman 1983), and a AgNO3 precipitation method (Thompson 1983). The former requires the use of both a gamma counter and a beta liquid scintillation counter, whereas the latter two require access to a beta counter only. Our analysis suggests that investigators who have access to both a liquid scintillation counter and a gamma spectrometer would find the sequential method relatively simple to use and reasonably reliable. Those with access to only a liquid scintillation counter would be best advised to use the AgNO3 method described by Thompson. PMID- 3826381 TI - Multiple mediators of type I hypersensitivity reactions in epithelia. PMID- 3826382 TI - Lithium clearance in mineralocorticoid escape in humans. AB - Lithium clearance (CLi) has been advanced as an indicator of Na delivery from the proximal tubules. We studied CLi in eight healthy males before and after mineralocorticoid escape, a maneuver that may induce suppression of fractional proximal Na reabsorption (FPRNa). FPRNa was also estimated from changes in maximal free water clearance (CH2O). According to the latter method, FPRNa dropped from 85.7 +/- 2.2 to 81.3 +/- 3.4%, whereas inulin clearance rose from 125 +/- 11 to 149 +/- 15 ml/min. The changes in CLi were surprisingly large, from 40.6 +/- 7.6 to 75.8 +/- 18.4 ml/min. If lithium is a valid marker of Na handling in the proximal tubule in humans, this change would imply a fall in FPRNa from 67.5 +/- 3.9 to 49.7 +/- 9.0%, suggesting a much larger shift in tubular Na reabsorption in escape than hitherto suspected. In addition, it would suggest that the inevitable back diffusion of a part of the solute-free water in the distal nephron, and thus overestimation of FPRNa by the CH2O method, increases importantly during escape. Alternately, lithium may not be a good marker of proximal tubular Na handling. For instance, both lithium reabsorption and escape may take place beyond the proximal tubule, or lithium may be excreted in the distal nephron in certain conditions. Present methods do not permit further analysis of these options in the human model. PMID- 3826383 TI - K transport in upper portion of descending limbs of long-loop nephron from hamster. AB - By use of the in vitro microperfusion technique, we investigated potassium transport in the upper portion of the descending limb of the long-loop nephron isolated from hamster kidney. The net potassium flux determined by ultramicro flame photometry was -0.63 +/- 1.84 pmol X mm-1 X min-1, a value that was not significantly different from zero. The salt permeability for KCl was calculated from the amount of potassium entering the tubular lumen when the concentration of potassium in the bath was increased by approximately 5 mM. The value was 38.9 +/- 1.9 X 10(-5) cm X s-1. The bidirectional fluxes of 86Rb were measured as indices of potassium fluxes. Flux coefficients from lumen-to-bath and bath-to-lumen were 51.2 +/- 9.2 and 48.8 +/- 13.5 X 10(-5) cm X s-1, respectively. These values were not significantly different, confirming that there was no net flux for 86Rb. In another series of five experiments, the lumen-to-bath 86Rb flux coefficients were 69.4 +/- 13.2 X 10(-5) cm X s-1 in the absence of unlabeled Rb, and 70.2 +/- 13.9 X 10(-5) cm X s-1 in the presence of 5 mM unlabeled Rb. The lumen-to-bath 42K flux coefficient measured in the same series of animals was 85.3 +/- 10.5 X 10( 5) cm X s-1 (n = 10), a value that is slightly higher than, but not significantly different from, that of 86Rb. These data show that active potassium transport may exist in this segment and that the passive permeability for potassium is very high.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826384 TI - Profiles of water and solute transport along long-loop descending limb: analysis by mathematical model. AB - We simulated profiles of water and solute transport along the descending limb of the long-loop nephron by a mathematical model based on mass balance equations for water, sodium, potassium, and urea, using phenomenological coefficients reported for hamsters. We assumed that interstitial concentration of sodium, potassium, and urea increased linearly along the descending limb from 150 to 350, from 5 to 50, and from 5 to 300 mM, respectively. Under this condition an increase in osmolality at the end-descending limb was mainly accounted for by the absorption of water. Considerable amounts of potassium and urea were secreted along the descending limb. Sodium was reabsorbed rather than secreted along the descending limb by both diffusion and solvent drag. The secreted amounts of urea and potassium were comparable to those observed by micropuncture studies. The sodium concentration in the lumen was higher than in the interstitium, with the transmural sodium gradient being 15 meq/liter at the hairpin turn. The potassium mass flow rate at the end-descending limb increased by 2.4 times. Large variations in potassium concentration of the delivered fluid scarcely changed the potassium mass flow rate at the end-descending limb. The secretion of urea and potassium and the reabsorption of sodium were increased as a function of delivered flow rate. An increase in corticomedullary urea gradient decreased the net potassium secretion along the descending limb. When the transport parameters for rabbits were used, both reabsorption of sodium and addition of urea were decreased, but a similar amount of potassium was secreted. These analyses indicate that the mathematical model that takes the species difference and internephron heterogeneity into consideration is useful in illustrating the transport processes along the descending limb of Henle's loop under various physiological and pathophysiological conditions. PMID- 3826385 TI - Intracellular messenger for action of angiotensin II on fluid transport in rabbit proximal tubule. AB - These studies were designed to examine the cellular messenger that mediates the action of angiotensin II on fluid transport (Jv) in the rabbit proximal tubule. We measured the effects of angiotensin II on Jv, activation of adenylate cyclase, and the concentration of cytosolic free calcium (Cai) in the rabbit proximal tubule. In nine rabbit proximal convoluted tubules (PCT), angiotensin II, 10(-8) M and 10(-6) M, decreased Jv by 18 and 25%, P less than 0.05. In eleven rabbit proximal straight tubules (PST), 10(-8) and 10(-6) M angiotensin II decreased Jv by 20 and 23%, P less than 0.02. Angiotensin II did not affect lumen-to-bath phosphate fluxes in PCT or PST, and it did not activate adenylate cyclase in PST. In a preparation of proximal tubules (PCT and PST) loaded with aequorin, angiotensin II, 10(-8) and 10(-6) M, transiently increased Cai by 13 and 32%, P less than 0.001. We propose that Cai surges, activated by angiotensin II, are part of a cellular message that inhibits Jv in the rabbit proximal tubule. PMID- 3826386 TI - Corticosteroids decrease glomerular angiotensin receptors. AB - Angiotensin II (ANG II) receptors of glomerular mesangial cells are regulated in vivo by changes in Na balance, effects that are presumed to be secondary to changes in circulating ANG II. However, since changes in ANG II were accompanied by parallel changes in plasma aldosterone in all models tested, it is possible that aldosterone may have also participated in the modulation of glomerular ANG II receptors. To test this hypothesis, short-term aldosterone infusions within the physiological range were employed to favor actions that would be mediated through a high-affinity mineralocorticoid receptor. The glucocorticoid, dexamethasone, was also tested to determine the mineralocorticoid specificity of the response. Two infusion rates were associated with a decrease in glomerular ANG II receptor density of 33 and 45%, respectively. There were no changes in the affinity of ANG II in either tissue or in adrenal receptor density. Serum potassium and urinary Na/K ratio were lower in the aldosterone group. Spironolactone abolished the effect of aldosterone consistent with an action mediated through a specific mineralocorticoid receptor. Dexamethasone administration produced similar downregulation of glomerular ANG II receptor and was unaccompanied by a change in electrolyte balance or blood volume. These studies support the hypothesis that corticosteroids modulate glomerular ANG II receptors and validate the complexity of glomerular receptor modulation. The downregulation observed would be expected to diminish the ability of ANG II to influence glomerular hemodynamics in models such as mineralocorticoid and glucocorticoid-induced hypertension. PMID- 3826387 TI - Plasma glutamine and renal ammoniagenesis in dogs with chronic metabolic acidosis. AB - The purpose of this investigation was to determine whether the rate of glutamine metabolism in the kidneys of normal dogs and dogs with chronic metabolic acidosis was influenced by the plasma glutamine concentration. Because glutamine is a major renal energy fuel, results were examined at a constant rate of energy or ATP turnover [i.e., per 100 ml glomerular filtration rate (GFR)]. Glutamine extraction per 100 ml GFR was directly proportional to the filtered load of glutamine in normal and acidotic dogs. The slope depicting this relationship was parallel to the filtered load of glutamine; however, in normal dogs it was lower and in acidotic dogs it exceeded the filtered load by approximately 22 mumol/100 ml GFR. With respect to the fate of the nitrogens of the glutamine extracted, alanine and ammonium were produced in normal dogs at a rate nearly equivalent to that of glutamine extracted, whereas ammonium production was almost twofold greater than the rate of glutamine extraction during acidosis. There was a relatively small but constant alanine release over the entire range of plasma glutamine concentrations in these dogs. Furthermore, infusion of glutamine to raise the plasma glutamine concentration twofold during acidosis resulted in an increased rate of glutamine extraction and ammonium production equal to that predicted from the increase in filtered load of glutamine. Therefore, variations of circulating glutamine concentration within the physiological range seem to have an important influence on the steady-state rate of renal glutamine metabolism in normal dogs and in dogs with chronic metabolic acidosis. PMID- 3826388 TI - Resetting of renal blood flow autoregulation in spontaneously hypertensive rats. AB - Renal blood flow (RBF) autoregulation was examined in untreated 10- and 40-wk-old spontaneously hypertensive rats (SHR) [mean arterial pressure (MAP) 125 +/- 4 and 167 +/- 7 mmHg] and in captopril-treated (7 days) 10- and 40-wk-old SHR (88 +/- 7 and 112 +/- 5 mmHg). Age-matched Wistar-Kyoto rats (WKY) were used as controls (MAP 91 +/- 3 and 104 +/- 2 mmHg). The study was carried out in rats with and without acute uninephrectomy. In 10-wk-old acutely uninephrectomized animals, the lower pressure limit of autoregulation was 78 +/- 4 mmHg in WKY, 102 +/- 5 mmHg in SHR (P less than 0.02), and 78 +/- 7 mmHg in captopril-treated SHR (P greater than 0.10). The renal vascular resistance (RVR) was significantly elevated at the lower pressure limit of RBF autoregulation in untreated SHR (P less than 0.02) but became normal after treatment (P greater than 0.10). Neither uninephrectomy nor variation of RBF between different batches seemed to influence the lower pressure limit of RBF autoregulation. In 40-wk-old acutely nephrectomized animals, the lower pressure limit of RBF autoregulation in WKY was 85 +/- 4 mmHg, 128 +/- 3 mmHg in SHR (P less than 0.001), and 101 +/- 5 mmHg in captopril treated SHR (P less than 0.01). RVR at the lower pressure limit was increased in untreated SHR (P less than 0.01), but fell to normal values during captopril treatment. Neither the uninephrectomy nor variation of RBF between different batches of rats seemed to influence the lower pressure limit of RBF autoregulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826389 TI - Influence of salt on response to nitrendipine by Dahl rat kidney. AB - We examined the responses to the calcium channel blocker, nitrendipine, of isolated perfused kidneys from Dahl salt-sensitive (DS) and salt-resistant (DR) rats that had been stabilized on high- and low-NaCl diets. Blood pressures of high-salt DS rats exceeded those of the other three groups. After norepinephrine vasoconstriction sufficient to increase renal vascular resistance (RVR) by 50%, the superimposition of 10(-5) M nitrendipine increased the glomerular filtration rate (GFR) of high-salt DS rat kidneys by 125% over control values but returned the GFR of high-salt DR kidneys only to control. Nitrendipine superimposition increased the GFR of low-salt DS and DR rat kidneys by 124 and 40% over control values, respectively, and partially restored the RVR toward control. Nitrendipine alone, without norepinephrine, did not affect the GFR or RVR. The persistence within the DS kidney of an exaggerated glomerular circulatory "rebound" response to nitrendipine following the development of hypertension suggests the possibility of a maladaptation of DS kidney cell calcium regulation. The DR kidney manifests a similar response during salt restriction, but this disappears on a high-NaCl diet. PMID- 3826390 TI - Transepithelial ammonia concentration gradients in inner medulla of the rat. AB - Transport of NH3 from loops of Henle to medullary collecting ducts has been proposed to play an important role in renal ammonia excretion. To determine whether transepithelial ammonia concentration gradients capable of driving this transport are present in the inner medulla, micropuncture experiments were performed in control rats and in rats with chronic metabolic acidosis. In situ pH and total ammonia concentrations were measured to calculate NH3 concentrations ([NH3]) for base and tip collecting duct, loop of Henle, and vasa recta. In control and acidotic rats, [NH3] in the loop of Henle was significantly greater than [NH3] in the collecting ducts. [NH3] did not differ in loop of Henle and adjacent vasa recta in either group of rats, indicating that NH3 concentration gradients between loop and collecting duct represent NH3 gradients that are present between medullary interstitium and collecting duct. During acidosis, an increase in collecting duct ammonia secretion was associated with an increase in the NH3 concentration difference between loop of Henle and collecting duct but occurred in the absence of a fall in collecting duct pH. The NH3 concentration gradient favoring diffusion of NH3 into the collecting ducts increased during acidosis because [NH3] in the loop of Henle and medullary interstitium increased more than [NH3] in the collecting duct. These findings indicate that transport processes involved in medullary ammonia accumulation play an important role in regulating ammonia secretion into the inner medullary collecting duct in vivo and that a fall in inner medullary collecting duct pH is not necessarily required for ammonia secretion by this segment to increase during chronic metabolic acidosis. PMID- 3826391 TI - Cimetidine transport in rabbit renal cortical brush-border membrane vesicles. AB - Cimetidine is an organic cation and commonly prescribed drug that is eliminated primarily by proximal renal tubular secretion. The present studies evaluated cimetidine transport in rabbit renal cortical brush-border membrane vesicles (BBMV). [3H]Cimetidine uptake varied inversely with media osmolarity and was stimulated with uphill transport above equilibrium values (overshoot) produced by an initial proton gradient directed from the vesicle interior outwardly. Uphill transport occurred earlier and was of greater magnitude at 25 degrees C than at 5 degrees C. pH-stimulated [3H]cimetidine uptake was inhibited by excess nonradiolabeled cimetidine, quinidine, and procainamide but was affected little by probenecid. Tetraethylammonium inhibited cimetidine uptake in the presence and absence of an initial proton gradient, indicating that nonionic diffusion and simple diffusion cannot totally account for cimetidine transport in BBMV. The protonophore carbonyl cyanide trifluoromethoxyphenylhydrazone (FCCP) inhibited pH stimulated cimetidine uptake but had no effect on uptake occurring in the absence of an initial pH gradient. Preloading BBMV with an excess of procainamide enhanced cimetidine uptake. However, in the presence of FCCP, the combination of FCCP and valinomycin, or nigericin the effect of preloading with procainamide was diminished, suggesting that the apparent countertransport of cimetidine produced by procainamide was indirect and due to generation of a transvesicular proton gradient. These results are consistent with the hypothesis that cimetidine is transported across BBMV by organic cation-proton exchange. PMID- 3826392 TI - Contribution of AV3V region in anephric NaCl-induced hypertension in the rat. AB - The role of the anteroventral third ventricle (AV3V) region in mediating hypertonic sodium chloride-induced pressor responses was investigated in conscious rats. Sham- and AV3V-lesioned rats were prepared with femoral artery and vein catheters and subjected to bilateral nephrectomy under gaseous anesthesia. After recovery, animals were infused intravenously with isotonic (0.5 meq/kg) or hypertonic (10 meq/kg) saline at a rate of 0.0103 ml/min over 2 h. Isotonic saline infusion did not affect arterial pressure or heart rate in either group of rats. Hypertonic saline increased arterial pressure 35 +/- 3 mmHg in sham-lesioned rats and only 10 +/- 4 mmHg in AV3V-lesioned animals (P less than 0.0005). Sham-lesioned rats infused with hypertonic saline had a greater vasopressin-dependent component maintaining arterial pressure than the other groups of rats. Conversely, the sympathetic nervous system-dependent component of blood pressure was suppressed in the hypertonic saline-infused sham-lesioned animals compared with the other animals. However, when the vasopressin receptors were blocked, the neurally mediated portion of blood pressure was similar in all four groups of rats. These results emphasize that circulating vasopressin is important for the rise in arterial pressure accompanying the osmotic stimulus. Furthermore, this study demonstrates that the AV3V region is necessary for vasopressin-dependent pressor responses caused by an osmotic stimulus. PMID- 3826393 TI - Oscillations in the proximal intratubular pressure: a mathematical model. AB - This study presents a dynamic continuous time model of the regulation of the renal proximal intratubular pressure in the rat. The model integrates a functional model of the glomerulus, a tubular model, a feedback model, and an afferent arteriolar model. The model has one equilibrium solution for the dependent variables (equilibrium point) for each set of independent variables. An equilibrium point, chosen to be in accordance with experimental data from Sprague Dawley rats, was used as the initial value for the dependent variables. The model is shown to have parameter ranges in which sustained stable oscillations in proximal pressure are present. For sustained oscillations to appear, it is necessary for the system's operating point to be located on a sufficiently steep portion of the tubuloglomerular feedback curve. The model analyses are compared with various experimental recordings of the proximal intratubular pressure. The model simulations show both spontaneous and induced oscillations in the proximal pressure in close agreement with the experimental results; but the steady-state mean pressure regulation is found to be less efficient in the model than that apparent from the experimental recordings, suggesting the involvement of additional pressure-regulating mechanisms other than those included in the present model. It is concluded that the dynamic systems approach used in the present study yields new insight into the mechanisms underlying the proximal intratubular pressure oscillations and that it can be of further value for the study of the factors regulating the proximal intratubular pressure. PMID- 3826394 TI - Time course of systolic loading is an important determinant of ventricular relaxation. AB - We studied the dependency of left ventricular relaxation on the timing of an abrupt increase in systolic load. In 10 canine isolated heart-lung preparations, a load step of 15 mmHg was imposed at specific intervals throughout systole, and the time of loading was defined as the interval from the R wave to the completion of the load step (R-load interval). Preload was held constant. The right atrium was paced at a cycle length of 450 ms. The decay of left ventricular pressure during isovolumic relaxation was described by a single exponential time constant (Texp). Load effects on isovolumic relaxation were expressed as a percent change in Texp as compared with Texp of the beat preceding the load intervention. Loads imposed early in systole consistently prolonged Texp [mean delta Texp = +17.01 +/ 1.64% (SE) for R-load intervals less than or equal to 120 ms]. Load changes late in systole consistently abbreviated Texp [mean delta Texp = -9.49 +/- 0.86% (SE) for R-load intervals greater than or equal to 130 ms]. The transition from augmentation to diminution of Texp always occurred when the R-load interval was 120-130 ms. The mean time interval of electromechanical systole for the test beats was not significantly different (P greater than or equal to 0.05) from that of the control beats [R-load intervals less than or equal to 120: test = 247.0 +/ 27.8 (SD) ms; control = 246.6 +/- 26.8 (SD) ms] [R-load intervals greater than or equal to 130: test = 243.3 +/- 29.1 (SD) ms; control = 243.8 +/- 28.4 (SD) ms].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826395 TI - Control of cardiac function and venous return in thyrotoxic calves. AB - The mechanisms responsible for maintenance of the high-output state associated with thyrotoxicosis have been investigated by measurement of cardiac-function curves and venous compliance during ganglionic blockade with trimethaphan. Thirteen calves were injected daily with L-thyroxine (200 micrograms/kg) for 12 14 days. Thyroxine treatment increased heart rate (70%), left ventricular systolic pressure (22%), cardiac output (120%), left ventricular maximum rate of pressure development (dP/dt) (56%), and total blood volume (18%) and decreased systemic vascular resistance (39%). These hemodynamic changes persisted during ganglionic blockade or autonomic blockade with atropine and propranolol. Cardiac function curves in conscious thyrotoxic calves were displaced upward and to the left. Mean circulatory filling pressure (MCFP), measured during anesthesia, was increased from 8 +/- 1 to 12 +/- 1 mmHg. During autonomic and ganglionic blockade MCFP remained elevated after treatment with thyroxine. Venous compliance decreased from 2.1 +/- 0.2 to 1.3 +/- 0.1 ml X mmHg-1 X kg-1 after thyroxine. Unstressed vascular volume was increased from 52.3 +/- 1.1 to 67.1 +/- 0.9 ml/kg. Thus the elevated cardiac output and new cardiac-function curve in thyrotoxicosis are associated with a combination of increased inotropic state, increased blood volume, and decreased venous compliance. These effects are not the result of autonomic influences and may represent direct actions of thyroid hormone on the heart and peripheral venous circulation. PMID- 3826396 TI - Neural control of adrenal medullary and cortical blood flow during hemorrhage. AB - Hemorrhagic hypotension produces an increase in adrenal medullary blood flow and a decrease in adrenal cortical blood flow. To determine whether changes in adrenal blood flow during hemorrhage are neurally mediated, we compared blood flow responses following adrenal denervation (splanchnic nerve section) with changes in the contralateral, neurally intact adrenal. Blood pressure was reduced and maintained at 60 mmHg for 25 min by hemorrhage into a pressurized bottle system. Adrenal cortical blood flow decreased to 50% of control with hemorrhage in both the intact and denervated adrenal. Adrenal medullary blood flow increased to four times control levels at 15 and 25 min posthemorrhage in the intact adrenal, but was reduced to 50% of control at 3, 5, and 10 min posthemorrhage in the denervated adrenal. In a separate group of dogs, the greater splanchnic nerve on one side was electrically stimulated at 2, 5, or 15 Hz (n = 4 each group) for 40 min. Adrenal medullary blood flow increased 5- to 10-fold in the stimulated adrenal but was unchanged in the contralateral, nonstimulated adrenal. Adrenal cortical blood flow was not affected by nerve stimulation. We conclude that activity of the splanchnic nerve profoundly affects adrenal medullary vessels but not adrenal cortical vessels and mediates the observed increase in adrenal medullary blood flow during hemorrhagic hypotension. PMID- 3826397 TI - Temperature distribution cannot predict local cardiac metabolism. AB - The objective of this study was to investigate if local myocardial metabolism can be determined from the transmural temperature distribution. Heat produced metabolically in the myocardium is carried away by the coronary blood and by diffusion. Transport by coronary flow (convectional heat loss) was determined from the coronary blood flow and the transcoronary temperature difference. This measured value was compared with one predicted from measured oxygen consumption, assuming a slab of tissue for the left ventricular free wall with homogeneous flow distribution and homogeneous metabolism. Measured and predicted convectional heat loss could not be shown to differ. Endocardial and epicardial heat production were estimated in two ways: 1) from the transmural temperature distribution (AT) and 2) from local flow (radioactive microspheres) and oxygen consumption (AO2). Ideally the ratio AT/AO2 should be unity. For flows in the resting physiological state (up to 100 ml X min-1 X 100 g-1) this ratio was not statistically different from one for both endocardium and epicardium: 0.86 +/- 0.11 and 1.09 +/- 0.07 (SE), respectively. For larger flows the ratio reduced to 0.66 +/- 0.08 endocardially. It is concluded that overall left ventricular metabolism can be predicted from conventional heat loss and that for physiological, but not for increased flow, the transmural temperature distribution predicts local metabolism. PMID- 3826398 TI - Effects of left circumflex coronary flow transducer implantation on posterior wall innervation. AB - To determine whether dissection around a coronary artery and implantation of a flow transducer resulted in partial regional denervation of the heart, the effects of bilateral stimulation of the ansae subclaviae were evaluated on regional left ventricular (LV) wall thickening (WT) and tissue norepinephrine content in four groups of dogs following 1) sham operations (n = 6),2) implantation of a Doppler flow transducer on the left circumflex coronary artery (n = 6), 3) selective circumflex coronary artery denervation with topical phenol application (n = 5), and 4) selective denervation of the posterior LV wall by extensive surgical stripping of the left circumflex coronary artery and local application of phenol (n = 6). One week later after anesthesia (chloralose 100 mg/kg) and a second thoracotomy for implantation of ultrasonic WT crystals, stimulation of the ansae subclaviae increased posterior WT by 67 +/- 9% in the sham group, 71 +/- 14% in the flow probe group, and did not increase systolic WT in the denervated group. In the posterior LV wall, norepinephrine levels were reduced (P less than 0.01) in the denervated group (6 +/- 4 pg/mg) but not in the flow probe group (629 +/- 4 pg/mg) compared with the sham group (589 +/- 88 pg/mg). Selective left circumflex coronary artery denervation did not result in either diminished norepinephrine levels in the posterior LV wall nor diminished response of WT to sympathetic nerve stimulation. Thus chronic instrumentation applied properly to the left circumflex coronary artery does not result in significant regional denervation of the posterior myocardium. PMID- 3826399 TI - Quantification of O2 consumption and arterial pressure as independent determinants of coronary flow. AB - The steady-state relationship between coronary arterial blood flow (CBF) and both myocardial O2 consumption (MVO2) and coronary arterial pressure (P) was explored in anesthetized dogs and goats. Both species were subjected to constant pressure perfusion of the left main coronary artery by an external pressure-controlling circuit. In addition a group of goats was studied with normal aortic perfusion using an occluder around the left main coronary artery to vary coronary arterial pressure. The statistical analysis revealed that despite the direct effect of P on MVO2 (the Gregg effect) the effects of both variables on CBF were independent and linear over a wide range of P and MVO2 so that multiple regression analysis with a linear equation (CBF = a X P + b X MVO2 + c) gave an excellent fit which was not improved by the introduction of an addition interactive term b3MVO2 X P. The mean correlation coefficient for all animals was greater than 0.9. From these data we conclude that any factor regulating coronary arterial flow would be influenced by both MVO2 and perfusion pressure in an independent way. This study characterizes the stationary behavior of local coronary flow control. Hence, it specifies quantitatively the relations to be predicted by hypotheses aiming to explain this control mechanism. PMID- 3826400 TI - Effect of dietary fish oil on myocardial phospholipids and myocardial ischemic damage. AB - The effect of dietary fish oil on myocardial phospholipids and ischemic damage to the heart was studied in the rat. Four weeks of feeding 5% (i.e., 12 energy percent) menhaden oil (MO) produced both profound changes in the fatty acyl composition of phospholipids in myocardial membranes and a significant reduction in the loss of creatine kinase following coronary artery ligation compared with feeding 5% (i.e., 12 energy percent) corn oil (CO). The MO diet did not change the content of either phospholipids or cholesterol in the heart. However, dietary MO resulted in significant elevations in the percent of fatty acids in the total phospholipids that were saturated, the n-3/n-6 ratio and the double-bond index. The changes in total phospholipids were not uniform for all phospholipid classes. Although the n-3/n-6 ratio was increased in each of the individual phospholipids examined, the predominant n-3 fatty acid incorporated (i.e., 20:5, 22:5, 22:6) differed among the major phospholipid classes. Also, the percent saturation was elevated in phosphatidylcholine with no change in double-bond index, whereas both the percent saturation and double-bond index were elevated in phosphatidylethanolamine. Thus dietary MO resulted in selective alterations in individual myocardial phospholipids. These membrane changes may be involved in the observed reduction of ischemic damage in the heart. PMID- 3826401 TI - Evidence for a pathogenetic role of xanthine oxidase in the "stunned" myocardium. AB - Recent evidence suggests that postischemic myocardial dysfunction (or myocardial "stunning") may be mediated by oxygen free radicals, but the mechanism for their production remains unknown. To explore the role of xanthine oxidase as a potential source of free radicals, open-chest dogs undergoing a 15-min occlusion of the left anterior descending coronary artery (LAD) followed by 4 h of reperfusion (REP) received intravenously either allopurinol (50 mg/kg 48 h, 20 h, and 30 min before occlusion, 10 mg/kg 1 min before REP, and 6.25 mg X kg-1 X h-1 throughout REP, n = 13) or saline (n = 14). The two groups were similar with respect to occluded bed size (postmortem perfusion) and collateral flow (radioactive microspheres). In controls, the transcardiac difference in plasma uric acid (great cardiac vein - arterial concentration) increased 199 +/- 70% (means +/- SE) during ischemia (P less than 0.02) and remained elevated for 5 min after REP; no increase was observed in treated dogs. Regional myocardial function was assessed by measuring systolic wall thickening with an epicardial Doppler probe. The two groups exhibited comparable systolic thickening under base-line conditions and similar degrees of dyskinesis during ischemia. Following REP, however, recovery of contractile function (expressed as percent of preocclusion values) was considerably greater in allopurinol-treated as compared with control dogs: 57 +/- 14 vs. -22 +/- 16 (P less than 0.01) at 1 h, 70 +/- 13 vs. -15 +/- 15 (P less than 0.001) at 2 h, 65 +/- 14 vs. -28 +/- 13 (P less than 0.001) at 3 h, and 68 +/- 13 vs. -17 +/- 14 (P less than 0.001) at 4 h. These differences could not be ascribed to hemodynamic factors. The results suggest that xanthine oxidase is a source of the oxygen free radicals responsible for myocardial stunning following a brief episode of reversible regional ischemia. PMID- 3826402 TI - Atrioventricular nodal accommodation: rate- and time-dependent effects. AB - To characterize intrinsic rate- and time-dependent properties of the atrioventricular (AV) node, we examined whether AV interval (AVI) would be comparable at identical heart rates (HR) reached using different types of stimulation paradigms. We compared changes in AVI during five consecutive 30-s, 20 beat/min increases in HR from control with AVI changes induced by 30-s single step protocols to each of the same levels. In addition, HR was maintained at each level for 30, 60, 90, 120, and 150 s to control for the influences of time. Chloralose-anesthetized dogs (n = 16) were autonomically decentralized and instrumented to record electrocardiogram, blood pressure, and multiple intracardiac electrograms. Computer-generated HR steps were begun 20 beats/min above control, while continuously recording AVI. The beat-by-beat changes in AVI within each step were quantitated for all protocols. Differences between AVI during single- and multiple-step protocols were most pronounced during the first 15 s of atrial pacing. Accommodation in AVI (change in AV conduction time associated with an increased but constant heart rate) was evident during both protocols. The degree of accommodation during multiple-step protocols was modulated by the cumulative effects of earlier HR; however, a similar degree of accommodation occurred at higher HR irrespective of protocol used. Finally, the time to onset of loss of 1:1 AV conduction was significantly shorter when HR was increased using a multiple-step protocol. Thus the intrinsic response of the AV node to HR change is dependent on absolute level of HR, duration of rate change, and the potential cumulative effects of any earlier HR steps. PMID- 3826403 TI - Characterization of pulmonary arterial input impedance with lumped parameter models. AB - The purpose of this study is to evaluate systematically the ability of lumped parameter models to approximate pulmonary arterial input impedance (Zin) and estimate characteristic impedance (Zc) and pulmonary arterial compliance (Cart). To assess goodness of fit, the parameters of each model were adjusted so that the model's impedance approximates the Zin measured in anesthetized cats. To assess the ability of the model to estimate Zc and Cart, the lumped parameter models were fitted to Zin calculated from a distributed parameter model of the feline pulmonary vasculature. In addition, we assessed the concordance between the lumped parameter model estimates of Zc and Cart. The results indicate that no one model was superior; any of four models would be a reasonable choice. A four element model was used to compare Zin measured at different phases of the respiratory cycle. Small differences in the impedance spectra were found that have not been previously reported. We conclude that lumped parameter models can be used to provide close approximations to Zin, to estimate Zc and Cart, and to provide a useful approach for statistical comparisons of impedance spectra. PMID- 3826404 TI - Hemodynamic effects of vasopressin compared with angiotensin II in conscious rats. AB - The mechanisms whereby arginine vasopressin influences hemodynamic and autonomic function were investigated in conscious rats. In normal rats, 60-min intravenous infusions produced dose-related increases of arterial pressure and total peripheral resistance with marked decreases of both heart rate and cardiac output. Cholinergic blockade with methscopolamine attenuated the bradycardia at higher doses of vasopressin, whereby the fall of cardiac output was not affected. beta-Adrenergic blockade with atenolol attenuated the fall of heart rate seen with lower doses of vasopressin but did not prevent the fall of cardiac output. Ganglionic blockade with methscopolamine and hexamethonium resulted in nearly a 60-fold enhancement of vasopressin pressor sensitivity. This was related to a greater rise of peripheral resistance, since the fall of cardiac output was not altered compared with normal rats. Hemodynamic responses to angiotensin II were determined in other groups of conscious, normal rats and rats with ganglionic blockade. Peripheral resistance increased in the normal rats, whereas the related decreases in cardiac output and heart rate were only 30% of the responses seen with equipressor doses of vasopressin. Ganglionic blockade increased pressor activity only two- to eightfold compared with the 60-fold increase observed with vasopressin. We conclude that vasopressin is a more potent vasoconstrictor than angiotensin II, decreases cardiac output independent of neural mechanisms, and results in withdrawal of sympathetic vascular tone to buffer rises of arterial pressure. PMID- 3826405 TI - Source of intrinsic innervation of canine ventricles: a functional study. AB - Recently it has been suggested that the parasympathetic innervation of the ventricles is by way of postganglionic axones that emanate from ganglion cells in the atria, reaching the ventricles by traversing the atrioventricular (AV) groove. We designed a series of experiments to test this hypothesis. Phenol (89%) was applied to the AV groove and surrounding 5 mm of epicardium in 21 dogs on cardiopulmonary bypass. The effects of intracoronary acetylcholine (ACh; 1-5 micrograms) and intracoronary nicotine (NIC; 25-100 micrograms) on cardiac isovolumic pressures were evaluated after beta-blockade. In another series of experiments, eight dogs were exposed to phenol in the same way and allowed to recover for 7-10 days. Atrial and ventricular responses to NIC were unaffected by phenol application to the AV groove in the acute animals when compared with application of saline alone. However, in the chronic animals, pretreatment with phenol 7-10 days previously reduced the ventricular responses to NIC by 70% while leaving the atrial responses intact. These data indicate that the intrinsic cardiac nerves (ICN) of the canine ventricles consist primarily of postganglionic parasympathetic axones which arise from supraventricular ganglia and cross the AV groove. PMID- 3826406 TI - Excitability and oscillatory afterpotentials in isolated sheep cardiac Purkinje fibers. AB - Oscillatory afterpotentials, or late afterdepolarizations, are one mechanism postulated to cause cardiac arrhythmias and possibly conduction disturbances. We studied excitability by determining strength-interval curves in Purkinje fibers under normal conditions and during the presence of oscillatory afterpotentials induced by cardiac glycoside toxicity. During exposure to acetylstrophanthidin (0.10-0.15 mg/l), the mean resting potential depolarized 5.6 mV and oscillatory afterpotentials of 3-17 mV appeared. Current threshold for evoking action potentials was reduced below control level (e.g., increased excitability) throughout electrical diastole. Associated with oscillatory afterpotentials was a marked biphasic variation in current threshold giving strength-interval curves a characteristic biphasic shape. During the rising phase of the oscillatory afterpotentials, excitability reached a maximum, whereas the minimum increase in excitability occurred during the falling phase of oscillatory afterpotentials. This biphasic change in excitability remained correlated with the oscillatory afterpotentials at different cycle lengths. Results show that during acetylstrophanthidin toxicity excitability is increased throughout electrical diastole, and characteristic time-dependent changes in excitability occur during oscillatory afterpotentials. Time-dependent changes in excitability were detected with both intra- and extracellular stimulation techniques. PMID- 3826407 TI - Atrioventricular interactions: a theoretical simulation study. AB - A quantitative model that describes the complex atrioventricular interactions, based on the structure and myocardial properties of the left atrium (LA) and left ventricle (LV), is presented. The description of the LV follows our earlier study that assumes a nested-shell spheroidal structure with fanlike fiber angle distribution, transmural electrical activation velocity, and the muscle fiber dynamics with the classical passive and active features of the sarcomeres. The LV model is extended here to include an exponential load-dependent relaxation and viscous (strain rate-dependent) features of the LV passive myocardium. The proposed LA model is based on a thin-wall spherical geometry with a random fibrous structure. The atrial muscle features differ from the ventricular muscle by being much stiffer in the passive state and weaker but faster in the active state. The LV and LA compartments are connected to a preload and afterload scheme and interconnected by the mitral flow with its inertial properties. The complex interactions between the LA and the LV are thoroughly studied here, and the calculated results are consistent with well-established experimental data. PMID- 3826408 TI - Seasonal, sexual, and individual variation in endurance and activity metabolism in lizards. AB - Amphibolurus nuchalis were collected in central Australia during mid- (January) and late summer (March). Endurance time at 1 km/h on a motorized treadmill is greater in larger lizards, scaling as M0.65. Maximal O2 consumption (VO2max) scales as M0.96; standard metabolic rate (SMR) scales as M0.83. Factorial aerobic scope thus increases ontogenetically (9.4 at 1 g vs. 15 at 50 g). All organ masses scale allometrically; larger lizards have relatively smaller livers, but larger hearts and thigh muscles. Hematocrit and hemoglobin increase during early ontogeny, but are mass independent in adults. Maximal in vitro catalytic rates were determined for citrate synthase (CS) and pyruvate kinase (PK) in liver, heart, and thigh muscle and for lactate dehydrogenase (LDH) (lactate oxidation) in heart. All enzyme activities (expressed per g tissue) scale positively, except CS in heart. Females exhibit lower SMR and heart CS activity. March animals exhibit elevated endurance, VO2max, heart LDH, and thigh CS and PK activities. Individual variation in endurance correlates with individual differences in heart LDH and thigh CS and/or PK activities. Individual differences in VO2max are partly related to variation in hematocrit. PMID- 3826409 TI - Effects of endurance training and captivity on activity metabolism of lizards. AB - Two groups of Amphibolurus nuchalis, an Australian agamid lizard, were maintained in captivity for 8 wk. The "trained" group was given submaximal exercise at 1 km/h on a motorized treadmill, 30 min/day, 5 days/wk; the treadmill was inclined 10% for the last 5 wk. The "sedentary" group was not exercised. Endurance capacity did not change significantly in either group, but sprint speed decreased in trained lizards. The sedentary group exhibited significant decreases in maximal O2 consumption, standard metabolic rate, and heart mass, but an increase in liver mass. Trained lizards exhibited significant decreases in heart and thigh muscle masses, but significant increases in liver mass, hematocrit, liver pyruvate kinase, and heart citrate synthase activities. It is concluded that the adaptive response to endurance training, typical of mammals, does not generally occur in lizards. Moreover, levels of chronic activity that would elicit adaptive responses in mammals may be excessive for lizards and may induce pathological effects in joints and skeletal muscle. The ecological and evolutionary significance of these conclusions is discussed. PMID- 3826410 TI - Distribution of antithrombin III in rabbits: role of host and protein. AB - Unlike in the case of some other species, the plasma curve of iodine-labeled antithrombin III (I-AT-III) in rabbits requires fitting with a three-term exponential function for obtaining reliable estimates of the catabolic rate and distribution of I-AT-III among various body compartments (Carlson, Atencio, and Simon. J. Clin. Invest. 74: 191-199, 1984). To decide whether this phenomenon is referable to the host or the protein, the behavior of rabbit and human I-AT-III was comparatively analyzed in rabbits. Data obtained with rabbit I-AT-III confirmed the findings by Carlson and co-workers. Human I-AT-III assumed a distribution that closely paralleled that of homologous I-AT-III, thus suggesting that the pattern of distribution is determined by the host species rather than its AT-III. Rabbits metabolized human I-AT-III 1.61 times faster than homologous I-AT-III by an unknown mechanism not involving immune response; a facet that may prove useful for the identification of the sites of catabolism of AT-III. The exponent of the body weight was calculated for the relationship between species size and AT-III turnover. A value of 0.5 was obtained that is distinctly lower than the exponents found earlier for some other plasma proteins. PMID- 3826411 TI - Sweating responses and body temperatures during nocturnal sleep in humans. AB - The changes in the central control of sweating were investigated in five sleeping subjects under neutral and warm conditions [operative temperature (To) = 30, 33, and 34 degrees C; dew-point temperature = 10 degrees C]. Esophageal (Tes) and mean skin (Tsk) temperatures, chest sweat rate (msw,1), and concomitant electroencephalographic data were recorded. Throughout the night, msw,1 was measured under a local thermal clamp of 38 degrees C. Results showed that the thermal environment exerted a strong influence on both the levels and the time patterns of body temperatures. Moreover, local sweating rate correlated positively with Tes, and this relationship varied according to sleep stages. For a given Tes level, there was a sleep stage-related gradation in msw,1 that was higher in slow-wave sleep (SWS) than in stage 1-2 and the lowest in rapid-eye movement (REM) sleep. This is explained by a change in the excitability or the sensitivity of the thermoregulatory system. The msw,1 differences between stage 1 2 and SWS are accounted for by a decrease in the Tes threshold (Tset) for sweating while the slope of the msw,1-Tes relation remains unchanged. The lower msw,1 in REM sleep is explained by a lesser slope for the msw,1-Tes relation without any Tset change from stage 1-2. PMID- 3826412 TI - Prevention of genetic fa/fa obesity with an ephedrine-methylxanthines thermogenic mixture. AB - A thermogenic mixture containing ephedrine and methylxanthines was administered to 8-wk-old genetically obese fa/fa rats (O-E/Mx group) for a period of 15 wk. Their energy balance and the final body composition were compared with an untreated ad libitum-fed (O-AL) group, as well as to other fa/fa obese animals that were either pair fed to lean controls (O-PF group), or that were food restricted to such an extent they maintained a similar body weight to that of lean animals (O-WF group). Energy intake was elevated above lean or O-PF levels by approximately 27 and 10% in the O-AL and O-E/Mx groups, respectively, but lower by 18% in the O-WF group. Energy expenditure, compared with the lean values, was 10% higher in both the O-AL and O-E/Mx groups, but reduced by 13 and 30% in the O-PF and O-WF groups, respectively. The gain in body energy and the efficiency of energy deposition remained elevated above the lean values by 2.3- to 3.5-fold in the O-AL, O-PF, and O-WF groups but were reduced to lean levels in the O-E/Mx groups. These studies indicate that, unlike food restriction, the ephedrine-methylxanthine mixture prevents or arrests the development of the obesity in the fa/fa mutant by normalizing their energetic efficiency to that of the lean. PMID- 3826413 TI - Inhibition of renal nerve sympathetic activity by spinal stimulation in rat. AB - We determined the physiological and anatomical properties of systems mediating renal nerve inhibition elicited by electrical and chemical stimulation of the cervical dorsolateral funiculus of the anesthetized spinally transected rat. Stimulus-response characteristics suggested that this system was well suited for a role in tonic inhibition of sympathetic activity. Inhibition was elicited from a region of the cervical spinal cord extending from a lateral position near the accessory nerve to the dorsal columns. Inhibition could not be elicited by spinal stimulation before lesions had been placed rostral to stimulation sites in the lateral funiculi. Inhibition was blocked by similarly placed lesions caudal to stimulation sites. Therefore, this system may course in the lateral funiculus, and it may be tonically active in intact rats. Renal sympathetic activity could be inhibited by electrical stimulation caudal to large, chronic, spinal lesions. Therefore, some component of the inhibitory system was either antidromically activated or propriospinal. Glutamate applied to the dorsolateral surface of the cervical spinal cord elicited inhibition indistinguishable from that elicited by electrical stimulation, which suggested that neurons with somas located superficially at cervical levels may be responsible for some component of the spinally elicited inhibition. PMID- 3826414 TI - Dynamics of insulin resistance in denervated slow and fast muscles in vivo. AB - Sciatic nerve in one hindlimb of rats was sectioned, and animals were investigated 3, 6, 9, and 24 h and 3, 8, and 17 days after surgery. Cellular uptakes of 2-deoxy-D-glucose (DG) and alpha-aminoisobutyric acid (AIB) by soleus, plantaris, and gastrocnemius muscles of the denervated and contralateral sham hindlimb were compared in vivo. Effects of insulin on DG and AIB uptakes by soleus and plantaris muscles, but not gastrocnemius muscles, were reduced 20-58% as early as 3-6 h after denervation. Three to 17 days after denervation, soleus muscle did not respond to insulin stimulation of DG uptake, whereas plantaris and gastrocnemius muscles responded, but the insulin-induced increment in DG uptake was reduced 24-68% compared with the sham muscles. In contrast, none of the denervated muscles increased AIB uptake in response to insulin stimulation 3-17 days after surgery. The levels of creatine phosphate and ATP in calf muscles frozen in situ 3 days after denervation were increased 7 and 9%, respectively, and those of ADP, AMP, glucose-6-phosphate, and lactate were unchanged compared with sham muscles. It is concluded that muscle denervation results in a rapid development of insulin resistance, the effect of denervation depends on muscle fiber population, and insulin resistance of denervated muscles is not due to a cellular energy deficit. PMID- 3826415 TI - Effects of hypercapnia on variability of normal respiratory behavior in awake cats. AB - Resting quiet awake cats breathing air in a steady state have a range of respiratory behavior, and this encompasses nonpurring and purring (D. B. Jennings and P. C. Szlyk, Can. J. Physiol. Pharmacol. 63: 148-154, 1985). On a given study day, individual cats usually breathed in a limited part of their potential respiratory range. Respiratory pattern, such as average breath frequency (f) and average tidal volume (VT) utilized for a given level of ventilation (V), could be predicted when cats breathed air; as well, inspiratory (TI) and expiratory (TE) times were specific for a given breath f. Inhalation of 2% and 4% CO2 in air caused an average increase in ventilation of 16 and 100%, respectively but breath to-breath variability of V, f, and VT persisted at each fractional concentration of inspired CO2 (FICO2). The range of different V utilized breath to breath when breathing 2% CO2 overlapped with V during air control studies. Substantial overlap with control V also occurred in three of six cats when breathing 4% CO2. The most consistent effect of progressive hypercapnia was to increase VT and decrease f at a given level of V; increase in V during hypercapnia was accounted for by an increase in mean inspiratory flow (VT/TI). Hypercapnia also caused the fraction of breathing cycle devoted to inspiration (TI/TT) to increase at low f but not at high f. PMID- 3826416 TI - Prolonged alterations in plasma cortisol circadian rhythms following trauma in baboons. AB - Few studies have been performed concerning alterations in the circadian rhythmicity of adrenocortical function following trauma. The present study examined the effects of surgical trauma of varying severity on the secretory pattern of adrenocorticosteroids in the female baboon (Papio anubus). In 30 baboons, blood samples were obtained every hour for three 96-h periods: 1 wk prior to surgery; beginning 30 min following incision closure; and beginning 7 days following surgery. Animals were divided into three groups: anesthesia/surgical controls, low-trauma group [(LT), laparotomy plus 5-min bowel traction], or high-trauma group [(HT), laparotomy plus 20-min bowel traction]. A postoperative rise in plasma cortisol was observed that persisted up to 10 days postsurgery and could be significantly correlated with severity of trauma. The episodic nature of cortisol secretion was unaffected by surgery. The circadian rhythm of cortisol was phase shifted in the LT group and abolished up to 8 days postsurgery in the HT group. We conclude that the magnitude of posttrauma rise and circadian disruption of plasma cortisol is correlated with magnitude of surgical trauma. However, contrary to previous reports, elevated levels of cortisol may persist for an extended time (10 days) following the primary insult. PMID- 3826417 TI - Hypoxic moderation of systemic hypertension in the spontaneously hypertensive rat. AB - The mechanism by which chronic, moderate, hypobaric hypoxia attenuates systemic systolic blood pressure (SBP) in the spontaneously hypertensive rat (SHR) was investigated in a three-part study. In experiment 1, 10 wk of hypoxia (3,658 m altitude) commencing in 7-wk-old rats was partially effective in preventing the rise in SBP [hypoxic SHR (SHR-H) 154 mmHg vs. normoxic SHR (SHR-N) 180 mmHg; P less than 0.01]. When hypoxia was initiated in 5-wk-old SHR (experiments 2 and 3), protection against hypertension was nearly complete (experiment 2: SHR-H 122 mmHg vs. SHR-N 175 mmHg; P less than 0.001; experiment 3: 135 vs. 152 mmHg, respectively; P less than 0.05). Elevations in O2 consumption (VO2) and rectal temperature (Tre) in SHR vs. normotensive [Wistar-Kyoto (WKY)] rats provided evidence that the SHR is a hypermetabolic animal. Thyroid hormonal indices suggested that SHR changed from a low to high thyroid status at a time that rapid blood pressure elevation occurred; however, hypoxia did not influence thyroid status. Acute, significant decrements in VO2 and Tre in SHR-H (experiments 2 and 3) accompanied the attenuation of SBP by hypoxia, whereas large decrements in VO2 and SBP did not occur in hypoxic WKY. Timely administration of moderate hypoxia protects against the development of hypertension in the SHR. This protection may relate to a metabolic adaptation made by the hypoxic SHR. PMID- 3826418 TI - Attenuated sodium appetite in response to sodium deficiency in Fischer-344 rats. AB - Fischer-344 (F-344) rats avoid NaCl solutions which are preferred by other strains. The present studies examined Na appetite induced by two methods: maintenance on a Na-deficient diet, and Na depletion by injection of furosemide. In comparison with outbred Wistar rats, F-344 rats showed no evidence of Na appetite induced by Na-deficient diet after the first 15 min (study 1) and demonstrated attenuated Na appetite in response to the natriuretic effects of furosemide (study 2). Since Na loss by Wistar and F-344 rats was similar, it is likely that this reduced Na appetite was due to hedonic differences between the strains rather than to differential renal response to furosemide or Na-deficient diet. PMID- 3826419 TI - Intestinal glucose transport and salinity adaptation in a euryhaline teleost. AB - Glucose transport by upper and lower intestinal brush-border membrane vesicles of the African tilapia (Oreochromis mossambicus) was characterized in fish acclimated to either freshwater or full-strength seawater. D-[3H]-glucose uptake by vesicles was stimulated by a transmembrane Na gradient, was electrogenic, and was enhanced by counter-transport of either D-glucose or D-galactose. Glucose transport was greater in the upper intestine than in the lower intestine and in seawater animals rather than in fish acclimated to freshwater. Glucose influx (10 s uptake) involved both saturable and nonsaturable transport components. Seawater adaptation increased apparent glucose influx Kt, Jmax, apparent diffusional permeability (P), and the apparent Na affinity of the cotransport system in both intestinal segments, but the stoichiometry of Na-glucose transfer (1:1) was unaffected by differential saline conditions or gut region. It is suggested that increased sugar transport in seawater animals is due to the combination of enhanced Na-binding properties and an increase in number or transfer rate of the transport proteins. Freshwater animals compensate for reduced Na affinity of the coupled process by markedly increasing the protein affinity for glucose. PMID- 3826420 TI - Effect of neuropeptide Y on ingestive behaviors in the rat. AB - Neuropeptide Y (NPY) is a potent stimulator of food and water intake in rats. NPY still increases food intake even after a 2-h delay in access to food after central injection. When two injections of NPY are given 2 h apart, the second injection produced a substantial increase in food intake. This suggests that tolerance to the NPY effect does not develop after a single injection of NPY. NPY increases moving and exploration in the absence of food when rats are in their home environment but not when tested in a novel environment. Following administration of NPY, rats preferred a high-carbohydrate diet over a high-fat or high-protein diet. Microinjections of NPY showed that active sites included the anterior ventromedial nucleus, paraventricular nucleus of the hypothalamus, and the posterior lateral hypothalamus. NPY was neither additive nor synergistic when coadministered with norepinephrine. Whereas norepinephrine-induced feeding was inhibited by adrenalectomy and vagotomy, these maneuvers had no effect on NPY induced food intake. This provides further evidence that NPY does not exert its effects on food intake through an alpha-adrenergic mechanism. The effects of NPY on food intake were attenuated by peripherally administered bombesin and centrally administered corticotropin-releasing factor and calcitonin. Cholecystokinin failed to inhibit NPY-induced feeding. NPY did not alter circulating glucose levels. These studies provide further insights into the role of NPY as a stimulator of ingestive behaviors. PMID- 3826421 TI - Unaltered regulatory thermogenic response to dietary signals in exercise-trained rats. AB - Thermogenic response to ingestion of high-fat diet was investigated in four groups of male rats, two groups being exercise trained and two remaining sedentary. One sedentary and one trained group each received a high-fat dietary supplement in addition to the stock diet. After 35 days, body energy and protein and fat contents were determined. Results indicate that exercise reduced metabolizable energy (ME) intake by 9 and 18% in stock- and high-fat-fed trained rats, respectively. Compared with stock-fed rats, ME intake was elevated 31 and 18% in sedentary and trained high-fat-fed rats, respectively. Exercise also affected energy gains; trained rats deposited almost 60% less energy than controls. Exercise largely decreased both fat and protein contents of rats, whereas the high-fat supplement enhanced fat deposition. Energy expenditure, excluding exercise cost, was calculated on a mass-independent basis and was revealed to be similar in appropriately matched (diet) trained and sedentary rats. High-fat feeding induced increases in expenditure assumed to be due to enhanced brown adipose tissue (BAT) regulatory diet-induced thermogenesis. Conversely, exercise did not affect further the regulatory thermogenic response of BAT to stimuli originating from high-fat diet. Excluding physical activity, energy expenditure components in sum (expressed mass independently), in high-fat- and stock-fed rats, appear unaltered by exercise training. PMID- 3826422 TI - Does a decrease in cortisol negative feedback efficacy precede ovine parturition? AB - In sheep and other ruminants parturition is stimulated by increased secretion of fetal cortisol. The mechanism of this increased fetal adrenal activity is not known, but may be dependent on a decreased fetal hypothalamopituitary sensitivity to the negative feedback inhibition by cortisol. Seven fetal sheep (129-142 days gestation), chronically prepared with vascular catheters, were infused with cortisol (10 micrograms/min; n = 5) or vehicle (n = 4) for 5 h. Cortisol infusion increased fetal plasma cortisol to 50.8 +/- 4.3 ng/ml, approximately 33 ng/ml above the corresponding plasma cortisol concentration in the vehicle-infused fetuses. One hour after the end of the cortisol or vehicle infusion, infusion of sodium nitroprusside (50 micrograms/min, iv) increased fetal plasma adrenocorticotropin hormone (ACTH) concentration in both groups of fetuses. Results of another study (15) demonstrated that increases in fetal plasma cortisol of only 1.7 ng/ml for 5 h in younger (117-131 days gestation) fetuses completely blocked the fetal ACTH response to the same dose of nitroprusside. The results indicate that the preparturient rise in fetal ACTH is accompanied by a decrease in cortisol negative feedback. PMID- 3826423 TI - Control groups for psychosocial intervention outcome studies. AB - In psychosocial outcome research, as contrasted to pharmacologic research, control groups receiving inert treatment, designed to raise expectations but otherwise provide no service, are almost never indicated; this is true because of methodologic as well as ethical reasons. Four types of comparisons suffice as alternatives: treatment versus no treatment, treatment versus minimal treatment, treatment A versus treatment B, and dismantling. When choices are made among these types of comparisons with power analysis and eight other factors taken into account, the questions of outcome research should be answerable with maximum economic efficiency, with maximum benefit to subjects, and without deception. PMID- 3826424 TI - Use of outpatient mental health services over time in a health maintenance organization and fee-for-service plans. AB - The authors compared the use of outpatient mental health services in a health maintenance organization (HMO) and fee-for-service plans over a 5-year period, using data from a randomized controlled trial. In any given year, enrollees in the HMO and a fee-for-service plan with identical benefits were equally likely to visit a mental health specialist. Over several years, the HMO enrollees were about 50% more likely ever to visit a mental health specialist; fee-for-service enrollees were more likely to receive mental health care in more than 1 study year. PMID- 3826426 TI - First-rank symptoms as a diagnostic clue to multiple personality disorder. AB - Thirty patients with multiple personality disorder had one or more of Schneider's 11 first-rank symptoms at initial assessment (mean = 3.6; range = 1-8). The author describes these symptom categories, eight of which were noted in the patients he interviewed, and illustrates them from the patients' case material. He suggests that inquiry about first-rank symptom phenomena may be a valuable diagnostic clue to the presence of multiple personality disorder. PMID- 3826425 TI - Pregnancy-related affective episodes among women with recurrent depression. AB - The authors examined 52 women with recurrent depression to determine the differences between women with and without histories of pregnancy-related affective episodes. The women with histories of such episodes (N = 24) had been significantly younger at illness onset, were more severely depressed at baseline, and tended to show less emotional stability. The EEG-recorded sleep of the women with pregnancy-related affective episodes was distinguished by longer REM sleep time and more REM activity, differences accounted for almost entirely by the women with histories of only postpartum episodes. PMID- 3826427 TI - Auditory hallucinations in combat-related chronic posttraumatic stress disorder. AB - Intrusive images have been reported to occur in a broad range of people with posttraumatic stress disorder, but the frequency of intrusive auditory perceptions has rarely been addressed. This study compared five posttraumatic stress disorder veterans experiencing auditory hallucinations with 31 nonhallucinating veterans on demographic, military, postmilitary, and symptom variables. Veterans who reported auditory hallucinations had higher combat exposure and more intense posttraumatic stress disorder symptoms than the other veterans. These veterans also tended to be more refractory to treatment than veterans with no hallucinations. Clinical vignettes of the veterans with auditory hallucinations are given, and the implications of the results for a subgroup of chronic posttraumatic stress disorder veterans are discussed. PMID- 3826428 TI - Discontinuation of alprazolam treatment in panic patients. AB - Alprazolam treatment was tapered in 17 panic patients at a rate of 10% of the starting dose every 3 days. Only four subjects completed withdrawal on schedule (4-5 weeks); four additional subjects discontinued treatment in 7-13 weeks. During withdrawal 15 patients had recurrent or increased panic attacks and nine had significant new withdrawal symptoms. Most common among the latter were malaise, weakness, insomnia, tachycardia, lightheadedness, and dizziness. None had seizures, psychosis, or significant neurological or EEG abnormalities. Results indicate that relapse and withdrawal are important considerations in the choice of alprazolam treatment for panic attacks. PMID- 3826429 TI - The significance of past mania or hypomania in the course and outcome of major depression. AB - Patients with primary major depression (N = 372) were followed for 2 years to determine the prognostic importance of past manic or hypomanic episodes. While bipolar I and bipolar II patients were more likely to relapse and bipolar I patients were more likely to attempt suicide, these patients resembled nonbipolar depressed patients in likelihood of recovery and psychosocial impairment in various areas. Compared to nonbipolar patients, those with bipolar I depression were much more likely to develop mania, while bipolar II patients were more likely to develop hypomania. Cycling during the index episode predicted a relatively low likelihood of recovery for bipolar I patients but had no apparent prognostic significance for patients with bipolar II illness. PMID- 3826430 TI - Ratings of videotaped simulated patient interviews and four other methods of evaluating a psychiatry clerkship. AB - Ratings of videotaped interviews with simulated patients were compared with four other measures commonly used to evaluate medical students during their psychiatry clerkship. Intercorrelations among self-reported attitude change, written examination grade, and student rating of satisfaction with the clerkship suggest that each measures different processes. Low but significant correlations between preceptor ratings of interaction skills and data-gathering skills and process and content scores based on an end-of-course videotaped interview suggest that preceptor ratings and the videotaped interview method evaluated the same skills. The authors conclude that preceptor evaluations supplemented by objective ratings of videotaped interviews show promise for evaluating the development of interviewing skills. PMID- 3826431 TI - Dependent personality disorder associated with phobic avoidance in patients with panic disorder. AB - Eighty-eight panic disorder patients were divided into three groups according to the extent of their phobic avoidance (none, limited, or extensive). These groups were compared on three personality disorder instruments: the Structured Interview for DSM-III Personality Disorders, the Personality Diagnostic Questionnaire, and the Millon Clinical Multiaxial Inventory. Phobic patients were found to have significantly more dependent personality disorder and DSM-III third-cluster personality disorders than nonphobic patients. A subgroup of patients with social phobic symptoms was found to resemble the rest of the phobic group in terms of personality. PMID- 3826432 TI - ECT-induced EEG asymmetry and therapeutic response in melancholia: relation to treatment electrode placement. AB - Six right-unilateral and bilateral ECTs were equally effective in reducing Hamilton Rating Scale for Depression scores in 34 melancholic patients whose EEG symmetry did not change after ECT. However, a substantial therapeutic advantage was recorded for bilateral ECT in those patients whose EEG symmetry changed. Accentuation of ECT-induced EEG slowing over the right hemisphere was associated with right-unilateral ECT and a lesser treatment response, suggesting that the therapeutic advantage reported by some investigators for bilateral over right unilateral ECT may be attributed to a poor outcome experienced by those unilateral ECT patients who developed right-sided EEG slowing. PMID- 3826433 TI - High rate of affective disorders in probands with attention deficit disorder and in their relatives: a controlled family study. AB - In a controlled family study of attention deficit disorder, data were collected on first-degree relatives of 22 children with attention deficit disorder and 20 normal children. The rate of major affective disorder was significantly higher in the attention deficit disorder probands (32%) and their relatives (27%) than in the normal control subjects (0%) and their relatives (6%). The findings indicate that attention deficit disorder is associated with higher risk for affective disorder and suggest that probands who have both disorders may represent a distinct subgroup. PMID- 3826434 TI - Prediction of response to nortriptyline and phenelzine by platelet MAO activity. AB - Thirty-seven depressed patients over the age of 55 were treated for 5-7 weeks with either nortriptyline, a tricyclic antidepressant, or phenelzine, a monoamine oxidase (MAO) inhibitor. Patients' platelet MAO activity was measured following a drug washout period before treatment. Patients with higher MAO activity had a better response to treatment, regardless of which drug was used. PMID- 3826435 TI - Long-term effects of extreme situational stress on sleep and dreaming. AB - Sleep data were obtained on 11 patients who had survived traumatic events and who complained of sleep disturbances. Each was awakened from REM and non-REM sleep for dream recall. The patients had lower sleep efficiency indices (because of prolonged sleep latency and larger amounts of "awake" plus "movement" time within sleep periods), shorter REM time, and longer REM latencies than did control subjects. Four of the 11 patients had REM- and non-REM-related nightmares, which, in two sea disaster patients, were associated with REM-related motor activity. The rest of the patients had unusually low dream recall in spite of high eye movement density. PMID- 3826436 TI - A field trial of DSM-III-R psychoactive substance dependence disorders. AB - The authors field-tested proposed criteria for diagnoses of psychoactive substance use disorders in the revision of DSM-III (DSM-III-R) and compared them with DSM-III criteria in a treated group of 83 patients. They found a high level of agreement between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis. The greatest cross-system agreement occurred when the minimum number of symptoms required to make the DSM-III-R diagnosis was set at three. Discrepant diagnoses between systems related to removal of social consequences as a requirement for the DSM-III-R diagnoses, less emphasis on physiological tolerance in DSM-III-R, and disagreement in subjects with mild symptoms. PMID- 3826437 TI - Current need versus treatment history as predictors of use of outpatient psychiatric care. AB - The authors conducted a study of treatment utilization and outcome on a sample of 116 psychiatric outpatients at a Veterans Administration (VA) hospital. Utilization and outcome measures were obtained at a follow-up interview 18 months after a baseline assessment. Comparisons between patients with high and low rates of utilization revealed negligible relationships between use of services and severity of illness, clinical change, or demographics. However, previous use of VA outpatient and inpatient psychiatric services and VA psychiatric disability rating predicted utilization of psychiatric care during the study. The authors conclude that use of VA outpatient psychiatric care may reflect patients' help seeking history more than their current clinical need. PMID- 3826438 TI - Male and female psychiatrists and their patients. AB - Data from a national survey were used to explore whether the patients of male and female psychiatrists differed substantially in demographic or clinical characteristics and whether there were any differences in psychiatrists' treatment of same-gender versus opposite-gender patients. Women constituted about two-thirds of the female but only one-half of the male psychiatrists' patient loads. Female psychiatrists tended to see all of their patients more frequently, but few other differences were found. Better educated patients of both genders tended to have same-gender therapists; patients experiencing marital disruption tended to be seen by therapists of the opposite gender. Implications of these differences for training and manpower development are discussed. PMID- 3826439 TI - Prevention of episodic water intoxication with target weight procedure. AB - An effective, practical, and inexpensive method of preventing water intoxication in inpatients is described. The procedure uses the relationship between acute changes in body water and body weight to predict body weights associated with severe hyponatremia. PMID- 3826440 TI - Smoking of prescription anticholinergic drugs. PMID- 3826441 TI - Clinical and chemical effects of lithium discontinuation. PMID- 3826442 TI - Criteria for the diagnosis of PTSD. PMID- 3826443 TI - A scale for measuring patients' ability to cope. PMID- 3826444 TI - Mania induced by lithium augmentation. PMID- 3826445 TI - Globus hystericus and panic attacks. PMID- 3826446 TI - Thioridazine for peptic ulcer disease? PMID- 3826447 TI - Lithium-responsive depressed patients. PMID- 3826448 TI - Fear of methadone maintenance. PMID- 3826449 TI - For-profit psychiatric hospitals. PMID- 3826450 TI - Psychoanalytic identity. PMID- 3826451 TI - Homer's Odyssey: a psychological journey. PMID- 3826452 TI - Death and authenticity. PMID- 3826453 TI - Contrasting views of felt aliveness. PMID- 3826454 TI - Analysis once a week. PMID- 3826455 TI - The self-psychological significance of trivia. PMID- 3826456 TI - A psychotic recovers: from symbiosis to adulthood. PMID- 3826457 TI - Appraising health risk appraisal. PMID- 3826458 TI - Community-based education of the health professions in Latin America and the US. PMID- 3826459 TI - The validity of health risk appraisal instruments for assessing coronary heart disease risk. AB - This study evaluated the validity of the scoring systems employed by 41 health risk assessment instruments (HRAs) with respect to the probability of death due to coronary heart disease. Validity was assessed by comparing predictions of mortality risk produced by each HRA to estimates from the Framingham Heart Study and the Risk Factor Update Project. Correlations with both epidemiologic estimates indicated that instruments employing logistic regression or the Geller/Gesner methodology had the highest validity coefficients, while validity was lowest for self-administered general health status and lifestyle questionnaires. However, most instruments using the Geller/Gesner technique appear to systematically overestimate the probability of CHD mortality. For HRAs based on additive risk scales, validity was often attenuated by the crude categorization of some risk factors and by the omission of the effects of age from the scoring system. PMID- 3826460 TI - What are the odds that smoking will kill you? AB - We calculated the long-term risks of death from smoking for individuals of various ages and smoking status in terms of the excess mortality contributed by smoking, over and above the baseline mortality from the same diseases caused by factors other than smoking using standard life table procedures. Since mortality data for specific smoking categories were available only from prospective studies in the late 1950s, we scaled these to the 1982 mortality levels. We assumed, for lung cancer, that the death rates for nonsmokers have not changed and, for other smoking-related diseases, that the risks of death for smokers relative to those for nonsmokers have not changed since the 1950s. Probabilities that result from alternative assumptions were also investigated and are presented. As many as one third of heavy smokers age 35 will die before age 85 of diseases caused by their smoking. The probabilities of death from smoking when compared with other causes may be persuasive as public education tools. Their effective use for this purpose is affected not only by the deficiencies in the public's factual knowledge of the magnitude of the risks from smoking, but also by numerous apparent misconceptions relating to the interpretation of risk information. Risk data should be presented to the public in a manner that clarifies these misconceptions and facilitates their understanding of the overwhelming risk imposed by smoking. PMID- 3826461 TI - Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures. AB - An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures. Persons who were unimmunized or immunized at less than 12 months of age had substantially higher attack rates compared to those immunized on or after 12 months of age. Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak. There was no evidence to suggest that waning immunity was a contributing factor among the vaccine failures. Close contact with cases of measles in the high school, source or provider of vaccine, sharing common activities or classes with cases, and verification of the vaccination history were not significant risk factors in the outbreak. The outbreak subsided spontaneously after four generations of illness in the school and demonstrates that when measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but that such transmission is not usually sustained. PMID- 3826462 TI - Advances in psychiatric epidemiology: rates and risks for major depression. AB - Over the last decade there has been a marked increase in information on the epidemiology of psychiatric disorders, particularly major depression, in adults living in the community and in families. The ability to conduct large epidemiologic studies of psychiatric disorders is due to improvements in diagnostic precision and reliability in psychiatry and to the development of systematic methods for collecting information on signs and symptoms to make diagnoses. Results from a recently completed epidemiologic survey of psychiatric disorders in five urban communities in the United States and from several large scale family genetic studies suggest that major depression is a highly prevalent disorder. It occurs in adults and children, and there is evidence for an increased rate in younger people. The average age of first onset is in young adulthood. Most depressions are untreated. The firm risk factors for major depression include being female; young (born after World War II); separated/divorced or in an unhappy marriage; and having a family history of major depression. There is a two-to-threefold increased risk for major depression if there is a family history of the disorder. The relevance of these findings to clinical practice and public health is discussed. PMID- 3826463 TI - Circumcision as a risk factor for urethritis in racial groups. AB - A retrospective population-based case-control study of sexually transmitted urethritis was conducted at a large military base over a 21-month period. During the study, 9,514 patients were seen for sexually transmitted disease. The analysis was restricted to active duty males and showed that Blacks had 14.8 times the incidence rate of gonococcal urethritis (GCU) and 4.7 times the rate of nongonococcal urethritis (NGU) compared to Whites. There were slightly fewer cases of NGU than GCU. A case-control study of active duty soldiers showed that both Black and White circumcised subjects were 1.65 times as likely to have NGU as uncircumcised subjects (95% CI: 1.37-2.00). However, circumcision was not associated with an increased incidence of GCU. PMID- 3826464 TI - Leisure time physical activity assessment of American adults through an analysis of time diaries collected in 1981. AB - One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per cent of adults 18-65 years of age to be participating regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure time physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per cent expended more than 1600 kcals/week in leisure time physical activity, and 10 per cent met the DHHS physical activity requirements. PMID- 3826465 TI - HMO membership, copayment, and initiation of care for cancer: a study of working adults. AB - This study compares diagnosis and commencement of treatment for cancer among persons with fully financed fee-for-service coverage, persons with copaid fee-for service coverage, and persons in an HMO (health maintenance organization). A total of 242 subjects actively employed at the time of their diagnosis were interviewed, typically within six months of beginning cancer treatment. After sex, age, income, education, residence (urban vs rural), and disease site and stage had been controlled, those who made copayments were found to have waited an average of 1.25 months longer (95 per cent confidence limit (cl) +/- .88) between initial suspicion of illness and obtaining a definitive diagnosis than those with full insurance coverage. Time from diagnosis until the beginning of treatment averaged .83 months longer (95 per cent cl +/- .41) for HMO members than those in fee-for-service. These relations were strongest in income categories equal to or exceeding $20,000 per year. PMID- 3826466 TI - Factors affecting breastfeeding among women of Mexican origin or descent in Los Angeles. AB - Data on breastfeeding intentions and behavior were collected in prenatal and postpartum interviews as part of a study on first birth among 518 women of Mexican origin or descent in two Los Angeles hospitals. The prenatal intentions of 82 per cent of the women to breastfeed were maintained postpartum in one hospital but dropped sharply in the other. A greater number of hours a day with the baby in the hospital and earlier initiation of breastfeeding were associated with the hospital where prenatal breastfeeding intentions were more likely to be carried out. The intention to work postpartum was associated both with the decision not to breastfeed at all and with shorter intended duration of breastfeeding. PMID- 3826467 TI - Incidence and costs of incidental appendectomy as a preventive measure. AB - Statewide hospital discharge data in South Carolina for the period 1979-81 were used to evaluate the effectiveness of the incidental appendectomy performed as a preventive measure. The occurrence of incidental appendectomy exceeded that of appendicitis treated by appendectomy, with population-based rates of 1.13/1,000 and 0.97/1,000 person-years, respectively. Over 64 per cent of appendicitis cases occurred in persons under 25 years of age while 74 per cent of incidental appendectomies occurred in persons age 25 and over. Extrapolating to the nation, the data suggest that 254,250 incidental appendectomies might prevent 3,382 future cases of hospitalized appendicitis. The cost of the prevented cases is estimated as $6,764,000. The cost of the incidental appendectomies would be $20,340,000 if as many as 10 per cent of surgeons' fees were separately charged and twice as much if twice as many were so charged. Information on charges for incidental appendectomies is not readily available. PMID- 3826468 TI - Hepatitis B virus transmission in a public school: effects of mentally retarded HBsAG carrier students. AB - In 1980, 18 institutionalized children, carriers of hepatitis B virus (HBV), were enrolled into two special education schools, and staff and students were monitored for HBV markers. Eleven HBV exposures were observed and those exposed were given hepatitis B immune globulin. After 3.5 years, no remaining staff showed serological evidence of HBV infection but three of 61 susceptible students did so. The three students probably acquired the infection outside the school. At the conclusion of the project, one school located in the community decided not to institute a vaccine program for students or staff. The other school, located inside the mental retardation institution, established an organized vaccine initiative. Indications for use of hepatitis vaccine in schools should be individualized to accommodate for differences in student and staff interaction, physical design of the school, and number and behaviors of HBsAg carrier students. PMID- 3826469 TI - Training physicians for community-oriented primary care in Latin America: model programs in Mexico, Nicaragua, and Costa Rica. AB - Under the rubrics of preventive and social medicine, public health, and family and community medicine, medical educators in Latin America have developed programs to train physicians for community-oriented health care (COPC). The historical background for such programs in Latin America is reviewed. Three relevant examples of programs in Mexico, Nicaragua, and Costa Rica are highlighted, drawing on the author's direct experience with and in these faculties. The paper addresses the relation between these programs and national and regional trends in education and services. PMID- 3826471 TI - Cigarette smoking and changes in smoking among a cohort of Michigan adults, 1980 82. AB - Factors related to cigarette smoking and to changes over two years were investigated in a sample of Michigan adults. Smoking was associated with age, sex, education, occupation, and beliefs regarding its health effects. Cessation was predicted by amount smoked at baseline, desire to stop, and belief concerning difficulty stopping. Starting smoking was associated with time off cigarettes (negatively), age, belief about health effects, sex, and education. Heavy smoking and maintenance of cessation are major problems. PMID- 3826470 TI - Projected changes in breast cancer incidence due to the trend toward delayed childbearing. AB - Because there has been a recent trend toward delay of childbearing in the United States, women in the birth cohort of 1945-49 will have an estimated 5 per cent greater incidence of breast cancer, and those in the cohort of 1950-54 an estimated 9 per cent greater incidence compared with the cohort of 1935-39, which had the distribution of age at first birth most favorable for breast cancer risk. PMID- 3826472 TI - Factors associated with low birthweight in an inner-city population: the role of financial problems. AB - A case-control study of low birthweight among residents of high risk areas of Alameda County was conducted in 1983. The relation of 13 variables to low birthweight was assessed using a multiple logistic regression analysis. A six fold increase in the risk of low birthweight was found in association with financial problems during the current pregnancy, controlling for differences in race, certain poor health habits, complications of pregnancy, and several other factors between cases and controls. PMID- 3826473 TI - Putting the brakes on lawbreaking: state bans on radar detectors. PMID- 3826474 TI - Accidental firearm fatalities. PMID- 3826475 TI - Whirlpool folliculitis. PMID- 3826476 TI - Fiber/fat/carbohydrates in weight loss. PMID- 3826477 TI - Atypical and malignant neoplasms showing lipomatous differentiation. A study of 111 cases. AB - One-hundred-eleven cases of histopathologically atypical or malignant lipomatous lesions in the somatic soft tissue and retroperitoneum were studied. These consisted of 48 differentiated fatty neoplasms of the somatic soft tissues (DFT S), 21 fatty neoplasms of the retroperitoneum (DFT-R), 33 myxoid liposarcomas from various sites and nine pleomorphic liposarcomas. DFT-S were defined as lipomatous lesions composed of mature fat and containing atypical stromal cells or lipoblasts. In the somatic soft tissues, this group included lesions that would be classified using published criteria as "atypical lipoma", "pleomorphic lipoma", "well-differentiated lipoma-like liposarcoma", and "sclerosing liposarcoma". All of the DFT-R met previously published criteria for "well differentiated liposarcoma" or "sclerosing liposarcoma". We found no consistent histologic differences between the DFT-S and DRT-R. No pure "round cell" liposarcomas were encountered although many myxoid liposarcomas had "round cell" areas. Follow-up data were available in 80 cases (72%) with a mean follow-up period of over 7 years. Among the DFT-S there were no uncontrollable recurrences, distant metastases, or tumor-related deaths. The depth of the neoplasm correlated with the tendency for local recurrence; no neoplasms primary in the subcutis recurred; 29% of the tumors recurred when they originated in the deep soft tissues or within the muscle. None of the recurrent tumors demonstrated "dedifferentiation." DFT-R had a recurrence rate of 67% and, although there were no distant metastases, nine patients (43%) died of tumor. Five retroperitoneal tumors dedifferentiated but did not metastasize. In light of this experience, we believe that the term "atypical lipoma" is warranted for the DFT-S and "well differentiated liposarcoma" is an appropriate label for the DFT-R. The overall mean survival for the 52 cases of liposarcoma (excluding DFT-S) was 13.6 years. The mean survival in "well differentiated liposarcoma" (11.25 years) was between that for myxoid liposarcoma (16.25 years) and that for pleomorphic liposarcoma (7 years). Six patients (29%) with myxoid liposarcoma developed local recurrences and 6 patients (29%) developed distant metastases and died. Metastasis was always associated with a round cell (or pleomorphic) component with increased numbers of mitotic figures in either the primary tumor or a local recurrence. PMID- 3826478 TI - Juvenile fibroadenoma with atypical epithelial hyperplasia. AB - We studied 49 patients with fibroadenomas with severe atypical epithelial hyperplasia, sometimes suggestive of in situ carcinoma. The term "juvenile fibroadenoma" (JFA) is recommended for these lesions, which occur mainly in adolescent and young women. Twenty-six cases (2%) were obtained through a review of 1,321 consecutive fibroadenomas and 23 were seen in consultation. The 49 patients ranged in age from 10-72 years (average 26 years); 50% were younger than 21 years. This age distribution was significantly lower than that of patients with adult FA (p less than 0.001). Four patterns of atypical epithelial hyperplasia were observed: ductal-laciform, ductal-solid, cystic-papillary and lobular-terminal ductal. Forty-six patients were treated by excision only. Eight years was the average follow-up and 7 years the median follow-up for 28 (57%) patients followed for more than a year (range 1-19 years). Two patients, aged 47 and 59 years at the time of diagnosis of JFA, subsequently developed carcinoma in the contralateral and ipsilateral breast, respectively; all others have remained well. Atypical epithelial proliferation in this setting should be interpreted conservatively. Long-term follow-up is recommended after excision of JFA. PMID- 3826479 TI - Pathology of the thyroid in amiodarone-associated thyrotoxicosis. AB - Among 83 consecutive patients operated on for thyrotoxicosis at the Mayo Clinic between January 1, 1980 and May 1, 1986, four had a combination of pathologic findings that were similar and unexpected: involutional changes; degenerative and destructive follicular lesions; and zones of fibrosis. These four, but none of the remaining 79, were being treated with amiodarone for cardiac tachyarrhythmias; this drug is known to be taken up by the thyroid gland. Characteristically, small groups of involuted follicles exhibited varying degrees of damage ranging from degenerative changes in a few lining cells to total follicular destruction. Damaged follicular cells were swollen and featured granular or vacuolated cytoplasm. This type of cytoplasmic alteration has been reported to occur in pneumocytes and hepatocytes damaged by amiodarone. Therefore, the drug probably is the cause of the thyroid cell damage, and follicular disruption (with consequent release of iodothyronines into the circulation) is likely to be an important contributor to the associated thyrotoxicosis. PMID- 3826480 TI - Microscopic bone pathology in two cases of surgically treated secondary hyperparathyroidism. Report of a distinct skeletal lesion. AB - We report bone biopsy findings in two hemodialysis patients with a history of secondary hyperparathyroidism treated by parathyroidectomy. Discrete, punched-out lesions in trabecular bone, which show little evidence of resorption or osteoblast activity, probably correspond to previous zones of osteoclastic tunneling resorption. Because we have seen these lesions in no other clinical setting, we suggest that they are residua of healed secondary hyperparathyroidism in dialysis patients. Their persistence may be due in part to aluminum intoxication. PMID- 3826481 TI - Breast sarcoma with giant cells and osteoid. A case report and review of the literature. AB - Breast sarcomas with giant cells and osteoid are rare and usually fatal. They should be distinguished from carcinomas with sarcomatous metaplasia. Our case is presented together with eight similar ones reported in the English literature. Their clinical, radiologic, gross, and histologic characteristics are analyzed. Most patients died within 1 1/2 years of diagnosis, survival apparently being related to the size of the tumor. Diagnosis is delayed because the tumor can be confused clinically and radiologically with a large fibroadenoma. Awareness of this problem, fine-needle aspiration, and computerized tomography may lead to earlier diagnosis and, consequently, improved survival. In our case, immunohistochemical studies supported the notion that the lesion was a primary sarcoma, rather than a carcinoma with sarcomatous metaplasia. PMID- 3826482 TI - Surgical pathology fellowship training in the United States and Canada. Results of a survey by the Arthur Purdy Stout Society of Surgical Pathologists. PMID- 3826483 TI - Mammary hamartoma. PMID- 3826484 TI - Appropriate proprias. PMID- 3826485 TI - Experimental infections of the multimammate rat (Mastomys natalensis) with Leishmania donovani and Leishmania major. AB - The susceptibility of the multimammate rat, Mastomys natalensis, to experimental infections with Leishmania donovani and L. major was examined. Inoculations of L. major promastigotes into the skin resulted in nonulcerating lesions in which parasites could be detected for more than 30 weeks later. Intravenous inoculations of L. donovani promastigotes produced visceral infections characterized by a continuing increase in splenic parasite burdens and liver parasite burdens which peaked during the first few weeks of infection and gradually decreased as the disease became chronic. L. donovani could be isolated from the blood throughout the infection, and promastigotes were cultured from the spleens of rats inoculated intradermally. Thus, the multimammate rat appears to be a good reservoir host for these parasites. PMID- 3826487 TI - Leishmania mexicana: destruction of isolated amastigotes by amino acid esters. AB - Amino acid esters can destroy intracellular as well as isolated amastigotes of Leishmania mexicana amazonensis. In the present study we examined, using a tetrazolium reduction assay, the toxicity of the esters for amastigotes isolated from mouse lesions. Parasite killing by the "prototype" compound L-leucine methyl ester at 1 mM concentration and at pH 7.3 took place within 15-30 min. Time-lapse cinematographic observations showed that the amastigotes rounded up and became less phase-dense before they rapidly broke down. Ammonium chloride, ethylamine or monensin, known to raise the intracellular pH, reduced the sensitivity of the amastigotes to L-Leu-OMe. This finding suggests that an acidified compartment is involved in the destruction of the parasites. The leishmanicidal activity of a series of L-amino acid esters was also investigated. The ED50 (concentration for half maximal effect) for methyl esters was (in mM): Leu (0.62), Trp (0.96), Met (1.13), Glu (2.0), Phe (2.5), and Tyr (3.8). In contrast, the methyl esters of Ile, Val, Ala, beta Ala, Gly, Ser, His, and Pro were either inactive or weakly active at 15 mM. Benzyl esters were more active than their methyl homologs: the ED50 of the benzyl esters of Leu, Val, Ile, Gly, Ala, beta Ala, and Pro were, respectively, 0.07, 0.20, 0.22, 0.88, 1.5, 2.3, and 6.7 mM. Ranks of leishmanicidal activity may reflect differences in the rates of ester uptake and trapping by the amastigotes, in the specificity of the relevant hydrolytic enzyme(s), in the accumulation and metabolic fate of the released amino acids, or in the toxicity of the amino acid or alcohol released within the amastigotes. PMID- 3826486 TI - Identification and distribution of New World Leishmania species characterized by serodeme analysis using monoclonal antibodies. AB - Five hundred thirty stocks of Leishmania isolated from human and domestic and wild reservoir hosts, representing a wide geographic distribution of endemic foci of American cutaneous (ACL) and visceral leishmaniases (AVL) were characterized and identified at species and/or subspecies levels based on their reactivity to a cross-panel of specific monoclonal antibodies using a radioimmune binding assay. This study confirms and extends our preliminary results on the high specificity of some of these monoclonals for the L. braziliensis, L. mexicana, and L. donovani complexes. This study also demonstrates the relative stability of these molecular markers and the general usefulness of the method for parasite identification. Two hundred ninety-two of 420 isolates of ACL were classified as members of the L. braziliensis complex. Two hundred twenty-seven were L. b. braziliensis; these showed the widest geographical distribution (Brazil: Amazonas, Bahia, Ceara, Espirito Santo, Goias, Minas Gerais, Para, Paraiba, Rio de Janeiro, and Sao Paulo; Honduras: Santa Barbara and Yoko; Peru: Ancash, Piura, and Ucayali; and Venezuela: Cojedes, Distrito Federal, Lara, Portuguesa, Vale Hondo, Yaracuy, and Zulia). Forty-one stocks were identified as L. b. guyanensis (from North Brazil: Amazonas, Amapa, Para, and Rondonia). Twenty-one stocks were identified as L. b. panamensis (from Costa Rica: Alajuela, Guanacasten, Limon, Puntarenas, and San Jose; and Honduras: El Paraiso, and Olancho). Out of 128 isolates classified as members of the L. mexicana complex, 74 were differentiated as L. m. amazonensis (from Bolivia; Brazil: Amazonas, Bahia, Ceara, Goias, Maranhao, Mato Grosso do Norte, and Para; Peru: Pasco Forest and Van Humboldt; and Venezuela: Carabobo, Guarico, and Merida). Forty-four stocks were identified as L. m. venezuelensis (from Venezuela: Lara). Six stocks were L. m. mexicana (from Belize; and Mexico: Campeche [corrected] and Quintana Roo, Yucatan). One hundred ten isolates from AVL were identified as L. donovani chagasi (from Brazil: Bahia, Ceara, Maranhao, Minas Gerais, Mato Grosso do Sul, Piaui, Rio de Janeiro, and Sergipe; and Honduras: Valle). The implications of these results with respect to both the clinical and epidemiological data (including the detection of seven unusual characterized stocks) are discussed. PMID- 3826488 TI - Host-parasite relationship of Leishmania mexicana mexicana and Lutzomyia abonnenci (Diptera: Psychodidae). AB - The life cycle of Leishmania mexicana mexicana in the gut of the sand fly, Lutzomyia abonnenci, was studied by light and electron microscopy. Development was suprapylarian with initial establishment of parasites in the bloodmeal (posterior midgut), and anterior migration of parasites to the cardia/stomodeal valve region beginning at 2.5 days post-infection. Flagellates were first observed in the esophagus at 3.5 days, in the posterior armature region of the pharynx at 5 days, and in the anterior pharynx at 7 days; but they were not detected in the cibarium or proboscis. Infection of the pylorus region of the hindgut and of the Malpighian tubules was also commonly observed. Three different morphological forms of L. m. mexicana developed in the gut: nectomonad promastigotes, short promastigotes, and paramastigotes. Nectomonads occurred primarily in the abdominal midgut after bloodmeal digestion, where they were oriented in longitudinal masses in the lumen, or interdigitated with epithelial microvilli via the flagellum. Short promastigotes found in the cardia/stomodeal valve region are described for the first time. These forms were smaller than nectomonads, showed an amplification of the kinetoplast, apposition of kinetoplast and nucleus, and were embedded in a gel-like matrix. To maintain position in the cardia, parasites commonly inserted the flagellum deep into microvilli or cytoplasm of the epithelium; adherence to the cuticular intima of the stomodeal valve was by flagellar modification and formation of hemidesmosome plaques. Paramastigotes occurred in the esophagus, were sometimes degenerated in appearance, and were attached via flagellar hemidesmosomes. Paramastigotes observed in the lumen of the pharynx were commonly degenerated and were not attached to the intima. L. m. mexicana was able to colonize the various gut habitats of Lu. abonnenci by a number of adaptations; this sand fly appears to be a suitable biological host for the parasite. PMID- 3826489 TI - Toxoplasma antibodies and retinochoroiditis in the Marshall Islands and their association with exposure to radioactive fallout. AB - Nearly universal serologic evidence of Toxoplasma gondii infection was found to have occurred by adulthood in 517 Marshallese tested in 1981-1982. The prevalence and incidence of retinal lesions compatible with toxoplasmosis were 3.9% and 273 cases/year/100,000 seropositive persons, respectively, thus indicating a significant public health problem. Seronegativity was significantly more common in a subgroup of Marshallese that had received 110-190 rads of total-body gamma radiation as a consequence of accidental exposure to radioactive fallout in 1954. Despite this finding there was no evidence of an increase in clinically significant lesions in exposed persons. PMID- 3826490 TI - Correlation of positive syphilis serology with invasive amebiasis in Japan. AB - Approximately 20% of 52 Japanese males with invasive amebiasis confirmed by gel diffusion precipitin test (GDP) were positive by both Treponema pallidum hemagglutination test (TPHA) and nontreponemal antigen tests, and an additional 20% were positive by TPHA alone. However, none of 109 GDP-negative Japanese males without invasive amebiasis were positive on these serologic tests for syphilis. At least 2 bisexuals and 4 homosexuals were among those with invasive amebiasis. All of these biased males were positive on both TPHA and nontreponemal antigen tests. Four of the biased males had liver abscess and 2 had amebic dysentery or colitis. Bisexual or homosexual males were not found in the negative GDP group. These observations suggest that sexually transmitted amebiasis due to Entamoeba histolytica occurs among sexually biased males in Japan. PMID- 3826491 TI - Cryptosporidiosis in Haitian children. AB - We used a modified acid-fast stain to detect Cryptosporidium oocysts in unconcentrated stools from 824 Haitian children less than 2 years of age with acute diarrhea. Oocysts were identified in stools from 17.5% of 291 children seen at a rural dispensary and in 16.3% of stools from 533 children in an urban hospital. Children with cryptosporidiosis were identified throughout a 22-month period from October 1982 to July 1984, without seasonal predilection. Cryptosporidiosis was twice as common in infants greater than 6 months of age than in younger infants. Cryptosporidium oocysts were rarely found in stools of infants receiving only breast milk. The clinical presentation of children with cryptosporidiosis was similar to other patients with diarrhea who did not have cryptosporidiosis. No asymptomatic Cryptosporidium infections were detected among 71 family members of 31 children with cryptosporidiosis. Three of the 71 family members less than 3 years of age were found to have diarrhea and Cryptosporidium oocysts. In follow-up studies of 31 patients, oocysts persisted in stools for a mean of 14 days (range 5-31 days). Duration of oocyst excretion was directly correlated with duration of diarrhea. These findings suggest that Cryptosporidium is an important cause of acute self-limited diarrheal illness to Haitian children. PMID- 3826492 TI - Shedding of oocysts in immunocompetent individuals infected with Cryptosporidium. AB - In June 1985, we investigated an outbreak of cryptosporidiosis at a day-care center in Florida. Through day-care center-wide stool screening, 33% (28/84) of the children and 22% (4/18) of the staff members submitting stool specimens were found to have cryptosporidiosis. Children 12-35 months of age and their teachers were at highest risk. All but 1 of the Cryptosporidium-positive patients reported diarrhea, which lasted between 1-44 days. Serial stool specimens were obtained from 8 infected individuals (5 children and 3 adults). Duration of oocyst shedding ranged from 8 to more than 50 days and continued in 5 individuals after diarrhea ceased. No relationship was found between duration of oocyst shedding and the age of the patient or duration or severity of diarrhea. Results of the investigation indicate that infected individuals may continue to excrete oocysts and, therefore, may remain infectious for days or weeks after gastrointestinal symptoms disappear. PMID- 3826493 TI - Autochthonous case of Schistosoma intercalatum from equatorial guinea. PMID- 3826494 TI - Genetic variation and differentiation of three Schistosoma species from the Philippines, Laos, and Peninsular Malaysia. AB - Electrophoretically-detected allozyme variation is described in strains of Schistosoma japonicum (4 Philippine strains), S. mekongi (Laos), and an undescribed anthropophilic S. japonicum-like schistosome from Peninsular Malaysia. Result, together with those reported previously for 8 other strains (S. japonicum, China, Formosa, Japan, Philippines; S. mekongi, 2 substrains; Malaysian schistosome, 2 strains) permit a composite genetic characterization of 15 strains of Asian schistosomes at 9-18 presumptive loci. The proportion of polymorphic loci (P) and the mean heterozygosity per locus (H) were zero in all strains. Although this was expected for strains that had been in laboratory culture for up to 50 years, we expected to detect variation in strains based on 10-50 recently field-collected infected snails. We expected S. japonicum to be as variable as S. mansoni (P = 0.13 (0-0.33), H = 0.04, 18 loci, 22 strains) as it is believed to reproduce sexually, has an evolutionary history of several million years, inhabits a wide geographic range, coevolved with a genetically variable intermediate snail host, and has a diversity of mammalian hosts. No differences were detected between the 5 S. japonicum strains from Leyte and Luzon (Philippines), between the 3 S. mekongi strains, or between the 3 Malaysian schistosome strains; these groups and the remaining S. japonicum strains representing Mindoro (Philippines), China, Formosa, and Japan each have distinctive multilocus electromorphic patterns. Nei's genetic distances (D) were calculated to estimate interstrain and interspecific divergence. Interstrain genetic distances in S. japonicum averaged greater than 0.3; much higher than those reported previously for S. mansoni (D = 0.06, D(max) = 0.24). S. japonicum (Mindoro) was moderately differentiated from the Leyte-Luzon strains (D = 0.29, 12 loci). Estimates of the S. japonicum China-Philippine distance (D greater than 0.4, 11 loci) are high for conspecific populations and further studies of the still poorly characterized Chinese parasite may reveal that these are, in fact, separate species. S. japonicum is shown to be only distantly related to S. mekongi and the Malaysian schistosome (D greater than 1); the latter is closely related to, but genetically quite distinct from, S. mekongi (D = 0.61 +/- 0.275, 11 loci) and warrants recognition as a new species. The medical significance of the isogenic nature of the Asian schistosome strains and their evolutionary divergence are discussed. PMID- 3826495 TI - Alkylphosphonates as unique compounds in the metabolism of the schistosomal vector Biomphalaria glabrata. AB - Examination of intact freshly laid egg masses of the schistosomal snail vector Biomphalaria glabrata by both 31P nuclear magnetic resonance spectroscopy and colorimetric phosphorus analysis indicated that 98% of the phosphorus in the egg masses was present in the form of alkylphosphonic acids. At least 87% of the total phosphorus originally present was comprised of 2-aminoethylphosphonic acid. During 11 days of embryonic development, alkylphosphonate-phosphorus decreased from 98% to 50% of the total phosphorus, indicating a possible role for phosphonate-phosphorus in the embryonic nutrition of these snails. Considering the relative uniqueness of the alkylphosphonates in nature, the very high concentration of these compounds in freshly laid eggs, and the reduction in their amount during embryonic development, the anabolic and catabolic pathways of alkylphosphonates may serve as sites for highly specific analogues in the control of these schistosomal vectors. PMID- 3826497 TI - Cysticercotic encephalitis: a severe form in young females. AB - Clinical and computerized tomography findings in patients with miliary infestation of cysticerci in brain parenchyma are presented. Cysticercotic encephalitis produces a severe and frequently fatal neurological disorder. Although parenchymal cysticercosis is common in endemic areas, in the cases reported here, the pathology is induced by a severe inflammatory response in brain parenchyma rather than by the physical presence of multiple cysts. As a result of diffuse brain edema, all cases develop subacute severe intracranial hypertension and compromise of visual function. One important feature of this form of neurocysticercosis is that it particularly affects young women. PMID- 3826496 TI - Onchocerciasis in southwestern Sudan: parasitological and clinical characteristics. AB - Parasitological and clinical observations were made on residents of Pongo Nuer, a village in the province of Bahr El Ghazal, southwestern Sudan. Of 202 skin biopsies, 189 (94%) were positive for microfilariae of Onchocerca volvulus. Nodules were most common around the pelvic girdle and rare on the limbs or head. Microfilarial intensities, ranging up to 1,094 mf/mg of skin, were highest at the iliac crest and shoulder; they increased rapidly in childhood but then appeared to reach a plateau maintained through adult life. Nodule presence and number, especially at multiple sites, was significantly related to skin microfilarial intensity. Dermal manifestations of O. volvulus infection were widespread and severe, ranging from acute maculopapular eruptions to chronic, diffuse, and degenerative changes, even in young adults. However, high skin microfilarial intensities were found in asymptomatic individuals; conversely, lowest intensities were in those with severest maculopapular lesions, suggesting that host response was a major determinant of disease outcome. Microfilariae were detected in the cornea or anterior chamber of the eyes of one third of those examined in all age groups, but lesions of the posterior segment, including optic neuritis, chorioretinitis, and pigmentary abnormalities, were considered responsible for visual deficits in the population sample. Some pathologic changes in the anterior segment attributable to microfilariae were more common in the young than in adults but there was no preponderance of sclerosing keratitis in adults, contrary to expectations in hyperexposed individuals in a Sudan savannah zone. The best correlate of the presence of microfilariae in the eye was the intensity of infection in shoulder skin snips. Little value could be derived from data on outer canthus samples, either in terms of severity of ocular infection or disease. Microfilaremia was common (76%) but in only one case was attributed to O. volvulus; the remainder were due to Mansonella perstans. PMID- 3826498 TI - Non-01 Vibrio cholerae infections in Cancun, Mexico. AB - To determine the role of Vibrio cholerae as a cause of diarrheal illness in Cancun, Mexico, an investigation was conducted in July and August 1983. Although toxigenic V. cholerae 01 were not found, non-01 V. cholerae were isolated from 22 (16%) of 134 stools from persons with diarrheal illness and none of 22 stools from well persons; 58 (92%) of 63 sewage samples; 12 (86%) of 14 untreated well water samples; a home storage tank for treated water; and 5 (21%) of 24 samples of raw seafood. None of the V. cholerae isolates from patients were toxigenic. The illness occurred mainly in small children, and were characterized principally by diarrhea and abdominal pain. No patient was seriously ill, and all recovered without sequelae. Seven different serotypes of non-01 V. cholerae were isolated from the stool specimens, and Smith serotype 12 accounted for 10 (46%) of the 22 isolates. A matched-pair case-control study found that cases were more likely than controls to have eaten home prepared gelatin (P = 0.03, OR = 5/0) and seafood (P = 0.06, OR = 4/0). PMID- 3826499 TI - Rhinofacial zygomycosis caused by Conidiobolus coronatus: a case report including in vitro sensitivity to antimycotic agents. AB - A case of zygomycosis caused by Conidiobolus coronatus, occurring in a 31-year old priest from the Ivory Coast, is reported. Lesions eventually resolved after 2 1/2 years, during which the patient was variously treated with intravenous amphotericin B and miconazole as well as surgical resection. It is difficult to be certain which, if any, of these treatments contributed to resolution of lesions. A report of in vitro sensitivity data to a variety of antifungal agents is included. PMID- 3826500 TI - Oral infection of Peromyscus maniculatus with Borrelia burgdorferi and subsequent transmission by Ixodes dammini. AB - We determined if deer mice (Peromyscus maniculatus) could be infected by Borrelia burgdorferi and develop sufficient spirochetemia to infect larval Ixodes dammini. Ten P. maniculatus were infected orally with 0.05 ml phosphate buffered saline containing approximately 400 B. burgdorferi. On days 21 or 28 after infection (AI) larval I. dammini were fed on the deer mice. Each of the P. maniculatus developed antibodies (up to 7 log2) to B. burgdorferi and B. burgdorferi was isolated from the blood of 1 deer mouse on day 51 AI. Nymphs resulting from these larvae were then allowed to feed on 10 uninfected P. maniculatus. All 10 of these tick-infected P. maniculatus developed antibodies (up to 7 log2) to B. burgdorferi, and B. burgdorferi was isolated from the blood of 1 of the 10 P. maniculatus 15 days after tick feeding and from the pooled organs of another of the tick-infected P. maniculatus. Six of the orally infected P. maniculatus developed clinical signs including ruffled hair coat, inappetence, reluctance to move, and lameness in the rear legs. All P. maniculatus tissues were grossly and histologically normal on necropsy. These findings show that P. maniculatus are susceptible to oral infection and develop sufficient spirochetemias to infect I. dammini larvae. PMID- 3826501 TI - Pediatric Lassa fever: a review of 33 Liberian cases. AB - Thirty-three cases of pediatric Lassa fever were identified at Curran Lutheran Hospital and Phebe Hospital in Liberia between January 1980 and March 1984. All 18 fetal cases died and the case-fatality rate for 15 childhood cases was 27%. We identified four clinical presentations according to age, including a case of congenital Lassa fever, a condition not reported previously. Two cases of Lassa fever were found serologically during a one-month survey of all pediatric admissions at Curran Lutheran Hospital, 2.4% of those children who had serum pairs collected. We also identified a "swollen baby syndrome" consisting of widespread edema, abdominal distention, and bleeding. This distinctive clinical presentation of Lassa fever ended in death in three of four cases and was present in three of the four childhood deaths in this series. Its absence seems to be a good prognostic indicator in children. PMID- 3826502 TI - Dengue shock syndrome in an American traveler with primary dengue 3 infection. AB - A previously reported case of childhood dengue shock syndrome in an American traveler to India was investigated serologically. The original studies neither indicated the infecting serotype nor proved primary or secondary infection. However, BHK suspension PRNT of 6-year convalescent serum now indicates that the child had primary dengue type 3 infection. Dengue, dengue hemorrhagic fever, and dengue shock syndrome are potential hazards for American travelers and American residents of dengue-receptive areas. PMID- 3826504 TI - Lack of attenuation of a candidate dengue 1 vaccine (45AZ5) in human volunteers. AB - A dengue type 1, candidate live virus vaccine (45AZ5) was prepared by serial virus passage in fetal rhesus lung cells. Infected cells were treated with a mutagen, 5-azacytidine, to increase the likelihood of producing attenuated variants. The vaccine strain was selected by cloning virus that produced only small plaques in vitro and showed reduced replication at high temperatures (temperature sensitivity). Although other candidate live dengue virus vaccines selected for similar growth characteristics have been attenuated for humans, two recipients of the 45AZ5 virus developed unmodified acute dengue fever. Viremia was observed within 24 hr of inoculation and lasted 12 to 19 days. Virus isolates from the blood produced large plaques in cell culture and showed diminished temperature sensitivity. The 45AZ5 virus is unacceptable as a vaccine candidate. This experience points out the uncertain relationship between in vitro viral growth characteristics and virulence factors for humans. PMID- 3826503 TI - Monoclonal antibodies against dengue 2 virus E-glycoprotein protect mice against lethal dengue infection. AB - A panel of 11 murine monoclonal antibodies directed against dengue type 2 was evaluated for antigen specificity by dot immunobinding assay and Western blot analysis and for in vitro and in vivo biological activities. Nine of the 11 monoclonal antibodies reacted with viral E-glycoprotein based on the Western blot analysis; one reacted with a 36 Kd protein present in dengue-infected C6/36 mosquito cells. The nine E-glycoprotein-reactive monoclonal antibodies also neutralized dengue 2 virus in a plaque reduction assay. Of the neutralizing monoclonal antibodies, five passively protected mice in vivo against lethal intracerebral dengue 2 challenge. The protective monoclonal antibodies were directed against viral determinants that fell into at least three spatially separate families of epitopes on E-glycoprotein, the antigenicities of which were preserved after heat/detergent denaturation. PMID- 3826505 TI - Endoscopic Congo red test during proximal gastric vagotomy. AB - Although proximal gastric vagotomy is widely performed as an elective treatment for duodenal ulcer, the incidence of recurrent ulcer is troublesome. There are several theories to explain recurrent ulcers, and important technical steps should be considered when performing proximal gastric vagotomy. The use of an intraoperative test may allow more accurate performance of the operation and more complete vagotomy of the parietal cell mass. This report describes the use of the endoscopic Congo red test in patients during proximal gastric vagotomy. The test allows rapid and accurate mapping of areas of the stomach with intact vagus and secretory nerves after operative vagotomy, and can be repeated several times if necessary to verify completion of the vagotomy. The use of universally available equipment and the potential for intraoperative and postoperative use are other attractive features of the test. Use of the endoscopic Congo red test provides physiologic evidence that vagus secretory nerve fibers traverse the right and left gastroepiploic nerves, leading us to believe that the gastroepiploic nerves should be routinely divided during proximal gastric vagotomy. In patients with recurrent duodenal ulcer requiring reoperation, the endoscopic Congo red test allows preoperative demonstration of the site of the intact vagal nerve trunks. The endoscopic Congo red test deserves further investigation and wider application during operations for chronic duodenal ulcer. PMID- 3826506 TI - Critical appraisal of horizontal gastroplasty. AB - We evaluated 77 consecutive patients who had undergone horizontal gastroplasty over a 2 year period. Mean follow-up was 26 months (88 percent of patients) and ranged from 15 to 45 months. There were no operative deaths. Early complications were common. Stomal dilatation resulting in cessation of weight loss or in weight regain occurred in 19 patients (25 percent). Stomal stenosis occurred in four patients. Among patients with an intact gastroplasty, the percentage excess weight decreased from a preoperative mean of 142 +/- 46 percent to 80 +/- 38 percent at 1 year, 68 +/- 30 percent at 2 years, and 83 +/- 45 percent at 3 years. Fewer than 25 percent of the patients weighed less than 50 percent above ideal body weight at 2 or 3 years. In our experience, horizontal gastroplasty was associated with an unacceptably high mechanical failure rate. Using strict criteria, weight loss was generally inadequate at 2 years and not sustained, even in patients with intact gastroplasty. PMID- 3826507 TI - Gastrin and partial gastrectomy in duodenal ulcer patients 25 years postoperatively. AB - Serum gastrin concentrations were measured in 26 patients (Group A) who underwent partial gastrectomy for duodenal ulcer disease at least 25 years previously. The basal serum gastrin level was 31.6 +/- 1.5 pg/ml, increasing significantly after food stimulation to 36.8 +/- 2.4 pg/ml (p less than 0.05). In 16 of these patients (Group B), endoscopic biopsy specimens were taken from the minor and major curvatures of the stomach, from the jejunal part of the gastrojejunostomy, and from the duodenum. Mucosal gastrin concentrations measured were 0, 20.4 +/- 3 ng/g, and 30 +/- 7.1 ng/g, respectively. Ten of these patients (Group C) had a repeated gastroscopy with food stimulation of the duodenal pouch, using a balloon catheter in the lower duodenum. Serum gastrin concentrations after pouch stimulation did not differ significantly compared with basal values. No changes in the mucosal gastrin concentrations during pouch stimulation were seen. In conclusion, since no gastrin could be detected in the gastric mucosa and the mucosal gastrin concentration in the duodenum was 50 times lower than reported in other studies, the gastrin release measured after food stimulation could have been of extragastric or extraduodenal origin. PMID- 3826508 TI - Use of intragastric balloons for weight reduction. An experimental study. AB - The effect of intragastric balloons as a noninvasive method for weight reduction was observed in nine castrated Yorkshire pigs. None of the animals lost weight. The appetites of the experimental animals were inhibited for only a short period of time. A significant dilatation of the stomach after balloon insertion was noted which resulted from increased food intake and obliterated the effect of the intragastric balloons. A long-standing lower blood glucose level played an important role in the increments in food intake and dilatation of the stomach. At the same time, ulceration was seen in 83.3 percent of the animals that received balloons. We conclude that intragastric balloon therapy may not be an effective approach for managing morbid obesity in human subjects. PMID- 3826509 TI - Effect of surgical treatment on stage IV melanoma. AB - One hundred eighty patients with hematogenous metastases from malignant melanoma were reviewed. Complete resection of the gross tumor was technically feasible in 33 percent of the cases. Patients who had complete resection of the gross tumor had an estimated median survival time of 11.4 months and an estimated 5 year survival rate of 14 percent. Patients with solitary lesions removed had a median survival time of 22.8 months and a 5 year survival rate of 23 percent. Patients with distant subcutaneous metastases completely removed had a median survival time of 31.9 months and a 5 year survival rate of 29 percent. Surgical resection of distant metastases, when technically feasible, particularly for solitary lesions and subcutaneous locations, increases the length of survival of patients with disseminated melanoma. PMID- 3826510 TI - An ideal operation for diverticulitis of the colon. AB - A review has been made of the records of 208 patients operated on for complications of diverticulitis of the colon. One hundred forty patients had emergency operations and 68, elective operations. Resection and anastomosis, with or without temporary diverting colostomy, practiced in the majority of emergency cases in the earlier years covered in this review, has been replaced in the past 10 years by resection without anastomosis. Transverse colostomy, first carried out as part of a three-stage procedure, has been partially replaced by descending colostomy in the past few years. A comparison of the findings at exploration in patient who underwent resection, anastomosis, and temporary transverse colostomy with the findings in those who had the Hartmann procedure showed a slightly higher incidence of free perforation or abscess in those who had the former procedure. The hospital stay was similar in the two groups, but time in the operating room and days of disability were much less in the resection group. Only 14 of the 23 patients who survived the Hartmann procedure underwent restoration of continuity, whereas all of those in the resection group did. Follow-up of the patients who had descending colostomy showed that only 6 of 11 surviving patients underwent resection and anastomosis, but that inflammation regularly subsided, and all those with continent sphincters under age 80 eventually had restoration of continuity. This is in contrast to a more than 20 percent incidence of permanent stomas in the transverse colostomy group, all of which were in patients under age 70. PMID- 3826511 TI - Treatment of intestinal ischemia with oxygenated intraluminal perfluorocarbons. AB - Liquid perfluorocarbons are biologically inert compounds capable of dissolving up to 40 percent oxygen by volume. This remarkable and reversible oxygen solubility has encouraged investigations into therapeutic application in situations where tissue oxygen delivery is impaired. One such setting is intestinal ischemia. Identically prepared devascularized segments of rat intestine were treated with either intraluminal oxygenated perfluorocarbon (perfluorotributylamine) or physiologic saline solution. After timed sacrifice, blinded quantitative histologic evaluation for ischemic injury was performed. The perfluorotributylamine treatment groups had histologic scores indicative of less severe injury between 1 and 4 hours. These scores achieved statistical significance (p less than 0.05). We conclude that intraluminal oxygenated perfluorocarbons have a significant protective effect in this model of intestinal ischemia. This quantitative analysis is unique and is an important aspect of the preclinical evaluation of the perfluorocarbon preparations. PMID- 3826512 TI - Effects of nonshunting operations on portal venous pressure and hepatic blood flow. AB - A comparative analysis has been presented of the effect of the nonshunting operation on portal venous pressure and effective hepatic blood flow in patients with liver cirrhosis and idiopathic portal hypertension. A reduction of portal pressure after splenectomy with esophagogastric devascularization in 17 patients with idiopathic portal hypertension was significantly greater than that in 79 patients with liver cirrhosis (-21 +/- 4.1 percent versus -8.9 +/- 1.6 percent, p less than 0.01). Clearance of galactose from the blood, which approximates effective hepatic blood flow, was decreased after the nonshunting operation by 6.7 percent in five patients with liver cirrhosis (p value not significant). On the other hand, there was a 19.4 percent reduction (statistically significant) in galactose clearance in four patients with idiopathic portal hypertension (p less than 0.05). Based on these data, we suggest that in patients with idiopathic portal hypertension, the splenic circuit largely contributes to the portal hypertension, the effective hepatic blood flow, or both. We recommend a nonshunting operation for the treatment of esophageal varices from the hemodynamic viewpoint in cirrhotic patients. PMID- 3826513 TI - Arterial insufficiency in hemodialysis access procedures: reconstruction by an interposition polytetrafluoroethylene graft conduit. AB - The interposition polytetrafluoroethylene graft conduit has found many uses in the armamentarium of the surgeon who performs vascular access for hemodialysis: when resection of aneurysm or pseudoaneurysm is required, or when an extension loop is required, either to simply lengthen the amount of graft or to circumvent an infected segment after resection. Herein, we have presented yet another use for the interposition polytetrafluoroethylene graft conduit, based on physiologically sound principles and a now proved successful outcome, namely as a surgical alternative for the patient with a hemodynamically unstable hemodialysis fistula resulting in arterial insufficiency. Poiseuille's Law regarding flow of liquids through a tube supports the concept on which our interposition graft is based: v = pi X P X R4/8 X 1 X n where v is the volume escaping per second, P the difference of pressure at the ends of the tube, R its radius, l the length of the tube, and n the coefficient of viscosity. Given the maintenance of all other parameters, if one increases the length of the tube through which blood is flowing, the volume of flow through said tube is simultaneously decreased, and the ischemic symptoms caused by arterial insufficiency are thereby ameliorated. PMID- 3826514 TI - Postoperative deep vein thrombosis in the Taiwanese Chinese population. AB - Reports of the incidence of postoperative deep vein thrombosis in the Chinese population of Taiwan are few in the literature. Over a 3 year period, the fibrinogen degradation products test, the pulse volume recorder, and venography were used to study 220 patients undergoing major operations at the Veterans General Hospital in Taipei, Taiwan. Deep vein thrombosis was found in 17 patients (7.7 percent). A comparison of the three diagnostic methods showed that the sensitivities of the fibrinogen degradation products test and the pulse volume recorder were 56.3 percent and 93.7 percent, respectively; the specificities, 97.4 percent and 95.7 percent, respectively; and the accuracies, 85.5 percent and 95.5 percent, respectively. These results support the combined use of the fibrinogen degradation products test and the pulse volume recorder for screening and diagnosing deep vein thrombosis. PMID- 3826515 TI - Modified radical neck dissection. Terminology, technique, and indications. AB - The terminology relating to the various modifications of radical neck dissection is loose and confusing. A simple system of nomenclature has been suggested which allows specification of the node levels dissected and the structures preserved. A technique of modified neck dissection, which excludes dissection of the posterior triangle and spares the sternocleidomastoid muscle and spinal accessory nerve, has been described. We believe this operation is appropriate when local disease is advanced and clinically uninvolved neck nodes are likely to harbor occult metastatic disease, when resection of the primary tumor is through the neck, or when clinical disease in the neck is minimal. Patients with multiple palpable nodes, patients with nodes larger than 3 cm in diameter, patients with disease in the posterior triangle, and patients in whom radiotherapy to the neck has failed may be better served by radical neck dissection. PMID- 3826517 TI - [To think or not to think, that is the question]. PMID- 3826516 TI - A rapid and relatively safer method of sclerosing esophageal varices utilizing a new transparent tube. AB - Over a 20 month period, 348 injection sclerotherapy treatments were performed using the new transparent tube. There was no occurrence of pulmonary complications or esophageal injury. Our experience with both the free-hand and the new tube techniques revealed that the latter provides an easier, safer, and more rapid method of sclerosing esophageal varices. The patients can swallow the new tube with no difficulty after administration of topical anesthesia and light sedation. PMID- 3826518 TI - [Cerebral resuscitation after hanging, in a general hospital]. PMID- 3826519 TI - [Hypoventilation test with pure oxygen after denitrogenation for the diagnosis of cerebral death. A preliminary study]. PMID- 3826520 TI - [Clinic, electrophysiology and x-ray computed tomography study of 10 cases of a chronic vegetative state]. PMID- 3826521 TI - [Can x-ray computed tomography confirm brain death?]. PMID- 3826522 TI - [High-flow intrailiac transfusion in the cadaver and 3 clinical cases from the point of view of the treatment of hypovolemic distress]. PMID- 3826523 TI - [Brain death]. PMID- 3826524 TI - [On the opinion of the National Ethics Committee]. PMID- 3826525 TI - [Chronic vegetative states and human experimentation]. PMID- 3826526 TI - [The holistic factor of the evolution]. PMID- 3826527 TI - The acute effects of some antidepressants on the plasma lipids in normolipidaemic and hyperlipidaemic rats. PMID- 3826528 TI - Changes in the suprarenal function during endotoxin shock. PMID- 3826529 TI - [Cerclage of the cervix uteri under electroacupuncture. Apropos of 39 cases]. PMID- 3826530 TI - [Anesthesia management in organ procurement: a fundamental stage in transplantation]. PMID- 3826531 TI - [Medicolegal obstacles in organ procurement. Effect of legislation in France and Europe]. PMID- 3826532 TI - [Fetal tissue transplantation: medical and ethical aspects]. PMID- 3826533 TI - [Organization of organ procurement: evaluation of 8 years' operation of a receiving center for the brain dead]. PMID- 3826534 TI - [Etiopathogenetic classification of factors involved in the development and growth of breast infections in the puerperium]. PMID- 3826535 TI - [Evaluation of local nonspecific resistance in chronic inflammatory gynecologic diseases]. PMID- 3826536 TI - [Riskogram for postpartum mastitis]. PMID- 3826537 TI - [Preservation of ovarian function during surgical treatment of cancer of the uterine cervix (preliminary report)]. PMID- 3826538 TI - Protecting the sources of admissions to university hospitals. PMID- 3826539 TI - Transporting mothers with fetuses in utero to a level III perinatal center. Report of a clinical experience, 1978-1982. PMID- 3826540 TI - The radiotherapeutic management of early stage Hodgkin's disease. Seventeen years' experience at the University of Alabama at Birmingham. PMID- 3826541 TI - A 35-year-old black woman with hypokalemia and accelerated hypertension. PMID- 3826542 TI - Computed tomographic evaluation of deep cerebral vein thrombosis. PMID- 3826543 TI - Coincidental hyperparathyroidism and cervical carcinoma. PMID- 3826544 TI - Current management of atherosclerotic stroke. PMID- 3826545 TI - Early diagnosis of prostate cancer. PMID- 3826546 TI - New considerations in the treatment of cataracts. PMID- 3826547 TI - Disk herniation. PMID- 3826548 TI - Common foot problems in children. PMID- 3826549 TI - Sleep study on patients with severe brain damage--polysomnographical examination. AB - Polysomnograms were obtained for five severely brain damaged patients, and phasic sleep parameters-body movements (BMs) and rapid eye movements (REMs)-were examined. CT scanning of their brains demonstrated large low density areas in the bilateral hemispheres. In the three patients with flat EEG, sleep could only be classified into two stages; one with REMs[R(+)] and one without REMs[R(-)]. In the other two patients, stage R(-) was further classified into two stages according to the EEG findings. Gross movements (GMs) showed a synchronous pattern in all the patients. GMs and low angle REMs decreased in number while twitch movements and high angle REMs showed almost the same incidences as in normal controls. Localized movements showed marked variations among the patients. It was suggested that, except for normal uncoordinated asymmetrical GMs, BMs did not necessarily require higher brain structures for their generation. PMID- 3826550 TI - Neurophysiological studies in the Leigh syndrome. AB - We performed neurophysiological studies in 12 patients with the Leigh syndrome (6 pathologically confirmed and 6 clinically diagnosed). The results are compared with data derived from a literature survey of 173 Leigh syndrome patients. We found no positive contribution of neurophysiological studies towards the diagnosis of the Leigh syndrome. PMID- 3826551 TI - Acute encephalopathy with hyperammonemia and dicarboxylic aciduria during calcium hopantenate therapy: a patient report. AB - We report a 3-year-old Japanese girl who developed acute encephalopathy while receiving calcium hopantenate (Calcium D-(+)-4-(2, 4-dihydroxy-3,3 dimethylbutyramido) butyrate hemihydrate). She had hyperammonemia, elevated CPK, lactic acidemia and pyruvic acidemia, however, she did not show elevated SGOT or SGPT. Calcium hopantenate has been used in Japan for the treatment of mental retardation with behavior abnormalities. Recently there have been three reports on the occurrence of Reye-like syndrome in patients receiving this drug. Clinical signs and laboratory data of these patients are similar to those of Reye syndrome. Calcium hopantenate causes pantothenic acid deficiency in the young rat, which may reduce the content of coenzyme A. If this drug decreases coenzyme A biosynthesis, it may reduce beta-oxidation of fatty acids and levels of dicarboxylic acids would increase because of increasing omega-oxidation. We suspect that there is a possible relationship between the occurrence of acute encephalopathy and calcium hopantenate therapy. PMID- 3826552 TI - Neuroaxonal dystrophy of neonatal onset with unusual clinicopathological findings. AB - A male infant with neuroaxonal dystrophy of neonatal onset is described. He was hypertonic, and exhibited horizontal nystagmus, occasional tremulous movements of the head and extremities, and an absence of waves III through V on auditory brain stem response examination. An autopsy at age 11 months revealed spheroid formation that was predominant in the cerebellum and brain stem, and dysmyelination that was mainly seen in the white matter of the cerebellum. This is in contrast with most of the previously reported patients of infantile neuroaxonal dystrophy in which these changes were evenly distributed throughout the central, peripheral and autonomic nervous systems. PMID- 3826553 TI - Clinical features in a girl with Duchenne muscular dystrophy with an X-autosome translocation; (X;4)(p21;q26). AB - A female with Duchenne muscular dystrophy (DMD) and an X/4 translocation is reported. Her clinical signs, laboratory data and muscle pathology are compatible with those of typical DMD. She also has a ASD, type II, with some kind of cardiomyopathy. Detailed cytogenetic analyses by means of high resolution banding and R-banding techniques showed that the exchange point was located in band p21 of the X chromosome, suggesting the localization of the DMD gene within it. The clinical course of DMD in a female with an X/autosome translocation is variable, as in the case of heterozygous females, compared with that in male patients. The mild phenotype in female cases with an X/autosome translocation could be explained by the fact that in some cultured cells the normal X chromosomes replicate early and therefore may be active. PMID- 3826554 TI - Muscular alteration in agyria with pyramidal tract anomaly. AB - A 4-year-old boy with a history of muscular hypotonia, mental retardation, microcephaly, and generalized convulsions was found at autopsy to have agyria, agenesis of the anterior commissure and posterior corpus callosum as well as an abnormal decussation of pyramidal tracts which descended in the spinal dorsal columns. Postmortem muscular alterations included type IIc fiber hypertrophy and type I fiber grouping, variably expressed in individual muscles and intramuscular fascicles. This may represent a developmental delay compatible with a gestational age between the 34th and 40th week. These studies also indicate the importance of examining multiple samples of postmortem muscles and muscles from patients afflicted with cerebral malformations. PMID- 3826555 TI - A case of ataxic diplegia, mental retardation, congenital nystagmus and abnormal auditory brain stem responses showing only waves I and II. AB - A three-year-old boy who had ataxic diplegia, mental retardation, horizontal pendular nystagmus with head nodding and abnormal auditory brain stem responses showing only waves I and II was presented. His clinical features coincided with recent reports in the Japanese literature of cases of a new syndrome that is congenital in origin and seen only in boys. PMID- 3826557 TI - [A foreign body in the nasopharynx]. PMID- 3826556 TI - The syndrome of the absence of a septum pellucidum with porencephaly. AB - Two cases of a complex brain malformation including the absence of a septum pellucidum and bilateral porencephaly were reported and compared with Aicardi's cases. The two cases have congenital hemiplegia or double hemiplegia and mental retardation, and one of them has optic atrophy. CT scans revealed the absence of a septum pellucidum and a specific position and shape of the clefts. The syndrome of the absence of a septum pellucidum and porencephaly may represent a specific type of true porencephaly, and the cause must occur before 16 weeks of gestation. PMID- 3826558 TI - [Neurootology and central pathology: a field for the otorhinolaryngologist. Electrooculographic findings]. PMID- 3826559 TI - [Electrooculographic findings in brain stem pathology]. PMID- 3826560 TI - [Electrooculographic findings in cerebellar pathology]. PMID- 3826561 TI - [Unilateral atresia of the choanae]. PMID- 3826562 TI - [Temporo-maxillary arthropathies]. PMID- 3826563 TI - [Ceruminoma of the external auditory canal with invasion of the middle ear. Apropos of a report on a new case]. PMID- 3826564 TI - [Laryngeal papillomatosis]. PMID- 3826566 TI - [The national health system of Mexico. Origins, definitions and advances]. PMID- 3826565 TI - [Cysts of the laryngeal ventricle]. PMID- 3826567 TI - [The Tropical Diseases Research program in the International Year of Peace]. PMID- 3826568 TI - Smoking and anaesthesia. PMID- 3826569 TI - Quality of axillary brachial plexus block. Comparison of success rate using perivascular and nerve stimulator techniques. AB - A perivascular catheter technique (PVT) and a nerve stimulator technique (NST) for axillary brachial plexus block were compared in terms of quality: complete, incomplete or failed blocks. In a randomised series, 30 PVT blocks and 30 NST blocks were performed by three staff anaesthetists. In the NST group, surgical anaesthesia was always achieved, whereas in the PVT group, four blocks required supplementation with general anaesthesia. In both groups eight patients needed supplementation with additional conduction blocks of 1-3 peripheral nerves. It is concluded that a nerve stimulator technique may increase the success rate of axillary brachial plexus block to some extent. PMID- 3826570 TI - Continuous display of plasma potassium during cardiac surgery. AB - We have evaluated the use of an intravascular ion-selective electrode for continuous plasma potassium monitoring in patients during and after cardiac surgery. Potassium estimations from the indwelling electrode provided a rapid and sensitive, but only moderately reliable, indicator of potassium as confirmed by blood samples. Several significant changes in the plasma potassium were found to occur in the period studied and using this continuous monitor, the precise time course of these changes was recorded. PMID- 3826571 TI - The prevalence of serological markers for hepatitis B virus infection amongst anaesthetists in the Oxford region. AB - A total of 125 anaesthetists from nine hospitals within the Oxford region were surveyed to study the prevalence of serological markers for hepatitis B virus (HBV) infection. No anaesthetists were positive for Hepatitis B Surface Antigen (HBsAg) and only four (3.2%) were positive for HBsAg antibody (anti-HBsAg). This result is in marked contrast to other studies and suggests that anaesthetists in the United Kingdom do not constitute a high risk population. The reasons for this are discussed. PMID- 3826572 TI - A prospective study of 200 consecutive twin deliveries. AB - A prospective study of a consecutive series of 200 twin pregnancies has provided some definitive and some tentative conclusions. It has been shown that in any attempt to assess the value of a form of clinical management, cases in which a nuchal cord was present in either twin must be disregarded and that attention must be paid to the techniques of analgesia/anaesthesia provided for delivery. There is a strong suggestion that the provision of an epidural for either Caesarean section or vaginal delivery is markedly beneficial to the second twin. There is also evidence to suggest that when vaginal delivery is conducted under an epidural, the acid-base status of the second twin is very likely to be as good as, or better than, that of its sibling, whereas that is most unlikely to be so among cases delivered without an epidural. Further benefit is conferred upon both twins if the bearing-down reflex is abolished. Attention is drawn to an apparently increasing frequency of abdominal delivery of the second twin following vaginal delivery of the first and to the consequent demand which this must make upon anaesthetic cover. PMID- 3826573 TI - The neuroleptic malignant syndrome. Case report with a review of the literature. AB - Following the administration of fluphenthixol (a depot phenothiazine) for a psychotic illness, a 44-year-old woman developed weakness, rhabdomyolysis and renal failure, together with hyperthermia (42 degrees C) and signs of both autonomic and central nervous system dysfunction. She died following massive intestinal haemorrhage, intra-abdominal sepsis and probable disseminated intravascular coagulation. A diagnosis of neuroleptic malignant syndrome had been made, but treatment with dantrolene sodium was probably instituted too late to prevent the progress of the complications she had developed. This syndrome, which follows the use of phenothiazines or butyrophenones, is rare, potentially fatal and probably underdiagnosed. It has been likened to malignant hyperthermia, but a review of the literature points to many differences. Both dantrolene sodium and dopaminergic drugs (bromocriptine, amantidine and L-dopa) have been shown to be efficacious and their continued use, despite a failure in this case, is advocated until more is known about this syndrome. PMID- 3826574 TI - Anaesthesia in the prune-belly syndrome. A review of 36 cases. AB - Between 1959 and 1984, 36 children with the prune-belly syndrome underwent 133 operations at the Hospital for Sick Children, Great Ormond Street. The anaesthetic and surgical problems have been reviewed. Minor postoperative respiratory tract infections followed eight anaesthetics. Three deaths occurred in the postoperative period. In two of these there were multifactorial causes, not directly related to the prune-belly syndrome. One death was related to the sequelae of the syndrome. Normal doses of muscle relaxants are recommended when intermittent positive pressure ventilation is used during anaesthesia. Monitoring of the patient's respiratory state and active physiotherapy are advisable postoperatively. Analgesics should be used with caution. PMID- 3826575 TI - Insertion of intratracheal stents. Anaesthetic management using high frequency jet ventilation or cardiopulmonary bypass. AB - The case histories of two patients who required the insertion of intratracheal stents are presented. The peroperative anaesthetic management of one case included the use of high frequency jet ventilation of the lungs; in the other case, partial cardiopulmonary bypass was used. The advantages and disadvantages of these two methods are discussed. PMID- 3826576 TI - Flow through intravenous cannulae. AB - The flows through intravenous cannulae, generated using the test described in British Standard 4843, are presented for all the cannulae available in the United Kingdom. These flows are compared to those obtained using clinical apparatus with two different pressure gradients. The implications of these results in selecting suitable intravenous cannulae and the other factors influencing flows through cannulae are discussed. PMID- 3826577 TI - Pethidine compared with meptazinol during labour. A prospective randomised double blind study in 1100 patients. AB - A randomised double-blind comparison of pethidine and meptazinol used as analgesics in labour was carried out in 1,100 consecutive women who would normally have received intramuscular pethidine. Pain assessments at 30-minute intervals were made independently by patients and midwives. Maternal and neonatal side effects were noted. The babies' requirements for resuscitation and weight changes in the first 5 days were studied. There was no difference in the analgesia provided by the two drugs; the pattern of side effects was similar, but the incidence of vomiting was greater following meptazinol administration. The babies in the two groups were similar with respect to resuscitation received, weight gains or losses and the incidence of clinical neonatal jaundice. The most striking findings were the poor quality of pain relief experienced by both groups following parenteral analgesics and the high incidence of side effects. PMID- 3826578 TI - Unexplained hepatitis following halothane. PMID- 3826579 TI - Alternative medicine. PMID- 3826580 TI - Alcuronium, pancuronium and phaeochromocytoma. PMID- 3826581 TI - Blood tests before elective surgery. PMID- 3826582 TI - Difficulties with tracheal suction. PMID- 3826583 TI - Simple device for the assessment of local anaesthetic blocks in children. PMID- 3826584 TI - Haemonetic cell saver. PMID- 3826585 TI - The health of anaesthetists. PMID- 3826586 TI - Morbidity and early retirement among anaesthetists and other specialists. AB - An historically prospective study of the rates of early retirement due to permanent ill health, early retirement between 60 and 64 years of age for other reasons, and deaths while in post, among consultant anaesthetists in England was carried out. The control group comprised consultants in four other hospital specialty groups. Approximately two-thirds of all consultants employed in the five specialties at National Health Service hospitals in England during 1966-83 were included in the study. Ill-health retirements among male anaesthetists were more than twice those expected on the basis of rates in the control group (p less than 0.001). The number of other early retirements between 60 and 64 was a third higher than expected (p less than 0.005). The number of deaths in post was also raised. For the smaller group of female anaesthetists there was not a statistically significant excess of ill-health retirements, but the number of early retirements between 60 and 64 was significantly greater than expected (p less than 0.005), as was the number of deaths in post (p less than 0.001). Possible causes of these excesses are discussed. PMID- 3826587 TI - Lung water during the puerperium. AB - An alteration in pulmonary water balance might be expected during pregnancy and the puerperium, as a result of the physiological adaptations to pregnancy. A preliminary investigation of this hypothesis was conducted using a radiological method of lung water measurement in 20 normal primigravidae during the early puerperium. Evidence of interstitial lung water was found in seven of the 20 mothers. There was a significant correlation with plasma volume (p less than 0.05) and fluid turnover (p less than 0.05) in the group with excess lung water. The implications of increased interstitial lung water and its possible causes during pregnancy are discussed. PMID- 3826588 TI - The effect of pregnancy on pulmonary nitrogen washout. A study of pre oxygenation. AB - Pre-oxygenation times were studied in 30 fit pregnant women during the course of their pregnancy. The mothers were studied in the supine position with a left lateral tilt and breathing through a standard Magill system with an oxygen flow rate of 8 litres/minute. Between 13-26 weeks gestation and 26-42 weeks the times needed to achieve an end-tidal nitrogen of 2% were 104 seconds (SD 30) and 80 seconds (SD 20), respectively. A control group of young women of similar age and weight needed 130 seconds (SD 30) to achieve the same end-tidal nitrogen concentration. A gas-tight mask was found to be essential to achieve effective denitrogenation (end-tidal nitrogen concentration of 2%). PMID- 3826589 TI - A new percutaneous infraclavicular approach to the axillary vein. AB - A new percutaneous infraclavicular approach for cannulating the axillary vein is described. The technique was devised using surface landmarks established by cadaver dissection. This is a relatively safe procedure with no risk of pneumothorax, provided that the tip of the needle remains inferior to the clavicle. PMID- 3826590 TI - Speed of injection and spread of bupivacaine in the epidural space. AB - Speed of injection of bupivacaine was assessed in 73 women who received epidural analgesia in labour. Rapid injection was shown to produce quicker onset of epidural block and more reliable perineal anaesthesia than slow injection, but there was no difference in the final extent of the block. PMID- 3826591 TI - Respiratory depression after intrathecal opioids. Report of a patient receiving long-term epidural opioid therapy. AB - Morphine 20 mg and pethidine 50 mg were accidentally injected intrathecally in a patient who had received large doses of opioids epidurally for cancer pain and who had shown tolerance to their effects. The well established tolerance to spinal opioids did not protect the patient against a moderate degree of respiratory depression. Morphine concentrations 6.5 hours after the morphine injection were 103,500 ng/ml and 52 ng/ml in cerebrospinal fluid and serum, respectively. PMID- 3826592 TI - Unilateral pulmonary oedema/atelectasis in the lateral decubitus position. AB - An obese male patient developed hypoxia, hyercarbia and radiological signs of pulmonary oedema/atelectasis in the dependent lung after surgery in the lateral decubitus position. This appears to have been due to ventilation-perfusion mismatch, although other factors were considered. The patient recovered following 36 hours of intermittent positive pressure ventilation of the lungs. PMID- 3826593 TI - Oxygen analysers. An evaluation of five fuel cell models. AB - Five currently available fuel cell oxygen analysers were studied with a view to their use in anaesthesia. The accuracy, response time and safety features of these analysers are discussed. Fuel cell analysers appear to be suitable oxygen monitors for routine anaesthetic use. PMID- 3826594 TI - The severance of epidural catheters. AB - Four groups of Portex Minipack epidural sets were tested to measure the force required to sever the catheter on the needle bevel. The 18-gauge radio-opaque catheter was found to sever at a significantly lower applied force and to stretch significantly less before breaking than the 18-gauge clear catheter or either of the 16-gauge catheters. The other catheters tested had breaking strains of between 10-20 Newtons (1-2 kg force) and stretched by more than 30% of their lengths before breaking. It is suggested that these other catheters may therefore be a preferable alternative to the 18-gauge radio-opaque. PMID- 3826595 TI - Explosive anaesthetic agents. A regional survey on the use of ether and cyclopropane. AB - A total of 156 consultant anaesthetists in the North East Thames Regional Health Authority were circulated with a questionnaire on their personal use of ether and cyclopropane and their attitudes towards restriction or withdrawal of these agents: 144 completed questionnaires were received (92% response). Four anaesthetists (3%) claimed to use ether regularly at least once a month and 27 anaesthetists (19%) felt that their anaesthetic practice would suffer if ether were withdrawn. Cyclopropane had 62 regular users (43%) and 65 anaesthetists (45%) felt that their practice would suffer if it were withdrawn. Ninety-two anaesthetists (64%) were prepared to confine their use of explosive agents to either the anaesthetic room or the operating room; of these, three-quarters favoured the anaesthetic room. There were few notable differences in the pattern of use of explosive agents between anaesthetists with more than 21 years in the specialty and those with less than 21 years. PMID- 3826596 TI - Evoked potentials following diazepam or fentanyl. AB - The effects of fentanyl or diazepam on somatosensory, visual and brainstem auditory evoked potentials were studied in 13 healthy patients scheduled for elective surgery. Following control recordings of evoked potentials, either diazepam 20 mg or fentanyl 200 micrograms was administered intravenously. Evoked potentials were then recorded twice in the subsequent hour. No significant changes occurred in the latency or amplitude of somatosensory, visual or brainstem auditory evoked potentials. Although dose-related changes in evoked potential latencies and amplitudes have been demonstrated with both the inhalational and intravenous anaesthetics, these changes did not occur with diazepam or fentanyl used alone. An anaesthetic technique based on these two drugs would be suitable when intra-operative evoked potential monitoring is required to assess ischaemia and preservation of evoked responses. PMID- 3826597 TI - Postoperative headache in young patients after spinal anaesthesia. AB - Spinal anaesthesia was performed on 247 young adult patients with a 25-G needle. Rectal administration of indomethacin had no significant effect on the incidence of postdural puncture headache, which occurred in 16.8% of patients who received the drug compared to 24.5% who received a placebo. A history of headache pre operatively did not influence the incidence of postlumbar puncture headache. PMID- 3826598 TI - Alcohol vapour and the Normac analyser. PMID- 3826599 TI - A difficult nasal intubation. PMID- 3826600 TI - Nitrous oxide in early pregnancy. PMID- 3826601 TI - Pyrexia associated with a retroperitoneal tumour. PMID- 3826602 TI - Broken control on a Selectatec vaporizer. PMID- 3826603 TI - Minitracheostomy. PMID- 3826604 TI - Transvenous misplacement and loop formation of spring guide wire. PMID- 3826605 TI - Pleural aspiration with a central venous catheter. PMID- 3826606 TI - Primary amyloidosis and skin damage. PMID- 3826607 TI - Difficulty in extubation. PMID- 3826608 TI - [What significance is undefined malignant hyperthermia-sensitivity for the doctor and patient?]. PMID- 3826609 TI - [Gamma-aminobutyric acid concentrations in the plasma in unconscious patients with severe craniocerebral trauma or nontraumatic intracranial hemorrhage]. AB - The detection of cerebral lesions by chemical laboratory studies has not as yet been possible. Tests were carried out to determine whether there was an increase in plasma concentration of the neurotransmitter gamma-aminobutyric acid (GABA) in 12 unconscious patients: 6 with severe craniocerebral trauma (CCT) and 6 with spontaneous intracranial hemorrhage. Normal plasma concentrations were detected in the central venous blood of patients with severe CCT (normal range 366 +/- 123 pmol/ml); in patients with intracranial hemorrhage the values were partially elevated. Maximal values in arterial blood were around 613 pmol/ml (patients with CCT) and 1723 pmol/ml (patients with spontaneous intracranial hemorrhage). The influence of fluid turnover on plasma GABA concentrations is discussed. PMID- 3826610 TI - [Problems in laser surgery and anesthesia]. AB - Accidental thermal damage in case of explosion and fire caused by laser-surgery is a well-known problem and still not solved. A combination of laser beam, oxygen and inflammable substances are only one aspect. A main problem is the venturi effect resulting from artificial ventilation under anaesthesia. An incidental observation during one case of endotracheal tube-fire led to some fundamental considerations. With a modified PEEP-ventilation hazard can not be prevented, but limited in its complications. PMID- 3826611 TI - [Postoperative hyperthermic syndrome with a questionable relationship to malignant hyperthermia and the need for elucidating susceptibility]. AB - Following anaesthesia with halothane and succinylcholine, a 56-year-old patient relapsed into unconsciousness which was accompanied by an increase of body temperature to 42 degrees C and further symptoms indicative of malignant hyperpyrexia (MH). Although a diagnosis of MH could not be established, during subsequent anaesthesia, the patient was treated as an individual susceptible to MH. The problems of this policy and the need to elucidate the susceptibility to MH are discussed with reference to this case. PMID- 3826612 TI - [Limits of obligation in the medical treatment of severely damaged newborn infants. Recommendations of the German Society for Legal Medicine proposed at the 1st Einbecker Experts conference, 27-29 June, 1986]. PMID- 3826613 TI - The measurement of xylulose 5-phosphate, ribulose 5-phosphate, and combined sedoheptulose 7-phosphate and ribose 5-phosphate in liver tissue. AB - A modification of the method of Kauffman et al. (F. C. Kauffman, J. G. Brown, J. V. Passonneau, and O. H. Lowry (1969) J. Biol. Chem. 244, 3647-3653) for the spectrophotometric determination of xylulose 5-phosphate, ribulose 5-phosphate, and combined ribose 5-phosphate and sedoheptulose 7-phosphate in tissue extract is presented. Using commercially available enzymes all three assays come to a clear endpoint with the assays described. Values for these metabolites in liver in three dietary states are reported; 48 h starved, ad libitum feeding of standard NIH rat ration, and meal feeding of a fat-free diet. Xylulose 5 phosphate values were 3.8 +/- 0.3, 8.6 +/- 0.3, and 66.3 +/- 8.3 nmol/g. Ribulose 5-phosphate values were 3.4 +/- 0.3, 5.8 +/- 0.2, and 37.1 +/- 5.3 nmol/g. Combined ribose 5-phosphate and sedoheptulose 7-phosphate were 29.3 +/- 0.3, 38.2 +/- 1.2, and 108.2 +/- 14.5 nmol/g. The ratio of measured tissue content of [xylulose 5-phosphate]/[ribulose 5-phosphate] was found to be 1.12 +/- 0.07 in starved animals, 1.48 +/- 0.04 in ad libitum fed animals and 1.78 +/- 0.03 in low fat meal fed animals. These data are in good agreement with the range of equilibrium constants reported for this reaction, suggesting that the ribulose 5 phosphate 3-epimerase reaction (EC 5.1.3.1) is a near equilibrium reaction despite a more than 10-fold change in the tissue content of these metabolites. PMID- 3826614 TI - Interference of melanin in protein determination. AB - Using several assay methods, synthetic eumelanin prepared by autooxidation of L beta-(3,4-dihydroxyphenyl)alanine and a natural melanin isolated from dog hair melanosomes were tested in model experiments to assess their possible interference in protein determination. The degree of interference was assessed by comparing the data obtained with the melanin samples with those derived from measurements of bovine serum albumin. In the common biuret and Lowry methods melanin interferes by falsely increasing the values obtained; the addition of Folin reagent only after melanin removal, as suggested by Doezema, decreased but did not eliminate melanin interference. Methods working at acid pH such as those according to Salo and Honkavaara with Ponceau S or Sedmak and Grossberg or Spector using Coomassie blue G-250 proved much better. Although melanins adsorbed a small amount of dye from the reaction systems in these procedures, their sensitivity to proteins makes the melanin interference negligible. Such procedures can therefore be recommended for protein determination in the presence of melanin. PMID- 3826615 TI - Isolation of choline and choline esters from Krebs-Ringer solution for gas chromatographic determination. AB - A simple and efficient novel method for isolating picomole amounts of choline and choline esters in milliliter volumes of Krebs-Ringer solution has been developed. The procedure is based on the observation that the solubility of choline esters in acetonitrile is 10(4)-10(5) times higher than that of the inorganic salt constituents of Krebs-Ringer solution. The glucose content of the medium, which prevented the one-step isolation of choline esters based on acetonitrile extraction from its lyophilizate, was removed using Amberlite CG-50 column chromatography. Bound compounds to the column were eluted in 0.25 N HCl and lyophilized. The lyophilizate was extracted with acetonitrile, which was then decanted and eliminated by evaporation to dryness. The resultant glucose and salt free residue can be assayed by gas chromatography. Total recoveries of added choline and choline esters over the entire isolation procedure, measured isotopically and/or gas chromatographically, were 93 and 97%, respectively. Due to the high and close-to-equal recoveries of choline esters, and the high purity of the final product, this procedure is suitable for estimating acetylcholine and choline in neural tissue perfusates by gas chromatography, as was demonstrated by this method using hippocampal slices. PMID- 3826616 TI - Selection of chemical spacers to improve isoelectric focusing resolving power: implications for use in two-dimensional electrophoresis. AB - Presented here is a straightforward and inexpensive method for expanding isoelectric focusing pH gradients relative to the gradients that are formed by commercially available narrow range ampholytes. This method requires no special equipment or techniques and is applicable to isoelectric focusing in acrylamide gels, in Sephadex, and in agarose. The utility of separators in improving the resolving power of two-dimensional polyacrylamide gel electrophoresis is demonstrated using proteins from the exocytotic trichocyst organelle of Paramecium tetraurelia. The mode of action of separators is briefly described. PMID- 3826617 TI - Isolation and purification of angiotensin II using affinity and high-pressure liquid chromatography. AB - Peptides have been found in a variety of tissues including brain. To purify the peptide angiotensin II, a three-step method for the isolation and purification has been developed using extraction, affinity chromatography, and high-pressure liquid chromatography. Angiotensin II antiserum purified by affinity chromatography was covalently coupled to Affi-gel 10 (Affi-gel 10-AB). The efficiency and usefulness of this column for the purification of angiotensin II from biological sources were tested with 125I- and 3H-labeled (Ile5)-angiotensin II added to rat brains prior to extraction. After extraction, the recoveries for both peptides were 74 and 75%, respectively. Recovery after the purification on Affi-gel 10-AB was 84 and 82%. Thirty-two percent of the radioactivity was not retained and 50% of the radioactivity could be eluted with 0.1 M Na citrate buffer containing 1 M NaCl using a stepwise pH gradient. Characterization by HPLC of the unretained radioactivity from the Affi-gel 10-AB column showed one peak for [125I]angiotensin II, coeluting with the [125I]angiotensin II standard and two minor peaks. Only 30% of unretained [3H]angiotensin II could be identified as intact [3H]angiotensin II on HPLC. Both [125I]angiotensin II and [3H]angiotensin II elutable at pH 5.0 and 4.0 on Affi-gel 10-AB could be demonstrated as highly purified [125I]angiotensin II and [3H]angiotensin II on HPLC with a purity of more than 90%. On HPLC, the recovery was 81% for [125I]angiotensin II and 99% for [3H]angiotensin II. The recovery for the entire three-step procedure was about 60%. The loading capacity of the Affi-gel 10-AB column for (Ile5)-angiotensin II was 550 ng.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826618 TI - Automated microanalysis of adenosine phosphates, phosphocreatine, creatine, and lactate in muscle. AB - An automated enzymatic procedure suitable for determination of ATP, ADP, AMP, phosphocreatine, creatine, and lactate in needle biopsies of human skeletal muscle (ca. 30 mg dry wt) using a fast centrifugal analyzer (Multistat III, Instrumentation Laboratory Inc.) is presented. Coefficients of variation ranged from 0.7 to 4.2% for multiple determinations of ATP, ADP, phosphocreatine, and creatine; from 6 to 24% for lactate; and from 9 to 20% for AMP. The procedure should be usable, with appropriate modification, with other tissues and with other fast centrifugal analyzers. Muscle samples are collected into liquid freon, lyophilized, and extracted with 600 microliter of 0.65 M perchloric acid. Neutralized supernatants can be stored for up to 3 years at -80 degrees C with no significant deterioration. The procedure takes much less time than similar manual procedures and gives better reproducibility, particularly for ADP and AMP. PMID- 3826619 TI - Alkaline phosphatase conjugated protein A as a sensitive reagent to immunoscreen an expression cDNA plasmid library: isolation of cDNA to the calcium-binding protein of the chick embryonic chorioallantoic membrane. AB - A highly efficient immunoscreening procedure has been developed to isolate cDNA clones to the calcium-binding protein (CaBP) of the chick embryonic chorioallantoic membrane (CAM). A library of total CAM cDNA was constructed using the expression plasmid vector, pUC 19. Bacterial clones containing plasmids with CaBP cDNA inserts were detected immunohistochemically based on their expression of hybrid CaBP protein sequences. For immunodetection, nitrocellulose bacterial colony replicas were treated with specific antibodies to the CaBP followed by incubation with Staphylococcus aureus Protein A conjugated with alkaline phosphatase (AP) which served as a secondary immunoreagent. Positive clones were then histochemically identified based on AP enzyme activity. The identity of the immunopositive clones was further verified by in vitro translation of mRNA selected by hybridization to the cloned cDNA. The AP-based immunoscreening procedure yields stable reaction products with relatively low background, and should find general application for isolating specific cDNA clones from expression cDNA libraries. PMID- 3826620 TI - Fluorescence-based assay of estrogen receptor using 12-oxo-9(11)-dehydroestradiol 17 beta. AB - 12-Oxo-9(11)-dehydroestradiol-17 beta (12-oxo-E2) was used to assay estrogen receptor binding in uterine cytosol preparations by an indirect fluorescence assay. In alkaline solution, 12-oxo-E2 has a fluorescence excitation maximum at 402 nm (epsilon = 24,000) and an emission maximum at 480 nm (phi f = 0.57), and its fluorescence can be observed down to 5 X 10(-11) M. The minimum detection limit of 12-oxo-E2 is 25 fmol by spectrofluorometry and 5 fmol by HPLC fluorometry. Although this compound is not appreciably fluorescent at neutral pH (i.e., at conditions under which it binds to the estrogen receptor), receptor binding by fluorometry can be measured indirectly: After equilibration of 12-oxo E2 with the receptor preparation and removal of excess free ligand, the receptor 12-oxo-E2 complex is disrupted, and fluorescence measurements are made on the dissociated 12-oxo-E2 in alkaline medium. This fluorometric assay was validated quantitatively by performing simultaneously, on the same receptor preparation, radiometric and fluorometric assays with [3H]E2 and [3H]-12-oxo-E2. The radiometric determinations with both compounds gave nearly equivalent estimates of receptor site concentrations, but the fluorometric estimate of binding site concentration was somewhat less (70-85%) than that expected on the basis of the [3H]E2 radiometric assay. The use of 12-oxo-E2 in an indirect spectro- or HPLC fluorometric assay provides a means for assaying estrogen receptor concentrations by fluorescence with a sensitivity approaching that of radiometric techniques. PMID- 3826621 TI - Isoelectric focusing of proteins in rewetted ultrathin polyacrylamide gel layers. AB - Ultrathin layers of polyacrylamide gel bound to glass can be washed, air-dried, and stored for at least 1 year before rewetting in ampholyte solutions for isoelectric focusing. Short-term drying affects neither fluorescent banding of the ampholytes (not evident in conventional gels) nor resolution of complex protein mixtures while prolonged storage seems to have no deleterious effects. Layers are fully functional after soaking for 10 min in solutions that may contain 8 M urea and 10% sorbitol. Rewetting allows the rapid survey of different ampholytes, gradient stabilizers, separator compounds, or protein reagents and is adaptable to concentration modification of the pH gradient (alone or with a gel overlay), to focusing in a transverse urea gradient, and to electrophoresis across a preformed pH gradient. The procedure avoids protein modification by residual polymerizing reagents while adding to the convenience and economy of using ultrathin layers in relatively small formats. PMID- 3826622 TI - Comparison of five techniques for the determination of protein content in mixed human saliva. AB - This study was conducted to assess the relative accuracy of five different assay techniques for the determination of protein concentration in human mixed saliva. The protein concentration of paraffin-stimulated saliva from 20 individuals was determined using the biuret reaction, the Lowry assay, a modified Lowry technique using bicinchoninic acid, and two dye-binding assays. Using bovine serum albumin as the standard, mean values ranged from 0.67 to 2.37 mg/ml. The use of bovine serum albumin, trypsinogen, lysozyme, bovine pancreatic ribonuclease, and poly-L lysine as standards with the five different assay techniques to measure protein concentration of pooled mixed saliva from the above subjects produced results ranging from 0.74 to 65.5 mg/ml. The protein concentration obtained for this saliva sample by amino acid analysis was consistent with the value obtained for the biuret reaction using any of the five different standard proteins. Thus, the protein concentration obtained for human saliva depends upon both the technique used and the protein standard. PMID- 3826623 TI - A set of procedures for resolving purine compounds by reversed-phase high performance liquid chromatography: application to the study of purine nucleotide and nucleic acid metabolism. AB - A set of simple procedures for the separation of major purine 5'-ribonucleotides including diguanosine polyphosphates, purine and pyrimidine bases, and 2'- and 3' nucleotide monophosphates using reversed-phase high-performance liquid chromatography and isocratic elution study of purine nucleotide and nucleic acid biosynthesis in Artemia is presented. PMID- 3826624 TI - Investigation of the competition of two ligands for the same binding sites on a protein. AB - The authors describe an experimentally simple method for investigating the competition of two ligands for the same binding sites on a protein. The free and bound concentrations of one ligand are modified by the presence of the other; binding isotherms are therefore deformed. The authors present a theoretical study based on the analysis of these isotherms obtained with different known concentrations of the competing ligand. It is shown that deformation of the isotherms can be used to obtain the affinity constant of the competitor. The method was applied to competition between different ligands for the binding sites of testosterone-estradiol-binding globulin, a serum protein specific for the transport of steroid hormones as essential as testosterone and estradiol. PMID- 3826625 TI - Rapid purification of Bordetella pertussis toxin by alternating affinity and hydrophobic chromatography. AB - Pertussis toxin was purified to homogeneity from a 2-day culture supernatant of Bordetella pertussis by stepwise elution from three columns of, consecutively, Blue Sepharose, phenyl Sepharose, and hydroxyapatite. The toxin was eluted from Blue Sepharose and hydroxyapatite by high ionic strength and from phenyl Sepharose with low ionic strength and with 17% glycerol. Toxin fractions from one chromatographic column were immediately charged on the next column, saving laborious and time-consuming concentration or dialysis steps. Based on peptide composition (after sodium dodecyl sulfate-polyacrylamide gel electrophoresis) and on HPLC profile (under nondenaturing conditions), the toxin was already practically pure after two steps, the third hydroxyapatite column serving only to separate the whole native toxin from any free S1 subunit. Recovery was estimated from the capacity of the preactivated toxin (and any preexisting free S1 subunit) to catalyze the ADP-ribosylation of the guanine nucleotide binding protein Ni in rat pancreatic plasma membranes: of the total capacity initially present in the culture medium, 23% could be recovered as pure native toxin with the present procedure. Besides, the nondenaturing HPLC method used to check the purity of the native toxin appeared to be superior to classical acidic polyacrylamide gel electrophoresis. PMID- 3826626 TI - Determination of trace amounts of organic and inorganic mercury in biological materials by graphite furnace atomic absorption spectrometry and organic mercury speciation by gas chromatography. PMID- 3826627 TI - Performance of a Hadamard transform photothermal deflection imager with continuous wave laser illumination. PMID- 3826628 TI - Computer-based mass measurement of fragment ion spectra from tandem magnetic sector mass spectrometers with an electrically floated collision cell. PMID- 3826629 TI - Laser-desorption Fourier transform mass spectra of polysaccharides. PMID- 3826630 TI - Physiologically relevant pseudophase high-performance liquid-liquid chromatography. PMID- 3826631 TI - Comparison of the pulsed amperometric detection of carbohydrates at gold and platinum electrodes for flow injection and liquid chromatographic systems. PMID- 3826632 TI - Fractionating power in programmed field-flow fractionation: exponential sedimentation field decay. PMID- 3826633 TI - Photoelectrochemical detection of benzaldehyde in foodstuffs. PMID- 3826634 TI - Sampling of airborne aromatic amines. PMID- 3826635 TI - Gas chromatographic-mass spectrometric analysis of creosotes extracted from wooden sleepers installed in playgrounds. PMID- 3826636 TI - Ion mobility spectrometry after supercritical fluid chromatography. PMID- 3826637 TI - Ion-selective electrode for the determination of metoclopramide. PMID- 3826638 TI - Liquid membrane electrode for the direct determination of ephedrine in pharmaceutical preparations. PMID- 3826639 TI - Decomposition and stability studies of methylmercury in water using cold vapour atomic absorption spectrometry. PMID- 3826640 TI - Rapid atomic spectrometric determination of sodium, potassium, calcium and magnesium in powdered milk by direct dispersion. PMID- 3826641 TI - Oxidimetric determination of amino acids and their metal complexes with organic monochloramines. PMID- 3826642 TI - [Dimensional behavior of enamel prisms in various depths and regions of the enamel of human permanent teeth]. AB - Different regions of broken enamel of human permanent teeth are observed by means of a scanning electron microscope. The diameter of the prisms must be considered as constant from the dentino-enamel junction up to the enamel surface. PMID- 3826643 TI - [Anatomo-microscopic study of the walls of the superior cerebral veins]. AB - The authors studied the structure and disposition of the tissue components of the tunicae of the superior cerebral veins at the levels of the subdural space and of the superior sagittal sinus. It was observed that, at the level of the transition vein-sinus, the tunica adventitia is formed by numerous and voluminous fascicles of collagenic fibers and thin elastic fibers, which describe system spirals more opened distant to the superior sagittal sinus. The tunica intima of these vascular segments exhibits an endothelium resting on a network of elastic fibers, which may play the role of an internal elastic lamina. From the lateral, superior and inferior walls of the sinus, there originates a connective system whose fascicles of collagenic and elastic fibers incorporated to the vascular walls after describing a stretch in spiral around the vascular lumen. The authors admit that this dispositive connective collagenic-elastic, more the presence of the septums fibrous of the venous walls, give to the superior cerebral veins one property of the lengthening and of the shortening of the walls, in order to regulate the blood debit to the sinus. Also, ist was noted that, at the level of the subdural space, vascular walls exhibits a fibrous structure similar to that of the sinus, and are fixed to the interne face of the cranial dura-mater, to the lateral wall of the sinus and to the falx cerebri. These adherences contribute to preserve the integrity of the walls and even of the resistance during the elevation of the venous pression, preventing to the collapsus of these veins. PMID- 3826644 TI - [Craniofacial growth modified by blood supply. 2. Changes in arterial cross sections and arterial blood supply]. AB - The cross sectional areas of arteries were calculated from their measured thicknesses. The monthly increase in size of the cross sectional area of the aorta is higher in both the controls and the operated animals between the 6th week and 4th month of life than during the subsequent period. The rate at which the cross sectional area of the aorta increased in operated animals was about twice that observed in the controls. The left common carotid artery increased its cross section in the operated animals most rapidly up to the fourth month. The cross sectional areas of all anastomoses increased five-fold by the 12th month of life. The quantities of blood flowing correlated closely with the angiometric values. PMID- 3826645 TI - Localization of frothy fluid-producing region in the cloaca of male turkey. AB - The region which produce a frothy fluid in the cloaca of male turkey was investigated macro- and microscopically. 2 kinds of tissues were recognized in the cloacal region: special tissue at the vicinity of the papilla of the ductus deferens (TVP) in the ventral cloaca and the triangular fold (TF), i.e., Glandula proctodealis dorsalis in the median-dorsal wall of the cloaca. TVP ejected a lymph-like fluid and TF produced a foam in the course of the mounting behavior which were added to the ductus deferens semen during natural mating. PMID- 3826646 TI - [Growth in length of the bearded seal (Erignathus barbatus, Erxleben 1777) following Benjaminsen (1973) data]. AB - Length data for almost 200 bearded seals around Svalbard and in the Barents Sea gained in 1968 and 1970 by Benjaminsen are taken as a basis for mathematical considerations. Age has been deduced from annual bandings of teeth in the upper jaw and in the claws. In the original treatment a curve for length growth has been drawn by eye despite severe scattering of the basic data. The mathematical methods now available allow approximations by growth functions and lead to a surprising agreement for 5 functions of quite different structure. Tables and graphs are added for the development of length growth and increase respectively. PMID- 3826647 TI - Lack of effect of compound 48/80 on human umbilical vein endothelium. AB - Human umbilical veins have been treated with compound 48/80, a histamine liberator factor, in order to obtain information about the histamine content in the Weibel-Palade bodies. Ultrastructural observations show a lack of effect in the morphology of this organelle. Our findings suggest that the Weibel-Palade bodies are not histamine storage organelles in human umbilical vein. PMID- 3826648 TI - Development of visual projections in the marsupial, Setonix brachyurus. AB - Retinal projections to the primary visual centres were studied following injection of tritiated proline into one eye in the Marsupial, Setonix brachyurus between 10 and 100 days postnatal and in adults. Initially, projections from the two eyes overlapped extensively, particularly between 20 and 50 days. There was a gradual refinement thereafter, including a segregation of inputs from the two eyes within both the lateral geniculate nucleus (LGN) and superior colliculus (SC) by 70 days. Such refinement in visual centres is discussed in relation to the concurrent emergence of retinal ganglion cell density gradients, a decrease in ganglion cell numbers, cell death in the ganglion cell layer and loss of optic axonal profiles. PMID- 3826649 TI - Distribution of capillaries in relation to the life cycle of odontoblasts in the rat incisor. The fate of the pulp at the incisal end. AB - Although the rat incisor is used widely in the study of dentinogenesis there is little information on the pulp capillaries and the fate of the pulp contents incisally. The capillaries have now been described in relation to the life cycle of the odontoblasts using light microscopy on perfusion fixed teeth and SEM on pulp vascular casts. Odontoblast precursors differentiated to preodontoblasts in the absence of local vessels. Capillaries entered the zone subjacent to preodontoblasts prior to their transformation to odontoblasts. They invaded the odontoblast layer after formation of odontoblast processes and during lengthening of their cell bodies. These capillaries formed a dense plexus which was separated from the predentine by about 10 micron thickness of odontoblast cytoplasm. Electron microscopy near the incisal end showed that the odontoblasts lost their processes and their polarity to form postodontoblasts. This coincided with the deposition of atubular collagenous tissue at the periphery of the pulp. Loss of fenestrations in the capillaries seemed to coincide with the diminution of odontoblast function. Odontoblastic capillaries were lost before the postodontoblasts became separated from one another. There was evidence of degenerating vessels, cells and extracellular debris near the incisal end. Light and transmission electron microscopical evidence from demineralised teeth was correlated with SEM evidence from anorganically prepared specimens and considered in relation to dynamic events at the incisal surface. Thus the pulp closure region was found to include a central zone of mineralised, moribund pulp cells and debris surrounded by atubular tissue. PMID- 3826650 TI - Anatomy of the veins of the dorsum pedis with regard to their suitability as vascular grafts in reconstructive microsurgery. AB - Attempts to locate veins suitable as micro-surgical vascular grafts were carried out in 16 preparations of the subcutaneous venous network of the dorsum pedis. For this reason the length, diameter, valve distances and frequency of longitudinal veins were especially examined. Four types of veins were defined as being suitable for transplantation and it was established that they are situated in the medial half of the dorsum pedis in the so-called microsurgical area in all cases. Collecting and conducting veins can be distinguished by means of the location of the valves, which are generally bicuspidal. In most cases, the level of the opening spaces of both the segment and the opening valves lies parallel to the surface of the skin. PMID- 3826651 TI - The development of the human brain and the closure of the rostral neuropore at stage 11. AB - Twenty embryos of stage 11 (24 days) were studied in detail and graphic reconstructions of twelve of them were prepared. The characteristic feature of this stage is 13-20 pairs of somites. The notochord sensu stricto appears first during this stage, and its rostral and caudal parts differ in origin. Rostrally, the notochordal plate is being transformed into the notochord in a caudorostral direction. The caudal part, however, arises from the axial condensation in the caudal eminence in a rostrocaudal direction. The caudal eminence (or end bud) represents the former primitive streak. The somites are increasing in number at a mean rate of 6.6 h per pair. The rostral neuropore closes towards the end of stage 11. The closure is basically bidirectional, being more rapid in the roof region and producing the embryonic lamina terminalis and future commissural plate in the basal region. The caudal neuropore is constantly open. The brain comprises telencephalon medium (represented by the embryonic lamina terminalis) and a series of neuromeres: 2 for the forebrain (D1 and D2), 1 for the midbrain, and 6 7 for the hindbrain (RhA-C; RhD is not clearly delineated). The forebrain still occupies a small proportion of the total brain, whereas the spinal part of the neural tube is lengthening rapidly. Some occlusion of the lumen of the neural tube was noted in 4 embryos, all of which had an open rostral neuropore. Hence there is at present no evidence that occlusion plays a role in expansion of the human brain. The marginal (primordial plexiform) layer is appearing, particularly in rhombomere D and in the spinal portion of the neural tube. The neural crest is still forming from both the (open) neural groove and the (closed) neural tube, and exclusively from both neural (including optic) and (mainly) otic ectoderm. The optic sulcus is now prominent, and its wall becomes transformed into the optic vesicle towards the end of stage 11. At this time also, an optic sheath derived from mesencephalic crest and optic crest is present. The mitotic figures of the optic neural crest are exceptional in being situated in the external part of the neural epithelium. The otic pit is becoming deeper, and its wall is giving rise to neural crest that is partly added to the faciovestibulocochlear ganglion and partly forms an otic sheath. The nasal plate does not yet give off neural crest. PMID- 3826652 TI - Somitomeres in the chick tail bud: an SEM study. AB - In the chick embryo the final number of somites is achieved at about stage 22 of Hamburger and Hamilton. By this time the neural tube and notochord have reached the tip of the tail bud but some paraxial mesoderm remains unsegmented. In this study using scanning electron microscopy we show that somitomeres are present in this mesoderm. This indicates that the terminal paraxial mesoderm of the tail bud may have the potential to form supplementary somites, though we do not as yet know what prohibits the completion of segmentation to the tip. PMID- 3826653 TI - An electron microscope study of vagus nerve composition in the ferret. AB - The total number of axons in the cervical and abdominal vagus nerves of the ferret was counted. The ratio of myelinated to non-myelinated, and afferent to efferent axons was determined. The fibre diameter spectrum of myelinated axons was measured. The total number of axons in the ferret cervical vagus is similar to other mammals (approximately 28,000); the majority of axons are afferent (approx. 24,000) and also the majority of axons are nonmyelinated (approx. 27,000). The dorsal abdominal trunk is about twice the size of the ventral trunk although both trunks have the same number of efferent axons. The abdominal vagal trunks are over 90% afferent. PMID- 3826654 TI - Two modes of free migration of amacrine cell neuroblasts in the chick retina. AB - The migration of amacrine neuroblasts toward the prospective amacrine cell layer in the chick embryo retina has been studied, in Golgi-stained sections, between days 5 and 9 of embryogenesis. Two distinct populations of presumptive amacrine neuroblasts have been identified on the basis of their shape and migratory behavior. One population (smooth amacrine neuroblasts) display smooth, monopolar or bipolar contours, moving freely across the retina without major changes in the original postmitotic shape, and give processes only after reaching the primitive inner plexiform layer. The second population (multipodial amacrine neuroblasts) includes multipolar neuroblasts with abundant filiform and/or lamelliform processes sprouting in various directions; these highly plastic cells begin modifying their shapes at the time of release from the ventricular lining and continue to do so as they move toward their definitive location. Thus, the well known heterogeneity of adult amacrine cells seems to be preluded by differences in neuroblastic migratory patterns, suggesting the existence of at least two different subsets of amacrine cell precursors. PMID- 3826655 TI - Nerve fibres and their terminals of the dura mater encephali of the rat. AB - The dura mater encephali of the rat is richly supplied by myelinated (A-axons) and unmyelinated (C-axons) nerve fibres. For the supratentorial part the main nerve supply stems from all three branches of the trigeminal nerve. Finally, 250 myelinated and 800 unmyelinated nerve fibres innervate one side of the supratentorial part. The vascular bed of the dura mater exhibits long postcapillary venules up to 200 micron in length with segments of endothelial fenestration. Lymphatic vessels occur within the dura mater. They leave the cranial cavity through the openings of the cribriform plate, rostral to the bulla tympani together with the transverse sinus, and the middle meningeal artery. The perineural sheath builds up a tube-like net containing the A- and C-axons. It is spacious in the parietal dura mater and dense at the sagittal sinus along its extension from rostral to caudal and at the confluence of sinuses. Terminals of both the A- and C-axons are of the unencapsulated type. Unencapsulated Ruffini like receptors stemming from A-axons are found in the dural connective tissue at sites where superficial cerebral veins enter the sagittal sinus and at the confluence of sinuses. The terminations of single A-axons together with C-fibre bundles mix up in their final course in one Schwann cell to build up multiaxonal units or terminations (up to 15 axonal profiles). A morphological differentiation is made due to the topography of these terminations; firstly, in different segments of the vascular bed: postcapillary venule, venule, the sinus wall, lymphatic vessel wall, and secondly, within the dura mater: inner periosteal layer, collagenous fibre bundles of the meningeal layer and at the mesothelial cell layer of the subdural space. PMID- 3826656 TI - Ultrastructure of hepatocytes in golden ide (Leuciscus idus melanotus L.; Cyprinidae: Teleostei) during thermal adaptation. AB - The morphological alterations of hepatocytes of golden ide, Leuciscus idus melanotus, following adaptation to low and high temperatures (14 and 28 degrees C) were investigated by means of light and electron microscopy. The temperature dependent behaviour of peroxisomes was visualized cytochemically with the alkaline diaminobenzidine medium; the morphological studies were supplemented by the biochemical determination of catalase activity. Cold adaptation of ide hepatocytes is manifested by proliferation and stacking of endoplasmic reticulum, an enhanced secretory activity of Golgi fields and a higher number of peroxisomes as compared with the warm-adapted animals. The latter organelles are characterized by a marked heterogeneity in size, shape and catalase activity, and by a more intimate association with mitochondria and endoplasmic reticulum. The occurrence of small peroxisomal profiles is restricted to lower temperature. Catalase activity can be shown both cytochemically and biochemically to increase during cold adaptation. Whereas the number of mitochondria seems to be unaffected by thermal adaptation, stacking of mitochondria as well as the formation of intramitochondrial membrane piles indicate cold-adaptive processes. A feature typical of warm-adaptation is the formation of membrane-glycogen complexes, which may represent the morphological expression of enhanced carbohydrate metabolism documented in a decreased storage of glycogen at 28 degrees C. At 28 degrees C lipid is the predominant storage product. These findings indicate that fish liver is well-suited to serve as a model for the analysis of the interaction of environmental temperature conditions and hepatic morphology. PMID- 3826657 TI - The hypothalamus of the human adult: chiasmatic region. AB - The human hypothalamus can be divided into a chiasmatic region, a tuberal region, and a mamillary region. The chiasmatic region comprises the magnocellular neurosecretory nuclei, several nuclei that are mainly formed of small nerve cells, and an ill-defined nerve cell assembly referred to as the chiasmatic gray. Small to medium-sized bipolar nerve cells predominate in the chiasmatic gray. With the use of Nissl preparations counterstained for demonstration of lipofuscin pigment, four types of neurons have been distinguished. Type I cells contain coarse and intensely stained lipofuscin granules. Type II cells are characterized by dense accumulations of small granules. Type III neurons harbour only a fine scattering of dust-like granules while type IV neurons are devoid of pigment. Pigmentoarchitectonic analysis of the chiasmatic region reveals the presence of eight nuclei embedded in or partially surrounded by the chiasmatic gray. The intermediate nucleus is a small compact accumulation of non-pigmented nerve cells located at the level of the optic chiasm half way between the paraventricular nucleus and the supraoptic nucleus. The periventricular nucleus and the uncinate nucleus are mainly formed of small pigment-laden type I and type II cells and appear as an anterior, respectively lateral extension of the paraventricular nucleus. Besides non-specific small cells, three neuronal types can be distinguished in the paraventricular nucleus on account of characteristic differences in their pigmentation. The supraoptic nucleus is formed of only two types of nerve cells. The cuneiform nucleus extends from the supraoptic nucleus to the ependymal lining of the third ventricle separating the suprachiasmatic nucleus from the retrochiasmatic nucleus. The suprachiasmatic nucleus contains the smallest neurons of the region. Cells of this nucleus are devoid of lipofuscin pigment. The retrochiasmatic nucleus is formed of a heterogeneous population of small and unusually large nerve cells. Numerous melanin-containing nerve cells and accumulations of nerve cells belonging to the lateral tuberal nucleus can be encountered within the boundaries of this nucleus as well. The technique and the data presented provide a basis for investigations of the aged and the diseased human brain. PMID- 3826658 TI - The mouse neural plate as starting material for studying neuronal differentiation in vitro. AB - Tissue from the mouse neural plate and neural tube was studied, by light and electron microscopy, as starting material for tissue culture. In vivo, up to embryonic day 9 (E 9, stage Th 14; Theiler 1972) all neuroepithelial cells of the neural plate were mitotically active. As judged from their light microscopic or ultrastructural appearance, they could hardly be distinguished from one another or from neuroepithelial cells of more mature embryos. The earliest few immature neurons in the mesencephalic anlage were discernible on day 9 1/2 (stage Th 15) in the prospective intermediate layer of the neural tube, concomitantly with the development of processes containing neurotubules and vesicles which were oriented in parallel to the basal lamina. For tissue culture, explants of the mesencephalic anlage of embryonic days 8 (Th 12/13), 9 1/2 (Th 15), and 11 (Th 18) were kept in vitro and their development was compared with each other and with the corresponding developmental stage in vivo in the initial phase of culture (e.g., E 8, day of explanation, kept in vitro for 2 days, E 10 in vivo being the stage for comparison). The study demonstrated that further in vitro development proceeded in an accelerated manner, independent of the developmental stage of the embryo from which the tissue was explanted. In vitro, proliferation of the explanted neuronal progenitor cells stopped in all explants within 24 h of culture as revealed by autoradiographic and electron microscopic techniques. Cytoplasmic transformation was observed corresponding to that found in vivo, but always greatly accelerated. Earliest axons had formed after 24 h in vitro; synapses with clear vesicles and dense core vesicles were observed after at least 3 days in culture in all explants regardless of age at the time of explantation (E 8 or E 11). The present ultrastructural results indicate that prospective neurons within the neuroepithelium of the neural plate and early neural tube were immediately able to develop into neurons without the complete sequence of mitotic events normally occurring under in vivo conditions. PMID- 3826659 TI - The timing of granule cell differentiation and mossy fiber morphogenesis in the opossum. AB - The timing of developmental events may be important for the orderly formation of neuronal interconnections. In the present study, the timing of granule cell migration is compared with the arrival and maturation of mossy fiber projections. The opossum was chosen as the experimental animal because its protracted postnatal development enables the examination of developmental sequences not as easily recognized in other more commonly used mammalian species. It is shown that all areas that project to the cerebellum as mossy fibers in the adult opossum do so by postnatal day (PD) 30. Their major target, the granule cells begin inward migration from the external germinal layer (EGL) prior to PD 30, but do not form a distinct internal granular layer (IGL) until PD 35. Migrating granule cells penetrate into the IGL deep to granule cells that have begun dendritic differentiation. By PD 50, Golgi impregnations reveal that many granule cells have numerous immature processes, somal spines and dendritic growth cones. After this age these structures are rare and the vast majority of granule cells exhibit short dendrites with digiform endings. Dendritic differentiation subsequent to PD 54 involves an increase in the length of the shaft and the further maturation of terminal digits. Also from Golgi material, immature mossy fiber endings can be identified in the IGL by PD 35 and exhibit mature characteristics at PD 73. Thus, the formation and maturation of granule cell dendrites and their afferents (mossy fibers) occur over an extended period of time (PD 35-73). Moreover, granule cells exhibit a sequence of development similar to that of Purkinje cells: early arrival of their primary afferent projections in the cerebellar anlage; a period of exuberant dendritic growth; and a protracted and overlapping period for dendritic and synaptic maturation. PMID- 3826660 TI - Intercellular gaps in the early development of chick mural endocardium. A TEM study. AB - Embryonic chick hearts stages 15 to 21 according to the Hamburger-Hamilton series (1951) were subjected to TEM and light-microscopical examination to investigate ventricular mural endocardium during early trabeculation. Serial sectioning of consecutively-aged embryos indicated an invagination of the endocardial layer which lines the intertrabecular and intermuscular spaces. During the proceeding development, frequently occurring approaches and contacts between mural endocardium and myocardium could be observed. At all stages examined, the cardiac jelly appeared as an acellular, at particular sites very attenuated matrix. The intercellular gaps of the endocardium could not be correlated to the invagination and the endothelialization of the intertrabecular spaces. PMID- 3826661 TI - The early development of the eye of the pouch-young of the marsupial Dasyurus hallucatus. AB - The development of the eye of the pouch-young of the marsupial native cat Dasyurus hallucatus from birth to day 30 is described. Following the staging system used by other authors, the stage of development of the eye at birth is comparable to that of a six-week human embryo, a 33 day rhesus embryo or a 14 day rat embryo. In contrast to eutherian mammals where development progresses from one stage to another at approximately the same rate, in the native cat the rate tends to progressively decrease. All of the neural development of the native cat eye occurs while the young is in the pouch. PMID- 3826662 TI - Effect of total spinal anesthesia on arterial and venous responses to dopamine and dobutamine. AB - To test whether acute denervation alters the vascular effects of dopamine and dobutamine, we anesthetized 16 greyhounds and placed them on total cardiopulmonary bypass (CPB). Eight dogs received total spinal anesthesia before drug testing; eight dogs were tested in the absence of total spinal anesthesia. During dopamine and dobutamine infusions, venous capacitance [determined by the volume of the CPB venous reservoir (VR)] and mean arterial pressure (MAP) were monitored. The CPB pump flows remained constant throughout our studies. Every dog received six increasing doses of both drugs. In the absence of total spinal anesthesia, both dopamine and dobutamine increased VR (decreased venous capacitance) in a dose-dependent manner. Dobutamine decreased MAP in a dose related fashion but dopamine had no significant effect on MAP. After total spinal anesthesia, both dopamine and dobutamine produced greater dose-related increases in VR (i.e., decreases in venous capacitance) than in the absence of spinal anesthesia. Dopamine increased MAP but dobutamine had no significant effect. These data demonstrate how dopamine and dobutamine differ in their effects on the arterial circulation in the presence or absence of spinal anesthesia. The acute denervation of spinal anesthesia altered venous and arterial dose-response relationships of both drugs. Finally, our study demonstrates the effectiveness of dobutamine and, perhaps even more so, dopamine as possible alternatives to ephedrine for the pharmacologic correction of the noncardiac circulatory sequelae of spinal anesthesia. PMID- 3826663 TI - Amrinone blunts cardiac depression caused by enflurane or isoflurane anesthesia in the dog. AB - The effects of two infusion rates of amrinone, a positive inotrope and vasodilator, were studied during high and low concentrations of either enflurane or isoflurane anesthesia in a canine model. The anesthetic concentrations used were: "low" = 2.1-2.2% enflurane or 1.7-1.8% isoflurane, and "high" = 3.4-3.5% enflurane or 3.0-3.1% isoflurane. The two infusion rates of amrinone were: "low" = 2 mg/kg plus 30 micrograms X kg-1 X min-1 and "high" = 4 mg/kg plus 100 micrograms X kg-1 X min-1. In the present study, amrinone, in sufficient doses, blunted the deleterious effects of enflurane or isoflurane on myocardial function, reduced systemic vascular resistance (SVR) and pulmonary capillary wedge pressure, restored left ventricular dP/dtmax (LVdP/dtmax), and maintained cardiac index, even at the high concentrations of enflurane or isoflurane that caused marked cardiac depression. However, with reduced SVR, mean arterial pressure remained low. With lower enflurane or isoflurane, high concentrations of amrinone elevated LVdP/dtmax and heart rate above baseline, which might be of concern if myocardial oxygen supply were limited. No arrhythmias were observed at any time in this study. Amrinone did not increase plasma catecholamine levels with either anesthetic. Elevated amrinone plasma concentrations persisted for at least 1 hr after cessation of the high amrinone infusion and continued stimulatory effects on the cardiovascular system were observed. These results suggest that in selected patients amrinone may be beneficial in the short-term treatment of perioperative depression of cardiac performance. PMID- 3826664 TI - Halothane hepatotoxicity in guinea pigs. AB - A recently reported animal model of halothane-associated hepatotoxicity in males of a colored strain of guinea pig was further characterized as to possible sex and strain specificity in outbred albino Amana, inbred albino Hartley, inbred colored strain 2, and inbred colored strain 13 guinea pigs. Exposure to 1% halothane for 4 hr in 21% O2 proved to be hepatotoxic in both sexes. Forty-eight hours after halothane exposure fatty vacuolization of hepatocytes was present in all animals. Histologically identifiable hepatic necrosis occurred in 60% of the guinea pigs exposed, along with concomitant increases in SGPT. Approximately one half of these responding animals had extensive centrilobular necrosis, which was still present 96 hr after halothane exposure. Females of the inbred strain 2 and males and females of strain 13 were the most susceptible to halothane-induced hepatic necrosis whereas the inbred Hartley strain was almost totally refractory to necrosis. Outbred Amana and male inbred strain 2 animals exhibited an intermediate hepatotoxic response. Comparison of the halothane-associated hepatic lesion with that induced by anoxic/ischemic mechanisms, (exposure to low (8%) oxygen during 1.7% enflurane anesthesia) showed obvious differences in the morphology of the hepatic necrosis and the apparent time course of lesion development. This guinea pig model of halothane-associated hepatotoxicity appears to be superior to previous animal models in that no pretreatment of the guinea pigs is required, both sexes are affected, and the resulting hepatic lesion is more persistent. PMID- 3826665 TI - Clinical experience with adenosine for controlled hypotension during cerebral aneurysm surgery. AB - The cardiovascular effects of adenosine-induced hypotension were studied in 47 patients undergoing intracranial vascular surgery under neurolept anesthesia. Adenosine infusion (214 +/- 18 micrograms X kg-1 X min-1) decreased mean arterial pressure (MAP) by 42 +/- 1% from 80 +/- 1 to 46 +/- 1 mm Hg for an average of 29 +/- 5 min of hypotension. Hypotension was associated with a minor increase in heart rate (13 +/- 2%) and with prolongation of the PR interval (9 +/- 2%). ST-T depression did not occur except in one patient with a previous history of myocardial infarction. The adenosine-induced increase in cardiac index (42 +/- 9%, n = 7) was associated with a 63 +/- 10% decrease in systemic vascular resistance index (n = 7) while the pulmonary capillary wedge pressure remained unchanged. Adenosine metabolism was limited and there was no accumulation of the end metabolite, uric acid. Serum creatinine levels were normal in all patients postoperatively. We conclude that adenosine rapidly induces a stable and easily controlled hypotension in man without tachyphylaxis or rebound hypertension. There were no signs of renal or myocardial dysfunction except for dysrhythmias that occurred in two patients with a history of myocardial infarction. PMID- 3826666 TI - Respiratory effects of sevoflurane. AB - The respiratory effects of sevoflurane were studied in seven patients and compared with values obtained in another seven patients anesthetized with halothane. Resting ventilation, resting PaCO2, and ventilatory response to CO2 were measured awake and at 1.1 and 1.4 MAC levels of both anesthetic agents. We found that with sevoflurane, tidal volume and the slopes of the CO2 response curves decreased and PaCO2 increased with increasing depth of anesthesia, as with other inhaled anesthetics. A compensatory increase in respiratory frequency was not enough to prevent a decrease in minute volume with increasing depth of anesthesia. At 1.1 MAC, sevoflurane produced almost the same degree of respiratory depression as halothane. At 1.4 MAC, sevoflurane produced more profound respiratory depression than halothane. PMID- 3826667 TI - Effect of morphine on the mechanical activity of common bile duct isolated from the guinea pig. AB - The contractile response of isolated guinea pigs common bile ducts (CBD) to transmural electrical stimulation and the effects of morphine and naloxone was studied. Contractile responses increased as a function of stimulus frequency. In the absence of naloxone morphine inhibited the contractile response to electrical stimulation in a dose-dependent manner. Naloxone prevented the inhibitory effect of morphine on the contractile response to electrical stimulation. We conclude that smooth muscle of the CBD in guinea pig is functional and can contribute to biliary motility, and that opiate receptors exist in nerve elements in the CBD. PMID- 3826668 TI - Failure of high frequency jet ventilation to ventilate patients adequately during extracorporeal shock-wave lithotripsy. PMID- 3826669 TI - Reversal of apparent tolerance to epidural morphine by epidural methylprednisolone. PMID- 3826670 TI - Caudal administration of morphine sulfate in anticoagulated and thrombocytopenic patients. PMID- 3826671 TI - Postpartum uterine atony after intravenous dantrolene. PMID- 3826672 TI - Postoperative neurologic dysfunction associated with preoperative administration of metoclopramide. PMID- 3826673 TI - Pericardial and subcutaneous air after maxillary surgery. PMID- 3826674 TI - Postoperative pain control by means of epidural narcotics in a patient with obstructive sleep apnea. PMID- 3826675 TI - Atrial fibrillation associated with intravenous fluorescein. PMID- 3826676 TI - A technique to aid blind nasotracheal intubation. PMID- 3826677 TI - Early blood patch recommended. PMID- 3826678 TI - Dural puncture headache suspected, cortical vein thrombosis diagnosed. PMID- 3826679 TI - What is the normal work of breathing. PMID- 3826681 TI - Temperature of i.v. solutions. PMID- 3826680 TI - pH adjustment of chloroprocaine solutions. PMID- 3826682 TI - Is isoflurane dangerous for the patient with coronary artery disease? PMID- 3826683 TI - Differential effects of isoflurane on regional right and left ventricular performances, and on coronary, systemic, and pulmonary hemodynamics in the dog. AB - The effects of isoflurane-induced hypotension to mean aortic pressures of 70 and 55 mmHg on global and regional right (RV) and left (LV) ventricular performance (ultrasonic dimension technique), and on coronary, systemic, and pulmonary hemodynamics (electromagnetic flow probes) were studied in 12 open-chest dogs anesthetized and paralyzed by continuous infusions of fentanyl and pancuronium. Isoflurane caused dose-dependent decreases in LV and RV dP/dt, and in myocardial segment shortening in the presence of unchanged heart rate, unchanged or increased (RV) preload, and unchanged (RV) or decreased (LV) afterload. RV and LV functions were affected differently: at a mean aortic pressure of 70 mmHg (mean inspired isoflurane 1.2%), RV end diastolic dimensions and pressure remained unchanged, whereas those of the LV decreased. At a mean aortic pressure of 55 mmHg (mean inspired isoflurane 1.8%), RV end diastolic dimensions and pressure increased above control, whereas those of the LV remained unchanged. Within the RV, inflow and outflow tract were affected quantitatively similarly, but dyssynchrony developed in four animals. Isoflurane caused dose-dependent decreases in coronary and systemic vascular resistances, but no change in pulmonary vascular resistance. At the lower concentration of isoflurane, coronary blood flow did not fall despite decreased LV and RV dP/dt, unchanged heart rate, unchanged or decreased preload, and unchanged or reduced afterload. The data indicate that isoflurane is a myocardial depressant and a potent coronary vasodilator. At both concentrations, LV function was better preserved than RV function, most likely due to the different effects of isoflurane on RV (unchanged) and LV (reduced) afterload. PMID- 3826684 TI - Effects of isoflurane on coronary arteries and coronary arterioles in the intact dog. AB - To determine the site of isoflurane-associated coronary vasodilatation, the authors measured epicardial coronary artery diameter and examined the effects of isoflurane on coronary arteriolar tone. Angiograms of the left coronary system were obtained in seven fentanyl-pentobarbital anesthetized dogs and quantitated with a computerized analysis system. Cross-sectional areas of the proximal, mid, and distal left anterior descending and proximal circumflex coronary arteries were obtained at three arterial pressures, and then the measurement repeated following administration of 0.75%, 1.5%, and 2.25% end-tidal isoflurane. At the same time coronary blood flow was measured using a 123Xe washout technique. Isoflurane was found to have no effect on epicardial coronary artery dimensions. No dilatation was observed throughout the range of isoflurane concentrations and coronary perfusion pressures investigated. However, despite the absence of epicardial coronary effects, coronary arterioles were dilated by both 1.5% and 2.25% isoflurane. Coronary blood flow corresponding to a myocardial oxygen consumption of 7.5 ml oxygen X 100 gm-1 X min-1 was calculated as 99 +/- 17 ml X 100 gm-1 X min-1 (mean +/- SD) during control conditions, and it increased to 150 +/- 26 ml X 100 gm-1 X min-1 at 1.5% isoflurane (P less than .004) and to 197 +/- 35 ml X 100 gm-1 X min-1 at 2.25% isoflurane (P less than .001). Although higher concentrations of isoflurane dilated intramyocardial arterioles, isoflurane had no effect on epicardial coronary arteries. PMID- 3826686 TI - Isoflurane causes regional myocardial dysfunction in dogs with critical coronary artery stenoses. AB - The effects of isoflurane-induced hypotension to mean aortic pressures of 70 and 55 mmHg on global and regional right and left ventricular performance (ultrasonic dimension technique) and on coronary hemodynamics (electromagnetic flow probes) were studied in 12 open-chest dogs (anesthetized and paralyzed by continuous infusions of fentanyl and pancuronium) with critical coronary artery stenoses (micrometer-controlled snares) of the right and left anterior descending coronary arteries. The stenoses reduced resting coronary blood flow by approximately 10% without affecting global or regional myocardial performance. During subsequent isoflurane administration, coronary blood flow fell markedly. In the areas supplied by the stenosed coronary arteries, segment length shortening decreased by 70% (P less than 0.01), and regional akinesis, paradoxical motion, or postsystolic shortening developed in 9 of 12 animals. In contrast, in the areas supplied by normal coronary arteries, myocardial segment length shortening decreased significantly less and did not show signs of dysfunction. In these non ischemic areas at both concentrations of isoflurane, end diastolic and systolic dimensions were greater in the right than in the left ventricle, probably related to differences in right (unchanged) and left (reduced) ventricular afterloads. The data indicate that in the presence of coronary artery stenoses, isoflurane induced hypotension may cause regional myocardial dysfunction suggestive of ischemia. PMID- 3826685 TI - Isoflurane induces coronary steal in a canine model of chronic coronary occlusion. AB - The hypothesis that isoflurane causes coronary steal was investigated in a canine model of chronic coronary occlusion. An ameroid constrictor was implanted in dogs to stimulate the development of intercoronary collateral vessels. During an acute experiment 3-4 weeks following implantation, heart rate, mean arterial pressure, and total coronary flow were held constant, and flow distribution was measured with microspheres in the presence and absence of isoflurane. Contractile function of the collateral-dependent zone and myocardial lactate extraction were also measured. Isoflurane produced a decrease in collateral flow and a decrement in collateral zone contraction, while, at the same time, enhancing flow in the normally perfused zone. In a second series of animals, isoflurane was found to have effects similar to those of adenosine, an arteriolar dilator known to produce coronary steal. In contrast, neither halothane nor nitrous oxide caused flow alterations or dysfunction of the collateral-dependent zone. PMID- 3826687 TI - The minimum alveolar concentration (MAC) of sevoflurane in humans. AB - Forty surgical patients were divided into two groups and anesthetized with either sevoflurane and oxygen or sevoflurane, oxygen, and nitrous oxide. The minimum alveolar concentration (MAC) for sevoflurane required to prevent movement in response to surgical incision in healthy patients was 1.71 +/- 0.07% (SE). The AD95 (anesthetic ED95) that prevented 95% of patients from moving was 2.07%. The addition of 63.5% end-tidal nitrous oxide allowed a reduction in the alveolar sevoflurane concentration to 0.66 +/- 0.06% (SE). The reduction in sevoflurane MAC was 61.4%. The AD95 for sevoflurane with 63.5% end-tidal nitrous oxide was 0.94%. PMID- 3826688 TI - Effect of lidoflazine on cerebral blood flow and neurologic outcome when administered after complete cerebral ischemia in dogs. AB - This study tested the hypothesis that lidoflazine, a calcium entry blocking drug, will improve post-ischemic neurologic outcome when administered after a period of complete cerebral ischemia, and that the improvement in outcome is related to an increase in post-ischemic cerebral blood flow (CBF). Complete cerebral ischemia was produced in 31 dogs by temporary ligation of the aorta and venae cavae. In six dogs, 10 min of complete cerebral ischemia was followed by an infusion of lidoflazine 1.0 mg X kg-1 iv over 10 min. CBF and cerebral metabolic rate for oxygen (CMRO2) were measured pre-ischemia, and for 90 min post-ischemia. The results from these six dogs were compared with results previously obtained from eight untreated dogs under similar, but not identical, conditions. The CBF measured post-ischemia in the dogs administered lidoflazine did not differ from the CBF measured post-ischemia in the untreated dogs. Both groups showed an initial hyperemia post-ischemia, followed by significant decreases in CBF from control values by 35 min post-ischemia. The post-ischemic CMRO2 also did not differ between lidoflazine treated and untreated groups. In 25 dogs, 11 min of complete cerebral ischemia was followed by an iv infusion of either lidoflazine 1.0 mg X kg-1 or saline placebo. The same iv infusions were repeated at 8 and 16 h post-ischemia. Seven dogs were excluded from data analysis for failure to meet pre-established protocol criteria. Neurologic injury was evaluated in the remaining dogs at 48 h post-ischemia by an observer blinded to the treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826689 TI - Hypoxia-induced pulmonary vasoconstriction in the human lung. The effect of isoflurane anesthesia. AB - The influence of isoflurane on hypoxic pulmonary vasoconstriction (HPV) was studied in eight subjects prior to elective surgery. The lungs were ventilated separately with a double-lumen endobronchial catheter. After oxygen ventilation of both lungs for 30 min during intravenous barbiturate anesthesia, the test lung was rendered hypoxic by ventilation with 8% O2 in nitrogen. The control lung was ventilated continuously with 100% O2. Isoflurane was added to the inspired gas, so that end-tidal concentrations of 1% and 1.5% were obtained. Cardiac output (QT) was determined by thermodilution, and the distribution of blood flow between the lungs was assessed from the excretion of a continuously infused, poorly soluble gas (SF6). The hypoxic challenge during intravenous anesthesia resulted in a reduction in the fractional perfusion of the test lung from 54% to 41% of QT. Mean pulmonary arterial pressure increased by 46%, and pulmonary vascular resistance (PVR) of the test lung more than doubled. Arterial oxygen tension fell from 375 mmHg (50 kPa) to 101 mmHg (13.5 kPa). Adding isoflurane to the inhalation gas, first at a concentration of 1%, then 1.5%, caused no further significant change in the distribution of pulmonary blood flow, although six of the eight subjects showed a small increase in test lung blood flow at isoflurane 1.5%. There was no change in PVR or in any other circulatory variable. Arterial blood gases remained essentially unaltered. When the hypoxic challenge was discontinued, all variables returned to control values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826690 TI - Morphine pharmacokinetics in renal failure. AB - The effect of chronic renal failure (RF) on the pharmacokinetics of morphine was studied in nine patients with end-stage RF, aged 58 +/- 8 yr (SD), and in seven control patients, aged 58 +/- 15 yr, undergoing peripheral surgery under general anesthesia. All patients received 0.2 mg X kg-1 as an intravenous bolus injection. Blood samples were collected over a 36 h period, and plasma concentrations were measured using a specific radioimmunoassay method. Unchanged morphine could be identified for only 12 h in all patients. The mean plasma concentrations of unchanged morphine were similar in the two groups, except in the first sample (5 min) where it was higher (P less than 0.05) in RF group. Patients with RF had a significantly smaller (P less than 0.05) central compartment (0.3 +/- 0.2 l X kg-1 versus 0.8 +/- 0.4 l X kg-1) than in the controls. Volume of distribution at steady state was also significantly (P less than 0.05) decreased in RF patients (2.8 +/- 1.0 l X kg-1) versus 3.7 +/- 1.2 l X kg-1 in the normal patients. The total apparent volume of distribution, the elimination half-life, and the plasma clearance were similar in the two groups. Identical peak levels of morphine metabolites were observed in the two groups, but plasma concentration of morphine metabolites was undetectable after 12 h in the control group and remained at a high level of 82 +/- 49 ng X ml-1 at 24 h and 83 +/- 57 ng X ml-1 at 36 h in RF patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826691 TI - The effect of isoflurane on cerebral blood flow and metabolism in humans during craniotomy for small supratentorial cerebral tumors. AB - Fourteen patients were studied during craniotomy for small supratentorial cerebral tumors. Cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) were measured twice by a modification of the Kety-Schmidt technique using 133Xe intravenously. Anesthesia was induced with thiopental 5-7 mg X kg-1, fentanyl 0.2 mg, and pancuronium, and maintained with 0.75% inspired isoflurane concentration in 67% nitrous oxide, and moderate hypocapnia. In one group of patients (n = 7), the inspired isoflurane concentration was maintained at 0.75% throughout anesthesia. One hour after induction of anesthesia, CBF and CMRO2 averaged 31 +/- 3 ml X 100 g-1 X min-1 and 2.1 +/- 0.2 ml O2 X 100 g-1 X min-1 (X +/- SEM), respectively. During repeat studies 1 h later, CBF and CMRO2 were unchanged. In a second group of patients (n = 7), an increase in the inspired isoflurane concentration from 0.75% to 1.5% was associated with a significant decrease in CMRO2 from 2.4 +/- 0.1 to 1.9 +/- 0.1 ml O2 X 100 g-1 X min-1, and no change in CBF. It is concluded that this anesthetic regimen is safe to use in patients with small supratentorial tumors in whom only a small midline shift has occurred. PMID- 3826692 TI - Hepatic oxygen supply and consumption in rats exposed to thiopental, halothane, enflurane, and isoflurane in the presence of hypoxia. AB - Hepatic oxygen supply and uptake were assessed in phenobarbital-pretreated male Sprague-Dawley rats receiving subanesthetic doses of thiopental, halothane, enflurane, or isoflurane combined with hypoxia (approximately 0.5 MAC and 12% oxygen) for the purpose of evaluating the role of these combinations in hepatic blood flow alterations and the concomitant hepatic oxygen supply and uptake. Hepatic blood flow was measured using microspheres; hepatic oxygen supply and consumption was calculated from measured hepatic blood flow and oxygen content in hepatic arterial, portal venous, and hepatic venous blood. In all anesthetic groups, total hepatic blood flow did not change from the control value. Oxygen supply to the liver was decreased from air control values in all anesthetic groups, but there were no significant differences among anesthetic groups. Hepatic oxygen consumption was significantly lower in animals exposed to halothane and isoflurane versus air controls, whereas it was not significantly decreased in animals receiving thiopental or enflurane. The hepatic oxygen supply/consumption ratio was higher in the air control and the isoflurane groups than in other groups; however, no significant differences in this ratio were observed among the thiopental, halothane, and enflurane groups. Oxygen content in hepatic venous blood correlated well with hepatic oxygen supply/consumption ratio in all five groups. These results show that, during exposure to mild hypoxia, a sub-MAC dose of isoflurane maintains the relationship of hepatic oxygen supply to uptake better than thiopental, halothane, or enflurane. However, a subanesthetic dose of halothane did not aggravate liver hypoxia specifically, compared with thiopental or enflurane. PMID- 3826693 TI - Correlation of regional cerebral blood flow (rCBF) with EEG changes during isoflurane anesthesia for carotid endarterectomy: critical rCBF. AB - A prospective evaluation of regional cerebral blood flow (rCBF) (ipsilateral middle cerebral artery distribution) was determined using a 133Xe clearance technique in 31 ASA P.S. II-III patients anesthetized with isoflurane-50% N2O in O2 for carotid endarterectomy. Each patient was monitored with 16-channel EEG throughout anesthesia and surgery. Critical rCBF was defined as that flow below which EEG signs of ischemia occurred. Critical rCBF (T1/2 method of analysis) was less than 10 ml X 100 g-1 X min-1 (mean +/- SE 5.9 +/- 1.2) in the six patients in whom transient EEG changes occurred at the time of temporary surgical carotid artery occlusion. No EEG changes occurred with occlusion in the other 25 patients; mean (+/- SE) occlusion rCBF in this group was 18.9 +/- 1.3 ml X 100 g 1 X min-1 (P less than 0.001). Preocclusion flows were not significantly different in the two groups. Critical rCBF during isoflurane anesthesia was less than that previously determined during halothane anesthesia (18-20 ml X 100 g-1 X min-1), and is compatible with the effects of isoflurane on CMRO2 and CBF. PMID- 3826694 TI - In vivo comparison of two mixed venous saturation catheters. AB - The accuracy and stability of mixed venous saturation pulmonary arterial catheters under adverse physiologic conditions has not been assessed. Either a Shaw Opticath catheter (three-wavelength) or a Swan-Ganz oximetry TD catheter (two-wavelength) was calibrated in vitro and positioned in the pulmonary artery in each of ten mongrel dogs. The in vivo saturations were compared to measured saturations from anaerobically collected mixed venous blood analyzed with a reference cooximeter at each step in the protocol. Oxygen delivery was varied to obtain a broad range of mixed venous saturations (Sv-O2) by altering inspired oxygen concentration, isovolemic hemodilution, reducing cardiac output, and increasing afterload. Calculated oxygen consumption varied from 128 to 311 ml/min. Pre-insertion calibration for both catheter types compared favorably with the cooximeter prior to physiologic manipulations, although the three-wavelength catheter more closely approximated the cooximeter. The three-wavelength catheter tracked measured Sv-O2 accurately under adverse conditions for up to 10 h (R = .994; SEE = 2.2%). The two-wavelength catheter tended to drift under the same conditions (R = .808; SEE = 10.6%). At the conclusion of the experiment, the two wavelength system was uniformly higher then the cooximeter by 5-31% with a mean of 21% (P less than or equal to .003 as compared with the initial difference by paired Student's t test). Pending further analysis of the tendency of the two wavelength system to drift it would seem prudent to limit its clinical application. PMID- 3826695 TI - Evaluation of the Ohmeda 3700 pulse oximeter: steady-state and transient response characteristics. AB - The authors determined the accuracy of the Ohmeda 3700 (version J) pulse oximeter in healthy volunteers rendered hypoxic (SaO2 from 60-98%) by breathing mixtures of O2 in N2. When equipped with an ear probe, the pulse oximeter reading (y) reliably predicted arterial saturation (x) under steady-state conditions (y = 1.05x - 4.66, r = 0.98) as well as when oxygen saturation was rapidly decreasing (y = 1.05x - 6.38, r = 0.96). Conversely, when equipped with a finger probe, the oximeter tended to significantly underestimate steady-state arterial saturation (y = 1.21x - 19.1, r = 0.98, P less than 0.001). In response to this information, the manufacturer modified the oximeter's software (version XJ1), resulting in improved agreement between oximeter readings and arterial values (y = 0.96x + 4.59, r = 0.99). Despite the close correlation between steady-state oximeter readings and arterial saturation, the 99% prediction limits for both the ear and finger probes (version XJ1) were +/- 8%. Finger probe readings did not reliably reflect radial arterial oxygenation during rapid desaturation (y = 0.55x + 45.2, r = 0.78). This may be related to the time required to "arterialize" the blood in the finger; during acute resaturation, we found that the ear- to finger-probe delay was 24.0 +/- 2.3 s (means +/- SE, P less than 0.001). PMID- 3826696 TI - In vitro cyanide release from sodium nitroprusside. AB - In vitro release of cyanide from sodium nitroprusside in 5% dextrose in water solution following exposure or non-exposure to fluorescent light (500 ft candles or 791 microwatt per square cm [muWcm-2]), was measured by a cyanide-specific ion electrode at 4, 8, 24, 48, and 72 h. The cyanide concentrations were significantly increased at 24 h in the light-exposed solution. In this group, 100% of the cyanide was released from sodium nitroprusside at 72 h exposure to light. However, cyanide concentrations showed no significant changes for 72 h in the light-protected solutions, which were either exposed to 500 foot candles fluorescent light or stored in a dark room. Less than 2.5% of the cyanide was released from sodium nitroprusside at 72 h in both of the light-protected groups. No significant differences in cyanide concentrations were observed at 8 h among the exposed or non-exposed solutions. After 24 h of exposure, the cyanide concentrations in the exposed group were significantly higher than those of the two light-protected solutions. However, there were no significant differences between the cyanide concentration in the light-protected solutions. These results substantiate the safety of sodium nitroprusside solution for 24 h if the sodium nitroprusside containing solutions are properly protected from light. An additional study performed showed that a significant amount of cyanide released from sodium nitroprusside was adsorbed to the surface of polyvinylchloride. PMID- 3826697 TI - The influence of periaortic collateral vessels on the intraoperative hemodynamic effects of acute aortic occlusion in patients with aorto-occlusive disease or abdominal aortic aneurysm. PMID- 3826698 TI - Accidental hyperthermia as a complication of extracorporeal shock-wave lithotripsy under general anesthesia. PMID- 3826699 TI - Neurologic dysfunction in postpartum patients caused by hypomagnesemia. PMID- 3826700 TI - Intrathecal morphine in conjunction with a combined spinal and general anesthetic in a patient with multiple sclerosis. PMID- 3826701 TI - End-tidal PCO2 monitoring in infants and children ventilated with either a partial rebreathing or a non-rebreathing circuit. PMID- 3826702 TI - Anesthetic management for cesarean section of a patient with Charcot-Marie-Tooth disease. PMID- 3826703 TI - Intraocular pressure changes during muscular hyperactivity after general anesthesia. PMID- 3826704 TI - Cardiac arrest from pulmonary outflow tract obstruction due to a double-lumen tube. PMID- 3826705 TI - Thoracopagus conjoined twins: management of anesthetic induction and postoperative chest wall defect. PMID- 3826706 TI - Nitrous oxide and dysrhythmias. PMID- 3826708 TI - The dose response of fentanyl in neonatal anesthesia. PMID- 3826707 TI - Periorbital edema after atracurium administration. PMID- 3826710 TI - Dental rolls for eye operations. PMID- 3826711 TI - An easily assembled device for transtracheal oxygenation. PMID- 3826709 TI - Using an ureteral catheter as a guide in difficult neonatal fiberoptic intubation. PMID- 3826712 TI - Preventing endotracheal tube fire during pharyngeal surgery. PMID- 3826713 TI - Mass spectrometer and/or capnograph use during low-flow, closed circuit anesthesia administration. PMID- 3826714 TI - Corneal abrasion during induction. PMID- 3826715 TI - Management of cuff incompetence in an endotracheal tube. PMID- 3826716 TI - Ranitidine prophylaxis in outpatients. PMID- 3826718 TI - Stress and hypokalemia. PMID- 3826717 TI - Questions concerning aspiration prophylaxis study. PMID- 3826719 TI - Abolishing pain on injection of etomidate. PMID- 3826720 TI - Trunk skin temperature after sympathetic nerve block--is the heat really on? PMID- 3826721 TI - Elastic foamed polymer earplug as a stethoscope earpiece. PMID- 3826722 TI - N2O has no place during oropharyngeal and laryngotracheal procedures. PMID- 3826723 TI - Malignant hyperthermia: are we really prepared? PMID- 3826724 TI - A simpler tidy adjunct to arterial cannulation. PMID- 3826725 TI - Prevention of leak of local anesthetic from under a pneumatic tourniquet. PMID- 3826726 TI - [Volume of circulating blood in neurosurgical patients during general anesthesia and intensive care]. PMID- 3826727 TI - [Prolonged epidural analgesia with trimecaine as a component of combined general anesthesia in children]. PMID- 3826728 TI - [Effect of different methods of general anesthesia on renal function during gastrectomy in oncologic practice]. PMID- 3826729 TI - [Disorders of the oxygen transport function of the blood as a high surgical risk factor in patients with acquired heart defects]. PMID- 3826730 TI - [Kinetics of blood ultrafiltration during hemoconcentration during artificial circulation in clinical practice]. PMID- 3826731 TI - [Evaluation of the reserve capacity of the heart during volume overload of the vascular bed]. PMID- 3826732 TI - [Mass-spectrometric gas analysis in the detection of risk factors in children with chronic bronchopulmonary diseases]. PMID- 3826733 TI - [Effect of microfilters from the firms Bentley and Pall on the blood during artificial circulation]. PMID- 3826734 TI - [Changes in central hemodynamics and oxygen consumption during extracorporeal perfusion oxygenation of the blood and bronchial lavage of patients with the obstructive form of severe status asthmaticus]. PMID- 3826735 TI - [Use of isoptin in the prevention of post-resuscitation heart damage]. PMID- 3826736 TI - [Prolonged sacral anesthesia with morphine in proctology]. PMID- 3826737 TI - [Intensive care of patients with status asthmaticus]. PMID- 3826738 TI - [Status of hemodynamics and metabolism in different phases of the course of bronchial asthma]. PMID- 3826739 TI - [Disorders of the rhythm of cardiac activity in response to the administration of calcium chloride to ischemic heart disease patients during the conduct of roentgeno-surgical studies]. PMID- 3826740 TI - [Hyperbaric oxygenation and hemosorption in the treatment of allergotoxic hepatic insufficiency]. PMID- 3826741 TI - [Features of the conduct of hemosorption in patients with severe craniocerebral injuries]. PMID- 3826743 TI - [A case of successful resuscitation after prolonged cardiac arrest]. PMID- 3826742 TI - [Central and peripheral hemodynamics in ketamine general anesthesia in children]. PMID- 3826744 TI - [Effect of different types of anesthesia on the function of the thyroid gland and adrenal cortex of children]. PMID- 3826745 TI - [Device for perfusing blood during hemosorption]. PMID- 3826746 TI - [Features of metabolism and circulation in the liver during general anesthesia during surgery in the maxillofacial area]. PMID- 3826747 TI - Depressor effects of ionized calcium infusion in essential hypertension. AB - The circulatory effects of an acute increase in serum ionized calcium were assessed in 27 patients with mild to moderate hypertension. Following a control period of fifteen minutes with confirmed circulatory variables, 1,375 mg calcium gluconate was infused over three minutes. Systemic mean arterial blood pressure and heart rate were recorded before, at one-minute intervals during, and for five minutes following the infusion. There was a brief increase of serum ionized calcium concentration (from 1.28 +/- 0.06 mmol/liter to 1.42 +/- 0.07 mmol/liter; p less than 0.001) maximum by one minute after infusion with return toward control by a further four minutes. This was accompanied by a significantly decreased mean arterial blood pressure (from 117 +/- 8 mmHg to 110 +/- 9 mmHg at three minutes; p less than 0.05) and heart rate (from 70 +/- 11 min-1 to 63 +/- 10 min-1 at three minutes; p less than 0.01). There was a significant correlation between the change in ionized calcium and that of the systemic arterial blood pressure (r = 0.68; p less than 0.01). No major side effects were recorded. The blood pressure reduction may theoretically be related to increased membrane stabilization of vascular smooth muscle cells, the acute increase in extracellular ionized calcium impairing calcium ions influx. PMID- 3826748 TI - Variability in arteriographic assessment of the carotid bifurcation. AB - We evaluated interobserver and intraobserver variability in the arteriographic assessment of the carotid bifurcation. Two neuroradiologists evaluated area stenosis and lumen surface morphology for 60 biplane carotid arteriograms in two reading sessions. Absolute interobserver differences for area stenosis averaged 8.8%, and interobserver differences were statistically significant for arteries of at least 50% stenosis. Analysis of observations for lumen surface morphology revealed statistically significant interobserver differences, averaging 29.5% disagreement. Intraobserver differences were not statistically significant. Observer variability for arteriography should be considered in the process of evaluating patients for carotid endarterectomy. PMID- 3826749 TI - Contrast echocardiography in the evaluation of interatrial septal defect. AB - One hundred twenty-four adult patients consecutively referred for suspected interatrial septal defect (IASD) were studied with contrast echocardiography. In 58 the study eliminated altogether the diagnosis of any significant cardiac defect. Fifteen patients had other forms of cardiac abnormalities with no shunting of blood, and 51 patients had echocontrast study positive for interatrial shunting; 48 of these were subsequently proven by cardiac catheterization to have IASD. Echocontrast provided a highly sensitive and specific means of both diagnosing IASD and eliminating this diagnosis. PMID- 3826750 TI - Anomalous origin of the coronary arteries. AB - The incidence and the clinical significance of various forms of anomalous aortic origin of coronary arteries are not well known. Among 2,000 consecutive patients who underwent selective coronary aretriography, 11 had such anomalies (0.55%). Two patients with atresia of the left main ostia developed ischemic symptoms at the ages of thirty-five and fifty-two, and both benefitted from coronary bypass graft operation. In other forms of anomalies the presence of ischemic symptoms was also associated with atherosclerotic stenosis (7 patients) or with constricting muscle bridge (1 patient). PMID- 3826751 TI - Anomalous right coronary artery arising from the midportion of the left anterior descending coronary artery--case reports. AB - Although coronary artery anomalies are detected during 0.8-1.2% of routine adult cardiac catheterizations, anomalies of the right coronary artery are relatively uncommon and are generally of no clinical significance. This report focuses, however, on 2 patients whose RCA originated from the midportion of the left anterior descending artery, an anomaly with potentially important clinical implications, which are explored. PMID- 3826752 TI - Radiation-induced aneurysm of the basilar artery--a case report. AB - A dolichoectatic basilar artery aneurysm, following irradiation for nasopharyngeal carcinoma, is described and discussed. PMID- 3826753 TI - Simultaneous bilateral central retinal arterial occlusion in a patient with Sneddon syndrome: case history. AB - A unique occurrence of simultaneous bilateral central retinal arterial occlusion in a thirty-four-year-old Indian male is reported. The patient's condition was an example of Sneddon syndrome because of association of recurrent strokes and cutaneous livedo reticularis. PMID- 3826754 TI - The pharmacokinetic and pharmacodynamic effects of varying the free fraction of disopyramide. AB - We have evaluated the influence of several factors on the binding of disopyramide to protein in human serum using a new ultrafiltration system and the enzyme multiplied immunoassay technique (EMIT) for disopyramide immunoassay. From these studies and those of other investigators, we conclude that the most significant in vivo factors influencing disopyramide binding in human serum are total disopyramide concentration, the concentration of alpha 1-acid glycoprotein, and the concentration of mono-N-dealkyldisopyramide. Significant variation in binding occurs in patients whose total disopyramide concentration is within the therapeutic range. The proportion of free disopyramide ranged from 16% to 54% in the sera of 50 cardiac patients whose total disopyramide concentration ranged from 0.5 to 5.8 mcg/ml. Since there is so much variation in the proportion of disopyramide that is free, and since it is the unbound form of the drug that is pharmacologically active, it is likely in patients whose arrhythmia responds to disopyramide therapy that unbound drug concentration will be a better indicator of drug efficacy and toxicity than will be total drug concentration. To test this hypothesis, we are investigating the relationship between steady state total and unbound disopyramide plasma levels in patients with supraventricular or ventricular arrhythmias, and pharmacologic response as determined by standard intracardiac electrophysiologic studies. PMID- 3826755 TI - Genomic hybridization of bovine class II major histocompatibility genes: 2. Polymorphism of DR genes and linkage disequilibrium in the DQ-DR region. AB - Class II genes of the bovine major histocompatibility complex have been investigated by Southern blot analysis using human cDNA probes for DQ alpha, DQ beta, DR alpha and DR beta. In this report restriction fragment length polymorphisms of DR alpha and DR beta are described. The polymorphisms were interpreted genetically by analysing five paternal half-sib families of the Swedish Red and White Breed, comprising altogether 28 offspring. Using the restriction enzymes BamHI, EcoRI and PvuII, three DR alpha and three DR beta allelic fragment patterns were resolved. The DR alpha and DR beta genes thus appear to be much less polymorphic than the previously described DQ alpha and DQ beta genes. Also, the observed linkage disequilibrium between DR genes was less pronounced than that between DQ genes, whereas the association between DR and DQ haplotypes was very strong. The family data available indicated strongly that the DQ alpha, DQ beta, DR alpha and DR beta genes are all closely linked. PMID- 3826756 TI - Genetic variability in fallow deer, Dama dama L. AB - Twelve blood proteins and enzymes were tested for polymorphism in a herd of fallow deer, Dama dama L., bred for meat production in Western Germany, to investigate the genetic constitution of the population. Although an enzyme polymorphism was detected (Catalase) for the first time in this species, electrophoretic variation is very low in comparison to other large ungulates. Possible explanations for this finding, such as recent inbreeding and a past genetic bottleneck, are given. The relationship between low genetic variation in biochemical marker systems and fitness is discussed. PMID- 3826757 TI - Transferrin variants in sheep: separation and characterization by polyacrylamide gel electrophoresis and isoelectric focusing. AB - Isoelectric focusing with carrier ampholytes in ultrathin polyacrylamide gels and polyacrylamide gel electrophoresis in a discontinuous buffer system were used for the separation of sheep transferrin variants. For identification of the different iron-binding sites of transferrin a stepwise urea gradient, different degrees of iron saturation and double one-dimensional electrophoresis were used. Isoelectric focusing results in an increased resolution of the Fe0-transferrin, Fe1 transferrin and Fe2-transferrin region. At the level of Fe0-transferrin and Fe1 transferrin the variants I, A, G, B, C, D, M, E, Q, P can be identified. The method is especially suitable for genetic studies. For screening purposes up to 108 samples can be separated within one run in an ultrathin gel. PMID- 3826758 TI - A microagglutination test for blood typing rhesus monkeys, Macaca mulatta. AB - We have developed a microagglutination test for typing rhesus monkey erythrocytes that is sensitive, accurate and easy to perform. The technique requires only microliter quantities of antiserum and cells, and agglutination is easily detected using an inverted microscope. An advantage of this technique is that the typing plates can be stored at -70 degrees C without loss of activity. The results of typing over 400 rhesus blood samples with this technique were 95% concordant with results using the standard microtitre agglutination technique. Preliminary results indicate that this test is also adaptable to typing human blood. PMID- 3826759 TI - Electrophoretic polymorphism of erythrocyte leucine aminopeptidase in the wild boar, Sus scrofa. AB - An erythrocyte leucine aminopeptidase (Rbc LAP) electrophoretic polymorphism was detected in Italian wild boars, Sus scrofa. Such a polymorphism has not previously been reported in the domestic pig. It is suggested that this locus could be a marker for genetic differences between the domestic and the wild forms of Sus scrofa. PMID- 3826760 TI - Joint report of the Third International Workshop on Lymphocyte Alloantigens of the Horse, Kennett Square, Pennsylvania, 25-27 April 1984. AB - The Third International Workshop on Lymphocyte Alloantigens of the Horse was held on 25-27 April 1984 in Kennett Square, Pennsylvania. Twelve laboratories from five countries participated. The principal purpose of this Workshop was to determine the phenotypic and gene frequencies of the 10 equine lymphocyte antigens (ELA) and a non-ELA lymphocyte antigen, ELY-2.1, in several breeds of horse. A total of 86 alloantisera characterized in previous workshops were tested against lymphocytes from 1179 horses. In addition, several experimental antisera were also tested against the same panel of lymphocytes. As a result of analysis of these data, the Workshop recognized two new equine lymphocyte alloantigens: W11 of the ELA system, and ELY-1.1, an antigen not linked to the ELA system. PMID- 3826761 TI - Studies on hair pigmentation and blood groups in the Bashkirs. PMID- 3826762 TI - Somatological investigation of three territorial groups of the Bashkirs. PMID- 3826763 TI - Somatology and phenylthiocarbamide (PTC) taste ability of the Bashkirs. PMID- 3826764 TI - Dental morphology of the Bashkirs. PMID- 3826765 TI - Opthalmoanthropological studies in Bashkirs. PMID- 3826766 TI - New data on the dermatoglyphics of the Bashkirs. PMID- 3826767 TI - Population genetic analysis of the Bashkirs on the basis of the material of the Soviet-Finnish expedition. PMID- 3826768 TI - Central nervous system vasculitis. PMID- 3826769 TI - Bronchial response to the food ingestion challenge. AB - A total of 143 food ingestion challenges were carried out in 107 patients suffering from bronchial asthma of a perennial type. In the group of 21 patients with "positive or highly suggestive food history" related to their bronchial complaints, 21 food challenges were performed. In the group of 86 patients with "unknown food history," 122 ingestion challenges with foods causing a positive skin response were performed. Fifteen of the 21 patients with "positive food history" developed 15 (71%) bronchus-obstructive responses to foods ingested, while 45 of the 86 patients with "unknown food history" developed 68 (56%) bronchial responses to the food ingestion challenge. Twenty-three isolated immediate (within 2 hours), 11 isolated late (4 to 24 hours), 34 dual late (a combination of an immediate and a late), 6 isolated delayed (28 to 56 hours), and 9 dual delayed (a combination of an immediate and delayed) bronchus-obstructive responses were recorded. No significant correlation of the individual types of bronchial response to food ingested with other in vivo and in vitro diagnostic parameters were found. Although the exact pathogenetic and immunologic mechanisms underlying the particular types of bronchial response to foods are not yet fully clarified, the involvement of different types of hypersensitivity cannot be excluded. It could be concluded that the involvement of foods in bronchial asthma is more frequent than is usually expected. The diagnostic value of the food ingestion challenge seems to be superior to that of other diagnostic parameters. The definite confirmation of the role of a certain food, in patients with bronchial asthma, should therefore be provided by the food ingestion challenge demonstrating one of the clinical types of bronchus-obstructive response. PMID- 3826770 TI - Adapting a self-management education program for asthma for use in an outpatient clinic. AB - A self-management patient education program for children with asthma which incorporates a slide tape program, pamphlets, nurse discussion, and physician discussion has been adapted from an emergency room site to an outpatient clinic for use during routine asthma clinic visits. Pre-interviews and post-interviews with and medical record review of 12 patients, aged 4 to 12 years, demonstrated that the children had statistically significant increases in knowledge of self management skills (recognition of asthma triggers and early warning signs and appropriate behaviors to manage acute episodes) and a significant increase in the sense of personal control (Health Locus of Control). Parents reported less disruption of family activities due to asthma and that the children had increased their use of asthma self-management techniques, resulting in improved management of asthma at home. Nurse and physician response to the program was enthusiastic and demonstrated the feasibility of integrating patient education into the outpatient clinic medical care routine. PMID- 3826771 TI - Optimal time for obtaining peak and trough theophylline levels in 12-hour and 24 hour products in children. AB - A direct relationship between bronchodilator efficacy and toxicity by the measurement of serum theophylline concentrations is well established. This study evaluated, in children receiving either 12-hour (Theo-Dur) or an experimental 24 hour (Theo-Beads) preparation, the most common time to reach peak and trough levels in the serum. Twenty-three children with chronic asthma between the ages of 7 and 12 years participated in the study. Twelve received theophylline every 12 hours at a dose ranging from 400 to 800 mg per 24 hours. Eleven children received a 24-hour preparation at a dose ranging between 400 and 1000 mg per 24 hours. The results demonstrated no relationship between dosing interval and the appearance of peak or trough levels with Theo-Dur. Theo-Beads reached its peak in 9 to 11 children between six and eight hours and for 10 to 11 children the trough value was at the end of the dosing interval. PMID- 3826773 TI - Allergies in school children. PMID- 3826772 TI - Systemic anaphylaxis due to an oxidation product of p-phenylenediamine in a hair dye. AB - An anaphylactic reaction to a hair dye is reported. Skin testing with the dye and its individual components demonstrated a wheal and flare response to an oxidation product of p-phenylenediamine. This product is N'N'-bis-(4-aminophenyl)-2,5 diamino-1,4-quinonediimine. Passive transfer of this sensitivity by the patient's serum to a normal control implicated an IgE-mediated reaction. PMID- 3826774 TI - Tobacco smoke sensitivity: a result of allergy? PMID- 3826775 TI - [Capacity of iron fixation by the serum or immunochemical determination of transferrin?]. PMID- 3826776 TI - [Methods for the determination of hydroxyproline in clinical biochemistry]. AB - In this paper, the different methodologies for the determination of hydroxyproline from biological fluids or tissue biopsies, are described. Thus, it is fitting to distinguish the methodologies requiring a chromatography before the revelation from the simplest methodologies with the colorimetric revelation of this amino acid in clinical biology; finally the two kinds of methodologies are different by their sensibility. PMID- 3826777 TI - [Wolman disease and cholesterol ester storage disease in adults. New means of study and diagnosis]. AB - Two clinical forms of lysosomal storage of neutral lipids with deficiency of acid lipase are known: the severe infantile form is called Wolman disease, whereas the more benign adult form is called "polycorie cholesterolique de l'adulte" or cholesteryl ester storage disease (CESD). We have developed several new tools for the study of hereditary enzymopathies and we report here their use in the study of genetic defects in lysosomal acid lipase. Lymphoid cell lines established by Epstein-Barr Virus transformation represent a new experimental model system in culture. The validity of such cell lines is demonstrated from the triple point of view of enzymology, metabolism and morphology (microscopic studies). Those lines are characterized by the deficiency in acid lipase whereas other lipases and carboxylesterases are not deficient. The study of lipid composition demonstrated the accumulation of neutral lipids (cholesterylesters and triglycerides). The use of fluorescent lipids for enzymatic studies and for diagnosing acid lipase deficiencies is reported and the reliability of these new substrates is demonstrated by comparison with currently used natural or synthetic substrates. For the enzymatic assays, these fluorescent substrates showed similar advantages as the radioactively labelled substrates, but not their disadvantages: thus, they can be easily used in the clinical laboratories. A new area in the field of research on lysosomal genetic diseases, is the experimental study of the metabolism in the intact living cell. The lipoproteins route is the best way to the lysosomal compartment and fluorescent lipids incorporated into lipoproteins allow to examine the lysosomal metabolism of these lipids simultaneously, by microscopic and biochemical techniques. PMID- 3826778 TI - [Cholesterol, phospholipid and apoB composition of LDL: comparison of precipitation and ultracentrifugation methods]. AB - Cholesterol, phospholipid and apoB levels were determined in LDL precipitated by amphiphatic polymers (Biomerieux kit, Marcy-l'Etoile, France). Intra-assay and inter-assay analysis performed on 4 serum pools were satisfactory. For 113 sera (triglyceride level less than 4.5 mmol/l, absence of VLDL-remnants), the 3 variables were well correlated with those of centrifuged LDL (0.93 less than r less than 0.98); however, LDL-cholesterol values were significantly higher (p less than 0.001), and those of LDL-phospholipids (p less than 0.001) and LDL-apoB (p less than 0.005) significantly lower. The correlations between the 3 constituents studied gave statistically different regression coefficients for the two methods. It is concluded that these precipitated lipoproteins do not seem to correspond to LDL but to "LDL markers". PMID- 3826779 TI - [In vitro activity of cefotaxime, latamoxef and ceftriaxone on hospital strains of Enterobacteriaceae resistant to cefalotine and cefoxitine]. AB - An in vitro study of the sensitivity of three cephalosporins of the third generation was performed on 119 wild strains of enterobacteriae selected because of their resistance to cefalotine and cefoxitine. Cefotaxime, latamoxef and cetriaxone remain very active on such strains since almost all of the strains were inhibited by a dose of 4 micrograms/ml and CI 50 p. cent was below 0.20 micrograms/ml. The activity of these three cephalosporins was comparable on groups E. coli, Klebsiella-Enterobacter-Serratia and C. freudii. Ceftriaxone appeared clearly more active than latamoxef and cefotaxime on Proteus stains. PMID- 3826780 TI - Analysis of free porphyrins in biological samples by high performance liquid chromatography. AB - High performance liquid chromatography has been used to separate and analyse the different free porphyrins in biological materials. The selective determination of uroporphyrin, coproporphyrin, protoporphyrin and hepta, hexa, pentacarboxylic porphyrins, the sensitive and quantitative fluorescence detection contribute to the clinical diagnosis of porphyria. PMID- 3826781 TI - [Chemical carcinogens and DNA, covalent binding and chemical modifications]. AB - Chemical carcinogenic agents are usually metabolized into final metabolites susceptible to be DNA bound to form adducts. They may also modify DNA bases. Binding may be studied in vitro in the presence of an enzyme system causing the formation of final metabolites or in vivo. Because of the small amount of adducts formed in vivo, they can only be visualized with radioactive compounds or with a 32P marking technique after DNA hydrolysis. A limit of detection of adduct for 10(8) nucleotides has thus been reached for polycyclic compounds. The covalent binding index enables to quantify this binding. The consequences of DNA alterations vary according to the substitutes. In the case of acetyl aminofluorene, they lead to mutations by shifting of the reading frame (frameshift). Alkylations lead to inaccurate pairing causing pin point mutations or depurinations. PMID- 3826782 TI - [Theory and practice of genetic toxicology tests. Tests on eukaryotes]. AB - The search for a mutation prone activity on bacteria must be completed by tests on eucaryotes, in vitro as well as in vivo. Tests on eucaryotes enable to study agents inducing gene mutations [on yeats, cultures of mammal cells (V 79, L 5278 Y), lethal recessive mutation linked to the sex chromosome, on drosophils...], chromosomal mutations (metaphases analysis in vitro and in vivo, micronucleus, lethal dominance), the involvement of repair mechanisms of DNA (non-programmed DNA synthesis, exchange of sister chromatides...). One must well differentiate the tests usable routinely for a screening from the tests currently validated and routine tests. It is only at the completion of a set of tests on bacteria and eucaryotes cells that the potential mutation risk of a product for human health, may be ascertained. PMID- 3826783 TI - [Strategy and interpretation of short-term tests]. AB - The important role of mutation events in oncogenes activity has intensified the interest of short-term tests in the detection of the carcinogenic potential of chemical substances. It should also be stated that mutations seem to occur not only in the initiation phase of cancerous processes, but also in the subsequent steps of promotion and progression. If the methods presently at our disposal permit to evaluate satisfactorily the carcinogenic properties of new products, an effort should be made in the development of faster and more reliable tests, as well as in the detection of carriers of genetic deficiencies which may sensitize or modify the response to chemical agents. PMID- 3826784 TI - [Methods of surveillance based on the genotoxic properties of chemical agents]. AB - Methods permitting to monitor human populations exposed to genotoxic agents are based either on research of cytogenetic alterations in germinal and somatic cells, or on the demonstration of genotoxic effects in biological fluids, especially urine and blood components. These effects are represented by: formation of mutation producing derivatives, sought in urine with mutagenesis bacterial tests, formation of additives with DNA in lymphocytes and with hemoglobin in red cells, induction of a non-programmed synthesis of DNA (reconstructive synthesis) in lymphocytes, presence of enzymatic mutants with a deficiency in hypoxanthine-phosphoribosyl-transferase in the lymphocytes. This second group of methods is described and examples of application are given. PMID- 3826785 TI - [Rate of germinal mutation in man. Measurement and surveillance]. AB - Estimate of the rate of germinal mutation in Man is difficult. Genic and chromosomic mutations must be considered separately. The only usable method, to avaluated the rates of genic mutation, is the direct method. The rate is estimated from the recording, at birth, of subjects with a particular phenotype due to a recent mutation, i.e. whose parents are normal. This mutation must be dominant with complete penetrance. In most of the cases, it is a dominant disease but a biochemical marker may also be used. This is a difficult method since there are many subjects to study and diagnosis errors are possible and the paternity is not always known. The rate of mutation of chromosomal aberrations may also measured. If we consider abnormalities of number, one has to know that the greatest majority results in early miscarriage; on the contrary, abnormalities of balanced structures are their detection is long and costly. The study of the variations of the mutation rate is, for those reasons, difficult. Methods of sequential analysis using "sentinel" phenotypes have factors which may modify the mutation rates are concerned, the effects of radiation are better known than those of chemical mutations in Man. PMID- 3826786 TI - French Society of Clinical Biology. Commission for Validation of Methods. PMID- 3826787 TI - [Toward standardized postgraduate teaching in anesthesiology in the European Community countries]. PMID- 3826788 TI - [Pharmacokinetics of thiopental in women and newborn infants]. AB - Plasma thiopentone concentrations after a single intravenous dose were determined by high pressure liquid chromatography in female surgical patients (n = 13), in pregnant women at term (n = 13) and in neonates (n = 13). In pregnant women, the apparent volume of distribution (Vd = 10.02 +/- 3.26 l X kg-1), plasma clearance (Cl = 22.03 +/- 7.55 l X h-1) and elimination half-life (t 1/2 (3) = 21.71 +/- 11.12 h) were significantly greater than in the surgical patients (Vd = 4.22 +/- 1.16 l X kg-1; Cl = 12.49 +/- 3.50 l X h-1; t 1/2 (3) = 13.79 +/- 3.09 h). Elimination half-life in neonates (t 1/2(e) = 17.9 +/- 9.7 h) was not different from half-life in mothers or in the surgical group. At delivery, the simultaneous concentrations were 5.3 +/- 1.3 mg X l-1 in venous blood and 3.8 +/- 1.6 mg X l-1 in cord venous blood. Apgar score was 10 in eleven neonates. For two babies, an Apgar score at 6 was explained by a uterine incision-to-delivery time interval greater than 2 min. PMID- 3826789 TI - [Radioimmunoassay method for the detection of IgE antibodies specific to alcuronium]. AB - A radio-immunoassay (RIA) was used to screen for specific IgE to myorelaxants. Alcuronium was coupled to epoxy-activated Sepharose. Sixteen patients with anaphylaxis to alcuronium (n = 2), gallamine (n = 2) or suxamethonium (n = 12) were studied. The diagnosis was established by intradermal tests (ID), passive cutaneous anaphylaxis tests and human basophil degranulation tests. The amount of non specific label retained by Sepharose-ethanolamine (with sera of patients) and Sepharose-alcuronium (with sera of 11 control subjects) was estimated. The RIA was positive 10/16 (8/14 patients having reacted to a muscle relaxant other than alcuronium). The RIA seemed to be useful in the diagnosis of anaphylaxis to muscle relaxants. Drug-reactive antibodies were specific of the quaternary ammonium radical, which was the common allergenic determinant of all molecules of muscle relaxants. This test accounted for in vitro cross-reactivity, but had no predictive value for the clinical risk of crossed-anaphylaxis. This risk was best assessed by ID; it was positive in three cases. Although it was not possible to compare ID and RIA, the interpretation of which was different, both tests should be recommended for the detection of sensitivity to muscle relaxants. PMID- 3826790 TI - [Spinal anesthesia with isobaric 0.5% bupivacaine. Effect of age]. AB - The effects of age on the characteristics of spinal anaesthesia with plain bupivacaine were investigated in 29 adult patients (less than 50 yr : group I), and 37 older patients (greater than or equal to 80 yr : group II). Three millilitres of 0.5% solution (15 mg) were injected at the L3-L4 interspace in the lateral position; the patients were turned supine immediately afterwards. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. Anaesthesia was unsatisfactory in one patient in group I and two patients in group II; they required a supplement with intravenous inhalation anaesthesia. These patients were not included in the analysis of the variables studied. The time to maximum spread was significantly shorter in the group I : 7.3 min versus 9.9 min in group II. A higher sensory spinal blockade was obtained in the older age group (T 10.4 versus T 11.2). There were no significant difference between the two groups in the mean time from the injection to recovery from analgesia in the two uppermost segments (121 min versus 107 min). The mean duration of analgesia at the L2 level did not differ significantly (149 min versus 164 min). All the patients had complete motor blockade of lower limbs. Only the Bromage's degrees 2 and 1 were greater in the elderly's group. In the older group, there was a tendency to a greater decrease in systolic arterial pressure from the preanaesthetic values ( 20.9% versus -13%). But moderate falls in mean and diastolic arterial pressures were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826791 TI - [Detection of peranesthetic malignant hyperthermia by muscle contracture tests and NMR spectroscopy]. AB - To diagnose malignant hyperthermia susceptibility (MHS), caffeine and halothane contracture tests were performed on six patients. One of them, who presented a peroperative crisis, was recognized as MHS; the five others were negative (MHN). By means of 31P-NMR spectroscopy, the muscular energetic metabolism of these patients was studied during and after moderate exercise in normal and moderate ischaemic conditions. Metabolic abnormalities appeared in the MHS patient. It must be concluded therefore that malignant hyperthermia is a latent myopathy. 31P NMR spectroscopy appeared to be a useful non-invasive tool for screening for this affliction. PMID- 3826792 TI - [Acute respiratory distress disclosing leptospirosis]. AB - The respiratory manifestations of leptospirosis are usually benign. A case is reported of anicteric leptospirosis with serious pulmonary affection. The clinical symptoms, the radiological manifestations and haemodynamic investigation were suggestive of an acute respiratory distress by non-haemodynamic pulmonary oedema. In accordance with other authors, one would be justified in including this acute respiratory failure as part of the acute respiratory distress syndrome of the adult (ARDS). PMID- 3826793 TI - [Lightning stroke]. AB - A case is reported of a 23 year old white man who was struck by lightning. The patient suffered cardiac and respiratory arrest. Immediately, he received external cardiac massage and artificial breathing, which were successful. He was then admitted to an intensive care unit, where the diagnosis of acute myocardial infarction was made, on the basis of electrocardiographic abnormalities, a significative elevation of cardiac enzymes, and ultimately a thallium-201 scintigraphy. There were no complications of this heart injury, except for a persistent sinus tachycardia, which was treated by the infusion of a beta blocking agent (oxprenolol). This case showed the importance of rapidly undertaking resuscitative measures in these circumstances, and to admit such a patient to an intensive care unit to undergo continuous cardiac monitoring, because the possibility of potentially serious cardiac complications, like life threatening cardiac rhythm disturbances or acute myocardial infarction, as well as preventive, or curative, treatment of the complications which may follow lightning injury. This attitude is justified by the usually excellent prognosis of these patients. PMID- 3826794 TI - [Tracheal rupture in closed cervicothoracic injuries]. AB - Two cases are reported of tracheal fracture occurring during blunt cervico thoracic trauma. The first case emphasized the impossibility of passing a tracheal tube below the fracture preoperatively, without the fibreoptic or rigid tracheoscope which has the added advantage of making an accurate diagnosis of the fracture. The clinical and paraclinical signs could only lead to a suspicion of the diagnosis, but not its confirmation. The second case showed the use of different ventilatory means during and after surgery (separate lung ventilation, jet ventilation, high frequency ventilation) in case of proximal fractures. The monitoring of intratracheal pressure should be used so as to have the best ventilation for the lowest pressures in the suture zone. PMID- 3826795 TI - [Heart arrest during general anesthesia in a child with unrecognized Duchenne's dystrophy]. AB - A three-year old child was anaesthetized by halothane. Cardiac arrest occurred soon after the injection of suxamethonium. Signs of rhabdomyolysis associated with hyperkalemia were present. The diagnosis of Duchenne muscular dystrophy was obtained afterwards. PMID- 3826796 TI - [Pneumothorax after ventriculoperitoneal shunt procedure]. AB - A respiratory distress syndrome is reported in a four month old girl, after placement of a ventriculo-peritoneal shunt for hydrocephalus. This complication was related to a surgical pneumothorax. It was an early and spontaneously resolving complication, which one should have in mind after shunting procedures. PMID- 3826797 TI - [Cardiac failure caused by an overdose of dantrolene]. AB - A case is reported of cardiac failure with repeated pulmonary oedema in a female patient suffering from renal failure and having been given incremental doses of dantrolene sodium. On withdrawal of the drug, all symptoms disappeared. This muscle relaxant was considered not to have any depressive myocardial side effects. However, recent studies on isolated myocardial fibres showed the existence of a constant dose-dependent negative inotropic effect of dantrolene sodium, only noticeable with high concentrations of the drug. PMID- 3826798 TI - [Heart conduction disorders in acute maprotiline poisoning]. AB - A case is reported of self-poisoning with maprotiline followed by prolonged disorders of intraventricular conduction. The cardiotoxicity of tetracyclic antidepressants was well established, but few cases were reported. Maprotiline pharmacokinetics explained the duration of the cardiovascular side-effects. The severity of maprotiline overdoses should not be underestimated. PMID- 3826799 TI - [Prevention of peroperative hypothermia]. PMID- 3826800 TI - [Value of the determination of myoglobinemia in traumatic rhabdomyolysis]. PMID- 3826801 TI - [Intramuscular methohexital in pediatrics]. PMID- 3826802 TI - Non-invasive assessment of aortic mechanical properties. AB - Echocardiography and sphygmomanometry were used to noninvasively assess the changes in aortic mechanical properties associated with aging. Fifty normal individuals were examined and were divided into three groups: young (less than 35 years of age), middle-aged (35-55), and old (greater than 55). Experimental measurements indicated that elastic aortic stiffness in the circumferential direction increased with increased age. It was concluded that this was consistent with increased deposition of circumferentially oriented collagen within the media. Associated with increased elastic aortic stiffness in the circumferential direction was a decrease in the ability of the aorta to act as an auxiliary pump. The average work per unit length recovered from aortas of older individuals was only 44% of that recovered from the aortas of individuals in the young group. These studies suggest that increased elastic aortic stiffness results in decreased aortic pumping efficiency and may lead to a compensating increase in blood pressure. PMID- 3826803 TI - Central origin vs. reflex feedback in the respiratory heart rate relationship. AB - In the midcollicular decerebrate cat we have observed unique respiratory variation in heart rate (respiratory-heart rate relationship, RHRR) in respiratory intervals of 2-7 s or Biot's breathing of paired breaths at 16-s intervals. Cardiac slowing that marked the respiratory segmentation of the heartbeat showed consistent relationship with the breath it preceded by 1 to 5 s. Thus, association of respiration and heartbeat must include synergistically central interrelated origins for respiration cardiac rates constituting the RHRR. PMID- 3826804 TI - The dynamic twisting of the left ventricle: a computer study. AB - A mathematical analysis which relates the dynamic twisting motion of the heart around its longitudinal axis to the mechanical function of the left ventricle (LV) is presented. The study thus extends our earlier model which relates the micro-scale sarcomere dynamics, the fibrous structure of the myocardium, and the electrical transmural activation wave to the global LV function. The analysis demonstrates that although the angular twisting motion of the heart moderates the sarcomere length (SL) and the strain rate distributions throughout the myocardium, the global characteristics of the LV function are almost independent of the twisting phenomenon. The endocardial sarcomeres are nevertheless subjected to higher strains and higher (negative) strain rates than the corresponding (positive) epicardial sarcomeres. Utilizing the sarcomere stress length area to predict oxygen demand, it is shown that the twisting motion of the heart produces the metabolic gradient across the LV wall. In spite of the moderating effect of the twist, a larger than normal gradient in oxygen demand is predicted for cases of concentric hypertrophy. PMID- 3826805 TI - Evaluation of the "tilt test" in children. AB - The "tilt test" (assessment of orthostatic pulse and blood pressure) is a non invasive screening test for acute intravascular volume loss with well-accepted utility in the emergency evaluation of adults. Its value in children has been questioned because of reports of high false-positive rates. We report a prospective study to compare "tilt test" results between children with and without clinical volume depletion in a pediatric emergency setting. Children 4 to 15 years old seeking care at an urban pediatric emergency department were eligible. Children meeting the following criteria were classified as dehydrated: an acute history of vomiting or diarrhea and a volume depletion score greater than or equal to 4. The control sample was selected from children with minor complaints, and a volume depletion score less than 4. Blood pressure and heart rate were recorded at one-minute intervals by an automatic noninvasive blood pressure monitor for three minutes in the supine position. Subsequently, measurements were taken for two minutes in the standing position with the arm supported at heart level. Sixteen dehydrated and 21 normal children were enrolled; the groups were comparable in mean age, weight, sex, and oral temperature, but differed significantly in racial background. The mean orthostatic rise in heart rate was 29.1 beats per minute (+/- 10.7) in the clinically dehydrated group and 13.1 beats per minute (+/- 8.5) in the control group (P less than .001). There was no significant difference between the two groups with respect to the small decrease in systolic blood pressure (0.38 and 0.46 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826806 TI - Utilization prediction for helicopter emergency medical services. AB - As the number of helicopter emergency medical services (HEMS) programs continues to expand rapidly, the need for an accurate, readily obtainable, inexpensive method of utilization prediction for these services has become apparent. Accurate volume and case mix prediction for these services are increasingly important as financial constraints become more severe. All previous methods of utilization prediction based on experiences of individual services or accident statistics have been either inaccurate, costly, or difficult to obtain in a relatively short period of time. Prediction of HEMS utilization requires consideration of many significant, simultaneous factors, in addition to patient needs based on population statistics. Through use of a survey of all hospital-based helicopter emergency service programs and published census data, this study analyzed factors relating to helicopter program volume and case mix, providing insight as to why previous methods utilizing total population were inaccurate. A more accurate yet simple and inexpensive method of utilization prediction for HEMS was developed. PMID- 3826807 TI - Prehospital advanced trauma life support for critical blunt trauma victims. AB - The ability of paramedics to deliver advanced trauma life support (ATLS) in an expedient fashion for victims of trauma has been strongly challenged. In this study, the records of 114 consecutive victims of blunt trauma who underwent laparotomy or thoracotomy were reviewed. Prehospital care was rendered by paramedics operating under strict protocols. The mean response time (minutes +/- SEM) to the scene was 5.6 +/- 0.27. On-scene time was 13.9 +/- 0.62. The time to return to the hospital was 8.0 +/- 0.4. On-scene time included assessing hazards at the scene, patient extrication, spine immobilization (n = 98), application of oxygen (n = 94), measurement of vital signs (n = 114), splinting of 59 limbs, and the following ATLS procedures: endotracheal intubation (n = 31), IV access (n = 106), ECG monitoring (n = 69), procurement of blood for tests including type and cross (n = 58), and application of a pneumatic antishock garment (PASG) (n = 31). On-scene times were analyzed according to the number of ATLS procedures performed: insertion of one IV line (n = 46), 14.8 +/- 1.03 minutes; two IV lines (n = 28), 13.4 +/- 0.92; one IV line plus intubation (n = 7), 14.0 +/- 2.94; two IV lines plus intubation (n = 9), 17.0 +/- 2.38; and two IV lines plus intubation plus PASG (n = 13), 12.4 +/- 1.36. Of the 161 IV attempts, 94% were completed successfully. Of 36 attempts at endotracheal intubation, 89% were successful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826808 TI - Brachial plexus injuries from blunt trauma--a harbinger of vascular and thoracic injury. AB - We reviewed the records of 59 patients who suffered brachial plexus injuries following blunt trauma between the years 1974 and 1984. The age of the patients ranged from 2 to 84 years, with a mean of 35.3 years. Forty-five were male patients. The majority of injuries (53%) were caused by motor vehicle accidents. Direct trauma was the mechanism of injury for 33 patients, traction for 18, shoulder dislocation for six, and acromioclavicular separation for two. The injuries occurred on the left side in 33 (56%); the right side in 23 (39%), and bilaterally in three (5%). Eight patients (14%) suffered complete brachial plexus palsies, and 51 (86%) incurred partial palsies. Nine patients (15.2%) presented in shock. Severe associated injuries occurred in this group of patients and included multiple rib fractures, hemopneumothorax, pulmonary contusion, head injuries, and upper extremity fractures. Subclavian artery injuries occurred in three patients, axillary artery in two patients, and an internal carotid injury in one patient. Complete resolution of the palsy occurred in 25 patients, partial resolution occurred in 17 cases, and the brachial plexus palsy remained permanent in nine. Eight patients were lost to follow-up. Brachial plexus injuries frequently occur in association with severe trauma, are usually partial palsies, and resolve partially or completely in two-thirds of cases. In addition, 10% of these patients suffered major vascular injuries and 10% incurred significant chest trauma. PMID- 3826810 TI - Admixture bloodwarming: a technique for rapid warming of erythrocytes. AB - Admixture of erythrocytes (packed red blood cells) with heated saline solutions may provide a faster and safer method of bloodwarming and infusion than is currently available. We developed and tested such a system for ease and efficacy. One-day-old aliquots of erythrocytes (6 to 10 C) were combined with equal amounts of saline that had been heated to a temperature of 50 or 60 C. After this rapid admixture, equilibrated temperatures were 29.1 and 34.0 C, respectively. The procedure also was performed using 35-day-old erythrocytes and 60-C saline. Samples were obtained for analysis immediately after admixture. There was no significant plasma hemoglobin elevation, indicating no significant hemolysis, in any sample at either temperature. Rapid admixture bloodwarming appears to be a technique in which erythrocytes and heated saline may be combined rapidly without causing significant hemolysis. However, further studies of red cell function and survival will be needed before this technique should be put into clinical practice. PMID- 3826809 TI - Single-dose oral phenytoin loading. AB - A single 18 mg/kg dose of oral phenytoin capsules or suspension (mean dose, 1.3 g) was given to 44 patients with recent seizures and no detectable serum phenytoin level. Mean serum phenytoin levels after loading for patients receiving capsules were 6.8 micrograms/mL at two hours, 9.7 micrograms/mL at three to five hours, 12.3 micrograms/mL at six to ten hours, and 15.1 micrograms/mL at 16 to 24 hours. Mean levels for patients receiving suspension were slightly, but not significantly, lower than for patients receiving capsules. No seizures occurred during an eight-hour observation period after loading. Drug toxicity was minimal. Single-dose, 18 mg/kg oral phenytoin loading provides rapid therapeutic levels and is well tolerated. PMID- 3826811 TI - Exposure to ionizing radiation in the emergency department from commonly performed portable radiographs. AB - To accurately assess the potential hazard of exposure to ionizing radiation from portable radiographs taken in the emergency department, a study was performed to measure such radiation at different distances from the edge of an irradiated field during portable cervical-spine (pC-S), portable chest radiograph (pCXR), and portable anteroposterior-pelvis (pAP-pelvis) radiographs. For all three types of portable radiographs, radiation exposure is a function of distance from the beam. However, at 40 cm (15 inches) away from the beam during a pC-S or pCXR and at 160 cm (63 inches) from a pAP-pelvis film, exposure is minimal. At these distances one would need to be exposed to more than 1,200 such radiographs to equal background environmental ionizing radiation. Medical personnel should not have to leave a patient care area for fear of undue acute and chronic radiation exposure while portable radiographs are performed in the ED. By using protective garments and standing appropriate distances away from the patient, continuous patient care can be maintained while portable radiographs are taken in the ED. PMID- 3826812 TI - Management of varicella-zoster virus-exposed hospital employees. AB - Emergency physicians frequently manage hospital employee health services. A common hospital infection control problem is varicella-zoster virus infection. We reviewed the literature to determine a rational basis for the management of the varicella-zoster virus-exposed hospital employee. Exposed employees include those with direct face-to-face contact with an infected person. The immune status should be determined in those employees with a negative or uncertain history of varicella infection by using a sensitive and specific technique such as the FAMA or ELISA tests. Employees with a positive history or a positive titer are immune and can return to work. Those with a negative titer are susceptible and should avoid patient contact from day eight to 21 following exposure. High-risk, susceptible contacts should be given varicella-zoster immune globulin. Varicella infection will become much less common after the release of varicella vaccine. PMID- 3826813 TI - Delayed absorption following enteric-coated aspirin overdose. AB - We present the case of a patient with an enteric-coated salicylate overdose, in which absorption was delayed significantly despite active treatment. The patient's serum salicylate level one hour and three hours after ingestion, as well as the initial gastric lavage, was 0. The serum salicylate level reached a peak of 35.8 mg% 24 hours after ingestion. The Done nomogram is of no benefit in the initial assessment of sustained release salicylate overdoses. PMID- 3826814 TI - Propafenone ingestion. AB - Propafenone is a type 1c antiarrhythmic drug that recently has become available for clinical trials within the United States. We present the case of a 2-year-old child who accidentally ingested 1,800 mg (133 mg/kg) of propafenone. The patient subsequently developed cardiac conduction abnormalities and generalized seizures. Following the administration of IV phenytoin, cardiopulmonary collapse occurred. The patient had a successful outcome with aggressive cardiopulmonary life support. PMID- 3826815 TI - Recurring epiglottitis in an adult. AB - We report a case of recurring epiglottitis in an adult. The patient presented with complaints of a sore throat and fever. The presence of a muffled voice led to radiologic and indirect laryngoscopic examination confirming the diagnosis. The patient responded promptly to glucocorticoids and parenteral antibiotics. Over the ensuing six months, he was readmitted to the hospital on three separate occasions with recurrent symptoms and findings of epiglottitis. On each occasion, he responded promptly to therapy. An exhaustive investigation failed to reveal a cause for this unique occurrence of recurring disease. PMID- 3826816 TI - Acute airway compromise due to tracheal mucocele. AB - Two cases of patients with acute airway compromise due to benign tracheal mucocele are presented. In each, the diagnosis was made by flexible fiberoptic bronchoscopy. Each patient developed the acute episode at 12 months of age following an upper airway infection. The mucoceles were "unroofed" and drained through rigid bronchoscopes. Both patients had been intubated following premature birth; trauma to the tracheal mucosa is proposed as the etiologic factor in the development of these mucoceles. PMID- 3826817 TI - Acute thrombosis of subclavian artery during CPR. AB - The case of a 73-year-old man who developed acute thrombosis of the left subclavian artery during CPR is presented. The patient was known to have severe chronic obstructive lung disease, hypertension, coronary artery disease, and severe peripheral vascular disease. He was admitted with ventricular fibrillation. CPR was successful, and the ECG revealed acute extensive anterior and recurrent inferior wall myocardial infarctions. Soon after, acute occlusion of the left subclavian artery was diagnosed. Thrombectomy was performed and circulation was restored to the left upper limb. The patient died 12 hours later from severe bradycardia and asystole. PMID- 3826818 TI - Perforation of the gall bladder following blunt abdominal trauma. AB - A 66-year-old man presented after having been involved in a motor vehicle accident. He was not wearing his seatbelt, and his vehicle had a deformed steering wheel after the incident. In the emergency department, his only complaint was mild right lower quadrant abdominal pain without signs of rebound or guarding. His laboratory and radiologic evaluations were unremarkable and he was observed in the intensive care unit. Nine hours after the accident, he developed an acute abdomen; exploratory laparotomy revealed a perforation of the gall bladder. Gall bladder injuries secondary to blunt trauma are infrequent events. PMID- 3826820 TI - Guidelines for trauma care systems. American College of Emergency Physicians. PMID- 3826819 TI - Spigelian hernia. AB - The clinical diagnosis of Spigelian hernia can be difficult due to lack of specific and constant findings. We report two patients whose only symptoms on presentation were progressive abdominal pain and intermittent palpable mass. The radiographic demonstration of bowel extending outside the expected confines of the peritoneal cavity allowed prompt diagnosis and proper operative management in both patients. Spigelian hernia requires surgical correction to prevent complications of acute abdomen with strangulation or incarceration. PMID- 3826821 TI - Trauma care system guidelines: improving quality through the systems approach. PMID- 3826823 TI - The stuck Foley catheter. PMID- 3826822 TI - High-pH automatic dishwashing detergents. PMID- 3826824 TI - Meprobamate & bezoar formation. PMID- 3826825 TI - Testing in emergency medicine. PMID- 3826826 TI - Aortoenteric fistula. PMID- 3826828 TI - Experimentally induced infections in turkeys with Cryptosporidium baileyi isolated from chickens. AB - Oocysts of Cryptosporidium baileyi isolated from chickens were inoculated by different routes into 3 groups of turkey poults. Intratracheal inoculation of oocysts produced clinical signs of respiratory tract disease, deaths, and gross lesions of airsacculitis. Parasites developed in the microvillous border of the nasopharynx, larynx, trachea, bronchi, and air sacs. Oral and intracloacal inoculations of oocysts caused no deaths or clinical signs of disease, but did produce patent infections. Respiratory tract infections limited to the nasopharynx, larynx, and trachea occurred in 3 orally inoculated poults. Respiratory tract infections were not observed in intracloacally inoculated poults. The mode of inoculation did not influence the distribution of C baileyi in the digestive tract. The cloaca was parasitized in 100% of the birds with intestinal infections, and the bursa of Fabricius was parasitized in 72.7%. PMID- 3826827 TI - Ovine anaplasmosis: in utero transmission as it relates to stage of gestation. AB - Seventeen mature, pregnant, anaplasmosis-susceptible and 3 anaplasmosis-carrier ewes were used in Anaplasma ovis in utero transmission studies. Susceptible ewes were arbitrarily allotted to 3 groups, 4 each in groups A and C and 9 in group B, and were inoculated with whole blood from a carrier ewe. Each group was Anaplasma exposed once during one of the thirds of pregnancy. In all ewes, resulting parasitemias were low and anemias were mild. Three carrier ewes comprised group D. Blood samples were obtained once during gestation from each fetus at various stages of development for evaluation and inoculation into splenectomized lambs. Blood obtained from neonates before nursing was also evaluated for Anaplasma presence. Parasitemia was not detected in any fetus or neonate; however, 3 of 16 splenectomized lambs inoculated with fetal or neonate blood developed acute anaplasmosis. Dams of fetuses/neonates with infective blood had been Anaplasma exposed during their 2nd or last 3rd of pregnancy. Infective Anaplasma agents crossed the placental barrier as early as 130 days of gestation. PMID- 3826829 TI - Genetic studies of neuraxonal dystrophy in the Morgan. AB - A naturally occurring disease condition, neuraxonal dystrophy, was identified in 27 male and 15 female Morgans, many of which were closely related. Five generation pedigrees were constructed for 33 of these horses and were compared with those for 29 randomly selected age- and sex-matched Morgans. Their mean coefficient of inbreeding was not statistically different (P greater than 0.1, 1 tailed t test; P less than 0.001, median test). Breeding of 2 severely affected and 2 normal stallions to 2 severely affected, 3 mildly affected, and 6 normal mares produced 10 mildly affected, 8 suspect affected, and 6 normal offspring. Breeding 4 normal stallions to 17 normal mares produced 22 normal offspring. Neuraxonal dystrophy seems to have a familial component, although neither a simple dominant not recessive mode of inheritance could be demonstrated. The condition could be inherited in a polygenic mode or as a dominant disorder with variable expression. PMID- 3826830 TI - Assessment of bovine mammary gland macrophage oxidative burst activity in a chemiluminescence assay. AB - A major bactericidal mechanism of neutrophils and macrophages is the generation of toxic oxygen-free radicals upon phagocytosis of microbes. Studies were conducted to assess the oxidative metabolism of bovine mammary gland macrophages. Bovine mammary gland macrophages were challenge exposed with a variety of phagocytic stimuli in an in vitro, luminol-assisted chemiluminescence assay. A measurable oxidative burst was observed when macrophages were challenge exposed with heat-aggregated bovine immunoglobulin, opsonified zymosan, and nonosponified zymosan. Addition of superoxide dismutase decreased mammary gland macrophage chemiluminescence in a dose-dependent manner. Brucella abortus, when opsonified with antiserum, lacteal antibody, or normal serum, produced an oxidative event, whereas nonopsonified B abortus did not. When challenge exposed with phagocytic stimuli, mammary gland macrophages produced an oxidative burst similar to that produced by other phagocytes for which an oxidative event is known to be bactericidal. PMID- 3826831 TI - Effect of aspirin on ex vivo generation of thromboxane in healthy horses. AB - Different dosages of aspirin were administered (by nasogastric tube) to 3 groups of 5 healthy adult horses to determine the minimal effective dosage needed to decrease serum thromboxane B2 (TxB2) concentrations and to determine the duration of this decrease. When compared with their base-line serum TxB2 concentrations, horses in group 1 (given 5 mg/kg) had a 71% decrease in TxB2 concentrations at 24 hours after aspirin was given and a 86% decrease at 48 hours; serum TxB2 concentrations were back to base-line values by 120 hours. Horses in group 2 (given 10 mg/kg) had a 60% decrease in TxB2 concentrations at 24 hours after aspirin was given, an 84% decrease at 48 hours, a 48% decrease at 96 hours, and an 18% decrease at 6 days. Horses in group 3 (given 20 mg/kg) had a 68% decrease in TxB2 concentrations at 24 hours, a 93% decrease at 72 hours, an 87% decrease at 96 hours, and a 70% decrease at 6 days after aspirin treatment was given. All groups had a statistically significant decrease in TxB2 concentrations (P less than 0.05) by 12 hours after aspirin was given, which persisted 96 hours for group 1 and throughout the study for groups 2 and 3. The maximal TxB2 decrease was similar among the 3 groups (90% decrease from base line), and there were no significant differences among the TxB2 concentrations between 24 and 72 hours after treatment was given.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826832 TI - Plasma lactate measurements in healthy beagle dogs. AB - Plasma lactate concentrations were determined in venous blood samples collected from 60 healthy Beagles aged 5 to 9 months. The range of values (0.42 to 3.58 mmol/L) obtained with an enzymatic method in the present study was similar to values reported in smaller studies with the colorimetric procedures. PMID- 3826833 TI - Clinical effects of low dietary phosphorus concentrations in feed given to lactating dairy cows. AB - Thirty-four Holstein cows, pregnant with their second calf, were individually fed diets containing 3 concentrations of phosphorus (P): 24 cows for 12 months and 10 cows for 7.5 months of lactation. Cows were randomly allotted to the specific dietary groups 2 months before expected parturition. The 3 dietary concentrations of P were 0.24%, 0.32%, and 0.42% in diet. Cows given 0.24% P in diets produced significantly less milk than did cows in the other groups. Other clinical signs of P deficiency in the cows fed the diet with 0.24% P included loss of body weight, decreased feed consumption, and lower inorganic serum P concentration 2 to 10 weeks after parturition. There were no significant differences in the variables measured between cows given dietary P concentrations of 0.32% and 0.42%. There was no evidence of hemoglobinuria after parturition. Reproductive performance did not differ significantly, although the trend was in favor of the cows fed the diet with 0.24% P. PMID- 3826834 TI - Effects of zeranol on reproduction in beef bulls: scrotal circumference, serving ability, semen characteristics, and pathologic changes of the reproductive organs. AB - Effects of zeranol on scrotal circumference, serving ability, semen characteristics, and postmortem measurements of the genital organs were determined in beef bulls from 9 to 20 months of age. Group 1 (n = 5) served as a nonimplanted control group. Group 2A (n = 5) was implanted with 36 mg of zeranol at birth and at 3 and 6 months of age. Group 2B (n = 5) was implanted with 36 mg of zeranol every 3 months from birth through 18 months of age. Scrotal circumference was adversely affected by zeranol in groups 2A and 2B, but values approached those of group 1 with increasing age. Serving ability was also affected adversely but tended to recover with increasing age. Semen quality was low in groups 2A and 2B and did not improve with increasing age. There was no difference in testicular weight, vesicular gland weight, and penis length among groups when bulls were slaughtered at 20 months of age. Epididymal weight was greater in group-2B bulls and was most likely a consequence of epididymal lesions. Histologic examination of the genital organs revealed that zeranol induced adenomyosis and sperm granulomas in the caudae epididymidis and markedly altered the structure of the sexual accessory glands of bulls in groups 2A and 2B. Alterations in the vesicular glands were characterized by reduced alveolar development and an increase in connective tissue. Low epithelium associated with focal areas of squamous metaplasia were common in the prostate of groups 2A and 2B bulls. Lesions in the bulbourethral glands were characterized by low glandular epithelium, focal areas of squamous metaplasia, cystic collecting ducts, and an increase in connective tissue. Groups 2A and 2B had more abnormal seminiferous tubules than did group 1. Lesions in groups 2A and 2B may have been direct effects of zeranol or may have resulted from reduced testosterone secretion. PMID- 3826835 TI - Inhibition of macrophage adenylate cyclase by the alpha-methylene-gamma-lactone moiety of sesquiterpene lactones from forage plants. AB - Inhibition of murine macrophage adenylate cyclase activity by sesquiterpene lactones isolated from toxic forage plants was highly correlated with the presence of the alpha-methylene-gamma-lactone moiety on the molecule (ie, hymenovin and helenalin). Tenulin, a sesquiterpene lactone which does not contain this reactive moiety, caused minimal inhibition of the enzyme. Reaction of the alpha-methylene-gamma-lactone moiety of hymenovin and helenalin with cysteine decreased the number of reactive moieties available to alkylate the enzyme, thus decreasing the inhibition of adenylate cyclase by these 2 sesquiterpene lactones. As the reaction time available for the reduction by cysteine of the alpha methylene-gamma-lactone moiety decreases, the amount of adenylate cyclase inhibition increases. Stimulation of the hymenovin- or helenalin-inhibited adenylate cyclase by prostaglandin E1 or E2 or by sodium fluoride did not reverse the inhibition of the enzyme, but did stimulate the undamaged adenylate cyclase in the sesquiterpene lactone treatment groups to the same degree as in the nontreated control. These data indicate that sesquiterpene lactones containing an alpha-methylene-gamma-lactone moiety are potent inhibitors of macrophage adenylate cyclase activity. This moiety may have a significant role in the toxicity of some sesquiterpene lactones in poisonous plants when ingested by livestock. PMID- 3826836 TI - Contamination during zinc and copper analyses. PMID- 3826837 TI - Effect of sulfadimethoxine-ormetoprim in the treatment of calves with induced Pasteurella pneumonia. AB - The efficacy of sulfadimethoxine (SDM)-ormetoprim (OMP) was evaluated in calves with induced Pasteurella pneumonia. A dose-titration study comparing 3 doses of SDM-OMP was performed to determine the optimal dose. Treatments included: group 1 -nontreated controls; group 2--33 mg of SDM-OMP/kg of body weight, orally on day 1 and 17 mg/kg on days 2 to 5; group 3--66 mg of SDM-OMP/kg, orally on day 1 and 33 mg/kg on days 2 to 5; group 4--99 mg of SDM-OMP/kg, orally on day 1 and 50 mg/kg on days 2 to 5; and group 5--11 mg of oxytetracycline/kg, IV daily for 4 days. Group-2 calves responded to treatment as well as did group-5 calves. Group 4 calves responded the same as did group-3 calves. However, group-2 calves did not respond as well as did groups 3, 4, and 5 calves. PMID- 3826838 TI - Pharmacokinetics and tissue residues of gentamicin in lactating cows after multiple intramuscular doses are administered. AB - Gentamicin was administered IM to 6 healthy, mature, lactating cows at a dosage of 3.5 or 5 mg/kg of body weight every 8 hours for 10 consecutive days (total, 30 doses). Endometrial biopsies were done at 72, 136 or 144, and 216 hours after the first dose was administered. On the 10th day, just before the last dose of gentamicin was administered, blood samples (designated 10th-day base-line samples) were obtained, and serial blood samples were obtained for 144 hours after the last injection was given. The cows were catheterized on the 10th day, and urine was obtained for 10 to 18 consecutive hours. Milk samples were also obtained. The cows were slaughtered at different times after the last dose was given, and samples were taken from 22 tissues and organs. Serum, milk, urine, and tissue gentamicin concentrations were determined by radioimmunoassay. Serum gentamicin concentrations were best fitted to a 2-compartment open model. The mean half-lives for absorption, distribution, and elimination were 0.16 +/- 0.14, 2.59 +/- 0.53, and 44.91 +/- 9.38 hours, respectively. Total body clearance and renal clearance were 1.65 +/- 0.69 and 1.32 +/- 0.25 ml/min/kg, respectively. The percentage of the dose excreted unchanged in the urine at 8 hours after the last dose was given was 98 +/- 15. As expected, of the tissues examined, the gentamicin concentrations in the kidney cortex and medulla were 1,500 times greater than those in serum. Renal function remained within the baseline range during the 10 days of gentamicin treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826839 TI - Tetramine cupruretic agents: a comparison in dogs. AB - The cupruretic effects of 2 tetramine (N,N'-bis (2-aminoethyl) alkane diamine) chelators were examined in healthy dogs fed a commercial dog food containing 12.2 micrograms of copper/g of dry diet. Two groups of 3 dogs each were given either 300 mg of 2,2,2-tetramine tetrahydrochloride or 2,3,2-tetramine tetrahydrochloride for 23 consecutive days. Serum and 24-hour urine samples obtained before drug administration and during therapy were analyzed for copper, zinc, and iron concentrations. Both tetramines produced a significant cupruresis without significant changes in serum copper or in serum or urine zinc and iron concentrations. The 2,3,2-tetramine tetrahydrochloride produced a 4- to 9-fold greater cupruresis than did 2,2,2-tetramine tetrahydrochloride and resulted in a daily loss of more than 2 mg of copper in the urine. The dogs had no laboratory or clinical evidence of toxic side effects to either cupruretic agent during the treatment period. The results of the present study indicate that 2,3,2-tetramine should be an effective decoppering drug for use in dogs. PMID- 3826840 TI - Myometrial activity during natural and dexamethasone-induced parturition in the cow. AB - Myometrial activity was monitored during natural and dexamethasone-induced parturition in 8 Holstein dairy cattle, using strain gauge transducers. Four gauges were attached to the serosal surface of the gravid uterine horn, dividing it into thirds. Parturition was induced in 2 of 4 heifers and 2 of 4 cows (group 1); the remaining animals were allowed to calve spontaneously (group 2). Chains of low-amplitude contractions (repeated small deviations from base line) were detected before parturition was induced, and these were more common at distended parts of the uterus. Uncharacteristically sharp peaks followed by small rhythmic contractions, during preinduction recording, indicated that the myometrium was responsive to fetal movement even several days before parturition. By 18 hours before parturition, discrete single contractions appeared independently of contraction chains, and the first tubocervical peristaltic contraction waves were detected. The mean area under recorded contraction curves (uterine work) increased quadratically and the frequency of contractions decreased linearly from 12 hours before parturition to 2 hours after parturition. There was also an increase in the proportion of tubocervical waves over this period, and contraction chains were no longer present. During the second stage of labor, distended and undistended parts of the uterus were equally active, and forceful maternal straining was associated with larger sustained contractions. Fetal membrane rupture was accompanied by a doubling in the rate of passage of contraction waves along the length of the uterus. After the calf was expelled, contractions became extremely regular, and the majority progressed in a tubocervical direction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826841 TI - Prostaglandin-induced abortion in swine: endocrine changes and influence on subsequent reproductive activity. AB - Gilts were treated during midgestation with prostaglandin (PG) F to study the efficacy of different treatment regimens on induction of abortion and to determine the adverse consequences of PGF-induced abortion in swine. In study 1, pregnant purebred Duroc gilts (60 to 90 days of gestation) were given (IM) 500 micrograms of cloprostenol (n = 12), 20 mg of dinoprost tromethamine (n = 11), or 10 mg of dinoprost tromethamine repeated 12 hours later by an additional 10 mg of dinoprost tromethamine (n = 11). The percentage of gilts that aborted and percentage of aborted gilts that returned to estrus for each treatment group were as follows: cloprostenol, 91.7% and 100%, respectively; 20 mg of dinoprost tromethamine, 36.4% and 25.0%, respectively; and 10 + 10 mg of dinoprost tromethamine, 100% and 90.9%, respectively. Treatment with cloprostenol and with 10 + 10 mg of dinoprost tromethamine caused more gilts to abort (P less than 0.01) than did treatment with 20 mg of dinoprost tromethamine. Gilts that did not abort were given a second treatment with 10 + 10 mg of dinoprost tromethamine. When the abortions by gilts initially treated with 500 micrograms of cloprostenol or 10 + 10 mg of dinoprost tromethamine were combined with those re-treated with 10 + 10 mg of dinoprost tromethamine, 32 of 33 (97.0%) gilts aborted, and 30 of the 32 (93.8%) aborted gilts returned to estrus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826842 TI - Effects of eight weeks of physical conditioning on atherosclerotic plaque in swine. AB - Effects of individually prescribed exercise on the regression or interference with deposition of atherosclerotic plaque were studied. Twenty miniature swine allotted, by litter, to a control-diet group (groups CE and CS) and an atherogenic diet group (groups AE and AS). All pigs were subjected to injury (balloon catheter) of the aortic endothelium. They were fed for 8 weeks and after an initial graded exercise test was done, then each group was suballotted to an exercising group (groups CE and AE) or a sedentary group (groups CS and AS). Groups CE and AE (exercised) were given 8 weeks of training. Groups CS and AS (sedentary) were sham exercised during this period. A second graded exercise test was administered to the swine (all groups) before they were euthanatized. Aortas were analyzed for the percentage of area involved and for atherosclerotic plaque density. Samples of blood from the swine after they were fasted were obtained before the start of the project (base line) and once every 2 weeks thereafter. These were analyzed for triglycerides, high- and low-density lipoprotein, and total cholesterol concentration. Comparison of results of blood lipid analyses from weeks 1, 9, and 15 did not show significant differences within diet groups between exercise and sedentary. Significant differences at weeks 9 and 15 were observed between diet groups (ie, the pigs fed the atherosclerotic diet had higher blood lipids). Plaque formation was not found in the pigs fed the control diet (groups CE and CS). Plaque formation was evident in all pigs fed the atherosclerotic diet (groups AE and AS) with no significant differences between exercised and sedentary groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826843 TI - Clinical and hematologic variables in ponies with experimentally induced equine ehrlichial colitis (Potomac horse fever). AB - The clinical and hematologic variables of 10 ponies with experimentally induced equine ehrlichial colitis (EEC; syn: Potomac horse fever) were studied for a 30 day period (6 ponies) or until death (4 ponies). The earliest clinical sign indicative of EEC was fever (rectal temperature exceeding 39 C). All ponies became depressed (CNS) at various times during the disease, and 90% of the ponies developed diarrhea between 9 and 15 days after infection was induced. The most significant hematologic change was an increase in plasma protein concentration after the onset of fever (P less than 0.05). The PCV in all ponies became increased above base line during the diarrheic phase of EEC. Forty percent of the ponies developed anemia (PCV less than or equal to 23%) during the study. White blood cell counts were highly variable, with 80% of the ponies developing leukopenia (WBC less than 5,000/microliters) during the illness and 60% of the ponies developing leukocytosis (WBC greater than 14,000/microliters) after leukopenia was observed. Differential WBC changes varied widely and included neutropenia with a left shift, lymphopenia, and eosinopenia. Serial thrombocyte counts, which were done for only 1 pony, identified the development of marked thrombocytopenia. Some hematologic changes in ponies with EEC were similar to those reported in canine monocytic and equine granulocytic ehrlichioses. These data are discussed in the context of the pathogenesis and differential diagnosis of EEC. PMID- 3826844 TI - Heparin-induced agglutination of erythrocytes in horses. AB - Heparin was administered subcutaneously 2 times a day for 4 days to 5 horses. An additional group of 5 horses was used as time-matched controls. Significant decreases in PCV, erythrocyte count, and hemoglobin concentration were observed during heparin therapy. The mean corpuscular volume (MCV) of the heparin-treated horses increased to a peak value of 66.1 fl on the last day of treatment. Erythrocyte creatine concentration and glucose 6-phosphate dehydrogenase activity increased moderately during the treatment. These data indicated that the rapid, profound increase in MCV during heparin therapy was not primarily a result of release of large immature erythrocytes from the bone marrow. A second experiment was subsequently performed, using 3 horses. These horses were given heparin 2 times a day, as was done in the first experiment. Saline wet mounts of erythrocyte suspensions were examined once a day for the presence of agglutination. Cell suspensions were examined with or without exposure to a dilute trypsin solution, and erythrocyte counts were done on each suspension, using an electronic cell counter. Agglutination of erythrocytes was evident on the first day of treatment and became more pronounced as treatment progressed. Exposure to trypsin solution reversed the agglutination. The apparent erythrocyte count decreased and MCV increased sharply in the samples processed normally, but there was little change in those suspensions exposed to trypsin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826845 TI - Cardiovascular and respiratory measurements in awake and isoflurane-anesthetized horses. AB - Circulatory and respiratory function was monitored in nonmedicated, spontaneously breathing horses (n = 7) immediately before, during, and 1 hour after 85 +/- 4.1 (X +/- SEM) minutes of constant 1.57% isoflurane in O2 anesthesia. Comparison of values during anesthesia with those obtained while horses were awake revealed a significant (P less than 0.05) decrease in arterial blood pressure that was related to a slight, but insignificant, decrease in cardiac output and peripheral vascular resistance. Although isoflurane anesthesia and recumbency resulted in a significant (P less than 0.05) decrease in stroke volume, cardiac output did not decrease significantly because heart rate tended to increase. Isoflurane and recumbency also significantly (P less than 0.05) increased PaCO2, peak expiratory gas flow, total expiratory time, and PCV and significantly decreased PaO2, minute expired ventilation, and the ratio of peak inspired to expired gas flow. Differences imposed by isoflurane anesthesia were reversed by 1.5 hour after anesthesia. PMID- 3826846 TI - Contribution of whole blood L-lactate, pyruvate, D-lactate, acetoacetate, and 3 hydroxybutyrate concentrations to the plasma anion gap in horses with intestinal disorders. AB - Increased anion gap (AG) was due, in part, to L-lactic acidosis in 14 of 14 horses with intestinal disorders. In a few horses, increased whole blood concentrations of D-lactate made a minor contribution to the AG. However, the increase in AG was often greater than the sum of the increases in these 2 acid anions. This unexplained increase was not a result of increases in whole blood pyruvate, 3-hydroxybutyrate, or acetoacetate concentrations or serum albumin or phosphate concentrations. Identification of other anions causing increased AG could lead to better understanding, diagnosis, and treatment of metabolic imbalances in critically ill horses. PMID- 3826847 TI - Cross protection of mice and swine given live-organism vaccine against challenge exposure with strains of Erysipelothrix rhusiopathiae representing ten serovars. AB - Mice and swine vaccinated (subcutaneous inoculation) with live acriflavine-fast attenuated Erysipelothrix rhusiopathiae, strain Koganei 65-0.15 (serovar 2), were challenge exposed with 10 strains of E rhusiopathiae pathogenic for swine; the latter strains comprised serovars 9 and 10 and other previously undetermined. Vaccinated mice did not die after they were challenge exposed (subcutaneous inoculation) with serovars 4, 6, 7, 8, 9, 10, 15, 16, or N, but vaccinated mice challenge exposed with strain 2553 (serovar 20) had 30% mortality. Nonvaccinated control mice died after they were challenge exposed with all serovars tested. One of 2 vaccinated swine challenge exposed (intradermal inoculation) with each of strains 911 (serovar 8), 2179 (serovar 10), or 2553 developed localized urticarial lesion at the site of intradermal inoculation. Vaccinated swine challenge exposed with serovars 4, 6, 7, 9, 15, 16, or N did not have clinical signs of acute swine erysipelas. Nonvaccinated control swine developed localized lesions at the site of intradermal challenge inoculation. PMID- 3826848 TI - Campylobacter jejuni infection in the ferret: an animal model of human campylobacteriosis. AB - Campylobacter infection in weanling ferrets (Mustela putorius furo) was studied as an animal model for enteric campylobacteriosis in persons. The screening of fecal cultures on selective campylobacter media showed that Campylobacter jejuni/coli was not present in the normal enteric flora. Intragastric feeding of a mixture of cat feed and 2.5 X 10(8) C jejuni isolated from ferrets with naturally occurring proliferative colitis was accomplished. All ferrets (n = 8) became infected on 3 days after they were inoculated, and at 5 to 7 days, they had bile-tinged, liquid feces with excessive mucus and blood. Ferrets gradually recovered from the diarrhea, and feces were normal 10 to 14 days after inoculation was done. Feces contained C jejuni at 14, 23, 28, 39, 46, 60, 91, 101, 109 and 144 days. In the second experiment, weanling ferrets initially were treated with 10% sodium bicarbonate, and 1 X 10(10) C jejuni organisms were administered in the cat feed. Diarrhea with fecal leukocytes and occult blood with occasional mucus appeared in almost all of the 21 ferrets from days 4 through 7. Campylobacter jejuni was isolated from the blood of 11 ferrets between 3 hours and 14 days after they were inoculated. Campylobacter jejuni bactericidal antibodies were present in serum samples at 14 days, with titers of 1:16 to 1:32. Intestinal lesions including cellular infiltration with mononuclear and polymorphonuclear leukocytes were in the lamina propria of the pyloric mucosa and small intestine of infected and control ferrets. The colon of 3 infected ferrets had small focal infiltrates of neutrophils on the lamina propria; one ferret had perivascular cuffing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826849 TI - Experimental infection and abortion of pregnant guinea pigs with a unique spirillum-like bacterium isolated from aborted ovine fetuses. AB - Study was made of the pathogenicity of a spirillum-like, anaerobic, gram-negative bacterium, originally isolated from aborted lambs, for pregnant guinea pigs. Reproducible conditions for propagation and preservation of the bacterium were determined as requisite for the preparation of cultures for animal inoculation. A preliminary experiment was done with 10 pregnant guinea pigs to test for an infective dose of organisms that would produce abortion. High-passage cultures (n = 50) were used to inoculate these guinea pigs intraperitoneally. Six of 10 guinea pigs aborted, and the organism was cultured from fetal tissues of 5 guinea pigs. Isolates from 3 of the 6 guinea pigs were propagated through 4 passages on blood agar and used to infect 3 groups, each of 5 guinea pigs. A 4th group of 5 guinea pigs was inoculated with the original culture. Three of 5 animals in the first 3 groups, which had been given the low-passage cultures from the preliminary trial, and 2 of 5 guinea pigs in the 4th group, which had been given the original culture, aborted. Antibody against the spirillum was detected in 19 of 30 inoculated guinea pigs. The major microscopic lesions were acute suppurative placentitis and splenitis. This bacterium retained pathogenic properties sufficient to cause infection, abortion, and microscopic lesions in two-thirds of the guinea pigs, in spite of high in vitro passage. The organism has unique ultrastructures, and its genus and species are yet to be determined. PMID- 3826850 TI - Infectivity of three Anaplasma marginale isolates for Dermacentor andersoni. AB - Three isolates of Anaplasma marginale--Virginia (VAM), Illinois (IAM), and Florida (FAM)--were compared for infectivity for Dermacentor andersoni. The isolates were selected, in part, because of a tail-like appendage that has been demonstrated in the VAM and IAM, but not in the FAM. Ticks were exposed to the isolates as nymphs either naturally by feeding on a calf with anaplasmosis or artificially by percutaneous inoculation with infected bovine erythrocytes. They were examined for infectivity after molting to the adult stage by determining their capability to transmit the disease to susceptible calves and by demonstrating colonies in tick gut sections. Only those ticks exposed to the VAM proved to be infected with A marginale; ticks naturally exposed and those artificially infected with this isolate transmitted the disease to susceptible calves. Colonies of A marginale were observed only in gut tissues of ticks naturally infected with VAM. The IAM (appendage present) and FAM (appendage absent) could not be found in ticks exposed by either method, indicating that factors other than the presence of inclusion appendages may be involved in infection of ticks by A marginale. PMID- 3826851 TI - Immunologic response to Pasteurella haemolytica and resistance against experimental bovine pneumonic pasteurellosis, induced by bacterins in oil adjuvants. AB - Immunogenicity of and protection afforded by Pasteurella haemolytica bacterins were studied in calves. Bacterins contained an aluminum hydroxide in gel (ALH) adjuvant or one of the following oil-in-water adjuvants: Freund's complete adjuvant (FCA), Freund's incomplete adjuvant (FIA), and trehalose dimycolate (TDM). On days 0 and 7, calves were vaccinated with phosphate-buffered saline solution (PBSS), a bacterin, or live P haemolytica. Transthoracic intrapulmonic challenge exposure was done on day 21. In 3 experiments, there were no significant (P greater than 0.05) differences between lung lesions induced in PBSS-or ALH bacterin-vaccinated calves. Both FCA and FIA bacterins significantly (P less than 0.05) enhanced resistance against challenge exposure. Resistance induced by FCA and FIA bacterins was comparable with that induced by vaccination with live P haemolytica. Calves vaccinated with FIA bacterin and challenge exposed to P haemolytica at a concentration of 4.5 X 10(9) colony-forming units (4.5 times greater than used in the first 3 experiments) resisted challenge exposure similar to calves given live organisms. The TDM bacterin failed to enhance resistance. All bacterins caused a significant increase (P less than 0.05) in serum antibody to P haemolytica somatic antigens, as measured by a quantitative fluorometric immunoassay. Pasteurella haemolytica leukotoxin neutralizing antibody titers did not increase significantly (P greater than 0.05) in sera after vaccination with any bacterin. Vaccination with FCA and FIA bacterins resulted in a significant increase (P less than 0.001) in serum antibody to a carbohydrate-protein subunit of P haemolytica, as measured by an enzyme-linked immunosorbent assay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826852 TI - Demonstration of Pasteurella-specific immunoglobulin E in bovine serum. AB - On the basis of recent observations that immunoglobulin (Ig) E antibodies specific for bacterial antigens occur in the serum of persons with chronic respiratory tract disease, we used bovine epsilon chain-specific antiserum to investigate the possibility that IgE antibodies are induced in cattle infected with Pasteurella. Using enzyme-linked immunosorbent assay and Western blotting techniques, we studied bovine sera to detect and quantitate the presence of IgE antibodies specific for antigens of Pasteurella. Immunoglobulin E antibodies reactive with whole formalinized P haemolytica, potassium thicyanate, and saline solution extracts were detected in serum of calves with bronchopneumonia, feedlot steers with interstitial pneumonia, as well as nonaffected penmates, and adult dairy cows. The role of parenteral vaccination in eliciting an IgE response was examined in healthy calves; vaccination with a Pasteurella bacterin failed to induce an IgE response. Adsorption studies were done to demonstrate the specificity of the antibodies for Pasteurella. Enzyme-linked immunosorbent assay absorbance values were significantly decreased by adsorption with P haemolytica, whereas adsorption with other gram-negative bacteria only moderately decreased serum absorbance values. To begin identification of the antigen(s) to which the IgE binds, Western blotting of P haemolytica extract with sera from calves with bronchopneumonia was done. A dense band of protein (approximately 60,000 daltons) reacted strongly with IgE in the highest titer sera. These results indicate that Pasteurella-specific IgE antibodies are not readily induced by parenteral vaccination, but can be found in serum of some cattle, possibly induced by existing or previous infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826853 TI - Absolute and relative concentrations of immunoglobulins G, M, and A, and albumin in the lacteal secretion of sows of different lactation numbers. AB - The concentrations of immunoglobulin (Ig)G, IgM, IgA, and albumin in the lacteal secretion of 80 sows were measured not more than 14 times during lactation to determine whether the age of the sow, the anatomic location of the mammae, or the farrowing barn housing of the sow influenced Ig concentrations. The combined data indicated that there were lactation stage-dependent changes in the total Ig concentration, as well as changes in the relative importance of the 3 classes of Ig studied. Mean values of any one time point showed enormous variation in absolute values, with coefficients of variation ranging up to 70% The largest variations were observed between colostral samples obtained on the first day. The IgM showed the least variation on day 1. Such variations hindered attempts to statistically identify their source. Normalization of Ig concentrations in relation to albumin concentrations decreased some of the apparent variation. Normalized data accentuated the changeover from colostrum to milk which occurred after the first 3 days. There was also a 3-fold increase in IgA concentrations which occurred during the last 4 weeks of lactation. Data showed that older sows tended to have higher concentrations of all Ig. Lactation number-dependent increases in IgM and IgG were restricted to colostrum in lactation numbers higher than 4. Immunoglobulin A increased in a similar pattern and, in addition, increased in mature milk in sows with more than 2 lactations. The enormous variations observed seemed to be individual animal variations. This allowed only trends, rather than statistically significant differences, to be recognized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826854 TI - Serologic survey of viral antibodies in the Peruvian alpaca (Lama pacos). AB - Sera from more than 100 alpacas (Lama pacos) from the Peruvian southern sierra were examined for antibodies to 8 viruses known to infect other domestic animals. On the basis of these serologic findings and previously published serologic or clinical data, it is now known that the alpaca can be infected with the following viruses: parainfluenza-3, bovine respiratory syncytial virus, bovine herpesvirus 1, bluetongue virus, border disease virus, influenza A virus, rotavirus, rabies virus, vesicular stomatitis virus, foot-and-mouth disease virus, and contagious ecthyma virus. PMID- 3826855 TI - Arterial hypotension and the development of postanesthetic myopathy in halothane anesthetized horses. AB - The effect of halothane-induced hypotension on the development of postanesthetic myopathy was studied, using 6 healthy adult horses. Horses were anesthetized with halothane in oxygen for 3.5 hours on each of 2 occasions. Intermittent positive pressure ventilation was used to maintain PaCO2 of 45 to 55 mm of Hg throughout both anesthetic exposures. By regulating the inspired halothane concentration, a mean arterial blood pressure of 85 to 95 mm of Hg (normotension) was maintained throughout the 1st anesthetic exposure, and a mean arterial blood pressure of 55 to 65 mm of Hg (hypotension) was maintained during the 2nd anesthetic exposure. All horses recovered uneventfully from normotensive anesthesia, but all had some muscle dysfunction after prolonged hypotensive anesthesia. Because of apparent animal discomfort and lameness involving more than 1 limb, 3 horses were euthanatized soon after they recovered from hypotensive anesthesia. The 3 other horses showed a degree of lameness. In addition, 1 horse had raised, swollen plaques over the hip, rib, and facial areas which were in contact with the surgical table, and another had evidence of facial nerve paralysis. One hour after the 6 horses stood after hypotensive anesthesia was completed, values obtained for aspartate transaminase and creatinine were significantly (P less than 0.05) greater than those obtained after normotensive anesthesia was completed. Aspartate transaminase, total bilirubin, and creatinine values were significantly (P less than 0.05) increased when compared with those obtained before horses were anesthetized. A large increase was measured in creatine kinase. Twenty-four hours after hypotensive anesthesia was completed, creatine kinase and lactate dehydrogenase in the 3 surviving horses were significantly (P less than 0.05) greater than those values after normotensive anesthesia was completed. PMID- 3826856 TI - Effects of xylazine on equine intestinal vascular resistance, motility, compliance, and oxygen consumption. AB - Isolated jejunal segments were perfused at a constant blood flow rate to determine simultaneously the effects of xylazine on intestinal vascular resistance, motility, compliance, and oxygen consumption in 12 anesthetized ponies. Xylazine was infused into the artery perfusing the intestinal segment (group 1), or into the jugular vein as a single IV bolus (group 2), or 3 times as IV boluses repeated at 10-minute intervals (group 3). Dose-response curves in group 1 indicated a biphasic response to the drug with vasoconstriction, increased motility, and increased oxygen consumption at lower doses followed by a return toward base-line values at higher doses. Intestinal compliance decreased at lower doses, but increased at higher doses. A single IV bolus of xylazine (group 2) induced systemic hypotension for 30 minutes, and increased intestinal vascular resistance for 10 minutes accompanied by increased motility, and repeatedly administered IV boluses of xylazine (group 3) increased and prolonged these effects. The results indicated that xylazine, especially in repeated doses, may decrease bowel viability by simultaneously increasing intestinal vascular resistance, motility, and oxygen consumption. PMID- 3826857 TI - Clearance of nasal mucus in nonanesthetized and anesthetized dogs. AB - Clearance rates for nasal mucus in the maxillary turbinate region were measured in 8 Beagle dogs. 99mTc Macroaggregated albumin (10 microliters) was instilled in the nasal maxillary region of dogs under general anesthesia. A gamma camera was used to detect movement of the 99mTc macroaggregated albumin in the nose for 1 hour after it was instilled. Velocity of mucus was measured in the 8 dogs each under 3 conditions of anesthesia: anesthesia with pentobarbital given IV (20 mg/kg of body weight), anesthesia with halothane gas, and no anesthesia. Mean velocities (+/- SD) were 3.7 +/- 1.4 mm/min in dogs anesthetized with pentobarbital, 4.3 +/- 2.5 mm/min in dogs anesthetized with halothane, and 3.4 +/ 1.7 mm/min in awake dogs. The differences between the 3 anesthetic conditions were not significant at the P less than 0.05 level. Use of anesthesia at a light surgical plane provides a controlled method for measurement of clearance of nasal mucus with minimal alterations from the nonanesthetized state. PMID- 3826858 TI - Eructation of gas through the gastroesophageal sphincter before and after truncal vagotomy in dogs. AB - The function of the gastroesophageal sphincter (GES) to eructate gas before and after vagotomy was investigated in conscious, fed dogs. Gastric and GES pressures were measured in 5 dogs, using a perfused 4-lumen catheter with a Dent sleeve. To induce eructation, nitrogen gas was insufflated (440 ml/min) into the stomach through 1 channel of the catheter. After base-line studies were completed on each dog, bilateral truncal vagotomy was performed 5 cm cranial to the diaphragm. Mean (+/- SE) GES pressure was 51.5 +/- 1 mm of Hg before vagotomy and 28 +/- 1.7 mm of Hg after vagotomy (P less than 0.001). Mean gastric contraction rates were the same, 4.91 +/- 0.11/min and 4.78 +/- 0.06/min in dogs before and after vagotomy, respectively. During insufflation, gastric pressures increased to 11.8 +/- 0.7 mm of Hg before eructation in dogs before vagotomy and to 18.4 +/- 0.8 mm of Hg in dogs after vagotomy (P less than 0.001). Eructation occurred at intervals of 1.79 +/- 0.09 minutes before vagotomy and 5.71 +/- 0.41 minutes after vagotomy (P less than 0.001). Atropine resulted in an interval of 1.98 +/- 0.18 minutes before vagotomy. Eructation was not seen in 2 dogs after vagotomy and was sometimes not seen in the 3 others. Gastroesophageal sphincter pressure in dogs before vagotomy began to decrease 4.5 +/- 0.2 s before the GES-pressure gradient disappeared, and GES pressure remained there for 5.3 +/- 0.3 s before the gradient began to return.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826859 TI - Anesthetic interaction in cardiovascular research models: effects of xylazine and pentobarbital in cats. AB - The effects of xylazine given to cats before anesthetization was induced with pentobarbital were determined. Cardiac hemodynamic variables and regional blood flow rates in the heart and other organs were measured, using radiolabeled microspheres. Two groups, each of 10 cats, were included in the study: one group (group 1) was anesthetized with pentobarbital given intraperitoneally and subsequently given xylazine; the other group (group 2) was first given 1 mg of xylazine/kg, IM, and then anesthetized with pentobarbital given IV. Anesthesia was maintained in both groups with nitrous oxide. The preanesthetic administration of xylazine decreased the amount of pentobarbital used for surgical anesthesia by approximately 50%. It also resulted in decreased heart rate, cardiac contractility, and cardiac output and increased left ventricular end-diastolic pressure, compared with those values in cats given pentobarbital (group 1). After the latter cats (anesthetized with pentobarbital) were given xylazine, heart rate, cardiac contractility, and cardiac output decreased and left ventricular end-diastolic pressure increased to values similar to those found in group 2 (given xylazine before anesthetization). Myocardial tissue blood flow rates in the left and right ventricles were lower in the cats of group 2. In group 1 cats, myocardial blood flow rates decreased when xylazine was subsequently added. Blood flow rates in the kidneys and gastrointestinal tract were generally decreased by xylazine. Xylazine profoundly changed cardiac hemodynamic function and perfusion in the heart, as well as several other organ systems, because of marked cardiodepression. PMID- 3826860 TI - An evaluation of agglutination and coagglutination techniques for serotyping of Haemophilus pleuropneumoniae isolates. AB - A comparative evaluation of rapid slide agglutination, tube agglutination, 2 mercaptoethanol tube agglutination, and coagglutination tests was made for serotyping isolates of Haemophilus pleuropneumoniae. The results indicated that a majority of the isolates could be serotyped by any of these tests. But, it was not uncommon to find isolates which were inagglutinable or poorly agglutinable in homologous sera. Heat treatment of whole-cell suspensions of such isolates was essential to unmask the serotype-specific antigenic determinants; however, in the process of heat treatment, cross-reactive common antigens of minor nature were also exposed. The antibodies involved in such cross-reactions were mainly of immunoglobulin M type, because the cross-reactivities were completely abolished in coagglutination and 2-mercaptoethanol agglutination tests. Thus, both these tests were satisfactory for serotyping inagglutinable mucoid strains. For serotyping strains which were either polyagglutinating or autoagglutinating, agglutination tests could not be used, but the coagglutination test proved to be satisfactory. The coagglutination test was serotype-specific, sensitive, simple, rapid, reproducible, and easier to read and interpret than rapid slide or tube agglutination tests. This test could be used to serotype mucoid, smooth, or rough isolates. PMID- 3826861 TI - Canine distemper virus: in vivo virulence of in vitro-passaged persistent virus strains. AB - Groups of ferrets were inoculated intraperitoneally with cell lysates or equivalent doses of whole cells from 9 different cell lines persistently infected with canine distemper virus. Viral persistence in these cell lines was characterized by noncytolytic infection and restricted release of cell-free infectious virus. In vivo replication competency of the various viruses in ferrets ranged from nil to virulent and did not correlate with in vitro titers of inocula. Ferret virulence (cell lysates only) for one cell line (CCL64-RCDV) was associated with morphologic absence of virion assembly, failure to interfere with lytic virus replication after superinfection, and in vitro infectivity restricted to canine macrophage-like tumor cells. Virion protein production in the CCL64 RCDV virulent inoculum and in the CCL64-Ly avirulent inoculum was evaluated by use of the immunoblot technique. All major virion proteins were produced by infected cells. Virulence was not associated with obvious changes in electrophoretic mobility of virion proteins when profiles of ferret-virulent CCL64-RCDV were compared with those of avirulent CCL64-Ly. PMID- 3826862 TI - Cross protection of mice and swine inoculated with culture filtrate of attenuated Erysipelothrix rhusiopathiae and challenge exposed to strains of various serovars. AB - Mice and swine inoculated subcutaneously with culture filtrate vaccine prepared from acriflavine-fast attenuated Erysipelothrix rhusiopathiae strain Koganei 65 0.15 (serovar 2), were challenge exposed to 20 pathogenic strains of E rhusiopathiae of 18 serovars and type N. Vaccinated mice survived after challenge exposure to serovars 1b, 2, 8 (strain Goda), and type N, but mortality occurred in vaccinated mice challenge exposed to other strains: 20% to 30% mortality in mice challenge exposed to serovars 1a, 11, 12, 15, 16, or 21; 40% to 50% mortality in mice challenge exposed to serovars 4, 5, 6, 7, or 8 (strain 911); and 60% to 80% mortality in mice challenge exposed to serovars 9, 10, 18, or 19. All vaccinated mice died after challenge exposure with strain 2553 (serovar 20). Non-vaccinated control mice died after challenge exposure to all strains. Of 2 vaccinated swine challenge exposed to strain 2553, 1 developed a local urticarial lesion at the site of intradermal exposure. Vaccinated swine challenge exposed to serovars 1a, 1b, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15, 16, 18, 19, 21, or type N did not have clinical signs of acute erysipelas. Nonvaccinated control swine developed acute generalized erysipelas or localized urticarial lesions at the site of intradermal exposure. PMID- 3826863 TI - Changes in basal lamina of seminiferous tubules associated with deranged spermatogenesis in the bull. AB - The basal lamina of seminiferous tubules of 16 beef bulls, with scrotal circumferences (SC) from 40.5 to 28 cm, was characterized. The mean thickness of basal laminae was from 0.55 to 0.94 micron in normospermic bulls with SC greater than 30 cm. Of 3 bulls that had a SC less than 30 cm, 1 had hypoplastic testes and was azoospermic, whereas 2 bulls had atrophic changes in their testes and were oligospermic. The latter 2 bulls had thick basal laminae, with a mean of 1.35 micron and 1.68 micron, respectively, whereas basal laminae of the bull with hypoplastic testes had a mean thickness of 0.96 micron, comparable with that of bulls with normal testes (SC, greater than 30 cm). Thickness of the basal lamina of seminiferous tubules might be a useful criterion in differentiating atrophy from hypoplasia. PMID- 3826864 TI - Abortion in sows experimentally infected with African swine fever virus: pathogenesis studies. AB - Thirteen sows that were 38 to 92 days pregnant were experimentally infected with an African swine fever (ASF) virus strain of low virulence (Dominican Republic isolate). Seven of 11 sows that were not killed had aborted. The pathogenesis of the abortions was studied, using virus isolation, tissue immunofluoresence, and histopathologic techniques. African swine fever virus was recovered from 179 of 1,329 (13.5%) fetal tissues tested. The 3 fetal tissues most frequently yielding virus were the fetal placenta, amniotic fluid, and fetal heart blood. Virus was not recovered from fetal tissues obtained from 2 of the aborting sows. Direct immunofluorescent microscopy for ASF viral antigen was done on approximately 1,175 fetal tissues. Although brightly fluorescing cells were common in maternal tissues, specific immunofluorescence was present in only placental tissues from 2 sows. Microscopic lesions in fetal tissues were inconsistent and included mild focal placentitis, mild heptic degeneration and necrosis, and mild interstitial pneumonia. These changes were not considered to be sufficiently specific to have diagnostic significance. In marked contrast to these changes in the fetal tissues, maternal tissues had high titers of virus, with marked necrosis of lymphoid tissues, and contained many cells with ASF viral antigen. We conclude that specific diagnosis of abortion resulting from ASF infection should, therefore, be based on examination of maternal tissues, rather than fetal tissues. The pregnancy failure seems to result from the effects of the virus infection on the dam more so than from direct viral damage to the placenta or fetus. PMID- 3826865 TI - Ultrastructural changes in inherited cardiac calcinosis of DBA/2 mice. AB - Cardiac dystrophic calcinosis, an inherited condition in DBA/2 mice, produced extensive calcific lesions in the right ventricular myoepicardium of affected mice. The morphogenesis of the cardiac alterations was evaluated by microscopic and ultrastructural studies. The initial event was necrosis and mineralization of subepicardial myocytes. Mineral deposits were seen as dense granular and spicular deposits in mitochondria only, mitochondria and adjacent sarcoplasm, or the entire sarcoplasm in necrotic myocytes. In mature myoepicardial calcific lesions, the remnants of necrotic myocytes were seen as scattered dense masses of mineralized debris with surrounding fibroplasia and occasional macrophages and giant cells. Male weanling DBA/2 mice (n = 135) were fed either a commercial diet adequate in selenium-vitamin E (Se-E) content, or a basal semipurified Se-E deficient diet with or without silver acetate for 15, 20 or 25 weeks. Cardiac calcinosis severity seemed to increase in mice which developed concurrent Se-E deficiency. Cardiac calcinosis in the DBA/2 mouse is a useful model of cardiac calcification. PMID- 3826866 TI - Pathogenesis of simulated natural infections with Ostertagia ostertagi in calves. AB - The possibility of a mucosal hypersensitivity reaction and its relationship to the pathogenesis of simulated natural infections with Ostertagia ostertagi were studied in calves. Four groups of 4 calves each were used. One group was used as noninfected control; a 2nd group was given increasing doses of infective larvae; a 3rd group was given increasing doses of larvae and these were removed by succeeding treatment with an anthelmintic; and a 4th group was given an initial dose of larvae which was then eliminated with an anthelmintic. All calves given larvae became sensitized, as shown by an intradermal skin test. The continuously infected calves had significantly (P less than 0.05) higher fecal egg counts, eosinophil counts, plasma pepsinogen values, and worm burdens and significantly (P less than 0.05) lower lymphocyte counts than did the other groups of calves. These animals also had the most extensive mucosal pathologic changes. The group given intermittent larval challenge exposures followed by an anthelmintic showed decreased lymphocyte values, but these were not significant. Plasma pepsinogen values of this group increased between every challenge exposure and treatment, a 3-day period. This indicated that a mucosal hypersensitivity reaction had occurred in these calves at these times, because they were shown to have been sensitized, and challenge-exposure infections were not present for sufficient time to have produced direct pathologic effects. It therefore seems that a part of the pathologic changes in O ostertagi infections may be the result of the continuous challenge exposure experienced by the animals through a constant intake of larvae from pasture and the intestinal reaction to this challenge exposure. PMID- 3826867 TI - Anthelmintic effect of levamisole hydrochloride or ivermectin on tissue toxocariasis of mice. AB - Paranatal transmission of Toxocara canis infection could be prevented in pups if an effective drug were administered to pregnant bitches. This drug also could eliminate the larvae in dogs that have been experimentally infected repeatedly to produce protective immunity. For these reasons, we assayed the effect of 2 doses of levamisole hydrochloride or ivermectin on T canis larvae. Mice (5 groups) were infected with 1,000 infective T canis larvae and then treated with 2 different dosages of levamisole hydrochloride (6 mg/kg or 12 mg/kg, given subcutaneously), 2 different dosages of ivermectin (0.2 mg/kg or 0.4 mg/kg, given IM) or 0.15M NaCl (given subcutaneously) once a day from days 15 to 28 of infection. On day 33 of infection, the parasites in liver, lungs, brain, and carcass were obtained and compared between groups. The smaller dosage of levamisole hydrochloride (6 mg/kg) significantly decreased only carcass parasitism to 17% of that in the controls, but did not affect significantly the total parasite load. The larger dosage of levamisole hydrochloride (12 mg/kg) decreased the infection in all organs, but particularly in carcass and brain; total parasitism was only 36% of that in the controls. The smaller dosage of ivermectin (0.2 mg/kg) significantly increased the number of larvae in the lungs to 550% of that in the controls, but it did not significantly affect the total parasite load. The larger dosage of ivermectin (0.4 mg/kg) significantly decreased only brain parasitism, but liver and total parasitism were decreased to 40% and 57%, respectively, compared with that in the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826868 TI - Clinical chemistry reference values in two breeds of swine and their changes during percutaneous exposure to soman. AB - Clinical chemistry reference values in blood from 48 nonfasting Chester White/Yorkshire and 48 Hanford Miniature swine were determined. Subsequently, 40 animals of each breed were restrained in a cloth sling and fasted for 24 hours while exposed percutaneously to pinacolyl methylphosphonofluoridate (soman). The range of dosages for the Hanford Miniature swine was 2.0 to 15.8 mg/kg, and for the Chester White/Yorkshire swine, the range was 4.0 to 25.0 mg/kg. Sham-exposed groups, consisting of 8 animals of each breed, were treated in an identical manner, except no anticholinesterase agent was administered. Samples of blood were drawn at 1, 7, 14, and 28 days after soman or sham exposure. In the sham exposed groups, significant changes from the reference values were observed as a result of the 24-hour restraint. In both breeds, skeletal muscle enzyme activities were increased, plasma cholinesterase activity (ChEPL) was decreased, calcium concentration was decreased, and phosphorus concentration was increased. Percutaneous exposure to soman resulted in decreases of ChEPL and erythrocyte cholinesterase activities (ChERBC). The ChEPL recovered more quickly than the ChERBC in both breeds. Even in asymptomatic swine, the decrease of ChERBC was greater than 60% after 24 hours. In the swine of each breed given the largest dosage, hyperglycemia was apparent in blood samples taken at the onset of apnea, especially when the animal survived for greater than 2 hours. We conclude that both breeds of swine, on the basis of dispersion in clinical chemistry reference values, were equally suited for this type of dermatotoxicity study. The sling method of restraint, however, caused some undesirable changes in biochemical values. PMID- 3826869 TI - Methionine toxicosis in cats. AB - Cats given DL-methionine (1 g/kg of body weight/day) developed severe hemolytic anemia with marked increase of methemoglobin (MetHb) concentration and Heinz-body formation at treatment-day 6 to 10. Cats fed 0.5 g of methionine/kg for 52 days had a moderate Heinz-body hemolytic anemia with methemoglobinemia at treatment days 17 to 31, but thereafter recovered from the anemia despite continuation of methionine feeding, indicating an adaptation of the cats. In vitro, significant (P less than 0.01) increases of MetHb concentration and Heinz-body formation were observed when RBC were incubated with plasma from cats fed (1 g of methionine/kg) or with 10 mM 3-methylthiopropionate, a product of methionine catabolism. However, these increases were not observed when RBC were incubated with 10 mM methionine. Seemingly, excessive methionine intake leads to production of an intermediate of the methionine catabolism that may affect RBC directly as an intensive oxidizing agent, resulting in an excessive oxidation of hemoglobin to MetHb and Heinz-body formation. PMID- 3826870 TI - Smooth muscle inhibition by an extract of Sesbania drummondii. AB - The acute effects of an extract of Sesbania drummondii were assessed in vitro on the smooth muscle contractility of intestine and lung parenchyma in the chicken and aortic arch in the rat. Dose-response contraction curves for histamine, carbachol, and norepinephrine were obtained in the ileal, parenchymal, and aortic strips, respectively. After washing was completed, the strips returned to baseline tensions and then were incubated for 10 minutes with an ethyl acetate extraction fraction of S drummondii (molecular weight less than 500). Dose response curves to the same agonists were repeated at the end of the incubation period. Contractile responsiveness of chicken ileum was little affected by acute incubation of the tissue with the extract. Comparison with the great inhibition of in vitro ileal contractility seen previously in chickens with chronic toxicosis indicated that intestinal inhibition was not due to acute effects of sesbania, but required time for a toxic metabolite to be formed or for damage to occur from affected vasculature. Contractile responsiveness of chicken lung parenchyma to histamine (10(-5) M and 10(-4) M) was significantly decreased, as was rat aortic responsiveness to norepinephrine (10(-7) M to 10(-4) M). Responses in parenchyma were not as greatly inhibited as those in tissue from animals with chronic toxicosis. Greatest inhibition of contractility was seen in the vascular strips, indicating that vascular inhibition has a role in pathologic changes. To test the vasculature inhibition effect in vivo, anesthetized, catheterized rats were given 100-microliter aliquots of dilutions of the extract, IV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826871 TI - Determination of bromide ion concentration in greyhound urine by ion chromatography. AB - An ion chromatographic method was used to determine Br ion in the urine of Greyhounds. Phenol was added to the urine, before filtration through a 30,000 molecular weight cutoff filter and to the eluant (pH 11, NaOH-Na2CO3), as a preservative. Urine from 103 racing Greyhounds resulted in a mean +/- SD of 3.60 +/- 2.72 mg of Br/L of urine. Urine samples obtained from a Greyhound, to which 2 g of KBr was administered, yielded a diurnal elimination pattern with a half-life of 7.6 days. PMID- 3826872 TI - Total protein, albumin quota, and electrophoretic patterns in cerebrospinal fluid of dogs with central nervous system disorders. AB - Cerebrospinal fluid was analyzed for total protein, albumin quota, and electrophoretic patterns of albumin and alpha-, beta-, and gamma-globulins in 10 healthy dogs and 35 dogs with CNS disorders. Values obtained in healthy dogs were used to establish control data. Samples also were collected from dogs with neurologic diseases that were classified according to clinical and pathologic diagnosis as inflammation, neoplasm, and spinal cord compression. The albumin quota and total CSF albumin values were used as indicators of blood-brain barrier disturbance. Four patterns were observed on agarose electrophoresis that included intrathecal immunoglobulin production, intrathecal immunoglobulin production combined with blood-brain barrier disturbance, blood-brain barrier disturbance, and unaltered CSF. These patterns correlated with the observed clinical and pathologic conditions. Seemingly, agarose electrophoresis of CSF is a simple and reliable technique that aids in the diagnosis of CNS disorders of dogs. PMID- 3826873 TI - Effect of shipping stress on clincopathologic indicators in F344/N rats. AB - A variety of hematologic, serum chemistry, and cytochrome P450 variables from 20 F344/N rats were measured and analyzed statistically to determine the effects of shipping stress on clinicopathologic indicators. Additionally, whole body, liver, and total kidney weights were recorded and compared. Ten rats were assayed upon receipt (stressed group), and 10 additional rats were held on a wire substrate for 12 days (poststress group) and assayed. Significant differences were detected between the 2 groups in ratio of total kidney weight to body weight, segmented neutrophil count, monocyte count, eosinophil count, and serum cholesterol, serum potassium, serum aspartate transaminase, and serum lactate dehydrogenase values. PMID- 3826874 TI - Blood antioxidant status and plasma pyruvate kinase activity of halothane reacting pigs. AB - Samples of blood were collected (by jugular venipuncture) from 10 homozygote halothane-reacting pigs and 7 homozygote nonreactors. Antioxidant status was assessed by measurement of blood glutathione peroxidase, glucose-6-phosphate dehydrogenase, and superoxide dismutase activities and plasma concentrations of vitamin E. Significant differences in these values were not apparent between halothane-reacting pigs and nonreactors. Halothane-reacting pigs had tissue damage as indicated by significantly increased plasma activities of the enzymes creatine kinase and pyruvate kinase. The latter showed better discrimination between the 2 populations than did creatine kinase and could prove to be a more effective marker for identification of stress-susceptible pigs. PMID- 3826875 TI - Investigation into the use of narcotic antagonists in the treatment of a stereotypic behavior pattern (crib-biting) in the horse. AB - Crib-biting in horses is a repetitive behavior pattern which may involve the activation of both narcotic receptors and dopamine receptors in the CNS. Crib biting frequency, determined in 7 nontreated horses under controlled conditions, was usually linear for many hours and ranged from 0.3 to 14.9 bites/min. Intravenous or IM injections of narcotic antagonists decreased these rates to almost zero by about 20 minutes after the injection was given. The duration of the response to a single injection ranged from 20 minutes for naloxone to 4 hours or more for nalmefene and diprenorphine. Effective doses were 0.02 to 0.04 mg of naloxone/kg, 0.04 mg of naltrexone/kg, 0.08 mg of nalmefene/kg, and 0.02 to 0.03 mg of diprenorphine/kg. Crib-biting could be prevented completely for up to a week by continuous infusion of 5 to 10 mg of nalmefene/hr. Crib-biting resumed when the infusion was discontinued, and plasma nalmefene concentrations decreased to below 5 ng/ml. Doses of nalmefene as large as 0.4 mg/kg, IV, produced only minor side effects. These side effects included some passage of semifluid fecal material, intermittent penile relaxation, and mild sedation. Treated horses responded normally to external stimuli, retained their appetites, and performed appropriately when ridden. Sedation wore off during the course of prolonged infusions. Narcotic antagonists may provide a novel and effective treatment of stereotypic behavior disorders. PMID- 3826876 TI - Effect of topical phenylephrine on the equine pupil. AB - The mydriatic effect of 10% phenylephrine was evaluated in 9 horses. Base-line pupillary size in mesopic conditions and during light stimulation was ascertained before application of pharmacologic agents. In study 1, 10% phenylephrine was applied to each eye (n = 5 horses). After 15 minutes, the pupillary size was determined in both lighting conditions. Phenylephrine was again applied to each eye, and after an additional 15 minutes, the pupillary size was determined. In study 2, 1% tropicamide was applied to each eye (n = 4 horses), and after 30 minutes, the pupillary size was determined in both lighting conditions. Tropicamide and phenylephrine were applied to each eye immediately after determination of pupillary size, and after an additional 30 minutes, the pupillary size was determined. There was no significant change (P greater than 0.9) in pupillary size when phenylephrine was used alone or when phenylephrine was used in an eye that had been dilated with tropicamide. PMID- 3826877 TI - Pulmonary research: what topics? What costs? PMID- 3826878 TI - Long-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease. AB - Both obstructive sleep apnea and chronic lung disease can be associated with intermittent or chronic hypoxemia leading to pulmonary hypertension and cor pulmonale. When these problems coexist, it is possible that the cardiopulmonary effects are additive. We hypothesized that hemodynamic disturbances in patients with apnea and lung disease would be more severe than in those with apnea alone, and that hemodynamic improvement should follow apnea cure, but perhaps at a slower rate than in those with apnea alone. To test these hypotheses, we prospectively followed 24 patients with sleep apnea syndrome. They were divided into 3 nonrandomized groups. Nineteen patients had both apnea and lung disease. Nine of these agreed to curative tracheostomy (Group 1). The other 10 subjects (Group 2) refused tracheostomy but accepted noncurative therapies, including nocturnal oxygen (n = 9), uvulopalatopharyngoplasty (n = 2), and protriptyline (n = 4). Five subjects with apnea but without clinically obvious lung disease received tracheostomies (Group 3). Subjects were followed at yearly intervals (mean follow-up, 27.2 months) with radionuclide motion studies and, in 15 of 24 who consented, right heart catheterization. The 3 groups did not vary with respect to age, percent ideal weight, or severity of apnea symptoms. The severity of right-sided hemodynamic dysfunction in the group with apnea but no obvious lung disease was less than that in the 2 groups with lung disease. A substantial decrease in pulmonary artery pressure (p = 0.056) and significant improvement in right ventricular ejection fraction occurred in the tracheostomized group with both apnea and lung disease. Pulmonary vascular resistance decreased in both groups receiving tracheostomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826879 TI - Nocturnal increase of urinary uric acid:creatinine ratio. A biochemical correlate of sleep-associated hypoxemia. AB - Sleep-associated hypoxemia may result in tissue hypoxia and increased production and excretion of adenosine triphosphate (ATP) degradation intermediates and uric acid. Urinary uric acid:creatinine(UA:Cr) ratio is a convenient method for estimating uric uric acid excretion. We measured the overnight changes in urinary UA:Cr ratio in 17 patients with documented sleep-associated hypoxemia, 13 control patients who remained normoxemic during polysomnography, and 14 normal volunteers. The urinary UA:Cr ratio increased overnight in patients with sleep associated hypoxemia (+31.2 +/- 10.9%), whereas it decreased in the control patients with negative sleep studies (-13.6 +/- 4.6%; p less than or equal to 0.01) and in the normal volunteers (-23.2 +/- 5.8%). Repeat polysomnography revealed interval resolution of sleep-associated hypoxemia in 2 patients and significant improvement in a third. In every case, this clinical improvement was accompanied by a decrease in the overnight change in UA:Cr ratio. We report that urinary UA:Cr ratio increased overnight in a nonhomogeneous group of patients with sleep-associated hypoxemia. PMID- 3826880 TI - Effects of digoxin on diaphragmatic strength generation in patients with chronic obstructive pulmonary disease during acute respiratory failure. AB - We studied the effects of digoxin, a compound that has an inotropic effect on the myocardium, on diaphragmatic function in 8 patients with chronic obstructive pulmonary disease. All the patients were in acute respiratory failure and were artificially ventilated. Diaphragmatic strength was assessed by measuring the transdiaphragmatic pressure generated at functional residual capacity during bilateral supramaximal electrical stimulation of the phrenic nerves. The latter were stimulated before and at 45 and 90 min after administration of digoxin (0.02 mg/kg infused for 10 min). In all the patients, cardiac output was measured by the thermodilution technique using a Swan-Ganz catheter placed in the pulmonary artery. Arterial blood gases and pH were maintained within normal range by mechanical ventilation. In all the patients, digoxin plasma levels reached the therapeutic range (mean values, 2.82 +/- 0.17 and 2.90 +/- 0.20 nmol/L at 45 and 90 min, respectively) after digoxin administration. Diaphragmatic strength improves significantly after digoxin administration, the transdiaphragmatic pressure for an identical phrenic stimulation increasing by 19.5% (p less than 0.001) on the average. This increase was noted 45 and 90 min after digoxin administration. We conclude that digoxin has a potent effect on diaphragmatic strength generation that may be beneficial in patients with chronic obstructive pulmonary disease during acute respiratory failure. Furthermore, this inotropic positive effect of digoxin on the diaphragm, as previously observed for the myocardium, emphasizes the similarities between these 2 contractile tissues. PMID- 3826881 TI - The impact of passive smoking on emergency room visits of urban children with asthma. AB - Baseline data obtained from a study of 276 children with asthma from 259 low income families were analyzed to test the hypothesis that passive smoking is associated with frequency of emergency room (ER) visits, hospitalizations, and impaired pulmonary function. The data were analyzed using multiple regression techniques. We controlled for other variables that might affect the frequency of ER visits, including smoking by the children themselves and the presence of other irritants or allergens in the child's home. Passive smoking was positively associated with ER visits (p less than 0.01), but not with hospitalizations or abnormalities in pulmonary function. The frequency of days with symptoms of asthma per month was also directly associated with ER visits (p less than 0.02). The estimated mean annual increase in ER visits attributable to the presence of one or more smokers in the household was 1.34 +/- 0.50, an increase of 63% over nonsmoking households. The estimated annual health care cost for emergency care of children with asthma that can be attributed to passive smoking is 92 dollars (95% confidence interval from 24 to 160 dollars) for families with 1 or more smokers. PMID- 3826882 TI - Density dependence of maximal expiratory air flow in asthmatics with exacerbation of their disease. AB - In an effort to evaluate the relationship between the site of air-flow obstruction and rate of improvement with therapy, we studied 20 asthmatics with spirometry, before and after bronchodilator, using air and 80% helium-20% oxygen (He-O2). Studies were obtained on 3 consecutive days after hospital admission and approximately 18 days after discharge. Greater He-O2 response ([Vmax50(He-O2)- Vmax50(air)]/predicted Vmax50) X 100, was associated with: less cigarette consumption (p less than 0.02), lesser frequency of chronic productive cough (p less than 0.02), more symptom-free intervals (p less than 0.02), and greater frequency of allergic rhinitis (p less than 0.03). Patients with greater He-O2 response (Group 1) reached maximal improvement in air flow by Hospital Day 2, whereas those with a lesser He-O2 response (Group 2) continued to improve throughout the observation period. The Group 1 mean peak expiratory flow rate (PEFR) improved by 24% of predicted per day to maximum, which was significantly greater (p less than 0.025) than the 11% per day rate of improvement of Group 2. The He-O2 response remained relatively stable throughout the course of the study except for 3 patients who dramatically improved their response with therapy. A highly significant correlation, adjusted for regression to the mean, (r = 0.95, p less than 0.0001) was found between mean baseline percent predicted Vmax50 and the mean He-O2 response. After adjustment for regression to the mean, there was no significant relationship between the degree of prebronchodilator He-O2 response and increase in He-O2 response with bronchodilator.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826883 TI - Density and frequency dependence of resistance in early airway obstruction. AB - The forced oscillation technique is a noninvasive and effort-independent test used to characterize the mechanical impedance of the respiratory system. The aim of this study was to assess the sensitivity of this method in detecting early airway abnormalities caused by smoking or occupational hazards. Respiratory mechanical parameters by the forced oscillation technique and maximal expiratory flow volume (MEFV) curves were obtained in a group of 82 workers from a gas manufacturing plant. In addition, the variations in the frequency dependence of total respiratory resistance between air breathing and a mixture of helium-oxygen (He-O2) were measured. All parameters were normalized for age, height, and weight. In order to compare the 2 types of testing, multiple linear regressions were performed with smoking or exposure as independent variables on one hand and parameters of the 2 types of testing on the other hand. This statistical procedure showed that 2 parameters of the forced oscillation technique constantly reached higher levels of significance than those of the MEFV parameters in the regression equations describing smoking history and occupational exposure: these were the frequency dependence of resistance and the change in frequency dependence between air and He-O2 breathing. When nonsmokers, ex-smokers, and smokers were considered separately, the degree of frequency dependence of resistance and the change in frequency dependence between air and He-O2 breathing were the only parameters that were significantly different between these 3 groups (one-way analysis of variance).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826884 TI - "Sensitive tests" are poor predictors of the decline in forced expiratory volume in one second in middle-aged smokers. AB - In 1978, we studied 3 groups of steelworkers 45 to 55 yr of age who were all smokers: "obstructive" smokers (OS) with a FEV1/VC less than 66.6% (59.8% in average) (n = 37), smokers with "small airways disease" (SAD) and an abnormal closing capacity and/or slope of phase III (delta N2) but normal FEV1/VC (n = 32), and "resistant" smokers (RS) with normal functional indices (n = 36). Smokers with SAD had a lower (p less than 0.05) FEV1/VC (71.7%) than did RS (74.9%). We studied again 6 yr later about 85% of survivors in each group. Analysis of variance showed that FEV1 decreased significantly (p less than 0.001) only in OS (from 2.67 to 2.46 L). In RS and smokers with SAD, FEV1 declined from 3.34 to 3.26 L and from 2.95 to 2.85 L, respectively (p greater than 0.05). In all 3 groups, delta N2 increased (p less than 0.001) from 0.77 to 1.30% N2/L in RS, 1.41 to 2.43% N2/L in smokers with SAD, and 2.22 to 4.20% N2/L in OS. A multivariate analysis showed that the initial N2 explained about 30% (p less than 0.001) of the decline in FEV1 in OS, but only 10% (p less than 0.001) in the 3 groups together. In fact, the link between delta N2 and fall in FEV1 was restricted to OS. Closing volume and maximal expiratory flow rates were not related to decline in FEV1. The link between uneveness of ventilation and subsequent loss of FEV1 is of physiopathologic interest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826886 TI - Effects of hypohydration on lung functions in humans. AB - We studied lung function tests during euhydration (Days 1 and 2), hypohydration (Days 3 and 4), and rehydration (Days 5, 6, and 7) in 6 normal subjects. Hypohydration was induced by administering chlorthalidone, and this resulted in a 4.5% loss of body weight. During hypohydration, lung volumes increased significantly. Interestingly, ventilatory lung function tests including peak expiratory flow rate, FEV1, maximal voluntary ventilation, and flow rates at low lung volumes also increased significantly and returned to normal upon rehydration. Diffusing capacity for carbon monoxide remained unchanged. The improvement in ventilatory lung function tests during hypohydration was surprising, and it is suggested that this was related to loss of water within and/or around the airways. This mechanism is opposite to that which occurs in pulmonary edema with excess lung water where reduction in flow rates occurs. PMID- 3826885 TI - Effects of volume history during spontaneous and acutely induced air-flow obstruction in asthma. AB - We examined the volume history effect on maximal expiratory flow (Vmax) in patients with asthma by comparing Vmax at 60% of VC from forced exhalation maneuvers begun just above FRC (partial, P) with those begun from TLC (maximal, M) and expressed the results as M-P ratios. In a clinic population with varying degrees of obstruction, we found that M-P ratios varied inversely with the severity of the obstructive process, i.e., the more severely obstructed patients had a fall in Vmax after a deep inhalation (DI). By contrast, equally severe obstruction acutely induced in subjects with mild asthma was associated with an increase in Vmax after a DI. There was no difference between the spontaneous versus the induced groups in degree of nonhomogeneity as assessed by single breath nitrogen tests. Changes in specific airway conductance after a DI during spontaneous obstruction were in the same direction as the changes in Vmax, and the time course for restitution of airway caliber in subjects who showed bronchoconstriction after a DI was significantly longer than for those subjects who showed bronchodilatation. We conclude that in severe bronchial asthma with spontaneous obstruction, a DI produces an increase in severity that is opposite to the results found in acutely induced obstruction, and the time course for reestablishing baseline airway caliber is more prolonged. We suggest that mechanisms for and sites of obstruction vary between the 2 groups. PMID- 3826887 TI - Effects of distention of the preterm fetal lamb lung on lung function with ventilation. AB - Constant distending pressure when applied to the immature fetal lamb lung was reported to improve compliance and prevent the subsequent development of the respiratory distress syndrome after delivery. These experiments were designed to repeat those observations and identify the mechanism(s) responsible for the effects of constant distending pressure on subsequent lung function. The compliance of the lungs of exteriorized fetal lambs at 130 to 133 days gestational age increased 2.5-fold after 1 h of 15 cm of distending pressure. However, subsequent ventilation of the lambs exposed to distending pressure and control lambs resulted in comparable sequential compliance and blood gas and pH measurements. Severity of lung disease as reflected by the peak inspiratory pressure needed to normalize Pco2 values decreased as surfactant-saturated phosphatidylcholine pool sizes increased (r values greater than 0.90) and minimum surface tensions of alveolar washes decreased, but the distention procedure did not change these relationships. Distention of the fetal lung did result in an apparent increase in pulmonary blood flow in the fetus and an increased leak of labeled albumin from the vascular space to the lung interstitium and airways during the 1-h period of ventilation after delivery. However, the leak of protein into the lungs exposed to the distending pressures was not increased during the period of exteriorization and distention, suggesting that distention sensitized the preterm lung to leak protein with subsequent mechanical ventilation. The leak of labeled albumin out of the airways was not changed by distention, and total lung water was not changed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826888 TI - The effects of intrauterine pneumonectomy in lambs. A morphometric study of the remaining lung at term. AB - A morphometric study was made of the remaining lung of term lambs that had undergone left pneumonectomy at 60, 80, 100, or 120 days gestation. All pneumonectomy lambs showed some compensatory growth since right lung volume to body weight ratio was higher in all lambs after pneumonectomy than in term controls. In 3 lambs operated at 80, 100, and 120 days, respectively, however, compensatory volume increase was more complete than in the other lamb of each age pair or the 2 lambs operated at 60 days. Despite individual variation, the potential for compensatory lung growth seems greater in the canalicular and later stages than in the pseudoglandular. Measurements indicating distal air-space size (volume density of alveoli, volume density of alveolar duct, surface density of alveolar epithelium, numerical density of alveoli, and mean linear intercept) were similar in all animals, but total alveolar surface area and number increased proportionally to lung volume. The fact that the remaining lung compensates by increasing alveolar number rather than by enlarging air spaces is a model of human developmental abnormalities in which the alveolar number at birth is greater than normal (polyalveolar). At the intraacinar level, a higher than normal proportion of muscularized arteries was found in lambs operated early in gestation and in lambs with smaller compensatory lung growth: an inverse relationship was seen--the lower the lung volume the higher the proportion of muscular arteries. The cause for this is unknown, but may result from the relatively increased flow to a vascular bed smaller than that of two normal lungs. PMID- 3826889 TI - Obesity-induced hyperplastic lung growth. AB - The effects of overnutrition on lung growth were studied in newborn male Long Evans rats made obese by nursing in small litters with subsequent feeding of a high fat diet. Control rats were nursed in normal-sized litters and then fed standard rat chow. The animals were killed at 8 wk of age. When compared with control rats, obese rats had significant increases in body weight (24%); fat pad weight (118%); fat pad weight/body weight ratio (77%); snout-to-anus length (11%); total lung weight (11%); lung content of DNA (19%), protein (22%), RNA (22%), total lipids (31%), cholesterol (20%), and triglycerides (141%); and the lung triglyceride/DNA ratio (217%). Serum levels of insulin (71%), total lipids (60%), cholesterol (64%), and triglycerides (90%) were also elevated in obese rats as compared with those in control rats. Unchanged were the ratios of lung protein/DNA, RNA/DNA, lipid/DNA, and cholesterol/DNA; lung phospholipid content; and serum concentrations of glucose and phospholipids. The results indicate the presence of cellular hyperplasia in lungs of young rats made obese by diet. Lipid deposition in the obese lungs suggests metabolic alterations in pulmonary composition occurring with obesity. PMID- 3826890 TI - Reduced oxygen tension induces pulmonary endothelium to release a pulmonary smooth muscle cell mitogen(s). AB - Bovine pulmonary endothelial cells grown in vitro were shown to release a factor that was mitogenic for pulmonary smooth muscle cells during exposure to a reduced oxygen tension atmosphere. The addition of hypoxic endothelium-derived medium resulted in a 60% increase in smooth muscle cell number after 24 h of exposure. Addition of medium from pulmonary endothelium exposed to normoxic conditions or medium derived from either hypoxic or normoxic aortic endothelium did not result in significant increases in smooth muscle cell number. Physicochemical characterization of the hypoxic pulmonary endothelial cell-derived factor(s) showed that it was resistant to heat and reducing agent treatment and stable between pH 3 and 10. The mitogenic activity decreased by 71% at pH 2 and by 68% after treatment with trypsin. The activity adhered to DEAE Sephadex. Gel filtration chromatography of the hypoxic-conditioned medium demonstrated 2 major peaks of smooth muscle cell growth factor activity corresponding to molecular weights between 6,000 and 14,000 and 20,000 and 65,000 daltons, respectively. These data suggest that this pulmonary endothelial cell-derived smooth muscle cell peptide mitogen(s) may be involved in the smooth muscle cell proliferative response seen with chronic alveolar hypoxia. PMID- 3826891 TI - Activation of the complement system in the adult respiratory distress syndrome. AB - The adult respiratory distress syndrome (ARDS) is an acute pulmonary disorder characterized by the accumulation of neutrophils within the lower respiratory tract. Because activation of the complement system can generate C5a, a potent neutrophil chemoattractant, complement activation was assessed in both serum and bronchoalveolar lavage fluid obtained from 10 patients with ARDS and compared with that from normal control subjects. Crossed immunoelectrophoresis was used to determine activation of the complement components C3 and properdin factor B (PFB), and radioimmunoassay was used to determine the presence of C5a. Complement activation was not detected either in the plasma or in the lung epithelial lining fluid of the control subjects. In contrast, evidence of C3 activation was found in the plasma of 50% of the patients with ARDS when initially studied; likewise, C3 activation, PFB activation, and C5a could all be detected in the epithelial lining fluid of all patients with ARDS with a single exception. Follow-up bronchoalveolar lavages revealed decreased amounts of C3 activation and C5a 2 to 7 days after the onset of ARDS, and the complement activation had resolved when the patients with ARDS had completely recovered. To determine if the C5a in bronchoalveolar lavage fluid could be responsible for the influx of neutrophils observed in ARDS, epithelial lining fluids obtained from both normal control subjects and from patients with ARDS were fractionated by molecular sieve chromatography. Two distinct fractions of chemotactic activity were found in the ARDS bronchoalveolar lavage fluid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826892 TI - Complement component C5 is required for release of alveolar macrophage-derived neutrophil chemotactic activity. AB - The influx of neutrophils into the alveolar structures can be induced by stimulation of the resident lung phagocyte, the alveolar macrophage, to release a potent neutrophil chemoattractant(s). We hypothesized that the fifth component of complement (C5) on the cell surface may be required for activation of the alveolar macrophage to release neutrophil chemotactic activity. C5 was identified on guinea pig alveolar macrophages by epifluorescent microscopy, flow cytometry, and enzyme-linked immunoabsorbent assay of eluted macrophages. When cultured for 4 h with stimuli that induce the release of chemotactic activity or for 24 h without added stimuli, purified Fab' fragments of a goat anti-C5 antibody significantly inhibited the ability of macrophages to release chemotactic activity as determined by a blindwell chamber method (p less than 0.001, all comparisons). This inhibition of chemotactic activity was not detected when anti C5 antibody was added after the culture period. In contrast, anti-C3 antibody had no inhibitory effect at 4 h or at 24 h (p greater than 0.2, all comparisons). Partial characterization of released chemotactic activity revealed it was of low molecular weight, partially lipid soluble, and not inhibited by C5a chemotactic factor inactivator. These studies suggest that C5 may have a regulatory role in the release of chemotactic activity by alveolar macrophages. PMID- 3826893 TI - Role of HLA-DR antigens in Japanese patients with sarcoidosis. AB - Fifty-three Japanese patients with sarcoidosis were tested for HLA-A,B,C, DR, and DQ antigens in order to investigate immunogenetic mechanisms in the pathogenesis of sarcoidosis. All of the patients had abnormal shadows on their chest radiographs, and all had histologically confirmed sarcoidosis. Groups of 60 and 57 unrelated Japanese served as control subjects for HLA-A,B,C and HLA-D region antigens, respectively. The frequency of HLA-DRw52 was 79.2% (42 of 53) in the patient group compared with 50.9% (29 of 57) in the control group, and the difference was significant (chi 2 = 9.66, p less than 0.005, pc less than 0.05, relative risk = 3.69). On the other hand, no significant association was found with HLA-A,B,C antigens. When various clinical features of the patients were taken into account, there was a tendency for the frequency of DRw52 to be lower in the patients who were in an advanced stage or who had resisted treatment with steroids. Furthermore, 31 of the 32 patients without ophthalmic involvement were DRw52-positive, which was highly significant (96.9% as compared with 50.9% of the control group; chi 2 = 19.74, p less than 0.001, pc less than 0.01, relative risk = 29.93), whereas the frequency of DRw52 in the patients with ophthalmic involvement was almost the same as in the control group. These results suggest that HLA-DR antigens play a significant role in the pathogenesis of sarcoidosis, and there may be a heterogeneity in the clinical entity of sarcoidosis. PMID- 3826894 TI - Prognostic significance of bronchoalveolar lymphocytosis in farmer's lung. AB - In 1983, we studied and reported the clinical and bronchoalveolar lavage (BAL) data of 26 patients with a history of previous farmer's lung. Most of these subjects (24 of 26) had a BAL lymphocytosis. In 1985, we restudied 14 of these subjects. Each subject had a clinical evaluation, chest roentgenogram, pulmonary function tests, and bronchoalveolar lavage. Results show that only 1 subject had evidence of an episode of acute recurrent disease, and only 1 had clinically progressive disease; however, 6 complained of chronic cough and sputum production. There were some fluctuations in individual pulmonary functions, with a significant decrease in FVC during the 2-yr period. The total number of cells on repeated lavage was 55.20 X 10(6) +/- 41.10 X 10(6) (mean +/- SD). This was not statistically different from the results obtained 2 yr earlier (69.5 X 10(6) +/- 43.01 X 10(6)). The percentage of BAL lymphocytes was also similar between the 2 studies, with abnormal values (greater than 20%) in 13 of 14 subjects (47.2 +/- 19.2). The BAL lymphocyte subsets, measured by monoclonal antibody in 8 subjects, showed a wide range of values, with individual OKT4/OKT8 ratios remaining similar at both studies. There were no correlations between changes seen in individual pulmonary function and BAL lymphocytosis. We conclude that a high intensity lymphocytic alveolitis, which persists after an acute episode of farmer's lung, does not predict the outcome of the disease. PMID- 3826895 TI - Idiopathic pulmonary fibrosis. Pretreatment bronchoalveolar lavage cellular constituents and their relationships with lung histopathology and clinical response to therapy. AB - Analysis of bronchoalveolar lavage cellular constituents has been recommended as a valuable method for the characterization of the inflammatory cellular population and for studying cellular interactions in the lower respiratory tract of patients with idiopathic pulmonary fibrosis (IPF). However, the clinical relevance of the enumeration of cells in bronchoalveolar lavage fluid (BALF) from patients with IPF remains controversial. We therefore examined the correlations between BALF cellular constituents and both the histopathologic abnormalities and the subsequent clinical response to corticosteroid therapy in 26 newly diagnosed, untreated patients with IPF. The BALF lymphocytosis was associated with moderate to-severe alveolar septal inflammation (p less than 0.0005) and with a relative lack of histologic honeycombing (p less than 0.05). On the other hand, BALF neutrophil and eosinophil contents did not significantly correlate with any of eleven particular histopathologic abnormalities, and BALF neutrophil and lymphocyte contents did not correlate with the degree of clinical impairment (quantitated by a composite score based on dyspnea, radiographic abnormalities, and physiologic impairment) upon presentation. However, BALF eosinophil content correlated significantly with the severity of clinical impairment, higher eosinophil counts being associated with more severe initial clinical impairment (p less than 0.01). Neither pretreatment BALF neutrophil nor eosinophil content was related to the frequency or magnitude of subsequent clinical change in 20 patients evaluated before and after 1 yr of corticosteroid therapy. In contrast, pretreatment BALF lymphocytosis was associated with significant subsequent clinical improvement (p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826896 TI - A comparison of bronchiolitis obliterans with organizing pneumonia, usual interstitial pneumonia, and small airways disease. AB - This report is based on 43 cases where a diagnosis of either bronchiolitis obliterans with organizing pneumonia (BOOP), usual interstitial pneumonia (UIP), or small airways disease (SAD) was established by lung biopsy. The severity of histologic abnormalities in the peripheral airways and interstitial spaces were measured on these biopsies using semiquantitative techniques and compared with the clinical data available in 42 of 43 cases, preoperative chest radiographs in 31 of 43, and preoperative pulmonary function tests in 29 of 43. The data show that when a diagnosis of BOOP was made, there was a higher total pathologic score for membraneous bronchiolitis (MB) and respiratory bronchiolitis (RB) than for UIP and SAD (p less than 0.005). This was due to peribronchiolar inflammation and the presence of loose connective tissue in the RB lumen. The pathologic changes in the interstitial space were less severe in SAD than in BOOP or UIP (p less than 0.005). Clubbing was more frequent in UIP (p less than 0.01), and symptoms were of shorter duration in BOOP (p less than 0.05). The radiographic assessment showed that the characteristic finding in BOOP was patchy air-space consolidation, a finding that was not present in UIP or SAD. PMID- 3826897 TI - Affinities of pirenzepine for muscarinic cholinergic receptors in membranes isolated from bovine tracheal mucosa and smooth muscle. AB - Muscarinic cholinergic receptors have been classified into subtypes based on their high (M-1 subtype) or low (M-2 subtype) affinities for the nonclassic antagonist pirenzepine, and this classification has important experimental and therapeutic implications. Because muscarinic receptors are abundant in the airways where they mediate several different cellular responses, the goal of this study was to characterize the affinities of pirenzepine for the muscarinic receptors in bovine tracheal mucosa and smooth muscle. After isolating membrane particulates from mucosa and smooth muscle, as well as from bovine cerebral cortex (a known source of M-1 receptors), we used 3H-quinuclidinyl benzilate to label muscarinic receptors in the particulates and performed competition radioligand binding assays in the presence of either atropine or pirenzepine. Receptors from all 3 tissues (mucosa, smooth muscle, and cerebral cortex) were of a relatively uniform affinity for atropine (range of KI values: 0.8 +/- 0.4 X 10( 9) to 2.4 +/- 1.7 X 10(-9) M), as would be predicted for this classic muscarinic antagonist. By contrast, affinities for pirenzepine differed depending on the tissue. In cerebral cortex, the majority of receptors were of high affinity for pirenzepine (KI = 1.8 +/- 1.4 X 10(-8) M). In both mucosa and smooth muscle, receptors were of low affinity for pirenzepine (Kl = 4.8 +/- 0.4 to 6.9 +/- 3.8 X 10(-7) M). We conclude that muscarinic cholinergic receptors in bovine tracheal mucosa and smooth muscle are predominantly of the M-2 subtype. PMID- 3826898 TI - Selective enhancement of pentamidine uptake in the lung by aerosolization and delivery in liposomes. AB - We examined the tissue distribution of pentamidine, both as free drug and encapsulated in liposomes, after intravenous (iv) and aerosol administration in healthy rodents. After iv injection, drug levels in the lung were increased as much as 34-fold by administration in liposomes. Concurrently, peak liver uptake was increased 4-fold and renal deposition reduced 3-fold. Liposome-mediated lung delivery was highly dependent on liposome size. Decreasing liposome mean diameter from 2.5 to 0.4 micron reduced lung uptake of pentamidine 90-fold while affecting extrapulmonary organ deposition to a much lesser degree. Aerosol delivery of pentamidine produced high, sustained lung levels, with no evidence of drug clearance from the lung between 1 and 48 h after administration. Extrapulmonary drug levels produced by aerosol delivery were negligible throughout this period. There were no significant differences in the organ distribution of aerosolized free versus liposome-encapsulated drug, apparently because of sequestration of pentamidine within the lung. Comparison of drug levels in material recovered by bronchoalveolar lavage suggests that aerosol delivery of pentamidine produces substantially higher deposition in the alveolar space than does iv drug injection. Light and electron microscopic (EM) examination of lung, kidney, and liver after iv or aerosol administration of liposomes revealed no tissue abnormalities, although isolated platelet clumps were noted in pulmonary capillaries by EM examination. PMID- 3826899 TI - Evaluation of a metered-dose aerosol delivery system using partial flow-volume curves. AB - In 12 normal subjects, FEV1, FVC, peak expiratory flow rate, and flow at 25% of FVC on maximal (MEFV) and partial (PEFV) expiratory flow volume maneuvers were measured before and after inhalation of 2.6 mg of metaproterenol from a metered dose inhaler (MDI) or from an MDI-holding chamber (MDI-HC) delivery system. The 2 delivery systems were studied on separate days using a randomized crossover design. Premetaproterenol pulmonary function results were very similar on both days. However, on the MDI-HC day, significantly greater bronchodilatation was observed; this was only detectable on PEFV maneuvers. Compared with those on the MDI day, postmetaproterenol PEFV rates on the MDI-HC day were approximately 11% higher (p less than 0.02); premetaproterenol to postmetaproterenol increments in PEFV rates were also larger on the MDI-HC day (p less than 0.05). These results can be explained by the phenomenon of airway hysteresis. The deep breath taken prior to performance of the FVC maneuver reduced bronchomotor tone in almost all subjects, thereby limiting the magnitude of possible change from inhaled bronchodilator. Partial flow-volume curves were not preceded by deep inspiration and were more sensitive in detecting bronchodilatation. PMID- 3826900 TI - Vesicles within vesicles: what role do multivesicular bodies play in alveolar type II cells? PMID- 3826901 TI - Pulmonary complications of intravesical Bacille Calmette-Guerin immunotherapy. AB - Lungs have rarely been reported to be affected by any side effects of BCG therapy. Interstitial pneumonitis, though, is known to occur under such circumstances, but its pathogenesis is still debated between an infectious and a hypersensitivity mechanism. We report here 3 cases of pulmonary complications of BCG therapy evaluated by bronchoalveolar lavage (BAL). Cellular data obtained from all 3 patients were characterized by a markedly increased alveolar lymphocytosis. The T4/T8 ratio was elevated compared with that in normal subjects and with the T4/T8 ratio of circulating lymphocytes. Furthermore, alveolar lymphocytes were highly sensitized to PPD, as evaluated by their proliferation and their production of interleukin 2 in the presence of PPD. Mycobacteria were not found in the 3 patients. We conclude that interstitial pneumonitis occurring during BCG therapy could be explained by a hypersensitivity phenomenon, leading to an intense immune and lymphocyte-mediated response within involved organs. PMID- 3826902 TI - Anti-cytoplasmatic antibody in Wegener's granulomatosis. PMID- 3826903 TI - American Lung Association, American Thoracic Association, 1987 annual meeting. May 10-13, 1987, New Orleans, Louisiana. Abstracts. PMID- 3826905 TI - Carcinoma of the colon in patients 35 years of age and younger. AB - Of 705 patients who were treated at the Vanderbilt University and Metropolitan Nashville General Hospitals from 1973 to 1984 for carcinoma of the colon, 45 (6.3%) were 35 years of age or younger at the time of diagnosis. There were 25 men and 20 women; the average age was 29.3 years. Twenty-six patients (57.7%) presented with pain, 19 reported a change in bowel habits, and 18 had gastrointestinal bleeding which led to diagnostic investigation. At the time of diagnosis, only two patients had lesions which could be classified as Dukes' A, eight were Dukes' B, 28 were Dukes' C, and the remaining seven had Dukes' D lesions with distant metastasis. Nineteen patients had poorly differentiated tumors; survival in this group averaged 1 year. In the 19 patients who had well or moderately well-differentiated tumors, survival averaged 4.3 years. Fifteen patients had unresectable tumors at the time of initial treatment, and survival in this group has averaged 1.5 years. Thirty patients had tumors which were considered to be resectable by the operating surgeon, and nine of these 30 patients are alive without evidence of recurrence for an average of 5.6 years. The prognosis of carcinoma of the colon in the young has been poor, with the major factors being the unfavorable histologic features of these tumors and the advanced disease at the time of presentation in these patients. Those few patients who present early in the course of their disease respond well to radical resection. PMID- 3826904 TI - Experience with adrenocortical neoplasms in childhood. AB - The experience with adrenocortical neoplasms in childhood is reviewed. During three decades, ten children with adrenocortical neoplasms were seen at the authors' institution. The literature was reviewed, and 209 patients 16.5 years or younger were found. All ten patients at Vanderbilt University Hospital (VUH) presented with endocrine manifestations of the tumor. Three patients had Cushing's, two patients had virilization, and five patients had features of both. In the literature, virilization, alone or with Cushing's, was the most common mode of presentation. Feminizing tumors were uncommon and nonfunctional tumors rare. The majority of patients were female. Features associated with malignancy included 17-KS levels greater than 40 mg/24 hr, diameter greater than 6 cm, weight greater than 500 g, and histologic evidence of diffuse growth pattern, vascular invasion, and tumor cell necrosis. Although uncommon, adrenocortical neoplasms should be suspected in children with Cushing's, virilization, feminization, or a combination of these. There has been an increased incidence reported in patients with hemihypertrophy, Beckwith-Wiedemann syndrome, hemangiomas, and nevi. Following endocrinologic evaluation, imaging studies should be performed. CT scan appears to be the most useful diagnostic tool. A posterior operative approach is recommended for suspected adenomas. An anterior thoracoabdominal approach is favored for suspected malignancies with uncompromised en bloc resection. There is no evidence that adjuvant therapy provides any additional benefit. PMID- 3826906 TI - Colon and rectal carcinoma. Forty years and 1400 cases. AB - One thousand four hundred cases of colorectal carcinoma were treated primarily at the Wake Forest University Medical Center between 1945 and 1985. The surgical approach was constant in all patients without obvious stage IV disease: wide resection, including at least the primary-level and intermediate-level lymph nodes. There were 812 women and 588 men in the series. Sixty-eight per cent of the 1400 cancers occurred in the rectosigmoid, but only 53 per cent of the last 300 cases were in this region. Initial staging showed 560 cases (40%) of local disease, 504 cases (36%) of regional disease, and 336 cases (24%) of distant disease. Cecal, ascending, hepatic, and transverse lesions were most often associated with stage IV disease. Among the 1115 patients with long-term follow up, 44 per cent with stage I disease, 37 per cent with stage II disease, 24 per cent with stage III disease, and 6 per cent with stage IV disease had survived for 5 years or longer. There were no differences when 5-year survival was correlated with site. This review provided no evidence that wide resection leads to increased long-term survival. PMID- 3826907 TI - Early discharge after mastectomy. A safe way of diminishing hospital costs. AB - In order to assess the risks and benefits of early discharge after major breast surgery, the authors analyzed 73 consecutive private patients who underwent operations by four surgeons over a 1-year period. Patient's ages ranged from 34 to 84 years, with a mean of 56.2 years. One patient was excluded from analysis because thoracotomy with a pulmonary resection was performed during the same hospitalization. Thirty-seven patients underwent total mastectomy with complete axillary dissection, 30 underwent segmental mastectomy with complete axillary dissection, and five underwent total mastectomy alone. For each patient the chest wall and axilla were drained by means of one or two Jackson-Pratt (American Heyer Schulte Corp., Goleta, CA) closed suction drains. Prior to discharge, all patients were instructed in the proper technique of drain care and were directed to record the daily drainage. Patients were discharged when they were fully mobile, did not require injectable narcotics, and felt capable of taking care of the drains as outpatients. The length of postoperative stay ranged from 1 to 9 days (mean 2.9), with all but three patients being discharged by the fifth postoperative day. Patient acceptance of early discharge with drains was excellent. Drains were pulled on an outpatient basis, usually within 7 to 10 days after surgery. Complications were observed in twelve patients (18%), consisting of seromas (8 patients), cellulitis (2 patients), and minimal superficial skin necrosis (2 patients). All complications were managed easily on an outpatient basis. We conclude that early discharge with Jackson-Pratt drains remaining in place is safe, well tolerated by patients, and has tremendous potential for substantial cost savings. PMID- 3826908 TI - Management of intra-abdominal lymphomas. AB - Fifty-nine patients (mean age 65) were evaluated for intra-abdominal lymphomas, localized or disseminated, during the period between 1977 and 1985. These lymphomas were lymphocytic (66%), histiocytic (17%), follicular (10%), and mixed (7%). Liver and retroperitoneal nodes were most frequently involved (32%), followed by stomach (31%), bowel (17%), and spleen (20%). Thirty-five patients (59%) underwent some type of surgical procedure supplemented by either chemo- or radiation therapy. Curative and palliative resections accounted for 40 per cent and 26 per cent, respectively while diagnostic laparotomy with or without staging accounted for 34 per cent. The 1-month postoperative mortality was 20 per cent. The 5-year survival was 12 per cent for the surgical group and 0 per cent for the medical group (P less than 0.05). Patients with lymphomas of the stomach and spleen, treated surgically, fared better than their medical counterparts. Most patients in this series died of their disease (55%) or from attempts to eradicate it. PMID- 3826910 TI - Primary adenocarcinoma of the duodenum. AB - Duodenal adenocarcinoma is an uncommon gastrointestinal neoplasm. Between September 1982 and March 1983, the authors performed two radical operations for this malignancy. A third patient underwent a palliative bypass procedure followed by radiotherapy and chemotherapy. The difficulty the authors encountered in making this diagnosis and the treatment courses chosen reflect the experience of the literature. An aggressive surgical approach in the management of localized duodenal adenocarcinoma is recommended. Five-year survival rates of 20 per cent to 25 per cent are reported after radical surgical procedures. PMID- 3826909 TI - Gastric cancer in the elderly. AB - The surgical treatment of gastric cancer in the elderly (over 65 years of age) was retrospectively studied in the department of surgery, at the Mount Sinai Medical Center, Miami Beach, Florida. The authors found 22 patients who were operated on for gastric cancer between 1979 and 1982. Ages ranged from 69 to 90 years of age. The male-to-female ratio was 1:1. Twenty of 22 patients were found to have carcinoma. Eleven of 20 had regional spread to the perigastric nodes, transverse colon, omentum, spleen, and liver. Stage of disease was: stage I--four patients, stage II--five patients, stage III--eight patients, and stage IV--three patients. Two of 22 patients had lymphoma. The mean hospital stay was 17.1 days, but decreased to 12.4 days if no complications occurred. Postoperative complications were minimal and included pneumonia, urinary tract infection, wound infection, and dumping syndrome. There were two postoperative deaths (9%) due to sepsis and myocardial infarction, respectively. Six of the remaining 18 patients died within 1 year. Seven of 18 were alive after 2 years, and six patients survived greater than 36 months (33%). Of the six long-term survivors, two had stage III and one had stage IV disease at the initial exploration. The average survival was 23.5 months. The authors conclude that gastric resection should not be withheld in the elderly. The elderly have the same morbidity and mortality from surgery for gastric cancer as patients under age 65.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3826911 TI - [Treatment of idiopathic thrombocytopenic purpura in childhood]. PMID- 3826912 TI - [Arterial blood pressure in the term neonate in the first month of life]. AB - Systolic blood pressure was valued by Doppler method, in 162 healthy full-term newborn at 48 hours of live, repeated in 134 in the second week and in 120 at the end of first month. A significant increase of systolic blood pressure along all the period with a strong increment in the first week was observed. Authors studied influences on blood pressure of the variabilities: weight, height, gestational age and heart rate. At 48 hours variability with a rate of correlation, weight was higher at birth (r = 0.324, p less than 0.001). There was not evident and significant relation with gestational age. Systolic blood pressure codes were lower when sleeping than when awake. Empirical percentiles of blood pressure are shown during first month of life. PMID- 3826913 TI - [The metacholine test for the study of unspecific bronchial hyperreactivity in childhood]. AB - To compare the results between asthmatics with different etiology, to study the bronchial reactivity in nonasthmatics, and verify if 8 mg/ml is a good limit of differentiation between asthmatics and healthy ones, a methacholine test was performed in fourty children distributed in four groups: group I (atopic asthmatics); group II (nonatopic asthmatics); group III (nonsymptomatic brothers of asthmatics) and group IV (healthy controls without IV. The means values of PC20 FEV1 were: Group I, 0.42; familiar antecedents of asthma). In groups I and II were all positives, in group III two cases (20%) and none in group II, 0.64; group III, 7.37, and group IV, 16.4 mg/ml. It is verified pathogenic meaning of the bronchial hyperreactivity in the asthma independently of its etiology, and the satisfactory differentiation between asthmatics and healthy ones with 8 mg/ml as limit of positivity. It is suggested the realization of extensive studies in brothers of asthmatics to determine the usefulness of the test as screening in such children. PMID- 3826914 TI - [Regional organization of a neonatal transportation system]. AB - Organization, operational plans, and initial experience of a Regional Neonatal Transport System is described. The system covers provinces of Bizcaia, and Alava in Northern Spain, with a total of 17,500 annual deliveries. In the first 10 months 31 newborn infants were transported. Their mean birth weight was 2,066 +/- +/- 931 Gm. Ten infants had a birth weight less than 1,500 Gm, and in 22 (71%) of them gestational age was under 37 weeks. Some types of respiratory distress was present in 71% of them, and 25.8% required mechanical ventilation during transport. Hypothermia was present in 36% of the infants at referral center, percentage that decreased to only 9% at their arrival to the NICU. During transport mean body temperature increased from 35.33 +/- 1.07 degrees to 35.84 +/ 0.9 degrees C (p less than 0.01). Infants condition was judged to improve in 13% of them. Overall survival rate was 74.2%, being 80.9% in those weighting from 1,000 to 1,500 Gm. Infants who were hypothermic had a lower survival (45.5%) than those who were not (90%) (p less than 0.05). PMID- 3826915 TI - [Usefulness of the determination of drugs in serum. Double-blind study with phenobarbital]. AB - A double-blind study to analyze usefulness of serum phenobarbital measurements has been done. First 125 measurements requested by five pediatrician to 70 child after introduction of this analysis in our laboratory have been analyzed. Results obtained indicate that 24% of determinations were under therapeutic range (TR) and that 22 children (31.4% of total) had in some moment of their treatment values under TR. With regard to each pediatrician, percentage of requested determinations under TR varied from zero to 55%. In conclusion we indicate usefulness to serum phenobarbital measurement to individualized doses and to detect noncompliance or abnormalities in drug absorption, distribution, biotransformation and excretion. PMID- 3826916 TI - [Chronic delay of growth with normal response of growth hormone secretion to provocation stimuli for its liberation and decreased somatomedin activity: treatment with growth hormone over 6 months]. AB - Four prepuberal children, two girls and two boys, aged 7 years 3 months to 11 years 6 months with chronic growth retardation were studied. Informed parental consent was obtained. Growth was followed for two years or more and was always less than P 3. Growth velocity during observation period was 4 cm/y or less. Gastrointestinal, hepatic, renal and thyroid functions were normal. Skeletal X ray examination revealed no anomalies. karyotype in the two girls was 44XX. Growth hormone (GH) secretion was evaluated in all cases by two different test: exercise-propranolol and insulin-induced hypoglycemia. Peaks of GH secretion were 10 ng/ml or more. In three patients, GH secretion was also evaluated during first two hours of deep-sleep. GH peaks were 10, 4 and 13.4 ng/ml, respectively. Somatomedin activity (SA) measured in basal condition on two different days with six month interval was low (0.28-0.70 U/ml) and increased after seven daily doses of 2 mg of GH, in all patients (0.80-1.12 U/ml). All patients were treated with GH (2 mg/3 times/week), and growth velocity increased from 4 to 8.7, from 3.9 to 8.8, from 3 to 6.5 and from 3.2 to 6 cm/y, respectively. In conclusion, SA is of value in selection of patients with chronic growth retardation, who may benefit from long-term GH therapy. PMID- 3826917 TI - [Comparison of the levels of serum ferritin and other hematologic parameters in males and pre-menarche and post-menarche females]. AB - Our study group consisted of 43 healthy preadolescence and adolescence of which 17 were boys and 13 premenarcheal and 13 postmenarcheal girls. Haematocrit, haemoglobin, serum iron, transferrin saturation, total iron-binding capacity, latent iron-binding capacity and serum ferritin were analyzed. Authors found that post-menarcheal girls are at lower levels than boys and that menstrual blood loss is a significant factor in determining iron status. PMID- 3826918 TI - [Review of 54 cases of idiopathic thrombocytopenic purpura. Evaluation of the response to treatment]. AB - Fifty four cases of idiopathic thrombocytopenic purpura with an evolution longer than six months are reported. Total remission was achieved in 96.2% of patients, half of them without treatment. Etiologic agent, clinical features and response to different ways of treatment are analyzed. PMID- 3826919 TI - [Infantile giardiasis. Study of 111 cases]. AB - One hundred eleven children with intestinal giardiasis, are studied taken into account: age, sex, place of residence, seasonal frequency, clinic, symptomatology, analyses, treatment and it efficacy and reinfections. Authors have investigated mainly the stools: presence of parasite in them, with only one sample, has been of 56.2%, reaching 70.7% when several samples were examined. Patients have been treated with metronidazole with good response in 93.3%, but 28.3% were infected again. Closed relatives of 99 children have also been examined and 21.4% presented infection. PMID- 3826920 TI - [Incidence of Pediculus capitis infestation in the student population of Alcala de Henares]. AB - Author studies incidence of Pediculus capitis infestation in children of public schools in Alcala de Henares, which was of 2.7 +/- 0.1% during years 1980-1984. Epidemiologic aspects are commented. PMID- 3826921 TI - [Infant nutrition in the first year of life]. PMID- 3826922 TI - [Limitation of articular mobility associated with type I diabetes mellitus]. PMID- 3826923 TI - [Hydrops fetalis caused by supraventricular tachycardia: effects of the administration of verapamil]. PMID- 3826924 TI - [2 cases of pneumonia with empyema caused by anaerobic micro-organisms in childhood]. PMID- 3826925 TI - [Nutrition in the first year of life]. PMID- 3826926 TI - [Supplementary nutrition: when should it start, how to do it, advantages and inconveniences of the time and way of starting it]. PMID- 3826927 TI - [Nutritional iatrogenesis in the first year of life]. PMID- 3826928 TI - [Round table: Scientific bases of outpatient pediatric practice in primary care]. PMID- 3826929 TI - [Outpatient pediatrics in the province of Torrelavega]. PMID- 3826930 TI - [Pediatrics in ambulatory services of Social Security]. PMID- 3826931 TI - [Pediatrics in independent health insurance organizations]. PMID- 3826932 TI - [Round table: Recurrent pain in pediatrics]. PMID- 3826933 TI - [Advances in natural lactation. Mechanisms regulating the start of lactation and sustaining it in transient crises of lacteal secretion. The most frequent causes of early weaning]. PMID- 3826934 TI - [Ambulatory pediatrics: field studies and research on a method]. PMID- 3826935 TI - [Comparative study of human milk and adapted formulas]. PMID- 3826936 TI - [Recurrent infection of the urinary tract in girls]. AB - A group of 18 girls, studied in a period between 1979 and 1985 with recurrent urinary tract infections (RUTI), with at least three culture documented episodes of bacteriuria in the previous year and without radiologic evidence of urinary tract abnormality is described. Incidence was 6.1% amount a selected group of 295 girls with urinary tract infection. The period of follow-up was between 2 and 6 years (X 3.33). Symptomatology was light. No predominance of urinary symptoms were found. E. coli was the most frequent germ isolated. The number of recurrences/year/girl were significantly lower with prophylactic treatment and with years of evolution. Renal damage was not found. Vesicoureteral reflux appeared in two girls only. They had a benign course and a good prognosis. Reduction of aggressive investigation in this group of patients is proposed. PMID- 3826937 TI - [Non-Hodgkins lymphoma in childhood, preliminary results of the LSA2 L2 protocol modified by high-dose methotrexate]. AB - From january 1982 to january 1986 we treated 23 pediatric patients who had non Hodgkin's lymphoma, with a new therapeutic protocol. This protocol is based on the LSA2 L2, modified during the induction phase with high-dose methotrexate and increasing of intrathecal therapy. Nineteen patients (83%) were in stages III and IV and the 47.4% were in stage IV. The distribution according to histology was: 10 Burkitt's undifferentiated lymphomas; 2 non-Burkitt's undifferentiated lymphomas; 5 lymphoblastic lymphomas convoluted-cells; 5 lymphoblastic lymphoma non-convoluted cells and 1 indeterminate lymphoma. The follow-up oscillated between 6 months and 4 years. The total survival rate is 82.6% with a 100% survival in stages I, II and III and 63.5% in stage IV. The survival according histology is 91.7% for undifferentiated lymphomas and 70% for lymphoblastic lymphomas; the actuarial survival rates in the two groups at 30 months are 87% and 55% respectively (p greater than 0.10). We concluded that adding high-dose methotrexate to the LSA2 L2 protocol improve the survival rate in undifferentiated lymphomas and in a less extent in lymphoblastic lymphomas, without significant toxicity. This new protocol is mainly indicated in undifferentiated and indeterminate non-Hodgkin's lymphomas. PMID- 3826938 TI - [Systemic-pulmonary fistula. Percentage of children attaining corrective surgery]. AB - Because of the lack of information on definitive long term results of the systemic pulmonary fistulae (SPF) we decided to review our experience. From 1978/1980, SPF was carried out on 91 children with a minimal follow-up period of 53 months, 80 (88%) survive the immediate postoperative period, 65 (71%) the late period, although only 48 (53%) reached corrective surgery. 14 (50%) of the 28 newborn children died and only 9 (32%) had corrective surgery. 12 (19%) of the 63 children of two months or older died and 39 (62 por 100) had definitive surgery. 72% with Fallot syndrome, 58% with TGA and pulmonary stenosis and less than 40% of other pathologies also reached definitive corrective surgery. Frequently the SPF is the only alternative to achieve total correction although there may be a high mortality and morbidity rate. The age (newborn children) and the complex pathology are unfavourable in the end results. PMID- 3826939 TI - [Absence of tuberculin reactivity after neonatal vaccination with BCG in Cantabria: analysis of 419 determinations]. AB - A prospective study is made of the tuberculin test sensitivity at 3 and 12 months after neonatal vaccination with BCG. From the results obtained in 419 tests the conclusion is that the percentage of positive tests is 3.8% and 1.6% at 3 and 12 months respectively, considering the threshold of positivity equal or superior to 10 mm (or 18.9 y 5.6% respectively with the threshold at 5 mm). These results are lower than the ones described previously, and therefore the conclusion is that in Cantabria the tuberculin tests should be valued without taken in consideration the antecedent of previous vaccination with BCG. PMID- 3826940 TI - [Intestinal invagination: a childhood pathology amenable to conservative treatment]. AB - Seventy five cases of intussusception during 1983 were studied in order to perform a statistical analysis of the relationship between clinical data an mode of treatment. Age (less than 3 months) and bloody stools upon finger rectal examination increased the percentage of surgical treatment. The reduction of intussusception by hydrostatic pressure under fluoroscopic guidance showed good therapeutical results in 89% of the cases in which it was performed. PMID- 3826941 TI - [Results of the sweat test, carried out by 2 methods, for the diagnosis of cystic fibrosis]. AB - Un review the results of the sweat test for the diagnosis of cystic fibrosis performed by 2 methods: Electric conductivity of the sweat (2,517 test in non cystic fibrosis and 114 in 37 cystic fibrosis children) and skin chloride electrode (121 test in non-cystic fibrosis and 20 in cystic fibrosis children). A 1% rate of false positive results was obtained with the former along with 6,1% falsely negative results in cystic fibrosis patients. The skin chloride electrode method was much less specific and sensitive. The diagnosis of cystic fibrosis should only be made once repeatedly altered sweat chloride concentrations are obtained together with careful correlation with the clinical findings. We think that both the implications of the diagnosis and the thoroughness needed in the proper performance of the sweat test warrant that the diagnosis should always be confirmed in a centre with experience in the disease. PMID- 3826942 TI - [Evaluation study of laparatomy in Hodgkins disease]. AB - We report 30 patients with Hodgkin's disease treated at "La Paz" Children Hospital of Madrid, from 1965 to 1984, to determine the role of the laparotomy in modifying the presurgical clinic stage. Laparotomy changed this stage in 40% of patients, in whom stage advanced from I or II to III or IV. The only side effect of surgery was pneumococcal sepsis in two patients. All children were treated with polyvalent pneumococcal vaccine and penicillin or erythromycin, before laparotomy. PMID- 3826943 TI - [Abnormal origin of the left coronary artery of the pulmonary artery trunk. Report of 2 cases]. AB - Two cases are presented with anomalous origin of the left coronary artery from the pulmonary artery. Both cases initiate clinical symptoms in the first three months of life, defined by angina and congestive heart failure. In both cases cardiac catheterization showed the existence of anomalous origin of the left coronary artery and underdeveloped collateral circulation. Reimplantation of the anomalous coronary to ascending aorta on the two patients. Has excellent results on the first patient, but not in the second one who died during surgery. PMID- 3826944 TI - [Study of infant milk formulas present on the Spanish market and its adaptation to the recommendations of the European Society of Gastroenterology and Pediatric Nutrition]. AB - The aim of this study was to investigate energy as well as the protein and mineral composition of milk formulas available on the Spanish market. We studied 20 milk formulas, 14 of which were adapted milk formulas intended for feeding newborns during the first 4-6 months of life and the other 6 ones were follow-up milk formulas. Determinations of energy, total protein, osmolality, sodium, potassium, chloride, phosphorus and calcium were performed by adiabatic calorimetry, cryoscopy, flame photometry, photocolorimetry and flame atomic absorption spectrophotometry respectively. Experimental energy in all formulas was higher than that determined by nutrient contents and conversion factors. Three of the adapted formulas presented higher values of protein than those recommended by ESPGAN and some of them also high levels for sodium total electrolytes. However, the estimated renal solute load for each of the formulas was lower than the minimum renal concentration ability. All formulas, except one, showed normal values for calcium and the contents of phosphorus, were within normalcy. All the follow-up formulas agreed with the ESPGAN recommendations related with protein and mineral composition. PMID- 3826945 TI - [Sequential surgery in familial hyperlipemia. Comments on 2 pediatric cases]. AB - The present report analyzes two cases of homozygotic familiar hypercholesterolemia. An actualization on the etiopathogenesis, the poor short term prognosis and the bad results obtained with the conservative therapy are discussed. The different surgical approaches excluding liver transplantation are reviewed. Both cases underwent staged portocaval shunts and ileal exclusions afterwards. Short and intermediate results are exposed. PMID- 3826946 TI - [Vesico-urethral injuries in patients with pelvic fractures]. AB - Rupture of the bladder and posterior urethra is a serious complication of pelvis fracture. From 1972 to 1984, 61 patients were admitted for genitourinary injuries. We present a review of 5 cases of bladder and urethral posterior injuries associated with pelvic fractures. We assess some current issues in the treatment and diagnosis. PMID- 3826947 TI - [Effects of tobacco on child health. The child as a passive smoker]. AB - The smoking habit within the family produces various harmful effects on child health when the child is considered as a passive smoker. In this paper we have reviewed the most recent studies which analyze the influence of parental smoking on the incidence of respiratory diseases, alteration in the pulmonary function and presence of other symptoms, during the first years of life. A number of recommendations have been extracted to prevent these problems during childhood. PMID- 3826948 TI - [Arterial hypertension secondary to the application of 9-alpha-fluoroprednisolone ointments]. PMID- 3826949 TI - [Epidural hematoma in the newborn infant]. PMID- 3826950 TI - [A case of mosaic Y-Y translocation associated with hypospadias]. PMID- 3826951 TI - [Double urethra. Report of a new case]. PMID- 3826952 TI - Airways obstruction and the risk for lung cancer. AB - The presence of airways obstruction identify in middle-aged male smokers at increased risk for lung cancer. This hypothesis was tested in a sample of patients with moderate to severe obstruction from the Intermittent Positive Pressure Breathing Trial and a sample of patients with no obstruction to moderate obstruction from the Johns Hopkins Lung Project, all of whom were followed for the development of lung cancer. On follow-up, the risk of developing lung cancer was found to be associated with entry values for age, smoking, and ventilatory status by linear, proportional hazard, and log-linear adjustment techniques. Among cigarette smokers, the presence of airways obstruction was more of an indicator for the subsequent development of lung cancer than was age or the level of smoking. The risk for lung cancer also increased in proportion to the degree of airways obstruction. These data suggest that smokers with ventilatory obstruction are at greater risk for lung cancer than are smokers without obstruction. PMID- 3826953 TI - Extracorporeal enzyme reactors for depletion of phenylalanine in phenylketonuria. AB - Multitubular enzyme reactors with immobilized enzymes were developed to achieve depletion of circulating substrate by extracorporeal means. To act as prototypes, reactors were prepared with immobilized L-phenylalanine ammonia-lyase, an enzyme that metabolizes phenylalanine to trans-cinnamic acid and ammonia without the need for a coenzyme. We report the first application of phenylalanine ammonia lyase reactors in an extracorporeal circulation system in a patient with phenylketonuria. A phenylalanine level of 1.82 mmol/L (for the last 6 years) decreased to 1.24 mmol/L after 5.5. hours of treatment, without the enzyme entering the circulation. Total phenylalanine depletion from blood and tissue stores was estimated at 1800 mg. The hemodialysis-like procedure proved to be without side effects, specific for phenylalanine, and suitable in the management of pregnant women with phenylketonuria and late-onset hyperphenylalaninemia. The extracorporeal use of enzyme reactors for temporary enzyme replacement represents a new, safe, and effective therapeutic modality. PMID- 3826954 TI - Cigarette abstinence, nicotine gum, and theophylline disposition. AB - When cigarette smokers with chronic lung disease become acutely ill or require surgery, they are often forced to stop smoking and may use nicotine gum. Smoking is known to accelerate the metabolism of theophylline, but the effects of short term abstinence or nicotine gum on theophylline metabolism have not been reported. We studied the effects of brief tobacco abstinence and nicotine gum on theophylline elimination in healthy volunteers. Abstinence from smoking for 1 week resulted in a 37.6% decrease in clearance and a 35.8% increase in half-life. Nicotine gum had no effect on theophylline clearance. Our data indicate that at least partial normalization of the enzyme-inducing effects of smoking can be seen after brief cigarette abstinence. For smokers who are taking theophylline chronically, their dose of theophylline will need to be reduced by one fourth to one third after brief tobacco abstinence. Plasma concentration monitoring may be necessary for optimal dosing of theophylline in such patients. PMID- 3826955 TI - Ornithine transcarbamylase deficiency: adult onset of severe symptoms. AB - Deficiency of ornithine transcarbamylase, an enzyme in the urea cycle, results in hyperammonemia. The X-linked recessive inheritance results in neonatal death of affected males but a variable symptomatic pattern in females, with onset of symptoms in childhood. We report the cases of two heterozygous women with onset of severe symptoms (encephalopathy and focal neurologic deficits) in adulthood. PMID- 3826956 TI - Parathyroid hormone radioimmunoassays in the differential diagnosis of hypercalcemia due to primary hyperparathyroidism or malignancy. PMID- 3826957 TI - Mechanism of pressor response in medical house officers on call. PMID- 3826958 TI - Esophageal testing of patients with noncardiac chest pain or dysphagia. Results of three years' experience with 1161 patients. AB - Records from 910 patients referred to our clinical esophageal manometry laboratory for evaluation of noncardiac chest pain between January 1983 and December 1985 were reviewed and compared with records from 251 patients referred for dysphagia. Evaluation included baseline esophageal manometry, acid perfusion test, and edrophonium provocation. In the chest-pain group, 655 patients (72%) had normal esophageal motility and 255 (28%) had abnormal motility. Nutcracker esophagus was present in 48% of abnormal tracings, suggesting that it is a manometric marker for noncardiac chest pain. Of the total chest-pain group, 243 patients (27%) had their pain reproduced during provocative testing ("definite" esophageal pain); 192 patients (21%) had baseline manometric abnormalities but no pain during provocative testing ("probable" esophageal chest pain). The highest percentage of positive provocative responses (34%) occurred in patients with nutcracker esophagus on baseline manometry. Manometric abnormalities were statistically commoner (p less than 0.001) in patients with dysphagia, occurring in 53%. Achalasia (36%) and nonspecific esophageal motility disorders (38%) were the commonest abnormalities in this group, with nutcracker esophagus being infrequent (10%). PMID- 3826959 TI - A proposal for more informative abstracts of clinical articles. Ad Hoc Working Group for Critical Appraisal of the Medical Literature. AB - Medical journals are a principal source of new knowledge for clinicians. Unfortunately, articles containing valid and valuable information are often buried among others of less value. Innovations are needed to assist clinicians in finding articles that are both scientifically sound and applicable to their practices. An easily implemented, although partial, solution is for authors of articles that have clinical implications to structure their abstracts so that key aspects of purpose, methods, and results are reported with a partly controlled vocabulary and in a standardized format. This would assist clinical readers to select appropriate articles more quickly, allow more precise computerized literature searches, and facilitate peer review before publication. PMID- 3826960 TI - Cholesterol reduction and life expectancy. A model incorporating multiple risk factors. AB - In deciding whether to undertake a dietary program to reduce serum cholesterol levels, a person must consider how much benefit to expect. We developed a model that assumes cholesterol reduction is effective and safe in reducing the risk for death from ischemic heart disease. In the model, we considered asymptomatic adults with total serum cholesterol levels between 180 and 300 mg/dL. We defined risk status on the basis of blood pressure, smoking habit, and high-density lipoprotein cholesterol level. For persons aged 20 to 60 years who are at low risk, we calculate a gain in life expectancy of 3 days to 3 months from a lifelong program of cholesterol reduction. For persons who are at high risk, the calculated gain ranges from 18 days to 12 months. Knowledge of the magnitude of the calculated benefits in increased life expectancy afforded by cholesterol reduction can assist persons in making decisions about dietary change. PMID- 3826961 TI - Cholesterol reduction and health policy: taking clinical science to patient care. PMID- 3826962 TI - Structured abstracts for papers reporting clinical trials. PMID- 3826963 TI - Validation of medical software: present policy of the Food and Drug Administration. PMID- 3826964 TI - Cerebral artery vasoconstriction and the Raynaud phenomenon. PMID- 3826965 TI - Calcium and cardiac arrest. PMID- 3826966 TI - Auranofin: a new drug for rheumatoid arthritis. PMID- 3826967 TI - Corynebacterium hemolyticum and pharyngitis. PMID- 3826968 TI - Acquired immunodeficiency syndrome and biliary tract disease. PMID- 3826969 TI - Possible response of paroxysmal cold hemoglobinuria to danazol. PMID- 3826970 TI - Acromegaly and colon cancer. PMID- 3826971 TI - Radioiodine for Graves' disease. PMID- 3826972 TI - Radiation-induced thyroid carcinoma. PMID- 3826973 TI - Serum testosterone levels during chronic glucocorticoid therapy. PMID- 3826974 TI - Acute respiratory distress during sclerotherapy for esophageal varices. PMID- 3826976 TI - Advanced Achievement in Internal Medicine. PMID- 3826975 TI - Aeromonas-associated diarrhea in the Netherlands. PMID- 3826977 TI - Increased intestinal permeability in Crohn disease. PMID- 3826978 TI - Implementation of SI units. PMID- 3826979 TI - Medicine in Cambodian refugee camps. PMID- 3826980 TI - Home health care. PMID- 3826981 TI - Pupillary abnormalities: light and sight. PMID- 3826982 TI - [Intestinal bacterial flora in normal and pathologic conditions. International meeting. Rome, 16-18 October 1985. Proceedings]. PMID- 3826983 TI - Normal human intestinal flora. PMID- 3826984 TI - Biochemical methods and experimental models for studying the intestinal flora. PMID- 3826985 TI - Stimulation of mucin release by dialysed C. difficile broth filtrate in vitro. PMID- 3826986 TI - [Factors influencing the normal intestinal flora]. PMID- 3826987 TI - [Normal intestinal flora in children and their changes in pathological conditions]. PMID- 3826988 TI - [Acute infantile enteritis]. PMID- 3826989 TI - [Epidemiologic observations on 337 cases of acute diarrhea in childhood]. PMID- 3826990 TI - Coagglutination and ELISA for detection of enterotoxins and colonization factor antigens in Escherichia coli and Salmonella. PMID- 3826991 TI - [The immunoenzyme system in research on E. coli enterotoxin LT and C. difficile toxins]. PMID- 3826992 TI - Colonization resistance of the digestive tract; mechanism and clinical consequences. PMID- 3826993 TI - Antimicrobial agents and the human oropharyngeal and intestinal microflora. PMID- 3826994 TI - Influence of feeding tubes and gastrostomy on the colonization of the stomach in neonates. PMID- 3826995 TI - [Flora: changes and resistance to colonization in healthy volunteers treated with broad-spectrum antibiotics]. PMID- 3826996 TI - [Composition of bacterial flora in the premenstrual syndrome. Preliminary note]. PMID- 3826997 TI - Bacterial flora and intestinal chronic diseases. PMID- 3826998 TI - The precursors of fecapentaenes. A preliminary report. PMID- 3826999 TI - Epidemiology of an outbreak of Clostridium difficile-associated-diarrhoea. Application of a typing system. PMID- 3827000 TI - Faecal carriage of Clostridium difficile in cystic fibrosis patients. PMID- 3827001 TI - Some aspects of colonic microbial activity in irritable bowel syndrome associated with food intolerance. PMID- 3827002 TI - The microbiology of ileal reservoirs following restorative proctocolectomy. PMID- 3827003 TI - [Infectious complications in patients with malignant blood diseases]. PMID- 3827004 TI - [Clostridium difficile colitis in patients with blood diseases]. PMID- 3827005 TI - [Conference on libraries and documentation centers in biomedicine: realities and prospects. Rome, 12-14 December 1984. Proceedings]. PMID- 3827006 TI - An overview of the World Health Organization's policies concerning health libraries and documentation centres. PMID- 3827007 TI - [Institutional tasks of the Central Library of the National Research Council and its activities in the biomedical area]. PMID- 3827008 TI - [How the Library of the Catholic University of the Sacred Heart responds to the information needs of university and hospital users]. PMID- 3827009 TI - [An experiment in coordination at the methodological and practical levels: the union catalog of periodical publications in the biomedical area]. PMID- 3827010 TI - [The Library of the Higher Institute of Occupational Prevention and Safety]. PMID- 3827011 TI - [University biomedical libraries of Palermo]. PMID- 3827012 TI - [Milan: how a great university makes up for the lack of a central biomedical library]. PMID- 3827013 TI - [The libraries of the Department of Medicine of Turin: analysis, critique and plans]. PMID- 3827014 TI - [The biomedical libraries of the University of Rome]. PMID- 3827016 TI - [Biomedical libraries in Apulia]. PMID- 3827015 TI - [Remarks on university biomedical libraries in Sardinia]. PMID- 3827017 TI - [Professional education of French librarians and information specialists, particularly in the biomedical area]. PMID- 3827018 TI - [The professional education of the librarian-information specialist in Italy. References in the biomedical field]. PMID- 3827019 TI - [Role of the Library and the Documentation Service of the Istituto Superiore di Sanita in the field of the National Health Service]. PMID- 3827020 TI - Biomedical libraries and information services in Great Britain. PMID- 3827021 TI - [Libraries and documentation centers in health education: the reality and the outlook]. PMID- 3827022 TI - [Notes for a new concept and realization of the library for Local Health Unit No. 25 of Verona]. PMID- 3827023 TI - [Experiences of a biomedical library in a hospital clinic]. PMID- 3827024 TI - [The situation of the Library of the Health and Welfare Aldermanry of the Piedmont Region]. PMID- 3827025 TI - [Local health units and the library: Rome and Rome Province]. PMID- 3827027 TI - [Analysis of the library structures of the local health units in Emilia Romagna: the principal data and reflexions]. PMID- 3827026 TI - [Role of the Regional Epidemiological Observatory and its affiliations with other health structures]. PMID- 3827028 TI - [Expert study of the biomedical libraries of the local health units of Palermo: comments on resources]. PMID- 3827029 TI - [Library structures of the local health units of Friuli-Venezia Giulia and Liguria]. PMID- 3827030 TI - [Biomedical libraries in Trentino-Alto Adige: the situation and outlook]. PMID- 3827031 TI - [Role of the National Tumor Institute in Milan in national health policy with special reference to biomedical information]. PMID- 3827032 TI - [Relation between a scientific institute and data banks in biomedicine]. PMID- 3827033 TI - [A specialized library of a research institute: the Gustavus A. Pfeiffer Memorial Library]. PMID- 3827034 TI - [The Library of the San Raffaele Scientific Institute: a panoramic view of its activities]. PMID- 3827035 TI - [The Documentation Service of the National Cancer Research Institute: its organization and affiliations]. PMID- 3827036 TI - Users of biomedical libraries. PMID- 3827037 TI - [Analysis of the scientific usership in the planning and development of information systems]. PMID- 3827038 TI - [Experience of the researcher]. PMID- 3827039 TI - [Experience of a district physician]. PMID- 3827040 TI - [Experiences and problems of a university library user]. PMID- 3827041 TI - [Libraries and centers of biomedical documentation and periodicals]. PMID- 3827042 TI - Information overload: the problem and working towards a solution. PMID- 3827043 TI - The British Council: publishing and book promotion. PMID- 3827044 TI - [The bookstore as an information source]. PMID- 3827045 TI - [Biomedical publishing in Italy]. PMID- 3827046 TI - [The impact of electronic technology in the area of scientific communication on information producers and intermediaries]. PMID- 3827047 TI - [The Institut National de la Sante et de la Recherche Medicale (INSERM) and biomedical information in France]. PMID- 3827048 TI - [The Library of the C. Serono Institute and its usership]. PMID- 3827049 TI - [A marketing documentation center]. PMID- 3827050 TI - [Introduction to and current accomplishments of the Francesco Angelini Scientific Information Center]. PMID- 3827051 TI - [The Farmitalia-Carlo Erba Documentation Service]. PMID- 3827053 TI - [Scientific documentation in the pharmaceutical industry]. PMID- 3827052 TI - [Role of documentation in the decision processes in the field of pharmacy]. PMID- 3827054 TI - [Production of data bases and information services in biomedicine]. PMID- 3827055 TI - [Survey of automation in Italian biomedical libraries]. PMID- 3827056 TI - [Brief analytical psychotherapies. II. Technic]. AB - The various methods of brief dynamic psychotherapies have in common the prior determination of a limited duration and a focalized aim. These principles involve the selection of patients according to previously defined criteria, as well as the choice of technical means, which set up the conditions of the treatment. These various points are discussed in reference to the positions of the major contributors to the literature concerning brief psychotherapies. PMID- 3827057 TI - [Drug addiction, anorexia: what is the connection?]. AB - Drug addictive and anorexic behaviours come from a same desire to reach an eventual autonomy. Drug addicts and anorexic people fight against dependency by instituting a new dependency, the one which ties them up to their behaviours; nevertheless this substitution from one dependency to another one does not happen by chance, it is chosen by these adolescents in order to allow them a possible structuring modification. These latter having difficulties to internalize "the father's law" in a certain way prepare the ground on which the law will become real by setting up a new alienating situation. In a way, drug addictive and anorexic behaviours carry out a "paternal metaphor" that is to say a metaphor which substitutes the "no of the father" to the place first symbolized by the operation of the mother's absence. PMID- 3827058 TI - [Does one become an alcoholic after age 60?]. AB - The authors have examined all the patients which were older than 60 years and had been hospitalised for alcoholism over a span of 10 years and within a certain region. The study of their files shows that more than 70% had a previous history of alcoholism. The patients without history of alcoholism, displayed mostly depressive syndromes. The authors conclude that the occurrence of beginning of alcoholism after age 60 is possible but rare. PMID- 3827059 TI - [Psychiatric department in a general hospital. What viewpoints? (apropos of 10 years of professional experience]. PMID- 3827060 TI - [Adoption and its current difficulties]. PMID- 3827061 TI - [Schizophrenics prior to schizophrenia. Comparative and statistical inquiry on the infantile antecedents of 35 schizophrenics and 35 control subjects]. PMID- 3827062 TI - Metastatic disease first presenting as eyelid tumors: a report of two cases and review of the literature. AB - We present two unusual cases in which an eyelid tumor was the first sign of metastatic disease. The first involved a 53-year-old man with pulmonary carcinoma and the second a 71-year-old man with malignant lymphoma. Fifteen similar cases from the literature are reviewed. The most frequent primary lesion is breast carcinoma in women, which appears as a diffuse lesion of one or two eyelids. Metastatic lung carcinoma in men appears as solitary nodules, representing the second-most common type of lesion. The questions of left- or right-side predominance, age and sex of patients, types of tumors, and prognosis are discussed. PMID- 3827063 TI - The role of carcinoembryonic antigen in surveillance of patients with choroidal malignant melanoma: a prospective study. AB - Serum carcinoembryonic antigen levels were measured in nine patients with choroidal malignant melanoma prior to enucleation and at three-month intervals thereafter for three years. Raised levels were found preoperatively in four of the nine patients. One of these patients had persistent and progressive elevation of serum carcinoembryonic antigen levels postoperatively, and clinical evidence of metastases subsequently became apparent. In the remaining eight patients, carcinoembryonic antigen levels remained at or returned to normal values and no clinical evidence of progression of the disease was detected. These results suggest that although serum carcinoembryonic antigen estimation is not a reliable diagnostic screening test for choroidal malignant melanoma, it may be useful for follow-up and monitoring of recurrences of the disease. PMID- 3827064 TI - New techniques for iodine-125 radiotherapy of intraocular tumors. AB - Low-energy radiation sources, such as iodine-125, are suitable for treating choroidal melanoma because of their physical characteristics. Iodine-125 emits x rays and gamma-rays between 27 and 35 keV. Gold plaques can direct radiation toward the tumor and minimize radiation to normal ocular structures. Effective treatment requires the cooperation of the ophthalmologist, radiotherapist, and radiation physicist. The preparation of the radioactive plaque and methods for its accurate surgical placement are detailed. PMID- 3827066 TI - The effect of chitosan on corneal wound healing. AB - Chitosan, a suspected inducer of vascular endothelium regeneration, was applied topically to the eyes of rabbits after they had sustained central corneal wounds. The rabbits were given chitosan tid for seven days in one experimental set and for 14, 17, and 21 days in subsequent sets. For all time sets, there were no apparent statistical differences in corneal wound tensile strength between the chitosan-treated eyes and control eyes. PMID- 3827065 TI - The idling retina: reversible visual loss in central retinal artery obstruction. AB - Based on experimental studies, sustained total central retinal artery obstruction (CRAO) lasting more than one and one-half hours has been considered to cause irreversible retinal damage. We have seen five cases of patients with pure CRAO that lasted longer than one and one-half hours who regained significant visual acuity. Three of the patients had a completely spontaneous improvement in visual acuity to 20/50 or better. In addition, the other two patients regained significant vision to 20/80 or better with a modified treatment regimen of acetazolamide, inhalation of 5% CO2 and 95% O2, and aspirin. No foveola-sparing cilioretinal arteries were present in any of the cases. We introduce the concept of reversible retinal ischemia following unsustained CRAO to account for these unexpected improvements in visual acuity. PMID- 3827067 TI - Upper eyelid retraction from inferior rectus restriction in dysthyroid orbit disease. AB - Findings from orbital computed tomography scans have shown inflammatory enlargement of the levator palpebralis superioris complex to be a likely cause of eyelid retraction in dysthyroid (Graves's) ophthalmopathy. We have studied a subgroup of nine dysthyroid patients in whom the eyelid retraction occurs as a relative malposition of the globe and eyelid due to inferior rectus restriction. Our explanation of this phenomenon in nine patients is based on Hering's law. Increased innervation required for a fixating superior rectus muscle to overcome a severely restricted inferior rectus muscle causes an unrestricted levator muscle to open the eyelid abnormally wide relative to the globe. The retraction is best demonstrated with fixation of the involved eye. We have performed inferior rectus recession to correct this type of eyelid retraction in three of our patients. PMID- 3827068 TI - Terson's syndrome--significance of ocular findings. AB - Ocular findings of three patients with Terson's syndrome are presented. Two patients had a ruptured intracranial aneurysm, and one had a subdural hematoma. Ocular findings included retinal, preretinal, and vitreous hemorrhages. Vitreous hemorrhage may be delayed in onset and may require vitrectomy if persistent. The eye findings are characteristic but not pathognomonic of this syndrome. The authors emphasize the diagnostic and prognostic importance of ocular findings in patients with spontaneous intracranial hemorrhages. Some of the primary theories of the syndrome are reviewed. PMID- 3827069 TI - [Perinatal outcome in diabetic pregnant women: 1963-75 and 1978-83]. PMID- 3827070 TI - [Immunohistochemical study of the area of placental insertion]. PMID- 3827071 TI - [Cellular bases of hypertension in pregnancy. II. Anatomical and humoral factors. Review of the literature and methodological introduction to the study]. PMID- 3827072 TI - [Cellular bases of hypertension in pregnancy. III. Immunologic factors. Review of the literature and methodological introduction to the study]. PMID- 3827073 TI - [Cellular bases of hypertension in pregnancy. IV. Longitudinal determination of intra-erythrocyte sodium in physiological and hypertension-complicated pregnancy]. PMID- 3827074 TI - [Term pregnancy in a patient with Hodgkin's disease subjected to multi chemotherapy treatment combined with radiotherapy (description of a typical case)]. PMID- 3827075 TI - [Lymphatic complications in the therapy of clinical cervix carcinoma. Cases of the decade from 1971 to 1980 (1157 patients)]. PMID- 3827076 TI - [Trepanation of the labyrinth and congenital malformations]. AB - Labyrinthine trepanation was performed in the majority of 16 patients with minor agenesis of middle ear involving either stapedovestibular ankylosis or absence of fenestra vestibuli. Preoperative findings are discussed, as well as the prevention and treatment of labyrinthine geysers and the possibility of obtaining a functioning labyrinthine opening. Results were good in simple cases but poorer in more complex lesions, for which the indication for use of this procedure is debatable. PMID- 3827077 TI - [Results of primary surgery in the treatment of oropharyngeal cancer]. AB - A homogeneous series of 106 cases of malignant tumor of tonsillar region was treated by first intention surgery. Treatment proposed for these patients with ulcerated or infiltration tumors often extending to pillars or to tongue was transmandibular buccopharyngectomy with curettage of glands and postoperative radiotherapy. Unadjusted survival rate at 3 years was 62% (T2 and T3) and at 5 years 35%. Clinical glandular enlargement, detected in 50% of cases, resulted in poorer prognosis, which decreased from 48% at 5 years to 25% in patients with histologic metastasis in lymph nodes. PMID- 3827078 TI - [Carcinomas of the posterior pharyngeal wall. Experience of the Institut Curie. Analysis of the results of radiotherapy]. AB - Between 1960 to 1982, 98 patients with squamous cell carcinomas of the posterior pharyngeal wall were treated at the Curie Institute by radiotherapy alone. The absolute survival is 30% and 18% at three and five years. The major cause of death is loco-regional failure. 95% of the local failures arrived within the 18 first months. The 2 years control rate ranged from 80% for T1, 64% for T2, to 36% for T3 and 22% for T4. The local control is so depending on the radiation induced regression of the primary. The 2 years control rate is 71% for the patients with complete regression and 12% for the patients with not complete regression at the end of the treatment. The improvement of these results by adjunction of other treatments (surgery, chemotherapy, hyperthermia) is discussed. PMID- 3827079 TI - [Requisite selection of surgical technics in the treatment of cancer of the larynx]. AB - Rules for functional surgery of cancer of larynx are defined by means of a detaited analysis of results of 43 cases of reconstructive anterior frontal laryngectomy, 17 cases of crico-hyoide-epiglottopexy and 32 cases of crico hyoidopexy. The carcinologic features of this surgery are discussed, and emphasis placed on the importance of the paraglottic space and its functional conditions in the light of recent physiologic data. Surgical procedures used are outlined with, for each of them, the neoplastic localization suitable for treatment and a critical analysis of postoperative functional results. Carcinologic follow up is still insufficient for several techniques used, preventing any precise conclusions to be drawn, but the authors consider it is justifiable to perform 66% of partial as against 34% of total laryngectomies. PMID- 3827080 TI - [Montgomery's tube in laryngotracheal stenoses in children (11 cases)]. AB - Because of the fragility of the laryngotracheal tree in children, and the serious consequences on function of any chondritic lesion or even mucosal edema, overall endoscopic treatments combined with prosthesis insertion are preferred to any surgical procedure. Eleven cases of laryngotracheal stenosis are reported where treatment involved use of Montgomery's calibrated tube. PMID- 3827081 TI - [Evaluation of 16 severe pharyngo-esophageal caustic stenoses. Value of the anterior approach in an ileo-colic transplant]. AB - Results of treatment of 16 cases of severe pharyngo-esophageal stenosis of caustic origin are reviewed. Emergency treatment is described, the place of otorhinolaryngology in investigation of lesions of upper respiratory and digestive tract discussed, and a description given of a technique of esophagopharyngoplasty by right ileocolic transplant with a suprahyoidal or supraglottic anterior cervical approach with epiglottectomy. Strict selection of patients is essential, taking into account their psychiatric profile. The functional result of this operation, with its long and difficult postoperative course, was inconstant (11 of the 16 cases could be fed liquids and solids by mouth exclusively, ensuring maintenance of body weight, although endoscopic dilatation might be necessary in one or two cases), and appears to depend on the outcome of corrosive lesions and psychologic behavior of patients. PMID- 3827083 TI - [Plunging and mediastinal goiters]. AB - Of 185 cases of substernal goitre operated upon between 1976 and 1985, four were patients with autonomous mediastinal goitre. Diagnosis was established from results of clinical examination, a scan of mediastinum and radiologie imaging with a cervical and mediastinal CT scan as the investigation of choice. Treatment is exclusively surgical because of the risk of mediastinal compression. Most cases in this series were operated upon through a purely cervical approach, but 22 patients required partial upper sternotomy combined with cervicotomy, this minimal approach route allowing very good exposure of upper mediastinum. PMID- 3827082 TI - [Effect of amygdalectomy on asthmatic and allergic children. Study apropos of 55 cases]. AB - The effects of tonsillectomy were investigated in 55 asthmatic and/or allergic children, by clinical and biologic, particularly immunoallergologic examinations before and 6 months and one year after operation. Tonsillectomy adversely affected clinical state of asthmatic and/or allergic children in less than 10% of cases, and then only to a moderate degree. In 40 to 60% the course of their illness was not affected by the operation and, a remarkable finding, in 40 to 45% of cases it was markedly improved. Biologic, and particularly immunoallergologic parameters studied were not significantly altered, but changes in immunoglobulins confirmed the immunocompetent role of the palatine tonsil. PMID- 3827084 TI - [Stereology of the dermo-epithelial interface of the matrix-papilla unit of the hair bulb. Computerized processing of tridimensional images]. AB - Images of the spatial relations of the matrix-papilla unit of the human hair bulb are shown. Hair bulbs were reconstructed in 3 dimensions by a computer graphics system from measurements made on horizontal sections parallel to the scalp surface. The outlines of hair matrix and dermal papilla of every fifth serial sections were fed into a computer as a segment 30 mu high (5 sections, each 6 mu thick). Processing of these segments into 3 dimensional models, using techniques adapted from those currently used for architectural drawing enabled us to avoid major distortion of the printed pictures. As an end result, the hair bulbs appear as wire frame structures in which the boundaries between consecutive segments have been connected to improve rendering of the dermal papilla interacting with the overlying epithelial hair matrix. This computerized method has been used to evaluate dermal-epithelial stereology of the interacting dermal papilla and epithelial hair matrix in hair bulbs. In a patient with trichorhinophalangeal syndrome the hair bulbs, and especially their dermal papillae, were found to the hypotrophic as compared with a sex- and age-matched control. Even though the pictures are somewhat artifactual in their present form, there are several means of improving the rendering of relief and of the interrelation between the hair follicle and other surrounding structures. This method could be useful to demonstrate disturbed dermal-epithelial interactions in other types of alopecia and to evaluate potential biological effects of drugs used in the treatment of alopecia. PMID- 3827085 TI - [Leg ulcer in disseminated lupus erythematosus. Apropos of a case]. PMID- 3827086 TI - [Leg ulcer and circulating anticoagulants]. PMID- 3827087 TI - [Multiple and recurrent Spitz melanoma. A case with a 16-year follow-up]. PMID- 3827088 TI - [Acquired acrokeratosis and ichthyosis associated with multiple myeloma]. PMID- 3827089 TI - [Nevus on nevus and nevus spilus]. PMID- 3827090 TI - [Dysplastic nevus syndromes]. PMID- 3827091 TI - [Lipid determination in current medical practice]. PMID- 3827092 TI - [Parapsoriasis en plaques]. PMID- 3827093 TI - [Amyloidosis]. PMID- 3827094 TI - [Treatment of keloid]. PMID- 3827095 TI - [Treatment of leg ulcer with benzoyl peroxide]. PMID- 3827096 TI - [Management of hygroma]. PMID- 3827097 TI - ["Artificial" or "assisted" procreation?]. PMID- 3827098 TI - [Etiology of insulin-dependent diabetes. Prospects for immunological therapy]. PMID- 3827099 TI - [Insulin pump treatment of diabetic children and adolescents]. PMID- 3827100 TI - [Switching the diabetic adolescent from pediatric facilities to diabetologic units for adults]. PMID- 3827101 TI - [Treatment of hypoglycemia in diabetic children]. PMID- 3827102 TI - [Everyday life of the young insulin-dependent diabetic. Scholastic, social and professional adjustment]. PMID- 3827103 TI - [Diabetic children and adolescents: psychological points of view]. PMID- 3827104 TI - [Diagnosis of congenital abnormalities of the vulva and vagina]. PMID- 3827105 TI - [Coalescence of the labia minora. Diagnostic and therapeutic aspects]. PMID- 3827106 TI - [Surgical treatment of vulvo-vaginal abnormalities]. PMID- 3827107 TI - [Turner syndrome and Rokitansky-Kuster-Hauser syndrome. Association in a patient with a 45,X/46,XX karyotype]. PMID- 3827108 TI - [Treatment of malignant germ cell tumors of the ovary in children]. PMID- 3827109 TI - [Benign tumors of the ovary and follicular cysts in children and adolescents]. PMID- 3827110 TI - [Spontaneously regressive central precocious puberty in girls. Impact on therapeutic indications in precocious puberty]. PMID- 3827111 TI - [Ovarian insufficiency and congenital galactosemia]. PMID- 3827112 TI - [Survey on the first 3 gynecological years among 392 school girls in Val-de-Marne in 1985]. PMID- 3827113 TI - [Idiopathic hirsutism in girls: in vitro physiopathologic studies]. PMID- 3827114 TI - [Therapeutic assay of smectite in non-specific inflammations of the rectal and colonic mucosa in children. Clinical, endoscopic and histological study]. PMID- 3827115 TI - Results following reduction mammaplasty as evaluated by the patients. AB - Reduction mammaplasty was performed on 365 patients using the technique of Pers and Bretteville-Jensen. Two to 13 years after the operation, the patients were asked to complete questionnaires; the answers were analyzed and compared with answers from a smaller group of patients who had undergone surgery with McKissock's technique. Primary complications to the procedure were few, and it is remarkable that total necrosis of the nipple was absent in the series. More than 80% of the patients had their general expectations fulfilled, but one third in both groups found the resulting scars unacceptable. The character of the scars seems to be more important than the location. Primary complications were more frequent in overweight patients, and preoperative weight regulation is recommended. An improvement in the character of scars after reduction mammaplasty would be beneficial, and detailed preoperative information is essential if postoperative disappointment is to be avoided. PMID- 3827116 TI - Epidemiology of orofacial clefts in Finland: a review. AB - Epidemiological studies on clefts in Finland seem to give support to the following theories: 1. Both genetic and environmental factors seem to play a role in the pathogenesis of cleft lip and/or cleft palate, which in the majority of cases are probably two different anomalies. 2. The incidence of cleft lip and/or cleft palate in Finland has increased, probably because of a change in the environmental factors. 3. The incidence of cleft palate in Finland is higher than anywhere, which seems to be the result of differing genetic factors. 4. The exogenous factors remain unidentified, but in cleft lip and/or cleft palate parallel fluctuations and an increasing trend have been noticed, arguing for similar and simultaneous factors. 5. More patients with cleft palate than cleft lip/palate have "cleft syndromes." PMID- 3827117 TI - Excitability in free muscle transfers: an optimal method of monitoring tissue circulation? AB - Recent methods of postoperative monitoring of free muscle transfers were used in 4 patients operated on with free revascularized gracilis muscle. The contractility/electromyographic (EMG) activity in response to electrical stimulation was used as an index of viability, i.e., intact circulation. However, during operations it was observed that contractions as well as EMG potentials could be evoked 1 to 2 hours after blood flow had been arrested. Muscle excitability was further studied in the gracilis muscle from a patient who had undergone hemipelvectomy; it was found that contractility and EMG potentials were evoked at least 4 hours after circulatory arrest. It thus seems that loss of muscle excitability is not as early a sign of impaired blood supply as recently has been suggested. Spontaneous EMG activity, which can be recorded 2 to 3 weeks after denervation, is reported to be affected earlier than muscle excitability by circulatory arrest. Thus, the recording of spontaneous EMG activity in previously denervated muscles is proposed as an alternative and simple electrophysiological method for post-operative monitoring of vascularization in free muscle transfers. PMID- 3827118 TI - A technique for lining the palatopharyngeal flap with a single hinge flap. AB - A new technique for lining the superiorly based pharyngeal flap is described. After the soft palate in the oral mucosa is incised, the muscular velum is dissected laterally. A flap is then prepared on the nasal side of the palate with its pedicle on one side of the posterior edge of the palate. The pharyngeal flap is sutured into the donor defect of the palatal flap, which is reflected and used to line the pharyngeal flap. Both surface and bulk are added to the pharyngeal flap and the obturating effect is increased. This method is therefore especially indicated in patients with primary velopharyngeal insufficiency and decreased lateral pharyngeal mobility. In 8 patients studied over a two-year period we achieved reduced nasality and no rhinolalia clausa. PMID- 3827119 TI - Priority grouping in a waiting list of patients for reduction mammaplasty. AB - A model for priority grouping of patients waiting for a reduction mammaplasty is described. Various factors such as age, breast volume, weight, ptosis, asymmetry, and extensive psychic or somatic distress form the basis for grouping. PMID- 3827120 TI - The craniofacial approach to trauma. AB - Craniofacial surgical techniques have yielded better methods of treating severe craniofacial trauma. In this paper surgical techniques are discussed in principle and specifically presented through case reports. We conclude that the most important factors for successful reconstruction after craniofacial trauma are to do as much as possible the first time, to obtain wide exposure, to ensure rigid fixation of bone pieces and grafts, and to make use of a workbench procedure where bone fragments are assembled on a side table for subsequent reattachment to the head. PMID- 3827121 TI - The predictive validity of psychosocial factors for patients' acceptance of rhinoplasty. AB - Adaptation to rhinoplasty one year postoperatively was studied in 56 patients and the results compared with their preoperative psychosocial profiles. Of the patients, 21 (37%) reported unfavorable experiences with the operation, such as dissatisfaction with the results and/or increased nervous symptoms. Patients dissatisfied with the operational result were more often men who had experienced a nose trauma as an adult. A high consumption of alcohol, poorly established social relations, and an outgoing sthenic attitude were other characteristics. Patients reacting with increased mental symptoms after the operation had expected the operation to result in a substantial change in their general life situation. Their sensitivity regarding the shape of their noses was, in some cases, of a delusional severity. The remaining 35 patients (63%) adapted fairly well to the operation. By a system of different weights given to interview items, it was possible to demonstrate a significant predictive validity of the preoperative psychosocial evaluation with regard to postoperative adaptation. Application of this evaluation technique therefore should increase the possibility of reliably predicting the outcome. Operations on patients not suited to rhinoplasty might be avoided with the application of such a technique. PMID- 3827122 TI - The UNILINK instrument system for fast and safe microvascular anastomosis. AB - A new instrument system for fast and safe mechanical microvascular anastomosis is presented. It can be used for both end-to-end and end-to-side anastomosis of small arteries and veins and has the potential for use in other small tubular structures. With moderate training, the surgeon can perform the full microvascular anastomosis within 2 to 3 minutes. The device has proved successful in animal studies and in the clinic, with overall patency rates of about 98% in both arteries and veins. PMID- 3827123 TI - Hypospadias: simple, safe, and complete correction in two stages. AB - Hypospadias is a common abnormality treated by surgeons with different training and experience, using a wide variety of surgical methods. Ideally, reconstruction ought to be simple and safe with few complications, and the resulting penis should be satisfactory both functionally and cosmetically. These criteria are met by the following technique in which the first stage includes meatotomy, correction of the chordee, partial splitting of the glans penis, and covering the defect with a pedicle flap from the preputial hood. The second stage, performed six months later, is then easily carried out using available tissue to reconstruct the glans penis and the urethra. Urethrostomy or cystostomy is not necessary. More than 80 patients have undergone our two-stage operation, with very few complications. The procedure is suitable for all degrees of hypospadias and for congenital short urethra. PMID- 3827124 TI - Toxic shock syndrome after augmentation mammaplasty. AB - Toxic shock syndrome was first described in children in 1978. Two years later the strong connection between this disease and the colonization of vaginal tampons with certain strains of Staphylococcus aureus was noted. Even from the earliest descriptions, however, it has been clear that the same clinical picture may be caused by staphylococcal infections elsewhere, and that the presence of foreign materials in the body is not mandatory. We describe a patient with toxic shock syndrome after augmentation mammaplasty. PMID- 3827125 TI - Experience with one hundred consecutive free flaps. AB - Our first 100 free flap operations are reviewed. The location and cause of the defects requiring free flaps, the flaps used, and the outcome are tabulated. The lower leg was the most common site of defect. Osteomyelitis and trauma were the most common causes. The latissimus dorsi and tensor fascia lata were the most useful flaps. Of the 15 patients with failed flaps, wound closure was accomplished by other methods in 13 and 2 underwent amputation. One of the patients with a successful free flap ultimately underwent amputation because of recurrent osteomyelitis. PMID- 3827126 TI - The free ulnar forearm flap. AB - Many flaps have been described based on the septocutaneous perforators; these have many advantages for the coverage of soft tissue defects. The ulnar forearm flap described by Lovie is a septocutaneous flap based on the septocutaneous perforators of the ulnar artery. We report the use of this flap in 2 patients who required soft tissue coverage. The ulnar forearm flap has the advantages of thin and pliable skin, constant and large pedicle, and the technical possibility of combination with the muscles, sensory or motor nerve, and ulna. Comparing it with the radial forearm flap, there is no possibility of exposure of flexor tendons, which usually results in the good take of skin grafts. After skin grafting, the donor scar is unnoticeable because of its position on the forearm. This flap is for the coverage of thin defects that require mobility, such as in the extremities or the intraoral region. It also could be used for the coverage of hand or arm defects as a distally or proximally based island flap, respectively. PMID- 3827127 TI - Mammary construction and reconstruction in one surgical stage. AB - The authors' personal technique for mammary reconstruction, including the nipple areola complex, is presented. The technique is simple and effective and is performed in only one surgical stage. It is applicable to mammary construction in the case of congenital absence as well as to reconstruction after mastectomy. PMID- 3827128 TI - Routine use of a suction drain in facial rhytidoplasty. AB - The effectiveness of a suction drain in facial rhytidoplasty was evaluated in 46 women ranging in age from 41 to 78 years. The drain was placed on the left side of the face in 16 and on the right in 14, and no drain was used in 16 patients. The drain was removed in 24 hours regardless of the amount aspirated, which varied between 0 and 25 ml, with an average of 7.8 ml. Although none of these patients developed a hematoma while the drain was in place, a hematoma did occur in 1 patient on the drain side following its removal. Despite the variable quantities of fluid aspirated, there was no clinical difference in swelling noted around the face and neck area when the two sides were compared. Similarly, one could not distinguish this group of patients from those 16 who did not receive the drain. The routine use of continuous suction drains for patients undergoing rhytidoplasty is therefore probably unnecessary. PMID- 3827129 TI - The stair-step flap for nasal reconstruction. AB - The stair-step nasal flap, which was originally designed to allow re-creation of the alar rim, has proved to be equally versatile for reconstruction of many other soft tissue defects of the nose. When a skin graft is unwarranted, this is a simple method for local flap transposition that minimizes any aesthetic deformity while allowing primary donor site closure. It is best suited for small or moderate sized defects of the lower and middle thirds of the nose. PMID- 3827130 TI - The treatment of intraarterial pentazocine injection injuries with intraarterial reserpine. AB - From 1979 to 1983, 14 patients were treated at the University of Maryland Hospital for injuries sustained as a result of the injection of crushed pentazocine tablets partially dissolved in water into the arterial system of the upper extremity. Eight patients received intraarterial reserpine within 15 hours of the injury and had no functional or tissue loss. Six patients either received no treatment or were given the reserpine more than 15 hours after the injury; they sustained notable functional or tissue loss. The results of this review would indicate that there may be a role for the use of intraarterial reserpine in the treatment of impending tissue loss from intraarterial drug injections. PMID- 3827131 TI - Biostimulation of wound healing in vivo by a helium-neon laser. AB - Clinical observations have suggested that low-energy lasers might stimulate wound healing. To understand the mechanism of the biostimulation, we previously examined the effects of low-energy lasers on collagen production by human skin fibroblasts and reported an increase of collagen synthesis in vitro. To examine the effects of low-energy lasers in vivo, hairless mice were experimentally wounded, sutured, and subjected to laser irradiation by a helium-neon laser with a power output of 1.56 mW and an energy fluence of 1.22 Joules/cm2. Experimental wounds were subjected to laser treatment every other day for 2 months; control wounds remained untreated. Specimens from the wounds were then examined for histological findings, tensile strength, and total collagen content. Results demonstrated a considerable improvement in the tensile strength of the laser irradiated wounds at 1 and 2 weeks. Furthermore, the total collagen content was significantly increased at 2 months when compared with control wounds. These results suggest a beneficial effect of the helium-neon laser on wound healing in vivo. PMID- 3827132 TI - Detailed technique of subcutaneous mastectomy with and without mastopexy. AB - Successful subcutaneous mastectomy without an unreasonable incidence of complications is achievable only with meticulous attention to detail. Detailed techniques of subcutaneous mastectomy with and without mastopexy and concomitant reconstruction with submuscular implants are described. Based on the results of the present study, the procedure, while not truly prophylactic, does reduce the risk of cancer. PMID- 3827133 TI - The reverse lateral upper arm flap for elbow coverage. AB - Closure of soft tissue defects in the vicinity of the elbow has been attempted by numerous methods. The reverse lateral upper arm flap was conceived by applying concepts of previous work. Cadaver studies demonstrated the cutaneous territory and vascular anatomy of this region. The nature of the posterior recurrent radial artery and its perforators allows this fasciocutaneous flap to be perfused in a retrograde fashion. The flap can be used for covering various soft tissue defects around the elbow in a single stage with acceptable donor site morbidity. A case is presented in which the flap was used in a reverse flow fashion to cover an 8 X 11 cm acute cubital defect present after soft tissue release. Operative technique is discussed. PMID- 3827134 TI - Recurrent breast carcinoma at the time of breast reconstruction. AB - Detection of recurrent breast carcinoma following reconstruction of mastectomy defects is of concern to plastic surgeons and oncologists. During the past four years we have found recurrent, previously undetected breast cancer in 4 patients at the time of reconstruction. The recurrent disease presented differently in each patient: as fascial thickening, as a small node hidden under a pectoralis muscle stump, as a microscopical tumor contained within the mastectomy scar, and as a small mass which developed during the interim between the last office visit and the scheduled surgery. All of the patients received additional treatment and one has been reconstructed. Our study of these patients prompts the following recommendations: carefully reexamine the patient just prior to reconstruction; biopsy any abnormal tissue; submit all excised mastectomy scars for histological examination; create and examine the recipient pocket before raising a flap; and reconsider the patient for reconstruction following additional cancer therapy. PMID- 3827135 TI - Squamous cell carcinoma occurring in hidradenitis suppurativa. AB - A patient is described who had severe hidradenitis suppurativa of the perineum for three years. Excision of the involved area demonstrated a well-defined squamous cell carcinoma. A review of the literature shows only 12 reported cases of squamous cell carcinoma occurring in patients with hidradenitis suppurativa; most patients developing cancer in chronic inflammatory lesions have had longstanding disease. In this case there was a short interval between disease onset and the occurrence of a squamous cell carcinoma. PMID- 3827136 TI - Intraosseous lipoma of the skull: a report of two cases. AB - Case histories of a 12-year-old boy and a 20-year-old woman with hyperostosis of the frontoparietal bones are presented. Microscopical examination of the lesions showed intraosseous lipoma with hyperostosis of diploe. In both cases, only the prominent part of the tumor was removed for cosmetic reasons. The results were satisfactory, and there was no evidence of recurrence over a period of six years. PMID- 3827137 TI - Further improvement in a dressing for hypospadias. PMID- 3827138 TI - New technique for intralesional steroid injections. AB - A fast, simple, and accurate method is described for intralesional injections using a laboratory repetitive pipette that was modified for this specific purpose. PMID- 3827139 TI - Re: Franco: face-lift stigmas. PMID- 3827140 TI - [Magnetic resonance imaging of the spine]. PMID- 3827141 TI - [Value of extensive coronarographic evaluation for performing optimal myocardial revascularization]. PMID- 3827143 TI - [Residual retroperitoneal masses of non-seminomatous germ cell tumors of the testis after chemotherapy. X-ray computed tomography-histology correlates]. PMID- 3827142 TI - [Magnetic resonance imaging of the prostatovesical area]. PMID- 3827144 TI - [Adrenal adenoma and adrenal metastasis. Do x-ray computed tomography differentiation criteria exist?]. PMID- 3827145 TI - [Comparative study of the toxicity of metal chlorides and a synthetic organic molluscacide, N-tritylmorpholine, in 2 fresh-water amphipods, Gammarus pulex and Echinogammarus berilloni]. AB - The effects of three metal salts (BaCl2, CuCl2, ZnCl2) and of N-trityl-morpholine (Triphenmorph) were studied on two aquatic amphipod species, Gammarus pulex and Echinogammarus berilloni. Experiments were made up in eucalcic and oligocalcic waters for determining the LC50 at different exposure times. The order of toxicity was the same in eucalcic water with the two species: Triphenmorph greater than Cu2+ greater than Zn2+ greater than Ba2+. This order was the same in oligocalcic water with Echinogammarus berilloni; with Gammarus pulex, CuCl2 was more toxic than Triphenmorph. PMID- 3827146 TI - Cardiovascular lesions in cobalt-vitamin B12 deficient sheep. AB - Cardiovascular lesions were observed at necropsy in five of six sheep which were subjected to an experimentally induced cobalt-vitamin B12 deficiency during a period of 34 weeks. The classical symptoms of cobalt-vitamin B12 deficiency (anorexia, cachexia, anaemia) were seen in all six sheep at week 20 of the experiment. Histologically, lesions of the auricular epicardium and myocardium consisted of a high concentration of inflammatory cells dominated by polynuclear eosinophils as well as the haemorrhagic inflammation of blood vessels accompanied by necrosis of auricular tissue. The similarity between the lesions observed in the present experiment and those seen in arteriosclerosis, led to the suggestion that a deficiency of vitamin B12 may be implicated in the pathogenesis of arteriosclerosis. A hypothesis is advanced in this respect. PMID- 3827147 TI - Effect of Eimeria maxima infection on development of Eimeria tenella in immunized chickens. AB - Chickens previously immunized against Eimeria tenella were reinfected with this species with and without infection by E. maxima. The present of E. maxima at the time of reinfection appears to decrease the immunity of the animals and enables E. tenella to develop. In this case, the development of E. maxima is not affected by the presence of E. tenella. PMID- 3827148 TI - [Myocardial infarction in the pre-hospital phase]. AB - The pre-hospital phase of myocardial infarction has a major importance today, since it is unanimously recognized that the treatment should be started in the very few hours following the occurrence of the symptoms, in order to limit the size of the infarction and prevent complications, particularly rhythm disorders. The prevention of the ventricular rhythm disorders justifies the use of lidocain. A review of the literature is carried out in order to evaluate the results obtained with this product, used intravenously or intramuscularly, before the arrival of the patient in the hospital. The attempt to limit the size of the necrotic area leads to consider the efficacy of calcium antagonists, beta blockers and mainly fibrinolytic agents or tissue activators of plasminogen, used during the first 4 to 6 hours, at home or in the specialized ambulance taking the patient to the hospital. A review of the first results is presented. PMID- 3827149 TI - [Implantable defibrillators. Clinical experience]. AB - The clinical experience with the Automatic Implantable Cardioverter-Defibrillator (AICD) now extends to over 800 patients suffering from malignant ventricular arrhythmias, most of them survivors of sudden cardiac death. This device monitors cardiac rhythm for long periods of time, identifies ventricular fibrillation and life-threatening ventricular tachycardias, and then restores normal heart action with effective electrical discharges. The AICD practically eliminates the need for trained personnel and the time constraints associated with conventional out of-hospital resuscitation, significantly decreasing the arrhythmic and total mortality rates of the implantees. Through August, 1985, 130 consecutive patients underwent implantation of the AICD at The Johns Hopkins Hospital in Baltimore; the one-year mortality due to arrhythmias was 1.7%. These results are similar to those reported by other centers. Thus, the growing clinical experience with the automatic implantable cardioverter-defibrillator has demonstrated a marked reduction of the mortality rate of the implantees. PMID- 3827150 TI - [Silent myocardial ischemia]. AB - Silent myocardial ischemia seems a relatively frequent manifestation of coronary insufficiency. The practice of more and more sophisticated tests to detect myocardial ischemia shows that it is a relatively frequent pathological occurrence. It occurs in patients with an abnormality or a transient or constant failure of the alarm system, represented by pain during the ischemia. It is an heterogenous picture which may take the appearance of a completely silent ischemia (the metabolic, hemodynamic and electrical consequences of ischemia being the only symptoms of coronary insufficiency, demonstrated by the presence of severe, angiographic or anatomical, stenoses); of a silent transient ischemia (with alternance of symptomatic and silent episodes or with silent episodes after myocardial infarction); of myocardial necroses without pain or ischemic myocardiopathies. It is the consequences of either an ischemia which is too moderate to reach the pain threshold, or a severe ischemia in patients presenting alterations of the transmission system and of the perception of pain. It has metabolic, hemodynamic and anatomical consequences which may lead to necrosis or degeneration and fibrosis of the myocardium. The prognosis of a painless disease is difficult to make but it does not seem to be as poor as the one of the usual forms of ischemic cardiopathies. Medical treatment is mandatory, and surveillance of its efficacy must be systematic using the techniques of detection of the ischemia. PMID- 3827151 TI - [Identification of the patient at risk for sudden death after infarction]. AB - Considerable efforts have been made in the last few years to improve the diagnostic and treatment methods of arrhythmias following myocardia infarction. The recent progress in electrophysiology and in surgery have contributed to improve the prognosis of ventricular tachycardias, sustained and recurrent. On the contrary, the prognosis and therapeutic approach to "potentially malignant" but asymptomatic ventricular arrhythmias remain a subject of controversy and further study. The door remains open for the development of new techniques of detection and prevention of sudden death following myocardial infarction. PMID- 3827152 TI - [Is it necessary to treat arterial hypertension after age 70?]. PMID- 3827153 TI - [Developmental profile of scintigraphic parameters within 3 weeks following primary myocardial infarction without any attempt at revascularization]. AB - 30 patients with a transmural primary myocardial infarction conventionally treated, are explored by myocardial scintigraphy using thallium 201, and calculation of a lesional score (L.S) and angio-scintigraphy on the first day (D1) and at three weeks (D21). The results of these examinations are compared to those of coronography at D21. Anterior necroses present a myocardial fixation defect and a dysfunction of the left ventricle which are more severe than in inferior necroses. Patients with a marked fixation defect (L.S 2) at D1, present a low ejection fraction (EF) becoming significantly worse at D21. Coronary permeability is accompanied by an appreciable improvement of the myocardial fixation from D1 to D21 and a stability of EF. On the contrary, if the occlusion persists, the fixation defect is stable and the EF decreases significantly. In this study, the coronary permeability appears to be associated to a perservation of the ischemic myocardium which may only be demonstrated by knowing the evolution of the various parameters during the first three weeks of the infarction. PMID- 3827154 TI - [Comparison of the effects of ajmaline and procainamide in the diagnosis of paroxysmal atrioventricular block]. AB - 14 suspected of having a paroxystic atrio-ventricular block underwent a complete electrophysiological exploration including an ajmaline test. It was administered at the standard dose of 1 mg/kg at the rate of 1 mg/s. In order to evaluate a replacement test, an equivalent dose of procainamide was injected at the same rate (10 mg/kg, 10 mg/s) a few hours later. In 4 out of 14 cases the ajmaline test was positive. In only one patient, procainamide was able to demonstrate a sub-nodal block. The maximal lengthening of HV occurred at an earlier time after ajmaline than after procainamide (2.2 +/- 0.75 min. versus 4.1 +/- 1.59 min, p less than 0.02) and certainly more clear-cut (MaxHV = 73.5 +/- 12.9 ms versus 59.5 +/- 12.1 ms, p less than 0.01). The lengthening of HV after administration of these two products was significantly correlated but always markedly lesser with procainamide. In conclusion, the procainamide is less sensitive than the ajmaline test in the positive diagnosis of paroxystic atrio-ventricular blocks concerning absolute criteria in the positive diagnosis as well as relative criteria such as a definite lengthening of HV with ajmaline. PMID- 3827155 TI - [Frank's sign and coronary disease]. AB - The authors study the sensitivity, the specificity and the predicting value of Frank's sign (presence of a groove at the level of the earlobe) on a group of 172 patients undergoing a clinical examination, an EKG at rest and effort, and a selective coronary arteriogram for suspicion of coronary disease. The criteria retained for the diagnosis of coronary disease is the presence of stenosis superior or equal to 75 p. cent in one of the three main coronary vascular trunks. Statistical studies using the CHI 2 test reveal a highly significant association between Frank's sign and coronary disease (p less than 0.001). The sensitivity of Frank's sign reaches 75 p. cent, its specificity 57.5 p. cent and its positive predicting value 80.3 p. cent. The predicting value is a function of the sex: it is a great deal lower in women (50 p. cent) than in men (84.7 p. cent). The prevalence of Frank's sign increases progressively with age: 42 p. cent in the 30-39 age group and 75.8 p. cent in the 60-69 age group. The predicting value remains high however beyond 60 years: predicting value of 77 p. cent. Frank's sign is correlated neither with the gravity of the coronary disease, nor the duration of the angina, nor with any of the risk factors studied here: tobacco, hypercholesterolemia, arterial hypertension, diabetes, obesity. Frank's sign is therefore considered as a marker of the coronary disease, independent of risk factors but frequently associated with them. If its absence does not permit in any way to exclude the diagnosis of coronary disease, its presence corresponds in three quarters of the cases to an established coronary disease within a symptomatic population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827156 TI - [Significance of an upward shift of the ST segment during an exercise test]. AB - The objective of this study is to investigate the significance of the occurrence of an upward shift of the ST segment curing a stress test in patients with no previous history of myocardial infarction. Over 10 years, totalling 9,500 stress tests, we have collected 10 cases. They always concern men including one with angina on exertion, one with spontaneous angina, one with spontaneous angina occurring at the end of an intense stress, and 7 with mixed angina. None of them had a previous history of myocardial infarction or documented spastic angina. The upward shift of the ST segment occurred 9 times during stress and once during recovery. 9 patients had a coronary arteriogram with in 8 cases severe fixed coronary lesions. The patient with the upward shift of ST during the recovery period had a normal coronary arteriogram with a positive methylergometrin test. There is a good correlation between the appearance of an upward shift of ST during stress in the anterior derivations and a significant involvement of the anterior interventricular artery. In our series, there were no complications, especially myocardial infarction, in the immediate period following the stress test. 7 patients underwent an aorto-coronary by-pass. The 10 patients are presently asymptomatic after a 47 months follow-up. The occurrence of an upward shift of ST during stress, in the absence of a previous history of myocardial infarction, represents in more than 80 p. cent of the cases the existence of severe coronary lesions leading to hospitalization and the immediate performance of a coronary arteriogram.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827157 TI - [Arterial hypertension in the elderly. Double-blind study versus placebo of the efficacy and tolerability of an alpha-beta blocker: labetalol]. AB - The purpose of this study was to investigate the efficacy and safety of labetalol, an alpha and beta-adrenergic receptor blocking agent in 32 patients aged from 72 to 97 years (mean = 85 years) with blood pressure (B.P.) greater than or equal to 160/95 mmHg. This study was carried out in a double-blind, randomized, placebo-controlled design. After 6 weeks of treatment with labetalol (mean dose = 235 +/- 47.5 mg/day), the systolic pressure was lowered from 187 +/- 24 to 145 +/- 28 mmHg (p less than 0.001) and the diastolic pressure from 98 +/- 10 to 82 +/- 9 mmHg (p less than 0.001). Likewise, in the placebo group, both systolic and diastolic pressures were significantly reduced but the changes were significantly greater in the labetalol group, -33 +/- 26 versus -13 +/- 20 mmHg and -14 +/- 10 versus -8 +/- 14 mmHg respectively. Labetalol achieved B.P. control (160/95 mmHg) in 64% of the treated patients, compared to 40% in the placebo group. Two patients on labetalol discontinued their treatment due to side effects (one bradycardia and one cutaneous reaction) compared with one patient on placebo (cardiac failure). Two other cases in the labetalol group had side effects (one fatigue and one dizziness) which prevented increasing the treatment as necessary. PMID- 3827158 TI - [Effect of ventricular and sequential cardiac stimulation on carotid output]. AB - 12 patients (10 men and 2 women), of 59 +/- 10.5 years of age, including 4 with a patent cardiomyopathy and 7 with a cardiothoracic index higher than 0.52, presenting a permanent and complete atrio-ventricular block and fitted with a two chambers cardiac stimulator, underwent a carotid output study by Doppler sonography. The objective of this study was to determine the factors which could influence the carotid output: synchronous atrial systole, frequency of the electro-stimulated rhythm, atrio-ventricular delay in sequential mode, cardiomyopathy, increase of the cardiothoracic index, age and body area. It appears that the carotid output, for an identical stimulation frequency, is significantly higher in sequential mode than in one-chamber ventricular electrostimulation (p less than 0.05 at 70 c/min, p less than 0.01 at 80 c/min and p less than 0.001 at 90 c/min) and this is even more marked in case of cardiomyopathy (p less than 0.01 versus p less than 0.05). On the contrary, an elevated cardiothoracic index does not alter the nature of the results. An accelerated electrostimulated rhythm discloses an increase of the carotid output (p = 0.01) up to a threshold frequency of 70 c/min in the entire population and of 60 c/min in case of cardiomyopathy. Beyond that, the carotid output decreases. Sequential stimulation does not prevent this decrease from 80 c/min (p = 0.001). The carotid output is significantly lower (p less than 0.01) with an atrio ventricular delay of 115 ms than with a delay of 165 ms. The carotid output decreases in direct ratio to age (p = 0.01) but the gradient of the regression axis is lower in sequential mode.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827159 TI - [Prognostic value of hemodynamic results in the acute phase of myocardial infarction]. AB - The prognostic value of right cardiac catheterization in the acute phase of myocardial infarction is presently well established. The objective of this study is to determine the best discriminating threshold of the pulmonary capillary pressure (PCP) on the one hand and the cardiac index on the other hand. 96 patients presenting an acute myocardial infarction were entered in the study. Six thresholds for each parameter were studied. The following results were obtained: there are important clinical and hemodynamic discrepancies, especially for severe cases. The cardiac index (CI) has a better prognostic value than the pulmonary capillary pressure. The threshold greater than 18 mmHg for PCP and less than 2.2 l/min for the cardiac index, proves to be the most discriminating (better sensitivity with better specificity: sensitivity 60 p. cent with specificity at 81 p. cent for PCP; sensitivity at 73 p. cent with specificity at 78 p. cent for CI). A combined analysis of the two parameters, associated to their best discriminating threshold enables to identify a class of high-risk patients presenting approximately an 80 p. cent mortality in a hospital environment. In spite of the development of non-invasive methods to evaluate the prognosis in the acute phase of myocardial infarction, the hemodynamic exploration remains the leading method for its evaluation. PMID- 3827160 TI - [Infectious endocarditis caused by rare germs. Review of the literature apropos of 2 cases]. AB - The authors report two new cases of endocarditis secondary to exceptionnally encountered germs: one to Pasteurella pneumotropica, the other ascribed to Leptospira ictero-haemorragiae, on serologic criteria. Concerning these two cases, they propose to take a census of rare germs, from a detailed study of the literature. Among more than 5,000 cases of endocarditis published after 1944, are considered as rare germs those causing a disease in less than one p. cent of the cases. This purely "mathematical" definition enable to include 45 germs. A synthesis of all the cases reported attempts to demonstrate a few particular traits of these endocardites secondary to rare germs. PMID- 3827161 TI - [Echocardiography and connective tissue diseases]. AB - The aim of this study is to show the clinical value of the echocardiography in the heritable disorders of connective tissue, within a series of 10 cases, from 7,500 echocardiograms reviewed between 1978 and 1985. Echocardiography visualized an aneurysm of the ascending aorta in three patients, a dilatation of the pulmonary artery in one case, a mitral valve prolapse in six patients associated with an aortic and tricuspid valve prolapse in two cases, and a tricuspid valve prolapse and aortic regurgitation in one case. In two patients, an aortic valve prolapse was isolated. Other echocardiographic features were intracardiac calcifications (4 cases), septal hypertrophy (2 cases) and an incompetent foramen ovale (2 cases). Echocardiographic examination must be performed in all connective tissue diseases because cardiovascular complications are responsible for the vast majority of deaths. Conversely, all the patients with valvular prolapse, dilatation of the great vessels, aneurysm of the sinuses of Valsalva or congenital heart defects type incompetent foramen ovale should be suspected of connective tissue disorders. Such diagnosis is crucial when a surgical intervention is being considered because of the fragility of the tissues. PMID- 3827163 TI - The clinical value of tumour markers. PMID- 3827162 TI - Parietal cell vagotomy for duodenal and pyloric ulcer: clinical and secretory results. AB - In the Department of Surgery, University of Turku, 310 patients underwent parietal cell vagotomy for duodenal (268 patients) or pyloric-prepyloric ulcer (42 patients) in the years 1973-82. The male/female ratio was 4/1 and mean age 43 years. There was no mortality. Splenic injury led to splenectomy in 2.6%. A relaparotomy for intraabdominal bleeding was done in 1%. No case of minor curve necrosis occurred. During the follow-up of 3-9 (mean 5) years 9 patients had died of unrelated causes and 29 could not be traced leaving 272 patients for study. Late symptoms occurred as follows: Dyspepsia 20% (recurrences excluded), heartburn 17%, regurgitation 8%, vomiting 4%, epigastric fullness 12%, dumping 5% and diarrhoea 6%. There were 17 proven recurrences of ulcer (6.3%), 11 after original duodenal ulcer (4.7%) and 6 after pyloric-prepyloric ulcer (16.7%). In addition, 4 patients were reoperated for other reasons (1 for dyspepsia, 1 for stenosis and 2 for oesophagitis). The overall results according to the Visick classification were as follows: Grade I 49%, grade II 18%, grade III 15%, grade IV 18%. CONCLUSION: the method is safe and when used for duodenal ulcer will give satisfactory results, but after pyloric or prepyloric ulcer the recurrence rate may be higher. PMID- 3827164 TI - Mortality from breast cancer. PMID- 3827165 TI - Changes in the treatment and prognosis of breast cancer. AB - The data of 331 women with breast cancer treated in the Second Department of Surgery, Helsinki University, during the period 1976-1980 (patient material, treatment, prognostic factors) is evaluated and compared with an equally large patient material treated during the period 1951-1961 in the same hospital. A breast lump was the main symptom in 94% and the tumour was found by the patient in most cases. Only two patients were younger than 30 years. The median delays to the first medical contact and to operative treatment were 30 and 20 days respectively. The delay had no influence on the prognosis. Also, the age of the patients and the localization of the tumour had no significant effect on the prognosis. Simple mastectomy with axillary lymph node excision was the main operative treatment in the present material whereas Halsted's radical mastectomy was frequently performed in the previous study. Operative radicality was the same in both studies. The prognosis has improved in all clinical stages. The present relative five year survivals in stages I-IV were 95, 83, 53 and 18%, whereas in the previous study they were 75, 58, 41 and 0%, respectively. The improvement in stage II-IV breast cancers is probably due to advances in radio- and chemotherapy. However, the improvement in the prognosis of stage I and to a lesser extent of stage II breast cancers cannot be explained on this basis alone. Neither do the shorter delays in treatment fully explain the differences in the prognosis. The most frequent sites of metastasis were bone and lung/pleura where almost half of the total metastasis occurring during the follow-up were found. PMID- 3827166 TI - Three days cefoxitin in perforated appendicitis. AB - This study was undertaken to assess the efficacy and safety of a 3-day course of treatment with Mefoxitin (cefoxitin sodium, MSD) in patients with perforated or ruptured appendicitis. A series of 235 patients undergoing surgery for perforated or ruptured appendicitis were treated with cefoxitin for 3 days. Twenty-four patients (10%) developed wound infection and 28 (12%) developed an intra abdominal abscess postoperatively. No side effects were observed during the study. Compared with the results of our previous series, where a 5-day course of cefoxitin was used, the incidence of wound infection was similar. However the incidence of intra-abdominal abscesses in the present series was significantly higher (p less than 0.01). The results seem to indicate that a 3-day course of cefoxitin is as effective as a 5-day course in controlling the incidence of wound infection following surgery for perforated or ruptured appendicitis, whereas the 3-day course seems to be inferior to a 5-day course in controlling the incidence of intra-abdominal abscesses. PMID- 3827167 TI - Spontaneous clostridial myonecrosis. A collective review and report of a case. AB - A collected series from the English literature up to 1984 of spontaneous clostridial myonecrosis (SCM) is presented in order to reveal possible common denominators. SCM was associated with malignancy (colonic cancer and leukaemia), diabetes, and injections in descending order. C. perfringens was isolated in more than 70% of the cases followed by C. septicum in 27 and C. novyi in 7%. The pathogenesis is still speculative but is thought to be due to bacteraemia especially from the gastrointestinal tract, due to growth of dormant spores in tissue following antecedent trauma or as an infection descending along the ilio psoas sheath from a gastrointestinal focus. The symptoms are pain in an oedematous, discoloured, crepitant area with haemorhagic bullae and often shock. The diagnosis is based on the clinical findings and Gram-positive rods in the exudate. Treatment instituted promptly constitutes of surgical debridement, antibiotics and hyperbaric oxygen. The prognosis of SCM is worse than for other cases of clostridial myonecrosis and survival was in this collected series only 19%. PMID- 3827168 TI - Pisiform-triquetrial osteoarthritis as cause of wrist pain. AB - Five patients with chronic and disabling pisiform area pain in the wrist are presented. Pain was due to solitary arthrosis of the pisiform-triquetrial joint. Successful treatment was excision of the pisiform bone. PMID- 3827169 TI - Optical internal urethrotomy with and without catheter. A comparative study. AB - The role of postoperative catheter treatment after optical internal urethrotomy was studied in a prospective, consecutive, randomised series of 54 patients. Group one was treated without catheter and group two with catheter for one day. No significant difference in recurrence rate was found between the two groups studied by means of voiding interview, uroflowmetry and retrograde urethrography. PMID- 3827170 TI - Late sequelae following laparoscopic sterilization employing electrocoagulation and tubal ring techniques: a comparative study. AB - Data on 211 consecutive laparoscopic sterilized women were compared. Half the patients were sterilized using unipolar electrocoagulation and the rest had tubal rings. The period of observation was 21-50 months, median 36.5 months. Four failures were observed, median 15 months after the operation. Pregnancy rates were 0.32 per 100 woman years using electrocoagulation and 1.02 using tubal rings. A total of 11% had experienced low abdominal pain and 4% dyspareunia. Menstrual pattern changes were reported by 31% in the electrocoagulation group and 43% in the tubal ring group. The rates of late sequelae were statistically significant independent of the technique employed. PMID- 3827172 TI - An unusual case of postoperative incarcerated diaphragmatic hernia. AB - A very unusual case of incarcerated afferent loop in a postoperative diaphragmatic hernia after a Billroth II operation and a subsequent thoraco abdominal resection of a benign oesophago-cardial stricture is presented. Insufficient closure of the diaphragm combined with long loops after a gastro jejunostomy seemed to be the predisposing factor to this unusual postoperative complication. The risk of rare cases of incarcerated diaphragmatic hernia should be considered after proximal gastric resection. PMID- 3827171 TI - Microcirculatory changes in visceral organs during slowly progressing hypovolaemia in pigs. AB - The loss of 30% of the blood volume, reported in early experimental haemorrhagic pancreatitis, was simulated in anaesthetized piglets by inducing slowly progressive haemorrhage leading to the loss of one third of the blood volume during five hours. Cardiac output, determined by thermodilution, was measured hourly as was mean blood pressure and pulse rate. Organ blood flow was determined before and at the end of the experiment with the reference sample method using radioactive microspheres. During the experiment cardiac output decreased by 33% (p less than 0.001) and mean blood pressure by 21% (p less than 0.005), the decrease being almost linear in both parameters. However, pulse rate increased only slightly. Organ blood flow decreased roughly in proportion to the decrease in cardiac output in almost all organs the decrease being significant in the spleen, antral mucosa and kidneys. Blood flow to the spleen, however, decreased significantly more while blood flow to the adrenal glands increased insignificantly. According to the results, it is obvious, that some form of vasoregulation took place during the experiment, since no frank hypovolaemic shock was observed. The present results closely resemble those observed earlier during experimental haemorrhagic pancreatitis, with the exception of greater cardiac output related decrease in organ blood flow in experimental haemorrhagic pancreatitis, suggesting that the circulatory changes during experimental haemorrhagic pancreatitis are mainly due to secondary hypovolaemia. PMID- 3827173 TI - The detection of laxative abuse. PMID- 3827174 TI - The effect of storage pH on the precipitation of proteins in deep frozen urine samples. PMID- 3827175 TI - Blood collection bottles for glycated haemoglobin measurement. PMID- 3827176 TI - When is a variation seasonal? PMID- 3827177 TI - Creatinine clearance: a redundant clinical investigation. PMID- 3827178 TI - Predictive value of CK-MB measurement in myocardial infarction. PMID- 3827179 TI - Glucose tolerance tests--preparation of the patient. PMID- 3827180 TI - Interference from heparin ... in the measurement of plasma sodium on ion selective electrodes. PMID- 3827181 TI - Calcium, vitamin D and parathyroid hormone relationships in pregnant Caucasian and Asian women and their neonates. AB - Plasma calcium, serum 25 hydroxyvitamin D [25(OH)D], 1,25 dihydroxyvitamin D[1,25(OH)2D] and parathyroid hormone (PTH) have been measured in pregnant and newborn Caucasians and Asians. Calcium and 25(OH)D concentrations were lower in Caucasian than in Asian women at all four stages (three trimesters and during labour) of pregnancy. PTH concentrations were greater in Asian than in Caucasian women during the three trimesters, but not at labour, and increased in both groups through pregnancy, without a concomitant change in plasma calcium concentrations. There was a significant inverse correlation between calcium and PTH, as well as 25(OH)D and PTH, concentrations. These data demonstrate the presence of progressive 'hyperparathyroidism' during pregnancy in Caucasian and Asian women. The higher PTH concentrations in Asian women may reflect the necessity of maintaining adequate plasma calcium concentrations through PTH induced osteolysis in the face of vitamin D deficiency. Relative hyperparathyroidism in Asians may contribute to net loss of calcium from the skeleton and osteopenia in Asian women. Calcium, 25(OH)D and 1,25(OH)2D concentrations were lower, and those of PTH higher, in Asian newborns compared with Caucasian newborns. Serum 1,25(OH)2D concentrations in the Asian newborn, though lower than respective maternal levels, were comparable with normal adult levels, indicating that 1,25(OH)2D biosynthesis is stimulated in the Asian newborn to compensate for the low serum 25(OH)D concentrations. PMID- 3827182 TI - Drugs as probes of organ function: evaluation of the hepatobiliary axis using oral rifampicin and novel high performance liquid chromatography. AB - Investigation of the uptake and metabolism of drugs by organs such as the liver may allow assessment of specific aspects of organ function. Rifampicin, when orally administered, is transported into the hepatocyte from portal blood and thence passes, with its deacetylated metabolite, into the systemic circulation and into bile. This paper reports an investigation of the pharmacokinetics of a sub-therapeutic oral dose of rifampicin in healthy subjects, in patients with cirrhosis and in subjects with Gilbert's syndrome. The areas under the plasma concentration curves (AUC) in patients with cirrhosis were significantly greater than in healthy subjects. Subjects with Gilbert's syndrome had decreased AUCs compared with healthy subjects and were clearly distinguished from patients with cirrhosis. Rifampicin concentration in serum was measured by HPLC using a novel direct injection technique. PMID- 3827183 TI - Adaptation of coenzyme stimulation assays for the nutritional assessment of vitamins B1, B2 and B6 using the Cobas Bio centrifugal analyser. AB - Adaptation of coenzyme stimulation assays for the nutritional assessment of thiamine, riboflavin and pyridoxine on the Cobas Bio centrifugal analyser are described. Whole blood was collected into acid-citrate dextrose, which preserves the erythrocytes, prior to assay for several days. Washed erythrocytes stored at 70 degrees C and subsequently thawed, showed altered enzyme activities. The methods offer improved precision over existing procedures and take advantage of the high throughput capabilities of the instrumentation. PMID- 3827184 TI - Does the measurement of serum fructosamine accurately reflect levels of glycated albumin in insulin-dependent diabetes? AB - We have measured serum glycated albumin (GSA) by affinity chromatography and immunoturbidimetry, and serum fructosamine using a Cobas FARA analyser in blood samples from 37 type I diabetics and 21 healthy controls. Random blood glucose and glycated haemoglobin levels were also measured. Glycated haemoglobin (HbA1) correlated with glycated albumin and fructosamine in the diabetic group. A less clear relationship was found between glycated albumin and fructosamine. HbA1, GSA and fructosamine correlated poorly with random blood glucose levels. These data indicate that serum fructosamine levels do not accurately reflect those of glycated albumin, as has recently been suggested, in type I insulin-dependent diabetics where glycaemic control fluctuates more than in type II diabetics. It is postulated that the two methods reflect varying glycaemic levels to a different degree, thereby accounting for the disparity. PMID- 3827185 TI - Short-term effect of a 75 g oral glucose load on glycohaemoglobin levels. AB - Two hundred and twenty-three subjects out of a total of 347 with various degrees of glucose tolerance were recalled after a screening survey for diabetes. They were a randomly selected sample of people over the age of 40 and they underwent a formal 75 g glucose tolerance test in order to assess the effect of a glucose load on glycohaemoglobin levels measured by four different assay methods. Oral glucose loading was found to affect glycohaemoglobin levels only when these were measured by an agar-gel electrophoretic method that did not remove the labile aldimine-linked Schiff base fraction. The increase in glycohaemoglobin during the glucose tolerance test as estimated by this method was proportional to the 2 h blood glucose level. Glycohaemoglobin levels measured by agar-gel electrophoresis with elimination of the Schiff base, by affinity chromatography and by iso electric focussing, were not affected by a 75 g oral glucose load. We conclude that blood samples for glycohaemoglobin assay may be collected at any time of the day, without regard to the subject's previous food intake, provided an assay method is used that removed the aldimine-linked labile fraction. PMID- 3827186 TI - Radioimmunoassay of blood-spot 17 alpha-hydroxyprogesterone in the management of congenital adrenal hyperplasia. AB - A robust assay for routine measurement of blood-spot 17 alpha-hydroxyprogesterone (17-OHP) concentrations has been developed using a magnetizable, solid-phase antiserum and an 125I-radioligand. The working range of this assay (13.5-500 nmol/L) is well suited for the initial diagnosis of congenital adrenal hyperplasia (CAH) and for monitoring replacement therapy in CAH patients. Data derived from multiple blood-spot samples, collected on two consecutive days, provide 17-OHP profiles. These profiles have been used to construct a chart allowing a rapid visual assessment of the efficacy of replacement therapy in CAH patients. Measurement of 17-OHP in the blood-spots of overtreated patients and accurate determination of normal range values in healthy infants relied on development of a sensitive assay (range 1.7-34 nmol/L). In the blood-spots of normal male (n = 50) and female (n = 50) infants collected 5-7 days after birth, 17-OHP concentrations were 7.62 +/- 2.55 nmol/L and 7.32 +/- 2.87 nmol/L respectively. Retrospective measurement of this steroid in samples from known CAH patients (n = 4), which had values ranging from 224 to 2145 nmol/L, support a role for measurement of blood-spot 17-OHP in high-risk screening programmes. PMID- 3827187 TI - Quantitation of apolipoprotein C-III in normal and in hyperlipaemic serum samples by enzyme-linked immunosorbent assay. AB - A specific and sensitive Sandwich enzyme-linked immunosorbent assay (ELISA) for the quantitative determination of apolipoprotein C-III, a major apolipoprotein of human very low density lipoproteins is described. The assay is non-competitive and it uses the same affinity isolated sheep antibody both for coating the wells and as conjugate with alkaline phosphatase. Total serum apo C-III was determined in a normal population of 24 men and 21 women. The difference was not statistically significant. In both sexes apo C-III concentration correlated positively with the serum triglyceride levels. In patients with hyperlipoproteinemia, apo C-III levels were increased. PMID- 3827188 TI - Improved measurement of monoclonal paraproteins in serum using agarose gel electrophoresis. AB - Serum paraproteins can be accurately and precisely measured by means of agarose gel electrophoresis and densitometry at 520 nm after staining with Coomassie Brilliant Blue G. The results obtained for this method agree closely with the quantity of paraprotein recoverable from preparative agarose gel electrophoresis. The method is preferable to cellulose acetate electrophoresis stained with Ponceau S. PMID- 3827189 TI - Improved resolution of cellulose acetate membrane electrophoresis. AB - A simple modification to cellulose acetate membrane electrophoresis is described. The results are comparable to those achieved with agarose gels at high voltage. PMID- 3827190 TI - Measurement of ethylene glycol (ethane-1,2-diol) in biological specimens using derivatisation and gas-liquid chromatography with flame ionisation detection. AB - Ethylene glycol in plasma, urine or dialysis fluid is analysed as the phenylboronate derivative by mixing with acetonitrile/acidified 2,2 dimethoxypropane containing phenylboronic acid. After centrifugation, a portion of the supernatant is analysed directly by gas-liquid chromatography using a 3% OV-101 column at 150 degrees C and flame-ionisation detection. Propane-1,3-diol is used as a reactive internal standard. The limit of accurate measurement is at least 0.1 g/L and the linear range extends up to 5.0 g/L. No sources of interference have been identified. PMID- 3827191 TI - Investigations into negative interference by jaundiced plasma in kinetic Jaffe methods for plasma creatinine determination. AB - Negative interference by jaundiced plasma in kinetic Jaffe methods for plasma creatinine determination is caused by both conjugated and unconjugated bilirubin. The amount of interference observed is method- and temperature-dependent and is directly related to bilirubin concentration but is independent of the creatinine concentration. Bilirubin also significantly reduces the precision of the creatinine estimation. A mechanism of bilirubin interference in kinetic Jaffe methods is proposed and the influence of picrate concentration, hydroxide concentration and temperature on the magnitude of bilirubin interference has been investigated. PMID- 3827192 TI - Estimation of imprecision in immunoassay quality assessment programmes. AB - A computer was used to produce and store a large body of simulated thyroxine and thyrotropin radioimmunoassay results over wide concentration ranges. Sets of 24 results, designed to represent results returned to an external quality assessment survey, were randomly drawn from the stored results in order to compare limited data survey estimates of imprecision with the 'true' values obtained from the population data. Results show that estimation of an imprecision profile has advantages over the usual index of imprecision, but that neither form of estimate is particularly reliable when the available data is limited. Results suggest that survey organisers should place considerably less emphasis on results from any one survey and greater emphasis on analysing cumulative data and method comparison data. PMID- 3827193 TI - [Catecholamines in the cardiovascular expression of pheochromocytoma. II--Study of free urinary catecholamines in 14 pheochromocytomas. Classification of pheochromocytomas according to type of secretion]. AB - Studies were conducted in 14 patients with pheochromocytoma over a 3-year period. Circumstances of detection of these tumors varied greatly and were sometimes misleading, hypertension being an inconstant finding in the clinical history and was not always the predominant feature. Biologic exploration involved assay of excretion of free urinary noradrenaline (NA), adrenaline (AD) and dopamine (DA) using a HPLC technique as well as assay of total methoxy derivatives and urinary vanilmandelic acid. Validity of each assay in the diagnosis of pheochromocytoma could be evaluated and only the total free methoxy derivatives gave false negative results. Hormonal secretion of pheochromocytoma is often mixed, but sometimes predominant or exclusive for a single catecholamine. Relative increases of the different catecholamines, evaluated from the ratios DA/NA and DA/NA + AD, are an important factor since a relation exists between blood pressure induced symptomatology and equilibrium between hypotensive hormone (DA) and pressor amines (NA + AD); 3 types of pheochromocytoma can be described: NA-induced with paroxysmal or permanent hypertension but without typical metabolic and cardiac disorders, and with a very reduced DA/NA + AD ratio during hypertensive crises; AD-induced without permanent hypertension but with a mainly orthostatic hypotension and episodes of cardiovascular collapse following hypertensive attacks and with an AD/NA ratio greater than 1; finally the DA-induced lesion in which hypertension is never associated and manifestations are misleading and atypical with an elevated DA/NA + AD ratio. PMID- 3827194 TI - [Treatment of thyroid ophthalmopathies by external orbital radiotherapy]. AB - From January, 1977, through December 1983, 62 patients with thyroid edematous ophthalmopathy were given external orbital radiotherapy according to S.S. Donaldson's technique: 5,5 MV photons produced by a linear accelerator were used to irradiate the muscular conus, with a total of 20 grays in 10 sessions over 2 weeks. Good results were obtained in 46 patients (77%). This simple therapy may be a first choice in recent ophthalmopathy. PMID- 3827195 TI - 15th annual meeting of the European Thyroid Association. Stockholm, 29 June-4 July, 1986. Abstracts. PMID- 3827196 TI - [Detection of thyroid cancer : utopia or reality? Or the value of thallium 201 in thyroid pathology]. AB - Faced with a diagnosis of cold thyroid nodule as evidenced by routine scintigraphy, the clinician has to determine whether this nodule is malignant or not. This is a serious problem since, according to literature, 7-20% of cold thyroid nodules are malignant. In 1982 some Japanese authors demonstrated the possibility of using 201 T1 in diagnosing thyroid tumors. This study refers to 120 patients who underwent an operation for thyroid disorders characterized by the presence of one or several cold nodules (as evaluated with conventional scintigraphy) and enables a comparison between a thorough evaluation of the thyroidal status and the 201 T1 scintigrams. These were obtained with a gamma camera using a pinhole collimator. If a cold nodule is positive with 201 T1, surgery is incontestably indicated, as such a finding correlates with the existence of a thyroid tumor (benign follicular adenoma or carcinoma) in 89.5% of the observed cases. In the cancer group the sensibility of the Thallium test is of 85% and its specificity 80%. We may assert that there is a very low risk of Thallium negative (old) nodules being malignant. The pre-operative 201 T1 scintigraphy is easy to perform in any Nuclear Medicine department. Nowadays, the combination of aspiration cytology and 201 T1 scintigraphy should make it possible to make and accurate diagnosis in the vast majority of differentiated and undifferentiated thyroid cancers. PMID- 3827197 TI - [Autoimmune polyendocrinopathies. Pathogenic hypotheses]. AB - In most of the cases, once a given endocrine gland is involved, the corresponding specific autoantibody may be detected; for example, anti-islet cell antibodies are produced within the first few years, after onset of symptoms in insulin dependent diabetes (DID). Accompanying autoantibodies are quite frequently found in the patient himself. In Schmidt's syndrome (thyroid and adrenal glands are involved and associated to IDD in 30% of the cases) thyroid microsomal antibodies are found in 38% of the cases, thyroglobulin antibodies in 11% of the cases, islet-cell antibodies in 7% of the cases and steroid cell antibodies in 17% of the cases. Associations are also possible in patient family members. Aberrant expression of HLA-DR molecules at the membrane of follicular thyroid cells (as of any other endocrine gland), following a viral aggression, could well account for the endocrinopathy combinations, but alternative mechanisms should be discussed. PMID- 3827198 TI - [New area of endemic goiter : the northeast Benoue, (North Cameroon)]. AB - Endemic goiter was thought to essentially spread in the southern part of Cameroun. In fact the North-East Benoue (NEB) area also appears to be concerned. We studied 1242 individuals from 5 representative villages. The overall goiter frequency was 28.4%. Study of emigrants showed a spreading of the endemic area towards the boundary part of Tchad. However increase of morbidity was related to the duration of settlement in NEB (18% after 1 year vs 34% after 5 years, p less than 0.01). Samples of urine from one single micturition were kept at 4 degrees C and assayed for iodide within 3 days. The results exhibited marked iodine deficiency (iodide : 9.6 +/- 1.5 micrograms/l; urinary ratio : iodide/creatinine : 17.9 micrograms/l). The way of preserving urine before iodine assay was critical. After 8 days of daylight exposure of the samples at 30 degrees C, the most part of assayable iodine had disappeared. The goitrogenic effect of manioc was weak : there was no relationship between the presence of goiter and the amount of ingested manioc. Concentration of thiocyanates in urine was correlated neither with manioc consumption nor with goiter volume. An automatic classification was obtained by computerization of several parameters. 88% of the patients distributed in 10 groups whose goiter frequencies were markedly different. Because of the well-defined characteristics of each group, it seems possible to perform valid biological or nutritional studies using a limited number of individuals. PMID- 3827199 TI - The Ok Tedi Health and Nutrition Project, Papua New Guinea: physique, growth and nutritional status of the Wopkaimin of the Star Mountains. AB - A survey was carried out to establish baseline anthropometric and health data in the Wopkaimin, a small group of Mountain Ok-speaking hunter-horticulturalists who live in a remote and isolated part of the Highland fringe of Papua New Guinea, where a major gold and copper mine is being developed. Malaria is hyperendemic in the region and infant mortality has been estimated at approximately 230 per thousand. A 79% sample of the population was examined and the results of the anthropometric survey are reported. Wopkaimin childrens' heights and weights are well below the 50th percentile of British standards throughout growth; at maturity boys' weights and girls' heights and weights are at or below the 3rd percentile, and boys' weights are just above the 10th percentile. Wopkaimin children lag far behind British children in percentage of adult height achieved at all ages, and appear to attain maturity at least four years later. This relatively slow growth and short adult stature may represent an adaptive response to chronic nutritional deprivation, for which there is evidence from skinfold thickness and arm circumference measurements. Younger adults are significntly taller, heavier, fatter and more muscular than older adults; possible explanations for this are discussed. Within the sample, individuals living in villages less than a day's walk from the mine town are significantly taller, heavier and fatter than those living further away, and there are also similar significant anthropometric differences between employed and unemployed men. Ready food availability which has come with the mine development appears to be the most likely explanation for these differences. A continuing study of changing patterns of health and nutrition in the area has been initiated. PMID- 3827200 TI - Changes of recollected menarcheal age and month among women in Tokyo over a period of 90 years. AB - Data on the recollected age at menarche of 47,881 women born between 1881 and 1970 were examined. The mean menarcheal age had changed from 15.1 years in those born up to 1900 to 12.5 years in those born during the 1960s. The age at menarche differed according to the month of birth, and the pattern of average age distribution by month of birth was not the same when the year of birth was different. Among women born before 1955 the menarcheal age was earlier in those born in the summer. However, among women born after 1955, menarche occurred later when they were born in the summer. The monthly distribution of menarche had also changed during this 90-year period. Two peaks in April and August were prominent among those born up to 1960. A third peak in January became also apparent in those born after 1960. PMID- 3827201 TI - Isoelectric focusing studies of transferrin and haptoglobin subtypes in an Australian white population. AB - This investigation presents the results of Hp and Tf subtyping of sera from 307 Australian whites by means of isoelectric focusing. Five Hp alleles were detected, these being Hp1F = 0.168, Hp1S = 0.235, Hp2FF = 0.003, Hp2FS = 0.561 and Hp2SS = 0.033. In the Tf system six alleles were found, TfC1 = 0.761, TfC2 = 0.176, TfC3 = 0.054, TfC6 = 0.002, TfB = 0.006 and TfD = 0.002. The usefulness of IEF together with modifications was highlighted for differentiating Tf and Hp subtypes; in particular, the absence of Hp2FF and Hp2SS in some earlier studies could be related to the technique used. The implication of the simultaneous presence of B and D transferrin variants in Caucasian populations is discussed. PMID- 3827202 TI - Fetal growth from 12 to 26 weeks of gestation. AB - 175 freshly aborted fetuses (including three pairs of twins), 12-26 weeks postmenstrual age and products of induced expulsion from 172 Kashmiri women, were observed for 12 anthropometric measurements, namely, crown-heel length, crown rump length, trunk height, head length, head circumference upper-arm length, fore arm length, hand length, thigh length, leg length, foot length and weight. The general pattern of age changes in various body dimensions conforms to the sigmoid nature of human fetal growth. Comparison of the present findings with those from other studies reveals no definite population trends. The mean values for various anthropometric variables of Kashmiri fetuses lie within the overall range of observations made by various authors. PMID- 3827203 TI - Effect of dietary cholesterol and polyunsaturated fats on plasma and liver lipids in guinea pigs. AB - Weanling male Hartley guinea pigs were fed for 6 weeks on a regular chow supplemented with 5% polyunsaturated fats (safflower, linseed, or evening primrose oil) or 5% saturated fats (hydrogenated coconut oil) with or without the addition of 1% cholesterol to the diet. Cholesterol feeding resulted in slower growth, hyperlipidemia, and a fatty liver. Cholesterol contents (predominantly in the form of cholesterol esters) in plasma and liver were increased, but the increase of plasma cholesterol was significantly reduced when unsaturated fats in place of saturated fat were added to the diet. The essential fatty acid contents in plasma and liver lipids were modulated by the dietary fats and by the cholesterol feeding. The latter reduced the proportions of 20:4 (n-6), but increased or had no effect on the levels of 18:2 (n-6). These results led to a reduced ratio of 20:4 (n-6)/18:2 (n-6), suggesting that cholesterol feeding may impair the desaturase activities. PMID- 3827204 TI - Sulphur amino acid levels in some tissues of the rat during pregnancy and lactation. AB - Variations in free sulphur amino acid content in some rat tissues have been measured during pregnancy and lactation. As a general trend, sulphur amino acids tend to accumulate in tissues in late pregnancy. This accumulation is quantitatively more important in the liver and striated muscle than in the skin and the kidneys. Among sulphur amino acids, taurine shows the most marked changes, with a maximum accumulation in the liver and striated muscle on day 19 of pregnancy. After delivery, the levels of amino acids in the tissue pools show a tendency to drop, especially in liver and striated muscle. As expected, taurine shows the most marked decrease, returning to normal values in muscle but decreasing to depletion in the liver on day 20 after delivery. These results can be interpreted as follows: during pregnancy, increased food intake is sufficient to accommodate the metabolic needs of the mother, but during lactation, the requirements of milk synthesis promote the release of these amino acids from the tissues. PMID- 3827205 TI - Zinc transfer among proteins in rat duodenum mucosa. AB - Duodenums from freshly killed stock colony rats were incubated in Krebs buffer containing carrier-free 65ZnCl2 for periods of time between 5 and 60 s. Mucosa cytosol was separated and fractionated by gel filtration on Sephadex G-75. 65Zn was present in two main bands of protein with molecular weights of about 45,000 and 6,500, but the ratio between them rose progressively with time of exposure to the isotope. Addition of metabolic inhibitors greatly lowered the 45,000/6,500 ratio for 65Zn. It is concluded that when zinc enters the mucosal cytoplasm during absorption, it rapidly binds to the 6,500 protein in a passive way and is then transferred to the protein of molecular weight 45,000 by an active process. PMID- 3827206 TI - Hepatic cholesterogenesis and cholesterol 7 alpha-hydroxylase activity in hamsters fed diets enriched with pectins and/or cholesterol. AB - Cholesterol 7 alpha-hydroxylase activity was determined in parallel with the rate of cholesterogenesis from acetate and mevalonate in the liver of hamsters fed diets enriched with pectins (5%) and/or cholesterol (0.1%). Cholesterol feeding reduced the rate of incorporation of the precursors into cholesterol. Moreover, the radioactivity derived from mevalonate was found mainly in the esterified form of the newly synthesized molecules. In parallel, cholesterol 7 alpha hydroxylation decreased by 50%. Pectins did not greatly affect hepatic cholesterogenesis or 7 alpha-hydroxycholesterol formation. In contrast, the fibers prevented to a large extent the metabolic alterations resulting from cholesterol feeding. Cholesterogenesis from mevalonate remained active; ester formation declined and the activity of cholesterol 7 alpha-hydroxylase persisted. Pectins could maintain the activity of this enzyme through multiple mechanisms, one of them being the channeling of substrate into the specific compartment of cholesterol which is destined to form bile acids. PMID- 3827207 TI - Dietary ascorbic acid and selenium relationships in the guinea pig. AB - Plasma-, erythrocyte- and liver Se-dependent glutathione peroxidase (GPx) activity, ascorbic acid (AA) concentration, and erythrocyte and liver Se levels were analyzed in groups of guinea pigs fed a Torula yeast-based semipurified diet supplemented with either O (-AA), 200 (+AA), or 400 (++AA) mg of AA/kg of diet and either 0.05 (+Se) or 0.2 (++Se) ppm of Se for 24 days. Plasma, erythrocyte, and liver AA concentration were directly related to the levels of AA fed. There were 21.2 +/- 2.7% and 51.2 +/- 4.5% (p less than 0.0001) increases in erythrocyte and liver Se, respectively, in ++Se guinea pigs compared to +Se guinea pigs. Dietary AA had no effect on erythrocyte or liver Se levels. Plasma, erythrocyte, and liver GPx specific activities were significantly (p less than 0.001) increased in ++Se guinea pigs compared to +Se guinea pigs. In addition, liver, plasma, and erythrocyte GPx activities were directly related to the level of AA fed. These data indicate that dietary AA has no influence on tissue levels of Se but increases plasma, liver, and erythrocyte GPx activities in the guinea pig. PMID- 3827209 TI - Vasospasm versus vasculitis in cases with "isolated benign cerebral vasculitis". PMID- 3827208 TI - Acute paraparesis secondary to Arnold-Chiari type I malformation and neck hyperflexion. AB - A 2-year-old child experienced clinical manifestations of Arnold-Chiari Type I malformation, rare in early childhood, after a mild hyperflexion injury of the neck that resulted in acute paraparesis. Recovery occurred after decompressive laminectomy. PMID- 3827210 TI - Repetitive divergence. PMID- 3827211 TI - Effects of beta blockade on contingent negative variation in migraine. PMID- 3827212 TI - Risk factors for complex partial seizures: a population-based case-control study. AB - This investigation is to our knowledge the first population-based case-control study of risk factors for complex partial seizures (CPS). Included in the study were all patients with onset of complex partial seizures before age 35, who were residents of Rochester, Minnesota, at the time of diagnosis between 1935 and 1979, and who were also born in Rochester (n = 82). Two control subjects were matched to each patient, and for both patients and control subjects, the unique records-linkage system for residents of Rochester was used to obtain information about possible risk factors. A history of epilepsy or febrile seizures in the mother, febrile seizures, neonatal convulsions, cerebral palsy, head trauma, and viral encephalitis were significantly more common in patients than in control subjects (p less than 0.05). None of the prenatal or perinatal factors investigated were found to be associated with complex partial seizures, except for being small for gestational age at birth. This factor lost significance after adjustment for cerebral palsy. PMID- 3827213 TI - GABA-mimetic drugs enhance apomorphine-induced contralateral turning in rats with unilateral nigrostriatal dopamine denervation: implications for the therapy of Parkinson's disease. AB - The underlying mechanisms responsible for advanced Parkinson's disease's becoming refractory to dopamimetic therapies are unclear. Postmortem brain studies indicate that patients with Parkinson's disease have decreased basal ganglia gamma-aminobutyric acid (GABA) function in addition to profound striatal dopamine (DA) deficiencies. In experimental animals, GABA-utilizing striatal and nigral projection neurons appear to mediate motor behaviors arising from the stimulation of striatal DA receptors by agonists. We have examined the ability of directly and indirectly acting GABA-mimetic drugs to alter turning behavior elicited by administering apomorphine, a DA agonist, to rats with unilateral lesions of dopaminergic nigrostriatal neurons. Low doses of directly acting postsynaptic GABA agonists (progabide, 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridin--3-01) or a neuronal GABA transport inhibitor (SKF 100330-A) potentiate apomorphine-induced turning. Higher doses of these agents or acute inhibition of GABA catabolism inhibits turning. Our results suggest that low doses of certain GABA mimetics will improve the responses of patients with Parkinson's disease to concurrent DA receptor agonist therapy. PMID- 3827214 TI - Sympathetic neuronal destruction in macaque monkeys by guanethidine and guanacline. AB - To determine whether the peripheral sympathetic neurons of subhuman primates are destroyed by guanacline treatment, we treated Macaca fasicularis with 2 or 20 mg/kg of guanethidine, guanacline, or the saturated analog of guanacline (SAG) 5 times per week for 4 or 12 weeks. All monkeys given 20 mg/kg of guanethidine, guanacline, or SAG showed a marked loss of neurons in the ganglia of the peripheral sympathetic nervous system. Treatment of macaques with 2 mg/kg of the guanidinium compounds resulted in patches of small-cell infiltrate, slight neuronal loss, and degenerative alterations in the sympathetic ganglia. Neuronal alterations in sympathetic ganglia of all treated monkeys were accompanied by a prominent heterogeneous infiltrate of mononuclear cells arranged primarily in a perivascular distribution and extending into the ganglionic neuropil. Peripheral sensory ganglia were unaffected. These histological findings are similar to those described in the guanethidine-induced immune-mediated sympathectomy, which has been extensively studied in the rat. PMID- 3827215 TI - Tobacco-induced primary-position upbeat nystagmus. AB - The effects of tobacco smoking on the eye movements of normal human subjects were studied using direct current electrooculography and the magnetic search coil technique. Tobacco induced a transient primary-position upbeat nystagmus in the dark, which was suppressed by visual fixation. It obeyed Alexander's law and was associated with oblique upward fast phases that alternated from side to side. Tobacco-induced nystagmus exhibited a latency of onset at 40 to 90 seconds, a duration of 10 to 20 minutes, and maximum slow-phase velocities at 2 to 3 minutes. We suggest that tobacco induces primary-position upbeat nystagmus through the excitatory effects of nicotine on the central vestibular pathways. PMID- 3827216 TI - Wernicke's encephalopathy in patients on peritoneal dialysis or hemodialysis. AB - Although the occurrence of Wernicke's encephalopathy (WE) in patients on dialysis is frequently alluded to, review of the literature reveals only 3 described cases. We describe 5 patients on dialysis who developed WE in the absence of alcoholism or other predisposing factors. The clinical diagnoses included uremic encephalopathy (2 patients), dysequilibrium syndrome (1), dialysis dementia (1), and brainstem hemorrhage (1). At postmortem examination, classic findings of WE were evident. The rarity of WE in patients on dialysis may in part be explained by studies indicating a genetic defect in transketolase activity. Patients on dialysis are also potentially at risk for thiamine deficiency because of anorexia, vomiting, and intravenous alimentation. Other factors altering thiamine requirements, such as glucose load or infections, may also contribute. Preventable and potentially curable, WE should be suspected in all patients on dialysis who have an unexplained neurological picture. PMID- 3827217 TI - Posterior cerebral artery stenosis. AB - We analyzed the clinical features of symptomatic posterior cerebral artery (PCA) stenosis in 6 patients selected from 15 patients with angiographically documented PCA atherostenosis occurring during a 7-year period. Transient ischemic attacks (TIAs) were the major presentation in 5 patients. A homonymous visual field defect was present in 2 patients. TIA symptoms were predominantly visual or sensory, or both. The most common visual symptom was difficulty seeing to one side. One patient saw flashing lights. Sensory spells were always paresthetic, usually involving the arm and hand and occasionally the face and leg. Three patients had visual and sensory spells together. Two patients with a visual field defect had calcarine infarcts found by computed tomography. All patients were treated with warfarin. During follow-up (4 months to 4 years), no patient had a new stroke in the PCA territory, and only one continued to have TIAs. PCA atherostenosis is rarer then PCA embolic occlusion. In contrast to those with PCA embolism, our patients with PCA atherostenosis had more TIAs and fewer infarcts. The clinical features of PCA stenosis--preponderance of visual and sensory TIAs- distinguish this vascular lesion from stenosis of the middle cerebral artery. PMID- 3827218 TI - Electrophysiological differences between demented and nondemented patients with Parkinson's disease. AB - Long-latency auditory evoked potentials were studied in demented and nondemented patients with Parkinson's disease who were matched for age, stage of disease, duration of illness, and amount and nature of antiparkinsonian medication. We found clear electrophysiological differences between the two groups of patients in that the N1, N2, and P3 peak latencies were prolonged in the demented group compared both to the nondemented group and to normal controls. Moreover, the N1 latency but not the N2 and P3 latency prolongation distinguished the demented parkinsonian patients from demented patients with Alzheimer's disease. These results provide strong evidence for the existence of different subtypes of dementia and suggest that electrophysiological recordings may be helpful in establishing the underlying pathogenesis of a dementia syndrome when there is clinical uncertainty. PMID- 3827219 TI - Deficiency of a cholinergic differentiating factor in fibroblasts of patients with Alzheimer's disease. AB - Skin fibroblasts from patients with Alzheimer's disease and from apparently normal control subjects were compared for their production of a cholinergic differentiating factor. The factor's activity was assayed by measuring the induction of choline acetyltransferase (CAT) activity in cultured sympathetic neurons. Culture medium conditioned by exposure to normal human fibroblasts induced substantial levels of CAT activity in sympathetic neurons, indicating that human fibroblasts produce a soluble factor that promotes cholinergic expression. In contrast, medium conditioned by Alzheimer fibroblasts induced only about one-third as much CAT activity, a highly significant reduction (p less than 0.01). These observations suggest that Alzheimer fibroblasts may be deficient in their secretion of a cholinergic factor and raise the possibility that the pathophysiology of the disease is related to a defect in the release of this factor. The fibroblast abnormalities suggest that Alzheimer's disease may be a systemic disease involving nonneuronal cells that are outside as well as within the brain. PMID- 3827220 TI - Caloric-induced nystagmus with isoelectric electroencephalogram. AB - Caloric vestibular testing induced nystagmus in a patient with an isoelectric electroencephalogram after cardiopulmonary arrest. This has been demonstrated previously in patients in a chronic persistent vegetative state with intact brainstem reflexes, but never in a patient with an isoelectric electroencephalogram. Animal studies indicate that the quick phase of nystagmus and horizontal saccades are generated in the paramedian pontine reticular formation. The present case supports the conclusion that caloric-induced nystagmus originates in the brainstem in rudimentary form. PMID- 3827221 TI - Irradiation of meningiomas of the intracranial anterior visual pathway. AB - Twenty patients with progressive visual loss caused by intracranial meningiomas involving the anterior visual pathway were treated with irradiation alone (n = 4) or with irradiation combined with tumor excision (n = 16). Improvement in visual performance occurred in 13 patients; 2 patients experienced temporary improvement; and 5 others maintained stable visual function for up to 9.5 years (mean follow-up, 4.0 years). Radiotherapy seemed to have no effect in 2 patients. One patient experienced temporary improvement, but eventually died from spread of tumor. Only one definite complication of radiotherapy occurred and was related to excessive radiation dose (greater than 7,000 cGy). Irradiation in the range of 5,000 to 5,500 cGy was effective either alone or in combination with surgical excision. Serial assessment of visual acuity and fields allowed us to demonstrate and quantify improvement in our patients following radiotherapy; in contrast, follow-up computed tomographic studies rarely demonstrated reduced tumor size. PMID- 3827222 TI - Latencies of visually guided saccades in unilateral hemispheric cerebral lesions. AB - Latencies of lateral visually guided saccades were studied in 60 patients without hemianopia who had unilateral focal lesions clearly visible on computed tomographic (CT) scan that were variously located in both cerebral hemispheres. Significantly asymmetrical latencies were found in 29 patients whose lesions had damaged the deep and posterior frontal region near the corpus callosum and/or, just inferior to this region, the anterior part of the internal capsule. In the 31 other patients, including those with lesions of the frontal eye fields (FEF), latencies were not significantly asymmetrical and the lesions spared the entire region just described. These topographical features suggest that the asymmetry of latencies is due to damage in a certain portion of the efferent pathways descending from the FEF. A significant increase in bilateral latency was observed in most patients whose lesions had damaged the posterior part of the parietal cortex and/or the underlying white matter. The parietal lobe could therefore exert an excitatory bilateral action on the triggering of visually guided saccades, probably mediated via the superior colliculus. A significant decrease in the bilateral or ipsilateral latency was often found in patients whose lesions had damaged the FEF or the underlying white matter. The frontal lobe could therefore exert a predominantly inhibitory bilateral action on this triggering, probably also mediated via the superior colliculus. However, an increase in contralateral latency in some patients with subcortical frontal lesions indicates that the FEF also probably have an excitatory action. This action could be transmitted directly (or indirectly via the superior colliculus) to the reticular premotor structures by tracts decussating partly through the corpus callosum. PMID- 3827223 TI - Cortical blindness: etiology, diagnosis, and prognosis. AB - We examined 15 patients with cortical blindness, reviewed the records of 10 others, and compared these 25 patients to those in previous studies of cortical blindness. Although cerebrovascular disease was the most common cause in our series, surgery, particularly cardiac surgery, and cerebral angiography were also major causes. Only 3 patients denied their blindness, although 4 others were unaware of their visual loss. Electroencephalograms (EEGs) were performed during the period of blindness in 20 patients and all recordings were abnormal, with absent alpha rhythm. Visual evoked potentials recorded during blindness were abnormal in 15 of 19 patients, but did not correlate with the severity of visual loss or with outcome. Bioccipital lucencies were found in computed tomographic (CT) scans of 14 patients; none of the 14 regained good vision. Recovery of vision was poor in all 8 patients who had a spontaneous stroke, but fair or good in 11 of the other 17 patients. Prognosis was best in patients under the age of 40 years, in those without a history of hypertension or diabetes mellitus, and in those without associated cognitive, language, or memory impairments. We conclude that the prognosis in cortical blindness is poor when caused by stroke; EEGs are more useful than visual evoked potentials for diagnosis; and bioccipital abnormalities shown on CT scan are associated with a poor prognosis. PMID- 3827224 TI - Defective biosynthesis of proteolipid protein in Pelizaeus-Merzbacher disease. AB - The brain of an 18-year-old patient with Pelizaeus-Merzbacher disease was examined by standard neuropathological and biochemical methods and by immunocytochemical and immunochemical techniques. Analysis revealed a lack of myelin-specific lipids, but showed a residual immunoreactivity for myelin basic protein, myelin-associated glycoprotein, and 2',3'-cyclic nucleotide-3' phosphodiesterase. Examination by immunocytochemistry and enzyme-linked immunosorbent assay showed an absence of proteolipid apoprotein (lipophilin). The peripheral nervous system was normal. Pelizaeus-Merzbacher disease in humans shares many neuropathological and biochemical features with X-linked mutations in animals, e.g., the jimpy mouse and myelin-deficient rat. The specificity of this protein deficiency in Pelizaeus-Merzbacher disease gains additional support from the recent mapping of the lipophilin gene to the human X chromosome. PMID- 3827225 TI - Brain extraction of a calcium channel blocker. AB - Dihydropyridine calcium channel blockers may be effective treatment for acute cerebral ischemia, but the uptake of these drugs into the brain is unknown. A 0.2 ml bolus of [14C]nicardipine hydrochloride and [3H]water was injected into the common carotid arteries of 7 normal and 7 ischemic rats. The corrected first-pass extraction of nicardipine, compared to water, was calculated to be 30.7% into the hemispheres and 42.3% into the hippocampi. The uptake was greater into the ischemic hemispheres (p less than 0.001). These data suggest that dihydropyridines are available to binding sites and calcium channels in neurons. PMID- 3827226 TI - Anticonvulsants, folate levels, and pregnancy outcome: a prospective study. AB - Folate levels in serum and red cells, as determined by a microbiological assay using Lactobacillus casei, and plasma anticonvulsant concentrations were monitored concurrently in nonpregnant (50 subjects) and pregnant (49 pregnancies in 46 subjects) epileptic women. Twenty-three (46%) nonpregnant women had subnormal serum folate levels and 4 nonpregnant women (8%) showed subnormal red cell folate levels. In pregnant women not taking folate supplements, the incidence of folate deficiency increased as the pregnancy advanced. Pregnant women taking folate supplements achieved normal or supranormal blood folate concentrations. In both nonpregnant and pregnant women, serum and red cell folate levels were inversely correlated with plasma concentrations of phenytoin and of phenobarbital, and with the number of anticonvulsants. In 49 pregnancies, there were 10 abnormal outcomes (20.4%): 4 spontaneous abortions (8.2%) and 6 children with major congenital malformations (12.2%). Blood folate levels were significantly lower in pregnancies with an abnormal outcome than in those with a normal outcome. The results suggest a dose-response relationship among anticonvulsants, folate, and adverse pregnancy outcome. PMID- 3827227 TI - Sardinia, a high-risk area for multiple sclerosis: a prevalence and incidence study in the district of Alghero. AB - Findings from small descriptive studies carried out in the last few years in Sardinia suggest that this region is now of high rather than medium risk for multiple sclerosis. It is uncertain whether this high prevalence reflects a different approach in case finding over time or a true change in disease occurrence. We report the results of a prevalence and incidence survey conducted in the district of Alghero, a community of 78,000 people in northwest Sardinia. Based on data from 31 patients, the average annual incidence for the period 1971 through 1980 was 4.1 per 100,000. On December 31, 1980, the prevalence rate was 59 per 100,000. The results support the view that Sardinia is now a high-risk area for multiple sclerosis, and further suggest a rise in the occurrence of the disease in recent years. PMID- 3827228 TI - Evaluating the quality of quantitative data. PMID- 3827229 TI - Training clinical neuroscientists. PMID- 3827230 TI - Parasagittal infarction in neonatal asphyxia. AB - A patient is described who suffered a bilateral hemorrhagic infarction in the parasagittal cerebrum following neonatal asphyxia. This case confirms experimental results that show the parasagittal cerebrum is especially vulnerable to ischemic damage in newborns. PMID- 3827231 TI - Pontine ataxic hemiparesis studied by a high-resolution magnetic resonance imaging system. AB - Using a high-resolution magnetic resonance imaging system, we studied 3 patients who had exhibited pontine ataxic hemiparesis. In each patient, the ischemic lesions responsible for the contralateral ataxia were located in the dorsomedial basis pontis. The isointensity bands in the ischemic area on T2-weighted images showed the spared transverse fibers originating from the contralateral pontine nuclei, and this may explain the cause of the unilateral ataxia. PMID- 3827232 TI - Increased monomeric immunoglobulin A levels in tears from multiple sclerosis patients. AB - Mucosal immunity and the secretory antibody are known to be important defense mechanisms against many common viruses. Tears were selected as a representative mucosal fluid, and immunoglobulin A (IgA) was examined by enzyme-linked immunosorbent assay and immunoblot. Tears from 38 normal controls and patients with systemic or ocular diseases contained almost exclusively polymeric IgA. In contrast, almost 75% of 23 patients with multiple sclerosis had detectable monomeric IgA in addition to polymeric IgA. The functional importance of this alteration in the molecular form of secretory IgA remains to be determined. PMID- 3827233 TI - Opsoclonus induced by phenytoin and diazepam. PMID- 3827234 TI - Genetic variation of esterase D (EsD) polymorphism in Indian populations. AB - Data are presented on the phenotypes and gene frequencies of esterase D (EsD) polymorphism in various endogamous caste groups of Patiala and Faridkot districts of Punjab, north-west India. The frequency of the EsD2 allele in these groups varies from a minimum of 0.157 in Khatris to a maximum of 0.253 in Ramdasia Sikhs, a range quite typical of the north Indian populations. Examination of the available data on esterase D system in indigenous populations demonstrates the existence of a north-south cline in the distribution of the EsD2 allele in India. PMID- 3827235 TI - Thoracic adaptation to high altitude. AB - Growth in the thoracic region and its adaptation to higher altitude was investigated in boys between 5 to 18 years of Rajput origin at two altitudes, i. e. Rampur Bushahr (800 m above sea level) and Kinnaur (3,000 m above sea level). Both places are located in Himachal Pradesh. The sample includes 405 individuals From Bushahr and 676 individuals from Kinnaur. The results of this study reveal that as the higher altitudes are attained the vital capacity also increases relatively more, and these differences become more pronounced after adolescence, indicating longer time of apnoea. The population living at higher altitudes is also characterised by a significant greater chest length. PMID- 3827236 TI - A study of cephalo-facial measurements from age 20 to 80 in Jat-Sikh and Bania females of Punjab (India). AB - The sample consists of 502 Jat-Sikh and 510 Bania females ranging in age from 20 to 80 years. Most of the measurements of head and face have shown a trend of increase up to fifth or sixth decade followed by a decrease, with intermittent fluctuations. Nose length and nose breadth have shown a trend of continuous increase up to the last age group. But this increase or decrease observed for these measurements during successive age-groups is significant only in few age groups. On an average, the Jat-Sikh females possess significantly bigger heads, however some measurements like bigonial breadth, morphological upper facial length and nose breadth are significantly larger in Banias. The head is generally dolichocephal, with broad upper face and medium jugo-mandibular index in both the communities. The maximum frequency of Jat-Sikh females possess leptorhinae noses, whereas in Banias there is a transition from leptorhinae to mesorhinae noses. PMID- 3827237 TI - Long-term follow-up study of rostral mesencephalic reticulotomy for pain relief- report of 34 cases. AB - A long-term follow-up study of rostral mesencephalic reticulotomy (RMR) for pain relief is presented. 34 patients (24 males and 10 females) were operated. Ages ranged from 18 to 65 years. The follow-up period was 1-70 months. The overall effectiveness of RMR showed good relief of pain in 23 patients (67%). The study of effectiveness of RMR according to type of pain showed good relief of pain in 5 out of 6 patients (83%) with nondenervation pain, whereas satisfactory pain relief was obtained in 18 out of 28 patients (64%) with denervation pain. PMID- 3827238 TI - Responses of raphe-spinal neurons to stimulation of the pontine parabrachial region producing behavioral nociceptive suppression in the cat. AB - Cholinergic stimulation of the pontine parabrachial region (PBR) produces behavioral nociceptive suppression in the awake cat. This report shows that electrical stimulation of both PBR sites (verified to be associated with behavioral nociceptive suppression on cholinergic stimulation) and the periaqueductal gray (PAG) excites raphe-spinal neurons which have been implicated in descending nociceptive suppression. Although several lines of evidence have strongly indicated that pathways from the PBR and PAG for nociceptive suppression are anatomically as well as neurochemically distinct, the results of the present study appear to suggest that certain components of the pathways from the PBR may be synergic in function with those from the PAG with regard to the activity of raphe-spinal neurons. PMID- 3827239 TI - Response of single alpha motoneurons to high-frequency pulse trains. Firing behavior and conduction block phenomenon. AB - Studies were conducted on 25 cats to document the discharge rates of alpha motoneurons during stimulation of the sciatic nerve at frequencies from 100 to 10,000 pulses per second (pps). In addition, the feasibility of using high frequency pulse trains to block the conduction of action potentials was investigated. Two cuff electrodes were placed around the proximal portion of the left sciatic nerve, and recordings of antidromic potentials were taken from single fibers of the L7 ventral root. When stimulating through the more proximal electrode, discharge rates were generally equal to or were subharmonics of the stimulation rate up to 1,000 pps. Firing often decreased in rate during 3-min runs. At 2,000-10,000 pps, fibers responded briefly at rates of several hundred per second but stopped firing within seconds after stimulus initiation. After cessation of response to the high-frequency pulse train, action potentials generated at 50 pps at the more distal electrode did not propagate to the recording electrodes. The 'electrical block' so induced was maintained for up to 20 min, and recovery following termination of the pulse train was complete within 1 s. PMID- 3827240 TI - Chlorinated fatty acid distribution in Mycobacterium convolutum phospholipids after growth on 1-chlorohexadecane. AB - The composition of phospholipids from Mycobacterium convolutum R22 was determined after growth at two temperatures (20 and 30 degrees C) with 1-chlorohexadecane as the substrate. Comparisons were made with the phospholipids of cells grown on n hexadecane. Phosphatidylinositolmannosides and phosphatidylethanolamine (PE) were the major phospholipids in n-hexadecane-grown cells. In 1-chlorohexadecane-grown cells, phosphatidylinositolmannosides were approximately half of the total phospholipids, with lesser amounts of PE and cardiolipin (CL). The relative level of PE was greater at 20 degrees C (versus that at 30 degrees C) after growth on either substrate. A determination was made of structure and positional distribution of constituent fatty acid in both CL and PE. The relative amount of unsaturated fatty acid was higher at 20 degrees C. There were two C16:1 fatty acids (C16:1 delta 9 and C16:1 delta 11), and these had positional preferences in both CL and PE. The positional sites of chlorinated fatty acids differed in both CL and PE at the two temperatures. The results confirm that microorganisms can specifically distribute chlorinated fatty acids into cellular phospholipids. PMID- 3827241 TI - Naphthalene biodegradation in environmental microcosms: estimates of degradation rates and characterization of metabolites. AB - Naphthalene biodegradation was investigated in microcosms containing sediment and water collected from three ecosystems which varied in past exposure to anthropogenic and petrogenic chemicals. Mineralization half-lives for naphthalene in microcosms ranged from 2.4 weeks in sediment chronically exposed to petroleum hydrocarbons to 4.4 weeks in sediment from a pristine environment. Microbiological analysis of sediments indicated that hydrocarbon-utilizing microbial populations also varied among ecosystems and were 5 to 12 times greater in sediment after chronic petrogenic chemical exposure than in sediment from an uncontaminated ecosystem. Sediment from an ecosystem exposed to agricultural chemicals had a mineralization half-life of 3.2 weeks for naphthalene and showed about a 30-fold increase in heterotrophic bacterial populations in comparison to uncontaminated sediments, but only a 2- to 3-fold increase in hydrocarbon degrading bacteria. Analysis of organic solvent-extractable residues from the microcosms by high-pressure liquid chromatography detected polar metabolites which accounted for 1 to 3% of the total radioactivity. Purification of these residues by thin-layer chromatography and further analysis by gas chromatography mass spectrometry indicated that cis-1,2-dihydroxy-1,2-dihydronaphthalene, 1 naphthol, salicylic acid, and catechol were metabolites of naphthalene. These results provide useful estimates for the rates of naphthalene mineralization in different natural ecosystems and on the degradative pathway for microbial metabolism of naphthalene in freshwater and estuarine environments. PMID- 3827242 TI - Solid-state 13C nuclear magnetic resonance spectroscopy of simultaneously metabolized acetate and phenol in a soil Pseudomonas sp. AB - We investigated concentration-dependent primary and secondary substrate relationships in the simultaneous metabolism of the ubiquitous pollutant phenol and the naturally occurring substrate acetate by a Pseudomonas sp. soil isolate capable of utilizing either substance as a sole source of carbon and energy. In addition to conventional analytical techniques, solid-state 13C nuclear magnetic resonance spectroscopy was used to follow the cellular distribution of [1 13C]acetate in the presence of unlabeled phenol. With 5 mM acetate as the primary substrate, Pseudomonas sp. 9S8D2 removed 1 mM phenol (secondary substrate) at a rate of 2 nmol/mg of total cell protein. Although extensive acetate metabolism was indicated by a significant redistribution of the carboxyl label, this redistribution was not affected by the presence of phenol as a secondary substrate. When the primary and secondary substrate roles were reversed, however, the presence of 1 mM phenol altered the metabolism of 0.1 mM acetate, as evidenced by both the two- to fourfold increases in carboxyl label that appeared in terminal methyl and acyl chain methylene carbon resonances and the decrease in label that occurred in the carbohydrate spectral region. These results suggest that, when phenol is present as the primary substrate, acetate is preferentially shuttled into fatty acyl chain synthesis, whereas phenol carbon is funnelled into the tricarboxylic acid cycle. Thus, simultaneous use of a xenobiotic compound and a natural substrate apparently does occur, and the relative concentrations of the two substrates do influence the rate and manner in which the compounds are utilized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827243 TI - Production and characterization of antibodies against HT-2 toxin and T-2 tetraol tetraacetate. AB - Three new immunogens which were prepared by conjugation of the carboxymethyl oxime (CMO) derivatives of HT-2 toxin, T-2 tetraol (T-2 4ol), and T-2 tetraol tetraacetate (T-2 4Ac) to bovine serum albumin (BSA) were tested for the production of antibodies against the major metabolites of T-2 toxin. Antibodies against HT-2 toxin and T-2 4Ac were obtained from rabbits 5 to 10 weeks after immunizing the animals with CMO-HT-2-BSA and CMO-T-2 4Ac-BSA conjugates. Immunization with CMO-T-2 4ol-BSA resulted in no antibody against T-2 4ol. The antibody produced against HT-2 toxin had great affinity for HT-2 toxin as well as good cross-reactivity with T-2 toxin. The relative cross-reactivities of anti-HT 2 toxin antibody with HT-2 toxin, T-2 toxin, iso-T-2 toxin, acetyl-T-2 toxin, 3' OH HT-2, 3'-OH T-2, T-2 triol, and 3'-OH acetyl-T-2, were 100, 25, 10, 3.3, 0.25, 0.15, 0.12 and 0.08%, respectively. Antibody against CMO-T-2 4Ac was very specific for T-2 4Ac and had less than 0.1% cross-reactivity with T-2 toxin, HT-2 toxin, acetyl-T-2 toxin, diacetoxyscirpenol, deoxynivalenol, and deoxynivalenol triacetate as compared with T-2 4Ac. The detection limits for HT-2 toxin and T-2 4ol by radioimmunoassay were approximately 0.1 and 0.5 ng per assay, respectively. PMID- 3827244 TI - Dynamics of extracellular DNA in the marine environment. AB - The production and turnover of dissolved DNA in subtropical estuarine and oligotrophic oceanic environments were investigated. Actively growing heterotrophic bacterioplankton (i.e., those capable of [3H]thymidine incorporation) were found to produce dissolved DNA, presumably through the processes of death and lysis, grazing by bacteriovores, and excretion. Production of dissolved DNA as determined by [3H]thymidine incorporation was less than or equal to 4% of the ambient dissolved DNA concentration per day. In turnover studies, the addition of [3H]DNA (Escherichia coli chromosomal) to seawater resulted in rapid hydrolysis and uptake or radioactivity by microbial populations. DNA was hydrolyzed by both cell-associated and extracellular nucleases, in both estuarine and offshore environments. Kinetic analysis performed for a eutrophic estuary indicated a turnover time for dissolved DNA as short as 6.5 h. Microautoradiographic studies of bacterial populations in Tampa Bay indicated that filamentous and attached bacteria took up most of the radioactivity from [3H]DNA. Dissolved DNA is therefore a dynamic component of the dissolved organic matter in the marine environment, and bacterioplankton play a key role in the cycling of this material. PMID- 3827245 TI - Conversion of indole to oxindole under methanogenic conditions. AB - When indole was incubated under methanogenic conditions with an inoculum of sewage sludge, the chemical was metabolized with 10 days and temporary formation of an intermediate was observed. The metabolite was isolated by thin-layer chromatography and determined to be 1,3-dihydro-2H-indol-2one (oxindole) by UV spectroscopy (lambdaMAX, 247 nm) and mass spectrometry (m/z, 133). The methane produced (net amount) indicated nearly complete mineralization of indole. PMID- 3827246 TI - High incidence of selenite-resistant bacteria from a site polluted with selenium. AB - The level of selenium-resistant bacteria in water, algal mats, and sediment from Kesterson reservoir, Calif., a site with known selenium pollution, was compared with that in nearby Volta reservoir, a site with low selenium levels. A high percentage (greater than 50%) of all isolates from the Kesterson samples were resistant to 10 mM selenite. In contrast, only a small percentage of the Volta isolates were resistant to this level of selenite. The identity of some selenite resistant isolates and MICs of selenite, selenate, arsenate, tellurite, and tellurate were determined. PMID- 3827247 TI - Isolation from swine feces of a bacterium which decarboxylates p hydroxyphenylacetic acid to 4-methylphenol (p-cresol). AB - An obligate anaerobe has been isolated from swine feces which decarboxylates p hydroxyphenylacetic acid to 4-methylphenol (p-cresol). The bacterium was an ovoid rod, gram positive, nonsporeforming, and nonmotile. Lactate and acetate were major end products of glucose fermentation. Based on its characteristics, the bacterium is tentatively assigned to the genus Lactobacillus. PMID- 3827248 TI - Identification of environmental Vibrio vulnificus isolates with a DNA probe for the cytotoxin-hemolysin gene. AB - We screened 44 lactose-positive Vibrio strains isolated from the marine environment for homology with a 3.2-kilobase DNA fragment encoding the Vibrio vulnificus cytotoxin-hemolysin gene. All 29 marine isolates identified as V. vulnificus on the basis of numerical taxonomy and DNA-DNA hybridization studies hybridized with the cytotoxin gene probe, as did all V. vulnificus reference strains. Homologous gene sequences were identified in no other lactose-positive marine vibrio isolates nor in 10 other Vibrio species. PMID- 3827249 TI - Formation of moniliformin by Fusarium sporotrichioides and Fusarium culmorum. AB - Two strains of Fusarium sporotrichioides and one strain of F. culmorum were shown to produce the mycotoxin moniliformin in rice culture. Identification was by reverse-phase liquid chromatography, thin-layer chromatography, and mass spectrometry. PMID- 3827250 TI - Induced parasexual processes in Claviceps sp. strain SD58. AB - A homokaryotic, clavine alkaloid-producing strain of ergot, Claviceps sp. strain SD 58, was used in an attempt to demonstrate parasexuality. Genetically marked auxotrophic strains were produced by mutation with N-methyl-N'-nitro-N nitrosoguanidine. Protoplast fusion of pairs of unlike doubly auxotrophic strains and isolation of stable prototrophic fusion products were carried out. By growth of the fusion products on complete medium, selective pressure for prototrophy was removed and auxotrophic segregants were allowed to form. Analysis of these and recovery of segregants with nonleaky, non-parent-type combinations of auxotrophic characteristics has provided strong evidence that a parasexual cycle can function in Claviceps sp. strain SD 58. Preliminary work suggests that the genetics of ergot might be studied by mitotic analysis and that protoplast fusion and selection procedures might be useful for the enhancement of favorable characteristics in Claviceps strains. PMID- 3827251 TI - Lysostaphin lysis procedure for detection of Staphylococcus aureus by the firefly bioluminescent ATP method. AB - The objective of this study was to examine the use of lysostaphin as an ATP extracting agent for the estimation of Staphylococcus aureus cell number by a rapid bioluminescent ATP method. The results of the study showed that lysostaphin (22 U/ml) was able to lyse most of the S. aureus cells (greater than 99.9%) at room temperature in 1 min; ATP of S. aureus cells extracted by the lysostaphin lysis procedure was stable for 24 h in the presence of EDTA; there was a linear relationship between the ATP content and the number of S. aureus cells (ranging from 10(4) to 10(6) CFU/ml); and the lysis of S. aureus cells by lysostaphin allowed estimation of the number of S. aureus cells in mixed cultures and in meat samples. PMID- 3827252 TI - Meiotic prophase in the left embryonic testis of the Japanese quail (Coturnix coturnix japonica L.). AB - Spontaneous, transitory feminization of the left embryonic testis occurs in the majority of male Japanese quails from day 11 of incubation until the 2nd day after hatching. The feminized gonad is composed of a testicular part and of an ovarian-like cortical region, which develops outside the tunica albuginea. The cortical region contains numerous germ cells some of which enter meiosis on day 11 (i.e. at the time characteristic of female germ cells) and reach pachytene on day 14. Cortical regions are best developed on day 16 (day of hatching), but regression, accompanied by degeneration of many germ cells, begins shortly afterwards. The mechanism of feminization of the left embryonic testis is discussed. PMID- 3827253 TI - [Clinical and basic studies on the treatment of cancer metastasis]. AB - Lung resection for metastatic lung tumors from cancers of other organs has shown a significant curative success rate among affected patients. Hepatectomy also shows promise as a good curative approach for patients with liver metastasis from cancers of various abdominal organs. Descriptive data and their analysis of metastases by Bross and Viadana indicate a cascade spreading process. The fact that key-sites such as the lung and/or liver which, for some time, have proved a stumbling block to the generalization of cancers by metastases, has led to the success of therapy for metastasis in the clinical field. Chemotherapy as an adjuvant therapy to surgery for key-site metastatic foci is anticipated to raise future cure rates. PMID- 3827254 TI - [The treatment of brain metastasis from lung cancer]. AB - From August, 1976, through May, 1986, 111 patients with brain metastasis from lung cancer received various treatments according to their systemic conditions. Forty-two out of 55 patients without systemic metastasis were selected for surgical removal followed by radiation therapy, and the remaining 13 inoperable patients received radiation therapy alone. The median survival of the former group was 14.5 months with a 1-year survival rate of 57.2%, and was 11.0 months with a 1-year survival rate of 38.1% for the latter group. Twenty patients among the former group received intraoperative radiation therapy, and the result obtained was the same as that of the remaining 22 patients treated by surgery and conventional external radiation therapy. As to the conservative therapy applied for the 47 cases with systemic metastasis, radiation therapy, surgical decompression or steroid therapy were planned. The overall median survival of patients of this group was 3.5 months, with a 6-month survival rate of 27.7%. Radiation therapy combined with cisplatin was evaluated to be effective, showing more than 50% reduction of tumor volume in 73.9% of patients. The surgical removal of metastatic tumors should be considered for patients without systemic metastasis, and should also be followed by radiation therapy. Such cases would be expected to survive for more than 1 year, whereas there is no suitable treatment for patients with systemic metastasis. PMID- 3827255 TI - [Diagnosis and treatment of metastatic lung tumors]. AB - Almost all cases with metastatic lung tumor have no symptoms and their metastatic lesions of the lung are detected on X-ray films. The shapes of the shadows are so different that many kinds of examination are made. Among them, the radiographic examination is the most common and useful. It is important to make a diagnosis of metastatic lung tumor in the early stage in order to select effective treatment. In forty patients in whom metastatic lung tumors were removed in our institute hospital, the 5-year survival rate is as good as that of primary lung cancer. Ten of these patients survived for over 5 years after surgical treatment for metastatic lesions. The number of lesions and the type of lung resection did not relate to the prognosis. The thoracotomy is an effective therapeutic method for operable patients with metastatic lung tumor. PMID- 3827256 TI - [Diagnosis and treatment of bone metastasis]. AB - Diagnosis and treatments of bone metastasis were reviewed with clinical experiments in National Medical center Hospital. As for diagnosis of bone metastasis, early detection of bone metastasis was significantly improved by using bone scintigrams recently progressed. But the results of reviews suggest the possible improvements in diagnosis of bone metastasis. X-CT (X-ray Computed Tomography) for diagnosis of bone metastasis is advantages in three dimensional delineation of the extend and spread of bone lesions in bone marrow over bone scintigram. MRI (magnetic resonance imaging) has clinically been developed since 1981, does not directly represent bone structures but soft tissues in bone marrow, giving useful information concerning changes and spread of metastatic bone tumor not only inside the bone but also around it. MRI is now in technical progress and expected some improvements, could be expected in early diagnosis of bone metastasis. Regarding as treatment, we have individually to choose from radiotherapy, hormonal therapy, chemotherapy, surgical therapy according to clinical circumstances and does themselves. Radiation treatment is widely approved not only much effective in relieving the pains from bone metastasis, but also it is considered at the first choice in treatment of the spinal cord paresis by vertebral metastasis, because of frequently bringing good therapeutic effects. PMID- 3827257 TI - [Fundamental studies on the properties of a new adriamycin delivery system involving adsorption to activated carbon particles]. AB - Adriamycin (ADM) was absorbed onto fine particles of activated charcoal. The characteristics of this newly developed drug delivery system were then examined in vitro. Eighty micrograms of ADM was released from the charcoal reversibly, and the biological activity of ADM released from the charcoal was retained perfectly. The ADM was released so slowly and continuously that the concentration of ADM around the charcoal particles remained high for a long time. Such characteristics suggested that ADM-CH may be available for the treatment of peritonitis carcinomatosa and lymph node metastases. PMID- 3827258 TI - [Salvage chemotherapy of non-Hodgkin's lymphoma with a four-drug combination of mitoxantrone, etoposide, cisplatin and prednisolone (MEPP)]. AB - Twenty-two patients with non-Hodgkin's lymphoma were treated with a four-drug combination of mitoxantrone, etoposide, cisplatin and prednisolone (MEPP) after their disease had failed to respond to, or had relapsed after, induction chemotherapy consisting of cyclophosphamide, adriamycin, vincristine and prednisolone with/without bleomycin (CHOP/CHOP-bleo). Of 18 evaluable patients, four (22%) achieved complete remission and six (33%) responded partially. The median duration of response was 29 weeks (range, 9 to 54 weeks). The median survival time was 45 weeks for responders and 22 weeks for non-responders. Gastrointestinal toxicity was common, but well tolerated. Myelosuppression was the major dose-limiting toxicity: 11 patients (61%) experienced a febrile episode during periods of neutropenia and two patients, both of whom had massive bone marrow involvement of the disease, succumbed to infection. Despite the moderate to severe myelotoxicity, these results provide evidence that MEPP is an effective regimen for non-Hodgkin's lymphoma resistant to CHOP or CHOP-bleo. PMID- 3827259 TI - [Comparison between the succinate dehydrogenase inhibition test and ATP assay for in vitro chemosensitivity testing]. AB - The predicted level of cell viability was compared between the succinate dehydrogenase inhibition (SDI) test and the adenosine triphosphate (ATP) assay, both of which are used for in vitro human tumor chemosensitivity testing. After HeLa cells had been exposed to various concentrations of 5-FU for 1, 2, 3 or 4 days, the decrease occurring in viable cell number correlated with that of succinate dehydrogenase (EC 1.3.99.1) activity and that of the intracellular ATP level of the viable cells. In dead cells, the ATP level was extensively decreased, but the succinate dehydrogenase activity remained at a level of 11% of that of 5-FU-untreated viable cells, even on day 4. The cell viability correlated well with the intracellular ATP level, as compared with the succinate dehydrogenase activity. The activity remaining in dead cells must thus be taken into consideration for the prediction of chemosensitivity in the SDI test, but not in the ATP assay. PMID- 3827260 TI - [Intraperitoneal versus intravenous infusion of cis-platinum in advanced ovarian cancer--examination of pharmacokinetics]. AB - The pharmacokinetics of i.p.- and i.v.-infused cis-platinum (55 mg/m2) was studied in five patients with advanced ovarian cancer. The area under the concentration time (AUC) of non-protein-binding platinum in ascites had on anti tumor activity 44 times larger with i.p. infusion than that with i.v. infusion. Comparing with the concentration curve of non-protein-binding platinum in plasma, there was little difference between i.p. and i.v. infusion, and the AUC of non protein-binding platinum was almost equal between i.p. and i.v. infusion. In cases of low renal function, cisplatin was infused at 70 mg/m2 with sodium thiosulfate (STS). The AUC of ultrafiltrable platinum in plasma was 3 times larger in STS combination therapy. Therefore, STS was confirmed to be a powerful antidote against cis-platinum in plasma. Amounts of total platinum in 24-h urinary secretion were slightly less for i.p. than for i.v. infusion. Consequently, i.p. infusion of cis-platinum was shown to be highly effective on the local site and as effective as i.v. infusion on the whole body. Moreover, this route is effective for reducing ascites production and is expected to be effective against metastatic sites other than the abdominal cavity. PMID- 3827261 TI - [Experimental study on the control of cisplatin-induced emesis in dogs]. AB - In order to search for methods of controlling cisplatin-induced emesis, a series of experiments were performed with dogs. Cisplatin was administered i.v. to dogs at three-day intervals, and the number of emetic episodes and latency period to the first episode following injection were examined. The dose of cisplatin was 0.3mg/kg at the first injection, and thereafter square root 2-fold higher doses than the preceding ones were injected up to a maximum of 2.4 mg/kg. Emesis was observed from 0.42 g/kg. The number of emetic episodes increased with escalation of the dose up to 0.85 mg/kg, but decreased at higher doses. On the other hand, the latency period shortened with increase of the dose up to the highest one. From these results, the latency period is concluded to be a reliable parameter for evaluating the emetic activity of cisplatin and the efficacy of anti-emetics. The anti-emetic effect of vagotomy, ethyl amino-benzoate or metoclopramide was then examined. When 1 mg/kg of cisplatin was administered i.v., mean values of latency period and the number of episodes in dogs of a control group were 200 minutes and 20 times, respectively. In vagotomized dogs, no emesis was observed. When ethyl amino-benzoate was administered p.o. at doses of 12, 24 and 48 mg/kg 30 minutes before and 90 minutes after cisplatin injection, the number of episodes decreased to between 8 and 4.3 times, but the latency period was not prolonged. When s.c. injections of 1 mg/kg metoclopramide were combined with cisplatin in a similar manner to ethyl amino-benzoate, the latency period was prolonged up to 343 minutes, and the number of episodes decreased to 2.7 times. These results suggest that the peripheral autonomic nervous system is involved in the mechanism of emesis induction by cisplatin. Finally, the anti-emetic effect of metoclopramide was examined using the following administration schedules of cisplatin: a single i.v. injection of 3.75 mg/kg and daily i.v. injections of 1.25 mg/kg for three days. Metoclopramide showed a superior anti-emetic effect in the latter schedule, when the dose of 2 mg/kg was given i.v. 30 minutes before and 90 and 210 minutes after the cisplatin injection. PMID- 3827262 TI - [A study of preoperative administration of CDDP in 10 cases of esophageal carcinoma]. PMID- 3827263 TI - [Application of Nd-YAG laser hyperthermia in urogenital tumors]. PMID- 3827264 TI - Antibiotic prophylaxis and dermatologic surgery. PMID- 3827265 TI - Systemic plasmacytosis and the Crow-Fukase syndrome. PMID- 3827266 TI - Actinomycetoma caused by Nocardiopsis dassonvillei. PMID- 3827267 TI - Pityriasis rotunda: a dermatophytosis? PMID- 3827268 TI - Cryotherapy of psoriasis. PMID- 3827269 TI - Anthralin minute entire skin treatment: a follow-up and comparison with methoxsalen plus ultraviolet light. PMID- 3827270 TI - Isolation of human ferrochelatase. PMID- 3827271 TI - Perineal eruption in Kawasaki's syndrome. PMID- 3827272 TI - Papular elastorrhexis: a variety of nevus anelasticus? PMID- 3827273 TI - Recurrent herpes simplex infection masquerading as dermatitis artefacta. PMID- 3827274 TI - Congenital malalignment of the big toenail: a new subtype. PMID- 3827275 TI - Lichen sclerosus et atrophicus. PMID- 3827276 TI - Acute cellulitis. PMID- 3827277 TI - Cholinergic urticaria. A clinical and histologic study. AB - We studied the natural history, the prevalence of atopy, and the frequency of systemic symptoms during attacks in 35 patients with cholinergic urticaria, the histologic condition of the eruption in seven patients (20%), and the response to intradermal injections of acetylcholine, histamine, and methacholine in 18 patients (51%). In most patients symptoms began between the ages of 10 and 30 years, persisted for many years, and caused them to modify their activities to avoid the provoking factors of exercise, emotion, and heat. The condition usually improved with time, and five patients (14%) had a spontaneous remission. Atopy, present in about 12 (34%) of the patients, was more frequent than in the general population. Systemic symptoms were uncommon during attacks, and patients had no greater responses than controls to the intradermal tests. The histologic study revealed neutrophils in and around the walls of superficial subpapillary dermal vessels. PMID- 3827278 TI - Early detection of streptococcal group antigens in skin samples by latex particle agglutination. AB - The streptococcal group antigens (A to G) were researched in skin biopsy specimens by a latex agglutination technique using commercial (Slidex Streptokit bio-Merieux and Streptex Wellcome) and experimental reagents. Twenty-seven patients with obvious cutaneous infections (12 cases of erysipelas, nine cases of cellulitis, and six cases of necrotizing fasciitis) and 27 age- and sex-matched controls were studied. Our preliminary data demonstrated the possibility of an early diagnosis of streptococcal cutaneous infections involving the deep dermis and/or hypodermis. We used a latex agglutination technique that is quite specific and gives a better sensitivity (0.63) than either conventional bacteriologic cultures on needle aspiration or skin biopsy specimens. PMID- 3827279 TI - Langerhans' cells in paracoccidioidomycosis. AB - Langerhans' cells (LCs) appear to be altered in diseases that express a depressed cellular immune response. We measured the density of LCs in the skin of patients with the disseminated form of paracoccidioidomycosis. The study was performed using adenosine triphosphatase staining of epidermal sheets. Sixteen patients with paracoccidioidomycosis were evaluated. They had a highly significant reduction in LCs (LCs, 323 +/- 135/mm2) when compared with the number (LCs, 689 +/- 204/mm2) found in the control subjects. Morphological alterations of these cells were noted in patients with low numbers of LCs. These findings may reflect the depressed cellular immunity secondary to the infection with Paracoccidioides brasiliensis. PMID- 3827280 TI - Familial occurrence of lichen sclerosus et atrophicus. Case reports of a mother and daughter. AB - A mother and daughter with lichen sclerosus et atrophicus (LSA) are described. Both had lesions restricted to their lower legs. Both patients were positive for HLA-B40, which has been associated with LSA. Sex steroid hormones showed no decrease in dihydrotestosterone, free testosterone, or androstenedione levels in the daughter as was demonstrated in a previous study of this disease, but did show some decrease in androstenedione in the mother. This article provides further evidence for a possible familial predisposition for LSA. PMID- 3827281 TI - Prolidase deficiency in two siblings with chronic leg ulcerations. Clinical, biochemical, and morphologic aspects. AB - Prolidase deficiency occurred in two sisters suffering from recurrent leg ulcers that appeared in early childhood. The patients presented the typical clinical symptoms of the disease, including characteristic facies, dermatologic manifestations of the lower extremities, splenomegaly, and hematologic anomalies. Large amounts of iminodipeptides were excreted into the urine, and prolidase activity in their erythrocytes was virtually absent. Changes associated with a connective-tissue disorder were demonstrated by light and electron microscopic studies of the patients' apparently normal skin. Collagen fibers were smaller than in controls and were irregularly packed; the fibrils had normal aspect but were significantly smaller than in one age-matched control. Elastin fibers appeared altered both in size and structure. PMID- 3827282 TI - Compositae dermatitis in childhood. AB - Compositae dermatitis occurred in a 9-year-old boy with a strong personal and family history of atopy. Positive patch test reactions were 2+ for dandelion (Taraxacum officinale), false ragweed (Ambrosia acanthicarpa), giant ragweed (Ambrosia trifida), short ragweed (Ambrosia artemisifolia), sagebrush (Artemisia tridentata), wild feverfew (Parthenium hysterophorus), yarrow (Achillea millifolium), and tansy (Tanacetum vulgare) and 1+ for Dahlia species and English ivy (Hedera helix). Patch tests were negative for another 30 plants, including cocklebur (Xanthium strumarium), dog fennel (Anthemis cotula, fleabane (Erigeron strigosus), sneezeweed (Helenium autumnale), and feverfew (Tanacetum parthenium). The eruption resembled atopic dermatitis morphologically but was prominent on the palms and face and dramatically spared the area of the boy's feet covered by his shoes. The condition has always been seasonal, worsening in summer, especially July, and it clears on avoidance of contact. This case is believed to represent a contact dermatitis to oleoresins of Compositae plants; inhalants as a cause of systemic aggravation are not likely to be important in this patient. PMID- 3827283 TI - The CHILD syndrome. Histologic and ultrastructural studies. AB - A 4 1/2-month-old female infant had cutaneous and musculoskeletal changes consistent with the diagnosis of congenital hemidysplasia with ichthyosiform erythroderma and limb defects (CHILD) syndrome. This syndrome encompasses abnormalities of several organ systems, and its origins and pathogenesis are poorly understood. This report describes an additional patient with this uncommon syndrome and includes light and electron microscopic studies of her skin lesions. Our patient's clinical features of meningocele, Shone's syndrome, and the electron microscopic findings have not previously been described in the American literature (to our knowledge) in association with this syndrome. PMID- 3827284 TI - An annular erythema of infancy. AB - An unusual annular and arciform erythema in an infant is reported. Skin lesions appeared when the child was 4 days old, and multiple lesions have been present during the subsequent two years. Individual lesions gradually enlarge over a period of a few weeks, and they resolve spontaneously without any residual cutaneous abnormality. This annular erythema is clinically and histologically distinct from previously described annular erythemas of infancy, with which it is compared. PMID- 3827285 TI - Subcutaneous island pedicle flaps. AB - The subcutaneous island pedicle flap is a useful and reliably successful means of closing small- to medium-sized cutaneous excisional defects. It is especially useful in areas where primary closure could result in distortion of critical features. The technique is conceptually straightforward and offers advantages over skin grafting and transposition flaps. We describe our experience with 60 consecutive, successful subcutaneous island pedicle flaps. PMID- 3827286 TI - Rapid onset of pustular plaques. Acute febrile neutrophilic dermatosis (Sweet's syndrome). PMID- 3827287 TI - Papules and nodules in a patient with sarcoidosis. Chromoblastomycosis. PMID- 3827288 TI - Malformations in different ethnic groups. PMID- 3827289 TI - Club foot. PMID- 3827290 TI - Videourodynamic assessment of diurnal urinary incontinence. AB - Persistent daytime incontinence is a fairly uncommon but important problem. Videourodynamic studies were carried out in 215 children presenting with this problem in whom there were no neurological signs and who had not responded to simple measures. Over 90% of symptomatic children were shown to have an abnormality, of which over half had detrusor instability and a fifth had the wide bladder neck anomaly. We consider that it is important that these children are fully assessed as many can be helped. PMID- 3827291 TI - Vascular access for acute haemodialysis. AB - Vascular access for acute haemodialysis was required on 29 occasions in 26 children over a six year period. Comparison was made of the forms of vascular access employed, these being the Scribner shunt, the Hickman line, and percutaneous polyvinylchloride cannulae. The Hickman catheter was used to provide vascular access in 17 patients (mean age 8.8 years (range 2.5-16 years) and mean weight 25.5 kg (range 7.7-60 kg)) and allowed adequate haemodialysis to occur. Only one catheter had to be removed because of infection, and no other serious complications were encountered. These results show the superiority of the Hickman catheter as vascular access for acute haemodialysis in children. PMID- 3827292 TI - Outbreak of cephalosporin resistant Enterobacter cloacae infection in a neonatal intensive care unit. AB - Enterobacter cloacae resistant to third generation cephalosporins emerged rapidly during an outbreak of serious infections due to this organism in a neonatal intensive care unit where ampicillin and gentamicin were used as first line antibiotic treatment. Organisms resistant to cephalosporins were isolated from 12 infants, six of whom developed systemic infection. Two infants died. Isolates of E. cloacae from four of five infants treated with cefotaxime showed a loss of sensitivity to this antibiotic during treatment, but in the three infants who survived sensitive organisms were again isolated after treatment had stopped. Stopping treatment with the cephalosporins, closure of the unit to new admissions, and strict cohorting of colonised infants resulted in a prompt end to the outbreak. This outbreak suggests that the routine use of third generation cephalosporins for suspected sepsis may be inappropriate in the presence of a large reservoir of organisms with the potential for rapidly developing resistance. Routine bacteriological surveillance, however, might permit their use on a rotational basis. PMID- 3827293 TI - New fontanometer for continuous estimation of intracranial pressure in the newborn. AB - Intracranial pressure was estimated by a new pneumatic applanation fontanometer in babies in intensive care. A close correlation with cerebrospinal fluid pressure was found on 35 separate occasions. In 12 control babies the mean (SD) fontanelle pressure was 5.2 (2.2) cm H2O, in eight with a hypoxic-ischaemic encephalopathy it was 12.6 (4.3) cm H2O, and in nine with post-haemorrhagic hydrocephalus it was 10.8 (4.3) cm H2O. In four babies monitored continuously over seven days the correlation remained good. The fontanometer enables pressure to be monitored accurately, continuously, and non-invasively in neonates at risk of raised intracranial pressure. PMID- 3827294 TI - Knemometry in assessment of linear growth. AB - A rigorously designed auxological study was carried out to assess the operational characteristics of the knemometer and the value of short term lower leg and height measurements in estimating and predicting rates of linear growth. Measurements were made on 18 normal children monthly for six months and on six normal children weekly for six weeks. Six other children measured weekly underwent tonsillectomy after three weeks to determine the effect of stress on growth. The measurement protocol permitted estimations of both inter- and intraobserver variation. Knemometry is a sensitive, precise, and robust technique that enables accurate measurements to be made of the lower leg by interchangeable observers. The lower leg does not grow smoothly and variations in growth rate seen in both healthy children and children with transient intercurrent stress limit the practical clinical value of knemometry to the measurement of linear growth in the short term. PMID- 3827295 TI - Ten minute radiopharmaceutical test in biliary atresia. AB - To provide an objective rapid means of excluding extrahepatic biliary atresia (atresia), a hepatic index was devised from the ratio of the net hepatic to cardiac distribution of 99mTc diisopropyl iminodiacetic acid or methylbrom iminodiacetic acid between 2.5 and 10 minutes after injection. The hepatic index was compared with subjective assessment of abdominal scintigraphy performed repeatedly over 24 hours. In 22 infants with hepatitis the hepatic index ranged from 5.03 to 14.9, one having no excretion on scintiscan. In 26 infants with atresia the index ranged from 0.49 to 4.26 and in two with paucity of intralobular bile ducts it was 1.85 and 3.69. None of these infants had excretion apparent on scintiscans. Similarly, low hepatic indices occurred in four infants with liver dysfunction but pigmented stools, three of whom had no excretion apparent on scintiscans. These preliminary studies suggest that a hepatic index of greater than 5 is much more rapid and as specific in excluding atresia as repeated abdominal scintigraphy. PMID- 3827296 TI - Iron deficiency in cystic fibrosis. AB - Iron state was measured as part of the comprehensive assessment of 165 patients with cystic fibrosis. Of 127 patients, 41 (32%) had low serum ferritin concentrations and at least this proportion were iron deficiency. Iron state did not correlate with clinical score, radiological score, or results of sputum culture. There was no evidence that patients with iron deficiency were either in better or worse clinical condition than those with better iron stores. PMID- 3827297 TI - Hearing loss due to mumps. AB - The possibility of mumps was considered in 33 children with profound unilateral sensorineural hearing loss of unknown origin. Fifteen gave a history of mumps, of whom 12 contracted the infection between the last normal and first abnormal hearing tests. Hearing should be tested after mumps infection. PMID- 3827298 TI - Meningitis presenting as hypertension. AB - A 21 month old girl who presented with what seemed to be hypertensive encephalopathy is described. Although her encephalopathy resolved with antihypertensive treatment, subsequent investigations revealed haemophilus meningitis. PMID- 3827299 TI - Phosphatidylglycerol in tracheal aspirates for diagnosis of hyaline membrane disease. AB - Lecithin:sphingomyelin ratio and phosphatidylglycerol were determined by a rapid, simple method in tracheal aspirates obtained from 132 newborn infants with respiratory diseases, sixty five of whom developed hyaline membrane disease. Phosphatidylglycerol determination was more sensitive (97%) than lecithin:sphingomyelin ratio, but their specificities were similar (76%). PMID- 3827300 TI - Platelet thromboxane B2 production in neonatal pulmonary hypertension. AB - Production of platelet thromboxane B2, a stable metabolite of thromboxane A2, was measured in seven newborn infants with pulmonary hypertension during the first day of life. Platelet thromboxane B2 production was significantly lower than in 12 healthy controls but did not correlate with simultaneous blood gas values. PMID- 3827301 TI - Hydrops fetalis due to abnormal lymphatics. AB - A case of generalised lymphatic abnormality that presented with hydrops fetalis is described. This seems to be the first such case reported. PMID- 3827302 TI - Prognosis of chronic hepatitis B transmitted from HBsAg positive mothers. AB - Nine children born to HBsAg positive mothers, who became chronic HBsAg carriers with associated liver disease, were followed for five to 10 years. Five children with active hepatitis or active cirrhosis at presentation achieved complete remission within six years, while three HBeAg positive patients with minimal histological lesions remained unchanged. PMID- 3827303 TI - Antibiotic use in the neonatal unit. PMID- 3827304 TI - Epilepsy and prejudice. PMID- 3827305 TI - High plasma urea concentrations in collodion babies. PMID- 3827306 TI - Inhaled beclomethasone and oral candidiasis. PMID- 3827307 TI - Treatment with iron increases weight gain and psychomotor development. PMID- 3827308 TI - Minimal change nephrotic syndrome and cyclophosphamide. PMID- 3827309 TI - Serum albumin concentrations and oedema in the newborn. PMID- 3827310 TI - High dose intravenous methylprednisolone in treatment of recessive osteopetrosis. PMID- 3827311 TI - Unilateral renal agenesis associated with ipsilateral blind vagina. AB - All cases of unilateral renal agenesis are associated with an ipsilateral blind vagina except when there is agenesis of a urogenital ridge. Herlyn-Werner syndrome and some Gartner's duct cysts or Wolffian remnants also represent a blind vagina and lend support to the idea that the caudal segments of the Wolffian ducts participate in the formation of the human vagina. PMID- 3827312 TI - Instant effect of induced abortion on serum ceruloplasmin activity, copper and zinc levels. AB - Serum ceruloplasmin activity, serum copper and zinc levels were determined in 20 patients aged 19-43 with normal pregnancies of first trimester (5-9 weeks) admitted to hospital for legal abortion. Blood samples were taken from each patient 30 min before and 3 h after induced abortion. Significantly reduced ceruloplasmin activity (P less than 0.01) and serum copper level (P less than 0.05) were observed following induced abortion while zinc level didn't demonstrate any significant change (P greater than 0.05). A high degree of correlation was observed between the ceruloplasmin activity and the serum copper level (r = 0.87). Ceruloplasmin activity and serum copper values seem to be an index of feto-placental function in early pregnancy. PMID- 3827313 TI - Surface morphology of the perfused rabbit ovary. AB - Using transmission electron microscopy we examined the morphology of the surface epithelium of the isolated and perfused rabbit ovary after an ovulatory dose of HCG. Rupture of follicles occurred in vitro approximately 13 h after HCG injection and 6 h after the start of perfusion. The ultrastructural changes during the perfusion were similar to those occurring in vivo. The perfused ovarian epithelium had villous processes of varied architectural complexity with squamoid and cuboid epithelial cells. The superficial cells contained pinocytotic vesicles, coated and noncoated endocytotic caveolae, and occasional vacuoles. Dense bodies were more commonly found in vitro than in vivo. Occasionally structures similar to "Call-Exner-bodies" were found on the surface epithelium near to preovulatory follicles. Intercellular spaces of various sizes were also numerous. Disappearance of surface epithelium in the apex of follicles was often observed and the matrix of the tunica albuginea consisted of dissociated fibers and degenerating cells. This study showed that the isolated perfused rabbit ovary can serve as a model for studying the biology and pathology of ovarian surface epithelium. PMID- 3827314 TI - Severe hypertensive reaction after naloxone injection during labor. AB - A case of severe hypertension during labor after Naloxone injection is described in a patient with previous mild hypertension. The interaction of andogenous opioids and opiate antagonists, and their role in the control of blood pressure is discussed. Opiate antagonists should be given with caution to obstetric patients with mild to moderate hypertension. PMID- 3827315 TI - The measurement of amniotic fluid immunoglobulins by laser nephelometry. AB - Using laser nephelometry IgG, IgA, and IgM levels in amniotic fluid samples from normal pregnancies were measured between 15 and 24 weeks and between 37 and 41 weeks gestation. Not enough samples between 25 and 36 were available for statistical analysis. IgG levels increased until the 20th and 24th weeks of gestation and declined significantly at term. However amniotic fluid IgM and IgA levels rose at term. Five samples of amniotic fluid associated with a fetus of abnormal karyotype were examined. In one case of Down's syndrome excessive IgA and IgM levels were found. In amniotic fluid obtained after intrauterine fetal death at term, very high levels of all three immunoglobulins were found. PMID- 3827316 TI - Vulval liposarcoma. AB - A 60-year-old woman complained about an indolent and slowly growing tumor of the vulva. Clinical examination showed a sharply circumscribed lump in the posterior part of the left labium majus, suggestive of a cyst of Bartholin's gland. At operation a solid, macroscopically encapsulated tumor was found, which was a mostly well-differentiated liposarcoma on histological examination. Ten months after operation, the patient was well and had no signs of local or distant recurrence. The clinical and pathological features of this extremely rare case are presented and discussed. PMID- 3827317 TI - [CEA and ABO antigens as early signs of malignancy in urotheliomas of the upper urinary tract]. PMID- 3827318 TI - [The clinical history]. PMID- 3827319 TI - [Urographic manifestations in thrombosis of the inferior vena cava]. PMID- 3827320 TI - [Results of the surgical correction of urethral stenosis using a patch of umbilical vein]. PMID- 3827321 TI - [Multilocular cyst and renal adenocarcinoma]. PMID- 3827322 TI - [Thrombosis of the renal artery in a 2-month-old child: presentation of a case]. PMID- 3827323 TI - [Extraperitoneal bladder rupture in children without associated pelvic fracture. Apropos of a case]. PMID- 3827324 TI - [Renal oncocytoma: development over a 10-year period]. PMID- 3827325 TI - [Spontaneous urinary extravasation of the renal pelvis. Apropos of a case]. PMID- 3827326 TI - [Prevention of thromboembolic disease in urologic surgery with low-dose heparin]. PMID- 3827327 TI - [What place can chemotherapy occupy in the treatment of infiltrating transitional carcinoma of the bladder?]. PMID- 3827328 TI - [Surgical possibilities in bilateral renal carcinoma and in carcinoma of the solitary kidney: our experience]. PMID- 3827329 TI - [Varicocele: review of 41 cases]. PMID- 3827330 TI - [Cutaneous metastasis in prostatic carcinoma. Apropos of 2 cases]. PMID- 3827331 TI - Demonstration of an unidentified 48 kD polypeptide in circulating immune complexes in rheumatoid arthritis. AB - Circulating immune complexes (CIC) were isolated from 25 patients with rheumatoid arthritis (RA) by anti-C1q affinity chromatography. The components were detected by silver stained sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS PAGE) gels and identified by the Western blot. The CIC were composed of 20 different polypeptides, including albumin, immunoglobulin, complement, and acute phase reactants. Two components (molecular weight 48 kD and 45 kD respectively) remained unidentified. The 48 kD polypeptide was found in CIC from six out of 14 patients (43%) with extra-articular RA, but from none of eight patients with vasculitic complications of other connective tissue diseases. All immunoreactants were more frequently found in the patients with extra-articular features of RA. Although these results emphasise that most CIC in RA are composed of endogenous proteins, the 48 kD polypeptide is a candidate for an extrinsic antigen in RA. PMID- 3827332 TI - Sensitivity of lymphocytes from patients with systemic lupus erythematosus to the induction of sister chromatid exchanges by alkylating agents and bromodeoxyuridine. AB - Several authors have suggested that the cells of patients with systemic lupus erythematosus (SLE) have defects of DNA repair. Cells from patients with the classical chromosomal instability syndromes, thought to be due to defects in DNA repair, are hypersensitive to the chromosome damaging effects of some DNA damaging agents, measured as sister chromatid exchange (SCE). We have observed that lymphocytes of patients with SLE are not more sensitive than lymphocytes from healthy individuals to the SCE inducing effects of the DNA damaging agents methyl nitrosourea, methyl methanesulphonate, chlorambucil, and bromodeoxyuridine. These observations do not support the suggestion that cells of patients with SLE have an underlying defect of DNA repair. PMID- 3827333 TI - Circulating yersinia specific immune complexes after acute yersiniosis: a follow up study of patients with and without reactive arthritis. AB - The occurrence of immune complexes (ICs) containing Yersinia enterocolitica antigen and immunoglobulin was studied in 216 serum samples from 51 patients with recent yersiniosis at an early stage of the disease and during a follow up of two to 12 months. Twenty eight of the patients developed reactive arthritis, 23 recovered from the infection without any complications. An enzyme linked immunosorbent assay (ELISA) recently developed for detection of ICs containing yersinia antigen(s) and IgM, IgG, or IgA was applied. During the first two months after onset of the infection yersinia specific IgM complexes were demonstrated in higher concentrations in patients with arthritis than in those not developing this postinfection complication (p less than 0.02). The difference in the occurrence of IgM complexes between the two groups decreased with time. Yersinia specific IgA complexes were demonstrable in four patients with arthritis and in none of the non-arthritic patients. Yersinia specific IgG complexes were occasionally present in both patient groups. Altogether, more than eight months after onset of the infection yersinia specific ICs were detected in six arthritic and two non-arthritic patients, suggesting that in certain individuals yersiniae may hide after the initial infection for prolonged periods. PMID- 3827334 TI - Anaemia in juvenile chronic arthritis: serum inhibition of normal erythropoiesis in vitro. AB - Serum from patients with juvenile chronic arthritis (JCA) was shown to inhibit colony formation by normal erythropoietic progenitor cells cultured in vitro. The inhibition was proportional to the degree of anaemia and to certain indices of activity of the arthritis and systemic disease. It occurred in a dose dependent manner with increasing serum concentration and was independent of previous blood transfusion or administered drugs. Erythropoietic progenitor cells from the bone marrows of anaemic patients with JCA showed normal requirements for accessory cells (T lymphocytes and macrophages) in culture, and autologous accessory cells were not deficient in providing normal growth requirements. PMID- 3827335 TI - Failure to find disease similarity in sibling pairs with rheumatoid arthritis. AB - Clinical and laboratory measures of disease expression were compared within and between 33 families with two or more affected siblings with rheumatoid arthritis (RA). None of the variables studied--age and calendar year of disease onset, pattern of joint involvement, the presence of rheumatoid nodules, Sjogren's syndrome, a positive latex or antinuclear antibody (ANA) titre--showed a greater concordance within the families than between them. The families were then divided into those in which the affected sibling pairs were and were not HLA identical. Such a division did not alter the conclusion, with the possible exception of a positive latex titre. These results suggest that genetic or unique environmental factors within families may have only a limited role in explaining disease heterogeneity in RA. Conversely, the absence of homogeneity within the families justifies their use in genetic linkage studies and the extrapolation of results obtained from affected siblings to the commoner sporadic disease. PMID- 3827336 TI - Observer variation in grading sacroiliac radiographs might be a cause of 'sacroiliitis' reported in certain disease states. AB - Radiological sacroiliitis in Behcet's syndrome (BS) has been a subject of controversy. We have examined pelvic radiographs of 38 patients with BS and 28 age and sex matched controls which we reported previously, and also 17 with ankylosing spondylitis (AS), 27 with non-renal familial Mediterranean fever (FMF), and 33 with primary osteoarthrosis (OA). Initially, five observers assessed radiographs on two different occasions according to the New York criteria for sacroiliitis in a blind protocol. Later, three of them examined the various possible abnormalities of the sacroiliac (SI) joints after training sessions. Although the inter- and intraobserver variation was quite high, all observers found the expected changes in patients with AS. The abnormalities detected in the other diseases were either mild, inconsistent, or both. Erosions were confined to patients with AS, and osteophytes and glenoid sulci to patients with OA. We conclude that high observer variation in interpreting a film of the anteroposterior (AP) view of the pelvis for sacroiliitis may be a major cause of reported 'sacroiliitis' in BS and FMF. PMID- 3827337 TI - SLE-like and sicca symptoms in late component (C9) complement deficiency. AB - Hereditary deficiencies in early and late complement components are well known to predispose to SLE-like syndromes or recurrent infection. Hitherto reported C9 deficient cases have usually been healthy subjects, however, and it is not considered that C9 deficiency is associated with any specific disease. We describe a completely C9 deficient patient with possible Sjogren's syndrome and discuss the relationship. PMID- 3827338 TI - Acquired sideroblastic anaemia after aplastic anaemia caused by D-penicillamine therapy for rheumatoid arthritis. AB - A 68 year old man with rheumatoid arthritis developed marrow aplasia during D penicillamine treatment. Recovery of granulopoiesis and erythropoiesis was ineffective with features of a secondary sideroblastic anaemia. Absence of megakaryopoiesis persisted. Therapeutic measures failed, and the patient finally died. These events illustrate a haematopoietic stem cell injury induced by D penicillamine. PMID- 3827339 TI - Pulmonary hypertension, systemic lupus erythematosus, and the contraceptive pill: another report. AB - I report the case of a woman with systemic lupus erythematosus who had pulmonary hypertension unassociated with chronic interstitial lung disease or pulmonary emboli. She had started taking the contraceptive pill seven months previously. PMID- 3827341 TI - Development of Garrod's pads in the fingers of a professional violinist. PMID- 3827340 TI - Unusual cranial and abdominal computed tomographic (CT) scan appearances in a case of systemic lupus erythematosus (SLE). AB - A 35 year old woman presented with headache and fever. Computed brain tomography showed diffuse low attenuation in the cerebral white matter. Several months later, serological tests for systemic lupus erythematosus (SLE) became positive. In spite of immunosuppressive therapy she relapsed after six months of treatment, presenting with abdominal symptoms and signs. On this occasion an abdominal CT scan showed distended and oedematous loops of bowel attributed to an underlying vasculitis. This case illustrates novel CT scan appearances in two systems involved in SLE. PMID- 3827342 TI - Serum myoglobin and creatine kinase concentrations in patients with polymyositis or dermatomyositis. PMID- 3827343 TI - Ankylosing spondylitis and middle ear impairment. PMID- 3827344 TI - Thyroid disorders in systemic lupus erythematosus. PMID- 3827345 TI - Treatment of Wegener's granulomatosis with cyclosporin. PMID- 3827346 TI - Adherence of rheumatoid polymorphonuclear cells (PMNs) to cultured endothelial cell monolayers. AB - Blood polymorphonuclear cells (PMNs) from 40 patients with rheumatoid arthritis (RA) and 40 normal subjects were incubated with confluent cultures of porcine aortic endothelium and their adherence assessed by either a microscopic or radiometric enumeration assay. There was no difference between the number of rheumatoid and control PMNs adhering. The synovial fluid PMNs from patients with RA were less adherent than their paired blood samples when autologous serum was present in the incubation medium and more adherent when serum was absent. Most of the RA sera tested inhibited the adhesion of normal PMNs, an effect that was not due to an increase in PMN aggregation. A similar inhibition was seen with sera obtained from patients with Felty's syndrome. These findings suggest that there is no intrinsic difference between the adhesiveness of rheumatoid PMNs and normal PMNs but that there are soluble factors present in RA serum which inhibit the attachment of normal PMNs to vascular endothelium. PMID- 3827347 TI - Rheumatoid blood decreases the adherence of polymorphonuclear cells (PMNs) to cultured endothelium. AB - Rheumatoid sera and plasma inhibited the adherence of normal blood polymorphonuclear cells (PMNs) to cultured porcine endothelium. This inhibition of adhesion was not seen when PMNs were treated with the plasma or serum from normal subjects or patients with other inflammatory arthropathies. The abrogation of PMN adherence was directly related to the levels of circulating immune complexes and was not dependent upon the type of anti-inflammatory therapy that the patients were receiving nor on any of the recorded clinical parameters. A similar inhibition of adhesion was seen with heat induced aggregated human IgG (HAGG) provided that serum was present in the culture medium. In view of these results we propose that circulating immune complexes in RA may have a significant role in controlling the interaction of PMNs with vascular endothelium and in perpetuating the entry of these cells into the synovial fluid of the inflamed joints. PMID- 3827348 TI - [Too sensitive a diagnosis or too toxic a treatment?]. PMID- 3827349 TI - [Use of the CATT Testryp in screening for trypanosomiasis in Nioki, Zaire]. PMID- 3827350 TI - [Tuberculosis infection in a cattle-breeding region in Sahelian Africa]. PMID- 3827351 TI - [Endemic goiter in Nyarutovu, Rwanda]. PMID- 3827352 TI - Anemia of pregnancy in Niger, West Africa: a prevalence study. PMID- 3827353 TI - [Presentation of a local health information system in Kinshasa, Zaire. The Kinshasa Health for All Project]. PMID- 3827354 TI - [A new focus of onchocerciasis in Burundi]. PMID- 3827355 TI - Obstructed labour due to vesical calculus. PMID- 3827356 TI - Gastric autonomic nerve (GAN) tumor and extra-adrenal paraganglioma in Carney's triad. A common origin. AB - Carney's Triad comprises a triad of neoplasms: gastric stromal tumor, extra adrenal paraganglioma (usually functional), and pulmonary chondroma. At least two of these are needed for the presumptive diagnosis of the Triad. This report presents a patient who had resected a gastric tumor and nonfunctional extra adrenal paraganglioma. The gastric tumor resembled a gastric leiomyosarcoma by light microscopy, but electron microscopy revealed it to be a gastric autonomic nerve (GAN) tumor. Based on this evidence it appears that both the gastric lesions and the paragangliomata of Carney's Triad are tumors of the autonomic nervous system. Thus, the Triad may be a disorder of the autonomic nervous system rather than a multiple endocrine neoplasia syndrome or multiple hamartoma syndrome. PMID- 3827357 TI - Natural history of cholelithiasis in patients with alcoholic cirrhosis (cholelithiasis in cirrhotic patients). AB - To assess the natural history of cholelithiasis in patients with cirrhosis, 32 charts coded for both diseases were retrospectively reviewed. Cholecystectomy was performed in 22 patients. Only two patients met criteria for acute cholecystitis and two patients had suspected choledocholithiasis. Despite the high incidence of preoperative jaundice (32%), no common duct stones were documented. There was no operative mortality. The complication rate was 45%. In 10 patients not operated upon, two patients died of liver failure and the remaining eight patients are alive 8 months to 13 years after diagnosis (mean: 46 months) with no active biliary disease. It is concluded that: jaundice in this subpopulation most often reflects hepatocellular injury and rarely biliary tract obstruction, there appears to be a much lower incidence of acute cholecystitis and choledocholithiasis in cirrhotic patients with cholelithiasis than in the normal population, and patients with cirrhosis and asymptomatic cholelithiasis can be safely managed without operation. PMID- 3827358 TI - Subtotal resection of the head of the pancreas combined with ductal obliteration of the distal pancreas in chronic pancreatitis. AB - Subtotal resection of the head of the pancreas combined with duct obliteration of the distal pancreas by prolamine was performed in 12 selected patients who had chronic alcohol-induced pancreatitis with most destruction in the proximal pancreas. The main indication for operation was intractable pain. There was no postoperative mortality but morbidity was high when no pancreaticojejunostomy was constructed. After a follow-up period of 32 months, lasting pain relief was obtained in 10 patients; pseudocyst formation occurred in three patients; calcification of the distal pancreas, absent before operation, was demonstrated in four of six patients; six of 11 nondiabetic patients became hyperglycemic either abruptly (1 patient) or progressively (5 patients); quality of life improved in most patients. This procedure preserves the stomach, duodenum, spleen, distal pancreas and common bile duct if possible. However, pancreatic ductal obliteration with prolamine does not prevent relapses of chronic pancreatitis. PMID- 3827359 TI - Diffuse intraductal papillary adenocarcinoma of the pancreas. AB - The incidence of multicentricity in pancreatic cancer has been reported to be as high as 38%. Recent surgical and autopsy series have documented multicentric disease and the presence of carcinoma in situ in association with invasive carcinoma. Described are the clinical and pathologic findings in a 41-year-old woman who had total pancreatectomy for diffuse ductal transformation to papillary adenocarcinoma associated with a wide spectrum of extensive ductal epithelial changes. The significance of epithelial abnormalities as they relate to the occurrence of multicentric tumor is discussed, and the findings in this patient are compared with those of other distinctive clinicopathologic entities. Despite an apparently favorable outcome and 20-month disease-free follow-up in this patient, no good evidence indicates that age, extent of procedure, or lack of tumor invasion has prognostic significance in pancreatic cancer. PMID- 3827360 TI - The influence of a brief preoperative illness on postoperative healing. AB - In a study of wound healing at high altitude, subcutaneously implanted PTFE tubes were used to stimulate and measure accumulation of wound hydroxyproline (an index of collagen) in 26 patients who had appendectomy and in 38 patients who had cholecystectomy. Patient age, length of surgery, and postoperative recovery seemed to predict better healing in patients who had appendectomy, but there was a difference in the preoperative illness of the two groups: acute cholecystitis was treated medically and cholecystectomy performed after resolution of the acute phase of illness, whereas patients who had appendectomy were taken to surgery as soon as a diagnosis was made. It was observed that patients who had appendectomy accumulated 20% less hydroxyproline than patients who had cholecystectomy (p less than 0.02), and that the depression of hydroxyproline accumulation was significantly related to length of preoperative illness (p = 0.008). This decrease in wound hydroxyproline accumulation is attributed to the acute preoperative illness. Conceptually, this is a unique situation since the brief illness did not produce lasting debility, and the source of illness, the inflamed appendix, was not present during healing. This indicates that even a brief preoperative illness has a more prolonged influence on postoperative healing than usually anticipated. PMID- 3827361 TI - Hepatic resection for colorectal liver metastases. Influence on survival of preoperative factors and surgery for recurrences in 80 patients. AB - This report analyses an experience with 80 liver resections for metastatic colorectal carcinoma. Primary colorectal cancers had all been resected. Liver metastases were solitary in 44 patients, multiple in 36 patients, unilobar in 76 patients, and bilobar in 4 patients. Tumor size was less than 5 cm in 33 patients, 5-10 cm in 30 patients, and larger than 10 cm in 17 patients. There were 43 synchronous and 37 metachronous liver metastases with a delay of 2-70 months. The surgical procedures included more major liver resections (55 patients) than wedge resections (25 patients). Portal triad occlusion was used in most cases, and complete vascular exclusion of the liver was performed for resection of the larger tumors. In-hospital mortality rate was 5%. Three- and 5 year survival rates were 40.5% and 24.9%, respectively. None of the analysed criteria: size and number of liver metastases, delay after diagnosis of the primary cancer, Duke's stage, could differentiate long survivors from patients who did not benefit much from liver surgery due to early recurrence. Recurrences were observed in 51 patients during the study, two thirds occurring during the first year after liver surgery. Eight patients had resection of "secondary" metastases after a first liver resection: two patients for extrahepatic recurrences and six patients for liver recurrences. Encouraging results raise the question of how far agressive surgery for liver metastases should go. PMID- 3827362 TI - Patterns of failure following surgical resection of colorectal cancer liver metastases. Rationale for a multimodal approach. AB - A total of 45 patients, after surgical resection of colorectal liver cancer metastases, were retrospectively analyzed to define areas of failure, to identify some possible prognostic factors (site of primary, stage, site, number of metastases, preoperative carcinoembryonic antigen, differentiation of the primary, type of surgery), and to seek a new rationale for a multimodal approach. The median postoperative follow-up was 18 months (range: 4-45 months). Survival rate was calculated by the actuarial method, and statistical significance was tested by the Mantel-Haenszel test. Twenty-eight patients had a relapse. These recurrences were hepatic in 11 patients, extrahepatic (intra- and extra abdominal) in 12 patients, and intra- and extrahepatic in five patients: The stage (classification of the Istituto Nazionale Tumori of Milan) was the most important parameter related to the overall recurrence rate (47% in stage I, 62% in stage II, and 81% in stage III) and to the overall and disease-free survival. Stage was significantly related to hepatic relapse but not to extrahepatic relapse. In stage I the failure rate of 18 months was similar in hepatic and extrahepatic relapses (one third to one fourth of the patients); in stages II and III the hepatic failure rate was always higher than the extrahepatic rate. These data indicate that surgery alone is an inadequate form of therapy in cases of colorectal cancer metastases of the liver, and an adjuvant therapy, including alternate regimens of intraperitoneal and systemic chemotherapy, should be considered. PMID- 3827364 TI - A comparative experimental study of the organization of arterial and venous thrombi. AB - Organization of a venous thrombus proceeds much faster than that of an arterial thrombus. Two different double-ligation procedures were used for study of the time sequence of thrombus organization by the vascularized (in situ) and devascularized (dissected) walls of the external jugular vein and common carotid artery in 21 mongrel dogs. Blood in the ligated segments of the in situ veins remained mostly fluid. In these segments, intimal hyperplasia was observed after 4 weeks with apparent preservation of an endothelial lining. However, in the dissected veins, the trapped blood rapidly thrombosed. Remarkable cell proliferation quickly occurred in these dissected walls with rapid invasion of the thrombus to achieve complete organization by 4 weeks. In contrast, a thrombus formed in the ligated segments of all arteries, whether in situ or dissected, and organization was much slower, requiring about 4 months for completion. Full-wall viability was maintained in 100% of the in situ veins and in 95% of the devascularized veins, but inner wall viability was lost in 30% of the in situ arteries and in 95% of the devascularized arteries. PMID- 3827363 TI - Management and outcome of retroperitoneal abscesses. AB - Retroperitoneal space abscesses are unusual clinical problems encountered by general surgeons, internists, and surgical subspecialists. An insidious, occult illness marked by diagnostic delay, inadequate drainage, and considerable morbidity and mortality is common. Anatomic reviews detailing the complex extraperitoneal spaces have been published, but less attention has been focused on diagnostic and drainage techniques useful to the practicing surgeon. In a retrospective review of 50 extraperitoneal abscesses, attention was directed to clinical presentation, diagnosis, and therapy. On the average, 12.7 days were required to establish the diagnosis; 50% of patients suffered major complications. A strikingly high mortality was associated with positive blood cultures and persistent fever within 48 hours of drainage (75% and 71%, respectively). Computed tomography has greatly enhanced the diagnosis of extraperitoneal abscesses, and radiologic drainage in selected cases appears to be a useful initial approach. A simplified anatomic classification and treatment plan is proposed to facilitate comparison between clinical series. PMID- 3827365 TI - Atrial caval shunting in blunt hepatic vascular injury. AB - Of 51 patients with major blunt hepatic trauma treated at a Level I trauma center, 29 patients (56.8%) survived. Nine of the 51 patients required insertion of the atrial caval shunt, as indicated by uncontrollable hemorrhage due to disruption of the perihepatic veins. Eight of these nine patients sustained injury to the hepatic veins or the retrohepatic vena cava. Of the eight patients with hepatic vascular injury, four (50.0%) were long-term survivors. In hepatic trauma patients with suspected hepatic vascular injury, aggressive use of the shunt can control hemorrhage before the onset of coagulopathy or hypothermia. PMID- 3827366 TI - Esophageal atresia and tracheoesophageal fistula in the twin. Anatomic variants. AB - Recent experience with a twin who had esophageal atresia and tracheoesophageal fistula revealed complex anatomy not suspected before operation. The experience in patients with esophageal atresia and tracheoesophageal fistula who were twins was reviewed at the Children's Hospital of Los Angeles. Of 245 patients seen in the past 23 years, 16 were twins (only two of whom were siblings). Six of the 16 patients (38%) had other than the most frequent anatomy, i.e., proximal atresia of the esophagus and distal fistula. Two of these patients had extremely complex anatomy. Twenty-five per cent of the patients had a right aortic arch compared with 5% of all patients with tracheoesophageal fistula. The surgeon who encounters a twin with esophageal atresia or tracheoesophageal fistula is appropriately cautioned that significant anatomic complexity may be encountered. PMID- 3827367 TI - Student attitudes about surgery in older patients before and after the surgical clerkship. AB - Although emphasis has been placed on including content on treating the elderly in the medical school curriculum, little attention has been given to whether content on surgical management of the elderly should be provided in the surgical clerkship. The purpose of this paper is to describe geriatric principles emphasized in a surgical clerkship and changes in attitudes of students. Junior students (N = 175) were tested on attitudes before and after the clerkship. Attitudes about treating the elderly and surgery in the elderly changed significantly and positively. Attitudes about emergency surgery in the elderly became more realistic, particularly in those selecting surgery as a career. This study differs from others that found that students became more negative about treating the elderly as they progressed through medical school. The surgical clerkship provides a different perspective of the older patient from that seen on medicine or in long-term care, in that the elderly are usually admitted and treated successfully in a short time. The fact that the surgical clerkship, in contrast to other medical school experiences, can positively influence attitudes about aging for all students, regardless of career choice, is encouraging and suggests that including content on surgical management of the elderly can help students become more favorable about treating older patients. PMID- 3827368 TI - Peptic ulcer in acquired columnar-lined esophagus: results of surgical treatment. AB - Ulcerative peptic esophagitis may lead to the progressive replacement of squamous by columnar epithelium in the distal esophagus. A typical peptic ulcer (Barrett's ulcer) may develop in the columnar-lined segment, although this is a rare occurrence. Between 1975 and 1985 at Toronto General Hospital we treated 11 patients with penetrating peptic ulcer and acquired, columnar-lined esophagus. Presenting symptoms related to the ulcer were precordial and lower dorsal back pain in 4 patients, dysphagia in 6, and massive hemorrhage of the upper gastrointestinal tract in 4. None of the ulcers healed following a trial of medical therapy, and ultimately all 11 patients underwent antireflux procedures (gastroplasty and partial fundoplication). There was one operative death. Complete healing of the ulcer was observed in the 8 patients who underwent follow up endoscopy between two and five months after operation. There has been no recurrence of symptoms resulting from ulcer in subsequent follow-up, which extends from 1 to 11 years (mean, 5 years). Adenocarcinoma developed in the columnar-lined segment in 2 of the 11 patients, which was diagnosed at 32 and 91 months following operation, respectively. PMID- 3827370 TI - Clinical and pathologic characteristics in patients with tracheobronchial tumor: report of 50 patients. AB - From January, 1961, to July, 1985, 50 patients in the Peking Union Medical College Hospital with intraluminal tracheobronchial tumors were operated on. There was no gender or age predominance either in the 24 patients with tracheal tumor or in the 26 patients with bronchial tumor. The 13 cell types found in these patients' specimens were divided into four groups: malignant, low-grade malignant, benign with tendency to recur and benign without tendency to recur. Squamous cell carcinoma and adenoid cystic carcinoma were the most common tumors of the trachea. Carcinoid and adenoid cystic carcinoma were the most common tumors of the bronchus in this group of patients. Conservative excision with postoperative irradiation may be sufficient for patients with advanced lesions of low-grade malignancy. PMID- 3827369 TI - Effect of aortic stenosis on oxygen balance in partially ischemic myocardium. AB - Valvar aortic stenosis can result in myocardial underperfusion with or without coronary obstruction. The purpose of this study was to determine how hearts with valvar aortic stenosis without hypertrophy can maintain their oxygen supply/consumption balance with partial left anterior descending coronary artery (LAD) occlusion. Open-chested, anesthetized dogs (n = 9) were subjected to mild valvar aortic stenosis and then to a reduction of LAD flow to 50% of baseline, while controls (n = 9) received partial LAD occlusion without aortic stenosis. Blood flows were determined before and after aortic stenosis and after LAD occlusion using radioactive microspheres. The hearts were then removed for microspectrophotometric analysis of regional venous and arterial oxygen saturation. Aortic stenosis resulted in a pressure gradient of approximately 50 mm Hg, representing mild aortic stenosis. Only a slight increase in myocardial blood flow was seen with aortic stenosis. Ischemia resulted in a significant drop in blood flow in control (40%) and aortic stenosis (55%) animals compared with their own preocclusion values. These ischemic region flows were not different from each other. Aortic stenosis itself did not alter oxygen extraction, although partial occlusion similarly increased extraction for all groups in the ischemic zone. The LAD occlusion resulted in a decreased oxygen consumption in the occluded region of all groups, with no differences noted between control and aortic stenosed animals. Thus, mild, acute aortic stenosis without hypertrophy does not appear to significantly increase the severity of an ischemic episode precipitated by partial LAD occlusion. PMID- 3827371 TI - Serum creatine kinase and lactate dehydrogenase isoenzyme levels in patients after major esophageal surgery, esophageal dilation, and acute myocardial infarction. AB - All three isoenzymes of creatine kinase (CK), including MB, the fraction used in diagnosing acute myocardial infarction (AMI), have been found in the esophagus. Clinical reports suggest that injuries to the esophagus can cause changes in peripheral serum CK. This prospective study was designed to delineate whether esophageal dilation or major esophageal surgery would cause changes in serum CK and lactate dehydrogenase isoenzymes that might be consistent with the diagnosis of an AMI. Two groups of patients admitted to a coronary care unit were used as controls: patients with electrocardiographically proved AMI and those who had chest pain but who had AMI ruled out by sequential electrocardiograms. The coronary care unit patients had serum enzymes determined on admission, then every 8 hours for four samples, and then daily for 3 days. The surgical patients had determinations preoperatively, in recovery, every 8 hours for four samples, and daily for 5 days. The patients who had esophageal dilations had serum enzyme levels drawn before the procedure and every 8 hours for 2 days after dilation. Serum total CK and lactate dehydrogenase levels were determined by automated spectrophotometry. Isoenzyme levels were determined by agarose gel electrophoresis. The data suggest that small serum CK-MB bands that may be generated by esophageal surgery or dilation can be differentiated from those seen in AMI and that AMI can be confirmed by simultaneous analysis of serum lactate dehydrogenase isoenzymes. PMID- 3827372 TI - Thromboembolic and other events following valve replacement in a pediatric population treated with antiplatelet agents. AB - To determine if anticoagulation therapy is necessary after valve replacement with the St. Jude Medical prosthesis in young subjects, 30 consecutive patients were studied. They ranged in age from 4 to 20 years, and each had undergone valve replacement some time between February, 1982, and June, 1984. There was 1 hospital death (3.3%; 70% confidence limits [CL] = 0.4% to 10.9%). The 29 hospital survivors were treated with aspirin and dipyridamole. All patients were followed up. There were 5 late deaths (17.2%; 70% CL = 9% to 27%), at a mean of 8 months postoperatively. Follow-up revealed that 7 thromboembolic events occurred in 7 of the hospital survivors (24.1%; 70% CL = 15% to 35%). Hemiparesis occurred in 1 patient, and documented valve thrombosis and death occurred in another. Transient sensorimotor deficits were found in the 5 other patients. Prosthetic valve endocarditis developed in 1 hospital survivor (3.5%; 70% CL = 0.4% to 11%) and resulted in late death. There were no reoperations in the hospital survivors. We conclude that the St. Jude Medical prosthesis is useful for valve replacement in the young because of its low profile, durability, and hemodynamic characteristics. However, we recommend that these patients receive full anticoagulation therapy. PMID- 3827373 TI - Pathophysiology of pulmonary edema following experimental brain death in the chacma baboon. AB - Systemic and pulmonary hemodynamics have been studied during the induction of brain death in the chacma baboon. In 11 animals brain death was induced by acute intracranial hypertension. Continuous recording of blood flow through both the pulmonary artery and the aorta was obtained by electromagnetic flow meters placed around these vessels. Mean arterial, central venous, pulmonary arterial, and left atrial pressures were recorded continuously. Systemic and pulmonary vascular resistances were calculated. During the agonal period marked sympathetic activity occurred, with significant increases in circulating catecholamines and systemic vascular resistance. The great increase in systemic resistance resulted in acute left ventricular failure. Mean left atrial or pulmonary capillary wedge pressure rose above the mean pulmonary arterial pressure in 9 animals. As the systemic vascular resistance rose, a significant difference between pulmonary artery and aortic blood flows occurred, leading to blood pooling within the lungs. A mean of 72% of the total blood volume of the animal accumulated within these organs. The increase of left atrial pressure to levels higher than pulmonary artery pressure indicated a state of pulmonary capillary blood flow arrest. This, associated with the blood pooling within the lungs, almost certainly resulted in disruption of the anatomic integrity of the pulmonary capillaries (blast injury); 4 animals developed pulmonary edema, with alveolar septal interstitial hemorrhage. PMID- 3827374 TI - Endoscopic gluing of bronchopleural fistula. AB - Three patients with postpneumonectomy bronchopleural fistula were treated with endoscopic gluing of the fistula. The technique and the results of this method are described. PMID- 3827375 TI - The effect of pericardial insulation on hypothermic phrenic nerve injury during open-heart surgery. AB - Phrenic nerve injury was evaluated prospectively in 133 patients undergoing open heart surgery using iced saline slush for topical hypothermia. In the control group of 70 patients no attempt was made to shield the phrenic nerves from direct exposure to ice. Phrenic nerve damage occurred in 73% of these patients, as assessed by persistent diaphragm paralysis evident on inspiratory chest roentgenogram. In 2 patients the paralysis was bilateral. In the second group of 63 patients a pericardial insulation pad was used to prevent contact of the iced slush to the phrenic nerve. Diaphragm paralysis was observed in 17% of these patients. This difference was highly significant (p less than .001). Diaphragm paralysis in the control group was clinically significant; life-threatening respiratory complications developed in 7 patients (14%), frequently resulting in multiple reintubations, tracheostomy, and prolonged mechanical ventilation. In addition, 4 patients with phrenic nerve injury exhibited a clinical syndrome consistent with gastric ileus, which may possibly represent hypothermic injury to the thoracic vagi. The likelihood of phrenic nerve injury when iced saline slush is used for topical myocardial cooling and the possibility of developing serious respiratory disability would support the routine use of pericardial insulation when this method of hypothermia is used. PMID- 3827376 TI - A new method to induce topical cooling of the right atrium for treatment of supraventricular tachyarrhythmia: an experimental study. AB - Supraventricular tachyarrhythmia (SVT) such as sinus tachycardia and atrial dysrhythmia is a life-threatening problem in the period immediately following an open-heart operation. Because of their negative inotropic effects, antiarrhythmic agents are not recommended for patients with low cardiac output syndrome. A device was developed that topically cools the right atrial surface for antiarrhythmic treatment. In experiments, this device lowered right atrial temperature and did not affect the temperature of the right ventricle or the whole body. When right atrial temperature decreased from 37 degrees to 28 degrees C, heart rate was reduced from 146.3 to 109.7 beats per minute (p less than .001). Meanwhile, cardiac output and blood pressure remained within control levels. In the treatment of experimental SVT induced by the intravenous infusion of isoproterenol hydrochloride and by direct application of aconitine, this method worked effectively and was reproducible. The results demonstrated the beneficial effects of this method in the treatment of SVT in experimental studies and suggested its future clinical application following open-heart operations. PMID- 3827377 TI - Peripheral pulmonary artery aneurysm in a patient with limited respiratory reserve: controlled resection using cardiopulmonary bypass. AB - Pulmonary artery aneurysms are rare lesions for which operative management is not frequently undertaken. When operation is indicated, central lesions involving the pulmonary trunk, right main pulmonary artery, or left main pulmonary artery are repaired using cardiopulmonary bypass. Peripheral aneurysms in segmental intrapulmonary arteries have been managed most frequently by lobectomy, but occasionally by aneurysmectomy and pulmonary arterial repair. We used cardiopulmonary bypass for peripheral pulmonary aneurysmectomy in a patient with limited respiratory reserve because he had undergone prior contralateral bilobectomy; this allowed controlled resection while preserving a maximal amount of pulmonary parenchyma. PMID- 3827378 TI - Technique for implantation of phrenic nerve electrodes. AB - Permanent ventilatory support is necessary in patients with upper motor neuron respiratory muscle paralysis and central alveolar hypoventilation. Weaning these patients from chronic ventilation is extremely advantageous. Diaphragm pacing accomplishes this goal. In the past implantation of phrenic nerve electrodes has been undesirable either because the procedure is too extensive or because of the high failure rates. This report describes a simple, expeditious, and uniformly successful technique for bilateral phrenic nerve electrode placement. PMID- 3827379 TI - Pulmonary vein clamping during cardiopulmonary bypass: enhancement of operative field visualization and myocardial hypothermia. AB - In certain diagnostic entities temporary occlusion of the pulmonary veins during cardiopulmonary bypass essentially eliminates the left ventricular return of blood. This, in turn, improves visualization of the operative field and enhances myocardial hypothermia by preventing rewarming of the left ventricle to the perfusate temperature. Two methods of easily accomplishing pulmonary vein clamping are described. PMID- 3827380 TI - Clamp/repair of traumatic transection of descending aorta. PMID- 3827381 TI - Spontaneous extrusion of epicardial pacemaker leads. PMID- 3827382 TI - Vascular surgery. PMID- 3827383 TI - Oligozoospermia: present status? PMID- 3827384 TI - Cytogenetics and recombinant technology in male infertility. PMID- 3827385 TI - Intersexuality: definitions, diagnosis, and dilemmas. PMID- 3827386 TI - Sperm/cervical mucus contact test for sperm antibodies. AB - Thirteen couples with a history of primary infertility for at least 3 years were selected according to the following criteria: a positive sperm/cervical mucus contact (SCMC) test, the presence of sperm-agglutinating antibodies in the cervical mucus, and/or seminal fluid of one of the partners. Nine of the males and 4 of the 13 females were accordingly treated with high dosages of corticosteroids for 6 months. Among 4 (44%) males and 2 (50%) females a pregnancy ensued. Four (80%) of the 6 patients in whom a pregnancy was reported showed not only a decline in their sperm antibody titer but also a decrease in the percent shaking spermatozoa during SCMC testing. PMID- 3827387 TI - Sperm/cervical mucus contact test compared to immunobead test for sperm antibodies. PMID- 3827388 TI - Possible changes in male fertility over a 15-year period. PMID- 3827389 TI - Ultrastructural changes in the acrosome of human sperm during freezing and thawing: a pilot trial. AB - As a pilot trial, a semen sample was diluted with a glucose-citrate-egg yolk diluent and frozen in 0.5 ml PVC paillettes in liquid nitrogen vapor. Motility and acrosome integrity of the sample were evaluated before and after freezing, and longevity was monitored up to 6 h postthaw. Acrosome integrity was assessed by comparing Spermac-stained thin smears with TEM. Acrosome damage was found to be progressive, and four main types of acrosome state were identified and illustrated. PMID- 3827390 TI - Sperm swimming velocity as evaluated by frame lapse videography and computer analysis. AB - A videographic method is described to measure the swimming velocity of fresh human, frozen-thawed bull and white mussel (Donax serra) sperm. The method can be accurately controlled. The pattern of sperm movement can be analyzed on a frame by-frame basis or over 0.0206-sec intervals. Sperm velocities can be standardized per time unit. Sperm swimming velocity of different species ranging from very slow to very fast erratically moving sperm can be measured. Parameters such as swimming speed, progressive swimming speed, progressiveness ratio, and percentage motility can be evaluated. PMID- 3827391 TI - Male reproduction in the Cape horseshoe bat (Rhinolophus capensis). PMID- 3827392 TI - Sperm differentiation in cestodes. PMID- 3827393 TI - Respiratory physiology of fish, amphibian, and mammalian sperm. AB - Teleost (Liza dumerili) and toad (Xenopus laevis) sperm consume oxygen optimally at high oxygen tensions (120-150 mm Hg) close to the saturation level of the diluents. Oxygen consumption of sperm of both species declines rapidly below a pO2 of 60 mm Hg. Sperm of both species consume more oxygen per unit sperm in dilute than in dense sperm suspensions and conform to the so-called respiratory dilution effect. In contrast, ram sperm do not conform to the respiratory dilution effect and utilize oxygen with the same efficiency over a pO2 range of 4 130 mm Hg. Sperm respiration over this range of oxygen tensions was therefore linear and averaged 19 mu 10(2) X 10(-8) sperm X h-1. PMID- 3827394 TI - [Genetic polymorphism in humans and animals. Samedi, 12 April 1986. Proceedings]. PMID- 3827395 TI - [Development of the histocompatibility system in man and animal]. PMID- 3827396 TI - [The HLA system in human pathology. Disease associations and regulation of the immune response]. PMID- 3827397 TI - [Introduction to exotic pathology encountered by the European clinician]. PMID- 3827398 TI - [Risk of legionellosis related to the environment in countries with a temperate climate]. PMID- 3827399 TI - [Criteria used in the assay of dominant lethal mutations as a function of the relationship existing between the distribution of corpora lutea and those of other variables]. PMID- 3827400 TI - Loss of water from heart muscle cells during aging of rats as measured by X-ray microanalysis. AB - Age-dependent changes of the intracellular water content (IWC) of the rat myocardium have been measured by X-ray microanalysis of deep-frozen bulk specimens (Zs.-Nagy et al., 1982), using a slow warming up and drying of a very superficial layer of the sample, in order to minimize space charging effects. These results were compared with those calculated from the conventionally measured tissue water contents (TWC) and data from literature of morphologically estimated volume density of the extracellular space (David et al., 1981). The IWC values obtained from these two independent methods are in very good agreement, showing that the etching of the surface during the bulk specimen analysis is sufficiently small, i.e., it does not result in any considerable error in the quantitative X-ray microanalysis. The IWC of heart muscle cells decreases significantly with advancing age (from about 80% by weight at the age of 14 days to 71% by the age of 24 months). This observation is consistent with the membrane hypothesis of aging (Zs.-Nagy, 1978). Comparison of the IWC with TWC of the heart muscle shows that the increase of the volume density of the extracellular space during aging balances the age-dependent loss of myocytes to a certain extent. PMID- 3827401 TI - Age-dependent alterations of the intracellular water and electrolyte content of heart and muscle cells. AB - Age-dependent alterations in intracellular concentrations of monovalent ions (Na+, K+ and Cl-) were measured in heart and muscle cells of rats using energy dispersive X-ray microanalysis of bulk specimens. Separate measurements were performed in order to get the elemental concentrations in the dry mass of the cells, and to determine the intracellular water and dry-mass content. The in vivo concentrations were calculated from these two measurements assuming that the monovalent ions were dissolved in the cell water. A statistically significant decrease was measured in the water content of the myocytes of old rats, suggesting an increase in density and viscosity of the cytoplasmic colloid during aging. This loss of cellular water was accompanied by a significant increase in both the single ion concentrations and the total monovalent ion content of the intracellular water. These age-dependent alterations in heart and muscle cells are similar to those demonstrated previously in neurons and hepatocytes. PMID- 3827402 TI - Age-related morphological rearrangements of synaptic junctions in the rat cerebellum and hippocampus. AB - A quantitative investigation has been carried out on the age-related morphological changes of the synaptic junctions in the cerebellar glomeruli and in the supragranular layer of the hippocampal dentate gyrus of young (3 months), adult (12 months) and old (28-30 months) rats. The numerical (Nv) and surface (Sv) density as well as the average length (L) of E-PTA stained synapses was calculated by means of morphometric methods. The results we obtained showed a similar trend in both these areas of the CNS. Nv significantly increased between young and adult rats and significantly decreased in the old group, when compared both to young and adult animals. Sv appeared to be unchanged comparing young and adult animals, whereas it was significantly reduced in the old group. L showed a decrease between 3 and 12 months of age and appeared to be markedly increased in the old animals when compared to adult values. From the present findings it can be inferred that number (Nv) and size (L) of the synapses are in a close inverse relationship which, through the organism's life span, aims to maintain the constancy of the surface contact area (Sv) among the dendritic network. By considering Nv, L and Sv altogether per age group, we were able to obtain a reliable measurement of the morphological aspect of synaptic plasticity through different periods of the life. With regard to aging we found that, despite the 'compensative synaptogenesis' brought about by the increased size (L) of the synaptic appositions, the reactive capacity of old nerve cells is seriously impaired. PMID- 3827403 TI - Effects of aging on the recycling via the pentose cycle and on the kinetics of glycogen and protein metabolism in various organs of the rat. AB - The rate of metabolic kinetics and the frequency of biological cycles may be correlated with the rate of aging and the maximum life-span potential. Therefore, investigations either into changes with age of such parameters within one species or into differences between species may give some information about the genetic programming of the aging process. Male Sprague-Dawley rats aged 3.5, 7, 12, 17, 23 and 33 months (m) were used to determine the changes with age of those metabolic pathways mentioned in the title, using the liver, kidney, brain, heart and the skeletal muscle. The maximum percentage of glucose utilization via the pentose pathway, compared to the total glucose utilization, was calculated after intravenous administration of D-[1-14C]- and D-[6-14C]glucose by the determination of the trioses (as lipids) 3 hours after the application. Glycogen kinetics was determined analogously. Total protein metabolism was observed using the essential amino acid L-[2,5-3H]histidine. The results indicate a decrease in the glucose utilization via the pentose pathway in the course of aging in liver, kidney, heart and skeletal muscle and a decrease from 3.5 months on in brain, a small but not significant change of the kinetics of glycogen metabolism (a lower turnover), and a reduced rate of protein synthesis in liver, kidney, heart and brain through an age of 23 months, followed by an elevated rate. Brain did not show any changes. The reduction of the pentose pathway may possibly be the cause of higher lipofuscin accumulation in the cells of some organs, lacking sufficient reduction equivalents for lipid metabolism. Furthermore, there could exist a connection with the reduced protein turnover, because less riboses are provided for the synthesis of nucleic acids. PMID- 3827404 TI - The change with age in biogenic amines and their metabolites in the striatum of the rat. AB - The changes in the content of the biogenic amines and their metabolites in the striatum of the rat during the aging period (3-30 months) have been studied. The maximum levels of dopamine (DA) have been found at 6 months of age and this concentration is maintained until 24 months. Between 24 to 30 months there is a decrease in the concentration of this compound. At that time, there is a slight increase in 3,4-dihydroxyphenyl acetic acid (DOPAC) and homovanillic acid (HVA) concentration, the main metabolites of DA, which suggests a slight increase in DA metabolism. The 3-methoxytyramine (3-MT) concentration also increases at this time. The maximum concentration of noradrenaline (NA) was also found at 6 months of age. Tryptophan has the maximum concentration after DA and this is maintained over the life-span of the rat. The concentration of serotonin (5-HT) is high and does not change during this period. However, the concentration of 5-HT, as occurred with DA, decreased between 24 and 30 months. Also the DA/5-HT ratio does not change during the period studied. PMID- 3827405 TI - Age-dependent phagocytosis of erythrocytes by the isolated perfused rat liver after galactosamine hepatitis and alpha-naphthylisothiocyanate cholestasis. AB - Isolated rat livers were perfused with an immunoglobulin-free fluid containing homologous rat erythrocytes suspended in an isotonic saline solution. Galactosamine hepatitis and alpha-naphthylisothiocyanate cholestasis were induced as experimental liver diseases. The glutamic oxalacetic transaminase (GOT) and guanosine triphosphate (GPT) activities, the potassium level as well as the redox quotients of lactate/pyruvate and beta-hydroxybutyrate/acetoacetate were determined as liver function parameters. RESULTS: The same dose of galactosamine led to two different types of reaction. The group suffering more damage (rendering maximum GOT activities) phagocytosed significantly (p less than or equal to 0.05) more erythrocytes than the other group. Galactosamine hepatitis significantly slows down the phagocytosis of erythrocytes. The function of the mononuclear phagocytosing cells in the liver is intact. The alpha naphthylisothiocyanate (ANIT) cholestasis significantly reduces the capacity of the mononuclear phagocytosing cells in the liver. Young erythrocytes were phagocytosed significantly better than old ones in either type of liver damage, in galactosamine hepatitis and in ANIT cholestasis as well as by healthy livers. PMID- 3827406 TI - Antithrombotic efficacy and its time course after application of naftidrofuryl in vivo. AB - The antithrombotic efficacy of naftidrofuryl (Naf) was assessed with the following method: an endothelial cell damage is induced in arteriolar vessels of the hamster cheek pouch by intravascular excitation of fluorescein-isothiocyanate dextran. On these damaged cells, platelets adhere and a stable thrombus grows. This process progressively obstructs the vessel's aperture and hence reduces blood flow. Blood cell velocity may thus be used to quantitate thrombus growth. Thrombus growth is assessed before and repetitively after parenteral application of 1, 5 and 20 mg/kg Naf. Efficacy is compared with 10 and 100 mg/kg acetylsalicylic acid. Naf shows a significant antithrombotic property, beginning with a dosage of 1 mg/kg which further increases relative to the dosage, and the stability of thrombi decreased. The antithrombotic effectiveness of Naf increases continuously during 120 min after application. Vessel diameter and cell velocity were the same in compared groups thus excluding an influence of the vasodilatory property of Naf on thrombus growth. Sixty min after application, 5 mg/kg Naf was as effective as 10 mg/kg acetylsalicylic acid. PMID- 3827407 TI - Combined phenytoin and salicylate effects on thyroid function tests. AB - To evaluate the effects of salicylates (ASA) on thyroid function tests (TFT's) in patients already taking phenytoin (DPH), 6 adults received a daily dose of DPH to achieve a steady state serum DPH. ASA was then added stepwise (325, 650, 975 mg q 4hr) at 2-day intervals. TFTs, total serum and free salivary DPH were measured. Therapeutic steady state phenytoin levels caused a significant decrease in serum free thyroxine (FT4), total T4, total T3 (TT3) and a significant but slight increase in T3RU. The TSH remained normal. When ASA was co-administered with DPH, the serum free DPH increased, the total T4, TT3, FT4 significantly decreased further, and the T3RU significantly declined toward pre-treatment levels. The decrease of FT4 was in contrast to the increase in FT4 known to occur with ASA alone. Despite the decline in total T4, TT3, and FT4, the TSH remained normal. In conclusion, when ASA is co-administered with DPH, further alterations in TFTs occur which require cautious interpretation. Our in vivo and in vitro data show that these changes are consistent with ASA-induced displacement of T4 from its binding proteins and DPH-induced clearance of FT4. PMID- 3827408 TI - Effect of mexiletine on reperfusion-induced ventricular arrhythmias: comparison with lidocaine. AB - Thirty mongrel dogs underwent proximal occlusion of the left anterior descending coronary artery to evaluate the comparative action of mexiletine and lidocaine on ventricular arrhythmias during myocardial reperfusion. Heart rate, arterial blood pressure, left ventricular end-diastolic pressure and dp/dt max were evaluated before and at the 20th and 25th min after coronary occlusion; at the 25th min coronary occlusion was removed. Dogs were randomly assigned to one of the following groups of 10: 1) control group; 2) dogs given i.v. mexiletine; 3) dogs given i.v. lidocaine. As expected, during ischemia, myocardial contractility decreased after mexiletine or lidocaine administration more than in the control group. Ventricular arrhythmias during myocardial reperfusion occurred in 9 dogs of the control group (ventricular tachycardia in 2 cases and ventricular fibrillation in 7 cases). Among dogs given mexiletine only 1 had ventricular fibrillation (p less than 0.001 vs control). Six of the 10 dogs given lidocaine had ventricular arrhythmias (ventricular tachycardia in 5 cases and ventricular fibrillation in 1 case) (p = ns vs control group; p less than 0.05 vs mexiletine group). Thus mexiletine and lidocaine had similar effects on cardiac function during myocardial ischemia and only mexiletine showed a protective effect against reperfusion ventricular arrhythmias. PMID- 3827409 TI - Tricyclic antidepressant inhibition of the electrical evoked responses of the rat urinary bladder strip-effect of variation in extracellular Ca2+ concentration. AB - The effects of tricyclic antidepressants-amitriptyline (AMI) and desipramine (DMI)--on the rat urinary bladder strip contractility evoked by field stimulation was studied at different calcium ion (Ca2+) concentrations. In the normal Tyrode solution-(Ca2+ concentration 1.8 mM) the tricyclics reduced the electrical twitch heights. In this medium, the inhibitory effect of atropine on the twitch height was enhanced by these agents. When the Ca2+ concentration was increased 2-fold (3.6 mM) and 4-fold (7.2 mM) the effectiveness of the tricyclics was significantly reduced. When the Ca2+ concentration was reduced to one-quarter (0.45 mM) and half (0.9 mM), electrical stimulation of the strips produced contractions which were about 15% of the control twitch height in normal Tyrode solution. At these Ca2+ concentrations, the tricyclics did not produce a further reduction in twitch height. These results provide further evidence in favour of an interference with Ca2+ movement as the mechanism of the direct muscle relaxant effect of the tricyclics on the urinary bladder. PMID- 3827410 TI - Electrophysiological and behavioral assessments of dopamine autoreceptor activation to apomorphine in rats. AB - Single neuronal activity was recorded extracellularly in the substantia nigra pars compacta (SNC) in rats anesthetized with chloral hydrate. Haloperidol in a dose of 10 micrograms/kg had no significant effects on the SNC neurons. R( )apomorphine (cumulative i.v. dose of 40 micrograms/kg, given as: 5, 5, 10 and 20 micrograms/kg) inhibited the firing rate of dopaminergic neurons, in a dose dependent manner. Haloperidol (cumulative i.v. dose of 10 micrograms/kg, as: 2.5, 2.5 and 5 micrograms/kg) reversed the effect of apomorphine. Complete reversal of the firing rate to haloperidol was observed with a dose of 10 micrograms/kg. In rats pretreated with 10 micrograms/kg of haloperidol, there was a dramatic shift to the right of the apomorphine dose-response curve (cumulative i.v. dose of 800 micrograms/kg, as: 50, 50, 100, 200 and 400 micrograms/kg), and this inhibition was reversed by haloperidol (cumulative i.v. dose of 400 micrograms/kg, as: 50, 50, 100 and 200 micrograms/kg). Apomorphine in doses of 40 micrograms/kg and 800 micrograms/kg elicited yawning behavior and stereotypy, respectively. Apomorphine in a dose of 800 micrograms/kg elicited stereotypy in rats treated 3 min before with 10 micrograms/kg of haloperidol. Therefore, electrophysiological determinations of events in the SNC dopaminergic neurons are given support by the behavior observed in these rats. PMID- 3827411 TI - Effects of long-term administration of propyldazine on blood pressure and counter regulatory systems in conscious hypertensive dogs. AB - The counter-regulatory effects in response to blood pressure reduction by propyldazine were studied in conscious dogs with bilateral cellophane perinephritis hypertension. During a 22-day period of chronic treatment, the initial increase in heart rate, plasma renin activity, angiotensin II, aldosterone, and vasopressin, which indicate counter-regulation to the drug induced decrease in blood pressure, vanished. On the fifth day of treatment another, presumably cellular mechanism, had taken over the restitution of blood pressure and thereby led to tolerance towards the action of further propyldazine administration. Seven days after the end of chronic treatment a renewed propyldazine administration did not produce the same effects as obtained with the first administration; after 28 days the hypotensive effect of propyldazine was identical to the one observed before treatment. PMID- 3827412 TI - MEDIS. A philosophical breakthrough in medical information management. PMID- 3827413 TI - The complex of myxomas, spotty pigmentation, and endocrine overactivity. PMID- 3827414 TI - Exposing the iceberg of unrecognized disability. The benefits of functional assessment of the elderly. PMID- 3827415 TI - Outcome and function following prolonged mechanical ventilation. AB - Prolonged periods of mechanically assisted ventilation are reasonably common occurrences, but there are no data regarding outcome for this patient population. We retrospectively reviewed the medical records of 250 consecutive patients with a minimum of ten days of ventilatory support during a five-year period. The overall survival was 39.2% at discharge, 28.6% at one year, and 22.5% at two years. Age and functional status prior to respiratory failure were the best predictors of survival. In addition, patients with postoperative or neurologic disease as the cause of respiratory failure were found to have the highest survival rate while those with cardiac and pulmonary disease had the worst prognosis. Of those patients who survived to discharge, 39.6% were institutionalized (nursing homes) and 32.7% were confined to their homes. Prolonged mechanical ventilation is associated with a limited survival and poor functional status in many who do survive. PMID- 3827416 TI - The use of isosorbide in the treatment of severe, uncontrolled hypertension. AB - Isosorbide dinitrate was administered sublingually and compared with placebo in a double-blind, randomized fashion to determine its effectiveness and safety in the rapid control of severe arterial hypertension. In 11 patients who received 10 mg of isosorbide dinitrate, blood pressure (BP) dropped from 205 +/- 8/131 +/- 3 to 166 +/- 9/106 +/- 5 mm Hg at 120 minutes. In eight patients who received placebo, BP dropped from 203 +/- 8/130 +/- 3 to 193 +/- 11/122 +/- 5 mm Hg at 120 minutes. When 10 mg of isosorbide dinitrate was administered sublingually after 120 minutes to placebo-pretreated patients, their BP dropped to 161 +/- 7/105 +/- 6 mm Hg at 240 minutes. Our study group (19 patients) was compared with a "control" group (six patients) whose BP (203 +/- 12/132 +/- 8 mm Hg) was treated only with conventional antihypertensive medications and bed rest; five (83%) of the six controls achieved steady BP control at 24 hours vs nine (47%) of the 19 study patients pretreated with isosorbide. There were no side effects, including hypotension, orthostatic effect, and reflex tachycardia. Sublingual isosorbide safely and effectively lowers systolic and diastolic BP in patients with severe, uncontrolled arterial hypertension. PMID- 3827418 TI - Warfarin therapy. The effect of heparin on prothrombin times. AB - Sharp decreases in the prothrombin time after discontinuing heparin have been reported in patients undergoing oral anticoagulant therapy. Twenty-five patients receiving continuous intravenously administered heparin and orally or intravenously administered warfarin were studied. All patients had prothrombin times greater than 1.40 times control, and activated partial thromboplastin times 1.5 to three times control before discontinuing heparin therapy. Prothrombin times on the heparin infusion and four to six hours after it was discontinued were compared. The mean change in the prothrombin time was -1.60 s with a range of +0.8 to -5.5 s. Eight (32%) of 25 patients had a decrease of greater than 2 s. The decrease in prothrombin time correlated poorly with heparin dose or activated partial thromboplastin time in patients taking heparin. Since the change in prothrombin time is unpredictable, a repeated prothrombin time is recommended after stopping heparin therapy prior to discharging a patient. PMID- 3827417 TI - Low serum cobalamin levels in primary degenerative dementia. Do some patients harbor atypical cobalamin deficiency states? AB - Serum cobalamin (vitamin B12) levels were analyzed retrospectively in 17 patients with primary degenerative dementia and 11 with specific demonstrable causes of dementia (secondary dementia). The prevalence of low cobalamin levels was significantly increased in primary dementia (29% vs 0% in secondary dementia). Because typical findings of deficiency often seemed absent, we prospectively studied two other patients with primary dementia and low cobalamin levels. Neither of these two had megaloblastic anemia; one had a normal Schilling test while the other's was borderline. Despite this absence of the expected findings, the deoxyuridine suppression test gave biochemical evidence of cobalamin deficiency in both cases. Our survey of 28 patients thus established that low serum cobalamin levels are frequent in primary dementia. Our findings in the two prospectively studied cases (as well as in some of the patients in the survey) indicate that these levels are associated in at least some cases with an atypical deficiency state rather than with disorders such as pernicious anemia. Such atypical deficiency states cannot be identified by classic hematological criteria or by the Schilling test. PMID- 3827419 TI - 'Idiopathic' hematuria. A prospective evaluation. AB - Evaluation of the patient with isolated hematuria is often problematic. Sixty five patients with this entity were studied prospectively with renal biopsy; serum IgA levels, skin biopsy for IgA immunofluorescence, and HLA typing were also studied in most patients. Previously, all patients had had a non contributory history and physical examination, normal results of structural evaluation, serologic and clotting studies, and proteinuria of less than 1000 mg/d (less than 1 g/d). Seventy-eight percent were found to have abnormal renal biopsy results and were divisible into two patient groups: those with IgA nephropathy (49%, 32/65) and those with multiple nonspecific abnormalities (29%, 19/65). Ancillary testing, demographic data, and clinical data, other than abnormal amounts of proteinuria, were not distinguishable between these groups and patients with normal renal biopsy results (22%, 14/65). Etiologic differentiation of the hematuria was possible only by renal biopsy. At present, renal biopsy in this group of patients makes no difference therapeutically or, probably, prognostically. It should not, therefore, be considered necessary for routine management of asymptomatic hematuria. PMID- 3827420 TI - Clinical confirmation of organophosphate poisoning by serial cholinesterase analyses. AB - Three groups of agricultural workers with a history of exposure to organophosphate pesticides were followed up to evaluate the utility of sequential postexposure cholinesterase analyses to confirm organophosphate intoxication in the absence of baseline cholinesterase values. Three or more cholinergic symptoms were reported by 50 of the 72 patients. Initial plasma and red blood cell cholinesterase values of 45 of the workers were above the lower limit of the laboratory normal range. Follow-up examinations, including cholinesterase analyses, were conducted on 57 patients. When final postexposure cholinesterase determinations were taken as estimates of individual normal baseline values, the plasma and red blood cell activity of the three groups was shown to have been inhibited. The data support the use of sequential postexposure plasma cholinesterase analyses to confirm the diagnosis of organophosphate-induced illness in the absence of baseline values. PMID- 3827421 TI - Adrenocortical micronodular dysplasia, cardiac myxomas, lentigines, and spindle cell tumors. Report of a kindred. AB - In a family encompassing three generations, six of 11 evaluated members have two or three elements of a triad comprising adrenocortical micronodular dysplasia, mucocutaneous lentigines, and cardiac myxomas. Evaluation of the adrenals in affected members revealed characteristic pathologic lesions of micronodular adrenal hyperplasia and corticotropin-independent steroidogenesis that correlated with age, suggesting a progressive lesion that begins in early childhood. Since all subjects with micronodular hyperplasia and/or cardiac myxomas also had mucocutaneous lentigines, the skin lesions were markers for affected subjects. This family is one of the larger reported with this syndrome. Of special note was the finding of rare visceral tumors in affected family members, including melanocytic schwannomas and a fibrolamellar hepatoma, signaling another feature of the syndrome. Since 60% of this family encompassing three contiguous generations were affected, the syndrome appears to be inherited as an autosomal or X-linked dominant gene. PMID- 3827422 TI - Serum magnesium and potassium in acute myocardial infarction. Influence on ventricular arrhythmias. AB - Over a 13-month period, serum potassium and magnesium levels were measured in 590 patients admitted to a coronary care unit. Hypokalemia, often in the absence of diuretic use, occurred in 17% of the 211 patients with acute myocardial infarction. Patients with acute myocardial infarction and a potassium level of less than 4.0 mEq/L (4.0 mmol/L) had an increased risk of ventricular arrhythmias (59% vs 42%). Because hypokalemia is common in acute myocardial infarction and is associated with ventricular arrhythmias, routine measurement of serum potassium levels and prompt correction are recommended. Hypomagnesemia occurred in only 4% of the patients, but it was more common in the group with acute myocardial infarction than in the group without myocardial infarction (6% vs 3%). Ventricular arrhythmias occurred in ten of the 13 patients with both acute myocardial infarction and hypomagnesemia, but eight of these patients also had low serum potassium levels. This low incidence of hypomagnesemia does not justify routine measurement of serum magnesium levels. However, the mean level (2.5 +/- 0.4 mg/dL [1.03 +/- 0.16 mmol/L]) in a reference population of healthy volunteers was unexpectedly high and suggests that the low incidence of hypomagnesemia in our population may not be applicable to other centers and may reflect a higher magnesium content in our geographic area of southeastern Ontario. PMID- 3827423 TI - Genetic aspects of sarcoidosis. Class II histocompatibility antigens and a family study. AB - In a study designed to evaluate the concept of inherited susceptibility to sarcoidosis, 73 patients with histologically proved chronic disease of sarcoid lung fibrosis (group 1) underwent typing of HLA-A, -B, -C and -DR antigens. Tests on 156 antiserum samples comprising 52 antigens of A, B, and C loci and on 35 comprising seven DR antigens on the surface of B cells were performed by means of the microdoplet assay of human serum cytotoxins. Two race-matched control groups consisted of 37 patients with lung fibrosis due to chronic extrinsic allergic alveolitis (group 2) and 162 healthy volunteers (group 3). The study further included a kinship with progressive sarcoidosis. The frequency of HLA-DR5 was significantly increased only in group 1 (relative risk, 6.6). HLA-DR5 was found in 38 patients (52%) in group 1, compared with five (14%) in group 2 and 23 (14%) in group 3. In the one family studied, HLA-DR5 was present only in one member, who had sarcoidosis. This study supports the hypothesis that the role of an infectious agent triggering sarcoidosis cannot be envisaged without considering genetically linked cofactors. PMID- 3827424 TI - Functional assessment of the elderly. A comparison of standard instruments with clinical judgment. AB - Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable through early intervention. PMID- 3827425 TI - Blocking of iron absorption by a preliminary oral dose of iron. AB - Using a small-dose iron tolerance test (ITT) in mildly iron-deficient healthy adults, we have examined the phenomenon of mucosal block. First proposed and demonstrated by Hahn et al with radioiron, "mucosal block" describes diminished avidity for iron of the intestinal mucosa following an orally administered blocking dose. In the ITT, the index of absorption is an increase in plasma iron concentration, rather than retained radioactivity. The absorption of a blocked 10 mg test dose of iron was compared with that of a 10-mg control dose given to the same subject. Both 60- and 30-mg blocking doses of iron resulted in diminished absorption of the test dose. The refractory state of the intestine lasted as long as 24 hours. PMID- 3827426 TI - The effect of dietary protein restriction on the progression of diabetic nephropathy. A 12-month follow-up. AB - Eight patients with insulin-dependent diabetes mellitus and progressive renal dysfunction as determined by serial serum creatinine values were placed on a diet containing 40 g of high-biologic-value protein. Selected factors of renal function were determined over a 12-month interval. After the first 12 months of the protein-limited diet, creatinine clearance was not significantly changed. The rate of decline in renal function during the dietary protein restriction slowed from the rate over the prior 12 months in seven patients. Five of these seven demonstrated improvement in renal function. Daily urinary protein excretion decreased significantly, from 2105 +/- 1355 to 142 +/- 164 mg/d (2.11 +/- 1.36 to 0.14 +/- 0.16 g/d). Body weight did not change significantly, whereas serum albumin level increased significantly from a mean of 3.5 +/- 0.6 to 4.3 +/- 0.3 g/dL (35 +/- 6 to 43 +/- 3 g/L). These findings suggest that dietary protein restriction has a beneficial role in treating patients with diabetic nephropathy. PMID- 3827427 TI - Predisposing factors for the diabetic hyperosmolar state. AB - To better understand risk factors for the development of diabetic hyperosmolar state (DHS), we studied 135 patients with DHS and 135 age-matched randomly selected diabetic controls admitted to two general hospitals during an 11-year period. To be eligible for the study, patients had to have a hospital admission glucose level of greater than 600 mg/dL (33.3 mmol/L) and an osmolality of greater than 325 mOsm/L (32.5 mmol/L). Patients were significantly more likely than controls to be female (71% vs 53%), to be nursing-home residents (28% vs 15%), to be newly diagnosed diabetics (36% vs 7%), to have a history of dementia (18% vs 8%), and to have an acute infection at the time of admission to the hospital (39% vs 19%). Multivariate analysis revealed three significant independent predictors of DHS: female gender, newly diagnosed diabetes, and acute infection; nursing-home residence and dementia had no independent effect. Other functionally debilitating diseases, acute illnesses, or medications that may impair glucose tolerance were not significantly associated with DHS. PMID- 3827428 TI - A two-year review of salicylate deaths in Ontario. AB - A review of all fatal cases of salicylate poisoning in Ontario during 1983 and 1984 disclosed that salicylates were the most common agent responsible for single drug deaths (51 cases in two years). The patients' conditions on arrival at the hospital were variable: 31.4% of the patients were dead on arrival, 21.6% of the patients were comatose, and 45.1% of the patients were alert but symptomatic on arrival. Interestingly, the third group had the highest serum salicylate levels. The patients who were alive on arrival at the hospital died an average of 13 hours later. Autopsy results showed that 50% of patients had pulmonary abnormalities, 28% had lesions of the gastrointestinal tract, and 18% had nervous system abnormalities; 25.6% of patients on whom autopsies had been performed had no acute pathologic changes. Management difficulties occurred in establishing the diagnosis, administering activated charcoal, and using hemodialysis. Suggestions are offered for the improvement of the care provided to patients with severe salicylate poisoning. PMID- 3827429 TI - Transplantation of thymic tissue into patients with AIDS. An attempt to reconstitute the immune system. AB - Thymic epithelial fragments were transplanted into 15 patients in an advanced stage of the acquired immunodeficiency syndrome (AIDS). One patient was given interleukin 2 in addition to thymic tissue. We demonstrated the following: Thymic epithelial fragments cultured before transplantation to remove T cells survived for months after transplantation in eight of 15 patients and seemed to be responsible for a partial, selective, but transient repopulation of the circulating T-cell pool. The absolute number of T8 cells, but not T4 cells, increased three to four weeks after the procedure in eight of the 15 subjects. This increase in T8 cells was associated with clinical improvement in some cases and increased T-cell responsiveness in vitro. Thymic tissue transplantation as a single therapeutic maneuver is unlikely to reconstitute the immune system of patients with AIDS, but the potential of the approach, used in combination with agents that block replication of human T-cell lymphotropic virus type III, deserves further study. PMID- 3827430 TI - Association of diabetes mellitus with gastric bezoar formation. AB - The association of diabetes mellitus with gastric bezoars is not well documented. Our endoscopic experience over a seven-year period (1979 to 1985) included 3247 esophagoduodenoscopies (EGDs). Bezoars were found in 14 patients (0.4%). The mean age of these 14 patients was 63 years (range, 27 to 84 years); there were eight men and six women. In 11 patients, there was a history and/or findings of peptic ulcer disease (PUD). Two patients had prior surgery (Billroth II in one and vagotomy in another). Seven patients had diabetes mellitus; five had diabetes for over five years, and three of these five had diabetes for over ten years. Diabetes was newly diagnosed in one patient. Except for the newly diagnosed patient, the other diabetic patients had evidence of autonomic neuropathy. Two other patients (not included with the diabetic patients) had hyperglycemia only during stress. The three patients with bezoars but without PUD all had diabetes for many years (9, 17, and 19 years). In two control groups of 14 patients each who also underwent endoscopy, only one diabetic patient was discovered. We conclude that diabetes mellitus and associated gastropathy are major risk factors for bezoar formation, especially in the absence of PUD. PMID- 3827431 TI - Lactose and calcium absorption in postmenopausal osteoporosis. AB - The prevalence of lactase deficiency and the relationship between lactose and calcium malabsorption in postmenopausal osteoporosis has been assessed in 46 subjects. Malabsorption of lactose occurred in 25 (54%) of the subjects and was associated with a significantly lower milk intake. Malabsorption of calcium occurred in 11 (44%) of the lactase-deficient subjects and in 11 (52%) of normal lactose absorbers. There was no relationship between lactose and calcium malabsorption. Vertebral and forearm mineral densities were not significantly different between normal lactose absorbers and lactase-deficient subjects. PMID- 3827432 TI - A reappraisal of the United Kingdom epidemic of fatal asthma. Can general mortality data implicate a therapeutic agent? AB - The 1960s epidemic of asthma deaths that affected young persons in England and Wales, as well as in other countries, was attributed to the effect of newly available pressurized aerosols containing sympathomimetic bronchodilators. The subsequent decision to ban the nonprescription sale of these agents in the United Kingdom represented a unique use of national and international mortality data. The application of such data for decisions about therapeutic agents has implications for the current rise of asthma deaths in New Zealand, for the recent United States regulatory action regarding the nonprescription sale of aerosolized bronchodilators, and for the appraisal of adverse reactions to other pharmaceutical substances. This article is concerned with the quality of the scientific evidence used to implicate bronchodilators in the 1960s epidemic, and also with the strengths and weaknesses of the ecologic studies on which the implication depended. After concluding that the causal link between asthma deaths and bronchodilators was not supported by satisfactory scientific evidence, we present new data and an alternative diagnostic-exchange hypothesis that may, in part, help explain the original association. PMID- 3827433 TI - Symptomatic hypotension induced by nifedipine in the acute treatment of severe hypertension. AB - The optimal acute treatment for severe hypertension remains controversial. In the last few years, the use of sublingual and oral nifedipine has been supported by a growing literature and clinical experience. Most reviews have minimized the risk of hypotension caused by nifedipine therapy. This report describes three patients who developed profound hypotension after acute treatment of hypertension with the usual doses of nifedipine. A review of the literature reveals no previous reports of symptomatic hypotension from the use of nifedipine alone in this setting. Clinicians should be aware of this potentially life-threatening toxicity and titrate doses and monitor patients accordingly. PMID- 3827434 TI - Endothelial cells. Not just a cellophane wrapper. AB - This summary provides an overview of some of the new information about the metabolic and regulatory functions of vascular endothelial cells and discusses possible important consequences of endothelial abnormalities in disease. PMID- 3827435 TI - Allergic interstitial nephritis due to diazepam. AB - A 56-year-old man developed allergic interstitial nephritis and deterioration of preexisting chronic renal failure after receiving diazepam. On discontinuation of diazepam, kidney function returned to the baseline level and itching, eosinophilia, and eosinophiluria subsided. A causative correlation between allergic interstitial nephritis and diazepam is suggested. PMID- 3827436 TI - Accurate patient diagnosis of acute porcine valve failure. AB - Spontaneous porcine bioprosthetic valve failure is usually of gradual onset. We report a case of acute porcine mitral valve rupture resulting in rapid hemodynamic decompensation. The patient perceived the moment of valvular failure as the abrupt onset of a vibrating sensation in his chest. As the number of patients with porcine bioprostheses continues to increase, acute valvular failure may become a more common clinical entity. PMID- 3827437 TI - Severe symptomatic atrioventricular block induced by pilocarpine eye drops. AB - An 89-year-old man with chronic glaucoma received hourly pilocarpine eye drops for seven hours, when he developed third-degree atrioventricular block with a slow idioventricular escape rate. After discontinuing the pilocarpine, the atrioventricular block gradually disappeared. The site of pilocarpine-related block was most likely within the His-Purkinje system. PMID- 3827438 TI - Pulmonary edema associated with subarachnoid hemorrhage. Evidence for a cardiogenic origin. AB - A 56-year-old woman with no history of cardiac disease developed acute pulmonary edema following a subarachnoid hemorrhage. A constellation of findings, including elevated creatine kinase MB isoenzyme activity in the absence of electrocardiographic or scintigraphic evidence of acute myocardial infarction, elevated pulmonary artery wedge pressure, segmental wall motion abnormalities, and depressed ejection fraction of the left ventricle demonstrated by two dimensional echocardiography and radionuclear ventriculography, pointed to a direct myocardial injury leading to cardiac failure. The evidence for cardiogenic origin of pulmonary edema provided by this case is in contrast to the belief that "neurogenic" pulmonary edema is of noncardiac origin. PMID- 3827439 TI - Recurrent reversible acute renal failure from amphotericin. AB - A patient with cryptogenic cirrhosis and disseminated sporotrichosis developed acute renal failure immediately following the administration of amphotericin B on four separate occasions. The abruptness of the renal failure and its reversibility within days suggests that there was a functional component to the renal dysfunction. We propose that amphotericin, in the setting of reduced effective arterial volume, may activate tubuloglomerular feedback, thereby contributing to acute renal failure. PMID- 3827440 TI - Atrial septal aneurysm associated with systemic embolism and interatrial right-to left shunt. AB - Prior to the advent of two-dimensional echocardiography, atrial septal aneurysm was rarely diagnosed during life. In this article, two-dimensional echocardiography identified an atrial septal aneurysm as the site of intracardiac right-to-left shunting, causing hypoxemia in a patient with acute right ventricular infarction. In addition to this rare presentation, the patient also had systemic embolism, a known complication of atrial septal aneurysms. PMID- 3827441 TI - Right-sided Staphylococcus aureus presenting as staphylococcal scarlet fever. PMID- 3827442 TI - Brain metastases from papillary thyroid carcinoma. PMID- 3827443 TI - Propylene glycol intoxication. PMID- 3827444 TI - Valsalva's maneuver for evaluating the integrity of baroreceptor reflex arc. PMID- 3827445 TI - Ascites during treatment with amiodarone. PMID- 3827446 TI - Choice of antibiotics in diabetic foot ulcers. PMID- 3827447 TI - Premedical education. A modest proposal repeated. PMID- 3827448 TI - Significance of blood culture isolates of Staphylococcus epidermidis. PMID- 3827449 TI - Cardioembolic stroke, early anticoagulation, and brain hemorrhage. Cerebral Embolism Study Group. AB - Brain hemorrhage is a feared complication of early anticoagulation therapy in patients with cardioembolic brain infarction. We describe nine patients with cardioembolic stroke who experienced clinical deterioration associated with computed tomography-documented hemorrhagic transformation. The clinical features of these nine patients combined with 15 previously reported cases were analyzed to determine factors associated with hemorrhagic worsening. Patient age, embolic source, and intensity of anticoagulation were not associated with hemorrhagic worsening. Large infarct size and initiation of anticoagulation after early (less than 12 hours) computed tomography were associated with hemorrhagic transformation and clinical worsening in patients who received anticoagulation therapy. PMID- 3827451 TI - Is thiazide-produced uric acid elevation harmful? Analysis of data from the Hypertension Detection and Follow-up Program. AB - Interaction of thiazide diuretics and the serum uric acid and creatinine levels was studied in 3693 stepped care participants in the Hypertension Detection and Follow-up Program not receiving treatment at baseline. Among men grouped into quartiles by their level of uric acid at baseline, the upper quartile (average uric acid, 7.7 mg/dL [458 mumol/L]) had an average serum creatinine level of 1.2 mg/dL (106 mumol/L) and the lowest quartile (uric acid, 4.9 mg/dL [291 mumol/L]) had an average serum creatinine level of 1.1 mg/dL (97 mumol/L). Similar findings were present in women. Therapy with chlorthalidone or other thiazide-type diuretics tended to increase levels of uric acid and creatinine, but the increase in both was less in the upper quartile than in the lower quartile. Among individuals who were prescribed uric acid-lowering drugs, the level of serum creatinine increased just as much as in those whose uric acid level was not pharmacologically lowered. Baseline uric acid level was a weak predictor of mortality in men; the introduction of an interaction term for creatinine suggested that this effect was primarily restricted to those with elevated levels of both uric acid and creatinine at baseline. Change in uric acid level at one year after therapy was inversely correlated with mortality in men. There were few episodes of gout (only 15 recorded in five years among 3693 participants at risk). These results suggest that neither the baseline uric acid level nor the change in uric acid level produced by therapy injures the kidney. These results suggest no reason to lower uric acid levels pharmacologically in the treated hypertensive patient who is not gouty. They leave unanswered whether there is a predictive value to baseline uric acid level not explainable by other correlated cardiovascular risk factors. PMID- 3827450 TI - Peripheral emboli from left ventricular thrombi of different echocardiographic appearance in acute myocardial infarction. AB - In four patients with anterior wall acute myocardial infarction (AMI) and left ventricular thrombi diagnosed by two-dimensional (2-D) echocardiography, disappearance of left ventricular thrombi was demonstrated by 2-D echocardiography immediately after the patients had suffered peripheral emboli. Two thrombi were pendulous with free motion during the cardiac contractions; one of these consisted of two separated pendulous clots that disappeared after two episodes of embolization six and 16 days, respectively, after the onset of AMI. Two thrombi were initially broad based, flat, and without intracavitary motion. One thrombus caused two episodes of peripheral emboli; the other began as a flat thrombus without intracavitary motion but progressed to show central echolucency and, then, vigorous intracavitary motion of the margin prior to embolization. Five of six embolic episodes occurred when these patients were receiving high dose anticoagulants. These anticoagulants were administered once the thrombi were diagnosed. Left ventricular thrombi of very different appearance on 2-D echocardiography may cause embolization, which may occur during therapeutic anticoagulation administered after thrombi have developed in patients with AMI. PMID- 3827452 TI - Pharmacokinetic prediction of serum digoxin concentration in the elderly. AB - The usefulness of pharmacokinetic predictions of serum digoxin concentrations was evaluated in a group of 19 elderly residents of a nursing home. A statistically significant correlation between the calculated and measured digoxin level was found with a 95% confidence limit of 0.55 ng/mL (0.7 nmol/L). Although the use of liquid-filled digoxin capsules and the utilization of the equations described in this article resulted in improved predictability of steady-state serum digoxin concentrations, the calculated serum digoxin level significantly underestimated the measured value in 33% of the patients who were not receiving any medications known to increase serum digoxin concentration. Further studies are needed to improve the reliability of pharmacokinetic models in estimating serum digoxin concentrations in the elderly. PMID- 3827453 TI - Vasculitis in hairy-cell leukemia. AB - Vasculitis associated with hairy-cell leukemia (HCL) has been reported occasionally. We determined the clinical and biological significance of this association by the retrospective study of a series of 50 patients with HCL, including nine patients with vasculitis. The development of vasculitis was not related to a variant of HCL on the basis of hematologic findings and survival. Vasculitis could occur at any time during the course of HCL, and was the circumstance for the diagnosis of HCL in three cases. Clinical and immunohistologic findings were those of hypersensitivity vasculitis in the nine patients. Infection was found to be an associated factor. Thus, eight of nine patients were infected at vasculitis onset, four died of their infection with no remittance of the cutaneous lesions, and three recovered from both infection and vasculitis. The monocyte deficiency in HCL is known to favor intracellular pathogen infection; however, we could not demonstrate that it also correlates with a decrease in the clearance of IgG-sensitized erythrocytes. Finally, vasculitis in HCL appears to be associated with a lasting infection in most cases. PMID- 3827454 TI - A simple index to identify occult bacterial infection in adults with acute unexplained fever. AB - Patients with acute fever (less than three weeks' duration) and no localizing symptoms or physical findings to suggest a source (unexplained fever) may have self-limited illness or occult bacterial infection requiring prompt treatment. To develop a management strategy for patients with unexplained fever, we studied 880 adults who were evaluated for acute fever in an emergency room. At presentation, 135 (15%) patients had unexplained fever. Occult bacterial infection was found in 48 (35%) of these 135 patients, and 21 (44%) of 48 infected patients had bacteremia. Four bacteremic patients were incorrectly discharged from the emergency room without antimicrobial therapy. Neither a "toxic" appearance of the patient nor an initial temperature of greater than or equal to 39.4 degrees C (103 degrees F) were predictive of occult bacterial infection. An index of predictive features was developed that included: age 50 years or older; diabetes mellitus; a white blood cell count greater than or equal to 15,000/mm3 (15 X 10(9)/L); a neutrophil band cell count greater than or equal to 1500/mm3 (1.5 X 10(9)/L); and a Wintrobe erythrocyte sedimentation rate greater than or equal to 30 mm/h. In patients with 0, 1, 2, or 3 or more index features present, the proportions having occult bacterial infection were 5% (1/21), 33% (15/45), 39% (15/38), and 55% (17/31), respectively. All four bacteremic patients incorrectly discharged had two or more of the index features. Adults presenting with acute unexplained fever often have life-threatening bacterial infection. A simple clinical index can be used to estimate the likelihood of occult infection and may reduce the frequency of diagnostic error. PMID- 3827455 TI - Familial Prader-Willi syndrome. AB - Three adult sisters with previously unrecognized Prader-Willi syndrome (PWS) demonstrated the six diagnostic features of this congenital condition: neonatal hypotonia, hypomentia, hypogonadism, obesity, short stature, and dysmorphism. Detailed endocrine investigations were performed, including ovarian biopsy in the propositus. HLA genotype A2 was present in each patient. The normal high resolution prometaphase karyotypes indicated heterogeneity; the absence of the deletion 15q12 frequently found in patients with sporadic PWS distinguished this sibship as representing a possible autosomal recessive type of PWS. Current evidence suggests that the diagnosis of PWS may be often overlooked. Increased clinical awareness of the features of PWS should result in prompt diagnosis and optimal management of affected patients, together with increased understanding of this enigmatic condition. PMID- 3827456 TI - Deflazacort vs prednisone. Effect on blood glucose control in insulin-treated diabetics. AB - Glucocorticoid treatment produces a deterioration of blood glucose control in diabetics. Recent reports have indicated that deflazacort is less diabetogenic than prednisone in healthy subjects. Ten insulin-treated diabetics who required steroid drugs were treated with deflazacort (30 mg/d for four weeks) and prednisone (25 mg/d for four weeks) in randomized, double-blind design after a pretreatment period of four weeks. At the end of each treatment, plasma glucose profile (five determinations per day), hemoglobin A1 level, and insulin requirements were compared. Mean (+/- SEM) plasma glucose level (139 +/- 28 vs 169 +/- 32 mg/dL [7.7 +/- 1.5 vs 9.4 +/- 1.8 mmol/L]) and hemoglobin A1 values (8.81% +/- 1.19% vs 10.71% +/- 1.17% of total hemoglobin) were significantly lower after deflazacort than after prednisone. Also, insulin requirement was significantly lower after deflazacort than after prednisone (29.3 +/- 11.6 vs 47.3 +/- 2.0 U/d). These results indicate that deflazacort, when employed in an anti-inflammatory dose equivalent to prednisone, should prove advantageous in insulin-treated diabetics who require steroid treatment. PMID- 3827457 TI - Treatment of postmenopausal hyperparathyroidism with norethindrone. Effects on biochemistry and forearm mineral density. AB - The effects of norethindrone (5 mg daily) on biochemical variables and forearm mineral density were assessed in 20 postmenopausal women with mild primary hyperparathyroidism. Norethindrone produced a significant fall in plasma calcium levels and the fasting urinary calcium-creatinine and hydroxyproline-creatinine ratios after three months of treatment. There was no change in the plasma parathyroid hormone concentrations. The forearm mineral density before treatment was low in 16 of the 20 patients and there was a significant increase in forearm mineral density after norethindrone treatment. No side effects were reported. We conclude that norethindrone is an effective treatment for mild hyperparathyroidism in postmenopausal women. PMID- 3827458 TI - Bulimia. An underlying behavioral disorder in hyperlipidemic pancreatitis: a prospective multidisciplinary approach. AB - Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy. PMID- 3827459 TI - Potassium-lowering effect of albuterol for hyperkalemia in renal failure. AB - To study the effect of specific beta 2-adrenergic stimulation on potassium metabolism in renal failure, we intravenously administered albuterol (Salbutamol) sulfate, 0.5 mg, to 20 patients with chronic renal failure (glomerular filtration rate, less than 5 mL/min) receiving maintenance hemodialysis. Within 30 minutes after albuterol administration, serum potassium level dropped from 5.6 +/- 0.2 (+/- SEM) to 4.5 +/- 0.2 mEq/L (5.6 +/- 0.2 to 4.5 +/- 0.2 mmol/L). There were no changes in plasma aldosterone levels or arterial pH, but blood glucose and serum insulin levels increased. Albuterol, however, induced similar decreases in serum potassium levels in three diabetic patients while free C peptide levels remained undetectable or subnormal after administration of the drug. Albuterol sulfate alone (0.5 mg intravenously) was also used to treat 24 patients with acute or chronic renal failure and hyperkalemia. Their serum potassium levels dropped from 7 +/- 0.2 mEq/L (7 +/- 0.2 mmol/L) to 5.6 +/- 0.2 mEq/L (5.6 +/- 0.2 mmol/L), 5.6 +/- 0.2 mEq/L (5.6 +/- 0.2 mmol/L), 6 +/- 0.2 mEq/L (6 +/- 0.2 mmol/L), and 6.2 +/- 0.2 mEq/L (6.2 +/- 0.2 mmol/L) at 30, 60, 180, and 360 minutes after receiving albuterol, respectively, and this was accompanied by reversal of the electrocardiographic manifestations of hyperkalemia. Despite inducing transient tachycardia, albuterol was remarkably well tolerated and no serious side effects were observed. beta 2-adrenergic stimulation of intracellular potassium uptake by albuterol is a safe and effective alternative for the treatment of hyperkalemia in renal failure. PMID- 3827460 TI - Audibility of the fourth heart sound. Relationship to presence of disease and examiner experience. AB - To determine the meaning of an audible fourth heart sound (S4), 51 subjects (21 normal and 30 abnormal persons), aged between 38 and 74 years (mean, 55.4 years), were examined by nine "blinded" physicians (four cardiologists, five house staff officers). Audibility scores were compared with phonocardiographic, echocardiographic, and hemodynamic measurements. An S4 was recorded graphically in 35 (68.6%) of all 51 subjects and splitting of the first sound (S1), in 37 subjects (72.5%). The abnormal group did not differ significantly from the normal subjects in incidence of recordable S4 or splitting of S1. Audibility of S4, however, correlated with its recorded amplitude, size, and palpability of the presystolic apical impulse, left ventricular systolic and diastolic diameters, and history of myocardial infarction. Despite variation among examiners, house staff officers were likelier than cardiologists to believe an S4 present even in cases lacking a recordable S4 and in normal subjects and were more apt to believe an S4 present when splitting of S1 was identified graphically. We conclude that an audible S4 continues to provide evidence for cardiac disease, and that increasing examiner experience renders this finding fairly specific. Less experienced examiners are likelier to confuse splitting of S1 with the S4, suggesting that training should be focused on means to improve this differentiation. PMID- 3827461 TI - Amiodarone-induced thrombocytopenia. AB - Amiodarone hydrochloride-induced thrombocytopenia seems to be an additional side effect in the course of amiodarone treatment. Two patients with thrombocytopenia during amiodarone treatment are described, in whom the diagnosis of amiodarone induced thrombocytopenia was made by the fact that thrombocytopenia developed during amiodarone treatment and by rechallenge with the drug. Amiodarone-induced thrombocytopenia is probably due to delayed hypersensitivity reaction as indicated by the strongly positive lymphocyte stimulation test results using amiodarone. According to our results, platelet counts should be included in the routine follow-up of patients within the first two weeks after initiation of amiodarone treatment. PMID- 3827462 TI - Albendazole therapy for neurocysticercosis. AB - Seven patients with chronic parenchymal brain cysticercosis were treated with albendazole for one month at daily doses of 15 mg/kg of body weight. Computed tomographic follow-up studies were made at the following times: a mean of 16 months before the trial; the beginning of treatment; the end of treatment; and three months afterward. Computed tomographic studies at the beginning of treatment showed a total of 157 cysts, the last day of treatment the number had decreased to 39 cysts, and three months later, the total number of lesions was 22; this represents 86% improvement in the number of cystic lesions. Control studies in the same group of patients had shown chronic persistence of lesions without spontaneous improvement in most cases. Two patients had been treated with praziquantel previously with partial response; in both cases albendazole therapy was effective with 100% and 77% improvement. We conclude that albendazole is highly effective for the treatment of parenchymal brain cysticercosis. It is also effective in patients who had shown poor therapeutic response to praziquantel. PMID- 3827463 TI - Reassessment of theophylline toxicity. Serum concentrations, clinical course, and treatment. AB - It has been reported in the medical literature that in cases of theophylline toxicity a relationship exists between the serum theophylline concentration and the severity of symptoms. We reviewed the records of 20 inpatients receiving long term theophylline therapy who had serum theophylline concentrations of at least 20 mg/L (111 mumol/L) or who had symptoms of theophylline toxicity. No relationship between the serum concentrations and the severity of toxic effect was seen. Metabolic abnormalities similar to those previously reported in intentional acute intoxication were noted. Cardiac arrhythmias were seen in approximately half of the patients, hypotension in only one. No patient in whom a conservative form of therapy was initiated at diagnosis went on to develop additional toxic effects. It is our finding that severe toxic reactions to theophylline can occur over a wide range of serum concentrations. Conservative treatment measures, specifically drug discontinuation and interference with additional oral absorption by activated charcoal, should be instituted unless life-threatening symptoms are present, when more aggressive therapy (such as charcoal hemoperfusion) is warranted. PMID- 3827464 TI - Beliefs about osteoporosis. A critical appraisal. AB - The awareness of osteoporosis as a common problem with a large degree of associated morbidity has increased recently. In this article, three beliefs concerning osteoporosis are examined. These beliefs concern the usefulness of radiologic screening for osteoporosis, the prevalence of osteoporotic fractures, and the benefit of calcium supplementation. It is concluded that as a widely used screening test, radiologic examination does not greatly aid in the estimation of risk of future bone fracture; that fewer than one fourth of women will ever have a meaningful complication from excessive bone loss; and that, although low calcium intake is probably inadvisable, the present data do not allow us to recommend any certain level of calcium intake as being optimal. PMID- 3827465 TI - Is the dose of warfarin prescribed by American physicians unnecessarily high? PMID- 3827466 TI - Association of primary hyperparathyroidism with myotonic dystrophy in two patients. AB - In two patients primary hyperparathyroidism developed in association with myotonic dystrophy (MyD). Both patients had solitary adenoma, and the adenomas were surgically removed. After the operation, subjective improvement of muscle weakness was found in one patient. Because parathyroid hormone secretion is regulated by extracellular calcium concentration and because abnormalities in transmembrane calcium transport are thought to play a role in the pathogenesis of MyD, the concurrence of these rather rare disorders in two patients raises the possibility that abnormalities in transmembrane calcium transport may underlie the development of primary hyperparathyroidism in patients with MyD. Although further studies are needed to clarify the possible link between these two disorders, the present study emphasizes the importance of evaluation of parathyroid function in patients with MyD. PMID- 3827467 TI - Henoch-Schonlein purpura following thiram exposure. AB - Henoch-Schonlein purpura (HSP) is an uncommon, nonthrombocytopenic hypersensitivity vasculitis that is often idiopathic, but may be induced by infectious agents, drugs, foods, environmental chemicals, or insect bites. To our knowledge, we report the first recognized case of HSP following exposure to the widely used industrial and agricultural agent, tetramethylthiuram disulfide. Few reports of HSP or other vasculitides resulting from exposure to structurally similar compounds are available. Despite the widespread use of tetramethylthiuram disulfide, many cases of exposure may remain unrecognized, resulting in a subsequent failure to properly identify sequelae. PMID- 3827468 TI - Pharmacology of propylthiouracil in thyrotoxicosis and chronic renal failure. AB - The simultaneous occurrence of thyrotoxicosis and renal failure has rarely been reported in the literature, and data concerning appropriate antithyroid drug management in this circumstance are limited. We studied propylthiouracil pharmacokinetics in one such patient basally and while the patient was receiving hemodialysis. On a day when the patient was not receiving hemodialysis, propylthiouracil serum levels were high, but serum propylthiouracil half-life was not prolonged. During hemodialysis, serum propylthiouracil levels were normal, and the time to peak serum levels was delayed; the disappearance of the drug from the serum was normal after hemodialysis was completed. The amount of propylthiouracil that appeared in the dialysate was approximately 5% of the administered dose. These data suggest that propylthiouracil can be administered in standard dosages to patients with thyrotoxicosis and renal failure. PMID- 3827469 TI - Fatal pneumonia in an adult due to respiratory syncytial virus. AB - Respiratory syncytial virus (RSV) infections in adults are generally mild, and no fatalities in uninstitutionalized adults have been reported. To our knowledge, we document herein the first case of fatal RSV pneumonia in a previously healthy elderly woman living at home, in whom complement fixation titers against RSV rose from less than 1:8 to reach 1:256 at death. Cytoplasmic inclusions characteristic of RSV were detected at autopsy. PMID- 3827470 TI - Macronodular lesions associated with Staphylococcus aureus bacteremia. A condition that resembles a 'lymphocutaneous' syndrome. AB - A 54-year-old man, diagnosed as having Wegener's granulomatosis and treated with a regimen of cyclophosphamide and prednisone and hemodialysis, was found to have Staphylococcus aureus in blood, urine, and pus that were removed from the infected area. He had unusual macronodular lesions of the skin that resembled the lymphocutaneous syndrome. These lesions resolved with antibiotic therapy. To our knowledge, this condition has not been described previously. PMID- 3827471 TI - Prognostic value of antithrombin III in cirrhosis of the liver. PMID- 3827472 TI - What is a restrictive defect? PMID- 3827473 TI - Body volume and surface area/volume ratio in the first trimester of prenatal life. PMID- 3827474 TI - [Experimental morphologic studies of the retina of the goldfish (Carassius auratus L.) after prolonged exposure to light and darkness]. PMID- 3827475 TI - [Total hip replacement]. PMID- 3827476 TI - [Experimental study on the prevention of vasospasm following subarachnoid hemorrhage by a thromboxane A2 synthetase inhibitor, OKY-046]. PMID- 3827477 TI - [Eosinophilia in patients with carcinomas of the stomach and colon: release of eosinophilopoietic factor from carcinoma tissue]. PMID- 3827478 TI - [Experimental and clinical studies on gastric exocrine and endocrine functions following pancreatoduodenectomy with preservation of the stomach]. PMID- 3827479 TI - [Clinico-pathological studies and the result of surgical treatment of esophageal cancer]. PMID- 3827480 TI - [Effect of hepatic vagotomy on the function of the biliary tract and periarterial sympathectomy of the common hepatic artery as a countermeasure]. PMID- 3827481 TI - Application of solid low residue diets consisting mainly of elemental diet in colorectal diseases. PMID- 3827482 TI - [Studies on the concentration of lipid peroxide in the plasma and erythrocytes during cardiopulmonary bypass]. PMID- 3827483 TI - [Experimental studies on the tolerance of the brain to ischemia following occlusion of the cerebral arteries with respect to electrophysiological parameters]. PMID- 3827484 TI - [The role of VIP in experimental dumping as a humoral factor]. PMID- 3827485 TI - [Effect of secretin and vasoactive intestinal polypeptide on mucosal defensive factors in cysteamine-induced duodenal ulcer]. PMID- 3827486 TI - Intra-aortic balloon pumping in infants. PMID- 3827487 TI - [Unfavorable effect of abdominal arteriography on obstructive jaundice]. PMID- 3827488 TI - [Clinical analysis of long-term administration of Glyceol]. PMID- 3827489 TI - [Abdominal surgery in patients with heart block with a cardiac pacemaker in place]. PMID- 3827490 TI - Cholelithiasis in hereditary spherocytosis: report of a case. PMID- 3827491 TI - Computed tomography with cystic acoustic schwannomas. PMID- 3827492 TI - [Thyroid cancer in a 13-year-old girl]. PMID- 3827493 TI - [Measuring the thickness of facial soft tissues using nuclear magnetic resonance tomography for the purpose of identification]. AB - Nuclear spin tomography since its beginnings in the seventies has steadily gained in importance as a method of examination in medical diagnostics as it produces a picture. In the field of forensic medicine the NMR technique as used for anatomic anthropologic issues attempting to identify skulls this is a valuable supplement to an extension of the existing methods of investigation. The results of a measurement of the thickness of soft facial tissue in a live test person is shown as compared to measures obtained by sonography. PMID- 3827494 TI - [Case reports of railway traffic deaths]. PMID- 3827496 TI - [Thermoregulatory heat production in laying hybrids--influence of effective environmental temperature]. PMID- 3827495 TI - [Decapitation by hanging]. AB - This case report describes the most infrequently observed decapitation by the rope in the event of a suicidal hanging. Knowing the length of the drop, it was possible to estimate the loading of the neck of about 13 500 N. This value appears to applicable to indicate the upper limit of tolerance of the neck. PMID- 3827497 TI - [Acid-base parameters in blood, erythrocytes, liver tissue and urine in completely compensated metabolic acidosis of cattle]. PMID- 3827498 TI - [Influence of diseases of the gastrointestinal system on growth, food requirement and iron resorption in weaned piglets]. PMID- 3827499 TI - [Histomorphologic changes in the endometrium of cattle during the puerperium]. PMID- 3827500 TI - [Effect of UV rays on parasitic arthropods. 1. Studies in vitro and in vivo on the influence of UV rays on the developmental stages of Haematopinus suis]. PMID- 3827501 TI - [Orthology of the epiphysis cerebri in sheep (Ovis aries L.)]. PMID- 3827502 TI - Changes in the cerebrospinal fluid of calves in relation to plasma following uraemia. PMID- 3827503 TI - Evaluation of halothane anaesthesia with and without thiopental sodium induction in spontaneously ventilating buffalo calves (Bubalus bubalis). PMID- 3827504 TI - [Biomorphosis of the kidney in swine. 1. Body length and body weight and weight of the kidney capsule and blastema]. PMID- 3827505 TI - [Functional variations in the permeability of the plasma membrane of sperm for ethidium bromide]. PMID- 3827506 TI - [The importance of pH value for the estimation of sperm quality and course of estrus for the attainment of good fertilization results. 3. Behavior of the pH value in original and diluted sheep sperm and its relation to rate of pregnancy]. PMID- 3827507 TI - [Histoenzymatic and ultrastructural studies of plasma membranes of lymphoid cells in mice with transplantable leukemia L1210]. PMID- 3827508 TI - [Development of the physiologic response to stress in the neonatal period]. AB - An attempt was made to assess the course of physiological response to stress - an autonomic regulation process - in 60 newborn infants during the 1st month of life. Data used in this study were based on results of the B.N.B.A.S. (Brazelton Neonatal Behavioral Assessment Scale) applied on the 1st, 3rd and 28th days of life. An improvement of scores was demonstrated in all items throughout the 1st month of life. PMID- 3827509 TI - [Behavior and opinions of health care personnel with regard to breast feeding]. AB - Breast feeding (BF) practice is related to cultural, social and economic patterns of the future mothers; nevertheless hospital personnel seems to have some influence on infant feeding habits. This study describes the professional practices among personnel in the maternity hospitals of the Departement de la Seine Maritime (France) and reports their opinions about BF. Most of the respondents consider that they have a small role in influencing the decision to breast feed, the choice being made before pregnancy. Delivery training sessions seem to be the most suitable time for information about BF. Psychological arguments are considered as the most effective approach. BF is not estimated as leading to an increased work goal by hospital personnel. BF appears to be generally well controlled by mothers before discharge. Technical factors were given as the primary influencing reason for cessation of BF. This survey indicates several ways for establishing future health education programs for the promotion of BF. PMID- 3827510 TI - [Evaluation of 6-years' experience of screening for hyperphenylalaninemia caused by cofactor deficiency]. AB - Since the treatment of tetrahydrobiopterin deficiency differs from that for phenylalanine-hydrolase deficient patients, early differential diagnosis of the various types of hyperphenylalaninemia is essential. Results of screening for tetrahydrobiopterin deficiency in 261 cases with hyperphenylalaninemia, including 152 newborns, are reported. Urinary pteridine analysis appears as a valuable method for the recognition of cofactor deficiency. However, accurate interpretation depends on the quality of urine sampling (especially for DHRP deficiency recognition), age-paired comparison and possible pathological interferences. PMID- 3827511 TI - [Charcot-Marie-Tooth disease and glomerular nephropathy]. AB - Anatomoclinical profile and follow-up of a glomerular nephropathy in a prepubertal girl with Charcot-Marie-Tooth disease is reported; striking common pattern features with the few cases previously published of such an association strongly suggest that renal involvement is possible in sensorineural neuropathies and may be one major factor in the overall prognosis of the disease. PMID- 3827512 TI - [Bile peritonitis caused by idiopathic perforation of a choledochal cyst]. AB - The case of a 8 month-old infant presenting with biliary peritonitis, mild icterus and slowly progressive ascites is reported. Diagnosis was made through paracentesis showing higher bilirubin levels in the ascitic fluid (18 mg/100 ml) than in serum, and abdominal ultrasonography which showed pictures suggestive of choledochal cyst. A perforated choledochal cyst was surgically removed. The biliary duct was reconstructed by means of a hepatic Roux-en-Y jejunostomy. Postoperative course was satisfactory. PMID- 3827513 TI - [Post-traumatic arthritis of the wrist caused by an intra-articular foreign body]. AB - The authors report the case of a 12 year-old child presenting with post-traumatic arthritis of the wrist with intra-articular metallic foreign bodies. The trauma was initially considered to be benign, not operated on and forgotten by the child and its family. Excision of a synovial granuloma was followed by a favorable outcome. PMID- 3827514 TI - [Hemodynamic repercussions of a giant hemangioma treated by compression]. AB - The authors report a case of giant hemangioma with thrombocytopenia, whose very important increase was responsible for acute congestive heart failure with pre renal failure. In order to limit the tumoral volume, a compressive dressing was applied which had to be removed at first, as it had respiratory and hemodynamic consequences. A dressing was reapplied, and with concomitant diuresis obtained a dramatic improvement. The volemic changes observed in this case are discussed. PMID- 3827515 TI - [Iconographic rubric. Mesenteric compression syndrome]. PMID- 3827516 TI - [Infantile hypothyroidism in a 3-and-a-half-year-old child. Value and limitations of neonatal screening tests based on measurement of TSH in dried blood]. PMID- 3827517 TI - [Nutritional study in bronchopulmonary dysplasia]. PMID- 3827518 TI - Pierre Janet on obsessive-compulsive disorder (1903). Review and commentary. AB - Pierre Janet's classic contribution to the understanding of obsessive-compulsive disorder, Obsessions and Psychasthenia (1903), remains untranslated as well as unappreciated by American psychiatry, despite increasing recognition of the importance of this mental health problem. Herein the work is summarized and discussed. Although it tends to be remembered for its theoretical ideas, most of which have become dated, the most valuable aspect of Obsessions and Psychasthenia is its clinical discoveries. These include the important role played in the disorder by symptoms that are closely related to, but yet cannot properly be called, obsessions and compulsions (the "forced agitations"); the underlying psychasthenic mental state; and the obsessive-compulsive person's specific failure to adapt to reality. Despite the passage of nearly a century, these observations, and Janet's suggestions regarding treatment, are as timely now as when they were made. PMID- 3827519 TI - Occurrence of myoclonus in patients treated with cyclic antidepressants. AB - Myoclonus associated with cyclic antidepressant therapy has been considered to be a rare phenomenon. Ninety-eight patients who were to begin receiving cyclic antidepressant therapy were prospectively evaluated for myoclonus. Thirty patients experienced clinically insignificant drug-associated myoclonus. Nine patients had clinically significant myoclonus. The myoclonus was reversible with the discontinuation of therapy but tended to persist if medication changes were not made. None of the tested clinical variables were able to predict which patients would develop myoclonus. PMID- 3827520 TI - Tricyclic antidepressants in depressed patients with cardiac conduction disease. AB - The observation that fatalities from tricyclic antidepressant (TCA) overdose are associated with heart block and/or arrhythmias has led to concern about the cardiovascular effects of TCAs. Contrary to expectations, studies have shown TCAs to be relatively safe in patients without heart disease. However, it is unclear whether these drugs are also safe in patients with heart disease. This prospective study compared the risk of cardiovascular complication at therapeutic plasma concentrations of TCAs in 196 depressed patients, 155 with normal electrocardiograms and 41 with either prolonged PR interval and/or bundle-branch block. The prevalence of second-degree atrioventricular block was significantly greater in patients with preexisting bundle-branch block (9%) than in patients with normal electrocardiograms (0.7%). Orthostatic hypotension occurred significantly more frequently with imipramine than with nortriptyline, and in patients with heart disease. PMID- 3827521 TI - A 2.5-year follow-up of cocaine use among treated opioid addicts. Have our treatments helped? AB - During a 2.5-year follow-up study of opioid addicts, we found that cocaine abuse had become an increasing and major problem through 1983. Cocaine abuse had only minimally declined during the follow-up period despite treatment, and the number of opioid addicts with at least weekly cocaine abuse had doubled. The clear effect of methadone maintenance treatment in reducing opioid abuse was not evident for cocaine abuse. During the follow-up period, more cocaine use was reported by the methadone-treated subjects than by those undergoing detoxification only. Prognostically, cocaine users were more likely to be nonwhites and men. Subjects who increased their cocaine use during the follow-up period were more likely to have depressive disorders and more likely to be found among methadone- and "drug-free"-treated subjects than among detoxification subjects. Thus, among methadone- and drug-free-treated subjects, depression appeared to be a risk factor for escalating cocaine abuse; this risk factor may benefit from specific interventions. PMID- 3827522 TI - Cognitive training in treatment of hyperactivity in children. PMID- 3827523 TI - Cocaine withdrawal. PMID- 3827524 TI - The physiology of cocaine craving and 'crashing'. PMID- 3827525 TI - Conception and stages of development of the microbiological cancer test. AB - Pathology and experimental bacteriology have, in scientific medicine, created fundamental methodical presuppositions for the description and recognition of etiologic entities. With the tumour-tetanus phenomen, two pathogenic principles- cancer growth and tetanus infection--coincide in a so far unknown manner. Analytical experiments have led to the novel idea of the mitosis-stimulated anaerobic tetanus infection. This specific pathomechanism and its mathematical model formed the basis for the development of the serological Clostridium-tumour test with nontoxic, apathogenic Butyricus Clostridia as test microbes. As viable diagnostic agents the test spores are subject to the 12th Regulation of the Drug Act of the GDR. Only the histopathological judgement allows for the detection of micro-tissue alterations following i.v. overdoses of spores. The test spores were confirmed as safe and effective, and the microbiological cancer test approved to be appropriate for a clinical trial. PMID- 3827526 TI - [Serum sialic acid levels in cancer, pregnancy and upper respiratory infections]. AB - A significant increase in sialic acid content is demonstrable in the sera of cancer patients. Our investigations were performed to find out whether the serum sialic acid level is altered also during pregnancy or with infections of the upper respiratory tract. Our results have revealed a slight increase in sialic acid level to occur only in the last trimester of pregnancy. However, this distinct, though statistically insignificant, increase will not lead to misjudgement in regard to cancer diagnosis, or in case control of this disease. By contrast, in 7 out of 15 patients with infected upper respiratory tract the sialic acid content was clearly above the tolerance limit so that false positive findings may possibly be obtained. PMID- 3827527 TI - Primary pulmonary sporotrichosis. PMID- 3827528 TI - Botryomycosis in acquired immunodeficiency syndrome. AB - The first case, to our knowledge, of an integumentary form of botryomycosis is reported in a homosexual man with acquired immunodeficiency syndrome. Anal fistula and ischiorectal and gluteal abscesses developed following severe cryptosporidial diarrhea. Grains composed of gram-positive cocci were identified in the suppurative exudate. The grains had attached to multinucleated macrophages, many of which contained clusters of cocci in their cytoplasm. It is postulated that the cocci were able to survive and probably replicate in the cytoplasm of multinucleated macrophages, and were subsequently extruded as grains. These observations suggest a defect in intracellular killing of cocci by the monocyte-macrophage system. This may relate to failure in induction of control of macrophage activity by T4-inducer subsets. PMID- 3827529 TI - The surgical pathology of hypertrophic cardiomyopathy. AB - The pathologic diagnosis of hypertrophic cardiomyopathy (HCM) rests on the gross cardiac morphology and the presence and extent of myofiber disarray in the interventricular septum. Little attention, however, has been focused on the features of HCM in endomyocardial biopsy or septal myomectomy specimens. We therefore examined nine right ventricular biopsy specimens and 89 myomectomy specimens from 98 patients with clinically diagnosed HCM. Myofiber disarray was present in three (33%) of the biopsy specimens and 52 (58%) of the septectomy specimens. Associated findings in both specimen types included myocyte hypertrophy and interstitial fibrosis. The myomectomy specimens also frequently contained areas of patchy fibrosis, abnormally thick coronary arteries, and a fibrous endocardial plaque. When myofiber disarray was present in myomectomy specimens, it was confined to the deepest portion in 79% of the specimens, confirming that the disarray is frequently confined to the middle transverse third of the septum. Endomyocardial biopsy specimens may be used to suggest the diagnosis of HCM; however, because of their small size and their relatively nonspecific pathologic changes, they are of limited value in making the diagnosis of HCM. Septal myomectomy specimens usually contain pathologic findings consistent with HCM. The role of the surgical pathologist in the myomectomy cases is to confirm that these changes are present and are characteristic of the disorder. PMID- 3827530 TI - Myocardium as emboli in the systemic and pulmonary circulation. AB - Myocardium as emboli is a decidedly rare phenomenon. Only three such examples were identified among 8033 consecutive autopsies performed over a ten-year period, 1976 to 1985, an incidence of 0.037%. In two of these three cases, myocardial emboli occurred in the systemic (coronary) circulation. The source of emboli was attributed to postinfarction ruptured ventricular septum in one patient, and to traumatized myocardium during surgical reconstruction of a univentricular heart (single ventricle) in the other. In the third case, myocardial emboli occurred in the pulmonary circulation, originating from excavation of the infundibulum at surgical correction of pulmonary atresia. A literature search has uncovered only five previously reported cases of myocardium as emboli, all occurring in the systemic circulation. To my knowledge, there has not been any previous report of myocardial emboli in the pulmonary circulation. PMID- 3827532 TI - Villous regeneration in ulcerative colitis. AB - Three cases with extensive villous regeneration were identified in a review of 92 colectomy specimens of ulcerative colitis. Villous regeneration was evident grossly as numerous poorly defined zones of velvety mucosa present primarily in the ascending and transverse colon. These zones were characterized histologically by discrete, well-formed villi lined by epithelium with prominent regenerative changes. Occasionally, the epithelium demonstrated an oncocytic appearance that may be the result of adaptive mitochondrial hyperplasia. Distinguishing villous regeneration from epithelial dysplasia may be difficult because several features, including cytologic atypia, dystrophic goblet cells, and a villous configuration, can be seen in both. However, close attention to the nuclear changes and the type of mucous differentiation will aid in the distinction. PMID- 3827531 TI - Peanut lectin binding sites in colons of patients with ulcerative colitis. AB - We studied peanut lectin (PNA) binding sites in patients with ulcerative colitis (UC) with various degrees of disease activity and dysplasia. Peanut lectin binds to B-D-galactose (1-3) N-acetyl-D-galactosamine, which is the purported determinant for the T-blood-group antigen and the immediate precursor of the MN blood-group glycoprotein. In the normal colon, PNA binds to the supranuclear (SN) portion of goblet and columnar cells, representing nascent glycoproteins in the Golgi apparatus prior to the addition of terminal sialic acid. In severely active UC, PNA binds to the glycocalyx and/or apical portion of columnar cells, crypt goblet cells, and the total cytoplasm of "regenerating or hyperplastic" epithelium. These patterns have been previously reported in colonic cancers, adenomas, and fetal colons, indicating the synthesis of incomplete glycoproteins. Cases of inactive UC and mildly active UC expressed PNA binding in an SN distribution similar to controls. Cases with dysplasia showed PNA binding patterns similar to colonic neoplasms. In UC, the perturbation of cell kinetics similar to colonic neoplasms and the more rapid cell migration and turnover may be reflected as synthesis of incomplete glycoproteins, as expressed by abnormal PNA binding patterns. These findings indicate that the epithelial cells in patients with severely active UC synthesize incomplete glycoproteins similar to colonic neoplasms; however, this abnormal glycoprotein pattern is reversible when inflammation is more quiescent. PMID- 3827533 TI - Mesenteric cyst-ovarian implant syndrome. AB - Primary tumors and cysts of the mesentery are quite rare. The cysts are said to be from embryonic, traumatic, or neoplastic origin. Mesenteric cysts of ovarian tissue origin, which, to our knowledge, have been reported only three times, appear under the term ovarian remnant syndrome, and involved patients with previous oophorectomies. It appears that the incidental implantation and growth of the minute portions of the ovarian tissue in the pelvis or lower abdomen is the origin of the syndrome. We describe two cases of the mesenteric cyst-ovarian implant syndrome with a brief review of the literature. PMID- 3827534 TI - Pilomatrixoma. Cytologic features with differential diagnostic considerations. AB - Pilomatrixoma are neoplasms of the hair cortical cells. They are most common during the first two decades of life and, usually, involve the head, neck, and upper extremities. These tumors may be encountered during aspiration biopsy of subcutaneous masses, and are, occasionally, confused with other neoplasms, particularly squamous cell carcinomas and epidermal inclusion cysts. The cytologic features of three such neoplasms are presented, and the characteristics that differentiate them from other benign and malignant lesions of the skin are discussed. The presence of two cell populations, the anucleated shadow cells and the basaloid cells, which lack nuclear features of malignancy, is fairly specific for pilomatrixoma. In addition, the specimens obtained from aspiration may be misinterpreted as originating from a hyperplastic lymph node in view of the intense chronic inflammatory and foreign body reaction seen in the background. Calcific deposits that lack lamellations, unlike psammoma bodies, help in establishing the definitive diagnosis of these benign neoplasms. PMID- 3827535 TI - Sporothrix infection of the lung without cutaneous disease. Primary pulmonary sporotrichosis. AB - The clinical spectrum of sporotrichosis is expanding and now includes pulmonary infection in absence of skin lesions. Lung involvement, albeit unusual, is a granulomatous pneumonitis which may progress to bilateral, apical, fibrotic, and contracted infiltrates or cavities, thereby mimicking tuberculosis or histoplasmosis. The patients are most often middle-aged men with alcoholism and chronic obstructive pulmonary disease. Our case report is yet another variant of primary pulmonary sporotrichosis that presented as diffuse, bilateral granulomatous pneumonitis without cavitation or predilection for upper lobes. PMID- 3827536 TI - Fatal acute dissection of the right hepatic artery after appendectomy. AB - A 53-year-old normotensive man underwent an appendectomy for suppurative appendicitis with peritonitis and Escherichia coli bacteremia. On the third postoperative day, he became severely dyspneic, developed bright red blood flow from his abdominal drains, collapsed, and died. At autopsy, a ruptured intramedial dissection of the right hepatic artery was found. Hepatic artery dissections are rare, but may be associated with abdominal operation, peritonitis, hypertension, or preexisting arterial disease. PMID- 3827537 TI - Universal staging system for colorectal cancer. PMID- 3827538 TI - Quality health care. Meeting the challenge. PMID- 3827539 TI - A core curriculum in graduate medical education in pathology. PMID- 3827540 TI - Calibration of hematology analyzers. Role of the microhematocrit. AB - Discrepancies between the hematocrit values measured by automated methods and those measured by centrifugation have discouraged the use of the centrifuged microhematocrit to calibrate automated hematology analyzers. The discrepancy appears to be due to changes in the internal viscosity of red blood cells and can be eliminated in the most popular line of automated whole blood analyzers (Coulter Counters) by use of a simple correction table. Fresh blood obtained from volunteers was separated by centrifugation into fractions of increasing mean corpuscular hemoglobin concentration. A correction table for hematocrit values obtained by automated equipment was derived from the linear relationship between the discrepancy in hematocrit values and the manually obtained values for mean corpuscular hemoglobin concentration. With the use of the correction table, an average of three randomly selected fresh blood samples is sufficient to transfer a centrifugally determined hematocrit value to a multichannel analyzer with a coefficient of variation of 1.5%. Thus, this straightforward approach permits the microhematocrit to function as a practical calibration standard. PMID- 3827541 TI - Bleeding time decreases with age. AB - Template bleeding times were determined in 48 men and women under 50 years of age, and in 95 men and women over 50 years of age. There was no significant male/female difference in any age group, but there was a significant reduction in the bleeding time with increasing age in both men and women. PMID- 3827542 TI - Myxoid leiomyosarcoma of the urinary bladder. AB - A 16-year-old male patient with hematuria was found to have a 3-cm mass on the right posterolateral wall of the urinary bladder. After a biopsy specimen disclosed a myxoid tumor, a partial cystectomy was performed. The specimen contained a gelatinous tumor that, on microscopic examination, was a myxoid leiomyosarcoma similar to the neoplasm recently described in the uterus and several other locations. This tumor, which is the first of its type (to our knowledge) reported to occur in the bladder, must be distinguished from other neoplasms and nonneoplastic lesions that occur in this organ. The patient is well two years postoperatively. PMID- 3827543 TI - Geriatric autopsy pathology in centenarians. AB - The determinate causes of death, physical findings, and major pathologic findings in the organ systems of 32 patients, aged 100 years or older who died between 1921 and 1983, on whom autopsies were performed, are described. Atherosclerosis, neoplasia, and bronchopneumonia were common, but diabetes mellitus, obesity, hypertension, and cerebrovascular accident were absent or rare. Deaths from infection were fewer in the era of antibiotic usage, while cardiovascular and neoplastic deaths became more frequent during that time. The pathologic findings in our series of centenarians indicate that few of these patients died from debilitating diseases and that mortality from infection has been modified by antibiotic usage. PMID- 3827545 TI - Primary squamous cell carcinoma of the thyroid associated with leukocytosis and hypercalcemia. AB - Primary squamous cell carcinoma of the thyroid is an extremely rare, aggressive neoplasm with a uniformly poor prognosis. Described herein is a case of a 66-year old man with primary squamous cell carcinoma of the thyroid associated with hypercalcemia (13 mg/dL [3.24 mmol/L]) and unexplained leukocytosis (28,400/mm3 [28.4 X 10(9)/L]). The histogenesis of squamous cell carcinoma of the thyroid remains controversial. The associated hypercalcemia and leukocytosis most likely represent a form of paraneoplastic syndrome; possible mechanisms will be discussed in the light of recent studies on tumor-derived mediators. PMID- 3827544 TI - A maternal death due to thrombotic disease associated with anticardiolipin antibody. AB - We report a case of fetal death at 30 weeks' gestation followed by the unexpected death of the mother 28 1/2 hours later. At postmortem examination, extensive small-vessel thrombi were found in the maternal organs, including the uterus, kidney, and heart. In retrospect the mother had evidence of chronic pericarditis and myocarditis. Laboratory tests of antemortem serum demonstrated elevated titers of anti-double-stranded DNA and of anticardiolipin antibodies. PMID- 3827546 TI - Malignant paraganglioma of the thyroid gland. AB - Paragangliomas of the thyroid gland are rare lesions, only four previous cases having been reported in the literature, to our knowledge. We report herein a fifth case, which, to our knowledge, is the first to exhibit malignant behavior manifested by invasion into perithyroidal soft tissue through the wall of the trachea into the tracheal mucosa. PMID- 3827547 TI - Giant leiomyoma of the prostate. AB - Giant leiomyoma of the prostate is a rare lesion. We document a case in a 61-year old man who presented with urinary obstructive symptoms. He had undergone transurethral resection twice before he was seen at our institution, where suprapubic prostatectomy was performed. At follow-up 18 months postoperatively, no evidence of recurrent disease was found and his voiding pattern was normal. PMID- 3827548 TI - Adenomyoma of the papilla of Vater. AB - An adenomyoma of the papilla of Vater that caused biliary obstruction resulted in an extensive surgical resection because of the clinical and roentgenographic suspicion of carcinoma. Benign neoplasms of the papilla and extrahepatic bile ducts are exceedingly rare, but their recognition is of clinical importance. Histologically, the adenomyoma, characterized by lobules of ducts and ductules with interlacing bundles of smooth muscle, was similar to the adenoleiomyomatous hamartoma of the intestines and to lesions of the gallbladder or extrahepatic ducts known as adenomyomas or adenomyomatous hyperplasia. The presumed rapid recent growth of the present lesion, as roentgenographically documented by the recent onset of dilatation of the common bile duct in an elderly woman, as well as the lack of gallstones or inflammatory disease of the biliary tract, might support the contention that the present lesion was neoplastic. On the other hand, the possibility that the lesion represents a hamartoma or diverticulosis of the saccules of Beale cannot be excluded. PMID- 3827549 TI - Visceral intravascular capillary hemangioma. AB - In the course of routine pathologic examination of an ovarian serous cystadenoma excised from a 35-year-old woman, an intravascular mass in the cyst capsule was noted. Histologically, this was found to be an intravenous capillary hemangioma. To our knowledge, no such lesion has been previously reported. The relationship of this lesion to intravenous pyogenic granuloma and features by which the two may be distinguished are discussed. Other primary intravascular endothelial tumors are briefly reviewed. PMID- 3827550 TI - Some characteristics of academic departments of pathology in the United States. Implications for training of academic pathologists. AB - Data concerning the activities of faculty and various characteristics of academic departments of pathology were obtained from questionnaires returned by 94 chairmen and 1571 faculty members. Data concerning manpower that was the subject of a previous report indicated that the projected supply of MD pathologists for faculty positions was significantly less than the anticipated demand. This article describes the characteristics of academic departments, particularly the activities of faculty that have bearing on the training and expectations of pathologists who are seeking faculty positions. PMID- 3827551 TI - The Walter J. Zeiter lecture. Lessons learned from spinal cord injury. PMID- 3827552 TI - Median and radial sensory latencies to digit I: normal values and usefulness in carpal tunnel syndrome. AB - Median and radial sensory latencies were recorded from digit I at a distance of 10cm in 78 neurologically healthy people aged 20 to 79 years. The mean median latency was 2.5 +/- 0.3ms, and mean radial latency was 2.4 +/- 0.2ms. Both were measured to the negative peak. Twenty individuals with carpal tunnel syndrome determined by traditional electrodiagnostic techniques had at least 1ms longer latency in median nerve than the median latency for the healthy control group. This technique is useful in diagnosis of carpal tunnel syndrome. PMID- 3827553 TI - Brainstem auditory evoked potentials: intraoperative monitoring technique in surgery of posterior fossa tumors. AB - Brainstem auditory evoked potentials (BAEPs) were used to monitor eight neurosurgical procedures involving posterior fossa tumors to assist the neurosurgeon in preservation of hearing postoperatively. The technique included placement of recording electrodes over the Cz (vertex) and both earlobes. Stimulation was accomplished intraoperatively with a specifically designed intraauricular click stimulator that did not interfere with surgical access to the suboccipital region. Continuous BAEP recording was performed with particular attention to the sequence of preincision, opening of the dura, tumor mobilization, tumor excision, and closure. Absolute latencies and interpeak latencies of all five waves were recorded when possible. In three patients BAEPs were not significantly altered intraoperatively, and hearing was preserved postoperatively. In another three patients the acoustic nerve was severed during surgery and intraoperative monitoring was discontinued. In the remaining two patients medical complications arose intraoperatively, and significant irreversible changes in BAEP were observed despite no gross anatomical damage to the acoustic nerve. Both of these patients experienced postoperative hearing loss. These two cases illustrated some of the BAEP abnormalities that occurred during surgery. Difficulties during the procedures included electrical noise and interference, use of a bipolar cautery device, and unclear wave forms. Solutions for these difficulties were braiding the electrodes and using extra ground electrodes and a spike suppressor; switching off the evoked potential equipment when the bipolar cautery device was in use; and increasing repetitions and changing click intensity and polarity, respectively. Monitoring BAEPs in posterior fossa surgery can be accomplished with presently available equipment and may aid the neurosurgeon in preserving or minimizing injury to auditory pathways and adjacent structures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827554 TI - Musculoskeletal profile of male collegiate soccer players. AB - Twenty-five collegiate soccer players were evaluated for lower extremity flexibility and muscle strength at the end of preseason training and before the onset of the collegiate soccer season on two successive seasons. The purpose of the evaluation was to determine whether symmetry was present in their legs and whether deficits in flexibility or strength would affect the susceptibility to hamstring or groin muscle strain injuries. The mean (+/- SE) flexibility of the dominant leg for hip abduction was 41 degrees +/- 1.2 degree; for hip flexion, 76 degrees +/- 1.9 degree; for hip extension, 174 degrees +/- 0.7 degree; and for ankle dorsiflexion, 33 degrees +/- 1.3 degree. The mean (+/- SE) isokinetic torque of the dominant leg (tested at 30 degrees per second) for knee extension was 214 +/- 8 newton meters and for flexion was 128 +/- 4 newton meters, while isometric strength for hip flexion was 315 +/- 8 newtons and for ankle plantar flexion was 1721 +/- 58 newtons. No significant differences were found between the dominant and nondominant legs in flexibility or strength. During this study no hamstring or groin strain injuries occurred. The lack of leg muscle strain injuries appeared to be directly related to the initiation of a controlled warmup and stretching program and underlines the importance of this in injury prevention. Interestingly, more than 50% (13 of 25) of the players were found to have significant deficits in one or more specific muscle groups. Two athletes sustained low back strain injuries and one athlete had a knee sprain injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827555 TI - Upper extremity functional rating for patients with Duchenne muscular dystrophy. AB - The corresponding deterioration of upper extremity strength and functional capability with increasing age and the relationship between average strength and function were evaluated in 28 boys with Duchenne muscular dystrophy (DMD). Manual muscle testing (MMT) was used to evaluate strength and the Brooke upper extremity grading scale to rate upper extremity function. Mean MMT was found to relate to age in logarithmic fastion, ie, a 1% increase in age led to a 0.9% decrease in mean MMT. Functional grade (FG) related to age in a more complex fashion, revealing three groups based on age: under age 10, all in FG 1; between ages 10 and 13, concentration in FG 2 through 4; and over age 13, eight of ten in FG 5. Regression analysis did not contribute further useful information. Finally, mean MMT was found to be highly significantly related to FG. The plot of mean MMT against FG revealed an S-shaped curve, with rapidly rising functional grade once an average upper extremity strength of 4w was reached. The Brooke scale appears to be useful in describing upper extremity function among DMD patients, although it may reflect a three-grade rather than a six-grade discrimination capability. In describing the natural history of DMD, this scale demonstrates a pattern of rapid functional deterioration during the early adolescent years. This functional deterioration apparently takes place when the decline in strength reaches a threshold which cannot be compensated by muscle substitutions. At that time function deteriorates along a relatively rapid but undefined course. PMID- 3827556 TI - Upper extremity strength deficits in hemiplegic stroke patients: relationship between admission and discharge assessment and time since onset. AB - This study describes objective upper extremity strength deficits in hemiplegic stroke patients on initial and discharge assessment, and the relationship between these deficits and the time since onset. The static strength of ten different muscle groups had been measured bilaterally in patients (n = 24 to 58, depending on the muscle group), using a hand-held dynamometer. Strength deficits were calculated in relation to the nonparetic side of the body. Zero order correlations were calculated for strength deficit and time variables. Only the relationships between the strength deficits of the initial and discharge assessments were significant (p less than 0.01). These results suggest that the strength deficits of an initial assessment are the best predictors of strength deficits at discharge. This finding has implications for clinicians in clinical decision-making and in addressing patient expectations. PMID- 3827557 TI - Calcaneal bone density reduction in patients with restricted mobility. AB - This cross-sectional study revealed a prevalence of reduced calcaneal bone density in a population of 49 chronic continuing care patients with restricted mobility. Calcaneal bone density was measured using the Compton gamma ray scattering technique, which permits examination of trabecular bone. Predicted densities were determined from the ages and weights of the subjects. Descriptive factors such as gender, diagnosis, duration of the condition, and muscle tone were correlated with bone density. Twenty-eight patients (57%) had indications of reduced calcaneal bone density. None of the descriptive factors was associated with the variability in bone density ratio (forward stepwise regression analysis, p = NS). The reduced calcaneal density found in these patients with restricted mobility is probably a result of their not bearing weight and the inevitable severe reduction in their physical activity. PMID- 3827558 TI - Static magnetic field influence on human nerve function. AB - In an attempt to understand the possible neural mechanism mediating the effects of a static magnetic field (SMF), nerve conduction velocity (NCV) and excitability index (EI), measured as the ratio of the amplitude of the submaximally evoked compound muscle action potential during or after magnetic exposure to that before exposure from the same intensity of stimulation of the motor nerve, were studied on ten normal volunteers (aged 17 to 39), when the nerve was exposed to an SMF of 1 tesla (T) for 15 seconds. NCV and EI were measured before, during (5, 10, and 15 sec) and three minutes after magnetic exposure. Both NCV and EI were measured on median nerve in all ten subjects, the peroneal nerve in seven subjects, while the ulnar nerve was measured for only EI in eight subjects. There was no significant change in NCV over the segment exposed to the magnetic field. However, EI was significantly increased during the magnetic exposure in all three nerves. The effects were observed as early as five seconds after exposure and disappeared by three minutes after exposure. It is concluded that the excitability of the motor nerve is increased when it is exposed to an SMF with a density of 1T. PMID- 3827559 TI - Somatosensory evoked potentials following pudendal nerve stimulation as indicators of low sacral root involvement in a postlaminectomy patient. AB - Somatosensory cortical evoked potential studies (SEPs) following stimulation of the pudendal nerves proved useful in objectively documenting preoperative low sacral root involvement in a 33-year-old postlaminectomy patient, presenting with impending cauda equina syndrome and treated by piriformis muscle release with good clinical results. Preoperative P40(P1) latencies of SEPs were abnormally prolonged (47 msec) and returned to normal values (38 msec) postoperatively. This new noninvasive electrodiagnostic method has been described previously for normal subjects only. Further experience with this method is still needed, especially to elucidate the diagnostic reliability of various SEP parameters. PMID- 3827560 TI - Atypical electromyographic findings in pronator teres syndrome. AB - The electrodiagnostic differentiation between pronator teres syndrome and entrapment of the median nerve at the ligament of Struthers is generally thought to be aided by the absence of electromyographic (EMG) findings in the pronator teres muscle in pronator syndrome. This report describes a patient with surgically documented pronator teres syndrome who had EMG changes in the m. pronator teres, which was apparently innervated as or after the median nerve passed through. It is concluded that EMG abnormalities in the m. pronator teres should not alone be used to distinguish pronator teres syndrome from entrapment of the median nerve at the ligament of Struthers. PMID- 3827561 TI - Thromboembolic disease presenting as fever in spinal cord injury. AB - A 45-year-old man had complete C5 quadriplegia after sustaining a C6-7 fracture dislocation in a motor vehicle accident. Twenty-six days after injury the patient spiked nightly temperatures of 100.5F to 102.5F. Before a full fever workup could be completed, the patient developed shortness of breath. Thromboembolism was confirmed via venography and Ventilation/Perfusion scan. Other clinical signs of asymmetric swelling or warmth were notably absent throughout the course of the thromboembolic event. The patient became afebrile on the third day of anticoagulant therapy and remained afebrile. This case indicates that thromboembolic disease can present with fever only and the disease should be included in the differential diagnosis for fever in any patient with acute spinal cord injury. PMID- 3827562 TI - Thrombosis of the inferior vena cava in a patient with spinal cord injury. AB - Thrombosis of the inferior vena cava developed in a 25-year-old man with quadriplegia. The condition occurred six years after his cervical spinal cord injury. The patient had no previous history of thromboembolic disease. Clinical features of inferior vena cava thrombosis were massive bilateral lower extremity edema and dilated superficial abdominal veins. Based on the literature and outcome in this patient, anticoagulants provide the most effective long-term treatment. PMID- 3827563 TI - Spinal pain with recumbency. PMID- 3827564 TI - Improving survival in patients with cirrhosis undergoing major abdominal operations. AB - Fifty-one patients with cirrhosis underwent 65 major abdominal procedures, with an 8% mortality and a 28% complication rate. Preoperative and perioperative management was comparable to that rendered patients with cirrhosis undergoing portosystemic shunting procedures. Emergency operation, persistent coagulation defects (prothrombin time and partial thromboplastin time prolonged greater than 2 s), blood loss greater than 4 U, and exploration of the common bile duct were factors associated with increased mortality. Major surgical procedures can be safely performed in critically ill patients with cirrhosis with intensive preoperative care and with minimizing intraoperative blood loss. PMID- 3827565 TI - Flexible angioscopy seems faster and more specific than arteriography. AB - Fiberoptic angioscopy was performed with 2.5- and 3.3-mm angioscopes in 25 arteries and grafts in 19 patients. Radiologically normal and abnormal arteries and anastomotic sites were examined. All vessels and grafts were visualized and images of normal arterial wall, subclinical and obstructing atherosclerotic plaque, and suture lines were defined. Unexpected endovascular findings were noted in five patients (26%) and included large amounts of free-floating clot (one patient), atherosclerotic debris (two patients), and membranelike obstructions (two patients). Angioscopy required three to ten minutes and resulted in no complications. Experience with the flexible angioscope indicates that satisfactory visualization and specific recognition of angiographically unsuspected problems can be obtained. The flexible angioscope is faster and appears more etiologically specific than arteriography. PMID- 3827566 TI - Role of endoscopy in the diagnosis of early gastric cancer. AB - Early gastric cancer (EGC) is characterized by tumor invasion limited to the submucosa, with or without regional lymph node involvement, and five-year survival rates in excess of 90%. Although infrequently reported in the United States, EGC represents 35% of gastric cancers in Japan. A retrospective analysis of all patients with gastric cancer (1972 through 1985) was performed to determine the frequency and most efficacious diagnostic modalities in this group of patients. Early gastric cancer was identified in 6% (17/302) of all these patients and in 28% (17/61) of patients undergoing curative resection. A review of presenting historical, physical, laboratory, radiologic, and endoscopic findings identified fiberoptic endoscopy as the most sensitive diagnostic procedure. Increased use of endoscopy in patients with persistent nonspecific gastrointestinal tract complaints may increase the number of patients seen with EGC. PMID- 3827567 TI - The role of flexible sigmoidoscopy in the preoperative screening of patients with inguinal hernia. A high yield of neoplasms. AB - Disagreement persists as to whether all patients with inguinal hernia should undergo screening examinations for colorectal cancers before hernia repair. The purpose of this study was to prospectively evaluate the effectiveness of flexible sigmoidoscopy (FS) as a screening examination for these patients. In an 18-month period, 110 patients with inguinal hernia (99% men) with an average age of 63 +/- 10 years underwent FS. Diverticulosis was found in 36% of the patients, colorectal polyps in 26%, and colorectal cancers in 3.6%. Occult blood was found in the stool of only 11% of these patients and, thus, was an ineffective screening test. These results suggest that FS is an effective means of screening for premalignant and malignant colorectal lesions in patients with inguinal hernias. PMID- 3827568 TI - Early detection of gastric remnant carcinoma. The role of gastroscopic screening. AB - Partial gastrectomy for benign ulcer disease has been associated with carcinoma in the gastric remnant. To detect formation of this cancer in patients having undergone this operation, we initiated a screening protocol using barium contrast studies, flexible gastroscopy, and biopsy. Patients were selected from a group of 233 patients who had undergone partial gastrectomy for benign disease between 1960 and 1975. In this group, operations for duodenal ulcer had been performed in 156 patients (83 Billroth I and 73 Billroth II reconstructions) and subtotal gastrectomy in 77 patients with gastric ulcer (17 Billroth I and 60 Billroth II reconstructions). From July 1980 to July 1985, 163 patients underwent gastroscopy and biopsy with a median postoperative interval of 14.6 years. Through screening, three resectable remnant carcinomas were found. We conclude that routine gastroscopy leads to earlier detection and a higher rate of resectability if gastric remnant carcinoma is found; yearly screening should be performed after a ten-year postresection interval; and gastroscopic biopsy is more accurate than upper gastrointestinal tract barium contrast studies and should be used preferentially to identify gastric remnant carcinoma. PMID- 3827569 TI - Massive intracerebral hemorrhage following carotid endarterectomy. AB - To our knowledge, a particularly lethal complication of carotid endarterectomy, intracerebral hemorrhage, has not been given due consideration in the literature concerning carotid surgery. In the Atlanta area, massive intracranial hemorrhage developed in ten patients following routine carotid endarterectomies performed during a recent ten-year period. All ten of the patients in this series died despite a variety of therapeutic interventions. Risk factors may include the following: extreme arterial stenosis with resultant postoperative hyperperfusion, involvement of multiple extracranial cerebral vessels, postoperative systemic hypertension, and administration of anticoagulant or antiplatelet medications. Unfortunately, identification of the subset of patients potentially at risk for this complication is difficult, and, to date, therapy has been generally ineffective. PMID- 3827570 TI - The use of infrared photoplethysmography in identifying early intestinal ischemia. AB - Acute intestinal ischemia and infarction remain serious clinical problems despite early operative intervention. An accurate and reproducible method of assessing ischemic tissue is critical to determine the precise limits of resection. The purpose of this study was to compare the utility of infrared photoplethysmography, intravenous fluorescein, and Doppler ultrasound in assessing intestinal ischemia in an operative canine model. After five segmental mesenteric arterial ligations in each of six conditioned dogs, the detection threshold for the limits of arterial perfusion of each modality was determined and correlated with the respective histopathologic specimens. Infrared photoplethysmography proved to be 100% sensitive for ischemia when its waveform amplitudes were 50% or greater of matched reference waveforms, whereas both intravenous fluorescein and Doppler ultrasound were 88% sensitive. All were comparably specific. We conclude that infrared photoplethysmography is comparable to intravenous fluorescein and Doppler ultrasound in the assessment of ischemic intestinal segments. PMID- 3827571 TI - The etiology of symptoms in patients with recurrent carotid stenosis. AB - We performed 33 carotid endarterectomies in 29 patients for recurrent carotid stenosis. The interval between the initial and second operations ranged from six weeks to 11 years with a mean of 56 months. Three types of pathologic lesions were identified: (1) recurrent atherosclerosis (RA), (2) neointimal fibromuscular hyperplasia (NFH), and (3) lesions with elements of both RA and NFH (complex lesions). Histologic examination of early-recurring lesions (less than three years) revealed NFH in 17 patients and one complex lesion. Late-recurring lesions (three years or later) were due to atherosclerosis in eight vessels, NFH in four, and both RA and NFH in three. Focal neurologic symptoms occurred in 25 (76%) of 33 vessels, and an embolic source could be identified in 16 (64%) of 25 patients. Embolic events rather than reduced blood flow due to progressive stenosis are more frequent causes of symptoms in patients with recurrent carotid stenosis than was formerly believed. PMID- 3827572 TI - Growth of neomucosa after intestinal resection. AB - The growth of neomucosa over patched intestinal defects may prove useful in the short-bowel syndrome. This study was done to determine if the timing of intestinal patching with respect to intestinal resection affects neomucosal growth. Twelve dogs underwent 75% intestinal resection, with intestinal patching done either simultaneously or 12 weeks later. Energy intake, final body weight, albumin level, and length of remnant patched were similar in both groups. Forty weeks after patching, neomucosal coverage of the defect (95.2% +/- 2.0% vs 94.2% +/- 1.6%), neomucosal surface area (36.2 +/- 4.5 vs 31.8 +/- 2.9 cm2), and patch size (56.2% +/- 6.8% vs 51.9% +/- 9.7%) were similar in both the simultaneous and delayed groups, as were villus height of neomucosa and disaccharidase activity. Neomucosal growth is similar whether intestinal patching is performed simultaneously or 12 weeks after resection. Intestinal patching is not indicated at the initial intestinal resection. PMID- 3827573 TI - Reconstruction of infected median sternotomy wounds. AB - Infected median sternotomy represents a major complication of cardiac surgery, with significant morbidity and mortality. The treatment of choice is immediate drainage and closure over suction irrigation catheters. However, when this conservative approach fails or radical debridement makes primary closure impossible, muscle flap closure is indicated. This form of reconstruction facilitates the obliteration of large mediastinal wounds; prevents spreading of infection on the heart, suture lines, grafts, or prosthetic material; and significantly decreases morbidity and mortality. We performed muscle flap closure in 11 consecutive patients in whom conservative treatment of infected median sternotomy wounds failed. All patients required closure with at least two muscle flaps or omentum for the complete obliteration of the mediastinal wounds. There was one postoperative death in our series due to acute heart failure. There were two superficial skin losses requiring skin grafting and one persistent draining sinus after reconstruction. Based on our experience and that of others, we conclude that muscle flap reconstruction should be considered as an important technique for the reconstruction of infected median sternotomy wounds. PMID- 3827574 TI - Alterations in renal perfusion and renal energy charge in murine peritonitis. AB - Whether acute renal failure following overwhelming bacterial septicemia is a initially a consequence primarily of a cytotoxic insult or a perfusion insufficiency remains unclear. To assess the effects of intra-abdominal sepsis on the distribution of renal blood flow and renal cell bioenergy status, the glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and energy charge ratios were measured in rats following cecal ligation/puncture (CLP) or sham laparotomies. The CLP animals demonstrated a decrease in ERPF of 42% and 58% from sham groups at ten and 20 hours, respectively. The GFR showed similar but more severe impairments of 53% and 71% at ten and 20 hours, respectively, following insult despite moderate increases in cardiac output. The disproportionate decrease in GFR over ERPF supports the hypothesis of a corticomedullary redistribution of renal blood flow in sepsis. Renal energy charge, unchanged at ten hours, decreased significantly at 20 hours. Diminished renal perfusion and the redistribution of renal blood flow precedes and may contribute to the renal cell bioenergy derangements in septic acute renal failure. PMID- 3827575 TI - Does cholecystectomy affect colonic tumorigenesis? AB - To determine if cholecystectomy predisposes to colon cancer, & study of this operation's influence on chemically induced murine colonic neoplasia was conducted. One hundred mice underwent cholecystectomy or a sham operation. Equal groups received either ten weekly injections of 1,2-dimethylhydrazine (DMH) or injections of saline. Twenty-four weeks after operation, the site, histologic findings, and number of tumors were noted. Crypt metaphase index (CMI) and proliferative zone size (PZS) determinations served as markers of preneoplasia. Tumors were found in the majority of animals receiving DMH while no tumors were found in the saline groups. Both CMI and PZS were significantly increased by DMH administration. Within the saline group, cholecystectomy increased CMI and PZS two and three times, respectively, over levels seen in the sham-operated animals. This suggests that cholecystectomy alone induces preneoplastic changes in the murine colonic crypt. PMID- 3827576 TI - Emergency right colon resection. AB - Controversy exists over the management of the stoma following emergency right colonic resection. To define the stoma management following colon resection, 70 patients who underwent an emergency right colectomy were studied retrospectively. Thirty-six underwent a primary anastomosis and 34 received a diversion with an ileostomy. Indications for resection were as follows: penetrating injury, 28 patients; blunt injury, five patients; obstruction, 13 patients; perforation, 15 patients; vascular injury, seven patients; and hemorrhage, two patients. The mortality was equal in both groups (21%). Severe morbidity directly related to the ileostomy was noted in six patients (18%), and three leaks (8%) were noted in the anastomotic group. High mortality continues to be associated with emergency right colon resection, regardless of the indication for the procedure. This high death rate is not lowered by diversion in deference to an anastomosis. PMID- 3827577 TI - Galactose elimination kinetics in sepsis. Correlations of hepatic blood blow with function. AB - To study hepatic blood flow with clearance techniques during sepsis, it is essential to work within the limitations of the test being applied. Based on galactose elimination kinetics, this study validates galactose clearance at low concentrations as an estimate of effective hepatic blood flow in a rat peritonitis model of cecal ligation and puncture. Hepatic function as determined by galactose elimination capacity fell 25% at ten hours after induction of peritonitis, which correlated closely with the 20% reduction in effective hepatic blood flow at the same time point despite a normal cardiac output. The pattern of reduced flow and reduced function is consistent with intrahepatic flow redistribution. Inadequate flow at the microvascular level with secondary cellular injury may explain the liver dysfunction observed during sepsis. PMID- 3827578 TI - Peritoneal accumulation of infused stroma-free hemoglobin. Potential toxicity of an oxygen-carrying substitute. AB - The efficacy of stroma-free hemoglobin (SFH) as an oxygen-carrying red blood cell substitute in shock and trauma remains inconclusive. A major problem is the retention of sufficient intravascular persistence. The sites and mechanisms for clearance of SFH or its chemically modified variants are not well characterized. Capillary leakage has been reported. Any significant leak into the peritoneal cavity may be toxic, especially if bacteria are present. The present study quantitates peritoneal accumulation of SFH and chemically modified adenosine triphosphate (ATP)-SFH following a 50% exchange transfusion in rats. m-Dansyl cadaverine, an endocytotic blocking agent, was studied for its ability to alter accumulation of hemoglobin in the peritoneum. Differences in renal clearance corresponded to differences in vascular halflife of SFH (90 minutes) and ATP-SFH (210 minutes). Peritoneal leakage was not related to vascular persistence. We found that MDC significantly decreases the peritoneal accumulation of ATP-SFH but not that of SFH. We also noted that MDC neither inhibits nor alters renal clearance of either hemoglobin variant. Total peritoneal leakage is, at most, 4% of infused SFH at four hours. Molecular size and charge might be factors important in hemoglobin transport from the vasculature to the peritoneum. PMID- 3827579 TI - Influence of vein-patch angioplasty on carotid endarterectomy healing. AB - We studied the influence of venous patching on the patency, endothelial regeneration, and wall healing of endarterectomized carotid arteries in a canine model. Thirteen dogs underwent bilateral common carotid endarterectomies (intimectomy and partial media excision). In each dog, one artery was closed by continuous suture and the contralateral artery was closed by external jugular vein-patch angioplasty; arteries were excised at two postoperative intervals (two to three and four to five weeks) for light, scanning, and transmission electron microscopy. The patency of arteries closed primarily (9/13 [69%]) was not significantly different compared with arteries closed with venous patches (12/13 [92%]). By scanning electron microscopy, regeneration of the endothelial monolayer occurred by migration from the endarterectomy end points and suture lines. Despite survival of the vein-patch endothelium, the rate and pattern of reendothelialization was not altered by venous patching. In both patched and unpatched vessels, endothelial regeneration was incomplete at two to three weeks and completed by four to five weeks. The histologic characteristics of the endarterectomized arterial wall after operation were also not influenced by the closure technique. In contrast with the healing artery wall, vein-patch walls did not develop a thickened intima. Although venous patching does not influence early patency, endothelial regeneration, or wall healing after endarterectomy, vein patch angioplasty does increase vessel diameter and prevents the development of circumferential intimal thickening, attributes that are beneficial in minimizing restenosis. PMID- 3827580 TI - Nonoperative management of selected popliteal aneurysms. AB - In the management of 95 popliteal aneurysms, surgical therapy was initially successful in 90% of operations, while major limb amputation was required in 6%. Durability of surgical reconstruction was improved if autogenous saphenous vein was used and if the reconstruction was performed before development of complications. Twenty asymptomatic popliteal aneurysms were repaired without loss of limb and with a five-year secondary cumulative patency rate of 93%. Among 26 small asymptomatic popliteal aneurysms managed without operation, complications developed in only two (8%) during the period of observation. Because of the demonstrated safety and efficacy of surgical treatment, repair of popliteal aneurysms is recommended in acceptable operative candidates. However, there exists a subgroup of asymptomatic higher-risk patients with small popliteal aneurysms in whom a conservative nonoperative approach is reasonably safe. PMID- 3827581 TI - [Determination of endogenous nitrogen in feces using the isotope technic]. AB - A ration consisting of wheat gluten and N-free components was supplemented with L lysine and L-leucine and fed to two groups of growing Wistar rats. Group 1 received 15N Lys and unlabelled Leu, group 2 received unlabelled Lys and 15N Leu in order to study the influence of the utilization of the 15N marker on the labelling quota of faeces and urine as well as various fractions of the body. The good utilization of Lys in group 1 results in a higher 15N excess in faeces and a reduced 15N abundance in urine in comparison to group 2 with a lower utilization of 15N Leu. The results show that the 15N abundance in urine is unsuitable as an indicator of the 15N labelling quota of endogenous metabolic faecal nitrogen. PMID- 3827582 TI - [Urea utilization by growing lambs. 5. N-balance with half synthetic rations]. AB - In experiment with 14-week-old lambs a combination of semisynthetic rations containing 1.2% or 0.7% resp. native crude protein an intraruminal infusion of urea clearly influenced the biologic processes in the rumen. The molar quotas of butyric and valeric acid in comparison with acetic were high. The lambs could cope with infused amounts of 0.67 g urea/kg body weight if they received the daily amount of 1.35 g/kg body weight in two parts. When more than 1.9 g/kg body weight were applied, feed intake decreased even though the daily amount was distributed over 4 doses. In 10 out of 16 lambs N retention was, in dependence on the urea amounts infused, higher than the N amount retained from native crude protein. The result indicates that urea is utilized by 14-week-old lambs. Growing energy and N intake had a positive influence on the N balance. PMID- 3827583 TI - [Annual meeting of the Society for Nutrition of East Germany, Animal Nutrition Section. 9-11 September 1985, Leipzig. Abstracts]. PMID- 3827584 TI - [Dependence of energy maintenance requirements on nutrients in rats. 3. Effect of the protein levels of food on the energy maintenance requirements of growing rats]. AB - In addition to earlier experiments with growing rats on the protein levels 10, 25 and 40% crude protein in the dry matter of the feed (Hoffmann et al., 1982 a), two groups of nine male Wistar rats each received feed mixtures with 6 or 25% crude protein resp. and energy metabolism on the energy maintenance level in an N equilibrium or with a positive N balance resp. were measured on 6 levels of live weight between 65 and 250 g and additionally also at subsequent fasting day. Energy maintenance requirement on average of the 6 periods amounted to 381 and 377 kJ metabolizable energy/kg W 0.75 X d on a low or middle protein level resp. and thus did not show changes at the decrease of N retention to values of about zero even with regard to different ATP formation capacities of the nutrients. PMID- 3827585 TI - [Utilization of N15-labelled urea in the laying hen. 5. N15-labelling of the content and tissue of separate parts of the gastrointestinal tract]. AB - In the series of experiments with labelled urea three colostomized laying hybrids were butchered after a six-day application of 1% urea with 96.06 atom-% 15N excess (15N') in the ration and another 2 days with a supplement of 1% unlabelled urea. Out of the individual samples from crop, gizzard, small intestine, caecum and rectum, the content of the small intestine and the caecum showed the highest labelling with greater than 1 atom-% 15N'. The TCA soluble fraction of the content of the gizzard was more highly and that of the intestines less labelled than the total nitrogen. The tissue of the gizzard is distinctly less labelled than the "omasum system" and the small intestine. The atom-% 15N' of the oesophagus with crop and glandular stomach largely showed agreement in the individual hens with that of intestinal tissue and ranged between 0.71 and 0.89 atom-%. 2% of the 15N' supplemented with the urea could be recovered in the content and the tissue of the gastro-intestinal tract. PMID- 3827586 TI - [Utilization of N15-labelled urea in the laying hen. 6. Incorporation in the liver and kidneys]. AB - In an experiment 3 colostomized laying hybrids received a normal ration containing 1% 15N labelled urea with 96.06% atom-% 15N excess (15N') over six days. Subsequently the same ration with unlabelled urea was given over 2 days, after which the animals were butchered. In the kidneys the 15N' amounted to 1.1 atom-% and 1.8 atom-% in the liver. The TCA soluble N fraction and the ammonia were more highly labelled than the total N. Lysine, histidine and arginine were lowly labelled in the kidneys. This also applies to the liver with the exception of histidine. In the branch-chained and aromatic amino acids of the liver the 15N' was between 0.2 and 0.3 atom-%. The highest labelling of non-essential amino acids was found in glutamic acid with 0.9 atom-% 15N' and aspartic acid with 1.1 atom-% 15N'. The evaluation of the amino acid in the liver showed that the 6 non essential amino acids account for two thirds of the total amino acid 15N' whereas the 9 essential ones account for one third of the amino acid 15N' only. PMID- 3827587 TI - [Vitamin E requirements of laying hens]. AB - In 5 experiments with 1,296 laying hybrids at the age of 22-73 weeks producing eggs for consumption a varied supplementation of between 0 and 20 mg vitamin E per kg of a semisynthetic ration was tested. The vitamin E content of the basal ration was less than 1 mg per kg feed. The quotas of selenium and unsaturated fatty acids in the feed were taken into consideration. Vitamin E and Se supplements did not influence, feed intake, laying, performance, feed efficiency/100 g egg development of body weight and mortality. The supplementation of 14% vitamin-E-free sunflower oil caused a significant decrease of the laying performance by 15%. There was no relation between the humoral immune reaction and vitamin E supply. The peroxide value of the abdominal fat and the activities of the creatine phosphokinase, the aspartate and alanine amino transferase in the blood serum were not directionally changed by the vitamin E, Se and oil supplements. There were no significant relations between the vitamin E content of the feed and that of the yolk and the yolk sac of the chicken. A vitamin E requirement of less than 1 mg and a requirement norm, including a safety margin, of 5 mg per kg feed was derived from the results for laying hens for egg production. A supplement of synthetic vitamin E to laying hen feed is thus not necessary. PMID- 3827588 TI - Reproductive toxicity of acrylamide and related compounds in mice--effects on fertility and sperm morphology. AB - Acrylamide and its three neurotoxic analogues, which are known to induce testicular damage in animals, were tested for reproductive toxicity in male and female mice and for the effect on germ cells in males, after subchronic treatment. After mating the treated males with untreated females, a decrease in fertility rate for all analogues except for N-hydroxymethylacrylamide, and an increase in the number of resorptions/dam for all test compounds were found. When untreated males were mated with treated females, an increase in the number of resorptions/dam was seen only after acrylamide dosing without any effect on the fertility rate. The reproductive toxicity appeared with only slight or no testicular atrophy, and without any apparent neurotoxicity after treatment with all test compounds. High doses of all test compounds produced both a decreased sperm count and an increase in abnormal sperm morphology. PMID- 3827589 TI - The development of acetaminophen-induced nephrotoxicity in male Fischer 344 rats of different ages. AB - Male Fischer 344 rats classified as young (2-4 months), middle-aged (12-15 months) and aged (22-25 months) were administered 600 mg/kg acetaminophen (APAP) IP. Rats were killed 6 and 12 h after dosing, and renal damage evaluated by blood urea nitrogen (BUN) levels and histopathology. In addition, plasma levels of APAP and its sulfate and glucuronide conjugates were determined after 6 h. There was no evidence of renal damage in any age group 6 h after APAP. While no nephrotoxicity was present in young animals after 12 h, BUN was elevated 94% and 214% in middle-aged and aged rats, respectively, compared to young animals. At 12 h, APAP-induced renal lesions were more severe in aged rats compared to middle aged animals. APAP-induced renal damage, as judged by BUN and histopathology, was not altered in young or middle-aged rats following unilateral nephrectomy. Six hours after APAP, both the middle-aged and aged animals had significantly higher plasma levels of APAP and APAP glucuronide compared to young rats. There were similar amounts of the sulfate conjugate in the plasma of each age group. This suggests pharmacokinetic differences could contribute to the age-related increased susceptibility of male Fischer 344 rats to APAP-induced nephrotoxicity. PMID- 3827591 TI - Identification and quantitative determination of mercapturic acids formed from Z- and E-1,3-dichloropropene by the rat, using gas chromatography with three different detection techniques. AB - Z- and E-1,3-dichloropropene, mutagenic geometric isomers and major constituents of commercial soil fumigants, were found to be metabolized to mercapturic acid derivatives by the rat. Extremely small quantities of mixtures of the parent compounds were administered intraperitoneally to the rat and the isomeric urinary mercapturic acids were quantified in three ways. Gas chromatographic procedures with nitrogen selective, sulphur selective and mass spectrometric detection, using negative chemical ionization with single ion detection, were evaluated with respect to selectivity and sensitivity. Applying the former two techniques, urinary mercapturic acids could still be quantified following 5 micrograms doses of each of the dichloropropene isomers. With gas chromatography-negative chemical ionization mass spectrometry, only mercapturic acid metabolites arising from 25 micrograms doses and higher could be quantified because of interference from endogenous compounds. These results suggest that all three analytical methods can be used to determine exposure of men to soil fumigants containing low levels of 1,3-dichloropropene. PMID- 3827590 TI - Toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin in cold-adapted rats. AB - The toxicity of 60 micrograms/kg 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) given IP in corn oil/5% acetone was examined in male Sprague-Dawley rats adapted to 25 degrees C or 4 degrees C ambient temperature. Cold exposure significantly reduced mean time to death and tended to increase mortality. Body weight at the time of death was reduced at both ambient temperatures to about the same extent. Thus, the rate of body weight loss was about twice as fast in non-survivors at 4 degrees C than at 25 degrees C. There was a continuous decrease in feed intake of the non-survivors at 25 degrees C until death. However, no reduction in feed intake occurred in any of the rats at 4 degrees C ambient temperature. At 14 days after dosing all TCDD-dosed animals were hypothyroid in terms of T4 but essentially euthyroid in terms of T3. Oxygen consumption at 10 days after dosing was reduced to the same extent in all TCDD-dosed rats without regard to survival status. By day 20 after TCDD dosage, survivors increased their oxygen consumption at both ambient temperatures to nearly control levels whereas non-survivors were unable to do so. Body temperature of all animals remained within normal range except for the non-survivors, which showed reduced rectal temperature shortly before death.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827592 TI - Species difference between rat and hamster in tissue accumulation of mercury after administration of methylmercury. AB - The accumulation of mercury in tissues of the rat and hamster was determined after the administration of a single dose of 203Hg-methylmercury chloride (10 mg/kg body weight). On day 2, the mercury contents of hamster tissues were higher than those of rat tissues, except for red blood cells, in which the mercury content was about 6-fold higher in the rat than in the hamster. After that time, the mercury content of hamster tissues decreased rather steeply and on day 16 it had reached 14-25% in nervous tissues and 7-15% in other tissues, of the levels on day 2. In the rat, on the other hand, the mercury content of nervous tissues on day 16 was higher than that on day 2 (106-220%), except for dorsal roots and dorsal root ganglia, which showed slight decreases (75-94% of the levels on day 2). In non-neural tissues, the decreases up to day 16 were also small (71-92% of the levels on day 2). Thus, both the uptake and elimination of mercury seem to be more rapid in the tissues of hamster compared with those of the rat. Similar trends of mercury accumulation and elimination were observed when animals received multiple injections of methylmercury that induced acute methylmercury intoxication. Significant biotransformation of the injected methylmercury to inorganic mercury was detected in the liver, kidney and spleen of both animal species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827593 TI - The stability of soman and its stereoisomers in aqueous solution: toxicological considerations. AB - The paucity of information regarding the characteristics of soman (pinacolyl methylphosphonofluoridate) in aqueous solution has limited its use as a toxicological or pharmacological reagent. We report here on the stability of soman under conditions in which it may normally be found during use and storage in the laboratory. Solutions of 1 mM soman in normal saline were not hydrolyzed after 5 months of storage at -90 degrees C. Samples that were repeatedly thawed but not allowed to warm to room temperature and then immediately refrozen showed no apparent hydrolysis. Portions of the same solution, stored in the refrigerator just above freezing, exhibited 50% hydrolysis after 150 days. When portions of this solution were stored at 21 degrees C, the time for 50% hydrolysis was in excess of 5 days. This rate of hydrolysis was the same for all four of the soman stereoisomers. In buffered solutions at pH 7.4, 8.0 and 8.6 the half-times were 6.6, 3.2 and 2.2 h at 27 degrees C and 4.8, 1.6 and 1.2 h at 37 degrees C, respectively. Hydrolysis rates were not significantly influenced by the presence of a carbodimide stabilizer in the agent. There is no reason to expect any deviation from a direct correlation between total soman concentration and toxicity. PMID- 3827594 TI - Studies on the decomposition of the oxime HI 6 in aqueous solution. AB - HI 6 has been shown to be efficacious in soman intoxication of laboratory animals by reactivation of acetylcholinesterase. To assess possible risks involved in the administration of HI 6 its degradation products were analyzed at pH 2.0, 4.0, 7.4, and 9.0. At pH 2.0, where HI 6 in aqueous solution has its maximal stability, attack on the aminal-acetal bond of the "ether bridge" predominates, with formation of formaldehyde, isonicotinamide, and pyridine-2-aldoxime. Besides, HI 6 decomposes at the oxime group yielding 2-cyanopyridine. Liberation of hydrocyanic acid at pH 2.0 is below 5%. At pH 7.4, primary attack is on the oxime group, resulting in formation of the corresponding pyridone via an intermediate nitrile. The pyridone has been isolated and identified as 2 pyridinone, 1-[(4-carbamoylpyridinio)methoxy)methyl)formate. This major metabolite deaminates further to the 2-pyridinone, 1-[(4 carboxypyridinio)methoxy)methyl) derivative, which ultimately decomposes into formaldehyde, isonicotinic acid, and 2-pyridone. Hydrolysis of the acid amide group probably also occurs with HI 6 itself. Significant amounts of free hydrocyanic acid were only detected in the presence of an alkali trap; otherwise hydrocyanic acid reacts with formaldehyde to yield hydroxyacetonitrile from which hydrocyanic acid can be liberated again. Up to 0.6 equivalents of hydrocyanic acid were evolved at pH 7.4. After repetitive administration and impaired renal elimination of HI 6, e.g. during renal shock, there might be some risk of cyanide intoxication. PMID- 3827595 TI - Pharmacokinetics and pharmacodynamics of the oxime HI6 in dogs. AB - The pharmacokinetics and pharmacodynamics of the oxime HI6 were investigated in conscious and anesthetized beagle dogs following intramuscular injection. The absorption of HI6 (100 mumol/kg) was slower in conscious dogs as compared to the anesthetized dogs, and the maximum concentrations in plasma were lower (200 instead of 300 mumol/l). In comparison, the elimination of HI6 (100 mumol/kg) was twice as rapid in the conscious dogs (ke = 0.013 instead of 0.006 min-1) as in the anesthetized animals and was equal to the elimination after injection of 50 mumol/kg (likewise in anesthesia). The more rapid elimination was accompanied by a greater renal excretion of unchanged HI6 (60% instead of 40% in 3 h). HI6 penetrated the blood-brain barrier. The concentration of the oxime in CSF increased rapidly during the absorption phase (by 30 min after injection). The maximum concentrations (1-3 mumol/l) were reached between 60 and 120 min. The peak concentrations in plasma and CSF did not correlate with each other. In the anesthetized dogs the higher dose of HI6 (100 mumol/kg) caused a steady decrease in mean blood pressure (20 mm Hg) and blood flow (50%) in the femoral artery and a fall in left ventricular pressure (20 mm Hg), lasting for at least 60 min; the lower dose (50 mumol/kg) did not cause circulatory effects. EKG, respiration, hematocrit, arterial blood gases, and pH were not influenced. PMID- 3827596 TI - Effect of sub-chronic endosulfan exposure on humoral and cell-mediated immune responses in albino rats. AB - The present study was designed to evaluate the effect of sub-chronic doses of endosulfan on humoral and cell-mediated immune (CMI) responses in albino rats. Male albino rats were given a diet containing 5, 10 or 20 ppm endosulfan for 8-22 weeks and immunized with tetanus toxoid in Freund's complete adjuvant subcutaneously 20 days before terminating the exposure. The humoral immune response was studied by serum globulin level, immunoglobulin (IgM and IgG) concentration and antibody titre against tetanus toxoid. The CMI response was studied by leucocyte migration inhibition (LMI) and macrophage migration inhibition (MMI) factors. The antigen-induced increases in serum globulin fraction and immunoglobulin level were reduced at high doses of the endosulfan after 12 weeks of exposure. Antibody titre was significantly decreased in endosulfan-exposed rats at 10 and 20 ppm levels and a consistent trend was observed. Rats in the 10 and 20 ppm dose groups had significantly depressed LMI and MMI responses. Results obtained in this study revealed marked suppression of the humoral and CMI responses in rats administered with sub-chronic doses of endosulfan. Both cellular and humoral immune responses were decreased in a dose time dependent pattern. Suppression of immune responses by endosulfan is clearly an important aspect of its toxicology. PMID- 3827598 TI - Concerning the article "Toxicity studies on clove cigarette smoke and constituents of clove: determination of the LD50 of eugenol by intratracheal instillation in rats and hamsters" by LaVoie et al. (1986) PMID- 3827597 TI - Metabolism of free fatty acids (FA) and triacylglycerol (TG) in acute and subacute fluoride intoxication of the rat. AB - In rats acute intoxication with 100 mg sodium fluoride/kg body wt. orally has the following metabolic consequences. Oxygen consumption is reduced by about 30-50%. Plasma free FA decrease in fed as well as in starved rats. Hepatic FA synthesis is enhanced, but TG secretion to the blood is not altered. Intravenously injected Intralipid 20% is removed at a normal rate. In subacute intoxication (30 mg sodium fluoride/kg body wt given orally per day over 1 week) oxygen consumption is not affected. TG secretion and removal of Intralipid remain in the normal range whereas hepatic FA synthesis is increased as in acute intoxication. TG concentration in the liver, however, increases by about 30% after 1 week. PMID- 3827599 TI - Replication of human adenoviruses in guinea pig embryo cells: an ultrastructural study. AB - Guinea pig embryo (GPE) cells showed different degrees of susceptibility to human adenovirus types as determined by virus infectivity assay and electron microscopic examination. Adenovirus 2 and 5 induced extensive cellular changes and produced high titers of infectious virus in GPE cells as in human cells. Mature progeny virus and protein crystals were observed in both cell types. Adenovirus 7 induced some cellular changes in GPE cells but only a small number of cells yielded progeny virus as determined by electron microscopy. Adenovirus 3, 8 and 31 induced some cellular changes but no progeny virus was found under electron microscopic examination. Characteristic fibers were observed in nuclei of adenovirus 31 infected cells. The ability of human adenovirus 2 and 5 to replicate in GPE cells is an example of an unusual cross-species biological property of certain adenovirus types. This property may be useful as a biological marker for these virus types. PMID- 3827600 TI - Passive immunization of mice with monoclonal antibodies raised against tick-borne encephalitis virus. Brief report. AB - Adult Balb/c mice were passively immunized with monoclonal antibodies (100 micrograms/mouse) raised against tick-borne encephalitis (TBE) virus then challenged 24 hours later s.c. with 10 LD50 of TBE virus (Neudorfl isolate). None of the mice showed evidence of premature death although all except one of the monoclonal antibodies tested are capable of enhancing the infectivity of TBE virus in the Fc receptor-bearing mouse macrophage-like cell line P 388 D 1. The ability of monoclonal antibodies to neutralize TBE virus in vitro, and to fix complement was examined, and of these properties only a single monoclonal antibody, which was able to neutralize virus, was also able to protect mice against virus challenge. PMID- 3827601 TI - Intestinal replication of influenza A viruses in two mammalian species. Brief report. AB - The sites of replication of influenza A viruses in ferrets and pigs were studied. The majority of the swine, equine, and avian influenza A viruses tested were recovered from the intestinal tract of ferrets as well as from the respiratory tract; most of the human influenza viruses studied were recovered only from the respiratory tract. In contrast with ferrets, only Hong Kong/1/68 (H 3 N 2) influenza virus was recovered from the intestinal tract of pigs. Despite the large biological variability found in ferrets and in pigs, the results do establish that the majority of influenza viruses have the potential to replicate in the intestinal tissues of some mammals. Additionally, the study suggests that there are differences among the influenza A viruses in tissue tropism in different mammals. Both viral and host genetic factors determine the tissue tropism of influenza viruses in mammals. PMID- 3827602 TI - [Correlation between small airway obstruction and bronchial responsiveness in patients with bronchial asthma and chronic bronchitis]. PMID- 3827603 TI - [Comparison of bioavailability and pharmacokinetic profiles between Theodur and a new sustained-release theophylline formulation]. PMID- 3827604 TI - [Pathogenesis of radiation-induced abnormalities of the bones and joints of white rat embryos]. AB - After X-radiation of pregnant rats on the 10th day of pregnancy, in 50% of the fetuses studied subtotal aplasia of the tibial bone anlage and decreasing number of the metatarsus and finger phalanges anlages are observed. Radiation on the 11th day of embryogenesis does not result in anomaly formation of the thoracic and pelvic extremities. After radiation on the 12th day of embryogenesis, the most specific anomaly of the pelvic extremity is phocomelia. The thoracic extremity skeleton lesions are revealed as an ulnar type of distal ectromelia, or axial ectromelia. After radiation on the 13th--14th day, hypoplasia of the bone anlages, that make zeugopodium, autopodium, is observed. After radiation on the 13th day, a partial or total aplasia of the fibular bone anlage can take place. In all the fetuses a sharp decrease in number of the hand and foot bone anlages is observed; it is connected with a total aplasia of some of them and with fusion of the others. A specific feature for radiation lesions of the extremity skeleton is that the oppositely situated anlages of the bones do not separate from each other. This results from certain disturbances in the joint interzone formation at early stages of embryogenesis and from underdevelopment of the joint cleft. Qualitatively different radiation anomalies of the extremity skeleton development are formed as consequence of disturbances in morphogenetic processes of determination: migration, proliferation, morphogenetic cell death and differentiation. PMID- 3827605 TI - [Projections of the amygdala and septum to the caudate nucleus of the cat brain]. AB - By means of the retrograde axonal transport of horseradish peroxidase in the cat, direct projections of neurons in the magno- and mediocellular parts of the basal nucleus of the amygdalar complex have been stated nearly to all parts of the caudate nucleus and projections of a small amount of neurons in the nucleus of the Brocka diagonal ligament--only to the medial edge of the caudate nucleus. The possibility to divide the caudate nucleus into limbic and non-limbic parts is discussed. PMID- 3827606 TI - [Morphofunctional restoration of a nerve trunk by filling the defect with a blood vessel]. AB - Dynamics of morphologic and functional restoration of the nerve trunk and separate receptive skin formations have been investigated in white rats after a sutureless connection of the cut nerve by means of the implanted artery. For testing the reparative processes neurohistological and electrophysiological techniques have been used. In spite of a relatively early restoration of the integrity of the injured nerve and reaching the nervous fibers up to the skin, functional organization of the dermal sensory apparatus is observed only in a year after the operation. PMID- 3827607 TI - [Morphologic differences in the cutaneous receptors of low- and high-excitability lines of rats]. AB - By means of methylene blue staining of the rat plantar skin, receptor terminals in lines with low- and high-excitability have been revealed with a subsequent morphometric and cytophotometric estimation of the dye sorption degree. Divergence of the signs at selection according to excitability of the nervous muscular apparatus is spreading to the peripheral nervous system elements, affecting its structural and tinctorial indices. In rats with low threshold of excitability increasing size of the receptor plates and areas of the receptors division is observed in comparison to the animals with high threshold of excitability. The receptors in the former line are stained less intensively than the receptors in the latter line. PMID- 3827608 TI - [Morphologic aspects of local blood flow regulation in the myocardium]. AB - In 67 preparations of the human hearts at the first and second periods of mature age, spatial interrelations between blood vessels and cardiac muscle fibers in the ventricle myocardium have been studied. All the elements of the myocardial blood bed are oriented under a certain angle in relation to the cardiac muscle fibers. Regular arrangement of the arteries and sinusoid dilated veins under endocardium on the top of the papillary muscles and in the muscular trabecules is demonstrated. As proves the mathematical model, the slope orientation of the blood bed elements towards the cardiac muscle fibers ensures and adequate realization of the external influence of the contractile cardiomyocytes to the successive movement of blood along the intramural myocardial vessels. From morphological positions, a conclusion on the mechanism of the intracavitary pressure effect on blood movement along the intramural veins of the ventricular myocardium is argued. A conclusion is made on the leading role of the extravascular factors (intramyocardial and intercavitary pressure) in the local regulation of the blood stream in the myocardium and in development of working cardiac hyperemia. PMID- 3827609 TI - [Formation of structuro-functional units of the microcirculatory bed of muscles in the postnatal period of the ontogenesis of the white rat]. AB - By means of biomicroscopy, histological methods and scanning electron microscopy topological relationships between the white rat m. cremaster microvessels and changes of their spatial organization have been studied in the postnatal development beginning from the 3d to the 14th week. In the terminal link of the microcirculatory bed zonal functional complexes of microvessels--myoangions are revealed. They represent rather autonomic and regularly repeating constructions of microvessels, having spatial regularity in respect to muscle fibers. With age the myoangion increases its stretchness from 303 +/- 14 in 3-week-old up to (70 +/- 3) X 10 mcm in 14-week-old animals. Capillary density in the m. cremaster during the development decreases from 354 +/- 12 up to 210 +/- 4 mcm, respectively. Distance between the longitudinal capillaries increases from 16.1 +/- 1.3 up to 31.2 +/- 1.8 mcm. Increase of transversal connections takes place in the capillary network, increasing number of the branching knots; this demonstrates certain complication of the nutritive link of the muscle microcirculatory bed. By the time of sexual maturation (6 weeks) there is a sharp decrease of the inflow and outflow coefficients. Higher meanings of the coefficient (0.70-0.74) are noted before sexual maturation period in comparison to that in mature animals (0.53-0.55). PMID- 3827610 TI - [Cyclic groups of nonlinear transformations in morphology and the conception of cyclogenesis]. AB - When describing multiunit organic forms, it is expedient to generalize the classic science on biological symmetries of similarity at the expense of transition to symmetry operations from wider groups of transformations, first of all mebiusian and projective. A vast class of biological structures is successfully modelled on the base of cyclic groups not only the linear, but also non-linear transformations. This is evidently connected with existence of morphogenetically significant biochemical cycles. The suggested means of mathematical modelling for biological symmetries open new possibilities of morphometrical analysis and investigation of a known problem of morphogenetic parallelisms. The results obtained prove V. V. Vernadsky's hypothesis on biological significance of the non-Euclidian geometry. PMID- 3827611 TI - [Functional significance of the left adrenal vein and the gonadal veins]. AB - Owing to the investigation of changeability variants of the left adrenal, anastomosis of the inferior diaphragmatic and ovarian (testicular) veins- tributaries of the human left renal vein, three variants in inflow of the left adrenal vein in comparison to the left ovarian (testicular) vein have been revealed. In the first variant, that occurs in 70% of cases, the left adrenal vein flows into the left renal vein by 15 cm more medially from the ostium of the ovarial (testicular) vein. The second variant occurs in 11%. The left adrenal and ovarian (testicular) ostia are situated at the same level. The distance from the hilus renalis to the place, where the ostia mentioned get into the renal vein, is about 39 mm. In the third variant (19%) the left adrenal vein gets into the left renal vein nearer to the hilus renalis than the ovarian (testicular) veins. An average distance from the hilus renalis to the ostium of the left adrenal vein is 33 mm. The second variant, when the left adrenal vein gets into the left renal vein, contributes to appearance of the primary varicocele at the left. When the operation for nephrectomy is made at the left, our data make it possible to recommend a purposeful ligation of the left renal vein more laterally to the ostium of the ovarian (testicular) vein. In 80% this ligation will not disturb the function of the left adrenal vein. PMID- 3827612 TI - [Growth of the jugular lymph sacs and establishment of the topography of the cervical portion of the thoracic duct during early human ontogenesis]. AB - In 196 human embryos, prefetuses, fetuses and newborns, by means of a complex of morphological methods, development of the jugular lymphatic sacs and the process of settling of the thoracic duct cervical part topography have been studied. The jugular lymphatic sac anlages take place on the 6th week of the development. From the lymphatic cleft, situating in the mesenchyme near the anterior cardinal veins, multichambered cavities laid with endotheliocytes are forming,--the jugular lymphatic sacs. Connection of the initially close lymphatic sacs with the venous system takes place secondarily by the end of the embryonic period of development. In the area of the sac ostia a valve is formed, that makes morphological premises for unidirected lymph flow into the venous system. The lymph nodes developing at the place of the reducing jugular lymphatic sacs, ensure formation: from the left jugular lymphatic sac--the cervical part of the thoracic duct, from the right jugular lymphatic sac--the right lymphatic duct and the jugular and the subclavicular lymphatic trunks. Variability in the form and topography of these structures are determined both by the form and construction of the jugular lymphatic sacs and by developmental peculiarities of the lymph nodes at their place. The process of settling of the thoracic duct cervical part topography depends on age changes of its size and form, as well as on development of structures situating nearby, and by the time of birth it is not completed. PMID- 3827613 TI - [Age and the extent and topography of solitary lymphoid nodules in the wall of the human small and large intestine]. AB - Amount and topography of small lymphoid nodules (SLN) have been studied by means of the quantitative method in flat total preparations of the small and large intestine obtained from 111 corpses of persons of both sex (from newborn up to old age). Total amount of the SLN in the large intestine wall in all age periods exceeds that of the SLN in the small intestine wall. From birth up to the period of the 1 childhood total amount of the SLN increases successively, reaching (51 +/- 14) X 10(2) in the small and (74 +/- 11) X 10(2) in the large intestine at the age of 4-7 years. Beginning from 8 years of age up to old age, total amount of the SLN decreases successively, to a more degree in the wall of the small intestine than in the large intestine. The arrangement density of the SLN in the large intestine wall essentially exceeds that of the SLN in the small intestine wall during the all age periods. From birth up to early childhood the arrangement density of the SLN increases and then gradually decreases both in the small and large intestine. This demonstrates that development of the SLN takes place during the first 4-7 years of the human life, in contrast to the lymph nodes and tonsils, their greatest development takes place during juvenile and adolescent age. PMID- 3827614 TI - [Macrophage activation in the immune response]. AB - In inbred white rats, immunized with sheep erythrocytes, contents and phagocytic activity of the spleen and pulmonary macrophages have been studied on the 3d, 4th, 5th, 6th, 7th, 11th, 14th and 20th days of the experiment in the light, scanning and transmissive electron microscope, as well as the effect of the cells mentioned on proliferation of lymphoid elements. Maximal phagocytic activity of the splenic and alveolar macrophages is observed on the 7th day of the experiment. At the same time, certain drop in the lymphoid cells proliferation takes place. The change in the macrophages contents also influences proliferation of the lymphoid cells. PMID- 3827615 TI - [Possible causes of the heterogeneity of the histochemical properties of tissue basophils]. AB - By means of a complex of histochemical staining techniques cytoplasmic biopolymeres of tissue basophils (TB) have been studied in the stomach of the men (64 observations), in that of the rat and dog (40 species each). The data obtained are compared to those of the literature on presence of histamin in the TB investigated. A hypothesis is formulated according to which heterogeneity of the TB histochemical properties at the level of the histophysiological microsystem is a reflection of the intertissue integration along the line: parenchymal cell-TB of the connective tissue stroma; at the cellular level TB heterogeneity is determined by presence or absence in them of histochemically determinated protein, its qualitative composition that, in its turn, depends on type and/or on set of bioamines, initiating the TB new formation. PMID- 3827616 TI - [Prospects and approaches to improving pathologo-anatomic services from the standpoint of the therapist]. AB - The paper defines the morphologic basis of modern clinical medicine as one of the determining factors of its further development. Approaches to improvement of studies of the life-time biopsy specimens are discussed, as well as variants of cooperation between the pathoanatomists and clinical morphologists. The system of pathoanatomical reports, the work of treatment- and- control commissions and conferences on clinical anatomy are considered from the physician's point of view. Optimal measures should be taken to make the analysis of the physician's errors comprehensive and useful. Combined efforts are needed for the further improvement of the nomenclature, classification and terminologic characteristics of the diseases. Closer interactions between the pathoanatomists and therapists are suggested. PMID- 3827617 TI - [Chronic dissecting aneurysm of the aorta]. AB - Three observations (2 males, aged 44 and 63, and a female of 47) of chronic dissecting aortic aneurysms are described. In all the cases the patients didn't die immediately from the acute dissection, as the blood accumulated in the canal formed, broke back into the aortic lumen, thus a lower orifice of the chronic aneurysm was formed. It might be possible that in some aortic dissections the hematomas fused, forming subsequently a canal. The new canal joined the main trunk (the aorta) by 2 or 3 orifices. The duration of the dissection was not identified clearly, but the canals formed were in all cases organized and had a smooth inner surface. Histology revealed striate-like necroses in the aortic wall, as well as fragmentation, swelling and lysis of the elastic fibers, resulting in the formation of slits, cavities with accumulation of metachromatic substances, i. e. the changes, characteristic for the medianecrosis (Gsell Erdheim syndrome). A possible primary injuring effect of xenobiotics on the aortic wall is suggested. PMID- 3827618 TI - [Pathomorphology and morphogenesis of obliterating endarteritis]. AB - The author has examined the pathomorphological arterial changes in 37 amputated legs of patients with obliterating endarteritis. He has studied the principal morphogenetic stages of the disease. Obliterating endarteritis was shown to have an inflammatory origin. Its morphogenesis was found to be characterized by the main stages appearing in the following order: fibrinoid swelling and necrosis of the intima; lymphoid-macrophagal infiltration of the intima (sometimes with presence of giant multinuclear cells) involving the media; intimal hyperplasia and thrombosis occluding the vascular lumen; sclerosis of the vascular wall. At different levels of the amputated limb one could find different stages of the pathologic process due to the undulating character of the disease. The distal sites of the major arteries (mainly located in the lower third of the crus) were the first to undergo changes, and the disease progressed proximally. PMID- 3827619 TI - [Diabetic macroangiopathies of the lower extremities]. AB - Arteries of 98 legs amputated for diabetic and arteriosclerotic gangrene were studied, as well as arteries of diabetic patients whose death was not associated with the lower limb pathology; 10 legs of subjects killed in an accident were examined for control. The authors applied histological, histochemical, angiographical, and morphometrical methods in line with multifactorial statistical analysis of the revealed changes. Morphological manifestations of the arterial changes found in the lower limbs of patients with diabetic and arteriosclerotic gangrene appeared to vary significantly in frequency and predominant localization of lipid/fibrous plaques and organized thrombi causing the occlusion of major arteries, in the patterns of plaque and muscular layer calcinosis, as well as in the features of the development of collateral circulation. Therefore, the authors consider diabetic macroangiopathy not as early acute arteriosclerosis, but as a separate pathologic entity. PMID- 3827620 TI - [Current problems in improving pathologo-anatomic services]. AB - A number of organizational measures directed to the improvement of pathoanatomic service has been put forward for the discussion. In particular, it is advised to generalize regularly all the autopsy findings according to a unified form, which will be of the greatest scientific and practical importance. The authors necessitate increasing the number of autopsies in cases of death at home. Measures to improve the quality of investigating the biopsy and surgical material are recommended, as well as methods of monitoring this work. The major principles in appointing the Chief regional pathoanatomist are discussed. PMID- 3827621 TI - [Hypertensive angiopathy of the brain]. AB - Cerebral vessels were studied by light microscopy in 20 autopsies after hemorrhagic stroke from arterial hypertension. Primary (acute), secondary (reparative) changes, as well as changes reflecting compensatory-adaptive processes, were found in the intracerebral and superficial arteries of the brain. The whole complex of these vascular changes was defined as hypertonic angiopathy. The usage of such terms as "angiopathy" and "combined angiopathy" were discussed. Criteria of morphologic diagnosis of angiopathies were proposed. PMID- 3827622 TI - [Ultrastructural diagnosis of changes in the human myocardium during protection of the heart with cardioplegic solutions]. AB - Results of qualitative and quantitative assessment of myocardial changes are presented based on examinations of 180 cardiobiopsy specimens taken from 58 patients with acquired heart diseases during open-heart surgery. For quantitative assessment of intracellular organelle changes a 6-score scale has been developed by means of which the time course of injury to the major cellular components was studied: before aortal clamping, at the height of ischemia, and during reperfusion. Basing on the integral assessment of structural changes it is possible to assess the severity of myocardial damage; such approach is valuable in the assessment of the efficacy of cardioplegic solutions in the clinical practice. PMID- 3827623 TI - [Effect of experimental acute ischemia on capillary-neuro-muscular relations]. AB - Ultrastructural changes in myofibrils, their supplying hemocapillaries, and motor nerve endings were studied in 24 dogs with the experimental acute circulatory ischemia induced by injury to the major arteries of the limbs or tourniquet application for 2, 4, 6, and 9 hours, as well as during the blood stream restoration. Structural rearrangements of myofibrils, capillaries, and axomuscular synapses were found to be simultaneous and depend on the severity of ischemia. Six-hour disruption of the blood flow causes breaking of intracellular homeostatic mechanisms in the soft tissues of the extremities, while a 9-hour ischemia causes irreversible changes in the muscle tissues. PMID- 3827624 TI - [Pseudotumor processes in children ( according to material from the Filatov Children's Clinical Hospital)]. AB - Pseudoneoplastic tumors are considered as a clinicoanatomic entity with a characteristic macro- and microscopic pattern, obscure etiology and genesis. The dissection data have demonstrated the forms of pseudoneoplastic processes. Observations of the most rare pseudotumors, such as "inflammatory" pseudotumor and tumor-like myositis ossificans are presented. "Inflammatory" pseudotumors are characterized by the involvement of the immune system cells, increased fibrillogenesis, and intensive osteogenesis in the lungs and the stomach. Cases of pseudoneoplastic myositis ossificans combined with tissue malformation are given particular attention. PMID- 3827625 TI - [Relation between lymphogenous metastasis of cancer of the rectum and the structure and function of the lymphatic bed]. AB - Lymph vessels of the rectum in health and during early stages of metastasizing rectal cancer were studied. It was shown that changes occurring at this stage constitute the "cascade" process whose stages are determined by 3 structural elements of the rectal lymphatic vasculature, i. e. capillary, postcapillary, and vessel. Compensatory adaptive changes in the lymphatic routes in rectal cancer and in cases of secondary metastases to the rectum were examined. PMID- 3827627 TI - [Method of producing cooled liquid propane in a histochemistry laboratory]. AB - A simple and inexpensive method of gaseous propane liquefaction is proposed using the facilities of a histochemical laboratory. The method is based on the principle of propane condensation. Propane has a higher liquefaction temperature than liquid nitrogen used as a cooling agent. The method advocated provides production in 5-7 minutes of 15-20 ml of liquid cooled propane by the evaporation of about 100 ml of liquid nitrogen. PMID- 3827626 TI - [Letterer-Siwe disease in half-brothers]. AB - Letterer-Siwe disease is reported in half-brothers, 15 and 11 months old, with a duration of the disease about 2 and 1 month. A similar clinical picture manifested by hyperthermia, hepatosplenomegaly, moderate lymphadenopathy, cutaneous changes in one of the brothers, increasing hypochromic anemia, thrombocytopenia, as well as similar morphologic changes (marked histiocytic infiltration of the viscera, hemorrhages, necroses, neoplastic changes in the liver and lungs of one boy) allowed differentiation of familial hemophagocytic histiocytosis from Letterer-Siwe disease in one family. PMID- 3827628 TI - [Pathohistology of costal cartilage and immunomorphologic characteristics of collagen in funnel chest]. AB - Biopsy samples from the costal cartilage tissue were studied for 68 children with funnel deformity and from 20 children with normally formed chest. The authors present general morphologic features characteristic of the costal cartilage structure in norm and in case of funnel chest. These features include vast acellular sites, map-like areas, unmasked chondrin fibers and "marrow" cavities. In funnel chest they develop, however, 6-7 years earlier, than normally, and are consequent stages of the accelerated costal cartilage involution. Costal cartilage matrix was found to have an increased content of fibronectin and V collagen type in case of funnel chest. Besides III and IV procollagen types were noted in the chondrocytes. The accelerated growth of costal cartilages is involved in the formation of funnel chest. PMID- 3827629 TI - [Reactive-inflammatory process in the spinal canal after implantation of autologous intervertebral disk cartilage]. AB - The results of 6-month follow-up morphologic and immunomorphologic studies on 34 rabbits after the implantation of an autologous intervertebraldisk cartilage into the epidural space are presented. The data indicate of the reactive inflammatory process with a specific two-phase course of development. The cellular structure and the change of immunocompetent cell populations in the inflammation foci suggest the formation of hypersensitivity reaction 3 weeks after implantation. Inflammatory reactions in the vertebral canal tissues in response to disk fragment prolapse result in wide-spread cicatrix changes. PMID- 3827630 TI - [Molecular-genetic mechanisms of the pathogenesis of human diseases related to disorders of processes involved in the repair of DNA damage]. AB - One of the major systems providing cellular homeostasis is a system of DNA repair. Disorders of this system lead to the development of certain diseases, transformation of a normal cell into a malignant one, premature aging of a cell. The activity of reparative systems is related with an enzyme complex controlled by the corresponding genes. A number of hereditary diseases is described in which disturbances in the DNA reparative processes induced by physical or chemical mutagenes are found. Some diseases are also characterized by genome instability due to which there is a spontaneous increase in chromosome aberrations or sister chromatid exchanges. The impairment of the reparative DNA processes was first found in the author's laboratory in a number of hereditary diseases (Marfan's syndrome, homocystinuria) and diseases with hereditary prerisposition (schizophrenia). It is suggested that disorders of reparative DNA systems form the basis for molecular and genetic mechanisms of pathogenesis both in hereditary diseases, and the diseases with hereditary predisposition. Knowledge of the molecular level of cell organization in the pathologic state will ensure new methods of diagnosis and treatment. PMID- 3827631 TI - [Possibilities for defining dysplastic changes in the gastric mucosa during cytologic studies of gastric biopsies]. AB - The authors compared the data of cytologic and histologic studies of gastric biopsy material from 95 patients with different degree of epithelial dysplasia revealed histologically. Differentiation impairment and epithelial cell atypia can be revealed in cytologic preparations; basing on these features epithelial dysplasia was diagnosed cytologically in 40 patients (30 of them with adenomas). Cytological and histological diagnosis of epithelial dysplasia did not fully coincide. The most reliable are the cytological features of severe dysplasia, thus the main goal of a morphologic study is achieved. One should not identify the term "dysplasia" in a cytologic study with a term "proliferation". Gastric biopsy material may have the following cytologic characteristics: tegmental-fossa epithelium proliferation, marked proliferation of tegmental-fossa epithelium with atypia, epithelial dysplasia and such epithelial dysplasia when cancer is not ruled out. PMID- 3827632 TI - [Prognostic significance of histologic signs in squamous cell carcinoma of the skin of the trunk and extremities]. AB - One hundred sixteen cases of squamous cell skin cancer were studied: 83 male and 33 female patients, with their age range being 21-73 yr (mean 50.1 +/- 4.3 yr.). Extremities were the most common localization. The aim of the work was to clarify the correlation between morphologic features and clinical course of the disease. Six out of 14 histologic features studied have demonstrated statistically significant correlation with clinical course. They are: 1) tumour margins; II) form of tumour structures; III) the size of tumour invasion; IV) the presence of tumour cells in the vessels; V) the degree of lymphoplasmocytic infiltration; VI) maximal number of mitoses in one visual field. Three malignancy degrees of squamous cell skin cancer were determined basing on the above-mentioned criteria. Degree I was characterized by 2.8% of metastases and the 5-year survival was 97.2%; for degree II the figures were 26.1% and 85.1%, respectively; and degree III--76.9% and 35.6%, respectively. PMID- 3827633 TI - [Cytologic diagnosis of glial tumors of the central nervous system]. AB - The authors analysed retrospectively 476 histologic and cytologic preparations made from the biopsy specimens of neuroectodermal CNS tumours. The identity of histologic and cytologic diagnoses was determined in 89.5% of cases. Cytologic diagnostic criteria for tumours with different histogenesis, such as astrocytomas, oligodendrogliomas, ependymomas, glioblastomas, medulloblastomas, are presented. Anaplasia features of these tumours are identified according to IV degrees of malignancy. PMID- 3827634 TI - [Clinico-anatomic correlations in active forms of tuberculosis]. AB - Basing on 1957 autopsies of the patients with active forms of TB that has been incorrectly diagnosed either intravitally, or postmortEM, the authors distinguish 5 forms of discrepancy between the pathoanatomical and clinical diagnoses. Thus, spread progressive TB was primarily diagnosed postmortem in 12.3%; the discrepancy of the diagnoses in form, stage, specific TB complications was found in 46.5%; "pseudo-diagnosis" of TB was made in 1.7%; the difference in the diagnoses concerning the associated diseases was noted in 26.6%; no information on TB in the pathoanatomical diagnosis when death occurred of other diseases and accidents was found in 12.9%. To improve the intravital and postmortal diagnosis of TB the authors recommend to organize a course of lectures on TB for different specialists, as well as to introduce special cards of emergency to be sent by the pathologic anatomists and medicolegal experts to the antituberculous dispensaries. PMID- 3827635 TI - [Aspergillotic septic endocarditis of the mitral and trigeminal valves as a complication of silicotuberculosis]. AB - Fungal endocarditis is caused by fungi Candida and Aspergillus. Continuous intravenous infusions, catheterization, open-heart surgery, tracheal injuries, artificial heart valves can serve as predisposing factors. Aspergillus endocarditis is more common in severe infectious diseases after a prolonged use of antibiotics, cytostatics, glucocorticoids. A case of aspergillus endocarditis of mitral and tricuspid valves is described in a 55-year old patient. The man had been long suffering from silicotuberculosis and had been on a prolonged antibacterial therapy. The aspergillus endocarditis must have developed in the patient due to marked dysbacteriosis. PMID- 3827636 TI - [Case of death from trichinosis with acute lesions of the stomach and small intestine]. AB - A 54-year old man was hospitalized with such acute complaints, as vomiting, fatigue, severe gastric pain, progressive weight loss. Gastric cancer was suspected, but the severity of the patient's state excluded X-ray examination of the stomach. The death occurred on day 9 of the hospital stay. It was only the microscopic pathoanatomic examination of the stomach and small intestine, that revealed trichinosis. Absence of Trichinella larvae in the gastric mucosa was suggestive of a massive alimentary infection in the patient. PMID- 3827637 TI - [Xanthogranulomatous cholecystitis]. AB - The morphologic changes are described found in the gallbladder of a female patient, aged 40; she had xanthogranulomatous cholecystitis secondary to cholelithiasis combined with a hiatal hernia and multiple duodenal diverticulae (Saint's triad). PMID- 3827638 TI - [Histologic varieties of adeno-squamous cancer of the endometrium]. AB - Adenosquamous carcinoma of the endometrium combines glandular and squamous cell tumour structures. It is advisable to distinguish well- and poorly differentiated variants of adenosquamous carcinoma (ASC). Well-differentiated ASC is characterized by the intraglandular growth of squamous cell structures in the form of pseudopapillae and has a favourable prognosis (5-year survival rate is 88%). Squamous cell structures of poorly differentiated ASC involve the myometrium in line with the glandular component and this variant has an unfavourable prognosis (5-year survival rate in 45%). PMID- 3827639 TI - [What to call glomerulonephritis: controversial problems of classification]. AB - Basing on the general pathologic definition "glomerulonephritis" the authors analyse its modern morphologic classifications and arrive at a conclusion that minimal changes (lipoid nephrosis), membranous glomerulopathy and focal segmental glomerular hyalinosis should be excluded from the group of glomerulonephritis. These diseases form the group of primary nephrotic syndrome. Glomerulonephritis group is represented by the following morphologic forms: proliferative (endo- and extracapillary, mesangioproliferative and mesangiocapillary) and sclerosing (fibroplastic) glomerulonephritis. Each of these forms can reflect the peculiarities of etiology (the presence of infection), pathogenesis (the character of the immunopathologic process), morphology (type and the degree of glomerular inflammation extension), clinical manifestations (degree of renal and extrarenal symptoms) of glomerulonephritis, its course (acute, subacute, chronic) and prognosis. PMID- 3827640 TI - [Does glomerulonephritis exist?]. PMID- 3827641 TI - [Glomerulonephritis today]. PMID- 3827642 TI - [Functional morphology of interstitial cells of the renal medulla after treatment with indomethacin and unilateral nephrectomy]. AB - The ultrastructure of the renal medullary interstitial cells was compared with the quantitative estimation of the interstitial space and its proteoglycan content after stimulation (left nephrectomy) and inhibition (indomethacin administration) of the prostaglandin synthesis. Lysosomes were found to play a functional role in the lipid granule depletion and arachidonic acid release. The ratio of lysosomes to lipid granules within the interstitial cells may serve as a criterion of their functional activity in the process of prostaglandin synthesis. Functional state of the rough endoplasmic reticulum of the interstitial cells was indicative of the cells involvement in the production of the mediate intercellular substance. PMID- 3827643 TI - [Correlation between bidimensional echocardiography and left cineventriculographic findings in the apical lesion of the left ventricle in chronic Chagas' cardiopathy]. PMID- 3827644 TI - [Pericardial diseases: clinico-surgical aspects]. PMID- 3827645 TI - [Long-term study of patients with the Lifemed heterologous prosthesis]. PMID- 3827646 TI - [Evaluation of ventricular performance in acute myocardial infarction]. PMID- 3827647 TI - [Normalization of contractile dysfunction with digitalis in patients with mitral valve prolapse. Echocardiographic demonstration using the phenylephrine test]. PMID- 3827648 TI - [Treatment of hyperlipidemia]. PMID- 3827649 TI - [Probucol in the treatment of hyperlipidemias]. PMID- 3827650 TI - [Analysis of the movement of the interventricular septum in complete left bundle block]. PMID- 3827651 TI - [Prognosis of myocardial infarction by dynamic echocardiography. Proposal of a new score]. PMID- 3827652 TI - [Myocardial bridges of the anterior descending arteries. Morphological study]. PMID- 3827653 TI - [Use of laser beams in the removal of atheromatous plaques in vivo. Experimental study]. PMID- 3827654 TI - [Acute myocardial infarction and spontaneous reperfusion. Impact on the global and regional function of the left ventricle]. PMID- 3827655 TI - [Exercise test in cardiac insufficiency]. PMID- 3827656 TI - [Mortality due to ischemic heart disease in the municipality of Sao Paulo. Evolution from 1950 to 1981 and recent changes in the trends]. PMID- 3827657 TI - [Aortic coarctation. Postoperative analysis of the blood pressure at rest]. PMID- 3827658 TI - [Intracoronary thrombolysis in acute myocardial infarction]. PMID- 3827659 TI - [Behavior of biological prostheses in children under 15]. PMID- 3827660 TI - [Exchange transfusion during extracorporeal circulation in the correction of complex congenital heart diseases]. PMID- 3827661 TI - [Permanent cardiac artificial pacemaker in patients subjected to heart surgery]. PMID- 3827662 TI - [Prevalence of arterial hypertension among the personnel of a general hospital]. PMID- 3827663 TI - [Acute dissection of the aorta (De Bakey type I), associated with aortic insufficiency and acute renal insufficiency. Surgical treatment. Report of a case]. PMID- 3827664 TI - [Comprehensiveness and potentialities of cardiac catheterization]. PMID- 3827665 TI - [A universal atrioventricular pacemaker. Criteria for indications and benefits]. PMID- 3827666 TI - [Correlation between the clinical aspects of the patient evaluated by functional class and left ventricular function in chronic aortic insufficiency]. PMID- 3827667 TI - [Enlargement of the aortic annulus and/or ascending aorta]. PMID- 3827668 TI - [Experimental models of the use of calcium antagonists in arterial hypertension]. PMID- 3827669 TI - [Complications of transvenous pacemakers. Considerations apropos of 2 necropsy cases]. PMID- 3827670 TI - [Ventricular myxomas and cardiac arrhythmias. Report of 2 cases]. PMID- 3827671 TI - [Rhabdomyoma of the heart. Report of a case operated with success]. PMID- 3827672 TI - [Long-term course of congenital heart disease after surgical treatment]. PMID- 3827673 TI - [Comparative study between a new contrast medium of low sodium concentration, AG 64-03 (meglumine ioxithalamate and sodium) and iothalamate meglumine and sodium]. PMID- 3827674 TI - Cerebrospinal fluid IgG changes in neurosyphilis after high-dose penicillin G treatment. PMID- 3827675 TI - Epidemiologic studies of multiple sclerosis. PMID- 3827676 TI - Epilepsy, psychosis, and forced normalization. PMID- 3827677 TI - Gait disorder in late-life hydrocephalus. AB - Computerized analysis of gait was performed in six patients with hydrocephalus (mean age, 75.7 years), for comparison with other elderly patients with gait problems and age-matched controls. A decrease in velocity and stride, an increase in sway, and the proportion of time spent in double-limb stance were nonspecific features correlated with declining performance. Certain features appeared to characterize hydrocephalic gait when compared among groups; cadence was diminished, and there was a reduction of step height and a decreased counterrotation of the shoulders relative to the pelvis. An abnormal tendency toward cocontraction in antagonist muscle groups was observed in electromyographic data from the leg muscles, suggesting that the normal phased activation of muscle groups is disturbed. Although data are not conclusive, we believe that the gait disorder in normal-pressure hydrocephalus reflects a subcortical motor control disorder rather than a phenomenon of spasticity or apraxia. PMID- 3827678 TI - Influence of dietary protein on motor fluctuations in Parkinson's disease. AB - On a nearly zero protein diet, 11 patients with Parkinson's disease with the "on off" effect demonstrated great sensitivity to levodopa (L-dopa)-carbidopa and reduced fluctuations. Eight patients required a 41% reduction in total L-dopa dosage and discontinuation of all adjuvant therapy to reduce the preponderance of chorea. On a high-protein diet, all patients were immobilized by bradykinesia for most of the day. A low-protein dietary regimen during the daytime offers an important technique for the control of fluctuations in patients with Parkinson's disease who are receiving L-dopa-carbidopa. PMID- 3827679 TI - Trimodal evoked potentials compared with magnetic resonance imaging in the diagnosis of multiple sclerosis. AB - Twenty-three patients with the clinical diagnosis of possible multiple sclerosis (MS) were tested with magnetic resonance imaging (MRI) and trimodal evoked potentials. Fourteen patients showed abnormalities on both MRI scans and at least one evoked potential modality (65%). Four patients had normal MRI scans but at least one abnormality on evoked potential testing (17%). One patient had normal triple evoked potentials with an abnormal MRI result. Four patients had normal results on both MRI and triple evoked potential testing; two of these patients were later found to have immunologic abnormalities in the cerebrospinal fluid consistent with the diagnosis of MS. Combined evoked potential testing was found to have a higher sensitivity than MRI in confirming a diagnosis of MS. Three patients with the clinical diagnosis of definite MS were also tested. All these patients showed abnormalities on evoked potential testing, although one patient had a normal MRI result. Of all 26 patients who were studied, 17 showed abnormal MRI results and 21 showed at least one abnormality on evoked potential testing. PMID- 3827680 TI - Prediction of early beneficial response to plasma exchange in Guillain-Barre syndrome. AB - We attempted to identify predictive factors of early beneficial response to plasmapheresis in Guillain-Barre syndrome (GBS). We reviewed 24 patients with typical severe GBS who underwent plasmapheresis and analyzed their outcome at one month. One group of 14 patients, designated as responders, improved dramatically, while ten patients showed little response. Age was the only important clinical predictor, with responders being younger. No other clinical variable (sex, preceding illness, severity, timing of plasmapheresis, cranial nerve involvement, or cerebrospinal fluid findings) reached significance. Among electrophysiologic parameters obtained before plasmapheresis, the amplitudes of compound muscle action potentials with distal stimulation of median and peroneal nerves were significantly reduced in non-responders. Plasmapheresis may improve only a subgroup of patients with GBS. Among patient characteristics, age and amplitudes of compound muscle action potentials are important predictors of early responsiveness. PMID- 3827681 TI - Magnetic resonance imaging in tuberous sclerosis. AB - Twenty-five patients with tuberous sclerosis were studied with magnetic resonance imaging (MRI), and these findings were compared with those of computed cranial tomography (CCT) and with the clinical severity of the disease. Multiple high signal MRI lesions involving the cerebral cortex are characteristic of tuberous sclerosis and probably correspond to the hamartomas and gliotic areas seen pathologically. These cortical lesions were only occasionally seen with CCT. The periventricular calcific lesions characteristic of tuberous sclerosis are better visualized with CCT than with MRI, but the larger periventricular calcifications produce low-signal MRI abnormalities. Seven patients had high-signal MRI lesions of the cerebellum; small calcific cerebellar lesions were also noted with CCT in three patients. As in earlier studies, no clear correlation was seen between the number of abnormalities visible with CCT and the clinical severity of the disease. By contrast, the more severely affected patients tend to have a higher number of cerebral cortical lesions detected with MRI. Thus, MRI may be useful in predicting the eventual clinical severity of younger children with newly diagnosed tuberous sclerosis. PMID- 3827682 TI - Global aphasia without hemiparesis. AB - Three patients acutely developed global aphasia, but did not manifest the typical accompanying right hemiparesis. Computed tomography and magnetic resonance imaging studies demonstrated that the patients had two discrete left hemisphere lesions, one in the anterior language cortices or language-related subcortical areas, and one in the posterior language cortices. Cerebral angiography showed that two patients had complete occlusion of the left internal carotid artery, and the third had an intraluminal "clot" in the supraclinoid portion of the left internal carotid, findings suggestive of an embolic etiology. Our cases indicate that global aphasia without hemiparesis predicts two discrete lesions and a particularly good recovery of speech and language. PMID- 3827683 TI - The ischemic hypotheses of migraine. PMID- 3827684 TI - Migraine. A biobehavioral disorder. PMID- 3827685 TI - Cervical diastematomyelia. Report of a case and review of a rare congenital anomaly. AB - Cervical diastematomyelia is a rare congenital abnormality. To our knowledge, only 18 cases have been reported. The present case was highly unusual in that it occurred in an adult. Other clinical features in the present case included symptoms that began after trauma and the presence of other associated congenital anomalies. The diastematomyelia was identified with computed tomographic metrizamide myelography and magnetic resonance imaging. The patient's neurologic deficits improved with surgery. PMID- 3827686 TI - Abnormal neuroanatomy in a nonretarded person with autism. Unusual findings with magnetic resonance imaging. AB - Recent studies of infantile autism using computed tomographic scanning emphasized the importance of studying cases of classic autism (Kanner's syndrome) without complicating conditions such as mental retardation. Computed tomographic scan studies of such patients reported no evidence of anatomical abnormalities of cerebral hemispheres or of subcortical structures, which are defined by landmarks such as the lateral ventricles and lentiform nuclei. Examination of the cerebellum was not mentioned. The most recent postmortem neuropathologic study reported significant cerebellar abnormality, but the study was of a severely retarded autistic individual. Using magnetic resonance imaging, we have found in vivo evidence of a significant and unusual cerebellar malformation in a person with the classic form of autism uncomplicated by mental retardation (current nonverbal IQ = 112), epilepsy, history of drug use, postnatal trauma, or disease. The finding showed hypoplasia of the declive, folium, and tuber in posterior vermis, but not of the anterior vermis, and hypoplasia of only the medial aspect of each cerebellar hemisphere. The right posterior cerebral hemisphere also showed pathologic findings. PMID- 3827687 TI - Sporadic case resembling autosomal-dominant motor system degeneration (Azorean disease complex). AB - We describe a case of an adult-onset progressive dystonia with external ophthalmoplegia, occurring in a black man without a family history of neurologic disorders. Neuropathologic examination demonstrated neuronal loss and gliosis in the anterior horn and Clarke's column in the spinal cord, nuclei of cranial nerves III, VI, X, and XII, vestibular complex, lateral cuneate nucleus, lower pontine tegmentum, red nucleus, substantia nigra, and dentate nucleus. The cerebral cortex, corpus striatum, basis pontis, inferior olives, and cerebellum were spared. The clinical and pathologic findings closely resemble autosomal dominant motor system degeneration or "Azorean disease," without, however, demonstrable familial transmission. In addition to the absence of a family history, unique features of the case include the presence of Alzheimer type II glial cells in the red nucleus and an unexplained persistent elevated concentration of serum amylase. PMID- 3827688 TI - Facial numbness and dysesthesia. New features of carotid artery dissection. AB - Facial numbness and dysesthesia have not been emphasized as presenting features in spontaneous internal carotid artery dissection. Progressive facial pain, accompanied by oculosympathetic paresis, altered taste, and facial numbness suggest the possibility of basal skull neoplasm. We describe a patient, with previously undiscovered fibromuscular dysplasia, who presented with severe neck and face pain, dysgeusia, oculosympathetic paresis, and markedly reduced facial sensation due to a spontaneous vascular dissection. Altered facial sensation should now be included in the symptomatology of internal carotid artery dissection. PMID- 3827689 TI - Loss of deep dyslexic reading ability from a second left-hemispheric lesion. AB - It has been hypothesized that the residual reading ability in people with deep dyslexia (an acquired dyslexia in which the subjects make semantic paralexias, eg, child read as boy) utilizes right hemispheric structures. A patient who was deep dyslexic following an initial left hemispheric stroke was studied. Following a new left hemispheric stroke, he lost his residual reading ability. In this patient, deep dyslexic reading abilities were dependent on left hemispheric structures. PMID- 3827690 TI - Magnetic resonance imaging in patients with intractable focal seizures. PMID- 3827691 TI - Clinical assessment of 31 patients with Wilson's disease. Correlations with structural changes on magnetic resonance imaging. AB - Thirty-one patients with Wilson's disease were evaluated with detailed neurologic and medical examinations. Mean age (+/- SD) at onset was 21 +/- 5 years and at examination was 28 +/- 6 years. Of the 90% of patients who were first treated with penicillamine, 31% deteriorated initially despite therapy, and half never recovered to pretherapy baseline. At the time of our evaluations, the most common neurologic findings were dysarthria (97%), dystonia (65%), dysdiadochokinesia (58%), rigidity (52%), gait and postural abnormalities (42%), and tremor (32%). Chorea and dementia were rare. Twenty-two patients underwent magnetic resonance imaging. All but one of the 19 symptomatic patients had abnormal scans. The three asymptomatic patients had normal scans. Most lesions were seen in the caudate, putamen, subcortical white matter, midbrain, and pons. Generalized brain atrophy was also common. Lesions were less common in the thalamus, cerebellar vermis, midbrain tegmentum, globus pallidus, red nucleus, and dentate nucleus. Dystonia and bradykinesia correlated with putamen lesions, and dysarthria correlated with both putamen and caudate lesions. PMID- 3827692 TI - Mood disorder and multiple sclerosis. AB - A systematic psychiatric evaluation was performed on 100 consecutive patients attending a multiple sclerosis clinic. Forty-two percent of the patients had lifetime history of depression, and 13% fulfilled criteria for manic-depressive illness. Only 28% of the patients had no psychiatric diagnosis. The relationship of psychiatric disorder to neurologic dysfunction and other aspects of multiple sclerosis are presented. Clinical and theoretical implications of these findings are discussed. PMID- 3827693 TI - The relevance of contralateral recordings and patient disability to assessment of brain-stem auditory evoked potential abnormalities in multiple sclerosis. AB - Brain-stem auditory evoked responses (BAER) were recorded in a group of 83 patients with a diagnosis of clinically definite or probable multiple sclerosis to assess the relevance of recording contralateral responses simultaneously with ipsilateral responses and to correlate patients disability with the detection of abnormalities. The contralateral responses generally mirrored the ipsilateral responses, but in seven patients the responses differed, mainly involving the presence or absence of wave V. However, contralateral recordings did not contribute significantly to the sensitivity of lesion detection, and their main value was to aid in the recognition of waves when they were not clearly seen in the ipsilateral recordings. The BAER abnormality rates were found to be significantly correlated with disability, and it is suggested that this is an important variable to consider when undertaking or comparing results of BAER studies in patients with multiple sclerosis. PMID- 3827694 TI - Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. AB - Delusions, depression, and hallucinations were assessed in 30 patients with dementia of the Alzheimer type (DAT) and 15 with multi-infarct dementia (MID). The nature and prevalence of delusions did not distinguish DAT from MID: delusions were present at the time of examination in 30% of patients with DAT and in 40% of patients with MID, and had occurred at some time in the course of the illness in half the patients of each diagnostic group. Delusions were primarily paranoid in type and involved elementary misbeliefs concerning theft or infidelity. Depression was significantly more common in MID than DAT. Seventeen percent of patients with DAT had depressive symptoms; none with severe depression were identified. Four of 15 patients with MID exhibited major depressive episodes and 60% manifested depressive symptoms. Depression and delusions were not deducted in patients with severe dementia. Hallucinations occurred in both diagnostic groups but were not common: one patient with DAT and one with MID had auditory hallucinations, and three patients with MID had visual hallucinations. PMID- 3827695 TI - Tactile discrimination learning deficits in Alzheimer's and Parkinson's diseases. AB - Neuropsychological mechanisms of dementia in Alzheimer's and Parkinson's diseases were compared using a tactile discrimination learning paradigm adopted from animal models. There were two components to the task: tactile original learning (TOL), which is sensitive to parietal lobe damage in nonhuman primates; and tactile reversal of original learning (TRL), a measure of perseveration. The patients with Alzheimer's disease were significantly impaired on TOL compared with demented patients with Parkinson's disease, even though both groups were equated for severity of dementia. On TRL, the patients with Alzheimer's disease and demented patients with Parkinson's disease were both significantly impaired, but the patients with Alzheimer's disease showed significantly more perseverative errors. The mechanisms underlying TOL and TRL deficits may serve to differentiate Alzheimer's from Parkinson's dementia, and may involve selective parietal system lesions. PMID- 3827696 TI - Cholinesterases in cerebrospinal fluid. A longitudinal study in Alzheimer disease. AB - We measured acetylcholinesterase (AChE) and butyrylcholinesterase activities in the lumbar cerebrospinal fluid (CSF) of 39 patients with dementia of Alzheimer type and 21 age-matched controls. The mean lumbar CSF AChE activity in our patients did not differ significantly from that of controls. The 7S and 11S molecular forms were also unchanged. When CSF was analyzed at six-month intervals, there was no significant decline in AChE activity over a span of 12 months. Our results and those of previous studies demonstrate that CSF AChE is not a useful diagnostic marker of Alzheimer disease. PMID- 3827697 TI - Hyperlipidemia is a risk factor for decreased cerebral perfusion and stroke. AB - Possible effects of chronically elevated serum cholesterol and triglyceride levels on measurements of cerebral blood flow were investigated by between-group comparisons of individuals, with and without hyperlipidemia, among 56 neurologically normal elderly volunteers and among 102 age-matched patients with symptoms of transient ischemic attacks (TIAs). Results demonstrated significantly higher levels of serum cholesterol and triglyceride among the TIA patients compared with randomly selected age-matched normal controls of similar educational and environmental backgrounds. Cerebral blood flow levels were reduced among groups of TIA patients with elevated levels of either cholesterol or triglycerides compared with the TIA patients with normal lipid levels. Similar trends were seen among normal volunteers, but these did not reach levels of statistical significance because of the limited numbers available. Analysis of frequency distributions for risk factors other than hyperlipidemia indicated that hypertension, atherosclerotic heart disease, diabetes mellitus, and cigarette smoking were also more prevalent among TIA patients than among age-matched normal controls. PMID- 3827698 TI - Multifocal central nervous system lesions in three patients with trichinosis. AB - Three patients with trichinosis developed central nervous system complications. Cerebral computed tomography showed multifocal hypodense lesions in two patients. The lesions were associated with contrast enhancement and cortical gyral enhancement in the first case, suggesting hypoxia and infarction. In the second patient, magnetic resonance imaging showed multiple high-signal-intensity lesions. Early cerebral computed tomography was normal in the third patient. All patients recovered after treatment with antiparasitic drugs and corticosteroids. We suggest that neurologic complications of trichinosis should be treated by corticosteroids and flubendazole. PMID- 3827699 TI - Neurologic aspects of boxing. AB - The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies. PMID- 3827700 TI - Corneal photoablation by far ultraviolet lasers. PMID- 3827701 TI - Use of the Jaffe speculum in eyelid surgery. PMID- 3827702 TI - Semantics: compliance is a better term than cooperation. PMID- 3827703 TI - Patient compliance vs cooperation. PMID- 3827704 TI - Bilateral total occlusion during the critical period of visual development. Case report. PMID- 3827705 TI - Eye injury during "war games" despite the use of goggles. Case report. PMID- 3827706 TI - Optic nerve avulsion. Case report. PMID- 3827707 TI - Primary congenital glaucoma in a patient with trisomy 2q (q33----qter) and monosomy 9p(p24----pter). Case report. PMID- 3827708 TI - Pupillary block with posterior chamber intraocular lenses. AB - We present 12 cases of pupillary block associated with extracapsular cataract extraction and posterior chamber intraocular lenses. In one case, pupillary block occurred despite the presence of a surgical iridectomy. The other 11 patients did not have a surgical iridectomy performed. We recommend that a surgical iridectomy or laser iridotomy be performed in all patients who undergo extracapsular cataract extraction with the implantation of posterior chamber intraocular lenses. Ophthalmologists need to be vigilant in watching for the development of pupillary block in these patients, since pupillary block is not a benign event and serious visual loss or disability may occur. PMID- 3827709 TI - Acute severe irreversible visual loss with sphenoethmoiditis-'posterior' orbital cellulitis. AB - Orbital cellulitis secondary to adjacent paranasal sinusitis presents with marked proptosis, ophthalmoplegia, eyelid edema, chemosis, and/or conjunctival hyperemia. These conditions often precede visual dysfunction. "Posterior" orbital cellulitis secondary to sphenoethmoidal sinusitis may be defined as the clinical syndrome in which early severe visual loss overshadows or precedes accompanying inflammatory orbital signs. The visual loss may be attributed to involvement of the intracanalicular or orbital apical segment of the optic nerve. Total irreversible unilateral visual loss developed in three patients with this syndrome. Severe visual loss was preceded by diplopia in one patient and by bilateral eyelid edema in another. One patient with chronic panparanasal sinusitis with acute visual loss presented with isolated optic disc edema. Proptosis and ductional restriction subsequently developed. The irreversible blindness in these cases may be due to a combination of intracanalicular edema and vasculitis causing optic nerve infarction. PMID- 3827710 TI - Papillopathy caused by amiodarone. AB - Disc swelling and hemorrhages appeared in three eyes of two men receiving amiodarone hydrochloride for cardiac arrhythmias. The initial diagnosis was ischemic optic neuropathy, but visual acuity was preserved, and visual field changes were present in only one eye. Amiodarone is a cationic amphiphilic compound, and other drugs with this property have keratopathy, retinopathy, and optic neuropathy as side effects. We believe our patients had an amiodarone induced papillopathy. PMID- 3827711 TI - Radiotherapy for choroidal melanoma. An 18-year experience with radon. AB - Twenty-three patients were treated with radon therapy for choroidal melanoma at the Ohio State University Hospitals, Columbus, between 1968 and 1976. We present an 18-year experience, including follow-up of at least eight years, in all those receiving therapy. Three patients (13%) died of metastatic disease. Four patients (17.4%) died of other causes. Sixteen patients (69.6%) were alive, with no signs of metastatic disease. Eight patients subsequently required enucleation due to inadequate tumor response. Of the 15 patients who demonstrated successful tumor destruction and retained their eyes, 13 (86.7%) developed substantial irradiation induced retinopathy, including hard exudates, telangiectasias, neovascularization, microaneurysms, intraretinal and vitreous hemorrhages, secondary glaucoma, and irradiation-induced cataract. Our long-term results indicate a high incidence of both vascular complications and decreased visual acuity. PMID- 3827712 TI - Leber's congenital amaurosis. Retrospective review of 43 cases and a new fundus finding in two cases. AB - Leber's congenital amaurosis is a hereditary clinical disorder that may be associated with several different diseases. This study consists of a retrospective review of 43 cases. Twenty of our patients had fundus appearances that resembled retinitis pigmentosa. Five had normal-appearing fundi. The remainder had other, previously reported fundus abnormalities, with the exception of two patients who demonstrated a new fundus finding, a nummular pigmentary pattern. Other associated eye anomalies included cataracts, keratoconus, ptosis, and strabismus. The most frequent systemic associations were mental retardation, cystic renal disease, skeletal disorders, and hydrocephalus. PMID- 3827713 TI - Retinal degeneration with nanophthalmos, cystic macular degeneration, and angle closure glaucoma. A new recessive syndrome. AB - Seven related patients had a progressive pigmentary retinal degeneration, characterized by nyctalopia, visual field restriction, and cystic macular degeneration in younger patients and a macula of nonspecific atrophic appearance in older patients. In addition, each patient had high hyperopia (+9.50 to +16.00) and nanophthalmos (axial lengths, less than 20 mm), with diffuse choroidal thickening on ultrasound. Younger patients had slitlike anterior chamber angles; older patients developed progressive synechial angle closure and eventual glaucoma. Chromosomes were normal. On electroretinographic testing, younger patients had absent rod signals, with normal cone wave form and near-normal b wave amplitudes but markedly delayed cone b-wave implicit times; older patients had severely diminished or extinguished electroretinograms. This family appears to represent a newly recognized autosomal-recessive syndrome. PMID- 3827714 TI - Vitamin C levels in human tears. AB - Human tears, collected using the Schirmer strip method, were analyzed by high performance liquid chromatography for vitamin C (ascorbic acid). In "basal" tears, the levels of ascorbic acid ranged from 3.9 to 23 mg/dL (220 to 1310 mumol/L); lower values correlated with higher tear flow rates. In reflex tears, induced by brief ammonia inhalation, the ascorbic acid level fell dramatically and appeared to reach a minimum level around 2 mg/dL (110 mumol/L). Even the low level in reflex tears, however, was consistently higher than plasma levels. Ascorbic acid in tears has a potential anti-inflammatory role. PMID- 3827715 TI - Conjunctival goblet cells and mitotic rate in children with retinol deficiency and measles. AB - To study the effect of retinol deficiency and measles on the conjunctival epithelium, we determined the epithelial mitotic rate (MR) and goblet cell frequency (GCF) in conjunctival biopsy specimens from preschool children in Hyderabad, India. We studied three groups of children: normal appearing, clinically retinol deficient (defined by the presence of superficial fine punctate keratitis), and clinically retinol deficient with measles. The last group was subdivided into those with low serum retinol levels (less than or equal to 20 micrograms/dL [less than or equal to mumol/L]) and those with normal serum retinol levels (greater than 20 micrograms/dL [greater than 0.70 mumol/L]). In the control group of seven normal-appearing children with a mean age of 4.6 years, the mean MR was 1.3% +/- 0.4%, and the mean GCF was 8.0% +/- 3.6% of the basal epithelial cells. In seven children with clinical retinol deficiency, the mean MR was 15.4% +/- 1.2%, and the mean GCF was 1.0% +/- 0.5%, values significantly different from normal ones. Among 11 children with clinical retinol deficiency, measles, and low serum retinol levels, the mean MR was 9.0% +/- 1.9%, and the mean GCF was 3.1% +/- 1.1%, values not statistically different from those in children with clinical retinol deficiency alone. Five children with clinical retinol deficiency, measles, and normal serum retinol levels had a mean MR of 10.2% +/- 3.7% and a mean GCF of 1.9% +/- 1.7%, values similar to those in the other disease groups. This indicates that retinol deficiency sufficient to cause clinical signs without subepithelial scarring or keratinization is associated with hyperproliferation of the conjunctiva whether or not there is a superimposed measles infection. PMID- 3827716 TI - Ocular and adnexal complications of unilateral orbital advancement for plagiocephaly. AB - Strabismus, ptosis, lateral canthal dystopia, nasolacrimal obstruction, and cranial nerve palsy were noted preoperatively in 32%, 21%, 14%, 12%, and 9% of 34 patients, respectively, undergoing ophthalmologic evaluation prior to unilateral orbital advancement for plagiocephaly. Thirty-two percent of the patients had normal preoperative ocular and adnexal examination results. Ptosis, strabismus, and amblyopia were frequently acquired postoperative abnormalities in 29%, 18%, and 18% of the patients, respectively. Forty-four percent of the patients had no new abnormalities following craniofacial surgery. PMID- 3827717 TI - Optic nerve sheath decompression. Review of 17 cases. AB - Seventeen patients (19 eyes) with progressive visual loss associated with retrobulbar optic nerve and/or sheath enlargement were treated by surgical nerve sheath decompression at the Bascom Palmer Eye Institute, Miami, from 1969 through 1984. A decision to intervene was based on progressive visual loss unresponsive to other modes of therapy and accompanied by retrobulbar optic nerve sheath enlargement as determined by computed tomography, contrast orbitography, or orbital echography. Follow-up ranged from three months to nine years, with an average of 17 months. Visual function improvement was noted within one month after operation in seven of 19 eyes. The other 12 eyes showed no improvement or continued to worsen. Postoperative complications were infrequent, with motility disturbances being the most common. Optic nerve sheath decompression via the medial orbital approach has a low operative morbidity and may improve visual function in patients with progressive visual loss associated with the accumulation of compressible fluids in the retro-orbital optic nerve sheaths. This relatively safe surgical approach to the retrobulbar optic nerve may also be of future use in the retrieval of optic nerve tissue and fluid for chemical and cytologic analysis. PMID- 3827718 TI - Heterotopic brain tissue in the orbit. AB - A 3-month-old female infant with Turner's syndrome was noted to have progressive swelling of the left upper lid at the age of 1 month. A computed tomogram demonstrated a well-circumscribed, low-density, homogeneous orbital mass. Initially, the main clinical differential diagnosis included dermoid cyst, hemangioma, and encephalocele. Medial orbitotomy followed by histopathologic examination disclosed a cystic choristomatous malformation containing brain tissue. No choroid plexuses within the mass were demonstrated on microscopic examination. Aspiration of fluid from the cystic mass and subsequent biochemical studies unequivocally demonstrated that the mass was filled with cerebrospinal fluid. Despite five surgical procedures, including two frontal craniotomies, and specialized roentgenographic studies, no communication could be demonstrated between the orbital mass and the central nervous system. We postulate that the cerebrospinal fluid was produced within the orbital mass, which represented ectopic brain tissue. Problems in diagnosis and management of this unusual orbital malformation are discussed. PMID- 3827719 TI - Multivesicular liposomes. Sustained release of the antimetabolite cytarabine in the eye. AB - We entrapped the antimetabolite cytarabine hydrochloride in a multivesicular liposome for sustained drug delivery to the eye. The in vitro half-life of cytarabine release from these liposomes was 359 hours. Following subconjunctival administration of 6 mg of cytarabine to 12 rabbits, the tissue half-life of drug at the injection site was 52.5 hours in the six rabbits treated with liposomes compared with 0.2 hours in the six nonliposome controls treated with the same amount of drug in normal saline solution. The aqueous humor drug concentration peaked after 1.5 hours in both the experimental (0.4 mg/L) and control (19 mg/L) groups. In control eyes, the cytarabine level of both the tissue and aqueous humor had decreased to less than 1% of peak value by eight hours. In the liposome treated eyes, almost 30% of the cytarabine remained in the conjunctiva and episcleral tissue after 72 hours. The difference in cytarabine levels in tissue between the liposome-treated group and controls was highly significant. By controlling the rate of drug release, it may be possible to reduce the ocular toxicity and increase the efficacy of this drug for treating ocular proliferative disorders. PMID- 3827720 TI - A rabbit model of staphylococcal blepharitis. AB - Rabbits immunized with cell wall antigens of Staphylococcus aureus developed blepharitis after topical challenge with viable S aureus. The lids of these rabbits were thickened and erythematous. Crusting was found around the lashes, and the lids developed loss of lashes and hair. Histopathologic examination of lids from rabbits with blepharitis showed a dense leukocytic infiltrate and dilated blood vessels beneath an intact epidermis and palpebral conjunctival epithelium. The infiltrate contained neutrophils as well as mononuclear cells, including macrophages, plasma cells, and lymphocytes. The meibomian glands appeared normal. Gram's staining of lid sections did not show gram-positive cocci. The results of this study suggest that hypersensitivity to the S aureus cell wall, and particularly the ribitol teichoic acid that it contains, plays a role in the pathogenesis of staphylococcal blepharitis. PMID- 3827721 TI - Hereditary benign intraepithelial dyskeratosis. PMID- 3827722 TI - Semiconductor laser endophotocoagulation of the retina. AB - Laser endophotocoagulation is an important technique in vitreoretinal surgery. We performed successful retinal endophotocoagulation in the eyes of Dutch-belted rabbits, using high-power phased-array semiconductor lasers, emitting at 808 and 817 nm. The laser itself measured 25 X 30 X 21 mm, was air cooled, and was portable. At a treatment power of 100 mW, uniformly white photocoagulation lesions were seen at exposure durations of 0.2 to 1.0 s. Lesions were similar in appearance to argon laser photocoagulation lesions, as determined by ophthalmoscopy and fluorescein angiography. Thin-section histologic examination of acute lesions revealed injury localized to the outer retina; chorioretinal scar formation was noted ten days after photocoagulation. To our knowledge, this study is the first in which therapeutically useful lesions were produced using a diode laser and demonstrates the feasibility of using these highly efficient and compact laser sources for ophthalmic photocoagulation. PMID- 3827723 TI - Microsurgical reversal of tubal sterilization. PMID- 3827724 TI - A case of pelvic arteriovenous fistula. PMID- 3827725 TI - Factors affecting breast-feeding among Hong Kong Chinese. PMID- 3827726 TI - Pattern change of late deceleration throughout pregnancy: a case report. PMID- 3827727 TI - In vitro fertilization applied for tubal and non-tubal causes of infertility. PMID- 3827728 TI - Health implications of traditional female circumcision in pregnancy. PMID- 3827729 TI - Obstetric performance of elderly primiparae. PMID- 3827730 TI - Heteroimmunization against human male reproductive antigens: immunogenicity and antisperm antibody patterns. PMID- 3827731 TI - Trends of oestriol and progesterone in normal pregnancies. PMID- 3827732 TI - Uterine activity in oxytocin induced labour. PMID- 3827733 TI - Steroid receptors and histological types in cervical cancer. PMID- 3827734 TI - Trehalase isozymes in amniotic fluid. PMID- 3827735 TI - Street drugs: clinical aspects and management. PMID- 3827736 TI - Alcohol abuse in an Australian community. PMID- 3827737 TI - Drugs and driving: the road to action. PMID- 3827738 TI - A community response to drug issues. PMID- 3827739 TI - Acupuncture in perspective. PMID- 3827740 TI - Congestive heart failure. Pathophysiology and treatment. PMID- 3827741 TI - A desk top system. PMID- 3827742 TI - Production of steroids and release of prostaglandins by spherical pig blastocysts in vitro. AB - Levels of pregnenolone and progesterone in spherical pig blastocysts (near 4 and 15 microM respectively) exceeded respective levels in histotroph by about 400 fold. When blastocysts were cultured for 5 days in a synthetic medium containing pregnenolone sulfate (1 microM), daily rates of release of pregnenolone, progesterone, androstenedione, testosterone, oestrone and oestradiol were determined to be near 320, 45, 26, 27, 0.8 and 9.2 fmol per blastocyst respectively. Daily outputs of progesterone and testosterone (fmol per blastocyst) diminished (P less than 0.05) to 1.3 and undetectable levels (less than 2) respectively in the presence of Trilostane (94 microM). Increasing the content of pregnenolone sulfate in the culture medium (to 4.5 microM) resulted in higher daily rates of release of pregnenolone and progesterone (to near 1740 and 380 fmol per blastocyst respectively), verifying activity of 3 beta-hydroxy-delta 5-steroid dehydrogenase, and of arylsulfatase, in tissues of intact spherical pig blastocysts. Prostaglandin E2 was the predominant prostaglandin (PG) released by cultured blastocysts (about 1 fmol per blastocyst per hour), hourly rates of release of PGH2 (derived) and PGF2 alpha being near 0.1 and less than 0.06 fmol per blastocyst respectively. The data establish a capacity for spherical pig blastocysts to release a range of steroids and PGs of possible significance to embryonic growth and development in vivo. PMID- 3827743 TI - Pattern of loss of spermatozoa from the vagina of the ewe. AB - In a series of experiments spermatozoa were inseminated blindly into the vagina of ewes and then recovered at varying times after insemination. Most of the spermatozoa inseminated were lost by drainage through the vulva. The rate of loss was not affected by the motility of spermatozoa or oestrous state of the ewe. Initially after insemination the loss was not rapid with 82% of the insemination 18% of spermatozoa remained and by 12 h 10% remained. Spermatozoa were removed from the vagina during withdrawal of the penis after intromission and the extent of this loss varied between rams and with the volume of semen already in the vagina. Up to half the inseminate was lost in this way when there was 0.5 ml of semen in the vagina but only 11% was lost when the volume of inseminate was 0.1 ml. The unavoidable loss of spermatozoa may influence the quantity available for fertilizing ova. PMID- 3827744 TI - Time required for spermatozoa to remain in the vagina of the ewe to ensure conception. AB - Oestrous ewes (N = 202) were inseminated with 0.1 ml of semen containing 500 X 10(6) motile spermatozoa and the spermatozoa were flushed from their vagina either immediately or 0.25, 0.5, 1, 2, 4 and 8 h after insemination. Pregnancy was determined by returns to service and laparoscopy. Some ewes became pregnant (10.71%) after spermatozoa had been flushed from the vagina only seconds after insemination and about 40% of ewes became pregnant after spermatozoa had been in the vagina for 15 min. Maximum conception (55%) was achieved when spermatozoa had been in the vagina for at least 2 h. It was concluded that the losses of spermatozoa that occur from the vagina will not influence the chance of a ewe conceiving because sufficient spermatozoa to ensure a normal conception move up the reproductive tract before large losses from the vagina take effect. PMID- 3827745 TI - Effect of suppressing prolactin in the mouse on liveweight, food intake and ovulation rate. AB - The involvement, if any, of prolactin in the relationship between appetite and ovulation rate was studied in mice. Injections of 0, 50, 100 or 150 micrograms of bromocriptine were given twice-daily to 46-day-old virgin mice for a minimum of 15 days. Between days 5 and 12 of treatment, mice receiving either 50, 100 or 150 micrograms of bromocriptine consumed 3.1, 4.3 and 6.2 g more food, respectively, than did mice in the control group. Liveweights and liveweight gain, however, were unaffected by bromocriptine injections. From day 0 to 12 of treatment mice grew 0.16, 0.15, 0.21 and 0.16 g/day in the 0, 50, 100 and 150 micrograms bromocriptine groups, respectively, (P greater than 0.05). Plasma prolactin concentrations were suppressed, but ovulation rates were similar in the 50, 100 and 150 micrograms bromocriptine groups compared with the control (median prolactin concentrations and mean ovulation rates were 32.9, 32.5 and 31.6 ng/ml and 14.4, 15.1 and 15.7 ova, respectively, compared with 217.2 ng/ml and 14.9 ova in the control). The results do not support the hypothesis that prolactin directly mediates a relationship between appetite and ovulation rate in the post pubertal mouse. PMID- 3827746 TI - Synaptic connections of horizontal canal mediated ascending Deiters tract axons on medial rectus motoneurons in cat. AB - This study demonstrates the termination of ascending tract of Deiters' (ATD) axons on ipsilateral medial rectus (MR) motoneurons. Horseradish peroxidase (HRP) was iontophoretically injected into ATD axons which were recorded in the MR motoneuron pool of the oculomotor nucleus. MR motoneuron cell bodies were identified by retrograde transport of HRP injected into MR muscles in the orbit. ATD axons were identified by Type I responses to horizontal rotation, monosynaptic responses on stimulation of the ipsilateral labyrinth, and no response on contralateral labyrinth or contralateral abducens nucleus or on ipsilateral MR nerve stimulation. Light microscopic examination showed the main stem axons to be lateral to the medial longitudinal fasciculus, and terminal boutons were in contact with ipsilateral identified MR motoneurons (Furuya and Markham: Exp. Brain Res. 43: 289-303, 1981). Light microscopy and semi-thin sections showed boutons of ATD in contact with identified MR motoneuron cell bodies and proximal dendrites. The electron micrographs (EM) showed the HRP injected ATD axons have synapses on MR motoneurons. ATD boutons made axosomatic and axodendritic synapses on MR motoneurons. The boutons contained numerous spheroidal synaptic vesicles. Several examples showed clear asymmetrical post synaptic membrane specialization. This confirms the synaptic connection between horizontal canal activated elements in the ATD and MR motoneurons. PMID- 3827747 TI - Special issue to mark the occasion of the thirtieth anniversary of the Japan Society for Equilibrium Research. PMID- 3827748 TI - Vascular loops in internal auditory canal as possible cause of Meniere's disease. AB - Vascular loops were found in 2 patients diagnosed clinically as having Meniere's disease. A vascular loop was suspected of being present within the internal auditory canal in another patient who complained of tinnitus and vertigo. Diagnosis was performed by air CT cisternography in the former patients and by CT with contrast enhancement in the latter patient. In Case No. 1, the attacks of vertigo disappeared after endolymphatic sac decompression. In Case No. 2, hearing loss progressed despite remission of vertigo. In Case No. 3, the patient had only tinnitus and dizziness. Although it was difficult to definitely conclude that there was a causal relationship between the vascular loop and the clinical symptoms, we felt that there was a need to investigate the vascular loop as a possible cause of vertigo, tinnitus, and progression of sensorineural hearing loss. PMID- 3827749 TI - Acoustic tumor with hearing loss of sudden onset and recovery. AB - In many cases of acoustic tumor the hearing loss is gradually progressive, but some cases of acoustic tumor show a sudden onset of hearing loss. In this paper we report two interesting cases of acoustic tumors which were diagnosed as sudden deafness at the first examination. Being treated with steroid hormones, their hearing was partially recovered. But the hearing loss recurred in both cases. At the second examination, CT showed the cerebellopontine angle tumors. So it was emphasized that careful questioning as well as the caloric test and the auditory brainstem response (ABR) was important. If one of these tests shows abnormality, the patient should be examined by the CT scan. The same may be said of patients who show recovery due to steroid hormone therapy. PMID- 3827750 TI - Spontaneous downbeat nystagmus in two sisters with sudanophilic leukodystrophy. AB - Two sisters who manifested downbeat nystagmus at the early stage of leukodystrophy are reported. The younger sister whose onset was at the age of 20, deteriorated rapidly to the vegetative state, and died of acute pneumonia 7 years after. Her downbeat nystagmus was observed only during the early 2 years of the course of her disease. The histopathological study on her brain enabled a diagnosis of sudanophilic leukodystrophy which demonstrated overall gliosis of white matter in the cerebrum and severe depopulation of Purkinje cells in the cerebellum, particularly in the vermis. The elder sister's onset was at the age of 29 and deteriorated rapidly to akinetic mutism. Her downbeat nystagmus was observed only during the first year of the course of her disease. For over 10 years she has been at the vegetative state. CT-scan of her brain demonstrates low density areas in the white matter of the cerebrum and in the vermis of the cerebellum. These two cases showed similar clinical signs and courses of their diseases, which were spontaneous nystagmus, early changes of personality and intelligence, and extra-pyramidal sign and later rapid deterioration of the stage of akinetic mutism. Histopathologically these cases are suspected as having an identical hereditary etiology of sudanophilic leukodystrophy. In these cases it is noted that downbeat nystagmus was the early sign of the disease. PMID- 3827751 TI - Neurotological findings in amyotrophic lateral sclerosis. AB - Neurotological examinations with special regard to eye movements using electronystagmography (ENG) were performed and analyzed on 22 patients with amyotrophic lateral sclerosis (ALS). Optokinetic nystagmus, pursuit and saccadic eye movements were abnormal in a considerable number of the patients. The incidence of abnormalities correlated to the severity, but not to the duration of illness. The mechanisms of abnormalities of eye movements were considered initially supranuclear, and later both supranuclear and nuclear involvements would play main roles in the appearance of the abnormalities of eye movements. PMID- 3827752 TI - Nystagmus during attack in Meniere's disease. AB - Nystagmus in Meniere's disease before the vertiginous attack to its end was recorded using a newly devised long recording portable electronystagmograph. The nystagmus to the affected side was recorded before the patient complained of vertigo, while the non-affected side was recorded at the onset of the attack. And the nystagmus to the affected side was recorded in the middle and at the end of the attack. PMID- 3827753 TI - Structural similarities between kinocilium of vestibular hair cell and tracheal motile cilium in the guinea pig. AB - A rapid-freeze, deep-etch method was used to visualize the membrane characteristics as well as the three-dimensional ultrastructural features of a kinocilium of the guinea pig vestibular hair cell. A kinocilium of the vestibular hair cell had a typical ciliary necklace, consisting of six to seven parallel intramembrane particle arrays. The basal body of a kinocilium had a plate structure called a terminal plate, in its interior. In the shaft region of a kinocilium, peripheral microtubules were connected to the central microtubules by periodic tiny linkers, called radial spokes. These structural features of a kinocilium were identical to those of the tracheal motile cilium. PMID- 3827754 TI - Relationship between movements of the head and the center of gravity of the body in Meniere's disease. AB - The body sway of the patients with unilateral and bilateral Meniere's disease was recorded by using a cephalograph and a stabilometer, and analyzed with a microcomputer. The results show that the locus type, locus area and locus length traced by the head's center and the body's center of gravity are useful parameters of the body sway, representing the characteristics of peripheral vestibular disorders. The noteworthy characteristics are shown in the right-and left type and forward-and-backward type in statokinesigram, in the significant differences of locus area and/or locus length between the head movement and the movement of the center of gravity, and the change of the averaged divisional frequencies of the body sway with eye-closing. PMID- 3827755 TI - Electronystagmographic assessment of cerebellar lesions. AB - Remarkable progress has been achieved in the neurophysiological study of the cerebellum. Based on these neurophysiological data, electronystagmographic (ENG) assessment of cerebellar lesions was made to ascertain to what extent cerebellar lesions could be diagnosed. In 13 patients out of 17 whose lesions were mainly localized on one side through CT, cerebellar lesions could be diagnosed by electronystagmographic findings. In the 1 patient with amyotrophic lateral sclerosis of the remaining 4, asymptomatic cerebellar infarction was detected unexpectedly through CT. In the remaining 3 patients, differential diagnosis from brainstem lesions was difficult to evaluate on the basis of ENG findings. In 13 patients showing cerebellar signs and symptoms, pursuit eye movements, optokinetic nystagmus (OKN), and fixation-suppression of caloric nystagmus were impaired on both sides, suggesting large mass effects upon the bilateral brainstem. However, either rebound nystagmus or opposing positioning nystagmus characteristic of cerebellar lesions was detected in 13 patients (81%). The same was true in patients with bilateral cerebellar lesions. ENG test, however, could not detect any patients who showed neither cerebellar signs nor symptoms. Further investigations are needed to supplement the gap between basic and clinical research. PMID- 3827756 TI - Equilibrium disorders and R-R intervals in ECG. AB - We have measured RR intervals on patients with equilibrium disorders to check the function of the autonomic nervous system. And we have obtained two parameters (coefficient of variation "CV%" (the static function of the autonomic nervous system] and "A-B" (the dynamic function of the autonomic nervous system). The dynamic function of the autonomic nervous system (A-B) further deteriorated in elderly patients with central nervous system disorders. We concluded that disorders in the dynamic function of the autonomic nervous system affected the autoregulation which caused the central nervous system disorders, especially in elderly patients. PMID- 3827757 TI - Clinical significance of biphasic head-shaking nystagmus. AB - Biphasic head-shaking nystagmus (b-HSN) is a rather uncommon phenomenon which was first reported by Kamei in 1975 (Arch. Otorhinolaryngol. 209: 59-67, 1975). He pointed out that b-HSN appeared in cases of peripheral vestibular disturbance especially in the cases of unilateral disturbance, and that the direction of the second phase indicated the damaged side. While investigating cases of b-HSN, the author encountered some cases which did not correspond to b-HSN reported by Kamei. Nineteen patients in whom b-HSN was recorded by electronystagmography were investigated. These patients visited our clinic in the last two years and showed no spontaneous nystagmus in the narrow sense. Of these, 16 were cases of unilateral peripheral vestibular disturbance. In 13 of these (81%), as Kamei had described, the first phase beat toward the healthy side and the second phase beat toward the damaged side, while in the remaining 3 cases (19%), the first phase beat toward the damaged side, and the second phase toward the healthy side. This is contrary to Kamei's report. This time the b-HSN was also observed in 3 cases of central vestibular disturbance, which indicates that b-HSN occurs not only in cases of peripheral vestibular disturbance but also in cases of central vestibular disturbance. PMID- 3827758 TI - Classification of non-nystagmic spontaneous pathological eye movements. AB - We attempted to classify the well-known spontaneous pathological eye movement (SPEM), to provide a unified nomenclature, to describe its pathophysiology, and to determine its significance in determining a differential diagnosis. Nomenclature was according to the first reporter. These phenomena are easy to confuse with artifact when recording ENGs. A careful analysis which considers history and general neurological findings can identify many of these as true clinical findings which may be as important as nystagmus in the establishing of a clinical diagnosis. Each SPEM, once confirmed, plays a decisive role in the localization of lesions within the central nervous system. PMID- 3827759 TI - Spontaneous activity of first-order horizontal canal neurons in the guinea pig. AB - The spontaneous activity of the primary horizontal canal neurons was investigated in 12 alert albino guinea pigs. Seventy-one neurons were recorded for analyzing spontaneous activity. These neurons had an average resting rate of 46.6 +/- 20.9 spikes/sec and a range of 2.2 to 113.6 spikes/sec. This was significantly higher than previously reported data recorded from anesthetized guinea pigs. The neurons were classified into three groups from values of coefficient of variation; regular, intermediate, and irregular firing units. Of the 71 units measured, 42.3% were regular, 42.3% were intermediate, and 15.4% were irregular discharge units. The incidence of the irregular units was slightly lower than that in the anesthetized animals. The difference in resting activity of the primary neurons with or without general anesthesia is discussed. PMID- 3827760 TI - Graphical analysis of two-dimensional eye movements. AB - Horizontal and vertical monocular movements were recorded by electronystagmography using silver plate electrodes or by the magnetic search coil system. Both horizontal and vertical monocular movements were simultaneously measured with the use of a computer-controlled testing system. The data was composed by the computer and presented as a two-dimensional graphical plot of the actual eye movement trajectories. There are three factors in eye movements, that is, slow component of eye movements--pursuit; quick component--saccades; and fixation. The two-dimensional plot of pursuit monocular movements in normal subjects indicated that the eye did not move in a perfectly straight horizontal or vertical line. The plot appeared to be a series of smooth and snaky movements. Saccades showed quick jumping movement to reach a target and fixation. During fixation, eye position was not restricted to the point of a target and the eye moved around the target. Disturbance of pursuit is known as saccadic or ataxic. A two-dimensional plot of pathological pursuit showed a series of smaller saccades and fixation. Disturbance of saccades is shown as overshoot or undershoot. Also, a two-dimensional plot of pathological saccades was made of smaller saccades and of fixation. Failure of fixation showed larger and more irregular movements around the target. Thus, the two-dimensional plot of monocular movements clearly showed normal or pathological pursuit, saccades, and fixation. PMID- 3827761 TI - Predominance of nasal over temporal saccades in fast eye movement. AB - Quantitative analysis of saccadic eye movement caused by 20 degree amplitude gaze in horizontal plane was undertaken in 131 subjects using the Contraves' computerized oculomotor testing system. All of the subjects were free from any spontaneous nystagmus, neurological symptoms, and abnormalities of vestibular function. Both of the monocular recordings of saccade were made with a 3 sec time constant, 25 Hz high-cut filter, and digitized with a 3.9 msec sampling time. Four parameters i.e., maximum velocity, gain, latency, and duration, were analyzed. The average (S.D.) of each parameter was 337.1 (65.7) degree/sec, 1.00 (0.14), 199.1 (44.0) msec, and 128.3 (20.2) msec, respectively. We discussed the differences between nasal saccade and temporal saccade. The former was faster than the latter in maximum velocity and shorter in duration, while no differences were recognized in latency. It is suggested that the predominance of nasal saccade in fast eye movement is due to the anatomical difference of the vestibulo ocular pathway between the medial rectus and the lateral rectus. In other words, because the synaptic inputs to the medial rectus are excitatory as opposed to the inhibitory and excitatory the inputs to the lateral rectus, the difference in muscle tone between the two muscles results in a faster maximum velocity of nasal saccades in fast eye movement. PMID- 3827762 TI - Gain of slow-phase velocity of optokinetic nystagmus. AB - Although slow-phase velocity of optokinetic nystagmus (OKN) increases according to the increase of stimulus velocity, it is not obvious whether both are quite equal or not. In this study, gain of slow-phase velocity in OKN response to stimulation velocity was analyzed by two methods of stimulation, constant acceleration, and constant velocity stimulation. In our observation, the gain of slow-phase velocity was not equal to 1.0 even at low-speed stimulation. On the other hand, the number of nystagmus almost corresponded to the number of stimulation stripes passing through the center of an OK-drum up to high-speed stimulation. The results of this study indicate that pursuit eye movement of slow phase OKN should not be quite equal to that of the eye tracking test, i.e. being required to continuously look at a moving spot. PMID- 3827763 TI - Transfer function of right- and leftward eye movements in patients with unilateral labyrinth. AB - In patients with loss of unilateral labyrinthine function, the dynamic characteristics of rightward eye movement and leftward eye movement induced by the healthy labyrinth were displayed respectively. In patients who were examined within a few months after loss of unilateral labyrinthine function, the gain of eye movement toward the healthy labyrinth was low compared with that of eye movement toward the opposite direction. These differences in the gain were remarkable in the frequency range from 0.01 to 0.1 Hz. But those differences in the gain were not detected in patients who were examined more than 3 months after loss of unilateral labyrinthine function. PMID- 3827764 TI - Postural deviation evoked by caloric stimulation during upright standing in man. AB - To understand a disequilibrium of the peripheral vestibular disorders, we tried to analyze the body sway evoked by unilateral or bilateral caloric stimulation with warm and cold water systematically. As for postural deviation, the results of our study are summarized as follows. Unilateral warm stimulation evokes heterolateral and anterior postural deviation. Unilateral cold stimulation evokes homolateral and anterior postural deviation. Bilateral warm stimulation evokes posterior postural deviation. Bilateral cold stimulation evokes anterior postural deviation. Therefore we consider that there are several patterns of static disequilibrium of upright posture in the peripheral vestibular disorders. PMID- 3827765 TI - Microvibration-related responses to optokinetic stimulation. AB - The body surface of all warm-blooded animals vibrates constantly. This phenomenon was termed microvibration (MV) by Rohracher. Since 1961 Kawata and students have been studying MV otolaryngologically and they detected slight changes with auditory and vestibular stimuli in the waves of MV. The authors observed changes in the MV responses in the upper extremities, in the presence of optokinetic stimulation. They found a close relationship between the direction of optokinetic stimulation and changes in the MV response. Therefore, these observations suggest that for MV recording, optic stimulation can be used to test the oculospinal reflex. PMID- 3827766 TI - Cervico-vestibular interaction in eye movements. AB - The cervico-vestibular interaction was investigated in normal subjects and patients with unilateral labyrinthine dysfunction using neck vibratory stimulation and caloric stimulation. There is a functional interaction between sensory inputs from the neck proprioceptors and the peripheral labyrinth in the patients with unilateral labyrinthine dysfunction. However, this interaction was not observed in normal subjects. This result indicates that the role of the cervical sensory inputs in normal subjects and the patients is different. That is, inputs from the neck proprioceptors have little effect on the control of eye movements in normal subjects, whereas the neck inputs are quite important for the control of eye movements in patients with unilateral labyrinthine dysfunction. PMID- 3827767 TI - Computer analysis of optokinetic nystagmus for clinical usefulness. AB - A computer program was developed for on-line analysis of nystagmus parameters using a microcomputer (SORD M243EX). In this paper, the clinical utilities of microcomputer analysis of optokinetic nystagmus (OKN) were described, and quantitative analysis of each parameter of OKN was performed in 20 normal subjects and 49 patients with central nervous system (CNS) disorders. The average gain was accurately measured and the maximal stimulus velocity during which time the gain was more than 0.8, was termed as the "optokinetic adaptation limit (OAL)," and used as a clinical index for evaluation of OKN abnormalities. All patients in the present study showed a remarkable decrease in OAL. The differences in OAL among these patients at each level of lesion site, however, proved to be statistically insignificant. The relationship between the direction of OKN limitation and the lesion side was investigated. In all patients who had lesions on the thalamus, midbrain, and cerebellum, OKN limitation was observed toward the lesion side. The OKN limitation, however, was seen toward the intact side in 7 of 11 patients with medullary lesions and in 2 of 11 patients with cerebellopontine angle (CPA) tumors. hence, OKN in a useful diagnostic tool for the assessment of infratentorial lesions and computer analysis of OKN may be clinically useful. PMID- 3827768 TI - Breathing and the transition from intrauterine to extrauterine life. PMID- 3827769 TI - Comparison of the ability of the Lapicque and exponential strength-duration curves to fit experimentally obtained perception threshold data. PMID- 3827770 TI - A comparative study of the maximum entropy method and the fast Fourier transform for the spectral analysis of the third heart sound in children. PMID- 3827771 TI - Computing services in a large Australian teaching hospital. PMID- 3827772 TI - Spastic paresis in a Poll Hereford heifer. AB - A case of unilateral spastic paresis in a Poll Hereford heifer is described. The heifer could not actively flex the right stifle or hock and the toe just contacted the ground. There was cranial distortion and collapse of the distal tibial epiphysis and remodelling of the articular surfaces within the stifle and hock. There was moderately severe muscle atrophy, but a primary peripheral or central neuropathological lesion could not be found. PMID- 3827773 TI - Exotic bacterial pathogens Edwardsiella tarda and Edwardsiella ictaluri from imported ornamental fish Betta splendens and Puntius conchonius, respectively: isolation and quarantine significance. PMID- 3827774 TI - Observations on the control of ovine face lice (Linognathus ovillus) with closantel. PMID- 3827775 TI - Sheep may be more averse to electro-immobilisation than to shearing. PMID- 3827776 TI - A schwannoma causing cervical spinal cord compression in a dog. PMID- 3827777 TI - The application of a serological test to screen dogs entering Australia for antibody to Brucella canis. PMID- 3827778 TI - Isolation of Chlamydia psittaci from commercial broiler chickens. PMID- 3827779 TI - Citrullinaemia as a cause of neurological disease in neonatal Friesian calves. PMID- 3827780 TI - Poisoning of cattle by hairy or woolly-pod vetch, Vicia villosa subspecies dasycarpa. PMID- 3827781 TI - An egg development test for the evaluation of benzimidazole resistance in Nematodirus spathiger. PMID- 3827782 TI - Selection of injection technique for the intraperitoneal vaccination of merino sheep. PMID- 3827783 TI - Suspected anaphylaxis to thiopentone in a dog. PMID- 3827784 TI - Aerobic fitness and susceptibility to motion sickness. AB - Susceptibility to motion sickness was evaluated in 29 males having high, moderate, and low levels of aerobic fitness. Subjects underwent Coriolis (cross coupled) vestibular stimulation on a Stille-Werner rotator during a 10 min modification of the Brief Vestibular Disorientation Test (BVDT). Variables evaluated were: spin time before aborting (ST), heart rate (HR), respiratory rate (RR), mean skin temperature (Tsk), subject observation values (SV), and observation values (OV). Aerobic fitness and ST for the total population were inversely related (r = -0.506, p less than 0.01). Difference in ST was significant (F(2.26) = 6.67, p less than 0.01), with the high aerobic group demonstrating an earlier ST and greater SV than the low aerobic group (Student Newman-Keuls; alpha = 0.05). Analysis of HR, RR, and Tsk between groups revealed limited differences. Based on these data, men with high aerobic fitness appear to have an increased susceptibility to motion sickness. PMID- 3827785 TI - Noise, vibration and changes in wakefulness during helicopter flight. AB - The investigation was carried out in cooperation with the helicopter school AF 1 in Boden. Measurements were made in two different types of helicopter, Hkp 3 and Hkp 6. Three different parameters were recorded during the flights: noise, vibrations, and wakefulness. Noise and vibration exposures were mainly correlated to the main rotor energy and frequency. Both types of exposure were dominated by lower frequencies, below 10 Hz. Analyses of wakefulness during long-distance flights, about 4 h, and short-distance flights, less than 2 h, were based on EEG and EKG recordings. As expected the level of wakefulness was influenced by the stress upon the pilots. Take-offs and landings, as well as unexpected events during the flight, were correlated to an increased level of wakefulness. In some cases flying was correlated to a gradual increase of weariness. The correlation between weariness, types of flying, and the external environmental factors of noise and vibration, is also discussed. PMID- 3827786 TI - Effectiveness of an air-cooled vest using selected air temperature and humidity combinations. AB - We evaluated the effectiveness of an air-cooled vest in reducing thermal strain of subjects exercising in the heat (49 degrees C dry bulb (db), 20 degrees C dew point (dp] in chemical protective clothing. Four male subjects attempted 300-min heat exposures at two metabolic rates (175 and 315 W) with six cooling combinations--control (no vest) and five different db and dp combinations. Air supplied to the vest at 15 scfm ranged from 20-27 degrees C db, 7-18 degrees C dp; theoretical cooling capacities were 498-687 W. Without the vest, endurance times were 118 min (175 W) and 73 min (315 W). Endurance times with the vest were 300 min (175 W) and 242-300 min (315 W). The five cooling combinations were similarly effective in reducing thermal strain and extending endurance time, although there was a trend for the vest to be more effective when supplied with air at the lower dry bulb temperature. At 175 W, subjects maintained a constant body temperature; at 315 W, the vest's ability to extend endurance is limited to about 5 hours. PMID- 3827787 TI - Failure of metoclopramide to control emesis or nausea due to stressful angular or linear acceleration. AB - Orally administered metoclopramide (REGLAN) at doses of 10 or 20 mg, 75 min prior to either stressful linear acceleration (parabolic flight) or cross-coupled accelerative semicircular canal stimulation in a rotating chair was evaluated for its ability to prevent emesis or nausea II, respectively. Although metoclopramide is an effective antiemetic agent that enhances gastric emptying and prevents cancer chemotherapy-induced emesis, we were unable to demonstrate any significant (p less than 0.05) effects of this drug on motion sickness. PMID- 3827788 TI - Slow oscillations of psychophysiological parameters in human operators during monotony. AB - Objective estimation of the human operator's functional state is an urgent problem in applied psychophysiology. It helps to forecast the reliability and efficiency of the operator's activity. Slow (minute) changes in the functional state of 22 subjects were recorded and analysed in experiments simulating the long-term operator's activity. Spatial synchronization of the electroencephalogram (EEG) and the heart-rate (HR) served as parameters. It was shown that the time of detection and identification of visual signals (geometrical figures) amid visual "noise" in a long-term observation naturally depends on the changes in a subject's state. These changes were estimated by slow (2-3 min) components of the changes in spatial synchronization of EEG and HR throughout 3 h of the experiment. These objective parameters of the human operator's state may be used to predict efficiency. The connection between minute oscillations of electrophysiological parameters and time of reaction is absent during the first 30 min of the experiment, then appears and increases throughout further stages, becoming clearly marked in its second half. PMID- 3827789 TI - Changes of skin potential level and of skin resistance level corresponding to lasting motion discomfort. AB - The qualitative correspondence between degree of motion discomfort and electrodermal activity was investigated. Skin potential level (SPL) and skin resistance level (SRL) in the arousal sweat area and the thermal sweat area were recorded. In order to induce motion discomfort, Coriolis stimulation and/or horizontal body rotation were provided by using a rotatory chair. The degree of discomfort was evaluated according to reports by the subjects. It was observed that SPL depolarized in the arousal sweat area as well as in the thermal sweat area and SRL lowered in the thermal sweat area coincidentally with lasting motion discomfort. SPL showed better correspondence the recovery period from the motion discomfort. PMID- 3827790 TI - Changes in body water and electrolytes during heat acclimation: effects of dietary sodium. AB - In an effort to describe the influence of both high (HNA) and low (LNA) dietary sodium (399 vs. 98 mEq Na+ X d-1) on body fluids during heat acclimation (HA), nine untrained males underwent 8 d of HA twice (90 min treadmill walking, 5.6 km X h-1, 6% grade) in an environmental chamber (40.1 degrees C, 23.5% RH). Mean wholebody Na+ balance calculations indicated that HNA resulted in an increase of Na+ of $916 mEq per 8 days per subject, whereas LNA resulted in a relative Na+ deficiency of -230 mEq per 8 days per subject. Subjects exhibited typical HA adaptations of decreased heart rate (HR), decreased rectal temperature (Tre) during exercise, and an increase in resting plasma volume (PV) during both diets. Significant HNA vs. LNA differences (p less than 0.05) were observed in HR (days 3-5), Tre (days 3-6), PV (day 4), plasma osmolality (day 4), plasma Na+ (day 4), urine Na+ (days 2-8), and sweat Na+ (days 4 and 8). The between-diet differences in HR, Tre and PV were not detectable by the end of each dietary-exercise regimen. Needle biopsy samples (20-50 mg, lateral aspect of the gastrocnemius) indicated that muscle Na+ and muscle water were similar on all days, except day 9 when intracellular fluid expansion during LNA was noted. Change in body weight was not strongly correlated with delta PV (R2 = 0.47, 0.10) and neither osmotic forces nor plasma protein movements explained all PV shifts adequately.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827791 TI - Effect of heat and chemical protective clothing on cognitive performance. AB - This study examined the effects of heat on the sustained cognitive performance of sedentary soldiers clad in chemical protective clothing. There were 23 men trained for 2 weeks on selected military tasks. Then they performed the tasks for 7-h periods on 4 successive days (Days 1 and 3 = 21.1 degrees C, 35%rh, battle dress uniform; Day 2 = 12.8 degrees C, protective clothing; Day 4 = 32.8 degrees C, 61%rh, protective clothing). After 4-5 h in the heat wearing protective clothing, the cognitive performance of the group began to deteriorate markedly. By the end of 7 h of exposure to heat, increases in percent group error on investigator-paced tasks ranged from 17%-23% over control conditions. Virtually all of the decrements were due to increases in errors of omission. The productivity of the group on a self-paced task (map plotting) diminished by approximately 40% from control conditions after 6 h in the heat in protective clothing; accuracy of plotting was not markedly affected. PMID- 3827792 TI - Differential neuropsychological effects of diving to 350 meters. AB - Six divers were compressed on heliox to 350 m. Repeated neuropsychological and neurological tests were conducted during the dive. Averaged increased tremor during the compression was found. Two divers had major EEG changes, while two divers had a completely normal EEG. Memory was most impaired among the cognitive variables. At 350 m there was some normalization in the EEG, and the tremor levels returned to normal. Memory impairment, however, was sustained. Three months later nine divers performed an open sea dive to 300 m. Whereas minor fatigue effects were found for the experimental dive, examinations after the open sea dive indicated more specific cerebral after effects. An increased tremor, reduced hand grip strength and foot tapping speed, lowered autonomic reactivity, and memory problems were found. Some divers had unequivocal asymmetrical plantar responses and unilateral weak abdominal reflexes, accompanied by EEG changes with corresponding laterality. In three of the divers these signs were not present 1 month later. PMID- 3827793 TI - Medical helicopters: carbon monoxide risk? AB - Carbon monoxide exposure of medical personnel working beneath the turning rotor of a medical helicopter appeared to cause mild clinical illness. We measured the carbon monoxide levels found in various locations beneath the rotor of a jet helicopter under two different conditions. Carbon monoxide levels ranged from 8 76 ppm depending on location of sampling and speed of operation of the engine. This level of carbon monoxide is potentially a problem, as is the inhalation of jet fuel vapor, when working beneath the rotors of an operating helicopter. PMID- 3827794 TI - Hydrostatic theory and G protection using tilting aircrew seats. AB - A hydrostatic theory of blackout is generally supported in the acceleration literature, but there is disagreement as to the correct origin in the thorax for h, the hydrostatic distance to the eye. Our goal was to determine whether representative published data would preferentially support some particular origin for h. Based upon a reanalysis of published data (1) relating acceleration tolerance (T) to seat-back angle (theta), it was found that a simple hydrostatic model, with h measured from the aortic valve to the eye, yields an excellent fit. The nonlinear equation fitted was Ti = Tmin 1/cos(theta i-phi), where phi = correction to back angle. The value of phi derived from the 1975 data (1) (13.74 degrees) was the same as the independent estimate of phi for this same seat (13.06 degrees) derived from published values of h, which were measured by X-ray with h referenced to the aortic-valve and eye (2). The acceleration tolerance data for the other two seats of the 1984 study also strongly supported the model. Future studies should measure h (aortic valve-to-eye), use seat-back angles giving even spacing on a 1/h scale, and analyze data using the required nonlinear methods. PMID- 3827795 TI - Cases from the aerospace medicine residents' teaching file. Case #16. A student pilot with an avulsion fracture of C5. AB - A student pilot presented to the emergency room with neck pain after having received a blow to the back of the head during participation in a sports event. The clinical presentation, diagnosis, and aeromedical disposition of this patient are discussed. A review of radiologic findings in cervical fractures is also presented. PMID- 3827796 TI - Patients with asymptomatic coronary artery disease. PMID- 3827797 TI - Arteriovenous malformations of the brain. PMID- 3827798 TI - Acetylcholinesterase in normal and malignant human cells. AB - Acetylcholinesterase (AChE) activity was determined in normal and malignant human cell lines by histochemical methods. In normal human fibroblasts, no AChE activity could be demonstrated by any histochemical technique or substrate. Enzymic activity was observed in HT-1080 human fibrosarcoma cells, RD 2 human rhabdomyosarcoma cells, and SW 311 human colon carcinoma cells. Activity was localized around the nuclear envelope, in the cytoplasm and associated with the cortical region of most cells. The specificity of the reaction was shown through the use of specific cholinesterase inhibitors. PMID- 3827799 TI - Evaluation on the effects of cutaneous chemical agents by nuclear magnetic resonance techniques. AB - A change in relaxation times has been determined in skin tissues after administration of hyaluramine, by means of nuclear magnetic resonance. Results are discussed in terms of water redistribution between the free and bound compartment. PMID- 3827800 TI - The diamond knife "semi": a substitute for glass or conventional diamond knives in the ultramicrotomy of thin and semi-thin sections. AB - The diamond knife "semi" for ultramicrotomes was originally designed by its manufacturer (DIATOME S.A.), for cutting semi-thin sections from 0.2 micron to 2.0 micron. Cutting tests of Epon-embedded material (nervous system, myelin sheat) with this knife have shown that the quality of semi-thin sections is equivalent or better than that obtained with a glass knife, and much time could be saved during the microtomy of serial sections. The quality of thin sections (0.07 micron to 0.12 micron) is excellent and comparable to that obtained with a conventional diamond knife. Furthermore, when adjacent sections are cut thin and semi-thin (for immunochemistry or high voltage microscopy), both are excellent in that they are of uniform thickness. In conclusion, this tool has advantages for both light microscopy and transmission electron microscopy. PMID- 3827801 TI - [Results of conservative treatment of tibial fractures using a short plaster cast]. PMID- 3827802 TI - [Functional treatment of humerus shaft fractures using a cork cuff]. PMID- 3827803 TI - [New aspects of bone lengthening osteotomy of the tibia in children and adolescents]. PMID- 3827804 TI - [Underwater traction in lumbar spinal nerve root compression syndrome (technic and experiences)]. PMID- 3827805 TI - [32d meeting of the Society for Orthopedics of East Germany. 11-13 March 1986, Erfurt. Abstracts]. PMID- 3827806 TI - [Effects of a beta-carotene supplement on the fertility of cattle. 1. Blood concentration and diagnostic possibilities]. PMID- 3827807 TI - [The ventricle cell cycle. Examples from the early development of Ammon's horn in the bovine embryo in light and electron microscopic studies]. PMID- 3827808 TI - [Electrophoretic presentation of the protein component of crop milk of pigeons (Columba livia domestica) by isoelectric focusing and SDS-electrophoresis]. PMID- 3827809 TI - [A hereditary disorder of vitamin D metabolism in swine. Pseudo- vitamin D deficiency rickets, type I]. PMID- 3827810 TI - [Fine structure of embryonal intestinal epithelium]. PMID- 3827811 TI - [Functional morphology and microarchitecture of the circumcaudal organ of Cervus elaphus and C. nippon]. PMID- 3827812 TI - Glucose dehydrogenase from the thermoacidophilic archaebacterium Sulfolobus solfataricus. AB - Glucose dehydrogenase has been purified to homogeneity from cell extracts of the extreme thermoacidophilic archaebacterium Sulfolobus solfataricus. The enzyme utilizes both NAD+ and NADP+ as coenzyme and catalyses the oxidation of several monosaccharides to the corresponding glyconic acid. Substrate specificity and oxidation rate depend on the coenzyme present; when NAD+ is used, the enzyme binds and oxidizes specifically sugars presenting equatorial orientation of hydroxy groups at C-2, C-3 and C-4. The Mr of the native enzyme is 124,000 and decreases to about 60,000 in the presence of 6 M-guanidinium chloride and to about 30,000 in the presence of 5% (w/v) SDS. The enzyme shows maximal activity at pH 9, 77 degrees C and 20 mM-Mg2+, -Mn2+ or -Ca2+ and is fairly stable in the presence of chaotropic agents and water-miscible organic solvents such as methanol or acetone. PMID- 3827813 TI - Regulation of the pentose phosphate cycle. Cofactor that controls the inhibition of glucose-6-phosphate dehydrogenase by NADPH in rat liver. AB - A cofactor of Mr 10(4), characterized as a polypeptide, was found to co-operate with GSSG to prevent the inhibition of glucose-6-phosphate dehydrogenase by NADPH, in order to ensure the operation of the oxidative phase of the pentose phosphate pathway, in rat liver [Eggleston & Krebs (1974) Biochem. J. 138, 425 435; Rodriguez-Segade, Carrion & Freire (1979) Biochem. Biophys. Res. Commun. 89, 148-154]. This cofactor has now been partially purified by ion-exchange chromatography and molecular gel filtration, and characterized as a protein of Mr 10(5). The lighter cofactor reported previously was apparently the result of proteolytic activity generated during the tissue homogenization. The heavier cofactor was unstable, and its amount increased in livers of rats fed on carbohydrate-rich diet. Since the purified cofactor contained no glutathione reductase activity, the involvement of this enzyme in the deinhibitory mechanism of glucose-6-phosphate dehydrogenase by NADPH should be ruled out. PMID- 3827814 TI - Intramitochondrial regulation of fatty acid beta-oxidation occurs between flavoprotein and ubiquinone. A role for changes in the matrix volume. AB - Rat liver mitochondria were incubated in media of different osmolarities and in the presence of various substrates. Rates of oxygen consumption and mitochondrial matrix volumes were measured in the presence and absence of ADP and uncoupler. Duroquinol oxidation was insensitive to matrix volume, whereas other substrates tested showed increased rates of oxidation when the matrix volume increased from 1.0 to 1.5 microliter/mg of protein; this is the range of values measured in situ [Quinlan, Thomas, Armston & Halestrap (1983) Biochem. J. 214, 395-404]. Palmitoylcarnitine, octanoate and butyrate oxidations were particularly sensitive to the matrix volume, increasing from negligible rates to maximal rates within this range. Swelling induced by K+ uptake also stimulated palmitoylcarnitine oxidation. A similar effect of volume on substrate oxidation was seen when ferricyanide in the presence or absence of ubiquinone-1 replaced oxygen as terminal electron acceptor. Measurement of flavoprotein reduction (A 460-480) demonstrated that the locus of the effect of matrix volume is between the electron-transfer flavoprotein and ubiquinone. It is suggested that volume mediated regulation of fatty acid and proline oxidation may be an important component of the hormonal stimulation of their oxidation. PMID- 3827815 TI - Purification and properties of a xylanase from Streptomyces lividans. AB - An extracellular xylanase produced by a cellulase-negative mutant strain of Streptomyces lividans 1326 was purified to homogeneity. The purified enzyme has an apparent Mr of 43,000 and pI of 5.2. The pH and temperature optima for the activity were 6.0 and 60 degrees C respectively, and the Km and Vmax. values, determined with a soluble oat spelts xylan, were 0.78 mg/ml and 0.85 mmol/min per mg of enzyme. The xylanase showed no activity towards CM-cellulose and p nitrophenyl beta-D-xyloside. The enzyme degraded xylan, producing mainly xylobiose, a mixture of xylo-oligosaccharides and a small amount of xylose as end products. Its pattern of action on beta-1,4-D-xylan indicates that it is a beta 1,4-endoxylanase (EC 3.2.1.8). PMID- 3827816 TI - Regulation of ketogenesis, gluconeogenesis and the mitochondrial redox state by dexamethasone in hepatocyte monolayer cultures. AB - The effects of the glucocorticoid dexamethasone on fatty acid and pyruvate metabolism were studied in rat hepatocyte cultures. Parenchymal hepatocytes were cultured for 24 h with nanomolar concentrations of dexamethasone in either the absence or the presence of insulin (10 nM) or dibutyryl cyclic AMP (1 microM BcAMP). Dexamethasone (1-100 nM) increased the rate of formation of ketone bodies from 0.5 mM-palmitate in both the absence and the presence of BcAMP, but inhibited ketogenesis in the presence of insulin. Dexamethasone increased the proportion of the palmitate metabolized that was partitioned towards oxidation to ketone bodies, and decreased the cellular [glycerol 3-phosphate]. The latter suggests that the increased partitioning of palmitate to ketone bodies may be associated with decreased esterification to glycerolipid. The Vmax. of carnitine palmitoyltransferase (CPT) and the affinity of CPT for palmitoyl-CoA were not affected by dexamethasone, indicating that the increased ketogenesis was not due to an increase in enzymic capacity for long-chain acylcarnitine formation. Dexamethasone and BcAMP, separately and in combination, increased gluconeogenesis. In the presence of insulin, however, dexamethasone inhibited gluconeogenesis. Changes in gluconeogenesis thus paralleled changes in ketogenesis. Dexamethasone decreased the [3-hydroxybutyrate]/[acetoacetate] ratio, despite increasing the rate of ketogenesis and presumably the mitochondrial production of reducing equivalents. The more oxidized mitochondrial NADH/NAD+ redox couple with dexamethasone is probably due either to an increased rate of electron transport or to increased transfer of mitochondrial reducing equivalents to the cytoplasm. PMID- 3827817 TI - The synthesis of peptidylfluoromethanes and their properties as inhibitors of serine proteinases and cysteine proteinases. AB - A synthesis of peptidylfluoromethanes is described that utilizes the conversion of phthaloyl amino acids into their fluoromethane derivatives. These can be deblocked and elongated. The inactivation of chymotrypsin by Cbz-Phe-CH2F (benzyloxycarbonylphenylalanylfluoromethane) was found to be considerably slower than that of the analogous chloromethane. The fluoromethane analogue inactivates chymotrypsin with an overall rate constant that is 2% of that observed for the inactivation of the enzyme with the chloromethane. However, the result is the same. The reagent complexes in a substrate-like manner, with Ki = 1.4 X 10(-4) M, and alkylates the active-centre histidine residue. Cbz-Phe-Phe-CH2F and Cbz-Phe Ala-CH2F were investigated as inactivators of the cysteine proteinase cathepsin B. The difference in reactivity between fluoromethyl ketones and chloromethyl ketones is less pronounced in the case of the cysteine proteinase than for the serine proteinase. Covalent bond formation takes place in this case also, as demonstrated by the use of a radiolabelled reagent. PMID- 3827818 TI - Fractionation and purification of hepatic microsomal cytochrome P-450 isoenzymes from phenobarbital-pretreated rats by h.p.l.c. A convenient tool for screening of isoenzymes inactivated by allylisopropylacetamide. AB - A procedure incorporating the salient features of ion-exchange column chromatography with ion-exchange h.p.l.c. is described for the fractionation and purification to homogeneity of several membrane-bound rat hepatic phenobarbital (PB)-inducible cytochrome P-450 isoenzymes, including the major PB-inducible species. The resolving power of this technique makes it a highly promising tool for the isolation and purification of closely related cytochrome P-450 isoenzymes. In addition, it may also be used for screening of individual isoenzymes either selectively induced or repressed by a variety of endobiotics or xenobiotics. Accordingly, we have exploited this particular feature to identify not only the PB-inducible cytochrome P-450 isoenzymes destroyed in vivo by allylisopropylacetamide, a suicide inactivator of cytochrome P-450, but also to distinguish those that are reparable by exogenous haemin from those that are irreparably damaged. PMID- 3827819 TI - Inhibition of microsomal oxidation of ethanol by pyrazole and 4-methylpyrazole in vitro. Increased effectiveness after induction by pyrazole and 4-methylpyrazole. AB - Pyrazole and 4-methylpyrazole, which are inhibitors of alcohol dehydrogenase, were also found to be effective inhibitors of the oxidation of ethanol by liver microsomes (microsomal fractions) in vitro. Ethanol oxidation by microsomes from rats previously treated for 2 or 3 days with either pyrazole or 4-methylpyrazole appeared to be especially sensitive to inhibition in vitro by pyrazole or 4 methylpyrazole. The kinetics of inhibition by pyrazole or 4-methylpyrazole in all microsomal preparations were mixed, as the Km for ethanol was elevated while Vmax was lowered. However, Ki values for pyrazole (about 0.35 mM) and especially 4 methylpyrazole (about 0.03-0.10 mM) were much lower than those found with the saline controls (about 0.7-1.1 mM). In contrast, Ki values for dimethyl sulphoxide as an inhibitor of microsomal ethanol oxidation were similar in all microsomal preparations. Pyrazole and 4-methylpyrazole reacted with microsomes to produce type II spectral changes whose magnitude increased after treatment with either pyrazole or 4-methylpyrazole. Thus the increased inhibitory effectiveness of pyrazole and 4-methylpyrazole appears to be associated with increased interactions with the cytochrome P-450 isoenzyme(s) induced by these compounds. These isoenzymes have properties similar to those of the isoenzyme induced by chronic ethanol treatment. Therefore, caution is needed in the use of pyrazole or 4-methylpyrazole to assess pathways of ethanol metabolism, especially after chronic ethanol treatment, since these agents, besides inhibiting alcohol dehydrogenase, are also effective inhibitors of microsomal ethanol oxidation. PMID- 3827820 TI - Characterization of the N-linked high-mannose oligosaccharides of the insulin pro receptor and mature insulin receptor subunits. AB - The insulin receptor is synthesized as a 190,000-Mr single-chain precursor that contains exclusively asparagine-N-linked high-mannose-type carbohydrate chains. In this study we have characterized the structure of the pro-receptor oligosaccharides. IM-9 lymphocytes were pulse-chase-labelled with [3H]mannose, and the insulin pro-receptor was isolated by immunoprecipitation and SDS/polyacrylamide-gel electrophoresis. The pro-receptor oligosaccharides were removed from the protein backbone with endoglycosidase H and analysed by h.p.l.c. Immediately after a [3H]mannose pulse the largest oligosaccharide found in the pro-receptor was Glc1Man9GlcNAc2; this structure represented only a small fraction (3%) of the total. The predominant oligosaccharides present in the pro receptor were Man9GlcNAc2 (25%) and Man8GlcNAc2 (48%). Smaller oligosaccharides were also detected: Man7GlcNAc2 (18%), Man6GlcNAc2 (3%) and Man5GlcNAc2 (3%). The relative distribution of the different oligosaccharides did not change at 1, 2 or 3 h after the pulse with the exception of the rapid disappearance of the Glc1Man9GlcNAc2 component. The mature alpha- and beta-subunits of the insulin receptor are known to contain both high-mannose-type and complex-type oligosaccharides. We have also examined here the structure of the high-mannose chains of these subunits. The predominant species in the alpha-subunit was Man8GlcNAc2 whereas in the beta-subunit it was Man7GlcNAc2. These results demonstrate that most (approx. 75%) oligosaccharides of the insulin pro-receptor are chains of the type Man8GlcNAc2 or Man9GlcNAc2. Thus, assuming that a Glc3Man9GlcNAc2 species is transferred co-translationally, carbohydrate processing of the pro-receptor appears to be very rapid and limited to the removal of the three glucose residues and one mannose residue. Further mannose removal does not occur until the pro-receptor has been proteolytically cleaved. In addition, the degree of mannose trimming appears to be different in the alpha- and beta-subunits. PMID- 3827821 TI - Renal neuraminidase. Characterization in normal rat kidney and measurement in experimentally induced nephrotic syndrome. AB - Several lines of evidence suggest that increased neuraminidase activity may be responsible for the loss of glomerular N-acetylneuraminic acid (AcNeu) observed in various glomerular diseases. However, virtually no information is available on the activity of neuraminidase in glomeruli or the potential role of this enzyme in glomerular pathophysiology. Utilizing 2'-(4-methylumbelliferyl)-alpha-D-N acetylneuraminic acid (4MU-AcNeu) as substrate, we defined optimal assay conditions and characterized neuraminidase activity in glomeruli and, for comparison, in other renal fractions and liver. Neuraminidase activity in glomeruli, cortex and tubules was maximal at pH 4.4. The Km for 4MU-AcNeu was estimated to be 195 microM for glomeruli and 226 microM for cortex. Glomerular neuraminidase was inhibited by AcNeu (90% at 25 mM) and high concentrations of Triton X-100 (26% at 0.5%), but unaffected by CaCl2, EDTA or N-ethylmaleimide (each 1 mM). Neuraminidase activity (nmol/h per mg of protein; mean +/- S.E.M.) in normal rat kidney was: cortex, 14.47 +/- 0.76; medulla, 7.85 +/- 0.64; papilla, 2.64 +/- 0.11; tubules, 13.79 +/- 0.70; glomeruli, 5.57 +/- 0.28. In comparison, neuraminidase activity in rat liver was 2.58 +/- 0.14. Puromycin aminonucleoside (PAN)-induced nephrotic syndrome is a model of glomerular disease in which the loss of glomerular AcNeu is well documented. In two separate studies, we observed no change in the specific activity of neuraminidase in either glomeruli or cortex isolated from rats treated with PAN (15 mg/100 g, intraperitoneally) and killed at either the onset or the peak of proteinuria. Results were similar whether neuraminidase activity was expressed per mg of protein or per microgram of DNA. PMID- 3827822 TI - Biosynthesis of the third component of complement (C3) by the human monocytic cell line U-937. Induction by phorbol myristate acetate. AB - Phorbol myristate acetate (PMA)-stimulated human monocyte-like cells (U-937) were found to synthesize the third component of complement (C3), as shown by enzyme linked immunosorbent assay and immunoprecipitation from [35S]methionine-labelled culture supernatants. C3 synthesis occurred at a rate of about 160 ng of C3/24 h per 10(6) cells on day 7 after addition of PMA; it was blocked by cycloheximide treatment and was restored after removal of the inhibitor. SDS/polyacrylamide-gel electrophoretic analysis of the immunoprecipitated protein showed that the size and subunit structure of the newly synthesized C3 were identical with those of plasma C3, and that a single-chain intracellular precursor was present in the cell lysates. Haemolytic assays showed that the synthesized C3 fully expressed functional activity in early culture within 4 h. After longer culture, a loss of haemolytic activity was observed. The possibility that newly secreted C3 is cleaved by U-937 cells themselves was suggested. PMID- 3827823 TI - Molecular cloning of a cDNA and assignment of the C-terminal of sarcotoxin IA, a potent antibacterial protein of Sarcophaga peregrina. AB - A previous paper described the complete amino acid sequences of sarcotoxins IA, IB and IC, which are a group of potent antibacterial proteins with almost identical primary structures produced by Sarcophaga peregrina (fleshfly) larvae [Okada & Natori (1985) J. Biol. Chem. 260, 7174-7177]. The present paper describes the cDNA cloning and complete nucleotide sequencing of a cDNA clone for sarcotoxin IA. The C-terminal amino acid residue of sarcotoxin IA deduced from the nucleotide sequence was glycine, whereas it was found to be arginine by amino acid sequencing of purified sarcotoxin IA. Analysis of the elution profiles on h.p.l.c. of the synthetic derivatives of sarcotoxin IA showed that the C-terminal amino acid residue of authentic sarcotoxin IA is amidated arginine, which is probably produced by enzymic cleavage of terminal glycine. PMID- 3827824 TI - Further evidence for the involvement of a phosphoprotein in the respiratory burst oxidase of human neutrophils. AB - Phosphorylation of a 47 kDa protein in human neutrophils is induced by phorbol 12 myristate 13-acetate (PMA), opsonized latex beads, fMet-Leu-Phe, calcium ionophore A23187 and fluoride. All of these stimuli activate the specialized microbicidal respiratory burst of neutrophils, and in each case the kinetics of activation correspond with the kinetics of phosphorylation of the 47 kDa protein. Trifluoperazine (50 microM) and chlorpromazine (100 microM), inhibitors of calmodulin and protein kinase C, abolish the increase in oxygen consumption and selectively prevent phosphorylation of the 47 kDa protein after PMA stimulation. Treatment of neutrophils with pertussis toxin totally inhibits both superoxide production and phosphorylation of this protein in response to fMet-Leu-Phe, but not in response to PMA, indicating that a GTP-binding protein modulates the fMet Leu-Phe receptor signal. Phosphorylation of the 47 kDa protein, a phenomenon absent from the neutrophils of subjects with autosomal recessive chronic granulomatous disease, which lack the respiratory burst, appears to be the common trigger for activation of the burst in normal neutrophils. PMID- 3827825 TI - Mechanism of enzymic isomerization and epimerization of D-erythrose 4-phosphate. AB - The mechanism of the enzymic isomerization and epimerization of D-erythrose 4 phosphate (Ery4P) by an enzyme preparation from bovine liver was investigated with the use of 2H2O. The incorporation of 2H was quantitatively determined by a procedure using gas chromatography-mass spectrometry. About one atom of 2H was incorporated per molecule of the enzymic epimerization reaction product of Ery4P (D-threose 4-phosphate) or that of D-ribulose 5-phosphate. Computer simulation of the Ery4P isomerization reaction indicated that the 2H of 2H2O was not directly incorporated into the enzymic reaction product (D-erythrulose 4-phosphate). Instead, intramolecular transfer of hydrogen atoms had occurred. PMID- 3827826 TI - IMP production and energy metabolism during exercise in rats in relation to age. AB - IMP production in and force exerted by rat quadriceps muscle in situ during various types of exercise were examined in relation to age. During continuous isometric exercise with constant stimulation time, the amount of IMP was linearly and inversely related to the age of the animals; a higher IMP concentration was found in intermittent isometric and dynamic exercise. No relationship was found between the total AMP deaminase activity and age. Exercise influenced neither the total activity nor the activity in the soluble fraction. From the results it is concluded that: the IMP concentration is linearly related to the free intracellular ATP4-/ADP3- ratio and the free AMP2- concentration; older animals are better able to maintain a high intramuscular ATP4-/ADP3- ratio and a low AMP2 concentration; IMP is produced in particular under conditions when the muscle has to work under extreme stress. IMP possibly exerts a feed-back control on the contraction system. PMID- 3827827 TI - Modification of human haemoglobin with glucose 6-phosphate enhances tetramer dimer subunit dissociation. AB - Studies using equilibrium gel-permeation chromatography demonstrate that formation of the covalent adduct of D-glucose 6-phosphate (G6P) with human haemoglobin promotes dissociation of the haemoglobin tetramer into its component alpha beta dimer pairs [Kdoxy = 2.57 X 10(-6) versus Kdoxy (G6P) = 11.22 X 10(-6) M-haem]. On the other hand, Kd for glucosylated haemoglobin is identical with those of the O2- and CO-liganded forms of intact haemoglobin A0. These data are consistent with the phosphate moiety alone being responsible for a 4.5-fold increase in the tetramer-to-dimer apparent Kd. This suggests the glucose 6 phosphate moiety does not bind to the same sites on haemoglobin as do the free organic phosphates, as suggested by ligand-binding kinetics data or structural analysis. My study presents a working model for studying changes in protein subunit assembly as altered by protein phosphorylations. PMID- 3827828 TI - Determination of the molecular mass of apolipoprotein B-100. A chemical approach. AB - Apolipoprotein B-100 (apo B-100) is the protein ligand in low-density lipoproteins that binds to a specific cell-surface receptor. Its molecular mass has been a subject of controversy. We have determined the molecular mass of the protein by a chemical approach. After complete CNBr cleavage, the C-terminal fragment of apo B-100 was purified by reverse-phase h.p.l.c. Amino acid N- and C terminal analyses confirm that this peptide represents the C-terminal peptide as deduced from the DNA sequence of a human apo B-100 cDNA clone. A chemically synthesized peptide was used to determine the recovery of the peptide (74.72%). On the basis of these data, the molecular mass of apo B-100 was determined to be 496.82 +/- 24.84 kDa. PMID- 3827829 TI - Activation of hypolipidaemic drugs to acyl-coenzyme A thioesters. AB - Compounds possessing the characteristics of CoA thioesters of the hypolipidaemic peroxisome proliferators clofibric acid, nafenopin and ciprofibrate were formed on incubation of the drugs with rat liver microsomal fractions, ATP and CoA. The reactivity of the drugs correlated with their pharmacological potency. It is proposed that the active species of these compounds are their acyl-CoA thioesters. PMID- 3827830 TI - [gamma-32P]ATP as a tracer of the fragmentation of Ca-F-actin. AB - [gamma-32P]ATP-G-actin was polymerized in 4 mM-CaCl2, and the distribution of the radioactive nucleotide among the oligomeric and the polymeric species was studied. The results obtained are best explained by assuming spontaneous fragmentation. PMID- 3827831 TI - Carbohydrate and protein conformation. PMID- 3827832 TI - Structural characteristics and intermolecular organization of human pulmonary surfactant-associated proteins. AB - The structural relationships and intermolecular organization among the proteins associated with pulmonary surfactant are largely unknown. We studied the pulmonary-surfactant-associated proteins in the bronchoalveolar lavage fluid obtained from a patient with the clinical syndrome of alveolar proteinosis. The major proteins with Mr values of 32,000-36,000 and 62,000 formed thiol-dependent complexes (Mr greater than 400,000) with intermolecular disulphide bonds present in the collgenase-sensitive domains of these proteins. In contrast, other proteins, which were collagenase-insensitive, formed thiol-dependent oligomers that were not covalently linked to the major proteins. The associations of these proteins in the surfactant of a normal individual were similar. By amino acid analysis, two-dimensional peptide mapping and bacterial-collagenase digestion the 32,000-36,000-Mr and 62,000-Mr proteins were nearly identical. Differences in CNBr cleavage products suggested that the larger of the proteins was formed by non-disulphide, covalent, cross-links in the collagenase-sensitive domains of the 32,000-36,000-Mr proteins. Thus the evidence suggested that the lipid-associated proteins of Mr 32,000-36, 000 contained both disulphide and non-disulphide cross links in the collagen-like N-terminal region of the proteins and form higher-Mr complexes. This organization may support the three-dimensional conformation of surfactant in the alveolar space. PMID- 3827833 TI - Metabolism of apolipoprotein E-containing human plasma lipoproteins by rat and human cells in culture. AB - Cultured preadipocytes from rat epididymal fat pads were able to bind, internalize, and degrade human plasma very-low-density lipoproteins (VLDL) more efficiently than low-density lipoproteins (LDL). VLDL, but not LDL, activated acyl-CoA: cholesterol acyltransferase (ACAT) and increased cholesterol accumulation in these cells. However, trypsin-treated VLDL (T-VLDL) lost the capacity to bind, activate ACAT, and increase cholesterol accumulation. After the treatment of VLDL with trypsin, SDS/polyacrylamide-gel electrophoresis and immunoblotting showed that apolipoprotein E (apo E) was completely degraded, whereas apolipoprotein CII (apo C-II) was preserved. ApoE complexed with dimyristoyl phosphatidylcholine (DMPC) was able to complete with VLDL for binding to the cells. Although T-VLDL did not bind to the preadipocytes, these cells accumulate triacylglycerols from T-VLDL, presumably after lipolysis, as efficiently as from native VLDL. Rat smooth muscle cells and skin fibroblasts also bind and metabolize human VLDL better than LDL. However, human skin fibroblasts and omental preadipocytes metabolized LDL better than VLDL. These studies indicate that rat tissues can recognize and metabolize apoE-containing human plasma VLDL although they cannot recognize human LDL. PMID- 3827834 TI - New isolation procedure and further biochemical characterization of glycoproteins IIb and IIIa from human platelet plasma membrane. AB - We describe a new procedure for isolation of glycoproteins IIb (GPIIb) and IIIa (GPIIIa) from human platelet plasma membrane with high yields (2.7 mg of GPIIb and 3.3 mg of GPIIIa per 100 mg of starting platelet membrane proteins), equivalent to a recovery of 35% and 55% respectively of the total GPIIb and GPIIIa of the membrane. The procedure involves Triton X-100 differential extraction of platelet membranes, SDS solubilization of the 4%-Triton X-100 supernatant, zonal centrifugation in a sucrose density gradient, and preparative high-performance size-exclusion chromatography. The weight percentage of sugar is 15.7% for GPIIb and 12.5% for GPIIIa. Neuraminic acid is present in both glycoproteins, representing 30% and 15% respectively of the total sugar weight of GPIIb and GPIIIa. Mannose, galactose and glucosamine account for 45%, 13% and 28% respectively of the sugars of GPIIIa, whereas galactosamine was not detected. Mannose, galactose, glucosamine and galactosamine represent 17%, 21%, 24% and 10% respectively of the sugar content of GPIIb. The molar percentages of half-cystine and methionine are 4-fold and 2-fold higher respectively in GPIIIa than in GPIIb. From the amino acid and sugar compositions we confirmed the acidic nature of both glycoproteins. The Mr values obtained, 136,500 for GPIIb and 91,500 for GPIIIa, are in very good agreement with those obtained by physical methods. The apparent lack of free thiol groups in both glycoproteins indicates that the tertiary structure of GPIIIa is maintained by 21 intrachain disulphide bonds, and that there are eight intrachain and interchain disulphide groups in GPIIb. PMID- 3827835 TI - Isolation and biochemical characterization of the alpha- and beta-subunits of glycoprotein IIb of human platelet plasma membrane. AB - The alpha- and beta-subunits of glycoprotein IIb (GPIIb) of human platelet plasma membrane were isolated in fully reduced, partially reduced and alkylated, and fully alkylated forms, by size-exclusion chromatography after reduction of pure GPIIb. The sugar moiety of GPIIb alpha accounts for 16.4% of its total weight, whereas that of GPIIb beta accounts for only 10.2%. The molar percentages (per 100 mol of total amino acids) of neuraminic acid and galactose in the alpha subunit more than double those in the beta-subunit, whereas galactosamine is present only in GPIIb alpha. From the amino acid and sugar compositions the acidic nature of both subunits was confirmed. The Mr values obtained, 114,000 for GPIIb alpha and 22,200 for GPIIb beta, are in very good agreement with those obtained by physical methods. We found by stepwise reduction of pure GPIIb with dithioerythritol that GPIIb alpha and GPIIb beta are joined by a single interchain disulphide bridge, while the remaining half-cystine residues participate in intrachain bonds, six in GPIIb alpha and one in GPIIb beta, the intersubunit disulphide bond being that reduced first. Neither of the two subunits is liberated from isolated plasma membranes when this GPIIb interchain bond is reduced in isolated membranes. PMID- 3827836 TI - Comparison of the primary structures of ribonuclease U2 isoforms. AB - The primary structures of the two isoforms of ribonuclease U2, RNAases U2-A and U2-B, were analysed and compared with each other. Among the chymotryptic peptides obtained from the reduced and S-carboxymethylated enzymes, only peptides C-3 were different from each other in terms of chromatographic behaviour on reverse-phase h.p.l.c. On the basis of chemical analyses of these peptides, it was shown that RNAase U2-B had an isopeptide bond in which Asp-32 was linked to Gly-33 through the beta-carboxy group in its side chain instead of the alpha-carboxy group. Deamidation of Asn-32 in RNAase U2-A led to the formation of this unusual linkage. The previously reported sequence of RNAase U2 [Sato & Uchida (1975) Biochem. J. 145, 353-360] was corrected by changing amino acid residues at eight different positions and by inserting an asparagine residue at position 32. The numbering of the positions of amino acid residues located downstream of Asn-32 was therefore shifted by 1. Accordingly, RNAase U2-A was shown to be composed of 114 amino acid residues. PMID- 3827837 TI - Rat heparins. A study of the relative sizes and antithrombin-binding characteristics of heparin proteoglycans, chains and depolymerization products from rat adipose tissue, heart, lungs, peritoneal cavity and skin. AB - 35S-labelled heparins were recovered from adipose tissue, hearts, lungs, peritoneal cavities and skins of rats given H2(35)SO4. Their purification involved incubation with Pronase, precipitation with cetylpyridinium chloride in 1.0 M-NaCl, gradient elution from DEAE-Sephacel and incubation with chondroitinase ABC. Each product was divided into proteoglycan and "depolymerization products' fractions by gel filtration on Bio-Gel A-15m. Heparin chains were released from a portion of each proteoglycan fraction by beta elimination with NaOH. Proteoglycans, chains and depolymerization products were separated by gradient elution from a column of antithrombin-agarose into fractions with no affinity, low affinity and high affinity for antithrombin. The relative sizes of the products were determined by gel filtration on columns of Bio-Gel A-50m, A-15m, A-1.5m and A-0.5m. Skin was the major source of heparin and contained the largest proteoglycans and the lowest proportion of depolymerization products. Lungs contained the smallest proteoglycans, the smallest depolymerization products and the highest proportion of depolymerization products. The highest proportions of proteoglycans, chains and depolymerization products with high affinity for antithrombin were found in adipose tissue. The lowest proportions of each of these fractions were found in the peritoneal cavity. The data suggest that there was relatively little biosynthesis of sites with high affinity for antithrombin in peritoneal-cavity mast cells and that heparin catabolism was most active in lungs. Each source of heparin was unique with respect to both biosynthesis and subsequent breakdown of its proteoglycans. PMID- 3827838 TI - Interspecies conservation of structure of interphotoreceptor retinoid-binding protein. Similarities and differences as adjudged by peptide mapping and N terminal sequencing. AB - Structural properties of the retinal extracellular-matrix glycolipoprotein interphotoreceptor retinoid-binding protein (IRBP) from human, monkey and bovine retinas have been compared. SDS/polyacrylamide-gel-electrophoretic analysis of limited tryptic and Staphylococcus aureus-V8-proteinase digests show virtually identical patterns for the monkey and human proteins, whereas both sets differ considerably from the bovine protein pattern. Time-course digestion shows monkey IRBP to be more readily cleaved than bovine IRBP and also cleaved to smaller fragments. Also, reversed-phase h.p.l.c. of complete tryptic digests of the IRBPs indicate that, although they have in common a similar preponderance of hydrophobic peptides, all three proteins differ extensively in their fine structure. The N-terminal sequences of monkey and bovine IRBPs have been extended beyond those presented in our previous report [Redmond, Wiggert, Robey, Nguyen, Lewis, Lee & Chader (1985) Biochemistry 24, 787-793] to over 30 residues each. The sequences yet show extensive homology, differing at only two positions, although the major monkey sequence has an additional five amino acid residues at its N-terminus ('n + 5' sequence) not observed with bovine IRBP ('n' sequence). The newly determined N-terminal sequence of human IRBP demonstrates the presence of equal amounts of the 'n' and 'n+5' sequences that are qualitatively identical with those of the monkey. The presence of the five-amino-acid-residue extension in primate, but not bovine, IRBP may indicate variation in post-translational processing. PMID- 3827839 TI - Stimulation, by vasopressin and other agonists, of inositol-lipid breakdown and inositol phosphate accumulation in WRK 1 cells. AB - WRK 1 cells were labelled to equilibrium with 2-myo-[3H]inositol and stimulated with vasopressin. Within 3 s of hormone stimulation there was a marked accumulation of 3H-labelled InsP2 and InsP3 (inositol bis- and tris-phosphate), but not of InsP (inositol monophosphate). There was an associated, and rapid, depletion of 3H-labelled PtdInsP and PtdInsP2 (phosphatidylinositol mono- and bis phosphates), but not of PtdIns (phosphatidylinositol), in these cells. Some 4% of the radioactivity in the total inositol lipid pool of WRK 1 cells was recovered in InsP2 and InsP3 after 10 s stimulation with the hormone. The selectivity of the vasopressin receptors of WRK 1 cells for a variety of vasopressin agonists and antagonists revealed these to be of the V1a subtype. There was no receptor reserve for vasopressin-stimulated inositol phosphate accumulation in WRK 1 cells. The accumulation of inositol phosphates was enhanced in the presence of Li+ions. Half-maximal accumulation of InsP, InsP2 and InsP3 in vasopressin stimulated cells was observed with 0.9, 3.0 and 3.6 mM-Li+ respectively. Bradykinin and 5-hydroxytryptamine also provoked inositol phosphate accumulation in WRK 1 cells. The effects of sub-optimal concentrations of bradykinin and vasopressin upon inositol phosphate accumulation were additive, but those of optimal concentrations of the hormones were not. PMID- 3827840 TI - The turnover of phosphate bound to myosin light chain-2 in perfused rat heart. AB - The rate of exchange of phosphate bound to ventricular myosin light chain-2 (LC2 P) was measured in rat hearts perfused with [32P]Pi at various levels of perfusate Ca2+. Computer simulations of the light-chain labelling suggested the presence of two isotopically distinct pools of LC2-P, one large pool comprising 90% of the total and a small pool consisting of the remaining 10%. At control levels of perfusate Ca2+ the phosphate of the large pool turned over very slowly (t 1/2 congruent to 250 min), whereas that of the small pool turned over much more rapidly (t 1/2 congruent to 1 min). At high levels of perfusate free Ca2+ (5mM) the turnover of the phosphate of the small pool decreased markedly, whereas that of the large pool remained little changed. Conversely, at low perfusate free Ca2+ (0.2 mM), the turnover of the large pool decreased, whereas that of the small pool remained unchanged. The possible identity of these two pools is discussed. The total myosin-light-chain kinase activity of rat ventricle was found to be only 2-3-fold higher than the kinase activity expressed in the heart under control conditions. This, coupled with the very low turnover of most of the LC2-bound phosphate, implies that, in heart, there is insufficient myosin-light chain kinase activity to cause a rapid rise in the overall level of light-chain phosphorylation, even under conditions of increased cytoplasmic Ca2+. PMID- 3827841 TI - Effect of physical environment on the conformation of ricin. Influence of low pH. AB - The molecular properties of ricin (the toxic lectin from Ricinus communis seeds, RCA II or RCA 60) were evaluated by analytical ultracentrifugation, viscosimetry, c.d., fluorescence and equilibrium dialysis. Measurements of sedimentation (S0(20,W) = 4.60 S) and viscosity (eta = 2.96 X 10(-2) dl/g) indicated that, at neutral pH, the ricin molecule is very compact. Various transitions were explored, and a pH-triggered change in the ricin conformation was observed between pH 7 and 4. In this range, the sedimentation coefficient, far-u.v. c.d. and fluorescence altered simultaneously without unfolding. Below pH 7 the change in the ricin conformation was accompanied by a decrease in the affinity of ricin for galactosides, and at pH 4.0 by an alteration in its binding capacity. These effects of low pH are discussed in relation to the physical conditions encountered by ricin molecules during their entry into living cells. PMID- 3827842 TI - Structure and stability of Ricinus communis haemagglutinin. AB - The molecular properties of the haemagglutinin of Ricinus communis (RCA I or RCA 120) were evaluated by analytical ultracentrifugation, light-scattering, c.d. and fluorescence. The native molecule had a fairly expanded structure (f/f0 = 1.43) and dissociated into two subunits of equal size in 6 M-guanidinium chloride. This native structure was stable in alkali (up to pH 11) and resistant to thermal denaturation at neutrality. A pH-triggered change in the haemagglutinin conformation was observed and characterized by analytical ultracentrifugation, c.d. and fluorescence between pH 7 and 4.5, the range in which its affinity for galactosides decreased [Yamasaki, Absar & Funatsu (1985) Biochim, Biophys. Acta 828, 155-161]. These results are discussed in relation to those reported in the literature for other lectins and more especially ricin, for which a pH-dependent conformation transition has been observed in the same range of low pH. PMID- 3827843 TI - Oxidative radioiodination damage to human lactoferrin. AB - Oxidative iodination of human lactoferrin (Lf) as commonly performed by using the chloramine-T, the Iodogen or the lactoperoxidase method produces an unreliable tracer protein because of excessive and heterogeneous polymer formation. Before iodination a minor tetramer fraction may be demonstrable in iron-saturated Lf only. Iodination-induced polymerization of iron-poor as well as iron-saturated Lf occurs independently of the presence or absence of 10 mM-EDTA and the 125I-/Lf molar ratio used for iodination. 125I-Lf polymers are mainly covalently linked, as suggested by the lack of substantial dissociation in SDS/polyacrylamide-gel electrophoresis. Damage to the 125I-Lf monomer may be another consequence of oxidative iodination. This is demonstrated in SDS/polyacrylamide-gel electrophoresis where 50% of the radioactivity of apparently normal monomer (Mr 75,000) is displaced to a lower-Mr region (30,000-67,000) after reduction with dithiothreitol. Non-oxidative iodination by the Bolton-Hunter technique produces an antigenetically stable tracer that is not being subjected to polymerization and monomer degradation as judged by high-performance gel chromatography and SDS/polyacrylamide-gel electrophoresis with and without dithiothreitol treatment. It is concluded that oxidation in itself leads to covalent non-disulphide cross linking between human Lf molecules and, possibly, to intramolecular peptide-bond breaking becoming unmasked under reducing conditions. In biological experiments with human 125I-Lf this problem should be carefully considered. PMID- 3827844 TI - Phosphatidylglycerol of rat lung. Intracellular sites of formation de novo and acyl species pattern in mitochondria, microsomes and surfactant. AB - The subcellular site of phosphatidylglycerol (PG) formation for lung surfactant has not been convincingly clarified. To approach this problem we analysed the acyl species pattern of lung PG in mitochondria, microsomes and surfactant by h.p.l.c. separation of its 1,2-diacyl-3-naphthylurethane derivatives. Both mitochondrial and microsomal PG proved identical with surfactant PG, containing the major species 1-palmitoyl-2-oleoyl-PG and 1,2-dipalmitoyl-PG. The fatty acid composition of mitochondrial PG differs markedly from that of diphosphatidylglycerol. This may be taken as an indication that mitochondrial PG is synthesized on purpose to form surfactant, rather than being only the precursor of diphosphatidylglycerol. In vitro, sn-[U-14C]glycerol 3-phosphate incorporation into PG of mitochondria or microsomes occurs in the presence of CTP, ATP and CoA but independently of the supply of exogenous lipoidic precursors. Although the rate in vitro of autonomous PG synthesis, and the endogenous PG content, are higher in mitochondria than in microsomes, it is assumed that both subcellular fractions are involved in PG formation for surfactant. PMID- 3827845 TI - The role of haem in the regulation of rat liver tryptophan metabolism. AB - At saturating concentrations of tryptophan, the activity of tryptophan 2,3 dioxygenase was the same in isolated liver cells and in extracts with added haematin. Intraperitoneal injection of haematin did not increase tryptophan oxidation in livers subsequently perfused in situ. Preincubation of liver cells with physiological concentrations of tryptophan caused maximal saturation of tryptophan 2,3-dioxygenase with haem in liver cells. In cell-free extracts tryptophan 2,3-dioxygenase exhibited complex kinetics with haem. The results have important implications for the understanding of the role of haem in tryptophan metabolism. PMID- 3827846 TI - Regulation of Ca2+-dependent protein turnover in skeletal muscle by thyroxine. AB - Dantrolene, an agent that inhibits Ca2+ mobilization, improved protein balance in skeletal muscle, as thyroid status was increased, by altering rates of protein synthesis and degradation. Thyroxine (T4) caused increases in protein degradation that were blocked by leupeptin, a proteinase inhibitor previously shown to inhibit Ca2+-dependent non-lysosomal proteolysis in these muscles. In addition, T4 abolished sensitivity to the lysosomotropic agent methylamine and the autophagy inhibitor 3-methyladenine, suggesting that T4 inhibits autophagic/lysosomal proteolysis. PMID- 3827847 TI - Multiple forms of cytochrome P-450 related to forms induced marginally by phenobarbital. Differences in structure and in the metabolism of alkoxyresorufins. AB - The properties of five structurally related forms of cytochrome P-450 (PB1a, PB1b, PB2a, PB2b and PB2d) isolated from rats treated with phenobarbital have been compared with two forms isolated previously now termed 'PB1c' and 'PB2c'. These enzymes were characterized by their marginal inducibility by phenobarbital and are clearly distinguishable from the major phenobarbital-inducible proteins. PB1a and PB1b differed in Mr (52,700 and 52,900), absorption spectra and papain proteolysis fragments. However, they had identical N-terminal sequences. PB2a, PB2b and PB2d had apparent Mr values of 52,900, 52,900 and 50,800. PB2a and PB2b had different N-terminal sequences and, after digestion with papain, gave different papain-proteolysis fragments. The N-terminal sequence of PB2b was similar to, but not identical with, that of pregnenolone-16 alpha-carbonitrile inducible P-450 species, and PB2b was the protein most closely related to PB2c. The extent of immunocross-reactivity among the forms was stronger within, than between, the PB1 and PB2 groups. Even structurally similar forms were functionally diverse, exhibiting large differences in metabolic specificity in the dealkylation of a series of alkoxyresorufins. PMID- 3827849 TI - Four classes of beta-hairpins in proteins. AB - We show that beta-hairpins can be divided into four classes, each with a number of members. Hairpins from a single class are readily interconverted by loss or gain of hydrogen bonds, but interconversion between classes requires complete unzipping and reformation of the entire beta-hairpin. Sibanda & Thornton [(1985) Nature (London) 316, 170-174] have classified beta-hairpins as either two residue, three-residue, four-residue etc., loops. We point out that their nomenclature, by itself, gives rise to ambiguities, but that, if the class (one of the four mentioned above) is also specified, the description of beta-hairpins becomes straightforward. A range of proteins of known three-dimensional structure has been examined; it provides examples of hairpins of each of the four classes and give some indication of their frequency of occurrence. The distribution observed is substantially different from that described by Sibanda & Thornton [(1985) Nature (London) 316, 170-174]. PMID- 3827848 TI - The effect of fatty acids and starvation on the metabolism of gluconeogenic precursors by isolated sheep liver cells. AB - Isolated liver cells prepared from fed sheep synthesize glucose from propionate at twice the rate observed with cells from starved animals. Addition of palmitate or palmitate + carnitine to incubations of liver cells from starved animals inhibited the rate of glucose synthesis with lactate as a precursor, but had little effect when propionate and pyruvate were substrates. Liver cells from fed and starved sheep synthesized lactate and pyruvate when incubated with propionate. Fatty acids inhibited this formation of lactate and pyruvate from propionate. It is proposed that the different responses of gluconeogenic precursors to fatty acids can be explained by the effect of reducing equivalents on the transport of carbon atoms across the mitochondrial membrane. PMID- 3827850 TI - Haemosiderin-like properties of free-radical-modified ferritin. AB - Conjugated-Schiff's-base-type fluorescence was measured in iron-depleted samples and chloroform extracts of human spleen haemosiderin. Incubation of ferritin with liposomes and ascorbate led to the formation of compounds with similar fluorescence properties. Analysis of protein subunits by SDS/polyacrylamide-gel electrophoresis confirmed that ferritin was damaged in incubations with ascorbate. Since previous studies have shown that intact ferritin is resistant to proteolytic degradation, it is suggested that haemosiderin may be a product of oxidative reactions involving ferritin and lipid. PMID- 3827851 TI - Specificity of inositol phosphate-stimulated Ca2+ mobilization from Swiss-mouse 3T3 cells. AB - Pure samples of inositol 1,3,4-trisphosphate, inositol 1,3,4,5-tetrakisphosphate and inositol 1,2-cyclic 4,5-trisphosphate were prepared and tested for their ability to mobilize calcium from intracellular stores in a permeabilized Swiss mouse 3T3 cell preparation. In this system inositol 1,4,5-trisphosphate mobilizes Ca2+ with a half-maximal dose of 0.3 microM. Inositol 1,2-cyclic 4,5 trisphosphate mobilized Ca2+ to the same extent with a half-maximal dose of 0.3 microM, whereas inositol 1,3,4-trisphosphate required a half-maximal dose of approx. 9 microM to give the same effect. Inositol 1,3,4,5-tetrakisphosphate was ineffective up to 20 microM and at that concentration did not antagonize the mobilization induced by inositol 1,4,5-trisphosphate. The relevance of these findings to the function of the inositol tris/tetrakis-phosphate pathway is discussed. PMID- 3827852 TI - Buffer capacity of intracellular Ca2+ indicators. PMID- 3827853 TI - Electron-microscopic and electrophoretic studies of bovine femoral-head cartilage proteoglycan fractions. AB - Proteoglycans (A1D1) extracted from bovine femoral-head cartilage were examined by electron microscopy using benzyldimethylammonium chloride as a spreading agent. The preparation contained a mixture of particles, some with a 'beaded' structure and a contiguous filamentous 'tail' at one end and others which appeared as round 'blobs', some of which also had filamentous tails. Previous electron-microscopic studies of proteoglycan monomers have indicated that their length distributions were apparently unimodal, a finding that contrasted with agarose/polyacrylamide-gel-electrophoresis results, which generally indicated two bands. In the present study proteoglycans isolated from the slowly migrating electrophoretic band were shown to be predominantly the larger molecules of beaded appearance, whereas the rapidly migrating proteoglycans were predominantly molecules with the 'blob-like' appearance. Gel-filtration, isopycnic-density gradient-centrifugation and rate-zonal-centrifugation techniques were evaluated as means of proteoglycan fractionation by electron microscopy and agarose-gel electrophoresis. Rate-zonal centrifugation in mixed-salt gradients of caesium chloride/4 M-guanidinium chloride yielded the most effective fractionation. PMID- 3827854 TI - Cat pancreatic eicosapeptide and its biosynthetic intermediate. Conservation of a monobasic processing site. AB - Pancreatic eicosapeptide is synthesized together with the hormone pancreatic polypeptide in a common precursor in the major endocrine cell type of the duodenal pancreas. This processing has been previously demonstrated in man and in the dog. In the present study the cat pancreatic eicosapeptide and a C-terminally extended form of this were isolated and characterized from acid/ethanol extracts of pancreas by gel filtration and reverse-phase h.p.l.c. The sequence homology in the C-terminal part of the eicosapeptides from different species was shown to continue to the other side of the monobasic cleavage site in the extended intermediate form, whereas the end of the extension differed both in chain length and amino acid sequence. It is concluded that the processing site in the intermediate form of the pancreatic eicosapeptide is an example of a proline directed monobasic cleavage site that has been conserved during evolution. PMID- 3827855 TI - Purification of foetal steroid-binding protein from human serum by affinity chromatography on 5 alpha-androstane-3 beta,17 beta-diol 3-hemisuccinate aminohexyl-Sepharose 6B. AB - In order to develop an immunoassay for foetal steroid-binding protein in human serum, which is impossible to assay quantitatively in normal samples by conventional ligand-binding techniques, the protein was purified by salt precipitation, affinity chromatography and gel filtration. Elution was by competing ligand or alkaline pH. The purified protein was further characterized and a highly specific antiserum was raised in rabbits. PMID- 3827856 TI - Formation of aryl and aryldiazenyl complexes in reactions of arylhydrazines and aryldiazenes with a synthetic model compound of haemoprotein. AB - The anaerobic reaction of chelated protohaemin, a synthetic model compound of ferrihaemoglobin, with phenyldiazene produced a compound with the visible absorption spectrum of a ferrihaemochrome. The compound reacted with CN-, which is a ligand of both ferric and ferrous porphyrins, to produce the complex of the synthetic ferrihaemoglobin with CN-. Though the spectrum of the compound formed by the addition of phenyldiazene to chelated protohaemin is characteristic of a ferric porphyrin complex, this compound reacted with both toluene-p sulphonylmethyl isocyanide and CO, which are strong ligands of ferrous porphyrins, to produce the corresponding ferrous complexes. These ligand-binding reactions indicated that the complex of chelated protohaem with phenyldiazene can behave either as a complex of a ferric porphyrin with phenyldiazenyl anion (C6H5N = N-) or a complex of a ferrous porphyrin with phenyldiazenyl radical (C6H5N = N.). Para substituents on phenyldiazene were without effect on the formation of 4 substituted phenyldiazenyl complexes with chelated protohaem. Ortho substituents resulted in less-stable complexes. The phenyl complex of chelated protohaem was prepared by the aerobic reaction of phenylhydrazine with chelated protohaemin, and its structure was confirmed by its n.m.r. spectrum. The ligand-binding properties, n.m.r. spectrum and absorption spectrum of this complex differed from those of the phenyldiazenyl complex. The phenyl complex also was produced when the phenyldiazenyl complex was exposed to O2. PMID- 3827857 TI - Location of antithrombin-binding regions in rat skin heparin proteoglycans. AB - Rat skin heparin proteoglycan labelled biosynthetically with 35S was fractionated on a column of antithrombin-Sepharose into fractions with varying degrees of affinity for antithrombin. These were treated with NaOH to release heparin chains (Mr 60,000-100,000), by beta-elimination or incubated with serum to produce fragments of the same order of size as commercial heparin (Mr 5000-30,000), by endoglycosidase cleavage. Chains and fragments were then fractionated on antithrombin-Sepharose. The various fractions were deaminated with HNO2 at pH 1.5 followed by reduction with NaB3H4. Approx 90% of the incorporated 3H was associated with disaccharides. These were fractionated by high-performance ion exchange chromatography. A unique minor component corresponding to the sequence glucuronosyl-N-sulphoglucosaminyl (3,6-di-O-sulphate) in the polysaccharide was found only in fractions with high affinity for antithrombin. The glucosamine residue linked to C-4 of this glucuronosyl unit was predominantly (or exclusively) N-sulphated rather than N-acetylated, pointing to a structural difference between the antithrombin-binding region of rat heparin and that of pig mucosal heparin. Calculations based on the distribution of the glucosaminyl 3-O sulphate group showed that approximately two-thirds of the total antithrombin binding regions present in the unfractionated material were accommodated by only 20% of the proteoglycan molecules, and by 10% of the polysaccharide chains. While most of the proteoglycan molecules thus lacked such regions (and hence affinity for antithrombin) a minor proportion of the polysaccharide chains contained on the average three binding regions per molecule. These findings support by direct chemical analysis an earlier proposal, based on anticoagulant activities of similar rat skin heparin fractions, that the distribution of antithrombin-binding sites in intact heparin proteoglycans is markedly non-random. PMID- 3827858 TI - Bryodin, a ribosome-inactivating protein from the roots of Bryonia dioica L. (white bryony). AB - Bryodin is a strongly basic (pI greater than or equal to 9.5) glycoprotein (neutral sugar content 6.3%) with Mr 30,000, purified from the roots of Bryonia dioica (white bryony). This protein inhibits protein synthesis by a rabbit reticulocyte lysate with and ID50 (concentration causing 50% inhibition) of 0.12 nM (3.6 ng/ml) and has much less effect on protein synthesis by whole cells, with ID50 values ranging from 46 nM to 2.27 microM (1.4-67 micrograms/ml). Bryodin acts by inactivating ribosomes, with a less-than-equimolar ratio, which suggests a catalytic action. Bryodin decreases the number of local lesions induced by tobacco mosaic virus in the leaves of Nicotiana glutinosa. From all its properties, bryodin can be considered to be a ribosome-inactivating protein, similar to those already known [reviews: Barbieri & Stirpe (1982) Cancer Surveys 1, 489-520; Stirpe & Barbieri (1986) FEBS Lett. 195, 1-8]. PMID- 3827859 TI - The relationship between the optical properties and the kinetic behaviour of ascorbate-inhibited alkaline phosphatase. AB - Aromatic residues of bovine kidney alkaline phosphatase appear to be involved in the interaction with ascorbate, as shown by the strong quenching of intrinsic fluorescence and absorption. Difference u.v.-absorption spectra clearly indicate that conformational changes also occur. The pH value at which the greatest fluorescence deactivation is found is close to that necessary for optimal catalytic activity and for maximal inhibition by ascorbate. A protective effect against ascorbate is afforded by Pi. Time profiles of inactivation on one side and of absorbance and emission quenching on the other display opposite behaviours. Attempts to reverse the effects by the use of KOH fail to restore enzyme activity or to modify the spectral effects of ascorbate. The protein alterations are related, directly or indirectly, to the enzyme active centre and can be probably ascribed to the redox and chelating properties of ascorbate. PMID- 3827860 TI - Altered lipid synthesis in type II pneumonocytes exposed to lung surfactant. AB - When type II pneumonocytes were exposed to purified lung surfactant that contained 1-palmitoyl-2-[3H]palmitoyl-glycero-3-phosphocholine, radiolabelled surfactant was apparently taken up by the cells since it could not be removed by either repeated washing or exchange with non-radiolabelled surfactant, but was released when the cells were lysed. After 4 h of exposure to [3H]surfactant, more than half of the 3H within cells remained in disaturated phosphatidylcholine. Incorporation of [3H]choline, [14C]palmitate and [14C]acetate into glycerophospholipids was decreased in type II cells exposed to surfactant and this inhibition, like surfactant uptake, was half-maximal when the extracellular concentration of surfactant was approx. 0.1 mumol of lipid P/ml. Inhibition of incorporation of radiolabelled precursors by surfactant occurred rapidly and reversibly and was not due solely to dilution of the specific radioactivity of intracellular precursors. Activity of dihydroxyacetone-phosphate acyltransferase, but not glycerol-3-phosphate acyltransferase, was decreased in type II cells exposed to surfactant and this was reflected by a decrease in the 14C/3H ratio of total lipids synthesized when cells incubated with [U-14C]glycerol and [2 3H]glycerol were exposed to surfactant. Phosphatidylcholine, phosphatidylglycerol and cholesterol, either individually or mixed in the molar ratio found in surfactant, did not mimic purified surfactant in the inhibition of glycerophospholipid synthesis. In contrast, an apoprotein fraction isolated from surfactant inhibited greatly the incorporation of [3H]choline into lipids and this inhibitory activity was labile to heat and to trypsin. It is concluded that the apparent uptake of surfactant by type II cells in vitro is accompanied by an inhibition of glycerophospholipid synthesis via a mechanism that involves a surfactant apoprotein. PMID- 3827861 TI - Carbohydrate structures of the third component of rat complement. Presence of both high-mannose and complex type oligosaccharide chains. AB - We investigated the carbohydrate structure of the third component of complement (C3) newly synthesized by cultured rat hepatocytes. When the cells were incubated with [3H]mannose, [3H]galactose or [3H]glucosamine, these radioactive precursors were incorporated only into the alpha subunit of C3, demonstrating that only the alpha subunit contains oligosaccharide chains. [3H]Mannose-labelled C3 was purified from the culture medium by immunoaffinity chromatography. Oligosaccharides prepared by Pronase digestion and strong alkaline hydrolysis were separated into two fractions by Bio-Gel P-2 chromatography (Fractions I and II). The two fractions were analysed by concanavalin A-Sepharose chromatography, ion-exchange high-performance liquid chromatography, and Bio-Gel P-4 gel filtration before and after sequential exoglycosidase digestions. It was found that Fraction I contained two complex type oligosaccharide chains, (NeuAc)2(Gal)2(GlcNAc)2(Man)3(GlcNAc)2 and (NeuAc)3(Gal)3(GlcNAc)3(Man)3(GlcNAc)2, and Fraction II contained the high mannose type, consisting mainly of (Man)8(GlcNAc)2. Taken together with the carbohydrate composition of rat serum C3, the results suggest that rat C3 has one high-mannose type oligosaccharide chain and two complex type chains in the alpha subunit, which is different from the proposal for human C3. PMID- 3827862 TI - Collagen defects in lethal perinatal osteogenesis imperfecta. AB - Quantitative and qualitative abnormalities of collagen were observed in tissues and fibroblast cultures from 17 consecutive cases of lethal perinatal osteogenesis imperfecta (OI). The content of type I collagen was reduced in OI dermis and bone and the content of type III collagen was also reduced in the dermis. Normal bone contained 99.3% type I and 0.7% type V collagen whereas OI bone contained a lower proportion of type I, a greater proportion of type V and a significant amount of type III collagen. The type III and V collagens appeared to be structurally normal. In contrast, abnormal type I collagen chains, which migrated slowly on electrophoresis, were observed in all babies with OI. Cultured fibroblasts from five babies produced a mixture of normal and abnormal type I collagens; the abnormal collagen was not secreted in two cases and was slowly secreted in the others. Fibroblasts from 12 babies produced only abnormal type I collagens and they were also secreted slowly. The slower electrophoretic migration of the abnormal chains was due to enzymic overmodification of the lysine residues. The distribution of the cyanogen bromide peptides containing the overmodified residues was used to localize the underlying structural abnormalities to three regions of the type I procollagen chains. These regions included the carboxy-propeptide of the pro alpha 1(I)-chain, the helical alpha 1(I) CB7 peptide and the helical alpha 1(I) CB8 and CB3 peptides. In one baby a basic charge mutation was observed in the alpha 1(I) CB7 peptide and in another baby a basic charge mutation was observed in the alpha 1(I) CB8 peptide. The primary defects in lethal perinatal OI appear to reside in the type I collagen chains. Type III and V collagens did not appear to compensate for the deficiency of type I collagen in the tissues. PMID- 3827863 TI - Synthesis of the small subunit of ribulose-bisphosphate carboxylase from genes cloned into plasmids containing the SP6 promoter. AB - DNA sequences encoding ribulose 1,5-bisphosphate carboxylase small subunit precursor from Pisum sativum L. have been transcribed from plasmids containing the SP6 promoter, and translated in a wheat germ cell-free system. The small subunit precursor polypeptide, its N-terminal leader sequence (transit peptide) and the mature small subunit have each been synthesized independently from three different plasmid constructs. The precursor polypeptide is imported into isolated pea chloroplasts and processed to the mature small subunit by a stromal proteinase. The mature polypeptide is neither imported, nor subject to proteolysis by stromal extracts. The transit peptide alone is very rapidly degraded by a stromal proteinase activity which can be inhibited by EDTA or 1,10 phenanthroline. The use of these gene constructs helps to establish the crucial role of the transit peptide in protein import into the chloroplast. PMID- 3827864 TI - Changes in glucose 1,6-bisphosphate content in rat skeletal muscle during contraction. AB - Glucose 1,6-bisphosphate, fructose 2,6-bisphosphate, glycogen, lactate and other glycolytic metabolites were measured in rat gastrocnemius muscle, which was electrically stimulated in situ via the sciatic nerve. Both the frequency and the duration of stimulation were varied to obtain different rates of glycolysis. There was no apparent relationship between fructose 2,6-bisphosphate content and lactate accumulation in contracting muscle. In contrast, glucose 1,6-bisphosphate content increased with lactate concentration during contraction. It is suggested that the increase in glucose 1,6-bisphosphate could play a role in phosphofructokinase stimulation and in the activation of the glycolytic flux during muscle contraction. PMID- 3827865 TI - Calmodulin-binding proteins and calmodulin-regulated enzymes in dog pancreas. AB - Calmodulin was isolated and purified to homogeneity from dog pancreas. Highly purified subcellular fractions were prepared from dog pancreas by zonal sucrose density ultracentrifugation and assayed for their ability to bind 125I-calmodulin in vitro. Proteins contained in these fractions were also examined for binding of 125I-calmodulin after their separation by polyacrylamide-gel electrophoresis in SDS. Calmodulin-binding proteins were detected in all subcellular fractions except the zymogen granule and zymogen-granule membrane fractions. One calmodulin binding protein (Mr 240,000), observed in a washed smooth-microsomal fraction, has properties similar to those of alpha-fodrin. The postribosomal-supernatant fraction contained three prominent calmodulin-binding proteins, with apparent Mr values of 62,000, 50,000 and 40,000. Calmodulin-binding proteins, prepared from a postmicrosomal-supernatant fraction by Ca2+-dependent affinity chromatography on immobilized calmodulin, exhibited calmodulin-dependent phosphodiesterase, protein phosphatase and protein kinase activities. In the presence of Ca2+ and calmodulin, phosphorylation of smooth-muscle myosin light chain and brain synapsin and autophosphorylation of a Mr-50,000 protein were observed. Analysis of the protein composition of the preparation by SDS/polyacrylamide-gel electrophoresis revealed a major protein of Mr 50,000 which bound 125I calmodulin. This protein shares characteristics with the calmodulin-dependent multifunctional protein kinase (kinase II) recently observed to have a widespread distribution. The possible role of calmodulin-binding proteins and calmodulin regulated enzymes in the regulation of exocrine pancreatic protein synthesis and secretion is discussed. PMID- 3827866 TI - Metabolic effects of D-glyceraldehyde in isolated hepatocytes. AB - The effects of D-glyceraldehyde on the hepatocyte contents of various metabolites were examined and compared with the effects of fructose, glycerol and dihydroxyacetone, which all enter the glycolytic/gluconeogenic pathways at the triose phosphate level. D-Glyceraldehyde (10 MM) caused a substantial depletion of hepatocyte ATP, as did equimolar concentrations of fructose and glycerol. D Glyceraldehyde and fructose each caused a 2-fold increase in fructose 1,6 bisphosphate and the accumulation of millimolar quantities of fructose 1 phosphate in the cells. D-Glyceraldehyde caused an increase in the glycerol 3 phosphate content and a decrease in the dihydroxyacetone phosphate content, whereas dihydroxyacetone increased the content of both metabolites. The increase in the [glycerol 3-phosphate]/[dihydroxyacetone phosphate] ratio caused by D glyceraldehyde was not accompanied by a change in the cytoplasmic [NAD+]/[NADH] ratio, as indicated by the unchanged [lactate]/[pyruvate] ratio. The accumulation of fructose 1-phosphate from D-glyceraldehyde and dihydroxyacetone phosphate in the hepatocyte can account for the depletion of the intracellular content of the latter. Presumably ATP is depleted as the result of the accumulation of millimolar amounts of a phosphorylated intermediate, as is the case with fructose and glycerol. It is suggested that the accumulation of fructose 1-phosphate during hepatic fructose metabolism is the result of a temporary increase in the D glyceraldehyde concentration because of the high rate of fructose phosphorylation compared with triokinase activity. The equilibrium constant of aldolase favours the formation and thus the accumulation of fructose 1-phosphate. PMID- 3827867 TI - The structures and proteolytic specificities of autolysed human thrombin. AB - Three Arg/Lys-Xaa bonds in the B-chain of human alpha-thrombin were found to be the major autolytic sites. Under the conditions of 1 mg of alpha-thrombin/ml in 50 mM-ammonium bicarbonate solution at 25 degrees C, the 50% cleavage times of Lys-Gly (residues 154-155), Arg-Tyr (residues 70-71) and Arg-Asn (residues 73-74) were 32 h, 72 h and 96 h respectively. Fragments generated from these three major autolytic sites were purified and analysed. In addition, minor and random autolytic cleavages occurred simultaneously that eventually led to the complete breakdown of the enzyme. These results reveal several novel aspects about the process of autolysis and the structure of autolysed human thrombin. It identifies a major autolytic site at Arg-Tyr (residues 70-71) that has not been previously reported. It demonstrates that beta-thrombin is not an obligatory intermediate during the process of conversion of alpha-thrombin into gamma-thrombin. There exists a new form of autolysed thrombin, designated as beta'-thrombin (with cleavage at Lys-Gly only), which also serves as the intermediate in the conversion of alpha-thrombin into gamma-thrombin. It shows that autolysis of human alpha-thrombin does not proceed in an absolutely clear-cut manner. Numerous minor cleavages, which amount to approx. 20% of the three major autolytic sites, occur simultaneously. It is the first time that several autolytic sites of human alpha-thrombin have been quantitatively analysed, and that it has been shown that formation of beta-, beta'- and gamma-thrombins can be quantitatively followed by the h.p.l.c. method. Furthermore, the data demonstrate that alpha-thrombin and the autolysed thrombin (mixture of beta-, beta'- and gamma-thrombins) have comparable proteolytic activity and specificity towards various sizes of non fibrinogen polypeptide substrates with relative molecular masses ranging from 3000 to 25,000. PMID- 3827868 TI - The exponential model for a regulatory enzyme. An interpretation of the linear free-energy relationship. AB - A physical mechanism is suggested to explain the linear free-energy relationship employed in the exponential model for a regulatory enzyme [Ainsworth (1977) J. Theor. Biol. 68, 391-413]. The interpretation depends on the assumption that the structure of the enzyme changes in proportion to its saturation by substrate but at a rate that is low compared with the rates of the association-dissociation reactions of the enzyme-substrate system. PMID- 3827869 TI - Computer simulations of the kinetics of irreversible enzyme inhibition by an unstable inhibitor. AB - Computer simulations of the irreversible inhibition of an enzyme by an unstable inhibitor are presented. Data obtained at the end point of reaction are shown to conform poorly in many situations with relationships derived from integrated rate equations by setting t = infinity, and the implications concerning the experimental use of this method to determine kinetic constants describing inactivation are considered. The alternative approach of conducting experiments under conditions of inhibitor excess over enzyme is further discussed, and a graphical procedure is suggested for the description of time courses of reaction of enzyme with unstable inhibitor when an enzyme-inhibitor adsorptive complex is involved. PMID- 3827870 TI - Inhibition of the low-Km mitochondrial aldehyde dehydrogenase by diethyl maleate and phorone in vivo and in vitro. Implications for formaldehyde metabolism. AB - Formaldehyde can be oxidized primarily by two different enzymes, the low-Km mitochondrial aldehyde dehydrogenase and the cytosolic GSH-dependent formaldehyde dehydrogenase. Experiments were carried out to evaluate the effects of diethyl maleate or phorone, agents that deplete GSH from the liver, on the oxidation of formaldehyde. The addition of diethyl maleate or phorone to intact mitochondria or to disrupted mitochondrial fractions produced inhibition of formaldehyde oxidation. The kinetics of inhibition of the low-Km mitochondrial aldehyde dehydrogenase were mixed. Mitochondria isolated from rats treated in vivo with diethyl maleate or phorone had a decreased capacity to oxidize either formaldehyde or acetaldehyde. The activity of the low-Km, but not the high-Km, mitochondrial aldehyde dehydrogenase was also inhibited. The production of CO2 plus formate from 0.2 mM-[14C]formaldehyde by isolated hepatocytes was only slightly inhibited (15-30%) by incubation with diethyl maleate or addition of cyanamide, suggesting oxidation primarily via formaldehyde dehydrogenase. However, the production of CO2 plus formate was increased 2.5-fold when the concentration of [14C]formaldehyde was raised to 1 mM. This increase in product formation at higher formaldehyde concentrations was much more sensitive to inhibition by diethyl maleate or cyanamide, suggesting an important contribution by mitochondrial aldehyde dehydrogenase. Thus diethyl maleate and phorone, besides depleting GSH, can also serve as effective inhibitors in vivo or in vitro of the low-Km mitochondrial aldehyde dehydrogenase. Inhibition of formaldehyde oxidation by these agents could be due to impairment of both enzyme systems known to be capable of oxidizing formaldehyde. It would appear that a critical amount of GSH, e.g. 90%, must be depleted before the activity of formaldehyde dehydrogenase becomes impaired. PMID- 3827871 TI - Interorgan metabolism of amino acids, glucose, lactate, glycerol and uric acid in the domestic fowl (Gallus domesticus). AB - Arterial--venous differences for metabolites across liver, kidney and hindquarters were measured in fed or starved, artificially ventilated chickens. The results indicate that the liver takes up amino acids under both conditions. Urate and glucose are released by the liver in both the fed and the starved state. Lactate and amino acids are extracted from blood by the kidneys, and this increases in the starved chicken. Urate is removed from the circulation by the kidney in the fed and starved state and excreted. In the fed bird there is no significant arteriovenous difference of glucose across the kidney, but in the starved state the kidney releases glucose into the circulation. The hindquarters take up glucose in the fed but not in the starved state. The branched-chain amino acids valine and leucine were taken up by the hindquarters in the fed, but not the starved, chicken. Glycerol is released by the hindquarter of fed and starved chickens. In the starved state, alanine and glutamine represent 57% of the amino acids released by the hindquarter. Lactate is released by the hindquarter of starved chickens and represents the major gluconeogenic carbon source released by the hindquarter and taken up by kidney and liver. Although the liver is the major gluconeogenic organ in the starved chicken, the kidney accounts for approx. 30% of the glucose produced. PMID- 3827872 TI - Protein degradation in cat liver cells. AB - Body proteins in cats were prelabelled with [14C]valine, and protein degradation was studied in isolated hepatocytes. Amino acids appeared to have a direct inhibitory effect on protein degradation, but the effects were generally smaller than those previously shown in the rat. The amino acid control of protein degradation in the cat differs from that in the rat, as shown by the lack of effects of glutamine, asparagine, arginine or methionine in cat hepatocytes. This may be related to the unique features of protein metabolism of this species. NH4Cl, leupeptin and amino acids, which suppress lysosomal protein degradation by different mechanisms, caused less than 30% inhibition of protein degradation when used at the optimum concentrations reported for the rat. The ability of the lysosomal system to respond to nutritional deprivation is apparently lower in the cat than in the rat. PMID- 3827874 TI - Histone acetylation in chicken erythrocytes. Estimation of the percentage of sites actively modified. AB - Within the N-terminal regions of the DNA-bound histone, 26 lysine residues per nucleosome may be acetylated and deacetylated. In the present paper the percentage of these residues actively acetylated and deacetylated in chicken erythrocytes was measured. This percentage is estimated as 3.7% in chicken immature, and 2.1% in chicken mature, erythrocytes. In metabolically active, dividing, cells one would predict that, after a few generations, each site would at some point in time be modified. We conclude that, in the relatively inactive immature chicken erythrocyte, no more than 1-2% of the genome is composed of dynamically acetylated and deacetylated histone, this percentage decreasing with cell maturity. The active histone acetylation and deacetylation may be confined to transcriptionally active or potentially active erythrocyte domains. PMID- 3827873 TI - Human monoclonal antibody recognizing liver-type aldolase B. AB - A human hybridoma clone (4E3) has been established by fusing lymphocytes from a lymph node taken from a breast cancer patient and human lymphoblastoid cells, LICR-LON-HMy2, by the poly(ethylene glycol) method. 4E3 has been stabilized and continued to secrete IgMk antibody into culture medium (greater than 10 micrograms/ml) for over 1 year. The following characteristics of the antigen strongly suggested that 4E3 recognizes liver-type aldolase B (EC 4.1.2.13): the Mr of the native molecule is 160,000 and that of the subunit is 40,000, and thus it has a tetrameric structure of identical subunits; the antigen is abundant in the liver and kidney of human, mouse and rabbit, and is localized by immunohistochemical methods in the cytoplasm of hepatocytes and in the proximal tubules of the kidney; the antigen is precipitable by 50-80% saturation with (NH4)2SO4; the antigen shows charge-dependent heterogeneity on DEAE-cellulose chromatography. To confirm this notion, aldolase B was purified to homogeneity from the liver of human, mouse and rabbit by phosphocellulose chromatography. During the chromatographic purification, the antigen activity as assayed by enzyme-linked immunosorbent assay (e.l.i.s.a.) was superimposed on the enzymic activity of aldolase. Furthermore, monoclonal antibody 4E3 strongly reacted with purified aldolase B in SDS/polyacrylamide-gel electrophoresis followed by Western blotting and also in e.l.i.s.a. using microplates coated with purified enzyme. The reaction between aldolase B and 4E3 activated the human complement system as assessed by the attachment of C3 to the immune complex of aldolase B and 4E3. PMID- 3827875 TI - Chromatographic resolution of chicken phosvitin. Multiple macromolecular species in a classic vitellogenin-derived phosphoprotein. AB - Chicken phosvitin was prepared from egg yolk by a variety of published methods, including a modification of our own original procedure. Yolk granules and all phosvitin preparations have been previously found to contain major phosphoproteins at Mr 40,000 and 33,000 and minor satellite components when electrophoresed on polyacrylamide gradient gels and stained with Stains-all. However, only our current preparation contained three additional phosphoproteins (Mr 18,000, 15,000 and 13,000) that are also present in yolk granules. Our current phosvitin preparation also appeared to have additional components when compared with other preparations by size-exclusion and anion-exchange chromatography. Particularly complex but entirely reproducible patterns were obtained by hydrophobic-interaction chromatography. However, a cross-referencing of fractions eluted by size-exclusion chromatography to the other procedures employed, including gel electrophoresis, reinforced the notion that unfractionated chicken phosvitin contains at least five major components, designated B, C, E1, E2 and F for the Mr 40,000, 33,000, 15,000, 18,000, and 13,000 phosphoproteins, respectively. Stoichiometric considerations lead us to suggest that vitellogenin I gives rise to phosvitins C and F, vitellogenin II gives rise to phosvitin B, and vitellogenin III gives rise to either phosvitin E1 or E2, but not both. Thus, a fourth, as yet undetected, vitellogenin may exist for the chicken. PMID- 3827876 TI - [3H]dipyridamole binding to nucleoside transporters from guinea-pig and rat lung. AB - Membranes from guinea-pig lung exhibited high-affinity binding of [3H]dipyridamole, a potent inhibitor of nucleoside transport. Binding (apparent KD 2 nM) was inhibited by the nucleoside-transport inhibitors nitrobenzylthioinosine (NBMPR), dilazep and lidoflazine and by the transported nucleosides uridine and adenosine. In contrast, there was no detectable high affinity binding of [3H]dipyridamole to lung membranes from the rat, a species whose nucleoside transporters exhibit a low sensitivity to dipyridamole inhibition. Bmax. values for high-affinity binding of [3H]dipyridamole and [3H]NBMPR to guinea-pig membranes were similar, suggesting that these structurally unrelated ligands bind to the NBMPR-sensitive nucleoside transporter with the same stoichiometry. PMID- 3827877 TI - Tissue distribution of rat glutathione transferase subunit 7, a hepatoma marker. AB - Polyadenylated RNA isolated from NN-dimethyl-4-aminoazobenzene-induced rat hepatoma was used to prepare a cDNA library in lambda gt10. Full-length clones complementary to mRNA coding for glutathione transferase subunit 7 were isolated and one of these clones (pGSTr7) was fully characterized. In Northern blot analysis, mRNA hybridizing to 32P-labelled pGSTr7 was found in poly(A)-containing RNA isolated from seven normal rat tissues but not from testis and liver. A similar hybridizing mRNA species was also detected in human placental mRNA. The same probe, used in a Southern blot analysis of genomic DNA, suggests the presence of a multigene family in the rat. PMID- 3827878 TI - The occurrence of polyenoic fatty acids with greater than 22 carbon atoms in mammalian spermatozoa. AB - Fatty acids with carbon chain lengths greater than 22 (VLCFA) have been detected in boar, ram, bull and human spermatozoa. Saturated and mono-unsaturated fatty acids were present in all spermatozoa but, except for human spermatozoa, polyenoic fatty acids were quantitatively the most important components. Marked differences in polyenoic fatty acid composition were observed. Whereas human spermatozoa contain predominantly di-, tri- and tetraenoic fatty acids with up to 32 carbon atoms, boar, ram and bull spermatozoa also contain pentaenoic and/or hexaenoic acids with up to 34 carbon atoms. Human and boar spermatozoa differ markedly from those of the ram and bull in that only n-6 series acids are present. PMID- 3827879 TI - Thiyl and phenoxyl free radicals and NADH. Direct observation of one-electron oxidation. AB - Absolute rate constants for the reaction of NADH with thiyl free radicals derived from various sulphur-containing compounds of biological significance were measured by using the technique of pulse radiolysis. These and related reactions with phenoxyl free radicals are believed to occur through one-electron-transfer processes. Further evidence comes from studies with deuterated NADH. The results support the possibility that, in biochemical systems, thiols may act as catalysts linking hydrogen-atom and electron-transfer reactions. PMID- 3827880 TI - Valine metabolism. Gluconeogenesis from 3-hydroxyisobutyrate. AB - During valine catabolism in muscle both 2-oxoisovalerate and 3-hydroxyisobutyrate can be released into the circulation. 3-Hydroxyisobutyrate is a good gluconeogenic substrate in isolated cortical tubules and hepatocytes. The maximal rate of gluconeogenesis from 3-hydroxyisobutyrate was greater than from 2 oxoisovalerate. We propose that 3-hydroxyisobutyrate is an inter-organ metabolite by which the gluconeogenic potential of valine, whose catabolism has been initiated in muscle, may be conserved. PMID- 3827881 TI - Micro-injection of inositol 1,3,4,5-tetrakisphosphate activates sea urchin eggs by a mechanism dependent on external Ca2+. AB - Micro-injection of submicromolar concentrations of inositol 1,3,4,5 tetrakisphosphate caused a raising of the fertilization envelope in eggs of the sea urchin Lytechinus variegatus. This effect was dependent both on the presence of extracellular Ca2+ and on co-injection with a Ca2+-mobilizing compound, inositol 2,4,5-trisphosphate. Inositol 1,3,4,5-tetrakisphosphate was the most potent compound tested in this assay; removal of the 3- or 5-phosphates or randomization of the phosphates in the inositol ring decreased its potency. These results show that inositol 1,3,4,5-tetrakisphosphate is an intracellular second messenger, and suggest that its function is to control cellular Ca2+ homoeostasis at the plasma membrane. PMID- 3827882 TI - A triple-binding-domain model explains the specificity of the interaction of a sphingolipid activator protein (SAP-1) with sulphatide, GM1-ganglioside and globotriaosylceramide. AB - The conformations of the neutral glycosphingolipid, globotriaosylceramide, and of the methyl ester of GM1-ganglioside have been predicted by energy-minimization techniques and compared with those previously obtained for GM1- and GM2 ganglioside. A triple-binding-domain model is put forward to explain known specificities of binding between these glycosphingolipids and activator proteins. This model suggests that hydrophobic interactions, electrostatic interactions and hydrogen-bonding between sugar residues are important. The model is discussed in relation to previous studies on the effect of chemical modification of glycosphingolipids on their ligand properties. PMID- 3827883 TI - Accumulation of globotriaosylceramide in a case of leiomyosarcoma. AB - Analysis of the glycosphingolipid composition in one case of uterine leiomyosarcoma metastasized to the liver showed an accumulation of globotriaosylceramide as compared with normal liver and uterus from which the tumour originated. The structure and the amount of glycosphingolipids were established by using specific glycosidases, permethylation analysis and h.p.l.c. The reason for the accumulation of globotriaosylceramide in leiomyosarcoma remains to be answered. PMID- 3827884 TI - Nomenclature of esterases. PMID- 3827885 TI - Endocytosis and epithelial biogenesis in the mouse early embryo. PMID- 3827886 TI - Non-radioactive nucleic acid probes for the diagnosis of virus infections. PMID- 3827887 TI - Molecular analysis of familial human growth hormone disorders. PMID- 3827888 TI - Structural and functional domains on actin. PMID- 3827889 TI - Amidohydrolysis of N-methylhydantoin coupled with ATP hydrolysis. AB - A new enzyme, N-methylhydantoin amidohydrolase, was highly purified from Pseudomonas putida 77: it catalyzes the hydrolysis of N-methylhydantoin to N carbamoylsarcosine with the concomitant stoichiometric cleavage of ATP to ADP and orthophosphate. The enzyme absolutely requires ATP, MG2+ and K+ for the N methylhydantoin hydrolysis. The rapid and complete degradation of N methylhydantoin during the cultivation of P. putida 77, which rapidly degrades creatinine via only N-methylhydantoin and which shows high activities of the enzymes involved in creatinine degradation (Yamada et al. (1985) FEMS Microbiol. Lett. 30, 337-340), seems to be due to the continuous ATP-generation during cultivation. PMID- 3827890 TI - Isolated bovine myocardial sarcolemma and sarcoplasmic reticulum vesicles contain tightly bound calcium-dependent protease inhibitor. AB - Bovine myocardial sarcolemma and sarcoplasmic reticulum vesicle preparations contained calcium-dependent protease inhibitor protein. No inhibitor was detected in mitochondrial membranes. The membrane-bound inhibitor co-purified with the marker enzymes for sarcolemma and sarcoplasmic reticulum, Na+,K+-ATPase and Ca2+,K+-ATPase respectively, on isopycnic ultracentrifugation through linear sucrose density gradients. Sarcolemma and sarcoplasmic reticulum vesicles contained about 1 mg of inhibitor per g of membrane protein. However, about one half of the inhibitor in sarcoplasmic reticulum vesicles was not tightly associated with the membrane. The membrane-bound inhibitor may function to modulate calcium-dependent proteolytic cleavage of sarcolemmal or sarcoplasmic reticulum-associated proteins. PMID- 3827891 TI - ADP-ribosylation by type C1 and D botulinum neurotoxins: stimulation by guanine nucleotides and inhibition by guanidino-containing compounds. AB - We recently reported that type D botulinum neurotoxin ADP-ribosylates a specific protein of Mr 21,000 in membrane fractions of various tissues (Ohashi, Y. and Narumiya, S. (1987) J. Biol. Chem. in press). We examined similar enzyme activities in other types (types A, B, C1 and E) of botulinum neurotoxins. Of these, only type C1 toxin showed the activity similar to type D toxin and ADP ribosylated the same Mr 21,000 protein in membranes of mouse brain. No enzyme activities were detected in type A, B and E toxins under the present experimental conditions. GTP stimulated ADP-ribosylation by the two toxins in a concentration dependent manner from 10 nM to 100 microM. The maximum stimulation was about 6 fold. GDP was 10 times less potent than GTP and achieved similar maximum at 1 mM, while GMP, ADP and ATP had little effect. Several guanidino-containing compounds dose-dependently inhibited the activities of both toxins. The IC50 values were 8.5, 14.5 and 45 mM for agmatine, L-arginine methyl ester and guanidine, respectively. PMID- 3827892 TI - The mechanism of the hypolipidemic effect of garlic oil extract in rats fed on high sucrose and alcohol diets. AB - The effect of feeding garlic oil to white albino rats maintained on high sucrose and alcohol diets was studied. It is proposed that the mechanism of the hypolipidemic effect of the oil involves the active principle, diallyl disulphide, inactivating enzymes and substrates containing thiol groups in an exchange reaction; increased hydrolysis of triacylglycerols as increased lipase activity is induced by the oil; and the reduction in the biosynthesis of triacylglycerols as NADPH is made unavailable for the process by the metabolism of the oil. PMID- 3827893 TI - Fourier transform infrared spectra of aqueous protein mixtures using a novel attenuated total internal reflectance cell with infrared fibers. AB - A specially designed cell containing a silver halide (AgBr:AgCl) infrared fiber allows convenient and reproducible loading of viscous protein solutions and suspensions. Attenuated total internal reflectance measurements using an FTIR spectrometer were made for bovine serum albumin-water past. Dynamic changes in the protein films are readily followed, a technique which should be generally useful. A band assigned to a secondary structural feature, the alpha-helix, is similar in intensity to that reported (T.M. Fong, M.G. McNamee, submitted for publication). PMID- 3827894 TI - Protein kinase C and meiotic maturation of surf clam oocytes. AB - We report here that phorbol ester, a potent activator of protein kinase C, induces germinal vesicle breakdown in surf clam oocytes. However, phorbol ester induced activation is slow and is not accompanied by an increased Ca2+ influx. Simultaneous additions of phorbol ester and various amounts of K+ ions, which induce Ca2+ influx of different amplitudes, result in successful activation within the normal time schedule at K+ concentrations inefficient alone in activating the oocytes. In vivo, increased protein phosphorylation triggered by phorbol ester amounts to about one third that seen after fertilization. These results suggest that increased Ca2+ influx and protein kinase C activation act in synergy to cause resumption of meiotic maturation in these oocytes. PMID- 3827895 TI - The induction of a specific form of cytochrome P-450 (P-450j) by fasting. AB - In previous work we have demonstrated that liver microsomal N nitrosodimethylamine demethylase (NDMAd) activity is increased in rats by fasting, and we have postulated that this is due to the induction of a specific form of cytochrome P-450. This communication provides evidence for such a hypothesis. Fasting for 24 and 48 h caused 59 and 116% increases, respectively, in NDMAd activity in male rats, and fasting for 48 h caused a 63% increase in female rats. These increases were accompanied by corresponding increases of cytochrome P-450j (P-450ac) determined by immunoblotting. Fasting for 24 and 48 h also increased the mRNA for P-450j by 153 to 250%, as determined by hybridization with a cDNA probe of this cytochrome. The results suggest that fasting affects the gene expression of P-450j. PMID- 3827896 TI - Antileukemic agent alkyllysophospholipid regulates phosphorylation of distinct proteins in HL60 and K562 cells and differentiation of HL60 cells promoted by phorbol ester. AB - The tumor-promoting 12-0-tetradecanoylphorbol-13-acetate (TPA) stimulated phosphorylation of several proteins in block I (including protein Ia) and protein 3 in HL60 cells. The antileukemic agent alkyllysophospholipid (ALP) inhibited the TPA-stimulated phosphorylation of these proteins and the TPA-induced differentiation of the cells. In comparison, TPA only stimulated phosphorylation of protein 3 in K562 cells which, in contrast, were not induced to differentiate by TPA and lacked protein Ia and had a very high basal phosphorylation of protein B. ALP inhibited phosphorylation of protein 3 as well as protein B in K562 cells. The data suggest that the presence of distinct phosphoproteins and regulation of their phosphorylation may be related to the selective susceptibility of the two leukemia cell lines to the maturating effect of TPA and cytotoxicity of ALP. PMID- 3827897 TI - Immunoblotting detection of lectins in gluten and white rice flour. AB - The gluten lectin was isolated by affinity chromatography, separated by sodium dodecyl sulphate-gel electrophoresis together with purified wheat germ agglutinin (WGA) and electrotransferred to nitrocellulose filters. The binding pattern of anti-WGA to the blotted filters confirmed the presence of WGA in gluten. A lectin from rice bran and white rice flour, respectively, was isolated by affinity chromatography. Both lectins reacted with anti-WA in immunoblotting. As patients with coeliac disease are known to tolerate rice flour, the finding of a WGA-like lectin questioned the suggestion that WGA in gluten is involved in the pathogenesis of coeliac disease. A second lectin was also isolated from rice flour which reacted only with antibodies against soybean lectin on immunoblots. This may indicate a contamination of soybean proteins in rice flour. PMID- 3827898 TI - Estrogenic effect of phenol red in MCF-7 cells is achieved through activation of estrogen receptor by interacting with a site distinct from the steroid binding site. AB - MCF-7 cells serially subcultured in media containing phenol red show poor stimulation of progesterone receptor (PR) synthesis in response to estradiol compared to cells grown in phenol red-free media. Phenol red, when added to cytosol, did not compete with [3H]estradiol for estrogen binding sites in concentrations ranging from 2 microM-1 mM. However 25 microM of the dye was sufficient to increase nuclear translocation of estrogen receptor (ER) in the intact cell. Phenol red activates cytoplasmic ER as indicated by DNA-cellulose binding studies. When cells grown in phenol red-free medium were exposed to phenol red for 48 h, PR levels increased in a dose dependent manner. From these data, it may be concluded that phenol red causes estrogenic effect in MCF-7 cells through activation of cytoplasmic receptor by interacting at a site distinct from the steroid binding site. PMID- 3827899 TI - Photoreductive path of carbon fixation in green plant photosynthesis. Reaction pathway of six-carbon ribulose 1,5-bisphosphate carboxylation adduct intermediate. AB - In this paper we examine the six-carbon intermediate pathway of ribulose 1,5 bisphosphate (RuBP) carboxylation reaction in photosynthesis. Based on the observed reactions of purified RuBP carboxylase, mechanisms are described for carbon dioxide assimilation leading to the hydrolytic splitting of the six-carbon intermediate to two enzyme-bound glycerate-3-P (3-PGA) molecules. It is concluded that, under photosynthetic conditions, the reduction of enzyme-bound NADP+ by the chlorophyll is responsible for the rapid carboxylase turnover rate given by the lifetime, tau L = 0.4 s, which is nearly two orders of magnitude shorter than the corresponding value, tau D = 11 +/- 3 s, for the dark decay of enzyme-bound RuBP. The nocturnal inhibition and photoactivation of RuBP carboxylation are described in terms of the reversible light-dark cycles of the NADP+/NADPH redox couple and endogenous changes that accompany the 2-carboxy-D-arabinitol-1-phosphate binding to the enzyme active site. PMID- 3827900 TI - Tumor promoter chloroform is a potent protein kinase C activator. AB - The major interaction site for tumor-promoting phorbol esters is the calcium activated, phospholipid-dependent protein kinase (protein kinase C), a key element in signal transduction. Binding of phorbol esters results in enzyme activation which mediates, at least in part, the action of these agents. We have investigated the effects of tumor promoter chloroform on protein kinase C activity. Like thrombin and 12-O-tetradecanoylphorbol-13-acetate (TPA), chloroform was able to activate protein kinase C in intact rabbit platelets. In addition, chloroform stimulated enzyme activity as well as TPA binding capacity in cell-free system. Scatchard analysis of the data has shown that chloroform increased the number of phorbol ester binding sites. Structurally related compounds, carbon tetrachloride and methylene chloride, activated the enzyme similarly. PMID- 3827902 TI - A marked increase of fucosylation of glycoproteins in IMR-90 human diploid fibroblasts during senescence in vitro. AB - Possible changes of glycoproteins in IMR-90 human embryonic lung fibroblasts during senescence in vitro were studied by the metabolic labeling technique using radioactive precursors for carbohydrate moieties of glycoproteins. IMR-90 fibroblasts at three different population doubling level (PDL) were incubated with [3H]fucose and [3H]glucosamine for various periods of time. The radioactively labeled glycoproteins were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and fluorography. The results indicated a marked increase, by more than eight-fold on per mg protein basis, of labeling by [3H]fucose in old IMR-90 fibroblasts (PDL = 45) as compared to young (PDL = 22) and middle-age (PDL = 30) IMR-90 fibroblasts. In contrast, no significant difference in [3H]glucosamine labeling was observed in young and old IMR-90 cells. PMID- 3827901 TI - Major intrinsic polypeptide (MIP26K) of the lens membrane: covalent change in an internal sequence during human senile cataractogenesis. AB - Polyclonal antisera to three synthetic peptides of bovine MIP26K have been used in combination with Western blot analysis to probe for changes of the MIP26K molecule during human senile cataractogenesis. Anti-MIP26K229-237 binds well to the 26K component from cataractous lens membranes, but binds poorly to the same component from normal lens. In contrast, antisera to two other sequences of MIP26K (anti-MIP26K252-259 and anti-MIP26K256-263) bind approximately equally well to the 26K component from either cataractous or normal lens. Together, these results demonstrate that during cataract development there is a selective covalent change in a region of the MIP26K molecule that may have profound effects upon the ability of this molecule to facilitate intercellular communication between lens fiber cells. PMID- 3827903 TI - cis-Diamminedichloroplatinum(II) selectively cross-links high mobility group proteins 1 and 2 to DNA in micrococcal nuclease accessible regions of chromatin. AB - The reaction of cis-diamminedichloroplatinum(II) with chicken erythrocyte nuclei produces covalent cross-linking of HMG proteins 1, 2 and E to DNA, in addition to cross-links amongst LMG proteins. This is supported by and consistent with the observations that all cross-links are chemically reversed by NaCN treatment, while only the cross-links involving the HMG proteins 1,2 and E are eliminated after a limited digestion with micrococcal nuclease. Having identified the subset of proteins selectively cross-linked to DNA by the bifunctional cis-(NH3)2PtCl2, a tentative model is proposed for the interactions between DNA and HMG proteins 1 and 2 in bulk chromatin. In addition, possible modes of action for this anti neoplastic drug are suggested in light of these findings. PMID- 3827904 TI - Age related changes in fluidity of rat renal brushborder membrane vesicles. AB - Fluorescence anisotrophy of 1,6 diphenyl-1,3,5-hexatriene was determined in renal brushborder membranes prepared from rats 7, 14, 21 and 28 days of age, and adults, from 5 degrees C to 45 degrees C. There is a parallel relationship between temperature and mean fluorescence anisotrophy in the different age groups with a progressive decrease in fluidity with age. There is no phase transition apparent in membranes from any age group as evidenced by the lack of a fluorescence polarization "break point". There is also a linear relationship between limiting hindered anisotrophy and previously determined values for the height of the Na+-proline overshoot. This suggests that the physical characteristics of the renal brushborder membrane responsible for differences in fluidity are related to age-dependent transport alterations. PMID- 3827905 TI - Regulation of free cytosolic Ca2+ in the isolated guinea pig gastric chief cells. AB - Stimulation with COOH-terminal octapeptide of cholecystokinin (CCK8) or carbachol resulted in a rapid increase in Quin-2 fluorescence of isolated guinea pig gastric chief cells, whereas histamine, vasoactive intestinal peptide, secretin or forskolin had no effect. The minimum effective dose of CCK8 or carbachol to elicit the rise in Quin-2 fluorescence was almost similar to that for pepsinogen secretion. Removal of Ca2+ from extracellular medium or Ca2+ channel blockers did not affect CCK8- or carbachol-induced increase in Quin-2 fluorescence. Moreover, following addition of CCK8, carbachol was unable to stimulate a second increase in Quin-2 fluorescence. These results suggest that CCK8 and carbachol share common Ca2+ pools and an increase in free cytosolic Ca2+ concentration may mediate CCK8- or carbachol-induced pepsinogen secretion from gastric chief cells. PMID- 3827906 TI - Novel and potent biological antioxidants on membrane phospholipid peroxidation: 2 hydroxy estrone and 2-hydroxy estradiol. AB - Catechol estrogens, 2-hydroxy estrone, 2-hydroxy estradiol and 2-hydroxy estriol, were tested as possible antioxidants of phospholipid peroxidation induced by Fe3+ ADP-adriamycin, using phospholipid liposomes as lipid source and alpha-tocopherol or other steroids as reference compounds. The parameters of antioxidant activities were: elongation of induction period, inhibition of O2 consumption required for lipid peroxidation and inhibition of peroxidative cleavage of unsaturated phospholipid. Of the tested compounds, 2-hydroxy estradiol or 2 hydroxy estrone had more potent activity than that of tocopherol. PMID- 3827907 TI - Formation of phosphatidylethanol in rat brain by phospholipase D. AB - The mechanism of phosphatidyl [14C]ethanol formation was studied in rat brain microsomal fraction. Phospholipase D and base-exchange enzymes were assayed with [14C]ethanol as substrate. Phospholipase D was found to catalyse the formation of phosphatidylethanol. The reaction was dependent on sodium-oleate as activating factor. Phosphatidylethanol formation by phospholipase D has previously only been reported to occur in plant tissues. Stimulation of base-exchange enzymes with calcium in the presence of [14 C]ethanol did not induce any formation of phosphatidylethanol. These findings indicate that phosphatidylethanol formation in ethanol intoxicated rats is catalysed by phospholipase D. PMID- 3827908 TI - Pseudomonas diminuta LPS with a new endotoxic lipid A structure. AB - Lipid A that contains mainly 2,3-diamino-2,3-dideoxy-D-glucose, phosphate and fatty acids in the molar ratio 2:1:5-6 was found in Pseudomonas diminuta lipopolysaccharide. The lipid A was considered to have a diamino-sugar disaccharide structure that carries a nonglycosidic phosphomonoester group and amide-bound acyloxyacyl and 3-hydroxy fatty acyl groups. The lipopolysaccharide exhibited endotoxic activities including lethal toxicity, pyrogenicity, local Shwartzman activity, body weight-decreasing toxicity and Limulus activity. The free lipid A was also endotoxic. PMID- 3827909 TI - Nonoxidative ethanol metabolism in human leukocytes: detection of fatty acid ethyl ester synthase activity. AB - Oxidative pathways of alcohol metabolism such as alcohol dehydrogenase usually are not present in human blood and therefore clinical studies correlating ethanol metabolism with alcohol abuse syndromes have not been performed. To assess the activity of nonoxidative ethanol metabolism in blood, we assayed for the activity of fatty acid ethyl ester synthase, a pathway recently described as abundant in the human organs most commonly damaged by alcohol. Indeed, peripheral human leukocytes contain detectable fatty acid ethyl ester synthase activity: 1.2 X 10(6) leukocytes from 10 ml blood catalyze the synthesis of ethyl oleate at 1.4 nmol/4 hr. The reaction is linear with respect to cell number and expended time; Km oleate = 600 microM, Km ethanol = 600 mM. DEAE cellulose chromatography partially purifies synthase activity into a minor and major form (activity ratio = 10/1). Thus, gene products exist in human blood that recognize ethanol and whose biological activity is conveniently assayable for clinical investigations of alcohol metabolism and abuse. PMID- 3827910 TI - Long-chained 1-mercapto-n-alkanes as potent inhibitors toward liver alcohol dehydrogenase. AB - Long-chained 1-mercapto-n-alkanes showed potent inhibitory effects on horse liver alcohol dehydrogenase (HLADH). The inhibitory effect of the thiols was enhanced by increasing the number of the alkyl carbon atoms up to 10-12 and steeply lowered by further increase in the carbon number. The HLADH activity was almost completely inhibited in competitive manner by an equivalent concentration of 1 mercapto-n-decane or -n-dodecane to that of the subunit of the dimeric zinc enzyme; inhibition constant Ki was 0.55 nM for the former. The present study strongly suggests that the thiols interact simultaneously with at least two sites of HLADH; the primary one could be the zinc atom in the active site of the enzyme, interacting with the sulfhydryl groups, and the other a hydrophobic binding site for the their alkyl carbons. PMID- 3827911 TI - 25-hydroxylation of vitamin D3 in rat liver: roles of mitochondrial and microsomal cytochrome P-450. AB - A mitochondrial cytochrome P-450 fraction, which catalyzed 25-hydroxylation of vitamin D3 much more efficiently than intact mitochondria was isolated from livers of male and female rats. For comparison, a microsomal cytochrome P-450 fraction was isolated by the same procedures. The mitochondrial cytochrome P-450 from female rats catalyzed 25-hydroxylation as efficiently as the same material from male rats. The microsomal 25-hydroxylation was male specific. The 25 hydroxylase activity in intact mitochondria and the 25-hydroxyvitamin D3 concentration in serum were similar in male and female rats. There was no correlation between the 25-hydroxylase activity in microsomal cytochrome P-450 and the 25-hydroxyvitamin D3 concentration in serum. PMID- 3827912 TI - A 500 MHz 1H NMR spectroscopic study of Met5-enkephalinamide in aqueous solution: ethanol induced conformational changes. AB - An analysis of spin coupling constants, less than 3J greater than C alpha H-NH, from a high resolution 500 MHz 1H NMR study of [Met5]-enkephalinamide in aqueous solution, suggested that beta-sheet structure is the likely conformer. The effect of ethanol on the conformation of [Met5]-enkephalinamide in aqueous solution was investigated. From the upfield drift of observed chemical shifts and changes in coupling constants, especially of the amide NH resonances, it is concluded that ethanol disrupts the conformation possibly by influencing the hydrogen bonding. The above observation is consistent with a recent study of the ethanol induced conformational changes occurring in [Met5]enkephalinamide [Rapaka, R.S. et al. (1986) Life Sciences 39, 837-842]. PMID- 3827913 TI - Monoclonal antibodies to angiotensin II. AB - Three hybridomas producing monoclonal antibodies to angiotensin II were generated using somatic cell fusion techniques. Dissociation constants, determined by Scatchard analysis of radioimmunoassay data, were 9.3 X 10(-10) M, 1.5 X 10(-9) M and 1.8 X 10(-8) M for antibodies KAA8, ICH2 and ICA10, respectively. The antibodies exhibited various degrees of cross-reactivity towards peptide metabolites of angiotensin II, but minimal cross-reactivity towards antagonists created by substituting the hormone at both the amino and carboxy terminus. In contrast to a rabbit polyclonal angiotensin II antibody preparation, the three monoclonal antibodies competed effectively with angiotensin receptors on rat adrenal cortical microsomes for hormone binding. These antibodies may have broad utility for a number of applications in angiotensin II research. PMID- 3827914 TI - Serotonin induced actin polymerization and association with cytoskeletal elements in cultured bovine aortic endothelium. AB - Serotonin, (5-hydroxytryptamine, 5-HT) binds to cultured endothelial cell stress fibers as identified by fluorescence microscopy and in vitro induces actin polymerization as measured by DNase 1 inhibition and differential centrifugation; the structural change in actin in the presence of 5-HT resembles actin paracrystals as visualized by negative staining under electron microscopy. These observations indicate that 5-HT, which is taken up by endothelium by a non mediated diffusion, may interact directly with actin to affect cytoskeletal changes. PMID- 3827915 TI - Identification of the phosphate-translocator from maize mesophyll chloroplasts. AB - Intact maize mesophyll chloroplasts have been isolated in yields of up to 10 mg of chlorophyll per preparation. The chloroplasts were able to reduce 3 phosphoglycerate at a rate of 2.4 mumol of oxygen/min/mg of chlorophyll. This activity was inhibited by preincubating the intact chloroplasts with pyridoxal 5 phosphate. Chloroplast envelopes have been prepared and the protein profile has been obtained on SDS-polyacrylamide gels. The phosphate-translocator from the chloroplast envelope has been identified as a 30kDa polypeptide. PMID- 3827916 TI - Photoregulation process of sorghum leaf phosphoenolpyruvate carboxylase: study with monoclonal antibodies. AB - Monoclonal antibodies were produced against the G isozyme subunit of PEP carboxylase (PEPC) from Sorghum leaves by the hybridoma technique. More than 400 antibodies-producing hybridomas to PEPC were produced from the fusion of spleen cells from immunized mice with NS1 myeloma cells. By using an ELISA, three hybridomas (91-G, 83-G, 49-EG) were selected. Monoclonal antibodies were subsequently characterized in a Western experiment; Mabs 83-G and 91-G were found to be highly specific to the G isozyme whereas Mab 49-EG recognized both forms (E and G isozymes) of the enzyme. Addition of Mabs to the enzyme preparation did not modify its catalytic activity nor its activation by glycine. Use of these probes provided direct and definite evidence of the specific enhancing effect of light on the G form and on its corresponding mRNA. PMID- 3827917 TI - The amino-terminal sequence of the 85-90K nonhormone binding component of the molybdate-stabilized estradiol receptor from calf uterus. AB - The first six N-terminal amino acid residues of the 85-90K non-estrogen binding component of the calf uterine, molybdate-stabilized estradiol receptor have been determined by Edman degradation. After affinity chromatography of the stabilized receptor oligomer, the 85-90K unit was purified to homogeneity by preparative gel electrophoresis using electroelution for protein recovery. Inverse-gradient high performance liquid chromatography provided the 85-90K protein suitable for amino terminal sequence analysis. PMID- 3827918 TI - Identification of 2-benzimidazolyl urea as a new antimitotic compound based on cross resistance studies with nocodazole resistance mutants of CHO cells. AB - The cross resistance patterns of a set of nocodazole-resistant (NocR) and podophyllotoxin-resistant (PodR) mutants of Chinese hamster ovary cells, which exhibit highly specific cross resistance towards compounds that show nocodazole like antimitotic activity, towards a large number of benzimidazole derivatives have been examined. Of the various compounds examined, the NocR and the PodR mutants were found to exhibit increased cross resistance towards only 2 benzimidazolyl urea, indicating that this compound may possess similar biological activity as nocodazole. The nocodazole-like antimitotic activity of 2 benzimidazolyl urea has been confirmed by its ability to block cells in mitosis, and by its competition of 3H-podophyllotoxin binding to microtubule proteins in cell extracts. The nocodazole-like behavior of 2-benzimidazolyl urea and lack of similar activity in other benzimidazole derivatives examined, provides valuable information regarding structural features that are required for this type of biological activity. PMID- 3827919 TI - Impaired cholesterol esterification in primary brain cultures of the lysosomal cholesterol storage disorder (LCSD) mouse mutant. AB - Esterification of cholesterol was investigated in primary neuroglial cultures obtained from newborn lysosomal cholesterol storage disorder (LCSD) mouse mutants. An impairment in 3H-oleic acid incorporation into cholesteryl esters was demonstrated in cultures of homozygous LCSD brain. Primary cultures derived from other phenotypically normal pups of the carrier breeders esterified cholesterol at normal levels or at levels which were intermediary between normal and deficient indicating a phenotypic expression of the LCSD heterozygote genotype. These observations on LCSD mutant brain cells indicate that the defect in cholesterol esterification is closely related to the primary genetic defect and is expressed in neuroglial cells in culture. PMID- 3827920 TI - Triiodothyronine decreases the production of androgen binding protein by rat Sertoli cells. AB - Triiodothyronine (T3) effects on cultured Sertoli cells from immature rats were investigated by evaluating the production of androgen binding protein (ABP) a biochemical marker of Sertoli cell function. The results demonstrate that T3 administration to the rat as well as T3 addition to the culture medium specifically decreases ABP production by Sertoli cells, suggesting a direct regulatory role of thyroid hormone on male reproductive function. PMID- 3827921 TI - Interaction of the thyrotropin receptor on rat FRTL-5 thyroid cells with thyrotropin and a thyrotropin-stimulating autoantibody from Graves' patients. AB - FRTL-5 rat thyroid cells were either surface-labeled with 125I or biosynthetically labeled with [3H]N-acetylglucosamine, solubilized by lithium diiodosalicylate and immunoprecipitated after sequential exposure to bovine thyrotropin and anti-bovine thyrotropin. Autoradiography of polyacrylamide gels run under denaturing conditions and in the presence of a reducing agent revealed two prominent bands with approximate molecular weights of 66-70 kDa and 47 kDa. Immunoprecipitation of the same radiolabeled and solubilized membrane preparations with a Graves' disease IgG having thyroid stimulating but no thyrotropin-binding inhibiting activity revealed only one major band, migrating near the 47 kDa component reactive with thyrotropin. No bands were immunoprecipitated in control incubations using normal human IgG or substituting radiolabeled, solubilized membranes from a rat thyroid cell line with no thyrotropin receptor activity. Thin layer chromatography of Folch extracts of the [3H]-N-acetylglucosamine-labeled immunoprecipitates obtained by either procedure indicated that a specific thyroid ganglioside was coprecipitated with the immunoprecipitated proteins in both cases. PMID- 3827922 TI - Relaxin from an oviparous species, the skate (Raja erinacea). AB - An acid-acetone extract prepared from ovaries of the skate, Raja erinacea, contained a weakly crossreacting molecule when tested in a pig relaxin radioimmunoassay. The material was isolated and purified to homogeneity by ion exchange chromatography, molecular exclusion chromatography, and HPLC. Analytical tests proved the molecule to consist of two chains and to have a molecular weight of 7,500. Sequence analyses of the A and B chains yielded the following sequence: Glu-Glu-Lys-Met-Gly-Phe-Ala-Lys-Lys-Cys-Cys-Ala-Ile-Gly-Cys-Ser-Thr-Glu- Asp-Phe Arg-Met-Val-Cys and Arg-Pro-Asn-Trp-Glu-Glu-Arg-Ser-Arg-Leu-Cys-Gly-Arg-Asp-Leu Ile-Arg-Ala- Phe- Ile-Tyr-Leu-Cys-Gly-Gly-Thr-Arg-Trp-Thr-Arg-Leu-Pro-Asn-Phe-Gly Asn-Tyr- Pro-Ile-Met respectively. Skate relaxin has 0.2% of the activity of B29 pig relaxin in the symphysis pubis assay and 0.5% in the mouse uterine muscle strip contraction inhibition assay. PMID- 3827923 TI - 13-cis-retinal stimulates proliferation and induces intranuclear protein accumulation in the human mammary tumor cells MCF-7. AB - The human mammary tumor cells MCF-7 show enhanced proliferation when treated with low doses (10(-8)-10(-7) M) of 13-cis Retinal (a vitamin A derivative). These results are independent of the growth medium used. We describe a novel effect of 13-cis Retinal: the increased synthesis and accumulation of nuclear proteins in chronically treated cells. The cytoplasmic proteins and proteins released to the culture medium are transiently and oppositly modified. Moreover, chronic treated cells have growth advantages over the untreated counterparts in a clonogenic soft agar assay. PMID- 3827924 TI - Sarcolemmal phospholipid N-methylation in genetically determined hamster cardiomyopathy. AB - The heart sarcolemmal phosphatidylethanolamine N-methylation in UM-X7.1 strain of cardiomyopathic hamsters was examined by using 0.055, 10 and 150 microM S adenosyl-L-(methyl-3H) methionine as methyl donor for sites I, II and III, respectively. In comparison with control values, methylation activities at site I was increased in 40, 120 and 250 days old cardiomyopathic hamsters. On the other hand, methylation activities at sites II and III in 120 and 250 days old cardiomyopathic animals were depressed without any change in the 40 days old group. The alterations in N-methylation activities were associated with kinetic changes in apparent Vmax values without any changes in the apparent Km. These results indicate a defect in the phospholipid N-methylation process in heart sarcolemma during the development of genetically determined cardiomyopathy. PMID- 3827925 TI - Dexamethasone coordinately inhibits plasminogen activator gene expression and enzyme activity in porcine kidney cells. AB - The peptide hormone, calcitonin, induces urokinase-type plasminogen activator (uPA) enzyme activity in cultured LLC-PK1 pig kidney cells. This induction occurs as a consequence of transcriptional activation of the uPA gene. Treatment with the synthetic glucocorticoid hormone, dexamethasone, was found to inhibit calcitonin induction of uPA enzyme activity by as much as 80%. The inhibitory effect of dexamethasone was attributed to at least two mechanisms: induction of an inhibitor of uPA enzyme activity, and reduction in uPA mRNA levels. Study on reduction of uPA mRNA levels showed that dexamethasone significantly reduced the transcription rate of the calcitonin-induced uPA gene, without affecting the half life of uPA mRNA. Although dexamethasone has been reported to induce inhibitors of plasminogen activator enzyme activity and to inhibit transcription of various genes, the system described here appears novel in that both actions are coordinated. PMID- 3827926 TI - Omega-hydroxylation of N-acetylleukotriene E4 by rat liver microsomes. AB - Previous investigations have demonstrated metabolism of leukotriene (LT) C4 in vivo involving transformations of the tripeptide, but not the fatty acid part, yielding N-acetyl LTE4 as a main biliary metabolite in the rat. In addition, several polar metabolites were detected in the same studies. The present report describes the characterization of a metabolite of N-acetyl LTE4 formed during incubations with rat liver microsomes. The structure, 5,20-dihydroxy-6-s-(2 acetamido-3-thiopropionyl)-7,9-trans-11, 14-cis-eicosa-tetraenoic acid, of this metabolite showed that it is formed by hydroxylation of the fatty acid part. Preliminary evidence indicates that it is one of several polar metabolites formed in vivo. PMID- 3827927 TI - The catalytic center of lecithin:cholesterol acyltransferase: isolation and sequence of diisopropyl fluorophosphate-labeled peptides. AB - Lecithin:cholesterol acyltransferase (LCAT) was purified from hog plasma and subsequently reacted with [3H]-Diisopropyl fluorophosphate (DFP). The labeled enzyme was digested with pepsin and the peptides separated by high performance liquid chromatography (HPLC). Two radioactive peptides were isolated, subjected to automated amino acid sequencing and yielded the following data: A) Ile-Ser-Leu Gly-Ala-Pro-Trp-Gly-Gly-Ser, and B) Tyr-Ile-Phe-Asp-x-Gly-Phe-Pro-Tyr-x-Asp-Pro Val. Both of these sequences represent very highly conserved regions of the enzyme when compared to the sequence of human LCAT. Peptide (A) is considered to represent the catalytic center of LCAT based on comparisons with data reported in the literature. PMID- 3827928 TI - Trans-stimulation and driving forces for GSH transport in sinusoidal membrane vesicles from rat liver. AB - Sinusoidal membrane vesicles from rat liver were employed to study the characteristics of GSH transport. Saturable concentration dependent uptake was best described by the sum of a high and low Km transport. Preloading with GSH markedly stimulated the initial uptake of GSH. GSH transport was electrogenic; uptake was enhanced by an inwardly directed K+ gradient which could be blocked by the K+-channel blocker, Ba2+. The other cations such as Na+, Li+ were poor substitutes for K+. These results therefore show that net GSH transport involves movement of K+. PMID- 3827929 TI - Characterization of the fusogenic properties of glyceraldehyde-3-phosphate dehydrogenase: fusion of phospholipid vesicles. AB - A fluorescence assay based on resonance energy transfer has been used to characterize the fusogenic properties of glyceraldehyde-3-phosphate dehydrogenase. The extent of phospholipid vesicles fusion induced by the protein increased with decreasing pH, being maximum at pH 4.5-5.0. Fusion reaction was temperature dependent with an activation energy of 10 Kcal/mol, and virtually completed within 1 min. at pH 5.0. Fusion is most efficient with vesicles bearing negative charge, however uncharged and even positively charged vesicles were fused. The negatively charged and uncharged vesicles showed the same pH dependence. These observations suggest the importance of hydrophobic interaction in the process of fusion, which was supported by a correlation between extent of fusion and exposure of hydrophobic region of the protein. PMID- 3827930 TI - Chinchilla "big" and "little" gastrins. AB - Gastrin heptadecapeptides (gastrins I and II which differ in the presence of sulfate on the tyrosine of the latter) have been purified and sequenced from several mammalian species including pig, dog, cat, sheep, cow, human and rat. A 34 amino acid precursor ("big" gastrin), generally accounting for only 5% of total gastrin immunoreactivity, has been purified and sequenced only from the pig, human, dog and goat. Recently we have demonstrated that guinea pig (GP) "little" gastrin is a hexadecapeptide due to a deletion of a glutamic acid in the region 6-9 from its NH2-terminus and that GP "big" gastrin is a 33 amino acid peptide. The chinchilla, like the GP, is a New World hystricomorph. This report describes the extraction and purification of "little" and "big" gastrins from 31 chinchilla antra. Chinchilla "little" gastrin is a hexadecapeptide with a sequence identical to that of the GP and its "big" gastrin is a 33 amino acid peptide with the following sequence: (See text) PMID- 3827931 TI - Volume expansion-induced changes in renal tubular membrane protein phosphorylation. AB - The influence of volume expansion (VE) on the in vitro phosphorylation of membrane protein in the proximal brush border membrane (BBM) of the thyroparathyroidectomized (TPTX) rat was studied in the presence and absence of cyclic AMP and the results were compared to those obtained in control TPTX and intact animals. The results indicate that the cyclic AMP-independent phosphorylation of a protein band (Mr = 72,000) was stimulated both by VE and by the presence of parathyroid hormone in the circulation, whereas the cyclic AMP dependent phosphorylation of membrane proteins (Mr = 40,000, 52,000 and 87,000) was inhibited by the same maneuvers. These findings, taken together with data previously available, which demonstrate inhibition of BBM phosphate transport following VE, may provide a link between alterations in phosphate transport in renal BBM vesicles and the phosphorylation of membrane proteins. The results further suggest that membrane protein phosphorylation may be a common mechanism by which a number of agents and maneuvers induce an inhibition of renal tubular phosphate transport. PMID- 3827932 TI - Identification of a characteristic cytosolic polypeptide of rat preneoplastic hepatocyte nodules as placental glutathione S-transferase. AB - Evidence is presented that a distinctive type of glutathione-S-transferase (GSHTase-P), and a cytosolic polypeptide of Mr 52,000 (P-52), each appearing in greatly increased amounts in hepatocyte nodules during liver carcinogenesis in the rat, are so far indistinguishable. The probable identity of the two polypeptides was established with the use of SDS polyacrylamide gel electrophoresis and Western blot techniques with purified GSHTase-P and P-52 and their respective antibodies and by comparison of the sequence of the first 26 N terminal amino acids. Since the enzyme and the polypeptide are each considered to be the best available early markers for hepatocyte nodules, as putative precancerous lesions, their probable identity makes them attractive cellular components for in depth studies on their transcriptional and translational regulation and their use in new approaches to the sequential analysis of liver carcinogenesis. PMID- 3827933 TI - Measurements of in vivo hepatic halothane metabolism in rats using 19F NMR spectroscopy. PMID- 3827934 TI - Mechanisms of fasting-induced potentiation of acetaminophen hepatotoxicity in the rat. AB - The effects of an acute fast on acetaminophen metabolism and hepatotoxicity were investigated in male Long Evans Hooded rats. Histologic studies confirmed that fasting potentiated acetaminophen-induced hepatic necrosis. The previous known fasting-induced decrease in hepatic levels of glutathione and depletion of glycogen levels were also confirmed. Pharmacokinetic studies revealed that, at high dose levels of acetaminophen, fasting decreased the overall rate of elimination as evidence by a longer blood half-life of the drug. The decreased clearance was largely the result of decreases in the apparent rate constants for glucuronidation (ca. 40%) and for sulfation (ca. 30%). Fasting had no significant effects on the apparent rate constants for formation of either acetaminophen mercapturate or the methylthio derivatives. The depression of the nontoxic glucuronidation and sulfation pathways resulted in an increased proportion of the dose converted to the toxic metabolite and, hence, contributed to the potentiation of liver injury in fasted rats. In addition, these studies demonstrated that significant glucuronidation capacity (ca. 60% of that in fed rats) was maintained in fasted rats, indicating that: the glucuronidation capacity was not directly correlated with glycogen levels; and in fasted rats the glucose required for UDP-glucuronic acid formation for acetaminophen glucuronidation was supplied from sources other than glycogen. PMID- 3827935 TI - Evidence for distinct binding sites in the cumene hydroperoxide-dependent metabolism of benzo[a]pyrene catalyzed by cytochrome P-450. AB - A few constitutive cytochrome P-450 isozymes in male rat liver microsomes catalyzed the metabolism of benzo[a]pyrene (BP) in cumene hydroperoxide (CHP) dependent reactions, which produced predominantly 3-hydroxyBP and BP quinones. This process varied with the concentration of CHP. At 0.05 mM CHP, 3-hydroxyBP was the major metabolite. An increase in CHP concentration reduced 3-hydroxyBP formation but increased the level of BP quinones. This change in metabolic profile was reversed by preincubation with pyrene. Pyrene selectively inhibited quinone formation and enhanced 3-hydroxyBP formation. Naphthalene, phenanthrene and benz[a]anthracene nonspecifically inhibited total metabolism. BP binding to microsomal protein correlated with quinone formation, suggesting a common precursor reactive intermediate. BP metabolism by female rat liver microsomes also depended on CHP concentration but was much less effective than that in the male. With females, quinones were the major metabolites at all CHP concentrations, and their formation was again modulated by pyrene. These data indicate that two distinct binding sites are responsible for the formation of 3 hydroxyBP and BP quinones. PMID- 3827936 TI - Hepatotoxicity of precocene I in rats. Role of metabolic activation in vivo. AB - The mechanism of the hepatotoxicity of precocene I has been investigated in male, Sprague-Dawley rats. Administration of a single dose of precocene I caused a large depletion of liver glutathione (GSH) levels that was both time and dose dependent. Concomitant with the decrease of liver GSH, there was an increase in serum glutamic pyruvic transaminase (GPT) levels which was also time and dose dependent. Administration of a single dose of [4-3H]precocene I resulted in extensive covalent binding of the radiolabel to liver proteins and DNA in the liver; the extent of binding increased with increasing dose. Treatment of the rats with the mixed-function oxidase inhibitor piperonyl butoxide, before administration of precocene I, significantly decreased the proportion of the radiolabel bound covalently to proteins and DNA, although the total radioactivity (bound and unbound) in the liver remained the same. Piperonyl butoxide pretreatment limited both the liver GSH depletion and the hepatic necrosis normally caused by precocene I. These results are consistent with the view that the hepatotoxicity of precocene I is due to reactive metabolites formed through cytochrome P-450 mediated metabolism of precocene I. PMID- 3827938 TI - In vitro and in vivo effects of indomethacin on phytohemagglutinin-stimulated lymphocyte mitogenesis. AB - The in vitro and in vivo effects of indomethacin on blastogenesis of rat splenic lymphocytes in response to phytohemagglutinin (PHA) were investigated. Direct addition of indomethacin to lymphocyte cultures was found to have both a stimulatory effect at low concentrations (less than or equal to 0.003 microM) and an inhibitory effect at higher concentrations (greater than or equal to 0.01 microM). The in vitro stimulation was significant only at submaximal and supramaximal concentrations of PHA, whereas the inhibitory response was observed with a wide range of mitogen concentrations. When indomethacin was administered to animals twice daily for 3 days, similar dose-dependent stimulatory and inhibitory effects were observed. Again the stimulatory effects were associated with lower doses (0.1 microgram/kg) and were found to be significant only with submaximal PHA concentrations. The inhibition with higher doses of indomethacin (IC50 = 0.20 mg/kg) was accompanied by a dose-dependent decrease in the maximal response and an increase in the EC50 to PHA in indomethacin-treated animals. These inhibitory effects of indomethacin administration on lymphocyte proliferation were found to occur at doses which closely approximate those required for the anti-inflammatory effects of the drug. PMID- 3827937 TI - Effect of methylglyoxal bis(guanylhydrazone) on hepatic, heart and skeletal muscle mitochondrial carnitine palmitoyltransferase and beta-oxidation of fatty acids. AB - Methylglyoxal bis(guanylhydrazone) (MGBG) is an antileukemic agent and a structural polyamine analogue which inhibits S-adenosyl methionine decarboxylase. However, MGBG also produces profound mitochondrial structural damage and inhibition of fatty acid oxidation. Carnitine palmitoyltransferase-A (CPT-A) is located on the outer surface of the inner mitochondrial membrane and is the putative rate-controlling enzyme for mitochondrial long-chain fatty acid oxidation. The present experiments were designed to determine if MGBG inhibits CPT-A. Liver, heart and skeletal muscle mitochondria were isolated from rats following 24 hr of starvation. Measuring the reaction in the direction of palmitoylcarnitine plus CoA formation from palmitoyl-CoA plus carnitine ("forward reaction"), MGBG was competitive with l-carnitine. The MGBG CPT-A Ki values were (mM): liver, 5.0 +/- 0.6 (N = 15); heart 3.2 +/- 1.2 (N = 3); and skeletal muscle, 2.8 +/- 1.0 (N = 3). Lysis of hepatic mitochondria with Triton X-100 yielded a Ki of 4.0 +/- 2.0, which was not significantly different from intact mitochondria or inverted vesicles (4.9 mM). Purified hepatic CPT had a Ki of 4.2 mM. MGBG did not inhibit purified CPT in the "reverse reaction" (palmitoyl-CoA plus carnitine formation from palmitoylcarnitine plus CoA). Spermine and spermidine, which are structurally similar to MGBG, did not inhibit either CPT activity or acid-soluble product formation from 1-[14C]palmitoyl-CoA. MGBG inhibited mitochondrial state 3 oxidation rates of palmitoyl-CoA and palmitoylcarnitine, as well as of glutamate. However, the fatty acid substrates were considerably more sensitive than glutamate to MGBG inhibition. MGBG also increased hepatic mitochondrial aggregation which was reversed by l-carnitine. Fluorescence polarization, using 1,6-diphenyl-1,3,5-hexatriene (DPH) as a probe, indicated that MGBG increased membrane rigidity in a dose-dependent manner. This effect was not altered by l-carnitine. MGBG also inhibited purified pigeon breast carnitine acetyltransferase (CAT; Ki = 1.6 mM). While MGBG appeared to be competitive with l-carnitine for both CPT and CAT, MGBG also exhibits a number of effects which may be mediated through membrane interaction and which are not reversed by carnitine. PMID- 3827939 TI - Increased anti-tumor effect of adriamycin-loaded albumin microspheres is associated with anaerobic bioreduction of drug in tumor tissue. AB - Anti-tumor activity and fate of adriamycin incorporated into biodegradable albumin microspheres was examined in vivo after direct intratumoral injection. Adriamycin in microspherical form displayed superior anti-tumor activity to a comparable dose of drug in solution. This was associated at later time points (40 hr, 50 hr and 72 hr after injection) with higher median parent drug concentrations in tumor tissue (4.1, 3.6, 2.6 micrograms/g respectively for microspheres and 1.6, 1.7 and 1.0 micrograms/g for solution) and the consistent detection of 7-deoxyaglycone metabolites, end products of reduction of adriamycin under anaerobic conditions (1.1, 1.0, 1.0 micrograms/g respectively for microspheres and less than 0.1 micrograms/g at all time points for solution). It is generally considered that the redox properties of anthracyclines are responsible for their toxicity to normal tissues whereas other mechanisms are responsible for antineoplastic activity. In this study we show that inducing metabolism of Adriamycin via reductive pathways is associated with increased anti tumor effect. PMID- 3827940 TI - Effect of combined exposure to lead and ethanol on some biochemical indices in the rat. AB - We investigated the effect of daily oral administration to young rats of lead (10 mg/kg) and ethanol (10%, v/v, in drinking water), either alone or in combination, for 8 weeks on the uptake of lead in tissues, brain biogenic amines, hepatic alcohol dehydrogenase and cytosolic and mitochondrial aldehyde dehydrogenase and some selected lead-sensitive variables. Lead given in combination with ethanol produced more pronounced inhibition in the activities of hepatic glutamic oxalacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) as compared to lead alone treatment. Simultaneous exposure to lead and ethanol produced a greater depression of dopamine (DA) and 5-hydroxytryptamine (5-HT) levels in the whole brain of rats, compared to rats treated with lead alone. The concentrations of lead in blood, liver and brain were significantly higher in rats exposed simultaneously to lead and ethanol. Though ethanol treatment alone inhibited the activities of hepatic alcohol dehydrogenase and cytosolic and mitochondrial aldehyde dehydrogenase, no effect of lead treatment alone on these variables was observed. The results suggested that animals exposed to ethanol and lead are more vulnerable to the neurologic and hepatotoxic effects and the systemic toxicity of lead. PMID- 3827941 TI - Effects of slow cooling in situ and freeze-thaw procedures on [3H]hemicholinium-3 binding in rat cerebral cortical plasma membranes. PMID- 3827942 TI - Beta-lactam antibiotics and transport via the dipeptide carrier system across the intestinal brush-border membrane. PMID- 3827943 TI - Dithiolthione-induced alterations in hepatic glutathione and related enzymes in male mice. PMID- 3827944 TI - Immunochemical determination of microsomal epoxide hydrolase (preneoplastic antigen) in extrahepatic tissue. PMID- 3827945 TI - Metabolism and pharmacokinetics of the N- and C-n-octyl analogues of pyridoglutethimide [3-ethyl-3-(4-pyridyl)piperidine-2,6-dione]: novel inhibitors of aromatase. PMID- 3827946 TI - Drug-protein conjugates--XI. Disposition and immunogenicity of dinitrofluorobenzene, a model compound for the investigation of drugs as haptens. AB - The conjugation of drugs to autologous proteins is thought to be a key step in the hapten mechanism of drug hypersensitivity. We have studied the mild arylating agent dinitrofluorobenzene (DNP-F) as a model compound with which to investigate the relationship between the disposition and immunogenicity of drug haptens in two species, the rat and rabbit. Intramuscular administration of DNP-F (0.027-27 mumol/kg/day) for 4 days to male Wistar rats produced a dose-dependent (ED50 2.7 mumol/kg) IgG anti-DNP antibody response, measured by enzyme-linked immunosorbent assay. Subsequent monthly administrations (for 4 days) increased both the frequency and titre of antibody response. Intravenous administration of [3H]DNP-F (0.27 or 2.7 mumol/kg) for 9 days to male New Zealand White rabbits produced an IgG and IgM anti-DNP response in all animals from day 9 onwards. Formation of circulating (serum) DNP-protein conjugates was determined by radiometric analysis, and found to reach steady state (0.12-0.17% dose/ml) between days 6 and 8 and decline with a half-life of 7.4 days. The immunogenicity of fully characterized haptenated, autologous proteins was investigated in further experiments in which dinitrophenylated serum protein conjugates (DNP-RSP) and albumin conjugates (DNP-RSA) were prepared ex vivo and then administered (50 mg/kg; i.v.) to the rabbit from which the protein had been obtained. The plasma clearance and immunogenicity of DNP-RSA conjugates was dependent on epitope density. Anti-DNP antibodies were detected after administration of an RSA-DNP15 conjugate but not after either RSA-DNP0.5 or RSA-DNP5. Plasma concentrations of RSA-DNP15 conjugate declined slowly initially, but then fell rapidly between days 8 and 10. The plasma clearance of DNP-RSP conjugates showed a dependence on epitope density from day 1 onwards and anti-DNP antibodies were detectable after administration of all conjugates investigated (range of epitope densities 0.5-30 DNP/albumin equivalent). Thus conjugates derived from proteins other than albumin are likely to be the effective immunogens, for the model hapten DNP. These studies show that DNP-F is a useful model compound in studies of the disposition and immunogenicity of drugs acting as haptens, and may therefore be used as a positive control in experiments designed to assess the potential immunogenicity of drugs and other xenobiotics. PMID- 3827947 TI - Drug-protein conjugates--XII. A study of the disposition, irreversible binding and immunogenicity of penicillin in the rat. AB - The disposition, irreversible binding and immunogenicity of benzylpenicillin (BP) were studied in male Wistar rats. [3H]BP, administered i.v. to anaesthetized rats at two doses (27 mumol/kg, 2.7 mmol/kg), showed dose-dependent kinetics: plasma and tissue concentrations of total BP were disproportionately increased at the higher dose. BP was rapidly cleared from the plasma at both doses (less than 0.05% of administered dose/ml plasma after 3 hr). In spite of the disproportionately elevated levels of total BP after the higher dose, covalent binding to plasma proteins was quantitatively similar as a percentage of the dose at both doses. Three hours after i.v. injection of 27 mumol/kg and 2.7 mmol/kg of the drug, 5.6% +/- 1.7% and 3.3% +/- 1.1% respectively of circulating BP was covalently bound, representing less than 0.004% of the administered dose bound per ml of plasma in each case. Covalent binding of BP to rat plasma proteins in vitro was of a similar magnitude to that observed in vivo: 1.6% +/- 0.4% of BP was bound to 25% rat plasma after 3 hr incubation at 37 degrees. In a separate series of experiments the immunogenicity of BP was studied by chronic administration of the drug to rats. Following daily i.v. or i.m. administration of BP (27 mumol/kg, 270 mumol/kg, 2.7 mmol/kg) for 4 consecutive days at 4-week intervals (three series of injections) neither IgG nor IgM anti-benzylpenicilloyl (BPO) antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Intravenous administration of the high dose of BP was discontinued after the first series of injections due to local necrosis. In contrast to free BP, BPO keyhole limpet haemocyanin (BPO-KLH, 42 nmol BP bound/mg KLH) administered by single i.v. injection at 4-week intervals at two doses (20 and 200 micrograms conjugate/kg, corresponding to 0.84 and 8.4 nmol BPO/kg) readily induced IgG and IgM anti-BPO antibody responses (median IgG titres were 872 and 5470 one week after the third injection of the low and high dose of conjugate respectively; corresponding IgM titres were 4513 and 22,866). The specificity of the IgG and IgM antibodies for the BPO determinant was confirmed by ELISA inhibition with BPO aminocaproate. These experiments show that BP binds irreversibly, but to a limited extent, to plasma proteins in vivo, and that such a degree of conjugation appears to be insufficient to elicit a detectable anti-BPO antibody response. PMID- 3827948 TI - Low-affinity binding of [3H]imipramine to primary astrocyte cultures. AB - High-affinity uptake of serotonin (5-HT) by primary cultures of rat cortical astrocytes has been shown recently to be potently inhibited by tricyclic antidepressants in a manner similar to that described for brain synaptosomes [Katz and Kimelberg, J. Neurosci. 5, 1901 (1985)]. Since the high-affinity binding of [3H]imipramine (IMI) to brain membranes has been well correlated with the inhibition of synaptosomal 5-HT uptake, the binding of [3H]IMI to these astrocyte cultures was examined. No evidence for the existence of a high-affinity binding site was detected in either intact astrocytes or membranes prepared from astrocyte cultures. However, a very dense population of low-affinity binding sites was observed using both methods. This site was similar in affinity (0.606 microM for membranes and 0.959 microM for intact cells) to a low-affinity site observed with rat brain membranes (1.79 microM) but was present at a much greater density in astrocytes (1610 pmoles/mg protein for membranes and 672 for intact cells versus 53 pmoles/mg protein in brain), and may have prevented detection of the high-affinity site. Low-affinity binding to astrocytes was sodium independent, as was low-affinity binding to brain membranes. There was a poor correlation between the inhibitory potencies of the drugs tested against imipramine binding and 5-HT uptake. The binding of 15 nM [3H]IMI was nearly equipotently inhibited by all of the antidepressants tested with IC50 values ranging from 0.56 to 2.6 microM. Other receptor ligands such as 5-HT, chlorpheniramine, quipazine, atropine and benztropine were relatively weak inhibitors of [3H]IMI binding, whereas chlorpromazine was more potent than the tricycle antidepressants. PMID- 3827949 TI - Cellular interactions of auranofin and a related gold complex with RAW 264.7 macrophages. AB - Auranofin (AF) is an orally active chrysotherapeutic agent whose precise mechanism of action with its putative target cell, the macrophage, is not known. In a previous paper, we described a sequential thiol exchange mechanism that explained auranofin's molecular mechanism of interaction with RAW 264.7 cells. To further understand the mode of action of AF and to test the validity of the thiol exchange model, we have continued to study the interactions with macrophages of AF and a related gold complex, triethylphosphine gold chloride (TEPG). Evaluation of the effects of AF and TEPG on RAW 264.7 cells demonstrated that: more gold from TEPG than AF associated with cells over time and with a variety of concentrations; and cellular association of AF and TEPG was temperature dependent. The energy of activation for cell association, the rate-limiting step in the thiol exchange process, was lower for TEPG than AF; cellular association and uptake of both compounds did not require metabolic energy; and efflux of both AF and TEPG was time, temperature, and thiol dependent. Based on these and previous data, we conclude that sequential thiol exchange may be a generic phenomenon for cellular uptake and distribution of thiol reactive gold compounds and that the rate-limiting step is the exchange of either tetraacetylthioglucose (TATG) or chloride for a membrane-localized sulfhydryl group. PMID- 3827950 TI - Subcellular distribution of the antidepressant drug desipramine in cultured human fibroblasts after chronic administration. Drug-effect on the subcellular distribution of accumulated phospholipids. AB - Desipramine (DMI) is an important antidepressant drug and a lysosomotropic substance. In cultured fibroblasts it interferes with lysosomal functions, e.g. phospholipid degradation. Chronic exposure of cells with DMI induces storage of phospholipids. Subcellular fractionations of cultured human fibroblasts that had been exposed to a short pulse of 3H-DMI showed accumulation of DMI in two acidic compartments, one of high density represented the lysosomes and one of much lower density may contain pinosomes. In chronically exposed cells DMI accumulated in the subcellular fractions of lower density only. DMI induced an important shift of lysosomal enzymes from vesicles of high density to the ones of lower density. Phospholipids were accumulating in those vesicles of lower density as well as in the fractions that contained plasma membranes. DMI also accumulated in one part of the Golgi vesicles of acute and chronically exposed cells. In the latter phospholipids and arylsulfatase A activity were also accumulating. DMI possibly interferes with membrane recycling. This eventually could induce changes in phospholipid content and composition in the plasma membrane which may have important implications for membrane functions. PMID- 3827951 TI - Inhibition of adenylosuccinate lyase by L-alanosyl-5-aminoimidazole-4-carboxylic acid ribonucleotide (alanosyl-AICOR). AB - L-Alanosyl-5-aminoimidazole-4-carboxylic acid ribonucleotide (alanosyl-AICOR) has been synthesized enzymatically using 4-(N-succino)-5-aminoimidazole-4-carboxamide ribonucleotide (SAICAR) synthetase in conjunction with 5-aminoimidazole-4 carboxylic acid ribonucleotide and L-2-amino-3-(N-hydroxy-N nitrosoamino)propionic acid (alanosine). The product was characterized by chromatography, ultraviolet spectrum and NMR spectrum at 300 MHz. Alanosyl-AICOR was not a substrate of adenylosuccinate lyase from rat skeletal muscle, but it was an apparent competitive inhibitor in both of the reactions catalyzed by the enzyme. The KI values for alanosyl-AICOR were approximately 1.5 and 1.3 microM in the SAICAR and adenylosuccinate cleavage reactions respectively. These KI values were essentially the same as the Km values for the two substrates of adenylosuccinate lyase. They compare with an accumulation of 70 microM alanosyl AICOR in leukemic nodules of mice treated with alanosine [A. K. Tyagi and D. Cooney, Cancer Res. 40, 4390 (1980)]. Thus, inhibition of adenylosuccinate lyase may account for much of the inhibitory effect exerted by alanosyl-AICOR in vivo. We confirmed the previous observation that alanosyl-AICOR is an inhibitor of adenylosuccinate synthetase. PMID- 3827952 TI - Decreased erythrocyte delta-aminolevulinate dehydratase activity after styrene exposure. AB - delta-Aminolevulinate dehydratase (ALA-D:porphobilinogen synthase, 5 aminolevulinate hydro-lyase, EC 4.2.1.24) activity was depressed markedly in red cells of rats exposed to 0.21 g/m3 styrene, a chemical widely used in commercial products. The depression was not restored in vitro after treatment with dithiothreitol and zinc. Consistent with this finding, radioimmunoassay of the enzyme protein demonstrated reduction in the enzyme concentration by styrene exposure. There was a good correlation between the decrease in enzyme activity and its concentration in the styrene-treated animals, suggesting that the depression of the enzyme activity was essentially due to the reduction in the enzyme content. Decrease in the enzyme content in bone marrow cells to almost the same extent as that in erythrocytes seems to indicate the decreased synthesis of ALA-D in the bone marrow. In vitro studies showed that styrene 7,8-oxide, the major intermediate of styrene metabolism, decreased the activity of purified ALA D but that styrene, the parent compound itself, had no inhibitory effect. The activity and concentration of erythrocyte ALA-D in workers chronically exposed to styrene were also depressed significantly. These findings indicate that the styrene exposure-mediated decrease of ALA-D activity in erythrocytes was a reflection of reduction in the enzyme protein, which may have been the result of styrene 7,8-oxide action, and they suggest that a similar process may also be involved in the reduction of erythrocyte ALA-D in styrene-exposed workers. PMID- 3827953 TI - Flavonoids as antioxidants evaluated by in vitro and in situ liver chemiluminescence. AB - Administration of eriodyctiol and (+)-catechin (10 mg/100 g of body weight) to mice inhibited the enhancement of in situ liver chemiluminescence produced by CCl4 (0.5 ml/100 g) by 32 and 38% respectively. 3,4-Dicaffeoylquinic acid was less effective (13%), and cynarin had no effect. Previously, these compounds and other polyphenols were assayed as in vitro antioxidants by their abilities to inhibit the tert-butyl hydroperoxide (t-BOOH)-initiated chemiluminescence of mouse liver homogenates, and the IC50 (microM) values were as follows: (+) catechin, 3; eriodyctiol, 9; myricetin and 4,2',4'-trihydroxy-6'-metoxychalcone, 15; 3,4-dicaffeoylquinic acid, 20; isochlorogenic acid, 30; caffeic acid, 5,6,3' trihydroxy-7,4'-dimethoxyflavone and cynarin, 50; chlorogenic acid and apigenin, 150; quercetin, pedalitin, sylimarin and quercetin-3-methyl ester, 200; 7,4' dihydroxy-5-methoxyflavonone and kaempferol-3,7-dirhamnoside, 500; quercitrin, 900; and galangin-3-methyl ether, genkwanin, hesperidin, ombuoside, phloridzin, quinic acid, rhoifolin, rutin and sophoricoside, greater than 1 mM. The in vitro and in vivo effects of these flavonoids and polyphenols may be related to their antioxidant abilities, making them promising substances to be investigated as water-soluble protectors against lipid peroxidation and other free radical mediated cell injury. PMID- 3827955 TI - Inhibition of thrombin-induced platelet aggregation by uteroglobin. AB - Uteroglobin, a steroid-dependent, small molecular weight (15K) protein in the rabbit, inhibited thrombin-induced aggregation of both rabbit and human gel filtered platelets (GFP). GFP aggregation by arachidonic acid was not affected by uteroglobin. There were no effects of uteroglobin on thrombin-induced clotting of plasma or purified fibrinogen, or inhibition of thrombin by antithrombin III. Additionally, preliminary results suggest that uteroglobin does not interfere with binding of thrombin to platelets. We suggest that inhibition of platelet aggregation by uteroglobin may function in preventing thrombosis and ensuring free flow of blood through the microvasculature of the uterus and the placenta and may induce some of the antimotility effects of progesterone on the uterus. PMID- 3827954 TI - Depression of rat testicular 17-hydroxylase and 17,20-lyase after administration of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). AB - Toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), such as chloracne, hirsutism, and skin hyperpigmentation, suggest endocrine involvement, however, little is known about the effects of TCDD on steroidogenic organs. It is known that TCDD can cause decreases in testicular heme, testicular microsomal cytochrome P-450, and serum testosterone in the rat. This study was designed to examine the activities of the testicular hemoprotein microsomal cytochrome P-450 dependent enzymes, 17-hydroxylase and 17,20-lyase, following a single, oral dose of either 12.5, 25, or 50 micrograms/kg TCDD. TCDD caused dose- and time dependent decreases in the activity of the 17-hydroxylase enzyme. Significant decreases were observed at 3, 7 and 14 days at the lowest dose of 12.5 micrograms/kg TCDD. The 17,20-lyase enzyme seemed to be less sensitive to the toxic effects of TCDD with significant decreases in enzyme activity being observed at days 3, 7 and 14 only after treatment with 50 micrograms/kg TCDD. Both microsomal cytochrome P-450 and serum testosterone levels decreased in a dose- and time-dependent manner following 12.5, 25 and 50 micrograms/kg doses of TCDD. These results indicate that decreased testosterone production following treatment with TCDD is related to decreased activities of the testicular microsomal cytochrome P-450-dependent enzymes 17-hydroxylase and 17,20-lyase. PMID- 3827956 TI - Inhibition of cardiac phosphodiesterases by amiloride and its N-chlorobenzyl analogues. PMID- 3827957 TI - Non-Hodgkin's lymphoma of the synovium simulating rheumatoid arthritis. AB - Skeletal involvement in patients with non-Hodgkin's lymphoma (NHL) is common, although direct involvement of the joints is unusual. We describe 2 adults who presented with features suggestive of a diagnosis of rheumatoid arthritis, but who were found to have diffuse NHL of the synovium. Results of a review of the literature, and assessment of the few similar cases in which NHL presented in the joint, suggest that the lymphoma may mimic either a monarticular or polyarticular synovitis, without lymphadenopathy or hepatosplenomegaly. Radiographic demonstration of associated bone destruction is the best evidence for non Hodgkin's lymphomatous arthropathy in patients with rheumatic symptoms. PMID- 3827958 TI - Detection of antibodies to total histones and their subfractions in systemic lupus erythematosus patients and their asymptomatic relatives. AB - Sera drawn from 75 patients with systemic lupus erythematosus, 141 healthy relatives (from the families of 51 patients), and 115 healthy control subjects were examined, by enzyme-linked immunosorbent assay, for IgG and IgM antibodies to total histones and their subfractions. Compared with the controls, statistically significant numbers of patients and their relatives had antihistone antibodies of both isotypes. Among the relatives, the sera from females, notably sisters of the patients, contained the highest levels of anti-total histone antibody. Anti-H2A/H2B and H3 antibodies were most prevalent among the lupus patients, but many of the relatives had IgM anti-H4 antibodies. These findings indicate that antihistone antibodies can serve as a genetic marker in patients with systemic lupus erythematosus. PMID- 3827959 TI - Adult-onset Still's disease. Clinical course and outcome. AB - We reviewed the long-term natural history of 21 adult-onset Still's disease patients. Patient subsets were identified according to clinical course patterns. These included monocyclic systemic disease in 4, polycyclic systemic disease in 2, chronic articular monocyclic systemic disease in 10, and chronic articular polycyclic systemic disease in the remaining 5 patients. Functional outcome differed according to course patterns and the extent of articular involvement. Systemic manifestations, per se, did not contribute to poor functional prognosis. Chronic articular disease had the worst outcome: 27% evolved to functional class III status, compared with none in the cyclic systemic groups. Those patients who had a chronic articular pattern or a polyarticular onset and course were at higher risk to develop disabling arthritis. An aggressive approach to therapy, including the early use of remittive agents, should be considered in these patient subsets. PMID- 3827960 TI - Proteoglycan-induced arthritis in BALB/c mice. Clinical features and histopathology. AB - Immunization with chondroitinase ABC-digested fetal human cartilage proteoglycan and Freund's complete adjuvant induced polyarthritis and ankylosing spondylitis in female BALB/c mice. The initial external symptoms of the joint inflammation were swelling and redness. This was associated with edema of the synovium and periarticular tissues and gross proliferation of cells, which reached a peak during weeks 7-9 of the experiment. Mononuclear cell infiltration, with perivascular concentration and occlusion of small vessels, was common. Synovitis increased in severity, villous pannus developed, and erosions of bone, articular cartilage, and occasionally, growth plate were observed. The lumbar spine and the proximal intervertebral discs of the tail also exhibited inflammatory and degenerative changes. As the arthritis progressed, sometimes with acute inflammatory exacerbations, more joints became involved and, by the sixteenth to the twentieth weeks of the experiment, a progressive polyarthritis, with gross joint deformities and restricted function, developed in the majority of the limb joints. Clinical and morphologic features of the disease correlated well with radiologic analysis and with an increased deposition of 99mTc-methylene diphosphonate (determined by radionuclide imaging). The development of this arthritis was accompanied by the expression of cell-mediated and humoral immunity to the immunizing antigen. However, this immunity was also observed, although it was generally less well developed, in mice that received the intact or digested proteoglycan without adjuvant. These mice did not usually develop arthritis. Control mice that received only adjuvant did not develop arthritis. PMID- 3827961 TI - Creatine kinase activity inhibitor in sera from patients with muscle disease. AB - Sera from patients with muscle disease contain an inhibitor of creatine kinase (CK) which may lead to underestimation of CK activity. The inhibitor was dialyzable, but was not related to previously described low molecular weight inhibitors of CK. In a small group of patients with myositis, the amount of inhibitor present in serum was correlated with the severity of the illness. Our findings suggest that the CK inhibitor may be released into serum from injured muscle. PMID- 3827962 TI - Septic arthritis due to Streptobacillus moniliformis. PMID- 3827963 TI - Hypothenar hammer syndrome presenting as bilateral Raynaud's phenomenon. PMID- 3827964 TI - A case of Lyme disease in a 9-year-old black male. PMID- 3827965 TI - Tophaceous gout of the cervical spine without peripheral tophi. PMID- 3827966 TI - Myelitis in systemic lupus erythematosus. PMID- 3827967 TI - Megakaryopoiesis disturbances in atherosclerotic rabbits. AB - Rabbits given a hypercholesterolemic diet (500 mg/day) for 6 months and then maintained for another 6 months on a normal diet were found to have developed fibrous lipidic lesions in the aorta. Although circulating platelet levels in these animals were normal there was a reduction in mean megakaryocyte ploidy. The high concentrations of megakaryoblasts in all the sedimentation fractions collected by the 'STAPUT' system suggested an increase in megakaryocyte turnover with activation of committed stem cells. In addition, other defects in maturation of megakaryocytes were observed, such as abnormalities in the demarcation membrane system and granule number. These data reveal that defects in megakaryocyte maturation and turnover may occur during the process of reparative fibrosis of the arterial tree following a period of moderate hypercholesterolemic diet in the rabbit. PMID- 3827968 TI - Cholestyramine treatment in early life. Immediate and delayed effects on arterial cholesteryl ester metabolizing enzymes in the rabbit. AB - Feeding of cholestyramine-enriched diet to weaned normocholesterolemic rabbits resulted in: lowering of plasma cholesterol and distinctly decreased activity of aortic acyl-CoA cholesterol acyl transferase with no changes in aortic acid and neutral cholesteryl esterase activity. At 9 weeks after cessation of cholestyramine treatment enhanced activity of both aortic esterases were noted despite normalization of plasma cholesterol. No evidence for the presence of plasma factor influencing esterases activity was found in lipoprotein-free serum from cholestyramine-treated animals. These studies show that cholestyramine treatment in early life causes immediate and delayed changes in rabbit arterial cholesteryl ester metabolizing enzymes. PMID- 3827969 TI - The effect of nicotine on aortic endothelium. A quantitative ultrastructural study. AB - This study used quantitative electron microscopy to assess ultrastructural features of endothelial injury occurring with exposure to nicotine. Fourteen mice were given nicotine in their drinking water for 5 weeks. The dose (5 mg/kg body wt/day) was equivalent to a human smoking 50-100 cigarettes/day. A control group of mice was unexposed to nicotine over the same period. Stereological analysis of electron micrographs of endothelium from both groups revealed that the nicotine exposed endothelium showed greater cytoplasmic vacuolation, mitochondrial swelling and subendothelial oedema than the control endothelium. In addition the intercellular cleft morphology was significantly (P less than 0.005) less complex than in the control endothelium. This difference in cleft morphology suggests the nicotine-exposed endothelium is more permeable than the control endothelium. The ultrastructural differences noted in this study are indicative of endothelial damage, and provide structural evidence to support the hypothesis that nicotine contributes to the pathogenesis of arterial disease in smokers. PMID- 3827970 TI - Fish oil feeding results in an enhancement of cholesterol-induced atherosclerosis in rabbits. AB - We investigated the influence of fish oil on cholesterol induced atherosclerosis in rabbits. Group I, a control group was fed a cholesterol-free diet, group II was fed a diet supplemented with 1.5% cholesterol, group III received in addition to cholesterol supplementation a purified fish oil concentrate (Maxepa, 2 ml/d). The animals received these diets for 5 months (100 g/d). Aortic atherosclerosis as measured by planimetry of sudanophilic lesions was significantly higher (+59%) in group III as compared with group II, even though serum cholesterol levels were comparable. No differences were found in platelet half-life times between groups II and III, but these values were significantly lower than the half-life of platelets in the control group I. Total serum peroxide levels, expressed as malondialdehyde equivalents were significantly elevated in the fish oil-treated group. This may be due to malondialdehyde modification of the lipoproteins and may be responsible for the enhanced development of atherosclerosis in these animals. PMID- 3827971 TI - Proteoglycan composition of rabbit arterial wall under conditions of experimentally induced atherosclerosis. AB - The concentration and composition of proteoglycans (PG) of the neointima developed following balloon catheter removal of aortic endothelium in rabbits, were assessed. PG were extracted from the aortic intimal-medial tissues with 4 M guanidinium chloride in the presence of protease inhibitors and purified subsequently by cesium chloride gradient ultracentrifugation and fractionation by high-performance liquid chromatography (HPLC). PG so obtained was analysed for its protein, cholesterol and glycosaminoglycan (GAG) content. For the characterization of the GAG moiety, an exhaustive proteolytic digestion was done. The GAG were then recovered by ethanolic precipitation and their relative distribution was determined after a selective enzymatic digestion using specific enzymes. Results show a significant increase in the amount of PG in the areas of the injured arterial wall covered by regenerated endothelium. In addition, changes in the composition of GAG were also found in the PG isolated from experimental animals when compared to PG isolated from normal aorta. A marked increase in the content of chondroitin sulfates and dermatan sulfate of injured tissue was seen. Hyaluronic acid content also changed in response to de endothelialization and cholesterol feeding, but only moderately. The content of heparan sulfate remained unaffected in experimental tissues. Furthermore, cholesterol feeding aggravated the injury-induced increment of GAG. These findings are consistent with previously reported morphological observations, and correlate well with reports that arterial injury and cholesterol feeding act synergistically in the evolution of the atherosclerotic lesion and provide further evidence that the interaction of lipid and PG of the arterial wall may be of particular importance to our comprehension of the pathogenesis of atherosclerosis. PMID- 3827972 TI - Increased growth stimulation of human vascular cells by serum from patients with primary hyper-LDL-cholesterolemia. AB - Premature atherosclerosis in hypercholesterolemic patients may be due, in part, to increased growth of vascular cells. Therefore, the growth stimulating effect of serum and serum fractions from patients with primary hyper-LDL-cholesterolemia (LDL-cholesterol: 7.5 +/- 1.7 mmol/l) and from healthy subjects on human arterial smooth muscle cells and fibroblasts has been investigated over 5-7 days in culture. Human hypercholesterolemic sera increased the growth of both cell types up to a mean of 133% compared with normal sera (100%) (P less than 0.001). Removal of the dialyzable serum fraction (m.w. less than 3,500 daltons) reduced the growth effect of the hypercholesterolemic sera by 32% (P less than 0.001) and of the normal sera by 11% (P less than 0.01). Readdition of the hypercholesterolemic serum dialysate to its dialyzed serum restored completely the original growth effect. There was no significant difference in growth stimulation between the dialyzed hypercholesterolemic and normal sera excluding a major additional growth effect by LDL-cholesterol. The low molecular weight growth factor(s) of hypercholesterolemic serum (m.w. less than 3,500 daltons) showed a linear dependence of growth stimulation over a 20-fold concentration range. Increased amounts of this factor(s) might easily penetrate the arterial wall, thus contributing to atherogenesis. PMID- 3827973 TI - Lipoprotein patterns in nondiabetic, borderline diabetic, and diabetic Macaca nigra. AB - Lipoproteins were isolated by sequential ultracentrifugation, and the concentrations and compositions were determined in nondiabetic (ND), borderline diabetic (BD), and diabetic (D) Macaca nigra males consuming a chow ration. The total concentrations and components of the VLDL and IDL increased significantly with metabolic deterioration (P less than 0.01). Concentrations and components of LDL increased in the BD and D monkeys, but changes were not statistically significant. The HDL2 and HDL3 particles were virtually unchanged among the three different metabolic groups. The VLDL was the major carrier of the triglycerides, especially in D monkeys. Cholesterol was present predominantly in the LDL. The LDL-cholesterol to HDL-cholesterol ratio increased in the BD and D monkeys, owing mainly to increases in the LDL-cholesterol content. Apoprotein antisera showed apoprotein B in the VLDL, IDL, and LDL, apoprotein E in the VLDL and IDL, and apoprotein A-I in the HDL2 and HDL3 fractions. Because Macaca nigra consume a nonatherogenic, low-cholesterol, low-fat ration, the changes in lipoproteins, particularly in VLDL and IDL, are attributable to metabolic alterations associated with diabetes. PMID- 3827974 TI - Influence of saturated and unsaturated fats on platelet fatty acids in cholesterol-fed rabbits. AB - Feeding natural fats varying in contents of palmitate (16:0), stearate (18:0), oleate (18:1), and linoleate (18:2) to rabbits resulted in modulation of platelet phospholipid fatty acyl composition. Rabbits were fed high fat semipurified diets containing 2% corn oil (CO) + 18% CO, cocoa butter (CB) or milkfat (M) for periods of up to 300 d. Platelet phospholipid linoleate contents corresponded to diet levels with 18:2 highest in CO-fed rabbits and following the sequence CO greater than CB greater than M. Stearate was highest in CB-fed rabbits, corresponding to high 18:0 levels in CB, but palmitate levels were not affected by diet. Both CB and M-fed rabbits were higher than CO-fed rabbits in oleate. Though CO is highest in 18:2, the accepted 20:4 precursor, arachidonate was highest in M-fed rabbits. Adding cholesterol (0.2%) to the diets did not affect platelet phospholipid fatty acyl composition except to elevate 20:4 in M-fed rabbits. CO-fed rabbits showed uniquely high levels of tetracosadienoate (24:2). Fatty acyl composition data were essentially constant between 200 and 300 d on diet. Phospholipid fatty acyl unsaturation was apparently homeostatically controlled as mole percent unsaturate to saturate ratios were independent of diet. The observed homeostasis resulted in minimal diet influences on platelet membrane fluidity and ADP or collagen stimulated platelet aggregation. Platelet fluidity, determined by fluorescence polarization, was a function of oleate and linoleate contents of the cells. Cholesterol feeding generally lowered platelet fluidity and altered the dependence of fluidity on fatty acyl composition. PMID- 3827975 TI - Beta 2-glycoprotein-I (apo-H) inhibits the release reaction of human platelets during ADP-induced aggregation. AB - In order to further characterize the modulation of the ADP-induced aggregation of gel-filtered human platelets by beta 2-glycoprotein-I (beta 2-G-I), the influence of this glycoprotein upon the serotonin (5-HT) release during aggregation was measured. The following results were obtained: beta 2-G-I completely inhibits the 5-HT release during ADP-induced platelet activation. The inhibition is correlated with the inhibition of the second wave of the ADP-induced aggregation. This effect of beta 2-G-I is not dose-dependent and appears above a threshold concentration of 0.1-0.15 mg/ml in the assay. The specificity of the beta 2-G-I interaction with the ADP-activation is supported by results obtained with collagen or thrombin as aggregating agents. In these cases neither the aggregation nor the release is influenced by the glycoprotein. In respect to the results obtained, beta 2-G-I is a potent candidate to be a modulator of ADP induced platelet activation in vivo. PMID- 3827976 TI - Action of cholestane-3 beta,5 alpha,6 beta-triol on rats with particular reference to the aorta. AB - Cholestane-3 beta,5 alpha,6 beta-triol, administered orally to rats in different doses and for varying lengths of times, effected toxic cell damage on aortic smooth muscle cells and endothelium. Cholesterol, applied in the same doses, did not lead to appreciable alterations of the aorta. After parenteral application of lipids with simultaneous administration of cholestane-triol there were no demonstrable fat deposits in the damaged aortic wall with angiotensin II (AII) induced hypertension. Thus, there was no recognizable influence of hypertension on increased fat passage in the arterial wall, or any action of lipids to enhance the permeability of vessels. However, the hypertension had an exacerbating effect in so far as in animals with AII-induced blood pressure rise alterations of the media were more pronounced after cholestane-triol, although we were unable to rule out a primary effect of AII. A potentiation of the cholestane-triol action by simultaneous application of cholesterol demonstrated for the rabbit did not occur in rats. Blood content was lowered mostly by cholestane-triol, also by cholesterol. HDL-cholesterol was little affected; almost no influence was observed in triglycerides. The strong cytotoxic action of cholestane-triol underlines its health-damaging role. Due to its action on the aorta of the rat, despite the animal's resistance to arteriosclerosis, involvement of this cholesterol derivative in the pathogenesis of arteriosclerotic alterations can not be excluded. PMID- 3827977 TI - Atherosclerosis in the hypercholesterolemic hare. Comparison of coronary artery lesions induced by dietary cholesterol in the hare and the rabbit. AB - Atherosclerotic lesions in coronary arteries were compared in 10 hybrid hares and 14 rabbits after induction of hypercholesterolemia, using a cholesterol-enriched diet. All proximal portions of hare coronary arteries contained intimal lesions, often with severe luminal stenosis. These lesions were characterized by the presence of foam cells, smooth muscle cells, and areas of atheronecrosis. Foam cells were also found focally in the media. As part of the intimal changes, iron deposition was present in 65% and calcification was present in 32.5% of proximal segments examined. The proportion of segments with intimal lesions and the intima/media cross-sectional area ratios (I/M ratios) were greatest in proximal segments with stepwise decreases in the mid and distal segments. As area of myocardial infarction was present in one hare. In contrast, 46.5% of proximal segments of rabbit coronary arteries had no intimal lesions and those lesions present had no calcium or iron deposition. No infarction was observed in rabbit hearts. The proportion of segments with lesions and the mean I/M ratios were significantly greater in the hare than the rabbit, with proximal and mid coronary segments showing the most marked differences. The hare appears to develop coronary artery lesions more like those seen in man, with high grade, proximal stenoses occurring uniformly in hypercholesterolemic animals. In contrast, the atherosclerosis developing in rabbit coronary arteries is less uniform and includes involvement of intramyocardial arterioles. The hare offers several advantages as a model of human atherosclerosis. PMID- 3827978 TI - Stimulation of smooth muscle cell glycosaminoglycan synthesis by cultured endothelial cells is dependent on endothelial cell density. AB - Smooth muscle cells (SMC) cultured in the presence of endothelial cells (EC), or in EC-conditioned medium, show increased synthesis of glycosaminoglycans (GAG). We have found that both the amount and type of GAG produced by the SMC are dependent on the density of the EC. EC (porcine) at a low density (0.1-0.5 X 10(6) cells/25 cm2), or their conditioned media, where the most active per cell in stimulating GAG. All GAG were stimulated but the increase was due mostly to hyaluronic acid (HA). At intermediate densities (1.0 X 10(6)/25 cm2) stimulation was markedly reduced, but still present, and both HA and sulphated GAG were similarly increased. At high densities (1.5-3 X 10(6)/25 cm2) where EC were confluent there was very little stimulation of HA but continued stimulation of sulphated GAG synthesis. The shift in stimulation from HA to sulphated GAG with increasing density was most clearly demonstrated by the decrease in the HA to the chondroitin sulphate ratio. These findings provide support for the general concept that SMC metabolism may be affected by changes in the state of the endothelium. PMID- 3827979 TI - Coronary artery disease and bile acid synthesis in familial hypercholesterolemia. AB - A cohort of 97 consecutive patients (mean age 43 years), heterozygous for familial hypercholesterolemia (FH) with tendon xanthomata, were studied to explore the possible association of coronary artery disease (CAD) with classical risk factors of CAD and parameters of cholesterol metabolism, including cholesterol and bile acid synthesis. Seventy percent of the patients had CAD. Male sex, advanced age (in females), increased blood pressure (in females), obesity (in males), short stature and clinical signs of tissue deposition of cholesterol were more common in the patients with than without CAD. Serum total and LDL-cholesterol and triglyceride levels were not associated with the presence of CAD. As compared with normolipidemic healthy subjects, studied under similar conditions, the bile acid synthesis was subnormal in FH. However, the low bile acid values were associated with CAD, especially in men, while the bile acid formation was within the normal limits in the healthy FH patients. The findings suggest that FH patients with a low bile acid synthesis have an increased risk to develop coronary heart disease by an unknown mechanism. PMID- 3827980 TI - The effect of acute exercise on high density lipoprotein-cholesterol and the subfractions in females. AB - The effect of an acute exercise session on high density lipoprotein-cholesterol (HDL-C) and the subfractions HDL2-C and HDL3-C was determined for 9 healthy females (VO2max = 46.62 +/- 4.82 ml X kg-1 min-1). Each subject underwent a continuous 40-min run on a treadmill at a workload corresponding to 70% of VO2max. A venous blood sample was obtained immediately prior to exercise and 5 min, 24, 48 and 96 h after the exercise. Pre-exercise values were: HDL-C (61.7 +/ 3.7 mg X dl-1); HDL2-C (22.4 +/- 2.1 mg X dl-1); HDL3-C (39.3 +/- 2.0 mg X dl 1). At 5 min after exercise, HDL-C (66.2 +/- 4.4 mg X dl-1) and HDL3-C (44.5 +/- 2.8 mg X dl-1) were significantly elevated (P less than 0.01) when compared to pre-exercise values. HDL-C and HDL3-C were not significantly different from pre exercise at the remaining time points. In comparison with pre-exercise, HDL2-C showed no significant change at any of the post-exercise time points. Results indicated that the rise in HDL-C following acute exercise was due to an increase in the subfraction HDL3-C. The change in total HDL-C and HDL3-C was transient in that pre-exercise values were re-attained within 24 h following acute submaximal exercise. PMID- 3827981 TI - Influence of bezafibrate and colestipol on LDL-cholesterol, LDL-apolipoprotein B and HDL-cholesterol in hyperlipoproteinaemia. AB - A significant increase of LDL-apolipoprotein B by 13% and LDL-cholesterol by 19% was observed in a group of 9 patients with hyperlipoproteinaemia Type III after bezafibrate treatment. Additional administration of colestipol caused a significant decrease of both LDL-apolipoprotein B by 18% and LDL-cholesterol by 25%. In 10 patients of hyperlipoproteinaemia Type IIb a significant decrease of both LDL-apolipoprotein B by 28% and LDL-apolipoprotein B by 18% was observed after bezafibrate therapy. When bezafibrate was given together with colestipol a further decrease of both LDL-cholesterol by 17% and LDL-apolipoprotein B by 16% occurred. HDL-cholesterol concentration increased significantly in both groups of hyperlipaemic patients during therapy. This may be the effect of both bezafibrate and colestipol. It is concluded that bile acid resins may effectively prevent the LDL-cholesterol concentration increase observed sometimes after clofibrate analogues. PMID- 3827982 TI - Italian multicenter study of reversible cerebral ischemic attacks. Part 5. Risk factors and cerebral atherosclerosis. AB - As part of a prospective study, the influence of several premorbid and environmental factors on the presence, extent and severity of cerebral vessel atherosclerosis was studied in 462 patients with clinical diagnosis of RIA who underwent cerebral angiography. The extent and severity of atherosclerosis of the cerebral vessels was quantified using extracranial and intracranial cerebrovascular scores (ECS, ICS) based on the number and severity of the lesions in 11 extracranial and 21 intracranial arterial segments. Results of univariate and multivariate analyses indicate that the presence of atherosclerotic changes of cerebral vessels, as shown by angiography, was strongly related with age in both sexes. The lesions were more frequent in males, in particular under age 55. Elevated cholesterol was associated with a higher incidence of atherosclerotic lesions. Smoking was associated with a higher incidence of extracranial lesions. Age, smoking and history of hypertension were the best predictors of the extent and severity of cerebral vessel atherosclerosis. PMID- 3827983 TI - Effects of partial ileal bypass on the progression of atherosclerotic lesions in WHHL rabbits. AB - At age of 40 weeks, 9 WHHL rabbits were necropsied as a baseline control group for evaluating aortic and coronary atherosclerosis. An additional 18 WHHL rabbits of the same age underwent either a partial ileal bypass (PIB) or a sham operation. Serum cholesterol concentrations were significantly lower in PIB rabbits than in sham-operated rabbits, mean postsurgical values being 7.9 +/- 2.3 mmol/l and 13.2 +/- 2.4 mmol/l, respectively. This effect was mainly due to a lower LDL-cholesterol concentration. Serum triglycerides remained unaffected. Thirty weeks after surgery the PIB and sham rabbits were necropsied and atherosclerosis was evaluated. Progression of atherosclerotic plaque size in the sham group was most prominent in the aortic arch. PIB largely prevented this progression. The frequency of plaque complications in the aortic arch also increased in the sham groups. Here, no significant improvement was found in the PIB group. Extensive examination of the heart showed some affected coronary arteries in every 40-week-old WHHL rabbit. Progression of coronary atherosclerosis during the postsurgical period was small in both sham and PIB groups. However, while PIB did not affect the plaque size, it significantly reduced the number of coronary arteries affected. PMID- 3827984 TI - Vitamin B6 and coronary artery disease. Epidemiological observations and case studies. AB - The finding of low plasma pyridoxal-5'-phosphate levels in patients suffering from myocardial infarction has been construed as possible evidence for the pathogenetic role that vitamin B6 deficiency may play in causing premature ischaemic heart disease. However, the presence of normal plasma pyridoxal-5' phosphate levels in patients with angiographic evidence of coronary artery narrowing but with no previous infarctions prompted the investigation of possible short-term alterations in plasma pyridoxal-5'-phosphate levels during the acute phase of myocardial infarction. In the follow-up of 30 patients with acute myocardial infarction, all of them showed a continuous decrease of approximately 45% in plasma pyridoxal-5'-phosphate levels during the acute phase. These levels subsequently returned back to normal before discharge from hospital. A large number of volunteers from an ethnic group known to have a very low incidence of ischaemic heart disease were found to have both significantly lower total cholesterol and plasma pyridoxal-5'-phosphate levels than a Caucasian group in the same geographic area which is known to have a high incidence of ischaemic heart disease. These findings therefore do not support the contention that vitamin B6 deficiency may be a risk index for ischaemic heart disease. PMID- 3827985 TI - Esterases in inbred strains of mice with differential cholesterolemic responses to a high-cholesterol diet. AB - Specific esterase isoenzyme patterns in plasma may be associated with responsiveness of serum cholesterol to dietary cholesterol. In rabbits and rats the presence and absence of a high-mobility, anodal esterase band on electrophoresis have been shown to be associated with hypo- and hyperresponsiveness, respectively. We fed for 28 days male mice of 7 inbred strains either a low-cholesterol, commercial diet or a diet containing 2% (w/w) cholesterol, 0.5% cholic acid and 5% olive oil. Feeding the high-cholesterol diet revealed marked inter-strain differences in the responses of plasma and liver cholesterol; the increases ranged from 21 to 129% and from 10 to 80-fold, respectively. There was no association between esterase isoenzyme patterns in plasma and the sensitivity to the high-cholesterol diet. The mean baseline plasma total esterase activity tended to be positively associated with the absolute response of plasma cholesterol to the high-cholesterol diet (r = 0.56; n = 7), but the positive relationship between the baseline concentration of the ES-1 component in plasma and the cholesterolemic response was stronger (r = 0.84; n = 7; P less than 0.05). The high-cholesterol diet caused a significant increase in plasma total esterase activities in 6 out of the 7 strains. Evidence is presented that the increase in plasma total esterase activity, which was associated with an increase in the activity and concentration of the so-called ES-2 isoenzyme, is the result of an enhanced release of esterases from the intestine, rather than from the liver. A significant, positive correlation was found between the baseline intestinal esterase activity and the cholesterolemic response after cholesterol feeding (r = 0.83; n = 7; P less than 0.05). PMID- 3827986 TI - Risk factors for atherosclerosis in proper perspective. AB - There is widespread misconception about risk factors for atherosclerosis in general and for myocardial infarction in particular. Based on fifty-two years of practice of pathology and forty-six years of study of atherosclerosis, misunderstandings are being corrected by placing risks into proper perspective. Risk factors are being scrutinized, the etiologic roles of hypertension and of diabetes are being re-evaluated and transvalued. PMID- 3827987 TI - Increased cholesterol concentration in intermediate density lipoprotein fraction of normolipidemic non-insulin-dependent diabetics. AB - There is increasing agreement about the atherogenicity of intermediate density lipoprotein (IDL). In order to determine whether normocholesterolemic diabetics are at a higher risk of atherosclerosis, cholesterol concentrations in three subclasses of triglyceride-rich lipoprotein fraction (Sf 12-400) were examined. Their plasma triglyceride and cholesterol levels were limited to below 150 and 250 mg/dl, respectively. They were divided into 3 groups according to their treatment: insulin injection (group I), sulphonylurea (group S) and diet alone (group D). Age-matched healthy normolipidemic non-obese subjects served as controls (group C). Triglyceride-rich lipoproteins were separated by ultracentrifugation: very low density lipoprotein (VLDL), Sf 60-400; intermediate density lipoprotein (IDL1), Sf 20-60; IDL2; Sf 12-20. Cholesterol concentrations in total plasma, VLDL, IDL2 and high density lipoprotein (HDL) were all identical in every group. A significant increase in cholesterol concentration was found in IDL1 of groups S and D. Low density lipoprotein-cholesterol of group I was also increased. These findings indicate an increased risk factor in normolipidemic diabetics. PMID- 3827988 TI - Age-related changes in anti-elastin antibodies in serum from normal and atherosclerotic subjects. AB - A modified version of the enzyme-linked immunosorbent assay (ELISA), utilising human insoluble aortic elastin, was used for determination of anti-elastin antibodies in serum from normal and atherosclerotic subjects. The age-related changes in their level among healthy persons were investigated. Anti-elastin antibodies were found in all the tested human sera, showing the highest level at the age of 18-20 and the lowest at the age over 60 and especially among atherosclerotic patients. The possible role of the immune system in the turnover of elastin is discussed. PMID- 3827989 TI - Lectin binding sites related with rat ascites hepatoma cell adhesion. AB - In order to elucidate the correlation between cell surface lectin binding sites and the degree of cell adhesiveness, quantitative lectin binding assays were performed using three types of rat ascites hepatoma cell lines (free cell, mixed cell, and island-forming cell types). The lectin binding site patterns showed no remarkable differences among the intact tumor cell lines, but treatment of the cells with L-1-tosylamide-2-phenylethyl chloromethyl ketone (TPCK)-trypsin or neuraminidase induced remarkable differences in the modulation of the number of lectin binding sites. TPCK-trypsin treatment caused a marked decrease in the number of peanut agglutinin binding sites on the island-forming and mixed cell types, concomitant with disaggregation of the cells, showing that trypsin sensitive binding sites are involved in the cell-cell adhesion. Neuraminidase treatment caused a decrease in wheat germ agglutinin binding sites and an increase in castor bean agglutinin binding sites, and these effects were greater for the free cell type. These results indicated that alpha-sialyl-beta-D galactosyl residues are more abundant on the cell surface of the free cell type than the other cell types. Therefore, it was suggested that electrostatic repulsion due to negative charges of the cell surface sialic acid contributes to the low cell adhesiveness of the free cell type. PMID- 3827990 TI - Serial determinations of glutathione levels and glutathione-related enzyme activities in human tumor cells in vitro. PMID- 3827991 TI - Pathogenesis of lupus dermatoses in autoimmune mice. VI. Correlation between positivity of lupus band test and lupus nephritis. PMID- 3827992 TI - Neutrophil kinetics in O2-exposed rabbits. AB - Hyperoxic injury results in an influx of polymorphonuclear leukocytes (PMN) into the lung. To better understand the role of the PMN in this injury, kinetic studies were used to assess the survival of PMNs in the circulation. The rate of deposition of PMNs in the lungs of rabbits exposed to hyperoxia was also examined. The half-lives (T1/2) of [3H]thymidine-labeled PMNs in the circulation in rabbits exposed to air or to 95% O2 for less than or equal to 48 h varied between 3.9 and 4.5 h. After 72 h of hyperoxic exposure, T1/2 fell to 2.2 h, the marginal and circulating PMN pool increased and 3H deposition in the lung increased 10-fold. Autoradiographs confirmed that [3H]thymidine was initially nuclear- and cellular-associated but, with time, [3H]thymidine dispersed throughout the lung, suggesting PMN disintegration. These PMN events seem to occur in the later phases of O2 toxicity, and because PMNs are an additional source of oxyradicals, they may further amplify oxidant injury. PMID- 3827993 TI - Norepinephrine applied in the paraventricular hypothalamic nucleus stimulates vasopressin release. AB - The present experiments were designed to investigate the effect of norepinephrine (NE) applied directly in the area of the paraventricular nucleus (PVN) of the hypothalamus on arginine-vasopressin (AVP) release and blood pressure. A microinjection of 0.4 micrograms NE in the PNV produced a plasma AVP level of 26.3 +/- 5.3 pg/ml compared to 5.3 +/- 0.6 pg/ml in controls receiving dextrose (P less than 0.001). This rise was associated with blood pressure elevations varying between 10 and 13 mm Hg, lasting for about 5 min. Systemic injection of an antivasopressor AVP antagonist reversed or prevented the blood pressure rise induced by NE microinjection. The data suggest that locally applied NE in vasopressinergic neurons of the hypothalamus stimulates the release of AVP and induces an AVP-dependent rise in blood pressure. PMID- 3827994 TI - Susceptibility of buffaloes, cattle and goats to infection with different stocks of Trypanosoma vivax transmitted by Glossina morsitans centralis. AB - A comparison was made of the susceptibility of buffaloes, cattle and goats to infection with Trypanosoma vivax transmitted either by Glossina morsitans centralis or by syringe inoculation. Three different isolates of T vivax (two from East Africa, one from West Africa) were used to compare skin reactions, parasitaemia, anaemia and the development of trypanosome-specific antibodies in buffaloes, cattle and goats. African buffaloes reared in captivity in an area free from trypanosomiasis proved to be highly resistant to infection with the three stocks of T vivax tested, irrespective of whether infection was by tsetse transmitted metacyclic forms or by intradermal or intravenous inoculation of bloodstream forms of the parasite. The bites of 19 tsetse infected with a West African T vivax stock did not cause local skin reactions, detectable bloodstream infections or antibody responses in two buffaloes. Following the bites of 120 tsetse flies infected with the same stock, two different buffaloes showed no local skin reactions, but had detectable bloodstream infections without showing signs of anaemia. Cattle and goats infected in a similar way showed severe local inflammatory skin reactions, high levels of parasitaemia and severe anaemia. The two East African stocks of T vivax caused no local skin reactions and only a transient parasitaemia in buffaloes following tsetse-transmitted infection or intradermal inoculation of bloodstream forms. On the other hand, cattle and goats infected with the East African stocks showed high parasitaemias but local skin reactions only occurred in the goats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3827995 TI - On the stability of phencyclidine discrimination in the pigeon. AB - Pigeons trained to discriminate phencyclidine from saline under a color tracking procedure using second-order schedules were studied over a period of more than 5 years. During this time, many other drugs were studied and a variety of procedural changes were made, yet when phencyclidine discrimination was studied under the same second-order schedule, the phencyclidine generalization curve could be reproduced reliably. When the birds were not tested or given any injections for two months, the typical phencyclidine generalization curve could be generated during the first session that testing resumed. These data illustrate the long term stability of phencyclidine discrimination in the pigeon. PMID- 3827996 TI - The effect of ethanol and temperature on calcium-dependent sensory neuron action potentials. AB - The ability of ethanol to decrease the duration of sensory neuron action potentials was evaluated at different temperatures. Intracellular stimulation and recordings were made as the drug was perfused onto dorsal root ganglion neurons in vitro. The cells were bathed in a medium which caused the evoked action potentials to have long durations which were calcium dependent. Ethanol decreased the duration of the action potentials in a dose-dependent manner, without altering amplitude, rate of rise, or resting potential. Furthermore, the potency of the drug varied directly with the temperature of the bathing medium. The recovery time for the reversal of ethanol's effect was also found to be temperature dependent. However, moderate temperature changes alone did not significantly alter the action potential waveform. These data are compatible with a boundary lipid or direct effect on the calcium channel for the mechanism of ethanol's action. PMID- 3827997 TI - Genetic selection of mouse lines sensitive (cold) and resistant (hot) to acute ethanol hypothermia. AB - Using the technique of within-family selective breeding, we have generated mouse lines that differ genetically in sensitivity to the acute hypothermia induced by injection of 3 g/kg ethanol (EtOH). After 5 generations of selection, the difference in maximal hypothermic response between COLD and HOT lines was 1.6 degrees C in the first replicate and 1.2 degrees C in the second replicate. Estimates of realized heritability were h2 = .17 in each replicate. No differences in EtOH metabolism have developed, so the differences between HOT and COLD mice are presumably in neurosensitivity. These lines of animals should be useful for studying the biological mechanisms underlying neurosensitivity to EtOH. In conjunction with other selectively bred lines, they should improve our understanding of the genetic relationships among EtOH neurosensitivity, tolerance and physical dependence. PMID- 3827998 TI - Endogenous adenosine-receptive systems do not mediate the discriminative stimulus properties of ethanol. AB - Adenosine is an endogenous neuromodulator with depressant effects on CNS neurons. Adenosine agonists produce biphasic effects on activity, decreases in operant response rate, and anticonvulsant effects. These effects are similar to some of the behavioral effects of ethanol. In addition, it has recently been shown that relative sensitivities to some of the behavioral effects of ethanol and purinergic drugs are similar in inbred strains of mice. These findings have prompted the speculation that ethanol's behavioral effects may be mediated by an agonist action on adenosine-receptive neurons. The present study provided a direct test of this hypothesis with respect to the discriminative stimulus properties of ethanol. In this study, neither the A1 receptor agonist N6 cyclohexyladenosine nor the A2 receptor agonist N6-ethylcarboxamide adenosine produced significant generalization to the ethanol stimulus. In addition, neither the adenosine deaminase inhibitor erythro-9-(2-hydroxy-3-nonyl)-adenine nor the adenosine uptake inhibitor dipyridamole were able to enhance the level of ethanol appropriate responding seen after a low dose of ethanol. Both caffeine and 8 phenyltheophylline partially but significantly antagonized the stimulus properties of ethanol. However, the doses required to achieve these effects were much higher than those needed to block adenosine receptors. These findings strongly suggest that the discriminative stimulus properties of ethanol are not mediated through an agonist action on adenosine-receptive neurons. PMID- 3827999 TI - Stress enhances the development of tolerance to the hypothermic effect of ethanol. AB - Handling procedures used for body temperature measurement in rats, such as repeated rectal probing during restraint, raise body temperature in a manner similar to other stressors. Thus, the common use of this procedure to monitor temperature may actually obscure the results of experiments measuring the acute and chronic effects of alcohol. In the present experiment, temperature was continuously monitored with implanted biotelemetric sensors, thus eliminating the need for repeated stressful handling. Handling stress was found to interact with the effects of ethanol intoxication to augment the initial hypothermic effect of ethanol. Moreover, the rate and extent of tolerance development to ethanol induced hypothermia was enhanced. PMID- 3828000 TI - Pentobarbital discrimination in the mouse. AB - Mice have rarely been used for drug discrimination research. A procedure is described for training mice to discriminate sodium pentobarbital (PB) from vehicle and the pharmacological specificity of the PB stimulus was assessed by generalization testing with methohexital, ethanol, chlorpromazine and morphine. Mice were trained to discriminate PB from vehicle using a two-lever procedure with responding maintained under a fixed-ratio 20 schedule of milk presentation. Training was initiated with 10 mg/kg PB or saline given i.p. 20 min prior to the sessions, and stimulus control was assessed every third session during 2-min periods when responding on either lever was reinforced. After 48 training sessions, good stimulus control had not been achieved. The PB dose was increased to 15 mg/kg, and after 12 additional training sessions, a mean accuracy of 93.5% and 88.1% was obtained on PB and saline tests, respectively. Generalization tests for the time course of the PB stimulus indicated that over 90% PB-lever responding occurred with pretreatment times of 5, 10 and 20 min, falling to 25.6% by 40 min and 15.4% by 60 min. Dose-dependent generalization was also obtained with doses of 15, 20 and 30 mg/kg occasioning over 75% and doses of 5 and 10 mg/kg occasioning less than 25% PB-lever responding. The mice also generalized from PB to methohexital and ethanol, although with the latter greater than 90% PB lever responding was only produced by a dose that substantially decreased overall rates of responding. Generalization was not obtained with morphine nor chlorpromazine. Typical drug discrimination procedures utilized for pigeons, rats and monkeys can also be used with mice. PMID- 3828001 TI - The response of rat brain protein synthesis to ethanol and sodium barbital. AB - Central nervous system (CNS) depressants such as ethanol and barbiturates under acute or chronic conditions can induce changes in rat brain protein synthesis. While these data demonstrate the individual effects of drugs on protein synthesis, the response of brain protein synthesis to alcohol-drug interactions is not known. The goal of the present study was to determine the individual and combined effects of ethanol and sodium barbital on brain protein synthesis and gain an understanding of the mechanisms by which these alterations in protein synthesis are produced. Specifically, the in vivo and in vitro effects of sodium barbital (one class of barbiturates which is not metabolized by the hepatic tissue) were examined on brain protein synthesis in rats made physically dependent upon ethanol. Using cell free brain polysomal systems isolated from "Control," "Ethanol" and 24 h "Ethanol Withdrawn" rats, data show that sodium barbital, when intubated intragastrically, inhibited the time dependent incorporation of 14(C) leucine into protein by all three groups of ribosomes. Under these conditions, the "Ethanol Withdrawn" group displayed the largest inhibition of the 14(C) leucine incorporation into protein when compared to the "Control" and "Ethanol" groups. In addition, sodium barbital when added at various concentrations in vitro to the incubation medium inhibited the incorporation of 14(C) leucine into protein by "Control" and "Ethanol" polysomes. The inhibitory effects were also obtained following preincubation of ribosomes in the presence of barbital but not cycloheximide. Data suggest that brain protein synthesis, specifically brain polysomes, through interaction with ethanol or barbital are involved in the functional development of tolerance. These interactions may occur through proteins or polypeptide chains or alterations in messenger RNA components associated with the ribosomal units. PMID- 3828002 TI - Ethanol and aging effects on movement initiation can be dissociated from general behavioral impairment using a high-speed lever-release task in rats. AB - An animal model of human reaction time was used to assess the effects of ethanol on reactive capacity (RC) as a function of age. Three doses of ethanol (0.5, 1.0 & 1.5 g/kg of 20% v/v, i.p.) were confirmed by gas chromatographic analysis of blood samples taken immediately following every behavioral test. Fisher 344 rats were trained to use their forepaws to hold down a lever until the onset of a buzzer and light that signalled impending foot shock, which occurred within 200 1000 msec of the stimulus. All rats were shaped to release the lever faster than 200 msec, which permitted them to avoid all shock under saline treatment. In the first experiment, only young adult rats (3-4 mos) were tested. Ethanol caused a dose-dependent impairment of RC. In a second experiment, rats aged 4, 12 and 24 mos were tested. As in previous work, RC was reduced by age. Ethanol caused a dose-dependent impairment of response speed (as indicated by the average of the fastest five RTs) that was exaggerated in the 24 mo-old rats. Ethanol also appeared to amplify the trial-by-trial variability in RC that was typical of the old rats under saline conditions. Nevertheless, if given enough time (1000 msec) most rats (except for a few in the oldest group) were able to avoid shock under ethanol as reliably as under saline conditions, even at the highest dose. Thus, ethanol specifically slowed reaction time while sparing memory and motivational and motor capacities required for success in this task. Both extensive practice and pre-test warm up sessions modified the effects of ethanol; however they did not do so differentially across ages. PMID- 3828003 TI - Chronotropic and inotropic effects on atria of chronic ethanol ingestion in the aging rat. AB - Both aging and chronic ethanol consumption have been correlated with reduced cardiac chronotropic and inotropic function. This study tested the hypothesis that aging potentiates the negative cardiac effects of chronic ethanol consumption. Using isolated tissue techniques we assessed baseline and maximum automaticity and tension development in atria from 4 groups of Fischer-344 rats (young normal, young ethanol, old normal, old ethanol). Baseline and maximum rate was depressed by aging and further depressed by chronic ethanol ingestion. Baseline and maximum tension was depressed only by aging plus chronic ethanol ingestion. PMID- 3828004 TI - Demonstration of a threshold concentration for ethanol at the time of regaining the righting response in long-sleep and short-sleep mice. AB - The duration of loss of the righting response (sleep time) is often used to assess central nervous system sensitivity to ethanol. It has been assumed that there is a threshold concentration of ethanol at which an animal will regain the righting response, and that this level should not change with dose or route of administration of ethanol. Five hypnotic doses of ethanol were given to Long sleep and Short-sleep mice by intraperitoneal injection. At the time of awakening, blood and brain ethanol levels were measured. It was found that within a line, the animals awoke at the same blood and brain ethanol concentration irrespective of the ethanol dose given. The threshold blood ethanol level was 265 mg% for Long-Sleep males and 484 mg% for Short-Sleep males. These results indicate that there is a threshold value for ethanol, and that this threshold is characteristic for a given mouse line. PMID- 3828005 TI - Inhibition of voluntary ethanol intake in rats by a combination of dihydroergotoxine and thioridazine. AB - Dihydroergotoxine (DHET) decreased voluntary ethanol intake in rats selected for their stable ethanol preference (mean daily ethanol intake 8 g/kg). DHET inhibition was markedly potentiated by thioridazine. The potentiation is explained with a synergistic inhibitory effect on dopaminergic transmission: that is, DHET acting on dopamine (DA) autoreceptors and thioridazine preferentially inhibiting postsynaptic DA receptors. PMID- 3828006 TI - Disassociation of cerebellar phospholipid composition and acute ethanol effects in mice selectively bred for differential sensitivity to ethanol. AB - The relationship between genetically determined acute ethanol sensitivity and cerebellar phospholipid composition was investigated. Cerebellar phospholipid composition was compared in two lines of mice that have been selected for differential sensitivity to the acute hypnotic actions of ethanol. The relative ethanol sensitivity of the long sleep (LS) and ethanol resistance of short sleep (SS) mice is well established, and was observed in this study. Cerebellar phospholipid and cholesterol concentrations were found to be identical in the two lines. No differences were found in the total cerebellar or synaptosomal plasma membrane phospholipid fatty acid composition between the two lines. Additionally, there was no change in phospholipid composition or cholesterol concentration in the cerebellum of either SS or LS mice following chronic alcohol treatment. This study suggests that neither total cerebellar nor synaptosomal phospholipid composition is a major determinant of the differential response to acute ethanol in the ethanol sensitive and resistant mouse lines. PMID- 3828008 TI - Viruses, immunodeficiency, and human cancer. Proceedings of the sixth annual Sapporo Cancer Seminar. July 2-4, 1986, Sapporo, Japan. PMID- 3828007 TI - Sex-differences in ethanol sensitivity and alcohol and aldehyde dehydrogenase activities in the Syrian hamster. AB - Because male Syrian hamsters demonstrate greater preference for ethanol than female hamsters, we compared them with regard to ethanol sensitivity and hepatic alcohol and aldehyde dehydrogenase activities. Male hamsters were slower to recover righting response and had lower blood alcohol levels upon recovery than did females. Hepatic alcohol dehydrogenase activity was approximately twice as high in females as males, but gender differences were not found for either cytosolic or non-cytosolic aldehyde dehydrogenase activities. The results suggest that the reduced ethanol sensitivity of female hamsters is due to more rapid metabolism. However, the finding that female hamsters have higher blood alcohol concentrations upon recovery also suggests the possibility of reduced CNS sensitivity. PMID- 3828009 TI - AIDS-related benign lymphadenopathy and malignant lymphoma: clinical aspects and virologic interactions. AB - Infection with the human immunodeficiency virus (HIV) leads to selective depletion of the helper/inducer lymphocyte subset and a subsequent state of acquired cellular immunodeficiency. Simultaneously, evidence of B-cell hyper activity may exist. A subset of patients infected with HIV demonstrates a syndrome of persistent generalized lymphadenopathy (PGL). Lymph node biopsies reveal benign reactive changes with a pattern of florid follicular hyperplasia. A polyclonal hypergammaglobulinemia reflects humoral immune dysfunction. Patients with PGL are similar to those with full-blown AIDS with regards to demographics, immune and virologic studies. Our prospective natural history study of PGL patients initiated in November 1981 reveals a 15% rate of evolution to AIDS in the 200 patient cohort. Factors associated with increased risk of transformation to AIDS include severity of constitutional symptoms, shrinking adenopathy, oral candidiasis or viral hairy leukoplakia, peripheral cytopenias, elevated erythrocyte sedimentation rate or an antecedent episode of herpes zoster. Therapeutic interventions to prevent evolution to AIDS in high risk subsets of lymphadenopathy patients have been investigated. In addition to benign B-cell proliferation associated with HIV infection, malignant lymphomas have also been diagnosed in 29 patients in AIDS risk groups in our clinic population. All patients were male; 26 homosexuals, 2 IV drug abusers and 1 multiply transfused sickle cell anemia patient. Seven patients had antecedent PGL. Non-Hodgkin's lymphoma was diagnosed in 19 patients. Histologies were predominantly diffuse undifferentiated or large cell. Eleven patients were Stage IV at diagnosis. Of 10 patients with mixed cellularity Hodgkin's disease, 7 were Stage IV-B at presentation. Extranodal disease was frequent in patients with lymphomas. Fourteen patients lacked peripheral lymphadenopathy. Response to chemotherapy was good, but complicated by prolonged marrow suppression and development of AIDS related opportunistic infections. Median survival was 7 months. Laboratory studies investigating the possible role of lymphotropic retroviruses in the development of AIDS-related lymphomas revealed that serum from all patients with high grade non-Hodgkin's lymphoma contained antibodies to HIV and that the majority also expressed antibodies to HTLV-I. This degree of seroreactivity to HTLV-I and HIV was characteristic only of lymphoma patients as sera from only 10 15% of AIDS and ARC patients in San Francisco had similar findings. PMID- 3828010 TI - Plasma atropine concentrations via intravenous, endotracheal, and intraosseous administration. AB - To date, there have been limited studies on the pharmacokinetics of intravenous atropine and no pharmacokinetic studies on the endotracheal or intraosseous administration of atropine. This study examines the time to peak plasma concentration of atropine following intravenous, endotracheal, and intraosseous administration in anesthetized monkeys using a triple crossover design. Plasma atropine was assayed by a radioreceptor method. The time to peak plasma concentration of atropine was shortest with intravenous administration; and longest with endotracheal administration. The mean plasma concentration of atropine was significantly higher in intravenous administrations than in endotracheal administrations at 0.75 and 2 minutes; compared to that noted in intraosseous administrations, the concentration was significantly higher only at 0.75 minutes. The mean plasma concentration of atropine administered intraosseously was significantly higher than that of endotracheal administrations at 5 minutes and was greater than that of intravenous and endotracheal administrations for the samples collected from 5 to 30 minutes. The endotracheal and intraosseous routes provide alternatives to the intravenous administration of atropine when intravenous access is limited or not available. PMID- 3828011 TI - Pediatric splenic trauma: predicting the success of nonoperative therapy. AB - The charts of all pediatric patients discharged from the Massachusetts General Hospital with a diagnosis of a ruptured spleen were reviewed over a six-year period to determine if any factors could be used to predict which children could be managed safely without operation. Seventy-five percent of these injuries were so managed. The patients who required surgical intervention were older (mean age, 17 years), had multiple injuries (mean ISS, 41), presented with more blood loss (mean hematocrit, 23.5%), and suffered their injuries as a result of a motor vehicle accident. The patients who were successfully managed nonoperatively were younger (mean age, 12 years), had fewer associated injuries (mean ISS, 18), required fewer blood transfusions, and suffered their traumas secondary to falls, sporting events, or altercations. We propose that the injury severity score, the number of units of blood transfused, patient age, as well as the type of trauma suffered be used to predict which patients can be safely managed nonoperatively. PMID- 3828012 TI - Thigh and leg compartment syndrome in the absence of lower extremity trauma following MAST application. AB - This report describes a patient with massive hemoperitoneum secondary to a gunshot wound. The patient sustained no lower extremity trauma but developed a thigh and leg compartment syndrome after application of military antishock trousers (MAST). This is an unusual complication, but if it is recognized and treated promptly, further morbidity can be avoided. PMID- 3828013 TI - Perforated stomach following the Heimlich maneuver. AB - The use of infradiaphragmatic abdominal pressure for relief of airway obstruction caused by food was first described by Henry Heimlich in 1974. Since that time, several complications have been reported. We report a case of gastric perforation occurring in a choking victim following the application of the Heimlich maneuver. PMID- 3828014 TI - Small bowel infarction and death from primary mesenteric venous thrombosis. AB - A case is reported of a young man who presented with complaints of epigastric abdominal discomfort secondary to unrecognized mesenteric venous thrombosis, an infrequent but critical condition causing abdominal distress. The patient subsequently died of small bowel infarction. This entity may occur as a primary phenomenon or secondary to a predisposing condition such as trauma, infection, or hypercoagulability. PMID- 3828015 TI - Cortical blindness and late postpartum eclampsia. AB - Blindness developed in a 22-year-old woman five days postpartum. She developed recurrent generalized tonic-clonic seizures despite early institution of intravenous magnesium sulphate. After a loading dose of phenytoin was given, the seizures stopped and the blindness gradually resolved. A review of the literature pertaining to blindness and eclampsia is presented and the use of phenytoin is discussed. PMID- 3828016 TI - Medicolegal interpretation of gunshot wounds. PMID- 3828017 TI - Emergency management of missile injuries to the brain: resuscitation, triage, and preoperative stabilization. PMID- 3828018 TI - Arrest team management of pediatric cardiopulmonary arrest. PMID- 3828019 TI - Acute blunt laryngeal and tracheal trauma. AB - Five cases of blunt trauma to the anterior neck were presented. It is most important to keep a high index of suspicion for the potential of total airway obstruction. Persons trained in establishing multiple types of emergency airways should be available until laryngotracheal damage has been ruled out, as the usual endotracheal tube or cricothyreotomy may be inadequate. PMID- 3828020 TI - Cerebral infarction with a single oral dose of phenylpropanolamine. AB - Phenylpropanolamine (PPA), a synthetic sympathomimetic that is structurally similar to amphetamine, is available over the counter in anorectics, nasal congestants, and cold preparations. Its prolonged use or overuse has been associated with seizures, intracerebral hemorrhage, neuropsychiatric symptoms, and nonhemorrhagic cerebral infarction. We report the case of a young woman who suffered a cerebral infarction after taking a single oral dose of PPA. PMID- 3828021 TI - Profound acidosis caused by isoniazid ingestion. AB - Isoniazid (INH) is the cause of one of the most common serious drug overdoses and can cause severe metabolic acidosis. We report a case of INH overdose that is most notable because the patient survived without apparent sequelae after experiencing an extremely low pH level (6.49). This is the lowest reported pH level with patient survival. Toxicity and pharmacology of INH and various aspects of metabolic acidosis are discussed. PMID- 3828022 TI - Respect and commitment in emergency medicine. PMID- 3828023 TI - Pneumatic antishock garments and the compartment syndrome. PMID- 3828024 TI - Open-chest cardiac massage esophageal trauma. PMID- 3828025 TI - Wound infection following high-pressure syringe and needle irrigation. PMID- 3828026 TI - The value of outpatient blood cultures in the emergency department. AB - The value of adult outpatient blood cultures was assessed by a retrospective chart review of all patients for whom cultures were obtained in an emergency department. Eighty-six of 411 patients for whom cultures were obtained were not admitted. Five of these 86 patients were identified as being bacteremic by positive blood culture growth the next day, and three of the five had endocarditis. All endocarditis patients had identifiable risk factors for this disease. Although blood cultures cannot be recommended for most patients discharged from the emergency department with a febrile illness, they are helpful in detecting endocarditis and other bacteremic conditions before obvious signs develop. PMID- 3828027 TI - The fluctuating incidence of human scabies. PMID- 3828029 TI - [Treatment of scabies with a dermatological lotion of decamethrin at 0.02%. Study of 127 patients using 2 therapeutic regimens]. PMID- 3828028 TI - [Rudolphitrema chilensis sp. nov. a new digenic parasite of the Chilean anura eusophus roseus (Leptodactylidae)]. PMID- 3828030 TI - [Epidemiology of toxoplasmosis in Chile. I. Prevalence of human infection, studied by the indirect hemagglutination reaction, in the 1st 3 regions. 1982 1985]. PMID- 3828031 TI - [Diphyllobothrium pacificum: the finding of plerocercoid larvae in marine fish of Peru and development of adult forms of the parasite in Canis familiaris]. PMID- 3828032 TI - [New concepts of the morpho-functional importance of the limbic system]. PMID- 3828033 TI - [Electrophysiologic aspects of the limbic system]. PMID- 3828034 TI - [Neural integration of food habits]. PMID- 3828035 TI - [Regulating mechanisms of eating behavior]. PMID- 3828036 TI - [Participation of dopamine in motivation]. PMID- 3828037 TI - [Pancytopenia and glue inhalation ]. PMID- 3828038 TI - [Seckel syndrome and multiple intestinal atresia]. PMID- 3828039 TI - [Human mycoses in Mexico]. PMID- 3828040 TI - [Serological survey of anti-Toxoplasma gondii antibodies in pregnant women]. PMID- 3828041 TI - [The flocculation-agglutination test in capillaries in the serologic diagnosis of typhoid fever in children]. PMID- 3828042 TI - [Gross articulatory substitutions in the diagnosis and treatment of velo pharyngeal insufficiency]. PMID- 3828043 TI - [Manganese, copper, iron and molybdenum in the early secretion of human colostrum]. PMID- 3828044 TI - Information processing in goal-directed movements. AB - Sensory-motor interaction in pointing at visual targets without sight of the pointing arm was evaluated in human subjects, using information theory. Equations were derived to determine transformation in channels with amplitude-continuous output signals, which overcome the problems involved in dividing the output into discrete bins. The equations were applied to calculate transinformation in our pointing experiment, and to predict transinformation under a variety of different experimental conditions. The results apply also to other systems that can be regarded as channels with similar properties. PMID- 3828045 TI - The performance of visual tasks while segments of the inferotemporal cortex are suppressed by cold. AB - Cold was used to suppress the function of subdivisions of the inferotemporal cortex. Three cryodes were placed bilaterally, one over the lower bank of the superior temporal sulcus (sts), one over the middle temporal gyrus (mtg) and one over the inferior temporal gyrus (itg). The animals were tested with delayed match-to-sample (DMS) and simultaneous visual discriminations. The DMS required the animal to recall a projected image of an object over delays of 0, 15, 30 and 45 s. The 3 cryodes were cooled separately during the performance of the DMS and only itg cooling produced a deficit. This was compared to the effects of ablative bilateral lesions; damage to itg but not mtg disrupted performance of DMS. The greatest deficit was in an animal with a small lesion in the ventral pole and anterior extreme of itg. Cooling individual cryodes was without effect on a discrimination between horizontal and vertical stripes, but produced a significant deficit from each of the 3 placements on a discrimination between monkey faces. Chance performance on all visual discriminations resulted from cooling all cryodes. Unilateral cooling of all cryodes produced significant effects on the face discrimination, but there was no significant difference between the two sides in the severity of the deficit. PMID- 3828046 TI - Natural syntax rules control action sequence of rats. AB - Knowledge of the principles by which behavioral sequences are generated is essential to progress in our understanding of neural mechanisms. We describe here a set of natural principles or syntax rules that organize the components of grooming and feeding. The behavioral stream of facial grooming or of taste elicited ingestive/aversive consummatory actions of rats can be viewed as a long series of individual movements linked together to form functional sequences. In order to ascertain the syntax rules that determine how these actions are linked together, many thousands of spontaneous grooming and elicited ingestive/aversive actions were videotaped and scored with a microcomputer. Techniques of information analysis of sequential stereotypy, tabulation of the sequential transitions between single actions and between action groups, and visual inspection for linear action chains, were employed to expose underlying rules of behavioral sequencing. These analyses revealed two global patterns: action perserveration and transitional reciprocation between sequential pairs and triplets, which together account for approximately 75% of all sequential transitions during grooming and ingestion/aversion. The pattern of transitional reciprocation could be divided further into patterns of alternation between individual actions on the one hand, and between perseverating bouts of actions on the other. Global syntax rules applied equally to actions emitted during grooming or during taste-elicited ingestion/aversion. In addition, a specific rule of linear chaining was found to apply only to facial grooming. These natural rules of action syntax provide insight into the sequential structure of behavior, and lend themselves well to analyses of neural mechanisms. PMID- 3828047 TI - Deafferentation does not disrupt natural rules of action syntax. AB - Natural rules of action syntax control the sequential order of grooming and ingestive/aversive actions emitted by rats. Grooming and ingestive actions share a common feature in that all are performed with or directed towards the mouth, tongue, and face. This study examined the role of orofacial somatosensory cues and feedback in the generation of natural action syntax. Bilateral deafferentation of the mandibular and maxillary branches of the trigeminal nerve was used to eliminate tactile sensation from the rostral face and mouth while preserving motor function. Neither the overall degree of sequential stereotypy (H) of grooming or ingestive sequences, nor the generation of particular natural sequencing rules were affected by trigeminal deafferentation. These natural rules appear to be specified by the brain without need of somatosensory feedback. PMID- 3828048 TI - Evaluation of stressor effects on intracranial self-stimulation from the nucleus accumbens and the substantia nigra in a current intensity paradigm. AB - The effect of uncontrollable footshock was evaluated in animals responding for intracranial self-stimulation from the nucleus accumbens and the substantia nigra (pars compacta) in a descending current intensity paradigm. Responding for brain stimulation from the nucleus accumbens was found to be affected by the stressor at the upper end of the rate-intensity curve. In contrast, responding for brain stimulation from the substantia nigra was unaffected by the stressor at any of the current intensities employed. The variations of responding for self stimulation from the nucleus accumbens were unrelated to alterations of locomotor activity or rearing. It is suggested that stressor-provoked reductions of responding for intracranial self-stimulation are not a result of the brain stimulation taking on aversive properties, but rather reflect a reduction in the reinforcing or motivational value associated with the stimulation. PMID- 3828049 TI - Associative control of tolerance to the sedative effects of a short-acting benzodiazepine. AB - The role of Pavlovian conditioning in tolerance to the depressant effect of a benzodiazepine (midazolam) on the ambulatory activity of rats was examined. The depression of activity by low doses (1.0 and 4.0 mg/kg, ip) of midazolam diminished quickly over repeated doses given at 48-hr intervals (Experiment 1). Equivalent tolerance was observed in groups measured at 2 min and 30 min after drug injection. When challenged with saline, however, drug-tolerant animals tested immediately after injection were hyperactive in comparison with nontolerant controls, whereas equivalent groups tested 30 min after injection were not. A second context was designed, and its discriminability from the original was established by assessing context-specific suppression of activity following exposure to mild electric shock (Experiment 2). In Experiment 3A, although tolerant animals tested in the drug-associated context remained fully tolerant, a second group demonstrated a complete loss of tolerance when given the drug in a saline-associated context. Both groups were fully tolerant when tested again in the drug-associated context after 14 drug-free days. In Experiment 3B, tolerance was significantly reduced by 14 extinction exposures to the drug associated environment without the drug. These results are uniquely predicted by associative models of drug tolerance and may have implications for the clinical use of this class of drugs. PMID- 3828050 TI - Contingency learning and causal detection in Hermissenda: I. Behavior. AB - The addition of extra light-alone or rotation-alone presentations to sequences of light-rotation pairings reduced the associative suppression of phototaxic behavior for the nudibranch Hermissenda. Training-induced changes in Type B photoreceptor light responses were found to parallel the training-induced behavioral changes in the intact animal. The decremental effects of the degraded contingency treatments upon neural and behavioral changes normally occasioned by light-rotation pairings reflected two processes. One factor was the increased stimulation frequency entailed by degraded contingency training. The second factor reflected the specifically unpaired character of the added light-alone or rotation-alone presentations, independent of frequency changes. The attenuation of phototaxic suppression was not because of a general habituation process or adaptation to the effects of either visual or vestibular stimulation. Instead, attenuation seemed to reflect a local interference effect of interspersed unpaired stimuli. The present experiments demonstrate a sensitivity to stimulus contingencies for Hermissenda similar to that of many vertebrates and indicate that contiguity and contingency relations are both encoded and stored in the Type B photoreceptors. The results indicate that similar neurophysiological mechanisms are involved. PMID- 3828051 TI - The topography of amphetamine and scopolamine-induced hyperactivity: toward an activity print. AB - The increased locomotor activity induced by systemic injections of d-amphetamine or scopolamine in rats was studied in Digiscan Animal Activity Monitors. This multifactorial analysis of locomotion demonstrated that activity measures of horizontal (ambulatory), vertical (rearing), stereotypic, and rotational behaviors differed depending on dose and drug. The topographies of these activity variables may be unique for the dopaminergic and cholinergic systems underlying hyperactivity. These results are a first step toward a needed increase in the sophistication of behavioral pharmacological techniques, allowing for the development of specific activity prints for different classes of psychoactive agents. PMID- 3828052 TI - Lateralization of emotionality in right parietal cortex of the rat. AB - Lesions of right parietal cortex in the rat increase activity in the open field compared with left parietal lesions, especially after section of the corpus callosum. Left or right motor or medial frontal cortex lesions do not have a lateralized effect. This evidence of a localized asymmetry between the cerebral hemispheres strongly implies that right parietal cortex has a role in emotionality in this species. Our findings suggest a functional similarity to right parietal cortex in man. PMID- 3828053 TI - Differential gastric ulceration in rats receiving shocks on either fixed-time or variable-time schedules. AB - Research suggests that predictable electric shocks produce less stress than unpredictable shocks. In this experiment, predictability was manipulated by using fixed-time (FT, predictable) and variable-time (VT, unpredictable) schedules of shock delivery. Rats receiving 3-mA, 1-s electric shocks on a FT 45-s schedule developed less gastric pathology than another group that was administered identical shocks on a VT 45-s schedule. It is argued that this finding represents a more subtle effect of predictability than has been obtained heretofore. PMID- 3828054 TI - Development of interocular equivalence in rats trained on a distal-cue navigation task. AB - What is learned about the visual world through one eye can be retrieved and used to guide behavior by the other eye. To study the development of this phenomenon, called interocular equivalence, we trained rats on a spatial learning task. Rats only 22 days old were able to learn this task with one eye, but they demonstrated no interocular equivalence. This capacity began to emerge when pups were 25 days old but was not robust until pups were 28 days old. That interocular equivalence emerges gradually during development suggests that the young rat, in some ways, may function as a split-brain animal. PMID- 3828055 TI - An evaluation of spatial information processing in aged rats. AB - The spatial learning abilities of young, middle-age, and senescent rats were investigated in two experiments using several versions of the Morris water maze task. In Experiment 1, Long-Evans hooded rats were trained to find a submerged escape platform hidden within the water maze. During this phase of testing, aged rats exhibited acquisition deficits compared with either young or middle-age subjects. With continued training, however, all age groups eventually achieved comparable asymptotic levels of performance. Subsequent testing in Experiment 1 revealed that following original training, aged rats were not impaired in learning a novel escape location or in their ability to locate a visible, cued escape platform. In an attempt to identify the basis of the age-related impairments observed in Experiment 1, naive young and aged rats in Experiment 2 were initially tested for their ability to locate a cued escape platform in the water maze. During this phase of testing, the escape latencies of both young and aged rats rapidly decreased to equivalent asymptotic levels. Subsequent analyses revealed that following cue training, young subjects exhibit a significant spatial bias for the region of the testing apparatus where the platform was positioned during training. In contrast, aged rats showed no spatial bias. Training was continued in Experiment 2 using a novel submerged platform location for each subject. During these place training trials, the escape latencies of senescent rats were longer than those of young subjects. These impairments were also accompanied by a lack of spatial bias among aged rats relative to young control subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828056 TI - Ontogeny of spatial navigation behaviors in the rat: dissociation of "proximal"- and "distal"-cue-based behaviors. AB - Rats can use both "proximal" and "distal" cues to locate goal objects in their environments (Morris, 1981). In the proximal-cue situation, local stimuli that spatially co-occur with the goal are available to guide behavior. In the distal cue situation, there are no cues that co-occur with the goal object; thus to directly locate the goal, the rat must learn about the spatial location of the goal relative to distal cues. Using the Morris water maze, we found that these two navigation behaviors are dissociated during ontogeny. Rats only 17-days-old are capable of using proximal cues to locate a safe platform. It was not until the rats were 20-days-old, however, that they began to display minimal evidence of distal-cue utilization. Control experiments indicated that the 17-day-old subjects' failure on the distal problem was likely due to their inadequate spatial learning skills. These results were interpreted within a Jacksonian perspective of brain-behavior relations. PMID- 3828057 TI - Hyperstriatal lesions and attention in the pigeon. AB - In two experiments, pigeons with bilateral lesions of the hyperstriatum were compared with unoperated control birds on tasks designed to test an attentional account of hyperstriatal function. In both experiments, hyperstriatal lesions disrupted reversal learning but did not influence the retardation of learning associated with either nonreinforced preexposure to the to-be-conditioned stimulus (Experiment 1) or prior nondifferential reinforcement to the to-be discriminated stimuli (Experiment 2). There was, however, evidence of an impairment in both the acquisition and maintenance of autoshaped responding in lesioned birds, an impairment which may reflect a disruption of classical associations in hyperstriatal pigeons. PMID- 3828058 TI - Maternal ethanol consumption: effect on skeletal muscle development in guinea pig offspring. AB - The effect of ethanol on developing skeletal muscle was analyzed by examining the gastrocnemius muscle from newborn guinea pigs, exposed to ethanol during the second half of gestation. Electron microscopy revealed vacuolated sarcoplasmic reticula, enlarged lipid droplets, decreased glycogen and mitochondrial abnormalities in the skeletal muscle samples from the ethanol-exposed newborn guinea pigs. None of these abnormalities were seen in the newborn controls who were born to dams which consumed the same amount of calories as the ethanol treated dams. The ethanol-associated abnormalities, seen in this study, are similar to those seen in ultrastructural examination of skeletal muscle from chronic alcoholics. PMID- 3828059 TI - The effects of ethanol on exploration in DBA/2 and C57Bl/6 mice. AB - The effect of ethanol (0.8, 1.6, and 2.4 g/kg) was assessed on the behavior of DBA/2 and C57Bl/6 mice in a holeboard test. Ethanol caused a dose-related decrease in the locomotor activity of the C57Bl/6 mice, and the highest dose also significantly decreased exploratory head-dipping. In contrast ethanol significantly increased the locomotor activity of DBA/2 mice. Only the lowest dose, however, significantly increased exploratory head-dipping, and the highest dose caused a marked decrease in exploration. These results emphasize the importance of distinguishing between the effects of ethanol on locomotor and exploratory activities. PMID- 3828060 TI - A role for taste aversion learning in FLA-57 induced reductions of voluntary alcohol intake. AB - It has been proposed by Amit, Brown and colleagues that the reduction in voluntary alcohol intake observed after the administration of FLA-57 in rats can be attributed to decreased NE levels produced by FLA-57. Our studies investigated whether a conditioned taste aversion could better explain this phenomenon. In the key study, two groups of rats were injected with FLA-57 or Ringers before drinking alcohol for five days, while a third group was injected with FLA-57 before exposure to intragastrically intubated (untasted) alcohol in amounts identical to those in the tasted group. Results showed that only the FLA-57 group that tasted alcohol reduced subsequent voluntary alcohol intake. When a CTA was precluded, allowing only for an effect due to reduced NE, no reduction was observed. This suggests that FLA-57 reduces VAI, not via reduced NE levels, but by a conditioned taste aversion. A second study, utilizing saccharin instead of alcohol, generally supported this conclusion. While these results support a CTA explanation, it is possible that under other conditions FLA-57 might produce a central pharmacological effect. PMID- 3828061 TI - Attenuation of ethanol metabolism by supplementary carnitine in rats. AB - The purpose of this study was to examine the effect of supplementary D,L carnitine on blood-ethanol levels and ascertain if the effect was a result of altered absorption or metabolism of ethanol. Mature male Sprague-Dawley rats were fed Purina Rat Chow as such or supplemented with various levels of D,L-carnitine. First it was established that supplementing carnitine at 1% (w/w) level produced steady state concentrations of carnitine in blood after 3 days of feeding. When a single dose of ethanol was given orally after 5 days of carnitine supplementation, the blood levels of ethanol remained significantly elevated for 2-8 hours in the carnitine supplemented animals. Time course of blood-ethanol concentrations revealed that carnitine did not affect the rates of ethanol absorption and therefore, the effect must be due to the attenuation of ethanol clearance from the blood. PMID- 3828062 TI - Alcohol preference in rats lacking gustatory neocortex. AB - Ingestion of alcohol solutions (in concentrations from 0.5 to 12% v/v) was examined in three experiments where rats lacking gustatory neocortex (GN) were compared with intact and control lesion rats. Two experiments tested alcohol consumption during a restricted schedule of fluid access with one or two bottle tests. The last experiment involved testing with continuous access to water and alcohol solutions in two bottle tests. Subgroups of rats in each experiment were presented with either an ascending or descending order of concentrations. In all experiments, GN rats consumed less total fluid during testing (relative to control rats). In general, GN rats exhibited similar patterns of alcohol consumption as that found in control rats. Where differences between GN rats and control rats were found, GN rats consumed more alcohol than control rats during tests with restricted fluid access. During continuous fluid access, however, no significant differences between GN rats and control rats were found. PMID- 3828063 TI - Ethanol metabolism by rat heart homogenates. AB - Supernatant of rat heart homogenates obtained by centrifugation at 700 X g for 10 min, incubated in the presence of ethanol (25 and 50 mM) and glucose (10 mM) were found to oxidize ethanol to acetaldehyde (AcH) in such a way that after 60 minutes of incubation around 5 to 8 nmole per mg of protein were recovered. The addition of glucose oxidase (5 micrograms/ml), a known hydrogen peroxide generator system, to the incubation medium, significantly increased by about ten times the recovery of acetaldehyde. On the opposite, the presence of 3-amino 1,2,4-triazole (10 to 40 mM), a known catalase inhibitor, induced a concentration dependent reduction of the amount of AcH recovered during incubation even in presence of glucose oxidase. These findings support the idea that a catalase mediated oxidation of ethanol is acting in rat heart homogenates. AcH content of a medium in which rat heart homogenates were incubated in the presence of NAD (0.7 mM) decreased by 87% at 60 minutes. This effect was not observed in the absence of NAD or in the simultaneous presence of NAD 0.7 mM and disulfiram 30 mM. This fact is consistent with an NAD dependent disposal of AcH by a DS sensitive enzyme. PMID- 3828064 TI - Buspirone attenuates volitional alcohol intake in the chronically drinking monkey. AB - Four macaque monkeys which showed excessive preference for ethyl alcohol solutions in a self-selection paradigm were used as subjects. Earlier these animals had been given intracerebroventricular (ICV) injections of human cerebrospinal fluid, which produced pharmacologically significant effects on the animals' alcohol consumption. The purpose of the present investigation was to determine whether the parenteral administration of a new anxiolytic compound, buspirone, would alter the pattern of alcohol drinking already established in the monkey. Initially the maximally selected concentration of alcohol of 12% was determined on the basis of a standard ad lib alcohol-water preference screen. Each monkey was offered 12% alcohol and water for a basal pre-injection period of 4 days. Then, on each of the next three days, either the saline control vehicle or buspirone, 1.25, 5.0 or 20.0 mg/kg, was injected intramuscularly at 930 and 1630 hours. On these days, behavioral observations were recorded before and after buspirone's administration in order to evaluate the latency as well as recovery from the drug's effect. Subsequently, a four-day post-injection, 12% alcohol water test was conducted. Although the saline control and 1.25 mg/kg dose of buspirone were without effect on alcohol intake, both the 5.0 and 20.0 mg/kg doses of buspirone attenuated significantly the consumption of alcohol by the monkeys. This reduction in terms of absolute g/kg as well as the proportion of alcohol to water ingested was approximately 30-60% of baseline intakes. Following buspirone treatment, the amount of alcohol consumed returned essentially to previously high levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828065 TI - Sensitivity of inbred and selectively bred mice to ethanol. AB - The Long-Sleep (LS) and Short-Sleep (SS) mice were bred for differences in sensitivity to ethanol as measured by duration of loss of the righting response (sleep time). The foundation population was a heterogeneous stock (HS) which was derived from a cross of eight inbred strains. Ethanol-induced sleep time and waking blood and brain ethanol levels were measured in the eight inbred strains, LS, SS and HS mice. The C3H and ISBI strains were quite resistant to ethanol as measured by sleep time, and only one, RIII, was very sensitive. Waking ethanol concentrations were similar for all of the inbreds, implying a narrow range of central nervous system sensitivity to ethanol. The HS mice had relatively short sleep times and blood ethanol levels equal to most of the inbred. The LS mice were significantly more, and the SS mice significantly less sensitive to ethanol than any of the inbreds or HS mice. These studies suggest that the extremes of CNS sensitivities to ethanol manifested by the LS and SS mice cannot be traced to any of the inbred strains, and must have arisen through the selection process by changes in allelic frequencies of those genes conferring ethanol sensitivity and resistance. PMID- 3828066 TI - Differential concentration-response curves for oral ethanol self-administration in C57BL/6J and BALB/cJ mice. AB - In an earlier study ethanol drinking was induced by reducing mice to 80% of their free-feeding weight and feeding them their daily food allotment prior to the experimental session. The mice were given an ascending series of ethanol concentrations (1 to 8%). The inducing condition was subsequently eliminated to determine if the drinking of 8% ethanol would persist in its absence. Eight percent ethanol served as a reinforcer for the C57BL/6J mice but not for the BALB/cJ mice. The purpose of the present study was to examine strain differences in ethanol maintained behavior over a range of concentrations from 1 to 32% (w/v). Ethanol served as a reinforcer for the C57BL/6J mice at concentrations of 4, 8 and 16%. Lever presses and volume of liquid consumed per unit of body weight were inverted U-shaped functions of ethanol concentration. Post-session blood ethanol levels confirmed intake of pharmacologically significant amounts of ethanol. Results with the BALB/cJ mice were very different from those with the C57BL/6J mice. The level of responding did not increase above baseline levels at any of the concentrations tested, and levels of responding decreased below baseline at 32%. Thus, ethanol did not serve as a reinforcer for the BALB/cJ mice at any of the concentrations tested. These results demonstrate that over a range of ethanol concentrations genotype is an important determinant of ethanol reinforced behavior. PMID- 3828067 TI - Enhanced acetaminophen toxicity associated with prior alcohol consumption in mice: prevention by N-acetylcysteine. AB - It is well established that hepatotoxicity is associated with an overdose of acetaminophen and that this hepatotoxicity can be increased by prior alcohol exposure in either humans or animal models. N-Acetylcysteine (NAC) has been developed as a tool to prevent the hepatotoxicity associated with acetaminophen overdosing. The present investigation observed that prior acute and chronic ingestion of alcohol to mice resulted in enhanced toxicity following acetaminophen injection. This increased toxicity was prevented by treatment with NAC. These results suggest that NAC may be a useful tool for combatting the enhanced acetaminophen toxicity associated with alcohol ingestion. PMID- 3828068 TI - Absence of effect of 3-amino-1,2,4-triazole pretreatment on blood ethanol levels after oral administration, in rats. AB - Blood ethanol levels registered in rats receiving 90 mmole/kg by gavage were not different in rats pretreated with aminotriazole (1 g/kg IP) 1 hour before, than in untreated controls. Results are consistent with the idea that no measurable gastrointestinal catalase first pass effect is present in rats. PMID- 3828069 TI - Reviews and comments on alcohol research. PMID- 3828070 TI - Application of hypoxia-induced shut down of replicon initiation to the analysis of replication intermediates in Ehrlich ascites cells. AB - Cultured Ehrlich ascites cells were subjected to hypoxic conditions for about 2 h, then reaerated or allowed to remain hypoxic. The newly formed DNA of hypoxic or reaerated cells was labeled with [3H]thymidine using different pulse and pulse/pulse-chase protocols. The chain length distribution of the labeled DNA molecules was analysed by sedimentation after lysing the cells on the top of alkaline sucrose gradients. The results indicated that the hypoxia effectively and reversibly suppressed the initiation of new replication units. Initiation, growth and integration of Okazaki pieces into active replicons was not noticeably affected. In marked contrast to aerobic cells, the use of hypoxic cells allows the separation of Okazaki pieces as a distinct class of pulse labeled short DNA chains. Short daughter DNA of very recently initiated replicons did not interfere at pulse times shorter than 4 min. For examination of the newly initiated replicons it seems favourable to trigger a burst of initiations by reaeration. PMID- 3828071 TI - Cholesterol esterification in mouse peritoneal macrophages in the presence of pathological human plasma lipoproteins. AB - Mouse peritoneal macrophages were incubated with abnormal lipoproteins (LP-X, HDL E, VLDL-p, IDl-p and LDL-p) from a patient with secondary deficiency in phosphatidylcholine-sterol acyltransferase, or with phosphatidylcholine/cholesterol liposomes, and the stimulation of cholesteryl ester formation was studied. Acetylated low density lipoproteins served as a control. It was found that macrophages incubated with LP-X, the other pathological lipoproteins or with liposomes did not show an enhanced cholesterol esterification. Also HDL-E had no effect despite of its high apoE content and the fact that apoE has been postulated to be the agonist in beta-VLDL binding to macrophages. PMID- 3828072 TI - Human Ile-Ser-bradykinin, identical with rat T-kinin, is a major permeability factor in ovarian carcinoma ascites. AB - Ascites from patients with metastatic ovarian carcinoma contains high amounts of an activity that increases vascular permeability, as easily detected by a rat skin test. Ascites was fractionated by gel permeation and reversed-phase high performance liquid chromatographies. The fractions were analysed for permeability increasing activity. In this way a peptide was isolated and identified as Ile-Ser bradykinin by sequence and amino-acid analyses. It is identical with T-kinin which has previously been detected as a product of an acute-phase protein, T kininogen, in rats but never in human material. The so far identified human kininogens, i.e. high- and low-molecular mass kininogens, can only release Met Lys-bradykinin or its degradations products, as Ile-Ser-bradykinin is not a part of their structure. However, the present results provide evidence that the permeability factor Ile-Ser-bradykinin under certain conditions can be produced in considerable amounts also by human tissues. PMID- 3828073 TI - The primary structure of bdellin B-3 from the leech Hirudo medicinalis. Bdellin B 3 is a compact proteinase inhibitor of a "non-classical" Kazal type. It is present in the leech in a high molecular mass form. AB - A proteinase inhibitor was isolated from extracts of the leech Hirudo medicinalis by gel filtration and anion exchange chromatography. This inhibitor is similar to the bdellins in that it blocks the activity of trypsin, plasmin and sperm acrosin but has a molecular mass, as estimated by SDS polyacrylamide electrophoresis, of about 20 kDa, whereas the bdellins have molecular masses in the range 5-6 kDa. It is therefore designated as high-molecular mass bdellin B-3 (HMB). The amino-acid sequence of the inhibitor was elucidated as far as position 56. This revealed that the molecule consists of a bdellin B-3 moiety, corresponding to the N terminal 46 residues, which is then extended at the C-terminus by a polypeptide chain of the composition Asx15, Glx25, Gly6, Val, His26-27 and Lys4. It has been formerly concluded from a partial amino-acid sequence that bdellin B-3 is a Kazal type inhibitor. However, the complete sequence of bdellin B-3, represented by the N-terminal 46 residues of HMB, discloses that bdellin B-3 is a non-classical Kazal-type inhibitor when the number of amino-acid residues between half-cystines are considered. Presuming that formation of disulfide bridges principally follows the same pattern as in classical Kazal-type inhibitors the bdellin B-3 molecule was modeled based on the known three-dimensional structure of the third ovomucoid domains. This showed that a compact arrangement of the peptide chain of bdellin B 3 is conceivable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828074 TI - The primary structure of a mouse-eared bat (Myotis velifer, Chiroptera) hemoglobin. AB - The hemoglobin of the Mouse-Eared Bat Myotis velifer consists of one component. We present the primary structures of the alpha- and beta-globin chains which have been separated by chromatography on carboxymethyl-cellulose CM-52. The sequences have been determined by Edman-degradation with the film technic or the gas phase method, using the native chains and the tryptic peptides, as well as the C terminal prolyl-peptides obtained by acid hydrolysis of the Asp-Pro-bonds. Compared to the corresponding human chains we found only 13 substitutions in the alpha-chains, but 27 in the beta-chains. The amino-acid residues substituted in the alpha-chains are not involved in any contacts, whereas in the beta-chains, one exchange involves a heme contact, three alpha 1/beta 1- and one alpha 1/beta 2-contacts, the latter [beta 43(CD2)-Glu----Thr] brings for the first time threonine in this position of the beta-chains. Comparison with the Egyptian Fruit Bat (Rousettus aegyptiacus) shows 12 and 25 substitutions in the alpha- and beta chains, respectively, suggesting a large phylogenetic distance between Micro- and Megachiroptera. We consider this primary structure as a contribution towards solving the problem of the origin of bats and their relation to primates. PMID- 3828075 TI - Amino-acid sequence of the alpha and beta chains of adult hemoglobin of the harbor seal, Phoca vitulina. AB - The complete amino-acid sequences of the alpha and beta chains of adult hemoglobin of harbor seal, Phoca vitulina that belong to carnivora were determined as follows. The alpha and beta chains isolated by chromatography on a CM-cellulose column were digested with trypsin after S-carboxymethylation. Amino acid sequences of the tryptic peptides derived from both chains were analysed. Comparing the primary structures of the alpha and beta chains of the seal hemoglobin with those of human, dog, bear, badger and cat, 19, 12, 12, 11, and 16 substitutions, respectively, were recognized in the alpha chain, and 12, 10, 4, 6, and 19 (22) in the beta chain. PMID- 3828076 TI - Protein pico-sequencing with 4-([5-(dimethylamino)-1-naphthylsulfonyl]amino) phenyl isothiocyanate. AB - A novel manual liquid phase protein sequencing method using the fluorescent reagent, 4-([5-(dimethylamino)-1-naphthylsulfonyl] amino) phenyl isothiocyanate proposed by Jin et al. (FEBS Lett. 198, 150, 1986) has been established. This method allowed sequence determination using 100 pmol and 1 nmol of insulin B chain (oxidised) for 9 and 19 cycles respectively with thin-layer chromatographic identification of the fluorescent thiohydantoin amino-acid derivatives. The method compares favorably in sensitivity with other conventional manual protein sequencing methods. PMID- 3828077 TI - High altitude respiration of birds. The primary structures of the major and minor hemoglobin component of adult European black vulture (Aegypius monachus, Aegypiinae). AB - The primary structures of the hemoglobin components Hb A and Hb D of the European Black Vulture (Aegypius monachus) are presented. The globin chains were separated on CM-Cellulose in 8M urea buffer. The amino-acid sequences were established by automatic Edman degradation of the globin chains and the tryptic peptides in liquid phase and gas-phase sequenators. The sequences are compared with those of the Golden Eagle, and with those of the Andean Condor, a New World vulture. The possible evolutionary significance of the alpha D-chains is considered. This paper serves as a reference study for high-altitude respiration of Falconiformes. PMID- 3828078 TI - Primary structure of the hypertrehalosaemic factor II from the corpus cardiacum of the Indian stick insect, Carausius morosus, determined by fast atom bombardment mass spectrometry. AB - The primary structure of hypertrehalosaemic factor II, isolated from the corpus cardiacum of the Indian Stick Insect Carausius morosus, has been assigned as Glu Leu-Thr-Phe-Thr-Pro-Asn-Trp-Gly-Thr-NH2 from its fast atom bombardment (FAB) mass spectrum and metastable scans of its FAB spectrum. The structure assigned shows close homology to other insect neuropeptides. A synthetic sample of this peptide gave the same FAB spectra, reversed-phase high-performance liquid chromatographic behavior, and biological behavior as the natural material. Mass spectrometric fragmentation of the synthetic peptide was examined by B/E linked scan and MIKES techniques in a two-sector mass spectrometer and by the MS/MS technique in a four sector (tandem) spectrometer. PMID- 3828079 TI - Three modes of age-related changes of hydrolytic enzymes in murine brain. AB - We followed the time course of the activities of various hydrolytic enzymes in murine brain for 30 months to investigate their roles in the aging process. Although most of the 15 enzymatic activities tested tended to rise with the increase in age, by analyzing them by multivariate analysis their movements could be divided into three types, each having a particular mode of nonlinear regression: exponential, logarithmic, or parabolic. Several enzymatic activities, including those of angiotensin-converting enzyme, esterase, trypsin-like enzyme, post-proline-cleaving enzyme, and Gly-Pro-aminopeptidase, showed rhythmic oscillations with about one cycle per 3 months throughout the period of 30 months. The behavior of these enzymes probably represents some particular aspect of metabolism relatively independent from the aging process. These findings may provide a fundamental clue in association with the process of maturation and aging in the brain. PMID- 3828080 TI - Vitamin C partially reversed some biochemical changes produced by vitamin E deficiency. AB - Feeding a basal diet free of vitamins E and C to weanling male rats for 8 months resulted in biochemical changes characteristic of vitamin E deficiency. These included increased liver thiobarbituric acid values; decreased blood GSH levels, plasma vitamin E levels, and glutathione peroxidase activities; and increased activities of plasma pyruvate kinase, glutamic-oxaloacetic transaminase, creatine kinase, lactic dehydrogenase, and malic dehydrogenase. Tube-feeding vitamin C for 21 days resulted in partial reversal effects on the above parameters except activities of glutathione peroxidase, lactic dehydrogenase, and malic dehydrogenase. The results suggest that vitamin C may spare in part the metabolism of vitamin E through its antioxidant property. PMID- 3828082 TI - Polymer phase partition in the purification of cytochrome P-450 and cytochrome b5 from the yeast Brettanomyces anomalus. AB - About 0.5% of the total cellular protein in the yeast Brettanomyces anomalus is membrane-bound cytochrome P-450, when this yeast is grown in the presence of 5% glucose as the main carbon and energy source. A partial purification of cytochrome P-450 by phase partition is described. Breakdown of yeast cell walls with microbial enzyme preparations led to extensive losses of this hemoprotein. Instead, by a carefully controlled mechanical breakage as much as 50% of the total cellular cytochrome P-450 could be recovered. During the solubilization of cytochrome P-450 from the cell homogenate with Triton X-100, the protective agents dithiothreitol, EDTA, and butylated hydroxytoluene prevented major losses of the hemoprotein. Applying a three-phase partition system (polyethylene glycol Ficoll-dextran) to the solubilized whole cell homogenate in the presence of 1 M sodium chloride, followed by a precipitation of the top "oily layer" with 25% polyethylene glycol, a 25- to 60-fold enrichment of cytochrome P-450 was obtained. This corresponds to a specific content of 0.8-2.2 nmol of cytochrome P 450 per milligram of protein. Cytochrome b5 enriched (41%) to the PEG-Ficoll interphase, and NADPH-cytochrome c reductase and "cytochromes P-420" to the Ficoll and dextran phases. The polymer phase partition system thus serves as an excellent initial purification step of cytochrome P-450 without a need for the preparation of the microsomal fraction. Another advantage of the method is that it allows the simultaneous partial purification of cytochrome b5. PMID- 3828081 TI - Immobilization of lactate dehydrogenase on polyacrylamide beads. AB - Pig muscle lactate dehydrogenase (L-lactate:NAD oxidoreductase, EC 1.1.1.27) was covalently immobilized on polyacrylamide beads containing carboxylic functional groups activated by water-soluble carbodiimide. The effects of immobilization on the catalytic properties and stability of the lactate dehydrogenase were studied. There was no shift in the pH optimum of the immobilized enzyme compared to that of the soluble one. The apparent optimum temperature of the soluble enzyme was 65 degrees C, while that of the immobilized enzyme was between 50 and 65 degrees C. The apparent Km values of the immobilized enzyme with pyruvate and NADH substrates were higher than those of the soluble enzyme. As a result of immobilization, enhanced stabilities were found against heat treatment, changes in pH, and urea denaturation. PMID- 3828083 TI - Serum decreases permeability of some compounds from liposomes. AB - Although serum is generally regarded to increase the permeability of liposomes containing entrapped substances, we found that a low concentration of serum (10%) significantly reduced the permeability of liposomes to the spin label tempocholine chloride and the polar drug methotrexate, although it increased the permeability of the lipid-soluble drug actinomycin D. Liposomes containing sphingomyelin and cholesterol were considerably less permeable than liposomes containing phosphatidylcholine and cholesterol. Although a higher concentration of serum (88%) increased the permeability of liposomes containing either lipid, the amount of tempocholine which had leaked from sphingomyelin-containing liposomes in 88% serum after 50 h at 37 degrees C was only 25%, three times less than that from phosphatidylcholine-containing liposomes. Thus the effect of serum on liposome permeability depends on the compound entrapped as well as the type of lipid used. PMID- 3828084 TI - The effect of various coupling methods on the adsorption of serum proteins by immobilized concanavalin A. AB - Concanavalin A was coupled to Sepharose 6B after activation by cyanogen bromide, divinyl sulfone, or glutaraldehyde and its adsorption behavior toward human serum proteins was investigated. The capacity and selectivity of the lectin were influenced markedly by the method used for its immobilization. When coupled to agarose via CNBr, the resulting absorbent showed the highest capacity and the lowest selectivity relative to the other two derivatives. When coupled to agarose via divinyl sulfone, the lectin exhibited high selectivity but its adsorption capacity was significantly reduced. Coupling to agarose via glutaraldehyde gave an absorbent that behaved, in some respects, differently from the other two. The variability in the adsorption behavior of the immobilized concanavalin A is attributed in part to variations in the degree of multipoint attachment of the lectin or its subunits to the agarose matrix. The selectivity increases also with increasing sample load, irrespective of the coupling method used, apparently due to protein-protein displacement. PMID- 3828085 TI - Utilization of porcine pancreatic phospholipase A2 for the preparation of a marine fish oil enriched in (n - 3) polyunsaturated fatty acids. AB - A simple and rapid method is described for the preparation of a marine oil fraction highly enriched in (n - 3) polyunsaturated fatty acids. Cod roe, containing lipid up to 15% of its dry weight, approximately 70% of which is phospholipid, was the starting material. Incubation of a concentrated aqueous extract of the roe with porcine pancreatic phospholipase A2 (EC 3.1.1.4) was the key step in the procedure. Extraction of the freeze-dried reaction product with diethyl ether containing formic acid produced an oil in a yield of 1.0 g/100 g wet wt of starting roe. The oil contained over 95% as free fatty acids, with 20:5 (n - 3) and 22:6 (n - 3) accounting for up to 24 and 40%, respectively, of the total free fatty acids. The therapeutic use of the oil is mentioned. PMID- 3828086 TI - Animal and cellular models of Gaucher's disease. I. Refractoriness of thio analogs of glucocerebroside to enzymatic hydrolysis. AB - In order to develop a nonmetabolizable analog of glucocerebroside to investigate the distribution and accumulation of this lipid in model systems, thiohemiacetal derivatives were synthesized and their susceptibility to enzymatic hydrolysis by purified human placental glucocerebrosidase was examined. Sulfur analogs were found to be completely refractory to the activity of this enzyme, indicating their potential use in animal and isolated cell models and possibly for the preparation of affinity chromatography columns for the isolation of glucocerebrosidase. PMID- 3828088 TI - [Delta co-infection: prevalence, severity and association with risk factors]. AB - The prevalence of delta coinfection in course of acute B hepatitis has been studied in two periods (September-November 1984: 51 cases; April-June 1985: 50 cases). The prevalence resulted of 37.2% in the first period and of 48% in the second, without a statistically significant increase. Delta coinfection did not show greater severity, as evaluated by the levels of AST, ALT, total bilirubin and prothrombin activity, than hepatitis B not coinfected. The only factor of risk statistically significant for the acquisition of delta coinfection was i.v. drug abuse. PMID- 3828087 TI - [Comparative evaluation of the diagnostic specificity and sensitivity of various 3d generation tests for the detection of markers of hepatitis B virus in serum- II--anti-HBc IgM]. AB - The authors have evaluated comparatively the diagnostic reliability of four RIA or ELISA tests for the determination of the anti-HBc IgM in serum. Statistically it has been possible to point out significant differences as regards the various Kits. PMID- 3828089 TI - [Natural history of the state of asymptomatic carrier of HBsAg: 7-year follow up]. AB - Ninety-six chronic asymptomatic HBsAg carriers underwent liver biopsy. Liver histology was normal in 5 cases, showed nonspecific changes in 67, chronic persistent hepatitis in 18, and chronic-active hepatitis in 6. Seventy-four patients were followed for up to 105 months (mean 80 months) in order to evaluate the occurrence of clinical, biochemical, serological or histological changes. Only two patients cleared the HBsAg, respectively 10 and 96 months after undergoing liver biopsy; the latter patient became anti-HBs positive 6 months after he cleared HBsAg. All 10 patients who initially were negative for both HBeAg and anti-HBe became anti-HBe positive during follow-up. All 4 patients who were HBeAg positive at the time of liver biopsy cleared HBeAg 6 to 39 months thereafter. Two of them became anti-HBe positive. None of the patients initially HBeAg negative became positive for this antigen during follow-up. Significant increases of serum transaminases were observed in 5 patients; in one superinfection by delta agent was documented, the other 4 being constantly anti delta negative. Three of the latter patients underwent repeat liver biopsy, which showed progression from minimal changes to chronic persistent hepatitis in one, and from minimal changes to chronic active hepatitis in another. In the third patient, repeat biopsy showed persistence of chronic persistent hepatitis. IN CONCLUSION: chronic hepatitis occurs in about 25% of chronic asymptomatic HBsAg carriers; clearance of HBsAg is a rare event among these patients; the HBe system has little diagnostic or prognostic value; delta superinfection is rare; however, deterioration of liver histology may occur even in the absence of delta superinfection. PMID- 3828090 TI - Antibacterial activity of six beta-lactams and six quinolones against urinary gram negative bacteria. AB - Three hundred eighty seven gram negative bacterial strains were isolated from urine specimens of as many patients affected by urinary tract infections. Susceptibility of bacteria to six quinolones (ciprofloxacin, norfloxacin, oxolinic, nalidixic, pipemidic acid and cinoxacin) and six beta-lactams (ceftazidime, ceftizoxime, ceftriaxone, cefamandole, cefoxitin and cefotaxime) was studied determining the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of each compound by a miniaturized dilution broth method. Ciprofloxacin, a quinoline carboxylic acid compound structurally related to nalidixic acid, and ceftazidime a new beta-lactamase stable beta-lactam showed a much higher antibacterial activity against all the bacterial strains including Pseudomonas. The best antibacterial activity of ciprofloxacin and ceftazidime was expressed either by the lower MICs and lower MBCs with respect to those of the other compounds or by a low MBC/MIC ratio, which represent an important clinical advantage in clinical practice. PMID- 3828091 TI - Fluctuations of NK activity in human volunteers receiving vitamin A or a placebo daily. AB - This paper examines the effect of prolonged daily administration of Vitamin A on NK activity. A placebo and a pill containing 50,000 IU retinol acetate (RA) were taken daily for 120 days by 5 and 6 healthy volunteers respectively. NK activity was determined on days -45, -40, -30 and -10 to calculate each volunteer's inherent variability and then twice a month throughout the administration period. To minimize the experimental variability, an internal control was inserted in each assay. This consisted of two lymphocyte preparations from two healthy individuals divided into cryopreserved aliquots. The cytotoxicity percentage in each assay was corrected against these reference standards and converted into NK values by angular transformation. No increase in NK activity was noted during the study in the group receiving RA. A marked individual variability, however, was noted in both groups. PMID- 3828092 TI - [Level of protection against tetanus in an outpatient population]. AB - Protection levels against tetanus toxin were estimated in 332 patients, at our Laboratory, by means of the passive haemagglutination with turkey erythrocyte test. The testing showed that the protection level decreases with age, it is higher among males in those over 30 yrs; roughly 10% of those who were not vaccinated were protected. Furthermore, it has been demonstrated that in some cases the protection level remains high even after a long period of time since the last vaccination, whereas a certain percentage of the recently vaccinated patients is not protected; consequently the effectiveness of the vaccination must be checked by measuring the antibody titers. PMID- 3828093 TI - [Cutaneous reactions to ubiquitous antigens in a young population hospitalized for minor pathologies]. AB - Delayed hypersensitivity was evaluated by means of skin testing with ubiquitous antigens (Candidin, Tricophytin, Varidase and PPD) in a population of 233 young subjects (mean age 21 years, range 19-24) referred to the Army Hospital of Milan for minor pathologies. The results show a high incidence of anergies (20.1%) and hypoergies (50.9%) in the sample studied and low percentages of positive responses to Candidin (12.45%), Tricophytin (3%) and PPD (15.9%). A significant enhancement of the percentages of anergic subjects has also been observed in two subgroups selected on the basis of blood lymphocyte count (less than 1250 cells/mm2) (p less than 0.01) and on gamma-globulin levels (greater than 1.5 g/100 ml) (p less than 0.05). The observed findings are discussed. PMID- 3828094 TI - [Serum immunoconglutinin in patients with a respiratory allergy syndrome, before and after specific immunotherapy]. AB - Immunoconglutinins (Ic) are a group of predominantly IgM antibodies formed towards antigenic determinants exposed in fixed complement components (C3b and C4). Ic production is stimulated by bacterial and viral infections; elevated titers were also found in a number of other diseases involving completement fixing reactions in vivo. High titers have been associated with the infectious morbidity within a particular population. The object of this investigation was to determine the correlations of autostimulated Ic titre with several parameters in 100 atopic nondesensitized subjects with respiratory allergies and in 140 non atopic, healthy, individuals. Eighty of them had rhinitis and/or conjunctivitis, 9 asthma and 11 rhinitis and asthma. All the atopics were studied also after at least 6 months of specific immunotherapy. None of the subjects received any other therapy at the time of study. Atopic subjects with high titers of Ic are significantly more numerous than controls, without significant correlation with the kind and beginning of atopic syndrome, and with immunotherapy. These results might be attributed to a higher incidence of infections in the atopic population. The Ic might play an important role in the immunoregulation involving complement system. PMID- 3828095 TI - House mite dust bronchial asthma: clinical and epidemiological observations. AB - The incidence of respiratory allergy in an adult population from Lazio is reported. A high prevalence rate of bronchial asthma was found, whereas the evolution of allergic rhinitis into bronchial asthma was less pronounced than that reported for childhood allergy. The mean age of onset of the symptoms was 15 +/- 5 years. A remarkable number of patients suffered from oculorhinitis, which resulted in bronchial asthma in a mean time of 5 +/- 3 years. Most of the patients came from Rome and were low-middle class. Previous history of possible co-factors in the development of respiratory allergies showed a high percentage of family atopy and of asthmatiform bronchitis. Studies of allergens responsible for disease revealed that house mite dust and Dermatophagoides are the major allergens responsible for the symptoms. An analysis of the most common therapy used for treating patients demonstrated a prevalence of anti-histamine, DSCG and chetotifen whereas cortisone treatment and hospitalization were less overspread. The present epidemiological survey shows a prevalence of adult onset bronchial asthma due to house mite dust. The importance of this observation in preventive medicine programmes is discussed. PMID- 3828096 TI - [Antipneumococcal vaccination: comparison between vaccines]. AB - Fourteen antigen and 17 antigen polyvalent vaccines against Str. pneumoniae have been tested on 137 healthy volunteers. They have been shown to cause side-effects infrequently. A two-fold or higher increase of antibody concentration (detected by RIA) has been demonstrated in 80% of the vaccinees against all antigens of the 17 valent vaccine; while such increase has been demonstrated only for 12 out of 14 antigens in the other vaccine (for the other two antigens the percentages have been 66.7% (antigen 1) and 73.7% (antigen 12F). It is stressed that the use of these vaccines is particularly recommended for the prevention of pneumococcal diseases in higher risk subjects. PMID- 3828098 TI - The medicinal plants in our time. PMID- 3828097 TI - [Changes in the response time of anti-HBc IgM in a hepatitis B case load. Diagnostic implications]. AB - Anti-HBc IgM were determined in 46 patients whose serum was positive for hepatitis B surface antigen (HBsAg). All sera were tested from 1:4000 up to 1:8128000 dilution with a radioimmunometric assay. Anti-HBc IgM persisted at detectable level for up 15 months from acute infection in more than 50% of the patients. High levels of anti-HBc IgM are seen only in the acute phase but it is difficult to establish a cut-off dilution displaying diagnostic value between current and remote infection. Anti-HBc IgM are always detectable in acute hepatitis B virus (HBV) so that the absence of HBc IgM in acute hepatitis with positive HBsAg allows to discard HBV as the causative agent and to suspect a non B hepatitis (A, delta, NANB). On the contrary the presence of anti-HBc IgM in detectable amounts in patients with acute hepatitis and negative HBsAg makes possible the diagnosis of acute B virus hepatitis. PMID- 3828099 TI - [Bioengineering, pharmaceutical development and control of contamination: the three components of pharmaceutical engineering and their influence in advanced methods of production]. PMID- 3828100 TI - Methods in heparin depolymerization: oligo-heteropolysaccharides as antithrombotic agents. New frontiers in prophylaxis of venous thrombosis. PMID- 3828101 TI - [Characterization of Mycoplasma isolated from human and animal matter: cultural, morphological and biochemical tests]. PMID- 3828102 TI - Urinary and biliary excretion kinetics of ketamine and its metabolites in the rabbit. PMID- 3828103 TI - Antibacterial activity of cholane compounds: amido and amino derivatives (VI). PMID- 3828104 TI - Nonlogical factors in research: chance and serendipity. AB - Although successful biological research appears to be based on logical inference, on systematic accumulation of information, and on evaluation and hypothesis testing, many nonlogical, unpredictable factors may play an important role or even open new avenues of research. These may include emotional decisions, laboratory accidents, the impact of unanticipated external events, unplanned interactions with other scientists, and relationships with graduate students and postdoctoral fellows. Based on personal experiences, the impact of such nonlogical factors, if exploited fully, can be considerable. PMID- 3828105 TI - Comparison of glucose transport mechanisms at opposing surfaces of the renal proximal tubular cell. AB - This review contrasts the glucose transport mechanisms at opposing surfaces of the renal proximal convoluted tubule: the Na+-dependent D-glucose transporter localized at the brush border membrane and the Na+-independent transporter localized at the basolateral surface. The two sugar transport mechanisms are discussed from the point of view of their specificity, kinetic, and regulatory behaviors. Recent results focussing on molecular characterization of these different carrier proteins are also described, including some newer information on purification of the Na+-dependent glucose carrier from the brush border membrane. PMID- 3828106 TI - Selective loss of uncoupling protein from mitochondria of surgically denervated brown adipose tissue of cold-acclimated mice. AB - The effects of unilateral surgical denervation on brown adipose tissue (BAT) composition were evaluated to assess the importance of the sympathetic innervation in the maintenance of a high concentration of the uncoupling protein thermogenin in cold-acclimated (CA) mice and to assess whether suppression of neural activity could account for BAT atrophy observed during fasting or when CA mice are returned to a thermoneutral environment (33 degrees C). Denervation induced BAT atrophy was characterized by protein and thermogenin losses in absence of changes in the tissue cellularity (DNA content). There was a marked reduction in the concentration of thermogenin in mitochondria isolated from denervated BAT, but the concentration of the adenine nucleotide translocator was unchanged. Fasting or exposure of CA mice to 33 degrees C induced a rapid and extensive loss of tissue protein from both innervated and denervated BAT. In CA mice exposed to 33 degrees C, there was also reduction in tissue cellularity and loss of thermogenin from BAT mitochondria. Since surgical denervation suppressed BAT hyperplasia and the increase in the mitochondrial concentration of thermogenin observed during cold exposure, these results indicate that an intact innervation is required for both synthesis and maintenance of a high mitochondrial content of thermogenin in CA mice. In addition, the lesser changes in tissue composition caused by denervation compared with those caused by fasting or exposure of CA mice to 33 degrees C question the importance of the suppression of neural activity as the exclusive cause of rapid BAT atrophy in mice. PMID- 3828107 TI - Modulation by phenobarbital of the differentiation of 3T3 preadipocytes. AB - The effect of phenobarbital upon the differentiation of two preadipocyte cell lines, 3T3 F442A and 3T3 L-1, was examined by measuring the synthesis and secretion of lipoprotein lipase. Extracellular enzyme was measured by treating intact cells with heparin, and the intracellular enzyme was subsequently assayed in cell homogenates. When confluent cultures of 3T3 F442A cells were treated with insulin, the cells underwent differentiation as indicated by increased activity of lipoprotein lipase within 6 days, followed in turn by increased levels of protein and triglyceride. Addition of phenobarbital with insulin enhanced total lipoprotein lipase, protein, and triglyceride content. The activity of lipoprotein lipase accumulated in the heparin-releasable fraction during differentiation was increased 2- to 3-fold and the intracellular enzyme was enhanced 15- to 20-fold by the addition of phenobarbital. The ability of phenobarbital to modulate differentiation was dependent upon the time of addition. When added early in the postconfluent period, there was a greater increase in lipoprotein lipase activity than when the drug was added at later times. Phenobarbital also stimulated lipoprotein lipase in differentiating 3T3 L 1 cells in the presence of insulin, although lipoprotein lipase activity was moderately enhanced by phenobarbital alone in these cells. These results suggest that phenobarbital may affect the conversion of adipoblasts into preadipocytes and thereby increase the proportion of cells susceptible to the differentiating stimulus. PMID- 3828108 TI - Correlations between the 44D7 antigenic complex and the plasma membrane Na+-Ca2+ exchanger. AB - The exchange of Na+ for Ca2+ across the plasma membrane is mediated by a carrier transport system known as the Na+-Ca2+ exchanger. We have recently reported the specific inhibition of Na+-Ca2+ exchanger activity in cardiac and skeletal muscle sarcolemmal vesicles by monoclonal antibody 44D7. In this review, we summarize the properties of the 44D7 monoclonal antibody and the antigenic complex reacting with this antibody. The 44D7 antibody was produced against human acute lymphocytic cells and recognizes a molecular complex composed of two subunits of the apparent molecular weights 95 000 and 38 000, linked by disulfide bonds. Two other monoclonal antibodies react with the same complex:4F2 which binds to the same epitope as 44D7 and specifically inhibits the Na+-Ca2+ exchanger activity, and 44H7 which reacts with a distinct epitope and does not inhibit exchanger activity. The 44D7 antibody reacts with nerve fibers in brain and proximal convoluted tubules of kidney, both known to possess Na+-Ca2+ exchanger activity. Reactivity of 44D7 antibody with tonsil and thymus sections is restricted to certain subpopulations of cells. The reactivity of the antibody is very weak with resting lymphocytes in suspension; however, activated T lymphocytes and leukemic cells show increased binding to 44D7 antibody. Several malignant cell lines express high levels of the 44D7 antigen. The reactivity of a human hepatoma with 44D7 antibody is much greater than that observed with normal hepatocytes. The inhibition by monoclonal antibody 44D7 of the Na+-Ca2+ exchanger activity and the similarity in tissue distribution of the 44D7 antigenic complex and the exchanger system suggests that these two molecules might be related.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828109 TI - Chemical and genetic comparison of the glucose and nucleoside transporters. AB - Glucose and nucleoside uptake into human red cells occurs through protein(s) which copurify in a complex, known as band 4.5 of relative mass (Mr) 66,000 to 50,000. The specific inhibitor of glucose transport, [3H]cytochalasin B, and the specific inhibitor of nucleoside transport, [3H]nitrobenzylthioribofuranosylpurine ([3H]NBMPR), incorporate covalently into component(s) of band 4.5 upon irradiation with ultraviolet light. Both photolabelled components are shown to be glycoproteins, since their migration in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) is increased after treatment of photolabelled band 4.5 with endoglycosidase F. Peptide maps of the photolabelled components were compared. Red cell membranes were photolabelled with either [3H]cytochalasin B or [3H]NBMPR and subjected to SDS-PAGE. The region containing band 4.5 was cut and transferred to a second SDS-PAGE system and exposed to either papain or Staphylococcus aureus V8 protease. Papain (5 micrograms) completely cleaved band 4.5 and produced fragments of Mr 33,000, 26,000, 21,000, 15,000, and 12,500. Of these, the 21,000 fragment was the most conspicuous and it retained the label of [3H]cytochalasin B; the 33,000 fragment retained the label of [3H]NBMPR. The V8 protease (0.75 microgram) completely cleaved band 4.5 and produced fragments of Mr 35,000, 28,000, 22,000, 16,000, 13,500, and 9,000. The 28,000 fragment retained the label of [3H]cytochalasin B. The label of [3H]NBMPR was distributed along the gel in several regions comprising the 35,000, 28,000, and 16,000 fragments. Longer treatment with the V8 protease did not alter the position of the 28,000 [3H]cytochalasin B labelled peak, but completely abolished the [3H]NBMPR labelled peaks. Genetic segregation of the glucose and nucleoside transporters was determined in a lymphoma cell line. A mutant (14T- g) of S49 cells was selected which had lost the capacity to transport thymidine or to bind NBMPR. Uptake of either 2-deoxyglucose or 3-O methylglucose, inhibitable by cytochalasin B, was not impaired in this mutant. It is concluded that the nucleoside and glucose transporters are glycoprotein components of band 4.5, which are differentiated by peptide map analysis. Further, a lymphoblast mutant was isolated which had lost the nucleoside transport function but retained the glucose transport function. PMID- 3828110 TI - Changes in cytoplasmic free calcium caused by halothane. Role of the plasma membrane and intracellular Ca2+ stores. AB - Malignant hyperthermia is a muscle disease characterized by an abnormal response to anaesthetics, stress, and exercise. It is typified by muscle contracture and a dramatic elevation in body temperature. A defect in the regulation of the concentration of cytoplasmic free calcium, [Ca2]i, is thought to underlie this disease, but the actual [Ca2+]i was not measurable until recently. We have shown that the anaesthetic halothane increases [Ca2+]i in isolated lymphocytes from malignant hyperthermia-susceptible humans and pigs but not in the normal counterparts. In this report we extend these observations to a larger number of cases and analyze the molecular mechanisms responsible for the increase. The halothane-mediated rise in [Ca2+]i required external Ca2+ and was prevented by nifedipine, an inhibitor of the voltage-sensitive Ca2+ channels of the cell membrane. In addition, the effect of halothane on the releasable Ca2+ from intracellular stores was determined by measuring the size of the releasable pool before and after addition of the anaesthetic. After addition of halothane, about 73% of this Ca2+ pool was still available for release by the Ca2+ ionophore ionomycin in cells from normal humans and pigs. In contrast, only about 45% of the free Ca2+ in intracellular stores was left after treatment with halothane in cells from malignant hyperthermia-susceptible humans and swine. These results indicate that halothane acts both at the cell membrane and at intracellular organelles, and that this action results in a net increase in [Ca2+]i in malignant hyperthermia, but not in normal cells. The action at the cell membrane appears to be on the voltage-sensitive Ca2+ channels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828111 TI - Actions of dietary orotic acid on liver synthesis of phosphatidylcholine and phosphatidylethanolamine in rats. AB - The in vivo rates of the reactions of the cytidine pathways of liver phosphatidylcholine and phosphatidylethanolamine synthesis were measured in rats after 1 day of feeding on a semisynthetic diet containing 1% orotic acid. The calculations were made from the specific and total radioactivity versus time curves of the precursors and products following intraportal injection of [1,2 14C]choline, [2-14C]ethanolamine, and [2-3H]glycerol. The liver CTP level was increased twofold and the rates of CDP-choline and phosphatidylcholine synthesis were stimulated 4.5-fold in the rats fed orotic acid. The rate of CDP ethanolamine synthesis was increased but could not be accurately quantified because of its extreme rapidity. No change occurred in the rate of the ethanolaminephosphotransferase reaction and the overall rate of phosphatidylethanolamine synthesis was unchanged by orotic acid feeding. The catalytic activities of the enzymes of the cytidine pathways of phosphatidylcholine and phosphatidylethanolamine synthesis were not affected by feeding orotic acid for 1 day. Similar findings were obtained 3 h following intragastric administration of 100 mg of orotic acid. The results suggest the possibility that changes in the levels of liver CTP may play a role in regulation of the cytidine pathway of liver phosphatidylcholine synthesis but not of phosphatidylethanolamine synthesis, because the latter pathway appears to be tightly controlled at the ethanolaminephosphotransferase step. PMID- 3828112 TI - Functional incorporation and preferred orientation of phytohemagglutinin receptor glycoproteins in phospholipid vesicles. AB - Porcine lymphocyte Phaseolus vulgaris phytohemagglutinin (PHA) receptor glycoproteins purified by affinity chromatography have been reassembled into vesicles made of phosphatidylcholine and phosphatidylserine by detergent (dodecyltrimethylammonium bromide) dialysis. The receptor glycoproteins were incorporated into the lipid vesicles in a nonselective manner with a yield of 65 70%. Vesicles containing the glycoproteins were sealed as evidenced by their impermeability to calcium ions, using quin 2 trapped inside the vesicles. The vesicles were agglutinated by PHA, suggesting that the saccharidic moiety of the reconstituted glycoproteins was, at least in part, oriented towards the extravesicular medium. This observation was further supported by the fact that the vesicles bound 125I-labeled PHA in a specific and saturable manner. At maximum amount of lectin bound, a ratio of 1.01 +/- 0.05 microgram of PHA per microgram glycoprotein incorporated was measured. When the binding data were analyzed by Scatchard plot, a downward concave profile was observed, suggestive of a positive cooperativity at low concentrations of lectin. The orientation of the reconstituted lectin receptor glycoproteins was determined by proteolytic treatments of labeled glycoproteins. The combined action of trypsin and chymotrypsin released, in the 120,000 X g supernatant, approximately 80% of label when 125I-tagged PHA receptor glycoproteins were incorporated into the vesicles. When the oligosaccharidic moieties of the receptor glycoproteins were specifically labeled, the simultaneous action of the two enzymes released approximately 70% of tritium labeling present in the reconstituted system. Taken together, these results suggest that the reconstituted PHA receptors are preferentially oriented into the phospholipid vesicles. The reconstituted PHA receptor glycoproteins competed effectively with cellular receptors in the assay of PHA-induced porcine lymphocyte activation. A 50% inhibition of [3H]thymidine incorporation was observed when 1 microgram of glycoproteins in vesicles was added to the cultured cells, whereas vesicles alone had no effect at this (equivalent) concentration. PMID- 3828113 TI - cAMP-dependent protein kinase isozymes with preference for histone H2B as substrate in mitochondria of bovine heart. AB - Mitochondria from bovine hearts were fractionated by three different procedures and the fractions were characterized by marker enzymes. Highly purified outer membranes, membrane vesicles, and inner membranes, as well as two high-speed soluble fractions, were obtained. Azide (or oligomycin) resistant ATPase was not found to be a marker for outer membranes. The data were consistent with the association of the protein kinase activity with the soluble matrix of the mitochondria. Activity was highest with histone H2B as the substrate, with histone H1 next in preference. In contrast to the mitochondrial protein kinases studied previously, protamine, casein, and phosvitin were very poor substrates and there was no detectable phosphorylation of pyruvate dehydrogenase. Activity was stimulated by cAMP but not by cGMP, calmodulin, or phosphatidylserine- diolein, with or without Ca2+. Two cAMP-dependent isozymes were separated from the soluble fraction of the mitochondria by chromatography on DE-52 columns. Phosphorylation of histone H2B by the isozymes was inhibited by 98% by Kemptide. PMID- 3828114 TI - Examination of heat shock protein mRNA accumulation in early Xenopus laevis embryos. AB - Elevation of the incubation temperature of Xenopus laevis neurulae from 22 to 33 35 degrees C induced the accumulation of heat shock protein (hsp) 70 mRNA (2.7 kilobases (kb)) and a putative hsp 87 mRNA (3.2 kb). While constitutive levels of both hsp mRNAs were detectable in unfertilized eggs and cleavage-stage embryos, heat-induced accumulation was not observed until after the mid-blastula stage. Exposure of Xenopus laevis embryos to other stressors, such as sodium arsenite or ethanol, also induced a developmental stage-dependent accumulation of hsp 70 mRNA. To characterize the effect of temperature on hsp 70 mRNA induction, neurulae were exposed to a range of temperatures (27-37 degrees C) for 1 h. Heat induced hsp 70 mRNA accumulation was first detectable at 27 degrees C, with relatively greater levels at 30-35 degrees C and lower levels at 37 degrees C. A more complex effect of temperature on hsp 70 mRNA accumulation was observed in a series of time course experiments. While continuous exposure of neurulae to heat shock (27-35 degrees C) induced a transient accumulation of hsp 70 mRNA, the temporal pattern of hsp 70 mRNA accumulation was temperature dependent. Exposure of embryos to 33-35 degrees C induced maximum relative levels of hsp 70 mRNA within 1-1.5 h, while at 30 and 27 degrees C peak hsp 70 mRNA accumulation occurred at 3 and 12 h, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828115 TI - Effect of sodium arsenite on liposomes and erythrocyte membranes. PMID- 3828116 TI - [Quantitative radiologic evaluation of the effect of estro-progestin therapy on the bone mineral content of ovariectomized rats]. PMID- 3828117 TI - Effects of oophorectomy on trabecular bone mineral content in the rat. PMID- 3828118 TI - [Demonstration of the heterogeneity of DNA polymerase alpha in embryonal tissues with high proliferative activity: structural analysis of the subunit in the human fetal liver]. PMID- 3828119 TI - [Naloxone and naltrexone antagonism of various central effects of morphine]. PMID- 3828120 TI - [Activity of naloxone and naltrexone on the development of the morphine withdrawal syndrome]. PMID- 3828121 TI - The Hammett equation for a series of pyridines. PMID- 3828122 TI - [Saturated, mono-unsaturated and polyunsaturated fatty acids in the regulation of fat]. PMID- 3828123 TI - [System for the automated acquisition of electrophysiological data]. PMID- 3828124 TI - [Changes in the spindle activity during sleep in subjects with advanced predominantly motor polyneuropathy]. PMID- 3828125 TI - [Analysis of the EEG spectrum in attacks of common migraine]. PMID- 3828126 TI - [Analysis of the EEG spectrum in attacks of classical migraine]. PMID- 3828127 TI - [Intraerythrocytic sodium and hypertension in pregnancy]. PMID- 3828128 TI - [HBV, HDV and HTLV-III infections in drug addicts, cirrhotics and hemodialysis patients]. PMID- 3828129 TI - Acid phosphatase activity is stimulated in isolated osteoclasts by vitamin A. PMID- 3828130 TI - The effect of retinol on osteoclasts is mediated by a specific cytosolic binding protein. PMID- 3828131 TI - [Platelet function and metabolic parameters in normal subjects given a diet enriched with polyunsaturated fatty acids]. PMID- 3828132 TI - [Changes in plasma concentration of prolactin in the first hours and the first day of life of fullterm healthy newborn infants]. PMID- 3828133 TI - [Effect of streptomycin on the operant behavior of the rat]. PMID- 3828134 TI - [Metadoxine in the control of oxidative stress caused by acute and chronic ethanol poisoning]. PMID- 3828135 TI - [Ultrastructural aspects and the interaction between erythroid precursors and stromal cells of human bone marrow]. PMID- 3828136 TI - Two thalamic projection patterns to the motor cortex in the rat. PMID- 3828137 TI - [Afferent projections to the raphe pontis and zona incerta. Study using using fluorescent dye markers]. PMID- 3828138 TI - Relationships between pyramidal and extrapyramidal systems. PMID- 3828139 TI - [Pediatric neurology and developmental behavioral science]. PMID- 3828140 TI - [An autopsy case of Shy-Drager syndrome preceded by a urinary disturbance for over 20 years]. AB - An autopsy case of Shy-Drager syndrome preceded by urinary disturbance for over 20 years was reported. A 43-year-old woman was admitted to our hospital because of urinary disturbance and orthostatic hypotension. At the age of 19 she developed urinary disturbance with polyuria and retention. These symptoms were getting worse with years, and at the age of 33 she was diagnosed to have neurogenic bladder of uninhibited type. During her hospital course her symptom became worse, and by the age of 42 she showed marked dysarthria, disturbance of smooth pursuit eye movement, Horner's syndrome, marked rigidity and tremor of four extremities, generalized hyperreflexia, marked limb and truncal ataxia, neurogenic bladder and orthostatic hypotension. Serial brain CT scan revealed progressive brain stem and cerebellar atrophy with clinical course. Severe autonomic nervous system dysfunctions were also documented. She died of respiratory failure at the age of 43. On autopsy, brain stem and cerebellum showed marked atrophy macroscopically. Microscopically marked depletion of neuron was seen in the substantia nigra, pontine nuclei, inferior olive, Purkinje cells, the intermediolateral column of spinal cord and Onuf's nucleus of S2. Although numerous cases of Shy-Drager syndrome have been reported in the past, there is no case which developed this syndrome after urinary disturbance of over 20 year's duration. We should be alert to observe the cases with longstanding urinary disturbances in order to not overlook degenerative disorders as exemplified in this case. PMID- 3828141 TI - [Intracranial hemorrhage in infancy due to vitamin K deficiency: report of a case with multiple intracerebral hematomas with ring-like high density figures]. AB - It is well known that vitamin K deficiency is an important cause of the spontaneous intracranial hemorrhage in infancy. A 60-day-old male infant with spontaneous intracerebral hematomas due to vitamin K deficiency was presented. He was breast-fed. He had been medicated oral antibiotic agent for diarrhea and fever. Three days later he developed petechien, vomiting and twitching, and became drowsy. The blood studies showed anemia, and advance of ESR. He was administered of vitamin K immediately. CT scan was showed four intracerebral hematomas with niveau, which were surrounded by high-density rings. The ring-like figures were unique for this case. The reason may be next, we think. Under the states in which blood can separate easily with advance of ESR, blood clot would adhere to the wall of the hematomas. So these hematomas showed ring-like figures and had niveau in them. CT scan of this case was also interesting because there was little deviation in spite of the big hematomas. The reason of this may be that the brain of infancy is incomplete in myelination and contains much water, and that the possibility of bleeding due to vitamin K occurs slowly. We examined 84 cases of intracranial hemorrhage due to vitamin K deficiency from literatures, and they were all identified for the hemorrhage sites by CT scan. Subarachnoidal hemorrhage was in 72 cases (85.7%), subdural hemorrhage was in 41 cases (48.8%), intracerebral hematomas was in 36 cases (42.9%) and intraventricular hemorrhage was in 9 cases (10.7%). In 52 cases the CT findings were described.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828142 TI - [The groping phenomena in a case of Alzheimer type dementia]. AB - We reported a case of senile dementia, Alzheimer type, with groping in response to a visual stimulus ("visual groping"). T.S. was a right-handed woman, 69 years old. In the beginning she displayed "visual groping" of the right hand, besides aphasia, lowered registration and Casteigne's "Motor neglect" of the right upper extremity. As the disease progressed, "visual groping" of the left hand developed, followed by "forced grasping" of the left hand. When the patient was 62 years old, she first showed decreased volition and lowered registration. Later poor finger movement and lessened speech were marked. At the age of 69, she was admitted to our hospital with aphasia and reduced registration. The patient showed preservation in naming and drawing tests. She also displayed a "visual groping" phenomenon of the right hand. This phenomenon was revealed when an examiner displayed something about 50 cm in front of the patient, and then she extended the upper extremity gropingly. We considered this phenomenon as "groping in response to a visual stimulus" of Denny-Brown. At the same time, the motor or praxic disorder of this patient consisted of paucity of movement. When she was told to imitate, her right upper extremity was hardly utilized, although later movements could be realized by her practice. When she was told to pour water from one glass into another, she used her left hand, although she used her right hand for spontaneous actions. So we considered this dyspraxia as a motor neglect of Casteigne.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828143 TI - [Dementia and disturbance of consciousness in thalamic degeneration]. AB - A 53-year-old male with thalamic degeneration is presented. He had double vision, cerebellar signs, and pyramidal and extrapyramidal tracts signs in addition to hypersomnia, decrease in spontaneity and attention, and impairment of memory as psychic symptoms. These signs and symptoms were progressive, and he subsequently developed akinetic mutism and died of pneumonia 17 months after the onset of the disease. His clinical diagnosis was considered as Gerstmann-Straussler syndrome due to progressive dementia, cerebellar signs and the other signs mentioned above. The postmortem pathological investigations, however, revealed thalamic degeneration. The pathological observations showed marked loss of nerve cells and glial proliferation in the medial and anterior nuclei of thalamus. The same pathological changes were more or less demonstrated in the pulvinar, the periaqueductal gray matter of midbrain, inferior olivary nucleus, the medial parts of globus pallidus, the substantia nigra and the dentate nucleus. In the early stage of the clinical course, it was difficult to know whether the main symptoms were caused by dementia or by the disturbance of consciousness. Retrospective considerations, however, showed that dementia had appeared at first, and subsequently the disturbance of consciousness had joined. As the result, it seems that they finally caused akinetic mutism. It is known as thalamic dementia that in the cerebrovascular disease the lesions in the medial and anterior parts of bilateral non-specific thalamic nuclei cause dementia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828144 TI - [Trigeminal somatosensory evoked potentials: I. Recording technic and normal responses]. AB - The general wave form and time course of somatosensory evoked potentials (SEP) to the stimulation of upper and lower extremities has been well known in recent years. However, only a little information has been published so far on SEP to the trigeminal nerve stimulation (TSEP), and at present there is not always common methodology available in clinical practice. These may be due to the technical problems from the close proximity of stimulating and recording electrodes. The purpose of this report is to attempt to solve some of the difficulties of the procedure, as well as to show the morphology and time course of TSEP in a group of normal healthy subjects. Twenty healthy volunteers were investigated. Their age ranged from 22 to 61 years old (mean 29.3). Clip shaped silver-balled stimulating electrodes with 2 mm contact surface and interelectrode distance of 10 mm were applied to the inner surface of the lips. They were held in place without any support, thus minimizing muscle activity of the subject. Each half of the upper and lower lip was then stimulated in turn by an electrical rectangular pulse of 3 or 4 times sensory threshold (usually 1.5-2.0 mA) and 0.2 msec duration, at a rate of 2.3 per second. TSEP was recorded contralaterally from C'5 or C'6 (midpoint between Cz and external auditory porus). Fz was used as a reference. Four hundred responses were averaged by a Nicolet Pathfinder II, which also generated stimulation pulses. Stimulus polarity was reversed after each 100 stimuli to eliminate stimulus artifact. Analysis time was set to 50 msec.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828145 TI - [Regional cerebral blood flow in children--normal value and regional distribution of cerebral blood flow in childhood]. AB - The changes in CBF and rCBF through the entire age range include the rapid period in childhood was reported. Sixteen children between the ages of 1 and 15 and 14 adults were studied. These 30 subjects were either volunteers of out-patients without CT and EEG abnormalities. rCBF was measured by the 133Xe intravenous injection method using Varmet rCBF analyzer. Ther relationship between age and CBF, the correlation coefficient was calculated based on the regression equations and the regression curve with the highest correlation was chosen. For the analysis of rCBF, he mean rCBF values (ISI) of 3 channels corresponding to the frontal, temporal, parietal and occipital lobes were expressed as a percentage of the hemispheric CBF. The hemispheric blood flow (ISI and CBF gray) of children less than 5 years of age was approximately twice that found in adults. This value decreased rapidly with age and in the 10-15 years the blood flow was approximately 1.3-fold that of adults. Thereafter, there was a slow decrease and a negative correlation with age was found. The decrease showed the correlation on the following equations; y = 146.5 - 58.5 log x. (r = -0.903) for ISI and log y = 2.26 - 0.29 log x. (r = -0.881) for CBF gray, which was statistically significant. In contrast, the CBF white showed a slightly higher value in the 1-2 years old children, but thereafter the CBF did not show a notable decreases with age. Through the entire age range, a best fit for the Fw values was found with : y = 18.3 + 37.5/x. (r = 0.798), which was also statistically significant. PMID- 3828146 TI - [Moyamoya disease in twins]. AB - The authors described twins of ten-year-old girls who developed Moyamoya disease at the same time. The family history showed no abnormality. They were born in 1973 under the cesarean section for the early rupture of the membranes and weak pains. The first case experienced tonic convulsions, and abnormal findings on the EEG were pointed out on May, 1979. Seven months later, CT scan was performed in another hospital, which showed the findings of brain atrophy. She experienced absence attacks on January, 1980, and had the first admission. She was diagnosed as epilepsy. Right carotid angiography (CAG) was performed, which showed no abnormal findings. On August, 1983, she complained transient ischemic attacks (TIA) of right hemiweakness and sometimes loss of consciousness for 5 to 10 minutes. She had the second admission on September, 1984. Growing status and neuro-psychological findings were normal. The EEG seemed almost normal, but she complained a TIA on right upper extremity two minutes after the hyperventilation, so the examination was stopped. CT findings was the same as that performed in 1979. Bilateral CAG showed marked stenosis of the internal carotid arteries (ICA) at the siphon and basal moyamoya vessels. Vertebral angiography had no sterno occlusive lesions. Left encephalo-duro-arterio-synangiosis (EDAS) was performed, and six weeks later, right EDAS. Postoperatively, TIAs disappeared and she had a good clinical course. The second case had a similar history as described in case 1, except the absence of epileptic attacks. EEG abnormality was pointed out, and she also had the diagnosis of epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828147 TI - [Recovery in aphasia (Part 3)--Study by multivariate analysis]. AB - In order to elucidate the factors which have influence on the prognosis of aphasia, correlation between recovery rate of aphasia and the five factors, i.e. initial evaluation of speech test, age, educational level, time between onset and institution of therapy and size of abnormal findings in CT (computed tomography), was studied in 76 right-handed aphasic patients, using multivariate analysis. Cluster analysis and factor analysis were used for analysis of five factors and multiple regression analysis was used for estimation of recovery rate of aphasia. The method of calculation of recovery rate of aphasia is the same to our previous report. The results obtained were as follows: As to analysis of factors, first similarity group among initial evaluation of speech test, recovery rate of aphasia and educational level and second similarity group among time between onset and institution of therapy, size of abnormal findings in CT and age were observed. As to the estimation of recovery rate of aphasia, multiple correlation coefficient of regression analysis using five factors were 0.758, 0.444, 0.627, 0.620, 0.810 and 0.375 respectively in total score, hearing, speaking, reading, writing and calculation on standard language test of aphasia. As to the weight or partial correlation coefficient of regression analysis to the five factors, initial evaluation of speech test, time between onset and institution of therapy and educational level were 129.46, -49.93 and 45.65 respectively and the one of the size of abnormal findings in CT was not high. Stepwise multiple regression analysis of five factors were made.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828148 TI - [Waveform caused by raised intracranial pressure--application of spectral analysis in the study of waveform]. AB - Changes in spectrum of the intracranial pressure (ICP) pulse wave were studied while ICP was raised by the epidural balloon inflation. ICP and systemic blood pressure were estimated in the lateral ventricle and thoracic aorta, respectively. Transmission of pulsation from arterial pressure to ICP was estimated by the amplitude transfer function (TFa). Waveform of ICP pulse was also evaluated by distortion factor to represent how ICP pulse is different form a pure sine wave. The spectra of ICP and arterial pressure showed basically the same pattern; they consisted of fundamental wave (FW) and three harmonic waves (HW 2, HW 3, HW 4). Amplitude and values of TFa of each spectral component were increased as ICP was raised and revealed significant correlation. FW and HW 2 components showed break points when ICP was raised up to 35 mmHg, thereafter increments of amplitude and TFa became more remarkable in the range of higher ICP. TFa and amplitude of each spectral component of ICP pulse revealed significant correlation. These findings proved that changes of ICP pulse were the results of changed efficiency of pulse transmission from arterial pressure to CSF. It was already reported that the cerebrovascular tonus had decisive influences on the transmission of pulsation from arterial pressure to ICP because lowered vascular tonus would diminish the damping effect by arterial wall and facilitate the transmission of arterial pressure pulse to ICP. The break point of amplitude and TFa were considered to indicate that tonus of cerebral artery was remarkably lowered and the autoregulation of cerebral blood flow was exhausted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828149 TI - [Pathogenesis and the treatment of secondary syringomyelia]. AB - Six cases with secondary syringomyelia were evaluated clinically and the pathogenesis was discussed. Three cases had the tumors; an ependymoma arising from the conus medullaris and the filum terminale, a foramen magnum meningioma extending to C2 and a thoracic astrocytoma. Two cases had past history of spinal cord injury with L1 and L2 fracture-dislocation, respectively. One case showed hydromyelic symptoms associated with isolated fourth ventricle after post meningitic hydrocephalus. Clinical symptoms and signs were complex and various in each case due to the association of the original disease and the syrinx. Syringomyelic symptoms were dominant in three cases of which the syrinx extended from the conus to the cervical cord. Initial symptoms of two cases with post traumatic syringomyelia were tingling pains which began near the site of injury and extended rostrally. Metrizamide myelography revealed complete or incomplete block at the location of the tumors or the injuries. Delayed CT demonstrated the syrinx in all cases. The syrinx was always present near the sites of primary lesions. The communication between the syrinx and the fourth ventricle was suspected in three cases, and the communication of the syrinx and the spinal subarachnoid space was suspected in two cases. All cases underwent the surgical treatments. Total removal of the tumors were completed in two cases and relieved the majority of symptoms. On the other hand, a case with a thoracic astrocytoma underwent biopsy of the tumor and irradiation, followed by poor outcome. Syringo peritoneal shunts were performed in two cases with post-traumatic syringomyelia and relieved pain, but neurological signs were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828150 TI - [Sleep spindles and physical parameters]. AB - In 4 identical (Nos. 1-4) and 3 fraternal (Nos. 5-7) male twin pairs (mean age, 16 years), sleep spindles were analysed during sleep. The height, body weight, plantar length and chest circumference were measured, and the correlations between sleep spindles and these physical parameters were examined. The physical parameters showed concordance between identical twin pairs except one pair (No. 4) and one fraternal pair (No. 5) but discordance between two fraternal twin pairs (Nos. 6 and 7). Number of sleep spindles and sleep spindle density showed almost concordance between identical twin pairs and one fraternal pair (No. 5), while discordance between two fraternal ones (Nos. 6 and 7). Both number of sleep spindles and sleep spindle density were inversely correlated with body weight (r = -0.61, p less than 0.02; r = -0.62, p less than 0.02). These facts would suggest that sleep spindles rather reflect the individual development than genetic trait. PMID- 3828151 TI - [Time course of the cerebroprotective effect of dexamethasone in experimental head injury]. AB - Despite the widespread use of glucocorticoids in patients with severe head injury, the usefulness is still controversial. In the past, the effect was investigated only in terms of dose-response relationship. We have, however, studied the time factor for the administration of dexamethasone to obtain maximal beneficial effect together with investigating the influence of actinomycin-D, an inhibitor of messenger RNA synthesis, before dexamethasone treatment. Awake male mice of dd-strain were restrained and subjected to head injury using a bakelite weight of 30 g dropped from a height of 17.8 cm above the skull. This injury resulted in immediate loss of consciousness in 100%, convulsive seizure in about 70% and death in about 30% of animals. The severity of consciousness disturbance was evaluated by a pair of indices in time interval: time required for the recovery of righting reflex (RR) and for the recovery of spontaneous movement (SM). 4 mg/kg of dexamethasone phosphate was given intraperitoneally 0.5, 4, 6, 12, 18 or 24 hours before injury. Actinomycin-D of 0.5 mg/kg was injected intravenously 1 h before each dexamethasone treatment in separate animals. In the other group of animals, dose was changed with varying time course of dexamethasone pretreatment, e.g., 2, 4, 6 or 8 mg/kg given 0.5, 2 or 4 h before injury. It was found that dexamethasone of 4 mg/kg pretreatment 4-12 hours significantly improved the recovery from consciousness disturbance and death rate. Actinomycin-D given before dexamethasone treatment completely abolished the protective effect of dexamethasone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828152 TI - [Morphometry of the brainstem with transverse section of the upper pons]. AB - The authors developed new method of morphometry in the brainstem, which used transverse section of the upper pons. After fixation with formalin, the brainstem was separated from the cerebrum and the cerebellum. Both junctions of midbrain pons and pons-medulla were cut and then the pons was horizontally separated into four slices. The oral surface of the second slice from oral side, in which the central portion of the locus ceruleus is located, was measured with computed digitizer after enlarging the picture. The authors measured the total size of the slice in the pons (Total S), the tegmentum size (Teg S), the total length (Total L), the tegmentum length (Teg L) and so on. The tegmentum was separated from the base along the ventral line of the medial leminiscus. In the study of 23 control cases (16 to 77 year old, 13 male and 10 female, all were Japanese), Total S (563 +/- 85 mm) and Teg S (136 +/- 19 mm) ranged to some extent, while the percentage of the tegmentum size to the total size (Teg S/Total S X 100: %Teg S) distributed in narrow range (24.4 +/- 2.3%), which was considered to be an appropriate index to reveal normal structure of the upper pons. The percentage of the tegmentum length to the total length (%Teg L) was also an appropriate and a simple index. Using this method to stained preparation, it was confirmed that the tegmentum size of such cases with olivopontocerebellar atrophy or infantile spasms were significantly small. PMID- 3828153 TI - [The value of neuron specific enolase (NSE) in patients with brain tumors]. AB - gamma gamma-Enolase is considered a specific protein of neuron, which is called neuron specific enolase (NSE). Recent reports clarified that NSE exists not only in neurons but also in neuroendocrine cells, thrombocytes and lymphocytes. Besides normal neuronal tissues, high serum levels of NSE were noticed in the patients with neuroblastomas, small cell carcinomas of the lung, and malignant gliomas, etc. In order to clarify the usefulness of NSE as a marker for intracranial neoplasms or an indicator for prognosis of the patients with intra cranial tumors, we studied serum, CSF and intratumoral fluid levels of NSE in 62 patients with intra-cranial tumors by radioimmunoassay. Serum level of NSE in healthy adults ranged from 4.1 to 8.9 ng/ml (5.6 +/- 1.38 ng/ml, n = 15) and that of CSF ranged from 4.9 to 7.3 ng/ml (means 6.1 ng/ml, n = 3). Serum samples from patients with malignant gliomas and primitive neuroectodermal tumors contained abnormally high level of NSE, of which mean value were 22.3 ng/ml and 16.1 ng/ml, respectively. However, serum samples from patients with low grade gliomas and other intracranial tumors arising from non-neuroectodermal tissues were within normal range. In 9 patients, not only serum levels but CSF levels and/or intratumoral cyst levels of NSE were examined at the same time. Except one meningioma case, CSF levels of NSE were higher (4.9-55.3 ng/ml, mean: 19.3 ng/ml) than that of serum levels (2.3-17.3 ng/ml, mean: 12.7 ng/ml). Mean NSE concentrations of intratumoral fluids in both malignant and benign tumors were 181.7 ng/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828154 TI - [Influence of long-term antihypertensive treatment on cerebral ischemia induced by bilateral common carotid artery ligation in SHRSR--protective effect of nicardipine hydrochloride]. AB - We have already reported that the long-term antihypertensive treatment reduced the degree of cerebral ischemia induced by bilateral common carotid artery ligation (BLCL) in stoke-resistant spontaneously hypertensive rats (SHRSR). This antihypertensive treatment was achieved by the combination of captopril and hydroflumethiazide. In this study, nicardipine hydrochloride which is one of the Ca2+ antagonist was similarly administrated to SHRSR for 8-10 weeks (T-SHR). The effect of long-term antihypertensive treatment by this agent on cerebral ischemia induce by BLCL was investigated and compared with untreated SHRSR (U-SHR). The degree of cerebral ischemia 4 hr after BLCL was estimated by the levels of brain energy metabolites (ATP, lactate, c-AMP) and brain water content. The brain metabolites and water content were measured in the forebrain and hindbrain of each hemisphere. And also the histopathological study on brain vessels 3 hr after BLCL was achieved by using scanning electron microscopy (SEM). The blood pressure of T-SHR gradually declined from 185 +/- 10 mmHg (mean +/- S.D.) to 154 +/- 8 mmHg after 8-10 weeks of antihypertensive treatment. However the blood pressure of U-SHR spontaneously changed from 185 +/- 8 mmHg to 206 +/- 12 mmHg after 8-10 weeks. The blood pressure of T-SHR after the treatment was significantly lower than that of U-SHR. The levels of ATP and c-AMP in T-SHR after BLCL were statistically higher than those in U-SHR, and the lactate levels in T-SHR were significantly lower than in U-SHR in the both fore- and hindbrain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828155 TI - [An autopsy case of progressive supranuclear palsy showing "pure akinesia without rigidity and tremor and with no effect by L-dopa therapy (Imai)"]. AB - Eleven cases of "pure akinesia without rigidity and tremor and with no effect by L-dopa therapy" were first reported by Imai in 1980. Three cases were added by Hayashi and Hayashi (1983). However there have been so far no autopsy cases, remaining the nosological position of this syndrome uncertain. The authors have had an opportunity of observing the third case in the report by Hayashi and Hayashi for 8 years and autopsy was done as well. Case report The patient was a female farmer. On account of postural-reflex troubles, the pulsion phenomenon and feet freezing, which had progressed since the age of 54, she easily tumbled over. Eight years after the beginning of those symptoms, vertical oculomotor palsy, pseudobulbar palsy and dementia were added; she was diagnosed as a progressive supranuclear palsy. Before this diagnosis, her illness was being regarded as "pure akinesia without rigidity and tremor and with no effect by L-dopa therapy". Neck dystonia was not observed even in the terminal stage. She died at the age of 65. The total clinical course was about 11 years. Pathological observation The brain weighed 1,170 g before fixation. Marked atrophy of the subthalamic nucleus, globus pallidus and pontine tegmentum was observed. The substantia nigra was shown to be severely depigmented. Microscopically, loss of neurons and gliosis were seen in the subthalamic nucleus, globus pallidus, substantia nigra, hypothalamus, superior colliculus, central grey matter, brain stem reticular formation, cerebellar dentate nucleus, etc. The characteristic finding was the appearance of neurofibrillary tangles in these regions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828156 TI - [Identification of HETE in the rat brain and its relevance to ischemic cerebral edema: Part 2]. AB - We reported the detection of 11-hydroxy-eicosatetraenoic acid(HETE) in rat brain and its relevancy to ischemic brain edema. But the further study disclosed that the peak of 11-HETE on high performance liquid chromatography (HPLC) had been contaminated by dibutyl phthalate. The results and our speculation about the roles of 11-HETE in ischemic brain turned out to be incorrect. Re-examination of lipoxygenase products in rat brain was performed using gas chromatography-mass spectrometry (GC-MS) and HPLC. The rat middle cerebral artery (MCA) occlusion model was used. The rat was sacrificed by in situ freezing 24 and 72 hours after MCA occlusion. The identification and quantitative study of HETEs in normal and ischemic rat brain was performed by HPLC and GC-MS. In the present study, several kinds of HPLC were used to prevent misinterpretation by the contamination. Sham operated control rat brain contained only 15-HETE and its content was 2.1 +/- 2.1 (mean +/- SE) ng/g wet weight. In 24 hours ischemic brain, 11-HETE newly appeared and the 15-HETE content was increased. But these increases were not statistically significant. The hemisphere rendered ischemic for 72 hours contained all HETEs, namely, 5,9-, 8- and 12-, 11-, and 15-HETEs. Their amounts were 18.3 +/- 2.8, 16.6 +/- 3.0, 23.7 +/- 14.9, 14.0 +/- 3.4, 19.8 +/- 5.5 ng/g wet weight, respectively. All HETE contents except 8- and 12-HETEs were significantly increased 72 hours after MCA occlusion when ischemic cerebral edema reached its maximum (p less than 0.01, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828157 TI - The failure of home hemodialysis. PMID- 3828158 TI - Kinetics of peritoneal dialysis with glycerol and glucose as osmotic agents. AB - The kinetics of peritoneal dialysis with dialysis fluid containing either glucose (1.36, 2.27, or 3.86 g/dl) or glycerol (0.85, 1.40, or 2.50 g/dl) as an osmotic agent was investigated in 24 single dwell studies of 360 min on four uremic patients. To compare the effects of glycerol and glucose on the transport of fluid and solutes across the peritoneal barrier, a new mathematical method for calculation of intraperitoneal dialysate volumes and diffusive mass transport coefficients (KBD) was developed. Radioisotopically tagged albumin (RISA) was added to the dialysate and the rate of fluid transfer was determined by the dilution principle with corrections applied for elimination of RISA from the peritoneal cavity. The elimination rate of RISA varied between 1 and 2 ml/min. KBD values for urea, creatinine, glucose, glycerol, and total protein were calculated during dialysate isovolemia. Glycerol appeared to increase the peritoneal permeability as indicated by an increased KBD value for total protein. The osmotic effect during the initial part of the dwell was similar to that of glucose, but the duration of effective ultrafiltration was shorter because glycerol was absorbed more rapidly than glucose, and ultrafiltered volumes after 6 h were significantly smaller than with glucose. PMID- 3828159 TI - A rabbit model for implanting continuous drug infusion pumps. AB - This paper describes a surgical technique for implanting a readily available, human-sized drug infusion pump in rabbits. We developed this technique in order to expand uses of implantable infusion pump technology in the laboratory. The dog, which has been the research animal of choice in previous studies using implantable pumps, can now be replaced by smaller, less expensive animals for similar or other laboratory purposes. This technique can be of particular importance in the study of atherosclerosis where the dog is a poor model and the rabbit an excellent one. In 18 rabbits with inferior vena cava cannulations, we were able to obtain 100% survival and constant solution delivery for up to and greater than 6 months. This technique is safe and reproducible. By employing a simple catheter modification and using special pump anchoring precautions, we found that we could successfully use a human-sized device in rabbit studies. Commentary is also made concerning the relative contributions to patency and vein sclerosis of catheter diameter and the infusate media. PMID- 3828160 TI - The use and complications of three peritoneal dialysis catheter designs. A retrospective analysis. AB - Three types of peritoneal dialysis catheters were used for maintenance peritoneal dialysis access. Seventy-nine single-cuff Tenckhoff catheters, 63 double-cuff Tenckhoff catheters, and 53 Oreopoulos-Zellerman (Toronto-Western) catheters were placed into 147 patients between 1980 and 1984. The double-cuff Tenckhoff catheter proved the most durable of the catheter designs, with a median survival of 19.1 months. Single-cuff catheters exhibited a high risk of failure due to late exit site complications, while surgically placed Oreopoulos-Zellerman catheters often required removal to permit eradication of peritonitis. PMID- 3828162 TI - Proceedings of the Anaesthetic Research Society. Newcastle, July 4-5, 1986. Abstracts. PMID- 3828161 TI - Adverse effects of drugs used in anaesthesia. PMID- 3828163 TI - Nitrous oxide in neurosurgical anaesthesia. PMID- 3828164 TI - Radiographic study of intercostal nerve blockade in healthy volunteers. AB - The spread of solutions injected to the intercostal space was studied in 10 healthy volunteers. Up to 20 ml of a 50:50 mixture of local anaesthetic solution and a radiopaque dye was injected through a modified extradural catheter placed in an intercostal space at the posterior angle of the rib. Radiographic films demonstrated spread by an extrapleural route into adjacent intercostal spaces and this was confirmed by the occurrence of analgesia in the corresponding dermatomes. The relevance of these results to clinical practice is discussed. PMID- 3828165 TI - Postoperative paravertebral blocks for thoracic surgery. A radiological appraisal. AB - Five patients who underwent thoracic operations had an extradural catheter placed in the paravertebral space. X-ray contrast was injected through the catheters. In those who had detectable analgesia, contrast spread extensively, laterally, along one intercostal space, and up and down the paravertebral spaces. In one patient, contrast appears to have entered the extradural space and, in another who had no detectable analgesia, the contrast was probably dispersed intrapleurally. The significance of these findings is discussed. PMID- 3828166 TI - Continuous intercostal blockade after cardiac surgery. AB - The provision of analgesia using continuous bilateral intercostal blockade was compared with that provided by conventional i.v. narcotics for the first 48 h after cardiac surgery. The subjective quality of analgesia was significantly superior with the regional technique. However, pulmonary function tests, gas exchange, lung volume, and radiological and clinical evidence of pulmonary complications were not improved. The failure to reduce morbidity and the potential for complications such as pneumothorax, makes it difficult to recommend the regional analgesia technique in this situation. PMID- 3828167 TI - Oral intubation v. nasal intubation in adult cardiac surgery. AB - Time for intubation, incidence of mechanical complications, occurrence of bacteraemia caused by intubation, and postoperative discomfort were assessed in relation to nasal and oral tracheal intubation in adult cardiac surgery. The time for placement of the tube was 2.5 times longer for nasal intubation. Nasal bleeding was observed in 45.3% of patients intubated through the nose. In patients in whom a naso-tracheal tube was passed, 9.4% (v. 2.3% of patients intubated via the mouth), exhibited positive blood cultures just after intubation; however, the difference was not significant. Postoperative discomfort was similar in both groups. It can be concluded that nasal tracheal intubation offers no advantage over oral tracheal intubation in adult cardiac surgery. PMID- 3828168 TI - Pulmonary ventilation and gas exchange before and after correction of congenital cardiac malformations. AB - Sixteen children with congenital cardiac malformations were divided into cyanotic (n = 9) and acyanotic (n = 7) groups, and pulmonary ventilation and gas exchange were assessed before surgery, after sternotomy, just after the completion of cardiopulmonary bypass (CPB), 30 min after CPB and after closure of sternostomy before transfer to ICU. Most patients in the cyanotic group had oligaemic, while all in the acyanotic group had overperfused, lungs before surgery. Total compliance was similar in the two groups. Alveolar ventilation was higher and the physiological deadspace to tidal volume ratio (VD/VT) lower in the acyanotic group compared with the cyanotic group (P less than 0.05) before surgery. In the cyanotic group the preoperative large difference between arterial (PaCO2) and end tidal (PE' CO2) carbon dioxide tension was smaller immediately after CPB and remained so after closure of the sternum. In the acyanotic children the small arterial to end-tidal carbon dioxide difference before CPB had increased just after and 30 min after CPB, and VD/VT was significantly increased (P less than 0.05) just after CPB. After closure of the sternum the arterial to end-tidal carbon dioxide difference and the VD/VT ratio had returned to baseline. The arterial to end-tidal carbon dioxide difference is a good indicator of ventilatory efficiency after open heart surgery. PMID- 3828169 TI - High- and low-dose fentanyl anaesthesia: circulatory and plasma catecholamine responses during cholecystectomy. AB - The cardiovascular and neuroendocrine effects of a high-dose fentanyl anaesthesia (100 micrograms/kg body weight) were compared with those of a balanced type of fentanyl anaesthesia (5 micrograms kg-1) during upper abdominal surgery. High dose fentanyl anaesthesia prevented the increase in catecholamine concentrations and attenuated the circulatory response to surgical stress seen in the group anaesthetized with the balanced technique of anaesthesia. PMID- 3828170 TI - Cardiovascular and neurological effects of laudanosine. Studies in mice and rats, and in conscious and anaesthetized dogs. AB - The effects of laudanosine, a metabolite of atracurium, on the behaviour of conscious mice, rats and dogs, and on cardiovascular function in conscious and anaesthetized dogs have been evaluated: EEG studies were performed in anaesthetized dogs. In mice and rats, i.v. bolus doses of laudanosine 10-20 mg kg 1, caused convulsions and hind limb extensions; these effects were prevented by pretreatment with diazepam. After the continuous infusion of laudanosine to conscious dogs, plasma concentrations in the order of 1.2 micrograms ml-1 did not cause behavioural disturbances. In anaesthetized dogs, laudanosine plasma concentrations of more than 6 micrograms ml-1 caused hypotension and bradycardia, laudanosine concentrations greater than 10 micrograms ml-1 induced epileptic EEG spiking and plasma concentrations greater than 17 micrograms ml-1 produced prolonged seizures. There is a wide difference between laudanosine plasma concentrations in patients given atracurium by bolus injection or by short-term infusion for surgical use and those required to induce epileptic activity in dogs. However, during the prolonged infusion of atracurium to patients this difference will be decreased. It is unlikely that the use of atracurium, in patients, would result in plasma concentrations of laudanosine capable of producing neurological or cardiovascular disturbances. PMID- 3828171 TI - Evaluation of closed-loop control of arterial pressure after cardiopulmonary bypass. AB - A closed loop computer system has been developed to deliver sodium nitroprusside (by infusion) to control systolic arterial pressure (SAP) after cardiopulmonary bypass. The performance of the closed-loop control system was evaluated by comparing nurse and computer control of SAP in 60 patients during the early postoperative period. The computer system provided better control of SAP than manual control by a member of the nursing staff. PMID- 3828172 TI - An acoustic model of the patient undergoing artificial ventilation. AB - The difficulty of applying conventional concepts of respiratory mechanics to high frequency ventilation (HFV) has so far inhibited its general acceptance by clinicians. The basis of an approach derived from an acoustic analysis of the ventilated patient is presented which may help to clarify the mechanism of action of HFV and offer some guidelines to its clinical application. The ventilator is considered as an acoustic source, and the patient's acoustic response to the ventilator is analysed. A response equation for the patient's respiratory system at low frequencies is derived, from which an expression for the fundamental resonant frequency is obtained. The high frequency acoustic response of the patient is examined with particular reference to the possibility of exciting multiple resonant modes within the airways. Following this, we have discussed the significance of the acoustic response and acoustic resonance in relation to gas exchange. It is suggested that these resonances may be used in adjusting indices of HFV in order to obtain optimum ventilation. PMID- 3828173 TI - Myasthenia gravis and cardiac surgery. A case report. AB - This paper describes the successful management of a diabetic patient with bulbar myasthenia who underwent mitral valve replacement and coronary revascularization. PMID- 3828174 TI - Towards safer anaesthesia in obstetrics. PMID- 3828175 TI - Effect of isoflurane on the auditory evoked response in man. AB - We have examined the effects of isoflurane (0.6-2.9% end-tidal) on the auditory evoked response (AER) in six patients before elective surgery. Isoflurane produced significant dose-related changes in the AER: reductions in amplitude and increases in latency of the cortical waves Pa and Nb, and increases in the latency of the brainstem waves III and V. When isoflurane was compared with halothane and enflurane using an MAC-based comparison, we found no differences in the effect of the three agents on the amplitude of the early cortical waves, although the latencies showed significant differences. The consistent dose related effect on the amplitudes of the cortical waves implies that the AER could be a promising index of the depth of anaesthesia. PMID- 3828176 TI - Stereophotogrammetric analysis of changes in body volume associated with the induction of anaesthesia. AB - Changes in the volume of the trunk were measured in seven supine patients, when anaesthesia was induced with thiopentone i.v. Stereo-photograms were taken before and after induction and measurements of volume calculated from contour plots of a reconstructed stereo image. The changes in volume of the visible part of the trunk were between -846 and +505 ml. No systematic change in total or lower trunk ("abdominal") volume was evident, but there was a significant negative linear relationship (r = -0.87) between upper trunk ("ribcage") volume change and obesity (expressed as actual weight/expected weight). Changes in volume were more evident in the upper parts of the supine subject, in both ribcage and abdomen (P less than 0.05). PMID- 3828177 TI - Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. AB - The catecholamine and cardiovascular responses to laryngoscopy alone have been compared with those following laryngoscopy and intubation in 24 patients allocated randomly to each group. Following induction with fentanyl and thiopentone, atracurium was administered and artificial ventilation undertaken via a face mask for 2 min with 67% nitrous oxide in oxygen. Following laryngoscopy, the vocal cords were visualized for 10 s. In one group of patients, ventilation was then re-instituted via a face mask, while in the second group the trachea was intubated during the 10-s period and ventilation of the lungs maintained. Arterial pressure, heart rate and plasma noradrenaline and adrenaline concentrations were measured before and after induction and at 1, 3 and 5 min after laryngoscopy. There were significant and similar increases in arterial pressure and circulating catecholamine concentrations following laryngoscopy with or without intubation. Intubation, however, was associated with significant increases in heart rate which did not occur in the laryngoscopy-only group. PMID- 3828178 TI - Effect of topical lignocaine on the sympathoadrenal responses to tracheal intubation. AB - The catecholamine and cardiovascular responses to laryngoscopy and tracheal intubation have been studied in 30 patients undergoing elective gynaecological surgery, allocated randomly to one of three groups: group 1 received 4% lignocaine 160 mg using a Forrester Spray; group 2 received 4% lignocaine 160 mg by "Laryng-o-jet"; group 3 received an equal volume of saline administered by Forrester Spray. In all three groups, there were similar and statistically significant increases in mean arterial pressure and plasma adrenaline and noradrenaline concentrations 1 min after intubation, with diminution of these responses by 5 min after intubation. There were no differences between the three groups at any stage, which suggests that topical anaesthesia of the mucosa of the upper airway, as performed conventionally, is ineffective as a means of ameliorating the pressor and catecholamine responses to routine laryngoscopy and intubation. PMID- 3828179 TI - Can one risk fasting the obstetric patient for less than 4 hours? AB - Forty patients scheduled for elective Caesarean section under general anaesthesia were divided into two groups. A control group of 20 patients was treated conventionally, whereas the other group was offered a light breakfast of tea and toast within 4 h of surgery. The volume of gastric contents was significantly greater (P less than or equal to 0.02) and the pH of the aspirate significantly lower (P less than or equal to 0.05) in the study group than in the control group. It is, therefore, not recommended that obstetric patients be fasted for less than 4 h. PMID- 3828180 TI - Inflation pressure, gastric insufflation and rapid sequence induction. AB - An investigation was carried out into the relationship between the inflation pressures of normally compliant lungs and the airways pressure necessary to produce the insufflation of gas to the stomach. This relationship was examined during manual ventilation with a mask, using a rapid sequence induction technique. In the absence of cricoid pressure the lungs of all the patients could be ventilated "gently" satisfactorily by hand without gas entering the stomach. In only half of the patients could gas be redirected to the stomach when maximal inflation pressures were generated. It was not possible to cause gas to enter the stomach in any patient with a patent airway when cricoid pressure was applied. PMID- 3828181 TI - Continuous extradural analgesia in labour. Comparison between "on demand" and regular "top-up" injections. AB - In a prospective comparative study 240 patients received extradural bupivacaine, either by regular timed injections or "on demand", for pain relief during the first stage of labour. Three concentrations of bupivacaine were used (0.5%, 0.375% and 0.25%). Quality and continuity of analgesia, motor blockade, spread of sensory blockade, cardiovascular changes, fetal outcome and maternal sequelae were recorded. Overall, the analgesia provided by regular top-up injections was superior to the on demand technique, especially when 0.375% bupivacaine was used. This improved analgesia was achieved without causing an increased incidence of operative deliveries or deleterious sequelae, with respect to the mother or the neonate. PMID- 3828182 TI - Extradural infusion of 0.125% bupivacaine at 10 ml h-1 to women during labour. AB - One hundred primigravidae were allocated randomly to receive either an extradural infusion of 0.125% bupivacaine (Marcain) 10 ml (12.5 mg) per hour during labour, or no infusion. Both groups had intermittent "top-ups" of 0.5% bupivacaine when indicated. The mean interval between top-ups was significantly longer in the infusion group (218 min v. 152 min). Seventy-six percent of the mothers in the infusion group required no or only one top-up. Although the infusion patients received a higher mean dose of bupivacaine (178 mg v. 130 mg), there was no difference between the groups with respect to mode of delivery, need for urinary catheterization, adverse cardiovascular effects on mother or fetus, or the time taken after delivery to recover sensation and motor power. The only real disadvantage was that the infusion group had an increased incidence of lower limb weakness (64% v. 44%). The neonates had similar Apgar scores, times to sustained respiration and requirements for resuscitation. The technique, therefore, should be safe if coupled with testing of sensory level, as no block extended higher than T6. PMID- 3828183 TI - Effect of gravity on the spread of extradural anaesthesia for caesarean section. AB - The effect of gravity on the spread of extradural anaesthesia was evaluated in a series of parturients undergoing elective Caesarean section. Following placement of an extradural catheter, 25 patients were placed 30-40 degrees head-up for 20 min during the administration of the local anaesthetic drug; 25 additional patients remained supine during injection. Extradural anaesthesia was induced with 3% 2-chloroprocaine 23 ml and analgesia to pinprick assessed at 5-min intervals. Additional drug was given after 20 min, if required. There were no differences in the rate of onset of sacral blockade or in the extent of neural blockade between the two groups. The semi-upright position was not necessary to ensure adequate sacral anaesthesia for Caesarean section. PMID- 3828184 TI - Effect of posture during the induction of subarachnoid analgesia for caesarean section. Right v. left lateral. AB - Thirty-five women scheduled for elective Caesarean section were randomly assigned to have subarachnoid analgesia induced in either the right or left lateral position. They were then turned supine with a wedge under the right hip. No patient in the right-sided group required further analgesia. Five patients in the left-sided group required postural manipulation to encourage the spread of analgesia and two required supplementary analgesia (P less than 0.01). PMID- 3828185 TI - Double-blind comparison of the efficacy of extradural diamorphine, extradural phenoperidine and i.m. diamorphine following caesarean section. AB - A randomized, double-blind study of the efficacy, duration of action and side effects of three analgesic regimens following Caesarean section is described. Patients received i.m. diamorphine 5 mg, extradural phenoperidine 2 mg or extradural diamorphine 5 mg. Analgesia was of rapid onset in all groups, as judged by reductions in linear analogue pain scores and rank pain scores. Time to next analgesia was significantly greater after extradural phenoperidine (5.96 h) and extradural diamorphine (8.39 h) than after i.m. diamorphine (3.40 h) (P less than 0.001). Itching was reported on direct questioning by 50% of patients in the extradural groups. No serious side effects were reported. Factors affecting the disposition of extradurally administered diamorphine are discussed. PMID- 3828186 TI - Enflurane-induced burst firing of hippocampal CA 1 neurones. In vitro studies using a brain slice preparation. AB - Enflurane can produce seizure activity in the cortical EEG, in vivo, at concentrations associated with surgical anaesthesia. The present study was designed to determine whether this seizure-like burst activity could occur in isolated cortical neurones. Enflurane altered synaptic transmission in the in vitro rat hippocampal slice preparation and produced seizure-like burst discharges of CA 1 neurones, at vapour concentrations equivalent to those obtained during anaesthesia (2-6 vol%; 0.5-1.5 mmol litre-1). Burst discharges occurred both spontaneously and in response to stimulation of stratum radiatum fibres in the CA 1 pyramidal region, but not in the dentate area. Low concentrations of enflurane (approx. 0.75 mmol litre-1), decreased the field potential responses of CA 1 neurones; however, dentate granule neurone responses were increased. Input/output analyses of field excitatory post-synaptic potential (EPSP) and population spike amplitudes revealed that the enflurane-induced depression of field potential responses was associated with decreases in synaptic input, whereas burst activity resulted from a decrease in the threshold of CA 1 neurones. PMID- 3828187 TI - Differential nerve blockade: esters v. amides and the influence of pKa. AB - The in vitro sensitivities to local anaesthetic blockade of A, B and C fibres in rabbit vagus nerves were examined using a series of structurally similar amide agents, which varied in lipid solubility and anaesthetic potency. The actions of these drugs were compared with one another, and with those of a series of amino ester local anaesthetics studied previously. The results demonstrated that A fibres are the most, and C fibres the least, sensitive to blockade by local anaesthetic agents. As with the ester drugs, equipotent concentrations of the amides blocked C fibres at approximately the same rate, but the absolute and relative rates of development of A fibre blockade were related to lipid solubility. As the latter increased, so did the rate of A fibre blockade. Combining the results of the two studies suggests that an agent of low lipid solubility and high pKa might be used to produce differential C fibre blockade. Comparison of the results obtained with the two different classes of drug indicates that the ester structure may have an inherently more potent action than the amide. PMID- 3828188 TI - Elapid snake bite. AB - Four patients were admitted with respiratory muscle paralysis following an elapid snake bite. Two were treated with antivenine, repeated doses of neostigmine and artificial ventilation; the other two with artificial ventilation only. There was no clinically significant difference in recovery. It is suggested that one should avoid the use of antivenine and neostigmine in the management of elapid snake bite once muscle paralysis has become established. PMID- 3828189 TI - Analysis of costs of anaesthetic breathing systems. PMID- 3828190 TI - Acute (type 1) hypersensitivity to i.v. Diazemuls. PMID- 3828191 TI - Pharmacokinetics of intravenous amodiaquine. AB - Amodiaquine hydrochloride (3 mg base kg-1) was given by constant rate intravenous injection over 10 min to seven healthy adult male volunteers, and by constant rate infusion (10 mg base kg-1) over 4 h to 10 adult patients admitted to hospital with falciparum malaria. After intravenous injection in volunteers there was considerable variation in plasma concentration profiles between subjects; peak plasma concentrations ranged between 65 and 1921 ng ml-1. A biexponential equation was fitted to the plasma concentration time data and the following estimated pharmacokinetic parameters (geometric mean; range) were derived; lambda 1 = 24.4 (7.6-95.0) h-1, lambda 2 = 0.33 (0.12-0.79) h-1, V1:1.1 (0.3-3.6) 1 kg 1, Vss: 17.4 (2.3-95.9) 1 kg-1 and systemic clearance 13.0 (4.7-56.6) 1 kg-1 h-1. After intravenous infusion there was also considerable variability between patients with post-infusion plasma concentrations ranging between 82 and 836 ng ml-1. The plasma concentration-time profiles were biphasic with the following estimated pharmacokinetic parameters (geometric mean; range) alpha = 1.87 (0.60 8.52) h-1, beta = 0.069 (0.021-0.265) h-1, V1: 4.6 (0.5-29.3) 1 kg-1, Vss: 38.3 (3.7-127.9) 1 kg-1 and systemic clearance CL (1.6-17.3) 1 kg-1 h-1. There was no measurable long terminal elimination phase, and the principal metabolite desethyl amodiaquine was not detected in the plasma samples. There was no serious toxicity in either group. During intravenous injection there was a significant fall in systolic blood pressure in four subjects (mean fall 16 mm Hg) but there was no significant change in heart rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828192 TI - Preliminary studies of the pharmacokinetics and pharmacodynamics of prochlorperazine in healthy volunteers. AB - The pharmacokinetics and pharmacodynamics of prochlorperazine were studied in healthy volunteers using a recently developed h.p.l.c. assay. Eight subjects received 12.5 mg and 6.25 mg i.v. doses of prochlorperazine, a 25 mg oral dose and placebo in random order. Plasma half-life (t1/2) of prochlorperazine was 6.8 +/- 0.7 h and 6.9 +/- 0.8 h for the 12.5 mg and 6.25 mg i.v. doses respectively. Apparent volume of distribution and plasma clearance were high and the kinetics did not appear to be dose-related. Absorption of oral prochlorperazine appeared to be slow and bioavailability was very low. A metabolite, possibly prochlorperazine sulphoxide, was noted after oral dosing. Mild sedation was common after i.v. prochlorperazine, but cardiovascular effects were minimal. The main adverse effect was akathisia which was reported by five out of eight subjects after the higher i.v. dose. These results provide preliminary information on the pharmacokinetics of i.v. prochlorperazine which were previously unknown. PMID- 3828193 TI - A haemodynamic and radionuclide assessment of diltiazem in coronary heart disease. AB - To obtain multiple dose-response haemodynamic and radionuclide data on i.v. diltiazem, 12 ischaemic patients were studied during routine catheterization. At rest, following a 20 min stable control period, the effects of four doses (0.0625, 0.0625, 0.125 and 0.25 mg kg-1 diltiazem at 5 min intervals) were measured in the 3-5 min following i.v. injection. The exercise effects of the cumulative 0.5 mg kg-1 dosage were assessed by comparing a control and post drug period of supine bicycle exercise. The increase in plasma diltiazem levels correlated linearly with the administered dose and achieved therapeutic levels. There were significant dose-related reductions in systemic arterial blood pressure and vascular resistance index; the heart rate fell and cardiac stroke index increased. The calculated double-product (heart rate X systolic blood pressure) was significantly reduced. The left ventricular filling pressures, ejection fraction and cardiac volumes were unaltered. During supine bicycle exercise, the systemic diastolic blood pressure, heart rate and calculated double product were reduced without change in other parameters. Over the dose range 0.0625-0.5 mg kg-1, diltiazem acutely increased cardiac stroke index and reduced resting heart rate. These haemodynamic data, taken together with its described coronary vasodilator activity suggest that its role in acute vasospastic angina and during angiographic procedures ought to be explored further. PMID- 3828194 TI - Differences between acute and long-term metabolic and endocrine effects of oral beta-adrenoceptor agonist therapy with pirbuterol for cardiac failure. AB - The metabolic, hormonal and haemodynamic effects of oral pirbuterol, a new beta 2 adrenoceptor agonist, were studied acutely (n = 19) and after 3 months treatment (n = 11) in patients with severe heart failure receiving chronic frusemide therapy. In the acute study fasted patients (n = 10) showed reductions in plasma K+ (P less than 0.005) and cortisol (P less than 0.01) and increases in plasma glucose (P less than 0.005), insulin (P less than 0.01), lactate (P less than 0.005) and pyruvate (P less than 0.0025). These acute changes were less in unfasted subjects (n = 9). Maximal increase in stroke volume occurred at approximately half the plasma pirbuterol concentration required for maximal effect on plasma insulin. Treatment with pirbuterol for 3 months was associated with sustained increases in stroke volume and fasting plasma glucose and insulin, but there was loss of all other acute metabolic effects. Despite concurrent frusemide and digoxin therapy acute hypokalaemia caused no adverse effects. Hypokalaemia did not occur with chronic pirbuterol administration. PMID- 3828195 TI - Naproxen pharmacokinetics in patients with rheumatoid arthritis during active polyarticular inflammation. AB - Patients with rheumatoid arthritis often have hypoalbuminaemia as a sign of disease activity. In view of the extensive binding of naproxen to albumin, the pharmacokinetics of total and unbound drug were studied in eight patients and eight healthy male volunteers during chronic intake of 500 mg twice daily. The area under the serum concentration-time curve of total naproxen during a dose interval, AUC (0,12), smaller in patients (641 +/- 101 mg l-1 h) than in volunteers (896 +/- 85 mg l-1 h; P less than 0.0001). The unbound naproxen AUCu (0,12) was larger in patients (1.9 +/- 0.9 mg l-1 h) than in volunteers (0.7 +/- 0.2 mg l-1 h; P less than 0.01). The higher unbound naproxen concentrations in patients were accompanied by an approximately 40% increase in apparent clearance/bioavailability (CL/F) and a 60% increase in volume of distribution (V/F). Both CL/F and V/F were inversely correlated with the individual serum albumin concentration (r = 0.76, P less than 0.001; r = -0.85, P less than 0.001, respectively). The high unbound naproxen concentration in the serum of patients with active rheumatoid arthritis and concomitant hypoalbuminaemia is not known to be accompanied by an increase in side effects and may be beneficial if anti inflammatory effects correlate with unbound drug concentration. PMID- 3828196 TI - Benoxaprofen--adverse reactions and monitoring in general practice. AB - We report on the pattern of use of benoxaprofen (Opren) in a single group practice for a period which included the complete clinical life of the drug. One hundred and seventy-two patients of the 6495 practice patients had been prescribed benoxaprofen, but 55% had only a small exposure (less than 20 g). Recorded adverse reactions, of which none was serious, appeared in 25 patients. Most were taking benoxaprofen for osteoarthritis (53%) or non-specific musculoskeletal pain (39.9%). The issue of a prescription was not recorded in 19.6% of cases and 88% were on additional drugs. Greater precision in record keeping is required to avoid problems similar to the experience with benoxaprofen. PMID- 3828197 TI - The analysis of dose-response curves--a practical approach. AB - The rationale for the objective assessment of dose-response curves (DRCs) is presented. Using data derived from isoprenaline/heart rate responses studies, two new statistical methods of objectively defining the terminal linear segment of an incomplete DRC are presented. Using data derived from phenylephrine/diastolic blood pressure response studies, the parallel shift quadratic model of Sumner et al. (1982) has been extended to include a measure of the suitability of the quadratic model for each individual data set using the Akaike information criterion. A parallel shift Emax model is proposed for complete DRCs. PMID- 3828198 TI - N-desmethylclobazam: a possible alternative to clobazam in the treatment of refractory epilepsy? AB - The development of anticonvulsant tolerance during 10 days treatment with either clobazam or its principal metabolite, N-desmethylclobazam (NDMC), was compared in mice using an i.v. infusion of pentylenetetrazole as the convulsive stimulus. Subsequently the anticonvulsant activity of NDMC was assessed in patients with refractory epilepsy. In mice, a highly significant tolerance (P less than 0.001) developed to clobazam (10 mg kg-1 twice daily). During the same period, there was no significant change (P greater than 0.05) in the protection afforded by NDMC (40 or 80 mg kg-1 twice daily) although some reduction in anticonvulsant activity was apparent. NDMC (30 mg once daily) was given to nine patients with frequent complex partial and/or grand mal seizures who had become tolerant to the anticonvulsant effect of clobazam. Seven of the patients had been free from benzodiazepine therapy for at least 2 weeks, while the other two patients were switched directly from clobazam. Eight of the nine patients showed a favourable response to NDMC. In the seven who had been given a holiday from clobazam the response to NDMC was similar to the initial response to clobazam and was achieved at plasma NDMC concentrations in the same range as those seen during clobazam administration (1000-3000 ng ml-1). It is concluded that NDMC is active as an anticonvulsant in man and there is evidence from the animal studies to suggest that it may be preferable to clobazam. PMID- 3828199 TI - Intravenous bumetanide attenuates the rise in plasma vasopressin concentrations during major surgical operations. AB - During a study in seven patients on the endocrine response to major surgical procedures under general anaesthesia an incidental finding was that the administration of intravenous bumetanide prior to surgical stimulation led to reduced concentrations of plasma vasopressin (AVP) when compared with a control group of patients. PMID- 3828200 TI - Intravenous midazolam for upper gastrointestinal endoscopy: a study of 800 consecutive cases relating dose to age and sex of patient. AB - In many endoscopy units midazolam is replacing diazepam as the intravenous sedative of first choice. Midazolam is approximately twice as potent as diazepam. Although generally considered a safe drug, there have been a number of recent reports, particularly in the elderly, of the drug causing hypotension, respiratory depression and even death. There have been at least ten studies comparing diazepam with midazolam for upper gastrointestinal endoscopy but many have involved relatively small numbers and none have adequately addressed the question of dosage in the elderly. We have carefully recorded the dose of intravenous midazolam used to produce adequate sedation prior to upper gastrointestinal endoscopy in 800 consecutive patients. The dose of midazolam decreased markedly with age in both male and female patients. There was a highly significant correlation in both sexes between age and the dose of midazolam (rho 0.787, P less than 0.001 for males and rho -0.768, P less than 0.001 for females). There was only a small difference in dose in men and women, an average of 1 mg; and no difference in dose over the age of 70 years. In patients over 70 years of age the dose of midazolam necessary for endoscopy is often so small that overdosage is all too easy. PMID- 3828201 TI - Antagonism of phenylephrine-evoked sweating by trazodone and amitriptyline in humans in vivo. PMID- 3828202 TI - Food and nifedipine pharmacokinetics. PMID- 3828203 TI - Speech and language handicap: towards knowing the size of the problem. PMID- 3828204 TI - Spastic dysarthria after acquired brain injury: an acoustic study. PMID- 3828205 TI - Relationships between dysarthric groups. PMID- 3828206 TI - Cluttering: a diagnostic case report. PMID- 3828207 TI - Some new data using the English Picture Vocabulary Test (full range version) with a British sample. PMID- 3828208 TI - Developing linguistic awareness: a theoretically based approach to phonological disorders. PMID- 3828209 TI - Laryngographic changes following endotracheal intubation in adults. PMID- 3828210 TI - Mother-child dialogues: considerations of cognitive complexity for young language learning children. PMID- 3828211 TI - Cutaneous and ocular side-effects of oral photochemotherapy: results of an 8-year follow-up study. AB - To determine the long-term cutaneous side-effects of oral photochemotherapy (PUVA), we examined 95 patients, 59 with psoriasis and 36 with mycosis fungoides (MF). These comprised 80% and 69% respectively of the patients with these disorders treated with PUVA in our department from 1977 to 1985. Two psoriatic patients had squamous carcinomas, both of whom had received high cumulative UVA doses and also methotrexate concurrently with PUVA. Six patients with MF had actinic keratoses. The mean age of these patients (69 years) was significantly greater than the mean age of the patients without actinic keratoses (54 years), but there was no significant difference in their cumulative UVA doses. No patients developed basal cell carcinomas or malignant melanoma. 'PUVA lentigines' were found in 46% of the patients. They were most frequent in patients currently being treated and in those who had received high cumulative UVA doses, but persisted for up to 7 years after discontinuing therapy. Seventy-one patients had yearly ophthalmological examinations, or a single examination at least 3 months after commencing PUVA. This examination included retinal function tests to detect any subclinical visual impairment. Five of these patients had cataract prior to PUVA therapy, and were significantly older (mean age 71 years) than those without cataract (mean age 53 years). Three patients (mean age 61 years) developed new lens opacities whilst receiving PUVA. However, none of these patients was considered to have cataract as none had impairment of visual acuity due to lens opacity. No patients without lens opacity developed evidence of subclinical visual impairment. PMID- 3828212 TI - Reduction of anthralin inflammation by potassium hydroxide and Teepol. AB - Application of 1% potassium hydroxide (KOH) reduced subsequent development of anthralin inflammation without loss of its therapeutic effect on psoriasis. Teepol had a similar but smaller effect on subsequent development of inflammation. The action of KOH appears to have resulted from enhanced oxidation of anthralin to inactive products and the action of Teepol to have increased anthralin solubility and removal. The effect of KOH and Teepol decreased with time after anthralin application and both were ineffective by 24 h, indicating that anthralin persists on the skin in an active form for up to 24 h after a single application. The reduction of anthralin inflammation without loss of therapeutic effect is potentially useful in short contact anthralin therapy. PMID- 3828213 TI - Essential fatty acids in the plasma phospholipids of patients with atopic cataracts. AB - Abnormal levels of the essential fatty acids (EFA) in plasma phospholipids have been reported in atopic dermatitis. We have compared EFA levels in 10 patients with atopic cataracts and 29 atopic dermatitis patients without cataracts and found no significant differences, with the exception that higher levels of adrenic acid occurred in those with cataracts. PMID- 3828214 TI - The onset of ultraviolet erythema. AB - The onset of erythema induced by UVB and by UVC radiation was monitored in two subjects using a reflectance instrument. It was shown that vasodilation occurred some time before erythema became visible, even with small exposure doses of UVB or UVC, after which visible erythema was not apparent for several hours. In one subject, vasodilation was detected very shortly after irradiation and may have even begun during irradiation. In the other subject vasodilation was detected later at most exposure doses, but still some time before erythema became visible. We conclude that the so-called 'latent period' between irradiation and appearance of erythema is an artificial concept arising from the insensitivity of the eye. PMID- 3828215 TI - Retrospective radiographic study of skeletal changes after long-term etretinate therapy. AB - Radiographic skeletal examinations were performed in eight adult patients who had received the aromatic retinoid etretinate for various disorders of keratinization over periods ranging from 1 to 7 years. Age- and sex-matched controls were also examined. In all patients, alterations of ossification were found to a varying degree, including calcification of the anterior spinal ligament, vertebral hyperostoses at the anterosuperior and anteroinferior margins of the vertebral bodies, unilateral bridging of vertebral bodies, hyperostoses of the calcanei at the insertion of the plantar ligament and bone accretion at the anterolateral lips of the acetabula. All the bone changes were asymptomatic. Serum calcium, inorganic phosphate, alkaline phosphatase, calcitonin and parathormone were within normal physiological ranges. In general, the bone changes observed after long-term etretinate treatment closely resembled the effects of isotretinoin on the skeleton. PMID- 3828216 TI - Bowenoid papulosis in a penile epidermal inclusion cyst. AB - We report a case of bowenoid papulosis occurring in an epidermal inclusion cyst. This is, to our knowledge, the first reported case of these lesions occurring in an inclusion cyst. PMID- 3828217 TI - Multicentric reticulohistiocytosis. AB - A case of multicentric reticulohistiocytosis associated with a pleural mesothelioma is reported. The cutaneous and joint manifestations resolved after treatment with cyclophosphamide, and the remission persisted until the patient's death 3 years later. As corticosteroids have such an unpredictable effect on this condition, cyclophosphamide may be regarded as the treatment of choice until more cases can be assessed. PMID- 3828218 TI - A graft-versus-host disease-like syndrome with carcinomatosis. AB - A patient who developed a syndrome resembling chronic graft-versus-host disease in association with disseminated carcinoma is described. There has only been one previous report of this association. PMID- 3828219 TI - Tricho-dental syndrome: a disorder with a short hair cycle. AB - A family pedigree is described in which the propositus has tricho-dental syndrome. Evidence is presented that the short hair frequently observed in this condition is due to a short anagen phase of the hair cycle. PMID- 3828220 TI - A combination of phototherapy and cholestyramine for the relief of pruritus in primary biliary cirrhosis. AB - A patient with primary biliary cirrhosis is reported in whom UV phototherapy alone was repeatedly effective in controlling severe pruritus. Symptomatic relief was sustained by introducing cholestyramine at a low dosage, despite previous failure of the drug alone to produce any therapeutic benefit, even in large doses. Bile acid concentrations were measured in sera, urine and suction blister fluid from skin exposed to ultraviolet light before, during and following treatment. The findings suggest that phototherapy reduces cutaneous bile acid levels which can subsequently be maintained by low dose cholestyramine. Routine liver function tests remained unaltered. This combination of phototherapy and cholestyramine may be useful in controlling severe pruritus in primary biliary cirrhosis when the drug alone is not tolerated or is ineffective. PMID- 3828221 TI - Generalized pustular psoriasis (von Zumbusch) responding to cyclosporin A. AB - A 49-year-old patient developed generalized pustular psoriasis after tapering off the methotrexate therapy he had been receiving for severe psoriasis and arthralgia. Treatment with cyclosporin A produced a dramatic reduction of the cutaneous lesions and the joint symptoms. PMID- 3828222 TI - A paired comparison of cream and ointment-based dithranol in short contact treatment of psoriasis. PMID- 3828223 TI - Local PUVA treatment for nail psoriasis. PMID- 3828224 TI - Treatment of psoriasis with a combination of dithranol and coal tar. PMID- 3828225 TI - Changes of the phenotype of erythroid progenitor cells (BFU-E, CFU-E) and their progenies during early steps of differentiation. AB - Early differentiation processes of human erythroid progenitor cells (BFU-e, CFU e) have been studied during in vitro proliferation using a panel of monoclonal antibodies with known reactivity on different levels of the erythroid cell line. Two antibodies recognizing structures on BFU-e (VIP-2b, BMA 021), two antibodies reactive with CFU-e and nucleated red cells (5F1, CLB-Ery-3) and one antibody directed against glycophorin A (VIE-G4) were used for this study. Normal human bone marrow cells were induced to proliferation in an erythroid progenitor cell assay and, after different periods of incubation, agar cultures were treated with these antibodies and complement. Thereafter, the remaining erythroid cells were incubated again to continue their proliferation with the same stimulators as before. The changes of the phenotype of BFU-e and CFU-e progenies during in vitro proliferation were determined by the reduction of colony formation in comparison with untreated control cultures. Our results indicate that the loss of HLA-DR antigens and the p45 structure is accompanied by the acquisition of structures recognized by the antibodies 5F1 and CLB-Ery-3. After 5-7 d of incubation BFU-e derived progenies exhibit the same antigenic structure as has been found for CFU e. Glycophorin A expression could only be demonstrated at a late differentiation stage of the erythroid cell lineage. PMID- 3828226 TI - Antithrombin III Pescara: a defective AT III variant with no alterations of plasma crossed immunoelectrophoresis, but with an abnormal crossed immunoelectrofocusing pattern. AB - An abnormal AT III variant was found in five members from a family where a high incidence of thromboembolism occurred. In all the affected subjects AT III antigen concentration was normal, whereas antithrombin and antifactor Xa progressive activities as well as heparin cofactor activities were low. Crossed immunoelectrophoresis performed either in absence or in presence of heparin showed a normal plasma pattern. Further chromatographic investigations showed a normal affinity to heparin. An abnormal plasma pattern was evidentiated by crossed immunoelectrofocusing throughout all the AT III pH range. These data are consistent with the presence of an abnormal AT III variant with a defective binding to serine proteases and clearly identifiable only by crossed immunoelectrofocusing. This variant appeared different from the other qualitative AT III defects so far described and was named 'Antithrombin III Pescara'. PMID- 3828227 TI - Evolution of coagulation abnormalities following Russell's viper bite in Burma. AB - The evolution of coagulation abnormalities was studied in Russell's viper bite victims who, on admission to hospital, showed no clinical signs of systemic envenoming. Based on the laboratory results and subsequent clinical course, three groups were distinguished. The first group, consisting of five cases, showed no activation of coagulation at any stage. The second group, consisting of six cases, developed mild to moderate abnormalities in some tests, particularly in the aPTT and factor V assay, which corrected to normal without treatment. The third group, consisting of nine patients, developed haemostatic abnormalities as early as 1-2 h after the bite, which progressed to severe defibrination 4-8 h later at which time antivenom was given. Comparison of the haemostatic abnormalities in the three groups suggested that serial monitoring of the serum FDP concentration may be of value in predicting the likelihood of systemic envenoming and progression to complete defibrination. PMID- 3828228 TI - Red cell Th activation: biochemical studies. AB - The peanut agglutinin from Arachis hypogea is a lectin that reacts with red blood cells expressing the Th antigen. The Th antigen has been said to be qualitatively similar to the T antigen, a well-defined antigen due to desialylation of glycophorin A and B that also reacts with the peanut agglutinin. We examined Th activated red blood cells from two patients with Fanconi's anaemia using 125I radiolabelled peanut agglutinin as a probe in Western blotting of red blood cell membrane proteins. We also probed the surface of intact Th activated red blood cells for structures related to the T antigen using [3H]sialic acid and a purified sialyltransferase. Neither of these techniques found antigens on the Th activated red blood cells that were similar to the antigen found on T activated red blood cells. These results show that the Th antigen in Fanconi's anaemia is qualitatively different to the antigen found in T activation. PMID- 3828229 TI - Haplotypes and alpha globin gene analyses in sickle cell anaemia patients from Kenya. AB - Over 60 patients from the Luo and Luhya tribes of Western Kenya, aged 1-23 years, with severe sickle cell anaemia were evaluated through haematological and gene mapping analyses. Nearly all (56 of 58 tested) were homozygous for haplotype 20 (Antonarakis et al, 1984) which is also frequently present in SS patients of the Central African Republic. All patients had a severe haemolytic anaemia with low Hb F levels and low levels of G gamma chains. An alpha-thalassaemia-2 heterozygosity (-alpha/alpha alpha; -3.7 kb deletion) was present in 26 of 53 patients tested; one patient was a homozygote [f(-alpha) = 0.255]. The alpha-thal 2 was type I in all but one subject with this deficiency; the one exception had an alpha-thal-2 heterozygosity, type II. Heterozygosity for the alpha-thal-2 did not affect the clinical condition nor the haematology; Hb F levels were somewhat lower in SS patients with -alpha/alpha alpha than in those with alpha alpha/alpha alpha. A high frequency was observed for the absence of an Xba I restriction site 5' to the zeta globin gene; the frequency of this anomaly [f(Xba I-)] was estimated at 0.39 for the chromosome with two alpha globin genes and at 0.74 for that with the alpha-thal-2 deletion. An Apa I restriction site polymorphism was observed in the IVS-II of the alpha 2 globin gene; 13 alpha 2 genes of 53 normal (alpha alpha/) chromosomes had this restriction site which was absent in the hybrid alpha globin gene of the -alpha/chromosome. PMID- 3828230 TI - Androgen therapy in haemodialysis patients. II. Effects on red cell metabolism. AB - Activities of the red cell enzymes hexokinase, glucose 6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, lactic dehydrogenase and aspartate aminotransferase were measured in 17 chronic haemodialysis patients receiving androgen therapy, 15 untreated chronic haemodialysis patients and 15 normal subjects. Compared to normal subjects, untreated haemodialysis patients had similar reticulocyte counts but significantly increased levels of all five enzymes studied. This finding suggests the presence of a younger red cell population in the peripheral blood and is consistent with the shortened red cell survival known to occur in this clinical setting. Red cell enzyme activities in untreated haemodialysis patients were significantly correlated with one another and with the serum phosphate level. Moreover, in this population, red cell DPG content was directly related to hexokinase and glucose 6-phosphate dehydrogenase activities while haemoglobin-oxygen affinity (P50) was inversely related to all five enzyme activities. In contrast, in androgen-treated haemodialysis patients, despite higher reticulocyte counts, red cell enzyme activities were the same or lower than those in the untreated haemodialysis group and only slightly higher than those in normal subjects, suggesting an overall older red cell population. Moreover, relationships of red cell enzymes to one another, to serum phosphate levels and to both red cell DPG content and haemoglobin-oxygen affinity were significantly different in androgen-treated subjects than in the untreated haemodialysis group. These changes are consistent with a direct effect of androgens on red cell metabolism and an improved red cell survival during androgen therapy. PMID- 3828231 TI - Acquired loss of red cell Kell antigens. AB - A 19-year-old patient with a long history of idiopathic thrombocytopenic purpura developed a potent antibody against a high-incidence antigen in the Kell blood group system. The direct antiglobulin test on his red cells was negative. His cells exhibited profound depression of Kell blood group antigens, but antigens of other blood groups were normal. Transfusion of incompatible blood was well tolerated and differential agglutination tests, using selected Rh antisera, showed in vivo survival of the transfused red cells for more than 8 weeks. However, the transfused red cells also showed acquired loss of Kell antigens. Five months after the initial findings, Kell-related antibody disappeared and Kell antigens reappeared on his red cells. The patient's serum stored from the initial investigation now reacted with his freshly collected red cells. These data suggest that an environmental agent in the patient's plasma was responsible for the temporary loss of Kell antigens from red cells in his circulation. PMID- 3828232 TI - Human serum ferritin G-peptide is recognized by anti-L ferritin subunit antibodies and concanavalin-A. AB - Ferritin was purified from serum of patients with idiopathic haemochromatosis. Analysis on SDS electrophoresis showed that it is composed of two major bands of 19,000 and 23,000 Mr. The smaller peptide has an electrophoretic mobility and immunochemical reactivity similar to that of tissue L subunit. The larger, previously named G subunit, is recognized by concanavalin-A and by anti ferritin L-subunit, but not by anti-H, monoclonal antibodies. All of the antibodies show higher affinity for the L than for the G subunit. Therefore, the G chain appears immunochemically similar, but not identical, to ferritin L chain, and is responsible for serum ferritin binding concanavalin-A. PMID- 3828233 TI - The fate of intravenously administered hepatic ferritin in normal, phenylhydrazine-treated and scorbutic guinea-pigs. AB - When highly purified hepatic 59Fe-ferritin was injected intravenously into normal guinea-pigs more than half of it was taken up by red cell precursors and the iron was used for haem formation. This was studied in more detail in animals in which a reticulocytosis had been induced either by phenylhydrazine or by repeated venescetions. 55% of the injected ferritin iron was found in reticulocytes at 1 h. Experiments using ferritin doubly labelled with 59Fe and 125I indicated that the whole molecule was taken up, with two-thirds of the radioactivity being associated with the membrane at 1 h and one third being already within the cell. There was a progressive loss of 125I activity over the ensuing hours, while most of the 59Fe was slowly internalized and incorporated into haem between 1 and 24 h. In contrast, 90% of the activity taken up by red cell precursors from 59Fe transferrin was present as haem at all times. The liver and spleen were the two other major sites of 59Fe-ferritin uptake in phenylhydrazine treated animals. While there was an early uptake of 59Fe into haem in these organs, some redistribution occurred with time, since most of the 59Fe was in a non-haem fraction by 24 h. In a final experiment the distribution and fate of 59Fe ferritin was studied in scorbutic animals treated with phenylhydrazine. The findings were similar to those in normals similarly treated, which suggests that ferritin iron was being effectively mobilized for haem formation despite the ascorbic acid depletion. PMID- 3828234 TI - Increased platelet associated immunoglobulin in myelodysplastic syndromes. PMID- 3828235 TI - Heparin-induced thrombocytopenia in pregnancy. PMID- 3828236 TI - Red-cell filterability: correcting for the cell size effect. PMID- 3828237 TI - Precipitation of beta-globin chains within the erythropoietic cells of a patient with congenital dyserythropoietic anemia, type III. PMID- 3828238 TI - Evaluation of the acidified glycerol lysis test. PMID- 3828239 TI - Clinical and laboratory studies of 1,25-dihydroxycholecalciferol in myelofibrosis. PMID- 3828240 TI - Adenosine deaminase in blood cells in various neurological conditions. PMID- 3828241 TI - Further assessment of the effects of occupational radiation exposure in the United Kingdom Atomic Energy Authority mortality study. AB - The United Kingdom Atomic Energy Authority mortality study was designed to investigate the relation between exposure to ionising radiation and mortality among the authority's employees. The present paper describes some of the problems encountered in assessing occupational exposure to low dose radiation and examines whether the study's conclusions about the relation between exposure and mortality could be affected by the methods used. The study covered the years 1946 to 1979 during which time the frequency with which personal film dosimeters were issued changed from weekly to monthly, and the threshold level below which measurements were not made decreased 20-fold. Exposure from "below threshold" readings made an important contribution to total exposure in the early years. Estimates, based on the remeasurement of a sample of old films, indicated that the average whole body exposure before 1961 may have been about double that which was measured. Furthermore, although records were kept of when dosimeters were lost or damaged, the associated exposures were unknown and could only be estimated. Workers whose dosimeter readings were missing for more than 5% of the time during which they were monitored had higher all cause mortality (p = 0.04) and higher mortality from accidents and violence (p = 0.05) than other radiation workers. The results of analyses of mortality in relation to whole body exposure were compared when the exposures included estimates of the below threshold and missing exposures and when these exposures were assumed to be zero. Some of the findings differed, but none changed sufficiently to alter the general conclusions. Although the trend in mortality from all cancers changed from one in which the increase with exposure was far from statistically significant (p = 0.3) when the below threshold and missing values were assumed to be zero to one that approached significance (p = 0.06) after they were estimated, calculations of the annual excess deaths from cancer per unit dose resulted in broadly similar estimates. Studies of workers exposed to ionising radiation usually focus on mortality in relation to whole body exposure. In the present paper its relation to neutron and surface exposure is also examined. Workers with measured neutron exposures had significantly lower all cause mortality than other workers with a radiation record (p = 0.03). Surface exposure was significantly related to mortality from all cancers (p = 0.02) and prostatic cancer (p less than 0.001). Some data on cancer registration are presented but these cannot be readily interpreted because cancer registration details were available only for ex-employees who may not be typical of the workforce as a whole. PMID- 3828242 TI - Mortality of workers employed in two asbestos cement manufacturing plants. AB - In a study of the mortality experience of 6931 employees of two New Orleans asbestos cement products manufacturing plants over 95% were traced. Chrysotile was the primary fibre used in both plants. Plant 1 also used small amounts of amosite and, later, crocidolite irregularly whereas plant 2 used crocidolite steadily in pipe production. Previously reported exposure concentration estimates were revised, based on additional air sampling data and re-evaluation of these data. Workers in the two plants had similar duration of employment (overall, a mean of 3.8 years) and estimated exposure concentration (a mean of 7.6 million particles per cubic foot (mppcf)). Mortality was similar for these plants and comparable with Louisiana rates for all causes combined, nonmalignant causes, and primary cancers of specified sites other than lung. Short term workers from both plants showed raised and similar risk of lung cancer, but risk among longer term workers differed--for example, for workers employed over one year there was no excess in plant 1 (16 observed, 17.2 expected) but a significant excess in plant 2 (52 observed, 28.9 expected, p less than 0.001). After excluding short term workers, risk of lung cancer in plant 2 showed a significant trend with estimated cumulative asbestos exposure; using a conversion of 1.4 fibres/ml = 1 mppcf, the slope of the line was 0.0076. The slope for plant 1 was 0.0003. Among all workers (the 6931, plus 167 early employees) ten mesotheliomas had occurred up to 1984: two from plant 1, eight from plant 2. In plant 2 a case-control analysis found a relation between risk of mesothelioma and duration of employment (p less than 0.01) and proportion of time spent in the pipe area (p less than 0.01), thus adding to the evidence of a greater risk of mesothelioma from crocidolite than chrysotile asbestos. A review of the mortality findings of eight cohorts of asbestos cement workers is presented. PMID- 3828243 TI - Computed tomography and psychometric test performances in patients with solvent induced chronic toxic encephalopathy and healthy controls. AB - Patients with chronic toxic encephalopathy caused by occupational exposure to organic solvents and diagnosed between 1976 and 1981 have been re-examined during a follow up period of 21-88 months (median 48). Thirty two patients underwent computed brain tomography (CT), were retested psychometrically, and the results were compared with a group of age matched control subjects from the same socioeconomic level. The age of the patients was 33-69 (median 55) and they had been exposed to organic solvents for 7-50 years (median 26). The CT examinations were quantified by linear measurements on the films of the four largest sulci, the minimum width of the cella media and the third ventricle. Bifrontal horn, bicaudate, and third ventricle--Sylvian fissure distances were also measured; and measurements were adjusted for variation in skull diameter. No differences were found between the patients and controls. Most of the measures were correlated with age, to a somewhat higher degree in the patients. The patient-control differences did not increase with increasing age of the subjects. Psychometrically the patients performed worse than the controls despite adjustments for possible differences of intellectual level in the two groups. In the patients correlations were found between some of the CT measures and psychometric test performances suggesting slower psychomotor speed and attention difficulties among subjects with central and cortical brain substance reduction. No such correlation was found in the control group. It is concluded that patients with solvent induced chronic toxic encephalopathy have no severe loss of brain substance. PMID- 3828244 TI - Occupational exposure to benzene in China. AB - Of a total of 528,729 workers exposed to benzene or benzene mixtures in China, 508,818 (96.23%) were examined. Altogether 2,676 cases of benzene poisoning were found, a prevalence of 0.15%. A higher prevalence of benzene poisoning was found in the cities of Hangjou, Hefei, Nanjing, Shenyang, and Xian. The geometric mean concentration of benzene in 50,255 workplaces was 18.1 mg/m3 but 64.6% of the workplaces had less than 40 mg/m3. There was a positive correlation between the prevalence of benzene poisoning and the concentration in shoemaking factories. The prevalence of benzene induced aplastic anaemia in shoemakers was about 5.8 times that occurring in the general population. The results of this investigation show the need for a practicable hygiene standard to prevent benzene poisoning. PMID- 3828245 TI - Application of weight-height relations for assessing adiposity in a United Kingdom offshore workforce. AB - Weight (W), height (H), and skinfold thicknesses at biceps, triceps, subscapular, and suprailiac sites were measured in a United Kingdom offshore workforce. Weight and height were used to calculate W/H relations. The percentage body fat was estimated from skinfold thicknesses and the correlations of adiposity with the various W/H relations were evaluated. The significant increase in percentage body fat (%BF) with increasing age resulted in the development of age group specific regression equations relating %BF to the indices of W/H1.5 and W/H2 (body mass index or Quetelet index). Little difference regarding the qualities of these two indices were detected in terms of poor correlation with height and strong correlation with weight. Thus either may be used with similar levels of confidence. Comparison with other studies, however, would be more easily accomplished if W/H2 were used. In the absence of skinfold thickness measurements the W/H2 could readily be implemented during a routine medical and applied for the estimation of %BF in the offshore population provided that the appropriate regression equation were used and that the limitations of the technique are recognised. Percentage values for W, H, W/H relations, and %BF by age group are provided for comparison with other population studies. PMID- 3828246 TI - Ethnic differences in accident rates at work. AB - The accidents at work of 4482 employees in a car engine machining and assembly plant in south east England were studied retrospectively over a 12 month period. The study population was composed of Asian (22%), white (66%), and West Indian employees (12%). The crude accident rates differed among the groups, the means being Asians 1.58, white 1.23, and West Indians 1.28. There was, however, no consistent ethnic difference after adjustment for other factors such as age, type of job, and duration of service. Accident rates were higher in those employees who were younger, newly employed, and in production jobs. The findings of this research imply that accident prevention programmes should be directed to those factors known to relate to accidents and not to any specific ethnic group. PMID- 3828247 TI - Determination of toxicologically important partition coefficients of carbon disulphide by means of the vial equilibration method. PMID- 3828248 TI - Health, fitness, physical activity, and morbidity of middle aged factory workers. I. PMID- 3828249 TI - Benzene exposure in chemical workers. PMID- 3828250 TI - Lung function in coalworkers' pneumoconiosis. PMID- 3828251 TI - Prophylactic blood transfusion in maternal sickle cell syndromes. AB - An assessment of the benefits of prophylactic blood transfusion during 51 pregnancies in women with haemoglobin SS, haemoglobin SC and haemoglobin S-beta thalassaemia in a retrospective study from 1978 to 1984 has failed to demonstrate any clear conclusions as to their efficacy. Of the transfused patients, 22% developed atypical red cell antibodies and 14% had immediate minor transfusion reactions. Our data show no significant difference in fetal or maternal outcome between those patients who were transfused prophylactically and those who were not. A prospective study to clarify the appropriate place of this important aspect of management in women with sickle cell disease in pregnancy is suggested. PMID- 3828252 TI - Decline in skin collagen content and metacarpal index after the menopause and its prevention with sex hormone replacement. AB - The thigh skin collagen content and the metacarpal index were measured in 69 untreated postmenopausal women and in 37 postmenopausal women who had been receiving oestradiol and testosterone implants for 2-10 years. There was a significant positive correlation between the skin collagen content and the metacarpal index in both groups of patients. In the untreated group, there was a statistically significant decrease both in the thigh skin collagen content and in the metacarpal index with the years since the menopause. This decrease was preventable in women who were on sex hormone replacement therapy. PMID- 3828253 TI - Continuous oestrogen-progestogen treatment and serum lipoproteins in postmenopausal women. AB - Serum lipids and lipoproteins were examined in 44 healthy postmenopausal women every 3 months during 1 year of treatment with either continuous oestrogen norethisterone acetate or placebo. Total serum cholesterol and LDL-cholesterol levels were reduced by approximately 15% and 20% (P less than 0.001), respectively in the hormone group but were unchanged in the placebo group. Serum triglycerides levels remained constant in both groups. HDL-cholesterol levels were significantly reduced by approximately 10% in the hormone group but significant reductions of 5-10% also occurred in the placebo group so that differences between the two groups were only significant after 3 months of treatment. Vaginal bleedings were experienced during the first 3 months by eight of the 21 women receiving hormones, but in only one woman after 9 months of therapy. The addition of norethisterone acetate to postmenopausal oestrogen therapy in clinically relevant doses had no adverse effects on lipoproteins as previously reported, even though administered continuously. Moreover, the low frequency of bleeding with continuous oestrogen-progestogen therapy would make this an appropriate alternative in postmenopausal replacement therapy. PMID- 3828254 TI - Bonney's test--fact or fiction? AB - A prospective urodynamic study in 61 incontinent women assessed the validity of the Bonney test in the diagnosis of true sphincter weakness stress incontinence. The urodynamic findings in all the patients indicated that the Bonney test produced significant increases in the urethral closure pressure and transmission of impulse from the abdomen to the urethra which indicated occlusion of the urethra rather than elevation of the bladder neck. The Bonney test does not differentiate between patients with sphincter weakness and those with bladder instability and therefore should be discarded. PMID- 3828255 TI - Tumour-associated monoclonal antibodies for the diagnosis and assessment of ovarian cancer. AB - A tumour-associated radiolabelled monoclonal antibody (HMFG 2) was used to investigate 51 patients who were referred with a pelvic mass and suspected ovarian cancer or recurrent disease. The day before operation the 123I-labelled antibody was injected and the patients then underwent radioimmunoscintigraphy immediately and again 4 and 22 h after the injection. An exploratory laparotomy with appropriate surgery was then performed and the tumours were staged. Tumours were positively imaged 3 min-22 h after injection in all the patients with ovarian cancer, with a mean 0.6% of the injected antibody taken up by the tumour. The presence of HMFG antigen on the tumour was confirmed by immunoperoxidase staining of the surgically-removed tissues. Of the 51 patients, 39 proved to have ovarian cancer. The accuracy of diagnosis and detection of primary and metastatic malignant disease was 95% when correlating pre-operative radioimmune scan findings and laparotomy findings. The procedure is minimally invasive, apparently without side-effects and offers information for tumour detection as an adjunct or alternative to existing methods. PMID- 3828256 TI - Genital condylomata acuminata in pregnancy: effectiveness, safety and pregnancy outcome following cryotherapy. AB - Fifty-one patients, 16 in the second trimester and 35 in the third, were treated by cryotherapy for genital condylomata acuminata; 19 of them had cervical cryotherapy in the second and third trimesters for cervical involvement. Cryosurgical treatment was performed on an out-patient basis, with no general anaesthesia or analgesia, and repeated every 2 weeks until resolution of the condylomata. Male partners were treated as necessary. Patients were followed every 2 weeks before and after delivery until 6 weeks postpartum. The newborn infants were examined for the presence of genital or laryngeal condylomata. Most women required two cryosurgical treatment sessions before complete resolution of condylomata; all resolved in pregnancy and no patient had residual disease at 6 weeks postpartum. There was no case of preterm premature rupture of membranes or premature delivery following cryotherapy, and no case of fetal injury. Labour and delivery were unaffected even by cervical cryotherapy. PMID- 3828257 TI - Idiopathic acute fatty liver of pregnancy associated with transient diabetes insipidus. Case report. PMID- 3828258 TI - Malignant mixed mesodermal tumour of the fallopian tube. Case report. PMID- 3828259 TI - XY-hermaphroditism with unique combination of gonadal tumours. Case report. PMID- 3828260 TI - Clinical and microbiological investigation of women with acute salpingitis and their consorts. PMID- 3828261 TI - 'The next lady has a heart defect'. PMID- 3828262 TI - Orbital decompression for severe dysthyroid eye disease. AB - Current methods of medical treatment of this difficult condition are briefly reviewed, with comments on the generally unsatisfactory response. Attention is therefore directed to surgical methods and a short history given of the various routes used for orbital decompression. The author's own results of transantral, and more recently ethmoidal, decompression are given, with a detailed description of the technique for the latter approach. An interesting frequent consequence of postoperative A pattern to the ocular movements is discussed in the light of Koornneef's concept of orbital fascial anatomy, and suggestions are made for its avoidance. PMID- 3828263 TI - Effect of age on visual acuity after cataract extraction. AB - The best Snellen visual acuity in the three months after cataract extraction was found to decline with the age of the patient. The relationship was identical in 111 patients who had extracapsular extraction and a Pearce tripod posterior chamber intraocular lens and in 50 patients who had intracapsular extraction with spectacle correction. Vision after operation varied from a mean value of 6/5 at 50 years to 6/12 at 90 years, a decline of 1 line per 13.4 years. In the intracapsular group, over a mean follow-up period of 14 years, the rate of fall in acuity with increasing age after operation was found to be statistically similar to that of the early postoperative acuity plotted against age for both types of operation. This suggests that the rate of decline with age is unchanged after a prolonged period of aphakia with presumed increased exposure to ultraviolet and blue light. The data were found to be similar to the decline in the neurosensory elements of vision with age measured experimentally in 20 phakic subjects by laser interferometry. This method of assessment of contrast sensitivity threshold effectively bypasses changes in the optical media. The findings indicate that the previously recognised drop in visual acuity with age is not related to changes in the aging crystalline lens and support the view that there is a decline in the neurosensory elements of vision. It is important to recognise this deterioration so that results of surgery or other treatment are adjusted to allow for the age of the patients. PMID- 3828264 TI - Public health ophthalmology. AB - Public health ophthalmology, often referred to as preventive or community ophthalmology, focuses on three community based activities: preventive, curative, and promotive. The pioneering work of Professor Barrie Jones in this field is recognised. Examples of each activity are provided, with emphasis on the developing world. PMID- 3828265 TI - Fluorescein angiography in the differential diagnosis of sclerokeratitis. AB - Anterior segment fluorescein angiography has been used in the investigation of patients with sclerokeratitis. This showed that corneal thinning or destruction was associated with non-perfusion of the episcleral vasculature. The changes arose either as a result of a systemic vasculitis in seropositive individuals or were induced by surgery to the eye. Infiltrative forms of sclerokeratitis were commoner in seronegative patients and were less often associated with vascular shutdown. PMID- 3828266 TI - Management of unsuccessful lacrimal surgery. AB - Two hundred and eight cases of failed dacryocystorhinostomy presenting to the Lacrimal Clinic at Moorfields Eye Hospital between 1970 and 1985 were reviewed. All cases underwent a further operation. The reasons for failure were usually apparent on reoperation. The surgical technique is described. A second dacryocystorhinostomy is a highly successful technique that spares both patient and surgeon the lifelong commitment to a bypass tube. PMID- 3828267 TI - Clearing the cataract backlog. PMID- 3828268 TI - Perinuclear lens retrodots: a role for ascorbate in cataractogenesis. AB - Lens retrodots are round, oblong, or oval features in the perinuclear zone of the adult lens after the fifth decade of life and associated with cataract. Retrodots were found in 47 out of 121 eyes with cataract (39%) in the present series. They show birefringence in vivo and in vitro, and chemical studies suggest that they contain calcium oxalate. It is proposed that ascorbic acid, which is abundant in the normal human lens, is the most likely source for this oxalate. Ascorbic acid is thought to have a protective role against oxidative stress in the lens and other parts of the eye, and its level is known to be reduced in senile cataract. The presence of the retrodots may identify lenses which have been exposed to oxidative stress and are less capable of resisting oxidative damage. PMID- 3828269 TI - Significance of abnormal pattern electroretinography in anterior visual pathway dysfunction. AB - The pattern electroretinogram (PERG) findings in 72 patients with disease of the anterior visual pathways are presented in relation to the site of dysfunction. Two components of the PERG are described which are selectively involved in different pathologies. In particular, the main positive P50 component is invariably affected in retinal/macular dysfunction, whereas the late negative N95 component is principally affected in optic nerve disease. PMID- 3828270 TI - Intracranial extension of choroidal melanoma via the optic nerve. AB - A 62-year-old woman was treated with cyclocryotherapy for neovascular glaucoma of uncertain origin. Fifteen months later she was diagnosed as having a choroidal melanoma, which extended extrasclerally to fill the orbit and invaded the optic nerve intracranially to the chiasm. She was treated by orbital exenteration and neurosurgical resection of the intracranial portion of the optic nerve. The patient is alive and clinically free of metastasis five years after the onset of neovascular glaucoma and almost four years after surgical resection. The significance of this highly unusual growth pattern of uveal melanoma is discussed. PMID- 3828271 TI - Intraocular pressure during cardiopulmonary bypass. AB - Intraocular pressure was measured in 24 patients undergoing elective cardiopulmonary bypass surgery. There was a rapid rise when the bypass circulation began, and this was maintained for about 30 minutes. A simultaneous drop in arterial perfusion pressure and packed cell volume occurred. We suggest that marked haemodilution is responsible for this effect, through increased ocular blood flow and low colloidal osmotic pressure. The possible aetiological significance in relation to ischaemic optic neuropathy complicating cardiopulmonary bypass is discussed. PMID- 3828272 TI - Pressure compliance of the optic nerve head in low tension glaucoma. AB - Twenty eyes of 10 healthy subjects, 11 eyes of seven patients with low tension glaucoma, and three eyes of three patients with ischaemic optic neuropathy were investigated. Visual evoked responses were recorded under stepwise artificially increased intraocular pressures. The results of the visual evoked response recording (pressure compliance test) allow a clear distinction to be made between healthy subjects, patients with low tension glaucoma, and patients with ischaemic optic neuropathy. In the groups investigated a lack of autoregulation of the optic nerve head circulation was found in patients with low tension glaucoma only. Patients with anterior ischaemic optic neuropathy showed the same pressure compliance behaviour as healthy subjects. The methods used here seem to provide a practicable clinical tool in the differential diagnosis of low tension glaucoma. PMID- 3828273 TI - Laser trabeculoplasty as supplementary treatment for primary open angle glaucoma. AB - A prospective trial was conducted of laser trabeculoplasty randomly assigned to one eye of a group of elderly patients with bilateral primary phakic open angle glaucoma who were already taking the maximum medical treatment that they could tolerate. With a minimum follow-up of 2 1/2 years (mean 35 months) a significant fall in mean intraocular pressure of over 7 mmHg (30%) at the time of the patient's last visit was noted in the treated eye. PMID- 3828274 TI - Use of contrast sensitivity measurement in the detection of subclinical ethambutol toxic optic neuropathy. AB - Contrast sensitivity was measured by means of Arden grating plates in 100 patients on medication for pulmonary tuberculosis. The scores were abnormal in 38.2% of the patients whose therapy included ethambutol for three months, and 36.7% of the patients on similar treatment for six months. In comparison with age matched groups of patients on a regimen where streptomycin replaced ethambutol a statistically significant number of the patients on ethambutol had abnormal scores. This study suggests that Arden contrast sensitivity plates would be effective in detecting subclinical toxic optic neuropathy due to ethambutol and therefore could be used for routine monitoring of ocular function of patients on ethambutol. Loss of contrast sensitivity may explain why some patients on ethambutol with normal visual acuity and colour perception may still complain of visual disturbance. PMID- 3828275 TI - Basal iridectomy at 6 o'clock in the aphakic eye treated with silicone oil: prevention of keratopathy and secondary glaucoma. AB - In the aphakic eye, with intact iris diaphragm, silicone oil has frequently caused a pupillary block. In this situation aqueous humour accumulates behind the iris and forces silicone oil through the pupil into the anterior chamber. An iridectomy at the 6 o'clock position can effectively prevent this pupillary block. The iridectomy allows free passage of aqueous to the anterior chamber which remains free of silicone oil. No permanent contact with silicone oil and the cornea is established, and development of keratopathy is prevented. The effect of this iridectomy in 62 eyes with intact iris diaphragm in patients in Rotterdam (35 cases) and Nagoya (27 cases) is demonstrated. Only in 6.5% of the cases was silicone oil present in the anterior chamber at the end of the follow up period of 7 months. PMID- 3828276 TI - Microcornea associated with retinopathy of prematurity. AB - Eight children with retinopathy of prematurity (ROP) in whom the corneal diameters were abnormally small in one or both eyes are reported. The mechanisms for microcornea in ROP are discussed. The differential diagnosis of microphthalmos is briefly considered. PMID- 3828277 TI - Congenital horizontal tarsal kink: a simple surgical correction. AB - A case is reported in which a simple anterior lamellar repositioning procedure was used successfully to repair an upper lid entropion associated with a horizontal tarsal kink. This obviates the need for the more complex and destructive procedures which have previously been described for the treatment of this condition. PMID- 3828278 TI - Corneal thickness, astigmatism, and atopy. AB - Keratometry and regional pachometry were performed on atopic patients with no history or signs of atopic keratoconjunctivitis. In a series of 80 eyes there was a skewed distribution towards thinner corneas (p less than 0.01) and a preponderance of against-the-rule astigmatism. The maternal age at birth of this group of patients was higher than that in the general population. These findings are discussed in the context of the known association of atopy with keratoconus. PMID- 3828279 TI - Comparison of aqueous humour and serum zinc levels in humans. AB - Zinc concentrations in aqueous humour and serum were determined by means of atomic absorption spectrophotometry in 11 patients with cataract. The zinc content of the aqueous humour was found to be considerably lower than the corresponding serum values. From this finding it is suggested that aqueous humour does not serve as a likely route of delivery of zinc to the cornea. PMID- 3828280 TI - Modern cataract surgery in a highly myopic population. AB - A retrospective series of 117 highly myopic eyes with extracapsular cataract extractions and posterior chamber lens implants is presented. The results are analysed with reference to the current understanding of the complications anticipated. Of particular note is the use of low-powered posteriorly vaulted posterior chamber implants, with and without primary posterior capsulotomy. The results show a low retinal detachment rate (one eye, mean follow-up 12 months); low induced astigmatism (average 0.86 D); low myopic postoperative refraction (median -1.0 D); and high patient satisfaction. PMID- 3828281 TI - Lipofuscin and melanin content of the retinal pigment epithelium in a case of Sjogren-Larsson syndrome. AB - Necropsy material from the eye of a 23-year-old male known to have suffered from the Sjogren-Larsson syndrome, characterised by mental retardation, spastic diplegia or tetraplegia, congenital ichthyosis, and so-called glistening dots in the foveal and parafoveal areas of the fundus of the eye, was investigated ultrastructurally. The retinal pigment epithelium in the macular area showed a significant increase in lipofuscin granules, most likely because of a reduced capacity for digestion of phagocytosed material, and a significant decrease in melanin and melanolipofuscin granules in comparison with a normal control material. The ophthalmoscopically visible glistening dots and the pigment epithelial 'windows' seen on fluorescein angiography may possibly be explained by a further progression of these changes. No retinal changes were found in the macular area, the midperiphery, or the periphery that could be attributed with certainty to any other origin than post-mortem autolysis. More material would be needed, however, to elucidate further the fundal changes in the Sjogren-Larsson syndrome. PMID- 3828282 TI - Congenital iris cysts. AB - Unilateral, spontaneous, non-pigmented iris cysts appeared before the age of 2 years in four patients. Histopathological specimens obtained in three cases showed stratified to cuboidal, non-pigmented, epithelial lined cysts. Goblet cells were recognised in two of the three specimens. The clinical features and histopathological findings indicate that these cysts are derived from surface ectoderm and may be congenital. PMID- 3828283 TI - Rapid microassay for protein kinase C translocation in Swiss 3T3 cells. AB - The Ca2+/phosphatidylserine-stimulated protein kinase C (PKC) appears to exist as interconvertible inactive, soluble and active, membrane-bound forms. Changes in the bimodal distribution of PKC induced by diacylglycerol or tumor-promoting phorbol esters have been proposed to regulate the activity of this kinase [Nishizuka, Y. (1984) Nature (London) 308, 693-698]. A rapid microassay for assessment of protein kinase C translocation between cytosol and membranes was developed. This procedure, which relied on the selective digitonin-mediated release of cytoplasmic proteins, eliminated potential homogenization and fractionation artifacts. PKC activity toward histone H1 was determined after limited trypsinolysis, which abolished the Ca2+/phospholipid requirement of the enzyme and prevented interference by inhibitory proteins. Complete translocation of PKC to the membrane fraction and subsequent down-regulation of the kinase in response to 12-O-tetradecanoylphorbol-13-acetate treatment of Swiss 3T3 cells could be demonstrated by this method. Platelet-derived growth factor, insulin like growth factor 1, vasopressin, and prostaglandin F2 alpha facilitated partial conversions of PKC to the membrane-bound form in quiescent 3T3 cells. PMID- 3828284 TI - Iron(II)-substituted metallothionein: evidence for the existence of iron-thiolate clusters. AB - Metallothioneins (MT's) are unique low molecular weight (Mr 6000-7000) metal- and cysteine-rich proteins characterized by two tetrahedral tetrathiolate clusters containing three and four metal ions. Naturally occurring proteins usually contain the diamagnetic metal ions Zn(II) and/or Cd(II). We have now succeeded in substituting these ions by paramagnetic Fe(II). Rabbit liver MT-1 in which all seven metal binding sites were occupied by Fe(II) ions displays absorption features typical of tetrahedral tetrathiolate Fe(II) coordination. This is documented by the presence of a ligand field 5E----5T2 transition in the near infrared region centered at about 1850 nm (epsilon Fe approximately 100 M-1 cm-1) and a broad charge-transfer absorption in the UV region with a shoulder at 314 nm. A metal-thiolate cluster structure is inferred from the 7 to 20 ratio of metal ions to cysteine residues and from spectral studies in which successive increments of Fe(II) were incorporated into the metal-free protein. Thus, to about 4 equiv, the charge-transfer absorption and magnetic circular dichroism (MCD) features of the complexes formed resemble closely those of reduced rubredoxin from Desulfovibro gigas in which tetrahedral tetrathiolate Fe(II) coordination is documented. However, upon further addition of Fe(II) ions, the charge-transfer absorption bands undergo a progressive red-shift until the full metal occupancy of seven Fe(II) ions per molecule is reached. The bathochromic shift which is also manifested in the MCD spectra can be ascribed to the transformation of some of the terminal thiolate ligands to bridging when the full complement of Fe(II) is bound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828285 TI - Selective deamidation and enzymatic methylation of seminal ribonuclease. AB - Isoenzymatic forms alpha 2, alpha beta, and beta 2 of bovine seminal ribonuclease are generated by the transformation of beta-type into alpha-type subunit through deamidation of a single amide group [Di Donato, A., & D'Alessio, G. (1981) Biochemistry 20, 7232-7237]. The residue involved in this selective deamidation has been identified as Asn67. Deamidation occurs by formation of a cyclic imide intermediate involving the Gly at position 68. Opening of the cyclic imide may occur on either side of the nitrogen, generating both the normal alpha-aspartyl and an isoaspartyl residue at position 67. The alpha-carboxyl of the isoaspartyl residue is effectively methylated by bovine brain protein carboxylmethyltransferase. PMID- 3828286 TI - Thiol reactivity of histone H3 in soluble and DNA-associated histone complexes: evidence for allosteric and torsional regulation. AB - The reactivity of chick erythrocyte and calf thymus histone H3 thiol groups toward 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB) has been investigated both in the soluble, DNA-free state and in various nucleohistone complexes. We have found that the thiol reactivity of both tetramers and octamers decreases continuously as the ionic strength of the assay is increased, up to and beyond 2.0 M NaCl. Upon association of dimers with tetramers, there is loss of labeling by DTNB at one site, suggesting the existence of allosteric regulation [see also Godfrey, J. E., Eickbush, T. H., & Moudrianakis, E. N. (1980) Biochemistry 19, 1339-1346] of dimer-tetramer interfaces emanating from within the tetramer complex. Comparison of the thiol reactivities of chick and calf tetramers indicates that the thiol groups at amino acid positions 96 and 110 are not chemically equivalent. When the histones are associated with DNA, in either reconstituted complexes, core particles, or long soluble chromatin, the thiol reactivity is greatly diminished, and this "DNA effect" overwhelms any influence of dimers. However, if single strand nicks are introduced into the DNA backbone of core particles and other chromatin-like complexes by the action of DNase I, the influence of the DNA double helix upon thiol reactivity is reduced, and the effect of dimers can be detected once again. We can therefore conclude that the DNA effect derives from intranucleosomal torsional strain of the continuum of the double helix in equilibrium with coupled protein conformational changes. These observations support the concept that the octamer complex is a dynamic tripartite structure whose properties can be modulated through its interactions with DNA and by changes occurring in the dimer-tetramer interfaces. PMID- 3828287 TI - Inhibition of the thermally driven B to Z transition by intercalating drugs. AB - Poly(dG-m5dC) in phosphate buffer containing 50 mM NaCl and Mg2+ will undergo a reversible thermally driven conversion from the B to the left-handed Z conformation. The temperature at the midpoint of the thermally driven B to Z transition (denoted Tz) is dependent upon the total Mg2+ concentration, with [d(1/Tz)]/(d ln [Mg]) = 0.0134 K-1. The Mg2+ concentration at the midpoint of the equilibrium B to Z transition curve, denoted [Mg]1/2, is dependent on temperature, with (d ln [Mg]1/2)/(d ln T) = -1.02. Binding of the anticancer drug daunomycin to the polymer results in a pronounced increase in Tz, dependent on the molar ratio of added drug. Tz is increased by 71.9 degrees C with nearly saturating amounts of drug bound. Transition profiles are biphasic at less than saturating amounts of bound drug. By experiments monitoring such biphasic curves at a visible wavelength sensitive to the binding of daunomycin, it may be demonstrated that no drug is released until the later phase of the transition. These results are analogous to the effects of intercalating drugs on the thermal denaturation of DNA and indicate that drug molecules preferentially interact with B-form DNA and are redistributed to regions in the B conformation over the course of the transition. Comparative studies show that some intercalators stabilize right-handed DNA more effectively than others. At similar initial binding ratios, the following order, from most to least effective, was experimentally observed: actinomycin greater than daunomycin greater than ethidium greater than proflavin. PMID- 3828288 TI - Evidence that heme d1 is a 1,3-porphyrindione. AB - Heme d1 is the noncovalently associated heme prosthetic group of the bacterial nitrite reductase known as cytochrome cd1. Additional evidence has been obtained in support of a dioxoisobacteriochlorin, or 1,3-porphyrindione, skeleton for this heme. The new data include the natural abundance 13C NMR spectrum of the free base methyl ester derivative of d1, mass spectrometric determinations of the molecular mass of the free base methyl ester and the Cu and the Zn chelates, visible and 1H NMR spectral comparisons between d1 and synthetic porphyrindione model compounds, and the isolation and characterization of several byproducts formed during the purification of the free base methyl ester of d1. The accumulated evidence strongly supports the following structure for the skeleton of d1: 1-oxo-2-methyl-2'-acetyl-3-oxo-4-methyl-4'-acetyl-5-methyl-6-acrylyl+ ++-7 propionyl-8-methylporphyrin. PMID- 3828289 TI - ATP-induced dissociation of rabbit skeletal actomyosin subfragment 1. Characterization of an isomerization of the ternary acto-S1-ATP complex. AB - The adenosine 5'-O-(3-thiotriphosphate) (ATP gamma S) induced dissociation of actomyosin subfragment 1 (S1) has been investigated by monitoring the light scattering changes that occur on dissociation. We have shown that ATP gamma S dissociates acto-S1 by a mechanism similar to that of ATP but at a rate 10 times slower. The maximum rate of dissociation is limited by an isomerization of the ternary actin-S1-nucleotide complex, which has a rate of 500 s-1 for ATP gamma S and an estimated rate of 5000 s-1 for ATP (20 degrees C, 0.1 M KCl, pH 7.0). The activation energy for the isomerization is the same for ATP and ATP gamma S, and both show a break in the Arrhenius plot at 5 degrees C. The reaction between acto S1 and ATP was also followed by the fluorescence of a pyrene group covalently attached to Cys-374. We show that the fluorescence of the pyrene group reports the isomerization step and not actin dissociation. The characterization of this isomerization is discussed in relation to force-generating models of the actomyosin cross-bridge cycle. PMID- 3828290 TI - Structure of a stable form of sulfheme. AB - A stable green heme was extracted from ferric cyanosulfmyoglobin after it had undergone an internal conversion reaction. After iron removal and conversion to the methyl ester, the resulting green porphyrin was purified by high-pressure liquid chromatography. Visible, 1H NMR, and mass spectrometric studies provided evidence to identify the substituents of the porphyrin. Nuclear Overhauser enhancements enabled an assignment of the single modified pyrrole. Substituent positions 1, 2, 5, 6, 7, and 8 have the original protoporphyrin IX substituents. At ring B, the 4-vinyl group has cyclized with a single sulfur atom to form a fifth ring with a 2,5-dihydrothiophene type of structure. PMID- 3828291 TI - Inhibition of malic enzyme by S-oxalylglutathione, a probable in vivo effector. AB - Various oxalyl thiol esters (RSCOCOO-), especially S-oxalylglutathione (GS-Ox), were found to be very effective inhibitors of chicken liver malic enzyme. When the conditions are similar to those encountered physiologically [high reduced nicotinamide adenine dinucleotide phosphate (NADPH) concentrations], inhibition is detectable with less than 1 microM concentrations of GS-Ox. The amount of inhibition is not reversed by excess glutathione, thus indicating that it is not due to oxalyl transfer to some enzymic thiol group with release of glutathione. Detailed kinetic studies show that the inhibition by GS-Ox can be treated as a simple reversible binding to the enzyme; the double reciprocal plot patterns indicate that the inhibition is linear noncompetitive (mixed type), vs. both L malate in the oxidative decarboxylation reaction and pyruvate in the reverse reaction. At pH 7.4 and 25 degrees C in the presence of 100-200 microM NADPH, the Kis and Kii values for GS-Ox are 0.7 and 5 microM, respectively, and are the same for reactions run in either direction. The high specificity for GS-Ox is indicated by the observation that, under similar conditions, the Kis values for S oxalyl coenzyme A and S-oxalyl-N-acetylcysteamine are 40 and 150 microM, respectively. Such high specificity indicates that the enzyme has evolved a specific binding site for the glutathione part of GS-Ox. The current results, when considered in conjunction with recent evidence that oxalyl thiol esters are present in animal tissues at concentrations up to 50 microM, imply that GS-Ox is an important in vivo regulator of malic enzyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828292 TI - Interaction of blood coagulation factor Va with phospholipid vesicles examined by using lipophilic photoreagents. AB - Two different lipophilic photoreagents, [3H]adamantane diazirine and 3 (trifluoromethyl)-3-(m-[125I]iodophenyl)diazirine (TID), have been utilized to examine the interactions of blood coagulation factor Va with calcium, prothrombin, factor Xa, and, in particular, phospholipid vesicles. With each of these structurally dissimilar reagents, the extent of photolabeling of factor Va was greater when the protein was bound to a membrane surface than when it was free in solution. Specifically, the covalent photoreaction with Vl, the smaller subunit of factor Va, was 2-fold higher in the presence of phosphatidylcholine/phosphatidylserine (PC/PS, 3:1) vesicles, to which factor Va binds, than in the presence of 100% PC vesicles, to which the protein does not bind. However, the magnitude of the PC/PS-dependent photolabeling was much less than has been observed previously with integral membrane proteins. It therefore appears that the binding of factor Va to the membrane surface exposes Vl to the lipid core of the bilayer, but that only a small portion of the Vl polypeptide is exposed to, or embedded in, the bilayer core. Addition of either prothrombin or active-site-blocked factor Xa to PC/PS-bound factor Va had little effect on the photolabeling of Vl with TID, but reduced substantially the covalent labeling of Vh, the larger subunit of factor Va. This indicates that prothrombin and factor Xa each cover nonpolar surfaces on Vh when the macromolecules associate on the PC/PS surface. It therefore seems likely that the formation of the prothrombinase complex involves a direct interaction between Vh and factor Xa and between Vh and prothrombin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828293 TI - Mechanism of isomerization of 11-cis-retinal in lipid dispersions by aromatic amines. AB - It has previously been shown that retinotoxic, primary aromatic amines catalyze the isomerization of 11-cis-retinal to its all-trans congener after Schiff base formation [Bernstein, P.S., Fulton, B.S., & Rando, R.R. (1986) Biochemistry 25, 3370-3377]. This process led to the short-circuiting of the visual cycle and the observed retinotoxicity when it occurred in vivo. The catalysis was also observed to occur in vitro in phosphatidylcholine-based vesicles but not in hydrocarbon solutions. The rate of isomerization of an aromatic amine Schiff base of 11-cis retinal in the phospholipid vesicles was typically 10(3)-fold more rapid than in hydrocarbon solutions. In this article, the mechanistic basis of this apparently membrane-specific catalysis is described. It was found that the rate enhancement effect observed was independent of the lipid used. Moreover, a bilayer structure was not important because rate enhancements were also observed in micelles. The rapid isomerization rates observed in lipid dispersions appear not be free radical initiated because free radical quenching agents, such as alpha-tocopherol and beta-carotene, had little effect on the isomerization rates. It was further found that aliphatic amines, such as n-dodecylamine, could be substituted for the aromatic amines in phospholipid. Finally, and most importantly, it was found that the isomerization of the aromatic amine retinal Schiff bases in phospholipid vesicles was acid-catalyzed. It is concluded that the rate enhancements observed for the isomerization of 11-cis-retinal-aromatic amine Schiff bases in lipid dispersions over that in hydrocarbon solvents are due to the occurrence of acid base catalysis in the former. PMID- 3828294 TI - Comparison of the precursor and mature forms of rat heart mitochondrial malate dehydrogenase. AB - The complete amino acid sequence of mitochondrial malate dehydrogenase from rat heart has been determined by chemical methods. Peptides used in this study were purified after digestions with cyanogen bromide, trypsin, endoproteinase Lys C, and staphylococcal protease V-8. The amino acid sequence of this mature enzyme is compared with that of the precursor form, which includes the primary structure of the transit peptide. The transit peptide is required for incorporation into mitochondria and appears to be homologous to the NH2-terminal arm of a related cytoplasmic enzyme, pig heart lactate dehydrogenase. The amino acid differences between the rat heart and pig heart mitochondrial malate dehydrogenases are analyzed in terms of the three-dimensional structure of the latter. Only 12/314 differences are found; most are conservative changes, and all are on or near the surface of the enzyme. We propose that the transit peptide is located on the surface of the mitochondrial malate dehydrogenase precursor. PMID- 3828295 TI - Reaction of (bromoacetamido)nucleoside affinity labels with ribonuclease A: evidence for steric control of reaction specificity and alkylation rate. AB - Four new bromoacetamido pyrimidine nucleosides have been synthesized and are affinity labels for the active site of bovine pancreatic ribonuclease A (RNase A). All bind reversibly to the enzyme and react covalently with it, resulting in inactivation. The binding constants Kb and the first-order decomposition rate constants k3 have been determined for each derivative. They are the following: 3' (bromoacetamido)-3'-deoxyuridine, Kb = 0.062 M, k3 = 3.3 X 10(-4) s-1; 2' (bromoacetamido)-2'-deoxyxylofuranosyluracil, Kb = 0.18 M, k3 = 1700 X 10(-4) s 1; 3'-(bromoacetamido)-3'-deoxyarabinofuranosyluracil, Kb = 0.038 M, k3 = 6.6 X 10(-4) s-1; and 3'-(bromoacetamido)-3'-deoxythymidine, Kb = 0.094 M, k3 = 2.7 X 10(-4) s-1. 3'-(Bromoacetamido)-3'-deoxyuridine reacts exclusively with the histidine-119 residue, giving 70% of a monoalkylated product substituted at N-1, 14% of a monoalkylated derivative substituted at N-3, and 16% of a dialkylated species substituted at both N-1 and N-3. Both 2'-(bromoacetamido)-2' deoxyxylofuranosyluracil and 3'-(bromoacetamido)-3'-deoxyarabinofuranosyluracil react with absolute specificity at N-3 of the histidine-12 residue. 3' (Bromoacetamido)-3'-deoxythymidine alkylates histidines-12 and -119. The major product formed in 57% yield is substituted at N-3 of histidine-12. A monoalkylated derivative, 8% yield, is substituted at N-1 of histidine-119. A disubstituted species is formed in 14% yield and is alkylated at both N-3 of histidine-12 and N-1 of histidine-119. A specific interaction of the "down" 2'-OH group, unique to 3'-(bromoacetamido)-3'-deoxyuridine, serves to orient the 3' bromoacetamido residue close to the imidazole ring of histidine-119. The 2'-OH group of 3',5'-dinucleoside phosphate substrates may serve a similar role in the catalytic mechanism, allowing histidine-119 to protonate the leaving group in the transphosphorylation step. (Bromoacetamido)nucleosides are bound in the active site of RNase A in a variety of distinct conformations which are responsible for the different specificities and alkylation rates. PMID- 3828296 TI - Energetics of alpha-chymotrypsin-mediated hydrolysis of a strained cyclic ester. AB - Hydrolysis of omicron-hydroxy-alpha-toluenesulfonic acid sultone (sultone II) is mediated by alpha-chymotrypsin. Sultone II is a highly strained cyclic ester substrate that forms a covalent intermediate with the enzyme and is therefore expected to release ring-strain energy upon formation of the sulfonyl enzyme species. It is found that the equilibrium constant for forming the covalent intermediate from the Michaelis complex is quite modest (K2 = 16.4), suggesting that perhaps the strain energy is not released in the ring-cleavage event. The implied retention of chemical (strain) energy by the sulfonyl enzyme species raises the question of the means by which the enzyme avoids expression of strain energy and the implications of this effect in the catalytic sequence. High pressure liquid chromatography (HPLC) rate data demonstrate facile reversion of sulfonyl enzyme to the Michaelis complex, and that reversion is preferred over hydrolysis of the covalent intermediate. pH-independent rate and equilibrium constants are derived for the alpha-chymotrypsin-mediated hydrolysis of sultone II, and pKa values for groups on the enzyme are reported that are consistent with literature values obtained from analysis of nonspecific substrate hydrolysis by the enzyme. PMID- 3828297 TI - Multilayered vesicles prepared by reverse-phase evaporation: liposome structure and optimum solute entrapment. AB - Liposome structure and solute entrapment in multilayered vesicles (MLVs) prepared by reverse-phase evaporation (REV) were studied. MLV-REV vesicles prepared from ether/water emulsions have high entrapment. Entrapment depends on drug, drug concentration, lipid, lipid concentration, and the container used to prepare the vesicles. By use of 300 microL of aqueous phase and 100 mg of phosphatidylcholine (PC), vesicles prepared in a test tube 25 mm X 175 mm have higher entrapment than vesicles prepared in a 100-mL round-bottom or pear-shaped flask. By use of a test tube, 100 mg of PC, and 300 microL of aqueous phase containing sucrose (1-50 mg/mL), greater than 90% sucrose entrapment was obtained. Increasing lipid content to 150 mg of PC decreased entrapment to approximately 80%. Neutral PC MLV REV vesicles have optimum entrapment. Mixing negatively charged lipids or cholesterol (CH) with PC to make MLV-REV vesicles results in decreased entrapment compared to using only PC. Preparing vesicles with the solid lipid dipalmitoylphosphatidylcholine (DPPC) or DPPC/CH mixtures (0 less than or equal to mol % CH less than or equal to 50) results in approximately 30-40% entrapment when diethyl ether is used to make the MLV-REV emulsion. Substituting diisopropyl ether for diethyl ether and heating the MLV-REV emulsion during vesicle formation generate DPPC/CH vesicles that entrap 60% of added solutes. The high entrapment found for MLV vesicles prepared from water/organic solvent emulsions depends on maintaining a core during the process of liposome formation. A method to calculate the fraction of water residing in the liposomes' core is presented and used to compare multilayered vesicles prepared by different processes. X-ray diffraction data demonstrate that a heterogeneous distribution of lipid may exist in multilayered vesicles prepared by the REV process. PMID- 3828298 TI - Ovomucoid third domains from 100 avian species: isolation, sequences, and hypervariability of enzyme-inhibitor contact residues. AB - Ovomucoids were isolated from egg whites of 100 avian species and subjected to limited proteolysis. From each an intact, connecting peptide extended third domain was isolated and purified. These were entirely sequenced by single, continuous runs in a sequencer. Of the 106 sequences we report (five polymorphisms and chicken from the preceding paper [Kato, I., Schrode, J., Kohr, W. J., & Laskowski, M., Jr. (1986) Biochemistry (preceding paper in this issue)]), 65 are unique. In all cases except ostrich (which has Ser45), the third domains are either partially or fully glycosylated at Asn45. The majority of the third domain preparations we isolated are carbohydrate-free. Alignment of the sequences shows that their structurally important residues are strongly conserved. On the other hand, those residues that are in contact with the enzyme in turkey ovomucoid third domain complex with Streptomyces griseus proteinase B [Read, R., Fujinaga, M., Sielecki, A. R., & James, M. N. G. (1983) Biochemistry 22, 4420-4433] are not conserved but instead are by far the most variable residues in the molecule. These findings suggest that ovomucoid third domains may be an exception to the widely accepted generalization that in protein evolution the functionally important residues are strongly conserved. Complete proof will require better understanding of the physiological function of ovomucoid third domains. This large set of variants differing from each other in the enzyme inhibitor contact area and augmented by several high-resolution structure determinations is useful for the study of our sequence to reactivity (inhibitory activity) algorithm. It is also useful for the study of several other protein properties. In the connecting peptide fragment most phasianoid birds have the dipeptide Val4-Ser5, which is absent in most other orders. This dipeptide is often present in only 70-95% of the molecules and appears to arise from ambiguous excision at the 5' end of the F intron of ovomucoid. Connecting peptides from the ovomucoids of cracid birds contain the analogous Val4-Asn5 peptide. In laughing kookaburra ovomucoid third domain we found (in 91% of the molecules) Gln5A, which we interpret as arising from ambiguous intron excision at the 3' end of the F intron. PMID- 3828299 TI - Lipid polymorphism of mixtures of dioleoylphosphatidylethanolamine and saturated and monounsaturated phosphatidylcholines of various chain lengths. AB - The L alpha-HII phase transition behavior of many lipid-water liquid crystals is dominated by the competition between the tendency to curl the lipid layers to an intrinsic radius of curvature and opposing hydrocarbon packing constraints. In particular, packing constraints can increase the free energy of the inverted hexagonal (HII) phase as compared to that of the lamellar (L alpha) phase. This is especially true where the lipid molecule is not long enough to reach into the corners of the lattice in large hexagonal structures necessitated by a large intrinsic radius of curvature. In this paper it is shown that the addition of a minor fraction long-chain lipid to a system of otherwise uniform chain composition can also relax packing constraints, thereby lowering the lamellar to hexagonal transition temperature. For the specific systems used, dioleoylphosphatidylethanolamine (di-18:1c-PE) with minor fractions of 1,2-diacyl sn-glycero-3-phosphocholines [di-n:1c-PC (n = 14, 18, 22, and 24)], the observed HII lattices systematically increased in size with increasing chain length, suggesting that the chain length also may affect the intrinsic curvature of the mixture. These experiments demonstrate that the lipid "shape concept", which is a qualitative expression of the concept quantitatively described by the intrinsic radius of curvature, is insufficient to understand the L alpha-HII transition. It is necessary to, at least, consider the competition between curvature and packing. PMID- 3828300 TI - Kinetics of ganglioside transfer between liposomal and synaptosomal membranes. AB - The transfer of ganglioside GM1 from micelles to membranes and between different membrane populations has been examined by using a pyrene fatty acid derivative of the ganglioside. The transfer of gangliosides from micelles to membranes depends on the physical state as well as the molecular composition of the acceptor vesicles. At 30 degrees C, the transfer of micellar gangliosides to dipalmitoylphosphatidylcholine (DPPC) large unilameller vesicles (Tm = 41.3 degrees C) is characterized by a rate constant of 0.01 min-1; at 48 degrees C, however, the rate constant is 0.11 min-1. Below the phase transition temperature, the activation energy is 25 kcal/mol whereas above the phase transition it is 17 kcal/mol. Similar experiments performed with synaptic plasma membranes yielded a rate constant of 0.05 min-1 at 37 degrees C. The rate of transfer of ganglioside molecules, asymmetrically located on the outer layer of donor vesicles, to acceptor vesicles lacking ganglioside depends on the physical state of both the donor and acceptor vesicles. For the transfer of ganglioside from DPPC (donor) vesicles to dimyristoylphosphatidylcholine (DMPC) (acceptor) vesicles, the rates were essentially zero at 15 degrees C in which both vesicle populations were in the gel phase, 0.008 min-1 at 30 degrees C in which DPPC is in the gel phase and DMPC is in the fluid phase, and 0.031 min-1 at 48 degrees C in which both vesicle populations are in the fluid phase. The transfer of ganglioside from DPPC vesicles to synaptic plasma membranes was also dependent on the physical state of the donor vesicles and showed an inflection point at the phase transition temperature of DPPC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828301 TI - Thermal expansion of a protein. AB - The thermal expansion of a protein, metmyoglobin, was investigated by analysis of the refined X-ray crystal structures at 80 and 255-300 K. On heating from 80 to 300 K, the volume occupied by myoglobin increases by approximately 3%. The linear thermal expansion coefficient is estimated to be 115 X 10(-6) K-1. This value is more than twice as large as that of liquid water but less than that of benzene. As the temperature is raised, the internal volume change does not come from the large, atom-sized internal cavities in the structure but from an increase in the small, subatomic free volumes between atoms. The largest expansion occurs in the region of the CD and GH corners; both these regions move away from the center of the protein. The remainder of the expansion results from the lengthening of contacts between segments of secondary structure. PMID- 3828302 TI - Crystal and molecular structure of the serine proteinase inhibitor CI-2 from barley seeds. AB - Chymotrypsin inhibitor 2 (CI-2), a serine proteinase inhibitor from barley seeds, has been crystallized and its three-dimensional structure determined at 2.0-A resolution by the molecular replacement method. The structure has been refined by restrained-parameter least-squares methods to a crystallographic R factor (= sigma parallel Fo magnitude of-Fo parallel/sigma magnitude of Fo) o of 0.198. CI 2 is a member of the potato inhibitor 1 family. It lacks the characteristic stabilizing disulfide bonds of most other members of serine proteinase inhibitor families. The body of CI-2 shows few conformational changes between the free inhibitor and the previously reported structure of CI-2 in complex with subtilisin Novo [McPhalen, C.A., Svendsen, I., Jonassen, I., & James, M.N.G. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 7242-7246]. However, the reactive site loop has some significant conformational differences between the free inhibitor and its complexed form. The residues in this segment of polypeptide exhibit relatively large thermal motion parameters and some disorder in the uncomplexed form of the inhibitor. The reactive site bond is between Met-59I and Glu-60I in the consecutive sequential numbering of CI-2 (Met-60-Glu-61 according to the alignment of Svendsen et al. [Svendsen, I., Hejgaard, J., & Chavan, J.K. (1984) Carlsberg Res. Commun. 49, 493-502]). The network of hydrogen bonds and electrostatic interactions stabilizing the conformation of the reactive site loop is much less extensive in the free than in the complexed inhibitor. PMID- 3828303 TI - Kinetic studies of actinomycin D binding to mono-, oligo-, and polynucleotides. AB - The kinetics of association of actinomycin D with poly(dG-dC) and the oligonucleotides d-(CGCGCGCG), d(GCGCGC), d(ATGCAT), d(CGCG), and d(GC), as well as with several mononucleotides, have been investigated. In all cases, the association interaction was characterized by several slow, unimolecular processes with qualitatively similar rate constants. The activation enthalpies and entropies for the association of actinomycin with deoxyguanosine 5'-monophosphate resemble closely those typical for calf thymus DNA. This observation of little or no sequence or length dependence in the binding kinetics suggests that the slow phases arise from properties of the drug alone. These results are discussed in terms of both the shuffling model of Fox and Waring [Fox, K.R., & Waring, M.J. (1984) Eur. J. Biochem. 145, 579] and the model of Muller and Crothers [Muller, W., & Crothers, D.M. (1968) J. Mol. Biol. 35, 251] involving both rapidly forming and slowly forming complexes, with the rapidly forming species being the predominant one. PMID- 3828304 TI - Selective solubilization of beta-globin oligonucleosomes at low ionic strength. AB - We [Rocha, E., Davie, J.R., van Holde, K.E., & Weintraub, H. (1984) J. Biol. Chem. 259, 8558-8563] have previously reported that the transcriptionally competent beta-globin gene domain is selectively enriched in chromatin fractions eluted with solutions of approximately physiological ionic strength from micrococcal nuclease digested mature chicken erythrocyte nuclei. In this report, we demonstrate that beta-globin chromatin is eluted as oligonucleosomes while vitellogenin, a transcriptionally inactive gene, is eluted as mononucleosomes as is the bulk of sequences found in this fraction. Following removal of the salt, the eluted chromatin was made 100 mM KCl and separated into aggregation-prone and aggregation-resistant fractions. Globin sequences were present in both fractions and had the greatest enrichment in the aggregation-prone fraction which contained H1 and H5, H1 being more abundant. A procedure is presented in which H1 is selectively removed from the erythrocyte nuclei. Following the selective removal of H1 and subsequent fractionation, globin but not vitellogenin oligonucleosomes were present in the aggregation-resistant chromatin fraction. The results indicate the beta-globin domain is a mosaic of aggregation-resistant and aggregation-prone regions with the latter being associated with H1 and H5. Vitellogenin sequences were associated principally with aggregation-prone regions complexed with H5. PMID- 3828305 TI - Isolation and identification of 1,23-dihydroxy-24,25,26,27-tetranorvitamin D3, a new metabolite of 1,25-dihydroxyvitamin D3 produced in rat kidney. AB - A new metabolite of vitamin D3 was produced in vitro by perfusing rat kidneys with 1,25-dihydroxyvitamin D3 (4 X 10(-6) M). It was isolated and purified from the lipid extract of the kidney perfusate by high-performance liquid chromatography. By means of ultraviolet absorption spectrophotometry, mass spectrometry, chemical derivatization, and chemical synthesis, the new metabolite was identified as 1,23-dihydroxy-24,25,26,27-tetranorvitamin D3. Along with the new metabolite, three other previously identified metabolites, namely, 1,24,25 trihydroxyvitamin D3, 1,25-dihydroxy-24-oxovitamin D3, and 1,23,25-trihydroxy-24 oxovitamin D3, were also isolated. The new metabolite was also formed when 1,23,25-trihydroxy-24-oxovitamin D3 was used as the substrate. Thus, the new metabolite fits into the following metabolic pathway: 1,25-dihydroxyvitamin D3--- 1,24(R),25-trihydroxyvitamin D3----1,25-dihydroxy-24-oxovitamin D3----1,23,25 trihydroxy-24-oxovitamin D3----1,23-dihydroxy-24,25,26,27-tetranorvitamin D3. Further, we used 1 alpha,25-dihydroxy[1 beta-3H]vitamin D3 in the kidney perfusion system and demonstrated 1,23-dihydroxy-24,25,26,27-tetranorvitamin D3 as the major further metabolite of 1,25-dihydroxyvitamin D3, circulating in the final perfusate when kidneys were perfused with 1,25-dihydroxyvitamin D3 (6 X 10( 10) M) for 4 h. The biological activity of 1,23-dihydroxy-24,25,26,27 tetranorvitamin D3 (C-3 alcohol) and its metabolic relationship to 1-hydroxy-23 carboxy-24,25,26,27-tetranorvitamin D3 (calcitroic acid or C-23 acid), the other previously identified side-chain cleavage metabolite of 1,25-dihydroxyvitamin D3, are unknown and are presently undergoing investigation. PMID- 3828306 TI - Free energy couplings between ligand binding and subunit association in hemoglobin are of first order. AB - The calculations presented in a recent paper [Johnson, M. L. (1986) Biochemistry 25, 791-797] to the effect that the free energy couplings between oxygen binding and subunit association in hemoglobin A can be of either first or second order are examined. The fitting of the experimental data to a system with second-order couplings carried out by Johnson belongs to a tetramer in which, in contradistinction to hemoglobin A, oxygen binding promotes subunit association. PMID- 3828307 TI - Induction of lateral phase separations in binary lipid mixtures by alcohol. AB - It has previously been shown that alcohol has different effects on the gel to liquid-crystal phase transition of phosphatidylcholines (PC's) and phosphatidylethanolamines (PE's) [Rowe, E. S. (1985) Biochim. Biophys. Acta 813, 321-330]. In this investigation, the thermotropic properties of binary PE-PC mixtures were studied in the presence of ethanol in order to determine whether the differential interactions of alcohol with PC and PE would lead to lateral phase separations. Phase diagrams of the dilaurylphosphatidylethanolamine dipalmitoylphosphatidylcholine [PE(12:0)-PC(16:0)] system were constructed in the presence and absence of ethanol. It was shown that lateral phase separations occur in the gel phase over a certain composition range in the presence of 100 mg/mL ethanol. In the absence of alcohol these two lipids are miscible in both the gel and liquid-crystal states. The data suggest that in the presence of ethanol these lateral phase separations involve the coexistence of regular bilayer gel and the fully interdigitated gel phase, which has previously been shown to occur in pure PC(16:0) under these conditions [Simon, S. A., & McIntosh, T. J. (1984) Biochim. Biophys. Acta 773, 169-172]. The biological implications of these findings are discussed. PMID- 3828308 TI - Enzymatic methylation of band 3 anion transporter in intact human erythrocytes. AB - Band 3, the anion transport protein of erythrocyte membranes, is a major methyl accepting substrate of the intracellular erythrocyte protein carboxyl methyltransferase (S-adenosyl-L-methionine: protein-D-aspartate O methyltransferase; EC 2.1.1.77) [Freitag, C., & Clarke, S. (1981) J. Biol. Chem. 256, 6102-6108]. The localization of methylation sites in intact cells by analysis of proteolytic fragments indicated that sites were present in the cytoplasmic N-terminal domain as well as the membranous C-terminal portion of the polypeptide. The amino acid residues that serve as carboxyl methylation sites of the erythrocyte anion transporter were also investigated. 3H-Methylated band 3 was purified from intact erythrocytes incubated with L-[methyl-3H]methionine and from trypsinized and lysed erythrocytes incubated with S-adenosyl-L-[methyl 3H]methionine. After proteolytic digestion with carboxypeptidase Y, D-aspartic acid beta-[3H]methyl ester was isolated in low yields (9% and 1%, respectively) from each preparation. The bulk of the radioactivity was recovered as [3H]methanol, and the amino acid residue(s) originally associated with these methyl groups could not be determined. No L-aspartic acid beta-[3H]methyl ester or glutamyl gamma-[3H]methyl ester was detected. The formation of D-aspartic acid beta-[3H]methyl esters in this protein in intact cells resulted from protein carboxyl methyltransferase activity since it was inhibited by adenosine and homocysteine thiolactone, which increases the intracellular concentration of the potent product inhibitor S-adenosylhomocysteine, and cycloleucine, which prevents the formation of the substrate S-adenosyl-L-[methyl-3H]methionine. PMID- 3828309 TI - Differential absorption flattening optical effects are significant in the circular dichroism spectra of large membrane fragments. AB - The circular dichroism spectra of membrane particles are distorted by effects of differential absorption flattening, which are a consequence of the nonrandom distribution of chromophores in these samples. We have shown that this phenomenon is not significant in small unilamellar vesicles with high lipid to protein ratios [Mao, D., & Wallace, B. A. (1984) Biochemistry 23, 2667-2673]. It has recently been claimed [Glaeser, R. M., & Jap, B. K. (1985) Biochemistry 24, 6398 6401] that absorption flattening effects are also inconsequential in large membrane fragments with high protein concentrations, such as purple membrane sheets. This paper will demonstrate that absorption flattening is significant in these samples and that it causes substantial distortion of the calculated protein secondary structures derived from the uncorrected circular dichroism data. PMID- 3828310 TI - Picosecond resolution of tyrosine fluorescence and anisotropy decays by 2-GHz frequency-domain fluorometry. AB - We extended the technique of frequency-domain fluorometry to an upper frequency limit of 2000 MHz. This was accomplished by using the harmonic content of a laser pulse train (3.76 MHz, 5 ps) from a synchronously pumped and cavity-dumped dye laser. We used a microchannel plate photomultiplier as the detector to obtain the 2-GHz bandwidth. This new instrument was used to examine tyrosine intensity and anisotropy decays from peptides and proteins. These initial data sets demonstrate that triply exponential tyrosine intensity decays are easily recoverable, even if the mean decay time is less than 1 ns. Importantly, the extended frequency range provides good resolution of rapid and/or multiexponential tyrosine anisotropy decays. Correlation times as short as 15 ps have been recovered for indole, with an uncertainty of +/- 3 ps. We recovered a doubly exponential anisotropy decay of oxytoxin (29 and 454 ps), which probably reflects torsional motions of the phenol ring and overall rotational diffusion, respectively. Also, a 40-ps component was found in the anisotropy decay of bovine pancreatic trypsin inhibitor, which may be due to rapid torsional motions of the tyrosine residues and/or energy transfer among these residues. The rapid component has an amplitude of 0.05, which is about 16% of the total anisotropy. The availability of 2-GHz frequency-domain data extends the measurable time scale for fluorescence to overlap with that of molecular dynamics calculations. PMID- 3828311 TI - Remote nitrogen-15 isotope effects on addition of cyanide to NAD. AB - The reversible reaction NAD + CN(-)----NAD-CN was examined for remote secondary 15N isotope effects caused by isotopic substitution at the ring nitrogen of the nicotinamide group. These were compared with analogous effects for dehydrogenase catalyzed reactions, since both cyanide and the hydride ion add at the N-4 position of the nicotinamide ring. The 15N effects on the rate constants for the forward and reverse processes were examined directly by conducting both the normal and isotopic reactions simultaneously under carefully controlled conditions in the sample and reference cells of a dual-beam spectrophotometer. In both cases, the 15N kinetic isotope effect differed from 1.00 by considerably less than 0.01. The 15N equilibrium isotope effect, 15K, was obtained as the ratio of equilibrium constants measured separately with natural-abundance and labeled NAD by using a concentration jump procedure [1.004 +/- 0.002 (cyanide addition)]. A similar value for 15K of 1.010 +/- 0.008 was obtained in an analogous manner for the reaction catalyzed by lactate dehydrogenase: NAD + lactate----pyruvate + NADH + H+. The latter value is significantly smaller than a previously reported value obtained from kinetic studies [1.044 +/- 0.012; Cook, P. F., Oppenheimer, N. J., & Cleland, W. W. (1981) Biochemistry 20, 1817]. The present value also is smaller than might be expected for a change in bond order from 4 to 3 [Cleland, W. W. (1980) Methods Enzymol. 64, 104-125] on the basis of the canonical resonance structures for NAD and NADH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828312 TI - Photoaffinity labeling of tubulin subunits with a photoactive analogue of vinblastine. AB - A photoactive, radioactive analogue of vinblastine, N-(p-azido[3,5-3H]benzoyl)-N' (beta-amino-ethyl)vindesine ([ 3H]NABV), was used to localize the Vinca alkaloid binding site(s) on calf brain tubulin after establishing that its in vitro interactions with tubulin were comparable to those of vinblastine. Microtubule assembly was inhibited by 50% with 2 microM NABV or vinblastine. At higher drug concentrations, NABV and vinblastine both induced tubulin aggregation, and both drugs inhibited tubulin-dependent GTP hydrolysis. Vinblastine and NABV inhibited each other's binding to tubulin, but the binding of neither drug was inhibited by colchicine. Two classes of binding sites for NABV and vinblastine were found on calf brain tubulin. High-affinity sites had apparent KD values of 4.2 and 0.54 microM for NABV and vinblastine, respectively, whereas the low-affinity binding sites showed apparent KD values of 26 and 14 microM for NABV and vinblastine, respectively. Mixtures of tubulin and [3H]NABV were irradiated at 302 nm and analyzed for incorporation of radioactivity into protein. Photolabeling of both the alpha- and beta-subunits of tubulin with increasing concentrations of [3H]NABV exhibited a biphasic pattern characteristic of specific and nonspecific reactions. Nonspecific labeling was determined in the presence of excess vinblastine. Saturable specific covalent incorporation into both subunits of tubulin was observed, with an alpha:beta ratio of 3:2 and maximum saturable incorporation of 0.086 and 0.056 mol of [3H]NABV/mol of alpha-tubulin and beta tubulin, respectively. Such photolabeling of the tubulin subunits will permit precise localization of Vinca alkaloid binding sites, including identification of the amino acid residues involved, an essential requirement for understanding the interactions of these drugs with tubulin. PMID- 3828313 TI - Function of pyridoxal 5'-phosphate in glycogen phosphorylase: a model study using 6-fluoro-5'-deoxypyridoxal- and 5'-deoxypyridoxal-reconstituted enzymes. AB - A new vitamin B6 analogue, 6-fluoro-5'-deoxypyridoxal (6-FDPL), was synthesized and characterized. This analogue, as well as 6-fluoropyridoxal (6-FPAL), 6 fluoropyridoxal phosphate (6-FPLP), and 6-fluoropyridoxine, showed positive heteronuclear 1H-19F nuclear Overhauser effects between the 5'-protons and the 6 fluorine. Apophosphorylase reconstituted with 6-FDPL showed 1% of the activity of the native enzyme in the presence of phosphite. The kinetic pattern, apparent pH optimum of activity, and the activity-temperature dependency of the 6-FDPL-enzyme were virtually identical with those of phosphorylase reconstituted with the parent compound, 6-FPAL [Chang, Y. C., & Graves, D. J. (1985) J. Biol. Chem. 260, 2709-2714], except the Km of phosphite toward the 6-FDPL-enzyme was 9 times higher than that with the 6-FPAL-enzyme and the 6-FDPL-enzyme showed a lower Vmax value. Phosphorylase reconstituted with 5'-deoxypyridoxal (DPL) also showed activity in the presence of phosphite. The kinetics and the temperature-activity dependency of this reconstituted enzyme were investigated. 19F nuclear magnetic resonance studies showed that the binding of glucose 1-phosphate to a 6-FDPL enzyme-adenosine 5'-phosphate (AMP) complex shifted the 19F signal 0.6 ppm upfield, whereas a 2.1 ppm change was observed when the 6-FPAL-enzyme-AMP formed a complex with glucose 1-phosphate [Chang, Y. C., Scott, R. D., & Graves, D. J. (1986) Biochemistry 25, 1932-1939].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828314 TI - Chemical consequences of incorporation of 5-fluorouracil into DNA as studied by NMR. AB - The cytotoxic analogue of thymine, 5-fluorouracil (Uf), is known to be incorporated into DNA in biological systems. This abnormal base has been synthetically incorporated into short DNA oligomers. The ionization of the N-3 proton of this base within DNA oligomers was measured by observation of the 19F chemical shift at varying pH values. The pKa values for the Uf ring of dTpdUfpdT and dApdUfpdA were determined to be 7.84 and 7.9, respectively. The self complementary 12-mers d(G-C-G-C-A-A-T-Uf-G-C-G-C) and d(C-G-A-T-Uf-A-T-A-A-T-C-G) were synthesized, and 1H NMR was used to compare the helix dynamics and stability of the interstrand imino proton hydrogen bonds with those of the 12-mers d(G-C-G C-A-A-T-T-G-C-G-C) and d(C-G-A-T-T-A-T-A-A-T-C-G). The N-3 hydrogen bond of the A Uf base pair was less stable than the corresponding hydrogen bond in A-T base pairs in the same helix, and the A-Uf base pair was less stable than the A-T base pair in the analogous position of the control helix. The observed temperature dependent dynamics and NMR melting temperatures of the control and dUf-containing oligomers were similar. PMID- 3828315 TI - Properties of a water-soluble, yellow protein isolated from a halophilic phototrophic bacterium that has photochemical activity analogous to sensory rhodopsin. AB - A water-soluble yellow protein, previously discovered in the purple photosynthetic bacterium Ectothiorhodospira halophila, contains a chromophore which has an absorbance maximum at 446 nm. The protein is now shown to be photoactive. A pulse of 445-nm laser light caused the 446-nm peak to be partially bleached and red-shifted in a time less than 1 microsecond. The intermediate thus formed was subsequently further bleached in the dark in a biphasic process occurring in approximately 20 ms. Finally, the absorbance of native protein was restored in a first-order process occurring over several seconds. These kinetic processes are remarkably similar to those of sensory rhodopsin from Halobacterium, and to a lesser extent bacteriorhodopsin and halorhodopsin; although these proteins are membrane-bound, they have absorbance maxima at about 570 nm, and they cycle more rapidly. In attempts to remove the chromophore for identification, it was found that a variety of methods of denaturation of the protein caused transient or permanent conversion to a form which has an absorbance maximum near 340 nm. Thus, by analogy to the rhodopsins, the absorption at 446 nm in the native protein appears to result from a 106-nm red shift of the chromophore induced by the protein. Acid denaturation followed by extraction with organic solvents established that the chromophore could be removed from the protein. It is not identical with all-trans-retinal and remains to be identified, although it could still be a related pigment. The E. halophila yellow protein has a circular dichroism spectrum which indicates little alpha helical secondary structure (19%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828316 TI - Biosynthesis of lasalocid A: biochemical mechanism for assembly of the carbon framework. AB - Labeling experiments on the biosynthesis of the polyether antibiotic lasalocid A (1) using carboxylic acid precursors bearing 13C, 2H, and 3H labels at various positions established the following: (1) 2H or 3H at C-2 of propionate or 2H at C 2 of butyrate was partially retained at C-12 and C-14 of 1, respectively. (2) 2H at C-2 of propionate or at C-2 and C-3 of succinate did not label C-10. These and earlier data [Hutchinson, C. R., Sherman, M. M., Vederas, J. C., & Nakashima, T. T. (1981) J. Am. Chem. Soc. 103, 5953; Hutchinson, C. R., Sherman, M. M., McInnes, A. G., Walter, J. A., & Vederas, J. C. (1981) J. Am. Chem. Soc. 103, 5956] are consistent with a hypothesis for the stereochemical control of lasalocid A biosynthesis, whose main tenets are that the configuration of C-12 and C-14 is determined by the stereoselectivity of the carbon chain forming condensation between acyl thio ester and 2-carboxyacyl thio ester intermediates and that the configuration of C-11 and C-15 results from the reduction of 2-keto thio ester intermediates with opposing stereospecificities. PMID- 3828317 TI - Lipid domain structure correlated with membrane protein function in placental microvillus vesicles. AB - Membrane fluidity properties of placental microvillus membrane vesicles (MVV) were determined from fluorescence anisotropy (r), dynamic depolarization, and lifetime heterogeneity studies of diphenylhexatriene (DPH), trimethylamino-DPH (TMA-DPH), and cis- and trans-parinaric acids (c-PnA and t-PnA). Plots of r against temperature for DPH and TMA-DPH in MVV had slope discontinuities at 26 degrees C (Tc, transition temperature); however, analysis of r in terms of probe rotational rate (R), limiting anisotropy (r infinity), and lifetime (tau) revealed that DPH reported a phase transition because of changes in r infinity, whereas the phase transition observed by TMA-DPH occurred primarily because of changes in R. Heterogeneity analysis using phase and modulation lifetimes at three frequencies showed that DPH and TMA-DPH lifetimes were homogeneous in MVV. Both long (greater than 25 ns) and short (less than 6 ns) lifetime components were detected for c-PnA and t-PnA in MVV, corresponding to the probes in solid and fluid lipid phases. The fractional amplitude of the long lifetimes (solid phase) decreased from 0.86 to 0.12 with increasing temperature (5-55 degrees C) as the membrane passed through the phase transition, with 50% of the change occurring at 27 degrees C (c-PnA) or 33 degrees C (t-PnA). The activation energies for alkaline phosphatase, aminopeptidase M, and sodium-proton antiporter activities all showed discontinuities in the temperature range 27-31 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828318 TI - Isolation and characterization of nucleoprotein assembly intermediates of tobacco mosaic virus. AB - During assembly of tobacco mosaic virus from pure RNA and 20S capsid protein aggregates under conditions where protein is limiting, partially assembled intermediates of specific sizes accumulate; these were isolated on sucrose density gradients. The earliest intermediate found in substantial quantity sedimented at 56 S and was shown, by measurement of its buoyant density and of the length of the RNA segment protected by the capsid protein from nuclease digestion, to consist of RNA that is 13% encapsidated (corresponding to a rod length of about 39 nm); the next intermediate sediments at 78 S and is 18% encapsidated (corresponding to a rod length of about 54 nm). Studies of the distribution of intermediates at various input ratios of protein/RNA indicated that their accumulation results from decreases in the rate constants for protein binding that are local to specific points in the course of encapsidation. After extensive nuclease digestion, the RNA still associated with the first intermediate was shown to include a portion that is unencapsidated. This segment of the RNA may be a region of stable secondary that confers the nuclease resistance despite the lack of protection by capsid protein. Such RNA secondary structure, if it exists, would also cause the accumulation of intermediates by imposing an energy barrier to subsequent rod elongation. PMID- 3828319 TI - Iron(III) clusters bound to horse spleen apoferritin: an X-ray absorption and Mossbauer spectroscopy study that shows that iron nuclei can form on the protein. AB - Ferritin is a complex of a hollow, spherical protein and a hydrous, ferric oxide core of less than or equal to 4500 iron atoms inside the apoprotein coat; the apoprotein has multiple (ca. 12) binding sites for monoatomic metal ions, e.g., Fe(II), V(IV), Tb(III), that may be important in the initiation of iron core formation. In an earlier study we observed that the oxidation of Fe(II) vacated some, but not all, of the metal-binding sites, suggesting migration of some Fe during oxidation, possibly to form nucleation clusters; some Fe(III) remained bound to the protein. Preliminary extended X-ray absorbance fine structure (EXAFS) analysis of the same Fe(III)-apoferritin complex showed an environment distinct from ferritin cores, but the data did not allow a test of the Fe cluster hypothesis. In this paper, with improved EXAFS data and with Mossbauer data on the same complex formed with 57Fe, we clearly show that the Fe(III) in the distinctive environment is polynuclear (Fe atoms with Fe-Fe = 3.5 A and TB = 7 K). Moreover, the arrangement of atoms is such that Fe(III) atoms appear to have both carboxylate-like ligands, presumably from apoferritin, and oxo bridges to the other iron atoms. Thus the protein provides sites not only for initiation but also for nucleation of the iron core. Sites commodious enough and with sufficient conserved carboxylate ligands to accommodate such a nucleus occur inside the protein coat at the subunit dimer interfaces. Such Fe(III)-apoferritin nucleation complexes can be used to study the properties of the several members of the apoferritin family. PMID- 3828320 TI - Mammalian folylpoly-gamma-glutamate synthetase. 1. Purification and general properties of the hog liver enzyme. AB - Folylpolyglutamate synthetase was purified 30,000-150,000-fold from hog liver. Purification required the use of protease inhibitors, and the protein was purified to homogeneity in two forms. Both forms of the enzyme were monomers of Mr 62,000 and had similar specific activities. The specific activity of the homogeneous protein was over 2000-fold higher than reported for partially purified folylpolyglutamate synthetases from other mammalian sources. Enzyme activity was absolutely dependent on the presence of a reducing agent and a monovalent cation, of which K+ was most effective. The purified enzyme catalyzed a MgATP-dependent addition of glutamate to tetrahydrofolate with the concomitant stoichiometric formation of MgADP and phosphate. Under conditions that resembled the expected substrate and enzyme concentrations in hog liver, tetrahydrofolate was metabolized to long glutamate chain length derivatives with the hexaglutamate, the major in vivo folate derivative, predominating. Enzyme activity was maximal at about pH 9.5. The high-pH optimum was primarily due to an increase in the Km value for the L-glutamate substrate at lower pH values, and the reaction proceeded effectively at physiological pH provided high levels of glutamate were supplied. PMID- 3828321 TI - Mammalian folylpoly-gamma-glutamate synthetase. 2. Substrate specificity and kinetic properties. AB - The specificity of hog liver folylpolyglutamate synthetase for folate substrates and for nucleotide and glutamate substrates and analogues has been investigated. The kinetic mechanism, determined by using aminopterin as the folate substrate, is ordered Ter-Ter with MgATP binding first, folate second, and glutamate last. This mechanism precludes the sequential addition of glutamate moieties to enzyme bound folate. Folate, dihydrofolate, and tetrahydrofolate possess the optimal configurations for catalysis (kcat = 2.5 s-1) while 5- and 10-position substitutions of the folate molecule impair catalysis. kcat values decrease with increasing glutamate chain length, and the rate of decrease varies depending on the state of reduction and substitution of the folate molecule. Folate binding, as assessed by on rates, is slow. Dihydrofolate exhibits the fastest rate, and the rates are slightly reduced for tetrahydrofolate and 10-formyltetrahydrofolate and greatly reduced for 5-methyltetrahydrofolate and folic acid. The on rates for most pteroyldiglutamates are similar to the rates for their respective monoglutamate derivatives, but further extension of the glutamate chain results in a progressive decrease in on rates. Tetrahydrofolate polyglutamates are the only long glutamate chain length folates with detectable substrate activity. The specificity of the L-glutamate binding site is very narrow. L-Homocysteate and 4 threo-fluoroglutamate are alternate substrates and act as chain termination inhibitors in that their addition to the folate molecule prevents or severely retards the further addition of glutamate moieties. The Km for glutamate is dependent on the folate substrate used. MgATP is the preferred nucleotide substrate, and beta,gamma-methylene-ATP, beta,gamma-imido-ATP, adenosine 5'-O-(3 thiotriphosphate), P1,P5-di(adenosine-5') pentaphosphate, and free ATP4- are potent inhibitors of the reaction. PMID- 3828322 TI - Mammalian folylpoly-gamma-glutamate synthetase. 3. Specificity for folate analogues. AB - A variety of folate analogues were synthesized to explore the specificity of the folate binding site of hog liver folylpolyglutamate synthetase and the requirements for catalysis. Modifications of the internal and terminal glutamate moieties of folate cause large drops in on rates and/or affinity for the protein. The only exceptions are glutamine, homocysteate, and ornithine analogues, indicating a less stringent specificity around the delta-carbon of glutamate. It is proposed that initial folate binding to the enzyme involves low-affinity interactions at a pterin and a glutamate site and that the first glutamate bound is the internal residue adjacent to the benzoyl group. Processive movement of the polyglutamate chain through the glutamate site and a possible conformational change in the protein when the terminal residue is bound would result in tight binding and would position the gamma-carboxyl of the terminal glutamate in the correct position for catalysis. Steric limitations imposed on the internal glutamate residues that loop out and additional steric constraints imposed by binding of different pterin moieties would be expected to effect slight conformational changes in the protein and/or the terminal glutamate and would explain the decrease in on rate and catalytic rate with increased polyglutamate chain length, and the differential effect of one-carbon substitution on the catalytic rate with polyglutamate derivatives. The 4-amino substitution of folate increases the on rate for monoglutamate derivatives but severely impairs catalysis with diglutamate derivatives. Pteroylornithine derivatives are the first potent and specific inhibitors of folylpolyglutamate synthetase to be identified and may act as analogues of reaction intermediates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828323 TI - Mammalian folylpoly-gamma-glutamate synthetase. 4. In vitro and in vivo metabolism of folates and analogues and regulation of folate homeostasis. AB - The regulation of folate and folate analogue metabolism was studied in vitro by using purified hog liver folylpolyglutamate synthetase as a model system and in vivo in cultured mammalian cells. The types of folylpolyglutamates that accumulate in vivo in hog liver, and changes in cellular folate levels and folylpolyglutamate distributions caused by physiological and nutritional factors such as changes in growth rates and methionine, folate, and vitamin B12 status, can be mimicked in vitro by using purified enzyme. Folylpolyglutamate distributions can be explained solely in terms of the substrate specificity of folylpolyglutamate synthetase and can be modeled by using kinetic parameters obtained with purified enzyme. Low levels of folylpolyglutamate synthetase activity are normally required for the cellular metabolism of folates to retainable polyglutamate forms, and consequently folate retention and concentration, while higher levels of activity are required for the synthesis of the long chain length derivatives that are found in mammalian tissues. The synthesis of very long chain derivatives, which requires tetrahydrofolate polyglutamates as substrates, is a very slow process in vivo. The slow metabolism of 5-methyltetrahydrofolate to retainable polyglutamate forms causes the decreased tissue retention of folate in B12 deficiency. Although cellular folylpolyglutamate distributions change in response to nutritional and physiological modulations, it is unlikely that these changes play a regulatory role in one-carbon metabolism as folate distributions respond only slowly. 4 Aminofolates are metabolized to retainable forms at a slow rate compared to folates. Although folate accumulation by cells is not very responsive to changes in folylpolyglutamate synthetase levels and cellular glutamate concentrations, cellular accumulation of anti-folate agents would be highly responsive to any factor that changes the expression of folylpolyglutamate synthetase activity. PMID- 3828324 TI - Spectroscopic investigations of the single tryptophan residue and of riboflavin and 7-oxolumazine bound to lumazine apoprotein from Photobacterium leiognathi. AB - Spectroscopic techniques have been applied to investigate the conformation, local structure, and dynamic properties of the apoprotein of the lumazine protein from Photobacterium leiognathi and the holoprotein reconstituted with either the natural ligand 6,7-dimethyl-8-ribityllumazine or the closely related analogues riboflavin and 6-methyl-7-oxo-8-ribityllumazine (7-oxolumazine). The analogues are bound similarly to the natural prosthetic group. They exhibit similar shifts on binding in their absorption and fluorescence spectra, single-exponential fluorescence decays, and no independent motion from the protein as evident from a long-lived anisotropy decay (single-exponential phi = 10 ns, 20 degrees C) and high initial anisotropy. Steady-state anisotropy measurements result in similar KD's (40 nM, 20 degrees C, 50 mM inorganic phosphate) for all ligands. Circular dichroism in the far-UV region (190-250 nm) indicates no change in secondary structure on binding to the apoprotein. In the spectral region of 250-310 nm relatively large changes occur, indicating changes in the environment of the tyrosine and tryptophan residues. The single tryptophan residue shows a three exponential decay of its fluorescence in both the apoprotein and the holoprotein. Radiationless energy transfer also occurs from the tryptophan to the bound ligand, especially evident with 7-oxolumazine. We have designed a new method for evaluation of the rate constant of energy transfer by measuring the (picosecond) rise time of the acceptor fluorescence. The anisotropy decay of the tryptophan residue shows two correlation times, a short one (phi approximately equal to 0.4 ns) representing rapid but restriced oscillation of this residue and a longer one (phi 2 = 5-7 ns, 20 degrees C) representing the motion of a larger segment of the protein. PMID- 3828325 TI - 13C NMR study of effects of fasting and diabetes on the metabolism of pyruvate in the tricarboxylic acid cycle and the utilization of pyruvate and ethanol in lipogenesis in perfused rat liver. AB - 13C NMR has been used to study the competition of pyruvate dehydrogenase with pyruvate carboxylase for entry of pyruvate into the tricarboxylic acid (TCA) cycle in perfused liver from streptozotocin-diabetic and normal donor rats. The relative proportion of pyruvate entering the TCA cycle by these two routes was estimated from the 13C enrichments at the individual carbons of glutamate when [3 13C]alanine was the only exogenous substrate present. In this way, the proportion of pyruvate entering by the pyruvate dehydrogenase route relative to the pyruvate carboxylase route was determined to be 1:1.2 +/- 0.1 in liver from fed controls, 1:7.7 +/- 2 in liver from 24-fasted controls, and 1:2.6 +/- 0.3 in diabetic liver. Pursuant to this observation that conversion of pyruvate to acetyl coenzyme A (acetyl-CoA) was greatest in perfused liver from fed controls, the incorporation of 13C label into fatty acids was monitored in this liver preparation. Livers were perfused under steady-state conditions with labeled substrates that are converted to either [2-13C]acetyl-CoA or [1-13C]acetyl-CoA, which in the de novo synthesis pathway label alternate carbons in fatty acids. With the exception of the repeating methylene carbons, fatty acyl carbons labeled by [1-13C]acetyl-CoA (from [2-13C]pyruvate) gave rise to resonances distinguishable on the basis of chemical shift from those observed when label was introduced by [3-13C]alanine plus [2-13C]ethanol, which are converted to [2 13C]acetyl-CoA. Thus, measurement of 13C enrichment at several specific sites in the fatty acyl chains in time-resolved spectra of perfused liver offers a novel way of monitoring the kinetics of the biosynthesis of fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828326 TI - Structure and thermotropic properties of hydrated 1-eicosyl-2-dodecyl-rac-glycero 3-phosphocholine and 1-dodecyl-2-eicosyl-rac-glycero-3-phosphocholine bilayer membranes. AB - The ether-linked phosphatidylcholines 1-eicosyl-2-dodecyl-rac-glycero-3 phosphocholine (EDPC) and 1-dodecyl-2-eicosyl-rac-glycero-3-phosphocholine (DEPC) have been investigated by differential scanning calorimetry (DSC) and X-ray diffraction. DSC of hydrated EDPC shows a single endothermic transition at 34.8 degrees C (delta H = 11.2 kcal/mol) after storage at -4 degrees C while DEPC shows three endothermic transitions at 7.7 and approximately 9.0 degrees C (combined delta H approximately 0.4 kcal/mol) and at 25.2 degrees C (delta H = 4.7 kcal/mol). Both the single transition of EDPC and the two higher temperature transitions of DEPC are reversible, while the approximately 7.7 degrees C transition of DEPC increases in enthalpy on low-temperature incubation. At 23 degrees C, X-ray diffraction of hydrated EDPC shows a sharp reflection at 4.2 A together with lamellar reflections corresponding to a bilayer periodicity, d = 56.2 A. Electron density profiles derived from swelling experiments show a phosphate-phosphate intrabilayer distance, dp-p, of 36 A at all hydrations. This, together with calculated lipid thickness and molecular area considerations, suggests an interdigitated, three chains per head group, bilayer gel phase, L beta*, with no hydrocarbon chain tilt. This is structurally analogous to the bilayer gel phase of hydrated 18:0/10:0 ester PC [McIntosh, T. J., Simon, S. A., Ellington, J. C., Jr., & Porter, N. A. (1984) Biochemistry 23, 4038]. In contrast, DEPC at -4 degrees C shows an L beta' bilayer gel phase with tilted hydrocarbon chains (d = 61.1 A). However, this transforms above 9 degrees C to an interdigitated, triple-chain, L beta* bilayer gel phase (identical with that of EDPC) with d = 56.6 A and a phosphate-phosphate distance of 36 A. Above their respective chain melting transitions, Tm, EDPC and DEPC exhibit liquid crystalline L alpha bilayer phases with d = 64.5 and 65.0 A at 55 and 45 degrees C, respectively. The ability of both EDPC and DEPC to form triple-chain interdigitated gel-state bilayers suggests that the conformational inequivalence at the sn-1 and sn-2 positions is less pronounced in the ether-linked PCs compared to the ester-linked PCs, where only one of the positional isomers, e.g., 18:0/10:0 PC but not 10:0/18:0 PC, forms the triple-chain structure (J. Mattai, unpublished results). Thus, a different conformation around the glycerol is predicted for ether-linked PC compared to ester-linked PC. PMID- 3828327 TI - Structural organization of the human glucocorticoid receptor determined by one- and two-dimensional gel electrophoresis of proteolytic receptor fragments. AB - The structural organization of the steroid-binding protein of the IM-9 cell glucocorticoid receptor was investigated by using one- and two-dimensional gel electrophoresis of proteolytic receptor fragments. One-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of receptor fragments isolated after trypsin digestion of immunopurified [3H]dexamethasone 21-mesylate ([3H]DM-) labeled receptor revealed the presence of a stable 26.5-kilodalton (kDa) steroid-containing, non-DNA-binding fragment, derived from a larger, less stable, 29-kDa fragment. The 26.5-kDa tryptic fragment appeared to be completely contained within a 41-kDa, steroid-containing, DNA-binding species isolated after chymotrypsin digestion of the intact protein. Two-dimensional electrophoretic analysis of the [3H]DM-labeled tryptic fragments resolved two (pI congruent to 5.7 and 7.0) 26.5-kDa and two (pI congruent equal to 5.7 and 6.8) 29-kDa components. This was the same number of isoforms seen in the intact protein, indicating that the charge heterogeneity of the steroid-binding protein is the result of modification within the steroid-containing, non-DNA-binding, 26.5-kDa tryptic fragment. Two-dimensional analysis of the 41-kDa [3H]DM-labeled chymotryptic species revealed a pattern of isoforms more complex than that seen either in the intact protein or in the steroid-containing tryptic fragments. These results suggest that the 41-kDa [3H]DM-labeled species resolved by one dimensional SDS-PAGE after chymotrypsin digestion may be composed of several distinct proteolytic fragments. PMID- 3828328 TI - The effect of a ferric iron complex on isolated rat-liver mitochondria. III. Mechanistic aspects of iron-induced calcium efflux. AB - Addition of iron(III)-gluconate complex to isolated rat liver mitochondria induced a net efflux of Ca2+ which was not inhibited by ruthenium red. This process resulted in the enhancement of Ca2+ cycling and a consequent membrane potential drop. Under these experimental conditions the content of mitochondrial glutathione did not appear to be critically modified, whereas an extensive oxidation of mitochondrial pyridine nucleotides was parallelly detected. Iron failed to induce appreciable changes in the oxidation level of pyridine nucleotides in mitochondria isolated from rats fed a selenium deficient diet, a condition in which mitochondrial glutathione peroxidase resulted inhibited by 80%. The iron-induced Ca2+ release in Se-deficient mitochondria appeared largely delayed and the membrane potential of these mitochondrial did not present gross alterations. Iron was also found to induce a transient increase in the mitochondrial cyanide-insensitive oxygen consumption. This effect was largely prevented by the addition of the hydrogen peroxide scavenger catalase. It was concluded that iron induced the activation of a specific Ca2+ efflux pathway via the oxidation of pyridine nucleotides due to the hydrogen peroxide metabolism by glutathione enzyme system. PMID- 3828329 TI - Quantitative relationship between protonophoric and uncoupling activities of substituted phenols. AB - The protonophoric activity through liposomal membranes was measured and compared with the uncoupling activity with the oxidative phosphorylation of rat-liver mitochondria for 19 substituted phenols. Quantitative analyses of the protonophoric activity of the phenols in terms of physicochemical molecular parameters showed that the activity was mostly decided by two factors: the partition coefficient between the liposome and aqueous buffer phases and the acid dissociation constant. Correlation was excellent between protonophoric and uncoupling activities when the difference in the effect of acidity of phenols between liposomal and mitochondrial membranes was taken into account. The results were further evidence for the shuttle-type of mechanism of weakly acidic uncouplers based on the Mitchell chemiosmotic hypothesis. PMID- 3828330 TI - Effect of the O-methylation of tyrosine on the pore-forming properties of iturins. AB - A comparison has been made between the pore-forming properties of the antibiotic lipopeptide iturin A and a derivative methylated on the tyrosine residue which shows a restricted biological activity. It is shown that this derivative increases the ion permeability of planar lipid membranes as does iturin A. Nevertheless, the global conductance of the doped membrane is very much lower at the same lipopeptide/phospholipid ratio and the ion selectivity is inverted (PK/PCl = 6 instead of 0.6 with iturin A). The characteristics of the induced conducting pores are also rather different. This suggests an important role of the D-Tyr2 residue, present in all the compounds of the iturin family, both in the biological and in the pore-forming properties of iturin A. PMID- 3828331 TI - Dynamics of appearance and disappearance of the ripple structure in multilamellar liposomes of dipalmitoylphosphatidylcholine. AB - The physical properties of the pretransition (P beta'----L beta') of dipalmitoylphosphatidylcholine liposomes were investigated using freeze-fracture electron microscopy. The kinetics of pretransition examined in the previous paper using TEMPO spin probe (Tsuchida, K., et al. (1985) Biochim. Biophys. Acta 812, 249-254) was extensively studied by observing the ripple structures in the freeze fractured surfaces at different time intervals. When the temperature is decreased from 38 degrees C to 30 degrees C, the ripple structure disappears in the following steps. The intervals between ripples begin to expand with the decrease of ripple density upon the temperature shift, and this process continues for several tens minutes. Then, each ripple disappears gradually and changes into a completely smooth surface at 3 h after the temperature shift. The comparison of relaxation times between the previous ESR measurement and the present experiment suggests that the fast relaxation observed in the previous study corresponds to the expansion of the intervals between ripples. On the other hand, the ripple structure of regular intervals appears rapidly in some places and then spreads over the whole area of fractured surface when the temperature is increased from 23 degrees C to 35 degrees C. The results obtained in this work and the previous ESR work strongly suggest that the formation and disappearance of ripple structure is closely related to the relaxation processes near the pretransition temperature. PMID- 3828332 TI - Properties of a GTP sensitive microdomain in rough microsomes. AB - Stripped rough microsomes (SRM) fuse when incubated with physiological concentrations of GTP and MgCl2. In order to examine further to what extent such fusions are associated with other membrane functions of rough endoplasmic reticulum, we have evaluated the role of cytosolically exposed peptide constituents of SRM in fusion, and the possible relationship of GTP/MgCl2-induced fusion in protein transport across endoplasmic reticulum (ER) membranes, and in ER-Golgi interactions. Controlled proteolytic digestion of SRM led to the loss of fusion capability at 15 micrograms/ml trypsin--a concentration which maintained the latency of intraluminal mannose-6-phosphatase. Hence, a cytosolically exposed protein(s) regulated fusion. Based on ribonuclease-induced ribosome capping experiments, it was further concluded that the cytosolic oriented protein(s) was sequestered beneath the ribosome. As co-translational cell free translocation of placental lactogen across SRM was similar in control membranes compared to those rendered incapable of fusing, it was concluded that the fusion phenomenon may not be related to translocation. Under conditions promoting homologous fusion of SRM or Golgi membranes, mixtures of the two membranes showed no heterologous membrane fusion as assessed morphologically or by the transport of newly synthesized membrane glycoprotein. These experiments attest to the specificity of cytosolically exposed protein(s) in regulating nucleotide/divalent cation-induced membrane fusion. PMID- 3828334 TI - Molecular packing of a crystalline ether-linked phosphatidylcholine: an electron diffraction study. AB - Electron diffraction data from solution- and epitaxially-crystallized samples of 1,2-dihexadecyl-sn-glycerophosphocholine are used in an analysis of its molecular packing in the minimally hydrated crystal form. The molecular chain axes are found to be perpendicular to the bilayer plane and the chains pack in the hexagonal methylene subcell. Translational search of a model based on a known diacyl phosphatidylcholine crystal structure indicates that a crystallographic residual minimum corresponds to a headgroup packing distance similar to values found for the dipalmitoyl analog at low relative humidity. The bilayer packing for the ether-linked phosphatidylcholine is therefore similar to the one reported for a sphingomyelin. PMID- 3828333 TI - Influence of alcohols, temperature, and region on the mobility of lipids in neuronal membrane. AB - Fluorescence recovery after photobleaching was used to examine lipid diffusibility in different regions of Aplysia neurons. Differences in diffusion of 1-acyl-2-(6-[N-(7-nitrobenz-2-oxa-1,3-diazol-4- yl)]aminohexanoyl)phosphatidylcholine (NBD-C6-PC) in the cell body, axon hillock, and axon were not apparent. Lipid diffusibility during temperature variations and exposure to alcohols was also examined by photobleaching techniques. For these studies, all measurements were made on the cell body. Alcohols were found to be selective in their effects upon the diffusibility of lipid probes. Neither ethanol nor butanol affected the diffusibility of NBD-PC. However, at the same concentrations, both of these alcohols caused a significant increase in the diffusion coefficient (D) for rhodamine-phosphatidylethanolamine (Rho-PE). The diffusion coefficient for NBD-PC in the cell body plasma membrane did not increase with warming, between 4 degrees C and 25 degrees C. The fraction of lipid probe free to diffuse (per cent recovery; %R) however, increased as temperature increased, within this range. The nonconventional relationship between temperature and D was even more pronounced for Rho-PE. As temperature increased, D became smaller for this probe, concurrent with an increase in %R. These results suggest that immobile viscous lipid is recruited into a mobile fraction as temperature increases, resulting in the maintenance of constant diffusibility. The effects of temperature on D and %R, and the selective effects of alcohols on lipid diffusibility suggest that the membrane is heterogeneously organized, on a submicroscopic scale, into domains. The implications of this organization for nerve function and responses of nervous systems to temperature and anesthetics are discussed. PMID- 3828335 TI - Changes in cell surface charge and transmembrane potential accompanying neoplastic transformation of rat kidney cells. AB - Free flow electrophoresis measurements have been used to determine the surface charge density of normal rat kidney (NRK) cells and a clone of NRK, designated as 6m2, that exhibit a transformed phenotype at 33 degrees C and a non-transformed phenotype at 39 degrees C. A clone of 6m2, designated 54-5A4, which is transformed at both 33 degrees C and 39 degrees C was also studied. A surface charge density of -1.42 microC/cm2 was obtained for the NRK and non-transformed 6m2 cells at 39 degrees C, whereas at 33 degrees C values of -1.85 and -1.78 microC/cm2 were determined for the transformed 6m2 and 54-5A4 cells, respectively. It was found that 72% of the increased charge that appeared on the transformed 6m2 cells compared with the non-transformed 6m2 cells was RNAase sensitive. The time-dependent decrease in surface charge that accompanied the shift of the 6m2 cells from their transformed to non-transformed state was found to mirror the increase in transmembrane potential previously reported using a fluorescent dye technique, and was also comparable to the reported temporal changes in their morphology and virally-coded protein content. PMID- 3828336 TI - The kinetics of sulfobromophthalein uptake by rat liver sinusoidal vesicles. AB - The kinetics of bromo[35S]sulfophthalein (35S-BSP) binding by and uptake across the hepatocyte sinusoidal membrane were investigated using isolated rat liver sinusoidal membrane vesicles containing K+ as the principal internal inorganic cation. Uptake of 35S-BSP into vesicles was found to be temperature dependent, with maximum uptake between 35 and 40 degrees C; only binding occurred at or below 15 degrees C. Uptake at 37 degrees C was saturable and resolvable by Eadee Hofstee analysis into two components: one with high affinity (Km = 53.1 microM) but low capacity, and the second of low affinity (Km = 1150 microM) but high capacity. By pre- or post-incubation, respectively, with unlabelled BSP, trans stimulation and counter transport of 35S-BSP could also be demonstrated in these vesicles. Uptake was inhibited competitively using 5 microM Rose bengal and 10 microM indocyanine green, and non-competitively using 10 microM DIDS. Taurocholate did not inhibit uptake, and actually enhanced transport at concentrations greater than or equal to 250 microM. Imposition of inwardly directed inorganic ion gradients resulted in the enhancement of 35S-BSP transport when chloride ions were part of this gradient, irrespective of the cation employed whereas there was no apparent cation effect. However, substitution of 10 mM Na+ for 10 mM K+ as the internal cation resulted in a significant increase in uptake in the presence of external K+ as compared to Na+ gradients. This effect was not observed when 10 mM Tris+ was employed as the internal cation. The kinetics of 35S-BSP uptake by isolated sinusoidal membrane vesicles are indicative of facilitated transport. While the observed inorganic ion effects suggest a possible electrogenic component, the driving forces for hepatic BSP uptake remain uncertain. Isolated sinusoidal membrane vesicles provide a useful technique for studying hepatic uptake processes independent of circulatory or subsequent cellular phenomena. PMID- 3828337 TI - Binding of phospholipids to the phosphatidylinositol transfer protein from bovine brain as studied by steady-state and time-resolved fluorescence spectroscopy. AB - The phosphatidylinositol transfer protein isolated from brain, liver, heart and platelets was found to be present in two subforms which could be distinguished on the basis of the isoelectric points. In this study we have demonstrated that the two subforms isolated from bovine brain are due to the presence of either phosphatidylinositol or phosphatidylcholine in the lipid binding site of the protein. The transfer protein accommodates one phosphatidylinositol molecule in the binding site. The binding site for the sn-2 fatty acyl chain was investigated by incorporating in the transfer protein either phosphatidylinositol or phosphatidylcholine carrying a parinaroyl-chain attached at the sn-2 position. Time-resolved fluorescence spectroscopy revealed that the sn-2 fatty acyl chains for both phospholipids in the lipid-protein complex were completely immobilized (i.e., rotational correlation times of 17.4 ns for phosphatidylcholine and 16.3 ns for phosphatidylinositol). The similarity in correlation times suggests that the sn-2 fatty acyl chains of both phospholipids are accommodated in the same hydrophobic binding site of the protein. PMID- 3828338 TI - Iron-binding lipids of rabbit duodenal brush-border membrane. AB - Rabbit duodenal brush-border membrane contains chloroform/methanol (2:1, v/v) extractable Fe-binding lipids (27.2 +/- 6.7 nmol/mg protein, mean +/- S.E. (n = 5)). Thin-layer chromatography in two solvent systems reveals that the major Fe binding component(s) co-migrate with free fatty acids. Fe-binding by pure lipids reveals that phosphatidic acid, phosphatidylserine, oleic and stearic acids all show apparent Fe-binding in filtration assays, although oleic acid shows the highest apparent binding (5-10-fold) on a molar basis. The free fatty acid content of brush-border membrane vesicles is sufficient to account for the chloroform/methanol extractable Fe-binding observed in vesicle preparations. The pH dependence of Fe-binding by oleic acid is similar to that reported for the detergent extractable Fe-binding lipid which has been implicated in transport of Fe from Fe/ascorbate solutions by rabbit duodenal brush-border membrane vesicles (Simpson, R.J. and Peters, T.J. (1986) Biochim. Biophys. Acta 859, 227-236). PMID- 3828339 TI - Transport of Fe2+ across lipid bilayers: possible role of free fatty acids. AB - Fatty acids can form lipid-soluble complexes with Fe2+. Incorporation of fatty acids into phosphatidylcholine/cholesterol liposomes renders them permeable to Fe2+. Of several fatty acids tested, the most effective Fe2+ carriers were linoleic and oleic acids followed, in decreasing order of efficacy, by linolenic, myristic, arachidonic and palmitic acids. The initial Fe2+ transport rate for oleic acid depends on free Fe2+ in the medium which in turn shows a strong pH dependence above pH 7.0. The overall pH dependence of Fe2+ transport for several fatty acids shows an optimum near 6.9. Fe2+ transport catalysed by oleic acid can be inhibited by high NaCl concentrations but not 1 mM Co2+. It is suggested that free fatty acids may act as mediators of Fe2+ transport across biological membranes, particularly isolated intestinal brush-border membrane. PMID- 3828340 TI - Membranes modification of differentiating proerythroblasts. Variation of 1,6 diphenyl-1,3,5-hexatriene lifetime distributions by multifrequency phase and modulation fluorimetry. AB - The fluorescence emission of 1,6-diphenyl-1,3,5-hexatriene (DPH) in K562 cell membranes has been studied using multifrequency phase and modulation fluorimetry. The DPH decay data collected at various modulation frequencies were analysed by assuming either a model of discrete exponential components or a model of continuous lifetime distribution. The fits showed smaller values of the reduced chi square using the model of continuous lifetime distribution. The K562 cell membranes dynamics were investigated during the cell differentiation along the erythroid pathway. By using the continuous lifetime distribution method for the analysis of the DPH decay, marked variations were observed during the four initial days of the erythroid differentiation. Namely, the width of the DPH lifetime distribution increased by a factor of about two, while the center value of the distribution remained constant. By using the discrete exponential components model for the analysis of the DPH decay no variations were observed during the K562 differentiation. PMID- 3828341 TI - A differential scanning calorimetry study of the interaction of alpha-tocopherol with mixtures of phospholipids. AB - When alpha-tocopherol was included in multibilayer vesicles of dimyristoylphosphatidylcholine, dipalmitoylphosphatidylcholine and distearoylphosphatidylcholine it induced a broadening of the main transition and a displacement of this transition to lower temperatures, as seen by differential scanning calorimetry. This effect was quantitatively more important in the samples of distearoylphosphatidylcholine than in those of the other phosphatidylcholines. Alpha-Tocopherol when present in equimolar mixtures of dimyristoylphosphatidylcholine and diastearoylphosphatidylcholine, which show monotectic behaviour, preferentially partitions in the most fluid phase. The effect of alpha-tocopherol on the phase transition of dilauroylphosphatidylethanolamine and dipalmitoylphosphatidylethanolamine is qualitatively different of that observed on phosphatidylcholines, and several peaks are observed in the calorimetric profile, probably indicating the formation of separated phases with different contents in alpha-tocopherol. The effect was more apparent in dipalmitoylphosphatidylethanolamine than in dilauroylphosphatidylethanolamine. The inclusion of alpha-tocopherol in equimolar mixtures of dilauroylphosphatidylethanolamine and dipalmitoylphosphatidylcholine, which show cocrystallization, only produced a broadening of the phase transition and a shift to lower temperatures. However, in the case of equimolar mixtures of dipalmitoylphosphatidylcholine which also show cocrystallization, the effect was to cause lateral phase separation with the formation of different mixtures of phospholipids and alpha-tocopherol. Alpha-Tocopherol was also included in equimolar mixtures of phosphatidylethanolamine and phosphatidylcholine showing monotectic behaviour, and in this case alpha-tocopherol preferentially partitioned in the most fluid phase, independently of whether this was composed mainly of phosphatidylcholine or of phosphatidylethanolamine. PMID- 3828342 TI - Electron microscopic and biophysical studies of liposome membrane structures to characterize similar features of the membranes of Streptomyces hygroscopicus. AB - To characterize the novel non-planar plasma membrane structure of bacteria (wafer structure), liposome membranes from the bacterial lipid mixture and individual lipid fractions were prepared and investigated by freeze-fracture electron microscopy, microcalorimetry and 31P-NMR spectroscopy. The phospholipid content of the membranes is essential for the formation of the non-planar membrane structure and there is no indication that the formation of the structure is connected with temperature-induced lipid phase transition processes. An exaggerated form of the wafer structure (raspberry structure) is also visible and additionally, in both cases, many small spherical vesicles are observed. We suggest that both membrane features of the liposomal and bacterial membranes are induced by these vesicles, forming a hexagonal or cubic organization of vesicles on the cytoplasmic surface of the biological membrane, and in between the multilamellae in the artificial membranes. PMID- 3828343 TI - Optical birefringence of phosphatidylcholine liposomes in gel phases. AB - A simple and rapid method for studying optical anisotropic properties of liposomes was proposed. Intensities of transmitted light through one spherical liposome of dipalmitoylphosphatidylcholine placed between two polarizers were measured at various wavelengths by a microscopic spectrophotometer. Large increases in the intensities were observed at the prephase-transition temperature, which were caused by an increase in the birefringence of the multilayer of the liposome. The birefringence values obtained from the intensity data were about 0.020 below the pretransition temperature and 0.028 above that temperature. These values are in good agreement with the results reported for the plane samples in which lipid bilayers are stacked. The obtained values of the birefringence were far lower than the values estimated from polarizabilities. This lower birefringence is attributed to disordering of the tilt direction in the multilayer. The degree of order of the liposome multilayers calculated from the birefringence increased by 38% at the pretransition. This simple method is applicable to the study of the multilayer structure of liposomes in water. PMID- 3828344 TI - Ca2+-induced fusion of large unilamellar phosphatidylserine/cholesterol vesicles. AB - The effect of cholesterol on the Ca2+-induced aggregation and fusion of large unilamellar phosphatidylserine (PS) vesicles has been investigated. Mixing of aqueous vesicle contents was followed continuously with the Tb/dipicolinate assay, while the dissociation of pre-encapsulated Tb/dipicolinate complex was taken as a measure of the release of vesicle contents. Vesicles consisting of pure PS or PS/cholesterol mixtures at molar ratios of 4:1, 2:1 and 1:1 were employed at three different lipid concentrations, each at four different Ca2+ concentrations. The results could be well simulated in terms of a mass-action kinetic model, providing separately the rate constants of vesicle aggregation, c11, and of the fusion reaction itself, f11. In the analyses the possibility of deaggregation of aggregated vesicles was considered explicitly. Values of both c11 and f11 increase steeply with the Ca2+ concentration increasing from 2 to 5 mM. With increasing cholesterol content of the vesicles the value of c11 decreases, while the rate of the actual fusion reaction, f11, increases. Remarkably, the effect of cholesterol on both aggregation and fusion is quite moderate. The presence of cholesterol in the vesicle bilayer does not affect the leakage of vesicle contents during fusion. PMID- 3828345 TI - Changes in the apparent chloride permeability of Necturus enterocytes during the sodium-coupled transport of alanine. AB - The membrane potential and intracellular Cl- activity of Necturus enterocytes were measured with double-barrelled ion-selective microelectrodes and apparent permeability coefficients (PCl) for the apical membrane calculated from Cl(-) replacement experiments. In the presence of L-alanine in the mucosal solution an increase in PCl took place. It is proposed that this might reflect the activation of a Cl- conductance during active substrate transport. PMID- 3828346 TI - The interaction of an anti-lipid antibody (TEPC 15) with a model biomembrane system (monolayer). AB - The interaction which occurs between an anti-lipid antibody (TEPC 15) and two phospholipids, phosphatidylcholine and phosphatidylethanolamine, when they are arranged in a lipid monolayer system has been studied. It is shown that the antibody is stabilised under the influence of a high lateral pressure when it is mixed with a lipid monolayer and that the behaviour of the antibody depends upon the lipid used. Measurements of the surface pressure and surface potential parameters of the lipid monolayers indicate that the antibody interacts differently with phosphatidylcholine compared with phosphatidylethanolamine. The antibody also exhibits a different interaction when it is pretreated with phosphorylcholine prior to being spread with a phosphatidylcholine monolayer. The interaction of the antibody with phosphatidylcholine-cholesterol monolayers has also been studied. PMID- 3828347 TI - Purification of multiple forms of plasma angiotensinogen: molecular weight and charge heterogeneity. AB - A method of purifying angiotensinogen (C.A. 11002-13-14) from dog plasma using a monoclonal antibody is presented. More than 98% of applied angiotensinogen was sequestered by the 2-C: G7F7 anti-angiotensinogen monoclonal antibody in solid phase adsorption assays. Employing immunoaffinity column chromatography, sufficient angiotensinogen was purified for subsequent investigation of angiotensinogen molecular heterogeneity. SDS-polyacrylamide gel electrophoretic analysis resolved two molecular weight forms, an alpha-form at Mr 59,000 and a beta-form at Mr 57,000. These alpha- and beta-plasma angiotensinogen forms were separated by anion-exchange HPLC; an additional gamma-form was also identified. Homogeneous dog angiotensinogen, recovered by reverse-phase HPLC, was partially sequenced. The dog angiotensinogen N-terminal sequence was shown to be more similar to rat than to human angiotensinogen. Since neuraminidase reduced the molecular weight of alpha-angiotensinogen by 4000 and beta-angiotensinogen by 2000, these two forms of the prohormone in dog plasma contain two and one carbohydrate side chain, respectively. PMID- 3828348 TI - Identification of cortisone 5 beta-reductase as delta 4-3-ketosteroid 5 beta reductase. AB - Cortisone 5 beta-reductase (4,5 beta-dihydrocortisone:NADP+ delta 4 oxidoreductase, EC 1.3.1.3) was purified from rat liver 100,000 X g supernate to a homogeneous state based on the catalytic activity. In the course of purification the activity was always accompanied by androstenedione 5 beta reductase (3-oxo-5 beta-steroid:NADP+ delta 4-oxidoreductase, EC 1.3.1.23) and no fraction which revealed only cortisone 5 beta-reductase activity but lacked androstenedione 5 beta-reductase was observed. Partial denaturation of the purified enzyme with p-chloromercuribenzoate or wtih heat reduced both enzyme activities to a similar extent. When both substrates were added together at concentrations sufficient to saturate or nearly saturate the enzyme when added separately, the total rate of the reactions was much less than the sum of the rates of the reactions measured separately. Judging from these results it was concluded that cortisone 5 beta-reduction and that of androstenedione are catalyzed by the same catalytic site of a single protein. PMID- 3828349 TI - Conformation between the substrate-binding site and heme of cytochrome P-450 studied by excitation energy transfer. AB - The conformation between the substrate-binding site and heme of cytochrome P-450 was studied by excitation energy transfer. Cytochrome P-450 was obtained from the hepatic microsomes of polychlorinated biphenyl-treated male rats, and ten polycyclic aromatic hydrocarbons were used as substrates. The energy transfer from the substrate to the heme of the enzyme was measured according to the Forster equation. On the basis of the assumption that the substrates are bound at different positions in the plane of the same substrate-binding site, the position of the heme in relation to the substrate-binding site was determined in solution and in the presence of synthetic phospholipid. The results demonstrated that the distance between the substrate-binding site and the heme of cytochrome P-450 was greater when the enzyme was incorporated into micelles of phospholipid than when in solution, and that the conformational relationship of the substrate-binding site towards the heme was changed by an angle of 21 degrees on incorporation of the enzyme into phospholipid micelles. PMID- 3828350 TI - Further studies on the catalytic mechanism of human liver alpha-L-fucosidase. AB - Radiolabeling of human liver alpha-L-fucosidase (alpha-L-fucoside fucohydrolase, EC 3.2.1.51) with [1-3H]conduritol C trans-epoxide revealed that there are four active sites per tetrameric enzyme complex. Solvent isotope effect experiments give evidence for a proton transfer at the rate-limiting step in catalysis. Transglycosylase activity was observed using methanol as an alternative glycone acceptor to produce methyl alpha-L-fucoside, suggesting that alpha-L-fucose is formed when water is the acceptor. Initial burst kinetics experiments suggest that a glycosyl-enzyme intermediate is formed, although the magnitude of the burst is not stoichiometric with the number of active sites. These data, along with previous results, suggest a general acid-general base catalytic mechanism involving double inversion of stereochemistry at C-1 of fucose, as well as the formation of either a covalent glycosyl-enzyme intermediate or a tight ion pair between a charged active-site residue and a hypothetical fucosyl oxocarbonium ion intermediate. PMID- 3828351 TI - Actin-binding site of pig cardiac myosin. AB - An actin-binding site is also present in the tryptic 20 kDa peptide fragment of the subfragment-1 heavy chain of pig cardiac myosin. As previously reported for skeletal myosin (Katoh, T., Katoh, H., and Morita, F. (1985) J. Biol. Chem. 260, 6723-6727), the site was further narrowed down to the 10 kDa peptide containing the reactive SH1 and SH2 groups. Thus it appears that the actin-binding site around the two thiols found in skeletal myosin is common to different types of myosin. PMID- 3828352 TI - Isolation and two-dimensional 1H-NMR of peptide [1-24] of dog serum albumin and studies of its complexation with copper and nickel by NMR and CD spectroscopy. AB - The NH2-terminal peptide fragment [1-24] of dog serum albumin was obtained by controlled peptic digestion of the protein. The peptide was purified to homogeneity by gel filtration and ion-exchange chromatography. The NMR assignments of the protons of the individual amino acid residues were made by using two-dimensional correlation matrix, spin-decoupling experiments and analysis of the titration curves. The polypeptide itself has a random-coil conformation. There is a conformational change as a function of pH, but it does not arise from any direct involvement of the amino acid side chains. Complexation of the peptide fragment with Ni(II) and Cu(II) has been investigated by NMR and CD. The Ni(II) complex is in slow exchange with the free ligand on the NMR time scale. The complexation involves the alpha-NH2, three deprotonated amide nitrogens of Ala-2, Tyr-3 and Lys-4 residues. The phenolate oxygen of Tyr-3 is not involved in the metal binding; however, an interaction between the aromatic ring and the metal ion is likely. The CD results of Cu(II)-binding to this peptide suggest that the complexation takes place from the terminal NH2 and step by step to three deprotonated amide nitrogens. There is no major conformational change of the peptide fragment upon complexation. PMID- 3828353 TI - Location of two cysteines in brain beta 1-tubulin that can be cross-linked after removal of exchangeable GTP. AB - Two cysteines of the major neuronal beta-tubulin subunit (beta 1) can be specifically cross-linked with the bifunctional sulfhydryl reagent N',N' ethylenebis(iodoacetamide) after removal of GTP. A cysteine in position 12 cross links with one of the cysteines in position 201 or 211. Although the two cross linked cysteines are separated by at least 189 residues in the primary structure of tubulin, they are maximally 9 A apart in the tertiary structure. PMID- 3828354 TI - Acid-assisted anion interaction with deoxyhemerythrin. AB - The interaction of N3-, CNO- and F- with deoxyhemerythrin was monitored from pH 6 to 9 and 3 degrees C to 25 degrees C at an ionic strength 0.5 M (Na2SO4) by using competition with O2. A proton is involved in forming the adduct and is not lost from the protein even at pH values as high as 9. Thermodynamic and kinetic parameters for the interaction of each anion are obtained. It is considered that the proton is introduced as the acid HX and the corresponding parameters for the reaction of HX with deoxyhemerythrin are calculated. These are compared with those for the O2 reaction with deoxyhemerythrin. The adducts are remarkably inert and have dissociation half-lives ranging from 7 s (N3-) to 70 s (CNO- and F-) at 25 degrees C. This stability is ascribed to protonation of a bridged hydroxy group or even bridge-breakage. PMID- 3828355 TI - Tropomyosin from human erythrocyte membrane polymerizes poorly but binds F-actin effectively in the presence and absence of spectrin. AB - Actin in the human erythrocyte forms short protofilaments which are only long enough to accommodate tropomyosin monomers (Shen, B.W., Josephs, R. and Steck, T.L. (1986) J. Cell Biol. 102, 997-1006). This interaction between actin and tropomyosin monomers is predicted to be weak, since tropomyosin polymerization parallels its affinity for F-actin. We examine the binding of human erythrocyte tropomyosin to actin in the presence and absence of spectrin and its ability to polymerize. The binding of human erythrocyte tropomyosin to F-actin is not affected appreciably by the present of spectrin. Saturating F-actin with erythrocyte tropomyosin, however, weakens the binding of spectrin dimers to actin. Although tropomyosin from human erythrocyte and rabbit cardiac muscle have similar affinity for F-actin, the polymerizability of erythrocyte tropomyosin as determined by viscosity measurements is much reduced relative to muscle tropomyosin. This unusual property of erythrocyte tropomyosin is likely due to differences in its primary structure from other known tropomyosin at the amino and carboxyl terminal regions which are responsible for its head-to-tail polymerization and cooperative binding to F-actin. Analysis of the distribution of tyrosine by 2-dimensional tryptic mapping of 125I-labelled erythrocyte tropomyosin shows that tyrosine at positions 162, 214, 221, 261 and 267 in rabbit cardiac tropomyosin are conserved in human erythrocyte tropomyosin but Tyr-60 is absent. This observation suggests that erythrocyte tropomyosin has a carboxyl terminal region similar to its muscle counterparts but its amino terminal region resembles that of platelet tropomyosin which also lacks Tyr-60. PMID- 3828356 TI - Hydrodynamic characterization of the size and shape of atropinesterase from Pseudomonas putida. AB - Atropinesterase from Pseudomonas putida has been investigated by means of different ultracentrifugation methods under native and denaturing conditions. The following quantities were determined: sedimentation coefficient, translational diffusion and friction coefficient, partial specific volume and molecular weight. From these data the size, shape and hydration of the enzyme molecule in solution were estimated. The results suggest that atropinesterase is a globular protein which consists of a single polypeptide chain with a molecular weight of about 30,000. In solution under non-denaturing conditions, it occurs mainly as a dimer which hydrodynamically behaves as a rigid impenetrable particle. Calculations based on the spheroid model indicate that this particle resembles a hydrated sphere with a diameter of 6.1 +/- 0.2 nm and a hydration of 0.4 +/- 0.1 g of H2O/g of protein rather than a significantly less hydrated ellipsoid of revolution. Under denaturing conditions dissociation into monomers takes place. The effects of sodium dodecyl sulphate (SDS) on size and shape suggest that dimerization results from side-by-side association of two elongated monomers rather than from end-to-end association. Approximately 57 molecules of SDS are bound per dimer before dissociation occurs concomitant with the additional binding of about 19 molecules of detergent. PMID- 3828357 TI - Amino-acid sequence of a tetrameric, manganese superoxide dismutase from Thermus thermophilus HB8. AB - The amino-acid sequence of a tetrameric manganese superoxide dismutase from Thermus thermophilus HB8 has been determined. The protein was cleaved with cyanogen bromide (BrCN) into four peptides and their alignment was deduced through the fragment of partial cleavage with BrCN and the peptides were produced by cleavage of the protein with o-iodosobenzoic acid. Most of the peptides were sequenced by solid phase Edman degradation. Some of the peptides were sequenced by the Edman dansyl method after sub-fragmentation by proteinase digestion. The amino-acid sequence consists of 203 residues corresponding to a subunit molecular weight of 23,144. PMID- 3828358 TI - Albumin Canterbury (313 Lys----Asn). A point mutation in the second domain of serum albumin. AB - Albumin Canterbury is a fast-migrating variant of human albumin. It constituted 50% of the total serum albumin in two unrelated New Zealand males. Two dimensional tryptic mapping suggested that the mutation occurred between residues 313 and 317 inclusive. This was confirmed by mapping of S. aureus V8 proteinase digests. The expected neutral peptide Ser-Lys-Asp-Val-Cys-Lys-Asn-Tyr-Ala-Glu (312-321) was missing and was replaced by an acidic peptide Ser-ASN-Asp-Val, Cys, Lys, Asn, Tyr, Ala, Glu. The mutation of 313 Lys----Asn, which occurs in the second domain of albumin Canterbury, does not alter the thyroxine (T4) or T3 binding. There was no discernible physical handicap associated with the presence of this new albumin. PMID- 3828360 TI - The pH dependence of pre-steady-state and steady-state kinetics for the papain catalyzed hydrolysis of N-alpha-carbobenzoxyglycine p-nitrophenyl ester. AB - Pre-steady-state and steady-state kinetics of the papain (EC 3.4.22.2)-catalyzed hydrolysis of N-alpha-carbobenzoxyglycine p-nitrophenyl ester (ZGlyONp) have been determined between pH 3.0 and 9.5 (I = 0.1 M) at 21 +/- 0.5 degrees C. The results are consistent with the minimum three-step mechanism involving the acyl X enzyme intermediate E X P: (Formula: see text). The formation of the E X S complex may be regarded as a rapid pseudoequilibrium process; the minimum values for k+1 are 8.0 microM-1 s-1 (pH less than or equal to 3.5) and 0.40 microM-1 s-1 (pH greater than 6.0), and that for k-1 is 600 s-1 (pH independent). The pH profile of k+2/Ks (= kcat/Km; Ks = k-1/k+1) reflects the ionization of two groups with pK' values of 4.5 +/- 0.1 and 8.80 +/- 0.15 in the free enzyme. The pH dependence of k+2 and k+3 (measured only at pH values below neutrality) implicates one ionizing group in the acylation and deacylation step with pK'' values of 5.80 +/- 0.15 and 3.10 +/- 0.15, respectively. As expected from the pH dependences of k+2/Ks (= kcat/Km) and k+2, the value of Ks changes with pH from 7.5 X 10(1) microM (pH less than or equal to 3.5) to 1.5 X 10(3) microM (pH greater than 6.0). Values of k-2 and k-3 are close to zero over the whole pH range explored (3.0 to 9.5). The pH dependence of kinetic parameters indicates that at acid pH values (less than or equal to 3.5), the k+2 step is rate limiting in catalysis, whereas for pH values higher than 3.5, k+3 becomes rate limiting. The observed ionizations probably reflect the acid-base equilibria of residues involved in the catalytic diad of papain, His159-Cys25. Comparison with catalytic properties of ficins and bromelains suggests that the results reported here may be of general significance for cysteine proteinase catalyzed reactions. PMID- 3828359 TI - Nonenzymatic reduction of ferric leghemoglobin. AB - Ferric leghemoglobin isolated from soybean root nodules was reduced nonenzymatically to ferrous leghemoglobin in vitro at pH 5.2 using either 1.0 mM NADH or NADPH as the reductant. In the pH range of 5.2 to 7.0, the highest rates of reduction occurred below pH 6.5 with a maximum rate observed at pH 5.2. Rates of nonenzymatic ferric leghemoglobin reduction above pH 6.5 or at reduced pyridine nucleotide concentrations below 0.4 mM were insignificant. Oxygen was required for the nonenzymatic reduction. Inhibition of ferric leghemoglobin reduction by superoxide dismutase and catalase indicated that superoxide and hydrogen peroxide may be intermediates in the reaction. PMID- 3828361 TI - Comparison of the binding of Na+ and Ca2+ to bovine alpha-lactalbumin. AB - alpha-Lactalbumin is a metal-binding protein which binds Ca2+- and Na+-ions competitively to one specific site, giving rise to a large conformational change of the protein. For this reason, the enthalpy change of binding Ca2+ to apo-alpha lactalbumin (delta Ho) is strongly dependent on the concentration of Na+ ions in the medium. From that relationship a molar enthalpy of -145 +/- 3 kJ X mol-1 is calculated for the Ca2+-binding at pH 7.4 and 25 degrees C, while a delta Ho of 5 +/- 3 kJ X mol-1 is found to substitute a complexed Na+ by a Ca2+-ion. These measurements also allowed us to calculate a binding constant for Na+ of 195 +/- 18 M-1. The molar enthalpy of Na+-loading was found to be -142 +/- 3 kJ X mol-1, a value very close to delta Ho of the binding of Ca2+ to alpha-lactalbumin. Both enthalpy changes in binding Ca2+ and Na+ are independent of the protein concentration. These exothermic values are in agreement with the hypothesis that both Na+- and Ca2+-ions are able to induce the same conformational change in alpha-lactalbumin upon which hydrophobic regions are removed from the solvent, yielding a less hydrophobic protein. The latter is confirmed by means of affinity measurements of the hydrophobic fluorescent probe 4,4'-bis[1-(phenylamino)-8 naphthalene sulphonate](bis-ANS) to alpha-lactalbumin. The association constant (Ka) decreased from (6.6 +/- 0.5) X 10(4) M-1 in the absence of NaCl to (2.7 +/- 0.2) X 10(4) M-1 in 75 mM NaCl, while the maximum intensity (Imax) of the binary bis-ANS-alpha-lactalbumin complex remained constant at 0.44 +/- 0.02 (arbitrary units). The Ka value of bis-ANS for Ca2+-alpha-lactalbumin was determined at (1.7 +/- 0.2) X 10(4) M-1 and Imax was 0.43 +/- 0.02 (arbitrary units). The difference in hydrophobicity between the two conformational states of the protein was further demonstrated by adsorption experiments of both conformers to phenyl Sepharose. Apo-alpha-lactalbumin, hydrophobically bound to phenyl-Sepharose, can be eluted by adding Ca2- or Na+-solutions. PMID- 3828363 TI - Biosynthetic and structural studies on pheomelanin. AB - 13C-NMR spectroscopy of pheomelanin biopolymers, prepared from isotopically enriched precursors, has been developed as a tool for structure elucidation of melanins. By employing large pulse-widths and short cycle time, only the signals originating from labeled carbons are observed in the high-resolution spectra of these polymers. PMID- 3828362 TI - 13C-NMR study of labeled vinyl groups in paramagnetic myoglobin derivatives. AB - The 13C-NMR spectra of high-spin met-aquo myoglobin, spin-equilibrium met-azido myoglobin, low-spin met-cyano myoglobin, deoxy myoglobin and carbonmonoxy myoglobin from sperm whale reconstituted with hemin 13C enriched at both vinyl alpha or beta positions have been recorded. In all cases the labeled vinyl 13C signals are clearly resolved and useful spectra could be obtained within approx. 15 minutes. The decoupling of multiplet structure due to attached proton(s) has led to the specific assignment of vinyl 13C alpha signals in all paramagnetic derivatives and the 13C beta signals in met-cyano myoglobin. In all other cases, the collapse of the proton multiplet structure as a function of 1H decoupling frequency has located, but not assigned, the attached 1H resonance positions which are obscured by the intense diamagnetic envelope in the 1H-NMR spectrum. The resulting vinyl 13C hyperfine shifts follow Curie behavior, and the patterns closely resemble those in the appropriate model complexes in the same oxidation/spin/ligation state, except that the protein exhibits more in-plane asymmetry. The hyperfine shift patterns are indicative of dominant pi contact shifts for all ferric complexes. Deoxy myoglobin vinyl 13C and 1H contact shifts provide little evidence for pi bonding. PMID- 3828364 TI - beta-Muricholic acid; potentiometric and cholesterol-dissolving properties. AB - Some physicochemical properties of beta-muricholic acid (3 alpha,6 beta,7 beta trihydroxy-5 beta-cholanic acid), a major bile acid biosynthesized by rat liver, were determined and compared to those of ursodeoxycholic and chenodeoxycholic acids. From potentiometric studies, the following characteristics of beta muricholic acid were shown: a low monomer solubility (13 microM), a high equilibrium precipitation pH (7.92 for 30 mM solution), an apparent critical micellar concentration of 4 mM, and a very low micellar capacity of the bile salt to dissolve the protonated bile acid. Sodium beta-muricholate solution (30 mM) poorly solubilized cholesterol, as indicated by a bile salt/cholesterol molar ratio of 1430, whereas saturation ratios obtained with chenodeoxycholate and ursoseoxycholate were 24 and 384, respectively. Sodium beta-muricholate (30 mM)/phosphatidylcholine/cholesterol mixtures contained non-micellar aggregates from very low cholesterol concentrations. At physiological phosphatidylcholine concentrations, sodium beta-muricholate (100 mM) dissolved cholesterol crystals via essentially lamellar liquid-crystal formation. These solubilizing properties might have important physiological relevance to the dissolution of cholesterol gallstones in man. PMID- 3828365 TI - In vitro formation of HDL-2 from HDL-3 and triacylglycerol-rich lipoproteins by the action of lecithin:cholesterol acyltransferase and cholesterol ester transfer protein. AB - In order to study the factors responsible for the formation of high-density lipoprotein subfraction-2 (HDL-2), very-low-density lipoproteins (VLDL) and HDL-3 were mixed and incubated with purified bovine milk lipoprotein lipase, human serum lecithin:cholesterol acyltransferase, cholesteryl ester transfer protein and mixtures thereof. The results can be summarized as follows: Incubation of HDL 3 and VLDL for 24 h at 37 degrees C without enzymes did not cause any significant change in the protein:lipid ratio or in the flotation constant of the HDL. Cholesteryl ester transfer protein treatment caused only an exchange of part of the HDL cholesteryl esters with VLDL triacylglycerols. Lipoprotein lipase caused a slight shift of HDL-hydrated density to lower values; HDL-2b, however, was not formed. Incubation of HDL-3 and VLDL with lecithin:cholesterol acyltransferase or mixtures of lecithin:cholesterol acyltransferase and lipoprotein lipase reduced the HDL-protein:lipid ratio and increased the HDL-flotation rate. The newly formed HDL resembled that of native HDL-2a. The incubation of HDL-3 and VLDL with lecithin:cholesterol acyltransferase and cholesteryl ester transfer protein caused a shift of the HDL-3 into an HDL-2b-like fraction. Particles resembling HDL-2b in the analytical ultracentrifuge were also formed if VLDL + HDL-3 were incubated with lipoprotein lipase or lipoprotein lipase + cholesteryl ester transfer protein in a medium containing low amounts of albumin, insufficient for binding all liberated fatty acids during hydrolysis. The incubation of mixtures of HDL-3 and chylomicrons enriched with apoAI in the presence of lecithin:cholesterol acyltransferase and cholesteryl ester transfer protein caused the formation of HDL-2-like particles which resembled those of native HDL 2 also with respect to the apoAI/AII ratio. PMID- 3828366 TI - Evidence for a high activity of sphingomyelin biosynthesis by phosphocholine transfer from phosphatidylcholine to ceramides in lung lamellar bodies. AB - Biosynthesis of sphingomyelin from ceramides was investigated in lung subcellular fractions by incubating a lyophilized mixture of albumin and subcellular fraction (0.1-0.2 mg of protein) coated with [acyl-14C]-ceramide and phosphatidyl[methyl 3H]choline in Tris-buffer. The lamellar-body-rich fraction exhibited the highest specific activity for sphingomyelin biosynthesis measured by 14C incorporation into sphingomyelins or by [3H]phosphocholine transfer from phosphatidylcholines. Plasma membranes formed the next most active fraction, followed by the 'smooth' and, then, the 'rough' endoplasmic reticulum. Sphingomyelin biosynthesis by lamellar bodies was optimum at pH 7.4 and was inhibited by sphingomyelins formed. Slight inhibitory effects were also observed with Mn2+, Ca2+ and lysophosphatidylcholine. Phosphocholine transfer from CDPcholine was not observed under the reaction conditions employed. Ceramide conversion and phosphocholine transfer increased with ceramide concentration to reach a maximum at about 0.06 mM. The highest conversion rate was observed when 18:1 ceramide was used as an acceptor. When 1-palmitoyl-2-oleoylphosphatidylcholine was the phosphocholine donor, the overall biosynthesis of sphingomyelin was much higher than when using dipalmitoylphosphatidylcholine. These results suggest the possible involvement of the studied reaction in the control of the degree of saturation of the surfactant phosphatidylcholine. PMID- 3828368 TI - Carnitine palmitoyltransferase: characterization of a labile detergent-extracted malonyl-CoA-sensitive enzyme from rat liver mitochondria. AB - Rat liver mitochondria were preextracted with Triton X-100 in the absence of salts to remove malonyl-CoA-insensitive carnitine palmitoyltransferase. From the remaining membrane residues a malonyl-CoA-sensitive enzyme was solubilized with octyl glucopyranoside in the presence of KCl. Significant enzyme activity, [2 14C]malonyl-CoA binding and malonyl-CoA inhibition of this enzyme was present only after removal of detergent by precipitation with poly(ethylene glycol). The enzyme activity was rapidly lost in the solubilized form. High concentrations of glycerol protected the enzyme. The alkylating irreversible inhibitor, S-(4-bromo 2,3-dioxobutyl)-CoA, strongly inhibited the malonyl-CoA-sensitive enzyme in the membrane residues. The enzyme was protected against this inhibitor by malonyl-CoA and palmitoyl-CoA. The more loosely membrane-bound malonyl-CoA-insensitive enzyme failed to bind malonyl-CoA, was stable in the presence of detergents and was not inhibited by S-(4-bromo-2,3-dioxobutyl)-CoA. It is suggested that two different carnitine palmitoyltransferase proteins exist in the inner mitochondrial membrane and that the detergent-labile malonyl-CoA-sensitive enzyme is the less easily extracted of the two. PMID- 3828367 TI - Induction of cytosolic clofibroyl-CoA hydrolase activity in liver of rats treated with clofibrate. AB - Among subcellular fractions of liver homogenates of rats, the clofibroyl-CoA hydrolase activity is found mainly in the cytosolic fraction. It is here shown that the subcellular distribution of clofibroyl-CoA hydrolase appears to be different from the distribution of palmitoyl-CoA hydrolase activity. Thus, in contrast to the case with palmitoyl-CoA, no hydrolysis of clofibroyl-CoA was catalysed by the microsomal fraction. Furthermore, the hydrolysis of palmitoyl CoA and clofibroyl-CoA in the cytosolic fraction seemed to be catalyzed by two different enzymes. Rats treated with clofibrate (0.3%, w/w) showed a significant increased clofibroyl-CoA hydrolase activity where the cytosolic hydrolase was increased 3.5-fold. Clofibrate administration also elevated the specific clofibroyl-CoA hydrolase activity by factors of 1.7 and 1.5 in the mitochondrial and the light-mitochondrial fractions, respectively. Thus, it is possible that clofibroyl-CoA hydrolase has also a multiorganelle localization. PMID- 3828369 TI - Changes in muscle lipid metabolism induced in vitro by 1,25-dihydroxy-vitamin D 3. AB - 1,25-Dihydroxy-vitamin D-3 has been shown to increase phosphatidylcholine and decrease phosphatidylethanolamine levels in skeletal muscle in vitro. To elucidate the metabolic pathway and mechanism involved in the effect of the sterol, chick embryo myoblast and vitamin D-deficient chick soleus muscle cultures were treated with 1,25-dihydroxy-vitamin D-3 (5.0 X 10(-10)-3.6 X 10( 11) M, total concentration) for 12-14 h and 1 h, respectively, in the absence and presence of protein and RNA synthesis inhibitors. Lipids were then labelled with [3H]glycerol and [14C]acetate. A significant increase in phosphatidylcholine and triacylglycerol labelling and a decrease in phosphatidylethanolamine labelling were observed in response to the hormone. Cycloheximide suppressed these changes in both types of preparations. Puromycin and actinomycin D were also effective blockers in cultured muscle cells. In addition, double-labelling of control and 1,25-dihydroxy-vitamin D-3-treated myoblasts with [3H]choline and [14C]ethanolamine were performed. The sterol did not affect [3H]choline labelling of total cell lipid extracts and phosphatidylcholine. However, the total lipid fraction of treated cells was labelled to a greater extent with [14C]ethanolamine. In addition, an increased incorporation of this precursor into phosphatidylcholine accompanied by a proportional decrease in phosphatidylethanolamine could be shown in cells pretreated with the metabolite. These changes were abolished by cycloheximide and actinomycin D. The results suggest that 1,25-dihydroxy-vitamin D-3 stimulates methylation of phosphatidylethanolamine into phosphatidylcholine in myoblasts by a nuclear mechanism. The data are consistent with the presence in the cells of a receptor specific for the hormone. PMID- 3828370 TI - The quantitative separation of chylomicrons and chylomicron remnants by column chromatography. AB - Chylomicrons and chylomicron remnants cannot be separated by classical techniques of ultracentrifugation or gel filtration, since there is a marked overlap of density and size. Chylomicron remnants develop a high negative surface charge during their formation presumably due to surface-oriented free fatty acids. Two chromatographic matrices have been identified which separate these two lipoprotein species based on the charge differences. Both DEAE-Sephacel and protamine-Affi-Gel 10 effect a quantitative separation. These techniques may be useful in studies of chylomicron metabolism both in vivo and in vitro. PMID- 3828371 TI - Isolation of two forms of carboxylester lipase (cholesterol esterase) from porcine pancreas. AB - Carboxylester lipase (cholesterol esterase, EC 3.1.1.13) has been purified to homogeneity from porcine pancreas. The enzyme is isolated in two molecular mass forms, a monomer of 74 kDa and a dimer of 167 kDa. The dimer consists of two catalytically-active subunits which have molecular masses approximately 9 kDa greater than the monomers. The difference in size was not attributable to carbohydrate or lipid content. The catalytic properties of the two forms are comparable on a weight basis, the amino acid compositions are quite similar, and the N-terminal sequences are nearly identical for 24 residues. These similarities suggest a possible precursor-product relationship between the two carboxylester lipase forms. PMID- 3828372 TI - Mechanism of modification of rat brain lysophospholipase A activity by cationic amphiphilic drugs. AB - The three psychotropic cationic amphiphilic drugs, chlorpromazine, desmethylimipramine and propranolol were found to have biphasic effects on rat brain lysophospholipase A, stimulating the enzyme at low, and inhibiting it non competitively at higher concentrations. Low concentrations (less than or equal to 50 microM) of the drugs prevented the formation of micelles of lysophosphatidylcholine, whereas high concentrations caused a phase transition of the substrate with formation of a highly ordered membranous lattice. A possible mechanism of stimulation and inhibition of the enzyme activity by cationic amphiphilic drugs is proposed. Stimulation is explained by a decrease in the concentration of substrate micelles, which are inhibitory for the activity, whereas inhibition may be caused by adsorption of the enzyme onto the membranous lattice formed by the substrate in the presence of high cationic amphiphilic drug concentrations. PMID- 3828373 TI - Microsomal ethanol-oxidizing system in purified rat Leydig cells. AB - These studies provide evidence for the presence of a microsomal ethanol oxidizing system in rat Leydig cells. Activity of the microsomal ethanol oxidizing system in Leydig cells was 47.4 +/- 4.1 nmol acetaldehyde per 20 min per mg protein, while activity in crude interstitial cells was 26.0 +/- 5.4 nmol. This suggests that among cells comprising interstitial cells, activity is concentrated in Leydig cells. Activity was linear with respect to protein concentration and incubation time. The highest specific activity was observed in the microsomal fraction. The most effective cofactor was NADPH. The apparent Km for ethanol was 4 mM, suggesting that this system could effectively metabolize ethanol at concentrations found in the blood of males who drink. The apparent Km for NADPH was 11 microM. The activity in Leydig cells was unaffected by 4-methylpyrazole or potassium cyanide, which inhibit alcohol dehydrogenase and catalase activities, respectively. These data provide strong evidence for an enzyme system in Leydig cell microsomes which is capable of metabolizing ethanol. PMID- 3828374 TI - Binding of lipoproteins to inert materials revisited with computer-assisted analysis. AB - A number of studies conducted in the last decade showed that saturable ('specific') binding, by itself, does not necessarily imply biological significance. That is, biological ligands were shown to bind to inert materials as well as to biological receptors in a saturable manner. In these studies specific binding was operationally defined as binding that was displaceable by excess concentrations of unlabeled ligand. This method of measuring specific binding is now no longer considered optimal. To investigate whether optimal (computer-assisted) techniques of measuring specific binding--namely, nonlinear least-squares curve fitting of total binding data, with mathematical separation of the total binding into its various components--might ensure biological significance of measured specific binding, we studied the binding of high-density lipoproteins (HDL3) to tissue culture dishes as an example of binding without biological significance. This binding closely followed the paradigm of a ligand interacting with a class of homogeneous, saturable sites and with a class of relatively unsaturable sites, just as it would have if the HDL3 were interacting with an unpurified biological receptor. This finding indicates that computer assisted analysis, while most accurately describing binding data, nevertheless does not ensure that measured specific binding has biological significance. Saturability is such a nonselective feature of equilibrium binding data that it should probably no longer be considered one of the criteria for deciding whether or not a defined binding site is a receptor. PMID- 3828375 TI - Phosphatidylethanolamine methyltransferase: evidence for influence of diet fat on selectivity of substrate for methylation in rat brain synaptic plasma membranes. AB - Male weanling rats were fed diets containing 20% (w/w) fat differing in fatty acid composition for 24 days. Synaptic plasma membranes were isolated from the brain and the fatty acid composition of phosphatidylethanolamine and phosphatidylcholine was determined. In vitro assays of phosphatidylethanolamine methyl-transferase activity were performed on fresh membrane samples to assess effect of dietary fat on the rate of phosphatidylethanolamine methylation for phosphatidylcholine synthesis via the phosphatidylethanolamine methyltransferase pathway. Dietary level of n-6 and ratio of n-6 to n-3 fatty acids influenced membrane phospholipid fatty acid composition and activity of the lipid-dependent phosphatidylethanolamine methyltransferase pathway. Rats fed a diet rich in n-6 fatty acids produced a high ratio of n-6/n-3 fatty acids in synaptosomal membrane phosphatidylethanolamine, and elevated rates of methylation of phosphatidylethanolamine to phosphatidylcholine by phosphatidylethanolamine methyltransferases, suggesting that the pathway exhibits substrate selectivity for individual species of phosphatidylethanolamine containing long-chain homologues of dietary n-6 and n-3 fatty acids (20:4(n-6), 22:4(n-6), 22:5(n-6) and 22:6(n-3). It may be concluded that diet alters the membrane content of n-6, n-3 and monounsaturated fatty acids, and that change in phosphatidylethanolamine species available for methylation to phosphatidylcholine alters the rate of product synthesis in vivo by the phosphatidylethanolamine methyltransferase pathway. PMID- 3828376 TI - The oxidation of apomorphine and other catechol compounds by horseradish peroxidase: relevance to the measurement of dihydropteridine reductase activity. AB - It has been reported by Shen et al. (Shen, R.-S., Smith, R.V., Davis, P.J. and Abell, C.W. (1984) J. Biol. Chem. 259, 8894-9000) that apomorphine and dopamine are potent, non-competitive inhibitors of quinonoid dihydropteridine reductase. In this paper we show that apomorphine, dopamine and other catechol-containing compounds are oxidized rapidly to quinones by the horseradish peroxidase-H2O2 system which is used to generate the quinonoid dihydropterin substrate. These quinones react non-enzymatically with reduced pyridine nucleotides, depleting the other substrate of dihydropteridine reductase. When true initial rates of dihydropteridine reductase-dependent reduction of quinonoid dihydropterins are measured, neither apomorphine nor any other catechol-containing compound that has been tested has been found to inhibit dihydropteridine reductase. PMID- 3828377 TI - Estimation of tissue phospholipids by natural abundance 13C-NMR. AB - The total phospholipid content of excised rat muscle, liver, brain and kidney and of human muscle biopsies was estimated by natural abundance 13C-NMR after complete solubilization of the tissue membranes with excess halothane. An external dioxane capillary, calibrated against pure palmitic acid and phospholipid vesicles with known phosphate concentration, was inserted into the tissues, and the repeating methylene carbon peak area in the spectra of the halothane-treated tissues was integrated versus the dioxane reference peak area. The amount of tissue used for NMR analysis was quantitated by dry weight determination after 13C spectroscopy was completed. The phospholipid content estimated by the indirect NMR method was in good agreement with that measured by direct phosphate analysis and with literature data. For human muscle biopsies, the NMR method can also estimate the fraction of the total phospholipids which are mobile without treating the muscles with halothane. In this respect human muscles could be separated into three different groups: normal and nonspecific muscle diseases, myotonia and myopathy, Duchenne dystrophy; with increasing fraction of the mobile phospholipids in this order. PMID- 3828378 TI - Peroxidase-promoted aerobic oxidation of 2-nitropropane: mechanism of excited state formation. AB - Using sensitized emission, the horseradish peroxidase-catalyzed aerobic oxidation of the toxic pollutant 2-nitropropane to nitrite and acetone is shown to produce the latter in the electronically excited triplet state. In turn, this chemiexcitation implies a hydroperoxide precursor. Taking into account the stoichiometry of the reaction and available isotopic data it is inferred that the hydroperoxide reacts with a second molecule of the substrate (aci form). While triplet acetone formed from isobutanal (enol form) is generated within the enzyme, in the present case triplet acetone is formed in the bulk solution. PMID- 3828379 TI - Minor modifications to the structure of tunicamycin lead to loss of the biological activity of the antibiotic. AB - Three analogues of tunicamycin, each with minor alterations in structure in different regions of the molecule, have been employed to study the effects of such modifications upon the biological activity of the antibiotic. The data indicate that any modification of structure results in loss of the ability of the antibiotic to inhibit N-glycosylation of proteins. In contrast to tunicamycin itself, none of the analogues had any deleterious effects upon cellular macromolecule synthesis, nor upon the kinetics of export of de novo synthesised IgM or IgG molecules from treated rat hybridoma cells. In addition, the incorporation of tritiated sugars into acid-precipitable macromolecules was not inhibited. Endoglycosidase H digestion of isolated IgG molecules further suggested that the analogues employed did not interfere with qualitative glycosylation at the level of N-acetylglucosamine transferases I and II in the golgi apparatus. The data are consistent with the interpretation that tunicamycin has very precise structural requirements for expression of inhibitory effects upon protein glycosylation, and that small variations of structure can lead to loss of its inhibitory effects. PMID- 3828380 TI - Intestinal and renal origin of trehalase activity in rabbit amniotic fluid. AB - To utilize specific fetal markers in amniotic fluid for prenatal detection of fetal anomalies, it is necessary to determine the precise tissue origin of these markers. In rabbit fetuses, we distinguished between intestinal and renal forms of trehalase (alpha,alpha'-trehalose-1-D-glucohydrolase, EC 3.2.1.28) in amniotic fluid on the basis of differences in net electric charges. Trehalase was solubilized from purified brush-border membranes of fetal rabbit kidney and intestine by Triton X-100 treatment, whereas the trehalase activity in amniotic fluid was soluble. The kinetic properties of trehalase from intestine, kidney and amniotic fluid were very similar. The Mr of the soluble amniotic fluid trehalase was between 72,600 and 66,300 from hydrodynamic parameters, depending on the amount of sugar bound to the enzyme, and 48,500 by radiation inactivation, a method which detects only the protein part of the enzyme. For membrane-bound trehalase from kidney and intestine in situ the radiation inactivation method also gave a molecular size of around 49,000. Isoelectric focusing of freshly solubilized membranes allowed us to distinguish between renal and intestinal forms of trehalase in rabbit fetuses on the basis of different isoelectric points. Each trehalase form was also present in the amniotic fluid but in varying proportions depending on the gestational age at which the amniotic fluid was collected. The results suggest that early in gestation amniotic fluid trehalase activity originates exclusively from the fetal kidney but that more and more intestinal enzyme is released into the amniotic cavity as the fetus develops. Similar results were also obtained when ion-exchange chromatography was used to separate the various trehalase forms. The development of trehalase activity in rabbit fetal kidney and intestine correlates well with its occurrence in the amniotic fluid; trehalase activity in the kidney develops early in gestation whereas the intestinal trehalase activity develops just before term. PMID- 3828381 TI - Isolation and partial characterization of biologically active Fc receptor of chicken red cells. AB - It has previously been demonstrated that chicken red cells have a receptor with the capacity to bind aggregated IgG, IgM 7 S or antigen-complex IgG. This receptor was isolated from Nonidet P-40 soluble extracts of chicken red cells by immunoadsorption with either immobilized aggregated IgG or monomeric IgM (IgM 7 S) and further gel filtration through a Sephacryl S-300 column. The Fc binding material was characterized as a glycoprotein with a molecular weight of 30,000 which retained its Fc receptor activity after the isolation procedure. This was demonstrated by its capacity to inhibit the binding of 125I-IgM 7 S or 125I labelled aggregated IgG to chicken red cells. After Bacillus cereus phospholipase C treatment the Fc receptor activity remained unchanged, but the molecular weight (15,000) did not, suggesting that the phospholipids cleaved by this treatment were not essential for the interactions of the receptor with specific ligands. However, this Fc-binding component was shown to have a molecular weight of 13,000 and a diminished Fc receptor activity after reduction with dithiothreitol, suggesting the presence of at least one disulphide bridge, necessary to maintain the total ligand-binding activity. PMID- 3828382 TI - The effect of calcium channel blockers on blood platelet function, especially calcium uptake. AB - The effects of organic and inorganic calcium antagonists on washed platelets from rat and human have been studied. Platelet aggregation was assessed by turbidimetry. Endogenous serotonin release was measured on the same sample by means of electrochemically treated carbon fiber electrodes. The organic calcium antagonist, nitrendipine, and the inorganic calcium channel blockers (Co2+, Mn2+, Cd2+, La3+) drastically inhibited rat and human platelet aggregation induced by thrombin, ADP or adrenaline in the presence of 0.32 mM Ca2+. In our conditions, the thrombin-induced release of endogenous serotonin was found to be external Ca2+-dependent and completely inhibited by 20 microM nitrendipine or 1 mM Cd2+. In addition, Ba2+ or Sr2+ ions can be substituted for Ca2+ to bring about platelet aggregation as well as endogenous serotonin secretion. In Ba2+ or Sr2+ containing media, rat platelet aggregation and/or serotonin secretion can be inhibited by either nitrendipine or Cd2+. Finally, we have also studied the thrombin- and external Ca2+-dependence of radiolabeled calcium uptake by rat platelets. We found that the thrombin-induced 45Ca uptake was inhibited by either 18 microM nitrendipine or 1 mM Cd2+. These results provide strong evidence for the existence of an influx of divalent cations (Ca2+, Sr2+, Ba2+) triggering platelet function. They also suggest, although they do not prove, that the translocation of these cations occurs through an agonist-operated channel as proposed by Hallam and Rink (FEBS Lett. 186 (1986) 175-179). PMID- 3828383 TI - Organothallium(III) reagents for modification of biomacromolecules: irreversible labelling of phosphoglycerate kinase from rabbit muscle. AB - Organothallium(III) reagents, by analogy with organomercurials, have been found to rapidly label phosphoglycerate kinase from rabbit muscle. By use of a radio labelled version of p-methylphenylthallium(III) bis-trifluoroacetate (MPT) the inhibition was shown to be irreversible by the criterion of gel filtration desalting. The rate of labelling was shown to depend on the temperature, enzyme and thallium reagent concentrations, and the presence or absence of the various substrates of the enzyme. The structure and oxidation state of the thallium reagent used affected the extent of modification by the compounds MPT, o carboxyphenylthallium(III) bis-trifluoroacetate, thallic trifluoroacetate and thallous acetate. A number of pieces of evidence implicate cysteine residues in the labelling, including changes in the free thiol titre of the enzyme on thalliation, model studies on the interaction of thiols (e.g. glutathione) with thallium(III) and thallous materials, the lack of inactivation of phosphoglycerate kinase from yeast (which has only one thiol residue distant from the active site), and the partial restoration of enzymic activity by treatment of thalliated enzyme with sulphydryl reducing agents. Substrate protection studies showed that modification of rabbit muscle phosphoglycerate kinase by MPT was fully prevented by 3-phosphoglycerate and partially by MgATP. The latter protected only against the fast phase of thallic modification, the slower phase being unaffected. The presence of MgADP potentiated the labelling by MPT. No evidence of an MgADP-induced conformational change in the enzyme could be obtained from fluorescence or circular dichroic spectroscopies, although changes of the native spectra were noted on thalliation by MPT alone. The cross-linking potential of these arylthallium(III) reagents is discussed along with conformational changes required to trigger the hinge-movement between the N- and C-domains of the protein. PMID- 3828384 TI - Influence of selenium deficiency on glutathione disulfide metabolism in isolated perfused rat heart. AB - Selenium deficiency causes a fall in rat cardiac glutathione peroxidase activity. As a consequence, isolated perfused selenium-deficient heart does not release increased amounts of GSSG when hydroperoxide is infused. However, the total amount of glutathione measured as intracellular GSH, intracellular GSSG and GSSG released from the heart when hydroperoxide is infused does not equal the total glutathione measured in these pools in untreated hearts (Xia, Y., Hill, K.E. and Burk, R.F. (1985) J. Nutr. 115, 733-742). GSSG can react with protein sulfhydryl groups to form glutathione-protein mixed disulfides (PrS-SG). PrS-SG were measured in perfused selenium-deficient and control hearts infused with t butylhydroperoxide and were found to account for the previously unmeasured glutathione. The ability of the selenium-deficient heart to transport GSSG was also examined. GSSG was produced non-enzymatically by infusing diamide. The diamide-treated selenium-deficient heart formed GSSG and released it at the same rate as similarly-treated control heart. Thus although selenium deficiency decreases GSSG formation by glutathione peroxidase, it does not affect cardiac GSSG transport. PMID- 3828385 TI - Binding of human monomeric type I collagen to platelets. AB - Interaction of platelets with subendothelial collagen is important in primary hemostasis and thrombosis. Although activation of platelets by collagen polymers has been widely investigated, only insufficient data are available concerning the binding of genetically distinct collagen types in their triple helical (monomeric) form to platelets. We report on the binding of 125I-labeled human type I collagen to platelets. The binding assay was performed at 20 degrees C in the presence of arginine in order to prevent polymerization of the collagen monomers. The binding of monomeric 125I-labeled human type I collagen is dose- and time-dependent, saturable and specific, since it is competitively inhibited by unlabeled type I collagen, but not by unlabeled human type V collagen. Scatchard analysis reveals a class of specific high affinity binding sites with a Kd of 2.5 X 10(-8) M. These results suggest that platelets interact with type I collagen through specific binding sites, and that there are various different binding sites on the platelet membrane for the genetically distinct collagen types. PMID- 3828386 TI - Effects of novel aggregation inhibitors on serotonin uptake by human blood platelets. AB - Novel aggregation inhibitors blocked serotonin uptake by human blood platelets in concentrations ranging from 0.7 +/- 0.1 microM to 237.5 +/- 35.7 microM; a modified procedure, validated by kinetic analysis, was employed in which pH drift was minimized to 0.03 during the active assay period. Structural features in carbamoylpiperidine and nipecotoylpiperazine derivatives which actually constitute molecular probes, and show remarkable specificity for aggregation inhibitory target sites, disclosed striking differences between the latter and serotonin receptors or other loci affecting serotonin uptake. PMID- 3828387 TI - Effect of dimethyl sulfoxide on transformed rat Schwann cells. AB - Cultured rat Schwann cells transformed by Simian Virus 40 (SV40) have previously been shown to retain their ability to synthesize myelin-associated galactosylceramide and sulfatide. Little is known about the mechanism regulating galactosphingolipid synthesis in Schwann cells. We have found that growing the transformed Schwann cells in the presence of dimethyl sulfoxide (DMSO) markedly inhibits the incorporation of [35S]sulfate into sulfatide, in a time- and dose dependent manner. The concentration of DMSO which resulted in a half-maximal inhibition after 6 days of incubation was 0.5%, and the incubation time required for a half-maximal effect at 1.0% DMSO was approximately 4 days. In contrast, DMSC did not affect the incorporation of [35S]sulfate into glycosaminoglycans. In addition, DMSO treatment has little effect on the synthesis of cellular DNA, proteins and lipids. When transformed Schwann cells were treated with DMSO, a substantial decrease in the incorporation of [3H]galactose into galactosylceramide was observed. The concentration of DMSO which resulted in a half-maximal inhibition of galactosylceramide synthesis was approximately 0.5%, similar to the concentration required for a similar effect on sulfatide synthesis. However, the incubation time required for a half-maximal inhibitory effect on galactosylceramide synthesis at 1.0% DMSO was less than 1 day, which was substantially shorter than the time required for the inhibition of sulfatide synthesis at this concentration. This finding is consistent with the interpretation that treatment with DMSO inhibits the synthesis of galactosylceramide, a precursor of sulfatide, which results in a decrease in the synthesis of sulfatide during a prolonged incubation of DMSO. PMID- 3828388 TI - Catalase in cultured skin fibroblasts from patients with the cerebro-hepato-renal (Zellweger) syndrome: normal maturation in peroxisome-deficient cells. AB - We have compared the properties of catalase in cultured skin fibroblasts from patients with the cerebro-hepato-renal (Zellweger) syndrome, in which peroxisomes are deficient, with those of catalase in fibroblasts from control subjects. The enzymes from the two types of fibroblasts are indistinguishable with respect to kinetic properties, subunit size and molecular mass of the native enzyme. The turnover of the enzyme, measured by following the rate of reappearance of catalase activity in fibroblasts after irreversible inactivation of existing molecules by 3-aminotriazole treatment of the cells, was the same in Zellweger fibroblasts as in control cells. These findings indicate that normal maturation of catalase can occur in the soluble cytoplasm and provide an explanation for the occurrence of extra-peroxisomal catalase in tissues and cells. PMID- 3828389 TI - Metabolic pathways for androstanediol formation in immature rat testis microsomes. AB - Metabolic routes from progesterone to androstanediol in washed rat testicular microsomes were investigated, with special emphasis on the importance of 4-ene-3 oxosteroids, as well as the effect of a minimal effective dose of human chorionic gonadotropin on these transformations. Incubation of equimolar concentrations of a mixture of [14C]progesterone and 17 alpha-hydroxy[3H]progesterone resulted in a large preference of 17 alpha-hydroxyprogesterone over progesterone as substrate for androstanediol formation. Incubation of [3H]progesterone together with [14C]androstenedione resulted in the inhibition of C-17,20-lyase and in a low 14C/3H ratio in androstanediol, indicating the preference of progesterone over androstenedione as substrate for androstanediol production. When a mixture of 17 alpha-hydroxy[3H]progesterone and [14C]androstenedione was incubated with the microsomes, a more than 8-fold preference of 17 alpha-hydroxyprogesterone as substrate for androstanediol production was found. The minimal dose of human chorionic gonadotropin stimulated testosterone production but inhibited androstanediol formation and effected, in some instances, a change in the metabolic routes. It is concluded that androstanediol is produced preferentially through 17-hydroxylated C-21 steroids, and also, to a lesser extent, through C-19 steroids. PMID- 3828390 TI - The influence of ozone on human red blood cells. Comparison with other mechanisms of oxidative stress. AB - Exposure of red blood cells to ozone resulted in K+ leakage, lipid peroxidation and inhibition of some membrane-associated enzymes. On the other hand, carrier mediated transport of glucose, leucine, sulfate and glycerol and the nonspecific permeation of glycerol, L-glucose and erythritol were not affected by ozone. The cellular level of reduced glutathione declined, whereas the ATP content of the cells was quite insensitive to ozone exposure. It was shown that, most probably, lipid peroxidation and K+ leakage are not causally related. Further, K+ leakage did not reflect gradual, progressive loss of K+ from all cells simultaneously, but occurred in an all-or-none fashion. Finally, ozone-induced damage was compared to damage induced by H2O2, t-butyl hydroperoxide and photosensitizers plus light. It appeared that the pathways leading to membrane deterioration are quite dissimilar in these various forms of oxidative stress. PMID- 3828391 TI - Transformation of glucocorticoid-receptor complex oligomers to DNA-binding forms in the absence of monomerization. AB - The contention that transformation of steroid-receptor complexes is represented by dissociation of receptor oligomers was tested by comparing sedimentation and DNA binding properties of glucocorticoid-receptor complexes from HeLa cell cytosol under several conditions. Transformation of glucocorticoid-receptor complexes could be induced by heat, and/or salt treatment of cytosolic extracts, but not by dilution. Heat-induced transformation of receptor complexes was also confirmed by DEAE-cellulose chromatography. Analysis of cytosolic extracts showed that sedimentation and DNA binding properties of glucocorticoid-receptor complexes did not correlate. Both oligomeric and monomeric receptor complexes, in fact, were found to be either transformed, or untransformed, depending on the treatments cytosolic extracts underwent, before being subjected to analysis. We then concluded that release of glucocorticoid receptor monomers cannot account for their transformation to a DNA-binding form in vitro, and suggested that exposure of positive charges on the surface of receptors in the course of transformation occurs in some region of the glucocorticoid receptor which is not involved in interactions between the proteinaceous components of oligomers. PMID- 3828392 TI - 2-Hydroxypyridine-N-oxides: effective new chelators in iron mobilisation. AB - The 2-hydroxypyridine-N-oxide derivatives, 2-hydroxypyridine-N-oxide, 2,4 dihydroxypyridine-N-oxide, 2-hydroxy-4-methoxypyridine-N-oxide and 2-hydroxy-4 (2'-methoxyethoxy)pyridine-N-oxide have been shown to remove iron from human transferrin and horse spleen ferritin at pH 7.4 at levels higher than those caused by desferrioxamine. Their reactions with transferrin were mainly biphasic and took 2-5 h to reach completion but iron mobilisation from ferritin was slower and their reactions continued after 40 h of incubation. The intraperitoneal and intragastric administration of 2,4-dihydroxypyridine-N-oxide to two iron-loaded 59Fe-labelled mice caused an increase in 59Fe excretion which is comparable to that caused by desferrioxamine intraperitoneally. These results increase the prospects for the use of these chelators as probes for studying iron metabolism and in the treatment of iron overload and other diseases of iron imbalance. PMID- 3828393 TI - Crystal structures of 1 : 1 complexes of meclofenamic acid with choline and ethanolamine. AB - The hydrated 1:1 complex of meclofenamic acid with choline crystallizes in the orthorhombic space group Pna2(1) with a = 9.637(1), b = 12.962(5), c = 33.099(4) A and Z = 8. Crystals of the corresponding anhydrous complex with ethanolamine are triclinic, space group P1, with a = 9.232(3), b = 12.287(5), c = 17.033(3) A, alpha = 70.21(2), beta = 76.72(2), gamma = 68.21(3) degrees and Z = 4. The structures have been solved by direct methods and refined to R values of 0.062 and 0.079, respectively for 1942 and 2852 observed reflections. The four crystallographically independent meclofenamate anions in the complexes have nearly the same molecular geometry which in turn is very similar to that found in the crystal structure of free meclofenamic acid. The choline and ethanolamine molecules assume a gauche conformation with respect to the central C-C bond. The invariant structural features observed in the crystals of the free fenamates are retained by the meclofenamate ions in the complexes. These features are the rigid coplanar geometry of the six-membered ring carrying the carboxyl group, the carboxyl group and the imino nitrogen atom, and the internal hydrogen bond connecting the imino and the carboxyl groups. The crystal structures are stabilised by ionic interactions between the carboxylate groups of meclofenamate ions and choline or ethanolamine cations, and hydrogen bonds. The choline complex exhibits pseudosymmetry and the distribution of molecules in it is nearly centrosymmetric although the space group is noncentrosymmetric. The packing of molecules in the crystals is such that the polar columns are surrounded by non polar regions. The core of each column in the choline complex is made up of water molecules connected by hydrogen bonds involving disordered protons. The results of the X-ray structure analysis of fenamates and their crystalline complexes provide some insights into structure-function relationships in this family of drugs. PMID- 3828394 TI - Effects of hypothyroidism on the distribution and fatty acyl composition of phospholipids in sarcoplasmic reticulum of fast skeletal muscle of the rat. AB - The distribution of phospholipids and fatty acyl composition of individual phospholipids in sarcoplasmic reticulum from fast skeletal muscle of hypothyroid and euthyroid (control) rats have been determined. Hypothyroidism resulted in a 24% decrease in the phosphatidylethanolamine (PE) content and a concomitant increase in the phosphatidylcholine (PC) content of the sarcoplasmic reticulum. The amounts of other phospholipids and cholesterol remained unaffected. Fatty acyl compositions of PE and PC were quantitatively different, but hypothyroidism affected these compositions similarly. Changes included an increase in the proportions of docosahexaenoic (22:6(n - 3)), arachidonic (20:4(n - 6)), icosatrienoic (20:3(n - 6)) and stearic (18:0) acids and a decrease in those of linoleic (18:2(n - 6)), palmitic (16:0) and oleic (18:1(n - 9)) acids. The effects of hypothyroidism on the phospholipid distribution could be reversed by treatment of hypothyroid animals with thyroid hormone for a period of 14 days (10 micrograms T3/100 g body weight per 2 days). The fatty acyl composition of the phospholipids was also restored to the euthyroid values by this treatment. Exceptions were 18:2 and 22:6 in PE, in which case reversal was significant but not complete, and 18:2, 20:4 and 22:6 in PC. The levels of these acids in PC were not reversed to the euthyroid values after the 14-day treatment, but rather the opposite occurred. PMID- 3828395 TI - Quantitation and characterization of human platelet glycoprotein IIIa by radioimmunoassay. AB - Glycoprotein IIIa was quantitated in human platelets by radioimmunoassay using antisera specific to platelet membranes and purified glycoprotein IIIa. Glycoprotein IIIa and glycoprotein IIb were isolated from washed platelets by Triton X-114 extraction followed by preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis. Radioiodinated glycoprotein IIIa was further purified by affinity chromatography on Lentil lectin-Sepharose 4B. Purified glycoprotein IIb showed little crossreactivity with 125I-labeled glycoprotein IIIa using the anti-platelet membrane or anti-glycoprotein IIIa antisera on a competition inhibition radioimmunoassay. The expression of glycoprotein IIIa epitopes were the same for the purified glycoprotein IIIa and glycoprotein IIIa in Triton X-100 solubilized platelets. A 66 kDa protein derived from glycoprotein IIIa by limited proteolysis of platelet membranes also expressed the same epitopes as intact glycoprotein IIIa. Solubilized platelets contained approximately 16 micrograms of total glycoprotein IIIa antigen per 10(9) cells. The level of glycoprotein IIIa determined by radioimmunoassay in one patient with Glanzmann's thrombasthenia amounted to 6.7% of normal and it was close to the values obtained by other methods. PMID- 3828396 TI - Polymeric inhibitors of platelet aggregation. II. Copolymers of dipyridamole and related drugs with N-vinylpyrrolidone. AB - A study has been made of the behaviour of the drugs dipyridamole and mopidamol (RA 233) attached to poly(N-vinylpyrrolidone). The inhibitory activities towards platelet aggregation induced by ADP or platelet activation factor (PAF) in sheep plasma have been examined and found to exceed the activities of the parent drugs, by factors up to 20. At the same time the abilities of the polymer-bound drugs in potentiating prostaglandin-type anti-aggregatory activities are much lower than those of the unattached drugs. The observations are explained in terms of polymer adsorption on to the platelet membranes, producing a high surface concentration of the drugs with consequent high inhibitory action. Intracellular action, such as the inhibition of phosphodiesterase, is reduced by the difficulty experienced by the polymeric drug in passing through the membrane, so that potentiation of prostaglandin activity, particularly against PAF, becomes small. A terpolymer containing units of dipyridamole and the prostaglandin analogue 5-(6 carboxyhexyl)-1-(3-cyclohexyl-3-hydroxypropyl)hydantoin (245C) shows a degree of 'self-potentiation'. PMID- 3828397 TI - Relative importance of physiological precursors for ketogenesis in the nutritional homeostasis of the development of the embryonic chick. AB - This paper investigates the relative importances of specific amino acids, and, in particular, branched chain amino acids and their keto derivatives as possible ketogenic precursors in suspensions of liver cells isolated from chick embryos. Addition of the branched chain keto acids stimulated ketogenesis. The order of potency was alpha-ketoisocaproic acid greater than alpha-ketoisovaleric acid greater than DL-alpha-keto-beta-methyl-n-valeric acid. The relative order of effectiveness for branched chain keto acids was maintained at all comparable concentrations, and in each case maximum rates were observed with concentrations of 1-2 mM. In contrast to the stimulation of ketogenesis by their keto derivatives, branched chain amino acids were ineffective as precursors for ketogenesis. Of the other amino acids (utilised at concentrations present in chick embryo plasma) only Tyr, Lys, Phe and Arg produced significant increases in ketone body formation above the endogenous rate. At these physiological concentrations, the effectiveness of the amino acids were in the order of Tyr greater than Lys = Phe greater than Arg. The interactions between three groups of ketogenic precursor (fatty acids, amino acids and keto amino acids, all at physiological concentrations), produced rates of ketogenesis that were purely additive. These results indicate that high concentrations of hydroxybutyrate and acetoacetate found in plasma of developing chick embryos may arise from hepatic metabolism of several distinct precursors. The relative importance of each category of precursor may vary with the precise developmental status of animals. PMID- 3828398 TI - Calcium ionophoretic activity of chemically synthesized oligomeric derivatives of prostaglandin B1. AB - Chemically synthesized dimers, trimers and tetramers of 15-dehydroprostaglandin B1 and 16,16'-dimethyl-15-dehydroprostaglandin B1 facilitate the release of Ca2+ from isolated rat liver mitochondria. The parent monomeric prostaglandins had no significant activity. The rate of release was stimulated by exogenous K+ or Na+, suggesting an antiport exchange of monovalent cations for intra-mitochondrial Ca2+. The activity depended upon the presence of ruthenium red, which prevented recycling of Ca2+; comparison of the activity with A23187 and carbonyl cyanide p trifluoromethoxyphenylhydrazone indicated that the prostaglandin B1 oligomers were functioning as ionophores and the release of Ca2+ was not caused by an uncoupling of oxidative phosphorylation. The oligomers caused a major decrease in the membrane potential but only when the mitochondria were preloaded with exogenous Ca2+, and even then, the Ca2+ efflux was completed before the membrane potential decreased to less than 90 mV. The oligomeric molecules were able to form supramolecular aggregates in the presence of Ca2+ as detected by light scattering. They extracted Ca2+ into an organic phase, and translocated Ca2+ from one aqueous domain to another across an organic barrier; K+ and Na+ modulated these processes. The prostaglandin B1 derivatives also translocated Rb+ from one aqueous phase to another across an organic barrier when Ca2+ was translocated. PMID- 3828399 TI - Membrane methylation in isolated rat testis interstitial cells unmasks functional luteinizing hormone receptors. AB - Treatment of intact isolated rat testis interstitial cells with S adenosylmethionine as methyl donor, increases substantially the number of LH human CG receptors (100-200%) without modifying the equilibrium dissociation constant. The increase in binding capacity was associated with an augmentation in the sensitivity of the rat testis interstitial cells to produce testosterone in response to LH, suggesting a functional role of the unmasked receptors. The amount of S-adenosylmethionine necessary to obtain an increase in LH binding capacity and preserve cell viability was 25-50 micrograms/ml per 1.6 X 10(7) cells. 10 mM MgCl2 in addition to the Mg2+ present in the medium was necessary to maintain cell viability. 3H-labelled methyl groups were incorporated mainly into the lipid fraction (208 fmol/10(6) cells) when 3H-S-adenosylmethionine was incubated with the cells for 2 h at 30 degrees C. Our results are consistent with the conclusion that early action of LH may involve an activation of methyltransferase activity, phospholipid methylation, an increase in LH binding capacity and an increase in receptor function. PMID- 3828400 TI - Cell attachment and chemotaxis can utilize the same peptide sequence of fibronectin. AB - Fibronectin and fragments of the parent molecule are involved in cell-substrate attachment, cell migration and chemotaxis. The cell attachment sequence, Gly-Arg Gly-Asp-Ser-Pro, was synthesized and tested for its ability to effect ligamentum nuchae fibroblast chemotaxis. This hexapeptide and fibronectin itself both caused directed cell migration, with maximal activity in the 10(-10) to 10(-9) M range. These data demonstrate that the fibronectin cell binding site and chemotaxis site share a common sequence. PMID- 3828401 TI - 31P-NMR saturation transfer measurements of exchange between Pi and ATP in the reactions catalysed by glyceraldehyde-3-phosphate dehydrogenase and phosphoglycerate kinase in vitro. AB - Recent 31P-NMR saturation transfer measurements of flux between Pi and ATP in the perfused rat heart (Kingsley-Hickman, P., Sako, E.Y., Andreone, P.A., St. Cyr, J.A., Michurski, S., Foker, J.E., From, A.H.L., Petein, M. and Ugurbil, K. (1986) FEBS Lett. 198, 159-163) have given a P/O ratio (mols ATP synthesised/atoms oxygen consumed) which was close to 6. This anomalously high value was attributed to exchange in the reaction catalysed by the mitochondrial F1F0-ATP synthase. We show here that this exchange could also be catalysed by the glycolytic enzymes glyceraldehyde-3-phosphate dehydrogenase and phosphoglycerate kinase. 31P-NMR saturation transfer measurements of the exchange catalysed by these enzymes in vitro, under conditions designed to mimic those present in the perfused rat heart, have shown that they could catalyse a quantitatively significant Pi-ATP exchange in vivo. A three-site exchange model is used to investigate the effects of Pi-ATP exchange on saturation transfer measurements of the reverse flux in the creatine kinase reaction. A discrepancy in the measured and forward and reverse fluxes in this reaction has been attributed previously to the participation of the gamma-phosphate of ATP in other exchange reactions. PMID- 3828402 TI - Darwinian evolution in games with perfect information. AB - We consider a model of Darwinian evolution in games with perfect information like chess or checkers. The evolution is viewed as a sequence of strategies, each of which wins over its immediate predecessor. We argue that the intelligence level of strategies need not necessarily increase during this type of evolution. PMID- 3828403 TI - Local structure analyzers as determinants of preattentive pattern discrimination. AB - Contemporary literature suggests that preattentive texture or pattern discrimination is induced by differences between local structure features or "textons." This paper presents a model for the description of such local structure features based on the computation of local autocorrelations within the image. By means of this structure model a measure of structure dissimilarity is introduced. Experiments have been carried out to test a hypothesized relation between the detectability of a target pattern in a field of background patterns and the value of the structure dissimilarity measure. The experimental results show that it seems justified to relate, in a quantitative way, the detectability of the target pattern to the value of the structure dissimilarity measure. PMID- 3828404 TI - Statistical inference on spontaneous neuronal discharge patterns. I. Single neuron. AB - A statistical analysis was performed on extracellularly recorded spike trains of spontaneously active mesencephalic reticular neurons of rats. Only stationary records were used for detailed examination. The moments of interspike intervals were computed, hypothesis of renewal process and its specific forms was tested. Implications for statistical methodology are considered on the basis of the results. The main emphasis is laid on the connection between experimental results and stochastic neuronal models. PMID- 3828406 TI - [Pharmacological correction of the acute effects of microwave irradiation in an experiment]. AB - Possible ways of correction of acute effects developing in organism under the intensive microwave radiation (AMWE) are considered. The literature review demonstrates that the pharmacological preparations which cause stimulation of the supreme sections of the central nervous system (CNS) and breathing (analeptics, psychostimulants), an elevation of the vascular tone (adrenomimetics), an increase of the heart working capacity (cardiac glycosides) and an increase of energetic metabolism level (some hormones and vitamins) are suitable for the AMWE correction. For the AMWE prevention before radiation the drugs reducing excitability of CNS (sleeping draughts) oppressing the interoceptive reflexes (neuroplegic drugs) and antihypoxiac drugs can be used. PMID- 3828405 TI - A self-organizing neural network sharing features of the mammalian visual system. AB - This paper describes a neural network model whose structure is designed to closely fit neuroanatomical and -physiological data, and not to be most suitable for rigorous mathematical analysis. It is shown by computer simulation that a process of self-organization that departs from a fixed retinotopic order at peripheral layers and includes Hebbian modifications of synaptic connectivity at higher processing levels leads to a system that is capable of mimicking various functions of visual systems: In the initial state the overall structure of the network is preset, individual connections at higher levels are randomly selected and their strength is initialized with random numbers. For this model the outcome of the self-organization process is determined by the stimulation during the developmental phase. Depending on the type of stimuli used the model can either develop towards a feature-selective "preprocessor" stage in a complex vision system or towards a subsystem for associative recall of abstract patterns. This flexibility supports the hypothesis that the principles embodied are rather universal and can account for the development of various nervous system structures. PMID- 3828408 TI - [Gestural forms of communication in primates. I. Development of gestural forms of communication in ontogenesis and phylogenesis]. AB - The gestural and tactile forms of communication using arms among the young and adult specimen of lower monkeys of subfamily Cercopithecoidea and higher monkeys of subfamily Hominioidea have been investigated. It has been concluded that gestures are the new form of phylogenesis in comparison with the contact patterns, their development is generally connected with the aggressive behaviour. The growing differentiation of gestures connected with the transition from participation of the whole arm to the leading role of the hand and finger gestures has been determined. The frequency of gestures is closely connected with the species structural organization and ecology. PMID- 3828407 TI - [Effect of corticosteroids on the fluorescence of aniline naphthalenesulfonate in mitochondria after changes in temperature]. AB - The influence of corticosteroid hormones and cholesterol on the anilinonaphthalenesulfonate (ANS-) fluorescence in the rat liver mitochondria at different temperatures has been studied. The fluorescence intensity has been found to decrease by warming and increase by cooling the mitochondrial suspension. The steroids studied in proportion to their hydrophobic nature decreased the ANS- fluorescence at 25 degrees C and increased it at 5 degrees C, i.e. at higher and lower temperatures of the phase transition of the membrane lipids. It has been concluded that steroid hormones influence the fluidity of the mitochondrial membranes. PMID- 3828409 TI - [Effect of cobalamin derivatives on DNA synthesis in cells of Propionibacterium freudenreichii subsp. shermanii]. AB - The increase of DNA-synthesis rate (according incorporation [8-14C]adenine) in B12-deficient cells Propionibacterium shermanii as a result of different cobalamines adding into the cell suspension including metoxyethyladenile analog of adenozilcobalamin and some components of vitamin B12 molecule has been found. The DNA-synthesis rate in B12-deficient cells is nearly twice lower as compared with one in B12-normal cells. Considerable stimulative effect (80-100%) was provided with coenzyme forms of cobalamin. The data confirm the participation of vitamin B12 in DNA-synthesis in Propionibacterium cells. PMID- 3828410 TI - [Age-related changes in human body proportions studied by the method of principal components]. AB - The method for analysis of the ontogenetic changes of size and shape based on the decomposition of Kullback divergence into parts corresponding to the principal components, found for intragroup variability of signs is suggested. The application of this method is illustrated by the analysis of age changes of body proportions for boys 3-17 years old. Before the pubertal period the stable tendency to a relative lengthening of extremities which changes to a contrast one at age of 12-14 has been pointed out. The definitive differences of proportions to a considerable extent is determined by variability of biological age at the group of children. PMID- 3828411 TI - [Activation of serotonin release in a perfused in situ segment of the rat jejunum]. AB - The speed of the serotonin release into the opening of the perfused part of the small intestine of anesthetized rats increases considerably at adding into the solution of saccharose and protein hydrolyzates and also at increasing of medium acidity (pH 6,0). The block of vegetative ganglions and peripheral cholinoreactive structures reduces essentially speed of amine release. PMID- 3828412 TI - [The thyroid gland in emotional and pain stress]. AB - The reaction of wild rodent thyroid gland on emotional and painful stress appearing as a result of animal's catching has been studied. The thyroid activity has been shown to raise considerably during the primary stage of stress reaction. Later on the function of the gland normalizes in animals without trauma and in traumatized animals it becomes weaker. The complete normalization of the thyroid function in traumatized animals coincides with osteal regeneration according to time. PMID- 3828413 TI - Wavelength dependence of the geometric and structural photoisomerization of bilirubin bound to human serum albumin. AB - The two quantitatively important photoisomers in bilirubin metabolism during phototherapy are (ZE)-bilirubin and (EZ)-cyclobilirubin. We describe in vitro studies on the wavelength dependence for the geometric (delta 4Z, delta 15Z--- delta 4Z, delta 15E) and structural (endovinyl cyclization) photoisomerization of bilirubin bound to human serum albumin by a high performance liquid chromatography method. For the geometric photoisomerization from (ZZ)-bilirubin to (ZE)-bilirubin, the most effective wavelength in vitro was 410 nm. For the structural photoisomerization, green light at 510 nm is the most efficient for causing cyclization of (ZZ)-bilirubin to (EZ)-cyclobilirubin via (EZ)-bilirubin and this may depend on a larger cross-section of (EZ)-bilirubin than (ZZ) bilirubin in this spectral region and/or on a larger quantum yield for cyclization than geometric photoisomerization. PMID- 3828414 TI - Metabolic quotients and oxygen extraction across the uterus of the post-term pregnant rabbit under chronic steady-state conditions. AB - The extraction of oxygen by the uterus in the term rabbit has been found to be very high. During post-term pregnancy, the fetuses of the rabbit are approximately 40% larger, despite a reduction in placental weight of approximately 30%. The purpose of our study was to investigate the changes that occur in the maternal rabbit to allow survival of the fetus under these conditions. Post-term pregnancies were induced in 5 white New Zealand rabbits by injections of chorionic gonadotropin and progesterone on the 26th day of gestation. Catheters were placed surgically on day 28, and blood samples were taken daily from the femoral artery and uterine veins starting at day 31. Each sample was analyzed for pH, PCO2, PO2, oxygen capacity and saturation, glucose, beta-hydroxybutyrate, lactate and acetoacetate. Coefficients of extraction were calculated for oxygen and metabolic quotients were calculated for each substrate. These data are compared with those obtained for the term rabbit in previous studies. There was a significant increase in the coefficient of oxygen extraction in the post-term animals; however, the metabolic quotients across the uterus were not significantly different between the term and the post-term rabbit. PMID- 3828415 TI - Contribution of hepatic fatty acid oxidation and exogenous galactose supply to the regulation of glucose homeostasis in the newborn rabbit. AB - The inhibition of hepatic gluconeogenesis by 3-mercaptopicolinic acid (3-MPA) leads to a profound hypoglycemia in both suckling and fasting 24-hour-old rabbits. This hypoglycemia is totally reversed 1 h after the intragastric injection of an amount of galactose corresponding to the one ingested daily by the suckling newborns. This results from an active gluconeogenesis from galactose, which bypasses the site of inhibition by 3-MPA. However, this amount of galactose is not sufficient to maintain a normal blood glucose concentration for a long time, since 3 h after galactose injection, the blood glucose concentrations of newborn rabbits return to hypoglycemic values. When hepatic fatty acid oxidation is inhibited by 2-[6-(4-chlorophenoxy)hexyl]oxirane-2 carboxylate (POCA), 24-hour-old fasting rabbits become rapidly hypoglycemic secondary to a decrease in liver gluconeogenesis. The rate of hepatic gluconeogenesis is totally restored by giving medium-chain triglycerides, and the 24-hour-old rabbits become normoglycemic. PMID- 3828416 TI - Tin protoporphyrin inhibits carbon monoxide production in suckling mice. AB - The carbon monoxide excretion rate (VeCO) of groups of 1-day-old mice was measured after administration of two separate doses of 50 nmol of tin protoporphyrin (TP) per gram of body weight. The mean VeCO of the saline-treated control groups over the study period was 1.50 +/- 0.26 nmol/g/h, and that of the TP-treated groups was 1.35 +/- 0.29 nmol/g/h. Tin protoporphyrin treatment reduced the CO excretion by approximately 14% in 2-day-old mice over 24-48 h. PMID- 3828417 TI - Characterization of lipoprotein lipase activity in the newborn rat liver. AB - Acetone ether powders of livers from starved newborn rats were applied to heparin Sepharose affinity columns. The so-called hepatic triacylglycerol lipase was eluted with 0.9 M NaCl and a second lipolytic activity peak was eluted with 1.5 M NaCl. The behaviour of this 1.5 M NaCl-eluted fraction against increasing concentrations of serum, NaCl, protamine sulfate and heparin in the assay mixture was almost identical to that shown by partially purified lipoprotein lipase from adult rat adipose tissue, and clearly different from that shown by partially purified hepatic triacylglycerol lipase from the adult rat liver. We conclude that the newborn rat liver contains a lipoprotein lipase activity with similar properties to those found in adult adipose tissue lipoprotein lipase activity. It is suggested that this enzyme enables the neonatal liver to take up circulating triacylglycerols directly. PMID- 3828418 TI - Effect of metoclopramide therapy on arginine vasopressin excretion and renal water handling in premature infants. AB - The role of endogenous dopamine (DA) in regulating arginine vasopressin (AVP) release and renal water excretion was studied in 10 premature infants with a mean birth weight of 1,341 g (range 1,150-1,660 g) and a mean gestational age of 30.2 weeks (28-33 weeks), who were given metoclopramide (MTC), a specific DA antagonist. It was demonstrated that in response to MTC urine flow rate increased significantly from a basal value of 0.90 +/- 0.07 to 1.27 +/- 0.09 ml/min/1.73 m2 (mean +/- SE; p less than 0.01), urinary sodium excretion from 6.10 +/- 1.47 to 11.7 +/- 2.24 microEq/min/1.73 m2 (p less than 0.025) and osmolar clearance from 0.38 +/- 0.044 to 0.600 +/- 0.075 ml/min/1.73 m2 (p less than 0.01). MTC administration did not cause any alterations in free water clearance, whereas urinary AVP excretion fell significantly from 49.38 +/- 10.13 to 32.66 +/- 6.53 ng/min/1.73 m2 (p less than 0.05) after MTC. It is concluded that, contrary to adults, in low birth weight premature infants endogenous DA is enhancing rather than inhibiting AVP release and the MTC-induced water diuresis is independent of the fall of AVP since free water clearance remained unaltered after MTC. PMID- 3828419 TI - Breast-milk-enhanced intestinal and somatic growth in neonatal rats. AB - Ten rat pups fed pooled rat milk and 9 pups fed artificial formula had significantly heavier stomachs and intestines that contained more DNA and RNA by 40 h of age than 12 pups sacrificed at birth. Breast-milk-fed animals had significantly heavier intestines, livers and kidneys than animals fed artificial formula. The intestines of pups fed breast milk contained more DNA and RNA with a lower RNA:DNA ratio than the intestines of pups fed artificial formula. Hence, when caloric intake and mode of feeding are controlled, natural milk enhances neonatal intestinal growth more than artificial formula. PMID- 3828420 TI - Autonomic reactions to social and neutral stimuli in subjects high and low in public speaking fear. AB - People with specific animal phobias react with increased autonomic activity when exposed to fear-relevant stimuli. The present study examined whether individuals having a less circumscribed fear (public speaking fear) also react with increased autonomic responses when exposed to fear-relevant i.e. social stimuli. A High fear and a Low-fear group, as indicated by the PRCS questionnaire, were exposed to pictures of faces (social stimuli) and mushrooms (neutral stimuli) while heart rate (HR) and skin conductance responses (SCRs) were measured. It was found that: Social stimuli evoked larger SCRs as compared to neutral stimuli only in the High fear group; SCR magnitude to social stimuli was positively correlated with self reported fear in the High-fear group; the High-fear group showed larger overall SCRs compared with the Low-fear group; the High-fear group showed slower SCR habituation to social stimuli as compared to the Low-fear group; the High-fear group displayed more nonspecific electrodermal fluctuations than did the Low-fear group. Both the High-fear and the Low-fear group displayed HR deceleration to social but not to neutral stimuli. Thus, subjects high in public speaking fear reacted with increased skin conductance activity when exposed to social stimuli compared to low-fear subjects. The two groups did not differ in heart rate responses. These results are discussed in terms of orienting, defense and species specific response patterns. PMID- 3828421 TI - The need to respond and cardiac cycle effects: an alternative hypothesis. AB - Lacey and Lacey have proposed that stimulation by sensorimotor events produces a discrete burst of vagal activity which alters the length of the cardiac cycle in which such an event falls, and the length of the subsequent cycle, according to the point in the cycle in which the stimulus occurs. To test this hypothesis an experiment was conducted with 24 subjects in which they received three types of trials. These were signalled reaction time tests with a 5-s foreperiod, signalled reaction time tests during which subjects were instructed to sit still and stop breathing, and 5-s periods of immobility. Lacey and Lacey's results were only partially replicated in that no cardiac effect for the beat concurrent with the imperative stimulus was observed, but an effect similar to the one which they describe was found for the beat subsequent to the imperative stimulus. Cycle effects not predicted by the Laceys' hypothesis were found during the beat in which the cycle occurred and the subsequent beat. An alternative explanation of these phenomena is proposed which fits both their data and those of this study. Rather than being a consequence of a burst of vagal activity produced by the stimulus as they suggest, such cycle effects may reflect an underlying monotonic change in the heart rate. PMID- 3828422 TI - Pace variation and control of work pace as related to cardiovascular, neuroendocrine, and subjective responses. AB - Two studies of paced and self-paced arithmetic performance are reported. Heart rate and blood pressure were recorded and ratings of subjective arousal obtained. In one of the studies, plasma levels of catecholamines and cortisol were determined. Under externally paced experimental conditions pace variation was found to be quantitatively related to changes in systolic and diastolic blood pressure, as well as to ratings of stress and irritation. This was not the case for heart rate or positively evaluated aspects of subjective arousal. Performance was better and ratings of stress and irritation were lower during self-paced than during paced work at a comparable work pace. In one of the studies the diastolic blood pressure increased less when subjects controlled the pace. Plasma catecholamines did not increase significantly during either externally or self paced work, but adrenaline tended to increase during paced work. Our findings give partial support to the suggestion that personal control may attenuate sympathoadrenal activation and cardiovascular reactivity. PMID- 3828423 TI - The neural basis of visual selective attention: a commentary on Harter and Aine. AB - Harter and Aine (1984) have proposed a 'neural specificity' model of visual selective attention, based primarily on evidence from recordings of event-related brain potentials (ERPs) in human subjects. In this framework, they consider ERP components elicited during visual-spatial attention to reflect selective neural processing in the tectopulvinar-partietal pathway, whereas selection of visual attributes such as pattern, color, and orientation is manifested by ERPs arising from the geniculostriate-inferotemporal projection system. The present article examines the empirical basis for anatomically-specific hypotheses and considers alternative explanations for the observed ERP changes during selective attention. PMID- 3828424 TI - The neural-specificity theory of visual selective attention evaluated: a commentary on Harter and Aine. AB - This paper evaluates Harter and Aine's (1984) 'neural-specificity theory' of visual attention which is based on a series of studies conducted by Harter and his colleagues on selective-attention effects on visual event-related potentials. Attended stimuli evoke slow 'selection negativities' interpreted by Harter and Aine as indicating selective pre-stimulus facilitation of the feature-detector systems. This interpretation, which is central to their theory, is challenged in the present paper on several grounds. It is concluded that Harter's selection negativities can be taken to support other theories that Harter and Aine have criticized, in particular the 'attentional-trace theory' of selective attention proposed by Naatanen (1982). On the other hand, there are some other data, obtained by several other groups, which support Harter and Aine's theory but those data, involving visual spatial attention, are not consistent with the respective data of Harter and his colleagues. PMID- 3828425 TI - Discussion of neural-specificity model of selective attention: a response to Hillyard and Mangun and to Naatanen. AB - Hillyard and Mangun (this issue) and Naatanen (this issue) have made a number of reflective, important observations in regard to the model we described in our earlier paper (Harter & Aine, 1984). The attention they have given to our paper and model is greatly appreciated and has helped us more clearly conceptualize some of the assertions and observations set forth in our original paper. The scholarly contributions of Hillyard, Naatanen, and their colleagues during the last 20 years, along with those by others related to the neurophysiology and neuroanatomy of the visual system, have led us to propose the somewhat different perspective represented by the neural specificity model of selective attention. Hillyard's and Mangun's and then Naatanen comments will be abstracted and discussed in order. PMID- 3828427 TI - Pulsatile release of immunoreactive luteinizing hormone (irLH) in hypophysectomized male rats. AB - The concentration of plasma luteinizing hormone (LH) was monitored every minute by radioimmunoassay in male rats that were either hypophysectomized, or castrated and hypophysectomized. Castrated rats showed a pulsatile fluctuation of plasma immunoreactive LH (irLH) concentration with an elevated basal level, confirming previous work. The hypophysectomized and castrated hypophysectomized rats also showed pulsatile changes in plasma irLH concentration. This unexpected result indicates that ectopic irLH is not only actively released after hypophysectomy, but is released in pulses. The pulse interval was approximately 20 minutes for all 3 groups. The slope of the rate of decline of plasma irLH in the castrated rats is parallel to a theoretical disappearance rate of 5 min, while these slopes in the hypophysectomized and castrated hypophysectomized rats correspond to a 1 to 2-min disappearance rate. The difference in these slopes implies that the two irLH molecules may not be identical. PMID- 3828426 TI - Effective oral administration of 17 beta-estradiol to female C57BL/6J mice through the drinking water. AB - 17 beta-Estradiol (E2) was dissolved in the drinking water of female C57BL/6J mice and presented ad libitum. The oral administration of E2 produced expected responses in E2-sensitive target tissues. Vaginal smear cytology changed from the thin leukocytic smears characteristic of ovariectomized controls to thicker smears containing only cornified epithelial cells. Uterine weight and the specific activities of uterine glucose-6-phosphate dehydrogenase and alkaline phosphatase were elevated, while the postovariectomy elevation in serum luteinizing hormone (LH) was suppressed. However, oral E2 did not influence the specific activity of uterine acid phosphatase. During oral administration of E2 through the drinking water, serum estrone and E2 were elevated during the night and returned to low baseline levels during the day, in parallel with the circadian patterns of drinking. Similar transient elevations of serum E2 levels were observed after subcutaneous injections of E2. The oral administration of E2 has advantages over the widely utilized parenteral routes of E2 administration (i.e., injection or surgical implantation of E2-containing capsules), particularly for long-term experiments, and may be more analogous to the usual oral route of estrogen administration in women as contraceptives or as postmenopausal estrogen-replacement therapy. PMID- 3828428 TI - The relation of ovarian steroid levels in young female rats to subsequent estrous cyclicity and reproductive function during aging. AB - In multiparous rats, the incidence of regular estrous cyclicity and fertility decreases markedly at middle age. However, recent studies have shown that repeated pregnancies or progesterone (P) implants can subsequently cause retired breeder females to maintain regular cyclicity for an extended period of time; these results suggest a P-mediated deceleration of reproductive aging. In the present study, we examined the relation of ovarian steroid levels in young virgin females to their subsequent estrous cyclicity and reproductive function during aging as compared to multiparous females. Beginning at 4 mo of age and continuing to 6 mo of age, regularly cyclic virgin rats received either consecutive P implants (n = 41) or no implants (controls, n = 45) for 3 wk, followed by implant removal for 1 wk. Additional females (n = 72) were mated and allowed to undergo repeated pregnancies at 4, 6 1/2, and 8 mo of age. Blood samples were obtained throughout the estrous cycle (virgin females), during pregnancy (multiparous rats), and on Day 11 of successive treatments with P implants (virgins with P implants) for P, estradiol (E2), and testosterone (T) measurements. Subsequently, regularly cyclic females from all three groups were mated with fertile males to undergo term pregnancies at 10 and 12 mo of age. While the virgin controls showed cyclic increases in P, T, and E2 secretion during their estrous cycles, the P implanted females had persistently low E2 and high P and T levels during treatment, which indicates an inhibition of ovarian E2 synthesis by P.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828429 TI - Prostaglandin concentrations in peripheral plasma and ovarian and uterine plasma and tissue in relation to oviposition in hens. AB - An increase in the plasma concentrations of prostaglandins (PGs) is associated with uterine contractile activity and with oviposition in the hen. In order to assess the contribution of potential sources of prostaglandins to the increase in prostaglandin levels observed at oviposition, prostaglandins E2, F2 alpha, and 13,14-dihydro-15-keto PGF2 alpha (PGFM, the stable but biologically less active metabolite of PGF2 alpha) were measured in plasma from the brachial vein, ovarian follicular vein and uterine vein, and in tissues from ovarian follicles and the uterus 12 h before and at midsequence oviposition or a terminal oviposition. These two ovipositions differ in that a midsequence oviposition is followed within 0.25-1.0 h by the next ovulation of the sequence, whereas the terminal oviposition is followed by an ovulation 14 h later. The concentration of PGFM in plasma from the brachial vein increased at midsequence oviposition, while the levels of PGE2 were unchanged. Prostaglandin E2, F2 alpha, and FM levels were each similar in the plasma from the brachial and uterine veins at the time of midsequence oviposition. In plasma from the largest preovulatory follicle, the concentration of PGF2 alpha and PGFM increased 19- and 7-fold, respectively, from 12 h before midsequence oviposition to midsequence oviposition, although no changes were observed in the concentrations of PGE2 during this interval. The levels of PGF2 alpha increased in the tissues of the two largest preovulatory follicles and the two most recently ruptured follicles during the 12-h period before a midsequence oviposition, while there was no change or a decrease in PGE2 levels in these tissues during the same interval. In contrast, the concentration of PGF2 alpha did not increase during the 12-h period preceding the terminal oviposition of the sequence in plasma from the brachial, uterine, or follicular veins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828430 TI - The effect of indomethacin on ovarian prostaglandin release in hens. AB - Indomethacin, an inhibitor of prostaglandin (PG) synthetase, will block uterine muscle electromyographic activity (EMG activity) and oviposition at a midsequence oviposition and ovulation in domestic hens, but does not block the increase in EMG activity associated with the first ovulation of a sequence. To assess the potential relationship between prostaglandin release from the ovarian follicles and EMG activity in egg-laying hens, we determined the concentrations of PGF2 alpha, 13,14-dihydro-15-keto-PGF2 alpha (PGFM), and PGE2 in brachial, ovarian follicular and uterine venous plasma and tissues in relation to uterine muscle EMG activity at the first ovulation and at a midsequence oviposition. The concentrations were measured after an i.m. injection (25 mg/hen) of indomethacin. In control hens sampled hourly, beginning 4 h before the peak of EMG activity at the first ovulation of a sequence, there was a sharp increase (p less than 0.05) in concentrations of PGF2 alpha and PGFM in brachial vein plasma coincident with the increase (p less than 0.05) in uterine EMG activity. Hens pretreated with indomethacin also had increased plasma PGF2 alpha and PGFM levels (p less than 0.05) in brachial vein plasma and increased uterine EMG activity (p less than 0.05) at this time. Indomethacin treatment lowered but did not eliminate mean levels of PGF2 alpha in the venous effluent from the largest preovulatory follicle at the first ovulation (36.0 +/- 9.9 ng/ml vs. 14.4 +/- 1.8 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828431 TI - Influence of stage of the estrous cycle on endogenous opioid modulation of luteinizing hormone, prolactin, and cortisol secretion in the gilt. AB - Fourteen gilts that had displayed one or more estrous cycles of 18-22 days (onset of estrus = Day 0) and four ovariectomized (OVX) gilts were treated with naloxone (NAL), an opiate antagonist, at 1 mg/kg body weight in saline i.v. Intact gilts were treated during either the luteal phase (L, Day 10-11; n = 7), early follicular phase (EF, Day 15-17; n = 3), or late follicular phase (LF, Day 18-19; n = 4) of the estrous cycle. Blood was collected at 15-min intervals for 2 h before and 4 h after NAL treatment. Serum luteinizing hormone (LH) concentrations for L gilts averaged 0.65 +/- 0.04 ng/ml during the pretreatment period and increased to an average of 1.3 +/- 0.1 ng/ml (p less than 0.05) during the first 60 min after NAL treatment. Serum prolactin (PRL) concentrations for L gilts averaged 4.8 +/- 0.2 ng/ml during the pretreatment period and increased to an average of 6.3 +/- 0.3 ng/ml (p less than 0.05) during the first 60 min after NAL treatment. Serum PRL concentrations averaged 8.6 +/- 0.7 ng/ml and 7.6 +/- 0.6 ng/ml in EF and LF gilts, respectively, prior to NAL treatment, and decreased (p less than 0.05) to an average of 4.1 +/- 0.2 ng/ml and 5.6 +/- 0.4 ng/ml in EF and LF gilts, respectively, during the fourth h after NAL. Naloxone treatment failed to alter serum LH concentrations in EF, LF, or OVX gilts and PRL concentrations in OVX gilts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828432 TI - The functional competence of uterine-derived polymorphonuclear neutrophils (PMN) from mares resistant and susceptible to chronic uterine infection: a sequential migration analysis. AB - The functional competence of uterine-derived polymorphonuclear neutrophils (PMNs) from 28 mares was measured for migration responsiveness by use of a chamber (filter) assay. Uterine infection was induced with Streptococcus zooepidemicus in mares considered resistant to chronic uterine infection (Grade I). In sequential analysis of uterine flushings obtained from these mares 5, 12, 15, 20, and 25 h after infection was induced, PMNs showed an initial rise at 12 h (from 5), then a general decline in migration response and in concentration of cells per ml from 12 through 25 h post-inoculation. In contrast, PMNs obtained from the uterine flushings from mares considered susceptible to chronic uterine infection (Grade III) demonstrated premature migration dysfunction 12 h after infection. Subsequent increases in functional competence of the PMNs were demonstrated at 15 and again at 25 h after induced infection. The concentration of uterine PMNs per ml from mares considered susceptible to chronic endometritis remained elevated from 12 through 25 h after inoculation, which suggests a possible continued recruitment of new PMNs from the peripheral circulation. The results of this study suggest that uterine-derived PMNs obtained from mares susceptible to chronic uterine infection have a compromised ability to migrate. This dysfunction may play an important role in rendering the endometrium (uterus) susceptible to chronic endometritis. PMID- 3828433 TI - Changes in the kinetics of follicular growth in response to selection for large litter size in mice. AB - The present study examined a randomly selected control line (C) and a large litter size-selected line of mice (S1) to determine changes in the kinetics of follicular growth that have occurred in response to selection for large litter size. For each follicle type (FT), the number of healthy and atretic follicles, length of components of granulosa cell cycle, follicular growth rate, and follicular flux were determined microscopically from serially sectioned ovaries of Lines C and S1 mice. Selection for litter size significantly increased the number of small and medium, and some large follicle-size classes. While selection for litter size did not change the overall incidence of atresia at proestrus, it did decrease the incidence of atresia in the large Type 7 follicles by 19%. Selection for litter size also increased ovarian weight at proestrus. Selection for litter size increased the rate of growth through FT 3a, 5a, and 5b, and reduced the time required for follicles to grow from primordial to Graafian follicles from 39.1 days in Line C to 33.4 days in Line S1. Selection for large litter size also increased the flux of follicles through follicle Types 3a to 5b by 72%, and through follicle Types 6 and 7 by 21%. Genetic variation was found in many aspects of the kinetics of follicular growth. PMID- 3828434 TI - Plasma steroid hormones in relation to behavioral sex role reversal in the spotted sandpiper, Actitis macularia. AB - Plasma samples collected from spotted sandpipers during the reproductive season were analyzed for testosterone, dihydrotestosterone (DHT), estradiol-17 beta and progesterone. Prior to incubation, plasma testosterone and DHT levels were significantly greater in males than in females. Estradiol levels of paired females were significantly greater than those of paired males. Testosterone and DHT levels of unpaired resident and paired males were significantly greater than those of incubating and brooding males. A 25-fold decline in testosterone occurred in males from the 1- or 2-egg stage to the 3-egg stage, when incubation is initiated. In females, testosterone values were low in unpaired, brooding, and transient birds. Paired females had levels 7-fold greater than unpaired birds. In both sexes, there was a strong correlation between testosterone and DHT levels. Prolactin values were negatively correlated with testosterone and DHT in males. These results indicate that the high level of intrasexual competition for mates among female spotted sandpipers is not based upon a total reversal of the normal male/female levels of androgens and estradiol. Territoriality and intense competition for mates in females may be based upon enhanced receptivity of neural centers to moderate hormone levels. Relative changes in testosterone between unpaired and paired females indicates that this hormone may play a role in mate acquisition and territoriality of these sex role-reversed females. PMID- 3828435 TI - Transferrin receptors of isolated rat seminiferous tubules bind both rat and human transferrin. AB - The binding and uptake of rat and human transferrin by isolated rat seminiferous tubules was studied. During the isolation and incubation of the tubules, the blood-testis barrier remained intact. Iron-saturated and iron-free (apo-) transferrin use the same binding sites on the surface of the tubules, but the dissociation constant is about two times higher for apotransferrin than for iron saturated transferrin. The affinity of the receptors is equal for rat and human transferrin, but human transferrin binds to more surface binding sites (2.6 X 10(10) per 10 cm tubule length) than rat transferrin (1.1 X 10(10) per 10 cm tubule length) at 0 degrees C. At 33 degrees C equal numbers of human and rat transferrin molecules are taken up (about 8 X 10(10)) per 10 cm tubule length. The quantitative difference between 0 degrees C and 33 degrees C is caused by the fact that at 33 degrees C receptor-mediated endocytosis and recycling occur. As a consequence, both surface and intracellular transferrin receptors are detected at 33 degrees C. The dissociation constants are not temperature-dependent. PMID- 3828436 TI - Kainic acid lesioning of the preoptic area alters positive feedback of estrogen in prepubertal female rats. AB - Stereotaxic infusion of kainic acid (KA) was performed to induce intrinsic neural lesions of the preoptic area (POA) in 25-day-old female rats. After KA infusion, rats in Experiment 1 received 10 micrograms of estradiol benzoate (EB) administered subcutaneously to assess positive feedback of EB on release of luteinizing hormone (LH) from the pituitary gland. Rats were perfused for light microscopic (LM) or electron microscopic (EM) evaluation of the lesion site. Rats of Experiment 2 were allowed to develop until the appearance of vaginal opening (VO) after which time vaginal lavages were taken to monitor the cyclicity of the vaginal epithelium. At 50 days of age, the right ovary from each rat was removed, trimmed of fat, and weighed. At 60 days of age, the remaining ovary was removed to assess compensatory ovarian hypertrophy (COH). In Experiment 3, we investigated the effects of POA/KA-infusion on sexual behavior. Sex behavior tests were conducted at 48 h after EB during the dark phase of the light cycle. In Experiment 1, all the control and saline-infused rats exhibited the expected rise of plasma LH two days after estrogen injection while the POA/KA-infusion abolished the positive feedback effect of EB on LH release. Ultrastructural examination of the lesion site revealed that neurons were undergoing acute degeneration while axons and afferent terminals seen in the same fields of analysis were morphologically intact. Preoptic area/KA lesions caused a marked delay in the appearance of VO. Duration of this temporal delay in POA/KA-lesioned rats was approximately 4 days, or one vaginal cycle. The lesioned animals showed normal compensatory hypertrophy after unilateral ovariectomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828437 TI - Effect of frontal hypothalamic deafferentation on duration of breeding season and melatonin secretion in the ewe. AB - The objectives of this study were to determine if ewes subjected to frontal hypothalamic deafferentation (FHD) during anestrus remained anestrus or began to have estrous cycles, and if melatonin secretion was disrupted by FHD. Ovary intact ewes in Group 1 were subjected to either FHD (n = 10) or sham FHD (n = 5) in early July 1983. Estrous cycles were monitored by measuring circulating progesterone concentrations from before FHD until September 1985. Group 2 ewes (n = 4) were subjected to FHD in October 1984. In late April 1985, blood samples were taken from all ewes at 1- to 4-h intervals from 1100 h to 0700 h of the following day to monitor diurnal changes of melatonin. Hypothalami were collected for histological evaluation of lesions. All Group 1 ewes (sham FHD and FHD) initiated normal estrous cycles in August and September 1983, and all ceased cycles by mid-February 1984. All sham FHD and 4 FHD ewes remained anestrus until August or September of 1984 and then resumed normal cycles. In contrast, 5 FHD ewes resumed cycles as early as April 1984 and then cycled intermittently or almost continuously. Two Group 2 ewes cycled continuously after FHD and 2 cycled infrequently. FHD ewes that showed prolonged breeding seasons had cuts that damaged the suprachiasmatic nucleus (SCN) and adjacent structures. Mean nocturnal (2000 h-0500 h) melatonin concentrations did not differ (p greater than 0.05) between sham FHD, FHD "normal season," and FHD "continuous cycle" ewes. In summary, damage to the SCN region by FHD during anestrus had no detectable effect on either onset or cessation of the next breeding season but greatly prolonged subsequent breeding seasons. Thus, the environmental signals that both initiated and terminated the 1983 breeding season apparently had been given before FHD was performed in midsummer. Damage to the SCN region during the breeding season caused some ewes to cycle continuously. The effects of FHD apparently were not due to disruption of melatonin secretion. FHD ewes that showed prolonged breeding seasons had normal seasonal changes of plasma prolactin concentrations. This suggests that different neural structures control seasonal patterns of gonadotropin and prolactin secretion. PMID- 3828438 TI - The influence of hibernation on testis growth and spermatogenesis in the golden mantled ground squirrel, Spermophilus lateralis. AB - Testis size and spermatogenesis were monitored serially in individual golden mantled ground squirrels before, during, and after the hibernation season. During hibernation, animals spent 81% of days in torpor at body temperatures of 3-4 degrees C. Torpor bouts of 6 days duration were interspersed with brief arousals from torpor during which animals were normothermic. In the 5 mo between December (when animals entered hibernation) and April (when torpor was spontaneously terminated), the estimated mass of testes increased gradually from 500 to 1100 mg, but spermatogenesis did not advance beyond pachytene spermatocytes, which were present before hibernation began. In contrast, during the month after torpor was terminated, testes increased rapidly to 3500 mg and after 31 days, spermatozoa were found in the epididymides. We suggest that the limited testis growth that occurred during the hibernation season was restricted to intervals during which squirrels were aroused from torpor. The major portion of gonadal growth and spermatogenesis in the laboratory, and presumably in the field, occurs after ground squirrels have regained the normothermic state. Since males are reproductively mature when first trapped in spring, these findings suggest that males are normothermic for several weeks before they emerge from their hibernacula in the spring. PMID- 3828439 TI - Morphometric analysis of cell types in the ovine corpus luteum throughout the estrous cycle. AB - The cellular composition of ovine corpora lutea obtained during the early (Day 4), mid (Days 8 and 12), and late (Day 16) stages of the estrous cycle was determined by morphometric analysis. Individual corpora lutea were collected via midventral laparotomy from a total of 19 ewes. A center slice from each corpus luteum was processed for electron microscopy and subsequent morphometric analysis of the numbers and sizes of steroidogenic and nonsteroidogenic cells. Luteal weight progressively increased throughout the estrous cycle (p less than 0.05). Corpora lutea collected on Day 16 were assigned to one of two subgroups on the basis of gross appearance and weight: nonregressed (NR, 542 +/- 25 mg) or regressed (R, 260 +/- 2 mg). There were no significant changes in the proportion of the corpus luteum occupied by small luteal cells (19 +/- 2%) or large luteal cells (36 +/- 1%) throughout the estrous cycle. The total number of steroidogenic cells per corpus luteum increased from 21.8 +/- 3.7 (X 10(6)) on Day 4 to 61.7 +/ 5.4 (X 10(6)) on Day 8 (p less than 0.05) and remained elevated thereafter. The number of small luteal cells was 10.0 +/- 2.7 (X 10(6)), 39.7 +/- 1.4 (X 10(6)), 46.1 +/- 5.8 (X 10(6)), 49.0 +/- 13.7 (X 10(6)), and 29.9 +/- 8.6 (X 10(6)) on Days 4, 8, 12, 16 (NR), and 16 (R), respectively (p less than 0.05, Day 4 vs. Days 8, 12, 16 NR). In contrast, the number of large luteal cells was 11.8 +/- 1.5 (X 10(6)) on Day 4 and did not vary significantly during the remainder of the estrous cycle. The numbers of nonsteroidogenic cell types increased (p less than 0.05) from Day 4 to Day 16 (NR) but were decreased in regressed corpora lutea (Day 16 R). Regression was characterized by a 50% decrease (p less than 0.05) in the total number of cells per corpus luteum from 243 +/- 57 ( X 10(6)) on Day 16 (NR) to 125 +/- 14 ( X 10(6)) on Day 16 (R) (p less than 0.05). Small luteal cells remained constant in volume throughout the entire estrous cycle (2520 +/- 270 microns 3), whereas large luteal cells increased in size from 5300 +/- 800 microns 3 on Day 4 to 16,900 +/- 3300 microns 3 on Day 16 (NR) (p less than 0.05). In summary, small luteal cells increased in number but not size throughout the estrous cycle, whereas large luteal cells increased in size but not number. PMID- 3828440 TI - Suppression of testicular maturation and fertility following androgen administration to neonatal male rats. AB - Administration of supraphysiologic doses of androgen to male rats within the first few neonatal days markedly suppresses subsequent testicular maturation; this effect diminishes as androgen is injected on succeeding postnatal days. Testosterone propionate (TP) administered neonatally at dosages up to 3.5 mg appreciably diminished postnatal testicular growth; postpubertal androgen secretion, as assessed by accessory sex organ weights and serum testosterone concentrations and as reflected by a castrationlike developmental pattern of the hepatic enzyme, histidase; spermatogenesis; and fertility. Beyond three mo of age testicular growth rates and androgen secretion--but not fertility--tended to be restored. These effects of neonatal androgen do not require aromatization to estrogen; indeed 5 alpha-dihydrotestosterone elicited more profound testicular suppression than TP, which was sustained until at least 100 days of age. Testes of neonatally androgenized rats were capable of responding to gonadotropins administered at three wk of age with increases in weight and androgen secretion. These findings suggest that a developmental event, suppressible by pharmacologic doses of androgen, occurs at a nontesticular site during the first few post partum days in the male rat; this event programs subsequent testicular maturation. PMID- 3828441 TI - Haemocompatibility and biological course of carbonaceous composites for cardiovascular devices. AB - A new class of carbonaceous composites has been developed for cardiovascular devices. The aim of the present study, performed in dogs, was to test the immediate blood compatibility of these materials when inserted within the vascular bed. Biocompatibility studies were performed on vascular cylinders (6 mm i.d.) and intra-atrial implants. The specimens were examined sequentially by SEM at 10, 20, 30, 180 s and 10 min after re-establishment of the blood flow. Patency of the vascular cylinders was tested during the second and third postoperative month by Doppler ultrasound investigations; specimens were examined by light and electron microscopy (scanning and transmission) at 15, 60 and 110 d following implantation. As early as 10 s after re-establishment of the blood flow platelet adhesion and a limited fibrin mesh with few erythrocytes developed on the material. Platelet aggregates were only observed on intravenous implants. Except in the case of the intravenous insert, no thrombosis developed at the contact of intra-arterial or intracardiac implants. After 15 d it was completely covered by a fibrocellular layer (3-5 cells thick) consisting of large myofibroblasts with microfilaments, newly synthesized collagen and elastin. Endothelial-like cells developed and were completed 2 mnth after implantation. However, deposits present inside and outside the fibrocytic cells of the newly developed tissue were observed corresponding to carbon peaks as indicated by wavelength dispersive X ray microanalysis. PMID- 3828442 TI - Calcification of poly(2-hydroxyethyl methacrylate)-collagen composites implanted in rats. AB - Samples of the polyHEMA-collagen composites with varying collagen content have been implanted into the popliteal region of rats. Three, six and twelve months after the implantation, calcification of the implanted material was determined using a radioactive indicator. At the same time, the implants and surrounding tissue were examined histologically. The degree of calcification of the implants was dependent on the collagen content; it was more pronounced with a higher amount of collagen. The composites with 30% (w/w) or more collagen were biodegraded during the long-term implantation. It is suggested that the composites containing less than 20% (w/w) of fibrillar collagen are used for biomedical applications and that those with a higher collagen content for the in vitro studies. PMID- 3828443 TI - Polymers for healing caps on titanium implants. AB - Healing caps are used during the healing period after abutment connection on titanium implants of the Branemark type. These healing caps consist of a screw embedded in polyamide-6 (PA-6) which is considerably weakened during this healing period. The properties of PA-6 and poly(4-methyl-1-pentene) (PMP) were studied. Storage in water at 37 degrees C led to a marked reduction in the flexural modulus of PA-6, but only a minor decrease for PMP. PA-6 showed a marked increase in volume due to water uptake, whereas PMP showed no significant change in volume. The improved properties of PMP compared to PA-6 when used for healing caps were demonstrated. The results of an agar overlay cytotoxicity test indicated that both PMP and PA-6 were nontoxic under laboratory controlled conditions. PMID- 3828444 TI - The effects of fibre reinforcement and gold plating on the flexural and tensile strength of PGA/PLA copolymer materials in vitro. AB - Changes in the flexural and/or tensile strength of plates and rods made of PGA/PLA copolymer submerged in water for a period of 4 wk were investigated. During this time, the effects of PGA/PLA fibre self-reinforcement, carbon fibre reinforcement and gold plating on tensile and/or flexural strength were examined. The results were used for evaluation of the surgical applications of PGA/PLA copolymer and its composites. The initial tensile strength of non-reinforced material was 45 Mpa and its flexural strength was 150 MPa: the flexural strength of self-reinforced material was 265 MPa. The tensile strength of carbon fibre reinforced material was 90 MPa and its flexural strength 190 MPa. The initial strengths of plated and unplated samples were the same but plating delayed the loss of the mechanical strength of carbon fibre reinforced samples. After 4 wk the flexural strength of self-reinforced and carbon fibre reinforced samples was decreased to the level of cancellous bone (10-20 MPa) while the flexural strength of non-reinforced samples was below that level (less than or equal to 5 MPa). The results suggested that self-reinforced PGA/PLA composites may be used for the treatment of fractures in cancellous bone. Positive animal experiments led to clinical studies in vivo. These studies showed that there was no difference in outcome between 2 groups of patients with displaced fractures of the ankle treated with metallic implants or PGA/PLA fibre self-reinforced implants, respectively. Self-reinforced biodegradable implants are now used routinely in Helsinki University Central Hospital. PMID- 3828445 TI - Strength and strength retention in vitro, of absorbable, self-reinforced polyglycolide (PGA) rods for fracture fixation. AB - The initial shear strength and changes in flexural strength of self-reinforced, absorbable polyglycolide (PGA) composite rods, submerged in distilled water (at 37 degrees C) for a period of 6 wk, were investigated. The recently developed self-reinforced absorbable material consists of an absorbable polymeric matrix reinforced with fibres of the same polymer. The initial shear strength of self reinforced cylindrical PGA rods with a diameter of 3.2 mm was 250 MPa and the initial flexural strength of the rods was 370 MPa. During the first week of immersion the level of flexural strength decreased very little i.e. to 320 MPa. The loss of flexural strength increased after 1 wk immersion. However, after 3 wk it was 90 MPa. After 5 wk the flexural strength decreased to the level of strength of cancellous bone i.e. 10-20 MPa. The gamma-irradiation of the PGA rods (total dosage 2.5 Mrad) decreased the initial bending strength to 300 MPa but the hydrolytic behaviour of the rods was not changed. The in vitro strength and the strength retention of self-reinforced PGA rods are clearly better than the corresponding values for self-reinforced glycolide/lactide copolymer rods which we developed recently. Self-reinforced PGA rods are now used routinely in Helsinki University Central Hospital in the treatment of certain types of cancellous bone fracture. PMID- 3828446 TI - Acute tissue reactions to potassium alginate with and without colour/flavour additives. AB - The acute tissue reactions to potassium alginate, locally applied to a microvascular bed, were studied with the use of the vital microscopic hamster cheek pouch model combined with correlative histology. This experimental model permitted us to study microvascular permeability, blood flow, vessel diameters and leucocyte adhesion to vessel walls intravitally, and leucocyte migration and mastcell degranulation histologically. Deionized water alone and potassium alginate with flavour and colour mixed in saline was found to cause severe microvascular alterations, while potassium alginate, without flavour and colour, but mixed in saline and applied to the microvasculature resulted in a minor inflammatory reaction. PMID- 3828447 TI - Polymerization shrinkage of methacrylate esters. AB - The polymerization shrinkage of a range of poly(n-alkyl methacrylates) in the range C1 to C16, some of their isomers and the polymers of cyclic and heterocyclic methacrylates have been measured using densitometry. The percentage volume shrinkage decreases with the size of the substituent side group. This proved to reflect the fact that the change in molar volume on polymerizing a methacrylate ester is reasonably constant at 22 cc/mol irrespective of the geometry of the substituent group. However, the glass transition temperature of the polymer depends very critically on the geometry of the side group. Hence one method for the development of low shrinkage glassy polymers is to investigate methacrylate esters of large molar volume, but with side group geometry that results in a high glass transition temperature. Polymerization shrinkage can be used to determine the degree of conversion of a polymer, using the value of 22 cc/mol as the change in molar volume. PMID- 3828448 TI - Polyethylene/hydrophilic polymer blends for biomedical applications. AB - Polyethylene blends with poly(2-hydroxyethyl methacrylate) [poly(HEMA)] or poly(2,3-dihydroxypropyl methacrylate) [poly(DHPMA)] were prepared by swelling polyethylene with HEMA or 2,3-epoxypropyl methacrylate (EPMA) and by polymerization of the respective monomers. Poly(EPMA) in blends was hydrolysed to poly(DHPMA) with acetic acid. The blends had similar surface and bulk compositions. Swelling with water and surface wettability were proportional to the content of the hydrophilic component; at the same content the polyethylene/poly(DHPMA) blends appeared more hydrophilic than those of polyethylene/poly(HEMA). Thrombus formation in contact with blood examined ex vivo and in vivo was considerably slower on the blends than on unmodified polyethylene. The tests indicated optima in composition; the best biological response was achieved with the blends containing about 14% poly(HEMA) or 16% poly(DHPMA). PMID- 3828449 TI - Chemical and biological evaluation of heparinized poly(amido-amine) grafted polyurethane. AB - By a simple process poly(amido-amine) chains have been grafted onto the surface of polyurethane. The poly(amido-amine) was found to be able to complex heparin by electrostatic interaction. Heparin can be released only at pH greater than 10 with NaOH solution. The heparin adsorbing capacity of the material was biologically tested, and the anticoagulant activity of the heparinized polyurethane was demonstrated. PMID- 3828450 TI - Resorbable materials of poly(L-lactide). VI. Plates and screws for internal fracture fixation. AB - Poly(L-lactide) (PLLA) with an extremely high molecular weight (Mv up to 1 X 10(6)) was synthesized at a low catalyst concentration (0.015 wt%) and temperatures between 100-110 degrees C. Besides good mechanical properties the as polymerized PLLA exhibited a microporous structure. Plates and screws of this material were used for the treatment of mandibular fractures, both in dogs and in sheep. Bone healing was uneventful and proceeded without callus formation or signs of inflammation. Fracture healing was accompanied by a progressive degradation of the microporous implants of PLLA. PMID- 3828451 TI - Complement-induced thrombus formation on the surface of poly(N-vinylpyrrolidone) grafted polyethylene. AB - The role of complement activation in thrombogenesis was investigated on the surface of hydrophilic monomer-graft copolymerized polyethylene (PE) tubes. N vinylpyrrolidone (NVP)-grafted tubes activated in an in vitro complement system of canine serum; but no activation occurred in 2-hydroxyethyl methacrylate (HEMA) grafted tubes. The relative patent time for NVP-grafted tubes implanted in canine peripheral veins was shorter than that for HEMA-grafted tubes and adhesion of numerous leucocytes was observed on the luminal surfaces of the NVP-grafted tubes. Decomplementation by prior administration of cobra venom factor elongated the relative patent time for NVP-grafted tubes only and also inhibited the adhesion of leucocytes onto them. These results suggest that the complement activation participates in thrombus formation on the polymer surfaces in canine veins. PMID- 3828452 TI - Measurement of rate constants for the contractile cycle of intact mammalian muscle fibers. AB - Small, random length changes were applied to bundles of intact fibers from rat and mouse extensor digitorum longus (EDL) and soleus muscles, while they were being tetanically stimulated. With increasing frequency of length changes, EDL muscle stiffness (tension change per unit change in length) increased, then decreased and increased again. The decrease was not seen in the soleus muscles. The EDL frequency-response could be well fitted by three exponential components with apparent rate constants of approximately 25, 150, and 500 s-1 at 20 degrees C. All rate constants increased steadily with temperature and for each 10 degrees C increase in temperature, the rates in the mouse EDL increased by a factor (Q10) between 1.8 and 2.4. With tetanic stimulation, force increased nearly exponentially to a steady level with a rate constant of 24 s-1 at 20 degrees C in mouse EDL muscles, and a Q10 of 2.4. These values correspond closely to the lowest frequency rate constant measured with length perturbations, which suggests that this process may limit the rate of rise of force in intact muscle fibers. During fatigue the high frequency and intermediate frequency rate constants declined, but the low frequency rate constant remained unchanged. These results are discussed in relation to current biochemical models for cross-bridge cycling. PMID- 3828453 TI - Diffusion- and reaction rate-limited redox processes mediated by quinones through bilayer lipid membranes. AB - The mediation of redox reactions through bilayer lipid membranes was studied. With an appropriate choice of electron acceptors the redox process can be limited either by the chemical reaction rate between the mediator and the reactants or by the shuttle frequency of the mediator through the membrane. Both modes were demonstrated for redox reactions mediated by 2,6 dichlorobenzoquinone (DCBQ) and by alpha-tocopherol with ascorbate entrapped inside vesicles using ferricyanide (a mild oxidant) or hexachloroiridate (a strong oxidant) in the external solution. The redox processes were reaction rate-limited and diffusion-limited for ferricyanide and hexachloroiridate, respectively. The kinetics of the redox processes in the diffusion- and the reaction rate-limited modes allows the determination of the shuttle frequencies and of the interfacial reaction rates of the mediators, respectively. The shuttle frequencies of DCBQ and alpha-tocopherol were approximately 8 and 0.08 s-1, respectively, in L-alpha-dipalmitoyl phosphatidylcholine (DPPC) cholesterol vesicles at 25 degrees C. Interfacial reaction rates between the mediators and ferricyanide were about two- and tenfold lower compared with bulk reaction rates for DCBQ (water) and tocopherol (50% ethanol solution), respectively, i.e., tocopherol is relatively less accessible to aqueous oxidants at the membrane interface. Tocopherol and oxidized tocopherol are reversible hydrophobic redox couples that interact very rapidly with strong oxidants. In both modes of mediation DCBQ was more effective than alpha tocopherol. PMID- 3828454 TI - Na+/Ca2+ exchange in cardiac myocytes. Effect of ouabain on voltage dependence. AB - Sarcolemmal sodium/calcium exchange activity was examined in individual chick embryonic myocardial cell aggregates that were loaded with quin 2. The baseline [Ca2+]i was 68 +/- 4 nM (n = 29). Abrupt superfusion with sodium-free lithium solution produced a fourfold increase in steady-state [Ca2+]i to 290 +/- 19 nM, which was reversible upon sodium restitution. Other methods of increasing [Ca2+]i such as KCl-depolarization or caffeine produced a dose-dependent increase in quin 2 fluorescence, accompanied by sustained contracture. The [Ca2+]i increase in zero sodium was linear, and its half-time (t1/2) of 15.1 +/- 0.1 s was similar to that of the sodium-free contracture (t1/2 = 14.4 +/- 0.5 s) under the same conditions. The sodium-dependent [Ca2+]i increase was not significantly greater when potassium served as the sodium substitute instead of lithium. This suggests that sodium/calcium exchange has little voltage dependence in this situation. However, in aggregates pretreated with ouabain (2.5 microM), the [Ca2+]i increase was almost threefold greater with potassium than with lithium (P less than 0.007). Ouabain therefore potentiated the effect of membrane potential on calcium influx. We propose that elevation of [Na2+]i is a prerequisite for voltage dependence of the sodium/calcium exchange under the conditions studied. Sodium loading will then drastically increase calcium influx during the action potential while inducing an outward membrane current that could accelerate repolarization. PMID- 3828455 TI - Computer simulation of action potential propagation in septated nerve fibers. AB - The nonlinear, core-conductor model of action potential propagation down axisymmetric nerve fibers is adapted for an implicit, numerical simulation by computer solution of the differential equations. The calculation allows a septum to be inserted in the model fiber; the thin, passive septum is characterized by series resistance Rsz and shunt resistance Rss to the grounded bath. If Rsz is too large or Rss too small, the signal fails to propagate through the septum. Plots of the action potential profiles for various axial positions are obtained and show distortions due to the presence of the septum. A simple linear model, developed from these simulations, relates propagation delay through the septum and the preseptal risetime to Rsz and Rss. This model agrees with the simulations for a wide range of parameters and allows estimation of Rsz and Rss from measured propagation delays at the septum. Plots of the axial current as a function of both time and position demonstrate how the presence of the septum can cause prominent local reversals of the current. This result, not previously described, suggests that extracellular magnetic measurements of cellular action currents could be useful in the biophysical study of septated fibers. PMID- 3828456 TI - Nuclear magnetic resonance spectroscopic and computer-stimulated structural analyses of a heptapeptide sequence found around the N-glycosylation site of a proline-rich glycoprotein from human parotid saliva. AB - The proline-rich glycoprotein from human parotid saliva has a common heptapeptide sequence around four of six N-glycosylation sites (Maeda, N., H. S. Kim, E. A. Azen, and O. J. Smithies, 1985, J. Biol. Chem., 20:11123-11130). A synthetic model of the heptamer protein sequence, NH2-Q(1)-G(2)-G(3)-N(4)-Q(5)-S(6)-Q(7) CONH2, was examined by nuclear magnetic resonance (NMR) spectroscopy and the ECEPP/2-VAO4A (Empirical Conformation Energy Program for Peptides) energy minimization computer algorithm (Scheraga, H. A., 1982, Quantum Chemistry Program Exchange, 454; Powell, M. J. D., 1964, Quantum Chemistry Program Exchange, 60). The NMR spectrum was almost completely assigned in dimethylsulfoxide-d6 (DMSO), and the amide chemical shift temperature dependence, phi dihedral angles, and chi 1 rotamer populations elucidated. These data indicated that a significant population of the heptamer could exist as a type I beta-turn [4----1 between Q(5) and G(2)] and/or a type II' beta-turn [4----1 between (Q)5 and G(2) and/or a gamma-turn [3----1 between Q(5) and G(3)] with the amino acid chi 1 torsion angles weighted toward the gauche- conformation. Starting from these three possible conformations, the ECEPP/2-VAO4A rigid geometry energy minimization program was used to find the localized predominant in vacuo structures of this heptapeptide sequence. The type II' beta-turn conformation best fits the data based on internuclear hydrogen-bonding distances, minimum potential energy considerations, and the NMR parameters. PMID- 3828457 TI - Possible role of helix-coil transitions in the microscopic mechanism of muscle contraction. AB - Local helix-coil transitions in the coiled coil portion of myosin have long been implicated as a possible origin of tension generation in muscle. From a statistical mechanical theory of conformational transitions in coiled coils, the free energy required to form a randomly coiled bubble in the hinge region of myosin of the type conjectured by Harrington (Harrington, W. F., 1979, Proc. Natl. Acad. Sci. USA, 76:5066-5070) is estimated to be approximately 25 kcal/mol. Unfortunately this is far more than the free energy available from ATP hydrolysis if the crossbridges operate independently. Thus, in solution such bubbles are predicted to be absent, and the theory requires that the rod portion of myosin be a hingeless, continuously deforming rod. While such bubble formation in vivo cannot be entirely ruled out, it appears to be unlikely. We further conjecture that in solution the swivel located between myosin subfragments 1 and 2 (S-2 and S-1) is due to a locally random conformation of the chains caused by the presence of a proline residue at the point that physically separates the coiled coil from the globular portion of myosin. On attachment of S-1 to actin in the strong binding state, the configurational entropy of the random coil in the swivel region is greatly reduced relative to the case where the ends are free. This produces a spontaneous coil-to-helix transition in the swivel region that causes rotation of S-1 and the translation of actin. Thus, the model predicts that the actin filaments are pushed rather than pulled past the thick filaments by the crossbridges. The specific mechanism of force generation is examined in detail, and a simple statistical mechanical realization of the model is proposed. We find that the model gives a substantial number of qualitative and at times quantitative predictions in accord with experiment, and is particularly appealing in that it provides a simple means of free energy transduction--the well known fact that topological constraints shift the equilibrium between helical and random coil states. PMID- 3828458 TI - Kinetics of actin-myosin binding. I. An exactly soluble one-variable model. AB - To treat the kinetics of actin-myosin binding as simply as possible, a one variable model is developed and the notion of effectivity factors is introduced. An effectivity factor is a ratio of the reaction rate in the presence of cooperativity to that in the noncooperative case and is calculated by averaging cooperativity factors over all sites belonging to one seven-site actin unit. The technique is applicable to a variety of models involving cooperative association and dissociation processes. This averaging assumes the equivalence of all regulated actin units. The model may be solved exactly for arbitrary degrees of "preloading" of subfragment 1 (S1) on the regulated actin. PMID- 3828459 TI - Kinetics of actin-myosin binding. II. Two-variable model and actin gelation. AB - We consider a model of actin-myosin interaction in which the sites belonging to each seven-site regulated actin unit are subdivided into two classes, "internal" and "external." The time evolution of each class of sites is considered separately, leading to a pair of coupled differential equations that may be integrated numerically. We also consider the critical sol-gel transition point for actin filaments crosslinked by two-headed heavy meromyosin (HMM). The possibility of new types of chemical oscillation and pattern formation arising from periodic sol-gel transitions is discussed. PMID- 3828460 TI - Measurement of tissue potassium in vivo using 39K nuclear magnetic resonance. AB - 39K nuclear magnetic resonance (NMR) spectra were readily obtained, in vivo, from rat muscle, kidney, and brain in 5-10 min with signal-to-noise ratios of approximately 20:1. Quantitation of the K+ signal was achieved by reference to an external standard of KCl/dysprosium nitrate as well as by reference to the proton signal from tissue water. In vitro NMR studies of isolated tissue showed a K+ visibility (NMR K+/total tissue K+) of 96%, 62 +/- 8%, 47 +/- 1.9%, 45 +/- 3.5%, and 43 +/- 2.5% for blood, brain, muscle, kidney, and liver, respectively. Absolute tissue K+ was determined by flame photometry of acid-digested tissue. Changes in tissue K+ status by chronic K+ depletion or acute K+ loading produced changes of 39K NMR signal intensity that were equal to changes of absolute tissue K+. Acidosis, alkalosis, mannitol, or RbCl infusion did not significantly change the NMR K+ signal. These results indicate that the changes in K+ detected by NMR were specifically and accurately detected. To investigate the factors that affect the 39K NMR signal, the effects of liver homogenate on 39K NMR signal intensity were studied. Addition of homogenate produced a 60% loss of signal intensity, suggesting that a large portion of cell K+ may be only 40% visible. Addition of RbCl to undiluted homogenate increased the NMR K+ signal by 11 +/- 2 mumol/g. Addition of H2O or NaCl had no effect, suggesting that Rb+ was replacing K+ in sites of low (less than 40%) NMR visibility. These results demonstrate that 39K NMR experiments can be performed using intact organs. To explain the lack of detectable K+ and changes in K+ NMR visibility, a three compartment model is proposed. PMID- 3828461 TI - Resonance Raman studies of dioxygen and carbon monoxide binding to imidazole appended hemes. AB - Resonance Raman spectroscopy has been employed to probe the effects of proximal base strain on the bonding of O2 and CO in three synthetic hemins with covalently linked imidazole ligands. The strain is introduced by varying the length of the imidazole-containing side chain and by restricting the side chain flexibility with a phenyl ring. These hemins are abbreviated as "long," "short," and "stiff" hemins, respectively. In the deoxy state, the iron-imidazole stretching frequencies [nu(Fe--N epsilon)] for long, short, and stiff hemins are detected at 200, 207, and 204 cm-1, respectively. The strain induced in the iron-imidazole bond by the short hemin results in a higher nu(Fe--N epsilon) frequency, in contrast to the strain induced by sterically hindered 2-methylimidazole or 1,2 dimethylimidazole complexes in which the Fe--N epsilon bond is tilted and lengthened, but the imidazole ring remains perpendicular to the heme plane. However, in the short hemin, the plane of the imidazole ring may not be perpendicular to the plane of the porphyrin, altering the amount of pi interaction (hence the strength of Fe--N epsilon bond) and the nature of normal mode containing Fe--N epsilon bond stretching. Upon CO binding, we have observed the nu(Fe--CO) stretching frequencies at 497 (long), 499 (short), and 496 cm-1 (stiff), somewhat lower than those reported by Mitchell et al. (Inorg. Chem., 1985, 24:967) for the chelated-heme X CO complexes (i.e., 501-506 cm-1). This is the first report of an iron-oxygen-associated vibration observed in solution for an unprotected heme. The oxy complexes were formed by introducing dioxygen to the deoxy complexes at -700C. The isotope-sensitive line was detected at 576 cm- (1602) in oxy stiff hemin, which was shifted to 545 cm-1 upon 1802 substitution. This is perhaps the largest isotope shift (31 cm-') observed to date, compared with the usual 22-24 cm-'.For the long and short hemins, the iron-oxygen associated vibration was detected at 574 and 573 cm-', respectively.These values are very similar to those observed(N-methylimidazole) and myoglobin/hemoglobin. PMID- 3828462 TI - Resonance Raman evidence for the mechanism of the allosteric control of O2 binding in a cobalt-substituted monomeric insect hemoglobin. AB - The substitution of iron for cobalt in the monomeric insect hemoglobin CTT (Chironomus thummi thummi) III does not alter the Bohr effect for O2-binding. The cobalt substitution in this hemoglobin allows us to identify not only the O-O and Co-O2 stretching mode but also the Co-O-O bending mode by resonance Raman spectroscopy. The assignments were made via 16O2/18O2 isotope exchange. The modes associated with the Co-O-O moiety are pH-dependent. These pH-induced changes of the resonance Raman spectra are correlated with the t = r conformation transition. At high pH (high-affinity state) two unperturbed O-O stretching modes are observed at 1,068 cm-1 (major component) and 1,093 cm-1 (minor component) for the 18O2 complex. These frequencies correspond to split modes at 1,107 cm-1 and 1,136 cm-1 and an unperturbed mode at approximately 1,153 cm-1 for the 16O2 complex. At low pH (low-affinity state) the minor component becomes the major component and vice versa. The Co-O2 stretching frequency varies for approximately 520 cm-1 (pH 5.5) to 537 cm-1 (pH 9.5) indicating a stronger (hence shorter) Co O2 bond in the high-affinity state. On the other hand, the O-O bond is weakened upon the conversion of the low- to the high-affinity state. The Co-O-O bending mode changes from 390 cm-1 (pH 9.5) to 374 cm-1 (pH 5.5). In the deoxy form the resonance Raman spectra are essentially pH-insensitive except for a vinyl mode at 414 cm-1 (pH 5.5), which is shifted to 416 cm-1 (pH 5.5). PMID- 3828463 TI - Influence of specific contacts on the stability and structure of proteins. Theory for the perturbation of a harmonic system. AB - The question of how specific contacts within a protein influence its stability and structure is examined within a formal theoretical framework. A mathematical model is developed in which the potential energy of a protein is taken as a harmonic expansion of all of its internal or normal coordinates. With classical statistical mechanics the properties of the system can be derived from this potential energy function. A few new contacts are then introduced as additional energy terms, each having a quadratic dependence on a single internal coordinate. These terms are added as perturbations to the original potential energy, and the attendant changes in the properties of the system are obtained. Exact expressions can be derived for changes in the enthalpy, entropy, and for any arbitrary internal degree of freedom. These quantities are expressed in terms of the parameters of the potential energy functions of the new contacts, and the mean square displacements and positional correlation functions of the internal coordinates. These results provide qualitative insights into the role of contacts in stabilizing a particular conformation. Estimates are given for the entropy of formation of a hydrogen bond in a protein. A criterion is proposed for determining whether a contact is essential to the stability of a protein conformation. This model may be applicable to many experimental systems in which mutant or modified proteins are available that differ by one or a few amino acids. The results may also be useful in thermodynamic analyses of computer simulations. PMID- 3828464 TI - Theory of sample translation in fluorescence correlation spectroscopy. AB - New applications of the technique of fluorescence correlation spectroscopy (FCS) require lateral translation of the sample through a focused laser beam (Peterson, N.O., D.C. Johnson, and M.J. Schlesinger, 1986, Biophys. J., 49:817-820). Here, the effect of sample translation on the shape of the FCS autocorrelation function is examined in general. It is found that if the lateral diffusion coefficients of the fluorescent species obey certain conditions, then the FCS autocorrelation function is a simple product of one function that depends only on transport coefficients and another function that depends only on the rate constants of chemical reactions that occur in the sample. This simple form should allow manageable data analyses in new FCS experiments that involve sample translation. PMID- 3828466 TI - Spectral characterization of ciliary beating. Temperature dependence on spectral parameters. AB - Ciliary beating was optically examined in tissue cultures from frog palate epithelium. Consecutive segments of the analog signal were Fast-Fourier transformed. The three main parameters which define the spectrum, position of the peak maximum (f), width of the spectral line (S.D.), and area (A) under the spectrum, were all measured as a function of temperature. These measurements were also examined as a function of the number of cilia by varying the examined area from 1.2 to 122 microns2. It was found that: all the parameters were exponentially temperature dependent; and the average frequency was independent of the number of cilia examined, while S.D. was dependent on it. On a physiological level, we demonstrated that the ciliary fluctuation in frequency is temperature dependent, increasing with increase in temperature. Moreover, it was shown that where a relatively small number of cilia were measured (d = 1.24 micron), the area A under the observed spectrum was directly proportional to the amplitude of ciliary beating. Increasing the temperature decreases the amplitude and vice versa. According to our suggested model the dependence of A on f was predicted and verified experimentally. A mathematical model which simulates the S.D. as a function of examined area and temperature is suggested. The calculated results from the model are in a good agreement with our experimental findings. PMID- 3828465 TI - Evidence for rhodopsin refolding during the decay of Meta II. AB - Fourier transform infrared difference spectroscopy (FTIR) reveals that the Meta II intermediate of the rhodopsin bleaching cascade is structurally distorted relative to rhodopsin. In addition to previously detected alterations in the state of carboxyl groups, a small part of the protein back-bone undergoes a conversion from alpha-helical to beta-type structure. All of these changes partially reverse during Meta II decay. This evidence together with FTIR studies of earlier photointermediates indicates that of the known photointermediates the protein structure of Meta II is the most distorted. It is concluded that light causes rhodopsin to convert into a conformationally distorted form (Meta II), which subsequently refolds into a more rhodopsin-like conformation (opsin). PMID- 3828467 TI - Interaction of human low density lipoprotein and apolipoprotein B with ternary lipid microemulsion. Physical and functional properties. AB - Based on data from sedimentation velocity experiments, electrophoresis, electron microscopy, cellular uptake studies, scanning molecular sieve chromatography using a quasi-three-dimensional data display and flow performance liquid chromatography (FPLC), models for the interaction of human serum low density lipoprotein (LDL) and of apolipoprotein B (apo B) with a ternary lipid microemulsion (ME) are proposed. The initial step in the interaction of LDL (Stokes radius 110 A) with the ternary microemulsion (Stokes radius 270 A) appears to be attachment of the LDL to emulsion particles. This attachment is followed by a very slow fusion into particles having a radius of approx. 280 A. Sonication of this mixture yields large aggregates. Electron micrographs of deoxycholate-solubilized apo B indicate an arrangement of apo B resembling strings of beads. During incubation, these particles also attach to the ternary microemulsion particles and, upon sonication, spherical particles result which resemble native LDL particles in size. Scanning chromatography corroborates the electron microscopy results. By appropriate choice of display angles in a quasi three-dimensional display of the scanning data (corrected for gel apparent absorbance) taken at equal time intervals during passage of a sample through the column, changes in molecular radius of less than 10 A can be detected visually. Such a display gives a quantitative estimate of 101 +/- 2 A for these particles (compared to 110 A for native LDL). The LDL-ME particles and apo B-ME particles compete efficiently with native LDL for cellular binding and uptake. Cellular association studies indicate that both LDL- and apo B-ME particles are effective vehicles for lipid delivery into cells. PMID- 3828469 TI - Dynamic light-scattering study on polymerization process of muscle actin. AB - Globular actin (G-actin) polymerizes into a fibrous form (F-actin) under physiological salt conditions. The polymerization process of muscle actin was studied by a dynamic light-scattering method. The intensity correlation functions G2(tau) of scattered light from a G-actin solution containing 2 mM Tris-HCl (pH 8.0) and 0.1 mM ATP were analyzed by a cumulant expansion method, and the translational diffusion coefficient was determined to be D = (8.07 +/- 0.10) X 10(-7) cm2/s at 20 degrees C. This D value gave a diameter of 5.3 nm for spherical G-actin including a hydration layer. Polymerization of 1-3 mg/ml G actin in a solution containing 10 mM Tris-HCl (pH 8.0), 0.2 mM ATP and 60 mM KCl was followed by successive measurements of G2(tau) for a data accumulation period of 60-300 s/run. The time evolution of G2(tau) was analyzed by a least-squares fitting to the field correlation function of a multiexponential form g1(tau) = sigma iAi exp(-gamma i tau) with gamma 1 greater than gamma 2 greater than 3 greater than ..., and the static scattering intensity I(t) = mean value of I as a function of time t after initiation of polymerization was decomposed as I(t) = mean value of I sigma iAi. At the early stage of polymerization, a two exponential fit gave results indicating that component 1 came from G-actin and component 2 from F-actin growing linearly with t. At the middle stage of polymerization, a three-exponential fit gave the results that component 1 came from G-actin and possibly its small oligomers, component 2 from polymers with a number-average length Ln of about 900 nm which was independent of t, and component 3 from 'ghosts' in dynamic light scattering in a semidilute regime. Component 3 was concluded to arise from restricted motions of polymers with lengths much longer than Ln in cages formed by polymers giving component 2, and a fragmentation-elongation process of F-actin was suggested to start at the middle stage of polymerization, resulting in the size redistribution of F-actin. PMID- 3828468 TI - Effects of thermodynamic nonideality on protein interactions. Equivalence of interpretations based on excluded volume and preferential solvation. AB - Published results on the stabilization of proteins by sucrose (J.C. Lee and S.N. Timasheff, J. Biol. Chem. 256 (1981) 7193) have been reexamined and interpreted in terms of thermodynamic nonideality. The composition dependence of activity coefficients may be accounted for on a statistical-mechanical basis using the concept of excluded volume. An expression is derived in which the effect of sucrose on determination of the partial specific volume of a protein, previously interpreted in terms of preferential protein solvation, is also seen to be attributable to excluded volume. Gel chromatographic studies of the reversible unfolding of alpha-chymotrypsin are presented which demonstrate temperature- and sucrose-mediated changes in the effective volume of the enzyme. These measurements support the quantitative interpretation of the stabilization in terms of thermodynamic nonideality arising from the difference between covolumes for sucrose and the two isomeric states of alpha-chymotrypsin. By establishing the equivalence of the two approaches that have been used to account for the effects of inert solutes on protein transitions, the present investigation eliminates the need for any distinction between such solutes on the basis of molecular size; and also enhances greatly the potential sensitivity of thermodynamic nonideality as a means of probing protein isomerizations, since greater displacement of the equilibrium position may be effected by small rather than by macromolecular solutes present at the same weight concentrations. PMID- 3828470 TI - What causes the depolarization of trypsin and trypsinogen fluorescence. Intramolecular mobility or non-radiative energy transfer? AB - Analysis of protein data bank information about the coordinates of definite atoms of protein macromolecules provides an opportunity to evaluate the efficiency of non-radiative resonance energy transfer within the model of fixed, strictly oriented oscillators. Such evaluations for trypsin and trypsinogen (and also for trypsin complex with a pancreatic inhibitor) show that the efficiency of energy transfer among each pair of tryptophan residues is negligibly small. It is also shown that a fairly effective energy transfer from tyrosine to tryptophan residues is possible. The conclusions have been made that the Tyr-Trp energy transfer is one of the factors determining the shape of the trypsin polarization spectrum, and that upon fluorescence excitation at the long-wavelength edge of the absorption spectrum, the depolarization of trypsin fluorescence in aqueous solution at ambient temperature - compared to model compounds (tryptophan, N acetyltryptophan, glycyltryptophan, etc.), under the conditions of infinite viscosity - is due to the Brownian rotational motion of the macromolecules as a whole as well as the intramolecular mobility. The differences in the level and character of intramolecular mobility of trypsin and trypsinogen are discussed. PMID- 3828471 TI - The dynamics of the DNA hydration shell at gigahertz frequencies. PMID- 3828472 TI - Number of binding sites of DNA and polynucleotides with tris(2,2' dipyridyl)ruthenium(II) cations. PMID- 3828473 TI - Poly[d(A-T)-Cs+] conformations studied by IR spectroscopy. PMID- 3828474 TI - Sodium ion and solvent nuclear relaxation results in aqueous solutions of DNA. PMID- 3828475 TI - The biological functions of low-frequency vibrations (phonons). VI. A possible dynamic mechanism of allosteric transition in antibody molecules. PMID- 3828476 TI - Equilibrium theory for the binding of bivalent antibodies to regularly spaced sites on a DNA molecule. PMID- 3828477 TI - Lasers in the treatment of cancer of the prostate. An overview. AB - The results of therapy of prostate cancer with laser therapy either in the experimental animal model or in human application are preliminary and rudimentary. Difficulty in access to the prostate, variability in depth of laser penetration and problems in assessment of therapeutic attempts makes it impossible to be dogmatic about re the future application. The tumour does however respond to Nd: YAG and P. D. T. therapy and it is possible that the crude attempts to date will be supplanted in the future by more refinements that will enable laser energy to be harnessed. PMID- 3828478 TI - Laser photocoagulation of choroidal malignant melanoma. PMID- 3828479 TI - Hypothyroidism and anaemia. AB - Hypothyroidism can lead to a wide variety of anaemic disorders, and numerous mechanisms are involved in the pathogenesis of these anaemias. Attention to the haematological status of hypothyroid patients is correspondingly important. PMID- 3828480 TI - [Photometric measurement of cell density in microplate cultures]. AB - A rapid technique for measuring cellular density in microplates cultures is described. Cells are stained by toluidine blue (0% to 1% acetic acid), washed in 1% acetic acid and digested by trypsin (1%) or pronase (0.1%). Absorbance rate is read in an automated spectrophotometer for microplates. The correlation coefficient between absorbance and cellular number is higher than 0.99. The measures accuracy is satisfactory in the experimental conditions used. PMID- 3828481 TI - Fatty acid composition of plasma lipids in gout. AB - The changes occurring in the fatty acid composition of the plasma lipids were studied in gout. The major changes consisted in an increase in oleic acid and a decrease in linoleic and arachidonic acids in most lipid fractions of plasma; linoleic acid is unchanged in plasma cholesteryl esters and in FFA while arachidonic acid does not vary only in FFA. These changes are not related either to diet or to the age of patients and are similar to those reported in atherosclerotic and diabetic patients, as well as those with cardiac ischemia. The variations observed are directly influenced by the ratio essential fatty acids/monoenoic acids and all factors affecting this ratio. PMID- 3828482 TI - Effects of arginine butyrate on bacterial growth. AB - The antibacterial activity of arginine butyrate was tested on 15 different strains. Its bacteriostatic action was detected, depending on the organisms, at concentrations between 55 and 250 mM, except for the Streptococcus B. The latter was not only resistant, but its growth was even stimulated at low concentrations (1.95 mM to 31.2 mM). It is possible that this characteristic is related to its persistence in the female genital tract where the anaerobes produce butyrate. It has previously been demonstrated that this cytostatic activity applies not only to the prokaryotes, but also to the eukaryotes, where it is seen in much lower concentrations (6 mM): since the arginine butyrate could be used in antitumor treatment, it is important to investigate its bacterial growth effects. PMID- 3828483 TI - Pharmacokinetics of the thiazide diuretics. PMID- 3828484 TI - Effect of intravenous infusion time on the pharmacokinetics and pharmacodynamics of the same total dose of furosemide. AB - The pharmacokinetics and pharmacodynamics of furosemide were evaluated after intravenous administration of the same total dose of furosemide in different lengths of infusion time (10 s, 30 min, 2 h, and 8 h) to 6 dogs. The fluid loss in urine was immediately replaced volume for volume with intravenous infusion of Lactated Ringer's solution. The pharmacokinetic parameters such as per cent of the dose excreted in urine, total body and renal clearances, and terminal half life were not significantly different with four different infusion times. The volume of distribution at steady state and mean residence time based on venous data, on the other hand, appeared to increase with increasing infusion time. The mean values for Vss were 0.334, 0.478, 0.499, and 0.708 1 kg-1 for 10 s, 30 min, 2 h, and 8 h of infusion, respectively, and the corresponding values for MRT were 17.5, 22.2, 24.8, and 38.1 min. The diuretic effects (urine output and urinary excretion of sodium) were generally found to increase with increasing infusion times; the total mean 24 h urine outputs were 1102, 1464, 2190, and 3470 ml for 10 s, 30 min, 2 h, and 8 h of infusion, respectively, and the corresponding values for sodium excretion were 170, 175, 272, and 440 mmol. Furosemide plasma concentrations and hourly urinary excretion rates of furosemide, sodium, and potassium during the apparent steady state (between 2 and 8 h) in the 8 h infusion study were fairly constant. PMID- 3828485 TI - Plasma concentrations and bioavailability of propranolol by oral, rectal, and intravenous administration in man. AB - Eight normal male volunteers received 80 mg doses of propranolol by the oral and rectal routes and 2.2 mg by intravenous administration in a crossover fashion. Plasma concentrations of propranolol were measured by a gas chromatographic method using an electron capture detector. Individual subject concentration-time data were analysed and results indicated that the data fit a two compartment model with first order absorption. An approximately two-fold higher plasma propranolol concentration was observed after rectal administration as compared with oral dosing. Statistical analysis of the difference in the total AUCs indicates a significantly higher bioavailability of propranolol administered by the rectal route. The reduced bioavailability after oral administration indicates a substantial first pass effect but that it is possible to bypass the liver, at least partially, by giving the drug rectally to man. PMID- 3828486 TI - Mechanism for the interaction between triazolam and cimetidine. AB - Four normal volunteers each received three intraduodenal infusions of 0.5 mg triazolam solutions. Three treatments were: a pH 2.3 solution in which 47 per cent of the dose had hydrolysed to form a triazolo-benzophenone (TB); a pH 6.0 solution containing negligible TB; the pH 6.0 solution administered during cimetidine treatment (1200 mg day-1). TB was stable in serum and only very low TB serum concentrations were observed from the pH 2.3 treatment. No difference was observed in any triazolam pharmacokinetic parameter between the pH 6.0 and the pH 2.3 treatments. Cimetidine increased the triazolam AUC infinity and Cmax by 54 and 35 per cent, respectively. These results indicate that TB undergoes extensive presystemic conversion to triazolam and the triazolam-cimetidine interaction occurs primarily through a reduction in triazolam clearance. PMID- 3828487 TI - The relationship between drug input and mean residence time in the body. AB - The relationship between the mean residence time after oral dosing or any other non-instantaneous mode of administration (MRTni) was explored by a series of computer simulations. MRTni was calculated from the ratio of AUMC to AUC (where AUC and AUMC are the zeroth and first statistical moments, respectively, of the drug concentration-time curve). A continuous linear relationship between MRTni and 1/ka or 1/k0 was observed. In the 'flip-flop' case where ka less than K (where K is the last elimination rate constant), the extrapolation from t* to infinity (where t* is the last observed plasma concentration) should be done using ka instead of K. If K is used, underestimated values of MRTni will be obtained. The findings from this investigation have practical application in the design and pharmacokinetic evaluation of novel sustained-release dosage forms. PMID- 3828489 TI - Pinocytic capture and exocytosis of rat immunoglobulin IgG-N-(2 hydroxypropyl)methacrylamide copolymer conjugates by rat visceral yolk sacs cultured in vitro. AB - Rat immunoglobulin (IgG) was covalently bound to N-(2 hydroxypropyl)methacrylamide (HPMA) copolymers via glycylglycyl spacer. The resultant conjugate, free IgG and HPMA copolymer (containing a low percentage of tyrosinamide to facilitate radiolabelling) were radioiodinated, and their rates of pinocytic uptake, intracellular degradation and exocytic release by rat visceral yolk sacs cultured in vitro were determined. Free IgG was pinocytosed rapidly by the yolk sac and some IgG was subject to intracellular proteolysis. In comparison the IgG-HPMA copolymer conjugate was captured more slowly, but faster than unmodified HPMA. IgG was also exocytosed rapidly by the yolk sac following pinocytic capture and similarly IgG-HPMA copolymer had a much higher rate of release than unmodified HPMA. Measurement of tissue accumulation of 125I-labelled IgG-HPMA copolymer in the presence of increasing concentrations of non radiolabelled IgG showed competition for membrane binding sites between the free, and polymer-bound immunoglobulin. These experiments indicate that immunoglobulins can be covalently bound to a soluble polymer developed as a drug-carrier in such a way that they can still interact with specific membrane receptors and they are subsequently subjected to specific cellular transport mechanisms. PMID- 3828488 TI - Intrinsic fluorescence studies on saccharide binding to Artocarpus integrifolia lectin. AB - The combining region of Artocarpus integrifolia lectin has been studied by using the ligand-induced changes in the fluorescence of the lectin. The saccharide binding properties of the lectin show that C-1, C-2, C-4, and C-6 hydroxyl groups of D-galactose are important loci for sugar binding. The alpha-anomer of galactose binds more strongly than its beta-counterpart. Inversion in the configuration at C-4 as in glucose results in a loss of binding to the lectin. The C-6 hydroxyl group is also presumably involved in binding as D-fucose does not bind to the lectin. The lectin binds to the Thomsen-Friedenreich antigen (Gal beta(1----3)GalNAc) more strongly than the other disaccharides studied, viz. Gal beta (1----4) Gal and Gal beta (1----3) GlcNAc, which are topographically similar to T-antigen. This observation suggests that the combining region of Artocarpus lectin is complementary to that of T-antigen. Solvent accessibility of the protein fluorophores have been probed by the quenching of protein fluorescence by Iodide ion in the absence and presence of sugar. In the presence of sugar a slight inaccessibility of the fluorophores to the solvent has been observed. PMID- 3828490 TI - External anions relieve DIDS inhibition of SO4 efflux from placental membrane vesicles. AB - Sulphate efflux from human placental microvillus membrane vesicles was inhibited by external DIDS (KI congruent to 10(-6) M). This inhibition was partially reversed on addition of the translocated substrates sulphate or selenate to the external medium: selenite which is not translocated does not protect against DIDS inhibition. These findings show that the mechanism responsible for sulphate efflux can be modified by substrate in the external medium. PMID- 3828491 TI - Rabbit antibodies against the folate binding protein from cow's milk. Production, characterization and use for development of an enzyme-linked immunosorbent assay (ELISA). AB - Rabbit antibodies to purified folate binding protein from cow's milk whey were used for development of a two-site enzyme-linked immunosorbent assay (ELISA) for quantitation of bovine folate binding proteins. The folate binding proteins in human milk and serum showed no cross-reactivity. A partial saturation of purified bovine folate binder with folate gave rise to an increased antigenicity probably due to a ligand (folate)-induced exposure of antigenic sites on the protein. PMID- 3828492 TI - Effect of garlic oil extract on glutathione reductase levels in rats fed on high sucrose and alcohol diets: a possible mechanism of the activity of the oil. AB - The effect on glutathione reductase activities of feeding garlic oil to white albino rats maintained on high sucrose and alcohol diets was studied. Whereas high sucrose and alcohol diets resulted in significant increases in the activity of glutathione reductase in liver, kidneys and serum, the presence of garlic oil restored the levels to near normal. It is proposed that the mechanism of this action of garlic oil involves the active principle, diallyl disulphide, which interacts in an exchange reaction with enzymes and substrates such as glutathione reductase and glutathione which contain thiol groups. PMID- 3828493 TI - Characterization of a membrane-specific tubulin isoform by peptide mapping. AB - A membrane-specific tubulin-like protein, found in preparations of synaptic plasma membranes and brain mitochondria, was analyzed by chemical and proteolytic peptide mapping to determine which part of the molecule was different from cytoplasmic tubulin. The membrane polypeptide was identical to alpha tubulin in the first two-thirds of the molecule containing the amino terminal, as found by peptide mapping. However, some differences were observed in the peptide maps of the carboxy terminal one third of the molecule which includes a domain that is important in the regulation of tubulin self-assembly. PMID- 3828494 TI - Nucleotide sequence of a cDNA coding for mitochondrial fumarase from human liver. AB - The nucleotide sequence of a 1.46 kb cDNA, selected from a human liver library by the expression of fumarase antigenic determinants, was determined using the dideoxy chain termination method. The cDNA contained an open reading frame extending from the extreme 5'-base and coding for a protein with 468 amino acids. This protein, with the exception of an N-terminal methionine, was identified as mitochondrial fumarase. The protein showed a high degree of identity of structure with the fumarase from Bacillus subtilis (56.6%) and a fumarase from Escherichia coli (product of the fumC gene, 59.3%), and a lower degree of identity with the aspartase of E. coli (37.2%). PMID- 3828495 TI - [Action of barium and potassium ions on fluctuations of the myocyte membrane potential in the rat papillary muscle]. AB - Using a common microelectrode technique membrane potential fluctuations (MPF) have been studied in experiments on the papillary muscles of rat cardiomyocytes. Parallel measurements of oscillations in resting tension (mechanical noise--MN) from the muscle ends were performed. A correlation between MPF and MN was absent in the control. After the addition of barium (0.2 mM) MPF increased, assumed a sinusoidal form and synchronized with MN. Membrane depolarization evoked by external current resulted in a similar effect. However, the depolarization induced by a high potassium dose (30 mM) was accompanied by MPF and MN decrease. The opposite effects of barium and potassium on MPF might be a result of their different influences on the muscle length constant (which is increased by Ba2+ and decreased by K+). PMID- 3828496 TI - [Effect of noradrenaline on reactive myocardial hyperemia in dogs]. AB - The effect of norepinephrine (NE) on reactive myocardial hyperemia (RH) after a brief (20 sec) flow arrest was studied in 9 closed-chest anesthetized dogs. NE infusion into the left ventricle resulted in the increase of RH peak during coronary flow and the elevation of the left ventricular pressure and its first derivative. The increased coronary dilatation may be explained by the activation of beta 1-adrenergic myocardial receptors. RH peak decreased later, with the coronary flow, left ventricular pressure and its first derivative returning to the control level. This RH decrease can be explained by the activation of alpha adrenergic receptors of the coronary vessels and the competition between alpha receptors for vasoconstriction and metabolic vasodilatation. PMID- 3828497 TI - [Water-soluble and membrane proteins of the central nervous system of the edible snail at different stages of long-term sensitization]. AB - An increase in the amount of water-soluble proteins with the mobility of 0.56 in polyacrylamide gel was observed in the snail central nervous system at the early stages of long-term sensitization of the defensive reflex. Such an increase seems to be associated with the enhanced motor activity and a rise in the excitation level at this stage. 2 hours, 1 day and 3 days after long-term sensitization a dramatic decrease in the amount of water-soluble proteins with the mobility of 0.54, 0.42, 0.40 and membrane protein with the molecular weight of 24000 kD was observed. Such a decrease appears to reflect the stage nature of long-term sensitization and to be linked with shifts in the functional characteristics of some cellular elements of snail central nervous system. PMID- 3828498 TI - [Antithrombin III inhibition of the reaction to thrombin excitation of the anticoagulation system]. AB - It has been established that intravenous administration of alpha-thrombin antithrombin III preparations (1 mkM) has practically no effect on anticoagulation parameters (thrombin time, additive fibrinolytic activity, nonenzymatic fibrinolysis and nonenzymatic fibrinolytic activity). Administration of 1 mkM of alpha-thrombin caused a statistically significant increase of all the parameters. The experiments on perfusion of the humorally isolated sinocarotid area of the rabbit with alpha-thrombin-antithrombin III preparations (1.25 mkM) showed no changes peculiar to the induction of anticoagulation response with thrombin. It is concluded that antithrombin III blocks the ability of thrombin to activate anticoagulation system function. PMID- 3828499 TI - [Interstrain differences in cellular glucocorticoid reception in mice and the degree of suppression of normal killer activity during immobilization stress]. AB - The correlation between the level of stress-induced natural killer (NK) depression and glucocorticoid binding to specific spleen cell receptors and hormonal profile in inbred mouse strains (CBA, BALB/c, C57BL/c, A/Sn) has been investigated. Stable interstrain differences in stress-induced natural killer activity and glucocorticoid receptor binding (Bm and Kd) have been revealed. It was demonstrated that the mechanism of NK activity depression during stress consists in genetically determined potential sensitivity of lymphoid cells to physiological fluctuations of glucocorticoid levels. This made it possible to identify stress-resistant and stress-sensitive mouse strains. PMID- 3828500 TI - [Intensification of human myocardial contractile activity as affected by blood serum]. AB - The effect of human serum diluted in Tyrode solution (1:1) on the cardiac contractility has been studied. Fragments of the right auricle myocardium from patients with congenital and acquired heart disease have been used to study serum effect on the contraction force. Myocardial strips were repeatedly stimulated with electrical impulses at a frequency of 0.1 to 1.5 Hz. All the perfusion solutions were maintained at 31-33 degrees C and Ca++ ion concentration was 2 +/- 0.2 mM/l. The serum increased the contraction force in the isolated myocardial fibers from patients with congenital and acquired heart disease. Positive inotropic serum action on the myocardium of patients with acquired heart disease was accompanied by a marked diminution of mechanical oscillations. At the same time human serum does not affect the form of force-frequency curves in both types of the preparations. The results suggest that human serum increases calcium ion homeostasis in the cardiac cells of patients during contraction-relaxation cycle. PMID- 3828501 TI - [Erythrocyte and microcirculatory functions during artificial circulation]. AB - Erythrocyte morphology, their aggregation ability and microcirculatory pattern in the mesentery of the small intestine have been studied stepwise on 12 dogs under artificial blood circulation. It has been shown that erythrocyte lesions followed by pathological aggregation play an important role in the pathogenesis of microcirculatory failure. Prolonged artificial circulation provokes structural reorganization in erythrocytes, thus affecting both blood rheology and gas exchange. PMID- 3828502 TI - [Smooth muscle function of the portal vein in spontaneously hypertensive rats]. AB - Increased contractility and adrenoreactivity of the portal vein smooth muscles were revealed in spontaneously hypertensive rats (SHR) only at the early stage of the disease. In stable hypertension the changes were milder both at the early and chronic stages. Portal vein smooth muscles were capable of contracting in low calcium medium, which suggests a membrane defect in the smooth muscles of animals with arterial hypertension. PMID- 3828503 TI - [Prenatal hydrocortisone modification of the adrenocortical function of adult rats with hereditary arterial hypertension]. AB - The adrenocortical function of adult normotensive (Wistar) and hypertensive rats with hereditary stress-induced arterial hypertension was studied after the injection of hydrocortisone to their mothers on the 16th and 18th days of gestation. Prenatal hydrocortisone treatment decreased adrenocortical reactivity to emotional stress or to intracerebroventricular injection of norepinephrine in adult Wistar rats, but did not modify the reaction to stress induced by bleeding, ether anesthesia or central stimulation with carbocholine. Hormonal treatment did not change the reactivity of rats with hereditary stress-induced arterial hypertension to both stress factors employed, enhanced it by intracerebral norepinephrine injection but decreased it by carbocholine intracerebroventricular injection. Thus, the interstrain differences in the modification action of the hormones were observed. These differences may be caused by peculiar brain organization of hypertensive rats, namely their decreased reactivity to norepinephrine. PMID- 3828504 TI - [Effect of visual cortex stimulation on lipid peroxidation in the rabbit retina]. AB - Chronic experiments on rabbits have shown that visual cortex stimulation resulted in intensified lipid peroxidation in the retina with the parallel decrease of electroretinogram amplitude parameters. The transsection of the optic nerve resulting in the elimination of retinal corticofugal inputs diminished the accumulation of lipid peroxidation products in the rabbit retina during light adaptation. Preliminary insertion of antioxidants to animals (vitamin E and ionol) prevents the inhibitory effect of the cortex on the function of the retina. The data obtained are discussed in view of possible involvement of lipid peroxidation in the retina into the realization of the regulating influence of the cortex on the function of the retina. PMID- 3828505 TI - [Biochemical and immunological changes in guinea pigs with experimentally reproduced amyotrophic leukospongiosis]. AB - Biochemical blood serum tests at different stages of amyotrophic leukospongiosis have shown differences in lactate and pyruvate levels as well as in lactate dehydrogenase activity, indicative of the increased oxidative exchange in sick guinea-pigs. It is suggested that intensified glycolysis is a compensatory adaptive reaction in response to hypoxia due to respiratory disorders (spinal type) and degeneration and death of motoneurons. Leukospongiosis was accompanied by the decline in the complement level in the blood serum and production of antibodies to nervous fiber proteins. PMID- 3828506 TI - [Thrombocyte aggregation in the plasma and whole blood and ATP secretion during hypoxia in cats]. AB - Platelet aggregation in platelet rich plasma and whole blood, as well as ATP secretion were studied during hypoxia in cats. A significant inhibition of collagen-induced aggregation in plasma and whole blood and ADP-induced aggregation in plasma alone with a parallel decrease of platelet ATP secretion were demonstrated. The data obtained are indicative of an important modulatory role of eicosanoids in the vascular wall interaction during hypoxia with a possible involvement of thromboxane A2. PMID- 3828507 TI - [Blood antioxidative enzymes during epileptic activity]. AB - It has been shown that the development of generalized epileptic activity in rats led to the decrease in superoxide dismutase (SOD) activity without affecting glutathione peroxidase (GP) and glutathione reductase (GR) activity. Long-term examination of 13 patients suffering from generalized forms of epilepsy has shown an about 30% decrease in SOD and GP activity in red blood cells. It is assumed that the functional insufficiency of the antioxidative system plays an essential role in the development of lipid peroxidation disturbances during epilepsy. PMID- 3828508 TI - [Effect of the lipid composition of liposomes on their clearance from the circulation and accumulation in the liver of mice]. AB - The effect of phospholipid and ganglioside liposome composition on the liposome clearance from the circulation and accumulation in the mouse liver has been studied. It has been shown that liposomes constituting of liver lipids are quicker removed from the circulation and accumulated in the liver. Liver gangliosides increased liposome uptake by the mouse liver and their clearance from the circulation. PMID- 3828509 TI - [The chemical nature of the fluorescing products accumulating in the lipids of the crystalline lenses of mice with hereditary cataract]. AB - The content of diene conjugates (lipid hydroperoxides) was shown to be significantly higher in lipids extracted from the lenses of mice with hereditary cataract than in the controls. The same holds true for characteristics of fluorescence of the end-product of lipid peroxidation. Two (low- and high molecular weight) peaks were detected in chromatographic lipid profile of cataract lenses measured by fluorescence on Sephadex LH-20 column, whereas only one (high-molecular weight) peak was found in lipids from normal lenses. It was established that high-molecular weight fluorescent fractions corresponded to lipid components of lipofuscin-like pigments. NMR and mass spectrometry of low molecular weight fractions suggested that they contained predominantly products of free radical oxidation of long chain polyunsaturated fatty acids (C22:6). PMID- 3828510 TI - [Quantitative changes in Cu, Zn-superoxide dismutase and catalase isolated from the liver of alloxan diabetic rats]. AB - The contents of Cu, Zn-superoxide dismutase and catalase isolated and purified from the rat liver at the terminal stages of alloxan diabetes were decreased by 40% and 15%, respectively, as compared to the control. It can be concluded that the decrease in superoxide dismutase and catalase activity in experimental alloxan diabetes is mainly connected with the decline in the content of these proteins at the terminal stages of the disease, this, probably, being the result of DNA degradation and RNA transport disturbances under the effect of oxygen active forms. PMID- 3828511 TI - [Diagnostic importance of determining leucine aminotransferase activity in acute pancreatitis]. AB - It has been experimentally and clinically established that the determination of leucine-aminotransferase activity in the blood serum and abdominal exudate may serve as a marker for the early determination of pancreonecrosis and edematous (serous) pancreatitis. PMID- 3828512 TI - [Isolation of Ca/Mg-dependent endonuclease of cell nuclei as the basic component in the chromatin nuclease complex of human lymphocytes]. AB - Highly purified preparations of Ca/Mg-dependent cell nuclear endonuclease have been obtained from human spleen lymphocytes. The purification was 2000-fold, and the enzyme was a polypeptide with a molecular weight of 57-54 kD. The study of its binding with monoclonal antibody enzyme, produced by various hybridoma strains obtained upon the immunization of mice with non-fractionated nuclear extract has shown that Ca/Mg-dependent endonuclease was the best expressed endonuclease of lymphocyte cellular nuclei. Possible production of some other cell nuclear endonucleases during processing of CH/Mg-dependent endonuclease is suggested. PMID- 3828513 TI - [Interaction of isolated brain synaptic vesicles with flat bilayer membranes in the rat]. AB - The conductivity of planar bilayer membrane comprising asolectin and phosphatidylserine (concentration ratio 9:1) in a buffer solution increased sharply in the presence of synaptic vesicles (SV) isolated from the rat brain and added to one side of the membrane only. The bilayer remained stable upon modification, and the conductivity increment was dependent on SV concentration in the range from 4 to 16 mu of the total protein per ml. If I mM CaCl2 was present in the buffer solution, the conductivity increased by 2 to 3 orders of magnitude upon the addition of SV at a final concentration of 3-4 mu protein per ml. The membrane was unstable and its rupture occurred often at an early stage of conductivity changes. In the absence of SV addition the membrane was stable, with its conductivity remaining unchanged for 2 h and more. With I mM CaCl2 addition to the solution already containing SV, no conductivity changes were observed, the cause perhaps, being Ca2+-induced SV aggregation. PMID- 3828514 TI - [Effect of the hexapeptide dalargin on ornithine decarboxylase activity in the duodenal mucosa of rats in experimental duodenal ulcer]. AB - The effect of an opioid antiulcerogenic hexapeptide dalargin on ornithine decarboxylase activity of duodenal mucosa has been studied in rats with experimental duodenal ulcers induced by cysteamine. The intraperitoneal injection of 12.5 micrograms/kg of dalargin inhibited ulcerogenesis and activated the enzyme. The effect of the peptide was antagonized by an opiate antagonist naloxone. 5000 micrograms/kg of dalargin failed to inhibit the ulcer formation or to activate ornithine decarboxylase. Since ornithine decarboxylase activation is a marker of intensified cell proliferation and tissue regeneration, our results suggest that the antiulcerogenic effect of dalargin is due to the enhancement of duodenal mucosa regeneration. PMID- 3828515 TI - [Behavior of the nucleolus organizer regions of the chromosomes in polykaryocytes consisting of micronuclei]. AB - The nucleolar organizer regions (NORs) of Chinese hamster chromosomes (clone 237, cell line BIId-ii-FAF28) were studied in mononuclear cells and polykaryocytes induced with colcemid. The chromosomes with NORs were marked as 1, 2, 3, 4. The activity of NORs in mononuclear cells was higher in chromosomes 1, 2, 3. The associations of NORs were observed between chromosomes I and 2 (3% of all metaphases). In polykaryocytes the chromosomal pairs 1, 2, 3 showed different NOR activity in different metaphases. The associations of NORs in pairs of chromosome I were found in 51.3% of cases. The associations of NORs in pairs of chromosome 2 were observed in 7.5% of cases. This method may be used for the estimation of association potency of NORs in chromosomes. PMID- 3828516 TI - [Comparative study of methods for the quantitative assessment of the C-segment size of human chromosomes]. AB - The possibilities of comparison and reproducibility of results of estimation of the absolute dimensions of chromosomal C-segments measured by different methods have been studied. The data obtained indicate good comparability of the results obtained by all the methods in a definite range of chromosome condensation. All the methods demonstrated satisfactory reproducibility of the results on chromosomes 1 and 9. The errors of the quantitative estimation of chromosome 16 in the coupled cultures is discussed in view of the artefact nature of C-segment size variability. PMID- 3828517 TI - [Changes in the nature of the estrous cycle and gametogenesis during superovulation stimulation in rats at different stages of the cycle]. AB - Estrous cycle, ovulation rate and gamete quality were studied in rats with superovulation induced on different days of the cycle. It was shown that the rat ovaries in estrous were most sensitive to the action of gonadotropins. Heterogeneity in the ovulation rate was noted in animals at the same phase of the cycle. There was a relative increase in the number of gametes with chromosomal alterations in experimental rats, with the value depending on the stage of the cycle when PMS was injected. The study of the estrous cycle in rats with superovulation induced on different days of the cycle has revealed strong hormonal influences on the sequence of stage alterations. PMID- 3828518 TI - [Effect of a calcium channel blocker on the hypophyseal secretion of luteinizing hormone in intact and castrated rats of both sexes]. AB - The effect of verapamil on luteinizing hormone secretion by pituitary body was studied in normal and castrated male and female rats. Intragastric verapamil administration at a dose of 10 mg/g body weight two hours prior to decapitation decreased luteinizing hormone serum and pituitary levels in female rats only in proestrus. It is suggested that preovulatory luteinizing hormone secretion depends partially on estradiol-stimulated calcium transport. PMID- 3828519 TI - [Clonal nature of fibroblast colonies formed by stromal bone marrow cells in culture]. AB - The clonal nature of CFUf-derived fibroblast colonies was tested in mixed cultures of CBA and CBAT6T6 bone marrow cells. Inoculation of marrow cell suspensions into flasks coated with poly-I-lysin has proved that no stromal aggregates were present among cells subjected to explantation. Marrow cell cultures depleted of macrophages and myeloid cells were used for chromosome analysis. The coincidence of karyotypes within a stromal colony was found in mixed cultures, which proves that CFUf-derived fibroblast colonies are cell clones. PMID- 3828520 TI - [Chromatin matrix activity in Purkinje cells and granular cells of the rat cerebellar cortex during postnatal differentiation]. AB - Moore's method used for the examination of chromatin template activity in Purkinje and granule cells of 7, 14, 30 days and 3 months old rate cerebellar cortex has shown the age-dependent changes during differentiation period. The histograms for Purkinje cells have demonstrated that all neurons were distributed into 3 groups of activity according to their nuclear labelling. The cell percentage in each group varied during ontogenesis. PMID- 3828521 TI - [Ultrastructure of the sinus and atrioventricular nodes in experimental myocardial infarct]. AB - The ultrastructure of sinus and atrioventricular nodes was studied in white rats with experimental myocardial infarction. 24 hours after the induction of the disease mitochondrial enlargement characterized by the increase in their area, decrease in the number of cristae and the decline in the rate of mitochondrial energy effectiveness was detected. Different degrees of nuclear chromatin aggregation and membrane permeability for colloidal lanthanum were observed. Characteristic types of conduction cellular lesions were revealed in experimental myocardial infarction. PMID- 3828522 TI - [Characteristics of the intrapulmonary cytogram in compensatory lung hypertrophy]. AB - Bronchoalveolar lavage (BAL) was performed on days 1, 3, 5 after left-side extirpation of the lung in albino random-bred adult male rats. BAL cell composition was studied. Compensatory lung growth was shown to be accompanied by restoration of BAL total cell number. BAL comprised 81.7% of macrophages, 15.6% of neutrophils and 2.5% of lymphocytes. The number of neutrophils was high (over 20%) in animals with postoperative pneumonia. PMID- 3828523 TI - [Mast cell population in rats with experimental atherosclerosis]. AB - Mast cell population was studied in rats with experimental atherosclerosis. It has been established that animals kept for 8 months on atherogenic diet revealed marked changes in mast cell population. Predominance of light cells and cell defects were noted. Heparin saturation index was reduced (0.35), as compared to the control (3.9). Stimulation of anticoagulation system by DIP-alpha-thrombin in such animals revealed no heparin in the blood. Mast cell subpopulation was characterized by light cell predominance and low heparin saturation index. The nature of cell degradation remained unchanged. The data obtained indicate the defects in mast cell pool in animals with experimental atherosclerosis. PMID- 3828524 TI - [Cytological mechanisms of the development of mucosal candidiasis after exposure to a steroid aerosol preparation]. AB - Mucosal candidosis was induced in CBA mice by intraoral inoculation following treatment with corticosteroid-containing aerosol (beclomethasone dipropionate). Histologically, in hormone treated mice the adherence of the pathogen to the mucosal surface was found during the first hours after inoculation. This is followed by the formation of the germ tubes and invasion in the epithelial layer. Pseudomycelial invasion in the malpighian layer is accompanied by the leukocyte response that limits the further spread of the fungal cells. In intact mice, the inoculation is not followed by the effective attachment of the fungal cells to the mucosal surface and induction of mycotic lesions. In vitro experiments have demonstrated the enhanced adherence of fungal blastospores to the epithelial cells of the hormone treated animals, that appears to be one of the mechanisms in the pathogenesis of candidosis in these animals. PMID- 3828525 TI - [Role of impaired regeneration of the mucosal epithelium in the pathogenesis of acute ulcers of the stomach and small intestine]. AB - The method of modelling of acute gastric and small intestinal ulcers by intraperitoneal administration of vincristine at a dose of 0.15-0.30 mg/kg body weight is suggested. The method is based on the property of vincristine to stop mitotic cell division at the stage of metaphase, thus impairing regeneration of the epithelium in the stomach and small intestine. The experiments on 20 dogs have shown that single vincristine administration caused the accumulation of cells with nuclei at the stage of metaphase in the generative areas. Mucosa defects formed at these sites acquired all the features of acute ulcers by the third day. The model demonstrates the pathogenetic role of impaired mucous epithelium regeneration and permits the studies of pathogenesis of acute ulcer formation. PMID- 3828526 TI - [Effect of short-term adaptation to hypoxia on the development of acute cerebral circulatory disorders in rats genetically disposed to epilepsy]. AB - The exposure of KM rats genetically predisposed to autogenic convulsive fits, to hypobaric hypoxia had a protective effect on the extension of cerebrovascular disorders in conditions of acoustic stress, reducing the severity of motor disorders and the degree of intracranial hemorrhage (subdural, subarachnoidal, intraventricular). PMID- 3828527 TI - [Histochemical study of reverse reactions in experimental leprosy in armadillos]. AB - Morphological and histochemical characteristics of reverse reactions in M. leprae infected armadillos are reviewed. The reverse reactions develop in generalized lepromatous disease and are characterized by a dramatic decrease in mycobacterial macrophage load and the appearance of lymphocytes, epithelioid and giant multinuclear cells with peripheral nucleus distribution. Histochemical investigation has shown a decrease in the activity of redox enzymes and alpha naphthyl acetate esterase and an increase in beta-glucuronidase activity. The reverse reactions in the liver are accompanied by hepatic granuloma and hepatocyte destruction. PMID- 3828528 TI - Erythropoietic repopulating ability of stem cells from long-term marrow culture. AB - Hemopoietic precursors are heterogeneous with respect to their capacity for self renewal and long-term repopulating ability. Bone marrow cultures produce a variety of precursors over many weeks, including CFU-S; however, it is important to determine whether these populations retain the functional ability shown by fresh marrow. The most primitive precursor or stem cells have the most long-term repopulating ability. We here describe direct measurements of this ability in cells from marrow cultures by using competitive repopulation assays. Cultured adherent cells repeatedly showed less capacity than fresh marrow cells to repopulate erythropoiesis in irradiated recipients, whereas cultured suspension cells consistently had less capacity than adherent cells. Concentrations of macroscopic CFU-S measured at nine or 12 days were similar in cultured adherent and suspension cells and generally lower than those in fresh marrow. In every experiment, the long-term repopulating ability of the marrow cells used was substantially reduced after transfer into tissue culture. Thus, primitive stem cells may not proliferate in such cultures despite extensive production of CFU-S and more differentiated cell types. PMID- 3828529 TI - Megakaryocyte morphogenesis stimulated in vitro by whole and partially fractionated thrombocytopenic plasma: a model system for the study of platelet formation. AB - Isolated guinea pig megakaryocytes were cultured in the presence of plasma from normal or thrombocytopenic rabbits. Thrombocytopenic but not normal plasma stimulated formation of long cytoplasmic processes and cytoplasmic fragmentation. Activity was found in the 60% to 80% ammonium sulfate fraction of thrombocytopenic plasma but not in the 0% to 60% fraction. The 60% to 80% fraction of normal plasma contained a small amount of activity. Both colchicine and vincristine inhibited the morphogenesis stimulated by thrombocytopenic plasma. Cytochalasin B and D both mimicked the thrombocytopenic plasma-induced morphological change and affected more megakaryocytes than did the thrombocytopenic plasma. Cytochalasin and thrombocytopenic plasma together had a synergistic effect, causing many megakaryocytes to form processes and break into cytoplasmic fragments 3 to 6 microns in diameter. Immunofluorescence staining with antitubulin antiserum showed that cytoplasmic processes formed in the presence of thrombocytopenic plasma contain microtubules and that fragments released by the megakaryocytes contain microtubule rings. A model for the cytoskeletal basis of platelet formation is proposed. PMID- 3828530 TI - Sardinian delta beta zero-thalassemia: a further example of a C to T substitution at position -196 of the A gamma globin gene promoter. AB - Selective overexpression (50- to 100-fold) in adult erythroid cells of either G gamma or A gamma fetal globin gene is observed in hereditary conditions known as delta beta zero-thalassemia and hereditary persistence of fetal hemoglobin (HPFH). Recently, a C----T change at position -196 of an overexpressed A gamma globin gene from an Italian HPFH was hypothesized, on the basis of indirect evidence, to represent the cause of the functional defect. We now show that the same mutation is present in a different overexpressed A gamma-globin gene from a Sardinian patient with a different syndrome (delta beta zero-thalassemia). The Sardinian A gamma globin gene differs from both the HPFH and the normal A gamma globin gene at nucleotide 1,560 in the noncoding portion of the third exon, where an A is deleted. In addition, the mutant -196 A gamma-globin gene is linked to a normal beta globin gene in HPFH, and to a beta-thalassemic gene (beta 39CAG--- TAG) in delta beta zero-thalassemia. These data strengthen the suggestion that 196 mutation is causally linked to the abnormal phenotype and raise the question of whether the same or multiple mutational events are responsible for the appearance of the -196 mutation in different syndromes. PMID- 3828531 TI - Identification of a functional role for human erythrocyte sialoglycoproteins beta and gamma. AB - Four distinct erythrocyte membrane sialoglycoproteins (SGPs) denoted alpha, beta, gamma, and delta have been described, but their functions have not yet been defined. Recent evidence suggests that several of these SGPs associate with membrane skeletal proteins. Because the membrane skeletal protein network plays an important role in regulating the membrane material properties of deformability and mechanical stability, we wanted to determine whether the SGPs, through their interaction with the membrane skeleton, can modulate these membrane properties. We measured membrane mechanical stability and membrane deformability of erythrocytes that were deficient in either alpha, or delta or beta and gamma SGPs. Only erythrocytes deficient in beta and gamma SGP had altered membrane properties, as evidenced by marked decreases in both membrane mechanical stability (50% of normal) and membrane deformability (40% of normal). Erythrocytes deficient in either alpha or delta SGP had normal deformability and stability. Based on these data, we suggest that an interaction of beta and/or gamma SGP with the membrane skeleton plays a functionally important role in regulating normal erythrocyte membrane properties. PMID- 3828532 TI - Vitamin B12-responsive neonatal megaloblastic anemia and homocystinuria with associated reduced methionine synthase activity. AB - We present findings on an infant with neonatal megaloblastic anemia, homocystinuria, and neurologic dysfunction that included developmental delay and tonic seizures. There was no methylmalonic aciduria. Cyanocobalamin therapy was accompanied by complete hematologic and neurologic recovery, diminished homocystine excretion, and subsequently normal neurologic development. Cultured fibroblasts and lymphoblasts showed a reduced methionine synthase activity and a growth requirement for methionine. Cobalamin incorporation by the patient's lymphoblasts was normal, but the proportion of cellular methylcobalamin in the patient's lymphoblasts and fibroblasts were markedly reduced and that of adenosylcobalamin normal. The reduced methionine synthase activity was independent of assay reducing (thiol) conditions, but normal levels of activity accompanied culture of the patient's lymphoblasts in medium with markedly increased cobalamin concentration. The characteristics of the reduced methionine synthase of our patient differ significantly from that of the previously described infant with cobalamin E disease and suggest that genetic heterogeneity may characterize this mutation. PMID- 3828533 TI - The molecular basis of beta-thalassemia in Lebanon: application to prenatal diagnosis. AB - A study of the molecular lesions of beta-thalassemia in Lebanon revealed the presence of eight different mutations in 25 patients with Cooley's anemia. The IVS1 position 110 mutation predominated with a frequency of 62% and was almost invariably associated with Mediterranean chromosome haplotype I. Five other mutations commonly found in the Mediterranean area occurred with frequencies of 2% to 8%. In addition a G----C substitution in IVS1 position 5 (a lesion previously found in Chinese and Asian Indians) was demonstrated in a patient with Mediterranean haplotype IX. A new mutation at codon 29 was found in two other patients with haplotype II. The characterization of these beta-thalassemia mutations should allow the implementation of a prenatal diagnosis program in that country. PMID- 3828534 TI - Localization of chlorotetracycline fluorescence in human polymorphonuclear neutrophils. AB - Chlorotetracycline (CTC) has been used in many cells as a probe for membranous calcium. In polymorphonuclear neutrophils (PMN), the changes in CTC fluorescence upon stimulation are considered to monitor an early event in the activation process. Using quantitative video-enhanced microscopy, we report that in resting cells about 80% of the CTC signal emanates from the perinuclear region of the cell, indicating that internal structures are labeled with CTC. Approximately 20% of the total CTC fluorescence is taken up in a compartment sensitive to mitochondrial inhibitors, which is not present in neutrophils depleted of nucleus and granules or cytoplasts. Upon stimulation PMN loaded with CTC exhibit a rapid, biphasic decrease in fluorescence that is dose dependent. The second phase of the response is not seen in neutrophil cytoplasts. These results suggest that internal stores of CTC are responsive upon stimulation and could account for the later decrease in CTC fluorescence, whereas the early phase of CTC changes represents the plasma membrane response. PMID- 3828535 TI - Monocyte adhesion to subendothelial components. AB - Human monocytes have been shown to penetrate the endothelial layer of large blood vessels and to adhere to the subendothelial basement membrane. To determine the active components of this process, we have studied the ability of monocytes to adhere to isolated components of the subendothelial matrix. Using a quantitative dot-blot adhesion assay, we find that monocytes adhere preferentially to immobilized laminin and elastin. The monocytes adhere less well to fibronectin and bind poorly or not at all to collagen types I and IV, or to heparan sulfate. Monocyte binding to elastin requires an intact, crosslinked molecule as no binding was observed to soluble, acid-alcohol elastin extracts, to pepsin or elastase digests of elastin, to tropoelastin monomer, or to desmosine/isodesmosine crosslinks. Similar binding profiles to elastin, laminin, and fibronectin were seen with the established human leukocyte cell line U937. The promyelocytic cell line HL60 adhered equally well to laminin but showed slightly reduced adhesion to elastin when compared with the fresh monocytes or U937 cells. Freshly isolated human erythrocytes did not demonstrate significant adhesion to fibronectin, laminin, or elastin. PMID- 3828536 TI - Impaired nicotinamide adenine dinucleotide synthesis in pyruvate kinase-deficient human erythrocytes: a mechanism for decreased total NAD content and a possible secondary cause of hemolysis. AB - Erythrocytes from individuals with pyruvate kinase (PK) deficiency have approximately half the total (oxidized and reduced) nicotinamide adenine dinucleotide (NAD) of normal erythrocytes. In order to elucidate the mechanism(s) for the decrease in total NAD, we examined NAD synthesis in intact erythrocytes. It is demonstrated that NAD synthesis is impaired in PK-deficient erythrocytes to a degree that is dependent on the PK activity and adenosine 5'-triphosphate (ATP) concentration of these cells. After incubation in the presence of fluoride, which simulates the characteristics of PK deficiency by inhibiting enolase, normal erythrocytes had impaired NAD synthesis and decreased ATP concentrations. Fluoride did not inhibit NAD synthesis in a hemolysate system that is not dependent on glycolysis for ATP generation. These data suggest that fluoride does not inhibit the enzymes of NAD synthesis and that impairment of NAD synthesis by fluoride is mediated by decreased ATP formation. Thus, it is concluded that impaired NAD synthesis in PK-deficient erythrocytes is caused by decreased ATP formation due to the PK deficiency. Since the rate of glycolysis is limited by the availability of NAD+, it is suggested that impaired NAD synthesis causes further ATP depletion and thereby may enhance hemolysis in PK-deficient erythrocytes. PMID- 3828537 TI - Survival in vivo of platelets stored for 48 hours in the buffycoat at 4 degrees C compared to platelet rich plasma stored at 22 degrees C. AB - High speed centrifugation allows separation of whole blood into cell free plasma, a buffy coat and leukocyte poor red cells. The buffy coat can be used for the preparation of platelet concentrates. High lactate production at 22 degrees C requires storage of the buffy coat at 4 degrees C. Survival in vivo of platelet concentrates prepared from buffy coats stored at 4 degrees C for 48 h (BC-PC) was compared with the survival in vivo of platelet concentrates from platelet rich plasma stored at 22 degrees C for 48 h (PRP-PC). Both methods were studied in the same healthy volunteers (n = 8) using 51Cr labeled autologous platelets. The mean +/- SD recovery 15 min after reinfusion of the BC-PC was 30.5% +/- 13.3% and for PRP-PC 41.4% +/- 7.9% (p less than 0.0001). The survival in vivo for BC-PC was 2.4 days +/- 0.4 days and for PRP-PC 7.0 days +/- 1.4 days (p less than 0.0001). Since the survival in vivo is significantly less for platelets derived from the buffy coat stored at 4 degrees C, we advocate storage of platelets at 22 degrees C. PMID- 3828538 TI - Comparison of posttransfusion recoveries achieved with either fresh or stored platelet concentrates. AB - The effectiveness of platelet concentrate transfusion depends on such variables as blood bag material, donor--recipient compatibility, and time elapsed between donation and transfusion. To study the latter a corrected thrombocyte increment for recovery in the recipients was evaluated with 108 platelet transfusions in 31 patients. In 83 treatment programs, the mean recovery at the one-hour post transfusion time point was 8.6 X 10(9) platelets/l with fresh platelets and 5.9 X 10(9) platelets/l with stored platelets. Significantly better recovery was achieved with freshly prepared platelet over the total of platelet concentrates stored for up to 96 hours; however, if the recoveries in different patient groups given stored platelets were considered separately in terms of storage times of up to 48 h or 48-96 h, the good recovery with fresh platelets was significantly better only when compared to the older (p = 0.034) but not to the younger group of stored platelets. In patients with signs indicating enhanced platelet destruction (fever, splenomegaly, disseminated intravascular coagulation) the transfusion with fresh platelet concentrates gave a significantly better recovery compared to stored platelet concentrates (p = 0.028), whereas in the absence of such signs the recovery produced by fresh concentrates was not significantly higher than with stored concentrates. These findings may be relevant for the logistics in blood banking. PMID- 3828539 TI - The prognostic significance of cytological, histological and cytogenetic findings in refractory anaemia (RA) and RA with sideroblasts. A follow up study. AB - Two independent observers performed a double review of cytological and histological bone marrow material obtained at diagnosis and during follow up in 34 patients with the myelodysplastic syndrome (MDS), subtypes refractory anaemia (RA) and RA with ringed sideroblasts (RA-S) (26 and 8 patients, respectively). Average values were used for the analyses. Data obtained at diagnosis confirmed earlier observations that a worse prognosis was indicated by high blast cell counts (P less than 0.01), presence of blast foci and clonal cytogenetic abnormalities (P = 0.08). Data obtained during follow up, in addition, showed that an increased probability of progression to FAB-subtype RA with an excess of blasts was related to both the occurrence of blast foci (P less than 0.05) and the occurrence of new or additional clonal abnormalities (karyotype shift) (P less than 0.01). The relationship between parameters investigated at diagnosis, during follow up, and in the pooled material, points to RA-S being a separate entity having a better prognosis than RA, and further substantiates an earlier observed relationship between blast cell accumulation and the frequency of cytogenetically abnormal metaphases. PMID- 3828540 TI - Fluid trapping of erythrocytes under hypoosmolar conditions. AB - 125I albumin was used to assess the amount of trapped fluid after microhematocrit centrifugation of erythrocytes suspended in buffers of different osmolality. Surprisingly the total amount of trapped fluid per volume unit of packed erythrocytes decreased with decreasing osmolality of the suspending buffer despite erythrocyte swelling. However, if the contribution of the individual erythrocyte to the trapped fluid was calculated, the trapped fluid per erythrocyte did not change between 311 mosm/kg and 256 mosm/kg. For osmolalities below 256 mosm/kg a significant increase of trapped fluid was obtained. It is concluded that the packing ability of erythrocytes is not impaired in suspending fluid of moderate to severe infraphysiological tonicity. The daily clinical experience that considerable degrees of plasma hypoosmolality are tolerated in vivo without hemolysis or impairment of oxygen transport by erythrocytes may be explained by the excellent ability of shape adaptation of erythrocytes to each other and to other surfaces such as vascular endothelia. The method of trapped fluid determination might be of potential value as a complementary method in the evaluation of erythrocyte rheology if the amount of trapped fluid is related to the individual erythrocyte. PMID- 3828541 TI - Bronchial challenge: ventilation during 'tidal volume breathing' inhalation is not constant. AB - Standardization of bronchial challenge (BC) in order to improve repeatability of both non-specific and specific challenges is desirable. In the tidal volume breathing BC (tBC), the patient inhales bronchoconstrictor during the entire inspiratory phase of the tidal volume breathing. We determined 2 min ventilation (VE) at each histamine concentration during 187 BCs. Thirty-four patients were challenged twice. We used a standard technique (Cockcroft), except for our patient operated Pari nebulizer. Between-subject (SD = 37%) as well as within subject (SD = 21%) (p less than 0.01) variations in VE were observed. Furthermore, VE during inhalation of threshold dose (VE-threshold) was smaller than VE during inhalation of the previous dose (VE-threshold-1) (p less than 0.001). For paired differences in VE during two challenges, the within subject SD was 21%. The between subject SD for VE was 32%. VE-threshold was lower in first challenge (p less than 0.001). VE threshold in both challenges was significantly lower than VE-threshold-1. These observations indicate that the respiratory pattern during tBC needs further standardization and that respiratory frequency and inspiratory time during tBC would be worth investigating. PMID- 3828542 TI - [Comparative in vitro and in vivo study of several long-acting theophyllines]. AB - This study describes the comparative in vitro and in vivo release of six slow release formulations. In vitro, with half-change method, differences appear in the profiles, some formulations showing a linear release (Dilatrane, Euphylline LA, Theostat), the others an irregular release with 'plateau' related to the pH gradient (Armophylline, Cetraphylline, Theolair). In vivo, at steady state, the fluctuations are less important and the comparative kinetic study in ten normal healthy volunteers after chronic oral dosing of six different formulations show a slight variability in the theophylline release during 12 h. Great interindividual variations appear with all formulations. In fact, none of the formulations present an ideal release over a 12 h period. PMID- 3828543 TI - Improvement of gas exchange during inhibition of hypoxic pulmonary vasoconstriction by nitrendipine in piglets. AB - To determine how nitrendipine (N), a calcium antagonist, interferes with haemodynamics and gas exchange during hypoxia, we studied 12 piglets (4-6 weeks, 4.3-9.0 kg) anaesthetized with pentobarbital (20 mg.kg-1 i.p.). Haemodynamics, blood gases and multiple inert gas elimination were measured at the end of three consecutive 30 min periods of spontaneous breathing: room air (RA), 11-12% FIO2 (H) and 11-12% FIO2 with a randomly selected infusion of N (3 micrograms.kg-1.min 1) (HN) or the carrier solution (HP) (6 animals in each group). Pulmonary vascular resistance (Rpv) doubled from 8.7 +/- 2.8 mmHg.min-1.1-1 in RA to 19.5 +/- 10.0 (mean +/- SD) in H while PaO2 fell from 83 +/- 8.3 mmHg to 28.7 +/- 5.2. With N, Rpv fell back to room air value: 8.7 +/- 2.0 (p less than 0.02; comparison H and HN), while PaO2 rose from 29.3 +/- 6.3 mmHg in H to 46.1 +/- 6.1 HN (p less than 0.001) and PaCO2 fell from 33.8 +/- 10 to 23.9 +/- 3.7 mmHg. There was a small non-significant rise in VE. Haemodynamics and blood gases of the placebo group were not statistically different in H and HP. No extrapulmonary shunting was evidenced during any experimental period. The perfusion to lung zones with VA/Q lower than 0.005 rose from 1.1 +/- 2.1% in RA to 8.9 +/- 5.7% in H, but no further increase was obtained with N: 5.1 +/- 2.5%. Overall VA/Q matching did not deteriorate with N during hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828544 TI - Measurement of right ventricular ejection fraction with krypton-81m in chronic obstructive pulmonary disease. AB - Thirty patients with chronic obstructive pulmonary disease (COPD) and 15 healthy volunteers have been studied to assess the value of measuring right ventricular ejection fraction (RVEF) at rest with a perfusion of krypton-81m (81mKr). With this perfusion, equilibrium RVEF can be measured in a 30 degrees right anterior oblique projection, avoiding a superimposition of cardiac cavities. The average RVEF of the patients with COPD was significantly lower than that of the normal patients (36.3 +/- 9.3% vs 52.6 +/- 3.9%; p less than 0.001). An inverse linear relation was found between mean pulmonary artery pressure (Ppa) and RVEF (r = 0.543; p less than 0.01). The RVEF in a group of 15 patients with COPD and pulmonary hypertension (Ppa greater than 20 mmHg), averaged 30.4 +/- 7.26%, which was significantly lower than that of the other 15 COPD patients with normal Ppa, whose RVEF averaged 42.3 +/- 7.1% (p less than 0.01). Taking a RVEF value less than or equal to 35% as an indicator of pulmonary hypertension, the sensitivity was 80% and specificity was 75%, the predictive value for a positive test was 75%, and for a negative test was 80%. A positive but weak correlation was found between RVEF and PaO2 (r = 0.52; p less than 0.01), SaO2 (r = 0.41; p less than 0.05) and the forced expiratory volume in one second (FEV1) (r = 0.40; p less than 0.05). No correlation was found between RVEF and prior history of right cardiac insufficiency, PaCO2, pH, the ratio FEV1/vital capacity, ECG signs of cor pulmonale and left ventricular ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828545 TI - Cardiovascular and respiratory consequences of tension pneumothorax. AB - The physiologic responses to acute pneumothorax were investigated in awake, standing sheep. Pleural pressure (Ppl) was raised in graded increments by injecting air from a 500 ml syringe into the pleural cavity of eight sheep to produce pneumothorax volumes of 0, 17, 35 and 45 ml.kg-1. At the maximum value of 45 ml.kg-1 (approximately equal to 1,400 ml), Ppl at end-expiration was raised to 10 +/- 2 mmHg (mean +/- SD) whereas end-inspiratory Ppl remained negative in half the sheep as the result of increased thoracic pressure swings. The most striking haemodynamic impairment was a 22% fall in stroke volume. Cardiac output, however, remained fixed at baseline values as a result of a 28% rise in heart rate. Although hypotension has been commonly held as a consequence of severe pneumothorax, mean systemic arterial pressure increased, rising by 19% in the entire group at the maximal pneumothorax tolerated. Pulmonary gas exchange was significantly disrupted by pneumothorax, as indicated by both a 40% fall in Pao2 and a 19% reduction in arterial oxygen content. Despite a reduction in tidal volume, the sheep initially remained eucapnic by generating an increased respiratory rate and slightly increasing minute-ventilation. However, at pneumothorax volumes of 45 ml X kg-1, the sheep were no longer able to sustain minute-ventilation and a small rise in PaCO2 followed. The reduced arterial oxygen content and the fixed cardiac output led to a progressive reduction in systemic oxygen transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828546 TI - [Short-term tracheobronchial clearance in apparently pure Gougerot-Sjogren syndrome]. AB - Bronchopulmonary involvement in the Sjogren syndrome can lead to distal obstructive airway disease. This syndrome induces a decrease in secretions which become rare and thick, and consequently a slowing down of mucociliary activity. This activity, which can be estimated by tracheobronchial clearance studies, was investigated in seven non-smoking women (mean age = 56.7 yr) with the Sjogren syndrome but without patent distal bronchial impairment. After oral inhalation of radioactive particles labelled with 111In during spontaneous breathing (MMAD = 3 micrograms; sigma g = 1.4; energies gamma 173 and 247 keV, radioactive half-life = 2.8 days), the incorporated radioactivity was measured by a gamma-camera at the end of inhalation and then every 5 min throughout 90 min and 2, 4, 5, 6 and 24h thereafter. Biological decrease in radioactivity was exponential in form. Considering, as may authors do, the clearance of the tracheobronchial compartment to be completed within 24h, we calculated an initial biological period corresponding to the beginning of this clearance. It was equal to 101 +/- 27 min in 12 normal subjects. It was normal in three of our patients (T = 90, 91 and 101 min) and longer for the four others (T = 178, 203, 240 and 304 min). We hypothesize that three of these four patients with slow clearance and normal penetration index (tracheobronchial deposition/pulmonary deposition) had bronchiolar involvement, creating anomalies in the mucociliary escalator which were undetectable by clinical, radiological or functional examinations. These results argue in favour of strict pulmonary surveillance in patients with altered short-term clearances to enable early detection of bronchiolar disease. PMID- 3828547 TI - Alveolar macrophage membrane phospholipid methylation in sarcoidosis and hypersensitivity pneumonitis. AB - Methylation of phospholipids seems to be an essential step in the recognition and transduction of regulatory signals by eukaryotic cells. Phosphatidylethanolamine methylation was compared in alveolar macrophage membrane from patients presenting with pulmonary sarcoidosis or hypersensitivity pneumonitis and control subjects. Phosphatidylethanolamine methyltransferase (PMT1) activity was determined by various measures of incorporation of tritiated methyl group from (3H) S-adenosyl L-methionine in membrane phospholipids. Tritiated methyl group incorporation in macrophage membrane was higher in some patients presenting with sarcoidosis or hypersensitivity pneumonitis, than in controls. PMT1 activity was found to be higher in sarcoidosis patients with a positive gallium lung scan. As lipids play an important role during macrophage activation and cell interaction, although a wide heterogeneity was observed in PMT1 activity, increased membrane phospholipid methylation seems to be an important feature in pulmonary diseases where macrophages are involved. PMID- 3828548 TI - Refractoriness after hyperventilation-induced asthma. AB - It is still debated as to whether the bronchospasm induced by hyperpnoea in asthmatic subjects is followed by a period of refractoriness to a subsequent challenge. We studied, therefore, the effect of repeated challenges with eucapnic hyperpnoea in asthmatic subjects and compared it to that in normal subjects. Ten normal and 34 asthmatic subjects were challenged twice with a steady isocapnic hyperventilation (25 l X min-1 X m-2 BSA for 6 min) of dry air at room temperature. The interval between challenges was 30 min in the normal subjects and was 30-60 min in asthmatic subjects to allow for full recovery of FEV1 before the second challenge. In the normal subjects, neither the first nor the second challenge caused a detectable change in FEV1. In the asthmatic subjects, the fall in FEV1 was on average less marked at 5, 8 and 10 min after the second challenge than after the first one (p less than 0.05 by analysis of variance). Analysis of data from individuals showed partial to full refractoriness in 14 of the 34 subjects. In no instance was the fall in FEV1 significantly greater after the second challenge than after the first one. Thirteen other asthmatic subjects were challenged twice at a 30-60 min interval with stepwise increases in ventilation of dry air at room temperature until wheezing or chest tightness occurred or a ventilation of 50 l X min-1 X m-2 BSA was reached.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828550 TI - Forced expiratory flow-volume curves during the application of lower-body negative pressure. AB - Ten normal subjects were studied during supine rest and quiet standing, and when exposed, supine, to lower-body negative pressure (LBNP) of 30, 40 and 50 mmHg, each for a period of 7 min, in random order. Their partial and complete flow volume curves, heart rate and blood pressure were recorded during the last 3 min in each condition. The expected reflex cardiovascular responses to the decrease in central blood volume during standing and during LBNP were seen. The forced vital capacity was somewhat greater during standing and during LBNP than while supine. The airflow variables measured from the flow-volume curve-except MEF25% (partial)--were significantly increased during progressive LBNP but did not reach the raised values found when the posture changed from supine to standing. The observations suggest that besides the redistribution of the central blood volume to the periphery, other factors must contribute to the increase in airflows during standing. PMID- 3828549 TI - Mean and instantaneous expiratory flows, FVC and FEV1: prediction equations from a probability sample of Michigan, a large industrial state. AB - Prediction equations for FVC, FEV1, FEV1/FVC, FEF25-75%, FEF75-85%, FEF50% and FEF75% were modelled for 396 normal non-obese adult lifetime nonsmokers and continuing smokers. Subjects came from a random cross-section of the white population of Michigan, a large industrial state. In both sexes, linear models utilizing age and height were appropriate for FVC, FEV1/FVC and FEV1; flows were better described by logarithmic transformation. These regression equations provided similar predicted values for FVC and FEV1 in nonsmokers to other models in wide use. Previous equations for instantaneous flows have yielded inconsistent predicted values. It is hoped that the present equations will be useful for these measurements. Duration of cigarette smoking was a significant prediction variable for FEV1, FEV1/FVC and mean and instantaneous flows in these normal men, but not in normal women. For FEV1, the effect of each year of smoking was 40% of the effect of ageing. PMID- 3828551 TI - The single-breath nitrogen test does not detect functional impairment in children with passive exposure to tobacco smoke. AB - Respiratory symptoms and pulmonary function were compared in 46 nonsmoking children aged 10 to 16 years, whose parents were smokers, and an identical number of children (matched for sex, age and height) whose parents were nonsmokers. Passive exposure to parental tobacco smoke resulted in a higher prevalence of respiratory symptoms, more frequent upper airway infections and a significant decrease in forced expiratory flows; these effects were more marked in boys. The single-breath nitrogen washout test, a sensitive test of small airways obstruction in adults, did not detect any effect of involuntary smoking in this limited sample of children. PMID- 3828552 TI - Spinability of respiratory mucous. Validation of a new apparatus: the Filancemeter. AB - Spinability is the ability of various biological fluids to be drawn into threads when stretched. This rheological parameter is of particular importance in the mucous transport process and can be easily measured using a newly commercialized apparatus: the Filancemeter. The measurement limits and the volumes of the samples used are presented. By studying the effect of sample volume on spinability, the importance of using well-calibrated samples is demonstrated. For the small volumes of sample (less than 5 microliters), the reproducibility of the measurement is low (coefficient of variation: 63% with 1 microliter sample), whereas it is significantly improved with larger volumes (coefficient of variation: 16% with 5 microliters sample). The measurements on respiratory mucous are in good agreement with the results obtained with a previous apparatus using a clip as a prehension system of the sample. With fluids exhibiting low viscosity like saliva, the higher values obtained with the Filancemeter can be attributed to a better prehension of the sample. This apparatus appears to be suitable for measuring the spinability of various biological fluids such as mucous. PMID- 3828554 TI - Methods for measuring total respiratory impedance by forced oscillations. PMID- 3828553 TI - Measurement of total respiratory impedance via the endotracheal tube; a model study. AB - The feasibility of applying the forced oscillation technique to determine the impedance of the respiratory system in intubated subjects was investigated on a model. This showed that the losses in kinetic energy occurring at the end of the endotracheal tube are not important when the flow is oscillatory (frequencies of 2 Hz and higher). Also, if the respiratory system is sufficiently linear, the alinearity of the tube can be dealt with if its mechanical characteristics, as well as the size of the oscillatory flow, are known. The tube impedance at that flow can then be subtracted from the total impedance of the tube connected to the respiratory system. When the driving signal is a complex wave containing several frequencies, the impedance of the tube can still be determined (and thus subtracted) by performing the measurements at various amplitudes of the driving flow and by extrapolating the resistance values (corresponding to those amplitudes) to zero flow. The latter is possible only if the measurements are performed during an apnea. To avoid these complexities, pressure can be measured at the outlet, rather than at the entrance of the tube. Accurate measurements of respiratory impedance can thus be obtained, whether the flow is determined at the entrance or outlet of the tube, even with a complex driving signal. PMID- 3828555 TI - Simulation in cancer research. Proceedings of a symposium/workshop/conference on Computer Modeling in Cancer Research. 6-7 January 1986, Durham, North Carolina, U.S.A. PMID- 3828556 TI - The role of simulation in biomathematical modeling. PMID- 3828557 TI - On mathematical modeling of critical variables in cancer treatment (goals: better understanding of the past and better planning in the future). PMID- 3828558 TI - A stochastic model for the origin and treatment of tumors containing drug resistant cells. PMID- 3828559 TI - Chemical carcinogenesis and toxicity models: matching complexity to objectives. PMID- 3828560 TI - Physiological pharmacokinetics. PMID- 3828561 TI - Cell kinetics simulation languages. PMID- 3828562 TI - Kinetic simulation of anticancer drug effects on metabolic pathway fluxes: two case studies. PMID- 3828563 TI - Use of the circuit simulation program SPICE2 for analysis of the metabolism of anticancer drugs. PMID- 3828564 TI - Cancer chemotherapy: optimal control using the Verhulst-Pearl equation. PMID- 3828565 TI - Future directions in computer simulation. PMID- 3828566 TI - Strategies for computer modeling. PMID- 3828567 TI - SCoP: an interactive simulation control program for micro- and minicomputers. PMID- 3828568 TI - Conference retrospective: an appropriate modeling infrastructure for cancer research. PMID- 3828569 TI - IgA-affinity purification and characterization of the lectin jacalin. AB - We describe the use of IgA-Sepharose 4B affinity chromatography to purify the lectin jacalin from saline extracts of Artocarpus integrifolia L. seeds. Elution with 0.8 M D-galactose provides 10-15 mg lectin/50 mg seed protein. Jacalin behaved like a single component on immunoelectrophoresis and a single, somewhat diffuse band was obtained by polyacrylamide gel electrophoresis (PAGE) at pH 4.5. A single peak corresponding to an apparent molecular weight of 43 kDa was obtained by gel filtration on Sephadex G-75 (10 mM phosphate buffered saline (PBS), pH 7.4). On SDS-PAGE +/- 2-mercaptoethanol two bands of apparent molecular weights 11.8 and 14.7 kDa were detected. Jacalin behaved like a protein of apparent molecular weight of 13-14 kDa on Sephadex G-50 eluted with PBS containing 0.2% SDS. These data indicate that the jacalin molecule consists of 3 4 non-identical polypeptide subunits not connected by disulfide bridges. The amino acid composition of IgA affinity-purified jacalin (mol/405 mol amino acids) is Lys (24), His (5), Arg (4), Trp (6), Asx (36), Thr (35), Ser (48), Glx (31), Pro (18), Gly (53), Ala (13), Val (25), Met (3), Ile (23), Leu (25), Tyr (30), Phe (26), which corresponds to a molecular weight of 44.163 kDa. PMID- 3828570 TI - On the dose equivalence of flurazepam and triazolam. AB - Flurazepam (30 mg), triazolam (0.5 mg) and placebo were given in the morning to 6 normal volunteers in a double-blind crossover study. Subjects were evaluated by a large battery of psychophysiological tests before and 1 and 5 hours after drug administration. Triazolam was significantly more sedative than flurazepam and both were significantly different from placebo. Slope-ratio assay analysis of the results from the present study pooled with those from a similar previous study (C. Gorenstein and V. Gentil, Psychopharmacology, 80: 376-379, 1983) indicated that these doses are non-equivalent. We suggest that dose-equivalence studies based on the present method should be carried out early in the development of new hypnotic drugs. PMID- 3828571 TI - Previous exposure to a novel experience enhances performance in two simple memory tests in humans. AB - Young healthy human volunteers (N = 52), non-amnesic patients (N = 53), and amnesic patients (N = 52) were submitted once a day on three consecutive days to two simple memory tests: recognition of the pictures of famous faces (actors, politicians, sports figures) cut from newspapers or news magazines, and the recall of the year in which widely publicized major events happened (the Pope's visit to Brazil, a famous fire that destroyed a block downtown, etc.). One, 3 or 6 h prior to testing either on the 2nd or the 3rd day, the subjects were exposed to one of the following experiences: staying in a room where they had never been before for 10 min, or a 5 min digit learning task to which they also had never been submitted. Exposure to either of the two novel experiences 1 or 3, but not 6, h before testing was followed by increased scores in both memory tests. PMID- 3828572 TI - The local origin of decidual cells in pregnant mice. AB - In order to evaluate the participation of extrauterine cells in the formation of mouse antimesometrial decidua, [3H]-thymidine was administered ip on days 1, 5 and 6 of pregnancy and the animals were killed 1 h afterwards. A second group of mice received four ip injections of [3H]-thymidine at 6-h intervals on the 1st day of pregnancy and were killed on the 2nd, 5th or 6th day of pregnancy. A third group of virgin mice in estrus received [3H]-thymidine ip four times at 6-h intervals and was killed 96 h after the first injection. Radioautographs of the uteri showed that few endometrial stromal cells were labelled on the 1st and 2nd day of pregnancy. Although many decidual cells incorporated thymidine on the 5th and 6th day of pregnancy in pulse-labelled animals, only few labelled decidual cells were found on the 5th and 6th day of pregnancy in animals that received several injections of thymidine on the 1st and 2nd day of pregnancy. These results indicate that the antimesometrial decidual cells that develop at the beginning of pregnancy are mostly of local origin. The short-term migration of extraneous cells into the uterus to participate in decidualization is not supported by these data. PMID- 3828573 TI - Effect of spermatic cord phenolization on the spermatogenetic and secretory activities of adult rat testes. AB - We evaluated the effect of testicular denervation on the spermatogenetic and secretory activities of the adult rat testis. Testes were denervated by applying 20% (v/v) phenol to the spermatic cord and measurements were made 30 days thereafter. There was an increase in the frequency of stages VII-VIII of the seminiferous epithelium cycle, indicating an increase in the relative amount of mature elongated spermatids present in the seminiferous tubules. The frequency of stage XIV remained unchanged, suggesting that the rate of reductional divisions was constant. A decrease in the nuclear volume of Leydig cells paralleled increased plasma LH and testosterone levels. The results are discussed in terms of a possible role of phenol-sensitive neural elements which affect testicular spermatogenetic and secretory functions. PMID- 3828574 TI - A new technique for the isolation of placental phagocyte cells and a description of their macrophage properties after in vitro culture. AB - We describe a method for the separation of phagocytic cells from human placenta by mechanical stirring for 2 h in the absence of proteolytic enzymes. About 60% of the cells were separated by adherence to glass. These adherent macrophage-like cells were able to ingest solid particles; 17% of them phagocytized opsonized sheep red cells and 96% ingested Staphylococcus aureus. IgGFc receptors were expressed in 22% of these cells and C3b receptors in 62% of them. Ultrastructural studies of adherent cells revealed different cells of varying shapes and sizes containing lysosomal granules, heterophagosomes and residual bodies. The cells were peroxidase-negative. PMID- 3828575 TI - Respiratory and acid-base parameters during salicylic intoxication in dogs. AB - This paper examines the mechanism responsible for hyperventilation and accompanying respiratory alkalosis during acute salicylism. Sodium salicylate (250 mg/kg) was administered to 8 spontaneously breathing anesthetized dogs (alpha-chloralose, 50 mg/kg, and urethane, 500 mg/kg, iv). The trachea was sectioned and connected to a pneumotachograph. A catheter was placed in the cisterna magna for sampling cerebrospinal fluid (CSF) and a femoral artery was cannulated for blood sampling and pressure determinations. Once the cardiorespiratory steady-state was obtained, air flow, tidal volume, arterial pressure, ECG and rectal temperature were measured for baseline control. The measurements were repeated 8 times during 100 min after salicylate infusion. Simultaneous determinations of CSF and plasma salicylate showed that plasmatic levels were maximal just after infusion, diminishing with time. CSF concentration increased gradually as the salicylate diffused through the blood-brain barrier. Minute ventilation increased to more than 600% of control values and was maximal between 60-100 min after salicylate infusion. Respiratory alkalosis and hyperthermia (up to 40.3 degrees C) followed the time-course of hyperventilation. Only a small part of hyperventilation can be attributed to the temperature increase. A high correlation coefficient (r = 0.974) was obtained by regression analysis of the values for ventilation and CSF salicylate. We conclude that the central action of salicylate is much more important for increasing ventilation than effects related to oxidative phosphorylation uncoupling. PMID- 3828576 TI - Distal nephron sodium handling by normal, nephrotic, pyelonephritic and partially nephrectomized rats. AB - The renal tubular handling of sodium was evaluated in 10 normal (N), 9 edematous nephrotoxic serum nephrotic (Ne), 9 pyelonephritic (Py) and 12 partially nephrectomized (Nx) Wistar rats during maximal free-water clearance induced by intravenous infusion of hypotonic sodium chloride solutions. Fractional deliveries of sodium to distal nephron [(CH2O + CNa)/GFR%] were similar (P greater than 0.05) in N (23.2 +/- 0.69%), Ne (24.3 +/- 1.30%) and Nx (26.9 +/- 2.6%) rats. However, the fractional distal sodium reabsorption [CH2O/(CH2O + CNa)%] was significantly higher (P less than 0.05) in Ne (76.8 +/- 1.80%) and lower (P less than 0.05) in Nx (33.3 +/- 3.1%) rats when compared to normal rats (50.3 +/- 1.80%). Py rats exhibited a higher fractional delivery of sodium to distal nephron (33.5 +/- 3.4%) and a lower fractional distal sodium reabsorption (35.9 +/- 5.9%) when compared to normal rats (P less than 0.05). These data suggest that the distal nephron, by altering sodium reabsorption, contributes to the maintenance of sodium balance in Nx rats, whereas in Ne rats the distal nephron generates a positive sodium balance and edema. At very low glomerular filtration rates (GFR), as is the case for Py rats, sodium balance is maintained both by the proximal and distal portions of the nephron. PMID- 3828577 TI - Extrathyroidal conversion of thyroxine to 3,5,3'-triiodothyronine in cold acclimated thyroxine-maintained thyroidectomized rats. AB - Chronic exposure of rats to cold (4 degrees C) leads to thyroid gland hyperactivity as a compensatory mechanism for activating body heat production. There is increased extrathyroidal production of T3 from T4 in parallel to thyroid hormone hypersecretion. Since the 5'-deiodination (5'-D) of T4 can be modulated by thyroid hormones, it has been suggested that the increased thyroid hormone secretion may activate the 5'-D enzymatic pathway leading to increased extrathyroidal T3 production. In an attempt to explore this possibility, T4 to T3 conversion was studied in liver and kidney homogenates of thyroidectomized rats which received T4 (0.5 to 50 micrograms/100 g body weight per day) for 10 days. Tissue homogenates were incubated with T4 (5 micrograms) for 2 h and the T3 generated was measured by RIA as an index of the activity of the 5'-D pathway. A direct relationship between T4 dose and the production of T3 by the homogenate was observed. 5'-D activity was significantly decreased in hypothyroid rats and greatly increased in hyperthyroid rats. Thyroidectomized rats treated with a replacement dose of T4 (1 microgram/100 g body weight/day) were exposed to 4 degrees C for 60 days. Despite the absence of the thyroid gland, increased 5'-D activity was observed in both liver and kidney homogenates compared to both intact and T4-treated thyroidectomized rats maintained at 25 degrees C. We conclude that chronic cold exposure of rats stimulates 5'-D activity which is independent of the concomitant thyroid gland hyperactivity. PMID- 3828579 TI - The conceptual problem of 'functional hearing loss'. PMID- 3828578 TI - Cardiovascular reflexes in conscious sodium-depleted rats. AB - Reflex arterial pressure regulation was studied in control and sodium-depleted rats fed a diet containing 0.1 mEq Na+ for 6 days associated with furosemide (5 mg/kg, ip, on the 1st and 5th day). The hypertensive response produced in conscious rats by bilateral common carotid occlusion (5 to 60 s) was significantly smaller in the sodium-depleted rats (MAP = 113 +/- 3 mmHg) than in the controls (MAP = 121 +/- 2 mmHg) in terms of absolute as well as relative values. Sixty min after recovery from ether anesthesia, the rats submitted to sino-aortic denervation showed a similar relative increase in MAP (30%), whereas the hypertensive level attained by the sodium-depleted rats was only mild (MAP = 126 +/- 5 mmHg). Sodium-depleted rats required 3.5 and 2.4 times larger dose of norepinephrine and angiotensin II, respectively, than the control rats to produce an increase in MAP of 20-25 mmHg. Changes in vascular reactivity associated with impaired cardiac function might be important factors to explain the decreased pressor responses produced by carotid occlusion and by sino-aortic denervation in sodium-depleted rats. PMID- 3828580 TI - Guessing and speechreading. AB - The present experiment investigated the relation between guessing (cf. synthetic ability, Jeffers and Barley, 1971) and speechreading performance. Guessing was measured by two types of completion tests: One sentence-completion test (SCT), and one word-completion test (WCT). The results indicated that skilled guessing - in terms of SCT-performance - proved to be critical for longer sentences to be speechread, while skilled guessing - as measured by a WCT - proved to be critical for speechreading situations where a low level of contextual information was offered. The latter result was also obtained for one of the SCT-subtests. The results suggest that speechreading and guessing skill are related to each other, and that different types of guessing tests predict different aspects of the speechreading process. PMID- 3828581 TI - The effect of linguistic background on staggered spondaic word and dichotic consonant vowel scores. AB - This study was undertaken to determine the effect of linguistic background on scores obtained by native and non-native subjects on two dichotic speech tests in American English, the staggered spondaic word (SSW) and the dichotic consonant vowel (CV) tests. Thirty subjects whose native languages were either Hindi or Arabic were tested. Test findings were compared to results obtained from 10 native English-speaking subjects. The non-native English speakers showed abnormally high error scores on the SSW test while the native speakers performed with no errors on that test. Performance on the dichotic CV test was comparable for both the native English and the Hindi subjects, while the Arabic subjects performed significantly worse than the two other groups. These data indicate that tests of speech perception using English must be interpreted with caution when administered to non-native English speakers, and that neither the SSW nor the dichotic CV tests may be assumed to be free of linguistic bias. PMID- 3828582 TI - Self-noise problems in hearing aids. AB - A study has been carried out to determine the extent to which the self-noise of a hearing aid constitutes a problem for aid users. A survey of hearing aid users was carried out followed by a laboratory study. None of the 75 hearing aid users seen during the survey complained of being troubled by self-noise and none of the subjects investigated at the Institute of Sound and Vibration Research was able to hear any self-noise at normal aid settings when listened for in a sound proofed room. Tests confirmed that aid noise becomes audible only when the noise level in any 1/3 octave band rises above the threshold for a pure tone at the centre of that band, and typical equivalent input noise levels indicate that audible self-noise is caused by gain being applied over a frequency band where the aid user has negligible or no hearing loss, as is likely in the case of persons with 'ski-slope' hearing loss. It is suggested that anyone else complaining of problems with self-noise is probably mistaking external background noise for self-noise of the aid. PMID- 3828583 TI - Treatment of tinnitus: a controlled comparison of masking and placebo. AB - Seventeen out of 21 patients with severe tinnitus rated their tinnitus intensity during a baseline period, during treatment with a portable masker, and during a period with a comparable placebo apparatus. Group analyses showed no significant differences between any of the three periods. Seven patients showed significantly reduced tinnitus intensity ratings during the masker period; five of them also did so during the placebo treatment. After each of the treatment periods, the 21 patients answered a questionnaire about specific (tinnitus related) and general beneficial effects experienced during treatment. Specific, but not general, effects were more pronounced during masker than during placebo treatment. In conclusion, masker treatment is not unequivocally superior to placebo; there is some evidence, however, for the placebo treatment effects to be more 'nonspecific' than effects observed during masker treatment. PMID- 3828584 TI - Self-reported disability and handicap in the population in relation to pure-tone threshold, age, sex and type of hearing loss. AB - A self-administered questionnaire concerning auditory disability and handicap was completed by 1691 subjects who were part of a two-stage random sample of the UK adult population. A principal components analysis of questionnaire replies identified four components. They were interpreted as (a) disability for everyday speech, (b) disability for speech-in-quiet, (c) localisation, and (d) hearing handicap. Components (a) and (d) were the strongest, accounting for 68% of the variance. Subjects also performed pure-tone audiometry amongst other tests. Audiometric information was well described by a two-parameter model characterised by low-to-mid-frequency loss and high-frequency slope. All four components increased progressively with increasing low-to-mid-frequency loss, independent of high-frequency slope. They were best correlated with a binaural average over 0.5, 1 and 2 kHz weighted 4:1 in favour of the better ear, out of several audiometric descriptors examined. Sex and socio-economic group did not generally affect disability or handicap, but people of similar hearing impairment reported less disability and handicap as age increased. This is interpreted as over compensation for the effects of age in self-report. There were three unexpected findings which may entail some changes in current thinking on the relationship between auditory impairment and self-perceived disability/handicap. Hearing losses incorporating a conductive component in the better ear were more disabling and handicapping than sensorineural losses of equal magnitude. Localisation ability and, to a lesser extent, general hearing handicap were more highly correlated with measures of impairment in the worse ear than in the better ear. There was little evidence for the concept of a 'low fence' in the relationship between impairment and either disability or handicap. PMID- 3828585 TI - Goal planning in audiological rehabilitation. AB - This paper describes the processes involved in goal planning, a means of structuring and evaluating a rehabilitation programme which is individually designed for a particular patient. The goal planning procedure involves a multi disciplinary effort with the patient as an integral member of the team. Goals, which are identified from a strengths-needs list compiled by the team for a patient, are broken down into specific steps which should be easy to achieve by a given target date. The patient's strengths are used to help achieve the goals. Each step should be written in clear and objective terms and the use of vague goals such as 'the patient should make better use of a hearing aid', should be avoided. Goal planning does not dictate which therapy should be used but it does provide a framework for implementing any therapy that the team decide is appropriate. An example of a goal plan used in an audiological rehabilitation clinic is given. PMID- 3828586 TI - Optimum side for fitting a monaural hearing aid. 1. Patients' preference. AB - The criteria generally used to decide in which ear to fit a monaural hearing aid are based on theory or anecdote and have not been verified by experimental observation. In this study to determine optimum side of fitting, 58 new hearing aid users were fitted with a hearing aid in one ear for 10 weeks, and then fitted in the other ear for a further 10 weeks. Subsequently, the subjects were asked their preference for side of hearing aid use and their reasons for this preference. 30 (52%) subjects reported better hearing with their aid in one ear than in the other; 24 (80%) of these preferred the ear with the poorer half-peak level elevation on a speech audiogram. The remaining 28 (48%) reported no difference in their aided hearing ability between ears, though 20 preferred one ear for practical reasons, unrelated to audiometric parameters. A patient's preference for side of fitting can be predicted from audiometric data but with only modest reliability. It is, therefore, recommended that bilateral ear moulds should be routinely provided for bilateral mild to moderate hearing impairment (speech frequency average less than 75 dB HL). If it is decided that only one ear mould should be provided, this should be made for the poorer hearing ear. The poorer hearing ear is best identified from the half-peak level elevation on a speech audiogram. PMID- 3828587 TI - Optimum side for fitting a monaural hearing aid. 2. Measured benefit. AB - The benefit obtained from wearing a hearing aid in either ear was assessed in 52 subjects using an audiovisual test. The sound source was located directly in front of the subject. Overall the subjects obtained more benefit with their aid in their better hearing ear, despite having expressed a preference for using the aid in their poorer hearing ear. Seven of the subjects who had asymmetrical hearing were tested further using an auditory test with the sound source either in front of the subject or to either side. The results suggest that the subjects' preference for the poorer hearing ear are based on a desire to minimise their disability in the most disadvantageous listening situations. PMID- 3828588 TI - The Manchester high pitch rattle. AB - The Manchester rattle is now in regular use by clinical staff and health visitors in several countries. The rattle is useful in a screening protocol for infants - being capable of eliciting responses from normally hearing children in a distraction test at frequencies above 5 kHz. The construction and acoustic characteristics of the rattle are described. PMID- 3828589 TI - Audiometric earphone calibration using the IEC 303 reference coupler: a cautionary note. AB - The diaphragm of a condenser microphone is exceedingly fragile and, in normal use, is covered by a protective grid. However, when the microphone is incorporated into the IEC 303 reference coupler for the calibration of audiometers or audiometric earphones, the Standard demands that the diaphragm be left exposed. Nevertheless, in order to avoid inadvertent mechanical damage, some users leave a protective grid on the microphone. The effects of two particular grids have been investigated and the magnitude of the resulting errors is indicated. PMID- 3828591 TI - Audiometer calibration. PMID- 3828590 TI - BAOL/BSA method of assessment of hearing disability. PMID- 3828592 TI - Client-therapist congruence of expectations over the course of therapy. AB - The study explores the congruence in role expectations of therapists and clients, and tests whether expectations tend to get similar over the course of therapy. Similarity in expectations was examined both on the group level (therapists vs. clients) and on the dyad level. Role expectations of therapists and clients in a university counselling centre in Israel were compared. Two subsamples were studied: 66 therapy sessions which were first meetings, and 81 sessions at various points over the course of therapy (median = 9 months in therapy). Both therapists and clients in therapy dyads filled in the 'expectation part' of the Role Expectation and Preference Questionnaire' to describe their role expectations regarding the approaching session. The main findings were that there were discrepancies in expectations between therapists and clients, especially with regard to therapists' behaviours. There was no increase in similarity of expectations over the course of therapy. The similarity on the dyad level, on the other hand, was low in first sessions but became higher in subsequent ones. The implications for pre-therapy training and for future research are discussed. PMID- 3828593 TI - Schizophrenia: a failure to control the contents of consciousness? AB - Frith (1979) proposed that the 'positive' symptoms of schizophrenia, i.e. hallucinations, delusions, and though disorder, could be accounted for in terms of a defect in the mechanism(s) that controls and limits the contents of consciousness. The present study was designed to test one of the predictions derived from this model; that schizophrenics should fail to inhibit alternative meanings of ambiguous words. As a means of testing this prediction the effects of semantic priming on the 'availability' of subsequent target words to consciousness were assessed, measuring recognition thresholds. The priming conditions employed were expected to either facilitate or inhibit perception of target words in the control groups, normals and depressed patients without psychotic features. A strong priming effect was obtained in the control groups, but was much weaker in the schizophrenic group; this provides some support for the model. PMID- 3828594 TI - A controlled trial of treatments for generalized anxiety. AB - Treatments for chronic anxiety have received considerable interest recently. Firstly, there is a body of research which has shown problems of dependence and habituation in the long-term use of anti-anxiety drugs. A second development is that of psychological treatments for anxiety. Because of the problems involved in the use of benzodiazepines, it is important to determine whether or not psychological treatments are a reasonable alternative when treating chronic anxiety. This study was designed to test the relative effectiveness of cognitive behavioural therapy, anxiety management training and treatment by benzodiazepines against a waiting list control. Measures were taken on both the process and outcome of treatment. The most immediate and greatest improvements in anxiety were seen in the group receiving drugs. However, these improvements reduced as the trial progressed and were minimal at the end of therapy. Both psychological treatment groups improved as the trial progressed with the most significant and consistent changes seen in the cognitive-behaviour therapy group. However, at follow-up there was no difference between the two groups receiving psychological treatments. Because of their lack of sustained improvement, over half of the group receiving drugs refused to wait without treatment until the follow-up assessment. PMID- 3828595 TI - Attentional resources and hemispheric functional asymmetry in schizophrenia. AB - Inconsistent findings within certain areas of schizophrenia research--processing of verbal and pictorial stimuli, and hemispheric functional asymmetry--suggest the importance of examining the attentional resources associated with the cerebral hemispheres among schizophrenics. A cognitive task battery was developed which assessed the functioning of the left and right hemispheres under varying attentional loads. This battery was administered to paranoid and non-paranoid schizophrenics, and three control groups. Error rate and response latencies were monitored. It was found that the schizophrenics, particularly the non-paranoids, displayed evidence of a generalized decrease in available resources across attentional pools. In addition, response latencies were indicative of a complex interaction involving loads and visual field of stimulus presentation, which differed across schizophrenic subtypes. These lateralized effects among the schizophrenics did not interact with the differential sensitivity of the hemispheres to stimulus characteristics. PMID- 3828596 TI - Compulsive eating and dietary restraint. AB - The phenomenology of compulsive eating has encouraged comparisons with addictive behaviours and this has suggested that similar underlying processes might be at work. In this paper it is argued that craving for food, preoccupation with eating and loss of control over food intake represent a natural psychobiological adaptation to sub-optimal weight and food deprivation. Compulsive eating is therefore best understood in terms of a conflict between a biologically derived drive for food and a culturally derived drive for thinness. Both of these processes have their parallels in the maintenance of dependency disorders. The crucial difference however is that the urge to eat is biologically adaptive, and recovery from compulsive eating depends upon relaxing restraint. PMID- 3828597 TI - WAIS scores for a non-clinical British sample. AB - The Wechsler Adult Intelligence Scale (WAIS) was administered to a British sample of 63 volunteers. The mean Full Scale Intelligence Quotient obtained was 116.5, with a standard deviation of 9.7. This finding is discussed in relation to the accepted (American) WAIS norms, and further study suggested. PMID- 3828598 TI - Expectancy and outcome in prescriptive vs. exploratory psychotherapy. AB - Client ratings of the credibility of prescriptive and exploratory therapies were compared, and correlated with clinical improvement. Both expectancies and outcomes favoured prescriptive therapy in the first, but not the second, period of a cross-over design, and modest correlations were obtained between credibility and improvement. Regression analysis suggested that the impact of expectancy on outcome was secondary to the treatment effect rather than its cause. PMID- 3828599 TI - Adherence to medical regime and related factors in youngsters on dialysis. AB - A pilot study is reported in which 18 children in end-stage renal failure, undergoing either haemodialysis or continuous ambulatory peritoneal dialysis were assessed with regard to adherence to their treatment regime. Measures were used to assess level of depression, locus of control and social desirability. Adherent behaviour was significantly related to high social desirability, and a shorter length of time on dialysis. There was no relationship between adherence and depression or locus of control. PMID- 3828600 TI - Neuroticism, anxiety and psychosocial development. AB - The current study investigated the relationship between resolution of Eriksonian crises and neuroticism and trait anxiety. Eighty-eight undergraduate students completed Constantinople's (1969) Inventory of Psychosocial Development (IPD), the Neuroticism scale from H.J. Eysenck & S.B.G. Eysenck's (1975) EPQ, and Spielberger et al.'s (1970) A-Trait scale. Correlations for both males and females were strongly significant and in the expected direction. Successful resolution of Eriksonian crises was negatively related to maladjustment, as successful resolvers had low anxiety and neuroticism scores. The relationship between adjustment and psychosocial development is discussed. PMID- 3828601 TI - Self-reported anger intensity and blood pressure. AB - During a health survey of a New Zealand community, two S-R inventories measuring responsiveness to anger and to anxiety provoking situations were administered to 1127 adults. With age treated as a covariate, no association was found between scores on these measures and blood pressure. PMID- 3828602 TI - Perception of emotionally valenced information in depression. AB - Bower's (1981) associative network model of mood and cognition predicts that depression will selectively facilitate the perception of negatively toned words. Recent studies by Clark et al. (1983) and by Powell & Hemsley (1984) have, however, produced apparently discrepant results. Alternative means of accommodating the discrepancy are considered, and the current experiment empirically distinguishes between these possibilities. The results are inconsistent with Bower's model. PMID- 3828603 TI - Is a problem shared a problem shaved? An evaluation of hairdressers and social support. AB - Despite growing interest in social support as a moderator of stress, few studies have attempted to demonstrate the effects of a psychological intervention in this domain. Hairdressers are an acknowledged source of social support and a randomly selected group (n = 8) were given structured training in the provision of social support to their customers. In comparison with a group of their untrained colleagues (n = 7), repeated measures indicated a significant training effect in terms of the hairdressers' understanding and proficiency in providing social support, while a generalization effect was suggested by customers' ratings of their perceived 'helpfulness'. PMID- 3828604 TI - Performance of normal adults on the Matching Familiar Figures Test. AB - Seventy-seven subjects underwent the Matching Familiar Figures Test (MFFT) and the Wechsler Adult Intelligence Scale. Mean latency to the first response (L) and square-root-transformed error score (T) on the MFFT were normally distributed in the sample. T was correlated positively with age and negatively with IQ; L was not significantly correlated with either. Orthogonal 'impulsiveness' (I) and 'efficiency' (E) indices were derived from the standard scores for L (zL) and T (zT) using the formulae I = zT - zE, and E = -(zT + zL). The interpretation of I and E, and the potential usefulness of the MFFT as a neuropsychological test, are discussed. PMID- 3828605 TI - Where will technology put the library of the 21st century? PMID- 3828606 TI - Medical rare book provenance. AB - Provenance is defined as the record of a book's ownership history. Its value and uses are explored. A survey of provenance practices in medical school rare book libraries found that only 21% of the reporting libraries maintain this important file. Examples of the uses and value of a provenance file in a medical rare book collection are presented. Decisions necessary to institute and maintain such a file are outlined and discussed. PMID- 3828607 TI - Health sciences libraries: strategies in an era of changing economics. AB - Libraries in health care settings reflect their parent institutions, which, in turn, are affected by environmental changes. The economic climate of the 1980s, unleashing competitive forces and threatening the survival of some institutions, has had a major impact on both hospitals and academic health centers. The challenge to libraries of these institutions calls for reassessment of programs and realignment in their power structures. It is argued that libraries which position themselves to capitalize on the current economic environment will create a future with new opportunities. PMID- 3828609 TI - Telefacsimile service in a hospital consortium. PMID- 3828608 TI - Effect of institutional mergers on hospital libraries. PMID- 3828610 TI - Lending computer hardware and software. PMID- 3828611 TI - An appraisal of library facilities and services at the Medical Library of the University of Ilorin, Nigeria. PMID- 3828612 TI - A comparison of interlibrary loan requests received by the National Library of Medicine: 1959 and 1984. AB - In 1962, an analysis of interlibrary loan requests for serials filled by NLM in 1959 was published. In the twenty-five years following 1959, important changes occurred in the biomedical library community, which had a significant impact on interlibrary loan activities, including the development of MEDLARS and online searching, the Regional Medical Library (RML) network, and union listing for serials. To describe NLM's current interlibrary loan request traffic for serials and to identify any significant changes in traffic between 1959 and 1984, a comparative analysis of 1984 serial loan requests was performed, primarily by manipulation of automated request records. The changes in request traffic strongly suggest that the efforts to strengthen regional document delivery through the RML program have been successful and that NLM's collection is now used primarily as a last resort. PMID- 3828613 TI - Moral dimensions in treating combat veterans with posttraumatic stress disorder. PMID- 3828614 TI - U.S. Army psychiatry in Vietnam: preliminary findings of a survey. II. Results and discussion. PMID- 3828615 TI - Unique characteristics of Army psychiatry residency programs. PMID- 3828616 TI - Unmasking the illusion of safety. Psychic trauma in war. PMID- 3828617 TI - U.S. Army psychiatry in Vietnam: preliminary findings of a survey. I. Background and method. PMID- 3828618 TI - Varieties of reaction and adaptation to combat experience. PMID- 3828619 TI - Combat-related posttraumatic stress disorder among Israeli soldiers. A two-year follow-up. PMID- 3828621 TI - Evaluating hospital performance through simultaneous application of several indicators. PMID- 3828620 TI - The survivor syndrome. Massive psychic trauma and posttraumatic stress disorder. PMID- 3828622 TI - Cadmium pollution in La Oroya, Peru. PMID- 3828623 TI - Human onchocerciasis foci and vectors in the American tropics and subtropics. PMID- 3828624 TI - Polio in northeast Brazil. PMID- 3828625 TI - Tobacco use and world health: a situation analysis. PMID- 3828626 TI - Aspects of surgery in the elderly: preoperative medical assessment. AB - Currently, approximately one in four patients admitted to surgical beds is over 65 years of age and about 10% are over 75. Much of the excess morbidity and mortality in the older patient appears to have its roots in coincidental medical problems which are present before operation. This is the rationale behind a careful preoperative medical assessment in the older patient. PMID- 3828627 TI - Aspects of anaesthesia in the elderly. AB - Many anaesthetists find themselves spending an increasing amount of time in the perioperative care of patients more than 65 years old. This article considers some aspects of anaesthesia for these patients which will help to ensure safe anaesthesia. PMID- 3828628 TI - Dermatology. AB - Disease processes occur in the skin and its appendages, as in other organs, against the background of age-related and degenerative changes. The skin is additionally influenced by the cumulative effect of environmental factors, especially solar radiation. PMID- 3828629 TI - Diuretics or ultrafiltration in the treatment of congestive cardiac failure? AB - Ultrafiltration provides a method of removing large volumes of fluid from patients with congestive cardiac failure without potentiating haemodynamic upset. It is a useful alternative treatment in those patients with gross oedema who are refractory to diuretic and vasodilator therapy. PMID- 3828630 TI - Early experience with fine-needle aspiration cytology in a district general hospital. AB - The authors' early experience on introducing fine-needle aspiration cytology as a diagnostic aid into a district general hospital is presented. The use, benefits and criticisms of the technique in the assessment of breast lumps and lymphadenopathy and its peroperative applications are discussed. Results equivalent to those of specialist centres can be quickly attained. PMID- 3828631 TI - The significance of hyperplastic lymphadenopathy. AB - The finding of reactive hyperplasia in a lymph node removed for diagnostic purposes often induces a feeling of disappointment in the clinician. However, this review indicates that reactive hyperplasia is frequently associated with a number of well-defined clinical conditions. PMID- 3828632 TI - In-vivo chemical choledocholitholysis using MTBE. AB - Following endoscopic sphincterotomy, it is possible to clear a large proportion of stones from the bile ducts. In a few cases, however, the stones are too large to retrieve. Mechanical lithotripsy is unpredictable and carries a substantial risk of impaction. We report a patient who had multiple large stones in the bile ducts which were successfully dissolved using MTBE. No adverse effects were noted. PMID- 3828633 TI - Splenogonadal fusion. PMID- 3828634 TI - Endarterectomy--the new "gold standard"? PMID- 3828635 TI - Interplay with private sector discouraged. PMID- 3828636 TI - The purpose of research training in anaesthesia. PMID- 3828637 TI - New initiatives to help the elderly. PMID- 3828639 TI - The case for not stripping the long saphenous vein. PMID- 3828638 TI - Surgical prophylaxis of stroke. PMID- 3828640 TI - The GMC and education of doctors. PMID- 3828641 TI - AIDS--a conspiracy of misinformation? PMID- 3828642 TI - Medical manpower: the future. PMID- 3828643 TI - Manpower problems. PMID- 3828644 TI - Who looks after stroke patients? AB - This article first reviews the evidence concerning who does look after stroke patients, including those at home, and then puts forward a plan for improving the care of all stroke patients. PMID- 3828645 TI - The plain chest X-ray in acquired heart disease in adults. AB - The chest X-ray is a cheap, easily repeatable and reproducible method of investigating the structure and function of the heart. While it is rarely of decisive diagnostic importance in the setting of modern methods of noninvasive investigation, it is valuable in evaluating the severity of cardiac pathology and also in revealing unsuspected abnormalities which may complicate management. For this reason all patients should have a chest X-ray, preferably both frontal and lateral, at the first attendance for cardiac evaluation. In most cardiac departments a routine frontal chest X-ray is taken at each outpatient appointment. PMID- 3828646 TI - Differential diagnosis of the swollen optic disc. AB - The differential diagnosis of a swollen optic disc is described, paying particular attention to the two areas of greatest difficulty: differentiation between a normal optic disc and early disc swelling; and differentiation between optic disc swelling and a simulating condition. PMID- 3828647 TI - Psychosocial aspects of AIDS. AB - Bereavement after diagnosing AIDS or other HIV disease, psychological symptoms secondary to brain disease and the social consequences of having AIDS all interact to produce a devastating illness where the patient may be intensely grieving, demented and totally rejected by all of society. PMID- 3828648 TI - Performance indicators. AB - Performance indicators have been introduced by the DHSS for scrutinizing the activity of regional and district health authorities. Because these are based on routine information, there are a number of problems in understanding what these indicators mean and there is a need to look at alternative ways of measuring performance. PMID- 3828649 TI - Spontaneous rupture of a benign cystic teratoma mimicking acute appendicitis. PMID- 3828650 TI - Neonatal intestinal obstruction. PMID- 3828652 TI - Inadequate care for dementia sufferers. PMID- 3828651 TI - Oesophagectomy: is thoracotomy necessary? PMID- 3828653 TI - Intermittent claudication. PMID- 3828654 TI - Regional differences of reactivity to stimulants in the dog portal tree. AB - We studied the regional differences both of reactivity to various stimulants and of neurogenic responses elicited by transmural stimulation in the longitudinal and circular muscles of the truncal portal vein, mesenteric vein, splenic vein and gastric vein of the dog portal tree. Strong spontaneous activity appeared in the longitudinal muscle of the truncal portal vein (96% of preparations tested). Weak spontaneous activity sometimes appeared in the circular muscle of the truncal portal vein (41%) and rarely in the longitudinal muscle of the mesenteric vein (12%). It did not appear in other segments. The splenic vein and the gastric vein showed similar patterns in the relationship between resting tension and response to noradrenaline; that is, the responsiveness of either longitudinal or circular muscle of these two veins increased and then decreased almost parallel as resting tension increased and reached a maximum under the same resting tension. The longitudinal muscle of both the truncal portal vein and the mesenteric vein was more responsive to noradrenaline, acetylcholine, histamine and KCl than the circular muscle; for example 2.02 and 1.44 times more responsive to noradrenaline, respectively. On the other hand, the longitudinal muscle of the splenic vein and the gastric vein responded less well than the circular muscle; for example 0.36 and 0.16 times as responsive to noradrenaline, respectively. Acetylcholine and histamine caused marked contractions which were comparable to those elicited by noradrenaline in the longitudinal muscle of the truncal portal vein. Acetylcholine also elicited similar contractions in the longitudinal muscle of the mesenteric vein but the responses induced in preparations of other segments were small. 6 The longitudinal muscle of the truncal portal vein responded well even to low-frequency stimulation of 2 Hz, while the circular muscles of the truncal portal and splenic veins gave marked responses only to high-frequency stimulation of 10 or 20 Hz or more. These contractile responses were attenuated by phentolamine (10-6 M) or atropine (10-6 M). The longitudinal muscle of the splenic vein showed no significant response to stimuli of any frequency. 7 It seems that the portal tree receives not only adrenergic but also cholinergic innervation. In addition, the longitudinal muscle of the truncal portal vein may receive non-adrenergic, noncholinergic innervation as well. 8 The longitudinal muscle of the portal vein may be crucial to venous return in assisting movement of the blood it contains. If this is the case in man, then the regional differences in the portal tree demonstrated in this study may explain why varicose changes during portal hypertension occur preferentially in the oesophagogastric region and rarely in other regions, as blood stasis may occur more readily in the regions of the gastric and splenic veins where the longitudinal muscle is not very active. PMID- 3828655 TI - An in vitro analysis of purine-mediated renal vasoconstriction in rat isolated kidney. AB - In the rat isolated perfused kidney, 2-chloroadenosine and L-N6-phenyl-isopropyl adenosine (L-PIA) produced a modest vasodilatation. After kidneys had been pretreated with methoxamine (to elevate vascular tone) and forskolin (to activate adenyl cyclase and reduce vascular tone), both purine agonists produced vasoconstriction at low doses and vasodilatation at higher doses. This was consistent with the working hypothesis that vasoconstriction resulted from activation of A1-purinoceptors mediating adenyl cyclase inhibition and vasodilatation from activation of A2-purinoceptors stimulating adenyl cyclase. These kidney preparations also demonstrated a marked potentiation of purine mediated vasoconstriction in the presence of various concentrations of 8-p-sulpho phenyltheophylline (8-SPT), a drug reported in the literature to be a competitive antagonist of A1- and A2-purinoceptors. Maximal renal vasoconstriction to 2 chloroadenosine and L-PIA was observed in the presence of 10 mM 8-SPT; the fact that this vasoconstriction was sensitive to the selective A1-receptor antagonist 8-(2-amino-4-chlorophenyl)-1,3-dipropylxanthine (PACPX) and that the order of potency of agonists for this effect was L-PIA greater than 2-chloroadenosine greater than D-PIA greater than N6-ethylcarboxamide adenosine (NECA) was consistent with activation of vascular A1-purinoceptors. While these data are consistent with the hypothesis that purines activate vascular A1- and A2 receptors in the rat isolated kidney, the nature of the results did not allow definitive classification of the receptors mediating the purine effects. PMID- 3828656 TI - P2-purinoceptors of two subtypes in the rabbit mesenteric artery: reactive blue 2 selectively inhibits responses mediated via the P2y-but not the P2x-purinoceptor. AB - alpha,beta-Methylene ATP and ATP both produced concentration-dependent contractions of the isolated mesenteric artery of the rabbit that were not inhibited by reactive blue 2. In preparations where the tone had been raised with noradrenaline, ATP and 2-methylthio ATP, but not alpha,beta-methylene ATP, produced relaxations of the vessel. These relaxations were inhibited in the presence of reactive blue 2. Reactive blue 2 did not inhibit the contractions to noradrenaline, and only slightly inhibited relaxations to adenosine and acetylcholine. The rank order of potency of purine nucleotide analogues in contracting the vessel was: alpha,beta-methylene ATP greater than beta,gamma methylene ATP = 2-methylthio ATP greater than ATP, and in relaxing the vessel at raised tone was: 2-methylthio ATP greater than ATP greater than beta,gamma methylene ATP greater than alpha,beta-methylene ATP. It is concluded from this study that in the isolated mesenteric artery of the rabbit, purine nucleotides act via P2y-purinoceptors to cause the muscle to relax and via P2x-purinoceptors to cause the muscle to contract. The results also suggest that reactive blue 2 selectively inhibits responses mediated via the P2y-purinoceptor, at least within a limited concentration range. PMID- 3828657 TI - The effect of angiotensin II upon electrogenic ion transport in rat intestinal epithelia. AB - Epithelial sheets from rat jejunum and descending colon have been shown to respond to angiotensin II (AII) when studied under short-circuit conditions and bathed on both sides with Krebs-Henseleit solution. The octapeptide AII elicited increases in short-circuit current (SCC) in preparations of jejunum and decreases in SCC in the descending colon; both responses occurred when the peptide was applied to the basolateral surface, but not when applied to the apical solution. Responses in both tissues were highly specific, being inhibited by a range of AII antagonists with the following order of potency: [Sar1. Thr8]-AII greater than [Sar1. Leu8]-AII greater than [Sar1. Ile8]-AII greater than [Sar1. Ala8]-AII greater than [Des,Asp1. Ile8]-AII in rat jejunum. AII responses were not affected by alpha- or beta- adrenoceptor antagonists, atropine or tetrodotoxin. AII responses were totally inhibited by the chloride channel blocker, diphenylamine-2 carboxylate (DPC) while cotransport inhibitors e.g. piretanide and frusemide significantly reduced the size of AII responses in colon and jejunum. These patterns of activity suggest that in the jejunum the responses result from electrogenic chloride secretion. Although AII responses in colon were sensitive to DPC the transporting ions have not yet been identified. Both piroxicam and indomethacin inhibited the increase in SCC elicited by AII in the jejunum, and the reduction in SCC caused by AII in the colon. Taken together these results indicate that eicosanoids are involved in AII responses in both tissues. This is the first study to demonstrate a direct, electrogenic effect for AII on transporting epithelia from the gastrointestinal tract. The responses are most probably initiated by All interacting with previously identified specific All receptors within the epithelial membranes. PMID- 3828658 TI - The development of reading: as you seek so shall you find. AB - In this paper we critically examine different methods of investigation of reading development and reading disability. We argue that there is need for longitudinal studies of reading where a differential design allows assessment of the relative degree of involvement of associated skills. We then describe one study of this type. The results chart the development of children who become skilled readers and of those with generalized or specific reading disability. They also demonstrate the crucial effects of decisions regarding subject matching, test design, and measurement of differential abilities on the outcomes of such investigations. A cohort of 40 children was assessed for their abilities on 44 variables which involved reading, spelling, vocabulary, short-term memory (STM), visual skills, auditory-visual integration, language knowledge, rote knowledge and ordering ability as they developed from five to eight years old. Three groups were extracted at age eight on the basis of reading and IQ scores. Group A showed a relatively specific reading disability (high IQ, low reading), Group B were good readers of similarly high IQ, Group C showed a more generalized reading deficit whereby they were at the same level as Group A in reading but their IQ scores were low. The data were then searched retrospectively to describe the development of these patterns of ability from the very beginnings of reading acquisition. The children with specific reading retardation differed from their better-reading peers in terms of relatively few variables which concerned phonological segmentation, STM and naming. The children with generalized reading disability differed from their better-reading peers in almost every respect, but the strong discriminators concerned phonological processing. The children with specific reading disability differed from those with generalized reading disability in terms of abilities which involve visual processing. These patterns of ability were replicated at each age from five to seven years old. PMID- 3828659 TI - A comparison of some retrograde and anterograde effects of electroconvulsive shock in patients with severe depression. AB - Seventy severely depressed patients were randomly assigned to receive either a standard course of bilateral electroconvulsive therapy (ECT) or a course of simulated ECT (muscle relaxant and anaesthesia) identical to the real course except that the shock was omitted. Anterograde amnesia due to the shock was demonstrated in recognition memory for word lists and in recall of labels for faces, but this was eliminated by priming. Retrograde amnesia was also present for labels for faces learned the day before a treatment, but this was not eliminated by priming. Recognition memory for material learned in the remote past was better in the patients who had received shock than in those who had received only anaesthetic. PMID- 3828660 TI - Seeing the impossible and building the likely. AB - Young & Deregowski (1981) state that the reason for some subjects' failure to perceive 'impossible' figures as confusing is probably that they do not integrate the stimuli, even though they see elements of the figures as depicting spatial arrangements. This suggests that such subjects should also tend to build distorted models of geometrical structures. This hypothesis was tested in the course of the present experiment. The results support the hypothesis. PMID- 3828661 TI - Enhanced oxidative metabolism of neutrophils from patients with systemic sclerosis. AB - Pathological features of systemic sclerosis (SS) such as endothelial cell injury may be associated with damage caused by active oxygen species, especially peroxides. Neutrophils from SS patients express more Fc(IgG) receptors and generate significantly more peroxide than control cells when cultured alone or with heat-aggregated IgG, but not with F-Met-Leu-Phe. We suggest that circulating neutrophils are activated in SS and may, through secretion of toxic peroxides, contribute to the early vascular pathology of this disease. PMID- 3828662 TI - Finger flexion function in rheumatoid arthritis: the reliability of eight simple tests. AB - The inter- and intra-observer errors of eight tests of finger flexion function were estimated from the results obtained by three observers assessing 10 patients with rheumatoid hand involvement. Measurements of finger flexion and muscle power involved both conventional and novel techniques using simple and easily constructed apparatus. For each test, measurements were in agreement between observers and were reproducible on three occasions. These tests may now be used with confidence by other investigators. PMID- 3828663 TI - Measurement of proximal interphalangeal joint circumference in rheumatoid arthritis: one joint or ten? AB - Serial measurements of proximal interphalangeal joint circumference using a single joint that was selected as being 'worst' on clinical grounds or the largest joint at baseline were compared with the mean of all 10 joints in patients with active rheumatoid arthritis receiving second-line drugs. Use of the worst joint gave comparable results to the mean of 10 joint measurements, while the largest joint showed earlier and greater improvement than occurred with the mean of 10 joint sizes. Measurement of a single joint saves time without loss of accuracy or sensitivity. PMID- 3828664 TI - Assessment of stiffness in rheumatology: the use of rating scales. AB - A study of 100 patients with rheumatoid arthritis has shown good correlation amongst three rating scales when used for measuring severity of morning stiffness and severity of stiffness present at the time of interview. Duration of morning stiffness was found to correlate only moderately well with severity of morning stiffness and poorly with severity of stiffness present at the time of interview. Investigation of the patients' definitions of stiffness, with and without the aid of a list of descriptive words, indicated an inter-relationship of pain and limited movement in the majority. This linking of the two symptoms under the term 'stiffness' may explain why some objective methods of measurement do not appear to reflect the subjective stiffness of which patients complain. PMID- 3828665 TI - Serum biochemistry in rheumatoid arthritis, seronegative arthropathies, osteoarthritis, SLE and normal subjects. AB - Most arthritic conditions are characterized by chronic inflammation, resulting in secondary changes in serum biochemistry. In an attempt to profile different mechanisms of inflammation which might account for the clinical diversity of rheumatic diseases, we have measured C-reactive protein (CRP), plasma viscosity, serum histidine and total serum sulphydryl in 259 patients with rheumatoid arthritis (RA), 84 with ankylosing spondylitis (AS), 76 with osteoarthritis, 69 with psoriatic arthritis, 34 with systemic lupus erythematosus (SLE), 36 with Reiter's syndrome and 121 normal controls. The most extreme abnormalities were seen in rheumatoid arthritis and the least in osteoarthritis. The seronegative spondarthritides and SLE occupied a midway position, emphasizing a correlation between biochemical abnormality and severity of inflammation. A low serum histidine characterized both RA and SLE. The former was more likely to be associated with a raised CRP. Plasma viscosity was characteristically raised in psoriatic arthritis and CRP in AS. PMID- 3828666 TI - Erythrocyte sedimentation rate, plasma and serum viscosity as measures of disease activity in rheumatoid arthritis. AB - The activity of rheumatoid arthritis was assessed in 96 unselected out-patients by performing a number of clinical measurements and comparing them to ESR, plasma and serum viscosity. It was found that ESR correlated with clinical parameters better than did both plasma and serum viscosity. These tests were repeated 3 months later in 87 of the same patients and again change in ESR correlated with change in disease activity better than did change in plasma viscosity. Plasma viscosity was a consistently more reliable measure of disease activity than was serum viscosity. PMID- 3828667 TI - What a rheumatologist should know about the law: I. Battery, breach of contract and negligence. PMID- 3828668 TI - Skin-fold thickness and nail-fold capillaries in diabetics: relationship to limited joint mobility and retinopathy. PMID- 3828669 TI - Clinical and echocardiographic assessment in juvenile-onset spondyloarthropathy. PMID- 3828670 TI - Trends in rheumatoid arthritis. PMID- 3828671 TI - Non-aspirin nonsteroidal anti-inflammatory drugs and active gastroduodenal ulceration in the elderly. PMID- 3828672 TI - Clinical measurements in rheumatology. PMID- 3828673 TI - Laboratory markers of joint inflammation and damage. PMID- 3828674 TI - Severe subcutaneous calcification in the 'CREST' syndrome: evidence of high turnover of calcific deposits. AB - Four patients with mild CREST syndrome and extensive subcutaneous calcification have been studied over a 5-year period. There was no correlation between mineral deposition and other features of the disease and no obvious clinical or metabolic cause of the calcification. Mineral deposits, identified as crystalline carbonated apatite, were very labile. A clear pattern of radiographic evolution was apparent. Bone scans showed a higher uptake of isotope in new, developing deposits than in older lesions. Spontaneous formation and disappearance of adjacent deposits occurred in some patients. Loss of mineral could not be explained by extrusion through the skin. PMID- 3828675 TI - Septic arthritis in patients with sickle-cell disease. AB - The presenting features, modes of treatment and sequelae of septic arthritis of 50 joints in 31 Nigerians with sickle-cell disease were studied prospectively over a 66-month period. Most patients were in the second or first decade of life. Males predominated, and the hip was the commonest site of involvement. Infection was polyarticular in 39% and was associated with osteomyelitis in 84%. Most presented with a long history of local disease. The remainder were toxic and desperately ill patients in whom arthritis occurred later. Gram-negative infection predominated, and the commonest organism was Salmonella. Treatment was conservative in most cases, and arthrotomy was performed in only 12 joints. No deaths resulted, but severe complications occurred in 76%, apparently due to delay in diagnosis, severity of illness and a high incidence of hip-joint infection. PMID- 3828676 TI - British Society for Rheumatology. Spring meeting. London, 9-10 April 1987. Abstracts. PMID- 3828677 TI - Attributional style and learned helplessness: relationship to the use of causal schemata and depressive symptoms in children. AB - The attributional style associated with learned helplessness in children is examined in terms of its stability over a six-month period; impact on causal schemata used by children; and association with depressive symptoms. Seventy three fifth grade children provided attributions for success and failure and were divided into learned helpless and mastery-oriented groups on the basis of the attributions typically associated with these response patterns. The attributional styles were relatively stable, influenced responses to stimuli used to investigate the use of causal schemata and were related to depressive symptoms. These results are discussed in terms of research on learned helplessness in children and several research questions are identified. PMID- 3828678 TI - Sex-role beliefs, work attitudes and mental health in employed and non-employed mothers. AB - The attitudes of mothers to their home and child-care role, to their employment role and to sex roles are potentially important correlates of mental health but have been little researched. Results from a general population survey of 160 working-class mothers of young children suggest that dissatisfaction with the home-maker role is associated with higher levels of psychiatric symptoms, psychological distress and self-depreciation. These relationships are strongest for full-time home-makers. For employed mothers, dual-role conflict was more strongly associated with psychological distress than was job satisfaction. Liberal sex-role attitudes were associated with lower psychiatric symptom levels in employed mothers and with higher self-esteem in non-employed mothers. There was a significant interaction between employment status and sex-role beliefs in relation to anxiety. Employed mothers with traditional attitudes and non-employed mothers with liberal attitudes were more anxious. This result was replicated in an independent sample of 200 working-class and middle-class mothers. PMID- 3828679 TI - Evidence for an aggressive (and delinquent) personality. AB - An aggressive (and delinquent) personality can be shown to exist when observations are made across a large enough sampling of exemplars. Arguments against the existence of such a personality are based on a failure to use sufficiently aggregated measures. Numerous estimates are preferable in order to average out idiosyncratic variance thereby leaving a clearer view of underlying dimensions of behaviour. We illustrate the usefulness of this principle and suggest that consistent patterns of individual and group differences in aggression are to be found, are associated with delinquent behaviour, and are moderately heritable. PMID- 3828680 TI - Delinquency and attitude to authority: a comment on Reicher and Emler. AB - In their study of self-reported delinquency, Reicher & Emler (1985) use an ad hoc scale to measure attitudes to authority rather than one of the well-validated scales already in the literature. The items they finally used were almost all anti-authority--thus rendering their results susceptible of an explanation in terms of acquiescent response bias. It is shown that such an explanation would indeed provide a powerful account of what they found. Their work is therefore of uncertain meaning. PMID- 3828681 TI - Modified method of diuresis renography for the assessment of equivocal pelviureteric junction obstruction. AB - Thirty-five hydronephrotic kidneys, in which diuresis renography showed either an equivocal (13) or non-obstructive (22) response pattern, were studied by a modified method in which intravenous frusemide was given 15 min before the start of the renogram so as to assess elimination during the period of maximum diuresis. Thirteen kidneys were identified as obstructed, including three in which the standard diuretic renogram appeared to exclude obstruction. These results indicate that the modified method increases the specificity of diuresis renography when used to assess patients with equivocal pelviureteric junction obstruction. PMID- 3828682 TI - Skeletal anomalies associated with unilateral renal agenesis. AB - Unilateral renal agenesis is sometimes associated with skeletal anomalies. The skeletal malformations are easily detectable and, if found, should suggest further urological investigations. The embryological aspect of the association is explored. Two cases are presented and the relevant literature is reviewed. PMID- 3828683 TI - Long-term results of conservative and surgical management of blunt renal lacerations. AB - In the management of renal lacerations most attention has centered on surgical or non-surgical treatment and little attention has been given to the long-term results. We have evaluated the medical records and radiographs of 70 patients with blunt renal lacerations; 30 had initial non-surgical management and 40 had initial surgical management. Patients with initial non-surgical management were followed up for an average of 40.4 months. Normal blood pressure and/or radiological evaluation of the kidney were noted in 22% of those who had non surgical management (hypertension in 55%) and in 75% of those who had delayed renal surgery (hypertension in 29%). Patients with immediate surgical management were followed up for an average of 49.6 months and normal blood pressure and/or radiological evaluation of the kidney were present in 83% (no hypertension). On long-term follow-up, patients with non-surgical management had a much higher rate of hypertension and/or abnormal radiological evaluation of the kidney than those with immediate surgical management. PMID- 3828684 TI - An ecological study of infected urinary stone genesis in an animal model. AB - Direct molecular and morphological techniques of modern microbiology were used to monitor the sequential development of bacterial microcolonies and biofilms in a rat model of urinary infection and to demonstrate that the urease activity of the infecting organisms sets in course a series of reactions in which struvite and apatite crystals develop within the matrix of the enlarging bacterial aggregate. This forms multiple stone nidi on the uroepithelial surface upon which succeeding bacterial biofilms develop and with the incorporation of other urine components, such as urinary mucroproteins, establishes a matrix skeleton that becomes mineralised, thus allowing for the growth of the stone in concentric layers. To arrive at this hypothesis, we studied infection stone genesis using a newly developed model for infection-induced bladder stone formation in the rat. We examined in detail the sequential events in the evolving microbial ecology of progressive struvite calculogenesis, using conventional microbiological techniques, direct ultrastructural observation, newly developed ultrastructural cytochemical localisation techniques and immunological procedures for stabilisation of the biofilm glycocalix and stone matrix in the rat model. It was concluded that the organic glycocalix material secreted by the associated bacteria comprises a substantial and aetiologically important part of the infection stone calculogenesis and matrix production. PMID- 3828685 TI - Enkephalin inhibits presynaptically the contractility of urinary tract smooth muscle. AB - The influence of methionine-enkephalin and leucine-enkephalin on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was investigated in vitro. The enkephalins inhibited the smooth muscle contractility presynaptically. Methionine-enkephalin was about 40% more potent than leucine enkephalin. Phentolamine-resistant contractions were less inhibited by the enkephalins than atropine-resistant contractions and contractions that were not blocked. The inhibitory nerve responses of the trigone, bladder neck and urethra were unaffected. PMID- 3828686 TI - A study of the pathogenesis, urodynamic assessment and outcome of detrusor instability associated with bladder outflow obstruction. AB - One hundred patients awaiting surgery for bladder outflow obstruction were studied prospectively. All patients completed a symptom score and had urodynamic studies pre-operatively. These results were not known to the urologist and did not therefore influence the course of surgery. There was a good positive correlation between both the severity and the duration of irritative symptoms and the presence of detrusor instability. Eighty per cent of patients were significantly improved 3 months post-operatively. Patients with detrusor instability or low compliance were four times more likely to have an unsatisfactory outcome than those with stable bladders. The outcome could have been predicted in half of the unsuccessful patients on the basis of their pre operative symptom score and urodynamic studies. Whilst a full urodynamic evaluation is usually unnecessary, all patients should have a flow rate estimation and those with a high urgency symptom score and an unexpectedly high flow rate require full urodynamic assessment. These patients should be considered for alternative treatment or warned pre-operatively of the likely outcome. PMID- 3828687 TI - Urodynamic findings in sacrococcygeal chordoma. AB - The clinical and urodynamic findings in two cases of sacrococcygeal chordoma are described. The urodynamic findings suggest that the urinary problems in this condition are caused by an incomplete lower motor neurone lesion. PMID- 3828688 TI - Urinary fibrin/fibrinogen degradation products in transitional cell carcinoma of the bladder. AB - Urinary fibrin/fibrinogen degradation products (FDPs) were measured in 210 specimens from 174 patients with newly or previously diagnosed transitional cell carcinoma of the bladder. They were detected in 94% of patients with deeply invasive bladder tumours (pT2-4) compared with 17% of superficial tumours. Microalbuminuria (greater than 50 micrograms/g creatinine) was also found in 80% of patients with pT2-4 lesions. Both were compared with urine cytology. Urinary FDPs are markers of bladder tumour invasion. Our results suggest that urinary FDPs are not of value in screening for the presence of bladder neoplasia but their role may be in following patients with superficial bladder tumours to detect those tumours which become invasive. The mode of excretion of the FDPs in the urine is discussed. PMID- 3828689 TI - Urethral rhinosporidiosis. Analysis of 27 cases. AB - An analysis of 27 cases of urethral rhinosporidiosis is presented. Only 11 cases have been previously reported. The disease is chronic and causes no systemic derangement. The key to diagnosis is its characteristic histology and diathermy excision provides the best treatment. PMID- 3828690 TI - Neonatal testicular torsion and infarction: aetiology and management. AB - Thirty neonates presented with signs of testicular ischaemia over a 20-year period. Eighteen children had primary exploration revealing extravaginal torsion (10), intravaginal torsion (3), infarction without torsion (2) and torsion of the appendix testis (1). The other two children had simple biopsy of necrotic testes. In two instances the testis was untwisted and retained but both subsequently atrophied. The remainder underwent orchiectomy. Twelve children did not have initial exploration and 11 of these had subsequent testicular atrophy. At contralateral testis fixation, performed in 17 cases, signs of contralateral involvement in the ischaemic process were found in seven, suggesting that the primary event in the condition is infarction, with torsion occurring secondarily. PMID- 3828691 TI - Surgical salvage of advanced testicular tumours. AB - After combination chemotherapy, 19 patients underwent salvage surgery for testicular neoplasia. Active malignancy was found in nine patients, three of whom have died of the disease. Those with benign residual disease have had a good prognosis without further treatment. Biopsy alone of the residual masses proved reliable in determining which patients were to be simply followed or given further chemotherapy. If active malignancy was not resected fully, the prognosis was very poor. Our policy continues to be to attempt complete excision of residual masses after induction chemotherapy and to give salvage chemotherapy to patients with residual active malignancy. PMID- 3828692 TI - Scope and limitations of the MAGPI hypospadias repair. AB - Results and complications are reported in 67 boys who underwent a modified MAGPI procedure for hypospadias between 1981 and 1986. Excellent cosmetic and functional results were achieved in 91% of the patients. Some degree of chordee can be corrected by this procedure but severe degrees of chordee were associated with an increased complication rate. PMID- 3828693 TI - Analgesic nephropathy complicated by transitional cell carcinoma of the renal pelvis. PMID- 3828694 TI - Recurrent inversion of the urinary bladder. PMID- 3828695 TI - Paraffinoma of the ureter. PMID- 3828696 TI - An unusual retroperitoneal seminoma. PMID- 3828697 TI - Intermittent hydronephrosis due to transitional cell carcinoma of the renal pelvis. PMID- 3828698 TI - Giant renal calculus. PMID- 3828699 TI - Renal carcinoma with hypercoagulability. PMID- 3828700 TI - Simulated testis using vascularised autogenous tissue. PMID- 3828701 TI - Interstitial cystitis. PMID- 3828702 TI - Nephroureterectomy. PMID- 3828703 TI - Incidence of renal stones in 18 British towns. A collaborative study. AB - The geographical distribution of renal stones in England and Wales was investigated by selecting 18 towns which encompassed a range of social and economic conditions. Case registers of stone patients were maintained in the hospitals for 2 years; they included out-patients and in-patients. The annual registration rate was 22/100,000 population. Additional information was available for 1980 from Hospital Activity Analysis and the annual rate was 28/100,000. It is suggested that this is the best estimate of the incidence of renal stones in England and Wales. The rate ranged from 56/100,000 in Canterbury to 15/100,000 in Burton-on-Trent. The incidence of renal stones was higher in towns with better social and economic conditions. In comparison, climatic factors, latitude and water hardness were not important determinants of the distribution of renal stones. PMID- 3828704 TI - Prevalence of calcified upper urinary tract stone disease in a random population survey. Report of a combined study of general practitioners and hospital staff. AB - There are few randomised studies specifically designed to establish the prevalence of upper urinary tract stone disease. The present random study sampled a population of 7000 in the central belt of Scotland. Three thousand three hundred and ninety-eight subjects were X-rayed and possible calcified upper tract stones were further investigated, revealing a prevalence rate of 3.5% of the total surveyed population. Socio-economic characteristics of the population were determined, such as occupation, history of previous infection, stone disease and backache. Simple urine and blood analyses were undertaken. There was no difference in stone prevalence between males and females (1.03:1) as distinct from treated stone patients. There were no differences between the sexes with respect to family history of stone disease but females have a greater chance of having had previous urinary tract infection. PMID- 3828705 TI - Computed tomography in acute pyelonephritis. AB - The computed tomographic findings in nine female patients with acute pyelonephritis were reviewed. The major impact of CT was the demonstration of renal enlargement, abnormal contour, perirenal inflammatory extension and, on contrast-enhanced scans, abnormal nephrograms and impaired renal function. It was concluded that CT can provide specific information about the nature and extent of the inflammatory process, thus complementing intravenous urography so that appropriate therapy may be selected. Follow-up studies can be helpful in monitoring the progress of a patient. PMID- 3828706 TI - Prediction of pyelocaliectasis in follow-up of patients with spinal cord injury. AB - Two hundred and fifty spinal cord injury patients were studied on each of two occasions, 12 to 24 months apart, to determine which urological findings could be used to predict the subsequent development of clinically significant pyelocaliectasis. An equation was developed which correctly classified 90% of the patients who remained free of clinically significant pyelocaliectasis and 82% of the patients who subsequently developed clinically significant pyelocaliectasis. The statistically significant risk factors were renal calculi, bladder diverticula and a decrease in effective renal plasma flow. This study suggests that the presence of these risk factors warrants careful monitoring of renal function in these patients and appropriate management of bladder dysfunction. PMID- 3828707 TI - Haematuria following a marathon run: source and significance. AB - Urine specimens were obtained from 98 runners before and immediately after running a half (21 km) or full (42 km) marathon. Specimens were examined for the presence of proteinuria, haematuria and whether the erythrocytes were normomorphic or dysmorphic as determined by phase contrast microscopy. Proteinuria occurred in 35% of those running the half and 69% running the full marathon. Haematuria with or without proteinuria occurred in 21% running the half and 22% running the full marathon. In runners with haematuria, dysmorphic erythrocytes were found in 30% of the half and 81% of the full marathon group. No urinary abnormalities were found on repeat examination 4 to 12 weeks after the run. These results suggest that non-glomerular bleeding, possibly from bladder contusions, predominates at shorter distances. With greater distances glomerular bleeding occurs. These abnormalities disappear with rest and do not appear to signify underlying urinary tract disease. PMID- 3828708 TI - Ureteric stone surgery in practice. AB - From 1983 to 1986 140 patients underwent surgery for ureteric calculus. In approximately 30% "blind" basket extraction was considered appropriate and continued to be effective. Increasing expertise with the rigid ureterorenoscope led to a considerable reduction in open ureterolithotomy (15% in 1985-86), the majority following failed ureteroscopic extraction. In the same year both "blind" basket extraction and ureteroscopy were successful in 82 and 86% of attempts respectively. Electrohydraulic and ultrasonic lithotripsy were used in 12 patients to reduce large impacted calculi. The commonest complication of ureteroscopic stone surgery was perforation; this occurred in 14% of cases, though it was usually trivial and near the vesicoureteric junction. Perforations higher in the ureter tended to follow endoscopic lithotripsy and were often associated with urinary extravasation. Extra-ureteric stone fragments were also occasionally observed in such cases. There were no serious sequelae, although the in-patient stay was prolonged beyond the 48 h customary for uncomplicated extraction. The results suggest that ureteroscopic stone extraction, which can be conveniently introduced into urological practice, should become a standard endoscopic procedure. PMID- 3828709 TI - Prospective study of intravesical dimethyl sulphoxide in the treatment of chronic inflammatory bladder disease. AB - Thirty patients with biopsy-proven chronic inflammatory bladder disease were treated with intravesical dimethyl sulphoxide (DMSO). Satisfactory symptomatic relief was achieved in 80% of patients completing treatment and no significant side effects were encountered. Despite the improvement in symptoms there was no significant alteration in the endoscopic or morphological appearance of the bladder after treatment. Intravesical DMSO is safe and relatively easy to administer and seems to have a place in the management of patients with this difficult problem. PMID- 3828710 TI - Are biopsies from the prostatic urethra useful in patients with superficial bladder carcinoma? AB - Fifty male patients entered a Mitomycin C trial for superficial bladder cancer and biopsies in the prostatic urethra were taken with a cold cup biopsy forceps. In one patient this procedure failed. In 21 of 49 patients no abnormalities were detected but in the remaining 28 patients (57.1%) histological changes were found in the prostatic urethra. In 13 of these patients (26.5%) the changes were either carcinoma in situ (CIS) or superficial bladder carcinoma. Carcinoma in situ in the prostatic urethra was found in nine patients (18%) and in all but one it was combined with CIS in the bladder. These results indicate that biopsies from the prostatic urethra must be taken routinely in order to plan adequate therapy. PMID- 3828711 TI - Pathogenesis of nocturnal urinary incontinence after ileocaecal bladder replacement. Continuous measurement of urethral closure pressure during sleep. AB - Urethral closure pressure was recorded in four patients during sleep in order to determine the pathogenesis of nocturnal incontinence after radical cystectomy and ileocaecal bladder replacement. The sleep stages were determined by electroencephalography. The resting pressure in the intestinal bladder was low and increased only slightly during filling. The maximum urethral pressure decreased during sleep but the urethral closure pressure remained positive when the intestinal bladder was not contracting. The peristaltic contractions in the intestinal bladder continued during sleep, causing incontinence. The nocturnal incontinence is probably a result of the reduced level of consciousness that makes it impossible to increase the tone of the external urethral sphincter during contractions of the intestinal bladder. PMID- 3828712 TI - Flutamide as primary treatment for metastatic prostatic cancer. AB - Ten men with newly diagnosed generalised cancer of the prostate were treated with Flutamide (SCH 13521). After 18 months of treatment, one patient had stable disease and was symptom-free. Seven patients left the study because of progression of cancer and two because of the side effects of Flutamide. None of the patients with progression showed an objective response to second-line oestrogen therapy. PMID- 3828713 TI - Assessment of the immediate and long-term effects of pharmacologically induced penile erections in the treatment of psychogenic and organic impotence. AB - Thirty-eight patients with predominantly organic and 29 with psychogenic impotence had intracavernosal injections of a combination of 30 mg papaverine and 1 mg phentolamine on at least one occasion. An immediate increase in length and penile rigidity resulted in all subjects. Eighteen of the organic patients subsequently developed spontaneous erections for periods ranging from 1 week to 1 month. Nineteen of the 24 patients in the psychogenic group had spontaneous erections, five for at least 4 months and 14 for 2 to 8 weeks. Increasing the dose was of benefit only to organic patients who initially had a poor response. Three of eight patients with a poor immediate response to pharmacologically induced penile erections (PIPE) were found to have venous incompetence. PIPE is therefore of value in the diagnosis and treatment of organic and psychogenic impotence. PMID- 3828714 TI - Aspiration and instillation of tetracycline in the treatment of testicular hydrocele. AB - Testicular hydroceles recurred within 6 months in 7 of 15 patients (46.7%) treated by aspiration and instillation of tetracycline. There was objective reduction in the size of the hydrocele in three patients (20%) but only five (33.3%) were cured. Severe pain was a complication in seven cases. This form of treatment is not recommended. PMID- 3828715 TI - Abstracts of the proceedings of the Urological Society of Australasia, 39th annual scientific meeting. Perth, Australia, 1986. PMID- 3828716 TI - Application of leeches to reduce swelling after reconstructive surgery. PMID- 3828717 TI - Matrix calculus anuria. PMID- 3828718 TI - Carcinoma of prostate presenting as dysphagia. PMID- 3828719 TI - Marjolin's ulcer of urethrostomies and urethroplasty. PMID- 3828720 TI - Large leiomyoma of prostate. PMID- 3828721 TI - Gastric carcinoma metastatic to the bladder. PMID- 3828722 TI - Non-venereal sclerosing lymphangitis of the penis associated with masturbation. PMID- 3828723 TI - Removal of foreign bodies from the female bladder. PMID- 3828724 TI - Long-term follow-up of detrusor instability following the colposuspension operation. PMID- 3828725 TI - Spontaneous regression of metastatic renal carcinoma. PMID- 3828726 TI - Rising detection rate of symptomatic Dukes' A colorectal cancers. AB - All 197 patients admitted to the Bristol Royal Infirmary during the 16 year period 1970-1985, and diagnosed as having Dukes' A colorectal cancers, were studied. The numbers diagnosed per year by 1985 were 20, compared with 9.4 per year for the period 1970-1979. This represented an increase in the percentage of Dukes' A cancers of all the colorectal cancers diagnosed from 8.3 to 15 per cent. The increase was largely due to better quality double contrast barium enemas and increased use of flexible sigmoidoscopy and colonoscopy. The operative mortality dropped from 17 to 3 per cent in the last 6 year period. The recurrence rate was 9.6 per cent of which 1 per cent were locally resected and crude 5 year survival was 90.4 per cent up to 1981. PMID- 3828727 TI - Dysplasia of the colon after jejuno-ileal bypass. AB - Colonoscopic biopsies were performed on 38 patients, 10-13 years after jejuno ileal bypass. No significant dysplasia or premalignant change was seen in 371 biopsies. In one patient two tubulovillous adenomata were found in an otherwise normal colon, which is likely to be a chance finding. Although it will take another 10-20 years to establish whether jejuno-ileal bypass is associated with an increased risk of large bowel cancer in humans, there is at present no indication for regular colonoscopic surveillance. PMID- 3828728 TI - Omnitract retractor. PMID- 3828729 TI - Alteration in colonic epithelial cell DNA associated with intestinal neoplasia: selection of high risk patients. AB - The proliferative activity of the colonic crypts of patients who are at high risk of developing colonic tumours has been assessed. Cells from the upper parts of the colonic crypts were collected at colonoscopy, and were stained for DNA by the Feulgen technique. Using a microdensitometer the DNA content of the cells was measured and a proliferative index calculated. Patients with single neoplasms had a proliferative index similar to controls although individual patients with hyperplastic mucosa could be identified. Patients with multiple neoplasms had an elevated proliferative index. These results may form the basis of a screening programme for colonic tumours. PMID- 3828730 TI - Removal of retained Foley catheter. PMID- 3828731 TI - Blood transfusion and recurrence of cancer of the colon and rectum. AB - Clinical and experimental studies indicate that transfusion of allogeneic blood has immunomodulating properties, and that the behaviour of some tumours may be influenced by the immune system of the host. Eighty-seven patients who had undergone 'curative' resection of cancer of the colon or rectum were studied retrospectively to determine whether blood transfusion adversely affected the rate of cancer recurrence. Fifty-three patients (61 per cent) were transfused and 34 were not. The transfused and non-transfused groups were comparable in terms of age, sex, duration of follow-up, mode of presentation, stage of disease and haemoglobin level at discharge from hospital, and differed in admission haemoglobin and distribution of tumour locations (right- or left-sided colonic or rectal tumours). Recurrent malignancy was detected in 36 per cent of transfused patients and 26 per cent of non-transfused patients (P greater than 0.1). There was no association between the number of transfusions and recurrence for any tumour site or stage. The incidence of recurrence was significantly higher in those patients who received transfusions during surgery than in those who received transfusion either before or after surgery (chi 2 = 7.01, d.f. = 1, P less than 0.01) or no transfusions (chi 2 = 4.23, d.f. = 1, P less than 0.05). The study indicates that factors influencing the need for blood transfusion during operation had a greater bearing on prognosis than receipt of a blood transfusion per se and that future prospective studies investigating the association between transfusion and cancer recurrence need to determine accurately the indications for transfusion. PMID- 3828732 TI - Late results of mucosal proctectomy and colo-anal sleeve anastomosis for chronic irradiation rectal injury. AB - Ten patients with severe chronic irradiation injury to the rectum were treated by mucosal proctectomy and colo-anal sleeve anastomosis. The indications were: recurrent rectal bleeding (five), stricture (three), fistula (one) and intractable pain (one). Overall follow-up has ranged from 8 to 77 months (mean 40 months). In the present survivors (n = 7) the follow-up ranges from 18 to 77 months (mean 52 months). Six patients have been followed up for more than 3 years and four for more than 5 years. There was no operative mortality. Three anastomotic strictures occurred but the protecting stoma could be closed in all but one patient. Continence was acceptable although urgency and frequency of defaecation were troublesome symptoms. The operation is recommended for life threatening, haemorrhagic chronic irradiation injury to the rectum. PMID- 3828733 TI - Duodenum-preserving total pancreatectomy for end stage chronic pancreatitis. AB - The classical Whipple procedure for chronic pancreatitis has been associated with significant long term postoperative morbidity. The pylorus-preserving procedure of Longmire has reduced but not eliminated the long-term morbidity. Preservation of the whole duodenum with total pancreatectomy has been introduced for the treatment of patients with end-stage chronic pancreatitis after favourable experience with this procedure in infants for nesidioblastosis. Fourteen patients with chronic pancreatitis have had a total pancreatectomy with preservation of the duodenum and the bile duct. All patients are still alive (median follow-up 9.5 months) and none suffered major complications in the perioperative period. One patient developed a biliary stricture at 3 months, requiring biliary reconstruction. Six of the patients have returned to full-time work; nine require no analgesia. All patients require pancreatic enzyme replacement, and all patients have gained weight postoperatively. Diabetic control is satisfactory with a twice daily insulin regime. Duodenum-preserving total pancreatectomy is feasible in the adult without mortality or high morbidity; early experience suggests that preserving the duodenum improves gastrointestinal function with easier control of the diabetes. PMID- 3828734 TI - Mucobilia: an unusual cause of jaundice. PMID- 3828735 TI - Mechanism of the haemostatic effect of ethanolamine oleate in the injection sclerotherapy for oesophageal varices. AB - Changes in coagulation and fibrinolysis were investigated in 20 patients with oesophageal varices, who underwent endoscopic injection sclerotherapy (EIS) with 5 per cent ethanolamine oleate (EO), by means of serial determination of plasma fibrinopeptide A (FPA) and fibrinopeptide B beta 15-42 (B beta 15-42). One hour after the completion of EIS, the value of FPA was significantly increased to 38.1 +/- 11.1 ng/ml (mean +/- s.e.m.) from a pre-EIS value of 7.1 +/- 1.4 ng/ml (P less than 0.01) and it gradually returned to normal range by 48 h after EIS. A very similar change was observed in the value of B beta 15-42 (P less than 0.01). These observations indicated that EIS provokes transient activation of coagulation and fibrinolysis. In vitro studies, however, revealed that EO inhibits fibrin clot formation because of the Ca2+-chelating ability of its constituent ethanolamine, although oleate or benzyl alcohol exhibited procoagulant activity in FPA formation in vitro. Nevertheless, an external application of EO or oleate over decapsulized kidney of rat resulted in a significant accumulation of 125I-labelled fibrin(ogen). From these results it was suggested that intravascular injection of EO, which exerts an inhibitory effect on coagulation in vitro, activates the local coagulation system. The activation may be accelerated by an acute inflammatory process provoked by oleate, which is supported by such clinical manifestations as mild fever, retrosternal pain leukocytosis and an increase in plasma fibrinogen level which was observed in all during the period. PMID- 3828736 TI - Primary sclerosing cholangitis: biliary drainage and duct dilatation. AB - A further extension of the U-tube technique is described in the treatment of six patients with primary sclerosing cholangitis who developed progressive jaundice and recurrent biliary sepsis. All six patients had operative intrahepatic duct dilatation and U-tube placement. Three patients in addition had a Roux-en-Y hepaticojejunal anastomosis. Five patients are improved and are well after a median follow-up period of 56 months. Two patients have had the U-tube removed electively. Three patients with progressive disease required further percutaneous catheter dilatation of intrahepatic strictures via the U-tube tract. Application of the technique permits evaluation of the biliary system by tube cholangiography and provides access in complex cases for repeated therapeutic intrahepatic stricture dilatation. PMID- 3828737 TI - Nipple preservation during mastectomy. AB - In a retrospective study of 100 patients with operable breast cancer, microscopic involvement of the nipple-areola complex was found in 16 cases. Each of these 16 cases occurred in patients with centrally situated tumours. In contrast, nipple involvement did not occur with peripherally situated tumours lying greater than 2 cm outside the areolar margin (P less than 10(-6), Fisher's exact test). Nipple involvement was more likely in patients with greater than or equal to 4 positive axillary nodes (P less than 0.01, chi 2 test). From this study it appears that nipple preservation may be undertaken during mastectomy for small peripheral tumours, provided the nipple is clinically normal, and frozen section analysis of the sub-nipple area is shown to be free from tumour invasion. These criteria for nipple preservation were satisfied in 20 patients out of a prospective series of 60. In this group, nipple preservation on the skin flap improved the cosmetic result of breast reconstruction in 35 per cent, and facilitated skin closure in 20 per cent. After a mean follow-up period of 50.4 months, nipple preservation was not associated with any significant excess of local recurrences. PMID- 3828738 TI - Stitch granulomata after thyroid surgery. PMID- 3828739 TI - Does intercostal blockade improve patient comfort after cholecystectomy? PMID- 3828740 TI - Rate of bacterial recolonization of the skin after preparation: four methods compared. PMID- 3828741 TI - New general purpose rectal biopsy forceps. PMID- 3828742 TI - Peripheral false aneurysms in Behcet's disease. PMID- 3828743 TI - Spontaneous regression of pulmonary metastases from renal adenocarcinoma before nephrectomy. PMID- 3828744 TI - Chylous ascites following aortic surgery. PMID- 3828745 TI - Calculous disease of a primary vaginal hydrocele in an infant. PMID- 3828747 TI - FFP in pancreatitis. PMID- 3828746 TI - Primary nerve tumours of the brachial plexus. PMID- 3828748 TI - The canine elbow. PMID- 3828750 TI - Techniques for the safe and humane capture of free-living muntjac deer (Muntiacus reevesi). PMID- 3828749 TI - Veterinary work with non-domesticated pets. III. Birds. PMID- 3828751 TI - Mastitis and milk production in cattle in a communal land of Zimbabwe. PMID- 3828752 TI - The distribution of selenium in the tissues of lambs following intramuscular administration of different levels of sodium selenite. PMID- 3828753 TI - Some characteristics of the antibodies involved in allergic skin reactions of the horse to biting insects. PMID- 3828754 TI - The effect of sequence of ejaculation on frequency of sperm abnormalities in bulls. PMID- 3828755 TI - Behavioural and ovarian changes during the oestrous cycle in the Boran (Bos indicus). PMID- 3828756 TI - The evaluation of a new rapid milk progesterone test as an aid to improving dairy herd fertility. PMID- 3828757 TI - Binding of rabies virus to purified Torpedo acetylcholine receptor. AB - The binding of 125I- and 35S-labeled rabies virus (CVS strain) to affinity purified acetylcholine receptor from Torpedo electric organ was demonstrated. The binding of rabies virus to the acetylcholine receptor increased with increasing receptor concentration, was dependent on the pH of the incubation medium, and was saturable with increasing virus concentration. Binding of radioactively labeled virus was effectively competed by unlabeled homologous virus particles. Binding of 35S-labeled rabies virus to the AChR was inhibited up to 50% by alpha bungarotoxin and up to 30% by (+)-tubocurarine but was not affected by atropine. These results demonstrate direct binding of rabies virus to a well-defined neurotransmitter receptor, namely the acetylcholine receptor and indicate that at least a portion of the virus interaction occurs near the acetylcholine binding site on the receptor. These findings support the hypothesis that the acetylcholine receptor may serve as a rabies virus receptor in vivo. PMID- 3828758 TI - The metabolic turnover of the major proteins of the postsynaptic density. AB - We have used the method of Austin, Lowry, Brown and Carter, to measure the steady state metabolic half-life of tubulin (alpha and beta individually) and actin (beta and gamma together) in the total cytosolic (S3), microsomal (P3), synaptic plasma membrane (SPM) and synaptic junction (SJ) subcellular fractions from 6-day old and adult chicken forebrain. In the SPM and SJ fractions we also measured the steady-state metabolic half-life of the major postsynaptic density protein (mPSDp). In SPM and SJ fractions from 6-day-old chickens tubulin and actin turned over approximately twice as slowly (t1/2 approximately equal to 24 days) as tubulin and actin in the S3 fraction (t1/2 approximately equal to 13 days). This difference was unlikely merely to be due to association with membranes since the t1/2 values for the proteins were the same in P3 and S3. The estimated t1/2 values for mPSDp were similar to that for tubulin and actin in SPM and SJ fractions. Similar results were obtained in adult chickens except that all t1/2 values in all fractions were approximately 30% larger. The calculated t1/2 values did not change between labelling periods of 4 and 6.5 h suggesting that the lag phase of incorporation of newly synthesized PSD proteins is sufficiently rapid to not produce this result artefactually. When the brain from a non-labelled chicken was homogenized in the presence of the S3 fraction from a labelled chicken and sub-fractionated the relative specific activities of the SPM and SJ fractions produced were 1-2% of those from the labelled brain. These results support the notion that tubulin and actin are intrinsic components of the PSD. PMID- 3828759 TI - Vasopressin and oxytocin mRNAs in adrenalectomized and Brattleboro rats: analysis by quantitative in situ hybridization histochemistry. AB - 35S-labeled synthetic oligodeoxyribonucleotide probes were used to measure levels of vasopressin (VP) and oxytocin (OT) mRNAs in rat hypothalamus by quantitative in situ hybridization histochemistry (ISHH). VP and OT mRNA-containing cells were seen in the paraventricular (PVN) and supraoptic (SON) nuclei. VP mRNA was found to increase five-fold in the parvocellular region of the PVN after adrenalectomy while no changes occurred in magnocellular VP or OT mRNA levels. In the Brattleboro rat, VP mRNA levels were decreased and OT mRNA levels increased in the magnocellular regions. RNA species containing the VP introns were present at one fortieth of the level of processed VP mRNA in control rats. We also performed ISHH followed by immunohistochemistry on the same sections. We found that VP and its encoding mRNA were always located together as were OT-neurophysin and its encoding mRNA. In this study, we extend previous work by showing the characteristic distributions in the PVN and SON of VP and OT mRNA-containing cells and by measuring neuropeptide mRNA changes. PMID- 3828760 TI - Direct relation of long-term synaptic potentiation to phosphorylation of membrane protein F1, a substrate for membrane protein kinase C. AB - One hour after long-term potentiation (LTP) in the intact hippocampus, a selective increase in protein F1 in vitro phosphorylation was observed in homogenate prepared from dorsal hippocampus. Protein F1 phosphorylation was directly related to the magnitude and persistence of potentiation. No other phosphoprotein studied exhibited a relationship with synaptic enhancement. Low frequency, non-potentiating stimulation did not increase protein F1 phosphorylation, and phosphorylation of F1 was not elevated when high-frequency stimulation did not produce potentiation. We also confirmed our earlier demonstration of a similar pattern of results 5 min after LTP. In related work we have previously observed: that protein F1 is a substrate for protein kinase C (PKC); that membrane PKC activity was increased by translocation from the cytosol following LTP; and that membrane PKC activity was directly related to the persistence of enhancement. We therefore predicted in the present study that protein F1 phosphorylation in a dorsal hippocampal membrane fraction would be related to LTP. Hippocampal membrane protein F1 was found to be directly related to both the magnitude and persistence of response enhancement. Thus the molecular events leading to prolonged potentiation may involve increased PKC/protein F1 association. Persistence of potentiation may be related to synaptic growth processes involving the growth-associated function of protein F1. PMID- 3828761 TI - Inhibitory effects of cerebellar lesions on respiration in the spontaneously breathing, anesthetized cat. AB - Acute cerebellectomy depressed spontaneous respiration in cats anesthetized with chloralose-urethane. After cerebellectomy there was an increased interbreath interval (TTOT) accompanied by increased inspiratory and expiratory durations (TI and TE, respectively). However, the change of TE exceeded that of TI so that TI/TTOT decreased. Tidal volume (VT) and mean inspiratory flow (VT/TI) were not affected. No respiratory variable was significantly altered when cerebellectomy was performed subsequent to bilateral vagotomy. Bilateral lesions of the rostral fastigial nuclei (FN) in cats with intact vagi also caused a reduction in ventilation due to increased TTOT. In this case TI and VT/TI increased, but VT and TI/TTOT remained unchanged. Bilateral control lesions that usually included portions of the dentate nuclei did not influence respiration. The results suggest that in the anesthetized cat the cerebellum tonically excites respiratory centers controlling respiratory rate and the termination of inspiration. A part of this influence may be mediated by the rostral FN. In addition, vagal input appears to be important in the expression of the cerebellar influence on spontaneous respiration. PMID- 3828762 TI - Heterogeneity of binding sites for N-ethylcarboxamido[3H]adenosine in rat brain: effects of N-ethylmaleimide. AB - Binding sites for N-ethylcarboxamido[3H]adenosine (NECA) in rat brain membranes and cryostat sections were examined in relation to their sensitivities to displacement by unlabeled NECA and R(-)-phenylisopropyladenosine (R-PIA). In membrane fractions from cerebral cortex, cerebellum, hippocampus and striatum, nanomolar concentrations of these adenosine receptor agonists displaced [3H]NECA such that R-PIA was more effective than NECA, consistent with the presence of an A1-adenosine receptor. At concentrations of displacing agent higher than 1 microM, R-PIA was unable to displace [3H]NECA further in cerebral cortex, cerebellum and hippocampus. In striatum, a second R-PIA-sensitive component of [3H]NECA binding was evident which was more sensitive to NECA than to R-PIA, i.e. it showed the characteristics of an A2-adenosine receptor. In striatum, however, R-PIA was also unable to displace [3H]NECA binding completely. Similar results were obtained in quantitative autoradiographic studies. Preincubation of cryostat sections with N-ethylmaleimide (NEM) abolished both the A1- and R-PIA-insensitive binding components such that both NECA and R-PIA were able to displace [3H]NECA binding completely. The remaining sites showed IC50 values of 0.13 and 3.68 microM for NECA and R-PIA, respectively. These A2-like [3H]NECA binding sites had a highly specific distribution in the brain, being concentrated in the striatum, nucleus accumbens and olfactory tubercle. The results indicate the presence in brain tissue of at least 3 classes of [3H]NECA binding sites, an A1-site, an A2 site and a third, unidentified R-PIA-insensitive site. PMID- 3828763 TI - Single unit activity of noradrenergic neurons in locus coeruleus and serotonergic neurons in the nucleus raphe dorsalis of freely moving cats in relation to the cardiac cycle. AB - Single unit activity of serotonergic (5-HT) neurons in the nucleus raphe dorsalis (NRD) and of noradrenergic (NE) neurons in the locus coeruleus (LC) was recorded in relation to the cardiac cycle in awake, freely moving cats. The discharge of NRD-5-HT neurons showed no relationship to the cardiac cycle, while LC-NE neurons displayed a cardiac periodicity such that the units were most likely to fire from 80 to 180 ms after the peak of the cardiac r-wave (diastole), and least likely to fire during the period from 40 ms before to 60 ms after the r-wave (systole). The strength of this periodicity was inversely related to the discharge rate of individual cells. Exposure to a noxious environmental stimulus (15 min of 100 dB white noise) greatly attenuated the cardiac relationship of LC-NE neurons. A blood volume expansion of approximately 15% (9.0 ml/kg b. wt.) decreased unit rate by about 25%, but did not alter either the timing or the magnitude of the LC NE cardiac relationship. These data are discussed in terms of the participation of NRD-5-HT and LC-NE neurons in cardiovascular function, and the possible role of LC-NE neurons in short- and long-term volume homeostasis. PMID- 3828764 TI - A comparative study on characterization and distribution of cholecystokinin binding sites among the rat, mouse and guinea pig brain. AB - Using the in vitro quantitative receptor autoradiographical technique, [propionyl 3H]propionylated cholecystokinin octapeptide ([3H]pCCK-8) binding sites were investigated in tissue sections of rat, mouse and guinea pig brains. In all the tested animals, [3H]pCCK-8 bound very slowly to the tissue sections. Dissociation was also slow, and had a biphasic profile suggesting CCK-8 binding sites are heterogeneous. Dissociation rate constants were, however, unequal among these species. In the saturation binding studies, both Bmax and (Kd)app values varied among the animal species. The autoradiograms revealed marked species differences in [3H]pCCK-8 binding sites in the brain among 3 closely related species of rodents. [3H]pCCK-8 binding sites were undetectable in the nucleus accumbens/caudate-putamen and the amygdaloid complex of the mouse brain, and scarcely found in the ventromedialis of the hypothalamus of the mouse and guinea pig brain. Furthermore, moderate-to-high densities of [3H]pCCK-8 binding sites were observed in the cerebella of the mouse and guinea pig, whereas in the rat cerebellum the binding sites were undetected. The above-mentioned observations suggest the existence of species differences in the binding pattern of CCK-like peptides among closely related animal species. Furthermore, it would appear that CCK-like peptides in the brain may play different physiological roles among animal species. PMID- 3828765 TI - Effects of androgens and estrogens on the vasopressin and oxytocin innervation of the adult rat brain. AB - Recently we reported that castration of rats eliminates vasopressin immunoreactivity in the lateral septum and other areas that appear to receive vasopressin innervation from the bed nucleus of the stria terminalis. Testosterone treatment counteracts this effect of castration. In the present study, we investigated whether this action of testosterone depends on its androgenic or estrogenic metabolites by treating long-term castrated rats with estradiol (E) and/or 5 alpha-dihydrotestosterone (DHT) or testosterone. The brains were then processed for immunocytochemistry or radioimmunoassay. DHT did not increase vasopressin staining in the lateral septum, although it fully restored the size of the seminal vesicles. E did restore the original fiber density, but individual fibers stained more weakly than in sham-operated males. Only treatment with both E and DHT fully restored the vasopressin innervation. This pattern was also reflected in the radioimmunoassay data. The vasopressin content of the lateral septum decreased about 90% after castration but was fully restored by either testosterone or E + DHT treatment. E alone, however, was only half as effective as E + DHT. The treatments had no effect on the oxytocin content of the septum, or on the vasopressin or oxytocin content of the dorsal vagal complex. The results suggest that E mediates most of the effects of testosterone on the vasopressin innervation of the lateral septum. DHT enhances the response to E but has little effect on its own. PMID- 3828766 TI - Active properties of dendritic membrane examined by current source density analysis in hippocampal CA1 pyramidal neurons. AB - The laminar profile of extracellular field potentials evoked by alveus or stratum radiatum stimulation was recorded at the CA1 region of guinea pig hippocampal slices. One-dimensional approximation of the current source density analysis method was applied to the data. When the alveus was stimulated, the location of inward membrane current (sink) moved from the cell body layer to the dendritic region for a distance of at least 200 micron at a velocity of 0.16 +/- 0.03 m/s (n = 6). This sink movement was not blocked by either low- Ca2+ or Ca2+-free/high Mg2+ medium, but was blocked by tetrodotoxin application restricted to the dendritic region by a local perfusion method. When the stratum radiatum was stimulated, sink movement from the dendritic region to the cell body layer was not distinct. Retrograde sink movement from the cell body layer to the dendritic region subsequent to the cell body spike was not observed. These findings indicated that the dendrites of the CA1 pyramidal neurons can generate action potentials which propagate along the dendrite and that they might primarily be mediated by Na ion. PMID- 3828767 TI - Selective localization of calcium-binding protein in human brainstem, cerebellum and spinal cord. AB - The 28,000-Da vitamin D-dependent calcium-binding protein, CaBP, which is induced by one hormonally active form of vitamin D3, 1,25-dihydroxyvitamin D3, was localized by immunocytochemistry in the human brainstem, cerebellum and cervical segment of the spinal cord. Positive structures (neurons and their processes) were restricted to some well-defined motor and sensory pathways. In motor regions, the highest density of immunoreactive sites was found in the Purkinje cell layer of the cerebellar cortex, and CaBP-positive neurons were also found in the reticular formation and the inferior olivary nucleus. In sensory pathways, positive neurons were mainly localized in structures associated with protopathic thermalgesia (pain and temperature), as well as in the solitary nucleus and parabrachial nucleus of the taste pathway. PMID- 3828768 TI - Firing properties of two types of nucleus raphe dorsalis neurons during the sleep waking cycle and their responses to sensory stimuli. AB - Spontaneous activity of the nucleus raphe dorsalis (NRD) neurons during the sleep waking cycle and effects of sensory stimuli upon NRD neurons were studied in cats. Seventy-one neurons recorded within the NRD were classified into two groups with the use of the coefficient of variation of firing intervals during waking (W): 41 regularly firing (clock-like) and 30 irregularly firing (non-clock-like) neurons. The majority of clock-like and one-third of non-clock-like neurons showed a decrease in their firing rate during slow-wave sleep (SWS) compared with W. All neurons of both types displayed their lowest level of activity during paradoxical sleep. During the late phase of SWS, many clock-like neurons reduced their firing prior to the occurrence of pontogeniculo-occipital waves, whereas non-clock-like neurons did not show such a specific property. Clock-like neurons were totally unresponsive to nociceptive and non-nociceptive somesthetic stimuli, while about half of the non-clock-like neurons were driven by these stimuli. Half of the clock-like and one-third of the non-clock-like neurons were driven by click stimulation, and the majority of them showed an excitatory response. Some of the clock-like and non-clock-like neurons exhibited inhibitory and excitatory response to flash stimulation, respectively. The results of this experiment show that two types of neurons do exist in the NRD and suggest that they play a functionally different role in the brain. PMID- 3828769 TI - Retraction and degeneration of sympathetic neurites in response to locally elevated potassium. AB - Sympathetic neurons from superior cervical ganglia of newborn rats were plated into center compartments of 3-compartment culture dishes, allowing exposure of distal neurites to media of different composition than provided to cell bodies and proximal neurites. Cultures were maintained initially with an external potassium concentration ([K+]o) of either 5 mM in all compartments or 50 mM in all compartments. After neurites had elongated into distal compartments, the culture medium was changed such that: the cell bodies and proximal neurites were exposed to 5 mM [K+]o; the distal neurites in one side compartment of each culture were also exposed to 5 mM [K+]o; but the distal neurites in the opposite side compartment were exposed to 50 mM [K+]o. During the next 7-10 days, the distal neurites locally exposed to 50 mM [K+]o degenerated. Many neurites developed a stretched appearance before degenerating, and detailed observations suggest that the neurites retracted to the point where mechanical tension exceeded their strength and then abruptly disintegrated. Neurites in opposite side compartments exposed to 5 mM [K+]o were normal in appearance and did not degenerate. These results suggest that a proximo-distal increase in [K+]o causes an extreme retraction of neurites distal to the increase. These results raise the possibility that K+ released by active nerve endings might cause the retraction of inactive nerve endings, thus providing a possible mechanism for the influence of activity on competition for synaptic sites, a pervasive phenomenon in the developing nervous system. PMID- 3828770 TI - Nucleus basalis of Meynert neuronal activity during a delayed response task in monkey. AB - A total of 183 nucleus basalis of Meynert (NBM) neurons were recorded in a monkey performing a delayed response task. Significant changes in discharge rate were detected in 74% of the NBM cells sampled with most responses occurring in the choice (64%) or the reward (67%) epochs of the task. Neuronal responses in the cueing epoch were less common (31%) and less robust than in the choice epoch, although the animal made essentially the same arm movement in both cases. Only 14% of the task-related NBM cells had significant changes in discharge rate in the delay period, and none of these responded differentially for the two positions indicated in the preceding cueing epoch. These findings do not support a role of the NBM in the differential responses of cortical neurons in delayed response tasks, but they provide further evidence for NBM involvement in aspects of reward acquisition. PMID- 3828771 TI - Cell bodies of origin of serotonin-immunoreactive afferents to the inferior olivary complex of the rat. AB - Previous studies have used immunohistochemistry to localize serotonin to distinct olivary nuclei in several mammalian species. However, the location of the cell bodies of origin for the serotoninergic projection to the inferior olive in any of these species was unknown. In the present study, a paradigm which combines transport of horseradish peroxidase (HRP) and serotonin immunohistochemistry (PAP) was used to identify the cell bodies of origin of this afferent system to the inferior olivary complex of the rat. Cells which contain both retrogradely transported HRP and brown cytoplasmic staining indicating that they are serotoninergic cells that project to the inferior olivary complex are found exclusively in an area dorsal to the rostrolateral dorsal accessory olive within the nucleus reticularis paragigantocellularis. Neurons within this nucleus were also found to be a source of serotoninergic afferents to the cerebellum and spinal cord of the rat. This raises the possibility that individual serotonin immunoreactive neurons within this nucleus may project to all 3 areas. Future studies will be designed to address this possibility. No double-labeled cells were observed within any of the raphe nuclei. PMID- 3828772 TI - Isolation of specific proteins affected by estradiol in the arcuate-median eminence of prepuberal female rats. AB - Prepuberal female rats (25 days of age) were injected with estradiol benzoate (EB 10 micrograms/rat, s.c. in oil) or oil vehicle. Forty-eight hours after treatment, all animals were decapitated, their brains removed and sectioned. The arcuate nucleus of the hypothalamus and median eminence were microdissected and processed for isoelectric focusing followed by slab gel electrophoresis. The resulting two-dimensional electrophoretic gels were analyzed to quantitate the specific proteins resolved using a scanning microdensitometric method. Out of 235 proteins measured, 8 proteins were found to be significantly increased and 4 were decreased by EB treatment. The proteins which increased in concentration ranged in molecular weight from 15 to 43 kDa and isoelectric points (pI) of 4.9 to 7.0. The 4 proteins decreased by the EB treatment were 44, 67, 74 and 80 kDa in molecular weight and their pI's ranged from 6.5 to 7.1. It is suggested that these proteins might be involved in some of the neuroendocrine effects that are induced by estradiol in this region of the brain. PMID- 3828773 TI - Entorhinal lesions result in increased nerve growth factor-like growth-promoting activity in medium conditioned by hippocampal slices. AB - Nerve growth factor (NGF) is present in high concentrations in the rat hippocampal formation where it may be involved in sympathetic sprouting following septohippocampal denervation. In addition, recent evidence suggests that some forebrain cholinergic neurons, including septohippocampal neurons, are responsive to exogenous NGF. Since septohippocampal neurons have been shown to sprout in response to entorhinal lesions both in rats and, recently, in humans, we sought to determine whether endogenous NGF-like activity increases in the rat hippocampal formation following injury to the entorhinal cortex. We found that entorhinal lesions which result in extensive denervation of the dentate granule cells, and subsequent sprouting of septohippocampal axons, do result in greater NGF-like growth-promoting activity in medium conditioned by slices of the denervated tissue when compared to medium conditioned by control tissue. These results suggest that brain NGF may be involved in injury-induced sprouting of forebrain cholinergic neurons. PMID- 3828774 TI - Decreased phosphorylation of synaptic glycoproteins following hippocampal kindling. AB - Rats with chronic electrode implants to region CA3 of the hippocampus were rapidly kindled by stimulation with a 10 s, 10 Hz train of biphasic square waves presented every 5 min, until generalized seizures developed (60-70 stimulations). The hippocampi were isolated from the brains of control animals (implanted but not stimulated), and experimental animals which had developed generalized seizures. Synaptic membranes (SM) were prepared. SM were incubated with [gamma 32P]ATP and the incorporation of 32P into proteins and glycoproteins isolated by affinity chromatography on concanavalin-A-agarose was investigated. There was no difference in the phosphorylation pattern of total SM proteins between groups. In contrast, the phosphorylation of a glycoprotein with an apparent molecular weight of 180,000 was decreased 20-40% in kindled animals. This result was replicated in three independent experiments. The results suggest that the phosphorylation of glycoprotein 180 may be related to neuroplastic events. PMID- 3828775 TI - Nipecotic acid: preferential accumulation in the cochlea by GABA uptake systems and selective retrograde transport to brainstem. AB - [3H]Nipecotic acid was shown to be preferentially accumulated by the same cochlear structures which selectively accumulate [3H]gamma-aminobutyric acid ([3H]-GABA), including the terminals of a subset of olivocochlear neurons. With both amino acids, olivocochlear fibers selectively transported label in a retrograde direction, from cochlea to brainstem. However, only [3H]nipecotic acid produced dense labeling, and labeling of cell bodies in the superior olive, presumably because it is metabolized very slowly. Nipecotic acid appears to provide a selective retrograde tracer, specific to neurons whose terminals exhibit preferential GABA uptake. PMID- 3828776 TI - Evidence for GABAergic inhibition of a hypothalamic sympathoexcitatory mechanism in anesthetized rats. AB - The hypothesis that endogenous gamma-aminobutyric acid (GABA) suppresses the activity of a latent hypothalamic sympathoexcitatory mechanism was tested by examining the effects of stereotaxic intrahypothalamic microinjection of drugs influencing GABAergic inhibition in anesthetized rats. Bicuculline methiodide (BMI) 1-25 ng, a competitive antagonist at post-synaptic GABA receptors, as well as isoniazid (INH) 35 and 70 micrograms and 3-mercaptopropionic acid (3MP) 0.02 microliter, inhibitors of GABA synthesis, all evoked marked increases in heart rate and modest pressor responses. However, while the effects of BMI appeared almost immediately and peaked within 10 min of injection, changes caused by INH or 3MP developed much more slowly, attaining a maximum 35-40 and 19 min after injection, respectively. The effects of BMI on heart rate were blocked by pretreatment with propranolol 2 mg/kg i.v. or hexamethonium 20 mg/kg i.v. plus atropine 2 mg/kg i.v. and were shown to be highly localized to the posterior hypothalamic nucleus and the adjacent lateral hypothalamus. In addition to the cardiovascular effects, BMI also elicited dose-related increases in respiratory rate which were independent of the heart rate changes although they followed a similar time course. The results support the notion that hypothalamic GABA inhibits a local mechanism capable of generating cardiorespiratory arousal. PMID- 3828777 TI - Decreased somatostatin-like immunoreactivity in cerebral cortex and cerebrospinal fluid in Alzheimer's disease. AB - To investigate changes in the somatostatinergic neurons of patients with Alzheimer's disease (AD), we determined the somatostatin-like immunoreactivity (SLI) in post-mortem brain tissue of histopathologically confirmed AD patients and in CSF of probable AD patients (according to DSM III). The CSF values were then correlated with psychological test scores. In 6 AD patients the SLI values were decreased 42% (P less than 0.005) in the frontal cortex, 28% (P less than 0.05) in the temporal cortex and 42% (P less than 0.01) in the parietal cortex but not in the thalamus and putamen compared to 11 control patients. In some brain areas there were statistical correlations between SLI values and cholinergic markers, choline acetyltransferase and acetylcholine esterase activities, suggesting a relationship between these two neurotransmitter systems. In the CSF among 75 AD patients SLI was 35% lower (P less than 0.001) than in controls. Severely demented power (P less than 0.001) than in controls. Severely demented patients showed lower SLI values than moderately demented individuals, but this difference was not significant. There was a weak but statistically significant correlation between SLI values in CSF and neuropsychological test scores. This study further confirms the involvement of somatostatinergic neurons in AD and suggests that this involvement may be related to the progression of dementia symptoms. PMID- 3828778 TI - Suppression of exploratory locomotor activity and increase in dopamine turnover following the local application of cis-flupenthixol into limbic projection areas of the rat striatum. AB - Recent neuroanatomical tracer studies have demonstrated the topography of 'limbic' (A10) projections into the striatum of the rat (see Introduction). The target areas include the nucleus accumbens and the ventromedial part of the neostriatum, whereas the dorsolateral part of the neostriatum does not receive such afferents. Taking this topography into account, the present results show that local application of cis-flupenthixol (10-40 micrograms/side) into the nucleus accumbens or the ventromedial, but not the dorsolateral, neostriatum produces suppression of exploratory locomotor activity in the rat. trans Flupenthixol (40 micrograms/side) was completely ineffective when locally applied into the nucleus accumbens. Measurements of the concentrations of the dopamine metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) at the site of injection, and in neighboring areas at different times after cis flupenthixol administration, indicated that there was little or no diffusion of the drug from the injection sites. Much higher concentrations of DOPAC and HVA in a given area were found after systemic administration of cis-flupenthixol as compared with local application of the drug to the same area. PMID- 3828779 TI - Astrocytes play a role in regulation of synaptic density. AB - Exposure of neonatal cerebellar explants to cytosine arabinoside destroys granule cells and arrests surviving glia in an early stage of maturation. Purkinje cells lack astroglial ensheathment and are hyperinnervated by sprouted Purkinje cell recurrent axon collateral terminals. Such granuloprival cultures were transplanted with optic nerve in order to supply mature glial cells. It was observed that not only were Purkinje cells almost completely ensheathed by astroglia, but there was a greater than 60% reduction in the number of somatic synapses compared to the non-transplanted granuloprival cultures. This astroglial ensheathment, which may be neuronally directed, could be the physical element provoking the reduction in the number of synapses. PMID- 3828781 TI - Which endoneurial microvessel histologic measurements are least influenced by vasomotor tone? AB - The thickness and area of rat sciatic endoneurial microvessel components (endothelial cells, basement membranes and wall) were assessed to test whether collapse or vasoconstriction was typical of immersion (I) as compared to perfusion (P) or in situ (S) fixation and to determine whether area, but not thickness, would be unaffected by collapse or vasoconstriction. In S and in P fixation there was no apparent collapse or vasoconstriction; in fact, none of the measurements were significantly different between themselves except for index of circularity (IC), which was a little lower in S than in P fixation. By contrast to S or P, in I fixation, the lumen was much smaller and more irregular and the wall was thicker. Area of wall (and of its components) was not significantly different among I, P or S fixation, but thickness was significantly greater in I than in P or S fixation. For comparison to such properties of vessels as permeability, thickness may be the appropriate measurement, but for other purposes, such as determining the amount of basement membrane in diabetes mellitus, area may be a better measurement as it is less affected by collapse or vasoconstriction. PMID- 3828780 TI - Impact of circulating estradiol on melatonin binding sites in discrete areas of the female rat brain. AB - The distribution of 125I-melatonin binding sites in 6 discrete brain regions of female rats at the estrous stage and the effects of ovariectomy and subsequent 17 beta-estradiol treatment on these binding sites were studied. Specific binding of 125I-melatonin was found in the hypothalamus, medulla-pons, hippocampus, cerebellum, striatum and parietal cortex of the female rats. Ovariectomy produced a large estradiol-reversible decrease in 125I-melatonin binding in the medulla pons and hypothalamus. In contrast, 125I-melatonin binding sites in the other brain regions were generally unaffected by ovariectomy or estradiol. The estradiol-regulated changes in melatonin binding in the hypothalamus and medulla pons may reflect the role of a specific estradiol-melatonin interaction in the coordination of the neuroendocrine reproductive axis. PMID- 3828782 TI - Effects of adrenalectomy and hypophysectomy on postictal seizure protection. AB - Endogenous opioid systems activated by seizures appear to contribute to the postictal inhibition of subsequent seizure activity. In consideration of the possible postictal anticonvulsant actions of endogenous opioids of peripheral origin, we examined whether intact adrenal or pituitary sources of these opioids are necessary for the progressive decline in convulsion intensity and duration normally recorded during a series of 6 intermittent maximal electroshocks (MES). Adrenalectomy did not alter the progressive seizure protection associated with repeated MES. Hypophysectomy, in contrast, increased convulsion duration and abolished progressive reductions in convulsion severity. These data indicate that: adrenal secretions do not substantially contribute to postictal protective mechanisms, and endogenous opioids of pituitary origin may be involved in postictal protective mechanisms. PMID- 3828783 TI - Thermal inhibition of nociceptor-driven spinal cord neurones in the cat: a possible neuronal basis for thermal analgesia. AB - Extracellular and intracellular recordings were made from within the dorsal horn of 10 anaesthetised and gallamine triethiodide-paralysed cats. Inhibition of background and residual noxious-evoked discharge by cooling and warming was demonstrated in 7 out of 33 nociceptor-driven dorsal horn neurones. Five units were inhibited by warming of the noxious mechanical excitatory receptive field. Four units were inhibited by 100%. One unit was inhibited by 42%. Cold stimulation inhibited two units. The background and residual noxious evoked discharge was inhibited by 100%. Cooling (32-20 degrees C) excited two units; warming (32-43 degrees C) also excited two units. Heating above 43 degrees C excited 8 units; cold below 20 degrees C excited 3 units. The units inhibited by thermal stimulation may provide some neuronal basis for thermal analgesia. PMID- 3828784 TI - Myelin mosaicism in female heterozygotes of the canine shaking pup and myelin deficient rat mutants. AB - Female heterozygotes of the shaking pup and myelin-deficient rat sex-linked recessive traits, show myelin mosaicism of the optic nerve and spinal cord. This is most marked in the optic nerve especially in the rat where mosaic patches persist with aging. In both the rat and dog, abnormal oligodendrocytes with distended rough endoplasmic reticulum are found in the abnormal patches and are a marker of the trait. Female heterozygote dogs can develop a marked tremor which disappears with age. PMID- 3828785 TI - Noxious mechanical stimuli increase the release of Met-enkephalin-like material heterosegmentally in the rat spinal cord. AB - Although the physiological functions of the endogenous opioid systems are not yet clearly established, it is widely accepted that they exert an inhibitory control on pain transmission. However, the well-documented hypoalgesic effects of low doses of the opiate antagonist naloxone both in animals and humans do not fit in with this concept. The present investigations, at two different spinal/medullary levels (viz. cervicotrigeminal and lumbar) demonstrate that, in the rat, a noxious mechanical stimulus does not alter the release of Met-enkephalin-like material (MELM) from neural segments related to the stimulated area of the body, but does increase its release from other segments. Electrophysiological studies have already demonstrated the existence of such heterosegmental mechanisms, notably 'diffuse noxious inhibitory controls' (DNIC), which are naloxone reversible and could play an important role in pain perception. The involvement of spinal enkephalins in DNIC would seem to mean that the heterosegmental spinal release of MELM triggered by noxious stimuli participates in pain processes. PMID- 3828786 TI - Kappa-flavitoxin: isolation of a new neuronal nicotinic receptor antagonist that is structurally related to kappa-bungarotoxin. AB - A peptide, termed kappa-flavitoxin (kappa-flavitoxin), has been purified from the venom of the red-headed krait, Bungarus flaviceps, by low- and high-pressure liquid chromatography. kappa-Flavitoxin has a pI of 8.8 and an apparent molecular weight on sodium dodecyl-sulfate-polyacrylamide gel electrophoresis of 6500 Da. kappa-Flavitoxin is a potent inhibitor of nicotinic transmission in autonomic ganglia, producing a complete and long-lasting blockade at doses as low as 50 nM. Intracellular recordings reveal a selective blockade of neuronal nicotinic receptors by the toxin, with no effects on other active or passive properties of neuronal membranes. kappa-Flavitoxin shares a number of pharmacological and biochemical properties with kappa-bungarotoxin, purified from the venom of Bungarus multicinctus. The two peptides exhibit considerable homology in their amino acid sequences. Radiolabeled kappa-flavitoxin binds to a nicotinic site in ciliary ganglia previously identified by kappa-bungarotoxin, which appears to be associated with the neuronal nicotinic receptor. This site is not recognized by alpha-bungarotoxin, which also does not block nicotinic transmission in this ganglion. PMID- 3828788 TI - Changes during the moult cycle in the bursting firing pattern of the electrical activity recorded extracellularly from the sinus gland of the terrestrial isopod, Oniscus asellus. AB - Ongoing electrical activity of the sinus gland (SG) of the terrestrial isopod, Oniscus asellus, was recorded extracellularly from almost intact breeding or non breeding females to delineate the major times of neurohormone release during the moult cycle. In intermoult, SGs discharged in long bursts (10-50 s) at high frequency (10-45 Hz), and their activity ratios (total burst duration divided by total time the SG was monitored) ranged from 0.22 to 0.73. At premoult initiation when release of moult-inhibiting hormone is expected to decline, a decrease in SG activity occurred. It rose again in early premoult in parallel with increases in ecdysteroid titre; declined again in late premoult during peak ecdysteroid titres; increased again just prior to posterior ecdysis, and was very low during posterior ecdysis itself. Activity increased immediately after posterior and anterior ecdysis suggesting the release of neurohormones involved in calcification of the new cuticle. Burst duration was ca. two-fold longer in breeding compared to non-breeding females during early premoult suggesting the release of neurohormones involved in vitellogenesis, and before anterior ecdysis suggesting release of neurohormones involved in egg deposition. Thus, the release of neurohormones occurred during 4 major periods in each moult cycle, clearly demonstrating a relationship between SG activity in situ, and the physiological events dependent on SG hormones. PMID- 3828787 TI - Brain dopamine receptor levels elevated in canine narcolepsy. AB - Concentrations of dopamine D2 receptors in discrete brain areas differed significantly between dogs with the genetically transmitted form of narcolepsy, and age- and breed-matched controls. D2 receptors were assayed and quantified with Scatchard analysis using [3H]spiperone. Receptor densities in the nucleus accumbens, rostral caudate, and amygdala were consistently higher in narcoleptic animals. In amygdala, dopamine receptor abnormalities were associated with elevated dopamine and 3,4-dihydroxyphenylacetic acid concentrations, but no change in 3-methoxytyramine or homovanillic acid concentrations. These data indicate mesolimbic system involvement in canine narcolepsy and point to impaired dopamine release as a possible etiologic factor. PMID- 3828789 TI - Biochemical and morphological studies on GABA neurons in reaggregate culture. AB - Dissociated cells from the 14-day fetal mouse corpus striatum (CS), rostral mesencephalic tegmentum (RMT) and tectum were reaggregated in rotation-mediated cultures in the following combinations: CS alone, RMT-CS, RMT-tectum, and tectum alone. Reaggregates were cultured for 1-4 weeks. An even distribution of gamma aminobutyric acid (GABA)-positive cells was observed in all the reaggregate combinations that were cultured for 1 and 2 weeks. With increasing time in culture, cellular staining was decreased while positive fiber staining increased. CS and RMT-CS co-cultures increased their capacity to take up [3H]GABA with time in culture. All reaggregates reached a maximum uptake/accumulation capacity of 30 40 pmol/mg protein/30 min, by 4 weeks in vitro. There were no significant differences between the various co-aggregate combinations in the accumulation capacity. [3H]GABA accumulation in the reaggregates was largely blocked by the putative neuronal GABA uptake inhibitor, diaminobutyric acid, and was inhibited to a much lesser degree by the putative glial uptake inhibitor beta-alanine. All reaggregates released [3H]GABA to 70 mM potassium depolarization, in a calcium dependent manner. One-three week CS reaggregates released more [3H]GABA in response to the potassium-induced depolarization than RMT-CS co-cultures. Since nigral dopamine neurons within the RMT proliferate processes and actively release dopamine only when co-cultured with CS target cells, it is suggested that these dopamine neurons might chronically inhibit striatal GABA neurons in the RMT-CS co cultures, thereby depressing stimulated release of [3H]GABA. PMID- 3828790 TI - Locomotion elicited by lateral hypothalamic stimulation in the anesthetized rat does not require the dorsal midbrain. AB - Locomotor stepping elicited by lateral hypothalamic stimulation in the anesthetized rat is blocked by lesions in the anterior ventromedial midbrain. This study determined in acute experiments whether the dorsal midbrain regions implicated in locomotion were also part of the necessary pathway. Rats were anesthetized with Nembutal and held in a stereotaxic apparatus so that stepping responses rotated a wheel. Stepping was elicited by stimulation of the lateral hypothalamus (up to 100 microA, 0.5 ms cathodal pulses, 50 Hz, 10-s train length). Nine rats received unilateral lesions ipsilateral to the locomotor electrode and 3 rats received bilateral lesions. None of the dorsal midbrain lesions reduced locomotion elicited by ipsilateral lateral hypothalamic stimulation. Therefore the following regions are unnecessary for this type of locomotion: the dorsal and lateral central gray, the tegmentum lateral to the central gray, and in particular the area cuneiformis and the dorsal aspect of the pedunculopontine region. The neural systems required for lateral hypothalamic locomotion are located ventral to the superior cerebellar peduncle. PMID- 3828791 TI - Cerebrospinal fluid levels of uric acid in dogs and the effect of allopurinol. AB - Uric acid (UA) levels in cerebrospinal fluid (CSF) were measured in 15 dogs and the entrance and effect of allopurinol, a specific inhibitor of enzyme xanthine oxidase (XO), in brain were measured by sampling CSF in dogs. Allopurinol was administered intravenously 25 mg/kg every 6 h for 48 h. Drug level as well as UA level in plasma and CSF was measured by high-performance liquid chromatography. A significant concentration of allopurinol was achieved in CSF and a remarkable suppression of CSF UA level was observed at all time points measured. Decrease of UA in CSF level was more pronounced than in plasma, and was not considered secondary to suppression of systemic XO activity. Therefore the regimen employed was proven to be sufficient to suppress XO activity in the subarachnoid space, and drug concentration observed in CSF during this period (5 micrograms/ml) is considered to be in the therapeutic range. PMID- 3828792 TI - Auditory- and movement-related neural activity interact in the pulvinar of the behaving rhesus monkey. AB - We recorded the activity of 101 pulvinar nucleus neurons in a rhesus monkey performing an auditory discrimination task. The monkey was trained to push a lever to the left after hearing a noise burst and to the right after hearing a tone. When the stimulus was presented every 3 s the auditory evoked potentials (AEPs) habituated very rapidly to about 10% of initial height. With a stimulation rate of 1 every 15 s, however, the AEPs maintained full amplitude. A movement related increase in firing rate was recorded in 81 units (80%) and could usually be detected 100-200 ms before onset of arm EMG. A stimulus-related firing was detected in 70 units (69%). Most of the stimulus-driven units (65/70) were also movement-driven. No responses correlated to the movement or to the sound stimuli were seen during passive conditions, i.e. when the monkey was not engaged in task performance. The occurrence of both stimulus- and movement-related activity in single pulvinar units suggests sensory-motor interaction possibly related to the decision to perform a certain movement. PMID- 3828794 TI - Morphometric and dendritic analysis of fascia dentata granule cells in human aging and senile dementia. AB - In this study the cellular morphology in the human fascia dentata of 5 very old demented cases (4 Alzheimer's disease and 1 multi-infarct dementia patients) was compared with 5 (very) old controls cases. The postmortem delay in fixation was for all cases within 3.5 h. In the demented group, a significant reduction in thickness of the molecular layer, density of dendritic spines in the middle third of the molecular layer and total dendritic length (+/- 30%) was found. The number of dendritic segments, indicative of the branching frequency showed no difference. In both the control and the demented group, three-quarters of all dendritic bifurcations of granule cells occurred in the inner third of the molecular layer in which the commissural and associational fibers terminate. The size of the dendrites in the demented group could be the result of at least 3 independent processes: a regressive change due to partial denervation of the outer two-thirds of the molecular layer as axons from the perforant pathway are lost; a dendritic regrowth in response to sprouting of the commissural associational fiber systems and septal afferents, which is presumed to occur in response to degeneration of perforant path axons; a dendritic regrowth in response to the loss of the dendrites of neighboring cells which have died. Analysis of our material suggests that dendritic degeneration is the predominant factor in the demented group. PMID- 3828793 TI - Dendritic extent in human dentate gyrus granule cells in normal aging and senile dementia. AB - Granule cells of the hippocampal dentate gyrus of 22 human brains obtained at autopsy were studied in Golgi-Cox stained tissue. Seventeen cases were cognitively normal and ranged from 43 to 95 years of age. Five cases had a progressive, dementing disease consistent with the diagnosis of senile dementia (SD) of the Alzheimer's type. Dendritic extent of granule cells was found to increase in normal aging between middle age (fifties) and early old age (seventies). However, dendritic regression was found in the oldest old (nineties). This finding of dendritic regression following growth is in contrast to previous quantitative reports of continued dendritic growth in parahippocampal gyrus of normal aging human brain and suggests that changes in dendritic extent in normal aging are region and age specific. In cases with SD, dendritic extent was greatly reduced when compared with the normal cases of the same age (seventies) and slightly reduced when compared with middle-aged cases. The very old normal and SD cases were similar in dendritic extent, suggesting that the functional and memory deficits characteristic of SD cannot be explained solely on the basis of the static status of dendritic extent of single neurons. PMID- 3828795 TI - Membrane excitability changes in hindlimb motoneurons induced by stimulation of the locus coeruleus in cats. AB - The present analysis describes the cellular mechanisms underlying the heightened membrane excitability of hindlimb flexor and extensor motoneurons upon stimulation of the locus coeruleus (LC) in unanesthetized, decerebrate cats. In a total of 73 cells, brief train stimuli to the LC at 50-300 microA intensity evoked one of 4 patterns of motoneuronal responses: a simple excitatory postsynaptic potential (EPSP) with weak trailing depolarization, a double-peak EPSP, an EPSP succeeded by a weak hyperpolarization, or a slow rising EPSP. As the initial dominant EPSP was a consistent finding among all cells and the ensuing potentials were variable in polarity, quantitative characterization was focused on the initial EPSP only. In all cells tested (n = 11), the LC-EPSP was accompanied by a decrease in input resistance. The excitatory LC action was further demonstrated by the consistent (n = 25 cells) motoneuron rheobase decrease when the latter was measured coincident with the summit of an LC-EPSP. Furthermore, the time course of the single-spike afterhyperpolarization became shortened during the LC conditioning stimuli (n = 16 motoneurons). Our data show that the descending LC action on motoneurons is typified by an EPSP accompanied by a net decrease in input resistance as well as a concurrent increase in motoneuron electrical excitability. PMID- 3828796 TI - D-[3H]aspartate release from hippocampus slices studied in a multiwell system: controlling factors and postnatal development of release. AB - Medium components and various factors were tested to define optimal conditions for D-[3H]aspartate release. Isolation of the hippocampus and preparation of the slices in a medium without Ca2+ increased the release of D-[3H]aspartate in response to veratridine when subsequently tested in a regular Ca2+ containing medium. Apparently, the absence of Ca2+ during preparation of the slices reduced irreversible damage due to hypoxic conditions which prevail throughout the interval between killing the animal and immersion of the slices in a well oxygenated medium. Substitution of 10 mM Mg2+ for Ca2+ was an efficient procedure to test for Ca2+ dependence of D-[3H]aspartate release induced by veratridine. The inhibition was readily reversible when Ca2+ was readded. Veratridine (50 microM) was superior to high K+ (45 mM) in inducing D-[3H]aspartate release under all conditions tested in slices of mature animals. Furthermore, veratridine induced release could be completely blocked by tetrodotoxin while K+-induced release was essentially unaffected by this toxin. Postnatal development of the D [3H]aspartate release induced by veratridine was found to require 40-45 days, whereas release induced by K+ reached about 80% of maximum at postnatal day 22. K+-induced release appears to reach maturation when most hippocampal cells have been formed while veratridine-induced release probably requires completion of the neural circuit, involving also extensive sodium channel formation. These investigations were conveniently performed using a modified plastic culture box in which 24 slice systems can be studied simultaneously. PMID- 3828797 TI - Receptive field properties of somatosensory callosal fibres in the monkey. AB - The corpus callosum is the principal neocortical commissure which transmits lateralized information between the hemispheres. The aim of the present experiment was to study the receptive field properties of somatosensory callosal fibres in rhesus macaque monkeys. The callosum was approached under direct visual control and axonic responses were recorded using tungsten microelectrodes. All sensory submodalities which could be examined with the available instruments were found (light touch, medium and deep pressure, joint movement and light pinches). Most fibres had receptive fields concerned with the trunk, followed by the head, with only a few responding to stimulation of the extremities. The medial borders of the unilateral receptive fields situated on the trunk and the head extended to the midline. The results are interpreted in terms of the roles of the corpus callosum in midline fusion and interhemispheric transfer. PMID- 3828798 TI - Carbachol changes spike-generation properties of GH3 pituitary cells. AB - Membrane effects of carbachol (50 microM) on GH3 pituitary cells were studied using whole-cell type electrophysiological techniques. Carbachol (50 microM) decreased the threshold for generation of spontaneous and current-induced action potentials and prolonged their duration. It is suggested that carbachol blocks potassium channels in GH3 pituitary cells, and that the effect is mediated via activation of muscarinic cholinergic receptors. PMID- 3828799 TI - Differential distributions of cholecystokinin in hamster and rat forebrain. AB - Rats and golden hamsters show a differential feeding response to intracranial injections of cholecystokinin (CCK). Rats, but not hamsters reduce food intake after CCK injections into the hypothalamic paraventricular nucleus. In view of this species difference, we undertook an immunohistochemical study of the distribution of CCK-immunoreactivity in the hamster hypothalamus and remaining forebrain. CCK-immunoreactive perikarya were abundant in the neocortex, claustrum, hippocampal formation, amygdaloid complex, bed nucleus of the stria terminalis, nucleus of the lateral olfactory tract and in the magnocellular basal nucleus. CCK-immunoreactive neurons had a more restricted distribution in the diencephalon and were relatively rare in the preoptic area-hypothalamus. The only exception was the suprachiasmatic nucleus and adjacent medial anterior hypothalamus, in which CCK-immunoreactive neurons were numerous. CCK-containing perikarya were not observed in the hamster hypothalamic paraventricular and supraoptic nuclei, where they have been reported to occur in the rat. Groups of CCK-positive perikarya were also noted in the hamster thalamic paratenial and parafascicular nuclei. CCK-immunoreactive fibers/terminals were localized in the caudate and putamen, periventricular zones, dorsolateral geniculate, thalamic reticular nucleus and the superficial layer of the optic tectum. Fiber/terminal labeling was also present in those regions associated with CCK-immunoreactive perikarya. Our results indicate that the telencephalic distribution of CCK containing neurons in the hamster appears to be similar to that reported in the rat. However, several differences occur in the diencephalon. Perhaps the most striking is that the hamster differs from the rat in having a large group of CCK containing neurons in the suprachiasmatic nucleus, and in lacking the CCK containing perikarya observed in the rat paraventricular and supraoptic nuclei. These differences may underly species differences in feeding responses to intracranial CCK injections and gonadal responses to short photoperiods. Our data further suggest that the distribution of neuropeptides and other neuroactive substances may not always be conserved during evolution. PMID- 3828800 TI - The characterization of [3H]sulpiride binding sites in rat striatal membranes. AB - The characteristics of [3H]sulpiride binding to the D2 dopamine receptor in rat striatal membranes were examined under several conditions. In the absence of sodium ions, the specific binding of [3H]sulpiride could not be detected. In the direct binding experiment, at 25 degrees C, the affinity of [3H]sulpiride for D2 receptors was increased in a dose-dependent manner of sodium ions whereas magnesium ions have opposite effects on an affinity of [3H]sulpiride binding. The lowering incubation temperature (4 degrees C) also produced a further increase in affinity of the ligand. Under all conditions, [3H]sulpiride labeled a single homogenous site of the receptor. On the other hand, the result from quantitative analysis of agonist/[3H]sulpiride competition curves indicated an existence of high (RH) and low (RL) affinity states for agonists and the proportion of two affinity states was modulated by guanosine triphosphate (GTP), magnesium ions and lowering temperatures. GTP, together with sodium ions, caused a full conversion of RH to RL, while an increase in the affinity for agonists with a partial conversion of RL to RH could be induced by magnesium ions at 25 degrees C. At a lower (4 degrees C) temperature, the agonist competition curve indicated an existence of a single agonist low-affinity state (RL) and then, the effects of GTP and magnesium ions in the agonist affinity observed at 25 degrees C were abolished. These results can be incorporated into a two-step, ternary complex model involving an inhibitory guanine nucleotide binding protein for the agonist and antagonist interaction with D2 receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828801 TI - Suppression of the recurrent inhibitory pathway in lumbar cord segments during locus coeruleus stimulation in cats. AB - The present study revealed a consistent reduction of ventral root-induced recurrent inhibition of monosynaptic reflexes in both extensor (gastrocnemius soleus) and flexor (common peroneal) motonuclei upon delivery of preconditioning stimuli to the locus coeruleus (LC) in decerebrate cats. The magnitudes of the LC induced decrease in recurrent inhibition, functionally disinhibition, and of recurrent inhibition were significantly correlated. Direct recordings from Renshaw cells have indicated that LC conditioning stimuli cause a decrease in the number of spikes and the duration of firing in response to single antidromic (ventral root) volleys. These results suggest that the LC depression of the recurrent inhibitory pathway is attributed, in part at least, to inhibition of Renshaw cell activity. PMID- 3828802 TI - Acute ethanol effect on calcium antagonist binding in rat brain. AB - We investigated the effect of acute ethanol administration on voltage-sensitive calcium channels (VSCC) by measuring [3H]nitrendipine ([3H]NTP) binding to crude synaptosomal membrane preparations from different rat brain areas, i.e. cerebral cortex, hippocampus and striatum. Ethanol enhances the number of binding sites shortly after the administration (40 min), then Bmax returns towards control values while the binding affinity increases. Kd decreased peaks 8 h after the oral administration and returns within the range of control values at 36 h. The in vitro addition of ethanol has no effect on [3H]NTP binding at various concentrations up to 600 mM. These results suggest that acute ethanol treatment modifies VSCC supporting the concept that the short-term neurochemical alterations induced by in vivo ethanol administration involve calcium channels. PMID- 3828803 TI - Cortical ablation fails to influence striatal dopamine target cell supersensitivity induced by nigrostriatal denervation in the rat. AB - The possible influence of the corticostriatal (glutamatergic) pathway on denervation-induced striatal dopamine target cell supersensitivity has been investigated in the rat by measuring the changes in striatal acetylcholine levels induced by the dopamine agonist pergolide and the basal dopamine D2-receptor density after combined 6-hydroxydopamine-induced lesion of the substantia nigra and cortical ablation. Lesion of the nigrostriatal dopaminergic pathway alone enhanced the ability of pergolide (0.06-1 mg/kg i.p.) to increase acetylcholine levels and increased the maximal density of [3H]spiperone binding sites in the striatum. Similar changes in these biochemical parameters were observed after combined cortical ablation and nigral lesion. Cortical ablation by itself slightly diminished acetylcholine levels and reduced by 30% [3H]spiperone binding site density in the striatum. These results indicate that the corticostriatal tract does not influence striatal dopamine target cell supersensitivity caused by dopaminergic denervation. PMID- 3828804 TI - Adrenergic receptor and catecholamine distribution in rat cerebral cortex: binding studies with [3H]prazosin, [3H]idazoxan and [3H]dihydroalprenolol. AB - The tritiated adrenergic antagonists [3H]dihydroalprenolol ([3H]DHA; beta receptors), [3H]prazosin ([3H]PRZ; alpha 1-receptors), and [3H]idazoxan ([3H]IDA; alpha 2-receptors) were used to determine the distribution of these sites in 5 defined areas of the adult rat cerebral cortex. The highest density of [3H]PRZ binding was found in the prefrontal cortex, with a lower and homogeneous distribution for the frontal, parietal, occipital and temporal areas. The [3H]IDA binding sites were fairly uniform for all areas, except for the temporal cortex where it was very dense. In contrast, beta-adrenoceptors labelled by [3H]DHA were very homogeneous for all the regions examined. The functional significance of the distribution of alpha 1, alpha 2 and beta-adrenoceptors is discussed in relation to the catecholamine innervation and monoamine contents measured by high performance liquid chromatography. PMID- 3828805 TI - Anesthetic protection against anoxic damage in the rat hippocampal slice. AB - Evoked population spikes were recorded from the dentate granule cell layer of hippocampal slices obtained from adult rats. These slices were subjected to short periods of anoxia in the presence of different anesthetics. The recovery of the population spike after anoxia was compared across treatments. Little or no recovery was found after 10 min of anoxia when no anesthetic (4 +/- 4%), 1.5% isoflurane (5 +/- 5%), or 15% isoflurane (0 +/- 0%) was present during the anoxic periods. However, the population spike did recover to 81 +/- 7% of its preanoxic amplitude within 1 h after the anoxia if thiopental 160 mg/liter was present in the perfusate during the anoxia. Fifteen percent isoflurane and 160 mg/liter thiopental were equipotent in reducing the amplitude of the evoked population spike before anoxia but only thiopental protected against the damage after 10 min of anoxia. Our results suggest that the blocking of the evoked population spike by thiopental is not the sole mechanism of its protection against anoxic damage. Isoflurane (1.5%) was able to provide a small degree of protection against shorter periods (7 min) of anoxia. PMID- 3828806 TI - Is there a serotonergic tonic descending inhibition on the responses of dorsal horn convergent neurons to C-fibre inputs? AB - In the anaesthetized rat the intravenous injection of 5-HT antagonists, cinanserin and methysergide, induces in two-thirds of neurones studied, an increase in the responsiveness of dorsal horn convergent neurones to C-fibre stimulation. These results are in favour of the existence of serotonergic tonic descending inhibitory effects on the spinal transmission of noxious messages. PMID- 3828807 TI - Neurotensin self-injection in the ventral tegmental area. AB - Earlier work with the conditioned place-preference paradigm suggested that neurotensin (NT) acts as a behavioral reinforcer when microinjected into the ventral tegmental area (VTA) of the midbrain. We report here that animals will perform an operant task to obtain microinfusions of NT into the VTA. Rats reliably pressed a lever to obtain NT infusions while neglecting an identical but inactive lever. Substitution of saline for NT initiated response extinction; following the reintroduction of NT, reliable responding resumed. These results extend earlier work suggesting that NT in the VTA can be a positive reinforcer. PMID- 3828808 TI - Changes in the frequency of basket cells in the dentate fascia following chronic ethanol administration in mice. AB - The frequency of basket cells in the granule cell layer of the dentate fascia of Short Sleep (SS) and Long Sleep (LS) mice was determined following 3 months of ethanol exposure. These mice were bred for their differential susceptibility to the narcotic effects of acute doses of ethanol. The ethanol-insensitive SS mice were unaffected by the treatment while the ethanol-sensitive LS mice that received ethanol showed a significant decrease in basket cell frequency over their control group counterparts. These basket cells are thought to control the tonic level of activity of the granule cells. Thus, a decrease in basket cell frequency might lead to higher granule cell activity following chronic ethanol exposure. This effect could counteract the assumed stronger depressant effect of ethanol in the relatively ethanol-sensitive LS mice. PMID- 3828809 TI - Effects of beta-endorphin2-9 on arginine-8-vasopressin and oxytocin levels in hypothalamic and limbic brain regions. AB - Immunoreactive arginine-8-vasopressin (AVP) and oxytocin (OXT) were measured in rat hypothalamic and limbic brain regions after the intracerebroventricular administration of beta-endorphin fragment 2-9 (beta E2-9). The peptide decreased the AVP content of the hippocampus and the OXT levels in the septum and amygdala. The present data favor the view that beta E2-9 interacts with limbic AVP- and OXT systems. PMID- 3828810 TI - 'Slow' field potentials in penicillin-perfused hippocampal slices. AB - Slow field potentials (SFP) lasting up to 5 s followed penicillin-induced bursts in CA3 of guinea pig hippocampal slices and accounted for most of the interburst interval. The longest lasting component of the SFP which was maximal in the distal apical dendritic region was usually absent in s. pyramidale. Potassium flux underlies the entire potential, however, chloride-mediated components also contribute to the initial portion (approximately 1 s). The SFP was associated with neuronal afterhyperpolarization and glial cell depolarization, however, no unique cellular events could be identified with the 3 peaks of the SFP. The complex waveform of the SFP is probably the result of summation of neuronal and glial components. PMID- 3828811 TI - Angiotensin II inhibits the K+-evoked release of [3H]norepinephrine from hypothalamic synaptosomes of the spontaneously hypertensive rat. AB - The effect of angiotensin II on the basal and K+-evoked release of [3H]norepinephrine was examined in hypothalamic and brainstem synaptosomes from adult male normotensive (Wistar-Kyoto, WKY, and Sprague-Dawley, SD), and spontaneously hypertensive (SH) rats. Angiotensin II attenuated the [3H]norepinephrine release caused by maximal depolarizing concentrations of K+ (75 mM) in hypothalamic synaptosomes of the SH rat, but had no effect on basal [3H]norepinephrine release. Angiotensin II had no effect on either the basal or K+-evoked release of [3H]norepinephrine in brain synaptosomes prepared from either WKY or SD adult male rats. The results suggest a distinct role of angiotensin II in the modulation of catecholamine release in the SH rat. PMID- 3828812 TI - The dose-response effects of caffeine on sleep in rats. AB - Caffeine at doses of 0.125, 1.25, 12.5 and 25 mg/kg was administered to rats and the subsequent effects on the sleep-wake cycle were measured. The 12.5 and 25 mg/kg doses of caffeine increased wakefulness, and decreased slow wave sleep-1 (SWS1), SWS2, rapid eye movement (REM) sleep and total sleep time (P less than or equal to 0.05). The 0.125 and 1.25 mg/kg doses of caffeine increased SWS1 at the expense of SWS2 (P less than or equal to 0.05), and did not affect total sleep time in any time period measured. Adenosine or adenosine agonists have been shown to increase SWS2 at the expense of waking or SWS1 with an increase in total sleep time. The effects of caffeine on sleep reported in this study suggest that caffeine administration not only antagonizes the effects of adenosine at the receptor level, but also at the behavioral level. PMID- 3828813 TI - Noradrenergic sub-sensitivity in the cerebral cortex of the tottering mouse, a spontaneously epileptic mutant. AB - The glycogenolytic action of norepinephrine (NE) was examined in the tottering mouse, a spontaneously epileptic mutant which presents a noradrenergic hyperinnervation of various CNS areas, including the cerebral cortex. The potency and efficacy of NE in promoting glycogenolysis were markedly decreased in cerebral cortical slices prepared from homozygous tottering (tg/tg) when compared to control C57BL/6j (+/+) mice, indicating a sub-sensitive response to a cellular action of NE. The metabolic nature of this adaptive change suggests that an impaired capacity of NE in mobilizing energy substrates may be related to the expression of the epileptic symptomatology in this mutant. PMID- 3828814 TI - Release of cerebellar inhibitory activity by partial destruction of the inferior olive with kainic acid in rat. AB - Partial destruction of the neurones of the inferior olive was obtained by local ionophoretic injection of kainic acid. Complex spike discharges of the Purkinje cells are suppressed 2-3 h after application of the drug. The metabolic activity increases in the region of the cerebellar nuclei within 2 h and persists for 3 days following the kainic acid injection. The increase is only observed in those parts of the cerebellar nuclei receiving terminals from the Purkinje cells deafferented of the climbing fibres. No changes were detected when the injection affected only the underlying reticular formation. PMID- 3828815 TI - The role of the temporal lobe amygdala in ponto-geniculo-occipital activity and sleep organization in cats. AB - Ponto-geniculo-occipital (PGO) spikes propagate to different structures of the limbic system, including the temporal lobe amygdala. There is direct connection between the amygdala and the pontine nuclei involved in the generation of PGO spikes. It has also been shown that both the amount and the pattern of PGO spike discharges are under the influence of several brainstem and forebrain structures. In the present work, PGO activity was analyzed in unrestrained cats submitted to low-intensity amygdaloid electrical stimulation during paradoxical sleep (PS) episodes. General sleep organization as well as number, mean duration and percentage of PS episodes, were assessed in 8-h sleep recordings during amygdaloid stimulation. Amygdaloid stimulation significantly increased PGO number, spike density and, specially, PGO burst density. No significant changes were found in PS episodes or in the slow-wave sleep. It is concluded that the amygdala plays a role in the modulation of PGO activity by means of a facilitatory influence. It is proposed that this influence is probably exerted through a positive feedback mechanism. The independence between PGO generation and PS maintenance mechanisms is emphasized. PMID- 3828816 TI - Pentobarbital-induced changes in the mouse brainstem auditory evoked potential as a function of click repetition rate and time postdrug. AB - The effects of pentobarbital (80 mg/kg, i.p.) and saline injections on the BAEP were studied in 10 adult female BDF1 mice. Pentobarbital anesthesia induced statistically significant increases in the amplitudes and latencies of various BAEP components relative to preinjection and saline control values. These pentobarbital-induced changes were maximal shortly after drug administration and dissipated over time in a pattern similar to a drug elimination curve. Since pentobarbital and fast stimulus repetition rates are considered to be 'synaptic stressors', it was predicted that pentobarbital anesthesia and click repetition rate would have combined effects on the BAEP. This prediction was partially supported in that pentobarbital-induced changes in P4 amplitude and latency were significantly dependent on click repetition rate. The pentobarbital-induced effects on earlier BAEP components, however, proved to be largely independent of click rate. Pentobarbital-associated changes in the BAEP were not due to such factors as core temperature changes, circadian variations, and stress. The importance of anesthetic-induced changes in the BAEP for clinical and experimental studies is discussed. PMID- 3828817 TI - Influence of meprobamate and phenobarbital upon local cerebral glucose utilization: parallelism with effects of the anxiolytic diazepam. AB - The [1-14C]2-deoxyglucose technique was employed for an evaluation of the regional pattern of alteration of brain metabolism induced by the anxiolytics phenobarbital (which is described in small doses as anxiolytic agent) and meprobamate. Their effects were compared with those produced by the anxiolytic benzodiazepine diazepam which we have described in a previous study. In low doses, both meprobamate (30 mg/kg i.v.) and phenobarbital (5 mg/kg i.v.) elicited a regional pattern of changes similar to those seen with diazepam. Thus, the local cerebral glucose utilization (LCGU) of the mammillary nuclei, the lateral and ventral thalamic nuclei, the anterior thalamic nuclei and the geniculate nuclei was significantly decreased. A doubling of the dose (meprobamate 60 mg/kg i.v.; phenobarbital 10 mg/kg i.v.), however, resulted in a decrement in LCGU in virtually every brain region examined. Further, at this higher dose, phenobarbital significantly increased LCGU in the interpeduncular nucleus. These data demonstrate that both meprobamate and phenobarbital, in moderate doses induce selective alterations in LCGU in particular brain regions with the pattern of changes similar to that induced by diazepam. The structures affected may be of general importance for the expression of the anxiolytic actions of each of those classes of minor tranquilizers in clinical use. PMID- 3828818 TI - Retention of classically conditioned eyelid responses following acute decerebration. AB - We show that classically conditioned eyelid responses are retained in albino rabbits following decerebration. The presence of these responses represents retention rather than reacquisition in that they are present in the initial trials following decerebration. This excludes the possibility that the post decerebration conditioned responses are mediated by pathways different from those involved in the intact animal. These data indicate that the conditioned response pathway, and sites of plasticity, for eyelid conditioning are spared by decerebration and are contained within the brainstem and cerebellum. PMID- 3828819 TI - Monoaminergic correlates of kindling. AB - High-performance liquid chromatography with electrochemical detection was used to measure the regional concentrations of monoamines and metabolites in the brains of rats killed 2 or 4 weeks after kindling of generalized seizures with amygdaloid stimulation. Each kindled rat was compared to a yoked control that received brief trains of non-convulsive low-frequency stimulation of the amygdala. Two weeks after kindling we found a significant depletion of noradrenaline (NA) in the ipsilateral frontal cortex, a significant depletion of serotonin (5-HT) in the stimulated amygdala and contralateral hypothalamus, and no significant changes in concentration of dopamine (DA). Four weeks after kindling we found significant depletions of NA in the stimulated amygdala and ipsilateral hypothalamus, a significant depletion of 5-HT in the ipsilateral hippocampus, and no significant changes in DA. These findings generally fail to replicate previous reports of monoaminergic correlates of kindling. Furthermore, the alterations in monoamines produced by kindling do not fall into a simple and readily interpretable pattern. PMID- 3828820 TI - Cysteamine-induced depletion of central somatostatin-like immunoactivity: effects on behavior, learning, memory and brain neurochemistry. AB - The effects of a wide range of doses of systemically administered cysteamine were studied on locomotor behavior, passive avoidance memory, cortical and cerebrospinal fluid somatostatin-like immunoactivity and cortical levels of dopamine and norepinephrine. High doses of cysteamine (200 and 250 mg/kg s.c.) led to sustained locomotor activation. Doses of 150 mg/kg and above resulted in head and neck tremor and increased defecation. When cysteamine was administered immediately following the acquisition of a passive avoidance response, doses of 50 mg/kg and above resulted in significant attenuation of passive avoidance retention test performance. Cysteamine in doses of 50 mg/kg and above depleted cortical somatostatin-like immunoactivity by approximately 50%. The depletion of cortical somatostatin-like immunoactivity was accompanied by a rapid rise in somatostatin-like immunoactivity in cerebrospinal fluid. In addition to the depletion of somatostatin-like immunoactivity, high doses of cysteamine (150 mg/kg and above) produced changes in cortical levels of norepinephrine and dopamine, reminiscent of dopamine-beta-hydroxylase inhibition. The results of this series of experiments suggest that somatostatin, in addition to its effects on hormonal regulation, may play an important role in behavior and passive avoidance learning and memory. It is possible that the amnesia produced by cysteamine may have been due to the release of somatostatin into CSF from tissue stores, rather than somatostatin depletion per se. It is also possible that the catecholaminergic effects of high doses of cysteamine contribute to the behavioral deficits observed. PMID- 3828821 TI - Eicosanoid synthesis elicited by norepinephrine in piglet parietal cortex. AB - We investigated effects of exogenous norepinephrine and isoproterenol on pial arterial diameter and cerebral eicosanoid synthesis in anesthetized newborn pigs. Norepinephrine in artificial cerebrospinal fluid (CSF) constricted pial arteries from 203 +/- 27 micron (X +/- S.E.M.) to 164 +/- 18 micron (20 +/- 2%) (n = 21 vessels from 16 animals) at 10(-4) M. In the same animals, norepinephrine caused the concentration in CSF of 6-keto-prostaglandin F1 alpha to increase from 768 +/ 91 to 1544 +/- 151 pg/ml, thromboxane B2 to increase from 188 +/- 37 to 269 +/- 38 pg/ml, and prostaglandin E2 to increase from 2067 +/- 448 to 6575 +/- 751 pg/ml. Topical application of prostaglandin E2 in CSF to the cortical surface demonstrated that concentrations as low as 10,000 pg/ml were able to dilate pial arteries substantially. Blockade of cyclo-oxygenase activity by indomethacin (5 10 mg/kg, i.v.) potentiated pial arterial constriction to norepinephrine. Topical isoproterenol dilated pial arteries, but isoproterenol did not affect levels of measured eicosanoids in CSF. We conclude that norepinephrine elicits release of prostanoids from the cortical surface, and that these substances limit cerebrovascular constriction to norepinephrine. PMID- 3828822 TI - GABAergic mechanisms in nucleus tractus solitarius alter blood pressure and vasopressin release. AB - GABAergic agents microinjected into the nucleus tractus solitarius (NTS) influence blood pressure (BP) and plasma vasopressin (VP) levels. The direct acting GABAergic agonist muscimol (3.75-160 pmol) microinjected bilaterally into the NTS of chloralose-anesthetized, paralyzed, ventilated rats increased BP without significantly altering heart rate. Similar results were obtained using the indirect GABA agonist nipecotic acid (10 nmol), a GABA uptake blocker. In contrast, blocking the action of GABA with bicuculline (5 pmol) elicited a small but consistent decrease in BP. Injections of the vehicle (artificial cerebrospinal fluid) into the NTS or GABAergic agents in an area lateral to the NTS did not alter BP. Unilateral injection of muscimol into the NTS did not elicit immediate pressor responses as did bilateral injections; unilateral muscimol injections following destruction of the contralateral NTS produced a pressor response similar to that seen following bilateral muscimol administration. Stimulation of GABA receptors within the NTS by either muscimol or nipecotic acid resulted in an increase in plasma VP levels. The elevated levels of plasma VP contributed to the pressor response elicited by stimulation of GABAergic receptors as evidenced by the decrease in BP observed following the intravenous administration of a VP pressor antagonist during the pressor response. These studies indicate that tonically active GABAergic mechanisms within the NTS influence BP and VP release, and provide further evidence that VP can be involved in cardiovascular responses elicited from the NTS. PMID- 3828823 TI - Cerebrovascular and metabolic changes during the delayed vasospasm following experimental subarachnoid hemorrhage in baboons, and treatment with a calcium antagonist. AB - A model has been designed in baboons for simulating the clinical situation during the late phase of vasospasm in patients with subarachnoid hemorrhage (SAH). A total amount of 14-33 ml autologous blood was injected into the cisternal system on 3 occasions in the course of 4 days. Neurological symptoms were seen, and the mortality rate was 29%. Angiography 3 days after the last injection showed arterial vasoconstriction amounting to 23% in the vertebro-basilar system, and 11% (right) and 18% (left) in the carotid system. Cerebral blood flow (CBF) measured by the intra-arterial 133Xe technique and the cerebral metabolic rate of oxygen (CMRO2) were reduced by 18% and 11%, respectively. The hypercapnic CBF response was significantly impaired, from a mean of 3.90 ml/100 g/min to 1.72 ml/100 g/min of flow increase for each mm Hg elevation of paCO2. Autoregulation, tested by administration of angiotensin II, was also significantly affected as evidenced by a pressure-dependent increment of CBF during hypertension in 5 out of 7 animals tested. The impaired autoregulation was reflected in the autoregulatory index, which in the whole group increased from 0.06 ml/100 g/min for each mm Hg increase in MABP in the pre-SAH animals to 0.29 ml/100 g/min per mm Hg post-SAH. Treatment with the calcium antagonist, nimodipine (0.5 microgram/kg/min i.v. during 45 min), enhanced CBF significantly by 17% before experimental SAH, whereas after SAH the effect was slight and did not reach statistical significance; CMRO2 was not significantly affected in either group. Intravenous nimodipine combined with hypertension resulted in a marked increase in the autoregulatory index to 1.58 ml/100 g/min per mm Hg in pre-SAH animals and a less pronounced increment to 0.58 ml/100 g/min per mm Hg following experimental SAH. The beneficial effect of nimodipine reported in SAH patients is therefore, in view of our findings, more likely due primarily to a protective mechanism at the cellular level than to an influence on the vascular bed. PMID- 3828824 TI - Effects of ischemic nerve block on the early and late components of the stretch reflex in the human forearm. AB - To investigate the peripheral afferent mechanisms which mediate the short latency (M1) and long latency (M2) components of the stretch reflex, we have recorded EMG responses to extension perturbations at the wrist before and following inflation of a blood pressure cuff around the upper arm. After approximately 30 min of ischemia, the reflexes had almost completely disappeared, although subjects were still able to activate the forearm muscles voluntarily. As the ischemic block developed, the M2 component began to decrease in amplitude sooner than M1, and up to the time of complete loss of reflex activity, the suppression of M2 was relatively greater than that of M1. These results suggest that M2 may be mediated by a population of afferent fibers different from the Ia afferents which are believed to generate the M1 response. PMID- 3828825 TI - Node-like axonal undercoating in the optic nerve of heterozygous myelin-deficient rats. AB - Focal regions of node-like axonal undercoating occur occasionally in the myelin deficient rat spinal cord. In the optic nerve of heterozygous myelin-deficient rats, areas of amyelination are present, within which many axons show regions of node-like undercoating. These structures were most easily seen when fixation resulted in round axonal profiles. In one-year-old rats, these structures were common. The ubiquitous association of patches of axonal undercoating with regions of chronic amyelination and demyelination indicates that chronically demyelinated axons differ structurally from recently demyelinated axons. It is possible that such axons may have lost their ability to recruit myelin-forming cells. PMID- 3828826 TI - Serotonin-like immunoreactivity of giant olfactory interneurons in the crayfish brain. AB - A pair of large interneurons on each side of the brain of the crayfish, Orconectes virilis, react with an antibody raised against serotonin. Both neurons of each pair branch extensively in the olfactory lobe and terminate among the axons of the olfactory globular tract. PMID- 3828827 TI - Morphometry of individual capillary beds in the hypothalamo-neurohypophysial system of rats. AB - Unusually high capillary densities, volumes, and surface areas were revealed by morphometric analysis of the hypothalamic paraventricular nuclei (magnocellular and parvocellular divisions), supraoptic nuclei, and pituitary neural lobe of Long-Evans and Brattleboro rats. Capillaries of the magnocellular division of the paraventricular nucleus were greater in number, but smaller in diameter, than those in the parvocellular division. Expressed per unit area or volume, capillary dimensions in the hypothalamo-neurohypophysial system of Brattleboro rats were the same as in Long-Evans rats. PMID- 3828828 TI - Respiratory rhythm generator neurons in medulla of brainstem-spinal cord preparation from newborn rat. AB - Rhythmic neuronal activity preceding C4 inspiratory activity (Pre-I neuron activity) was recorded in rostral ventrolateral (near ventral surface) medulla of brainstem-spinal cord preparation isolated from newborn rat. Vagal stimulation inhibited C4 activity but not Pre-I neuron activity. Rhythmic Pre-I neuron-like activity was still recorded in the block of rostral medulla after transection. Results suggest that Pre-I neurons generate the basic respiratory rhythm and trigger inspiratory activity. PMID- 3828829 TI - Effects of ovariectomy and estradiol benzoate on high affinity choline uptake, ACh synthesis, and release from rat cerebral cortical synaptosomes. AB - Several presynaptic processes were studied in cerebral cortical synaptosomes prepared from intact adult female rats or from ovariectomized animals that received 3 subcutaneous injections of either estradiol benzoate (10 micrograms/kg) or vehicle. Injections were given 1/day, every other day, and animals were sacrificed 1 h after the last injection. High affinity choline uptake and coupled acetylcholine (ACh) synthesis were reduced by ovariectomy, and restored to control levels by the estradiol benzoate injections. In contrast, low affinity choline uptake and depolarization-induced [3H]ACh release were unaffected by either ovariectomy or estradiol benzoate injections. These results suggest that changes in estradiol levels may alter the high affinity transport process regulating ACh synthesis in this tissue. PMID- 3828830 TI - S(+)methylenedioxy-N-n-propylnoraporphine: an orally active inhibitor of dopamine selective for rat limbic system. AB - The 10-11-methylenedioxy (MDO) derivative of S(+)N-n-propylnorapomorphine (NPA) was prepared and tested as a possible active prodrug to S(+)NPA, which we have recently found to exert in vivo activity suggestive of selective antagonism of dopamine receptors in the limbic forebrain but not the extrapyramidal basal ganglia. Like S(+)NPA, S(+)MDO-NPA inhibited the behavioral arousal induced by dopamine injected into nucleus accumbens of the rat, but not the head-turning response to dopamine injected into the corpus striatum. However, only MDO-NPA was orally active and it was somewhat longer-acting than NPA. The activity of S(+)MDO NPA was prevented by pretreatment with the oxidase inhibitor SKF-525A. These properties are analogous to those of R(-)MDO-NPA, which we had previously reported as an orally active prodrug of the dopamine agonist R(-)NPA. Thus the methylenedioxy derivatives of the two entantiomers of NPA have properties desirable in a potentially clinically useful dopamine agonist and limbic dopamine antagonist, respectively. PMID- 3828831 TI - The circadian-gated timing of birth in rats: disruption by maternal SCN lesions or by removal of the fetal brain. AB - The roles of the maternal suprachiasmatic nuclei (SCN) and fetal brain in the circadian-gated timing of birth were studied in rats. The circadian gating of birth was shown by exposing different groups of dams to lighting cycles of opposite phase during pregnancy. Regardless of the phase of the prenatal lighting cycle, the time of birth was gated over a 36-h temporal window so that most births occurred during subjective day. Destruction of the maternal SCN eliminated the circadian gating; births occurred in a single distribution that peaked in the middle of the 36-h window. Removal of the fetal brain also disrupted the circadian gating of birth; dams of brain-aspirated fetuses no longer exhibited a daytime preference for births. These results show that the maternal SCN are necessary for the normal circadian gating of birth and are also consistent with a role for the fetal brain in this process. PMID- 3828832 TI - The accessory optic system of the monocularly deprived cat. AB - Single-unit extracellular recordings were made in the lateral (LTN) and dorsal (DTN) terminal nuclei of the accessory optic system (AOS) of 10 monocularly deprived cats. The separate effects of monocular deprivation (MD) observed in each hemisphere are outlined below. Unlike many units in normal animals, LTN and DTN cells in the hemisphere contralateral to the non-deprived (open) eye, were no longer activated through visual stimulation of the ipsilateral (deprived) eye. In both nuclei, cells were driven effectively only by stimuli presented via the contralateral eye. The distribution of preferred directions was considerably altered in the LTN but not in the DTN. Almost every LTN unit encountered in MD cats preferred downward stimulus motion, in contrast to normal animals where equal numbers of LTN cells show preferences for upward and downward movement (J. Neurophysiol., 51 (1984) 276-293). DTN units showed the usual preference for horizontal motion toward the recorded hemisphere. Velocity preferences were slower on average in the DTN, and unaffected in the LTN. In the hemisphere contralateral to the deprived eye, the ocular dominance distribution of LTN and DTN cells showed a distinct shift in favor of the contralateral (deprived) eye. This effect was not as complete as that observed in the other hemisphere. Cells in both nuclei displayed a small influence from the ipsilateral (exposed) eye in some animals, but this input was much less than that observed in normally reared cats. Average velocity preferences among DTN units were slower than normal, and slower relative to the DTN population in the opposite hemisphere. No pronounced changes were observed in LTN velocity tuning. The distributions of preferred directions for both nuclei were similar to those obtained in the other hemisphere: DTN cells were found to prefer horizontal motion, while most LTN units were activated best by stimuli moving vertically and down within their receptive fields. PMID- 3828833 TI - Effects of enucleation at different ages on the sizes of neurons in the lateral geniculate nucleus of infant and adult monkeys. AB - Cell areas have been measured in the lateral geniculate nucleus following enucleation in 7 infant and 3 adult monkeys. Deafferented cells showed rapid transneuronal degeneration. Following enucleation at birth non-deafferented parvocellular LGN cells underwent hypertrophy which was followed by a delayed return to normal size. Enucleation at 7 months of age caused marked shrinkage of non-deafferented parvocellular cells. These changes in the non-deafferented cells are similar to those following monocular lid closure at the same ages. Sizes of non-deafferented cells were unchanged following enucleation of adult monkeys. PMID- 3828834 TI - Changes in the size of cells in the monocular segment of the primate lateral geniculate nucleus during normal development and following visual deprivation. AB - Cell areas have been measured in the monocular segment of the lateral geniculate nucleus in a series of 18 normal rhesus monkeys and in 27 following monocular or binocular lid closure or monocular enucleation. Cells in the parvocellular monocular segment shrank by 16% during the later period of normal development, between about 3 and 18 months of age, in contrasts to cells in the binocular segment which did not. Monocular closure at birth caused hypertrophy of cells in the undeprived monocular segment whereas long-term closure started later caused shrinkage of both deprived and undeprived parvocellular cells additional to that occurring during normal development. In both these instances cells in the monocular segment related to the undeprived eye are undergoing changes indicating some form of binocular interactions even in the monocular segment, but these interactions are considerably weaker than in the binocular part of the nucleus. Enucleation caused marked transneuronal degeneration of cells in the contralateral monocular segment of both infant and adult monkeys. PMID- 3828835 TI - Ontogeny of [3H]neurotensin binding sites in the rat cerebral cortex: autoradiographic study. AB - The ontogeny of the neurotensin binding sites in the rat caudal cortex such as the retrosplenial cortex, the visual area containing area 17 and 18, the caudal somatosensory area and temporal area was examined by autoradiography. During the early postnatal period (from birth to day 10), very-high-density [3H]neurotensin binding sites were observed in the caudal cortical area, but the number of binding sites decreased markedly with age. On the other hand, the ventral tegmental area and substantia nigra pars compacta had a low density of binding sites at birth, but the density increased until about day 15 and remained even in the adult rat. These findings were confirmed by the biochemical binding analysis. PMID- 3828836 TI - Prolonged odor exposure causes severe cell shrinkage in the adult rat olfactory bulb. AB - Adult sensory systems generally remain viable as long as stimulation or disease do not physically damage the sensors. Continuous exposure of adult rats to a single odor for two months, however, caused a shrinkage of mitral cells in the olfactory bulb which was more extensive and severe than found in adult rats exposed to deodorized air, or normal rat colony odors. The results suggest that lack of excitation of mitral cells may cause significant shrinkage (deodorized air treatment), but more severe shrinkage may occur through inhibition or masking by a single dominant odor in the environment. These results have implications for humans living or working in odorous environments. PMID- 3828837 TI - Large and small medial frontal cortex lesions and spatial performance of the rat. AB - Rats with sham operations, or small or large medial frontal cortex lesions were compared for the acquisition of a position habit and for learning a series of 4 position habit reversals. No differences were found during acquisition of the position habit. On the reversals, the rats with the larger lesions were markedly impaired, while less severe deficits or control-like performance characterized the rats with the smaller ablations. Analyses of the error scores showed that the rats with the larger lesions made more perseverative errors than the other groups and performed more sporadically even after breaking a previous position habit. These results confirm the hypothesis that a strong relationship exists between medial frontal cortex lesion features (depth and length) and performance. The differences found in acquisition vs. reversal learning, and the nature of the errors observed, also suggest that this part of the brain functions as more than simply a spatial analyzer. PMID- 3828838 TI - Laminar distribution of GABA-immunoreactive neurons and processes in area 18 of the cat. AB - Intracortical inhibition mediated by the neurotransmitter gamma-amino butyric acid (GABA) plays a crucial role in the formation of the physiological response properties of neurons in mammalian visual cortex. Using a potent antibody developed against the amino acid neurotransmitter. GABA (Immunoclear Co., USA), we have identified GABA-immunoreactive neuronal somata and processes in area 18 of the cat. The GABA-positive neurons included multipolar, bipolar and bitufted but not pyramidal cell types. The density of GABA-immunoreactive neurons was higher in Layers I-IV (range 182-205 cells/mm2) than in Layers V-VI (range 78-92 cells/mm2). The mean areal measurement of GABA-immunoreactive somatic profiles was 135 micron2 (s.d. = 66). We observed numerous GABA-immunoreactive fiber fragments predominantly in Layers I, III, IV and V. Most of the fibers were oriented with their long axis tangential to the cortical surface, but, vertically oriented fibers were observed as well. Many of the fibers were axonal-like and appeared beaded in Layer I and occasionally in II, while most of the fibers in the other layers appeared myelinated. A dense GABA-immunoreactive neuropil was present in Layer V. Results from our studies provide immunohistochemical evidence for a system of GABA-immunoreactive neurons and axonal collaterals which presumably mediate inhibition in the visual cortex. Since many of the GABA immunoreactive fibers were oriented tangential to the cortical surface, the structural elements required for inhibition between functional columns are present. GABA-mediated inhibition both within and between functional columns likely assists in the formation of receptive field properties in the visual cortex. PMID- 3828839 TI - Chronic haloperidol decreases dopamine release in striatum and nucleus accumbens in vivo: depolarization block as a possible mechanism of action. AB - The effects of chronic haloperidol administration on the basal release of endogenous dopamine (DA) in the intact rat striatum and nucleus accumbens were investigated using in vivo electrochemical techniques. Repeated (21 day) treatment with haloperidol produced marked decreases in the release of DA in both brain regions. Administration of apomorphine to vehicle-treated control animals rapidly reduced DA release, in accord with its inhibitory, hyperpolarizing actions on DA neurons. In contrast, apomorphine reversed the haloperidol-induced reductions in DA release to values that were not significantly different from those measured in control animals. The present study is the first report to demonstrate decreased DA release in response to chronic neuroleptic treatment and to present evidence for induction of depolarization block of DA cell firing as a possible mechanism underlying this effect. PMID- 3828840 TI - Somatic labeling of the medial terminal nucleus of the accessory optic system with WGA-HRP injected into the rat occipital cortex. AB - Neuronal cell bodies in the medial terminal nucleus of the accessory optic system (MTN) were labeled with WGA-HRP which was injected ipsilaterally into the occipital cortex in the rat. We suggest that the label was first transported anterogradely to the pretectal nucleus of the optic tract, then moved transneuronally from axon terminals of occipital cortical neurons to axon terminals of MTN neurons, and finally transported retrogradely to reach cell bodies of MTN neurons. PMID- 3828841 TI - Retrograde HRP demonstration of afferent projections to the midbrain and nest calls in the ring dove. AB - Midbrain control of vocalization was evaluated in the ring dove by determining the major afferent inputs with retrograde tract tracing technique. Horseradish peroxidase was infused into various portions of the nucleus intercollicularis, an estrogen concentrating area, which disrupts nest calls when lesioned and induces the vocalization when stimulated by estrogen. Most labelled cell bodies were found in the archistriatum, including a region homologous to the mammalian amygdala. PMID- 3828842 TI - Projections between the hypothalamus and the dorsal vagal complex in the cat: an HRP and autoradiographic study. AB - The hypothalamus is known to be intimately involved in the control of autonomic function. This study provides detailed information about pathways between the hypothalamus and the dorsal vagal complex in cat. Injection of horseradish peroxidase into the dorsomedial medulla produced retrograde neuronal labeling in the paraventricular nucleus of the hypothalamus. Injection of 3H-leucine into the paraventricular nucleus produced dense anterograde labeling in the dorsal motor nucleus of the vagus, and lighter labeling in the nucleus of the tractus solitarius, particularly in its medial subnucleus. The subnucleus gelatinous was virtually free of label, except in its medial and lateral portions. Anterograde labeling was distributed bilaterally, with an ipsilateral predominance. Injection of horseradish peroxidase into the area of the paraventricular nucleus produced retrograde neuronal labeling bilaterally in the nucleus of the tractus solitarius and the reticular formation ventrolateral to the dorsal vagal complex. anterograde terminal labeling overlapped the distribution of retrogradely labeled neurons. These findings are compared to those in rat, and discussed in relation to their functional implications. PMID- 3828843 TI - Brown adipose tissue thermogenesis induced by low level electrical stimulation of hypothalamus in rats. AB - Brown adipose tissue (BAT) is an energy dissipating form of adipose tissue implicated in non-shivering thermogenesis as well as diet-induced thermogenesis. In the present study, in vivo interscapular BAT (IBAT) temperature was recorded prior to and following low level electrical stimulation (a 30 sec train of 60 Hz, 100 microA 0.5 msec isolated pulses) of various hypothalamic regions in rats. Significant increases in IBAT temperature were observed after stimulation of the anterior, medial preoptic, paraventricular and dorsomedial hypothalamus but not after stimulation of either ventromedial or caudal hypothalamus. For positive sites, IBAT temperature typically increased at 3-4 minutes following stimulation, peaked at 7-8 minutes after stimulation and declined at 20 minutes after stimulation. Although alterations in diet-induced thermogenesis have been reported after ventromedial hypothalamic lesions, the increases in BAT temperature noted in the present study suggest that inhibitory fibers that course through the paraventricular hypothalamus may form part of the central nervous system control of brown adipose tissue thermogenesis induced by overfeeding. PMID- 3828844 TI - The microcirculation of rat circumventricular organs and pituitary gland. AB - Blood volume, blood flow, and blood-to-tissue transfer of an amino acid in circumventricular organs, such as the median eminence and subfornical organ, and the pituitary gland of conscious rats were measured by using quantitative autoradiographic techniques and computer-assisted processing of the tissue images. Retained erythrocyte and plasma volumes observed in circumventricular organs and the anterior and neural lobes of the pituitary gland were dissimilar but in all cases greater by several times than those in cerebral grey matter; these findings suggest the presence of a dense network of high-resistance microvessels in circumventricular organs. The rate of capillary blood flow in the subfornical organ and median eminence was similar to that of grey matter, whereas blood flow in the pituitary neural lobe was several times higher than in grey matter. Thus the apparent velocity of intracapillary blood flow is much higher in the neural lobe than in the subfornical organ. Blood-to-tissue transfer of a small neutral amino acid, alpha-aminoisobutyric acid, was 200 to 700 times more rapid in circumventricular organs and pituitary neural lobe than in the inferior colliculus and caudate nucleus, structures having a blood-brain barrier (BBB). Morphometric analyses indicated that capillary volume and surface area were two times larger in the neural lobe than in the subfornical organ. Moreover, capillaries of the neural lobe and subfornical organ had numerous endothelial fenestrations and cytoplasmic pits or vesicles, whereas capillaries of the inferior colliculus had no fenestrations and fewer vesicles. These studies demonstrate quantitative differences in the microcirculatory systems not only between circumventricular organs and BBB structures but also among circumventricular organs. PMID- 3828845 TI - [Bronchial hyperreactivity. Significance and methods of its determination in functional diagnostic practice]. PMID- 3828846 TI - [Vectorcardiographic manifestations of interventricular septum activation]. PMID- 3828848 TI - [Blood pressure at the beginning and the end of the aorta]. PMID- 3828847 TI - [Mechanoreceptor sensitivity in the mucosa of the respiratory tract and pleura in cats with carrageenan pleuritis]. PMID- 3828849 TI - [Pathophysiology of dyspnea]. PMID- 3828850 TI - [Chromosome inversions]. PMID- 3828851 TI - [Epidemiologic aspects of the incidence of malignant tumors in Slovakia. The position and structure of mortality statistics in malignant tumors]. PMID- 3828852 TI - [The effect of beta-aescin, a saponin, on prenatal development in mice]. PMID- 3828853 TI - [Changes in the population of mitochondria in a model of myocardial cell damage]. PMID- 3828854 TI - The haematopoietic response to burning: studies in a splenectomized animal model. AB - Several haematopoietic changes occur following burning. These changes are important because they may effect a patient's ability to fight infection and to heal wounds. Studies of haematopoiesis in burned humans are difficult because of the complexity of these patients and because of the difficulty of collecting specimens. We therefore established a mouse model of these haematopoietic events; however, this model differed from the human situation as all three haematopoietic cell lines were being produced by the murine spleen. In this paper, we modified the model by removing the spleen and then repeating our previous studies. After splenectomy, granulocyte production, murine mortality and body weight did not change. Compared with the original model, the modified splenectomy model could not expand erythropoiesis. The result was greater anaemia. This model is, now, a closer simulation of the human situation and will prove useful in studies of haematopoiesis after thermal injury. PMID- 3828855 TI - The use of venovenous extracorporeal membrane oxygenation in sheep receiving severe smoke inhalation injury. AB - Smoke inhalation injury now represents the most frequent cause of death in burn patients, and accounts for 20-80 per cent of overall mortality. We have studied the use of extracorporeal membrane oxygenation (ECMO) to support sheep which have received lethal pulmonary smoke damage. The animals (n = 19) received inhalation injury induced by insufflation with smoke derived from burning cotton delivered with a bee smoker. The treatment group, those placed on ECMO at the time of injury (n=6), were systemically heparinized and placed on a venovenous perfusion circuit consisting of a roller pump, membrane oxygenator and heat exchanger. Blood flow rate in the circuit approximated 20-25 per cent of cardiac output. The animals remained on partial venovenous bypass until the termination of the experiment 96 h after injury. All animals in the treatment group survived. The control sheep (n = 7) received inhalation injury alone and had a 100 per cent mortality (P = 0.0015 ECMO vs. control). Ventilatory management of treatment and control groups followed an identical protocol. We have also studied a third group (n = 6) composed of animals receiving inhalation injury with systemic heparinization but not ECMO. This group had a 66 per cent mortality at 96 h. These studies suggest that partial venovenous ECMO may be a valuable form of adjunctive treatment in severe inhalation injury. PMID- 3828856 TI - Fluid resuscitation with hypertonic salt solutions in experimental burn shock. PMID- 3828857 TI - New ideas in splinting of burns. AB - Splinting in burns is by no means a new subject, but this paper tries to demonstrate a new approach using new materials and sometimes humour. Conventional burn splints, dynamic and static, have been described in the past. All the following splints are made either with Mediplast, a new Israeli product, or Hexcelite. PMID- 3828858 TI - A study to assess the effects of a new Betadine cream formulation compared to a standard topical treatment regimen for burns. AB - This study has shown that Betadine cream with or without Aserbine is as easy to apply and remove as Betadine ointment plus Aserbine. With Betadine cream there is as good as and in some instances better healing than with Betadine ointment/Aserbine in the topical treatment of burns. However, the addition of a necrolytic cream to Betadine cream does have favourable effects on wound healing and bacterial counts. More importantly, this study suggests that Betadine cream can penetrate the wound more effectively than the Betadine ointment/Aserbine combination but that the addition of a necrolytic cream is still advantageous. PMID- 3828859 TI - Psychosocial problems among adult burn victims. AB - The following tentative conclusions may be drawn from this pilot study: Depression and anxiety are moderately elevated in pre-discharge burn patients, and drop to normal or low levels with the passage of time. There is a significant incidence of post-traumatic stress disorder among recently burned patients, and the prevalence actually increases with time. This increase may be due to the incidence of the 'delayed' form of the disorder. Personality factors which may predict post-burn psychosocial outcome are neuroticism, trait anxiety and hypochondriasis. Burn severity does not usefully predict psychosocial outcome. The presence of compensation issues is associated with post-burn psychosocial difficulties, particularly in intimate family relationships. However there is no association with depression or anxiety. Pre-burn psychiatric morbidity is associated with poor post-burn psychosocial adjustment. PMID- 3828860 TI - Quantitative analysis of tight junctions and the uptake of 99mTc in human gliomas. AB - The structural dimensions of capillary tight junctions and the uptake of 99mTc pertechnetate in human gliomas were studied. Quantitative analysis revealed a correlation between the uptake of radionuclides and the length of endothelial tight junctions. It is suggested that brain scintigraphy might be used for the selection of malignant brain tumors with altered tight junctions which might be accessible to chemotherapy with water-soluble agents. PMID- 3828861 TI - Induction of the plateau phase and rescue of MOPC 104E by nonspecific immunization. AB - The enhancement of MOPC 104E myeloma growth by nonspecific immunostimulation with C. parvum or immunization with sheep red blood cells and levan mixture was evaluated in BALB/c mice. We observed increased levels of serum MOPC 104E IgM and early mortality in the tumor-bearing mice following treatment with C. parvum or antigenic stimulation. The enhancement of tumor growth observed was due to the production of lymphokine mitogenic factors produced in response to the nonspecific immunostimulation. PMID- 3828862 TI - Sibling incest: a study of the dynamics of 25 cases. AB - The purpose of the present study was to explore the frequently observed dynamics distinctive to the sibling incest family system, and to evaluate how these dynamics might predispose the family system to act out its dysfunction through sibling sexual conduct. Being a descriptive study by nature, the data is based on 25 families which were reported to the Boulder County (Colorado) Sexual Abuse Team between May 1982 and December 1985. The 25 families yielded a significant pattern of common dynamics. Those dynamics which were repeatedly observed throughout these cases were: distant, inaccessible parents; parental stimulation of sexual climate in the home; and family secrets, especially with regard to extramarital affairs. The implications of the findings suggest that the patterns that are emerging are becoming more predictable, making prognosis and therapeutic intervention far more encouraging. PMID- 3828863 TI - Attitudes of health professionals to child sexual abuse and incest. AB - While there has been increasing interest in the topic of child sexual abuse, few studies have focused on attitudes or the determinants of such attitudes held by professionals. To what extent concern is based on stereotyping or factual knowledge is not clear. The present study uses a combination of experimental and survey methodologies to address these issues. Sample case histories were issued to subjects who were then asked to complete a questionnaire on topics relating to the case and to incest in general. Results showed that the type of sexual activity involved influenced responses; type of relationship between adult and child, less so. Estimates of incest were low, but incest was considered, especially by female respondents, to be harmful to the victim. PMID- 3828864 TI - Back to the future. PMID- 3828865 TI - Child abuse potential and work satisfaction in day-care employees. AB - The Child Abuse Potential (CAP) Inventory and a Work Satisfaction Questionnaire were administered to 228 day-care employees at 40 centers to investigate the relationship between potential for child abuse and degree of job satisfaction. In addition, the ability of the CAP abuse scale to distinguish between groups of day care employees thought to differ in the quality of child care provided was studied. Small, albeit significant, inverse correlations were observed between abuse scores and two job satisfaction items. As clarity of job expectations and as overall job satisfaction increased, abuse scores decreased. Although abuse scores for all day-care employees were not significantly different from norm scores, significantly lower scores were found for employees from "superior" day care centers and for employees rated "high" by center directors. Abuse scores for employees rated "high" were also significantly below scores for employees rated "low." While these data indicate only limited relationships between child abuse and job satisfaction, the findings suggest the CAP abuse scale can distinguish some subgroups of day-care employees thought to differ in quality of child care provided. PMID- 3828866 TI - Teacher awareness program on child abuse: a randomized controlled trial. AB - Teachers have a significant role in preventing, detecting and reporting child abuse and neglect. They are hindered in fulfilling this role by a serious lack of knowledge of the law, of school board policies, and of maltreatment. A comprehensive professional development workshop was developed and presented to elementary school teachers. The package was evaluated by means of a randomized controlled trial. The workshop proved to be effective in increasing and maintaining knowledge. PMID- 3828867 TI - Teacher awareness of child abuse and neglect. PMID- 3828868 TI - [Child abuse and cultural attitudes: the example of Tunisia]. PMID- 3828869 TI - Children's response to a sexual abuse prevention program: a study of the Spiderman comic. PMID- 3828870 TI - Eardrum perforation as evidence of child abuse. PMID- 3828871 TI - Infant whiplash syndrome. PMID- 3828872 TI - Scarring for life: abuse with electric cords. PMID- 3828873 TI - Parents anonymous: helping clients to accept professional services, a personal opinion. PMID- 3828874 TI - Growth at the age of 4 years subsequent to early failure to thrive. AB - Fifty-five children previously investigated for failure to thrive (a rate of weight gain below -2 SD) during at least 6 weeks at 4-18 months of age were followed up and reinvestigated at the age of 4 years. The children were studied in two groups: children with organic causes (OFTT) (n = 21); and children for whom no organic cause was found (nonorganic failure to thrive, NFTT) (n = 34). In children with OFTT, normalization of growth was found for both weight and height attained, as most of the diseases were either amenable to treatment or spontaneously subsided. The only exception was a child with severe encephalopathy. In children with NFTT, much lower values were found, particularly for weight, p less than .01 for both weight and height. Children with a low psychosocial score (less than or equal to 3 adverse factors) showed partial catch up growth, although significantly lower than that of children with OFFT. Among 13 children with high psychosocial scores (greater than or equal to 4), 6 children had been subjected to strong social and/or psychological intervention. These children showed a more favorable growth pattern compared to children with comparable psychosocial scores where no intervention had been undertaken. The children with NFTT continued to grow slowly, remained meager and seemed to maintain a suboptimal growth pattern, particularly those with higher numbers of risk factors. PMID- 3828875 TI - The medical and psychosocial needs of children entering foster care. AB - The estimated three to four hundred thousand children in foster care represent a population at high risk for medical and psychosocial problems. Their problems are compounded by the lack of adequate resources available to them while in foster care. This study provided a medical and psychosocial screening of 149 abused and neglected children entering the foster care system. The goal was to generate a profile of the medical and psychosocial needs of children entering the foster care system as a first step toward development of a better health care delivery system. Results indicated that these children have a much greater incidence of chronic medical conditions, are likely to weigh significantly less and be significantly shorter than the general population, require significant amounts of medical sub-specialty care, have a high incidence of developmental delays, and major deficits in adaptive behavior and have a large number of behavioral problems often associated with psychiatric disorders. Results are discussed in terms of the development of a regional model to effectively manage the health care needs of children entering foster care. PMID- 3828876 TI - Mental health care for foster children in California. AB - This paper reports on a study conducted to assess the health care needs of foster children in California. To evaluate foster children's mental health problems and the services provided to meet them, 154 program administrators, social workers, foster parents, and health care providers were interviewed in 14 counties. Foster parents and social workers were interviewed in groups, and foster parents and administrators also completed questionnaires. We found that although all counties care immediately for children who are injured, abused, or ill, only one county performs routine mental health evaluations of all children, and in most counties less than a third of children ever receive such evaluations. Informants identified mental health problems as more severe than medical problems in this population, and they identified four major barriers to access to appropriate therapy. Recommendations are that all children should receive comprehensive mental health evaluations, and procedures for immediate and ongoing care with consistent providers who are sensitive to foster children's needs should be included in case management plans, and covered by improved payment mechanisms. Additionally, communication, coordination and joint planning should be instituted among relevant agencies to address foster children's needs, and increased resources and training should be directed towards social service agencies and foster parents. PMID- 3828877 TI - Variables associated with disrupted placement in a select sample of abused and neglected children. AB - The purpose of this study was to examine the placement history of 172 abused and/or neglected children who had been placed in a residential home for maltreated children. Data were collected on the child's placement history (i.e., number of placements, time in transition, and placement rate) and also on child and family characteristics. Pearson correlation coefficients were run between child and family variables and each of the three placement history variables. In addition, t-tests were also used as a method of analysis. Results indicated that children with the following characteristics or life circumstances experienced the more disruptive experience while in foster care: children having severe behavior problems; children who were very young when first removed from their natural home; and children having drug addicted and/or alcoholic parents. Implications of these findings indicate social workers and judges need to be alert to the potential for system abuse of children in foster placement, responsible long-term planning for any child in foster care is critical, and those involved in therapeutic treatment for abused/neglected children should be attentive to the child's placement history. PMID- 3828878 TI - Clinical judgment of abuse-proneness based on parent-child interactions. AB - Professionals skilled in working with abusive families and a sample of university undergraduates viewed video tapes of abusive and matched control parent-child dyads interacting in a free play setting. Subjects were asked to indicate which of each pair of dyads was abusive and the reasons for their judgment. Performance of both groups was at chance levels. Implications of these results for the prediction and prevention of child abuse and the training of clinicians are discussed. PMID- 3828879 TI - Intelligence and personality profile of battering parents in Greece: a comparative study. AB - Studies on parental intelligence and personality characteristics of battering parents are often contradictory. This research is part of a large project on child abuse and neglect in Athens aiming at identifying abusing families and studying the characteristics of parents, children, siblings, as well as welfare and legal issues. Thirty-three battering parents (17 mothers and 16 fathers) and 33 matched controls were investigated with the Wechsler Adult Intelligence Scale and Cattell's 16 Personality Factor Questionnaire (16 PF). The mean age of fathers was 39.9 and of mothers 29.1 years. They belonged primarily to the low socioeconomic class. No difference was found in the I.Q.s of battering fathers compared to controls while battering mothers' general, verbal and performance I.Q.s were significantly lower than those of the control group as well as of battering fathers' I.Q.s. Battering mothers were found significantly more shy, restrained, timid and threat-sensitive (Factor H of the 16 PF), and undisciplined, self-conflicted, following own urges (Factor Q3 of the 16 PF) than the control mothers. Factor H also was found to differentiate significantly between battering and control fathers but in the opposite direction than that of mothers. The above results are discussed and interpreted within the context of Greek cultural characteristics and intercultural comparisons. PMID- 3828880 TI - [Spinal anesthesia in urology]. PMID- 3828881 TI - [Spinal anesthesia with tetracaine and metaraminol in urologic surgery]. PMID- 3828882 TI - [Atmospheric pollution in pediatric surgery and its prevention. Importance of filtering cartridges]. PMID- 3828883 TI - [Filter circuits and pollution]. AB - The contamination of air of a 50 m3 operating room has been analyzed after three and half hours of halothane enaesthesia with a closed circle system and an opened system. The analysis has been made by gaz chromatography. Concentrations of Halothane found during the use of an opened system are 100 to 120 times the allowable norms in U.S.A. After using the closed circle system, the analysis of air does not reveale any trace of Halothane. PMID- 3828884 TI - [Closed-circuit anesthesia with isoflurane in neurosurgery]. PMID- 3828885 TI - [Action of ranitidine on changes in gastric pH during the perioperative period in cardiac surgery]. AB - Any state of stress originates a reduction of gastric pH contributing to the development of digestive lesions. The objective of this prospective work was to evaluate in subjects having undergone a heart surgical procedure, the effect of an anti-H2 agent, ranitidine, on the changes with time of gastric pH during the first 24 hours following induced anaesthesia. Administered discontinuously intravenously, ranitidine was shown to have a clearcut effect on gastric pH, shifting the pH profiles towards higher values. This phenomenon proves to be statistically significant from the 12th hour following the beginning of anesthesia. PMID- 3828886 TI - [Indications for a bronchial separator in lung surgery]. PMID- 3828887 TI - [Cardiorespiratory resuscitation. Current recommendations 1986]. PMID- 3828888 TI - Electrocardiography is alive and well and living in Halifax. PMID- 3828889 TI - Twenty-one year survival of a homograft aortic valve. AB - A patient who received one of the first homograft valves in Canada in 1965 is presented. Recent assessment including cardiac catheterization has shown that the valve is functioning well after 21 years. The patient is presented for historic interest, since this may be one of the longest functioning homograft valves. PMID- 3828890 TI - Pericardial tamponade in sarcoidosis. AB - A woman with a three month history of progressive right heart failure was found to have sarcoid pericarditis complicated by pericardial tamponade. The pericardial fluid was serosanguineous, and numerous nodules were noted on the parietal and visceral pericardium. Non-caseating granulomas were found in biopsy specimens of the pericardium, lung and skin. Right-sided heart failure in sarcoidosis is usually attributed to cor pulmonale or primary myocardial sarcoid. Pericardial tamponade should be considered in patients who present with sarcoidosis complicated by right heart failure. PMID- 3828891 TI - The electrophysiologic effects of nicardipine hydrochloride in man. AB - Nicardipine hydrochloride is an investigational antianginal calcium channel blocking agent with potent vasodilating properties. To study its acute electrophysiological effects in man, 12 patients (mean age 66, range 58-84), 6 with normal conduction and 6 with bifascicular block were evaluated. Each subject underwent electrophysiologic studies before and after a bolus and an intravenous infusion of nicardipine titrated to lower the mean blood pressure by at least 10%. The actual drop in mean blood pressure was 17% (p less than .01). The mean bolus was 2.2 +/- 1.2 mg (mean +/- standard deviation). The infusion rate was .21 +/- .06 mg/min. The drop in mean blood pressure was associated with an increase in heart rate of 13% (p less than .01). Maximum sinus node recovery time and sinoatrial conduction time decreased (p less than .01). The QT interval decreased (p less than .01), although the corrected QT remained unchanged. There was a tendency for a decrease in the atrioventricular nodal effective refractory period, functional refractory period, paced atrioventricular and ventriculoatrial conduction times. Intra-atrial, intraventricular and infranodal conduction times did not change. The administration of intravenous nicardipine produces hemodynamic effects consistent with arteriolar vasodilatation and a reflex sympathetic increase in heart rate. Except for the changes in sinus node function, the lack of marked electrophysiologic effects with intravenous nicardipine suggests that reflex sympathetic activity masks its direct slow channel blocking electrophysiologic effects in man. PMID- 3828892 TI - Dopamine negatively modulates its own blood pressure increasing action. AB - To evaluate the mechanisms of the hypertensive action of dopamine and its dependence on its metabolic patterns we infused a borderline hypertensive dose of free dopamine into healthy subjects. The moderate rise in systolic and diastolic blood pressure with an expected considerable increase of plasma free dopamine concentrations was associated within 30 minutes with an increase in plasma free norepinephrine and huge increases in plasma 3-4-dihydroxyphenylacetic acid, homovanillic acid and dopamine sulfate, the latter mostly between 60 and 180 minutes of infusion when diastolic blood pressure decreased. The overall pre-, per- and postinfusion changes in systolic blood pressure were negatively correlated with corresponding changes of free dopamine and dopamine sulfate. Reproducible patterns of blood pressure responses to the dopamine infusion made possible a subdivision into those who were blood pressure responders (who generated dopamine sulfate with delay) and non responders (who generated dopamine sulfate immediately). The data suggests that the 4 micrograms/kg/min dopamine infusion rate raises blood pressure indirectly via norepinephrine. Free dopamine and dopamine sulfate (the velocity of generation of which may be an inherited trait) are probably negative modulators of this action. PMID- 3828893 TI - Cardiovascular actions of amrinone in anesthetized open-chest pigs with an acute mild stenosis in the left anterior descending coronary artery. AB - A 15 minute reduction of the flow in the left anterior descending coronary artery (LAD) to 50% of baseline caused a 10% decrease in cardiac output in anesthetized open-chest pigs (n = 12), together with a fall in max LV dP/dt (20%), mean arterial blood pressure (15%) and stroke volume (7%), while left ventricular filling pressure rose from 9 +/- 1 to 15 +/- 1 mmHg. The decrease in perfusion of the LAD nourished myocardium was not evenly distributed as endo-epi blood flow ratio decreased from 1.03 +/- 0.05 to 0.50 +/- 0.08. Regional myocardial wall thickening of the ischemic segment decreased from 34 +/- 6 to 7 +/- 3%, while the arterio-coronary venous differences in pH and PCO2 increased five and two fold, respectively. Subsequently, 6 animals received 1 mg X kg-1 plus 50 micrograms X kg-1 X min-1 amrinone for 10 minutes, whereas 6 other animals were treated with saline. In the following 10 minutes cardiovascular performance in the saline treated animals did not change dramatically, although there was a tendency to further deterioration. Administration of amrinone led to a decrease in left ventricular filling pressure (30%), stroke volume (20%), cardiac output (10%) and mean arterial pressure (20%). There was also a mild positive chronotropic action (15%) and an initial positive inotropic action as indicated by an increase in max LV dP/dt (25%). The positive inotropic effect, however, was short-lasting as max LV dP/dt returned to baseline within 10 minutes after the bolus injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828894 TI - The expected probabilities of identity for the circular stepping-stone model. AB - The expected values of the probabilities of identity by descent are derived for the circular stepping-stone model. The results are more easily interpreted than those derived previously. PMID- 3828895 TI - Symposium on Gene Regulation by Environmental Stress. Contributed paper session on stress-induced gene expression. London, Ont., Canada, 28 June 1985. PMID- 3828896 TI - Heat shock induced changes in the gene expression of terminally differentiating avian red blood cells. AB - Reticulocytes, purified from the blood of quail and chickens recovering from anaemia, respond to heat shock by the new and (or) enhanced synthesis of heat shock protein (HSPs) with relative molecular masses of greater than 400,000, 90,000, 70,000, and 26,000 (quail) or 24,000 (chicken) and the depressed synthesis of many proteins normally produced at a control temperature. The synthesis of these HSPs is noncoordinate since the expression of each protein depends upon the particular temperature and duration of the time at that temperature. Separation of proteins from quail reticulocytes into Triton X-100 soluble and insoluble fractions demonstrates that the 70,000 and 26,000 Da HSPs are found in both fractions, whereas the greater than 400,000 and 90,000 Da HSPs are located only in the detergent-soluble fraction. Triton X-100 fractionation also reveals that there are three isoelectric variants of the 70,000 Da HSP and that they are constitutively synthesized and selectively partitioned between cellular compartments. Heat shock induced synthesis of the 90,000, 70,000, and 26,000 Da quail HSPs is prevented by actinomycin D, while enhanced synthesis of the greater than 400,000 Da HSP is unaffected by this inhibitor. These results demonstrate that nucleated, terminally differentiating avian red blood cells are capable of responding to heat stress by rapid changes in their highly restricted "program" of gene expression. PMID- 3828897 TI - Heat-shock gene expression in animal embryonic systems. AB - We have examined the expression of heat shock or stress genes in fish, echinoderm, amphibian, and mammalian embryonic systems. In a Chinook salmon embryo cell line, elevation of the incubation temperature or exposure to metal ions (e.g., cadmium and zinc) induced a set of heat-shock proteins HSPs. Transcriptional inhibitor, in vitro translation, and Northern hybridization studies suggest that fish HSP synthesis is regulated at the transcriptional level. The synthesis of HSPs during early development of Arbacia punctulata, Xenopus laevis, mouse, and rabbit is a stage-dependent phenomenon. In each of the developmental systems, HSP synthesis could not be induced until after cleavage stages. The ability of the embryo to undergo a heat-shock response (i.e., HSP synthesis) was correlated with the ability to detect HSP mRNA accumulation by either in vitro translation or Northern hybridization assays. Thus, the stage dependent synthesis of HSPs appears to be controlled at the transcriptional level. Finally, in all of the organisms studied, the capacity to synthesize HSPs and accumulate HSP mRNA also coincides with acquisition of thermotolerance. PMID- 3828898 TI - The synergistic effect of hyperthermia and ethanol on changing gene expression of mouse lymphocytes. AB - Cultured mouse lymphocytes respond to a brief incubation at an elevated temperature (41-43 degrees C) with the new and (or) enhanced synthesis of a select group of polypeptides (known as heat-shock proteins, HSPs) having relative molecular masses of 110, 100, 90, 70, and 65 kilodaltons (kDa). Expression of these HSPs is dependent on new RNA synthesis. Because the synthesis of any particular HSP is dependent on the temperature and the length of time cells remain at a particular elevated temperature, synthesis of each HSP is not necessarily coordinated with the synthesis of the other HSPs. Cultured mouse lymphocytes treated with arsenite or ethanol exhibit new and (or) enhanced synthesis of HSPs with molecular masses of 110, 90, 70, and 65 kDa but do not exhibit enhanced synthesis of the 100-kDa HSP. Short-term concurrent exposure of mouse lymphocytes to an elevated temperature and a level of ethanol, which individually do not induce detectable HSP synthesis, results in the pronounced synthesis of HSPs similar to those seen following exposure to higher levels of either stress applied separately. Thus, in this study we demonstrate that hyperthermia and ethanol stress can act synergistically to affect a dramatic change in the gene expression of mouse lymphocytes. PMID- 3828900 TI - Genetic analysis of blood pressure in the Milan hypertensive strain of rat (Rattus norvegicus). AB - Estimates of heritability (h2) of blood pressure level and the number of loci controlling the trait were derived from two genetic crosses involving the Milan hypertensive strain of rat and its control with normal blood pressure. In the genetic cross involving backcrosses, the estimates were h2 = 64% and the number of loci was two or three; there was some evidence of dominance of the alleles for normal blood pressures. In the other cross with only F2's, the degree of genetic determination (heritability in the broad sense) was 45%, involving at least three loci. PMID- 3828899 TI - Sperm head morphology and nuclear chromatin structure evaluated by flow cytometry in a diallel cross in mice. AB - Genetic factors affecting spermatogenesis, sperm morphology, and chromatin structure in mice were estimated using a diallel cross of the inbred lines C3H/HeJ, C57BL/6J, DBA/2J, and BALB/cByJ. Flow cytometry of acridine orange stained cells was used to evaluate proportions of testicular tetraploid, diploid, and haploid cells and nuclear chromatin structure of sperm, measured by resistance of chromatin to in situ acid denaturation, and quantified by the ratio of double- to single-stranded DNA (alpha t). Percent morphologically abnormal sperm was scored by light microscopy. Heterosis, line, maternal, and reciprocal effects, and general and specific combining abilities were estimated for body and testis weights, testicular cell proportions, sperm alpha t values, and percent abnormal sperm. Heterosis was important for testis weight, alpha t values, and percent abnormal sperm. Inbreds varied in body and testicular weights, alpha t values, and percent abnormal sperm. Significant maternal effects were noted for several traits but could be due to sex-linked (X or Y) factors, since maternal and sex-linked effects were confounded. Although a high positive correlation existed between alpha t values and percent abnormal sperm, the proportion of sperm with altered chromatin structure, measured by FCM, was generally much lower than proportion of morphologically abnormal cells. PMID- 3828901 TI - Stimulation of aortic tissue calcium uptake by an extract of spontaneously hypertensive rat erythrocytes possessing hypertensive properties. AB - In earlier reports we have described the isolation of a fraction from the erythrocytes of spontaneously hypertensive rats that produced hypertension when administered to normotensive rats. In addition, it was found that the fraction stimulated the uptake of "lanthanum-resistant" calcium by aortic rings excised from normotensive rats. In these studies we have found that the fraction causes a greater increase in the in vitro uptake of calcium by aortic tissue than that produced by depolarization of the tissue with high K+ or the receptor-mediated influx of calcium induced with norepinephrine. The hypertensive fraction appeared to be more effective in promoting increased calcium uptake in rabbit than in rat aortic tissue, suggesting that significant differences in tissue sensitivity to the active compound(s) may exist between species. In addition, we obtained evidence indicating that the tissue sensitivity to the action of the hypertensive fraction was greater in aortae from spontaneously hypertensive rats than from those of normotensive animals. Attempts to block the action of the hypertensive fraction with verapamil, nifedipine, and sodium nitroprusside had no significant effect on the elevation in tissue calcium. It was found, however, that the action of the hypertensive fraction was temperature dependent with reduced activity at lower temperatures. The data suggest that a compound(s) is present in the erythrocytes of rats that may have a marked effect on vascular tissue metabolism of calcium. PMID- 3828902 TI - Effect of ovine conceptus and endometrial secretory products on luteal progesterone production in vitro. AB - The objectives of this study were the following: (i) to determine if ovine conceptus secretory products are directly luteotrophic to luteal tissue in vitro and (ii) to determine if ovine conceptus secretory products stimulate endometrial tissue to secrete a luteotropin in vitro. Conceptus-conditioned medium (CCM) was prepared by incubating day 14 ovine conceptuses in minimal essential medium (MEM) for 24 h and harvesting the supernatant. Endometrium-conditioned CCM (E-CCM) and endometrium-conditioned medium (ECM) were prepared by incubating dispersed ovine endometrial cells from day 9-10 cycling ewes in CCM or MEM, respectively, for 16 h and harvesting the supernatants. Media, conditioned as described, were incubated at various dilutions with dispersed luteal cells from day 9-10 cycling ewes for 90 min or 6 h in the absence or presence of 50 ng/mL ovine luteinizing hormone (oLH). CCM did not alter progesterone (P4) production in the 90-min incubation but did increase (p less than 0.05) P4 production in the 6-h incubation (1:4, 1:8, 1:16 dilutions). When coincubated with oLH, CCM did not increase P4 production above that stimulated by oLH alone. The effect of E-CCM was similar to CCM or ECM and did not differ significantly from basal. It is concluded that the day 14 ovine conceptus does secrete a factor that is able to directly stimulate P4 secretion by luteal cells in a 6-h, but not a 90-min, incubation. Conceptus secretory products did not stimulate endometrial cells to secrete a luteotropin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828903 TI - Mechanisms of response to antigen in isolated guinea pig trachea after active sensitization. AB - A study was made of the responses of guinea pig tracheal muscle in vitro after sensitization by either subcutaneous or intraperitoneal administration of antigens. No difference was observed in the responses of strips from either group to cumulative or single doses of antigen. The responses of the tracheal muscle to antigen were analyzed as to magnitude (relative to maximal carbachol responses), time to peak contraction, and time to half decay. Pyrilamine, an H1-receptor antagonist, slowed the onset of contraction and decay. The latter result suggested a role for histamine in controlling the release of or the response to other mediators and the former was consistent with previous evidence that histamine release augments the initial response. An inhibitor of 5'-lipoxygenase and cyclooxygenase (5,8,11,14-eicosatetraynoic acid), indomethacin, and the slow reacting substance of anaphylaxis (SRS-A) antagonist FPL-55712 all shortened the time to half decay of the contraction, presumably by different mechanisms. The release and actions of leukotrienes may have been limited by eicosatetraynoic acid and FPL55712, respectively, but the action of indomethacin suggests a modulating role for prostanoids in leukotriene action or release. Nordihydroguaiaretic acid both reduced the maximum response and accelerated decay of this response, suggesting that the maximum response depends upon leukotriene release. Cromoglycate, methysergide, and an inhibitor of thromboxane synthetase were without effect. Both tetrodotoxin and atropine delayed the time to peak contraction and tetrodotoxin also delayed the decay of the contraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828904 TI - Characteristics of body temperature, vasopressin, and oxytocin responses to endotoxin in the rat. AB - Several physiological variables were measured after endotoxin administration in the rat to examine the relationship between these variables. Rats responded to endotoxin with a biphasic body temperature response, an initial decrease and a subsequent increase in body temperature. Plasma vasopressin and oxytocin levels increased markedly after endotoxin administration. Diarrhea occurred in some animals. There was a strong negative correlation between increase in body temperature and base-line body temperature, and weak correlations between body weight and plasma vasopressin release and between base-line body temperature and minimum body temperature reached. Plasma vasopressin and oxytocin levels were correlated if samples from all time points were analyzed together, whereas they were not correlated if data from each time point were analyzed separately or if total peptide release for each rat was evaluated. These data suggest similar regulation for the release of vasopressin and oxytocin, that is, release by a common stimulus, but the magnitude of release of vasopressin and oxytocin appears to be independent, probably reflecting differences in synthesis and storage of these two peptides. PMID- 3828905 TI - Serious infectious complications of open-heart surgery. AB - Serious infectious complications of open-heart surgery in 521 adults who underwent 534 open-heart procedures are reviewed. Bacteremia complicated seven (1.3%) of the procedures, carditis six (1.1%) and deep sternal wound infections nine (1.7%). The overall rate of these infections was 4.1% with an associated death rate of 11.7% (2 of 17). With respect to the risk of this complication, no differences were noted in the age of the patients, duration of surgery or perioperative prophylaxis with cephalothin or cloxacillin. The chance of carditis developing was significantly related (p less than 0.001) to a valve replacement procedure and the risk of a deep sternal wound infection (p less than 0.01) to a procedure classed as "other". Staphylococci remained the most commonly isolated pathogens with an almost equal frequency of Staphylococcus epidermidis and Staphylococcus aureus. Gram-negative aerobes and Streptococcus faecalis were found to be other important pathogens in this clinical setting. PMID- 3828906 TI - Snowblower injuries to the hand. AB - A single heavy snowstorm in Saskatoon in late 1984 resulted in nine patients sustaining snowblower injuries to 19 digits. Factors leading to injury included rapid onset of colder temperatures, sudden reuse of snowblowers after storage for the summer, a heavy mid-week storm that created a sense of urgency to clear snow in dusky light conditions after a day at work, frustration as exit chutes became repeatedly clogged with heavy wet snow and limited operator education. The injuries themselves resembled low-velocity "missile" injuries. A practical preventive measure would be to encourage manufacturers to equip machines with remotely located spring-opening clutches. PMID- 3828907 TI - Arthrodesis of the wrist. AB - In a retrospective study, the wrists of 18 patients who underwent arthrodesis by the AO technique were assessed clinically, for hand strength and function. Follow up averaged 4 years (range from 1 to 7 years). Although wrist arthrodesis improved grip strength, it was still only 50% to 60% of normal. Hand function improved to within normal limits in 78% of patients and bony union occurred in 94.4%. Thirteen patients were back at work within 18 months. The AO technique of wrist arthrodesis allows correction of deformity, relief of pain, increased grip strength and improved hand function. PMID- 3828909 TI - Implantable device for venous access. AB - This paper reports the experience at the Royal Victoria Hospital in Montreal with the first 50 Port-A-Cath devices implanted for venous access in patients requiring long-term chemotherapy. There were 25 women and 22 men, ranging in age from 18 to 85 years. Twenty-two devices were implanted for hematologic malignant disease, 26 for solid tumours and 2 for benign disease. The mean operative time was 46.3 minutes, using a percutaneous subclavian stick technique in 94% of insertions. Blood sampling and infusions were easy in 88% and 92% respectively. Seventy-eight percent of the patients accepted the device well. Nine devices were removed, four at the end of therapy (median functioning time of 208.5 days) and five because of sepsis (median time 18 days). The median time of the still functioning devices in live patients is 141.5 days. Septic complications were seen in 12%, blockage in 6% and skin necrosis in 2%. One death occurred from sepsis in a poor-performance patient with stage IV breast cancer and hypercalcemia. We breast cancer and hypercalcemia. We believe that the Port-A Cath is efficient, safe and easily accessible for patients on long-term chemotherapy. PMID- 3828908 TI - Hazards of epidural anesthesia in patients with previous vascular grafts. AB - Two cases are described in which thrombosis of both limbs of an aortobifemoral bypass occurred after epidural anesthesia for a nonvascular operation. This has not previously been reported, and possible reasons for its occurrence are discussed. It seems likely that the hypotension associated with epidural anesthesia, particularly in patients already hypotensive or volume depleted, may precipitate this phenomenon. In addition, the sensory loss produced by the anesthetic may mask the signs and symptoms of acute vascular occlusion. Epidural anesthesia is not recommended in heparinized patients because of the risk of an epidural hematoma. PMID- 3828910 TI - New options in the surgical management of Crohn's disease. AB - Conventional surgical treatment of Crohn's disease involves multiple or extensive resections or bypass procedures. These contribute to the morbidity and mortality of the disease. Minimal resection with appropriate "strictureplasty" is proposed as an alternative approach. Strictureplasty is analogous to pyloroplasty. The authors performed 15 strictureplasties in three patients, all of whom had previously undergone small-bowel resection for Crohn's disease. They presented with symptoms of chronic bowel obstruction resistant to medical therapy. There were two minor postoperative complications. Two patients were asymptomatic 20 months postoperatively; the third required reoperation for recurrent enterovesical fistula. The technique is safe. Its efficacy will be determined by long-term follow-up. PMID- 3828912 TI - The cost of arthroscopy. PMID- 3828911 TI - Transient focal cerebral ischemia resulting from digital palpation of the carotid artery in the neck. AB - Complications of digital palpation of the carotid artery in the neck are uncommon. They include cardiac arrhythmias and cerebral ischemic events. A 65 year-old woman experienced transient paralysis of the left arm immediately after palpation of the right carotid artery; at surgery, a friable, atherosclerotic plaque was removed from the bifurcation of the artery. The most likely cause of a transient neurologic deficit after digital manipulation of the carotid artery in the neck is an embolus from an atherosclerotic carotid plaque. The authors review the literature on the frequency and pathogenetic mechanism of this complication. PMID- 3828913 TI - The need to use the Huber-point needle in the Port-A-Cath implantable device. PMID- 3828914 TI - Tibialis anterior muscle hernia: a rationale for treatment. AB - Tibialis anterior muscle hernia is an orthopedic problem that should be dealt with carefully since the potential complications of treatment are serious. The literature is reviewed to provide a better understanding of the natural history, incidence, classification and treatment of muscle hernias. Guidelines are proposed for a rational treatment plan for tibialis anterior muscle hernias. Asymptomatic hernias need no treatment. Longitudinal fasciotomies are recommended as the treatment of choice in symptomatic tibialis anterior muscle hernias that are refractory to conservative treatment. PMID- 3828915 TI - Long-term review of the McGoey-Evans high-friction uncemented total hip arthroplasty. AB - To assess the long-term clinical results of uncemented total hip arthroplasty with the McGoey-Evans bipolar high-friction hip prosthesis, the authors reviewed the findings in 86 such hip replacements. The minimum patient follow-up was 5 1/2 years (mean 9 years). Overall, satisfactory results were obtained in 46.5% of cases. There were no deep infections. In contrast to the experience with the cemented hip replacements, the authors found that the results were better in men than women and that most of the revisions were done within 5 years of the original operation. Tissue hypersensitivity resulted in implant loosening in only two cases and no harmful systemic effects arose from the use of this uncemented cobalt-chromium prosthesis. Although this particular hip prosthesis is not recommended because of its inferior design, the findings of the study could be useful in the current practice of uncemented hip arthroplasty. PMID- 3828916 TI - Is preoperative colonoscopy in carcinoma a realistic and valuable proposition? AB - Colonoscopy was performed preoperatively in 100 consecutive patients as a prospective study to establish the feasibility of the procedure and its value, which was considered "adequate" when the colon remaining after surgical resection had also been examined preoperatively. Colonoscopy was adequate in 35 of 46 patients (76%) with malignant tumour located in the cecum and ascending and transverse colon, but in only 15 of 54 patients (28%) who had a tumour in the left colon or rectum. Synchronous malignant tumours were present in 2 patients, and 54 additional adenomas were discovered in 29 patients. These adenomas could be removed endoscopically in 13 patients and were included in the standard resection in 12. Extension of the planned operation was necessary in only four patients with synchronous adenomas. Routine preoperative colonoscopy to assess the presence of synchronous colonic tumours is more likely to be adequate in proximal or right-sided large-bowel tumours than in left-sided tumours because of the annular configuration of the latter. Because of the high rate (46%) of synchronous adenomas in adequate examinations, inadequate preoperative colonoscopy should be complemented by a repeat examination 3 to 6 months postoperatively in every patient with a malignant tumour of the large bowel. PMID- 3828917 TI - Portal vein injury. AB - With the increasing number of traumatic injuries being seen in emergency departments, physicians must be aware of the less common and less obvious types of serious injury. Portal vein injury is serious (death rate 50%) and may be diagnosed only at laparotomy. Fortunately this injury is rare. Its management can be difficult, but an awareness of the possible methods of treatment could be life saving. The authors report their experience with this injury and survey the literature on the subject. PMID- 3828918 TI - Direct effects of autotransfused blood on myocardial muscle mechanics in man. AB - Homologous blood transfusions carry risks--febrile reactions, isoimmunization incompatibility reactions and transmission of infectious diseases such as AIDS and hepatitis. Although autotransfusion techniques will reduce the need for banked homologous blood, autologous shed blood does contain various cellular fragments that may act directly as myocardial depressants. Accordingly, the myocardial muscle mechanical properties of isolated human right atrial trabeculae contracting in vitro were measured in a bath containing either blood collected in the Sorensen ATS Autotransfusion Receptal unit or arterial autologous blood. Muscles were tested randomly in each solution by measuring their isometric resting and developed forces and the mean rate of developed force at different stimulation rates (force-frequency relation). In addition, biochemical, hematologic and immunologic assays were performed on each blood specimen. Significant increases (p less than 0.05) in potassium and plasma-free hemoglobin indicated that cell disruption had occurred in blood collected in the autotransfusion apparatus; however, there was no statistically significant difference in mechanical performance between muscles contracting in either solution. From these results, the authors conclude that autotransfused blood does not directly affect human heart-muscle mechanics. PMID- 3828919 TI - Surgical treatment of bronchogenic carcinoma: the importance of staging in evaluating late survival. AB - From 1971 to 1980, 1292 patients with lung cancer were admitted to the Hopital du Sacre-Coeur de Montreal. This diagnosis represented 0.5% of admissions in 1971 and 1.7% in 1980 (240% increase). Only 4% of patients were nonsmokers. Patients ranged in age from 30 to 93 years with a male to female ratio of 5.5 to 1. Of 414 cervical mediastinoscopies carried out for right and left pulmonary tumours, 120 (29%) showed mediastinal lymph-node metastasis (positive biopsy). For 35 left sided lesions, both cervical and left parasternal mediastinoscopies produced 13 (37%) positive biopsies. For 45 left upper lobe and left hilum tumours, left parasternal mediastinoscopy alone yielded 18 (40%) positive biopsies. Only 297 (23%) of the 1292 patients were considered to have operable lesions and they underwent thoracotomy - 164 (55%) lobectomies, 104 (35%) pneumonectomies, 2 (1%) segmentectomies and 27 (9%) exploratory thoracotomies. The most common postoperative complication was respiratory failure - in 27 cases (9%); there were 12 (4%) bronchopleural fistulas. The operative death rate was 5% - 1.8% for lobectomy, 7.4% for exploratory thoracotomy and 9.6% for pneumonectomy. Causes of death were respiratory failure (60% of the deaths), hemorrhage (13%), cardiac events (13%) and bronchopleural fistula (13%). The overall 5-year survival was 9.2%. For the 297 patients operated on, the survival at 5 and 10 years was 55% and 36% for stage I disease, 30% and 20% for stage II disease and 10% and 8% for stage III disease, respectively. The mean postoperative follow-up was 41.5 months (range from 3.5 to 14 years).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3828920 TI - Physicians' guide to driver examination. PMID- 3828921 TI - Use of promethazine (Phenergan) in labour. PMID- 3828922 TI - Scientific performance and MRC grants to pharmacologists. PMID- 3828923 TI - Native health care: an alternative approach. PMID- 3828924 TI - Oral acyclovir for genital herpes: not a cure, but close. PMID- 3828925 TI - Questionnaire development: 2. Validity and reliability. PMID- 3828926 TI - Faculty development practices in Canadian medical schools. AB - Twelve Canadian medical schools that had an organized faculty development program were surveyed to evaluate the extent to which such programs were used and to estimate their effectiveness. Common practices included sabbaticals and programs designed to improve instructional skills. The main problems included underfunding, poor participation and inadequate instructor evaluation. PMID- 3828927 TI - Perceived discrimination against cured cancer patients in the work force. AB - To evaluate perceived discrimination against cured cancer patients in the work force in Montreal, in 1982-83 we surveyed 101 cured cancer patients and 101 control subjects who had never had cancer and who were matched for age, sex and neighbourhood of residence. In addition, 24 of the cured patients were randomly selected and paired with cancer patients with a poor prognosis who were matched for age and sex. Discrimination was slightly more common among cured patients (18%) than among control subjects (15%), and 21% of the cancer patients with a poor prognosis reported discrimination. Analysis of the comparisons between the cured and control groups indicated no statistically significant differences. The cured cancer patients reported the following problems faced by cancer patients returning to work: fatigue (30%), absenteeism (14%), psychologic problems (12%), social stigma (12%) and discrimination by an employer (10%). PMID- 3828928 TI - Carotid-ophthalmic aneurysm: an uncommon cause of acute monocular blindness. PMID- 3828929 TI - Oral "hairy" leukoplakia: a clue to HIV-I exposure. PMID- 3828930 TI - Recommendations for tracing contacts of people infected with HIV. PMID- 3828931 TI - Fighting back: the search for a solution to prescription drug abuse. PMID- 3828932 TI - Health effects of cigarette smoking: data from the Ontario Longitudinal Study on Aging. PMID- 3828933 TI - Fitness and health evaluations by older exercisers. PMID- 3828934 TI - Staphylococcus aureus strains associated with food poisoning in Quebec. PMID- 3828935 TI - Assessing the effectiveness of a management information system in improving preschoolers' use of fluoride supplements. PMID- 3828936 TI - The ethics of paternalism in public health. PMID- 3828937 TI - Services to preschool aged children: a survey of Canadian Health Departments. PMID- 3828938 TI - The impact on medical services utilization of British Columbia's 1982/83 physician fee 'giveback': preliminary results. PMID- 3828939 TI - Changes in hygienic habits in food preparation: facilities to use water. PMID- 3828940 TI - The effect of roost sealing as a method to control maternity colonies of big brown bats. PMID- 3828941 TI - Nutrition applications in public health nursing: a survey of needs and preferences of public health nurses for continuing education in nutrition. PMID- 3828942 TI - Chronic otitis media and hearing deficit among native children of Kuujjuaraapik (Northern Quebec): a pilot project. PMID- 3828943 TI - Recognizing the importance of ethnicity for Canada's elderly. PMID- 3828944 TI - Treatment of stage IIIB cervical cancer with Californium-252 fast-neutron brachytherapy and external photon therapy. AB - From January 1977 to July 1984, 32 patients with Stage IIIB cervical cancer were treated at the University of Kentucky Medical Center by a combination of outpatient neutron brachytherapy and external pelvic radiation. These patients received 4500 to 5000 rad external photon therapy and two or three outpatient Californium-252 (252Cf) implants, plus sidewall boost irradiation. Treatment results were compared retrospectively to those obtained in a historical control group of patients with Stage IIIB cervical cancer treated with external radiation and conventional photon brachytherapy from 1972 to 1976. Local or regional tumor recurrence developed in 53% of patients treated with neutron therapy and an additional 9% experienced distant metastases. Thirty-eight percent of patients remain free of disease 12 to 96 months (mean, 51 months) after therapy. The 2 year and 5-year survival rates of patients treated with neutron therapy were 53% and 36%, which were not significantly different than those obtained with photon brachytherapy (2-year survival, 61%; 5-year survival, 34%). Complications of neutron therapy were minimal and included proctitis (19%) and vaginal stenosis (9%). There were no cases of enteric fistulae. Outpatient neutron brachytherapy was cost effective and was well tolerated by patients. PMID- 3828945 TI - Circulating IgA immune complexes in head and neck cancer, nasopharyngeal carcinoma, lung cancer, and colon cancer. AB - A double antibody enzyme-linked immunosorbent assay (ELISA) was developed to quantitate circulating immune complexed IgA (IgA IC) in human serum. The serum panel for this study consisted of normal blood donors, benign surgery (BS), head and neck cancer (HN), nasopharyngeal carcinoma (NPC), lung cancer (LC), and colon cancer (CC) patients. Immune complexes (IC) were isolated from these sera by precipitation with 3.5% polyethylene glycol (PEG), washed and then redissolved in 0.1 M phosphate-buffered saline pH 7.2. The amount of IgA IC present were then quantified using the double antibody IgA ELISA. This assay was found to be both sensitive (26.0 ng/ml) and reproducible (intra-assay coefficient of variation 4.0%). The mean IgA IC for each cancer group tested (HN = 11.38 +/- 12.54 micrograms/ml; NPC = 13.36 +/- 17.56 micrograms/ml; LC = 17.39 +/- 13.04 micrograms/ml; CC = 26.50 +/- 4.60 micrograms/ml) were significantly elevated (P = 0.001) over both the normals (5.12 +/- 4.09 micrograms/ml) and the benign surgery controls (5.92 +/- 5.04 micrograms/ml). In addition to providing a new tumor marker the presence of high levels of IgA IC in cancer patients could provide a source of tumor-specific antibody as well as antigen and provide reagents to study immune regulation in cancer patients. PMID- 3828946 TI - Primary culture of squamous head and neck cancer with and without 3T3 fibroblasts and effect of clinical tumor characteristics on growth in vitro. AB - Twenty-one tumors from patients with squamous cell carcinoma of the head and neck (SCC H/N) were cultured with and without 3T3 fibroblasts in order to determine whether, on the basis of improved tissue culture medium, 3T3 cells could be deleted without altering growth and cloning efficiency. Thirty-five additional primary SCC H/N specimens, cultured in the presence of 3T3 fibroblasts, were studied to assess the effect of tumor differentiation, site of primary tumor, and site of specimen procurement on growth. The authors conclude that 3T3 cells remain essential for optimal growth and cloning efficiency. Also, 3T3 cells improved the number of successful cultures by 33% to 100% depending on the plating density, and cloning efficiency was improved by 50% in the presence of 3T3 cells. Growth did not correlate with tumor differentiation or site of origin of the tumor specimen. Culture of specimens from the primary site resulted in growth significantly more frequently than culture of specimens obtained from metastatic neck nodes. PMID- 3828947 TI - Intraductal spread of esophageal squamous cell carcinoma. AB - In order to determine the pathways of tumor dissemination in esophageal carcinoma, 175 lesions of squamous cell carcinoma of the esophagus were studied histopathologically and by electron microscope in relation to the intraepithelial spread and involvement of the esophageal glands by the carcinoma. The study compared vessel invasion and lymph node metastasis. Intraepithelial spread was seen in 111 lesions (63%) and gland duct involvement in 33 lesions (19%). Gland duct involvement was observed in 30% of the lesions positive for intraepithelial spread. In the intramucosal carcinomas, gland duct involvement was observed in 24%. Even in a very small carcinoma 7 X 5 mm in size, ductal spread was detected. This carcinoma did not reach the submucosa through stromal invasion. Patients with intramucosal carcinoma showed low incidence (20%) of lymphatic and/or blood vessel invasion and no incidence of lymph node metastasis. Examination by electron microscope showed that the cancer cells of the intraepithelial spread entered the duct by raising the normal ductal epithelium in the ductal cavity although the basal lamina was retained. Normal gland duct cells and cancer cells were either attached with desmosomes directly or were separated by degenerated epithelial cells. A high incidence of ductal involvement of the esophageal glands was seen in squamous cell carcinoma of the esophagus, indicating its possible importance as a route to the deep tissue in the early stage of this carcinoma. PMID- 3828948 TI - Early carcinoma of the gastric cardia. A clinicopathologic study of 21 cases. AB - A clinicopathologic study was done on 21 cases of early carcinoma of the gastric cardia. The disease was preponderant in men, with a male-female ratio of 17:4. Five patients had no symptoms, while the other 16 had epigastric pain, epigastric discomfort, or other symptoms. Melena or hematemesis occurred in five patients. The first detection was made by barium study in 16 and by endoscopy in five. Detailed examinations using double-contrast radiography in both the prone right anterior oblique and supine left lateral projections were useful to detect the early carcinoma of the gastric cardia. All depressed-type carcinomas were incidentally detected during endoscopic examinations of benign peptic ulcers, therefore, whenever endoscopic examinations are being done for other entities, all the stomach including the cardia should be examined, carefully and continuously. Compared with early carcinomas of the other areas of the stomach, grossly elevated and histologically well-differentiated early carcinomas were more common in the gastric cardia. In the mucosa adjacent to the carcinoma, chronic gastritis was apparent in almost all cases, although intestinal metaplasia was found less frequently than in other areas of the stomach. PMID- 3828949 TI - Histologic features relating to prognosis in synovial sarcoma. AB - Although the American Joint Commission has classified all synovial sarcomas as "high grade," histologic subtypes can be identified. By histologically subclassifying synovial sarcoma tumors according to percent glandularity and mitotic rates, the authors were able to define high-risk and low-risk patients. Charts and original pathologic slides were reviewed on 45 synovial sarcoma patients. With a 41-month median follow-up, the low-risk patients showed 100% survival, whereas the high-risk patients showed 37% survival. PMID- 3828950 TI - Splenectomy for end-stage chronic lymphocytic leukemia. AB - Between February 1980 and December 1985, splenectomies were performed in 13 patients with advanced (Stage III and IV) chronic lymphocytic leukemia (CLL). Patients had advanced disease for a median of 32 months at the time of splenectomy and all were refractory to chemotherapy. All patients were anemic with a median hematocrit of 27.5%; nine patients were thrombocytopenic with a median platelet count of 46,000/microliter. There was no surgical mortality and minimal morbidity. Median hematocrit was 35% at 1 month and 6 months postsplenectomy. Median platelet count in previously thrombocytopenic patients was 261,000/microliter at 1 month and 177,000/microliter at 6 months postsplenectomy. Median survival postsplenectomy in this advanced patient group was 24 months with four patients surviving more than 30 months. Splenectomy is a valuable adjunct to the management of end-stage CLL. PMID- 3828951 TI - Female-male differences in patients with primary lung cancer. AB - This report is based on responses to a mailed questionnaire from 927 patients with lung cancer (730 men, 197 women), or their next of kin, and information obtained from the Saskatchewan Cancer Foundation Tumour Registry. Women were diagnosed at an earlier mean age than males (means +/- SE, 63.5 +/- 0.85 years versus 67.6 +/- 0.37 years, P less than 0.001), a finding which was consistent for each major histologic type. Women were more frequently diagnosed before age 60 years (42.0%) than were men (25.6%) (P less than 0.001). Female patients were significantly more likely to be lifetime nonsmokers of cigarettes than male patients (23% versus 3.7%, P less than 0.001). Among current smokers, women started smoking at an older age (19.3 +/- 0.69 versus 16.5 +/- 0.21 years, P less than 0.001), smoked for fewer years (41.0 +/- 1.2 years versus 47.4 +/- 0.57 years, P less than 0.001) and smoked slightly fewer cigarettes per day than male patients (23.6 +/- 1.0 versus 26.7 +/- 0.63, P less than 0.05). Similar results were found for the duration of the smoking habit and number of cigarettes smoked among exsmokers. When current smokers and exsmokers were combined, the distribution of pack years by gender was significantly different. A higher percentage than expected of women as compared to men, are clustered in the lower pack-year categories (P less than 0.0003). No occupational exposure or familial factors which might act in synergism with cigarette smoking were identified. Thus, women developed primary lung cancer at an earlier age while smoking for fewer years than men. PMID- 3828952 TI - Growth rate analysis of lung metastases from histologically benign giant cell tumor of bone. AB - A growth rate analysis of lung metastases of benign giant cell tumor (GCT) of bone, histologically indistinguishable from the primary benign tumor, is presented. The doubling time (DT) was 186 days in the first 13 months of growth, and 465 days in the last 4 months. These DTs are much longer than DT of lung metastases of any other tumors, and have a good correlation with a long survival time. Backward extrapolation showed that the lung metastases began to develop years before the primary tumor was diagnosed and treated. If this can be confirmed in a larger number of patients, it could be concluded that there will be no indication for amputation as a treatment for benign GCT whether or not lung metastases are present. The growth rate analysis supports the concept that these metastases might represent a benign process, and as such are a unique histologic and clinical phenomenon. PMID- 3828953 TI - Nonsecretory multiple myeloma. AB - Among 186 patients with multiple myeloma (MM), five women were diagnosed as having MM without M-component in serum and or urine at the diagnosis and along the evolution. Bone marrow plasmacytosis at greater than 30% was found in all patients and bone x-rays showed lytic lesions in all but one case, osteoporosis in all, and pathologic fractures in two. Serum electrophoresis showed a striking hypogammaglobulinemia in all, and polyclonal immunoglobulin levels were markedly reduced. The immunofluorescence of plasma cells in bone marrow was positive for monoclonal light chain polypeptides in four patients, and the ultrastructure showed mature plasmocytes with a wide rough endoplasmic reticulum (RER) and an intact Golgi apparatus. In three patients, therapy with melphalan plus prednisone was started. The remaining two were treated with an M-2 protocol. Death was an early event in two patients; the response was good in the remaining patients, without differences regarding secretory MM. Despite some reports stressing an unfavourable prognosis in MM without M-component, in our series it is roughly the same as in MM with secretion. PMID- 3828954 TI - Perfusion of colorectal hepatic metastases. Relative distribution of flow from the hepatic artery and portal vein. AB - The importance of portal circulation in the delivery of drugs and nutrients to colorectal hepatic metastases is controversial. Using 13N (nitrogen 13) amino acids and ammonia with dynamic gamma camera imaging, we demonstrate, for the first time in human beings, a quantitative advantage of hepatic artery compared with portal vein infusion. Eleven patients were studied by hepatic artery injection, five patients were studied by portal vein injection, and two patients had injections through both routes. Data collected from the liver for 10 minutes after rapid bolus injection of 13N L-glutamate, L-glutamine, or ammonia were compared with 99mTc (technetium) macroaggregated albumin (MAA) images produced after injection through the hepatic artery or portal vein at the same session. Tumor regions defined from 99mTc sulfur colloid scans were compared with nearby liver areas of similar thickness. For the 13N compounds, the area-normalized count rate at first pass maximum (Qmax) and the tissue extraction efficiency were computed. The tumor/liver Qmax ratios for MAA and 13N compounds were highly correlated. Both tumor and liver extracted more than 70% of the nitrogenous compounds. The tumor/liver Qmax ratios reflect the relative delivery of injected tracer per unit volume of tissue. After hepatic artery injection the Qmax ratio was 1.03 +/- 0.33 (mean +/- SD), significantly exceeding the Qmax ratio of 0.50 +/- 0.34 after portal vein injection (P less than 0.003). Therefore, more than twice as much of a nutrient substrate is delivered per volume of tumor relative to liver by the hepatic artery as by the portal vein; the high extraction efficiency demonstrates that the hepatic artery flow is nutritive; and the delivery of substance in solution (such as nutrients or drugs) to tumor and liver tissue correlates with the distribution of colloids such as macroaggregated albumin after hepatic arterial and portal venous injection. PMID- 3828955 TI - Pathologic findings from the national surgical adjuvant breast project. Correlations with concordant and discordant estrogen and progesterone receptors. AB - Pathologic materials were available for review from 1597 women with Stage II (positive regional node metastases) invasive breast cancer in whom estrogen receptor (ER) and progesterone receptor (PR) assays of the primary tumor were performed. These women were enrolled in a clinical trial comparing the effect of postmastectomy adjuvant L-phenylalanine mustard (L-PAM) and 5-fluorouracil (5-FU) with and without tamoxifen (NSABP Protocol No. 9). Significant pathologic and clinical associations with receptor status were similar for both ER and PR except that the latter, unlike ER, was not related to patient age. Regression analyses revealed that the most significant pathologic features related to a concordant positive ERPR receptor status was low (well differentiated) nuclear and histologic grades, slight or absent tumor lymphoid infiltrate, slight or absent necrosis and moderate or marked elastica in decreasing order of importance. All of the factors enumerated are directly or indirectly related to tumor differentiation. Recognition of four or five conforming pathologic features allows for the prediction of either ER or PR status in 70% to 80% of instances respectively, and the presence of three features in 69%. This latter figure is similar to that of estimation of nuclear grade alone. Thirty percent of ERPR estimates were discordant i.e., either ER-PR+ or ER+PR-. Pathologic features associated with discordant assays were not similar to those found when the ERPR estimates were concordant. Life table analyses revealed patients with discordant receptors to exhibit disease-free survival intermediate to that of those with ER+PR+ and ER-PR- values. This information suggests that a discordant receptor status is more reflective of an aberration of ER metabolism than a methodologic error. Histograms correlating frequency of nuclear grades with levels of ER and PR were comparable and revealed patterns indicating the propriety of relating values less than 10 fm/mg as being receptor negative. The frequency of well differentiated nuclei increased with ascending levels of ER and PR. PMID- 3828956 TI - Malignant histiocytosis. Complete remission in two pediatric patients. AB - The experience with the treatment of malignant histiocytosis has been disappointing. Despite modest treatment success with a combination of cyclophosphamide, Adriamycin (doxorubicin), vincristine and prednisone, the overall prognosis remains poor. There are only a few reports of prolonged complete remissions in pediatric patients. The following report describes two children who have had long-term remission with an aggressive combination chemotherapy program that included intrathecal prophylaxis. The chemotherapeutic regimen described merits further evaluation in a larger number of patients. PMID- 3828957 TI - The relationship between prognosis and scintigraphic evidence of bone metastases in neuroblastoma. AB - The clinical records, scintigrams, radiographic skeletal surveys, and bone marrow aspiration and trephine results of 30 children with neuroblastoma were reviewed to determine the relationship between the result of the scintigram and the clinical outcome of the patient. The nine patients with normal radiographic skeletal surveys and no evidence of bone metastases on scintigraphy are alive and well having been off treatment for between 14 and 83 months. Eleven of the 13 children who had bone metastases on scintigraphy and radiography have died, as have seven of the eight patients who had positive scintigrams and normal radiographs. Scintigraphic evidence of bone metastases is associated with a very poor prognosis irrespective of the results of other investigations. PMID- 3828958 TI - Levamisole as adjuvant immunotherapy in breast cancer. AB - Results are reported of a double-blind randomized study on 198 patients with resectable node positive mammary cancer, evaluating the effect of the immune modulating drug levamisole in an adjuvant setting. Drug treatment was started after completion of postoperative radiotherapy. In a two-arm trial 97 patients used levamisole and 101 patients used a placebo. No difference was noted in overall survival and disease-free survival between the two groups. Toxicity was reason for discontinuation of the drug in 30 of 97 of the patients in the levamisole group and 8/101 in the placebo group. PMID- 3828959 TI - Characterization of opioid peptides in human thyroid medullary carcinoma. AB - A thyroid medullary carcinoma from a man with the multiple endocrine neoplasia syndrome Type IIB was examined for the presence of opioid peptides. The tumor contained peptides derived from all three opioid precursors: pro-opiomelanocortin (POMC), pro-dynorphin, and pro-enkephalin. The tissue concentrations of the various opioid peptides varied considerably. beta-Endorphin, a POMC-derived peptide, was present in concentrations between 9 to 12 pmoles/g tissue; 8 pmoles/g tissue of alpha-neo-endorphin, a pro-dynorphin-derived product, were seen, whereas the pro-enkephalin-associated peptides were present in much lower concentrations (0.6-2.1 pmoles/g tissue). Immunohistochemical studies showed scattered opioid-positive cells in the tumor tissue and in two other thyroid medullary carcinomas. These data demonstrate that malignant neuroendocrine tumors may contain peptides derived from all three families of the endogenous opioids. PMID- 3828960 TI - Relationship between androgen receptor binding activity in human prostate cancer and clinical response to endocrine therapy. AB - The authors investigated the ability of androgen receptor binding in prostate cancer tissue to predict the response of prostate cancer patients to endocrine therapy. The clinical response of 37 previously untreated patients with various grades and stages of prostate cancer was correlated with androgen receptor binding and detailed histologic data obtained before treatment. All patients underwent cold-punch transurethral resection of the prostate and received endocrine therapy. The association between time to progression and cytosolic androgen binding was not significant. However, the associations of time to progression to nuclear binding and to total androgen binding were significant (P = 0.029 and 0.038, respectively). The authors found no association between clinical stage and time to progression, but did find an association between time to progression and pathologic grade (P = 0.003); grade 4 lesions were the least responsive to hormone therapy. When grade 4 lesions were excluded (N = 3), binding levels were still predictive of progression independently of grade and stage. The authors conclude that nuclear receptor binding activity in localized and metastatic prostate cancer tissue is predictive of response to hormonal manipulation. PMID- 3828961 TI - Metabolic efficiency of the liver in patients with breast cancer as determined by pharmacokinetics of phenazone. AB - Phenazone pharmacokinetics was determined in 24 healthy women and in 39 women with breast cancer; in the latter before and after antineoplastic treatment. The mean phenazone half-life time (t0.5) was significantly shorter in patients with breast cancer (8.880 +/- 2.5585 h) than in healthy persons (12.024 +/- 3.8486 h, P less than 0.001). Mean elimination rate constant (K, 0.063 +/- 0.0197 h-1) and mean metabolic clearance rate (MCR, 54.968 +/- 20.3476 ml/min) differed statistically (P less than 0.01) from the same parameters in control group, where K was 0.063 +/- 0.0197 h-1, MCR was 41.832 +/- 14.7153 ml/min. In patients receiving antineoplastic drugs, pharmacokinetic parameters of phenazone did not differ significantly in comparison with the initial values. Our results obtained with phenazone as a model substance suggest that in breast cancer elimination of other drugs metabolized by the pathway similar to phenazone also may be changed. This should be considered in selection of their dosage. PMID- 3828962 TI - Splenectomy during chronic lymphocytic leukemia. AB - The combination of discontinuous high-dose chlorambucil therapy with splenectomy greatly increased the prognosis of aggressive forms of chronic lymphocytic leukemia (CLL). The median survival for 43 patients was 84 months from diagnosis and 48 months from splenectomy. For 15 stages O, according to Rai classification, obtained after splenectomy, duration ranged from 3 to 105 months. The median survival of a group of patients showing "nodular splenic infiltration" was 104 months and superior to that of a group of patients showing "diffuse splenic infiltration" (72 months). In four of 15 cases studied, the peripheral blood lymphocytic clone disappeared after splenectomy. PMID- 3828963 TI - Mortality-associated factors in infected lymphoma patients. AB - Three hundred eighty-eight medical records of patients with lymphoma seen between 1971 and 1980 were analyzed for factors related to infection-associated mortality. Infection occurred in 100 patients (36 Hodgkin's lymphoma [HL], and 64 non-Hodgkin's lymphoma [NHL]). The overall mortality with infection was 17% (6 of 36) for HL and 52% (33 of 64) for NHL. In patients with NHL mortality correlated with infection in the respiratory tract (P less than or equal to 0.0001), blood (P less than or equal to 0.003), and multiple sites (P less than or equal to 0.0004) and with the following factors: granulocytopenia (P less than or equal to 0.05), thrombocytopenia (P less than or equal to 0.035), and cytotoxic therapy (P less than or equal to 0.034). Patients with HL showed a positive correlation only with staphylococcal infections (P less than or equal to 0.001) and monocytopenia (P less than or equal to 0.01). The above data may be used to generate a risk factor profile of patients at greater risk of mortality associated with such infections. Advance knowledge of such a profile may assist in the clinical management of these high-risk patients. PMID- 3828964 TI - Brain metastasis in patients with superior sulcus tumors. AB - During a 20-year period, from 1963 to 1983, 68 patients were treated for carcinoma of the lung presenting in the superior sulcus. Their ages ranged from 41 to 79 years (median, 56 years). Thirty-six patients had squamous cell carcinoma, 13 had adenocarcinoma, 14 had large cell carcinoma, two had small cell carcinoma, and three had clinical diagnosis only. All tumors were considered to be inoperable or unresectable and were treated with external irradiation alone. The 3-year disease-free survival was 25%. Brain metastasis developed in 23 patients (34%); the brain was the first site of metastasis in 16 patients (24%), five of whom eventually developed other sites of metastasis. The cumulative probability of brain metastasis was 53% at 3 years. Brain metastases were seen in ten patients (28%) with squamous cell carcinoma, five patients (38%) with adenocarcinoma, seven patients (50%) with large cell carcinoma, and one patient without a histocytologic diagnosis. The proportion of patients younger than 60 years (19/41, 46%) who developed brain metastasis was significantly greater than that for patients 60 years or older (4/27, 15%) (P less than or equal to 0.01). Nine of 11 patients with metastasis only to the brain died as a consequence of the intracranial disease 1 to 13 months (median, 6 months) after the diagnosis of brain metastases. The other two patients received therapeutic irradiation to the entire brain and survived longer than 5 days after the whole-brain irradiation: one died at 62 months of intercurrent disease, and the other is alive and well 129 months after diagnosis. The high probability of brain metastasis from superior sulcus tumors, regardless of histopathologic type and the frequency with which the brain is the only site of clinical failure, suggest that systematic prophylactic cranial irradiation could reduce the morbidity and perhaps even contribute favorably to the survival of these patients. PMID- 3828965 TI - Familial pancreatic adenocarcinoma in three generations. A case report and a review of the literature. AB - Although scattered case reports of familial clustering of pancreatic cancer have appeared in the literature, hereditary factors have not been clearly associated with increased risk for this malignancy. The current report documents the familial occurrence of pancreatic adenocarcinoma in three women of consecutive generations who died of their disease at progressively younger ages. The diagnoses are histologically confirmed in all three cases. Although two of the women carried a single known risk factor for pancreatic carcinoma (cigarette smoking), a familial predisposition to this disease is strongly implicated. The case suggests that the role of inheritance in pancreatic carcinoma may merit further exploration. PMID- 3828966 TI - Smoking, body weight, and early-stage endometrial cancer. AB - The effect of cigarette smoking on the risk of early-stage endometrial cancer was evaluated in a population-based case-control study of women aged 40 to 69 years from upstate New York. Two hundred women with early-stage endometrial cancer diagnosed between 1979 and 1981, and 200 matched community controls were interviewed in person and asked about smoking habits and other risk factors. Statistical analysis revealed a significant decline in relative risk with increased smoking (P less than 0.05). This effect strongly modified the well known increase in risk with body weight. Among smokers risk did not increase with body weight, whereas among nonsmokers risk increased rapidly with body weight, especially among nonsmokers in whom the peripheral conversion of androgens was the primary source of serum estrogen. Despite this apparent reduced risk for endometrial cancer, smoking remains a major health hazard for women as well as men. PMID- 3828967 TI - Primary small intestinal lymphoma in adults. A comparative study of IPSID versus non-IPSID in the Middle East. AB - Seventy-five cases of primary small intestinal lymphoma (PSIL) were diagnosed in adults at the American University of Beirut Medical Center (AUBMC) during the period from 1961 to 1980. Two additional cases of immunoproliferative small intestinal disease (IPSID) in the premalignant phase also were studied. Thirty two patients had IPSID; 27 non-IPSID; and in 18 patients it was difficult to distinguish IPSID from non-IPSID. While the former was shown to be a distinct disease entity with characteristic clinical, pathologic, and immunologic features, the latter was found to have no particular features in this part of the world. In addition to alpha heavy chain protein (AHCP) which is the biological marker of IPSID, the most important finding that distinguished the two diseases was that IPSID was always associated with a dense, compact mucosal cellular infiltrate (MCI) that was continuous and uninterrupted all along the length of the small intestine. In non-IPSID, MCI was lacking and the pathology was confined to sites of gross abnormalities. Sites distant to the primary lesion were free of disease. It was reported previously that the MCI in IPSID is characteristically diffuse plasmacytic or lymphoplasmacytic (DLP). Our study indicates that in addition to this infiltrate, the disease may be associated with another type of infiltrate which is follicular lymphoid (FL). Sixteen patients had DLP; ten, FL; and three, mixed infiltrate. The relationship of AHC disease and IPSID is discussed. AHCP may be found in intestinal fluid, serum, within the abnormal cell, or at its surface. Immunofluorescence and immunoperoxidase studies must be done on all intestinal and nodal tissue specimens in all patients with PSIL for the detection of AHCP, particularly in those where serum and intestinal fluid are negative for this protein. The hypothesis that the DLP infiltrate represents the secretory form of IPSID, while the FL the nonsecretory form, is introduced. IPSID is an ideal model for the study of the etiology and pathogenesis of lymphoma in man. PMID- 3828968 TI - Time trends and occupational differences in cancer of the testis in New Zealand. AB - The findings are reported from a New Zealand Cancer Registry-based case-control study involving 427 male patients with testicular cancer registered during the period 1979-1983 and aged 20 years or more at time of registration. Controls were also males chosen from the Cancer Registry with two controls per case, matched on age and year of registration. It was found that, as in other countries, persons in the upper social class groupings were at increased risk of testicular cancer. Persons in professional occupations were also at increased risk, but the odds ratio of 1.09 was much smaller than found in other studies. The previously reported excess risks for farmers, food and beverage workers, forestry workers, and pulp and paper workers were not supported by the New Zealand data. On the other hand, the previously reported excess risk for sales and service workers including members of the armed forces was supported, to some extent, by the New Zealand data with odds ratios of 1.38 (95% confidence limits 0.98-1.93) and 2.15 (95% confidence limits 0.80-5.79), respectively. Other groups with elevated risk include: physicians (odds ratio = 6.50, 95% confidence limits 1.29-32.6); production supervisors (odds ratio = 2.85,95% confidence limits 1.00-8.13); and motor vehicle mechanics (odds ratio = 2.02, 95% confidence limits 0.93-4.42). However, the New Zealand data generally does not suggest that occupational factors (or lifestyle factors associated with occupation) are of major direct importance in the etiology of testicular cancer. The incidence of testicular cancer has a bimodal age distribution in New Zealand and has risen markedly during the period 1948-1979. The New Zealand data differed from patterns observed in other countries in that the relative increase was approximately uniform across age groups rather than being stronger in the younger age groups. PMID- 3828969 TI - Missing Y chromosomes in lymph nodes from patients with non-Hodgkin's lymphoma. AB - Five of 86 male patients with non-Hodgkin's lymphoma had chromosomally abnormal clones in their lymph nodes, which involved a missing Y chromosome. The loss of the Y chromosome was confined to the malignant cells when normal cells were present. The patients ranged in age from 41 to 85 years. All five patients had B cell lymphomas with the histologic subtype diffuse large cell in two patients and immunoblastic, follicular large cell and follicular mixed in a single patient each. The t(14; 18)(q32;q21) chromosome abnormality accompanied the missing Y chromosome in four of the five patients. It appears that Y chromosome loss is one of the secondary abnormalities associated with non-Hodgkin's lymphoma. PMID- 3828970 TI - A chromosomal profile of polycythemia vera. AB - One hundred four patients with a diagnosis of polycythemia vera and a variable period of follow-up had one or more cytogenetic investigations. Chromosome abnormalities were found in 13% of untreated patients, in 56% of cases treated with radioactive phosphorus (32P) or cytotoxic drugs, and in 85% of patients in which transformation of the disease had occurred. Nonrandom chromosome abnormalities found before treatment included +8, +9, 13q-, 20q-; their prognostic value is little, as they are often associated with longstanding, stable disease. In contrast, 5q- anomaly and the appearance of subclones in patients with an abnormal karyotype were found to be poor prognostic signs, as they are usually coincidental with evolution of the disease to myelofibrosis or leukemia. Chromosomally two patterns of acute leukemia were observed in polycythemia vera patients. The first type resembles de novo acute leukemia, in that the clinical and cytologic characteristics of the disorder are easily defined by FAB criteria and the chromosome changes compatible with the types usually found in those conditions. In the second type, assignment to a FAB morphologic subgroup was more difficult, myelodysplastic changes were often present, and the karyotype showed complex abnormalities frequently involving chromosomes #5 and #7. All these features suggest the occurrence of secondary leukemia. PMID- 3828971 TI - Enhanced expression of four cellular oncogenes in a human glioblastoma cell line. AB - Examination of a human glioblastoma cell line displaying a relatively stable karyotype and absence of both copies of chromosome #13 (HeRo) as well as of a SV 40 transformed subline (HeRo-SV) using analysis on the DNA and RNA level showed that both cell lines express high levels of abl, erb B, myc, and Ha-ras mRNA. Neither gene amplification nor gene rearrangement at the loci concerned nor abnormal transcription account for this activation of expression. The possible influence of the deleted sequences in the context of a suppressor gene hypothesis is discussed. PMID- 3828972 TI - Double minutes and other chromosomal aberrations in malignant cell line of Shionogi carcinoma 115. AB - G-banded karyotypes and structural abnormalities of chromosomes are described in two clones of the mouse mammary carcinoma SC 115 cell line. The cells showed multiple numerical and structural abnormalities. Structural anomalies, such as double minutes, acentric fragments, gaps or breaks, radials, ring chromosomes, endoreduplications, dicentrics, and elongated chromosomes were observed in varying proportions. Unstable chromosomal aberrations, such as breaks, gaps, fragments, and radials, frequently appeared without any particular pretreatment. Increased numbers of double minutes per cell correlated positively with the presence of elongated chromosomes, which did not contain homogeneously staining regions by the G-band technique. PMID- 3828973 TI - Heterochromatic segment length of Y chromosome in 55 boys with malignant diseases. AB - By investigating heterochromatic segment variability in a group of boys with malignant disease a significantly greater value of the Yc:F index in relation to the control subjects was established. PMID- 3828974 TI - Trisomy 7 and i(5p) in a transitional cell carcinoma of the ureter. PMID- 3828975 TI - Cytogenetic analyses in 89 patients with secondary hematologic disorders--results of a cooperative study. AB - Eighty-nine patients who developed a secondary hematologic disorder and were studied with chromosome analysis were collected from nine institutions. The results of the study confirmed previous findings, in particular, -5/5q-, -7/7q-, 17, and +21 were the most frequently encountered aberrations. Moreover, a t(1;7)(p11;p11) was reported in four cases and consistent chromosome abnormalities were observed in a small group of patients who had been treated only with surgery, but not with chemo- or radiotherapy for a previous tumor. PMID- 3828976 TI - Cytogenetics of Mendelian mutations associated with cancer proneness. AB - About 5% of Mendelian mutations displaying neoplastic tendencies are associated with chromosomal aberrations. The best established examples are retinoblastoma and del(13)(q14) and aniridia-Wilms' tumor and del(11)(p13). Evidence suggests that both mutations behave as dominant traits in the individual and as recessive traits in the cells. DNA analysis indicates that tumorigenesis arises from homozygosisty for the mutant allele at these loci, as a consequence of mitotic nondisjunction or from a mitotic recombination event. An additional argument for this conclusion is provided by the demonstration of duplication of 11p15 in some patients with the Beckwith-Wiedemann syndrome, which is complicated often by Wilms' tumor and other embryonal tumors. Data obtained with molecular probes have shown that also rhabdomyosarcoma and hepatoblastoma arise by homozygosity for a mutant allele at a locus on 11p, suggesting ontogenic relatedness of these tumor types. Additional examples of Mendelian mutations associated with chromosome deletions and neoplasia include Langer-Giedion syndrome with multiple exostoses and del(8)(q24.1), multiple endocrine neoplasia and del(20)(p12.2). While the presence of specific chromosome changes in subjects with high susceptibility to neoplasia does pinpoint the location of DNA sequences involved in the predisposition to certain types of cancers, selected Mendelian mutations associated with chromosome instability and cancer proneness may elucidate biological principles of cell proliferation and transformation. However, our current knowledge of mechanisms resulting in increased frequency of chromosome breakage and cancer susceptibility in ataxia-teleangiectasia, Fanconi's anemia, Bloom's syndrome, and similar conditions are still very incomplete. PMID- 3828977 TI - Estrogen receptor in dissociated and cultured human breast fibroadenoma epithelial cells. AB - Estrogen binding was measured by a whole cell receptor assay in epithelial cells isolated from 20 premenopausal patients with breast fibroadenomas. A high affinity specific binding for estrogens was detected in the epithelial cells isolated from all 20 fibroadenomas. A relationship between estrogen binding and the phase in the menstrual cycle of the patient has been observed. Cell culture experiments using serum-free medium have also shown that estrogen binding can be augmented by cortisol. PMID- 3828978 TI - Short-term quantitative in vitro cytotoxicity assay involving an S-9 activating system. AB - Mouse 3T3 fibroblasts grown in 96-well microtiter plates are used for a test which incorporates an S-9 mixed function oxidase system into a neutral red viability assay for the assessment of the acute cytotoxicity of xenobiotics in vitro. This sensitive, quantitative, semi-automated assay was suitable for the rapid screening of a broad spectrum of substances, including pharmaceuticals, carcinogens, and anti-neoplastic agents. The test was applicable to the analysis of toxic ranges, for the detection of biotransformability of parent compounds and for the evaluation of the cytotoxic effects of chemotherapeutic agents. PMID- 3828979 TI - Production of urinary tract tumors by co-administration of uracil and N-[4-(5 nitro-2-furyl)-2-thiazolyl]-formamide in F344 rats. AB - Co-administration of uracil and N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) to weanling female Fischer rats produced uracil stones in the bladder and significantly reduced the incidence of bladder tumors. Contrary to bladder tumors, the incidence of renal pelvic and ureteric tumors was increased by this regimen. Feeding of uracil alone produced bladder tumors, in addition to the hyperplasia of renal pelvis, ureter and bladder. The mechanism of uracil's effect on FANFT carcinogenesis is not known. PMID- 3828980 TI - Cellular uptake and photosensitizing properties of hematoporphyrin di-ethers with similar chromatographic properties as the tumorlocalizing fraction of hematoporphyrin derivative. AB - The di-methyl-, di-ethyl-, di-propyl-, di-normal butyl-, and di-iso-butyl-ethers of hematoporphyrin were synthesized and shown to possess chromatographic properties similar to those of the tumorlocalizing components of hematoporphyrin derivative (Hpd). The cellular uptake of these ethers, as well as their retention in cells during incubation with porphyrin free medium, increased with decreasing polarity and so did their efficiency in sensitizing cultured cells to photoinactivation. The least polar of the porphyrin ethers tested showed up to a 10-fold stronger efficiency in sensitizing cultured cells to photoinactivation than Hpd and Photofrin II (P II). PMID- 3828981 TI - Effect of anti-inflammatory drugs on the production of tumour necrosis factor and lipopolysaccharide induced-mortality in mice. AB - Mice injected with viable Listeria monocytogenes or powdered Corynebacterium parvum and challenged with endotoxin released tumour necrosis factor (TNF) into the blood. However, the rate of mortality from endotoxin shock was high. Administration of the non-steroidal anti-inflammatory drugs acetylsalicylate, indomethacin and phenylbutazone protected the animals against the lethal effect of endotoxin without affecting the ability of animals to produce TNF. The significance of these observations are discussed. PMID- 3828982 TI - A new medium for primary cultures of adult murine epidermal cells: application to experimental carcinogenesis. AB - A culture medium has been formulated to support the long-term proliferation and differentiation of normal murine epidermal cells in primary cultures. This formulation is based upon MCDB-151 modified by the addition of 1.2 mM Ca2+, 1% fetal bovine serum (FBS) or 0.1% purified bovine serum albumin (BSA), trace elements, and growth supplements. For 4-12 weeks, the cultures demonstrate desmosomes, keratin fibers, basal proliferation, and stratification characteristic of keratinocytes. The addition of 12-O-tetradecanoylphorbol-13 acetate (TPA) resulted in approximately 70% cellular detachment, but with continued treatment, the remaining cells proliferated to confluence and stratified. This culture medium has application to a number of studies related to skin carcinogenesis in the murine model system that have not previously been possible. PMID- 3828983 TI - Active H-ras and N-ras in rat fibrosarcomas induced by 1,6-dinitropyrene. AB - The activated oncogenes in rat fibrosarcomas induced by subcutaneous injection of 1,6-dinitropyrene (1,6-DNP), an environmental mutagen-carcinogen, were examined by NIH3T3 cell transfection assay and Southern blot analysis. DNAs from two of eleven fibrosarcomas, 1,6-DNP6 and 1,6-DNP9T, induced transformants which contained rat specific repetitive sequences. Three primary transformants, obtained with DNA from 1,6-DNP6, and two secondary transformants of one of these primary transformants tested, contained rat H-ras. DNA from 1,6-DNP9T; a fourth transplant of 1,6-DNP9, also induced transformants. All the primary transformants with DNA from 1,6-DNP9T, and three secondary transformants of one of them, contained rat N-ras. The DNA from the original tumor, 1,6-DNP9, however, did not give any transformants by several transfection assays. Activation of N-ras oncogene during serial transplantations is discussed. PMID- 3828984 TI - Paradoxical effect of dichlorobis(1-phenylbutane-1,3-dionato)molybdenum (IV), (Mo(bzac)2Cl2 on the growth of autochthonous chemically induced colorectal tumors in SD rats. AB - The influence of dichlorobis(1-phenylbutane-1,3-dionato)molybdenum (IV), (Mo(bzac)2Cl2) in acetoxymethyl-methylnitrosamine (AMMN) induced colorectal cancer in SD rats was assessed. Treatment was given intravenously twice a week for 10 weeks immediately after the end of the induction period (G1 and G2) or following coloscopic diagnosis of the tumors (G4, G5 and G6). Paradoxical therapeutic effect of Mo(bzac)2Cl2 on the growth the AMMN induced colorectal cancer was observed. PMID- 3828985 TI - Heat-sensitivity of the Harding-Passey melanoma. AB - We have shown that the Harding-Passey melanoma is heat-sensitive. Its heat sensitivity increases as the tumor develops in the host. Excision achieved a higher percentage of long-term cure than hyperthermia, during the time period of tumor development studied in these experiments, but did not give the host long term protection from subsequent tumor challenge. PMID- 3828986 TI - Modulation of polycation-induced redistribution of melanoma cell surface anionic macromolecules by retinoic acid. AB - The ability of cationized ferritin (CF) to redistribute negatively charged cell surface molecules has been shown to increase after malignant transformation. Pretreatment of murine melanoma S91-C2 and B16-F1 cells with retinoic acid (RA), which suppresses their transformed phenotype, decreased the ability of CF to cluster surface anionic sites. In contrast, a similar pretreatment of RA resistant mutant clone S91-C154 and subline B16-F10 caused only a minor reduction in CF-induced patching of anionic sites. These results indicate that the effect of RA on the redistribution of negatively charged cell surface molecules is related to the growth-inhibitory action of this vitamin A metabolite. PMID- 3828987 TI - Total calories, body weight, and tumor incidence in mice. AB - The relation between total caloric intake, body weight, and tumorigenesis, as well as the independence of these effects from those of dietary fat, were evaluated using data from 82 published experiments involving several tumor sites in mice. Comparing experimental (calorie restricted) to control (ad libitum) groups showed that the former consumed 29% fewer calories (experimental groups consumed fewer calories than control groups in all but a few isocaloric experiments), 50% less total fat, 11% less protein, and weighed 25% less than control animals. Adult body weight was highly correlated to caloric intake in both males (r = 0.85) and females (r = 0.74), although this correlation decreased with increasing caloric intake. Cumulative tumor incidence was, on average, 42% lower in the restricted groups. Multivariate regression analyses revealed that, regardless of the level of dietary fat, tumor incidence increased with increasing caloric intake and body weight over a wide range of intakes, including moderate caloric restriction (i.e., 7-20%). These data indicate that total caloric intake is an important determinant of tumorigenesis in mice, and that body weight may be a more sensitive indicator for this effect than is caloric intake alone. PMID- 3828988 TI - Correlation between antitumor activity of protein A and in vivo formation of defined high molecular weight complexes with immunoglobulin G in BALB/c mice. AB - The purpose of this study was to test the hypothesis that antitumor activity of staphylococcal protein A (SpA) is related to the composition of complexes formed in vivo with IgG. BALB/c mice were inoculated intradermally with 10(6) Meth A fibrosarcoma cells on day 0 and treated i.v. on days 3 and 7 with between 1 and 405 micrograms of SpA. The 45- and 15-micrograms doses significantly inhibited tumor growth and enhanced survival time compared to saline controls in four of four and two of four experiments, respectively. Sucrose gradient ultracentrifugation was used to show that serum from tumor-bearing or normal mice given 45 or 15 micrograms of 125I-labeled SpA contained only high molecular weight [(IgG)2SpA]2 complexes for up to 24 h after injection, whereas serum from mice given higher ineffective doses (135 and 405 micrograms) contained low molecular weight (IgG)(SpA) complexes over the first 1-4 h. Serum from mice undergoing successful therapy with 45 micrograms of unlabeled SpA also contained only [(IgG)2SpA]2 complexes. In contrast, when mice with large tumors (120-150 mm2) were treated on days 16 and 20, only the 135- and 405-micrograms doses significantly inhibited further tumor growth. Serum from mice with 16-day tumors contained only [(IgG)2SpA]2 complexes even after 5 min and when 135 or 405 micrograms of 125I-SpA was given. This result is consistent with significantly higher (2.7-3.4-fold, P less than 0.0001) levels of total and SpA-reactive IgG in serum from these mice compared to normal mice or mice with 3-day tumors. Our results demonstrate a correlation between antitumor activity of SpA and in vivo formation of [(IgG)2SpA]2 complexes in an established animal model, and help to define the mechanism of SpA action at the molecular level. PMID- 3828989 TI - Tumoricidal effector mechanisms of murine Bacillus Calmette-Guerin-activated macrophages: mediation of cytolysis, mitochondrial respiration inhibition, and release of intracellular iron by distinct mechanisms. AB - Murine Bacillus Calmette-Guerin-activated macrophages mediate discrete cytotoxic effects in cocultured tumor target cells in vitro. These effects include: the loss of intracellular iron, in part associated with reversible inhibition of the Kreb's cycle enzyme, aconitase; cytostasis, associated with reversible lesions inflicted in the electron transport chain (ETC) of the mitochondria resulting in reversible loss of proliferative capacity; and cytolysis, manifested by eventual gross perturbation of the integrity of the plasma membrane. We demonstrate that these manifestations of cytotoxicity are the result of three independent mechanisms employing apparently distinct macromolecules for their commission. Analysis of target cells that are highly susceptible (L-929), highly resistant (L 1210), or have incomplete resistance (EMT-6) to the cytolytic effects of cocultured activated macrophages indicates that there is no consistent relationship between the release of intracellular 59Fe and 51Cr. Thus, perturbation of intracellular iron pools did not appear to be an obligatory step on the pathway to cytolysis. Further evidence for this dissociation was obtained by employing a specific heteroantiserum reactive with cytolytic molecule(s). This antiserum could block the cytolytic response (51Cr release of cocultured L-929 and EMT-6 targets) but had no effect on the extent of iron release from viable EMT-6 or L-1210 targets. Furthermore, the cytolytic factor itself was incapable of mediating effects on the ETC or in causing release of intracellular iron. Two lines of evidence suggested that effects on the ETC are not linked with loss of intracellular iron. First, the monokine respiration inhibitory factor was incapable of causing release of intracellular iron from target cells in which the mitochondria were strongly suppressed. Second, the kinetics of release of respiration inhibitory factor from endotoxin-triggered Bacillus Calmette-Guerin activated macrophages indicate a retarded appearance compared to the time at which a factor mediating release of intracellular iron was detectable. Our results strongly suggest that these three distinct cytotoxic reactions are under differential control by the effector cell. PMID- 3828990 TI - Direct antiproliferative effects of recombinant human interferon-alpha B/D hybrids on human tumor cell lines. AB - The purpose of these studies was to examine the antiproliferative properties of 16 recombinant human IFN-alpha B/D hybrids against various human tumor lines of different histological origin and to determine whether any of the hybrid molecules possessed immunomodulating activity that could active antitumor properties in peripheral blood monocytes of normal donors. Hybrids with the B domain at the NH2 terminal end exhibited higher activity for antiviral activity and a higher level of direct antitumor antiproliferative activities as compared with hybrids with the D domain at the NH2 terminal end. The positive hybrids were directly cytostatic to melanoma, glioblastoma, renal carcinoma, colon carcinoma, and prostatic carcinoma cells. Tumor cell sensitivity to IFN-alpha hybrids was independent of sensitivity to IFN-gamma or to Adriamycin. The growth of a normal cell line (human embryo fibroblast) was unaffected by IFN-alpha hybrids but was completely arrested by Adriamycin. Some of the IFN-alpha hybrids were also cytostatic to mouse melanoma, lung carcinoma, and fibrosarcoma cell lines, albeit at lower levels than they were to human cells. The incubation of monocytes with IFN-alpha hybrids with the B domain at the NH2 terminal end was also associated with marked antitumor cytotoxicity. Kinetic studies, however, indicated that this activity was attributable to IFN-alpha carried on monocytes and acting directly on tumor cells. We conclude that recombinant human IFN-alpha B/D hybrids possess potent direct antiproliferative activity against a large variety of human tumor lines. PMID- 3828991 TI - Yield of DNA-protein cross-links in gamma-irradiated Chinese hamster cells. AB - gamma-Irradiation of Chinese hamster V79 cells increases the percentage of nuclear DNA cross-linked to proteins. Studies were carried out to ascertain whether the radiation-induced increase in DNA-protein cross-links (DPC) is due to an increase in the number of DNA fragments which are cross-linked to protein or to an increase in the size of bound DNA fragments. Cells were prelabeled with [3H]thymidine and irradiated (10-600 Gy), and DPCs were collected on nitrocellulose filters. Native gel analyses of the DNA recovered from the filters indicate that the number average molecular weight of cross-linked DNA (1.22 X 10(7) Da) is the same in unirradiated cells and in cells given up to 100 Gy. Assuming 5 pg of DNA per V79 cell, it was possible to calculate that there are approximately 6 X 10(3) DPC per unirradiated cell and that 150 DPC are formed per gray of gamma-radiation for doses of 0-100 Gy. Thus, radiation increases the number of new linkages between DNA and protein. At radiation doses greater than 200 Gy the percentage of nuclear DNA cross-linked to protein approaches a plateau value. The number of DPC (greater than 6 X 10(4)) formed at higher doses is within the range of the estimated number of DNA attachment sites on the nuclear matrix. PMID- 3828992 TI - Altered levels of protein kinase C and Ca2+-dependent protein kinases in human colon carcinomas. AB - Protein kinase C (PKC) is a Ca2+- and phospholipid-dependent protein kinase which is implicated in tumor promotion, since it has been demonstrated to be a high affinity receptor for tumor promoters such as 12-O-tetradecanoylphorbol-13 acetate. Colon carcinogenesis appears to proceed through distinct stages of initiation and promotion. The present studies show that PKC and calcium-dependent protein kinase specific activities are reduced in human colon carcinomas when compared to their normal adjacent colon mucosa. There were significantly higher Ca2+-dependent protein kinase and PKC specific activities observed in both the cytosolic and particulate fractions of the normal mucosa relative to the corresponding values obtained with the carcinoma fractions. The average specific activity ratios were 5.1 (normal cytosolic/carcinoma cytosolic) and 3.7 (normal particulate/carcinoma particulate) for PKC. PKC activity was reduced in the carcinoma tissues with respect to both protein and tissue weight. The percentage of Ca2+-dependent protein kinase and PKC activities that were present in the particulate fraction of each of the samples varied considerably among tissues, and in general there was no systematic difference between the carcinoma and normal mucosa samples. However, in the carcinoma samples that contained an extensive admixture of benign adenomatous tissue, the particulate fractions consistently contained greater than 60% of the total Ca2+-dependent protein kinase and PKC activities. The present studies indicate that colon carcinogenesis is associated with alterations in cellular levels of protein kinase activities. PMID- 3828993 TI - Effects of monoclonal anti-transferrin receptor antibodies on in vitro growth of human solid tumor cells. AB - To determine whether anti-transferrin (Tf) receptor monoclonal antibodies might be useful in treatment of human solid tumors, in vitro effects of immunoglobulin A (42/6) and immunoglobulin G (B3/25) anti-Tf receptor antibodies on human solid tumor growth were examined. In colony and liquid cultures containing 10% serum, B3/25 did not inhibit growth of melanoma or ovarian carcinoma cell lines. 42/6 caused modest dose-dependent inhibition in colony cultures (maximum inhibition approximately 50%), and slowed growth of melanoma, ovarian carcinoma and epidermoid carcinoma cells in liquid culture. Inhibition was more pronounced in low (1%) serum, and was abrogated by 200 micrograms/ml iron-saturated Tf or 50 microM ferric nitriloacetate. All cells displayed high affinity Tf receptors (4 20 X 10(4)/cell). Cells grown in 1% serum and epidermoid carcinoma cells displayed more receptors, and susceptibility to 42/6 inhibition appeared related to higher receptor number. After culture with anti-Tf receptor antibodies, solid tumor cells showed a 57-93% reduction in surface Tf-binding sites. Tf uptake by cells grown for 24 h in B3/25 was approximately 50% of control, but was reduced to less than 10% of control with 42/6. Immunofluorescence staining of melanoma and HL60 promyelocytic leukemia cells suggested greater heterogeneity of Tf receptor display on melanoma than on leukemia cells. Previous studies showed 42/6 completely blocked blood cell Tf internalization and is a potent inhibitor of hemopoietic cell growth. In contrast, in solid tumor cells, inhibition of Tf uptake and growth inhibition are subtotal. Solid tumor resistance to 42/6 may be due in part to greater heterogeneity of Tf receptor display by proliferating cells. However, responses to iron-saturated Tf and ferric nitriloacetate in the presence of 42/6 also differ in hemopoietic and solid tumor cells, suggesting possible differences in Tf processing or iron growth requirements. PMID- 3828994 TI - Biochemical and morphological effects of cigarette smoke condensate and its fractions on normal human bronchial epithelial cells in vitro. AB - We investigated the effect of cigarette smoke condensate (CSC), two basic fractions (BIa and BIb) of CSC, the ethanol-extracted weakly acidic fraction (WAe), and the methanol-extracted neutral fraction (Nmeoh) on the clonal growth rate, plasminogen activator (PA) activity, cross-linked envelope (CLE) formation, and ornithine decarboxylase activity, epidermal growth factor (EGF) binding, thiol levels, and DNA single strand breaks in cultured human bronchial cells. Neither CSC nor any of the fractions were mitogenic over the range 0.01-100 micrograms/ml. All were growth inhibitory at higher concentrations. The 40% growth inhibitory concentrations for CSC, BIa, BIb, WAe, and Nmeoh were 10, 10, 10, 3, and 1 micrograms/ml, respectively. Effects on CLE formation, morphology, PA, and ornithine decarboxylase activities, EGF binding, and thiol levels were evaluated using 40% growth inhibitory concentrations. We found that CSC and all fractions caused an increased formation of CLEs, from a baseline of 0.5% in the untreated cells to a maximum increase of 25% induced by Nmeoh. A squamous morphological change was observed within 1 h after exposure to Nmeoh, WAe, and CSC. The BIa and BIb fractions had little effect. Only Nmeoh increased PA significantly, from 2.5 +/- 0.4 to 5.1 +/- 0.3 units/mg cellular protein. CSC and the WAe and Nmeoh (Nmeoh greater than WAe greater than CSC) fractions caused a decrease in EGF binding, in each case reaching a maximum effect after a 10-12-h incubation. This effect on EGF binding was further characterized in the case of Nmeoh. In untreated normal human bronchial epithelial cells, by Scatchard analysis the kd was 2.0 nM and there were 1.2 X 10(5) receptors/cell. In cells incubated in medium containing Nmeoh (3 micrograms/ml) the kd was 3.2 nM and there were 1.1 X 10(5) receptors/cell. Thus, inhibition of EGF binding by Nmeoh was due primarily to a decrease in the affinity. At the 40% growth inhibitory concentrations neither CSC nor any of the fractions significantly affected intracellular thiol levels. While a 3-h incubation in medium containing CSC caused significant DNA single strand breaks only at a concentration of 100 micrograms/ml, Nmeoh caused a marked effect at 5 micrograms/ml. Neither CSC nor any of the fractions had an effect on ornithine decarboxylase activity. Due to the effects of the Nmeoh fraction on growth, morphology, EGF binding, PA activity, and formation of single strand breaks we consider it to be the most likely portion of CSC to contain compounds with actions similar to those of the phorbol ester, indole alkaloid, and polyacetate tumor promoters. PMID- 3828995 TI - Multiple mechanisms of resistance to cis-diamminedichloroplatinum(II) in murine leukemia L1210 cells. AB - As an experimental model for resistance to cis-diamminedichloroplatinum(II) (cis DDP), murine leukemia L1210 cells have been exposed to a stepwise increase in cis DDP concentration to produce a variety of resistant cell lines. Intraspecies hybrids of the sensitive and resistant cells were made to determine whether cis DDP resistance is a dominant or recessive trait. Hybrid cells displayed a partial degree of resistance as compared to the parental cells. To determine whether this was due to a single codominant trait or contribution from a variety of resistance mechanisms, the cells and hybrids were investigated for alterations in the accumulation of drug, as well as alterations in glutathione levels which might inactivate the drug. The cis-DDP-resistant cells demonstrated both a 50% reduction in accumulation of drug and a 1.7-fold increase in intracellular glutathione. Reducing the glutathione levels in these cells with buthionine sulfoximine did not sensitize them to cis-DDP. The hybrid cells had the same accumulation and the same levels of glutathione as the cis-DDP-sensitive cells. Parallel studies were performed with cells resistant to 1,2 diaminocyclohexaneplatinum(II) analogues. These cells also demonstrated reduced drug accumulation but no increase in glutathione. Therefore, both a decrease in accumulation and increase in glutathione may mediate resistance. Both mechanisms represent recessive traits as demonstrated in the cell hybrids. These mechanisms can only account for a small part of the resistance in these cells. A major, dominant mechanism occurs after the DNA has been platinated, but it remains to be determined whether this involves DNA repair, postreplication repair, or some other as yet unidentified process. PMID- 3828996 TI - Tumor cytokinetics in the presence of normal, alloimmune, or Bacillus Calmette Guerin-activated host cells simultaneously assayed in vivo and in vitro. AB - Rates of tumor cell loss, replication, and growth were determined simultaneously for P-815 mastocytoma cells placed in culture or transplanted as a peritoneal ascites tumor. Cytokinetic parameters were concordant in vitro to in vivo for P 815 cells growing in the presence of syngeneic DBA/2 resident or proteose peptone elicited macrophages and under allogeneic C57BL/6 nonimmune conditions. Under alloimmune conditions, measured parameters differed in vitro from in vivo but conclusions were consistent in that alloimmune host cells were cytolytic and cytostatic and caused tumor regression. In contrast, syngeneic Bacillus Calmette Guerin-activated macrophages were cytolytic and cytostatic in vitro but not in vivo despite equivalent or greater effector to target ratios, presence or absence of endotoxin in the tumor inoculi, or changes in the injection schedule of Bacillus Calmette-Guerin. Similarly, Bacillus Calmette-Guerin-activated macrophages were cytolytic in vitro but not in vivo when admixed with tumor cells prior to injection into the leg. This study is the first simultaneously conducted cytokinetic analysis of a common pool of labeled tumor cells growing in vitro and in vivo using randomly selected mice as donors of host effector cells or as recipients of tumor transplantation. It demonstrates that activated macrophages which are cytolytic and cytostatic in vitro for P-815 cells may not function analogously in vivo in controlling tumor growth. PMID- 3828997 TI - Targeting of murine radiolabeled monoclonal antibodies in the lymphatics. AB - The tissue localization of a radiolabeled monoclonal antibody directed against a mouse Class I major histocompatibility antigen has been determined in mice following i.v. and s.c. administration. When labeled antibody was given s.c., radioactivity rapidly accumulated in regional lymph nodes draining the injection site, allowing visualization of the nodes by gamma camera imaging within minutes of injection. At 2 h after s.c. injection, radioactivity in regional nodes was present largely as intact antibody, but considerable degradation of antibody present in nodes was noted by 12 h after injection. Since little of the radioactivity reached the blood stream, visualization of regional nodes was possible for long periods after dosing. In contrast, antibody given i.v. showed no significant accumulation in lymph nodes at any time after dosing. PMID- 3828998 TI - Secretory epithelial cell marker on gastrointestinal tumors and in human secretions defined by a monoclonal antibody. AB - A new marker for human secretory epithelial cell types (Exo-1) has been defined by a mouse monoclonal antibody (Pa-G14). The antibody was raised against a human exocrine pancreatic tumor cell line (Capan-1) and tested against 46 cultured human cell types and 228 freshly frozen human tissue sections. It reacted specifically with 28 normal and 55 secretory neoplastic epithelial tissues tested. Eleven different secretory epithelial cell types expressed this antigen, as well as human fetal tissues of the gut and bronchi. One hundred and twenty samples of normal tissues, cells, and tumors of nonexocrine origin were Exo-1 negative. In normal secretory tissues staining was most pronounced at the apical poles and as shown by immunoelectron microscopy in the case of the duodenum, at the microvilli. In cultured Exo-1 positive tumor cells the antigen was not demonstrable on the cell surface but in the cytoplasm after acetone/methanol fixation only. The antigen was identified biochemically as a polar neutral glycolipid and detected in human salivary, bronchial, pancreatic, and intestinal secretions by an enzyme-linked immunosorbent assay, but was not found in sera of healthy controls or patients with gastrointestinal and other tumors. Antigen Exo 1 represents a novel common antigen for normal and tumorous glandular epithelial cells. PMID- 3828999 TI - P-glycoprotein expression in human breast cancer cells. AB - Multidrug resistance in Chinese hamster ovary cells is associated with the Mr 170,000 surface glycoprotein. Using our monoclonal antibody to this protein, we have isolated a complementary DNA clone from an expression vector library. This complementary DNA recognizes a 4.5-kilobase mRNA in drug-resistant but not sensitive Chinese hamster ovary cells; it also recognizes a 5.0-kilobase mRNA in our Adriamycin-resistant subline of the MDA-231 human breast cancer cell line which is not expressed in the drug-sensitive parent line. Southern blot analysis shows that the P-glycoprotein sequences are greatly amplified in resistant Chinese hamster ovary cells but not in the resistant human breast cancer cells, indicating that amplification and expression of the Mr 170,000 P-glycoprotein gene are not necessarily coordinate events. Amplification of this gene may not be required for multidrug resistance in human cells. PMID- 3829000 TI - Different modifying response of butylated hydroxyanisole, butylated hydroxytoluene, and other antioxidants in N,N-dibutylnitrosamine esophagus and forestomach carcinogenesis of rats. AB - The modifying effects of antioxidants were examined in a carcinogenesis system after N,N-dibutylnitrosamine treatment. Male F344 rats were given 0.05% N,N dibutylnitrosamine in their drinking water for 4 wk and then treated with basal diet containing 2% butylated hydroxyanisole (BHA), 1% butylated hydroxytoluene (BHT) with 7 ppm vitamin K, 0.8% ethoxyquin, 5% sodium L-ascorbate, 5% sodium erythorbate, or no added chemical for 32 wk. BHA enhanced forestomach carcinogenesis but did not enhance esophageal carcinogenesis. BHT enhanced esophageal carcinogenesis but did not enhance forestomach carcinogenesis. Ethoxyquin significantly enhanced esophageal tumorigenesis. Neither esophageal nor forestomach carcinogenesis was affected by the other antioxidants evaluated. BHA significantly increased DNA synthesis of the forestomach epithelium, whereas BHT tended to increase that of the esophageal epithelium. Thus, BHA and BHT showed different modifying responses in carcinogenesis of the esophagus and forestomach. PMID- 3829001 TI - Development and characterization of a human colon adenocarcinoma xenograft deficient in thymidine salvage. AB - In order to determine the contribution of thymidine (dThd) salvage to intrinsic resistance to antimetabolites (5-fluoropyrimidines, antifolates) in the human colon adenocarcinoma xenograft, H X GC3, a subline deficient in thymidine kinase has been developed. A cell line (GC3/M) was established in continuous culture that demonstrated a karyotype identical to that of the stem line of H X GC3 (46,X, - Y + 12). After inoculation of GC3/M cells into immune-deprived CBA/CaJ mice, the H X GC3/M xenografts retained histological, histochemical, and growth characteristics of the H X GC3 xenograft. To develop a line deficient in dThd salvage, GC3/M cells were selected with BrdUrd (100 micrograms/ml). Three clones characterized were unable to proliferate in HAT medium, and were deficient (less than 10% control) in the cytosolic form of thymidine kinase. Activities of dThd phosphorylase and dTMP synthase were unchanged from parental GC3/M cells. Of the three clones inoculated into mice, GC3/M TK- 100 C3 was tumorigenic, the xenografts demonstrating histological and growth characteristics similar to H X GC3. The in vivo activity of the cytosolic form of dThd kinase was 3.5% of that in H X GC3 xenografts. Incorporation in vivo of [methyl-3H]dThd into acid insoluble material was 14% of that in H X GC3 tumors. Autoradiographs prepared from these tumors demonstrated that incorporation of radiolabel into nuclei occurred only in stromal cells derived from the host. It is anticipated that H X GC3/M TK- 100 C3 will be a line valuable for determining the role of dThd salvage in intrinsic resistance to 5-fluoropyrimidines or antifolates in human colon adenocarcinomas growing as xenografts and also the relevance of dTMp synthase as a target for antimetabolites in this histiotype. PMID- 3829002 TI - Platelet aggregating activity mediated by thrombin generation in the NCG human neuroblastoma cell line. AB - Platelet aggregating activity of the NCG human neuroblastoma cell line was compared with that of the HL-60 human promyelocytic leukemia cell line. NCG, in intact cell suspensions and ultracentrifuged pellets, induced platelet aggregation most significantly in heparinized platelet rich plasma (PRP) containing 2.5 units/ml of heparin, but not in the presence of higher concentrations of heparin or 5 mM ethylenediamine-tetraacetate or in citrated PRP. NCG induced platelet aggregation was also inhibited by hirudin or (2R,4R)-4 methyl-1-[N2-(3-methyl-1,2,3,4-tetrahydro-8-quinolinesulfon yl)-L- arginyl]-2 piperidinecarboxylic acid (MD 805) in the same manner as that of tissue thromboplastin induced platelet aggregation. HL-60 cells did not induce platelet aggregation in our heparinized PRP assay systems; however, after treatment with neuraminidase HL-60 cells became active in aggregating platelets in either heparinized or citrated PRP. NCG demonstrated high procoagulant activity by either intact cell suspensions or ultracentrifuged pellets. The procoagulant activity of NCG was reduced in Factor VII deficient human plasma as it was in the results obtained by tissue thromboplastin. These results suggest that NCG induces platelet aggregation via thrombin generated through procoagulant activity which is shed in association with microvesicles demonstrated in the ultracentrifuged pellets. This type of platelet aggregating activity found in NCG is significantly different from that of HL-60. PMID- 3829003 TI - Comparison of the localization of chromosome damage induced by calcium chromate and nickel compounds. AB - Chromosomal aberrations were studied in Chinese hamster ovary cells and in C3H10T1/2 cells following treatment with NiCl2, crystalline NiS, and CaCrO4. All three compounds caused an increase in chromosomal aberrations in a concentration- and time-dependent fashion. The chromosomal aberrations induced by NiCl2 and crystalline NiS occurred predominantly in heterochromatic regions of the chromosomes. Additionally, treatment of cells with crystalline NiS and to a smaller extent long-term treatment with NiCl2 caused a preferential effect on the condensation state of the heterochromatic long arm of the X-chromosome in hamster cells. In contrast, treatment of cells with CaCrO4 did not induce aberrations preferentially in heterochromatin. These results are interesting because nickel(II), which is thought to be the ultimate carcinogen of nickel compounds, binds poorly to DNA, is weakly mutagenic, but induces chromosome damage, probably because of its interaction with nuclear proteins in heterochromatin. Chromate binds to DNA, is mutagenic, and interacts with chromatin randomly. PMID- 3829004 TI - Varying probability of the development of acute nonlymphoblastic leukemia in refractory anemia patients with an excess of blasts. AB - The cumulative leukemia-free survival rate of refractory anemia with excess of blasts was fitted to three parametric failure time models, i.e., the usual exponential and Weibull, and exponential mixture models. Among the three, the best fit model was the exponential mixture model, which was 119 times more likely to assume that samples came from the exponential mixture distribution than to assume that those were from the usual Weibull distribution. This strongly suggests that refractory anemia with excess of blasts consists of subgroups with very high and very low probability to develop acute nonlymphoblastic leukemia. The estimated proportion of the very low probability group was about 30%. Analysis by the exponential mixture model with covariates revealed that the probability of a patient to develop acute nonlymphoblastic leukemia could be estimated by three covariates, i.e., bone marrow blast percentage; abnormal granules of granulocytes; and mononuclear large megakaryocytes. The estimated probabilities ranged from 17 to 99%, according to the model. PMID- 3829005 TI - Role of antitumor activity of alveolar macrophages in lung cancer patients. AB - The purpose of this study is to clarify the significance of antitumor activity of alveolar macrophages (AM) in lung cancer patients. AM from tumor-bearing and non tumor-bearing segments were obtained separately by the lavage of bronchoalveolar tracts of resected lungs of 74 patients with primary lung cancer. Cytostatic activity (CTS) of AM obtained from non-tumor-bearing segments was stable in spite of enlargement of tumor size or progression of N factor. In contrast, CTS of AM obtained from tumor-bearing segments may be augmented at Stage II as compared with Stage I, and suppressed with an advance of stage from II through IV, although the number of Stage II patients was as small as three. Moreover, CTS of AM from tumor-bearing segments was suppressed in N2 as compared with N0 or N1, and also it was suppressed as compared with that of AM from non-tumor-bearing segments in N2 disease. CTS of AM from smokers was suppressed as compared with that of nonsmokers in both tumor-bearing and non-tumor-bearing segments. These results suggest that lung cancer cells or their products may suppress antitumor activity of AM in the tumor-bearing segments at advanced stages, and cigarette smoking is a suppressive factor on antitumor activity of AM. PMID- 3829006 TI - Clinical pharmacokinetics of 5-fluorouracil and its metabolites in plasma, urine, and bile. AB - Kinetics of 5-fluorouracil (FUra) and FUra metabolites in plasma and urine were investigated in 10 cancer patients following i.v. bolus administration of 500 mg/m2 FUra with 600 microCi of [6-3H]FUra. Biliary excretion was examined in two patients with external biliary catheters. Quantitation of unchanged drug and metabolites was assessed by a highly specific high-performance liquid chromatographic method. FUra plasma levels declined rapidly with an apparent elimination half-life of 12.9 +/- 7.3 min. Dihydrofluorouracil was detected within 5 min in most patients, demonstrating rapid catabolism and reached maximum peak levels of 23.7 +/- 9.9 microM at approximately 60 min. The apparent elimination half-life of dihydrofluorouracil (61.9 +/- 39.0 min) was consistently greater than that of the unchanged drug. The apparent elimination half-lives of the subsequent metabolites alpha-fluoro-beta-ureidopropionic acid and alpha fluoro-beta-alanine were prolonged with values of 238.9 +/- 175.4 min and 1976 +/ 358 min, respectively. Approximately 60-90% of the administered dose was excreted in urine within 24 h, primarily as alpha-fluoro-beta-alanine. Biliary excretion accounted for 2-3% of total administered radioactivity. The major fraction of this radioactivity eluted on high-performance liquid chromatography as a previously unrecognized FUra metabolite. Analysis of its structure is currently ongoing in our laboratory. In conclusion, this study provides the first comprehensive analysis of the formation and excretion of FUra metabolites in plasma, urine, and bile following i.v. bolus administration of FUra in humans. PMID- 3829007 TI - Tardive dyskinesia induced by sulpiride in a patient with hypothyroidism. PMID- 3829008 TI - Pharmacologic evaluation of dopaminergic receptor blockade by metoclopramide. AB - The occurrence of adverse extrapyramidal effects following metoclopramide (MCP) therapy has been well documented in humans. In rats, MCP produced catalepsy and inhibited apomorphine-induced stereotypy, locomotor activity, and rotational behavior. MCP also accelerated dopamine turnover, potently stimulated prolactin release, and, at high concentrations, inhibited [3H]spiperone binding to striatal membranes. These behavioral and biochemical effects induced by MCP were similar to those observed with haloperidol. We conclude that MCP possesses most of the pharmacological properties of neuroleptic agents. PMID- 3829010 TI - Writer's cramp and the endogenous opioid system. PMID- 3829009 TI - Stress and caffeine: effects on central adenosine receptors. AB - The effects of two different kinds of stress (social and physical) on central adenosine receptors were investigated in mouse whole brain membranes using 1,3 diethyl-8-[3H]phenylxanthine ([3H]DPX) as a ligand. Chronic but not acute social stress induced an increase in the number of adenosine receptors similar to that induced by chronic, nontoxic doses of caffeine. Acute but not chronic social stress also induced an increase in the number of benzodiazepine receptors labeled by [3H]beta-carboline-3-carboxylate ethyl ester. The group submitted chronically to both stress and caffeine showed an increase in [3H]DPX binding relative to that found with either of these factors alone. The adenosine uptake site, labeled by [3H]nitrobenzylthioinosine, was not modified by either stress or caffeine administration. PMID- 3829011 TI - Action of 7-ethylcamptothecin on tumor cells and its disposition in mice. AB - Some biological effects of camptothecin (CPT) and its new derivative 7 ethylcamptothecin (ECPT) were studied. The drugs were effective against murine leukemia; ECPT was more effective than CPT. Ip administration of ECPT or CPT gave maximum treated/control values of 325% and 232%, respectively. The drugs also inhibited the growth of KB cells in vitro, 50% effective doses of 3.5 ng/ml of ECPT and 8.6 ng/ml of CPT, indicating the stronger activity of ECPT. Pharmacokinetic studies of the drugs in mice showed that ECPT had a longer biological half-life in the terminal phase and a larger amount remained in the plasma compared with CPT. After iv administration of ECPT, the drug accumulated in the intestine, suggesting that the main route of excretion of the drug is through the biliary tract. The study on cell cycle progression by flow cytometry suggested that the main effect of both drugs on L1210 cells was the blocking of G2-M phase. These results suggest that the main reasons for the superior antitumor activity of ECPT compared with CPT are as follows: (a) ECPT had a stronger growth-inhibiting activity against tumor cells, and (b) ECPT remained in the intestinal tract for a longer time and in higher amounts when administered in vivo. PMID- 3829012 TI - Effects of mitoxantrone and doxorubicin on energy metabolism of the rat heart. AB - In animal models anthracyclines and anthracenediones show similar antineoplastic activity but somewhat different cardiotoxicity. The effects of doxorubicin and the free base of mitoxantrone (NSC-279836) on the energy metabolism of the rat heart were compared. Both compounds not only reduced oxygen consumption in heart mitochondria ex vivo, but also uncoupled oxidative phosphorylation, inhibited creatine phosphate kinase, and damaged the semipermeability of the inner mitochondrial membrane (measured as creatine influx). The effects on the myocyte membrane activities, calcium transport, and Na/K, Mg, and Ca ATPases were slightly different for the two compounds. Cardiotoxicity of the two compounds may have its origin in their interference with heart cell energy metabolism. PMID- 3829013 TI - Increased therapeutic efficacy and reduced toxicity of doxorubicin linked to pyran copolymer via the side chain of the drug. AB - Doxorubicin was covalently linked to divinyl ether-maleic anhydride copolymer (pyran copolymer) in its polycarboxylate form via the methylketone side chain through a nucleophilic substitution reaction of the 14-bromo derivative of the drug. The drug conjugated to the synthetic polyanionic polymer was tested for antitumor activity in a range of experimental murine tumor systems. When administered ip to mice bearing ip implanted tumors (P388 leukemia or macrophage tumor J774), the polymer-linked drug was superior to free doxorubicin and daunorubicin in increasing the life span of treated animals. Treatment with the conjugate also resulted in an improvement in survival time of mice bearing ascitic M50 tumor, although the effects of a single dose of free drug, in the range of maximum tolerated doses, were marginal. When given iv, the conjugate was more effective than free drug against systemic Gross leukemia. The therapeutic advantage of the polymer-linked doxorubicin over free drug was more marked when a multiple treatment schedule was used. Studies in vitro showed that the drug following covalent fixation to the polymer had only marginally decreased cytotoxicity against HeLa and P388 cells when compared with that of free anthracycline. This effect paralleled the lack of reduction in in vivo potency. Moreover, the covalent linkage of the drug to synthetic polymer reduced drug toxicity. This effect was more marked with the ip route of administration than with the iv route. PMID- 3829014 TI - Cell kinetics as a prognostic marker in locally advanced breast cancer. AB - The study analyzes the prognostic implication of cell kinetics on 52 locally advanced breast cancers. All patients were subjected to a multimodal treatment, including primary chemotherapy with doxorubicin and vincristine, surgery, or radiotherapy followed by additional chemotherapy with the same drug regimen. Pretreatment labeling index (LI) is not related to response to primary chemotherapy, whereas it provides information on the course of the disease. In fact, high LI significantly predicts a higher progression rate at the end of the entire combined treatment, a shorter time to disease progression, and a poorer probability of 4-year survival in comparison to low LI. From the present findings, LI appears to be a useful tool to select women with locally advanced breast cancer that would require very aggressive treatment. PMID- 3829015 TI - Inefficacy of cisplatin and etoposide as salvage therapy for children with recurrent or unresponsive soft tissue sarcoma. AB - Cisplatin (CPDD) and etoposide (VP-16) have activity as single agents in children with recurrent soft tissue sarcoma, with response rates approximating 20%. Sixteen evaluable patients with soft tissue sarcoma, 0.9 to 16 years of age, were treated with a combination of CPDD (75-100 mg/m2 iv X 1) and VP-16 (100-150 mg/m2/day iv X 3-5) every 3 weeks after recurrence or failure to respond to standard therapy. Toxicity consisted of vomiting and myelosuppression. There were no complete responses, and only two children (12.5%) had partial responses lasting 6 weeks. Every patient died of progressive tumor. CPDD and VP-16, as given on this study, had minimal activity. PMID- 3829016 TI - Clonidine for anticipatory nausea and vomiting: a pilot study examining dose toxicity relationships and potential for further study. AB - In preparation for studies of noradrenergic activity in anticipatory nausea and vomiting, we performed an open-dose study of clonidine to examine dose-toxicity relationships and indications of antiemetic activity. Nine patients, three each at 0.1, 0.2, and 0.4 mg/day, received clonidine twice a day for 5 days before chemotherapy. Unwanted effects, principally blood pressure reduction, dry mouth, and sedation, accumulated between 4 and 5 micrograms/kg/day. Four of eight evaluable patients had no anticipatory symptoms on clonidine. It is concluded that clonidine, at a dose of 4 micrograms/kg/day, might safely probe the role of noradrenergic activity in anticipatory nausea and vomiting. PMID- 3829017 TI - Respiratory dyskinesia due to antiemetic therapy in a cancer patient. AB - Cancer patients commonly receive neuroleptics as antiemetics to relieve nausea and vomiting induced by chemotherapeutic agents. Respiratory dyskinesia, an infrequent, acute, neuroleptic-induced, dystonic reaction, is a potentially life threatening entity that responds promptly to anticholinergic medication. PMID- 3829018 TI - "Pharmacokinetics and immediate effects of high-dose carmustine in man". PMID- 3829019 TI - Unusual skin reaction to echinomycin. PMID- 3829020 TI - Some thoughts on the future of clinical trials groups in cancer. PMID- 3829021 TI - Intraspinal communication of sacrococcygeal dermal sinuses. PMID- 3829022 TI - Giant sacrococcygeal teratoma in an African child. PMID- 3829023 TI - Giant cerebellar hemangioma in an infant. PMID- 3829024 TI - Pathophysiology of aqueductal obstruction in isolated IV ventricle after shunting. AB - The authors report their cases of isolated IV ventricle and discuss their concepts of secondary obstruction of the aqueduct, analyzing CSF dynamics, pressure measurements, serial CT scan changes, and the outcome of various treatment modalities. Two distinctly different categories were identified: functional obstruction in which the obstructed aqueduct reopened either as the result of decreasing the elevated infratentorial pressure (Raimondi's phenomenon) or from correction of overdrainage of the supratentorial system; permanent obstruction with pathological occlusion of the aqueduct, necessitating a IV ventriculoperitoneal shunt. It is the pathophysiology and pathoanatomy of secondary obstruction of the aqueduct that determine the specific treatment to be used in managing the isolated IV ventricle syndrome. PMID- 3829025 TI - Problems with lateral canthal advancement. AB - The technique of lateral canthal advancement for the treatment of premature coronal craniosynostoses has been employed in 12 cases. In patients with high intracranial pressure aesthetic problems after the operation were observed. The frontolateral area did not reossify and the brain bulged forward. For secondary correction in these cases the bilateral advancement of Marchac and Renier was used. A sufficient increase of intracranial volume could be achieved by complete osteotomy of the skull base. The bone segments were stabilized by miniplate osteosynthesis. The results were thereby improved. PMID- 3829026 TI - Radiological and pathological findings in three cases of childhood pineocytomas. AB - The radiological and pathological findings in three children with pineocytomas are described. The patients presented with symptoms and signs of increased intracranial pressure. CT scans demonstrated obstructive hydrocephalus, but failed to visualize pineal masses that were subsequently seen on MR scans. A suboccipital, supracerebellar approach was used to obtain tissue for histological diagnosis and, in one case, achieve a total removal. Light microscopy demonstrated typical pineocytomatous rosettes without evidence of gangliocytic or astrocytic differentiation. Electron microscopy revealed numerous dense core vesicles with synaptic ribbons, suggesting neurosecretory capability. These three cases demonstrate the diagnostic advantage of MR imaging for tumors in the pineal region as well as the relatively well-differentiated histopathological characteristics of pineocytomas. PMID- 3829027 TI - Auditory brainstem-evoked response in childhood brainstem glioma. AB - Auditory brainstem-evoked responses were recorded from 14 children with clinical and radiological evidence of brainstem glioma. Responses were abnormal in all cases. The findings were consistent with intrinsic brainstem lesions in all except one case with a glioma, which was shown to be located predominantly in the medulla oblongata. Seven of the children had more than one test and changes in the responses paralleled clinical changes in all except the case with glioma of the medulla. The usefulness of auditory brainstem-evoked responses as an aid in diagnosing and monitoring changes in brainstem gliomas is discussed. PMID- 3829028 TI - Extradural hematoma complicating middle fossa arachnoid cyst. AB - Two cases of post-traumatic extradural hematoma complicating an arachnoid cyst of the middle cranial fossa in children are described. While subdural and intracystic hemorrhages are well-known complications from this malformation, the association with extradural hematoma has never been previously reported in the literature. The pathogenetic mechanisms are discussed and the particular vulnerability of intracranial arachnoid cysts is stressed. PMID- 3829029 TI - Acute head injuries in children in Ibadan, Nigeria. AB - The city of Ibadan has a population of 3 million people and is the third largest city in Africa. In the mid-1970s, the economic boom in Nigeria was at its peak, which caused many changes in the socioeconomic scenario in the country, changes which affected the pattern of acute head injuries, especially in children. We therefore conducted a prospective study on all head injuries encountered in Nigerians treated in the Emergency Room of the University College Hospital in Ibadan between 1 July and 31 December 1974. PMID- 3829030 TI - Surgical treatment of acute subdural hygroma in children. AB - During the years 1967-1984, 91 children were operated on because of acute compressive traumatic intracranial hematoma: 16 (17%) had traumatic acute subdural hygromas. These were unilateral in 12 cases and bilateral in 4. The causes of injury were traffic accidents in 11 children, a fall in 1, and acute deceleration injuries in 5. Nine children suffered multiple injuries to the thorax, inferior extremities, and pelvis. Clinical manifestations and evolution of clinical symptoms included changes in conscious level, palsy, high fever, nystagmus, maximum dilation of either pupil and spontaneous, irregular breathing. The diagnosis was made on the basis of the clinical picture and supplementary clinical investigations: CT, EEG, echoencephalography, isotope cisternography, and arteriography. Treatment was by simple trephination of the cranium and evacuation of hygromatous liquid. All children survived the surgical treatment; 1 child died after the operation and 2 developed hydrocephalus. PMID- 3829031 TI - Cystic meningiomas in children. AB - Two cases of cystic meningioma simulating glioma, both clinically and radiologically, are reported and the literature is reviewed. The majority of cystic meningiomas in children are seen below the age of 1 year, with male preponderance. There is no relationship between cyst formation and histological type of meningioma. PMID- 3829032 TI - Symptomatic cyst of the septum pellucidum. AB - The presentation and management of a patient with symptomatic hydrocephalus from a cyst of the septum pellucidum is described and the underlying pathophysiology in relation to treatment is considered. The cyst appeared to cause intermittent obstruction of the foramina of Munro according to the degree of ventricular dilatation. Drainage and collapse of the cyst by fenestration reestablished continuous drainage of the ventricles with immediate symptomatic relief. PMID- 3829033 TI - Primary intracranial ependymoblastoma presenting as spinal cord compression due to metastasis. AB - A primary intracranial ependymoblastoma presented only with symptoms of spinal cord compression due to metastatic spread of the tumor via the leptomeninges. Such a presentation is very rare among primary neoplasms of the central nervous system (CNS) and unique among the 12 previously reported ependymoblastomas. The previous cases all arose as primary brain tumors and several were remarkable for extensive leptomeningeal spread of the tumor. These observations and the presentation of our patient suggest that a histological diagnosis of ependymoblastoma of the spinal cord, with or without symptoms of intracranial tumor, should suggest that an intracranial primary lesion might be present. PMID- 3829034 TI - Cyst of the septum pellucidum presenting as hemiparesis. AB - An 11-year-old boy with Down syndrome is presented who suffered progressive hemiparesis on the left side for a period of 5 years. Computed tomography demonstrated a large cyst of the septum pellucidum and a calcified spot in the head of caudate nucleus on the right side. By penetrating the cyst wall to create a communication into the lateral ventricle, shrinkage of the cyst and improvement of the hemiparesis were obtained. The pathogenesis of the hemiparesis was presumed to be attributed to circulatory compromise in the deep cerebral veins, secondary to the cyst. PMID- 3829035 TI - Haematemesis from distal extracranial carotid aneurysms. Case report and literature review. AB - A 5-year-old white boy presented with life-threatening haematemesis from spontaneous rupture of an aneurysm of the high cervical internal carotid artery (ICA). The haemorrhage was controlled by emergency trap ligation of the distal ICA in the neck. The child made an excellent recovery and 7 years later has no neurologic deficit other than an Horner's syndrome. The diagnosis of an extracranial carotid artery aneurysm without a pulsatile lump may be very deceptive. PMID- 3829036 TI - Synthesis of 2,3-epoxypropyl beta-glycosides of (1----6)-beta-D galactopyranooligosaccharides and their binding to monoclonal anti-galactan IgA J539 and IgA X24. AB - Reaction of 2,3,4-tri-O-acetyl-6-O-(bromoacetyl)-alpha-D-galactopyranosyl bromide (2) with allyl 2,3,4-tri-O-acetyl-beta-D-galactopyranoside gave allyl O-[2,3,4 tri-O-acetyl-6-O-(bromoacetyl)-alpha- and -beta-D-galactopyranosyl]-(1----6) 2,3,4-tri-O-acetyl-beta-D- galactopyranoside, 4 (4%) and 5 (88%), respectively. Selective removal of the bromoacetyl group from 5 gave allyl O-(2,3,4-tri-O acetyl-beta-D-galactopyranosyl)-(1----6)-2,3,4-tri-O-a cet yl-beta - D galactopyranoside (6), which, after condensation with 2,3,4,6-tetra-O-acetyl alpha-D-galactopyranosyl bromide (1) yielded both allyl O-(2,3,4,6-tetra-O-acetyl alpha- and -beta-D-galactopyranosyl)-(1----6)-O-(2,3,4-tri-O-acetyl-beta-D- galactopyranosyl)-(1----6)-2,3,4-tri-O-acetyl-beta-D-galactopyranoside, 7 (10%) and 8 (70%), respectively. When 6 was condensed with 2, allyl O-[2,3,4-tri-O acetyl-6-O-(bromoacetyl)-beta-D-galactopyranosyl]-(1----6 )-O- (2,3,4-tri-O acetyl-beta-D-galactopyranosyl)-(1----6)-2,3,4-tri-O-acetyl -beta-D - galactopyranoside (75%) was obtained. This was selectively O-de(bromoacetyl)ated to yield the nonaacetate, which was condensed with bromide 1 to give allyl O (2,3,4,6-tetra-O-acetyl-alpha- and -beta-D-galactopyranosyl)-(1----6)-O-(2,3,4 tri-O-acetyl-beta-D- galactopyranosyl)-(1----6)-O-(2,3,4-tri-O-acetyl-beta-D galactopyranosyl )- (1----6)-2,3,4-tri-O-acetyl-beta-D-galactopyranoside, 14 (4%) and 15 (70%). Epoxidation of the allyl group of 8 and 15 with m chloroperoxybenzoic acid, and removal of the acetyl protecting groups with sodium methoxide, gave, respectively, 2,3-epoxypropyl O-beta-D-galactopyranosyl-(1----6) O-beta-D-galactopyranosyl-(1----6)-be ta-D- galactopyranoside (17) and the corresponding tetrasaccharide 19. Sequential acetylation and O-debenzylation of 6 O-benzyl-D-galactose, followed by coupling of the product with bromide 1, yielded O-(2,3,4,6-tetra-O-acetyl-beta-D-galactopyranosyl)-(1----6)-1,2,3,4-tetr a-O- acetyl-beta-D-galactopyranose (12). Conversion of 12 into the bromide by treatment with bromotrimethylsilane, and condensation of the product with nucleophile 6 also gave the beta-linked tetrasaccharide 15 of this series. Epoxidation of the allyl group, followed by removal of acetyl blocking groups in the latter compound, again gave 2,3-epoxypropyl O-beta-D-galactopyranosyl-(1--- 6)-O-beta-D-galactopyranosyl-(1----6)-O- beta-D- galactopyranosyl-(1----6)-beta-D galactopyranoside (19).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3829037 TI - Specific synthesis and stereochemical assignment of the diastereomeric 3,5-O benzylidene-1,2-O-isopropylidene-alpha-D-glucofuranose isomers. AB - Pyridinium tosylate-catalyzed acetal exchange between benzaldehyde dimethyl acetal and 6-O-(tert-butyldiphenylsilyl)-1,2-O-isopropylidene-alpha-D-glucofu ranose was investigated as an alternative to the original procedure of Brigl and Gruner (condensation of a D-glucose triol with benzaldehyde under zinc halide catalysis) for synthesis of 3,5-O-benzylidene-1,2-O-isopropylidene-alpha-D glucofuranose. The two routes afford opposite benzylidene diastereoisomers: the traditional procedure leads to the thermodynamically favored isomer (phenyl and C 6 trans), whereas the new sequence gives the cis compound. The orientations and conformations of these isomers were determined after conversion into the corresponding 6-iodides 5 and 7. X-Ray crystallography revealed that the 1,3 dioxane ring of the trans isomer 7 exists in the expected chair, "O-inside" conformation. In contrast, a combination of n.m.r. spectroscopy and molecular mechanics calculations demonstrated that the same ring of cis diastereomer 5 does not adopt the alternative chair, "H-inside" conformation; instead, it exists in a specific twist form. PMID- 3829038 TI - Structural analysis of papaya polysaccharide II. AB - The structure of papaya polysaccharide II (PP II) isolated by Chandrasekaran et al. [Carbohydr. Res., 60 (1978) 105-115] has been investigated by methylation analysis of the carboxyl-reduced polymer and by partial hydrolysis of both the intact (arabinose, 31.0; rhamnose, 13.3; galactose, 42.6; glucuronic acid, 10.3; and 4-O-methylglucuronic acid, 2.8%), and carboxyl-reduced polymers. Methylation analysis of carboxyl-reduced PP II indicated a very highly branched structure in which approximately 39% of the galactopyranose units are disubstituted, 24% are monosubstituted, 20% are trisubstituted, and 17% are nonreducing end units. Methylation analysis of products of partial hydrolysis of both intact and carboxyl-reduced polymers indicated that the backbone of the polysaccharide is made up of galactosyl residues substituted at either O-3 or -6, that the principal aldobiouronic acid fragment is 6-O-(glucopyranosyluronic acid)galactose, that the rhamnosyl units are substituted at O-3 with either terminal arabinofuranosyl or galactopyranosyl groups, and that the rhamnosyl residues are themselves linked to glucuronic acid residues through O-4. From this information, a possible statistical fragment with six arabinofuranose and two galactopyranose nonreducing end-groups per 19 sugar units [five units in the main chain of (1----3)-linked galactopyranose units] is proposed. PMID- 3829039 TI - N.m.r. assignments of acetyl and trityl groups in derivatized carbohydrates via proton-carbon long-range couplings. PMID- 3829040 TI - The X-ray crystal structure of DL-(1,3,5/2,4)-1,2,3,4-tetraacetoxy-5 (acetoxymethyl)cyclohexane. AB - The crystal and molecular structure of the pseudo-sugar DL-(1,3,5/2,4)-1,2,3,4 tetraacetoxy-5-(acetoxymethyl)cyclohexane ("pseudo-beta-DL-glucopyranose pentaacetate") has been determined by X-ray diffraction and statistical-phasing procedures. The data were refined to R = 0.049 and Rw = 0.054 over 1543 reflections with I greater than 3 sigma(I). The racemic crystals are monoclinic, space group P2(1)/c, a = 11.580(2), b = 8.276(1), c = 22.031(2) A, beta = 104.33(1) degrees, Dc = 1.26 g/cm3, with four molecules in the unit cell. The ring has a 4C1(D), 1C4(L) conformation, with puckering amplitude of 0.582(4) A, a pseudorotation angle of -168.35 degrees, and a gg orientation about the C-5-C-6 bond. PMID- 3829041 TI - Evidence for structural changes in dermatan sulfate and hyaluronic acid with aging. AB - Three dermatan sulfates (DS18, DS28, and DS35) were isolated from women's skin of ages 19 +/- 2.5, 35 +/- 3.5, 47 +/- 1.7, 60 +/- 0.8, and 75 +/- 5 years. They sequentially precipitated with 18, 28, and 35% ethanol. Their sulfate content was: 23.5, 25.3, and 29.0% (w/w) for DS18 at ages 19-35, 47, and 60 years, respectively; 29.0, 24.0, and 18.8% for DS28; and 18.0, 20.0, and 20.6% for DS35 at ages 19-47, 60, and 75 years, respectively. Both DS18 and DS28 decreased, respectively, from 0.030% (of wet-skin weight) to traces at age 75, and from 0.020 to 0.010% at 60 years. At age 75, DS28 apparently increased by 30%. The DS35 values (traces-0.006%) had no age-related trend. Hyaluronic acid (HA) precipitated with 45% ethanol, was 0.030% of skin-weight at ages 19-47, and decreased to 0.015 and 0.007% at 60 and 75 years, respectively. Its electrophoretic mobility was slower at age 47. In the oldest group, i.r. spectra of HA and DS35 displayed no bands at 1650-1600, 1380, and 1320 cm-1, and a new band at 1560 cm-1. Moreover, ninhydrin-positive material of HA and DS35 increased by 75 and 95%, respectively, and the reducing GlcNAc content of HA decreased. These data showed three chemically different dermatan sulfates (two of which were preponderant) and N-deacetylation of HA and DS35 of the oldest group. After age 47, total DS and HA considerably decreased, DS18 and DS35 were oversulfated, and DS28 became undersulfated with aging. PMID- 3829043 TI - Structure of acidic oligosaccharides isolated from pronase-treated glycoprotein of bonnet-monkey (Macaca radiata) cervical mucus. AB - The major glycoprotein component of cervical mucus of bonnet monkey was treated with Pronase, and the enzyme-resistant glycoprotein purified by gel filtration on Sepharose 4B followed by DEAE-cellulose chromatography. Alkaline-borohydride cleavage of the carbohydrate chains gave a mixture of neutral and acidic oligosaccharides. Seven acidic oligosaccharides were characterized by chemical and enzymic procedures; their proposed structures are: alpha NeuAc(2----3)-[beta GalNAc(1----4)]beta Gal(1----4)GlcNAc(1----6)[alpha Fuc(1----2)beta Gal(1--- 3)]GalNAc-ol; alpha Fuc(1----2)beta Gal(1----3)/6)[alpha NeuAc(2----3)beta Gal(1- --4)GlcNAc(1----3)/6)]GalNAc-ol; alpha GalNAc(1----3)beta Gal(1----3)[alpha NeuAc(2----3)beta Gal(1----4)GlcNAc(1----6)]GalNAc-ol; beta GlcNAc(1----3)[alpha Fuc(1----2)]beta Gal(1----3)[alpha NeuAc(2----6)]GalNAc-ol; beta Gal(1----3) [alpha NeuAc(2----6)]GalNAc-ol; alpha NeuAc(2----6)GalNAc-ol; and beta Gal3SO3(1- --4) GlcNAc(1----6)[alpha Fuc(1----2)beta Gal(1----3)]GalNAc-ol. PMID- 3829042 TI - Improved and large-scale synthesis of certain glycosyl cyanides. Synthesis of 2,5 anhydro-5-thio-D-allononitrile. AB - The first synthesis of 2,5-anhydro-5-thio-D-allononitrile starting with L-lyxose, via a trifluoromethanesulfonic ester intermediate, has been accomplished. Methods have been developed to achieve a large-scale synthesis of 3,4,5,7-tetra-O-acetyl 2,6-anhydro-D-glycero-D-talo-heptononitrile (5). An improved procedure has been developed to synthesize 2,5-anhydro-3,4,6-tri-O-benzoyl-D-gulononitrile (9). The structures of 5 and the thioamide derivative from 9, 2,5-anhydro-3,4,6-tri-O benzoyl-D-gulonothioamide, were confirmed by X-ray crystallographic analysis. PMID- 3829044 TI - Second International Symposium on Immunobiology in Clinical Oncology and Immune Dysfunctions. Nice, April 4-7, 1987. Abstracts. PMID- 3829046 TI - Construction and characterisation of a hybrid-hybrid monoclonal antibody recognising both carcinoembryonic antigen (CEA) and vinca alkaloids. AB - Recent developments of hybridoma technology have allowed us to prepare a bispecific monoclonal antibody recognising both the tumour-associated antigen carcinoembryonic antigen (CEA) and the cytostatic vinca alkaloids. The yields of the hybrid-hybrid 28.19.8 monoclonal after affinity chromatography purification are close to 50% of the total Ig produced. The hybrid-hybrid has a molecular weight ca. 150,000 daltons. The heavy chains of the hybrid-hybrid are a gamma 1 heavy chain from the parental anti-CEA monoclonal and a gamma 2a heavy chain from the anti-vinca alkaloid donor lymphocytes. PMID- 3829045 TI - Heterogeneous expression of a murine B16 melanoma-associated antigen correlates with cell cycle. AB - A murine monoclonal antibody (MM2-3C6) that reacts with a B16 murine melanoma associated membrane antigen was used to study the relationship of antigen expression to the cell cycle. Dual-parameter flow cytometric measurements of membrane antigen and DNA revealed that antigen-positive cells were present throughout the cell cycle. Peak antigenic expression was noted during the late log phase of the cell growth curve with negligible antigen-negative population. The emergence of a distinct antigen-negative population (30%-40%) was noted in the late stationary phase. Cell cycle analysis indicated that the negative subpopulation was restricted to the G0/G1 phase, thus, demonstrating antigenic heterogeneity within the tumor cell population. Cell sorting was performed to analyze the origin of such heterogeneity. Following two sequential sortings, the antigen-negative cells became antigenic upon reculture. Again, at the late stationary phase, a distinct antigen-negative population (30%-40%) emerged. The sorted antigen-positive cells showed flow cytometric profiles identical to the sorted antigen-negative population upon reculture. Therefore, in this murine model, it appears that antigen expression is cell cycle dependent and such expression seems to be associated with proliferation. PMID- 3829047 TI - Specific in vitro and in vivo drug localisation to tumour cells using a hybrid hybrid monoclonal antibody recognising both carcinoembryonic antigen (CEA) and vinca alkaloids. AB - By using a bispecific monoclonal antibody recognising both carcinoembryonic antigen (CEA) and the cytostatic vinca alkaloid drugs we have been able to show specific tumour localisation of vinca alkaloids. In vitro studies with sections of human colorectal tumours have demonstrated that the hybrid-hybrid 28.19.8 monoclonal is able to specifically localise vindesine to cells expressing CEA. Furthermore, the hybrid-hybrid 28.19.8 localises in vivo preferentially to tumour tissues in nude mice bearing the MAWI human xenograft tumour. This tumour-bound hybrid-hybrid monoclonal antibody induces profound changes in the bio distribution of vinca alkaloid drugs, targeting them specifically to tumour tissues. PMID- 3829048 TI - Increased therapeutic effect of vinca alkaloids targeted to tumour by a hybrid hybrid monoclonal antibody. AB - Unmodified vinblastine (VLB) targeted through one of the antigen combining sites of the hybrid-hybrid 28.19.8 monoclonal is potentially more effective in suppressing the growth of established MAWI tumour xenografts implanted on nude mice than free VLB in the absence of the targeting agent, presumably due to an increased local drug concentration. Our efficacy results in this study suggest that drug, specifically removed from the circulation by hybrid-hybrid antibody previously located to the tumour mass, can be made available in a pharmacologically active from. Histological analysis of the treated tumours revealed dramatic changes in the tumour organisation with only a few surviving tumour cells with altered morphology. PMID- 3829049 TI - Criteria for selecting monoclonal antibodies with respect to accumulation in melanoma tissue. AB - Immunohistology provides a necessary but insufficient criterion for selecting monoclonal antibodies (MAbs) capable of tumour targeting in vivo. Additional selection procedures have been evaluated using a panel of anti-melanoma MAbs, including immunoreactivity of (labelled) MAbs, antibody affinity, kinetics of binding and release, apparent antigen density and accumulation in nude mouse transplants. According to these criteria, MAbs M.2.7.6 and M.2.9.4 showed the most favourable properties, i.e. high immunoreactivity and pronounced internalization into melanoma cells. With MAbs M.2.10.15 and KG 6-56, moderate immunoreactivity and a binding pattern characterized by temperature dependence in the absence of internalization was observed. According to the paired label assay, all four MAbs showed specific accumulation into solid melanoma tissue. However, application in the patient still requires evaluation of the side effects of antigen cross-expression on normal human tissues. PMID- 3829050 TI - Activation of mouse peritoneal macrophages by synthetic glyceroglycolipid liposomes. AB - Liposomes composed of chemically synthesized glyceroglycolipids, such as 1,2 dipalmityl-[beta-cellobiosyl-(1'----3)]- glycerol (Cel-DAG), 1,2-dipalmityl-[beta lactosyl-(1'----3)]-glycerol, or 1,2-dipalmityl-[beta-maltosyl-(1'----3)] glycerol, were found to enhance protective immunity against transplantable tumor cells (sarcoma 180) in ICR mice. Peritoneal exudate cells prepared from mice treated in vivo with Cel-DAG showed cytostatic activity in vitro against the mouse leukemia cell line, EL-4. Adherent cells separated from this preparation showed similar activity. Peritoneal cells from polypeptone-injected mice acquired appreciable cytostatic activity when incubated in vitro in the presence of glyceroglycolipid liposomes. The adherent cell fraction alone showed rather weak cytostatic activity when pretreated with the glyceroglycolipids, and full activity was restored by supplementing with the nonadherent cell fraction. The ability of glycolipids to induce tumoricidal effects was affected by cholesterol content: with increasing cholesterol content, the activities decreased. Cholesterol-free glycolipid liposomes were taken more efficiently by macrophages than cholesterol-containing liposomes. Cholesterol modifies the surface property of glyceroglycolipid liposomes. Activation of macrophages is responsible for enhancement of protective immunity against tumor cells by injection of these glycolipids in vivo. PMID- 3829051 TI - Synergistic action of human recombinant tumor necrosis factor with endotoxins or nontoxic poly A:U against solid Meth A tumors in mice. AB - Antitumor effects of i.v. injected human recombinant tumor necrosis factor (rTNF) against solid Meth A tumors in mice appeared to be critically dependent on the dose and were limited by its toxicity. Extensive necrosis and complete cures were only induced by doses having untoward effects, such as diarrhea, hypothermia, ruffled fur, and lethargy. Murine tumor necrosis serum (TNS, 0.5 ml) had about the same antitumor potential and induced all side effects except diarrhea. More extensive necrosis and approximate doubling of the incidence of complete regression in the absence of gross side effects were observed upon administration of a low dose of rTNF combined with detoxified endotoxin, nontoxic poly A:U, or submicrogram doses of toxic endotoxin. The separate constituents had little antitumor effects, if any at all. Increasing the dose of toxic endotoxin resulted in a further potentiation of necrosis, overt toxicity, but no cures. Muramyl dipeptide and interferon alpha/beta did not potentiate effects of rTNF. In vitro growth of Meth A cells was not inhibited by toxic endotoxin, rTNF or the combination, although TNS was highly inhibitory. Data show that therapeutic effects of rTNF and its synergy with endotoxin are not due to direct effects on the tumor cells and that the extent of prompt in vivo tumor necrosis does not predict the course of tumor growth. Therapeutic effects of both TNS and toxic endotoxin probably involve a synergy between low levels of TNF and other factors/effects induced by endotoxin. Detoxified endotoxin and poly A:U probably induce the latter effects and little or no TNF, so explaining the absence of side effects, their weak antitumor potential, and their powerful synergistic action with rTNF. A role for interferon alpha/beta as an induced synergistic factor is not likely. Muramyl dipeptide and TNF might share properties needed for synergy with endotoxins. PMID- 3829052 TI - Antitumor effect of the streptococcal preparation OK-432 in a murine model of ovarian cancer. AB - The antitumor effects of the streptococcal preparation OK-432 were analyzed in a murine ovarian teratocarcinoma (MOT) model. Administration of OK-432 i.p. prevented tumor outgrowth in 75% of mice challenged with 10(3) MOT cells i.p. 24 h previously. Treatment was less successful in mice challenged with 10(4) or 10(5) cells, preventing tumor growth in 25% of the former and only 5% of the latter group. Tumor-challenged mice cured by injections of OK-432 were not rendered resistant to a subsequent challenge with 10(3) MOT cells 75 days after initial treatment. Only the i.p. route of administration was effective as i.v. OK 432 did not prolong survival of tumor-challenged mice. An antitumor response was detected as early as 24 h after i.p. treatment. This correlated temporally with an influx of neutrophils into the peritoneal cavity. Peritoneal cells obtained between 6 and 24 h after treatment were capable of lysing MOT targets in vitro. A single cell cytotoxicity assay demonstrated that peritoneal neutrophils, elicited by i.p. injection of OK-432, could bind to and lyse MOT targets. These data indicate that OK-432 is effective against small tumor cell inocula in this murine model of ovarian cancer and, furthermore, that the neutrophilic response into the peritoneal cavity plays a role in tumor rejection. PMID- 3829053 TI - Combined treatment of advanced malignant melanoma with coumarin and cimetidine. A phase II study. AB - Immunostimulant therapy with coumarin and cimetidine was evaluated in 17 patients with advanced malignant melanoma. Induction therapy with coumarin 100 mg daily was given for 8 weeks, whereupon cimetidine 1000 mg daily was added. No patients had been previously treated with cytotoxic drugs, and all patients had a good performance status. In 16 patients progressive disease was observed, and only 1 patient experienced no change in condition, lasting 30 weeks. We conclude that treatment with this schedule of coumarin and cimetidine is without effect in advanced malignant melanoma. PMID- 3829054 TI - Recruitment of exogenous macrophages into metastases at different stages of tumor growth. AB - The endogenous tumor-associated macrophage content and recruitment of labeled peritoneal exudate cells into experimental murine B16 melanoma metastases has been examined at different stages in the progressive growth of metastatic lesions. The recruitment of thioglycollate-elicited peritoneal exudate cells and peritoneal exudate cells activated in vitro with muramyl dipeptide was studied. Tumor-associated macrophages and labeled peritoneal exudate cells were identified in paraffin sections by specific histochemical staining and their density in individual metastases measured morphometrically. The density of tumor-associated macrophages and exogenously recruited peritoneal exudate cells was high in very small lesions but decreased rapidly as a function of enlargement of metastases, MD:An; where MD is macrophage density, A is the cross-sectional area of the lesion and n is a negative number. No significant difference was observed in the recruitment of activated and nonactivated peritoneal exudate cells. These results suggest that decreased recruitment of macrophages from the circulation may explain the decrease in the density of tumor-associated macrophages as metastases grow and indicate that macrophage activation is not accompanied by enhanced localization and/or uptake of macrophages into metastases. PMID- 3829055 TI - [Endomyocardial biopsy of the right ventricle]. PMID- 3829056 TI - [The right ventricle in post-capillary pulmonary hypertension]. PMID- 3829057 TI - [Morphofunctional aspects of the right ventricle in congenital heart diseases]. PMID- 3829058 TI - [The right ventricle in heart diseases]. PMID- 3829059 TI - [Unstable pectoris angina]. PMID- 3829060 TI - [Silent myocardial ischemia]. PMID- 3829061 TI - [Ventricular arrhythmia in chronic ischemic heart disease]. PMID- 3829062 TI - [Mechanisms of action and clinical results of calcium blocking in exertion angina, mixed or spontaneous]. PMID- 3829063 TI - [Physiopathology of acute myocardial infarct]. PMID- 3829064 TI - Acute coronary artery obstruction: status in 1986. PMID- 3829065 TI - [Evaluation of the physical capacity of heart disease patients]. PMID- 3829066 TI - [Physiopathologic bases for adapting to muscular work in normal subjects and heart disease patients]. PMID- 3829067 TI - [Evaluation of physical capacity in normal subjects]. PMID- 3829068 TI - [Functional evaluation of hypertensive patients]. PMID- 3829069 TI - [Ergometric functional evaluation of chronic coronary disease patients]. PMID- 3829070 TI - [Ergometric evaluation of patients with a previous myocardial infarct]. PMID- 3829071 TI - [Functional evaluation of heart insufficiency]. PMID- 3829072 TI - [Physiopathology of the right ventricle]. PMID- 3829073 TI - [Role of 2-dimensional Doppler echocardiography in the morpho- functional evaluation of the right ventricle]. PMID- 3829074 TI - [Hemodynamic and angiographic evaluation of right ventricle function]. PMID- 3829076 TI - [Therapy of chronic congestive heart failure in elderly subjects]. PMID- 3829075 TI - [Radioisotopes]. PMID- 3829077 TI - [Rehabilitation of the elderly]. PMID- 3829078 TI - [Clinical aspects of the physiopathology of the ischemic event in clinical medicine]. PMID- 3829079 TI - [Mechanical effects in acute coronary ischemia and during intracoronary infusion of lidocaine in open-chest dogs]. PMID- 3829080 TI - [Systolic and diastolic left ventricular function studied using Doppler echocardiography]. PMID- 3829081 TI - [Role of Doppler echocardiography in the evaluation of mitral valve defects]. PMID- 3829082 TI - [Doppler echocardiography and aortic valve defects]. PMID- 3829083 TI - [2-dimensional and Doppler echocardiography in the study of tricuspid valve defects]. PMID- 3829084 TI - Thrombolysis and the heart. PMID- 3829085 TI - Urogenital chlamydial infections: an international perspective with a focus on doxycycline. Proceedings of a symposium. Paris, France, June 27, 1986. PMID- 3829086 TI - Chlamydia trachomatis infections in Japan. AB - Several studies were conducted to determine the incidence of Chlamydia trachomatis infections in various populations, including pregnant women, prostitutes, men with nongonococcal and gonococcal urethritis, women with nongonococcal and gonococcal cervicitis, and patients with the urethral syndrome. Levels of IgG and IgA were also determined. The efficacy of doxycycline in the treatment of chlamydial urethritis was evaluated in 106 patients. After two weeks of treatment, 98% of the infections were cured. Only one patient had to continue therapy for three weeks to eradicate the C trachomatis. PMID- 3829087 TI - Diagnosis of chlamydial infection in the female urogenital tract, and treatment with doxycycline. AB - Microbiologic diagnostic tests (comprising phase-contrast microscopy, fungal cultures, staining cytology, and immunofluorescence microscopy with monoclonal antibodies against Chlamydia trachomatis) were performed in 100 women with recurrent urogenital infections. The incidence and localization of Chlamydia trachomatis are reported. The therapeutic efficacy of systemic treatment with doxycycline in this group was evaluated. All of the 25 patients in whom treatment and treatment results could be supervised reported marked or complete relief of symptoms after ten days of treatment with 200 mg/day of doxycycline. All clinical findings were normal, and immunofluorescence microscopy showed that the microorganisms were eradicated in all patients. Doxycycline was well tolerated, with only two patients reporting mild abdominal pain, which did not require termination of treatment. PMID- 3829088 TI - Evaluation of doxycycline in the treatment of chlamydial salpingitis. AB - Acute salpingitis caused by Chlamydia trachomatis and other associated pathogens was diagnosed in 55 patients by means of laparoscopy and serological tests. All patients were treated with intravenous injections of doxycycline (200 mg/day) for four days followed by the same dosage orally for 20 days. Other antibiotics were given concomitantly for the associated infections. Treatment efficacy was evaluated on day 7 and day 30. Clinical symptoms had disappeared in 45 (82%) of the patients, and improvement was seen in another four (11%). Failure to improve in six cases was attributed to concurrent infection with microorganisms other than C trachomatis. After 30 days of treatment, two infections attributed to C trachomatis had not been cured with the doxycycline treatment; one of the patients was believed to have been reinfected and the other did not follow the prescribed treatment. The finding of clinical failure due to associated infection, sometimes discovered after two or three weeks of treatment, necessitates treatment of chlamydial salpingitis with multiple antibiotics, subsequent follow-up procedures (laparoscopic and serological), and appropriate changes in antibiotic therapy after C trachomatis has been eradicated but other pathogens remain. PMID- 3829089 TI - A retrospective study of doxycycline in the treatment of genitourinary infections. AB - A retrospective study was conducted to assess the prevalence of Chlamydia trachomatis, Ureaplasma ureolyticum, and Mycoplasma sp in patients with suspected genital infection, and to assess the efficacy of doxycycline and other current antibiotic therapies. Over a three-year period, 1,048 records of patients (64% female; 36% male) were reviewed. C trachomatis, U ureolyticum, or Mycoplasma hominis was found in 39% of the men and 49% of the women. Other pathogens included Gardnerella vaginalis (in 21%), Candida albicans (in 12%), Neisseria gonorrhoeae (in 4%), and Trichomonas vaginalis (in 1%). Doxycycline eradicated C trachomatis in 88% of patients, U ureolyticum in 87%, and M hominis in 95%. Eradication rates with erythromycin were 91%, 71%, and 100% and with tetracycline, 88%, 92%, and 80%, respectively. PMID- 3829090 TI - The prevalence of Chlamydia trachomatis in women with genitourinary symptoms. AB - Two studies were conducted to determine the prevalence of Chlamydia trachomatis in the urine and cervical exudates of women with genitourinary symptoms. In the first study, 873 women attending the World Health Organization-Sexually Transmitted Disease Center of the Alfred Fournier Institute, in Paris, were examined. In 7% of these women, culture results were positive for the presence of C trachomatis. Women with C trachomatis in the urethra had more polymorphonuclear cells in the urine than did those with C trachomatis in the cervix (P less than 0.001). The second study at the same center involved 180 women with vaginal or urethral signs and symptoms. Positive cultures for C trachomatis were found in 12% of the 140 women reporting vaginal problems and in 22% of the 40 women reporting urinary symptoms. Cell cultures from both the cervix and urethra were positive for C trachomatis in 1.4% of the women with vaginal signs and symptoms and in 2.5% of the women with urinary symptoms. These data support the value of urethral cultures for detecting C trachomatis in women with genitourinary symptoms. PMID- 3829091 TI - Comprehensive multidisciplinary assessment and management of osteoarthritis. Proceedings of a symposium. New York City, September 26, 1986. PMID- 3829093 TI - Overview of arthritis. PMID- 3829092 TI - Physical therapy in the multidisciplinary assessment and management of osteoarthritis. AB - As part of a multidisciplinary approach to the management of osteoarthritis, 77 patients with a mean age of 69 years were assessed by physical therapists. Goniometrics and strength evaluations of the shoulder, elbow, hip, and knee were performed at the initial and final assessment of this 12-week study. Biweekly gait evaluations consisted of timed free-speed walking over a 12-foot distance. Although the patients with osteoarthritis had joint pain with movement and limitations in joint range of motion and muscle strength, statistically significant improvements were obtained in a number of variables over the course of the study. The gait speed had a direct correlation with joint range of motion and muscle strength and an inverse correlation with pain. PMID- 3829094 TI - Occupational therapy in the multidisciplinary assessment and management of osteoarthritis. AB - As part of the multidisciplinary assessment of osteoarthritis, two occupational therapists evaluated the signs and symptoms of osteoarthritis in the hands of 77 patients. The patients were seen every two weeks for 12 weeks. Initially 58% considered themselves disabled; their mean disability score, on a scale of 0 to 3, was 1.7. Crepitus and pain of the joints and tendons occurred in 36% of the patients. Three hundred fifty-five cysts/nodules, primarily bony, were identified, the mean number being significantly greater (P less than 0.05) for women (8.8) than for men (5.3). Despite considerable disability due to osteoarthritis, none of these patients had ever consulted an occupational therapist. At the end of the study, the mean disability score was 1.2, significantly (P less than 0.05) lower than the initial score. Osteoarthritis of the hand was associated with considerable disability, more so in women than in men, and improvement was evident when an occupational therapist participated in the management of this disease. PMID- 3829095 TI - Nutrient intake and obesity in a multidisciplinary assessment of osteoarthritis. AB - The nutritional composition of diets and prevalence of obesity in 77 osteoarthritis patients were assessed biweekly for 12 weeks as part of a multidisciplinary approach to the management of osteoarthritis. Height was measured at the first visit, and weight was measured at each of the seven biweekly follow-up visits. A body mass index was calculated, based on height and weight, to determine obesity. Nutrient information was obtained by use of a 24 hour dietary recall and a food frequency questionnaire. Seventy-nine percent of the patients were obese. Obesity was positively related to pain from osteoarthritis and was more prevalent among these osteoarthritis patients than it is among the general geriatric population. Dietary intakes of vitamin D, folacin, vitamin B6, zinc, and pantothenic acid were below 80% of the recommended dietary allowance. Osteoarthritis patients may benefit from weight loss if they are obese and from eating more foods that supply the nutrients in which they are deficient. In addition to providing nutritional recommendations to avoid dietary deficiencies, a registered dietitian can assist in the multidisciplinary treatment of osteoarthritis by providing weight-control counseling and follow-up. PMID- 3829096 TI - Medical aspects of the multidisciplinary assessment and management of osteoarthritis. AB - Osteoarthritis, the most common form of arthritis, influences a person's mental well-being, ability to work or perform activities of daily living, and personal and family relationships. Ideally, the management of this disease is multidisciplinary, involving not only the use of medication but also exercise instruction, dietary counseling, and psychosocial interventions. The effects of such a comprehensive treatment program have not been well studied. A 12-week trial of multidisciplinary assessment and management of osteoarthritis was conducted. In addition to receiving the anti-inflammatory agent sulindac, patients were evaluated and followed up by health professionals in the disciplines of medicine, physical therapy, occupational therapy, nutrition, social work, and psychology. An initial assessment of the degree of pain, swelling, tenderness, stiffness, and ability to conduct activities of daily living was made, which represented patients' entry status. Subsequent assessments were made by the multidisciplinary team every two weeks for 12 weeks. Seventy seven patients completed at least ten of the 12 weeks. On entering the study, two thirds of the patients had pain, tenderness, or swelling affecting the hip, knee, or hand. At the end of 12 weeks, 80% of the patients had improvement in their osteoarthritis, and 71% improved in their ability to conduct activities of daily living. The results support the view that a comprehensive approach to osteoarthritis can significantly reduce disability and pain. PMID- 3829097 TI - Psychosocial aspects of the multidisciplinary assessment of osteoarthritis. AB - The social network, family functioning, and health-protective behaviors of 77 osteoarthritis patients treated for 12 weeks by a multidisciplinary team were assessed. Measures included assessments of social network using components of the OARS, family satisfaction using the APGAR, family cohesion and adaptability using the FACES II, alcohol abuse using the CAGE, and indicators of health-protective behaviors. Participants were generally socially active, socially integrated, and satisfied with family relationships. Reported health-protective behaviors were low, indicating the need for assistance in improving preventive health practices. Few of the patients appeared to be at risk for alcoholism. Improvements in pain and activities of daily living were not correlated with changes in social functioning. Social functioning appeared to be relatively stable and not altered by short-term improvements in osteoarthritis. Social workers can play an important role in facilitating individual and family adjustment to the limitations imposed by osteoarthritis and in the rehabilitation process for osteoarthritis patients. PMID- 3829098 TI - Psychological evaluation of well-being in the multidisciplinary assessment of osteoarthritis. AB - Relationships among psychological well-being, pain, and disability were investigated in 77 osteoarthritis patients who were followed up for 12 weeks by a multidisciplinary assessment and management team. The General Well-Being Schedule and six subscales were used to measure overall psychological well-being in this group of elderly patients (mean age, 69 years). Individuals with high levels of pain and disability at the initial and final visits had less psychological well being, less control over emotions and behaviors, more concern about their health, and more depressive symptoms. Patients who were more disabled reported lower energy levels and more anxiety. Overall, the subset of osteoarthritis patients aged 65 to 74 years was similar in psychological well-being to the same age group in the general population. PMID- 3829099 TI - The histochemical pattern of tetrahydrofolate dehydrogenase in the cerebellar postnatal histogenesis of the rat. PMID- 3829100 TI - Lectin binding pattern and morphometry in submandibular glands of mice treated with secretagogues. PMID- 3829101 TI - Effects of synaptic activity on the metabolism and release of purines in the rat superior cervical ganglion. AB - The release of radioactive metabolites from isolated rat superior cervical ganglia was measured under various conditions following preloading with 3H adenosine. The 3H label was recovered primarily in the adenosine metabolites, ATP, ADP, AMP, IMP, and inosine, rather than in adenosine itself. Increased release was evoked by preganglionic stimulation or by exposure to a high-K+ medium, whereas in a low-Ca2+-high-Mg2+ medium, both spontaneous release and evoked release of most metabolites were inhibited. Exposure of the ganglion to an atmosphere of N2 also increased the release of most labeled metabolites, but this release was not substantially affected by a low-Ca2+ medium. The fluorescent derivatives of the endogenous adenine-containing compounds present in the ganglion were prepared from homogenates and separated by high-performance liquid chromatography (HPLC). By the end of the testing period (6 hr), levels of ATP in the isolated ganglia had dropped to 10-20% of the initial values, while levels of ADP, AMP, and adenosine increased. There was little difference in these values between nonstimulated ganglia and those exposed to N2 or to a high-K+ medium. PMID- 3829102 TI - The effects of short-chain fatty acids on the neuronal membrane functions of Helix pomatia. III. 22Na efflux from the cells. AB - The effect of short-chain fatty acids on both ouabain-sensitive and ouabain insensitive fractions of 22Na efflux from the neurons of Helix pomatia was studied. Fatty acids, having fewer than 10 carbon atoms in the hydrocarbon chain, increased the ouabain-sensitive 22Na efflux from the neurons, while fatty acids, having more than 9 carbon atoms, inhibited the 22Na efflux in comparison with that in normal physiological solution. All the fatty acids used had an inhibiting effect on the ouabain-insensitive 22Na efflux from the cells independent on the number of carbon atoms in the hydrocarbon chain. These studies indicate that these short-chain fatty acids can be effective modulators of both ouabain sensitive and ouabain-insensitive fractions of Na efflux from the cells. PMID- 3829104 TI - [Processing indeterminate data in medicine]. PMID- 3829103 TI - Depression of neuron responses to acetylcholine by combined application of norepinephrine and substrates of the tricarboxylic acid cycle. AB - The possible relationship between the function of nicotinic acetylcholine receptors in Lymnaea stagnalis neurons and energy metabolism was studied. Oxidative phosphorylation was activated by treatment of neurons with substrates of the tricarboxylic acid cycle and norepinephrine. Transmembrane currents induced by acetylcholine in isolated neurons were measured by voltage clamp. Succinate dehydrogenase activity was determined histochemically in the same neurons. Cyclic adenosine monophosphate concentration in ganglia were assayed by the protein saturation method of Gilman (1970). When used alone, succinate depressed the responses of about 50% of neurons to acetylcholine. Norepinephrine did not affect the acetylcholine-induced currents but almost doubled the inhibitory action of succinate. The mixture of norepinephrine and isocitrate also diminished the responses to acetylcholine but to a lesser extent than norepinephrine with succinate. A short-term exposure of the ganglia to succinate with norepinephrine led to the activation of succinate dehydrogenase in neurons and a threefold increase in cyclic adenosine monophosphate concentrations in ganglia. When used alone, norepinephrine doubled the cyclic adenosine monophosphate concentration. The results obtained suggest energy-dependent regulation of acetylcholine receptors. PMID- 3829105 TI - [Prediction of serum digoxin levels]. PMID- 3829106 TI - [Left ventricular relaxation in hypertrophic cardiomyopathy and possibilities of controlling it with verapamil]. PMID- 3829107 TI - [Telephone transmission of the electrocardiogram: possibilities, indications, trends]. PMID- 3829108 TI - [Quantification of intracardiac shunting using radionuclide angiocardiography: correlation with the Fick method]. PMID- 3829109 TI - [Possibilities of combining 2-dimensional and Doppler echocardiography in the assessment of mitral and aortic regurgitation]. PMID- 3829110 TI - [Isolated congenital mitral valve cleft. An unusual cause of mitral valve regurgitation in adulthood]. PMID- 3829111 TI - Amino and carboxyl propeptides in bone collagen fibrils during embryogenesis. AB - Collagen fibrillogenesis was studied in tibiae of chick embryos, 9, 11, and 14 days old. Specimens were incubated with antibodies against the amino and the carboxyl propeptides of type-I collagen and subjected to ferritin-labelling immuno-electron microscopy. The amino propeptide was found in thin fibrils, 20-40 nm in diameter, distributed at 60-nm periodicity. The carboxyl propeptide antibody labelled a wide spectrum of fibrils, although the majority were in the range of 40-100 nm, distinctly larger than those labelled with the amino propeptide antibody. The presence of pN (amino propeptide plus collagen) and pC (carboxyl propeptide plus collagen) collagen was also demonstrated by Western blotting in all specimens. This study suggests that the sequence of propeptide removal may regulate collagen fibril diameter. PMID- 3829112 TI - Fine structural characteristics of neurophysin-positive perivascular plexus that develop in the rat hypothalamus following interruption of the hypothalamo neurohypophysial tract. AB - Transection of neurosecretory axons of the hypothalamo-neurohypophysial tract within the hypothalamus by stereotactic grafts of various tissues or knife cuts induced the development of neurophysin-positive plexus around arterioles, venules and capillaries in the vicinity of these grafts or cuts. These plexus ranged from single axons to densely woven networks and tended to increase progressively with time after experimental intervention. At the fine structural level, typical neurosecretory axon profiles were either abutting the perivascular connective tissue space or located within it. They were usually accompanied by astrocyte processes or microglial cells. Many of these axons had extensive contact with the surrounding basal lamina at which point clusters of microvesicles reminiscent of axon terminals in the neural lobe were present. PMID- 3829113 TI - The cytoskeleton of cryofixed Purkinje cells of the chicken cerebellum. AB - Cerebella of 3- to 6-week-old chickens were cryofixed in a nitrogen-cooled propane jet, deep-etched and rotary-shadowed. The use of a brief perfusion of 0.32 M sucrose improved the quality of the cryofixation and allowed the study of the deeper layers of the cerebellar cortex. It is reported that the cytoskeleton of the Purkinje cells (PC) shows distinct domains and composition of filamentous structures in the different regions of the cell cytoplasm, such as the perikaryon, the cytoplasm of dendrites and the axoplasm. The perikaryon is occupied by a meshwork of fine filaments, 4-7 nm in diameter, that extends from the nuclear outer membrane to the cell membrane. In this zone the cell organelles (e.g., endoplasmic reticulum, mitochondria) adopt a circular arrangement around the nucleus. All structures are anchored by microfilaments to the cytoplasmic network. The dendrites show a dense cytoplasmic network including bundles of microtubules, neurofilaments and microfilaments. Numerous aggregated globular components are attached to this cytoskeleton. The cytoskeleton of the dendritic spines shows axially oriented 10-nm bundles of filaments, which are interconnected and anchored also to the cell membrane and the components of the agranular endoplasmic reticulum by cross-linkers. As described in peripheral nerves, the axoplasm of axons in the central nervous system exhibits predominantly neurofilaments and microtubules aligned along the axis of the neurites in a three-dimensional arrangement and interconnected by cross-linker filaments and filamentous structures. PMID- 3829114 TI - Autonomic innervation of the arteriovenous anastomoses in the dog tongue. A histochemical and ultrastructural study. AB - The innervation of the arteriovenous anastomoses in the dog tongue has been investigated. At the light-microscopic level, the vessels were found to be densely supplied with adrenergic and AChE-positive nerve plexuses and less densely with the quinacrine-binding nerve plexus. At the electron-microscopic level, at least two apparently different types of axon profiles were identified: Small vesicle-containing axons, characterized by many small granular vesicles, variable numbers of small clear vesicles and large granular vesicles. Storage of endogenous amines and uptake of exogenous amines into most small granular vesicles and many large granular vesicles was demonstrated. These axons stained only lightly with reaction products for AChE activity and thus seemed to be adrenergic in nature. Some axons contained numerous large granular vesicles, whose cores occasionally stained with uranyl ions; this suggests a co localization of ATP or peptides as neurotransmitters. Small granular vesicle-free axons, containing small clear vesicles and large granular vesicles in variable ratio. Most cores of these large granular vesicles were heavily stained with uranyl ions. No storage or uptake of amine into the synaptic vesicles was detected. Some axons appeared to be typically cholinergic, some, typically non adrenergic, non-cholinergic, and the rest, intermediate between the two. All axons stained heavily with reaction products for AChE activity, suggesting their cholinergic nature. PMID- 3829115 TI - Application of automatic image analysis for morphometric studies of peroxisomes stained cytochemically for catalase. II. Light-microscopic application. AB - The feasibility of the application of a television-based image analyzer, the Texture Analysis System (TAS, Leitz Wetzlar, FRG) in conjunction with a light microscope for morphometric studies of hepatic peroxisomes has been investigated. Rat liver peroxisomes were stained with the alkaline-DAB method for localization of catalase and semithin (0.25 and 1 micron) sections of plastic-embedded material were examined under an oil immersion objective. The TAS detected the peroxisomal profiles selectively and determined their morphometric parameters automatically. The same parameters were obtained also by morphometric analysis of electron micrographs from the same material. The volume density of peroxisomes determined by TAS in semithin sections of normal liver, after correction for section thickness, is quite close to the corresponding value obtained by morphometry of electron micrographs. The difference is approximately 20%. In animals treated with the hypolipidemic drug bezafibrate, which causes proliferation of peroxisomes, TAS detected readily the increase in volume density of peroxisomes in semithin sections. In comparison with electron microscopy, however, the light-microscopic approach seems to underestimate the proliferation. The lower resolution of the light microscope and overlapping of neighbouring particles in relatively thick sections used for light-microscopic analysis may account for the differences. The present study has demonstrated the usefulness of automatic image analysis in conjunction with selective cytochemical staining of peroxisomes for morphometry of this organelle in rat liver. The light-microscopic approach is not only faster but is also extremely economical by obviating the use of an electron microscope. PMID- 3829116 TI - Segmental variations in the organization of the endoplasmic reticulum of the rat nephron. A stereomicroscopic study. AB - The spatial organization of endoplasmic reticulum (ER) was examined in all segments of rat nephron. Tissues were fixed with glutaraldehyde, impregnated "en bloc" with osmium tetroxide, prepared for and examined by standard (80-100 kV) and high voltage (1 mEV) transmission electron microscopy. In all proximal tubule cells, ER forms a continuous and extensive network of canaliculi and abundant fenestrated saccules which surround mitochondria and cytoplasmic bodies; the cage like structure of the fenestrated saccules was most evident around the spherical mitochondria of the S3 segment. In the cells of the distal straight and convoluted tubules, the network consists mostly of canaliculi with rare non fenestrated saccules. The ER network of canaliculi is particularly rich in intercalated cells, in contrast with its rudimentary appearance in the adjacent principal cells of the collecting tubule. In fact, in these cells there are few isolated ER cisternae and they are rarely impregnated. The nuclear envelope is well impregnated in most cells throughout the various segments. Segmental variations in ER organization and its relative abundance are most likely related to the well, established functional heterogeneity of the nephron segments. Moreover, the extensive and unique organization among mitochondria, ER and the basolateral membrane suggests that these three organelles function as a unit which is related to active electrolyte transport. In addition, because of its transepithelial organization, ER may well constitute a transcellular pathway for molecules. PMID- 3829117 TI - Differences in myocyte subpopulations from segments of the thoracic aorta and their modifications with age and hypertension in the rat. AB - Smooth muscle cells obtained from three distinct segments of the thoracic aorta of both Wistar Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR) taken at different stages of development were studied in terms of their volume, DNA content in single cell suspensions, and doubling time in primary cultures. The proliferative activity and mean cell volume of myocytes from WKY rats increase along the thoracic aorta in a gradient from the aortic arch to the diaphragm. The slope of this gradient is increased in SHR because of an extension of the area that contains myocytes with low proliferative activity in primary cell culture and large cell volumes in suspension. Tetraploid myocytes are found in both strains and their proportions are larger in SHR than in WKY, specifically after the onset of hypertension. However, they appear to be evenly distributed along the thoracic aorta with a size distribution that is included in that of the diploid cells from the same area. It is suggested that changes in the structural properties of the aortic-cell compartment, associated with maturation and hypertension, reflect quantitative changes in the relative proportions of several myocyte subpopulations within the aorta of the rat. PMID- 3829118 TI - Immunocytochemical study of the GABAergic innervation of the mouse pituitary by use of antibodies against gamma-aminobutyric acid (GABA). AB - The GABAergic innervation of the mouse pituitary, including the median eminence, was studied at light-microscopic and ultrastructural levels by use of a pre embedding immunocytochemical technique with antibodies directed against GABA. In the median eminence, a high density of GABA-immunoreactive fibers was found in the external layer where the GABAergic varicosities were frequently observed surrounding the blood vessels of the primary capillary plexus. In the internal and subependymal layers, only few fibers were immunoreactive. The intense labeling of the external layer was observed in the entire rostro-caudal extent of the median eminence. In the pituitary proper, a dense network of GABA immunoreactive fibers was revealed throughout the neural and intermediate lobes, entering via the hypophyseal stalk. The anterior and tuberal lobes were devoid of any immunoreactivity. The GABA-immunoreactive terminals were characterized in the median eminence, and in the intermediate and posterior lobes at the electron microscopic level. They contained small clear vesicles, occasionally associated with dense-core vesicles or neurosecretory granules. In the intermediate lobe they were seen to be in contact with the glandular cells. In the posterior lobe and in the median eminence, GABA-immunoreactive terminals were frequently located in the vicinity of blood vessels. These results further support the concept of a role of GABA in the regulation of hypophyseal functions, via the portal blood for the anterior lobe, directly on the cells in the intermediate lobe, and via axo axonic mechanisms in the median eminence and posterior lobe. PMID- 3829119 TI - Embryonic somatic nerve destruction with beta-bungarotoxin. AB - The effects and time course of a single injection of beta-bungarotoxin into E14 rat embryos were examined with an electron-microscopic study of development of the internal intercostal somatic nerve. Within 24 h of injection, axons in this nerve became swollen and fused at points along their length. By 48 h after injection no component of the nerve remained in distal segments of ribcage; complete loss of axons and components of the nerve sheath from proximal regions took slightly longer. At later times, no trace of peripheral nerve axons, Schwann cells or elements of the nerve sheath remained. beta-Bungarotoxin applied on E17 destroyed developing axons in a similar manner, but the perineurium remained in place, and axons regenerated within the original nerve trunk. The study confirms that sensory and motor neurons are much less able to survive axon degeneration on E14 than after the major period of normal cell death (which is nearly over by E18), and that the maintenance and continued development of the perineurium during E14-E16 depends on the presence of peripheral nerve axons. PMID- 3829120 TI - Analysis and in situ detection of cholecalcin messenger RNA (9000 Mr CaBP) in the uterus of the pregnant rat. AB - The molecular cloning of a cDNA fragment synthesised from rat duodenal mRNA coding for cholecalcin (calbindin), a 9000 Mr vitamin D-induced calcium-binding protein (CaBP), has been previously described. DNA/RNA hybridisation assays have been used to examine CaBP mRNA production in the uterine horns and duodena of pregnant (21 day) rats using the cloned CaBP cDNA. Northern hybridisation studies showed that the 32P cDNA sequence hybridised to a single 500-600 nucleotide species in both the uterus and the duodenum, thus demonstrating identical CaBP mRNA processing in both tissues. Dot blot hybridisation studies showed that the CaBP mRNA concentration was greatest in the duodenum while that of the uterine horns was about 10% of the duodenal level. The observed differences in CaBP mRNA levels correlate well with the in vivo CaBP concentrations. In situ hybridisation histochemistry using 3H cDNA revealed that CaBP mRNA visualised by silver grains was found in all the parts of the endometrium and the myometrium. However, CaBP mRNA was more concentrated in the outer and inner muscular fibres and in the luminal cells of the endometrium than in the stroma cells. These results demonstrate that the CaBP gene is expressed in specific cells of the rat uterus. PMID- 3829121 TI - Primary cultures of the dog's tracheal epithelium: fine structure, fluid, and electrolyte transport. AB - Cells from the dog's tracheal mucosa formed confluent epithelial sheets in culture. Typical tight junctions separated the apical from the basolateral portion of the cell membrane. The apical portion of the cell contained numerous short microvilli and a pronounced glycocalyx. The basolateral portion of the plasma membrane was unspecialized except for extensive gap junctions between cells. Freeze-fracture showed that the cultured cells lacked the basolateral square (orthogonal) arrays of the original tissue, particles previously implicated in ion transport. Formation of domes indicated the presence of active fluid absorption. Domes appeared between days 4 and 8 of culture and persisted for about 1 week. Cell sheets showed a transepithelial resistance of approximately equal to 400 omega X cm2 and a short-circuit current (Isc) of approximately 5 microA X cm-2. The effects of transport inhibitors indicated that both active Na absorption and active Cl secretion were present. Isc was increased by isoproterenol, prostaglandins E2 and F2 alpha, vasoactive intestinal peptide, dibutyryl cyclic AMP, leukotrienes C4 and D4, and bradykinin. These changes were probably due to stimulation of active Cl secretion. PMID- 3829122 TI - Intracellular free calcium levels in mononuclear cells of patients with cystic fibrosis and normal controls. AB - The time course of resting free intracellular calcium concentrations in isolated mononuclear blood cells following a one hour incubation period with the fluorescent dye quin2 was evaluated. Under equal experimental conditions, a slow time-dependent increase of intracellular free calcium in patients with cystic fibrosis and normal healthy controls was noted. Using regression analysis, cystic fibrosis patients were seen to exhibit significantly higher free intracellular calcium concentrations than the controls over the time span covered. At an arbitrarily selected time (60 minutes) the free calcium level was 143.7 +/- 4.3 nM (SEM) in the patients, and 125.5 +/- 2.6 nM in controls. From these data it is concluded that neglecting the time-dependent (Ca2+)i changes following quin2 incubation leads to over- and/or underestimation of the unstimulated resting, basic free calcium levels and prevents the detection of differences between normals and cystic fibrosis patients. PMID- 3829123 TI - Agonist-induced oscillations in cytoplasmic free calcium concentration in single rat hepatocytes. AB - The effects of the alpha 1-adrenergic agonist phenylephrine and the peptide hormones angiotensin II and arg8-vasopressin on cytoplasmic free calcium concentration were investigated in single rat hepatocytes microinjected with the photoprotein aequorin. Hepatocytes responded to physiological concentrations of the glycogenolytic agonists with a series of repetitive Ca transients. In each transient free Ca rose in 2-3s to above 600 nM from a resting level of 200 nM. Transient duration depended on the agonist and ranged from approximately 7s for phenylephrine to approximately 15s for angiotensin. Transient frequency, but not shape or size, depended on agonist concentration. The period ranged from less than 20s to several minutes. We suggest that the frequency of the Ca transients is the principal determinant of the amplitude of the cellular response to calcium mobilizing agonists. PMID- 3829124 TI - The T=4 envelope of Sindbis virus is organized by interactions with a complementary T=3 capsid. AB - The three-dimensional structure of Sindbis virus, an enveloped animal virus, has been determined to a resolution of 35 A by using a common lines procedure to combine cryoelectron micrographs of vitrified particles. The spikes of the virus appear as columnar trimers arranged on a T=4 lattice. The lipid bilayer of the virus envelope is polyhedral and surrounds a smooth T=3 nucleocapsid. Hence, a complete Sindbis virion (molecular weight 46.4 X 10(6)) contains 240 copies of each of the spike proteins and 180 copies of the capsid protein. The arrangement of the spike proteins is complementary to that of the nucleocapsid. Two types of spike-capsid interactions are seen. Spike trimers near the fivefold axes interact tightly with triplets of capsid elements, whereas those on the threefold axes interact more loosely. PMID- 3829125 TI - Members of a nicotinic acetylcholine receptor gene family are expressed in different regions of the mammalian central nervous system. AB - Nicotinic acetylcholine receptors found in the peripheral and central nervous system differ from those found at the neuromuscular junction. Recently we isolated a cDNA clone encoding the alpha subunit of a neuronal acetylcholine receptor expressed in both the peripheral and central nervous system. In this paper we report the isolation of a cDNA encoding the alpha subunit of a second acetylcholine receptor expressed in the central nervous system. Thus it is clear that there is a family of genes coding for proteins with sequence and structural homology to the alpha subunit of the muscle nicotinic acetylcholine receptor. Members of this gene family are expressed in different regions of the central nervous system and, presumably, code for subtypes of the nicotinic acetylcholine receptor. PMID- 3829126 TI - Developmental pattern of mouse skeletal myosin heavy chain gene transcripts in vivo and in vitro. AB - We have studied the transcripts of the embryonic, perinatal, and adult fast myosin heavy chain (MHC) genes in mouse skeletal muscle in vivo before and after birth, and in vitro in myogenic cell lines. In vivo, in 15-day fetal muscle, embryonic and perinatal MHC mRNAs are both present, and the former is the major transcript. By 18 days the perinatal is predominant and the adult MHC mRNA appears. In beta-bungarotoxin-treated fetuses, a similar developmental pattern is detected, suggesting that it is nerve-independent and that primary myotubes alone undergo the same developmental changes. In vitro, in the absence of the nerve, embryonic, perinatal, and adult IIB MHC mRNAs accumulate. The level of the latter two isomRNAs is influenced by culture conditions. PMID- 3829127 TI - Colocalization of DNA-binding and transcriptional activation functions in the human glucocorticoid receptor. AB - Using a combination of a transient expression assay and in vitro mutagenesis, we showed previously that the human glucocorticoid receptor (hGR) is composed of a series of discrete functional domains. Here we report the effects of selective deletion of each of these domains on hGR ability to activate transcription of the MTV-CAT fusion gene. Deletion of the immunogenic domain or the entire amino terminal half of the protein reduces but does not abolish the ability of the hGR to induce transcriptional activation. Somewhat surprisingly, deletion of the steroid-binding domain engenders a constitutively active receptor, revealing that this domain normally represses receptor function. However, the central, cysteine rich region contains all the information required for both DNA binding and trans activation. Taken together, these data delineate a core domain in the hGR spanning 88 amino acids that determines both DNA-binding and transcriptional activation functions. This physical linkage distinguishes the glucocorticoid receptor from other described eukaryotic regulatory proteins, where these two functions have been shown to be separable. PMID- 3829128 TI - Distinct patterns of expression of different protein kinase C mRNAs in rat tissues. AB - The identification of multiple protein kinase C (PKC) cDNA sequences from rat, bovine, and human tissues has led to the discovery of a family of PKC genes. Using probes complementary to three cDNA sequences from rat brain, designated PKC I, -II, and -III, the distribution of PKC transcripts in rat tissues was studied by in situ hybridization histochemistry. In brain, PKC-II and PKC-III transcripts colocalized except in the brain stem and spinal cord, where some cells appeared to contain only PKC-III message. PKC-I mRNA had a different, but partially overlapping, pattern of expression. In spleen, PKC-II and PKC-III, but not PKC-I, transcripts were concentrated in the marginal zone of white pulp, the major B lymphocyte compartment of rat spleen. The distinct distributions of rat PKC mRNAs suggest that different members of the PKC family have specialized functions. PMID- 3829129 TI - Junctional permeability in heart muscle is independent upon the non-junctional membrane potential. AB - The influence of high K solution on the longitudinal movement of Lucifer Yellow CH along dog atrial trabeculae was investigated. It was found that in normal heart muscle the dye diffused from cell-to-cell and the average diffusion coefficient (D) was 4.3 +/- 1.3 X 10(-7) cm2/s. In muscles exposed to 20, 40 or 60 mM K solution the resting potential was reduced from -78 mV (S.E. +/- 0.71) (control) to -41 mV (S.E. +/- 0.95), -30 mV (S.E. +/- 0.64) and -22.5 mV (S.E. +/ 0.64), respectively. Despite the maintained depolarization the cell-to-cell diffusion of Lucifer Yellow CH did not change. These findings indicate that the junctional permeability in heart muscle is not influenced by the non-junctional membrane potential. PMID- 3829130 TI - A fluorescent dye which recognizes mature peripheral erythrocytes of myeloproliferative disorders. AB - Based on the previous finding that erythrocytes from patients with chronic myelogenous leukemia stain with the fluorescent dye merocyanine 540, erythrocytes from patients with other myeloproliferative disorders were examined for their ability to bind the membrane probe. As assessed by both fluorescence staining and a quantitative dye removal assay, all samples of erythrocytes from patients with chronic myelogenous leukemia, polycythemia vera, myelofibrosis with myeloid metaplasia and essential thrombocythemia bound more dye than did erythrocytes from normal, healthy individuals. Erythrocytes from three of six patients with acute myelogenous leukemia also showed increased affinity for the dye. In contrast, erythrocytes from three patients with acute lymphocytic leukemia and one with unclassifiable leukemia bound only normal amounts of dye. The procedures described may be useful as a supplemental aid to diagnosis of myeloproliferative disorders or for investigation of hematological diseases where multilineage involvement is suspected. PMID- 3829131 TI - Malignant epithelial cell strains cultured from BALB/c mouse lung adenoma. AB - Urethane-induced lung adenomas from adult BALB/c mice were explanted onto a plastic substratum and cultured in order to establish the epithelial cell strain NUL1. The cell strain exhibited a polygonal morphology with high nuclear to cytoplasmic ratio and osmiophilic lamellar bodies characteristic of lung adenoma cells. A reproducible large and small cell heterogeneity was preserved despite multiple cell cloning. NUL1 was malignant at all passage numbers tested exhibiting anchorage-independent growth and subcutaneous formation of carcinomas in immune-suppressed mice. The cell strain was diploid at low passage numbers and became pseudo-diploid with increasing passages. PMID- 3829132 TI - Multiple transfer of lysosomal enzymes from normal lymphocytes to I-cell disease fibroblasts. AB - Cells from patients with inherited lysosomal deficiency diseases can acquire the missing lysosomal enzyme by direct cell-to-cell transfer from normal lymphocytes. Cells from I-Cell Disease (Mucolipidosis type II; ICD) patients are simultaneously deficient in many lysosomal enzymes due to an inborn error of glycoprotein processing. In this study we show that such cells acquire high levels of several of the missing lysosomal enzymes when they are cultured in contact with lymphocytes. Moreover, the present results also show that enzyme levels in the donor lymphocytes are not depleted but increase during cell contact with the fibroblasts. PMID- 3829133 TI - Transition vesicles of the cis Golgi apparatus face of rat liver are increased by retinol. AB - Golgi apparatus of livers of rats receiving 60 mg/100 g body weight all-trans retinol (vitamin A) in olive oil responded by a reproducible and significant increase both in the number of cisternae per Golgi apparatus stack and in the number of transition vesicles of the cis Golgi apparatus face compared to rats receiving olive oil alone as determined by quantitation from electron micrographs. These vesicles were identified by a simple, non-clathrin coat, a uniform diameter of about 60 nm and a location primarily in association with cis Golgi apparatus elements. They were distinct from clathrin-coated vesicles of the trans Golgi apparatus face which was unaffected by vitamin A treatment. Transition vesicles may be involved in the transfer of membrane materials to the Golgi apparatus from endoplasmic reticulum. PMID- 3829134 TI - In-vitro evaluation of antifungal agents in the treatment of yeast peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). AB - This study compared the static and kinetic activities of six antifungal agents, in broth and used dialysate, against six yeast strains known to have caused peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD). Minimum inhibitory concentrations (MIC) and IC50 results show a trend towards greater activity by amphotericin B, 5-fluorocytosine, tioconazole and itraconazole in comparison to miconazole and ketoconazole although there was some strain variability. Minimum fungicidal concentrations (MFCs) of amphotericin B were less than or equal to 1mg/l, while 5-fluorocytosine and the azoles showed large discrepancies between MIC and MFC values. In kinetic studies amphotericin B was the most potent fungicidal agent. 5-fluorocytosine showed modest activity and failed to achieve total killing. The azoles demonstrated variable degrees of inhibition of C. glabrata and showed minimal activity with C. albicans. Itraconazole showed good activity against C. parapsilosis in broth. All agents, with the exception of 5-fluorocytosine, showed reduced activity in used dialysate in comparison to broth. PMID- 3829135 TI - Pharmacokinetics of cefotaxime after a single intravenous dose in patients with impaired renal function. AB - Twelve male patients with impaired renal function and six healthy male volunteers were given a single i.v. dose of cefotaxime (1000 mg). Serum concentrations of cefotaxime were determined by a microbiological assay. The pharmacokinetic parameters were obtained using an open two-compartment model. Results showed that the median elimination t1/2 of cefotaxime was prolonged in patients (3.25 h) compared to volunteers (1.4 h) (P less than 0.001). The median AUC0----infinity was increased in patients (211.99 micrograms/ml X h) compared with volunteers (78.21 micrograms/ml X h) (P less than 0.001). Also, the median clearance was decreased in patients (4.73 l/h) compared with volunteers (12.82 l/h) (P less than 0.001). This study shows prolonged half-life and decreased elimination of cefotaxime in patients with impaired renal function. PMID- 3829136 TI - In vitro activity of macrolides on human phagocytic functions. AB - The aim of this study was to examine the in vitro activity of erythromycin, josamycin, flurithromycin, miocamycin and roxithromycin on some leukocyte functional parameters. All tested macrolides did not interfere with the frequency and index of phagocytosis, nitroblue tetrazolium reduction to formazan deposits and candidacidal activity of human polymorphonuclear leukocytes (p greater than 0.05). Among macrolide antibiotics, only flurithromycin significantly inhibited neutrophil chemotaxis at a high concentration (greater than or equal to 50 micrograms/ml). All macrolides, at 10 and 50 micrograms/ml, reduced the survival of a susceptible strain of Staphylococcus aureus ingested by human monocytes. PMID- 3829137 TI - Metastatic malignant melanoma treated with procarbazine, vincristine and lomustine (POC). AB - Fourteen consecutive melanoma patients with evaluable metastatic disease were treated with combination chemotherapy including procarbazine, vincristine and lomustine (POC). All but two patients had been previously treated with single agent chemotherapy (dacarbazine 11 patients, melphalan plus hyperthermia 1 patient). One transient partial response and 4 stable disease were noted. Median overall survival was 5 months. In our experience POC seems unlikely to improve the response rate compared with other chemotherapy combinations. Patient characteristics can partially explain the contrasting results reported in the literature. PMID- 3829138 TI - Metastatic breast cancer: an analysis of prognostic factors in patients treated with aminoglutethimide. AB - An analysis of 127 women with metastatic breast cancer was carried out. All patients were treated with aminoglutethimide: of 117 evaluable patients, 29 responded, 46 remained stable and 42 progressed. A series of patients' characteristics were analyzed for their prognostic importance for response to this drug. The most important features able to predict response were found to be a previous response to tamoxifen and a long disease-free survival after mastectomy. PMID- 3829139 TI - Functional relationship between initial oxidation of 7-ethoxycoumarin and subsequent conjugation of 7-hydroxycoumarin in isolated perfused rat livers. AB - Functional relationship between the initial mixed function oxidation of 7 ethoxycoumarin (EC) to 7-hydroxycoumarin (HC) and the subsequent conjugation of this metabolite to sulfate ester and glucuronide has been studied using isolated perfused rat livers. When increasing concentrations of EC (from 25 to 200 microM) were infused, perfused liver can oxidize only up to about 60 nmol of the infused EC to HC per min/g liver tissue. Most of this HC metabolite was released as sulfate ester, but there was a dose dependent shift to a more significant glucuronidation at the expense of the sulfate form. The dose dependent shift observed upon infusions with increasing dose of EC was not extensive so that the major portion of metabolite released was always the sulfate ester. However, the shift observed with HC was extensive and the major portion released was the glucuronide conjugate. Upon infusions with increasing concentrations of HC, the maximal rates of sulfation and glucuronidation were found to be 60 nmol and 120 nmol of HC conjugated per min/g liver tissue, respectively. Furthermore, the ranges in the rates of conjugation for the infused HC were divided into a sulfate ester 'zone' (less than 20 nmol), a dose-dependent shift 'zone' (between 20 and 180 nmol) with the 'cross-over' occurring at 80 nmol/min/g liver, and reaching the maximal conjugation 'capacity' rate (180 nmol), above which the unconjugated free form of HC was released. Under conditions when EC was infused into normal rat livers, the calculated maximal oxidation rate was only 60 nmol of HC produced/min/g liver. Consequently, under such a condition, the oxidation rate may never reach the 'cross-over' rate and this explains the lack of extensive dose-dependent shift and further indicates that there remained a large reserve conjugation capacity (120 nmol/min/g). PMID- 3829140 TI - Evidence for the reversible binding of paraquat to deoxyribonucleic acid. AB - Evidence for the reversible binding of paraquat to calf thymus DNA has been obtained using equilibrium dialysis and thermal melting point determinations. The data indicated the presence of at least two populations of binding site with affinity constants of 6.2 X 10(4) and 7.1 X 10(3) M-1, respectively. The binding capacities of DNA for paraquat were 66 and 480 nmol/mumol DNA nucleotide, respectively, and were equivalent to one ligand bound per 2 DNA phosphate groups. Putrescine inhibited paraquat binding to the low affinity sites without altering binding to the high affinity sites. Scatchard plots of paraquat binding characteristics indicated the presence of positive cooperativity between the compound and DNA. Thermal melting curves of DNA in the presence of paraquat and the endogenous amines putrescine, spermidine and spermine, provided evidence that paraquat cross-linked to DNA with a similar affinity as spermidine. The thermal melting point data also suggested the presence of positive cooperativity between ligand and macromolecule that possibly resulted from a conformation change in the structure of the DNA molecule. Paraquat competitively inhibited the binding of ethidium bromide to DNA and this effect was reversed by Na+. From the data, it is suggested that paraquat binds primarily to the negatively charged phosphates on the DNA backbone but is displaced into the interbase region occupied by the intercalator ethidium bromide. DNA binding of paraquat may, in part, account for its weak mutagenic activity. PMID- 3829141 TI - Effects of spirogermanium on the in vitro assembly and disassembly of brain microtubules. AB - The inhibition of microtubule proteins (MTP) assembly by Spirogermanium (SP, 1.25 100 microM) has been studied. Assembly at 37 degrees C was monitored by turbidity measurements and electron microscopy. For SP in 1:1 protein-drug ratio the inhibition of assembly was 50%. Addition of 12.5 microM SP to microtubules induced spontaneous disassembly. SP had less effect on the assembly of pure tubulin (tubulin 6S). Complete inhibition of assembly induced by glycerol and Mg2+ was found with 250 microM and the ratio of SP to tubulin to obtain 50% inhibition was higher than with MTP. PMID- 3829143 TI - Possible relevance of the stability of the glycosyl bond of undesired nucleosides in DNA to the mechanism of their repair. PMID- 3829142 TI - The isolation and characterization of 2-carboxyethyl adducts following in vitro reaction of acrylic acid with calf thymus DNA and bioassay of acrylic acid in female Hsd:(ICR)Br mice. AB - Reaction of acrylic acid (AA) at pH 7.0 and 37 degrees C for 40 days with 2' deoxyadenosine (dAdo), 2'-deoxycytidine (dCyd), 2'-deoxyguanosine (dGuo) and thymidine (dThd) resulted in the formation of 2-carboxyethyl (CE) adducts via Michael addition. The alkylated 2'-deoxynucleoside adducts isolated (percent yield after 40 days) were 1-CE-dAdo (5%), N6-CE-dAdo (11%) (via Dimroth rearrangement of 1-CE-dAdo), 3-CE-dCyd (7.5%), 7-CE-Gua (4%), 7,9-bis-CE-Gua (0.9%) (formed by reaction of AA with depurinated 7-CE-Gua during the course of the reaction) and 3-CE-dThd (0.5%). The products isolated following in vitro reaction of AA with calf thymus DNA at pH 7.0 and 37 degrees C for 40 days were (nmol/mg DNA) 1-CE-Ade (9.9), N6-CE-Ade (8.2), 7-CE-Gua (7.2) and 3-CE-Thy (1.9). Compound 3-CE-Cyt was not detected. Thus the adducts formed following in vitro reaction of AA with DNA are identical to those formed by in vitro reaction of the carcinogen beta-propiolactone (BPL) with DNA as reported in an earlier paper. Structures were assigned on the basis of identical UV spectra, Rf values on paper chromatograms and Rt values on HPLC as marker compounds prepared from reactions of BPL with 2'-deoxynucleosides and 2'-deoxynucleotides-5'-monophosphoric acids. AA was assayed for carcinogenic activity by s.c. injection (20 mumol, once a week for 52 weeks) in female Hsd: (ICR)Br mice. Two mice with sarcomas at the site of application were observed out of 30 mice. Malignancies were not observed in solvent and no-treatment controls. The bioassay results reported in this paper and elsewhere in the same strain of mice suggest that AA is a weak carcinogen in female Hsd:(ICR)Br mice. PMID- 3829144 TI - Anomalous temperature dependence of the phosphorus-31 nuclear magnetic resonance chemical shift in d(CCGG) and d(CCTAGG) at the junction of the pyrimidine stack followed by the purine stack. PMID- 3829145 TI - Synthesis and physicochemical properties of cyclic peptides. PMID- 3829146 TI - Synthesis of renierone, 7-methoxy-1,6-dimethyl-5,8-dihydroisoquinoline-5,8-dione and N-formyl-1,2-dihydrorenierone, antimicrobial metabolites from a marine sponge, Reniera sp. PMID- 3829147 TI - Tannins and related compounds. XLVIII. Rhubarb. (7). Isolation and characterization of new dimeric and trimeric procyanidins. PMID- 3829148 TI - Studies on chemical carcinogens and mutagens. XL. Chemoselectivity of acylating agents toward aniline in aqueous medium. PMID- 3829149 TI - Synthesis and hypoglycemic activity of 7,8-dihydro-6H-thiopyrano[3,2-d]pyrimidine derivatives and related compounds. PMID- 3829150 TI - The X-ray analysis of caesalpin J from sappan lignum. PMID- 3829151 TI - A comparison of chromogenic substrates for horseradish peroxidase as a label in steroid enzyme immunoassay. PMID- 3829152 TI - Studies on protection by glutathione against lipid peroxidation in rat liver microsomes. Effect of bromosulfophthalein. PMID- 3829153 TI - Interaction of several drugs with Tyr 411 anthraniloyl human serum albumin. PMID- 3829154 TI - Effect of alkyl chain length of benzalkonium chloride on the bactericidal activity and binding to organic materials. PMID- 3829155 TI - Effect of extract from rhei rhizoma on dietary hyperazotemia in rats. PMID- 3829156 TI - Effects of dose and vesicle size on the pharmacokinetics of liposomes. PMID- 3829157 TI - Feasibility of magnetic liposomes as a targeting device for drugs. PMID- 3829158 TI - Intestinal absorption of a beta-adrenergic blocking agent nadolol. III. Nuclear magnetic resonance spectroscopic study on nadolol-sodium cholate micellar complex and intestinal absorption of nadolol derivatives in rats. PMID- 3829159 TI - Inhibitory effect of melinamide on cholesterol solubility in mixed micellar solution of sodium taurocholate. PMID- 3829160 TI - Stability of pilocarpine ophthalmic formulations. PMID- 3829162 TI - Action of methylcellulose on disintegration and dissolution properties of tablets. PMID- 3829161 TI - Effects of sodium metallochlorophyllins on the activity and components of the microsomal drug-metabolizing enzyme system in rat liver. PMID- 3829163 TI - Erythrocyte membrane penetration of basic drugs and relationship between drug penetration and hemolysis. PMID- 3829164 TI - Flocculation kinetics of the didisperse system-computer simulation of flocculation by the random coalescence model. PMID- 3829165 TI - Some physicochemical properties of glassy indomethacin. PMID- 3829166 TI - Measurement of K vitamins in human and animal feces by high-performance liquid chromatography with fluorometric detection. PMID- 3829167 TI - Energization of mitochondrial inner membranes by L-malate under anaerobic condition is driven by energy derived at side I of phosphorylation. PMID- 3829169 TI - Effect of activation or blockade of the phagocytic system on the antitumor activity of grifolan. PMID- 3829168 TI - Triiodothyronine rapidly stimulates mitochondrial respiration in isolated hepatocytes. PMID- 3829170 TI - Adsorption and prevention of gastrointestinal absorption of nalidixic acid by activated carbon beads. PMID- 3829172 TI - Particle size distribution affects the human bioavailability of phenytoin. PMID- 3829171 TI - Comparative study of interactions between 4-biphenylacetic acid and sulfamethizole, and between fenbufen and sulfamethizole in rats. PMID- 3829173 TI - Synthetic studies of vitamin D3 analogues. VIII. Synthesis of 22-oxavitamin D3 analogues. PMID- 3829174 TI - The active principle of alismatis rhizoma which inhibits contractile responses in aorta. PMID- 3829175 TI - Yadanzioside P, a new antileukemic quassinoid glycoside from Brucea javanica (L.) Merr with the 3-O-(beta-D-glucopyranosyl)bruceantin structure. PMID- 3829176 TI - Influence of temperature and ionization on self-association of theophylline in aqueous solution. Studies by proton nuclear magnetic resonance spectroscopy. PMID- 3829177 TI - Quantum-chemical elucidation of the mechanism of the NIH-shift during aryl hydroxylation catalyzed by cytochrome P-450. PMID- 3829178 TI - Studies on the constituents of Asclepiadaceae plants. LXVI. The structures of three new glycosides, cynapanosides A, B, and C, from the Chinese drug "xu-chang qing," Cynanchum paniculatum Kitagawa. PMID- 3829179 TI - Synthesis of some side-chain homologues of 1 alpha,25-dihydroxyvitamin D3 and investigation of their biological activities. PMID- 3829180 TI - Studies on the metabolites of Penicillium diversum var. aureum. II. Synthesis and cytotoxic activity of trihydroxytetralones. PMID- 3829181 TI - Azinomycins A and B, new antitumor antibiotics. II. Chemical structures. PMID- 3829182 TI - Fatty acids and sterols of the tunicate, Salpa thompsoni, from the Antarctic Ocean: chemical composition and hemolytic activity. PMID- 3829183 TI - Synthesis of 4-demethoxyanthracyclines carrying a lipophilic alkanoyl group at the C9-position. PMID- 3829184 TI - Synthesis of novel 13-methyl-13-dihydroanthracyclines. PMID- 3829185 TI - High-performance liquid chromatographic assay for catechol-O-methyltransferase in human and rat erythrocyte membrane and soluble fractions, and rat tissues. PMID- 3829186 TI - Evidence for the presence of two kininogens in porcine plasma and the isolation of high-molecular-weight kininogen. PMID- 3829187 TI - Peroxisomal enzyme activities in the liver of overtly diabetic non-obese diabetic mouse. PMID- 3829188 TI - Effect of extracts obtained from rhubarb in rats with chronic renal failure. PMID- 3829189 TI - Inhibition of rat liver glucokinase by alloxan and ninhydrin. PMID- 3829190 TI - Suitable size of preparations to evaluate the bioavailability of enteric-coated preparations by the use of gastric-acidity-controlled rabbits. PMID- 3829191 TI - Effect of environmental temperature on cytochrome P-450 and the associated electron transfer system: proposal for the appropriate dosage regimen corresponding to seasonal change. PMID- 3829192 TI - Interactions between crystalline medicinals and porous clay. PMID- 3829193 TI - Studies on peptides. CXLV. Synthesis of a 27-residue peptide amide corresponding to the entire amino acid sequence of canine gastrin-releasing polypeptide (cGRP). PMID- 3829194 TI - Studies on peptides. CXLVI. Synthesis of Gln15-motilin and examination of its immunological properties. PMID- 3829195 TI - Studies on 2(1H)-quinolinone derivatives as gastric antiulcer active agents. Synthesis and antiulcer activity of the metabolites of 2-(4-chlorobenzoylamino)-3 [2(1H)-quinolinon-4-yl]propionic acid. PMID- 3829196 TI - Isolation of an anti-histaminic substance from green-lipped mussel (Perna canaliculus). PMID- 3829197 TI - Studies on the constituents of Vitex rotundifolia L. fil. PMID- 3829198 TI - Saponins from Panax pseudo-ginseng Wall. subsp. pseudo-ginseng Hara collected at Nielamu, Tibet, China. PMID- 3829199 TI - Effect of high-molecular-weight hyaluronic acid on the viscosity of rabbit pericardial fluid measured with a cone and plate viscometer. PMID- 3829200 TI - Release of bases from deoxyribonucleic acid by ascorbic acid in the presence of Cu2+. PMID- 3829201 TI - Inhibitors of aminopeptidase B suppress the development of hypertension in spontaneously hypertensive rats. PMID- 3829202 TI - Polymorphism of methyl (E)-3-phenyl-2-propen-1-yl 1,4-dihydro-2,6-dimethyl-4-(3 nitrophenyl)pyridine-3,5-dicarboxylate (FRC-8411). PMID- 3829203 TI - Suppression of phorbol myristate acetate-induced pleurisy by CV-3988, an antagonist of platelet-activating factor. PMID- 3829204 TI - Glycolipids. PMID- 3829206 TI - Animal and cellular models of sphingolipid storage disorders of humans. AB - The synthesis of L-galactosylceramide is described. Data are presented indicating that this enantiomorph of D-galactocerebroside is not cleaved by galactocerebroside-beta-galactosidase obtained from mammalian tissues. The synthesis of L-glucosylceramide and beta-D-glucothiocerebroside are outlined. These compounds are also refractory to catabolism by glycosidases in mammalian tissues that catalyze the hydrolysis of naturally occurring cerebrosides. L Hexosyl- and thioanalogs of cerebrosides and perhaps psychosines as well may be helpful for investigating the pathogenesis of Krabbe's disease and Gaucher's disease. PMID- 3829205 TI - Isolation and characterization of poly-N-acetyllactosaminylceramides accumulated in the erythrocytes of congenital dyserythropoietic anemia type II patients. AB - Congenital dyserythropoietic anemia type II or hereditary erythroblastic polynuclearity with positive acidified serum test (HEMPAS) is a rare genetic disease inherited by a recessive mode. Previous studies on HEMPAS erythrocytes have shown that Band 3 and Band 4.5 glycoproteins were not glycosylated by lactosaminoglycans, while polylactosaminyl carbohydrates are accumulated as glycolipids (P. Scartezzini et al., Br J. Haematol., 51 (1982) 569; M.N. Fukuda et al., Br. J. Haematol., 56 (1984)55). Presently, we have isolated polylactosaminyl lipids from HEMPAS blood cells and analyzed their structures by fast atom bombardment-mass spectrometry (FAB-MS), methylation analysis, endo-beta galactosidase digestion. The results indicate that polylactosaminyl lipids accumulated in HEMPAS erythrocytes are a species of poly-N acetyllactosaminylceramides which are also present in normal erythrocytes, but at 7 approximately 9 times lower level. Isolated polylactosaminylceramides exhibit I , i-, H- and Lex antigenic activities which suggest that the polylactosaminylceramides are derived from both erythrocytes and granulocytes. PMID- 3829207 TI - Phase behavior of synthetic N-acylethanolamine phospholipids. AB - Both saturated and unsaturated N-acylethanolamine phospholipids form lamellar structures when dispersed in buffer. The addition of excess Ca2+ (Ca2+/N acylphosphatidylethanolamine greater than 0.5) results in precipitation. Freeze fracture replicas indicate that the addition of Ca2+ to the unsaturated lipid results in a non-bilayer structure while the Ca2+-complex of the saturated lipid is lamellar. Since unsaturated phosphatidylethanolamine (PE) is a non-bilayer lipid, its N-acylation with a saturated fatty acid converts a non-bilayer lipid into an acidic bilayer lipid capable of interacting with Ca2+ to return to a non bilayer structure. Ca2+ may thereby exert an influence on membrane phenomena by regulating phase behavior within certain membrane domains. Differential scanning calorimetry (DSC) indicates that N-acylation of unsaturated PE with a saturated fatty acid also results in changes in thermotropic phase behavior. Therefore, N acylation may affect fluidity within certain membrane domains. PMID- 3829208 TI - Interaction of surfactants with vesicle membrane of dipalmitoylphosphatidylcholine. Effect on gel-to-liquid-crystalline phase transition of lipid bilayer. AB - The gel-to-liquid-crystalline phase transition of dipalmitoylphosphatidylcholine (DPPC) vesicle membrane was observed in the presence of various types of surfactants; sodium alkylsulfates, alkyltrimethylammonium bromides, alkanoyl-N methylglucamides, and hexaethyleneglycol mono n-dodecyl ether. The phase transition was monitored by a change in scattered light intensity of the lipid suspension. For all the surfactants examined, the phase transition temperature was depressed linearly with the surfactant concentration in the measured concentration range, from which the partition coefficient, K, of the surfactant between bulk solution and lipid membrane was estimated. Except alkyltrimethylammonium bromides, log K and log CMC showed a linear relationship, which indicates that the driving force to transfer the surfactant from bulk solution to lipid membrane is a hydrophobic interaction. The addition of surfactants increased the transition width. The extent of widening the transition width was in the order of sodium alkylsulfate greater than alkyltrimethylammonium bromides greater than hexaethyleneglycol mono n-dodecyl ether; in the case of alkanoyl-N-methylglucamides, the transition width was not affected by the addition. These effects on the transition width was interpreted qualitatively in terms of the cooperativity of the transition. PMID- 3829209 TI - Prediction of the critical micelle concentrations of mono- and di-acyl phospholipids. AB - The experimental linear chainlength dependence of the logarithm of the critical micelle concentration (ln [CMC]) of mono- and di-acyl phosphatidylcholines, together with recent measurements of the polar headgroup dependence of the CMCs of a variety of spin-labelled phospholipids, and the relative solubilities of saturated and unsaturated hydrocarbons, have been combined to devise a scheme for making general predictions of the CMCs of both mono- and di-acyl phospholipids, such as are found in biological membranes. PMID- 3829210 TI - Inverted micellar intermediates and the transitions between lamellar, cubic, and inverted hexagonal amphiphile phases. III. Isotropic and inverted cubic state formation via intermediates in transitions between L alpha and HII phases. AB - Inverted cubic and isotropic phases have been observed in phospholipid and glycolipid systems. These phases exhibit characteristic morphologies in freeze fracture electron micrographs, isotropic 31P-NMR resonances and (in some cases) cubic X-ray diffraction patterns. It is proposed here that these phases may form from the same intermediates that are involved in lamellar/inverted hexagonal (L alpha/HII) phase transitions, and that it is possible that these cubic and isotropic phases are metastable. According to a kinetic theory of L alpha/HII phase transitions, intermediates in such transitions can form structures known as interlamellar attachments (ILAs). It is shown that ILAs should form in large numbers during L alpha/HII transitions in systems like those reported to form inverted cubic or isotropic structures. ILAs cannot readily assemble into either the HII phase or well-ordered arrays of L alpha phase bilayers, and represent a kinetic trap for intermediates in L alpha/HII transitions (although it is possible that they are marginally more stable in a thermodynamic sense than the L alpha phase in a small temperature range below TH). It is also shown that arrays of ILAs should form metastable arrays with the same morphology and isotropic 31P NMR resonances that are observed in isotropic and inverted cubic states. In particular, under some circumstances ILAs will assemble into a structure identical to the bicontinuous inverted cubic phase previously described in monoglycerides and very similar in morphology to structures observed in phospholipid systems. Finally, since isotropic and cubic states form from ILAs, which also can mediate fusion of unilamellar vesicles, unilamellar vesicles should fuse to at least some extent under the same conditions in which multilamellar samples of the same lipid form isotropic or inverted cubic states. This correlation has been observed. PMID- 3829211 TI - Separation of phosphatidylethanolamine from its oxidation and hydrolysis products by high-performance liquid chromatography. AB - 1-Palmitoyl-2-linoleoyl-phosphatidylethanolamine degrades relatively quickly when subjected to common storage and handling procedures. The degradation products consist of compounds in which double bonds in the sn-2 position acyl chain are partially oxidized and of products arising from the hydrolysis of the acyl ester bonds. Thin-layer chromatography (TLC), which is widely utilized to isolate and to ascertain the purity of phospholipids, does not readily separate the oxidation products from the parent lipid class. High-performance liquid chromatography (HPLC), however, employing a normal phase column and an isocratic, UV-transparent solvent system, can be employed to produce a rapid analytical or preparative of phosphatidylethanolamine (PE) from these degradative impurities. PMID- 3829212 TI - [Urban and rural malaria in Niger. The case of the Department of Maradi]. AB - In Niger, two communities, a urban one (Maradi) and a rural one (Tarna), living in a same malarious Soudano-Sahelian climatic area, were compared during wet and dry seasons by different methods (spleen rate, parasite rate, parasite count, level of immunity). During wet and dry season, spleen rates (0.7% and 2.6%) and parasite rates (1% and 1.6%) are considerably lower at Maradi than those observed at Tarna (spleen rates: 38% and 42%; parasites rates: 10% and 22.5%). It is shown that seroconversion occurs later in urban sector (100% between 20 and 29 year age) than in rural sector (100% between 10 and 15 year age). All malarious indicators were negative in a high percentage of Maradi-born children under 9 (79% during wet season and 81% during dry season) against respectively 28% and 31% at Tarna. Better paludometric index in urban community is a favourable sanitary indication. But epidemiological control must be prosecuted since the number of non-immune subjects is increased. PMID- 3829213 TI - [Evaluation of the clinical, parasitological and immunological indices of malaria in the Bonny's Bay area of Central Africa]. AB - The authors report the results of 4 sample surveys carried out in Equatorial Guinea and Cameroon in the Bonny's Bay area, to evaluate the main malarial indexes. In rural and semi-rural areas one notice a high rate of fever attacks and splenomegaly. Parasitaemia is more important in rural areas than in urban areas and is decreasing where the therapeutic pressure is strong and long lasting. Immunological indexes are high everywhere. PMID- 3829214 TI - [The sheep: an experimental model for the study of African trypanosomiasis]. AB - An experimental model of human african trypanosomiasis is realized in sheep with Trypanosoma brucei brucei. Clinical and biological evolution is comparable to human disease. This model is useful to test efficient drugs and to get a better knowledge about sleeping sickness physiopathology. PMID- 3829215 TI - [Epidemiological study of intestinal helminthiasis in 4 Barombi villages (Cameroon-South-West Province)]. AB - The prevalence of intestinal helminthiasis is measured by means of stool examinations. Larvae of S. stercoralis are seen in 9.8% of the specimens, eggs of A. lumbricoides in 51.4%, eggs of T. trichiura in 85.2% and eggs of N. americanus in 64.1%. Strongyloidiasis occurs in foci and affects 16.8% of the inhabitants in one of the studied villages. PMID- 3829216 TI - [Reactions to vaccination against yellow fever]. AB - The frequency of reactions to vaccinations against Yellow Fever was determined in a population of 370 travellers in good health. 25% suffered from reactions, most of which were minimal, 5% were local and 22% general of which half were of the post vaccinal viral syndrome type with multiple pains and pyrexia. Strong reactions appeared in only 8 subjects (2%). Age, sex, or number of antigens injected did not cause any significant differences. PMID- 3829217 TI - [Osteoarticular manifestations of thalassemia]. AB - Thalassemia is a genetic illness which exists every where in the world. In Black Africa, intermediary thalassemia and beta-thalassemia minor are mainly observed. The osteoarthropatic signs are caused by erythroid hyperplasia and overload iron. We mention the roentgenographic skeletal survey of intermediary thalassemia and other less frequent bone abnormalities. We analyse the publications concerning osteoarticular manifestations in beta-thalassemia minor. We report a clinical and anatomical case of intermediary thalassemia with gout complications. PMID- 3829218 TI - [Carriage of HBs antigen and infection by delta agent in Cameroon]. AB - Serum samples taken from 370 healthy individuals (aged 15-44) constituting a randomized sample representative of the adult population of the town of Nkongsamba, Cameroon, were tested for Hepatitis B virus surface antigen (HBs); positive samples were then tested for Hepatitis B virus [e] antigen (HBe) and anti-Delta antibody. The mean carrier rate of HBs was 8.4% +/- 2.8%; within HBs carriers, 29% exhibited HBe and 6.5% anti-Delta antibody. PMID- 3829219 TI - [Post-vitrectomy hemorrhage in a diabetic patient: simple transconjunctivo scleral puncture with injection of air]. PMID- 3829220 TI - [Retinal incarceration: clinical signs and technic of disincarceration]. PMID- 3829221 TI - [Optic nerve and magnetic resonance]. PMID- 3829222 TI - [Presentation of an adjustable device for electropneumatic aspiration in the surgery of cataract and the vitreous body]. PMID- 3829223 TI - [Importance of simple vitrectomy without internal tamponade in surgical prognosis of rhegmatogenous retinal detachment]. PMID- 3829224 TI - [Blood-retinal barrier]. PMID- 3829225 TI - [Endo-ocular approach in the surgery of retinal detachment]. PMID- 3829226 TI - [Endothelial effects of direct and inverse incisions]. PMID- 3829227 TI - [Effects of the insertion of an anterior-chamber artificial crystalline lens on postoperative astigmatism]. PMID- 3829228 TI - [Prevention of complications of secondary implantation]. PMID- 3829229 TI - [Significance of the correction of aphakia by hard lenses permeable to gases]. PMID- 3829230 TI - [Extracapsular extraction of the crystalline lens and toxic corneal edema]. PMID- 3829231 TI - [Keratic correction or corrective surgery of astigmatism]. PMID- 3829232 TI - [Silicone oil in the surgery of retinal detachment]. PMID- 3829233 TI - [Results of the classical surgical treatment in 100 successive cases of retinal detachment]. PMID- 3829234 TI - [What therapeutic attitude to adopt in juvenile retinoschisis?]. PMID- 3829235 TI - [Acute edematous capillaropathies in insulin-dependent diabetics]. PMID- 3829236 TI - [Surgery in Stilling-Turk-Duane syndromes (retraction syndromes considered as restriction syndrome)]. PMID- 3829237 TI - [Non-Hodgkin's malignant lymphoma of the rectus superior oculi muscle causing a deficit of the elevation]. PMID- 3829238 TI - [Paradoxical results of the retinometry using helium-neon laser interferometry]. PMID- 3829239 TI - [Significance and limitations of magnetic resonance imaging in ophthalmology]. PMID- 3829240 TI - [Chorioretinal involvement in Churg-Strauss angiitis]. PMID- 3829241 TI - [Trabeculectomy with conjunctival opening at the limbus. Apropos of 20 cases]. PMID- 3829243 TI - [Inflammatory complications and anterior chamber implants after intracapsular extraction of the crystalline lens]. PMID- 3829242 TI - [Value of an amphoteric isotonic solution in the early treatment of corneoconjunctival alkali chemical burns: experimental and histological study]. PMID- 3829244 TI - [Is polypropylene degraded in the eye?]. PMID- 3829246 TI - [Are there complications in technics for preventing retinal detachment?]. PMID- 3829245 TI - [Separation of epiretinal membranes from the subjacent retinal plane]. PMID- 3829247 TI - [Fluorophotometry and cataract surgery: symptomatology]. PMID- 3829248 TI - [Retinal periphery of pseudophakic patients. Study of 300 cases]. PMID- 3829249 TI - [Mesopic blue colored perimetry in pseudophakic patients]. PMID- 3829250 TI - [Artificial crystalline lenses and aniseikonia: some simple rules to be followed in the choice of implant]. PMID- 3829251 TI - [Study of the visual field in outbreaks of multiple sclerosis. Discussion apropos of 30 cases]. PMID- 3829253 TI - [Crystalline lens implant: from concept to commercialization]. PMID- 3829252 TI - [Benign intracranial hypertension or pseudotumor cerebri]. PMID- 3829254 TI - [Use of the SRK (Sanders-Retzlaff-Kraff) regression formula in the preoperative calculation of the power of crystalline implants]. PMID- 3829255 TI - [Binocular vision and artificial crystalline lenses]. PMID- 3829256 TI - [Epidermoid cysts of the orbit]. PMID- 3829257 TI - [Tuberculous osteoperiostitis of the orbit. Apropos of a case]. PMID- 3829258 TI - [Macroscopic aspects of the long posterior ciliary arteries]. PMID- 3829259 TI - [Treatment of traumatic hyphemas]. PMID- 3829260 TI - [Respective role of ocular biometry and peroperative keratometry in final optic correction of pseudophakia patients]. PMID- 3829261 TI - [Secondary implantation of artificial crystalline lenses in traumatic cataract]. PMID- 3829262 TI - [Macular photoinjury caused by a welding arc on an eye with an implant]. PMID- 3829263 TI - [Late choroid detachment after cataract surgery]. PMID- 3829264 TI - [Ciliary and retinal occlusion following local retrobulbar anesthesia with orbital compression (2 cases)]. PMID- 3829265 TI - [Current status of retinopathy of premature infants in northern France]. PMID- 3829266 TI - [Retinal detachment and Marfan's syndrome]. PMID- 3829267 TI - [Treatment of superior retinal tears with retinal detachment by a single intravitreal injection of gas combined with cryoapplication]. PMID- 3829268 TI - [Treatment of cystoid edema of the macula with krypton laser in retinal vein occlusions]. PMID- 3829269 TI - [Lattice degeneration. Incidence. Epidemiological aspects]. PMID- 3829270 TI - [Silverman's syndrome (apropos of a case)]. PMID- 3829271 TI - [Treatment of retinal vein occlusions by a platelet antiaggregant: sulfinpyrazone (Anturan 200)]. PMID- 3829272 TI - [Surgical treatment of ptosis associated with paralysis of the superior rectus muscle]. PMID- 3829273 TI - [Granulomatous nodule of the conjunctiva]. PMID- 3829274 TI - Succinylcholine use in emergency eye operations. PMID- 3829275 TI - Water trap for fresh gas flow line of Bain or CPRAM circuit. PMID- 3829276 TI - Preventing kinking of disposable preformed endotracheal tubes. PMID- 3829277 TI - Clinical signs of difficult direct laryngoscopy. PMID- 3829278 TI - Combined subarachnoid and epidural block for caesarean section. PMID- 3829279 TI - Anaesthetic management of the malignant hyperthermia susceptible parturient. PMID- 3829280 TI - Effects of anaesthesia and surgery on the solubility of volatile anaesthetics in blood. AB - To determine the effects of anaesthesia and surgery on the solubility of volatile anaesthetics in blood, we measured the blood/gas partition coefficients of enflurane, halothane, isoflurane, and methoxyflurane in vitro in blood obtained from six healthy unpremedicated adults at three different times during isoflurane anaesthesia: awake; 20 minutes after induction of anaesthesia, but before surgical incision; and, 90 minutes after surgical incision. The blood/gas partition coefficients of the four volatile anaesthetics decreased significantly after induction of anaesthesia and after surgical incision (p less than 0.05). Values for haematocrit and the serum concentrations of albumin, globulin, and cholesterol decreased parallel to the decrease in blood/gas partition coefficients. PMID- 3829281 TI - Postoperative complications: factors of significance to anaesthetic practice. AB - In an attempt to define what factors are important to the development of postanaesthetic complications, the data from a nine-year prospective study of anaesthetic practice in a large tertiary care institution were evaluated. A model of anaesthetic morbidity dependent upon factors of patient illness, surgical practice, anaesthetic technique and physician experience, and duration of anaesthesia was developed. Postoperative anaesthetic morbidity was defined as any anaesthetic-related complication which, in the opinion of the follow-up nurse, was associated with prolonged hospitalization or documented compromise of the patient. Using a multiple logistic regression, ASA physical status was a risk factor for postoperative complications (odds ratio = 1.95) but the number of preoperative conditions and age were not. The type of surgical procedure, classified by site or by degree of trauma, did not influence postanaesthetic complication rates. The duration of anaesthetic exposure was an important determinant of risk (odds ratio = 2.53), with complications increasing with the length of anaesthetic time. As to factors under control of the anaesthetist those patients experiencing operating room complications (odds ratio = 3.36) or those receiving pure spinal (odds ratio = 5.53) or narcotic techniques (odds ratio = 2.14) had higher risks of postoperative complications. Finally, it would appear that the greater the experience of the anaesthetist the less the risk of postoperative problems (odds ratio = 0.52). PMID- 3829282 TI - Intravenous regional analgesia with a forearm tourniquet. AB - Lidocaine 0.5 per cent in a dose of 2 mg X kg-1 was used for intravenous regional analgesia with the tourniquet cuff placed over the forearm. The level of tourniquet cuff pressure employed was the arterial "occlusion pressure" plus 50 mmHg. In 48 normotensive patients successful analgesia was achieved; in seven hypertensive patients, four were pain-free, but the other three required more lidocaine to achieve adequate analgesia. No toxic symptoms and signs were observed. Measurement of serum lidocaine concentrations in 12 patients confirmed the safety of the technique, although small leakage of lidocaine past the inflated forearm tourniquet was detected in some patients. PMID- 3829283 TI - The effect of high-dose fentanyl on human median nerve somatosensory-evoked responses. AB - Median nerve somatosensory evoked responses (MnSSERs) were recorded in nine neurologically normal adult cardiac patients before and during the administration of high-dose fentanyl. MnSSERs were recorded prior to induction and at t = 20 min and t = 45 min postinduction. Fentanyl was administered as a slow bolus (53.2 +/- 9.1 micrograms X kg-1), followed by a continuous infusion at 10-20 micrograms X kg-1 X hr-1 (total dose 63.6 +/- 10.1 micrograms X kg-1). All MnSSER waveform components remained recordable and easily identifiable during anaesthesia. The effect of fentanyl was more pronounced on cortical waveform components, leaving subcortical components largely unaffected. There was a significant increase in the latency of the cortical MnSSER at t = 20 min, e.g., for the initial negative cortical wave, N1, the latency was 21.18 +/- 1.55 ms preinduction versus 22.18 +/ 1.42 ms at t = 20 min. There was also a significant decrease in the amplitude of the cortical response at t = 20 min, i.e., 2.04 +/- 1.30 microV preinduction versus 1.31 +/- 0.74 microV at t = 20 min. However, the degree of change was quite variable (range = 0-65 per cent). No further changes occurred at t = 45 min. The authors conclude that MnSSERs can be consistently and reliably monitored during high-dose fentanyl anaesthesia. However, fentanyl produces modest but significant changes in the MnSSER which should be taken into account lest they be misinterpreted as neurologic injury in evolution. PMID- 3829284 TI - Haemodynamic effects of clonidine injected epidurally in halothane-anaesthetized dogs. AB - The haemodynamic effects of clonidine administered in the epidural space were studied in 16 halothane-anaesthetized dogs. The animals were randomly assigned to two groups: Group I received three doses of 3 ml of normal saline, Group II received three doses of 3 micrograms X kg-1 of clonidine, through an epidural catheter, whose tip was located between L2-T11. Control haemodynamic measurements were taken one hour after completion of the surgical preparation (period P1); they were repeated every 45 minutes after each incremental dose (periods P2, P3, P4) and 105 minutes after a total cumulative dose of 9 micrograms X kg-1 of clonidine or 9 ml of saline were given (period P5). No significant changes over time were observed in Group I. In Group II clonidine produced statistically significant reductions of systemic blood pressure (BP), mean left ventricular pressure (LV), heart rate (HR), cardiac output (CO) and peak LV dP/dt only after a total clonidine dose of 9 micrograms X kg-1 and these changes were sustained. BP fell 15 per cent, CO 21 per cent, HR 25 per cent, LV 20 per cent and peak LV dP/dt 30 per cent when P5 measurements were compared to control values within Group II (p less than 0.05). These haemodynamic effects of clonidine are likely due to minimal systemic absorption and/or cephalad spread of the drug towards its site of action in the brain stem. The reductions of HR, CO, BP, and isovolemic indices of contractility are likely explained by a reduction of sympathetic outflow at the spinal cord and medulla oblongata levels as well as increased parasympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829285 TI - Anaesthesia training in Nepal. AB - The background, organization, problems, and successful implementation of an anaesthesia training program in Nepal are described. Nepali physicians had previously taken their postgraduate anaesthesia training in western countries, especially in Britain. The low pay of anaesthetists, poor maintenance of equipment, and irregular supplies of anaesthetic drugs in their own country has led many of them to stay abroad. In 1985 there were only seven Nepali anaesthetists in Nepal for a population of 16 million. An alternative approach to training is presented in which a series of Canadian anaesthetists, over a three year period, are supporting the establishment of a one-year Diploma in Anaesthesiology program in Nepal. They are working with Nepali anaesthetists and the Institute of Medicine in Kathmandu, Nepal. The local anaesthetists supervise most of the clinical training while the Canadians give academic leadership and guidance. PMID- 3829286 TI - A panel summary: Monitoring of oxygen. PMID- 3829287 TI - Use of atracurium in a patient with plasma cholinesterase deficiency. AB - The use of atracurium during anaesthesia for abdominal hysterectomy in a 37-year old patient with homozygous plasma cholinesterase [EsEs] deficiency is described. Intubation was achieved utilizing 0.47 mg X kg-1 of atracurium. Subsequent doses of 0.08 mg X kg-1, 0.12 mg X kg-1 and 0.12 mg X kg-1 were given 34, 57 and 78 minutes respectively after the initial dose. At the time of reversal of the residual effects of neuromuscular blockade, 26 minutes after the last dose, spontaneous respiration had resumed. The duration of action of the drug was not different from that described in normal patients. Atracurium would appear to be a safe drug to provide neuromuscular relaxation in patients with plasma cholinesterase deficiency, where surgical procedures of intermediate duration are being undertaken. PMID- 3829288 TI - Intraoperative death during caesarian section in a patient with sickle-cell trait. The Anaesthesia Advisory Committee to the Chief Coroner of Ontario. AB - The case of a woman with sickle cell trait who sustained a cardiac arrest and died during a Caesarian section under general anaesthesia is reported. Because the common causes of intraoperative hypoxia and shock were ruled out in this case, we believe that death was due to severe concealed aorto-caval compression. After delivery, the release of a large volume of hypoxaemic, acidotic blood with sickled cells could cause cardiac depression and arrest. The fact that the patient's mucous membranes were pink and she was haemodynamically stable while her uterus was cyanotic prior to delivery provides some positive evidence for this hypothesis. We emphasize that while complications secondary to sickle cell trait during general anaesthesia are very rare, they can occur. We discuss methods of monitoring such patients. PMID- 3829289 TI - Anaesthetic implications of hereditary angioneurotic oedema. AB - Hereditary angioneurotic oedema (HANE) presents the danger of laryngeal oedema that may, among other causes, be triggered by the anaesthetist's manipulation of the patient's airway. Local and regional anaesthesia are usually recommended. This report pertains to a patient who successfully tolerated general endotracheal anaesthesia and whose management included prophylactic treatment with danazol and fresh-frozen plasma. PMID- 3829290 TI - Intraoperative cyanosis: a case of dapsone-induced methaemoglobinaemia. AB - Intraoperative cyanosis is most commonly caused by hypoxaemia. The anaesthetist is required to perform a rapid series of diagnostic manoeuvres and take remedial action. Occasionally methaemoglobin, sulfhaemoglobin, or haemoglobin M, undetected preoperatively, is the cause of the cyanosis. We report a case of methaemoglobinaemia secondary to dapsone ingestion that was diagnosed intraoperatively. Dapsone, a sulfone, is used therapeutically to treat leprosy and dermatitis herpetiformis. The differential diagnosis of cyanosis, and the origin and fate of methaemoglobin are discussed. In addition the diagnostic steps and the laboratory investigations required to make the diagnosis are listed. PMID- 3829291 TI - Percutaneous transtracheal ventilation for laser endoscopic procedures in infants and small children with laryngeal obstruction: report of two cases. AB - The case reports of two children with obstructive lesions of the larynx are presented to illustrate the advantages of transtracheal ventilation for paediatric endoscopic laser surgery. The first patient was a four-month-old infant with inspiratory stridor due to a subglottic haemangioma obstructing 80 per cent of the lumen. The second patient was a five-year-old child with posterior synechiae of the larynx. The anaesthetic and ventilation techniques were the same for both cases. A transtracheal catheter was introduced percutaneously into the trachea under endoscopic control and connected to a high frequency jet ventilator. The advantages of this technique during laser surgery are: clear vision of the operative field, good gas exchange, elimination of airway trauma from intubation, reduction of the hazard of airway fires, and decreased risk of aspiration of blood and debris. In addition, this method of providing oxygen and/or mechanical ventilation may be extended into the postoperative period. In certain situations, this technique can be an attractive alternative to a tracheostomy with its potentially dangerous and incapacitating complications in infants and small children. PMID- 3829292 TI - The effect of pancuronium on the solubility of aqueous thiopentone. AB - In this study we identified the precipitate formed when pancuronium bromide (pH 3.9) and sodium thiopentone (pH 10.6) are combined in vitro. A precipitate formed when sufficient pancuronium was added to thiopentone to decrease the pH below 9.25. The precipitate was isolated, redissolved in alkaline solution and identified as thiopentone using ultraviolet spectrophotometry. Pancuronium was soluble in water in the pH range of 2.0 to 12.0, whereas thiopentone was soluble in water only at a pH greater than 9.90. We conclude that thiopentone precipitates when combined with pancuronium because of a pH-dependent decrease in the solubility of thiopentone, rather than a chemical interaction. PMID- 3829293 TI - Effect of bumetanide in capillary permeability pulmonary oedema. AB - To determine if bumetanide, like furosemide, improves shunt through pulmonary vasoactivity, 20 dogs with unilobar oleic acid pulmonary oedema were studied. Fractional perfusion and intrapulmonary shunt of the oedematous lobe were measured at: baseline, 1 1/2 hours after oleic acid infusion, 15 minutes later after either 0.1 mg X kg-1 of bumetanide in ten dogs (Bumetanide Group) or without bumetanide in ten dogs (Control Group), and 2 1/2 hours after the oleic acid, the bumetanide being administered immediately after the 1 1/2 hours post oleic acid measurements. Lobar shunts for the Bumetanide Group were: 9.3 +/- 4.0, 54.3 +/- 13.6, 54.7 +/- 13.6, 38.6 +/- 12.0 per cent and for CONTROLS: 8.7 +/- 1.6, 45.1 +/- 8.8, 48.3 +/- 7.8, 70.4 +/- 6.2 per cent. Fractional perfusions of the oedematous lobe were: 29.9 +/- 1, 14.7 +/- 1.1, 14.6 +/- 0.7, 19.3 +/- 1.9 per cent in the Bumetanide Group and 28.6 +/- 2.1, 14.2 +/- 1.1, 14.2 +/- 1.5, and 9.9 +/- 1.1 per cent in CONTROLS. Oedema (wet to body weight ratio) was less (p less than 0.05) in the contralateral lobe (2.5 +/- 0.2 vs. 2.9 +/- 0.3) and the oedematous lobe (4.7 +/- 0.4 vs 6.0 +/- 0.5) after bumetanide-induced diuresis. We conclude that bumetanide decreases shunt by decreasing oedema and not through pulmonary vasoactivity. PMID- 3829294 TI - Airway obstruction in infants and children. PMID- 3829295 TI - Revised guidelines to the practice of anaesthesia. PMID- 3829296 TI - The effect of preoperative oral fluid and ranitidine on gastric fluid volume and pH. AB - One hundred unpremedicated daycare patients were randomly assigned to one of four groups. Between two and three hours preoperatively all patients received either oral ranitidine 150 mg, or placebo, with bromosulphthalein (BSP) 50 mg in 10 ml water, immediately followed by either 150 ml water or no further fluid. The residual gastric volume (RGV) in the two placebo groups was significantly lower in patients given 150 ml water (20.6 +/- 14.1 ml) than in those who continued fasting (29.9 +/- 18.2 ml) (p less than 0.05). The RGV was further significantly decreased in the two ranitidine groups (10.0 +/- 8.8, 9.7 +/- 10.5 ml) compared with the two placebo groups (20.6 +/- 14.1, 29.9 +/- 18.9 ml) (p less than 0.01). Mean pH values were significantly higher in the two ranitidine groups (6.71 +/- 0.99; 6.31 +/- 1.81) than in the two placebo groups (2.05 +/- 1.41; 1.72 +/- 0.33) but were not significantly different in the fluid versus non-fluid groups. In patients who ingested 150 ml water there was no correlation between the premedication interval and either RGV or pH values. The extremely low percentage of the original BSP (less than 0.9 per cent) in the gastric fluid of these patients demonstrated that gastric emptying of the ingested water was virtually complete prior to surgery. The combination of RGV of 25 ml or more with pH less than 2.5 was present in 56 per cent of patients who had only a sip of water with placebo, in 28 per cent of those who received 150 ml water with placebo, and in only two per cent of those patients who received ranitidine. PMID- 3829297 TI - The effects of cremophor EL in the anaesthetized dog. AB - The effects of cremophor EL were studied in 13 anaesthetized, paralyzed and ventilated dogs. Twenty per cent cremophor EL in a dose of 4.3 +/- 0.92 ml was infused at a rate of 30 ml X hr-1. In seven dogs, thoracopulmonary compliance, heart rate, systemic arterial pressure (SAP), pulmonary pressures (PAP, PCWP, RAP), cardiac output (CO) and platelet and white cell counts, were measured before the injection of cremophor EL, at the end of infusion and 5, 10, 30 and 150 minutes after the end of infusion. In six dogs, SAP, CO, and blood volume were measured before the injection of cremophor EL, at the end of infusion and 10, 30, 90 and 150 minutes after the end of infusion. Plasma histamine and catecholamines were assayed before the injection of cremophor EL and 2, 5, 10, 30, 90 and 150 minutes after starting the infusion. Cremophor EL induced a marked, sustained and significant decrease in SAP at the end of infusion and at 5, 10 and 30 minutes after the completion of the infusion (-68, -71, -70 and -43 per cent respectively), in PCWP, RAP and CO (-78 per cent at the end of infusion, -32 per cent 150 minutes after the end of infusion). Heart rate and systemic vascular resistance did not vary significantly. Pulmonary vascular resistance increased at the end of infusion, five and ten minutes after the end of infusion (+734, +548 and +439 per cent respectively). Plasma volume decreased 10 and 30 minutes after the end of infusion (-28 and -30.5 per cent respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829298 TI - Systemic haemodynamic and metabolic effects of deliberate hypotension with isoflurane anaesthesia or sodium nitroprusside during total hip arthroplasty. AB - Isoflurane (ISO) was examined as an alternative hypotensive agent to nitroprusside (SNP) in 16 patients (mean age: 60 years) anaesthetized for total hip arthroplasty. MAP was decreased to 50 per cent of the awake level by infusion of SNP in Group I (n = 8) and with ISO in Group II (n = 8). Fentanyl (10-16 micrograms X kg-1) was administered to both groups. Haemodynamic measurements were repeated in the lateral position before, during and after hypotension. Polygeline and fresh frozen plasma were infused throughout the study period in volumes sufficient to maintain pulmonary capillary wedge pressure in the 7-9 mmHg range. The MAP decrease was the same in both groups, as were perioperative blood replacement (mean 500 ml), and postoperative haematocrits. Total perioperative fluid replacement was higher (p less than 0.01) in Group I (mean 2500 ml) than in Group II (mean 1300 ml). Venous tone was more affected by SNP than by ISO. ISO decreased the systemic vascular resistance index and oxygen consumption (VO2) without any change in CI or in Qs/Qt, in contrast to SNP which increased CI, VO2 and Qs/Qt. PMID- 3829299 TI - Ventilatory consequences of the lateral position and thoracotomy in children. AB - Functional residual capacity (FRC), breath-by-breath compliance of the respiratory system (Crs) and arterial oxygen tension (PaO2) were measured in ten children, two months to nine years of age, during anaesthesia for surgical correction of patent ductus arteriosus or coarctation of the aorta. The children were mechanically ventilated with halothane, nitrous oxide and oxygen. FIO2 was kept constant in each child. After induction of anaesthesia, FRC was 17 +/- 7 ml X kg-1 (mean +/- 1 SD), corresponding to 60 +/- 22 per cent of a predicted awake value. FRC increased to 21 +/- 8 ml X kg-1 (p = 0.0005) when the child was turned to its right side and decreased to 13 +/- 5 ml X kg-1 (p = 0.0003) when the pleura was opened. No significant change in Crs or PaO2 occurred during these manoeuvres. Retraction of the upper lung to visualize the great vessels caused a significant decrease in FRC, Crs, and PaO2. The lowest PaO2 observed during this stage was 70.0 mmHg. After surgery FRC and PaO2 were about the same as before surgery while Crs had decreased from 0.87 +/- 0.18 preoperatively to 0.64 +/- 0.15 ml X cmH2O-1 X kg-1 (p = 0.0069). This study shows that FRC increases when mechanically ventilated children are placed in the lateral position, and that thoracotomy is associated with marked changes in FRC, Crs and PaO2. PMID- 3829300 TI - Barbiturates inhibit stress-induced analgesia. AB - The effect of pentobarbitone and thiopentone on stress-induced analgesia was studied in 40 male Sprague-Dawley rats. Antinociception was determined by measuring motor reaction threshold to the noxious pressure on the tail with the use of an "Analgesymeter." Stress was induced by placement of a clamp on the hind paw. The stress procedure was found to cause an increase in reaction threshold, which was partially suppressed by naloxone 0.5 mg X kg-1. Pentobarbitone in a subanaesthetic dose of 25 mg X kg-1, SC, almost completely abolished the stress induced increase in the reaction threshold (an increase in reaction threshold from 329 +/- 33 g to 486 +/- 62 g in control group, and from 250 +/- 26 g to 273 +/- 35 g in pentobarbitone group, p less than 0.02 for the difference in the threshold changes). Thiopentone used in a dose of 25 mg X kg-1, IV, caused a loss of the righting reflex for 37 +/- 10 minutes; stress procedure applied ten minutes after regaining the righting reflex did not cause any increase in the reaction threshold (with an increase in the reaction threshold in control group from 355 +/- 50 g to 540 +/- 26 g, p less than 0.001 for the difference between the groups). The results suggest that the barbiturates in subanaesthetic doses inhibit stress-induced analgesia. Thiopentone used in an anaesthetic dose has the potential for inhibition of stress-induced analgesia in the period of recovery from anaesthesia. PMID- 3829302 TI - Geriatric anaesthesia. PMID- 3829301 TI - Plasma concentrations of fentanyl in infants, children and adults. AB - To evaluate whether there are age-related differences in the plasma concentration vs-time course of fentanyl, the authors administered fentanyl to seven infants (3 10 months), seven children (1-9 years) and seven adults (18-41 years). Anaesthesia was induced with thiopentone, nitrous oxide, and pancuronium; following tracheal intubation, fentanyl (approximately 30 micrograms X kg-1 for infants and children, 20 micrograms X kg-1 for adults) was administered as a 2 min IV infusion. Anaesthesia was maintained with nitrous oxide, pancuronium, and morphine sulphate as clinically indicated. Plasma samples were obtained for 4 h and fentanyl concentrations determined by radioimmunoassay. Plasma concentrations per microgram X kg-1 fentanyl administered were lowest in infants 4-10 and 60-240 min after the start of the 2-min infusion; values for children were lower than those for adults 4, 180 and 210 min after the start of the 2-min infusion. These findings are consistent with the authors' clinical observation that infants tolerate larger doses of fentanyl than do adults. PMID- 3829303 TI - Catheter-induced pulmonary artery perforation associated with an unusual wedge pressure tracing. AB - Pulmonary artery perforation is one of the most serious complications of pulmonary artery catheterization. We report a case of a pulmonary artery perforation which occurred during the placement of a Swan-Ganz catheter in a patient with mitral valve regurgitation. During the insertion of the catheter a deep negative pressure wave was seen in the pulmonary artery tracing, with concomitant haemoptysis. The postoperative chest radiograph revealed an infiltration distal to the tip of the pulmonary artery catheter. This type of unusual capillary wedge pressure tracing during pulmonary artery catheterization has not previously been reported. PMID- 3829304 TI - Fibreoptic bronchoscopy for tracheal and endobronchial intubation with a double lumen tube. AB - A 68-year-old patient was scheduled for a thoracotomy. A double-lumen endobronchial tube was requested by the surgeon to facilitate operating conditions. Initial attempts at intubation by conventional methods were unsuccessful. The proximal ends of a 37F double-lumen tube were then shortened and a 4-mm fibreoptic bronchoscope was passed through the bronchial lumen. The patient's larynx was easily visualized and the bronchoscope was passed into the trachea. The double lumen tube was then advanced over the bronchoscope and correctly positioned. Shortening a double-lumen tube allows the use of a fibreoptic bronchoscope to aid in tracheal intubation in a patient whose larynx is difficult to visualize by conventional methods. PMID- 3829305 TI - Pneumothorax and pulmonary embolism complicating post-traumatic hip surgery. AB - A case of intraoperative pneumothorax preceded by a pulmonary embolus is presented. A high index of suspicion led to further investigation, after resolution of the pneumothorax was not accompanied by clinical improvement. The literature is reviewed, and the various methods of prophylaxis and treatment discussed. PMID- 3829306 TI - Delayed digoxin toxicity following discontinuance in acute renal failure. AB - A digitalized 75-year-old patient with postoperative renal failure demonstrated a progressive rise in serum digoxin concentration, peaking at 3.4 nmol X L-1 three days following discontinuance of the drug. This was accompanied by cardiac bradyarrhythmias. Although the serum digoxin concentration had already started to climb from a therapeutic level prior to the discontinuance of the drug, the unabated and substantial rise was consistent with a dramatic decrease in the apparent volume of distribution of digoxin accompanying acute renal failure. Serum digoxin levels were determined with fluorescence polarization immunoassay, which has an improved specificity when compared to the commonly used radioimmunoassays for digoxin. PMID- 3829307 TI - Invasive monitoring and anaesthetic management of a parturient with mitral stenosis. AB - The anaesthetic management of a parturient with mitral stenosis is presented and discussed. In particular, the beneficial effects of epidural anaesthesia for vaginal delivery are described with respect to the significant improvement noted in haemodynamic parameters. The information derived from the pulmonary artery catheter greatly assisted the management of the patient throughout labour and in the puerperium. PMID- 3829308 TI - Safe use of induced hypotension in a patient with cirrhotic liver disease. AB - Induced hypotension was used in a patient with chronic active hepatitis and cirrhosis presenting for clipping of an intracranial aneurysm. A mean arterial pressure of 50 mmHg was produced with a combination of sodium nitroprusside and labetalol. The patient sustained no postoperative changes in hepatic function. Previous studies have examined the effects of induced hypotension on the function of the normal liver, but there is relatively little information available on its effects in the presence of liver disease. The lack of an adverse outcome in this patient does not prove the safety of this technique in patients with liver disease; further studies of this patient group are required. PMID- 3829309 TI - Postoperative paraplegia associated with epidural narcotic administration. AB - Epidural injections of buprenorphine were given for postoperative pain relief to a patient with pulmonary carcinoma who underwent a right upper lobectomy. Paraplegia occurred postoperatively and the patient's neurological status deteriorated after each injection of epidural narcotic. Laminectomies on the third postoperative day revealed an expanded oxidized cellulose (Oxycel) pledget in the epidural space. Neurologic dysfunction after epidural narcotic administration was caused by the oxidized cellulose which had migrated into the epidural space following use for surgical haemostasis and subsequently expanded with the narcotic solution and blood. PMID- 3829310 TI - Transurethral prostatectomy complicated by intraperitoneal extravasation of irrigating fluid. AB - A patient underwent transurethral resection of the prostate (TURP), which was complicated at the outset of the procedure by an inadvertent puncture wound of the dome of the bladder and the peritoneum. Shortly after resection was initiated, the patient developed shoulder pain and a tensely distended abdomen, although at this time the serum sodium concentration remained normal. Over the next several hours the patient developed significant hyponatremia. The prolonged and gradual time course of this development suggests that fluid and electrolyte shifts occurred via diffusion across the peritoneal membrane. This case illustrates a rare but potentially dangerous complication of TURP that requires recognition prior to initiation of appropriate therapy. PMID- 3829311 TI - The haemolytic uraemic syndrome and anaesthesia. AB - The Haemolytic Uraemic Syndrome is the most important cause of renal failure in infancy and childhood. The disease usually consists of a typical triad of renal failure, haemolytic anaemia, thrombocytopenia. It is, however, a multisystem disorder which may also involve the liver as well as cardiovascular, pulmonary and central nervous systems. We present a case of a female child with Haemolytic Uraemic Syndrome who presented for placement of an arteriovenous shunt to facilitate haemodialysis. The clinical presentation and management of the Haemolytic Uraemic Syndrome is discussed. Anaesthetic management of patients with the Haemolytic Uraemic Syndrome is discussed and recommendations are made. PMID- 3829312 TI - Modification of IVAC 530 infusion pump for patient controlled analgesia. AB - This article describes an inexpensive device for delivering patient-controlled analgesia. Details of the necessary modifications of a standard IVAC 530 infusion pump are included. The total cost of the modified pump was $2200. PMID- 3829313 TI - The difficult tracheal intubation. PMID- 3829314 TI - Rapid tracheal intubation--atracurium may not be the answer. PMID- 3829315 TI - Ocular responses after intravenous lidocaine. PMID- 3829316 TI - Plasma cholinesterase activity following administration of glycopyrrolate or atropine. PMID- 3829317 TI - Percutaneous sheath introducer shaft-hub disconnection during pulmonary artery catheterization. PMID- 3829318 TI - Morphological transformation in three mammalian cell systems following treatment with 6-nitrochrysene and 6-nitrobenzo[a]pyrene. AB - Two nitroaromatics, 6-nitrobenzo[a]pyrene (6-N-BaP) and 6-nitrochrysene (6-N CRY), and the corresponding parent hydrocarbons, benzo[a]pyrene (BaP) and chrysene (CRY), were studied in in vitro transformation assays with Syrian hamster embryo (SHE) cells, BALB/3T3 and C3H10T1/2 mouse cell lines. The three cell systems showed different sensitivities to the transforming effects of the chemicals studied, SHE cells being the most efficient, followed by 3T3 cells and the last being C3H10T1/2 cells. In the SHE cell system all compounds were active. Considering the concentrations (in microM) and the transformation frequency BaP was the most active, followed by 6-N-BaP, 6-N-CRY and CRY. In the BALB/3T3 standard assay and in the C3H10T1/2 assay only BaP was clearly active. When used as initiators 6-N-BaP and 6-N-CRY were inactive in the C3H cell system. In conclusion 6-N-BaP appears less active in in vitro systems than the parent compound BaP; 6-N-CRY is probably negative since it is questionable in vitro and negative in mouse skin. PMID- 3829319 TI - Induction of oral cavity cancer by 3-diazotyramine, a nitrosated product of tyramine present in foods. AB - A mutagenic nitrosation product of tyramine, 4-(2-aminoethyl)-6-diazo-2,4 cyclohexadienone (3-diazotyramine, 3-DT) preferentially induced tumors of the oral cavity. Squamous-cell carcinomas of the mucosa of the oral cavity floor developed in 19 out of 28 male F344 rats administered 0.1% 3-DT in their drinking water. Tyramine and nitrite are found at fairly high concentrations in various foods. This demonstration of the carcinogenicity of 3-DT indicates that although the implications of 3-DT for human cancer are not clear, other nitrosable mutagen precursors need to be tested as possible risk factors in human cancer. PMID- 3829320 TI - Characterization and properties of the DNA adducts formed from N-methyl-4 aminoazobenzene in rats during a carcinogenic treatment regimen. AB - Chronic oral administration of the carcinogenic aminoazo dye N-methyl-4 aminoazobenzene (MAB) to rats is known to result in the induction of liver tumors. In order to assess the role of carcinogen-DNA adduct formation in MAB hepatocarcinogenesis, male rats were fed 0.06% [3'-3H]MAB in the diet for 1, 3 or 5 weeks. Groups were sacrificed at 0, 24 and 72 h after dosing, and DNA was isolated from the liver and from two non-target tissues, the kidney and spleen. Upon enzymatic hydrolysis of the DNA, [3H]aminoazo dye-nucleoside adduct levels in these tissues were determined by h.p.l.c. Rats concurrently administered unlabeled MAB for 5 weeks and continued on a control diet for 9 months developed hepatocellular carcinomas (16/30 animals). No tumors were observed in 21 rats given only control diets. After chronic administration of [3H]MAB, three major MAB-DNA adducts were found in vivo: N-(deoxyguanosin-8-yl)-MAB (C8-dG-MAB), 3 (deoxyguanosin-N2-yl)-MAB (N2-dG-MAB) and 3-(deoxyadenosin-N6-yl)-MAB (N6-dA MAB). In addition, several minor products were identified as: an (8,9)-purine ring-opened derivative of C8-dG-MAB that may represent an intermediate in DNA repair; N-guanosin-8-yl-MAB which is present due to trace RNA contamination; cis isomers of C8-dG-MAB and N-guanosin-8-yl-MAB, formed by photo-illumination during analyses; and N-(guanin-8-yl)-MAB, a deribosylated product resulting from thermal depurination of C8-dG-MAB. In addition, N-(deoxyguanosin-8-yl)-4-aminoazobenzene (C8-dG-AB), a major adduct previously detected in mouse liver after a single dose of 4-aminoazobenzene, was found in rat liver but appeared to be present in significant amounts only after chronic treatment with MAB. This product co chromatographed with N6-dA-MAB but could be removed by selective decomposition in 0.1 N NaOH. For all tissues examined N2-dG-MAB and C8-dG-MAB were the major adducts observed with each accounting for 40-50% of the total carcinogen bound to DNA in rats that were sacrificed immediately after MAB feeding for 1, 3 or 5 weeks. The levels of total MAB-DNA adducts in the liver were 2-10 times greater than in the kidney or spleen and appeared to increase 2- to 3-fold over the dosing period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3829321 TI - 32P-postlabeling analysis of DNA adduction in mice by synthetic metabolites of the environmental carcinogen, 7H-dibenzo[c,g]carbazole: chromatographic evidence for 3-hydroxy-7H-dibenzo[c,g]carbazole being a proximate genotoxicant in liver but not skin. AB - The DNA adduction by the environmental carcinogen 7H-dibenzo[c,g]carbazole (DBC) and chemically synthesized 2-OH, 3-OH, and 4-OH metabolites of DBC was investigated in liver and skin of female CD-1 mice. After topical application to the skin of 37 mumol/kg of DBC or the phenolic metabolites, DNA adducts were measured by a 32P-post-labeling assay employing carrier-free [gamma-32P]ATP and ATP-deficient conditions. In liver, DBC produced four major and several minor chromatographically distinct adducts of as yet undetermined chemical structure. The adduct pattern elicited by 3-OH-DBC was qualitatively similar to the DBC adduct pattern, while this was not the case for 2-OH-DBC and 4-OH-DBC. On the basis of co-chromatography experiments under various conditions, the DBC and 3-OH DBC adducts appeared identical, and the total of adduction elicited by these compounds in liver was substantial. Similar results were observed when DBC or 3 OH-DBC were administered i.p. As a major difference between the two compounds, one 3-OH-DBC adduct (no. 3) was 4.4- and 7.0-fold lower than the corresponding DBC adduct after i.p. and topical dosing, respectively. In skin, DBC produced two major adduct fractions after topical application, one of which could be chromatographically resolved into three subcomponents. Prominent adducts produced in skin DNA by each of the three metabolites were different from those elicited by DBC, and the level of adduction by the metabolites was significantly lower than that by DBC. Comparison of the skin and liver DBC-DNA adduct patterns after topical application of DBC showed that only one of the four major chromatographically resolved skin adducts corresponded to a major liver adduct (no. 3), and that total adduction in liver was 13.5-fold higher than in skin. These results suggested that activation of DBC to DNA-binding compounds in liver occurs through at least two pathways with 3-OH-DBC being a proximate carcinogen involved in the formation of most of the adducts; 3-OH-DBC and the other two phenolic metabolites investigated play a minor role, if any, in the formation of DBC-DNA adducts in skin; metabolic activation of DBC to DNA-binding compounds in liver and skin appears to follow pathways that are different in terms of both the chemical nature and the amount of the adducts formed; and DBC and 3-OH-DBC exhibit a strong preference for liver versus skin DNA. PMID- 3829322 TI - Base excision repair of DNA in gamma-irradiated human cells. AB - Escherichia coli endonuclease IV was used to incise cellular DNA specifically at apurinic/apyrimidinic (AP) sites prior to alkaline elution to measure the resulting DNA strand breaks. gamma-Irradiated HeLa cells initially contained DNA strand breaks and no AP sites. Upon incubation at 37 degrees C the strand breaks were rapidly repaired and AP sites were generated and subsequently repaired. The transient nature of the AP sites indicates the in vivo operation of a base excision repair pathway whereby damaged bases are removed from DNA by DNA glycosylases to produce AP intermediates that are then substrates for AP endonucleases. PMID- 3829323 TI - Conversion of diets at tumor induction shows the pattern of tumor growth and metastasis of the first given diet. AB - In a previous study, significant differences in the growth rate of a transplantable mammary adenocarcinoma were observed between rats receiving a diet rich in saturated fatty acids (lard, diet A), and rats on a diet in which the saturated fat was partly replaced by polyunsaturated fatty acid of the omega-3 type (Menhaden oil, diet B). In the present investigation, it was our aim to study tumor growth in rats on diet A and B, as well as in rats that had, at tumor inoculation, a change of diets, from diet A to diet B. Tumor growth of rats receiving diet A throughout the whole experiment was the same as in those rats that had a conversion of diets. The data shows that the observed inhibiting effect of diet B on tumor growth could not be obtained when this diet was given exclusively after tumor inoculation. PMID- 3829324 TI - Suppression by methionine and choline of onco-fetal patterns of liver tRNA methyltransferase activities in carcinogen-treated rats. AB - When male Fischer rats were fed Purina chow supplemented with 2% D,L-methionine and 1% choline chloride, the rapid increase in N2-guanine tRNA methyltransferase II (NMG2) activity otherwise seen in response to cancer-promoting doses (0.02% in the diet) of 2-acetylaminofluorene (AAF) was prevented, and the increase in NMG2 activity otherwise caused by carcinogenic doses of AAF (0.06% in the diet) was decreased by 50%. In addition, the return of NMG2 activity to a normal level after completion of a 3-week regimen of 0.06% AAF was accelerated in animals fed the methionine plus choline supplemented diet. As shown earlier in this laboratory, liver tRNA methylating enzyme activities are shifted rapidly to an onco-fetal pattern in rats receiving methyl-deficient diets. This pattern is characterized by selectively elevated NMG2 activity while the activities of other base-specific tRNA methylating enzymes are relatively unchanged. Our combined results indicate that the exogenous supply of methyl groups is a factor in regulating NMG2 activity and can modulate at least one response of animals to carcinogens. PMID- 3829325 TI - Chemical stability of oligonucleotides containing the acetylated and deacetylated adducts of the carcinogen N-2-acetylaminofluorene. AB - We have prepared and characterized the single-stranded oligonucleotide heptamer 5'-ATCCGTC-3' in which the lone guanine of the oligonucleotide is modified at the C8 position with either the acetylated or deacetylated form of the carcinogenic adduct 2-aminofluorene. These two lesions represent the two major adducts formed upon the in vivo administration of the potent experimental carcinogen N-2 acetylaminofluorene. The stability of the adducts was compared by analyzing the oligonucleotide for strand scission or depurination by polyacrylamide gel electrophoresis following treatment under either neutral, acidic or basic conditions or incubation in the presence of piperidine. The results show that both adducts are stable near neutral pH but that the deacetylated adduct is less stable than the acetylated adduct to either basic or acidic conditions. Both adducts are equally susceptible to piperidine. The method of analysis described here could prove useful for characterizing other adduct structures, thus providing a general procedure to determine the stability of a variety of lesions in DNA. PMID- 3829326 TI - Detrimental effect of recent thyroidectomy on hemorrhagic shock and resuscitation. AB - Shatney and coworkers, in 1984, reported that recent thyroidectomy in dogs improved survival following hemorrhagic shock induced by reservoir bleeding to a mean pressure (MAP) of 60 torr for 60 min. Since thyroidectomy reduces preshock MAP, their control dogs had a relatively greater fall in MAP during hemorrhage. To circumvent this inequity, this study was designed to elucidate the effects of recent thyroidectomy in 20 splenectomized dogs subjected to acute hemorrhagic shock induced by phlebotomy of a predetermined volume of blood independent of resultant MAP. During splenectomy, ten dogs had thyroidectomy with parathyroid preservation and ten dogs had sham neck operation; 12 days later, hemorrhagic shock was induced by the stepwise bleeding of 35 ml/kg body weight over 75 min. Parameters measured at preshock (baseline), postshock (PS), postresuscitation (PR), and day 2 included MAP, cardiac output (CO), wedge pressure (PCWP), T3, T4, TSH, and hematocrit (Hct). Hypothyroidism was confirmed by low T3 and T4. Baseline and PS hemodynamic parameters were similar for both groups; PR data showed a significant rise in CO (6.7 liter/min vs 3.9 liter/min) and a fall in PCWP (13.2 mmHg vs 18.6 mmHg) in the euthyroid dogs compared to the hypothyroid dogs. Increased CO persisted through day 2 in the euthyroid dogs (3.14 liter/min vs. 1.95 liter/min). Four thyroidectomized dogs died during shock compared to one control dog. Contrary to prior data, this study shows that recent thyroidectomy reduces the survival and compensatory response to hemorrhage. The mechanism leading to this impaired response needs to be defined. PMID- 3829327 TI - Leukotriene D4 increases extravascular lung water in the dog. AB - The peptide leukotrienes have been detected in animals that have received endotoxin injections and also have been associated with patients suffering from the adult respiratory distress syndrome (ARDS). The ability of leukotriene D4 (LTD4) to cause pulmonary capillary permeability changes was investigated in ten anesthetized mongrel dogs. Four dogs were used as controls and six dogs received intravenous LTD4 (0.25 microgram/kg). There was a variable response in that two treated animals showed no apparent effect of LTD4. Analysis of the results from the remaining four treated animals demonstrated a significant increase in extravascular lung water (EVLW) that peaked 3 hr after LTD4 from 5.4 +/- 0.6 to 10.3 +/- 0.5 ml/kg (P less than .01). In these four dogs, EVLW increased before slight, but statistically significant, rises in pulmonary artery wedge pressure (4 +/- 1 to 9 +/- 1 mm Hg, P less than .01) and mean pulmonary artery pressure (13 +/- 1 to 17 +/- 1 mm Hg, P less than .01) occurred. During the same period, cardiac output decreased 56 +/- 7% (P less than .01), but no change in airway resistance was observed. This study is the first in vivo demonstration that LTD4 directly alters pulmonary fluid balance in the dog. We conclude LTD4 can cause increases in EVLW and may be an important mediator of the permeability changes observed in various clinical events that lead to the adult respiratory distress syndrome. PMID- 3829328 TI - Effect of single and repeated scalding on adenine nucleotides concentration in rat liver. AB - Changes in ATP, ADP, AMP, and total adenine nucleotide (TAN) concentrations and in the adenylate energy charge (EC) were investigated in the livers of rats subjected to single and repeated scalding. Single scaldings were of two grades of severity: 20% (nonlethal) and 40% (lethal within 24 hr) of the total body surface area. A repeated scald (additional 20%) was inflicted on the intact skin of the opposite side of the body either 3 hr or 3 days after a nonlethal scald. The results suggest that the energy state of the liver is related to the severity of a single scald, that the EC at the moment of repeating the scald is important for survival, and that the changes in ATP, EC, and TAN following a repeated scald are qualitatively or quantitatively different from those after a single scald. PMID- 3829329 TI - Low-dose dopamine improves effective hepatic blood flow in murine peritonitis. AB - Diminished effective hepatic blood flow (EHBF) has been postulated as contributory to hepatocellular dysfunction in sepsis. In addition, dopamine has been demonstrated to increase perfusion to selective viscera. In order to examine the effects of peritonitis upon hepatic perfusion and its response to dopamine infusion, peritonitis was induced in rats via cecal ligation and perforation (CLP). Sixteen to 20 hours following insult, cardiac outputs were determined by thermodilution, and effective hepatic blood flow was determined by low-dose galactose clearance. Studies were performed in peritonitis-induced rats (CLP) and sham-operated controls with and without dopamine infusion for 30 minutes (0.5 microgram/100 g/min). Peritonitis resulted in a significant reduction in effective hepatic blood flow (p less than 0.01) despite a maintained cardiac output. Low-dose dopamine infusion resulted in a significant restoration of effective hepatic blood flow in CLP rats without altering cardiac output or hemodynamic status significantly. Dopamine may be beneficial in the maintenance of effective hepatic perfusion in peritonitis. PMID- 3829330 TI - A computer model of hemorrhagic shock in domestic swine. AB - We used a modified version of the computer model of the circulation developed by C.V. Greenway (Pharmacol Rev 33:213-251, 1982) to study the volume-pressure relationship of the systemic venous circulation during and immediately after massive blood loss. Our theoretical predictions were based on experimental measurements performed in conscious, chronically instrumented swine subjected to massive and rapid loss of a predetermined amount of blood. These animals were subjected to an exponential removal of either 50% of their calculated blood volume in 1 hour or a linear removal of 60% in 15 minutes. Our computer model indicates a hysteresis effect between the volume-pressure curves during and immediately following hemorrhage. The results emphasize the importance of venous capacitance changes as a compensatory response to blood loss. PMID- 3829331 TI - Increased inotropic state during splanchnic artery occlusion shock in the dog. AB - Myocardial function during various forms of shock and its assessment remain the subjects of continuing controversy. Dogs were instrumented for the measurement of a lead II ECG, systemic arterial pressure, LV pressure, LVdP/dt, and LV anterior wall thickness. Afterload was varied with a snare occluder around the aorta. Contractility was assessed by the end-systolic pressure-wall thickness relationship. After taking control measurements, shock was induced by occluding the celiac and the superior and inferior mesenteric arteries for 2 hr followed by reperfusion. The end-systolic pressure-wall thickness relationship was determined at 1 and 2 hr postocclusion and then at 15, 30, 45, and 60 min postrelease and hourly thereafter. The slope of this relationship was either unchanged or increased (ie greater negative slope) during occlusion. Over the first hour of reperfusion of the splanchnic bed the slope averaged 204 +/- 17% of control, and it reached 221 +/- 41% of control by 3 hr postrelease. Myocardial depression was seen only as an agonal event (39 +/- 6% of control). Sham control dogs were stable over a 4 hr period following sham occlusion. Thus, myocardial contractility was increased during splanchnic artery occlusion shock except as a terminal event. Early depression of circulatory performance was a result of decreased venous return and not cardiac dysfunction. PMID- 3829332 TI - Pathologic features of myocardial hamartomas causing childhood tachyarrhythmias. AB - We have observed in 11 infants, aged 2 years or less, a distinct clinicopathologic lesion responsible for tachyarrhythmias that were fatal in 96% (25/26) of previously reported cases. Nine of the 11 patients, who underwent electrophysiologic mapping and surgical excision of the lesion, have survived, with follow-up periods ranging from 1 month to 6 years. The morphologic findings in these 11 patients and in the 26 cases cited in the literature are reviewed. Pathogenic considerations have included viral-induced lesion, cardiomyopathy, neoplasm, and developmental disorder of Purkinje cells. We believe this lesion to be a myocardial hamartoma. Supportive evidence includes prevalence in infants, tumorlike growth pattern without mitotic figures, and association of other developmental abnormalities. Through electrophysiologic mapping, this myocardial hamartoma is potentially accessible to surgical excision and long-term cure. PMID- 3829333 TI - Arterial wave reflection in heart failure. AB - Arterial wave reflection may adversely influence both left ventricular afterload and ejection performance. Therefore, using multisensor catheter manometers, we derived wave reflection indexes from ascending aortic pressure and velocity recordings in 17 subjects with clinical heart failure secondary to idiopathic dilated cardiomyopathy and 11 control subjects free of detectable cardiovascular disease. Patients were studied at rest as well as during submaximal supine bicycle exercise. Eight of the subjects with cardiomyopathy were also studied during infusion of nitroprusside at rest and on exercise. Reflection indexes decreased on exercise in normal subjects but did not consistently do so in the subjects with heart failure. In both groups the reflected wave on exercise returned earlier during the ejection period. Infusion of nitroprusside at rest in subjects with heart failure had dramatic, and significant, effects on the magnitude and timing of arterial wave reflections. The effect of nitroprusside on reflection magnitude persisted on exercise, although the timing of the reflected wave was disadvantageous. The systemic arterial response to exercise in heart failure is characterized by a smaller change in wave reflection indexes in spite of a comparable decrease in systemic vascular resistance. Nitroprusside diminishes the potentially adverse impact of wave reflections by decreasing the magnitude of the reflected wave and altering its timing. Additional dose titration studies are necessary to fully assess the benefits of pharmacologic vasodilation during exercise. PMID- 3829334 TI - Prediction of the physiologic significance of coronary arterial lesions by quantitative lesion geometry in patients with limited coronary artery disease. AB - Studies in animals with normal coronary arteries have shown that coronary flow reserve can be predicted by angiographic measurements of arterial stenosis. Studies in man, however, suggest that even quantitative analysis of coronary angiograms cannot predict the physiologic significance of individual coronary lesions. These studies, however, were carried out in patients with either widespread, diffuse coronary artery disease or by measurement techniques that tend to underestimate maximal coronary flow reserve. To determine the relationship between coronary arterial stenosis and coronary flow reserve (CFR) in patients with discrete limited coronary atherosclerosis, we studied 50 patients with a single discrete coronary stenosis in only one or two vessels. The minimum coronary arterial cross-sectional area (mCSA), percent area stenosis (%AS), and percent diameter stenosis in the left and right anterior oblique projections were determined by the Brown/Dodge method of quantitative coronary angiography. A No. 3F coronary Doppler catheter was placed immediately proximal to the lesion. Measurements of CFR were obtained by intracoronary administration of papaverine in doses sufficient to provide maximal arteriolar vasodilation. In 25 patients, a translesional pressure gradient was obtained with an angioplasty catheter. CFR measured in patients with coronary artery disease was compared with that in 13 patients with normal coronary vessels. In normal patients, CFR averaged 5.0 +/- 0.6 (peak/resting velocity ratio; mean +/- SEM, range 3.7 to 8.2). In patients with limited coronary artery disease, CFR was closely correlated with %AS (r = .85), mCSA (r = .79), and the translesional pressure gradient (r = .83). Additionally, the most severe percent diameter stenosis in either the left or right anterior oblique view was also highly correlated with CFR (r = .82). Importantly, all arteries with lesions producing less than 70% area stenosis and less than 50% diameter stenosis, or with greater than 2.5 mm2 mCSA had CFR of over 3.5. These results suggest that, in contrast to the poor correlation of percent area and percent diameter stenosis to CFR measured in patients with multivessel coronary artery disease, CFR measured at angiography in patients with discrete, limited coronary artery disease correlates closely with luminal stenosis determined precisely with quantitative coronary angiography. Differences in the extent of diffuse arterial narrowing may account for these discrepancies. PMID- 3829335 TI - Atrioventricular block in posterior acute myocardial infarction: a clinicopathologic correlation. AB - The specialized conducting systems of 44 hearts with posterior-inferior acute myocardial infarction were studied to clarify the anatomic basis of atrioventricular (AV) block. The results showed a lack of correlation between the block and the lesional pathology of the specialized conducting system. On the other hand, an evaluation of the atrial prenodal myocardium revealed strong clinicopathologic correlation between the block and the necrotic damage to these fibers. Twenty-nine or 97% of patients with AV block showed acute necrosis of the prenodal atrial myocardium. Considering the conducting prenodal septal atrial myocardium as a suprahisian structure, the necrosis at this level would provide an anatomic basis of the block in posterior-inferior acute myocardial infarction. Analysis of the behavior of the AV block after pharmacologic treatment further established a relationship between the block and acute lesions in the central conduction system. PMID- 3829336 TI - Spontaneous morphologic changes in left ventricular thrombi: a prospective two dimensional echocardiographic study. AB - Previous retrospective echocardiographic studies have reported a higher embolic potential of left ventricular thrombi with protruding configuration and patterns of mobility. The present study was performed to prospectively assess the shape and mobility patterns of left ventricular thrombi and their spontaneous changes with time. Two-dimensional echocardiograms were obtained in 109 consecutive patients with acute anterior myocardial infarction within 24 hr of the onset of symptoms, every 24 hr until day 5, every 48 hr until day 15, and then every month for a follow-up of 1 to 29 (mean 14 +/- 8) months in the survivors. None of the patients were treated with anticoagulants or platelet inhibitors during the study period. Left ventricular thrombi, detected in 59 patients (54%), appeared from 1 to 362 (mean 12 +/- 47) days after myocardial infarction. At first detection, the shape was mural in 21 patients and protruding in 38; patterns of mobility were present in eight patients. During follow-up, changes in the shape of the thrombi were noted in 24 patients (41%; from mural to protruding in nine, from protruding to mural in 15). These variations were encountered between 2 and 490 (mean 64 +/- 117) days after the first observation of the thrombus. Patterns of mobility, previously detected in eight patients, disappeared in five of eight within 2 to 28 (mean 14 +/- 11) days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829337 TI - Direct assessment of right ventricular transmural pressure. AB - Although the measurement of transmural pressure is important, calculation of transmural pressure is complicated by the difficulties in measuring pericardial pressure. Recently, flat balloons have been proposed to measure pericardial pressure. Over a wide range of volumes, right ventricular diastolic pressure and pericardial balloon pressure were similar in diastole, suggesting that the right ventricle is unstressed at physiologic volumes and that right atrial pressure can be used to estimate pericardial pressure. To evaluate these concepts and to assess indirectly the accuracy of measuring pericardial pressure using flat balloons, six canine hearts were examined postmortem. The pericardium was removed and the hearts were submerged in cold cardioplegic solution. Balloons were inserted into the right and left ventricles, and right and left ventricular pressure-volume curves were obtained. Right ventricular transmural pressures of 2.6 +/- 0.5, 3.9 +/- 0.9, 5.9 +/- 1.4, and 8.9 +/- 2.4 mm Hg were required to distend the right ventricle to 10, 20, 30, and 40 ml, respectively. For the left ventricle, transmural pressures of 3.4 +/- 0.7, 5.4 +/- 1.2, 8.6 +/- 2.1, and 14.1 +/- 3.8 mm Hg were recorded at volumes of 10, 20, 30, and 40 ml, respectively. Although the right ventricular transmural pressures were less than the left ventricular transmural pressures over the physiologic range, right ventricular transmural pressures were always positive and increased with increments in ventricular volume. Thus the right ventricle is not unstressed over the entire range of physiologic volumes, suggesting that pericardial balloon pressures may overestimate pericardial pressure and that right atrial pressure cannot be used to estimate pericardial pressure. PMID- 3829338 TI - Color Doppler evaluation of aortic dissection. AB - Color Doppler studies were performed in 16 adult patients with proven DeBakey type I and III aortic dissection. Simultaneous opacification of both aortic lumina with oppositely directed flow was noted by color Doppler in at least one aortic segment in 14 of 16 patients (12 type I, two type III). In two patients (one type I, one type III), flow was seen in one lumen only, with clot demonstrated in the other lumen in one of them. Of 12 patients in whom communication between two aortic dissection channels was shown by angiography/surgery, color Doppler correctly identified them in nine patients (four ascending aorta, two aortic arch, and three descending aorta), either by direct visualization of flow moving from one lumen into the other (six patients) or indirectly by analyzing differences in timing of opacification of the two lumina and flow direction (three patients). Also, color Doppler correctly diagnosed aortic regurgitation as severe (aortic regurgitation jet occupying more than 75% of left ventricular outflow) in three patients and moderate in four patients. Color Doppler provides comprehensive evaluation of flow dynamics in aortic dissection. PMID- 3829339 TI - The relationship of mitral annular shape to the diagnosis of mitral valve prolapse. AB - The geometric or anatomic diagnosis of mitral valve prolapse, as opposed to the pathologic diagnosis of myxomatous valve disease, is based on the relationship of the mitral leaflets to the surrounding anulus. Current echocardiographic criteria for this diagnosis include leaflet displacement above the annular hinge points in any two-dimensional view; implicit in this equivalent use of intersecting views is the assumption that the mitral anulus is a euclidean plane. Prolapse by these criteria is found in a surprisingly large proportion of the general population. In most of these individuals, however, prolapse is present in the apical four chamber view and absent in roughly orthogonal long-axis views of the left ventricle. This frequently observed discrepancy between leaflet-annular relationships in intersecting views suggests an underlying geometric property of the mitral apparatus that would produce the appearance of prolapse in one view without actual leaflet distortion. To address this possibility, a model of the mitral valve and anulus was constructed. When the model anulus was given a nonplanar, saddle-shaped configuration, the clinical observations were reproduced: the leaflets appeared to lie above the low points of the anulus in one plane, and below its high points in a perpendicular plane. Therefore, the appearance of mitral valve prolapse can occur without actual leaflet displacement above the most superior points of the mitral anulus if the anulus is nonplanar. To determine whether this pattern is reflected in the human mitral anulus, two dimensional echocardiographic views of the mitral apparatus were obtained by rotation about the cardiac apex in 20 patients without evident annular or rheumatic valvular disease. In all cases the mitral anulus, as reconstructed from these views, had a nonplanar systolic configuration, with high points located anteriorly and posteriorly. This is consistent with the findings of other groups in animals, and would favor the appearance of prolapse in the four-chamber view and its absence in long-axis views that are oriented anteroposteriorly. This model can therefore explain the frequently observed discrepancy between leaflet annular relationships in roughly orthogonal views. It challenges the assumption that the mitral anulus is planar as well as the diagnosis of prolapse in many otherwise normal individuals based on that assumption. PMID- 3829340 TI - Long-term follow-up of patients with the antibiotic-sterilized aortic homograft valve inserted freehand in the aortic position. AB - A series of 252 isolated aortic homograft valves in 248 patients have been followed for 9 to 16.5 years (mean 10.8). The valves were sterilized in antibiotic solution and stored in a nutrient medium at 4 degrees C and were nonvital. There were 15 in-hospital deaths (6%) and a mortality of 2.7% in patients undergoing an elective first operation. Actuarial survival with the study valve in situ was 57% at 10 years and 38% at 14 years. Only 8.4% of the patients died late from homograft valve failure, chiefly because of failure to refer patients with endocarditis for reoperation or because reoperation was refused in elderly, frail subjects. Incompetence was the sole cause of valve failure and was due either to valve wear or endocarditis. Significant incompetence required reoperation. On actuarial analysis, freedom from significant incompetence for the entire group was 95% at 5 years, 78% at 10 years, and 42% at 14 years. Factors increasing the risk of significant incompetence due to valve wear on multivariate analysis were increasing donor valve age (greater than or equal to 55 years), recipient age (less than 15 years), and an aortic root diameter over 30 mm. Analysis of the patient group that excluded each of these variables (low-risk group), which comprised 61% of the study population, indicated freedom from significant incompetence due to valve wear of 98% at 5 years, 94% at 9 years, and 56% at 13 years. PMID- 3829341 TI - Percutaneous balloon valvotomy for patients with severe mitral stenosis. AB - Thirty-five patients with severe mitral stenosis underwent percutaneous mitral valvotomy (PMV). There were 29 female and six male patients (mean age 49 +/- 3 years, range 13 to 87). After transseptal left heart catheterization, PMV was performed with either a single- (20 patients) or double- (14 patients) balloon dilating catheter. Hemodynamic and left ventriculographic findings were evaluated before and after PMV. There was one death. Mitral regurgitation developed or increased in severity in 15 patients (43%). One patient developed complete heart block requiring a permanent pacemaker. PMV resulted in a significant decrease in mitral gradient from 18 +/- 1 to 7 +/- 1 mm Hg (p less than .0001) and a significant increase in both cardiac output from 3.9 +/- 0.2 to 4.6 +/- 0.2 liters/min (p less than .001) and in mitral valve area from 0.8 +/- 0.1 to 1.7 +/ 0.2 cm2 (p less than .0001) Effective balloon dilating diameter per square meter of body surface area correlated significantly with the decrease in mitral gradient but did not correlate with the degree of mitral regurgitation. There was no correlation of age, prior mitral commissurotomy or mitral calcification with hemodynamic results. PMV is an effective nonsurgical procedure for patients with mitral stenosis, including those with pliable valves, those with previous commissurotomy, and even those with mitral calcification. PMID- 3829342 TI - Polymorphism of propafenone metabolism and disposition in man: clinical and pharmacokinetic consequences. AB - The relationship between debrisoquine metabolic phenotype and the pharmacokinetics and pharmacodynamics of propafenone was studied in 28 patients with chronic ventricular arrhythmias (22 extensive metabolizers [EMs] and six poor metabolizers [PMs] of debrisoquine). EMs were characterized by a shorter propafenone elimination half-life (5.5 +/- 2.1 vs 17.2 +/- 8.0, p less than .001), lower average plasma concentration (Cp) (1.1 +/- 0.6 vs 2.5 +/- 0.5 ng/ml/mg daily dosage, p less than .001), and higher oral clearance (1115 +/- 1238 vs 264 +/- 48 ml/min, p less than .001). The active metabolite 5 hydroxypropafenone, assayed in 12 patients, was identified in nine of 10 EMs but in neither of the PMs. A lower incidence of central nervous system side effects was noted in EMs (14% vs 67%, p less than .01). The magnitude of QRS widening at any given propafenone Cp was greater in EMs than PMs. There was no significant difference between EMs and PMs in effective propafenone dose or frequency of antiarrhythmic response. Inhibition of debrisoquine 4-hydroxylation by propafenone was demonstrated both in vivo and in a human liver microsomal system in vitro. We conclude that propafenone is metabolized via the same cytochrome P 450 responsible for debrisoquine's 4-hydroxylation, and that its pharmacokinetics and concentration-response relationships and the incidence of central nervous system side effects are different in patients of different debrisoquine metabolic phenotype. PMID- 3829343 TI - Idiopathic ventricular fibrillation: inducibility and beneficial effects of class I antiarrhythmic agents. AB - Ventricular fibrillation in patients without recognizable heart disease is uncommon and electrophysiologic data on such patients is limited. Over a 7 year period, five patients (three men and two women, ranging in age from 24 to 52 years) without demonstrable heart disease underwent electrophysiologic studies with pharmacologic drug testing because of single (four patients) or multiple (one patient) documented episodes of ventricular fibrillation. The arrhythmic event was unrelated to myocardial ischemia or infarction, metabolic or electrolyte disturbances, drug toxicity, preexcitation, or prolonged QT syndromes. In all three patients receiving no antiarrhythmic drugs and in two pretreated with amiodarone, a rapid poorly tolerated ventricular tachyarrhythmia requiring cardioversion was induced by programmed ventricular stimulation with up to two extrastimuli. In all instances, addition of either oral quinidine or oral disopyramide prevented the induction of sustained ventricular arrhythmias. All five patients were placed on antiarrhythmic drug regimens found effective during electrophysiologic studies and remained asymptomatic during follow-up periods ranging from 12 to 93 (mean 52) months. We conclude that in the patients with idiopathic ventricular fibrillation in our study: programmed ventricular stimulation reliably replicated the spontaneous arrhythmia, class I antiarrhythmic agents effectively prevented induction of the arrhythmia in the laboratory, and in contrast to the severity of the presenting arrhythmia, a benign clinical course was observed during long-term therapy with class I antiarrhythmic agents. PMID- 3829344 TI - Experimental congestive heart failure produced by rapid ventricular pacing in the dog: cardiac effects. AB - Chronic rapid ventricular pacing in the dog reportedly produces a useful preparation of low-output heart failure. However, little information is available regarding cardiac changes in this preparation. Accordingly, we evaluated the effects of both short-term (3 weeks) and prolonged (2 months) rapid ventricular pacing on cardiac hemodynamics, mass, and chamber size. The effects of short-term pacing on left ventricular wall thickening, blood flow, and metabolism were also examined. Compared with 16 control dogs, dogs paced for either 3 weeks (n = 8) or 2 months (n = 13) exhibited reduced cardiac outputs (control 130 +/- 20 ml/min/kg, 3 week pacing 112 +/- 19 ml/min/kg, 2 month pacing 116 +/- 14 ml/min/kg) and elevated pulmonary wedge pressures (control 10 +/- 3 mm Hg, 3 week pacing 26 +/- 5 mm Hg, 2 month pacing 26 +/- 8 mm Hg) and right atrial pressures (control 4 +/- 1 mm Hg, 3 week pacing 13 +/- 3 mm Hg, 2 month pacing 9 +/- 3 mm Hg) (all p less than .01 vs control). At the postmortem examination, both groups of paced dogs also exhibited increased left ventricular volumes (control 13 +/- 6 ml, 3 week pacing 27 +/- 6 ml, 2 month pacing 26 +/- 8 ml), right ventricular volumes (control 13 +/- 5 ml, 3 week pacing 27 +/- 9, 2 month pacing 24 +/- 7 ml), and right ventricular mass (control 27 +/- 5 g, 3 week pacing 32 +/- 6 g, 2 month pacing 34 +/- 6 g) (all p less than .03 vs control) but had normal left ventricular mass. Three weeks of pacing also decreased percent left ventricular shortening (34 +/- 6% to 17 +/- 7%) associated with a disproportionate deterioration of posterior wall thickening (58 +/- 16% to 17 +/- 18%) (both p less than .01), as assessed by echocardiography. This left ventricular dysfunction was associated with no change in myocardial lactate extraction (prepacing 40 +/- 10%, 3 week pacing 36 +/- 10%), myocardial arteriovenous O2 difference, or myocardial histology, suggesting that it was not due to myocardial ischemia. These data indicate that rapid ventricular pacing in the dog produces a useful experimental preparation of low-output heart failure characterized by biventricular pump dysfunction, biventricular cardiac dilation, and nonischemic impairment of left ventricular contractility. PMID- 3829345 TI - Results of sympathetic denervation in the canine heart: supersensitivity that may be arrhythmogenic. AB - Latex-induced transmural myocardial infarction or epicardial application of phenol interrupts sympathetic fibers innervating myocardium apical to the infarction or to the phenol-painted area. These denervated regions subsequently show supersensitive shortening of effective refractory period (ERP) in response to the infusion of norepinephrine (denervation supersensitivity). The purpose of this study was to test the hypothesis that such denervation supersensitivity is arrhythmogenic. Ventricular arrhythmias were elicited by programmed ventricular stimulation (PVS) during a control period, during bilateral stimulation of the ansae subclaviae (4 msec pulses, 4 Hz and 3 mA), and during the infusion of norepinephrine (0.5 microgram/kg/min). Study groups consisted of 14 sham-operated dogs, 16 dogs with phenol painted over a diagonal branch, 13 dogs with latex embolization of a diagonal branch that resulted in transmural myocardial infarction, 14 dogs with a one-stage ligation of a diagonal branch producing nontransmural myocardial infarction, and 12 dogs undergoing both phenol painting and one-stage ligation of a diagonal branch. Four to 22 days after the first operation, PVS was performed in anesthetized, open-chest dogs after neural decentralization of the heart. Dogs with phenol painting on the epicardium and dogs in which latex was injected into a diagonal branch showed supersensitive shortening of ERP to infused norepinephrine at apical sites. PVS resulted in ventricular fibrillation more often during stimulation of the ansae subclaviae (p less than .001) and infusion of norepinephrine (p less than .001) than during the control state in dogs treated with phenol alone. The incidence of ventricular fibrillation was highest in dogs with ligation-induced infarction that received phenol compared with all other groups during control (p less than .001), stimulation of the ansae subclaviae (p less than .002), and the infusion of norepinephrine (p less than .01). Propranolol (0.5 mg/kg or 10 mg iv at maximum) attenuated supersensitive shortening of ERP and decreased the incidence of induction of ventricular fibrillation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3829346 TI - Indications for intracardiac electrophysiologic studies in patients with atrioventricular and intraventricular blocks not associated with acute myocardial infarction. PMID- 3829347 TI - Indications for use of intracardiac electrophysiologic studies for the diagnosis of site of origin and mechanism of tachycardias. PMID- 3829348 TI - Indications for intracardiac electrophysiologic studies in patients with supraventricular tachycardia. PMID- 3829349 TI - Intracardiac electrophysiologic studies for drug selection in ventricular tachycardia. PMID- 3829350 TI - Intracardiac electrophysiologic studies for drug selection in ventricular tachycardia: the need for new approaches based in perturbations of the electrophysiologic matrix. PMID- 3829351 TI - Electrophysiologic studies in patients with unexplained syncope. PMID- 3829352 TI - Indications for intracardiac electrophysiologic studies in patients with unexplained palpitations. PMID- 3829353 TI - Techniques for implantation of antitachyarrhythmia devices. AB - Implantation of ATDs is similar surgically to transpericardial implantation of conventional antibradycardia pacemakers, but considerable special expertise is involved in choosing the appropriate device and deciding how it should be programmed. Experience has reinforced our view that ATD implantation should be performed in what is essentially an operating-room setting, by a qualified team possessing the necessary surgical, electrophysiologic, and technical skills. ATD follow-up is different from that of conventional pacemakers and, particularly in the case of AIDS and AICDs, requires additional specialized instrumentation and more flexibility in scheduling. PMID- 3829354 TI - Indications for intracardiac electrophysiologic studies in pediatric patients and the adult with congenital heart disease. PMID- 3829355 TI - Surgery for tachycardia: indications and electrophysiologic assessment. PMID- 3829356 TI - Atrioventricular and intraventricular block. PMID- 3829357 TI - Electrical treatment of tachycardia. PMID- 3829358 TI - Atrioventricular nodal reentry. PMID- 3829359 TI - Consensus statement of the Conference on the State of the Art of Electrophysiologic Testing in the Diagnosis and Treatment of Patients with Cardiac Arrhythmias. PMID- 3829360 TI - Mechanisms of atrial fibrillation, atrial flutter, and ectopic atrial tachycardia -a brief review. PMID- 3829362 TI - The electrocardiogram and arrhythmias: limitations of a technique. PMID- 3829361 TI - Mechanisms of ventricular tachycardia. PMID- 3829363 TI - Exercise stress testing for exposure of arrhythmias. PMID- 3829364 TI - The recognition of arrhythmia vulnerability by body surface electrocardiographic mapping. PMID- 3829365 TI - Transesophageal electrocardiography and cardiac pacing: state of the art. PMID- 3829366 TI - Occupational asthma in nurses handling psyllium. AB - Five nurses aged 31-55 years old had a history of asthmatic symptoms after being exposed to psyllium that they prepared and distributed to patients. They had been nurses for 9-20 years and had reported asthmatic symptoms related to work in the past 3-12 months. They reported symptoms of rhinoconjunctivitis and all were atopic but only one had a previous history of asthma. Four of the five tested subjects had an immediate skin reaction to a commercial psyllium extract. All had IgE antibodies to psyllium. At the time that they were investigated, four out of the five had a significant increase in bronchial responsiveness to methacholine (PC 20 less than 8 mg/ml). Inhalation challenges with psyllium caused isolated immediate (one subject) and dual reactions (three subjects). One subject exposed for only 1 min to the psyllium powder experienced a severe immediate bronchospastic reaction, which required intubation for 3 h with complete functional recovery thereafter. This experience illustrates the precautions necessary, with the inclusion of a cautious dose-response approach, even with an 'occupation-type' challenge in the laboratory. PMID- 3829367 TI - Serological and clinical investigation of humidifier fever. AB - A group of nineteen normally healthy subjects in a microprocessor factory reported various degrees of work-related respiratory and systemic symptoms that in some were suggestive of humidifier fever (HF). They all had normal serology against a variety of infectious agents, but serum-precipitating antibody against antigens in the factory humidifier water was present in twelve subjects, primarily those with symptoms most in keeping with HF. There was extensive serological identity between the antigens from this and other confirmed sources of HF. The antibody-positive subjects were all non-smokers and had significantly raised serum IgG. Nine months later, following modification of the humidifier system, the symptoms had resolved in fourteen of the nineteen subjects, the precipitins were reduced in seven but persisted in five subjects, and the total IgG levels were significantly reduced in all subjects. The measurement of total, as well as specific, IgG may be of value in assessing this disease. PMID- 3829368 TI - Lack of allergenic cross-reactivity between storage mites and Dermatophagoides pteronyssinus. AB - The allergenic cross-reactivity between storage mites (Lepidoglyphus destructor, Glycyphagus domesticus, Tyrophagus putrescentiae and Acarus siro) and the house dust mite Dermatophagoides pteronyssinus was studied with the radio-allergo sorbent test (RAST) and the RAST inhibition technique. RAST-positive sera were obtained from fifty-three farmers who were positive to at least one of the four storage mites. Sera from twelve of these farmers, eight of whom were also positive to D. pteronyssinus, were investigated with the RAST inhibition technique. No significant correlations were found between IgE-antibody levels to any single storage mite and D. pteronyssinus. There was no correlation between the RAST results to A. siro and G. domesticus, whereas a significant correlation was found between L. destructor, G. domesticus and T. putrescentiae. The RAST inhibition studies confirmed the greater allergenic similarity between L. destructor, G. domesticus and T. putrescentiae than between A. siro and the other three storage mites. The results of our studies support the hypothesis that each of the storage mites and D. pteronyssinus possess their own unique allergen or allergens. Furthermore, L. destructor, G. domesticus and T. putrescentiae seem to be allergenically more closely related to each other than to A. siro. PMID- 3829369 TI - Oral allergy syndrome (OAS): symptoms of IgE-mediated hypersensitivity to foods. AB - Eighty highly atopic patients were selected for study because they had either atopic eczema (fifty cases) or atopic reactivity to foods, as judged by a positive skin-prick test (thirty cases). In all, sixty-five out of eighty subjects (81%) described symptoms of some kind provoked by foods, but correspondingly positive skin tests were found in only half of these, thirty three out of eighty (41%). The symptoms experienced by thirty-one of the thirty three patients with positive skin tests were immediate in onset (within 1 hr) and were at first confined to the upper gastrointestinal tract, the most frequent symptoms being oral irritation and throat tightness. In a proportion of these patients, further symptoms such as urticaria, asthma or anaphylaxis developed following the initial oral symptoms, which suggested the term 'oral allergy syndrome'. In the absence of the oral allergy, symptoms such as asthma, urticaria, migraine or eczema starting later than 1 hr after food were seldom associated with positive skin tests. In the oral allergy syndrome, the characteristic symptoms (strong association with positive skin tests and RAST, time of onset and sites at which symptoms are expressed) suggest a causative relationship between exposure to food antigens and specific IgE-induced release of mediators. In cases of food intolerance that lack a characteristic symptom pattern and a positive skin test or radio-allergo-sorbent test, it seems appropriate to consider non-IgE-mediated causes. PMID- 3829370 TI - Allergy to mice. I. Identification of two major mouse allergens (Ag 1 and Ag 3) and investigation of their possible origin. AB - An extract of dust from the outlet filters of a mouse isolator was used as a basis for determining the source of inhalant allergens for subjects sensitive to this species. The antigenic components, identified by crossed immunoelectrophoresis (XIE), were compared to those found in extracts of other mouse-derived source materials, i.e. urine, fur, dander and saliva. Of the eight dust components, one (Ag 1) was identified as antigenically identical to the major urinary pre-albumin whilst the others were detected in fur, and to a lesser extent dander and saliva. None of the dust antigens was detected as a component of food or bedding. Crossed radio-immunoelectrophoresis (XRIE), performed using sera from a group of fifteen mouse-allergic subjects (positive by RAST to mouse extracts), identified seven of the dust antigens as IgE-binding components. Antigens 1 and 3 were reactive with all the sera tested and have, therefore, been termed the 'major' allergens. Varied responses were obtained to the other 'minor' antigens. Ag 1 (urinary pre-albumin) and Ag 3 were detected in all samples of mouse dust studied. RAST and RAST inhibition also indicated the presence of urinary pre-albumin. These findings suggest that the major mouse inhalant allergens may be derived predominantly from urine and secretions originating in the skin and present on the fur. PMID- 3829371 TI - Clinical and socio-professional fate of isocyanate-induced asthma. AB - Thirty-one patients with isocyanate-induced asthma were studied 6-54 months after diagnosis. Four had the same work conditions and unchanged or worse respiratory symptoms; seven had an alternative job or safer work conditions at the same work place and suffered from mild to severe symptoms. The remaining twenty subjects were definitely removed from exposure; of these, ten (50%) remained symptomatic after being removed from exposure for an average of 19 months. Asymptomatic patients appeared to be younger and to have shorter durations of total and symptomatic exposures, while symptomatic patients were more reactive to acetylcholine at diagnosis. For patients removed from isocyanate exposure and for those re-employed at the same work-place, quality of the new work site seems to play a role in the evolution of isocyanate-induced asthma. PMID- 3829372 TI - The effect of seasonal and domestic factors on the distribution of Euroglyphus maynei in the homes of Dermatophagoides pteronyssinus allergic patients. AB - A survey of the house dust mite population was carried out in the homes of fifty asthmatic Liverpool individuals with strongly positive skin tests to Dermatophagoides pteronyssinus. As expected, D. pteronyssinus was the commonest species found. However, Euroglyphus maynei made up 37% of the total adult mite count and was the predominant species in 48% of beds examined. There was a good correlation between increasing numbers of E. maynei and decreasing social class, but only a weak one with percentage relative humidity. Ionic sodium levels in bed dust were found to correlate with decreasing social class and increasing E. maynei levels. In nineteen beds, mites were sampled at 4-monthly intervals for 1 year--this showed a relative decrease in the proportion of E. maynei compared with other mites in the autumn, when relative humidity was high. A further twenty beds underwent intensive house dust eradication (including the use of plastic covers) for 1 year--these beds showed a progressive fall in the proportion of E. maynei recovered, suggesting that this mite is more vulnerable to anti-house dust mite measures. Euroglyphus maynei is a common house dust mite and further work needs to be done to assess its antigenic nature and clinical significance. PMID- 3829373 TI - Murine passive cutaneous anaphylaxis test (PCA) for the 'all or none' determination of allergenicity of bovine whey proteins and peptides. AB - A passive cutaneous anaphylaxis test (PCA) for determination of the allergenicity of bovine whey proteins and peptides was developed in mice. Antisera against whey proteins raised in rabbits and in mice, using a procedure for high IgE titre mixed with Freund's incomplete adjuvant, were applied intradermally, and various whey proteins and whey protein hydrolysates were tested for positive PCA reaction. Unhydrolysed whey and peptides larger than 6500 Da were found to react positively, peptides between 6500 Da and 3400 Da reacted weakly, whereas peptides smaller than 3400 Da were unable to initiate a reaction. The studies indicate that guinea-pigs, widely used by tradition, may be successfully replaced by mice in determination of the allergenicity of various compounds. The sensitivity of the two species is similar, but the husbandry and handling of mice is more convenient, and they are less expensive. PMID- 3829374 TI - Sublingual therapy for allergic rhinitis. PMID- 3829375 TI - Gas chromatographic-mass spectrometric assay for 6-hydroxymelatonin sulfate and 6 hydroxymelatonin glucuronide in urine. AB - Circulating melatonin is hydroxylated to 6-hydroxymelatonin and excreted in urine as the sulfate and glucuronide conjugates. We extracted these two compounds from urine by using octadecylsilane-bonded silica cartridges to eliminate most of the urea and electrolytes, and silica cartridges to separate the sulfate and glucuronide conjugates. After hydrolyzing the separated conjugates enzymically, we determined the free hydroxymelatonin by gas chromatography-mass spectrometry. Though recoveries were low and variable, we were able to quantify the analyte in the original sample by adding deuterated sulfate and glucuronide conjugates to the urines before extraction. PMID- 3829376 TI - Characterization and assay of tartrate-resistant acid phosphatase activity in serum: potential use to assess bone resorption. AB - We improved the spectrophotometric assay of tartrate-resistant acid phosphatase (TrACP; EC 3.1.3.2) activity in serum. During development of the assay we found that human serum contains a dialyzable, mixed-type noncompetitive inhibitor(s) of TrACP activity, the effects of which on the assay were substantially lessened by diluting the serum sample with water before assay and increasing the substrate concentration. Hemolysis releases into serum a significant amount of TrACP activity from erythrocytes, which can be inactivated by incubating the serum at 37 degrees C for 1 h before assay. Our improved assay was reproducible (CV = 5%), and measured within 10% of the amount of added bovine skeletal TrACP activity. Preliminary application of the assay revealed that the amount of serum TrACP activity in patients with skeletal diseases differed from normal values and changed in the same direction as the expected change in bone turnover, suggesting that TrACP activity in serum could be useful clinically as a marker of bone metabolism, possibly of bone resorption. PMID- 3829377 TI - Urinary organic acids: isolation and quantification for routine metabolic screening. AB - A method for isolating organic acids from acidified urine on an equivolume mixture of Porapak Q and Porapak T is described, and results are compared with extraction with ethyl acetate and ion exchange on DEAE-Sephadex. Average recoveries of 14C-labeled oxalic acid, lactic acid, succinic acid, alpha ketoglutaric acid, citric acid, and cinnamic acid were equal to or better than those obtained with the solvent-extraction method. The ion-exchange method gave higher recoveries for oxalic acid, lactic acid, and citric acid. The quantification of separated acids from reconstructed mass spectrometric ion traces is compared with quantification from the simultaneously recorded flame ionization detector response signals. A good correlation was obtained. With the present routine metabolic screening method we have detected several patients with inborn errors of metabolism. PMID- 3829378 TI - Further investigations regarding the toxicity of sodium nitroprusside. AB - Sodium nitroprusside is a valuable vasodilator, but its use has been curtailed because of numerous reports that, in the presence of blood, nitroprusside decomposes with release of toxic cyanide. We have examined the release of cyanide in terms of the known chemistry of nitroprusside and suggest that photochemical decomposition of nitroprusside and (or) its metabolism in vivo invalidates the analytical procedure used by previous workers. We also present evidence for the stability of nitroprusside in blood, based on 13C nuclear magnetic resonance studies. PMID- 3829379 TI - Fast kinetic method for methemoglobin developed and adapted for quantification of hemoglobin in whole blood. AB - We studied the kinetics of the reaction of cyanide with methemoglobin (mHb), used the information to develop a fast kinetic method for quantifying methemoglobin, then used that method to quantify hemoglobin (Hb) in whole blood based on the reaction with ferricyanide to produce mHb. Reaction conditions for mHb and cyanide are adjusted to give pseudo-first-order behavior with an apparent rate constant that increases linearly with cyanide concentration, decreases linearly with pH, and follows an Arrhenius-type relationship with temperature. Absorbance change, computed from kinetic data with a curve-fitting method, varies linearly with mHb concentration. Although the reactions are monitored most reliably with stopped-flow mixing, cyanide concentration was used to decrease reaction velocities to be compatible with centrifugal mixing. Kinetic results (y) for Hb in blood by both mixing methods correlate well with equilibrium results (x): y = 1.000x + 0.02 mmol/L, Syx = 0.06 mmol/L with stopped-flow mixing; y = 1.03x + 0.12 mmol/L, Syx = 0.07 mmol/L with centrifugal mixing; r = 0.96 and n = 21 in each case. PMID- 3829380 TI - Estimating fat in feces by near-infrared reflectance spectroscopy. AB - We describe use of near-infrared reflectance spectroscopy (NIRRS) to estimate the amount of fat in feces, for diagnosis of steatorrhea. After sample homogenization, the spectrum of the fecal homogenate is scanned over the near infrared region. Assay of 94 samples of feces having a known concentration of fat showed the appropriate wavelengths for the NIRRS procedure to be 1734, 1778, 1818, 2270, and 2310 nm. The reflectance output of 47 fecal samples subsequently measured at these wavelengths was used to compute the reflectance scaling factors (F values) by the instrument's microprocessor. Assay of fat content in a further 124 fecal samples, by both hydrolysis/titration (J Biol Chem 1949;177:347) and the NIRRS procedure at the wavelengths and corresponding F values previously determined, gave results that correlated highly satisfactorily. However, the NIRRS procedure demonstrated much better precision. PMID- 3829381 TI - Analyses of creatine kinase isoenzymes and isoforms in serum to detect reperfusion after acute myocardial infarction. AB - Isoenzymes and isoforms of creatine kinase (CK, EC 2.7.3.2) were measured to assess reperfusion after acute myocardial infarction (AMI). In streptokinase treated and in spontaneously reperfused AMI patients, total CK, CK-2 activity and concentration, and CK-3(3) isoform activity peaked significantly (p less than 0.05) earlier than conventionally treated, non-reperfused patients. The ratio for CK-3(3) to CK-3(1) activities peaked significantly (p less than 0.05) earlier in both the streptokinase-treated and spontaneously reperfused groups, and indicated a greater release of enzyme (higher ratio) than in the conventionally treated patients. The ratio of CK-3(3)/3(1) also peaked significantly (p less than 0.05) earlier in all three groups than did total CK, CK-2, and CK-3(3) activities or concentrations. The clearance rates of total CK, CK-2, and CK-3(3) were not significantly different in all three groups. Thus, the ratio CK-3(3)/3(1) was the earliest indicator of infarction in both reperfused and non-reperfused patients. PMID- 3829382 TI - Detecting errors in blood-gas measurement by analysis with two instruments. AB - We performed a two-stage prospective evaluation of the error detection capabilities of duplicate analysis of blood-gas specimens. In the first stage we analyzed 1601 specimens with a Corning Model 175 blood-gas analyzer as the test instrument and a Corning Model 178 analyzer as the reference instrument, and in the second stage we analyzed 1544 specimens with two Model 178 analyzers. In each stage the designated reference instrument underwent troubleshooting whenever an analytical error was detected; the test instrument underwent troubleshooting only when error conditions were indicated by means other than duplicate analysis. An error was considered to have occurred if the difference between the duplicate analyses exceeded 0.02 (for pH), 0.53 kPa, i.e., 4 mmHg (pCO2), or 7% (pO2). The number of specimens for which errors were detected was 97 (6.1%) in the first stage, 23 (1.5%) in the second. For each analyte more errors were detected with the Model 175 analyzer (of older design) than with the newer Model 178 analyzer. Furthermore, in certain periods associated with the use of particular electrodes there were very high error rates for individual analytes: 8% for pCO2, 18% for pO2. We conclude that duplicate analysis should be considered as a possible required standard for error detection. PMID- 3829383 TI - Prevalence of magnesium and potassium deficiencies in the elderly. AB - Concentrations of magnesium and potassium in erythrocytes and plasma were determined in a population of 381 unselected elderly men and women, most of them in their eighties. The effects of biological factors (age, sex, weight) and a large set of pathological conditions, malignant or not, were examined. Analyses of variance showed a relation between age and concentrations of plasma potassium and between weight and concentrations of plasma magnesium. The chi-square test showed correlations between low concentrations of plasma magnesium and diabetes, abuse of alcohol and tobacco, and also between low values for erythrocyte magnesium and hypertension. Low values for plasma potassium were correlated with hypertension whereas high values were correlated with cardiovascular disease. Although some of the differences in the mean concentrations observed were statistically significant, these differences were always small. Most interesting was the distribution of the concentrations of the cations. This study shows that assays of both of these cations in erythrocytes were better than assays in plasma to evidence a deficiency. Indeed, about 20% of the studied population had low concentrations of both erythrocyte potassium and magnesium, whereas 2 and 10% had low values for plasma potassium and magnesium, respectively. This study underlines the large prevalence of magnesium and potassium deficiencies in the elderly, an observation we could not attribute to pathology or treatment. Routine electrolyte studies therefore appear to be justified in aged human subjects. PMID- 3829384 TI - Indirect vs direct measurement of magnesium and zinc in erythrocytes. AB - We evaluated three methods (two indirect and one direct) for determining the magnesium (Mg) and zinc (Zn) content of erythrocytes, to compare methodologic differences and to establish a method suitable for use in field studies. For the indirect methods, erythrocytes in whole blood were lysed by adding either de ionized water (I) or nitric acid, 2 mol/L (II). For the direct method (III), erythrocytes were isolated by density centrifugation, washed, then digested in concentrated HNO3. Mg and Zn concentrations were measured by atomic absorption spectrophotometry in plasma and whole blood for the indirect methods, and in the pellet for the direct method. Hematocrit and hemoglobin were measured, and erythrocytes were sized and counted on all samples. Within-run CVs for the three methods ranged from 2.2% with method III for Mg to 5.4% with method I for Zn. CVs for reproducibility of the analytical procedures ranged from 2.6% with method II for Zn to 4.2% with method I for the two cations. Analytical recoveries of added Mg and Zn ranged from 93.8 to 104.7%. When values for the three methods were compared, those by method I were significantly (p less than 0.05) lower than those by methods II and III. Values obtained by method II were 100.1% for Mg and 102.4% for Zn of those by the direct method. Thus, the indirect method with 2 mol/L HNO3 lysing solution provides a reproducible, reliable, accurate, and simple technique for measuring Mg and Zn in erythrocytes. PMID- 3829385 TI - Presence of nonesterified and acylcarnitine in human polymorphonuclear leukocytes and mononuclear cells. AB - We demonstrate the presence of nonesterified carnitine and acylcarnitine in leukocytes, but not in erythrocytes, from 16 healthy adults. After carefully separating the different kinds of blood cells we measured significant amounts of nonesterified carnitine and acylcarnitine in polymorphonuclear leukocytes (28.5 +/- 6.1 and 18.5 +/- 6.3 mumol/10(9) cells) and mononuclear cells (25.4 +/- 5.2 and 14.8 +/- 4.5 mumol/10(9) cells). We also measured nonesterified carnitine, long-chain acylcarnitine, and short-chain acylcarnitine in plasma after fractionation with perchloric acid and obtained the following values (mean +/- SD): 41.4 +/- 2.6, 3.9 +/- 1.2, and 6.0 +/- 1.6 mumol/L, respectively. The mean percentages of total carnitine (n = 6) in polymorphonuclear leukocytes, mononuclear cells, and plasma were approximately 62%, 27%, and 13% of whole-blood carnitine, respectively (mean recovery was 102%). The percentage of acylated carnitine was 37% in leukocytes, as compared with 19% in plasma. PMID- 3829386 TI - Radioimmunoassay of somatomedin-C in filter paper discs containing dried blood. AB - We describe a simple radioimmunoassay (RIA) for estimating concentrations of somatomedin-C (Sm-C) in dried blood on filter paper. A single 3.2-mm blood spot specimen on filter paper is eluted overnight into buffer containing antibody and 125I-labeled Sm-C. The following day, bound and free hormones are separated by addition of goat anti-rabbit gamma globulin in 60 g/L polyethylene glycol solution. The correlation between values obtained for such blood-spot discs and the corresponding wet plasma is highly significant (r = 0.90, p less than 0.001). The relative concentrations (arbitrary units) of Sm-C as determined for specimens on filter paper from mothers and infants, and for cord bloods, are similar to those reported by others using acidified serum. PMID- 3829387 TI - Methods compared for determining glutathione peroxidase activity in blood. AB - We compared four methods for determination of glutathione peroxidase (EC 1.11.1.9) activity, using blood samples from 52 healthy volunteers. Two methods depended on direct assay of the amount of glutathione remaining at specific time intervals; the two indirect methods involved measuring the rate of disappearance of NADPH. We assessed the precision and reproducibility of each method. One of the indirect assays proved to be far superior to the other methods. Results of each of the methods were correlated with one another. We present the normal reference intervals for glutathione peroxidase activity for all four methods. PMID- 3829388 TI - Natural and recombinant DNA-derived human insulin-like growth factor-I compared for use in radioligand assays. AB - We compared two preparations of human insulin-like growth factor (IGF)-I, one isolated from human plasma and the other prepared by recombinant DNA technology, for use in three radioimmunoassays and a radioreceptor assay for IGF-I, two radioreceptor assays for IGF-II, and a protein-binding assay for both IGFs. In the IGF-I assays, iodinated natural IGF-I consistently showed higher binding than did iodinated biosynthetic IGF-I, whether or not the iodopeptides were purified before use by hydrophobic interaction chromatography. Comparing the potency of the unlabeled peptides in the eight assay systems, we found the natural and the biosynthetic IGF-I to be equipotent in every case except for a radioimmunoassay involving a monoclonal IGF-I antibody (the synthetic peptide had 2.4 times greater activity), and an IGF-II radioreceptor assay involving ovine placental membrane receptors (the natural peptide had 10-fold greater activity). We conclude that recombinant DNA-derived IGF-I is suitable for use, both as a standard and as a radioligand, in a wide variety of IGF assays. PMID- 3829389 TI - Prospective clinical evaluation of an improved fluorescence polarization assay for predicting fetal lung maturity. AB - We performed a prospective clinical evaluation of our newly developed fluorescence polarization procedure to predict fetal lung maturity (Clin Chem 1986;32:248-54). Net fluorescence polarization was measured at 34 degrees C after a 6.5-min incubation of amniotic fluid with fluorophore. For the 26 cases of neonatal respiratory distress syndrome encountered in 196 deliveries, the net polarization exceeded 0.287 for 22 (85%) of these, and exceeded 0.260 for all 26. The specificity of the polarization assay equaled or exceeded the specificity of the lecithin/sphingomyelin ratio for all sensitivities greater than 70%. Neither assay was a good predictor of the clinical severity of respiratory distress. For a separate group of 21 amniotic fluid specimens clinically contaminated with blood or meconium, the discriminatory power of the polarization assay was decreased, but six of seven respiratory-distress cases still had polarization values greater than 0.260. We conclude that this fluorescence polarization assay is a better overall predictor of fetal lung maturity than is the lecithin/sphingomyelin ratio, and that polarization values less than 0.260 are associated with little risk of respiratory distress. PMID- 3829390 TI - Rapid detection of leukemia cells by use of a complement-mediated cytolytic reaction and an imaging sensor system. AB - We describe a system for detection of leukemia cells involving complement mediated cytotoxic reaction and an image processing system, consisting of a charge-coupled-device image sensor, an image memory board, a personal computer, and a phase-contrast microscope. Then added to a cell suspension, monoclonal antibody specific to the fetal thymus antigen-1 of the mouse leukemia GRSL cell produced cytolysis of only GRSL cells. This cytolysis decreased the brightness of the cells observed by phase-contrast microscopy. The remaining brightness was subtracted from that of the phase-contrast image of the cells before cytolysis, which had been converted to a digital signal and stored in computer memory. Measurement time is 2 s. The time course for complete GRSL cytolysis, as measured with this system, is 12 min; overall measurement time, including reaction time, is approximately 15 min. GRSL cells in a suspension of mixed cells were determined specifically by the system. PMID- 3829391 TI - Clinical value of immunoradiometric assay of thyrotropin for patients with nonthyroidal illness and taking various drugs. AB - Using a two-site immunoradiometric assay, we measured concentrations of thyrotropin (TSH) in serum of 134 clinically euthyroid subjects, 93 patients with nonthyroidal illness, and 80 patients who were being treated with various drugs. Abnormal concentrations of TSH, free thyroxin, and free triiodothyronine, respectively, were recorded in serum of three (3.2%), 19 (20.4%), and 37 (39.8%) of the patients with nonthyroidal illness and in three (3.8%), five (6.3%), and 10 (12.5%) of the patients taking drugs. TSH could be detected in all patients' serum samples. We conclude that, for most patients without thyroid disease, a basal (i.e., unstimulated) measurement of their TSH concentration in serum will indicate their thyroid status more reliably than will assay of free thyroxin or free triiodothyronine. PMID- 3829392 TI - Ascorbic acid as an antioxidant in measurements of catecholamines in plasma. AB - Sodium metabisulfite, commonly used to prevent the oxidation of catecholamines during extraction from plasma onto alkaline alumina, does not prevent their subsequent degradation in acetic acid eluates. However, ascorbic acid, a potent antioxidant, is extracted with the catecholamines onto the alumina and prevents such destruction. However, ascorbic acid may interfere with the electrochemical measurement of catecholamines, unless sequential oxidation and reduction are used. Other methods of minimizing catecholamine oxidation in acetic acid eluates include refrigerating at 4 degrees C and capping the sample vials to exclude atmospheric oxygen. PMID- 3829393 TI - Metabolic profiles of urinary organic acids recovered from absorbent filter paper. AB - We evaluated for reliability and reproducibility a semiquantitative gas chromatographic assay of organic acids in samples of normal urine recovered from absorbent filter paper. We also evaluated this method for use in diagnosis of some of the more common organic acidurias. Transfer of urine from diapers to absorbent filter paper eases the usual trauma of specimen collection from young children; it also simplifies sample storage and shipment. PMID- 3829394 TI - Comparison of Coomassie Brilliant Blue protein dye-binding assays for determination of urinary protein concentration. AB - We investigated the influence of assay protocol upon results of Coomassie Brilliant Blue protein dye-binding assays for urinary protein. Sensitivity and working range for, and linearity of response (including dilution dependence) of, three standard assays and four micro assays to bovine albumin, gamma-globulin, and urine are compared. The Read and Northcote standard assay (Anal Biochem 1981; 116:53-64) appears to be the method of choice. PMID- 3829395 TI - Erythrocytic glucose-6-phosphate dehydrogenase measured by a differential pH technique. AB - We propose a new quantitative electrochemical method for determining glucose-6 phosphate dehydrogenase (EC 1.1.1.49) activity in purified erythrocytes or in whole blood, based on measurement of the pH change caused by oxidation of glucose 6-phosphate to 6-phosphogluconic acid, with simultaneous reduction of NADP+ to NADPH + H+. No sample pretreatment (e.g., preparation of hemolysate) is needed, and the automatic correction for sample blanks obviates interference from 6 phosphogluconate dehydrogenase (EC 1.1.1.44). The method is simple and fast, and the standard curve is linear to at least 2200 U/L at 37 degrees C. The within-day CV was 3.9% for activities in healthy individuals (mean value 1204 U/L), and 10% for deficient ones (classified as belonging to class II, mean value 407 U/L). Results (y) correlated well with those obtained with the WHO-recommended method (x): y = 1.13x + 0.02 (r = 0.971) for purified erythrocytes. Normal reference intervals are reported for the enzyme in purified erythrocytes and in whole blood. PMID- 3829396 TI - Lactate and pyruvate electrochemical biosensors for whole blood in extracorporeal experiments with an endocrine artificial pancreas. AB - Glucose, lactate, and pyruvate can be continuously measured in whole blood by using three extracorporeal electrochemical biosensors. We fixed two newly developed sensors, for lactate and pyruvate, in series with an endocrine artificial pancreas ("Betalike") without affecting its performance. These new sensors for use with whole blood should be able to clarify the fate of the intermediary metabolites of glucose in diabetic patients receiving infusions of drugs or insulin. PMID- 3829397 TI - Activity of phospholipase A compared in serum of patients with pancreatic and nonpancreatic diseases. AB - Phospholipase A (PLA) activity was measured with a semi-automated photometric test system that is based on liberation of fatty acids from phosphatidylcholine by phospholipases A1 (EC 3.1.1.32) and A2 (EC 3.1.1.4). We studied 528 serum samples from 86 patients whose lipase activities were increased owing to pancreatitis, pancreatic carcinoma, and extrapancreatic diseases. PLA activity showed no correlation with lipase or amylase activities or with the primary cause of the disease, but was clearly related to prognosis. Noncomplicated acute pancreatitis was characterized by "normal" PLA activities (0-10 U/L), whereas the values (50-137 U/L) were highest in necrotizing pancreatitis and septicemia with a lethal outcome. Changes in lipase and phospholipase A activities exhibited completely different time courses in the various diagnostic groups. PMID- 3829398 TI - Caffeine-splitting of bilirubin/albumin complex: its relevance to the spectrophotometry of bilirubin in serum. AB - By means of gel-filtration of bilirubin/albumin mixtures, it is shown that unconjugated bilirubin remains completely linked to albumin (both human and bovine) in tetraborate buffer (pH 9.3), protein-free bilirubin appearing only when the bilirubin/albumin molar ratio exceeds two. On the other hand, bilirubin is completely set free from its protein link in the caffeine reagent. Additional chromatographic and spectrophotometric evidence is reported indicating the formation of a low-affinity complex between bilirubin and caffeine. These data explain why the spectrophotometric properties of bilirubin/albumin mixtures are matrix-dependent if measured in the tetraborate buffer but are no longer so when measured in the caffeine reagent. The relevance of these findings to the spectrophotometric "direct" assay of bilirubin in serum is discussed with reference to the occurrence of "delta-bilirubin" in pathological sera: this tightly protein-bound bilirubin fraction does not split in the presence of caffeine. PMID- 3829399 TI - Improved radioimmunoassay of melatonin in serum. AB - Melatonin was extracted from serum by using Baker reversed-phase C-18 columns. More than 99% of the applied melatonin was retained by the columns, and more than 97% was eluted from the columns in 300 microL of methanol. We then determined melatonin in the serum extract by a modification of a standard radioimmunoassay, using filtration instead of centrifugation to collect the [3H]melatonin-antibody complex precipitated by saturated ammonium sulfate. These modifications allow more rapid, accurate, and reproducible determination of melatonin than do previously published procedures. PMID- 3829401 TI - Enzymic method for acetaminophen adapted to an Abbott ABA-200 analyzer. PMID- 3829400 TI - Enzyme-linked immunosorbent assay for urinary albumin at low concentrations. AB - We describe an enzyme-linked immunosorbent assay (ELISA) for urinary albumin. It requires only commercially available reagents, can detect as little as 16 micrograms of albumin per liter, and analytical recovery ranges from 92 to 116%. The assay is simple, rapid, and inexpensive. Albumin excretion was 6.2 (SD 4.1) mg/24 h in healthy subjects (n = 40), 14.7 (SD 7.2) mg/24 h in albumin-test-strip negative Type I diabetics (n = 11), and 19.7 (SD 16.2) mg/24 h in patients with essential hypertension (n = 12). PMID- 3829402 TI - Sweat osmolality values in normal adults. PMID- 3829403 TI - Significance of urine assay sensitivity in marijuana detection. PMID- 3829404 TI - Discrepant thyroid-function test results by fluorescent polarization and radioimmunoassay in nonthyroidal illness. PMID- 3829405 TI - A bromcresol purple method for measuring albumin in the "Monarch" centrifugal analyzer. PMID- 3829406 TI - Serum magnesium determined by use of methylthymol blue. PMID- 3829407 TI - Benzethonium chloride interference with subsequent assays involving heparinized plasma in a centrifugal analyzer. PMID- 3829408 TI - Measurement of urine N-acetyl-beta-D-glucosaminidase with a centrifugal analyzer. PMID- 3829409 TI - Pyruvate interference with continuous-flow (SMAC) methods for aspartate and alanine aminotransferases. PMID- 3829410 TI - Problems of gelation in determination of electrolytes in serum from a patient with IgA myeloma. PMID- 3829411 TI - Cardiac enzyme changes in myxedema coma. AB - A 74-year-old man with myxedema and hypothermia had increased activities in plasma of creatine kinase (CK; EC 2.7.3.2), aspartate aminotransferase (AST; EC 2.6.1.1), and lactate dehydrogenase (LD; EC 1.1.1.27) and increased proportions of CK-MB (up to 20% of total CK) and LD1 isoenzymes, but no clinical or investigational evidence of associated myocardial infarction. This case illustrates that plasma enzyme activity and isoenzyme profiles in such clinical settings should be interpreted with caution, because increases in CK-MB and LD1 may relate to myxedema coma or hypothermia (or both) rather than to myocardial infarction. PMID- 3829412 TI - Probable source of discrepancies in alkaline phosphate assays. PMID- 3829413 TI - Chloride binding to serum proteins. PMID- 3829414 TI - Amerlite and Amerlex-M assays for total triiodothyronine compared. PMID- 3829415 TI - Relationship between fructosamine and plasma lipid concentrations in patients with diabetes mellitus. PMID- 3829416 TI - Effect of digoxin-like immunoreactive factor on the TDx digoxin II assay. PMID- 3829417 TI - Low-ultraviolet "white" fluorescent lamps fail to protect pyridoxal phosphate from photolysis. PMID- 3829418 TI - Discordant inter-kit results in immunoradiometry of serum thyrotropin. PMID- 3829419 TI - Are 'precipitated LDL' really low density lipoproteins? AB - Cholesterol, phospholipid and Apo B levels were determined in low density lipoproteins (LDL) precipitated by amphipathic polymers (Biomerieux kit, Marcy l'Etoile, France) and compared to those of ultracentrifuged LDL. For 113 sera (triglyceride level less than 4.5 mmol/l, absence of very low density lipoproteins-remnants) LDL-cholesterol values were significantly higher (p less than 0.001), and those of LDL-phospholipids (p less than 0.001) and LDL-Apo B (p less than 0.005) significantly lower. The correlations between the 3 constituents studied gave statistically different regression coefficients for the two methods. It is likely that discrepancy in results is due to the effect of ultracentrifugation and precipitation removing from the lipoprotein spectrum different sections which nonetheless have some common physicochemical or immunological properties. It would seem that the term 'LDL' is inappropriate to designate these precipitated lipoproteins. PMID- 3829420 TI - Diagnostic sensitivity of fasting and postprandial serum bile acids determined by different methods. AB - The diagnostic sensitivities of serum bile acids determined by three different methods in the fasting and in the postprandial state were compared in 43 patients with cirrhosis of the liver. When a method with high analytical sensitivity (capillary gas-liquid chromatography, GLC, or radioimmunoassay, RIA) was used, the serum concentrations of bile acids exhibited similar diagnostic sensitivities in the fasting state (GLC, 98%; RIA, 93%) and in the postprandial state (GLC, 95%; RIA, 93%). By contrast, when an enzymatic method with limited analytical sensitivity was employed, the diagnostic sensitivity of fasting serum bile acids was lower (79%) than that of postprandial serum bile acids (93%). The measurement of individual serum bile acids by GLC did not add any further diagnostic information. The results of this study demonstrate that the diagnostic sensitivity of serum bile acids strongly depends on the analytical method used. PMID- 3829421 TI - Development and validation of an improved radioimmunoassay for serotonin in platelet-rich plasma. AB - A radioimmunoassay (RIA) using a 125I-tracer is described for measurement of serotonin (5-hydroxytryptamine, 5-HT) in human platelet-rich plasma (PRP). Antisera were raised against 5-HT-succinamate conjugated to bovine albumin and, to improve assay sensitivity, the analyte was made chemically similar to the immunogen by conversion to N-acetylserotonin prior to assay, using the specific amino reagent N-acetoxysuccinimide. The assay shows good correlation with a high pressure liquid chromatography (HPLC) reference method (5-HT RIA = 1.007 X 5-HT HPLC + 29.3, r = 0.936, p less than 0.001, n = 40), indicating that no significant cross-reactions were detected. Samples of PRP are diluted 1/20 to fall within the working range (80-15% B/B0) of the assay, which is 4.75-325 nmol/l, (0.95-65.0 pmol/tube), corresponding to 95-6500 nmol/l in PRP. Intra- and interassay coefficients of variation were 5.0-10.5% and 12.0-21.2% respectively for serotonin concentrations of 250-2,500 nmol/l added to platelet-poor plasma. With this improved assay, it is possible to analyse up to 100 samples/day, compared with 10-20 samples/day by HPLC. PMID- 3829422 TI - Human inter-alpha-trypsin inhibitor and immunologically related inhibitors investigated by quantitative immunoelectrophoresis. II. Pathological conditions. AB - Inter-alpha-trypsin inhibitor (I alpha I) and the immunologically related prealbumin-like-migrating proteinase inhibitor (pA-PI) were investigated by crossed immunoelectrophoresis in sera from 68 persons with myocardial infarction, neoplastic diseases, inflammatory diseases, collagenosis, cirrhosis of the liver or uremia. The concentration of pA-PI in serum increased during each of these diseases (p less than 0.01). The concentration of I alpha I was significantly decreased in patients with cirrhosis (p less than 0.01). In day to day studies of a patient with myocardial infarction, a patient with erysipelas and a postoperative patient the concentration of I alpha I was low normal to decreased in the first days of the conditions and increased thereafter to high normal values. A comparison of the concentration of pA-PI with the excretion of the immunologically identical urinary proteinase inhibitor (UPI) showed that the excretion could not be caused by simple overflow of pA-PI in the kidney. The excretion of UPI followed closely the acute-phase-response, as measured by serum C-reactive protein. PMID- 3829423 TI - An enzyme-linked immunosorbent assay (ELISA) for plasma progesterone: immobilised antigen approach. AB - A single extraction ELISA for plasma progesterone is described using the fixed antigen approach. Progesterone is covalently coupled to bovine thyroglobulin and adsorbed onto a 96-well microtitre plate in guanidine hydrochloride. The assay, performed on an automatic ELISA processor, follows an established methodology used for other steroid hormones analysed in this laboratory with concomitant advantages in assay standardisation, cost structure and result throughput. A comparison with an established RIA shows the assay to be rapid, of similar specificity and accuracy with a sensitivity of less than 0.5 nmol/l and is suitable for use in a routine endocrine laboratory for determination of luteal function. PMID- 3829424 TI - Interference in the measurement of red cell glycogen by glycogen from white cells. AB - An enzymatic method for determining red cell glycogen was developed and its recovery and precision ascertained. Initial red cell glycogen values in 24 healthy volunteers ranged from 11-60 micrograms/g haemoglobin which compares with 20-105 micrograms/g haemoglobin previously reported. More thorough removal of leucocytes suggested however that variations in the determined red cell glycogen were due to glycogen derived from leucocytes. In 34 red cell preparations with varying leucocyte numbers, the glycogen concentration correlated positively with leucocyte count (r = +0.81, p less than 0.001), whereas glycogen concentration showed poor correlation with red cell count (r = -0.30, 0.1 greater than p greater than 0.05). The results question the reported presence of glycogen in normal red cells and suggest that contamination by leucocytes has been responsible for the previously reported normal range. PMID- 3829425 TI - Human erythrocyte transketolase: no evidence for variants. AB - Using isoelectric focusing of human erythrocyte transketolase, the isoenzyme pattern described recently (Kaczmarek and Nixon, 1983) was reexamined. Seven bands having pI values of 7.4-8.4 were common to the central part of the transketolase isoenzyme pattern in 63 healthy subjects investigated and were definitely reproduced, whereas four additional marginal bands (pI values of 7.2, 7.3, 8.6 and 8.8) were found with varying intensities in part of the samples and could not always be reproduced. We conclude that the method used does not permit the distinction of transketolase variants, that would allow to postulate a genetic polymorphism, based only on variation of the marginal bands of the pattern. PMID- 3829426 TI - The effect of combined fenofibrate and cholestyramine therapy on low-density lipoprotein kinetics in familial hypercholesterolemia patients. AB - The effects of combined drug treatment (fenofibrate and cholestyramine) have been investigated in vivo by simultaneously determining total and receptor-independent LDL catabolism with 125I-labelled LDL and 131I-labelled LDL coupled with cyclohexanedione. Receptor-mediated catabolism of LDL determined as the difference between the turnover of 125I and 131I, was found to be reduced in heterozygotes with familial hypercholesterolemia. Treatment with combined fenofibrate and cholestyramine markedly stimulated both receptor-mediated (by more than 2-fold) and receptor-independent catabolism. LDL-Apo B and LDL cholesterol levels were reduced by 38% and 36%, respectively. The combined treatment also reduced the absolute synthetic rate of LDL-Apo B (by 9%). The mechanisms responsible for these kinetic effects are discussed. PMID- 3829427 TI - Inhibition by 5-sulphosalicylic acid of the glutathione reductase recycling assay for glutathione analysis. PMID- 3829428 TI - On the definition of imprecision. PMID- 3829429 TI - Electroencephalographic study of head injury in childhood. AB - A careful study of head injury in childhood shows that 14 and 6 per second positive spikes are not normal. They are a delayed reaction to mild injury and are more characteristic of slight injury than of severe injury, but they are common during recovery among patients with severe injury. PMID- 3829430 TI - Prolonged ictal paralysis: electroencephalographic confirmation of its epileptic nature. AB - Somato-inhibitory status epilepticus is a rare condition which may pose some problems of differential diagnosis. The authors describe the case of a girl who suffered from episodes of prolonged ictal paralysis lasting from some minutes to some hours. One seizure was described 2 hours from onset. The EEG showed a continuous spike activity on the right side, predominantly on the parieto rolandic areas. Status was stopped by the administration of clobazam per os. The physiopathological mechanism of this rare form of status epilepticus is discussed. PMID- 3829431 TI - Relationship between hepatic injury status and event related potentials. AB - Visual, auditory and somatosensory event related potentials were recorded from 58 patients with chronic nonalcoholic liver disease. The results of this study indicate that a significant, although somewhat modest, amount of variance on brainstem auditory, pattern visual and somatosensory ERP latency can be predicted by routinely obtained liver functional measures, albumin, prothrombin time, fasting ammonia level, globulin and especially indocyanine green clearance. Moreover, these associations are present in persons who are not overtly encephalopathic, underscoring the sensitivity of neurophysiologic measurement for detecting hepatic encephalopathy concomitant to only moderate severity of hepatic injury. PMID- 3829432 TI - A comparative study of electroencephalography and computed axial tomography in recent cerebral infarction. AB - In order to re-assess the present role of electroencephalography in the investigation of cerebral infarct, we prospectively studied 50 adults with recent supratentorial cerebral infarction over a ten-month period. All 50 patients had EEG's and CT scans within the first two weeks of the apoplectic event. The time span between the two procedures was one week or less in all patients. We monitored the following EEG parameters: characteristics of alpha rhythm (depressed, unchanged, or enhanced); prevalence, type, rhythmicity, and topography of focal slowing; and presence or absence of FIRDA. We grouped the patients on the basis of CT findings as follows: depth of the infarct (cortical subcortical, deep white matter, or lacunar); size of the infarct (large, medium, or small); and presence or absence of mass effect. Statistical analysis revealed no differences with regard to the EEG parameters between the groups. However, when patients were categorized according to topography of the infarct, the group with parietal infarct showed a significantly higher incidence of depressed alpha rhythm compared with the groups with frontal or occipital infarct. Of the 50 patients, four patients whose history and clinical presentation suggested infarct had normal CT scans despite the presence of EEG abnormality. On the contrary, in two patients, the EEG was normal, whereas the CT confirmed the infarct. Our data suggested that physiological factors may play a major role in the pathogenesis of EEG abnormalities in cerebral infarct, thus accounting for the discrepancies between the EEG parameters and CT findings observed in our population. It was also suggested that EEG's be included routinely in the investigation of cerebral infarct. PMID- 3829433 TI - Spindle coma in viral encephalitis. AB - Our patient's EEG evolved from the spindle coma pattern to normality in parallel with his clinical improvement. This clinical and EEG evolution has been described previously, and emphasizes the heterogeneity of the spindle pattern. The initial focal asymmetry implied focal cerebral abnormality, and was one of the clinical findings favoring HSV encephalitis in the absence of radiologic or pathologic support. The ability of partially-damaged cerebral cortex to express spindle activity is well-described with various cerebral lesions, as is the spindle coma pattern after intoxication. We are not aware of a previous report with HSV or other encephalitis, but an infectious etiology could be suspected in two patients of Hansotia et al. and is conceivable in the three comatose patients of Britt in whom no diagnosis could be established. In such cases, the pathophysiology of the spindle coma pattern is likely to involve an aberrant cortical response to normal reticular formation input and thalamic spindle pacemakers. PMID- 3829434 TI - Staging of base of tongue carcinoma by computed tomography. AB - Staging of carcinoma of the base of the tongue according to the system adopted by the American Joint Committee on Cancer relies on clinical examination possibly augmented by multiple biopsies. Palpation of the tongue base can be difficult without anaesthesia due to retching and vomiting. Computed tomography can, however, accurately depict the deep structures of the base of the tongue without discomfort to the patient. It can also demonstrate the nodal stations of the neck. In 12 patients with primary carcinoma of the base of the tongue the clinical staging results were compared with the CT findings. In 10 of the 12 patients there was good correlation between tumour size and location, while only 2 patients showed a 1.0-1.5 cm discrepancy in the size estimate of the primary tumour. A total of 9 enlarged lymph nodes or nodal groups were only found by CT. The majority of positive nodal stations demonstrated only by CT were in the contralateral neck. Computed tomography is a valuable complement when staging tongue base carcinomas, particularly when evaluating the neck for lymph node metastasis. PMID- 3829435 TI - Ceramic prostheses used as a columella. AB - Ceramic stems, their lateral end capped with a modelled ossicle, or ceramic prostheses manufactured with a cap-shaped head were used as a columella from the stapes footplate to the tympanic membrane or a fascia graft in 41 ears operated on during 1982-1985. Six ears had no membrane perforations and no severe disease of the tympanic mucosa. Twelve ears underwent primary operations for cholesteatoma and 23 ears had revision surgery. Good hearing improvement occurred in well-aerated ears while hearing in ears with extensive tympanic disease did not improve after surgery. No tissue reactions to the ceramic prosthesis were observed and no prosthesis was extruded. Ceramic can be regarded as an acceptable alternative to bone for columella grafts used in surgery for chronic middle ear disease when the stapes superstructure is missing. PMID- 3829436 TI - Malignant tumours in patients with non-invasive squamous cell lesions of the vocal cords. AB - The concept of 'field cancerization' is applicable throughout the upper aerodigestive tract, oesophagus and lung. The material for this study consisted of 232 patients with hyperplasia, keratosis with or without dysplasia, and carcinoma in situ of the vocal cords. The overall risk for these patients with non-invasive squamous cell lesions of the vocal cords to have or to develop an independent, primary malignant tumour was 12.9% (30/232). Carcinomas of the head and neck, lung or oesophagus were diagnosed in 8.2% (19/232) of the patients. Patients with hyperplasia, keratosis, dysplasia and carcinoma in situ of the vocal cords should be carefully followed-up, not only as progression to invasive carcinoma may occur many years after the initial diagnosis, but also as there is a high incidence of independent primary tumours, especially of the multicentric type. PMID- 3829437 TI - Epistaxis and the flexible nasopharyngoscope. AB - Posterior epistaxis differs from anterior epistaxis only by its position in the nose, which makes direct access to the bleeding vessel difficult. With the aid of a flexible nasopharyngoscope, however, the bleeding point may be identified and cauterized directly. In this preliminary report, 12 consecutive patients admitted for posterior epistaxis were successfully treated by the technique described. PMID- 3829438 TI - Oto-rhino-laryngological Research Society (ORS). Nottingham, 3-4 April 1986. Abstracts. PMID- 3829439 TI - The Netherlands ENT Society. Leiden, November 1985. Abstracts. PMID- 3829440 TI - The effect of Mucodyne on nasal clearance in healthy adults. AB - A randomized double-blind cross-over trial in healthy young adults compared the effect of S-carboxymethylcysteine (2.25 g per day for 7 days) against placebo on nasal mucociliary clearance. The clearance rate of a radio-labelled aqueous test spray was measured by gamma scintigraphy. Analysis of the data revealed no significant effect of the drug compared to placebo. PMID- 3829441 TI - Congenital ichthyosis with alopecia, eclabion, ectropion and mental retardation- a new genetic syndrome. AB - A syndrome with severe generalized congenital ichthyosis, alopecia, eclabion, ectropion and mental retardation without neurological symptoms or macular changes in the eyes was seen in two sibs and in two aunts and uncles in an inbred North Swedish family. The clinical picture of the patients in the present family strongly deviated from that seen in the Sjogren-Larsson syndrome found in the same area. This could be a new syndrome with autosomal recessive inheritance. PMID- 3829442 TI - A case report of a de novo tandem duplication (5p) (p14----pter). AB - The case described in this paper represents on the basis of cytogenetic evidence, the first reported example of a de novo tandem dup (5p)(p14----pter). Clinical changes were minimal, unlike previously described cases in which more complex structural chromosomal changes were involved and a phenotype was provisionally attributed to dup (5p)(p14----pter). The duplicated segment of minimal effect identified in this case involved more than five eighths of 5p. It is proposed that there is a localised critical segment elsewhere on the short arm of chromosome 5 (p11-p13), which when duplicated is of greater significance in terms of clinical effects. PMID- 3829443 TI - Osteopetrosis. A genetic and epidemiological study. AB - By a systemic search of osteopetrosis in the county of Funen, Denmark, the prevalence was 5.5/100,000 inhabitants. The study disclosed 33 patients of whom 32 had the mild, autosomal dominant form of osteopetrosis. Two obligate carriers, who had the genotype but were not phenotypically affected, were disclosed. There was a great variation in the clinical manifestations; 39% were asymptomatic. The age of first appearance of symptoms also varied widely (8-76 years), with a tendency to increasing symptoms with aging. The frequency of fractures was low. Plasma inorganic phosphate was low in 7% of the patients, and plasma acid phosphatase was increased in 39%. PMID- 3829444 TI - Inv(4)(p16q21). A five-generation pedigree with 24 carriers and no recombinants. AB - A familial inv(4)(p16q21) ascertained through a woman who had a thanatophoric dwarf daughter and two abortions is presented. She and 23 other relatives were carriers, but no recombinants were found. The proportion of abortions and neonatal deaths in carriers' offspring was similar to that in non-carriers. A random segregation of the inverted chromosome was observed. The analysis of the present and previous familial chromosome 4 pericentric inversions indicates that: the breakpoint in q, with a limit between q21 and q25 determines the occurrence of inherited unbalances, and most recombinant chromosomes have duplication of the larger distal segment. PMID- 3829445 TI - Comparison of noradrenaline and isoprenaline removal in the canine hindlimb and kidney. AB - Because isoprenaline is not a substrate for neuronal uptake (Uptake-1, U-1), the difference in regional removal of isoprenaline from regional removal of the sympathetic neurotransmitter noradrenaline has been proposed as an index of regional U-1 activity. U-1 activity has not been assessed in the kidney, where decreased U-1 may account for increased renal spillover of noradrenaline into plasma in disorders such as essential hypertension. Tracer-labelled noradrenaline and isoprenaline were simultaneously infused intravenously into anaesthetized dogs, and the regional removal of noradrenaline and isoprenaline was measured in the hindlimb and kidney after administration of the U-1 blocker desipramine, hydrocortisone, which inhibits extra-neuronal uptake of noradrenaline (Uptake-2, U-2), or no drug. Hindlimb removal of noradrenaline (51%) exceeded that of isoprenaline (36%). Desipramine abolished this difference by decreasing removal of noradrenaline without affecting removal of isoprenaline. Renal removal of isoprenaline exceeded that of noradrenaline (74% vs 54%) even after U-1 blockade. Hydrocortisone did not affect removal of noradrenaline or isoprenaline in either bed. The results suggest that differences in removal of noradrenaline and isoprenaline reflect U-1 activity in the hindlimb but not in the kidney; U-1 is much more important than U-2 in the regional removal of noradrenaline; and one mechanism of noradrenaline removal in the kidney is by neuronal uptake. PMID- 3829446 TI - Erythrocyte water content in spontaneously hypertensive rats and DOCA-salt hypertensive rats. AB - Intra-erythrocyte water, sodium and potassium contents were measured in spontaneously hypertensive rats (SHR) and deoxycorticosterone acetate (DOCA)-salt rats. In 12 week old SHR, the intra-erythrocyte water content was slightly but significantly lower than that in age-matched Wistar-Kyoto (WKY) rats. SHR also exhibited a significantly lower intra-erythrocyte potassium content, but sodium content tended to be elevated. Although sodium content was not correlated with the water content, potassium content was. In DOCA-salt hypertensive rats, the intra-erythrocyte sodium content was higher than that in age-matched normotensive Sprague-Dawley rats by about 33%, but the water and potassium contents were similar. There were no significant correlations between these parameters. These findings provide no evidence of water retention in erythrocytes from DOCA-salt rat or SHR even though intra-erythrocyte sodium content was increased. PMID- 3829447 TI - Propranolol ameliorates exercise-induced regional myocardial dysfunction in dogs. AB - The effects of propranolol (0.5 mg/kg) on exercise-induced regional myocardial dysfunction were investigated in an animal model with limited coronary reserve. Limited coronary reserve was accomplished in conscious, chronically instrumented dogs by external filling of a hydraulic cuff occluder placed on a coronary vessel which did not impair resting myocardial function but induced severe dysfunction during treadmill exercise. Propranolol led to a distinct reduction of heart rate, myocardial contractility and systolic blood pressure, thereby ameliorating exercise-induced regional myocardial dysfunction. PMID- 3829448 TI - Effect of calcium withdrawal and agents affecting calcium translocation on agonist-induced contractions of the rabbit ovarian artery. AB - The effect of extracellular calcium ion (Ca2+) depletion, diltiazem, D-600 and TMB-8 on potassium (K+), norepinephrine-(NE) and histamine-induced contractions of the rabbit isolated ovarian artery was studied. K+-induced contractions, which were biphasic, were rapidly lost (congruent to 5 min) when calcium was removed from the physiological saline solution (O-Ca2+ PSS). NE and histamine-induced contractions also declined rapidly under nominal O-Ca2+ conditions without any evidence of a depletion resistant component. However, after 1 h under these conditions there was a partial restoration of their responses. EGTA (10(-3) mol/l) abolished these contractions to NE and histamine but not those in normal PSS. Diltiazem and D-600 were more effective against K+-induced than NE- and histamine-induced contractions while the intracellular Ca2+ antagonist TMB-8 was equally effective against all three responses. Histamine could still evoke contraction of the K+-contracted ovarian artery after this had been completely abolished with diltiazem or D-600 but not TMB-8. These results are interpreted to suggest that K+, NE and histamine probably release intracellular Ca2+ to evoke contractions of the ovarian artery. They differ, however, in the mechanisms they employ to facilitate entry of extracellular calcium, which in turn leads to intracellular calcium release. PMID- 3829449 TI - Influence of ethanol treatment on the plasma concentrations of prolactin and luteinizing hormone in turkeys (Meleagris gallopavo). AB - The effect of ethanol consumption on the plasma concentrations of prolactin (PRL) and luteinizing hormone (LH) was investigated in turkey poults. Ethanol (4-5% v/v in drinking water for 42 days) significantly increased the concentration of PRL, and tended to decrease that of LH. It is suggested that the hyperprolactinaemia produced by ethanol might be due to its stressor action on the birds. PMID- 3829450 TI - Serum immunoglobulin A levels and ethnicity in an Israeli population sample. AB - Serum IgA concentrations were measured in 1799 healthy Israeli military recruits (698 women and 1101 men) using an automated nephelometric system. The overall prevalence of IgA deficiency defined at a level of less than 50 mg/liter was 1.0 +/- 0.46% (95% confidence limits). No significant difference was found between the sexes in the mean values of serum IgA. Statistically significant ethnic differences were evident. Recruits of European origin had lower serum IgA concentrations than the North African, Israeli, or Asian origin groups. Whether the apparently high prevalence of IgA deficiency in this young population in Israel has clinical significance is at present unknown. PMID- 3829451 TI - Inhibition of the neutrophilic infiltrate of experimental tubulointerstitial nephritis in the Brown-Norway rat by decomplementation. AB - Anti-tubular basement membrane (TBM) antibody-associated tubulointerstitial nephritis (TIN) in Brown-Norway rats is induced by immunization with bovine TBM antigens and adjuvants. The lesion is characterized by linear deposition of IgG and C3 along the TBM with sequential neutrophil (Days 8-9)- and mononuclear (Day 10 and after)-dominated inflammatory infiltrates. To study the complement dependence of the infiltrative process, immunized rats were decomplemented with cobra venom factor (CVF). The CVF treatment did not affect the production or renal deposition of anti-TBM antibodies. CVF markedly reduced the neutrophilic inflammatory infiltrate. In rats immunized with suboptimal doses of soluble bovine TBM antigens to produce a mild lesion, decomplementation also decreased the mononuclear inflammatory infiltrates on Days 10-13. In rats immunized optimally with particulate TBM to induce maximally severe TIN, decomplementation did not affect the mild mononuclear cell infiltrate on Days 8 and 9 but did somewhat reduce the subsequent mononuclear infiltrate on Days 10 and 12. These results demonstrate that the anti-TBM antibody- and C3-associated neutrophilic inflammatory infiltrate is largely complement dependent. The early mononuclear cell infiltrate that was unmodified by CVF treatment may be dependent on complement-independent humoral events or related to cell-mediated immune events. A portion of the later mononuclear inflammatory infiltrate could be dependent on the preceding neutrophilic inflammatory phase. PMID- 3829452 TI - Enhancing effects of tilorone on collagen arthritis and humoral immune response to type II collagen. AB - The effect of tilorone, which is known to suppress adjuvant arthritis, on the induction of collagen arthritis in rats was investigated. Combined data of the present experiments show that all of the tilorone-treated rats except one in the lowest dosage group developed arthritis but that the incidence of arthritis in the tilorone-treated groups was not significantly different from that of the control group. The results also show that the two higher dosages (12.5 and 25 mg/kg/day) of tilorone caused a significant increase in the severity of collagen arthritis. Humoral immune response to type II collagen was significantly augmented in these two higher dosage groups; however, delayed-type hypersensitivity response to type II collagen was suppressed while tilorone was administered continuously. In addition, treatment with tilorone caused a significant increase in the concentration of anticollagen IgG extractable from the joint tissue. Anticollagen IgG subclass analysis revealed that the major subclass was IgG2a in both the serum and paw extract, with minor amounts of IgG2b, IgG2c, and IgG1. The response of all these subclasses was almost equally activated by tilorone treatment. PMID- 3829453 TI - Effect of partial testosterone replacement or thymosin on anti-DNA in castrated (NZB X NZW)F1 males. AB - Castration of young (3-week-old) but not older (3-month-old) male (NZB X NZW)F1 mice was associated with autoantibody production similar to that of untreated female littermates. The castration-induced disease provided a unique model for the evaluation of therapeutic modalities during the first 9 months of life. Castrated male (NZB X NZW)F1 mice were treated with either long-term thymosin (fraction 5) or testosterone for different periods of time. Continuous testosterone replacement abolished the autoimmune disease-accelerating effects of castration at 3 weeks. Brief treatment during either the early or the later periods of life of castrated (NZB X NZW)F1 males was insufficient to prevent accelerated anti-DNA production. Thymosin treatment, when started at the time of castration and continued through life, abolished the rise in anti-DNA. These studies suggest that androgens work throughout the first 7 months of life of the mouse to suppress anti-DNA and that lack of androgens for a relatively brief period allows anti-DNA production to be initiated. Once initiated it cannot be completely suppressed. The cellular basis of the fixed aspect of this process is unknown. A possible role of the thymus is suggested by the ability of thymosin to suppress anti-DNA. PMID- 3829454 TI - Soluble immune complexes in lupus mice: clearance from blood and estimation of formation rates. AB - Elevated levels of circulating immune complexes (IC) occur in patients with systemic lupus erythematosus (SLE) and in several strains of mice that spontaneously develop a lupus-like illness. An increase in circulating IC might occur as a result of increased IC formation or decreased IC clearance. Previous work with one murine lupus strain, NZB/W, demonstrated normal clearance of soluble IC. We studied the in vivo behavior of stable model IgG IC in two murine lupus strains. MRL/l and BXSB, and in two normal strains, C3H/HeN and BALB/c. IC were injected intravenously, and blood radioactivity was measured over 3 hr. A clearance curve was derived for each mouse using the Marquardt-Levenberg curve fitting method. A formula is derived which predicts the formation rate of IC in each animal from the blood level of IC and the clearance curve parameters. All mice exhibited biphasic exponential clearance of IC over 3 hr. Clearance of IC was significantly slower in MRL/l mice than in normal strains (P less than 0.02), and clearance in BXSB mice was significantly faster than in normals (P less than 0.02). However, the derived formula suggests that the observed differences in IC clearance have only a small effect on the blood levels of IC in the mice studied, and therefore suggests that the major factor which accounts for increased blood levels of IC in lupus mice is an increase in the IC formation rate. PMID- 3829455 TI - Prevalence and significance of hepatitis B virus antigens: expression in peripheral blood mononuclear cells in chronic active hepatitis. AB - One-hundred four chronic active hepatitis (CAH) patients were investigated for the expression of the hepatitis B virus (HBV) surface and core gene products (HBs Ag, HBc/HBe Ags) in peripheral blood mononuclear cells (PBMC). Two-thirds of 59 HBs antigenemic patients expressed HBs Ag in PBMC but 26% of cases positive for both anti-HBs and anti-HBc also expressed HBs Ag while none of the controls reacted. Among HBs antigenemic patients, only those who replicated HBV express the core gene products (HBc and/or HBe Ag) in PBMC, and high replicators did so more often than low replicators (P less than 0.05). The HBs Ag prevalence in PBMC, although slightly higher among HBe Ag/DNAp-positive cases could not be correlated with the intensity of HBV replication. In 16 cases (8 replicants and 8 nonreplicants) HBV DNA was detected by DNA hybridization spot test, while 8 controls devoid of HBV markers were negative. Both T and non-T cells reacted similarly for antigenic or genomic HBV markers. When the expression of HBV gene products in PBMC among 43 cases with HBs antigenemia was compared with that in the liver, a good correlation was found in 70% of cases for HBs Ag but in only 40% for HBc and HBe Ags. By contrast, among 38 cases lacking HBs Ag in the serum but positive for anti-HBc with or without anti-HBs, concordance between liver and PBMC expression of core gene products (69%) was better than for HBs antigenemic patients (40%). These data suggest that PBMC including T lymphocytes may represent the second-best HBV target and may mimic the steps of HBV cycle within hepatocytes. PMID- 3829456 TI - The fifth component of complement (C5) is necessary for maximal pulmonary leukocytosis in mice chronically exposed to cigarette smoke. AB - Recruitment of elastase-containing leukocytes to the alveoli and small airways of cigarette smokers is thought to be a major contributing factor in the pathogenesis of pulmonary emphysema. The fifth component of complement (C5), when activated, acts as a potent chemoattractant for these cells. We therefore examined the effect of chronic cigarette smoke exposure on numbers of pulmonary leukocytes in congenic strains of C5-deficient (C5-) and C5-sufficient (C5+) mice. Animals were exposed daily to 15 puffs (1.5 cigarettes) or unfiltered smoke from 2A1 Kentucky Reference cigarettes. After 8 weeks of exposure, the total number of bronchoalveolar leukocytes, recovered by lavage, was significantly increased in cigarette smoke-exposed animals (both C5- and C5+) vs their sham exposed counterparts. In addition, cigarette smoke exposure also significantly increased the total number of recovered alveolar polymorphonuclear leukocytes (PMNs) and the PMN chemotactic activity of cell-free bronchoalveolar lavage supernatants in both strains vs those of sham controls. However, total numbers of recovered bronchoalveolar leukocytes and PMNs in smoke-exposed animals were significantly greater (P less than 0.001) in C5+ mice than in their congenic C5- counterparts. In C5+ mice, acute smoke exposure caused an immediate but transient increase in chemotactic activity of lung fluids, which was not observed in C5- mice following acute smoke exposure. These results suggest that cigarette smoking induces an increase in leukocytes in the lungs of mice by mechanisms which are partly dependent on C5. PMID- 3829457 TI - Autoantibodies against liver cell membrane antigens detected by enzyme-linked immunosorbent assay in acute and chronic liver disease. AB - An enzyme-linked immunosorbent assay was developed to detect serum antibody binding to liver membrane antigen derived from human hepatoma cell line SK-Hep-1. When we tested sera from 214 patients with this assay, IgM antibodies were detected in 100% of patients with acute type A, but not with type B or non-A, non B hepatitis. IgM antibodies were also found in highest frequency (76%) and titer in patients with autoimmune chronic active hepatitis (CAH) among chronic liver disease groups. IgG antibodies occurred in over 50% of patients with acute type A hepatitis, type B chronic active liver disease (CALD), and autoimmune CAH. IgA antibodies were present in 43% of the patients with alcoholic liver disease, but were also seen in other patient groups. When freshly isolated rat hepatocytes were used as target cells, prevalences and titers similar to those obtained with SK-Hep-1 were found. The levels of serum membrane binding antibody were significantly reduced by the addition of human liver-specific membrane lipoprotein in all patient groups. In particular, IgM antibodies became negative in over 50% of patients with CALD (both type B and non-A, non-B) and autoimmune CAH, whereas in acute hepatitis over 50% lost their positivity for IgG antibody. These results indicate that circulating liver membrane binding autoantibodies are heterogeneous, occurring in hepatitis virus-induced acute and chronic liver disease as well as in autoimmune CAH. PMID- 3829459 TI - The genodermatoses. PMID- 3829458 TI - Depressed antibody responses to exogenous antigens in mice with lupus-like graft versus-host disease. AB - Previous work has established that a disease resembling systemic lupus erythematosus (SLE) can be induced in certain nonirradiated F1 mice undergoing a suitable graft-versus-host reaction (GVHR), e.g., (C57BL/10 X DBA/2)F1 mice injected with DBA/2 T cells. Here, we studied the antibody responses of such autoimmune graft-versus-host F1 mice to exogenous antigens, i.e., sheep erythrocytes, trinitrophenyl keyhole limpet hemocyanin, and levan. We found that primary antibody responses, in particular of IgG isotype, to the T-dependent antigens, sheep erythrocytes, and trinitrophenyl keyhole limpet hemocyanin were strongly suppressed during the entire observation period. Secondary anti-sheep erythrocyte responses, however, were normal, although the peak response was delayed for about 3 days. In contrast to the long-lasting depression of responses to T-dependent antigens, primary antibody responses to the T-independent antigen levan were depressed only at an early stage (i.e., week 2) of the graft-versus host reaction. In spite of their depressed antibody responses to exogenous antigens, the graft-versus-host F1 mice showed increased numbers of spleen cells spontaneously secreting IgG, and produced IgG autoantibodies characteristic of systemic lupus erythematosus. Mixing experiments performed in vitro with cultures involving graft-versus-host spleen cells revealed that the decreased antibody formation cannot be attributed to suppressor T cells nor to a defect in helper T cell function. Instead, the mechanism of decreased immune reactivity in SLE-like GVHR seems to operate at the level of B cells. Parallels between the decreased immune reactivity observed in lupus-like GVH disease and that described in human SLE as well as in spontaneously arising murine SLE are discussed. PMID- 3829460 TI - The ectodermal dysplasias. AB - In order to be considered an ectodermal dysplasia, a disorder should meet the following criteria: it must be congenital; it must be diffuse (not localized) and must involve the epidermis as well as at least one of its appendages; and it must not be progressive. Included is a discussion of some well-documented, as well as some newer, conditions about which there appears to exist enough information to make some decisions concerning their categorization. PMID- 3829461 TI - Genetic counseling. AB - In spite of all that has been discussed, there are no hard data documenting what influences a couple's decision to have more children after the birth of a child with a genetic disorder. It is likely that recurrence risk does not play a major role. The difference between a 25 per cent and a 50 per cent recurrence risk with each pregnancy probably does not have a great deal of personal significance. However, the burden of a disease is something to which every couple can relate. They know how the disease has affected the living situation of their family, and that is very meaningful. Because genetic counseling services are not standardized and the prediction of the outcome of these services is so difficult to quantify, third parties have not been very agreeable to pay for genetic counseling. I think it is important, however, to realize that the standardization of procedures may be less important than the emotional support given to a couple during the difficult time after they have been informed that their child has a genetic disease. PMID- 3829462 TI - Advances in Extracorporal Bloodtreatment: an Interface symposium. January 30-31, 1986, Oss, The Netherlands. Proceedings. PMID- 3829463 TI - Preliminary technical and clinical evaluation of a new hollow fiber dialyzer with a 5 microns thick cuprophan membrane. AB - In vitro and in vivo studies were performed on 10 dialyzers with 5 microns thick cuprophan membrane to evaluate hydraulic properties and permeability to solutes. Inlet and outlet pressures of the filter were measured at different blood flows to assess the resistance of the device and the end-to-end pressure drop. Hysolated ultrafiltration was performed to evaluate the spontaneous filtration at increasing blood flows, the ultrafiltration rate at different transmembrane pressures and, finally, the sieving coefficients for solutes. Standard hemodialysis was also performed to study the clearances throughout a 4-h session. During hysolated ultrafiltration the UF rate was increased up to 37 ml/min showing a very high hydraulic permeability of the membrane. The spontaneous filtration rates related to blood flow were quite low. Since the end-to-end pressure drop in the filter was also relatively low at high blood flow we may conclude that the geometry of the device is able to dissociate the influence of blood flow on the hydrostatic pressure inside the filter. This results in a easy modulation of the membrane permeability to water. Sievings were surprisingly high and clearances were stable along the dialysis session (BUN = 196 ml/min, creatinine = 161 ml/min and phosphate = 163 ml/min). PMID- 3829464 TI - Biocompatibility and clinical performance of a new modified cellulose membrane. AB - A new modified cellulose dialysis membrane (MC, 1.2 m2) in which less than 5% of cellulosic OH-groups are substituted by tertiary amino groups was tested in a 6 week clinical trial for biocompatibility and clinical performance and compared to both regenerated cellulose (RC, 1.2 m2) and cellulose acetate (CA, 1.0 m2). Ten patients on maintenance hemodialysis took part in the study; all hollow fiber modules were equally well tolerated and no adverse reactions were observed. Using MC/RC/CA, mean clearances after 15 min of hemodialysis (HD) amounted to 162/169/150 ml/min for urea, to 143/143/124 ml/min for creatinine, and to 104/107/84 ml/min for phosphate (QB = 200 ml/min, QD = 500 ml/min, UFR = 0). Mean drop of systolic blood pressure was 6/10/8 mmHg and mean decrease of heart rate averaged 3/3/3 beats per minute, respectively, during the first hour of HD as compared to starting conditions. Residual blood volume in the modules after HD was low and heparin consumption identical for all 3 membranes (34 IU/kg X h). Mean peak C3a generation for MC/RC/CA amounted to 1312/3486/3099 ng/ml, respectively; leucocyte and platelet counts dropped to a minimum of 67/24/47% and 81/86/91%, respectively during the first hour of HD as compared to initial values. Elastase release from PMNL and platelet factor 4 from platelets showed no significant differences between the membranes. In conclusion, the new MC membrane showed a significantly better biocompatibility and equally good clinical performance as compared to RC and CA. PMID- 3829465 TI - Granulocyte activation during hemodialysis. AB - Plasma levels of granulocyte lactoferrin, myeloperoxidase, and elastase in complex with alpha 1-proteinase inhibitor (E-alpha 1PI) during hemodialysis were investigated in patients undergoing maintenance hemodialysis with dialyzers made from cellulose hydrate, polymethylmethacrylate, cuprophan, ethylene-vinyl alcohol copolymer, polycarbonate, polyacrylonitrile or polysulfone. Polymethylmethacrylate membrane caused markedly elevated plasma lactoferrin (712.5 +/- 165.9 ng/ml) and E-alpha 1PI (681.8 +/- 102.6 ng/ml). Lower levels were observed in patients dialyzed with cuprophan or polycarbonate dialyzers, while cellulose hydrate membrane caused a maximal increase of the E-alpha 1PI levels (1,6590 +/- 256.8 ng/ml). Polyacrylonitrile membrane provoked minimal E alpha 1PI formation (267.6 +/- 79.6 ng/ml) but markedly elevated plasma levels of lactoferrin. However, polysulfone dialyzers displayed only very modest increases of the plasma E-alpha 1PI and lactoferrin levels. Plasma levels of myeloperoxidase were unchanged comparing the effects of the different dialyzers. We conclude that granulocyte activation during hemodialysis does not necessarily need anaphylatoxin formation. PMID- 3829466 TI - Research on dialyzers with improved biocompatibility. AB - Until now cellulosic membranes, especially Cuprophan, are still widely applied in the treatment of uremic patients. The success of this type of membrane for routine hemodialysis is related to a number of very useful properties with respect to performance, handling and biocompatibility. However, during dialysis Cuprophan membranes induce transient leucopenia which is closely connected with incidentally occurring pulmonary disfunction. These phenomena are thought to be complement mediated and Cuprophan has been recognized as an activator of complement. Synthetic membranes, such as PAN and PMMA show less complement activation than their cellulosic counterparts. Nevertheless these synthetic membranes cannot meet the performance quality of Cuprophan for routine dialysis and therefore dialyzers with synthetic membranes need special precaution to prevent excessive ultrafiltration. Consequently, research has been focussed on the development of a new cellulose-based dialyzer in which excellent performance suitable for routine dialysis is combined with improved biocompatibility. Two different approaches have been followed for the realization of this objective: The application of thinner membranes and The application of modified cellulose. PMID- 3829467 TI - The status of sorbent technology in hemodialysis treatment. AB - Twenty years ago an engineer in the aerospace field suggested the possibility of regenerating hemodialysate. This suggestion led to the development of the REDY Sorbent Hemodialysis System. In 1973, when the system was first introduced, the emphasis was on home hemodialysis. This motivation, combined with the relative portability and "no need for plumbing", led to the rapid introduction of the REDY System. Economically, the REDY System has not competed with central systems. However, the REDY System meets a special need for the preparation of individualized dialysate for the chronic and acute renal failure patient. Because of the small volume of the system (6 l), different dialysates can be readily prepared to adjust acid/base balance and normalize electrolyte concentrations. To simplify home hemodialysis, sorbent systems have now become available in which the dialysate side is disposable. This facilitates set-up and eliminates sterilization of the equipment. The Sorbent System can be reduced in size resulting in a continuously wearable hemodialysis system. PMID- 3829468 TI - Sorbent recycling of ultrafiltrate in man--a 45-week crossover study. AB - Chronic hemofiltration as a treatment for end stage renal disease has been shown to have several advantages over standard hemodialysis including: improvement in well being, increased strength, decrease in hypotensive episodes during treatment and decrease in the degree of hypertension between treatments. The major drawback of hemofiltration as practiced today is the need to replace the large quantities of ultrafiltrate formed with sterile, pyrogen-free replacement solution. We have solved this problem by passing the ultrafiltrate through a sterile REDY Sorbent Cartridge to remove urea, creatinine and "uremic toxins" prior to returning it to the patient via a closed system. We have called this system SRUF for Sorbent Recycling of Ultrafiltrate and have carried out an A-B-A, B-A-B cross-over study (15 week periods) comparing SRUF with standard hemodialysis in 8 ESRD patients previously treated with hemodialysis. Clinical and laboratory parameters measured included: hemoglobin, hematocrit, blood transfusion requirement, electrolytes, aluminum levels, liver function tests, enzymes, lipids, glucose, cardiac function studies, weight, blood pressure, urea generation, urea space, incidence of hypotension and muscle cramps, and questionnaires on well being. The results of these studies can be summarized as follows: SRUF can be performed by the hemodialysis staff as a routine, outpatient procedure for ESRD patients utilizing the machinery and tubing developed as part of this protocol. SRUF, when used as a chronic treatment for ESRD patients, has no deleterious effects and is associated with many of the same benefits ascribed to routine hemofiltration, including improvement in well being, decrease in cramping and decrease in symptomatic hypotension during treatment as compared to hemodialysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829469 TI - A continuous hemofiltration system using sorbents for hemofiltrate regeneration. AB - Plasma ultrafiltrate obtained by glomerular filtration undergoes tubular modification which leads to the elimination of toxic substances, excess water and electrolytes, and consequently maintains homeostasis. Using normal urine and the substances it contains as a reference, we have developed a wearable device capable of replacing both the renal excretion function and maintaining fluid and electrolyte equilibrium in uremics within acceptable biological limits. Our device includes a hemofilter allowing continuous plasma ultrafiltration and sorbents obtained from a Redy sorbent cartridge to treat 85% of the ultrafiltrate, whereas 15% of this UF is rejected untreated. After calculating the quantity of ultrafiltrate (about 13 l) containing an amount of waste products of metabolism equivalent to 24-h urine elimination, we determined in vitro the amount of sorbent required to eliminate these waste products from the ultrafiltrate (e.g., 20 g of urea/day) and we have evaluated the quantities of other substances which must be replaced using a tailored diet. This extra corporeal detoxification process was used in a uremic patient who had been on traditional hemodialysis for the past two years. The continuous treatment permitted maintenance of fluid and electrolyte equilibrium at the desired level and allowed rapid improvement of patient clinical status: elimination uf nausea, vomiting, diarrhea and edema, which had previously reappeared during the interdialytic periods, as well as a rapid decrease in heart size as ascites disappeared. In addition, the patient regained sexual drive and the ability to have an erection. In conclusion, traditional hemodialysis and hemofiltration techniques allow intermittent elimination of products retained by the body and reestablish nearly normal fluid and electrolyte balance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829470 TI - Urea removal by means of direct binding. AB - The availability of more efficient means for the removal of metabolic waste products, especially urea, from dialysates, body fluids or the gastrointestinal tract, is a key to new and simpler ways of treatment of renal failure patients. A research program of Organon Teknika in cooperation with AKZO Chemie has resulted in development of a new sorbent in which the active element is the ninhydrin entity. This product irreversibly binds urea under mild conditions without formation of side products. Also creatinine is bound. The sorbent proves to be non-toxic, non-pyrogenic, stable, insoluble and resistant against acid and sterilization procedures. In combination with amongst others a sorbent for phosphate and potassium developed earlier, the urea sorbent can be applied in dialysate regeneration. In vitro experiments show that for dialyses of four hours duration less than one kg of urea sorbent can be sufficient. Also other applications, e.g., oral use are mentioned. PMID- 3829471 TI - Response to apheresis: problems of assessment in immune disease. AB - Systemic lupus erythematosus (SLE) was one of the first diseases to be treated by plasmapheresis, because of the abundance of serological disturbances, and the strong evidence that tissue damage is related to the deposition of immune complexes. Early results in small, uncontrolled studies were promising, but no large-scale controlled trials have yet been reported. The conditions for which well-controlled trials are now available are either diseases affecting a single organ-system, in which clinical abnormalities are readily measurable, such as Guillain-Barre syndrome, or conditions in which serological abnormalities correlate closely with clinical disturbances, such as myasthenia gravis. Definitive answers are also available in rheumatoid arthritis, where many years of clinical experience have led to the development of well-validated indices of clinical activity. Many studies of SLE suggest that serological abnormalities, though important, are often not quantitatively linked to the clinical manifestations of the disease. Attempts to develop indices of clinical activity for SLE are handicapped by the range of different organ systems which may be involved. Progress in the development of clinical trials of plasmapheresis in SLE is most likely to result from multicenter cooperative groups, which will have the capacity to study large enough numbers of patients for adequate stratification, and from the development and validation of indices of clinical activity, which will make possible the quantitation of clinical response, and the measurement of the rate of accumulation of permanent organ damage. PMID- 3829472 TI - New advances in understanding the treatment of glomerulonephritis. AB - Glomerulonephritis is the commonest cause of renal failure, yet there is little understanding as to its etiology except that immunological mechanisms are thought to be important. This has considerably hampered efforts to develop appropriate treatment. Only in rapidly progressive nephritis (RPGN) has clear progress been made as a result a radical improvement in prognosis obtained. In some forms of RPGN aberrant immunological mechanisms have been identified and their components characterized. The best defined are those in which auto-immune responses are generated and lead directly or indirectly to renal injury. As yet, only humoral auto-immune responses are easy to characterize in man; technical difficulties surround attempts to identify cellular auto-immune reactants. However, both can be investigated in animal experimental models. This presentation will focus on the more recent studies of the auto-immune responses in human RPGN and the possible contribution that these (together with those derived from animal studies) make towards a better understanding of the treatment of glomerulonephritis. PMID- 3829473 TI - Methods for selective blood component removal. AB - The objective of therapeutic Extra Corporeal Blood Treatment (ECBT) is the removal or conversion of unwanted (mostly pathogenic) substances present in blood. At present ECBT is generally performed by using physical techniques such as dialysis, membrane filtration and centrifugation. These techniques are characterized by a low level of specificity leading to simultaneous removal of useful compounds. Administration of large quantities of substitution fluids (e.g., plasma-exchange, hemofiltration), is therefore often necessary. Higher levels of specificity can be obtained by using specific binders. Recent results obtained with synthetic polymers show the high potential of this technique. The use of biological substances, such as enzymes and antibodies, will enable an almost 100% level of specificity. It is obvious that the natural defence mechanism of the patient to be treated should not be triggered by the compounds used. This can be realized by either immobilizing the biological compounds on a solid phase, or by a physical separation between the compounds and the blood (e.g., by membranes). The former method seems more favorable since the efficiency will be optimal. The problems encountered, however, are numerous. PMID- 3829474 TI - Clinical sequelae of complement activation in hemodialysis. AB - During clinical hemodialysis, interactions between blood and dialysis membranes lead to the activation of several pathways such as the coagulation, kallikrein and complement pathways. The sum of these interactions defines the biocompatibility of the dialysis membrane; Cuprophane membranes, the most widely used dialysis membranes elicit intense blood-membrane interactions. Complement activation can be measured by determining the concentration of the activated third and fifth component of the complement cascade, namely C3a and C5a. These active products lead to the well known neutropenia seen during the early phase of dialysis. However, the neutropenia is only the most visible manifestation of the effects of complement activation. C5a-induced secretion of granule enzymes from neutrophils and their subsequent desensitization to further chemotaxis and phagocytosis may be an important factor in the incidence of infections in the dialysis patient. Endothelial cell damage by complement stimulated granulocytes mediated via superoxide anion may also play a role in the pulmonary dysfunction seen in dialysis patients, and recent evidence suggests that complement products may lead to cardiac dysfunction manifested by impaired ventricular contractility. Although some of these events may not be mediated directly by activated complement products, recent studies suggest that they play a role in the activation of several other pathways and pathophysiological process. PMID- 3829475 TI - Rapid improvement in severe lupus glomerular lesions following intensive plasma exchange associated with immunosuppression. PMID- 3829476 TI - Statistical methods for predicting the progression of chronic renal failure in children. PMID- 3829477 TI - Prediction of urinary flow rate from urine creatinine concentration. PMID- 3829478 TI - The relationship between peritoneal glucose absorption and body fluid loss by ultrafiltration during continuous ambulatory peritoneal dialysis. AB - Eight continuous ambulatory peritoneal dialysis (CAPD) patients were studied during six consecutive days using dialysate with a different glucose concentration on each day. For all dialysate glucose concentrations ranging from 70 to 198 mmol/l, an inverse linear relationship was found between the percentage of absorbed glucose and the ultrafiltration rate. In each patient a linear correlation was demonstrated between the dialysate glucose concentration and the quantity of body fluid removed by ultrafiltration. Therefore the dialysate glucose concentration without net removal of fluid could be calculated for each patient: DGCUF = 0. This DGCUF = 0 is a parameter of the relationship between the transport of water and glucose over the peritoneal membrane and can thus be considered a marker of the individual ultrafiltration. The calculated DGCUF = 0 was compared with DGCUF = 0 predicted from the glucose absorption using the equation as derived from our data: DGCUF = 0 (mmol/l) = 2.1 X glucose absorption (%) -67 (mmol/l). As marked day to day variations were found, the results of these predicted DGCUF = 0 should be interpreted cautiously when used for long term follow-up of peritoneal permeability in CAPD patients. PMID- 3829479 TI - The effect of dietary protein on glomerular filtration rate in normal subjects. AB - The acute effect of the ingestion of 90 g of protein as meat and as milk protein (Casilan) on glomerular filtration rate (assessed by creatinine clearance) was examined in healthy subjects. The creatinine clearance increased 1.5 hours after the ingestion of meat and remained elevated for a further 2.5 hours. The mean maximal increase in creatinine clearance was 18 ml/min. Casilan on the other hand did not produce a significant increase in the creatinine clearance. When 6 subjects ingested 90 g of protein as Casilan daily for 5 days, the creatinine clearance increased after a delay of 3 to 4 days. When the same subjects increased their meat protein intake by 90 g as meat daily for 5 days, the creatinine clearance increased from the first day (by 23 ml/min) and remained elevated throughout the 5 days of study. We conclude that the effect of protein on glomerular filtration rate depends on the type of protein. PMID- 3829480 TI - Tubular proteinuria in IgA glomerulonephritis. AB - In the renal biopsy samples of some patients with IgA glomerulonephritis (IgA GN), tubulointerstitial changes and a significant correlation between these changes and the serum creatinine levels had been observed earlier. In order to get an insight into the function of the tubules, 45 patients with IgA GN have been examined for proteinuria with special reference to low molecular weight (LMW) proteins, also called tubular proteins using sodium-dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE). Thirty-seven of the 45 patients had proteinuria (200-1890 mg/day). On the basis of the middle molecular weight/high molecular weight (MMW/HMW) protein ratio, the proteinuria was non selective in 28. Twenty-nine patients had 40-200 mg LMW protein/day in the urine. There was a statistically significant correlation between the tubulointerstitial changes seen in the renal biopsy samples (characterized by the tubulointerstitial index) and the tubular proteinuria. On the basis of these results it is suggested that in most patients with IgA GN there is, in addition to the glomerular lesion, also morphological and functional tubulointerstitial damage, which is in connection with the progression of the disease. PMID- 3829481 TI - Membranous glomerulonephritis in rheumatoid arthritis not related to gold or D penicillamine therapy: a report of four cases and review of the literature. AB - In a series of 96 patients with membranous glomerulonephritis (MGN) there were 14 who had concomitant rheumatoid arthritis. Ten of these had been treated with gold or D-penicillamine; in four patients neither of these drugs could have been responsible for the MGN. One of them received intrasynovial osmium tetroxide two months before the clinical onset of MGN. Three of the patients had positive rheumatoid factor. HLA-type was examined in three patients and all showed B27 antigen but not DR3. No patient developed signs of systemic lupus erythematosus during the follow-up (mean 5.9 years). In two patients MGN persisted as judged from urinary abnormalities, one patient recovered after a relapse period and one developed secondary amyloidosis. PMID- 3829482 TI - Angiotensin I in peritoneal dialysis fluid improved hypotension: a case report. AB - In a bilateral nephrectomized woman undergoing continuous ambulatory peritoneal dialysis, angiotensin I instilled intraperitoneally with the dialysis fluid prevented the fall in systemic blood pressure at peritoneal dialysis and elevated, in high doses, the systemic blood pressure in a dose-dependent manner over the whole observation period. The blood pressure lowering effect could be completely reversed by infusion of the angiotensin II receptor antagonist, saralasin. However, some side effects observed, like increased motility of gut, diarrhea and abdominal pain probably will limit the application of the drug in clinical routine. PMID- 3829483 TI - Position as a variable for cardiovascular responses during exercise. AB - Twenty-one normal young male subjects underwent resting and exercise (bicycle) radionuclide angiography in the full supine and 70 degrees upright tilt positions in order to examine the effects of position on left ventricular size and performance, hemodynamics, and exercise duration. All subjects also underwent full (90 degrees) upright bicycle ergometry with respiratory gas analysis to establish the level of maximal exercise capacity for each. Body position significantly (p less than 0.05) affected resting and exercise cardiovascular parameters. End-diastolic and endsystolic left ventricular volumes and stroke volume were larger in the supine position, both at rest and during exercise. The cardiac output at rest and during exercise were comparable for the two positions; an increase in resting and exercise heart rate in the 70 degrees tilt position compensated for the reduced stroke volume of this posture. At maximal exercise, the 70 degrees upright position was associated with a greater response in left ventricular ejection fraction, otherwise this parameter was not position related. Exercise capacity, in terms of duration and workload, was significantly higher in the supine (1870 +/- 390 s) and full upright (1830 +/- 250 s) positions than in the 70 degrees tilt position (1730 +/- 260 s). Changes in body position significantly alter parameters of ventricular, cardiovascular, and exercise performance. PMID- 3829484 TI - Bidirectional flow in congenital ventricular septal defect: a Doppler echocardiographic study. AB - The purpose of this study was to demonstrate the value of combined two dimensional and pulsed Doppler echocardiography (echo) in localizing and recording bidirectional flow in congenital ventricular septal defect. Eight children, aged 8 months to 16 years, with clinical signs of a ventricular septal defect, underwent two-dimensional and pulsed Doppler echo study prior to cardiac catheterization. The ventricular septal defect was documented anatomically by two dimensional echo in all eight patients. Flow patterns in systole and diastole through the ventricular septal defect and on both sides of the defect were carefully studied. In all eight children, systolic, high velocity, pathologic, left to right flow was documented when the sampling volume was positioned on the right ventricular side of the defect. When the sampling volume was positioned inside the defect, to and fro flow, left to right in systole and right to left in diastole, was observed. In children with moderate to large defects, the diastolic flow had a peak in early diastole. Increased pressure in the right ventricle over the left ventricle during the same period was demonstrated by cardiac catheterization and coincided with the Doppler flow. The direction of flow across the defect was affected by the size of the defect and the magnitude of the net shunt. Two-dimensional and pulsed echo Doppler were shown to be useful in demonstrating the ventricular septal defect and estimating its size and hemodynamic significance noninvasively. PMID- 3829485 TI - Impaired left ventricular rapid filling during exercise in patients with hypertrophic cardiomyopathy. AB - The influence of exercise on left ventricular diastolic filling was evaluated in 14 patients with hypertrophic cardiomyopathy (HCM) and 14 normal controls (NC) by dynamic exercise echocardiography. Using X-Y digitizer and computer, normalized peak rate of change of the left ventricular dimension during systole (pVs) and the rapid filling phase (pVd) were determined from the left ventricular echocardiograms at rest and during exercise when heart rate reached 100 beats/min. At rest and during exercise, pVs was significantly higher in HCM (3.2 +/- 0.4/s at rest, 4.3 +/- 1.4/s during exercise) than in NC (2.4 +/- 0.5/s at rest, 3.0 +/- 0.4s during exercise) (p less than 0.001, p less than 0.001, respectively), but pVd in HCM (4.2 +/- 1.0/s at rest, 5.8 +/- 1.0/s during exercise) was not significantly different from that in NC (4.1 +/- 1.0/s at rest, 6.0 +/- 0.7/s during exercise). The ratio of pVd to pVs (pVd/pVs) in HCM did not show significant increment during exercise (1.35 +/- 0.38 to 1.43 +/- 0.35), though that ratio in NC was significantly increased by exercise (1.67 +/- 0.22/s to 1.97 +/- 0.19/s, p less than 0.001). There was no correlation between pVd and the degree of left ventricular hypertrophy. These results suggest that diastolic reserve to exercise is depressed in HCM and that other factors besides left ventricular hypertrophy may account for diastolic abnormality. PMID- 3829486 TI - Asynergy and left ventricular performance in dilative cardiomyopathy. AB - The purpose of this work was to evaluate the presence and importance of asynergy in dilative cardiomyopathy. A semiautomatized analysis of left ventriculograms was performed in 18 cases, the morphology of longitudinal and transverse axes time-length curves was evaluated, and mathematical indices of asynchrony and hypokinesis were defined. Ten normal subjects and 9 patients affected by aortic regurgitation were used as controls. In dilative cardiomyopathy, anomalous (polyphasic) time-length curves were present in 55% of the cases, while they were absent in aortic regurgitation and in all normal subjects but one. In addition, the asynchrony index was slightly increased and the hypokinesis index significantly increased (28.8 +/- 7.2% vs. 17.8 +/- 7.1%, p less than 0.001). A negative correlation existed between the asynchrony index and the ejection fraction (r = -0.483, p less than 0.05) and both the ejection fraction and the maximum normalized velocity of contraction were reduced in the patients with the anomalous curves (29.7 +/- 6.9% vs. 46.0 +/- 11.5%, p less than 0.01; 1.66 +/- 0.52 s-1 vs. 2.86 +/- 1.33 s-1, p less than 0.02). It was concluded that asynergy, and especially asynchrony, is frequent in dilative cardiomyopathy and it is strongly associated with a major impairment of overall left ventricular function. PMID- 3829487 TI - Does "physiologic" mitral valve prolapse occur with acute blood loss? AB - Intravascular volume changes are reported to affect the clinical and echocardiographic spectrum of patients with known mitral valve prolapse syndrome (MVPS). We tested whether acute blood loss can produce MVP in normal adults. Twenty-one subjects were studied with Doppler echocardiography before and after donating 550 ml whole blood. Two subjects demonstrated minimal (1+) prolapse postphlebotomy, but in only one echocardiographic view, and without mitral regurgitation by Doppler. Three subjects demonstrated slight, early (not late or pansystolic) mitral regurgitation after phlebotomy, but without prolapse. Left atrial dimensions decreased significantly after the blood donation but the left ventricular size was not significantly smaller. The 1+ MVP is within the range of superior systolic motion found in 35% of a normal population, free of heart disease, and without intervention. We find no evidence in our study or in the literature that pathologic degrees of MVP can be produced in normal subjects by physiologic alteration in blood volume. PMID- 3829488 TI - Effect of spontaneous reperfusion on myocardial infarct size. AB - The effect of perfusion of the infarct artery on myocardial infarct size was studied in 39 patients who had not received interventive therapy. At predischarge coronary angiography, 19 patients had subtotal and 20 total occlusion of the infarct artery. The early ST-segment elevation recorded on a 12-lead electrocardiogram was used as an index of the amount of initially jeopardized myocardium. Infarct size was estimated by peak serum creatine kinase and, at discharge, by a QRS score, sigma Q and sigma R on a 12-lead electrocardiogram, and by radionuclide global and infarct segment left ventricular ejection fraction. Despite a similar degree of initial ischemia (sigma ST), infarct size was smaller in the 11 patients with anterior infarction and subtotal occlusion than in the 9 patients with anterior infarction and total occlusion when measured by peak serum creatine kinase (2114 +/- 1192 U/l vs. 3653 +/- 1059 U/l, p less than 0.02), QRS score (5.0 +/- 2.7 vs. 9.6 +/- 3.5, p less than 0.01), sigma Q (3.25 +/- 2.74 mV vs. 5.92 +/- 3.56 mV, p less than 0.10), sigma R (4.36 +/- 1.25 mV vs. 2.16 +/- 0.91 mV, p less than 0.001), global left ventricular ejection fraction (45.0 +/- 12.2% vs. 33.4 +/- 6.7%, p less than 0.05), and infarct segment ejection fraction (40.4 +/- 8.2% vs. 30.3 +/- 5.4%, p less than 0.05). In the inferior infarct patients, both the degree of initial ischemia and final infarct size were similar in the 8 patients with subtotal and in the 11 patients with total occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829489 TI - The relationship of ventricular arrhythmias to the angiographically and scintigraphically estimated extent of ventricular damage late after myocardial infarction. AB - In order to study the quantitative relationship of ventricular arrhythmias to myocardial damage and ischemia, 61 patients with a previous myocardial infarction (at least 6 months previously) were studied by 24-hour ambulatory ECG monitoring, cardiac catheterization, and thallium-201 scintigraphy. Thirty-five patients (57%) had no ectopic beats or only infrequent, unifocal ones and 26 patients (43%) had complex ventricular arrhythmias. Left ventricular function was lower in the latter (p less than 0.05), but the number of diseased vessels did not differ in the two groups. The reduction of thallium activity in the infarct area was more marked in patients with complex arrhythmias (p less than 0.001). Multiple thallium defects were not more common in arrhythmia patients, however. These data support the view that complex ventricular arrhythmias are more closely related to the severity of ventricular damage than the presence of myocardial ischemia remote to the area of previous infarction. PMID- 3829490 TI - Acute and chronic pulmonary thromboembolism: current perspectives. Part VIII: Summary and references. PMID- 3829491 TI - Isolated pulmonary valve prolapse: a sign of pulmonary hypertension. AB - Isolated pulmonary valve prolapse may be a sign of pulmonary hypertension. Three patients with pulmonary hypertension as a result of left ventricular failure, chronic obstructive pulmonary disease, and primary pulmonary hypertension, respectively, are described in the case reports. It is likely that the morphological change of the pulmonary valve is due to exaggeration of the normal convexity of the elastic pulmonary leaflets as a result of a high pulmonary artery diastolic pressure. This two-dimensional echocardiographic sign may prove to be a useful qualitative hallmark for pulmonary hypertension. Present methods to detect pulmonary hypertension by two-dimensional echocardiography rely on remote findings of right heart abnormalities or changes in systolic time intervals. Pulmonic valve prolapse is the first direct sign of pulmonary hypertension found on two-dimensional echocardiography. PMID- 3829492 TI - Double-chambered right ventricle with pulmonary valve endocarditis. AB - A rare case of isolated pulmonary valve endocarditis associated with a double chambered right ventricle in a nonaddict, was diagnosed on two-dimensional echocardiography and cardiac catheterization and angiography. The patient was successfully operated and the above findings confirmed on the operation table. PMID- 3829493 TI - Razoxane, metastasis and adjuvant chemotherapy. PMID- 3829494 TI - Effect of razoxane on metastases from colorectal cancer. AB - At a median follow-up of 5 years, adjuvant razoxane (125 mg b.d.) given 5 days/week indefinitely following resection of colorectal cancer provided no benefit in terms of survival or recurrence for Dukes' A or B patients when compared to untreated controls. However in Dukes' C patients this treatment reduced the recurrence rate (P = 0.05) and possibly increased survival time (P = 0.08). Analysis now of the development of metastases in this trial which entered 272 patients over 7 years shows that in the Dukes' C group the incidence of liver metastases in the razoxane-treated patients is only about half that of the untreated patients (18 per cent versus 34 per cent) and that the time to first appearance of the liver metastases is twice as long in the razoxane-treated group as it is in the untreated group (80 weeks versus 40 weeks). It is concluded that the benefit of adjuvant razoxane observed in the Dukes' C patients is due to the antimetastatic activity of the drug in reducing and slowing down the development of hepatic secondaries. PMID- 3829495 TI - Isolation of metastatic B16 melanoma variants using anti-Met 72 monoclonal antibodies and flow cytometry. AB - Analysis of a number of B16 melanoma clones has revealed a high correlation between metastatic activity and the quantitative expression of a 72,000 dalton glycoprotein, Met 72. In the present study, metastatic tumor cell variants have been directly isolated from a heterogeneous, poorly metastatic melanoma (B16-F1) by anti-Met 72 monclonal antibodies and cell sorting procedures. These studies provide direct proof that Met-72 antigens are in fact surface markers of B16 melanoma metastatic variants and may provide the means of monitoring their presence, influence and autonomy during tumor progression. PMID- 3829496 TI - Lewis lung carcinoma (3LL) cells treated in vitro with ultraviolet radiation show reduced metastatic ability due to an augmented immunogenicity. AB - The metastatic ability of 3LL tumor following in vitro irradiation with ultraviolet (u.v.) light was studied. Tumor cells were exposed to two courses of u.v.-irradiation (3LL X 2u.v. cells) and after two weeks of culture they were inoculated intravenously (i.v.) into syngeneic mice. These cells produced significantly fewer pulmonary metastases than the untreated population. In addition, intrafootpad (i.f.p.) injections of 3LL X 2u.v. cells into immunocompetent animals induced tumors only in 40 per cent of recipients. Interestingly, in normal mice with progressively growing 3LL X 2u.v. tumors, the formation of spontaneous pulmonary metastases was prevented, whereas metastatic foci were observed in 70 per cent of the nude recipients. The metastatic properties of u.v.-treated tumor cells were further analysed by using individual clones with varying immunogenicity. We found that variants with augmented immunogenicity also showed a parallel decrease in metastatic potential. Studies on H-2 antigen expression in different clones revealed that immunogenic and low metastatic variants expressed levels of H-2 antigens higher than the tumorigenic and metastatic clones. Finally, by using cyclophosphamide (Cy) treatment and adoptive transfer of immune spleen cells were able to eradicate macroscopic 3LL pulmonary metastasis. These results demonstrate that the decrease of metastatic ability in u.v.-treated cells was mainly due to an increase in their immunogenicity and H-2 antigen expression. PMID- 3829497 TI - Potentiation of CCNU activity by misonidazole in metastases. AB - The KHT sarcoma is a model system in which metastases can be studied in multiple organs without prior clonal selection. The present series of experiments were designed to evaluate and compare the extent of potentiation of chemotherapeutic agent activity by radiosensitizers when KHT sarcoma cells were grown in different anatomical sites. In these studies the effect of combining misonidazole (MISO) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) on KHT lung nodules and ovarian metastases was determined. Ovarian metastases were a consequence of the direct spread of tumor cells growing as lung nodules. Once established, KHT cells in the lungs and ovaries grew with a similar doubling time (1-2 days). Response of tumors at either site to chemotherapy in the presence or absence of a sensitizer was assessed using an in vivo to in vitro excision assay. MISO (1.0 mmol/kg) was administered simultaneously with a range of CCNU doses and survival of clonogenic tumor cells was measured 24 h after treatment. The results demonstrate that the addition of MISO to CCNU treatment potentiated the action of this chemotherapeutic agent at both tumor sites although greater cell kill enhancement occurred in the ovarian metastases. In the lung nodules, when combined with CCNU, a 1.0 mmol/kg dose of MISO was found to yield a dose modifying factor (DMF) of approximately 1.3. The same combination resulted in a DMF of approximately 1.8 in the ovarian metastases. This difference in DMF was not a result of an intrinsic difference in sensitivity to CCNU since cells grown at either site gave rise to the same dose response curve. Rather the difference in dose modification by MISO appears to be a consequence of the larger fraction of radiobiologically hypoxic cells in the ovarian tumors (approximately 50 per cent) than in the lung nodules (approximately 5 per cent) at the time of treatment. These findings suggest the use of drug-sensitizer combinations to treat disseminated disease and provide further evidence for the requirement of hypoxia in chemopotentiation by radiosensitizers. PMID- 3829498 TI - Tumor cell-platelet interactions in vitro and their relationship to in vivo arrest of hematogenously circulating tumor cells. AB - Aggregation of rat platelets was induced in vitro by homologous rat Walker 256 carcinosarcoma cells and the extent of tumor cell-platelet interactions examined ultrastructurally. By 30s there was surface contact between unstimulated platelets and tumor cell microvilli. By midphase aggregation (2-3 min) tumor cells became enmeshed within expanding platelet aggregates. Tumor cell microvilli and platelet pseudopodia interdigitated as aggregation progressed. During the later stages of aggregation (6-10 min) tumor cells formed large processes which penetrated deep into the aggregate. Platelet activation (i.e. degranulation) occurred in gradient fashion and was concentrated near tumor cell membrane sites involved in process formation. At these later stages tumor cells near the aggregate periphery were found to have engulfed platelets or platelet fragments. Tumor cell-platelet interactions in the pulmonary microvasculature were also studied in vivo following injection of murine Lewis lung carcinoma, 16C mammary adenocarcinoma, and B16 amelanotic melanoma tumor cells into the tail vein. Platelets demonstrated a biphasic association with arrested tumor cells with peak interactions occurring at 10-30 min and 4-24 h. Ultrastructurally, tumor cells exhibited newly formed processes which interdigitated with the platelet aggregate. Such processes formed only in areas of contact with platelets and not in areas of contact with endothelial cells or other blood elements (i.e. erythrocytes, polymorphonuclear leukocytes). Numerous tumor cell mitochondria were concentrated in the areas of greatest platelet-tumor cell process activity. At early time intervals (2-10 min), intravascular platelet degranulation was observed primarily in platelets associated with tumor cell processes. Tumor cells also were found to have engulfed platelet fragments in vivo. PMID- 3829499 TI - Slipped capital femoral epiphysis in southern Sweden. Long-term results after nailing/pinning. AB - One hundred seventy-two patients with 204 slipped capital femoral epiphyses treated with nailing or pinning were evaluated an average of 28 years after surgery. Follow-up evaluation was obtained by questionnaire in 153 cases (181 hips) and by clinical and radiographic reexamination in 132 cases (157 hips). Segmental collapse was seen in four of 179 hips nailed/pinned in situ and in four of 25 hips operated after reduction. This was the only early complication associated with problems at reexamination. Arthrosis was twice as frequent after reduction (53%) than after fixation in situ (24%). The clinical and radiographic results were better than those from the same region after other methods of treatment. Nailing or pinning in situ is the method of choice when possible, regardless of the degree of slipping. Bilateral slipping was found in 67% of the hips; therefore, prophylactic pinning of the contralateral hip is indicated in cases with unilateral slipping. PMID- 3829500 TI - Extrinsic femoral artery occlusion following internal fixation of an acetabular fracture. A case report. AB - Vascular injury is one of the drastic complications that can arise from internal fixation of acetabular fractures. A 29-year-old, obese man sustained multiple trauma, including a displaced transverse acetabular fracture. Extreme obesity made adequate exposure to the posterior acetabular area difficult, causing placement of a large lag screw in malposition, such that it penetrated the superior pubic ramus at a point adjacent to the superficial femoral artery. Angiography, immediately after operation, revealed extrinsic compression of this vessel. The lag screw was successfully repositioned, with immediate return of vessel patency and no sequelae. The surgical approach and anatomic landmarks for placement of posterior to anterior lag screws are reviewed in an effort to prevent this complication. PMID- 3829501 TI - Correction of valgus knee deformity with a supracondylar V osteotomy. AB - Valgus deformities at the knee can be successfully corrected with V-shaped supracondylar osteotomy. The advantages of this relatively simple technique are low morbidity, good stability with early weight-bearing, no need for internal fixation, and ability to adjust alignment with postoperative cast. Healing is relatively rapid (two months), and the range of motion returns (two months after cast removal) to preoperative values. This technique proved useful for deformities in both young and old patients with osteoarthritis. This is a preliminary report of the surgical technique, postoperative management, and short term results of a prospectively evaluated series of 14 consecutive cases. PMID- 3829502 TI - Fracture of the tibia complicated by acute compartment syndrome. AB - A consecutive series of 32 patients with tibia fractures complicated by compartment syndrome was treated with fasciotomy. One group was also treated with closed reduction of the fracture and cast immobilization and compared with a comparable group treated with internal fixation without case immobilization after fasciotomy. All other patients were treated with fasciotomy and reduction followed with either external skeletal fixation, pins and plaster, or skeletal traction. Care of the open fasciotomy incisions, observation of the neurovascular status of the limb, and rehabilitation of the extremity were facilitated by internal fixation operations without subsequent external cast immobilization. The anatomic and functional results in this group were better than those treated with fasciotomy and cast immobilization. All fractures were united by 20 weeks. Complications in both groups were similar, although one deep infection, which was resolved with appropriate treatment, occurred in the group treated with internal fixation. Six open tibia fractures were treated with external skeletal fixation after fasciotomy; the results were less satisfactory, but the initial injuries were also more severe in this group. Patients with closed tibial fractures complicated by compartment syndromes should be treated expeditiously with fasciotomy, followed by stable internal fixation. PMID- 3829503 TI - Pneumatic nailgun injuries to the knee. AB - Injuries from pneumatic nailguns have increased over the past ten years. From a review of clinical records and a cadaver study it was determined that no permanent clinical disability may ensue. Based on long-term results, it was found that treatment should be simple removal of the nail, after radiographs have ruled out retained metal fragments. Arthroscopy may play a role in treatment of complications. PMID- 3829504 TI - Improved external skeletal fixation for unstable fractures. AB - A novel external fixation device (EX-FI-RE) is described with which it is possible to manipulate fracture fragments under complete control of stability. EX FI-RE is a unilateral, telescopic, single-frame device, consisting of two functionally separate components, the correction unit and the fixation unit. The correction unit allows reduction of angular, parallel, and longitudinal dislocations. Sustained transverse compression of an oblique fracture is a special feature. After reduction has been achieved, pin retainers and transcutaneous pins can be transferred to the fixation unit without change of position of the fracture fragments. Its mechanical behavior under load is analyzed and compared with that of a Hoffman-Vidal Adrey quadrilateral system. In axial loading, the two systems were similar within the loading range of 0-1000 N. In the anteroposterior plane, the stiffness ratio of the EX-FI-RE was significantly higher. In lateral bending and axial loading, the two systems were comparable. The turning moment required to induce a 5 degree angular deformation of the quadrilateral system was 4.8 +/- 0.6 Nm; the corresponding figure for the unilateral system was 8.8 +/- 0.4 Nm. After more than two years of clinical experience with this new device, closed atraumatic reduction, sustained transverse compression, and early weight-bearing were found to promote union. There were no pin tract infections or mechanical failures in more than 70 cases treated. PMID- 3829505 TI - Traumatic venous aneurysm. Case report. AB - A traumatic venous aneurysm within the greater saphenous vein occurred in a 15 year-old hockey player. The patient had early diagnosis and surgical excision of the lesion. Venous aneurysm is a rare clinical entity and a pathologic curiosity in the absence of varicose veins. It can lead to serious complications, such as pulmonary embolism, portal hypertension, and rupture. Early diagnosis with the use of venography and surgical excision of the lesion can prevent major complications. PMID- 3829506 TI - The tarsal tunnel syndrome. Report of two cases of unusual cause. AB - Since Keck described the tarsal tunnel syndrome (TTS) in 1962, it has been one of the most frequently diagnosed of the entrapment neuropathies. TTS is usually of unknown origin. This is a report of two unusual cases: TTS caused by neurilemmoma in a 33-year-old woman, and TTS caused by subperiosteal ganglion in a 14-year-old girl. The symptoms were relieved, in both instances, with surgical excision. PMID- 3829507 TI - Nutritional status and wound healing in lower extremity amputations. AB - This prospective study examines the importance of nutritional status in 41 consecutive patients with lower extremity amputations proximal to the Symes level. The nutritional status of the patients was assessed by evaluating serum albumin levels and total lymphocyte counts, proven indices of nutritional status. Fifteen of 16 patients with normal nutritional parameters healed their amputations uneventfully, whereas 11 of 25 malnourished patients suffered either local or systemic postoperative complications. The difference in the complication rate between the nourished and malnourished groups is statistically significant (p less than 0.05). Malnutrition adversely affects the prognosis for healing lower extremity amputations, but it seems to be less detrimental to wound healing in the more proximal amputations, where blood flow is superior. Based on these findings, it is recommended that patients being admitted for lower extremity amputation should be screened at the time of admission, and those with laboratory parameters indicative of malnutrition should have elective surgery postponed until their malnourished state is corrected. Patients requiring urgent surgical treatment should probably receive supplemental nourishment in the perioperative period. PMID- 3829508 TI - Injuries of the atlas and axis. A follow-up study of 85 axis and 10 atlas fractures. AB - In a follow-up study of ten atlas and 85 axis fractures, 12% had residual symptoms in the form of local and radiating cervical pain. The residual symptoms were interpreted as a sign of a mild demyelinating process initiated by the trauma of the medulla. At least 22% of the accidents occurred while the person was under the influence of drugs or alcohol. Therefore, a wide range of residual symptoms (progressive or nonprogressive) could be attributed in part to abuse of drugs and alcohol. A permanent measurable loss of motion occurred following injury to the atlas or axis, irrespective of the modality of treatment. Cervical fusion created the greatest loss of motion and collar immobilization the least. Skull traction and a halo-vest were intermediate in patients with loss of motion, and the degree of loss of range was essentially equal. Residual symptoms, including pain, were found in 20% of those treated with a collar, 40% of those treated with surgical methods, 5% of those treated with traction, and 5% of those treated with a Halo-vest. Residual symptoms did not correlate at all with degree of displacement of the original fracture. PMID- 3829509 TI - Fracture-dislocation of the thoracic spine without neurologic lesion. AB - An 18-year-old man with a fracture-dislocation of the thoracic spine showed remarkable displacement, but without neurologic complications. The halo-femoral traction allowed a reduction, which has been only partially maintained. Despite this, the clinical result is satisfactory. The lesion appears to be more common than the few cases published in the literature would suggest. PMID- 3829510 TI - Effects of repetitive loading on the integrity of porous coatings. AB - In spite of the increasing numbers of porous coated total hip femoral components implanted each year, little is known about the shear strength or fatigue performance of the interface between coating and implant substrate. The appearance of loose beads in clinical follow-up roentgenograms suggests that shear failure of bead welds does occur and that the coating could be a weak link in the implant-bone or implant-cement-bone system. In this study, a test specimen design and test regimen for quasistatic and fatigue testing of implant-porous coating shear properties was developed. Both cobalt-chromium (CoCr) alloy and titanium (Ti) bead-substrate interfaces of various surface designs were studied. Results showed that static bead-substrate interface properties for both titanium and CoCr specimens were superior to published values of bone-bead shear strengths. By comparison, fatigue tests showed that the strength of bead welds on a smooth substrate was inadequate, with a preferential failure site being between beads and substrate rather than between beads and cement or beads and bone. However, implant surface contours or a bead recess were found to protect the bead welds, and specimens with those features successfully withstood ten million dynamic loading cycles. PMID- 3829511 TI - [Autonomic neuropathy with dissociation of dysfunction of the sympathetic nervous system--a case report]. PMID- 3829512 TI - [An unusual case associated with atrophy of the caudate nucleus, acanthocytosis and severe muscular wasting--neuroacanthocytosis syndrome]. PMID- 3829513 TI - [Short-term treatment of progressive supranuclear palsy with amitriptyline]. PMID- 3829514 TI - [Examination of ADH in a case of brain death]. PMID- 3829515 TI - [A case of myotonic dystrophy associated with SIADH]. PMID- 3829516 TI - [A case of postprandial hypoglycemia combined with convulsion and a sharp-and slow-wave complex on the EEG]. PMID- 3829517 TI - [Magnetic resonance imaging of spinal lesions in multiple sclerosis]. PMID- 3829518 TI - [A case of unusual myotonic syndrome associated with tubular aggregation and nemaline rods in muscle biopsy in an aged patient]. PMID- 3829519 TI - [Distribution of skeletal muscle involvement in distal myopathy with rimmed vacuoles: a clinical and computed tomographic study]. PMID- 3829520 TI - [A simultaneous appearance of paroxysmal kinesigenic choreoathetosis (PKC) and paroxysmal dystonic choreoathetosis (PDC) in a case of arterio-venous malformation of the parietal lobes]. PMID- 3829521 TI - [A case of mitochondrial encephalomyopathy with nephrotic syndrome]. PMID- 3829522 TI - [Intellectual activity in late-stage amyotrophic lateral sclerosis]. PMID- 3829523 TI - [Clinical and neuroradiological investigation of Wallenberg's syndrome]. PMID- 3829524 TI - [Searching for the cause of amyotrophic lateral sclerosis]. PMID- 3829525 TI - [Brain edema: mechanisms and management]. PMID- 3829526 TI - [The present state of neurology in China]. PMID- 3829527 TI - [Treatment of SSPE (subacute sclerosing panencephalitis): selective killing of SSPE virus infected cells]. PMID- 3829528 TI - [Morphological features of Alzheimer's disease]. PMID- 3829529 TI - [Molecular and genetic bases for deposition of amyloid fibrils in familial amyloidotic polyneuropathy]. PMID- 3829530 TI - Right ventricular aneurysm due to ischemic disease. Diagnosis by radionuclide angiography with localization of the site of PVC origin by phase analysis. AB - A case of right ventricular aneurysm due to coronary artery disease in a 69-year old male with no prior history of surgery or chest trauma is reported. The presence of the aneurysm was diagnosed by gated radionuclide angiography and confirmed by contrast angiography. This is the first description of an isolated right ventricular aneurysm on the basis of ischemic disease. In addition, the patient had recurrent ventricular tachycardia and frequent premature ventricular contractions (PVC's). Using radionuclide angiographic phase analysis of the PVC's, their apparent origin was localized to the margin of the right ventricular aneurysm. PMID- 3829531 TI - Grading of reflux by radionuclide cystography. AB - Over a three-year period, radionuclide cystography (RC) was performed on 145 patients. Of these, 31 nephroureteral units in 25 patients demonstrated vesicoureteral reflux by RC and also by radiographic cystography (XC). The RC and XC studies were performed within three months of one another. The grading of reflux was determined by RC and then compared with that of XC using the criteria for grading as established by the International Reflux Study Committee (IRSC). Of 18 nephroureteral units in 14 patients with grade II reflux by XC, 14 were similarly graded by RC (78%). Of five nephroureteral units in five patients with grade III reflux by XC, the correlation by RC was 100%. However, when grades II and III were combined into a single category of low-grade reflux, the correlation achieved between the two cystographic techniques was 100%. Of five nephroureteral units in four patients with grade IV reflux by XC, the correlation was 60%, and in three units in two patients with grade V reflux the correlation was 100%. When grades IV and V are combined into a category of high-grade reflux, a correlation of 100% is achieved. When the reflux is graded into the five IRSC categories, the overall unequivocal correlation between the two studies is 80%. However, when only two categories are used (low grade = grades II and III, and high grade = grades IV and V), a correlation of 100% is obtained. PMID- 3829532 TI - Radioiodine therapy of hyperthyroidism precludes thallium-201 myocardial scintigraphy. AB - The authors attempted to perform Tl-201 myocardial perfusion scintigraphy in a 42 year-old man 23 and 35 days after he received 9.8 mCi of oral I-131 for documented Graves' disease. Interference from primary and scattered photons from residual thyroid I-131 made Tl-201 myocardial scintigraphy technically impossible. A series of phantom and patient studies using I-131 and Tl-201 were performed, yielding guidelines for planning Tl-201 myocardial scintigraphy following radioiodine therapy. PMID- 3829533 TI - Pelvic "doughnut". Sign of incidental pregnancy on bone scintigraphy. AB - The "doughnut" sign as a scintigraphic pattern compatible with a gravid uterus was observed on the multiphase bone scan. Awareness of this scintigraphic finding should alert the nuclear physician to the possibility of incidental pregnancy. PMID- 3829534 TI - Stress fracture of the pubic ramus in a swimmer. AB - Stress fracture is common in military recruits, joggers, and runners. Stress fracture in the pubic ramus is not common, and it constitutes only 1.25% of all stress fractures. A stress fracture, avulsion type of the pubis at the insertion of adductor magnus on an active swimmer is reported here. PMID- 3829536 TI - Scintigraphic hot nodules and thyroid carcinoma. AB - Three patients who had hot nodules on I-123 scan were found to have thyroid cancers in the nodule. Two of the cancers were follicular, one was a follicular variant of papillary cancer. PMID- 3829535 TI - Bone scintigraphic demonstration of synovial chondromatosis. AB - Markedly increased periarticular Tc-99m diphosphonate uptake around the knee is described in a patient found to have synovial chondromatosis. The pathophysiology and possible causes of bone tracer uptake in this cartilaginous disorder are discussed. PMID- 3829537 TI - Septic arthritis in an immunocompromised patient. PMID- 3829538 TI - Rib artifact demonstrated on xenon-133 lung imaging. PMID- 3829539 TI - Comparative imaging. Massive osteolysis (Gorham's syndrome, disappearing bone disease). PMID- 3829540 TI - Groin hernia with inguinoscrotal herniation of the urinary bladder. PMID- 3829541 TI - Technetium-99m red blood cell venography of the lower limb in symptomatic pulmonary embolization. AB - Tc-99m RBC venography of the legs was obtained in 42 patients with primary pulmonary symptomatology and a diagnosis of pulmonary embolization. In 31 of these 42 patients (74%), the nuclear venogram revealed the presence of deep vein thrombosis (DVT) and a source of embolization. Of the 31 patients with leg DVT documented by venography, 13 (42%) showed thrombosis confined to the calf. Clinical findings suggested that only 20 of the 31 patients (65%) with DVT could have harboured a source of embolization in the legs. Tc-99m RBC venography is a useful noninvasive test for the global and comprehensive assessment of patients with symptomatic pulmonary embolization. PMID- 3829542 TI - Diagnosis of malignant pericardial effusion during dynamic hepatic scintigraphy. AB - Three clinically unsuspected malignant pericardial effusions were discovered during routine dynamic hepatic scintigraphy. The only common clinical feature shared by the patients was dyspnea. Static scintigrams alone would not have detected these effusions, which points out again the importance of including dynamic scintigraphy in routine radionuclide evaluations of the liver. PMID- 3829543 TI - Colonic varices demonstrated by technetium-99m red cell scintigraphy. AB - Colonic varices is a rare condition, generally associated with portal hypertension, which normally presents as acute, severe, gastrointestinal blood loss. A case is presented in which the varicosities were observed serendipitously in a patient with a pancreatic tumor, in whom the bleeding was not variceal but due to two small unrelated gastric hemangiomas. The literature is reviewed and scintigraphic features described. PMID- 3829544 TI - Diagnosing iliofemoral vein occlusion from radionuclide blood pool venography. AB - There have been reports regarding the efficacy of Tc-99m labeled RBC venograms. The authors have found that potentially dangerous iliac vein occlusions can be missed unless especially careful attention is paid in looking for any asymmetry of the iliac vessels with respect to intensity, thickness, and/or definition, along the whole or at least 50% of one of the vessel's length, and the presence or absence of blood pool activity in the most proximal portion of the left common iliac vein, i.e., whether the activity arises from the IVC or the aorta. Eight (21%) of 38 consecutive labeled RBC venograms performed at this institution over six months produced findings that met criteria and/or. Iliofemoral vein occlusion was confirmed in six of the eight patients (16% of all patients). Thus, while the above criteria are not pathognomonic for iliofemoral vein occlusion, their rigid application has enabled the authors to detect a significant proportion of patients with iliofemoral occlusions which would otherwise have gone undetected. All eight cases were confirmed by further workup with direct injection radionuclide venography or contrast venography. PMID- 3829545 TI - Phase abnormalities in right heart studies. Demonstration of six different patterns. AB - Phase imaging abnormalities of the right side of the heart detected on multiple gated blood pool angiography (MUGA) have received less attention than similar abnormalities of the left ventricle. It has been found that certain different patterns of phase abnormalities of both right ventricle and right atrium are useful in the detection of six pathological conditions: right bundle branch block, ischemic right coronary artery disease, pericardial effusion, tricuspid regurgitation, pulmonary hypertension, and atrial septal defect. The authors emphasize the importance of these abnormal phase patterns during interpretation of gated cardiac studies, as they are helpful in directing the physicians attention towards the proper diagnosis. PMID- 3829546 TI - The gamut of increased whole bone activity in bone scintigraphy in children. AB - Whole bone activity on skeletal scintigraphy in children, although nonspecific, is uncommon and was caused by unusual presentations of osteomyelitis in two of eight patients. Soft tissue pathology, including cellulitis and vascular obstruction, was causative in four of eight cases. Whole bone activity was seen in two children with trauma due presumably, to subperiosteal hematoma formation and strongly supported the diagnosis of child abuse. PMID- 3829547 TI - Long-term follow-up in untreated Plummer's disease (autonomous goiter). AB - Plummer's disease presents a spectrum of forms and its evolution is often slow. Longitudinal studies have been limited both in number of patients and duration of follow-up. In order to answer the question of whether euthyroid patients with no local symptoms should be treated prophylactically, 70 patients were reexamined 5.2-21.8 years (average, 8.9) after Plummer's disease had been diagnosed. Data are included on four others who developed symptoms that indicated treatment within five years. Gross (clinically relevant) changes were seen in 24 cases. Of these, 16 were progressive, including 12 where hyperthyroidism developed. Gross regressive changes included two cases with complete remission. Minor changes (28 cases) were about as often regressive as progressive. Most patients with a solitary autonomous nodule showed either gross changes or no change, whereas minor changes prevailed in multifocal autonomy. All eight male patients had a solitary nodule, 28 of 66 females had multifocal autonomy. Gross changes were seen in nine of 12 patients under 40 years at presentation, more often than in those over 49 years; seven of these changes were progressive. Six short case reports illustrate the great diversity in evolution. It is concluded that treatment seems wise in teenagers and in elderly patients with borderline (biochemical) hyperthyroidism but others generally may be left untreated, as long as they have few or no complaints. PMID- 3829548 TI - Extrinsic causes of vesical filling defects on scintigraphy. AB - Three children are reported with vesical filling defects on scintigraphy secondary to extrinsic causes. In two chronically constipated individuals undergoing bone scintigraphy, the extrinsic pressure on the bladder by rectosigmoid feces resulted in simulation of intrinsic space-occupying lesions. Focal attenuation of bladder activity on nuclear cystography by the metal distal hook of a Harrington rod also produced the pseudo-appearance of a vesical filling defect in a third patient. PMID- 3829549 TI - Indium-111 chloride imaging with ununited fractures. AB - Twenty patients with ununited fractures and a suspicion of infection had In-111 chloride imaging. Surgically obtained cultures were positive for infection in 12 and negative in eight patients. In-111 chloride images were positive in all 12 patients with infection but also were positive in six of the patients with negative cultures. It is not possible to differentiate infected from noninfected ununited fractures by In-111 chloride imaging. PMID- 3829550 TI - Erythema nodosum leprosum reaction of leprosy causing the double stripe sign on bone scan. Case report. AB - Leprosy is a disease that is widely distributed in underdeveloped tropical regions, with cases also occurring in the United States. The bone scan findings in a patient with leprosy who had developed a reactional state of the disease, erythema nodosum leprosum, are presented. His scan showed bilaterally symmetrical double stripe signs involving the distal tibias, similar to those seen in hypertrophic osteoarthropathy. Physicians should be aware that this reactive phase of leprosy can also produce the double stripe sign. PMID- 3829551 TI - Platelet sequestration in widespread pulmonary hemangiolymphangiectasia. Demonstration by indium-111 labeled platelets. AB - A thrombocytopenic patient with pulmonary hemangiolymphangiectasia proven by biopsy, was studied for platelet sequestration with In-111-labeled autologous platelets. The 24-hour scan showed diffuse increased uptake throughout both lung fields, indicating platelet sequestration by the diffuse pulmonary hemangiolymphangiectasia. PMID- 3829552 TI - Luxury perfusion syndrome in cerebral vascular disease evaluated with technetium 99m HM-PAO. AB - A recently developed Tc-99m radiocompound, hexamethylpropyleneamine oxime (Tc-99m HM-PAO), exhibits favorable properties for regional cerebral blood flow study in man. The authors present a case of luxury perfusion syndrome observed in a 72 year-old patient with acute stroke and a right-sided hemiplegia, documented by planar scintigraphy and SPECT study in correlation with CT scan. The metabolic basis of this phenomenon is discussed and the usefulness of assessing regional brain perfusion by Tc-99m HM-PAO with conventional nuclear medicine equipment is underlined. PMID- 3829553 TI - The cholescintigraphic pattern of small bowel obstruction. AB - An elderly patient presenting with acute abdominal pain, nausea, and vomiting underwent a hepatobiliary scan. This demonstrated normal filling of the gallbladder but dilatation of the small bowel, which was found to correspond radiographically to partial small bowel obstruction. PMID- 3829555 TI - Delay in renal perfusion due to elongated vascular graft. PMID- 3829554 TI - "Bulls-eye" image of gallbladder volvulus. PMID- 3829556 TI - Technetium-99m red blood cell scintigraphy in diagnosis of hepatic hemangioma. PMID- 3829557 TI - Vascular pseudotumor of the pelvis as demonstrated by technetium-99m MDP skeletal scintigraphy. PMID- 3829558 TI - Rare collateral pathway in superior vena cava obstruction. The development of the venous shunts between systemic veins and the left heart. PMID- 3829559 TI - Hepatic cirrhosis in a patient with total situs inversus. Unique findings on liver-spleen imaging. PMID- 3829560 TI - Comparison of the pharmacokinetics of cephradine and cefazolin in pregnant and non-pregnant women. AB - The pharmacokinetics of cephradine, a cephalosporin with a low degree of protein binding, was studied in 12 women after oral and intravenous administration of the drug during and after pregnancy. Six of the 12 women also received a cephalosporin with a high degree of protein binding, cefazolin, intravenously during and after pregnancy. For both drugs most pharmacokinetic parameters were altered in pregnancy. The area under the plasma concentration-time curve (AUC) following intravenous administration was smaller for both drugs during as compared to after pregnancy (mean change 39% for cephradine and 31% for cefazolin). Half-lives of both drugs were significantly shorter during compared with after pregnancy (mean change 26% for cephradine and 35% for cefazolin). Consequently, total body clearance was increased during pregnancy. A significant negative correlation between length of gestation and total clearance per kg bodyweight was seen for cephradine. The bioavailability of oral cephradine did not differ significantly during compared with after pregnancy. It is concluded that the dosage of both cefazolin and cephradine should be increased when treating infections in pregnant women in order to obtain the same antibacterial effect as when treating non-pregnant women. PMID- 3829561 TI - Hypersensitivity pneumonitis due to dove antigens in an adolescent. AB - Hypersensitivity pneumonitis is infrequently reported in children. This article describes a 15-year-old girl who presented with insidious onset of dyspnea and weight loss. A hamster and doves were housed in her bedroom. Chest radiographs showed bilateral nodular infiltrates. Pulmonary function tests showed a restrictive pattern with O2 desaturation at rest. The diagnosis was substantiated by the presence of precipitating antibody to dove serum and droppings and by clinical improvement, along with marked improvement in pulmonary function test, after the doves were removed from her environment. The importance of making an early diagnosis to prevent debilitating fibrotic lung disease is emphasized. A detailed environmental history is essential. PMID- 3829562 TI - Term abdominal pregnancy, meconium aspiration, and extracorporeal membrane oxygenation. AB - This report describes a term gestation abdominal pregnancy resulting in meconium aspiration syndrome (MAS) complicated by pulmonary hypertension. These cases occur infrequently. In this instance, extracorporeal membrane oxygenation (ECMO) was successfully utilized to support the infant after conventional neonatal medical support failed to yield sufficient oxygenation. PMID- 3829563 TI - Neonatal intussusception associated with neonatal small left colon syndrome. AB - A newborn infant with intestinal obstruction resulting from intussusception associated with neonatal small left colon syndrome is described. Differences between neonatal and infantile intussusception are detailed. Chronic loose intussusception in utero is proposed as one cause of the neonatal small left colon syndrome. Consideration should be given to doing a rectal biopsy and a sweat chloride test to differentiate neonatal small left colon syndrome from Hirschsprung's disease and cystic fibrosis, respectively, when the clinical diagnosis is not readily apparent. PMID- 3829564 TI - Small bowel obstruction as a complication of Kawasaki disease. AB - A case of small bowel obstruction in an 8-month-old infant with Kawasaki disease is described. At laparotomy a discrete area of jejunal stricture with adhesions was noted. Microscopic examination revealed evidence of small artery thrombosis. Kawasaki disease results in a diffuse vasculitis, which may produce significant abnormalities in multiple organ systems. Serious abdominal complications can occur and should be considered when gastrointestinal symptoms develop in a patient with Kawasaki disease. PMID- 3829565 TI - Hypertension and intussusception. AB - Two unusual cases of intussusception in children less than a year old are presented. Each patient was brought to the author's attention because of altered level of activity, and both were found to be hypertensive. The hypertension resolved after the intussusception was reduced. Diagnosis of hypertension in children, when associated with gastrointestinal dysfunction, is discussed. PMID- 3829566 TI - Pneumonia associated with acute rheumatic fever. AB - Pulmonary involvement in acute rheumatic fever is rare. Clinical and laboratory findings in rheumatic pneumonia are non-specific. Most of the cases of rheumatic pneumonia described in recent years have had a fulminant course often resulting in death. Autopsy findings are suggestive of but not specific for rheumatic pneumonia. In this article a case of pneumonia associated with acute rheumatic fever is described. Pneumonia and carditis occurred simultaneously in a 10-year old boy treated without steroids, which resulted in recovery. The clinical spectrum of rheumatic pneumonia can range from mild to fulminant. PMID- 3829567 TI - Epidermoid cyst of the spleen successfully treated by marsupialization. AB - Nonparasitic splenic cysts, although rare, should be considered in the differential diagnosis of persistent vague upper abdominal pain in children and young adults. These cysts, which are less common than traumatic pseudocysts, include hemangiomas, dermoids, lymphangiomas, and, as in the present case, epidermoid variants. Ultrasound is diagnostic. The pathogenesis of these lesions remains obscure. While some continue to advocate splenectomy as definitive treatment, an operation with splenic salvage should be possible, even in centrally located lesions. PMID- 3829569 TI - Breastfeeding. PMID- 3829568 TI - The management of lactation as a physiologic process. AB - Lactation is the physiologic completion of the reproductive cycle. The breast is ready to provide complete nourishment for the newborn and the normal infant has all the necessary reflexes. Mother, however, must learn to adopt her actions to complement the physiologic process for successful milk production. PMID- 3829570 TI - Clinical uses, collection, and banking of human milk. AB - The Mothers' Milk Bank (MMB) of San Jose, CA, has provided banked human milk to clinicians and researchers since its founding in 1974. This article briefly acknowledges the many and varied reasons for the use of human milk. Its primary focus however, is to review the protocol followed by the MMB for collection, banking, and distribution of human milk. PMID- 3829571 TI - High tech-soft touch: breastfeeding issues. AB - Hospital practices and staff interactions need to be reviewed carefully in each institution and community to examine the direct or indirect effects on human lactation and breastfeeding. With the increased incidence of breastfeeding and the continued promotion by the Surgeon General and the American Academy of Pediatrics, it is imperative that health care professionals examine the attitudes that affect their behavior as they interact with their patients about lactation. The high-tech routines must be altered to facilitate the normal aspects of the breastfeeding process. A mother must be close to learn how to interact with and touch her new infant. The greatest challenge is not in changing the written policies nor the curtains or surroundings but in changing the attitudes and beliefs of the staff, so that human lactation and breastfeeding are treated as normal physiologic, psychological, and nurturing activities of mothers and infants. PMID- 3829572 TI - Pulmonary hypertension in the fetus, the newborn, and the child. AB - Pulmonary hypertension is a syndrome characterized by high pulmonary vascular resistance. It is a well described entity in newborn infants and children but almost unknown in the fetus. Therefore, this article focuses mainly on the former and then summarize how we diagnose and manage the problem in the fetus. PMID- 3829573 TI - Providing professional lactation management consultation. AB - The probability of successful lactation and breastfeeding can be maximized by professional lactation management consultant services such as those provided by the San Diego Lactation Program. There are four distinct service components of the program: prenatal guidance; skilled immediate postpartum assistance; a telephone consultation service; and evaluation of lactation progress and problem solving in a special lactation clinic. To insure the best care for the mother infant couple, these services must be provided by health care professionals with "hands-on" backgrounds in one of the perinatal specialties (M.D. or R.N.) as well as knowledge and skills in the specific area of lactation. Teaching hospital based lactation programs such as the San Diego model can offer both consultant services and provide a much needed learning opportunity in lactation and breastfeeding management for such health professionals. PMID- 3829574 TI - The clinical pharmacology section of the International Union of Pharmacology. PMID- 3829575 TI - New indications for already-approved drugs: time trends for the new drug application review phase. AB - For 55 individual drugs, the time required for approval of the original new drug application (NDA) was compared with the time required for approval of supplemental NDAs. The mean time required for the original NDAs was 22.2 +/- 18.1 months; the mean for review of all 46 follow-on indications was similar (19.1 +/- 17.9 months). Since subsequent applications do not ordinarily require new assessment of clinical safety or animal toxicity studies, one would expect the subsequent applications to be processed more expeditiously. Such is not the case. The negative implications of these facts are discussed. PMID- 3829576 TI - Pharmacokinetics and pharmacodynamics of methadone in patients with chronic pain. AB - Concentrations of methadone in plasma, estimates of pain relief, and pupillary size were determined after a single intravenous dose (10 to 30 mg) of methadone hydrochloride to eight patients with chronic pain, five of whom had cancer. The pharmacokinetic parameter estimates reveal rapid and extensive distribution (Varea) and a slow apparent elimination half-life (t1/2) (mean Varea = 3.59 L/kg and harmonic mean t1/2 = 23 hours). The harmonic mean blood clearance is 106 ml/min, the harmonic mean renal clearance is 3.9 ml/min, the mean hepatic extraction ratio is 0.089, and plasma protein binding is 86% to 89%. These results suggest that only the free (unbound) fraction of methadone present in blood is extracted by the liver and that methadone can be classified as a low (hepatic)-extraction drug. The data were fit to a pharmacokinetic-pharmacodynamic model to obtain estimates of the steady-state plasma methadone concentration required to produce 50% of the maximum pain relief. This value varied from 0.04 to 1.13 micrograms/ml (mean = 0.29 micrograms/ml). These results indicate substantial interindividual variation in the relationship between changes in plasma methadone concentration and analgesia in patients with chronic pain receiving opioids. A pharmacokinetic-pharmacodynamic model may be useful for the individualization of analgesic dosage and therefore the optimization of pain management in patients with chronic pain. PMID- 3829577 TI - Increased clearance of propranolol and theophylline by high-protein compared with high-carbohydrate diet. AB - The objective of this study was to determine whether changes in dietary protein and carbohydrate influence the oral clearance of propranolol, a high-clearance drug, and theophylline, a low-clearance drug. Six normal subjects studied in a clinical research center each received a single oral dose of propranolol, 80 mg, and theophylline, 5 mg/kg, after having been on each of two well-defined diets for a period of 10 days. When the diet was altered from high carbohydrate/low protein to low carbohydrate/high protein, the oral clearance of propranolol increased by 74% +/- 20% (mean +/- SE; range 9% to 156%; P less than 0.01) with no change in plasma half-life or plasma binding. This dietary change resulted in an increase in theophylline clearance of 32% +/- 6% (range 18% to 50%; P less than 0.02) and a corresponding decrease in plasma half-life of 26% +/- 6% (range 6% to 42%; P less than 0.05) with no alteration in the apparent volume of distribution. These observations reemphasize the importance of diet in drug disposition and suggest that the clearance of high-clearance drugs like propranolol is more susceptible than the clearance of low-clearance drugs to dietary manipulations, effects that may have to be considered in drug therapy. PMID- 3829578 TI - Dose-dependent pharmacokinetics of acetaminophen: evidence of glutathione depletion in humans. AB - The time course of excretion of acetaminophen and its metabolites in urine was determined in eight healthy adults (seven men and one woman) who ingested 1 gm of the drug and collected timed urine samples for 24 hours. The mean time of peak excretion rate was 1.3 to 3.7 hours for acetaminophen, its glucuronide, sulfate, cysteine, mercapturate, and methoxy metabolites but 13.5 hours for methylthioacetaminophen. The mean half-life of acetaminophen was 3.1 hours and the mean half-life of the metabolites other than methylthioacetaminophen ranged from 4.1 to 5.7 hours. The half-life of methylthiometabolite could not be determined because of its very late peak time. In a second study the effect of dose on the clearance of acetaminophen was determined in nine healthy adult subjects (eight men and one woman) who received doses of 0.5 and 3 gm acetaminophen on separate occasions, separated by 4 to 10 days. The renal clearance of acetaminophen and the formation clearances of the sulfate, glutathione, and catechol metabolites were lower (by 38%, 41%, 35%, and 46%, respectively) at the higher dose. The renal clearance of acetaminophen sulfate and glucuronide conjugates were not different between doses. In a third study (10 men), 10 gm N-acetylcysteine was found to increase the formation clearance of the sulfate conjugate by 27% and that of the glutathione conjugate by 10%. The data suggest that the hepatic supply of reduced glutathione and 3'-phosphoadenosine 5' phosphosulfate begins to be depleted over the range of 0.5 to 3 gm acetaminophen and that the depletion is overcome by the administration of N-acetylcysteine. PMID- 3829579 TI - Human pharmacology and abuse potential of meptazinol. AB - Meptazinol was assessed in nine opioid abusers according to a double-blind, randomized, crossover design to determine if it produced typical morphine effects. A comparison of physiologic and subjective effects was made between morphine, 7.5, 15, and 30 mg, meptazinol, 70, 140, and 280 mg, and placebo. Both drugs constricted pupils. Meptazinol, 140 and 280 mg, decreased body temperature. Valid relative potency estimates of morphine to meptazinol were obtained for self reported liking, opiate symptoms, and pupillary constriction. Meptazinol did not increase euphoria or sedation scale scores but did increase dysphoria scale scores. In the therapeutic dose range, meptazinol produced miosis, morphine-like identification and symptoms, limited liking, and some dysphoria. Dysphoria predominated at the 280 mg dose of meptazinol. From these data, it is concluded that meptazinol is not a typical morphine-like drug and has limited abuse potential. PMID- 3829580 TI - Plasma biguanide levels are correlated with metabolic effects in diabetic patients. AB - Metabolic abnormalities occur in biguanide-treated diabetic patients. We investigated the relationship between plasma metformin and phenformin concentrations and metabolic effects. Drug levels were measured in 37 type II diabetic patients by HPLC. The method was sensitive, specific, and linear over a wide range of drug concentrations. Metformin and phenformin values ranged from 236 to 718 ng/ml and from 28 to 114 ng/ml, respectively. The plasma metformin level was correlated with triglycerides (r = -0.55; P less than 0.05) but not with drug dosage, plasma glucose, HbA1, creatinine, creatinine clearance, lactate, pyruvate, lipid, and clinical parameters. Plasma phenformin concentrations correlated with lactate (r = 0.49; P less than 0.05) and HbA1 (r = 0.50; P less than 0.05) but not with drug dosage, parameters of diabetes control, creatinine, creatinine clearance, pyruvate, and clinical parameters. The clinical usefulness of this HPLC method, the evidence that the increase of lactate is related to the circulating phenformin levels, and the demonstration that the metformin effect on triglyceride metabolism is correlated to plasma drug levels are the positive findings of this work. PMID- 3829581 TI - Effects of bolus injection of esmolol in healthy, exercising subjects. AB - Esmolol is an investigational ultra-short-acting beta-adrenergic blocker that has potential application in many clinical cardiology settings. The purpose of this study was to investigate the effect of a bolus dose of esmolol on heart rate, blood pressure, and PR interval in healthy, exercising male subjects. We gave a single esmolol bolus over 30 seconds to 13 men who exercised to a predetermined target heart rate. Each subject performed the exercise protocol twice, receiving a different dose between 10 and 300 mg each time. An additional eight subjects received two esmolol boluses 5 minutes apart while performing the same exercise protocol. Esmolol doses of 180 mg or greater caused a 13% to 18% decrease in heart rate, an 11% to 18% decrease in blood pressure, and a 13% to 22% prolongation of the PR interval. The median time to peak esmolol effect was 1 minute for heart rate, 2 minutes for blood pressure, and 4 minutes for PR interval. The median time required to recover 50%, 75%, and 90% of the decrement in heart rate was 8, 10, and 13 minutes, respectively. The rapid onset and disappearance of esmolol effects may make it an appealing drug in acute care settings. PMID- 3829582 TI - Effect of calcium antagonists on basal and digitalis-dependent changes in splanchnic and systemic hemodynamics. AB - We investigated the effects of the calcium antagonists verapamil and tiapamil on basal splanchnic and systemic hemodynamics and digoxin-induced vasoconstriction in 16 healthy men, using the hepatic venous catheter technique, the thermodilution method, and systolic time intervals. After a baseline period, verapamil or tiapamil were given by a primed-constant infusion in six of 16 subjects each, and hemodynamic changes were determined. Thereafter digoxin (1 mg) was concomitantly infused and hemodynamic changes were observed over 105 minutes. Control trials with digoxin alone were performed in seven of 16 subjects. Four of 16 subjects received only placebo. Digoxin provoked an increase in systolic blood pressure and splanchnic vascular resistance. Estimated splanchnic blood flow, mean pulmonary artery pressure, and total electromechanical systole decreased. Verapamil did not change basal hemodynamic parameters. Tiapamil decreased diastolic blood pressure and systemic and splanchnic vascular resistance. Both drugs attenuated the vasoconstricting effect of digoxin on the splanchnic vascular bed. Results indicate that calcium antagonists might be beneficial in treatment of digitalis-induced splanchnic vasospasm. PMID- 3829583 TI - Determinants of nicotine intake while chewing nicotine polacrilex gum. AB - Nicotine polacrilex gum is widely used as substitution therapy during cigarette smoking cessation. We studied circadian blood nicotine concentrations, daily intake of nicotine, and extraction of nicotine from gum in smokers switched experimentally to 2 or 4 mg nicotine gum, 12 pieces per day. Nicotine levels and intake were much lower while chewing gum than during ad libitum smoking. Extraction of nicotine from gum by the chewer was incomplete, averaging 53% and 72% for 2 and 4 mg gum, and variable (more than twofold) among individuals. The systemic dose of nicotine was less than expected based on analysis of nicotine in the chewed gum. Disproportionately higher metabolite-to-nicotine ratios while chewing gum compared with smoking suggested that some nicotine was swallowed and underwent first-pass metabolism. Nicotine and metabolite data were used to estimate buccal vs. gastrointestinal absorption. Relative buccal absorption vs. swallowing of nicotine appears to be an important determinant of systemic nicotine intake. PMID- 3829584 TI - Influence of tobacco abstinence on the disposition kinetics and effects of nicotine. AB - Habitual tobacco smoking accelerates the metabolism of many drugs. With tobacco abstinence, it was expected that nicotine metabolism would be slower than when smoking. To test this hypothesis, the disposition kinetics of intravenous nicotine were studied in 20 healthy smokers while smoking, after abstaining from smoking for 1 week, and (in six subjects) when smoking again. Cardiovascular responses to nicotine were also measured. Unexpectedly, total and nonrenal clearance of nicotine increased by 36% and 39%, respectively, during abstinence. The increase in clearance after brief abstinence suggests that nicotine or its metabolites or another component of cigarette smoke inhibits nicotine metabolism in smokers. Cardiovascular responses to nicotine were greater after 1 week compared with overnight abstinence, consistent with loss of tolerance. PMID- 3829585 TI - Reproducibility of vibratory perception thresholds in patients with diabetic neuropathy. AB - Using an improved biothesiometer, intraindividual variability of vibratory perception thresholds was investigated in 60 healthy volunteers, 39 diabetics with diabetic neuropathy and 21 diabetics without symptoms or signs of neuropathy. Reproducibility of vibratory perception thresholds was satisfactory in the normal subjects and most diabetic patients. However, a considerable variability was found in some diabetics. For determination of vibratory thresholds, vibrometers with amplitude measurement and controlled application pressure are recommended. In longitudinal studies of patients with diabetic neuropathy, a combination of neurophysiological test methods should be used to monitor impaired nerve function. PMID- 3829586 TI - The spectrum of non-insulin-dependent diabetes in the young in a migrant Indian population. AB - The familial aggregation and degree of adiposity of 108 Indian patients with non insulin-dependent diabetes in the young was studied. All patients had onset of diabetes under 30 yr and the female to male ratio was 5:1. Obesity as defined was present in 52 patients (48.2%). A positive family history of diabetes was present in 90 patients (83.3%). Two distinct subtypes emerged in the patients with a positive family history; the offspring of conjugal diabetic parents (29%) and maturity onset diabetes of the young (MODY) with 3-generation transmission (13%). In conclusion, the syndrome of NIDDY in Indians comprises at least 3 subtypes: offspring of conjugal diabetic parents, MODY and patients without a family history (sporadic type). PMID- 3829587 TI - Microvascular complications and non-insulin-dependent diabetes of the young in South African Indians. AB - 103 Indians (74 females, 29 males) with NIDDM diagnosed before age 30 yr on the basis of the revised WHO diagnostic criteria were studied in order to assess the prevalence of microvascular complications. The mean duration of NIDDM in the subjects was 11 yr (range 2-38 yr). 24 patients (23%) eventually required insulin therapy for control after a mean interval of 11.8 yr (range 5-38 yr). Diabetic retinopathy was present in 37 patients (35.9%), of whom 6 had proliferative retinopathy. Nephropathy was found in 16 patients (15.5%). The mean GFR of these patients was 46.8 ml/min, compared to a mean of 97.1 ml/min in 12 of the patients without nephropathy who had a similar mean duration of disease. The mean duration of disease in patients with retinopathy and nephropathy was 14.9 yr and 14.8 yr respectively. In the patients who eventually required insulin therapy both retinopathy (75%) and nephropathy (41%) were more common but the mean duration of disease in these patients was longer (16 yr vs 9 yr). This study has underlined the heterogeneity of NIDDM in the young, as microvascular complications are by no means uncommon in South African Indians with the disease. PMID- 3829588 TI - Glucose absorption from maltotriose and glucose oligomers in the human jejunum. AB - The jejunal absorption of glucose from (1-4)-linked glucose oligomers including maltotriose has been compared with that from free glucose and sucrose in normal subjects. A steady-state perfusion technique in vivo was used to study proximal jejunal assimilation of isotonic sugar-saline solutions isocaloric with 140 mmol/l glucose. Endogenous alpha-amylase was excluded from the test segment by proximal balloon occlusion. The glucose oligomer mixture consisted mainly of maltotriose, maltotetraose, maltopentaose and maltoheptaose. Glucose absorption was significantly faster from maltotriose alone and from the glucose oligomer mixture than from 140 mmol/l glucose controls, whereas glucose absorption from 70 mmol/l sucrose was similar to that from 70 mmol/l glucose plus 70 mmol/l fructose. Hydrolysis in vivo of maltotriose, the oligomer mixture and sucrose were similar, indicating that capture of glucose released by brush border sucrose hydrolysis was less efficient than that associated with (1-4)-linked oligomer hydrolysis. This suggests that the stoichiometric relationship of the active hydrolysis sites for sucrose to the glucose transport system is less advantageous than that of active sites for maltose hydrolysis. Hydrolysis of oligomers larger than maltohexaose may be rate limiting for glucose absorption in the absence of luminal amylase activity. PMID- 3829590 TI - Assessment of beat to beat changes in cardiac output during the Valsalva manoeuvre using electrical bioimpedance cardiography. AB - Beat to beat changes in cardiac output during standardized Valsalva's manoeuvres were recorded using electrical bioimpedance cardiography in 13 normal subjects. Cardiac output increased by 12 +/- 5% after 1 s of straining solely because of an increase in heart rate. Subsequently, cardiac stroke volume and cardiac output fell during the strain to lows of -40 +/- 6% and -21 +/- 3% respectively at 15 s. There was a sustained increased in cardiac output (maximum +17 +/- 4%) in the late post strain period. The mean coefficient of variation in impedance measurements of cardiac output was 6.8% during all parts of Valsalva's manoeuvre, with no single value exceeding 10%. PMID- 3829589 TI - The effect of iron and folate therapy on maximal exercise performance in female marathon runners with iron and folate deficiency. AB - Of the 85 female marathon runners examined in this study, 14 (16%) had serum ferritin levels below 40 ng/ml but only two (2%) had iron deficiency anaemia (haemoglobin below 12 g/dl); 28 (33%) had serum folate levels below 4.8 ng/ml and of these two (2%) had haemoglobin levels below 12 g/dl and 13 (15%) had mean corpuscular volumes greater than 95 fl. One week after treatment with oral folate (5 mg/day) or iron (50 mg of elemental iron/day), serum ferritin and folate levels were normal but maximum oxygen uptake, maximum treadmill running time, peak blood lactate levels and the running speed at the blood 'lactate turnpoint' were not changed from values measured during an identical test performed 1 week earlier. These parameters were also unchanged in a third exercise test performed after a further 10 weeks of treatment. Serum folate or serum ferritin levels in a control (placebo-treated) group with initially high serum ferritin or folate levels fell with placebo treatment but maximum treadmill running time, maximum oxygen uptake values, peak blood lactate levels and the running speed at the blood 'lactate turnpoint' were unchanged. We conclude that biochemical evidence of iron and folate deficiency is relatively common in female distance runners; that 1 week of treatment corrects the biochemical evidence of folate and iron deficiency but that such treatment does not influence maximal exercise performance nor does it alter blood lactate levels during exercise. In the absence of iron deficiency anaemia, iron therapy for reduced serum ferritin levels, or folate therapy for low serum folate levels, may not improve maximal treadmill performance even in trained runners.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829591 TI - Interaction between renal prostaglandins and angiotensin II in controlling glomerular filtration in the dog. AB - Although previous studies suggest that the renal vasoconstrictor effects of angiotensin II (ANG II) are normally confined to the efferent arterioles, the mechanisms that prevent ANG II from constricting preglomerular vessels are still unclear. In the present study, the role of prostaglandins (PG) in protecting preglomerular vessels from ANG II constriction was examined in dogs with normal or non-filtering kidneys in which ANG II formation was blocked with captopril and renal artery pressure was servo-controlled at 75-80 mmHg. Before PG blockade (n = 6), ANG II infusion (20 ng min-1 kg-1) decreased renal blood flow (RBF) by 54 +/- 4%, but did not change glomerular filtration rate (GFR) significantly. After PG blockade (n = 6), ANG II infusion decreased GFR by 37 +/- 7% and RBF by 56 +/- 6%, while increasing calculated preglomerular resistance much more than before PG blockade. In another group of dogs, secondary changes in renal resistances, due to tubuloglomerular feedback, were prevented by occluding the ureter during mannitol diuresis until glomerular filtration ceased. After inhibition of tubuloglomerular feedback in non-filtering kidneys (n = 7), ANG II decreased RBF by 40 +/- 3% and increased glomerular hydrostatic pressure, estimated from stop flow ureteral pressure and plasma colloid osmotic pressure, by 8.7 +/- 1.7 mmHg. Postglomerular resistance increased by 91 +/- 12% while preglomerular resistance was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829592 TI - A modified single breath method for estimation of cardiac output in humans at rest and during exercise. AB - This study was undertaken to determine the accuracy of a modification of a single breath method for estimation of cardiac output. The technique incorporated a single rebreathing stage followed by a prolonged expiration. Cardiac output was determined from the O2 uptake and the instantaneous changes in O2 and CO2 in the expired gas during the prolonged expiration. The mean values and the random errors (determined from the differences between pairs of estimates) of cardiac outputs in normal subjects at rest and exercise were 5.42 and +/- 0.60 litres/min (2 SD, 60 pairs) and 14.1 and +/- 1.8 litres/min (40 pairs). Larger random errors were obtained in a group of cardiac patients but, except in hypoxic patients, the mean values obtained by the single breath and the direct (Fick) methods were almost identical. We conclude that our modification of the single breath method is simple to use and sufficiently reliable for use in humans both at rest and during steady states of light exercise. PMID- 3829593 TI - Coffee consumption and blood pressure: an Italian study. AB - The relation between habitual coffee consumption and blood pressure was studied in 500 Italian subjects, males and females, aged 18-62 years. After allowing for sex, age and weight, the pressure levels showed a significant decrease with increasing coffee consumption. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were respectively 130.4 +/- 1.8 (SE) mmHg and 81.5 +/- 1.1 mmHg for non-coffee drinkers, 129.4 +/- 1.4 and 82.2 +/- 0.9 mmHg for 1 cup per day, 128.4 +/- 0.8 and 81.4 +/- 0.5 mmHg for 2-3 cups per day, 124.9 +/- 1.1 and 78.8 +/- 0.7 mmHg for 4-6 cups per day, and 124.1 +/- 2.5 and 78.7 +/- 1.6 mmHg for more than 6 cups of coffee daily (analysis of covariance: SBP F = 3.46, 4 df, P less than 0.01; DBP F = 3.46, 4 df, P less than 0.01). Even after correcting pressure levels for habitual alcohol intake and cigarette smoking, we observed a mean reduction in SBP and DBP of 0.80 mmHg and 0.48 mmHg respectively per cup per day. PMID- 3829594 TI - Effect of thyroparathyroidectomy on the activities of thymidylate synthetase and thymidine kinase during liver regeneration after partial hepatectomy. AB - Thyroparathyroidectomy (TPTX) carried out at 72 h before partial hepatectomy (PH) reduced the induction of hepatic thymidylate synthetase (TS) and thymidine kinase (TK), which are rate-determining enzymes in DNA synthesis, at 24 h after PH. When TPTX was carried out at 24 h before PH, TK activity at 24 h after PH was not reduced at all, yet TS activity was reduced significantly. Thus the effect of TPTX differed in time dependence between TS and TK. The depression of TK activity in rats which were subjected to TPTX at 72 h before PH, was recovered by Ca2+ supplementation. This result demonstrated that the rise of TK activity in regenerating liver is regulated by plasma Ca2+. Since a high dose of tri iodothyronine (T3) was required to cause elevation of the activities of these enzymes and DNA content in 24 h-regenerating liver of TPTX rats, the relative contribution of T3 to liver regeneration may be small. PMID- 3829595 TI - The ulcerogenic and protective action of rice and rice fractions in experimental peptic ulceration. AB - The ulcerogenic and protective effects of various rice fractions in the diet were studied in the pylorus ligated ulcer model in the rat. Oil present in rice and particularly rice bran becomes ulcerogenic on storage and in this model results in a significant increase in the median (range) numbers of ulcers from six (one to ten) to nine (six to 15) (P less than 0.05). The ulcerogenic effect of stored rice bran oil was reversed by cysteine which significantly reduced the ulcer incidence from 100% to 60% (P less than 0.005) and the numbers of ulcers from 26 (six to 70) to one (zero to four) (P less than 0.001). Fresh rice bran significantly reduced the numbers of ulcers from six (one to ten) to one (one to four) (P less than 0.05). Similarly, unmilled rice and freshly milled newly harvested rice was also shown to be protective in this model by significantly reducing the ulcer incidence from 87.5% to 50% and 0% respectively (P values less than 0.025) and the numbers of ulcers from three (zero to 17) to one (zero to one) and zero (zero to zero) respectively (P values less than 0.001). These results could in part explain the geographical distribution of duodenal ulceration, where the incidence is high in all the rice eating areas of the world, and provide a plausible hypothesis to explain the mechanism of dietary ulcerogenesis. PMID- 3829596 TI - AMP deaminase deficiency: study of the human skeletal muscle purine metabolism during ischaemic isometric exercise. AB - Muscle biopsies were taken from 10 control subjects and five AMP deaminase (AMPD) deficient individuals before and after an ischaemic isometric exercise test and analysed for purine nucleotide, NAD+, creatine phosphate (CP) and lactate content. The decrease of ATP induced by the exercise test was significantly lower in the AMPD deficient patients than in the controls, but the decrease of creatine phosphate and the increase of lactate did not differ. There were no significant differences in the exertional performance level between patients and controls and no evidence was obtained of an increased energy expenditure per unit of performance in AMPD deficiency. The AMPD deficient individuals were equally capable of maintaining a high adenylate energy charge (EC) as the control subjects, which indicates a normal regulation of the balance between ATP consumption and ATP regeneration. ATP, ADP and total adenine nucleotide (TAN) but not AMP, were significantly elevated in the AMPD deficient patients as compared with the controls before as well as after the exercise test. This underlines the role of AMPD activity in the adenine nucleotide catabolism of skeletal muscle. PMID- 3829597 TI - Resting and stimulated cytosolic free calcium levels in neutrophils from patients with Bartter's syndrome. AB - Cytosolic free calcium concentrations ([Ca2+]i) were measured in resting and chemotactic peptide-activated neutrophils from eight patients with Bartter's syndrome and compared with levels determined in neutrophils isolated from healthy controls. [Ca2+]i was measured with the intracellular trappable fluorescent indicator Quin2. The synthetic tripeptide formylmethionyl-leucyl-phenylalanine (fMet-Leu-Phe) was used as a stimulant. No difference was found in resting [Ca2+]i between neutrophils from normal controls and those from patients with Bartter's syndrome. On the contrary increases in [Ca2+]i stimulated by fMet-Leu Phe concentrations higher than 10(-8) mol/l were significantly less in neutrophils from patients with Bartter's syndrome. It is suggested that neutrophils from patients affected by Bartter's syndrome exhibit an intrinsic anomaly in the mechanism responsible for intracellular Ca2+ mobilization. PMID- 3829598 TI - Trace elements during the development of hypertension in the spontaneously hypertensive rat. AB - Total plasma concentrations of bromine, copper, rubidium, selenium and zinc were measured in spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) of 5-20 weeks of age, using an X-ray fluorescence spectrometry technique. Although plasma levels of bromine, rubidium, selenium and zinc varied at different ages when comparing SHR and WKY, their general evolution was similar. Copper levels increased more in SHR than in WKY. These perturbations in trace element levels could perhaps participate in the establishment of hypertension in SHR, but could also be due to genetic differences between the strains, unrelated to the development of hypertension. PMID- 3829599 TI - Controlling the spread of AIDS. PMID- 3829600 TI - Electron microscopy of leukemias and lymphomas. AB - Modern advances in the diagnosis and treatment of the leukemias and lymphomas make use of dynamic techniques in immunology, genetics, and molecular biology, and, as a result, morphology represents a smaller proportion of the total diagnostic work-up of these diseases today than heretofore. However, morphology still remains a basic and necessary starting point in the study of these diseases, as is evidenced in the continuing general application of classifications such as the FAB (French-American-British) for the leukemias, and the "Working Formulation" (Working Formulation of Non-Hodgkins Lymphoma for Clinical Usage) for the lymphomas. Although accurate interpretation of cell-type is often possible at the light microscopic level, there are other occasions when electron microscopy may be necessary or useful. Furthermore, a familiarity with the ultrastructure of hematopoietic, lymphoid, and other cells should increase the pathologist's and hematologist's diagnostic acumen and, perhaps, even enhance his or her perspective at the light microscope level. PMID- 3829601 TI - Psychiatric rehabilitation: past myths and current realities. AB - Psychiatric rehabilitation treatment has a unique and complementary contribution to make to the treatment of persons with a severe psychiatric disability. However, the development of the psychiatric rehabilitation field, and the adoption of its philosophy and techniques by mental health agencies, has been hampered by past myths. Research carried out in the 1960s and 1970s has exposed these myths as a part of the past, no longer relevant to the present practice of rehabilitating persons with severe psychiatric disabilities. PMID- 3829602 TI - Do therapists bias their ratings of patient functioning under peer review? AB - The present study was an attempt to examine the rating bias of therapists participating in an evaluation of an experimental quality assurance system at a community mental health center. The test program was intended to identify patients who demonstrated lack of progress or poor level of functioning after two months of treatment, and to employ a clinical assessment process by independent clinicians to evaluate problems in the quality of care. It was believed that the therapists knowledge that they might have their clinical work assessed would lead to biased ratings of more severe symptomatology in their patients. The results of this study partially supported the hypothesis. Patients in the peer review system were rated as more dysfunctional at admission on Psychological Functioning than patients in the control groups. No differences, however, were found on Basic Life Functioning, Anti-Social Behavior, or Mental Processes. The implications for these results relative to psychotherapy research, quality assurance, and program evaluation are discussed. PMID- 3829603 TI - Community mental health services and the elderly: retrenchment or expansion? AB - Data gathered from a recent survey of CMHC's suggest that the elderly are increasing their utilization of CMHC services. As more responsibility for mental health services is shifted to the states, a commitment to mental health services for the elderly increasingly becomes an issue of state discretion, and of state finances. This makes it probable that accessibility to mental health services for the elderly will become more variable and problematic on a national basis. This is especially important in light of data that indicates an increasing awareness by CMHC's of the mental health needs of the elderly. PMID- 3829604 TI - CMHC's and elderly services: an analysis of direct and indirect services and service delivery sites. AB - This study identified significant sources of variability in the utilization of CMHC services by the elderly. Program and staff specialization were examined as they critically influenced the rate of service utilization as well as the types of services made available. Data from a 1984 national survey of CMHC's were analyzed and statistically significant differences were found in overall utilization, types and amounts of direct and indirect services, and number and types of separate service delivery sites. These results suggest that variability in services utilization may be attributable to programmatic differences between CMHC's and may constitute a significant aspect of services designed to address the special needs of the elderly. PMID- 3829605 TI - Travel distance as time price and the demand for mental health services. AB - The ways in which health and mental health services are rationed is an area of growing concern among policy makers and administrators. More attention is being focused on how publicly supported mental health services are utilized and on how health care services in general are used depending upon how they are organized and reimbursed. Price is the marketplace's principal rationing device; the price and the consumption of a good are inversely related. Mental health services, however, tend to have a low money such that money price may not act as a rationing device for those services. This investigation examines the effect of travel distance, a surrogate for time price, from one's home to a community mental health center on the utilization of the center's services. A random sample of 224 clients was studied to determine the effect of their individual travel distances, ages, fees at the center, incomes, employment, gender, and the presence of substitutes on the length and intensity of utilization. Six log linear regression models were specified and Ordinary Least Squares was used to determine the effect of each independent variable on the utilization of services. In each model travel distance as a measure of time price was found to be a significant factor in utilization. Time price elasticities of demand from this study are compared with elasticities reported in earlier time price studies in health care. The administrative and policy implications of the findings are discussed. PMID- 3829606 TI - Issues in the treatment of mentally retarded patients in the community mental health system. AB - Developmental disability, particularly mental retardation, both affects a person's cognitive functioning and places that person on an alternative track of development which, when combined with social, political and economic pressures, places the developmentally disabled person at increased risk for mental illness. The presenting symptoms of mental illness will be modified by the mentally retarded person's cognitive impairment, personality development, and massively different life experience, as will the nature of his interactions with helping agencies. Evaluation, diagnosis and treatment must evolve from an alliance with the mentally retarded persons, not with caretaking agencies, and must be modified to take into account the retarded person's powerlessness. The therapist must be prepared to act as both advocate and bridge-builder for the patient, with the patient's increasing participation. The therapist must be prepared to steer between the Scylla of ignorance about the diagnosis and treatment of mental illness in the mentally retarded and the Charybdis of financial disincentives for human service agencies to collaborate in their care. The advantages of inter agency cooperation in the treatment of dually-diagnosed individuals is described and illustrated. PMID- 3829607 TI - Commentaries on the Better Health Commission's final report to the Federal government, "Looking forward to better health". PMID- 3829608 TI - The Better Health Commission's Final Report to the Federal Government, "Looking Forward to Better Health". Volume 1: The Commission's major findings and recommendations. PMID- 3829609 TI - The Better Health Commission's Report to the Federal Government, "Looking Forward to Better Health". Another view of Volume one. PMID- 3829610 TI - Cardiovascular disease: a preventable epidemic. PMID- 3829611 TI - Better nutrition for Australians. PMID- 3829612 TI - The injury taskforce. PMID- 3829613 TI - Better health for groups at risk: the special needs or basic rights? PMID- 3829615 TI - Health and the media in Australia--an uneasy relationship. PMID- 3829614 TI - Women and health: community development, its role in health: the future of public health research in Australia. PMID- 3829616 TI - Financial incentives for the promotion of health. PMID- 3829617 TI - Preventive medicine, medical education and better health. PMID- 3829618 TI - Promoting health promotion: health or hype? PMID- 3829619 TI - Strengthening health promotion in the community health sector. PMID- 3829620 TI - Community organisation for health promotion. PMID- 3829621 TI - Public health strategies and political constraints. PMID- 3829622 TI - Metabolism of three stereoisomers of astaxanthin in the fish, rainbow trout and tilapia. AB - In rainbow trout (Salmo gairdneri), the dietary astaxanthin diesters were mostly absorbed and accumulated in their integuments keeping their configurations, and partially metabolized to (3R, 3'R)-zeaxanthin (major) and/or (3R, 3'S)-zeaxanthin (medium) and/or (3S,3'S)-zeaxanthin (minor). In tilapia (Tilapia nilotica), the three stereoisomers of astaxanthin diesters were promptly metabolized to only (3S,3'S)-astaxanthin, and subsequently to (3R,3'R)-zeaxanthin and/or (3R,3'S) zeaxanthin and/or (3S,3'S)-zeaxanthin at an invariable ratio, 4:1:0.3. The above facts indicate that the conversion from 3S- to 3R-configuration was carried out in vivo, and vice versa, and that astaxanthins were reductively metabolized to zeaxanthins in both the fish. PMID- 3829623 TI - Sheep haemopexin: immunological cross-reactivity with other vertebrate sera and evidence for the absence of haemopexin in some mouflon. AB - A monospecific antiserum to sheep haemopexin was produced in rabbits. By using this antiserum, as well as absorbed antisera to sheep and mouflon serum proteins, it was proved that some mouflon sera lack haemopexin. In immunodiffusion, when using the monospecific antiserum, immunoprecipitates were present only in species' belonging to suborder Ruminantia. None of the other mammalian, nor any of the avian, reptilian, amphibian and fish species tested, showed reaction. PMID- 3829624 TI - Seasonal changes in hepatic activity of G-6-phosphate and alpha-glycerophosphate dehydrogenase in farmed polecats and raccoon dogs. AB - Liver weight of both male and female polecats was significantly higher in winter than in summer. There were no seasonal or sex differences in the liver weight of raccoon dogs. Body weight of male polecats was highest in winter. No marked seasonal changes in body weight of female polecats, or raccoon dogs of both sexes were found. Total hepatic glucose-6-phosphate dehydrogenase activity of polecats and raccoon dogs was higher in winter than in summer. Specific activity of alpha glycerophosphate dehydrogenase was highest in summer, but total hepatic activity did not show any seasonal changes. PMID- 3829625 TI - Detoxication of cyanide in the chicken by conversion to thiocyanate, as influenced by the availability of transferable sulphur. AB - The urinary excretion of thiocyanate by hens after dosage with cyanide (30 mumol) has been studied in a series of acute experiments involving 6 hr urine collection periods. More than half of the dose could be recovered as thiocyanate when cyanide was given by intravenous infusion and the rate of excretion closely paralleled plasma thiocyanate concentration. Little cyanide was excreted directly. The excretion of thiosulphate fell by an amount that suggested that availability of sulphane sulphur might limit the extent of conversion. However, neither thiosulphate nor sulphur amino acids enhanced thiocyanate excretion when they were infused together with cyanide; indeed, thiocyanate excretion decreased as the level of sulphur compound given was increased. Both nitrite and sulphite depressed thiocyanate excretion also but they differed in their effects on plasma thiocyanate levels and the pattern of urinary excretion. Comparison of excretion from both sides of the kidneys separately emphasised the importance of the first pass of cyanide in its conversion to thiocyanate. The results suggest that although sulphur availability may be limited the in vivo production of sulphite also restricts cyanide detoxication. PMID- 3829626 TI - A comparative study of three methods for the estimation of total plasmalogens in lingual taste epithelium and other tissues. AB - The total plasmalogen content of lingual and other tissues was analyzed using the iodine-addition (Method 1), the p-nitrophenylhydrazone (Method 2), and the two dimensional thin layer chromatography procedure (Method 3). Methods 1 and 2 were simple, rapid and reproducible, yielding values usually in close agreement with each other, and values higher than those of Method 3. Method 3 exhibited poor reproducibility. All three methods were of comparable sensitivity (less than 20 nmol of total plasmalogen per sample). According to Methods 1 and 2, there was more total plasmalogen in lingual epithelium containing taste buds compared with lingual epithelium devoid of taste buds. Plasmalogen content of bovine and rat brain, heart and liver agreed with literature values. PMID- 3829627 TI - Phytosphingosine is a characteristic component of the glycolipids in the vertebrate intestine. AB - Sphingoids in the intestinal lipids of an agnatha, a chondrichthyes, two osteichthyes, three amphibia, three reptiles and two avian species were analyzed by reversed phase high performance liquid chromatography. The glycolipid fraction of all the samples studied contained 4-D-hydroxysphinganine as the major component together with sphingosine and sphinganine. While the trihydroxy base was not found in their sphingomyelin fraction. The trihydroxy base was considered to be a characteristic component of the intestinal glycolipids for the vertebrates in general. Its concentration in the intestinal tissue had little correlation with the food habitat of the animals. PMID- 3829628 TI - Anadara ovalis hemoglobins: distinct dissociation and ligand binding characteristics. AB - The red cells of the arcid clam Anadara ovalis contain two electrophoretically distinct hemoglobins: Hb Major (Hb Ma) and Hb Minor (Hb Mi). The major component consists of two electrophoretically indistinguishable tetramers each composed of two heterodimers; the minor hemoblogin is a homodimer whose subunits are different from the tetramer. Functionally, Hb Ma has a higher P50, exhibits a concentration dependent oxygen affinity, has significant ligand cooperativity (n = 2.0), lacks a Bohr effect and is unaffected by ATP. HB Mi has a P50 which is lower and independent of hemoglobin concentration, shows appreciable cooperativity (n = 1.4) and exhibits no heterotropic effects. Both Hb Ma and Mi are resistant to dissociation in the presence of 1.0 M NaI, NaCl and guanidine HCl but dissociate to monomers when converted to the aquamet but not the cyanmet derivative. The dissociation is completely inhibited by mercaptoethanol. The large number of reactive -SH groups (10-13 per tetramer) suggests that the monomerization is mediated by intra-subunit disulfide bridge formation. PMID- 3829629 TI - Kidney gluconeogenesis: its importance to net glucose synthesis during the development of chick embryos. AB - A technique is described for the preparation of viable isolated kidney tubules from chick embryos. Assessment of the potencies of various possible gluconeogenic precursors indicates that kidney is the site of net glucose synthesis from physiologically relevant precursors during embryonic life. The plasma concentrations of physiological gluconeogenic precursors was determined and the rates of glucose synthesis by tubules was measured from a precursor mixture which stimulated plasma contents. PMID- 3829630 TI - Lipids in the laminated layer of liver, lung and daughter hydatid cysts of equine Echinococcus granulosus (Cestoda). AB - Lipids extracted from the laminated layers of horse liver and lung hydatids, including a daughter liver cyst, were analysed using TLC. No differences in lipid composition was detected in 11 liver cysts, whether from the same or different livers, and di- and triacylglycerols, cholesterol, wax and steryl esters, oleic acid, sphingomyelin, phosphatidyl choline, phosphatidyl inositol and ceramide hexosides were detected. The daughter cyst differed from its "parent" cyst in lacking diacylglycerols and wax and steryl esters. The lung cyst differed from the liver cysts in that cholesterol, wax and steryl esters and diacylglycerols were not detected. PMID- 3829631 TI - Effect of opsonization on oxidative metabolism of plaice (Pleuronectes platessa L.) neutrophils. AB - The effect of serum opsonization on Vibrio alginolyticus (heat-killed)-stimulated chemiluminescence (CL) by plaice kidney- and peritoneal exudate-derived neutrophils was investigated. Peritoneal neutrophils only recognized heat-labile and kidney neutrophils only heat-stable opsonic activity in normal serum. Specific antibody did not show opsonic activity nor any synergism with the normal serum opsonins for either neutrophil population. Evidence was found for the production, by plaice neutrophils, of H2O2, O2-, OH. and two or more, as yet unidentified, reactive oxygen species (ROS). PMID- 3829632 TI - Structural and functional studies on insulin receptors from alligator brain and liver. AB - Insulin receptors are present in membranes prepared from Alligator mississippiensis brain and liver. The apparent molecular weight (MW) of the alpha subunits are 132 kDa and 118 kDa in liver and brain respectively. Apparent MW of the beta subunit is 92 kDa in both brain and liver receptors. Despite the structural differences between brain and liver alpha subunits, brain insulin receptors demonstrate the normal coupling between alpha and beta subunits, i.e. following binding of insulin to the alpha subunit the beta subunit undergoes autophophorylation and stimulates tyrosine specific phosphorylation of exogenously added substrates. These findings suggest that functional insulin receptors are evolutionarily well conserved. PMID- 3829633 TI - Interaction of the organic anion 1-aniline 8-naphthalene sulfonate (ANS) with isolated rat hepatocytes. AB - The interaction of ANS with rat hepatocytes in time was studied by fluorescence spectroscopy. The intercept of the first linear portion of the time curve of interaction showed a positive value over all the ANS concentration range employed. This value was maintained after cellular disruption by homogenization. It was affected by ionic strength, pH, and divalent cation in the incubation medium, all conditions affecting the cellular surface. These data suggest that this phenomenon might be a binding of the compound to the hepatocytes surface. Due to the time constant and its disappearance after cellular disruption the other slower component of the curve seems to correspond to a process of translocation across the membrane. PMID- 3829634 TI - Comparative studies on the isoenzymes of glutathione S-transferase of rat brain and other tissues. AB - Six forms of glutathione S-transferase (GST) designated as GST 9.3, GST 7.5, GST 6.6, GST 6.1, GST 5.7 and GST 4.9 have been purified to homogeneity from rat brain. All GST isoenzymes of rat brain are apparent homodimers of one of the three type subunits, Ya, Yb, or Yc. More than 60% of total GST activity of rat brain GST activity is associated with the isoenzymes containing only the Yb type of subunits. In these respects brain GST isoenzymes differ from those of lung and liver. The Ya, Yb, and Yc type subunits of brain GST are immunologically similar to the corresponding subunits of liver and lung GST. The isoelectric points and kinetic properties of the Yb type subunit dimers in brain are strikingly different from those of the Yb type dimers present among liver GST isoenzymes indicating subtle differences between these subunits of brain and liver. PMID- 3829635 TI - A correlative lipid and lipolytic study of the pancreas and small intestine of the guinea-pig. AB - With the aid of a variety of TLC preparations the phospholipid and neutral lipid profiles of guinea-pig pancreas and small intestine has been established. Changes in these profiles, subsequent to incubation of these tissues and prior to lipid extraction, has provided evidence relating to their respective lipolytic enzyme capabilities, mainly in the phospholipase group. PMID- 3829636 TI - Comparative analysis of the malate dehydrogenases isolated from the cytosolic fraction of several tissues of guinea-pig Cavia porcellus. AB - The specific activities of the malate dehydrogenase and lactate dehydrogenase present in the soluble fraction of several guinea-pig tissues are reported. The electrophoretic patterns showed always two forms (A and B) with malate dehydrogenase activity and the five isoenzymes of lactate dehydrogenase. Chromatography of the different soluble fractions through 5' AMP-Sepharose allowed both molecular forms of malate dehydrogenase to be separated and obtained free from lactate dehydrogenase. Comparative studies of the two forms of malate dehydrogenase evidenced that the A and B forms exhibited cytosolic and mitochondrial characteristics, respectively. PMID- 3829637 TI - Distribution of adenosine deaminase in some rat tissues. Inhibition by ethanol and dimethyl sulfoxide. AB - The level of adenosine deaminase in various rat tissues has been tested. The enzyme activity of cytosolic fractions decreased in the following order: lung greater than spleen greater than small intestine greater than stomach greater than kidney greater than heart greater than liver greater than skeletal muscle greater than forebrain greater than cerebellum. The enzyme had identical patterns from tissue to tissue with respect to Km, V, and Ki values for ethanol and for dimethyl sulfoxide, with respect to electrophoretic behaviour and to inhibition by antibodies anti-rat brain adenosine deaminase. PMID- 3829638 TI - A computer program for variance function estimation, with particular reference to immunoassay data. AB - A computer program is described for estimating a simple one or two parameter variance function using approximate conditional likelihood. The inverse of the fitted function provides a smooth weighting function for use in subsequent manipulation of the data. The program is designed for immunoassays, where both the raw experimental observations, and the final results from data reduction, are well known to exhibit nonuniformity of variance, but it may also have application in other areas where the observations follow approximately normal distributions and a weighting function is required. Five variance function forms are optionally available as subroutines, and if necessary, one or more of these can be incorporated into existing software with trivial modification. The test of fit of the assumed function provides an objective criterion for detecting outliers, and the program includes automatic outlier exclusion as an option. PMID- 3829639 TI - Estimation and removal of power line interference in the electrocardiogram: a comparison of digital approaches. AB - Global filtering of AC interference in the digitized ECG is introduced as a new concept. Two different filters embodying a global approach are presented. One is based on a least-squares error fit, the other uses a special summation method. Both methods are compared with a local predictive filter by applying each filter to artificial signals and to real ECGs. A critical evaluation of the results is given. PMID- 3829640 TI - A computerized system for acquiring DNA solution viscosity data. AB - A new computerized system for monitoring time-dependent viscosity changes of DNA solutions is reported. It provides an extremely sensitive measure of DNA lesions induced by chemical carcinogens. The described apparatus consists of some precision mechanical modules, derived by an early manual version of the system, and of some new electronic parts as optical sensors, a microprocessor-based unit and a personal computer. The new system allows the analysis of more than one specimen at the same time. Compared with the early manual method of measuring, this computerized system, by removing subjectivity and a certain number of casual and systematic errors that might occur with the operator manual intervention, makes possible the evaluation of the resolving power of the viscometers themselves in detecting viscosity changes. PMID- 3829641 TI - An interactive computer program for the analysis of growth curves. AB - An interactive FORTRAN program, MUDIFT, is presented. This program was designed to perform a multivariate distribution-free significance test for the comparison of growth curves. Such a test, not assuming functional forms of individual growth, has proved useful when the variety of observed growth curves was too broad to be represented by the family of growth functions and when there were incomplete observations. A numerical example illustrates the use of MUDIFT to analyze serial data pertaining to the measurable solid tumors in 20 mice treated with liposome incorporated muramyltripeptide phosphatidylethanolamine and a control group of 30 mice. The tumor volumes were recorded weekly for 10 weeks following initial entry into the research protocol. The test hypothesis was whether the tumors grew slower in the treated group than in the control group. The test statistic, an asympotically chi 2 statistic, was 7.312 with df = 2, which was significant at alpha = 0.05. PMID- 3829642 TI - Interactive statistical analysis of survival data. AB - This paper describes a SAS macro which facilitates the interactive analysis of right-censored survival data. Such data commonly occur in medical studies. The program produces Kaplan-Meier survival curves on a wide variety of graphics devices. The program also performs log-rank and generalized Wilcoxon significance tests among all plotted curves and for each pairwise contrast if desired. Because the program is intelligent and does not prompt the user for information that it can independently obtain, it is quite easy to use. PMID- 3829643 TI - An interactive program for determining tentative gene assignments from immunological data. AB - This paper announces an interactive program that could be useful for workers investigating new immunogenetic systems and theoreticians seeking to resolve persistent puzzling questions about systems already developed. The program seeks symbolic representations of data and its interpretations. By its ability to work with symbolizations in their most general form it is able to reveal symbolic patterns that may correspond directly to otherwise unexpected genetic models. PMID- 3829644 TI - Determining drug-drug interactions and related effects on microcomputers. AB - Algorithms for determining drug-drug interactions are described. They handle all the generic drugs in the British National Formulary (BNF) (Number 5, British Medical Association and Pharmaceutical Society of Great Britain, 1984) and allow these drugs to be identified by generic or trade name. They also accept and identify interactions for compound drugs prescribed by a single trade name. The algorithms can be implemented on any microcomputer and in a number of languages. The choice of algorithm and number of drugs handled depend on size and disk storage of the microcomputer. It was tested in collaboration with the Department of Geriatric Medicine, Liverpool University, and is used in a prescribing monitoring system operational in some wards of the Royal Liverpool Hospital. The drug data are stored in the form given in the BNF and can be easily updated from this publication. The algorithms can also handle drug allergies and cross sensitivities. PMID- 3829645 TI - Real-time acquisition and analysis of cardiac action potentials and twitches using a programmable digitizer and a microcomputer. AB - Action potentials and single twitches from papillary muscles were acquired and analyzed in real-time using a programmable digitizer and a microcomputer. This combination provides greater control and flexibility during data acquisition than standard analog-to-digital converters. The present system was designed to facilitate evaluation of experimental drugs. However, the combination of a programmable digitizer and a laboratory microcomputer can be applied to a variety of applications in biomedical research. PMID- 3829646 TI - PRONUC: a software package for the analysis of protein and nucleic acid sequences. AB - PRONUC is a menu-driven software package from which a molecular biologist may gain access to a variety of tools for the analysis of protein and nucleic acid sequences. Features include various algorithms for sequence comparisons, secondary structure prediction, sequence manipulation (translation complementation etc.) and finding restriction enzyme cut-sites. The sequences under study can be retrieved from several databases of published sequences or a users sequence(s) can be entered by means of a sequence editor or retrieved from a database constructed by the user. PRONUC comes with a comprehensive manual and on-line help which reflects several years of user feedback and is available for Digital VAX computer systems running the VMS or micro-VMS operating system. PMID- 3829647 TI - Analysis of underlying and multiple-cause mortality data: the life table methods. AB - The stochastic compartment model concepts are employed to analyse and construct complete and abbreviated total mortality life tables, multiple-decrement life tables for a disease, under the underlying and pattern-of-failure definitions of mortality risk, cause-elimination life tables, cause-elimination effects on saved population through the gain in life expectancy as a consequence of eliminating the mortality risk, cause-delay life tables designed to translate the clinically observed increase in survival time as the population gain in life expectancy that would occur if a treatment protocol was made available to the general population and life tables for disease dependency in multiple-cause data. PMID- 3829648 TI - Computer programs for the analysis of protein fluorescence quenching data. AB - Educational computer programs for analysis of fluorescence quenching studies of proteins have been developed. The program is written according to the classical Stern-Volmer equation and some modified Stern-Volmer equations. The static and dynamic quenching constants as well as the accessibility of the quencher molecules to the fluorescence groups are calculated. The experimental data are plotted on a high resolution graph. The calculated data or the graphs can be printed out to obtain a hard copy for filing. PMID- 3829649 TI - Computer program for calculation of kinetic and pharmacologic parameters using a 'direct linear plot' derived algorithm. AB - Data processing using nonparametric statistics was performed using a 'direct linear plot' algorithm of ECB. ECB (Eisenthal and Cornish-Bowden) is a computer program designed to calculate the Km and V parameters in enzyme kinetics. It is also suitable for estimation of EC50 (ligand or drug concentration for 50% effect) in pharmacological studies. PMID- 3829650 TI - A microcomputer program for simulation of linear compartmental physiological models: computation on Apple IIe. AB - The microcomputer program presented here allows the simulation of linear compartmental physiological models whose structure is known. The method used is the 4th order Runge-Kutta method. Implemented on the Apple IIe, this program is fully interactive and presents the possibility of changing model parameters or initial values from run to run. PMID- 3829651 TI - A simple BASIC program for the calculation of nonparametric confidence intervals in bioequivalence testing. AB - A BASIC program is described which allows the calculation of confidence intervals on the basis of observations following a balanced two-way cross-over design. The algorithms executed by the program are completely outlined. They do not contain assumptions as to the expected properties of the sampling distribution. The function of the program modules is explained in detail with reference to the program listing provided. A test run of the program is presented, which demonstrates its validity on the basis of literature data. PMID- 3829652 TI - Reading, storing and statistical calculation of weight data. AB - A BASIC program is described which reads and computes weight data. Tara and gross weight data are read from an analytical balance. The net weights are calculated and stored on a disc. A statistical test (e.g. unpaired t-test or unpaired Wilcoxon test) can then be carried out with the weight data. The program calculates a descriptive statistic before the tests. PMID- 3829653 TI - The impact of suicide on therapists in training. PMID- 3829654 TI - Primary and secondary affective disorders: unipolar patients compared on familial aggregation. PMID- 3829655 TI - A lack of justification for routine screening assays for syphilis in general hospital psychiatric patients. PMID- 3829656 TI - A conceptual model for research on required length of psychiatric hospital stay. PMID- 3829657 TI - Cognitive therapies with neurotic disorders: clinical utility and related issues. PMID- 3829658 TI - Panic disorder: residual symptoms after the acute attacks abate. PMID- 3829659 TI - The Foulds hierarchy of personal illness: a review of recent research. PMID- 3829660 TI - The treatment of depression: electroconvulsive therapy v antidepressants: a naturalistic evaluation of 1,495 patients. PMID- 3829661 TI - The prevalence of abnormal paranasal sinus x-rays in patients with olfactory disorders. PMID- 3829663 TI - Should your children become doctors? PMID- 3829662 TI - Sarcomas of the kidney. PMID- 3829664 TI - Identification and disposition of trauma patients with substance use or psychiatric illness. PMID- 3829665 TI - Metered dose inhalers. PMID- 3829666 TI - Consensus development summaries. Infantile apnea and home monitoring. National Institutes of Health. PMID- 3829667 TI - Health effects of smokeless tobacco. AMA council on Scientific Affairs. PMID- 3829668 TI - Clarifying the therapist's duty to warn potential victims: II. PMID- 3829669 TI - The value of hepatic imaging in the management of blunt abdominal trauma. PMID- 3829670 TI - Consensus development summaries. Platelet transfusion therapy. National Institutes of Health. PMID- 3829671 TI - The physician's dilemma. PMID- 3829672 TI - The Ganser syndrome: a diagnostic and etiological enigma. PMID- 3829673 TI - Disseminated aspergillosis and Cushing's syndrome in a community hospital. PMID- 3829674 TI - Menstrual blood loss, haemoglobin and ferritin concentration of Beijing women wearing steel ring, VCu 200, and TCu 220c IUDs. AB - Menstrual blood loss (MBL), serum ferritin and whole blood cyanmethemoglobin were measured at pre- and 1, 3, 6, 12, 18 and 24th postinsertion cycles in 60 women wearing the Steel Ring, the Copper V (VCu 200) or the Copper T (TCu 220c). The MBL, incidence of menorrhagia and iron deficiency anemia were lower among users of the Steel Ring than among users of the Copper V and T. Anemia occurred later and the duration of menstruation was shorter with the Steel Ring than with the Copper T. There were no statistically significant differences between the Copper V and T. PMID- 3829675 TI - A multi-compartment vaginal ring system for independently adjustable release of contraceptive steroids. AB - A multi-compartment contraceptive vaginal ring system has been designed for the simultaneous zero-order release of contraceptive steroids, the rates of which can be programmed independently. This vaginal ring system consists of two or more drug-containing Silastic tubes with an outer diameter of 5 mm. The tubes with different lengths, with a total length of 16.5 cm are connected with specially shaped glass stoppers to obtain a ring with an outer diameter of 60 mm. The stopper prevents migration of the steroids from one compartment to the other and guarantees optimal release characteristics of both steroids even after long-term storage. An additional advantage of glass is the good adherence to Silastic, enabling construction of systems with sufficient tensile strength. The release characteristics have been followed in vitro and can be programmed independently by changing the wall thickness of the tube (membrane thickness) and/or the length of each individual steroid-containing compartment. Multicompartment vaginal rings were made and tested with 3-keto-desogestrel and ethinylestradiol. The rings had an outer diameter of 60 mm, and were fabricated with independent in vitro release rates ranging from 75 to 300 micrograms/day and 10 to 30 micrograms/day for, respectively, 3-keto-desogestrel and ethinylestradiol. Using the multi compartment vaginal ring system, contraceptive devices can be fabricated relatively simply with pre-programmed release rates for a progestogen and an estrogen to investigate the optimal daily doses for vaginal hormonal contraception. PMID- 3829676 TI - Quantitation of RU 486 in human plasma by HPLC and RIA after column chromatography. AB - Chromosorb column chromatography was used for separation of RU 486 from its immunologically cross-reacting metabolites prior to quantitative analysis by radioimmunoassay (RIA) or high-performance-liquid chromatography (HPLC). The results of the two assay methods were in good agreement with each other (r = 0.99, n = 29). The retention time of RU 486 in our HPLC system was 2.5 min. Plasma concentrations of RU 486 were measured by HPLC up to 48 h following single oral administration of 100, 400, 600 and 800 mg of RU 486 to female volunteers. The plasma peak concentrations (2.0-2.5 micrograms/ml) were reached within the first hour. After redistribution, the plasma concentrations of RU 486 were not significantly affected by the doses studied but remained in the same range throughout the 48 hours. The plasma half-life between 24 and 48 hours was 27 hours or more. We conclude that HPLC is valuable in studies on the metabolism and pharmacokinetics of RU 486, but a less laborious RIA method after Chromosorb column chromatography is suitable and gives reliable results in large-scale clinical studies. PMID- 3829677 TI - Disruption of pregnancy in mouse by aristolic acid: I. Plausible explanation in relation to early pregnancy events. AB - Aristolic acid (AA), obtained from Aristolochia indica Linn, disrupted nidation in mice when administered on Day 1 of pregnancy. The implantation inhibiting effect of the compound was assessed with respect to certain parameters which are characteristics of early pregnancy, such as tubal transport of ova into the uterus, hyperpermeability of the endometrial capillaries, increase in uterine weight and total protein content, endometrial bed preparation and changes in uterine phosphatase enzymes during Days 4-6 of pregnancy. The compound did not affect tubal transport of eggs, but the uterine blue reaction, caused by extravasation of the dye, pontamine blue, at future implantation sites was inhibited significantly in treated mice. Histological picture of the uterus revealed AA-induced impairment of development (i.e. decidualization) and reconciled with decreases found in uterine weight and its total protein contents in treated animals. In control untreated mice, specific uterine alkaline phosphatase (ALP) activity increased significantly from Days 4 through 6 of pregnancy, but this was prevented in treated mice. On the other hand, specific uterine acid phosphatase (AP) activity was high on Day 5, while in treated mice uterine AP activity remained low during Days 4 and 5 and increased significantly thereafter. It was inferred that AA interferes with steroidal conditioning of the uterus and renders it hostile to ovum implantation. PMID- 3829678 TI - Results of metabolic investigations. PMID- 3829679 TI - New perspectives in diagnosis and treatment of kidney disease. PMID- 3829680 TI - Clinical effects of long-term dietary protein and phosphorus restriction in patients with early chronic renal failure. PMID- 3829681 TI - Comparative analysis after 6 years of results obtained with continuous ambulatory peritoneal dialysis and hemodialysis. PMID- 3829682 TI - Dietetic education and assessment of compliance in patients with chronic renal insufficiency. PMID- 3829683 TI - Percutaneous surgery in the management of renal stones. PMID- 3829684 TI - Shock waves lithotripsy. PMID- 3829685 TI - The use of two-dimensional and Doppler echocardiography in assessing mitral regurgitation and segmental contractility disturbances in patients with dilated cardiomyopathy and ischaemic heart disease. AB - Forty-three patients with dilated cardiomyopathy (DCMP) and 12 patients with ischaemic heart disease (HD) in different stages of heart failure were examined using ultrasound sector scanning and pulsed Doppler echocardiography. The degree of mitral regurgitation was determined semi-quantitatively, according to the distance at which the turbulent blood stream penetrates into the left atrial cavity. The dimensions of the left atrium and auscultatory manifestations are not always a reliable indicator of the degree of regurgitation. The severity of mitral regurgitation depends on the dilatation and reduced contractility of the left ventricle as well as on the dilatation of the mitral annulus. Segmental contractility of the left ventricle was assessed using computer analysis of two dimensional EchoCG. A characteristic feature of DCMP is not only a diffuse decrease in left ventricular contractility but also its segmental disturbances. These disturbances are in DCMP the same as in IHD, but in patients with DCMP there is no simultaneous occurrence of normokinetic and dyskinetic segments. PMID- 3829686 TI - Use of verapamil in the treatment of hypertrophic cardiomyopathy. AB - Thirty-seven patients with hypertrophic cardiomyopathy were treated with verapamil in a dose of 240-360 mg/day and followed for 40 months. Marked symptomatic improvement (by at least one class according to the NYHA classification) occurred in 21 (57%) of the patients improved. An increase of left ventricular end-diastolic dimension and volume was recorded. A significant reduction of isovolumic relaxation period (peak velocity of filling and peak velocity of circumferential fibre changes in diastole) occurred. These favourable effects were, however, no longer unequivocal from the fourth month of treatment onwards. Verapamil treatment in hypertrophic cardiomyopathy is a valuable approach by which symptomatic improvement and a favourable effect on some left ventricular functions can be achieved. Its value is, however, to some degree reduced by the lack of long-term effect. PMID- 3829687 TI - A critical appraisal of M-mode echocardiography in mitral stenosis. AB - The reliability of M-mode echocardiography in confirming mitral stenosis and in assessing its severity was tested in 39 patients with mitral stenosis. None of the conventional echocardiographic signs of mitral stenosis is absolutely reliable. Unless at least 2 signs are combined, the diagnosis is not conclusive (sensitivity = 0.97, specificity = 1.00). Of a number of echocardiographic parameters and equations recommended (as tools) to determine the severity of mitral stenosis, the early diastolic velocity of anterior leaflet opening (EF) is the only one with a statistically significant relationship to the mitral valve area (MVA) calculated by Gorlin (r = 0.712, p less than 0.001), and this only in uncomplicated unoperated mitral stenoses, but not in mitral restenoses and combined mitral defects. Even the recently published Seitz's equation for calculating MVA from echocardiographic data is not reliable. M-mode echocardiography is an excellent technique for the primary diagnosis of mitral stenosis. However, it is not suitable to even an approximate assessment of its haemodynamic severity. PMID- 3829688 TI - The possibility of non-invasive identification of occluded coronary artery in acute myocardial infarction. A comparison of ECG and echocardiography with coronary arteriography or autopsy. AB - In 73 patients with acute occlusion of single coronary artery, the authors assessed the possibilities of ECG and echocardiography in determining non invasively which of the 3 main arteries had been occluded. The sensitivity of ECG for the individual arteries and particular ECG signs ranged between 30-98%, the specificity was between 86-100%. While it was always possible to determine occlusion of the left anterior descending coronary artery (LAD), in several cases it was difficult to distinguish between occlusion of the left circumflex (LCX) and the right coronary artery (RCA). The LCX occlusion is a frequent source of error in interpreting electrocardiograms of patients with fresh myocardial infarction. The sensitivity of echocardiography in identifying the occluded coronary artery ranged between 77-100%, specificity 97-100%. The following ECG and echocardiographic signs of coronary occlusion were determined. The LAD occlusion is indicated by ECG changes in V1-4, and anteroseptal and apica asynergy on echocardiography. LCX occlusion: increased R wave amplitude in V1, and lateral and posterior wall asynergy. The RCA occlusion: ECG changes in II, III, aVF, asynergy of the posterior wall and part of the septum and right ventricle. These combined signs make possible the identification the occluded coronary artery in 95% of patients with myocardial infarction. PMID- 3829689 TI - Surgical treatment of left ventricular thrombi: two-dimensional echocardiographic diagnosis. AB - Two cases of successful surgical removal of left ventricular thrombi are presented. Two-dimensional echocardiography revealed in the first case multiple masses of thrombi in the dilated ventricle consistent with congestive cardiomyopathy and emergency surgery was performed for cerebral embolism. In the second case the thrombus was pedunculated and calcified, a probable sequel of a 17-year old myocardial infarction. The pertinent literature of echocardiographic and surgical aspects of left ventricular thrombi is reviewed. PMID- 3829690 TI - Diagnostic value of two-dimensional Doppler echography in structural and functional changes of the great arteries. AB - The paper discusses diagnostic possibilities of two-dimensional Doppler echography in ambulatory conditions in evaluating affection of the great arteries in patients with documented lesions of the vascular bed. The application of the given method substantially extends and complements information offered by routine clinical examination, and its informative value approximates that of the invasive examination methods. It makes possible visualization of the carotid, femoral and renal artery, measurement of their diameter, and quantitative assessment of the linear and volume velocity of blood flow. It proved particularly successful in diagnosing stenotic changes on the renal arteries, where it showed high specificity and sensitivity. PMID- 3829691 TI - The importance of quantitative Doppler in assessment of mitral stenosis. AB - Duplex Doppler echocardiography with high pulse repetition frequency was used to study: group A - 7 patients with mitral stenosis (MS) during cardiac catheterization, and group B - 26 patients with MS in whom the Doppler examination was performed 24 h-3 months prior to catheterization. Using the peak flow velocity within the stenotic flow jet, the pressure drop and mitral valve area (MVA) were calculated and compared with data obtained invasively. The inter observer variability of the two parameters was 12% and 5%, respectively. The correlation between Doppler pressure drop and invasive measurement was excellent in group A (r = 0.83), while less close in group B (r = 0.71). However, using only MVA estimates (group B), it was possible to recognize most of MS with catheterization MVA less than or equal to 1.0 cm2/m2 (sensitivity and predictive value both of 90%). Therefore, even nonsimultaneous quantitation of MS seems valuable in pre-operative patient evaluation, adding a new information to hitherto existing echocardiographic criteria. PMID- 3829692 TI - Diagnostic value of pulsed Doppler echocardiography in combined heart defects. AB - 26 patients with combined heart defects were examined by means of ultrasound methods (one-dimensional, two-dimensional and Doppler echocardiography). The results were compared with the results of clinical and roentgenological examinations. Taking into account literary data on high sensitivity and specificity of Doppler echocardiography, its informative value was assessed in cases when affection of two or more valves results in a balancing of haemodynamic changes. It was documented that pulsed Doppler EchoCG makes possible to assess the character and the direction of blood flow in different phases of the cardiac cycle in the heart cavities and the great vessels, and thereby provides additional information on the involvement of the valvular apparatus and on the state of haemodynamics. The sensitivity of this method is particularly high in the detection of regurgitant flow. PMID- 3829693 TI - Culture-bound syndromes and international disease classifications. AB - An important endeavor in the world psychiatric community is the development of an international classification of psychiatric disorders that will be more culture free than either the current DSM-III or ICD-9. This classification should be clinically useful and relevant to psychiatric experience in all countries of the world. A major problem in this endeavor is the existence of the so-called culture bound syndromes syndromes (CBS's) which reflect cultural influences on disease patterns and render them difficult to place in disease classifications which have their origins in Western cultures. Literally dozens of disorders have been labelled CBS's around the world, and considerable looseness has developed in the use of the CBS rubric. Recently it has been proposed that all illnesses (both physical and psychiatric) are in fact culture bound. In reaction to this drift towards meaninglessness, a new definition for CBS's is proposed - a collection of signs and symptoms (excluding notions of cause) which is restricted to a limited number of cultures primarily by reason of certain of their psychosocial features. In this definition, notions of etiology and illness labels are excluded because these are highly variable and change over time. On the other hand, collections of signs and symptoms (i.e., syndromes), insofar as they are reasonably complete descriptions of nature, remain constant over time and are verifiable by all investigators. Using two CBS's from the Pacific basin area - taijin-kyofu-sho and latah - as examples, the following conclusions are drawn: CBS status should not be assigned on the basis of differential distribution of illnesses because of accidents of geography or on the basis of local labels or notions of cause; epidemiological features of diseases such as global prevalence or age/sex differentials of those affected should not be used as basis of CBS status; the meaning of illness, both for individuals and for cultures, is an important area of study in its own right but such meanings should not be confused with syndrome descriptions or used as criteria for an international disease classification; a truly international classification of diseases is close to realization through relatively minor alterations in the Axis I designations and descriptions of DSM III. Few entirely new categories would be required. PMID- 3829694 TI - 'Mental' in 'Southie': individual, family, and community responses to psychosis in South Boston. AB - The deinstitutionalization of psychiatric patients is a deeply cultural as well as political task. It entails the sharing of responsibility for human distress with family and community. Consequently, the locus of social control has also shifted from psychiatric and medical expertise to community and legal institutions. Diagnosis and treatment models must be more compatible with lay explanatory models. This paper explores the various meanings of "going 'mental"' and "being 'mental"' in the white, working class, ethnic neighborhood of South Boston. The data are extracted from a study of the impact of deinstitutionalization on a cohort of middle-aged, psychiatric patients discharged from Boston State Hospital in the attempt to return them to community living. Individual, family, and community responses to, and interpretations of, the symptoms of mental distress are discussed. The study indicates that even seriously disturbed individuals are sensitive to cultural meanings and social cues regarding the perception, expression, and content of psychiatric episodes. While madness invariably disenfranchises, it does not necessarily deculturate the individual. PMID- 3829695 TI - Health beliefs and hypertension: a case-control study in a Moroccan Jewish community in Israel. AB - This research focuses on the efficacy of health interventions and patient physician negotiation in modifying patient belief models and influencing compliance behavior. It is an example of clinically applied anthropology in the Hadassah Family Practice Clinic of Beit Shemesh, Israel. Forty-six Moroccan Jewish hypertensives and normotensives were interviewed using a semi-structured questionnaire. Explanatory models of hypertension were elicited. In addition, the results from all questionnaires were scored according to the Health Belief Model Equation and correlated with each individual's assessed compliance. The only positive correlation, significant to p less than 0.05, was found among hypertensives: a correlation between the degree of compliance and the congruence of the individual's health belief model with that of the health provider. The authors conclude that hypertensive health belief and explanatory models were not perceptibly affected by health care intervention. The congruence of the patient's health belief model with that of the health provider may be predictive of compliance. PMID- 3829697 TI - International Conference on Herpetic Eye Diseases. North Lake Tahoe, California, USA, September 6-8, 1986. Proceedings. PMID- 3829696 TI - Conceptualization of psychiatric illness and help-seeking behavior among Chinese. AB - Problem conceptualizations of Chinese psychiatric patients were studied in relation to the patterns of help-seeking and ways of coping. Patients who conceptualized their initial problems in purely psychological terms were more likely to use self-directed psychological coping methods, delay initial professional consultation, and approach mental health professionals. Patients who used only somatic concepts were least likely to approach mental health professionals initially or any time during their previous consultation history, and tended to approach medical resources to cope with their problems. Patients who conceptualized their problems in mixed terms approached professional help early on and reached psychiatric resources soonest. These results provide a clearer perspective to understand the somatization tendency among Chinese patients. PMID- 3829698 TI - Herpetic keratitis therapy to reduce recurrence. AB - Since the herpes simplex virus locates latently in the ganglia and is reactivated by certain triggers, the important problem in treatment is to prevent or reduce recurrence. The present study investigates the role of mechanical debridement in lessening the recurrence of dendritic keratitis in patients with herpetic epithelial keratitis. Group A was treated with mechanical debridement plus IDU, Group B with IDU alone. Also studied was the effect of steroid subconjunctival injection on herpetic recurrence in patients with herpetic stromal keratitis: Group C was treated with intravenous infusion of pepsin-treated gamma-globulin (PTGG) and steroid subconjunctival injection, Group D with steroid subconjunctival injection alone and Group E with intravenous infusion of PTGG alone. The recurrence rates of dendritic keratitis were 19% in Group A and 40% in Group B (average follow-up periods: 24 and 25 months). The recurrence rates of stromal keratitis were 61% in Group C, 64% in Group D, and 36% in Group E (average follow-up periods: 20, 19 and 15 months). The difference between Groups D and E was statistically significant (chi 2 test, P less than 0.05). The recurrence rates of dendritic keratitis were 18% in Group C, 21% in Group D and 7% in Group E. In conclusion, mechanical debridement tended to reduce the recurrence of herpetic epithelial keratitis and steroid subconjunctival injection to increase the recurrence of epithelial or stromal keratitis. PMID- 3829699 TI - Adenosine deaminase in herpes simplex virus induced corneal stromal disease. AB - The development of herpes simplex virus (HSV)-induced disciform stromal disease produced by the intrastromal injection of the RE strain of HSV-1 is characterized by concurrent increases in adenosine deaminase (ADA) activity and corneal thickness. ADA activity increased from 8.6 units/cornea in normal corneas to about 14.1 units and 31.1 units in mock-infected controls and HSV-infected corneas respectively by 15 days postinjection. The molecular weight species of ADA in the corneas of HSV-infected rabbits appeared altered relative to that present in corneas which were not infected. A single topical dose with as low as 0.1% 2'-deoxycoformycin (dCF), an ADA inhibitor possessing immunosuppressive activity, was capable of totally inhibiting the corneal ADA activity. Titration of the free dCF in the cornea following a single topical dose of 0.25% dCF indicated that enough dCF remained in the cornea 24 hrs after instillation to totally inhibit all corneal ADA plus 66 units of additional enzyme. These data suggest that ADA may be a suitable target for immunosuppressive therapy during HSV-induced disciform stromal disease. PMID- 3829700 TI - The response of Langerhans cells in the cornea to herpetic keratitis. AB - Langerhans cells (LC) appear to have a role in the processing of antigens presented through cutaneous surfaces. In most species LC are found in the conjunctiva and limbal epithelium but are rarely found in the central cornea. A quantitative study of corneal LC was performed in guinea pigs and rabbits with HSV-1 keratitis. Corneal epithelial sheets were removed, stained with ATPase and counted in the peripheral, paracentral and central cornea. Results in guinea pigs showed statistically significant increases of LC on days 6, 16, 21 and 28 in the paracentral and central cornea of HSV eyes. Results in rabbits showed an increase in LC on days 9, 13 and 21 in the paracentral and central cornea of HSV eyes. No LC were found in the central cornea of control eyes. The results indicate a migration of LC to the central cornea as a result of HSV keratitis. PMID- 3829701 TI - Histopathology of herpes simplex virus keratouveitis. AB - Twenty-four eyes removed for complications of HSV keratitis were studied histopathologically. There were 20 men and 4 women with an average age of 61 years. Severe keratitis was seen in 14, moderate in 7, and mild in 3 eyes. Common features associated with severe keratitis were: acute perforation, granulomatous keratitis with giant cells in the stroma and Descemet's region, stromal inflammatory cells, angle-closure, severe iridocyclitis with diffuse or focal infiltration of lymphocytes and plasma cells, low-grade vitritis, choroiditis, and/or retinal periphlebitis. Specimens with moderate to mild keratitis had a similar distribution of inflammation but a lower incidence of granulomatous keratitis. PMID- 3829702 TI - Herpes simplex masquerade syndrome: acanthamoeba keratitis. AB - Acanthamoeba is a free-living, fresh-water protozoan that can cause severe corneal disease. Acanthamoeba keratitis can closely mimic epithelial and stromal Herpes simplex keratitis. Three cases of severe keratitis, were referred for treatment. One patient presented with a pseudodendritic epithelial lesion that gradually progressed to stromal involvement. A second patient presented with central stromal infiltrate and necrosis, while a third exhibited features of a disciform lesion with the later development of an immune ring. Acanthamoeba was recovered from the cornea in each case. The distinctive characteristics of the history and clinical findings in Acanthamoeba keratitis can aid the clinician in distinguishing between these two clinical entities. Cytopathology and special staining and culture techniques can confirm the diagnosis. PMID- 3829703 TI - A primate model for acute and recurrent herpetic keratitis. AB - Twelve squirrel monkeys were inoculated in both eyes with the Rodanus strain of herpes simplex virus type 1 (HSV-1) and were examined for the presence of acute epithelial keratitis. All of the eyes developed dendritic keratitis within 72 hours after inoculation. The twelve monkeys plus two additional similarly infected monkeys were also examined for the presence of clinical recurrences of ocular herpes infections and spontaneous shedding of virus in their tears. Two of the eyes developed stromal disease, and 13 of the monkeys had at least one episode of recurrent clinical epithelial disease. Virus was isolated from two of the eyes with recurrent dendrites. PMID- 3829704 TI - Histopathologic characteristics of two forms of experimental herpes simplex virus retinitis. AB - Herpes simplex virus type 1 (HSV-1) inoculated intracamerally into one anterior chamber of a BALB/c mouse produces retinitis in the uninoculated contralateral eye within 7 to 10 days while the retina of the inoculated eye is spared. In sharp contrast, animals receiving HSV type 2 (HSV-2) by the anterior chamber route develop a dramatic retinitis in the inoculated eye by day 7 postinoculation while the retina of the contralateral eye remains uninvolved. Histopathologic examination of retinal destruction in the HSV-2-infected ipsilateral eye revealed features which were distinct from those observed in the contralateral eye of HSV 1-infected animals. Whereas HSV-1 produced a rapid, explosive, retinitis which led to destruction of all cell layers of the contralateral retina, HSV-2 induced a retinitis in the ipsilateral eye that was more gradual in onset. Ipsilateral HSV-2 retinitis was characterized initially by disruption of the ganglion and inner nuclear layers which progressed by day 10 to 14 to complete replacement of the retina by a fibrocellular scar. These changes were dominated by a vigorous mononuclear cell infiltrate, a feature not observed in the HSV-1-infected contralateral retinitis. These results suggest that experimental retinitides produced by HSV-1 and HSV-2 are of diverse pathogenesis. PMID- 3829705 TI - Effect of neuraminidase on Fc and C3b receptors on rabbit corneal cells infected with herpes simplex virus. AB - The effect of neuraminidase on Fc receptors (FcR) and C3b receptors (C3bR) was studied in epithelial, stromal and endothelial cells of the rabbit cornea infected with type 1 (HSV-1) and type 2 herpes simplex virus (HSV-2) in vitro. FcR were induced on epithelial, stromal and endothelial cells of the rabbit cornea by both HSV-1 and HSV-2, but their activities were not enhanced by neuraminidase. On the other hand, the treatment of HSV-infected corneal cells with neuraminidase resulted in the enhancement of C3bR activities on epithelial, stromal and endothelial cells infected with HSV-1, and the enhancing effect of neuraminidase was more pronounced on corneal endothelial cells. A similar neuraminidase treatment had no significant effect on C3bR activities on the corneal cells infected with HSV-2. PMID- 3829706 TI - The acute abdomen in childhood. PMID- 3829707 TI - The interviewing process as it relates to the selection of candidates for general surgical residency programs. PMID- 3829708 TI - The role of tissue expansion in reconstructive surgery. PMID- 3829709 TI - Prostaglandin content of tissue lining vascular prostheses. PMID- 3829710 TI - The use of tonometry in the early diagnosis of mesenteric ischemia. PMID- 3829711 TI - Hemodynamic changes during reperfusion in two canine models of hind-limb ischemia. PMID- 3829712 TI - Quantifying stress ulceration in canine hemorrhagic shock. PMID- 3829713 TI - Decreased sensitivity to norepinephrine in vein bypass grafts. PMID- 3829714 TI - Metabolic rates of newborn infants with severe respiratory failure treated with extracorporeal membrane oxygenation. PMID- 3829715 TI - Dual outcome of treatment of colon cancer in rats with ABPP: inhibition versus enhancement; importance of tumor load and tumor site. PMID- 3829716 TI - Cone snails. PMID- 3829717 TI - Wolf spider bites. AB - Because of their dark color and hunting habits, wolf spiders (Lycosidae) are often confused with the much more dangerous brown recluse spider (Loxosceles reclusa). Unlike the brown recluse spider, wolf spider envenomation seldom causes cutaneous necrosis or systemic symptoms. In this report, two documented cases of wolf spider bites are described and the pertinent literature reviewed. PMID- 3829718 TI - Skin metastases in cancer patients. AB - Although every cancer may cause skin metastases, some do so more frequently. Proper diagnosis can lead to early detection of a previously unrecognized malignancy. Autopsy data from 7,518 patients with internal cancer were analyzed, and the findings were compared with the literature. PMID- 3829719 TI - Basal cell carcinoma arising in a tattoo. AB - Basal cell carcinomas arising in tattoos have been reported previously in four patients. We present the fifth reported case of a basal cell carcinoma arising in a tattoo that was at a site not frequently exposed to ultraviolet radiation and briefly review malignancy in tattoos. PMID- 3829720 TI - Coexistent leprosy and lupus erythematosus. AB - We present a patient who, while under therapy with systemic corticosteroids to control lupus erythematosus, noted lesions of leprosy (Hansen's disease) on her elbow and knee. The corticosteroids may have played a role in the emergence of the leprosy. Leprosy should be considered in the differential diagnosis of cutaneous lesions with sensory loss to hasten diagnosis and therapy. PMID- 3829721 TI - Letterer-Siwe disease in an adult. AB - Letterer-Siwe disease, a proliferative disorder of Langerhans' cells, usually affects children during the first year of life. A 67-year-old woman is described here whose initial manifestation was a characteristic skin eruption. The clinical, pathologic, and ultrastructural features of Letterer-Siwe disease are reviewed and their role in diagnosis discussed. PMID- 3829722 TI - Presternal swelling in mumps. AB - A case of presternal swelling associated with mumps is presented. presternal swelling occurs secondary to obstruction of the lymphatic drainage from the anterior-superior chest wall by the enlarged cervical salivary glands. The occurrence of this complication in mumps is discussed. PMID- 3829723 TI - Short-contact anthralin therapy for psoriasis using an aqueous cream formulation. AB - A pilot study of five patients was conducted using an aqueous anthralin cream (Drithocreme) and demonstrated that between twenty and forty minutes was an effective contact time to produce an improvement in induration of psoriatic plaques. In a further, bilateral controlled study, the anthralin cream was used to treat twenty patients with symmetrical chronic plaque psoriasis. The cream was applied to one side of the body overnight and then to the other side in the morning. Thirty minutes later it was washed off both sides in a bath or shower. The results indicated that both overnight and short-contact treatment were equally effective, and the short-contact treatment reduced staining and irritation. PMID- 3829724 TI - Evaluation of a new dressing in the treatment of sports-related skin lesions. AB - Twenty-seven players with superficial wounds (abrasions, turf burns, and blisters) were treated with a new Hydroactive dressing. We conclude that this dressing provides an excellent alternative to other forms of treatment since it is easy to use, comfortable, hypoallergenic, and provides impressive healing results. PMID- 3829725 TI - AIDS--be scared. PMID- 3829726 TI - Nail growth. PMID- 3829727 TI - Skin necrosis from intravenously infused materials. AB - Skin necrosis from extravasation of intravenous materials can result from nonphysiologic irritants, vasopressors, and chemotherapeutic agents. Careful handling of these materials is essential. Locally infiltrated phentolamine is recommended for accidental vasopressor extravasation. Early surgical excision and repair is recommended for chemotherapeutic infiltrations. General supportive care is recommended for all extravasations. PMID- 3829728 TI - Cutaneous manifestations of disseminated coccidioidomycosis in the acquired immunodeficiency syndrome. PMID- 3829729 TI - Eosinophilic fasciitis with atypical features. AB - Eosinophilic fasciitis has been reported to be a syndrome distinct from progressive systemic sclerosis, due to the absence of Raynaud's phenomenon, visceral disease, and autoantibodies as well as steroid responsiveness and an abnormal histopathologic appearance that primarily involves the lower subcutis and fascia. More recent studies, however, have noted considerable overlap in the clinical, pathologic, and laboratory features of these two entities. We report a case that further blurs the distinction between eosinophilic fasciitis and progressive systemic sclerosis. PMID- 3829730 TI - Dermatitis herpetiformis and vitiligo. PMID- 3829731 TI - Radio diagnosis of skin disease. PMID- 3829732 TI - Specific skin ulcers in Hodgkin's disease. AB - A young man with Hodgkin's disease who experienced specific cutaneous ulcers over the scalp during treatment is described. The relation of such ulcers to the disease's progress is discussed. PMID- 3829733 TI - Inverted variant of carcinoma cuniculatum of the toe. AB - An inverted variant of carcinoma cuniculatum of the great toe of a 55-year-old man is reported. Clinically the tumor presented as an inflammatory process of the toe with purulent drainage and bone destruction in the absence of cutaneous ulcer or exophytic growth. It was characterized histologically by endophytic sheets and cords of well-differentiated keratinizing squamous epithelium with minimal cellular atypia and numerous intraepithelial keratin cysts and microabscesses. The diagnostic challenge of the clinical presentation of this variant is emphasized. PMID- 3829734 TI - Rubella in pregnant Danish women 1975-1984. AB - During the period 1975 to 1984, 1,346 pregnant women had the diagnosis of rubella serologically confirmed. The incidence was one per 530 pregnancies. Of 1,330 women, 623 were subjected to therapeutic abortion. Thirty-five aborted spontaneously and 672 continued pregnancy; among these, four infants were stillborn. In 111 of 520 infants, rubella specific IgM was found in blood drawn from the umbilical cord. The frequency of rubella specific IgM in infants after maternal rubella during the first trimester was 50 percent (7 of 14); in the second trimester, the frequency had been reduced to 14 percent in the 28th week of pregnancy; and in the third trimester, the frequency rose again to 28 percent. Malformation occurred only in infants whose mothers had been infected before the 12th week. Preconceptional rubella was found in 32 cases; seven of these women carried their pregnancies to successful termination. In none of the infants was rubella specific IgM found, and no abnormalities could be found at birth. The importance of immunisation of women in the fertile age group is emphasised. By testing a blood sample from the fetus for rubella specific IgM, it is possible to show prenatally if a fetus has congenital rubella. This method will probably allow reduction of the number of therapeutic abortions after maternal infection between the 12th and the 16th week of pregnancy. PMID- 3829735 TI - Using outcome predictions to make treatment decisions. Simple, logical, and unexpectedly problematic. PMID- 3829736 TI - Introduction to the new department, exercise and the heart. PMID- 3829737 TI - Candida epiglottitis in immunocompromised patients. AB - Candida seldom has been reported to be a cause of epiglottitis. The clinical manifestations and management of three patients with Candida epiglottitis complicating their neoplastic disease are described. All patients were granulocytopenic. Candida epiglottitis occurred either as a localized infection, as a source of Candida bronchopneumonia, or as a manifestation of disseminated infection. Candida epiglottitis may be under-diagnosed and should be considered, especially in immunocompromised patients with symptoms of refractory pharyngitis. Treatment of Candida epiglottitis with intravenous amphotericin B is warranted in patients with sustained granulocytopenia. Prompt endotracheal intubation is indicated if the airway patency cannot be maintained. PMID- 3829738 TI - Bronchoscopic and angiographic comparison of bronchial arterial lesions in patients with hemoptysis. AB - In seven patients with nonmalignant disease, we bronchoscopically observed various types of bronchial arterial lesions that may have caused hemorrhage. Five of the seven showed a bulging lesion, and the other two demonstrated an intrabronchial mass. We also examined these seven patients using selective bronchial arteriography. Herein we report our comparative study of the bronchoscopic findings and the bronchial arteriograms of these bronchial arterial lesions. The bulge observed in bronchoscopy corresponded either to an aneurysm or to a hypervascular area in the bronchial arteriogram. The mass lesions corresponded to a hypervascular area or a focal dilatation in the bronchial arteriogram. The intrabronchial lesions observed bronchoscopically either disappeared or were significantly diminished by bronchial arterial embolization for management of the hemorrhage. A histologic examination in two patients who underwent surgery revealed vascular lesions corresponding to the intrabronchial lesions in bronchoscopy. The results of this comparative study have important application in the bronchoscopic examination of bronchial arterial lesions in patients with hemoptysis. PMID- 3829739 TI - Cardiac dysrhythmia following pneumonectomy. Clinical correlates and prognostic significance. AB - Cardiac tachydysrhythmias occurred in 53 (22 percent) of 236 consecutive patients undergoing pneumonectomy. All patients had preoperative electrocardiograms which showed normal sinus rhythm. Patients did not receive digitalis before surgery. Atrial fibrillation was the most common dysrhythmia (64 percent; 34/53), followed by supraventricular tachycardia (23 percent; 12/53) and atrial flutter (13 percent; 7/53). No episodes of ventricular tachycardia were documented. Elevated concentrations of cardiac enzymes were associated with 12 (28 percent) of 43 tachydysrhythmias. Recurrent or persistent dysrhythmias were documented in 29 (55 percent) of 53 patients despite medical management or electrocardioversion (or both). Thirty-one percent (9/29) of these patients subsequently died during their hospitalization. There was no correlation between standard preoperative pulmonary function tests and the incidence of postoperative dysrhythmia. In addition, there was no correlation of dysrhythmia with postoperative diagnoses, surgical staging for lung cancer, postoperative arterial blood gas levels, or the fact that a completion pneumonectomy or chest wall resection was undertaken. An increased incidence of tachydysrhythmia was noted in patients undergoing intrapericardial dissections and those who developed postoperative interstitial or perihilar pulmonary edema. Twenty-five percent (13) of the patients experiencing tachydysrhythmias died within 30 days following their pneumonectomy. We conclude that tachydysrhythmias after pneumonectomy are associated with significant mortality, have poor correlation to preoperative pulmonary function, and occur more frequently following intrapericardial dissection and in patients who develop postoperative interstitial pulmonary edema or perihilar pulmonary edema. PMID- 3829740 TI - Prediction of successful ventilator weaning using airway occlusion pressure and hypercapnic challenge. AB - We studied eleven patients during 14 attempts at weaning from mechanical ventilation to determine whether central ventilatory drive, measured as airway occlusion pressure 0.1 s after onset of inspiration (P 0.1), during spontaneous breathing before and during a brief hypercapnic challenge, could accurately predict the success or failure of the attempt. All patients were recovering from acute respiratory failure and could breathe spontaneously for 20 minutes on a T piece but were judged clinically to be marginal weaning candidates. Minute ventilation (VI) and P 0.1 were measured while breathing spontaneously and were repeated during a hypercapnic challenge that raised end-tidal PCO2 approximately 10 mm Hg. Seven of the 14 weaning attempts were unsuccessful, requiring reinstitution of mechanical ventilation. Although the failure group had lower mean maximum inspiratory force and higher spontaneous respiratory rate, no threshold value separated the failure from the success group. Ventilation increased more during hypercapnic challenge in those patients whose weaning attempt was successful, but overlap of results between the two groups rendered this test inaccurate for predicting weaning success. In contrast, successfully weaned patients had greater augmentation of P 0.1 during hypercapnia, expressed as the ratio of P 0.1 during CO2-stimulated to P 0.1 during baseline values, than did those who failed weaning (p less than 0.005). This ratio succeeded, and was thus both specific and sensitive as a predictor of successful weaning from mechanical ventilation in these patients. PMID- 3829741 TI - Magnetic resonance imaging to diagnose intralobar pulmonary sequestration. AB - Confirmation of the diagnosis of intralobar pulmonary sequestration has usually required angiographic demonstration of the systemic arterial supply. We report a young man who presented with non-resolving pneumonia where magnetic resonance imaging (MRI) suggested the correct diagnosis by demonstrating two arteries arising from the aorta supplying the sequestrum. MRI appears to offer a safe, noninvasive alternative for the diagnosis of sequestration. PMID- 3829742 TI - Comparative clinical experience with porcine bioprosthetic and St. Jude valve replacement. AB - From 1976 to 1984, 656 patients underwent aortic, mitral, or double valve replacement with a Hancock or Carpentier-Edwards porcine bioprosthesis (POR; n = 293) or with a St. Jude bileaflet valve (SJ; n = 363). Recipients of the St. Jude valve were of more advanced NYHA class preoperatively, required smaller prosthetic sizes, and more often had associated coronary artery disease necessitating bypass grafting (p less than .05). Despite these differences, POR and SJ recipients demonstrated similar 30-day mortality (7.5 vs 10.2 percent), five-year freedom from embolism (92 +/- 2 percent vs 92 +/- 2 percent), freedom from all valve-related complications (79 +/- 3 percent vs 79 +/- 4 percent), and survival (72 +/- 3 percent vs 71 +/- 3 percent) (p = NS). Structural failures occurred exclusively in POR recipients (3.0-4.5 percent/pt-yr after four years), and endocarditis was more common (1.0 vs 0.5 percent/pt-yr); as a result, the reoperation rate was three times higher in POR than SJ recipients (1.4 vs 0.46 percent/pt-yr, p less than .05). Warfarin-related bleeding (2.5 percent/pt-yr) was the most common complication in SJ recipients, but occurred equally frequently in POR recipients requiring anticoagulation; seven (44 percent) of 16 valve-related late deaths were warfarin-related. In properly anticoagulated patients, the thromboembolic rate was low (2.0 percent and 1.1 percent/pt-yr, POR and SJ); this rate increased significantly in SJ recipients receiving antiplatelet drugs alone (4.2 percent/pt-yr; n = 16) or no anticoagulant or antiplatelet therapy (26.4 percent/pt-yr; n = 18) (p less than .05), but increased only slightly in POR recipients (to 1.5 percent/pt-yr, n = 108, and 2.0 percent/pt-yr, n = 63, respectively). Postoperatively, NYHA class 1 was more often achieved in SJ than POR recipients (60 vs 39 percent, p less than .05), perhaps because of the better hemodynamic performance of the SJ valve. Thus, despite differences in patient selection and the nature of complications observed with each prosthetic type, porcine and St. Jude valves provide similar early and late survival, frequency of embolism, total complication rate, and freedom from valve-related morbidity and mortality after five years of follow-up. Limited durability, susceptibility to infection, and inferior hemodynamics remain drawbacks to use of the porcine bioprosthesis. The necessity for warfarin anticoagulation and the frequency of resultant bleeding complications are the major shortcomings of the St. Jude valve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3829743 TI - Variability in physician estimates of survival for acute respiratory failure in chronic obstructive pulmonary disease. AB - Physician estimates of patient survival often influence clinical decisions. I studied physician estimates of survival for a patient with acute respiratory failure and underlying chronic obstructive pulmonary disease to identify the factors that may influence these estimates. Physicians (n = 205) completed the same patient management problem and estimated the length of survival for the hypothetical patient. Physician estimates of survival were quite variable, ranging from one month to five years. Shorter estimates of survival were associated with acquisition of select case information: subjective information from family members and a professional colleague, and physiologic and functional data previously demonstrated to be predictive of survival. The study suggests that estimates of survival for the same patient may vary among physicians because of different considerations of social and physiologic case information. Physician estimates of patient survival and treatment recommendations may become more uniform with additional education or decision aids regarding the prognostication of survival. PMID- 3829744 TI - Hypergammaglobulinemia in cystic fibrosis. Role of Pseudomonas endobronchial infection. AB - Hypergammaglobulinemia, chronic endobronchial infection with Pseudomonas aeruginosa (PA), and the resulting systemic humoral immune response to PA are each associated with worsened clinical status and prognosis in patients with cystic fibrosis (CF). Major serum immunoglobulin isotype levels (IgG, IgA, IgM, and IgG1-4 subclasses) were measured in 31 CF patients and ten control subjects. Immunoglobulin levels were related to airway infection with PA and the resulting IgG antibody response against PA lipopolysaccharide (LPS). Hyperimmunoglobulinemia G was present with elevated IgG1 and IgG2 in 48 percent, IgG3 in 52 percent, and IgG4 in 42 percent of CF patients. The PA infection was associated with striking increases in IgG2. IgG2 levels correlated well with IgG2 antibodies to PA LPS (r = +0.70, p less than 0.001). However, even CF patients who were not infected with PA had an increased prevalence of high IgG3 (p less than 0.05) and IgG4 (p less than 0.01). The PA infection thus appears to be a major, but not the only factor causing hypergammaglobulinemia in CF. PMID- 3829745 TI - Colonization of the respiratory tract with Pseudomonas cepacia in cystic fibrosis. Risk factors and outcomes. AB - Between 1981 and 1983, some 85 patients with cystic fibrosis at Rainbow Babies and Childrens Hospital, Cleveland, developed colonization or infection of the respiratory tract with Pseudomonas cepacia. Twenty-nine (34 percent) of the colonized patients died; four were female patients with fulminant bacteremia with P cepacia prior to death. Case-control studies showed that increasing severity of underlying cystic fibrosis, increasing age, having a sibling with cystic fibrosis who was colonized with P cepacia, and previous hospitalizations were associated with increased risk of colonization. In patients with mild cystic fibrosis, no differences in clinical outcome were seen during the period of study; however, patients colonized with P cepacia who had moderate or advanced cystic fibrosis were hospitalized longer and died sooner after colonization, compared with control subjects with similar severity of cystic fibrosis. The excess mortality associated with such colonization varied in magnitude and trend according to the patient's sex and severity of underlying cystic fibrosis, reflecting the combined influence of colonization with P cepacia, sex, and severity of cystic fibrosis on the mortality of the patients. The source and mode of transmission of P cepacia were not determined, but the data suggest a possible nosocomial source. The results of this investigation showed that colonization with P cepacia most often affected patients with moderate or advanced cystic fibrosis and was associated with an adverse clinical outcome in these patients. PMID- 3829746 TI - Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airways diseases. AB - In order to determine the prevalence of reported sleep disturbances in a general adult population and the relationship of these complaints to age, gender and coexistent obstructive airways disease, 2,187 subjects in the Tucson Epidemiologic Study of Obstructive Airways Disease were surveyed in 1985 regarding their sleep symptoms. At least one symptom of disturbed sleep was present in 41.4 percent of all subjects. Women generally reported a significantly higher prevalence of both disorders of initiating and maintaining sleep (DIMS) and nightmares (NM)(p less than .001). Before age 64 years, the prevalence of complaints of excessive daytime sleepiness (EDS) among men and women were similar. However, the frequency of EDS was significantly higher in men than women after age 64 years. Prevalence of at least one sleep symptom and DIMS increased with advancing age. The prevalence of nightmares appeared to be age-related only among women, who displayed a declining prevalence with advancing age. EDS increased only after age 64 years. There was a significant relationship between DIMS and EDS with coexistent chronic bronchitis, concomitant asthma and chronic bronchitis, and emphysema, but not asthma as a solitary diagnosis. Nightmares were reported with much greater frequency among subjects with asthma, asthma and chronic bronchitis, and emphysema but not in subjects with chronic bronchitis alone. The presence of coexistent asthma and chronic bronchitis was associated with particularly high prevalence of complaints of DIMS, EDS and nightmares. We conclude that, in the general adult population, sleep disorder symptoms increase with age and usually are greater in women. Furthermore, there is an increased prevalence of sleep symptoms among adults with chronic airways obstructive disease, especially those with coexistent asthma and chronic bronchitis. PMID- 3829747 TI - Anxiety disorder and perception of inspiratory resistive loads. AB - Sensations of breathlessness in the absence of respiratory disease are common in anxiety disorders. Perceptions of breathlessness in eight patients with anxiety disorder were compared with eight normal control subjects, matched for age and sex, by the application of Steven's law to the magnitude of resistive load test. All subjects estimated the magnitudes of resistive loads to inspiration while peak inspiratory mouth pressures were monitored. Anxious patients' perceptions of the added loads were significantly less sensitive than normal, even though the effort, determined by peak inspiratory mouth pressure, in overcoming each load was normal. Correlations between estimates of resistive loads and peak inspiratory mouth pressure were significantly less for the anxious patients than for normal subjects. Thus, perception of breathlessness in anxiety disorders may be affected by factors not normally associated with breathlessness and may help account for the greater than normal variability in resistive load perception in respiratory disease. PMID- 3829748 TI - Pulmonary artery connection in the Fontan procedure. Flexible polytetrafluoroethylene conduit for expansion. AB - From clinical experiences with the Fontan operation in six cases, a few practical contrivances and operative steps are described. We stress that meticulous care should be taken not to cause any stenotic complication in the outflow tract toward the pulmonary artery, particularly by traction of the right atrial appendage only to achieve a direct anastomosis. Conduit repair would be necessitated by cases in order to expand the indicative criteria vertically as well as horizontally. For conduit material, we used consecutively nonvalved polytetrafluoroethylene that was reinforced by handmade stainless steel wire ring (Gore-Tex, Inc) or by spirally built-in stent (IMPRA, Inc). The latter was eventually useful in obtaining natural curving of the conduit without kinking or compression. Some contrivances in anastomosing a conduit were also proposed to achieve an excellent result. We believe these practical contrivances will serve for expansion of the indicative criteria and promise improved operative outcome. PMID- 3829749 TI - Determination of resting energy expenditure utilizing the thermodilution pulmonary artery catheter. AB - Accurate determination of the resting energy expenditure (REE) for patients in intensive care units has assumed increasing importance as the adverse effects of underfeeding or overfeeding have become clearer. As a result, indirect calorimetry is frequently used to determine the REE. This technique, however, is neither universally available nor inexpensive. Furthermore, it requires meticulous measurements of gas exchange and technical expertise. Because of this, we have developed a method to determine REE for those patients in intensive care units who have thermodilution pulmonary artery catheters in place. This method requires determining the oxygen consumption from data obtained from such a catheter. The REE is then calculated by multiplying the determined oxygen consumption by the caloric value for oxygen (4.86 kcal/L at a nonprotein respiratory quotient of 0.85). We made 20 simultaneous measurements of REE, comparing our method with indirect calorimetry in 19 patients. There was excellent agreement between both methods (r = 0.90; p less than 0.0001). Therefore, for those patients in intensive care units who require thermodilution pulmonary artery catheters, this method will allow accurate determination of REE and thus caloric requirements, without the need for indirect calorimetry using measurements of gas exchange. PMID- 3829750 TI - Diaphragmatic dysfunction in siblings with hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease). AB - Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease) is characterized by chronic degeneration of peripheral nerves and roots, resulting in distal muscle atrophy, beginning in the feet and legs and later involving the hands. The association of this disease with diaphragmatic dysfunction has not been reported. We studied a patient with hereditary motor and sensory neuropathy type 1 (Charcot-Marie-Tooth disease) and type 2 diabetes mellitus who had severe diaphragmatic impairment. Some of the clinical findings are similar to the sleep apnea syndrome, which could lead to incorrect diagnosis and delay in the administration of appropriate therapy. Transdiaphragmatic pressure studies on the subject's brother, who also has Charcot-Marie-Tooth disease and type 2 diabetes mellitus, revealed subclinical impairment of diaphragmatic function. These findings suggest that phrenic nerve involvement may be part of the spectrum of polyneuropathy in Charcot-Marie-Tooth disease in association with diabetes mellitus. PMID- 3829751 TI - Characteristic pulsed Doppler findings in patients with flail mitral valve. AB - Pulsed mode Doppler findings in the left atrium were studied in 18 patients with moderate to severe catheterization-proven mitral regurgitation, four with and 14 without flail mitral valve. Atypical markedly turbulent antegrade flow in the left atrium was observed in all four patients with flail mitral valve, whereas the typical retrograde mitral regurgitation pattern of flow was observed in the 14 patients without flail mitral valve. This Doppler pattern appears to be indicative of a flail mitral valve. PMID- 3829752 TI - Cardiac Wilson's disease. AB - Wilson's disease is a multisystem disorder. Heart involvement in Wilson's disease, however, has rarely been recognized. A prospective study was undertaken of 53 consecutive patients (28 men and 25 women, mean age of 21.4 years) with Wilson's disease. Electrocardiographic abnormalities occurred in 18 of 53 patients (34 percent), including left ventricular hypertrophy, biventricular hypertrophy, early repolarization, ST depression and T inversion, premature atrial or ventricular contractions, atrial fibrillation, sino-atrial block, Mobitz type 1 atrioventricular block, and tremor artifact. In contrast, 26 medical students and 14 carriers of Wilson's disease as control subjects (mean age of 22.6 years) all showed normal ECG. Eight out of 43 patients (19 percent) demonstrated asymptomatic orthostatic hypotension. An abnormal response to the Valsalva maneuver occurred in six of 18 patients (33 percent). There were two cardiac deaths; one died of repeated ventricular fibrillation (the copper content in the myocardium was 2.28 micrograms/g, and in the bundle of His 1.21 micrograms/g wet weight in the autopsy specimen); and the other, of dilated cardiomyopathy. It is concluded that four modes of cardiac manifestations in Wilson's disease include arrhythmias, cardiomyopathy, cardiac death, and autonomic dysfunction. Such possible cardiac involvement should be added to the clinical picture of Wilson's disease involving the hepatic and central nervous system. PMID- 3829753 TI - Detection of anatomically severe coronary artery disease by the ST/HR slope. PMID- 3829754 TI - Pleural-based mass in an elderly man with arthralgias. PMID- 3829755 TI - Tall and peaked U waves in hypokalemia. PMID- 3829756 TI - Severe febrile reaction to isoniazid. AB - A case of severe febrile reaction to INH is described. The patient had a mild febrile reaction two weeks following INH prophylaxis. Isoniazid was discontinued. Two weeks later and on rechallenge with INH she developed a severe febrile reaction with protracted hypotension. An initial mild febrile reaction to INH is a warning sign that rechallenge can result in a life-threatening situation. PMID- 3829757 TI - Isolated right-sided patent ductus arteriosus in right-sided aortic arch. Report of two cases. AB - An isolated right-sided patent ductus arteriosus has not been reported previously to occur in right-sided aortic arch associated with an aberrant left subclavian artery. We report such anomalies in two adult patients. In the first case of a 19 year-old woman, the ductus was successfully ligated via a left posterolateral thoracotomy; however, many technical difficulties were encountered. In the second case of a 36-year old woman, a right posterolateral thoracotomy enabled detailed demonstration of the ductus and its surrounding structures and facilitated its successful ligation. An isolated right-sided patent ductus arteriosus should be approached via right thoracotomy. PMID- 3829758 TI - Doppler echocardiographic detection of a ruptured acquired aneurysm of the sinus of Valsalva. Clinical-morphologic correlations. AB - Two-dimensional, pulsed Doppler echocardiographic and pathologic features of an unusual form of ruptured aneurysm of the sinus of Valsalva are presented. The presence of an aneurysm of the left sinus of Valsalva protruding into the left atrium complicating acute aortic valvular endocarditis was detected by two dimensional echocardiography. Rupture of the aneurysm of the sinus of Valsalva into the left atrial cavity was suggested by pulsed Doppler echocardiography. The size and location of the site of the rupture precluded recognition by two dimensional echocardiography or contrast angiography. This report illustrates the unique value of pulsed Doppler echocardiography to define the location and direction of intracardiac flow patterns in evaluating patients with an aneurysm of the sinus of Valsalva and suspected rupture. PMID- 3829759 TI - Allergic angiitis of Churg and Strauss syndrome. Response to pulse methylprednisolone. AB - Our patient presented with widespread airspace consolidation. He was a steroid dependent asthmatic receiving moderate doses of corticosteroid therapy. Open lung biopsy showed allergic angiitis of Churg and Strauss syndrome. The patient continued to deteriorate on high doses of prednisone. He was subsequently given four pulses of intravenous methylprednisolone with dramatic clearing noted on x ray film and resolution of his shunt. PMID- 3829760 TI - Pseudoidiopathic hypertrophic subaortic stenosis in a patient with cardiac tamponade. AB - A 53-year-old woman with a large pericardial effusion and tamponade presented with signs of IHSS including a grade 4/6 apical systolic murmur, severe SAM, early systolic aortic valve closure and a small hypercontractile left ventricle but at most borderline left ventricular hypertrophy. Following pericardiocentesis, the clinical and echocardiographic signs of subvalvular obstruction resolved completely. One year later the patient died of bronchial carcinoma and no evidence of hypertrophic cardiomyopathy was found at autopsy. Pericardial tamponade should be added to the list of possible causes of dynamic subvalvular obstruction in a structurally normal heart. PMID- 3829761 TI - Name that beat. PMID- 3829762 TI - Predicting postpneumonectomy FEV1. Half empty or half full? PMID- 3829763 TI - Vectorcardiography and COPD. PMID- 3829764 TI - Theophylline administration. How often is often enough? PMID- 3829766 TI - Never order a chest x-ray. You might find something. PMID- 3829765 TI - Preventing endotracheal fires. PMID- 3829767 TI - Allergy and pulmonary medicine. A natural union. PMID- 3829768 TI - Starling's laws of the heart. PMID- 3829769 TI - Antiamebic activity of new acridinic derivatives against Naegleria and Acanthamoeba species in vitro. AB - In vitro antiamebic activity of selected acridine derivatives has been investigated against Naegleria and Acanthamoeba species. The most active compounds belong to the 9-thioacridanone and the 1,2,3,4-tetrahydro-9 thioacridanone series. In addition, some structure-activity relationships are proposed. PMID- 3829770 TI - Locomotor development and oral reflexes. PMID- 3829771 TI - Low birth-weight prematures: preventive intervention and maternal attitude. PMID- 3829772 TI - Assaultive behavior in normal school children. PMID- 3829774 TI - A long-range follow-up study of former inpatients at a children's psychiatric hospital. PMID- 3829773 TI - Temperament in small-for-dates and pre-term infants: a preliminary study. PMID- 3829775 TI - Prison parenting: a challenge for children's advocates. PMID- 3829776 TI - Developing partnerships between families and service providers in rural Vermont. PMID- 3829777 TI - Routes to self-sufficiency: teenage mothers and employment. PMID- 3829778 TI - Treatment issues with sexually abused young children. AB - Sexual abuse of very young children confronts therapists with special difficulties in regard to the children, their parents, and possible legal consequences. This California treatment program involves parents and children in parallel groups, along with individual therapy. Factors with which therapists must deal are also presented. PMID- 3829779 TI - Working with parents of disturbed adolescents: a multifaceted group approach. AB - Experience with this parents' group model suggests that there are a number of advantages in using a multifaceted approach when working with parents of severely disturbed adolescents. Basic support and reduction of guilt and blaming are derived from the therapeutic aspect of the group process. This is augmented by having the parents in a leadership role, in the manner of a self-help group. Bringing in educational and advocacy elements allows the group to respond directly to the parents' need for detailed, accurate information about the disorders and treatment resources for dealing with them. This approach is not designed to replace family therapy, but to provide resources and support to parents. Future research will be necessary to substantiate the clinical impression that the group is quite helpful to parents and to elucidate all the factors producing success. PMID- 3829780 TI - Child abuse and neglect in North Carolina day care programs. AB - A study of child abuse and neglect complaints in child day care programs revealed factors affecting the filing of complaints, as well as problems with the investigation of complaints filed with the North Carolina Office of Child Day Care Licensing. The authors specify the cause of the problems and offer recommendations for improvement. PMID- 3829781 TI - Sexual abuse prevention: a rural interdisciplinary effort. AB - The alliance of social work and theater is a natural and powerful coalition. The cooperation of two undergraduate programs to produce a preventive program on sexual abuse education reached over 4,000 children. Social work was the catalyst in terms of identifying the need, obtaining grant money, and developing community support. Theater provided the talent to produce an outstanding performance. Communities planning to develop successful prevention programs must develop community support, clear goals, a well-trained follow-up team, education for professionals who work with children daily, a clear channel for reporting abuse, and an evaluation process. The use of volunteers keeps the cost of the project to a minimum. PMID- 3829782 TI - The firstborn's adjustment to the birth of a sibling: a longitudinal assessment. AB - 41 middle-class families were interviewed at 1 month prepartum and 1, 4, 8, and 12 months after the birth of a second child to assess the reaction and adjustment of firstborn children to this event. Family members were also observed in a semistructured play session in order to obtain information concerning changes in familial interaction patterns. A log linear analysis was conducted to fit a hierarchical model to a 2 (child gender) X 2 (infant gender) X 4 (time of measurement relative to birth of infant) X 2 (presence or absence of problematic regressive behavior) X 14 (type of problematic behavior reported) matrix. A model with 2 statistically significant effects was found to fit the observed frequency matrix quite well, goodness-of-fit (GF) chi 2(312, N = 2,296) = 97.47, p less than .99. This model suggests (1) that the type of response displayed by the firstborns varied as a function of time since the birth; that their initial responses were either imitations of the infant or confrontations with the mother or infant, whereas responses at 4 months postpartum were characterized by numerous anxiety behaviors but fewer imitations or confrontations, and later responses were primarily confrontations with the increasingly intrusive and independent infant; and (2) that a greater frequency of problematic behavior was reported by the mothers of same-sex sibling dyads, especially at the 1- and 8 month postpartum assessments. Observational data indicated that mothers dramatically decreased their interactions with the firstborn children over time but that fathers tended to remain relatively stable in their frequencies of interaction. PMID- 3829783 TI - Parental responses to grammatical and ungrammatical child utterances. AB - A descriptive study of the distribution of parental response types across grammatically correct and incorrect child utterances was done to examine the possibility that parents respond differentially to grammatical and ungrammatical child utterances. Free-play interactions of 2 subject groups, each containing 10 parents and their language-learning children (Group 1: MLU between 2 and 2.5; Group 2: MLU between 3 and 3.5), were analyzed. Frequencies of 6 parental response types following correct and incorrect child utterances were compared. Results showed differences in distribution of several of the parental response types, depending on the grammaticality of preceding child utterances. These differences were larger for Group 1. The largest distributional differences occurred for 2 parental response types--expansions and topic extensions. Parents expanded ungrammatical utterances more frequently than grammatical utterances and extended the topic more frequently after grammatical than ungrammatical utterances. Implications of these results for child language learning are discussed. PMID- 3829784 TI - Deaf children's referential messages to mother. AB - Deaf children 6-10 years of age, from oral or bimodal educational programs, were tested in 2 tasks. In the first, they were required to describe a designated picture from a set of 4 pictures so that their mother could identify the intended referent from the 4 alternatives. In the second, they studied a single picture and were subsequently required to identify it from a set of 4 related pictures. Despite greater hearing loss, bimodally educated children provided more differentiated messages than did orally educated children. Bimodally educated children also provided better reformulations of messages that were initially inadequate. Although mothers of orally educated children received inferior messages, they were as successful at selecting the correct referent as were mothers of bimodally educated children. Both groups of deaf children performed at near perfect levels on the picture recognition task, suggesting that performance differences were attributable to differential message formulation skill as opposed to differential visual processing of the referential array. PMID- 3829785 TI - Speech patterning of natural discourse of well and depressed mothers and their young children. AB - The speech behavior of 14 depressed and 18 nondepressed mothers during conversations with their 3-year-old children was examined in this study. Given the general motor retardation, reduced energy level, and social withdrawal of depressed individuals, the speech patterns of depressed mothers were predicted to differ from the speech patterns of well mothers. Depressed mothers vocalized less often and responded less quickly to the cessation of their children's speech than healthy mothers. However, in a mildly stressful situation (awaiting a doctor's visit) the depressed mothers, but not the healthy mothers, significantly increased their level of speech productivity. Children of the depressed mothers spoke less than children of healthy women, particularly while sitting and eating lunch with their mothers. The observed difference in the mothers' behaviors was interpreted as an indication that the 2 groups of children are exposed to very different patterns of socialization. The offspring of depressed women are being taught both to keep social interaction to a minimum and to be overreactive to even mild stresses. The differences in the children's behavior may indicate that already these 3-year-old children have learned to keep their interactions with their mother to a minimum. This manner of adaptation may have negative effects on the child's continued social, emotional, and cognitive development. PMID- 3829786 TI - Young children's sensitivity to logical necessity in their inferential search behavior. AB - Young children's ability to evaluate the logical necessity of 2 types of inferences was studied in 2 experiments involving 68 3-7-year-olds. Children searched the doors of model houses in order to determine whether a house matched a description specifying certain numbers and types of occupants. A search task used in Experiments 1 and 2 allowed children to search for additional information if initial information was insufficient to support a logically necessary inference about whether the house was correct or incorrect. A judgment condition used in Experiment 2 required a "can't tell" response to insufficient information. Even 3-year-olds showed some ability to evaluate the logical necessity of an inference that confirmed a house was correct. Developmental changes involved increased reliability of individuals' performance and increased range of application of children's inference evaluation procedures to include more difficult, disconfirmatory inferences and cases where greater certainty in reasoning seemed to be required. Results are discussed in terms of an account of the gradual development and consolidation of an ability to evaluate the necessity of inferences, perhaps first apparent in preschoolers' sensitivity to conditions of sufficient and insufficient information in information-acquisition problems. PMID- 3829787 TI - The Turner syndrome: cognitive deficits, affective discrimination, and behavior problems. AB - Individuals with sex chromosomal anomalies are known to be at increased risk for learning problems and in some cases social or behavioral problems. Girls with an absent or structurally abnormal second sex chromosome (the Turner syndrome) have been found to have cognitive problem solving deficits and immature, inadequate social relationships. The present study attempted to link cognitive and social problems by assessing the girls' ability to process affective cues. 17 girls with karyotypes consistent with a diagnosis of Turner syndrome were compared to a group of 16 short-stature girls of comparable age, verbal intelligence scores, height, and family socioeconomic status on the Affective Discrimination Task, which required interpretation of affective intention from facial expression. The results revealed that the Turner syndrome girls were less accurate at inferring facial affect than the short-stature controls. Analyses revealed that the Turner syndrome girls performed more poorly on spatial, attentional, and short-term memory cognitive tasks and had more psychosocial problems than the short-stature controls. Ability to discriminate facial affect may be another area of cognitive weakness for girls with the Turner syndrome and may underlie the psychosocial problems found in this sample. PMID- 3829788 TI - The stability of visual habituation during the first year of life. AB - The short-term reliability and long-term stability of visual habituation and dishabituation in infancy were assessed in a sample of 186 infants from 4 age groups (3-, 4-, 7-, and 9-month-olds) seen for 2 within-age sessions and in a sample of 69 infants seen longitudinally at 3, 4, 7, and 9 months of age. Moderate week-to-week reliability (r's = .30-.50) was observed for duration-based and magnitude of habituation variables at all ages, although better reliability was evident at 4 and 9 months than at 3 and 7 months. In most cases, the reliability of habituation magnitude measures was attributable to the reliability of the peak fixation alone. Data from the longitudinal sample suggested that only the duration of peak fixation was consistently stable across the ages tested, although stability for several measures emerged across the 7-9-month testing. No consistent reliability or stability emerged for the presence or magnitude of dishabituation in either sample. PMID- 3829789 TI - Infant visual sustained attention and respiratory sinus arrhythmia. AB - Infants were studied cross-sectionally at 14, 20, and 26 weeks of age. They were presented with varying and complex patterns on a TV screen. Two-thirds of the presentations were accompanied by an "interrupting stimulus" in the periphery delayed in time from the onset of fixation on the central stimulus. The infants were not easily distracted from looking at the central stimulus when the presentation of the interrupting stimulus occurred at the point of maximal heart rate (HR) deceleration. However, if the presentation occurred at the end of the HR response, the infants were easily distracted. Infants with large amounts of respiratory sinus arrhythmia (RSA; i.e., HR variability) in a baseline recording were less distractible during the deceleration-defined trials than were infants with low amounts of RSA. High-RSA infants also showed larger HR deceleration on these trials than did the low-RSA infants. These results are consistent with a model positing that sustained HR lowering during visual fixation is an index of active attention and that RSA is an index of voluntary, sustained attention in infants. PMID- 3829790 TI - Infant temperament and subject loss due to crying during operant conditioning. AB - Infants who failed to complete a 2-day operant-conditioning task were compared with a stratified random sample of those who did on measures of infant temperament and several demographic characteristics. A discriminant-function analysis revealed that female infants who cried differed from female infants who did not cry on measures of duration of orienting and latency to approach sudden or novel stimuli. Reliable prediction of crying and noncrying could not, however, be made for males. No sex differences emerged in the incidence of crying or in the number of sessions completed. Partially successful females (i.e., those completing 1 of the 2 sessions) could reliably be discriminated from those who cried during the first session on measures of age at testing and maternal ratings of smiling behavior. The results of this study suggest that, as with habituation studies, subject loss in operant-conditioning studies is influenced by individual differences among the infants which may or may not adversely affect external validity. PMID- 3829791 TI - Roundtable: what is temperament? Four approaches. AB - 4 current approaches to understanding temperament are discussed in the roundtable. In an introductory overview, Goldsmith outlines some of the major convergences and divergences in the understanding of this concept. Theorists representing 4 positions--Goldsmith, Buss and Plomin, Rothbart, and Thomas and Chess--outline their views by responding to each of 6 questions: How do you define temperament and explain the boundaries of the concept? What are the elements of temperatment? How does the construct of temperament permit you to approach issues or organize data in ways that are possible only if this construct is invoked? How does temperament develop? To what extent do you consider temperament to be a personological versus a relational or an interactional construct? and How does your approach deal with issues of temperamental "difficulty"? In 2 commentaries on the theorists' answers, Hinde highlights differences among their positions and indicates issues that current theories of temperament must take into consideration, and McCall draws on common aspects to propose a synthesizing definition that draws on all 4 approaches. PMID- 3829792 TI - [A rotating hip joint endoprosthesis BHH Mikromed]. PMID- 3829793 TI - [Total cement-free hip alloplasty in patients with rheumatoid arthritis]. PMID- 3829794 TI - [Epidemiology of femoral neck fractures in the Olsztyn province]. PMID- 3829795 TI - [Management tactics in fractures of the proximal end of the femur in advanced age]. PMID- 3829796 TI - [External stabilization of the cervical spine using a "halo-yoke" set]. PMID- 3829797 TI - [Selected problems in treating gunshot wounds of the locomotor system]. PMID- 3829798 TI - [Treatment of habitual dislocation of the patella by partial transplantation of the quadriceps muscle and patellar ligament]. PMID- 3829799 TI - [Surgical treatment of tennis elbow (epicondylitis humeri)]. PMID- 3829800 TI - [Hand injuries (data from the Department of Orthopedic Trauma Surgery)]. PMID- 3829801 TI - [Study of the axes of the lower extremities and feet in children aged 3 to 6]. PMID- 3829802 TI - [Developmental anomalies of tendons of the tibial muscles in congenital talipes equinovarus]. PMID- 3829803 TI - [Universal intramedullary nails for efficient osteosynthesis of fractures of the femur and tibia]. PMID- 3829804 TI - [Forceps of our design for stable holding of Kirschner wires and Rush nails]. PMID- 3829805 TI - [Cardia cancer: attempt at a therapeutically relevant classification]. AB - On the basis of a prospective analysis of 107 adenocarcinomas of the gastro esophageal junction we propose a differentiation into adenocarcinomas of Barrett's esophagus (endobrachyesophagus), "real" carcinoma of the cardia, and subcardial carcinoma of the fundus. This classification allows the determination of an adequate surgical resection. Therefore the operative risk can be kept low. Total esophagogastrectomy is reserved only for advanced "real" carcinomas of the cardia in this concept. PMID- 3829806 TI - [Gastrectomy in a rare caustic injury]. PMID- 3829807 TI - [Successful embolectomy without intestinal resection in acute occlusion of the superior mesenteric artery]. PMID- 3829808 TI - [Surgery of duodenal ulcer at the crossroads. Late sequelae of the surgery of ulcer]. PMID- 3829809 TI - [Treatment of subperitoneal hematoma in fractures of the pelvis in children. Value of hemostasis by embolization]. PMID- 3829810 TI - [Effects of the 1985 earthquake on the Mexican hospital network]. PMID- 3829811 TI - [Peroperative scintigraphy in the surgery of cancer of the thyroid. Technics and results]. PMID- 3829812 TI - [Ogilvie's syndrome. Primary pseudo-obstruction of the colon]. PMID- 3829813 TI - [Value of arteriography in spinal surgery]. PMID- 3829814 TI - [Post-traumatic intraparenchymal hepatic artery-portal vein fistula. Apropos of a case]. PMID- 3829815 TI - [Vascular complications of abnormalities of the first rib]. PMID- 3829816 TI - [Esopharyngoplasty by right ileocolic graft technic. Treatment of caustic lesions of the hypopharynx]. PMID- 3829817 TI - [Observation on the indications of cesarean sections for cephalopelvic disproportion]. PMID- 3829818 TI - [Fetal movement monitoring during pregnancy]. PMID- 3829819 TI - [An analysis of 125 cases with perinatal cardiomyopathy]. PMID- 3829820 TI - [Analysis of the causes and their risk rates in perinatal mortality]. PMID- 3829821 TI - [Observation on natural version rate in breech presenting cases]. PMID- 3829822 TI - [Relationship of fasting urinary calcium to estrogen levels in postmenopausal women]. PMID- 3829823 TI - [Cytogenetic diagnosis in primary amenorrhea]. PMID- 3829824 TI - [Evaluation of the surgical treatment of endometrial carcinoma]. PMID- 3829825 TI - [Preliminary study of the relation between carcinoma of the cervix and fungi]. PMID- 3829826 TI - [A study of the indications for X-ray pelvimetry]. PMID- 3829827 TI - Species-specific non-expression of ribosomal RNA genes in a mammalian hybrid, the mule. AB - The expression of nucleolus organizer activity in diploid cells was investigated in a model system for mammalian hybrids, the horse-ass cross (mule), by means of sequential Ag-NOR and chromomycin A3/distamycin A-DAPI (CDD) staining in lectin stimulated peripheral blood lymphocytes (PBL). As a rule we found species specific non-expression of the horse-derived NOR chromosomes in the mule, whereas the ass-derived NOR chromosomes were active. The results of PBL interphase studies were compatible with the data gained from mitotic metaphase analyses. PMID- 3829828 TI - A structural basis for R- and T-banding: a scanning electron microscopy study. AB - The structure of reverse (R)-banded and telomeric (T)-banded chromosomes was studied by examination of the same chromosomes first in the light microscope (LM) followed by the scanning electron microscope (SEM). This procedure demonstrated a structural basis to both the R- and T-banding techniques. A direct correlation was shown between the LM staining patterns and the structural patterns observed in the SEM. In the R-banded chromosomes the positively stained R-bands, viewed by LM, corresponded to highly fibrous three-dimensional regions in the SEM. The negatively stained R-interbands corresponded to flatter regions from which material appeared to have been extracted. These structural observations strongly support the suggestion that chromosomal material is preferentially lost from the R-interbands with aggregation of fibres in the R-bands. T-banded chromosomes showed a similar structure to the R-banded chromosomes. The positively stained T bands located at the telomeres corresponded to regions of highly aggregated fibres. The remainder of the chromosome, corresponding to the negatively stained area, had a flattened and extracted appearance. These similarities in morphology between the T- and R-banded chromosomes support the view that T-bands result from a progressive breakdown of the R-banded chromosome structure. PMID- 3829829 TI - Relationship between the arrangement of microtubules and chromosome behaviour of syntelic autosomal univalents during prometaphase in crane fly spermatocytes. AB - During meiotic prometaphase of crane fly spermatocytes, syntelic autosomal univalents are able to move between the spindle poles several times. The relationship between the behaviour of chromosomes and the arrangement of microtubules during this stage was studied using a fixation technique (Nicklas et al. 1979) which makes it possible to examine a certain cell in an electron microscope after live observation. After reorientation, when a syntelic univalent had started moving towards the opposite spindle pole, a short chromosome fibre was found. When a univalent had reached the equator, a chromosome fibre could be traced up to the spindle apex. During the movement towards the opposite spindle pole the degree of disorder in the chromosome fibre was high, whereas it was low in the fibre of a motionless univalent. The degree of disorder was determined by the relative proportion of skew fibre microtubules. At the beginning of reorientation a chromosome fibre was still present, but later, it was no longer possible to recognize such a fibre. Instead of a chromosome fibre, a bundle of microtubules laterally associated with the kinetochore was observed. Some microtubules of this bundle had a direct contact with the kinetochore. These observations strongly hint that the laterally associated microtubules have an important function in the reorientation of syntelic autosomal univalents. PMID- 3829830 TI - The distribution of intermicrotubular bridges in meiotic spindles of the crane fly. AB - The distribution of intermicrotubular bridges in spindles of tipulid spermatocytes (Pales ferruginea, first meiotic division) was analyzed using serial sections of pre-selected cells. Bridges were found in all spindle regions, including kinetochore microtubules and free microtubules in the chromosome fiber. The dimensions of bridges were variable, ranging between 60 and 300 A in length and 40 and 190 A in thickness. Bridges seem to be randomly distributed. No accumulation in or absence from particular spindle regions was detected. Quantitative analysis revealed a linear, positive correlation between the number of microtubules and the number of microtubule pairs capable of forming bridges and, on the other hand, between microtubule pairs and intermicrotubular bridges. The possible composition and significance of bridges are discussed. PMID- 3829832 TI - Individual variations in the content of giant secretory polypeptides in salivary glands of Chironomus. AB - Salivary glands in aquatic larvae of Chironomus are responsible for formation of a fiber that larvae use to construct feeding tubes. Major constituents of this fiber include a family (the sp-I family) of high Mr (1 X 10(6) secretory polypeptides. Because of our interest in the polypeptide composition and polymerization of the salivary fiber we conducted a survey of the electrophoretic pattern of sp-I components found in salivary glands obtained from individual larvae. The survey encompassed ten strains of Chironomus tentans, three strains of Chironomus pallidivittatus and four strains of Chironomus thummi. Salivary glands from C. tentans and C. pallidivittatus contained at least four sp-I components (sp-Ia, sp-Ib, sp-Ic and sp-Id) that behave identically with regard to their electrophoretic mobility and detectability when larvae were exposed to galactose or glycerol. Sp-I components in C. thummi were generally fewer and not directly comparable by electrophoretic mobility to sp-I components in the other two species. During this survey two important alterations were observed in the electrophoretic pattern of sp-I components obtained from C. tentans and C. pallidivittatus. First, all four sp-I components exhibited, with a low frequency, double bands that appeared as slow-versus-fast electrophoretic variants of a particular component. Secondly, the relative steady-state level of each sp-I component fluctuated in comparison to other sp-I components in the same extract. This fluctuation varied such that any one sp-I component might appear as a single prominent component.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829831 TI - Heterosynapsis and suppression of chiasmata within heterozygous pericentric inversions of the Sitka deer mouse. AB - The patterns of chromosomal pairing and chiasma distribution were analyzed in male Sitka deer mice (Peromyscus sitkensis) polymorphic for terminally positioned pericentric inversions of chromosomes 6 and 7. G- and C-banding of somatic metaphases indicated that the inversions involved 30% and 40% of chromosomes 6 and 7, respectively. Analysis of silver-stained synaptonemal complexes in surface spread zygotene and pachytene nuclei from heterozygous individuals revealed that inversion loops were not formed. The inverted segments proceeded directly to heterosynapsis without an intervening homosynaptic phase, and the heteromorphic bivalents remained straight-paired throughout pachynema. C-banded pachytene nuclei corroborated the occurrence of heterosynapsis, as the heteromorphic bivalents exhibited nonaligned centromeres. Analysis of diplonema and diakinesis indicated that crossing over had not occurred within the heterosynapsed inverted segments. The observation of chiasma suppression within the inversions indicates that pericentric inversion heterozygosity does not lead to the production of unbalanced gametes. Heterosynapsis of the inverted segments during zygonema and pachynema and the resulting chiasma suppression therefore represent a meiotic mechanism for the maintenance of pericentric inversion polymorphisms in this population of P. sitkensis. PMID- 3829834 TI - Junctional complexes of epithelial cells. PMID- 3829833 TI - Correlated changes in steady-state levels of Balbiani ring mRNAs and secretory polypeptides in salivary glands of Chironomus tentans. AB - Balbiani rings (BRs) on polytenized chromosomes in Chironomid salivary glands contain members of a homologous multigene family that encodes a family (the sp-I family) of high Mr secretory polypeptides. Each of these BR genes is comprised largely of tandemly duplicated core repeat sequences consisting of related constant (C) regions and intergenically divergent subrepeat (SR) regions. A set of oligodeoxyribonucleotide probes were synthesized that correspond to the transcribed strand of the SR region of BR1, BR2 alpha, BR2 beta, and BR6 core repeats. Under a defined set of conditions, it was possible to show that each oligonucleotide probe hybridized exclusively to its cognate repeat type without hybridization to other repeat types in cloned DNA templates. These BR probes were then used in dot-blot hybridization experiments to simultaneously follow alterations in the steady-state level of BR mRNAs in response to prolonged exposure of larvae to galactose. The results indicated that the relative amounts of these four BR mRNAs may change in a noncoordinate manner. These BR probes were also used in experiments to compare simultaneously the salivary gland content of sp-I components and specific BR mRNAs in larvae that exhibited naturally occurring or induced alterations in BR gene expression. A correlation was found which suggested that sp-Ia is encoded in a gene comprised of BR1 repeats, sp-Ib is encoded by BR2 beta repeats, sp-Ic is encoded by BR6 repeats and sp-Id is encoded by BR2 alpha repeats. PMID- 3829835 TI - Patterns of junctional communication in animal tissues. AB - Gap junctions provide pathways for direct communication between cells in almost all animal tissues. The junctional channels are freely permeable to small ions and molecules but not to macromolecules. A coupled cell population is as a consequence a partial syncytium, within which metabolites, cofactors, small control molecules and inorganic ions can all diffuse freely through the combined cytoplasmic compartment, while intracellular macromolecules remain relatively fixed in space, in the cells where they are synthesized. Little is known about the extent and distribution of these communication compartments in tissues. To further understand their significance, we have mapped the patterns of junctional communication in skin by intracellular injection of the tracer dye Lucifer Yellow. Cells in the dermal layer are widely coupled, with dye spreading through hundreds of cells in a few minutes. Dye spread in the epidermis is much more restricted, passing in the same time into only a few cells. Dermal-epidermal coupling is not normally detected but is occasionally seen in new-born mouse skin when hair follicles are starting to invaginate. Dermal cells are coupled to a band of follicular cells near the base of mature hair follicles, whereas sebaceous glands appear to be coupled units, isolated from surrounding cells. PMID- 3829836 TI - Factors affecting epithelial interactions. AB - In an investigation of endogenous regulation of epithelial interaction, it was found that cultured embryo fibroblasts release an activity which causes loss of junctional attachment and separation of contiguous epithelial cells. This activity was originally observed in freshly cultured human mammary cells, but the MDCK cell line is also sensitive and has been used to develop an assay of activity. The activity is due to a protein that is heat-labile and sensitive to reducing agents and has a relative molecular mass of approximately 50,000 by gel filtration in the presence of 6 M-guanidinium hydrochloride or 8 M-urea. We term the agent 'epithelial scatter factor'. It is not known whether the factor acts directly or indirectly on junctional components. Besides its effect on cell relationships, the factor causes a change in cell morphology and local movement. In investigations so far, the scatter factor has been released only by fibroblasts of embryonic origin. Some but not all epithelial cells are sensitive; other cell types are not. The factor may be involved in morphogenetic changes involving the epithelium in embryonic or adult life. There is as yet no evidence for a role in the spread of tumour cells. PMID- 3829837 TI - Cell junctions and the biological behaviour of cancer. AB - Quantitative and qualitative abnormalities in intercellular junctions have been described in a broad spectrum of human and animal cancers. Current efforts are aimed at exploring the possibility that some of these defects may account for the hallmarks of malignancy, namely tumour invasion and metastasis. This approach is hampered by a paucity of information on the natural history of human cancer. There is evidence from quantitative electron microscopy studies of urinary bladder carcinomas induced by a chemical carcinogen in Fischer rats that decreased intercellular adhesion, mediated in part by intercellular junctions, does not contribute to the invasive potential of tumours. However, it may account for increased cell shedding at the tumour surface. The increased leakiness of malignant epithelium is attributed to defects in occludens junctions. The defects appear to represent a failure to assemble intramembrane fibrils into fully competent occludens junctions, rather than a blockage of fibril synthesis. Gap junctional deficiencies are not an invariant in cancers. Further, gap junctional deficiencies are present in human cervical carcinoma-in-situ. These deficiencies are present many hundreds of cell generations before the development of invasive tumours. This argues against the hypothesis that gap junctions per se contribute to the biological behaviour (i.e. invasion) of malignant tumours. PMID- 3829838 TI - Recognition, calcium and the control of desmosome formation. AB - Since desmosome formation requires the participation of two adjacent cells, a crucial initiating event must be recognition between desmosomal adhesion molecules. Studies of mutual desmosome formation between different cell types suggest that the recognition mechanisms are highly conserved between different tissues and different species of animals. A further requirement for desmosome formation is an adequate extracellular concentration of Ca2+ (greater than 0.1 mM). Keratinocytes, MDCK cells and MDBK cells all show Ca2+-induced desmosome formation. The desmosomes of these cells also show variable stability to reduction in [Ca2+] and Ca2+ chelation. Desmosome formation at low [Ca2+] is triggered by tunicamycin in keratinocytes, suggesting that the carbohydrate moieties of desmosomal glycoproteins may be involved in the Ca2+ control mechanism. The desmosomal glycoproteins appear to bind Ca2+, while the desmosomal adhesion molecules known as desmocollins, like other Ca2+-dependent adhesion molecules, yield a soluble fragment on trypsinization in the presence of Ca2+. For desmocollins the soluble fragment has a relative molecular mass of 42,000. PMID- 3829839 TI - [Application of a reduction-fixation apparatus for delayed union and non-union of long bone shaft of the extremities]. PMID- 3829840 TI - [Experience in the treatment of 30 cases with gas gangrene from war wounds]. PMID- 3829841 TI - [Treatment of electric burns by early excision and primary repair with flaps: report of 147 cases]. PMID- 3829842 TI - [Pinched synovial-tissue syndrome]. PMID- 3829843 TI - [Degenerative spondylolisthesis: report of 29 cases]. PMID- 3829844 TI - [Discussion on the etiology of lateral femoral cutaneous neuritis of spinal origin]. PMID- 3829845 TI - [Arthroscopic operations]. PMID- 3829846 TI - [Studies on the morbidity of prostatic cancer]. PMID- 3829847 TI - [Treatment of femoral venous valvular incompetence by encircling suturing of venous wall]. PMID- 3829848 TI - [Autotransplantation of a vein segment with valve in the treatment of deep vein valvular insufficiency of the lower extremity]. PMID- 3829849 TI - [Clinical observations on the dumping syndrome after subtotal gastrectomy]. PMID- 3829850 TI - [Multiple intracranial meningiomas]. PMID- 3829851 TI - [Diagnosis and treatment of arteriovenous fistulae of the head and neck]. PMID- 3829852 TI - [Emphysematous pyelonephritis: report of 5 cases]. PMID- 3829853 TI - [Experimental study on the relation between bile viscosity and bilirubin stone formation]. PMID- 3829854 TI - [Vascular cast of primary liver cancer and scanning electron microscopic observations]. PMID- 3829855 TI - [Ligation for heminephrectomy]. PMID- 3829856 TI - Perforation of terminal ileal appendage of J-pelvic ileal reservoir. AB - If, during restorative proctocolectomy, the most distal segment of the terminal ileum is not incorporated into the reservoir during J-pouch construction, it will remain as an appendage and may twist upon itself and obstruct. Two cases in which this resulted in significant complications are described. PMID- 3829857 TI - Analysis of the morbidity, mortality, and cost of colostomy closure in traumatic compared with nontraumatic colorectal diseases. AB - One hundred sixteen patients with acute colorectal diseases, operated upon emergently and needing an intestinal stoma, were reviewed to determine the cost and morbidity of treatment of patients with colorectal trauma compared to other surgical illnesses. The first group (57 patients) perforating colonic or rectal trauma, the second (30 patients) perforated colonic disease, the third (24 patients) nonperforated colonic disease, and the fourth (five patients) a colonic injury, unrecognized initially but requiring subsequent treatment with a stoma. For the initial operation, hospital stay, complications, mortality, and costs were less for patients in group 1 (colonic injury) than in groups 2 and 3 (inflammatory or neoplastic diseases). Colostomy closure, whatever the antecedent disease or injury, required an average ten-day hospitalization, had no mortality, a complication rate of 0 to 6 percent, and an average hospital cost of $6,500. The hospital stay and costs for the total treatment were slightly higher for nontraumatic illnesses, although the rate of colostomy closure was significantly less (68 and 77 percent versus 86 percent, P = .05). PMID- 3829858 TI - Peroperative lavage of the obstructed left colon to allow safe primary anastomosis. AB - A series of 44 patients with complete or partial left-colon obstruction underwent laparotomy and intraoperative colonic lavage. Irrigation was unsuccessful in three, the operation being concluded by a Hartmann resection. In the remaining 41, the achievement of an empty colon allowed primary anastomosis after resection of the obstructing lesion. Seven patients (17.1 percent) died, none of dehiscence of the colorectal anastomosis, although minor anastomotic leaks occurred in four. The median postoperative hospital stay was 12 days. Two patients developed peritonitis (one fatal) from leakage of ileal contents when the irrigating catheter was introduced through an ileotomy and retained postoperatively, and this aspect of the technique is not recommended. The operation offers a single stage alternative for patients with unprepared or ill-prepared bowels who require resection of left-colon lesions. The results compare favorably with the authors' previous experience of two- or three-stage resections (in-hospital mortality rate, 42 percent). PMID- 3829859 TI - The long-term outcome in Crohn's disease. AB - The long-term outcome of Crohn's disease was reviewed in 139 patients who were treated at the Cleveland Clinic for a minimum of 15 years. At the time of diagnosis, 38 (27 percent), 39 (28 percent) and 62 (43 percent) patients had small-bowel, large-bowel, and ileocolic patterns of disease, respectively. The disease progressed with time and, eventually, 104 (75 percent) patients had ileocolic disease. One hundred twenty-two patients (88 percent) underwent at least one definitive operation for the disease. Forty-four (32 percent) patients had proctocolectomies and 65 (47 percent) have ileostomies. Associated manifestations of Crohn's disease occurred in a high proportion of patients; perianal disease in 78 (56 percent), intestinal fistulas in 45 (32 percent), extraintestinal disease in 49 (35 percent). Six patients died of causes directly related to the disease. Specific complications tend to occur at definite times in the course of the disease. Crohn's disease is not a benign condition. There is a relentless progression of the disease and a high incidence of complications when patients are followed over a long period. PMID- 3829860 TI - Late development of metachronous colorectal cancer. AB - The incidence of metachronous colorectal cancer has been reported to be 1 to 5 percent, with most of the cases being discovered within ten years of the initial cancer. A retrospective review of all colorectal cancer patients was conducted at the Southern Illinois University Affiliated Hospitals to determine the incidence of metachronous colorectal cancer at the authors' institution. In this study, a metachronous cancer was defined as a second colorectal primary occurring at least three years following discovery of the initial lesion. Between 1978 and 1984, there were 24 patients with metachronous colorectal cancer identified in an operative series of 707 patients for a frequency of 3.4 percent. These metachronous cancers were discovered at intervals ranging from 3 to 35 years. Sixteen (67%) metachronous lesions occurred 11 years of more after the original cancer. Synchronous or interval adenomatous colorectal polyps were noted in 17 (71 percent) of the patients. Thirteen of the metachronous cancers appeared in the right colon, while six were distributed throughout the transverse and descending colon, and five were in the rectosigmoid region. The incidence of late appearing metachronous colorectal cancers and the propensity to occur in the right colon underscores the need for evaluation of the entire colon as part of lifelong follow-up of the colorectal cancer patient. PMID- 3829861 TI - Repeat colonoscopy after endoscopic polypectomy. AB - The records of all patients undergoing endoscopic polypectomy between December 1979 and December 1982 were reviewed. One hundred seventy-two patients underwent colonoscopic polypectomy in the absence of carcinoma or inflammatory bowel disease. Of these, the polyp could not be retrieved in 4, and 19 were lost to follow-up. One hundred forty-nine patients underwent subsequent endoscopy from one to four years after the initial polypectomy. Seventy-five (50.3 percent) of the patients developed new polyps. Although 61 of the 75 patients with new polyps were identified in the first two years, new polyps were noted throughout all four years. The presence of multiple polyps on the initial examination was statistically significant in predicting new polyps. The age and sex of the patients, size of the polyps, and the presence of atypia did not identify patients at higher risk for new polyps. The data indicate that new polyps are more likely to develop in patients who had a previous polyp. It would appear that annual examinations should be performed until two successive examinations are negative. Following a second negative examination, reexamination at two- or three year intervals, unless symptomatic, would appear to be adequate. PMID- 3829862 TI - Enteritis cystica profunda in Peutz-Jeghers syndrome. Report of a case and review of the literature. AB - The hereditary condition known as Peutz-Jeghers syndrome is characterized by mucosal pigmentation and gastrointestinal polyps. The polyps, usually pedunculated hamartomas, are significant only for the symptoms they cause. Intramural lesions also have been described with gross microscopic features that are often interpreted as malignant. Careful evaluation may show most of these lesions to be enteritis cystica profunda. These rarely diagnosed but benign tumors have very different implications for treatment and prognosis. PMID- 3829863 TI - Severe complication of rubber band ligation of internal hemorrhoids. AB - In light of recent reports describing severe and even fatal complications, the authors would like to report good results in two patients with massive edema and one with localized necrosis following rubber band ligation of internal hemorrhoids, which were recognized early and treated aggressively. The potential for severe complications emphasizes the need for determining other causes of rectal symptoms before ligation of hemorrhoids is undertaken. PMID- 3829864 TI - Retroperitoneal abscess complicating colonoscopy polypectomy. AB - A case of retroperitoneal abscess revealing a perforation of the rectum due to colonoscopic polypectomy is reported. PMID- 3829865 TI - Adult Hirschsprung's disease. An experience with the Duhamel-Martin procedure with special reference to obstructed patients. AB - A two-stage management of six adult patients with Hirschsprung's disease of the rectum and rectosigmoid, with obstruction (two patients) or enormous dilatation of the proximal innervated colon is reported. A preliminary transverse loop colostomy was carried out urgently in two patients because of colonic obstruction, and electively in four patients; at the same time, a full-thickness rectal wall biopsy was taken in all patients to establish the diagnosis. Reconstruction was performed four to six months later with Martin's modification of the Duhamel procedure. The postoperative course was uneventful and functional results are excellent three to eight years later. Based on experience, the Duhamel-Martin procedure seems preferable in adult Hirschsprung's disease when a considerable discrepancy exists between the ganglionic and aganglionic segments of the colorectum. PMID- 3829866 TI - Strategies for preserving intestinal length in the short-bowel syndrome. AB - Total parenteral nutrition now permits long-term survival in patients after massive intestinal resection. Surgical therapy for the short-bowel syndrome is still largely experimental and cannot be recommended routinely. Thus, prevention of intestinal resection and conservation of intestinal length, when resection is necessary, should be emphasized. Strategies are presented that can be employed to preserve intestinal length when surgery is required in patients with a shortened bowel. These include strictureplasty, minimal resection, serosal patching, and intestinal tapering. In suitable candidates strictureplasty can relieve obstruction from strictures while avoiding resection. Minimal resection of involved intestine can be performed safely in selected patients with radiation injury or Crohn's disease. Serosal patching is an alternative to resection for the treatment of perforation or strictures of the intestine. Intestinal tapering can improve the function of dilated intestinal segments and eliminate the need for resection in intestinal atresia. The judicious use of these procedures can preserve intestinal length and obviate the need for long-term parenteral nutrition in patients after massive intestinal resection. PMID- 3829867 TI - A stapled S-shaped ileoanal reservoir. AB - An S-shaped ileoanal reservoir has the advantage of greater ease in obtaining adequate length for safe anastomosis vs. the J-pouch. The hand-sewn S-shaped pouch, however, takes considerably longer (70 vs. 20 minutes) to construct than either a hand-sewn or stapled J-pouch. Because of potential necrosis of the central bridge of tissue created between two longitudinal stapled lines in an S pouch, the same techniques of stapling a J-pouch cannot be used in an S-pouch. The authors have developed a safe, rapid, stapling technique for construction of an S-pouch in the dog and have used it with success in four patients. PMID- 3829868 TI - Temporary colostomy for trauma. A new method to simplify colostomy closure. AB - A technique for construction of a functional loop colostomy is described for the management of colonic injuries in which complete fecal diversion is not required. The colostomy and mucous fistula are converted into a functional loop colostomy at the initial procedure and exteriorized through a single stoma. Subsequent colostomy closure is simplified. Intraperitoneal colostomy closure can usually be performed by mobilizing the colon at the stoma site without resorting to formal laparotomy. PMID- 3829869 TI - Intraoperative high-flow antegrade irrigation. PMID- 3829870 TI - Colorectal cancer: Lahey Clinic experience, 1972-1976. An analysis of prognostic indicators. AB - The records of 344 consecutive patients with colorectal cancer treated operatively at the Lahey Clinic from 1972 through 1976 were reviewed, and the effects of 41 clinical and pathologic variables on survival were analyzed. The variables associated with poorer five-year survival rates were advanced Dukes' stage, four or more positive nodes, blood vessel invasion, lymphatic invasion, circumferential involvement, and obstruction at initial presentation. As a group, patients with right colon cancers (cecum and ascending colon) had the best survival rates. When fistula formation or localized perforation had occurred, en bloc resection of locally involved adjacent viscera improved survival rates. These prognostic indicators aid in the selection of patients for wider colonic and mesenteric resections. PMID- 3829871 TI - Genetic predictability and minimal cancer clues in Lynch syndrome II. AB - Increasing attention has been given to hereditary nonpolyposis colorectal cancer (HNPCC), a disorder which occurs four or five times more frequently than its hereditary counterpart, familial multiple adenomatous polyposis coli (FPC). Because of the lack of premonitory physical signs in HNPCC, its diagnosis must encompass pertinent family cancer history. This report describes a kindred with a subtype of HNPCC, the cancer family syndrome also referred to as Lynch syndrome II. Emphasis has been given to the temporal evolution of this disorder and the manner in which minimal clinical-genetic clues might best be employed for its diagnosis. PMID- 3829872 TI - Physician accuracy in diagnosing colorectal polyps. AB - Since the medical management of persons with adenomatous colorectal polyps differs from that of those with hyperplastic polyps, accuracy of diagnosis is essential. Although many physicians have grown confident that their skills of visual diagnosis are adequate, few data exist to support this confidence. In order to examine the accuracy of physicians' judgments regarding colorectal polyp histology, the visual diagnosis of physicians experienced in endoscopy was compared with the histologic report. Eighty-one polyps were discovered by flexible sigmoidoscopy among 718 participants in a colon cancer screening program. Eighty percent of all polyps were detected accurately. The diagnostic sensitivity of detecting adenomas was 69 percent, while specificity (accurate diagnosis of hyperplastic polyps) was 86 percent, and there were an additional eight false negative and eight false positive diagnoses. Further analyses revealed that there are individual patterns of diagnostic mistakes made by physicians and that mistakes frequently are related to polyp size. These findings are particularly important in light of the expanding numbers of relatively inexperienced primary care providers performing flexible sigmoidoscopy whose diagnoses may be strongly dependent on polyp size. PMID- 3829873 TI - The pathogenesis of inflammatory polyps. AB - Eighty-six consecutive colonic resection specimens for inflammatory bowel disease were studied to determine the modes of inflammatory polyp formation. The two major groups of inflammatory polyps were polypoid mucosal tags due to undermining ulceration and mature inflammatory polyps composed of mucosa, muscularis mucosae, and a submucosal core. Mature inflammatory polyps were derived from polypoid mucosal tags after regeneration and the adjacent mucosa showed regenerative changes and submucosal scarring. The study confirms that ulceration which undermines the muscularis mucosae is the major precursor of inflammatory polyps. PMID- 3829874 TI - Changes in cell proliferation and morphology in the large intestine of normal and DMH-treated rats following colostomy. AB - Colostomies were formed in the midcolon of normal and DMH-treated rats. Changes in cell proliferation in the mucosa adjacent to the colostomy and in the defunctioned distal segment were measured at seven, 14, 30, and 72 days using a stathmokinetic technique. Animals were given intraperitoneal injections of vinblastine and sacrificed three hours later; counts of mitotic and nonmitotic cells were made in tissue sections, and three-hour accumulated mitotic indexes were estimated. The results show that, except at seven days in DMH-treated rats, cell proliferation was unchanged in the colon proximal to the colostomy. Morphologic evidence of hyperplasia was seen in some animals at seven and 14 days. The defunctioned segment showed rapid atrophy of both mucosa and muscularis and a gradual but progressive decrease in cell proliferation. The morphology of the mucosa adjacent to the suture line in both functioning and defunctioned segments in normal and DMH-treated rats was abnormal in many animals. Abnormalities that were seen included collections of dysplastic epithelial cells in the submucosa, focal adenomatous changes, and intramural carcinoma formation. Aggregates of lymphoid tissue often were associated with carcinomas. PMID- 3829875 TI - The efficacy of barium-enema examinations in patients with anorectal disease. AB - This retrospective study examines the value of an air contrast barium enema examination in detecting proximal neoplasia in the patient presenting with benign anorectal disease as determined by history, physical examination, rigid, and flexible sigmoidoscopy. In 428 of these patients, the roentgenographic studies showed proximal colonic cancer or polyps in less than 1 percent of patients reviewed. In addition, a review of 402 patients with known colon and rectal cancer were surveyed using the same criteria for diagnosis, and less than 1 percent were misinterpreted as having benign anorectal disease. PMID- 3829876 TI - Squamous-cell carcinoma of the anus in condyloma acuminatum. Successful treatment with preoperative chemotherapy and radiation. AB - A 40-year-old black male had unresectable giant condylomata acuminata of the anorectum with invasive, squamous-cell carcinoma. He was treated with intravenous 5-fluorouracil and mitomycin-C and with extended field radiation to the primary lesion. An abdominoperineal resection was performed, and the surgical specimen contained no residual cancer. Three years after diagnosis, the patient has no recurrent cancer. This case illustrates that otherwise unresectable giant condylomata acuminata with invasive carcinoma may be rendered operable with chemotherapy and radiation. PMID- 3829877 TI - Relationship between degree of portal hypertension and liver histologic lesions in patients with alcoholic cirrhosis. Effect of acute alcoholic hepatitis on portal hypertension. AB - The relationship between the degree of portal hypertension and histologic liver lesions was studied in a group of 84 patients with histologically proven alcoholic cirrhosis. The degree of portal hypertension was evaluated by the gradient between wedged and free hepatic venous pressures. Five histologic lesions were quantified: liver cell necrosis, Mallory bodies, neutrophilic infiltrate, fibrosis, and fatty infiltration. The gradient between wedged and free hepatic venous pressures was significantly correlated with the degree of liver cell necrosis and the degree of neutrophilic infiltrate. The stepwise regression analysis showed that only liver cell necrosis has a significant and independent correlation for the degree of portal hypertension. The value for the gradient between wedged and free hepatic venous pressures was significantly higher in patients with (N = 48) than in those without (N = 36) acute alcoholic hepatitis (19.4 +/- 0.8 and 16.5 +/- 0.7 mmHg, respectively). Thus, histologic liver lesions observed in acute alcoholic hepatitis may play a role in the risk of complications of portal hypertension in patients with alcoholic cirrhosis. PMID- 3829878 TI - Comparative prevalence of gallstone disease at 100-year interval in a large Romanian town, a necropsy study. AB - The prevalence of gallstone disease in a large Romanian town was determined on 6275 necropsies performed during a 10-year period (1973-1982). The "crude" prevalence of gallstone disease in women was 17.1% and in men, 6.9%. Age standardized prevalence was 8.4% in women and 5.0% in men. This rate is lower than the prevalence of gallstones in northern or central European countries, but it is higher than that established in some southern countries of Europe. A comparison of the "crude" prevalence of gallstone disease was compared with that calculated for a similar 10-year period 100 years ago (1873-1882), on 1538 necropsies performed in the same town. Prevalence of gallstones rose significantly in a century (from a mean of 1.2% to 11.3%; P less than 0.001), a finding consistent with the concept that gallstone disease is a "disease of civilization." PMID- 3829879 TI - Urinary zinc excretion in Crohn's disease. AB - In order to study the reliability of urinary zinc levels as an index of zinc metabolism and status in Crohn's disease, we evaluated plasma and urinary zinc concentrations, urinary 3-methylhistidine excretion, and Crohn's disease activity index (CDAI) in 42 patients affected by Crohn's disease. Plasma zinc correlated directly with albuminemia (P = 0.01) and inversely with CDAI (P = 0.001). Urinary zinc excretion correlated with urinary 3-methylhistidine (P = 0.001) and plasma zinc levels (P = 0.01), and inversely with CDAI (P = 0.05). However, from multiple regression analysis, it was found that zincemia is influenced by CDAI and not by albumin, whereas zincuria is related to urinary 3-methylhistidine and plasma zinc, and not to CDAI. Our conclusion is that, in Crohn's disease, zincuria can be an index of zinc status when used together with measurements of lean body mass and turnover and factors influencing plasma ultrafiltrable zinc fraction. PMID- 3829880 TI - Indium-111-labeled autologous leukocyte imaging and fecal excretion. Comparison with conventional methods of assessment of inflammatory bowel disease. AB - This study was designed to evaluate the role of 111In-labeled leukocyte imaging and fecal excretion in the assessment of inflammatory bowel disease. We compared these tests to various indices of disease activity in Crohn's disease, to Truelove's grading in ulcerative colitis, and to endoscopy, x-ray, and pathology in both diseases. Eleven controls, 16 patients with Crohn's disease, 13 with ulcerative colitis, and 3 with other types of acute bowel inflammation were studied (positive controls). Indium scanning was performed at 1, 4, and 24 hr. Fourteen of 16 patients with active Crohn's disease had positive scans but in only five was localization accurate. One patient had inactive ulcerative colitis, and the scan was negative. Of 12 patients with active ulcerative colitis, 10 had positive scans but disease localization was accurate in only four. Disease extent was correctly defined in 1 of the 3 Positive Controls. There was no significant difference in the accuracy of scanning at 1, 4, or 24 hr. 111In fecal excretion was significantly higher in patients with inflammatory bowel disease than in controls, and there was correlation between 111In fecal excretion and most of the indices of disease activity in Crohn's disease. In ulcerative colitis, 111In fecal excretion did not correlate with Truelove's grading but reflected colonoscopic assessment of severity. In conclusion, 111In-labeled leukocyte scanning lacks sensitivity with respect to disease extent, but fecal excretion of 111In correlates well with disease severity as determined by other methods. PMID- 3829882 TI - Effect of omeprazole on acute gastric stress ulceration in cervical cord transected rats. AB - Patients with acute paraplegia from trauma have an increased frequency of developing gastric stress ulceration and subsequent hemorrhage. Current treatment of gastric stress ulcer is by antacids or H2 antagonists, but despite such therapy stress ulceration still occurs, probably because these agents are unable to maintain gastric pH above 4. Omeprazole, which blocks the terminal step of acid secretion--the proton pump, can produce long-lasting achlorhydria. This study examined the efficacy of omeprazole in preventing stress ulcer in rats with acute cervical cord transection. Omeprazole was administered intraduodenally at 1.725, 2.625, 3.5, and 17.5 mg/kg, and the ulcer incidence and gastric acid output were measured. Omeprazole produced a dose-dependent inhibition of gastric acid output in the cervical cord transected rat. At the highest dose, complete achlorhydria was achieved. The quantity of gastric ulceration was inversely proportional to the omeprazole dosage with nearly complete prevention of ulceration at the highest dose. In conclusion, omeprazole is very effective in preventing gastric stress ulcers in the spinal cord transected rat. This appears to be related to its potent long-lasting inhibitory effect on gastric acidity. PMID- 3829881 TI - Effect of stimulation of endogenous glucagon secretion by amino acid administration on canine hepatic bile flow. AB - Exogenous glucagon administration is associated with stimulation of hepatic bile flow. The physiologic role that glucagon plays in the control of hepatic bile flow remains indeterminant. The purpose of this study was to evaluate amino acid administration, a stimulus of endogenous glucagon release, on canine hepatic bile flow. The experiments were performed utilizing cholecystectomized dogs with chronic biliary fistulas. The enterohepatic circulation of bile salts was artificially maintained by intravenous bile salt administration. Intravenous L arginine stimulated endogenous glucagon release and hepatic bile secretion. Intravenous amino acid administration produced significant increases in hepatic bile flow and plasma glucagon and was significantly more potent than intravenous arginine. Intravenous amino acid administration produced small but significant increases in serum insulin but did not significantly change plasma concentrations of cholecystokinin. The results of this study suggest that endogenous glucagon secretion produces a choleresis and supports a role for glucagon in the physiologic control of canine hepatic bile flow. PMID- 3829883 TI - Chronic pancreatitis at early age of onset presenting interesting findings through endoscopic retrograde pancreatography and chemical analysis of nonopaque pancreatic concretion. AB - This case concerns a 20-year-old male patient with an approximate 10-year history of recurrent and severe abdominal pain radiating to the back. Endoscopic retrograde cholangiopancreatography revealed a short obstructing stenosis of the main pancreatic duct in the head of the pancreas, marked and tortuous dilatation of the prestenotic portion of the main pancreatic duct and its side branches, and a filling defect in the side branch in the body of the gland. Pancreaticojejunostomy was performed to induce decompression of the pancreatic duct. Histology of the pancreas showed advanced chronic pancreatitis. Three nonopaque concretions were obtained at operation. The largest one, which was milky white in appearance and elastic and soft in consistency, proved to be made up of protein. The concretion was rich in acidic amino acids, but poor in basic or aromatic residues. The molar composition of amino acids in the concretion was, in decreasing order, aspartic acid, serine, valine, glycine, and glutamic acid. Powder x-ray diffractometry revealed no crystalline structures. PMID- 3829884 TI - Steatosis and cirrhosis in an obese diabetic. Resolution of fatty liver by fasting. AB - A 54-year-old woman with obesity, type II diabetes mellitus, hyperlipidemia, and massive hepatomegaly was found to have severe steatosis and cirrhosis on liver biopsy. Complete evaluation led to the diagnosis of fatty cirrhosis associated with obesity and diabetic mellitus. She underwent four months of fasting with a protein-carbohydrate and vitamin-mineral liquid supplement to control her weight and metabolic abnormalities and to evaluate the effect of this diet on her liver disease. She lost 40 pounds to ideal body weight, normalized her serum glucose and lipids, and decreased total liver height by one third. Liver biopsy at the completion of her diet showed inactive cirrhosis and complete resolution of steatosis. Supplemented fasting with only modest weight loss can safely resolve fatty liver in obese diabetics with nonalcoholic steatosis and cirrhosis. Aggressive dietary approaches to achieve long-term weight loss deserve study in this subgroup of diabetics with unexplained chronic liver disease. PMID- 3829885 TI - Courvoisier's gallbladder: "render unto Caesar that which is Caesar's". PMID- 3829886 TI - The P450 gene superfamily: recommended nomenclature. AB - A nomenclature for the P450 gene superfamily is proposed based on evolution. Recommendations include Roman numerals for distinct gene families, capital letters for subfamilies, and Arabic numerals for individual genes. An updating of this list, which presently includes 65 entries, will be required every 1-2 years. Assignment of orthologous genes is presently uncertain in some cases--between widely diverged species and especially in the P450II family due to the large number of genes. As more is known, it might become necessary to change some gene assignments that are based on our present knowledge. PMID- 3829887 TI - Nucleotide quartets in the vicinity of eukaryotic transcriptional initiation sites: some DNA and chromatin structural implications. AB - Examination of all mammalian, nonmammalian vertebrate, and invertebrate genomic sequences present in the GenBank data shows a striking distribution of the G + C (A + T) content. It has been known for a few decades that the G + C content in higher organisms averages 42%. The average of the sequenced genomic regions is significantly higher, with a distinct peak near the transcription initiation site. This distribution, as well as the overall A + T genomic incidence may be directly related to DNA geometry. Specific A-T sequences may facilitate DNA curving, allowing more tight packaging of chromatin in eukaryotic genomes. To examine further which particular oligomers may potentially contribute to recognition of transcription initiation sites, an extensive search was instituted for detecting recurrences of particular oligonucleotides in the regions surrounding these sites. Accordingly, the analyzed mammalian genomic sequences have been scanned for the occurrences of each of the 256 quartets. The CAAT box components yield moderate peaks. As expected, the TATA box is much more pronounced, though the ATAA sequence yields a more striking peak than the TATA. Tetranucleotides containing solely A + T are relatively rare downstream from coding regions. Upstream, their level is low except for the distinct peaks; the level of A4 is very high upstream. All significant signals are enumerated. Of the G + C-rich quartets, CCCC and AGGG exhibit large peaks near transcription initiation sites. These may produce straight DNA segments. PMID- 3829888 TI - Molecular cloning and sequence of the cDNA for a 94-amino-acid seminal plasma protein secreted by the human prostate. AB - The precursor to a seminal plasma protein reported to have inhibin-like activity was characterized through cDNA cloning and sequencing. It is a 114-amino-acid polypeptide which differs from its seminal plasma derivative mainly by the presence of a 20-residue amino-terminal extension, a putative signal sequence, carrying a possible N-glycosylation site. The protein is specified by a single gene per haploid genome. Its mRNA is detectable in the prostate but not in the testis, which suggests that it is primarily a prostatic secretory protein. PMID- 3829889 TI - Cloning of bovine P1 protamine cDNA and the evolution of vertebrate P1 protamines. AB - A bovine P1 protamine cDNA from a bull testis cDNA library was isolated utilizing a series of oligonucleotide probes. Sequence analysis showed that the cloned cDNA insert extended 317 bp to the poly(A) tail. The 51-residue 6750-dalton protamine primary translated protein is encoded within a 156-bp segment. The protamine sequence predicted from the cDNA sequence differs from that previously reported for the amino acid sequence of bovine protamine P1 by the insertion of the tripeptide Cys-Arg-Arg from residues 39-41 in the carboxy-terminal region of the mature protein. Consistent with previous hybridization analysis, nucleotide sequence comparisons showed that trout protamine cDNA was more closely related to that of bovine than to that of mouse. However, bovine P1 protamine cDNA shared greater sequence homology with mouse P1. A common nucleotide sequence of 30 bp is conserved among all three of these species. Primer extension analysis revealed that, as with trout protamine mRNAs, the majority of the untranslated portion of the mRNA lies 3' to the coding segment. Comparisons of their mRNA secondary structures by computer modeling indicate that the mRNAs fold back onto themselves, producing similar, extensively hydrogen-bonded, convoluted forms. These models support the view that translational regulation of protamine mRNA may be partially dependent on secondary structure. Southern analysis suggests that the bovine protamine P1 gene is not sex-linked and is present as one (or relatively few) copy within the bovine genome. PMID- 3829891 TI - Program and abstracts from the Seventh Annual Congress for Recombinant DNA Research. March 1-4, 1987, San Francisco. PMID- 3829890 TI - A novel method for transfection and expression of reconstituted DNA-protein complexes in eukaryotic cells. AB - Transfection of foreign DNA into eukaryotic cells has become an important tool in molecular biology. Based on the results of previous studies of the core structure of human adenoviruses, we have developed a novel transfection method. The procedure involves the in vitro reconstitution of foreign DNA-of viral or other origins-with the major core protein VII of adenovirus type 2 (Ad2) or protamine from salmon sperm. Both proteins are rich in basic amino acids and appear to share structural features. The DNA-protein complexes are added directly to the medium of eukaryotic cells. The in vitro formation of specific DNA-protein complexes can be assessed by gel electrophoretic analyses. Bovine serum albumin does not enter into specific complexes with DNA. Transfection of DNA-protein VII or DNA-protamine complexes results in their rapid transport into the cell nuclei. About 2-4 hr after transfection, up to 40% of the DNA added to cell cultures in complexes can be found in the nucleus, as compared with less than 10% of the DNA when other transfection methods are applied or when naked DNA is added to cell cultures. DNAs transfected by the new method into mammalian or insect cells retain their characteristic restriction patterns at least 48 hr after transfection and are expressed efficiently. Supercoiled circular plasmid DNAs are converted to open circular or linear DNA. Expression has been measured both for transiently expressed genes (chloramphenicol acetyltransferase gene, Ad2 DNA in human HeLa cells) and for genes that have been integrated into the host genome and are expressed permanently, such as the gene for neomycin phosphotransferase in hamster BHK21 cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3829892 TI - [Effect of helium-neon laser irradiation on the spleen of intact and x-irradiated mice]. PMID- 3829893 TI - [Receptors of boar sex pheromones in the sow nasal cavity]. PMID- 3829894 TI - [Comparative characteristics of the metabolism of male Tryon rats (Tryon maze dull and Tryon maze bright) and the possibility of predicting their social status from biochemical indices]. PMID- 3829895 TI - [Plasticity of minced muscle tissue of old animals]. PMID- 3829896 TI - [Mosaic formation of neurons in the neurogenesis zone in the Xenopus laevis tectum]. PMID- 3829897 TI - [Proto-oncogenes in human teratocarcinoma cells]. PMID- 3829898 TI - [The role of fractionation of the dose of pulsed laser red rays in their effect on the spleen of intact and x-irradiated mice]. PMID- 3829899 TI - [Lateral elements of the synaptonemal complex containing carbohydrate groups]. PMID- 3829900 TI - [Amino acid composition of endogenous physiologically active oligopeptides]. PMID- 3829901 TI - [The origin of saw-like disturbances in sedimentation schlieren patterns of human serum]. PMID- 3829903 TI - [Comparative analysis of denervation atrophy and reinnervation of skeletal muscles in vertebrates]. PMID- 3829902 TI - [Serotonin level in the olfactory bulbs and pheromone-mediated regulation of aggressive behavior in male domestic mice]. PMID- 3829905 TI - [Mechanisms of 14C-beta-phenylethylamine transport in rat brain synaptosomes]. PMID- 3829904 TI - [Detection of prostaglandins in preparations from medicinal leeches (Hirudo medicinalis)]. PMID- 3829906 TI - [Characteristics of the regulating effect of the hippocampus on conditioning reflex activity in the hedgehog Erinaceus europaeus]. PMID- 3829907 TI - [Intercellular electrotonic interactions in the cardiac sinus node in the frog]. PMID- 3829908 TI - [Kinetic study of the effect of various olfactory signals on alkaline phosphatase activity in the olfactory tissue of Rattus norvegicus norvegicus]. PMID- 3829909 TI - Heparin-associated hematomas: possible allergic reaction. AB - Heparin hypersensitivity is a rare complication of anticoagulation therapy. Our case involved a 34-year-old black male who demonstrated a hypersensitivity to porcine heparin that manifested as bilateral hematomas with ecchymoses from intravascular access sites. When bovine heparin was substituted, there was no evidence of a similar reaction. However, the patient required five times the usual dose to be adequately anticoagulated (partial thromboplastin time 1 1/2-2 times normal value) and eventually developed generalized pruritus. PMID- 3829910 TI - Comparable steady-state bioavailability between two preparations of conventional release procainamide hydrochloride. AB - The pharmacy and therapeutics committee-based clinical evaluation can be a useful tool in the economic and functional effectiveness of a restrictive formulary system. We utilized this concept to evaluate a generic formulation of procainamide hydrochloride (PA) for admission to our formularies. The study performed was a randomized, single-blind, crossover comparison of the serum concentration profiles of two preparations (Squibb vs. Ascot) of conventional release PA. Ten outpatients requiring chronic PA therapy for the control of ventricular dysrhythmias were evaluated. The resultant dose-adjusted data showed no significant difference between mean serum PA concentrations at any sample time, area under the serum concentration-time curves, mean peak serum PA concentrations achieved, or peak-trough fluctuations. Relative bioavailability was calculated to be 0.972 +/- 0.59. The Ascot preparation demonstrated a delay of 15 minutes before the onset of absorption; however, it also showed an earlier tmax in comparison to the Squibb formulation. Generic substitution of Ascot PA in place of Squibb PA may be implemented with significant cost savings. PMID- 3829911 TI - Potential impact of quantitative susceptibility tests on the design of aminoglycoside dosing regimens. AB - Therapeutic drug monitoring of aminoglycosides currently applies pharmacokinetic principles to maintain peak concentrations between 4 and 10 micrograms/ml and troughs less than 2 micrograms/ml. These predetermined concentrations are based on statistical rates of cure and incidences of adverse effects. At present, recommended serum concentration ranges for aminoglycosides (as with other antibiotics) do not specifically target the susceptibility of the individual organism, but compensate only for altered clearance due to diseases. The design of antibiotic regimens based on both pharmacokinetics and pharmacodynamics is called dual individualization. Logically, the pharmacodynamic parameters, the minimum inhibitory concentration (MIC) of the organism and the postantibiotic effect (PAE), should also play a significant role in design of the dosing regimen. Simulations were performed to examine the consequences of designing aminoglycoside regimens considering both disease effects on excretion and bacterial susceptibility (MIC and PAE). The application of dual individualization concepts to aminoglycosides argues for a wider range of dosage requirements than observed with regimens that maintain desired peaks and troughs. If these concepts are accepted, some patients will clearly require more aminoglycoside than is currently used, and others can be managed with substantially less. The aminoglycoside therapeutic window, as it is now conceived, could be markedly different in the future. PMID- 3829912 TI - Cimetidine versus ranitidine: single-dose, oral regimen for reducing gastric acidity and volume in ambulatory surgery patients. AB - This placebo-controlled trial compared the efficacy of single oral doses of cimetidine or ranitidine in maintaining intragastric pH and volume greater than 2.5 and less than 25 ml, respectively, in ambulatory surgery patients requiring general anesthesia. Patients were randomized to receive either placebo, ranitidine HCl 150 mg, or cimetidine HCl 400 mg upon rising on the morning of surgery. At induction, the cimetidine and ranitidine groups had significantly higher (p less than 0.05) gastric pH values than the placebo group. At extubation, the ranitidine group had a significantly higher (p less than 0.05) gastric pH than either the cimetidine or placebo group. Both H2-blocker groups had lower volumes when compared with the placebo group at extubation (p less than 0.05). There were more patients at risk for aspiration pneumonitis (pH less than 2.5 and/or volume greater than 25 ml) in the cimetidine group (46 percent) than in the ranitidine group (15 percent). All placebo-treated patients were at risk for aspiration pneumonitis. We did not find subjective clinical evidence of aspiration pneumonitis in our patients. We conclude that both ranitidine and cimetidine are superior to placebo, but ranitidine may be the preferred agent because of its more consistent effect on gastric pH and volume. PMID- 3829913 TI - Evaluation of three manual drug information retrieval systems for investigational antineoplastic drugs. AB - The manual drug information retrieval systems, de Haen's Drugs in Use, Iowa Drug Information Service (IDIS), and International Pharmaceutical Abstracts (IPA), were evaluated to determine their usefulness as sources of drug information for investigational antineoplastic drugs during the years 1980-81. During both years, de Haen's provided the greatest number of antineoplastic drug citations, IPA the least. Concerning qualitative analysis, (the ability of the information systems to provide citations in seven subject areas for the five drugs), IDIS was found to have the greatest overall utility and was statistically different from IPA in many subject areas. IPA provided few citations in the seven subject areas for the five drugs. On pairwise analysis, no differences emerged between IDIS and de Haen's. Commonly available manual drug information retrieval systems such as IDIS and de Haen's appear to be useful sources of information for investigational antineoplastic drugs. PMID- 3829914 TI - Effectiveness of a printed leaflet for enabling patients to use digoxin side effect information. AB - The effectiveness of a printed leaflet designed to inform patients about digoxin was evaluated. The printed leaflet alone was compared to the verbal consultation alone and the verbal consultation in addition to the printed leaflet. The study assessed patients' decisions about the appropriate course of action to take if side-effect symptoms occurred. Patients receiving the printed leaflet alone scored higher than patients receiving the verbal consultation; however, they scored lower than patients receiving both the printed leaflet and verbal consultation together. Patients receiving both verbal and printed information scored significantly higher than those receiving verbal consultation only. The findings suggest that printed materials together with verbal consultation are essential for enabling patients to make appropriate decisions with respect to side effects. There is not enough evidence to support the use of printed materials in place of verbal consultation. Health practitioners should use printed materials as an adjunct to verbal information. PMID- 3829915 TI - MAOI-like reaction associated with cimetidine. PMID- 3829916 TI - Aspirin and uricosurics: interaction revisited. PMID- 3829917 TI - Bioavailability and absorption kinetics of slow-release theophylline. PMID- 3829918 TI - [Limits of lay resuscitation]. PMID- 3829919 TI - [Proton spin tomography in childhood. Experience with 407 studies in 275 children and adolescents]. AB - Over a period of three years magnetic resonance imaging (MRI), mostly neuroradiological, was performed 407 times in 275 children. It was found that MRI largely replaced previously applied imaging methods for solving oncological and neurological problems. The sensitivity of the method is poor for demonstrating small calcifications (computed tomography is better), for diffuse meningeal lesions (lumbar puncture is better), and diffuse spinal-canal metastases (myelography is better). The great advantage of the method lies in its low x-ray exposure because of the low field strength, and it can therefore be safely used repeatedly. PMID- 3829921 TI - [Unusual course of Candida endocarditis]. AB - Fever, anemia, pulmonary infiltrates and weight loss occurred in a 47-year-old man four weeks after a gastric operation. On echocardiography and cardiac catheterization an atrial myxoma was revealed. In removing the myxoma the tricuspid valve apparatus was destroyed, requiring insertion of a bio-prosthetic valve (Hancock). Signs of infection persisted post-operatively, together with complete A-V block and panuveitis. The Candida IGM titer was markedly increased and histological examination of the thrombus revealed massive fungal infection. Recurrent fever and massive vegetation on the prosthetic valve necessitated removal of the prosthetic valve under antimycotic treatment, which also cleared the pulmonary lesions. The patient's general condition improved. Right-heart failure was controllable by drugs. PMID- 3829920 TI - [Clinical testing of a new blood glucose measuring system. A cooperative study at 8 centers]. AB - The glucometer II system is a small measurement device with built-in batch specific pressbutton calibration. The corresponding test strip "Glucostix" uses a two-color system. The blood glucose test strip can be evaluated both visually and by instrument. The precision determined in series was between 2.0% and 6.7% using control sera. The day-to-day precision was between 1.5% and 7.9%. Comparison of the methods on the basis of 781 and 109 capillary blood samples respectively revealed a good agreement between the hexokinase method or the glucose oxidase method (Beckman analyser) and the glucometer II values. The precision of measurement by the system was comparable in the two test strip batches employed. Visual reading of the test strips revealed a good agreement with the laboratory method in the hypoglycemic and normoglycemic range; at higher concentrations of blood glucose, a trend to underestimation of the measurement values was shown. The easy handling and small size of the instrument facilitates measurement of blood glucose by the patient under everyday conditions. PMID- 3829922 TI - [Stage classification of chronic lymphatic leukemia as a basis for therapy decisions]. PMID- 3829923 TI - [Extent of resection in hyperthyroidism]. PMID- 3829924 TI - [Proposal for the division and classification of chronic arterial hypertension]. PMID- 3829925 TI - [Carotid thrombendarterectomy]. PMID- 3829926 TI - [The treatment of obesity]. PMID- 3829927 TI - [Campylobacter pylori--is there a connection with peptic ulcer?]. AB - In 67 patients, mucosal biopsies were taken in gastroduodenoscopy and culture set up to demonstrate Campylobacter pylori. Campylobacter pylori was cultured from 91% of the patients with peptic ulcer, in 76% of patients with gastritis and in 28% of patients without histological detection of gastritis. Electron microscopic investigations of duodenal mucosa showed that this bacterium attaches to the metaplastic cells of the antral type. This cell type is regularly encountered in the duodenal mucosa in healing duodenal ulcer. The ultrastructural features permit a clear distinction between Campylobacter pylori and other Campylobacter species. Campylobacter pylori may possibly have a pathogenic effect on the mucosa owing to its penetration into the interstitial spaces between the cells and into the interior of the cells. PMID- 3829928 TI - [Heart surgery in acute bacterial endocarditis without preoperative heart catheterization. Long-term observation of 40 patients]. AB - In 40 patients with acute bacterial endocarditis, the indication for cardiac valve replacement was established exclusively on the basis of the echocardiographic and clinical findings. The patients had an average age of 42 years and were under followup observation for an average of 2.2 years. The endocarditis involved the aortic valve 32 times, the mitral valve once, the tricuspid valve in two cases and the aortic and mitral valve together in five cases. In addition to the valve replacement, a ventricular septum defect and aneurysm of the ascending aorta had to be dealt with surgically in two cases each. The intraoperative and perioperative lethality was 2.5% (n = 1). The postoperative lethality was 12.5% (n = 5). In the surviving 34 patients, a recurrence of the endocarditis has not occurred up to now in any case. According to the NYHA classification, six of the surviving patients were to be classified as stage II and 28 as stage I, whereas stage III or IV had been present preoperatively in all cases. The postoperative echocardiographic investigation revealed a significant decrease of the left ventricular enddiastolic diameter (from 61 +/- 8 mm to 51 +/- 5 mm; P less than 0.001). In four cases, a slight insufficiency of the artificial valve could be detected. Reoperation was not necessary in any of these patients. PMID- 3829929 TI - [Formation of IgG antibodies to C1 inhibitor as the cause of life-threatening angioedema]. AB - A clinical picture with recurrent (in some cases potentially fatal) edema of skin and internal organs based not on a hereditary C1 inhibitor deficiency, but an acquired loss of C1 inhibitor activity due to antibodies is described for the first time in two patients. The clinical symptoms commenced in middle age patients between 40 and 46 years old. Anti C1 antibodies of the IgG were found in both patients. Quantitatively, these C1 inhibitor protein was in the lower range of normal, whereas no inhibitor activity could be demonstrated functionally. The function of the complement components C1, C2 and C4 was greatly reduced. The therapeutic use of C1 inhibitor concentrate at a high doses (6 X 500 U) as well as administration of high-dose corticosteroids in several emergency situations was unsuccessful. PMID- 3829930 TI - [Contraception and pregnancy in hereditary angioedema]. AB - The frequent first clinical manifestation of hereditary angioedema (HAE) in pubertal patients and the more frequent attacks of edema during menstruation indicate that the condition is affected by hormones. Medication with oral contraceptives containing estrogens can lead to severe attacks of edema. On the other hand, HAE mostly shows a favorable development in pregnancy. Despite the substantial trauma of delivery, complications are rare. In view of the literature report of a death and our own observation of potentially dangerous edema in the postpartal phase in one patient, it appears to us to be advisable to administer 500 units C1 inactivator prophylactically before the expulsive phase of birth in HAE patients. Oral contraceptives should not be administered. PMID- 3829931 TI - [Changes in the right of medical officers to perform extra work]. PMID- 3829932 TI - [Serum uric acid and antiepileptics]. PMID- 3829933 TI - [Risk of cancer in cyclophosphamide therapy of multiple sclerosis]. PMID- 3829934 TI - [Immunosuppressive therapy in panmyelopathy. Experiences with various forms of therapy in 42 patients]. AB - Immunosuppressive treatment according to four different regimens was administered over the course of eight years to 42 patients with aplastic anemia. With treatment protocols which included horse-ALG and horse-ATG, remissions were achieved in most patients, while with rabbit-ATG improvement was obtained, but only minimally, in 15 patients. First results with Cyclosporin A confirmed the effectiveness of this immunosuppressive agent in the treatment of aplastic anemia. The development of remission was, independently of treatment schedule, recognizable 23-88 days after onset of treatment. Often only partial remission was achieved. The long-term course, especially also survival, correlated with the results achieved within the first three months after onset of treatment. Recurrences occurred in 19% of patients but responded to repeated immunosuppressive treatment if preceded by complete remission. Side-effects to ALG and ATG occurred only during the first two weeks and were easily controllable. In some cases Cyclosporin A led to subjectively distressing side effects. PMID- 3829935 TI - [Postvaccinal neuritis following prophylactic vaccination against early-summer meningo-encephalitis]. AB - After a single dose of a commonly used commercial vaccine against early-summer meningo-encephalitis a 22-year-old woman developed neuritis of the nerves to the gravity muscles in the legs and feet. The course of the disease and absent antibodies in serum suggested a cellular immune response. In this case, as generally in postvaccinal neuritis, prognosis proved to be favorable. The estimated incidence of postvaccinal neuritis in general is 1:100,000. The indications for active immunization against early-summer meningo-encephalitis should continue to be narrowly defined. PMID- 3829936 TI - [Septicemia caused by enteritis due to Campylobacter fetus subspecies fetus]. AB - In a 55 year old man with renal insufficiency requiring hemodialysis after bilateral nephrectomy who had been hospitalized with febrile illness and enteritis, Campylobacter fetus subspecies fetus could be isolated from the blood and feces. Antibodies against the homologous strain (isolated from the blood) could be detected in the serum by means of the Widal test and the indirect immunofluorescence test. Culturing of Campylobacter fetus subspecies fetus (especially from blood cultures) may be difficult because of the poor growth conditions for microaerophilic bacteria. It is quite possible that this organism occurs more frequently in blood and feces than suggested by the routine investigations carried out so far. PMID- 3829937 TI - [Diagnostic characteristics of malignant melanomas and pigmented nevi with a tendency to develop into melanomas]. PMID- 3829938 TI - [Therapy of malignant melanomas]. PMID- 3829939 TI - [Cyclosporin A in the therapy of hematologic diseases]. PMID- 3829941 TI - [Life support care against the patient's will]. PMID- 3829940 TI - [Weaning from smoking. Psychological and pharmacological methods]. PMID- 3829942 TI - [Meningitis therapy in childhood]. PMID- 3829943 TI - [Alcohol consumption and blood-brain barrier]. PMID- 3829944 TI - [Danthron prohibition]. PMID- 3829945 TI - [Lasers in gastroenterology]. PMID- 3829946 TI - [Mistaken diagnosis in subarachnoid bleeding. A study of 154 cases]. AB - In 154 patients with spontaneous subarachnoid hemorrhage owing to a ruptured aneurysm, the way by which the diagnosis was arrived at was checked. The correct diagnosis was missed initially in 52 patients (33.8%) and the subarachnoid hemorrhage was misinterpreted most frequently as systemic infection, brain tumor, disorder of cerebral blood flow or cervical spinal syndrome. The proportion of false diagnosis was especially high in younger patients with an initially less severe illness. Freely practicing physicians without specialist neurological training missed the diagnosis in 33.3%, free practicing specialists for nervous diseases and neurologists in 17.4%, doctors at smaller hospitals in 16.3% and doctors at the Neurologic Division, University Hospital for Nervous Diseases in Homburg/Saar in 6.5%. The time up to correction of a wrong initial diagnosis was up to seven days in 34 patients (65.4%), up to 14 days in 13 patients (25.0%) and between 15 and 27 days in five patients (9.6%). PMID- 3829947 TI - [Cardiomyopathy in idiopathic hemochromatosis. Diagnostic possibilities using proton spin tomography]. AB - In idiopathic hemochromatosis, there is progressive deposition of iron in parenchymatous organs owing to a defect in iron absorption the nature of which is not so far known. This can result in cardiomyopathy with heart failure and arrhythmia which are refractory to therapy. Nuclear magnetic resonance tomography is a specific imaging technique for early detection of myocardial iron deposits. With quantitative determination of the T2 relaxation time of the myocardium, a progress control under venesection therapy is possible above and beyond diagnostics. PMID- 3829948 TI - [Can beta-receptor blockers trigger coronary spasm?]. AB - Beta-blockers are frequently administered in therapy of arterial hypertension and coronary heart disease. They mostly lead to an asymptomatic increase of peripheral and coronary resistance. Three patients in whom there were indications of a deterioration of myocardial blood flow under beta-blockade were observed within a few weeks. After discontinuation of the beta-blockers and instituting a therapy with calcium antagonists, both a reduction of ischemia in the exercise ECG and a reduction of symptoms could be observed. The possibility that beta blockers trigger coronary spasms and thus give rise to unfavorable effects on myocardial blood flow must be considered in the context of therapy monitoring, especially in patients with coronary heart disease. PMID- 3829949 TI - [Extra-hospital first aid in near-drowning]. PMID- 3829950 TI - [Transdermal melanotropin therapy in multiple sclerosis?]. PMID- 3829951 TI - [Information service for malignant hyperthermia emergencies]. PMID- 3829952 TI - [Unclear syncope]. PMID- 3829953 TI - New concepts and developments in toxicology. Proceedings of the Fourth International Congress of Toxicology. Tokyo, Japan, July 21-25, 1986. PMID- 3829954 TI - The effects of diet on the toxicity of nitroaromatic chemicals in rodents. PMID- 3829955 TI - The role of micronutrient, selenium, in the manifestation of toxicity of heavy metals. PMID- 3829956 TI - Percutaneous absorption and skin sensitization. PMID- 3829957 TI - Some factors influencing percutaneous absorption of organic solvents. PMID- 3829959 TI - Health assessment of exposure to developmental toxicants. AB - The U.S. EPA has taken an important step in developing these guidelines, the first of their kind. They more precisely delineate the hazard identification process and the factors important in supporting risk decisions for developmental toxicants than does any other document. Unfortunately, however, more precise estimates of risk are hampered by our lack of understanding of a number of factors, including the biological mechanisms underlying developmental toxicity, intra/interspecies differences, the influence of maternal effects on the dose response curve, the likelihood of thresholds for certain of these end points, and the appropriate quantitative models for dose-response data and for low-dose extrapolation. To this extent, the Agency is supporting and conducting a number of investigations which will hopefully further our knowledge and improve our ability to assess risks for the developing human. The guidelines will be updated as such information becomes available. PMID- 3829958 TI - Effect of ochratoxin A on gene expression in rat kidneys. PMID- 3829960 TI - Endpoints of reproductive dysfunction in an experimental epidemiological model: self-poisoned pregnant women. PMID- 3829961 TI - Metabolism of mutagenic 1-nitropyrene in rats. PMID- 3829962 TI - Metabolism of dinitropyrenes to DNA-binding derivatives in vitro and in vivo. PMID- 3829963 TI - Carcinogenicity of dinitropyrenes in rats and hamsters. PMID- 3829964 TI - Mechanisms of tumor induction by dinitropyrenes in the female CD rat. PMID- 3829965 TI - Carcinogenic effects of a mixture of nitropyrenes in F344 rats following its repeated oral administrations. AB - The carcinogenic effects of a mixture of 1-nitropyrene and three dinitropyrenes (1,3-, 1,6- and 1,8-dinitropyrene) were investigated in rats. Female F344/Jcl rats were given one of three doses (5, 10 and 20 mg/kg body weight) of the mixture by repeated intragastric instillations twice a week for 55 weeks, and then autopsied 49 weeks later. Mammary adenocarcinomas were induced in rats of all the three experimental groups dose-dependently, while no adenocarcinoma was induced in the control rats which were given only vehicle. Clitoral gland tumors, most of which were diagnosed as squamous cell carcinomas, were also commonly observed in the NP-treated rats in a dose-dependent way. In addition, high incidences of mononuclear cell leukemias were noted in the NP-treated rats. Other tumors were frequently induced in the uterus and endocrine organs, such as the pituitary, adrenal, and thyroid glands. However, the incidences of these tumors were almost equal in both the control and NP-treated groups. The results of the present study indicated the potential carcinogenic activities of nitropyrene compounds in female rats when they were treated by oral route, and suggest that the oral intake of nitropyrene compounds might be related to the incidence of cancer in humans. PMID- 3829966 TI - Nephrotoxicity of antibiotics and immunosuppressants. Proceedings of the satellite symposium. Sapporo, Japan, July 26-28, 1986. PMID- 3829967 TI - Aminoglycoside accumulation in the second compartment of kidney cell. PMID- 3829968 TI - Kinetics of the renal cortical uptake and release of aminoglycosides: a rational approach to the understanding and prevention of their nephrotoxicity. PMID- 3829969 TI - Drug-induced renal failure--current clinical aspect. PMID- 3829970 TI - Pathogenesis of cyclosporine nephrotoxicity. PMID- 3829971 TI - Cyclosporine A nephrotoxicity in patients with Behcet's disease. PMID- 3829972 TI - Evaluation of cisplatin-induced lipid peroxidation in rat renal tissues by means of slice technique. PMID- 3829973 TI - Nephrotoxicity of cisplatin in rats. PMID- 3829974 TI - Analysis of urinary N-acetyl-beta-D-glucosaminidase isozyme in patients treated with gentamicin or cis-diammine dichloroplatinum (II). PMID- 3829975 TI - Clinicopathological study on antibiotics induced nephropathies. PMID- 3829976 TI - Evaluation of aminoglycoside nephrotoxicity in the vesicle studies. PMID- 3829977 TI - Determining aminoglycoside dosage and blood levels of surgical patients using a microcomputer software system. PMID- 3829978 TI - Biological changes in kidney of rats fed subchronically with low doses of ochratoxin A. PMID- 3829979 TI - HPLC determination of "true" creatinine in rat plasma. PMID- 3829980 TI - Changes in urinary enzyme activities of renal origin during combination therapy with gentamicin and ampicillin. PMID- 3829981 TI - Experimental aminoglycoside nephrotoxicity. PMID- 3829982 TI - Protective effect of latamoxef on aminoglycoside nephrotoxicity in rats. PMID- 3829983 TI - Vasopressin-resistant polyuria induced by cephaloridine administration in rats. PMID- 3829984 TI - Renal lipid peroxidation induced by allopurinol-administration in rats. PMID- 3829985 TI - Gentamicin-induced alterations of intralysosomal pH and lysosomal enzyme activities. PMID- 3829986 TI - Transplantations of newborn CNS fragments into the brain of shiverer mutant mice: extensive myelination by transplanted oligodendrocytes. II. Electron microscopic study. AB - As already demonstrated by immunohistochemistry, oligodendrocytes from newborn normal mice are able to survive, migrate and myelinate when transplanted into the newborn shiverer (shi/shi) mouse brain. The survival of the grafted cells and their interaction with the host brain were studied at different times after transplantation. Normal myelin was found in the host parenchyma basing our observation on the morphological difference between normal and shiverer myelin: the shiverer myelin deprived of major dense line appears uncompacted as compared to normal myelin. Myelin formed by transplanted oligodendrocytes was detected around the graft and, after immunohistochemical prelocalization, at considerable distance from the site of implantation. Normal and shiverer myelin were detected around axons adjacent to each other or around the same axon. These results confirm and extend at the ultrastructural level our previous data obtained by immunohistochemistry. PMID- 3829987 TI - Lectins are markers of neuronal migration and differentiation in rat brain. AB - The binding of the lectins concanavalin A (Con A), peanut lectin (PNL), Ricinus communis agglutinin I (RCA I), Ulex europaeus agglutinin I (UEA I) and wheat germ agglutinin (WGA) to rat brains at several fetal and neonatal stages of development was evaluated. Cytochemical staining was performed using biotinylated lectins with an avidin-biotin complex with and without neuraminidase digestion. Differential binding to ventricular and intermediate layers, cortical plate and blood capillaries was demonstrated at different stages of development. WGA bound to blood capillaries at all ages, RCA I and PNL + N (PNL after neuraminidase digestion) from gestational day 22 on. During migration RCA I bound to cell fibers, PNL and UEA I to migrating cell bodies. Con A and UEA I stained perikaryonal structures of cortical neurons increasingly during neonatal development. It appears that cytochemical methods utilizing lectins can be used for the investigation of developmental processes of the central nervous system. PMID- 3829988 TI - Ontogenesis of multiple forms of monoamine oxidase in rat brain regions and liver. AB - The postnatal development of total, type-A and type-B monoamine oxidase (MAO) in the brain stem, forebrain and cerebellum, determined with preferred substrates or selective inhibitors, were found to follow different patterns. In the brain regions, MAO-A activity reached adult levels in the brain stem first, followed by the forebrain and cerebellum, while MAO-B reached adult levels in these regions at about the same time and later in postnatal life. On the other hand, both MAO-A and B activities were almost fully developed in the newborn liver. Moreover, total and type-A, but not type-B, showed a caudal-to-rostral sequence of biochemical maturation in the brain. The spatiotemporal pattern of differentiation of type-A and type-B activities in the brain tends to support the classification of brain MAO into two distinct isoenzymic forms. PMID- 3829989 TI - Application techniques for corrective and camouflage cosmetics. PMID- 3829990 TI - The use of cosmetics in facial plastic surgery. PMID- 3829992 TI - The cosmetic intolerance syndrome. PMID- 3829991 TI - Cosmetic therapy for the patient with facial disfigurement. PMID- 3829993 TI - Uses and abuses of cosmetics. PMID- 3829994 TI - An overview of cosmetics. PMID- 3829995 TI - Clinical uses and effects of cosmetics. PMID- 3829996 TI - Odontogenic necrotizing fasciitis of the neck. PMID- 3829997 TI - Spindle-cell carcinoma of the larynx. PMID- 3829998 TI - Diffuse amyloidosis of the larynx. PMID- 3829999 TI - Thrombophlebitis of the jugular vein. PMID- 3830000 TI - Myxoma of the oropharynx. PMID- 3830001 TI - Collecting the delinquent account. PMID- 3830002 TI - Revision mastoidectomy. PMID- 3830003 TI - Internal carotid artery thrombosis. PMID- 3830004 TI - Maxillary sinus mucoceles. PMID- 3830005 TI - Nasopharyngeal cancer in childhood. PMID- 3830006 TI - The etiopathogenesis of Meniere's disease. PMID- 3830007 TI - Rinkel versus SET. PMID- 3830008 TI - Adenocarcinoma of the nose and paranasal sinuses. PMID- 3830009 TI - Squamous-cell carcinoma of the lower lip. PMID- 3830010 TI - Croup and cystic fibrosis. PMID- 3830011 TI - Turbinectomies for allergic and vasomotor rhinitis. PMID- 3830012 TI - Combined therapy for fixed cervical lymph nodes in head and neck cancer. PMID- 3830013 TI - A retrospective study of squamous-cell carcinoma of the supraglottic larynx. PMID- 3830014 TI - Lead nitrate induced changes in the thyroid physiology of the catfish Clarias batrachus (L). AB - Chronic exposure of Clarias batrachus to sublethal dose of 5 ppm lead nitrate for a period of 150 days impaired thyroid function. Histological observations revealed hypertrophy, increased cell height, vacuolation, and reduction of colloid. The thyrotrophs of the pituitary also exhibited hypertrophy. But radioiodine (131I) uptake was significantly lowered. Fish exposed to 5, 10, and 25 ppm of lead nitrate for 7 days also exhibited significant reduction in 131I uptake which was dose dependent. These findings suggest that lead nitrate impairs thyroid function involving the hypothalamohypophysiothyroid axis. PMID- 3830015 TI - Comparative metabolism of fenitrothion in aquatic organisms. I. Metabolism in the euryhaline fish, Oryzias latipes and Mugil cephalus. AB - [14C]Fenitrothion at 0.1 ppm in running water is more rapidly absorbed in the killifish (Oryzias latipes) at 25 than at 15 degrees C to a similar plateau level, and bioaccumulation ratios of fenitrothion are 235 and 339, respectively. Water of higher salinity (23%) resulted in slightly higher accumulation ratios of fenitrothion in both killifish (303) and mullet, Mugil cephalus (179), than fresh water (235 and 30, respectively), but the half-lives are independent of temperature and salinity, with values of 0.24-0.36 day. Fenitrothion was metabolized primarily through hydrolysis by the killifish, demethylation by the mullet, and conjugation of the liberated phenol with glucuronic acid by both species. Although metabolism of the compound was not affected by the different salinities and temperatures in both fish, the glucuronide conjugate was more directly excreted into water under lower temperature and higher salinity conditions. 14C-labeled compounds are distributed primarily in the gall bladder as shown by whole-body radioautography. PMID- 3830016 TI - Comparative metabolism of fenitrothion in aquatic organisms. II. Metabolism in the freshwater snails, Cipangopaludina japonica and Physa acuta. AB - When freshwater snails, Cipangopaludina japonica and Physa acuta, were exposed to 0.1 ppm [14C]fenitrothion in a dynamic flow system, the concentrations of fenitrothion and 14C in the body reached equilibrium on Day 1 of exposure. The maximum bioaccumulation ratios of fenitrothion were 18 and 53 in C. japonica and P. acuta, respectively. These snails metabolized the compound primarily by demethylation, hydrolysis, and reduction. The liberated phenol moiety was found to be conjugated with sulfate in C. japonica and mainly with glucose in P. acuta. When the snails were transferred to a freshwater stream, fenitrothion and its metabolites were rapidly excreted, and the half-life of the parent compound was less than 0.5 day in both snails. Fenitrothion and its decomposition products were mainly distributed in liver of P. acuta, as evidenced by whole-body radioautography. PMID- 3830017 TI - Comparative metabolism of fenitrothion in aquatic organisms. III. Metabolism in the crustaceans, Daphnia pulex and Palaemon paucidens. AB - When the waterflea Daphnia pulex and the shrimp Palaemon paucidens were exposed to 1.0 ppb [14C]fenitrothion in a flowthrough system, the concentrations of fenitrothion and 14C in the body reached equilibrium, and the maximum bioaccumulation ratios of fenitrothion were 71 and 6 in the daphnia and shrimp, respectively. These crustaceans primarily metabolized the compound by oxidation of P = S to P = O, hydrolysis of P-O-aryl linkage, and demethylation. The liberated phenol was found to be conjugated with sulfate in the daphnia and with glucose in the shrimp. When the organisms were transferred to a freshwater stream, fenitrothion and its metabolites were rapidly excreted from their bodies, and the half-life of the parent compound was less than 0.2 day in both species. PMID- 3830018 TI - Impact of pesticides on lipid metabolism in the freshwater catfish, Clarias batrachus, during the vitellogenic phase of its annual reproductive cycle. AB - Specimens of either sex of the freshwater catfish Clarias batrachus were exposed to safe and sublethal concentrations of an organochlorine, gamma-BHC (2 and 8 ppm), and an organophosphorus compound, malathion (1 and 4 ppm), for 4 weeks during the vitellogenic phase of their annual reproductive cycle. The effects on total lipid and its various fractions, viz., free fatty-acids, monoglycerides, diglycerides, triglycerides, phospholipids, free cholesterol, and esterified cholesterol, were studied in the liver, plasma, gonads, and muscle. Except for elevated liver lipid in the male in response to malathion, no significant change in total lipid could be observed following pesticide exposure. However, various lipid fractions responded differently to two concentrations of the pesticides. Both pesticides affected the metabolism of nonpolar and less polar lipids alike. Malathion inhibited only mobilization of hepatic phospholipid to gonads but not its hepatic biosynthesis, whereas gamma-BHC reduced its synthesis in the liver as well. These pesticides seemed to restrict the conversion of esterified cholesterol into free cholesterol without affecting the biosynthesis of cholesterol as such. In both sexes, esterification of free fatty acids to acyl glycerides and their mobilization from liver to gonads seemed to be restricted as a result of pesticides action. PMID- 3830019 TI - Xenobiotic-metabolizing enzyme systems in test fish. I. Comparative studies of liver microsomal monooxygenases. AB - All monooxygenase activities assayed in guppy (Poecilia reticulata) and red killifish (Oryzias latipes) were 7-10 times higher than those measured in trout (Salmo gairdneri), carp (Cyprinus carpio), and golden orfe (Leuciscus idus). Cytochrome P-450 was 3 times higher in the former fish than in all the other species. Zebra fish (Brachydanio rerio) 7-ethoxycoumarin O-deethylase and bluegill (Lepomis macrochirus) ethylmorphine N-demethylase (EMND) were not greatly different from those of the former group. alpha-Naphthoflavone (NF) and methyrapone (MET) exerted qualitatively different actions on benzo[a]pyrene hydroxylase of guppy, trout, and bluegill liver: both chemicals enhanced the bluegill activity and inhibited that of trout; the guppy liver enzyme was inhibited by MET and activated by NF. EMND activity was inhibited by either compound in the three species. The relevance of all these data to the European Economic Community ecotoxicity tests is discussed. PMID- 3830020 TI - Effects of chlorophenols on isolated class A chloroplasts and thylakoids: a QSAR study. AB - A series of 22 chlorinated phenols was studied for their effects on photosynthesis of isolated chloroplasts. Each chlorophenol was an uncoupler, but the uncoupling activity depended upon substitution. The di-, tri-, or pentachloro substitution greatly enhanced the uncoupling activity. However, 2,6 substitution was not favorable to the uncoupling activity. Fifty percent uncoupling of photophosphorylations was obtained for concentrations between 4 mM for phenol itself, and 20 microM for pentachlorophenol. The quantitative structure-activity relationship (QSAR) study indicated a good relationship between, on the one hand, steric and electronic parameters, and, on the other hand, the uncoupling activity. In such equations, the A parameter describing ortho-substitution, always presented a negative sign. No good equation could be obtained with only log P and sigma. At concentrations which generally induced uncoupling, the chlorinated phenols inhibited the electron transfer in thylakoids. Di, tri, or penta substitution by chlorine enhanced the inhibition. A good relation appeared between this effect and the steric parameters MR and A. The study of isolated class A chloroplasts demonstrated that the uncoupling and the inhibition of the electron transfer in thylakoids could explain the effect of the chlorophenols on the whole photosynthetic mechanism. The effects of phenols on isolated chloroplasts were compared to those obtained with the same series on mitochondria. To explain the differences between QSAR equations, on the one hand for chloroplasts, and, on the other hand, for mitochondria, we suggested a selective binding of chlorinated phenols to proteins of the biological membranes. PMID- 3830021 TI - The limits of bioaccumulation of organic pigments in fish: their relation to the partition coefficient and the solubility in water and octanol. AB - A reliable experimental determination of the partition coefficient Pow of organic pigments is met with serious difficulties due to the extremely low water solubilities of these compounds. Therefore, the Pow values and the water solubilities were calculated for 11 typical organic pigments and some disperse dyes as well. The calculated Pow values of the pigments were very high predicting bioaccumulation factors (BF) several orders of magnitude above 100. Based on recent studies confirming that n-octanol simulates lipids in their solubilizing effect on organic chemicals, the solubilities of these organic pigments in n octanol were measured in order to estimate their potential for lipid storage. The very low solubility values indicate that in spite of the very high predicted BF such pigments cannot build up concentrations in lipids (hence in fish) which could be of concern considering their generally low toxicity and the extremely small amounts entering the environment. Therefore, there should be no need to perform a fish bioaccumulation test for assessing the bioaccumulation potential of such compounds, provided they show comparable solubility characteristics as the pigments investigated in this study. PMID- 3830022 TI - Long-term effects of bleached kraft mill effluents on carbohydrate metabolism and hepatic xenobiotic biotransformation enzymes in fish. AB - In a laboratory investigation, fourhorn sculpin (Myoxocephalus quadricornis) were exposed for 5-9 months to waste water from pine and birch lines from a bleached kraft pulp plant. The bleached kraft mill effluents (BKME) affected both the carbohydrate metabolism and the xenobiotic metabolism. Thus, an elevated muscle glycogen content in fish exposed to effluent from the pine pulp line suggests a metabolic imbalance. A liver enlargement and a strong elevation of the hepatic cytochrome P-450-dependent ethoxyresorufin-O-deethylase activity after exposure to the bleached pine pulp effluents indicate the presence of cytochrome P-450 inducing agents in the BKME. The results also demonstrate that many physiological test parameters may be used as good indicators of sublethal disturbances in fish to BKME exposure. PMID- 3830023 TI - Quantitative and qualitative aspects of fish crop in relation to environmental quality. AB - The effects of environmental quality on the quantitative and qualitative aspects of fish crop are reviewed with reference to fisheries in rivers, lakes, reservoirs, and coastal waters ranging from the temperate zone to subtropical areas in mainland China. The mechanism of these effects is discussed, and the insidiousness of long-term exposure to low-concentration pollutants to fish stock is stressed. Regarding the assessment of the effect of pollution on fish, most of our information has been derived from laboratory studies, in which the antagonistic or synergistic action between multiple pollutants was scarcely taken into consideration. One has to be cautious when the results of laboratory experiments are extrapolated to the realistic natural environment. It is advocated that surveys and tests concerning the relation between environmental quality and fish life be made on natural waters in addition to laboratory studies, and the effects be elucidated at the individual level, population level, and the ecosystem level. PMID- 3830024 TI - The effect of pentachlorophenol and its metabolite tetrachlorohydroquinone on RNA, protein, and ribosome synthesis in Saccharomyces cells. AB - The effect of pentachlorophenol (PCP) and its metabolite tetrachlorohydroquinone (TCH) were tested on growth, RNA, protein and ribosome syntheses, and ribosome content in yeast cells. Cells exposed to increasing concentrations of PCP show increasing inhibition to RNA and ribosome synthesis, and to cell growth. TCH causes a delay of the growth of the cell culture (prolongation of the lag phase) but does not cause inhibition. After treatment with TCH the maximum of the RNA synthesis was retarded, but subsequently reached nearly the same level as the untreated control cells. On ribosome synthesis and ribosome content, treatment with increasing concentrations of PCP, as well as of TCH, leads to a substantial decrease in ribosomal synthesis and, finally, total inhibition. Parallel to this, the content of free and membrane-bound ribosomes is diminished. PCP exhibits a stronger effect than TCH. The protein synthesis is only slightly reduced after treatment with PCP or TCH (with concentrations up to 20 micrograms/ml). PMID- 3830025 TI - Influence of cadmium exposure on selected hematological parameters in freshwater teleost, Notemigonus crysoleucas. AB - The use of hematological parameters for assessing the acute toxicity of heavy metals to mammals has shown considerable promise. These parameters include the measurement of blood glucose, hematocrit, and a variety of enzymes. The present investigation was undertaken to evaluate the use of selected hematological parameters in aquatic organisms. Exposure of Notemigonus crysoleucas to cadmium resulted in a 96-hr LC50 value of 3.15 mg Cd/liter. The influence of cadmium on selected hematological parameters was examined following 96 hr of exposure to 0, 1.35, and 2.40 mg Cd/liter. Cadmium exposure produced significant alterations (P less than 0.05) in the levels of glucose, aspartate aminotransaminase, and alanine aminotransaminase. Hematocrit was not altered by exposure to cadmium. These results indicate that glucose and transaminases may be useful as diagnostic tests for cadmium exposure in aquatic organisms. PMID- 3830026 TI - Pesticide-induced changes in peripheral thyroid hormone levels during different reproductive phases in Heteropneustes fossilis. AB - Effects of gamma-BHC (an organochlorine) and malathion (an organophosphorus) exposure on plasma triiodothyronine (T3) and thyroxine (T4) levels have been studied in the freshwater catfish, Heteropneustes fossilis, during its annual reproductive cycle. After 4 weeks exposure of gamma-BHC (8 and 16 ppm) and malathion (10 and 20 ppm), the effects on plasma T3, T4, and T3/T4 ratio varied during different reproductive phases. Malathion seems to have a stimulatory effect, while gamma-BHC seems to have an inhibitory effect on extrathyroidal conversion of T4 to T3. Changes in levels of various thyroid hormones during different reproductive phases occurred most probably due either to inhibited (in response to gamma-BHC) or to stimulated (in response to malathion) extrathyroidal T4 monodeiodination and their altered excretion or consumption rate. PMID- 3830027 TI - [The politics of human resources in health]. AB - In this article the term health manpower is applied to members of society who have acquired specific training and taken on responsibilities in health work. The different aspects of manpower development are viewed strictly from the standpoint of policy. They include the regulatory role of government and the influence of superstructure factors on decisions about health. There is a detailed discussion of the power relationships between decision-making groups and the organization of health services, and also of the role of knowledge as a power factor. The implementation of proposals on manpower depends on the operation of a sociopolitical process in which technical people who have the scientific ability and political sensitivity must participate to bring about changes that will benefit the majority. PMID- 3830028 TI - [The administration of knowledge. The biological and the social in the training of health personnel in Latin America]. AB - The article starts with the concept of the management of knowledge, a component of the mission of PAHO as formulated in 1982. The purpose of the article is to consider what ideas have been formulated on the biological and social elements in medicine and how, and to what extent, they have been put into practice. The first part of the document discusses the theory of medicine and the social sciences, and the biological and social nature of the health-disease process. The second part traces the historical development of the biological and social approaches in relation to the degree to which these elements have been isolated and integrated in instruction. The first stage, the decade of the fifties, was characterized by the influence of the Flexner Report: instruction was organized in a cycle of the basic and clinical sciences; there was almost complete separation between medicine and society, and seminars in the Hemisphere proposed the inclusion of an integrated approach. The second stage, the decade of the sixties, was one of the great advances in theory and practice. Hemispheric meetings among health authorities, professional associations and groups of social scientists, physicians, and educators explicitly expounded the need for integration of the social and biological elements into medical education. The biological basis of study plans was reinforced as well. The third stage, the decade of the seventies, was one of consolidation of social medicine in the profession and the intensification of studies in that discipline. The idea then emerged of interdependence between medical education, medical practice, and the organization of health services in a social context. The authors examine the years of the eighties as an unfinished stage of culmination of the integration of the social and biological elements in medicine with inclusion of the idea of the physician's commitment to society. PMID- 3830029 TI - [Leadership in the health services]. AB - The concept of leadership is not centered on strength of conviction or the ability to inspire support from others. Authority requires obedience, which is unlikely to bring about substantive changes. There are three classical types of leadership: bureaucratic (which depends on the size of one's share of power within an institution), prestige (which depends on one's technical expertise and standing in one's profession), and political (which depends on the extent of one's power in society at large). Prestige leadership pertains to an occupation and applies particularly to the health professions, especially the medical profession. Change is conditioned by factors internal to the health field (such as technological innovations and dissatisfaction with remunerations and social standing in some occupations) and by elements in the social context. These elements include historical situations favorable to change (crises) and forces for preservation of the status quo. PMID- 3830030 TI - [Education development in health. Perspectives for the year 2000]. AB - There are three aspects to the development of education in the health field: revision of the role of personnel, improvement of training schemes, and more efficient use of personnel. Since the setting of the goal of Health for All by the Year 2000, the world economic crisis has emerged as a new factor of analysis that opens up fresh prospects and points to alternative measures for the development of education in the health field. These prospects are the formulation of manpower planning and health personnel research policies; continuing education, which implies a redefinition of the role of teaching and service staffs; the integration of teaching and service; a search for an education methodology that encourages in-service learning; the monitoring and follow-up of the education process, and specific research on the relationship between manpower training and the labor market. PMID- 3830031 TI - [Teaching-service integration and primary health care]. AB - The concept of the integration of teaching with service focuses on the social setting of health and is always discussed at the level of the internal functioning of the health professions and health systems and at the external level of society. The article describes the development of the concept and of its application in practice, which have been expanding since the fifties. At first, this integration was considered an isolated activity whose proper place was the department of preventive and social medicine. Today its expansion to the entire health manpower training institution is proposed, with the participation of the teaching staff, the student from the moment of his enrollment, and health services personnel. In articulation with the primary care strategy, the strategy of integrating teaching with service is an arrangement for service to the community and not just an innovative approach to personnel training. In this service, the scientific method must be broadened in order to bring about a qualitative transformation of health practice. Research will be pursued in response to health problems and will feed back to the education and service processes. PMID- 3830032 TI - [The reorientation of medical education]. AB - The article is based on the prospective analysis approach to medical education. The instrument of analysis is a questionnaire on the medical education process and on the professional training institution, in which a series of indicators can be used that are grouped in four categories: context, structure, function, and integration. The article concludes with an enumeration of the basic principles to be borne in mind in planning, and with a scheme for the organization of a medical school suitable for attaining the goal of health for all. PMID- 3830033 TI - [Nursing education in Latin America]. AB - The article identifies health trends that must be taken into account in nursing and nursing education in Latin America if the goal of health for all by the year 2000 is to be achieved: population growth, the aging of the population, the rise of chronic diseases in groups at risk, the emergence of new pathological entities, the higher awareness of users of health services, and changes in the composition of the family and in the urban-rural composition of the population. The influence of these tendencies on nursing practice and training is examined. In the examination of practice, critical areas stand out: the numbers, distribution and use of nursing personnel; the quality of practice; the definition of functions for personnel categories; participation in decision making; and preparation to assume new functions. On the education side, the article examines the situation, envisages the needed activities, and outlines a model study plan guided by the following principles: a comprehensive view of man in society; an epidemiologic and "dialectic" conception of the health/disease process; adherence to the scientific method; attention to priority health problems; a scientific understanding of the object of study; integration of theory and practice; and a multisector and multiprofession approach to nursing. PMID- 3830034 TI - [Evaluation, teaching and learning]. AB - These observations center on the context of development that is the evaluation process. When the approach of education shifts from teaching to learning, the object to be evaluated changes too. Not only the quantity of what has been learned must be measured, but its quality as well. The student's performance must be evaluated, particularly in situations which present problems. Evaluation is a process that begins when the school sets its objectives and shapes the image of the health professional it desires to produce. The evaluation is a culmination of that process. There are evaluation techniques that are essentially observational, reactive, and mixed. The neutrality and objectivity of tests are discussed. Techniques must be used as instruments for learning and not be ends in themselves. PMID- 3830035 TI - [Continuing education in health in Latin America]. AB - The article considers continuing education as instruction to update knowledge and provide personal training. The first part defines concepts, terms, education, learning, socialization, critical awareness, and personal training. The underlying principles of continuing education are spelled out: Education is a continuing process; every social group is educational; continuing education is comprehensive; education is a dynamic process; education is an orderly process of thought; the education system is integrative in character; and education is an innovative process. The second section examines the relationship between work and continuing education, and views work as a social institution that completes the education process. A consideration of continuing education, health services, and the purposes of continuing education completes this part. The third part compares the new continuing education with the traditional variety. The former centers on the student, learning, and work, and the latter on the teacher and verbalization. The fourth part discusses methods, research, and evaluation and the existing kinds of continuing education in relation to their objectives. Continuing education in Latin America is the subject of the fifth part, which summarizes the disparate purposes, methods, and concepts of 155 continuing education program in the region. It is concluded that continuing education is a means, not an end, the end being to meet the public's health needs. PMID- 3830036 TI - [Continuing education in health. Possibilities and limitations]. AB - The author starts with a definition of continuing education as a system of educational activities organized with some continuity over extended periods and directed at in-service health personnel for the chief purpose of complementing their initial training and thereby improving or extending health coverage. This definition encompasses all categories of health personnel. It is noted that education today faces two challenges: attainment of the goals of health for all by the year 2000 through the strategies of primary care, and the revolution in information technology. Continuing education is a possible response from the education field. It is stated, however, that in many cases the socioeconomic and health systems of countries hamper the development of continuing education programs. PMID- 3830037 TI - [The job market in health. Concepts and methods]. AB - The eighties have been seen a rise in the number of studies done to identify trends in the health market. This interest is explained by the economic crisis, a surfeit of health professionals (and the resulting unemployment), and the spread of health research methods using a sociological approach. It is noted, however that research in this new field is impeded by a dissociation between theory and practice. A first approach to the idea of a work force comprises people in the health sector whose work skills are bought and sold. The concept is then broadened to encompass all persons employed in health--even those who are not paid--on the condition that they put in or be required to put in a regular number of hours per day (this includes the unemployed). The article examines the methodological difficulties involved in determining employment in health, notably the measurement of availability and use; the search for data on the number of occupations per individual and the number of remunerated and unremunerated posts; the nature of categorizing of self-employed, employee, and volunteer; the measurement of working time relative to a specific period of time and differentiating between employment in a health establishment and health employment in some other sector (in factories, for example). The article takes Brazil as its case in point. PMID- 3830038 TI - [The medical job market and the production of health services in Argentina]. AB - The article begins by considering the physician as a professional technically qualified to respond to a social need. First, the terms are defined: manpower equals the medical labor resource and the work of the physician in private practice, in the employ of a public or social security establishment, or in private firm. The article then examines the production system of medical care services in Argentina, where the functions of the State have been redefined since the depression of 1929 and have become more interventionist and care-oriented. This section describes three points: the organization and financing of medical care in three subsectors (public, social security, and private), advances in medical knowledge and technology, and the consequences for practice (specialization, subspecialization, and employment in large institutions). This part of the article stresses the effects on medical practice of introducing complex technology, and the special situation in Argentina where relatively highly qualified professionals are employed in auxiliary tasks. In the section specifically on the study of the labor market, relations between supply and demand care considered. This relationship depends on two interrelated social processes: medical education and medical practice. The possible relationships between these processes are examined, and the research is based on the assumption that there are many markets, each with its own supply of and demand for services and all differing in the sources of their financing. This section describes the characteristics of medical work in each subsector and their relationship to training. The section on the interconnection between the labor market and training describes the characteristics of undergraduate and graduate training and how they bear on the professional's placement on the labor market. Among the article's provisional conclusions, the authors emphasize the atypical character of this labor market, the social values involved, and the role of the State, which cannot be delegated, in the allocation of resources for health and in regulating the training and employment of medical human resources. PMID- 3830039 TI - Acute pancreatitis--a quantification of dynamics at clinical and radiomorphologic levels. AB - To quantify the dynamics of acute pancreatitis in a prospective clinical study on 108 patients, clinical and computed tomographic classifications were performed at days 1, 3 and 6 after admission. Sixty-two percent of the patients revealed a variable clinical staging at the times considered. Progredience of pancreatic necrosis was found in 20 of the 55 patients subjected to radiomorphologic investigations. Comparison between clinical and CT findings showed an increase in the agreement of both assessments from 69 percent (day 1) to 85 percent (day 6). Despite this high-level agreement in some patients both findings diverged remarkably. Acute pancreatitis is discussed as an interplay of necrobiosis and the "compensatory capacity" of the organism, with clinical findings acting as an indicator of the overall state of this struggle. PMID- 3830040 TI - [Clinical and metabolic evaluation of patients with chronic pancreatitis following a special peptide diet]. AB - The purpose of present investigations was to evaluate the effect of peptide diet upon clinical and metabolic course of chronic pancreatitis. Nitrogen, potassium and sodium balances were done for 24 days in 4 patients with chronic pancreatitis fed with peptide diet as well as in 5 patients fed with normal low fat diet. Administration of peptide diet improved protein nutritional status of all patients, due to better absorption of aminoacid components and increased nitrogen retention. On the basis of obtained results the authors discuss possibility of dietary treatment of chronic pancreatitis with peptide diet. PMID- 3830041 TI - [Rheologic properties of bile and their possible significance for lithogenesis]. AB - In the sparse literature dealing with the rheological characterization of bile You can find supporters of the Newtonian and the Maxwell flow behaviour theories. The submitted examinations of 33 bile specimens sampled postoperatively by T drainages were carried out with the help of a Contraves-Low-Shear-Viscometer. They definitely show the bile fluid's exponential increase in absolute dynamic viscosity under low shear conditions. Consequently bile behaves like a Maxwell (= Non-Newtonian) fluid, especially considering the variously caused pathological retardation of bile flow. This fact may play a decisive role in fostering lithogenesis. The classification of bile as a fluid with Maxwell behaviour is probably a pathophysiologically important fact with respect to cholelithogenesis and offers a model for further discussion on the prevention of recurrent biliary tract concrements formation. PMID- 3830042 TI - [A method for measuring oxalic acid absorption]. AB - Increased oxalic acid absorption, hyperoxaluria and oxalatelithiasis are found in many gastroenterological diseases. All persons receive 370 kBq 14C-oxalic acid for the measurement of oxalic acid absorption. The absorbed and in the urine excreted 14C-activities are measured with a scintillation spectrophotometer and scintillator composed of 2,5-diphenyloxazole(POP), 1,4-bis-(4-methyl-5-phenyl-2 oxazolyl)benzene (dimethyl-POPOP), naphthalene, toluene and ethyleneglycol monomethylether. Normal values of oxalic acid absorption are means +/- S = 7.17 +/- 1.87%/24 h (n = 40). PMID- 3830043 TI - Effects of the EMG amplifier filter settings on the motor unit action potential parameters recorded with concentric and monopolar needles. PMID- 3830044 TI - H-reflex potentials shape and amplitude changes at different length of relaxed soleus muscle. PMID- 3830045 TI - Electrophysiological study of fatigue during isometric contractions interrupted by different periods of rest. PMID- 3830046 TI - The electromyographic examination of the posterior auricular muscle. PMID- 3830047 TI - Guillain-Barre syndrome: the follow-up challenge using automatic electromyography. PMID- 3830048 TI - The application of the nearest neighbor decision rule in the evaluation of electromyogram in spinal muscular atrophy (SMA) of childhood. PMID- 3830049 TI - Effects of ice on the amplitude of M wave in distal latency. PMID- 3830050 TI - Blink reflex in unilateral hemispheric cerebrovascular lesions. PMID- 3830051 TI - Tissue distribution of insulin-like growth factor I and II messenger ribonucleic acid in the adult rat. AB - The insulin-like growth factors (IGFs) have both metabolic and growth-promoting activities in many cell and tissue types. Although the IGFs are present in serum, they are also thought to have important autocrine and paracrine functions. Using complementary DNA (cDNA) probes for rat IGF-I and mouse IGF-II, we have investigated the tissue distribution of messenger RNAs (mRNAs) for these growth factors in adult rats. IGF-I cDNA hybridized with three groups of transcripts, 7.0, 1.8 and 0.7-1.1 kilobases, which were detectable in all tissues examined, with liver demonstrating the highest level of expression. IGF-II cDNA also hybridized to a number of mRNAs, the most abundant of which was 4.0 kilobases. Of the tissues examined, IGF-II expression was highest in the brain, barely detectable in the liver, and undetectable under the conditions used, in lung, ovary, testes, and mammary gland. These studies support the notion of paracrine or autocrine function for IGF-I and demonstrate tissue-specific IGF-II expression in the adult rat. PMID- 3830052 TI - Cyclic Djungarian hamsters, Phodopus campbelli, lack the progesterone surge normally associated with ovulation and behavioral receptivity. AB - Serum levels of 17 beta-estradiol and progesterone were assayed at 4- to 5-h intervals across the estrous cycle in female Djungarian hamsters, Phodopus campbelli. The pattern of secretion for estradiol is similar to that described for the rat and the Syrian hamster, rising slowly from a baseline of 54 +/- 2 pg/ml during the morning of estrus to a peak of 187 +/- 16 pg/ml in the early afternoon of proestrus, then falling rapidly back to baseline levels. The pattern of progesterone secretion is significantly different from that of any estrous cycle previously described for a 4-day cyclic mammal. There is no evidence for a significant peak in serum progesterone levels associated with ovulation and receptivity. The highest levels of serum progesterone occur during the early afternoon of diestrous day 2 (8046 +/- 1063 pg/ml). The lowest levels of serum progesterone occur in the early morning of proestrus (720 +/- 125 pg/ml). During the period of sexual receptivity only 2504 +/- 654 pg/ml progesterone are found in the serum. Ovariectomized females show behavioral receptivity after 48 h of treatment with 50 micrograms estradiol benzoate/kg BW in sesame oil. Progesterone is not necessary for receptivity and will not facilitate receptivity when administered in conjunction with a subthreshold dose of estrogen. The presence of tubular ova confirms the time of ovulation to be a period of approximately 7 h between 2200 h on proestrus and 0500 h on estrus. Histological examination of ovarian sections from each of the 4 days of the estrous cycle shows follicular development to differ from that in the Syrian hamster in that the total number of follicles in the ovary is variable and low, and the ovulated follicles (new corpora lutea) are blood filled. Djungarian hamster primary follicles averaged 83 +/- 2 microns in diameter, and preovulatory follicles averaged 455 +/- 17 microns in diameter. The total number of intact follicles per ovary rose from 21 +/- 5 on the evening of estrus to 73 +/- 29 on the evening of diestrous day 2, then fell to 32 +/- 26 by the evening of proestrus. Preovulatory follicles increased in number from 1.0 +/- 0.6/ovary early on estrus to a maximum of 4 +/- 1 on the evening of diestrous day 2. However, at ovulation a combined total of only 5.1 +/ 0.8 ova are shed. PMID- 3830054 TI - Growth-promoting effects of relaxin and related compositional changes in the uterus, cervix, and vagina of the rat. AB - Although the precise role of relaxin has yet to be elucidated, it has been implicated in the regulation of physiological and biochemical processes in the reproductive tract during pregnancy and parturition. In this study, the growth promoting effects of relaxin and related compositional changes in the uterus, cervix, and vagina of immature ovariectomized estrogen-primed rats were examined. Relaxin increased the wet weight of the uterus, cervix, and vagina in a significant and linear manner over the log of the dose range (1-30 micrograms; 6 h). The increase in uterine weight was due to increases in both dry weight and water content at all doses. A dose of 1 microgram relaxin induced maximal increases in dry weights in the cervix and vagina over control values; higher doses increased wet weight, but these changes were due solely to increases in water content. Thirty micrograms of relaxin were found to increase total soluble protein and glycogen content of the vagina above control values after 6 h. Relaxin did not alter the total collagen levels of the uterus or cervix, and collagen concentrations were significantly reduced in these organs 6 and 24 h after treatment. Total glycosaminoglycan levels were elevated by relaxin in the uterus (6 h) and cervix (24 h). Total vaginal collagen was increased 24 h after relaxin injection, but the collagen concentration was decreased over the time interval studied, and glycosaminoglycan levels in the vagina were unaltered. In summary, relaxin stimulates growth of the uterus, cervix, and vagina by increasing water content and tissue mass. The increases in distensibility that relaxin induces in these organs appear to be related to changes in the fluid matrix and proteoglycan metabolism rather than alterations in collagen concentration, at least 6-24 h after a single injection. These results support the hypothesis that relaxin plays a significant role in the maintenance of pregnancy through its contribution to fetal accommodation and in the facilitation of parturition through expansion of the entire birth canal. PMID- 3830055 TI - Estrogen regulation of alpha 1(I)-procollagen messenger ribonucleic acid in the rat uterus. AB - A cDNA library, prepared from mRNA isolated from the uteri of 3-day estradiol stimulated immature rats, was constructed in pBR322. From this library an estrogen-regulated clone, pERU3, was isolated. This clone contained sequences complementary to uterine mRNA that migrated during gel electrophoresis as a double band of about 5.0 and 5.8 kilobases. Little of this mRNA was seen in several other tissues examined. An increase in the amount of this RNA in uterus was seen 2 h after estradiol treatment, with maximum hybridization occurring, in different experiments, between 18 and 36 h, followed by a decline. Hybridization of the cDNA insert of the pERU3 plasmid with known probes indicated that it coded for alpha 1(I)-procollagen. This conclusion was supported by in vitro translation experiments in which the hybrid-selected mRNA complementary to pERU3 DNA was shown to code for a collagenase-sensitive protein with a size corresponding to that of alpha 1(I)-procollagen. This system, therefore, provides an additional tool for the study of the estrogen regulation of gene expression in the uterus. PMID- 3830053 TI - The effects of postoperative factors on serum thyroid hormones and rat liver nuclear 3,5,3'-triiodothyronine receptor concentrations in surgical models of uremia and regenerating liver. AB - We have determined the individual effects of postoperative fasting, surgical/anesthetic factors, acute uremia (AU), and regenerating liver (RL) on nucleoplasmic (NP; 0.15 M KCl-extractable) and chromatin-bound (CB; 0.4 M KCl extractable) rat liver T3 receptors. AU and RL rats were studied 24 h after bilateral nephrectomy (blood urea nitrogen, 128 +/- 13 mg/dl) or two thirds hepatectomy, respectively. The effects of postoperative fasting were assessed by comparison of normal rats (N) with control rats (N6) pair-fed to match the caloric intake of the AU and RL rats. Surgical/anesthetic effects were determined by comparison of N6 rats with sham-operated pair-fed rats (S6). The effects of AU or RL were obtained by comparison with S6 controls. Changes in mean body weight attributable to fasting (N6-N), surgical/anesthetic effects (S6-N6), acute uremia (AU-S6), and regenerating liver (RL-S6) were: -17.3 (P less than 0.001), -4.0 (P = NS), -4.5 (P less than 0.05), and -1.0 g/24 h (P = NS), respectively. Changes in mean serum T4 (N, 5.3 +/- 1.3 micrograms/dl) were: -1.0 (P = NS), -0.6 (P = NS), -0.9 (P less than 0.05), and -1.0 micrograms/dl (P less than 0.05), respectively. Changes in mean serum T3 (N, 53 +/- 23 ng/dl) were: -8 (P = NS), 18 (P less than 0.05), -10 (P = NS), and -14 ng/dl (P less than 0.05), respectively. The NP and CB receptor pools of the AU and RL rats were not significantly different from those of age-matched N rats (NP, 25 +/- 5 fmol/mg DNA; CB, 405 +/- 134 fmol/mg DNA). Chronically uremic (CU) rats 2 weeks after five sixths nephrectomy (blood urea nitrogen, 36 +/- 2 mg/dl) did not exhibit significant change in their extractable receptor pools. Complete starvation for 24 h (NO) or 72 h (NOO) generally resulted in marked reductions in receptor concentrations compared to those in age-matched N rats fed ad libitum: NP pool (N, 31 +/- 17 fmol/mg DNA): NO-N, -40% (P = NS); NOO-N, -59% (P less than 0.01); CB pool (N, 303 +/- 105 fmol/mg DNA): NO-N, -19% (P less than 0.05); NOO-N, -41% (P less than 0.001). These studies indicate that severe AU, moderate CU, and LR have relatively little effect on solubilized rat liver nuclear receptor concentrations. In contrast, complete starvation is a potent depressant of both nuclear receptor pools. In the surgical models of AU and LR, postoperative fasting was the primary cause of weight loss.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3830056 TI - Evidence for a direct in vitro action of sex steroids on rabbit cartilage cells during skeletal growth: influence of age and sex. AB - A direct effect of sex steroid hormones on in vitro cartilage cell metabolism was demonstrated. Cells were derived from rabbit fetuses on day 20 of gestation, and from male and female rabbits aged from 2 to 80 days. Testosterone (T), dihydrotestosterone (DHT), or 17 beta-estradiol (E2) (10(-9) -10(-9) M) were added to primary culture of epiphyseal articular chondrocytes. They showed an age dependent stimulatory effect on [35S]sulfate incorporation into newly synthesized proteoglycans. In cultured rabbit fetal cartilage cells, the maximum active concentration of T and DHT was 10(-9) M with a 40% stimulating effect over control values. E2 was even more active with 80% stimulating effect when added at 10(-8) M. Chondrocytes from animals aged up to 5 days responded poorly and those from animals aged 5-30 days not at all. The response of cells from older animals varied with animal age and sex. T and DHT stimulated chondrocytes from males aged 32-55 days and females aged 40-52 days to about the same extent. E2 stimulated cells from animals of the same ages, but the response of female-derived cells was twice that of male-derived cells. The stimulating effect was dose dependent from 10(-11) to 10(-8) M and maximal at 10(-9) M for T and DHT and at 10(-8) M for E2. Puromycin completely abolished the effect. PMID- 3830057 TI - Opiate-serotonin synergism stimulating luteinizing hormone release in estrogen progesterone-primed ovariectomized rats: mediation by serotonin2 receptors. AB - A tonic inhibition of LH release by endogenous opiate systems is apparent after administration of opiate antagonists to ovariectomized estrogen-progesterone primed rats. In the presence of a serotonin agonist, morphine has been found to stimulate LH release in ovariectomized animals. Thus, in the present study the individual effects as well as interactions of the opiate and serotonin (5HT) systems have been examined using morphine and quipazine, respectively, as agonists and ketanserin (5HT2) and methysergide (5HT1 and 5HT2) as antagonists. Rats ovariectomized 2-4 weeks beforehand were primed with estradiol benzoate (15 micrograms; day 0) and progesterone (5 mg; day 2). Serial blood samples were collected from unrestrained rats via a jugular cannula inserted 3 days before, and plasma LH was measured by RIA. Neither morphine (4 mg sulfate) nor quipazine (2 mg/kg) administered iv at 1200 h significantly elevated plasma LH at 1210, 1220, or 1230 h compared to levels at 1200 h, although plasma LH concentrations at these times were significantly greater than those in animals receiving saline at 1200 h. However, injection of both morphine and quipazine at 1200 h greatly augmented LH release at 1210, 1220, and 1230 h compared to the response to either drug alone. The duration of the significant elevation of plasma LH was limited to 10 min by ketanserin (2.5 mg/kg, ip, at 0900 h) and to 20 min by methysergide (10 mg/kg, ip, at 0900 h), suggesting mediation of this response by 5HT2 receptors. These results suggest the possibility of an important interaction between opiate and serotonergic systems in controlling the release of LH and raise the intriguing question of its role, if any, in controlling events of the estrous cycle. PMID- 3830058 TI - Differential effects of neonatal and adult androgen exposure on the growth hormone secretory pattern in male rats. AB - The interactive effects of androgen exposure during neonatal and adult life on the pattern of GH secretion in adult male rats was investigated. Neonatal rats were orchidectomized or sham-operated on days 1-2 of life and injected immediately postoperatively with testosterone propionate (250 micrograms, sc) or vehicle. At 90-130 days of age the rats were bled every 20 min between 9 and 17 h from an indwelling intraatrial catheter. Some neonatally gonadectomized, testosterone- or vehicle-treated rats were also given depot testosterone (15 mg/kg, im) 5-10 days before blood sampling. Plasma GH concentrations were measured by RIA, and the pulsatile secretory patterns were analyzed by the PULSAR computer program. Neonatal orchidectomy resulted in a marked suppression (50-75%) of both the height and duration of GH secretory episodes, while baseline GH levels were higher in neonatally gonadectomized males than in sham-operated controls. Neonatal testosterone replacement therapy restored high amplitude GH pulses. However, the GH pulses of these animals were of significantly shorter duration and occurred more frequently, and baseline GH levels were markedly higher than those in intact male rats. In contrast, neonatally gonadectomized rats treated with testosterone both neonatally and during adulthood exhibited a GH pattern indistinguishable from that in normal males, with high amplitude and long-lasting (103 +/- 8 min) pulses at regular intervals (178 +/- 9 min). A similar masculine GH pattern was seen in neonatally gonadectomized rats given testosterone only during adult life. The present results indicate that high amplitude GH pulses can be induced by either neonatal or adult androgen exposure. However, while neonatal androgens irreversibly cause stimulation of overall GH secretion, only the continuous presence of androgens during adult life can induce a GH secretory pattern, consisting of large surges at regular 3-h intervals separated by a low baseline that is characteristic of normal male rats. PMID- 3830059 TI - Tissue-specific dopaminergic regulation of the glucocorticoid receptor in the rat pituitary. AB - The rat intermediate pituitary lobe is one of the rare tissues that is not a known glucocorticoid target and is devoid of immunoreactive glucocorticoid receptor. The intermediate lobe is poorly vascularized and receives a dopaminergic and serotonergic innervation from the hypothalamus. In previous studies we demonstrated that removal of this hypothalamic input results in the appearance of immunoreactive glucocorticoid receptor in the intermediate lobe, as demonstrated with the use of in vitro intermediate pituitary cultures and two in vivo experimental situations. We now show that this appearance of the glucocorticoid receptor is presumably due to removal of hypothalamic dopamine from the intermediate lobe cells, since in this study dopamine (or its potent agonist bromocriptine) inhibits expression of the glucocorticoid receptor in intermediate pituitary cells in primary culture, as demonstrated by [3H] dexamethasone binding and immunocytochemistry. The dopamine antagonist haloperidol blocks the inhibitory effects of the dopamine agonist. In contrast to the intermediate pituitary cells, bromocriptine does not affect glucocorticoid receptor expression in anterior pituitary cells in culture. The differential dopaminergic regulation of glucocorticoid receptor expression in the pituitary gland raises questions about possible effects of dopamine on glucocorticoid receptor levels and glucocorticoid response in other dopamine target tissues, especially in the brain. PMID- 3830060 TI - Diurnal variation in hepatic expression of the rat S14 gene is synchronized by the photoperiod. AB - We have analyzed the factors responsible for the circadian variation in rat hepatic mRNA-S14. Regulation of this sequence, which is found in lipogenic tissues and encodes a protein (S14) believed to be associated with fatty acid synthesis, is an excellent model of the interaction of thyroid hormone and dietary factors at the hepatocellular level. The mRNA exhibits a 3-fold diurnal variation (peak, approximately 2000 h; nadir, 0800 h) in ad libitum feeding rats on a 12-h light, 12-h dark photoschedule. We studied the effects of the photoschedule, periodic food intake, hypophysectomy, and induction by thyroid hormone (T3) on the mRNA-S14 rhythm. Adaptation to feeding restricted to either light or dark periods for 15 days did not greatly affect the diurnal rhythm. Photoreversal resulted in a 180 degrees phase shift, whereas the rhythm persisted in the presence of constant light. Oscillation continued around a higher baseline after a receptor-saturating dose of T3 in both normal and hypophysectomized rats. Our results indicate primary entrainment of the mRNA-S14 diurnal rhythm to the photoperiod, rather than to periodic food intake. Moreover, the circadian regulatory signal, which probably originates in the central nervous system, appears capable of antagonizing a maximal T3-inductive stimulus and does not originate in the pituitary gland. Persistence of the oscillation in constant light rules out circulating melatonin as the mediator. Synchronization of the rhythm by the photoschedule suggests that neuroendocrine factors are important determinants of rhythmic changes in hepatic gene expression. PMID- 3830061 TI - Electrophysiological responses to angiotensin II of isolated rat adrenal glomerulosa cells. AB - The membrane response of isolated rat glomerulosa cells to the application of angiotensin II (A II) has been studied using intracellular voltage measurements. The membrane response is biphasic. The first, brief phase involves an increase in membrane conductance and a hyperpolarization from the resting membrane potential. The second, long-lasting phase is characterized by a large decrease in membrane conductance and a depolarization from the resting membrane potential. The reversal potential for the second phase is -94 +/- 1.2 mV, and a linear relationship between reversal potential and external K+ indicates that the A II mediated response is predominantly inhibition of K+ permeability. The A II response can be elicited when external Ca2+ is replaced by Sr2+ or Ba2+, but the response is inhibited when Mn2+ is added to the bath or when stimulated in a Ca2+ free solution. A II appears to inhibit at least two conductances, when the cell is stimulated by long current steps. External application of A II inhibited the Ca2+ regenerative response found in glomerulosa cells in a dose-dependent manner. The rate of rise of the regenerative response was greatly attenuated by A II; half-maximal inhibition was produced by about 10(-9) M A II. In addition, rectification, evident at voltages more positive than -60 mV during current stimulation, was also inhibited. In conclusion, A II causes rat glomerulosa cells to depolarize due to the inhibition of resting K+ permeability. Action potential activity is not observed during A II-mediated membrane depolarization; rather, both Ca2+ and K+ conductances appear to be inhibited during A II application. PMID- 3830062 TI - Brain cortex reverse triiodothyronine (rT3) and triiodothyronine concentrations under steady state infusions of thyroxine and rT3. AB - T4 and reverse T3 (rT3) can inhibit 5'-deiodinase type II activity in rat brain cortex, pituitary, and brown adipose tissue, raising the possibility that T4 may act in vivo after conversion to rT3. The aim of this study was to measure in hypothyroid (Tx) rats the content of brain cortex rT3 during a constant 7-day infusion of either [125I]T4 alone, corresponding to 12 pmol T4/day X 100 g body weight (BW), or together with 400 pmol T4/day. [125I]T4, rT3, and T3 were extracted from brain cortex, pituitary, kidney, and liver with a combination of adsorption chromatography on Sephadex G-25, HPLC, and immunoprecipitation. [131I]T4, T3, or rT3 were used as internal standards. [125I]rT3 could be detected in brain cortex, liver, and kidney in Tx rats infused with [125I]T4 (12 pmol T4/day X 100 g BW) and in those infused with 400 pmol T4/day X 100 g BW. The highest rT3 concentrations were found in brain cortex, where it represented 6% to 10.5% of the local T4 concentration. During an infusion of 400 pmol T4/day X 100 g BW, brain cortex T3 concentration was 6 times higher in the brain cortex than in serum, and even exceeded that of T4. In Tx rats receiving [125I]T4 alone the brain cortex to serum T3 ratio was 3:1, but the total serum T3 concentration, measured by RIA, was much higher than that due to conversion [0.50 +/- (SE) 0.1 pmol/ml vs. 0.018 +/- 0.002 pmol T3/ml], indicating thyroidal secretion. The effect of the blood-brain barrier on rT3 was measured by infusing [125I]rT3 over 4 days. After killing, rT3 was isolated as above. Approximately 3% of serum rT3 was retrieved from the brain cortex, whereas during the T4 infusion 40-50% of serum rT3 was found demonstrating that brain cortex rT3 is locally produced. PMID- 3830063 TI - The relationship between declining plasma progesterone levels and increasing luteinizing hormone pulse frequency in late gestation in the rat. AB - The object of this study was to determine whether the increase in LH pulse frequency and mean blood LH levels on day 22 of pregnancy in the rat is due to the precipitous fall in plasma progesterone (P) levels that occurs late in gestation. On day 20 of pregnancy two groups of animals with indwelling jugular cannulae were implanted sc with empty or P-containing Silastic capsules. Blood samples were withdrawn 0.5 h before and 5.5 h postimplantation on day 20 (0800 and 1400 h), at 1400 h on day 21, and at the end of the study between 1200-1300 h on day 22 to follow the time course of changes in plasma P levels over this 2-day period in both groups. These groups were bled on day 22 for 3 h between 0900-1200 h for analysis of pulsatile LH release. A third group not implanted with Silastic capsules was bled on day 20 for 3 h; plasma P levels in these rats bled on day 20 did not differ from the preimplantation values observed in either group of capsule-implanted rats. In empty capsule-implanted animals, plasma P values declined slightly from days 20 to 21 and were dramatically reduced between days 21 and 22. In contrast, after implantation of P capsules, plasma P levels were elevated on day 20 and remained elevated on day 21 compared with preimplantation values. Although these increased plasma P values declined between days 21 and 22, reflecting a decrease in endogenous P secretion, they were nonetheless comparable to day 20 values due to the presence of the P-containing capsules. Plasma estradiol values did not differ significantly between any of the experimental groups. In the empty capsule group bled on day 22, mean blood LH levels and LH pulse frequency were significantly higher compared to day 20 values, at a time when plasma P levels had fallen significantly from day 20 values. However, in the P capsule group, mean blood LH levels and LH pulse frequency on day 22 were significantly lower than values in the empty capsule group and were not different from the low values on day 20. Thus, preventing a decline in plasma P values to the low levels normally found on day 22 prevented the increase in LH pulse frequency and mean blood LH levels normally seen at this time of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830064 TI - Extensive in situ activation of nuclear estrogen receptors after exposure of murine uteri to [3H]estradiol or [3H]4-hydroxytamoxifen. AB - Estrogen receptor activation has been examined in murine uteri by characterizing binding to ATP-Sepharose. Determinations were performed under conditions in which specific binding to estrogen receptors was demonstrated by both agonist and antagonist without participation by nonreceptor antiestrogen-binding components. Cell-free activation of estrogen receptors in cytosol was more effectively promoted by [3H]estradiol estradiol than by [3H]4-hydroxytamoxifen or [3H]tamoxifen aziridine. However, when in situ activation was examined after intact uteri were exposed to [3H]estradiol or [3H]4-hydroxytamoxifen, virtually all extracted nuclear receptors demonstrated activated binding to ATP-Sepharose within 20 min of hormone exposure. Profiles of nuclear receptor activation were remarkably similar after exposure to either agonist or antagonist. Estrogen receptors in cytosol prepared after exposing intact uteri to 3H-labeled ligands were characterized by much less ability to bind to ATP-Sepharose than nuclear receptors. After uteri were exposed to [3H]estradiol, the activated receptor fraction in the cytosol progressively increased in contrast to preparations obtained after uteri were exposed to [3H]4-hydroxytamoxifen, which demonstrated a constant level of activation. Thus, even when activation has occurred within the intact uterus, agonists and antagonists may be characterized by different apparent levels of receptor activation in the cytosol fraction. These differences in the cytosol, however, are considerably overshadowed by the extensive activation occurring within the nuclear fraction, which we have observed to be similar with agonist and antagonist. Since estrogen receptors appear to act within chromatin, and cytosol receptors may be produced by receptor redistribution during preparation, we interpret these observations to indicate that in situ receptor activation is very similar after exposure to either agonist or antagonist. Consequently, antagonism does not appear to be associated with antiestrogens that impede receptor activation within intact murine uteri. PMID- 3830065 TI - Cyclic variations in spinal cord levels of oxytocin and vasopressin during the stages of the rat estrous cycle. AB - Oxytocin (OT) and vasopressin (VP) have been localized to numerous central nervous system locations outside the classic hypothalamo-neurohypophyseal tract including all levels of the spinal cord. To date, the physiological function of these peptides within the spinal cord is unknown. The purpose of this study was to determine if the variations exhibited by pituitary OT and VP during the stages of the estrous cycle in the rat were also present in the spinal cord. The stage of the estrous cycle was determined by vaginal smears in female Long Evans rats. Following decapitation, the cervical, thoracic, and lumbosacral segments of the spinal cord were isolated and homogenized, and the hormones were extracted from the tissue with the Sep-pak method. OT and VP content were determined by RIA. A cyclic variation in spinal cord OT and VP was present, with maximal levels occurring in diestrus, a time in the estrous cycle when LH and estradiol levels are lowest. Our results suggest that spinal cord OT and VP may be regulated by ovarian hormones. These data represent the first documented changes in spinal cord levels of OT and VP under physiological conditions. PMID- 3830066 TI - Receptor binding in the rat liver nuclear matrix. AB - 3H-Dexamethasone (Dex)-receptor complexes prepared from the rat liver cytosol efficiently bound to the nuclear matrix from the same tissue. The binding was increased with the concentration of the 3H-Dex-receptor complex added and reached a maximum plateau. However, when the partially purified 3H-Dex-receptor complex was used, saturation of the binding sites in the nuclear matrix was not observed in the range of concentration of 3H-Dex-receptor complex used. Therefore, it was considered that the apparent saturability observed in the binding of the unpurified receptor complexes is caused by the translocation inhibitor(s) in the cytosol. When the binding capacity was expressed on the basis of unit weight of DNA, the nuclear matrix exhibited 20 times more of that of the unfractionated nuclei. However, no line of evidence of enrichment of the binding sites in the DNA isolated from the nuclear matrix was observed. These observations show that the role of the nuclear matrix in the action of glucocorticoid is quite uncertain. PMID- 3830067 TI - A case of normocalcemic primary hyperparathyroidism with osteomalacia. AB - A 59 year-old patient had lumbago and pain in hip joints, knees, and ribs of long duration. Severe hypophosphatemia and high serum ionized calcium were found in spite of normal level of total serum calcium. The serum parathyroid hormone and alkaline phosphatase levels were elevated, and diffuse demineralization of the bones and renal stones were found by x-ray examination. Parathyroid adenoma was diagnosed from the subtraction image of the 99mTc O-4 and 201Tl-Cl2 scintigrams. Osteomalacia was demonstrated by bone biopsy at the right iliac crest. A right lower parathyroid adenoma of 2.0 X 1.8 cm, weighing 4.0 g was removed. The long standing phosphate depletion and hypophosphatemia, due to hyperparathyroidism causing renal damage with nephrocalcinosis and reduced synthesis of active vitamin D, and milk tolerance due to gastroduodenostomy were probably responsible for producing the clinical picture of normocalcemic hyperparathyroidism complicated with osteomalacia. PMID- 3830068 TI - Treatment of pituitary dwarfism with methionyl human growth hormone in Japan. AB - Sixty-two patients with pituitary dwarfism were treated with three different preparations of methionyl hGH (m-hGH) for 3 to 14 months. They were given 0.5 IU/kg/week intramuscularly. The growth rate during treatment with the three different preparations was the same for each and increased from 3.5 +/- 0.9 to 8.2 +/- 1.7 cm/year. A high incidence of hGH antibody formation was observed following the treatment, but the titer of antibody was decreased according to the purity of m-hGH preparations. At the end of 12 month treatment with a highly purified preparation (Somatonorm III), 76.2% of the patients had hGH antibody. However, the presence of antibodies did not affect the growth rate except in one patient. No clinical or laboratory side-effects were observed following the treatment with m-hGH. Thus, m-hGH was considered to be useful for the treatment of GH deficient children. PMID- 3830069 TI - Pharmacokinetics of methimazole in normal subjects and hyperthyroid patients. AB - Serum and urinary concentrations of methimazole (MMI) were measured by high performance liquid chromatography (HPLC) with an electrochemical detector (ECD) in 10 normal subjects and 43 hyperthyroid patients after intravenous and oral administration of the drug. The pharmacokinetic parameters of MMI were estimated in 5 normal subjects and 15 hyperthyroid patients according to a two-compartment model after intravenous injection of a 10 mg dose. The mean half-life of the distribution phase (T1/2 alpha) was 2.7 +/- 1.0 h (mean +/- SD) and 3.1 +/- 1.4 h and that of the slower-phase (T1/2 beta) was 20.7 +/- 9.6 h and 18.5 +/- 12.9 h in normal subjects and hyperthyroid patients, respectively. There were no significant differences between pharmacokinetic parameters of normal subjects and those of hyperthyroid patients. No correlations between free T4 index (FT4I) and pharmacokinetic parameters were observed. Maximum serum MMI concentrations (Cmax) (213 +/- 84 and 299 +/- 92 ng/ml) were attained 1.8 +/- 1.4 h and 2.3 +/- 0.8 h after a single dose of 10 mg in 5 normal subjects and in 15 hyperthyroid patients, respectively. In hyperthyroid patients the time taken to reach the peak concentration (Tmax) after a single dose of 10 mg was similar to that after a single 15 mg and 30 mg dose. The pharmacokinetic parameters, except Cmax and the area under the curve (AUC), were not affected by the administered dose and those, except Cmax, were not affected by the thyroid function. All urine was collected at intervals of 3 h for the first 12 h and then at 24 h and 48 h after intravenous and oral administration of MMI. In all subjects, MMI rapidly appeared in the urine and the rate of excretion was highest in the first 3 h. The cumulative urinary excretion of MMI was 5.5-8.5% of administered doses in normal subjects and hyperthyroid patients. These findings in the present study are compatible with the assumption that the extent of absorption of MMI is high, if not complete, and hyperthyroidism does not affect the kinetics of MMI, and that interindividual variation is observed in the time taken to reach the peak concentration after oral administration. PMID- 3830070 TI - Neural lobe function in aged Wistar/Tw strain rats showing polydipsia and polyuria. AB - Neural lobe function in male rats of the Wistar/Tw strain was studied at 3, 7 and 16-18 months of age. A significant rise in the serum arginine vasopressin (AVP) level was noted in 16-18-month-old rats showing polydipsia and polyuria. The content and concentration of AVP in the neural lobe of aged rats were significantly less than those of younger animals (3 and 7 months). These results point out an enhancement of AVP release from the neural lobe of aged rats. The reduction in urinary volume in aged rats subjected to 24 hours of water deprivation was less than those in younger animals. No increase in urinary sodium, potassium and chloride concentrations was observed in aged rats, and the decrease in electrolyte excretion from urine during the dehydration period was less in aged rats than younger ones. These results suggest that the antidiuretic response to osmotic stimuli was reduced in aged rats. The administration of AVP to aged rats resulted in a significant decrease in water intake and urinary volume, but AVP administration did not induce any change in the electrolyte balance. Therefore, it is concluded that the main cause of the development of polydipsia and polyuria is the decline in renal function but not in neurosecretory activity, although exogenous AVP can effectively reduce water intake and urinary output in aged rats. PMID- 3830071 TI - Clinical evaluation of radiotherapy for Graves' ophthalmopathy. AB - Seventeen patients with moderately severe ophthalmopathy due to Graves' disease were treated by cobalt or supervoltage radiotherapy. All patients complained of diplopia. The mean proptosis value was 21.4 mm. Three patients (18%) showed good response, 7 (41%) moderate and 7 minimal or no response. Improvement was noted mainly in soft tissue changes and diplopia, while proptosis decreased in only 5 patients. All except one patient who had marked extraocular muscle involvement revealed by computed tomography responded to treatment. These data indicate that radiotherapy may be indicated in patients with progressive ophthalmopathy, especially in those who are associated with extraocular muscle enlargement. PMID- 3830072 TI - Oro-maxillofacial development in patients with GH deficiency and in normal short children. AB - Detailed oro-maxillofacial studies using dental cast, pantomogram and cephalogram were performed in 43 patients with GH deficiency aged 7-17 years and compared statistically to the results from 62 short children with normal GH secretion. The dental age was retarded as compared to the chronological age in patients with GH deficiency by a mean of 2.0 +/- 1.3 years. This value did not differ statistically from that observed in normal short children (1.7 +/- 0.8 years). However the bone age was significantly retarded in patients with GH deficiency (3.2 +/- 1.7 yrs vs 1.5 +/- 1.1 yrs, p less than 0.001). There was no difference between tooth size or cephalogram analysis results in the children in the two groups. The coronal arch length, basal arch width and basal arch length were shorter in patients with GH deficiency. These data indicate underdevelopment of the maxilla in patients with GH deficiency. PMID- 3830073 TI - Pathological characteristics of acute exacerbation of Hashimoto's thyroiditis- serial changes in a patient with repeated episodes. AB - A 76-year-old female patient with known Hashimoto's thyroiditis had 12 episodes of acute exacerbation, characterized by high fever and spontaneous pain in the thyroid over a period of 4 months. Percutaneous needle biopsies were performed before and serially after local steroid injection. Histological examination of the thyroid tissue involved obtained before steroid administration revealed quite a unique localized edematous and inflammatory appearance with rich but loosely arranged collagen fibers, and destruction of follicular structures and swollen degenerated epithelia. Neither remarkable cellular infiltrations nor granulomatous changes were observed in the area involved. Ultrasonogram showed an extremely hypoechoic lesion coincident with the location of pain and tenderness. Intrathyroidal administration of triamcinolone acetate (40 mg) resulted in an immediate relief of pain, fever and localized swelling. Surprisingly, remarkable histological improvements were observed even on the day following the injection. However, clinical manifestations as well as histological changes were reversed again within one week or so. After various therapeutic means, total thyroidectomy was performed which induced disappearance of the manifestations. The etiology remains unclear, but pathological findings observed in this patient may provide an insight into the pathogenesis of this rare but intractable condition. PMID- 3830074 TI - Responses of growth hormone to metoclopramide in normal women and amenorrheic women with or without hyperprolactinemia. AB - Response of growth hormone (GH) release to metoclopramide (MCP), a dopamine antagonist, was evaluated in normal women, hyperprolactinemic-amenorrheic patients with pituitary microadenoma and normoprolactinemic-amenorrheic patients. Mean basal concentrations of serum GH and prolactin (PRL) in amenorrheic patients were not significantly different from those in normal women except PRL concentrations in hyperprolactinemic patients. Serum GH concentrations significantly increased after MCP administration in normal women and normoprolactinemic-amenorrheic patients, but not in hyperprolactinemic patients. Dopamine causes modest and transient GH secretion in some subjects. Therefore MCP is not likely to stimulate GH secretion through its effect as a dopamine antagonist, and the mechanism of action of MCP on GH secretion is not known. Although the cause of the absence of GH response to MCP in hyperprolactinemic patients is unclear, it may be related to the increased hypothalamic dopaminergic tone which is operative in such patients or it may reflect a direct action of PRL on hypothalamic-pituitary GH regulation. PMID- 3830075 TI - Response of thyrotropin, prolactin and free thyroid hormones to graded exercise in normal male subjects. AB - Serum levels of thyrotrophin (TSH), prolactin (PRL), free thyroxine (FT4) and free triiodothyronine (FT3) were determined before and after physical exercise in 21 normal male subjects. The subjects were divided into 3 groups as follows: group I--light exercise (exercise on the Mijnhardt bicycle ergometer at 100 Watts for 15 min); group II--moderate exercise (a 5 km marathon); group III--heavy exercise (a 10 km marathon). In group I, TSH level rose from 1.96 +/- 0.42 mu u/ml (mean +/- SEM) to 2.52 +/- 0.30 mu u/ml (p less than 0.01), and PRL levels rose from 11.0 +/- 2.0 ng/ml to 19.0 +/- 5.2 ng/ml (p less than 0.01). In group II, TSH rose from 2.11 +/- 0.51 mu u/ml to 2.62 +/- 0.56 mu u/ml (p less than 0.05), and PRL rose from 11.2 +/- 1.6 ng/ml to 24.0 +/- 5.2 ng/ml (p less than 0.01). In group III, TSH rose from 2.01 +/- 0.41 mu u/ml to 2.36 +/- 0.45 mu u/ml (p less than 0.02), and PRL rose from 12.1 +/- 2.0 ng/ml to 47.7 +/- 9.3 ng/ml (p less than 0.01). The serum levels of FT4 showed different results among the three groups: Group I showed an increased response from 1.60 +/- 0.12 ng/dl to 1.72 +/- 0.12 ng/dl (p less than 0.01); Group II showed no significant difference; and group III demonstrated a diminished response from 1.61 +/- 0.14 ng/dl to 1.45 +/- 0.16 ng/dl (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830076 TI - Indomethacin suppresses basal but not HCG-stimulated testosterone secretion in the rat. PMID- 3830077 TI - [Methodologic studies of the determination of glycosylated hemoglobin in patients with insulin-dependent diabetes mellitus]. PMID- 3830078 TI - [Effect of cholecystokinin octapeptide (CCK-8) and bombesin on thyrotropin release from the rat pituitary gland in vitro]. PMID- 3830079 TI - [Effect of neurotensin on thyrotropin secretion in rats: in vivo studies]. PMID- 3830080 TI - The effect of naloxone on the secretion of pituitary hormones in patients with acromegaly, microprolactinomas, Cushing's disease and Nelson's syndrome. PMID- 3830081 TI - [Relation of serum levels of reverse triiodothyronine, thyroxine and triiodothyronine in selected thyroid diseases]. PMID- 3830082 TI - [Radioimmunologic method of analyzing testosterone using an I-125-labeled derivative]. PMID- 3830083 TI - [Effect of neurotensin on thyrotropin secretion in the rat. In vitro studies]. PMID- 3830084 TI - [Association of Addison's disease with hyperthyroidism]. PMID- 3830085 TI - [Gender identity in female patients with congenital adrenal hyperplasia]. PMID- 3830086 TI - Predictive clinical factors of visible vessel in bleeding peptic ulcer. AB - The endoscopic finding of a visible vessel in the base of a bleeding gastrointestinal lesion is a well-known indicator of the possibility of recurrent hemorrhage. We carried out a multivariate analysis of 277 patients with gastrointestinal hemorrhage, but no chronic liver disease, of the clinical history and parameters in relation to hemorrhage, in order to select patients at risk for this endoscopic picture. A clinical history of associated disease, the absence of ulcerogenic drug intake, presentation of bleeding in the form of hematemesis and active hemorrhage on admission had predictive value for visible vessel, The incidence of visible vessel was significantly greater in anastomotic stoma ulcers than in gastric and duodenal sulcers. On the basis of the clinical parameters mentioned, patients with a high probability of having a bleeding lesion with a visible vessel can be selected for priority endoscopy. PMID- 3830087 TI - Endoscopic sphincterotomy as a therapeutic measure in cholangitis and as prophylaxis against recurrent biliary tract stones. AB - Our purpose was to analyse the results of endoscopic sphincterotomy in patients with advanced cholangitis, and to assess the potential of this method in the prevention of recurrent biliary tract stones. Advanced cholangitis certainly predisposes to microlith formation, and we believe that the increased biliary drainage produced by sphincterotomy counteracts this process. Our grading of cholangitis was an intraoperative cholangioscopic assessment corresponding to Nishimura grades III and IV (erosions in the duct walls, patchy stone ulceration, biliary gravel, fibro-purulent plaques densely adherent to the biliary walls etc. 62 patients with grades III and IV cholangitis (as defined at choledochoscopy) underwent endoscopic sphincterotomy (GP-A). This group underwent a controlled prospective study with review at: one year, between 2 and 3 years, 5 years following surgery. The control group (GP-B) constituted 20 patients with comparable cholangitis who did not undergo sphincterotomy. Group A had no recurrent lithiasis, 4.8% revealed persistent cholangitis. In control group (GP B) 6 patients (30%) revealed recurrent lithiasis, on average 4.6 years following initial surgery. In addition, 35% of this group had clinical symptoms of cholangitis. These results indicate that endoscopic sphincterotomy is a worthwhile method in the treatment of cholangitis and prophylaxis against recurrent biliary tract stones. PMID- 3830088 TI - Transcholecystic endoscopic choledocholithotripsy: successful management of retained common bile duct stone. AB - Removal of large common bile duct stones has been a continuing challenge. The feasibility and efficacy of transcholecystic endoscopic choledocholithotripsy in a high-risk patient are demonstrated in this report. The procedure requires an established cholecystostomy track, catheter dilatation of the cystic duct, and the application of electrohydraulic shock waves to the calculus. The use of a choledochofiberscope permits the passage of the electrohydraulic probe and minimizes complications by direct monitoring. Stone fragments are removed by basket retrieval. This procedure in conjunction with minicholecystostomy may obviate the need for surgery in selected high-risk patients with combined gallbladder and common bile duct stones. PMID- 3830089 TI - A cuffed tube for the treatment of oesophago-bronchial fistulae. AB - An oesophageal tube provided with a foam-rubber cuff is described. The outside diameter of the cuff can be diminished while the tube is being introduced. After implantation, the expanded foam-rubber cuff achieves additional sealing of the oesophago-bronchial fistula. The tube described is suitable for sealing off oesophago-bronchial fistulae in the absence of the tumour-induced stenosis of the oesophagus. PMID- 3830090 TI - Postoperative biliocutaneous fistula: successful treatment by insertion of an endoprosthesis. AB - An elderly patient with a postoperative biliocutaneous fistula, the persistence of which was due to an unrecognized fibro-malignant stricture of the distal common bile duct, was treated by the insertion of an endoscopic biliary endoprosthesis. Immediately after the procedure, bile discharge through the fistula ceased completely, and the fistula closed in three days. Endoscopic treatment methods are worth trying before surgical revision of a biliocutaneous fistula is performed. PMID- 3830091 TI - A new ERCP mattress. PMID- 3830092 TI - Effects of an inhomogeneous magnetic field on flowing erythrocytes. AB - Effects of an inhomogeneous magnetic field on narrow erythrocyte streams in a wide and transparent laminar buffer flow were studied. The stream line of erythrocytes containing paramagnetic hemoglobin showed distinct displacement toward the stronger magnetic field. The displacement increased in the order, oxygenated erythrocytes (no displacement), erythrocytes containing cyanomethemoglobin, deoxygenated erythrocytes, erythrocytes containing methemoglobin in the high spin state; more precisely the displacement was proportional to the square of the paramagnetic moment of hemoglobin contained in the erythrocytes. In addition, the displacement was proportional to the product of the magnetic flux density and its gradient, and approximately proportional to the hematocrit of the flowing-erythrocyte suspension, and was much larger than that calculated for a single erythrocyte. These phenomena could be successfully interpreted by the interaction of paramagnetic erythrocytes with the inhomogeneous magnetic field, the resistance force (Stokes Law) from the bulk water, and the hydrodynamic interaction between erythrocytes. PMID- 3830093 TI - Gating processes of channels induced by colicin A, its C-terminal fragment and colicin E1 in planar lipid bilayers. AB - The dependence on pH and membrane potential of the pore formed by colicin A and its C-terminal 20 kDa fragment has been measured using planar lipid bilayers. The single channel conductance of the pore formed by both colicin A and the fragment increases with pH with an apparent pK of 6.0. At pH 5.0 the gating by membrane potential of the channels formed by either colicin A or its fragment is identical. At the same pH, quite similar pore properties were found when using the related bacteriocin, colicin E1. In agreement with previous studies, these data indicate that the protein structure containing the lumen of the pore resides in the 20 kDa C-terminal part of the colicin A and favours the recently proposed model, based on protein sequence analysis, which proposes that colicin A, E1 and IB C-terminal domains are folded in the same three-dimensional structure. However, it is also shown that colicin A and not its C-terminal fragment undergoes a pH dependent transition between an "acidic" and a "basic" form of the pore with an apparent pK of 5.3. The two forms of the pore differ by their gating charge but not by the channel size. These results suggest that there is a pH dependent association between the C-terminal domain carrying the lumen of the pore and another domain of the molecule which affect the pore sensitivity to membrane potential. PMID- 3830094 TI - Infrared studies of water induced conformational changes in bacteriorhodopsin. AB - Fourier transform infrared difference spectroscopy has been used to study the effect of water on the conformation of bacteriorhodopsin. The infrared spectra as a function of water content show a conformational change at about 0.06 g H2O/g bacteriorhodopsin. By an interference method the thickness of the sample was measured and shows similar behavior as a function of water content. This study gives insight into the process of water absorption by purple membrane. The observations are in good agreement with those found for other proteins. PMID- 3830095 TI - Symposium on the adrenal cortex. Proceedings of a conference. Newport Beach, California, June 22-23, 1986. PMID- 3830096 TI - Workshop on the Contribution of Airborne Pollutants to Respiratory Cancer. July 15-19, 1985, Snowbird, Utah. Proceedings. PMID- 3830097 TI - Short-chain carboxylic acids, a new class of teratogens: studies of potential biochemical mechanisms. AB - Certain short-chain carboxylic acids (SCCA) appear to share a common teratogenic potential, although the structural requirements for activity remain obscure. By using a whole rat embryo culture model system, several biochemical processes have been examined, either as potential initial sites of teratogenic action or as early steps in the pathway to malformation. Valproate, methoxyacetate, and butyrate were the prototype SCCA examined. Measurement of [14C]glucose utilization and lactate production confirmed that energy production by the early organogenesis embryo is predominantly from glycolysis. While the positive control agent, iodoacetate, caused a significant inhibition of lactate production, none of the SCCA affected this process or glucose utilization at teratogenic concentrations. Valproate did not influence embryonic acetyl CoA levels, in marked contrast to the reported response of adult liver, the other major target of valproate toxicity. Pinocytosis by the visceral yolk sac (VYS) was measured by the uptake of [125I]polyvinylpyrrolidone. This process ultimately supplies the embryo with amino-acids and is essential for normal development. SCCA induce morphological abnormalities of the VYS in embryo culture. Pinocytosis was slightly reduced by valporate, but not the other SCCA. However, comparison with the action of an antiserum, for which inhibition of pinocytosis is the initial teratogenic insult, suggests that this is not the mechanism for valproate. Incorporation of [3H]thymidine into embryo or yolk sac was not affected after 3 hr of SCCA exposure, but there was a marked effect of the positive control, hydroxyurea. This suggests that DNA synthesis is not directly influenced by SCCA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830098 TI - The potential role of redox cycling as a mechanism for chemical teratogenesis. AB - A survey of the literature indicates that several chemicals whose reduced metabolites are capable of undergoing redox cycling in biological systems also possess significant teratogenic properties when tested in vivo. We have initiated investigations to determine whether the embryotoxic effects of such chemicals could result from their redox cycling properties and whether redox cycling could be an important mechanism in chemical teratogenesis. In order to obviate the potentially confounding influences of maternal factors, our initial studies have been performed with a whole embryo culture system with redox cycling agents added directly to the culture medium. Several representative redox cycling agents including doxorubicin, paraquat, a series of nitroheterocycles, nitrosofluorene, and diethylstilbestrol (converted metabolically to redox cycling quinone/semiquinone radicals) have been investigated thus far. The nitroheterocycles which bear nitro groups with comparatively high redox potentials produced a striking, asymmetric defect involving primarily the right half of the prosencephalic and mesencephalic regions. The effect was exacerbated under conditions of low O2 tension. Accumulated data to date strongly suggest that reduction of the nitro group is an essential feature in the embryotoxic mechanism. Quinones (doxorubicin, paraquat) and compounds metabolically converted to quinones (diethylstilbestrol) appeared to produce embryotoxic effects via mechanisms not associated with redox cycling. Nitrosofluorene embryotoxicity was markedly exacerbated by changes in both intra- and extracellular glutathione levels, but definitive dependence on a radical-mediated effect or redox cycling was not demonstrated. PMID- 3830099 TI - Mechanism of nitrofen teratogenesis. AB - Nitrofen (2,4-dichloro-4'-nitrodiphenyl ether) is an herbicide with potent teratogenic activity in rats. When administered at doses as low as 0.15 mg/kg/day during organogenesis, abnormal development of the heart, kidneys, diaphragm, and lung occurs. The specific pattern of visceral malformations produced in the absence of overt maternal toxicity or embryolethality/cytotoxicity suggest that the compound perturbs processes unique or highly selective for embryonic differentiation. Despite findings of metabolic activation to mutagenic intermediates and carcinogenic activity in adult rodents, several lines of evidence indicate that teratogenicity is not based on mutagenic insult to the embryo. Rather, evidence is accumulating that nitrofen exerts a teratogenic effect via alterations in thyroid hormone status. The premature and pharmacologic exposure of the embryo to a nitrofen-derived thyromimetic challenge is believed to be the cause of abnormal morphogenesis of the heart, lungs, kidneys, and diaphragm. The parent compound itself could directly bind to embryonic nuclear receptors for T3, leading to altered differentiation of target organs. Alternatively, increased availability and placental transport of free thyroid hormones in the maternal compartment could be the source of thyromimetic challenge to the embryo. Overall, these studies indicate that, in the case of nitrofen, the mode of teratogenic activity is uniquely different from the mode of adult toxicity. PMID- 3830100 TI - Detection of alterations in testicular and epididymal function in laboratory animals. AB - The potential impact of an agent altering male reproductive function is greater for humans than for animals. Consequently, it is essential that sensitive criteria be used to look for effects on a multiplicity of target sites when an agent is evaluated using an animal model. No animal model has reproductive characteristics similar to those of humans, but this does not negate the validity of using animal models. Classic methodologies for reproductive toxicology are limited by the approaches used for subjective evaluation of testicular histology and use of natural mating for fertility tests. After dosing for an interval at least equal to six times the duration of one cycle of the seminiferous epithelium, sperm from ejaculated semen or the cauda epididymidis can be evaluated for normalcy of morphology or function and should be used for artificial insemination of females to critically evaluate fertility. Normal males of animal models ejaculate a great excess of sperm. A 50 or 90% reduction in the number of fertile sperm deposited during mating probably will not markedly reduce fertility. Artificial insemination of a critical number of sperm, selected to result in slightly less than maximal fertility for control animals, will maximize the probability of detecting a decrease in fertility if the same critical number of sperm is inseminated for treated animals as for control animals. Testicular function should be evaluated by objective, rather than subjective, criteria. For each male, a piece of testicular tissue should be appropriately fixed and an aliquot of parenchyma should be homogenized to allow enumeration of homogenization-resistant spermatids. Among the more sensitive criteria of testicular function are the minor diameter of essentially round seminiferous tubules, the ratio of leptotene spermatocytes to Sertoli cells, the corrected numbers of germ cells per seminiferous tubule cross section, and the number of homogenization-resistant spermatids per testis. PMID- 3830101 TI - Molecular loci for potential drug toxicity in ovaries. AB - Ovarian follicular development is dependent on the actions and interactions of the pituitary gonadotropins, FSH and LH, and the ovarian steroid hormone, estradiol. Agents which might block the effects of these hormones would increase follicular atresia and reduce fertility. In addition, any substance toxic to the oocyte and its normal pattern of growth and meiosis would lead to reduced numbers of oocytes and follicles and impaired fertility. Autoimmune diseases may be one major cause of premature ovarian failure, and such diseases might be triggered by toxic external stimuli. PMID- 3830103 TI - Contribution of radon and radon daughters to respiratory cancer. AB - This article reviews studies on the contribution of radon and radon daughters to respiratory cancer and proposes recommendations for further research, particularly a national radon survey. The steady-state outdoor radon concentration averages 200 pCi/m3, and indoor levels are about 4 times higher. The primary source of radon in homes is the underlying soil; entry depends on multiple variables and reduced ventilation for energy conservation increases indoor radon levels. Occupational exposures are expressed in units of radon daughter potential energy concentration or working level (WL). Cumulative exposure is the product of the working level and the time exposed. The unit for cumulative exposure is the working level month (WLM). The occupational standard for radon exposure is 4 WLM/year, and 2 WLM/year has been suggested as a guideline for remedial action in homes. Epidemiologic studies show that miners with cumulative radon daughter exposures somewhat below 100 WLM have excess lung cancer mortality. Some 3% to 8% of miners studied have developed lung cancer attributable to radon daughters. All of the underground mining studies show an increased risk of lung cancer with radon daughter exposure. All cell types of lung cancer increased with radon exposure. If radon and smoking act in a multiplicative manner, then the risk for smokers could be 10 times that for nonsmokers. The potential risk of lung cancer appears to be between 1 and 2 per 10,000/WLM, which yields a significant number of lung cancers as some 220 million persons in the United States are exposed on average to 10 to 20 WLM/lifetime. PMID- 3830102 TI - Sexual differentiation of the brain: a model for drug-induced alterations of the reproductive system. AB - The process of the sexual differentiation of the brain represents a valuable model system for the study of the chemical modification of the mammalian brain. Although there are numerous functional and structural sex differences in the adult brain, these are imposed on an essentially feminine or bipotential brain by testicular hormones during a critical phase of perinatal development in the rat. It is suggested that a relatively marked structural sex difference in the rat brain, the sexually dimorphic nucleus of the preoptic area (SDN-POA), is a morphological signature of the permanent or organizational action of estradiol derived from the aromatization of testicular testosterone. The SDN-POA of the male rat is severalfold larger in volume and is composed of more neurons than that of the female. The observation that the mitotic formation of the neurons of the SDN-POA is specifically prolonged has enabled us to identify the time course and pathway of neuronal migration into the nucleus. Study of the development of the SDN-POA suggests that estradiol in the male increases the number of neurons which survive a phase of neuronal death by exerting a neurite growth promoting action and/or a direct neuronotrophic action. It may not be possible to extrapolate this trophic effect of estradiol to all other structural sex differences since in the anteroventral periventricular nucleus, steroid exposure reduces the number of immunohistochemically defined dopaminergic neurons. Finally, although it is clear that gonadal hormones have dramatic permanent effects on the brain during perinatal development, even after puberty and in adulthood gonadal steroids can alter neuronal structure and, perhaps as a corollary to this, have permanent effects on reproductive function. For example, in the lightly androgenized rat which exhibits the delayed anovulation syndrome, exposure to estrogen prepubertally delays the onset of ovulatory failure, whereas estrogen exposure peri- or post-pubertally has an inhibitory effect on ovulation. Although the brain may be most sensitive to gonadal hormones or exogenous chemical factors during perinatal development, such sensitivity does not appear limited to this period. PMID- 3830104 TI - Pituitary function following treatment with reproductive toxins. AB - Appropriate regulation of reproductive processes are dependent upon the integrity of pituitary function. In this selected review, we evaluate the evidence that certain environmental compounds exert their effect on reproductive function via a direct action on the pituitary gland. We also discuss examples of changes in pituitary hormone secretion that occur in response to changes in neuronal or gonadal control of the pituitary. A limited number of studies suggest that measures of pituitary hormone secretion provide an early and sensitive measure of a compound's potential effects on the reproductive system. However, the most striking aspect of this area is the sparse and inconsistent information describing pituitary function following exposure to environmental pollutants. PMID- 3830105 TI - Age factors potentiating drug toxicity in the reproductive axis. AB - Traditionally, drug toxicity in the reproductive system has been a concern only as it affects fertility and fecundity in young individuals. The purpose of this report is to address the potential problem of synergy between drug actions and abnormal secretion of reproductive hormones that together produce disease in older individuals. Thus, reproductive toxicity has different, but no less serious implications in aging individuals. During aging, the coordinated function of elements within the reproductive neuroendocrine axis degrades. This change promotes atypical secretion of hormones producing abnormal responses in target organs and thus creates a condition with pathogenic potential. Certain drugs may contribute to reproductive toxicity in aging individuals either by accelerating the process of dysregulation and/or by synergizing with hormones to stimulate pathologic changes in target tissues. The geriatric population of the world is increasing, and since it consumes a proportionately larger percentage of drugs than younger groups, this novel form of reproductive toxicity may represent a problem in drug safety that warrants serious consideration. PMID- 3830106 TI - Effects of phthalic acid esters on the liver and thyroid. AB - The effects, over periods from 3 days to 9 months of administration, of diets containing di-2-ethylhexyl phthalate are very similar to those observed in rats administered diets containing hypolipidemic drugs such as clofibrate. Changes occur in a characteristic order commencing with alterations in the distribution of lipid within the liver, quickly followed by proliferation of hepatic peroxisomes and induction of the specialized P-450 isoenzyme(s) catalyzing omega oxidation of fatty acids. There follows a phase of mild liver damage indicated by induction of glucose-6-phosphatase activity and a loss of glycogen, eventually leading to the formation of enlarged lysosomes through autophagy and the accumulation of lipofuscin. Associated changes are found in the kidney and thyroid. The renal changes are limited to the proximal convoluted tubules and are generally similar to changes found in the liver. The effects on the thyroid are more marked. Although the levels of thyroxine in plasma fail to about half normal values, serum triiodothyronine remains close to normal values while the appearance of the thyroid varies, very marked hyperactivity being noted 7 days after commencement of treatment, this is less marked at 14 days, but even after 9 months treatment there is clear cut evidence for hyperactivity with colloid changes which indicate this has persisted for some time. Straight chain analogs of di-2-ethylhexyl phthalate, di-n-hexyl phthalate and di-n-oxtyl phthalate differ entirely in their short-term effects on the liver and kidney but have similar effects on the thyroid. The short-term in vivo hepatic effects of the three phthalate esters can be reproduced in hepatocytes in tissue culture. All three phthalate esters, as well as clofibrate, have early marked effects on the metabolism of fatty acids in isolated hepatocytes. The nature of these changes is such as to increase storage of lipid in the liver. A hypothesis is presented to explain the progress from these initial metabolic effects to the final formation of liver tumors. PMID- 3830107 TI - Calculation of 2,3,7,8-TCDD equivalent concentrations of complex environmental contaminant mixtures. AB - Sufficient toxicological data are now available to permit use of conventional risk assessment techniques to estimate the hazards associated with human exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). However, many real-world exposures involve complex mixtures of dibenzodioxins, dibenzofurans, and related compounds. Historical approaches to risk assessment on such mixtures have ranged from ignoring all compounds except 2,3,7,8-TCDD itself to assuming that all compounds have potencies equal to 2,3,7,8-TCDD. An alternative approach which uses existing literature data and analytical results to calculate the "2,3,7,8 TCDD equivalent" concentration of a mixture in order to "predict" its biological potency relative to 2,3,7,8-TCDD itself is advanced here. Previously reported in vivo acute and subchronic studies and some recently obtained analytical chemistry data are integrated here to clarify the utility of this important approach and to assess the uncertainties associated with its use. This predictive approach, and various conceptually similar ones, have now found wide applicability to the risk assessment process associated with exposure to complex mixtures of dioxins, dibenzofurans, and related compounds. PMID- 3830108 TI - Induction of contact dermatitis in guinea pigs by quaternary ammonium compounds: the mechanism of antigen formation. AB - Eight quaternary ammonium compounds were tested for their ability to induce contact dermatitis in guinea pigs by using a modified Freund's complete adjuvant test together with the guinea pig maximization test. Only two quaternary ammonium salts of the eight tested could be designated as strong allergens. These two active substances were shown to be capable of stable association with membrane lipids in forming immunogenic complexes. This surface complexation phenomenon was confirmed by using a spin-labeled quaternary ammonium salt which competed for binding sites at the surface of epidermal cells in vivo. Electron spin resonance was used to demonstrate that stable "ion-pairs" are formed between binding sites and the two allergenic preservatives. Furthermore, information was obtained on the kinetics of immunogenic complex formation as well as on the position and orientation of the quaternary ammonium ion at the cell surface. PMID- 3830110 TI - Respiratory symptoms and annoyance in the vicinity of coal-fired plants. AB - This study constitutes one part of a program for assessing the impact of coal fired power plants on the surrounding communities. A questionnaire was mailed to a total of 12,000 subjects living in six areas with coal-fired plants and in matched reference areas. The participation rate was 77.3%. In one coal-fired plant/reference area pair, a more detailed medical examination was carried out among subjects who reported symptoms of the respiratory tract. The match between coal-fired plant and reference areas was successful primarily in three pairs. Neither respiratory symptoms nor disease rates were increased among adults or children near any of these plants, but one plant seemed to give rise to annoyance. For the remaining coal-fired plants, consistently higher prevalences of respiratory tract symptoms and annoyance were observed in the surrounding population. The effects cannot, however, conclusively be related to the coal fired plants. It should be pointed out that the air pollution levels were relatively low, also in the vicinity of most of the plants in this study. PMID- 3830109 TI - Contribution of formaldehyde to respiratory cancer. AB - This article reviews the available data on the carcinogenicity of formaldehyde from experimental and epidemiologic studies and makes recommendations for further research. Two definitive chronic inhalation bioassays on rodents have demonstrated that formaldehyde produces nasal cancer in rats and mice at 14 ppm and in rats at 6 ppm, which is within the domain of present permissible human exposure (8-hr time-weighted average of 3 ppm, a 5 ppm ceiling, and a 10 ppm short-term exposure limit). Biochemical and physiologic studies in rats have shown that inhaled formaldehyde can depress respiration, inhibit mucociliary clearance, stimulate cell proliferation, and crosslink DNA and protein in the nasal mucosa. No deaths from nasal cancer have been reported in epidemiologic studies of cohorts exposed to formaldehyde, but three case-control studies suggest the possibility of increased risk. Although excesses of lung cancer deaths have been observed in some studies at industrial plants with formaldehyde exposure, uncertainties in interpretation limit the evaluation of these findings. Excess cancers of the brain and of lymphatic and hematopoietic tissues have been reported in certain studies of industrial groups and in most studies of formaldehyde-exposed professionals, but whether these excesses are related to formaldehyde exposure is not known. Several properties of formaldehyde pose unique problems for future research: the mechanisms responsible for its nonlinear response; its probable mechanism of carcinogenic action as a cross-linking agent; its formation in tissues as a normal metabolite; its possible action as a promoter and/or a cocarcinogen; and the importance of glutathione as a host defense at low exposure. PMID- 3830111 TI - Quantitative predictivity of carcinogenicity of the autoradiographic repair test (primary hepatocyte cultures) for a group of 80 chemicals belonging to different chemical classes. AB - In this work we have investigated the correlation existing between a short-term genotoxicity test (DNA repair in rat liver cells) and carcinogenicity in rodents. The work is in the framework of a line of thinking that considers as a possibility the utilization of the quantitative component of the information obtained from genotoxicity tests. In a preliminary report for 25 compounds belonging to different chemical classes, a correlation coefficient of 0.36 was found between carcinogenic potency in small rodents and potency in autoradiographic repair. This level of correlation is comparable with similar levels found for many other short-term tests: Ames test, alkaline DNA fragmentation in vivo, DNA adducts in vivo, morphological transformation in vitro and SCE induction in vivo. Obviously, since only 25 compounds were examined, assessment was rather uncertain, and the subdivision of the set into subsets for different chemical classes would have generated groups too small for a meaningful statistical analysis. With a much larger set (80 compounds) we hoped to be able to discriminate different predictivities for different chemical classes. This seems important because the test could be much more suitable for one given class than for another. Previous investigations with different short-term tests have shown that these differences can indeed exist and be very great. In this respect it is potentially very encouraging that the test considered here showed a fair correlation with carcinogenic potency for aromatic amines. Many other tests that we have examined so far have shown little or no predictivity for this important class of chemicals. PMID- 3830113 TI - Contribution of environmental fibers to respiratory cancer. AB - This article reviews studies of the carcinogenicity of mineral fibers, notably asbestos, and presents seven major recommendations for further research. Mineral fibers represent the greatest cause--after cigarette smoke--of respiratory cancer due to air pollutants. Past asbestos exposure may currently account for 2000 mesothelioma deaths per year and 4000 to 6000 lung cancer deaths per year. All major commercial types of asbestos (crocidolite, amosite, and chrysotile) can cause each of the major asbestos-related respiratory diseases. Lung cancers in asbestos-exposed individuals probably do not have a different distribution of histological types from that of non-asbestos-related lung cancers. Nonoccupational exposures are likely to be associated with malignant disease outcomes qualitatively similar to those associated with occupational exposures. Further investigations of fibers are needed to characterize the relationships among physicochemical properties, patterns of migration and clearance, dose, and adverse health effects. Transmission electron microscopy has been found to be the preferred method of analysis of environmental fibers. Relations among time factors (e.g., age at first exposure), dose, and risk for adverse health effects require analyses of existing and new epidemiologic studies of exposed cohorts. Concomitant exposure, behavioral factors, and host factors affecting susceptibility to asbestos should be identified. PMID- 3830112 TI - Contribution of organic particulates to respiratory cancer. AB - This paper presents some of the issues that remain to be resolved in order to assess the risk of cancer related to exposure to organic particulates. Most reviews of the effects of organic particulates from the outdoor environment on the risk of lung cancer show that this source seems to play a minor role. However, as fuel use and chemical composition of air pollutants change, the contribution of outdoor pollution as a cause of cancer may also change. Indoor air pollution is a more important source of exposure to organic particulates than is outdoor exposure. Although there is clear evidence that in occupational settings organic particulates cause human cancer, there has been almost no study of exposure to these types of particulates within indoor settings. Previous research has focused on cigarette smoke as the major indoor pollutant, but more specific characterization of contaminants in both the workplace and the home is required. The health effects of the higher levels of some of these contaminants in the workplace should be evaluated and the results extrapolated to populations exposed to lower levels in the home. Extensive research is needed to characterize organic particulate mixtures appropriately and test them for carcinogenicity. Studies on the health risks of nitropolynuclear aromatic hydrocarbons and polychlorinated dibenzodioxins and dibenzofurans are reviewed, but their contribution to the overall burden of respiratory cancer in humans cannot be estimated at this time. Characterization of mixtures, assessment of exposures, and linkage of exposures to health effects are the objectives of the recommendations proposed for further research. PMID- 3830114 TI - Contribution of passive smoking to respiratory cancer. AB - This article reviews data from experimental and epidemiologic studies on passive smoking and makes 12 recommendations for further study. The physicochemical nature of passive smoke, the smoke inhaled by nonsmokers, differs significantly from the mainstream smoke inhaled by the active smoker. At present, measurement of urinary cotinine appears to be the best method of assessing exposures to passive smoking. Data indicate that the greater number of lung cancers in nonsmoking women is probably related to environmental tobacco smoke. Exposures in utero and very early in life to passive smoking may be important in relationship to the subsequent development of cancer and need further consideration. The short term effects of environmental tobacco smoke on the cardiovascular system, especially among high-risk individuals, may be of greater concern than that of cancer and requires further study. Further study of increased risks of lung cancers in relation to environmental tobacco smoke exposure requires larger collaborative studies to identify lung cancer cases among nonsmokers, better delineation of pathology, and more careful selection of controls. In addition, studies of epithelial cells or specific cytology should be undertaken to determine evidence of cellular changes in relation to environmental tobacco smoke exposure. Animal inhalation studies with passive smoke should be initiated with respect to transplacental carcinogenesis, the relationship of sidestream smoke exposure with lung cancer, the induction of tumors in the respiratory tract and other organs, and the differences in the physicochemical natures of sidestream and mainstream smoke. PMID- 3830116 TI - Symposium: Mechanisms of Reproductive and Developmental Toxicology. April 1, 1986, Swedeland, PA. Proceedings. PMID- 3830115 TI - Contribution of metals to respiratory cancer. AB - This paper reviews studies on the adverse health effects of exposure to metals, using arsenic and cadmium as examples. The carcinogenic potential of arsenic has been studied in various settings. Inhalation is clearly related to the development of lung cancer in (copper) smelting and arsenical pesticide manufacturing, and also in heavily exposed wine merchants who had an additional source of exposure by ingestion. Animal studies have shown cadmium to be a lung carcinogen, while a study by Thun et al. provides the best evidence to date that cadmium inhaled as CdO particles may be a human lung carcinogen. On the basis of this latter study, EPA estimates the risk due to cadmium at 1.8 X 10(-3) cases/micrograms/m3, which results in more than 100,000 excess lung cancers (lifetime). For arsenic, the risk estimate of 4.29 cases/1,000 micrograms/m3, based on epidemiologic data also results in more than 100,000 lung cancers (lifetime). This paper reviews the bases for these estimates and presents recommendations for further research. Lung cancer risks also exist for other metals such as nickel, chromium, and beryllium. Further study is required before a definitive conclusion can be reached about the significance and magnitude of environmental exposures to metals as a cause of lung cancer. PMID- 3830117 TI - Overview of the risk of respiratory cancer from airborne contaminants. AB - This overview on defining risk of respiratory cancer from airborne pollutants summarizes broad issues related to a number of the environmental agents that are discussed in the articles that follow. Lung cancer kills more than 100,000 people annually and is the major form of cancer in both sexes in middle age. Cigarette smoking is the major cause of respiratory cancer and must be taken into account in any study of the effect of an environmental agent on the risk of respiratory cancer, particularly at relatively low levels of excess risk (RR greater than 1.0 but less than 2.0). The agents considered in this series all have the potential for widespread community exposures, either because there is widespread long-term exposure (passive smoking), the agents are direct byproducts of energy consumption (organic particles), have ubiquitous production and use patterns (formaldehyde and fibers), or occur widely in natural settings (radon). Several issues--measurement of exposure, latency, confounding factors and bias, extrapolation from animals to humans, population at risk, and attributable risk- must be considered for each agent. A further issue related to exposure estimates is the relationship of exposure to actual dose. Understanding exposure some 25 to 40 years in the past is important because of the prolonged latency period in the development of respiratory cancers. To the degree that these agents act synergistically with smoking, the reduction of smoking or of exposure to these agents may have greater public health consequences than would be anticipated from the directly measured attributable risk of each of these agents separately. PMID- 3830118 TI - Caffeine enhances the physiological response to occupational stress in medical students. AB - Caffeine (3.3 mg/kg) was tested against a placebo in 20 male medical students during periods of low (no exams) versus high (final exams) work stress. On each of 8 test days, heart rate and blood pressure were measured at baseline and over a 40-min postdrug interval; immediately afterward, blood was drawn to test plasma cortisol and serum lipid concentrations. Exams increased heart rate (p less than .005) and systolic blood pressure (p less than .02). Caffeine decreased heart rate (p less than .0001) and increased systolic blood pressure (p less than .005), diastolic blood pressure (p less than .0001), plasma cortisol levels (p less than .01), and serum cholesterol levels (p less than .02). Caffeine effects were additive with those of exams, and together they increased the number of men showing systolic blood pressures in the borderline hypertensive range. Thus, caffeine use during periods of increased occupational stress may enhance the cumulative stress response. PMID- 3830119 TI - Type A behavior pattern, parental history of hypertension, and cardiovascular reactivity in college males. AB - Two risk factors for cardiovascular disorders, parental history of hypertension and the Type A behavior pattern, were investigated concurrently with respect to cardiovascular reactivity to challenging situations. Sixty-four college males were given both the Structured Interview (SI) and Jenkins Activity Survey (JAS) for the Type A behavior pattern and a family health questionnaire to determine parental history of hypertension. The students were monitored for blood pressure (BP), heart rate (HR), and pulse transit time (PTT) response to four tasks: cold pressor, isometric handgrip exercise, a reading comprehension task, and backwards digit span. Type As based on SI classification had significantly higher HR levels across all tasks than did Type Bs, as well as higher diastolic BP levels in the cold pressor task. No main effects for Type A-B using JAS classification were found. Positive parental history students had higher HR and shorter PTT levels across all the tasks. Type A and parental history did interact in a limited way on some tasks, but the interactions were also dependent on the Type A classification used. PMID- 3830120 TI - A matching-to-sample feedback technique for training self-control of tinnitus. AB - Thirty individuals with subjective tinnitus aurium of a variety of types and severity were treated with a matching-to-sample feedback procedure. Following initial evaluation measures, the participants' experienced tinnitus sounds were reproduced audiometrically on all characteristics and were presented to them in the noninvolved ear or in both ears when the tinnitus was binaural. This experimental sound was then reduced in 5 decibel (dB) steps within sessions, and participants had the task of concentrating on reducing the loudness of their tinnitus until a match was achieved between it and the experimental sound at each new dB level. Results showed an overall highly significant difference in dB levels from baseline to final training session. Nearly all participants demonstrated a marked reduction in tinnitus loudness, with 84% reducing it by 10 dB to 62 dB and several eliminating it completely. Individual and pathological variables played no role in training or outcome. Our approach appears to have major advantages over other tinnitus treatment strategies in that it provides direct, significant relief and gives the patient the psychological benefit of gaining control over the problem. PMID- 3830121 TI - Decline of natural killer cell target binding and lytic activity in mice exposed to rotation stress. AB - We examined the effect of rotation-induced stress on the percentage distribution of NK-YAC-1 target-binding cells and natural killer (NK) cell activity from splenic lymphocytes of C3H/HeJ mice. Following a 6-day stress regimen, we observed a marked decline in both the percentage of target-binding cells and in NK cell activity. This decline was first evident 13 days after initiation of stress and persisted for 2 weeks. Our data indicate that intermittent rotation stress over a 6-day period results in a delayed but persistent deleterious effect on NK-YAC-1 target binding and NK cell activity. PMID- 3830122 TI - The effect of bending and rotation of the trunk on the intra-abdominal pressure and the erector spinae muscle when lifting while sitting. PMID- 3830123 TI - Memory and menstrual cycle. PMID- 3830124 TI - The immediate effects of strenuous exercise on free-recall memory. PMID- 3830125 TI - Occupational musculoskeletal disorders of visual artists. A questionnaire and video analysis. PMID- 3830126 TI - Spinal shrinkage in females: circadian variation and the effects of circuit weight-training. PMID- 3830127 TI - The metabolic cost of various occupational exposures. PMID- 3830128 TI - Shifts, duration of work and accident risk of bus drivers. PMID- 3830129 TI - Phylogenetic evidence for the acquisition of ribosomal RNA introns subsequent to the divergence of some of the major Tetrahymena groups. AB - Previous work has demonstrated the presence of a self-splicing intron in the large subunit ribosomal RNA coding region in some strains of the ciliate protozoan Tetrahymena. Sequence comparisons of the intron regions from six Tetrahymena species showed these to fall into three homology groups. In an attempt to evaluate the evolutionary origins of the intervening sequences, we have now determined complete small subunit ribosomal RNA gene sequences from 13 species of Tetrahymena and the absolute number of nucleotide differences between the sequences was used to construct a phylogenetic tree. This phylogeny was consistent with the groupings suggested by comparisons of other biochemical characters including cytoskeletal proteins, isozyme analyses, and restriction maps of complete rRNA transcription units. The homology groupings that were based upon the intron sequence data do not agree with the relationships inferred from the small subunit rRNA sequence data. These observations are taken to indicate that the intron character has been acquired independently in different species at a stage later than the branching out of the species. PMID- 3830130 TI - Trypanosome hybrids generated in tsetse flies by nuclear fusion. AB - Genetic exchange may occur between two particular Trypanosoma brucei clones simultaneously transmitted by the same tsetse fly. We report here that this exchange takes place in the fly, through nuclear fusion. The resulting hybrids appear to be sub-tetraploid, some particular DNA sequences from one of the parental stocks being lost before enough cloned hybrid trypanosomes could be harvested for DNA analysis. A further reduction of the DNA content of these hybrids occurs gradually upon growth and yields near diploid value in a major part of the population. This mode of hybrid generation is different from the fusion of haploid gametes, which is thought to occur normally upon inoculation of metacyclic trypanosomes in their mammalian host. In this respect, the sub tetraploid hybrids appear to undergo meiosis in the fly, generating sub-diploid metacyclic forms, then fusion in the mammalian blood. PMID- 3830131 TI - Homology between the ran1+ gene of fission yeast and protein kinases. AB - The ran1+ gene of the fission yeast Schizosaccharomyces pombe is a negative regulator of both sexual conjugation and meiosis. The nucleotide sequence of the gene has been determined and contains a region of open reading frame (ORF) capable of encoding a protein of 52,000 daltons. S1 nuclease analysis of ran1+ encoded RNA showed that the ORF was spanned by an uninterrupted transcript. A fragment of DNA containing the entire ran1+ gene was expressed in a bacterial expression vector and found to encode the expected product of 52,000 daltons. The putative ran1+ gene product shares significant sequence homology with known protein kinases. The level of the ran1+ transcript was similar in vegetative and meiotic cells suggesting that the ran1+ protein product rather than its transcript is regulated during sexual differentiation. PMID- 3830133 TI - Changes in Bereitschaftspotential during fatiguing and non-fatiguing hand movements. AB - This study investigates the electroencephalographic Bereitschaftspotential (Bp) during muscular-fatiguing and non-fatiguing rhythmical hand contractions at 20%, 50%, and 80% maximum voluntary contraction (MVC). A feedback arrangement was provided so that subjects were able to adjust the force as required. The results confirm that Bp depends on force level. An increase in force results in a Bp increase. Further, they show that muscular-fatiguing contractions at 80% MVC are accompanied by an increased Bp. This could be the result of an increase in the central nervous activation required when preparing for motor activity with fatigued muscles. A decrease in Bp was observed during non-fatiguing repetitive hand contractions at 50% MVC. Possibly, the decrease reflects a decrease in subjects intentional involvement due to the monotony of the exercise. Repetitive movements at 20% MVC, which require a high degree of concentration and attention to adjust exactly to this very small force level, also result in an increased Bp, perhaps due to the higher intentional involvement. It may be concluded that the influence of muscular fatigue on Bp should be investigated with consideration of the psychological aspects of repetitive movements. PMID- 3830132 TI - Effects of treadmill running and swimming on plasma and brain vasopressin levels in rats. AB - The influence of treadmill or swimming exercise on resting values of plasma and brain arginine vasopressin (AVP), and plasma sodium, potassium, osmolality and proteins was studied after 5 weeks of training using female Wistar rats. The duration of daily training sessions was progressively increased to reach 6 h/day for swim training (S) and 3 h/day for treadmill running (T). Compared to their untrained controls, treadmill and swim training were respectively associated with: a significant lower body weight; a decreased plasma AVP (36.4% for T and 47.4% for S) and hypothalamic AVP (20% for T and 16% for S); a higher hypophyseal AVP (145% for T and 36.3 for S); a decreased plasma osmolality (6.7% for T and 6.1% for S), sodium (1.2% for both) and potassium (15% for T and 22.4% for S); and no change in protein concentration. For T, rectal temperature increased (38.5 +/- 0.20 to 39.7 +/- 0.5) and for S rectal temperature decreased from 38.6 +/- 0.12 to 37.74 +/- 0.10). The differences observed in AVP contents of the pineal and Harderian glands (enhanced only in the treadmill groups) could be explained by the supposed role of these glands in thermoregulation. Two conclusions could be drawn from this study: there are no parallel changes in the hypothalamo hypophyseal system (where AVP plays its endocrine role) and the brain (where AVP is a neurotransmitter); plasma changes could be explained by an extracellular fluid expansion with Na and K loss leading to a decrease in AVP secretion. PMID- 3830134 TI - The metabolic response to prolonged walking in fed and fasted men. AB - Six healthy men walked 37 km (23 miles) per day over a 3-lap course for each of 4 consecutive days. Subjects were allowed breakfast and an unrestricted diet was consumed after completion of the walk, but no food was consumed during or between laps. At a later date the same subjects walked over the same course after an overnight fast and without breakfast. Completion time for each lap was 139 +/- 1 min (mean +/- SE) and exercise intensity was equivalent to 17 +/- 1% VO2max. Mean 24h energy intake was 14.5 +/- 0.8 MJ during the fed walk. Estimated daily energy expenditure was 12.0 MJ. Blood glucose concentration fell significantly on the first, third and fourth days of the fed walk, but no subject became hypoglycaemic. Glucose concentration did not fall during the fasted walk and was significantly higher pre-exercise and at the end of laps one and three when compared to the first day of the fed walk. Blood alanine concentration fell significantly after the end of the first lap of each day of the fed walk but not during the fasted walk. Blood lactate levels did not change during the course of either walk. Plasma free fatty acid, glycerol and blood 3-hydroxybutyrate concentrations were unchanged during the passage of the first lap on each day of the fed walk, but all three had increased significantly by the end of the first lap of the fasted walk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830136 TI - A thermographic study of the effect of body composition and ambient temperature on the accuracy of mean skin temperature calculations. AB - The problem associated with using measurements from a small number of sites to determine mean skin temperature was investigated by studying variations in distributions of skin temperatures of the bare torsos of humans exposed to ambient temperatures of 18, 23, and 28 degrees C. Following a 60 minute equilibration period the temperatures of four regions (chest, abdomen, upper back, and lower back) were measured using both thermistors and an infra-red thermographic system. Regions of the torso usually represented by a single temperature exhibited significant point-to-point temperature variations especially in chilled subjects. Also an earlier finding was confirmed: in that larger variations in skin temperature distributions occur as body fat content increases. Caution must therefore be used in applying the concept of a mean skin temperature derived from a few select sites, especially with nude subjects who are chilled or have a high body fat content. PMID- 3830135 TI - Central and peripheral hemodynamics during maximal leg extension exercise. AB - The purpose of this study was to examine the central and peripheral hemodynamic adaptations to maximal leg extension exercise. Seventeen men (X = 25 years, 84 kg) performed leg extension exercise (Universal equipment) for 12 repetitions (90s) to fatigue. Each repetition consisted of a 3s lifting motion, 1s pause, and 3s lowering motion. Impedance cardiography was used to measure stroke volume (SV), cardiac output (Q), systolic time intervals, and impedance contractility indices on a beat-by-beat basis. There were significant increases in systolic, diastolic, mean arterial pressure, total peripheral resistance, and HR during exercise. The mean Q remained similar throughout the protocol. SV decreased even though indices of myocardial performance indicated an enhancement of contractility. The magnitude of Q and SV were dependent upon the phase of leg extension. SV and Q during the lifting portions of the exercise were smaller than the lowering portions. The differences in SV and Q during the concentric and eccentric phases of the exercise most likely reflect the large static forces in exercising muscle which impeded venous return and increased afterload. PMID- 3830137 TI - Relationships between muscle lactate accumulation and surface EMG activities during isokinetic contractions in man. AB - In order to investigate the relationship between metabolic state and myoelectrical activity in working muscle during short term intense exercise, eleven healthy males performed isokinetic knee extensions at an angular velocity of 180 deg X sec-1 for 30 and 60 s. The median frequency (MF) of the surface electromyogram (EMG) recorded from vastus lateralis was decreased while the time lag of torque production after the onset of electrical activity (EMD) was increased during exercise. These changes (MF and EMD) corresponded well to muscle lactate accumulation in the same muscle. Over the exercise period, the integrated EMG/knee extension peak torque ratio (E/T ratio) was increased, which indicated a decrease in the efficiency of electrical activity. It was concluded that the changes in the frequency components of the EMG and in the contractile property of the muscle during short term intense exercise correlated with lactate accumulation in the identical muscle, and that the decrease in efficiency of the electrical activity in the muscle suggested peripheral fatigue. PMID- 3830138 TI - Ageing and isokinetic plantar flexion. AB - Isokinetic torques (Cybex II) of the plantar flexors in 25 healthy men were compared at 5 angular velocities (30, 60, 90, 120 and 180 degrees X s-1). The purposes were to compare plantar flexion torques in young and old subjects, and to determine whether the expected decrease was significantly associated with age, physical activity, or aerobic fitness. Four groups were studied: young (21.7 +/- 2.0 years) and older (63.3 +/- 2.8 years), active and sedentary. Measurements of height, weight, % body fat, VO2max, and daily leisure energy expenditure (questionnaire) were determined for each subject. Statistical measures of analysis of variance were used to determine significant differences among groups; product moment correlation and stepwise regression analysis were used to describe the degree of association between the dependent variable of plantar flexion torque and the independent variables at each velocity. A decline in torque was observed as the isokinetic velocity of angular motion increased. Age alone was a significant determinant of plantar flexion torque, whereas at the slowest speed, when VO2max was used as an explanatory variable, age was not a significant determinant of torque. At 30 degrees X s-1 47% of the variance in torque was explained by VO2max while at 180 degrees X s-1 49% of the variance was explained by age. PMID- 3830139 TI - Gas exchange parameters, muscle blood flow and electromechanical properties of the plantar flexors. AB - Sixteen men were tested to determine VO2max (ml X kg-1 X min-1), anaerobic threshold VO2 (ATVO2) and oxygen kinetics (time constant, T.C.) during running on a treadmill. For measuring maximal calf blood flow (maxBF, ml X 100 ml-1 X min 1), venous occlusion plethysmography was employed immediately following a combination of arterial occlusion and toe raising exercise to exhaustion. In addition, supramaximal electrical stimulations were given to determine maximal calf twitch force (Fmax, N), maximal rate of twitch force development (dF/dt) and relaxation (R X dF/dt, N X ms-1) and electro-mechanical delay time (EMD, ms). Results demonstrated that VO2max, ATVO2 and maxBF were all inversely related to T.C. (p less than 0.05). MaxBF and ATVO2 showed the highest correlation (r = 0.89, p less than 0.01). Stepwise multiple linear regression analyses revealed that variance in VO2max (60%) and ATVO2 (84%) could be accounted for by the combined effects of the following peripheral factors: VO2max = 51,25-3.24(dF/dt) + 0.14(maxBF), and ATVO2 = 11.68 + 0.42(maxBF) - 0.2(Fmax). These findings, together with the results of cluster analysis, suggest a tight link between ATVO2 and peripheral blood flow capacity. On the other hand, a moderate correlation (r = 0.64, p less than 0.01) between VO2max and maxBF might be due in part to individual differences in oxygen extraction-utilization capacity during heavy exercise above anaerobic threshold. PMID- 3830140 TI - Changes in blood pressure, body weight and urinary catecholamines during austerities. AB - More than one hundred monks belonging to Nichirenshu, a major Buddhist sect in Japan, participated in the annual hundred days austerities during the winter. Cold water bathing, insufficient sleep, hunger and emotional impact are considered to be the major stressors experienced by the monks subjected to these austere regimes. This study was conducted to evaluate the endocrinological and physiological changes in twenty newcomer monks during the first four weeks of the austerities. The urinary concentration of noradrenaline (NOR) increased significantly during the first four weeks but not that of adrenaline (ADR). The changes in urinary concentration of ADR and NOR indicated the main stressors possibly to be low ambient temperature and hunger. NOR is thus probably a better indicator than ADR for evaluating stress under austere conditions. Blood pressure (BP) did not rise but the concentration of NOR was noted to increase. NOR may possibly be excreted in excessive amounts to maintain normal BP against hypotensive factors such as loss of body weight due to low calorie intake. PMID- 3830141 TI - Effects of facial fanning on local exercise performance and thermoregulatory responses during hyperthermia. AB - To investigate the effects of hyperthermia and facial fanning during hyperthermia on hand-grip exercise performance and thermoregulatory response, we studied eight male subjects, aged 20-53 years. Subjects exercised at 20% of maximal hand-grip strength in the sitting position under three conditions: normothermia (NT), hyperthermia without fanning (HT-nf) or with fanning at 5.5 m X sec-1 wind speed (HT-f). Hyperthermia (0.5 degrees C higher oesophageal temperature than in NT) was induced by leg immersion in water at 42 degrees C. Mean exercise performance was markedly reduced from 716 contractions (NT) to 310 (HT-nf) by hyperthermia (P less than 0.01) and significantly (P less than 0.05) improved to 431 (HT-f) by facial fanning. Hyperthermic exercise was accompanied by significant increases in forearm blood flow (71%) and the local sweat rate on the thigh (136%) at the end of exercise compared with that in NT. Heart rate (HR) and rating of perceived exertion (RPE) increased during exercise and were higher in HT-nf than in NT at any given time of exercise. Oesophageal, tympanic (Tty) and mean skin temperatures were also significantly higher in HT-nf than in NT. Facial fanning caused a marked decrease in forehead skin temperature (1.5-2.0 degrees C) and a slight decrease in Tty, HR and PRE compared with that in HT-nf at any given time of exercise. These results suggested that hyperthermia increased thermoregulatory demands and reduced exercise performance. Facial fanning caused decreases in face skin and brain temperatures, and improved performance. PMID- 3830142 TI - Skeletal muscle creatine kinase MB alterations in women marathon runners. AB - Total creatine kinase (CK) and CK MB activities were determined in gastrocnemius muscle and serum obtained from 14 female marathon runners. The level of CK MB in muscle increased significantly (p less than 0.05) after chronic exercise training from 5.3% to 10.5% of the total CK activity, but not after acute exercise (post marathon 8.9%). No significant differences in total CK activities were detected. However, the total CK activity in the muscles were significantly (p less than 0.05) less than those previously reported from the muscle of men runners (1800 U/g, 3000 U/g respectively). No significant correlation existed between fiber type and muscle CK MB activity. Additionally, trace amounts of mitochondrial CK and CK BB were present in muscle homogenates. A significant correlation was observed in the increase in mean serum total CK (597 UL-1) and CK MB (23 UL-1) activities 24 h after the race (r = 0.97, p less than 0.05). These results suggest that gastrocnemius muscle in women adapts to training with increased CK MB activities and imply that skeletal muscle is the major source of elevated serum CK MB activities in women marathon runners. PMID- 3830143 TI - Metabolic responses to light arm and leg exercise when sitting. AB - Seven male subjects performed progressive exercises with a light work load on an upper limb or bicycle ergometer in the sitting position. At any comparable work load above zero, arm exercise induced higher oxygen uptake, ventilation, heart rate, oxygen pulse, respiratory rate and tidal volume than leg exercise. At similar levels of VO2 above 0.45 1 X min-1, heart rate and ventilation were higher during arm exercise. A close linear relationship between carbon dioxide output and oxygen uptake was observed during both arm and leg exercises, the slope for arm work being steeper. The ventilatory equivalent for VCO2 (VE/VCO2) gradually decreased during both types of exercise. The ventilatory equivalent for VO2(VE/VO2) remained constant (arm) while it rose (leg) to a peak at 9.8 W and then gradually decreased. Ventilation in relation to tidal volume had a linear relationship with leg exercise, but became curvilinear with arm exercise after tidal volume exceeded 1100 ml. The observed differences in response between arm and leg exercises at a given work load appear to be influenced by differences in sympathetic outflow due to the greater level of static contraction of the relatively small muscle groups required by arm exercise. PMID- 3830144 TI - Thermal stress and physiological strain in the glass bangle industry. AB - A preliminary survey of the few units of the small-scale glass bangle industry in Firozabad, Agra District, Uttar Pradesh, indicated that the workers were exposed to severe degrees of heat stress during various operations in the manufacturing processes. A more detailed study in eight glass bangle units was therefore undertaken to make quantitative estimates of heat stress on exposed workers in the summer season. The thermal data collected confirmed that the heat stress on the workers was severe but measurement of certain physiological indicators revealed relatively low levels of strain amongst the exposed workers. The findings could be attributable to high degrees of acclimatization, but further observations in the field supplemented by studies on simulated exposures of volunteers in a climatic chamber seem to be warranted. PMID- 3830145 TI - Effects of sustained manual work and partial sleep deprivation on muscular strength and endurance. AB - In a military field artillery trial, the effects of 8 days of sustained manual work and partial sleep loss on isometric right hand grip strength and upper and lower body anaerobic power (using the Wingate test) was investigated in 25 healthy young male soldiers. During the trial, the physical activity of each subject was essentially identical except that an experimental group (n = 18) manually handled a large quantity of artillery shells (weighing 45 kg) and charges (13 kg), whilst a control group (n = 7) merely simulated manual handling activities and did no lifting or loading of shells. The daily amount of sleep obtained by each group was similar (3 to 4 hours), as were their activity patterns and food and fluid intake. Isometric right hand grip strength for both groups fell progressively during the trial and did not return to pre-trial levels during 3 days of recovery. At the end of the 8 day trial, there were statistically significant reductions in the body weight (1.9%, p less than 0.001), % body fat (7.1%, p less than 0.001) and upper body mean power (7.3%, p less than 0.01) of the experimental group but not in the controls. Lower body peak and mean power were significantly increased at the end of the trial in both the experimental (14.7%, p less than 0.001 and 17.0%, p less than 0.001 respectively) and control (14.3%, p less than 0.01 and 15.0%, p less than 0.05 respectively) groups. Lower body power decrease was significantly increased (18.1%, p less than 0.05) in the experimental group but not in the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830146 TI - Physical fitness of blind and sighted children. AB - Twenty-seven children (age 7-17 years) with varying degrees of blindness but with no other known disorder were assessed for physical fitness. Twenty-seven randomly selected children with normal eyesight were also assessed. Maximum oxygen uptake (VO2max) was measured directly during a progressive exercise test on a treadmill. There was a significant and substantial reduction in VO2max in totally blind children (mean +/- standard deviation 35.0 +/- 7.5 ml X min-1 X kg-1) compared with normal children (45.9 +/- 6.6 ml X min-1 X kg-1). Partially sighted children had a significant but smaller reduction in VO2max. Fitness assessed by a step test was significantly reduced in the visually impaired children, and skin-fold thickness was also significantly greater in totally blind children. The level of habitual physical activity for each child, as assessed by a questionnaire, correlated with VO2max (r = 0.53, p less than 0.0001). Blind children were significantly less active than normal children, and the difference between mean VO2max for blind and normal children became non-significant when their different activity levels were taken into account. It is concluded that totally blind children are less fit than other children at least partly because of their lower level of habitual activity. PMID- 3830147 TI - Blood lactate parameters related to aerobic capacity and endurance performance. AB - The relationships among four descriptors of lactate increase: lactate threshold (LT) (the VO2 at which blood lactate concentration begins to increase above the resting level during an incremental exercise test), LT1 (the VO2 at which blood lactate increases 1 mM above the resting level), LT2 (the VO2 at which blood lactate concentration reaches a fixed value of 2 mM), onset of blood lactate accumulation (OBLA; the VO2 at which blood lactate reaches a concentration of 4 mM), were compared with aerobic capacity (VO2max) and 12 min running performance in 19 untrained female students. The VO2 (+/- SD) of LT, LT1, LT2, OBLA, and VO2max were 14.5 +/- 3.7 ml X kg-1 X min-1, 22.5 +/- 4.3 ml X kg-1 X min-1, 22.2 +/- 4.5 ml X kg-1 X min-1, 30.3 +/- 5.2 ml X kg-1 X min-1 and 36.0 +/- 5.1 ml X kg-1 X min-1, respectively. The mean (+/- SD) distance covered in the 12 min running was 2356 +/- 160 m. The results were as follows: 1) the lactate parameters (i.e. LT, LT1, LT2, and OBLA) were highly correlated with each other. 2) all the lactate parameters were related to VO2max and endurance running performance with a high correlation coefficient. Of the four descriptors of lactate change with exercise, LT correlated best with VO2max and endurance running performance compared to LT1, LT2 and OBLA. It is concluded that lactate threshold is the best index for aerobic capacity and endurance running performance. PMID- 3830148 TI - Maximal voluntary isometric strength in Danish adolescents 16-19 years of age. AB - The force in maximal voluntary isometric contraction of elbow flexors, knee extensors, trunk flexors, and trunk extensors was measured in a representative sample of Danish school children 16-19 years of age (128 boys and 165 girls). The 16 year old boys were 177.8 cm in height, with a mean increase of 1.4 cm per year up to 19 years, and they weighed 66.0 kg, with a mean increase of 1.8 kg per year up to age 19. The girls were 168.0 cm in height with no increase up to age 19, and their mean weight was 59.6 kg, which increased by 1.8 kg per year up to age 19 (p greater than 0.05). The strength in the four muscle groups for boys a girls respectively was 281 N and 182 N for elbow flexors, 574 N and 419 N for knee extensors, 601 N and 404 N for trunk flexors and 664 N and 499 N for trunk extensors. An increase in strength in the elbow and trunk flexors and a decrease in strength in the trunk extensors in relation to values obtained in 1956 was seen, and a difference in strength per kg lean body mass between the boys and the girls was also observed. The estimated strength per unit cross-sectional area of muscle was 38 N X cm-2 in both boys and girls. PMID- 3830149 TI - Modulation of slow and fast elbow extensor EMG tonic activity by stretch reflexes in man. AB - Reflex EMG responses to sudden passive flexion of the elbow were recorded from anconeus and triceps brachii in 5 human volunteers. While the subjects were required not to resist the flexion movement, they were required to maintain an extension torque of 3.5 or 7.0 Nm prior to its onset. Under these isotonic conditions, the latency and amplitude of the reflex activities from anconeus and triceps brachii did not differ significantly, in contrast to the findings of Le Bozec (1986) in actively relaxed subjects. The myotatic/postmyotatic EMG amplitude ratio did not provide a further quantitative way to distinguish between these muscles. The absence of a difference between the reflex activities of a slow (anconeus) and a fast (triceps brachii) muscle is interpreted as resulting from a strong drive of spindle activity on the whole extensor motoneuron pool, which outweights the differences in recruitment due to the differing relative amounts of type I and type II fibres in the two muscles. Differences like those described between finger and calf muscles by other authors are thought to be due to the relative degree of corticalization of these muscles. All short and long latency responses of the muscles increased in magnitude and decreased in latency with increasing background EMG activity as well as with increasing initial length. The position and tonic activity dependency of these responses is explained in terms of alpha-gamma coactivation. PMID- 3830150 TI - Properties, biosynthesis and processing of a sulfur-rich protein in Brazil nut (Bertholletia excelsa H.B.K.). AB - An abundant seed protein, which is exceptionally rich in the sulfur-containing amino acids, methionine (18%) and cysteine (8%), is synthesized in Brazil nut embryos about 9 months after flowering. This sulfur-rich protein consists of two low-molecular-mass polypeptide components, a 9-kDa polypeptide and a 3-kDa polypeptide. The two-subunit polypeptides associate through disulfide linkage(s) to form a 12-kDa protein molecule. We have demonstrated through in vitro translation studies, using RNA from 9-month-old embryos, that the sulfur-rich protein is synthesized as a larger precursor polypeptide of 18 kDa. In addition, data from in vivo labelling studies of 9-month-old Brazil nuts suggest that there are two intermediate precursors of the sulfur-rich protein, one of 15 kDa and another of 12 kDa. One of these precursors, the 12-kDa polypeptide, accumulates for a 2-month period in the developing embryos. From these data we infer that at least three stepwise cleavages are involved in the maturation of the sulfur-rich protein from its 18-kDa precursor. PMID- 3830151 TI - Soybean hydrophobic protein. Isolation, partial characterization and the complete primary structure. AB - A 9000-Mr protein isolated from a 60% ethanolic extract of soybean (Glycine max) seeds has been characterized and fully sequenced. The protein consists of 80 amino acid residues with four disulfide bonds. It contains a large number of hydrophobic residues and lacks methionine, phenylalanine, tryptophan, lysine and histidine residues. The protein readily crystallizes from water but is quite soluble in aqueous organic solvents like 95% 1-propanol. It aggregates to form large molecules (above 80 kDa) under ordinary denaturing conditions, such as 6 M guanidine X HCl and 8 M urea. Sequence analysis showed that the amino-terminal four-fifths is extremely hydrophobic and most of the acidic residues exist as their amide forms, and only the carboxyl-terminal short segment is rather hydrophilic. A computer search for homology detected an unexpected similarity of this protein to rat prolactin; however, its significance could not be assessed and this protein appears to represent a hitherto unknown protein family. Although no biochemical activity could be detected, the existence in relatively high abundance (approx. 200 mg from 1 kg seeds) of this novel protein may suggest its physiological significance in the plant. PMID- 3830152 TI - The phosphoglycerate kinases from Trypanosoma brucei. A comparison of the glycosomal and the cytosolic isoenzymes and their sensitivity towards suramin. AB - Trypanosoma brucei has two phosphoglycerate kinase (PGK) isoenzymes, one is particle-bound and localized in glycosomes while the other is present in the cytosol. The cytosolic isoenzyme (cPGK) was 900-fold purified from cultured procyclic trypanosomes by hydrophobic interaction chromatography on phenyl Sepharose followed by affinity chromatography on 2',3'-ATP-Sepharose and had a specific activity of 275 units/mg protein. cPGK was compared with the purified glycosomal isoenzyme (gPGK) from bloodstream-form trypanosomes as well as with the commercially available PGKs from yeast, rabbit muscle and Spirulina platensis, a blue-green alga. Like all other PGKs, cPGK was a monomeric protein with a molecular mass of approximately 45 kDa similar to that of the PGKs from other organisms but 2 kDa smaller than that of gPGK. Despite this difference in length and a great difference in isoelectric point, the two trypanosome isoenzymes strongly resembled each other in several respects. The kinetic parameters did not differ significantly from each other or from the PGKs of other organisms. Both trypanosome enzymes resembled the enzyme from S. platensis in that they had an almost absolute requirement for ATP, contrary to the enzymes from yeast and rabbit muscle, which were capable of utilizing GTP and ITP also. This difference in substrate specificity may be related to the amino acid substitutions, Trp 308----His and Ala 306----Glu in the adenine-binding site, which are only found in the two Trypanosoma isoenzymes. Kinetic analysis showed that these substitutions do not prevent binding of the ATP analogues, but probably prevent phosphoryl-group transfer. Both isoenzymes displayed an activity optimum at pH 6.0-9.0 similar to that for the enzyme of yeast. Both gPGK and cPGK were inhibited by the trypanocidal drug Suramin. This inhibition could be described as competitive both with ATP and 3-phosphoglycerate with two inhibitor molecules binding to one molecule of enzyme. The gPGK, however, was much more sensitive (Ki app. = 8.0 microM) to Suramin than either the cPGK (Ki app. = 20 microM) or the enzymes from rabbit muscle (Ki app. = 55 microM), yeast (Ki app. = 167 microM) or S. platensis (Ki app. = 250 microM). It is suggested that positive charges on the enzyme's surface may play an important role in the potentiation of the binding of the negatively charged Suramin molecule. PMID- 3830153 TI - Glyceraldehyde-phosphate dehydrogenase from Trypanosoma brucei. Comparison of the glycosomal and cytosolic isoenzymes. AB - Trypanosoma brucei contains two glyceraldehyde-phosphate (GAPDH; EC 1.2.1.12) isoenzymes; one is located in glycosomes and represents 80% of the total activity, whereas the other is present in the cytosol. The purification of the cytosolic GAPDH, which is identical in both bloodstream-form and insect-stage trypanosomes, is described, and the enzyme compared with its glycosomal counterpart. Cytosolic GAPDH is specific for NAD. It is a tetrameric enzyme with subunits of 33.5 kDa, 5 kDa smaller than those of the glycosomal GAPDH. The native enzyme has a pI of 7.9, which is 1.5 pH units less basic than the glycosomal enzyme. Both enzymes display maximal activity at pH 8 but the cytosolic enzyme has a much broader activity profile especially towards lower pH values. Sequence comparison of the first 85 amino acids reveals that the N terminal parts of both isoenzymes differ by 52%. The N terminus of the cytosolic isoenzyme resembles the corresponding N termini of ten other known GAPDH sequences in that they all lack three amino-acid insertions, which so far only have been found in the glycosomal isoenzyme of T. brucei. This observation explains in part the great difference in subunit size between the two T. brucei isoenzymes and suggests that at least one of these insertions is responsible for import of the glycosomal isoenzyme into the organelle. PMID- 3830154 TI - Primary structure of the Streptomyces R61 extracellular DD-peptidase. 1. Cloning into Streptomyces lividans and nucleotide sequence of the gene. AB - An 11,450-base DNA fragment containing the gene for the extracellular active-site serine DD-peptidase of Streptomyces R61 was cloned in Streptomyces lividans using the high-copy-number plasmid pIJ702 as vector. Amplified expression of the excreted enzyme was observed. Producing clones were identified with the help of a specific antiserum directed against the pure DD-peptidase. The coding sequence of the gene was then located by hybridization with a specific nucleotide probe and sub-fragments were obtained from which the nucleotide sequence of the structural gene and the putative promoter and terminator regions were determined. The sequence suggests that the gene codes for a 406-amino-acid protein precursor. When compared with the excreted, mature DD-peptidase, this precursor possesses a cleavable 31-amino-acid N-terminal extension which has the characteristics of a signal peptide, and a cleavable 26-amino-acid C-terminal extension. On the basis of the data of Joris et al. (following paper in this journal), the open reading frame coding for the synthesis of the DD-peptidase was established. Comparison of the primary structure of the Streptomyces R61 DD-peptidase with those of several active-site serine beta-lactamases and penicillin-binding proteins of Escherichia coli shows homology in those sequences that comprise the active-site serine residue. When the comparison is broadened to the complete amino acid sequences, significant homology is observed only for the pair Streptomyces R61 DD peptidase/Escherichia coli ampC beta-lactamase (class C). Since the Streptomyces R61 DD-peptidase and beta-lactamases of class A have very similar three dimensional structures [Kelly et al. (1986) Science (Wash. DC) 231, 1429-1431; Samraoui et al. (1986) Nature (Lond.) 320, 378-380], it is concluded that these tertiary features are probably also shared by the beta-lactamases of class C, i.e. that the Streptomyces R61 DD-peptidase and the beta-lactamases of classes A and C are related in an evolutionary sense. PMID- 3830155 TI - The pH dependence of the active-site serine DD-peptidase of Streptomyces R61. AB - Titration of the active-site serine DD-peptidase of Streptomyces R61 shows that formation of acyl enzyme during hydrolysis of the substrate Ac2-L-Lys-D-Ala-D-Ala and enzyme inactivation by the beta-lactam compounds benzylpenicillin, N acetylampicillin and ampicillin relies on the acidic form of an enzyme's group of pK approximately equal to 9.5. It is proposed that protonation of a lysine epsilon-amino group facilitates initial binding by charge pairing with the free carboxylate of the substrate and the beta-lactam molecules. Lowering the pH from 7 to 5 has no effect on the second-order rate constant of enzyme acylation by benzylpenicillin and N-acetylampicillin but results in a decreased rate constant of acylation by ampicillin and Ac2-L-Lys-D-Ala-D-Ala. Protonation of the side chain amino group of ampicillin and a decreased efficacy of the initial binding of the peptide to the enzyme seem to be responsible for the observed effects. Whatever the molecule bound to the enzyme, there is no sign for the active involvement of an enzyme's histidine residue of pK 6.5-7.0 in the hydrolysis pathway. PMID- 3830156 TI - Purification and characterization of a serine hydroxymethyltransferase from an obligate methylotroph, Hyphomicrobium methylovorum GM2. AB - A serine hydroxymethyltransferase was purified to complete homogeneity from a serine-producing obligate methylotroph, Hyphomicrobium methylovorum GM2. The enzyme has a molecular mass of about 98 kDa and consists of two subunits of identical molecular mass. The holoenzyme exhibits absorption maxima at 280 nm, 340 nm and 415 nm in potassium phosphate buffer, pH 7.3, the last of which shifts with a change in pH (6.0-7.5) and contains 2 mol pyridoxal phosphate/mol enzyme. The holoenzyme is converted to the apoenzyme on incubation with phenylhydrazine and reconstituted on the addition of pyridoxal phosphate. The enzyme activity was inhibited on the addition of several sulfhydryl-modifying reagents and then recovered with 2-mercaptoethanol. One sulfhydryl group per subunit was found to be responsible for the activity. Isoelectric focusing showed that the enzyme has a pI of 5.6. The Km values for glycine, L-serine and DL-beta-phenylserine are 0.046 mM, 0.15 mM and 33 mM respectively. PMID- 3830158 TI - Localization of the phalloidin and nucleotide-binding sites on actin. AB - Phalloidin was found to block nucleotide exchange in F-actin, without interfering with nucleotide hydrolysis. This inhibition of nucleotide exchange occurs under conditions in which monomers are able to exchange. The distance separating a fluorescent chromophore attached to phalloidin from the nucleotide on actin was determined using fluorescence resonance energy-transfer spectroscopy. They are separated by less than 1.0 nm. Added confirmation of the close proximity of phalloidin to nucleotide was obtained by extracting a small peptide-ATP complex from an actin digest. The peptide comprises residues 114-118, which are from the same region as the residues that others have shown to crosslink to phalloidin [Vandekerckhove et al. (1985) EMBO J. 4, 2815-2818]. The results suggest that phalloidin has two major effects. It traps actin monomers in a conformation which appears to be distinct from G-actin and it stabilizes the structure of F-actin, an event accompanied by the trapping of ADP. PMID- 3830157 TI - Purification and characterization of rat liver glutaminase. AB - Phosphate-dependent glutaminase (EC 3.5.1.2) from livers of starved rats was purified about 400-fold to near homogeneity. The specific activity of the final pool was more than 30 U/mg protein. For the rapid quantification of the enzyme activity a simple and sensitive assay, based on the determination of the produced ammonia with an o-phthalaldehyde reagent, was developed which avoids massive dilution of the samples. The enzyme preparation involved extraction of the enzyme from sonified isolated mitochondria after treatment with a brief hypotonic shock followed by ammonium sulphate precipitation, ion-exchange and hydroxyapatite chromatography. A major improvement was the stabilization of the enzyme by chymostatin protecting it from degradation by a protease of presumably lysosomal origin. In the presence of chymostatin or leupeptin the half-life of glutaminase in a crude mitochondrial preparation subsequent to mild treatment with digitonin could be increased to more than 200 h. The relative molecular mass of the protein (Mr 170,500) was estimated by sucrose gradient ultracentrifugation. The molecular mass of the subunits (Mr 57,000) was determined by sodium dodecyl sulphate/polyacrylamide gel electrophoresis. These results suggest a protein composed of three subunits of identical molecular mass. The molecular data clearly differentiate liver glutaminase from the phosphate-dependent glutaminase present in kidney. PMID- 3830159 TI - Migration of O-acetyl groups in N,O-acetylneuraminic acids. AB - Highly purified N-acetyl-4-O-acetylneuraminic acid (Neu4,5Ac2), N-acetyl-7-O acetylneuraminic acid (Neu5,7Ac2) and N-acetyl-7,9-di-O-acetylneuraminic acid (Neu5,7,9Ac3) were used to study spontaneous migrations of acetyl groups between hydroxyl groups. The techniques applied involved thin-layer chromatography, gas liquid chromatography/mass spectrometry, high-performance liquid chromatography and 360-MHz 1H-NMR spectroscopy. It was found that at pH values at which no significant de-O-acetylation is observed: (a) Neu5,7Ac2 can easily be transformed into Neu5,9Ac2, (b) Neu5,7,9Ac3 yields an equilibrium of Neu5,7,9Ac3 and Neu5,8,9Ac3 in a molar ratio of approximately 1:1, and (c) Neu4,5Ac2 does not give rise to O-acetyl migrations. The importance of these findings is discussed in terms of the biosynthesis of O-acetylated sialic acids. PMID- 3830160 TI - Prostaglandin E1 binds to Z protein of rat liver. AB - Z protein or fatty-acid-binding protein is abundant in the cytosol of many cell types including liver cells. It is considered to play an important role in intracellular transport and metabolism of long-chain fatty acids and other organic anions. We studied the role of Z protein in the metabolism of prostaglandin E1 (PGE1). Binding of tritiated prostaglandin E1 to this fatty-acid binding protein (Z protein) purified from rat liver was determined. The binding of [3H]prostaglandin E1 to Z protein is rapid, saturable and reversible. Scatchard analysis of [3H]PGE1 binding to Z protein showed a single class of binding sites with a dissociation constant (Kd) of 37 nM. The binding capacity is 110 nmol/mg Z protein. Optimal [3H]PGE1 binding occurred at pH 7.4. The presence of 3 mM MgCl2 stimulated the prostaglandin E1 binding to Z protein. Competition experiments show that the binding of this autacoid to Z protein is highly specific. It could not be displaced by other prostaglandins (PGA1, PGA2, PGE2, PGB1, PGI2, PGD2, PGF2 alpha, and 6-keto PGF1 alpha). Z protein might be involved in the metabolism of prostaglandins in the cytosol. PMID- 3830161 TI - Phosphorylation of a 40S ribosomal subunit protein in Tetrahymena. Lack of correlation with cellular growth and ribosome stability. AB - In Tetrahymena the small ribosomal subunit protein S7, which appears to be the equivalent of S6 of higher eukaryotes, undergoes reversible phosphorylation under a set of defined conditions. In an attempt to understand the physiological role of such reversible phosphorylation, we examined the status of ribosomal protein S7 in growing cells and growth-arrested cells, starving either non-specifically for nutrients or specifically for a single essential amino acid. These experiments allowed us to dissociate S7 phosphorylation from changes in the translational activity and the stability of ribosomes. The results revealed complete lack of correlation between phosphorylation of S7 and both the growth status of the cells and the in vivo stability of ribosomes. Taken together with the observation that phosphorylation of S7 occurs only when the cells are starved in buffers containing sodium chloride or high concentrations of Tris, non essential ions for normal growth, our data suggest that this protein modification is required to maintain the functional integrity of the ribosomes in an altered electrostatic environment, induced by changes in the extracellular ionic conditions. PMID- 3830162 TI - Juvenile-hormone-binding protein from the hemolymph of Galleria mellonella (L). Isolation and characterization. AB - A juvenile-hormone-binding protein (JHBP) has been isolated from Galleria mellonella hemolymph by gel filtration, phosphocellulose chromatography, and by chromatofocusing. The isolated protein is homogeneous as judged by column chromatography and gel electrophoresis in the presence and absence of denaturing agent. It has a relative molecular mass of 32,000, Stokes radius 2.4 nm, sedimentation coefficient of 2.3 S, molar absorption coefficient at 280 nm epsilon = 2.34 X 10(4) M-1 cm-1, and is composed of a single polypeptide chain. Chromatofocusing analysis (pI 8.6) and isoelectric focusing (pI 8.1) indicate that the JHBP is an alkaline protein. Its amino acid composition and fluorescence absorption spectra indicate that the protein does not contain tryptophan residues. The protein exhibits one class of binding sites for juvenile hormone (JH), 0.8 per molecule, with the following dissociation constants: JH I, 8.5 X 10(-8) M; JH II, 7.2 X 10(-8) M; JH III, 47 X 10(-8) M. The JHBP binds (10R, 11S) JH II enantiomer with 2.3-times higher affinity then (10S, 11R)-JH II enantiomer. The pH optimum of binding is 7.0. PMID- 3830163 TI - Hysteretic behaviour of citrate synthase. Symmetry in the kinetics of the synthase partial reactions. AB - The description of hysteretic behaviour of citrate synthase is completed with the demonstration of a burst period in the citryl-CoA lyase reaction. The kinetics of this partial reaction show symmetry to those of the citryl-CoA hydrolase reaction. The amplitudes of the burst periods of each partial reaction are proportional to synthase activity. Using the synthase species proteolytically nicked by endoproteinase Lys-C, a standard was elaborated to determine the actual ratio of hydrolase over lyase reactions which was found to be 0.72:0.28. The ratio found with native synthase averaged 0.8:0.2. These and other results indicate that less oxaloacetate is liberated from the synthase than is actually generated in the lyase reaction of citryl-CoA. The temperature dependence of hysteretic behaviour of both partial reactions is consistent with the participation of citryl-CoA-derived physiological substrates in the generation of this behaviour. More hydrolytic products were formed at low than at high temperature. As shown with the proteolytically nicked synthase species indicated above, this effect is related to different temperature coefficients of the partial reactions. The apparent activation energies of the citryl-CoA hydrolase and lyase reactions, 26.7 kJ X mol-1 and 44.6 kJ X mol-1, respectively, were determined. The action of established synthase inhibitors on the expression of hysteretic behaviour is described and discussed. PMID- 3830164 TI - Nitrile hydratase of Pseudomonas chlororaphis B23. Purification and characterization. AB - Nitrile hydratase of Pseudomonas chlororaphis B23 was completely stabilized by the addition of 22 mM n-butyric acid. The enzyme was purified from extracts of methacrylamide-induced cells of P. chlororaphis B23 in eight steps. At the last step, the enzyme was crystallized by adding ammonium sulfate. The crystallized enzyme appeared to be homogeneous from analysis by polyacrylamide gel electrophoresis, analytical ultracentrifuge, and double diffusion in agarose. The enzyme has a molecular mass of about 100 kDa and consists of four subunits identical in molecular mass (approximately 25 kDa). The enzyme contained approximately 4 mol iron/mol enzyme. The concentrated solution of highly purified nitrile hydratase had a pronounced greyish green color and exhibited a broad absorption in visible range with a absorption maxima at 720 nm. A loss of enzyme activity occurred in parallel with the disappearance of the absorption in the visible range under a variety of conditions. The enzyme catalyzed stoichiometrically the hydration of nitrile to amide, and no formation of acid and ammonia were detected. The enzyme was active toward various aliphatic nitriles, particularly, nitriles with 3-6 carbon atoms, e.g. propionitrile, n butyronitrile, acrylonitrile and cyclopropyl cyanide, served as the most suitable substrates. PMID- 3830165 TI - A mutant beta-tubulin confers resistance to the action of benzimidazole-carbamate microtubule inhibitors both in vivo and in vitro. AB - The mutant BEN210 of Physarum polycephalum is highly resistant to a number of benzimidazole carbamate agents, including methylbenzimidazole-2-yl-carbamate and parbendazole. The resistance is conferred by the benD210 mutation in a structural gene for beta-tubulin. This mutant allele encodes a beta-tubulin with novel electrophoretic mobility. We have used this strain to determine whether the mutant beta-tubulin is used in microtubules and whether this usage permits microtubule polymerisation in the presence of drugs both in vivo and in vitro. In vitro assembly studies of tubulin purified from the mutant strain have shown that microtubules are formed both in the absence of drugs and in all drug concentrations tested (up to 50 microM parbendazole). In contrast, the assembly of microtubules from wild-type tubulin in vitro is totally inhibited by 2-5 microM parbendazole. Thus the resistance of BEN210 to parbendazole observed in vivo has been reproduced in vitro using tubulin purified from the mutant strain. Electrophoretic analysis of the microtubules formed in vitro has shown that both the wild-type and the mutant beta-tubulin are incorporated into the microtubules and that the proportion of mutant to wild-type beta-tubulin appears to remain constant with increasing drug concentration. This is the first demonstration of a single mutation in a tubulin structural gene causing an altered function of the gene product in vitro. PMID- 3830166 TI - The role of tropomyosin in the interactions of F-actin with caldesmon and actin binding protein (or filamin). AB - The interactions of actin filaments with actin-binding protein (filamin) and caldesmon under the influence of tropomyosin were studied in detail using falling ball viscometry, binding assay and electron microscopy. Caldesmon decreased the binding constant of filamin with F-actin. In contrast, the maximum binding ability of filamin to F-actin was decreased by tropomyosin. The filamin-induced gelation of actin filaments was inhibited by caldesmon. Tropomyosin also inhibited this gelation. The effect of caldesmon became stronger under the influence of tropomyosin. Furthermore, both caldesmon and tropomyosin additionally decreased the filamin binding to F-actin. From these results, caldesmon and tropomyosin appeared to influence filamin binding to F-actin with different modes of actin. In addition, there was no sign of direct interactions between filamin, caldesmon and tropomyosin as judged from gel filtration. Under the influence of caldesmon and tropomyosin, calmodulin conferred Ca2+ sensitivity on the filamin-induced gelation of actin filaments. PMID- 3830167 TI - Ca2+ phospholipid-dependent and independent phosphorylation of synthetic peptide substrates by protein kinase C. AB - Several synthetic peptides reproducing fragments of protamines have been used as model substrates for Ca2+/phospholipid-dependent protein kinase C, tested both in the absence of any effector (basal conditions) and upon activation by either Ca2+ and phosphatidylserine (or diacylglycerol) or limited proteolysis. Only the peptide Arg4-Tyr-Gly-Ser-Arg6-Tyr [Ga(52-65)] shares the unique property of protamines of being readily phosphorylated even under basal conditions. Optimal activity in the absence of effectors is observed with Tris/HCl buffer pH 7.5; Pipes and Hepes are less effective at pH 7.5, and at pH 6.5 basal phosphorylation is reduced. Under the best conditions for basal phosphorylation of Ga(52-65), its derivative with ornithine replaced for arginine and those corresponding to its C terminal fragments Gly-Ser-Arg6-Tyr [Ga(57-65)] and Gly-Ser-Arg3 [Ga(57-61)], as well as the peptides Pro-Arg5-Ser2-Arg-Pro-Val-Arg [Th(1-12)], Arg4-Tyr-Arg2-Ser Thr-Val-Ala [Th(13-23)] and Arg2-Leu-Ser2-Leu-Arg-Ala are not significantly affected though all of them, like histones, are more or less readily phosphorylated upon activation of protein kinase C by Ca2+/phosphatidylserine. The peptide Ser2-Arg-Pro-Val-Arg [Th(7-12)] however, corresponding to the C terminal part of Th(1-12), is not phosphorylated even in the presence of activators. Limited proteolysis can roughly mimic the Ca2+/phosphatidylserine effect inducing however different extents of activation depending on the nature of the peptide substrates. Our results support the following two conclusions. Basal phosphorylation by protein kinase C in the absence of any effector requires peptide substrates whose target residue(s) are included between two extended arginyl blocks and is also dependent on pH and nature of the buffer. Peptides having extended clusters of either arginyl or ornithyl residues on the C-terminal side of serine are also readily phosphorylated, but they need activation of protein kinase by either Ca2+/phosphatidylserine or limited proteolysis. The same is true of peptides having basic residues only on the N-terminal side, or even on both sides but in limited number. PMID- 3830168 TI - Studies on the chemical structure of the core-lipid A region of the lipopolysaccharide of Acinetobacter calcoaceticus NCTC 10305. Detection of a new 2-octulosonic acid interlinking the core oligosaccharide and lipid A component. AB - Lipopolysaccharide of Acinetobacter calcoaceticus NCTC 10305 was treated with acid (0.1 M HCl, 100 degrees C, 1 h). The product obtained (LPSdegr) was subjected to various modification and degradation procedures including reduction, hydrazinolysis and strong acid hydrolysis. Methylation analysis of purified part structures revealed the presence of a 4'-phosphorylated (beta 1'-6)-linked D glucosamine disaccharide (lipid A backbone), which carried in position 6' a hitherto unknown 2-octulosonic acid (OclA) in highly acid-stable linkage. It was further shown that OclA is substituted in position 5 by a glucose tetramer, the reducing residue of which is phosphorylated. The hydrophilic region of the LPSdegr could thus be characterized as a phosphorylated heptasaccharide of the following structure: (Formula: see text). PMID- 3830169 TI - Receptors for fucose-binding proteins of Lotus tetragonolobus isolated from mouse embryonal carcinoma cells. Structural characteristics of the poly(N acetyllactosamine)-type glycan. AB - Receptors for fucose-binding proteins of Lotus tetragonolobus were isolated from N4-1 and F9 embryonal carcinoma cells. They were glycoproteins, whose major components had apparent relative molecular masses of more than 100,000. Carbohydrates released from the receptors of N4-1 cells by hydrazinolysis were separated into three fractions by gel filtration. Binding activity to the lectin was detected in the high-molecular-mass fraction. The composition of the large glycan was characteristic of the poly (N-acetyllactosamine)-type, and glucosamine was identified as the sugar involved in the protein-carbohydrate linkage. The glycan has one fucosyl residue per four N-acetyllactosamine units. Most of the fucose was linked to the C-3 hydroxyl group of N-acetylglucosamine. No Fuc alpha 1----2Gal or Fuc alpha 1----4GlcNAc linkage was detected. The glycan had a relative molecular mass of 9000 or more and the poly(N-acetyllactosamine) units were branched. N-Acetylgalactosamine residues were detected in non-reducing ends of at least a part of the glycan. Therefore, the glycan has a more complex structure than the related one from human granulocytes, although both of them have Fuc alpha 1----3GlcNAc termini. PMID- 3830170 TI - Molecular cloning and expression of rat aldolase C messenger RNA during development and hepatocarcinogenesis. AB - A rat brain cDNA library was screened at low stringency with an aldolase B cDNA probe corresponding to the coding sequence of the mRNA, then at high stringency with a 3' non-coding aldolase A cDNA probe. One clone, which hybridized only under the first conditions, was further characterized and used to screen the library again. Two overlapping clones, complementary to aldolase C mRNA, were obtained. They cover the 113 carboxy-terminal coding residues and the 3' non coding region up to the poly(A) tail. Their nucleotide sequence was determined. In the coding region the overall homology with aldolase A was 67% at the nucleotide level and 76% at the protein level. With aldolase B these values were 63% and 65% respectively. The 3' non-coding region was 380 bases long and did not exhibit any homology with the untranslated 3' extension of aldolase A and B mRNAs. Southern blot analysis indicates that probably a single aldolase C gene exists per haploid genome. Aldolase C mRNA was detected at low concentration in practically all the foetal tissues and its expression markedly and rapidly decreased after birth. In brain the concentration of aldolase C mRNA remained high and stable even after birth. Aldolase C mRNA is approximately 50-fold more abundant in brain than in foetal tissues, which are the richest in messenger RNA. In the course of azo-dye hepatocarcinogenesis the aldolase C gene is re-expressed early, with a maximum at the 4th week of carcinogenic diet, which probably corresponds to the maximal proliferation of the oval cells. PMID- 3830171 TI - Regulation of ribosomal protein S6 phosphorylation in heat-shocked HeLa cells. AB - Decreases in energy charge, ribosomal protein phosphorylation and rate of protein synthesis are well-documented facets of the cellular response to hyperthermia in non-vertebrates. We have tried to reproduce this response pattern in 32P-labelled HeLa cells in order to investigate the hypothetical causal relationship between these effects. In HeLa cells shifted from 36 degrees C to 42 degrees C, dephosphorylation of S6 and inhibition of protein synthesis, owing to a decreased initiation rate, were observed, but could not have been mediated by changes in the cells' general energy charge since the ATP and GTP levels were not reduced. In addition, we found that the hyperthermic translation block developed faster than the overall dephosphorylation of S6, showing that S6 dephosphorylation cannot be responsible for the translation block unless site-specific effects play a critical role. PMID- 3830172 TI - Are highly phosphorylated 40-S subunits preferentially utilized during protein synthesis in a cell-free system from HeLa cells? AB - It has been concluded from circumstantial evidence obtained with HeLa cells in vivo that the phosphorylation of ribosomal protein S6 increases the affinity of 40S particles for mRNP [Duncan, R. and McConkey, E. H. (1982) Eur. J. Biochem. 123, 535-538; Thomas, G., Martin-Perez, J., Siegmann, M. and Otto, A.M. (1982) Cell 30, 235-242]. This conclusion needs to be tested in vitro in a reinitiating cell-free translation system from growth-competent cells. We have prepared such a system from HeLa cells and have compared the capacity of homologous 40S subunits of various degrees of phosphorylation to enter the existing polysome pool. The 40S subunits' degree of phosphorylation was manipulated by exposing aliquots of growth-stimulated HeLa cells to hyperthermia (see accompanying paper). 40S subunits from heat-shocked and control cells, despite differences in S6 phosphorylation level as verified by two-dimensional electrophoresis, did not differ with respect to their recruitment into the existing polysome fraction. Owing to the reinitiation activity of the translation system, assay times could be kept sufficiently short, to avoid any serious interference by the S6 phosphatase activities of the system. Our results suggest that increased S6 phosphorylation by itself is not sufficient to accelerate the participation of 40S subunits in protein synthesis. PMID- 3830173 TI - Starvation-induced alterations of ribosomal protein phosphorylation in Bombyx mori L. Evidence for different phosphorylation kinetics in free and membrane bound ribosomes. AB - In the posterior silk gland of Bombyx mori, ribosomal protein S1, homologous to S6 in mammals, is partially phosphorylated in a normally fed animal. Before the first meal of the fifth larval instar, S1 is completely dephosphorylated. Likewise, starvation induces rapid dephosphorylation of the protein in both free and membrane-bound ribosomes. Upon refeeding after 48 h of starvation, S1 becomes phosphorylated again, first on membrane-bound ribosomes, then on free ribosomes, with a lag time of about 3 h. Following 48 h of refeeding, the most highly phosphorylated form of S1 predominates in both populations of ribosomes. These variations in phosphorylation are correlated with the level of protein synthesis in the posterior silk gland, 70% of the ribosomes occurring in polysomes upon feeding and only 30% upon starvation [Prudhomme, J.-C. & Couble, P. (1979) Biochimie (Paris) 61, 215-227]. After in vivo 32P labelling, the phosphopeptides of S1 from free and membrane-bound ribosomes were found to be identical and phosphoserine (only) was found in each S1. These results suggest the involvement of S1 phosphorylation in the regulation of protein synthesis at the translational level and the existence of at least two different pathways controlling this phosphorylation: one for the free ribosomes, the other for the membrane-bound ribosomes. PMID- 3830174 TI - Relationship between the two immunologically distinguishable forms of glucocerebrosidase in tissue extracts. AB - Extracts of human spleen contain two immunologically distinguishable forms of glucocerebrosidase: form I is precipitable by polyclonal or monoclonal anti (placental glucocerebrosidase) antibodies, whereas form II is not [Aerts, J. M. F. G., Donker-Koopman, W. E., Van der Vliet, M. F. K., Jonsson, L. M. V., Ginns, E. I., Murray, G. J., Barranger, J. A., Tager, J. M. & Schram, A. W. (1985) Eur. J. Biochem. 150, 565-574]. The proportion of form II glucocerebrosidase was high in extracts of spleen, liver and kidney and low in extracts of brain, placenta and fibroblasts. Furthermore, the proportion of form II enzyme was higher in a detergent-free aqueous extract of spleen than in a Triton X-100 extract of total spleen or splenic membranes. When form II glucocerebrosidase in a splenic extract was separated from form I enzyme by immunoaffinity chromatography and stored at 4 degrees C, a gradual conversion to form I enzyme occurred. The conversion was almost immediate if 30% (v/v) ethylene glycol was present. In the denatured state both forms of glucocerebrosidase reacted with anti-(placental glucocerebrosidase) antibodies. Form I glucocerebrosidase was stimulated by sodium taurocholate or sphingolipid-activator protein 2 (SAP-2), whereas form II enzyme exhibited maximal activity in the absence of the effectors. The pH activity profile of form II glucocerebrosidase was almost identical to that of form I enzyme in the presence of SAP-2. In the native state, form I glucocerebrosidase had a molecular mass of 60 kDa whereas that of form II glucocerebrosidase was about 200 kDa. After gel-permeation high-performance liquid chromatography of splenic extracts, the fractions with form II glucocerebrosidase contained material cross-reacting with both anti-(placental glucocerebrosidase) and anti-(SAP-2) antibodies. Preincubation of form I glucocerebrosidase with SAP-2 at pH 4.5 led to masking of the epitope on glucocerebrosidase reacting with monoclonal anti-(placental glucocerebrosidase) antibody 2C7. Furthermore, preincubation of form I glucocerebrosidase with monoclonal antibody 2C7 prevented activation of the enzyme by SAP-2. We propose that form I glucocerebrosidase is a monomeric form of the enzyme, whereas form II glucocerebrosidase is a high-Mr complex of the enzyme in association with sphingolipid-activator protein 2. PMID- 3830175 TI - Hysteretic behaviour of citrate synthase. The reaction mechanism and the exclusion of synthase being a hysteretic enzyme. AB - The non-Michaelis-Menten kinetics, burst and steady-state periods, expressed by citrate synthase in the presence of citryl-CoA, were investigated by labelling experiments with trace amounts of [14C]acetyl-CoA. The results indicate that citrate becomes labelled in the reaction of liberated acetyl-CoA with the binary synthase.oxaloacetate complex that is transiently generated in the lyase reaction of citryl-CoA. Mediated by the hydrolase function of synthase, the counteracting citryl-CoA lyase and ligase reactions operate towards a transient flow equilibrium. This precedes the thermodynamic equilibrium and is established during the burst period; it is maintained under steady-state conditions and corresponds to the formation of transiently nonproductive synthase. The rates of both synthase partial reactions, therefore, are likewise affected. Oxaloacetate in the presence of acetyl-CoA competitively inhibits the hydrolysis of citryl-CoA and vice versa. In the synthase dependence of the burst periods and during the time dependence of the steady-state periods, nonproportionally more of physiological substrates participate in citrate formation. The nonproportional increase is a consequence of the continuously changing conditions to establish or to maintain the flow equilibrium, respectively, during the reaction progress. Third rate periods after the steady state result if the equilibrium conditions cannot be satisfied. High concentrations of oxaloacetate inhibit the expression of non-Michaelis-Menten kinetics by formation of nonproductive synthase.oxaloacetate complex. The supply of acetyl-CoA is then sufficient and the formation of the flow equilibrium prevented. The implication of the results with structural work is discussed. PMID- 3830176 TI - Enzymes and microemulsions. Activity and kinetic properties of liver alcohol dehydrogenase in ionic water-in-oil microemulsions. AB - The activity and the kinetic properties of horse liver alcohol dehydrogenase have been studied in water-in-oil microemulsions containing sodium dodecyl sulfate (SDS) or hexadecyl trimethylammonium bromide (CTAB), 1-butanol or 1-pentanol or 1 hexanol or t-butanol, water and cyclohexane alone or with octane. In the anionic microemulsions (i.e. containing sodium dodecyl sulfate), the enzyme quickly lost its activity, but was efficiently protected by the coenzyme and some adenine nucleotides. In the cationic microemulsions (i.e. containing hexadecyl trimethylammonium bromide), the enzyme activity was more stable and with higher alcohols was stable for at least 20 min. The Michaelis constant of NAD+ calculated with respect to the water content was nearly constant and higher than in water. The maximum velocity in anionic microemulsions depends on the water content whereas in cationic microemulsions, the maximum velocity did not show a clear dependence on the water content and was close to the maximum velocity found in water. The pH dependence of Km and Vmax in these microemulsions was similar to that observed in water. The kinetic data for a hydrophobic substrate, cinnamyl alcohol, showed that this alcohol partitions between the pseudo-phases and thus the apparent Michaelis constant and the concentration at which substrate-excess inhibition appeared were increased. The catalytic properties of the enzyme in microemulsions were illustrated by the preparative reduction of cinnamaldehyde with cofactor recycling. The rate determination of NAD+ reduction and of 1 butanol/cinnamaldehyde redox reaction showed that at low water content (2.8%), the NAD+ reduction rate was close to zero whereas the redox reaction rate was about half of the rate at higher water content. Probably at low water content the coenzyme binding-dissociation rates are reduced much more than the binding dissociation rates of the substrates and the rates of the ternary complex interconversion. The cationic microemulsions seemed to be very favorable medium for enzyme activity, the tetraalkyl ammonium surfactant causing less denaturation than the anionic detergent dodecyl sulfate. PMID- 3830177 TI - Kinetics and regulation of 25-hydroxycholecalciferol 1 alpha-hydroxylase from cells isolated from human term decidua. AB - Kinetics and regulation of 25-hydroxycholecalciferol 1 alpha-hydroxylase from cells isolated from term human decidua were studied. The production of 1 alpha,25 dihydroxycholecalciferol (calcitriol) was linear with time for up to 6 h and was directly proportional to the number of cells up to 20 X 10(6)/dish at a substrate concentration of 100 nM. Under these conditions the apparent Km was 88 nM and the Vmax 3.0 pmol/10(6) cells. The production of [3H]calcitriol was inhibited by 0.1 nM (P less than 0.01) and 1 nM (P less than 0.005) unlabeled calcitriol. Unlike the kidney enzyme and for reasons that remain unclear, neither inorganic phosphate salts nor parathyroid hormone had any acute effect on the calcitriol production. Further studies are required to delineate the regulatory mechanism of this enzyme. PMID- 3830178 TI - Monoclonal antibodies against an intracellular phospholipase A2 from rat liver and their cross-reactivity with other phospholipases A2. AB - The membrane-associated phospholipase A2 from rat liver mitochondria was solubilized and partially purified by AcA 54 gel filtration and Matrex gel blue A chromatography. The approximately 2500-fold purified preparation was injected into mice to prepare monoclonal antibodies against phospholipase A2 after fusion of spleen cells and mouse SP2/0 myeloma cells. Hybridoma supernatants were assayed for antibody production in enzyme-linked immunosorbent assay with partially purified phospholipase A2 as antigen. Positive clones were tested for their ability to bind phospholipase A2 in a specific immunoprecipitation assay involving protein-A--Sepharose to which rabbit anti-(mouse immunoglobulins) and monoclonal antibodies from hybridoma supernatants were complexed. Twelve clones producing antibodies that bound mitochondrial phospholipase A2 were identified. The binding of all of these antibodies to protein fractions eluted from AcA 54 and Matrex gel blue A columns coincided with the phospholipase A2 activity in these fractions. All monoclonal antibodies showed cross-reactivity with rat liver cytosolic and solubilized rat platelet phospholipase A2. Extracellular phospholipase A2 from rat and pig pancreas or Crotalus atrox were not recognized by the anti-(mitochondrial phospholipase A2) antibodies. PMID- 3830179 TI - Regulation of hepatic glucokinase gene expression. Role of carbohydrates, and glucocorticoid and thyroid hormones. AB - The present study investigates the effect of thyroid and glucocorticoid hormones on the induction of hepatic glucokinase mRNA activity, enzyme synthesis and activity in starved/refed adrenalectomized, thyroidectomized and intact rats. In intact rats glucose refeeding resulted within 2 h in a more than tenfold increase in the functional messenger, followed by a corresponding increase in glucokinase synthesis and, a little later, in enzyme activity. Glucokinase mRNA and synthesis remained elevated at this level for about further 6 h. Then the mRNA activity and enzyme synthesis declined considerably to a new steady state (a factor of about 4 above the starvation level) within a further 8 h, while enzyme activity remained constantly elevated. The half-life of glucokinase mRNA, as determined after administration of cordycepin, was identical during the different refeeding periods. Thus the overshoot phenomenon, provoked by carbohydrate refeeding, in glucokinase mRNA is not explained by alteration of the glucokinase mRNA decay rates. In thyroidectomized or adrenalectomized rats, glucose refeeding resulted in only a small increase in glucokinase mRNA, synthesis and activity. Application of thyroid hormones in thyroidectomized rats, refed a carbohydrate-rich diet, enhanced the specific mRNA considerably within 8-10 h, while it took 20-24 h to enhance glucokinase mRNA by glucocorticoids in adrenalectomized rats refed a carbohydrate-rich diet. The decay in translatable glucokinase mRNA, as determined after administration of cordycepin, was identical in the hypothyroid and euthyroid fed state, while adrenalectomy resulted in a significant decrease in the specific mRNA half-life. We conclude that refeeding a carbohydrate-rich diet rapidly stimulates glucokinase mRNA regeneration showing overshoot kinetics. 3,3',5-Triiodothyronine in its physiological concentration significantly enhances the response in glucokinase mRNA at the nuclear level, while glucocorticoids in their physiological concentration predominantly stabilize the translatable glucokinase mRNA. PMID- 3830180 TI - Biosynthesis of major platelet proteins in human blood platelets. AB - We studied de novo protein biosynthesis in platelets of normal adult donors and in newly formed platelets isolated from splenectomized patients with idiopathic thrombocytopenic purpura (ITP). After metabolic labelling of platelet proteins, performed with different radiolabelled amino acids or carbohydrates, a tenfold increase in incorporation of radioactivity into trichloroacetic-acid-precipitable material was obtained with ITP platelets compared to control platelets. Electron microscopic studies of ITP platelets revealed the presence of rough endoplasmic reticulum and polyribosomes, providing morphological evidence for protein synthesis. SDS-PAGE of radiolabelled ITP platelet proteins followed by autoradiography showed that [35S]methionine and [3H]leucine were incorporated into almost all Coomassie-blue-stained proteins whereas [3H]carbohydrates only labelled a few bands. Using crossed-immunoelectrophoresis we identified some of the labelled platelet compounds and demonstrated that major membrane glycoproteins (GPIb, IIb, IIIa) and alpha-granule proteins, such as fibrinogen, thrombospondin, albumin and von Willebrand factor, were synthesized in newly formed circulating platelets. PMID- 3830181 TI - Energy dependence of autophagic protein degradation in isolated rat hepatocytes. AB - The effect of small changes in intracellular ATP on autophagic flux was studied in isolated rat hepatocytes by using inhibitors of ATP production or by varying the metabolic conditions. The following observations were made. There was a linear relationship between endogenous protein degradation and intracellular ATP, the rate of proteolysis declining with decreasing ATP concentrations. 15% of the maximal proteolysis is either independent of ATP or has a very high affinity for this metabolite. There was a linear relationship between the autophagic sequestration of cytosolic [14C]sucrose and intracellular ATP, the sequestration rate decreasing with decreasing ATP concentrations. ATP depletion did not cause release of [14C]sucrose previously sequestered in autophagosomes and lysosomes at high ATP levels. Intracellular accumulation of chloroquine, used as an indicator of the pH inside lysosomes and other acidic cell compartments, diminished with decreasing cellular ATP content. Amino acids inhibited proteolysis without affecting ATP levels or chloroquine accumulation. We conclude from the high sensitivity of autophagy towards relatively small changes in the concentration of intracellular ATP that, besides amino acids, ATP is a very important factor in controlling the rate of autophagy in rat hepatocytes. PMID- 3830182 TI - Structural investigation of Klebsiella serotype K10 capsular polysaccharide. AB - The primary structure of Klebsiella serotype K10 capsular polysaccharide has been investigated using mainly the techniques of methylation, partial hydrolysis, and 1H and 13C NMR spectroscopy. The polysaccharide was found to consist of hexasaccharide repeating units having the following structure: (formula; see text) PMID- 3830183 TI - Cell-cycle-dependent expression of DNA primase activity. AB - Protein extracts were prepared at various times after serum stimulation of growth arrested mouse 3T3 fibroblasts. The extracts were fractionated by sucrose gradient centrifugation and used to determine the activities of DNA polymerase alpha and DNA primase. We found that polymerase and primase appeared in close association in one homogeneous 8.2-S peak. Neither polymerase, free of associated primase, nor primase, free of polymerase, could be detected at any time after serum stimulation. The activities of both enzymes started to increase concomitantly at the beginning of the DNA replication phase of the cell cycle. We found five to six times more DNA primase activity in replicating than in resting 3T3 cells. Besides DNA primase, a second additional priming activity could be detected. This activity sedimented at 12.5 S and corresponded most probably to RNA polymerase I. PMID- 3830184 TI - The interaction between biologically inactive tRNA conformers and leucyl-tRNA synthetase from rabbit liver. AB - The interaction between tRNA conformers inactive in aminoacylation and leucyl tRNA synthetase has been investigated. Heat inactivation of the enzyme in the presence of inactive tRNA conformers is shown to lead to a marked increase of inactivation rate while active tRNA conformers, on the other hand, reveal a protecting effect. To study the properties of the enzyme complexed with different tRNA conformers limited proteolysis has been used. Active tRNA conformers are found to protect leucyl-tRNA synthetase against hydrolysis while inactive ones tend to intensify it. Inactive tRNA conformers are also shown to inhibit the aminoacylation of native tRNA in vitro. On the basis of these data biologically inactive conformers of animal tRNA are assumed to form an unproductive complex with leucyl-tRNA synthetase and the structure of the enzyme involved in such interaction is supposed to be more labile and 'extended' than that in complex with active tRNA conformers. PMID- 3830185 TI - Changes in H1 complement in differentiating rat-brain cortical neurons. AB - Neuronal nuclei have a low H1 content. A stoichiometry of 0.47 molecule/nucleosome, on average, is calculated for rat brain cortical neurons by comparing its H1 content with that of liver nuclei. The H1 fraction of rat cerebral cortex neurons has been resolved into five subtypes, H1a--e, that have the same mobility as the unphosphorylated H1 forms of other rat tissues. The subtypes H1a--d decay exponentially during postnatal development and are substituted to different extents by H1e. The higher replacement rate is shown by H1a with an apparent half-lifetime of about 5 days. The corresponding values for H1b, H1c and H1d are 11, 21 and 15 days. Several conclusions can be drawn from the observation of postnatal changes in H1 subtype proportions. The low H1 content of neuronal nuclei does not imply the presence of notable peculiarities in subtype composition or in subtype substitution pattern. There is turnover of H1 in differentiating neurons once cell proliferation and DNA replication have ceased. The relative rates of synthesis and/or degradation of the subtypes differ in germinal cells and in neurons. Comparison with previous results on H1 degrees accumulation also shows that in cortical neurons the regulation of the subtypes H1a--e differs from that of H1 degrees. PMID- 3830186 TI - Monoclonal antibodies against chicken brain acetylcholinesterase. Their use in immunopurification and immunochemistry to demonstrate allelic variants of the enzyme. AB - Acetylcholinesterase (AChE) from 1-day chicken brain was enriched over 2000-fold by affinity chromatography using N-methylacridinium-Sepharose. This preparation was used to prepare monoclonal antibodies (mAb) directed against AChE, of which two were extensively characterised for further application. Both mAbs bound to the enzyme from the chicken with high affinity (Kd approximately 8 X 10(-10) M) and one mAb, in addition, recognised AChE from quail brain and muscle. Neither mAb cross-reacted with mammalian or fish AChE. Both mAbs recognised AChE in the endplate region of adult chicken skeletal muscle and bound with equal affinity to the three major oligomeric forms found in early ambryonic muscle. One mAb was used to immunopurify chicken brain AChE to homogeneity (over 12000-fold enrichment), with nearly complete recovery of the enzyme and without detectable proteolytic breakdown. The other mAb recognised AChE after immunoblotting and was used to screen crude brain extracts from individual chickens for allelic variations. Evidence is presented to show that two allelic forms occur, represented in SDS-PAGE by a doublet polypeptide of Mr approximately 110,000, this pattern is maintained after deglycosylation of the N-linked oligosaccharides. This variation was found throughout development and in both the brain and the muscle of individuals. We conclude that the gene encoding the catalytic subunit of chicken AChE is polymorphic with either one or two equally active alleles being expressed. PMID- 3830187 TI - Quantification of recalcification of irradiated vertebral body osteolyses by dual energy computed tomography. AB - In 12 patients with osteolyses of the spine, the change of the vertebral mineral content after radiotherapy was quantified by Dual-Energy Computed Tomography (CT). In 11 of the patients, recalcification of radiated vertebral body metastases could already be detected at the completion of a 4 week course of radiotherapy. However, the amount of recalcification varied considerably between the patients. The methodological approach is described and the different reactions of the vertebral body osteolyses to radiotherapy are discussed. PMID- 3830188 TI - The subcarinal space revisited on a frontal chest radiography. An evaluation in subcarinal mass detection. AB - Subcarinal space lucency is visible on a routine frontal chest high kvp radiography because of a double density gradient (vertical and horizontal). Results obtained in the first part of the study concerning 300 normal subjects show that the vertical density gradient is visible in 83% of cases, the horizontal gradient in 93% and both gradients in 76%. The right internal bronchial stripe (RIBS) is inconstant and visible on the three segments of the right bronchial tree in only 31% of cases. Results obtained in the second part of the study concerning 30 cases of subcarinal pathology grant a good detecting value for subcarinal mass to the inversion of the vertical gradient and the disappearance of both gradients. PMID- 3830189 TI - Magnetic resonance imaging of cardiac anatomy. A standard procedure. AB - A standard procedure was developed allowing study of cardiac anatomy with electrocardiographically gated MRI, using alteration of a single gradient angle of the imaging plane combined with patient rotation. This resulted in projections of the heart through its anatomical axes. The obtained images allow correlation with 2D-echocardiography and left ventriculography. PMID- 3830190 TI - CT diagnosis of hepatic adenoma. AB - Only few publication have so far been known on case histories in the context of CT-findings of hepatic adenoma (HA). An analysis was, therefore, made of the findings of ten patients with HA. Precontrast and postcontrast scans (dynamic CT), densitometric evaluations (gamma-fit) and "profile" determination were taken into consideration. Diagnostic relevance is attributed to two types of features (with and without tumour haemorrhage) as well as to complementary findings (capsule-like structure and fat-ring around the tumour, island-like areas). PMID- 3830192 TI - A new puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery. AB - Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guidewire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced. PMID- 3830191 TI - NMR follow-up studies of CNS-tumors in infancy and childhood. AB - Sixteen children with brain tumors, fifteen of which were located in the posterior cranial fossa, were followed-up postoperatively with NMR. Four recurrences of medulloblastoma and one recurrence of an ependymoma were found. Three children showed signs of known therapeutic sequelae such as hygroma, atrophy and dilatation of the subarachnoid space. Previously unreported, boundary layer lesions were found in 8 children. The etiology of these lesions and their differentiation from tumor recurrence are discussed. PMID- 3830193 TI - MRI of facial skeleton and parapharyngeal space. AB - The diagnostic value of magnetic resonance imaging is examined in relation to computed tomography on the basis of 66 patients, who had pathological processes in the midfacial and nasopharyngeal space. The high power of contrast resolution in imaging soft tissue masses and the direct multiplanar capability of magnetic resonance offer advantages over computed tomography in respect of space occupying lesions in the median and lower parts of the craniofacial skull. Lymph nodes of more than 1 cm. in diameter were detected by both modalities. A disadvantage is the poorer detectability of tumour conditioned bone destruction at the base of the skull. In such cases, computed tomography remains the method of choice. PMID- 3830194 TI - Diagnostic approach to pulmonary lymphangioleiomyomatosis. Case report. AB - A diagnosis of lymphangioleiomyomatosis is to be considered in women with pleural chylous effusion when plain chest films show diffuse interstitial changes, possibly associated with cystic-like spaces and overinflation. The CT, showing the presence of a retroperitoneal mass, can ultimately help to outline the diagnosis of this syndrome as in the personal case observed in a postmenopausal woman. A presumptive pre-surgical biopsy diagnosis can be useful for studies of hormone-receptors and may be clinically relevant. PMID- 3830195 TI - Vascular ring in annular pancreas associated with rare variant of celiac trunk. Case report. AB - A 12-year-old patient with annular pancreas (AP) is presented. The AP was diagnosed preoperatively by angiography which not only clearly demonstrated a vascular ring around the duodenum, but also revealed an extremely rare upper abdominal vascular anatomy. PMID- 3830196 TI - A case of minute gastric cancer preoperatively diagnosed. AB - A case of minute gastric cancer which was preoperatively diagnosed, measuring 3 X 3 mm in diameter is reported. The X-ray examination revealed a faint barium collection surrounded by the mucosal folds. The endoscopic findings showed a small ulcerated lesion with a reddish and irregular margin and convergent folds. Radiological characteristics of the minute gastric cancer and its diagnostic approach are discussed. PMID- 3830197 TI - Rupture of the spleen by penetration of pancreatic pseudocysts. AB - 2 patients with known chronic recurrent pancreatitis and proven pancreatic pseudocysts in the tail of the pancreas developed a pseudocystic invasion of the spleen followed by tryptic erosion of it. This complication, previously seldom reported, occurred twice in one year, the diagnosis being achieved by CT. PMID- 3830198 TI - Abnormal nephrogram pattern as an adverse reaction to contrast material. Case report. AB - Up to now two abnormal nephrographic patterns have been described as a result of arterial hypotension as an adverse response to urographic contrast material. We would like to describe a third pattern. PMID- 3830199 TI - Intraarterial low-dose streptokinase infusion in the treatment of acute renal thromboembolism. AB - A case of acute renal thromboembolism treated by intraarterial low dose streptokinase infusion is reported. The treatment appears effective, safe and less-invasive then surgery, with quick relief of pain and normalisation of blood pressure and renal function. It is concluded that intraarterial infusion of thrombolytic agents should be attempted first in the treatment of renal arterial thrombo-embolism. PMID- 3830200 TI - Evaluation of left ventricular volumes measured by magnetic resonance imaging. AB - Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared with those measured simultaneously by a classical physiological indicator dilution technique. There was good agreement between cardiac output as measured by MRI and the indicator dilution method, when the multislice technique was used (r = 0.87, p less than 0.001). A poor correlation between the two methods was seen when the single slice technique was used (r = 0.06, p greater than 0.80). The results indicate that MRI is a reliable method for left ventricular volume determination when the multislice technique is used. PMID- 3830201 TI - Aortic valve orifice equation independent of valvular flow intervals: application to aortic valve area computation in aortic stenosis and comparison with the Gorlin formula. AB - An orifice equation is derived relating the effective aortic valve area, A, the average aortic valve pressure gradient, dP, the stroke volume, SV, and the heart frequency, FH, through considerations of momentum conservation across the aortic valve. This leads to a formula consistent with Newton's second law of motion. The form of the new equation is A = (7.5 X 10(-5)) SV FH2/Pd, where A, VS, FH and Pd are expressed in cm2, ml, s-1 and mmHg, respectively. Aortic valve areas computed with the new orifice equation are found to correlate with those computed by the Gorlin formula in conditions of resting haemodynamic states at a level of r = 0.86, SE = 0.25 cm2, N = 120. The results suggest that the new formula may be considered as an independent orifice equation having a similar domain of validity as the Gorlin formula. The new equation offers the possibility of deriving additional useful haemodynamic relationships through combination with established cardiological formulas and applying it in a noninvasive Doppler ultrasonic or echocardiographic context. PMID- 3830202 TI - Inotropic and vasodilating properties of amrinone depend on the mode of administration. AB - Intravenous infusion of amrinone at increasing rates (10-100 micrograms kg-1 min 1, N = 8) caused dose dependent decreases in left ventricular filling pressure (up to 22%, P less than 0.05) and cardiac output (up to 16%, P less than 0.05), but had no effect on heart rate, max LVdP/dt or total systemic vascular resistance in anaesthetized open-chest pigs. Despite unchanged total systemic vascular resistance, tissue vascular resistance decreased significantly in the heart, stomach, adrenals and kidneys. Although transmural left ventricular perfusion was not influenced by amrinone, coronary blood flow was redistributed in favour of the epicardium, as endo-epi blood flow ratio decreased from 0.95 +/- 0.03 to 0.82 +/- 0.03 (P less than 0.05). In the same model an intravenous bolus of 1 mg kg-1, followed by a continuous infusion of 50 micrograms kg-1 min-1 (N = 8), caused immediate changes (P less than 0.05) in left ventricular filling pressure (-35%), max LVdP/dt (+55%), heart rate (+15%) and total systemic vascular resistance (-15%). The changes in filling pressure and systemic vascular resistance persisted during the next 25 minutes, but maxLVdP/dt returned gradually to baseline in spite of increasing plasma concentrations of the drug. In the conscious pig (N = 4), administration of a 1 mg kg-1 bolus in the pulmonary artery led to similar increases in heart rate (15%) and max LVdP/dt (26%), while systolic left ventricular pressure was not affected. Direct infusion into the left anterior descending coronary artery (10-40 micrograms kg-1 min-1, N = 5) had negligible effects on overall haemodynamics and regional myocardial function. The only significant changes were a vasodilation in the coronary vascular bed accompanied by dose dependent increases in the coronary venous O2 content. From our study it appears that a bolus injection, as given in the clinical setting, is required to elicit an increase in max LVdP/dt and arterial vasodilation but that the effect on left ventricular preload is not sensitive to different modes of administration. PMID- 3830203 TI - Hydatid cyst of the interventricular septum causing obstruction of the right ventricular outflow tract: cross-sectional echocardiographic, angiographic and pathological findings. AB - Cardiac echinococcal cysts rarely involve the interventricular septum; when they do, they cause symptoms mainly related to the compression of the atrio ventricular conduction pathways. Mild obstruction of the right ventricular outflow tract has also been described in some cases. In the case reported here, an unusual large hydatid cyst located in the interventricular septum produced a marked, symptomatic obstruction of the right ventricular outflow tract (more than 100 mmHg gradient). Surgical resection of the cyst was complicated by a 'stone heart' syndrome, probably because of a severely affected right ventricle. Cross sectional echocardiography gave the exact site and aetiology of the mass. On the basis of these non-invasive findings, early surgery should be performed on asymptomatic patients to reduce the risk of life-threatening evolutions. PMID- 3830204 TI - Right atrial thrombosis in two premature infants: successful treatment with urokinase and heparin. AB - Vascular thrombosis is a harmful and rather frequent event in sick premature infants. Only recently has intracardiac thrombosis been described in preterm babies and virtually all the surviving cases are those treated surgically. We report the cases of two premature infants with intra-atrial thrombosis detected by cross-sectional echocardiography and successfully treated with heparin and urokinase for 12 and 16 days, respectively. Our patients required larger doses of urokinase over a longer period of time than are required at older ages to obtain thrombolysis. Our data suggest that fibrinolytic therapy may be an alternative to surgery in premature babies with right atrial thrombosis and that cross-sectional echocardiography is very useful in the titration of the therapy in order to achieve consistent dissolution of the thrombus. PMID- 3830205 TI - Vasodilator effect of amrinone in the pulmonary and systemic circulation. PMID- 3830206 TI - Cardiovascular reflexes in Parkinson's disease. AB - The autonomic nervous system (ANS) function of patients with Parkinson's disease (PD) was investigated in 30 patients with PD, and in 21 healthy subjects of similar age by utilizing cardiovascular reflex measurements as indicators. In deep breathing, in the Valsalva manoeuvre, and in the tilting test the heart rate variability (R-R variation) differed significantly between the patients and the controls: the beat-to-beat variation was clearly decreased in patients with PD. Responses in diastolic pressure to isometric work were also clearly diminished. However, no significant differences in any measured ANS indices were found between the patients who were treated with levodopa and those who were not. Similarly, anticholinergics did not seem to affect the results. PMID- 3830208 TI - Spindle and EEG sleep alterations in subjects affected by cortical cerebellar atrophy. AB - All-night polygraphic records (EEG, EOG and ECG) were performed on 9 subjects. Four of them were affected by Familiar Cerebellar Atrophy (FCA) whereas the others were their blood relatives without clinical signs of cerebellar deficit. In the former FCA was diagnosed clinically and the cerebellar atrophy was confirmed by computer tomography (CT). In all the latter except one who showed slight cerebellar atrophy, the CTs were negative. The EEG sleep records of the FCA patients were characterized by slowly changing phases between synchronized and desynchronized sleep, instability of the synchronized sleep with frequent modifications of EEG activity, subnormal measurement of both REM and slow-wave sleep and presence of spindles in REM sleep (only in 2 patients). The spindle activity was reduced in two FCA subjects. The electroencephalographic sleep records of two BRs, one of which with small cerebellar atrophy, showed qualitative and quantitative alterations similar to those of FCA patients, even if marked to a lesser degree. Increased spindle densities were present in the same BRs who showed sleep abnormalities. The EEG alterations observed in the two BR subjects could show small cerebellar injuries which would be insufficient to induce clinical signs. PMID- 3830207 TI - Long-term treatment of epilepsy: open multicenter trial with progabide in epileptic patients. AB - A long-term open multicenter trial was carried out in 15 European centers with therapy-resistant epileptics to evaluate the efficacy and safety of progabide, a new antiepileptic GABA receptor agonist; 187 patients, suffering from partial epilepsy (57%), primary generalized epilepsy (20%), secondary generalized epilepsy (21%), and unclassified generalized epilepsy (2%), participated in the study. All patients had a total seizure frequency higher than one per month in spite of standard antiepileptic medication; 46% had a mean partial seizure frequency from daily to weekly. Progabide was administered at a mean daily dose of 30.5 mg/kg/day as an add-on to the standard antiepileptic drugs up to one year in 115 patients; 37 patients (19.8%) dropped out because of reasons which were not drug-related (bad compliance, lost to follow-up); in 12 patients (6.5%) progabide was withdrawn for side effects and in 20 (10.7%) for lack of efficacy. 71.3% of patients treated for one year (62% considering the 'cumulative' number of patients) experienced more than a 50% reduction in seizure frequency. This reduction was equally present in patients with partial epilepsy (63.9%) and with generalized epilepsy (62.2% of patients with primary and 57.1% with secondary generalized epilepsy). No signs of tolerance phenomena to the antiepileptic effect of progabide were observed. No side effects were reported in 56.7% of the patients. Clinical side effects were mild and transient, leading to progabide discontinuation in 6.5% of the patients only; an increase in SGPT was observed in 5.7% of the patients, these increases were transient and without any clinical symptom.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830209 TI - Lateral gaze disturbance in a case of Wallenberg's syndrome. AB - A 63-year-old Caucasian man was admitted for Wallenberg's syndrome following a left vertebral artery thrombosis. In addition to the classical symptoms, an axial lateropulsion to the left and ocular motor disorders (vertical diplopia, tonic deviation of the gaze to the left, skew deviation and horizonto-rotatory nystagmus) were present. These clinical signs are unusual, but in common Wallenberg's syndrome, neurophysiological tests often reveal slight abnormalities of oculomotor function: impairment of jerks, skew deviation, lateral deviation of the gaze in darkness. Interruption of cerebellar pathways is thought to be the cause of these symptoms. Their existence does not seem to change the outcome of these cases. PMID- 3830210 TI - Long-term follow-up EEG studies in patients with traumatic apallic syndrome. AB - The report deals with the changes of brain functions in the course of traumatic apallic syndrome (TAS) by means of the EEG examination, in the classical way, and by computer analysis as well. The development of EEG changes during individual stages of the TAS is studied. The EEG examination was performed repeatedly in 35 patients from the first days up to several years after injury. As for EEG findings as a possible prognostic index, the authors find that a gradual increase of frequency from delta to theta and alpha zones can be considered a favourable prognostic. PMID- 3830211 TI - Stroke: cardiovascular risk factors and the quantitative effects of dietary treatment on them. AB - A quantitative analysis of the cardiovascular risk factors in 101 stroke patients and their reduction by dietary treatment is given. From the risk factors a risk index was calculated. It was reduced from an average 4.9 at admission to 1.4 at discharge. The most frequent risk factors at admission (high triglycerides, high blood pressure and a high LDL/HDL ratio) are probably caused by 'normal' alcohol consumption and overweight. All patients were disused from smoking and alcohol. Under a low-caloric diet all risk factors were reduced within one month. Most diabetic patients became independent of drug treatment: A treatment of type II diabetes mellitus with oral antidiabetic drugs could be avoided even in the elderly patients by a low caloric diet without alcohol. On average there was a 4.8 mg% decrease of fasting triglycerides and a 5.7 mg% decrease of total cholesterol per 1% Broca Index reduction. HDL was increased in all patients despite withdrawal of alcohol, and the HDL/LDL ratio was significantly improved by the diet. There was a significant blood pressure reduction in the whole group; in addition there was a weight-related reduction in the hypertensive patients only: the systolic blood pressure was reduced by 9.3 mm Hg for each 10% Broca Index decrease. The atherogenic and hypertensive potencies of 'normal' alcohol consumption and sulfonylurea treatment are emphasized. PMID- 3830212 TI - Response to monoclonal antibodies in melanoma: specific or non-specific? PMID- 3830213 TI - Should lymphomas of gastrointestinal tract be treated differently from other disease presentations? PMID- 3830214 TI - A clinical and pharmacokinetic phase I study of 1,2,4-triglycidylurazol (TGU, NSC 332488). AB - Twenty-six patients with advanced malignancies received TGU given as an intravenous (i.v.) bolus in physiological saline at 3 weekly intervals. The starting dose was 30 mg/m2 with standard graded escalations to 900 mg/m2. Myelosuppression occurred at 800 mg/m2, with a mean nadir of 2.0 +/- 0.8 X 10(9)/l and a mean nadir platelet count of 41 +/- 31 X 10(9)/l. At 800 or 900 mg/m2 nausea and vomiting was WHO grade 0 in 5, grade I in 6, grade II in 11 and grade III in 10 courses of therapy. Alopecia did not occur. TGU was given by i.v. infusion at 800 mg/m2 in 2 patients, both of whom developed severe thrombophlebitis. Five patients given TGU by i.v. bolus developed mild phlebitis. No renal, hepatic or cardiac toxicity was noted. Two patients had partial responses; both had adenocarcinoma of unknown primary origin, one of whom had been resistant to prior therapy with FAM. An HPLC analytical method was developed with a sensitivity of 250 ng/ml. The data from 7 patients studied best fit a one compartment pharmacokinetic model with an exponential decay and a t1/2 of only 2.1 min. In conclusion, the dose limiting toxicity of TGU appears to be myelosuppression and we would recommend a dose of 800 mg/m2 given as an intravenous bolus every 4 weeks for future phase II trials. PMID- 3830215 TI - Correlation between prolactin receptors (PRL R), estradiol (ER) and progesterone receptors (PgR) in human breast cancer. AB - Free (n = 432) and total (n = 387) prolactin receptors (PRL R) (after 3 M MgC12 desaturation) as well as estradiol (ER) and progesterone receptors (PgR) were measured in 547 breast cancer patients surgically treated in the Oscar Lambret Centre. Free PRL-R were found in 43% of the cases, total PRL R in 72%, ER in 81% and PgR in 55%. A statistically significant correlation was found by the Spearman test between ER on the one hand free PRL R (P less than 0.02) and total PRL R (P less than 0.001) on the other and between PgR on the one hand, free PRL-R (P less than 0.05) and total PRL R (P less than 0.01) on the other. A linear correlation test could be done on subgroups of values, excluding zero values, of each of the receptor type; a statistically significant correlation could be found between ER and total PRL R (P less than 0.001) and between PgR and total PRL R (P less than 0.05). These results confirm, on a large series, the relation between PRL R, ER and PgR in breast cancer. PMID- 3830216 TI - Serum and tissue copper content in two mammary adenocarcinomas with different biological behaviour. AB - We have determined serum copper levels in BALB/c female mice subcutaneously inoculated with two related mammary adenocarcinoma tumors. Serum copper content increased progressively with tumor size in animals bearing either variant, and reached levels up to four times those of control mice. In contrast, copper levels detected by cytochemistry in tumor cells are higher in the slow growing tumor variant. It is suggested that the stronger angiogenic effect previously described for this variant could be related to its higher cellular copper content. PMID- 3830217 TI - The influence of inosine on adriamycin-induced cardiomyopathy in rats. AB - The effect of inosine on adriamycin-induced cardiomyopathy was studied. Total adriamycin (ADR) dose of 25 mg/kg i.p. injected in 15 equal partial doses 3 times a week for five following weeks evoked fully developed cardiomyopathy in rats. Inosine 200 mg/kg i.p. injected 5 times a week parallel to ADR diminished ADR cardiotoxicity evaluated by electrocardiographic recordings and histopathological examination. Moreover lower cytostatic toxicity was observed as judged by less expressed leucopenia and lower SGOT activities in inosine treated animals. PMID- 3830218 TI - Localized ovarian cancer: surgery plus chemotherapy. AB - Fifty-four patients were referred to Medical Oncology after operation for "limited" ovarian cancer; 7 were excluded because immediate restaging showed evidence of macroscopic spread to structures outside the true pelvis, and 10 will be considered separately because of microscopic spread shown only by cytology. Thirty-seven patients (31 stage I and 6 stage II) were accordingly accepted as "localized", because peritoneal cytology and diaphragm and omental plus parietal peritoneum histology could rule out the spread to the large abdominal cavity. Some of the referred patients had been operated in nearby hospitals; the Padua GYN Cin. performed 14 of the 37 first surgery operations and 30 of the 37 second look operations. All patients soon after surgery underwent first-line chemotherapy with 5 courses of high dose adriamycin plus cyclophosphamide for 4 months, then surgical second look, and second-line non-cross-resistant chemotherapy for 3 months. During the second look the organ and tissue removal was completed in those 21 patients having received "limited" first surgery. Two patients died within 5 years from admission, so that the overall 5 year actuarial survival from referral is 93% for the entire group with 11 patients still at risk; 87% are disease free 5 years after the second look with 7 at risk. Subdivision of the patients according to "adequate" vs. "limited" first surgery, may select a group (the "adequate" one, composed of 16 patients) completely free from relapses, up to now. The complex therapeutic program described seems to offer long term relapse-free survival to the majority of patients, while the few failures seem closely related with inadequacies of the initial surgical procedure. PMID- 3830219 TI - Aminoglutethimide in the treatment of premenopausal patients with metastatic breast cancer. AB - Eighteen premenopausal patients with progressive metastatic breast cancer were treated with aminoglutethimide (AG)/cortisone. All patients received 1000 mg AG per day in combination with 2 X 25 mg cortisone acetate. Complete (CR) and partial remissions (PR) were achieved in 27.8%, a no change (NC) in 16.7% and progressive disease (PD) in 55.5% of all cases. The clinical results show that AG/cortisone acetate is effective in the therapy of premenopausal as well as postmenopausal patients with metastatic breast cancer. One hormone receptor negative tumour completely responded. Contrary to postmenopausal patients whose low oestradiol levels continuously decrease, oestradiol levels in premenopausal patients were not influenced by treatment. A distinct suppression of the ovarian activity does not occur. Thus concluding, a mechanism--at least partially different from those in the postmenopause and not necessarily of endocrine nature -must exist in the premenopause. We, therefore, no longer think it justified to assert that the therapeutic effect of AG is merely based on medical adrenalectomy. PMID- 3830220 TI - Estrogen production and metabolism in normal postmenopausal women and postmenopausal women with breast or endometrial cancer. AB - The metabolic clearance rates of estradiol in postmenopausal women with breast cancer (1269 +/- 370 1/24 hr, mean +/- S.D.) or endometrial cancer (1320 +/- 238 1/24 hr) were significantly higher than in normal postmenopausal women (922 +/- 238 1/24 hr). The metabolic clearance rates of estrone were elevated in women with endometrial cancer (2012 +/- 749 1/24 hr) or with conditions associated with an increased risk for breast or endometrial cancer (1830 +/- 413 1/24 hr) compared with values for normal postmenopausal women (1321 +/- 301 1/24 hr). The production rate of estradiol was only increased in women with breast cancer. Significant correlations were found between subjects' percentage of ideal body wt and the metabolic clearance rates of estrone and estradiol and also the production rate of estrone. The increased clearance rates may reflect differences in either the binding of estrogens to plasma proteins or the tissue metabolism of estrogens in cancer patients. PMID- 3830221 TI - Recombinant leukocyte A interferon and cimetidine treatment in disseminated melanoma. PMID- 3830222 TI - The necessary restructuring of special and regular education. PMID- 3830223 TI - Microcomputer use within micro-educational environments. PMID- 3830224 TI - How various forms of data affect teacher analysis of student performance. PMID- 3830225 TI - Does categorical teacher certification benefit the mildly handicapped child? PMID- 3830226 TI - Children's responses to retarded peers as a function of social behaviors, labeling, and age. PMID- 3830227 TI - Parents' perceptions of schooling for severely handicapped children: home and family variables. PMID- 3830228 TI - Interdisciplinary team training: a national survey of special education teacher training programs. PMID- 3830229 TI - From referral to placement: teachers' perceptions of their responsibilities. PMID- 3830230 TI - Hematopoiesis and aging. V. A decline in hematocrit occurs in all aging female B6D2F1 mice. AB - Longitudinal studies of hematocrits were done in aging B6D2F1 female mice at 54, 64, 91, 105 and 115 weeks of age. A modest decline in hematocrit was observed in 41/42 mice; we have previously shown that the decreased hematocrit of aged as compared to young mice is due to an expansion of plasma volume. Mice which died spontaneously after 91 weeks had lower hematocrits at 91 weeks and 105 weeks than did those which survived to 115 weeks. At each time interval, a sub-group of mice was killed and uptake of 59Fe into blood, foreleg, spleen and liver was studied and total nucleated cells per humerus was determined. The results were generally compatible with the thesis that aging mice maintain normal rates of erythropoiesis under basal conditions. Thus, it would appear that a decrease in hematocrit can be considered an expected part of the aging process in this mouse. PMID- 3830231 TI - Adult age differences in cross-modal recoding and mental tempo, and older adults' utilization of compensatory task conditions. AB - Free recall performance of younger and older adults was examined in three modes of presentation: visually presented sentences, auditorily presented sentences, and bimodally (visually + auditorily) presented sentences. For all modes, the sentences were presented at slow or fast rates. The main result was a three-way interaction between age, mode, and rate. The younger adults performed at the same level in all three modes at a slow rate of presentation, and at a higher level in the bimodal task than in the unimodal tasks at a fast rate of presentation. The elderly, on the other hand, performed at the highest level in the bimodal task regardless of rate of presentation. In addition, the younger adults outperformed the elderly in all mode by rate combinations; however, attenuated age differences in recall were observed for the bimodally presented sentences at a slow presentation rate. It is suggested that the adult aging process is associated with deficits in cross-modal recoding and rate of processing. Finally, the capability of older adults to utilize compensatory task conditions is discussed. PMID- 3830232 TI - Adult age differences in memory: effects of distinctive and common encodings. AB - To clarify the role of encoding distinctiveness and encoding cue utilization in age-related memory differences, young and elderly adults were instructed either to generate distinctive or common adjectives for 40 nouns and given 3 study recall trials for the nouns, both with no cues and with the adjectives that they had generated as cues. Their retention was compared with that of a control group that had rated the nouns for abstractness. Elderly adults were as likely as young adults to generate distinctive adjectives, but were less likely than young adults to generate common adjectives when instructed to do so. In both age groups, common adjective encodings produced superior free recall and distinctive adjective encodings produced superior cued recall. The results suggest that (1) elderly adults are as capable as young adults of generating distinctive encoding context cues when instructed to do so, and (2) age-related encoding differences occur in the processing of distinctive properties of the stimulus items themselves rather than in the utilization of cues generated during study. PMID- 3830233 TI - Age-related differences in recognition memory for pictures. AB - This study provided a normative data base for the Continuous Recognition Memory Test and also investigated age-related differences in recognition memory for pictures in a sample of 299 normal subjects (age range 10-89). Data analysis revealed that older subjects consistently set a lower response criterion (Cx), resulting in a significantly higher number of within-class false alarms. Older subjects also displayed significantly lower sensitivity (d'). Changes in sensitivity were attributed to both an increase in false alarms and a concurrent decrease in hits in subjects over 65. Analysis of the likelihood ratio (beta) revealed no significant change across age groups. PMID- 3830234 TI - Age and gender as factors in facial recognition and identification. AB - The present study was designed to test adult age differences in the recognition and identification of faces. Young and old women were shown slides of faces paired with common first names. Their task was to associate the names and faces for a subsequent recognition test. On the test, subjects were shown a larger set of faces and they were asked to indicate which of the faces had been presented earlier. For those faces judged to be familiar, subjects were asked to select, from two alternatives, the name which was originally paired with the face. It was hypothesized that people would remember faces most like their own and, as predicted, young subjects tended to make fewer errors with young faces and old subjects tended to make fewer errors with old faces. PMID- 3830235 TI - Assessing the predictive validity of psychomotor tests as measures of biological age in mice. AB - Two experiments assessed the predictive validity of a psychomotor test battery in male C57BL/6J mice. First, performance was recorded for 66 mice in rotorod, tightrope, grip strength, exploratory activity, and runwheel activity tasks at 24 mo of age. Except in the rotorod task, performance was positively and significantly correlated to lifespan, i.e. better performance indicated longer lifespan. Body weight and body temperature were also significantly correlated with lifespan, while water consumption was negatively related. Using the five behavioral scores in a multiple regression analysis, about 40% of the variance in lifespan was explainable. When measures of body weight, body temperature, and water consumption were added to the regression equation, about 54% of the variance in lifespan could be explained. As revealed by factor analysis, a high degree of interrelationship existed among variables. In a second experiment, 54 mice were tested in the psychomotor battery every 8 weeks from 24 mo. Scores in the tightrope and both locomotor activity tasks revealed age-related declines, whether considering all individuals or only those surviving to 28 mo. Significant correlations between first and subsequent scores indicated stability of individual differences for tightrope and exploratory activity at most ages and for runwheel activity at 26 mo but not later. Rotorod and grip strength scores were not stable and suggested confounding by learning. Significant correlations with lifespan were obtained at some ages for all tests. In contrast to the first experiment, however, there were no significant correlations between lifespan and scores at 24-mo for any test and little correlation among scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830236 TI - Short term lead exposure, age and food deprivation: interactive effects on wheel running behavior of adult male mice. AB - In three separate experiments, young-adult (75 days old) intermediate-age (220 days old), or older (365 days old) Binghamton Heterogeneous Stock (HET) male mice were maintained on food and either water or a 0.5% lead-acetate drinking solution for only three weeks prior to placement in cages with attached running wheels. Mice were kept on their assigned sources of fluid while in these wheeled cages for six days. On Days 3 and 4 of their 6-day access to the running wheels all mice were deprived of food, but the appropriate drinking fluid remained available continually. Even with this relatively low level of dietary lead exposure, which occurred only during adulthood and immediately prior to (and continued during) the 6-day measurement period, the 48-hour food deprivation challenge differentially altered the wheel running of lead-exposed and control mice; but those effects were apparently altered by the age of the adult mice used in each of the three experiments. These data are discussed in terms of the potency of environmental challenges in revealing behavioral changes related to age and even short-term exposure to environmental/dietary toxicants during adulthood. PMID- 3830237 TI - Age and openness to experience in autobiographical memory. AB - Adult age and openness to experience were examined as predictors of autobiographical memory in a group of men and women ranging from 25 to 85 years of age. The remoteness of autobiographical memories retrieved in response to prompt words was more dependent on the age of the respondent than on his or her tendency to be receptive to new experiences as measured by Costa and McCrae's (1978) Experience Inventory. Older adults were more past-oriented in their recollections than younger adults, and experientially-open individuals regardless of age recalled more events from their recent pasts than from their distant pasts. Number of memories recalled, while not related to age, was positively associated with experiential openness. PMID- 3830238 TI - A social and clinical evaluation of centenarians. AB - A social and clinical evaluation was performed on thirty Kentucky centenarians. The majority of the subjects were women (19/30), white (27/30), either widows or widowers (26/30), and lived in long term care facilities (15/30). Only one of thirty had ever smoked cigarettes and there was an absence of excessive alcohol use. Medication use varied from 0 to 9 medications. Digitalis, diuretics, and anti-inflammatory medications were common (12; 16; 15 respectively) while major and minor tranquilizers were less frequently used (7 and 4). Hypertension was present in 48%. Although rarely functionally significant, clinically evident cardiac disease was present in 38%. Ninety-three percent lacked vibratory sensation at the ankles while ankle jerks were absent in 82%. Functionally significant diminished vision and hearing were frequent (40% and 60% respectively). Functional assessment demonstrated moderate to nearly complete independence in 57%, while the remaining 43% were significantly to nearly totally dependent on others. The primary conclusion is that for all they have in common, centenarians remain unique individuals with a tremendous variability among themselves. PMID- 3830239 TI - Epidemiology of adverse drug reactions in intensive care units. A multicentre prospective survey. Italian Group on Intensive Care Evaluation (IGICE). AB - Clinically relevant events possibly attributable to drug exposure have been monitored prospectively over a period of six months in 27 general intensive care units. Fifty-four events attributed to drugs were reported in 51 patients during their stay in hospital, corresponding to an overall incidence of 1.35%. The behaviour of the physicians following attribution of the events to a prescribed drug is analyzed and discussed in detail with respect to its relationship to the quality and severity of the reaction, and the classes of drugs. Twenty-four of the 4537 monitored admissions during the six months were due to life-threatening emergencies linked to the administration of drugs (14) and radio-contrast media (10) (overall incidence 0.5%). While the clinical burden attributable to adverse drug reactions in Intensive Care Units appears to be relatively small, the analysis shows that there is ample room for a greater reduction in their incidence. PMID- 3830240 TI - Effects of FCE20700, a new PGE2 derivative, on gastric acid secretion and cytoprotective processes in man. AB - The pharmacodynamic effects of FCE20700, a new PGE2 derivative, have been investigated in 6 healthy volunteers given single intragastric (i.g.) and intraduodenal (i.d.) doses of 1 and 2 mg and placebo, according to a double blind, within-subjects design. For 30-270 min following i.g. administration the effect of FCE20700 on peptone-stimulated gastric acid secretion (AS) was assessed by i.g. titration, and serum gastrin (G) levels were also determined. For the same period after i.d. dosing the effect of the compound on pentagastrin stimulated AS and on mucoproteins and bicarbonate content in the gastric juice was measured. Blood pressure (BP), heart rate and possible side-effects were monitored. Following i.g. administration there was a moderate, dose-related, significant inhibition of AS; significant inhibition of G levels was observed only after the highest dose. After i.d. administration there was a very modest though dose-related and significant inhibition of AS; a brief maximal increase in mucoproteins and in bicarbonate levels was apparent after the 1 mg dose. After i.d. but not after i.g. administration of 2 mg there was a modest but significant decrease in BP. No side-effects of clinical relevance were reported. The results appear to suggest a major activity of FCE20700 on cytoprotection rather than in inhibiting gastric acid secretion. The observed change in BP may indicate that after i.d. administration there will be some systemic effects of FCE20700. PMID- 3830241 TI - Uncorrected pre-ejection period: a simple non-invasive measurement for pharmacodynamic screening of inotropic activity. AB - Since heart rate (HR) is an important determinant of the duration of systole, systolic time intervals (STI) from 8 healthy subjects were examined after infusion of atropine. As no overall correlation was found between HR and pre ejection period (PEP), the results confirm the need for individual estimates of the correction of the left ventricular ejection time (LVET) and the total electromechanical systole (OS2). In the same subjects the sensitivity of PEP to minor negative inotropic effects of mexiletine and disopyramide measured at Cmax was confirmed. Thus, in addition to its simplicity and reliability, the sensitivity of the uncorrected PEP should encourage use of this technique as part of any screening system for the early detection of an inotropic effect of new chemical entities. PMID- 3830242 TI - Pharmacokinetic interactions between felodipine and metoprolol. AB - This double-blind, cross-over study in healthy male subjects evaluated the pharmacokinetics of felodipine and metoprolol given both separately and in combination. During three, five-day study periods, felodipine 10 mg b.d., metoprolol 100 mg b.d. and a combination of the two, were given in random order. There was at least a 7-day washout period between each pharmacokinetic study day. Plasma levels of unchanged felodipine and metoprolol were measured for 24 h after the last dose, on the 5th day of each treatment period. Eight subjects, aged 19 22 years, completed the study. Both felodipine and metoprolol, given alone and in combination, were well tolerated. None of the felodipine pharmacokinetic variables (tmax, Cmax, Cmin, AUC (0-12) and t1/2) changed significantly when felodipine and metoprolol were given in combination. Cmax and AUC (0-12) for metoprolol increased significantly when metoprolol and felodipine were combined, although tmax, Cmin and t1/2 for metoprolol remained unchanged. The changes in metoprolol pharmacokinetics induced by felodipine are small and unlikely to be clinically important. PMID- 3830243 TI - Kinetics of cotinine after oral and intravenous administration to man. AB - Cotinine, the main metabolite of nicotine, was administered intravenously to healthy male non-smoking volunteers in doses of 5, 10 and 20 mg, and orally in doses of 10 and 20 mg. Intravenous administration was characterized by a dose independent half-life of 12.2 h, mean residence time of 15.9 h, total clearance of 3.64 l h-1 and a volume of distribution of 56.5 l. Renal clearance was 0.46 l h-1 and approximately 12.0% of the dose was excreted unchanged in the urine. The mean absorption time after oral dosing ranged between 1 and 3 h, the peak concentration was reached within 45 min and the mean elimination half-lives were 12.9 and 11.7 h, respectively, after the 10 and 20 mg doses. Systemic bioavailability ranged between 0.84 and 1.11 following 10 mg and between 0.97 and 1.03 following the 20 mg dose. Mean urinary recovery and renal clearance were almost identical with the values after iv administration. PMID- 3830244 TI - Pharmacokinetics of ciprofloxacin tablets in renal failure; influence of haemodialysis. AB - The pharmacokinetics of ciprofloxacin has been studied after a single oral dose of 500 mg given to 5 normal subjects (N) and to 15 patients grouped according to their residual renal creatinine clearance: Group I, 8-30 ml X min-1, Group II, less than 8 ml X min-1, and Group III, haemodialysed patients studied twice- during an interdialysis period (IIIa) and in a 4 h haemodialysis session (IIIb). Ciprofloxacin was assayed by reverse phase HPLC using a spectrofluorimetric detection. The peak plasma concentration (2-5 mg X l-1) was reached within 2 h after drug administration. Apparent volume of distribution, 6.6 (N), 5.0 (I), 2.7 (II) and 4.2 (IIIa) l X kg-1 and total plasma clearance, 770 (N), 440 (I), 378 (II) and 314 (IIIa) ml X min-1 were decreased in relation to the degree of renal impairment. Mean plasma half-lives for patients in the 4 groups were 7.3 (N), 10.4 (I), 7.2 (II) and 9.3 (IIIa) h. In groups N, I and II, 40, 16 and 8% of the administered dose was eliminated through the kidney, with mean renal clearances of 305 +/- 63, 61 +/- 21 and 21 +/- 3 ml X min-1. A linear relationship was found between the renal clearance of ciprofloxacin and the glomerular filtration rate (r = 0.75, n = 15). Ciprofloxacin was partly removed by haemodialysis (IIIb): the dialyser extraction ratio was 23% and the dialysis clearance was 40 ml X min-1. PMID- 3830246 TI - Skeletal muscle binding and renal excretion of digoxin in man. AB - Ten healthy subjects were treated with three or four different doses of digoxin, 0.25 to 0.88 mg daily, in random order. Digoxin concentrations in serum (SDC) and skeletal muscle (SMDC) were determined as well as its renal clearance after 2 weeks of treatment with each dose. The mean ratio SMDC/SDC decreased non significantly by about 20% from 33 +/- 15 at the lowest SDC interval (0.5-0.9 nmol/l) to 28 +/- 7 at the highest concentration interval (2.0-2.4 nmol/l). This is in accordance with findings from previous studies. No significant change was observed in the renal clearance of digoxin with increasing digoxin concentration, supporting the concept of first-order renal elimination of digoxin. PMID- 3830245 TI - The effects of obesity and exercise on the pharmacokinetics of caffeine in lean and obese volunteers. AB - The effects of obesity, exercise, and the interaction of obesity and exercise were examined in 6 caffeine naive, untrained, nonsmoking, college males (3 lean (LV), 3 obese (OV]. Each subject received caffeine (oral, 5.83 mg X kg-1 lean body weight) or placebo (50 mg citrate) prior to 3 h of seated rest and prior to 90 min of treadmill walking (40% of their maximal aerobic power) followed by 90 min of seated recovery. Serum samples were collected at various times and analyzed for caffeine by HPLC. Pharmacokinetic analysis indicated that at rest, OV had a significantly higher absorption rate constant (Ka 0.0757 vs. 0.0397 min 1), lower elimination rate constant (Ke 0.0027 vs. 0.0045 min-1), and longer serum half-life (t1/2 4.37 vs. 2.59 h) in comparison to LV. In exercise, as well as at rest LV and OV had a large difference in the volume of distribution (43.2 vs. 101.1) (rest, 54.1 vs. 103.1). Exercise consistently resulted in a decrease in the maximal serum concentration of caffeine and the area under the curve in OV while having no consistent effect on LV. The interactive effects of obesity and exercise could not be dissociated. However, these results demonstrate that both obesity and exercise have modified the pharmacokinetics of caffeine. PMID- 3830247 TI - Pharmacogenetic differences in the inhibitory effect of cimetidine on the metabolism of antipyrine. AB - The relationship between acetylator phenotype and the inhibitory effect of cimetidine on the hepatic metabolism of antipyrine has been studied in 20 subjects. Cimetidine, 1,0 g/day resulted in a significant decrease in the metabolic clearance rate of antipyrine, but only in slow acetylators, as fast acetylators were less affected. No sex difference was observed. No major change occurred in the urinary excretion of D-glucaric acid, which means that cimetidine had not-affected that Phase II reaction. It did significantly decrease the urinary partial clearance rate of norantipyrine, leaving that of antipyrine and 4 OH-antipyrine unchanged, which suggests that cimetidine had preferentially inhibited the P450 isozyme that catalyses norantipyrine formation. PMID- 3830248 TI - The chronopharmacokinetics of indomethacin suppositories in healthy volunteers. AB - The pharmacokinetics of a single 100 mg indomethacin suppository were studied in 12 healthy volunteers on two occasions at least 7 days apart. Suppositories were administered in randomised order at 9.00 and 21.00 hours to see if there was evidence of a diurnal variation in kinetic parameters. The study failed to show a significant change in single dose kinetics with the time of suppository administration. This is in contrast to previous work [1] demonstrating a circadian rhythm in the kinetics of a single oral dose of indomethacin. This suggests that the chronopharmacokinetics of indomethacin is dependent on the function of the upper gastrointestinal tract. PMID- 3830249 TI - Verapamil and norverapamil in plasma and breast milk during breast feeding. AB - The concentrations of verapamil and norverapamil have been measured in milk and plasma samples from a 32 year-old woman treated with verapamil 80 mg tds while breast-feeding her child. The average steady-state concentrations of verapamil and noverapamil in milk were, respectively, 60% and 16% of the concentrations in plasma. The breast-fed child received less than 0.01% of the dose of verapamil given to the mother. No verapamil or norverapamil (less than 1 ng/ml) could be detected in the plasma from the child. PMID- 3830250 TI - Interaction between gliclazide and cimetidine. PMID- 3830251 TI - Do antidepressants cause postural hypotension by blocking cardiovascular reflexes? AB - Postural changes in blood pressure, respiratory sinus arrhythmia, the heart rate response to Valsalva's manoeuvre and to standing, and the blood pressure and heart rate responses to isometric exercise have been measured in seven young women taking antidepressant medication and compared with seven controls. Among the patients there was a significant rank order correlation between the degree of postural hypotension and the daily dose of antidepressant medication. There was a significant impairment among the patients of all cardiovascular reflex responses measured, suggesting both cholinergic and adrenergic blockade. These results suggest that postural hypotension associated with antidepressant medication is caused in large part by a failure of reflex peripheral vasoconstriction. PMID- 3830252 TI - Psychomotor impairment and anticonvulsant therapy in adult epileptic patients. AB - Using a battery of simple tests, psychomotor performance was assessed in 11 healthy subjects, 14 untreated epileptic patients and 66 epileptics on chronic anticonvulsant medication. Significant differences were found between controls and untreated patients for choice reaction time, card sorting and Simple Simon memory game. Treated patients performed less well than both untreated epileptics and controls in choice reaction time (p less than 0.05; p less than 0.001), card sorting (p less than 0.01; p less than 0.001), Simple Simon (p less than 0.05; p less than 0.001) and finger tapping (p less than 0.05; p less than 0.001). Patients with centrencephalic epilepsy were slower than those with discrete focal EEG abnormalities in reaction time and card sorting. Patients receiving treatment with carbamazepine, phenytoin or sodium valproate alone all performed similarly to each other and to those patients taking anticonvulsant polypharmacy. Monotherapy patients with potentially "toxic" plasma anticonvulsant concentrations did no worse than those within or below the "therapeutic" range. Both the disease and its treatment reduce psychomotor performance. All major anticonvulsants appear to cause a similar degree of impairment across a wide range of concentrations. The effect of chronic anticonvulsant medication on "quality of life" should not be neglected in the pursuit of perfect seizure control. PMID- 3830253 TI - The effect of diazepam on the responsiveness of human eccrine sweat glands to carbachol: influence of ambient temperature. AB - The effect of diazepam (10 mg, p.o.) on the responsiveness of eccrine sweat glands to intradermally injected carbachol and on critical flicker fusion frequency was compared in 6 male healthy volunteers under two ambient temperature conditions, 22 degrees C and 35 degrees C. Carbachol evoked dose-related increases in sweat gland activity. Responsiveness to carbachol was significantly enhanced under the 35 degrees C condition as compared to the 22 degrees C condition, this being reflected in a higher value of Emax of the dose-response curve for carbachol under the 35 degrees C condition. Diazepam had no significant effect on responses to carbachol under the 22 degrees C condition, but prevented the increase in responsiveness produced by high ambient temperature. High ambient temperature had no significant effect on critical flicker fusion frequency. Diazepam significantly reduced critical flicker fusion frequency under both temperature conditions. It is suggested that diazepam may block the increase in sympathetic outflow normally evoked by high ambient temperature, thereby preventing the development of sweat gland hyper-responsiveness. PMID- 3830255 TI - The grouped continuous model for multivariate ordered categorical variables and covariate adjustment. AB - The grouped continuous model for multivariate ordered categorical data is described. This is based on partitioning an underlying multivariate normal distribution. Straightforward maximum likelihood estimation is really feasible only for one- and two-way tables. We introduce an estimation system based on maximum likelihood estimation in the one- and two-way marginal tables of higher order tables. This is computationally feasible and an example involving aspects of bird colouring is given. The approach is extended to provide a regression model for multivariate ordered categorical data, with an estimation scheme again based on the one- and two-way marginal tables. The above example is developed to investigate the covariate effect of time. The asymptotic efficiency of these sampling schemes is discussed; it appears that they have high efficiency. PMID- 3830254 TI - The effect of propranolol on exercise induced tachycardia is determined by plasma concentration and the density of adrenergic receptors on leukocytes. AB - The chronotropic response to a single oral dose of propranolol in 23 healthy subjects has been related to the plasma propranolol concentration and the density of beta-adrenoceptors on peripheral polymorphonuclear leucocytes. The percentage reduction in exercise-induced tachycardia was significantly correlated with the log plasma propranolol concentration within subjects but not between subjects. Taking the concentration of the active metabolite 4-hydroxypropranolol into account did not improve the interindividual correlation. The reduction in exercise-induced tachycardia was significantly correlated with the maximum binding density of (125I)-hydroxybenzylpindolol on polymorphonuclear leucocyte membrane fragments measured before medication. A response index (% reduction in exercise-induced tachycardia/plasma propranolol concentration) was correlated with the maximum binding density of (125I)-hydroxybenzylpindolol (pre-drug) at 2 h (rs = 0.72), 4 h (rs = 0.84) and 6 h (rs = 0.73) after dosing. The data suggest that interindividual variation in the response to propranolol after a single oral dose is determined by interindividual differences both in plasma propranolol and adrenoceptor density. PMID- 3830256 TI - Progeny testing with auxiliary traits. AB - The problem of determining the breeding worth of a male on the basis of the phenotypic values of his female progeny is discussed. The use of one or more auxiliary traits in conjunction with the main trait for progeny testing seems to have an edge over the conventional method in which no auxiliary traits are used. A general expression for the accuracy of selection based on the progeny test is derived and a generalised sire index is proposed. Detailed numerical investigation with one auxiliary trait reveals that the accuracy of the progeny test in such a case is always increased. The maximum gain in accuracy is found when the phenotypic and additive genetic correlations between the main and the auxiliary traits are of opposite signs. The number of progeny required to attain a pre-assigned value of accuracy is determined for several cases. It is found that the use of auxiliary trait reduces this number resulting in decreased cost of the progeny testing programme. The effect of the number of auxiliary traits on the gain in accuracy is also studied under some simplified situations. PMID- 3830257 TI - Nested analysis of variance with autocorrelated errors. AB - In this paper we consider the problem where there is a randomized experimental design with several successive time measurements on each experimental unit. One approach to the analysis of such data is to treat time as the subplot treatment and to use a split-plot analysis of variance. Alternatively, the problem may be considered in a more general multivariate framework. Here we recognize the time induced correlations and apply an autoregressive time series modelling approach. Estimation and testing are addressed. Two examples are presented to illustrate the practicality of our procedure. Some extensions are also considered briefly. PMID- 3830258 TI - A Cox regression model for the relative mortality and its application to diabetes mellitus survival data. AB - A Cox-type regression model for the ratio between the mortality in a cohort and that in a reference population is introduced. By means of the model it is possible to include in the survival analysis both individual (possibly time dependent) characteristics for the study cohort and changing trends in the mortality in the reference population. This is particularly relevant in long-term follow-up studies where there may be considerable changes in the mortality in the reference population. Estimation procedures in the model are discussed and large sample properties of the estimators are outlined. The model is applied to the analysis of two sets of data concerning the survival among insulin-dependent diabetics in Denmark. PMID- 3830259 TI - A semiparametric model for regression analysis of interval-censored failure time data. AB - Left-, right-, and interval-censored response time data arise in a variety of settings, including the analyses of data from laboratory animal carcinogenicity experiments, clinical trials, and longitudinal studies. For such incomplete data, the usual regression techniques such as the Cox (1972, Journal of the Royal Statistical Society, Series B 34, 187-220) proportional hazards model are inapplicable. In this paper, we present a method for regression analysis which accommodates interval-censored data. We present applications of this methodology to data sets from a study of breast cancer patients who were followed for cosmetic response to therapy, a small animal tumorigenicity study, and a clinical trial. PMID- 3830260 TI - The effect of conditional dependence on the evaluation of diagnostic tests. AB - The accuracy of a new diagnostic test is often determined by comparison with a reference test which also has unknown error rates. Maximum likelihood estimation of the error rates of both tests is possible if they are simultaneously applied to two populations with different disease prevalences. The estimation procedure assumes that the two tests are independent, conditional on a subject's true diagnostic status. If the tests are conditionally dependent, error rates for both tests can be substantially underestimated. Estimators for the prevalence rates in the two populations can be positively or negatively biased, depending on the relative magnitude of the two conditional covariances and the value of the prevalence parameter. PMID- 3830261 TI - Analysis of two-period crossover design in a multicenter clinical trial. AB - A technique is discussed for analyzing a two-period crossover design for a multicenter trial using identical study protocols. The technique is a modification of the analysis originally proposed by Grizzle (1965, Biometrics 21, 467-480; 1974, Biometrics 30, 727) for analyzing a two-period crossover design when study is not a factor. A mixed model using the first baseline as a covariate is analyzed to increase the power of the test of significance of the treatment-by period interaction. The baseline values are also used in a preliminary test. PMID- 3830262 TI - A Bayesian analysis of the two-period crossover design for clinical trials. AB - Statisticians have been critical of the use of the two-period crossover designs for clinical trials because the estimate of the treatment difference is biased when the carryover effects of the two treatments are not equal. In the standard approach, if the null hypothesis of equal carryover effects is not rejected, data from both periods are used to estimate and test for treatment differences; if the null hypothesis is rejected, data from the first period alone are used. A Bayesian analysis based on the Bayes factor against unequal carryover effects is given. Although this Bayesian approach avoids the "all-or-nothing" decision inherent in the standard approach, it recognizes that with small trials it is difficult to provide unequivocal evidence that the carryover effects of the two treatments are equal, and thus that the interpretation of the difference between treatment effects is highly dependent on a subjective assessment of the reality or not of equal carryover effects. PMID- 3830263 TI - A mixed-effects model for categorical data. AB - A mixed model for categorical data from unbalanced designs which is directly analogous to a two-way ANOVA model for quantitative data is proposed. An extension of the fitting constants method is developed to estimate model variance components based on appropriate reductions in sums of squares. The resulting variance component estimators are incorporated into the covariance structure of a general linear models Wald statistic to test for treatment differences. These procedures are illustrated with data obtained from a multicenter clinical trial in which the treatments are regarded as fixed effects and the clinics are regarded as random effects. PMID- 3830264 TI - Acquired immunodeficiency syndrome (AIDS) in infants and children: report of nine cases. AB - We report here nine children with AIDS. The risk factors of these patients were hemophilia in one, blood transfusions in four, maternal intravenous drug use in three and paternal AIDS in one. One baby was also of Haitian parentage. The major clinical symptoms included failure to thrive, hepatomegaly, lymphadenopathy, interstitial pneumonia, recurrent bacterial and viral infections and persistent oral thrush. Three infants had chronic recurrent parotitis. Five infants developed opportunistic infections primarily Pneumocystis carinii pneumonia and all five died of bacterial sepsis. None of the infants were lymphopenic but all had reversed T4/T8 ratios and poor in vitro lymphocyte responses to pokeweed mitogens. Although many of the clinical and laboratory features of pediatric and adult AIDS are similar, there are some unique features for pediatric AIDS such as the absence of lymphopenia and the high prevalence of recurrent bacterial infections and sepsis. PMID- 3830265 TI - Characterization of a human rhabdomyosarcoma cell strain in tissue culture. AB - A new human rhabdomyosarcoma cell strain, designated KYM-1, has been established from a neck tumor found in a 9-month-old infant. The cultured cells were round and mainly free-floating or in a moniliform pattern with a population doubling time of 75 hours. In stained preparations, the cells were pleomorphic and had a single round or oval nucleus in non-striated cytoplasm. However, the intracellular presence of myogenic markers was clearly shown by enzyme immunochemical stains. An ultrastructural feature of the KYM-1 cells was the presence of numerous intermediate filaments in the perinuclear area and around the Golgi complexes which were associated with abundant cell organelles and aggregates of glycogen granules. High viscosity of the spent culture medium was attributed to hyaluronic acid, identified by electrophoresis and hyaluronidase digestion, and immunological and biochemical analyses revealed that the increased concentration of plasminogen activator activity found in the culture medium was almost wholly of the tissue plasminogen activator type. The KYM-1 cells also contained high concentrations of alkaline phosphatase activity. Tumorigenicity of the cells was confirmed by heterotransplantation into hamsters treated with anti thymocyte serum. PMID- 3830266 TI - HLA antigens in multiple sclerosis in Alsace. AB - The distribution of HLA antigens A, B, C and DR was studied in 69 native Alsatian multiple sclerosis (MS) patients. Antigen DR2 was high in MS compared to healthy control subjects, as is known. Given antigens were more frequently, and, above all, more closely linked with certain clinical and organic parameters. Antigens A3, B7 and B40 were preferentially associated with progressive forms, and A32 with remitting forms. B7 may be predictive of the prognosis, as it was correlated with disease severity. B7 and DR2 were more frequent in MS patients presenting intrathecal immunoglobulin synthesis. Sex appeared to be a fundamental factor in the clinical expression of MS, interacting closely with the HLA system. These findings confirm the multi-factor etiology of MS. Several MS susceptibility genes may exist near the HLA complex, and their expression may modulate the clinical and organic signs of MS. Studies of this sort should be carried out on ethnically and geographically homogeneous populations. PMID- 3830267 TI - X-ray microanalysis of normal human neutrophils, lymphocytes, monocytes and platelets. AB - Elemental X-ray microanalysis of normal peripheral blood neutrophils, lymphocytes, monocytes and platelets was carried out with a scanning electron microscope fitted with an X-ray analytical system. Each cell type was characterized by its own spectrum. Nucleus containing cells displayed a high phosphorus level, while platelets showed a low peak of this element. The elevated level of sulfur observed in platelets, neutrophils and monocytes may result from their cytoplasmic granules which contain sulfur-rich substances. The highest amount of calcium was detected in the platelets. The results indicate that X-ray microanalysis may be applied for the detection of the elemental content of blood cells. PMID- 3830268 TI - Preoperative carcinoembryonic antigen and prognosis in patients with colorectal cancer. AB - The relationship between preoperative CEA, Dukes staging and disease recurrence, was analyzed in 92 patients with colon-rectal cancer, all who underwent curative surgery. Sixty-five of the 92 patients were followed for 36 months. A significant increase in disease recurrence risk is observable starting from a preoperative CEA value of greater than 7.5 ng/ml; corresponding values as such are verified by a significant fall in the actuarial survival curve in comparison to the progress of the curves of the other two groups with lower CEA values. A statistically significant correlation between preoperative CEA and staging was not observed, while both parameters result statistically very reliable (p less than 0.001) for prognosis; preoperative CEA values, less or greater than 7.5 ng/ml can help to stratify the Dukes tumours with respect to the probability of recurrence. PMID- 3830269 TI - Cells with annular nucleus in haemopathic patients. AB - Cells with annular nucleus (CAN) were observed in the bone marrow of patients with acute myeloid leukaemia (AML), sideroblastic anaemia (SA) and megaloblastic anaemia (MA), and in particular in the bone marrow (7/31) and in the peripheral blood (16/31) of patients with chronic myeloid leukaemia (CML). CAN were seen in only one out of four splenectomized CML patients and the number of CAN in the bone marrow (0.5-1.5%) was smaller than that in peripheral blood (0.5-5%); these data suggest that in CML peripheral blood CAN might be derived from the spleen. CAN were identified as neutrophilic myelocytes, but in a few cases they were characterized also as eosinophilic or monocytic cells. In only one case of CML an agar culture from peripheral blood cells led to the presence of circulating colony forming cells (CFC) capable of generating monocytic and eosinophilic CAN in cultures. Morphocytochemical anomalies were observed in CAN in some cases. Occasionally together with neutrophilic CAN there were neutrophilic metamyelocytes and granulocytes with annular nuclei, suggesting an intrinsic difficulty of CAN to undergo the normal process of segmentation. PMID- 3830270 TI - Conformation and processing of cathepsin D. AB - Cathepsin D occurs in two forms, a single polypeptide chain (Mr 44 000) and a non covalent complex of two peptides of Mr 14 000 and 30 000 that is derived by proteolytic processing of the 44 000 polypeptide. The two forms from bovine spleen are closely similar in secondary structure content, in aromatic amino acid environment and in the two step denaturation behaviour. Enzyme activity is lost irreversibly on denaturation but conformation can be partially regained. The two separated chains will only refold partially and this is related to their positions in the overall structure of cathepsin D. It is suggested that the processing step is related to protein turnover. PMID- 3830271 TI - High expression levels of ras p21 protein in normal mouse heart tissues. AB - We have investigated the levels of protein encoded by the ras oncogene in normal mouse tissues using an immunoblotting technique. We have found that heart from young or adult NIH or Balb C strains of mice contain high levels of ras protein as compared to lung, liver, spleen, kidney, brain and skeletal muscle tissues from the same animal. Our results indicate that cellular ras expression does not in every case correlate with cell proliferation. PMID- 3830272 TI - Further studies on the presumed adenine nucleotide storage compound of rat heart. AB - Further studies on the acid-precipitable radioactive substance formed during perfusion of Langendorff rat hearts with [14C]adenosine have shown that very brief (30 s) ischaemia causes a sudden rise (20-35%) in its level in the tissue which is followed by the steady fall we have previously described. Analysis of the products of alkaline hydrolysis of this compound shows that at least 96% of the radioactivity appears in the form of a mixture of 2'- and 3'-AMP as would be expected for RNA while its relatively high resistance to dilute alkali suggests that it is poly A. Subcellular localization studies indicate that radioactivity enters all compartments of the cell, with maximum label in the nucleus. However, a significant proportion is present in the mitochondria and may be poly A acting as the mitochondrial storage form of adenine nucleotides whose existence we have proposed. PMID- 3830273 TI - Post-meiotic transcription of phosphoglycerate-kinase 2 in mouse testes. AB - We have used a human phosphoglycerate kinase-1 (PGK-1) cDNA clone to study expression of PGK-2 during mouse spermatogenesis. Hybrid selection, in vitro translation with product identification by 2-D gel electrophoresis demonstrated that the PGK-1 cDNA clone hybridized to PGK-2 mRNA in mouse testes. Northern analyses of RNA purified from separated spermatogenic cells demonstrated a large increase in abundance of PGK-2 mRNA in post-meiotic cells. Thus, post-meiotic transcription of PGK-2 mRNA is demonstrable with cloned DNA probes. PMID- 3830274 TI - A C9 related channel forming protein in the cytoplasmic granules of human large granular lymphocytes. AB - Large granular lymphocytes (LGL) from human blood maintained in culture for 2 to 6 weeks with IL-2 were found positive in the K562 cell killing assay. The cytoplasmic granules of the LGL were isolated, lysed and the soluble proteins were passed over a Sepharose-anti-C9 column. The retained protein was eluted with NaCl and found to consist by SDS polyacrylamide gel electrophoresis of essentially one component with a molecular weight of approximately 70 000. The protein did not give a positive precipitation test with anti-human C9 by Ouchterlony analysis, but it reacted reproducibly with anti-human C9 by Western blot analysis. By ELISA the cross reaction with human C9 was less than 1%. The C9 related lymphocyte protein lacked C9 hemolytic activity, but it formed functional pores in liposomes in presence of Ca++. These results suggest that the cytoplasmic granules of human LGL that are capable of killing NK target cells contain C9 related protein which is involved in the cellular cytotoxicity reaction. PMID- 3830275 TI - Comparative study on fluorescent probes distributed in human erythrocytes and platelets. AB - Important cellular functions, such as rheological properties of cells are presumably related to the membrane lipid fluidity which may be approached by the use of fluorescence polarization method. However, biological membranes represent very heterogeneous media and the knowledge of the fluidity of membrane compartments requires the use of different probes. Two fluorescent probes, DPH and its cationic derivative, TMA-DPH, have been employed to probe the lipid fluidity of human platelets and red cell membranes. The results show that the informations given by DPH and TMA-DPH can present important differences, suggesting that DPH and TMA-DPH are localized in different regions of cell membranes. In an attempt to investigate relations between lipid fluidity and rheological properties of red cells, the behavior of probes was studied in a "Couette" viscometer with a device for studying the emissive properties of probes when red cell membranes are under shear conditions. PMID- 3830276 TI - Elasto-thixotropic properties of bronchial mucus and polymer analogs. I. Experimental results. AB - The non-newtonian viscous and elasto-thixotropic properties of native and lyophilized pathological bronchial mucus and of polymer solutions (3% and 6% PIB in decalin) used as mucus analogs were analyzed using a cone-plate Carri-Med rheometer and a Couette viscoelastometer that we have specifically developed for measuring the rheological properties of bronchial mucus in clinical practice. The master curves obtained for apparent viscosity under steady conditions as a function of shear rates (gamma: 2.6 X 10(-3) to 6.9 X 10(1) sec-1) were fairly similar, whatever the apparatus used. Under transient conditions, at low shear rate (gamma less than 1.4 sec-1), PIB and mucus exhibited a typical viscoelastic behavior: the shear stress increased slightly up to a steady-state value. At higher gamma, a transitory overshoot of sigma characteristic of the elastothixotropic systems appeared. Such a behavior can be interpreted as resulting from structural changes such as formation and rupture of the three dimensional network present in bronchial mucus as in polymer solutions. PMID- 3830278 TI - Red cell volume. PMID- 3830277 TI - Towards a concept of thrombosis in accelerated flow: rheology, fluid dynamics, and biochemistry. AB - The predilection sites of arterial thrombosis are characterized by local increase in wall shear stress, flow separation with eddy formation and stagnation point flow. The defenders of high shear, as well as those of low shear theory of thrombogenesis, point to correlations of predilection sites and the respective flow abnormalities. Experimental evidence is provided, that high shear rates can damage both red cells and platelets, that lysed red cells constitute a potent platelet stimulant, due to their content of adenine nucleotides, and that platelets do not adhere to surfaces unless transported onto them by convective motion, the effectiveness of the platelet-wall interaction being enhanced by platelet activation. Based on these facts, a resolution of the contrast between high and low shear theory of thrombosis is attempted in a way, that the different flow regimens, with blood cells sequentially passing them, are each considered important and interdependent steps on the way to thrombosis. PMID- 3830279 TI - Proceedings of the XXVth world conference of the IUAT (International Union Against Tuberculosis)--final. Buenos Aires, 15-18 December 1982. PMID- 3830280 TI - Use of SI-units in cardiorespiratory physiology and biophysics. AB - The Systeme International d'Unites (SI) is progressively being adopted in all branches of science. Physiology and biophysics are no exceptions. Resistance to the use of SI-units derives from the ingrained habit of utilizing traditional units, which may appear simpler but have many limitations. The SI not only simplifies units but also involves the standardization of spelling, symbols and presentation. This article describes the relationship between the SI and the units commonly used in cardiovascular and pulmonary physiology and biophysics. It provides conversion factors for SI units in the hope that it will stimulate a wider use of these new international units. PMID- 3830281 TI - Analysis of Blastocladiella emersonii ribosomal proteins in four two-dimensional gel electrophoresis systems. AB - Ribosomal proteins of the aquatic fungus Blastocladiella emersonii were isolated and characterized on four different two-dimensional polyacrylamide gel electrophoresis systems. 40S and 60S ribosomal subunit proteins from zoospores were identified. The position of every protein was determined in each electrophoretic system using the "four-corners" method (Madjar et al., Molecular and General Genetics, 171: 121-134, 1979). Thirty-two and 39 proteins were identified in the 40S and 60S ribosomal subunits, respectively. The molecular weights of individual proteins in the 40S subunit ranged from 10 000 to 37 000, with a number-average molecular weight of 20 000. The molecular weight range for the 60S subunit was 13 000-51 000 with a number-average molecular weight of 21 000. Proteins from ribosomes of different cell types were compared and found to be qualitatively indistinguishable. The only consistent difference in the patterns of proteins was in the S6 protein of the 40S subunit, which is the major phosphoprotein of Blastocladiella ribosomes. PMID- 3830282 TI - Patterns of variation in airflow obstruction and risk of death in clinically stable asthma. AB - In an attempt to identify patterns of variation in airflow obstruction and to detect patients with marked bronchial lability, a factor reported to be associated with an increased risk of sudden asthma death, we obtained serial peak expiratory flow rate (PEFR) recordings from out-patients with chronic, clinically stable, asthma (N = 27) for one week. Similar recordings were obtained for comparison from out-patients with chronic obstructive pulmonary disease (COPD) (N = 14) and from healthy controls (N = 14). Analysis of the recordings disclosed patterns of PEFR variation for 20 asthmatics but not for COPD patients or healthy subjects. Ten asthmatics were classified as "brittle" asthmatics (BA), nine as morning dippers (MD) and one as a gradually deteriorating (GD) asthmatic. Patients were considered at risk when their diurnal fall (DF) in PEFR was greater than 50% on at least one occasion during the survey. This was the case for seven BA, three MD and one GD patient. Diurnal falls in PEFR of this magnitude were not observed among asthmatics without a discernible pattern of variation of airflow obstruction or COPD patients. A relationship was found between the amplitude of PEFR fluctuations and the frequency of significant DF in PEFR (greater than 25%) during half or more days of the survey. A significant fraction of out-patients with chronic, clinically stable asthma may present patterns of variation in airflow obstruction and diurnal falls in PEFR of a magnitude such as has been associated with sudden asthma death. PMID- 3830283 TI - Subtle cardiac autonomic impairment in Chagas' disease detected by baroreflex sensitivity testing. AB - The sensitivity of baroreflex bradycardia and tachycardia was determined in fourteen patients with Chagas' disease who seemed to be normal with respect to cardiac autonomic control evaluated in terms of heart rate responses to the conventional atropinization and Valsalva maneuver tests. Eleven normal subjects were studied for comparison. Baroreflex sensitivity was determined by relating the beat-to-beat pulse intervals to systolic pressure values during transient phenylephrine- and amyl nitrite-induced changes in arterial pressure. Chagasic patients showed mean bradycardia sensitivity (10.1 +/- 1.3 ms/mmHg) which was significantly lower than that obtained for the control group (16.7 +/- 2.1 ms/mmHg). When only the subgroup of ten patients with overt disease (cardiac and/or digestive form) was considered, the value fell to 8.6 +/- 1.4 ms/mmHg. The lowest individual values were exhibited by the majority of patients with exclusive cardiac or associated cardiac and digestive disease. Patients with only digestive disease or without overt disease (indeterminate form) had values within the normal range. Tachycardia sensitivity (6.3 +/- 0.8 ms/mmHg) was similar to that obtained for the control group (6.6 +/- 1.0 ms/mmHg). Only one patient with associated disease presented a reduced value. These data show that the estimation of baroreflex sensitivity can be used to identify impaired cardiac autonomic control in chronic Chagas' disease not detectable by conventional tests. The reduced baroreflex sensitivity appears to be due to the subtle impairment of the parasympathetic influence on the heart. Furthermore, there is a relationship between the degree of baroreflex sensitivity and the clinical form of organic involvement in Chagas' disease. PMID- 3830284 TI - Social isolation and tolerance development to sodium barbital in mice. AB - The effect of the duration of isolation periods on the development of tolerance to sodium barbital was studied in mice. The HD50 values for pentobarbital-induced hypnosis were higher in all mice that were long-term treated with sodium pentobarbital, whether or not they were isolated or in groups. Diazepam HD50s were higher in mice isolated and long-term treated with sodium barbital for 38 days and in grouped animals treated with the barbiturate for 20 and 30 days. Social isolation for 8 weeks plus 23 days increased the pentobarbital hypnotic dose (HD50). These data show that social isolation increased the rate of tolerance acquisition to sodium barbital by mice. PMID- 3830285 TI - Effects of diet composition on the metabolic and heart rate responses to cold water exposure in men. AB - The reaction to immersion in cold water (22 degrees C) was studied in ten healthy male volunteers successively receiving balanced (C), hypercarbohydrate (HC), hyperprotein (HP), and hyperlipid (HL) normocaloric diets with a three week equilibration period on each diet. Oxygen consumption (ml min-1 m-2) increased from 149 to 224 during C, from 160 to 196 during HL, from 154 to 178 during HP, and from 166 to 187 during HL. Only the first two differences were significant. Pulmonary ventilation (ml min-1 m-2) increased from 4.08 to 6.24 during C, from 4.01 to 5.48 during HC, from 3.41 to 3.83 during HP, and from 3.77 to 5.48 during HL. The difference was statistically significant only for C. Heart rate (beats/min) decreased from 73 to 64 during C, from 74 to 61 during HC, from 73 to 60 during HP and from 72 to 64 during HL. The differences were statistically significant for all diets except HL. Oral temperature decreased in all groups (range 0.4 to 1.6 degrees C). Respiratory rate changes were not statistically significant. The calorigenic reaction to cold water immersion was demonstrable for all groups but more efficient in subjects receiving either balanced or HC diets, suggesting that HP and HL diets reduce cold adaptation. PMID- 3830287 TI - [Effect of ethanol on prenatal developments of rats]. PMID- 3830286 TI - The Bezold-Jarisch-like effect induced by veratridine and its potentiation by scropion toxin in the rat. AB - The Bezold-Jarisch-like effect (BJE) induced by 2.5 micrograms/100 g of veratridine injected intravenously or into the left ventricle was studied in anesthetized rats. The possible potentiation of the effect by a small dose (10 micrograms/100 g) of a purified scorpion toxin (tityustoxin) was also investigated. Heart rate (HR), electrocardiogram (ECG), mean arterial pressure (MAP) and respiratory rate (RR) were recorded. Intravenous (iv) injection of veratridine induced a BJE consisting of slight bradycardia in 4 out of 8 experiments, fall of MAP (from 107 +/- 3 to 90 +/- 4 mmHg) and apnea. The control RR was 105 +/- 5 insp/min and apnea, after veratridine, lasted 8 +/- 2 s. The BJE evoked by injection of a second dose of veratridine was potentiated 20 min after an iv injection of tityustoxin. The HR decreased from 334 +/- 16 to 108 +/- 17 beats/min, the MAP fell from 110 +/- 5 to 68 +/- 4 mmHg and the control RR of 92 +/- 5 insp/min was followed by a long period of apnea (68 +/- 17 s). Injection of veratridine into the left ventricle (lv) evoked a BJE characterized by slight bradycardia in 5 out of 10 experiments, arterial hypotension (from 110 +/- 6 to 89 +/- 6 mmHg) and tachypnea (from 82 +/- 6 to 102 +/- 7 insp/min). The effects induced by a second dose of veratridine were potentiated 20 min after an lv injection of tityustoxin. The HR decreased from 377 +/- 14 to 119 +/- 18 beats/min, the MAP fell from 119 +/- 5 to 72 +/- 10 mmHg and the RR increased from 80 +/- 6 to 117 +/- 9 insp/min. This tachypnea was followed by bradypnea 20 s later (21 +/- 6 insp/min). The ECG showed that hypotension induced by iv or lv injections of veratridine coincided with a slight sinus bradycardia before tityustoxin (N = 9) and A-V block after the toxin (N = 18). Cervical bilateral vagotomy prevented the cardiac and respiratory effects induced by lv veratridine in tityustoxin-treated rats, but a slight hypotension was still recorded (from 114 +/- 10 to 94 +/- 10 mmHg, P less than 0.05). Injection of veratridine (2.5 micrograms/100 g) into the ascendent aorta evoked a slight hypotension (from 105 +/- 6 to 87 +/- 7 mmHg, P less than 0.05) and tachypnea followed by bradypnea, but bradycardia was not recorded.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3830288 TI - [Fetal intrauterine death and fetal malformation induced by trypan blue in rats]. PMID- 3830289 TI - [Flower bud differentiation and development of opium poppy (Papaver somniferum L.)]. PMID- 3830290 TI - [Riboflavin Reference Standard (Control 831) of the National Institute of Hygienic Sciences]. PMID- 3830291 TI - [Ascorbic Acid Reference Standard (Control 831) of the National Institute of Hygienic Sciences]. PMID- 3830292 TI - [Saccharated Pepsin Reference Standard (Control 831) of the National Institute of Hygienic Sciences]. PMID- 3830293 TI - [Kallidinogenase Reference Standard (Control 841) of the National Institute of Hygienic Sciences]. PMID- 3830294 TI - [Thiamine Hydrochloride Reference Standard (Control 841) of the National Institute of Hygienic Sciences]. PMID- 3830295 TI - [Cyanocobalamin Reference Standard (Control 841) of the National Institute of Hygienic Sciences]. PMID- 3830296 TI - [Studies on the analysis of pesticide residues in foods (XLI). Chlorpropham (IPC) residues in imported refrigerated potatoes for french-frying]. PMID- 3830297 TI - [Studies on the analysis of pesticide residues in foods (XLII). Surveillance of the daily intake of endosulfan, chlorobenzilate, captan and others from total diet in 1982]. PMID- 3830298 TI - [Studies on the analysis of pesticide residues in foods (XLIII). Organochlorine and organophosphorus pesticide residues in unpolished rice grain imported from South Korea]. PMID- 3830299 TI - [Studies on pesticide residues in foods (XLIV). Surveillance of chlordane congeners residues in meat, dairy products, fish and shellfish on the market and imported meat, grain and beans]. PMID- 3830301 TI - [Studies on the analysis of pesticide residues in foods (XLVI). Confirmation of chlordane congeners in freshwater fish by gas chromatography-mass spectrometry (GC-MS)]. PMID- 3830300 TI - [Studies on the analysis of pesticide residues in foods (XLV). Surveillance of daily intake of chlordane congeners from total diet in 1983]. PMID- 3830302 TI - [Determination of o-phenylphenol in the peel and flesh of citrus fruits by high performance liquid chromatography with fluorescence detection]. PMID- 3830303 TI - [Supplementary examinations on material and migration test methods for acrylonitrile monomer in the final draft for Japanese standards on plastic packages and containers for foodstuffs]. PMID- 3830304 TI - [Migration of heavy metals from tableware determined by the method of the International Organization for Standardization]. PMID- 3830305 TI - [Comparison of natural yellow colors extracted from saffron (Crocus sativus Linne) and gardenia fruit (Gardenia jasminoides Ellis)]. PMID- 3830306 TI - [Bacteriological examination of marketed bean jam "AN", sauce-type seasonings and dehydrated foods]. PMID- 3830308 TI - [Pattern of foreign journal utilization as seen from frequency of citations--from the Bulletins of National Institute of Hygienic Sciences (1979-1983)]. PMID- 3830307 TI - [Studies on the acute oral toxicity of dehydroacetic acid, sorbic acid and their combination compound in rats]. PMID- 3830309 TI - [Determination of reducing sugars (dextrose equivalent) contained in various commercial dextrins]. PMID- 3830310 TI - [Oral subchronic toxicity studies of ferric chloride in F344 rat]. PMID- 3830311 TI - [Toxicity of oriental bezoar and its components]. PMID- 3830312 TI - [Acute toxicity of chemicals in household goods (II)]. PMID- 3830313 TI - [Studies on the evaluation of toxic renal injuries in rats--correlation between urinary enzyme activities and histological changes induced by puromycin aminonucleoside and bis-(2,3-dibromopropyl) phosphate]. PMID- 3830314 TI - [Mutagenicity tests on organic chemical contaminants in city water and related compounds. I. Bacterial mutagenicity tests]. PMID- 3830315 TI - [Mutagenicity tests on organic chemical contaminants in city water and related compounds. II. Chromosome aberration tests in cultured mammalian cells]. PMID- 3830316 TI - [Postnatal development of offspring from pregnant rats treated with trypan blue]. PMID- 3830318 TI - [Reactions of adenine and related compounds with formaldehyde]. PMID- 3830317 TI - [Purification and some properties of group A streptococcal pyrogenic exotoxin]. PMID- 3830319 TI - [Identification of psychotropic drugs. IV. Analysis of phencyclidine and its analogues]. PMID- 3830320 TI - [HPLC-pattern change of emetic ogonori (Gracilaria verrucosa Papenf.) components treated by an artificial gastric juice]. PMID- 3830321 TI - Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder. PMID- 3830322 TI - Depression: distress or disease? Some epidemiological considerations. AB - Surveys using clinical-type interviews have documented a high rate of depression among working-class women, and this is discussed in the light of a recent survey in an inner-city area. While women with caseness of depression contacting a psychiatrist did not differ in number of core depressive symptoms from those who did, they did in certain characteristics that would make them worrying for a general practitioner to deal with. It is concluded that there is a considerable overlap in the severity of depressive conditions between those seen by psychiatrists and those defined as cases in population surveys; any differences that do exist may relate more to the way symptoms are expressed than to the severity of the depressive disorder as such. PMID- 3830323 TI - Social disability and outcome in schizophrenic patients. AB - To gain more insight into the social (as opposed to clinical) outcome of schizophrenia, a unidimensional, heirarchical scale was constructed. Items were selected from the Disability Assessment Schedule (DAS)--a new instrument, used in the WHO Collaborative Study on the Assessment and Reduction of Psychiatric Disability. Data were derived from the Dutch cohort participating in this study, which consisted of patients with a first life-time episode of a non-affective, functional psychosis. Patients were followed-up during the first three years of their illness, and analyses of the stability and reliability of the scale proved to be satisfactory. It was subsequently used to characterise the course of social disability. PMID- 3830324 TI - The Scottish survey of new chronic in-patients: two year follow up. AB - 'New chronic inpatients' (patients aged 18-64 years in hospital more than one but less than six years) were followed-up two years after identification in the catchment areas of 14 psychiatric hospitals, serving 56% of the Scottish population. Nine per cent had died, 71% remained in-patients, and 20% had been discharged; 40% of those discharged had no contact with after-care services, and 37% of those remaining in hospital did not need in-patient care. Discharged patients were younger, had been in hospital a shorter time, and less often had organic brain disease. Only 13% of patients who, when first identified, had been rated at a low functioning level had been discharged; 64% of those remaining in patients at follow up had such a rating. PMID- 3830325 TI - Categories of depression: reported life events in a controlled design. AB - In a case control study, 32 onset cases of depression, separated into PSE-CATEGO Categories N and R, were compared with individually matched symptom free general practice attenders. Combining both categories of depressives together a significantly greater number reported an Undesirable Life Event and a Threatening Life Event in the six months prior to onset, compared with their matched controls. Significantly more CATEGO R (retarded or endogenous) depressives reported an Independent Threatening event than their matched controls. These findings do not support the view that depression secondary to a major life event is more likely to be mild in character. PMID- 3830326 TI - Puerperal mental illness, clinical features and classification: a study of 142 mother-and-baby admissions. AB - The case notes were studied of 142 mothers admitted to psychiatric hospitals in the south-east Thames region within 12 months of childbirth during the years 1979 and 1980. Only 6% of the sample were categorised as schizophrenics by RDC criteria, whereas affective disorders were found to predominate in 80%. Manic and schizo-affective illnesses almost always began within two weeks of parturition, as did psychotic depressions. A third of the patient sample had suffered relatively minor disorders, and given adequate resources, some might have been better managed in the community. A parallel investigation of diagnostic returns to the Department of Health revealed considerable uncertainty about how to classify puerperal mental illnesses in accordance with ICD-9. There is an urgent need to improve the system for categorising and registering mental illnesses related to childbirth. Until this is achieved, research into aetiology, outcome, and the provision of services will continue to be impeded. PMID- 3830327 TI - Life stress, medical lethality, and suicidal intent. AB - Eighty parasuicide patients were studied. The importance of life stress, age, and General Health Questionnaire score as predictors of the suicidal intent and medical lethality which they exhibited was examined. Medical lethality and suicidal intent were closely related: those whose parasuicide resulted in high lethality differed from those showing low lethality in their degree of suicidal intent, but did not differ in life stress, age, or GHQ score. Although both life stress and GHQ score were significantly correlated with suicidal intent, the GHQ score accounted for a greater proportion of the variance. These results suggest a more complex relationship between life stress, GHQ score, and suicidal intent than is often assumed. PMID- 3830328 TI - Psychiatric aspects of Wilson's disease. AB - A variety of psychiatric symptoms have been described in relation to Wilson's disease, an inherited disorder of copper metabolism. At least four symptom clusters can be identified: affective, behavioural/personality, schizophrenia like, and cognitive; the first two groups appear to be the commonest. Four cases (three newly reported) are described, and current approaches to the psychiatric management of Wilson's disease discussed. PMID- 3830329 TI - A comparison of CATEGO class 'S' schizophrenia in three ethnic groups: psychiatric manifestations. AB - We compared the psychiatric manifestations of 56 CATEGO S schizophrenic in patients from three ethnic groups (white, coloured and black). A marked similarity among the groups on both schizophrenic and non-schizophrenic symptoms was found, as well as a high prevalence of depressive and anxiety symptoms. Differences occurred on the syndromes of olfactory hallucinations and subcultural delusions and hallucination. Black patients had both syndromes more frequently than either white or coloured patients. PMID- 3830330 TI - On serious violence during sleep-walking. AB - It is not sufficiently realised that sleep-walking is not an hysterical condition, nor in any way related to epilepsy, nor that it can be accompanied by violent injury to the self or others. Three case reports here include that of a 14-year-old boy who rose from his bed at 2 a.m. and severely stabbed his five year-old girl cousin. The sleeping mind is not in touch with reality and amnesia for events during sleep is usual. PMID- 3830331 TI - Temporal orientation in the pre-senium and old age. AB - Temporal orientation in 235 normal elderly subjects was examined and compared with previous results from a young adult population. Orientation for time in the elderly remains reasonably intact; the major exception to this was inaccurate recall of the date, which was most pronounced among women in the older group studied (71 +). PMID- 3830332 TI - P3 and other long latency auditory evoked potentials in presenile dementia Alzheimer type and alcoholic Korsakoff syndrome. AB - The P300 (P3) and other long latency auditory evoked potentials were measured in 15 patients with presenile dementia Alzheimer type (ATD), 16 patients with alcoholic Korsakoff syndrome (KS) and 23 age-matched control subjects. All were drug free for at least four weeks before testing. The latency of the P3 was significantly longer and the amplitude significantly smaller in the ATD group than in both the KS and control groups. The KS group did not differ significantly from the control group in either latency or amplitude of P3 but both the KS and ATD groups had reduced N1 and P2 compared to controls. Using a combination of P3 latency and amplitude, 70% of the ATD patients could be separated from the other groups with no false positives. These findings suggest that evoked potential recording may be of value in the diagnosis of early ATD. PMID- 3830333 TI - Electrophysiological and hormonal responses to three types of electroconvulsive therapy. AB - Patients were treated with three different types of electroconvulsive therapy in random order in the first three sessions of their courses. Anaesthetic and muscle relaxants were administered in standard doses, and treatment applied a set time after bolus injection. Electroencephalographic recordings were undertaken before, during, and after treatment, and hormonal measures before and after. The responses to treatment differed between the three types of current in both EEG and prolactin measures. It is suggested that the quality of the convulsive response varies with different currents. PMID- 3830334 TI - Cognitive deficit in a case of retrograde amnesia. PMID- 3830335 TI - The oldest patient with Capgras syndrome? PMID- 3830336 TI - Abnormal dexamethasone suppression test in type II schizophrenia. PMID- 3830337 TI - Measuring abnormal movement in tardive dyskinesia: a pilot study. PMID- 3830338 TI - Munchausen's syndrome. PMID- 3830339 TI - DST results and platelet MAO activity. PMID- 3830340 TI - Using the PSE in Arabic culture. PMID- 3830341 TI - Vitamin supplement to alcoholic beverages. PMID- 3830342 TI - Hazards of hard contact lenses in psychotic patients. PMID- 3830343 TI - A clinical study of adult coprophagia. PMID- 3830344 TI - Cognitive deficits in systemic sclerosis. PMID- 3830345 TI - Hysterical conversion states. PMID- 3830346 TI - Influence of mercury (II), cadmium (II), methylmercury, and phenylmercury on the kinetic properties of rat liver glutathione peroxidase. AB - The effect of phenylmercury and methylmercury on rat liver glutathione peroxidase (GSH X Px) is investigated and compared with that of Hg(II) and with some previously reported results for Cd(II). Analysis of the kinetics of metal binding to the enzyme gives apparent inhibition rate constants: kc = 9.7 mM-1 min-1 for all three mercury compounds and 75 mM-1 min-1 for CdCl2. Glutathione (0.2 mM) protects the enzyme from metal inhibition, decreasing the apparent inhibition rate constants (kc) by 3.6 times for mercury compounds and 4.4 times for CdCl2. KI for the three mercury compounds is found to be 53 microM. It is unexpected that the same value of KI exists for all three forms of mercury studied and that inhibition of the enzyme by the metals is a relatively slow process. For Cd(II) the value of KI is 8.5 microM. It is suggested that inhibition of GSH X Px enzyme activity by cadmium, mercury, and organic mercury salts may not be due to simple complexation of the active site selenium moiety but may be due to a slower process, e.g., an alteration of the enzyme tertiary or quaternary structure. PMID- 3830347 TI - Isolation and characterization of nuclear envelopes from three variant cell lines of the Shionogi mouse mammary carcinoma: identification of androgen-dependent peptides. AB - We have isolated and purified, with good yields, nuclear envelopes from an androgen-responsive and from two androgen-unresponsive cell lines of the Shionogi mouse mammary carcinoma after subjecting purified nuclei to DNase at high pH and characterized them morphologically, chemically, and enzymatically. Phase-contrast microscopy revealed the nuclei to be free of cytoplasmic tags and that the nuclear envelopes were isolated as membrane "ghosts." Electron micrographs clearly showed the double-membrane system with nuclear pore complexes which illustrates that the nuclear envelopes were ultrastructurally intact. The nuclear envelopes contained little DNA, low levels of arylesterase or acid phosphatase activity, and undetectable levels of succinate dehydrogenase and 5'-nucleotidase activity. Coomassie blue staining of the nuclear envelope fractions on sodium dodecyl sulfate-polyacrylamide gels for all three cell lines revealed that most of the polypeptides were similar. However, we have identified androgen-dependent peptides of molecular weights 29 000, 32 000, and 34 000 in nuclear envelopes of the androgen-responsive cell line peptide profiles by comparing the nuclear envelopes prepared from the androgen-responsive cell line grown in intact mice, in castrated mice, and in mice which had been injected with testosterone after castration. Further investigation of the androgen regulation of these nuclear envelope peptides may help us understand the molecular mechanisms involved during morphological changes of the nucleus which occur in response to different hormonal environments. PMID- 3830348 TI - Mechanisms of cholesterol synthesis inhibition by D-glucosamine. AB - The amino sugar D-glucosamine possesses antitumor activity which is thought to depend in part upon its ability to impair cholesterol biosynthesis and damage cellular membranes. The present study examined the effect of glucosamine on acetate utilization for lipid and sterol synthesis in rat C6 glial tumor cells. At cytotoxic concentrations, the amino sugar inhibited [14C]acetate incorporation into nonesterified sterols and lipids but increased the flow of label into cholesteryl esters. A comparison of the rates of acetate utilization for glucosamine metabolism (N-acetylation) and sterol and lipid synthesis suggested that glucosamine might act by competing for a common cytosolic pool of acetyl CoA. The inhibition of lipid and sterol synthesis, however, remained constant over a wide range of extracellular acetate concentrations. These results suggest that, if glucosamine acts by restricting the supply of acetate for these biosynthetic processes, it probably inhibits a step prior to the formation of acetyl CoA. Alternative mechanisms are discussed. PMID- 3830349 TI - Central vasopressin in the modulation of catecholamine release in conscious rats. AB - Neurons containing arginine vasopressin (AVP) have been shown to project from the paraventricular nucleus of the hypothalamus to the nucleus tractus solitarius (NTS) in the medulla. We investigated whether AVP acts in brain stem regions to influence sympathoadrenal outflow. Cannulae were implanted into the fourth ventricle of rats 7 days prior to the experiment. The effects of intracerebroventricular (icv) injections of AVP, the vehicle, and AVP antagonist, d(CH2)5Tyr(Me)AVP, on mean arterial pressure (MAP) and plasma noradrenaline (NA) and adrenaline (A) levels were determined in conscious unrestrained rats. Injections of AVP (icv, 23 and 73 ng/kg) but not the vehicle increased MAP and plasma NA and A levels. In contrast, iv injection of AVP increased MAP but decreased plasma concentrations of A and NA. The pressor response to icv injection of AVP was abolished by prior icv injection of AVP antagonist. Injection of AVP antagonist (icv, 0.5 and 1.5 microgram/kg) had no effect on MAP or plasma NA or A levels. These results show that centrally injected AVP activates sympathoadrenal outflow, possibly via an inhibition of baroreceptor reflexes. Since centrally administered AVP antagonist did not influence MAP or plasma NA or A levels, it appears that endogenously released AVP does not have a tonic influence on central cardiovascular reflex system in conscious, unrestrained rats. PMID- 3830350 TI - Electromechanical characterization of the effects of racemic sotalol and its optical isomers on isolated canine ventricular trabecular muscles and Purkinje strands. AB - In both isolated canine ventricular trabecular muscle and Purkinje strand preparations, dl-sotalol and its two optical isomers d- and l-sotalol produced a concentration-dependent increase in action potential duration while other transmembrane electrical characteristics were not significantly affected. The magnitude of the increase in action potential durations was greater in Purkinje strand preparations. In Purkinje strand preparations, the effect was rate dependent (i.e., the increase in duration was proportionately greater when stimulation frequency was slowed). From the concentration of each compound calculated to produce a 50% maximal increase in Purkinje fiber action potential durations, d-sotalol appeared to be one to three times more potent than either l sotalol or the racemate. Each compound appeared to increase force development in ventricular trabecular muscle preparations stimulated at a frequency of 2 Hz. Increased force development was only observed in Purkinje strand preparations stimulated at slower rates (0.5-0.33 Hz). These results are unlike those produced by other beta-adrenergic blockers and suggest that the antiarrhythmic effects of sotalol are related primarily to its effect of action potential duration. The estimated potency ratios established for the effect of dl-sotalol and its optical isomers on both trabeculae and Purkinje fiber action potential durations (d greater than dl-l) may indicate that these effects are unrelated to the beta adrenergic blocking properties of these compounds. The differential effect of sotalol on isolated trabeculae and Purkinje strand preparations may help to explain the clinically reported phenomenon of sotalol-induced torsade de pointes. PMID- 3830351 TI - Resection of rabbit ileum: effect on brush border membrane enzyme markers and lipids. AB - Alterations in transport function have been described 6 weeks after surgical resection of 50% of the distal small intestine. Previous studies demonstrated a modest increase in the jejunal uptake of medium chain length fatty acids following resection, while the uptake of many other lipids (cholesterol, bile acids, fatty alcohols, short and long chain length fatty acids) appears to be unaffected. Marked changes in the kinetic constants for the carrier-mediated uptake of four sugars and leucine were observed following resection, but the changes in transport were not associated with changes in the mucosal surface area. This study was undertaken to examine the possible adaptive mechanisms that occur with ileal resection in the rabbit. A 29% increase in the wet weight of jejunal mucosal scrapings and a 53% increase in jejunal brush border membrane (BBM) protein was observed following resection. The jejunal BBM sucrase (S) was unchanged following ileal resection, but alkaline phosphatase (AP) total activities were increased in the resected rabbits. This resulted in a 45% increase in the ratio of AP/S with resection. The lipid composition (total free fatty acids, total bile acids, total cholesterol, total phospholipids, individual phospholipids, and the ratio of total phospholipids/total cholesterol) of BBM was similar in control and resected rabbits. This suggests that quantitative rather than qualitative changes in the membrane composition may be responsible for the transport changes observed in resected animals. PMID- 3830352 TI - The distension stimulus to gastric acid secretion in the isolated mouse stomach. AB - Distension of the isolated mouse stomach stimulated gastric acid secretion. Atropine, cimetidine, or proglumide antagonized the actions of cholinomimetics, histamine, and gastrin, respectively. However, these antagonists and the nerve blocking agent, tetrodotoxin, were without effect on basal secretion or distension-stimulated secretion. It is concluded that in the isolated mouse stomach neither basal secretion nor secretion evoked by distension involve the release of any of the established "physiological" secretagogues or the activation of intramural nerves. PMID- 3830353 TI - Modulation of rat hepatic microsomal testosterone hydroxylases by 2,3,7,8 tetrachlorodibenzo-p-dioxin and related toxic isostereomers. AB - The effects of several toxic halogenated aryl hydrocarbons including 2,3,7,8 tetrachlorodibenzo-p-dioxin, 2,3,7,8-tetrachlorodibenzofuran, 2,3,4,7,8 pentachlorodibenzofuran, 3,3',4,4'-tetrabromobiphenyl, 3,3',4,4'5 pentachlorobiphenyl, and 3,3',4,4'-tetrachloroazobenzene on hepatic microsomal testosterone hydroxylases were determined in the immature male rat. All of these compounds induced hepatic testosterone 7 alpha-hydroxylase and inhibited testosterone 6 beta-, 16 alpha-, 16 beta-, and 2 alpha-hydroxylases and androstenedione formation. It was observed that there was a good correlation between the increase in testosterone 7 alpha-hydroxylase by the halogenated hydrocarbons and their ability to cause body weight loss in the exposed rats. Comparable linear correlations were observed between toxicity and the decreased activities of other testosterone hydroxylases. The role of altered testosterone metabolism in the toxicity of halogenated aryl hydrocarbons is unknown. PMID- 3830354 TI - The effect of afterload on the cardiodepressor reflex response to coronary artery occlusion in dogs. AB - The acute hemodynamic responses to anterior and posterior wall ischemia were examined at different afterloads in 30 open-chest anaesthetized dogs. Regional and global left ventricular responses to acute ischemia were also measured before and following bilateral cervical vagotomy in 18 dogs. As the preocclusion afterload (mean aortic pressure) was progressively raised with intravenous methoxamine, a significant decrease in stroke volume occurred following circumflex artery occlusion, whereas no change in stroke volume occurred following occlusion of the left anterior descending artery. Bilateral cervical vagotomy completely inhibited the decrease in stroke volume during circumflex occlusion at high afterload. Vagotomy had no effect on the hemodynamic response to acute anterior wall ischemia. Reversible cold vagal block in paced hearts at high afterload unmasked compensatory inotropy in the nonischemic anterior myocardial segment during circumflex occlusion. Restoring vagal tone by rewarming attenuated the fractional shortening of the nonischemic segment. The results indicate that a relationship exists between myocardial wall tension and reflex cardioinhibition during acute posterior wall but not anterior wall ischemia in dogs. PMID- 3830355 TI - Evidence for a secretory component in the handling of unconjugated bilirubin by the isolated perfused rat kidney. AB - Previous studies in rats have suggested that the urinary excretion of unconjugated bilirubin (UB) comprises only a small fraction of the pigment that reaches the tubular lumen by glomerular filtration and escapes from tubular cell reabsorption. However, additional data also indicated that UB interacts with renal peritubular cell membranes impairing the secretion of p-aminohippurate (PAH). In this study we examined the possibility of a secretory step which could also be involved in the renal excretory mechanism for UB. An isolated rat kidney preparation was used, and the uptake of UB by renal tissue, the UB appearance in the urine, and the secretion of PAH were analyzed throughout the perfusion. The results indicated that the UB urinary excretion rate changed independently of UB filtered load. The latter remained almost unchanged during the perfusion, whereas the excretion rate of UB and the UB-to-creatinine (Cr) clearance ratio increased significantly. Furthermore, a relationship between the uptake of UB by the kidney, the UB-to-Cr clearance ratio, and the decrease in PAH secretion rate, was proved. In addition, when probenecid was added to the perfusate solution the cumulative uptake of UB by the kidney and the rate of excretion of UB in the urine were diminished. We conclude that the mechanism of UB excretion by the kidney may be considered as the result of a process involving glomerular filtration plus tubular secretion followed by a back diffusion step from the lumen in a similar way to other endogenous compounds, thus explaining the virtual absence of UB from the normal urine. PMID- 3830356 TI - Inhibition of monoamine oxidase by amiloride. AB - Amiloride was found to lower the overflow of 3,4-dihydroxyphenylethylene glycol from isolated rat tail artery. The overflow was reduced to about 50% in the presence of 10(-5) M concentration of the drug. Reduced overflows of the glycol were observed also under conditions when the nonexocytotic release of endogenous noradrenaline was enhanced by tyramine, reserpine, or by the elevation of external K+ in the absence of extracellular Ca2+. They were accompanied by increased overflows of the amine. Amiloride inhibited monoamine oxidase activity (E.C. 1.4.3.4) of the A form in rat brain homogenate by acting as a competitive inhibitor. PMID- 3830357 TI - The role of the pituitary-adrenal axis in the hyperthermia induced by acute peripheral or central (preoptic anterior hypothalamus) administration of morphine to unrestrained rats. AB - The role of the pituitary-adrenal axis in the mediation of morphine-induced hyperthermia of conscious, unrestrained rats was investigated. Rectal (TR) and tail (Tt) temperatures and oxygen uptake rates (VO2) were measured following peripheral or central injection of morphine sulphate (MS) in groups of Sprague Dawley rats before and after adrenalectomy (adx), hypophysectomy (hyp), or pituitary suppression (via dexamethasone treatment). The hyperthermic TR responses of groups given MS either subcutaneously (5 or 15 mg/kg) or directly into the preoptic anterior hypothalamus (POAH, 1 or 10 micrograms/microL) before adx were not different upon retesting with the same dose of MS 2 weeks later following adx. The hyperthermia with MS was not caused by vasoconstriction or by increases in basal metabolic rate, for Tt rose after the opiate injections whereas oxygen uptake rates (VO2) were reduced. Unexpectedly, the TR following POAH injections of sterile saline (SS) or deionized water after adx increased from those seen before adx. Adx groups supplemented with dexamethasone phosphate (either chronically with 20 micrograms/kg daily for 2 weeks post-adx before retesting with MS or acutely with 250 micrograms/kg 2 h before retesting) showed a hyperthermia to MS (5 mg/kg sc or 1.0 microgram/microL POAH) similar to that seen before adx. However, dexamethasone phosphate (250 micrograms/kg) supplementation to adx rats, that received POAH injections of SS, did reduce the rise in TR. Hyp rats given MS (5 mg/kg, sc) also evoked hyperthermic responses similar to those of non-hyp control groups. The results clearly show that the acute hyperthermia of unrestrained rats induced by either peripheral or central injections of morphine is not caused by activation of the pituitary-adrenal axis. PMID- 3830358 TI - Arginine esterase from isolated dog prostate secretory granules is fully active enzymatically. AB - We have isolated secretory granules from dog prostate homogenates and have determined whether a major portion of arginine esterase was localized in this fraction and if it was enzymatically active. Secretory granules were purified by density gradient centrifugation on sucrose, metrizamide, or Percoll. A major proportion of whole prostate homogenate arginine esterase was found in the granule fractions. Furthermore, the specific enzymatic activity in the granules was similar to the one observed in seminal plasma. No evidence could be found for the existence of significant amount of a zymogen inactive form of arginine esterase. These results suggest that arginine esterase could be active within the secretory granules in vivo and that it could hydrolyze protein substrates contained in this organelle. PMID- 3830359 TI - Effects of chronic streptozotocin-induced diabetes on the cardiac responses to milrinone. AB - We have studied the effects of milrinone on various cardiac preparations obtained from 6-week streptozotocin diabetic rats. The basal rate of spontaneously beating right atrium from diabetics was significantly lower as compared with controls. Milrinone (5 X 10(-5) to 8 X 10(-4) M) produced a dose-dependent positive inotropic and positive chronotropic effect in left atrium and right atrium, respectively. The positive chronotropic response to milrinone was slightly increased in right atria from diabetic animals. In papillary muscle neither the maximum response nor the pD2 value of milrinone was altered significantly in diabetic animals. The pD2 values of milrinone in right atrium and left atrium were found to be significantly higher in diabetic preparations compared with controls. The data indicate that the responses to milrinone are either unchanged or enhanced in hearts from diabetic animals. PMID- 3830360 TI - Donor insemination in Lagos. AB - The results of AID in a population with a high incidence of female factors is reported. Thirty-one patients started AID on 35 occasions resulting in 25 pregnancies and a cumulative conception rate of 71% at 8 months. Eleven patients with female factors present became pregnant. Some problems of AID practice in Lagos are highlighted. PMID- 3830361 TI - Immunoglobulins on human sperm: validation of a screening test for sperm autoimmunity. AB - The immunobead test (IBT) is a new method of detecting antisperm antibodies with the advantages of enabling determination of the presence of antisperm antibodies during routine semen analysis, immunoglobulin isotypes and antibody specificity for binding to sperm structures such as head or tail. The IBT is compared with the conventional methods of detecting antisperm antibodies in serum; the tray agglutination test (TAT) and the sperm immobilization test (SIT). Positive IBT (50% or more of washed motile sperm binding to anti-IgG and/or anti-IgA immunobeads) were found in 6.8% of 689 men being investigated for infertility. Both IgG and IgA were found to be present in all cases. The IBT correlated closely with the serum antisperm antibody tests; of the 202 men tested by all three methods, 200 (99%) were either positive for circulating antibodies and IBT or negative for both. No men with serum antisperm antibodies lacked local antisperm antibodies as detected by IBT, and only two men (1%) were IBT positive in the absence of either one or both types of circulating antibodies. Individually, the TAT and the SIT correlated equally well with the IBT; 97% and 98% of men tested by TAT and IBT, and SIT and IBT respectively, were either positive by both or negative by both. It is concluded that the IBT is an excellent procedure for the detection of sperm antibodies. PMID- 3830363 TI - Symposium on the aging process. PMID- 3830362 TI - Sperm autoimmunity in vasectomized men and its relationship to atherosclerotic coronary artery disease. AB - A study is reported of sperm autoimmunization in 707 men and its relationship with atherosclerotic coronary artery disease. The following groups were studied: healthy vasectomized men (278), healthy non-vasectomized men (231), vasectomized men with atherosclerotic coronary disease (ACD; 87) and non-vasectomized men with ACD(111). The gelatin agglutination test (GAT), tube slide agglutination test (TSAT) and sperm immobilization test (SIT) were used to detect circulating anti sperm antibodies. Sperm antibodies developed within 6 months of vasectomy and persisted for more than 20 years. There was no difference in the incidence of antibodies in vasectomized healthy and ACD men. The results of this study provide no evidence for an association between cardiac disease and vasectomy. PMID- 3830364 TI - Aging: a challenge to science, society, and the individual. AB - The author presents a summary of the nature of the scientific, social, and individual challenges and some of the successes and failures in meeting them. Also presented are some optimistic and perhaps "futuristic" predictions of whether our responses to these challenges will be successful two or three decades from now. PMID- 3830365 TI - Symposium on common surgical problems. PMID- 3830366 TI - Geriatric anesthesia: minimizing the risk. AB - Aging is an all-encompassing, multifactorial process involving a decreased capacity for adaptation and a gradual decrease in functional reserve of all the body's systems. Aging itself is not truly a disease process but is instead an index of the probability of many disease states. Underlying disease is not always clinically evident in the elderly. Increased operative risk, when present, is attributable to identifiable disease, not simply to the aging process. A thorough understanding of the expected physiologic deviations from the norm must be the benchmark for the anesthesiologist, surgeon, and consultant in formulating a treatment plan. Deviations exceeding those expected must be dealt with cogently by this health care team. It is, therefore, extremely important to establish and maintain communication and understanding among the care team, the patient, and the family. With this approach, we can minimize the risks of anesthesia in the elderly. PMID- 3830367 TI - Surgery of the head and neck in the older patient. AB - While threatening in appearance, head and neck surgery is well tolerated by most elderly patients. Most surgery on the nose, sinuses, ears, and salivary glands is performed for benign conditions. Malignant disease is more common in the oral cavity, pharynx, and larynx. PMID- 3830368 TI - The medical profile of cataract patients. AB - The medical profile of patients undergoing cataract extraction is reviewed, documenting preexisting and newly discovered conditions. This article concludes that significant medical conditions exist in this population and the elderly may require the support of facilities for inpatient-based elective cataract extraction despite the trend toward out-patient surgery. PMID- 3830369 TI - Multidisciplinary management of the elderly patient with ovarian cancer. AB - The management of ovarian cancer in the aged patient is multifaceted. Diagnosis may be difficult and delayed, and aggressive surgery is often compromised. Multimodality therapy is desirable, but may have to be modified. The primary physician, surgeon, gynecologist, and medical oncologist must thoroughly understand the disease and how it effects the elderly patient. PMID- 3830370 TI - Carcinoma of the prostate in the elderly. AB - A comprehensive practical approach to the diagnosis, staging, and treatment of carcinoma of the prostate is presented. Prostatic cancer in the elderly patient is not a benign clinical condition. The approach is designed to minimize the morbidity of the disease process and to allow the patient to live as normal a life as possible. PMID- 3830371 TI - Pseudoclaudication. A review of etiology, diagnosis, and treatment. AB - The authors have presented an historical and clinical review of the pseudoclaudication syndrome. This disorder has become increasingly recognized during the past years, and it is important to keep in mind that pseudoclaudication can coexist with vascular insufficiency. Appropriate diagnosis and treatment can be rendered only when the correct diagnosis or diagnoses are made. As always, a thorough history and physical examination together with supplementary radiologic and neurophysiologic studies will lead the clinician to the correct cause of the symptoms presented and an appropriate course of treatment. PMID- 3830372 TI - Reconstructive preprosthetic surgery. AB - The overall health of an edentulous patient may be significantly affected when added to the multiple medical and psychiatric problems common to the elderly. A patient who has a significant oral prosthetic problem may be helped with current reconstructive preprosthetic surgical techniques. PMID- 3830373 TI - Degenerative lumbar stenosis. AB - Stenosis is a condition that is not recognized as frequently as it should be. The diagnosis should be suspected primarily on the basis of bizarre history and physical findings. Myelography is diagnostic. Surgical decompression is the treatment of choice in severe cases. Considerable clinical and experimental investigation remains to be done if we are to further understand the cause, institute efficacious preventive measures, and achieve more success in the treatment of degenerative lumbar stenosis and other spinal afflictions. PMID- 3830374 TI - Total joint replacement. AB - As of 1980, approximately 1,800,000 people reached the age of 65 each year in the United States. It may be estimated that each year 35,000 of these people would benefit from total hip replacement surgery and are medically fit for it. Numbers for knee replacement are similar. Other joint replacements are much less in number but may be equally done when indicated. With the constant improvement of surgical technique, prostheses, and medical expertise, these people can be offered significant improvement in the quality of life by replacement of painful disabling joints. PMID- 3830375 TI - Management of chronic wounds in the elderly. AB - The elderly patient with a chronic wound displays many characteristics peculiar to the age group that must be considered by the treating physician. This article describes a variety of specific age-related influences on wound healing, and incorporates several illustrative case reports. PMID- 3830376 TI - Psychiatric complications associated with geriatric surgery. AB - Detection of pre-existing psychopathologic problems in the geriatric surgical patient can often preclude further psychiatric complications. When complications such as delirium arise, collaboration between the surgeon and the psychiatrist enhances a satisfactory outcome. PMID- 3830377 TI - Rectal prolapse. AB - Rectal prolapse occurs mostly in the geriatric female patient and can be a very disabling condition. The etiology is intussusception of the rectosigmoid secondary to excessive and prolonged straining. Medical therapy for this disease process is not helpful and patients will require a surgical procedure. The two best surgical procedures for the correction of rectal prolapse are low anterior resection of the rectosigmoid and proctopexy. A few patients who are unfit for laparotomy may require the Thiersch Wire procedure. Two unresolved problems after surgical therapy are continuing constipation and incontinence. Constipation is treated by dietary measures, stool softeners, and periodic enemas. Laxatives are to be discouraged. Incontinence in patients with rectal prolapse improves in most patients after a procedure to correct the prolapse. In those patients in which incontinence persists, no form of therapy has been found to be uniformly successful. PMID- 3830378 TI - Acute cholecystitis in the elderly. A comparative study. AB - Acute cholecystitis is not an unusual sequela of chronic cholelithiasis, nor is its occurrence predictable. The elderly patient with acute cholecystitis faces an increased risk of death and illness. Prompt, remedial medical preparation followed by early surgical extirpation of the gallbladder (with common bile duct exploration where indicated) is the surgical treatment of choice. Cholecystostomy should be considered for those patients in whom a more extensive procedure is judged to be too hazardous. With Americans' intense interest in maintaining a vigorous, healthy, and youthful profile and their fear of dying, it is a most suitable protective health measure to advocate that all patients with calculous biliary tract disease be urged to have surgical intervention of this disease process before the complication of acute cholecystitis occurs. The risks of a cholecystectomy under elective conditions are low and the results are most gratifying. PMID- 3830379 TI - Alternatives in the management of pancreatic cancer. AB - Pancreatic carcinoma is one of the most lethal malignancies seen in humans. If cure is to be effected, radical surgery for small lesions confined to the gland must be undertaken, but the cost in morbidity and mortality is high. An otherwise fit elderly patient should not be denied the small chance of cure because of age alone, but such a patient must be frankly appraised of the significant risks and limitations of resectional therapy. The Whipple procedure remains the standard operation for lesions of the head of the gland, but pre-existing severe diabetes and technical factors may dictate that a total pancreatectomy be performed. Patients with unresectable cancers who develop biliary or enteric obstruction should be bypassed internally if otherwise healthy. If frail or infirm from other organ failure, patients may be offered relief by a percutaneous decompression with minimal risk. Pain must be dealt with in all patients with celiac blocks or liberal use of analgesics. Adjuvant forms of therapy are experimental, costly in time and money, not without serious side effects, and should be advised cautiously in elderly patients. PMID- 3830380 TI - Surgical management of complicated diverticulitis. AB - The majority of patients with acute diverticulitis can be managed medically. Some will have a complication of diverticulitis such as free perforation with peritonitis, abscess formation, obstruction, or fistula formation. Perhaps even a larger number will develop recurrent diverticulitis, which is associated with an increased rate of complications. Although the preoperative diagnosis of these problems may be obvious in many patients, elderly or steroid-treated patients may have few manifestations of significant intra-abdominal disease. Of extreme importance in the management of these complications of diverticulitis is the preoperative resuscitation. Intravascular volume depletion is replaced with intravenous fluids, and intravenous antibiotics are given. At this time, with any of these complications, it is unusual to perform the classic three-stage operation, which includes an initial diverting colostomy and drainage followed by resection of the involved colon and, finally, a colostomy closure as the third stage. The usual treatment now is a two-stage operation with the initial operation being resection of the diseased segment and formation of a colostomy proximally and either a mucous fistula or a Hartmann's pouch distally. The second stage is the colostomy closure. This two-stage approach is indicated in patients with acute diverticulitis complicated by perforation, whether free or confined with abscess formation, and in patients with obstruction or fistula formation in whom a preoperative bowel preparation is not possible. Resection and primary anastomosis should not be performed in the elderly in the emergency setting for complicated diverticulitis. However, this is the procedure of choice in the elective treatment of diverticulitis and its complications in the elderly. PMID- 3830381 TI - Surgical treatment of low-lying carcinoma of the rectum. AB - The standard operative treatment of low-lying rectal cancer has been abdominoperineal resection. In the elderly patient, this treatment has significant risk. One-fourth of the patients had major complications and another one-fourth had minor complications. The operative mortality was 6.8 per cent for patients 65 years of age and over and 7.7 per cent for patients 70 years old and over. Patients with metastatic disease at the time of diagnosis had a dismal prognosis despite treatment with abdominoperineal resection. Postoperative pelvic radiotherapy should help reduce pelvic recurrence. Generally, patients with tumors less than 5 cm in diameter and less than 5 cm from the dentate line should be considered for initial transanal excision. It appears that very good local tumor control can be achieved by transanal excision for tumors confined to the bowel wall. Only 6.9 per cent of patients with tumors confined to the bowel wall had lymph node metastasis. The low risk of occult lymph node metastasis from tumors confined to the bowel wall is offset by the operative risk of abdominoperineal resection. Further evaluation of transanal excision of selected rectal cancers is indicated. Patients with villous adenomas with superficial carcinoma can be adequately treated repetitively with transanal local excision. In this case, there was a 50 per cent local recurrence rate. Local recurrence occurred in some patients five or more years after the initial treatment, thus emphasizing the need for prolonged close proctoscopic follow-up. PMID- 3830382 TI - Falls and gait disorders among the elderly. A challenge for research. PMID- 3830383 TI - Symposium on falls in the elderly: biologic and behavioral aspects. PMID- 3830384 TI - Clinical and laboratory studies of falls in old people. Prospects for prevention. AB - Elderly people at risk of falling may be divided into high, intermediate, and low risk groups. In all three, but especially in the low-risk group, a large number of people have to be treated in order to prevent an unfavorable outcome. Attempts have been made to prevent further falls, fractures, hospitalization, and death by domiciliary treatment of high-risk patients and by exercise and dance in low-risk subjects. These studies have proved difficult to establish and to evaluate, and as yet no clear evidence has been produced on the effectiveness of these interventions. PMID- 3830385 TI - Environmental factors associated with stair accidents by the elderly. AB - Stairs have been shown to be the most hazardous component of the everyday physical environment. The elderly have been identified as the segment of the population that is most vulnerable to accidents on stairs. Research reported herein attributes much of this heightened vulnerability to decrements in perceptual and motoric functioning associated with aging. Specific characteristics of stair design that have contributed to, or could minimize, this vulnerability are discussed. PMID- 3830386 TI - Falls, motor dysfunction, and correlative neurohistologic changes in the elderly. AB - The development of structural and functional deficits in the aging nervous system may constitute one important source of falls in the elderly. Present information is suggestive and is still based primarily upon tissue specimens from chronically ill and hospitalized patients. Within these limits, examples of structural changes are presented, and the possible functional consequences are examined. Although discrete patterns of motor weakness may follow such dysfunctions, overall problems in the timing and sequencing of motor action programs may be equally important in leading to falls and injury in the elderly. PMID- 3830387 TI - Symposium on hematologic disorders. PMID- 3830388 TI - Vitamin B 12 deficiency in the elderly. AB - Vitamin B 12 deficiency is usually a disease of older persons, and much controversy has surrounded the significance of the deficiency of this vitamin in these patients. This article explores the mechanism of action of vitamin B 12, the clinical and laboratory features of vitamin B 12 deficiency, and a rational treatment plan. Once vitamin B 12 deficiency is recognized and diagnosed, it can be easily treated, usually with gratifying results. PMID- 3830389 TI - Chronic lymphocytic leukemia. AB - Chronic lymphocytic leukemia is a neoplasm characterized by the accumulation of monoclonal lymphocytes in blood, bone marrow, and other tissues. Staging of the disease is based on lymphoid mass and the presence of anemia or thrombocytopenia, with prognosis also related to the pattern of bone-marrow involvement, chromosomal abnormalities, and surface membrane phenotype. Transformation to a diffuse large-cell lymphoma or to prolymphocytic leukemia may occur as a terminal event. A number of biochemical and surface membrane abnormalities that may suggest approaches for future clinical investigations have been described. PMID- 3830390 TI - Coagulation in the elderly. AB - The elderly have few bleeding disorders related exclusively to the aging process. However, abnormalities of coagulation are seen frequently in this group as complications of other illnesses. Thus a good understanding of basic coagulation physiology and testing will provide the necessary tools for therapeutic guidance. PMID- 3830391 TI - The use of antithrombotic therapy in the elderly. AB - The elderly are predisposed to atherosclerosis and venous thrombosis, the conditions for which anticoagulants are used. Anticoagulants can be used safely in the elderly with little or no more risk of bleeding than exists in younger patients. The prescribing physician must know the mechanism of drug action, be attentive to potential side effects, and monitor drug activity adequately. The authors emphasize the oral anticoagulants and heparin because, in general, their use is associated with a greater degree of risk and more clearly defined benefits than would apply for the antiplatelet agents. PMID- 3830392 TI - [Calcium antagonists and their clinical applications]. PMID- 3830393 TI - [Electrophysiologic profile of calcium antagonists]. PMID- 3830394 TI - [New perspectives in the treatment of ischemic heart diseases with calcium antagonists. Introduction]. PMID- 3830395 TI - [Vasospastic angina: natural history and changes induced by therapy with calcium antagonists]. PMID- 3830396 TI - [Role of diltiazem in the treatment of acute myocardial infarct]. PMID- 3830397 TI - [Clinical study of diltiazem in angina pectoris. Dose-effect relationship and randomized double-blind comparison with propranolol]. PMID- 3830398 TI - [Pharmacology of calcium antagonists]. PMID- 3830399 TI - A tuberculin survey in the Buhera district. PMID- 3830400 TI - Acute superior mesenteric vascular occlusion following internal herniation of redundant sigmoid colon. PMID- 3830401 TI - Growth and nutrition of Zambian children. PMID- 3830402 TI - Development of an objective method for assessing topical corticosteroid efficacy. PMID- 3830403 TI - Challenges for the use of evoked potentials and electrophysiology for monitoring patients in the operating theater. PMID- 3830404 TI - Spinal cord monitoring: basic principles and experimental aspects. AB - Spinal cord monitoring, based on spinal cord potentials recorded close to the conus medullaris and evoked by stimulating rostral spinal cord, has been extensively used clinically in Japan. To understand how such spinal cord evoked potentials (SCEP) reflect injurious effects on the spinal cord, we carried out the following animal experiments. The effects of spinal cord distraction, compression, and combined compression and hypotension or hypoxia were examined. We found that there is a critical point of compression or distraction of the spinal cord at which SCEP amplitude decreases significantly. Acute hypotension concomitant with moderate compression increases the risk of insult to the cord. Accordingly, we believe that repetitive monitoring and rapid feedback to the surgeon are indispensable to intraoperative spinal cord monitoring. Furthermore, hypotension should be carefully avoided whenever symptoms of spinal cord compression occur. A comparative study of SCEP and spinal SEP indicates that both potentials can substitute for each other, although the sensitivity of the SCEP for detecting hazardous effects is higher. PMID- 3830405 TI - Ascorbic acid: a putative biochemical marker of irreversible neurologic functional loss following spinal cord injury. AB - The development of permanent paraplegia in spinal injured cats is accompanied by a large progressive decline in total ascorbic acid (AA) and a transient increase in oxidized (AAox) ascorbate. Since AA is involved in a variety of processes required for normal central nervous system (CNS) performance we suggested that such large ascorbate loss may contribute to derangements in spinal cord function following injury. We now demonstrate that methylprednisolone (15 mg/kg) and naloxone (10 mg/kg), two treatments that preserve neurologic function in this model, rapidly block deteriorating ascorbate status. Naloxone at 1 mg/kg, a treatment providing no therapeutic benefit, has no protective effect on ascorbate. The results strongly support the hypothesis that loss of ascorbate homeostasis reflects irreversible loss of neurologic function following spinal cord injury. PMID- 3830406 TI - [The influence of genetic counseling on reproduction]. PMID- 3830407 TI - [Cluster analysis of pregnant women based on pelvic dimensions]. PMID- 3830408 TI - [Surgical treatment of extrauterine pregnancy]. PMID- 3830409 TI - [Amniotic uric acid and urea in the last trimester of pregnancy]. PMID- 3830410 TI - [Complete uterine rupture in the 1st trimester of pregnancy]. PMID- 3830412 TI - Siccanin: a new antifungal antibiotic with antidermatophytic properties. In vitro studies. AB - The in vitro antifungal properties of the antibiotic siccanin were determined by the minimal inhibitory concentrations (MIC) values against 51 fungal strains (yeasts and filamentous fungi). The comparison was made with econazole, clotrimazole, 5-fluorocytosine and griseofulvin. The results show the useful antidermatophytic activity of siccanin. PMID- 3830411 TI - [Diagnosis and treatment of precancerous states and cancer of the cervix. A selection of reports presented at the 5th Prague Oncology Seminar of the Gynecology Section of the Czech Oncologic Society. Prague, 11 January 1984]. PMID- 3830413 TI - Changes in resistance to aminoglycoside antibiotics of different bacterial strains isolated during the period 1978 to 1983. Netilmicin as alternative therapy. AB - The percentage resistance of 11,404 gram-negative and gram-positive bacterial strains isolated from different biological materials between 1978 and 1983 to some aminoglycoside antibiotics (gentamicin, tobramycin and amikacin) was determined. The percentage of resistant Pseudomonas, Staphylococcus and indole positive Proteus organisms significantly increased. There was also a significant decrease in gentamicin-resistant strains of the Escherichia coli and Proteus mirabilis species. We also compared the in vitro activity of netilmicin (routinely tested from the beginning of 1983) with those of the other aminoglycosides against 1546 bacterial strains. Netilmicin was found to have greater antibacterial activity than gentamicin or tobramycin. In addition, netilmicin was active against 48.9% of the strains that were resistant to gentamicin and/or tobramycin. PMID- 3830414 TI - Etoposide-induced hypersensitivity reactions. Report of two cases. AB - Two cases of hypersensitivity reactions following etoposide infusion are reported, occurring in patients not previously exposed to the drug. In both cases, bronchospasm and diffuse skin flushing were the associated clinical findings. The present experience does not confirm the previous report by O'Dwyer and Weiss, who inferred the existence of two distinct clinical patterns in such patients, with either bronchospasm or flush. Type I hypersensitivity must be regarded as a possible acute adverse effect of etoposide infusion therapy, but more research seems necessary to elucidate the pathophysiology of this phenomenon. PMID- 3830415 TI - Decrease of granulocyte-macrophage colony-forming units during high dose medroxyprogesterone acetate treatment in advanced breast cancer. AB - We treated 18 post-menopausal women with advanced breast cancer with medroxyprogesterone-acetate 1000 mg p.o. daily. The study of granulocyte macrophage colony forming units (GM-CFU) performed monthly, and peripheral white blood cell count showed an increase of granulocytes not statistically significant and a progressive decrease of GM-CFU that could protect marrow from chemotherapeutic agents or interfere with the myelosuppression of cytotoxic drugs. PMID- 3830416 TI - The influence of cross-linking time on the adsorption characteristics of microcapsules containing activated charcoal prepared by gelatin-acacia coacervation. PMID- 3830417 TI - Synthesis and antihypertensive activity of 5-(2-hydroxyphenyl)-1-(3 mercaptopropionyl)-2-pyrrolidinecarboxylic acids. PMID- 3830418 TI - Bifunctional variations of the antidepressant amitriptyline theme. PMID- 3830419 TI - Studies on analgesic oligopeptides. IV. Synthesis and analgesic activity of N terminal shorter analogs of [D-Arg2]dermorphin and des-Tyr1-dermorphin analogs. PMID- 3830420 TI - Studies on prodrugs. IV. Preparation and characterization of N-(5-substituted 2 oxo-1,3-dioxol-4-yl)methyl norfloxacin. PMID- 3830422 TI - Purification of vitamin D binding proteins (group-specific components) in human plasma using a chromatofocusing method. PMID- 3830421 TI - Syntheses and antiinflammatory activity of malonamic acid, malonamate and malonamide derivatives of some heterocyclic compounds. PMID- 3830424 TI - Pharmacokinetics in hepatic transport of amaranth in rats intoxicated with carbon tetrachloride and alpha-naphthylisothiocyanate. PMID- 3830423 TI - Structure-function Relationship of antitumor beta-1,3-glucan obtained from matted mycelium of cultured Grifola frondosa. PMID- 3830425 TI - Influence of vehicle on gastrointestinal absorption of phenytoin in rats. PMID- 3830426 TI - Comparison of the effects of sesame oil and oleic acid as suspension vehicles on gastrointestinal absorption of phenytoin in rats. PMID- 3830427 TI - Esterase-like activity of human serum albumin. V. Reaction with 2,4-dinitrophenyl diethyl phosphate. PMID- 3830428 TI - Fate of lipid and encapsulated drug after intramuscular administration of liposomes prepared by the freeze-thawing method in rats. PMID- 3830429 TI - Influence of bile on the gastrointestinal absorption of phenytoin in rats. PMID- 3830430 TI - Studies on hypolipidemic agents. IV. Influence of a new hypolipidemic agent, 5 tridecylpyrazole-3-carboxylic acid, on cholesterol metabolism in rats. PMID- 3830431 TI - A facile synthesis of aminocarboxylic acid derivatives, new anti-ulcer agents. PMID- 3830432 TI - Inhibitory effects of tannins on hyaluronidase activation and on the degranulation from rat mesentery mast cells. PMID- 3830433 TI - Platelet aggregation potentiators from cho-rei. PMID- 3830434 TI - Purification, antitumor activity, and structural characterization of beta-1,3 glucan from Peziza vesiculosa. PMID- 3830435 TI - Study of the interactions between sulfamethizole and three anti-inflammatory propionic acid derivatives at the renal level in rats. PMID- 3830436 TI - The effect of sacrificing method on the tissue concentration of exogenous creatinine in rats. PMID- 3830437 TI - Relationships between crystallinity of beta-cyclodextrin and tablet characteristics. PMID- 3830438 TI - Percutaneous absorption and metabolism of hydrocortisone butyrate propionate in dog skin. PMID- 3830439 TI - Preparation and evaluation in vitro and in vivo of polycarbonate microspheres containing dibucaine. PMID- 3830440 TI - Antitumor activity of 5-substituted 2-acylamino-1,3,4-thiadiazoles against transplantable rodent tumors. PMID- 3830441 TI - Significant effects of synthetic Gln-Val-Val-Ala-Gly and its derivatives, common sequences of thiol proteinase inhibitors, on thiol proteinase. PMID- 3830442 TI - [Congenital cystic adenomatoid malformation of the lung]. AB - Congenital cystic adenomatoid malformation of the lung (CCAM) has been reported with increasing frequency since it was first described in 1949. In a review of the literature by Halloran and co-workers in 1972, 61 cases were reported. After ten years, we collected from the literature 279 cases. The malformation is characterized by a multicystic mass of lung tissue with bronchiolar proliferation and alveolar impairment. The clinical picture of this pulmonary malformation varies with the age at presentation. In the neonatal period the respiratory distress syndrome is often very serious and may require an urgent treatment. In the older infant, the unrecognized disease has more often a chronic course characterized by recurrent respiratory infections and failure to thrive. Sometime, the malformation may be completely silent and be disclosed during a routine examination of the thorax for others reasons. Both types of presentations of the cystic adenomatoid malformation require a surgical therapy and the lobectomy is the treatment of choice. The prognosis following resection in the older patients is generally good, while in the neonatal period the remaining hypoplastic pulmonary tissue may represent a problem in the postoperative ventilatory management. Two cases of congenital cystic adenomatoid malformation observed in a 5 months old and in a 10 months old infants are reported. The clinical, pathologic and radiologic features of this pulmonary malformation are discussed. The hypothesis of a future "in utero" correction of the most severe cases, in order to prevent the pulmonary hypoplasia of the healthy parenchyma, is also suggested. PMID- 3830443 TI - [A new technic of gastric tube esophagoplasty in children]. AB - In cases of caustic oesophageal strictures that need oesophagoplasty, the removal of the injured oesophagus is always necessary--a fact that demands a new transthoracic operation. The authors describe a technique which combines, in a one stage operation, the blunt total transmediastinal oesophagectomy and reverse gastric tube oesophagoplasty, this being placed in the posterior mediastinum in the bed of the oesophagus removed by eversion stripping. The authors carried out thirteen oesophagoplasties of this type with no mortality and no severe complications. PMID- 3830444 TI - [Digestive stenosis after neonatal enterocolitis]. AB - Nineteen clinical cases of intestinal stricture due to neonatal necrotising enterocolitis and a review of available references are presented in this paper. Intestinal strictures are estimated to arise in 20% to 30% on neonatal enterocolitis. However the delay between the acute episode and the occurrence of the stenosis is variable; the depth and the extend, of the necrosis as well as inflammation and superinfection may contribute to the building up of the intestinal stricture. The histological aspects of the lesions are not unique, more over cases of spontaneously regressive stenosis are known. Question thus arising as to the most appropriate timing for surgery and the choice of surgical technics as a function of clinical aspects and of derivation of the disease are discussed in this paper. PMID- 3830445 TI - [Injuries of the liver in children. Review apropos of 30 cases]. AB - Between 1970 and 1983, 30 children have been treated for a liver trauma. 16 were from 5 to 10 years old. 6 had solitary hepatic lesions and 24 had visceral or polytraumatic associated lesions. All but one were operated and 27 underwent an emergency laparotomy. Superficial tears and subcapsular hematoma were found in 11 cases while penetrating wounds (14), vascular injuries (3) and ruptures (2) represent 2/3 of the whole lesions. In five cases, hepatectomy was necessary. Half of the 6 deaths result of a vascular injury, the others of the associated lesions. We have a resolutely surgical behavior when collapse or polyvisceral lesions are patent, while in isolated blunt injury a single clinical and echographic follow up is justified. A CT scan is necessary when a penetrating wound is suspected completed with an angiography. PMID- 3830446 TI - [Cardiovascular adaptability to acute hypercalcemia in the dog. The role of peroperative myocardial ischemia]. AB - Since the hemodynamic consequences of acute hypercalcemia are altered by numerous interferences we have evaluated the role of peroperative myocardial ischemia on the adaptability to rapid calcium increment. Twenty-two dogs served as control and 16 were submitted to 1 hour of myocardial ischemia along with topical myocardial cooling. Each animal was equipped with blood flow transducer positioned around the ascending aorta and with central venous and aortic catheters. During each study 0.90 mEq of calcium was rapidly injected and hemodynamic data were recorded until base-line resetting. This experimental protocol was carried out 3 hours postoperatively and then daily during one month. Base-line hemodynamic data indicated the presence of myocardial failure in the experimental group in the immediate postoperative period only. Rapid calcium administration elicited transient positive inotropic response, widening of the arterial pulse pressure, reflex bradycardia and no evidence of peripheral vasoconstriction. In the early postoperative period (3 hours after surgery) the failing myocardium is more sensitive to the inotropic effect of hypercalcemia. Twenty-four hours after surgery both groups of animals have the same hemodynamic response to this stress; thereafter for both groups this response gradually decreased and finally stabilized by the 6th to 10th day after surgery. Acute hypercalcemia bears hemodynamic consequences that are amplified early after peroperative myocardial ischemia. However in long term this surgical component widely used clinically does not interfered with the cardiovascular adaptability to this pharmacological stress. PMID- 3830447 TI - [Teratoma strictly of the buttocks in a 13-year-old girl]. AB - A 13-year old girl was admitted to our hospital because of an ulcerated gluteal tumor. This tumor was present since birth. A diagnostic procedure was performed. This tumor was strictly limited to the gluteal region, without pelvic extension, but with sacral malformation. Total surgical excision was completed. Pathology report revealed a histologically benign teratoma. The origin of the tumor is discussed. PMID- 3830448 TI - [Stenosis of the ureter in the development of Crohn's disease]. AB - The authors report the exceptional case of a young boy, 14 years old, affected by Crohn's disease, first treated medically. Extension and aggravation of injuries required right hemicolectomy. An obstruction of right ureter appeared, diagnosed by echography. The investigations showed up a stenosis of right ureter. A resection-suture was performed and the follow up at two years in good. PMID- 3830449 TI - [Anuria caused by renal pelvis candidiasis in an infant]. AB - Report of a case of rare anuria in a newborn, secondary to bilateral ureteropelvic fungus balls obstruction. Urinary decompression by bilateral nephrostomy associated to Ketoconazole therapy allowed recovery. PMID- 3830450 TI - [Benign mediastinal lipoblastomatosis]. AB - Two cases of mediastinal lipoblastomatosis have been observed and cured by surgical excision: one, a circumscribed form, in a 6 months old boy, other, a diffuse form, in a 20 months old girl. Both are in good health for a 11 and 2 years period of follow-up observation respectively. The subject is reviewed. PMID- 3830451 TI - [A case of ocular cysticercosis]. PMID- 3830452 TI - [Photosection using Yag laser. Mechanism of action, role of the plasma and contact lenses]. PMID- 3830453 TI - [Nd-Yag laser: clinical applications]. PMID- 3830454 TI - [Initial results of the use of the picosecond Yag laser in diseases of the vitreous body]. PMID- 3830455 TI - [Clinical examination in our understanding of strabismus]. PMID- 3830456 TI - [Tumors of the orbit. Aspects and problems concerning the approach]. PMID- 3830457 TI - [Association of glaucoma and cataract. Diagnostic and therapeutic approach]. PMID- 3830458 TI - [Primary empty sella turcica with chiasmatic involvement]. PMID- 3830459 TI - [Value and reliability of an automatic objective refractometer: the Dioptron Nova. A statistical study on computer of 600 measures]. PMID- 3830460 TI - [3 cases of retinal detachment caused by spontaneous dialysis at the ora serrata in the young emmetrope with presence of vitreous below the retina]. PMID- 3830461 TI - [Surgical treatment by intrascleral indentation of retinal dialyses]. PMID- 3830462 TI - [2 cases of bilateral acute necrotizing retinitis: 1 in icterohemorrhagic leptospirosis, the other caused by probable autoimmune involvement (bilateral acute retinal necrosis)]. PMID- 3830463 TI - [Clinical and therapeutic triad of strabismic amblyopia]. PMID- 3830464 TI - Symposium on new technology in pulmonary disease. PMID- 3830465 TI - Open lung biopsy. Processing, evaluation, and diagnosis. PMID- 3830466 TI - Transcutaneous oxygen monitoring. PMID- 3830467 TI - Diagnostic value of fiberoptic bronchoscopy in acquired immunodeficiency syndrome. PMID- 3830468 TI - Analytical electron microscopy in pneumoconiosis. PMID- 3830469 TI - Magnetic resonance imaging of the chest. Initial experience. PMID- 3830470 TI - Bronchoalveolar lavage. PMID- 3830471 TI - The importance of verifying the diagnosis of acute venous thrombosis. PMID- 3830472 TI - Orthostatic hypotension. Clinical experience with diagnostic tests. PMID- 3830473 TI - Inclusion body myositis. A possible chronic persistent muscle infection by mumps virus. PMID- 3830474 TI - Parathyroid hormone-like bioactivity in tumours from patients with oncogenic osteomalacia. AB - Extracts from the tumours of three patients with oncogenic osteomalacia stimulated renal adenylate cyclase in a parathyroid hormone (PTH) responsive system. The stimulation was suppressed by a specific PTH antagonist. These observations suggest that osteomalacia-producing tumours exert some of their effects through PTH-like material acting on PTH receptors. PMID- 3830475 TI - Serum thyroxine and triiodothyronine in patients receiving increasing doses of L thyroxine. PMID- 3830476 TI - Acquired subglottic stenosis in neonates. PMID- 3830477 TI - A history of acute suppurative otitis media and allergic symptomatology in children with chronic secretory otitis media and controls. AB - The parents of children with secretory otitis media and the parents of healthy children attending for routine school or community medical examinations have been questioned about previous acute otitis media, aural discharge, chronic nasal symptoms and allergic disorders. Eighty-nine pairs of children, matched for age and sex, were available for analysis. There was a significantly higher incidence of acute otitis media, aural discharge and chronic nasal symptoms in the secretory otitis group (P = less than 0.001). Amongst the allergic symptoms and disorders, the only significant differences demonstrated were for drug allergy, eye itching and eye running (P = less than 0.05). The results confirm that a relationship exists between acute otitis media and secretory otitis media and also support the conventional image of the child with secretory otitis as a mouth breather with nasal symptoms. They do not lend support to the view that allergy is an important factor in the pathogenesis of secretory otitis. PMID- 3830478 TI - Acoustic brainstem responses for clinical use: the effect of attention. AB - The acoustic brainstem response (ABR) is generally thought to be unaffected by variation in attention; however, recent papers suggest that during visual distraction of the subject wave Nv may be delayed. We have examined the ABRs of 22 normal subjects in states of auditory attention and visual distraction, using routine clinical testing procedures. We have shown that under these conditions altered attention states have no demonstrable effect on the latency of wave Nv. PMID- 3830479 TI - Subglottic stenosis: a clinicopathological study. AB - Subglottic stenosis is the most common serious long-term complication of endotracheal intubation in neonates and its pathogenesis is poorly understood. We describe the experience of one unit with 15 cases of subglottic stenosis requiring operative intervention seen over a 3-year period and review the pathology and pathogenesis of the condition. In 1 instance operative intervention was successful in treatment and avoided the need for long-term tracheostomy. A possible aetiological factor in at least 2 of the cases of subglottic stenosis was insertion of the wide shoulder of the endotracheal tube through the vocal cords. It is suggested that subglottic stenosis is due to reparative fibrosis following particularly severe acute intubation injury. Another factor may be delayed healing of the subglottic mucosa possibly exacerbated by full thickness cricoid cartilage necrosis. Although severe subglottic injury may occur at any time that the endotracheal tube is in situ, the most critical period is the first week of intubation. PMID- 3830480 TI - Cricoid pressure and sharp foreign bodies. AB - Cricoid pressure may be performed when a sharp object such as an animal bone is lodged in the post-cricoid oesophagus. This study was undertaken to determine what damage, if any, may be caused to the oesophagus. A sharp foreign body was inserted into the post-cricoid region of 15 cadavers. In five cases no other procedure was performed. In the remaining 10 cases, intubation with and without cricoid pressure was also performed. No significant damage was visible to the naked eye when the oesophagus was subsequently examined. Cricoid pressure does not seem to result in significant damage in this situation. PMID- 3830481 TI - The effect of adenoidectomy on secretory otitis media: a 2-year controlled prospective study. AB - Seventy-eight preschool children considered to be suffering from long-standing secretory otitis media on the basis of a combination of impaired or abolished mobility of the tympanic membrane and conductive deafness, were examined consecutively. All children underwent bilateral paracentesis. Those children whose ears contained mucous secretion subsequently constituted a prospective longitudinal study group. On the same occasion as the paracentesis was performed, 24 children with bilateral or unilateral mucous secretion in their ears underwent adenoidectomy. Thirty-five non-adenoidectomized children with mucous secretion in one or both ears served as controls. Both groups were followed up for 24 months. At the end of this period they were compared with respect to the state and mobility of the eardrum, a pure tone average audiogram and middle ear impedance. No difference was detected between the two groups. It is therefore concluded that the preventive and therapeutic effects of adenoidectomy on secretory otitis media are doubtful. PMID- 3830482 TI - Large meatoplasty technique for mastoid cavities. AB - A large meatoplasty improves the postoperative management of mastoid cavities in providing good ventilation, preventing otorrhoea and allowing ease of inspection for removal of wax. A technique to provide a large meatoplasty is described and the results of 56 operations performed over a 5-year period are reviewed. PMID- 3830483 TI - Treatment of haematoma auris. PMID- 3830484 TI - Symposium on melanoma and pigmented lesions. PMID- 3830485 TI - Melanocytic nevi and malignant melanoma. AB - It has been known for a long time that melanoma can have its origin in congenital or acquired melanocytic nevi. In regard to congenital nevi, there is sufficient evidence to state that large lesions (those greater than 20 cm in diameter) have a significant risk factor that is several-fold greater than for common acquired nevi. Prophylactic excision of such lesions should be strongly considered when it is feasible, but individual circumstances must be taken into account. The risk factors for small and medium-sized congenital nevi have not been accurately determined; therefore, no uniform recommendation can be made regarding their management. There is no objective evidence to indicate that common acquired nevi in any particular anatomic sites, such as volar or genital skin, are at greater risk for the development of melanoma than are any others. Patients with familial dysplastic nevus syndrome must be identified and followed carefully in order to recognize and eradicate evolving and early melanomas. The concept of the sporadic dysplastic nevus syndrome is intriguing and deserves careful study to further define the clinical and histologic diagnostic criteria that will enable accurate determination of its prevalence and risk factors. PMID- 3830486 TI - Dysplastic nevus syndrome. Familial and sporadic precursors of cutaneous melanoma. AB - Familial dysplastic nevus syndrome is an autosomal-dominant precursor of hereditary melanoma in which individuals have clinically and histologically distinctive nevi and a markedly increased risk for development of melanoma. Dysplastic nevi also are found in sporadic forms. Classification of the condition of the patient and proper management including regular examination of nevi can help to determine the risk of melanoma and minimize the potential for neoplastic progression. PMID- 3830487 TI - The dysplastic nevus. Clinical and pathologic features. AB - The dysplastic nevus has not only been considered to be a "marker," but also a formal "precursor" of malignant melanoma. Therefore, these lesions are important to recognize clinically. This article presents a classification of the dysplastic nevus based upon its variable clinical presentations. It is hoped that this classification will assist the physician to recognize many of the clinical variants of this unusual melanocytic nevus and, thus, to identify patients at greater risk for the development of malignant melanoma. PMID- 3830488 TI - The management of patients with dysplastic and congenital nevi. AB - Although both dysplastic and congenital nevi appear to have a greater-than expected risk for evolving into malignant melanoma, the magnitude of that risk is uncertain. For this reason, the management of patients with these lesions remains controversial. The National Institutes of Health Consensus Conference guidelines are presented with specific recommendations for the management of patients. PMID- 3830489 TI - Epidemiology of cutaneous melanoma. AB - Although intermittent intense solar exposure and genetic traits such as fair skin continue to be associated with the risk of developing cutaneous melanoma, these factors fail to account for much of the incidence. Suggestive evidence has increased speculation that viral agents, radiation, hormones, chemicals in the workplace, and dietary factors play some etiologic role. PMID- 3830490 TI - The clinical features of malignant melanoma. AB - The clinical diagnosis of malignant melanoma requires the following: an acceptance of the concept of "in situ" malignancy, both clinically and histologically; a high index of suspicion concerning any pigmented lesion; recalling the mnemonic "remember your A,B,C,D's"; and a knowledge of the clinical simulators of malignant melanoma. Prevention of death from malignant melanoma is possible through early diagnosis and prompt treatment of thin lesions (less than 0.76 mm in thickness). Such lesions have an excellent prognosis. This goal can be reached by carefully designed and implemented professional and public education programs such as those that have been introduced in Australia, West Germany, and the United States. Currently, new programs are being developed jointly by the American Academy of Dermatology and the American Cancer Society that are aimed at promoting self-examination of the skin as an adjunct to a routine physician examination as an additional means of detecting malignant melanoma at a time when it is wholly curable. PMID- 3830491 TI - Pathology of melanoma. AB - The biologic behavior of several common clinicopathologic types of melanoma is generally predictable by the depth of tumor invasion. However, some individuals have tumors that do no behave as predicted. These include what some authors have called borderline melanoma and minimal deviation melanoma as well as desmoplastic melanoma, thin superficial spreading melanoma with marked regression, and melanomas arising within some nevi. The reasons for the erratic behavior of these melanomas remains enigmatic. PMID- 3830492 TI - Ocular melanomas. AB - The importance of melanomas of the eye and adnexa is that they can be as deadly as the most aggressive cutaneous types, with 15-year mortality rates approaching 50 per cent. Also, treatment may permanently impair the sight. This discussion of melanomas that affect the eye and adnexa commences with the eyelids, proceeds to the conjunctiva, follows with the ocular globe, and includes a consideration of the dysplastic nevus syndrome as it affects the eye. PMID- 3830493 TI - Prognosis of malignant melanoma. AB - Multiple factors appear to influence survival in patients with malignant melanoma. Although at present thickness appears to be the best individual prognostic factor, other variables such as anatomic site of the lesion, ulceration, and level consistently appear in multivariate prognostic models. These multivariate models enable the assessment of patient prognosis for the optimization of treatment as well as the evaluation of future therapeutic trials. Future study of these prognostic factors will hopefully help us to understand the pathophysiology of melanoma and, possibly, unlock the secrets of the biology of this disease. PMID- 3830494 TI - Surgery for primary cutaneous malignant melanoma. AB - In summary, we believe that in the following situations elective regional lymph node dissection should not usually be performed: Patients whose primary malignant melanomas are in situ or have a maximal thickness of less than 1.0 mm. The incidence of regional node metastases in the latter group is so low that regional lymph node dissection is not justified. Patients whose primary malignant melanomas are in the midline of the head and neck or the trunk. Bilateral nodal dissections in these two regions of the body in the absence of a clearly demonstrable therapeutic advantage are not justified. Whether radioisotopic localizing studies will add greater definition to this group remains to be seen. Elderly patients or those with serious intercurrent disease. They should not undergo elective nodal dissection unless the primary malignant melanoma is very thick and lies directly over its nodal group. Patients with systemic metastases. For all remaining patients, the therapeutic or at very least prognostic advantages of elective regional lymph node dissections have been outlined. Conversely, an adverse effect on the course of the disease has never been demonstrated. We adhere to a policy that includes these procedures as primary therapy, provided they are performed with minimal morbidity. Should a surgeon elect not to perform such a procedure in the absence of clinically suspicious lymphadenopathy, careful clinical evaluation at 2-month intervals for the first 2 to 3 years following primary excision, with more prolonged intervals thereafter, would appear prudent. Until such time as effective means of eradicating systemic metastatic malignant melanoma exist, surgery remains the treatment of choice for this potentially fatal neoplasm. Efforts to develop effective adjuvant treatment based on the precise means of delineating prognosis that have thus far been developed has eluded investigators. A reasoned surgical approach is still required in our judgment until the identification and treatment of premalignant precursor lesions are universal or effective systemic therapy is available. PMID- 3830495 TI - Radiotherapy of malignant melanoma. AB - The role of radiotherapy in the treatment of malignant melanoma is limited, and surgery generally forms the mainstay of medical practice. However, there are some circumstances in which radiotherapy should be considered the treatment of choice. Symptomatic metastatic lesions in bone or brain can effectively be palliated in a substantial proportion of instances. At the current stage of our knowledge, conventionally fractionated treatment of such lesions forms the standard against which other treatments should be measured. In contrast, metastatic lesions to skin or lymph nodes that do not overlie critical normal structures probably are better treated by high-dose-per-fraction techniques. Radiotherapy may play a definitive role in the treatment of lentigo maligna. The precise optimal energy of the beam to be used remains to be defined. Slightly more penetrating radiation appears to be required for lentigo maligna melanomas. Here, too, the optimal energy remains to be defined. The treatment of nonlentigenous melanomas primarily by radiotherapy is unproved in my opinion. Certainly, the data from the Princess Margaret Hospital is exciting, but I believe it must be corroborated by a well designed trial before it can be accepted without question. Future directions in treatment of malignant melanoma are likely to include further trials of unconventional fractionation and the use of radiosensitizing agents in conjunction with radiotherapy. The time for dermatologists and radiation therapists to cooperate in such studies is at hand. PMID- 3830496 TI - Prevention of malignant melanoma. AB - In sum, it is highly likely that a concerted effort to identify thin malignant melanomas when they are curable is an achievable goal in the United States. The combination of alerting the public to factors thought to be responsible for the induction of malignant melanomas (such as sunlight), of identifying precursor or marker lesions of malignant melanoma (such as dysplastic and congenital nevocytic nevi), and of teaching the medical profession and public alike how to recognize thin melanomas (so that they may be treated promptly and, thus, cured) would predictably reverse the current unacceptable trend of increased incidence and death rates of malignant melanoma. PMID- 3830498 TI - Symposium on the nail. PMID- 3830497 TI - Precursors of malignant melanoma. Problems in computing the risk of malignant melanoma arising in dysplastic and congenital nevocytic nevi. AB - It has recently been shown that both dysplastic and congenital nevi are precursors to malignant melanoma. These findings are based upon mathematical models that show an increased risk of the nevi evolving into melanoma over random choice. However, problems exist with these models that may invalidate their results. The recommendation to remove dysplastic and congenital nevi prophylactically based upon models such as these is premature. PMID- 3830499 TI - Anatomy and physiology of the nail. AB - The nail plate lies under the proximal nail fold and over the matrix, nail bed, and hyponychium. The nail plate is made by the matrix. Although the few cells the nail bed contributes to the nail plate do not increase the bulk of the plate, they are important in attaching the plate to the bed. The interrelationships of the components of the nail and knowledge about their normal function are reviewed. PMID- 3830500 TI - An approach to initial examination of the nail. AB - A systematic method of examining nail disorders is important. A patient questionnaire (sample provided) and a basic method of categorizing various problems are helpful tools. Thorough investigation usually yields a diagnosis. PMID- 3830501 TI - Psoriasis of the nail. AB - The clinical picture of psoriasis of the nails varies according to the disease site. Confirmation of the diagnosis is essential prior to commencing therapy. Although treatment modalities are limited, careful planning and persistence produce rewarding results a good portion of the time. PMID- 3830502 TI - Lichen planus of the nail. AB - The clinical picture of lichen planus of the nail depends upon which components of the nail unit are involved in the pathologic process. Early diagnosis and treatment are essential because permanent destruction occurs in a significant number of patients. This is particularly valid in view of the fact that lichen planus of the nail may occur with associated cutaneous or mucous-membrane disease. PMID- 3830503 TI - Dermatologic diseases of the nail unit other than psoriasis and lichen planus. AB - Diseases in which involvement of the nails may be helpful in the diagnosis of dermatologic disease elsewhere include psoriasis, lichen planus, Darier's disease, alopecia areata and totalis, keratotic scabies, scleroderma, and lupus erythematosus and dermatomyositis. Dermatologic diseases in which involvement of the nail commonly occurs but is relatively nonspecific and not diagnostic include dermatitis, lichen striatus, parakeratosis pustulosa, pityriasis rubra pilaris, acrokeratosis paraneoplastica, pemphigus vulgaris, epidermolysis bullosa, porokeratosis of Mibelli, and acanthosis nigricans. These entities are described and treatments summarized as appropriate. PMID- 3830504 TI - Exogenous factors affecting the nails. Cosmetics, trauma, and occupational influences. AB - The external factors associated with nail disorders are multiple. Although not totally inclusive, this discussion has presented the more common cosmetic, traumatic, and industrial causes of nail disorders. Several common entities, such as the brown staining of fingernails in heavy tobacco smokers, have been omitted intentionally because little difficulty is encountered in determining their cause. Therefore, in evaluating a patient with abnormal nails, one should consider various external factors in addition to primary disease processes. Patch testing to determine if contact sensitivity is involved, in addition to a careful investigation of habits, employment, and exposures is mandatory. PMID- 3830505 TI - Trauma to the nail unit including occupational sports injuries. AB - Trauma to the nail unit is one of the most common causes of onychodystrophy and may be acute (a single overwhelming injury) or chronic (repeated minor injury). Immediate effects of acute trauma include splinter hemorrhages, subungual hematomas, and nail shedding. Delayed deformities include splits and ridges, pterygium, hook nails, pigment bands, and ectopic nail. Also discussed are the results of chronic trauma, including self-inflicted injury and repeated indirect injury. PMID- 3830506 TI - Nail pigmentation abnormalities. AB - Color changes of the nail unit may be innocent or may be associated with disease. Four tables provide the reader with a means of categorizing pigmentation abnormalities in the following manner: changes attributable to systemic disorders and some predominantly dermatologic conditions, changes caused by systemic drugs or ingestants, changes attributable to local agents, and changes attributable to some named nail entities. PMID- 3830507 TI - Paronychia. AB - Trauma to the nail folds can allow pathologic bacteria to invade this region. Once a primary, active infection has occurred in a nail fold, the area is often predisposed to chronic paronychia. Both chronic and acute paronychia are discussed, including their causes and treatments. PMID- 3830508 TI - Nails in systemic disease. AB - Nail abnormalities secondary to systemic disease are important to the dermatologist because they are readily examined and may be the initial signal that systemic disease may be present. Some of the abnormal nail findings represent part of a symptom complex that may be useful in physical diagnosis. The knowledge of the correct onychopathologic etiology may give the patient the correct nail prognosis and may prevent institution of possible incorrect lengthy and costly treatment regimens. In this article, nail signs are grouped according to the characteristics of the change and according to systemic diseases producing signs. PMID- 3830509 TI - Clubbing and koilonychia. AB - Although some cases of spoon nails and clubbing are manifestations of internal disease, a significant number are completely idiopathic and of no consequence to the patient. Many patients have been forced to pay high insurance premiums or have been denied employment because of insignificant nail changes. When a patient has spoon nails or clubbing, a thorough but reasonable search for a primary etiology should be made. It should be recalled that when the complete syndrome of hypertrophic osteoarthropathy is present and joint pain is prominent, the possibility of a bronchogenic carcinoma is great. If a cause of spooning or clubbing is found, it should be treated. However, when the physician becomes satisfied that no associated disorder exists, he should reassure the patient. In the author's experience koilonychia is most commonly due to psoriasis, fungus, or trauma. It is hypothesized that the curvature changes in spoon and clubbed nails are the result of angulation of the nail matrix secondary to connective tissue changes. The structural hypothesis presented here is largely based on observations of congenital and traumatic deformities. These cases have allowed visualization of the angle of the nail matrix. Both spoon nails and clubbing are such definite reaction patterns that there must be some common mechanism for each deformity. Structural rules that should apply to the nail have been used. It is easy to think of multiple internal disorders producing the same connective tissue changes that alter the angle of the nail matrix. It is difficult to think of another mechanism by which internal disease could alter the bonds in hard keratin. PMID- 3830510 TI - Nail changes caused by systemic drugs or ingestants. AB - Systemic drugs or ingestants may affect the nails. Changes vary from asymptomatic growth rate changes and pigmentation abnormalities to nail shedding and permanent deformity. The former two changes are most common. Presented are changes in nails caused by antibiotics, cancer chemotherapeutic drugs, poisons and ingestants, antimalarial drugs, and miscellaneous drugs. PMID- 3830511 TI - Nail surgery. AB - Competence in nail surgery requires a full understanding of the anatomy and structural relationship of the parts of the nail unit. A further facility to delineate the nail components allows the dermatosurgeon to approach the nail unit surgically and to correct any of its parts. This review has been an attempt to introduce the principles of nail surgery and analyze in depth four office nail surgical techniques. The techniques of nail plate avulsion, nail bed and matrix biopsy, matricectomy, and lateral wall excision are the most commonly used surgical modalities of the nail. These four techniques will give the dermatosurgeon the tools to treat most surgical nail problems. PMID- 3830512 TI - Histopathology of the nail. AB - Introductory sections on why and how to biopsy the nail unit and on the handling and processing of the specimen are followed by a presentation of normal histologic findings. These are contrasted with the abnormal changes in infections, especially fungal, of the nail unit, and in skin diseases that may affect the nail, especially psoriasis and lichen planus. Benign and malignant neoplasms that may occur beneath or around the nail, including melanoma, conclude the discussion. PMID- 3830513 TI - Dermatologic photography of nail pathologies. AB - Professional-quality photography of nail pathologies can easily be a routine in a dermatologist's office with the use of modern equipment for a camera system. The camera body component should be a single-lens reflex. The optics should be a true "macro" lens focusing to half life-size for multiple nails and, with an accessory tube, to life-size (X 1 or 1:1) for individual nails. If a choice of focal length macro lenses is available, the longer-length lens is preferable, somewhere between 90 and 120 mm, depending on the manufacturer. A portable electronic flash unit with both thyristor circuitry plus macro focusing sensor calibration is recommended. A flash bracket enabling off-camera flash positioning will provide shadow-producing "pointlight" illumination for delineating pictorial texture and anatomic architecture. One film should be standardized: a daylight-rated color film producing slides not prints, preferably Kodachrome 64 or Ektachrome 64 or 100, manufactured by Eastman Kodak Co. The ASA rating of the film should be matched with the power of the flash unit so that exposure should be a minimum of f.11 or f.16 to provide adequate depth of field at the close-up and ultra close up magnifications required for nail pathologies. Patient and camera should be positioned so that the major axis of the anatomic site parallels that of camera back (plane of film). The image should fill up as much of the film frame as possible by moving the camera system into close-ups while retaining anatomic landmarks and some portion of uninvolved nail or skin in the immediate area. Film inventories should be stored in either a refrigerator or freezer to avoid heat- and humidity-induced degradation of imaging. When exposed, the film should always be developed by the same processing laboratory, preferably one of Eastman Kodak's regional laboratories throughout the United States. PMID- 3830514 TI - [The 26th annual meeting of the Japanese Society of Neurology. Abstracts]. PMID- 3830515 TI - Methotrexate and rheumatoid arthritis. PMID- 3830516 TI - Anti-inflammatory drugs and upper gastrointestinal ulcer perforation. PMID- 3830517 TI - IgM, IgA and IgG rheumatoid factors in patients with rheumatoid arthritis and normal donors. AB - IgM, IgA, and IgG Rheumatoid Factors (RF) were measured by ELISA assay in serum from 26 patients with definite rheumatoid arthritis (RA) and 11 normal controls. IgM-RF was assayed by ELISA, radioimmunoassay, and also by the standard latex fixation test in all sera from RA patients. In patients with RA quantitative amounts of IgM, IgA, and IgG-RF as estimated by ELISA were highly correlated. Significant correlations were found between a physician's rating of disease activity and IgG-RF (r = 0.44; p less than .02) and IgA-RF (r = 0.38; p = .06 but not for IgM-RF as measured in any of the three assays. PMID- 3830518 TI - Somatometric characteristic of hypermobile patients with coxarthrosis. AB - Different body build has been observed in hypermobile women with coxarthrosis as compared with other hypermobile individuals. The study summarizes results of somatometric measurements in 38 hypermobile women with coxarthrosis based on congenital dislocation of the hip (CDH) and the same number of hypermobile controls. The following differences were found: Patients with coxarthrosis were heavier, shorter, more robust and had a larger quantity of fat tissue. In the control group ten out of 38 (26%) showed arachnodactyly, whereas in the coxarthrosis group no arachnodactyly was found. In Heath-Carter anthropometric somatotype the samples differed in all three somatotype components (endomorphy, mosomorphy, ectomorphy), the greatest difference being in ectomorphy. The results obtained are recommended for use in the primary preventive care of coxarthrosis. PMID- 3830519 TI - Abnormalities of sex hormones in men with systemic lupus erythematosus. AB - Sex hormone concentrations were studied in 10 men with systemic lupus erythematosus (SLE) before and after HCG stimulation and compared with those of 10 healthy volunteers. The SLE men had significantly lower testosterone/estradiol ratios (before HCG test) and significantly lower mean increases in testosterone after HCG stimulation than the normals. Our findings confirm that there are sexual hormone abnormalities in SLE and suggest that these abnormal patterns may be important in the modulation of immune responses in SLE. PMID- 3830520 TI - The thermographic pattern of the lower back with special reference to the sacro iliac joints in health and inflammation. AB - The thermographic appearance of the sacro-iliac joints in health and in active inflammation has been established on the basis of 72 thermographic examinations of healthy volunteers and 82 examinations of patients with clinically and radiographically active disease. In the latter group a certain number of cases showed increased heat over the sacro-iliac joints. In addition to the heat patterns described, the main conclusion of the study is a certain variability of the normal thermal pattern, a basic experience of which is necessary for the optimal interpretation of a thermogram in suspected sacro-iliitis. Despite this variability, it is possible to recognize a standard heat pattern from which most heat patterns can be derived with more or less quantitative variations. One factor affecting the thermal pattern in a fairly constant way is the amount of subcutaneous fat. PMID- 3830521 TI - Gastrointestinal function in patients with progressive systemic sclerosis. AB - In 24 patients with progressive systemic sclerosis (PSS) the pentagastrin stimulated gastric acid secretion was determined to investigate if acid hypersecretion is associated with reflux-oesophagitis--the most common complication to oesophageal involvement in PSS. Gastro-oesophageal reflux was observed in 12, reflux-oesophagitis in 9 and oesophageal mycosis in 8 patients. Gastric acid secretion was increased in 13 (54%) patients and tended to be higher in patients with oesophagitis. Patients with reflux and increased acid secretion seemed to be free from oesophageal mycosis. Bacterial overgrowth and malabsorption are known complications to intestinal scleroderma and these items were investigated using non-invasive methods. Four patients had increased bile acid deconjugation, 3 had increased (14C)xylose degradation indicating bacterial overgrowth and 7 patients had decreased fat absorption in the triolein breath test. Nutritional status with respect to selenium, folate, cobalamin and fat soluble vitamins was essentially normal. PMID- 3830522 TI - Palmar erythema in rheumatoid arthritis. AB - Palmar erythema ("liver palms") was seen in 32/100 consecutive patients with classical rheumatoid arthritis and in 10/100 patients with various other internal diseases (p less than 0.001). Age of the patients, sex, duration of disease, titer of rheumatoid factor, stage of disease, erythrocyte sedimentation rate and frequency of volar tenosynovitis of the hands did not differ between patients with and those without palmar erythema. Ulnar deviation of the fingers was less common and the hemoglobin content of the blood was higher in patients with palmar erythema. PMID- 3830523 TI - Bruising: a useful physical sign in ruptured knee joint. AB - The clinical distinction of a ruptured knee joint or popliteal cyst from a deep venous thrombosis is important in the planning of treatment, particularly to avoid anticoagulant therapy. Bruising, which may be severe, may occur when inappropriate anticoagulants are administered. It is less well recognised that spontaneous bruising may occur with a ruptured knee joint even when anticoagulant therapy has not been given. A case is presented which demonstrates this useful physical sign and shows also the value of the patient's history in eliciting the diagnosis. The bruising extended to the foot, its gravitational and propulsive advance being halted by the pressure of footwear. This appearance has not been emphasised in the rheumatology literature. PMID- 3830524 TI - Ankylosing spondylitis presenting as spondylodiscitis. AB - Spondylopathy is a relatively common finding in advanced ankylosing spondylitis (AS). However non-infectious spondylodiscitis as an early manifestation of AS seems to be exceptional. In this article, we present such a case in an adolescent. PMID- 3830525 TI - Spontaneous fusion of atlanto-axial dislocation in psoriatic spondylitis. AB - A 36-year-old man, suffering from psoriatic arthritis from the age of 17 years, was found to have developed atlanto-axial dislocation at the age of 30. Spontaneous fusion took place over the next two years. An explanation for this finding is based upon a review of the literature regarding the nature of spinal involvement in psoriatic arthritis. PMID- 3830526 TI - Are hip osteoarthritis and carcinomatous metastasis mutually exclusive? AB - A case of hip osteoarthritis is reported, in which histological investigation demonstrated the absence of tumoral involvement in femoral head in spite of nearby intraosseous carcinomatous metastasis. It comes in addition to a previously reported similar personal case. Further studies of surgical or post mortem specimens are needed to indicate whether these observations were fortuitous or whether the two conditions might not even be mutually exclusive. PMID- 3830527 TI - Erythema nodosum and giardia intestinalis. AB - We present the first report of erythema nodosum occurring in a woman with an intestinal infection due to giardia lamblia, an association not previously described. The authors suggest the possible role of giardia infection in the pathogenesis of erythema nodosum. PMID- 3830528 TI - Bf polymorphism and juvenile rheumatoid arthritis. PMID- 3830529 TI - Hypersplenism and splenectomy in lymphoproliferative and myeloproliferative disorders. AB - Splenic pooling of red cells and an expanded plasma volume are considered to be among the major mechanisms responsible for the anaemia in hypersplenism. In those conditions in which massive splenomegaly is associated with various degrees of marrow failure, diagnosis of the cause of anaemia may be difficult. A simple technique was used to estimate the degree of hypersplenism, from red cell mass data, in 94 patients with unequivocal lymphoproliferative or myeloproliferative disorders. The splenic effect was found to correlate well with both the size of the spleen (r = 0.75-0.90) and the actual red cell mass (0.79), and was abolished by splenectomy. Clinical data is also presented on 43 of these patients who underwent splenectomy. The incidence and type of complications, survival figures, and possible criteria for patient selection are discussed. PMID- 3830531 TI - Differential white cell counting on the Coulter Counter Model S Plus IV (three population) and the Technicon H6000; a comparison by simple and multiple regression. AB - Simple and multiple regression analyses have been used to see which of the differential white count measurements on the Technicon H6000 could be used to predict the differential white count measurements on the Coulter Counter Model S Plus IV (three population). The S Plus IV lymphocytes are predicted by the Technicon H6000 lymphocytes plus 39% of monocytes. The S Plus IV granulocytes are predicted by the Technicon H6000 neutrophils plus most of eosinophils, plus 43% of large unstained cells. The S Plus IV mononuclear cells are predicted by 5% of the Technicon H6000 lymphocytes plus 41% of monocytes, plus basophils, plus most of the large unstained cells plus 31% of eosinophils. PMID- 3830530 TI - C-reactive protein levels in neutropenic patients with pyrexia. AB - This study describes the experience of a clinical haematology unit in dealing with pyrexial episodes in 62 patients. Serum C-reactive protein levels were serially estimated and proved to be useful in following the course of the illness. No significant difference could be demonstrated in the C-reactive protein levels of those patients with bacteriologically proven illnesses, those in whom a clinically evident infection was present, and those with a 'pyrexia of unknown origin'. However, those patients in whom disease activity was thought to be responsible for the pyrexia had significantly lower C-reactive protein levels compared with those patients who had a septicaemic illness. PMID- 3830532 TI - Pooled cells versus individual screening cells in pre-transfusion testing. AB - Pooling of screening red cells used in pre-transfusion testing has been discouraged by many workers since it might lead to the failure to detect alloantibodies. However, there is minimal scientific data to support this view and in the UK a high proportion of blood transfusion laboratories were still using pooled red blood cells for antibody screening in 1982-1983. In order to solve the dilemma of sensitivity of serological tests when using pooled versus individual screening cells, a comparative evaluation of both approaches was carried out. One hundred and five sera known to contain weak, warm-reacting clinically significant alloantibodies were tested by the three same standard sensitive techniques using samples of individual screening cells and a pool of the same cells in parallel. Our results show that when pooled cells were used, 12% of the selected alloantibodies were undetectable and a further 23% were only detectable microscopically. All antibodies examined were easily detectable macroscopically when individual screening cells were used. It is concluded that the sensitivity of pre-transfusion screening tests is reduced when pooled red cells are employed as opposed to individual samples of screening cells and that the use of pooled cells should be discouraged in routine pre-transfusion and antenatal antibody screening. PMID- 3830533 TI - The potential value of immuno-isoelectric focusing in the diagnosis and management of solitary plasmacytoma. AB - Immuno-isoelectric focusing is a highly sensitive method of detecting small quantities of monoclonal protein. We have previously reported the first demonstration of serum paraprotein in non-secretory myeloma using this technique (Sheehan et al. 1985). We now report a case of solitary plasmacytoma where this technique revealed a small concentration of serum paraprotein when conventional techniques failed, and discuss the potential value of focusing in plasma cell dyscrasia, with limited tumor cell mass. focusing in plasma cell dyscrasia, with limited tumour cell mass. PMID- 3830534 TI - The detection of continuing blood loss in iron deficiency. PMID- 3830535 TI - Carriers of factor VII deficiency are not always asymptomatic. PMID- 3830536 TI - [Phenobarbital: an ever-current drug]. PMID- 3830537 TI - [Preventive therapy of migraine: flunarizine versus verapamil]. PMID- 3830538 TI - [Therapeutic potential of calcium heparin in the treatment of obstructive atherosclerotic arteriopathies of the legs]. PMID- 3830539 TI - [Behavior of CK-MB in uremic patients undergoing periodic hemodialytic treatment. Considerations and proposals]. PMID- 3830540 TI - [Calcitonin in the treatment of ankylosing spondylitis]. PMID- 3830541 TI - [A case of infectious Propionibacterium acnes endocarditis]. PMID- 3830542 TI - [When and how to treat the obese patient: a guide for the general physician]. PMID- 3830543 TI - [Comparative evaluation in the treatment of arterial hypertension between prolonged-action clonidine and atenolol]. PMID- 3830544 TI - [Amineptine: clinical considerations on a new antidepressive]. PMID- 3830545 TI - [Nifedipine treatment of hypertensive crisis in the aged]. PMID- 3830546 TI - [Cardiotoxicity caused by the use of antidepressive drugs]. PMID- 3830547 TI - On differentiation: a case study of the development of the concepts of size, weight, and density. PMID- 3830548 TI - Reasoning counterfactually in Chinese: are there any obstacles? PMID- 3830550 TI - Fiscal survival of community mental health centers in the 80's. PMID- 3830549 TI - Fiscal survival of community mental health in the 80's: sharing demonstrated methods to increase revenues and decrease expenses. PMID- 3830551 TI - Survival strategies for community mental health organizations: a conceptual framework. AB - Changing conditions call for each Community Mental Health Center (CMHC) to develop a survival strategy based on its own standards and values. The strategy must contain political, funding, programmatic, structural and role change components. A CMHC must orchestrate its strategy as part of an overall survival plan, but may be constrained by the degree of control it has over programs and resources. Major types of risks associated with entrepreneurial (viz., high control over programs and resources) and restricted models (viz., low control over programs and resources) are reviewed. PMID- 3830552 TI - Strategies for increasing productivity and revenues in community mental health centers. AB - Community mental health centers are challenged with the development of strategies for growth and prosperity in a cut-back environment. This paper shares strategies developed by two centers to increase productivity and revenues through the implementation of performance contracting and staff incentive plans. The process of development and implementation of the strategies is described, and the financial and program results are evaluated. Both Centers report substantial increases in productivity and revenues during a multi-year evaluation period. The paper concludes with a discussion of the issue multi-year evaluation period. The paper concludes with a discussion of the issues for community mental health centers to consider in the development of similar strategies. PMID- 3830553 TI - The private sector: revenue source of the 80's. AB - An important and largely untapped source of revenue for community mental health centers is private business and industry. A model describes how one center is meeting the challenge of decreased government funding and budget cutbacks by offering profitable and needed services to local industry. Through the center's human resource consulting firm, Hamilton Associates, five programs are being delivered to businesses: Needs Assessment Programs, Management Training and Development Programs, Employee Assistance Programs, Health and Wellness Promotion Programs, and Selection and Appraisal Programs. The consulting firm publishes a bimonthly newsletter on human resource topics, conducts training workshops for the community, delivers regular speaking presentations to various business associations, and holds "wellness" luncheons to promote individual health. Suggestions and recommendations are given about service offerings, marketing, and development of such services. PMID- 3830554 TI - Taking the center to market. AB - Community mental health centers have seldom been involved in marketing their services. Marketing is defined as responding sensitively to human needs, not hucksterism, and is an appropriate activity for centers. Centers are vulnerable because of declining federal funding and in order to serve the poor, must also service other populations with greater ability to pay for services or face retrenchment. Over the past twenty years, locally controlled centers have broadened their missions to serve many types of personal and family problems, not just the chronically ill. Centers should omit "mental health" for their names because of the stigma. Guidelines for creation of a positive image including name and logo selection, color, open houses, and ad campaigns are given using Madison Center (formerly the Mental Health Center of St. Joseph County) as a case study. Reactions of other providers, creative delivery of services through consultation and education, market segmentation and message levels of advertising are also discussed. PMID- 3830555 TI - An integrative model of cash collections for mental health centers. AB - Little has been published regarding Community Mental Health Centers and the collection of fees from clients. As centers of the 1980s have faced a sudden decrease in government funding, an effective system of cash collections has become paramount. Many locally-controlled centers have changed their mission to serving a broad spectrum of people with personal problems as well as the chronically mentally ill. This paper documents a system used by a midwestern center resulting in a 230% increase in client fee collections over four years. An integrative model describes collections assessment, developing an accountability system, basic principles of collections, fee setting and client mix. The ability to serve the poor, chronically mentally ill in the future will depend on the ability to serve the broader population of a community. PMID- 3830556 TI - Kinetic study of rheumatoid factor influence on complement-mediated modulation of immune precipitation. AB - Human monoclonal IgM kappa rheumatoid factor PA (mRF) expressed various effects on complement-dependent modulation of ovalbumin/antiovalbumin lattice formation measured kinetically by laser light scattering (LLS): (1) in the absence of complement, mRF (44.2-177 U/ml) caused enhancement of LLS in a dose-dependent manner; (2) mRF partially prevented expression of complement-mediated inhibition of lattice formation and, at the same time, complement inhibits mRF-dependent LLS enhancement; (3) complement caused disruption of lattice-mRF bonds during solubilization of preformed lattice-mRF complex as demonstrated by specific mRF activity in supernatants. This effect is dependent on complement activity and on both complement and mRF concentrations; (4) ovalbumin/antiovalbumin complexes gradually lost the ability to react with mRF during the first 2 min of complement mediated inhibition of lattice formation. PMID- 3830557 TI - Inside-out vesicles prepared from complement lysed sheep red blood cells. AB - Antibody sensitized sheep red blood cells were lysed to 68% by diluted human serum. The ghosts were shown to undergo vesiculation induced by low ionic strength buffer and gentle shearing forces like osmotically lysed ghosts. About 45% of the vesicles derived from complement lysed ghosts (as referred to vesicle protein) remained floating on top of a linear 3-18% dextran T110 gradient during ultracentrifugation. Using antibodies as probes for sideness about 90% of the floating vesicles displayed an inside-out orientation. Floating inside-out vesicles bear a slightly reduced but significant number of C9 molecules on their inverted extracellular side of the membrane as compared to the (leaky or collapsed) vesicles banding in the gradient. This finding suggests that the floating is not due to a lack of C5b-9 (under the assumption that all C9 was bound to C5b-9). It is concluded that lysis with diluted human serum may result partly in ineffective C5b-9 complexes and/or in lesions with limited permeability which do not impair vesicle floating on top of polymer gradients. PMID- 3830558 TI - Metabolic and endocrine disturbances in renal diseases. Bari seminars in nephrology. Bari, March 29-31, 1984. PMID- 3830559 TI - Predictive value of urinary solute excretion for stone recurrence rate. PMID- 3830560 TI - Long-term effects of low-dose thiazide and amiloride administration in recurrent renal stone formers. PMID- 3830561 TI - Red blood cell transmembrane oxalate flux in calcium-oxalate nephrolithiasis. PMID- 3830562 TI - Parathyroid hormone and hyperlipemia of uremia. PMID- 3830563 TI - Plasma catecholamines and vascular reactivity in acute and chronic renal failure. PMID- 3830564 TI - Relationship between plasma noradrenaline and blood pressure in uremia. PMID- 3830565 TI - The kidney in essential hypertension. PMID- 3830566 TI - Tissue distribution of endralazine and its clinical effect in refractory hypertension. PMID- 3830568 TI - Calcium antagonists: hypotensive and humoral actions in different forms of hypertension. PMID- 3830567 TI - Clinical and metabolic effects of long-term treatment with 25(OH)D3 in hemodialysis. PMID- 3830569 TI - Hyperparathyroidism and bone aluminum deposits may coexist. PMID- 3830570 TI - Iron removal by desferrioxamine in patients on chronic hemodialysis--kinetic study and long-term results. AB - Serum ferritin levels, cumulative number of administered blood transfusions, number of monthly transfused blood units and total months on hemodialysis (HD) treatment differed significantly in 7 patients on hemodialysis with clinical, biochemical and histological evidence of hemosiderosis, when compared to 37 controls (p less than 0.001 for all parameters). As a new treatment method desferrioxamine (DFO) therapy was introduced for iron detoxification in these hemosiderotic chronically hemodialyzed patients. Hence, to maximize the biological half-time, 30 mg/kg body weight DFO were given after the end of HD in the iron-loaded patients. Iron removal during the subsequent HD and the increase of iron excretion by the stool after DFO was measured by atomic absorption spectroscopy. Iron removal by the artificial kidney was calculated by investigating the function (QDi + QF)CDo over the duration of HD treatment, which equals the total amount of iron removal during HD. Using numerical integration of measured data this removal was found to be 21.8 +/- 6.9 mg whereas cumulative iron loss via the feces was found to be 36.5 +/- 14.6 mg. Therefore, total iron elimination was calculated to be on average 50-60 mg after administration of a single dose of DFO. Furthermore, long-term treatment of 5 patients resulted in a significant decrease of serum ferritin levels from 2,309 +/- 295 to 715 +/- 177 ng WHO/ml (p less than 0.001) after a period of 36 +/- 5 months. We conclude, that DFO in a dosage of 30 mg/kg body weight given at the end of HD is able to remove more than 500 mg iron/month if it is administered following each HD. Long term results indicate negative iron balance without significant change of transfusion frequency if not more than 2 U of blood (500 mg iron) are administered within 1 month. This treatment schedule might be superior compared to the previously used methods of administration where DFO was given at the beginning or throughout HD. PMID- 3830571 TI - Restoration of blood levels of testosterone in male uremics following a low protein diet supplemented with essential amino acids and ketoanalogues. PMID- 3830572 TI - Delayed progression of chronic renal failure: a prospective controlled trial with a low protein diet supplemented by keto acids. PMID- 3830573 TI - Hypercalciuria and nephrolithiasis. PMID- 3830574 TI - The contribution of the primary care doctor to the medical care of the elderly in the community. PMID- 3830575 TI - [Treatment of patellar fractures and its results]. PMID- 3830576 TI - [Coxa vara infantum, growth disorders of the hip, their etiopathogenesis and remote results of treatment]. PMID- 3830577 TI - [Radiological symptoms of so-called humeral epicondylitis]. PMID- 3830578 TI - [Post-injection damage of the ulnar nerve]. PMID- 3830579 TI - [The syndrome of idiopathic Gorham-Stout osteolysis]. PMID- 3830580 TI - [Pathology of the vertebral canal in compression fractures of the vertebrae and after reduction of dislocations evaluated on the basis of computerized tomography pictures, experimental studies and intraoperative observations]. PMID- 3830581 TI - [Stenosis of the spinal canal and intervertebral foramen following changes in the lateral recess]. PMID- 3830582 TI - [Orthopedic manipulation in the conservative treatment of discopathy of the lower segment of the spine]. PMID- 3830583 TI - [A method of surgical treatment of secondary stenosis of the spinal canal and intervertebral foramen by decompression with stabilization of the lumbar vertebrae]. PMID- 3830584 TI - [Results of the treatment of stenosis of the spinal canal and intervertebral foramen by decompression and "disk plasty" or intervertebral fusion]. PMID- 3830585 TI - [Evaluation of the results of the surgical treatment of stenosis of the lumbar segment of the spine]. PMID- 3830586 TI - [Correlations between clinical, radiological and intraoperative pictures in extra disk stenosis of the spinal canal]. PMID- 3830587 TI - [Radiological and anatomical studies of degenerative spondylolisthesis]. PMID- 3830588 TI - [Chondromatosis of the tarsal joint in a 5-year-old boy]. PMID- 3830589 TI - [20 years' activity of the department for the treatment of spinal injuries in the acute post-traumatic period]. PMID- 3830590 TI - [Instability-a cause of narrowing and stenosis of the spinal canal and intervertebral foramina in the lumbar segment of the spine]. PMID- 3830591 TI - ["Tight" spinal canal in the lumbar segment of the spine]. PMID- 3830592 TI - [Secondary stenosis of the spinal canal in the lumbar segment with few symptoms (spondylogenic urinary incontinence)]. PMID- 3830593 TI - [Surgical treatment of spinal stenosis of the lumbar segment]. PMID- 3830594 TI - [Roentgenological picture of non-neoplastic changes in the lumbar segment of the spine]. PMID- 3830595 TI - [Rare form of meningeal cyst and compression of lumbar and sacral spinal nerve roots]. PMID- 3830596 TI - [Congenital vertebral ankylosis of the cervical spine in the pathogenesis of spinal injuries]. PMID- 3830597 TI - [Stratigraphic examination and radiological picture of post-traumatic changes in articular processes of the cervical spine]. PMID- 3830598 TI - [Osteochondrosis of the thoracic spine complicated by paralysis of the lower extremities]. PMID- 3830599 TI - [Analysis of the duration of action potentials of crural muscles during walking in children treated surgically for clubfoot]. PMID- 3830600 TI - [2 cases of a rare syndrome of idiopathic osteolysis (Gorham-Stout syndrome]. PMID- 3830601 TI - [Surgery of pulmonary metastasis]. PMID- 3830602 TI - [Hepatic metastases of colorectal cancer. Natural history and surgical treatment by excision]. PMID- 3830603 TI - [Surgical treatment of cerebral metastases]. PMID- 3830604 TI - [Locoregional chemotherapy of hepatic metastases]. PMID- 3830605 TI - [Reestablishment of pharyngo-esophageal continuity with a small intestine autograft]. PMID- 3830606 TI - [Multiple colorectal cancer]. PMID- 3830607 TI - [Complex and comminuted femoral fractures in adults. Role of delayed osteosynthesis. Apropos of 53 cases]. PMID- 3830608 TI - [Treatment of acute portosystemic encephalopathy with zinc]. PMID- 3830609 TI - [Therapeutic evolution toward early excision in closed injuries of the pancreas]. PMID- 3830610 TI - [Our experience with inguinal hernia in the Central African Republic]. PMID- 3830611 TI - [Hospital care of emergency injuries]. PMID- 3830612 TI - Rhythmic changes in the activity of neurosecretory cells of the scorpion, Heterometrus fulvipes (C. Koch). AB - Changes in the activity of the neurosecretory cells in the cephalothoracic nerve mass (CTNM) of the scorpion, Heterometrus fulvipes (C. Koch) was studied over a 24-h period under natural light-dark cycles. Cytological and cytometric observations revealed that the first 3 groups of type 'A' cells in the sub oesophageal ganglion of CTNM evidenced ultradian variations in their activity. Two peaks were seen in the activity of these neurosecretory cells, at 12(00) and 00(00). It is inferred that the cells show a biphasic rhythm in the synthesis of two different principles possibly having antagonistic effects on the central nervous system. PMID- 3830613 TI - Essay in the classification of morning and evening types of activity in the light of the daily course of autonomically influenced body functions. AB - The present study is an attempt for an objective classification of types of activity by determining the daily periodicity of autonomically influenced body functions. On the basis of a questionnaire, the 23 probands of the test group were classified into morning types (7), evening types (11) and indifferent types (5). Then, for a period of 12h from 07(00) to 18(00), 17 different autonomically influenced parameters were recorded and their mean daily courses calculated separately for the probands of the morning and of the evening type. A comparison of the synchronous values showed that the greatest differences occur between the types at 10(00) and 17(00). At these times of the day, a multidimensional variance and discrimination analysis was carried out which resulted in a very good discrimination of the probands at 10(00) and in a satisfactory one at 17(00). At the same time, an evaluation of the individual parameters recorded was carried out according to their informative value. The most important parameters proved to be the vibration threshold, the R wave height, T wave height, peak time of the pupillogram and d.c. resistance of the skin. On the basis of these results, the classification of 10 probands of an independent test group was effected by a discrimination analysis. In 7 cases this resulted in an agreement with the classification according to the questionnaire. PMID- 3830614 TI - Seasonal variation of births in Greece. Temporal changes and regional differences over a 24-year period. AB - The seasonal variation of birth rates in Greece was studied for the years 1956 1979. The relatively constant pattern of the period 1956-1974 (with peak in January and February) turned abruptly into a new one (peak in May-July) for the following years. Whereas the seasonal variation of the first period could be explained as an effect of sociocultural (religious) factors on the rate of conceptions, no explanation was found for its change or for the new pattern. Regional differences between NW and SE Greece were also studied. Seasonal factors and their changes were almost similar in both regions. PMID- 3830615 TI - [Antihypertensive effect of indapamide and its effect on extracellular and intracellular Na and K concentrations in red blood cells]. PMID- 3830616 TI - [Hyperuricemia in patients with essential hypertension]. PMID- 3830617 TI - [Clinical evaluation of thallium-201 myocardial imaging]. PMID- 3830618 TI - [Clinical experiences with a fully automatic pacemaker (DDD) in 10 patients]. PMID- 3830619 TI - [Significance of serum prealbumin determination in hepatitis and cirrhosis]. PMID- 3830620 TI - [A clinical study of chromosome analysis of the cells in pleural effusions and ascites in diagnosing malignant diseases]. PMID- 3830621 TI - [Microsurgical treatment of 140 cases of intracranial berry aneurysm]. PMID- 3830622 TI - [Surgical treatment of internal carotid aneurysm]. PMID- 3830623 TI - [Occlusion of the neck by an anterior communicating aneurysm coupled with bilateral exploration of the carotid and vertebral artery]. PMID- 3830624 TI - [An indirect operation for the treatment of giant internal carotid aneurysm]. PMID- 3830625 TI - [Treatment of aneurysm of the cavernous carotid artery by electrothrombosis: a report of 4 cases]. PMID- 3830626 TI - [Surgical treatment of giant aneurysm of the posterior cerebral artery: a report of 1 case]. PMID- 3830628 TI - [Postoperative changes in plasma amino acid patterns]. PMID- 3830627 TI - [Changes in CK-isozyme and cathepsin D levels with strangulated obstruction of the small intestine]. PMID- 3830629 TI - [Observations on post-operative changes in thyroid function in critical patients]. PMID- 3830630 TI - [Nutritional assessment of non-emergency general surgery in-patients]. PMID- 3830631 TI - [The use of right atrial blood for the determination of cardiac output]. PMID- 3830632 TI - [Survey of the clinical use of intravenous procaine anesthesia]. PMID- 3830633 TI - [Aberrant pancreatic tissue in the gastrointestinal tract]. PMID- 3830635 TI - [Autotransplantation of the traumatized spleen: a report of 20 cases]. PMID- 3830634 TI - [Percutaneous transhepatic cholangiography and drainage]. PMID- 3830636 TI - [Quadrilateral syndrome of the shoulder]. PMID- 3830637 TI - [The extrarenal findings in renal carcinoma]. PMID- 3830638 TI - [Primary tumors of the ureter]. PMID- 3830639 TI - [Prosthetic replacement in the treatment of the ankylosed hip]. PMID- 3830640 TI - [Ceramic total hip joint replacement: an analysis of cases operated over 3 years previously]. PMID- 3830641 TI - [Clinical and experimental observation of the early division of the abdominal pedicle flap]. PMID- 3830642 TI - [Study of skin graft survival over avascular defects: a comparison of full thickness skin grafts with subdermal vascular network skin grafts]. PMID- 3830643 TI - [Axial skin or myocutaneous flap transfer for the management of soft tissue defects of the extremities: a report of 60 cases]. PMID- 3830644 TI - [One-stage reconstruction of a bucca cavioris defect by a platysma island flap: a report of 29 cases]. PMID- 3830645 TI - [Clinical use of the fasciocutaneous flap]. PMID- 3830646 TI - [A shoulder and back fasciocutaneous flap in the repair of axillary defects]. PMID- 3830647 TI - [Use of a posterior pedicled fascial flap of the leg in the repair of large soft tissue defects of the leg: a report of 5 cases]. PMID- 3830648 TI - [Study on the blood supply of pedicled second and third metatarsal bone transplantations]. PMID- 3830649 TI - [Microcirculation of the long bones: an experimental study]. PMID- 3830650 TI - [Electrophysiological observations of interfascicular nerve homografts in rats]. PMID- 3830651 TI - [30 years' experience in cardiac surgery]. PMID- 3830652 TI - [Clinical application of an extracardial pacemaker following open-heart surgery: a report of 53 cases]. PMID- 3830653 TI - [Surgical treatment of total anomalous pulmonary venous drainage]. PMID- 3830654 TI - [Primary carcinoma of the ureteral stump: a report of 4 cases]. PMID- 3830655 TI - [Extracranial carotid artery pseudoaneurysms]. PMID- 3830656 TI - [Primary vascular leiomyosarcoma]. PMID- 3830657 TI - [Biomechanical problems in microsurgical operations]. PMID- 3830658 TI - [A clinico-anatomical study of the pancreatic and peripancreatic arteries]. PMID- 3830659 TI - [Relation between position of the main pancreatic duct within the neck of the pancreas and pancreatic juice leakage complicated by pancreaticoduodenectomy]. PMID- 3830660 TI - [Computed tomography in chronic pancreatitis]. PMID- 3830661 TI - [Partial pancreatectomy in the treatment of acute necrotic pancreatitis]. PMID- 3830662 TI - [Treatment of acute hemorrhagic necrotizing pancreatitis with necrosectomy and peritoneal irrigation]. PMID- 3830663 TI - [Pancreaticoduodenectomy]. PMID- 3830664 TI - [Occlusive procedure of the pancreatic duct for pancreaticoduodenectomy]. PMID- 3830665 TI - [Pancreaticoduodenectomy with preservation of the gastric pylorus]. PMID- 3830666 TI - [External pancreatic fistula]. PMID- 3830667 TI - [The value of ERCP in the diagnosis of biliary tract disease]. PMID- 3830668 TI - [The use of a flexible carbon-fiber in orthopedic surgery: an analysis of 52 cases]. PMID- 3830669 TI - [Cranioplasty with autoabdominal subcutaneous preserved bone flaps]. PMID- 3830670 TI - [Venous valve transplant in the treatment of incompetent deep-veins of the lower extremities]. PMID- 3830671 TI - [Acute gastrectasis after open-heart surgery under extracorporeal circulation: a report of 20 cases]. PMID- 3830672 TI - [Mediastinal teratoid tumors misdiagnosed as pulmonary lesions: a report of 5 cases]. PMID- 3830673 TI - [Influence of oral sucrose on renal excretion of calcium, oxalate, urate and hydrogen ions]. PMID- 3830674 TI - Extracts from neuron-enriched cultures of chick telencephalon stimulate the proliferation of rat oligodendrocytes. AB - Both a soluble and particulate fractions from chick neuronal cultures contain factors that stimulate the proliferation of oligodendrocytes in rat brain cultures enriched for these cells, as measured by the number of cells containing 2', 3'-cyclic nucleotide 3'-phosphohydrolase. The presence of the soluble factor did not lead to increases in the number of cells with glial fibrillary acidic protein or tetanus toxin receptors. Supplementation of the cultures with a supernatant fraction from rat brain homogenate also resulted in increased numbers of oligodendrocytes; in contrast, supernatant fractions from liver and kidney homogenates did not. PMID- 3830675 TI - A developmental study of the biosynthesis of the neural cell adhesion molecule. AB - The neural cell adhesion molecule (N-CAM) is a glycoprotein found in neurons, glial cells and muscle cells. In this report we describe developmental changes in biosynthesis of N-CAM polypeptides in rat forebrain explant cultures. N-CAM was synthesized as the following polypeptides: HMr (Mr between 250,000 and 350,000), A (200,000 Mr), B (135,000 Mr) and C (115,000 Mr). The biosynthetic pattern of N CAM polypeptides changed during development: the biosynthesis of HMr and C increased relative to A and B. N-CAM biosynthesis decreased 100-fold from embryonic day 17 to postnatal day 25; N-CAM turnover decreased 350-fold during the same period. N-CAM polysialylation and sulfatation decreased markedly with age, whereas phosphorylation seemed to be constant during development. Only polypeptides A and B were phosphorylated, whereas A, B and C were sulfated. A was more sulfated and phosphorylated than B. It is concluded that the above described modulations of N-CAM may be of importance in the developmental regulation of cell cell adhesion. PMID- 3830676 TI - Developmental variation in monosialoganglioside content of embryonic chick retina and tectum. AB - Monosialogangliosides were extracted from the retinas and optic tecta of chick embryos at 6-12 days of incubation, and analyzed by high-performance liquid chromatography. The dominant monosialoganglioside was found to be N acetylgalactosaminyl (N-acetylneuraminyl) galactosylglucosylceramide (GM2). The specific concentration of GM2 in both the retina and tectum rose to a peak at 8-9 days of incubation, then declined. At day 10, GM2 was significantly lower in the dorsal than in the ventral or temporal quadrants of the retina. The same trend to a lesser degree was seen in the tectum. These results demonstrate striking variations in the monosialoganglioside content of the retina and tectum during formation of the retinotectal projection, and suggest that topological gradients may be a consequence of these developmental and spatial variations. PMID- 3830677 TI - Contribution of pharmaceutical organizations to medical education and research in Kenya--which is the best way? PMID- 3830678 TI - Aetiology of acute respiratory infections in children aged below 5 years in Kenyatta National Hospital. PMID- 3830679 TI - A preliminary study on serum magnesium levels in patients seen at the Kenyatta National Hospital, Nairobi. PMID- 3830680 TI - Studies of surface antigens on adult Schistosoma mansoni and Schistosoma haematobium. PMID- 3830681 TI - Duodenal ulcer disease at Kenyatta National Hospital. PMID- 3830682 TI - A two and a half year review of some aspects of twin delivery at the Kenyatta National Hospital. PMID- 3830684 TI - The prevalence of human trypanosomiasis in Uganda, 1970 to 1983. PMID- 3830683 TI - A profile of intra-partum and post-partum aspects of ante-partum haemorrhage from Pumwani Maternity Hospital, Nairobi. PMID- 3830685 TI - Congenital diaphragmatic hernia at Kenyatta National Hospital. Case studies and appraisal of clinical features and management. PMID- 3830686 TI - [An integrated program of occupational medicine: a proposal for medical schools in Brazil]. AB - The article is animated essentially by a conviction of the feasibility and necessity of acting to improve the health of workers by making the most of the opportunities and instruments offered by the medical sciences. Following an account of the present status of occupational health/occupational medicine in Brazil, a description is given of the areas in which action could be taken in these fields in Brazil today, and the priorities in the areas of instruction, research and community services are identified, which are the proper province of the medical schools. The article then states the characteristics and policies of a Comprehensive Occupational Medicine Program as a practical alternative for new programs. This program should not necessarily become a new discipline or department in the medical school, but be conceived, implemented and administered as a system, that is, as an inter- or multidisciplinary network, and should hence have an advisory committee representing the departments in the school that participate in the program. To facilitate the establishment of this network, the article proposes setting up a central unit for the program and enumerates the functions it should have. Finally, a number of strategies for implementation of the program are proposed and some activities identified that could be set in motion in the short term. PMID- 3830687 TI - [Changes in the professional expectations and attitudes of medical students toward the preventive and social aspects of education and medical practice]. AB - A prospective review was made of the occupational aspirations of a group of Mexican medical students and of their attitudes toward the preventive and social aspects of medical education and practice in order to determine whether they had changed in any way. In the pattern of their occupational aspirations, no changes were seen in their preference for specialization versus general medicine; the trend toward research and private practice had declined, but not toward full-time job in a public institution. In regard to their attitudes, there was increased recognition of the importance of social factors and a loss of respect for the public health disciplines and the effectiveness of preventive measures. As a possible explanation for this development, it is posited that the education process is not designed to reinforce attitudes in favor of prevention. Finally, recommendations are made for the ongoing study of these matters as of central importance to the planning and evaluation of the education process. PMID- 3830688 TI - [Evaluation model of the extra-mural program in nursing: cycle II, Colombia]. AB - In Cali, Colombia, a study was done to test and apply a model for the evaluation of out-of-school training programs in nursing in comparison with classroom programs. The article describes the evaluation model, which starts with the admission factors, considers how they are changed in the process, and compares the results by measuring the effects obtained against the established objectives. The information on admission factors was obtained by means of a questionnaire on health, a survey of teachers, pairing tests for students, and records of input/cost ratios; the source of information on the process was the tests of academic performance in the three courses provided in the design, the evaluation forms, and the student records. The academic records, a survey of graduates and a form for monitoring nursing activities were the three instruments used to measure the effects of the program. The conclusion of the study was that the objectives of the program were attained. Tested experimentally, the model of out-of-school nursing training was found to offer instruction of quality that is helpful to the learning process. The evaluation of the process made it possible both to identify and to solve the curricular, learning and administrative problems. The learning modules have been adapted for the wider diversity of students brought in by expansion of the program. Meanwhile, the instruments for the collection of data for the evaluation have been simplified on the basis of the experimental study. PMID- 3830689 TI - [Effects of social origins and professional socialization on the vocational preferences of medical interns in Mexico]. AB - Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine. PMID- 3830690 TI - [Participation of dentistry students in programs of teaching-assistance integration]. PMID- 3830691 TI - [A model of teaching training at the university level]. PMID- 3830692 TI - [Biochemical characterization and study by quantitative autoradiography of the binding sites of indalpine, a 5-HT uptake inhibitor, in cat brain]. AB - The [3H]indalpine binding sites have been characterized in slide-mounted cat brain sections. This inhibitor of 5-HT reuptake binds with a very high affinity to sites which have the pharmacological properties of the serotonin carrier. These sites can, however, be differentiated from the [3H]imipramine binding sites by their Na+ dependency and competitive inhibition by serotonin. Quantitative autoradiographic studies demonstrate that indalpine binding sites are localized in structures rich in serotonergic neurons. The widespread distribution of indalpine binding sites in limbic and associative areas is consisted with its well characterized antidepressant activity in human. PMID- 3830693 TI - [Lithium poisoning. 2 unpublished interactions: acetazolamide and niflumic acid]. AB - Two lithium intoxication cases due to an association with acetazolamide and niflumic acid are reported. They confirm the necessity of plasma lithium monitoring when a new drug is added. PMID- 3830694 TI - [Dexamethasone test in cluster headache]. AB - Cluster headache and manic depressive illness share in common similarities like: periodic symptomatology, accessibility to lithium therapy, abnormalities in circadian rhythm of cortisol. Though, in contrast to periodic depression, D.S.T. was found normal in 9 patients with cluster headache. PMID- 3830695 TI - Enzymes depolymerizing glycosaminoglycans in blood serum of patients with hyper and hypothyroidism. PMID- 3830696 TI - [Excretion of catecholamines and their various metabolites in children aged 10-12 years in relation to their mental development]. PMID- 3830697 TI - Free radical metabolites of toxic chemicals. PMID- 3830699 TI - Free-radical chemistry of sulfite. AB - The free-radical chemistry of sulfite oxidation is reviewed. Chemical transformations of organic and biological molecules induced by sulfite oxidation are summarized. The kinetics of the free-radical oxidations of sulfite are discussed, as are the kinetics of the reactions of the sulfite-derived radicals SO3 and the peroxy derivative SO5 with organic compounds. PMID- 3830698 TI - Mechanism of toxicity of nitro compounds used in the chemotherapy of trichomoniasis. AB - The mechanism of the trichomonicidal activity of metronidazole and other 5 nitroimidazoles appears to depend on the ferredoxin-mediated reduction of their nitro group, with generation of a reactive metabolite or metabolites which interact with DNA leading to a subsequent inhibition of nucleic acid and protein synthesis. Redox cycling of these compounds under aerobic conditions appears to be a detoxification reaction by inhibiting net reduction of the drugs, thereby inhibiting their uptake. On the other hand, redox cycling of nitrofurans or other compounds with more positive reduction potential results in formation of high steady-state concentrations of oxygen-derived metabolites that might be of toxicological significance. It seems likely that reduced metabolites of nitroimidazoles (perhaps through covalent binding to tissue macromolecules and/or thiols depletion) are also involved in the nitroimidazoles' toxic effects to animal tissues and in their mutagenic and carcinogenic action. PMID- 3830700 TI - Some reactions and properties of nitro radical-anions important in biology and medicine. AB - Nitroaromatic compounds, ArNO2 have widespread actual or potential use in medicine and cancer therapy. There is direct proof that free-radical metabolites are involved in many applications, and an appreciation of the conceptual basis for their therapeutic differential; however, an understanding of the detailed mechanisms involved is lacking. Redox properties control most biological responses of nitro compounds, and the characteristics of the one-electron couple: ArNO2/ArNO2- are detailed. The "futile metabolism" of nitroaryl compounds characteristic of most aerobic nitroreductase systems reflects competition between natural radical-decay pathways and a one-electron transfer reaction to yield superoxide ion, O2-. Prototropic properties control the rate of radical decay, and redox properties control the rate of electron transfer to O2 or other acceptors. There are clear parallels in the chemistry of ArNO2- and O2-. While nitro radicals have frequently been invoked as damaging species, they are very unreactive (except as simple reductants). It seems likely that reductive metabolism of nitroaryl compounds, although generally involving nitro radical anions as obligate intermediates (and this is required for therapeutic selectivity towards anaerobes), results in biological damage via reductive metabolites of higher reduction order than the one-electron product. PMID- 3830701 TI - Role of radical cations in aromatic hydrocarbon carcinogenesis. AB - Carcinogenic activation of polycyclic aromatic hydrocarbons (PAH) involves two main pathways: one-electron oxidation and monooxygenation. One-electron oxidation produces PAH radical cations, which can react with cellular nucleophiles. Results from biochemical and biological experiments indicate that only PAH with ionization potentials below ca. 7.35 eV can be metabolically activated by one electron oxidation. In addition, the radical cations of carcinogenic PAH must have relatively high charge localization to react effectively with macromolecules in target cells. Metabolic formation of PAH quinones proceeds through radical cation intermediates. Binding of benzo[a]pyrene (BP) to mouse skin DNA occurs predominantly at C-6, the position of highest charge localization in the BP radical cation, and binding of 6-methyl BP to DNA in mouse skin yields a major adduct with the 6-methyl group bound to the 2-amino group of deoxyguanosine. Studies of carcinogenicity by direct application of PAH to rat mammary gland indicate that only PAH with ionization potentials low enough for activation by one-electron oxidation produce tumors in this target tissue. These constitute some of the results which provide evidence for the involvement of one-electron oxidation in PAH carcinogenesis. PMID- 3830702 TI - What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale. AB - The Cook and Medley (1954) Hostility (Ho) scale, a measure of hostility derived from the Minnesota Multiphasic Personality Inventory (MMPI), was recently found in one cross-sectional study to be related to the severity of coronary artery disease and in two prospective studies to predict the development of coronary heart disease. Unfortunately, little information is available to clarify the meaning of the scale, and little is known about the psychosocial characteristics of individuals with high Ho scores. As a result, interpretation of the previous studies is difficult. Our two studies attempted to address these concerns. In Study 1, the Ho scale demonstrated convergent and discriminant validity. Data indicated that the scale primarily assesses suspiciousness, resentment, frequent anger, and cynical distrust of others rather than overtly aggressive behavior or general emotional distress. In Study 2, individuals with high scores displayed comparatively more anger, less hardiness, more frequent and severe hassles, and fewer and less satisfactory social supports. Thus, we propose that the Ho scale assesses cynical hostility and conclude that high scores are associated with a particularly unhealthy psychosocial risk profile. These findings refine our understanding of the Ho scale and assist in the interpretation of previous studies using this measure. PMID- 3830703 TI - Attributions, vulnerability, and psychological adjustment: the case of breast cancer. AB - This study examined the relationship between particular cognitions and psychological adjustment to breast cancer. It was hypothesized that adjustment would be positively associated with victims' perceptions of invulnerability to a recurrence of cancer and that victims' causal attributions for cancer would influence adjustment to the extent that the attributions contributed to or detracted from perceived invulnerability. A path model was developed based on the proposed association between invulnerability and adjustment, and attributions were tested for whether they directly or indirectly influenced adjustment. Responses from intensive interviews of 42 breast cancer victims were used to test the path model. Results strongly supported the hypothesized positive association between perceived invulnerability and adjustment and showed that the relationships between specific attributions and adjustment were mediated by vulnerability beliefs. PMID- 3830704 TI - Perception of expiratory flow by asthmatics and non-asthmatics during rest and exercise. AB - Perception of respiratory function may be an important factor in self-management of asthma. Previous research has suggested that asthmatics may not accurately perceive pulmonary functioning. The perception of normal and asthmatic individuals was assessed using a magnitude production procedure in a series of three studies, proceeding from normal individuals during rest, then submaximal exercise, to a comparison of normal and asthmatic adolescents during rest and submaximal exercise. At rest there were no differences between males and females, adults and adolescents, or asthmatics and non-asthmatics. However, there were significant differences in perception between rest and exercise for all groups. These findings suggest that a breakdown in perception does not occur during submaximal exercise in patients with asthma. PMID- 3830705 TI - Disqualified and qualified poor sleepers: subjective and objective variables. AB - Sleep laboratory studies of patients complaining of insomnia have demonstrated discrepancies between subjective reports and electroencephalograph (EEG)-recorded measures. In our research studies on sleeping aids, 60% of the self-described poor sleepers who reported usual sleep latencies of at least 45 min did not meet the laboratory qualification criterion of a 30-min or longer sleep latency. To learn to predict who would qualify for our studies, we compared 30 laboratory qualified poor sleepers (QPS) with 30 laboratory-disqualified poor sleepers (DPSs) on subjective report, mood, and all-night sleep laboratory variables. QPSs had significantly lower sleep efficiency and total sleep time in the laboratory, but these differences were due to the longer sleep latencies (50.7 +/- 27.8 min vs. 15.2 +/- 6.1 min) of the QPS group. QPSs and DPSs differed significantly in their morning estimates of their laboratory sleep latencies; as a group, QPSs gave an accurate estimate (51.6 +/- 27.8 min), but DPSs were significantly more likely to exaggerate their sleep latencies. Although we did not identify ways of predicting which poor sleepers would show sleep-onset insomnia in the sleep laboratory, we did find that, in this young, healthy population, there are poor sleepers who give an accurate report of a rather severe sleep-onset insomnia. PMID- 3830706 TI - Ruptured mitral chordae tendineae may be a frequent and insignificant complication in the mitral valve prolapse syndrome. AB - In this study, we performed 512 echocardiographic studies on 264 consecutive unselected patients with the idiopathic mitral valve prolapse syndrome. Twenty eight patients (10.6%) had evidence of ruptured chordae tendineae of the mitral valve on M-mode examination and in 24 the diagnosis was confirmed by two dimensional echocardiography. Mild to severe mitral insufficiency was proven in all of them by left ventriculography during cardiac catheterization. Eight patients underwent surgery to relieve symptomatic severe mitral regurgitation. At operation all had myxomatous degeneration of the mitral valve, two patients were found to have rupture of anterior mitral chordae, and six had rupture of posterior mitral chordae. Twenty (71%) patients with chordal rupture had either mild symptoms or were completely asymptomatic. It is concluded that chordal rupture in patients with the mitral valve prolapse syndrome may be present in asymptomatic patients and go undetected clinically in a substantial number of patients unless a high index of suspicion is maintained. Serial M-mode and two dimensional echocardiographic studies are of importance in identifying the progression of prolapse findings and may reveal the natural history of this pathologic condition in asymptomatic patients. PMID- 3830707 TI - Use of impedance cardiography in evaluating the exercise response of patients with left ventricular dysfunction. AB - Invasive studies in patients with left ventricular dysfunction show that data at rest (e.g. ejection fraction-EF) are poor predictors of the changes in cardiac output (CO) which occur with exercise. This investigation was undertaken to determine whether impedance cardiography could be used in such patients to assess CO response to exercise. The method was compared with the direct Fick method. Over a range of COs between 4 and 18 min-1 there was no systematic error. Reproducibility for CO over one week was highly significant (r = 0.94; P less than 0.001). Impedance cardiography was incorporated into routine exercise testing on a bicycle ergometer for a group of 15 patients (mean age 53.2 +/- 3.0 yrs, SEM) who had sustained a major myocardial infarct 6 to 12 months previously, (EF 38.1 +/- 3.5%, SEM). CO was measured at the end of each 3-min stage. In eight patients (EF 40.0 +/- 3.4%, SEM) CO response was abnormal with either a decrease or a failure to increase with increasing workloads. Conventional end-points i.e. angina, attainment of 85% of predicted maximum heart rate, abnormal blood pressure response or excessive dyspnoea did not indicate consistently a need to terminate the test. It is suggested that impedance cardiography is a useful non invasive method of evaluating patients with left ventricular dysfunction. PMID- 3830708 TI - Left ventricular response to exercise in coronary artery disease: relation to myocardial ischaemia and effects of nifedipine. AB - To assess the relationship between left ventricular (LV) response to exercise and myocardial ischaemia, 40 patients with coronary artery disease (CAD) and 17 control subjects underwent radionuclide ventriculography at rest and during semiupright exercise. In 14 of the 40 patients with CAD, radionuclide exercise studies were repeated 20 min after 20 mg of sublingual nifedipine. Patients with CAD had increases in both LV end-diastolic and end-systolic volumes and no change in ejection fraction during exercise. End-systolic volume increased and ejection fraction decreased significantly more in patients with multivessel disease, exercise-induced angina and/or ischaemic ST segment depression. Nifedipine reduced angina and ST-segment depression during exercise, attenuated exercise induced increase in end-diastolic and end-systolic volumes and improved ejection fraction. This study suggests that in patients with CAD, the response of LV volumes and ejection fraction to exercise is related to the degree of exercise induced myocardial ischaemia and nifedipine improves exercise LV performance. PMID- 3830709 TI - Medical and surgical treatment of sustained and recurrent post-infarction ventricular tachycardia. AB - Over a five-year period 57 patients (pts) with sustained, recurrent, post infarction ventricular tachycardia (VT) refractory to conventional antiarrhythmic treatment were evaluated. In 28 (49%) pts VT was controlled by amiodarone (A) in a dose of 3000 mg week-1. During long-term follow-up 5/28 (18%) pts died; no severe side-effects were observed with this dosage. In 17 of the 29 pts not controlled by this regimen, the dosage of A was increased to 6000-8000 mg week-1; short-term control of VT was achieved in 9/17 (53%) pts, but over a long-term follow-up 5/9 (56%) died and severe side-effects (11% pulmonary fibrosis and 11% hepatitis) occurred in 22%. Twenty pts, resistant to a low (12 pts) or high (8 pts) doses of A, underwent map-guided surgical treatment. In conclusion A is superior to conventional drugs in the treatment of sustained, recurrent, post infarction VT, but when high doses are necessary to prevent VT, long-term results are poor and severe side-effects frequent. In pts refractory to standard doses of A, map-guided surgery is the treatment of choice. PMID- 3830710 TI - Sinus of Valsalva aneurysm obstructing coronary arterial flow: case report and collective review of the literature. AB - One case of unruptured sinus of Valsalva aneurysm causing left coronary artery compression and lethal myocardial infarction in a 39-year old woman is described. In reviewing the literature, 15 previously published cases of sinus of Valsalva aneurysms disturbing coronary flow were found. It is concluded that the mechanism of coronary flow disturbance differs between aneurysms of the left and right sinuses, respectively. The rare congenital aneurysms of the left sinus carry a considerably greater risk of myocardial ischemia than those of the right sinus. The risk of this complication supports an aggressive surgical attitude towards asymptomatic sinus of Valsalva aneurysms. PMID- 3830711 TI - Loss of efficacy of flecainide in the Wolff-Parkinson-White syndrome after isoproterenol administration. AB - Although anterograde conduction through a Kent bundle with a short refractory period was suppressed by 300 mg of flecainide acetate, the infusion of small amounts of isoproterenol caused the reappearance of WPW and permitted the induction of an atrial tachycardia with 1/1 conduction through the accessory pathway at a rate of 260 beats min-1. This case shows that the effect of isoproterenol may be maintained after apparently successful flecainide therapy. PMID- 3830712 TI - Noninvasive quantification of the aortic valve area in aortic stenosis by Doppler echocardiography. AB - To develop a noninvasive approach to the quantification of the stenotic aortic valve area, Doppler echocardiography and cardiac catheterisation were performed in 24 patients with pure aortic stenosis. The transmitral volumetric flow was measured by Doppler echocardiography and calculated as the product of the corrected mitral orifice area (CMA) and the diastolic velocity integral (DVI). The maximal aortic jet velocities were recorded by Doppler technique and integrated to obtain the systolic velocity integral (SVI). Assuming that the aortic and mitral volumetric flows are equal, the aortic valve area (AVA) was calculated as: AVA = CMA X DVI/SVI. Mean pressure gradient and cardiac output were measured during catheterisation and the aortic valve area was calculated by the Gorlin formula. Comparison between the aortic valve area determined by Doppler technique and catheterisation yielded a close correlation (r = 0.92, P less than 0.001), and there was no significant difference between the two measurements. Good correlations of the instantaneous pressure gradient and the stroke volume were also obtained between the two techniques (r = 0.91 and r = 0.90, respectively, P less than 0.001). These results demonstrate that our Doppler echocardiographic method provides a promising approach to the noninvasive quantification of the aortic valve area in aortic stenosis. PMID- 3830713 TI - Determination of the mean pressure gradient in aortic stenosis by Doppler echocardiography. AB - Measurement of the mean pressure gradient across the stenotic aortic valve provides important information about the severity of aortic stenosis. However, determination of the mean pressure gradient by Doppler echocardiography has been difficult due to the squared relation between instantaneous velocities pressure gradients. In this study, the velocity curves in aortic stenosis were analysed mathematically to develop a new and simple method for calculating the mean pressure gradient (delta Pm) from Doppler velocity tracings. The new formula is: delta Pm = 8 V2m[Vp/(Vp + Vm)] where Vp is the peak systolic velocity and Vm the mean systolic velocity. Doppler echocardiography and cardiac catheterisation were performed in 41 patients with aortic stenosis to evaluate the accuracy of this mathematical method. There was a high correlation between the peak pressure gradients determined by Doppler technique using a modified Bernoulli equation and by catheterisation (r = 0.95, SEE = 8.58 mmHg), and the difference between the two measurements was not significant. The comparison between the mean pressure gradients determined by Doppler echocardiography using the new formula and by catheterisation yielded a high correlation (r = 0.95, SEE = 5.60 mmHg), and there was no significant difference between the two means. These results demonstrate the reliability of Doppler echocardiography for determining the mean pressure gradient in aortic stenosis using our mathematical method. Measurement of the mean pressure gradient will further enhance the usefulness of Doppler echocardiography in the non-invasive evaluation of patients with aortic stenosis. PMID- 3830714 TI - Biotransformations and plasma-level curves of chiral 1,4-benzodiazepine-2-ones. AB - Biotransformations of chiral 1,4-benzodiazepine-2-ones, (S)- and (R)-1 (7-chloro 1,3-dihydro-3 (S and R)-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one) in untreated and phenobarbital-pretreated rats were investigated. In urine, a 4'-oxygenated metabolite (compound 2) was identified as the biotransformation product from both enantiomers, (S)-2 being present in much higher amounts than (R)-2. Unchanged parent compounds were not found in urine. In plasma, 3'- and 4'-oxygenated metabolites were identified after administration of (S)-1 and (R)-1, respectively. The metabolite possessing an R-configuration was present in much lower amounts. The maximum concentrations of (R)-1 in plasma, following a single dose, was about 6 time as high as the maximum plasma concentration of (S)-1. Faster biotransformation and elimination of (S)-1 is assumed to be the explanation of these findings. PMID- 3830715 TI - Pharmacokinetics of theophylline and its metabolites in rabbits. AB - The pharmacokinetics of theophylline (1,3-DMX) and its metabolites were investigated in detail in four male rabbits after bolus intravenous injection (12 mg/kg) of the compound. Theophylline was measured in blood and urine, and its metabolites were determined only in urine. Apparent first-order rate constants for the metabolic processes involved in the formation of 1,3-DMX metabolites and their excretion in urine were calculated. An appropriate 13-compartment model was formulated to describe the disposition of 1,3-DMX and its metabolites. PMID- 3830716 TI - Pharmacokinetics and metabolism of S-adenosyl-L-homocysteine, in rats and dog. AB - Tissue distribution, metabolism and excretion of 14C-S-adenosyl-L-homocyteine were investigated in rat after oral and intraperitoneal administration. The radioactivity was distributed rapidly to the tissues. The urine was the major route of excretion: respectively 32% and 52% of radioactivity were excreted in 48 h urine after oral and intraperitoneal administration. Analysis of urine by HPLC showed that the major part of the radioactivity could be identified as uric acid. Absorption and pharmacokinetic parameters were determined in dog after oral and intravenous administration. The experimental data were fitted to a biexponential equation from a two-compartment open model. PMID- 3830717 TI - Steroid metabolism in isolated rat hepatocytes. AB - In vivo predictability of results obtained from studies of drug metabolism using isolated rat hepatocytes is questionable, mainly because of modeling difficulties due to the simultaneously occurring substrate transferring processes. In the present study, an attempt was made at simplifying the models used to describe the kinetics of biotransformation by enzymes enclosed in a cellular environment. Viability assessment of the cell preparation indicated that the cell membrane was intact and functional. Six corticosteroids were used in these studies. Simplifying assumptions concerning uptake and protein binding were confirmed by running independent experiments. Progress curves of unchanged steroid disappearance from the cell suspending medium at different initial concentrations were used to either confirm applicability or detect deviations from simple Michaelis-Menten behavior and were fitted to the appropriate kinetic models by means of nonlinear least-squares regression analysis. As an example, corticosterone extraction ratio obtained in this study compared well with literature values from intact rats. A linear correlation was found between the logarithm of the apparent first order rate constant (Vm/Km) obtained at low substrate concentrations and the logarithm of the oil/water partition coefficients of 17 alpha-hydroxyprogesterone, corticosterone and hydrocortisone. PMID- 3830718 TI - Absolute bioavailability of mianserin tablets and solution in healthy humans. AB - A pharmacokinetic study with mianserin . HCl was performed in six healthy male subjects. The subjects were treated on different occasions intravenously with a constant-rate infusion of 5 mg mianserin. HCl in 1 h, orally with a single dose of 60 mg as two tablets of 30 mg each and with 60 mg as an oral solution. The wash-out period between treatments was 1 month. Blood samples were taken at predetermined times over a period of 120 h following dosing. The mianserin concentration in the plasma samples was determined and the results were pharmacokinetically analyzed. The intravenous data could be adequately described by a 3-compartment model and the oral data by a 2-compartment model, both with first-order transfer and elimination rate constants. The mean plasma clearance of mianserin was found to be 19 +/- 2 l h-1 (mean +/- SEM), the kinetic volume of distribution 444 +/- 250 l, the steady-state volume of distribution 242 +/- 171 l and the elimination half-life 33 +/- 5 h. The absolute bioavailability in terms of extent of absorption was 22 +/- 3% for the solution and 20 +/- 3% for the tablets. The mean peak level for the solution was 79 +/- 11 ng X ml-1 and for the tablets 54 +/- 5 ng X ml-1; mean peak time for the solution was 1.1 +/- 0.2 h and for the tablets 1.4 +/- 0.2 h. The mean absorption half-life for the solution was 0.43 +/- 0.13 h and for the tablets 0.39 +/- 0.11 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830719 TI - Radionuclide study of the blood ocular barrier. AB - The purpose of this study was to investigate the permeability and clinical significance of the blood-ocular barrier. A new technique using systemic, subtenon, and retrobulbar injections was applied to the study of intraocular penetration of labelled steroid compound. The study was carried out in normal rabbits and in animals with artificially induced intraventional inflammation. It is concluded that there is no blood-vitreous barrier, a vague concept in any case, in the anterior region of the vitreous where free diffusion was observed between the anterior and posterior segments of the eye. High concentration of the labelled steroids was found in the cornea with the peak of activity usually at 30 minutes. However, traces of activity were detectable for up to 4 hours. This indicates the need for a depot long term respiratory form of corticosteroid that would deliver a high concentration of the medication. Local subtenon's and retrobulbar injections resulted in a relatively higher ocular I-125 Cortisol concentration than obtained by systemic route. It is concluded therefore that a high concentration of steroids applied locally will give better and less deletrious effects than systemic administration. Subtenon injection resulted in higher activity in various ocular tissues especially aqueous and vitreous. However, the I-125 Cortisol was rapidly cleared regardless of the route of administration. PMID- 3830720 TI - Intraocular penetration of fusidic acid with topical Fucithalmic. AB - Fucithalmic is a newly developed 1% microcrystalline suspension of the antistaphylococcal antibiotic fusidic acid. Penetration into the eye was investigated in twenty patients about to undergo cataract extraction. A single dose produced median antibiotic levels in the aqueous humour of 0.3 mcg/ml, maintained for at least 12 hours. Repeated doses produced significantly higher levels, median 0.8 mcg/ml, indicating some cumulative effect. The results show that fusidic acid passes the corneal aqueous barrier, and twice daily administration of Fucithalmic gives aqueous concentrations comparable with or higher than those seen after recommended systemic administration. PMID- 3830721 TI - The disposition and elimination of stereoisomeric pairs of thioridazine 5 sulfoxide in the rat. AB - The disposition and elimination of 2 stereoisomeric forms of thioridazine 5 sulfoxide (ring sulfoxide) were followed for 72 hr in male Sprague-Dawley rats following the administration of a single 40 mg/kg intraperitoneal dosage. The distribution half-lives for the fast (RSF) and slow (RSS) eluting ring sulfoxides in serum were 4.40 and 3.23 min, respectively. Elimination half-lives were 1.79 and 2.06 h. Both RSF and RSS were distributed throughout the tissue in equal amounts based on HPLC analysis of the tissues. Both isomers were found in lung tissue at concentrations 10 times that for other organs. Elimination of the ring sulfoxide was complete by 72 hours except in the brain, lung and kidney. The brain, heart, liver and kidney exhibited periodicity, or recycling of both RSF and RSS during the elimination phase. Release of RSF and RSS from myocardial tissue was slower than that for all other tissues. Excretion of unchanged thioridazine 5-sulfoxide occurred via renal, and to a lesser extent, biliary mechanisms. The biliary excretion pattern suggested an enterohepatic circulation of both isomers. These results indicate a lack of stereoselectivity in the disposition and clearance of the two ring sulfoxide isomers in the animal model; results that mirror those seen in man. PMID- 3830722 TI - Urinary pharmacokinetics of physostigmine in the rat. AB - Urinary pharmacokinetics of 3H-Physostigmine (Phy) were studied in rat after an intramuscular administration of 650 micrograms/kg. Urine was collected at 0-1, 1 2, 2-4, 4-6, and 6-24 hr and every 24 hr for seven days. The rats were sacrificed by decapitation and the tissues were analyzed for radioactivity. Less than one percent (.87%) of the dose remained in tissues after the seventh day. Liver, followed by kidney, accounted for the highest activity compared to other tissues. The amounts of 3H-Phy and metabolites were determined by HPLC and the rapid decline of Phy in urine was observed. Most of the radioactivity found in the urine was due to metabolites (47% of dose in 24 hr) indicating extensive metabolism. The cumulative percent of radioactivity excreted in the urine was 30.3 +/- 12.6% in 6 hr, 44.4 +/- 13.1% in 24 hr which increased to 52.7 +/- 12.0% after seven days. Urinary elimination rate constant (Ku) of Phy was found to be .051 +/- .009 hr-1 indicating that the urinary elimination of Phy accounted for a minor part (2.5-4.%) of the systemic elimination. PMID- 3830723 TI - Melanoma-associated antigens: prospects for clinical use. PMID- 3830724 TI - The prognostic significance of response to induction chemotherapy in Ewing's sarcoma. PMID- 3830725 TI - Salvage therapy in advanced breast cancer. PMID- 3830726 TI - Dietary intake, nutritional status and well-being of cancer patients: a prospective study. AB - Changes in dietary intake, nutritional status, body composition and well-being were studied in 108 cancer patients over a period of 20 weeks. The patients, constituting a group of elderly women with uterine cancer, a group of elderly men with urological cancer and a group of male and female patients of various ages with malignant lymphoma, were prospectively followed during and after aggressive treatment given with curative intent. Detailed information on the dietary intake was measured by a dietary history and cross-check method covering the 2 months prior to the onset of therapy and a 48-hr dietary record which was applied seven times during the observation period. The nutritional status was monitored by anthropometric measurements and laboratory assays in blood and urine. The patient's well-being was assessed by the use of standard performance scales by the observers and the application of patient's questionnaires concerning complaints, ability to self-care, mobility and daily activities. The main results are described here, indicating that: (1) most patients studied had a more than adequate diet during the 2 months preceding cancer therapy when compared to the Dutch Recommended Dietary Allowances; (2) the impact on dietary intake and nutritional status was relatively minor and generally transient; and (3) the treatment course was accompanied by distinct changes of well-being associated with, but not necessarily resulting from or leading to, changes of dietary intake. PMID- 3830727 TI - The role of serum tumour markers to aid the selection of lung cancer patients for surgery and the assessment of prognosis. AB - We have measured the following ten serum proteins in a sample of 290 patients presenting with possible lung cancer: carcinoembryonic antigen (CEA), alpha 1 acid glycoprotein (AGP), C-reactive protein (CRP), ferritin (FER), prealbumin (PAB), third component of complement (C3), immunoglobin E (IgE), alpha 2 pregnancy-associated glycoprotein (PAG), beta 2-microglobulin (beta 2-m) and retinol binding protein (RBP). It is found that, with the exception of PAG, C3 and IgE, there are significant differences between protein concentrations in the subsequently diagnosed cancer and non-cancer patients. However, protein concentrations in the cancer patients who were suitable for surgery do not differ significantly from the concentrations in inoperable patients. The prognostic significance of the proteins in the inoperable and operable cancer patients is also envisaged. In the operable group C3 appears to be useful, whilst AGP and RBP are prognostic indicators in the inoperable group. PMID- 3830728 TI - Etoposide prior to cis-diamminedichloroplatinum in combination chemotherapy: in vitro and in vivo studies. AB - Antitumor effect and toxicity of etoposide (VP 16) in combination with cis diamminedichloroplatinum (DDP) were studied on the in vitro C108 line and its in vivo counterpart, the M1087 line, both deriving from Lewis lung carcinoma. A colony-forming assay was used to assess the in vitro cytotoxicity of each drug and, on the basis of survival curve shape indications, different drug sequences were analyzed in order to find the optimal combination. Tumor growth inhibition, growth delay, metastasis reduction and percentage increase in lifespan were considered as parameters of therapeutic effect. From the present work it can be derived that the VP 16-DDP combination produces a poor antitumour effect against the Lewis lung carcinoma lines, otherwise associated with a highly acute toxicity. The sequence in which VP 16 is given before DDP induces a significant antimetastatic effect together with acceptable toxicity. PMID- 3830729 TI - Change in fibrinogen turnover in tumors by hyperthermia. AB - The effect of hyperthermia on the turnover of fibrinogen and albumin in the SCK tumor of A/J mice was studied. Immediately after heating at 43.5 degrees C for 30 min, the content of 131I-labeled fibrinogen in the tumors was about 2.7-fold that in the control tumor and remained elevated for 24 hr. On the other hand, the content of 125I-labeled serum albumin in the tumor immediately after heating was only 1.7-fold that in the control tumor and started to decrease soon after heating. The greater increase in the accumulation and the longer retention of the labeled fibrinogen as compared with the labeled albumin in the heated tumors appeared to be related to the heat-induced vascular damage accompanied by vascular occlusion, fibrination and subsequent thrombus formation. PMID- 3830730 TI - Comparative tumour localization of antibody fragments and intact IgG in nude mice bearing a CEA-producing human colon tumour xenograft. AB - The dynamics of distribution of radiolabelled F(ab')2 fragments of a monoclonal anti-CEA antibody have been studied in the nude mouse bearing a CEA-producing human colon carcinoma. Our results showed that the fragment was rapidly cleared from all normal organs reaching about 1% of that injected by 24 hr. Specific tumour localization occurred as early as 2 hr after injection and was complete by 4 hr. The amount of fragment localized in tumour was 4% of the injected dose, equivalent to that obtained with the intact antibody. Greatly improved tumour:normal tissue ratios were obtained with the fragment compared to intact IgG. However, the residence time of the fragment was much shorter (24 hr) than that of intact antibody (more than 3 days). Tumour localization indices suggested that fragments were superior to intact IgG at locating tumour specifically. The specificity indices based on lung, spleen and liver were much higher than those for intact antibody, reflecting the lack of Fc-receptor binding of fragments and their reduced excretion by these organs. The 'fragment index' enabled tumour:normal tissue ratios for the fragment and intact IgG to be compared. Together with the distribution study at different time points, this simplifies the task of defining a 'time window' in which tumour imaging and therapy might be optimal. PMID- 3830731 TI - Cell structure and function and response to chemotherapy in tumors heterotransplanted into the subrenal capsule of mice and rats. AB - Specimens from 16 freshly biopsied human tumors, two mammary adenocarcinomas, ten ovarian adenocarcinomas, two squamous cell carcinomas, one malignant histiocytoma and one chondrosarcoma of the bone, two human ovarian adenocarcinomas established by transplantation into nude mice and two adenocarcinomas induced in rat mammary gland were transplanted under the renal capsule of 510 normal immunocompetent mice and 180 rats and the effects of chemotherapy were evaluated. The results showed successful transplantation of all types of tumors in both animal species. Morphological analysis revealed preserved glandular structures with surface microvilli, mucin and CEA production and partially preserved basement membranes. Treatment with cyclophosphamide, vinblastine, adriamycin and cisplatin caused cell shrinkage, degradation and partial or total disappearance of the tumor cells. Vascularization was distinct in all specimens. A cellular infiltrate was found frequently but not consistently. A common end stage was a fibrotic scar with no cellular activity, occasionally giving a misleading impression of a growing tumor on gross observation. The results were obtained rapidly and suggest that the subrenal capsule assay would be useful for evaluating the sensitivity of human tumors to therapeutic manipulation, but needs supplementary histological examination. PMID- 3830732 TI - Suppression of normal and preneoplastic mammary growth and uterine adenomyosis with reduced growth hormone level in SHN mice given monosodium glutamate neonatally. AB - As a step in the evaluation of the role of growth hormone (GH) in mammary tumorigenesis, the effects of neonatal treatment with monosodium glutamate (MSG) on normal and neoplastic mammary growth, plasma levels of GH and prolactin (PRL) and the pattern of estrous cycles were determined in SHN virgin mice. The development of uterine adenomyosis, which is under similar hormonal control, was also examined in these mice. The formation of precancerous mammary hyperplastic alveolar nodules (HAN) was markedly inhibited and the number of 'ghosts', the remnants of regressed HAN, was increased by the single injection of 4 mg MSG on the day of birth, although spontaneous mammary tumorigenesis was not inhibited. The incidence of adenomyosis was suppressed by MSG treatment. Plasma GH level was chronically lower in the MSG-treated mice than in the controls. In contrast, plasma PRL levels and the pattern of estrous cycles were little affected by the treatment. These results indicate an involvement of GH in the development of HAN and uterine adenomyosis in mice. PMID- 3830733 TI - Elevated bioactive prolactin in women at risk for familial breast cancer. PMID- 3830734 TI - Phase one study of twice-weekly vindesine. PMID- 3830735 TI - Specificity of a neuronotrophic factor from rabbit corneal epithelial cultures. AB - Previous studies have demonstrated that of the three major cell types of rabbit cornea, only epithelial cells released a neuronotrophic factor that is active in both promoting survival and inducing neurite outgrowth of dissociated trigeminal neurons. In this study, the specificity of neuronotrophic factor production by selected epithelial cell types and the responsiveness of neurons from several different tissues to this trophic factor were determined. Cell cultures of various epithelia and dissociated neurons from several ganglia of neonatal and adult rabbits were utilized. In comparison with adult corneal epithelium, adult bulbar conjunctiva released a similar amount of trophic factor. Neonatal corneal epithelium released five times more, but adult retinal pigment epithelium and neonatal skin epithelium yielded less than a third and one-sixth respectively, and three cell lines (adult skin, kidney and neonatal lens epithelia) released only negligible amounts. Compared with its effect on neonatal trigeminal neurons, the trophic factor from adult corneal epithelium was similarly active on neonatal dorsal root neurons, but only half as effective on adult trigeminal neurons and less than one-tenth as effective on neonatal superior cervical neurons. The effect of nerve growth factor (from mouse submaxillary gland) on these neurons was tested for comparison. The results indicated that of the tissues studied, neuronotrophic factor was released in abundance only from corneal and conjunctival epithelia, and was active predominantly on trigeminal and dorsal root neurons (sensory neurons). This is consistent with the concept that the developmentally regulated release of trophic factor by target cells may be an underlying mechanism for neurogenesis and nerve regeneration. PMID- 3830736 TI - Development and degeneration of retina in rds mutant mice: photoreceptor abnormalities in the heterozygotes. AB - Mice homozygous for the rds (retinal degeneration slow) gene fail to develop receptor outer segments and show a slow loss of visual cells that starts from 14 21 postnatal days and results in complete absence at 1 year. In the heterozygous rds/+ mice the development of receptor outer segments is initially retarded. Although a distinct layer of outer segments of moderate length is formed, the disc structures remain disarrayed and form irregular whorls. Autoradiograms of rds/+ retinas show reduced incorporation of [3H]-leucine. Scleral movement of label, resulting from the addition of newly formed discs, is also retarded and appears irregular in comparison with the normal. Phagosomes, containing newly shed disc structures, within the retinal pigment epithelium of rds/+ mice are much larger than normal. Counts taken at different times of the dark- and light periods have shown an abnormally high turnover of phagosomes in the pigment epithelium of the rds/+ mice, with higher than normal peak frequency near the end of the light period, in contrast with the peak frequency in the normal pigment epithelium recorded around the beginning of the light period. Starting at 2 months, a very slow loss of visual cells, much slower than in the homozygous mutants, progresses throughout life. As a result, the outer nuclear layer at the age of 18 months or more is reduced to less than half. Prior to the reduction of the outer nuclear layer, the relative frequencies of the rod and cone perikarya in the rds/+ retina are similar to the normal values. With loss of visual cells, a small increase in the relative frequency of the cone perikarya is recorded in older rds/+ mice. This increase is more noticeable in the central than in the peripheral retina. The significance of the partial expression of the rds gene in the retina of the heterozygous mice in comparison with the changes observed in the homozygous retina is discussed. It is concluded that dose-dependent variation in phenotypic expression is an essential feature in the working of the rds gene. PMID- 3830738 TI - Effects of partial receptor cell loss on the electroretinogram of chimaeric mice. AB - A series of chimaeric mice were produced by aggregating morulae from rd/rd and normal (+/+) mice. In the retina of chimaeric mice, produced by aggregating morulae of these two genotypes, loss of rd/rd photoreceptor cells results in a patchy distribution of the surviving normal receptor cells. The number of remaining receptor cells vary between individual chimaeras. The inner retinal layers in the chimaeras, as well as in the two parental genotypes remain intact. Electroretinograms were recorded from 16 chimaeric mice, and various parameters were compared with the amount of visual cells present as estimated by the average thickness of the outer nuclear layer. The amplitudes of the a- and b-wave, showed a linear reduction with decreasing thickness of the outer nuclear layer thickness. However, threshold of the b-wave increased only when the thickness of the outer nuclear layer fell to about 25% of the normal thickness while the time to-peak of the waves did not change appreciably among the chimaeric individuals. These results suggest that the changes in the electroretinogram of the chimaeric individuals are related to the amount of visual cells present in the retina. PMID- 3830737 TI - Spatial and temporal mapping of the age-related changes in human lens crystallins. AB - Using the techniques of high performance liquid chromatography (HPLC), gel electrophoresis in the presence of sodium dodecyl sulfate (SDS), and immunoblotting, we have analyzed the age-related changes in soluble crystallins of the human lens. A 3 mm core along the optical axis of each lens was frozen sectioned and the sections were biochemically analyzed for distribution and quantity of the various soluble protein species. Both cortical and nuclear samples show a monotonic decrease in the concentration of the 19 000 and 21 000 MW proteins with age. We find that these proteins behave anomalously on SDS polyacrylamide gels, running near the top of the gel when the samples are not boiled before loading; this permitted us to observe the gradual, age-related loss of these bands from the gels of both nuclear and cortical samples. The high molecular weight, or TSK-3000 void volume, fraction (greater than 350,000) of the cortex contained alpha crystallin at all ages. However, in the nucleus, while this fraction is primarily composed of alpha crystallin early in life (i.e. before 15 years of age), there is a gradual incorporation of other crystallins into the void volume. This change in the composition of the high-molecular weight, soluble protein fraction is reflected in: a change in the subunit mobility on SDS-polyacrylamide gels; reactivity of the fraction to crystallin antibodies, i.e. in the young nucleus there is reactivity to anti-alpha crystallin only, with a gradual increase in reactivity to anti-beta and anti gamma crystallins. The void volume fraction of the nucleus persists as a major component of the soluble protein pool until 42-44 years of age, at which time the proportion of the total soluble protein represented by this void volume fraction decreases precipitously. These changes in the soluble protein profile are discussed in terms of their potential influence on the functioning of the lens. PMID- 3830739 TI - Age-induced changes in the aortas of rats. AB - In order to elucidate changes due to age in blood vessels, the aortic walls of Wistar rats ranging in age from 35 to 45 months were examined with an electron microscope. The remarkable changes of the walls were found mainly in the media: smooth muscle cell necrosis, increase of ground substances, as well as collagen fibrils, and calcification in some of the necrotic muscle cells. Branched smooth muscle cells were often found in the media. Elastic networks in the media, however, were hardly ever destroyed. The spider-web fashion in the peripheral cytoplasm of the smooth muscle cells was observed in all animals. Diffuse or localized slight intimal thickening could be seen in the subendothelial spaces, but aortic atherosclerosis was not present in the intima. No remarkable changes were seen in the adventitia. PMID- 3830740 TI - Connective tissue reactions in early phases of spontaneous regression of experimental malignant histiocytomas. An electron microscopic study. AB - Interactions between cancer and host are said to comprehend immunologic processes and stromal reactions including an angiofibroblastic response. We studied the latter phenomenon in spontaneously regressing experimental malignant histiocytomas produced by inoculation of an established macrophage-like cell line (WEHI-3) into baby rats. Light and electron microscopic investigations of the tumor tissue showed that there was a clear proliferation of fibroblasts and capillary vessels beginning from the 8th-10th day of the experiment. The vascular structures seemed to be somewhat changed and fibroblasts often displayed close contacts to tumor cells. The significance of these connective tissue reactions is discussed and, finally, the observations led to the conclusion that the angiofibroblastic reaction in the malignant histiocytoma model presented here may actively contribute to tumor breakdown and should not be interpreted as being only a secondary phenomenon after irreversible damage of tumor cells. PMID- 3830741 TI - Influence of 1-(alkylamino)silatranes and isoniazid on the antitumor activity of cyclophosphamide in mice bearing Sa 180 tumors. AB - It was the aim of our investigations to increase the antitumor activity of cyclophosphamide. Therefore we applied a combined treatment with silatranes and isoniazid in relation 1:20:1. The effects were directed against a transplantable sarcoma 180. The parablastomatous invasive zone and the regional lymph nodes draining an implanted tumor were taken for the histochemical and morphological studies. The doses ranged from 50 to 175 mg of body mass. The combined derivatives inhibited tumor growth by 70% in relation to the control. The authors connect the limitation of tumor progression in the applied experimental model in mice with the active response of T dependent zone of the regional lymph nodes, the rebuilding of stroma within the borderline invasive zone and the changes within the composition of cellular immune response of the peritumor tissue. PMID- 3830742 TI - Biochemical and substructural studies on hepatic and serum lipoprotein metabolism after acute liver injury induced by thioacetamide in rats. AB - The effect of an acute liver injury induced by thioacetamide (TAA) on hepatic and serum lipoprotein metabolism in rats was studied using biochemical and ultrastructural methods. A single dose of 100 mg TAA/kg body weight caused within 48 h a decrease of hepatic triglyceride (TG) output into the serum by about 50% in comparison to the controls. The steady state of serum TG concentration from 24 to 96 h after TAA treatment implies that the clearance of TG from serum must be diminished to the same extent as the hepatic TG output was found to decrease. Moreover, the TAA treatment caused changes in the electrophoretic mobility as well as in the concentration and composition of circulating serum-lipoproteins. The electrophoresis revealed a decrease in the alpha-band, which can be explained by the decrease in the high density lipoproteins (HDL) total lipid concentration. The pre-beta-migrating band disappeared, whereas a broad beta-mobility band appeared, which most likely consists of a mixture of very low density lipoproteins (VLDL) and low density lipoproteins (LDL) as can be concluded from the changes in concentration and composition of lipids in both fractions. For a better visualization of the VLDL-forming capability in perilobular and centrolobular liver parenchymal cells of the TAA-treated animals the VLDL secretion blocking agent colchicine was used. It was shown that in comparison with colchicine-treated controls the VLDL secretory products are accumulated at a considerably lower rate manifested in a diminution of VLDL clusters, secretory vesicle size and the number of intravesicular VLDL particles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830744 TI - FAO/WHO food additives data system. Evaluations by the Joint FAO/WHO Expert Committee on Food Additives, 1956-1984. PMID- 3830745 TI - Field trials on the application of expanded polystyrene (EPS) beads in mosquito control. PMID- 3830743 TI - Incidence of spontaneous tumors in laboratory rats. AB - The Caw-Hoe-Wiga strain of the Sprague-Dawley rat was observed for a period of ten years (1974--1983). In toxicity studies, a gradual increase of food intake could be noted in 12- to 13-week-old rats. The food intake of males was 21 g in 1974 and 27 g in 1983; in females 16 g in 1974 and 19 g in 1984. Correspondingly, a gradual increase of body weight was measured. The body weight of males was 400 g in 1974 and 470 g in 1983; of females 240 g in 1974 and 285 g in 1983. The gradual increase of food intake and body weight was followed by a gradual increase in the incidence of spontaneous tumors, 1974: 5% and 1983: 13%. Our experiments support the opinion of a causal connection between food intake, body weight and incidence of spontaneous tumors. Tumors can appear in any age group, but tumors. occur more often in older animals. In our studies, the increase in the incidence of spontaneous tumors was proportional to the increase in age: At 15 months only 6%, at 32 months 86%. 32% of the tumors were located in the mammary glands, 27% in the hypophysis, 12% in skin and appendages, and 9% in other endocrine organs. The comparison of toxicity and carcinogenicity studies revealed no change in the tumor spectrum, but strain-related tumors appeared earlier in life, more frequently and more often multifocally towards the end of the 10-year observation period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830746 TI - A three year report of the malaria clinic in Haldwani, District Nainital, U.P. PMID- 3830747 TI - Anopheles annularis as a vector of malaria in rural West Bengal. PMID- 3830748 TI - Studies on malaria transmission in hutments of Delhi. PMID- 3830749 TI - Studies on the detection of malaria at primary health centres. Part I. Reliability of parasitological diagnosis by decentralized laboratories. PMID- 3830750 TI - The biochemical and immunocytochemical characterisation of an antigen on the membrane of basal cells of the epidermis. AB - A murine monoclonal antibody, LICR-LON-23.10, which had been raised against a well-differentiated squamous cell carcinoma cell line (LICR-LON-HN5), recognises an antigen which is present on the membrane of basal cells of the epidermis. The tissue distribution of the antigen, as defined using immunohistochemical techniques, suggests that it is expressed preferentially on cells which are adjacent to a basement membrane. In squamous cell carcinomas, the antigen is expressed uniformly on undifferentiated cells, but in areas of keratinisation, the antigen is absent. The antigen recognised by the antibody was characterised as being a pair of glycoproteins with molecular masses of 120 and 135 daltons. The antibody was used for flow-cytometric analyses of epidermal keratinocyte preparations. Together with other basal cell markers, this antibody may be useful in the characterisation of the epidermal basal cell population as well as in broadening our understanding of the interaction between epithelial cell populations and their relationship with basement-membrane components. PMID- 3830751 TI - Mitosis in hepatocytes is generally associated with elevated levels of the target polypeptide of a liver carcinogen. AB - Rat hepatocytes have previously been found to contain in their cytoplasm a 14,000 dalton polypeptide that: is markedly and specifically increased in concentration during the infrequent mitoses that occur in hepatocytes of adult normal liver; is apparently related to a 17,500-dalton polypeptide that is tightly bound to the chromatin of nuclei of normal adult liver; is the principal covalent target of the carcinogen, N-2-fluorenylacetamide (FAA; 2-acetylaminofluorene), early during liver carcinogenesis; is present at highly elevated levels in the proliferating hepatocytes of hyperplastic foci brought about by the two liver carcinogens, FAA and 3'-methyl-4-dimethylaminoazobenzene; and is present at a greatly depressed level in the mitotically nonresponsive parenchyma that surrounds these hyperplastic foci. In the present investigation, we examined the levels of the two polypeptides in hepatocytes undergoing cell division at different rates in livers of diverse normal and regenerative states. Using immunohistochemical techniques, both polypeptides were detected in developing hepatocytes in as early as 15- and 19-day rat fetuses. With the increasing maturity of fetal and neonatal livers in normal rats, a greater percentage of dividing hepatocytes exhibited a higher concentration of the 14,000-dalton target polypeptide than that seen in adjacent interphase hepatocytes. The percentage of mitotic hepatocytes with an elevated level of the polypeptide increased progressively with hepatic development as follows: 38% in 15-day fetuses, 50% in 19-day fetuses, 85% in 1 day neonates, between 79% and 93% until 28 days of age, and finally, 99% in normal adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830753 TI - [Quantitative evaluation of the exercise test]. PMID- 3830752 TI - [Prediction of the presence and severity of coronary arteriopathy and left ventricular dysfunction by discriminant multivariate analysis of the exercise test]. AB - 266 male p., with chest pain and without previous myocardial infarction were studied by exercise test and coronary arteriography. 17 had no coronary disease (group C-0), 22 had less than or equal to 50% coronary stenosis (C-1), 65 had severe 1 vessel disease (C-2), 73 had 2 vessel disease (C-3), 89 had 3 vessel disease (C-4). 95 had normal ventricular function (group V-0), 111 had hypokinetic ventricular segments (V-1) and 60 had akinetic ventricular segments (V-2). 11 exercise test variables were stepwise selected to discriminate the C groups and the V-groups. For C-groups significant variables were: test result, heart rate increment, number of leads, work load, rate-pressure product, systolic pressure increment. By 4 discriminant functions, 41% p. were correctly classified. For V-groups significant variables were: hear rate increment, test result, effort angina, rate-pressure product, number of leads, ST depression, ST configuration, age. By 2 discriminant functions 53% p. were correctly classified. PMID- 3830754 TI - [Aortic coarctation surgically treated in the 1st year of life. Results in 36 cases]. AB - Thirty-six infants under one year of age underwent surgical repair of coarctation of the aorta between 1968 and 1983 in our institution. Coarctation was isolated or associated to a patent ductus arteriosus in sixteen cases, while in twenty it was associated with significant intracardiac disease. Twenty-nine patients were operated on in the first three months of life and in twenty a severe heart failure was present before the operation. Nine patients (25%) died while in the hospital: all of them were less than three months of age and all but one were affected by major intracardiac anomalies and severe heart failure. Surgical repair was by subclavian flap aortoplasty in twenty-nine cases, resection with end-to-end anastomosis in three, patch aortoplasty in three and Blalock-Park anastomosis in one. Operative mortality was unaffected by the surgical technique. The surviving children were followed-up for 30 +/- 7 months; one late death occurred suddenly, two months after the repair of a ventricular septal defect. An arm/leg pressure gradient, indicative of recoarctation, was detected in five cases: only one had been repaired by the subclavian flap technique, while the others were the only survivors of the end-to-end anastomosis and patch aortoplasty group. Subclavian flap aortoplasty is suggested as the operation of choice for coarctation of the aorta in the first year of life. PMID- 3830755 TI - [Neonatal aortic coarctation]. PMID- 3830756 TI - [Aortic coarctation with hypoplasia of the arch: description of a new surgical technic]. AB - The aortic coarctation is frequently associated with aortic arch tubular hypoplasia, especially in early infancy. The treatment in one time of both lesions is mandatory in these cases. We propose therefore a new surgical technique: after resection of the isthmic coarctation and appropriate cutting of both ends, the anastomosis is widely extended in the concavity of transverse aortic arch, beyond the hypoplastic region. We discuss the advantages of this technique over the classic end-to-end anastomosis, patch graft and subclavian flap angioplasty. PMID- 3830757 TI - [Aortic coarctectomy: when, how, with what results?]. PMID- 3830758 TI - [Intermittent atrio-ventricular block induced by exertion. Description of 3 cases]. AB - Three patients with 1:1 atrio-ventricular conduction at rest developed fixed 2nd or 3rd degree atrio-ventricular block during exercise testing. In all patients electrophysiologic study documented block distal to the atrioventricular node. The exercise induced block probably occurred because of increased atrial rate and abnormal refractoriness of the His-Purkinje conduction system. These findings suggest that high degree atrioventricular block appearing during exercise reflects conduction disease of the His-Purkinje system rather than of the atrio ventricular node, even in absence of bundle branch block. These patients should be considered for permanent cardiac pacing. PMID- 3830759 TI - Poor R wave progression in pure mitral stenosis. Correlation with hemodynamic data. AB - Poor R wave progression in the right precordial leads has frequently been reported in patients with pure mitral stenosis, but has never been investigated from clinical and hemodynamic points of view. In this work the clinical, electrocardiographic and hemodynamic data of 19 patients (mean age: 49 +/- 8.6 years), with pure mitral stenosis and poor R wave progression (study group) were compared with those of 19 subjects with pure mitral stenosis and normal R wave progression (control group). The age, sex distribution and duration of mitral valve disease were similar in the two groups; also clinical status, i.e. the distribution in the functional classes (NYHA), was similar in the two groups. Mitral valve area was similar in the two groups (1.3 +/- 0.5 vs 1.1 +/- 0.3 cm2), whereas wedge pressure, mean pulmonary artery pressure, systolic and diastolic right ventricle pressures and total pulmonary resistances showed significant lower values in patients with poor R wave progression compared to those with normal R wave progression (P less than 0.05). The hemodynamic variables of left ventricle and the cardiac index were similar in the two groups. In study group patients there was higher prevalence of vertical axis (P less than 0.05). These data indicate that in pure mitral stenosis, clinical status is similar in patients with poor R wave progression and in those with normal R wave progression, whereas in the former there is slighter hemodynamic involvement of the right ventricle. PMID- 3830760 TI - [Lower myocardial infarct with depression of the ST segment in anterior precordial leads. Correlation of the electrocardiogram, coronarography and ventriculography performed in the acute phase]. AB - We report on 11 pts affected by acute inferior myocardial infarction (group A: 4 pts without precordial ST-segment depression; group B: 7 pts with ST precordial ST-segment depression). These pts underwent left and right coronarography and left ventriculography in the course of intracoronary thrombolysis. We did not observe, in the group B pts, an involvement of the LAD branch of the left coronary, neither contractility abnormalities of the left ventricular anterior wall. ST depression in the precordial leads was associated with severe and extensive abnormalities of left ventricular inferior wall contractility. PMID- 3830761 TI - Two-dimensional echocardiography in complete transposition of the great arteries. AB - Sixty three patients with complete transposition of the great arteries (d-TGA) were studied by two dimensional echocardiography in order to assess: great artery relationships; ventriculo-arterial connections; presence and nature of the left ventricular outflow obstruction (LVOTO). From the parasternal short axis view at the great arteries level, four different relationships were imaged: the aorta was anterior and to the right in 35 patients, the two vessels were in a direct anterior-posterior position in 15 or side by side in 3 and the aorta was anterior and to the left in 10. Differently from normals, early pulmonary bifurcation of the artery arising from the left ventricle was imaged in 42 patients (84%) from the apical approach and in 36 (72%) from the subcostal longitudinal view. Left ventricular outflow tract obstruction was diagnosed in 29 patients (46%) and two distinct types of obstruction were differentiated: fixed and dynamic. We conclude that information derived from two-dimensional echocardiography is a valuable tool for the medical management, cardiac catheterization and surgical treatment of infants and children with d-TGA. PMID- 3830762 TI - [Bidimensional echocardiographic diagnosis of the pulmonary valve agenesis syndrome in the newborn infant. Description of 2 cases]. AB - We describe the cases of two neonates affected by the syndrome of pulmonary valve agenesis, in whom non-invasive diagnosis was possible by two dimensional echocardiography. The echocardiographic features we describe are the following: enlargement of the right ventricle in association with ventricular septal defect, malalignment type, dilatation of the right ventricular outflow tract, massive dilation of the main and branch pulmonary arteries, annular pulmonary stenosis. At the expected site of the pulmonary valve two ridges were seen, which did not have the typical motion of a fully developed valve. The ventricular septal motion was paradoxical in both cases. The diagnosis was confirmed at cardiac catheterization and the two neonates underwent operation unsuccessfully. The anatomic post-mortem examination confirmed the echocardiographic and angiographic findings. As successful treatment of this syndrome is difficult, we believe that a non-invasive echocardiographic diagnosis is very useful in order to avoid or, at least, delay a high risk cardiac catheterization. PMID- 3830763 TI - [Diltiazem in spontaneous angina: comparison with nifedipine and verapamil]. AB - Sixteen patients with spontaneous angina were studied to assess the relative efficacy of diltiazem (D) at different doses [240 mg/day (D240) versus 360 mg/day (D360)], nifedipine (N: 120 mg/day), and verapamil (V: 480 mg/day), given according to a latin-square protocol. Of the 16 patients, 6 had ischemic attacks with ST elevation, 6 had ischemic attacks with ST depression, 4 showed ST elevation or ST depression in different ischemic attacks. All the patients underwent 24-hour Holter monitoring: at the beginning of the study; during the third day of treatment with D240, D360, N or V; after the withdrawal of each treatment. An atrioventricular block was observed in 2 patients during treatment with V, and in 1 patient during treatment with D240 and D360. In the remaining cases, D and V significantly (p less than 0,05) prolonged the PR interval (D240: + 18%; D360: + 16%; V: + 20%), and reduced the mean daily heart rate (D240: -9%; D360: -12%; V: -11%). The effects of D and V were statistically not different. All the treatments significantly reduced the frequency of the ischemic attacks (p less than 0,05) (D240: -79%; D360: -93%; N: -90%; V: -90%). In particular, D240 reduced by the same percentage (-79%) the frequency of ischemic attacks with ST elevation and ST depression, while D360 completely abolished ischemic attacks with ST elevation and reduced by 79% those with ST depression. Our results suggest that: diltiazem is highly effective in the treatment of spontaneous angina; the efficacy of 360 mg/day of diltiazem is equivalent to that of 120 mg/day of nifedipine and of 480 mg/day of verapamil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830764 TI - [Diltiazem in spontaneous angina: double-blind cross-over study with Holter monitoring]. AB - Using Holter monitoring the Authors compared the effectiveness of diltiazem 120 mg every 8 hours for three consecutive days with the results of a placebo administered with the same regimen, following a double-blind completely balanced cross-over trial in 20 patients with angina at rest. During treatment with diltiazem the total number of recorded ischemic episodes was 100, during treatment with placebo the total number was 357 (Tab. I); P less than 0.01 at analysis of variance (Tab. II). Ischemic episodes during treatment with diltiazem had a shorter duration (3.9 versus 5.1 min.), less marked ST segment shifts (1.3 versus 2 mm), and were less symptomatic (20% versus 29%) than ischemic episodes during placebo (Tab. III). No significant differences at a paired t test were noted. Diltiazem was more effective in the morning (12 p.m. - 12 a.m.: from 187 to 34 ischemic episodes) than in the evening (12 a.m. - 12 p.m.: from 170 to 66 ischemic episodes) (Fig. 1); P less than 0.01 at the chi-square test (Tab. IV). Diltiazem reduced the number of ischemic episodes with ST segment elevation, peaking of T waves and negative T wave inversion (from 188 to 39) more than the number of episodes with ST segment depression (from 169 to 61) (Tab. V); P less than 0.05 at the chi-square test. In conclusion, in patients with angina at rest, diltiazem reduces the incidence and seems to reduce the severity of ischemic episodes, too.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830765 TI - [The ST and T in acute transient myocardial ischemia]. PMID- 3830766 TI - [Congenital aneurysm of the left atrial appendage]. AB - Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. We report the case of a 31-year-old woman with a marked prominence of the upper left heart border at the chest X-ray in whom the diagnosis of congenital aneurysm of the left atrial appendage was confirmed by cross-sectional echocardiography and computed tomography. Up to few years ago angiography was considered the method of choice in establishing the diagnosis. Cross-sectional echocardiography has recently become a safe and reliable method for diagnosing congenital aneurysm of the left atrium and should be considered in any case with abnormality of the profile of left atrium on the chest radiography. PMID- 3830767 TI - [Ventricular hyperkinetic arrhythmias and circulatory arrest in idiopathic isolated complete atrioventricular block. Description of a clinical case]. AB - Here we report on the case of a patient with idiopathic complete AV block and ventricular ectopic beats in basal state. The patient had been asymptomatic until the age of 50 and then suddenly began to suffer from relapsing episodes of syncope, related to "Torsade de Pointe" and Ventricular Fibrillation (hypokalaemia was present at the same time). We deal with the prognostic significance of ventricular ectopic beats and we make the hypothesis that hyperkinetic ventricular arrhythmias play a role in the origin of the symptoms of patients with congenital or idiopathic complete AV block. Finally, we discuss the limits of the therapeutic effectiveness of permanent pacing in these cases. PMID- 3830768 TI - [Primary angiosarcoma of the right atrium invading the pericardial cavity. Description of a case diagnosed by exploratory thoracotomy and surgically treated with success]. AB - The AA. report the case of a 43-year-old woman with an angiosarcoma arising from the right atrial wall and growing into the pericardial cavity. The patient presented with recurrent pericardial effusion initially responsive to medical therapy. The diagnosis was made at the exploratory thoracotomy. Repeated 2D Echocardiograms did not help for the diagnosis in this particular case. The patient underwent surgical resection of the tumor, chemo- and radiotherapy. After 30 months there are no signs of recurrence or metastasis. In our opinion the frequent recurrence of pericardial effusion in the same patient should be regarded with special suspicion. PMID- 3830769 TI - Long-term favourable effect of nifedipine in primary pulmonary hypertension. Report of a case with hemodynamic evaluation after 3 and after 16 months and with clinical follow-up during 36 months. AB - The favourable effect of long-term (36 months) treatment with nifedipine in a case of primary pulmonary hypertension is described. While clinical improvement was quick, pulmonary hemodynamic data were unchanged after 3 months of treatment, when acute administration of the drug showed a significant fall in pulmonary resistances. After 16 months of treatment a consistent decrease of pulmonary artery pressure was found, suggesting a selective favourable effect of the drug on the pulmonary circulation. The association with systemic arterial hypertension, whose onset was near contemporaneous with pulmonary hypertension, might indicate a common vasoconstrictive pathogenetic mechanism. PMID- 3830770 TI - [Therapeutic effectiveness of PTT-119 evaluated in vivo in experimental models]. PMID- 3830771 TI - [Characteristics of the immunomodulating action of bacterial and non-bacterial products]. PMID- 3830772 TI - Influence of some antibiotics on chemotaxis of human neutrophil granulocytes: in vivo study. PMID- 3830773 TI - [Chemoluminescence in the prevention of leukocyte injury caused by antibiotics]. PMID- 3830774 TI - [In vitro, activity of a new macrolide (RU 28965) against Chlamydia trachomatis and Ureaplasma urealyticum]. PMID- 3830775 TI - [Use of transformation in the study of the homology of genes for drug resistance]. PMID- 3830776 TI - [Value and limitations of sensitivity tests in vitro. Clinical observations]. PMID- 3830777 TI - [Development of resistance in Staphylococcus aureus]. PMID- 3830778 TI - [Multiresistance to antibiotics of bacteria of the genus Staphylococcus]. PMID- 3830779 TI - [Pseudomonas spp from hospitals: typing and sensitivity to antibiotics]. PMID- 3830780 TI - [Preliminary evaluation of the pharmacokinetics and toxicity of esorubicin]. PMID- 3830781 TI - [In vitro antibacterial activity of the trimethoprim/sulfadiazine combination]. PMID- 3830782 TI - [Inhibitor and bactericidal activity of the serum and urine of subjects treated with trimethoprim, sulfadiazine and with a combination of the 2 drugs, cotrimazine]. PMID- 3830783 TI - [Antibacterial activity of antibiotics in experimental encephalitis. An indirect approach to the evaluation of the pharmacokinetic pattern]. PMID- 3830784 TI - [Influence of serum on the minimal inhibitory concentration, the minimal bacterial concentration and bactericidal rate of various 2d and 3d generation cephalosporins]. PMID- 3830785 TI - [Beta-lactams and aminoglycosides: in vitro comparison of the effect on enterobacteria]. PMID- 3830786 TI - [Statistical comparison of the bacteriostatic and bactericidal activity of beta lactams and aminoglycosides on hospital bacteria strains (Pavia-Novara)]. PMID- 3830787 TI - [Hospital infections in obstetrics and gynecology]. PMID- 3830788 TI - [Changes in the defense against acute bronchopulmonary infections in patients with chronic respiratory insufficiency]. PMID- 3830789 TI - [Diagnostic and clinical aspects of neonatal infections]. PMID- 3830790 TI - [Possible role of adriamycinol in the cardiotoxicity induced by adriamycin in the rat]. PMID- 3830791 TI - [Effect of amrinone on the cardiotoxicity induced by adriamycin in the rat]. PMID- 3830792 TI - [Excretion of N-acetyl-beta-glucosaminidase in patients treated with ifosfamide]. PMID- 3830793 TI - [DTIC and its derivatives: cytotoxic or antimetastatic drugs?]. PMID- 3830794 TI - [Second instance chemotherapy with high-dose cisplatin in patients with advanced ovarian neoplasms in progression or recurrence after treatment with cisplatin]. PMID- 3830796 TI - [Analysis of the concentration of VP 16 and VM 26 in human brain neoplasms]. PMID- 3830795 TI - [Adjuvant chemotherapy with cisplatin and cyclophosphamide in FIGO I-II epithelial carcinoma of the ovary: preliminary results]. PMID- 3830797 TI - [In vitro drug sensitivity tests in human brain tumors]. PMID- 3830798 TI - [Malignant gliomas: current status and therapeutic prospectives]. PMID- 3830799 TI - [Measurement of hepatic function and short-term prognosis of hepatic diseases]. PMID- 3830800 TI - [Evaluation of the short-term prognosis of cirrhotic patients admitted to intensive care, using 4 scoring systems]. AB - A prospective evaluation of 4 scoring systems routinely used as prognostic indexes: 2 in hepatology units (Classification of Child-Turcotte, Classification of Pugh et al.) (specialized systems) and 2 in intensive care units (Acute Physiology Score, Simplified Acute Physiology Score) (non-specialized systems) was undertaken in 61 cirrhotic patients. Overall accuracy, defined as the percentage of survivors and non-survivors correctly classified, was not significantly different whatever the specialized system used (range: 59.0 p. 100 to 75.4 p. 100). Similarly, no difference was observed between the two non specialized systems (overall accuracy of 81.9 p. 100 for the Acute Physiology Score and of 90.0 p. 100 for the Simplified Acute Physiology Score). However, the overall accuracy given by the Simplified Acute Physiology Score was significantly higher than that obtained with the specialized systems (p less than 0.05). Furthermore, this nonspecialized system was as easy to calculate and more reproducible than the specialized systems. These results suggest that the Simplified Acute Physiology Score may be substituted for the Child-Turcotte and Pugh classifications as a prognostic index in cirrhotic patients admitted to intensive care units. PMID- 3830801 TI - [Effects of glypressin on the splanchnic and systemic circulation in patients with cirrhosis]. AB - Although not demonstrated in patients with cirrhosis, it is generally claimed that administration of vasopressin in the form of triglycyl-lysine-vasopressin (glypressin) may prevent untoward systemic effects of this former hormone. The aim of this study was to assess the effects of intravenous administration of 2 mg of glypressin on splanchnic and systemic hemodynamics in 9 patients with cirrhosis under stable circulatory conditions. One hour after the injection, the following statistically significant changes were observed as compared to the baseline values (m +/- SEM): wedged hepatic venous pressure, -9 +/- 2 p. 100; hepatic venous pressure gradient, -16 +/- 3 p. 100; azygos blood flow, -24 +/- 6 p. 100; heart rate, -16 +/- 3 p. 100; cardiac index, -23 +/- 2 p. 100; systemic vascular resistances, +47 +/- 11 p. 100; wedged pulmonary arterial pressure, +44 +/- 15 p. 100. In conclusion, in patients with cirrhosis in a stable hemodynamic condition, intravenous administration of glypressin decreased portal venous pressure and blood flow into the superior portal systemic collateral circulation but did not prevent the untoward systemic hemodynamic effects of vasopressin. PMID- 3830802 TI - [Cancer of the anal canal. Results of the treatment of a series of 195 cases]. AB - Between 1968 and 1982, 195 patients with invasive anal canal carcinoma were treated at Institut Curie (Paris, France). There were 168 females and 27 males - sex-ratio: 5.7/1, mean age: 67 +/- 11 yrs. (range: 38-85 yrs.). The initial size of the tumors was analyzed according to the circumferential invasion of the anal canal. The tumor involved 1/4 of the circumference in 49 cases, 1/2 of the circumference in 108 cases, 3/4 of the circumference in 22 cases and the whole circumference in 16 cases. Pathological examination revealed 20 cloacogenic carcinomas and 175 squamous carcinomas. All patients received radiotherapy as initial treatment and none received chemotherapy as a curative procedure. Eight patients received only palliative treatment. Twenty-seven patients were operated on because the response of the tumor to irradiation was partial or incomplete. One hundred and sixty patients received the full course of irradiation with a complete response. Among the latter, 100 patients were alive NED with a normal anal function with at least a 2-year follow-up. Local recurrences (n = 42) underwent salvage surgery in 50 p. 100 of the cases with a 3-year survival over 50 p. 100. Actuarial survival of the 195 patients was 68.5 p. 100 at 3 years and 58 p. 100 at 5 years. Survival was highly related to the initial size of the tumor and to the presence of positive inguinal nodes (p less than 0.0002). The histologic type was not related to the response to radiotherapy, nor to local recurrence or to survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830803 TI - [Spontaneous rupture of the spleen in chronic pancreatitis]. AB - Excepting splenomegaly related to segmental portal hypertension, splenic complications observed during the course of chronic pancreatitis are uncommon. These may include splenic necrosis, intrasplenic pseudocysts and splenic rupture. Spontaneous rupture of the spleen is one of the least common events, a total of 29 cases being reported thus far. We present herein 4 new cases, and previously documented cases were reviewed. In our cases, the splenic rupture occurred in young male patients. This complication revealed the pancreatic disease in one case while in the others, it occurred on the average 7 months after the symptomatic onset of pancreatic disease. This suggests that this complication occurs early in the natural history of chronic pancreatitis. The mechanism of the splenic lesion remains unclear, the different causes advanced, mechanic, enzymatic or vascular, are discussed. None of our patients had minimal trauma emphasizing the spontaneous character of rupture. Diagnosis was a surgical discovery except in one case in which selective arteriography was of most valuable aid in confirming diagnosis preoperatively. Treatment was simple splenectomy in 2 cases and associated with distal pancreatectomy in the 2 other cases. Recovery was uneventful. A corporal pancreatic pseudocyst was treated at the same time. PMID- 3830804 TI - [Results of a cooperative prospective study of treatment of primary digestive localizations of non-Hodgkin's lymphoma]. AB - We report the results of chemotherapy treatment in 82 patients presenting with primary digestive lymphoma and included in a study conducted between October 1977 and October 1985. There were 31 gastric lymphoma, 18 small intestinal lymphomas, and 19 with multiple involvement: 63 patients had had a surgical staging with total tumor resection in 15 cases. Nineteen patients with limited disease (ID and IID) were randomly assigned to either a 3-week chemotherapy regimen associated with whole abdominal radiotherapy or chemotherapy for 3 years. Twenty-seven stage IIID and thirty-six stage IV were treated with chemotherapy alone for 3 years. Low grade lymphomas (16 patients) received a cyclophosphamide, vincristine, prednisone association. Intermediate (56 patients) and high grade (10 patients) lymphomas received cyclophosphamide, vincristine, adriamycin, prednisone. The overall complete remission obtained was 63 p. 100 (51 patients) with 17 patients in relapse within 6 to 40 months. Overall survival was 46 p. 100 at 5 years. Survival was dependent on abdominal extension, histologic grade according to the new working formulation used for lymph-node lymphomas, initial localization (gastric lymphomas have the best survival) and achievement of complete remission. Chemotherapy is an effective treatment for primary digestive lymphomas. The role of surgery in the management of lymphomas has to be defined by further studies. PMID- 3830806 TI - [Subacute ulcerative colitis caused by Salmonella]. PMID- 3830805 TI - [Acute hepatitis caused by cyclofenil (Ondogyne). Apropos of 2 cases]. AB - We report the cases of two adults suffering from acute hepatitis due to cyclofenil (Ondogyne), a drug proposed for the treatment of dysovulation and scleroderma. Hepatitis developed 30 and 102 days after the beginning of discontinuous administration of the drug. A challenge test was positive in both cases. The course of hepatitis was reversible after withdrawal of the drug. Hepatitis induced by cyclofenil is likely to be due to an hypersensitivity mechanism. PMID- 3830807 TI - [Acute pancreatitis and Chlamydia trachomatis infection]. PMID- 3830808 TI - [Value of the assay of alveolar methane in hydrogen non-producers]. PMID- 3830809 TI - Depressed mood in new fathers: associations with parent-infant interaction. AB - In a sample of 37 middle-class families with firstborn 4-month-old infants, 52% of the fathers reported experiencing blues at some point after the birth of the baby. Observed behavior was found to differ between families in which the father reported eight or more days of blues (Group 2) as opposed to no blues (Group 1). Parents in Group 2 addressed fewer vocalizations to their babies. Group 2 fathers showed diminished proximity with their babies while their wives showed heightened proximity. Fathers in Group 2 engaged in less caregiving and touched their babies less than did their wives, while fathers in Group 1 engaged in more of this behavior than did their wives. Mothers and fathers in Group 2 were less likely to focus on the baby over other topics in their conversations with each other than the parents in Group 1. Few differences were found between the two groups on interview questions addressed to the fathers. However, those differences that were found, in addition to Group 2 fathers' descriptions of factors contributing to their blues, pointed to the spouse relationship as an area of concern. PMID- 3830810 TI - Young children's attention to dyadic conversation as modified by sociometric status. AB - Forty-eight American children, 12 popular and 12 rejected children from Grades 3 and 6, were paired with same-sex friends and nonfriends on an interactive task. Children were videotaped and their interactions judged for the amount and type of attention each child in the dyad gave to each other and the conversation. Main dependent measures included mutual engagements, acknowledgement of the partner, getting the attention of the partner, attention to the conversation, and social impact of the utterances. Both rejected and popular children attended to the conversation and the partner, but rejected children appeared to overattend in several ways. The interactions of rejected children and their matches involved more mutual engagements, conversational initiators, facilitators, terminators, and nonverbal attention-getting devices. Sex and developmental effects were also found. PMID- 3830811 TI - Clinical contributions to the developmental psychology of adolescence. PMID- 3830812 TI - Observations on research in adolescence. PMID- 3830813 TI - Stability of personality during adolescence and its relationship to stage of drug use. AB - The purpose of this study was to examine how stability of personality, measured at two points during adolescence, relates to adolescents' stage of drug use, measured at the second point in time. The subjects were 704 black and white high school freshmen and sophomores who participated again two years later. Results indicated that the earlier measures of personality were significantly associated with the later measures of personality, which in turn were associated with the adolescents' stage of drug use. In addition, the adolescents' personality attributes showed a fair amount of stability over the two-year span of the study. PMID- 3830814 TI - Name index. Volumes 1-30. PMID- 3830815 TI - Comprehensive assessment of the elderly patient: a clinical course of study for medical students. PMID- 3830816 TI - Developmental patterns of women returning to school ages 30 through 49. PMID- 3830817 TI - Partnerships in instruction: connecting gerontologists and librarians. PMID- 3830818 TI - The impact of the nursing home clinical on attitudes toward working with the elderly. PMID- 3830819 TI - Measuring change in undergraduate students' perceptions about aging using the Palmore Facts on Aging Quiz. PMID- 3830820 TI - Preparing medical students to effectively care for the elderly. PMID- 3830821 TI - [Incidence of dental caries among children from the village Rzozow, living in an area of emission of fluoride compounds]. PMID- 3830822 TI - [Effect of selected weather conditions and air pollution associated with them on the mortality rate in Cracow]. PMID- 3830823 TI - [Clinical studies of a magnesium-fortified diet for patients with cardiovascular diseases]. PMID- 3830824 TI - [Evaluation of the condition of the connective tissue of the lungs and of its role in the development of pulmonary emphysema in infants with pneumonia]. PMID- 3830825 TI - [Effect of the environment on the levels of selected bioelements in human body fluids (on the example of Cracow population)]. PMID- 3830826 TI - [Evaluation of the effect of cigarette smoke on the lungs of newborn and young mice]. PMID- 3830827 TI - [Effect of various levels of magnesium and fluorides on erythrocyte glycolysis in vitro]. PMID- 3830828 TI - [Effect of chronic administration of various magnesium salts on magnesium levels in rabbit erythrocytes and plasma in vitro]. PMID- 3830829 TI - [Magnesium in the urine of persons chronically exposed to fluorides emitted by an aluminum foundry before and 1 year after closing down the source of emission]. PMID- 3830830 TI - [Effect of magnesium salts on the urinary excretion of fluorine in persons chronically exposed to fluorides]. PMID- 3830831 TI - [Magnesium, calcium and phosphorus levels in the blood and urine of persons chronically exposed to fluorides before and after preventive administration of magnesium salts]. PMID- 3830832 TI - [Effect of magnesium on body metabolism and medical consequences of its deficiency]. PMID- 3830833 TI - [ATP, glucose and lactate levels in the blood of persons exposed to fluorides before and after preventive administration of magnesium salts]. PMID- 3830834 TI - [Effect of fluoride-polluted environment on health status and development of children living in Rzozow]. PMID- 3830835 TI - Proceedings for the 18th annual meeting of the Japan Epilepsy Society and the Japanese branch of the International League Against Epilepsy. October 5-6, 1984, Utsunomiya City, Tochigi Prefecture. PMID- 3830836 TI - The changing concepts of psychomotor epilepsy and complex partial seizures- especially on the phasic structure. PMID- 3830837 TI - Risk factors involving poor seizure prognosis of temporal lobe epilepsy--with special reference to neurosurgical approach. PMID- 3830838 TI - Complex partial seizures in childhood. AB - A clinical and electroencephalographic study was undertaken on 215 children with complex partial seizures as selected on the basis of the International Classification of Epileptic Seizures (1981). Complex partial seizures were noted in 7.8% of the epileptic children. The ictal symptoms of complex partial seizures closely resembled those of psychomotor triad described by Lennox. Interictal EEG revealed seizure discharges from the temporal or frontal focus in 57.2%. There existed a group with automatism as a main symptom having both diffuse slow spike waves and focal temporal spikes. This type should be interpreted to be one of secondary generalized epilepsies and be a variant of the Lennox syndrome. PMID- 3830839 TI - Long-term prognosis of complex partial seizures in childhood. AB - We studied the long-term prognosis of complex partial seizures in childhood including their electroencephalograms, behavioral problems and adaptation to school or society. In the clinical course, seizures were controlled in 25 cases out of 40 (62.5%). The rate of seizure control was significantly higher in cases with a past history of febrile convulsions, whose onset occurred before 6 years of age and in whom the CT scans were normal. Behavioral, motor and emotional problems included "clumsiness" in 25%, "poor athletes" in 22.5%, "hyperactivity" in 17.5% and "easily enraged" in 12.5% of the cases. The overall cooperation of the surroundings with the patients was thought to be as important a factor as the patients' IQ, motor or emotional problems so that they can get along in school or society. PMID- 3830840 TI - Episodic psychotic states in temporal lobe epilepsy: an investigation on their physiopathogenesis. AB - The discussion here is about the direct relationship of epileptic seizures to episodic psychotic states. The episodic psychotic states were divided into three groups: interictal, ictal and postictal. In each group, one representative case was described and the neurophysiological pathogenesis discussed according to a recent research, mainly depth-electrode findings. It is believed that: interictal psychotic state--limbic paroxysmal discharges play an important role in its pathogenesis, according to the theory of Geschwindt and others; ictal psychotic state--repetitive auras develop to the psychotic state, and aura continua itself can be described as a psychotic state; and postictal psychotic state--the increased limbic discharges might be responsible for the psychotic state. The common neurophysiological cause in all the three groups is due to the increased epileptic discharges in the limbic system. It is concluded that the episodic psychotic states in temporal lobe epilepsies are possibly of an epileptic nature in themselves. PMID- 3830841 TI - Suppression of amygdaloid kindled seizure and regional brain GABA content. PMID- 3830842 TI - The reliability of monoamine levels in the kindled brain. PMID- 3830844 TI - Proceedings of the fourth annual meeting of the Japanese Committee for the International Diagnostic Criteria in Psychiatry (JCIDCP). November 10, 1984, Tokyo. PMID- 3830843 TI - Prevalence of epilepsy in Okayama Prefecture: a neuroepidemiologic study. AB - On the prevalence day, 2,378 epileptic children were identified. Therefore, the prevalence rate for epilepsy was 8.2 per 1,000. The lowest prevalence rate was 1.2 in children under one year of age, and the highest was 11.0 at five years of age. The rate was higher for males than females. The annual incidence rate for epilepsy was estimated at 145.0 per 100,000 for 1975. The onset of seizures was high in the first three years, totaling 1,795 cases (77.7%), and this decreased after four years of age. Primary generalized epilepsy was found in 577 cases (31.7%), secondary generalized epilepsy in 167 (9.2%), partial epilepsy with elementary symptomatology in 205 (11.3%), with complex symptomatology in 61 (3.3%) and partial seizures secondarily generalized in 801 (44.5%). The study on such a number of cases had hitherto never been reported in the world. PMID- 3830845 TI - Survey of foot deformities among 166 geriatric inpatients. AB - A clinical survey on foot deformities among 166 geriatric inpatients was carried out. Direct measurements on hallux valgus, great toe movements, great toe deformities, lesser toe deformities, arch of the foot, callosities, ankle movements, inversion, and eversion were done by using the goniometer. A specially designed goniometer was created to measure inversion and eversion. The Harris Mat was used to study foot prints in correlation with the various deformities. About 50% of geriatric patients were found to have foot deformities of various types. This compared well with available data in literature. The target population was also checked for their symptomatology which, amazingly, was found to be really insignificant compared with the deformities present. This finding was found to be very much unlike data for Caucasian individuals with foot deformities, 50% of whom had symptoms related to pain and footwear. This major difference in the clinical presentation encourages the authors to carry on their study and, perhaps, direct cross-cultural studies in the future. PMID- 3830847 TI - Acute tears of the medial head of the gastrocnemius. AB - Twenty-five patients with acute tears of the medial head of the gastrocnemius were evaluated in follow-up from 1 to 3 years after injury. The patients were treated with a heel lift, calf sleeve, and physical therapy. The majority of the patients were men who injured their dominant lower extremity in one explosive episode. Cybex II testing revealed no significant difference in the plantarflexion strength of the noninjured and injured extremity after healing. All patients returned to their previous level of athletic activity. PMID- 3830846 TI - Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. AB - A retrospective study of 22 ankles in 22 patients with osteochondral talar dome lesions between 1975 and 1983 has indicated that surgical treatment yields superior results to conservative therapy. Thirteen male and 9 female patients, ages 9 to 72 years, average age 28 years, showed 10 medical lesions (Berndt and Harty classification (stage I (one); stage II/III (nine)) and 12 lateral lesions (stage II/III (5), stage IV (7)). Examination follow-up on 19 patients (86%) has averaged 24 months. The initial diagnosis seen retrospectively on x-rays was missed 43% of the time by emergency room physicians. A history of trauma was verified in 100% of the lateral lesions and 80% of the medial talar dome lesions. Of the 22 ankles, 14 lesions were isolated injuries, while 8 had concomitant fractures, lateral ligament, or peroneal tendon damage. Surgical treatment consisted of removal of the osteochondral fragment, curettage, and drilling of its bed. Two distinct surgical approaches were utilized. Lateral dome lesions were approached through the standard anterolateral incision, while medial dome lesions were approached through the anterior tibial tendon sheath with grooving of the anteromedial distal tibia articular surface. The medial approach allowed the somewhat posteriorly placed medial lesions to be reached, negating the need for a medial malleolar osteotomy and postoperative immobilization. On follow-up, no untoward ankle arthrosis was noted as a result of the grooving of the anteromedial distal tibia. Nineteen of the 22 patients had surgical therapy with 79% excellent or good, 21% fair, and no poor results. Five of the eight patients who elected prolonged conservative therapy finally had surgery. Of the three remaining patients conservatively treated, there were two fair results and one poor result. PMID- 3830849 TI - Plantar abscess in the diabetic patient. AB - This is a report on 42 plantar abscesses in 40 patients with diabetes mellitus. Data concerning the mode of origin, the microorganisms involved, the antibiotics used, the end results or treatment, and the length of stay are given. Several typical cases are presented. Below-knee amputation can usually be avoided in diabetic patients with plantar abscess. The extremity can often be saved by a team consisting of specialists in infectious diseases, vascular surgery, and orthopaedic surgery. PMID- 3830848 TI - Congenital vertical talus. AB - This series consisted of 15 congenital vertical tali in 12 patients, 11 of which were treated surgically and the remainder conservatively. Conservative treatment (casting alone) yielded poor results in three of four feet, while the results in the surgical group were four good, six fair, and one poor at an average follow-up of 8 years. The surgical procedures included a one-stage release with transfer of the anterior tibial tendon to support the neck of the talus. A Grice arthrodesis was performed either concurrently or within 2 to 4 years. The best results were obtained with early subtalar arthrodesis (Grice) and biplanar K wire fixation. Complications included skin sloughs, avascular necrosis of the talus, and pin tract drainage. Attempts to augment push-off power with tendon transfers were unrewarding. PMID- 3830850 TI - [Time trend in the types of gastric carcinoma. Analysis of autopsy cases]. PMID- 3830851 TI - [Single neuronal activities of the monkey orbitofrontal cortex and lateral hypothalamic area under vocalization-initiated feeding behavior]. PMID- 3830852 TI - [Cortical distribution of the neurons passing through the bulbar pyramid in the rat; an HRP study]. PMID- 3830853 TI - In defense of small area analysis. PMID- 3830854 TI - The state of PPOs: results from a national survey. PMID- 3830855 TI - Trends in health manpower. PMID- 3830856 TI - A method of reporting radial invasion and surgical clearance of rectal carcinoma. AB - Fifty rectal carcinomas resected during a 24-month period were examined by whole mount giant sections. By light microscopy, the distance of maximal tumour invasion (penetration) into the bowel wall and the surgical clearance were measured by a new standardized method. The outer border of the muscularis propria and the line of surgical excision were used as the reference points. Preliminary results suggest that there is a significant inverse correlation between tumour penetration and radial surgical clearance. The adequacy of radial surgical clearance may affect the risk of local recurrence, and may prove useful as a prognostic indicator. PMID- 3830857 TI - Septa in the appendix: a previously undescribed condition. AB - A previously undescribed condition of the appendix, consisting of complete and incomplete septa is reported in 25 cases. The abnormality occurred in persons younger than 30 years. In all cases the lesion was found to be associated with acute appendicitis. Possible factors discussed with respect to aetiology and pathogenesis are: a congenital abnormality similar to intestinal atresia; post inflammatory fusion of ulcerated, swollen mucosal folds; ischaemia caused by thrombosed vessels; mucosal folding in the process of expulsion of appendiceal contents. PMID- 3830858 TI - The design and evaluation of the neutral posture chair for surgeons. PMID- 3830859 TI - Thermovision parameters of brain responses to visual stimulation. PMID- 3830860 TI - Facilities for the neurophysiological study of evoked changes in neuronal discharge frequency by component analysis. PMID- 3830861 TI - Neuronal responses and evoked potentials of deep brain structures during visual recognition. I. Enunciation of the problem and basic methods of its study. PMID- 3830862 TI - Prestimulus electroencephalogram and evoked potentials in man during recognition of a meaningful photic stimulus. PMID- 3830863 TI - Interhemispheric asymmetry on the electroencephalogram of twins. PMID- 3830864 TI - State of motoneurons and the monosynaptic reflex arc before a simple voluntary movement. PMID- 3830865 TI - Effect of the collateral circulation on left ventricular function at rest and during exercise in patients after posterior wall myocardial infarction. PMID- 3830866 TI - Impedance of the arterial system and cardiac activity. PMID- 3830867 TI - Characteristics of external respiration in inhabitants of the northeast USSR. PMID- 3830868 TI - Humoral-hormonal control of functions in expert chess players. PMID- 3830869 TI - An experimental model to study blood and inflammatory neutrophils. AB - We sought to develop an experimental animal model in order to study the effects of hypothermia on host defences under conditions which were similar to those used for humans. We required a large animal which could tolerate arterial and venous catheters and serial blood sampling without significantly altering its blood volume and blood pressure. The animal should be intubated and ventilated to control blood gases and fluid and electrolyte balance. Finally the model should have anatomic, metabolic and physiologic similarities to humans. We describe an experimental pig model which appears to fulfill these criteria and provide important information relevant to man. PMID- 3830870 TI - Effect of immunization or cyclophosphamide treatment on growth of EL-4 leukemia cells in syngenic C57BL/6 mice. AB - Prolonged survival of C57BL/6 (B6) mice bearing syngenic EL-4 leukemia cells resulted from immunization with irradiated EL-4 cells on the day of inoculation of live leukemia cells. No prolongation of survival was observed if the irradiated cells were injected 6 or 13 days after live cell inoculation. Protection also was observed in EL-4-bearing mice that were treated with cyclophosphamide (CY) rather than by immunization, however, the protective effects were observed only when CY treatment was instituted 6 days after inoculation of live leukemia cells. No protection was seen when CY was administered on the day of, or 13 days after inoculation of live leukemia cells. In fact, administration of CY on the day live EL-4 cells were inoculated appeared to enhance the lethal effects of the tumor. In mice that underwent combined treatment, i.e., immunization and CY, prolonged survival was seen only in the group that received combined treatment 6 days after inoculation of live leukemia cells. No protection was seen in mice receiving combined treatment on the day of or 13 days after inoculation of live leukemia cells. The role that suppressor T cells might play in the observed results is discussed. PMID- 3830871 TI - The initial lag in phagocytic rate by macrophages in monolayer is related to particle encounters and binding. AB - Several investigators have described an initial "lag" in the phagocytic rates of macrophages in assay systems involving these phagocytes in monolayer. In the present study, we determined whether this apparent lag in phagocytic activity is due to a delay in the onset of macrophage phagocytic function per se, or if the lag phase can be explained by a relative lack of particle availability in terms of particle encounters and binding during the early phases of a phagocytic assay. Studies involving the pre-binding of opsonized erythrocytes to macrophages revealed that the lag in phagocytosis usually seen in assay systems involving macrophages in monolayer is related to particle availability. PMID- 3830872 TI - Age-related factors in carcinogenesis. Proceedings of a symposium. Leningrad, 7-9 December 1983. PMID- 3830873 TI - Relevance of age to some aspects of carcinogenesis. PMID- 3830874 TI - Papilloma development on young and senescent mouse skin treated with 12-O tetradecanoylphorbol 13-acetate. PMID- 3830875 TI - Ageing and cancer in the light of the ontogenetic 'model of medicine'. PMID- 3830876 TI - Tumorigenesis by exogenous carcinogens: role of target-cell proliferation and state of differentiation (development). PMID- 3830877 TI - The effects of age on the metabolism of chemical carcinogens and inducibility of O6-methylguanine methyltransferase. AB - Some aspects of the age-dependence of the metabolic activation of three classes of chemical carcinogen (polycyclic hydrocarbons, N-nitrosamines and aromatic amines) are considered. In general, and as with other xenobiotic agents, metabolism is low in fetal tissue, increases with maturation and decreases in old age. In a single-dose hydrocarbon carcinogenesis model system, a decrease in tumour incidence is correlated with increasing age at treatment, although other factors such as cell turnover at the time of carcinogen treatment are also correlated with this disease. Evidence is presented, in addition, that the induction of rat hepatic O6-methylguanine-DNA methyltransferase activity by the metabolism-requiring hepato-carcinogen 2-acetylaminofluorene increases with age. PMID- 3830878 TI - Effect of age on DNA repair in carcinogenesis due to alkylating agents. PMID- 3830879 TI - Changes in the adaptive system in ageing and cancer. PMID- 3830880 TI - Age-dependent metabolic immunodepression and cancer. PMID- 3830882 TI - Possibilities for rehabilitating cancer patients in old age groups. PMID- 3830881 TI - The growth hormone-glucose system in ageing and cancer. PMID- 3830883 TI - Heredity, age and cancer. AB - A factor analysis of mortality from gastric cancer in the populations of 41 countries has been made. It is concluded that the interrelation between age and cancer has both a biological and a chronological component. On the one hand, tumour development is linked to the molecular-genetic and systemic-physiological mechanisms of ageing. On the other, increasing mortality from cancer with age reflects the number of years for which the organism was exposed to the carcinogenic action. Each of these mechanisms is illustrated by the factor model of mortality from gastric cancer. Hereditary effects on both mechanisms that relate age and cancer are discussed. PMID- 3830884 TI - There is no such thing as ageing, and cancer is not related to it. AB - Several separate cellular processes have to accumulate in a normal cell to alter it into the seed of a growing carcinoma. Even though cancer is much commoner in the old than in the young, there is no good evidence whatever that these separate processes have any systematic tendency to take place more readily among old than among young adults. (Indeed, there are some instances in which carcinogenic treatments actually elicit cancer less rapidly among the old!) There are obvious evolutionary reasons why substantial cancer risks should be delayed until the end of the usual lifespan, and it appears that this is achieved chiefly not by having the component processes of neoplastic transformation themselves particularly dependent on age, but simply by requiring not one, but several, of them en route from full normality to full malignancy, and by giving at least some of them an extraordinarily low daily probability. The daily probabilities of these separate events are, of course, under evolutionary influence, and some of them appear to have changed by orders of magnitude over the tens of millions of years of evolution that separate humanity from various short-lived animals. PMID- 3830885 TI - Change in the metastatic mode of B16 malignant melanoma in C57BL/6 mice with ageing and sex. AB - An attempt has been made to determine whether changes in the host environment due to ageing or sex differences can influence the metastatic mode of malignant tumours. B16-F10 melanoma cells with a high pulmonary metastasizing potential were injected into the outer ear of C57BL/6 mice; the growth of primary tumour and metastasis of the cervical node were assessed every two days, and the number of lung compared; and in the second young male and female mice were used. The rate of growth of primary tumours was found to be comparable between young and ole mice. Metastasis in the cervical lymph node occurred earlier in old than in young mice. Lung metastases occurred earlier in old than in young mice, but their growth was slower in old than in young mice. Metastasis in the cervical node occurred earlier in males than in females. More lung metastases were found in male than in female mice. PMID- 3830886 TI - Relation of human cancer morbidity to age: general patterns and exceptions in the USSR. PMID- 3830887 TI - Age dependence in cancers of the breast, ovary and endometrium. PMID- 3830888 TI - Transformation assay of established cell lines: mechanisms and application. Proceedings of a workshop organized by IARC in collaboration with the US National Cancer Institute and the US Environmental Protection Agency. Lyon, 15-17 February 1984. PMID- 3830889 TI - Use of rodent hepatocytes for metabolic activation in transformation assays. AB - Although the evidence is not definitive, available information suggests that hepatocytes from appropriate rodent, and possibly other mammalian species, can be used to obtain metabolic activation in transformation assays that utilize cells with limited endogenous metabolic capabilities. On the basis of the available information, it appears that rat hepatocytes may be less suitable than hepatocytes from either mice or Syrian hamsters. In order to resolve these issues, it would be desirable to conduct a set of validation assays using: hepatocytes from several species, and possibly different mouse strains, a small selection of test chemicals from key chemical classes, and a reasonably facile and responsive assay system (BALB/c 3T3). This would provide the data needed to design one or more metabolic activation protocols for general use in screening transformation programs. In addition, the metabolic capacity of BALB/c 3T3 (3T3) cells to convert aniline-based amines to active carcinogens suggests that the application of genetic means to enhance the endogenous metabolic breadth of this or other cell strains, either by modulating control processes or adding genetic information, is a reasonable avenue of research. PMID- 3830890 TI - Recommendations for experimental protocols and for scoring transformed foci in BALB/c 3T3 and C3H 10T1/2 cell transformation. PMID- 3830891 TI - Locus of control and psychological distress among the aged. AB - A relationship between locus of control and adjustment has been found in many studies of young adults, with externals generally reporting higher levels of psychological distress. However, studies of locus of control and adjustment in the aged have produced conflicting results. This investigation examined the relationship between locus of control and self-reported psychopathology in a sample of 139 residents of a retirement complex. Correlation coefficients were computed for locus of control and each of the nine symptom dimensions of the Brief Symptom Inventory. These analyses were carried out separately for males and for females to determine if locus of control orientation was associated with adjustment for both males and females. Results indicate that locus of control is correlated with self-reported psychopathology for older women but not for older men. These results and those of related investigations are discussed within the context of Rotter's social learning theory. PMID- 3830892 TI - The effect of disaster on the health and well-being of older women. AB - Relatively little attention has been paid to the post-disaster health status and well-being of older persons. The data discussed in this article were gathered through use of a retrospective cohort survey five years following a major flood in the Wyoming Valley of Pennsylvania. The subsample of women sixty-five years and older used in this analysis is composed of 122 female victims and forty-five controls from the same communities. The instruments used to measure mental status included Langner's 22-Item Scale, Zung's Self-rating Depression Scale, and a modified Self-Report Symptom Inventory (SCL-90). Additional items related to self perceptions of health status, to influence of the flood on health and well-being, and to other issues. Significant differences occurred in self-perceptions, including state of mind after the flood (p less than .001), distress during recovery (p less than .001), quality of life after the flood (p less than .001), and frequency of thinking about the flood matters (p less than .025). Use of the instruments designed to assess mental status did not indicate greater levels of anxiety or depression in elderly victims as compared to non-victims. PMID- 3830893 TI - Coping with the stress of medical problems among black and white elderly. AB - This is a preliminary study looking at the coping responses of a group of black and white urban elderly women to the stressful event of a medical problem. Cognitive and active coping responses, as well as social support, were explored. Findings revealed these women were similar in many of the ways in which they responded to the stress of medical problems. However, there were some definite racial differences. These included level of social support, use of prayer in coping, and use of nonprescription drugs; the black elderly engaged in these latter behaviors more frequently. PMID- 3830895 TI - Social support and well-being: preliminary indicators based on two samples of the elderly. AB - The structure of social support and its relation to health, affect, and life satisfaction are compared for two samples of the elderly. The first is a national representative sample; the second is a distressed sample from South Miami Beach. Although there are similarities in the structure of social support across the two groups, those in the Miami Beach sample report fewer support figures, and far fewer within geographic proximity, than do those in the national sample. This comparative network impoverishment is particularly marked for male respondents and is accentuated by a high number of isolates in this group. In addition, stronger relationships are found between support network size and affect, and among affect, life satisfaction, and health in the South Miami Beach sample. Older men in poor health and without supportive relationships are targeted as a particularly high risk subgroup. The discussion includes a focus on personal, situational, and life span differences related to variations in support and well being and a consideration of implications for more recent waves of elderly sun belt migrants. PMID- 3830894 TI - The social epidemiology of alcohol use by urban older adults. AB - A sample survey of 928 Bostonians, aged sixty years or older, indicates that there are low levels of alcohol consumption: more than half report that they are abstainers; 6 percent indicate that they have two or more drinks daily. Levels of abstinence are particularly high among women, blacks, Jews, widows and widowers, the foreign-born, those with low levels of formal education, and those aged seventy-five years or older. Among social psychological variables, locus of control is most consistently associated with drinking: those who report little influence upon their futures--in terms of work, marriage, income, and leisure activities--are more likely to abstain. There is also an association with optimisim; those who are least optimistic about their prospects for work and leisure activities are most likely to abstain. Analysis of variance shows that gender, education, ethnicity, religion, age, and locus of control regarding work are independent correlates of alcohol use. The data suggest that older people drink mainly in social contexts and to facilitate social interaction. PMID- 3830896 TI - The effect of widowhood on the health status of older persons. AB - Interest in the relationship between stress and the onset of illness has stimulated research on the impact of various life events on health status. This article is an analysis of the health consequences of widowhood--the life event considered to require the most readjustment. Considering both objective and subjective measures of health, a structural equation model is developed and tested with panel data of a sample of elders. The findings indicate that widowhood results in an immediate decrease in perceived health but that the long term consequences are minimal. Also, certain categories of elders shown to be health optimistic are able to maintain their optimism after widowhood. The results are interpreted as reflecting relativity in medical perceptions and favor a transitional model for explaining the normalization of disability. PMID- 3830897 TI - Psychosocial development and subjective well-being in an age cross-section of adults. AB - Though often cited, Erikson's theory has been relatively neglected in empirical studies of adult development, partly because few measures operationalize his psychosocial constructs. The present research examined the internal consistency and construct validity of an expanded version of the Inventory of Psychosocial Development (E-IPD) which included the generativity and ego integrity scales created by Boylin et al. [1]. Participants were seventy-nine adults with a mean age of forty-two and mean educational level of fifteen years. Total E-IPD scores were found to have high internal consistency but many individual stage scales did not. Men's E-IPD scores showed discriminant validity with respect to social desirability and women's E-IPD scores showed convergent validity with a measure of subjective well-being. Psychosocial development scores were largely unrelated to age, indicating that the E-IPD may have little validity as a measure of adult development. PMID- 3830898 TI - Differences in the morale of older, rural widows and widowers. AB - The purpose of the study was to determine the effect of sex differences on the morale of older widowed individuals. It was hypothesized that when the direct and indirect effects of several background and intervening variables were isolated, sex would have a significant association with morale and that widowers would be more adversely affected. The sample (N = 257) included rural widows and widowers aged sixty-five to ninety-four years who were selected by a compact cluster sampling technique. Sex of respondent was not found to affect morale; however, perceived financial status and self-rated health had significant direct effects. Widows and widowers reporting higher morale were those who had higher perceived financial status and rated their health as good. Education had a significant positive effect on morale via health and financial status. Economic and physical resources appear to be more influential determinants of the widowed older adults' morale than sex differences. PMID- 3830899 TI - Conversational behavior in two health care institutions for the elderly. AB - This article develops a perspective for studying conversational behavior in geriatric institutions. The discussion first considers why conversation is a theoretically significant focus for communications researchers concerned with the aged, and then the article presents data from ethnographic studies of two nursing facilities. Symbolic interactionism underlies the analyses discussed here, for it is suggested that conversations are a means by which interactants communicate about (and so, "construct") their social reality, their relative social statuses, etc. The importance of conversational (more broadly, communicational) behavior for staff-patient relationships in nursing homes is especially highlighted by the data, which were collected over a fifteen-month period. PMID- 3830900 TI - The meaning of time-related concepts across the life-span: an Israeli sample. AB - Three-hundred-thirty-eight Israeli participants rated five time-related concepts on Semantic Differential Scales. Participants constituted six, age-based, groups, representing different life stages: childhood, adolescence, young adulthood, adulthood, late adulthood, and old age. The concepts rated were: time, past, present, and future. In addition, each group rated its own life stage. Results were analyzed in terms of the relationship between age and attributed meaning of these concepts, as denoted by the three Semantic Differential dimensions: evaluation, potency, and activity. The results indicate that people of different ages differ significantly in the way they construe most of the time-related concepts. Past ratings show a significant tendency to increase with progressive age, while future ratings decrease with progressive age. The ratings of present tend to remain stable across the life-span, and the ratings of life stages are significantly lower in older groups as compared to the younger ones. Results are discussed in light of developmental processes, the role that meaning of time related concepts play in psychological adjustment, and methodological aspects. PMID- 3830901 TI - A review of life span research with the Twenty Questions Task: a study of problem solving ability. AB - Research with the Twenty Questions Task which was aimed at investigating problem solving across the life span was reviewed. This research indicates that the use of an efficient problem-solving strategy increases during childhood and then decreases again during the later adult years. Investigations of the determinants of performance on the Twenty Questions Task indicate that both age and education are significantly related to performance. Training research further indicates that both young children and elderly adults are able to learn to use a more efficient strategy; modeling appears to be a very effective training technique. Attempts to facilitate the performance of elderly adults by means other than direct training have met with less success. No improvement in performance was obtained either in a study in which an attempt was made to increase elderly adults' motivation, in a study in which elderly adults were given additional practice with the Twenty Questions Task, or in a study in which an attempt was made to facilitate elderly adults' confidence in their ability to perform cognitive tasks. However, performance was facilitated when the demands of the task were made either so easy that the possibility of the use of an efficient strategy was obvious or so difficult that the necessity of using an efficient strategy in order to solve the problem was obvious. The results of all of the studies were discussed as fitting a model of life span cognitive development recently proposed by Denney. PMID- 3830902 TI - Spatial development across the life span. AB - Fifth graders, ninth graders, college students, and persons over age sixty-five were given three pencil-and-paper tasks in spatial development. Knowledge of Euclidean space was assessed in each of these three tasks. In Task 1, the participants were asked to draw water lines in tilted bottles on a horizontal stand. In Task 2, they were asked to draw water lines in tilted bottles on a tilted stand. In Task 3, they were asked to give directions from one place to another on a hypothetical map. The performance on Task 1 and 2 increased from fifth grade to college. The performance of the elderly was the same as the college students on Task 1, and less than the college students in Task 2. The elderly participants' performance on Task 3 was better than the other three age groups. These results were discussed in terms of ecological validity, experience, and the number of competing cues to be processed simultaneously. Piaget's formulation on adult cognitive development was used to explain the elderly's performance in relation to other groups [1]. PMID- 3830903 TI - Adult age differences in visual search. AB - The visual search technique was used to assess adult age differences in visual information extraction. The study included three adult age groups. In Experiment 1, participants searched for targets embedded in a list of unrelated words. Targets were defined structurally, phonemically, or semantically. Search for structural targets was faster than search for phonemic and semantic targets. This was true for all three age groups. In Experiment 2, targets were embedded in prose. The oldest age group required additional time to detect each target type, but the largest age difference was associated with semantic search. PMID- 3830904 TI - The relationship between death anxiety and the subjective experience of time in the elderly. AB - The present study explored the relationship between participants' level of anxiety about death and both their sense of purposefulness in life and their personal experience of time controlling for the effects of participants' general anxiety and social desirability set. Participants were 145 women aged sixty to eighty-five, members of senior citizens clubs in suburban New Jersey, who agreed to complete a booklet of questionnaires at home and return them anonymously. As hypothesized, respondents high in measured death anxiety were found to be more likely to express less sense of purposefulness to their lives, a sense that time is moving forward, a feeling of being harassed and pressured by the passage of time, an experienced discontinuity and lack of direction in their lives, an inclination to procrastinate and be inefficient in their use of time, and a reported disposition towards being inconsistent. For the most part, the relationship between death anxiety and the other variables was found to hold even when the effects of general anxiety and social desirability were partialed out. PMID- 3830905 TI - Mediators of estimates of brief time intervals in elderly domiciled males. AB - Conflicting interpretations questioning whether brief intervals of real time are perceived as passing more or less rapidly with increasing age have been reported. Reasons for these inconsistent results lie in semantic confusions, in variations in methodology, and in the effects of other mediating variables. The present study examined relationships between age, value of time over both the short and the long term, perceived time to death, self-perceived activity levels, and estimates of brief time intervals in a sample of older institutionalized males. The production method was used to obtain the estimates of time passage. Time intervals were increasingly underestimated with advancing age, indicating that time units are shorter with increasing age. While a number of other variables were interrelated, the only other factor consistently related to time estimates was the short-term value of time. Implications for future research and for interventions in institutional settings are discussed. PMID- 3830906 TI - Risk factors in eighty-plus year-olds living at home: an investigation of a Danish community. AB - A series of risk factors involving the health of the elderly were investigated among persons aged eighty years and older living at home in the community of Holbaek, Denmark. The investigation included a total of 459 participants, 84 percent of this age group. After a two-year period of observation, it was found that 75 percent were still living at home, less than 1 percent were hospitalized, 10 percent had moved to nursing homes, and 14 percent had died. A total of 62 percent had lived at home during the entire period without hospitalization. By means of comparing conditions of health in 1977 and subsequently in 1979, it is possible to point out a series of predictors which are statistically significant but of limited clinical value. The article concludes that it is scarcely possible to achieve more in the prophylaxis of acute breakdown in the life of the old people with the present Danish health policy. Two possibilities were suggested: twenty-four-hour care services, or strengthening of the informal social network. PMID- 3830907 TI - Quality, quantity, and age: the careers of ten distinguished psychologists. AB - The longitudinal relationship between quality and quantity of productive output is examined over the careers of ten recipients of the Distinguished Scientific Contributions Award. Four alternative models of this relationship-expertise acquisition, youthful-enthusiasm, peak-age, and constant-probability-of-success yield distinctive predictions regarding 1) how the ratio of major contributions to total output changes as a career advances and 2) the developmental association between major and minor works over consecutive time periods. The quality of a publication was assessed by the citations it earned in the professional literature. The results endorsed the constant-probability-of-success model (both across and within careers). Not only does confirmation of this model provide support for Campbell's blind-variation-and-selective-retention theory of creative thought, but it additionally has important implications for understanding the role of age and chance in the careers of successful psychologists. PMID- 3830908 TI - A cross-cultural look at the relationship between age and innovative behavior. AB - This study investigates the relationship of age to innovativeness when the effects of opportunity have been controlled. Data were obtained from the Basic Village Education Project. The analysis was conducted on two groups of farmers, the Spanish-speaking Ladino population found in Eastern Guatemala and the Quiche speaking Mayan population found in the mountains of Western Guatemala. Each group was subdivided into young, middle age and old categories. Innovativeness was defined as the level of agricultural technology utilized by individual farmers at the end of the BVE-project period. A separate analysis was conducted for each culture and findings for both indicate that younger farmers were more likely than their older counterparts to adopt new agricultural practices when economic opportunity is controlled. These findings are of three fold importance: they indicate the importance of economic constraints to innovation; they contain implications for policies concerning target development programs, and they contain a warning about ethnocentric hypotheses in research related to "underdeveloped" countries. PMID- 3830909 TI - A cross-cultural health study of Japanese and Caucasian elders in Hawaii. AB - A study of 1098 Japanese and 873 Caucasians sixty years of age and over from Hawaii State Department of Health data files revealed that better health was predicted not only by younger age, higher family income, and maintenance of work role, but also by Japanese ethnicity. Standardized partial regression coefficients showed ethnic membership per se to be as important as any of the demographic variables. Canonical correlation yielded the best correlation of the independent variables with a health index made up of number of chronic conditions, number of bed days and number of restricted days, with each of equal weight. Findings suggest the importance of ethno-cultural supports in health maintenance of the elderly, and have theoretical relevance for the role of culture in health. PMID- 3830910 TI - Observations of empathy of nursing-home staff: a predictive study. AB - This study examines the power of seven demographic variables to predict the extent to which nursing-home staff offer empathy in their interactions with nursing-home residents. Behavioral observations, found to have rater-to-rater reliability, were utilized. Of the seven predictor variables (sex, age, employment status, length of work experience, education, type of institution, and occupational level), only the multiple r and work experience were found significant, although age came close to significance. Younger staff members with moderate lengths of experience were found the most empathic. PMID- 3830911 TI - Modes of experiencing and adapting to retirement. AB - Retirement is typically viewed as a monolithic event which affects all individuals in generally the same way. As a way of beginning to transcend stereotypic views and understand the complex reality of how individuals actually experience retirement, this study was directed toward identifying and describing diversity in modes of retirement adaptation. Twenty-four individuals, drawn from a range of occupational groups, were intensively interviewed one month prior to and six to eight months following retirement. Interview transcripts were analyzed using a phenomenological method which generates systematic descriptions of the structure of an individual's experience. Comparisons among these analyses yielded four distinct ways of conceptualizing and experiencing retirement--as a transition to old age, as a new beginning, as a continuation of preretirement life structure, and as an imposed disruption. Features of each of these patterns of adaptation are described and implications of these findings for preretirement planning and counseling are discussed. PMID- 3830912 TI - Not yet equal: employment experience of older women and older men. AB - Women age forty-five and over are an important component of all working women and of the older labor force. They make up almost 30 percent of the female civilian labor force. Of the older labor force, 40 percent are women. Yet contrary to societal values about equality in the market place, employment-related experience of older women is not only different from that of men but frequently disadvantaged. This article examines the growing importance of the issue of market equality of older working women. It then considers six ways in which their employment-related experience differs from that of men: labor force participation rates; occupational distribution; earnings; unemployment; poverty; and retirement income. The article concludes with suggested policy directions that would improve the status of older women. Some of these would assist, as well, employment needs of older men. PMID- 3830913 TI - Growing more complex: conceptions of sex roles across adulthood. AB - Conceptions of femininity and masculinity in women who were college freshmen, in their midtwenties, midthirties, and midforties were examined with open-ended questions. Responses were analyzed from the perspective of the hypothesis that these conceptions change over the adult years, becoming more complex with age. Support for this hypothesis was found as the older women revealed a more articulated view of roles, with a tendency to put a greater emphasis on the biological element of their role, and a greater tendency to reject the idea of a general relationship between gender and personality. Younger women put a greater emphasis on physical characteristics in defining the conceptions and were more likely to note chivalry as an important factor between the sexes. Possible reasons for these differences and their implications for research on sex roles are discussed. PMID- 3830914 TI - Preretired and retired women's attitudes toward retirement. AB - This study explored the phenomenological meanings of retirement for women and factors associated with adjustment among samples of employed and retired women. In comparing groups of preretired (N = 25) and retired (N = 30) white-collar women, no significant differences were found in overall levels of morale, adjustment, or self-esteem. Instead, correlations of various background, current status, and attitudinal variables with the measures of morale, adjustment, and self-esteem indicated that the factors associated with psychological functioning may be different before and after retirement. These data lead to the hypothesis that change does not directly affect levels of psychological functioning but, instead, cause a shifting in the content of elements or mechanisms which relate to adjustment. PMID- 3830915 TI - Survival after retirement. AB - A study of survival rates after retirement was conducted for a large corporation in the petroleum industry. A regression analysis was performed to control for age, sex, job status, and type of work differences that may influence longevity. Examination of the residuals showed a bimodal distribution: one group died (on the average) six and a half years after retirement, while the second group survived (on the average) nineteen years. Implications for health care management are discussed. PMID- 3830916 TI - Emotional closeness and physical distance between friends: implications for elderly women living in age-segregated and age-integrated settings. AB - The author discusses the need for a better theoretical understanding of friendship in order for its role in the lives of elderly people to be understood. The applicability to friendship of Simmel's approach to the study of social relationships is outlined. From this perspective, types of friendship are determined by the physical distance separating friends and the emotional closeness bringing them together. The data consist of seventy in-depth interviews of senior, unmarried women in a middle-class community bordering on Chicago. Qualitative data are reported to support quantitative analyses. There were positive relationships between emotional closeness and physical distance, duration and emotional closeness, and frequency of interaction and proximity. The author describes the implications for elderly women of the tendency for their close, old friends to be physically separated from them and their neighbors to be casual friends, but constant companions. The author discusses the effects of the age-density of residential context and life history on the types of friends the women had. PMID- 3830917 TI - Characterizing adolescents, middle-aged, and elderly adults: putting the elderly into perspective. AB - Adolescents, middle-aged, and elderly adults used a Likert scale to describe an ideal, real, or typical person of either their own age group or one of the other two. On each of four dimensions of instrumentality, autonomy, acceptability, and integrity, ideal people were characterized more positively than real or typical ones. Age of neither participant or stimulus object affected these judgments. Stereotypes emerged when typical people were rated, though judgments on real people suggested little difference between elderly and middle-aged people. However, real adolescents were judged to be more unacceptable, dependent, and instrumental than were middle-aged and elderly adults. On instrumentality the age groups differed in their perceptions of each other. Adolescents and middle-aged adults perceived instrumentality to decline in old age, but the elderly did not agree. Thus attitudes reflected stereotypes when broad categorical decisions were required, but stereotypes broke down when known people were characterized. PMID- 3830918 TI - Methods of suicide by age: sex and race differences among the young and old. AB - The elderly have the highest suicide rate in the United States. In partial explanation of this finding, a common statement in the suicide literature is that older persons tend to use more drastic and effective methods of suicide. However, little, if any, data have been presented in defense of this explanation. In order to investigate the validity of this contention, annual official statistics for specific methods of suicide (firearms, hanging, poisons) by age for different sex and racial groups (whites, blacks, nonwhites excluding black) were examined from 1960 to 1978. Comparisons among the age-sex-race groups, along with trends over time and differences in the methods employed, were noted. For white males, blacks of both sexes, and nonwhites excluding black females, the findings confirmed the use of more violent methods by the elderly than by the young in terms of the proportion of suicides by firearms and/or hanging. Less support and, in fact, opposite results for method-related age differences were obtained for white females and nonwhites excluding black males. Another general finding was an increase in the use of firearms for most of the groups studied. The need for data for specific groups within the nonwhite category excluding blacks is apparent both from the available literature and from the present findings. Possible explanations and implications of the observed results are discussed. PMID- 3830919 TI - Effects of cognitive-behavioral, reminiscence, and activity treatments on life satisfaction and anxiety in the elderly. AB - This study involved an examination of effects of a cognitive-behavioral group condition, a reminiscence treatment group condition, and an activity group condition on anxiety and life satisfaction for senior citizens, aged sixty-five and older. No significant differences on life satisfaction and trait anxiety were found for the groups at pretest, posttest, and follow-up. A significant ANOVA for state anxiety at follow-up was followed by directional t-tests which were not significant in the predicted direction. The differences on state anxiety observed at follow-up appear to have resulted from improvement of the reminiscence group. Suggestions were made for further research on group treatment of the elderly. PMID- 3830920 TI - Academics beyond midlife: some observations on changing consciousness in the fifty to sixty year decade. AB - This article draws on in-depth interview data collected from forty-seven professors between the ages of fifty and sixty. The central focus is on the twenty-three interviews done with the men. A review of the literature suggests that professionals in the fifty to sixty year decade are actively assessing how to divide their energies at work and between work and other life spheres. After describing how aging is experienced in the fifties by both men and women, the article describes a set of related patterns of consciousness change among the male professors interviewed. As male professors approach sixty, they express a number of interconnected feelings and concerns that distinguishes them from younger colleagues. First, they stress the need to exercise greater selectivity in the allocation of their time. They recognize that a limited amount of time lies ahead in their careers and that they must make qualitatively good decisions about the work they do. Second, the men in our sample evidence a decreased intensity toward research work. Third, many men express a growing humanism; a concern with getting beyond the objective boundaries of their respective disciplines. Last, professors begin to develop an exiting consciousness as they approach sixty. PMID- 3830921 TI - Proceedings of the Tenth International Biometeorological Congress. 26-30 September, 1984, Tokyo, Japan. PMID- 3830922 TI - Clinical implications of physical fitness. PMID- 3830923 TI - Present state of knowledge regarding biological effects of magnetic, electric, and electromagnetic fields, as well as of natural radioactivity in indoor air. PMID- 3830924 TI - Urban climate from the viewpoint of atmospheric environment. PMID- 3830925 TI - Chronobiology and biometeorology. PMID- 3830926 TI - Photoperiodic influences of the moon on behavioral and developmental performances of organisms. PMID- 3830927 TI - Impact of photoperiodic information on pineal metabolism and physiology. PMID- 3830928 TI - Radiation in our environment from the atmosphere and from space. PMID- 3830929 TI - Endocrine and metabolic aspects of balneotherapy. PMID- 3830930 TI - L-tryptophan does not increase weight loss in carbohydrate-craving obese subjects. AB - Eight subjects, aged 26 to 50 years, who had long histories of carbohydrate (CHO) craving and were more than 45 kg above desirable body weight participated in a randomized, double-blind, crossover pilot study on the effects of L-tryptophan on weight loss and mood state. One g of tryptophan with 10 g of CHO was administered three times a day, 30 min before meals, as an adjunct to a weight-loss protocol that included nutritional consultation teaching low fat, high fiber diets ranging from 1200-1600 kcals/day, behavior modification, and supportive therapy. During the pretreatment period, body weight and plasma tryptophan levels were measured and the Beck Depression Inventory, SCL 90 rating, and Profile-of-Mood State (POMS) were used to assess mood. During the treatment periods, subjects kept daily records of food intake and the timing of medication. All patients were seen at least biweekly. After six weeks on medication, baseline measurements were repeated and the crossover between tryptophan and placebo was implemented. After an additional six weeks on placebo or tryptophan, the same measurements were repeated. For the eight patients who completed the three-month protocol, the mean weight loss for six weeks on placebo was 1.14 kg and for six weeks on tryptophan was 2.3 kg. Mean Beck scores were 8.8 during the control period, 8.3 on placebo, and 10.9 on tryptophan. Mean SCL 90 ratings were 69.2 during the control, 54.6 on placebo, and 64.2 on tryptophan. Mean scores for total mood disturbance on the POMS were 48 during the control period, 43 on placebo, and 52 on tryptophan.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3830931 TI - Obesity and hypertension: long-term effects of weight reduction on blood pressure. AB - Long-term follow-up studies were conducted on massively obese hypertensive subjects during and after a successful protein supplemented fast (PSMF) in order to correlate blood pressure changes with caloric intake and body weight. The blood pressures in 43 subjects were compared during rapid weight loss and at identical weights during post-fast weight gain (Study A). Blood pressures and body weights in 50 subjects were compared prior to starting PSMF and prior to restarting the program 21 months later (Study B). One hundred twenty-five compliant subjects were observed after one month of weight maintenance (Study C 1), and 39 subjects were followed during six months of weight maintenance (Study C-2). In Study A, during subsequent weight gain on an unrestricted diet blood pressure was significantly higher than at identical weight during continuous weight loss on PSMF. However, this increase in blood pressure was only approximately 30 percent of the original decrease. In Study B, weight loss and blood pressure reduction were significantly correlated. After one month of weight maintenance following continuous weight loss of 73 lb, there was no increase in blood pressure (Study C-1). A small but significant increase in blood pressure after six months (Study C-2) was associated with similar small weight increment. However, all blood pressures remained well within the normotensive range and significantly lower than control values. In this study, long-term changes in blood pressure correlated with changes in body weight. PMID- 3830932 TI - Relationship of hunger, use of a shopping list and obesity to food purchases. AB - Shopping with a list and shopping after a meal are two commonly employed behavioral weight loss guidelines designed to reduce food purchases and therefore food consumption. A survey of 596 female shoppers, which analyzed purchases on the basis of caloric value, failed to support either of these guidelines. Analysis of kilocalories (kcal) purchased indicated that overweight shoppers purchased more total kcal, with a greater percentage of their kcal coming from fat and correspondingly lower percentage of kcal coming from carbohydrates. PMID- 3830933 TI - Maturation of thermoregulation in Zucker rats. AB - We compared the development of thermoregulatory abilities of fatty (fa/fa) and lean (Fa/-) Zucker rats as they grew from two weeks to eight months of age. The rectal temperature of lightly restrained littermates was continuously recorded for 2-6 h, and at ages before body weights of fatty and lean pups became significantly different, oxygen consumption was simultaneously measured. At the rearing temperature of 25 degrees C, hypothermia with a 30 percent lower oxygen consumption was apparent in fatty pups at 16 but not at 24 days. At 5 degrees C on day 25 fatty pups became hypothermic with a metabolic rate only 10-15 percent lower than lean pups. Three-month old fatty and lean rats defended the same core temperature not only at 25 degrees C, but even during 6 h without food at 5 degrees C. The core temperature of 5-8 month old fatty rats fell slightly but significantly below that of lean rats only during the sixth hour at 25 degrees C, but not during 6 h at 5 degrees C. If the capacity for thermogenesis in brown adipose tissue of fatty rats is less than in lean rats, its decreased contribution to cold defense must be completely made up in 25 degrees C acclimated adults by more insulation and/or shivering. PMID- 3830934 TI - HLA system, body fat and fat distribution in children and adults. AB - The association between the genotypes and the alleles at the A, B or C locus of the HLA system and body fat was studied in a total of 1578 individuals subdivided in four cohorts: adult males (n greater than or equal to 204), adult females (n greater than or equal to 184), boys and male adolescents (n greater than or equal to 282), and girls and female adolescents (n greater than or equal to 257). None of these subjects were grossly obese or had known metabolic disorders. Percent body fat from underwater weighing, subcutaneous fat from 6 skinfold measurements, trunk fat (3 skinfolds) and extremity fat (3 skinfolds) were considered in the analysis. Although a few significant associations were encountered, the lack of consistency across samples suggested that they were probably random and biologically not meaningful. The same negative findings were found for the ratio of trunk subcutaneous fat to extremity subcutaneous fat and the ratio of subcutaneous fat (6 skinfolds) to total fat mass. Earlier reports indicating a significant association between high body fat content and antigens B18, Bw35 or Cw4 were not supported by the results of this study. It was concluded that no consistent pattern of association emerged between genotypes or alleles of the HLA system and percent body fat, subcutaneous fat or fat distribution in children and adults of both sexes. PMID- 3830935 TI - The effects of triiodothyronine on energy expenditure, nitrogen balance and rates of weight and fat loss in obese patients during prolonged caloric restriction. AB - We studied ten obese patients on prolonged caloric restriction by metabolic balance techniques two weeks before and two weeks after the start of treatment with triiodothyronine (T3) (0.36-1.01 micrograms/kg/d). The rate of weight, nitrogen and fat loss calculated from metabolic balance increased during T3 therapy and these effects were maximal in the second week of treatment. In seven patients studied continuously for four weeks on T3 therapy, the rates of weight and fat loss during the fourth week of treatment were not significantly different from pretreatment values while nitrogen loss was still significantly greater. The increase in nitrogen loss, studied after the period of adaptation to caloric restriction, implies that prolonged treatment with T3 can result in significant losses of lean tissue in addition to that resulting from caloric restriction alone. Mean weight loss increased by 92 g/d during T3 therapy. T3 significantly increased the metabolic rate as measured by two other independent measures: the resting energy expenditure (REE), measured by indirect calorimetry (fourteen patients), and the sleeping heart rate (six patients). PMID- 3830936 TI - Effect of dietary fat content on the incidence of obesity among ad libitum fed mice. AB - Graded increments in the fat-to-carbohydrate ratio of the diet elicited a gradual, but reversible increase in the average mass of body fat maintained by adult female (CDI) albino mice under ad libitum feeding conditions. In addition, the inter-individual variability in the animals' fat mass was greatly magnified by diets with a substantial fat content (greater than 30 percent of calories). As a result, the incidence of obesity (defined as one third or more of body weight as fat) increased progressively from 0 percent to 35 percent when the diet's fat content was varied from 1 percent to 64 percent of its total energy content. A state of weight maintenance can only become established when the relative rates of glucose and fatty acid oxidation are proportional, on average, to the carbohydrate-to-fat ratio of the diet. When diets with a relatively high fat content are consumed, a considerable enlargement of the adipose tissue mass appears to be necessary in many animals before weight maintenance becomes spontaneously established. It is proposed, therefore, that changes in the adipose tissue mass, along with shifts in the range in which glycogen levels are maintained, and other adaptive changes, contribute to bring about rates of fat oxidation commensurate with a diet's fat content. This impact of dietary composition on body composition may be a factor contributing to the increased incidence of obesity in affluent populations consuming diets with a substantial fat content. PMID- 3830937 TI - The effect of tri-iodothyronine (T3) on protein turnover and metabolic rate. AB - Obese patients who had an unusually slow weight loss on a restricted energy intake (2 MJ/d) were treated for approximately two weeks with small doses of T3 (20 micrograms three times daily). At the beginning and end of treatment whole body protein turnover was measured with a single dose of 15N-glycine and both ammonia and urea as end-products. T3 increased the rate of weight loss, with a significant increase in urinary nitrogen excretion. There were small increases in basal metabolic rate and protein turnover, which were not significant. It is concluded that the extra weight loss produced by T3 was at the expense of lean body mass and not of fat. PMID- 3830938 TI - On the early recognition of neuroleptic malignant syndrome. AB - Neuroleptic Malignant Syndrome, a serious and sometimes fatal complication, has been reported to occur in some patients with the administration of neuroleptic medications. Clinically it is manifested by four groups of symptoms which include muscular hypertonicity, autonomic instability, altered consciousness, and hyperthermia. Laboratory findings such as elevated creatinine phosphokinase and leukocytosis are also seen. While it is true that the incidence of the full blown clinical picture of this syndrome is rare, the authors report that only muscular hypertonicity and autonomic instability have occurred frequently in their setting leading to discontinuation of neuroleptics. Such abortive cases may go undetected. If properly diagnosed, the occurrence of this syndrome is not as rare as the published reports indicate. Second, it is reported that rechallenge with neuroleptics may not induce Neuroleptic Malignant Syndrome again. The authors noted recurrence of fever after rechallenge with a different neuroleptic drug. This article describes the method of early recognition and prevention of morbidity as well as mortality. PMID- 3830939 TI - Effects of cortical lesion location on psychiatric consultation referral for depressed stroke inpatients. AB - Although post-stroke depression occurs with lesions to either cortical hemisphere, increasing evidence supports the view that depression is more prevalent after left hemispheric damage. This retrospective study of depressed post-stroke inpatients referred for psychiatric consultation shows a significantly higher referral rate for patients with right-hemispheric lesions. The results suggest an underutilization of psychiatric consultation to patients with left-sided lesions, and perhaps underrecognition of affective disorders in these patients. Various reasons for this underutilization are proposed, including the greater likelihood of speech impairment in left-sided brain-damaged stroke patients, who may have greater difficulty verbally communicating their psychic distress. Increased physician awareness of the clinical presentations of post stroke depression will result in more patients benefitting from available treatments. PMID- 3830940 TI - Clonazepam: a novel therapeutic adjunct. AB - Clonazepam, a unique benzodiazepine with anticonvulsant and serotonin enhancing capacity, can be used in conjunction with conventional psychopharmacologic agents to treat a variety of psychiatric conditions including schizophrenia, borderline personality disorder, and psychotic mania. Three representative case studies are presented and specific guidelines for the use of clonazepam are discussed. PMID- 3830941 TI - Doubts about being of value: an important aspect of countertransference in consultation-liaison psychiatry. AB - Doubts about being of value to medically ill patients and their referring physicians is not an uncommon emotional reaction of consultation-liaison psychiatrists to the medical environment. Both realistic perceptions of negative attitudes of non-psychiatric physicians as well as unrealistic doubts about their potential usefulness, which may be projected upon and attributed to their non psychiatric colleagues, can contribute to this unsettling response. This reaction may interfere with effective collaboration between consultation-liaison psychiatrists and their non-psychiatric colleagues and needs to be understood and mastered. PMID- 3830942 TI - Coping with serious illness: on integrating constructs to enhance clinical research, assessment and intervention. AB - Empirical research suggests that given relatively similar illness contingencies, patients who cope successfully with serious illness have access to and use effectively social network support, believe events are to some extent within their control, perceive themselves to be effective, and employ an array of flexible coping strategies. Based on a selective literature review, the argument is made that more integrative conceptual frameworks are needed to advance theory and to enhance the applied value of research data. Clinical implications for assessment, intervention, and evaluation are set forth. PMID- 3830943 TI - Factitious disorder in a manic patient: case report and treatment considerations. AB - A case of factitious disorder with physical symptoms is described in a patient with manic-depressive illness. The coexistence of factitious disorder and bipolar disorder has not been previously reported. Clinicians should search for an underlying affective disorder in patients who fabricate signs and symptoms of physical illness, since mania may simulate or contribute to the production of factitious behavior. PMID- 3830944 TI - Psychosomatic aspects of myocardial infarction and implications for treatment. AB - Psychosomatic intervention with patients who have suffered myocardial infarction is directed toward prevention of complications, development of realistic coping strategies, working through emotions, reduction of stress, and modification of coronary prone behavior. PMID- 3830945 TI - A pilot study of women's attitudes towards breast-conserving surgery with primary radiation therapy for breast cancer. AB - Breast-conserving surgery ("lumpectomy") with primary radiation therapy is gaining acceptance as an alternative to mastectomy for breast cancer. Currently, little is known about the specific immediate and long-range biopsychosocial effects of breast-conserving therapy as compared to more traditional mastectomy procedures. Physicians' speculations about the women who chose breast-conserving treatment as opposed to mastectomy seem to have been influenced by the scientific debate concerning the efficacy of this procedure. This study is a preliminary investigation of the attitudes and experiences of women receiving breast-saving therapy for carcinoma of the breast. PMID- 3830946 TI - Long-term results after surgical treatment of laryngeal stenosis in small children. AB - Thirteen severe cases of laryngeal stenosis were operated on at the ages of 1-3 years. The operations were performed by making a laryngofissure in the front part of the larynx and excising the stenosing scar. The back wall of the larynx was incised in the midline and the two halves of the cricoid lamina were separated from each other. An indwelling prosthesis was placed in the larynx for 4 months. All patients but one were decannulated. The positive clinical result of the operation proved to be permanent through the rapid growth phase of puberty in 7 patients out of the 10 who had reached puberty. Three patients developed a gradually worsening laryngeal stenosis during the rapid growth phase of puberty. One of them was successfully re-operated. The mean follow-up time was 12 years. Ventilatory function tests were performed on 9 patients, 4 of which proved to have normal ventilatory function or only slight airflow limitation in central airways. PMID- 3830947 TI - The infant's pre-tympanic region of the eustachian tube in health and disease. AB - The size of the eustachian tube lumen of the pre-tympanic segment in infants and children from birth up to two years is presented. The material consisted of serially sectioned 28 eustachian tubes of normal temporal bones and 13 eustachian tubes of temporal bones harboring acute and secretory otitis media. The size of the eustachian tube lumen was measured with the aid of a millimetric grid mounted on a microscope. These measurements have shown that: there is no increase in the lumen size of the pre-tympanic region of the auditory tube from birth to two years of age. Each age group presents a considerable range in luminal size, compatible with a natural biological distribution. No obstruction of the eustachian tube lumen was encountered in any of the pathological specimens. There is no significant statistical difference between the lumen size of the pre tympanic region coming from normal temporal bones as compared to those from temporal bones with acute or secretory otitis media. PMID- 3830948 TI - A longitudinal study of the detection of otitis media in the first two years of life. AB - A number (210) of children were followed longitudinally through the first two years of life with pneumatic otoscopy and electroacoustic immitance, tympanometry, at every physician encounter. Tympanometry proved to have a high predictive value (86%) for detecting normal ears but relatively poor predictive value (58%) for detecting abnormal ears when utilized as a routine screening procedure with every clinic visit. In part the tympanometrically abnormal ears which appeared normal in otoscopic exam were temporally related to recent episodes of otitis and concurrent upper respiratory congestion, but many were unrelated to detectable middle ear pathology. These observations detract from the utility of tympanometry as a screening tool for middle ear pathology. PMID- 3830949 TI - The presentation and management of the nasal glioma. AB - Nasal gliomata are rare and experience in management is therefore not widespread. Clinical details of 5 children with nasal gliomata are presented. In each case the glioma was excised by an external approach without the need for craniotomy. These cases demonstrate the variability of presenting features and problems in management. They illustrate a relatively conservative surgical approach to treatment which we consider to be safe and effective. The characteristics of these unusual neural malformations are reviewed, and the management is discussed. PMID- 3830950 TI - Bacterial tracheitis, diagnosis and treatment. AB - During a 22-month period, 5 children, 6-13 months of age, presented with an acute obstructive upper airway infection which resembled both croup and epiglottitis. All 5 failed to respond to standard treatment for croup, including aerosolized racemic epinephrine. In all patients, direct laryngoscopy revealed minimal or no change in the epiglottis and aryepiglottic folds but severe subglottic swelling and copious purulent tracheal secretions. Gram stains of the purulent secretions revealed many polymorphonuclear leukocytes with gram-positive cocci (3 patients) and small gram-negative rods (2 patients). Cultures subsequently confirmed the presence of S. Aureus and H. Influenzae. Initial therapy for all patients included endotracheal intubation, antibiotic therapy for both S. Aureus and H. Influenzae and frequent tracheal suctioning. Hospitalization varied from one to 3 weeks. We reported findings in these patients because: the initial diagnosis was unclear due to confusion caused by clinical features common to both croup and epiglottitis and bacterial tracheitis requires a prompt accurate diagnosis and aggressive antibiotic and airway management in order to prevent unnecessary morbidity and mortality. PMID- 3830951 TI - Postintubation granuloma of the anterior subglottic larynx. AB - We present an unusual case of a granuloma in the subglottic laryngeal airway of a 6-week-old infant with a history of previous endotracheal intubation. Postintubation granuloma formation in this region has not been previously reported in infants. PMID- 3830952 TI - The correlation between estrogen and progesterone receptors and some clinical and pathological features in human breast cancer. AB - The correlation between estrogen (ER) and progesterone (PgR) receptor status and some clinical and pathological features was evaluated in a series of 680 breast carcinomas. ER status was significantly related to age, menopause, histological grade and vascular invasion. No relationship was found with tumor size, lymph node involvement, histotype and multicentricity. PgR status was significantly related to vascular invasion only. Despite the relationship between ER and favorable pathological features, ER-positive patients did not show a longer disease-free interval after surgery when no systemic adjuvant therapy was administered. ER status is thus of little prognostic value. PMID- 3830953 TI - Nutritional effects of total gastrectomy. A prospective randomized study of Roux en-Y vs Longmire-Mouchet reconstruction. AB - A prospective randomized study was carried out to evaluate the nutritional and clinical results of two reconstructive procedures after total gastrectomy for gastric cancer: Longmire-Mouchet (LM) operation with loop interposition and maintained duodenal transit and Roux-en-Y (RY) reconstruction with duodenal exclusion. 22 patients, 11 with LM reconstruction and 11 with RY reconstruction were studied pre-and postoperatively. The average follow-up was of 30 +/- 8 months. The clinical results were shown to be substantially similar to the two groups. No patients complained of heartburn or dysphagia. At esophagoscopy no signs of esophagitis were detected in both groups. The two time course curves of body weight variation did not show statistically significant differences even though in RY patients the body weight has reverted more rapidly to basal values. PMID- 3830954 TI - Increase of the mitotic activity of colonic mucosa in patients with multiple non familial adenomatous polyps. AB - A histological study of colonic mucosa, including the measurement of the mitotic index, was performed in routinely processed specimens from control subjects and patients with multiple non-familial adenomatous polyps, to ascertain whether the onset of adenomatous polyps was accompanied by an increase in mucosal mitotic activity as compared with controls. The mitotic index of both the polyps and the mucosa 20 cm from the anal orifice of the same patients was significantly (P less than 0.01) higher than that of control 20 cm from the anal orifice and a shift of the mitotic activity from the lower two-thirds to the upper third of glands was observed in the polyps. These data suggest that an increase of mitotic activity in the superficial third of the glands as compared with controls plays a pathogenetic role in the onset of adenomatous polyps and that this phenomenon is accompanied by a diffuse increase of mitotic activity in the deeper two-thirds of the glands. PMID- 3830955 TI - Cefoxitin and cefamandole levels in the human bile. AB - The bile levels of cefoxitin and cefamandole were studied in 75 patients. The two antibiotics were shown to be present at high concentration and to undergo a rapid metabolization. It is concluded that they represent the antibiotics of choice in the prophylactic and therapeutic treatment of biliary tract infections. PMID- 3830956 TI - Treatment of retained common bile duct stones with monooctanoin infusion. AB - A prospective study of 53 consecutive patients with retained common bile duct stones, treated with monooctanoin infusion is presented. Overall good results were obtained in 58.6% of cases and poor in 41.4%. No abnormal levels of hepatic and pancreatic enzymes were observed. The main cause of failures was due to stones located in the intrahepatic tree. In the presence of pigmented stones or when their size exceeds 30 mm, monooctanoin infusion should be associated to other instrumental procedures. It is concluded that when intrabiliary infusion of monooctanoin is well tolerated, it is an effective alternative for treatment of retained common bile duct stones. PMID- 3830957 TI - Radical cystectomy in the treatment of advanced bladder cancer. AB - Thirty-two cases of advanced bladder cancer (pT3b-pT4) undergoing radical cystectomy are compared with other similar series of patients of the same stages submitted to different treatments (radiotherapy, chemotherapy and combined treatments) reported in the literature. Survival rates at 3 and 5 years are analyzed in relation to the anatomopathological stage, cellular grading, lymph node infiltration, surgical risk and relative mortality. The results confirm that radical cystectomy is presently the most effective treatment. PMID- 3830958 TI - Use of the Montgomery T-tube in tracheal surgery. AB - The Montgomery T-tube was used in 33 patients over a total of 100 cases undergoing tracheal surgery. Of 21 cases with inflammatory stricture the T-tube was used in 18 in association with resection and end-to-end anastomosis, while in the remaining 3 cases the T-tube was the only treatment carried out. The results were good in 48% of cases, poor in 17% and still to be assessed in 29%. In neoplastic diseases (10 cases) the use of the Montgomery T-tube ensures the patency of the tracheal lumen avoiding the possible, severe asphyxial crises. The major limits of the T-tube appear to be its ineffectiveness against extended tracheomalacia and its possible displacement which may lead to asphyxial crises. PMID- 3830959 TI - Crohn's disease of the esophagus. A case report. AB - A case of Crohn's disease localized in the inferior third of the esophagus with negative radiological evidence, positive endoscopic evidence, and aspecific signs of esophageal wall inflammation is reported. Evaluation of clinical remission of dysphagia and endoscopic features of the esophageal lesions following steroid therapy led to the diagnosis of Crohn's disease of the esophagus in the patient already operated on for a colonic localization. Data from literature are examined with emphasis on the difficulty of the diagnosis. PMID- 3830960 TI - Median sternotomy for resection of lung metastases. AB - Three patients operated upon via median sternotomy for resection of bilateral lung metastases are presented. 2 show no evidence of disease 30 and 42 months after operation, one died 10 months after surgery. The literature on the subject is reviewed; median sternotomy is considered a quick, safe and reliable route, indicated when resection of bilateral lung metastases is to be carried out. PMID- 3830961 TI - Observations on the replacement of loose prostheses. AB - Revision surgery for loosening of the components in total hip prostheses is still a problem and not only from the purely technical aspects. According to our experience, the use of cement is contraindicated, at least in Schneider grades 2 and 3 of aseptic loosening, because of the biological damage it can cause to the bone grafts used in such cases. The stability of non-cemented reimplants is dependant on good biological anchorage through endosteal osteogenesis. The cardinal points of technique are: complete removal of all cement, necrotic bone, and interposed fibrous membrane; the use of autoplastic bone grafts in the form of chips to replace the lost "bone stock"; the use of prostheses designed for optimum load distribution (long stem, large acetabulum). In the case of ruptured stems, diaphyseal osteotomy is necessary for complete removal of the cement and prosthesis; this can be stabilised by using a Lord prosthesis with a long stem. PMID- 3830962 TI - Long term results of triradiate osteotomy of the pelvis. A follow-up study of 26 hips. AB - The authors reviewed 26 hips in 21 patients treated by triple osteotomy of the pelvis for the sequelae of congenital dysplasia or congenital dislocation of the hip. The minimum follow-up was 3 years, maximum 6 years. The clinical condition remained constant over this period. Pain, if present before operation, was either improved or disappeared. The Trendelenburg limp was either unchanged or improved. Reduction of range of hip movement was very rare. There was 0.5 cms lengthening of the leg compared with the pre-operative state. The post-operative radiographic parameters were unchanged over the follow-up period. These included the acetabular roof angle (C.E. angle), Hilgenreiner's roof angle, the neck/shaft angle, and anterior coverage of the femoral head. In about one third of the cases, however, there was deterioration in centralization. PMID- 3830963 TI - Aneurysmal cysts of long bones. AB - The authors reviewed 121 cases of aneurysmal cysts of the long bones treated at the Tumour Centre of the Rizzoli Institute of Orthopaedics of which 103 had been followed up for more than one year. A classification is proposed based on 5 morphological groups and 3 grades of aggression. All except 4 of these lesions were treated by curettage or resection (2 were treated by radiotherapy alone, and 2 only had biopsies). The overall results showed a recurrence rate of 13%, none of which were in the inactive group. There was no prognostically significant difference in the recurrence rate between the active and aggressive groups. In the morphological groups there were significant prognostic differences. The authors therefore advise a programme of treatment based on an assessment of the morphological type and aggressiveness of these tumours. PMID- 3830964 TI - Osteosynthesis of subtrochanteric fractures. A review of different methods. AB - The authors analysed the long-term results of 72 subtrochanteric fractures treated surgically over a period of 13 years. The case material was subdivided according to type of fracture and method of osteosynthesis and the results were evaluated with a view to ascertaining the best method of treatment in each type of fracture. The best results were obtained with osteosynthesis using an angled nail plate. PMID- 3830965 TI - Clinical and radiographic long term results of acetabular fractures associated with dislocations of the hip. AB - The authors carried out a long term review of 246 cases of fracture dislocation of the hip, based on a new classification of these injuries into six types. The average follow-up was 10 years (minimum 4 years). The review was aimed at ascertaining and comparing the clinical and radiographic results in each group in relation to type of treatment, age, sex, quality of reduction and time to weight bearing. The survey revealed discrepancies between the clinical and radiographic results that underlined the essential difference between idiopathic osteoarthritis and post-traumatic arthritis. The most important factor in reducing the incidence of ischaemic necrosis was reduction of the dislocation within 24 hours. Arthritis was more dependent on the quality of reduction than on the method of treatment used to achieve it, and was also less frequent when weight-bearing had been delayed for 60 days. The overall results were better in younger subjects. PMID- 3830966 TI - Control of post-operative infection in orthopaedic surgery. Clinical and bacteriological findings in 2555 elective operations. AB - Post-operative infection is still a serious problem in orthopaedic surgery. Technological advances aimed at achieving aseptic conditions in the operating theatre, and the prophylactic use of antibiotics during operation have considerably reduced this complication during the last decade. Two indispensable factors in monitoring the effectiveness of these preventive measures are the determination of the incidence of post-operative infection and monitoring of the microbacterial population of the hospital. PMID- 3830967 TI - Clinical and electrophysiological investigation of the results of operation for lumbar disc hernia. Preliminary results. AB - The long-term results of operations to remove disc hernias were assessed clinically and electrophysiologically in two groups of patients treated by different surgical techniques. The electrophysiological parameters determined were the motor conduction speed of the sciatic nerve, the H reflex, the minimum latency of the F wave and quantitative analysis of the EMG by the Willison method. The preliminary results reported in the present paper are related to two comparable samples of patients who underwent hemilaminoarthrectomy or hemilaminectomy for disc hernia at L5-S1. They show that the incidence of after effects was lower in the patients treated by simple hemilaminectomy. PMID- 3830968 TI - The lymphocytic transformation test (L.T.T.) in the evaluation of intolerance in prosthetic implants. AB - A state of hypersensitivity to the metallic constituents of prosthetic implants can be determined by culturing the patients lymphocytes in vitro in a medium containing the appropriate concentration of salts of the metal. If in these circumstances the lymphocytes proliferate, the patient is hypersensitive. Chromium, cobalt and nickel salts can produce such mitosis only in the lymphocytes of hypersensitive patients; the same test produces no such reaction in control subjects. This hypersensitivity can cause delayed loosening of the prosthesis. The lymphocyte transformation test (L.T.T.) is therefore a very useful preoperative measure in detecting patients who are allergic to these metals and so enables the surgeon to choose the right implant. PMID- 3830970 TI - [Association of severe intestinal villous atrophy and abdominal non-Hodgkin lymphoma. Apropos of 3 cases]. AB - Malignant lymphoma is a recognized late complication of adult celiac disease. In children, however, the association of lymphoma with celiac disease was so far identified only in one case of an Algerian girl in 1981. We have observed during the last 5 years 78 patients with non-Hodgkin lymphoma, 56% located in the abdomen. In three of these cases, the association of intestinal epithelial atrophy and non-Hodgkin abdominal lymphoma was observed and is reported in this paper. PMID- 3830969 TI - Long term results in Osgood-Schlatters disease. AB - The authors were able to establish a relationship between high patella (alta) and Osgood-Schlatter's disease. In a long-term study this was found in 38% of cases. There was also evidence of abnormalities of femoro-patellar relationship in 57% of cases, although only 14% of these had symptoms at the time of follow-up. Two alternative hypotheses on the pathogenesis of the disease are put forward, depending on whether the radiographic changes observed at follow-up were of a pre existing constitutional type, or the direct result of the disease. This question can be resolved if in future cases a precise radiographic examination is carried out on both knees at the onset of the disease, using the exact technique described so that the relevant parameters can be determined. PMID- 3830971 TI - Thyroid function in type 1 juvenile diabetes mellitus: tendency to the low T3 syndrome. AB - We have evaluated the thyroid function in 30 children and adolescents (average age 13 2/12 +/- 3 10/12 years) suffering from type 1 insulin-dependent diabetes (average duration of illness 5 +/- 3 3/12 years). We divided them into group A (good control) and group B (poor control), according to whether they had presented an HbA1C value lower or higher than 10%. The results obtained have been compared with a group of 30 normal patients of the same age. Both groups of diabetics presented T4 values which were notably lower than the control group (P less than 0.05). T3 was appreciably diminished both in group A (P less than 0.05) and in group B (P less than 0.01) and presented a negative correlation with HbA1C, only in group A however. The rT3/T3 ratio, on the other hand, was significantly increased in group B with respect to the controls. No significant differences were found with regard to FT3 and FT4, nor any correlations among thyroid hormones, C peptide, duration of illness, and daily insulin requirement. Our results indicated that the tendency to the low T3 syndrome, already described in adult diabetics, is also identifiable in young diabetics, particularly if poorly controlled. PMID- 3830972 TI - True precocious puberty: a long-term complication in children with shunted non tumoral hydrocephalus. AB - In 4/37 (10.8%) children, adolescents and young adults with successfully shunted hydrocephalus, puberty occurred or was occurring precociously, at an age ranging from 7.5 to 8.6 years, with a consequent impairment of their effective or predicted adult height as compared to the familial target height. All four patients had undergone a surgical intervention for the insertion of a ventricular atrial or a ventricular-peritoneal shunt during the first year of life; since the last surgical shunt revision (at the age of 5 years) no relapse of hydrocephalus had been recorded. The authors conclude that precocious puberty is to be regarded as a not infrequent long-term complication in patients with successfully shunted hydrocephalus. PMID- 3830973 TI - Opitz trigonocephaly syndrome and terminal transverse limb reduction defects. AB - In this report a male newborn with Opitz trigonocephaly syndrome is described. In addition to the typical dysmorphic stigmata, terminal transverse limb reduction defects were observed. Acral limb deficiencies have not been previously reported to be associated with this multiple malformation syndrome. PMID- 3830975 TI - [A drug therapy protocol in an intensive care unit calculated by microcomputer]. PMID- 3830976 TI - The hip. Proceedings of the thirteenth open scientific meeting of The Hip Society, 1985. PMID- 3830974 TI - Interruption of breast feeding as treatment of hyperbilirubinaemia. PMID- 3830977 TI - The effect of endoprosthetic mismatch and metal- or non-metal-backed acetabular components on in vitro pelvic stresses. PMID- 3830978 TI - Pathology and classification. AB - The most important change seen during the early and active phases of this disease is an overgrowth of the articular cartilage with a variable degree of infarction within the bony epiphysis. This accounts for the variable nature of the disease that is observed clinically. Treatment cannot alter the degree of bony infarction present; it can only attempt to control the growth disturbance that is present by maintaining the mobility of the femoral head and hence preventing the adduction contracture, which is the essential prerequisite of serious femoral head deformity. PMID- 3830979 TI - Computed tomography of the hip. PMID- 3830980 TI - Magnetic resonance imaging of the hip. AB - Magnetic resonance imaging of the musculoskeletal system in general and the hip in particular offers many exciting opportunities for innovative and revolutionary diagnostic avenues, the full potential of which awaits further investigative and clinical experience. PMID- 3830981 TI - Comparison of radiographic and radionuclide hip arthrography in determination of femoral component loosening of hip arthroplasties. PMID- 3830982 TI - Conservative treatment of Legg-Calve-Perthes condition. AB - As we continue to learn more about the evolution of Legg-Calve-Perthes condition, several advantages to early conservative treatment become apparent. First, since it may take as long as 6 months to determine the extent of femoral head involvement in patients who present early in the disease process, nonoperative methods may be used to improve the range of motion and to contain the femoral head within the acetabulum, thus minimizing further deformity. Second, since the duration of treatment need no longer be as extensive as was previously thought, the argument that nonoperative means are unrealistic for patient needs is not valid. Finally, it has been recognized that with moderate sphericity and moderate retention of the shape of the femoral head, as evaluated in relationship to secondary changes in the acetabulum, the patient can reach at least middle age before having significant secondary arthritic problems. A relatively conservative approach is therefore in order for most children whose disease is discovered in the early phases. Of course, it must be recognized that social problems develop in the older child, especially in girls, that contraindicate nonoperative care. Surgical considerations are indicated for many children in the older age group with more than one half of the femoral head involved, as well as in those with unsuccessful nonoperative efforts at containment. PMID- 3830983 TI - Acetabular fixation: clinical problems and possible solutions. PMID- 3830984 TI - Bone ingrowth into porous coated canine acetabular replacements: the effect of pore size, apposition, and dislocation. PMID- 3830986 TI - The place of femoral osteotomy in the management of Legg-Calve-Perthes disease. PMID- 3830985 TI - Comparative experience with canine and human cementless acetabular components. AB - Bone ingrowth in the porous canine implants does occur; the early clinical results are indeed encouraging and justify further investigation. The quality of ingrowth as measured by depth and extent in the dog was stress-related. Remodelling was superior in the more compliant or elastic acetabular components without an interposed metal shell. No human specimens have been retrieved thus far, but we are encouraged because the results in the canine model with acrylic fixed implants were comparable to the results we subsequently observed in human THARIES implantation. Those were initially excellent, but with time radiolucencies increased and loosening occurred. The quality of the canine biologic ingrowth suggests optimism for secure and durable fixation. Our patients have continued to improve through the follow-up period. There has not been a single case in which a qualitative increase in pain occurred over the cemented versions after operation. The technical problems of the surgical procedure have been overcome, but it must be performed precisely to achieve the initial inherent stability to assist in biologic ingrowth. The operative procedures in this series have been performed by or under the direct supervision of the senior author. As our competence has grown, we have applied the procedure to younger patients and those who have bone stock deficiency. One of the major advantages of the biologic ingrowth systems is the facility to graft cysts and defects. For humans, the current chamfered cylinder is an extremely bonestock-conservative procedure when combined with reaming of the femoral head to the neck size. Although space is limited in resurfacing, we have been able to achieve a minimum 4-mm bearing thickness of polyethylene. We believe that the compliant mesh chamfered cylinder system provides excellent stability. However, the hemispheric component, although technically more difficult to seat and fix, has definite applications in bonestock deficiency and with further refinement will be useful in primary replacements as well. Nevertheless, because of the uncertain future of any type of implant, especially new, we have encouraged the patients to follow a careful postoperative management program and refrain from heavy activity during the first year. Many are active and some are now participating in athletics, although this is certain to shorten the life of these implants just as was observed in acrylic fixed devices. The biologic problems of interface corrosion, migration, and metal ion transfer indicate that these implants must be followed for longer periods. Therefore it seems unwise to extend this technology to a wide clinical use at this time. PMID- 3830987 TI - Clinical experience with an acetabular cup for cementless use. PMID- 3830989 TI - A new concept of acetabular fixation. AB - In an attempt to overcome the problem of micromotion between implant and bone and to eliminate the deleterious effects of polyethylene wear particles, I developed large, flat, hollow cylinders with perforated walls through which lamellar bone growth rapidly occurs. These cylinders were combined with self-cutting, prestressed spherical rings of pure titanium. Metallic sockets and heads coated with 4 to 6 microns of titanium nitrite and titanium carbide were created to fit a cementless straight stem and the cementless acetabular implant. The system is in clinical evaluation. PMID- 3830988 TI - Replacement of the acetabulum with pegged press-fit components. PMID- 3830990 TI - Pathophysiology of Legg-Perthes disease. PMID- 3830991 TI - Ambulatory containment treatment in Legg-Calve-Perthes disease. PMID- 3830992 TI - Reimplantation for salvage of the infected hip: rationale for the use of gentamicin-impregnated cement and beads. PMID- 3830993 TI - Fractures of the acetabulum. AB - A critical analysis of the results reveals the following major factors in determining the outcome of an individual acetabular disruption: The damage to the acetabular articular surface, which is reflected by the pattern of fracture and its degree of comminution, impaction, and osteoporosis, and associated damage of the femoral head The adequacy of the reduction, which is reflected by intraoperative inspection and postoperative radiographs The associated complications of the fracture and treatment (e.g., avascular necrosis, sciatic palsy, and heterotopic ossification) We recommend principles of treatment of acetabular fractures comparable to those employed for most other displaced intraarticular fractures, namely an anatomic reduction, stable internal fixation, and early motion, to realize reproducibly optimal results. The principal contraindications to open reduction are osteoporosis and generalized comminution to a degree that precludes a reasonable likelihood for the surgical team to achieve a stable anatomic reduction. We have provided guidelines for the surgical approach, techniques of reduction, and methods of fixation, and an analysis of results, which provide the basis for the successful treatment of these difficult intraarticular injuries. PMID- 3830994 TI - Clinical effects of halothane concentration on trifluoroacetic acid excretion in urine. PMID- 3830995 TI - Effects of feeding regimen on 1,2-dimethylhydrazine-induced intestinal carcinogenesis in rats. PMID- 3830996 TI - Changes of histamine contents and mast cell population in the gastric mucosa of carbon tetrachloride-induced cirrhotic rats. PMID- 3830997 TI - Clinical studies on reversibility of pulmonary airway dysfunctions in asymptomatic smokers: role of nervous mechanism in small airway disease. PMID- 3830998 TI - A case of death after glue sniffing. PMID- 3830999 TI - Function of monocytes in the retired workers of the Okunojima Poison Gas Factory. PMID- 3831000 TI - Roentgenographic study of the chest of the aged--special reference to "senile lung" and the paraspinal line. PMID- 3831001 TI - Liver functional tests in patients with liver cirrhosis and chronic hepatitis diagnosed by operative biopsy of the liver. PMID- 3831003 TI - The Society for Applied Bacteriology. Abstracts. PMID- 3831002 TI - A cholera epidemic in North Sumatra, Indonesia. PMID- 3831004 TI - Influence of temperature on the number of Legionella pneumophila in hot water systems. AB - The occurrence of legionella in the hot water systems of two buildings (A and B) was investigated in relation to the water temperature. The peripheral parts of both hot water systems were found to be colonized by these organisms. A temperature of 60 degrees C in the hot water mains returning from the building eliminated legionellas from the mains as well as from the peripheral taps and showers. Legionellas could be isolated from taps, showers and the mains when the temperature in the return mains was kept at 54 degrees C. The hot water systems could not be completely decontaminated by raising the hot water temperature in the return mains to 70 degrees C combined with flushing all the taps and showers. It is suggested that failure to decontaminate the systems is due to dead ends in the pipeline network, which are not reached by the hot water and that these dead ends are the source for recolonization of the systems. PMID- 3831005 TI - A note on a selective agar medium for the enumeration of Flavobacterium species in water. AB - A selective nutrient agar medium containing kanamycin at 50 micrograms/ml was developed for the isolation and enumeration of yellow-pigmented colonies from the River Sowe, Coventry. Such organisms were shown to be members of the heterogeneous genus Flavobacterium. Typically, yellow pigmented colonies constituted less than 10% of the colonies on nutrient agar alone but up to 70% on nutrient agar plus kanamycin. This medium is a useful addition to the range of media available for the isolation and further ecological study of particular species of this important group of micro-organisms. PMID- 3831006 TI - [Experimental study on denervated plantar ulcer]. PMID- 3831007 TI - Assessment of internal primary structure of polypeptides newly translated in vitro by reticulocyte lysate: a study with cytochrome b5. AB - A modified peptide mapping technique is described that allows the survey of the primary structure of proteolytic fragments of particular newly translated proteins in reticulocyte lysate. The technique is demonstrated with rat liver cytochrome b5. PMID- 3831008 TI - Immunosorbent consisting of DNA immobilized on oxirane-activated sepharose. AB - The preparation of adsorbents for DNA antibodies is described. The degree of immobilization of native DNA on Sepharoses activated with epichlorohydrin or bisoxirane was investigated as a function of pH, temperature, time, concentration of DNA, and oxirane content in the supports. The maximum amount of DNA bound was obtained after 8 h at 40-50 degrees C at pH 11-11.5. The amount bound was increased by raising either the concentration of DNA or the oxirane content of the supports, and could reach 300 mg/g dry support. The immobilized DNA was applied to the adsorption of DNA antibodies using either commercial human serum with anti-native DNA activity or the sera of patients with systemic lupus erythematosus. The amount of antibody adsorbed depended on the amount of DNA. The thermal stability of the immobilized DNA was also examined. After heating at 80 degrees C, the leakage of DNA was slight and the adsorption of antibodies was not affected. PMID- 3831009 TI - Systematic diagnostic method of two-dimensional echocardiography in congenital heart disease. AB - A two-dimensional echocardiographic (2-DE) method of segmental approach for diagnosis of congenital heart disease is presented. Firstly, the visceroatrial situs is determined, i.e., whether it is solitus, inversus, or ambiguous, by identifying the inferior vena cava to right atrium junction. Secondly, it is ascertained whether the ventricular loop is D-loop or L-loop. The ventricular loop is determined by identifying the internal structure of the right and left ventricles by 2-DE. Thirdly, the spatial relationships of the great arteries are determined by identifying the pulmonary artery and aorta. The pulmonary artery is identified by its branches, and the other artery is the aorta. Fourthly, the atrioventricular connection is determined as follows: (1) usual alignment, (2) criss-crossing, (3) straddling, (4) double inlet, and (5) unilateral atrioventricular valve atresia, by using an apical four-chamber echo view. Finally, the ventriculo-great arterial relationship is determined from the apical four-chamber echo view with a tilting maneuver or by echocardiographic recognition of the existence of the fibrous continuities. Following this echocardiographic "five-step approach," hemodynamic considerations should be included, and by integrating all the information the diagnosis of congenital heart disease is completed. PMID- 3831010 TI - Development of the ventricular septum of the heart. PMID- 3831011 TI - Classification of ventricular septal defects--a matter of precision. PMID- 3831012 TI - Recurrent myocardial infarction showing a multiple coronary artery occlusive phenomenon in a 32-year-old male without basic coronary artery stenosis. PMID- 3831013 TI - Cytoplasmic microfilaments in endothelial cells of flow loaded canine carotid arteries. AB - To observe cytoplasmic microfilaments in the endothelial cells of flow-loaded arteries, an arteriovenous shunt was constructed between the common carotid artery and the external jugular vein in 26 dogs. After measuring the flow rates of the arteries, the endothelial layer was examined ultrastructurally with a transmission electron microscope at three different times: 1 week (acute experiments), 2-4 weeks (subacute experiments), and 4-7 months (chronic experiments). Six-to seven-nanometer microfilaments were found forming bundles, which usually ran longitudinally along the long axis of the vessel. In the acute experiments, the bundles increased in the endothelial cells of the flow-loaded arteries. They showed incomplete striation and were mostly located close to the basal cell membrane. In the subacute experiments, they showed an increase with the development of cross-striation. The half-desmosomal structure of the basal cell membrane had developed a close connection to the bundles. In the chronic experiments, the bundles were especially conspicuous around the intercellular junction. Tennanometer microfilaments increased in the endothelial cells of the flow-loaded artery in the subacute and chronic experiments. We consider that the bundles of 6- to 7-nm microfilaments might be structures developed to combat wall shear stress corresponding to actin filament stress fibers. PMID- 3831014 TI - Topographical study on arteriosclerotic lesions at the bifurcations of human cerebral arteries. AB - We have studied the topographical distribution of arteriosclerotic lesions at the bifurcation of the internal carotid-anterior cerebral-middle cerebral arteries (internal carotid bifurcation) and of the middle cerebral artery-first temporal branch (first bifurcation of M.C.A.) in humans. The arteriosclerotic lesions showed a distinct pattern with a high incidence on the outer walls of the daughter vessels and at the inner curvatures in the bifurcations where wall shear stress was believed to be relatively low. However, there were differences in the distribution of the lesions between the internal carotid bifurcations and the first bifurcations of M.C.A.. The former are considered to be three-dimensionally unsymmetrical and curved, and the latter symmetrical and straight. The present study suggests that lower shear stress is of considerable importance in both the initiation and localization of arteriosclerotic lesions, and that study of the three-dimensional blood vessel architecture and blood flow patterns needs to be done to clarify the role of hemodynamic forces in atherogenesis. PMID- 3831016 TI - Prognosis of dilated cardiomyopathy. An integrated analysis including endomyocardial biopsy findings. AB - A long-term prognostic study of up to 15 years of dilated cardiomyopathy (DCM) was carried out in 65 cases. The 5-year survival rate after the onset of subjective symptoms was 40%, and the 10-year survival rate 22%. To evaluate the prognostic factor of DCM, the cardiothoracic ratio (CTR), ECG, hemodynamics, and histopathological contractility failure index (HCFI), which we constructed through right ventricular endomyocardial biopsy, were compared. Patients having malignant arrhythmias, such as short runs or multifocal ventricular premature beats with mild impaired cardiac status, mild cardiomegaly, and low HCFI, were more prone to sudden death. In patients with progressively deteriorating cardiac status, refractory cardiomegaly, supraventricular arrhythmias, left axis deviation, prolongation of QRS interval, low voltage, and high HCFI, the cause of death is more likely to be refractory heart failure. PMID- 3831015 TI - Nicardipine releases sustained coronary arterial constriction induced by acetylcholine in the rhesus monkey. AB - In five rhesus monkeys (Macaca mulatta) the vascular bed of the left anterior descending coronary artery (LAD) was perfused at constant pressure with autologous blood. Nicardipine (1-30 micrograms), a dihydropyridine calcium antagonist when injected into the LAD, increased LAD flow without producing significant changes in other cardiohemodynamic variables. With continuous infusions of acetylcholine into the LAD, the flow decreased by about 34% of the basal value. Under these conditions, intra-LAD nicardipine produced an increase in LAD flow almost to the same extent as in the control. The effects of nicardipine were qualitatively similar to those of other calcium antagonists observed in previous experiments and indicate that nicardipine would be useful as an antianginal drug. PMID- 3831017 TI - Assessment of left ventricular function before and after Fontan's operation for the correction of tricuspid atresia. Changes in left ventricular function determined by left ventricular volume change. AB - Functional change in the left ventricle was studied in the light of changes in the left ventricular (LV) volume preload before and after Fontan's operation. Six cases with tricuspid atresia (TA) were studied, and they had either types Ib or IIb. The preoperative LV end-diastolic volume index (LVEDVI) was 123 +/- 44 ml/m2, which corresponds to 166% +/- 45% of normal values. This suggests that in TA the preload of the LV volume is increased because of its peculiar hemodynamic situation. After Fontan's operation, the LVEDV decreased by 24.6% to 119.6 +/- 87.7 ml (P = 0.01), which corresponds to 120% +/- 50.9% of normal values. Presenting a striking contrast to the decrease in LVEDV, the postoperative reduction in LV end-systolic volume (LVESV) was approximately 8%. Preoperative and postoperative values for LVESV were 67.1 +/- 50.8 ml and 62 +/- 45.6 ml, thus, the systolic volume was decreased. Because of the small change in LVESV, the ejection fraction (EF) of the left ventricle significantly decreased from 0.61 +/- 0.1 preoperatively to 0.48 +/- 0.1 postoperatively. The cardiac index (CI) remained in the range of 1.9-2.5 l/min/m2 with a mean of 2.2 +/- 0.2 l/min/m2 at 1 month after operation. But, later, improvement in EF was observed in one case, in which the CI increased from 2.5 to 3.2 l/min/m2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831018 TI - Left ventricular systolic function in children with coronary arterial lesion following Kawasaki disease. AB - Seventy-five children with Kawasaki disease underwent quantitative left ventricular cineangiography, and angiographic measurements were made to obtain left ventricular ejection fraction (LVEF) and mean velocity of circumferential fiber shortening (mVcf). In addition, left ventricular pressure and echocardiograms were taken simultaneously before and after nitroprusside infusion using a micromanometer. In the present study, the slope of the line describing end-systolic pressure-diameter relations (Emax) was calculated. The 75 children with Kawasaki disease were classified into five groups according to the severity or condition of associated coronary lesions: Grade 0 group (normal--no significant enlargement of the coronary artery is seen), grade 1 group (mild state of lesion--the maximum diameter of the coronary artery is 4.0 mm or less), grade 2 group (moderate state of lesion--the maximum diameter of the coronary artery is 4.0-8.0 mm), grade 3 group (serious state of lesion--the maximum diameter of the coronary artery is 8.0 mm or over, i.e., giant aneurysm), and stenotic lesion (SL) group (myocardial infarction or various other stenotic lesions are involved). Each group was investigated for each index of left ventricular function. In the grade 2 group, the averaged value of LVEF was slightly smaller than those for the grade 0 and 1 groups, while in the grade 3 and SL groups, the averaged values of LVEF were markedly smaller than those for all other groups. Grade 3 and SL groups showed averaged mVcf values that were smaller than those for other groups, while grade 2-3 and SL groups showed averaged values of Emax that were markedly smaller than those for the remaining groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831019 TI - Cultured heart cells from the spontaneously diabetic KK mouse. AB - In order to clarify the mechanism of myocardial changes in KK mice, cultured heart cells from both normal and spontaneously diabetic KK mice were studied by electron microscopy, photoelectric recording, and 45Ca activity. Compared with cultured heart cells from normal mice, those from KK mice showed a decrease in beating frequency and ceased beating more rapidly. The rhythm of the beating cells from KK mice became irregular, while that of the heart cells from normal mice was not changed significantly over a period of 10 days. Electron micrographs of cultured heart cells from KK mice showed an increased number of mitochondria, an intricate arrangement of myofibrils, poorly formed Z bands, and a lipidlike substance. The 45Ca activity of heart cells from KK mice, after incubation for 24 h in a medium containing 45Ca, was increased compared with heart cells from normal mice. Based on these findings, we conclude that ultrastructural alterations exist in cultured heart cells from KK mice and we suggest that an increase of intracellular Ca might play an important role in the pathogenesis. PMID- 3831020 TI - Regional work of the ventricle: wall tension--area relation. AB - We clarified that the set of the isotropic component (T) of wall tension and the area (A) of a selected region of the left ventricular wall expresses the regional work with sufficient accuracy. The area surrounded by the locus of the T-A relation in the T-A plane is approximately equal to the real work done by that region. The behavior of the T-A loop was studied in nine anesthetized dogs under various conditions. The regional area and diameter of the left ventricle were measured with ultrasonic crystal pairs. The wall tension was calculated from measured left ventricular pressure and diameter by a generalized Laplace's equation for a thick-walled model. During volume loading, administration of methoxamine, and aortic constriction, the regional work per stroke increased with the increase in end-diastolic regional area, which is considered to be the regional Frank-Starling mechanism. With the development of ischemia, the T-A loop for the ischemic region shifted to the right and the work done by that region decreased. After a certain stage in the development of ischemia, the work done by the ischemic region became negative. When only one of the segmental lengths, rather than the area, is measured, difficulty arises in the physical interpretation of pressure-length or tension-length data in some cases. The T-A loop diagram resolves such difficulty by defining the regional work correctly. We conclude that the T-A loop diagram is a useful tool for analyzing the regional ventricular function. PMID- 3831021 TI - Hyperkinetic contraction of a nonischemic segment of ischemic left ventricle in anesthetized dogs. AB - Regional myocardial function during acute coronary artery occlusion was studied with ultrasonic dimension gauges in 20 open-chest anesthetized dogs. Two pairs of ultrasonic crystals were implanted in the left ventricular free wall near the epicardium in an ischemic segment and in a control nonischemic segment, and the segment length (SL) and maximum velocity of systolic shortening (max dL/dt) were measured. In six dogs, the wall thickness (WT) was measured simultaneously in the same regions with sonomicrometry. Left ventricular pressure (LVP), aortic pressure (AoP), and plasma norepinephrine concentration in the coronary sinus (NECS) were also measured. The heart rate was kept constant (180 beats/min) with atrial pacing. The left anterior descending coronary artery was occluded at its distal portion without propranolol in 12 dogs (group 1) and 30 min after propranolol in eight dogs (group 2). In the ischemic region, coronary artery occlusion resulted in an increase in end-diastolic SL (50% at 3 min after occlusion in group 1, P less than 0.005), and a decrease in max dL/dt in systole (36% at 5 min after occlusion in group 1, P less than 0.02). In the nonischemic region, end-diastolic SL did not change significantly, but an increase in max dL/dt (29% at 10 min after occlusion in group 1, P less than 0.005) was observed in systole. Under propranolol (group 2), the results were similar to those of group 1. There were no significant changes in LVP, AoP, AoP, and NECS during occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831022 TI - The pathogenesis of eosinophilic endomyocardial disease in patients with carcinomas of the lung. AB - Studies were done on a patient with a carcinoma of the lung induced by hypereosinophilia who was thought to be at risk from developing eosinophilic endomyocardial disease to see whether the development of heart disease could be related to abnormalities in the morphology or kinetics of blood eosinophils. The patient was a 61-year-old man who had a partial resection of a squamous cell bronchial carcinoma of anaplastic large cell type which has spread locally. Seven months later, he developed a blood eosinophil count of 33.9 x 10(9)/1. There were only transient responses to treatment with steroids and tumor irradiation, and he died 15 weeks later. Up to 3 x 10(9)/1 blood eosinophils were degranulated, correlating with serum levels of eosinophil cationic protein. The blood half-life of 111indium-labeled eosinophils was prolonged to 53 h, but their distribution was normal. Although an unsuccessful search was made during life for the development of endomyocardial damage, at postmortem the left ventricle had features of eosinophilic endomyocardial disease in the acute necrotic stage. Among 13 other reported patients with carcinoma of the lung and hypereosinophilia, three also had endomyocardial disease or myocardial lesions. These findings confirm the suggestion that the presence in the blood of greater than 1 x 10(9)/1 degranulated eosinophils can be used to predict the development of eosinophilic endomyocardial disease before it becomes apparent clinically, and they also add weight to the hypothesis that blood eosinophil degranulation causes this complication of hypereosinophilic states. PMID- 3831023 TI - Left ventricular endomyocardial biopsy findings in patients with essential hypertension and hypertrophic cardiomyopathy with special reference to the incidence of bizarre myocardial hypertrophy with disorganization and biopsy score. AB - To investigate whether bizarre myocardial hypertrophy with disorganization (BMHD) is characteristic of hypertrophic cardiomyopathy (HCM), the histopathology of the biopsied left ventricular myocardium in 18 patients with essential hypertension (HT) and 14 patients with HCM was studied. A "biopsy score" was devised for a more quantitative evaluation of the BMHD and a comparative study on the biopsy score of the left ventricular biopsied specimen was also performed. The patients with HT were judged to be in stages I or II of the WHO criteria and had a history of hypertension of more than 5 years. The BMHD was defined as myocardial cells showing hypertrophy, disorganization, and bizarre nuclei. "Disorganization" of myocardial cells was distinguished both by the terminology and histopathological characteristics from "disarrangement" of myocardial cells. The biopsy score employed four factors and was determined according to the following formula: Biopsy score = hypertrophy of myocardial cells + (disorganization of myocardial cells) x 2 + bizarre nuclei + whorling of muscle bundles. Both the hypertrophy and the disorganization of myocardial cells were regarded as essential conditions indicating the presence of BMHD. The BMHD was found in 2 of 18 patients with HT (11%) and in 10 of 14 patients with HCM (71%) in the left ventricular biopsied specimens (P less than 0.005). However, "disarrangement" of myocardial cells was found in 13 of 18 HT patients (72%) and in 10 of 14 HCM patients (71%) in the left ventricular biopsied specimens, showing no difference between the two groups. The biopsy score in HCM patients was larger than that found in HT patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831024 TI - An aborted human fetus with truncus arteriosus communis--possible teratogenic effect of Tedral. AB - We recently performed a detailed anatomicopathologic examination on an aborted human embryo whose mother had taken four tablets of Tedral (one tablet of Tedral contains 130 mg theophylline, 25 mg ephedrine, 8 mg phenobarbital) for an upper respiratory tract infection when the embryo was at approximately 30 days of development. On the same day, the mother developed acute chest pain and a fast, irregular heart beat. The abortion occurred at approximately 80 days of gestation. The heart of the fetus showed truncus arteriosus (Van Praagh type A1). Although no direct cause and effect relationship was proven in this case, the possibility of a teratogenic effect of Tedral during early pregnancy is considered. PMID- 3831025 TI - Histologic abnormalities of the left ventricle in a patient with arrhythmogenic right ventricular dysplasia. AB - Right ventricular histologic abnormalities have been described in association with arrhythmogenic right ventricular dysplasia, but the cause of the disease is unknown. Identical abnormalities were noted in endomyocardial biopsy specimens from the right and left ventricles of a 20-year-old male patient with the clinical syndrome of arrhythmogenic right ventricular dysplasia. Left ventricular function was normal at rest and during bicycle exercise. Eighteen months previously, he had shown clinical and serologic evidence of mycoplasmal myocarditis. Arrhythmogenic right ventricular dysplasia may represent predominant involvement of the right ventricle in a generalized cardiomyopathic process, possibly as a consequence of healed myocarditis. PMID- 3831026 TI - The reliability of the tracing-method of fine cardiac fibrosis at a magnification of x10--preliminary study for quantitative analysis of fibrosis in large tissue sections of hearts with cardiomyopathy. AB - to define the reliability of the tracing method of fine fibrosis at low magnification (x10), the percentage area of fine fibrosis was compared between the traced pictures at magnifications of x10 and x250, using an image analyzer (Olympus VIP-21). A total of 25 tissue areas, each approximately 4 x 7 mm, from the inner and middle thirds of the left ventricular free wall and ventricular septum were selected from ten hearts with hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) and were stained with Masson trichrome. The percentage areas of fine fibrosis traced at a magnification of x10 correlated well with those traced at a magnification of x250 (Y = 1.08X - 1.1, r = 0.95, P less than 0.01). It is concluded that the overall percentage area of fibrosis is the same at magnifications of x10 and x250, despite the fact that at x10 one is unable to detect individual fibers which can be detected at x250. The tracing method of fine cardiac fibrosis at a magnification of x10 is reliable. Therefore, fine fibrosis in large tissue sections of hearts with cardiomyopathy, such as entire transverse sections of the left ventricular wall, can be quantitatively analyzed by this method. PMID- 3831027 TI - Cardiac embryology: the conotruncus. PMID- 3831028 TI - Migration and torsions of the conotruncus in the chick embryo heart: observational evidence and conclusions drawn from experimental intervention. AB - It seems difficult to escape the conclusion that conotruncal migration and torsions do occur: The amplitude, direction and timing of these movements can be accurately tracked and they can be experimentally arrested. The movements have a significant function: Associated with the partitionings, they regulate the outlet ventricular distribution at two levels, permitting an adjustment between the ampullae and conus (a function of migration) and between the proximal and distal conal segments (via torsions). Their defects result in malalignments--double outlet right ventricle and transposition of the great vessels, respectively. The mechanism of the migration is linked to the differential growth of ampullae; the right ampulla and certain areas of this ampulla appear as dominant during the embryonic period. The conus is carried by the right ampulla and passively undergoes migration. The mechanism of the torsions is not entirely clear. The proximal torsion appears to be linked to a myocardium--jelly dissociation; the distal torsion seems to be linked to an oriented myocardial growth of its wall; the torsion of the truncus is evidently passive, occurring as a consequence of the conus distal torsion. PMID- 3831029 TI - Improvement by denopamine (TA-064) of pentobarbital-induced cardiac failure in the dog heart-lung preparation. AB - The efficacy of denopamine, an orally active beta 1-adrenoceptor agonist, in improving cardiac failure was assessed in dog heart-lung preparations. Cardiac functions depressed by pentobarbital (118 +/- 28 mg; mean value +/- SD) such that cardiac output and maximum rate of rise of left ventricular pressure (LV dP/dt max) had been reduced by about 35% and 26% of the respective controls were improved by denopamine (10-300 micrograms) in a dose-dependent manner. With 100 micrograms denopamine, almost complete restoration of cardiac performance was attained, associated with a slight increase in heart rate. No arrhythmias were induced by these doses of denopamine. The results warrant clinical trials of denopamine in the treatment of cardiac failure. PMID- 3831030 TI - Modification of pacing-induced alterations in diastolic properties of the regional myocardium by nifedipine in patients with coronary artery disease. AB - The effects of nifedipine on regional dysfunction during pacing-induced ischemia were studied in eight patients with coronary artery disease. Single-plane left ventriculograms were obtained using a high-fidelity micromanometer-tipped catheter in the control and post-pacing periods both before and after pretreatment with nifedipine. All patients developed typical anginal pain during pacing tachycardia before but not after pretreatment with nifedipine. After pacing, left ventricular end-diastolic pressure (EDP) increased from 10 +/- 5 (SD) mmHg to 23 +/- 9 mmHg (P less than 0.01) with enlargement of the end diastolic volume (EDV). The ejection fraction (EF) was reduced from 66 +/- 10% to 54 +/- 13% (P less than 0.05). With nifedipine, a post-pacing increase in EDP was markedly attenuated together with a 17% reduction in left ventricular systolic pressure (P less than 0.05). The regional myocardial function was expressed by a radial coordinate system with its origin at the center of gravity of the end diastolic contour. Two representative radial grids for normal and ischemic segments were selected. In the normal segment, the end-diastolic length (EDL) was augmented by 14% (from 26.1 +/- 5.2 mm to 29.7 +/- 6.1 mm, P less than 0.01) associated with a 23% increase in stroke excursion (P less than 0.05) with pacing stress. In the ischemic segments, EDL remained unchanged in the post-pacing beat but stroke excursion was significantly reduced (from 11.4 +/- 5.2 mm to 4.3 +/- 1.8 mm, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831031 TI - A case of absent right superior vena cava with persistent left superior vena cava: cross-sectional echocardiographic diagnosis. AB - We report a case of absence of the right superior vena cava. Hitherto, the findings in this condition have only been obtained using invasive methods; this report is the first in which the diagnosis was made by means of echocardiography. The findings include a markedly enlarged coronary sinus draining into the right atrium and a specific finding of contrast echocardiography in which contrast material injected into the right antecubital vein can be seen in the enlarged coronary sinus. The contrast echo flows into the right atrium from the coronary sinus only. The size of the coronary sinus was far beyond the range (91 +/- 38 mm2/m2) in patients with persistent left superior vena cava with the presence of the right superior vena cava. PMID- 3831032 TI - Early clinical evaluation of a new Bjork-Shiley valve prosthesis with integral monostrut. AB - We evaluated preliminary results of valve replacement with a new Bjork-Shiley valve prosthesis with integral monostrut. Sixty-five valves were implanted in 56 patients (18 aortic, 30 mitral, 7 double, 1 triple). The age of the patients ranged from 30 to 62 years, and they were followed up for 7-17 months (mean, 12.5 months). There were three operative deaths (5.3%) not related to the prosthesis and no late deaths. Minor cerebral thromboembolism occurred in one patient 2 weeks after surgery despite anticoagulant therapy. Intraoperative transvalvular pressure gradients across the 23-mm aortic and 27-mm mitral valve prostheses were insignificant. Real-time two-dimensional echocardiography revealed no regurgitation at the moment of valve closure in 20 randomly selected patients. Though the data accumulated so far are still relatively incomplete and the follow up periods short, the clinical results obtained here were satisfactory, warranting further use of this new Bjork-Shiley valve prosthesis with integral monostrut for longer follow-up studies. PMID- 3831033 TI - Symposium on microvascular surgery. PMID- 3831034 TI - Microscopes and microinstruments. AB - This article outlines the basic physical principles of the operating microscope; in addition, it provides up-to-date, "state of the art" information of microinstruments. PMID- 3831035 TI - Postoperative management. AB - Postoperative vascular compromise can result from a problem at the anastomotic site, including vessel damage, improperly placed sutures, trauma to the vessel, or atherosclerosis. Systemic factors include decreased blood flow, vascular spasm, and atherosclerosis. External compression such as hematoma, tight skin closure, or a large drain pressing on a vessel can compromise flow. In patients who are to undergo elective microsurgery, angiography at the recipient site is helpful to select healthy vessels. Anastomosis is performed outside the zone of injury, and a patency test is performed after anastomosis to substantiate adequate blood flow. If a healthy vessel is repaired with a technically satisfactory anastomosis, without tension, and if attention is given to meticulous hemostasis, careful skin closure, and nonconstricting dressings, postoperative management will be easy. Surgeons who are less conscientious in these matters will become more familiar with difficult postoperative management problems. With comprehensive postoperative care of the patient, including repeated monitoring with both clinical evaluation and monitoring devices, arterial or venous insufficiency can be detected early. If the cause of the vascular compromise is identified and corrected rapidly, the failing free tissue transfer can often be saved. PMID- 3831036 TI - Preoperative assessment and hand therapy for elective microvascular surgery. AB - The special reconstructive needs of elective microsurgical candidates present a formidable challenge for the restoration of functional capacity. This article provides an overview of current hand rehabilitation procedures available for preoperative and postoperative management. The need for preoperative assessment is stressed and specific measurement variables and techniques are provided. Treatment principles and methods are shared and preferred splint design features are identified. The uniqueness of each individual case is emphasized, as it necessitates ongoing communication among the members of the treatment team who strive to define and achieve successful outcomes. PMID- 3831037 TI - Wrap-around procedure for thumb reconstruction. AB - The wrap-around procedure provides length, stability, and adequate sensibility for a functional pinch and grasp and also preserves the great toe. The procedure esthetically simulates the normal thumb and is relatively reliable when performed by a surgeon who is experienced in microsurgery. Although the technique requires thorough planning and lengthy and meticulous surgery, the successful outcome is rewarding. PMID- 3831038 TI - Great toe-to-hand free tissue transfer for thumb reconstruction. AB - Based upon our experience at the Massachusetts General Hospital, where 32 microneurovascular toe-to-hand transfers have been performed over the past eight years, this method of thumb reconstruction can be quite successful in carefully selected and educated patients. PMID- 3831039 TI - Thumb reconstruction using second-toe transfer. AB - Although toe transfer is a relatively new operation, its early results have been highly satisfactory. This article presents the author's experience from 1977 to 1983 with a total of 45 thumb reconstructions using the second toe. All but three of these patients have resumed employment. PMID- 3831040 TI - Neurovascular flaps to the hand. AB - The surgical return of sensibility in the injured upper extremity remains a major goal for the reconstructive surgeon. Free flaps have created the opportunity for successful reconstruction in those patients in whom irreplaceable sensory end organs have been destroyed. In addition, well-vascularized composite tissues may be transferred in continuity with the dorsalis pedis and forearm flaps, allowing for one-stage reconstructions. Extra blood supply is brought to a scarred area in a single step, unlike the multi-stage transfer of distant parasitic tissue. Donor site morbidity remains a problem with many of these flaps, and skin grafts are often required. Many of the larger flaps do not have a close skin match to the skin of the volar hand. There are reports of achievement of protective sensibility with use of all of these flaps. However, experience with fine two point discrimination has been limited to only the first web space flap. This return to near normal sensibility in the hand remains a standard by which all these flaps must be judged. PMID- 3831041 TI - Reconstruction of individual digits. AB - The development of microvascular techniques has encouraged the hand surgeon to re examine the principles of reconstructive surgery. The transfer of vascularized composite tissues, if technically well done, can obviate the need for time consuming staged procedures. However, success in microvascular reconstruction comes not in the knowledge of anastomotic techniques but in the understanding of the physiology of wound healing, the mechanics of hand function, and the principles and goals of hand reconstruction. PMID- 3831042 TI - Reconstruction of congenital hand defects with microvascular toe transfers. AB - From 1977 through 1984, the author transferred 49 toes in 38 patients to treat congenital defects of the hand. Eleven patients had successful transfer of two toes from different feet, with a six-month interval between operations. There was one failure in a 16-month-old infant with finger aplasia. On the basis of this experience, the author has refined his indications and timing, which are as precise and well defined as the technique. PMID- 3831043 TI - Digital sympathectomy for vascular insufficiency. AB - Digital sympathectomy for chronic vascular insufficiency has now been proved to be beneficial in the management of a select group of patients. These patients must be thoroughly evaluated preoperatively, must pass the cold stress test, and must experience improvement in response to cold stress following digital blockade to be considered candidates for this surgery. Complications to date have been minimal and the results are encouraging. PMID- 3831044 TI - Symposium on congenital deformities of the hand. PMID- 3831045 TI - Metacarpal distraction lengthening. AB - Metacarpal osteotomy and distraction lengthening is an excellent method of treating patients with multiple digit aplasia, metacarpal hypoplasia, and some types of digit amputation. The authors describe their technique and the results obtained in 24 patients operated on for 41 metacarpals. PMID- 3831046 TI - Congenital ulnar drift of the fingers. Pathogenesis, classification, and surgical management. AB - The classification of congenital ulnar drift is based on the tissues involved. Type I depends basically on malformation of the skin and retinaculum cutis. This is a fasciocutaneous deformity, corrected by simple release of the affected tissues followed by a free full-thickness skin graft. The deformity in Type II is more severe and the results of surgery are not as satisfactory as they are for Type I. PMID- 3831047 TI - Congenital pseudarthrosis of the forearm. AB - Early treatment of congenital pseudarthrosis of the forearm is necessary to prevent permanent angulation and shortening of the forearm with resulting loss of function. Total replacement of defective bone and complete excision of the destructive, abnormal fibrous tissue seem to be essential if an effective treatment is to be accomplished. PMID- 3831048 TI - Segmental digital transposition in congenital hand deformities. AB - A review of the current management of congenital digital hypoplasia in the hand has been presented. Techniques for augmenting the size and length of hypoplastic digits have included flap and graft techniques and segmental digital transposition techniques; they now include digital distraction lengthening techniques and free vascularized digital transposition techniques. Since all of these methods are still in use, the relationship between them has been described and some of the lesser known segmental digital transposition techniques have been discussed in greater detail. PMID- 3831049 TI - Classification and functional management of congenital central defect of the hand. AB - Classification of central defect of the hand includes three general categories- Type I (typical), Type II (atypical), and Type III (two, three, and four digit hand). These three types of central defect have one common denominator--central metacarpal deficiency or absence. Otherwise, these three distinct types differ completely in inheritance pattern, characteristic features, bilaterality, and functional management. Functional management of the Type I central defect combines release of the tethered thumb metacarpal from its adduction contracture and simultaneous closure of the cleft using that redundant skin to fabricate a physiologic thumb-index web. Type II reconstructive procedures should be planned to provide as effective a pinch and grasp as possible between the radial and ulnar columns by deepening the central cleft, excising "digital nubbins" and any impinging skeleton, and performing rotational osteotomies of either metacarpal base or both and, occasionally, transfers to provide active digital flexion. Type III reconstructive procedures should release the adducted thumb and fabricate a physiologic thumb-index web along with appropriate releases of syndactyly. In the two-digit hand, rotational osteotomies may increase function. PMID- 3831050 TI - Operative treatment of cerebral palsy. AB - Although the overall patterns of deformity may be repetitive in cerebral palsy patients, it is extremely important to recognize that nothing replaces a careful examination of the individual patient and an individualized plan of approach. Our mistakes are rarely caused by technical errors, and we should not attribute our failures to the patient and resort to such statements as, "tendon transfer in cerebral palsy is unpredictable." Instead, we should feel confident that although a normal extremity will never result after operative treatment, contractures and spasticity can be diminished in such a way to make possible certain coordinated actions that will help our patients in their activities of daily living. PMID- 3831051 TI - Congenital flexion deformities of the thumb. AB - A congenital flexion deformity of the IP joint of the thumb is usually due to a trigger finger. The diagnosis is based on the thumb being normal except for a fixed, flexed posture of the IP joint and a palpable nodule in the FPL tendon at the level of the A-1 pulley. Treatment can be postponed until after age 1, as spontaneous regression probably occurs in about 30 per cent of cases. After that age, surgical correction is the best approach to treatment and usually results in normal thumb function. Congenital soft tissue flexion deformities of the MP joint of the thumb vary from passively correctable deformities due to loss of extensor power to severe, fixed contractures involving multiple thumb structures and associated with significant anomalies of the wrists and fingers. The passively correctable deformities will frequently respond to cast immobilization in the very young but can otherwise be treated by an appropriate tendon transfer to re institute active extension. Complex clasped thumb deformities require elucidation of the specific pathologic features of the deformity, based both on clinical evaluation and surgical exploration. These digits will require not only an extensive release to correct the fixed contracture but also reconstructive procedures to correct lax ligaments and to substitute for absent muscles and skin as appropriate. The latter deformities are often associated with a syndrome affecting numerous body structures. It is hoped that recognition of these syndromes and documentation of the pattern of pathology present in these thumbs will result in a better method of classification. PMID- 3831052 TI - Classification of thumb hypoplasia. AB - The author describes eight types of hypoplastic thumb. This classification is important in planning reconstructive surgery, as the selection of an appropriate procedure depends largely upon the classification of the deformity. PMID- 3831053 TI - Fingertip reconstruction. AB - Fingertips are functionally important contact surfaces. Pain-free and stable tissue coverage with good sensibility is needed. The method of repair depends on many factors, as herein discussed, including careful donor site consideration if tissue is transferred for repair. A small injury to a finger can result in prolonged disability and morbidity so that such injuries deserve the same thoughtful consideration, planning, and technical adroitness as do all hand problems. PMID- 3831054 TI - The cross-finger flap. An established reconstructive procedure. AB - Cross-finger flaps have been performed by our group in more than 200 patients. Subjective questioning and objective testing in a random group of 23 of these patients confirms the value of this procedure for reconstruction of the injured finger. It is reliable and flexible in its application. The patients usually report their flaps to be functional, durable, and free of pain. Cold intolerance, as with other methods of reconstruction, remains a problem. Sensibility in the flaps proved to be functional in the majority of patients. The preservation of length and range of motion is reflected in the fact that disability settlement was a rare occurrence. This flap has been applied in patients of widely varying ages with minimal morbidity. Overall patient satisfaction has been quite rewarding. In the properly selected patient, the carefully performed procedure provides a superior means of reconstruction for the injured finger with loss of significant soft tissue. of reconstruction for the injured finger with loss of significant soft tissue. Overall patient satisfaction has been quite rewarding. widely varying ages with minimal morbidity. Overall patient satisfaction has been quite rewarding. This flap has been applied in patients of PMID- 3831055 TI - Volar advancement skin flap to the fingertip. AB - The use of volar advancement flaps is presented for volar oblique amputation of fingertips. Use of a mini-volar flap allows closure of a guillotine amputation that leaves no scar on the pad of the fingertip and has only to be elevated to the axis of rotation of the PIP joint. This procedure decreases the likelihood of dorsal necrosis over the middle phalanx, since the dorsal neurovascular bundle is not encroached upon. PMID- 3831056 TI - Nail bed injuries. AB - The nail bed injury is common in mechanized societies. Appropriate early care is essential to good postsurgical results. The timing and techniques of this care are described. PMID- 3831057 TI - Osteocutaneous flaps for thumb and digit reconstruction. In unique situations. AB - Osteocutaneous flaps from the foot are being utilized more for thumb and digit reconstruction. We have presented a few unique situations in which these flaps are beneficial. Not all patients with deformities similar to those described in this presentation should have these reconstructive procedures. The patient must understand the risks of donor site morbidity and possible complications. However, the advantages of this technique are that only one surgical procedure is necessary, the hospitalization is short, the cosmetic result is good, and the functional restoration is satisfactory. PMID- 3831058 TI - Distant flaps. AB - Tube pedicle flaps, jump flaps, and waltzed tube pedicle flaps are now only of historical note. The random abdominal flap and vertical hypogastric flap, the first axial flap described, are in their twilight years. The free flap is the current champion for composite tissue reconstruction, the only exception being the functioning myocutaneous transfers that are available in upper extremity reconstruction. The well planned distant flap still can provide high quality skin and subcutaneous tissue for upper extremity coverage. Utilization of this tool, however, requires an overall appreciation and understanding of flap physiology, the ability to shrewdly analyze the reconstructive needs of a given defect, and the skills and knowledge to commit the patient to what is inevitably a two-stage operation spaced over 3 to 5 weeks. PMID- 3831059 TI - The potential of diagnostics for improving community health in less developed countries. PMID- 3831061 TI - Challenges in research on immunology of parasitic diseases. PMID- 3831060 TI - Community-oriented health services education: a strategy for international cooperation. AB - This paper describes the approach of the Department of Community Medicine of the Mount Sinai School of Medicine in the education of local and foreign physicians and their participation in the development of community oriented health care systems. It also presents the first steps taken by this medical school to create an international program whose aims are to develop long-term partnership agreements with foreign universities by bringing together and integrating medical education with the development of community-oriented health care services. PMID- 3831062 TI - Immunopathology in leishmaniasis. PMID- 3831063 TI - Problem in filariasis control. PMID- 3831064 TI - Genetic aspects in filariasis. PMID- 3831065 TI - Immune responses to filarial infections. PMID- 3831066 TI - Application of serology in epidemiology of malaria. PMID- 3831067 TI - Drug immunity interaction in malaria. PMID- 3831068 TI - Generation and characterization of monoclonal antibodies reactive with simian and human malaria antigens. PMID- 3831069 TI - Seroepidemiology of human malaria in Pondicherry and Tamil Nadu. PMID- 3831070 TI - Serology and seroepidemiology of malaria. PMID- 3831071 TI - Bulk production and comparison of promastigote and amastigote antigens of Leishmania donovani for serodiagnosis and value of serum protein and immunoglobulin changes in diagnosis of kala-azar cases. PMID- 3831072 TI - Immunoprophylaxis against kala-azar egg homogenate (EH9) cultured L. donovani--a probable prophylactic. PMID- 3831073 TI - Monoclonal antibodies to leishmania parasite (a preliminary report). PMID- 3831074 TI - Conception of male and female homosexual stereotypes among university undergraduates. AB - Following the procedure used by Broverman, Broverman, Clarkson, Rosenkrantz, & Vogel (1970), male and female undergraduates described a male homosexual, lesbian, and normal adult in terms of 41 adjective rating scales, each scale having a masculine and a feminine pole. Results indicated that compared to ratings of the normal adult, the male homosexual was viewed unfavorably and was significantly different from "normality" on 27 scales. Ratings of the lesbian were closer to those for the normal adult, although significant differences appeared on 11 scales. Ratings for the lesbian differed significantly from those for the male homosexual on 20 scales. On all but two scales, lesbian ratings were closer to the more favorable pole than were male homosexual ratings. The position seems supported that male gender nonconformity is viewed more seriously than female gender nonconformity. PMID- 3831075 TI - The dangers of lexical inference with special reference to Maori homosexuality. PMID- 3831076 TI - Changes in labeling homosexuality in health sciences literature: a preliminary investigation. AB - The purpose of this paper is to describe the image of gay men and lesbian women in health sciences literature since the demedicalization of homosexuality by American psychiatry in 1973. The process of medicalization and demedicalization of any behavior labeled as deviant in American society has received scant attention until recently. In addition, labeling theory has for the most part ignored the labelers and the process by which powerful groups, in this instance American medicine and other health professions, influence the labeling process. Since the American Psychiatric Association's decision to demedicalize homosexuality from an illness to a "suboptimal condition," over 700 articles have been published in the health care literature about various aspects of homosexuality, including a continued debate about the health or illness classification of homosexuality. Literature reviewed for this investigation was limited to letters, policy statements, and editorials or articles written between 1974 and 1983 which were germane to the classification issue. PMID- 3831077 TI - Psychoanalytic theory and affirmation of the gay lifestyle: are they necessarily antithetical? AB - This article explores a conflict between the American psychoanalytic community and the American gay community which has played itself out in this country's mental health system for most of this century. The roots of the conflict are traced back to the American conception of diagnosis, as well as a lack of adequate developmental studies focused on the nature of homosexuality. The current psychoanalytic stance is presented as inimical to the stance Freud took, and an exploration of ways to ameliorate the conflict between American psychoanalytic thought and affirmation of homosexuality as an alternative healthy lifestyle is undertaken. PMID- 3831078 TI - [Stenosis and reflux after surgery of the ureterovesical junction in children. Indications and results of reoperation. Apropos of 460 ureterovesical reimplantations]. AB - Implantation of 460 ureters into bladder was performed in 278 children (68 boys, 210 girls) age range 3 months to 15 years. The operative technique used was generally that of Cohen (335 cases), more rarely that of Leadbetter-Politano (118 cases) and very exceptionally that of Lich-Gregoir (7 cases). Indications for surgery included: so-called "essential" reflux: 373 cases, reflux with Hutch's diverticulum: 20 cases, ureterocele: 14 cases, megaureter: 25 cases (including 14 "modelled" as described by Hendren), neurologic bladder: 10 cases, urethral valves: 7 cases, ectopic openings: 6 cases and multiple malformations: 3 cases. Results in antireflux ureterovesical implantations of 427 ureters were good but complications included 18 cases of stenosis and 9 with persistent reflux. Etiology of these unsuccessful cases, as described by H. Hendren, is discussed and indications and operative techniques for recovery surgery analyzed. Treatment in unsuccessful cases included nephrectomy for stenosis, skin shunt operation for neurologic bladder, a repeat Cohen operation and 8 repeat L.P. operations, with 8 successful results and one failure. Recurrence of reflux was treated in one case by interpyelic anastomosis on duplication, in 2 cases by Cohen's operation and twice by L.P.'s operation, with success in 4 cases. Five patients with stenosis and one with reflux were stabilized and recovery operation was not performed. Finally three patients with unsuccessful initial operation were lost to view. PMID- 3831079 TI - [Cancers of the bladder: new therapeutic orientations]. AB - Based on data obtained from a general review of treatment of infiltrating cancer of bladder, new therapeutic orientations are proposed in which chemotherapy occupies a privileged position as adjuvant treatment of surgical excision. Emphasis is placed on the frequency of bladder cancer and invasive tumors, as well as the high incidence of unsuccessful results due not to local recurrence but to metastases that do not respond to local and regional radiosurgical treatment. Objective results are obtained in approximately 50% of measurable metastases after combined Adriamycin and Cisplatin treatment. The efficacy of this chemotherapy suggests its prophylactic use to eradicate microscopic metastatic lesions remaining after local and regional therapy. If indications are well chosen, and not too heavy chemotherapy administered, then it is probable that as complementary treatment to surgical excision should improve efficacy of treatment of infiltrating cancer of bladder. The observation of necrosis of pulmonary metastases during chemotherapy provides justification for therapeutic orientation of this type. PMID- 3831080 TI - Urachal abscess remnant in an adult. PMID- 3831081 TI - Percutaneous stone extraction. Institutional experience of 400 cases. PMID- 3831082 TI - [Retrograde ejaculation, a little known complication of ectopic ureterocele with ureteral duplication]. AB - A 9 year old boy with an ectopic ureterocele on a left ureteral duplication was treated by radical surgery: nephro-uretero-ureterocelectomy. At 22 years of age he presented with total absence of ejaculation, shown to be due to retrograde ejaculation from permanent gaping of bladder neck. Urinary affections were absent and urologic results of operation were good. The prevention of this disturbing genital complication, and the manner to treat it if it does develop, are discussed. PMID- 3831083 TI - [Malignant mesenchymoma in the region of Denonvillier's fascia]. AB - A case with malignant mesenchymoma in the region of Denonvillier's fascia is presented. This localization has not been described in the literature up to now. It presented clinically by acute urinary retention. Morphologically it consists of three components: leiomyosarcoma, liposarcoma and chondrosarcoma. Tumor ablation with adenomectomy was performed by a retropubic approach. PMID- 3831084 TI - [Nephrogenic adenoma of the bladder]. PMID- 3831085 TI - Multi-drug therapy in bacilliferous leprosy--two years experience. AB - The data of thirty patients who completed two years of multi-drug therapy (MDT) is analysed in regard to clinical improvement, occurrence of reactions, bacteriological response and compliance to therapy. PMID- 3831086 TI - Short course treatment of paucibacillary (TT/BT) leprosy cases. AB - A study has been undertaken wherein (TT/BT) cases with less than 5 lesions have been given DDS for 12 months alone or in combination with steroids for initial 1 month or rifampicin for initial one week. It has been found that only about three fourths of the cases become disease inactive in 12 months period. Follow up of 15 to 21 months in the post treatment period has shown a relapse rate of 6.33 per 1000 patient months. There was no difference in number of relapses occurring in the three regimens i.e. with or without rifampicin. Half the relapses were primarily in the nerves. During the course of treatment, a slightly higher number of patient in the DDS group had nerve problems as compared to group wherein additional steroids had been given. PMID- 3831087 TI - Chemotherapeutic trials with different regimens containing rifampicin in paucibacillary type of leprosy cases--a preliminary report. AB - Different regimens containing Rifampicin have been tried in treating paucibacillary leprosy patients. In our study we have studied three regimens. Regimen I consists of treating patients with Rifampicin 600 mg once a month for six months combined with Dapsone 100mg daily and treatment is stopped at six months. Regimen II is same as regimen I except that instead of stopping treatment at the end of six months the treatment was continued with dapsone 100 mg daily for another six months and treatment was stopped at one year. Regimen III is the same as recommended by I.A.L. in which treatment is started with Rifampicin 600 mg daily for seven days in the first month to be followed by Rifampicin 600 mg once a month for five more months. This is combined with dapsone 100mg daily for one year. Treatment in this group is also stopped at one year. Eighty one patients in Regimen I, thirty five patients in Regimen II and sixty three patients in Regimen III completed the six month treatment. It was found that the inactivation index in all the three regimens was nearly the same. PMID- 3831088 TI - Correlation between serum choline esterase and serum albumin in leprosy. AB - The clinical material included 255 cases of leprosy consisting of Tuberculoid leprosy (74), Lepromatous leprosy (116), Lepromatous leprosy with lepra reaction. Liver biopsy could be performed on 50 cases of Lepromatous leprosy. Specific granulomatous changes and parenchymal cell damage were the significant findings. Serum choline esterase and serum albumin are synthesized in liver. Serum Choline esterase levels in the present study decreased abruptly with exacerbation of the disease but the serum albumin levels declined gradually and slowly. Possible hypothesis to explain the correlation and uneven fall in activity is discussed at the cellular level. PMID- 3831089 TI - Serum cations (calcium and magnesium) in leprosy. AB - Serum cations (calcium and magnesium) were studied in 80 leprosy patients and 40 normal healthy individuals to find out the correlation between the clinical status of leprosy with these cations levels in the serum. There was significant decrease of serum calcium in lepromatous leprosy (7.42 +/- 0.7 mg%, t = 14.12, P less than 0.001), which seems to be related with the extent of leprosy lesions and duration of illness as few patients (22.2%) with minimal lesions and shorter duration of illness had serum calcium within normal range. Serum magnesium was significantly decreased in all types of leprosy cases and lepromatous leprosy patients showed highly significant decrease in serum magnesium level (1.02 +/- 0.2 mEq/L, t = 14.54, P less than 0.001). PMID- 3831090 TI - Metabolic studies on mycobacteria-I. Demonstration of key enzymes of glycolysis and tricarboxylic acid cycle on polyacrylamide gels. AB - Polyacrylamide gel electrophoresis (PAGE) technique was standardised to demonstrate some key enzymes of glycolysis, hexose mono phosphate (HMP) pathway and tricarboxylic acid cycle in slow growing mycobacteria (M. avium. M. gastri) as well as in fast growing mycobacteria (M. vaccae, M. phlei). The enzymes studied were lactate dehydrogenase (LDH) glucose-6-phosphate dehydrogenase (G6PD), aconitase, isocitrate dehydrogenase (ICD), succinic dehydrogenase (SDH), fumerase and malate dehydrogenase (MDH). All the three pathways were found to be operative in slow as well as fast growing mycobacteria. Using this technique M. leprae specific MDH activity was demonstrated in the cell free extract of M. leprae. It's (MDH) electrophoretic mobility on gels lies in the range shown by other mycobacterial species studied and was distinct from that of host MDH. It appears that PAGE offers a useful tool for metabolic characterization of M. leprae using infected tissues. PMID- 3831091 TI - Metabolic studies on mycobacteria--II. Glyoxylate by-pass (TCA cycle) enzymes of slow and fast growing mycobacteria. AB - Glyoxylate by-pass of tricarboxylic acid cycle (TCA) comes into prominence during survival of microorganisms under oxygen limitations and study of these enzymes may contribute to understanding of physiology of 'persisters' in various mycobacterial diseases. The enzymes of glyoxylate by-pass have been assayed in the extracts of various mycobacterial species, namely, M. tuberculosis H37Rv, M. tuberculosis H37Ra, M. flavescens, M. vaccae, M. smegmatis and Mycobacteria strain w (M.w.). M.w. has been included because of its close antigenic resemblance to M. leprae. It has been found that all of the above investigated species possess isocitrate lyase and malate synthetase, the key enzymes of glyoxylate by-pass. The presence of the enzymes is being reported for the first time in M. flavescens, M. vaccae and M.w. whereas these were earlier shown to be present in M. tuberculosis and M. smegmatis. It was also demonstrated in M.w. where acetate alone could not serve as sole source of carbon, but in the presence of glycerol stimulates the activity of glyoxylate pathway enzymes. The importance of these findings has been discussed. PMID- 3831092 TI - Clinical manifestations of iridocyclitis in leprosy. AB - Iridocyclitis--an inflammation of the iris and ciliary body occurs in lepromatous spectrum of leprosy of long duration. It is usually bilateral, has a very chronic course with acute exacerbations which are suppressed with the help of corticosteroids and other antiinflammatory drugs--Mydriatic to keep the Pupil dilated and also an antibiotic to take care of secondary infection which may be present. It is a major cause of blindness, due to its secondary damaging effects on the various ocular tissues. Medical and Paramedical Workers attending these patients must be made aware of the chronicity of the iridocyclitis so that regular referrals for examination of the eyes including slit lamp examination could be done and the activity of the disease and its complications detected early and treated. This chronic variety of iridocyclitis often gets less medical attention because of its insidious onset and minimal clinical signs in early stages, except by slit lamp examination. 57 patients suffering from iridocyclitis attending the ophthalmic department of S.L.R. & T.C. Karigiri were followed up carefully over a period of 2 1/2 years to study the clinical manifestations of iridocyclitis, it's complications and management. PMID- 3831093 TI - Trace elements in the sera of leprosy spectrum. AB - Serum zinc, copper, calcium and magnesium levels were estimated by atomic absorption spectrophotometry in 56 leprosy patients comprising 14 BT, 12 BB, 11 BL and 19 LL. These findings were evaluated in comparison to 42 normal subjects serving as controls. A significant elevation of serum copper was recorded while reduction in zinc, calcium and magnesium was noted throughout the leprosy spectrum. The findings of our study are of considerable importance and need to be taken note of in the light of delineating these alterations to be the cause or effect of the disease. PMID- 3831094 TI - A 20-year study of the Leprosy Control Programme at the Hemerijckx Leprosy Centre in Polambakkam in South India. AB - The Hemerijckx leprosy centre at Polambakkam in South India covers a rural population of about 800,000 and has treated over 40,000 cases of leprosy during the period 1955-75. Based on a stratified random sample of 25% of the case records, information was obtained about the profile of newly-detected cases in various cohorts (1955-57, 1958-60, 1961-64, 1965-69, 1970-75), regularity in drug collection and response to treatment. In newly-detected cases, the ratio of males to females was stable (3:2), but the proportion of adults aged 45 years or more increased from 15% in 1958-60 to 20% in 1970-75 and the lepromatous rate decreased from 9% to 6%; the proportion deformed at the time of diagnosis ranged from 11% to 15%. Regularity in drug collection was unsatisfactory even in the first year of treatment, with less than half the patients making 6 (or more) of the 12 monthly drug collections. The clinical status at 4-6 years was known for 70-75% of the patients who started treatment and of those approximately 60% had inactive or arrested disease. Data from population surveys was sparse; about 60% of the expected numbers were initiated and less than 30% of these had a coverage of 75% or more. The limited evidence, however, showed a decline in the prevalence of about 2 per thousand per annum. Field studies to evolve strategies for better motivation of patients, introduction of short-course regimens, and continuous monitoring of the programme are urgently needed. PMID- 3831095 TI - A sample survey of leprosy in the ELEP Leprosy Control Project, Dharmapuri, Tamil Nadu. AB - A sample survey of the Dharmapuri Leprosy Control Project was undertaken in 1983; a population of 60855 was enumerated out of which 51205 was examined. The sampling procedure which was followed consisted of stratifying the sub-centres according to prevalence and classifying the villages by the size of the population. Villages were selected by random allocation. 10 leprosy inspectors participated in the survey examining 626 to 774 persons per day. 859 active cases were detected giving a prevalence of 16.77 per thousand. The child prevalence was 6.19 per thousand. The number of lepromatous and BL cases detected were 70 giving an infectivity rate of 8.15%. The prevalence of leprosy as found in the last survey conducted in the different areas in the project approximate to those of the sample survey. Therefore it could be said that the prevalence has decreased in this project from 19.94 per thousand as observed in the first survey. The child prevalence has likewise decreased from 9.40 to 4.09 in the project. PMID- 3831096 TI - A study of leprosy in Mangalore City through school survey. PMID- 3831097 TI - Osteoarticular complications in anaesthetic foot. AB - A clinico radiological comparative study of complications in the anaesthetic foot in 60 patients (48 leprosy and 12 spinal injuries) were done. It has been observed that these groups behave differently. PMID- 3831098 TI - Observations of tarsal disintegration in the cases operated for foot-drop. AB - Fifty cases operated for foot-drop during the years 1971-82 were called for follow-up. Out of fifty, twenty cases were reported to the hospital. Three cases among the twenty were found to have changes of tarsal disintegration. The changes were found more confined to the talo-navicular junction. X-ray changes both in non-weight and weight bearing were studied. Their line drawings (tracings from actual radiograph) are presented. It is concluded that due attention should be given to the pre-operative evaluation, operative procedure used and post operative management particularly the weight-bearing and proper footwear. PMID- 3831099 TI - A comparative study of the haemagglutination inhibition (HI) test and spot test for detection of dapsone in urine. AB - A comparative study of the HI test and paper spot test for screening dapsone in urine was carried out in 692 specimens of urine, 149 from the field and 502 from patients attending the C.L.T. and R.I. clinic or admitted in the wards and 41 control urines. A very good correlation was noticed between the 2 tests in relation to positivity or negativity as well as DDS concentration. Fifty one urine specimens showed a specific agglutination, 41 of them were considered HI positive and 10 of them HI negative based on DDS concentration. The results are discussed. PMID- 3831100 TI - A study of the cause of irregularity of patients attending the out patient department of Cjil, Agra. AB - A study of 195 patients attending the out patient department with regard to regularity is reported. 71 patients or 36.41% were found to be irregular. The causes of irregularity were found to be predominently socio-economic factors. Since irregularity may lead to emergence of drug resistance due to irregular, inadequate and interrupted drug compliance, socio-economic factor require amelioration. PMID- 3831101 TI - Knowledge, attitude and practices of the community and patients regarding leprosy in Mangalore--a study. AB - To get acquainted with the knowledge, attitude and practices of the community and the patients towards leprosy so as to evolve a suitable health education programme, a study was conducted in Mangalore as per the schedule prepared for the purpose. The information so collected has been summarised below. Very few people among the community know that leprosy is caused by a germ (8%). Knowledge regarding this was slightly better (22%) among patients. Only 15% of the community members and 42% of the patients were aware of the early signs of the disease. 54% of the community members and 41% of the patients felt that leprosy is contagious. 60% of the community and 86% of the patients were of the opinion that leprosy is curable. Many believe that leprosy is associated with deformities and disabilities (community 64%, patients 76%). Most of the community members (79%) and patients (88%) said it is necessary to attend a hospital for treatment when leprosy is suspected. 60% of the community members and 56% of the patients felt that it is necessary to segregate leprosy patients. The findings are highlighted and discussed in the article. PMID- 3831102 TI - A study of knowledge of disease among leprosy patients and attitude of community towards them. AB - A study has been undertaken to evaluate knowledge about disease among leprosy patients and attitude of family and neighbours towards patients. 310 O.P.D. patients attending this hospital have been interviewed and their answers have been analysed. It is observed that less than a fourth of the patients knew the causes of the disease while 40% feared that their children were more prone to get leprosy. Interestingly 75% of patients did not encounter any adverse reaction from the other family members, or neighbours even though most of them knew about the disease. PMID- 3831103 TI - Partial flexor carpi radialis many-tailed transfer for correction of claw fingers. AB - The method described shows, that correction of claw fingers is possible using a portion of the flexor carpi radialis as motor. Usually, this method is indicated, whenever it is desired to do a Palmaris Longus many-tailed transfer in the absence of palmaris longus (e.g. for correction of hyper-mobile claw fingers). PMID- 3831104 TI - Borderline leprosy in a three year old child. PMID- 3831105 TI - Bone changes in leprosy. A study of 50 cases. AB - The radiological bone changes have been studied in 50 patients comprising of lepromatous, tuberculoid, mixed (borderline lepromatous, borderline tuberculoid, dimorphous) and polyneuritic (neural) types of leprosy of which the former formed the largest group. The overall incidence of non-specific bone changes is higher as compared to specific bone changes. These were found to have highest incidence in the lepromatous type of leprosy, in the occupational group of manual workers and from 3rd to 6th decade of life. With the longer duration of the disease, the incidence of non-specific bone changes is also more. PMID- 3831106 TI - Leprous lesion with hyperpigmented border. AB - Two cases of leprosy--one Tuberculoid and the other Borderline are reported. The Tuberculoid patch shows sharply defined hyperpigmented border whereas in the Borderline patient, diffuse hyperpigmentation is present around the lesion. The cases are reported for documentation due to rare clinical pressentation. PMID- 3831107 TI - The challenging task of motivating leprosy workers. PMID- 3831108 TI - Urban leprosy control--methods used by the German Leprosy Relief Association. PMID- 3831110 TI - Activities of Regional Leprosy Training and Research Institute, Raipur (M.P.). PMID- 3831109 TI - WORTH--annual report for 1984. PMID- 3831111 TI - Adoption of IAL classification by the Government of India. PMID- 3831112 TI - Inoculation leprosy subsequent to dog bite. PMID- 3831113 TI - [Surgical treatment of metastatic lung cancer]. PMID- 3831114 TI - [Extensive resection of advanced carcinoma of the lung]. PMID- 3831115 TI - [A study of atrial potential--retrograde conduction and amplitude of the atrial potential]. PMID- 3831116 TI - [Prevention of posttransfusion hepatitis--intra- and postoperative autotransfusion by using the Cell Saver and preoperative storage of autologous blood]. PMID- 3831117 TI - [Hemodynamics of pulmonary stenosis with intact ventricular septum in the immediate postoperative period]. PMID- 3831118 TI - [Surgical management of bronchiectasis]. PMID- 3831119 TI - [Long-term evaluation of the Hancock Modified Orifice Xenograft Model 250 in aortic position]. PMID- 3831120 TI - [The influence of cardiopulmonary bypass on the platelet count, size and function]. PMID- 3831121 TI - [Simultaneous right ventricular reconstruction and the Glenn procedure for pulmonary atresia with intact ventricular septum]. PMID- 3831122 TI - [A case of congenital apical left ventricular aneurysm]. PMID- 3831123 TI - [A ruptured aneurysm of circumflex artery accompanying coronary artery fistula]. PMID- 3831124 TI - [Three operative cases of aortic dissections--especially the fate of the false lumen following medical and surgical treatment]. PMID- 3831125 TI - [A successful surgical removal of a left ventricular fibroma]. PMID- 3831126 TI - [A resected case with double primary lung cancers in one lobe]. PMID- 3831127 TI - [Surgical treatment of Morgagni's hernia--with discussion of hernial sac contents and operative approach]. PMID- 3831128 TI - [Lysis of plasma membrane by a unique oxygenated sterol: 22R-hydroxycholesterol]. PMID- 3831129 TI - [Sodium as an energy coupling ion]. PMID- 3831130 TI - Massive pulmonary embolism: embolectomy or thrombolysis? AB - The purpose of this paper is to evaluate the indications for surgical or thrombolytic treatment of massive pulmonary embolism. Analysis of the outcome of the disease depending on the indices of lung vascular damage volume and hemodynamics was performed. One hundred and thirty five patients with thromboembolism of truncus or main branches of the pulmonary artery were examined. Right cardiac catheterization, angiopulmonography and Tc-perfusion lung scanning were carried out. Predictive criteria of the lethal outcome (with 86% probability) were defined in patients without surgical treatment. These criteria included extensive volume of lung vascular damage (Miller angiographic index greater than or equal to 27, scannographic perfusion deficit greater than or equal to 60%) and significant hemodynamic disturbances (refractory systemic arterial hypotension or severe pulmonary arterial hypertension: right ventricular systolic pressure greater than or equal to 60 mmHg, right ventricular end diastolic pressure greater than or equal to 15 mmHg, mean right ventricular pressure greater than or equal to 25 mmHg, and mean pulmonary arterial pressure greater than or equal to 35 mmHg). With these indices available these are indications for pulmonary artery embolectomy. With lower indices, but close to those estimated in the study, thrombolytic therapy is indicated. PMID- 3831131 TI - Vein graft in toe to hand transfers. AB - These authors describe indications, techniques, short- and long-term results of toe to hand transfers using the vein grafts. 145 toe to hand transfers were performed in 115 patients. Fifty cases necessitated 44 vein grafts in 37 patients; there were 41 vein to artery and 3 vein to vein grafts carried out. The grafts were used to bridge defects of a vessel over 55 mm (usually in patients with heavy posttraumatic scar formation and/or distrophic changes resulting from burns and frost-bite in the vessel stumps, or in the main vessel nourishing the transplant), both in primary surgery and in re-operation following the resection of the thrombosed microanastomosis. Success was achieved in 28 patients who underwent primary interposition of vein grafts, with 34 survivals (90%) of 38 transferred toes. That exceeded the average survival rate of 84%. In 9 patients vein grafting of arteries followed the resection of the thrombosed microanastomoses and resulted in 5 survivals of 12 transferred toes. In 6 cases vein grafts to arteries were performed both intraoperatively and in re-operation. In this group of patients 7 of 8 transferred toes survived for re-operation had been prompt. Venous grafting in toe to hand transfers carried out without delay and in full conformity with the indications, produced results statistically similar to those obtained in procedures involving no venous grafting. PMID- 3831132 TI - Pathophysiology and selection of method for surgical management of thoracic outlet syndrome. AB - Over the period of 1977-82 seventy-eight patients with thoracic outlet syndrome were examined and treated at our Institute. Sixty-eight patients were operated on. The average age of the patients was 34.6. Women prevailed (42 patients). Trauma accounted for syndrome development in 36 patients. In the remaining patients congenital and acquired osseous alterations, supernumerary scalene muscle, congenital fibrous bands were the etiologic factors. Uncomplicated thoracic outlet syndrome was found in 36 patients, a complicated form--in 32 out of 68 patients operated on. The essential role of neurogenic factors in the development of the disease, especially of the uncomplicated variety was disclosed. In bony pathology one noted early appearance and prevalence of vascular complications. First rib resection should be considered the principal type of decompressive operation. Selection of approach and use of other surgical interventions is determined by clinical presentation of complications. Good and satisfactory results after surgical treatment were obtained in 61 patients (89.7%). PMID- 3831133 TI - Secondary arterial repair after aortoiliac surgery. AB - Late complications after operations on aorta and iliac arteries are analyzed in 763 patients with athesclerosis over 15-year period. Indications for recurrent reconstructive operations are presented, and the results of these operations are analyzed depending on surgical technique, incidence of recurrent thromboses and types of complications. Angiography, rheovasography, pathohistological and microscopic studies, raster electron microscopy, IR-spectroscopy were used in post-operative period. On the basis of the obtained data the following conclusions have been drawn. For more than a quarter of patients operated for aorto-iliac occlusions it was necessary to perform recurrent reconstructive operations in late post-operative period. The incidence of recurrent operations depends on many factors: stage of ischemia, nature of atherosclerotic lesions, technique of reconstruction. In primary operations profundoplasty was performed in comparatively rare cases. PMID- 3831134 TI - Soviet-made vascular prostheses. AB - The authors present some facts concerning the history of developing synthetic vascular prostheses in the Soviet Union, the data pertinent to the Soviet and some foreign models of synthetic vascular grafts, dwell on their characteristics. The authors discuss further possible modifications of vascular prosthesis. The vascular prosthesis is considered as an artificial false aneurysm within a synthetic frame, in this connection they discuss favourable possibilities of application of vascular grafts in arterial injuries and its consequences. The authors also provide information on some new types of vascular prostheses, velour and rough ones in particular, as well as microprosthesis. PMID- 3831135 TI - Reconstructive microsurgery in treatment of lymphoedema in extremities. AB - A total of 510 cases of primary and secondary lymphoedema in upper and lower extremities have been examined with two thirds of primary lymphoedema cases among them. Radical mastectomy combined with irradiation has led to the development of obstructive lymphoedema of upper limbs in most patients. 230 patients with primary and secondary lymphoedema have been subjected to microlymphatic surgery and lymphaticovenous anastomoses have been carried out with microsurgical techniques. Limb volume measurement, the results of direct lymphangiography and intralymphatic pressure reading were taken into account to select patients suitable for microlymphatic surgery. Most favourable results have been obtained in secondary obstructive lymphoedema cases (total 81.2%) due to well-marked hypertension in lymphatic vessels that contributes to better functioning of the lymphaticovenous anastomoses made in a patient. PMID- 3831136 TI - Surgical treatment of aortic aneurysms: timing and types of operation. AB - The work reports the experience with 88 cases of aortic aneurysms, 61 of them having been treated surgically. The conventional classification of aortic aneurysms which permits one to define the disease precisely and to time the operation should be selected for every patient individually. The variant of the main intervention on the aneurysm is finally determined by the surgeon during the operation. The new method of "bandaging" the aneurysm is presented. It is the operation of choice for small aneurysms with preserved elasticity of the wall. The aneurysm is bandaged up to the normal diameter of the aorta by a synthetic bandage. The presence of thrombus is not a contraindication. The immediate and distant results (up to 16 years) of this operation are beneficial. PMID- 3831137 TI - Surgical treatment of occlusive lesions of thoraco-abdominal aortic segment. AB - Forty-nine patients with the occlusive lesions of the thoraco-abdominal aortic segment, congenital hypoplasia (13 patients) and non-specific aortitis (36 patients) were operated on. Operations were performed under moderate hypothermia (+30-31 degrees C) through the left thoracophrenolumbotomic approach. In the majority of patients reconstruction of the aorta was done by means of its resection and replacement. In 9 patients with congenital hypoplasia we performed aortic reconstruction only, and in 4 it was combined with plastic procedure on the coeliac trunk. In 25 patients with non-specific aorto-arteritis aortic replacement was combined with revascularization of the visceral (renal) arteries. In this group reconstruction of the aorta and visceral branches was performed in 7 cases, that of the aorta and renal arteries in 62 and simultaneous reconstruction of the aorta, visceral and renal arteries in 16 cases. Total mortality was 6.1% (3 patients). There was no mortality in patients with aortic hypoplasia. PMID- 3831138 TI - Surgical treatment of chronic ischemia of the digestive organs caused by compressive stenosis of the celiac trunk. AB - Compressive stenosis of the celiac trunk is a common cause of chronic ischemia of the digestive organs with consequent morphological and functional changes in these organs. Decompression of the celiac trunk is an effective operation which normalizes the central and visceral circulation and results in resolution of ischemic lesions of the digestive organs and cicatrization of ischemic gastroduodenal ulcers, in particular. In some cases it is necessary to combine decompression of the celiac trunk with other surgical procedures to eliminate complications of ischemic lesions of the stomach and duodenum or other associated lesions. PMID- 3831139 TI - Results of treatment of 500 patients with civilian blood vessel trauma. AB - Results of treatment of 500 patients with blood vessel trauma are analyzed depending on trauma nature, shock severity, regional ischemia, technique of restorative surgery. Biochemical and ultrastructural changes in muscles are described in experimental conditions in ischemia of different degrees of severity to prognosis the reversibility of disorders. Restoration of blood circulation has been achieved in 82% of patients (5.1% mortality). Beside open and closed vessel trauma, it is expedient to distinguish between penetrating and non-penetrating injuries. Results of treatment of blood vessel trauma should be differentiated depending on the degree of regional ischemia, severity of traumatic shock and blood loss, combination of trauma and injury localization. Mechanical suture improves anastomosis quality, simplifies technique and reduces time of intervention. Introduction of microsurgery principles widens possibilities of vessel restorative surgery. The authors suggest classification of iatrogenic injuries of vessels, which promotes accurate diagnosis and choice of optimal surgical technique. PMID- 3831140 TI - Classification of chronic venous disorders of lower extremities and pelvis. AB - Variability of hemodynamic situations in different forms and stages of chronic venous disorders of lower extremities and the pelvis as well as the mushroom growth of surgical techniques used in their treatment make the author consider the correct choice of individual treatment to be the main problem. In the first place such treatment should be directed towards adequate correction of the deep venous circulation disorders providing for elimination of the main pathogenetic factors (e.g. occlusion of the main veins, pathologic impact of the gravitational column, blood regurgitation at standing and its flotation in ambulation, arterio venous run-off, etc.). The author has revealed a classification based on systematization of most frequently observed pathology, that allows a laconic functional and topical diagnosis and provides phlebological patients with individualized treatment. PMID- 3831141 TI - Hyperbaric oxygenation in treatment of peripheral vascular disorders. AB - The authors discuss the reaction of central and peripheral hemodynamics to HBO and therapeutic effect of superoxygenation on ischemic tissues. HBO not only improves the metabolism in the ischemic areas but also activates microcirculation in such areas with a reduced blood flow. The experience of the largest Soviet HBO center covers more than 3,000 cases of peripheral vascular disorders. PMID- 3831142 TI - Value of venous occlusion plethysmography to study venoactive medication in men. AB - Venous occlusion plethysmography is a useful tool to investigate the effect of a vaso-active medication on the venous circulation in man. However, room temperature can be very critical when small changes have to be detected. Therefore several authors induce a preconstriction of the veins for example with norepinephrine. When the conditions of the experiment are carefully controlled and a very sensitive plethysmograph is used, a significant effect on forearm veins can be shown even after small doses of nitrates and a high room temperature; matching with placebo is critically needed. It is likely that by lowering room temperature the response would be exaggerated. Taking these restrictions in mind, venous occlusion plethysmography can be a very valuable, non-invasive tool to study the effect of vaso-active treatment on the veins in men. PMID- 3831143 TI - Nifedipine and Raynaud's phenomenon associated with connective tissue diseases. AB - We have evaluated the therapeutic effect of the calcium-channel blocking agent nifedipine in Raynaud's phenomenon associated with connective tissue diseases and in idiopathic digital vasospasm. Thirty patients were included in this study: Raynaud's phenomenon was associated with progressive systemic sclerosis (PSS) in ten patients, systemic lupus erythematosus (SLE) in five and rheumatoid arthritis (RA) in three; it was idiopathic (I) in twelve patients. Each patient received, in a double-blind manner and random order, on two consecutive weeks, nifedipine (20 mg three times daily) and placebo. Nifedipine proved to be effective: the mean number of digital vasospastic attacks per week decreased from 20.30 to 5.83 (p less than 0.01). The results in the SLE and RA groups were similar and were pooled. The improvement (in percent decrease) was better in the idiopathic group (90.95) than in the SLE and RA group (78.63, p less than 0.02) and the PSS group (64.02, p less than 0.01). PMID- 3831144 TI - Lower limb haemodynamics during antihypertensive treatment with metoprolol and propranolol. AB - In order to evaluate the role of beta 1-selective beta-adrenoceptor blockade on lower limb haemodynamics, blood pressure, leg blood flow and vascular resistance were measured at rest and during reactive hyperaemia in 34 hypertensive patients. The study was performed as a randomized double-blind cross over trial involving four weeks' treatment with the beta 1-selective metoprolol 100 mg b.i.d., the non selective propranolol 80 mg b.i.d., and placebo b.i.d. Blood pressure was equally reduced by both beta-adrenoceptor blocking drugs. Reactive hyperaemic blood flow decreased by 19% (p less than 0.01) during propranolol and by 14% (p less than 0.01) during metoprolol treatment, when compared to placebo. Vascular resistance, however, was unaltered by these drugs. There were no significant differences between beta 1-selective and non-selective beta-blockade on lower limb haemodynamics in hypertensive patients. As the reason for diminished reactive hyperaemic blood flow we suggest a beta-blocking effect on the heart rather than a peripheral mechanism. PMID- 3831145 TI - Disobliteration of the aorto-iliac (-femoral) arteries with the plaque cracker, using the retroperitoneal approach. AB - The aorto-iliac disobliteration technique using the LeVeen plaque cracker is described and the results in 70 patients (operated on at the Elisabeth Hospital, Sluiskil, The Netherlands), are presented. The early mortality rate for the series was 4.3%. There were two cases of haemorrhage due to adventitial damage, within two weeks of the operation. The 5 year patency rate was 100%. The LeVeen disobliteration technique is a considerable improvement in the conventional open or half closed endarterectomy. The operation is shorter, and simpler. Also it is ideally suited for combination with the retroperitoneal approach. The technique can be easily combined with disobliterations distal to the groin. The relative advantages and disadvantages of the closed disobliteration and synthetic graft methods are discussed together with the reasons why the closed disobliteration technique seems to be the method of choice in those patients without aneurysms or excessive calcification. PMID- 3831146 TI - Detection of lipoprotein abnormalities by a sensitive electrophoretic test system for the prevention of cardiovascular disease. AB - With the use of new and improved technology and methodology, an electrophoretic test system has been developed to determine serum lipoprotein patterns. The main features of this system, which distinguish it from other methods are: (1) high sensitivity and sharp resolution, which enable the identification in human serum of two beta, two pre-beta, and alpha lipoprotein fractions and additional subfractions; (2) rapid analysis of blood samples to demonstrate accurately the lipoprotein fractions as they circulate in the natural state in plasma; and (3) low cost of the test since the materials and supplies are inexpensive. The application of the test system to the analysis of serum samples from normal individuals and patients with defined pathologic conditions resulted in the following new developments: (1) the demonstration of abnormal lipoprotein patterns that aid the diagnosis of clinical disorders of lipid metabolism; and (2) the detection of abnormal lipoprotein fractions associated with atherosclerotic cardiovascular diseases (ACD). The determination of serum lipoproteins is an indispensable part of the evaluation of an individual for ACD because they are the native molecules in the circulation which are intimately associated with the blood vessels that become atherosclerotic. PMID- 3831147 TI - Angiology and geriatrics: a challenge. PMID- 3831148 TI - Aging and arterial functions. AB - Normally it is difficult and quite frequently impossible to separate physiological aging from its pathophysiological variant. Biochemical, physical and morphological alterations in the arterial wall show a dependence on age. This was the reason for investigating the extent to which the peripheral arterial hemodynamics are changed by age. The parameters, measured by electronic oscillogram, ultrasonic-Doppler-technique and radioangiography, show age dependent alterations. However it must be considered, that peripheral arterial hemodynamics are also influenced by age dependent alterations in cardiac functions. PMID- 3831149 TI - Microcirculation in the elderly. AB - Studies on microcirculation in the elderly include observations in the small vessels of the bulbar conjunctiva and of the nailbed with respect to a classification of the findings according to a number of semeiologic criteria (diameter and shape alterations, terminal capillary network, intravascular red cell aggregation). In vascular diseases of the elderly there are typical alterations of the capillaroscopic findings in the bulbar conjunctiva and in the nailbed, particularly in cases of arteriosclerosis, arterial hypertension, diabetic microangiopathy, heart failure, ischemic myocardiopathies. During the treatment with some vasoactive drugs (nicotinic acid and its derivatives, buflomedil, CPD-choline) there are marked modifications of the small conjunctival vessels, with evident dilatations, appearance of collaterals, increased homogeneity of the blood flow, better evidence of the capillary network and reduction of intravascular red cell aggregation. PMID- 3831150 TI - Capillaroscopy at the nail bed in functioning people aged 70 and over. AB - A long survey in an homogenous population of 150 healthy and functioning male and female subjects 70 years of age and over is reported. In vivo capillaroscopic patterns observed at the nail bed, besides the lips, the gums, the tongue and the bulbar conjunctiva, are described and sometimes compared with fingertip biopsy. Three patterns are distinguished: (1) type I the most frequent similar to the children's one (2) type II less frequent but rather peculiar to senescence (3) type III rather typical but intermediate. Permanent dilatation and congestion of venules and capillaries seem to be related to the permanent opening of pulpar arteriovenous anastomoses and belong to "senile microangiopathy". PMID- 3831151 TI - Incidence and course of occlusive peripheral artery disease in geriatric patients. Possibilities and limits of prevention. AB - The fate of patients with chronic and acute OPAD was analysed in order to delimit needs and limits of preventive measures. Chronic disease. A high 5 year incidence of OPAD and a strong correlation with the risk factors at entry was observed in 2630 men initially free of disease. The incidence was at 114% in men with 3 risk factors vs 20% in the subgroup free of risk at entry. In a 11 year follow-up study of 239 men with OPAD a high mortality of 37% was observed vs 13% in the age matched randomized controls. Death was due to coronary heart disease (CHD) in 15.1% of OPAD vs 1.7%. The mortality was significantly correlated with the risk profile at entry 46% in persons with several risk factors vs 19% in those free of risk. The strong correlation between the risk profile and morbidity/mortality indicates that primary prevention by reduction or elimination of risk factors could successfully avoid or postpone CHD and OPAD, if started early and not only at the threshold of the 3d life. Acute disease. The analysis of a geriatric subgroup, 141 patients older than 70 years, demonstrated that acute artery occlusion is a limb-and life-threatening event with an in-hospital mortality of 33% and an amputation-rate of 19%. Life together with limb salvage was obtained, in spite of thrombectomy thrombolysis or anti-coagulants, in only 57%. The subgroup at increased risk could have been recognised in advance by antecedent atrial fibrillation, OPAD and/or myocardial infarction; 50% presented indeed with several, 33% with one and only 17% without the mentioned conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831152 TI - Carotid stenosis. Surgery after 75 years. AB - Is it reasonable and useful to perform surgery on carotid lesions after 75 years? ("old man" according to the W.H.O. classification). To answer this question, we re-examined 66 patients aged 75 to 87 years, who underwent 76 carotid thromboendarteriectomies with one post-operative death. The results study showed that morbidity and general complications were not more important than in younger patients. Late results from 2 to 94 months showed a very low percentage of secondary neurologic complications even if patients had a vascular or general surgical intervention in a second period: 13 cases. There were only 2 re stenoses. Indications were defined, but it was above all the asymptomatic patients or patients who had a TIA who could benefit from them. PMID- 3831153 TI - The white clot syndrome or heparin associated thrombocytopenia and thrombosis (WCS or HATT) (26 cases). AB - The Authors report a new iatrogenic complication of preventive or curative standard heparinotherapy. This so called "white clot syndrome" or "Heparin associated thrombocytopenia and thrombosis" is an anatomico-clinical entity characterized by severe, multiple, recurrent, arterial and/or venous thromboembolic accidents which are sometimes fatal. They appear, paradoxically, under heparin treatment and are concomitant with thrombocytopenia (generally less than 100 10(9)/l). Antiplatelet immunoallergic phenomena, via type IgG antibodies, induced by heparin, are the most commonly admitted in physiopathology; however they remain controversial. Treatment of "WCS" includes urgent suppression of standard heparin, administration of antivitamin K, or the new generation of low molecular weight heparin. This series presents 26 cases of HATT treated by LMWH (CY 216 CHOAY). Severe complications must be surgically cured. Prevention of WCS or HATT is mandatory by the systematic survey of platelet count during heparinotherapy. PMID- 3831154 TI - Value of phlebography for diagnosis and treatment of pulmonary embolism. AB - The frequency of recurrencies and of post-phlebitic syndrome after PE lead the Authors to perform phlebography of the legs before and after treatment of PE. A venous thrombosis was found in 124 cases out of 144 recent PE proven by angiopneumography. The thrombosis affected the ilio-caval veins 43 times, in 27/103 severe PE cases (24%), in 16/33 moderate PE cases (40%). Patients were treated: by H. in 67 cases; 33 (group I) with moderate PE, (4 (group II) with severe PE; by Streptokinase (SK) 24 times: 5 cases with moderate PE, 19 (group III) with severe PE; but U.K., high dose (UKf) 19 times; by U.K., moderate dose (UKm) 40 times, 3 cases with moderate PE, 37 cases (group V) with severe PE. After treatment, the mean volume of the venous clot, measured by the Marder's index, decreased in all groups. However, S.K. lysed 7 out of 17 proximal thrombosis, whereas the other treatments were unefficient. Failures were less frequent with S.K. (3/16) than with U.K. f (11/15), U.K.m (12/28) and H. (29/65). Recurrency was noticed 8 times: in 7 cases, it was seen in patients affected with proximal V.T. and not treated by I.V.C. interruption. Such facts warrant the systematic search for V.T. when PE is suspected. They justify the use of thrombolytic drugs not only for severe PE, but also for moderate PE which are associated to a proximal V.T. PMID- 3831155 TI - Surgical management and results of renal artery revascularization. AB - Many hypertensive patients with renal artery stenosis and abnormal finding on renin angiotensin assay can expect to enjoy a good clinical response from renal artery reconstruction. A total of 183 renal artery revascularisation procedures were carried out between 1976 and 1982 with an average follow up of 36 months. Over 86% of patients were cured or had significant improvement in their blood pressure parameters with a minimal of morbidity. Those patients who do not have satisfactory results from the surgical correction should undergo reevaluation to detect any correctable anatomic defect. PMID- 3831156 TI - The "functional" popliteal entrapment syndrome. AB - A patient with bilateral entrapment syndrome is reported, he only had symptoms of intermittent claudication with running. The "neutral angiograms" were normal, but the "dynamic angiographies" taken in the sustained active plantar flexion showed a complete occlusion of both popliteal arteries. No abnormalities, no anatomical trap were discovered at the time of surgery. The entrapment syndrome was caused by the muscular hyperdevelopment in this intensively trained athlete. That leads to the concept of "functional entrapment" versus "organic, anatomical entrapment". The diagnostic value of the invasive and non invasive techniques is discussed. Surgical exploration is diagnostic: this is the only means to rule out any organic anatomical entrapment. In a "functional entrapment" surgery may or may not be therapeutic. PMID- 3831157 TI - Intermittent ischemia caused by dissection of the abdominal aorta through myxoid degeneration. Case report. AB - Acute intermittent ischemia is generally caused by altered vasomotion and rarely by aortic dissection. There is reported a case of dissection of the abdominal aorta which presented a mixoid degeneration of the inner wall. The surgical finding was similar to a medio intimal aortic cylinder obtained generally during endarterectomy. Five years after the operation (endarterectomy of the mixoid cylinder) the patient presents a good patency of the aortoiliac area. PMID- 3831158 TI - Venous claudication. A report of 15 cases and a review of the literature. AB - The symptom of intermittent claudication is not invariably due to arterial disease. Exercise-related pain resulting from venous insufficiency is poorly defined, but has been described by a number of authors in the past. Fifteen patients with symptoms suggestive of venous claudication are reported. The history and clinical findings are described. The further investigation of these patients is outlined, starting with the non-invasive methods of Doppler ultrasonography and strain gauge plethysmography. Ascending phlebography was performed on all affected limbs (n. 19) and descending phlebography was performed on those shown to have a patent deep venous system. These investigations demonstrated deep venous abnormalities associated with the distinct symptom complex. Venous claudication is defined and the literature reviewed. It is hoped that a clearer understanding of the condition will result in more frequent and accurate diagnosis with subsequent benefit to the patient. PMID- 3831159 TI - The normal leg venogram: significance in suspected vein thrombosis. AB - Does a normal leg phlebogram exclude deep venous thrombosis (DVT)? Is it safe not to anticoagulate patients with suspected DVT and a normal phlebogram? To answer these questions a retrospective study was undertaken of 71 outpatients with clinically suspected DVT and a normal phlebogram. Patients were followed for 5 months on the average; data were obtained from conversations with referring physicians and interviews with patients. Nine patients were excluded from the study because of incomplete follow-up data; four others were excluded because they were treated with coumadin "on clinical grounds". Five patients continued having symptoms subsequently attributed to arthritis, cellulitis and/or venous stasis. Fifty-three patients had no venous thromboembolic problems during the follow-up period and their symptoms subsided without therapy. We conclude that a properly performed normal leg phlebogram excludes a diagnosis of clinically significant DVT. No patient in this study developed problems because anticoagulant therapy was withheld based on a negative phlebogram. PMID- 3831160 TI - The patient's perspectives after aortofemoral grafting for occlusive disease. AB - The late results of aortofemoral grafting for aortoiliac occlusive disease in 371 patients are presented. Late survival (30% after 15 years) was primarily dependent on age at the time of surgery and the presence of atherosclerotic heart disease on subinguinal atherosclerotic involvement. The majority of late deaths (42%) was due to atherosclerotic disease. With a mean follow-up period of 7 years the late complication rate was 29%. Late thrombosis was responsible for 66% of the late complications and a subsequent redo-operation was necessary in 24% of the patients. Age at the time of surgery and the presence of femoropopliteal occlusive disease were the most important factors. Regarding the late mortality rate of 45%, it is recommended that follow-up in these patients should be directed not only to late graft complications but also to other manifestations of generalized atherosclerosis. PMID- 3831161 TI - [Research for the prevalence of scoliosis]. AB - The number of scoliotic patients under treatment have recently showed a marked increase in Japan. In this situation, the author has raised two important questions. Firstly, has the incidence of scoliosis increased in Japan? Secondly, what happened to scoliotic patients who had been left untreated before the establishment of the current therapy. To seek answers for these questions, prevalence studies for all generations were carried out. As to the first question, the prevalence rate of scoliosis in adult from the twenties to forties was lower than in junior high and high school students. From this incidence and other several factors, the author concluded that the incidence of scoliosis in Japan increased recently. As to the second question, questionnaires were sent to each patients subjected to the secondary examination. Since the difference between scoliotic group and control group on the back symptoms did not appear significant, scoliosis and subjective symptoms apparently failed to show a correlation. PMID- 3831162 TI - [Specific protein in the plasma of rheumatoid arthritis patients]. AB - A unique protein was detected in the plasma of rheumatoid arthritis patients by two-dimensional electrophoresis. We named it rheumatoid arthritis specific protein (RASP). According to the pattern and concentration of its spot, RA patients were classified into three groups as RASP+, RASP +/- and RASP-. RASP+ was detected only in RA and its occurrence was 45/120 (38%). The occurrence of RASP including RASP +/- was 84/120 (70%) in RA, 6/13 (46%) in SLE, 2/8 (25%) in PSS, 11/51 (22%) in liver disease and 4/44 (9%) in normal. RA patients with RASP+ indicated significantly high level of ESR, CRP and platelet counts comparing with RA patients with RASP-. These results suggested that RASP might be a good indicator for the diagnosis and evaluation of the activity of RA. RASP was purified with gel chromatography repeated three times. RASP was very similar with immunoglobulin G in its biochemical and immunological properties. PMID- 3831163 TI - [Blood flow changes in the legs of patients with disc herniation and spinal canal stenosis]. AB - Blood flow changes through the leg were examined by thermography, heated thermocouple technique and straingauge plethysmography in patients with lumbar disc herniation and spinal canal stenosis. Hypothermal areas were observed in the affected leg in disc herniation and of both legs in spinal canal stenosis. An increased blood flow through the anterior tibial muscle during sustained contraction was slightly depressed, and post-contraction hyperemia showed an increase in amount and duration in disc herniation. Levels of resting arterial inflow through the leg were almost half that of healthy individuals, and reactive hyperemia after walking revealed a marked prolongation especially in spinal canal stenosis. In postoperative cases of spinal canal stenosis the thermogram and arterial inflow of the leg returned to their normal level. These results can provide evidence of latent ischemia of the leg that may be caused by a radicular or sympathetic dysfunction in the lumbar spinal diseases. PMID- 3831164 TI - [An experimental study on adhesion blocking in simultaneous injury of tendon and nerve]. AB - The formation of adhesions between simultaneously injured tendon and nerve with and without adhesion blocking materials was studied by using a rabbit model. A collagen membrane, produced from adult bovine corium and with a negative electric charge induced by chemical modification, was used as the blocking material. Microangiography and histological studies were performed to investigate the vascular supply to the adhesions. The following results were obtained. Blood vessel proliferation was observed parallel to the adhesion formation. The vessels to the adhesions originated mainly from intraneural and perineural vascular plexuses. The collagen membrane was effective in preventing the development of adhesions by restricting the blood supply. Within 5 weeks, the collagen membrane was almost absorbed, and healing of tendon and nerve was almost complete. PMID- 3831165 TI - [The change of the spinal evoked potential caused by constant-speed subacute compression of the spinal cord]. AB - The spinal cord of the cat was squeezed by a newly designed electromotive compressor at a constant rate of 0.5-6.0 mm/h. Meanwhile, the ascending spinal potential was measured with using epidural stimulation. The earliest change of wave pattern appeared near the compression site, i.e. an augmentation of the potential which turned to positivity with prolongation of latency at the compression ratio of 32-41%. The potential gradually reduced in amplitude at more cranial levels while it augmented at the caudal levels. The first and second components of the potential which conducted along the lateral and posterior tracts respectively, blocked completely at the compression ratio of 57-82% and 45 69% respectively. After decompression, the recovery was remarkable even after a complete block. Deformation of the spinal cord, providing a change of the volume conductor, likely caused such augmentation. PMID- 3831166 TI - Functional treatment of congenital dislocation of the hip using Pavlik harness (Riemenbugel). AB - The results of functional treatment using the Pavlik harness in congenital dislocation of the hip were examined. The study was conducted on 219 hips in 168 patients over periods of 5 to 13 years after the treatment. The age at the start of the initial treatment ranged between 3 and 12 months, making extensive movement of the lower extremities possible. The spontaneous reduction rates due to the Pavlik harness were 68.0% in dislocation and 97.9% in subluxation. Of those which could not be reduced with the Pavlik harness, 26 joints underwent manual reductions and the remaining 6 joints underwent surgical reductions. The results were evaluated by Severin's criteria. Severin I was observed in 76.0% of dislocations and in 95.5% of subluxations. In the group of successful reduction using the Pavlik harness alone, aseptic necrosis of the femoral head was observed in 11 joints (6.2%), and lateralization was observed in 21 joints (11.9%), but these changes were mild. PMID- 3831167 TI - Role of the metatarsophalangeal (MTP) joints of the foot in level walking. AB - This study investigates the motion and function of the metatarsophalangeal joints of the foot in customary, slow, fast and longer stride styles of level walking. Electromyograms of the tibialis posterior (TP), extensor hallucis longus (EHL), extensor digitorum longus (EDL), flexor hallucis longus (FHL), flexor digitorum longus (FDL), tibialis anterior (TA), gastrocnemius (TS) and peroneous longus (PL) and ground reaction forces, foot switch signals and electrogoniometers of the ankle and metatarsophalangeal (MTP) joints were recorded simultaneously. In customary and fast walking, the role of the long toe flexors is to act as an aid and they also act as roll off agents maintaining floor contact. In slow walking styles the function of the toes is not to exert propulsion forces but stabilizing forces. In longer stride walking it is suggested that the toes are required to exert propulsion forces. It is important to research multilaterally the causal relation of many parameters. PMID- 3831168 TI - Histological studies of electrically induced intramedullary callus. AB - The author studied the early changes of electrically stimulated bone marrow and carried out histological examinations. A constant current of 10 microAmp was delivered to the cathode which was placed in the humerus of each rabbit. On the 5th, 14th and 21 st day, the rabbits were killed, and the intramedullary tissues around the tip of the cathode were processed for light and electron microscopic observations. In the early stages after electrical stimulation, the leakage of erythrocytes, membranocystic degeneration of lipid cells, and proliferation of undifferentiated mesenchymal cells with moderately developed rER and collagen bundles were recognized. These findings indicate that the oxygen tension around the cathode was diminished in advance of the electrically stimulated callus formation. After prolonged electrical stimulation, both membranous and endochondral ossifications were more active than those in the control group. PMID- 3831169 TI - [Recurrence factors in the maxillary sinus carcinoma after multimodal treatment]. PMID- 3831170 TI - [Clinical significance of serum ferritin levels in carcinoma of the stomach and colon]. PMID- 3831171 TI - [Clinical significance of the shape of isodose curves in intracavitary radiation therapy of carcinoma of the uterine cervix]. PMID- 3831172 TI - [Flow-cytometric analysis of changes in lymphocyte subsets in the blood of cancer patients during radiotherapy. 9. Special reference to head and neck cancer patients]. PMID- 3831173 TI - [Combined treatment of radiofrequency hyperthermia and irradiation in advanced urological malignancies]. PMID- 3831174 TI - [An evaluation of the clinical course and prognosis of breast cancers detected by mass screening]. PMID- 3831175 TI - [Natural killer activity in brain tumor patients treated with interferon and steroid]. PMID- 3831176 TI - [Experimental study on the correlation between the antitumor activity and pharmacokinetics of cytosine arabinoside (Ara-C) and N4-behenoyl-1-beta-D arabinofuranosylcytosine (BH-AC)]. PMID- 3831177 TI - [A study on the contact effects producing radioresistance of uterine adenocarcinoma]. PMID- 3831178 TI - [Intravenous thrombolysis by urokinase in acute myocardial infarction]. PMID- 3831179 TI - [Measurements and comparisons of gastric emptying and esophageal manometry in patients with reflux esophagitis]. PMID- 3831180 TI - [The 1982 revised criteria of American Rheumatism Association for the classification of systemic lupus erythematosus: a review of 126 patients]. PMID- 3831181 TI - [The studies of cardiac function according to activities of daily life (ADL) classification in myotonic muscular dystrophy]. PMID- 3831182 TI - [Hemodynamics of splenic artery aneurysm]. PMID- 3831183 TI - [A case of idiopathic retroperitoneal fibrosis associated with localized swelling and pain on bilateral lower legs]. PMID- 3831184 TI - [A relived case by plasma exchange in serious complications of quinidine induced thrombocytopenic purpura]. PMID- 3831185 TI - [The coexistence of rheumatoid arthritis and systemic lupus erythematosus accompanied with Marfan syndrome (forme fruste) in two sisters]. PMID- 3831186 TI - [Lupus cystitis: a report of four cases]. PMID- 3831187 TI - [Diagnostic imaging of cardiovascular disease. A. Diagnostic imaging of heart disease]. PMID- 3831188 TI - [Diagnostic imaging of cardiovascular disease. B. Doppler flow imaging (color flow mapping)]. PMID- 3831189 TI - [Complications of diabetes mellitus]. PMID- 3831190 TI - [Clinico-pathological studies on ischemic stricture of the small intestine]. PMID- 3831191 TI - [A family of hereditary methemoglobinemia]. PMID- 3831192 TI - [An autopsy case of Behcet's disease presenting with pulmonary manifestations and multiple organ involvement]. PMID- 3831193 TI - [A case of essential hypernatremia presumably caused by partial diabetes insipidus, upward resetting of the osmostat and hypodipsia]. PMID- 3831194 TI - [Monckeberg's sclerosis with coronary arterial calcification]. PMID- 3831195 TI - [Patient with hypoplastic leukemia successfully treated with N4-palmitoyl-1-beta D-arabinofuranosyl cytosine]. PMID- 3831196 TI - [A case of membranoproliferative glomerulonephritis accompanied by hyper-IgM immunodeficiency]. PMID- 3831197 TI - [Extracorporeal ultrafiltration method in the treatment of refractory heart failure]. PMID- 3831198 TI - [A case of Gronblad-Strandberg syndrome with coronary artery disease]. PMID- 3831199 TI - [A familial case of Marfan's syndrome]. PMID- 3831200 TI - [A case of apical hypertrophic cardiomyopathy associated with atrial septal defect--a comparison of histopathological findings in the endomyocardial specimen obtained by biopsy and the specimen of the hypertrophied portion obtained surgically]. PMID- 3831201 TI - [A case of subcutaneous eosinophilic lymphoid granuloma (Kimura's disease) associated with membranous nephropathy]. PMID- 3831202 TI - Malignant histiocytosis: report of three cases. PMID- 3831203 TI - Incontinentia pigmenti, analysis of 15 cases. PMID- 3831204 TI - Hyperprolactinemia in infertile Thai women, its incidence and treatment with bromocriptine. PMID- 3831205 TI - Rapidly progressive glomerulonephritis in Ramathibodi Hospital. PMID- 3831206 TI - Maternal mortality in Ramathibodi Hospital: a 14-year review. PMID- 3831207 TI - A study of arm and forearm circumference differences on both sides in normal Thai females with particular reference to the diagnosis of postmastectomy arm oedema. PMID- 3831208 TI - Exercise-induced ST segment elevation. A report of two cases and review of the literature. PMID- 3831209 TI - Pulmonary alveolar microlithiasis: report of five cases and literature review. PMID- 3831210 TI - Actin genes in Xenopus and their developmental control. AB - The results summarized here have established the temporal and regional activation of three kinds of Xenopus actin genes. The cardiac and skeletal muscle actin genes are among the first cell-type-specific genes to be expressed in early development. The first transcripts to be synthesized by these genes appear to be correctly initiated, spliced, and at once translated into proteins. Both cardiac and skeletal actin genes are strongly transcribed in the axial skeletal muscle of embryos. The mechanism by which the cardiac actin gene is first transcribed in only the somite region of an embryo depends, at least in part, on materials already localized in the subequatorial region of a fertilized but uncleaved egg. Cells which acquire this material seem able to activate their cardiac actin genes without requiring normal contact with other cells. PMID- 3831211 TI - Epidermal development in Xenopus laevis: the definition of a monoclonal antibody to an epidermal marker. AB - A monoclonal antibody 2F7.C7 which identifies an epidermal antigen common to both anuran and urodele amphibia is described. This antigen has a high molecular weight and is expressed at stage 12 1/2 first inside and then on the surface of epidermal cells. It is not expressed on presumptive nervous tissue. It is expressed on all cells of the larval epidermis including ciliated and nonciliated cells and sucker. The relationship of the epidermal antigen to 'epimucin' is investigated by blocking experiments using Peanut agglutinin. These studies suggest that either the molecule recognized by 2F7.C7 is not epimucin, or that its epitope is far away from the lectin-binding site. Studies using this antibody in grafting and sandwich experiments are discussed and an overall scheme of epidermal development in Xenopus is presented. PMID- 3831212 TI - Neural induction: embryonic determination elicits full expression of specific neuronal traits. AB - In Pleurodeles waltl, the early neuronal differentiation of precursor cells from late gastrula stage has been studied by culture in vitro from either isolated neural plate (NP) or isolated neural fold (NF). The aim of this study was to delineate the information acquired by ectodermal target cells during neural induction. By culturing these cells in vitro either with or without the underlying chordamesoderm, we showed that in the absence of chordamesodermal influence such NP or NF cells exhibited a high degree of biochemical and morphological differentiation as revealed by the synthesis and the storage of neurotransmitters, the activity of specific enzymes, as well as by the expression of neuronal markers: specific changes in cell surface carbohydrates, tetanus toxin binding sites and neurofilament polypeptides. Remarkable changes in the cell adhesive properties were the first events observed in the different central (NP) and peripheral (NF) types. In cocultures the chordamesodermal cells exert a beneficial influence on this differentiation, specially increasing acetylcholine synthesis. There are some differences between central (NP) or peripheral (NF) neuroblast response to this further notochord or mesodermal influence. PMID- 3831213 TI - The function and mechanism of convergent extension during gastrulation of Xenopus laevis. AB - The processes thought to function in Xenopus gastrulation include bottle cell formation, migration of cells on the roof of the blastocoel, and autonomous convergent extension of the circumblastoporal region. A review of recent and classical results shows that only the last accounts for the bulk of the tissue displacement of gastrulation, including spreading of the marginal zone toward the blastopore, involution of the marginal zone, and closure of the blastopore. Microsurgical manipulation and explantation studies, analysed by time-lapse video and cine microscopy, shows that the dorsal circumblastoporal region contains two regions which show either autonomous or semiautonomous convergent extension. The dorsal involuting marginal zone (IMZ) undergoes convergence (narrowing) and extension (lengthening) after its involution, beginning at the midgastrula stage and continuing through neurulation, such that it simultaneously extends posteriorly across the yolk plug and narrows the blastoporal circumference. Concurrently, the corresponding region of the overlying non-involuting marginal zone (NIMZ) begins a complementary convergent extension, but at a greater rate, which spreads vegetally to occupy surface area vacated by the IMZ. Tissue recombination experiments show that the deep cells of the dorsal IMZ bring about convergent extension. Labelling of small populations of these cells with a cell lineage tracer shows that convergent extension involves intercalation of deep cells to form a longer, narrower array. Direct time-lapse video and cine micrography of deep cells in cultured explants show that convergent extension involves radial and circumferential intercalation. Removal of the entire blastocoel roof of the early gastrula, including all or part of the NIMZ, shows that convergent extension of the IMZ alone can bring about its involution and blastopore closure. The role of convergent extension in gastrulation of other amphibians and other metazoans and its significance to related problems in early development are discussed. PMID- 3831214 TI - Evidence for the role of fibronectin in amphibian gastrulation. AB - In amphibian embryos, fibronectin (FN) assembles as a fibrillar network on the roof of the blastocoel cavity, preceding mesodermal cell migration. Local inversion of the ectoderm to produce a site where no FN is available prevents mesodermal cell migration. Microinjection of monovalent antibodies to FN arrests gastrulation. A complete inhibition of mesodermal cell migration is obtained after microinjection of a synthetic peptide containing the cell binding site sequence of FN. Prevention of interactions between receptors and FN appears to be the primary cause for blockage of gastrulation. PMID- 3831215 TI - Chromosome replication in early development of Xenopus laevis. AB - Eggs of Xenopus laevis contain exceptionally large amounts of materials involved in chromosome replication. This maternal stockpile allows an embryo to produce about 80 000 cells in less than 24 h. The adaptations which achieve this involve the mechanisms of both DNA replication and chromatin assembly. PMID- 3831216 TI - Single cell analysis of commitment in early embryogenesis. AB - Fate maps of amphibian embryos tell us the destination of certain areas at later stages of development. After studying Vogt's fate maps, Spemann wrote (in 1938) that "the question which at once calls for an answer is whether this pattern of presumptive primordia in the beginning gastrula is the expression of a real difference of these parts, whether they are already more or less predestined or 'determined' for their ultimate fate, or whether they are still indifferent and will not receive their determination until a later time." Until recently answers to this question have relied upon explant experiments, which indicate that by the late blastula stage ectoderm, mesoderm and endoderm regions are distinctly determined. By using a method involving single cell labelling and transplantation, it is now possible to pinpoint more accurately the time during early embryogenesis at which individual blastomeres become committed. In the vegetal pole, determination towards endoderm is a gradual process beginning during the middle blastula stage (stage 8) and completed by the beginning of gastulation (stage 10). This method offers the possibilities of comparing the committed and the uncommitted state and studying at a molecular level the mechanisms of cell determination. PMID- 3831218 TI - Inductive interactions in early amphibian development and their general nature. AB - After a short discussion on cell interactions in general and inductive interactions in particular, the almost completely epigenetic nature of amphibian development is emphasized. In the symmetrized egg undergoing cleavage a large scale inductive interaction occurs which leads to the formation of the meso endoderm. Meso-endoderm formation gives rise to the morphogenic process of gastrulation. In the ensuing triple-layered embryo inductive interactions are strongly enhanced. The following large-scale inductive interaction leads to the formation of the neural anlage. This is again followed by the morphogenetic process of neurulation or neural tube formation. Subsequent interactions between the germ layers of the triple-layered embryo give rise to the formation of the regional pattern of organ anlagen. Finally, the most promising approaches to the nature of inductive interactions for mesoderm and endoderm formation are discussed. PMID- 3831217 TI - Cell lineage labels and region-specific markers in the analysis of inductive interactions. AB - This paper reviews work with cell lineage labels and cell-type specific markers in the analysis of inductive interactions in early amphibian development. Our results provide clear evidence for the existence of three such interactions. Mesodermal induction occurs in the early blastula and results from the action of vegetal pole cells on the animal hemisphere. At least two mesodermal rudiments are formed, one dorsal and one ventral. During the next interaction, which we call dorsalization, the ventral mesodermal rudiment becomes subdivided into several territories under the influence of the dorsal marginal zone, or organizer. Finally, during gastrulation, the involuting organizer induces neural tissue from the overlying ectoderm. This interaction is called neural induction. Although these phenomena can readily be demonstrated under experimental conditions, direct evidence that they occur in normal development awaits an understanding of the molecular basis of induction. PMID- 3831220 TI - The role of gap junctions in amphibian development. AB - The possibility that communication through gap junctions may be important during embryonic development has often been raised since gap junctions were first described between early embryonic cells. It is now known that this direct cell-to cell communication pathway disappears between groups of embryonic cells with different developmental fates as the embryo progresses through development, suggesting that transfer through the gap junctional pathway may play some part in controlling events during development. Supportive evidence for a role for gap junctions comes from experiments demonstrating that the properties of gap junctions differ at the border separating each segment in insect epidermis. Recently it has been shown that the ability to exchange small dyes between cells in the amphibian embryo depends on the position of each cell with respect to the grey crescent. When communication through gap junctions is prevented, by injecting antibodies to gap junctions protein, pattern formation is severely disturbed in the non-communicating region. The paper describes experiments on the pattern of junctional communication at early stages of development of the amphibian embryo and illustrates how anti-gap junction antibodies are being used to determine when and where communication through gap junctions may play an important role during development. PMID- 3831219 TI - Intracellular pH and ribosomal protein S6 phosphorylation: role in translational control in Xenopus oocytes. AB - The induction of amphibian oocyte maturation with progesterone as well as the activation of sea urchin eggs at the time of fertilization result in increased protein synthesis. The increase in both cases involves the recruitment of maternal mRNA onto polysomes. Further, it has been reported that sea urchin eggs, like full-grown Xenopus oocytes, contain no spare translational capacity based on the observation that injected heterologous mRNA is translated only at the expense of endogenous messages. The nature of the limiting component defined by such experiments is not known, but two factors which have been proposed to play a role in regulating protein synthesis are ribosomal protein S6 phosphorylation and intracellular pH. In the current paper, we review the literature and present new evidence on the roles intracellular pH and S6 phosphorylation have in regulating protein synthesis in Xenopus oocytes. We report that pHi does not increase between stage 3 and stage 6, yet the protein synthetic rate increases at least eight fold during the same period. Hence, we conclude that increasing pHi is not a prerequisite for increasing protein synthesis. Moreover, we present three arguments against increased ribosomal protein S6 phosphorylation being sufficient or necessary for increased protein synthesis S6 phosphorylation being sufficient or necessary for increased protein synthesis in Xenopus oocytes. First, the level of S6 phosphorylation does not increase between stages 4 and 6, a period exhibiting a two to three fold increase in protein synthesis. Second, the injection of globin mRNA into stage-4 oocytes increases total protein synthesis two to three fold, but has no effect on S6 phosphorylation. Third, when the injection of globin mRNA into stage-4 oocytes is followed by an injection of MPF, a dramatic increase in S6 phosphorylation is seen, but total protein synthesis is not further stimulated. PMID- 3831221 TI - The system specifying body position in the early development of Xenopus, and its response to early perturbations. AB - Evidence is presented that the system setting up preliminary specifications for contributions to the axial body plan, across vegetal regions of the Xenopus embryo, acts in a widespread way at early stages. Mechanisms that regulate the spatial profile of this primary positional variable, and thus ensure the constancy and harmony of the body plans normally achieved, have lost this integrative ability by the 4-cell stage one hour after the plasm shifts that precede first cleavage and symmetrize the egg. Abnormal, partial or distorted profiles of the positional system across whole eggs or isolates, recorded by these times, are retained to give correspondingly partial or imbalanced mes/endodermal pattern at tailbud larval stages. There is evidence that subsequent 'back-up' positional interactions, which can heal gross positional discontinuities in isolated presumptive lateral half-eggs and so restore bilateral symmetry, also do this at the price of loss of complete pattern specification. This is probably because of an asymmetrical principle whereby relatively activated (dorsoanterior specified) material can raise the level of originally posterior material on contact, whereas the reverse interaction cannot occur. The observations are discussed in relation to apparently different behaviour in certain other amphibian embryos, and to our knowledge of other positional interactions, normal and also experimentally provoked, such as those that set up the germ layers. PMID- 3831222 TI - Cytoplasmic localization and chordamesoderm induction in the frog embryo. AB - The experiments described here were designed to reveal the distribution in the frog early embryo of components which are sufficient for specification of the dorsal structures of the embryonic body axis. The approach was to allow cleavage planes to divide the embryo into various well-defined regions and to transplant cells from each region into recipient embryos which would otherwise fail to form axial structures. Partial or complete body axis development could then be scored by the use of external criteria or histological methods. Recipients were embryos which had been irradiated before first cleavage with ultraviolet light on the vegetal surface. Irradiated embryos display a well-characterized set of deficiencies in the dorsal structures of the body axis, but their development can be 'rescued' toward normalcy in several ways. In particular, transplantation of certain small groups of blastomeres from the normal 32- to 64-cell embryo into irradiated recipients was sufficient to cause partial or complete axis development. Cell groups which could cause rescue were located in the vegetal and equatorial levels of one quadrant of the normal embryo--the quadrant centered on the future dorsal midline. Clonal marking analysis showed that the vegetal-most cells of this quadrant contribute primarily to endodermal structures in normal development. In rescued recipient embryos, these cells also contributed only to the endoderm; the dorsal mesoderm and central nervous system were formed exclusively by host cells which originated near the transplant. Rescue could also result from transplantation of equatorial cells from the dorsal quadrant of the normal embryo. As in normal development, these cells formed primarily the chordamesoderm of the rescued embryo. Host cells were induced to contribute the somitic mesoderm, central nervous system, and other structures which would have been missing but for the presence of the transplanted cells. The frequency and degree of rescue caused by equatorial and vegetal transplants is variable. This was explained by the discovery that the location of components needed for rescue varies among individual embryos without regard to the positions of cleavage planes. This was true even when donor embryos were selected on the basis of a precisely regular pattern of cleavage. In such selected embryos, particular blastomeres make a predictable contribution of progeny to the body axis. Thus it may be that the positions of components which can cause axis formation vary without exact regard to the fate map of prospective areas. The implications of this for the study of cytoplasmic localization in the early embryo are discussed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3831223 TI - Proteoglycans from human articular cartilage: the effect of joint location on the structure. AB - Proteoglycan monomers from the articular cartilages of the knee, hip and shoulder of 3 subjects (21, 26 and 45 years old) were isolated and analysed. The proteoglycan monomers from the high weight-bearing knee and hip joints were smaller than those from the low weight-bearing shoulder joints and both had a lower chondroitin sulphate content. The proteoglycan monomers from knee joint cartilage had the lowest intra-individual chondroitin-4-sulphate content in each case. Hyaluronate binding capacity was not found to be dependent on joint location. PMID- 3831224 TI - Determination of haemoglobin in gastric aspirates. AB - The haemoglobin content of gastric aspirates can be quantitated by conversion of non-fluorescent haem to fluorescent porphyrins by heating gastric aspirates with oxalic acid and ferrous sulphate. Recovery of haemoglobin added to gastric aspirates was 92 +/- 9%, variation coefficient, n = 52, day to day variation less than 8%. This method was used to calculate blood (haemoglobin) loss in 211 (24 hours) gastric aspirates obtained from 58 intensive care patients. Gastric blood loss was also measured by the 51Cr radiolabelled erythrocytes method in the same samples. There was a good linear correlation (r = 0.942, p less than 0.001) between the two methods. The fluorimetric method of quantitating haem is therefore suitable for detecting and measuring blood loss in gastric contents. PMID- 3831225 TI - A programme for post-graduate training and quality control in blood cell morphology. AB - The programme presented can be considered as a combination of permanent education with quality control carried out on a regional level. The selection procedure of blood smears for distribution will be discussed. The sensitivity and specificity are tested of many frequently occurring haematological abnormalities. PMID- 3831226 TI - A comparison of reference method values for sodium, potassium and chloride with method-dependent assigned values. AB - The concentrations of sodium, potassium, and chloride in various control sera were determined by reference methods. The reference method values were compared with the corresponding method-dependent assigned values. Sodium: Measurements by flame photometry and ion selective electrodes differed on the whole by less than 1% from the reference method value; determinations by photometry differed, however, by -4.7%. Potassium: The mean bias was -1.2% with flame photometry and 0.4% with ion selective electrodes, whereas nephelometric procedures differed by 1.9 or -4.8%. Chloride: Satisfactory agreement was obtained with values given for ion selective electrodes (-0.3%), for some coulometric procedures (-0.7 and 0.4%), and photometric determinations using mercury rhodanide (-0.5 and +0.7%). Values for mercurimetric titration and for photometric determinations using mercury 2,4,6-tri-(2-pyridyl)-s-triazine differed by + 2.5 and + 1.8%. Proposals concerning the allowable deviation from reference method values are discussed. PMID- 3831227 TI - [Stability of steroids in plasma over a 10-year period]. AB - In order to examine whether plasma samples may be used for steroid analysis after long periods of storage, cortisol, testosterone, oestrone and oestradiol were remeasured in samples, which had been analysed 1.3-10.8 years earlier. The method for the measurement of these steroids was unchanged over this period. The results demonstrate that at a temperature of -25 degrees C steroids remained stable. Only cortisol and testosterone concentrations showed a small, insignificant decrease (6-9%) after 3 to 4 years of storage. These differences are well within the range of the precision of the method (interassay variation), which over a period of 11 years was 9.4%, 8.0%, 10.0% and 9.5% for cortisol, testosterone, oestrone and oestradiol, respectively. It is concluded that steroid hormones in human plasma are stable in our laboratory, and that they might be analysed even after more than 10 years of storage at -25 degrees C. PMID- 3831228 TI - [Determination of the lactate concentration in plasma using L lactate:ferricytochrome c-oxidoreductase and tetraxolium salt]. AB - A method is described for the determination of lactate in plasma using cytochrome b2, with tetrazolium salt as an electron acceptor. The chief advantages over the usual methods of lactate determination are high sensitivity, satisfactory specificity, high absorbance, use of the visible region of the spectrum, and low cost. PMID- 3831229 TI - [New method for the continuous determination of the catalytic activity of pancreatic carboxylesterase]. AB - A new method is reported for the continuous determination of the catalytic activity of pancreatic carboxyl esterase. 1-Naphthyl butyrate is employed as the substrate. The released 1-naphthol is coupled with a new colour reagent, 2,6 dichloroquinone-4-chloroimide. The intensity of the resulting colour is directly proportional to the enzyme activity. Preliminary reference values for serum and pancreatic secretion are reported. PMID- 3831230 TI - International Federation of Clinical Chemistry, Education Committee: and International Union of Pure and Applied Chemistry, Division of Clinical Chemistry: guidelines (1985) for clinical chemists for effective communication of clinical chemistry laboratory data. PMID- 3831231 TI - International Federation of Clinical Chemistry, Education Committee and International Union of Pure and Applied Chemistry, Division of Clinical Chemistry: definition of the terms certification, licensure and accreditation in clinical chemistry. PMID- 3831232 TI - Influence of cysteine deprivation on chlamydial differentiation from reproductive to infective life-cycle forms. AB - The effects of omission of individual amino acids from growth medium on the differentiation of Chlamydia trachomatis DK-20 (serotype E) during infection of cycloheximide-treated McCoy cells are described. As judged by inclusion body staining with acridine orange, omission of cysteine from the medium severely retarded differentiation of reproductive reticulate body (RB) to infective elementary body (EB) forms. The effect appeared specific to cysteine in that omission of other amino acids had little or no effect on differentiation once RBs appeared. On restoration of cysteine, culture infectivity increased and inclusions contained organisms which, by cytochemical and morphological criteria, were differentiating to infective forms, indicating that cysteine deprivation did not irreversibly inhibit differentiation. Impairment of RB to EB differentiation in cysteine-less medium was also observed for three strains of Chlamydia psittaci and 10 other strains of C. trachomatis. It is suggested that the effect arises via the biosynthetic requirement for cysteine for provision of three cysteine rich proteins, whose synthesis and insertion into the outer membrane have previously been shown to accompany RB to EB differentiation of C. psittaci 6BC and C. trachomatis 434 (serotype L2). Synthesis of cysteine-rich outer membrane proteins during differentiation may thus be common to all chlamydiae. PMID- 3831233 TI - Quantification of DNA uptake by Dictyostelium discoideum amoebae and the stability of the DNA during growth and development. AB - We have developed a simple and accurate method to determine the amount of intact plasmid DNA taken up and retained by Dictyostelium discoideum amoebae during various transformation protocols. We have used this method to compare the efficiency of three different methods for introducing foreign DNA into D. discoideum amoebae. Both a calcium phosphate and a spheroplast fusion procedure gave good uptake, but no intracellular plasmid DNA was detectable after calcium chloride treatment. The exogenous DNA was rapidly lost after transformation but was 20-fold more stable during starvation rather than growth conditions, suggesting a possible approach to improving transformation efficiency. No transient expression of neomycin phosphotransferase activity of any of the heterologous animal or plant promoters used could be detected using a sensitive gel assay procedure. PMID- 3831234 TI - Characterization of the anomalous infection and nodulation of subterranean clover roots by Rhizobium leguminosarum 1020. AB - Anomalous nodulation of Trifolium subterraneum (subterranean clover) roots by Rhizobium leguminosarum 1020 was examined as a model of modified host-specificity in a Rhizobium-legume symbiosis. Consistent with previous reports, these nodules (i) appeared most often at sites of secondary root emergence, (ii) were ineffective in nitrogen fixation and (iii) were as numerous as nodules formed by an effective Rhizobium trifolii strain. R. leguminosarum 1020, grown on agar plates or in the clover root environment, did not bind the white clover lectin, trifoliin A. This strain did not attach in high numbers, and did not induce shepherd's crooks or infection threads, in subterranean clover root hairs. However, R. leguminosarum 1020 did cause branching, moderate curling and other deformations of root hairs. The bacteria probably entered the clover root through breaks in the epidermis at sites of lateral root emergence. The anomalous nodulation was inhibited by nitrate. Only trace amounts of leghaemoglobin were detected in the nodules by Western blot analysis. The nodules were of the meristematic type and initially contained well-developed infection, bacteroid and senescent zones. Infection threads were readily found in the infection zone of the nodule. However, the bacteroid-containing tissue senesced more rapidly than in the effective symbiosis between subterranean clover and R. trifolii 0403. This anomalous nodulation of subterranean clover by R. leguminosarum 1020 suggests a naturally-occurring alternative route of infection that allows Rhizobium to enlarge its host range. PMID- 3831235 TI - Comparative electrophoretic profiles of esterases, and of glutamate, lactate and malate dehydrogenases, from Aeromonas hydrophila, A. caviae and A. sobria. AB - Esterases, and glutamate, lactate and malate dehydrogenases of 64 Aeromonas hydrophila, A. caviae and A. sobria strains, were analysed by polyacrylamide agarose gel electrophoresis and by thin layer isoelectrofocusing. On the basis of the isoelectric points of malate dehydrogenase from the three species and the mobility of lactate dehydrogenase from A. sobria, 8 species specific zymotypes were defined: three for A. hydrophila strains, three for A. caviae strains and two for A. sobria strains. These zymotypes correlated with previously established DNA hybridization groups. The other electrophoretic data were found to be less useful for distinction between A. hydrophila and A. sobria strains, but supported differentiation into zymotypes for A. caviae strains. The two-dimensional electrophoretic profile established by plotting isoelectric point against electrophoretic mobility of the major esterase illustrated the degree of enzyme polymorphism among the strains of the three species. Variation in electrophoretic patterns within A. hydrophila and A. caviae might provide useful epidemiological markers. PMID- 3831236 TI - Social interaction and interpersonal distance in normal and behaviorally disturbed boys. AB - Frequency of social interaction and interpersonal distance of 24 normal and 24 behaviorally disturbed white, preadolescent boys were examined. Each child's behavior was analyzed from videotapes that were recorded during four 60-min sessions, during which time the child played with the same unfamiliar peer, matched for age and emotional functioning. The results indicated that the frequency of global social interactions was a powerful discriminator between normal and disturbed boys at the older but not at the younger age levels. Proximity to peers and adults also was a powerful discriminator at both age levels. These results were discussed in relationship to the development of social skills in preadolescent children, the need to establish criteria for social competence, and the evaluation of social skills training programs from a development perspective. PMID- 3831237 TI - A factor analytic investigation of children's nighttime fear and coping responses. AB - Checklists of children's nighttime fears and nighttime coping responses, completed by 178 8- to 13-year-old children and one of their parents, were factor analyzed. The resulting factors from each checklist were comparable for children and parents. The nighttime fear categories consisted of content around security either for one's personal life, loss, or safety or for others' safety and continued presence; imaginal-numinous concerns; and characteristics inherent in a nighttime situation. The coping categories consisted of responses related to internal self-control, social support, support from inanimate objects, prayer, and avoidance or escape either by controlling the inanimate environment or by controlling others. PMID- 3831238 TI - Metacognitive components of visual search in children. AB - Two studies examined children's increasing ability to analyze tasks in terms of the perceptual features that affect task difficulty. Of particular interest was any understanding that perceptual confusions occur during the search for an object surrounded by objects similar in shape or color to that object. In Study 1, 32 pre-schoolers constructed arrays intended to make the search easy or difficult. They made the search difficult simply by putting many toys into the toy box. In a forced-choice situation, they indicated that task difficulty was influenced by the number of objects and the similarity in color and shape of the targets and the surrounding objects. Study 2 more thoroughly examined knowledge of color and shape confusions, using 96 children from Grades K, 1, 3, and 4, assigned to two age groups. The older children but not the younger ones showed a significant understanding of color and shape confusions. Both age groups understood that performance is affected by a person's interest level and degree of attention to the task. The results were discussed in terms of the accessibility of the children's knowledge under different conditions. PMID- 3831239 TI - Family constellation, social competence, and sex-role development. PMID- 3831240 TI - Childhood hemophilia: application of a measure of self-reported psychosocial distress. PMID- 3831241 TI - Cognitive reliability of the sense of touch confronted with the thinning effect. AB - The dependence of the cognitive function of the sense of touch of the area sensorium was investigated by means of the thinning illusion produced by rotating the cylindrical rod between the thumb and the forefinger. The genetic phases of this illusion were traced from sensations to perceptions and to meaningful cognition converting the rod's objective convexity into an apparent concavity, running seemingly around the rod. Adult subjects (N = 52) experimentally checked all variables on their optimum degree for producing this illusion, which showed an effective way for using illusions for a thorough investigation of mental synthetic processes. PMID- 3831242 TI - Progression of age changes in mature mouse motor nerve terminals and its relation to locomotor activity. AB - There is indirect evidence for morphologic 'turnover' of motor nerve terminals, but the consequences in terms of changing nerve terminal structure throughout mature lifetime are unknown. Therefore, quantitative morphometry of nerve terminals stained with zinc iodide-osmium was carried out in soleus and extensor digitorum longus (EDL) muscles of CBF-1 mice at various ages from 5 to 32 months. Because of previous questions as to the role of disuse in producing age changes in nerve terminal structure, locomotor activity was recorded for an average of 20 days continuously in mice spanning the same ages. The length, area, perimeter and tortuosity of nerve terminals increased either early in maturity (soleus) or progressively with age (EDL). Another prominent change, i.e. increased numbers of nerve terminal 'regions' (branches or boutons that are spatially separate or only connected by fine nerve filaments) per junction, only appeared late in life (at or after 25 months). This regionalization was characteristic of all terminals and involved a redistribution rather than an accretion of nerve terminal area. None of the morphological changes with age sufficiently account for previously reported physiologic findings in the same muscles. Locomotor activity (including peaks and troughs of daily activity and circadian rhythm) was not significantly altered over the period of mature lifetime in which nerve terminals were remodelling; therefore, disuse was not a factor in this process. However, slightly retarded and smaller age changes in soleus than in EDL nerve terminals may reflect a modifying effect of activity. It is inferred that two major processes account for morphologic alterations in nerve terminals of mature mice: changes that are simple continuations of normal development and late changes that reflect newly arising age-dependent extrinsic or intrinsic factors. PMID- 3831243 TI - Freeze-fracture study of the mechanoreceptive digital corpuscles of mice. AB - The freeze-fracture replication technique was used to study the mechanoreceptive digital corpuscles in toe pads of mice. The axon terminal plasmalemma had intramembranous particles (IMPs) at a density of 2367 +/- 517 microns-2 (mean +/- S.E.M.) in the P-face and 84 +/- 4 microns-2 in the E-face. Particles were 10 +/- 1.8 nm in diameter in the P-face and 10 +/- 1.5 nm (mean +/- S.D.) in the E-face. Particle-rich and particle-free areas were noted in the P-face. The lamellar cell plasmalemma had IMPs at a density of 3359 +/- 224 microns-2 in the P-face and 265 +/- 95 microns-2 in the E-face. Particles were 10 +/- 1.4 nm in diameter in the P face and 10 +/- 1.6 nm in the E-face. Non-terminal unmyelinated fibres in the connective tissue compartment of toe pads were also examined: the P-faces of the axolemma and Schwann cell plasmalemma had IMPs at a density of 1356 +/- 283 microns-2 and 1514 +/- 514 microns-2, respectively, while the E-face of these membranes had only a few particles. Particles were 9 +/- 1.2 nm and 10 +/- 1.6 nm in diameter in the P-faces of axon and Schwann cell plasmalemmata, respectively. The results show that the IMPs in terminal axolemma and in lamellar cell plasmalemma have a much higher density than those of non-terminal axons or Schwann cells in myelinated and unmyelinated fibres. In addition, IMPs in the terminal axolemma are larger than those in non-terminal axolemma except for the nodal axolemma. It can be said that plasmalemmata of both the axon terminals and lamellar cells of digital corpuscles are specialized in terms of IMPs, suggesting that they have specific physiological properties in mechanoreceptive functions including mechano-electric transduction. PMID- 3831244 TI - Filipin-sterol complexes at nodes of Ranvier. AB - Using the filipin-sterol technique, regional heterogeneity in the axonal and Schwann cell plasma membranes was investigated at the node of Ranvier and paranodes. Filipin-sterol complexes were abundant at the nodal axolemma but infrequent throughout the paranodal axolemma. The paranodal Schwann cell plasma membrane was rich in complexes which extended over the nodal Schwann cell microvilli. There were no regional differences in filipin labelling of the nodal paranodal Schwann cell plasma membrane in relation to features such as paranodal cytoplasmic columns or mesaxonal furrows. However, the paranodes of adjacent Schwann cells were sometimes markedly different from each other in the amount of filipin labelling. The extent to which filipin labelling is indicative of cholesterol membrane content is discussed and the findings are related to current concepts of distribution, mobility and interaction of protein and lipid in biomembranes, with particular reference to the nodal axolemma. PMID- 3831245 TI - Axo-glial relations in the retina-optic nerve junction of the adult rat: freeze fracture observations on axon membrane structure. AB - The axolemmal ultrastructure of nerve fibres within the retina-optic nerve junction (ROJ) from adult rats was examined by freeze-fracture electron microscopy. In the juxtaocular (proximal) region of the ROJ, all fibres are unmyelinated. The axons generally have a membrane ultrastructure similar to that of retinal nerve fibre layer axons, with a high density of intramembranous particles (IMPs) on the P-fracture face and a low density of IMPs on the E-face. However, along some axons in this region of the ROJ, localized aggregations of E face IMPs are observed. At levels of the ROJ closer to the optic nerve proper, the unmyelinated fibres enter a transition zone in which the axons acquire myelin sheaths. By the distal boundary of the transitional zone (optic nerve proper), virtually all fibres are myelinated. Within the transitional zone, conventional axo-glial associations and axolemmal ultrastructure is present at nodes of Ranvier. In addition, atypical axo-glial relationships and atypical nodal segments are observed in this region. At some nodes, an isolated oligodendroglial process, the axolemma usually displays a paranodal-like ultrastructure. Finger like oligodendroglial processes were also observed in association with non-nodal unmyelinated axon membrane. At these sites of association, the axon membrane tends to be indented and may have a paranodal-like morphology. Nodal axolemma may exhibit several atypical forms in the transition zone. At some nodes, the nodal axolemma has a low density of E-face particles. Also, nodes of extended linear length (approximately 2 micron) exhibit a lower-than-normal density of P-face IMPs. At heminodes, the axolemma immediately adjacent to the terminal loops lacks the usual nodal characteristics of high IMP density and high percentage of large particles. The results show that aberrant axo-glial associations accompanied by unusual ultrastructural characteristics of the axolemma are present in the ROJ of normal adult rats. PMID- 3831246 TI - Ultrastructure of the segmental giant neuron of crayfish. AB - The ultrastructure of the crayfish segmental giant (SG) neuron is described, and compared to other identified and unidentified crayfish neurons. The SG was specifically stained by intracellular injection of horseradish peroxidase and is divided into four regions of interest. In the dorsal region, finger-like dendrites of the SG make contact with the through-conducting giant fibres (GF). These contacts are physiologically defined rectifying electrical synapses. They are characterized by the presence of 30-95 nm agranular vesicles in the presynaptic GFs, some postsynaptic density in the SG, and a narrowing of the intermembrane cleft to approximately 5 nm. There is little evidence for connecting cytoplasmic bridges. Unidentified neurons make chemical input with either round or elliptical vesicle types onto SG bottlenecks close to the electrical synapses. Ventral to the GFs, dendritic profiles of the SG make three sorts of contact with unidentified neurons. (a) Regions of close membrane apposition (approximately 5 nm) are presumed to be electrical output synapses, but there are no vesicles such as at the input synapses, and, again, little sign of connecting bridges. (b) Chemical input is received from unidentified presynaptic neurons containing either round or elliptical vesicles. These synapses are characterized by 30-75 nm presynaptic agranular vesicles, widened cleft (approximately 20 nm), granular cleft material and postsynaptic density. There is no sign of any presynaptic density. (c) Very occasional SG profiles containing vesicles and making output synapses to unidentified neurons occur. In the lateral neuropil at the edge of the ganglion the SG gives rise to a small tuft of very fine dendrites. These are nearly all laden with vesicles and ramify in a complex region of neuropil containing many small profiles which are also vesicle-laden. The SG axon diminishes in diameter as it progresses along its peripheral nerve root, and finally terminates at a blind ending near the base of the swimmerets. It is sheathed along its entire length, and there is no sign of vesicles within it. We conclude that the SG axon makes no peripheral output. PMID- 3831247 TI - Ultrastructural studies of the nucleus ambiguus in cat and monkey following injection of HRP into the vagus nerve. AB - The fine structure of retrogradely labelled neurons in the nucleus ambiguus (NA) has been examined in cat and monkey (Macaca fascicularis) following injections of horseradish peroxidase (HRP) into the vagus nerve. Many retrogradely labelled neurons were observed in the NA although unlabelled neurons were also present within the boundaries of the NA as identified by the distribution of retrogradely labelled cells. In both species a wide range of sizes of labelled neurons (20-60 microns in long axis) was observed from rostral to caudal levels of the NA. Large labelled neurons were generally oval or spindle-shaped while smaller neurons were oval in cross-section. Unlabelled neurons observed among labelled NA neurons tended to be smaller on average than the labelled neurons and ranged in size from 15 to 30 microns in long axis. The unlabelled neurons typically had nuclei which were more invaginated than those of the labelled neurons. Quantitative analyses of the synaptic organization in the NA revealed high proportions of terminals containing round vesicles and making asymmetrical or symmetrical contact with the somata in both monkey and cat. Terminals containing pleomorphic vesicles and making symmetrical contact with somata were slightly less numerous. Retrogradely labelled neurons exhibited a positive correlation between the size of neuron and density of synapses on the surface. There tended to be a greater synaptic density on monkey NA neurons than on cat NA neurons of comparable size. PMID- 3831248 TI - Development of the mature distribution of synapses on fibres in the frog sartorius muscle. AB - Most of the fibres in mature frog sartorius muscle possess two or more synapses separated by up to one-third the length of the muscle. The aim of the present work was to determine how the relative distances between these synapses changes during development in the frog (Limnodynastes tasmaniansis), as the fibres increase in length from 2 mm (stage 56) to 20 mm (1 year postmetamorphosis). At the earliest stage investigated (fibres 2.0-4.0 mm in length; stages 56-57) about 80% of the fibres were innervated at two endplates. The percentage of fibres with two endplates then remained approximately constant with further development. The polyneuronal innervation of endplates was almost eliminated by stage 57. Muscle fibres with two endplates had each situated on average about one-third the length of the fibre from a tendinous insertion; these relative positions did not change throughout development. Thus the distance between endplates increased linearly with an increase in fibre length. The size of terminals and the complexity of their branching also increased continually throughout development, independently of the location of the terminals on the fibres. The observations suggest that the distance between terminals increases during development because of the intercalation of new plasma membrane and basal lamina associated with the increase in length and diameter of fibres. PMID- 3831249 TI - Freeze-fracture analysis of synaptogenesis in glomeruli of mouse olfactory bulb. AB - The relationship between intramembranous particle (IMP) aggregates appearing on the extracellular leaflet (E-face) of the postsynaptic membrane and postsynaptic densities was examined by electron microscopy during mouse olfactory bulb development. During prenatal development the IMP aggregates first increased in size and then decreased in size to the adult level, while the length of the postsynaptic densities tended to increase to a plateau. Concomitant with the size change, the shape of the IMP aggregates appeared to change during development from small, round clusters to large, anastomotic aggregations. Some of the IMP aggregates appeared to have a particle-free area in their centre. As development proceeded, the overall IMP density increased. The density of particles measuring 7-11 nm remained unchanged throughout prenatal life and decreased in the adult. These particles may be involved in stabilization of initial contacts and maintenance of mature synapses, rather than representing receptors or ion channels which would be expected to increase during development. The density of particles smaller than 7 nm increased prenatally, decreased at birth, then increased in the adult. These particles may represent two or more different macromolecules, one important in synaptogenesis, the other important in adult synapses. PMID- 3831250 TI - Clinical comparison of automated auscultatory and oscillometric and catheter transducer measurements of arterial pressure. AB - Arterial pressure measurements recorded from a radial artery catheter-transducer (RAC) system were compared with similar data obtained from an automated sphygmomanometer that uses both oscillometric (OSC) and auscultatory measurement techniques. Data were obtained from 50 patients during and immediately after surgery. The fundamental frequency of the RAC system was 23.7 +/- 6.7 Hz (mean +/ SD; range, 13 to 40 Hz), and the damping coefficient was 0.26 +/- 0.06 (mean +/- SD; range, 0.15 to 0.34). Linear regression analysis of RAC against OSC values (n = 385) revealed the following correlations: (1) systolic pressure: OSC = 0.92(RAC) + 3.5, r = 0.91; (2) diastolic pressure: OSC = 0.92(RAC) + 1.3, r = 0.76; and (3) mean pressure: OSC = 0.96(RAC) + 0.68, r = 0.84. There were significant differences between each pair of pressure values; mean percent differences (RAC pressure minus OSC pressure) were 4.5 +/- 0.3%, 5.5 +/- 0.7%, and - 2.7 +/- 0.5% for systolic, diastolic, and mean values, respectively. Manual and automated auscultatory measurements closely agreed, and both correlated well with OSC values for systolic and diastolic pressure. However, both manual and automated auscultatory, as well as OSC measurements, underestimated RAC systolic and overestimated RAC diastolic pressure. PMID- 3831251 TI - Tissue hypoxia distal to a Penaz finger blood pressure cuff. AB - The Penaz finger method to measure blood pressure uses a finger cuff in which the pressure level fluctuates in the vicinity of the mean arterial pressure level and thereby interferes with the circulation of blood to and from the fingertip. We measured capillary blood gases and saturation of hemoglobin in the finger during Penaz finger blood pressure (PFBP) monitoring to assess the degree to which it impairs circulation in the fingertip. Within 2.5 minutes after initiating PFBP monitoring, capillary oxygen tension (PO2) had decreased significantly, from about 71 mm Hg to between 49 and 58 mm Hg for up to 50 minutes. These changes were quite different from those occurring when an occlusive tourniquet was applied around the finger. Within 10 minutes of tourniquet application, acidosis (pH 7.25), hypercapnia (carbon dioxide tension, 59.0 mm Hg), and hypoxemia (PO2, 29 mm Hg) resulted. Within 30 seconds of releasing the PFBP cuff, capillary blood gas values were back to normal. Interspersing 30-second rest periods every 5 minutes during 35 minutes of PFBP monitoring actually decreased capillary oxygen values compared with monitoring without such rest periods. A finger pulse oximeter distal to the PFBP cuff showed desaturation from an average of 97% to 93.7%, with much variability. However, desaturation was statistically significant within 1 minute of application of the PFBP cuff. Within 1 minute the finger volume increased an average of 0.05 ml. After 1 minute the volumes varied widely and, on the average, returned to normal despite continued PFBP monitoring. PMID- 3831252 TI - Pulse oximetry. PMID- 3831253 TI - Transcutaneous oxygen tension: a physiological variable for monitoring oxygenation. PMID- 3831254 TI - Pulse oximetry for early detection of hypoxemia in anesthetized infants. PMID- 3831255 TI - Mean blood pressure algorithms. AB - Alternative methods of calculating average blood pressure are examined. It is suggested that the preferred method is calculation of the arithmetic mean if the average value itself is required. However, when blood pressure values are used to calculate other results, only the instantaneous value is appropriate in all situations. Arithmetic mean blood pressure values may be used with arithmetic mean flow values to calculate resistance, but only if resistance is constant over the interval (laminar flow). To calculate ventricular stroke work, the root mean square averages must be used because in this instance the arithmetic average yields large errors. Most monitors do not use these methods consistently to derive average blood pressure values, thus, the displayed values differ from those obtained from the appropriate calculation. Computational convenience, truncation error in averaging, or true errors in measurement or understanding of the associated physiologic state may account for observed differences. The interpretation of maximum systolic and minimum diastolic pressures with each beat requires additional considerations. Common monitoring algorithms obscure clinically important details, particularly by distorting the relationship between respiratory variation and pulse pressure. PMID- 3831256 TI - Comparison of a pulse oximeter with an ear oximeter and an in-vitro oximeter. AB - A pulse oximeter was compared with an ear oximeter for measurement of arterial hemoglobin saturation within the range of 70 to 100% in 11 healthy volunteer subjects. Two hundred seventy-seven pooled data points were obtained, and analysis was performed by means of linear regression. The accuracy was 3% (95% confidence limits). The pulse oximeter was also compared with an in-vitro oximeter, and accuracy was within 2%. The pulse oximeter was easy to use because, unlike the ear oximeter, it required no time-consuming instrument calibration or site preparation. In addition, the delays involved in taking an invasive sample, transporting it to the blood gas laboratory, and waiting for the results were eliminated. Saturation values were continually available, and placement and use of the pulse oximeter sensor caused no discomfort to the volunteer subjects. PMID- 3831257 TI - Automated monitoring of brainstem auditory evoked potentials in the operating room. AB - We monitored brainstem auditory evoked potentials in 112 patients undergoing retromastoid craniectomies for microvascular decompression. To provide information on latency changes as quickly as possible, we implemented a block averaging technique of data acquisition with automatic tracking of wave V latency, which is the most clinically useful information. A change in peak latency probably due to surgical manipulation was observed in 63% of the patients, and the change could be at least partially corrected by modification of surgical technique. Twenty percent of the 89 patients who underwent preoperative and postoperative audiometric testing showed a postoperative hearing decrement. Some patients had large intraoperative increases in latency without suffering postoperative hearing deficits, and some incurred hearing deficits even though the intraoperative latency increases were relatively small. However, patients whose brainstem auditory evoked potentials were lost during surgery, even temporarily, were likely to have postoperative hearing decrements. Patients who had deficits tended to have slightly greater increases in latency than patients without deficits, but the difference in the mean increases of the two groups was not statistically significant. Most of the deficits were small, and all resolved over time. PMID- 3831258 TI - Comparison of radial and femoral arterial blood pressures in children after cardiopulmonary bypass. AB - We compared radial and femoral arterial blood pressures in 29 patients, ranging in age from 1.25 to 17 years, during and after cardiopulmonary bypass for repair of congenital heart disease. Radial mean arterial pressure (MAP) was more than 10% lower than femoral MAP in 17 patients (58%), and in 7 of these patients (24%) radial MAP was more than 20% lower than femoral MAP. In 27 of 29 patients (93%) systolic radial pressure was 10% lower than systolic femoral pressure, and in 20 of these (69%) it was more than 20% lower. The ratio of radial to femoral pressure correlated with MAP (i.e., lower MAP produced greater differences), and the ratio of systolic radial to systolic femoral pressure inversely correlated with systemic vascular resistance index. We found no correlation between femoral minus-radial pressure difference and postoperative course. These data demonstrate that radial arterial pressure may be misleadingly low in children undergoing operation for correction of congenital cardiac defects. PMID- 3831259 TI - Pulmonary arterial catheterization before anesthesia in patients undergoing cardiac surgery. Placement of the pulmonary arterial catheter before anesthesia for cardiac surgery: safe, intelligent, and appropriate use of invasive hemodynamic monitoring. AB - Should one catheterize the pulmonary artery (PA) for cardiac surgery before or after induction of anesthesia? Issues of central importance to this question include (1) the patient's preexisting hemodynamic abnormalities, (2) cardiovascular effects of anesthetic induction drugs, and (3) hemodynamic stress caused by laryngoscopy, endotracheal intubation, and PA catheter insertion. Some clinicians use the PA catheter immediately before anesthetic induction to detect and correct acute abnormalities in preload and ventricular function. This approach has been described as being partially responsible for decreased morbidity and mortality in patients with cardiovascular disease. Hemodynamic instability during induction has been reported with many of the common anesthetic induction agents, especially in patients with poor ventricular function. Since blood pressure is the product of cardiac output and systemic vascular resistance, accurate interpretation and treatment of hypotension are possible only when these variables are provided by vigorous use of the PA catheter. Early detection of myocardial ischemia is possible with examination of acute changes in the pulmonary capillary wedge pressure tracing. However, the lack of such information can restrict even the best anesthetist. Insertion of the PA catheter in the awake patient can be accomplished effectively and with minimal risk, so long as good patient rapport, adequate premedication, and continuation of antianginal medication until the time of surgery are assured. Preinduction placement of the PA catheter provides valuable, objective information for the cardiac anesthesiologist without incurring significant risk to the patient. PMID- 3831261 TI - An algorithm for monitoring sensory evoked potentials. AB - Brainstem auditory evoked potentials (BAEP) testing is used extensively to monitor auditory function during retromastoid craniectomies for microvascular decompression. The latency between BAEP peaks can change notably over a period of several seconds or minutes, a much shorter time than is necessary to acquire and analyze a conventionally averaged BAEP. This article describes a continuous monitoring algorithm that detects both large, rapid changes in waveform and slow changes in latency. A prestimulus control interval in the response data window provides a mechanism for evaluating the reliability of the response. The algorithm tracks the latency and amplitude of a selected peak, using several checks to avoid detecting the wrong peak. The tracking mechanism is simple yet effective and eliminates the need to suspend averaging for manual measurement of peak parameters. The peak latency and amplitude are displayed immediately. The algorithm indicates gross changes in the BAEP within 30 seconds and provides reliable data on latency trends. By increasing the frequency of acquiring new waveforms, the algorithm provides more immediate information for the surgeon. PMID- 3831260 TI - Placement of the pulmonary arterial catheter before anesthesia for cardiac surgery: a stressful, painful, unnecessary crutch. AB - Catheterization of the pulmonary artery (PA) in patients with cardiac or major vascular disease is a popular practice. However, controversy surrounds the question of whether the PA catheter should be inserted before or after the induction of anesthesia. Review of the literature supports insertion after induction for several reasons. First, the information provided by a PA catheter may be misleading, since it does not provide a direct measurement of left ventricular function, but rather, an indirect reflection that is subject to many variables. Second, pharmacologic intervention before anesthesia to correct hemodynamic abnormalities detected by a PA catheter has not been shown to improve induction of anesthesia or outcome after cardiac surgery. Induction of anesthesia with synthetic narcotics in patients with either normal or abnormal hemodynamic function is fast and uneventful, making insertion of a PA catheter before induction unnecessary. Finally, the act of inserting a PA catheter produces cardiovascular stimulation that can lead to myocardial ischemia. Thus, insertion of a PA catheter can be more safely and rationally performed after the induction of anesthesia. PMID- 3831263 TI - Regulation of medical devices by the Food and Drug Administration. PMID- 3831262 TI - A faulty lumen resulting in erroneous thermodilution cardiac output measurement. PMID- 3831264 TI - Arterial pulse wave velocity: a limited index of systemic vascular resistance during normotensive anesthesia in dogs. AB - We investigated the relationship between systemic vascular resistance (SVR) and arterial pulse wave velocity (PWV) to determine if PWV might provide an index of SVR during anesthesia. A wide range of SVR measurements was obtained pharmacologically in 8 dogs during halothane anesthesia at each of three mean blood pressure (BP) ranges: low (40 to 60 mm Hg), medium (90 to 110 mm Hg), and high (140 to 160 mm Hg). For pooled data the SVR-PWV linear correlation coefficient at the low BP range was 0.44; at the medium BP range it was 0.75; in both cases p was less than 0.001. At the high BP range the correlation coefficient was -0.06 and was not significant. We conclude that only directional trends in SVR during normotensive anesthesia (medium BP range) can be estimated using arterial PWV measurements. Thus, on the basis of this study, PWV measurement cannot be used as a direct substitute for SVR measurement. Further study of SVR-PWV relationships is needed to determine if noninvasively measured PWV might provide a more accurate estimate of SVR. PMID- 3831265 TI - Umbilical catheters and arterial blood pressure monitoring. AB - The natural frequencies, damping coefficients, and accuracies of umbilical artery catheters were determined. The damping coefficients for the 3.5, 5.0, and 8.0 French catheters were 0.40 +/- 0.04 (mean +/- SD), 0.42 +/- 0.05, and 0.19 +/- 0.02, respectively. The natural frequencies were 24.2 +/- 3.2 Hz (mean +/- SD), 18.4 +/- 3.5 Hz, and 26.8 +/- 2.9 Hz, respectively. Measurements obtained with 3.5 and 8.0 French catheters were within 6% of the reference pressure at all pressures and rates tested. With the 5.0 French catheter, however, error greater than 10% from the reference pressure occurred when the rate was 200 pulses per minute or greater and the applied maximum pressure was 100 mm Hg or more. PMID- 3831266 TI - Pulse oximetry in critically ill children. AB - To confirm the clinical applicability of a commercial pulse oximeter, we compared arterial hemoglobin saturation values determined by in-vitro oximetry and pulse oximetry in 15 critically ill children. One hundred ninety-two paired hemoglobin saturations were determined by both noninvasive pulse oximetry and direct measurement of arterial blood samples. The correlation between these two methods of measurement was statistically significant (r = 0.895; p less than 0.001). The mean percentage difference between the two measurements was 1.8%. Pulse oximetry was found to be safe and less cumbersome than other methods of monitoring arterial oxygen content. Overall, pulse oximetry was precise and provided a clinically satisfactory noninvasive method for continuously monitoring arterial hemoglobin saturation in critically ill children. PMID- 3831267 TI - The posterior approach to cervical rizopathy. AB - The posterior approach to cervical rizopathy is a widely acquired technique; however only recently it encountered more favorable consideration. After a brief review of the literature, the Authors present some details of surgical approach, discuss its value and its limits with a comment on their own series. PMID- 3831268 TI - Sacrococcigeal and vertebral chordomas. Report of three cases and review of the literature. AB - Three cases of sacrococcygeal and vertebral chordoma are described. Histogenetic and anatomopathological aspects with particular reference to differential diagnosis from similarly distributed neoplasias are discussed. Anti-cytoskeleton monoclonal antibodies were used to this purpose. The clinical profile of sacrococcygeal and vertebral chordomas is characterized by a pronounced metastatic potential; radiation treatment can only partially counter their biological behaviour, while chemotherapy has proved little or no effectiveness. Where possible, radical surgery is currently the only treatment to guarantee long term survival or complete cure. Palliative surgery, associate with efficient painkilling, offers a better quality of life and slows down the progress of the disease. PMID- 3831269 TI - Mitral valve prolapse and transitory cerebral ischemia. Report on 8 cases. AB - Non-complicated mitral valve prolapse (MVP) may cause transitory ischemic attacks (TIA) of a probable micro-embolic nature, especially in young people. This study presents 119 cases of TIA, 41 occurring in patients under 45 years of age. All of the 119 patients were given a brain CT scan and associated risk factors such as dislipidemia, diabetes, arterial hypertension, polycythemia were corrected. In addition, 115 patients underwent an angiography. The 41 patients under 45 were given an echocardiogram. The 8 patients who were found to have mitral valve prolapse were submitted to a 24-hour continuous monitoring of the ECG (Holter test) and only 4 patients were given an angiography. On the basis of the results obtained the Authors propose: (1) to use CT scan and electrocardiograms to study youthful patients who have had one or more events of TIA, (2) not to give them an angiography if they suffer from MVP, (3) to conduct the Holter test on these patients and, (4) to establish a therapy using blood-platelet anti-aggregants. The use of anti-coagulants is debatable, even in cases with recurring events. PMID- 3831270 TI - Radical excision of a craniobasal tumor involving the middle cranial fossa. Technical note. AB - Craniobasal tumors affecting the middle cranial fossa are rarely treated radically; the main problem to solve is the presence of important nervous and vascular structures in this region. The Authors report a case of complete removal of a malignant tumor involving the temporal bone and the middle cranial fossa. Surgery was performed by the cooperation of the neurosurgical and the ENT teams. PMID- 3831272 TI - Large anterior communicating artery aneurysm with temporal hemianopsia. Case report. AB - Giant or large anterior communicating artery (ACOA) aneurysms producing bitemporal hemianopsia are extremely rare. A case is presented of an ACOA aneurysm measuring 2 X 1.4 cm with the patient having had a post-traumatic amaurosis of the left eye for many years. Then he had a subarachnoid hemorrhage and subsequently developed impaired vision in the right eye and temporal hemianopsia. The aneurysm was visible on C.T. but disappeared on post-operative scans. Visual acuity improved radically after treatment with neck ligation and opening of the sac. PMID- 3831271 TI - Successful treatment of a giant cystic craniopharyngioma. Case report. AB - The Authors present a case of giant cystic craniopharyngioma in a child; the tumor, diagnosed by CT scan, was completely removed. The Authors consider this cyst as the biggest one reported in the literature of the last ten years. PMID- 3831273 TI - Considerations on a case of intranasal cerebral ectopia. AB - The Authors report a case of intranasal cerebral ectopia; the problems concerning the nosographic and diagnostic definition of this condition as well as the differences from other similar pathologies with the same location (such as meningoencephalocele and nasal glioma) are discussed. Particular attention is payed to the various surgical techniques that can be used in these cases. PMID- 3831274 TI - Ossified epidural hematoma. Report of a case with epilepsy. AB - A case of post-traumatic ossified epidural hematoma associated to epileptic seizures is reported. After surgical treatment complete recovery was obtained. PMID- 3831275 TI - [Hearing loss caused by mumps--epidemiological investigation and clinical features]. PMID- 3831277 TI - [Auditory brain stem responses of premature infants in the neonatal intensive care unit]. PMID- 3831276 TI - [Treatment of squamous cell carcinoma of the floor of the mouth]. PMID- 3831278 TI - [Carcinoma of the floor of the mouth]. PMID- 3831279 TI - [Reconstructive surgery of the nose as assessed by rhinomanometry (adrenaline contraction test)]. PMID- 3831280 TI - [A study on laterality in the auditory reaction time of patients with cerebrovascular disorders]. PMID- 3831281 TI - [Analysis of nystagmus parameters using a microcomputer--an algorithm for analysis]. PMID- 3831282 TI - [Analysis of nystagmus parameters using a microcomputer--clinical value]. PMID- 3831283 TI - Educating community gatekeepers about alcohol abuse in women: changing attitudes, knowledge and referral practices. PMID- 3831284 TI - Single and multiple patterns of adolescent substance use: longitudinal comparisons of four ethnic groups. PMID- 3831285 TI - Using a stratified approach in substance intervention and prevention programs among adolescents: an empirical analysis. PMID- 3831286 TI - Health educators: role modeling and smoking behavior. PMID- 3831287 TI - Does drug and alcohol use lead to failure to graduate from high school? PMID- 3831289 TI - Chronic imperceptible pain as a cause of addiction. PMID- 3831288 TI - Alcohol and soap operas: drinking in the light of day. PMID- 3831290 TI - Drug treatment in New Jersey (and elsewhere?): in search of a paradigm. PMID- 3831291 TI - Synthesis of substituted quinoline-3-carbaldehyde (2,3-dihydrothiazol-2-ylidene) hydrazones of potential antimicrobial activity. PMID- 3831292 TI - Synthesis and study of the anti-leukaemic activity of N,N'-substituted amidines and bis-amidines. PMID- 3831293 TI - Separation and quantitative determination by HPLC of ergotamine and its stereo isomer ergotamine in pharmaceutical preparations. PMID- 3831294 TI - The formulation related impact of disks on the USP XX disintegration test. PMID- 3831295 TI - [Dietary microbial risk: toxi-infections]. PMID- 3831296 TI - [Dietary risks]. PMID- 3831297 TI - Pineal function in burns: melatonin is not a marker for general sympathetic activity. AB - Burn injury in humans or rats is a model of marked elevation of general sympathetic activity for weeks, manifested in part by increased heart rate, metabolic rate, core temperature, and plasma and urinary catecholamines. Plasma melatonin was sampled at 2-h intervals for 24 h in 9 control subjects and 11 patients with severe burn injury. Daytime melatonin was not different between the groups, but nighttime values were significantly lower in the burn patients. A nocturnal surge was still significant in the patients. Resting heart rate and rectal temperature were elevated in the burn patients. In male Sprague-Dawley rats, pineal melatonin content did not differ between controls and those with an experimental burn at 4 h into the light phase nor during the nocturnal surge. Male Syrian hamsters with burns had lower daytime pineal melatonin content than did controls, but the nocturnal surge in pineal melatonin was not significantly different between groups, nor was daytime morning serum melatonin. Sympathetic activity appears partitioned, with that controlling melatonin (nocturnal surge) regulated independently. In agreement with our previous findings in other models, melatonin is not a marker for general sympathetic activity, even following severe burn injury. PMID- 3831298 TI - The effects of photoperiod and melatonin on serum prolactin levels of mink during the autumn molt. AB - An experiment was conducted to determine the effects of a reduced daily photoperiod and exogenous melatonin on serum prolactin levels of mink during the autumn molt and growth of the winter pelage. During the last week of June, adult standard dark female mink (Mustela vision) were exposed to natural changes in daylength (controls), a reduced photoperiod of 6 h light: 18 h dark (6L:18D) or exposure to natural changes in daylength and treated with melatonin (10 mg) in a Silastic implant inserted subcutaneously over the scapular area. Beginning July 2, and continuing through October 22, blood samples were collected at nine biweekly intervals, and serum prolactin concentrations were quantified by a heterologous double antibody radioimmunoassay. Both reduced photoperiod and exogenous melatonin caused serum prolactin levels to decline rapidly after mid July, resulting in concentrations that were significantly lower than those of controls 6 to 8 wk earlier. These data suggest that growth of the winter pelage of mink is strongly associated with declining prolactin levels. It appears that part of the photoperiodic-induced effects on fur growth of the mink are mediated through melatonin and its effects on prolactin synthesis and/or secretion. PMID- 3831299 TI - Ultracytochemical localization of calcium in the superficial pineal gland of the Mongolian gerbil. AB - In order to demonstrate fine localization of Ca2+ in the superficial pineal gland of Meriones unguiculatus, the pyroantimonate technique was employed. Control experiments were performed with EGTA and analysis of obtained reaction product using an energy-dispersive x-ray microanalysis. Precipitates of calcium antimonate were formed almost exclusively in swollen clear pinealocytes, in and along their cell membranes, over their nuclei, in mitochondria, the Golgi apparatus, endoplasmic and integrade reticulums, acervuli, in vesicles surrounding synaptic bars, cytoplasmic matrix, and flocculent extracellular material. It has been concluded that the swollen pinealocytes represent a degenerative cell form probably occurring by impairment of plasmalemmal Ca2+ ATPase's ability to eliminate Ca2+ ion from the cell, with consecutive increase of calcium in the cytoplasmic matrix, followed by increase of intramitochondrial Ca2+ concentration, gradual arrest of mitochondrial function, depolymerization of cytoskeletal microtubuli, loss of the cell form, and cell death. Decrease of function of pinealocyte plasmalemma seems to be related to aging. PMID- 3831300 TI - Melatonin and N-acetylserotonin stress responses: effects of type of stimulation and housing conditions. AB - The effects of housing condition and type of stimulation on serum melatonin and N acetylserotonin (NAS) were investigated. Male rats were housed under a 12/12-hour light-dark cycle, with ad libitum food and water, either individually or in groups of four. At the start of the light phase, separate groups were sacrificed at rest or subjected for 3 minutes to the stimulation of cold water, noise, novel environment, or ether vapour and then decapitated at 0, 5, 15, 30 or 60 minutes after the end of stimulation. Melatonin was measured by a modified radioimmunoassay and NAS by a specific radioimmunoassay. Melatonin levels responded to stimulation with an increase, while NAS levels responded with a decrease. Housing condition had no effect on hormone response. However, the pattern of response for each of the two hormones differed greatly among the stimuli. For melatonin, cold water was the most potent stimulus, followed by noise, novel environment, and ether. NAS responded most to ether, fleetingly to cold, and in a bimodal manner to noise. The data are interpreted as suggesting that separate mechanisms regulate serum melatonin and serum NAS is response to environmental stimulation and that under appropriate control conditions melatonin from the pineal is very responsive to environmental stimuli, in a manner similar to that of pituitary hormones. PMID- 3831301 TI - Entrainment of the circadian rhythm in rat pineal N-acetyltransferase activity under extremely long and short photoperiods. AB - Entrainment of a pacemaker driving the circadian rhythm in rat pineal N acetyltransferase activity was studied under extremely long and short photoperiods. Adult male rats maintained under the light-dark regime (LD) 18:6 or under the regime LD 6:18 were exposed to a 1-min light pulse at different times at night, then they were released into darkness, and the next night phase-shifts of the evening N-acetyltransferase rise and of the morning N-acetyltransferase decline caused by light pulses were determined. The evening rise was phase delayed by at most 0.5 h under LD 18:6, but by as much as 2.8 h under LD 6:18. The morning decline was phase-advanced by at most 1.9 h under LD 18:6, but by as much as 3.5 h under LD 6:18. Hence, the magnitude of phase-shifts and consequently patterns of phase-response curves, which show possibilities of discrete entrainment, depend on the photoperiods under which animals are maintained. A 1-min light pulse applied within 1 h before the end of the dark period phase-advanced the morning N-acetyltransferase decline under LD 18:6 as well as under LD 6:18, while a pulse applied within 1 h after the beginning of the dark period phase-delayed the evening N-acetyltransferase rise only in rats maintained under LD 18:6, but not in those kept under LD 6:18. It seems that under very long photoperiods, the N-acetyltransferase rhythm may be entrained by evening as well as by the morning light, while under very short photoperiods the rhythm may be synchronized by morning light only. PMID- 3831302 TI - Alloxan-induced diabetes and the pineal gland: differential effects on the levels of pineal N-acetylserotonin, pineal melatonin, and serum melatonin. AB - Effects of alloxan treatment on the levels of pineal melatonin, pineal N acetylserotonin, and serum melatonin were investigated. Male rats were housed under a photoperiod of 12 h light: 12 h darkness and a temperature of 23 +/- 3 degrees C. Three weeks after alloxan (170 mg/kg) or carrier injection (s.c.), the animals were killed at mid-light (1200 h) and mid-dark (2400 h). Pineal and serum indoles were extracted and quantified by radioimmunoassays. It was found that pineal levels of N-acetylserotonin in the diabetic rats were significantly higher (P less than 0.05) than those of the controls. Conversely, pineal and serum levels of melatonin in the control rats were significantly higher (P less than 0.05) than those of the alloxan-induced diabetics. Our results suggest that alloxan-induced diabetes may decrease pineal melatonin synthesis in rats by reducing the activity of hydroxyindole-O-methyltransferase, resulting in a decrease in pineal melatonin secretion. PMID- 3831303 TI - Melatonin rhythms in quail: regulation by photoperiod and circadian pacemakers. AB - The profile of melatonin in the eyes, pineal, and blood of Japanese quail was assessed in birds held under LD 16:8 and LD 6:18 photoperiods. Melatonin levels in all three tissues showed a robust daily rhythm with higher levels occurring at night. The amplitude of the rhythm was depressed and its duration lengthened on LD 6:18 relative to LD 16:8. The blood melatonin rhythm precisely reflected the rhythms shown by the pineal and eyes, supporting the idea that the blood rhythm is a result of melatonin secretion by both the eyes and pineal. The ocular melatonin rhythm continued after sectioning of the optic nerve, was reentrainable to a shift in the phase of the LD cycle, and persisted for at least 2 days in constant darkness. It was concluded that either an intraocular circadian clock drives the ocular melatonin rhythm, or an extraocular clock drives the ocular melatonin rhythm via a route other than the efferent innervation (which enters the eye via the optic tract). PMID- 3831304 TI - Impact of psychosocial stress on pineal structure of male gerbils (Meriones unguiculatus, cricetidae). AB - Stress responses were investigated in 5-month-old male gerbils. Breeders having no pubescent litters served as controls. The first experimental group never left their parents' cage and were thereby fought by higher-ranking males; the second and third groups were stressed for a week by four daily 1-minute encounters with trained fighters, the second group during daytime, the third during the dark period. The first and second groups developed signs of gonadal regression, the third did not. The adrenals of the first group weighed the same as those of controls; the adrenals of both other groups were increased in weight. In the adrenal medulla of all experimental groups, a large number of cells were densely packed with noradrenaline-containing vesicles. In each experimental group the pineal changes included a remarkable decrease in nuclear size of pinealocytes, an increased number of colloidal cysts, and a reduction of that portion of the plasmalemma that is lined by subsurface cisterns. All these changes are interpreted in terms of pineal activation, as are the increased number of membrane whirls found in the first group. The third group exhibited an additional decrease in the size of mitochondria and in the number of "synaptic" structures. This finding and the day-night differences in the gonadal response indicate that stress interferes with the metabolic cyclicity of the pineal gland. However, it remains indiscernible whether the pineal stress reaction signals a general activation of the gland or a change in it's temporal activity patterns. PMID- 3831305 TI - Harderian glands of golden hamsters: temporal and sexual differences in immunoreactive melatonin. AB - Throughout a 24-h period, immunoreactive melatonin concentrations in Harderian glands of female golden hamsters were approximately 200 pg/mg protein with a significant decline to 80 pg/mg protein only at about 0600, 2 h after light on. Concentrations in glands of males are diurnally constant and low (ca. 20 pg/mg protein). Castration increases immunoreactive melatonin in glands of males to female levels. While blinding alone had no effect, it did prevent the castration induced increase. Lower concentrations were measured in glands of blinded or blinded ovariectomized females but this decrease was not significant. These data suggest that immunoreactive melatonin concentrations in the Harderian glands of hamsters are controlled by testosterone or its derivatives; these same factors also control the male or female character of these glands. PMID- 3831306 TI - Antigonadal actions of olfactory and light deprivation. I. Effects of blindness combined with olfactory bulb deafferentation, transection of vomeronasal nerves, or bulbectomy. AB - Olfactory bulbectomy is known to potentiate the antigonadal effects of light deprivation. However, the physiological interpretation of the effects of bulbar ablation is complex, since it simultaneously implies sequelae like: a) the loss of olfactory sensitivity (anosmia), b) the suppression of the accessory olfactory system (AOS), and c) the suppression of nonsensorial functions of the bulbs. To study the participation of these three mechanisms in the effects of bulbectomy + light deprivation, we compared, in 28-day-old male rats, the effects of olfactory bulb deafferentation (peripheral anosmia) with those induced by either olfactory bulbectomy or blocking the AOS, alone or associated with blindness. As compared to the intact or blinded animals, both blinded deafferented (EA) and blinded bulbectomized (EB) rats showed various reductions in weights of body, testes, accessory sexual glands, and prostates; serum testosterone levels were also depressed. Testes of EA rats showed various degrees of alterations in spermatogenesis. The only difference between EA and EB groups was in the pituitary weight, significantly lower in EA rats. PMID- 3831307 TI - Antigonadal actions of olfactory and light deprivation. II. Effects of pinealectomy or melatonin injections in olfactory bulb deafferented or bulbectomized male rats. AB - Since olfactory bulb deafferentation (peripheral anosmia) potentiates the antigonadal effects of light deprivation, we studied a) the pineal involvement in this action and b) whether peripheral anosmia might increase the response to melatonin injections. Four-week-old male rats were used in two experimental series. The first included rats in which blindness + peripheral anosmia was associated with either pinealectomy or sham pinealectomy. In the second series, intact, olfactory bulb deafferented and bulbectomized rats received daily injections of either melatonin (50 micrograms) or the vehicle alone. In both experiments animals were killed at 10 weeks of age. The reduction in the weight of accessory sexual glands and prostates, as well as in the serum testosterone levels, induced by blindness + peripheral anosmia was fully prevented by pinealectomy, whereas body and pituitary weight reduction induced by the dual sensory deprivation were only partially prevented. Melatonin produced no effects in intact animals whereas in rats with either peripheral anosmia or bulbectomy it reduced the weight of body, accessory sexual glands, and prostates. Serum testosterone levels were not modified in any case with melatonin treatment. PMID- 3831308 TI - Photoperiodic control of testicular size in the golden hamster: lack of a role for the deep pineal gland. AB - Removal of the superficial pineal gland prevents testicular regression from occurring in golden hamsters exposed to a short-day photoperiod, but to date no studies have examined the role of the deep pineal gland in the photoperiodic control of gonadal function. We investigated the role of the deep pineal gland in this process by monitoring testicular size in hamsters with an electrolytic lesion of the deep pineal gland. Sexually mature hamsters that had been sham lesioned or that had received a lesion aimed at the deep pineal gland were transferred from 14L:10D to 6L:18D or were maintained in 14L:10D for 73 d. Testicular widths were determined at 2-3-wk intervals and after 73 d the testes were removed and weighed. The mean testis widths of the seven animals with histologically confirmed deep pineal lesions and exposed to 14L:10D remained large, similar to those of the sham-operated control animals exposed to the same photoperiod. The testes regressed in the five animals with confirmed deep pineal lesions and exposed to 6L:18D in a similar manner to those of the sham-operated control animals exposed to the same photoperiod. No significant difference (P greater than .05) was found between the testicular weights of lesioned and unlesioned animals exposed to either photoperiod. The lack of a significant effect of a deep pineal lesion on testicular size demonstrates that this portion of the pineal complex is not required for normal regulation of testicular function by photoperiod. These results also suggest that nerve fibres projecting from the brain to the superficial pineal gland via the deep pineal gland are not involved in photoperiodic regulation of testicular function. PMID- 3831309 TI - Phase shift of daily profiles of N-acetyltransferase in the rat pineal gland. AB - Pineal N-acetyltransferase activity (NAT) has a circadian rhythm with peak values in the dark time and low values in the light time. NAT time profiles were measured in rats exposed to LD 14:10, to constant dark, and to acute (less than 48 hr) light-dark treatments. In all experiments, imposition of light suppressed NAT. The phase of the dark time NAT cycle was altered 2 hr or less by the following treatments: 3 hr light in the early subjective night, 3 hr light in the late subjective night, 2 hr or 6 hr light in the early subjective day, 4 hr early lights-on, 1 day of constant dark, or 1 day of constant light. When light was extended 4 hr into the dark time, NAT rose at lights out but fell again as the time of "expected" dawn approached. In contrast, the phase of the NAT cycle was shifted 12 hr (180 degrees) within 72 hr by reversing the phase of the light-dark cycle. NAT did not rise in the first dark period (coincident with the time of the subjective light time). The amplitude of the first shifted cycle was less than four control NAT profiles measured in rats kept in the original (unshifted) light dark cycle. PMID- 3831310 TI - Effects of photic history and illuminance levels on male golden hamsters. AB - Four-week-old male hamsters, born and raised in total darkness or in LD 14:10 (hr) were exposed to several low levels of illumination for 14 weeks. Analyses showed that testicular weights were significantly affected by both photic history and illuminance levels. Animals born in the dark possessed larger testes than those born in LD cycles and, further, displayed less responsiveness to levels of illumination below those required to suppress pineal function. While gonadal responses to photic duration may be said to be "all or none," those resulting from insufficient illuminance levels are seemingly graded. Thus, the pineal gland may act indirectly as a photodosimeter at low illuminance levels. PMID- 3831311 TI - The effects of spectral power distribution and illuminance levels on key parameters in the male golden hamster and rat with preliminary observations on the effects of pinealectomy. AB - Three different light sources were used to determine the effects of spectral power distribution (SPD) and illuminance levels on growth and organ weights of male golden hamsters and rats. SPD had little effect on organ weights or measurements of either rats or hamsters. However, responses to illuminance levels were quite apparent, provided they were equalized for the scotopic eye sensitivity curve characteristic of nocturnal animals. Under seven illuminance levels from 0 to 3.9 scotopic fc, hamsters demonstrated graded responses in gonadal weights and presumed function from 0 to 0.02 scotopic fc. Above this level, photopic saturation was apparent. The neuroendocrine system of pinealectomized animals failed to show sensitivity to illuminance levels. The suggestion is made that the pineal gland acts to monitor illuminance levels (below about 0.02 scotopic fc) as well as photic duration. While the latter appears to be an "all or none" effect, the former appears to be graded. PMID- 3831312 TI - Quantitative ultrastructural analysis of differences in exocytosis number in adrenomedullary adrenaline cells of golden hamsters related to time of day, pinealectomy, and intracellular region. AB - This research analyzed differences mainly in the incidence of exocytotic figures in adrenaline cells (A-cells) in pinealectomized (PX), sham-operated (SPX), and non-operated (NO) adult male golden hamsters, with the aim of determining whether these parameters change with the time of day and following pinealectomy, and whether intracellular regional differences exist in such changes. Animals acclimated to a standardized light:dark (LD) 12:12 photoperiod were sacrificed at 11 h after the onset of light (L-11h) and 1 h after the onset of darkness (D-1h) (8 animals/group/time) at 28 days postoperation. The adrenal medullas were examined and analyzed morphometrically by electron microscopy. The number of exocytoses per unit length (NEL) and the exocytosis index (a rough index of the number of exocytoses per cell) were measured in PF (perivascular-space-facing) and non-PF plasma membranes. NEL increased from L-11h (NO: 0.040 +/- 0.010, mean +/- SE) to D-1h (0.078 +/- 0.012) in all three experimental groups (ANOVA: P less than 0.005), showing over fourfold higher levels in PF than in non-PF membranes. NEL in PF membranes in PX animals showed higher levels than those in NO and SPX animals (P less than 0.025), but in non-PF membranes, no differences owing to time of day or surgery were seen. Exocytosis indices were (1) higher at D-1h than at L-11h in all three experimental groups (P less than 0.005), (2) similar in PF and non-PF membranes in control groups, and (3) higher in PF membranes in the PX group than in either non-PF membranes or PF membranes in control groups. In conclusion, the exocytosis number in A cells changes in relation to time of day, rising in early dark phase, and its rise following pinealectomy can be seen only in PF membranes. PMID- 3831313 TI - Melatonin secretion as a mediator of circadian variations in sleep and sleepiness. PMID- 3831314 TI - Stereologic studies on mitochondrial configuration in the rat pinealocytes. AB - Stereologic studies were performed on rat pinealocytes. In the morphometric analysis the following parameters were taken into consideration: the volume density of the outer and inner membranes, surface areas of the outer and inner membranes, inner membrane to outer membrane surface area ratio, volumes of the outer and inner compartments, and partition coefficients of these compartments. Visual analysis demonstrated three mitochondrial configurational states. Based on the mitochondrial criteria, the existence of three pinealocyte types may be demonstrated. The authors believe that these are the cells in three different functional states. PMID- 3831315 TI - Ultrastructural studies on the pinealocyte mitochondria during the daytime and at night. AB - Rat pinealocytes were found to contain mitochondria in three configurational states and they were calculated during their maximum (11:00) and minimum (23:00) serotonin content under various conditions of lighting (LD 12:12 and D 24). Their proportions were found to change in the circadian rhythm. Analysis of these results indicated the existence of correlation between pinealocyte bioenergetics and melatonin biosynthesis and its lack in relation to serotonin. Cell groupings with mitochondria in the same configurational state were observed, which suggests the existence of functionally differentiated zones within the pineal gland. In this context, the biochemically demonstrated circadian rhythm in the pineal gland secretion results from the synchronization at the organ level arising from the resultant function of individual pinealocytes. PMID- 3831316 TI - Pineal-induced depression of free thyroxine in Syrian hamsters. AB - Blind hamsters had no alteration of the dialyzable fraction of serum thyroxine (T4) but had depressed total and free T4 concentrations compared to controls. Prevention of the effects of blinding by pinealectomy indicates pineal influence on circulating free T4 concentration. Parallel changes in free T4 and the free T4 index indicate adequacy of the index in representing pineal-induced changes in free T4. PMID- 3831317 TI - In vitro uptake and metabolism of [3H]indole compounds in the pineal organ of the pike. I. A radiochromatographic study. AB - Thin layer chromatography analysis of [3H]serotonin and [3H]melatonin metabolites synthetized in vitro by the pineal organ of the pike was performed. After a 10 min pulse, [3H]serotonin was mainly converted into [3H]-5-hydroxyindoleacetic acid (37%), [3H]-5-hydroxytryptophan and [3H]-5-methoxytryptophan (12 to 14%), and [3H]-5-hydroxytryptophol and [3H]-5-methoxytryptophol (3.5 and 9%) at the onset of darkness. When the pulse was followed by postincubations (in a cold medium) of increasing duration (15, 30, and 60 min), it appeared that the amount of [3H]-5-hydroxyindoleacetic acid decreased, that of [3H]-5-hydroxytryptophol decreased faster than that of [3H]-5-methoxytryptophol, and the amounts of [3H]-5 hydroxy- and [3H]-5-methoxytryptophan increased. [3H]-N-acetylserotonin, [3H]melatonin, and [3H]-5-methoxytryptamine were found in very low amounts. At the beginning of the photophase or at the onset of darkness, the uptake and metabolism of [3H]melatonin (after a 10-min pulse followed by a 10-min incubation in cold medium) resulted mainly in the formation of [3H]-5-methoxytryptophol (23 to 43%) and of [3H]-5-methoxytryptamine (6 to 12%). These results show that the pike pineal organ can synthesize all indoles that are known in the pineal gland of higher vertebrates. Usual, but also unusual, pathways of the indole metabolism were found that will need further clarification. Among these are the possible carboxylation of serotonin and deacetylation of melatonin (leading to the synthesis of 5-methoxytryptophol). Altogether, the results obtained suggest that the indole metabolism might be more complex than what has already been described in vertebrates. PMID- 3831318 TI - In vitro uptake and metabolism of [3H]indole compounds in the pineal organ of the pike. II. A radioautographic study. AB - In a previous radiobiochemical study [Falcon et al., 1985] it was demonstrated that the pineal organ of the pike incubated in vitro takes up and metabolizes [3H]serotonin and [3H]melatonin. Parallel to this experiment (present work), pineal organs were investigated by use of light and electron microscopic radioautography to investigate the cell types involved in indole metabolism. Irrespective of the tracer and experimental conditions used, the radioautographic reactions were mainly found in cone-like and modified photoreceptor cells of the pineal parenchyma. Taking into account the limits of the method used as well as previous data concerning the direct photosensitivity of the organ, the localization of exogenous indoles, and the localization and circadian variations of endogenous ones, it is concluded that the photoperiodic information is translated into both nervous and indolic signals in cone-like photoreceptor cells and into indolic signals in modified photoreceptor cells. PMID- 3831319 TI - Effect of magnesium ions on rat pineal N-acetyltransferase (EC 2.3.1.5) activity. AB - N-Acetyltransferase (NAT) activity at night and following isoproterenol treatment in intact animals was higher in rats pretreated with magnesium than in controls. This effect was probably due to enhancement of agonist binding and/or adenylate cyclase activation caused by magnesium ions. A similar effect was observed in vitro, where magnesium increased norepinephrine-stimulated NAT activity in organ cultured pineal glands, suggesting that magnesium acts primarily on the pineal gland as opposed to some other peripheral or central site. This enhancement of NAT activity by magnesium would presumably lead to increased melatonin production; and as melatonin has been shown to decrease serum magnesium levels, a negative feedback mechanism may exist. PMID- 3831320 TI - Diurnal changes in sensitivity to melatonin in intact and pinealectomized Djungarian hamsters: effects on thermogenesis, cold tolerance, and gonads. AB - Djungarian hamsters kept in long photoperiod (16:8 L:D) were injected daily at 0800, 1200, or 1600 with 25 micrograms of melatonin. During 90 days of treatment, body weight and fur coloration were checked at weekly intervals, and at the end of the treatment the reproductive status of the hamsters and their thermoregulatory properties (could limit, maximum thermoregulatory heat production, nonshivering thermogenesis, cytochrome oxidase activity in brown adipose tissue) were measured. Hamsters injected at 1600 changed from summer to winter status with regard to all functions investigated responding simultaneously; i.e., their body weights decreased, their fur became white, their gonads regressed, and their thermoregulatory properties improved. All these changes were identical to the effects of short photoperiod (8:16 L:D) exposure. Injections of melatonin at 0800 and 1200 were ineffective for reproductive functions, but the injection of melatonin at 0800 caused slight improvements of thermogenesis. The response to melatonin injected at 1600 could be suppressed by an additional injection of melatonin at 0800 (75 micrograms). Pinealectomized or ganglionectomized hamsters kept in long photoperiod did not respond to daily injections of melatonin at 1600 for the first 60 days of treatment, but during a prolonged treatment their sensitivity to melatonin was restored. Similarly, pinealectomized or ganglionectomized hamsters failed to respond to short photoperiod for about 40 days, but during prolonged exposure their sensitivity to short photoperiod was restored. PMID- 3831321 TI - [Pharmacological studies on Cistanchis Herba. I. Effects of the constituents of Cistanchis Herba on sex and learning behavior in chronic stressed mice (1)]. PMID- 3831322 TI - [Quantitative analysis of glycyrrhizin and glycyrrhetinic acid in plasma after administration of FM-100 by using gas chromatography-selected ion monitoring]. PMID- 3831323 TI - [Connective tissue alterations and cholesterol accumulation sites in atherosclerotic aorta of rats induced by beta-aminopropionitrile]. PMID- 3831324 TI - [Reduction of flunitrazepam with enteric bacteria]. PMID- 3831325 TI - [In vivo and in vitro serum protein binding of sulfonamides in rabbits]. PMID- 3831326 TI - Lack of effect of metoclopramide on plasma aldosterone concentrations in young calves. AB - In five 10-day-old Holstein X Friesian male calves, the intravenous injection of the dopamine blocker metoclopramide (1 mg/kg bwt) had no significant effect on plasma aldosterone concentration. Plasma sodium, potassium, cortisol, corticosterone concentrations and plasma renin activity measured in these animals during 120 min following metoclopramide injection were never significantly different from those simultaneously measured in 5 control calves. PMID- 3831327 TI - [Effects of lithium on the spontaneous quantal release of transmitter from motor terminals of the diaphragm of rats]. AB - The mean miniature endplate potentials (m.e.p.p.) frequency has been examined at the neuromuscular junctions of the rat diaphragm, at 20 degrees and 37 degrees C, when all or part of the NaCl of the Krebs solution was replaced by LiCl. A high level of substitution (100% and 75%) causes initially an increase in m.e.p.p. frequency. This initial process can be fitted by an exponential function of time with a time constant which decreases with Li+ concentration and temperature. After reaching a maximum, m.e.p.p. frequency returns to a lower steady level which is higher than the one observed before the substitution and rises when either Li+-concentration or temperature are increased. At 37 degrees C, when the substitution of Li for Na+ is lower than 50%, m.e.p.p. frequency progressively rises towards a steady value which can be maintained for a long period. At 37 degrees C, a significant rise in m.e.p.p. frequency can be observed even after the replacement of 10% NaCl by LiCl. In the presence of prostigmine, m.e.p.p. disappear from the rat neuromuscular junction treated by Li, following an exponential decrease in frequency. These results are discussed in terms of presynaptic site of action of Li+. It is proposed that choline re-uptake by the presynaptic terminals could be sufficient to maintain a flow of acetylcholine release even after a complete substitution of LiCl for NaCl. PMID- 3831328 TI - [Analysis of the dependence of respiratory data during spontaneous ventilation at rest]. AB - Inspiratory duration (TI), cycle duration (TTOT), and tidal volume (VT) were continuously measured in 11 normal subjects during 400 respiratory cycles. Small breath to breath changes in these variables were separately analyzed. For each of these variables, successive observations are not statistically independent; "large" values tend to be followed by "large" values. A respiratory feedback may be involved in this sequential dependence. In that case, any known system of respiratory control could be associated with it, even those with time constant or delay longer than one cycle duration. PMID- 3831329 TI - The effect of previous experience on preference of approach for effective counseling. AB - Students in a general psychology class viewed four videotapes of initial vocational-educational and initial personal concern counseling sessions. The sessions were presented from a client-centered approach and from a behavioral approach, and employed the same client and counselor. After viewing the tapes, the students were asked to indicate which approach they thought would be more effective in helping a client. Results showed that students who had previously experienced counseling preferred a behavioral approach for both the vocational educational concern and the personal concern. Students with no experience of counseling did not exhibit a preference. PMID- 3831330 TI - The distortion of self-perception by learned helplessness. AB - This study examined the impact of learned helplessness on self-perception of competence. The participants were 180 undergraduates who were placed in control, failure, or success groups where they were given a list of traits on which to evaluate themselves, followed by an anagram-solution test. Significant performance effects were observed on the test; self-assessment was more representative of actual ability, however, than of the treatment situation. The results suggest that although experiencing uncontrollable failure may result in performance deficits, perception of ability may not be distorted. PMID- 3831331 TI - Oral interaction in cooperative learning groups: speaking, listening, and the nature of statements made by high-, medium-, and low-achieving students. AB - Oral interaction within cooperative learning groups was observed for high-, medium-, and low-achieving students. Initially, cooperative and individualistic learning situations were compared on achievement and attitudes. Forty-eight 4th grade American students were assigned to learning situations on a stratified random basis controlling for ability and sex. They participated in the study for 55 min a day for 15 instructional days. Two observation schemes were used. The results for the cooperative situation were factor analyzed to determine the basic dimensions of oral interaction within cooperative learning groups. Five orthogonal factors were identified: Exchanging Task-Related Information, Elaborating on the Information, Encouraging Each Other to Learn, Disagreeing With Each Other's Conclusions, and Making Nontask Comments and Sharing Personal Feelings. The oral participation of students from different achievement levels was differentially related to achievement. Vocalizing was found to be more strongly related to achievement than was listening to other group members vocalize. Medium and low achievers especially benefited from cooperative learning experiences. PMID- 3831332 TI - Age and sex differences in the cooperative and noncooperative behavior of pairs of American children. AB - Game playing behavior of same and mixed sex pairs of 5-, 8-, and 11-year-old American children was compared, using a game in which cooperative behavior maximized reward. Pairs of 8- and 11-year-old children were relatively more cooperative and attained significantly more Joint Reward Goals than 5-year-old pairs. Older pairs were not maximally cooperative, however, in terms of all the dependent measures; in adjusting for initial differences on practice trials, 5 year-olds and 8-year-olds took less time than the 11-year-olds, and 11-year-old pairs of boys took significantly more time than all other pairs. In addition, cooperative behavior increased across trials, especially for the 11-year-old children. PMID- 3831333 TI - A supervision approach for teaching structural/strategic therapy in a limited setting. AB - Many counselors are currently undergoing a Kuhnian paradigm shift from linear models of behavioral problem conceptualization to systemic conceptual models. As a result, it has become incumbent on counselor-educators to introduce the systems concept of family therapy to their students within a framework that renders it meaningful not only intellectually but also practically. This paper presents one way of doing this successfully with master's level counselors-in-training who have no live families on which to practice. An overview of systems approaches to family therapy is presented along with a seven-stage supervision approach for teaching structural/strategic therapy in limited situations where the supervision of live families is not practical or possible. PMID- 3831334 TI - Sex roles, gender, and fear. AB - Male and female college students classified as masculine, feminine, androgynous, or undifferentiated on the Bem (1974) Sex Role Inventory (N = 199) were given the Wolpe (1969) Fear Inventory. Significant differences in average fear scores were seen between men and women and between the four sex-role categories, with sex role and gender contributing equally to the variability. The argument is raised here that excessive fearfulness or fearlessness might be as much a product of sex role conditioning as a product of gender. PMID- 3831335 TI - Geographic mobility and locus of control. AB - Migrants and nonmigrants are often alleged to differ on numerous psychological traits; little empirical analysis, however, has examined this possibility. This study examined the hypothesis that geographic mobility is associated with locus of control, a key dimension of the self-concept. No relationships between these variables were uncovered for a national sample of older white men. PMID- 3831336 TI - Choledochotomy and sepsis in benign biliary disease. PMID- 3831337 TI - Routine transduodenal sphincteroplasty for common bile duct exploration. PMID- 3831338 TI - Evaluation of contact selective cholangiography during secondary biliary intervention. PMID- 3831339 TI - The new ReliaVac drain after cholecystectomy. A comparative clinical and ultrasonic trial. PMID- 3831340 TI - Oesophageal function following transection for varices. An assessment using barium swallow, oesophageal scintiscanning and manometry. PMID- 3831341 TI - Intragastric balloons. Short term solution to a long term problem? PMID- 3831342 TI - Intestinal obstruction in pregnancy. PMID- 3831343 TI - The surgical anatomy of the colonic intramural blood supply and its influence on colorectal anastomosis. PMID- 3831344 TI - Surgical treatment of dorsal and lumbar spinal tuberculosis. PMID- 3831345 TI - The treatment of lipomas by the "squeeze" technique. PMID- 3831346 TI - Squamous carcinoma of kidney. PMID- 3831347 TI - Intestinal obstruction and perforation due to an ingested Brazil nut. PMID- 3831348 TI - Campylobacter jejuni associated with acute relapse and abscess formation in Crohn's disease. PMID- 3831349 TI - Fatal spontaneous rupture of the spleen in asymptomatic infectious mononucleosis. PMID- 3831350 TI - Re: Burhenne technique for extraction of retained biliary calculi. PMID- 3831351 TI - [Evaluation of pathology of the small intestine by computed tomography. Apropos of 34 cases]. AB - A retrospective study reviewed computed tomography imaging findings in 34 patients with affections of the small intestine. In 68% of cases lesions were demonstrated by the CT scan before any other investigation. Whether the lesions were benign or malignant tumors, inflammatory or infectious disorders or malformations, all images showed segmental or localized parietal thickening of 5 mm or more. In many cases this thickened wall was associated with an extramural mass or an increased attenuation value of adjacent mesenteric fat. Computed tomography is the only available method that provides reliable information on the importance of the intra-and extra-mural components of small intestine affections. PMID- 3831352 TI - [Magnetic resonance imaging of the pelvis. Methodological aspects]. AB - Multiparametric choice is needed in Magnetic Resonance Imaging (MRI). In addition to matrix definition, section thickness, accumulation number, the repetition time TR, the echo time TE (for the spin echo technique) and the plane selection are of great importance. In pelvic examination, information supplied by T1 and by T2 weighted images is complementary. So, comparison between the three dimensional sections is of great interest. Although long acquisition times could, in theory, provide better images and therefore more clinical information, the patient comfort must be considered in choosing a reasonable examination time. We believe that it is possible, without great loss of information, not to make inversion recovery sequences. Using a 0.5 T superconducting magnet, sequences were done with TR of 1,200 ms for T2 weighted images and two echoes with TE of 40 or 50 ms. Twice repeated sequences (for averaging purpose) and 256(2) matrix (with a 42 cm field diameter) seem to be well adapted to MRI clinical applications. PMID- 3831353 TI - [Comparative study of scintigraphy, x-ray computed tomography and magnetic resonance imaging in the diagnosis of osteonecrosis of the hip and algodystrophy]. AB - Effectiveness of modern imaging techniques were compared when used for diagnosis of the painful hip in adults, particularly the distinction between aseptic osteonecrosis and decalcifying osteodystrophy. Although a small number of patients were studied (5 cases of osteonecrosis and 5 of decalcification) the series was homogeneous (same investigator for each technique and identical equipment for each patient), and the different methods of investigation (conventional radiology, scintigraphy computed scanography CE 10,000 and 0.15 resistive NMR imaging) could be validly compared. NMR images were recorded in only 5 patients but evaluation involved findings during use of this method of hip investigation over a period of 8 months. Results of comparison of the different imaging methods in osteonecrosis and osteodystrophy of hip showed conventional radiology to be much less effective for diagnosis. Conventional bone scintigraphy appeared to provide a good diagnostic approach, while C.T. images appeared to be as effective or even more specific than scintigraphy for differential diagnosis of the two affections. The only uncertainty is based on the radiologic latency in early stage disease, probably able to be filled by a densitometry. The use of NMR imaging appears to be promising, since it provides data as early as scintigraphy and as specific as scanography, particularly in view of apparent discrimination between osteonecrosis and osteodystrophy of the hip with respect to measurement of relaxation parameters. PMID- 3831355 TI - [Diagnosis of internal jugular vein thrombosis by x-ray computed tomography]. AB - We made the diagnosis of internal jugular vein thrombosis by computed tomography in 3 cases. The CT diagnostic signs are the following: widening of the vein caliber, absence of opacification or nonhomogeneous aspect of the opacification of the lumen, and parietal contrast fixation. Classical and more recent etiology refers to cervico-facial infections and injuries, central venous catheterizations and local surgery, compression by a cervical mass, and use of oral contraceptives. The advantage of CT consists in its noninvasive contribution to defining a diagnosis that pathology, which is nonspecific (painful cervical tumefaction), often cannot reach. PMID- 3831354 TI - [CRST syndrome with diffuse peri- and intra-articular calcifications. Value of x ray computed tomography]. AB - A patient with calcinosis universalis presented extensive calcifications involving fingers, shoulders, thoracic wall and cervical spine. Computed tomography imaging appeared to be a highly valid method of investigation of calcification of soft tissues and allowed detection of an intra-articular scapulohumeral calcium-provoked effusion. PMID- 3831356 TI - [Dynamic study of miction in patients with spinal cord injuries. Comparison with cystomanometry in 50 cases]. AB - Video recordings during radiodynamic studies of miction (ERDM) in 50 patients with spinal cord injuries produced images markedly superior in quality to permictional films in cases of dysuria. Correlation with cystosphincterometry (CSM) findings were good for normal cases. Dynamic studies were more effective than CSM for the neck, but less reliable for the detrusor and striated muscle on the condition than an electromyogram had been performed. In patients with complete spasticity the type of miction cannot be predicted from the level of the lesion. PMID- 3831357 TI - [The reno-calyceal index. Radiological evaluation of pyelocalyceal distensions in children]. AB - The ratio length of one kidney width of the lower calyx, measured pre and post operatively, is proposed as an objective index to assess the result of pyeloplasty in surgical treatment of hydronephrosis. Statistical approach on a series of 25 children with unilateral hydronephrosis and normal contralateral kidney has demonstrated the reliability of this index to determine the evaluation of the dilatation in the post-operative period. An increase of the ratio was present in all cases in which the result of surgery, as far as distension was concerned, was satisfactory. PMID- 3831358 TI - [X-ray computed tomography guided surgery. Equipment and procedure for transcutaneous approach to lesions]. AB - Percutaneous needle biopsy of subclinical lesions using computed tomography guidance requires a precise approach, made possible by a simple apparatus for cutaneous detection by metallic indices. This procedure allowed reliable and rapid determination, in the transverse axial plane, of the cutaneous puncture point and possible angulation of the biopsy needle in relation to vertical or horizontal axes. PMID- 3831359 TI - [Axial projections of the patella. Apropos of a new accessory]. AB - The author explains how to use an accessory allowing axial patella roentgenography without patient helping with different angulations: 30 degrees, 60 degrees and 90 degrees. Radiographs are realised with low rate contraction of quadriceps and immobilisation, with two femoro-patella joints on the same view with simple table and moving X-ray tube. PMID- 3831360 TI - [Efficiency of communications in a hospital milieu]. PMID- 3831361 TI - Methotrexate: a perspective on its use for rheumatoid arthritis. PMID- 3831362 TI - Methotrexate and the liver. AB - The findings of liver studies in 29 patients who were treated with low dose pulse methotrexate for rheumatoid arthritis (RA) are described. The biopsy specimens of 22 patients (76%) showed liver abnormalities, but cirrhosis did not develop in any patient. There were no statistically significant differences in age, duration of treatment, or cumulative dose between patients in whom abnormal liver histology developed and those in whom it did not. Our findings showed that isolated elevations of the aminotransferase enzymes or alkaline phosphatase levels did not predict liver disease, nor did the absence of elevation of these enzymes assure the absence of liver disease. Serial elevations of the aminotransferase and/or alkaline phosphatase enzyme levels and the development of hypoalbuminemia during treatment were specific indicators of the development of liver disease. In the patients studied, significant liver disease did not develop before 2 years of therapy or with a cumulative dose of methotrexate of less than 1500 mg. PMID- 3831363 TI - Solubilization of cell-membrane-antigen and its coupling to fixed and non-fixed erythrocytes. AB - Human type-A erythrocytes were lysed and solubilized with 0.3% sodium deoxy cholate (DOC). The solubilized membranes were coated onto human type-O glutaraldehyde fixed erythrocytes. The coated erythrocytes were found to agglutinate specifically by anti-A antibodies. Furthermore, solubilized membranes could be successfully coated to non-fixed erythrocytes after dialysing out the DOC. Quantitative absorption assays showed that the density of type-A blood group antigen on the coated erythrocytes was higher than the density of this antigen on human type-A erythrocytes. Erythrocytes that are coated with cell membrane antigens can be used to assess specific antibody titres and also can be applied for a sensitive selection and separation of rosetting lymphocytes that secrete specific antibodies against these antigens. PMID- 3831364 TI - SBE presenting with type III cryoglobulinaemia. AB - A case of subacute bacterial endocarditis which presented with cryoglobulinaemia is reported. A secondary cause of cryoglobulinaemia was suggested following characterization, which revealed a Type III (mixed polyclonal) cryoprotein. Levels of cryoglobulin were high and remained so until the source of infection was eradicated, and the cause of the cryoglobulinaemia is briefly discussed. PMID- 3831365 TI - Protective effect of malotilate (diisopropyl 1,3-dithiol-2-ylidenemalonate) on carbon tetrachloride-induced liver injury in mice and rats. AB - The protective effect of malotilate was studied on the liver injury induced by carbon tetrachloride (CCl4) in mice and rats. Plasma GOT and GPT activities were used as indices for the liver injury, and the liver was histopathologically examined. A remarkable suppressing effect on the liver injury was observed when malotilate was orally given 6 hr prior to oral administration of CCl4 in mice and 3, 6 or 12 hr in rats. Malotilate was also effective in preventing the liver injury caused by intraperitoneal injection of CCl4, indicating that the protective effect is not derived from the decreased CCl4 absorption. The liver injury was suppressed even when malotilate was given 12 or 24 hr prior to oral administration of CCl4 in mice and 24, 48 or 72 hr in rats. It may be the characteristic of malotilate that the protective effect lasts for a long period. It is supposed that the effect is due not only to the inhibition of the metabolic activation of CCl4 but also the other action(s) of malotilate. PMID- 3831366 TI - Thirteen-week subacute toxicity study of 4-bromophenyl chloromethyl sulfone (BCS) in rats. AB - Four groups of 12 Wistar SPF rats of both sexes were fed diets containing 4 bromophenyl chloromethyl sulfone (BCS) at the levels of 0, 20, 100 or 500 ppm for 13 weeks to evaluate the subacute toxicity. Males and females in the 500 ppm group showed increases in plasma protein and calcium and a decreased A/G ratio. The values of plasma total cholesterol and uric acid increased in this female group. In addition, significant increases in both absolute and relative weights were seen in the liver, thyroid and adrenal of this group of both sexes, together with the increased kidney weight in males. All males and females in the 500 ppm group had centrilobular hepatocellular swelling of the liver consisting of proliferation of the smooth endoplasmic reticulum. Males of this group also showed increased incidences of hyalin droplet degeneration of the proximal tubular epithelium and focal tubular atrophy of the kidney. The maximum no-effect level of BCS was determined to be 100 ppm (males: 6.25 mg/kg/day, females: 6.80 mg/kg/day). PMID- 3831367 TI - Stimulation and inhibition of DNA synthesis and cell growth by paraquat in cultured cells. AB - Paraquat, a popular herbicide, is known to be very toxic to man and animals. Using cultured mammalian cells (human embryo lung cell, R-66), the effect of paraquat has been studied. With autoradiography, stimulation of DNA synthesis was observed when the cells were exposed to 0.08 or 0.4 microM of paraquat; however, DNA synthesis was inhibited with 40 microM of paraquat. To determine cell growth rate, accumulation of mitotic cells was determined after addition of colcemid (0.2 microgram/ml) into the culture medium. The ratios of mitotic cells observed were proportional to the level of DNA synthesis. And the stimulation and inhibition of cell growth were observed even after washing off paraquat from media. PMID- 3831368 TI - Accumulation of germanium in the tissues of a long-term user of germanium preparation died of acute renal failure. AB - Acute renal failure developed in a patient accompanied by systemic manifestations such as myopathy and skin rash. The patient, a middle aged house wife, had been taking 600 mg of germanium (Ge) preparation daily for 18 months as an elixir. The main component of the preparation was GeO2 and some organic compound was also present. Histological study of the kidney post mortem showed foamy cell transformation of glomerular epithelia, degeneration of tubular epithelia with red blood cell casts and urate crystals, and a mild proliferation of mesangial matrix. Analysis of the tissue content of Ge, prompted by her history, revealed an increased accumulation of the metal. As compared to a non-user died of liver cirrhosis, the concentration of the metal was higher particularly in the spleen (183X), thyroid gland (175X), psoas muscle (93X), jejunum (76X), and renal cortex (69X). So far, neither accumulation of Ge in humal tissue nor systemic toxicity of the Ge in human has been reported. The relevance of massive accumulation of Ge to the renal failure as well as to other systemic manifestations the patient presented remains to be clarified. PMID- 3831369 TI - An analysis of alcoholics' perception of hostility before and after treatment. AB - Volunteer alcoholics being treated in a chemical dependency unit (CDU) were administered the Paired Hands Test-Adult to assess their perceptions of others before and after three weeks of treatment. This test assessed the perception of others along a friendliness-hostility dimension. Test data were compared to a non alcoholic control group who were not receiving any form of therapeutic services. The main hypothesis tested was that alcoholics experience more hostility than non alcoholics and project this hostility through perceptual defenses. A secondary hypothesis tested was that traditional short-term therapy reduces the alcoholic's perception of hostility. Neither hypothesis was supported. PMID- 3831370 TI - Crime as a source of income for narcotic addicts. AB - Although it has been well documented that narcotic addicts derive the bulk of their income from criminal activities and that there are major differences between black and white addicts, interview data presented in this paper show little difference between the two races with respect to the degree of dependence on criminal income. However, the results also highlight the diversity among narcotic addicts in that there are some individuals who derive none of their funds from illegal sources, thus suggesting that not all addicts should be treated in the same manner. PMID- 3831371 TI - Gradual vs. abrupt withdrawal of methylphenidate in two older dependent males. PMID- 3831372 TI - Losses and the substance abuser. PMID- 3831373 TI - Making a difference. PMID- 3831374 TI - Psychotherapeutic interventions with substance abusers--the clinical context. AB - Drug/alcohol dependent individuals need to discover and understand how they have adopted extraordinary drug solutions for a range of problems. I believe human relationships can best provide this opportunity through either a professional psychotherapeutic relationship or peer group experiences such as group therapy and self-help groups such as AA or NA. Addicts need to learn that drug solutions preclude more ordinary solutions to life problems, and that therapeutic and peer groups experiences can provide the creative challenges, tools, and impetus to find alternative solutions. Clinical work with severe and disabling human problems teaches the humbling nature of our work as health care professionals. Clearly, work with substance abusers is no exception. As we gain in our scientific, technical and clinical understanding of these problems, we are able to help our patients make enlightened choices about what is useful and effective in their treatment and recovery. However, there is much we do not understand about substance abuse, and there are many affected by the problem who cannot accept what we have to offer. Effective practice in this case, then, must still be guided by practical and empirical measures of what is safe and what works. Health care professionals do not have a corner on this market of what is safe and what works. Practitioners need to honor their traditions where treatment is guided by careful collection of data and continual pursuit of root causes, mechanisms, and etiologies. But, above all, rigid attitudes about the advantages of our own approach and the limitations of other approaches need to be avoided. In this respect we honor "above all" the primary tradition in clinical practice- "to do no harm". PMID- 3831375 TI - Comparison of nitrite treatment and stroma-free methemoglobin solution as antidotes for cyanide poisoning in a rat model. AB - The standard nitrite/thiosulfate regimen for cyanide poisoning was tested in our rat model. By modifying the treatment regimen and the nitrite solution an effective antidote against an LD90 of cyanide could be produced. However, this treatment was effective against two times the LD90 only when administered ten minutes prior to cyanide injection. These results are in marked contrast to our results with stroma-free methemoglobin solutions (SFMS) which showed SFMS to be a highly effective antidote against four times the LD90 when administered 30 seconds after an intravenous injection of cyanide. SFMS proved to be an effective antidote for two times the LD90 when administered up to sixty seconds after the cessation of respiration. PMID- 3831376 TI - Effect of orally administered magnesium hydroxide in experimental iron intoxication. AB - We have previously shown that ferrous and ferric ions readily for complexes with magnesium hydroxide [Mg(OH)2] thus reducing the absorption of iron salts from the gastrointestinal tract. The present study answers the following question: what is the optimal dose, time of administration, optimal limit of effectiveness, and potential hazard of this form of therapy. Adult mongrel dogs were administered ferrous sulfate [FeSO4] tablets at a dosage of 650 mg/lb of body weight. Either 30 or 60 minutes later, the dogs were given Mg(OH)2 at either 5 or l0 times the dose of elemental iron. Serum iron concentrations in all animals given Mg(OH)2 were significantly lower (p less than 0.05) than those of control animals. No significant differences were observed regardless of dose or time of administration of Mg(OH)2. Although serum Mg++ concentrations were significantly elevated (p less than 0.05) om all treated animals 4 and 6 hr post iron, no clinical manifestations of hypermagnesemia were observed. These studies demonstrate the effectiveness of Mg(OH)2 in the management of experimental iron intoxication and warrant a controlled clinical trial in humans. PMID- 3831377 TI - Improvement of cardiac conduction after hyperventilation in tricyclic antidepressant overdose. AB - Three patients wtih severe cardiotoxicity secondary to tricyclic antidepressant (TCA) overdosage were treated with induced mechanical hyperventilation. All three demonstrated marked QRS narrowing, reflecting improved intracardiac conduction, after hyperventilation therapy. Such therapy may help to prevent or abolish ventricular dysrhythmias, often a feature of life-threatening TCA overdoses. PMID- 3831378 TI - A review of thirty cases of rhabdomyolysis-associated acute renal failure among phencyclidine users. AB - Fifteen cases of rhabdomyolysis-associated acute renal failure among phencyclidine (PCP) users were seen at our institution between 1979-1984. An additional 15 cases were found from the literature. These 30 cases are reviewed here with respect to the incidence of acute renal failure among PCP users, its possible pathogenesis, clinical and biochemical features, and treatment. PMID- 3831379 TI - Blood concentrations and clinical findings in nonfatal and fatal intoxications involving glutethimide and codeine. AB - Blood concentrations and clinical findings were evaluated in twenty-six nonfatal and twelve fatal intoxications involving the combination of glutethimide and codeine ("loads"). The mean glutethimide concentration was 10 +/- 5 mg/L for nonfatal cases (range 2-18 mg/L) and 13.9 +/- 6.6 mg/L for fatal cases (range 4.6 26.4 mg/L). The mean codeine concentration for fatal intoxications was 1.21 +/- 1.17 mg/L (range 0.13-4.32 mg/L). Codeine concentrations were not measured in cases of nonfatal intoxication. Nine nonfatal cases required hospitalization on a medical ward (mean length of stay 3 +/- 3 days). Depressed level of consciousness was the most common abnormal physical finding (24 cases); 18 patients were lethargic but arousable with nonpainful stimulation and 6 patients with serum glutethimide concentrations of 10 mg/L or greater were comatose. The level of consciousness showed statistically significant correlation with the glutethimide concentration (P less than 0.01). Twenty-four nonfatal intoxications involved at least one other drug in addition to glutethimide and codeine (salicylates in 12 and acetaminophen in 4), while only 7 fatal cases involved at least one additional drug (acetaminophen and diazepam in 3 each). The finding of glutethimide should prompt a search for codeine and vice versa, especially when the presence of either does not in and of itself explain the clinical condition of the patient. PMID- 3831380 TI - Quinine amblyopia: is current management appropriate? AB - Thirty-one patients blind from overdoses of quinine are reported. One died from cardiotoxicity. Of the survivors, thirteen received bilateral stellate ganglion block, seven unilateral block, five a variety of other treatments aimed at increasing retinal blood flow, and five no specific treatment. Nine patients recovered vision completely but twenty were left with varying degrees of visual field constriction and one was blind at last follow-up. No treatment for oculotoxicity was of benefit. Since experimental and clinical observations show that the primary toxic effect of quinine is on photoreceptor cells, stellate ganglion block and other vasodilator treatments have no rational basis and should no longer be recommended. PMID- 3831381 TI - Dosage recommendations for activated charcoal-sorbitol treatment. AB - Activated charcoal-sorbitol mixture is used for the treatment of acute poisoning. Based on our experience with healthy adults, overdosed patients and published reports, we have devised a protocol for use of this mixture in different concentrations of sorbitol. The dose is based on the size of the patient, type of poison, and the clinical status. In seriously ill adult patients, we recommend the use of 1 g/kg of activated charcoal in 4.3 ml/kg body weight of 70% sorbitol every 4 hours until the first stool containing charcoal appears. In children and ambulatory adults, the same dose of activated charcoal may be administered in 4.3 ml/kg body weight of 35% sorbitol. Patients requiring multiple doses may be administered activated charcoal as aqueous and sorbitol suspensions alternately every 2-6 hours after the first charcoal stool has appeared. The patients on multiple dose regimen, especially children, should be closely monitored for any fluid or electrolyte imbalance or depletion of essential vitamins. PMID- 3831382 TI - Diagnosis of anion gap metabolic acidosis. PMID- 3831383 TI - Ultrastructure of distal nephron cells in rat renal cortex. AB - Distal nephron segments in the rat renal cortex contain distal convoluted tubule cells (DCT cells), connecting tubule cells (CNT cells), intercalated cells (I cells), and principal cells (P cells). The present study was carried out to expand present knowledge on the ultrastructure of these cells. The cells were sampled from superficial cortex and analyzed by electron microscopy. Several morphometric parameters were determined and statistical comparison between cell types was performed. Significant structural differences between the cell types were demonstrated. DCT cells showed the highest volume density of mitochondria whereas the amplification of basolateral membranes was higher in CNT cells than in I and P cells. The surface density of the membrane that bounds intermediate vesicles in the apical cytoplasm was twofold higher in I cells than in the other cell types. The morphological differentiation found in the present study adds to available evidence indicating a functional differentiation between the cell types and provides a reference for structure-function correlations in these cells. PMID- 3831386 TI - [Crystallization of reptile hemoglobin during its digestion in a pentastomide]. AB - The hemoglobin of the lizard Tarentola annularis has been studied within erythrocytes being digested in the gut of a parasitic pentastomide, Raillietiella sp. The hemoglobin is crystallized in the form of bundles comprised of numerous tubules (up to 2000). These tubules are simple or complex. Simple tubules are 50 nm in diameter; their wall is made up of two electron-opaque rings, separated by a clear ring. Complex tubules are up to 100 nm in diameter and show as many as 13 concentric walls. High magnification of transverse sections of simple tubules show 96 granules; each opaque ring is made up of 48 granules. Human hemoglobin is known to crystallize as 18-nm tubules, the wall of which is made up of six molecules; comparison of these data with our observations indicates that transverse sections of tubules of crystallized lizard hemoglobin should contain 24 molecules. Thus, each molecule of crystallized lizard hemoglobin consists of four granules; these granules may be considered as globin molecules. Erythrocytes in fresh lizard blood do not show crystallized hemoglobin; however, in blood treated with sodium bisulfite, they show tubules similar to that found in the parasite. PMID- 3831384 TI - Structural adaptation of intercalated cells in rat renal cortex to acute metabolic acidosis and alkalosis. AB - The structural responses of cells in the distal convoluted, connecting, and collecting tubule to acute acid/base changes were investigated by electron microscopy. Acute metabolic acidosis was induced by administration of ammonium chloride, and acute metabolic alkalosis by potassium or sodium bicarbonate. Morphometric analyses were performed on micrographs of randomly selected distal nephron cells. No structural responses were found in distal convoluted tubule cells, connecting tubule cells, or principal cells but prominent changes were observed in intercalated cells (I cells). Thus, the surface density of the luminal membrane in I cells was significantly higher in acidotic animals and lower in KHCO3 alkalotic animals than in controls. On the contrary, the surface density of the membrane that bounds apical vesicles was higher in KHCO3 alkalotic and lower in acidotic animals than in controls. These results suggest that the luminal membrane is internalized during alkalosis and that the membrane that bounds apical vesicles is transferred to the luminal membrane during acidosis. Since a proton translocating ATPase may be present in the luminal membrane the observations are consistent with the possibility that cortical I cells participate in the maintenance of acid/base homeostasis. PMID- 3831388 TI - Absorption of intraarticularly injected horseradish peroxidase in synoviocytes of rat synovial membrane: an ultrastructural-cytochemical study. AB - The ability of type A and type S synoviocytes to absorb horseradish peroxidase (HRP) and the intracellular fate of this tracer were studied by electron microscopic cytochemistry. Different concentrations of HRP (0.1-5 mg/ml) were injected into the left knee joint of rats and at intervals ranging from 1 min to 24 hr after injection the synovial membrane was fixed and incubated for HRP. Type A synoviocytes showed a striking ability to absorb HRP at low concentrations. At 1 and 5 min after injection reaction product was localized in coated pits and coated vesicles (110 nm) as well as in smooth-walled vesicles, vacuoles, and tubules. At 15 min to 4 hr postinjection the lysosomal system became increasingly loaded with reaction product. At 24 hr after injection reaction product had disappeared. At higher concentrations of HRP similar observations were made in the A cells, but reaction product was still apparent in lysosomes at 24 hr postinjection. With respect to type S synoviocytes no reaction product was detected within these cells at any time interval after injection of low concentrations of HRP. However, at 5 min after injection of higher concentrations of HRP reaction product was localized in smooth vesicles and vacuoles mainly restricted to the large cytoplasmic processes facing the joint cavity. At 30 min to 4 hr postinjection the lysosomal system became progressively more loaded with HRP reaction product. At 24 hr after injection reaction product still remained in the lysosomal system. The present findings that type A and type S synoviocytes showed major differences with respect to endocytic capacity and cellular structures involved in absorption of HRP support the interpretation that the A and S cells represent two distinct types of cells and further suggest that endocytosis in these two types of cells serve different functions. PMID- 3831387 TI - Type-A retrovirus particles in heterohybridomas: precaution for human monoclonal antibody purification. AB - Fine structural features of the murine myeloma MHFP-1 and two heterohybridomas secreting human IgM monoclonal antibody were examined. Intracisternal type-A retrovirus particles were found in both MHFP-1 and the heterohydribomas constructed by fusing MHFP-1 and human peripheral blood lymphocytes. The implications of this finding for the purification of human monoclonal antibody for therapeutic applications is discussed. PMID- 3831389 TI - Transtubular transport of proteins in rabbit proximal tubules. AB - The purpose of the present experiments was to study possible different pathways of intracellular transport of proteins after luminal and basolateral uptake in isolated rabbit proximal tubules. Tubules were exposed to cationized ferritin (CF) in the perfusion fluid and horseradish peroxidase (HRP) in the bath simultaneously or to HRP in the bath alone for 30 min. The peritubular fluid (bath) and perfusion fluid were then exchanged and the tubules either fixed immediately or allowed to function during chase-periods for 10, 20, 30, or 60 min before fixation to follow the migration of the proteins through the cells. The proteins were to a large extent found separated in different vacuoles and lysosomes at all time periods studied, indicating separate pathways after uptake via the luminal and basolateral membranes respectively. About 0.5% of the CF taken up by the cells was transported through the cells and became located in the intercellular spaces. HRP was transported from the peritubular fluid to the apical cytoplasm of the tubules indicated by a gradual accumulation of small HRP containing vesicles, first in the basal part of the cells and then in the apical cytoplasm. In tubules perfused with both CF and HRP in the perfusate, the CF and HRP were found together in apical vacuoles and lysosomes. After perfusion with HRP alone, this tracer was found in similar large vacuoles and lysosomes in the apical cytoplasm, in contrast to the small HRP-filled vacuoles seen after uptake from the bath. PMID- 3831390 TI - Substructure of a cytoskeletal complex associated with the hamster sperm acrosome. AB - Whole mount and thin section preparations of intact and selectively disrupted hamster spermatozoa revealed an organized array of cytoplasmic filaments associated with specific regions of the acrosome. The filaments were localized along the ventral surface of the spermatozoon and extended from its tip, distally to the anterior margin of the equatorial segment. Individual filaments were 11-13 nm in diameter and they were aligned parallel to one another to form a two dimensional sheet oriented in the long axis of the spermatozoon. The filament complex adhered preferentially to the cytoplasmic surface of the outer acrosomal membrane rather than the plasma membrane. Examination of disrupted spermatozoa revealed that the distribution of this cytoskeletal assembly correlated with the distribution of a specific acrosomal matrix component. The possible role of this complex in the acrosome reaction or in the organization of acrosomal matrix domains is discussed. PMID- 3831385 TI - The aflagellate spermatozoon of Diplozoon (Platyhelminthes: Monogenea: Polyopisthocotylea): a demonstrative case of relationship between sperm ultrastructure and biology of reproduction. AB - Diplozoon is known to display an exceptional biology of reproduction: the hermaphroditic adults are permanently fused together and their genital ducts communicate. In contrast to all other polyopisthocotylean monogeneans in which the spermatozoa show an homogeneous biflagellate structure, the spermatozoon of Diplozoon is aflagellate. It is filiform, and composed of a cytoplasmic region and a nuclear region. The cytoplasmic region exhibits mitochondria, a well developed smooth endoplasmic reticulum, and up to 450 longitudinal singlet microtubules. The microtubules show links between them; seen in cross section, they are arranged as rows or polygons. The spermatozoon nuclear region contains the nucleus surrounded by cortical longitudinal microtubules. The spermiogenesis shows no zone of differentiation, a typical structure found in all other parasitic Platyhelminthes. Diplozoon is the first case of aflagellate spermatozoon found in the parasitic Platyhelminthes. The atypical sperm structure is not linked with phylogeny, but is well correlated with the atypical biology of reproduction. PMID- 3831392 TI - A comparison of two exponential models of the time constant during left ventricular isovolumic pressure decay in coronary artery disease. AB - To make a comparison of two exponential models of the time constant (Tw: Weiss's method, Tc: exponential analysis with a variable asymptote) during left ventricular (LV) isovolumic relaxation, we assessed LV pressure decay in 104 patients with coronary artery disease (CADpts) and 21 normal subjects at rest and after pacing, and investigated the hemodynamic determinants of these two models using forward-backward stepwise multiple regression analysis. At rest, Tw was prolonged as the left ventricular minimal pressure (LVPmin), the left ventricular end-diastolic pressure (LVEDP) and the end-systolic volume (ESV) increased (multiple regression coefficient: R = 0.87), whereas Tc was prolonged as ESV and regional wall motion abnormality (RWMA) increased (R = 0.72). Pacing-induced changes in Tw were augmented as LVPmin and RWMA increased (R = 0.75), whereas changes in Tc were augmented as RWMA increased (R = 0.63). Thus, the changes in Tw may be due to an increase in LVPmin rather than to any direct effect of ischemia on the relaxation rate. The relaxation rate can be evaluated more reliably by Tc than by Tw, irrespective of associated pressure changes during ischemia in CADpts. PMID- 3831393 TI - The effect of verapamil on reperfusion arrhythmia in canine heart. AB - This study was designed to clarify the mechanism of reperfusion arrhythmia and with the effect of verapamil on arrhythmia. In vivo study: Fifty anesthetized dogs were divided into two groups the control group (n = 37) and the verapamil group (n = 13). The left anterior descending coronary artery (LAD) was occluded for 15 min and then reperfused for 5 min. Physiological saline or verapamil (0.4 mg/kg) was infused 5 min prior to the LAD reperfusion. Eleven (30%) of the control dogs developed "reperfusion arrhythmia" (arrhythmia group) but 26 did not (non-arrhythmia group), while in the verapamil group, none of the 13 dogs developed arrhythmia. Immediately after 5 min reperfusion, myocardial plasma membrane and mitochondria were prepared from the normal and the reperfused area. In the arrhythmia group, an increase in free fatty acids (FFA) and a decrease in phospholipids were observed in membrane samples, and the content of calcium in the mitochondria increased in the reperfused myocardium; these changes were not observed in the non-arrhythmia group or the verapamil group. In vitro study: In vitro study consisted of two experiments. In experiment 1, incubation of myocardial plasma membrane with phospholipase (PLase) A2 increased only the unsaturated FFA, while PLase C increased all the detected FFA. In experiment 2, the effects on myocardial membrane potentials induced by PLase A2 and PLase C were studied by using microelectrodes. Each PLase caused a decrease in the resting potential and in the magitude and duration of the action potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3831391 TI - Morphogenesis of the elastic fiber: an immunoelectronmicroscopy investigation. AB - In this study a rabbit antiserum against human aortic elastin, which showed a high degree of species specificity in ELISA tests, was used to examine elastin fiber formation in the human fetal aorta between the ages of 14 and 23 weeks. Elastin was first detected by the antibody in the matrix of the 14-week-old specimen in association with the microfibrillar component. At this stage of development, the sections did not reveal structures morphologically identifiable as elastin. By the 17th week, discrete loci of elastin deposition were observed together with well-defined elastin fibrils. Only by the 23rd week did the aorta show the characteristic layering of elastic fibrils separating the myoblasts of the tunica media. In the latter specimen, the newly synthesized uncrosslinked elastin appeared to be unevenly distributed on the surface of elastin fibrils where it formed continuous strips of variable width arranged mostly in the form of spirals. This observation is discussed with respect to the proposals that the morphogenesis of elastic tissue is a dynamic process involving a close interrelationship between elastic fibrils and elastogenic cells and the morphogenetic movement of elastogenic cells plays an important role not only in the growth of elastic fibrils but also in the ultrastructural organization of the tissue. PMID- 3831394 TI - The effects of M-protein fraction of hemolytic streptococci on embryonic heart in the rat. AB - Wistar rats were administered M-protein fraction (MP) of group A type 12 hemolytic streptococci on day 9 of gestation. When 9 mg/kg of MP was injected, the incidence of malformations was 11.8%, and the incidence of cardiovascular malformations was 7.9%. The main malformations were ventricular septal defect, microphthalmia, and hydrocephaly. Light and electron microscopic studies revealed no myocarditis nor endocarditis in either the maternal or fetal heart. Fluorescent antibody technique demonstrated no immunological cross-reaction between MP and rat heart tissue. The results suggest that MP is slightly teratogenic in the rat. PMID- 3831395 TI - On the interstitial fibrotic changes in acute and convalescent myocarditis obtained by serial endomyocardial biopsy. AB - In order to determine the characteristics of the interstitial fibrotic change of the myocardium in cases with viral or idiopathic myocarditis, right ventricular endomyocardial biopsy findings in 9 cases where serial endomyocardial biopsy had been performed at the acute (5-10 days after the onset of the disease), subacute (11-21 days) and convalescent stages (22-167 days) and in 1 case at the acute stage were analyzed. They were then compared with right ventricular endomyocardial biopsy findings from 58 cases with chronic right ventricular overloading and which were of various kinds of congenital and valvular heart diseases. The following results were obtained: Interstitial fibrosis was seen at the acute stage along with an increase in fibroblasts, macrophages and lymphocytes. An analysis of the interstitial changes revealed that, at the acute stage, thin collagenous fibers were prominent as well as interstitial edema and at the convalescent stage, the edema became less prominent and instead, thick collagenous fibers increased. Comparison with the 58 cases with chronic right ventricular overloading revealed that diffuse and/or subendocardial fibrosis and endocardial thickening were more frequent and statistically more significant in cases with myocarditis. PMID- 3831396 TI - Mass survey for coronary lesions in school children with history of Kawasaki disease in Shimane Prefecture. AB - In 1981, a mass survey for Kawasaki disease was performed in Shimane Prefecture. The incidence of the disease was 0.3% in elementary and 0.1% in junior high schools, respectively. The number of children with a past history of Kawasaki disease was 40. Selective coronary arteriography (S-CAG) was performed on 37 children by December 1983 and 3 cases having coronary lesions were detected. In all these 3 children, more than 8 years had elapsed since the onset of the disease and in one of them there were severe stenotic changes in the coronary artery, with coexisting mitral incompetence. Two-dimensional echocardiography (2D echo) was able to detect dilatatory coronary lesions, but it failed to delineate stenotic changes adequately in these 3 cases. The present data indicate that 2D echo cannot demonstrate the stenotic segments of the coronary artery and therefore S-CAG is necessary for that purpose. We suggest coronary arteriography (CAG) for school children with a past history of Kawasaki disease. PMID- 3831397 TI - Abnormal Q-wave in children. The first report: QS-pattern in lead V1. AB - Seventeen healthy children with QS-pattern in lead V1 were studied vectorcardiographycally. Age ranged from 6 to 15 years old. Azimuth at 10 and 20 msec displaced leftward and azimuth of maximum spatial voltage slightly displaced posteriorly. Anterior component was minimal. QS-pattern in lead V1 in children is not necessarily abnormal finding. The main cause of QS-pattern in lead V1 is electrical rotation of the heart. PMID- 3831398 TI - Usefulness of long-term ambulatory electrocardiography in heart disease screening system for school children and high school students. AB - Long-term ambulatory electrocardiography was utilized in a heart disease screening system for elementary school children and junior and senior high school students in Nagoya, Japan. The elementary school children, and junior and senior high school students who have serious arrhythmias or potential risk of syncope and sudden death are the subjects of ambulatory monitoring. Of 42 school children and students taking ambulatory electrocardiography for frequent ventricular premature contractions, 8 had Lown's grade 4A, 4B or 5. The cases with third degree AV block showed ventricular tachycardia or frequent ventricular premature contractions during exercise in ambulatory electrocardiograms. These complex ventricular arrhythmias are possible risk factors of sudden death. It has been proved that ambulatory monitoring is beneficial in the screening and management of serious arrhythmias in the heart disease screening system. PMID- 3831399 TI - A study on exercise test for mass examination of heart disease. AB - One thousand and twenty-two of senior high school students and 274 of primary and junior high school students screened as positive through heart disease mass examination were tested by the Master's two step Method. The results are as follow: 1) In order to get informations to give the guide line for school life, it is still insufficient triple amounts of exercise performed during 3 minutes and 45 seconds for high school male students although this may be appropriate for primary, junior high school students and female senior high school students. 2) Fatigue and their history concerning to athletic activity should not be neglected to evaluate the results of exercise test. 3) It is important to consider before evaluation of the test that QTc immediately after exercise shorten by 6 to 8% and QTc 3 minutes after the exercise prolonged by 3 to 4%. PMID- 3831400 TI - Direct estimation of cardiac reserve through analysis of relation between oxygen consumption and heart rate during exercise testing. AB - In order to elucidate fundamental relationship between exercise and cardiac reserve, we investigated the parameters of regression equation (VO2 = A X HR + B) between oxygen consumption (VO2 ml/kg/min) and heart rate (HR) during exercise test (Bruce). 62 male children were divided into 3 groups based on history and clinical evaluation. HR related linearly with VO2 (average r = 0.967, range 0.90 0.993). Both of the parameters A and [B] were significantly high in Athlete (A = 0.465 +/- 0.043, [B] = 36 +/- 6.07), low in Failed (0.297 +/- 0.055, 17.4 +/- 6.1) and middle in Ordinary group (0.366 +/- 0.078, 23.5 +/- 8.6) (p less than 0.005). Based on our result of linear VO2-HR relation, and on the previously reported studies that cardiac output linearly and consistently relates with VO2, we considered the meaning of the parameters as follows; A determines the possible maximum stroke volume (SV), and B determines the HR where SV reaches plateau. In conclusion, since the SV is considered as a measure of cardiac function, measuring the parameters of VO2-HR relation allows us to isolate cardiac functional reserve through the exercise tolerance test. PMID- 3831401 TI - Study on the mitral valve prolapse. I. Incidence in Kobe University students. II. Follow up study. AB - Incidence of mitral valve prolapse (MVP) in 4517 students of Kobe University, and clinical features in cases with MVP were studied. MVP was detected in 42 cases by two-dimensional echocardiography, and the prevalence of MVP was 0.93 percent (42 of 4517 cases). Among 42 cases with MVP, apparent mitral regurgitation (MR) was noted in one case with severe MVP, ventricular tachycardia was detected in one and ST-T wave abnormalities were detected in 10 respectively. In another follow up study of our hospital, 14 of 85 patients followed more than one year were noted to be deterioration in echocardiographic parameters. Eight of 14 patients had severe prolapse with severe MR, but remaining 6 had mild or moderate prolapse with mild or absent of MR. However, ST-T wave abnormalities, serious arrhythmias, and low response of %FS increase on exercise were found in high incidence in 6 of mild or moderate prolapse as well as in severe prolapse. So these follow up results suggested that not only students with severe MVP but also students with mild or moderate MVP with ST-T wave changes or VPC found in university medical examination must be followed up carefully. PMID- 3831402 TI - [Ultrastructure and function of bacterial cells, with special reference to the structural analysis of protein layers of the cell surface]. PMID- 3831403 TI - [Taxonomic studies on the causative organism of contagious equine metritis, Taylorella equigenitalis gen. and comb. nov]. PMID- 3831404 TI - [Increase of intradermal vascular permeability by pertussis toxin]. PMID- 3831405 TI - Mechanisms for improvement of cardiac performance by nifedipine in an acute mitral regurgitation in dogs. AB - To elucidate the mechanisms of the beneficial hemodynamic action of nifedipine in congestive heart failure, the systolic and diastolic hemodynamic parameters were evaluated for 30 min after sublingual administration of 20 mg of nifedipine in 12 dogs with acute mitral regurgitation (group 1) and in 5 dogs without mitral regurgitation (group 2, sham operation group). An additional 6 dogs with mitral regurgitation were followed for 30 min without nifedipine (group 3). Nifedipine lowered both arterial pressure and systemic vascular resistance, increased coronary blood flow and stroke volume significantly in both groups 1 and 2. The left ventricular developed tension was increased by nifedipine only in group 1, probably due to the geometric changes in the expanded left ventricle in failure, secondary to left ventricular preload and afterload reduction. Nifedipine had no effects on ventricular relaxation properties in this study. This study suggests that the mechanisms responsible for the improvement of cardiac performance induced by nifedipine in heart failure caused by an acute mitral regurgitation are essentially a reduction in left ventricular afterload and an increase in left ventricular contractility secondary to afterload reduction. PMID- 3831406 TI - Exercise-induced coronary artery spasm. A regional coronary blood flow study. AB - Regional myocardial blood flow during exercise was determined using the thermodilution technique in 2 patients suffering from both spontaneous and exertional chest pain. In both cases we observed that effort-related anginal attacks were due to coronary spasm with sudden reduction of regional left ventricular blood flow. In 1 patient the exercise-induced ST-segment elevation in the anterior leads was accompanied by a reduction of flow in the great cardiac vein. In the second patient the exercise-induced ST-segment depression in the lateral leads was accompanied by a reduction of coronary flow in the area supplied by the circumflex artery. In 1 patient, nifedipine was effective in prolonging exercise tolerance by preventing the occurrence of coronary spasm and by increasing blood supply to the ischemic region during exercise. PMID- 3831407 TI - Rapid cyclic fluctuations of blood pressure associated with treatment of pheochromocytoma by labetalol. AB - Rapid cyclic fluctuations of blood pressure in patients with a pheochromocytoma have rarely been reported. The suitable conditions to induce this phenomenon are not adequately known. We report here a patient with an adrenal pheochromocytoma who showed this phenomenon after oral administration of labetalol. PMID- 3831408 TI - Myocardial involvement in the Marfan syndrome. AB - A patient with the Marfan syndrome and echocardiographic and angiocardiographic evidence of hypertrophic cardiomyopathy is presented. Endomyocardial biopsy was performed. Histologic abnormalities of the endomyocardium noted in this patient were considered to be related to the basic generalized connective tissue abnormality, and the patient subsequently developed myocardial disease compatible with hypertrophic non-obstructive cardiomyopathy. We believe that this case emphasizes the possible co-existence of subclinical myocardial disease in patients with the Marfan syndrome. PMID- 3831409 TI - Prominent negative U wave in variant angina pectoris. AB - The extremely prominent negative U wave occasionally appears during a cardiac attack in variant angina pectoris. The clinical profile of the negative U wave was therefore studied in 80 patients with variant angina pectoris (VA) and 33 controls with resting angina pectoris (RA). The prominent negative U wave appeared in 55 of the patients with VA (68.8% of patients) and in 10 of the patients with RA (30.3%); thus, there was a significant difference in the appearance of the wave between the 2 groups of patients (p less than 0.001). The leads in which the negative U wave appeared were mostly consistent with those in which the ST segment was elevated. The negative U wave began to appear at about the time when ST-segment elevation began to improve; the wave then gradually became very prominent and then eventually disappeared. The patients with VA and also those with RA on whose ECGs the negative U wave appeared during exercise testing also had negative U waves during spontaneous episodes of angina. An investigation of the frequency of appearance of ST deviation and negative U waves during exercise testing, regardless of the type of angina pectoris, disclosed that the negative U wave appeared in 14 of 20 patients with ST-segment elevation (70% of patients), while the negative U wave appeared in only 52 of 519 patients with either no ST change or ST-segment depression (10.4%); thus, there was a significant difference in the appearance of the negative U wave between these 2 groups (p less than 0.001). Coronary cinearteriography failed to disclose any apparent difference between the appearance of the negative U wave and the presence of stenosis. The prognosis of VA and RA in patients with negative U waves was less favorable compared to those without negative U waves. In particular, we noted that of the 10 patients with RA associated with negative U waves, 4 died. Although the mechanism of the negative U wave is not yet known, we believe that the above findings contribute to its elucidation. PMID- 3831410 TI - Right ventricular function after extracardiac conduit repair for tetralogy of Fallot. A comparison among surgical approaches. AB - Right ventricular volume measurements and hemodynamic studies were performed in 20 patients after total correction of tetralogy of Fallot. There were 6 patients with an extracardiac conduit and Hancock xenograft (G-1), 8 with an outflow tract patch (G-2) and 6 without or with a minimal right ventriculotomy and repair of pulmonary valve (G-3). The age at the time of operation was over 3 years in each patient and averaged 5 +/- 2 (mean +/- SD) years. Right ventricular systolic pressure averaged 81 +/- 22, 55 +/- 22 and 58 +/- 30 mmHg in G-1, G-2 and G-3, respectively. Right ventriculography showed no contraction of the right ventricular free wall at the anastomosis to the conduit and poor contraction around the anastomosis in G-1. The right ventricular enddiastolic volume index (RVEDVI) was 114 +/- 31, 155 +/- 57 and 115 +/- 28 ml/m2 in G-1, G-2 and G-3, respectively. The right ventricular ejection fraction (RVEF) was 0.42 +/- 0.11 in G-1, 0.53 +/- 0.04 in G-2 (p less than 0.05, vs G-1) and 0.57 +/- 0.04 in G-3 (p less than 0.02, vs G-1). Pulmonary regurgitation was evident in 17 patients, and RVEDVI correlated well with degrees of pulmonary incompetence. Fourteen patients in G-2 and G-3 were divided into G-A and G-B to evaluate right ventricular function with or without pressure overloading of the right ventricle. G-A consisted of 7 patients with a right ventricular systolic pressure of more than 50 mmHg (74 +/- 26) and G-B of 7 patients with a value less than 50 mmHg (39 +/- 4). There was no difference in RVEDVI and RVEF between G-A and G-B. RVEF was significantly lower in G-1 than G-A (p less than 0.02) and G-B (p less than 0.05). These results suggested that an extracardiac conduit with Hancock xenograft reduced the contraction of the right ventricular free wall and induced a depressed right ventricular pump function in patients with a high right ventricular pressure. PMID- 3831411 TI - Cardiac free wall rupture after acute myocardial infarction. Clinical and pathological analysis. AB - Clinical and pathological findings in 15 autopsy cases, 13 males and 2 females, confirming cardiac free wall rupture after AMI were reported. The incidence is 30.6% of all autopsy cases of AMI in Chinese PLA General Hospital from 1958 to 1979. The ages ranged from 46 to 79 years, 10 being above 60 years. For 73.3% it was the first AMI and 66.7% of the patients had a history of hypertension. Thirteen of the 15 patients died within 5 days after the onset of AMI and another 2 within 7 days. When the cardiac rupture occurred, the ECG generally showed bradycardia, AV-junctional rhythm, III degrees AV block or isorhythmic ventricular rhythm and cardiac arrest. Both the gross and microscopic AMI were examined in 13 cases. All of them had a septal infarct, but only 2 had an ECG diagnosis. Of the 6 patients with inferior MI on ECG, 5 had right and left coronary lesions worse than grade III. The effective prevention of cardiac rupture consists of early diagnosis, control of chest pain and vomiting, prevention or treatment of hypertension or hypotension and 1 to 2 weeks of bed rest after the onset of AMI. PMID- 3831412 TI - Blood pressure tracking in Japanese adolescents. Five-year follow-up in Hisayama, Japan. AB - Blood pressures (BPs) were measured with standardized sphygmomanometers in 434 Japanese boys and girls living in the town of Hisayama. Simultaneously, data on pulse rate, weight and height were obtained. Out of the original 434 subjects, data were obtained repeatedly for 5 years in 280 subjects. BP levels were significantly correlated with weight in those aged 14-15 and also 19-20 years, but correlation coefficients were small. During the 5-year period, the mean systolic and diastolic blood pressure (SBP & DBP) increased significantly in both sexes, but the increments were greater in boys. Both SBP and DBP at 14-15 years of age were significantly correlated with data taken 5 years later for both sexes, and subjects with a higher initial BP (more than 90th percentile of the distribution) tended to have a higher BP after 5 years. SBPs after 5 years were independently correlated with initial SBP levels and changes in QI (D-QI) in both sexes. On the other hand, DBPs after 5 years were independently correlated with initial DBP levels and height for boys, and initial DBP levels and D-QI for girls. PMID- 3831413 TI - Relationships between red cell cation contents and blood pressure level. AB - Red cell sodium (R-Na), potassium (R-K) and sodium to potassium ratio (R-Na/K) were studied in 2,542 adults participating in periodic medical examinations. The mean values of R-Na and R-Na/K in untreated borderline (n = 406) and definite hypertensives (n = 485) were higher than those in normotensives (n = 1,651), but that of R-K was not different among the groups. The increased R-Na and R-Na/K in the hypertensives were observed only in those under 50 years, but not in those 50 years and over. In the normotensive subjects, age and sex affected the intraerythrocyte cation contents, but a positive family history of hypertension did not. Although a few characteristics correlated with both R-Na and mean blood pressure, and with both R-Na/K and mean blood pressure, multiple regression analyses revealed that R-Na and R-Na/K independently and significantly contributed to the variation in mean blood pressure. It was also indicated that these relations of R-Na and R-Na/K to mean blood pressure were significant in those under 50 years, but not in those 50 years and over. While several characteristics confound the relationships between red cell cation contents and blood pressure, these results suggest that the contributions of R-Na and R-Na/K to the mechanisms of human hypertension still persist in young to middle-aged people. PMID- 3831414 TI - Contrasting effects of dopamine and dobutamine on myocardial release of norepinephrine during acute myocardial infarction. AB - The effects of dopamine and dobutamine on release of norepinephrine from normal and ischemic myocardium were compared in 2 groups of open-chest anesthetized dogs. Both agents were infused intravenously at a rate of 10 micrograms/Kg/min for 2 hours, beginning 40 min after snare occlusion of the left anterior descending coronary artery. There were no major differences in hemodynamic responses between the 2 groups. Blood samples were taken simultaneously from the aorta, coronary sinus and the cardiac vein that ran parallel to the left anterior descending coronary artery before and after coronary artery occlusion. Plasma norepinephrine increased 40 min after the occlusion, with a net efflux in both coronary sinus and cardiac venous blood. Dopamine caused further increases in plasma norepinephrine. At 20 min after the beginning of dopamine infusion the coronary sinus concentration (4.09 +/- 1.36 ng/ml) was significantly greater than the arterial concentration (2.84 +/- 0.87 ng/ml). This transcardiac difference disappeared during continuous infusion 2 hours after coronary artery occlusion. Differences in norepinephrine concentration between the arterial and cardiac venous blood, however, were not significant. In contrast, plasma norepinephrine did not increase during dobutamine infusion in either the ischemic or non ischemic bed. Thus, the results suggest that while these two agents have similar systemic hemodynamic effects, only dopamine increases myocardial release of norepinephrine from either ischemic or normal myocardium during acute myocardial infarction. PMID- 3831415 TI - ST segment changes under occlusion of the proximal portion of major coronary arteries in the isolated canine heart. AB - We studied the mechanisms of ST segment displacement in the ECG recorded from the epi- and subendocardium of ischemic ventricles in the isolated and perfused canine heart. ST segment changes were observed in association with a relatively large area of ischemia produced by occlusion of the left anterior descending and septal arteries (LAD + Sept.) or of the left circumflex artery (LCx). Contrary to previous reports, we found that the amount of subendocardial ST elevation was not always greater than that in the epicardial ECG recorded at the center of ischemia. Also, in the non-ischemic area, the degree of the ST depression in the subendocardial record was nearly the same as the epicardial record. On the other hand, the degree of the epicardial ST elevation on the border zone was always smaller than that at the ischemic center, which seemed to be due to the broadness of the border zone. The amplitude of the ST depression in the non-ischemic area was greater when the recording electrode was near the ischemic border, which supports the solid angle theory. The degrees of both ischemic ST elevation and reciprocal ST depression in the LCx perfused area were always greater than in the LAD + Sept. perfused area. These results strongly suggest that ST segment displacement depends on the relative position of the recording electrode to the electric double layer which exists at the border between the ischemic and non ischemic area. PMID- 3831416 TI - [Leukocyte function: flow cytometric evaluation of granulocyte phagocytosis, using fluorescent microspheres]. PMID- 3831417 TI - [Detection of particle-associated antigens by flow cytometry]. PMID- 3831418 TI - [Investigation of leukemic cells using flow cytometry]. PMID- 3831419 TI - [Flow cytometric analysis of tumor cells during intra-arterial cis-platinum therapy of cervical cancer]. PMID- 3831420 TI - [Clinical application of two-color flow cytometry analysis]. PMID- 3831421 TI - [Flow cytometric analysis of lymphocyte subpopulations of normal human peripheral blood]. PMID- 3831422 TI - [Flow cytometry in pretransfusion testing--detection of red cell antigen-antibody reactions by FCM]. PMID- 3831423 TI - [A basic study on N-acetyl-beta-D-glucosaminidase (NAG) isoenzyme]. PMID- 3831424 TI - [Relation of diabetic markers and tumor markers--studies on causality]. PMID- 3831425 TI - [Dissociation of hematocrit values obtained by THMS and capillary centrifugal methods]. PMID- 3831426 TI - [Detection of cross-linked fibrin degradation products by the latex agglutination method using monoclonal antibodies]. PMID- 3831427 TI - [Discrepancy in CEA levels of different kits]. PMID- 3831428 TI - [Lipid composition of the ultracentrifugal sediment of serum in malignancy]. PMID- 3831429 TI - [The influence of vitamin A on cutaneous carcinogenesis in mice induced by 20 methylcholanthrene. 1. Carcinogenesis and tumor incidence]. PMID- 3831430 TI - [The influence of vitamin A on cutaneous carcinogenesis in mice induced by 20 methylcholanthrene. 2. Electron microscopy studies]. PMID- 3831431 TI - [Pigmented contact dermatitis due to cotton flannel nightdress]. PMID- 3831432 TI - [Isolation of dermatophytes from the house-dust]. PMID- 3831433 TI - [A case of malignant blue nevus]. PMID- 3831434 TI - [Plasma fibronectin levels in patients with vulgar psoriasis]. PMID- 3831435 TI - [Histological and immunohistochemical studies on SLE-like skin lesions in NC mice]. PMID- 3831436 TI - [Sensitization test of naphthol AS on guinea pigs]. PMID- 3831437 TI - [A case of reticulate hyperpigmentation distributed in zosteriform fashion]. PMID- 3831438 TI - [Two cases of cutaneous focal mucinosis and related diseases]. PMID- 3831439 TI - [Studies on superoxide dismutase in the human skin (2). Content of superoxide dismutase and lipid peroxide in normal human skin]. PMID- 3831440 TI - [Studies on biliary and fecal bile acids in Crohn's disease (2). Effect of ED treatment on bile acid metabolism]. PMID- 3831441 TI - [The role of the liver in normal immune responses]. PMID- 3831442 TI - [Studies on the mechanism of action of the cholestatic factor: no increase of biliary permeability in cholestatic factor-treated rats]. PMID- 3831443 TI - [Antipyrine plasma clearance in patients with liver cirrhosis]. PMID- 3831444 TI - [Correlation between enhancement of natural killer (NK) activity by an immunopotentiator (OK-432) and resistance to human hepatoma cell implantation in nude mice]. PMID- 3831445 TI - [Serum bile acid composition in patients before and after percutaneous transhepatic cholangiodrainage for obstructive jaundice]. PMID- 3831446 TI - [Effects of iridoid compounds on bile flow]. PMID- 3831447 TI - [Beta-glucuronidase activity in bile in cholelithiasis with special reference to anaerobes]. PMID- 3831448 TI - [Clinical significance of the fecal chymotrypsin test in chronic pancreatitis- comparative study of its value with the pancreozymin-secretin test, PFD test, and endoscopic retrograde pancreatography]. PMID- 3831449 TI - [Diagnostic value of fecal chymotrypsin determination in pancreatic diseases]. PMID- 3831450 TI - [A case of pseudomyxoma peritonei in which the primary site is supposed to be the urachus]. PMID- 3831451 TI - [A case report of young-onset pancreatolithiasis with some aspects of the etiology and therapy]. PMID- 3831452 TI - [Magnetic resonance relaxation times of spleen in chronic liver diseases]. PMID- 3831453 TI - [Effects of smoking on brain aging: II. Brain atrophy and smoking--a quantitative study with computed tomography]. PMID- 3831454 TI - [Disability and underlying diseases of the institutionalized elderly--analysis of causes of immobilization]. PMID- 3831455 TI - [The clinical study of hyponatremia in the elderly. Part Three. Plasma ADH secretion in dilutional hyponatremia]. PMID- 3831456 TI - [Studies on metal (Zn, Cu, Fe) kinetics for ageing phenomena on lens]. PMID- 3831457 TI - [Neuropathology of the centenarian brains]. PMID- 3831458 TI - [Low serum triiodothyronine in elderly subjects with non-thyroidal diseases]. PMID- 3831459 TI - [Studies on digoxin maintenance therapy in the elderly]. PMID- 3831460 TI - [Multivalidation analysis of the risk factors for ischemic heart disease and cerebral infarction]. PMID- 3831461 TI - [Effects of rehabilitation on the cerebrovascular diseases in the aged and discharge disposition]. PMID- 3831462 TI - [Malignant lymphoma of the elderly--evaluation of undiagnosed cases]. PMID- 3831463 TI - [Meningitis in the aged with unusual symptom of depressive state]. PMID- 3831464 TI - [Development and evaluation of the ambulatory relative metabolic rate (RMR) realtime monitoring system]. AB - Development of an ambulatory RMR monitoring system for evaluating the physical work-load is presented. This system can be used under special conditions where it is difficult to use the traditional "Douglas" method. The main features of this system are: Using an improved turbin-spirometer to measure expiratory gas volume, data-processing procedure is simplified by converting a 0.1 iota expiratory gas volume to an electric pulse signal. Utilizing a Galvanic-cell type sensor, a kind of porlarograph electrode, to measure oxygen concentration in expiratory gas, the temperature of the electrode is maintained constantly at 40 degrees C in order to stabilize the output of the sensor against change in environmental and expiratory gas temperature. To improve the accuracy measurement of oxygen concentration and to prevent the teflon membrane at the top of the electrode from chilling and vibrating by direct expiratory gas flow, the bypass stream line is led to the electrode and a small portion of expiratory gas is introduced to measure oxygen concentration. It is possible to measure the time-sequential RMR value for several hours by minimizing and lightening the measuring instruments. It is possible to measure the time-sequential changing characteristics of the physical work-load (RMR), heart rate, breathing rate, and skin temperature under the actual work environment by a telemetring or portable recording method. PMID- 3831465 TI - [Effect of cadmium on essential metals in blood in male and female rats]. PMID- 3831466 TI - [Clinical trial of oral adsorbent (AST-120) as conservative treatment in patient with chronic renal failure]. PMID- 3831467 TI - [Clinical significance of IgA deposits on the glomerular capillary wall in IgA nephropathy]. PMID- 3831468 TI - [Clinicopathologic study of IgA nephropathy and non-IgA mesangial proliferative glomerulonephritis]. PMID- 3831469 TI - [The effect of antigenic charges in the glomerular deposition of immune complexes in acute serum sickness nephritis in mice]. PMID- 3831470 TI - [Studies on intraglomerular coagulation in various renal diseases]. PMID- 3831471 TI - [The relation between urinary NAG and glomerular lesions studied in association with isozyme A and NAG/protein ratio and effects of walking]. PMID- 3831472 TI - [Effects of different salt intakes on urinary output of catecholamines and renal sympathetic nerve activity]. PMID- 3831473 TI - [Responses of plasma and urinary catecholamines after loading tests in patients with essential hypertension]. PMID- 3831474 TI - [Evaluation of renal kinetic function, using NMR-CT by gadolinium-DTPA. (2). NMR CT regional renogram and glomerular filtration ratio]. PMID- 3831475 TI - [Relation of time to te complete redistribution and severity of coronary artery disease: assessment by early and delayed redistribution]. PMID- 3831476 TI - [Radionuclide study in the detection of varicocele in infertile men]. PMID- 3831477 TI - [Clinical evaluation of cardiovascular disease by gated-MRI (magnetic resonance imaging) in the operating field of 0.35 and 1.5 tesla]. PMID- 3831478 TI - [Usefulness of the tomographic phase image in ventricular conduction abnormalities]. PMID- 3831479 TI - [A QRS scoring system for assessing left ventricular function and myocardial infarct size]. PMID- 3831480 TI - [Significance of I-131 meta-iodobenzylguanidine scintigraphy in diagnosing neuroblastoma]. PMID- 3831481 TI - [Fundamental and clinical evaluation of the Amerlex FT3 RIA kit]. PMID- 3831482 TI - [Evaluation of left ventricular function in patients with atrial fibrillation by ECG gated blood pool scintigraphy. Analysis of left ventricular filling and function curve]. PMID- 3831483 TI - [Basic and clinical evaluation of squamous cell carcinoma related antigen (SCC) RIA kit]. PMID- 3831484 TI - [The clinical significance of lung thallium uptake in stress thallium scan in cases with myocardial infarction]. PMID- 3831485 TI - [Hepatobiliary scintigraphy with Tc-99m-PMT in a case of Rotor's disease. Comparison with the image of Tc-99m E-HIDA]. PMID- 3831486 TI - [Clinical evaluation of lymphoscintigraphy using 99mTc-rhenium-colloid. Malignant lymphoma]. PMID- 3831487 TI - Congenital, latent and manifest latent nystagmus--similarities, differences and relation to strabismus. AB - Patients with congenital types of nystagmus, including congenital nystagmus (CN), latent/manifest latent nystagmus (LMLN) and combinations of the two, can be identified by waveform analysis and classified into three unambiguous groups. This categorization by waveform is supported by different clinical signs, including the relationship to strabismus. Strabismus is essential for LMLN but incidental to CN; most CN patients do not have strabismus. Seventy-seven percent of CN patients have a convergence null, 57% a gaze angle null and nearly half have both; only 14% have neither. Also supporting this patient grouping by waveform is the high incidence of patients in each of the two major groups (ie, they had either only CN waveforms or only the LMLN waveform). Comparing the incidence of each CN waveform, or combinations of waveforms, in families with that in the general CN population, reveals that heredity plays a role in determining waveform; heredity also affects other characteristics, such as gaze angle or convergence nulls. The nystagmus blockage syndrome has at least two mechanisms and the patients, therefore, can belong to either of two groups. Spasmus nutans is hypothesized to be an oscillation of the vergence system and therefore, unrelated to CN or LMLN. PMID- 3831488 TI - Macrosaccadic oscillation, saccadic dysmetria and motor error in spinocerebellar degeneration. AB - The macrosaccadic oscillation was analyzed quantitatively in a 31-year-old man with spinocerebellar degeneration, using DC electrooculogram. Over a follow-up period of one year the macrosaccadic oscillation changed into saccadic dysmetria where square oscillations were suppressed during fixation and occurred only after visually guided saccades. The initial movements in the oscillation followed the main saccades with a mean latency of 147.6 msec. When a saccade showed an overshoot, a fast movement occurred in the opposite direction, and with undershoot of the saccade, the fast movement occurred in the same direction as that of the saccade. Furthermore, the amplitudes of the oscillation had a close correlation with those of the motor error, ie, the difference in the amplitudes between the target displacement and saccade. The results suggest that square oscillations in the macrosaccadic oscillation and saccadic dysmetria may be caused by an elevation of the gain in the corrective saccadic system. PMID- 3831489 TI - Characteristics of the capillary-free zone in the normal human macula. AB - The dimensions of the foveal avascular zone (FAZ) were determined on fluorescein angiograms in 45 normal subjects, 25 men and 20 women, by means of a digital image processing system. The shape of the FAZ was usually irregular and showed considerable individual variations. The mean longest diameter was 0.88 +/- 0.16 mm (SD), the horizontal diameter was 0.73 +/- 0.15 mm, vertical diameter was 0.70 +/- 0.17 mm and the area averaged 0.43 +/- 0.16 mm2. The area of the FAZ and the age of the subjects showed a statistically significant positive correlation (r = 0.383, P less than 0.005). The enlargement of the FAZ with advancing age may be related to senescent changes of the retinal capillaries. It was stressed that it is of importance to measure the size of the FAZ by fluorescein angiography before laser photocoagulation is carried out near the macular region. PMID- 3831490 TI - Characteristics of the macular microvasculature. AB - The morphological appearance and the quantitative analysis of the structure of the macular microvasculature were investigated in 33 normal subjects by fluorescein angiography and stereoscopic mapping techniques. The foveal capillary network was formed by the anastomosis of 4 to 6 groups of terminal arteriolar and venous branches. The inner three rings of capillaries were a single layer of microangium. The apertures of the network differed in size and the closer to the foveal avascular zone, the larger were the apertures. The mean inner width of the capillaries in the fovea was 12.99 +/- 2.2 (SD) microns, and it was 24.55 +/- 6.51 microns on the edge of the fovea. There was a strikingly regular pattern of 4 to 6 arterioles with associated venules. The inner diameter of the smaller vessels on the edge of this area was 35.17 +/- 6.41 microns. In the external perifovea, the arterial and venous branches increased in number to more than 12 and the diameter of these vessels was 4.5 times larger than that of the capillaries in the fovea. The characteristics of the macular microcirculation provide a basis for studying macular disease, particularly the pathogenesis of vascular disorders. PMID- 3831491 TI - Lactate dehydrogenase levels in aqueous humor and serum in retinoblastoma. AB - The lactate dehydrogenase (LDH) levels were measured in the aqueous humor and serum of 16 patients (20 eyes) with retinoblastoma. The enzyme activity in the aqueous humor and serum did not show any correlation with each other. Age of presentation, age of enucleation, sex and disease duration had no correlation with the enzyme level either in the serum or aqueous humor. The stages of retinoblastoma were classified in Stages I to V: eyes with Stages I to III were included in Group 1, and those with Stages IV and V were in Group 2. The differences in LDH levels in the aqueous humor and in the aqueous to serum LDH ratio were highly significant (P less than 0.001) by Wilcoxon's nonparametric test between Groups 1 and 2. A considerable rise in the aqueous humor LDH level was observed without any alterations in the serum levels in Group 2 as compared to Group 1; hence the aqueous/serum ratio was increased in the former group. The LDH level in the aqueous humor and the aqueous/serum ratio can be a diagnostic tool in retinoblastoma of Stages IV and V. Though the lower aqueous levels of LDH do not rule out the presence of the disease, the higher levels are definitely helpful for diagnosis of retinoblastoma. PMID- 3831492 TI - Focal experimental demyelination in monkey optic nerve by lysophosphatidylcholine. AB - The optic nerve of 2 adult male Macaca fuscata was exposed and lysophosphatidylcholine dissolved in saline at 2% was slowly injected into the nerve at about 5 mm posteriorly from the eyeball. This procedure produced a focal lesion of demyelinating plaque. Kluver-Barreras and Bodian stain for myelin and axon revealed demyelination with myelin ovoids and relatively well preserved axons in the focal plaque. It was thought that this lesion would be an experimental model of the demyelinating lesion of retrobulbar optic neuritis. PMID- 3831493 TI - Changes of iris vessels in capsular glaucoma: three-dimensional and electron microscopic studies. AB - Iris specimens were obtained during trabeculectomy from 8 patients with capsular glaucoma. Serial sections for light and electron microscopies were prepared. By light microscopy, a three-dimensional model of the iris vessels accompanied by the pseudoexfoliation (PE) materials stained with toluidine blue was constructed. The PE materials attached to the vessel sometimes at a localized small area and sometimes along a certain length of the vessel; in some parts the vessel was free of the PE materials. By electron microscopy, the PE materials were seen to consist of fluffy fine filaments with the diameter of 20-30 nm and the length of 100-700 nm. They were accumulated underneath the vascular endothelial cells which showed a marked thinning and extended cytoplasmic processes. The accumulation of the PE materials produced a protrusion into the vascular lumen which was narrowed and sometimes completely occluded. The PE materials were mingled with the basement membrane which was displaced and sometimes disrupted. Some vessels surrounded by the PE materials showed marked endothelial degeneration, but some vessels free of the PE materials showed separation of the endothelial junctions leading to extravasation of erythrocytes. The endothelial cells and pericytes of the iris vessels as well as the stromal pigmented cells showed cytoplasmic indentations in which fine filaments with the diameter of 14-20 nm were present and were in close relationship with the cytoplasm at the bottom of the indentations, where the cytoplasmic membrane was indistinct. It was thought that these cells produced the PE materials, although established fine filaments of the PE materials could not be found within the cytoplasm. PMID- 3831494 TI - Distribution of motor and internuclear neurons in abducens nucleus of the cat. AB - The abducens nucleus is said to contain at least two types of neurons, ie, the motor neurons which supply the ipsilateral lateral rectus muscle, and the internuclear neurons which project to the medial rectus subdivision of the oculomotor complex via the contralateral medial longitudinal fasciculus. The distribution pattern of the motor and internuclear neurons within the abducens nucleus was examined in the cat, after horseradish peroxidase was injected into the lateral rectus muscle and the oculomotor complex, respectively. The results showed that both motor and internuclear neurons are distributed widely and intermingled without any topographical difference throughout the entire length of the abducens nucleus, and that the ratio of the motor to internuclear neurons was approximately 80:20-70:30. PMID- 3831495 TI - Effects of UV-cutting filters on aggregation of lens protein. AB - Physicochemical changes of the lens protein produced by UV light may be considered to be one of the pathogenic factors in the development of cataract. The effect of filters to eliminate these changes were investigated and evaluated using an in vitro system. UV irradiation caused degradation of alpha-crystallin to proteins with lower molecular weight, and thus the crystallin did not show insolubility. beta H- and beta L-crystallin showed insolubilization and aggregation with yellow coloration by photooxidation. The S-S linkage produced by oxidation of the SH group caused gamma-crystallin to aggregate and become insoluble. These chemical changes are prevented significantly by the UV-cutting colored filters. PMID- 3831496 TI - Co-carcinogenic effects of several Korean foods on gastric cancer induced by N methyl-N'-nitro-N-nitrosoguanidine in rats. AB - In study I, 48 ACI and Fisher inbred rats were given MNNG 100 micrograms/ml, with or without 1 per cent or 3 per cent red pepper diet; in study II, 164 Sprague Dawley rats given MNNG 100 micrograms/ml, with or without 5 per cent or 10 per cent NaCl; in study III, 181 Wistar rats given MNNG 83 micrograms/ml with or without maejoo 10 gm per cent/diet; in study IV, 78 Wistar rats given MNNG 83 micrograms/ml with or without ginseng extract 150 micrograms/ml; in study V, 120 Wistar rats given MNNG 83 micrograms/ml with or without retinyl palmitate 150,000 IU/kg. Except for study II (28 weeks), all rats were fed the diets for 37 weeks and were examined at 38 weeks or 40 weeks. In study I, tumor incidence in rats fed a red pepper diet and MNNG solution were 57 per cent (ACI rats, 1 per cent red pepper) and 63 per cent (Fisher rats, 1 per cent or 3 per cent red pepper) which were higher than control group (44 per cent, 43 per cent); in study II, gastric cancer, 61.9 per cent (10 per cent NaCl-MNNG), 27.3 per cent (control); in study III, gastric cancer, 14.8 per cent (maejoo-MNNG), 24 per cent (control); in study IV, malignant tumor of gastroduodenum, 3.4 per cent (ginseng-MNNG), 32.1 per cent (control); in study V, forestomach papilloma, 10.7 per cent (retinoid MNNG), 29.4 per cent (control), and cancer in duodenum and small intestine, 50.0 per cent (retinoid-MNNG), 17.6 per cent (control). Thus, gastric carcinogenesis was enhanced by red pepper and a high salt diet, was inhibited by a maejoo and ginseng diet and was not effected by vitamin A. PMID- 3831497 TI - Management of the infant with congenital diaphragmatic hernia (CDH) and persistent pulmonary hypertension (PPHN). PMID- 3831498 TI - Prognostic study of intramucosal carcinoma of the stomach with DNA aneuploidy. AB - Cell nuclear DNA content was microspectophotometrically measured in 70 patients with a gastric carcinoma lesion of less than 4.0 cm in diameter and with mucosal or minimal submucosal invasion. Two groups were prepared; low ploidy and high ploidy, according to the degree of dispersion on the DNA histogram. Twenty-four cases of high ploidy were reviewed from the aspects of clinicopathology and prognosis and the findings compared with data on 46 of low ploidy. The high ploidy group was characterized by an elevated lesion and a differentiated carcinoma while the low ploidy group had a depressed lesion and an undifferentiated carcinoma Postoperative recurrence was confirmed in none of the low ploidy cases and 2/24 of the high ploidy cases. The five and ten-year survival rates of the patients with high ploidy were 100 per cent and 91.1 per cent, respectively. Compared to the findings that patients with submucosal carcinoma of high ploidy survived at a rate of only 64.8 per cent in the 5-year follow-up, efforts should be directed toward a higher detection of gastric carcinoma with aneuploidy at the stage limited to within the intramucosal layer. Endoscopic treatment for early gastric carcinoma is not recommended, especially for a differentiated carcinoma, even if the invasion is confined to the mucosa, since it may include aneuploid carcinoma. PMID- 3831499 TI - Tissue CEA determination and cytophotometric DNA analysis of colorectal mucosa in patients with colorectal cancer. AB - Determination of tissue CEA content and cytophotometric DNA analysis of colorectal mucosa were carried out in 45 patients. Tissue CEA content in mucosa of tumor-bearing patients was significantly higher than in mucosa of the controls. In mucosa of the patients, tissue CEA content of transitional mucosa was significantly higher than that of background mucosa. Cytophotometric DNA analysis of colorectal mucosa disclosed that over 3c cells were not found in the upper third of the crypt in the controls, whereas appearance of these cells in the luminal surface of the crypt was characteristic in tumor-bearing patients. The population of over 3c cells in the upper third of the crypt was significantly larger in patients with multiple cancers or cancer accompanied by adenomas, than in the patients with solitary colorectal cancer. PMID- 3831500 TI - Long-term results of surgical treatment for intrahepatic stones. AB - One hundred and nineteen patients with intrahepatic stones treated surgically in Nagasaki University Hospital from 1969 to 1984 were reviewed. The patients were divided into four types according to location of the stones and the presence or absence of stenotic lesions and/or localized dilatation of the intrahepatic bile ducts. Types I and II patients were treated with choledocholithotomy or choledochojejunostomy, while type III patients underwent hepatic resection and type IV patients were treated by partial hepatic resection with bilioenteric anastomosis, including extended hepatico-choledochojejunostomy. The majority of operative or early deaths belonged to type IV and residual stones were present in almost all patients. The long-term results for the 88 patients revealed that the rate of improvement was 100 per cent for type I, 87 per cent for type II, 83 per cent for type III and 84 per cent for type IV. In type IV, the most excellent results (92 per cent) were obtained by extended hepaticocholedochojejunostomy, especially with hepatectomy. It is suggested that extended hepaticocholedochojejunostomy with partial hepatic resection is a reasonable procedure for treating patients with type IV intrahepatic stones. PMID- 3831501 TI - Effects of catecholamines on myocardial viability in early reperfusion following hypothermic global ischemia in dogs--comparison between epinephrine and dobutamine. AB - Attempts were made to define the effects of epinephrine and dobutamine on the myocardium during early reperfusion for 60 minutes following hypothermic global ischemia at a myocardial temperature of 28 degrees C for 60 minutes under cardiopulmonary bypass. Ischemia was induced by cross-clamping the dog aorta. Epinephrine (0.1 microgram/kg/min) and dobutamine (5 micrograms/kg/min) were given throughout the reperfusion period by intravenous drip infusion, a control group was treated with saline infusion. Comparison of hemodynamic parameters was made before cardiopulmonary bypass, and at 30 and 60 minutes of reperfusion. Epinephrine and dobutamine significantly increased stroke volume index, left ventricular stroke work index and tissue calcium content compared with saline, however, myocardial water content was only slightly higher in the group given saline, compared with the other two groups. Myocardial mitochondrial membranes and cristae were slightly damaged and creatine phosphate content was reduced. Ultrastructural integrity was related to myocardial tissue calcium content, with a significant negative correlation. These results suggest that epinephrine (0.1 microgram/kg/min) will improve stroke volume index and left ventricular stroke work index, as does dobutamine (5 micrograms/kg/min), however, both agents had a minimal effect on reducing myocardial morphological and biochemical integrity, although catecholamines have detrimental effects on the myocardium in early reperfusion following ischemia. PMID- 3831502 TI - Nonfunctioning adrenocortical carcinoma in a young girl. AB - A 9 year old Japanese girl was admitted complaining of left hypochondrial pain and a large upper left abdominal tumor. There were no clinical or laboratory signs of hormonal abnormality. Intravenous pyelography showed marked compression and deformity of the kidney by a tumor. This tumor was excised together with the left kidney. The pathological diagnosis was adrenocortical carcinoma. Postoperatively, the child was given neither irradiation nor chemotherapy. Twenty one months after the surgery, there was a hepatic metastasis, and she died 40 months after surgery from a combination of hepatic metastases and local tumor recurrence. PMID- 3831503 TI - Congenital choledochal dilatation associated with carcinoma after choledochocystoduodenostomy--case report and a review of the literature. AB - A 24-year old Japanese woman with congenital choledochal dilatation associated with carcinoma, cholelithiasis and pancreatolithiasis was treated. She had undergone choledochocystoduodenostomy at the age of 5 years. At the present admission, a dilated choledochus was excised and hepaticojejunostomy (Roux-en-Y anastomosis) and pancreatic ductojejunostomy were performed. Adenocarcinoma involved the entire mucosal surface of the resected specimen. We also present a review of the literature on the treatment and prognosis of patients with congenital biliary dilatation associated with carcinoma after bypass operation in childhood. We emphasize that in patients with congenital choledochal dilatation, the dilated choledochus should be excised, even in young children. PMID- 3831504 TI - Congenital bile duct dilatation--possibly an hereditary condition. AB - A female patient underwent resection of a large choledochal cyst and hepaticojejunostomy when she was 11 years old at Tokyo Medical and Dental University Hospital. Her mother, 48 years old, also had congenital bile duct dilatation (CBD) with cancer. The mother had an anomalous pancreatico-biliary ductal junction. To investigate the possibility of a genetic link, family members of another three consecutive CBD cases were examined for bile duct dilatation and anomalous pancreatico-biliary junction. Endoscopic retrograde choledocho pancreatography (ERCP) revealed an anomalous pancreatico-biliary ductal junction, without bile duct dilatation in the mother of a 17-year-old CBD patient. Two familial occurrences of CBD had been reported in the Japanese literature. Their combinations were; a father--a daughter and two sisters, respectively. Considering that the sex ratio of CBD is one male to 2.6 females, our results suggest that CBD or anomalous pancreatico-biliary ductal junction may be 1) an X linked dominant trait or 2) autosomal dominant trait with relatively low penetrance in males. Since anomalous pancreatico-biliary ductal junction does not necessarily develop into bile duct dilatation, more familial investigations on pancreatico-biliary ductal junction and bile duct dilatation are essential to clarify the genetic contribution to CBD. PMID- 3831505 TI - [Occupational lung cancer]. PMID- 3831506 TI - [Clinical studies on poison gas victims]. PMID- 3831507 TI - [Roles of vasoactive substances in various pulmonary diseases]. PMID- 3831508 TI - [Biochemistry in relation to respiratory diseases--biochemistry of fibrosis and emphysema of the lung]. PMID- 3831509 TI - [Hyperoxia, the oxygen radical and lipoperoxides]. PMID- 3831510 TI - [Pulmonary metabolism of norepinephrine in adult respiratory distress syndrome]. PMID- 3831511 TI - [Production mechanisms of fine crackles]. PMID- 3831512 TI - [Regional ventilation-perfusion ratio in chronic lung diseases measured with krypton-81m]. PMID- 3831514 TI - [A case of congenital partial pericardial defect associated with spontaneous pneumothorax and pneumopericardium]. PMID- 3831515 TI - [A case of desquamative interstitial pneumonia with a good response to steroid therapy for long time]. PMID- 3831513 TI - [A case of chronic hypersensitivity pneumonitis induced by wheat flour]. PMID- 3831516 TI - Smooth muscle physiology. PMID- 3831517 TI - Hawaii seminar 1985. Gastrointestinal smooth muscle in health and disease. January 10-12, 1985, Honolulu, Hawaii, U.S.A. PMID- 3831518 TI - Action of enkephalinergic neurons on the gastrointestinal motility. AB - The actions of the enkephalinergic neurons in the myenteric plexus on the gastrointestinal motility were studied using the opiate antagonist naloxone in the guinea pig in vitro and in vivo. Naloxone increased or decreased spontaneous contractions of the isolated small intestine. Both responses were abolished by atropine. Naloxone potentiated or inhibited the twitch response to transmural stimulation at a frequency of 0.1 Hz and the contractile response of the ileum to the mesenteric nerve stimulation. Naloxone reversed an inhibition of the twitch response occurred after repetitive transmural stimulation (10 Hz) for 5 minutes in the isolated ileal segment. The peristaltic reflex response in the isolated jejunum induced by its distention was reduced by repeated distention. This reduction was reversed by naloxone. Naloxone also potentiated the contractile response of the stomach to efferent vagal stimulation in vivo. It is concluded from the present results that enkephalinergic neurons in the myenteric plexus may regulate the gastrointestinal motility by inhibiting release of acetylcholine from myenteric cholinergic neurons, and that naloxone has both opiate antagonistic and partial agonistic effects on the gastrointestinal motility of the guinea pig. PMID- 3831519 TI - Difference of interdigestive gastroduodenal motility and duodenal pH between duodenal and gastric ulcer patients. PMID- 3831520 TI - Control of gastrointestinal motility with electrical pacing. PMID- 3831521 TI - Gastric motility and emptying in health and after vagotomy and after gastric resection. AB - By observing the relation of the three emptying curves on the whole stomach, proximal and the antral area, we could clarify the distinction of the emptying curves for the stomach forms in healthy subjects, and the gastric emptying motility and the movement of gastric contents were also clarified. Based on these results, the emptying curves on SPV and segmental gastrectomy were studied. From these results, we concluded that the emptying of SPV was similer to that of the healthy subjects when pyloroplasty was applied to SPV. On the segmental gastrectomy, we could make it clear that when pyloromyotomy was applied to the segmental gastrectomy, early rapid emptying did not occur, either. In addition to these results, we would like to emphasize the necessity for describing three curves on the whole stomach area, the proximal area and the antral area for the analysis of gastric emptying and motility. PMID- 3831522 TI - Bi-directional peristaltic conductivity of the alimentary tract in the earliest fetal stage. PMID- 3831523 TI - Response of intestinal smooth muscle to intestinal bypass. PMID- 3831524 TI - Studies on the effects of various types of surgery on electrical and contractile activities of the canine stomach. AB - In order to clarify the gastric electrical and contractile activity after various types of surgery, 32 mongrel dogs equipped with bipolar electrodes on the anterior wall of the stomach underwent various types of operations. The basic electric rhythm (BER) frequency after middle segmental gastrectomy (MSG) with SPV was markedly reduced, but gradually returned to show synchronization with that of the preoperative value. The propagation velocity of the BER decreased. Dysrhythmias were observed to occur in high incidence in the early postoperative period, but were transient occurrences. High-frequency-dysrhythmias were observed in cases of MSG with pyloroplasty (PP). PP increased the frequency of dysrhythmias probably due to deranging the electric insulator of the pyloric ring. In cases of upper segmental gastrectomy, the BER frequency didn't synchronize with that of the preoperative state even in the late postoperative period. The gastric motility after MSG with SPV recovered in the late postoperative period, so the pyloric ring could be preserved. After massive distal small bowel resection, propagation velocity of the BER of the stomach were markedly decreased. Of the 5 gut hormones examined, only CCK correlated with the propagation velocity of the BER. PMID- 3831525 TI - Colonic motor disorders. PMID- 3831526 TI - Local hormonal control of motility. PMID- 3831527 TI - Interdigestive cyclic activity in the gallbladder in the dog. PMID- 3831528 TI - Endocrine-induced alterations in intestinal motility and transit. PMID- 3831529 TI - Organization and functions of intrinsic plexuses. PMID- 3831530 TI - Contractions and transit in isolated segments. PMID- 3831531 TI - Intrinsic neural regulation of smooth muscle function. PMID- 3831532 TI - Ablation of myenteric neurons by chemicals with surfactant properties. PMID- 3831533 TI - Gastrointestinal hormones and motility of the human sphincter of Oddi. AB - We investigated the mechanism of humoral control of bile discharge into the duodenum. The actions of the GB, SO and duodenum were monitered by cinecholecystocholangiogrphy combined with manometry of the SO area using a hydraulic-capillary infusion system or MIKRO-TIP, and these were correlated with the plasma concentrations of GI hormones. We concluded that one of the most significant roles of the sphincter of Oddi is to limit bile flow. This postulation was favored by the observation of so-called 'spasm' of the SO where 8 to 10 contractions per min., in contrast to 'normal' contraction of 2 to 4 per min., were seen. On this special occasion, no discharge of the contrast material into the duodenum was noticed. Exogenous or endogenous CCK causes a coordinated action of the GB contraction, the SO relaxation and relaxation of the adjacent segment of the duodenum, resulting in an effective discharge of bile into the duodenum. The effect of Pancreozymin on bile discharge revealed by endoscopic cinematography was that Pancreozymin first made the orifice of the papilla of Vater widely open with a profuse bile flow and following this, caused a repeated shuttering action of the orifice with minimal discharge of bile. This observation opposes the opinion that active SO contractile activity is necessary to bile flow into the duodenum. Caerulein or CCK-33 caused no 'post-inhibition' enhancement of the SO activity that was seen in case of Pancreozymin administration. Motilin, calcium or other substances contained in Pancreozymin (Boots) might be causative for this enhancement. PMID- 3831534 TI - Developmental abnormalities of the intrinsic nervous system. PMID- 3831535 TI - Electrophysiological studies on the motility of esophageal achalasia. PMID- 3831536 TI - Cultured intestinal smooth muscle cells: its morphology and physiology. AB - The electrical properties and morphological characteristics of cultured smooth muscle cells were studied. During the culture, the cells proliferated, lined up in linear parallel arrays and exhibited a typical formation of hills and valleys. Injection of depolarizing or hyperpolarizing current pulses evoked action potentials in the cells, and the cells often displayed spontaneous action potential activity. These action potentials were found to be calcium dependent. ACh produced membrane depolarization, noradrenaline membrane hyperpolarization. The cells were coupled by low-resistance junctions that permit the cell-to-cell passage of electrical current and fluorescein dye. The permeability of junction was blocked by the increased concentration of cytoplasmic calcium ions. These results indicate that the cell-to-cell communication properties of cultured smooth muscle cells are modelated by the cytoplasmic calcium ions concentration. PMID- 3831537 TI - Regulation of transit through the esophagus. PMID- 3831538 TI - Hydrodynamic aspects of gastrointestinal (GI) transit. PMID- 3831539 TI - [Coronary circulation: the biophysical principle of flow in a constricted blood vessel]. PMID- 3831540 TI - [Hemodynamics in the left heart ventricle in stenosis of segment I or II of the dominant right coronary artery]. PMID- 3831541 TI - [Echocardiographic image of a pedunculated thrombus in the right atrium in a patient with pulmonary embolism]. PMID- 3831542 TI - [Hormonal studies in diseases of the cardiovascular system]. PMID- 3831543 TI - [Changes in the T wave as an early sign of developing myocardial infarction]. PMID- 3831544 TI - [Use of contrast studies in two-dimensional echocardiography. I. Interatrial shunt of the second foramen type]. PMID- 3831545 TI - [Use of contrast studies in two-dimensional echocardiography. II. Insufficiency of the tricuspid valve]. PMID- 3831546 TI - [The renin-angiotensin-aldosterone system in patients with pheochromocytoma. Evaluation of its interrelations with hemodynamics, electrolyte balance and kidney function]. PMID- 3831547 TI - [Comparative evaluation of the duration of QT and QpT intervals during the electrocardiographic exercise test]. PMID- 3831548 TI - [The opinions of Polish scientific circles with regard to selected problems in the prevention of coronary disease. III. Secondary non-pharmacological and pharmacological prevention]. PMID- 3831549 TI - [Correlation between the biological risk factors of arteriosclerosis and disorders of the central regulation of behavior in persons under 30 years of age. I]. PMID- 3831550 TI - [Correlation between the biological risk factors of arteriosclerosis and disorders of the central regulation of behavior in persons under 50 years of age. II]. PMID- 3831551 TI - [Use of oral anticoagulants in patients with heart defects. I. Indications for and the effectiveness of the antithrombotic treatment of patients with heart defects]. PMID- 3831552 TI - [Use of oral anticoagulants in patients with heart defects: II. Problems related to the long-term antithrombotic treatment of patients with heart defects]. PMID- 3831553 TI - [A new sensitive detection method for haptoglobin using agglutination of antibody labelled staphylococci]. PMID- 3831554 TI - [Histamine in the human eye]. PMID- 3831555 TI - [Histological changes in the sclera in retinal detachment. II. Detachment after injuries and in aphakic eyes]. PMID- 3831556 TI - [Path of tear outflow after external naso-lacrimal anastomosis]. PMID- 3831557 TI - [Positive Sabin-Feldman test in eye diseases in children]. PMID- 3831558 TI - [Difficulties in the diagnosis of small choroidal melanomas]. PMID- 3831559 TI - [Genetic aspects and prognosis in late congenital glaucoma]. PMID- 3831560 TI - [Expulsive hemorrhage in cataract surgery]. PMID- 3831561 TI - [Surgery of the vitreous body. Evaluation of presently used equipment]. PMID- 3831562 TI - [Ophthalmological problems of expert testimony in qualifying for automobile driving]. PMID- 3831563 TI - [Changes in medical strategy. Ambulatory ophthalmological surgical treatment in the USA]. PMID- 3831564 TI - [Late observations on patients treated for intraocular melanoma]. PMID- 3831565 TI - [Acute ischemic optic neuropathy. IV. Comparative ophthalmodynamometry]. PMID- 3831566 TI - [Cases of congenital glaucoma with a follow-up for several years]. PMID- 3831567 TI - [Vertical megalocornea]. PMID- 3831568 TI - [Blood supply of the anterior portion of the optic nerve]. PMID- 3831569 TI - [Extracapsular hard cataract extraction. A select surgical technic]. PMID- 3831570 TI - [Surgical treatment of myopia. Procedures on the sclera and operations reinforcing the posterior pole of the eyeball]. PMID- 3831571 TI - [Experimental studies of iron levels in the retina and choroid in ocular siderosis caused by an intraorbital foreign body]. PMID- 3831572 TI - [Computerized tomography in the diagnosis of eye injuries]. PMID- 3831573 TI - [Treatment of progressive myopia in children by saddamine and calcium iontophoresis and difrarel]. PMID- 3831574 TI - [Effect of treatment on the Sabin-Feldman test in ocular toxoplasmosis]. PMID- 3831575 TI - [Simultaneous lensectomy and vitrectomy in the treatment of complications of uveitis in children]. PMID- 3831576 TI - [Usefulness of fluorescein angiography in ocular toxoplasmosis]. PMID- 3831577 TI - [Diagnostic difficulties in synchronous degeneration of the macula and retinal periphery]. PMID- 3831578 TI - [Vision disorders in migraine: description of 2 cases of bitemporal hemianopsia]. PMID- 3831579 TI - [Pathophysiology of blood circulation in the anterior segment of the optic nerve]. PMID- 3831580 TI - [Stereoscopic resolving power in correct ocular refraction and in refractive errors]. PMID- 3831581 TI - [Liposomes as an ophthalmic form of drugs]. PMID- 3831582 TI - [Radiological examination of lacrimal passages. Technic, anatomy, indications]. PMID- 3831583 TI - [Clinical characteristics of uveal melanoma]. PMID- 3831584 TI - [Results of mass examination of intraocular pressure by the non-contact applanation tonometer]. PMID- 3831585 TI - [Clinical evaluation of the macula lutea after surgery of retinal detachment in relation to the type of operation and intraoperative complications]. PMID- 3831586 TI - [Complications of cerclage of the eyeball and the use of episcleral implants in the treatment of retinal detachment]. PMID- 3831587 TI - [Infections after operations for retinal detachment]. PMID- 3831588 TI - [Late results in using Bangerter's orbital implant]. PMID- 3831589 TI - [Harada's syndrome]. PMID- 3831590 TI - [Fluorescein angiography. Present status and prospects of its development]. PMID- 3831591 TI - Inhibition of protein kinase C activation by 8-(N,N-diethylamino)-octyl-3, 4, 5 trimethoxybenzoate (TMB-8), an intracellular Ca2+ antagonist. PMID- 3831592 TI - Meningeal involvement of myeloma. PMID- 3831593 TI - Effects of neuroleptics on dopamine release from striatal slices. PMID- 3831595 TI - A case report of tibialis spastic varus foot with tarsal coalition. PMID- 3831594 TI - Esophageal varices treated with endoscopic injection sclerotherapy--a pathological study. PMID- 3831596 TI - Pyrexia of uncertain origin. PMID- 3831597 TI - Gastrointestinal infection. PMID- 3831598 TI - Growth disorders. PMID- 3831599 TI - Anorexia nervosa. PMID- 3831600 TI - Enhancing child management skills of parents by the use of groups in Singapore. PMID- 3831601 TI - Echocardiography in mitral valve prolapse: M-mode or 2-D, supine or standing? PMID- 3831602 TI - Two-dimensional echocardiography in congenital heart disease. 1. Pre-operative assessment. PMID- 3831603 TI - Simple febrile convulsions--a transient viral encephalopathy. PMID- 3831604 TI - Platelet associated IgG (PAIgG), as quantitated by ELISA, in assessment of childhood thrombocytopenia. PMID- 3831605 TI - Antenatal management of terbutaline--effects on infants born preterm. PMID- 3831606 TI - Ectrodactyly, ectodermal dysplasia and cleft lip syndrome. PMID- 3831607 TI - Congenital tracheal stenosis. PMID- 3831608 TI - Rice gruel in management of infantile diarrhoea. PMID- 3831609 TI - Imitation of aggression by Lebanese children. PMID- 3831610 TI - Another look at the impact of juror sentiments toward defendants on juridic decisions. PMID- 3831611 TI - The reaction to rape by American male bystanders. PMID- 3831612 TI - Normative considerations in the labeling of harmful behavior as aggressive. PMID- 3831613 TI - The relation of cognitive style and manifest anxiety to academic performance among Chinese children. PMID- 3831614 TI - Perceived competence to help and the arousal of empathy. PMID- 3831615 TI - Thermodynamics and the conceptual structure of evolutionary theory. AB - Thermodynamics and evolutionary theory have spent most of their shared history in adversarial relationship to one another. The point of this paper is to consider some qualitative ways in which thermodynamics can enrich both the theory and epistemology of evolution. The "autonomy of biology" posture in evolutionary theory hangs on the supposed uniqueness of why-questions in biology. With this posture, and with the general obstruction of constructive dialogue between evolution and the physical sciences it fosters, come the perennial accusations that Darwinism deals in adaptational teleology but not mechanisms. Thermodynamics provides for a two-tiered hierarchy of causation in nature in which the why question is rendered not only legitimate materialistically, but essential to understanding the evolutionary process in its totality--from the emergence of life to the branching of lineages in speciation. PMID- 3831616 TI - Thermal torsion of F-actin. AB - The equipartition theorem is used to calculate the mode amplitudes for F-actin thermal torsion. The amplitudes phi n are found to scale as n-1, (EI)-1/2, and L1/2, where n is mode number, EI is actin bending stiffness, and L is filament length. Depending on conditions, the amplitude can be as large as 15 degrees; this is discussed briefly in terms of skeletal muscle mechanics. PMID- 3831617 TI - The significance of over- and underdominance for the maintenance of genetic polymorphisms. I. Underdominance and stability. AB - It is pointed out that the standard selection models in population genetics all require some form of heterozygote advantage in fitness in order to guarantee the maintenance or stability of genetic polymorphisms. Even more recent results demonstrating the existence of stable two-locus polymorphisms with marginal underdominance at both loci are based on certain epistatically acting heterosis assumptions. This raises the question as to whether heterozygote advantage in fitness is indeed a generally valid principle of maintaining polymorphisms. To avoid ambiguity in definition of heterozygote advantage (overdominance) as it appears in multiallele or multilocus systems, a one-locus-two-allele model is considered. This model allows for sexually asymmetric selection and random mating. It is shown that the model produces globally stable polymorphisms exhibiting underdominance in fitness for a considerable and biologically reasonable range of selection values. Having thus properly refuted the general validity of the common overdominance principle, a modified version is suggested which covers the classical viability selection model and its extension to arbitrary, sexually asymmetric viability and fertility selection. This modified overdominance principle is based on the notion of fractional fitnesses and relates protectedness of biallelic polymorphisms to the extent to which each genotype reproduces its own type. The fact that the model treated displays frequency dependent fitnesses which may change in ranking while approaching equilibrium is discussed in relation to problems of the evolution of overdominance and underdominance. PMID- 3831619 TI - Effect of exposure to cold on the ultrastructural changes in the myocardium of rats on low-magnesium diet. PMID- 3831618 TI - Histological and ultrastructural changes in femoral muscle of rat caused by low magnesium diet. PMID- 3831620 TI - The effect of lithium salt on the ultrastructural appearance and certain histochemical reactions in rat cardiac muscle. PMID- 3831621 TI - Axial computerized tomography of the brain in cases of early infantile spinal muscular atrophy (Werdnig-Hoffmann disease). PMID- 3831622 TI - Metabolism of bile acids in chronic diarrhoea of children. PMID- 3831623 TI - The problem of temporomandibular joints in juvenile rheumatoid arthritis. PMID- 3831624 TI - Clinical course of psoriatic arthropathy in children. PMID- 3831625 TI - Exercise rehabilitation after myocardial infarction. PMID- 3831626 TI - Advanced and locally unresectable gastric carcinoma: five years of survival with good quality of life. Case report. PMID- 3831627 TI - Chloroquine ototoxicity: an iatrogenic problem. PMID- 3831628 TI - [Evaluation and standardization of tests of tetanus toxoid potency. I. Evaluation of Polish standards and serial production vaccines]. PMID- 3831629 TI - [Evaluation and standardization of tests of tetanus toxoid potency. II. Elaboration of basic parameters of the tests on mice]. PMID- 3831630 TI - [Development and regression of tumors induced by M-MSV virus in mice after administration of rutin and quercetin]. PMID- 3831631 TI - [Evaluation of the sensitivity of the yeast-like fungi Candida and Torulopsis to yeast producers of killer toxins]. PMID- 3831632 TI - [Effect of skin lipid and fatty acid extracts on lipophilins of Pitysporium sp. in vitro]. PMID- 3831633 TI - Epileptogenic effect of intracortically applied kainic acid in cats. AB - The effect of two doses (5 micrograms/microliters) of kainic acid (KA) injected intracortically into the posterior lateral gyrus of cats was investigated. KA in a dose of 5 micrograms/microliters provoked cortical epileptogenic focus 8-12 min after its application, developing later into a focal seizure. Administration of 10 micrograms/microliters KA resulted after 15-20 sec in paroxysmal discharges of spikes and sharp-slow waves at the site of the application, which propagated ipsilaterally. Thereafter the paroxysmal activity spread contralaterally, became generalized and developed into an epileptic state. The effect of KA was considered to be a dose-dependent one. N-Aminomethylpiperazine-3, 3-diethyl-2, 4 pyridinedione (DKMP) in a dose of 100 mg/kg injected i.v. on the background of developed epileptic state exerted a rapid inhibitory effect of 60-100 min duration on the paroxysmal activity. employed as a model of secondary generalized focal epilepsy. PMID- 3831634 TI - Effect of piracetam on the electrocorticogram after traumatic brain oedema in cats. AB - The effect of piracetam on the electrocorticogram changes caused by experimentally-induced traumatic brain oedema in cats has been studied. The trauma was evoked by sticking a needle through the parietal associative cortical area. The electrocorticogram amplitude and frequency depression of the injured cortical area was eliminated and the bioelectrical activity restored to a normal pattern 22.4 +/- 10.3 min after a single dose of piracetam (100 mg/kg i.v.). The results indicate that piracetam recovered the cortical bioelectrical activity disturbed by experimentally-induced traumatic oedema. The beneficial effect of piracetam is probably due to an optimization of the functional state of the brain since piracetam acts as a nonspecific activator of brain excitability. PMID- 3831635 TI - Animal model for theophylline--cimetidine drug interaction. AB - Cimetidine (300 mg I.V.) and theophylline (15 mg/kg I.V.) were studied in Beagle dogs for possible drug interaction. The drugs were administered alone and in combination using a crossover design. Although none of the determined pharmacokinetic parameters for theophylline changed significantly in the presence of cimetidine, a trend towards significance was found for the terminal half-life, area under the curve, and mean residence time. The magnitude in changes found in Beagles is representative of the changes reported in man. PMID- 3831636 TI - Theophylline-ranitidine drug interaction in the beagle dog. AB - Ranitidine (300 mg p.o.) and theophylline (15 mg/kg i.v.) were studied in Beagle dogs for possible drug interaction. Using a crossover design drugs were given alone and in combination. For the combination treatment ranitidine was given twice daily for two days before theophylline was administered. No significant differences in drug disposition were found for theophylline and ranitidine when given simultaneously. The mean total clearance of theophylline decreased in the presence of ranitidine by about 10%, and the mean total clearance of ranitidine decreased in the presence of theophylline by about 17%. Due to the small number of subjects, not more than a possible trend for reduction in total clearance was found. The total clearance in ml/min/kg for both ranitidine and theophylline is about 3 times higher in the Beagle dog than in man. PMID- 3831637 TI - Pharmacokinetic studies of alizarin in man. AB - Alizarin, a constituent of the madder root, is employed in phytotherapy to prevent recurrences of calcium-containing urinary stones. Pharmacokinetic studies were carried out in human subjects during the development of a pharmaceutical product containing alizarin. After giving a single oral dose of 210 mg of alizarin there were two maxima in the serum concentration curves, the first at 2 4 h and the second at 6-8 h. Alizarin and its glucuronide conjugate were detected in both maxima by TLC. The mean elimination half-life was 12 h. The amounts excreted in the urine within 6 days ranged from 18.1 to 36.3%, and the amounts in the faeces from 21.6 to 33.0% (total recovery: 40-60%). In bile from a patient who had undergone cholecystectomy only 0.6% of the dose was recovered. To exclude any possibility that alizarin might be bound to calcium ions in bone, bone trephine specimens were examined from patients with oxalate stones who had previously been treated with alizarin for several years. No alizarin was detectable in these samples. When alizarin is mixed with fresh human faeces and incubated anaerobically it undergoes rapid bacterial decomposition. This in vitro experiment indicates that when alizarin is given orally a large proportion is broken down by bacterial action in the intestine. PMID- 3831638 TI - Probabilistic sensitivity analysis using Monte Carlo simulation. A practical approach. AB - The data for medical decision analyses are often unreliable. Traditional sensitivity analysis--varying one or more probability or utility estimates from baseline values to see if the optimal strategy changes--is cumbersome if more than two values are allowed to vary concurrently. This paper describes a practical method for probabilistic sensitivity analysis, in which uncertainties in all values are considered simultaneously. The uncertainty in each probability and utility is assumed to possess a probability distribution. For ease of application we have used a parametric model that permits each distribution to be specified by two values: the baseline estimate and a bound (upper or lower) of the 95 percent confidence interval. Following multiple simulations of the decision tree in which each probability and utility is randomly assigned a value within its distribution, the following results are recorded: (a) the mean and standard deviation of the expected utility of each strategy; (b) the frequency with which each strategy is optimal; (c) the frequency with which each strategy "buys" or "costs" a specified amount of utility relative to the remaining strategies. As illustrated by an application to a previously published decision analysis, this technique is easy to use and can be a valuable addition to the armamentarium of the decision analyst. PMID- 3831639 TI - Maximum Shannon information content of diagnostic medical testing. Including application to multiple non-independent tests. AB - The increase in Shannon information available from a diagnostic test associated with grading of the test results into many outcomes, rather than simply positive or negative, was examined to determine its upper limit as the number of test outcomes is increased indefinitely. Numerical methods were employed to find the optimal locations of outcome boundaries when a single normally distributed test variable is classified into 2, 3, 4, 5, 6, 8, 14, or 20 outcome categories. In each case Shannon information was computed for values of prior probability between 0.01 and 0.99 and for distances between the means in diseased and nondiseased populations ranging from 0.5 to 5.0 standard deviations. There is an important improvement in Shannon information as the number of outcomes defined is increased, but the increment in information diminishes rapidly with each additional category. A 20%-30% increment in information may be achieved with three outcomes instead of two. A further important increase in information occurs with four to seven outcomes, but beyond this the increment in inforation is negligible. The findings were similar over a wide range of prior probabilities and distances between the means. The analysis was extended to the case of multiple nonindependent tests by demonstrating their application to a Fisher discriminant function incorporating such tests. It was concluded that for normally distributed test variables: grading of test results significantly improves the information content of both single and multiple tests; the value of information content for 8-20 outcomes represents very nearly the maximum information content of a test; there is little value in using more than five to seven test outcomes; multiple grading should not be neglected for discriminant functions. PMID- 3831640 TI - Parameter estimates for a QALY utility model. AB - This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a patient's risk attitude with respect to survival duration. The parameter H(Q) represents the proportionate reduction in the utility of survival when health state Q prevails. Methods are described for estimating these parameters from the results of an individual patient utility assessment. Results are then reported for empirical estimation of parameters r and H(Q) from the preference judgments of a sample of 46 coronary artery disease patients. In this empirical study, health state Q takes on two values--survival with angina pectoris and survival free from angina pectoris. Estimated values of parameters r and H(Q) are discussed in relation to the decision analysis of coronary artery bypass graft surgery. Finally, it is argued that the model deserves consideration as a medical utility model, despite some preliminary evidence that assumptions of the model are descriptively false, because it provides a simple representation of the utility of survival duration and health quality. These aspects of health outcomes are known to be critically important in the expected utility analysis of health decisions. PMID- 3831641 TI - Instruction in medical decision making. A report of two surveys. AB - Results of two surveys (D and E) that assessed the current structure and status of instruction in medical decision making are reported. Both samples (Survey D, N = 80; Survey E, N = 92) consisted of members of the Society for Medical Decision Making. A consensus was obtained on topics considered important for teaching an introduction to clinical decision analysis to medical professionals. These topics were Bayes' theorem, decision trees, 2 X 2 tables, test sensitivity and specificity, utility, and ROC analysis. There was little agreement on course structure, level, or the preferred method for teaching decision analysis within medical settings. It was concluded that medical educators are in the process of constructing a knowledge base in decision-analytic techniques within academic medicine. It will soon be time to consider the place of more advanced topics within the continuum of medical education. PMID- 3831642 TI - Usual form of Bayes' theorem and "common names". PMID- 3831644 TI - The expert witness. PMID- 3831643 TI - Medical evidence in the coroner's court. PMID- 3831645 TI - The role of counsel. PMID- 3831646 TI - At what blood levels does alcohol kill? PMID- 3831647 TI - Anaesthetic and medico-legal problems in patients intoxicated by alcohol. PMID- 3831648 TI - Failed female sterilization and the law. PMID- 3831649 TI - Medical evidence in preparing a court case. PMID- 3831650 TI - Confidentiality and the medical report. PMID- 3831651 TI - The new clinical curriculum in Liverpool or from Garden Festival to another blooming change. PMID- 3831652 TI - Afterthoughts on selection. PMID- 3831653 TI - How to choose and use educational objectives. PMID- 3831654 TI - The way we teach medical students professional skills. PMID- 3831655 TI - A problem-based course in human sexuality. PMID- 3831657 TI - The effect of adjunct aids on learning from printed text. PMID- 3831656 TI - Teaching human sexuality. PMID- 3831658 TI - A short study-skills course for the new entrants to the medical school. PMID- 3831659 TI - How to plan a medical curriculum. PMID- 3831660 TI - How to use role-play in medical teaching. PMID- 3831662 TI - A brief history and overview of the Association of Teachers of Preventive Medicine. PMID- 3831661 TI - Patient explanations: the name of the game. PMID- 3831663 TI - Curriculum planning for the future. PMID- 3831664 TI - General practice in the context of an undergraduate course in behavioural sciences. PMID- 3831665 TI - Cross-cultural medicine: a teaching aid. PMID- 3831666 TI - Field and classroom instruction to AMP students in community medicine and its effect on cognitive ability. PMID- 3831667 TI - Clinical teaching strategies for physicians. PMID- 3831668 TI - Problem based attending rounds. PMID- 3831669 TI - An experiment in teaching histology and cell biology. PMID- 3831670 TI - Assessment of clinical competence in therapeutics: the use of the objective structured clinical examination. PMID- 3831671 TI - Personal view: the aims of continuing education in general practice. PMID- 3831672 TI - Preparing a student seminar: a student's view of learning and self teaching. PMID- 3831673 TI - In vivo measurements of NMR relaxation times. AB - A series of solenoidal NMR probes were built to measure T1 and T2 relaxation times in vivo in the mouse, over the frequency range of 5 to 60 MHz, using inversion-recovery and spin-echo pulse sequences. KHT tumors growing in the legs of C3H mice were studied and compared with normal mouse legs. The tumor relaxation times were studied at 10 MHz during the course of tumor growth and as a function of frequency when the tumor had a mass of approximately 0.9 g. Mouse legs with tumors have higher T1 and T2 values than those without tumors over the frequency range of 5 to 60 MHz. Significant changes in both relaxation times were detected before a palpable mass could be detected. T1 contrast between normal and tumor-bearing legs decreased with increasing frequency, while T2 contrast remained nearly constant. A comparison between in vivo and in vitro measurements was done using four different types of sample preparation: live mouse, dead mouse, excised whole mouse leg, and tissue sample. These studies showed small but significant differences between the relaxation times measured in vivo and those measured in vitro. PMID- 3831674 TI - The slotted cylinder: an efficient probe for NMR imaging. AB - The slotted cylinder, an inductive structure with low self-inductance, low electric field, has been studied as a probe for NMR imaging applications. A theoretical calculation allows us to map the magnetic field and to evaluate electrical parameters of the structure. Several implementations, including new designs, have been experimentally tested over a wide range of frequencies (4-40 MHz), and compared to a classical coil probe. This study demonstrates the efficiency of the slotted cylinder for NMR imaging. It is optimized for large conductive samples when imaging at high frequencies (for human head, above 20 MHz). PMID- 3831675 TI - Volumetric NMR imaging with time-varying gradients. AB - A novel generalized processing system is described whereby, using time-varying gradients, simultaneous data acquisition can be provided for all points in a volume. This is in sharp distinction to the sensitive-point method where only the null region is imaged. It is shown that time-varying gradients systems provide unique phase modulation functions which, when appropriately decoded, enable every point in the volume to be simultaneously imaged from a single FID signal. Methods are shown using the technique to provide simultaneously acquired, localized NMR spectra. Alternative gradient signals are considered including both periodic and aperiodic waveforms. PMID- 3831676 TI - Comparison of NMR imaging and aortography for preoperative evaluation of abdominal aortic aneurysm. AB - Seven patients (five male and two female, age range from 50 to 88) with angiographic proven abdominal aortic aneurysms were evaluated with magnetic resonance (MR) imaging (1.5-kG system) of the abdomen. Images were obtained in transverse, coronal, and saggital planes with three radiofrequency pulse sequences [saturation recovery (SR), inversion recovery (IR), and spin echo (SE)]. All of the aneurysms were identified as to site and relative size with MR images. The lumen in which there was rapidly flowing blood was always dark (low intensity), whereas the aneurysmal area which contained presumed clot or slow flowing blood was brighter (high intensity) on SR images. Although the size, location, and relationship to other blood vessels was best demonstrated on aortography, MR images provided similar information in all cases. MR images correctly demonstrated thrombus in six cases. In conclusion, MR imaging provides a clear delineation of the anatomy of abdominal aortic aneurysms. In addition, it can provide information concerning tissue type, i.e., it distinguished clot from moving blood. It may be possible in the future to further characterize atherosclerotic and other pathological changes in vessel architecture by using various pulse sequences and timing parameters to provide in vivo histological typing. PMID- 3831677 TI - Application of multipulse NMR to observe 13C-labeled metabolites in biological systems. AB - Limitations in resolution and sensitivity of 13C NMR spectroscopy have reduced the information obtainable from intact biological systems. With the aim of increasing the information from in vivo 13C NMR two multipulse NMR techniques, the DEPT pulse sequence and the gated spin-echo sequence, were used to obtain edited 13C NMR spectra from different 13C-labeled mammalian tissues. This allowed the separation of the 13C NMR signals from the tissues into subspectra containing either CH, CH2, or CH3 signals, thereby increasing the information obtainable from these spectra. Comparing the two techniques, the DEPT sequence gives more accurate editing than the gated spin-echo sequence but suffers from the difficulty of determining 1H pulse angles in vivo. PMID- 3831678 TI - A versatile perfusion technique for metabolic studies by NMR. AB - A perfusion technique applicable to metabolic studies by NMR is described in detail. The utility and versatility of the approach are demonstrated by following gluconeogenesis from [2-13C]pyruvate in the perfused, isolated mouse liver, and lipogenesis from [2-13C]acetate in perfused Acanthamoeba castellanii cells embedded in agarose filaments. PMID- 3831679 TI - Characterization of normal and malignant mouse tissue by NMR lineshape-relaxation correlations in the rotation frame. AB - With the NMR lineshape-relaxation correlation technique the relaxation times and the relative magnitudes of the proton spin groups characterized by these respective relaxation times are obtained. In most tissues the spin-lattice relaxation in the rotating frame is nonexponential. The magnetization evolution can be represented as the sum of three exponential decays characterized by three T1rho relaxation times. The short T1rho component, corresponding to the rigid network protons, gives the most interesting information on the tissue. Results at 38 MHz are given for muscle, spleen, lung, and tumor EMT6 fibrosarcoma grown in the dorsal subcutaneous tissue of BALB/c mice. The absence of the magnetization component with short T1rho and short T2 in spleen tissue of tumorous mice demonstrates that the spleen is swollen to at least 5 times its original size so that the relative magnitude of the magnetization corresponding to collagen network is proportionally reduced. The NMR correlation technique is thus shown to be appropriate for such quantitative analysis. PMID- 3831680 TI - Apparent changes of appearance of inversion-recovery images. AB - This note considers the anomolous contrast in inversion recovery images produced by NMR scanners if a map of [My] is reconstructed, rather than a map of My'. PMID- 3831681 TI - Application of linear prediction and singular value decomposition (LPSVD) to determine NMR frequencies and intensities from the FID. AB - A parametric spectral analysis based on linear prediction and singular value decomposition has been applied to the 31P FID of a tumor implanted in a mouse. It is found that a number of complications that may arise in in vivo FFT NMR can be circumvented. The new method yields all parameters of the spectral components, i.e., the frequency, amplitude, damping constant, and phase. PMID- 3831682 TI - Significance of histopathology in pulsed NMR studies on cancer. AB - Characterization of tissue by pulsed nuclear magnetic resonance spectrometry opened a new area of research. The differences in the NMR parameters T1 and T2 of normal and malignant tissues constitute the basis for their distinction by pulsed NMR spectrometry and also by NMR imaging in vivo. The present studies were undertaken to correlate the role of constituent histological elements encountered in various malignancy-associated changes and T1 variations and are based on evaluation of samples taken from surgically resected specimens of carcinoma of the esophagus, comprising the uninvolved portions of the esophagus and the gastric end on gross examination. The uninvolved and involved regions showed low and high T1 values, respectively. High T1 values were also encountered in the zones of samples of uninvolved esophagus which histologically revealed areas with dysplasia. This feature, viz., dysplasia representing malignancy-associated changes, has been found to recur in many samples. Detailed histological studies provided further evidence confirming that areas with dysplasia contribute to an increase in T1 values whereas in zones at the gastric end metaplasia and hyperplasia are more common. The results are of value for demarcation of tumor area by in vivo NMR imaging. PMID- 3831683 TI - Strategies and tactics in NMR imaging relaxation time measurements. I. Minimizing relaxation time errors due to image noise--the ideal case. AB - The effect of NMR image noise on errors in calculated values of relaxation times is quantitatively assessed by use of relaxation time noise figures, which are derived on the basis of statistical principles as functions of pulse delay, repetition, and recovery intervals for several types of pulse sequences. Two strategies for determining relaxation times are considered: two point (ratio of intensities for two experiments) and multipoint (least-squares fit of intensities to pulse-sequence functions for n experiments). For given total measurement times, values of pulse interval times are found which give minimum relaxation time noise figures. A comparison of ratio methods shows that the best is a combination saturation-recovery, inversion-recovery (SR/IR) technique. For short measurement times (less than about 10T1) this optimized SR/IR ratio determination is also superior to the best multipoint method, a series of inversion-recovery experiments with equally incremented inversion-recovery times. An examination of the effect of signal averaging on the relaxation time noise shows that up to a measurement time characteristic of the particular method used (e.g., for times up to about 5T1 for the SR/IR ratio determination, 100T1 for the multipoint inversion-recovery method), increased measurement time is more effectively allotted to longer pulse intervals than to signal averaging. Numerical examples are tabulated which can help one to set optimum values for pulse intervals, given a rough estimate of the relaxation time to be determined. PMID- 3831684 TI - Shielded solenoidal probe for in vivo NMR studies of solid tumors. AB - A shielded solenoidal probe, suitable for in vivo NMR studies of subcutaneous solid tumors, is described. The 31P NMR spectra obtained from phantom samples and in vivo subcutaneous solid tumors in mice show that spurious signals from the body are totally eliminated if the proper shield is used. PMID- 3831685 TI - The use of agar gel as a basic reference material for calibrating relaxation times and imaging parameters. AB - The relaxation properties of agar gels render it a potentially useful basic reference material for calibrating the NMR equipment. The T1 and T2 values are close to the values observed for most biological tissues; they are stable and can be varied by controlling the concentration of MnCl2. The temperature, concentration, and volume dependence of T1 and T2 were studied. PMID- 3831686 TI - Proton imaging with surface coils on a 0.15-T resistive system. AB - Coil development is fundamental to the optimization of imaging systems at any field; however, it is especially critical for low-field systems where signal strength is limited. Here we demonstrate a type of surface coil design which makes possible the acquisition of high-quality images of the neck and extremities. PMID- 3831687 TI - Theoretical description of depth pulse sequences, on and off resonance, including improvements and extensions thereof. AB - A general mathematical description of depth pulse sequences in terms of rotation matrices permits a single matrix, known as a cycle matrix, to be written down for each phase-cycled pulse in the overall sequence, such that the result for the total phase-cycled sequence is the product of the individual cycle matrices. It is straightforward to include the effect of the tilted rf axis off resonance and obtain exact solutions. The two types of phase-cycled pulse used in a depth pulse scheme are 2 theta [+/- x] and 2 theta [+/- x, +/- y] and for the general off resonance case, four of the off-diagonal elements in the 2 theta [+/- x] cycle matrix, and all of the off-diagonal elements in the 2 theta [+/- x, +/- y] cycle matrix, are zero. These simplifications enable important improvements of depth pulse schemes for the elimination of high-flux signals, the reduction of signals from sample regions experiencing pulse angles differing from 90 degrees, and the avoidance of deleterious off-resonance effects such as the production of dispersion signals. In all cases, the dependence of signal intensity off resonance can be easily and exactly calculated. There are important applications in in vivo spectroscopy. PMID- 3831688 TI - NMR compartmentalization of free water in the perfused rat heart. AB - Spin-lattice (T1) and spin-spin (T2) relaxation times have been measured on perfused rat hearts under two experimental conditions. T1 exhibits a monoexponential decay. On the other hand T2 has a decay with two components: a short one T2s and a long one T2l. These facts have been discussed according to cross-relaxation and a bicompartmentalization of tissue assuming a slow exchange model for spin-spin relaxation and a fast exchange model for spin-lattice relaxation. Increasing the osmotic pressure of the perfusion solution decreased the absolute density proton of the T2s compartment reflecting the loss of its water content. The paramagnetic ion manganese diminishes the values of T1 and those of the long component T2l without affecting its short component. Therefore the short component could be assigned to intracellular and the long component to extracellular free water. The extracellular T2 (459 ms) is approximatively 10 fold higher than the intracellular T2 (45 ms). With images of "pure T2" such a difference could be useful to enhance the contrast between organs and the surrounding liquid or between organs with different water compartmentalization. PMID- 3831689 TI - Chemical-shift imaging using filtered back-projection algorithms. AB - A method of performing chemical-shift imaging is described that avoids some of the disadvantages inherent in the techniques which use spin echos and phase encoding. A series of FIDs are recorded during the application of a series of static gradients and the spectral image is reconstructed using a conventional filtered back-projection algorithm. PMID- 3831690 TI - Fast Fourier imaging. AB - A new NMR imaging technique, aiming at a reduction of the data acquisition time, is described in detail. The method is applicable in all multidimensional imaging situations where at least one spatial coordinate is resolved. Discussed at some length are the point-spread function, the required bandwidth of the NMR spectrometer, and the sampling strategy used to diminish the loss in signal-to noise ratio. Experiments reveal that a reduction of the data acquisition time by at least a factor of four is attainable in practice. PMID- 3831691 TI - Field inhomogeneity correction and data processing for spectroscopic imaging. AB - To obtain separate NMR images of spatially resolved high-resolution chemical shift information the effects of magnetic field inhomogeneity must be accounted for. A suitable correction method is described which relies on first generating a plot of the magnetic field distribution. Using these data the spectroscopic imaging data can be processed to display the spatial distributions of separate resonances without distortion from field inhomogeneity. The field plot is obtained by using the same data acquisition sequence while imaging a phantom object or in particular cases the plot may be derived from the spectroscopic imaging data set itself. The correction procedure is illustrated using proton in vivo imaging of a cat. Some additional data processing techniques are presented which offer alternative methods of displaying spectroscopic imaging data. PMID- 3831692 TI - Interpolative computation of spin-lattice relaxation times from signal ratios. AB - An iterative linear interpolation is described for computing T1 estimates from image-signal ratios that are monotonous functions of T1. Whether the function decreases or increases with T1, the same algorithm described applies. The iterative process converges readily. Narrowing the whereabouts of T1 sought in lookup tables to T1 regions just small enough to require only a few subsequent interpolations tends to shorten overall T1 image computing time. Used with imaging methods for which the function is readily evaluated, the iterative interpolation allows a rapid and precise T1 computation compatible with variable choice of pulse-sequence parameters. The flexibility is suitable to stochastic analysis of T1 measurement from signal ratios. Examples of applications to computing the stochastic uncertainty represented either by crude indicators or by standard statistical quantities are given. A method of stochastic simulation yielding the statistical quantities is described. PMID- 3831693 TI - Design data for efficient axial gradient coils: application to NMR imaging. AB - A new design for an axial magnetic field gradient is described. Implemented in a four-coil configuration, it requires far less power than the conventional Maxwell pair, while maintaining the same field linearity. A practical design tool with a set of curves giving coil dimensions is proposed. Two realizations dedicated to NMR imaging are described and compared with the equivalent Maxwell pair. Substantial power reductions are achieved; in these cases, dc power is reduced by a factor of 5 and switching power by a factor of 15. PMID- 3831694 TI - Chemical-shift artifact correction scheme using echo-time encoding technique. AB - An investigation has been undertaken to study the effects of chemical shift on NMR image obtained by the projection reconstruction technique. Mathematical simulation studies indicate that chemical shift causes blurring in NMR images regardless of the image reconstruction technique. A systematic study of such artifacts is presented and possible correction schemes are proposed. Exemplary results with and without correction of the chemical-shift artifact and pulse schemes employed for projection reconstruction are presented. The present chemical-shift correction scheme is basically the same as a spectroscopic imaging technique such as the existing 4-D NMR imaging method except that the encoding steps required can be reduced substantially in the case of modest spectroscopic resolution. PMID- 3831695 TI - The placing of many large superconducting magnets in a limited space. AB - The problem of minimizing the space needed to house two or three superconducting magnets was studied. Dipolar fields were used to approximate the stray fields. Field contours of a single dipole mu are reviewed. The three-dimensional contour surface is discussed in terms of its intersection with planes parallel to a base plane containing mu. The area within a field contour H in the base plane was numerically determined to be 142.55 m2[(mu/mu 0)(H0/H)]2/3 where mu 0 = 10(9) erg/G and H0 = 5 G. For the contours within planes parallel to the base plane, the contour area and its intercepts with the planar x and y axes are given as a function of the distance from the base plane. For two dipoles at one site and for a given mechanical stress, the torque-free orientations allow closer spacing. Field contours for the four torque-free orientations are given for mu 1 = mu 2. For one zero-torque configuration (mu 1 and mu 2 antiparallel, but perpendicular to the line joining them) and for a mutual force of 667 N (150 lb), the 5-G contour area is only 36% greater than that for a single dipole. General expressions for the forces, torques, and field gradients for two dipoles are given. Torque-free cases of three superconducting magnets (two of which are identical) at one site are described. Contour plots of the linear arrangements of the magnets as well as of two symmetrical triangular arrangements (corner angle is either 70.5 or 109.5 degrees) are given. PMID- 3831696 TI - Natural-abundance 13C NMR of brain. AB - In natural-abundance 13C NMR spectrum of excised rat brain 55 resonances were resolved. The chemical shifts of most of the resonances were well correlated with those of pure brain metabolites, determined under identical experimental conditions. These resonances were also found in the cytosol fraction and perchloric acid extract of the brain. Some brain resonances were not observed in the perchloric acid extract but only in the microsomes or cytosol. PMID- 3831697 TI - The magnetic field dependence of transverse water proton relaxation induced by nitroxide radicals. AB - The magnetic field dependence of the water proton T2 is calculated for aqueous solutions of nitroxides based on a detailed analysis of early T1 measurements on nitroxide solutions made as a function of magnetic field. The results parallel those for T1 closely and, unlike metal systems, the implications for magnetic imaging are similar. PMID- 3831698 TI - Sensitive-volume localization for in vivo NMR using heteronuclear spin-echo pulse sequences. AB - Heteronuclear spin-echo techniques, which require the application of an inversion pulse on the second heteronucleus, may be applied with inhomogeneous rf coils such as surface coils. There are important applications in vivo including the detection of 13C-labeled and 15N-labeled metabolites in the 1H NMR spectrum. Using a depth pulse scheme for the 1H spin-echo sequence, and particular single or composite 13C pulses, two sensitive volumes are generated by the 1H and the 13C rf coils and signal is only obtained from the region of overlap between the two sensitive volumes. This method of signal localization for in vivo applications can be extended to 1H homonuclear editing and selective polarization transfer techniques. The off-resonance characteristics of several different composite pulses are explored. PMID- 3831700 TI - [Various plasma components and whole blood viscosity in patients with the vascular form of vibration disease]. AB - In 82 men suffering from vascular form of the vibration disease, divided by the degree of its advancement into two groups: I--consisting of 42 persons (average age 40 +/- 7,5 years) at an early stage of the disease and II--consisting of 40 persons (average age 49.7 +/- 5.6 years) with an advanced stage of the disease- the whole blood and plasma viscosity, the plasma fibrinogen level, the total protein level and its fractions and the total cholesterol level were determined. The control group (III) consisted of 100 men in good health (average age 41.3 +/- 8.4 years). The studies showed in both groups with the disease a significant growth of alpha 1, gamma globulins and fibrinogen. It was demonstrated that the increased blood viscosity is--among other things--a consequence of increased plasma viscosity and proteins disturbances. PMID- 3831699 TI - [Decrease in the respiration rate in mice as an indicator of the irritating effects of chemical substances on the upper respiratory tract]. AB - A method of measuring a decrease in the respiration rate as an index of chemical substances irritating effects upon mice's upper respiratory tract has been checked and adopted. A dose of irritating substances resulting in the respiration rate decrease by 50%--RD50 has been determined, as related to exposure to chlorine, ammonia and acrolein. The RD50 values for chlorine and acrolein approximated those quoted by Alarie Y., whereas for ammonia exposure this value differed. PMID- 3831701 TI - [Evaluation of the risk of internal contamination of persons working in isotope laboratories]. AB - The investigation covered 484 workers. Altogether 1787 determinations have been made, in this--1648 internal contaminations and 139 contaminations of air, hand skin and working surfaces. The internal contaminations (22% of results) resulted mainly from deviation from radiological protection rules and were reduced through certain changes. Those were tritium contaminations (application of tritium radioluminiscence dyes) and 125--and 131-iodine radioisotopes (in nuclear medicine laboratories) the highest levels of which were 20 mSv and 0.25% ALI respectively. The results of 238Pu air contamination measurements have indicates that the dust arising during the production of smoke detectors (with 238PuO2 sources) probably has no respirable fraction properties, which confines its absorption in lower segments of the respiratory tract. It has been demonstrated that in Poland there is no need of constructing a permanent central system of internal contamination control. PMID- 3831702 TI - [Health resources and utilization of occupational health services]. AB - In literature on health care organization a hypothesis has been formulated on the relations between resources and health care use. The very development of resources, and not populations health condition deterioration has been emphasized as a stimulating factor. Attempts have been made in the paper to partially verify this hypothesis in relation to occupational health service. The results have confirmed the adopted hypothesis. Almost all the relationships concerned were statistically significant. Particularly strong dependences of the use of benefits have been found in the specialist care, for consultations rendered due to a disease (not prevention) and at the territorial (provincial) level--not at the level of integrated occupational health service authorities. PMID- 3831703 TI - [Results of the treatment of humeral epicondylitis in Baildon foundry workers in Katowice by local injections of Depo-Medrol]. AB - Described in the paper are the results of treatment of epicondylitis humeri by local injections of Depo Medrol. Thirty hard working subjects (28 men and 2 women) have been controlled to check efficiency of the treatment. Good and very good results have been obtained in 87% of cases. The author shares the view enhanced in literature, that no more than 4-5 injections of Depo Medrol should be applied. If those injections are ineffective, and other possible reasons for the disease have been excluded and other methods of conservative treatment--exhausted the author suggests the operative treatment. Five subjects (4 men and 1 woman) exhibited a specific depigmentation and atrophy of skin at the injection place. PMID- 3831704 TI - Levels of processing in disruptive effects of prior information. PMID- 3831705 TI - Semantic congruity and expectancy as separate processes. PMID- 3831706 TI - Factors of imagery and event recall. PMID- 3831707 TI - The stimulus prefix is not irrelevant and is redundant in different ways. PMID- 3831708 TI - An analysis of the strength-latency relationship. PMID- 3831709 TI - Context effects: classroom tests and context independence. PMID- 3831710 TI - Surface form and the spacing effect. PMID- 3831711 TI - Evidence for a basic level in event taxonomies. PMID- 3831712 TI - Spelling-sound effects in reading: time-course and decision criteria. PMID- 3831713 TI - Detection of coherence-disrupting and coherence-conferring alterations in text. PMID- 3831714 TI - Sentence context effects on lexically ambiguous words: evidence for a postaccess inhibition process. PMID- 3831715 TI - Influenza virus replication in human cells exposed to the pesticide emulsifier Atlox. AB - The emulsifier Atlox was capable of enhancing the infectivity of influenza virus in Chang human conjunctiva cells. Prior to infection, pre-treatment of cells with 2.5 to 10 ppm of Atlox for 6 to 8 h was necessary to detect an increase in virus production. Although there was no difference in the amount of adsorbed virus, the number of successfully infected cells was at least 1 log higher in Atlox treated cells as compared to the controls. Monitoring the 51Cr release from Atlox treated cells indicated a temporary change in membrane structure of the cells as one of the mechanisms of virus enhancement. PMID- 3831716 TI - Isolation and characterization of a succinylated polysaccharide from the cell wall of Micrococcus agilis. AB - A polysaccharide consisting of rhamnose, galactose, glucosamine and ester-linked succinic acid was extracted from the isolated cell walls of Micrococcus agilis by the hot water-phenol and 5% trichloroacetic acid (TCA) extraction methods. The hot water-phenol extractable polysaccharide accounted for 30% of the weight of the wall, with 23% by the TCA method. Phosphorus contents were less than 0.01% of the polysaccharide. Succinyl residues released by alkali treatment (0.1 N NaOH, 30 min, 37 degrees C) were identified by gas-liquid chromatography, and accounted for 6.3% and 5.1% of the polysaccharide purified from the hot water-phenol and TCA extracts, respectively. The polysaccharide was not bound when chromatography on Concanavalin A-Sepharose 4B (Con A/Sepharose 4B) columns was performed and it could thus be separated from any residual membrane lipomannan. The purified polysaccharide behaved as a negatively-charged polymer on electrophoresis in 1% agarose (at pH 8.6). A strong cross-reaction, unaffected by removal of the succinyl groups, was observed with type XXIII pneumococcal polysaccharide antiserum indicating the presence of L-rhamnose, linked through non-reducing, lateral end groups. PMID- 3831717 TI - Effect of mutacin administration on Streptococcus mutans-induced dental caries in rats. AB - A bacteriocin from serotype c Streptococcus mutans strain C3603 was examined for its inhibitory effect on experimental dental caries in rats infected with S. mutans MT8148R (serotype c). Significant reduction in the incidence of dental caries was found only when bacteriocin was incorporated both in the drinking water and in the diet at a high concentration. However, caries reduction was not as great as expected and the addition of bacteriocin to drinking water alone had no effect on the recovery of S. mutans, plaque deposition or caries incidence. The bacteriocin activity must have been reduced in the oral cavity of rats, and the reasons were examined. Bacteriocin-resistant mutants were not detected and the bacteriocin was not inactivated by saliva. Whereas the bacteriocin did not kill the S. mutans cells grown in a sucrose-containing medium, it completely killed the cells grown in a sucrose-free medium. PMID- 3831718 TI - Correlation of in vitro properties of Rhodococcus (Corynebacterium) equi with virulence for mice. AB - To study the virulence of Rhodococcus (Corynebacterium) equi, seven ATCC strains of different serotypes were tested for their LD50 in mice, clearance of the organism from the lungs and spleen following intravenous or intratracheal inoculation, and in vitro interaction with murine peritoneal macrophages. Strains ATCC 33704 and 33705 were virulent for mice and multiplied in the lungs and spleen, resulting in death of the animal in 5 days. The other five strains were avirulent for mice. The number of bacteria in the lungs and spleen of mice given these five strains decreased immediately. Pulmonary clearance of strains ATCC 33703, 33706, and 33707 was significantly more rapid than that of the virulent strains ATCC 33704 and 33705 12 hr after inoculation. Complete clearance of the avirulent strain ATCC 33707 occurred by day 14, while that of virulent ATCC 33704 and 33705 strains occurred by day 30. The virulent strains ATCC 33704 and 33705 were resistant not only to phagocytosis but also to intracellular killing by macrophages. Strains ATCC 33702 and 33706 were rapidly killed by macrophages although they were rather resistant to phagocytosis. Strain ATCC 33703 was easily phagocytized though resistant to killing by macrophages. The most avirulent strains, ATCC 33707 and 6939, were easily phagocytized and rapidly killed by macrophages. These results indicate that virulence appeared to be related to the ability of the organisms to resist clearance from the lungs and spleen and to resist phagocytosis and intracellular killing by macrophages. PMID- 3831719 TI - Comparison of dengue virus plaque reduction neutralization by macro and "semi micro' methods in LLC-MK2 cells. AB - A simplified "semi-micro' plaque reduction neutralization test (PRNT) for dengue antibody in LLC-MK2 cells in disposable tissue culture plates is described. The assay compares favorably with the standard PRNT in glass prescription bottles, with relative sensitivity and specificity both 100% at a 1:40 screening dilution by 70% plaque reduction criteria. The assay is easy to perform, economical of time, expense, and storage space, and is suitable for study of sera available in small volumes, such as those obtained on filter paper or by the capillary method. The LLC-MK2 semi-micro PRNT is an acceptable alternative to the standard PRNT, particularly in laboratories that use these cells routinely for other tissue culture work and for flavivirus vaccine development. PMID- 3831720 TI - An assay for the receptor-destroying activity of influenza C virus. AB - We have developed a convenient method for assaying the receptor-destroying enzyme (RDE) activity of influenza C virus. This method measures the ability of the RDE to destroy the hemagglutination-inhibition activity of a potent inhibitor present in rat serum. Some physico-chemical properties of the RDE of influenza C virus were investigated by using this method. The temperature optimum for maximal activity of this enzyme was found to be 45 C to 53 C. There was little difference in thermostability between the RDE and hemagglutinating activities of influenza C virus. When influenza C virions were treated with various concentrations of trypsin, the RDE activity decreased in parallel with the decrease in the amount of residual gp88 glycoprotein, suggesting association of RDE with this glycoprotein. PMID- 3831721 TI - The development of complement activating ability as an age related factor in murine brains. AB - We recently reported on the ability of the myelin fraction of the murine brain to activate the complement system through the classical pathway, which might be important in the induction of secondary inflammation in various pathological conditions where brain tissue has been exposed to the complement. The present study was undertaken to investigate the relationship between the appearance of complement activity in the mouse brain and the synthesis of myelin in ICR mice up to ninety days of age. Here, we show that anti-complementary activity in the murine brain is closely related to murine brain weight and that its activity seems to be dependent on the amount of myelin in the murine brain. Myelin was isolated from brains of equal weight taken from both two-day old and ninety-day old mice, and we found that ninety-day-old myelin consumed a much greater amount of complement (C) than two-day-old myelin. However, for equal concentrations of myelin, almost an equal amount of C was consumed by the myelin of the two-day-old mice and by that of the ninety-day-old mice. It was suggested that the difference of anti-complementary activity was caused by the myelin contents of the murine brains, but the possibility of maturation of myelin was not excluded. The mechanism involved in the anticomplementary activity of the myelin was found to be related to the consumption of complement, mainly via the classical pathway but also less activity via the alternative pathway. PMID- 3831722 TI - Serological analysis of serogroup icterohaemorrhagiae using monoclonal antibodies. AB - Eighteen serovars (19 strains) of serogroup Icterohaemorrhagiae were serologically analyzed using 18 monoclonal antibodies against serovar copenhageni Shiromizu, M20 and serovar icterohaemorrhagiae RGA strains. The reaction patterns of the serovars against these monoclonal antibodies were different. According to these results, we divided the serovars, except for serovar tonkini, into the following three subgroups: Subgroup 1 reacted to many monoclonal antibodies including serovars icterohaemorrhagiae, copenhageni, hualien, monymusk, mankarso, and budapest. Subgroup 2 fell between subgroups 1 and 3 including serovars dakota, naam, bogvere, birkini, smithi, ndambari, gem, ndahambukuje and mwogolo. Subgroup 3 reacted to only a few monoclonal antibodies: serovars weaveri and sarmin. Serovar tonkini did not react to any of the monoclonal antibodies used. There is a possibility that serovar tonkini does not belong to serogroup Icterohaemorrhagiae. Further studies on the serological reactions of each strain revealed that it was impossible to distinguish the RGA strain from the serovar hualien LT11-31 strain, indicating that they may be identical. It was also observed that serovar copenhageni and monymusk seemed to be closely related. Serovars birkini and smithi, and serovars ndambari and gem were alike in their serological reactivities. Among the 18 monoclonal antibodies, RGAMA-1 was a unique antibody which reacted only to serovar icterohaemorrhagiae and serovar hualien, indicating that it must be the serovar icterohaemorrhagiae specific antibody. On the other hand, SHIRMA-2, 5, 6 reacted to all the serovars except for serovars weaveri, sarmin, and tonkini. These antibodies exhibited a broad reaction spectrum. PMID- 3831723 TI - 7 beta-dehydroxylation of 3,7-dihydroxy bile acids by a Eubacterium species strain C-25 and stimulation of 7 beta-dehydroxylation by Bacteroides distasonis strain K-5. PMID- 3831724 TI - [Measurement of the in vitro immune response of live attenuated measles virus vaccine and antibody levels in 0 to 10-year-old children]. AB - The present study was carried out in order to test the antigenic effectiveness of the live attenuated meales vaccine which is routinly employed in our country. Sera obtained from 11 children before and after measles vaccination were tested for measles antibodies by complement fixation and neutralization tests. Sera samples were also collected from 0-10 years old children with history of vaccination, passed measles infection and none at all. These sera were also tested for measles antibody by complement fixation test. Virus isolation and seroconversion studies in children who were admitted to the outpatient clinics of Hacettepe hospital is also presented in this communication. PMID- 3831725 TI - [The incidence of intestinal helminths in Samsun district]. AB - 17954 stool specimens that were brought to the Microbiology department of Ondokuzmayis University were investigated in regard to the intestinal helminth eggs and the incidence was found to be 16% and 62% of them being Ascaris lumbricoides. The incidence of the intestinal helminth which was %21.08 in 1978 was found to be decreased to %10.45 in 1984. PMID- 3831726 TI - A plea for a truly national blood transfusion service. PMID- 3831727 TI - Congenital rubella syndrome in Malaysia. PMID- 3831728 TI - Kawasaki syndrome in Malaysia. PMID- 3831729 TI - Complications of temporary transvenous pacing. PMID- 3831730 TI - The management of beta-thalassemia in an urban district hospital. PMID- 3831731 TI - Puffer fish poisoning: four case reports. PMID- 3831732 TI - Retropharyngeal abscess: case reports. PMID- 3831733 TI - Aeromonas hydrophila hand infection complicating an open Rolando fracture: a case report. PMID- 3831734 TI - Neonatal proximal femoral epiphysiolysis (NPFE): a case report. PMID- 3831735 TI - Retained Graefenberg ring intrauterine device mimicking fractured Lippes loop in utero. PMID- 3831737 TI - A case of lingual thyroid with hypothyroidism. PMID- 3831736 TI - Traumatic neuroma in wall of recurrent unicystic ameloblastoma: a case report. PMID- 3831738 TI - Foreign bodies in the vagina after childbirth. PMID- 3831739 TI - Extracorporeal shock-wave lithotripsy and the medical treatment of renal stones. PMID- 3831740 TI - To screen or not to screen--the diabetic dilemma. PMID- 3831741 TI - Nobel Peace Prize to medicine. PMID- 3831742 TI - The management of urinary calculi in a stone centre. AB - We report the management of the first 100 patients who presented with upper urinary tract calculi to The Devonshire Hospital Lithotripter Centre. Ninety-two patients were treated by extra-corporeal shock-wave lithotripsy (ESWL) alone, four by percutaneous nephrolithotripsy (PCN) and two with staghorn calculi by combined ESWL and PCN. Ten patients had ureteric stones, and two of these required conventional open surgery. The average inpatient stay was 3.7 days. Half the patients required no analgesia after ESWL. Of the remainder, most were comfortable with oral analgesia. Almost all returned to normal activity within a few days of discharge. Complications were minimal and were managed by percutaneous or endoscopic techniques. These figures confirm the West German experience that ESWL is a safe and effective urological procedure and requires a skilled back-up of percutaneous and ureteroscopic skills for optimal patient management. By means of these techniques, conventional open surgery is necessary for the treatment of fewer than 5% of cases of calculi in the upper urinary tract. PMID- 3831743 TI - Mortality among Vietnam veterans compared with non-veterans and the Australian population. AB - A retrospective cohort study of mortality was conducted to assess whether the military service of young Australian men in Vietnam has influenced their overall death rates, or those from specific causes. The study was of all national servicemen who were conscripted during the conflict and served in the Army for at least 12 months. Of these, 19 205 served in Vietnam (veterans) while 25 677 served only in Australia (non-veterans). These men were traced from the end of their national service (between 1966 and 1973) until the beginning of 1982. For most causes of death, the observed number of deaths of veterans and of non veterans was less than expected from Australian population death rates, and for no cause was there a statistically significant excess of deaths compared with that of the Australian population. Similarly, when veterans were compared with non-veterans, there was no statistically significant difference in deaths for all causes combined, for diseases of the circulatory system, for deaths in motor vehicle accidents, for suicide and for all external causes after adjustment for the different subsequent death rates of men who had served in different Army corps. All seven deaths from diseases of the digestive system were of veterans. There was no excess of deaths among veterans from cancer or from atypical causes of death in this group of young men. Three-quarters of deaths of both veterans and non-veterans were from external causes, often involving motor vehicle accidents. PMID- 3831744 TI - Effectiveness of mass screening for diabetes mellitus using random capillary blood glucose measurements. AB - The results of 23 228 finger-prick capillary blood glucose tests (the taking of which was coordinated by the Diabetic Association of New South Wales) were reviewed. All non-diabetic persons (n = 860) with a blood glucose result of greater than or equal to 8.0 mmol/L were surveyed and 459 responded (53.4%). The responders were typical of the surveyed group with respect to age and capillary blood glucose level. Sixty-four new cases of diabetes were detected, representing 15.8% of the replies from persons who were not known to have diabetes and 0.28% of the total number of persons screened. PMID- 3831745 TI - Munchausen's syndrome. A study of the casualty "Black books" of Melbourne. AB - Unofficial registers or casualty "Black books" have evolved to assist busy casualty department staff in the identification of patients who are suffering from Munchausen's syndrome, are drug abusers or have other "problem" disorders. Fourteen of Melbourne's 17 general public hospitals have such books which contain information on 835 patients. Amalgamation of information from all of these books reduced this to 713 individual patients, of whom 21 were regarded as cases of Munchausen's syndrome, 20 were probable cases, 652 were classified as drug abusers and 20 were classified as dangerous patients. All four groups shared a similar mean age, between 32 and 37 years. Munchausen's syndrome patients showed greater tendency to use aliases. Men predominated in all four groups, especially among dangerous patients. Conventional records rely upon obtaining an honest and accurate name and information from the patient and are quite inadequate for the identification and treatment of patients with Munchausen's syndrome and drug abusers. When these conditions are suspected, a detailed standard identification form, suitable for computerization, should be used at all hospitals. PMID- 3831746 TI - Squash rackets: a review--deadly or safe? AB - Squash is a game that provokes many comments about its safety. The physical and metabolic changes taking place during games are described here, and the injury patterns and concept of sudden death associated with squash are discussed. PMID- 3831747 TI - Alpha and omega: the grief of the heart donor family. AB - This paper focuses on the grief experienced by the families of persons whose hearts have been donated; it is also about the future of the heart transplantation programme at St Vincent's Hospital and the role continuing donation plays. The article makes suggestions about the future management of the heart donor process in order to avoid confusion of the pain of loss with the decision to donate a heart. PMID- 3831748 TI - Malingerophobia. AB - This paper discusses various aspects of malingerophobia, a disturbance of altruistic behaviour, which may affect doctors and other health care professionals. If unrecognized, the condition can have serious consequences. Methods for its early prevention, detection and control are discussed. PMID- 3831749 TI - Sick doctors. PMID- 3831750 TI - Treatment of tuberculosis in Australia. AB - The combination of isoniazid and rifampicin, initially accompanied by a third drug such as ethambutol, has become the standard treatment for pulmonary tuberculosis in Australia. Not all patients need admission to hospital but careful follow-up and encouragement of compliance with the regimen is important during the year of therapy which follows the diagnosis of the disease. Because of the higher incidence of drug resistance in disease acquired in Southeast Asia, a fourth drug, usually pyrazinamide, is added until the results of sensitivity testing are known. Pulmonary disease caused by environmental ("atypical") mycobacteria presents special problems in treatment because the infection usually complicates pre-existing lung disease; drug resistance is the rule; and there are no well controlled prospective trials to provide a rational basis for therapy. PMID- 3831751 TI - Appetite suppressant drugs. PMID- 3831752 TI - Statistics and the woman giving birth in the Melbourne ambulance. PMID- 3831753 TI - Acanthamoebic keratitis in a healthy Australian man. AB - We report a case of acanthamoebic keratitis that occurred after minor ocular trauma in a healthy 31-year-old man. Multiple microbiological investigations failed to reveal the causative organism, which was identified as Acanthamoeba castellanii only after a corneal graft operation had been performed. A review of previously described cases reveals that this rare ocular infection tends to cause recalcitrant corneal ulcers after minor eye injuries in otherwise healthy individuals. PMID- 3831754 TI - Penetrating wounds caused by needle-fish in Oceania. AB - Needle-fish are slender silvery fish with long pointed beaks. They are commonly seen swimming beneath the surface near fringing reefs in the Indo-Pacific area. Such areas are also frequented by Melanesian villagers. The speed of needle-fish, together with their tendency to leap out of the water when bright lights are used for fishing and at other times, occasionally result in deep, penetrating injuries to swimmers, waders, and, in particular, to fishermen who are working at night from small canoes. Injuries from needle-fish are a relatively common occupational hazard of subsistence village life in Oceania, and probably also for some fishermen in other coastal environments, such as those in Japan and Malaysia. PMID- 3831755 TI - AIDS in drug abusers. PMID- 3831756 TI - Contact dermatitis from Grevillea 'Robyn Gordon'. PMID- 3831757 TI - Alternative medicine. PMID- 3831758 TI - Pregnancy as a risk factor for injury in downhill skiing. PMID- 3831759 TI - The treatment of asthma. PMID- 3831760 TI - Children and birth control. PMID- 3831761 TI - Skin care and melanomas. PMID- 3831762 TI - Storage of phenytoin capsules. PMID- 3831763 TI - Aboriginal health services in Western Australia. PMID- 3831764 TI - First aid in epilepsy. PMID- 3831765 TI - Routine medical examinations. PMID- 3831766 TI - [The influence of age on insulin sensitivity in non-insulin-dependent diabetes]. PMID- 3831767 TI - [Considerations on 3 cases of secondary hypergonadotrophic amenorrhea. Importance of ovarian biopsy in the etiologic diagnosis]. PMID- 3831768 TI - [Hyperglycemia hyperosmolar nonketotic coma in a subject with post-thyroidectomy hypothyroidism]. PMID- 3831769 TI - [Anthropometric and metabolic evaluation in young obese subjects]. PMID- 3831770 TI - Cyanogen bromide cleaves Fc fragments of pooled human IgG at both methionine and tryptophan residues. AB - An attempt was made to obtain fragments containing the C gamma 2 region by selectively cleaving human Fc fragments prepared from pooled IgG at Met residues using cyanogen bromide. Based on the known locations of Met residues in the Fc regions of human IgG subclasses, fragments between Met 252 and 358, comprising the C gamma 2 domains, were expected from IgGl Gm -1, IgG2, IgG3 and IgG4. Greater fragmentation of the Fc fragments occurred, however, than was predicted. Automated N-terminal sequencing identified five major points (Trp 381, 313 and 277, and Met 397 and 252) and two minor points of cleavage (Met 428 and Trp 417). The majority of cleavage points occurred at Trp rather than Met. Furthermore, cleavage at Met 358, necessary to produce C gamma 2 domains, was not detected. Control experiments verified the integrity of the Fc fragments handled in exactly the same manner without cyanogen bromide exposure and the ability of the same cyanogen bromide preparation to produce the expected cleavages at Met of sperm whale apomyoglobin without fragmentation at Trp. Cleavage at Met 358 did not occur presumably because of the difficulty associated with cyanogen bromide cleavage at Met-Thr peptide bonds. Cleavage at Trp probably occurred by way of halogen promoted oxidation of the indole nucleus with resultant peptide bond fissure. These observations show that cyanogen bromide cleavage of pooled human Fc fragments is not selective for Met, but also cleaves at Trp residues. The resultant fragmentation of the C gamma 2 region coupled with the inability to make the required cleavage at the 358-359 Met-Thr bond resulted in the inability to produce fragments comprising the C gamma 2 domains. The reasons for the selective cleavage at Met in some proteins and the cleavage at both Trp and Met in others are not known. PMID- 3831771 TI - [Chemonucleolysis in the treatment of surgical sciatica]. AB - Enzymatic dissolution of nucleus pulposus by percutaneous injection of a papain preparation is now used frequently to treat lumbosacral disc hernias responsible for resistant sciatica. Mechanisms of action and techniques are reviewed, and the importance of applying strict criteria for indications for use emphasized. The method should be reserved for nerve root sciatica resistant to medical treatment or physiotherapy, and it constitutes the last stage of conservative treatment. Exclusion criteria are mainly "excluded" disc lesions, major dysfunction or associated spinal vertebral canal stenosis. The optimal indication is represented by the subacute disc hernia in the young. This alternative to open surgery in no way compromises the results in case of failure. Results obtained in a personal series of 150 cases are analyzed comparatively with those reported in the literature. PMID- 3831772 TI - [Surgical findings and results after failure of lumbar chemonucleolysis. 72 cases]. AB - Seventy two patients undergoing lumbar chemonucleolysis (LCN) involving one (49 cases) or two (23 cases) discs underwent surgery after failure of the procedure. In 5 cases the disc prolapse responsible for the recurrence of pain was at a different site from that of the LCN. Analysis of true failures in the light of operative findings showed that the presence of a migrated disc sequestrum at a distance from the space injected was rare (7% of cases). By contrast, the discovery of a true sub-ligamentous disc prolapse was common (32%). In 1/3 of cases these prolapses contained actual intra-discal sequestra within a scanty amount of basic substance, as if the enzyme had destroyed the latter but had no action upon the former. Simple disc protrusions were discovered in 36% of cases, combined in one case out of five with stenosis of a lateral recess. Finally, in 25% of cases the disc explored was flat, combined in 1 case out of 3 with a considerable inflammatory reaction. The percentage of good and very good operative results was 60.7% overall, rising to 70% taking into consideration only those patients undergoing LCN at one level only. The authors feel that no longer than a month should be allowed to pass before deciding to operate after failure of LCN. PMID- 3831773 TI - [Contribution of computer tomography in recent traumatology of the spine. Apropos of 31 cases]. AB - The authors report 31 cases of recent spinal injury (14 cervical, 17 thoraco lumbar) which have been investigated using computerized tomography. After a critical appreciation of the conventional approach to such lesions, the authors consider the advantages and limitations of computerized tomography. Analysis of the data from 31 cases studies confirms that this technique has considerable applications in the assessment of corporeo-discal and pediculo-lamar lesions and, in particular in the determination of the degree of spinal canal stenosis and in the detection of actual potential neuroaggressive factors which are important for the choice of therapy. Computerized tomography provides information which is essential in choosing the surgical strategy to be adopted in each case, and in particular allows determination of the best approach and of the time scale for successive operations in the case of a double approach. On the other hand, computerized tomography alone does not permit precise determination, either of the degree of instability of spinal lesions or of the magnitude of static deformations. PMID- 3831774 TI - [Osteosynthesis of the low lumbar spine and spondylolisthesis. Modification of the Scholner plate and pedicular screwing]. AB - A modification of Roy Camille's Technic for better screw location into the pedicle of vertebra of the low lumbar column and lumbo-sacral junction is reported. A small 5 millimeters resection of the inferior articular process allows a more cranial drill-hole which is more steadily in the pedicle of the vertebra as confirmed by X rays controls and anatomic specimens. A 10 degree slope to a caudal direction is needed at the L5 level and a 30 degree slope to a caudal direction is required at S1 level. 50 millimeters length screw can be used for adult patients. Some modification of Scholner's plate are proposed in spondylolisthesis surgery. PMID- 3831776 TI - [Reflections on surgery of high lesions of the internal carotid. Experimental study of the floating endarterial graft]. AB - The use of a floating graft is proposed in order to attempt resolution of surgical problems raised by distal internal carotid artery lesions located high in the neck. Surgical treatment is essential, but vascular suture is impossible below the petrosa and ligature of internal carotid artery is often the only solution. The floating graft, which is fixed proximally only and is allowed to float in the circulation, allows exclusion of the lesion and maintenance of the carotid vascular axis. Preliminary experimental studies in the rat have provided satisfactory results and research should be continued in larger animals prior to possible clinical use. PMID- 3831775 TI - [Use of barbiturates in posttraumatic comas at the mesencephalic level. Apropos of 38 cases]. AB - Thirty-eight patients with brain injury and mesencephalic coma, or a Glasgow score of less than 5, were treated routinely with Thiopental administered by electric syringe for a mean duration of 4 days. Follow up review criteria were based on clinical computed tomography and electroencephalographic data, as well as results of monitoring of intracranial pressure and assay of blood barbiturate levels. Global results indicated a mortality of 55.3% and reintegration of 34.2% of the patients. Results as a function of the different parameters of surveillance are discussed. PMID- 3831777 TI - [Multiple metastases during the course of a pineal germinoma]. AB - The clinical findings and course of a patient with a germinoma of the pineal region is presented. After a surgical procedure and radiation treatment, ten months after, the patient develops successively peritoneal, ventricular, spinal metastasis. Effective treatment was either radiation treatment or chemotherapy. The frequency of metastasis with germinomas of the posterior part of the third ventricle are discussed, following a review of the literature, prevention and treatment are discussed. PMID- 3831778 TI - Stroke in the Lehigh Valley: incidence based on a community-wide hospital register. AB - Since July 1982 a population-based study of stroke has been carried out in the Lehigh Valley, a region in Pennsylvania and New Jersey, USA, with 580,000 people. During the first year, the annual incidence rates of stroke and transient ischemic attack were 167 and 49 per 100,000 population, respectively. Cerebral thrombosis, embolus, cerebral hemorrhage and subarachnoid hemorrhage accounted for 76, 13, 8 and 3% of the strokes, respectively. The overall incidence rate and distribution of stroke by type agree well with other population-based studies. The large size of the population in the Lehigh Valley means that information on the epidemiology of stroke, as well as the effects of various therapies on stroke frequency and outcome, can be collected in a shorter period of time than in most other communities studied to date. Finally, an assessment of concordance in diagnosis between attending physicians and a neurologist using standardized criteria was possible for the entire community. PMID- 3831779 TI - Prevalence and correlates of diabetes, hypertension and diaphragmatic hernia among an epileptic population. AB - The occurrence of diabetes, hypertension, and diaphragmatic hernia was investigated in an institutionalized population of long-term epileptics. Review of medical records determined the prevalence ratio of diabetes to be about 1.6% and the prevalence of hypertension to be about 2.3%. Both of these estimates are significantly lower than the rates in the general US population. The prevalence of diaphragmatic hernia among females (4.8%) was found to be significantly higher than the general population rate, but the corresponding ratio among males (3.6%) was not. Associations with major drugs used were subsequently investigated using a case-control methodology. Implications for etiologic research are discussed. PMID- 3831780 TI - On the fine structure of the distribution of primary nervous system neoplasms in Western Poland. AB - The incidence rates of primary nervous system neoplasms in 5 districts (large administrative units) of Western Poland with a relatively homogeneous health care system but some contrasts in economic activity, as well as in 224 communes (smallest administrative units) located within these 5 districts, with a total population of 3,097,000 were estimated on the appointed day (31.12.79). Testing the hypothesis, assuming a homogeneous distribution of nervous system neoplasms over the region under investigation, that the incidence rates were distributed as a Poisson variable has revealed a focal distribution of these tumours; in 15 communes the frequency was higher than 9.0 and deviated from the remainder in the 5% right tail of the distribution. The main conclusion from the presented results was that tumours of the nervous system, of which 90% were intracranially located, may occur in clusters or foci, and this could prove to be of clinical as well as statistical import. PMID- 3831781 TI - Epidemiological data for multiple sclerosis in Greece. PMID- 3831782 TI - Pilot study to detect neurologic disease in Ecuador among a population with a high prevalence of endemic goiter. AB - A census, uniform screening questionnaire, and simple screening neurologic examination were administered in a door-to-door survey to residents of Quiroga, Ecuador, a rural community in the Andes Mountains. The screening procedures had been pretested to assure a high level of sensitivity for detecting children and adults with major neurologic disease. A total of 1,113 participated in the study. Of these, 399 had responses or findings suggesting the presence of neurologic disease. These individuals were then examined by a neurologist, who used fixed diagnostic criteria. The prevalence ratios (per 1,000) for the most common neurologic conditions identified in this survey are: recurrent/persistent severe headache = 68.3, and epilepsy = 17.1. PMID- 3831783 TI - Mortality from epilepsy. International patterns and changes over time. AB - Average annual age-adjusted mortality rates for epilepsy from 33 countries for 1967-1973 were calculated and compared to earlier data (when available) from the 1950s. Rates during 1967-1973 range from 0.6 deaths/100,000/year (Denmark) to 4.0 deaths/100,000/year (Portugal). Countries in Latin America generally have high rates. With few exceptions, epilepsy mortality rates have declined over time. For each country studied, the rates are higher for males. As prevalence surveys are implemented throughout the world, we shall no longer need to rely on mortality statistics to provide some indication of the patterns of epilepsy on an international basis. PMID- 3831784 TI - An accurate assessment of the prevalence ratio of epilepsy adequately adjusted by influencing factors. AB - The prevalence of epilepsy was estimated by defining an initial prevalence ratio based on a population study and modifying this figure on the basis of various factors which influenced it. The definition required 3 seizures diagnosed by a doctor and the influencing factors included false-negative responses (where the diagnosis was confirmed), false reporting (where the diagnosis had not been established) and falsely low seizure counts (where therapy had reduced the number of seizure below the mandatory 3). As a result of these calculations the figure of approximately 1 in 50 was offered as a reliable and reasonable estimate of the true prevalence ratio of epilepsy within a well-defined Australian population. PMID- 3831785 TI - False-negative response rate in epidemiologic studies to define prevalence ratios of epilepsy. AB - This study has adopted a tested questionnaire, used in a population prevalence study, and distributed it to a sample of people identified as having epilepsy to determine the false-negative response rate for this type of epidemiologic study. PMID- 3831786 TI - Impact of psychosocial factors on the prevalence of headaches in the industrial setting. A case-control approach. AB - A sociomedical survey of 975 workers employed in an electronic instrument factory was carried out by standardized interview and aimed at defining the relationship between some psychosocial working conditions and the occurrence of headaches. The findings showed different patterns of headaches in specific occupational categories with workers exposed to different psychosocial stresses. Headaches were more frequent in those who became nervous during their work, those who were often in conflict with their co-workers, and those holding managerial posts. PMID- 3831788 TI - Methodology of a cerebral palsy register. The Western Australian experience. AB - Population-based disease registers serve a variety of purposes and have proven their value in stimulating and facilitating epidemiological research and health planning. The methods used to establish and maintain the Western Australian Cerebral Palsy Register are described. Efforts to reduce diagnostic variation by regular interobserver study meetings with clinicians have been highly productive in addition to promoting awareness of the requirements of the register. The existence of perinatal data sets as denominators are essential to monitor trends, which in turn generate hypotheses that can be readily investigated with the case population and basic variables already identified. The costs of setting up and running an ongoing register are thus offset by its output and potential uses. These, as well as its limitations, are discussed. PMID- 3831787 TI - Lack of association of A/NJ/76 (swine flu) vaccine and polymyositis. AB - There is no indication of an increase in the number of cases of polymyositis/dermatomyositis observed and reported among the 43.3 million civilians who received the A/NJ/76 (swine flu) vaccine from October 1 to December 16, 1976, in the United States. Among nearly 1 million Army and Navy personnel who received the vaccine, there was no increase in the incidence rate of polymyositis/dermatomyositis. Furthermore, there was no indication of an increase in the number of cases of polymyositis/dermatomyositis diagnosed at the Mayo Clinic, the Cleveland Clinic, the Cleveland Metropolitan Hospital or the Massachusetts General Hospital during or following the national immunization program in 1976. PMID- 3831789 TI - Tracers for paralysis agitans in epidemiological research. III. Refinement of the model for estimation of the prevalence of the disease. AB - The study presents a refinement of a preliminary model for estimation of the prevalence of Parkinson's disease (PA) from information on sales of L-dopa derivatives (LDD) and demographic data. The new model made use of a set of age specific equations describing PA prevalences obtained from historical surveys and local infant mortality rates (IMR). This strategy made it possible to obtain age specific estimates of PA prevalence and adjust for differences in health services quality. The new model was tested using data from Sardinia and Iceland. The results are in agreement with the field surveys. When the model was tested in Sweden in 1983-1984 using data on age-specific consumption of LDD, the results also validated the model. The new refined model was found to be useful for estimation of age-specific prevalence from available data on total sales of LDD, the population and infant mortality rates. PMID- 3831790 TI - Tracers for paralysis agitans in epidemiological research. IV. Trends in national drug policy and measurement of the prevalence of the disease in Sweden. AB - This study is a time series analysis of the utilization of L-dopa derivatives (LDD) and bromocriptine by parkinsonism (PA) patients and of the age-specific PA prevalences estimated by using a previously reported model. The model combines information on LDD sales, infant mortality rates (IMR) and demographic data for Sweden during the period 1974-1984. Valid yearly prevalence estimates were obtained since 1980 when the early increments of LDD sales were less than 7.9% and the early introduction of bromocriptine in the treatment of PA had already occurred. The crude PA prevalence calculated for 1984 was 254.8 per 100,000. The precision of the estimates during the period 1980-1984 was 2.6%. The model monitored the age-specific prevalence of PA in Sweden during that period, giving increasing figures for the age group 70 years and older, and was not especially sensitive to any particular type of inaccurate input. Time trend analyses of yearly estimates for populations higher than 100,000 individuals and of LDD diffusion are recommended when using this model. PMID- 3831791 TI - [Epidemiology of progressive muscular dystrophy in selected regions of Poland]. AB - On the basis of the cases registered in the Outpatient Clinic for Muscular Diseases, Medical Academy in Warsaw including patients with progressive muscular dystrophy, and after an analysis of follow-up data the epidemiological indices and mutation indices were estimated in the population of Warsaw, Province of Warsaw and Province of Radom for the years 1960-1976. The calculated indices of incidence and prevalence of dystrophy and mutation were at the upper range of values reported in world literature. They were, however higher than those estimated in previous years in the same regions by Prot. The calculated index of natural abortions in mothers of patients with Duchenne's dystrophy was slightly higher than in the control group of women. Follow-up investigations show that the genetic counselling in this disease was insufficient in that time period. PMID- 3831792 TI - [The ascending frontal artery system: morphological and radiological analysis]. AB - After an analysis of anatomical preparations of cerebral hemispheres, postmortem angiograms and normal intravital angiograms the morphological pattern of the branches of the middle cerebral artery forming the system of the ascending frontal artery and the most frequent varieties of the origin, course and shape of these branches were evaluated. PMID- 3831793 TI - [Ability of the tissues to assimilate glucose and the pyruvate and lactate levels after intravenous glucose load in patients with peripheral facial paralysis]. AB - In 60 control subjects and 48 patients with peripheral facial nerve palsy carbohydrate metabolism was tested performing a rapid intravenous glucose tolerance test with 0.5 g glucose per 1 kg of actual body weight and with determination of concentrations of glucose, pyruvate and lactate at rest in fasting state and after intravenous glucose load. Glucose was determined in capillary blood by the orthotoluidine method, pyruvate and lactate in venous blood by the enzymatic method. In the group of patients with facial nerve palsy a significantly lower number of subjects had a normal ability of glucose assimilation by tissues and a significantly higher frequency of pathological results of glucose tolerance test with a high prevalence of fasting hyperglycaemia. In patients with abnormal glucose tolerance test the fasting pyruvate concentration was high. After an intravenous glucose load the concentration of pyruvate in the 120th minute of the test was significantly increased (p less than 0.05) in patients with facial nerve palsy independently of the degree of glucose tolerance impairment. In patients with pathological result of the glucose tolerance test disturbances were observed also in lactate concentration. The production of lactate was decreased in the initial phase and then it was increased in the time up to 120 minutes. No direct correlation was observed between the disturbances of pyruvate concentration and the preserved ability of glucose assimilation by the peripheral tissues. PMID- 3831794 TI - [Topographical and radiological correlations in aneurysms of the middle cerebral artery]. AB - The authors demonstrated topographic-radiological correlations in cases of middle cerebral artery aneurysms verified surgically. In an own material of 91 cases treated in the Department of Neurosurgery, Medical Academy in Cracow in the years 1980-1983 the relationship of the aneurysm to the neighbouring vessels and the direction of the dome of the aneurysm were analysed. In the presented material aneurysms of the middle cerebral artery accounted for 18% of all intracranial aneurysms. Most frequently they were situated at the main bifurcation of the artery (86.8%). The dome of the aneurysms of the main bifurcation was lying usually in the line prolonging the main trunk of the artery cephalad and laterally. The results of surgical treatment are presented in 81 patients with aneurysms of the middle cerebral artery treated surgically. PMID- 3831795 TI - [Relation between cerebral blood flow and the changes in perfusion pressure in patients with brain compression processes]. AB - In 20 patients with expanding intracranial lesions the cerebral blood flow was determined by the method of Kety-Schmidt in an own modification with an original device--N2O-meter, with simultaneous continuous measurement of the intraventricular pressure and arterial blood pressure. This made possible determination of the cerebral perfusion pressure and of the effect of its fluctuations on the cerebral blood flow. Lowering of the cerebral blood flow below the normal value occurred when the perfusion pressure fell below 60 mm Hg, but its further fall, even to 20 mm Hg, caused no proportional decrease of the cerebral blood flow. PMID- 3831796 TI - [Variability of V waves of auditory evoked potentials in patients with supratentorial transverse displacement of the brain caused by intracranial hematoma]. AB - The authors present a comparative analysis of the characteristics of the V wave of the brain stem auditory evoked potentials in relation to the degree of transverse shifting of the third ventricle. The investigations were carried out in 48 patients with non-traumatic intracerebral haematoma. A high correlation was found between the size of the amplitude and ventricle shift. No such correlation was observed with the interpeak time of the I--V waves. PMID- 3831797 TI - [Decompression of the vertebral arteries in patients with arterial insufficiency syndrome in degenerative changes in the cervical spine]. AB - The author reports early results of surgical decompression of vertebral arteries in cases of insufficiency of these arteries caused by degenerative changes of the cervical spine. The operation was carried out in 6 cases, and in 5 of them the technique of Jung was used. In five cases the early results of this treatment were good confirming the results reported in the literature and justifying, in the author's opinion, more frequent application of this method in patients with refractory symptoms not responding to conservative treatment. PMID- 3831798 TI - 24-hour plasma levels of prolactin, cortisol, growth hormone and catecholamines in schizophrenic patients. AB - The 24-hour pattern of prolactin, cortisol and growth hormone (GH) secretion, and the diurnal variations of plasma catecholamine levels, were tested in a sample of DSM III schizophrenics and in a control population of patients hospitalized in the same ward and diagnosed as suffering from neurotic disorders. All subjects were acclimated to the ward and kept free from any drug for at least 2 weeks. No difference between schizophrenics and controls was observed with respect to the 24-hour profile of plasma prolactin and cortisol levels. The nocturnal peak of GH secretion was absent in 10 out of the 23 schizophrenics. These patients did not differ from the other schizophrenics with respect to the mean scores on any item of the Comprehensive Psychopathological Rating Scale. The mean plasma noradrenaline levels were significantly higher in schizophrenics than in controls during the wake period, but not during the sleep hours. A consistent decrease of the amine levels during the sleep period was observed in both groups. Since the nocturnal surge of plasma GH concentration has been associated with slow-wave sleep, which has been reported to be reduced in schizophrenic patients, the possibility is considered that this abnormality of sleep pattern can explain the alteration of GH release in schizophrenics. On the other hand, findings concerning plasma noradrenaline are interpreted as an indication that the state of increased autonomic arousal of schizophrenic patients is closely linked to daytime social interaction. PMID- 3831799 TI - Rapid psychotherapeutic effects of anesthesia with isoflurane (ES narcotherapy) in treatment-refractory depressed patients. AB - Treatment-refractory depressed patients who objected to electroconvulsive therapy (ECT) were given a series of anesthesias with isoflurane (Forane), a modern and established inhalation anesthetic. According to our hypothesis to be tested, the brief period of electrocerebral silence (ES), which can be observed shortly after the grand mal seizure in ECT, may be in itself a crucial biological determinant for the therapeutic effects of ECT. Isoflurane is the only drug known to effect an ES in the EEG in nontoxic concentrations, which does not result in adverse effects on any body organ including the brain; no seizure activity can be observed. Eleven depressed patients received a total of 36 anesthesias with isoflurane (ES narcotherapy). Rapid antidepressant effects were observed in 9 patients (p less than 0.0001). Effects were reproducible and lasted up to several weeks. No adverse effects of anesthesia were noticed. PMID- 3831800 TI - Classification of sulpiride, clozapine and haloperidol by toposelective recording from different brain structures in the immobilized rat (stereo-EEG). AB - The formerly designed method for quantitative evaluation of drug effects in rats is employed for the classification of three different neuroleptic drugs, namely sulpiride, clozapine and haloperidol. Analysis of the power density spectra as obtained from the recorded activity in the cortex, striatum and reticular core results in a 'fingerprint' for each drug, which is then compared to the known data on various standard drugs by means of a stepwise discriminant analysis. After cumulative dosage dose-response curves are given for single frequency bands and different brain areas. The ED50 values are close to the drug dosages applied to humans. All three neuroleptics can be differentiated from each other, but are classified very close to low dosages of chlorpromazine according to the classification rule established in an earlier paper. Relying on the overall difference of the drug's action in comparison to placebo, a single dose-response relationship is given for each compound. PMID- 3831801 TI - The fine structure of granular endoplasmic reticulum in neurons and 14C-leucine incorporation into proteins in spinal ganglia of dog after ischemia. PMID- 3831802 TI - [Effect of indomethacin on ischemic damage of sector CA1 of the horn of Ammon in Mongolian gerbils]. PMID- 3831803 TI - [Ultrastructure of myelin of the central nervous system of rats after cobalt acetate poisoning]. PMID- 3831804 TI - Ultrastructure of brain capillaries in young rabbits treated with cyclophosphamide. PMID- 3831805 TI - Effect of BCNU given to pregnant female rats on neuroglia morphology and histochemistry in the progeny. PMID- 3831806 TI - [Morphological changes in the visual system of laboratory rabbits with congenital unilateral microphthalmos]. PMID- 3831807 TI - [Intracranial pressure and its applications in neuroanesthesia and resuscitation]. PMID- 3831808 TI - [Anesthesia and intracranial pressure. Critical phases of anesthesia during intracranial surgery]. PMID- 3831809 TI - [Continuous monitoring of conjunctival oxygen in patients in coma caused by cranial trauma]. PMID- 3831810 TI - [Prolonged cerebral electrical "silence" with intracranial pressure monitored by extradural approach in the treatment of post-traumatic coma using thiopentone combined with alphaxalone-alphadolone. Clinical case]. PMID- 3831811 TI - [Significance of intracranial pressure in the care of patients with severe cranial injuries]. PMID- 3831812 TI - [Role of early care and cerebral lesions in the mortality of young patients with cranial injuries. Preliminary study concerning 92 deaths]. PMID- 3831813 TI - [Barbiturates and hypothermia in post-traumatic cerebral metabolic protection: infective complications and mortality. Apropos of 50 cases]. PMID- 3831814 TI - [Variations of intracranial pressure in the surgery of the internal carotid artery in the neck: evaluation of the risk of cerebral lesions]. PMID- 3831815 TI - [Subanesthetic doses of althesin, etomidate and flunitrazepam: effects on intracranial pressure]. PMID- 3831816 TI - [Monitoring of the intracranial pressure during the postoperative period of tumors of the posterior cranial fossa]. PMID- 3831818 TI - [Study of the existing correlation between pressure and amplitude of the cerebral pulse in acute intracranial hypertension]. PMID- 3831817 TI - [Therapeutic methods of intracranial hypertension in neuroresuscitation]. PMID- 3831819 TI - [Continuous pluriparametric surveillance in neuroresuscitation. Practical examples]. PMID- 3831820 TI - [Intracranial pressure in patients with severe cranial injuries. Correlation between the severity of the injury and the prognostic value]. PMID- 3831821 TI - [Changes in intracranial pressure induced by assistance maneuvers in the head injured patient in a coma]. PMID- 3831822 TI - [Lidocaine protection of the pressure of cerebral perfusion in tracheal stimulation]. PMID- 3831823 TI - [Reproposal of the closed circuit in anesthesia]. PMID- 3831824 TI - [Apropos of central venous cannulation]. PMID- 3831825 TI - [Preliminary results in the treatment of severe brain injuries using thiopental and alphaxalone-alphadolone and monitoring of the intracranial pressure by extradural approach]. PMID- 3831826 TI - [Technological aspects in the measurement of intracranial pressure]. PMID- 3831827 TI - [Importance of monitoring intracranial pressure, by an extradural approach, for diagnosis. Clinical contribution]. PMID- 3831828 TI - [Monitoring intracranial pressure by lumbar subarachnoid approach]. PMID- 3831829 TI - [Diabetes insipidus of the coma patient: value of the constant infusion of a posterior hypophysis extract]. PMID- 3831830 TI - [Historical and current therapeutic and diagnostic aspects of bilateral post traumatic carotid-cavernous fistulas]. PMID- 3831831 TI - [Incidence of chronic alcoholism in 109 patients with cranial injuries. A 3-year study]. PMID- 3831832 TI - [Home management of intrathecal catheters]. PMID- 3831833 TI - [AIDS and surgery]. PMID- 3831834 TI - [Non-recurrent right lower laryngeal nerve. Presentation of 4 cases]. PMID- 3831835 TI - [Results of the surgical resection of pulmonary cancer: actuarial analysis according to TNM]. PMID- 3831836 TI - [Temporary decompressive gastrostomy in colonic surgery]. PMID- 3831837 TI - [Extensive surgery for cancer of the colorectum]. PMID- 3831838 TI - [Use of prolene mesh in the treatment of laparoceles and recurrent inguinal hernias]. PMID- 3831839 TI - [Cryosurgery in the treatment of lesions of the anal canal]. PMID- 3831842 TI - [Ischemic pathology of the superior mesenteric artery. Apropos of 2 cases treated surgically with success]. PMID- 3831841 TI - [Ceruletide as a pharmaco-dynamic test in the peroperative study of the choledoco duodenal junction]. PMID- 3831840 TI - [Post-operative atony of the gastric stump during treatment with H2 antagonists]. PMID- 3831843 TI - [Neurogenic tumors of the neck: a case of neurinoma of the cervical vagus]. PMID- 3831844 TI - [Spindle-giant cell carcinoma of the thyroid]. PMID- 3831845 TI - Topographic distribution of choline acetyltransferase activity and muscarinic and nicotinic receptors in Parkinson brains. AB - Six human control brains and three parkinsonian brains were sectioned coronally and analyzed for their anteroposterior distribution of choline acetyltransferase (ChAT) activity and number of muscarine- ([3H]-QNB) and nicotine- ([3H]-nicotine) like receptors in caudate nucleus, putamen, and hippocampus. In the putamen of the controls, the ChAT activity was doubled from anterior to posterior, whereas the number of muscarinic binding sites was inversely decreased. This was not observed in the parkinsonian cases. A severe reduction in ChAT activity was found in the two cases of Parkinson's disease with the longest duration of the disease. One of these cases also showed a generally increased number of muscarinic binding sites in all three brain regions. The ratio of [3H]-QNB binding/ChAT activity was also markedly increased 10-400 times in the two cases with a long duration of the disease. PMID- 3831846 TI - Dexamethasone effect on free fatty acid and diacylglycerol accumulation during experimentally induced vasogenic brain edema. AB - Free fatty acids (FFA), diacylglycerols (DG), and water content were measured in the right and left cerebral hemispheres of rats with brain edema cryogenically induced to the right cerebral hemisphere. The effect of dexamethasone pretreatment was also studied. Twenty-four hours after lesion, maximal edema was attained concomitant with an accumulation of FFA (8.5-fold) and DG (2.9-fold). Polyunsaturated fatty acids (PUFA), primarily docosahexaenoic acid, increased greatly in both lipid pools. In the contralateral hemisphere, only DG levels increased, especially those containing stearate and arachidonate, which increased by almost 50%. By 48 h, FFA had decreased 60%, whereas DG had attained sham levels. These changes occurred prior to edema resolution. Dexamethasone decreased the degree of edema and the accumulation of PUFA-containing DG by 30% in both hemispheres. There was a complete inhibition of FFA and arachidonic acid accumulation in the lesioned side. These results suggest that dexamethasone: (1) inhibits phospholipases A2 that, in turn, decrease membrane phospholipid breakdown; and (2) has a limited effect on the enzymatic systems involved in PUFA DG accumulation. Hence, in experimentally induced vasogenic brain edema, PUFA containing DG, rather than FFA, may be related closely to the spreading of edema fluid. PMID- 3831847 TI - Clinical experience with stress and delayed thallium-201 quantitative segmental washout curves (QSWC). AB - Stress thallium-201 myocardial studies in 29 patients with chest pain were performed. The findings of digital display (DD) and quantitative segmental washout curves (QSWC) were compared independently and jointly with coronary angiography. It was found that QSWC is more sensitive (71%) than DD (55%) but is less specific (58%) than DD (98%). Taking both approaches together the sensitivity rises to 94% and the specificity falls to to 61%. Using both DD and QSWC for interpretation of thallium studies improves the agreement ratio with coronary angiography by 25% more than when using DD only. PMID- 3831848 TI - Clinical evaluation of a technetium-99m bone imaging agent based on the vicinal diphosphonate 1,2-diphosphonoethyleneglycol (DPEG). AB - From a series of technetium-99m labelled agents based on a vicinal diphosphonic acid structure, the ligand 1,2-diphosphonoethyleneglycol (DPEG) was selected for clinical study on the basis of a biodistribution in rats which compared well with that of methylene disphonphonate (MDP). The 99Tcm-DPEG agent was assessed in ten patients in whom bone metastases had been demonstrated by 99Tcm-MDP imaging two to seven days previously. Visual comparison of the skeletal images obtained with the two agents revealed the same number of bone metastases at the same locations. Statistical analysis of the data revealed no significant differences between the two radiopharmaceuticals on the basis of lesion to soft tissue ratio and lesion to normal bone ratio, although a slightly higher lesion to soft tissue ratio was found for MDP than for DPEG (p less than 0.03). At least for the formulation tested, it is concluded that this new radiopharmaceutical based on the P-C-C-P structure does not possess diagnostic advantages over 99Tcm-MDP for the detection of bone metastases. PMID- 3831850 TI - Nuclear medicine: a therapeutic future. PMID- 3831849 TI - Oesophageal transit times. PMID- 3831851 TI - Idiopathic hypertrophic sub-aortic stenosis (IHSS): a new diagnostic method using ECG-gated thallium-201 myocardial scintigraphy. AB - A new diagnostic method for idiopathic hypertrophic sub-aortic stenosis (IHSS), using synchronized ECG gated 201Tl myocardial scintigraphy, is described. Twenty patients previously diagnosed as IHSS were evaluated by sequential three-view ECG gated 201Tl and 45 degrees left anterior oblique multigated (MUGA) cardiac blood pool imaging (Group A). The results were compared with two control groups: 20 patients with no previous history of heart disease (Group B), and 20 patients with coronary ischaemic heart disease (Group C). We suggest the following combination of scintigraphic signs as typical and diagnostic to obstructive IHSS: Elevated left ventricular ejection fraction (mean 83.9% +/- 6.15S.D. versus 72.5% +/- 5.35S.D. and 51.2% +/- 13.65S.D. in Groups B and C respectively); Systolic left ventricular cavity obliteration (71% of obstructive IHSS patients versus 0% in Groups B and C); A ratio of more than 1.3:1 in septal to free wall thickness (100% of patients with IHSS); Perfusion/wall-motion mismatch of septum was demonstrated in all (100%) of patients with IHSS (versus 0% in Group B and 10% in Group C). We suggest this last finding as a new specific diagnostic sign for IHSS, with the ability to differentiate between patients with ischaemic coronary heart disease and IHSS patients; whilst both groups may present chest pains, the first group was characterized by 'matching' of perfusion and motion of the affected myocardial wall while the patients with IHSS had 'mismatching' of these parameters. We suggest gated 201Tl myocardial scintigraphy as an additional sensitive tool for the early diagnosis and evaluation of IHSS patients. PMID- 3831852 TI - The reduction of renogram deconvolution to a direct method of transit time determination. AB - It is known that the intrarenal mean transit time (MTT) can be determined using renography by first deconvoluing the kidney retention function from the obtained time-activity curve and then integrating the retention function. A direct and approximate calculational method, based on an integral mathematical model, has also been employed to estimate the MTT. In this work it is shown that the direct approximate method is equivalent to the standard deconvolution method applied with the assumption of a time independent retention function. Potential errors incurred using the direct method are thus quantified and assessed over a range of representative decay parameters. PMID- 3831853 TI - Application of instantaneous relative growth rates to sexing in preweanlings of MF1 mice. PMID- 3831854 TI - Further report on somatological measurement of head and face of children with congenital rubella syndrome in Okinawa, Japan--at 14 and 16 years postnatal. PMID- 3831855 TI - Localization of origin cells of the superior and inferior laryngeal nerves in the nucleus ambiguus: an HRP study in the rabbit. PMID- 3831856 TI - The peroneus tertius muscle in the crab-eating monkey (Macaca fascicularis). PMID- 3831857 TI - Electron microscopic studies of the lung of the salamander, Hynobius nebulosus: III. A scanning and transmission electron microscopic observation on neuroepithelial bodies. PMID- 3831858 TI - Anomalous origin of the left coronary artery from the pulmonary artery (the Bland White-Garland syndrome). PMID- 3831859 TI - Heparin effects on lipid metabolism in healthy people. PMID- 3831860 TI - Hypertrophic cardiomyopathy: electrocardiographic and 2-dimensional echocardiographic correlations. PMID- 3831861 TI - Cytogenetic investigations in hairy cell leukemia. A survey of sixteen cases. PMID- 3831863 TI - How much can the risks of sequelae from radiotherapy for breast cancer be reduced? PMID- 3831862 TI - Cimetidine in the simple and retard form: comparison of the efficacy and tolerability in the management of duodenal ulcer. PMID- 3831864 TI - Chemotherapy criteria in tuberculous meningitis. PMID- 3831865 TI - Reconstruction of the gastrointestinal tract after total gastrectomy by interposition of iso- and anti-peristaltic jejunal loops. PMID- 3831866 TI - Alcohol, tobacco, cancer and death. Review of the literature. Report of a case. PMID- 3831867 TI - Characteristics of chronic and acute battered wives. PMID- 3831868 TI - [Pathomorphological changes in the gallbladder operated on for cholelithiasis and/or inflammation]. PMID- 3831869 TI - [Euclidean distance as a measure of the degree of differentiation of cancer of the uterine body]. PMID- 3831870 TI - [Correlates of the histological features of cancer of the uterine body]. PMID- 3831871 TI - [Rheumatoid articular pannus. Histogenesis and the mechanism of destruction of articular cartilage by pannus]. PMID- 3831872 TI - [A rapid method of preparing specimens obtained by fine-needle biopsy for transmission electron microscopy]. PMID- 3831873 TI - [Histoenzymatic studies of the kidneys of albino rats after experimental administration of serpasil and deslanoside]. PMID- 3831874 TI - [Malignant leiomyosarcoma of the gallbladder]. PMID- 3831875 TI - [The so-called calcifying epithelial odontogenic tumor (Pindborg's tumor). A case report]. PMID- 3831876 TI - [Round table: Histochemical evaluation of receptor status in breast cancer. Introduction]. PMID- 3831877 TI - [Round table: Histochemical evaluation of receptor status in breast cancer]. PMID- 3831878 TI - The scientific basis of a fluorescent histochemical estrogen receptor (ER) assay for breast cancer. PMID- 3831879 TI - [Interference of the stroma in the quantitative evaluation of estrogen receptors in breast carcinoma: comparison of histochemical and biochemical methods]. PMID- 3831880 TI - Determination of hormoneresponsive breast tumor cells by tamoxifen induced fluorescence. PMID- 3831881 TI - [Determination of cytoplasmic estrogen and progesterone receptors in breast carcinoma: comparison of a histochemical and a radiometric method]. PMID- 3831883 TI - [Correlation of histologically determined receptor state and the clinical course in tumors of the breast]. PMID- 3831882 TI - [Prognostic value of receptor state determined by radiometric method in breast carcinoma]. PMID- 3831884 TI - [Preliminary clinical correlations with the receptor state determined by histochemical method in primary breast tumors and secondary lesions]. PMID- 3831885 TI - [New trends in hormone therapy]. PMID- 3831886 TI - [New interpretation of the sphygmo-oscillographic method of determining arterial pressure]. PMID- 3831887 TI - [Hormonal evaluation of the functional state of the gonads, thyroid and adrenal glands in obese children]. PMID- 3831888 TI - [Determination of hemoglobin level in a dried blood drop]. PMID- 3831889 TI - [Brain volume and pulse amplitude in the frontal area in children with edema in the nephrotic syndrome]. PMID- 3831890 TI - [Multinodular angiomatosis of the liver]. PMID- 3831891 TI - [A case of congenital aplastic Fanconi's anemia with selective dysgammaglobulinemia type I]. PMID- 3831892 TI - [A foreign body of an unusual size in the vagina of a 13-year-old girl]. PMID- 3831893 TI - [Biliary atresia in children]. PMID- 3831894 TI - [Determination of the skeletal age of Warsaw children by the TW 2 method]. PMID- 3831895 TI - [Correlations between serum IgA and IgD levels in healthy children and in children with various frequently-occurring infectious diseases]. PMID- 3831896 TI - [IgD in children with markedly lowered IgA level or IgA dysgammaglobulinemia]. PMID- 3831897 TI - [Myoinositol levels in the serum and urine of healthy children]. PMID- 3831898 TI - [Isoagglutinins of the ABO system in universal blood preparations (KU-ABO) used for exchange transfusions in hemolytic disease of the newborn]. PMID- 3831899 TI - [Production of KU-ABO preparations in hospitals for the treatment of hemolytic disease of the newborn]. PMID- 3831900 TI - [Deletion of the long arm of the first chromosome pair in a 3-year-old boy, 46 XY DEL (1) (q43)]. PMID- 3831901 TI - [A case of partial trisomy 13 with robertsonian translocation on chromosome 15 in a 3-year-old boy]. PMID- 3831902 TI - [Branhamella catarrhalis in neonatal pulmonary infectious pathology]. AB - Bronchopulmonary infections has been described for the most part in adults. ORL and upper respiratory tract infections are encountered in children. In neonates, only conjunctivitis have been reported. In their report, the authors describes the first cases of bronchopulmonary infections due to Branhamella Catarrhalis in premature infants with respiratory distress syndrome. Three cases are described in which this bacteria has been isolated in bronchial secretions and in the culture of the nasotracheal tube. Clinical and biological features were not specific. Only orosomucoid serum level was increased. A favourable outcome was obtained by macrolides. Epidemiological survey permitted the isolation of Branhamella Catarrhalis in one of the nurse who had taken care of the neonates. Otherwise, these infections occurs in immunologically compromised hosts. Hyaline membrane disease appears most likely as an auspicious factor. PMID- 3831903 TI - [Acute hemorrhagic edema in infants: role of adenoviruses? Apropos of a case]. AB - A case of acute hemorrhagic oedema of the skin is reported. About it we discuss: Anatomo-clinical data, similar to immune complex type III hypersensitivity vasculitis. Antigen has never been defined. In our case adenovirus can be discussed. Evolution is usually benign, but lethal intestinal complications have been described. Nosologic relation with anaphylactoid purpura. PMID- 3831904 TI - [Epidermoid cysts of the cranial vault in children. Apropos of 6 cases]. AB - Six observations of epidermoid cysts of the cranial vault in children are reported. The main clinical sign is a cranial tumefaction; the radiological data consist in an edged osseous gap; the surgical extraction of this evolutional tumor is indicated. PMID- 3831905 TI - [A case of 49 XXXXY gonadosomatic dysgenesis: clinical elements and biological consequences of polysomy X]. AB - Discovery of 49 XXXXY syndrome in a six years young boy allows description of the main clinical characteristics of this disease: hypotrophy, facial anomalies, hypogenitalism, delayed speech development and oligophrenia. Radio-cubital synostosis is quite specific in this syndrome. The hypothesis of a correlation between clinical anomalies and excess of genes induced by polysomia has been suggested. We give results of five X-linked enzymatic activities: steroid sulfatase (STS) (located on the probably noninactivated segment), Hypoxanthine Guanine Phosphoribosyl Transferase (HGPRT), Glucose 6 Phosphate Deshydrogenase (G6PD), Phospho Glycerate Kinase (PGK), Alpha Galactosidase A (Alpha GAL A). Only STS activity seems to be significatively increased. PMID- 3831906 TI - [Delayed hemorrhagic syndrome caused by hypovitaminosis K]. AB - The authors describe two cases of delayed haemorrhagic disease by vitamin K deficiency, occurring at 28 days and 2 months 1/2 of age. The first case was revealed by an hematoma in the thoracic wall and anemia, and the second by convulsions caused by meningeal hemorrhage. The study of hemostasis and the correction of prothrombin rate after vitamin K injection show that it is a delayed haemorrhagic disease caused by vitamin K deficiency. Etiologic factors of this affection are discussed. The authors insist on the preventive role of the vitamin K injection in infants fed exclusively at breast and presenting diarrhea. PMID- 3831907 TI - The recognition of words after their acoustic offset: evidence and implications. PMID- 3831908 TI - Visual and production similarity of the handshapes of the American manual alphabet. PMID- 3831909 TI - Perceptual-motor coordination and adaptation during locomotion: determinants of prism adaptation in hall exposure. PMID- 3831910 TI - Dual hemispheric processing in a latter matching task. PMID- 3831911 TI - The roles of pattern orthogonality and color contrast in the generation of pattern-contingent color aftereffects. PMID- 3831912 TI - Balanced and unbalanced, complete and partial transparency. PMID- 3831913 TI - Perceptual grouping in good and poor readers. PMID- 3831914 TI - The computation of disparity and depth in stereograms. PMID- 3831916 TI - The effects of the contrast, spatial frequency, and temporal frequency of a surrounding field upon the detection thresholds of gratings. PMID- 3831917 TI - Sensitivity to phase distortions in central and peripheral vision. PMID- 3831915 TI - The varieties of visual persistence: comments on Yeomans and Irwin. PMID- 3831918 TI - Limitations of context conditioned effects in the perception of [b] and [w]. PMID- 3831919 TI - Suprathreshold contrast perception as a function of spatial frequency. PMID- 3831920 TI - Overall similarity and the identification of separable-dimension stimuli: a choice model analysis. PMID- 3831921 TI - A purely central movement aftereffect induced by binocular viewing of dynamic visual noise. PMID- 3831922 TI - Emergent features: a new factor in the object-superiority effect? PMID- 3831923 TI - A factor analytic study of hue discrimination. PMID- 3831924 TI - Suppression of visible persistence in apparent motion. PMID- 3831925 TI - Effects of presentation complexity on rapid-sequential reading. PMID- 3831926 TI - Form perception: some effects of brightness and motion. PMID- 3831927 TI - Comparing strong and weak models by fitting them to computer-generated data. PMID- 3831928 TI - [Computed tomography evaluation of liposarcoma]. PMID- 3831929 TI - [A scoring system for acute mucosal reactions in the head and neck region]. PMID- 3831930 TI - [Intracavitary irradiation of nasopharyngeal squamous cell carcinoma]. PMID- 3831931 TI - [Studies on dose calculation of thorax inhomogeneity for fast neutron beams from the NIRS cyclotron]. PMID- 3831933 TI - [A quantitative study of chronic radiation injury on striated muscle of mice]. PMID- 3831932 TI - [Distant telephone transmission of CT images: its clinical application]. PMID- 3831934 TI - Prognostic value of measurements of neck nodes before and after radiotherapy. PMID- 3831935 TI - [Athletic injuries--a review. Do not run in unsuitable shoes]. PMID- 3831936 TI - [Orthopedic surgery in Kuwait]. PMID- 3831937 TI - [Fournier's gangrene--a review]. PMID- 3831938 TI - [Self-tolerance and autoaggresson]. PMID- 3831939 TI - [Oral contraceptive agents and coronary disease]. PMID- 3831940 TI - [Type 1, 2 and 3 errors]. PMID- 3831941 TI - [Results and consequences of complaints made against physicians in Finland]. PMID- 3831942 TI - Organization and quality control in screening for cervical cancer in Finland. PMID- 3831943 TI - The effect of screening on the incidence and mortality of cervical cancer in Finland. PMID- 3831944 TI - [Breast cancer screening 1984. I. Mammography as a challenge for radiology]. PMID- 3831945 TI - [Carcinoembryonic antigen (CEA) in breast cancer]. PMID- 3831946 TI - [Evaluation of the clinical progression of soft tissue sarcomas]. PMID- 3831947 TI - [Value of postoperative radiotherapy combined with chemotherapy in patients with malignant gliomas of the brain]. PMID- 3831948 TI - [Evaluation of 2 years' results of the treatment of patients with bladder cancer by cystectomy following preoperative irradiation with 2000 rads]. PMID- 3831949 TI - [Clinico-morphological evaluation of primary cancer of the fallopian tubes]. PMID- 3831950 TI - [Geographical differences in malignant laryngeal neoplasm mortality in Poland 1970-1981]. PMID- 3831951 TI - [A case of neoplastic metastasis to the bones in a patient with radiologically diagnosed osteopoikilosis]. PMID- 3831952 TI - [Neurothekeoma--a benign nerve sheath tumor. Report of a case]. PMID- 3831953 TI - [Endodermal sinus tumor--clinical evaluation of 7 cases]. PMID- 3831954 TI - First International Symposium on Nonmammalian Peptides. Rome, Italy, May 11-15, 1985. PMID- 3831955 TI - Structure-activity relationships of dermorphin synthetic analogues. AB - A number of dermorphin analogues have been reviewed for antinociceptive activity after systemic administration. Analgesic peptides as potent as or more potent than dermorphin are found among the hepta- and tetrapeptide analogues, probably because of enhanced stability towards carboxyldipeptidases imparted by the Pro6 and D-Ala2 residues lying on the right and left side, respectively, of the point of cleavage. Hexapeptide analogues are practically inactive. [D-Arg2]derivatives are very potent, particularly in the tetrapeptide series. In binding studies dermorphin behaves as a pure opioid agonist, with a marked affinity and selectivity for the mu-type opioid receptors. In the heptapeptide analogues a direct correlation seems to exist between mu-selectivity and "sodium shift," and between lipophilicity and MVD/GPI potency ratio. PMID- 3831956 TI - Synthetic tetrapeptides related to dermorphin: potent long lasting analgesic action following subcutaneous administration. AB - To examine the opioid properties of D-MetO2-dermorphin tetrapeptides, eight new analogues based on the following formula, X-Tyr-D-MetO-Phe-aa-Y, were prepared. All these peptides show dose-related naloxone-reversible opioid effects in vitro and in vivo. Substitution of Sar or Gly-ol for Gly4 were well tolerated by the isolated guinea pig-ileum preparation as well as in the tail-flick test, while alkyl-amidation of the C-terminal proved detrimental. The central activity of H Tyr-D-MetO-Phe-Gly-NH2, the most potent compound in the series, was higher than that of dermorphin. Following intracerebroventricular or subcutaneous administrations in mice, H-Tyr-D-MetO-Phe-Gly-NH2 was about 1500 and 17 times as analgesic as morphine, respectively. PMID- 3831957 TI - Taxonomic and evolutionary significance of peptides in amphibian skin. AB - A tentative approach to the systematic distribution of active peptides in the anuran cutaneous tissue is presented. Eleven peptide groups have been so far detected in the frog skin. The occurrence of seven major groups in different Archaeo-, Meso-, and Neo-batrachian amphibian stocks is briefly discussed. Tachykinins and caeruleins have been isolated from some Mesobatrachian (Xenopus) and old Neobatrachian families, even of Gondwanian ancestry, such as leptodactylids, myobatrachids, pelodryadids and ranids. A more widespread systematic distribution is reported for bradykinins and bombesins, occurring in Archaeobatrachian and Neobatrachian frogs, represented by several primitive families both of Laurasian and Gondwanian origin: among them are liopelmatids, discoglossids, myobatrachids, pelodryadids, heleophrynids and ranids. The unique position of Neotropical phyllomedusid frogs, a peculiar hylid stock with ancestral leptodactylid myobatrachid affinities is emphasized. As many as seven major peptide groups are present in these specialized climbing anurans: tachykinins, caeruleins, bombesins, bradykinins, sauvagine, dermorphins, tryptophyllins. Phyllomedusid frogs appear to display the highest adaptive level yet reached in the peptide biochemical evolution of the amphibian skin. PMID- 3831958 TI - Electroencephalographic and autonomic effects of centrally administered dermorphin in rabbits. AB - Dermorphin, administered into the third ventricle of conscious rabbits, induces an increase of the total power density spectrum of the cortex and a decrease of the total power of the hippocampus. The electrocortical pattern is similar to that found with other opiates and reported as specific of mu agonists. Simultaneously the peptide causes respiratory depression, bradycardia and hypothermia. Naloxone (0.5 mg/kg IV) quickly and completely inverts all these effects. The activity of serotoninergic, Gabaergic, catecholaminergic and cholinergic systems does not seem to be required for these dermorphin actions. Thus, the hypothesis that dermorphin acts directly in modifying cerebral electrical activity is put forward. PMID- 3831959 TI - Cerebral sites of central action of dermorphin on intestinal motility in the rat. AB - Dermorphin (DM), microinjected at 0.4 nmoles/rat into various sites of the periaqueductal gray matter (PAG), provokes complete inhibition of intestinal propulsion always coupled with full analgesia and catalepsy. When electrolytic lesions were made in the raphe magnus nucleus (NRM) a slight but significant reduction of intestinal inhibition evoked by DM into the PAG was observed. In contrast, pretreatment into the NRM 10 days before DM with a selective antiserotoninergic agent (5,6 DHT 15 microgram/rat), did not influence intestinal inhibition. As expected, both lesions reduced DM-induced analgesia but catalepsy was not affected. DM-induced inhibition of intestinal transit was therefore unaffected by subdiaphragmatic vagotomy. Finally, some other central brain regions were found sensitive to DM for the above effects such as the lateral and medial hypothalamus and mid-line thalamus. Negative results were obtained for the supraoptic nuclei and postero-medial cortical amygdaloid nucleus. Some considerations are put forward about the existence in the central nervous system of selective areas involved in intestinal modulation and their relationship with those mediating other opiate behavioural effects. PMID- 3831960 TI - The role of caudate nucleus in dermorphin-induced catalepsy in rats. AB - Bilateral electrolytic lesions of caudate nucleus were observed to potentiate the cataleptic response, and to prevent the muscular rigidity produced by intracerebroventricular injection or infusion of dermorphin. These results suggest that caudate nucleus plays an inhibitory role in controlling the cataleptic response and its integrity is essential for full development of dermorphin-induced rigidity. PMID- 3831961 TI - Cross-tolerance between dermorphin and morphine to analgesia and catalepsy in rats. AB - Rats were made tolerant to dermorphin or to morphine by continuous ICV infusion of these drugs. Tolerance to the analgesic effect was assessed by evaluating the shift of the ED50 of dermorphin or morphine in dermorphin-infused or in morphine infused animal respectively, after single doses of these opioids. Tolerance to catalepsy was revealed with the significant reduction of this effect after single ICV dose of morphine in morphine-infused and dermorphin in dermorphin-infused rats. Both dermorphin and morphine induced tolerance to the analgesic and cataleptic effects. Acute administration (SC and ICV) of morphine in DER-tolerant rats induced a significant decrease of the analgesic and cataleptic effects of this opioid, showing the onset of cross-tolerance between morphine and dermorphin. Acute injections of dermorphin (ICV) in MOR-tolerant rats, while significantly decreasing its analgesic potency, indicating the development of cross-tolerance, did not modify the cataleptic response to the peptide, showing that no cross-tolerance was present to this effect. PMID- 3831962 TI - Intrathecal dermorphine in postoperative analgesia. AB - The effectiveness of intrathecal morphine (500 micrograms), intrathecal dermorphine (20 micrograms) and routine intramuscular pentazocine (30 mg) in the relief of postoperative pain, was compared in 150 consecutive patients after elective surgery, in a prospective randomized double blind study. The analgesic effect of intrathecal dermorphine was found to be profound and to last significantly longer (43.41 +/- 1.64 hr) than intrathecal morphine (34.45 +/- 2.35 hr) or the routine pentazocine therapy (10.79 +/- 2.23 hr). The mean postoperative hospital stay in the intrathecal dermorphine (5.6 +/- 4) and morphine groups (6.3 +/- 45) was significantly shorter than in the control group (8.7 +/- 42). Side-effects, as urinary retention, vomiting and headache, were not significantly different in the three groups of patients. PMID- 3831963 TI - Isolation and primary structure determination of amphibian skin tryptophyllins. AB - A large new set of peptides has been isolated from the skin of Phyllomedusa rohdei, a South American frog. All these peptides contain a tryptophyl residue, which justified the suggested denomination of tryptophyllins (TPHs). On the basis of their amino acid chain length, they have been classified as TPH-4, TPH-5, TPH 7 and TPH-13. With the exception of TPH-13 these peptides seem to possess an action on liver protein synthesis and body weight; in addition TPH-7 and TPH-13 show endocrine and behavioural effects. The methodologies employed in purification and structure determination of TPHs will be illustrated. PMID- 3831964 TI - A mass spectrometric assay for novel peptides: application to Xenopus laevis skin secretions. AB - The peptides secreted by the South African frog Xenopus laevis were screened systematically using a strategy based on fast atom bombardment mass spectrometry (FAB-MS). High performance liquid chromatography (HPLC) of crude and Sephadex G 10 chromatographed secretions showed that many more peptides were present in these secretions than those previously identified, i.e., xenopsin, caerulein, TRH and PGLa. Fractions from the HPLC were analyzed directly by FAB-MS to determine the molecular weights of these novel peptides. Subsequent analyses, using a combination of FAB-MS, manual Edman degradation, enzymatic digestions and amino acid analyses, identified the partial and sometimes complete sequences of these peptides which had molecular weights ranging from 700-2,700. Many peptides with structural features that are often indicative of biological activity, e.g., C terminal amides and pyroglutamic acid, were readily identified by FAB-MS. In some cases, molecular weight data combined with partial sequence data was sufficient to identify peptides as originating from PGLa and the spacer regions in the precursors to xenopsin and caerulein. PMID- 3831965 TI - The nonmammalian-mammalian transition through neurohypophysial peptides. AB - Neurohypophysial hormones are particularly proper evolutionary tracers. Whereas Eutherian mammals have oxytocin and virtually always arginine vasopressin, nonmammalian tetrapods possess instead mesotocin and vasotocin. The transitions of mesotocin-oxytocin and vasotocin-vasopressin involved in the passage of reptiles-mammals seem to have occurred independently. Australian marsupials are endowed with mesotocin but American marsupials have either oxytocin (South American opossums) or both oxytocin and mesotocin (North-American opossum). These results suggest that Australian Metatherians have preserved reptilian mesotocin and used it for milk-ejecting function whereas the change mesotocin-oxytocin appeared only in the American line. All marsupials have either arginine vasopressin or lysipressin and phenypressin (Australians) or lysipressin and arginine vasopressin (Americans). It is assumed that the change of vasotocin into arginine vasopressin occurred very early, perhaps in mammal-like reptiles, and duplication of the gene with subsequent mutations has led to the presence of two vasopressin-like peptides in most Metatherians. PMID- 3831966 TI - A new peptide from Crotalus atrox snake venom. AB - The presence of new hypotensive peptides, possibly not related to ACE inhibition, has been investigated on 66 snake venoms from crotalid, viperid and elapid families. Only the venom of Crotalus atrox showed a substantial amount of a new decapeptide, called POL-236, with the following aminoacid sequence: PYR-LEU-TRP PRO-ARG-PRO-GLN-ILE-PRO-PRO. Pharmacological assays performed on the synthesized peptide revealed effects on blood pressure, probably derived from vascular and cardiac interferences. PMID- 3831967 TI - Biochemical and physiological studies on peptides from the elasmobranch gut. AB - A peptide fraction has been purified from intestinal extracts of the dogfish Scyliorhinus canicula which is a powerful stimulant of rectal gland secretory activity. This peptide is distinct from elasmobranch vasoactive intestinal polypeptide (VIP). The elasmobranch VIP fraction is not active in the rectal gland assay and mammalian VIP is only an effective agonist in Squalus and not in Scyliorhinus or Raja. Preliminary characterisation of the elasmobranch VIP indicate that it has strong N-terminal similarities with mammalian VIP but has limited C-terminal comparability. It is suggested that the rectal gland stimulating peptide, rectin, rather than VIP is responsible for the control of fluid and electrolyte secretion of elasmobranchs. PMID- 3831968 TI - Native opioid-like peptides in Squilla mantis ganglia. AB - To detect the presence of a mammalian-like enkephalin precursor in suboesophageal ganglia of Squilla mantis, an arthropod shown to be sensitive in vivo to opiates [8], protein acid extracts were fractionated by gel filtration into three large pools: A(Mr greater than 65,000), B(10,000 less than Mr less than 65,000) and C(Mr less than 10,000). Only the low molecular weight pool, pool C, showed opioid like activity when assayed by displacing labeled D-Ala2-D-Leu5-enkephalin from rat brain membranes. After trypsin and carboxypeptidase B proteolysis, pool A remained inactive, while pool B turned out to be active and was shown to inhibit the twitch response of electrically stimulated guinea-pig ileum. After HPLC fractionation of proteolyzed pool B, most of the opioid-like activity was found to be associated with a fraction showing an elution volume different from that of opioid peptide standards. Furthermore, no fraction showed immunoreactivity with anti-Met-enkephalin antibodies. The results suggest that native opioid-like peptides are present in Squilla mantis and are most likely released from higher molecular weight precursor(s). PMID- 3831969 TI - Strategies for the isolation of insect peptides. AB - Two distinct diuretic peptides affect the rate of fluid secretion of the Malpighian tubules in Locusta. Diuretic peptide (DP 1) has a molecular mass ca. 4500 and acts via cyclic AMP: the second diuretic peptide (DP 2) has a molecular mass of ca. 1000 and operates via an unknown transduction mechanism; the possible involvement of cGMP, calcium mobilization and the breakdown of phosphoinositides has been investigated. Preliminary sequence data for DP 1 is reported and details are provided concerning the isolation and characterisation of a peptide which is present in large amounts in the storage lobes of the corpora cardiaca and co chromatographs with DP 1 on high performance size-exclusion chromatography. Adipokinetic hormones (AKH) present in the corpora cardiaca of insects can regulate lipid metabolism. AKH occurs in two forms as AKH I and as AKH II: these hormones have been isolated and characterised in both Locusta and Schistocerca. AKH I is a decapeptide of the following structure: pGlu-Leu-Asn-Phe-Thr-Pro-Asn Trp-Gly-ThrNH2 and is identical in Locusta and Schistocerca. AKH II is different in these two insects: AKH II-L from Locusta is: pGlu-Leu-Asn-Phe-Ser-Ala-Gly TrpNH2 and AKH II-S from Schistocerca is: pGlu-Leu-Asn-Phe-Ser-Thr-Gly-TrpNH2. These structures have been established using newly developed quick and simple procedures employing HPLC and gas-phase sequencing which enables full structures to be elucidated from 2-3 nmoles of peptide. Comparisons are made between the structures of AKH and related peptides isolated from insects and crustacea. PMID- 3831970 TI - Wasp venom peptides; wasp kinins, new cytotrophic peptide families and their physico-chemical properties. AB - In addition to wasp kinins, the wasp venom contains a series of hydrophobic peptides, mastoparans and chemotactic peptides as major peptidergic components. The first major component in the venom is mastoparam. The peptides in the mastoparan family are tetradecapeptide amides which cause degranulation of the mast cells to release histamine from the cells, and act on the adrenal chromaffin cells to release catecholamines and adenylic acids. Some mastoparans cause hemolysis and serotonin release from the platelets. The new cytotrophic peptides as the second major components are tridecapeptide amides possessing chemotactic activity for polymorphonuclear leucocytes and monocytes. Some of the peptides in this family also cause histamine release from the mast cells. Mastoparan takes a random coil structure in aqueous solution but changes its conformation to alpha helix in methanolic solution or in the presence of lysophosphatidyl choline. This fact is confirmed also by the transferred nuclear overhauser effect by NMR analysis. The similar phenomenon was observed in the family of chemotactic peptides. The helical conformation of these peptides are amphipathic structure in which all of side chains of the hydrophobic amino acids are located on one side of the axis, and those of the basic or the hydrophilic amino acid residues are on an opposite side. Mastoparan enhances the membrane conductivity of the lipid bilayer when the peptide is investigated by the black lipid membrane experiment. This indicates that the peptide may be assembled in the membrane by changing its conformation and, for some reason, enhances the ion transfer through the membrane. These properties of the peptide may reveal various activities on the cell membrane. PMID- 3831971 TI - Insect adipokinetic hormones. AB - Peptides with adipokinetic (and usually carbohydrate-mobilizing) potency have been demonstrated in various insects, including Locusta migratoria, Schistocerca gregaria, Manduca sexta, Danaus plexippus and Periplaneta americana. As far as characterized by now the adipokinetic factors are blocked peptides, consisting of eight to ten amino acid residues. In locusts the adipokinetic hormones are synthesized in the glandular lobe of the corpus cardiacum and released into the haemolymph in response to flight stimuli. This release is under direct control of neurons, the cell bodies of which are located in the lateral areas of the protocerebrum, while their axons run via the nervi corporis cardiaci II into the glandular lobe. Hormone release is modulated by axons present in the nervi corporis cardiaci I as well as by the haemolymph trehalose concentration. Trehalose apparently exerts its influence via a neuronal network present in the corpus cardiacum. The fat body is the main target organ of the adipokinetic hormones, which are involved in both mobilization and release of flight substrates from fat body stores, i.e., trehalose from glycogen and diacylglycerol from triacylglycerol. Lipid release is accompanied by haemolymph lipoprotein conversions. PMID- 3831972 TI - Caerulein in the treatment of biliary and renal colic. AB - A randomized controlled study has been carried out in order to check the activity of caerulein in the treatment of biliary and renal colic. In 88% out of 107 patients caerulein, 1 ng/kg IV, relieved biliary colic and had no side effects. To elucidate the mechanism of action of the peptide, 22 cholecystectomized patients, showing a dilation of the common bile duct (CBD), were submitted to caerulein treatment under echo-control. Reduction of CBD caliber was noticed when the dilatation was due to functional obstruction, whereas an organic obstruction of the terminal tract of CBD was found in the non-responding patients. Caerulein appears to be an effective agent in relieving biliary colic through a relaxation of Oddi's sphincter, and may be used in ultrasound differential diagnostics of terminal bile duct obstruction. Caerulein, 75 ng/kg intramuscularly, relieved renal colic in 75% of the examined patients; it is suggested that the effect of caerulein in this syndrome is due to central analgesic action. PMID- 3831973 TI - Effects of sauvagine on behavioural arousal of mice. AB - The effects of natural and synthetic sauvagine on locomotor activity and ECS induced seizures were studied in DBA/2 mice. A dose-dependent activity depression was evident following the administration of both compounds. Moreover they exerted a protective effect against ECS-induced seizures. This effect was naloxone reversible, suggesting the involvement of endogenous opioids. In both series of experiments natural sauvagine was more effective than the synthetic compound. PMID- 3831974 TI - The effect of a new amphibian peptide, Leu8phyllolitorin, on thermoregulation in the rat. AB - In this study we have examined the effect and the possible interaction of ICV injection of Leu8phyllolitorin and SC injection of naloxone on thermoregulation in fasted and fed rats at cold (4 degrees C) and ambient (22 degrees C) temperature. Central injection of Leu8phyllolitorin have been shown to produce hypothermia in animals exposed to a cold environment, but not in animals maintained at 22 degrees C. This suggests that the stressful situation of a cold temperature is an important factor in causing peptide hypothermia. Naloxone enhanced the hypothermic effect of Leu8phyllolitorin at 4 degrees C and 22 degrees C both in fasted and in fed rats, reflecting an opiate receptor interaction for this response. PMID- 3831975 TI - [Control of aspirin intolerance]. PMID- 3831976 TI - [Aspirin tolerance in patients with chronic rhinitis and hypersensitivity to aspirin]. PMID- 3831977 TI - [Pollen fallout and symptoms of hay fever]. PMID- 3831978 TI - [Sensitivity of various clinical strains of bacteria to cefoperazone]. PMID- 3831979 TI - [A rare case of cancer of the upper lobe of the right lung treated by sleeve resection 3 years after removal of a metastasis to the brain]. PMID- 3831980 TI - [Drug addiction on a world-wide scale during the last 5 years in the light of the report of the International Committee for Narcotics Control]. PMID- 3831981 TI - [The sex of transsexuals]. PMID- 3831982 TI - [Analysis of anthropometric characteristics of transsexuals]. PMID- 3831983 TI - [Presence of the Y chromosome in female patients with Turner's syndrome]. PMID- 3831984 TI - [Effect of iron-enriched rolls on the hematological indicators and clinical symptoms in women of childbearing age]. PMID- 3831985 TI - [Clinical symptomatology and diagnostic criteria in Rud's syndrome]. PMID- 3831986 TI - [Zinc levels in the blood of healthy children in Plock]. PMID- 3831987 TI - [Classification of hyperlipoproteinemia in the light of advances in pathogenetic studies]. PMID- 3831988 TI - [Analysis of changes in the serum levels of lipids and lipoproteins in obese persons and in patients with diabetes mellitus type 2 associated with obesity]. PMID- 3831989 TI - [Changes in the serum levels of triglycerides, free fatty acids and glucose in men after myocardial infarction and in healthy men after long-term physical exertion of moderate intensity]. PMID- 3831990 TI - [Evaluation of selected parameters of lipid metabolism in children with low body weight]. PMID- 3831991 TI - [Algorithm for the differential diagnosis of hyperlipidemia]. PMID- 3831992 TI - [Serum digoxin level during treatment combined with amiodarone]. PMID- 3831993 TI - [Interaction of cimetidine with quinidine, procainamide and digoxin]. PMID- 3831994 TI - [Pharmacokinetics of paracetamol after oral administration in patients with pyloric stenosis]. PMID- 3831995 TI - The lymphoepithelial phenomenon in the gastric mucosa. AB - Lymphocyte-like cells surrounded by a clear halo were found within the foveolar epithelium both in the fundus and the antrum in a gastrectomy specimen containing concomitantly a benign gastric ulcer. Electron microscopic studies demonstrated that these "in halo" cells had the ultrastructural characteristics of lymphocytes. "In halo" lymphocytes were found present in the subnuclear aspect of the foveolar cell cytoplasm, even in areas without inflammation in the lamina propria. The possible significance of the present finding is discussed. PMID- 3831996 TI - DNA content of diffusely infiltrative carcinomas in the stomach. AB - DNA content of diffusely infiltrative carcinomas of 15 Japanese patients, ranging in age from 38 to 65 years, was determined by cytofluorometry, using paraffin sections which were available for histological examination. Sections were stained with 0.0025% propidium iodide. By measuring the fluorescence intensity of at least 50 mitotic cells, ploidy patterns of the cancers were determined, whereas a control of the diploid DNA content was set by measuring the fluorescence intensity of mitotic cells in the non-cancerous gastric mucosa; only metaphase nuclei in the sections were considered to have a whole amount of nuclear DNA in the cytofluorometric measurement. In the present study, it was found that most of the diffusely infiltrative carcinomas consisted of a heteroploid cell line. Their stem DNA contents ranged between 2.8C and 4.8C (2C corresponds to a diploid amount of nuclear DNA). Of 15 cancers, four comprised a mosaic cancer of two different heteroploid cell lines. We encountered only one carcinoma containing a diploid cell line. However, this cancer also contained a heteroploid cell line. Six cancers contained a polyploid cell population, the DNA content of which was double of the stem DNA content. In most cases, the cancer cells distributed in the mucosal layer were also heteroploid, thereby suggesting a heteroploid origin of the diffusely infiltrative carcinomas. PMID- 3831997 TI - Biological characterization of human bone tumors. VII. Detection of malignancy in a giant cell tumor of bone by flow cytometric DNA-analysis. AB - The biological behavior of giant cell tumors of bone often cannot be definitively evaluated by light and electron microscopical criteria. As DNA aneuploidy was found to be a highly sensitive marker of malignant cells, we have analyzed this descriptive parameter in 4 giant cell tumors of bone by flow cytometry. Three of the four cases were non-metastasizing giant cell tumors, the fourth was a clinically malignant neoplasm presenting extensive visceral metastases four years after first diagnosis. Neither light- nor electron microscopical findings provided unequivocal criteria for defining the biological dignity of the four tumors. DNA aneuploidies were identified in the metastasizing case only, whereas the three clinically benign tumors showed a unimodal euploid DNA distribution. Thus flow cytometric DNA analysis is an additional diagnostic tool for the detection of malignancy in giant cell tumors of bone. PMID- 3831998 TI - Endocrine cells in median raphe cysts of the penis. AB - Serotonin-storing cells are distributed in all tissues derived from cloaca. They were observed in the cavernous portion of penile urethra whereas they were absent from the glans portion. Serotonin cells were detected in several morphologic varieties of median raphe cysts. It is suggested that these cysts arise from the endodermal part of urethra. PMID- 3831999 TI - Dysplasia in the large intestine. PMID- 3832000 TI - Stages in the evolution of squamous cell carcinoma of the uterine cervix: a critique of the concepts of "dysplasia" and "cancer". AB - A clinically detectable, frankly invasive, squamous cell carcinoma of the uterine cervix evolves through a series of step-like stages, at any one of which, except the last, its progress can be arrested. These stages are intraepithelial neoplasia, early stromal invasion, microcarcinoma and, eventually and irreversibly, invasive squamous cell carcinoma. Crucial to this concept of a series of plateaus in tumour development is the recognition that "dysplasia" is a differentiated intraepithelial neoplasm and the discarding of the term "cancer" in favour of the less emotionally loaded expression "neoplastic process". PMID- 3832001 TI - The value of cytodiagnosis in cervix cancer precursors and the latency and progression of carcinoma in situ. AB - The biological behaviour, the progression rate and the latency period of the carcinoma in situ of the cervix uteri are discussed. We have tried to find out this by concluding indirectly and evaluating epidemiologically our own material, and considering the literature. Between 1966 and 1982 we bioptically diagnosed 3.327 in situ and 1.653 invasive carcinomas. Among these there were 155 (9.4%) microcarcinomas. The annual average age of women with carcinomata in situ in the years 1973 to 1982 was between 35 and 40 years with tendency to younger groups. The average age of women with invasive carcinomas with the microcarcinoma excluded ranged from 51 to 59 years. The average age of 114 women with microcarcinomas during 1973 to 1982 was 47 years. The carcinoma in situ is a precursor of the invasive carcinoma in almost each case. The progression rate is approximately 30 to 50%. The period of latency from carcinoma in situ to microcarcinoma amounts to 7 to 10 years on the average, to clinically manifest invasive carcinoma 10 to 15 years. A reliable prognosis is impossible for the individual case. After the establishment of a cytological department at the Pathological Institute Schwerin in 1968 the annual number of cytological examinations has increased to 74,000 women in 1982 (approximately 40% of women over 20 years; 50% of women between 20 and 60 years). The incidence of invasive cervical carcinoma decreased from 1969 to 1982 from 38.9 to 20.7 per 100,000 (53% of the initial figure). The mortality decreased from 25.1 to as little as 9.7 per 100,000 (39%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832002 TI - Quantitative evaluation of heterochromatin in epithelial atypia by an image processing method. AB - Digital image analysis as a method enabling quantitative description of microscopical images is especially important in studying cellular atypia. However, by using that method for characterizing the complex chromatin structure and its changes during atypia considerable difficulties arise. Defining substructures of chromatin images we have developed new method for description chromatin structure based on locally adaptive thresholding. The results obtained suggest that typical for atypia are changes in the size, optical density and distribution of the high optical density regions (heterochromatin) identified within the cell nuclei. PMID- 3832003 TI - Brown adipose tissue changes in anencephalic infants. Image analysis study. AB - Perirenal brown adipose tissue was studied in 49 liveborn anencephalic infants of appropriate weight, whose lifespan ranged from 2 hours to 6 days. An additional series of 187 full-term infants was used as control. Morphological evidence of active and marked BAT lipolysis was found in large number of anencephalic infants suggesting that activation of BAT metabolism leading to lipolysis in the newborn does not depend on a diencephalic pathway but on peripheral mechanisms. Image analysis study did not sustain significant differences in the intrauterine storage of lipids in brown adipose tissue cells for the anencephalic and control infants who died within 24 hours of birth. PMID- 3832004 TI - Morphologic alterations in the long Q-T syndrome. Light and electron microscopic observations in the conduction system and in sympathetic trunks. AB - Post-mortem examinations of 2 patients with long Q-T syndrome revealed marked focal fibrosis and lipomatosis of the conduction system as well as focal round cell ganglionitis of both sympathetic trunks. The patients, young women of different nationality displaying syncopal attacks and a long Q-T interval in the ECG died suddenly of ventricular arrhythmias. A family study of one of them revealed Q-T prolongation in 4 generations. The ultrastructure of the conductive tissue and the ventricular myocardium showed no specific alterations indicative of a primary metabolic defect. Ganglionitis of the sympathetic trunks has not yet been reported in the long Q-T syndrome. Although the etiology of the inflammatory changes is uncertain a chronic viral infection, noninfectious toxic alterations or an autoimmunopathy are among the plausible causes discussed. PMID- 3832005 TI - In-vitro effects of bromocriptine on isolated pituitary adenoma cells. Ultrastructural and morphometrical studies. AB - 3 pituitary adenomas in hyperprolactinemia and 3 GH and prolactin producing tumours were analysed. The adenoma cells were prepared and held in suspension so that they could be treated with bromocriptine (10 ng and 100 ng). At different times after treatment (0.5, 60 and 90 minutes), the cells were fixed and prepared for conventional electronmicroscopy. Electron microscopic photographs were quantitatively analysed by the point counting method. The results were compared to those of an untreated control group. After bromocriptine influence, there was a decrease of the hormone secretion into the supernatant (2 of 3 prolactin producing adenomas). The prolactin secretion was unchanged in all 3 adenomas which produced prolactin and GH, but there was a decrease in the GH production in 1 of these cases. Ultrastructural morphometry revealed the following results: In prolactin producing adenomas, there was a decrease in the number of exocytoses, an increase in the volume density of lysosomes (2 cases) and an increase of the rough endoplasmic reticulum (1 case). The decrease of the "unorganized" cytoplasm was observed in all 3 cases, but was significant only in 1 case. There was a significant increase in secretory granules (1 case). In adenomas which produced prolactin and GH displayed a significant increase of the rough endoplasmic reticulum and of the granules. The outlines of the cellular membranes seemed smoother (1 case). The heterogeneous results may be interpreted as an expression of the reduced hormone secretion (secretory granules, lysosomes), some data are in accordance with the beginning of necrobiotic phenomena (rough endoplasmic reticulum). The decrease of the "unorganized" cytoplasm may be due to a shrinking process. PMID- 3832006 TI - What's new in lung physiology? Pulmonary vessel regulation/non-respiratory metabolic lung functions. AB - Whereas in the last few decades respiratory functions of the lung occupied a central role in research activity, current interests are concentrating more and more on non-respiratory functions. The present small overview concerns itself with vasoregulation and metabolic operations of the lung. A series of important review articles on this topic convey extensive information. PMID- 3832007 TI - Fibroadenoma of the female breast with multinucleated giant cells. AB - A fibroadenoma in the female breast is described, which contained multiple multinucleated giant cells within the stroma. The investigation indicated the giant cells to be of epithelial nature, caused by epithelial degeneration secondary to myoepithelial swelling of unknown cause. Their presence and morphology could cause anxiety about malignancy, but this was found groundless. PMID- 3832008 TI - Anatomy of the IXth European Congress of Pathology abstracts--a reply. PMID- 3832009 TI - Behavioral effects of two dipeptides: L-phenylalanyl-L-arginine (Phe-L-Arg) and L phenylalanyl-D-arginine (Phe-D-Arg) injected into the striatum or substantia nigra of rats. AB - Behavioral effects of two dipeptides: L-phenylalanyl-L-arginine (Phe-L-Arg) and L phenylalanyl-D-arginine (Phe-D-Arg) on rat behavior after intrastriatal or intranigral injections were investigated. The L-L diastereoisomer of dipeptide (10-100 nmol) did not change the behavior while the L-D diastereoisomer induced clonic convulsions. Pretreatment by naloxone in a dose of 2 or 5 mg/kg prevented this effect. It is suggested that Phe-D-Arg might act via opioid receptors in nigrostriatal system. PMID- 3832010 TI - Trifluoperazine protection of hypoxic myocardium. AB - Effect of trifluoperazine (TFP) (2.5 X 10(-7) M and 2.5 X 10(-6)M)--an inhibitor of calmodulin, on Langendorff-perfused rabbit hearts was examined. In the normoxic hearts TFP increased coronary flow and reduced force of contraction and oxygen consumption. In the hearts subjected to 180 min hypoxia followed by 30 min reoxygenation TFP reduced hypoxic release of LDH by approx. 50% and improved recovery of coronary flow, oxygen consumption and force of contraction upon reoxygenation suggesting protection of the heart against hypoxic injury. Reoxygenation-induced release of LDH was blocked in the TFP-pretreated hearts. It was not affected when TFP was administered only during reoxygenation. This suggests that TFP does not prevent reoxygenation-induced damage as such but only some changes developing during hypoxia which make myocardium more vulnerable to the reoxygenation damage. The mechanism of the TFP-induced protection of hypoxic myocardium is not apparent from this study. One of the possibilities is anti calmodulin action of the drug. PMID- 3832011 TI - Pharmacokinetics of prethcamide following rapid intravenous injection and oral administration in rabbits. AB - A simple gas chromatographic method for the quantitative determination of ethyl butamide and propyl butamide, the active constituents of the analeptic drug "Prethcamide", in whole blood and tissues has been developed. The method was used to study the disposition of the compounds after iv and po administration to rabbits. The course of changes of ethyl butamide and propyl butamide concentration following rapid intravenous injection and oral administration was described by the two-compartment and one-compartment open models, respectively. The mean half-life (t1/2 beta, min), the body clearance (Clb, 1/min), the mean absorption rate constant (ka, min1-) and tmax (min) values were, respectively: 43.07 +/- 10.54, 0.05 +/- 0.0125, 0.033 +/- 0.0073 and 30.0 +/- 5.0 for ethyl butamide and 30.0 +/- 4.13, 0.0962 +/- 0.0269, 0.0512 +/- 0.0328 and 30.0 +/- 5.0 for propyl butamide. The low bioavailability (F) of the compounds, in the range 24-32%, may be attributed to low absorption of the drugs from the gastro intestinal tract, or the first-pass effect, or both. The drugs accumulate predominantly in the liver. The faster metabolism and elimination of propyl butamide is postulated. PMID- 3832012 TI - Histamine in retina, optic nerve, choroid and brain of albino and pigmented rabbits. AB - Retina, optic nerve and various brain structures of both albino and pigmented rabbits contained histamine in the range of 40-400 ng/g tissue; choroid of both animal strains was characterized by several times higher amine content, i.e. 1.2 5.5 micrograms/g tissue. Among the studied structures the brain tissue was the only one able to synthesize substantially histamine from 1-histidine. Histological analysis of the ocular structures revealed the presence of mast cells only in the choroid of both albino and pigmented rabbits. Incubation of either the retina or optic nerve or choroid with compound 48/80 produced release of histamine only from the choroid. PMID- 3832013 TI - Pharmacological properties of 3-aminoalkyl and amide derivatives of 5,5 diphenylhydantoin. AB - 5,5-Diphenylhydantoin derivatives containing at the position 3 aminoalkyl (1, 2, 4, 5), aminohydroxyalkyl (3) and amide (6, 8) groups were synthesized. The compounds, given in a dose of 50 mg/kg, did not affect cardiac bioelectric activity and, in contrast to diphenylhydantoin, did not possess the antiarrhythmic properties and did not protect against pentetrazol seizures. PMID- 3832014 TI - Kinetics of azathioprine metabolism in fresh human blood. AB - Azathioprine (AZA) is transformed in the whole fresh human blood in vitro to 6 mercaptopurine (6-MP). The rate of the above reaction was followed as a function of time at 25, 30 and 37 degrees C. Pseudo-first-order rate constants and thermodynamic parameters were calculated. The statistical evaluation of the parameters calculated was provided. Half-life time of 6-MP formation in blood from AZA at e.g. 37 degrees C was equal to 28.9 +/- 2.8 min. PMID- 3832016 TI - The Polish Pharmacological Society. Symposium on pharmacological regulation of the mechanisms in the central nervous system. Joint meeting with the Pharmacological Society of German Democratic Republic. Ustron-Jaszowiec, November 5-8, 1984. PMID- 3832015 TI - Synthesis and radiosensitizing properties of some 2-furancarboxylic acid derivatives. AB - New S-2-furoyl-O-alkyldithiocarbonic anhydrides have been obtained by condensation of 2-furoyl chloride with potassium O-alkyl-dithiocarbonates. The toxicity and radiosensitizing activity of these compounds were determined. PMID- 3832017 TI - Modulation by dopaminergic and serotonergic systems of cholinergic interneurons in nucleus accumbens and striatum. AB - The acetylcholine turnover rate and the enzymatic activity of choline acetyltransferase were determined in the nucleus accumbens and striatum. Whereas both apomorphine and a serotonin agonist MK 212 led to a decrease in acetylcholine turnover rate, haloperidol showed the opposite effect in the nucleus accumbens and striatum, respectively. Dopamine and serotonin agonists induced a depression of the enzymatic activity but this effect was less pronounced than the effect on acetylcholine turnover rate. It is concluded that in the nucleus accumbens and striatum the cholinergic interneurons appear to be modulated by dopaminergic and serotonergic systems in an inhibitory manner. PMID- 3832018 TI - Changes in the rat brain histamine content following metoprine and other histamine-methyltransferase (HMT) inhibitors. AB - Four compounds: amodiaquine, quinacrine, 1,4-(tele)-methylhistamine and metoprine, which in vitro effectively inhibit histamine N-methyltransferase (HMT) activity, were tested for their effects on histamine (HI) levels in the rat brain and ex vivo HMT activity. In in vitro studies all these compounds at concentration of 10 microM produced complete inhibition of HMT activity. Amodiaquine, quinacrine and 1,4-(tele)-methyl-HI weakly inhibited HMT activity ex vivo and they failed to alter HI levels in the rat brain. Of the tested compounds only metoprine significantly increased brain HI levels in both normal rats and 1 histidine treated rats. Metoprine and, to much lesser degree, amodiaquine, but not aminoguanidine, slowed down the disappearance of exogenous HI from the rat brain. It is suggested that metoprine, because of its simultaneous capability of inhibiting HMT activity and increasing brain HI level, might be a useful pharmacological tool in studies of HI metabolism and neurotransmission in the central nervous system. PMID- 3832019 TI - The influence of social isolation on ethanol preference behavior and dopamine release in telencephalon slices in mice. AB - We examined the relation between the duration of social isolation and alterations in ethanol preference behavior and the dopamine release in telencephalon slices in mice. Ethanol preference developed only after an isolation period of 2 weeks and a further ethanol treatment of 2 weeks. It did not appear after an isolation period of 6 weeks, in mice without ethanol treatment, and in group-housed mice. The dopamine release was lowered in mice isolated for 2 weeks and is normalized in combination with ethanol treatment. The dopamine release inhibition evoked by social isolation of 2 weeks probably reflects a functional state with high sensitivity for induction of an ethanol preference behaviour. PMID- 3832020 TI - Interaction of antidepressants with antiparkinsonian agents in rats. AB - The influence of antidepressants: nomifensine, imipramine, amitriptyline and trazodone on the effect of antiparkinsonian agents: trihexyphenidil and L-DOPA + carbidopa mixture (sinemet) in the model of haloperidol catalepsy was investigated in rats. In some experiments deprenyl, a selective MAO-B inhibitor, was used. It was found that antidepressant drugs in doses not influencing haloperidol catalepsy enhanced significantly the anticataleptic effect of trihexyphenidil and L-DOPA + carbidopa. The most effective in the interaction with both antiparkinsonian agents was nomifensine. Imipramine and trazodone potentiated anticataleptic effect of L-DOPA + carbidopa more strongly than those of trihexyphenidil. The most potent anticataleptic effect was observed after combined treatment of rats with deprenyl and L-DOPA + carbidopa. PMID- 3832021 TI - Effects of angiotensin II on the acquisition of conditioned avoidance response in alcohol-dependent rats. AB - The effect of angiotensin II (ANG II), given in a single intraventricular dose (2 micrograms ivc), on the course of acquisition of a conditioned avoidance response was studied in rats pretreated with alcohol. Ethanol administered for 6 or 18 days did not affect the acquisition, while a prolonged administration (for 2 months) markedly depressed the ability to learn. This effect was not only reversed by ANG II, but the peptide significantly elevated the acquisition rate above the control value. PMID- 3832022 TI - Slipped capital femoral epiphysis, an assessment of treatment modalities. PMID- 3832023 TI - Limitations of conventional nailing. AB - The ideal case for conventional closed nailing consists of: Isthmal fractures or fractures in which the isthmus can be extended by reaming or fractures with inherent stability by virtue of cortical interdigitations; closed and open type I and II; transverse, comminution grade I, II, and some grade III. Some segmental and short oblique fractures are amenable to conventional nailing. The canal length and geometry should be studied to avoid mishap in the operating room and the proper equipment. assembled along with a well trained team. Once these prerequisites have been met, conventional nailing will prove successful for the majority of patients and fractures of the femoral shaft. PMID- 3832024 TI - Biomechanics of intramedullary fracture fixation. AB - Intramedullary rodding allows excellent control of bending forces on long bone fractures when adequate sized rods are used. This is made possible by reaming when necessary. Torsional stability is poor if adequate bone nail contact is not obtained and there is little bone fragment interdigitation. This can be optimized with the interlocking system, especially with proximal and distal fractures. Intramedullary rods allow transmission of compressive load so there must be adequate bone to bone contact without comminution to prevent shortening. If a great deal of comminution is present, an interlocking system must be used to resist compressive loads. The interlocked devices have not been proven to be a detriment to union and indeed are a semi-rigid fixation system when used in comminuted shaft fractures. The strength of an osteosynthesis with an intramedullary rod depends on the geometry of the rod and the geometry of the fracture complex. Both locked and nonlocked intramedullary rods perform extremely well when one understands the mechanical principles involved in intramedullary rodding and pays close attention to detail. PMID- 3832026 TI - Indications, instrumentation, and experience with locked tibial nails. PMID- 3832025 TI - The Grosse-Kempf interlocking nail: technique of femoral and tibial fractures. AB - An anatomical reduction is required on both the lateral and AP view. In our hands this is easiest obtained and maintained with the patient in the supine position. The supine position facilitates better anesthesia care in the multiply injured patient and aids in movement of the image intensifer during the procedure. Each step should be carefully followed and the horizontal screw placement is possible only when the image of the holes is perfectly round. When the previously mentioned conditions and steps are followed, a successful locking nail insertion can be achieved. PMID- 3832027 TI - Early results of the Sunnybrook experience with locked intramedullary nailing. AB - In the past two years the closed locked intramedullary nailing system has been used at the Sunnybrook Trauma Unit. This system has equalled the results reported by Hansen in the use of closed intramedullary nailing with conventional indications, and has provided an excellent means of handling complex and difficult shaft fractures of both the tibia and the femur. It appears to provide excellent rates of union with very rapid and early rehabilitation of the patient. It is particularly useful in the multiply injured patient with very difficult high energy femoral and tibial shaft fractures. It has a minimal blood loss and can be done with practice in a reasonable period of time. This technique will add greatly to the armamentarium of the trauma surgeon. PMID- 3832028 TI - Treatment of fractures of the femur with the Grosse-Kempf rod. AB - Intramedullary rod placement provides excellent fixation for many fractures of the femur. It also carries a high union rate, a low infection rate, and a shortened hospital stay for the patient. Certain fractures of the femur are not suitable for fixation with a standard intramedullary and alone. Use of the Grosse Kempf rod, with interlocking screws, allows for stable fixation for long oblique fractures, spiral fractures, comminuted fractures, segmental fractures, fractures with a butterfly fragment, and fractures located in the proximal or distal shaft of the femur. The Louisiana State University (LSU) Orthopedic experience in the use of the Grosse-Kempf rod is presented in this article. We have treated a total of 60 fractures of the femur in 58 patients with this fixation system. This series consists of 58 acute fractures, one established nonunion, and one established infected nonunion. All patients in the group of acute fractures and who have had adequate follow up and time have healed. This group consists of 29 healed fractures and four fractures which are healing, but have recently had the static screw removed. Eight patients were lost to follow up, two died of causes unrelated to the treatment, and 17 have been placed recently and have not had time to heal. There was one instance of wound infection in the acute fracture group, associated with the distal screws, but this has not required rod removal. The Grosse-Kempf rod provides the treating physician with another option in the treatment of fractures of the femur not suitable for use by the standard intramedullary rod. The procedure is difficult, but we have found it to be reliable in treatment of difficult fractures. PMID- 3832029 TI - Concomitant ipsilateral fractures of the hip and femur treated with interlocking nails. PMID- 3832030 TI - Subtle Salter type II: distal femoral epiphyseal fracture. PMID- 3832031 TI - Whistling face syndrome. PMID- 3832032 TI - Diffuse idiopathic skeletal hyperostosis (DISH). PMID- 3832033 TI - Spongious and cortical osteoblastoma of the axial skeleton. AB - Eleven cases of osteoblastoma (spongious osteoblastoma) and four cases of osteoid osteoma (cortical osteoblastoma) involving the spine, diagnosed at Hadassah Hospital between 1970 and 1983 were analyzed. The age range was 7 to 34 years and the average clinical follow up was 63 months. The cervical spine was involved in four patients, thoracic in four, lumbar in six and the sacrum in one patient. Back or neck pain associated with stiffness was present in all cases and was often accompanied by scoliosis or torticollis. All the patients with osteoid osteoma were symptom relieved by surgery without recurrence. Seven of the patients with benign osteoblastoma presented with neurological signs or symptoms and three of these had recurrence following primary surgery. Although cortical and spongious osteoblastoma are considered as members of the same family of benign tumors of osteoblastic derivation, spongious osteoblastoma does not seem to be limited in growth potential as is cortical osteoblastoma. PMID- 3832034 TI - Controlled mobilization of patients undergoing reconstructive spinal surgery: preliminary comparison of the kinetic therapy table vs the Foster frame. AB - Controlled mobilization is necessary in certain situations during the management of patients undergoing reconstructive spinal surgery. Chart review of 39 patients (20 maintained on the Roto-rest bed, 19 maintained on the Foster frame) was undertaken. Both beds protected spinal stability and no delays occurred in any staged surgical procedure. Patients maintained on the Roto-rest bed did have a significantly higher incidence of skin problems (p less than .05), but had no pulmonary emboli. Pulmonary emboli occurred in two of the 19 patients maintained on the Foster frame. Successful use of the Roto-rest bed was dependent upon skilled nursing personnel who were knowledgeable in the mechanical aspects of the bed and could provide a sense of security for the patient. No evidence was found that the Roto-rest bed affected the patients' use of postoperative analgesics. Both beds provided adequate controlled mobilization. Consideration of the patients' total medical profile would determine the choice of bed. PMID- 3832035 TI - Life-threatening clavicular osteomyelitis in two debilitated patients. AB - Two cases are presented of immunologically compromised patients who developed acute pyogenic clavicular osteomyelitis from direct spread of a contiguous focus. Each patient's condition declined despite antibiotic therapy drainage procedures until survival was in doubt. Both showed striking reversal of their conditions and recovery when an aggressive surgical debridement (total claviculectomy) was performed. Acute pyogenic osteomyelitis of the clavicle is uncommon and rarely reported. The special implications in our patients of this disease of the adapted therapy are discussed. PMID- 3832036 TI - Double osteotomy operation in the surgical treatment of coxa plana disease. AB - During the years 1975 to 1982, what was named the double osteotomy--which is a combination of pelvic osteotomy together with subtrochanteric varus, extension and derotation osteotomy--was applied to 26 cases suffering from coxa plana (Perthes-Calve-Legg disease). The postoperative follow up averages a period of three years and five months and was undertaken at the Department of Orthopedics and Traumatology of the Faculty of Medicine, University of Ankara, Turkey. PMID- 3832037 TI - Femoral artery laceration complicating an intertrochanteric hip fracture: a multi disciplinary therapeutic problem. AB - Major arterial injuries are uncommon complications of intertrochanteric hip fractures. Described is transcatheter embolization of a lacerated femoral artery complicated by a large hematoma, discovered following surgical repair of an eight day old intertrochanteric fracture. The case was complicated due to a history of aspirin usage, marked obesity, and thrombocytopenia. Interventional radiology techniques may provide an alternative to surgery in selected cases. PMID- 3832038 TI - Arthrodesis of the knee. PMID- 3832039 TI - Epidemiology, mortality and morbidity in multiple trauma patients. AB - Three hundred, twenty-nine multiple trauma patients with skeletal injuries admitted to Hennepin County Medical Center, Minneapolis were analyzed for mortality and morbidity based on injury severity score (ISS) and timing of fracture stabilization. Fifty-three deaths (16%) occurred with 38% dying during the first six hours. Survival prospects with injury severity score over 40 were bleak. Age, sex, mechanism of injury, and time of occurrence of injury was also tabulated. Two hundred, twenty-nine patients with 474 long bone fractures were analyzed based on timing of fracture stabilization: immediate stabilization within 24 hours; delayed primary stabilization over 24 hours to one week; secondary osteosynthesis more than one week; non-operative treatment. Respiratory distress syndromes occurred in 6%, 2.4%, 9%, and 12%; mortality rate of 3%, 0%, 6.4%, and 26% for treatment groups A, B, C, and D respectively. However, it must be noted that treatment group B with lower ARDS and mortality rate had no type III open fractures and lower injury severity score. PMID- 3832040 TI - Platyspondyly in Cushing's syndrome. PMID- 3832041 TI - Ankle arthroscopy: anatomical features. AB - The site and functional significance of the anatomical structures surrounding the ankle joint plays a major role in the selection of arthroscopic portals. PMID- 3832042 TI - Residual subluxation following medial approach open reduction in congenital dislocation of the hip. PMID- 3832043 TI - An unusual resolution of a complication of the hip sliding screw device. PMID- 3832044 TI - Ender nail fixation for concomitant unilateral hip and femoral-shaft fracture. A case report. PMID- 3832045 TI - Lateral tibial plateau fracture as a postoperative complication of high tibial osteotomy. AB - Fractures associated with valgus producing high tibial osteotomy are generally reported as operative complications which involve the medial proximal segment. Factors associated with this fracture at the time of surgery include forceful closure of the osteotomy after an inadequately perforated medial cortex, a proximal segment being less than 1.5cm in thickness, and osteotomes entering the medial compartment due to excessive bone loss. Three patients are reported with postoperative fracture of the lateral tibial plateau after tibial osteotomy. One patient's fracture was clearly due to trauma and the other two occurred in patients with a thin proximal segment. PMID- 3832046 TI - Pulsatile irrigation in orthopedics. AB - A brief history of the use of irrigation fluids in the management of traumatic and surgical wounds is presented. The development of irrigation fluid as a debridement technique and some of the problems in controlling the fluid dynamic parameters are described. Orthopedics requires varied applications of irrigation devices, and a machine has been developed which combines irrigation lavage or pulsatile debridement technique with the rapid suction removal of effluent. The applications, technique, and precautions in using a Rapid Suction Removal System are described. PMID- 3832047 TI - Pyogenic sacroiliitis. PMID- 3832048 TI - Dorsal bunion following clubfoot surgery. PMID- 3832049 TI - Centronuclear myopathy. PMID- 3832050 TI - Acute and chronic management of mallet finger. A case study. PMID- 3832051 TI - Innominate osteotomy and varus derotational osteotomy in the treatment of congenital dysplasia of the hip. AB - The long-term functional and radiographic outcome of congenital hip dysplasia in patients previously diagnosed and nonoperatively treated, who subsequently underwent operative treatment after walking age was retrospectively reviewed in 94 patients (87% return). Innominate osteotomy (75 hips, 15.2 years mean follow up) yielded satisfactory late radiographic results in 33% of the subluxated hips and 50% of the dislocated hips, despite more encouraging results at one year (56% and 63.6% respectively). Varus derotational femoral osteotomy (35 hips, 10.8 years mean follow up) yielded a satisfactory radiographic outcome in 55.6% of the subluxated hips and 38.5% of the dislocated hips, with little change from the results at one year. Late diagnosis, late operative treatment, and complications of treatment, particularly ischemic necrosis of the femoral head, were predictive of poor outcome. Combined procedures (10 hips, 12 years mean follow up) or secondary open procedures were ineffective. Although Severin radiographic grade varied with time, functional status remained virtually the same throughout individual follow up. Those patients followed beyond skeletal maturity who developed gross articular incongruity or osteoarthritis, showed a decline in functional status. PMID- 3832052 TI - Posterior tibial artery pseudoaneurysm following tibial fracture. A case report. AB - The presence of distal pulses is often times misleading and the severity of the fracture roentgenographically is frequently unrelated to the possibility of a vascular injury. Pseudoaneurysms following long bone injuries, although not as commonly seen in blunt as in penetrating trauma, are potentially limb threatening injuries requiring a high index of suspicion and the liberal use of angiography for early diagnosis and repair. A case of a pseudoaneurysm of the posterior tibial artery associated with a grade I open fracture following blunt trauma and a review of the literature concerning arterial injury in blunt trauma are presented. PMID- 3832053 TI - The embedded ring. Case report and review of the literature. PMID- 3832054 TI - Civilian gunshot wounds. AB - A wide variety of injuries are encountered in civilian gunshot wounds with the severity directly related to the amount of kinetic energy imparted on the tissues. A surgeon should be aware of the different ballistic properties of the various firearms and be prepared to treat each patient as an individual. Furthermore, the physician should be attentive to severe complications that may occur even after appropriate treatment has been given. During an 18 month period on the LSU Surgical Service, 431 patients were admitted for gunshot wounds of which 218 had extremity injuries. One hundred seventy of these patients were evaluated and surveyed for type of injury, surgical procedure, and complications relating to the velocity of the involved. PMID- 3832055 TI - In vitro characteristics of tobramycin-PMMA beads: compressive strength and leaching. AB - Antibiotic-impregnated polymethylmethacrylate (PMMA) bone cement beads have been used as a local drug delivery system for the treatment of bone and soft tissue infections. The beads deliver a high local level of antibiotic with a decreased risk of toxic systemic levels. This study was undertaken to determine the antibiotic release characteristics of tobramycin-impregnated beads over time and to determine the compressive strength of these beads. Acrylic resin (PMMA) bone cement beads were prepared with three different concentrations of tobramycin. The beads were tested for compressive strength, and their antibiotic release characteristics were determined over a 21 day period by radioimmunoassay and by biological testing against a variety of bacteria. The compressive strength of the beads was found to be adequate to avoid fragmentation during their clinical use. There was gradual release of tobramycin from the beads over the entire 21 days, but the release was most marked during the first 48 hours. There was antibiotic activity against both gram-negative and gram-positive organisms, except Enterococcus, for the entire 21 day period. The release of tobramycin followed a curvilinear relationship and was directly related to the initial antibiotic concentration of the bead. Tobramycin-impregnated polymethylmethacrylate beads may represent a reliable method of local antibiotic delivery with sustained activity against a broad spectrum of organisms. PMID- 3832056 TI - Bodyloading on atrophied bone and bone mineral content. An experimental study in the rabbit. AB - The quality of a cortical bone, as reflected in the bone mineral content, has been studied in rabbit tibiae during an experimental atrophy process, and following recovery and adaptation to increased loading. Atrophy of the bone was induced by a rigid internal fixation plate applied to the tibia for 12 weeks. During the process of recovery after the plate had been removed, the bone mineral content was studied by means of an ashing procedure. The bone mineral content per unit volume cortical bone remained unchanged both at maximum atrophy and during the subsequent process of recovery. PMID- 3832057 TI - The effect of athletic activity on the bone mass in human diaphyseal bone. AB - Both humeri of seven professional tennis players and seven controls were examined with x-ray spectrophotometry, and computed tomography. Both the bone mineral content and the cortical cross-sectional area were found to be larger in the dominant arm of the tennis players than in their non-dominant arm, and in comparison to both arms of the controls. The increase in cortical cross-sectional area was a result of an increased outer diameter of the diaphysis. PMID- 3832058 TI - Modified moberg opponensplasty in acquired spastic hemiplegia. AB - Loss of the transverse arch of the hand and decreased thumb opposition has heretofore been an unreported deformity in the adult acquired spastic hemiplegic upper extremity. Based on Moberg's experience in quadriplegic patients, 11 patients underwent release of the annular ligament at the base of the thumb. This procedure allows the flexor pollicis longus tendon to bowstring and substitute for thumb opposition. All 11 had increased prehension capacity following the surgery. In carefully selected adult acquired spastic hemiplegic patients, release of the annular ligament at the base of the thumb can functionally restore the transverse arch of the hand, improve thumb opposition and improve prehensile capacity. PMID- 3832059 TI - Anterior dislocation of the shoulder in patients over 50 years of age. AB - Six patients over 50 years of age were treated and followed for traumatic, first time anterior dislocation of the shoulder. Early post injury examination following the subsidence of acute pain due to the injury demonstrated passive motion that exceeded active motion. Later follow up, however, revealed that active motion was equal to passive motion. The author concludes that these patients injured their rotator cuffs at the time of the shoulder dislocation and that such rotator cuff injuries healed satisfactorily without surgical repair. PMID- 3832060 TI - Autogenous sural nerve grafts: a harvesting technique. AB - Sural nerve grafts have applicability in many facets of reconstructive surgery. A harvesting technique is described which utilizes a tendon stripper introduced through a single distal incision. This method provides adequate length of autogenous graft material without significant difficulty or morbidity. PMID- 3832061 TI - Congenital carpal tunnel syndrome. A case report. AB - A boy with bilateral idiopathic congenital carpal tunnel syndrome was first seen at the age 4 years 6 months. He presented with triggering of the finger flexors at the wrist, abnormal posturing of the fingers and inability to pinch on one side. The triggering was relieved by transection of the transverse retinaculum. Pinch was restored by a tendon transfer. There have been no previous reports of idiopathic carpal tunnel syndrome present since birth. The literature and case are reviewed. PMID- 3832063 TI - Intramedullary osteoid osteoma of lateral femoral condyle. PMID- 3832062 TI - Dysplasia epiphysialis hemimelica. PMID- 3832064 TI - Myeloma of bone. PMID- 3832065 TI - Evidence to the Royal Commission on the National Health Service. PMID- 3832066 TI - Quality in general practice. PMID- 3832067 TI - Modification of human dental pain thresholds by conditioning stimulation. PMID- 3832068 TI - Chiral and achiral phosphorothioate analogs of 2-5A: enzymatic synthesis, characterization, and biological activities. PMID- 3832069 TI - Structure-activity relationship of analogs of 2-5A determined using the core cellulose assay for 2-5A-dependent RNase. PMID- 3832070 TI - Mechanisms of antioncogenic activity of interferon. PMID- 3832071 TI - Regulation of c-myc expression by IFN in Burkitt's lymphoma cells. PMID- 3832072 TI - Characterization of the double-stranded RNA dependent protein kinase complex. PMID- 3832073 TI - Role of degradation products of 2-5A in the localized cleavage of viral RNA. PMID- 3832074 TI - Human recombinant interferon in the bovine species: induction of 2'5'A synthetase and antiviral activity. PMID- 3832075 TI - Presence and estrogen modulation of the 2',5'- oligoadenylate synthetase/endoribonuclease system in the rat uterus. PMID- 3832076 TI - 2-5A synthetase activity in patients with metastatic carcinoma and its response to interferon treatment. AB - The interferon-induced enzyme 2-5A synthetase was measured in extracts of ficoll purified peripheral mononuclear cells from normal healthy volunteers and a large group of patients with metastatic carcinoma. The range of values in both populations was very large and overlapped considerably. On average, individuals with disseminated cancer have a two-fold increase in 2-5A synthetase activity. In addition, several patients have been identified who appear to have fully induced 2-5A synthetase activity with no detectable serum interferon and no history of prior interferon injections. This indicates that the interferon regulated 2-5A system is activated in metastatic carcinoma. Treatment of patients with interferon-alpha caused a dose-dependent increase in enzyme activity. The maximum fold increase varied from individual to individual, as did the dose required for maximum enzyme stimulation. A rigorous attempt must now be made to correlate enzyme induction with the clinical outcome of interferon treatment in order to assess the clinical value of such measurements. PMID- 3832077 TI - Sequence-specific 2'5'-oligonucleotides in the molecular dissection of the biological activity of 2-5A. AB - Recently developed chemical synthetic methodology for facile preparation of sequence-specific 2'5'-oligonucleotides has allowed more exacting questions to be asked regarding the biological role of each of the nucleotide residues of 2-5A. We have found, employing analogs in which each adenosine residue has been sequentially replaced by adenosine (viz, ppp5'I2'p5'A2'p5'I, ppp5'A2'p5'I2'p5'A, ppp5'A2'p5'A2'p5'I) that the N6 amino group of the first (or 5'-terminal) adenosine residue of 2-5A trimer is critical in RNase L binding whereas the N6 amino moiety of the third (or 2'-terminal) adenosine residue of 2-5A is crucial for the activation of RNase L. The second or middle adenosine unit of 2-5A does not seem to be critical for either binding or activation. Similarly, in studies on sequence-specific tubercidin analogs of 2-5A, activation of but not binding to mouse RNase L was dependent on the presence of the purine N7 atoms of the first and third adenosine residues of 2-5A, but, as with the N6 amino group, the N7 moiety of the second adenosine residue of 2-5A was not essential for either binding to or activation of the 2-5A-dependent endonuclease. Finally, sequence specific purine 8-bromination provided analogs of dramatically varying biological properties, and provided a 5'-monophosphate, p5'A2'p5'(br8A)2'p5'(br8A), which possessed 8% of the translational inhibitory action of 2-5A itself. This latter result may represent an important impetus toward obtaining a 2-5A derivative with biological activity in an intact cell. PMID- 3832079 TI - Testicular cancer. Proceedings of the First International Symposium on Testicular Tumors. Paris, France, October 8-10, 1984. PMID- 3832078 TI - Radioimmuno assay for 2-5 A using a novel 125I-labeled 2-5 A analog, and analysis of 2-5 A and 2-5 A synthetase activity in human plasma. PMID- 3832080 TI - Rare dysgeneses and testicular cancer. PMID- 3832081 TI - Clinical classification of testicular tumors. PMID- 3832082 TI - Lymphography in testicular tumours. PMID- 3832083 TI - Computed tomography in the staging of testicular tumours. PMID- 3832084 TI - Nuclear magnetic resonance in the evaluation of retroperitoneal lymph node metastases from testicular cancer. PMID- 3832085 TI - The relative value of lymphangiography (LAG) and computed tomography (CT) in diagnosing small retroperitoneal metastases. PMID- 3832086 TI - Retroperitoneal lymphadenectomy (RPLND) in low stage disease (staging RPLND) (one point of view). PMID- 3832087 TI - Must every non seminomatous testis tumor (stage I or IIa) be treated by retroperitoneal lymphodenectomy? PMID- 3832088 TI - Is abdominal lymphadenectomy a therapeutic procedure in malignant non seminomatous testicular tumours. PMID- 3832089 TI - Primary unilateral retroperitoneal lymph node dissection (RLND) in non seminomatous testicular cancer. PMID- 3832090 TI - What type of retroperitoneal lymph node dissection (RPLND) should be performed for stage I non-seminomatous tumours of the testis. PMID- 3832091 TI - Modified RLND as a means to preserve ejaculation. AB - According to the results of this trial it is evident that radical RLND constitutes an overtreatment in NSGCTT pathological stage I. The modified RLND limiting the areas of dissection to recognized sentinel nodes combines accurate pathological staging with low morbidity and equal success in terms of postoperative relapse; it is superior to radical RLND in preserving ejaculatory ability. It will thus come to replace the radical approach and will compete favorably with expectant therapy for some time to come. Results of prospective and long-term investigations will help to define subsets of stage I patients for whom RLND may be unnecessary (DeWys et al. 1983; Oliver et al. 1984). PMID- 3832092 TI - Extent of radiotherapy for seminomas. PMID- 3832094 TI - Is radiotherapy still indicated in non-seminomatous testicular tumours? PMID- 3832093 TI - Non germinal tumors of the testis. PMID- 3832095 TI - The question of retroperitoneal lymph node dissection for clinical stage I non seminomatous testis tumors. AB - Fifty retroperitoneal lymph node dissection (RPLND) performed by the same surgeon on 45 clinical stage I and in 5 clinical stage II cases of non seminomatous testis tumors were reviewed. Of the 45 clinical stage I patients, 12 revealed retroperitoneal lymph node involvement. Of the 17 stage II cases, one survived for more than 4 years and 3 for more than 6 years with no other treatment. There was no evidence of recurrence. Eight patients with no other treatment died within one year and a half of RPLND. Five patients, some with gross nodal disease are alive with no evidence of recurrence after RPLND and chemotherapy (PVB) (Einhorn, Donohue 1977). Of the 50 patients, only two preserved ejaculation. The author questions the systematic use of RPLND in clinical stage I testis tumors. In view of the improvement of chemotherapy agents, he favors the option of careful surveillance of these patients, who should benefit from chemotherapy and eventually surgical resection according to the progress of the disease. PMID- 3832096 TI - Effects of vincristine versus vinblastine on clonogenic growth of human testicular tumor cells in soft agar. PMID- 3832097 TI - Patients outcome after removal of residual masses after chemotherapy. PMID- 3832098 TI - Treatment of advanced seminoma. AB - Many recent publications indicate a growing dissatisfaction with the results of radiation therapy for advanced seminoma, and have shown superior results with an approach based on initial chemotherapy. Moreover, previous radiation therapy is not innocuous, and therefore chemotherapy should be the initial mode of therapy for advanced seminoma, and not be reserved for radiation therapy failures. Prior radiation not only enhances the toxicity of subsequent chemotherapy, but may also compromise the efficacy of chemotherapy. The results of combination chemotherapy for advanced seminoma, particularly with regimens which include cis-platinum, have been uniformly good when chemotherapy is employed initially. Failure of advanced seminoma to respond to primary chemotherapy is a rare event, indicating that seminomas are highly sensitive to combination chemotherapy. In the event of complete response, no further therapy may be indicated, since adjunctive surgery in these cases rarely shows evidence of persistent viable tumor. In addition, it has been our experience and that of others that lymphadenectomy after cytoreductive chemotherapy for advanced seminoma presents a more difficult surgical exercise than in the case of nonseminomatous tumors (Walther, Paulson 1984; Vugrin, Whitmore 1984). Whether follow-up radiation in complete response to chemotherapy will lower subsequent relapse rates has not been demonstrated. When partial response occurs, therapeutic options include further chemotherapy, surgery, or radiation. The relative roles of the varying approaches have yet to be determined. To maximize cure rates, additional progress will have to be made in several areas. Efforts to standardize the staging of advanced disease so that the results of different treatment modes can be more readily compared are critical.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832099 TI - Testicular seminomas: study of relapses and causes of death on a series of 86 patients. PMID- 3832100 TI - The current therapeutic approach to seminomas. PMID- 3832101 TI - Hormonal profile of Leydig cell tumors with gynecomastia. PMID- 3832102 TI - Treatment of localized paratesticular rhabdomyosarcoma (RMS) in children. PMID- 3832103 TI - Orchidectomy alone for clinical stage I nonseminomatous tumours. PMID- 3832104 TI - Orchidectomy alone for clinical stage I non-seminomas. PMID- 3832105 TI - Non-seminomatous testicular cancer stage I. Orchiectomy alone versus orchiectomy + radiotherapy: a randomized study by the Danish Testicular Cancer Study Group. PMID- 3832106 TI - Unilateral lymphadenectomy in peroperative clinically negative non seminoma. PMID- 3832107 TI - Usefulness and harm of expectant therapy in clinical stage I non seminoma. PMID- 3832108 TI - Retroperitoneal lymphadenectomy for non-seminomatous testicular tumours. PMID- 3832109 TI - Current concepts of the treatment of stage I nonseminomatous testicular tumours. PMID- 3832110 TI - Metastatic tumors to the testicles. AB - Metastatic tumors to the testicles are rare. The most common primary sites are the prostate, the lung, the kidney, the gastrointestinal tract and the skin (melanomas). The majority of these tumors are diagnosed at autopsy or at orchiectomy for metastatic prostatic carcinoma. Their clinical manifestations can antedate the clinical discovery of the primary tumor and the correct pathologic diagnosis of the testicular tissue may result in the identification of an "occult" carcinoma. Although they commonly occur in old patients with a peak incidence in the fifth and sixth decade, they may also involve younger patients and should be differentiated from primary testicular tumors. The most common routes of metastasis to the testes are the lymphatics, the vas deferens, the spermatic veins and the hematogeneous (arterial) pathways. Their diagnosis, although suspected by the patient's age and clinical symptoms should be confirmed histologically. Their treatment which includes a high inguinal orchiectomy is directed to the primary neoplasm. The prognosis depends on the site, type, grade and extent of the original tumors. PMID- 3832111 TI - How to manage clinical stage 3? PMID- 3832112 TI - Testicular yolk sac carcinoma in infants: natural history in 56 consecutive patients. AB - Fifty six patients with yolk sac tumor are registered in the "Instituto Nacional de Enfermedades Neoplasicas" (Lima-Peru), from 1952-1980: 48.22% were less than 2 years of age; 51.78% were beyond that age.- Seventeen patients survived 3 years post diagnosis: 44% when patients less than 2 years of age and 17.2% when over two years of age. 25.9% of the patients less than 2 years of age were found to have metastases whereas 48.5% when over 2 years of age. 21/56 already had metastases when first seen. All tumors were greater than or equal to 3 cm. in diameter when first seen. Metastases were found in 38% of cases when tumors were less than or equal to 6 cm., compared to 61.9% of cases in which tumors exceeded 6 cm. 51.8% of clinical stage I survived 3 years without evidence of disease; 14.3% when stage II while none survived at clinical stage IV. It is to be expected that young patients who survive 3 years after diagnosis and treatment will not suffer a recurrence of the disease. PMID- 3832113 TI - Treatment of yolk sac tumor of the testis in children. PMID- 3832115 TI - Epidermoid cyst of the testis. Report of 6 cases. PMID- 3832114 TI - Leydig cell tumours in adults. A report of 13 cases. PMID- 3832116 TI - Primary lymphoma of the testis. Report of 2 cases. PMID- 3832117 TI - Influence of lymph node dissection and/or chemotherapy on fertility in patients with testicular cancer. PMID- 3832118 TI - Sperm cryopreservation preceding treatment of testis cancer. PMID- 3832119 TI - Elevated antisperm antibodies in patients with testicular cancer: is there a relationship with infertility? PMID- 3832120 TI - Human chorionic gonadotropin-positive seminoma: is this a special type of seminoma with a poor prognosis? AB - Prognosis and treatment of HCG-positive seminomas with syncytiotrophoblastic giant cells are still a matter of discussion. Between 1977 and 1982 the serum HCG and alpha-feto protein levels were determined in a prospective study of a total of 51 patients presenting with histologically proven pure seminomas. A total of 13 of the 51 patients with pure seminoma had elevated serum HCG levels, but all of them were negative for alpha-feto protein. On clinical examination six patients had tumor Stage I, six had had tuor Stage II A-B and one patient had a tumor Stage III. The clinical stage was not found to correlate with HCG levels. In six patients presenting with tumors of clinical Stage II who underwent orchiectomy and subsequently radiation therapy there was a decrease in HCG levels following therapy. Five patients were followed for five years after therapy had been discontinued. There is no indication of a relapse in four patients, and the patients are negative or HCG. One patient suffering from a tumor, Stage IIB died three years later as a result of cirhosis of the liver. Autopsy did not reveal any signs of a residual tumor; the serum HCG levels were negative. For the time being HCG-positive seminomas should be classified and treated as a special morphologic form of seminoma. PMID- 3832121 TI - [Evaluation of the course of bipolar affective disorder type I. Significance of phase dominance on its course]. PMID- 3832122 TI - [Analysis of selected elements of the clinical picture during the first hospitalization for schizophrenia in siblings]. PMID- 3832123 TI - [Evaluation of the degree of suicide risk by Poldinger method]. PMID- 3832124 TI - [Dynamics of personality changes in alcohol-dependent patients during treatment]. PMID- 3832125 TI - [The special place of homosexuality among the sexual deviations]. PMID- 3832126 TI - [Psychomotor status epilepticus--a case report]. PMID- 3832127 TI - [Training in psychiatry at the Institute of Medical Sciences in Sidi-Bel-Abbes in Algeria]. PMID- 3832128 TI - [Symptoms of the paranoid syndrome and personality characteristics in a systematic approach]. PMID- 3832129 TI - [The circulatory system in patients with depression during treatment with antidepressive drugs. I. Analysis of ECG records during the depressive phase of affective diseases]. PMID- 3832130 TI - [The circulatory system in patients with depression during treatment with antidepressive drugs. II. Effect of therapeutic doses of thymoleptics on ECG records in patients with endogenous depression]. PMID- 3832131 TI - [Effect of sleep deprivation on the clinical picture and various neurophysiological parameters of psychogenic depression syndromes]. PMID- 3832132 TI - [Psychiatric problems in emergency service units]. PMID- 3832133 TI - [The methods of evaluating social adjustment in psychiatric and sociological studies. II. The methods of collecting information and the methods of evaluating behavior]. PMID- 3832134 TI - [Thanatophobia associated with defense mechanisms in a retrospective interpretation of a patient after 10 years]. PMID- 3832135 TI - [The role of self-concept in depression]. PMID- 3832136 TI - [Changes in the serum thioridazine level after administration of pridinol]. PMID- 3832137 TI - Autoscopic and drug-induced perceptual disturbances. A case report. AB - The unique association of autoscopic and toxic hallucinatory phenomena is presented. These two phenomena were clearly differentiated by two clinical aspects--their course of appearance and the patient's attitude. Various conditions affecting the central nervous system have been associated with the autoscopic phenomena. In this case, hallucinatory disturbances were caused by drug intoxication. However, the special features of the autoscopic phenomena were retained and could be clearly distinguished. Psychiatrists should be familiar with the syndrome as lack of clinical recognition might cause wrong treatment decisions--as presented in our patient. PMID- 3832138 TI - Types of complaints in psychiatric and internal medical patients. AB - A follow-up study was made in groups of female neurotic, depressive, periodic catatonic, hypertonic, hyperthyreotic patients and normal control subjects using self-rating questionnaires to assess disposition, depressivity, neuroticism and subclinical symptoms. The subclinical symptoms scale (Sub-S) was elaborated on the basis of Huber's pure defect. We found that the experience (Sub-Exp) and behavior characteristics (Sub-Be) of the Sub-S form two separate subconstructs. The Sub-Exp belongs to the neuroticism factor and the Sub-Be can be evaluated as a subclinical appearance of manifest psychopathological behavior symptoms. The 'general disposition' construct is divided into subconstructs and shows contextual variants. It is proposed to use different methods for assessing it in the different problem areas simultaneously. PMID- 3832139 TI - Music psychopathology. II. Assessment of musical expression. AB - A short polarity profile which was well suited for the assessment of the musical expression of performances recorded from mentally ill patients and controls is described. 9 out of 12 polarities showed sufficient differentiating qualities, ranging from professional to poor amateur performances. Only 3 polarities had to be reformulated. The assessments of the 3 experts had a high interrater reliability and retest stability. The very significant correlation between the results of the experts and 50 independent subjects indicates the validity of the experiment. PMID- 3832140 TI - Music psychopathology. III. Musical expression and psychiatric disease. AB - Musical expression of the instrumental playing of 61 mentally ill patients and 29 controls recorded several times was assessed by means of a short polarity profile. The performances were reversibly impaired in correlation with the psychopathology. Musical expression followed a systematic variation according to nosological classification. Endogenous-depressive patients could be clearly distinguished from neurotic-depressive patients due to weakened motoric qualities in their playing. In schizophrenia, motoricity did not seem to be so much involved, although the performances were altered in the dimension of musical logic and order. Maniform syndromes had the least effect on musical expression. PMID- 3832141 TI - Mood disorders in left and right brain-damaged patients: comparison between ratings and self-ratings on the same adjective mood scale. Some methodological problems. AB - In the context of recent developments of the lateralization model of emotions, this study investigates the intensity of depressive mood in left (LBD) and right (RBD) unilateral brain-damaged patients, comparing expression and experience of negative emotion through rating and self-rating scales. Seventeen BD inpatients (6 LBD, 8 RBD and 3 neurological patients without lesions) completed the Zerssen 28-item mood scale a few days after their admission to hospital. During the same period, 2 nurses, one working during the morning, the other during the afternoon and 1 clinician, a neuropsychiatrist, under the instruction of rating the patient mood state, completed independently the same mood scale. Results show that there is a strong agreement among the self-rating and the observers' total scores, which is high between the clinician and the patient but less strong between the 2 nurses and each nurse and the patient. Morever, self-rating scores are significantly different from those attributed by observers. The comparison between LBD and RBD showed that LBD rated themselves as more depressed than RBD, but the differences were statistically significant in the case of the clinician ratings only. These results have been interpreted with reference to methodological problems rather than in terms of a possible discrepancy between expression and experience of affect. PMID- 3832142 TI - Bipolar mood disorders: an affected sibling study. II. Symptom correlations. AB - Part II of the affected sibling study raises questions of symptom correlation (incidence of delusions, states of confusion, suicide tendencies and attempts, hallucinatory episodes, hypochondriac attitudes, angry manias, and depressive stupor) in mood disorders. The investigated sample (307 sibling groups, 701 hospitalized patients; selection principle: at least 1 sibling showing a bipolar or manic axial syndrome) directs our attention to the possibility that the multiplicity of specific manic and depressive syndromes derives not only from the genetic complexity of the mood-producing system but mirrors the full range of human behavior. Moods must be conceptualized as interpretative metalanguages with respect to the entire wealth of behavioral object languages. PMID- 3832143 TI - Colour associations as predictors of the effectiveness of anti-depressant pharmacotherapy in endogenous depressive patients. AB - The authors examined the number of associations given for the 8 Luscher colours by 20 endogenous depressive patients (11 unipolar and 9 bipolar II) before anti depressant pharmacotherapy and on the 7th, 14th and 21st day of treatment. The depressive patients gave significantly fewer total responses before treatment than the 15 healthy control persons. While the number of associations obtained from the control persons was unchanged at the end of the 1st week, the depressive patients responding to the treatment (responders, n = 15) furnished significantly more responses on the 7th day than before treatment, although there had been no change in the intervening period in the severity of their depression measured by Hamilton depression scale; their clinical state showed a gradual improvement only from the end of the 2nd week. The number of associations obtained from non responder depressive patients (n = 5) increased only slightly (not significantly). Our preliminary findings suggest that this method could be used to follow changes in the state of depressive patients and to predict their response to anti-depressant pharmacotherapy. PMID- 3832144 TI - Hostile personality characteristics, dysthymic states and neurotic symptoms in urticaria, psoriasis and alopecia. AB - Three experimental groups of patients with urticaria, psoriasis and alopecia were compared for hostile personality characteristics, states of anxiety and depression, neurotic syndromes and stress with a control group of patients with other skin diseases. The patients from each experimental group were found to be less dominant, more intropunitive, more extrapunitive and more neurotic than the control group. The following neurotic syndromes differentiated the experimental groups: non-specific anxiety states in urticaria patients; neurotic depression in the patients with alopecia, and a variety of neurotic syndromes in the psoriasis patients. All experimental groups scored significantly higher than the controls in stress experienced during the year preceding the onset or the exacerbation of the illness. PMID- 3832145 TI - Concept of alexithymia. I. The prevalence of alexithymia in psychosomatic patients. AB - The prevalence of alexithymia was studied in a psychosomatic group consisting of 34 patients with duodenal ulcer, 35 patients with ulcerative colitis and 38 patients with irritable colon syndrome, and in a control group consisting of 29 patients with gallstone disease, 13 patients with inguinal hernia and 44 patients with varicose veins. The methods used were the Beth Israel Hospital Questionnaire, the Thematic Apperception Test, the Rorschach Test and the score of emotionality derived from Lazare's Test. The results showed that alexithymia can be detected in an unselected sample of psychosomatic patients. The social class was of no significance, but a high score of alexithymia was registered for the male psychosomatic patients. PMID- 3832146 TI - Alexithymia, hemisphericity, and conjugate lateral eye movements. AB - The conjugate lateral eye movements (CLEMs) of 102 university students were measured in conjunction with the administration of the Schalling-Sifneos Personality Scale, a self-report measure of alexithymia. There was a significant positive correlation between CLEM scores and alexithymia scores for all subjects, suggesting the existence of a relationship between right hemisphere activation and alexithymic characteristics. These results are discussed in terms of some theoretical models of alexithymia. PMID- 3832147 TI - Psychiatric evaluation in gastric surgery for obesity. AB - Gastroplasty, a newer form of surgery for morbid obesity, produces physical and psychosocial benefits equivalent to those of jejunoileal bypass, but with fewer complications. As interest in this approach to intractable obesity has increased, surgeons have looked to psychiatrists to help them to assess psychiatric risk associated with undergoing surgery. Drawing on a review of the literature and long-term experience with patients requesting gastroplasty, this review addresses the benefits of gastroplasty and offers suggestions about when and how to perform preoperative psychiatric evaluations in patients requesting surgery for obesity. PMID- 3832148 TI - Acute bereavement, threatened loss, ego defenses and adrenocortical function. AB - In this study of 43 acutely bereaved widows and widowers and a comparison group of 24 nonbereaved married persons who experienced critical illness in a spouse, we found no evidence of higher levels of affective arousal, higher levels of adrenocortical activity, less effective ego defenses, or higher levels of defensive work among bereaved persons by comparison with nonbereaved persons. Furthermore, we failed to observe expected relationships between ego defensive function and adrenocortical activity among either bereaved or nonbereaved persons. These observations are consistent with one previous study of bereaved parents. PMID- 3832149 TI - Ventricular arrhythmias. PMID- 3832150 TI - Mechanisms of ventricular arrhythmias--reentry or altered automaticity. PMID- 3832151 TI - The importance of the electrophysiologic substrates in the development of ventricular tachyarrhythmias. AB - Our electrophysiologic findings are summarized in Table 3. In our animal model of chronic myocardial infarction, induced sustained ventricular tachyarrhythmias occur from 3 days to months following the infarction procedure. Isolated tissues removed from the infarcted region in these animals and studied (table: see text) in vitro reveal regions of slow conduction and local conduction block. These characteristics also persist over this time period and appear to be the substrate responsible for the reentrant excitation at the basis of the ventricular tachyarrhythmias. Our cellular electrophysiologic studies indicate the mechanisms responsible for the abnormal conduction change with time. Up to approximately 2 weeks following the infarction procedure, cellular membrane depolarization is depressed and cell-to-cell electrical continuity is decreased. Both of these factors probably contribute to the slow conduction. Depression in membrane excitability does not seem to play a role. Although an increased dispersion in refractoriness probably contributes to the inducibility of ventricular reentry due to an enhanced propensity for a premature impulse to undergo functional block in one region while continuing to conduct in another region. At two weeks and beyond, action potential depolarization has returned to normal. At this time the sole contributor to the abnormal conduction appears to be cellular electrical uncoupling. Two possibilities for the cause of this cellular uncoupling are as follows: First, the low resistance gap junctions between cells may be modified in the infarcted region causing an increase in internal axial resistance. Another possibility is that the fibrotic matrix in which the surviving cells in the mottled infarct are distributed may contribute to an increase in extracellular resistance as compared to normal myocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832152 TI - Propensity to develop ventricular tachyarrhythmias: differences in homogeneous versus heterogeneous myocardial infarcts. PMID- 3832153 TI - Critical appraisal of programmed electrical stimulation for evaluating hearts prone to ventricular tachyarrhythmias. AB - Programmed electrical stimulation has provided a unique new opportunity to evaluate both mechanisms and treatment regimens aimed at preventing ventricular tachyarrhythmias. The variable results that have been reported from different laboratories, undoubtedly are due in part to the differences in programmed electrical stimulation protocols. Although it is unlikely that all laboratories will adapt the same programmed electrical stimulation protocol, it nevertheless is very important that the number of sites of stimulation, stimulus strength, stimulus duration, stimulus polarity, drive train length, and patient population all be listed in order for some comparison between laboratories to be made. PMID- 3832154 TI - Use of signal averaging to identify low level late potentials in hearts prone to developing tachyarrhythmias. AB - Our studies have shown that infarcted dogs which exhibit inducible sustained ventricular tachycardia had late potentials and could be distinguished from those with no arrhythmias by the following QRS characteristics. A QRS duration greater than 63 msec and a duration of late activity below 30 microvolts greater than 18 msec. In addition, delayed and fractionated epicardial activation in the infarcted region correlates with late potentials on the body surface. Finally, induced ventricular fibrillation in this animal model appears to have mixed causes and is a non-specific end point. PMID- 3832156 TI - Adolescence--an overview. PMID- 3832155 TI - Nosocomial infections. PMID- 3832157 TI - Bronchial asthma. PMID- 3832158 TI - [Phagocytic capacity of neutrophils (PMN) in various connective tissue diseases]. PMID- 3832159 TI - [Immunoglobulin levels in the serum of patients with psoriasis]. PMID- 3832160 TI - [Quantitative blood flow in the human scalp]. PMID- 3832161 TI - [Sezary syndrome among the cases at the Warsaw Dermatological Hospital]. PMID- 3832162 TI - [Urticarial vasculitis syndrome in cold-induced urticaria]. PMID- 3832163 TI - [Congenital skin defects]. PMID- 3832164 TI - [Comparative studies of the immunogenic and reactogenic properties of various vaccines against rubella. I. Seroconversion and post-vaccination reactions in girls immunized against rubella with Almevax vaccine]. PMID- 3832165 TI - [Characteristics of Salmonellae present in turtles in Poland and their enterotoxins. II. Partial purification of enterotoxins produced by Salmonella newport No. 6]. PMID- 3832166 TI - [Healthy dogs as possible reservoirs and sources of Campylobacter infections in humans and animals]. PMID- 3832167 TI - [Epidemiologic situation of hepatitis B in Poland 1979-1984]. PMID- 3832168 TI - [Role and tasks of specialized supervision in the sanitaro-epidemiological services]. PMID- 3832169 TI - [Problems and concepts of active immunologic prevention of human virus diseases]. PMID- 3832170 TI - [Training of personnel for sanitaro-epidemiological services]. PMID- 3832171 TI - [Prospects of information services in the activities of the State Sanitary Inspection]. PMID- 3832172 TI - [Consumption of alcoholic beverages and liver cirrhosis]. PMID- 3832173 TI - [Studies on the effect of urban and rural environments on serum levels of cholesterol and total lipids in normotensive and hypertensive persons]. PMID- 3832174 TI - [Various epidemiological and clinical aspects and diagnostic difficulties in subarachnoid hemorrhage]. PMID- 3832175 TI - [Diagnostic and clinical problems of rabies in the light of 3 observed cases]. PMID- 3832176 TI - [Microorganisms isolated from clinical specimens in the Department of Bacteriology, Institute of Microbiology, Medical Academy, in Cracow 1980-1981]. PMID- 3832177 TI - [Direct radiologic examination of the thorax in the study of the heart]. PMID- 3832178 TI - [Periarticular calcifications. A little-known sign of psoriatic arthritis]. AB - The hands of 40 patients with psoriasis were examined by conventional and direct magnification radiograms. In 5 cases the hands showed typical psoriatic arthropathy. In 5 other cases only small calcifications in the soft tissues at distal interphalangeal joints were visible: according to clinical and laboratory data, these lesions could be in connection with psoriatic arthritis. PMID- 3832180 TI - [Percutaneous transhepatic treatment of massive intrahepatic calculosis secondary to stenosis of a biliary-digestive anastomosis]. AB - The authors describe a successful technique for the percutaneous treatment of intrahepatic gallstones from a stenotic Rouxen-Y hepaticojejunostomy. A bilioplasty of the anastomosis with wash-out of the biliary tract has been achieved through two percutaneous external biliary drainage catheters, one inserted in the right biliary ducts and the other placed in the left biliary ducts by means of an anterior approach. PMID- 3832179 TI - [Right and left ventricular function and incidence of major complications in acute inferior myocardial infarct. Study by equilibrium-gated radioisotope angiography]. AB - By means of equilibrium gated radionuclide angiography (EGRA) 67 patients were studied with first inferior acute myocardial infarction (AMI) within 4 days of the onset of symptoms and 12 normal volunteers. Ejection fraction (EF) of the left ventricle (LV) and right ventricle (RV) was computed. The regional wall motion (RWM) was evaluated by parametric images of amplitude and phase (Fourier analysis). The following major in-hospital complications were diagnosed in 41 patients (61%): postinfarction angina, congestive heart failure (CHF), high degree atrioventricular (AV) block, ventricular tachycardia or ventricular fibrillation, shock, extension of infarction, pericarditis, pulmonary embolism and acute pulmonary edema. A significant correlation between RVEF and the extent of RVRWM abnormalities and the incidence of major complications was found. In particular, the incidence of shock and CHF was significantly correlated with that of the RV disfunction, while the LVEF was generally in the normal range despite a high incidence of LVRWM abnormalities. In the patients developing high-degree AV block this correlation did not reach statistical significance; in this group, 10 of 12 patients developed other major complications. Also in 10 of 13 cases with CHF, other complications arose during the period of hospitalization. In conclusion the disfunction of the RV can identify the subgroup of patients with inferior AMI who are at high risk for developing major complications, especially shock and CHF. AV block and CHF have a severe prognostic meaning, because they occur usually in association with other major complications. PMID- 3832181 TI - [Atypical radiologic picture in a case of tuberous sclerosis]. PMID- 3832182 TI - [Epidemiology of drinking habits among adolescents]. PMID- 3832183 TI - [Incidence of macro-orchidism in patients with mental retardation: according to evaluation criteria]. PMID- 3832184 TI - [Field study of a lyophilized BCG vaccine]. PMID- 3832185 TI - [Prophylactic use of antibiotics in umbilical catheterization in newborn infants]. PMID- 3832186 TI - [Renal dysplasia associated with an ectopic ureteral orifice into the vagina]. PMID- 3832187 TI - [Transorbital projectile simulating a carotid-cavernous fistula]. PMID- 3832188 TI - [Psychosocial development of adolescents from 12 to 15]. PMID- 3832189 TI - [A major cause of epidemics: the increase in tobacco consumption in France]. AB - There are conflicting reports on trends in tobacco consumption for France. We present here a synthesis of the available evidence from total sales and from population surveys. The consequences on future lung cancer death rates are briefly discussed and some possible actions are suggested. PMID- 3832190 TI - [Mortality of liver cirrhosis and alcoholism in France from 1950 to 1981]. AB - This work presents the evolution of mortality in France in males and females by acute or chronic alcoholism and cirrhosis of the liver between the years 1950 and 1981. The cohort analysis and the transversal trend analysis are used. The alcoholic mortality risk decreases for both sexes. This is confirmed by cohort and transversal analyses which make this decrease visible since 1958 in the various age groups. On the other hand, cirrhosis mortality's trend is to stabilisation. PMID- 3832191 TI - [Cause of death and young foreigners in France]. AB - An attempt is made to analyse death rate and causes of death among a subpopulation. But the lack of strictly defined population as a basis for rate calculation gives some uncertain outcome. Nevertheless a number of detailed causes can be selected by the mean of a rather simple statistical procedure. Some of these causes are significantly higher in foreign people of 1-24 years old and seem to be specifical of them. PMID- 3832192 TI - Continuity of care indices under an urn model. AB - An urn model of Polya-Eggenberger type is applied to the problem of measuring provider continuity in ambulatory care. The model is fitted to data from a Swedish community health care center, and predictions from the model are compared with observed counts from patients visit data. Two well known continuity of care measures, the COC and SECON indices, are shown to have a simple interpretation in terms of the model parameters, and their accuracy is discussed in the light of the urn model. Two further indices suggested in medical care literature are briefly discussed. PMID- 3832193 TI - [Urethritis in men in Belgium. Results of registration by a network of general practitioners]. AB - Through a network of 100 general practitioners, all cases of gonococcal and non gonococcal urethritis in males were registered over a period of one year. This study permitted us to estimate the annual number of cases in the whole country at 25,375 cases which is 66.8 cases per 10,000 males aged 15 years and over. The highest incidence was observed between 25 and 34 years of age and among bachelors. In more than 70% of cases, the contact could be traced. The most frequently identified contacts were casual partners and prostitutes, totalling 61.4% of known contacts. PMID- 3832194 TI - [Modification of smoking habits in Belgium army recruits between 1977 and 1980]. PMID- 3832195 TI - [Respiratory pathology during sleep in children]. PMID- 3832196 TI - [Intrathoracic localization of Behcet's disease]. AB - Five case histories of intra-thoracic involvement occurring in the course of Behcet's disease were studied. These included a superior vena caval obstruction, an obstructive syndrome, transitory infiltrates, repeated lung infections and a case of haemoptysis. A review of the literature was carried out "a propos" of each case. The blood results seemed to be the involved as a manifestation of all the varied clinical presentations. The advantage of specialised investigations such as pulmonary angiography, perfusion scintigraphy and bronchial arteriography is underlined. PMID- 3832197 TI - [The association of asthma and gastroesophageal reflux: strategy of paraclinical studies]. AB - This study was carried out on 104 patients of whom 94 were asthmatic and 10 patients presented with a spasmodic intractable cough; all presented with symptoms evocative of an associated gastro-oesophageal reflux (RGO). The clinical symptoms revealed a nocturnal cough (67%), cough preceeding asthma (46%) and heartburn in 60%. The asthma was severe (type III and IV in 89% of cases), or dependent on corticosteroids (37% of cases). pH monitoring of the oesophagus is the most sensitive examination (88% with positive results) slightly ahead of manometry and scintigraphy (both 81%), these examinations were clearly superior to radiographic examination (49%) and oesophageal fibroscopy (36%). The combination of pH monitoring and of scintigraphy enabled 98% of RGO cases to be identified by their clinical data. Medical treatment with Tagamet, Gaviscon and Primperan (alone or in combination) produced an improvement in the respiratory symptoms in 50% of the cases. Of the 14 surgically treated, 7 obtained an improvement in their respiratory symptoms. Seven of the ten patients with spasmodic cough were improved by medical treatment. Our study shows the frequency of oesophageal reflux in patients with severe asthma. In half of them RGO intervened as an aggravating factor and the medical treatment of RGO led to a clear improvement in the respiratory symptoms. PMID- 3832198 TI - [The diagnostic value of asbestos bodies in mesotheliomas]. AB - The exposure of asbestos was studied in 31 cases of mesothelioma from case histories and by microscopic mineralogical analysis of the broncho-alveolar lavage fluid (BAL) (31 cases) and of pulmonary tissue (5 cases). When definite exposure had occurred the lavage contained asbestos bodies in every case, except one patient with severe airflow obstruction. The most positive lavages, probably reflecting exposure to industrial amphiboles, were found in patients presenting with radiological evidence of asbestosis. Two patients had positive lavages 50 years after exposure had ceased. The lavage confirmed exposure in 6 out of 11 suspected cases and revealed contamination by asbestos in a further 4 cases, in a group of 6 not known to have been exposed. In 19.3% of cases there was a low concentration of asbestos bodies (less than 1AB/ml of BAL), comparable to what is found in 16.2% of controls from an urban population. An analysis of lung tissue confirmed massive exposure (greater than 20 000 AB/g) in two cases and in particular revealed a significant dust load (greater than 250 AB/g) in patients presenting with a weak positive BAL. Thus it seems that all the positive results should be taken into account. Of the 31 cases, 8 had a BAL without asbestos bodies. These were either mesotheliomas not linked to the inhalation of asbestos, or were the result of false negatives on account of artefacts related either to the BAL technique itself or linked to the technique of mineral analysis. Indeed the microscopic counts of asbestos bodies probably underestimate certain exposures, notably environmental exposure to chrysotile. PMID- 3832199 TI - [Application of computerized tomography to transthoracic puncture]. AB - Transthoracic puncture for peripheral pulmonary lesions not diagnosed by fibroscopy were performed on 70 patients under computed tomographic (CT) control. Sixty four cases had a simple cytological puncture associated in 23 cases with a tru-cut biopsy. Six patients had a needle biopsy. The CT enabled us to localise the tumour to be punctured very accurately, whatever its size or topography in relation to the thoracic wall or mediastinum. It also distinguished necrotic zones within the body of the tumour whose biopsy would lead to false negative results. The sensibility for detecting malign tumours by this method was 83% for cytology and 90% when a biopsy was associated with cytology by needle aspirate. The specificity was 94%. A more precise histological diagnosis was correctly suggested by simple cytology in 7 patients (20%). A tru-cut biopsy enabled histological characterisation in all the neoplastic cases; amongst the benign lesions a specific diagnosis was made on the biopsy in 4 out of 10 cases. There were complications -9% overall. None of the pneumothoraces produced required surgical drainage. There were no fatal complications. In conclusion, transthoracic puncture under CT control is a sensitive method for detecting peripheral malignant tumours and is associated with a low level of complications. PMID- 3832200 TI - [Theoretical bases in the treatment of chronic obstructive bronchopneumopathies]. AB - The natural history and pathophysiology of chronic airflow obstruction (BPCO) remain poorly understood. Therapy cannot cure the disease but should be aimed at palliating its effects: to reduce dyspnoea, to improve the exercise performance, to minimise the complications, to stabilise the disease and improve the quality of life, to prevent by combatting those factors which favour the development of the disease e.g. pollutants, tobacco, infections etc. The pre-requisite of any therapeutic action should be to recognise those factors which contribute to the pathology and the compensatory phenomena with which the organ opposes them. According to whether the compensation is insufficient or inappropriate the therapy should be either increased or designed to combat it. The therapeutic perspective demands a better understanding of the relationship between the respiratory centre and effector muscles on the one hand and the relationship between ventilation and pulmonary perfusion on the other. PMID- 3832201 TI - [Crohn disease as prothrombotic state. Application of new methods for the verification of hemostatic changes]. PMID- 3832202 TI - [Ophthalmoplegia plus]. PMID- 3832204 TI - [Knowledge, science and clinical practice of psychiatry]. PMID- 3832203 TI - [Evaluation of multivariate statistical analysis in the use of markers for the differential diagnosis between bronchopneumopathies and lung tumors]. PMID- 3832205 TI - [University clinics: yesterday, today, tomorrow]. PMID- 3832206 TI - [Sleep and its effect on pulmonary diseases]. PMID- 3832207 TI - [The effectiveness of steroid therapy in active-stage aortitis syndrome]. PMID- 3832208 TI - [Development and application of pulmonary mechanical properties analysing system]. PMID- 3832209 TI - [Clinical investigation into the mechanisms of pulmonary congestion in acute myocardial infarction]. PMID- 3832210 TI - [2-dimensional echocardiography in acute myocardial infarction--relationship between left ventricular wall thickness and wall motion abnormalities]. PMID- 3832211 TI - [Studies of circulatory responses during submaximal continuous and intermittent exercise in patients with coronary heart disease]. PMID- 3832212 TI - [Prognostic value of treadmill exercise testing early after acute myocardial infarction]. PMID- 3832213 TI - [A case of pulmonary arteriovenous fistula with mitral valve stenosis]. PMID- 3832214 TI - [A case of scimitar syndrome associated with varicosity of the pulmonary vein]. PMID- 3832215 TI - [Geometric reconstruction of the primary picture of the acetabulum and femur head in advanced rheumatoid coxitis]. PMID- 3832216 TI - [Total functional ability of patients with ankylosing spondylitis]. PMID- 3832217 TI - [Monoarthritis and migrating arthralgia in rheumatic fever]. PMID- 3832218 TI - [The specificity of speech therapy. Identity of the speech therapist]. PMID- 3832219 TI - [Genesis of language therapies and intra-familial communication]. PMID- 3832220 TI - [Being a speech therapist today]. PMID- 3832221 TI - [Another approach to the symptoms: language therapies and communication]. PMID- 3832222 TI - [The parents, the child, the speech therapist during speech therapy sessions]. PMID- 3832224 TI - [In what way does the early education of the deaf child pave the way for reading?]. PMID- 3832223 TI - [Rehabilitation and/or psychotherapy]. PMID- 3832225 TI - [The deaf child and reading]. PMID- 3832226 TI - [The oscillo-impedance concept of laryngeal vibration]. PMID- 3832228 TI - [Functional study of phonation. 2. Respiratory assessment]. PMID- 3832227 TI - [Laryngostroboscopic observations in "inferior glottoscopy"]. PMID- 3832229 TI - [Phoniatric therapeutics of the singing voice]. PMID- 3832230 TI - [So-called "functional" voice pathology]. PMID- 3832231 TI - [Relaxation in voice pathology]. PMID- 3832232 TI - [Influence of inter- and intra-sequential structure on the pitch discrimination of pure sounds]. PMID- 3832234 TI - [The value of rhinATP in the local treatment of chronic rhinitis]. PMID- 3832235 TI - [Pirebedil and sudden deafness]. PMID- 3832233 TI - [The language of children born with a labiopalatovelar cleft]. PMID- 3832236 TI - [Paroxysmal nocturnal hemoglobinuria: synthesis and reflections from a series of 151 patients in French-speaking countries]. PMID- 3832237 TI - [Cellular and molecular aspects of the erythrocyte deformability in chronic arteritis of the legs]. PMID- 3832238 TI - [Hemorrheological changes in 50 monoclonal dysglobulinemias treated by plasma exchange]. AB - Rheological examinations were performed before and after plasma exchanges in 50 patients with monoclonal dysglobulinaemia. The parameters investigated were blood and plasma viscosity, erythrocyte filtrability, erythrocyte aggregation and kinetics of agglutination. The results showed reduction of blood and plasma viscosity and improvement in agglutination kinetics under plasma exchanges. Rheological examinations therefore seem to be useful to follow up blood disorders, notably the hyperviscosity syndrome. They can be performed prophylactically, leading to early plasma exchanges to prevent clinical deterioration. PMID- 3832239 TI - [Intrasellar carotid aneurysm simulating prolactin adenoma]. AB - A 52-year-old woman with secondary amenorrhea presented with ophthalmoplegia, subarachnoidal bleeding. Pituitary function tests showed mild hyperprolactinemia and deficiencies of other functions of adenohypophysis. X-ray films of the skull showed enlarged sella turcica, and CT scan was interpreted as demonstrating pituitary tumour. Carotid arteriography led to diagnosis of intrasellar aneurysm of the right internal carotid, without any pituitary tumour. After embolisation of the aneurysm, followed, by a temporo-sylvian anastomosis, endocrine functions did not improve. The mechanism of hyperprolactinemia is discussed, probably due to pituitary ischemia. This case provides evidence of interest of further investigations before a transsphenoidal surgery in pituitary tumours, in particular if subarachnoidal bleeding occurs. PMID- 3832240 TI - [Radioimmunoassay of urinary albumin: early indicator of diabetic nephropathy?]. AB - Microalbuminuria is now considered a good biological marker predictive of diabetic nephropathy. The degree of microalbuminuria was determined by radioimmunoassay in 23 controls and 50 insulin-dependent patients with poor control of glycaemia. Higher levels were found in diabetics, whatever the duration of the disease. At the moment, this difference, which is reversible with good metabolic control, can be explained by blood glucose balance. Several authors have established the existence of a microalbuminuria threshold predictive of nephropathy, but its level is controversial, chiefly on account of the urine collection methods. PMID- 3832241 TI - [Actinobacillus actinomycetemcomitans infectious endocarditis. Apropos of 2 cases and review of the literature]. AB - This work reports two cases of endocarditis caused by Actinobacillus actinomycetemcomitans. As noted in the medical literature, the mean clinical features are a subacute infection without know source of bacteremia, in a male patient aged 40 years or older and who is suffering from a heart disease. In our two presentations, the good response to single antibiotic treatment, although the optimal therapeutic approach is not yet defined, and the lack of embolism phenomena are of special interest. Spectrum of bacteria which can be responsible of infective endocarditis is widening rapidly; this study is an example of this trend. PMID- 3832242 TI - [Exudative enteropathy and oddian tumor]. PMID- 3832243 TI - [Non-Hodgkin malignant lymphoma and autoimmune anemia during the development of sarcoidosis]. PMID- 3832244 TI - [Encephalitis and hepatitis after varicella. Relations with Reye's syndrome]. AB - We report the case of a 32 year old man who present two weeks after a typical varicella an alteration of consciousness with pleocytosis in the cerebrospinal fluid and abnormalities of EEG and CT Scan. An hepatic dysfunction with cytolysis and a high level of transaminases and ammonia was noted. About this case the author precise the encephalitic complication of varicella, and the different liver abnormalities, such as Reye's syndrome, hepatitis with parcellar necrosis, or hepatitis with hyperammonemia but without cytolysis or necrosis, as in our own. PMID- 3832245 TI - [Interstitial pneumopathy caused by amiodarone]. PMID- 3832246 TI - [The kidney in atrophic polychondritis]. PMID- 3832247 TI - [Aerobic capacity in patients with chronic limitation of airflow]. PMID- 3832248 TI - [Hospital bacteremias. Prospective study of their clinical and epidemiological characteristics]. PMID- 3832249 TI - [Evaluation of the physician-patient relation in the wards of a teaching hospital]. PMID- 3832250 TI - [Fine-needle aspiration cytology in the diagnosis of pulmonary nodules and masses. Experience with 35 cases]. PMID- 3832251 TI - [A radioisotope method in the evaluation of tricuspid insufficiency]. PMID- 3832252 TI - [Necrotizing external otitis]. PMID- 3832254 TI - [Cryptosporidium in Chile]. PMID- 3832253 TI - [Smoking among physicians and medical students]. PMID- 3832255 TI - [Can we improve the management of bronchial cancer?]. PMID- 3832256 TI - [Antibiotypes of Campylobacter jejuni strains of human and animal origin]. PMID- 3832257 TI - [Descriptive study of the physician-patient relationship]. PMID- 3832258 TI - [Serum levels of thyroid hormones in alcoholic subjects without hepatic insufficiency]. PMID- 3832259 TI - [Analysis of the mortality of patients with systemic lupus erythematosus. I]. PMID- 3832260 TI - [Determination of electrolytes in sweat in the diagnosis of cystic fibrosis. A 23 year experience]. PMID- 3832261 TI - [Diagnosis of Chlamydia trachomatis by direct examination with monoclonal antibodies]. PMID- 3832263 TI - [Ehlers-Danlos syndrome associated with acute pancreatitis]. PMID- 3832262 TI - [Chronic diarrhea due to Isospora belli and Kaposi's sarcoma in a male homosexual. Report of the 1st case of acquired immunodeficiency syndrome in Chile]. PMID- 3832264 TI - [Certification of medical specialists]. PMID- 3832265 TI - [Severe personality disorders]. PMID- 3832266 TI - [Some health indices in Atacama Indians from the Toconao oasis]. PMID- 3832267 TI - [Antibiotic resistance: a world health problem we cannot ignore]. PMID- 3832268 TI - [The scientific societies and the hospital situation]. PMID- 3832269 TI - [Medical education at the crossroads]. PMID- 3832270 TI - [Surgical treatment of pulmonary cancer]. PMID- 3832271 TI - [Humoral and cellular immunity studies in pleuropulmonary staphylococcal infection in children]. PMID- 3832272 TI - Contributions to the study of alcoholic acute intoxications in the children admitted to the 1st Paediatric Clinic between 1979 and 1983. PMID- 3832273 TI - [Summer epidemic of viral meningitis of undetermined etiology]. PMID- 3832274 TI - Surgical treatment of chronic pancreatitis. PMID- 3832275 TI - [Juxtacardial gastric ulcer. Clinical and therapeutic aspects]. PMID- 3832276 TI - [Radiosurgical sandwich treatment in malignant bladder tumors. Comments on 83 cases]. PMID- 3832277 TI - [Late results following primary gastrectomy in perforated ulcer. A mathematical interpretation]. PMID- 3832278 TI - [Mutilating pleural sequelae after therapeutic pneumothorax]. PMID- 3832279 TI - [Influenza in Moldavia (Romania) in the winter and spring of 1985]. PMID- 3832280 TI - [Possible involvement of the canine distemper virus in the epidemiology of multiple sclerosis]. PMID- 3832281 TI - [Teratogenic potential of the fungicide SN.350 in rats (Wistar). I. The processing of the results on the M-18 computer]. PMID- 3832282 TI - [Morphological considerations of Besnier-Boeck-Schaumann's disease located in the skin]. PMID- 3832283 TI - [Pharmacodynamic research on the antianemia effect of rutozid combinations with iron and ascorbic acid]. PMID- 3832284 TI - [Bazonco--the data base in the Radiological Oncology Clinic of Iasi (II)]. PMID- 3832285 TI - [Precautions required in the dental care of children with congenital cardiopathies]. PMID- 3832286 TI - [Stability studies of lecithin in pharmaceutical forms for internal use. I]. PMID- 3832287 TI - [Potentials for patient recuperation by psychosomatic help]. PMID- 3832288 TI - [Pulmonary lymphangiomyomatosis]. PMID- 3832289 TI - [Nondirective therapy and the recuperation of somatic patients]. PMID- 3832290 TI - [Etiopathogenetic considerations in pseudohypoparathyroidism]. PMID- 3832292 TI - [Medicine and philosophy (X)]. PMID- 3832291 TI - [Osteohematopoietic metaplasia of the indurated corpora cavernosa]. PMID- 3832293 TI - [Interview given by Prof. C. Gh. Marinescu, president of the Office of Methodology and Graduate Records of the Institute of Medicine and Pharmacy in Iasi, to Dr. R. Duda]. PMID- 3832294 TI - [What is health economics and what it studies]. PMID- 3832295 TI - [Clinical neurophysiology in the evaluation and physiopathology of Parkinson's disease]. AB - Clinical Neurophysiology brings about 2 major contributions in the study of Parkinson's disease: on the one hand, it makes it possible to measure the motor troubles; on the other, it enables their pathophysiological analysis. The 3 classical signs must be studied separately. Tremor can easily be recorded by electromyography. Moreover, its parkinsonian nature can be specified by studying the resetting of EMG bursts following electrical stimulation of the motor nerve. A pace maker has been demonstrated in the thalamus from where rhythmic messages are first sent to motor cortex and thereafter reverberated to spinal motoneurons. Rigidity can be assessed by sophisticated but not generalized methods. It is easier to evaluate it by long-loop responses evoked by proprioceptive or exteroceptive stimulations. These responses reflect activity in pathways relaying in supraspinal structures. Contrary to spasticity, rigidity is not basically due to dysfunctions in segmentary spinal circuits. It is more likely that it depends on hyperactive and hyperexcitable long loop pathways. This hypothesis is in agreement with well established facts showing that parkinsonian hypertonia vanishes after dorsal root section. Akinesia is complex semeiologically. It is made of various components some of which can be measured. Reaction times and movement times provide interesting data which however are not strictly correlated with the motor handicap. Motor programmes are assembled in normal delays but they are not "called upon" correctly, reflecting a disturbance in the motor planning. A lack of "energetization" of the motor cortex and the pyramidal tract is likely. A functional disconnection between the motor program/plan side and the execution side can be hypothesized to explain the 3 major signs; on the one hand, neural messages are not correctly transferred to the pyramidal system, on the other, spinoencephalospinal loops on the execution side become more active as they escape from the control normally exerted by the plan/program side where basal ganglia play a prominent role. PMID- 3832296 TI - [Cardiac and arterial causes of transient monocular blindness]. AB - It has been accepted that transient monocular blindness (TMB) is highly suggestive of an ipsilateral carotid artery lesion in patients with arterial risk factors. We confirmed this in 55 patients, who had an internal carotid artery severe stenosis, occlusion or ulceration on angiography in more than 50 per cent of the cases. However, 12-lead-ECG, 2 D--echocardiography and Holter monitoring also showed a potential cardiac source of emboli in 22 per cent of the patients. Most of these patients (83 per cent) also had an appropriate arterial lesion, and the exact cause of the episodes of TMB remained undetermined. Our study shows that every fourth of fifth patient with TMB may have a potential cardiac source of emboli, the detection of which could alter the management. Systematic non invasive cardiac investigations are warranted, especially in TMB patients with known heart disease. PMID- 3832297 TI - [Benign acute cerebral angiopathy. 4 cases]. AB - Presenting symptoms in 4 patients with acute benign cerebral angiopathy were headaches over several days, with a transient neurologic disorder in two cases. Angiography showed diffuse and segmental distal narrowing alternating with dilatations. In one patient, the radiologic anomalies persisted to a milder degree in the same region 2 months later, while the reduced cerebral blood flow failed to return to normal. The pathophysiology of this syndrome would appear to result initially of vasospasm in particularly reactive subjects, especially young women. Its cause appears to vary from one case to another: post-partum disorders, infection or inflammation, meningeal hemorrhage, paroxysmal hypertension. Adjuvant factors could be unusual effort, medication or a migraine context. In spite of this pathogenetic uncertainty this angiopathy in usually considered as an isolated, benign and non-relapsing disease. PMID- 3832298 TI - [Spinal forms of multiple sclerosis. Value and criticism of examination by cerebral magnetic resonance. Apropos of 4 cases]. AB - Four observations of spinal forms of multiple sclerosis (MS) have been studied by Magnetic Resonance Imaging (MRI) (Magniscan Thomson CGR 0,15 and 0,5 T). They concerned 3 females and 1 male, aged between 29 and 60. Evolution of MS varied between 1 year and 9 years. There were no familial story of neurological illness; there were no signs and symptoms of visual, oculo-motor, labyrinthic and cerebellar disorders in the past. VEP were abnormal in 2 cases (no 1, 3), BAEP in 1 case (no 2). CSF examination showed increased gamma globulins with an oligoclonal pattern in 2 cases (no 3,4). CT Scan performed with iodine contrast injection was normal in 3 cases (no 2,3,4). In all the cases, MRI using T2 weighted-SE sequences, showed high signal lesions in the white matter of the brain and/or the cerebellum, and periventricular patchy white matter lesions. It seems to be no relationship between the duration of MS and the number of abnormal high signals areas, but more important series are necessary to confirm or not such a result. These lesions seem to be without aetiological specificity. They have to be discussed according to the clinical biological, electro-physiological data and sometimes others neuroradiological procedures. PMID- 3832299 TI - [Right neglect with hemiasomatognosia, mental confusion, apraxia and agraphia without aphasia]. AB - A 74 year-old woman was admitted with a right hemiplegia resulting from a left infarct that had totally destroyed the territory supplied by the middle and anterior cerebral arteries. The patient presented with anosognosia and hemiasomatognosia and negligence of the right half-field. She was aprosodic, not aphasic, and there was a severe apraxia and total agraphia. These neuropsychological disorders are discussed in relation to the contradictory data relative to the manual lateralization of the patient. Findings in this case of a "crossed apraxia" show that management of language and of the propositional gestures are not necessarily ensured by the same hemisphere. It also appears that manual preference may be a poor clue for interpretation in terms of functional lateralization. PMID- 3832300 TI - [Spinal cord congenital epidermoid cyst (a dorsal case)]. AB - A 18 year-old man had a progressive paraparesis over a two months period due to a thoracic intramedullary epidermoid cyst. Surgical removal of the cyst was followed by a dramatic improvement. The frequency, the clinical manifestations and the congenital or acquired nature of the dermoid and epidermoid intraspinal cysts are reviewed. The possibilities and the limits of the surgical treatment of this rare intraspinal benign tumors are discussed. PMID- 3832301 TI - [Acute pseudobulbar syndrome. Bilateral infarction of the junction of the internal capsule with the corona radiata]. AB - A 33 year-old hypertensive woman presented with a pure, acute, pseudobulbar palsy, two years after a right transient facio-brachial hemiplegia. C.T. scan showed two areas of low density projecting over the junction of the internal capsule with the corona radiata, at the external border of the lateral ventricles. They involved the territories of both posterolateral choroidal arteries, at the junction with those of the external lenticulostriatal arteries. Clinical data, clinico-pathological correlations in pseudobulbar palsies, and new concepts about the corticobulbar tract anatomy are discussed with evidence from this case. PMID- 3832302 TI - [Hemiballism caused by metastasis to Luys' body]. AB - A 66 year-old man suddenly developed a left-sided hemiballism. CT scan revealed 3 metastases, one of them in the area of the right subthalamic nucleus (corpus Luysii). A primary lung tumor was suspected. Haloperidol and tiapride were unsuccessful to control the hemiballism. The patient died 5 months later. Pathological examination confirmed the diagnosis. The pathophysiology of this case is discussed with regard to the pathological findings. Hemiballism secondary to a metastasis is rare, 9 cases have been reported during the past 65 years. Vascular lesions are the usual cause (75 per cent); on rare occasions degenerative disorders (14 per cent), destructive (tumors: 10 per cent or surgical lesions: 0,3-9 per cent) can also result in hemiballism. PMID- 3832303 TI - [Conference at the Salpetriere, October 1984. Cerebral infarction, abortions and presence of circulating anticoagulant]. PMID- 3832304 TI - [Hospital infection: a study carried out at the Hospital do Servidor Publico Municipal de Sao Paulo]. PMID- 3832305 TI - [Evaluation of prenatal care in high-risk patients]. PMID- 3832306 TI - [Percutaneous transhepatic cholangiography with the Chiba needle]. PMID- 3832307 TI - [Hypercalciuria: renal or intestinal origin?]. PMID- 3832308 TI - [Antibiotic therapy in cesarean section]. PMID- 3832309 TI - [Prevention of occupational accidents in harbor areas]. PMID- 3832310 TI - [Clinical, anatomopathological and virological study of a case of fetal vaccinia]. PMID- 3832311 TI - [Severe aortic stenosis with arterial hypertension]. PMID- 3832312 TI - [Seroepidemiology of virus B hepatitis: the Brazilian experience]. PMID- 3832313 TI - [Serological markers for hepatitis B virus and delta antibody in Brazilian male homosexuals]. PMID- 3832314 TI - [Evolution of uterine height and abdominal circumference in normal pregnant women]. PMID- 3832315 TI - [Calcification of dura mater bioprosthesis: study in young patients]. PMID- 3832316 TI - [Neurological involvement of paracoccidioidomycosis, evaluated by computerized skull tomography]. PMID- 3832317 TI - [Propoxyphene: physical dependence and poisoning]. PMID- 3832319 TI - [Meningitis caused by Candida]. PMID- 3832318 TI - [Pulmonary siderosis due to iron oxide in workers: an inert dust?]. PMID- 3832320 TI - [Malignant hemangiopericytoma with a hypoglycemic syndrome]. PMID- 3832321 TI - [Cerebral infarct and fibromuscular dysplasia of the carotid artery: report of a case treated surgically]. PMID- 3832322 TI - [Strongyloidiasis and eosinophilia]. PMID- 3832323 TI - [Drainage by gravity: a new method of treating severe recurrent peritonitis. Experience in the general surgery service of the Central Military Hospital from 1977 to 1980]. PMID- 3832324 TI - [Post-cholecystectomy syndrome: a myth?]. PMID- 3832325 TI - [Polyps of the colon and rectum]. PMID- 3832326 TI - [Use of a silastic stent in the prevention of stenosis of the esophagus secondary to burns due to the ingestion of a caustic: preliminary report]. PMID- 3832327 TI - [Gardner's syndrome associated with carcinoma of the jejunum: report of a patient]. PMID- 3832328 TI - [An alternative in the repair of traumatic rupture of the choledochus: report of a patient]. PMID- 3832329 TI - [Congenital non-parasitic cysts of the liver: report of 2 patients]. PMID- 3832330 TI - [Abstracts of the papers presented at the national meeting of the Asociacion Mexicana de Gastroenterologia 1985]. PMID- 3832331 TI - [General considerations on the Brazilian Code of Medical Ethics]. PMID- 3832332 TI - [Modification of the McIndoe neovaginoplasty technic. Experience in 20 cases]. PMID- 3832333 TI - [Effect of various dietetic regimens and ad libitum intake on the enzyme content of the rat pancreas]. PMID- 3832335 TI - [The impact of mycoses in Brazil]. PMID- 3832334 TI - [Urinary acid excretion in subjects unilaterally nephrectomized for kidney donation]. PMID- 3832336 TI - [Multiple myeloma affecting the axis]. PMID- 3832337 TI - [Myxoid leiomyosarcoma of the uterus]. PMID- 3832338 TI - Leishmania mexicana in Didelphis marsupialis aurita in Sao Paulo State, Brazil. PMID- 3832339 TI - Stability of Schistosoma mansoni progeny to antischistosomal drugs. PMID- 3832340 TI - [Viability of Ascaris lumbricoides ova after human treatment with specific drugs. I--Levamisole and pyrantel pamoate]. PMID- 3832341 TI - [Isolation of Yersinia pestis in plague foci in northeast Brazil from 1966 to 1982]. PMID- 3832343 TI - Unpredicted factors of evolution. The theory of emergence revisited. PMID- 3832344 TI - Biology as an hermeneutic science. PMID- 3832342 TI - Labrea hepatitis--hepatitis B and delta antigen expression in liver tissue: report of three autopsy cases. PMID- 3832345 TI - Paradoxes and catastrophes. Beyond the 'finite fields' of taxology. PMID- 3832346 TI - Theories of preformation of encasement, etc. and cellular differentiation. PMID- 3832347 TI - [Autotransfusion, technical and organizational aspects]. PMID- 3832348 TI - [Post-transfusion infection by the delta hepatitis virus]. PMID- 3832349 TI - [Cryopreservation of erythrocytes: current status]. PMID- 3832350 TI - [Preventive vaccination specific for anti-hepatitis B in a hospital environment]. PMID- 3832351 TI - [Survey of subgroups A1-A2 in the population of Bresca with relation to the frequency of anti-A1 antibody in A2 and A2B subjects]. PMID- 3832352 TI - [Preparation of young erythrocytes for transfusion. Results of some experimental protocols in neocytopheresis]. PMID- 3832353 TI - [Transitory global amnesia]. AB - The authors studied 18 cases of transient global amnesia, a syndrome occurring in middle age, characterized by a sudden memory loss of recent events and transient inability to acquire new knowledge, while consciousness and personal identity are preserved. Chemical and laboratory findings indicates that TGA is probably due to transient ischemia in the temporal lobe and hippocampus. PMID- 3832354 TI - [Prognostic evaluation of the cardiopathy in Duchenne's muscular dystrophy]. AB - As it has now been ascertained that there is cardiac damage during the course of Duchenne muscular dystrophy (DMD), the authors have aimed at evaluating the relationship existing between the development of heart damage with respect to the advancement of age, and, at finding a sure prognostic index of the illness, easily acquired by using non-invasive techniques. Whilst the parameters which show the behaviour of the pumping function of the left ventricle (EF, Delta D%) did not demonstrate a clear correlation regarding their alteration in relation to age, the relationship PEP/LVET showed an accuracy of 92% predicting the terms of survival of patients suffering from DMD. PMID- 3832355 TI - [Late neuropsychiatric sequelae of carbon monoxide poisoning. Apropos of 3 clinical cases]. AB - The authors examined the neuropsychiatric sequelae developed in three patients who had had an acute carbon monoxide poisoning. Computed tomographic (CT) scans were performed as well as psychometric tests. The clinical features and CT scan findings showed to be related to the severity of the initial anoxic insult. PMID- 3832356 TI - [Therapeutic measures in acute bacterial meningitis]. PMID- 3832357 TI - [Epidemiological study of food handlers at a hospital]. PMID- 3832358 TI - [Salmonella: incidence of species and microbiological aspects]. PMID- 3832359 TI - [Oral toxicity of aluminum in rats over a prolonged period]. PMID- 3832360 TI - [The medical death certificate. Its reliability]. PMID- 3832361 TI - [Development of ideas in relation to the configuration of general medicine as a specialty in the territorial environment of the European Economic Community. The freedom of the general practitioners establishment in jurisprudence at the Tribunal of Justice of the European Communities]. PMID- 3832362 TI - [Health education within the permanent education of adults. An experience in the urban environment]. PMID- 3832363 TI - [Bases for the anti-tobacco campaign plan of the provincial government of Catalonia]. PMID- 3832364 TI - [Blindness in an industrial city: a transverse analysis]. PMID- 3832365 TI - [Bucco-dental consequences of the epidemic toxic syndrome]. PMID- 3832366 TI - [Diarrhea caused by Vibrio cholerae and Salmonella muenchen]. PMID- 3832367 TI - [Psycho-biological effects of child care facilities on children during their 3d year of life]. PMID- 3832368 TI - [Nervous system infections in immunosuppression]. PMID- 3832369 TI - [Current strategies of the anti-tobacco campaign]. PMID- 3832370 TI - [Viral hepatitis as an occupational disease in hospital health personnel. Health and economic importance]. PMID- 3832371 TI - [Tetanus in Cantabria, 1981-1983]. PMID- 3832372 TI - [Calculation of the user population in a general hospital]. PMID- 3832373 TI - [Analysis of data on the prevalence of dental caries in the city of Barretos, SP, Brazil, after 10 years of fluoridation of water supply]. PMID- 3832374 TI - [Clinical evaluation of the use of decamethrin in the treatment of pediculosis of the scalp]. PMID- 3832375 TI - [Time factors in alcoholism in development of organic diseases in women treated at the Hospital das Clinicas of Ribeirao Preto, SP, Brazil]. PMID- 3832376 TI - [Multivariate analysis of risk factors for low birth weight in live births in the municipality of Sao Paulo, SP (Brazil)]. PMID- 3832377 TI - [Serum levels of vitamin A and carotene in middle-aged and aged subjects, in 11 localities of the State of Sao Paulo, Brazil]. PMID- 3832378 TI - [Ranking of populations in broad classes of health levels, using a comprehensive indicator defined by a linear discriminant function]. PMID- 3832379 TI - [Detection and awareness of patients with hemoglobinopathies in the regions of Sao Jose do Rio Preto and Presidente Prudente, SP (Brazil)]. PMID- 3832380 TI - [Environmental public health for physicians and scientists]. PMID- 3832381 TI - [Legal principles of clean air policy (laws, regulations, guide lines)]. PMID- 3832382 TI - [Creating air pollution in closed areas by working at handicrafts]. PMID- 3832383 TI - [Wood preservatives]. PMID- 3832384 TI - [Effect of the room environment on the condition of the human]. PMID- 3832385 TI - [Smoking--passive smoking]. PMID- 3832386 TI - [Acid rain]. PMID- 3832387 TI - [Acute toxic effect of the inhalation of impregnating sprays]. PMID- 3832388 TI - [Systematic development and use of pesticides in experiments within the scope of evaluation conforming to paragraph 10 of the Federal pollution law]. PMID- 3832389 TI - [Detection of air pollutants--methodology and measurement technic]. PMID- 3832390 TI - [Problems in the drinking water supply]. PMID- 3832391 TI - [Mineral and drinking water]. PMID- 3832392 TI - [Re-processing of drinking water for household use]. PMID- 3832393 TI - [Special microbiological aspects of the study of drinking water]. PMID- 3832394 TI - [Nitrates in drinking water and possible transformation products--occurrence and risks]. PMID- 3832395 TI - [Legal principles of drinking water and water supply protection]. PMID- 3832396 TI - [Current problems in the protection of the water supply]. PMID- 3832397 TI - [Problems concerning clean air policy in a metropolis, exemplified by the Berlin situation]. PMID- 3832398 TI - [Environmental public health evaluations and waste water additions with biotests]. PMID- 3832399 TI - [Viruses in the water circulation]. PMID- 3832400 TI - [Viruses in swimming pools]. PMID- 3832401 TI - [Microbiological problems in public bathing facilities]. PMID- 3832402 TI - [Bacteriological problems of bathing waters with special reference to whirlpool baths and "psycho-tanks"]. PMID- 3832403 TI - [Preventive and restorative measures for maintaining the quality of soil and ground water]. PMID- 3832404 TI - [Hygienic problems concerning the use of water front filtrates for water supplies]. PMID- 3832405 TI - [Effects of acid precipitation on soil and ground water]. PMID- 3832406 TI - [Use of plant treatment substances in agriculture and their effects on ground water]. PMID- 3832407 TI - [Public health problems concerning ground water from old waste deposits]. PMID- 3832408 TI - [Use of clarifying sludge]. PMID- 3832409 TI - [Analysis of soil air for volatile halogenated hydrocarbons]. PMID- 3832410 TI - [Dioxins in the environment]. PMID- 3832411 TI - [Mechanisms of action of noise]. PMID- 3832412 TI - [Danger to health caused by environmental noise?]. PMID- 3832413 TI - [Radioactive substances in the environment--minimalization law and limit values]. PMID- 3832414 TI - [Radiation exposure in residential areas]. PMID- 3832415 TI - [New knowledge on the subclinical effect of lead on the body of the child]. PMID- 3832416 TI - [Excessive use of insecticides and acaricides in rooms because of a one-sided health concept]. PMID- 3832417 TI - [Inhalants: solvent-containing products as intoxicating and addictive drugs]. PMID- 3832418 TI - [Allergens in residential areas]. PMID- 3832419 TI - [The environment and cancer]. PMID- 3832420 TI - [Recommendations for the control of aerogenic deep mycoses in immunocompromised patients. A contribution to the epidemiology of aspergillosis, mucormycosis and cryptococcosis]. PMID- 3832421 TI - [Berlin pediatric study--evaluation of respiratory function and anamnestic surveys of groups of children in the winters 1982/83 and 1983/84]. PMID- 3832422 TI - [Significance of hypersensitivity of the respiratory tract for inhaled pollutant stress]. PMID- 3832423 TI - [Pseudocroup: Duisburg study]. PMID- 3832424 TI - [Air pollution and mortality. Results of a study in Berlin (West) from 1976 to 1982]. PMID- 3832425 TI - [Pollution of the outdoor air. Sources, emissions, trends, smog episodes, transportation, areas of concentration]. PMID- 3832427 TI - Problems of modernization and occupational health in the People's Republic of China. PMID- 3832426 TI - [Air pollution in closed areas]. PMID- 3832428 TI - Development of occupational hygiene standards in the People's Republic of China. AB - This article reviews the history and implementation of the development of occupational hygiene standard setting in the People's Republic of China. The author raises questions concerned with standard setting and gives examples of toxicants for which the scientific basis of revision is given. The principles and approaches used to set or revise hygiene standards in China are explained, and suggestions to help speed up the standard setting are also given. As a rule, field and epidemiologic surveys and the utilization of existing toxicologic information are emphasized. Repetitions of animal experimentation should be avoided. PMID- 3832429 TI - Occupational health services in "small plants" in Shanghai County. AB - With the reorganization of the grassroots structure and economic readjustment, the commune- and brigade-run plants have now been changed to district (town)- and village-run plants, respectively, and the role of industrial production has become more important to the total income of the people. The Qi-yi Commune (District) is a good example. The number of plants showed an increase of 80% from 1975 to 1983, whereas the number of workers increased by 149%. The number of workers as a percentage of the total population of the district grew from 10% to about 25%. The rapid progress of industry led to a need to promote occupational health services as part of primary health care. This article reviews the implementation of such services with the objective of attaining the goal "Health for all by the year 2000." PMID- 3832430 TI - Experience in controlling lead poisoning in the People's Republic of China. AB - This paper summarizes the work done to control lead poisoning in the People's Republic of China. The work can be divided into the following four phases: (i) health surveillance of lead workers, (ii) health standard setting, (iii) research for early detection indicators, and (iv) improvement of the work conditions and health surveillance of "undeserved" groups. In 1949 prevention started with the initiation of the health surveillance of lead workers. Since then health surveillance has been used to supplement environmental monitoring in the early detection of lead poisoning, and the prevalence of lead poisoning has decreased. This activity has also helped to identify the needs for improvement in technological control. The next step has been the promulgation of health standards. The current standard for lead gives the maximum allowable concentration in air as 0.03 mg/m3 for lead fume and 0.05 mg/m3 for lead dust. Research on indicators for the early detection of lead has improved the quality of prevention. It has recently led to the addition of zinc protoporphyrin to the list of indicators in use. Finally the work conditions and surveillance of workers that had earlier been considered "underserved," particularly workers in agriculture and small industries in rural areas, are being improved. PMID- 3832431 TI - Effects of occupational lead exposure. AB - Fifty-three workers in a battery factory, 52 solderers in a television factory, and 50 embroidery workers (a reference group) were studied. The average air lead levels of the three workplaces were 0.578 mg/m3, 0.002 mg/m3, and 0.001 mg/m3, respectively. Adverse effects in terms of clinical manifestations and biochemical criteria were evident among the battery factory workers. A significant dose response relationship existed between the toxic effects and the air lead levels. The solderers showed no apparent abnormalities in comparison with the embroidery workers. The early clinical manifestations were dysfunction of the central nervous system, indigestion, arthralgia, and myalgia in the extremities. A positive association was observed between the prevalence of fatigue, mild abdominal pain, and arthralgia and the blood lead (PbB), urinary lead (PbU), and zinc protoporphyrin (ZPP) levels. The symptomatic threshold values of PbB, PbU, and ZPP were 30 micrograms/dl (1.5 mumol/l), 0.045 mg/l (0.2 mumol/l), and 40 micrograms/dl (0.7 mumol/l), respectively. The PbB, PbU, free erythrocyte protoporphyrin, and ZPP levels and the blood aminolevulinic dehydratase ratio could be used as indicators of lead exposure, although ZPP is preferred for a preventive monitoring program. The motor and sensory conduction velocities of the median nerve were slower in the exposed groups than in the reference group. No effects on behavioral function were observed among the solderers. PMID- 3832432 TI - Peripheral nerve conduction velocity in workers occupational exposed to lead. AB - The peripheral nerve conduction velocity between the wrist and elbow of the right upper limb and the relationship between this parameter and biochemical parameters for workers occupationally exposed to lead were studied. The results showed that nerve conduction velocity could be altered by lead exposure. The nerve conduction velocity was decreased when the exposure level was 0.0652 mg/m3 (time-weighed average), and it slowed further in proportion to increasing exposure levels. There was a negative correlation between the nerve conduction velocity and the length of exposure. A decrease in the nerve conduction velocity was noted after less than three years of exposure to lead. There was a close relationship between the nerve conduction velocity and the level of lead in the blood; the nerve conduction velocity decreased proportionally with increasing blood lead levels. The blood lead level associated with a change in the nerve conduction velocity was less than 40 micrograms/100 ml (less than 1.9 mumol/l). No correlation between the nerve conduction velocity and the amount of metabolites of porphyrin was found. The measurement of nerve conduction velocity can be used as one of the sensitive criteria for the early detection of the toxic effects of lead. PMID- 3832433 TI - Treatment of yellow phosphorus skin burns with silver nitrate instead of copper sulfate. AB - The authors recommend the application of silver nitrate solution for the treatment of yellow phosphorus skin burns instead of the traditionally used copper sulfate solution. The latter may cause copper poisoning if absorbed through damaged skin. Silver nitrate treatment has been successfully applied in 13 cases of phosphorus burns. PMID- 3832434 TI - Lung function studies of asbestos workers. AB - Pulmonary function tests have been conducted on 155 asbestos workers and 130 referents. It was found that the lung function impairment in asbestos workers is predominantly a restrictive ventilatory defect appearing even when radiographic changes are not detectable. There was, however, no evidence of airway obstruction. As the disease progressed, all the pulmonary function indices, including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), maximal ventilation volume (MVV), total lung capacity (TLC), and pulmonary diffusing capacity (DLCO), were reduced dramatically, with the exception of FEV1.0/FVC(%). It is suggested that both radiographic examination and pulmonary function tests should be used as early detection measures of asbestos-induced lung disorders. VC, FVC, and FEV1.0 are the simplest, most reproducible, and most valid indices for the health surveillance of asbestos workers, while the FVC test is the most valuable for epidemiologic study. With stepwise regression analysis a quantitative relationship between dust exposure and pulmonary function was demonstrated. There was no significant difference in the small airway function of the exposed workers and the referents. Further study is needed to investigate the possibility of asbestos-induced small airway obstruction and to estimate the roles played by cigarette smoking and air pollution. PMID- 3832435 TI - Changes in health conditions in the Huainan coal mine in the past three decades. AB - Health conditions in the Huainan Coal Mine have improved greatly since 1950. In particular, the work and living environments, the underground dust concentration, the water supply and waste disposal systems, and the nutritional value of miners' food have become much better. Thus the rates of occupational, infectious, and parasitic diseases and nutritional deficiency diseases have decreased considerably among miners. The decreases in the prevalence of anthracosilicosis and hookworm have been especially striking. PMID- 3832436 TI - The role of early detection in the prevention of occupational disease--a review of work in the People's Republic of China. AB - The early detection of occupational diseases is the main purpose of the health surveillance of workers exposed to occupational hazards. While health surveillance is one of the important approaches to occupational disease prevention (in addition to environmental monitoring and improved technology), promulgating legislation and organizing and training professional personnel could guarantee the implementation. Chinese experience in industrial development is similar to that of other countries. Research determining indicators for the early detection of occupational diseases could improve the quality of preventive measures. PMID- 3832437 TI - Scientific fraud probed at AAAS meeting. PMID- 3832438 TI - Prenatal genetic diagnosis by chorionic villus sampling (CVS). PMID- 3832439 TI - Recent developments in neonatal screening. PMID- 3832440 TI - The role of the anatomical pathologist in perinatology. PMID- 3832441 TI - Reproductive fitness. PMID- 3832442 TI - Aphasia: a societal and clinical appraisal of pragmatic and linguistic behaviours. PMID- 3832443 TI - The profile of communicative appropriateness: a clinical tool for the assessment of pragmatics. PMID- 3832444 TI - Immediate echolalia and the interactive behaviour of autistic children. PMID- 3832445 TI - The relationship between phonology and inflectional morphology in an agrammatic aphasic. PMID- 3832446 TI - A stuttering therapy programme with spastic dysphonia--a single case study. PMID- 3832447 TI - A fluency-based programme with a clutterer: a case study. PMID- 3832448 TI - Laryngeal behaviour and fluency-inducing therapy. PMID- 3832449 TI - [Spectrographic analysis of vowels of the Afrikaans-speaking hearing- impaired patients]. PMID- 3832450 TI - Normal acoustic reflex amplitude growth and the influence of cochlear hearing loss. PMID- 3832451 TI - ABR audiometry: application to the paediatric population. PMID- 3832452 TI - [The incidence of ear and hearing pathology in children in the isolated community of Tshikunda-Malema]. PMID- 3832453 TI - Speech discrimination abilities of hearing impaired children using conventional hearing aids and radio neckloop at different signal-to-noise ratios. PMID- 3832454 TI - The influence of induced hypotension and spine distraction on canine spinal cord blood flow. AB - Deliberate hypotension is used in scoliosis surgery to reduce the need for blood transfusion and to improve operating conditions. There are concerns, however, that hypotension may decrease spinal cord blood flow (SCBF) and thereby predispose the spinal cord to ischemic injury, particularly when it is distracted during Harrington instrumentation. In a canine model, the mean arterial pressure (MAP) was reduced to 50% of the normotensive value with sodium nitroprusside and halothane to study its effects, with and without spinal distraction, on spinal cord blood flow measured by the hydrogen clearance technique. The induction of systemic hypotension resulted in a significant decrease in spinal cord blood flow from 15.7 +/- 1.1 ml/min/100 g (control) to 10.7 +/- 4.7 ml/min/100 g. This initial decrease in spinal cord blood flow returned to normotensive values by 35 minutes following the induction of hypotension, suggesting an autoregulatory effect. This indicates that the induction of deliberate hypotension to half its normotensive mean arterial pressure is associated with a significant decrease in spinal cord blood flow that returns to normotensive levels by 35 minutes. One and two centimeters of longitudinal distraction applied during systemic hypotension did not reduce spinal cord blood flow when it was applied at least 45 minutes after the hypotension was induced. Thus, when longitudinal stretch of a magnitude approximating that used clinically during Harrington instrumentation is applied in the presence of systemic hypotension, the normal SCBF is not reduced when the autoregulating system is functioning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832455 TI - Comparison of evoked spinal potentials by stimulation of the sciatic nerve and the spinal cord. AB - Spinal cord monitoring during surgery using evoked spinal potentials (ESP) is now popular. In cats, ESPs due to both sciatic nerve (SN-ESP) and spinal cord stimulation (SC-AESP and SC-DESP) were recorded from the epidural space. Both SN ESP and SC-AESP were compared by parameter studies. Stimulus frequencies up to 100 Hz did not significantly alter the SC-AESP, whereas the later components of the SN-ESP decreased greatly in amplitude. The SN-ESP was more sensitive to asphyxia than the SC-AESP. Augmentation of the ESP occurred approximately 5 minutes after the asphyxia was introduced, which was interpreted as an impending sign of anoxia of the spinal cord. The SN-ESP had more potentials arising from synaptic and postsynaptic activities, while the SC-AESP was mainly derived from the spinal tracts. To monitor the function of the spinal cord, both methods should be used. PMID- 3832456 TI - Free vascularized fibula transfer for stabilization of the thoracolumbar spine. A case report. AB - Anterior strut grafting for kyphosis has become an accepted procedure. High stresses are placed across these grafts, however, and it would seem advisable to use a living bone graft that could remodel in response to these stresses, rather than an avascular graft of fibula or rib such as is commonly employed. This case report demonstrates the use of a free, vascularized living bone graft in the treatment of a post-traumatic kyphosis, with successful subsequent incorporation into the anterior fusion mass. PMID- 3832458 TI - The posterior surface of the lumbar vertebral bodies. Part 2: An anatomic investigation concerning the curvatures in the horizontal plane. AB - The horizontal curvatures of the posterior surfaces of the lumbar vertebral bodies have been quantitatively evaluated by means of a simple measuring device. The measurements have been done near the superior and inferior vertebral margins. The aims of the study were: to obtain exact information on the degrees of curvatures and their interindividual variations and further compare the information obtained with current knowledge of the relevant embryologic and mechanical factors involved to explain the curvatures and to use the results as a basis for a theory on the development of some of the forms of lumbar canal stenosis. A horizontal concavity was always found in L1-L3, in L5 a posterior convexity was prevailing, and L4 occupied an intermediate position. The degree of medullary ascent and its relationship in time to vertebral development are probably important and are, together with the three first mentioned factors discussed, determinants in the evolution of lumbar canal stenosis. The results are discussed in light of a possible influence on moulding of the vertebrae caused by the contents of the spinal canal and the vertical load of the body weight. PMID- 3832457 TI - Torsional fatigue of the lumbar intervertebral joints. AB - The effect of cyclic torsional loads on the behavior of intact lumbar intervertebral joints was investigated. A total of 24 specimens, divided in two groups, were tested. In the first group, a specimen was subjected to a specified constant cyclic torque, and the resulting change in angular displacement with time was recorded. The specimens in the second group were subjected to a specified constant angular displacement and the resultant torque recorded. The results of the constant torque tests showed that fatigue failure was primarily a function of the averaged initial angular displacement and secondarily of the applied torque. The critical threshold values appear to be an initial angular displacement of +/- 1.5 degrees. All specimens, displaying an averaged initial angular displacement of less than +/- 1.5 degrees, did not fail in fatigue, while the others did. However, the specimens with angular displacements of less than +/ 1.5 degrees had lower applied torques (11.3 and 22.6 Nm), while specimens with higher applied torques (33.9 and 45.2 Nm) all exceeded the +/- 1.5 degrees threshold and failed in fatigue. Failure locations occurred in such diverse regions as end-plates, facets, laminae, capsular ligaments, etc. All specimens exhibited a synovial fluid discharge from the apophyseal joint capsule sometime during testing. Post-test examinations of all the cartilage surfaces showed fibrillation, whether or not the intervertebral joint failed. PMID- 3832459 TI - Correlation of the MMPI with lumbosacral spine fusion results. Prospective study. AB - This study was done to determine whether the Minnesota Multiphasic Personality Inventory (MMPI) aided in selection of appropriate lumbosacral fusion candidates, compared with those selected without an MMPI. Postoperative end-result ratings were done, categorizing patients into two groups: one group of 62 patients with a preoperative MMPI and a second group of 23 patients with no preoperative MMPI. Thirty patients with normal MMPIs, strong objective indications for initial surgery, and absence of compensation and/or litigation factors had 88% good or excellent end-results. Twenty-three patients had surgery without MMPI evaluation. Of 21 available for follow-up, 86% had good or excellent end-results. "Warning" physical signs aided selection of appropriate surgical candidates in the patients who did not have an MMPI. PMID- 3832460 TI - [The quality of hospital care evaluated on the basis of routine data gathering- mortality as a measurement of outcome]. PMID- 3832461 TI - [The role of the protamine-sulfate test in the diagnosis and evaluation of the evolution of disseminated intravascular coagulation]. PMID- 3832462 TI - [Dynamic and static scintigraphy of the salivary glands in patients with Sjogren's syndrome]. PMID- 3832463 TI - [Acute hepatitis in infectious mononucleosis]. PMID- 3832464 TI - [Poisoning in agriculture]. PMID- 3832465 TI - [Biological toxins as chemical weapons]. PMID- 3832466 TI - [Organization of the toxicology-chemistry laboratory]. PMID- 3832467 TI - [Thyroid function in children and adolescents with insulin-dependent diabetes]. PMID- 3832468 TI - [Developmental anomalies and hereditary diseases of the kidney in ambulatory practice]. PMID- 3832469 TI - [Occurrence of malignant neoplasms of the digestive organs in Yugoslavia]. PMID- 3832470 TI - [Coincidence of malignant tumors of the uterus and benign pathologic findings on the genital organs in operated patients]. PMID- 3832471 TI - [Adenomyosis in leiomyoma of the uterus]. PMID- 3832472 TI - [Malignant histiocytosis (histiocytic medullary reticulosis, HMR)]. PMID- 3832473 TI - [Doppler echocardiography in the diagnosis of rupture of the ventricular septum]. PMID- 3832474 TI - [Progestasert--a therapeutic system for the intrauterine administration of progesterone]. PMID- 3832475 TI - [Education of health personnel in toxicology]. PMID- 3832476 TI - [Problems in clinical toxicology]. PMID- 3832477 TI - [Lymphocyte subsets in erythema nodosum-like skin lesions from patients with Behcet's disease]. PMID- 3832478 TI - [A case of systemic lupus erythematosus following thymectomy for myasthenia gravis]. PMID- 3832479 TI - [A case of lupus cystitis with severe urinary bladder contraction and hydronephrosis]. PMID- 3832481 TI - [Lupus nephritis from the histologic point of view]. PMID- 3832480 TI - [A study on the prognosis of asymptomatic hyperuricemia--I]. PMID- 3832482 TI - Influence of vitamin E on platelet survival. AB - Vitamin E plays an important role in protecting fat tissue from peroxidation. Platelet survival was compared among vitamin E deficient, control and alpha tocopheryl nicotinate supplemented rats. The mean tocopherol level in the sera of the rats fed vitamin E deficient diet for two months was 21.5% of control, and the lipoperoxide level in the sera of these animals had not significantly (p greater than 0.05) increased. Platelet aggregation was not accelerated significantly (p greater than 0.05) after exposure to a concentration of 10 microM of ADP used as an aggregating agent. The rate of platelet survival was determined by the 51Cr-labeling technique. The survival rates were all normal in vitamin E deficient, control and alpha-tocopheryl nicotinate supplemented rats, with no significant difference (p greater than 0.1) among the groups. These results suggest that depletion of vitamin E per se does not shorten the periods of platelet survival. PMID- 3832483 TI - One point dilution enzyme-linked immunosorbent assay (ELISA) for Toxoplasma gondii seroepidemiological surveys. AB - A one point dilution enzyme-linked immunosorbent assay (ELISA) procedure suitable for determining immunoglobulin G (IgG) antibody levels to Toxoplasma gondii (T. gondii) in community seroepidemiological surveys is described. A two-fold serial dilution ELISA procedure was first used to determine the IgG titers in 56 and 83 sera earlier screened by the Sabin-Feldman dye test (DT) and the indirect hemagglutination test (IHA), respectively. The regression rate of the results by the DT and ELISA was 0.92. Comparison of the results by the IHA and the two-fold serial dilution ELISA gave regression coefficient of 0.92. Using the absorbance values for the test sera at dilutions of 1:20, standard curves made by plotting the optical density versus the corresponding dilution factor of a control sera were used to estimate the antibody levels. The regression coefficient of the results by the two-fold serial dilution method and those by the curves for sera with titers of up to 1:320 was 0.97. The curves could not, however, estimate accurately the antibody level in sera with titers above 1:320. The one point dilution ELISA described is a useful epidemiological tool for the screening of IgG antibody to Toxoplasma gondii in the community. However, larger series are required to confirm our observations. PMID- 3832484 TI - The chemical compositions of the thoracic aorta in diabetics and nondiabetics. AB - Chemical analysis of the composition of the thoracic aorta was performed in 19 age- and sex-matched pairs of diabetic and nondiabetic autopsy subjects. Contents of total lipid, cholesterol, triglyceride, phospholipid, free fatty acid and collagen in the aortic wall were greater in cases with advanced atherosclerosis than in those with less advanced atherosclerosis. According to severity of atherosclerosis, the ratio of cholesterol to total lipid in the aortic wall increased, while the ratios of triglyceride, phospholipid and free fatty acid to total lipid decreased. The cholesterol concentration in the aorta increased with dry weight of the aorta per area. The rate of increase was 2.6 times higher in diabetics than in nondiabetics. These results suggest that content of cholesterol in the aortic wall increases markedly according to the advance of atherosclerosis, especially in the diabetics. PMID- 3832485 TI - Effects of coronary artery stenosis on left ventricular end-ejection pressure ejected volume relationships in isolated perfused canine hearts. AB - We investigated the behavior of the left ventricular end-ejection pressure ejected volume relation with and without left circumflex coronary stenosis in isolated perfused canine hearts. To change ventricular afterload pressure, the peripheral resistance of the hydraulic model attached to the aortic root of the excised hearts was changed in a stepwise fashion to five different levels. The end-ejection pressure-ejected volume relationship was nearly linear in both pre ischemic and ischemic states. The slope changes following left circumflex coronary stenosis differed among the hearts used in the present study, and there was no significant difference in average slope (n = 10) between the pre-ischemic and ischemic states (i.e., -7.4 +/- 1.0 and -8.4 +/- 1.2 mmHg/ml, respectively). Therefore, the, slope of the relation was not useful in judging the presence of depressed ventricular function induced by coronary stenosis. In contrast, the ejected volume axis intercept decreased significantly from 16.5 +/- 1.1 ml to 13.6 +/- 1.1 ml (p less than 0.05) with regional ischemia. PMID- 3832486 TI - Diagnosis of the depth of cancer invasion by submucosography. AB - A new method was developed to diagnose the depth of cancer invasion using submucosography combined with special charcoal suspension containing mitomycin C, and applied to 8 cases of gastric cancer. Correct diagnosis of the depth of the cancer invasion was obtained in 7 of the 8 cases. As some cases of early gastric cancer can be treated endoscopically, it is important to know the condition of the invasion before any treatment is performed. PMID- 3832487 TI - Determination of urine neuron-specific enolase levels in neuroblastoma patients. AB - Urine levels of neuron-specific enolase were determined in 3 neuroblastoma patients (1 in an advanced state and 2 in remission), 25 control children, 37 control adults and 4 children with hematuria by means of the double-antibody inhibition radioimmunoassay specific to the gamma subunit of enolase isozymes. The levels of neuron-specific enolase mean +/- S.D. ng/creatinine mg in an advanced neuroblastoma patient were elevated (1.25 +/- 0.29 before or after treatment and range 1.61-74.2 during treatment) when compared with those of control subjects (0.51 +/- 0.26 in children and 0.36 +/- 0.17 in adults). The levels in 2 neuroblastoma patients in remission were within normal range. Urine samples with hematuria were not used for the assay. PMID- 3832488 TI - Population dynamics and chemotherapeutic control of Trichuris trichiura infection of children in Jamaica and St. Lucia. AB - Population dynamical parameters of Trichuris trichiura infections in children were estimated from longitudinal intensity and prevalence data from a population (n = 23) in a children's home in Jamaica. The theoretical predictions of a deterministic model incorporating these parameters were approximated to observed horizontal-age prevalence data from a naturally infected population (n = 203) of children in a St. Lucian village, and a rough estimate of the basic reproductive rate (Ro = 8-10) of T. trichiura obtained. The findings suggest that T. trichiura populations are intrinsically more difficult to control by traditional mass treatment chemotherapy (eradication requires greater than 91% of the population to be treated every 6 months for greater than 5 years) than are populations of Ascaris, but may be more susceptible to selective chemotherapy programmes which aim to treat only the most heavily infected individuals. PMID- 3832489 TI - Correlation between cell-mediated immunity and clinical forms of paracoccidioidomycosis. AB - Cellular immune response to specific and non-specific stimulants was investigated, both in vivo and in vitro, in 29 healthy controls and in 53 previously untreated patients with the chronic isolated organic form (CIOF), the chronic mixed form (CMF) and the acute progressive form (APF) of paracoccidioidomycosis. The study included skin tests to Paracoccidioides brasiliensis antigen (PbAg) and phytohaemagglutinin (PHA), DNCB sensitization, determination of T lymphocytes and complement rosette-forming cells, lymphocyte transformation and leucocyte migration inhibition tests using PbAg and PHA. Patients displayed staggered cutaneous response to PHA and to PbAg, with marked decrease in intensity in the APF group. DNCB sensitization test and proliferative response of lymphocytes to PHA and PbAg were severely depressed in most of the patients. Leucocyte migration inhibition indices to PbAg were highly positive, while response to PHA was slightly decreased regardless of the clinical form. The number of T lymphocytes was reduced in most of patients and in them the number of complement-rosette forming cells was normal. The distribution of patients according to a suppression index, based in the results of the tests employed, revealed a tendency towards an increased degree of cellular immunosuppression from the least severe (CIOF) to the most severe (APF) clinical form of the disease. On the whole, the present study demonstrated a gamut of immunological reactivity in paracoccidioidomycosis. PMID- 3832490 TI - Sero-epidemiology of rubella in Imo State of Nigeria. AB - 931 serum samples collected at random from healthy subjects in the four health zones of Imo State were analysed for the presence of rubella haemagglutination inhibition antibodies. Rubella antibodies were present in 625 of the samples giving a prevalence of 66.6%. There was a gradual increase in the prevalence of these antibodies with increase in age except in the age group 10 to 19 years which had a high prevalence of 80 to 90%. The distribution of antibodies appeared to be influenced by type of settlement. Okigwe and Umuahia health zones, in which settlements are close together had significantly higher numbers of seropositive individuals than Owerri and Aba zones, in which communities are widely spread. Immunity to the virus was influenced by socio-economic factors. The prevalence of antibodies to the virus was greater in individuals of low socio-economic status than those of high socio-economic status. The sex of the individual was also a factor in the distribution of antibodies to rubella, more females than males having antibodies. There was no difference between urban and rural populations in the prevalence of antibody to rubella. PMID- 3832491 TI - Avermectins, MK-933 and MK-936, for mosquito control. AB - Two avermectins were shown to be effective as mosquito larvicides or when fed to adult female mosquitoes in sucrose solution or in blood. Larval LC50 values of compounds MK-933 and MK-936, expressed as parts per billion, were found to be 3.94 and 2.42 for Culex pipiens, 5.85 and 2.90 for Anopheles stephensi and 23.4 and 10.4 for Aedes aegypti. When fed to adult females of An. stephensi, Ae. aegypti or Cx quinquefasciatus, MK-933 at 2.8mg active ingredient per litre in sucrose solution caused complete mortality within 60 hours. When female mosquitos engorged blood from mice injected subcutaneously 12 hours previously with MK-933 at 82 mg a.i./kg, mortality rates after 36 hours were 100% for An. stephensi, over 60% for Ae. aegypti and over 50% for Cx quinquefasciatus. Thus the systemic insecticidal effect was greater against anopheline than against culicine female mosquitoes. PMID- 3832492 TI - Effects of adjuvants and Toxoplasma gondii antigens on immune response and outcome of peroral T. gondii challenge. AB - Toxoplasma gondii antigens and adjuvants administered parenterally and perorally were tested for their ability to produce serum antibody to T. gondii, to enhance peritoneal microbicidal capacity for T. gondii, and to prevent acquisition of infection by T. gondii ingested subsequently. N-acetylmuramyl-L-alanyl-D isoglutamine-6-0-stearoyl (MDP) incorporated into liposomes administered intramuscularly to mice with 80 micrograms of T. gondii antigens and the synthetic adjuvant N,N-dioctadecyl-N',N'bis (2-hydroxyethyl) propanediamine (CP 20,961) administered intramuscularly to mice with 80 micrograms of T. gondii lysate antigens produced the highest titres of antibody to T. gondii in sera (i.e., the mean +/- S.D. of the log2 of the reciprocal of the antibody titre to T. gondii measured by Sabin Feldman Dye test was 9 +/- 2 in sera of mice that received T. gondii antigens plus MDP and was 8 +/- 1 in sera of mice that received T. gondii antigens plus CP 20,961). No orally administered preparation produced high titres of serum antibody to T. gondii. None of the preparations which were tested protected mice against infection with T. gondii when cysts containing the parasite were administered by mouth subsequently or enhanced macrophage microbicidal capacity between two and three weeks after the last immunizations. These experiments demonstrate that presence of Toxoplasma antibody (i.e., when log2 of the reciprocal of Toxoplasma antibody titres is 10 or less measured by Sabin Feldman dye test) does not protect mice against dissemination of ingested T. gondii from the gastrointestinal tract. The method of peroral challenge with T. gondii developed for this study is useful for examining effects of other potentially protective regimens in preventing acquisition of ingested T. gondii. PMID- 3832494 TI - Mermithid parasitism of Simulium damnosum s.l. and the transmission of human onchocerciasis. AB - Dissection data from a Simulium damnosum s.l. population in northern Ghana, heavily parasitized by the mermithid Isomermis lairdi, are presented. A simple calculation gives reason to suppose that this parasitism may significantly reduce the transmission of onchocerciasis at certain seasons. PMID- 3832493 TI - Hookworm burdens and faecal egg counts: an analysis of the biological basis of variation. AB - The relationships between various measures of faecal egg output and hookworm burdens were investigated in 84 villagers from West Bengal with mixed Necator americanus and Ancylostoma duodenale infections. The pattern of day to day variability in egg counts from individuals can be characterized by the linear relationship between the logarithms of the variances and means. Egg output is shown to be non-periodic in long runs of day-to-day records. The distribution of worm numbers per host is well described by the negative binomial probability model, and the relationship between per capita egg output and worm burden is non linear where egg output declines as parasite burden rises. Density-dependent effects on fecundity are shown to act at comparatively low worm burdens in relation to the range of observed parasite loads. Egg output measures are shown to be qualitative as opposed to quantitative measures of worm burdens as a consequence of inherent sampling heterogeneity and variability induced by biological processes, such as density-dependent depression of parasite fecundity. The analyses suggest that it is possible, on the basis of egg counts, to discriminate between individuals with low and high hookworm burdens. The intrinsic per capita fecundities of the two species of hookworms are shown to be similar, but density-dependent constraints on egg production by N. americanus appear to be more severe than those acting on A. duodenale. This observation may help explain why A. duodenale appears to produce larger numbers of eggs per unit of time than N. americanus. The regulatory role of density-dependent fecundity and aggregated distributions of worm numbers per person are discussed in relation to the over-all transmission dynamics of hookworm parasites. PMID- 3832495 TI - Isolation of Japanese encephalitis virus from Anopheles annularis and Anopheles vagus in Lombok, Indonesia. AB - Three strains of Japanese encephalitis (JE) virus were recorded from mosquitoes collected in Lombok, Indonesia, during March 1979, from pools of Anopheles vagus, An. annularis and Culex tritaeniorhynchus respectively. This is believed to be the first report of isolation of JE virus from An. vagus. The frequencies of JE viral infection in zoophilic Anopheles species were higher than in Cx tritaeniorhynchus, the principle vector of JE virus in Asia. The low frequency of infection in Cx tritaeniorhynchus and the relatively infrequent raising of pigs may account for the low prevalence of JE neutralizing antibodies in the human populations of Lombok. PMID- 3832496 TI - Serological studies on leptospirosis in livestock and chickens from Grenada and Trinidad. AB - Sera from 1,206 livestock animals and chickens on Grenada and Trinidad were tested for leptospiral antibodies by the microscopic agglutination test. 376 of the sera were positive (25% of those tested on Grenada and 44% on Trinidad). The positive sera were obtained from 25% of 324 cattle, 35% of 130 pigs, 35% of 146 sheep, 25% of 44 goats and 11% of 175 chickens on Grenada; and 92% of 26 cattle, 53% of 122 pigs, 76% of 87 horses and donkeys and 11% of 144 chickens on Trinidad. Eight sera from ducks and geese on Trinidad were tested and found to be negative. The serogroups most commonly found to react with the sera of the Grenadian animals were Autumnalis, Icterohaemorrhagiae, Hebdomadis and the related serogroups Sejroe and Mini, and Pyrogenes; in the Trinidadian animals they were Icterohaemorrhagiae, Autumnalis, Hebdomadis and its related serogroups, and Panama. Strains of serogroup Pomona do not appear to have become established as livestock pathogens on the islands. PMID- 3832497 TI - The behaviour of trypanosomes within the midguts of wild-caught tsetse from Zimbabwe. AB - Trypanosomes infecting the midgut of wild-caught tsetse from Zimbabwe were found on electron microscopic examination to be penetrating the peritrophic membranes and so entering the ecto-peritrophic space in the mycetome region of the midgut. Other trypanosomes entered midgut cells, behaviour similar to that previously reported in laboratory-infected tsetse colonies. PMID- 3832498 TI - Is neurological involvement possible in visceral leishmaniasis in Kenya. PMID- 3832499 TI - A new leishmanial parasite of the great gerbil (Rhombomys opimus) in the USSR. PMID- 3832500 TI - First Venezuelan record of Lutzomyia umbratilis Ward & Fraiha, 1977 (Diptera: Psychodidae), a proven vector of Leishmania braziliensis guyanensis. PMID- 3832501 TI - Non-01 Vibrio cholerae septicaemia. PMID- 3832502 TI - Community laboratory work and the hand-held EPHP microscope. PMID- 3832503 TI - Epidemiological observations on cutaneous leishmaniasis in the Dominican Republic. PMID- 3832504 TI - The behaviour of trypanosomes in Liberian tsetse. PMID- 3832505 TI - Death after failure by herbal doctor to give rabies post-exposure prophylaxis. PMID- 3832507 TI - Analysis of Turkish children's dental anxiety by various psychological tests. PMID- 3832506 TI - The incidence of goiter among students living in a group of mountain villages in the Black Sea region and their thyrotropin and thyroid hormone values. PMID- 3832508 TI - A case of constrictive pericarditis in an infant treated by radical pericardiectomy. PMID- 3832509 TI - Abetalipoproteinemia. A case report. PMID- 3832510 TI - Cutis marmorata telangiectatica congenita. PMID- 3832511 TI - Conjoined ischiopagus twins. PMID- 3832512 TI - [Reliable parasitic coprology: a necessity. Results of 5 years' teaching]. PMID- 3832513 TI - [Decision strategy in acute pneumopathies in the adult]. PMID- 3832514 TI - [Malignant tumors of the ovary. Apropos of 8 cases]. PMID- 3832515 TI - [Glaucoma and diabetes]. PMID- 3832516 TI - [Immediate value of the electroencephalogram in convulsions in newborn infants]. PMID- 3832518 TI - [The illness explained ... impact on the patient and on the physician-patient relationship. Apropos of functional diseases]. PMID- 3832517 TI - [Osteogenesis imperfecta. Apropos of a familial case]. PMID- 3832519 TI - [Spasmophilia, vasomotor rhinitis and respiratory allergy]. PMID- 3832520 TI - [Anesthesia and resuscitation in the surgery of hydatid cysts]. PMID- 3832521 TI - [Etiologic diagnosis of unilateral exophthalmias]. PMID- 3832522 TI - A comparison of subcellular element concentrations in frozen-dried, plastic embedded, dry-cut sections and frozen-dried cryosections. AB - Biological X-ray microanalysis of diffusible elements within cellular and subcellular compartments requires preparation methods to retain electrolytes in the compartments they occupied in vivo. X-ray microanalysis of frozen-dried, plastic-embedded samples has been used to quantitate electrolytes at the cellular level. We have compared the subcellular elemental distribution in dry cut sections from such samples with that in ultrathin frozen-dried cryosections. Rat pancreases were quench-frozen onto a helium-vapor-cooled copper block. Cryosections were cut at 130-150 K, transferred using a Gatan cold stage, frozen dried in the column and analysed at 190 K. Tissue fragments were frozen-dried at 190 K, and cut on a dry knife at 293 K. Both samples provided images permitting unambiguous identification of all major compartments except the Golgi complex. Intracellular potassium-to-sodium ratios obtained on frozen-dried plastic embedded sections were lower than for cryosections (e.g. 1.77 in basal cytoplasm in plastic sections as compared to 4.34 for cryosections) and varied with the pre embedding procedure (e.g. 1.77 in formaldehyde-fixed as compared to 2.87 in osmium-fixed plastic sections). Potassium gradients between adjacent organelles were large in cryosections and insignificant in plastic-embedded material. Higher cytoplasmic phosphorus, potassium and sulfur concentrations were observed in cryosections. Therefore, a redistribution of electrolytes and covalently bound elements occurred subcellularly in the plastic sections. Calcium was quantifiable in most organelles in cryosections but the plastic lowered sensitivity too much to permit routine calcium quantification. We conclude that in our hands frozen dried, plastic-embedded samples were compromised and provided lower sensitivity than cryosections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832523 TI - Toxemia of pregnancy pigment epitheliopathy masquerading as a heredomacular dystrophy. AB - Patients with toxemia of pregnancy may develop permanent alterations of the pigment epithelium that if first discovered in later life may be mistaken for a heredomacular dystrophy, a diffuse tapetoretinal dystrophy or other diseases. These nonprogressive changes are caused by multifocal areas of fibrous platelet occlusion of the choriocapillaris that usually occur just prior to or following delivery and is usually associated with a transient period of exudative retinal detachment. The pattern of pigment epithelial derangement is often sufficiently characteristic to suggest the correct diagnosis. PMID- 3832524 TI - Hyperglycemic acidotic coma and death in Kearns-Sayre syndrome. PMID- 3832525 TI - Chemotherapy of eyelid and peritorbital tumors. AB - Eight patients with nine histologically proven BCC or SCC involving the eyelids and periorbital tissues were treated with systemic and/or local (iontophoresis) chemotherapy using cisplatin and doxorubicin. All patients had either refused surgery, would have required extensive procedures, or had medical problems contraindicating surgery. Systemic chemotherapy induced a CR or PR in eight of nine lesions. No patient has required maintenance chemotherapy and no significant toxic side effects were encountered. The length of follow-up ranges from 2 to 50 months. Iontophoretic therapy with cisplatin was used to treat five small foci of new, recurrent or persistent tumor(s) in three of these patients, and resulted in a partial response in all five lesions. Systemic or local chemotherapy offers an alternative to current standard forms of treatment for BCC and SCC in selected cases. PMID- 3832526 TI - Expulsive hemorrhage: its incidence in cataract surgery and a report of four bilateral cases. AB - Between 1978 and 1983, 13,890 cataract extractions were performed in Baltimore at JHH and the GBMC with 14 expulsive hemorrhages for an incidence of 0.10%. In the years 1963 through 1983, 180,690 cataract extractions were performed in Taxila, Pakistan with 87 expulsive hemorrhages for an incidence of 0.05%. Reasons for the significant differences in incidence are presented. The six reported cases of bilateral expulsive hemorrhage are reviewed. Four more cases are added. A classification of choroidal hemorrhage is presented. PMID- 3832527 TI - Ocular massage before cataract surgery. AB - We used the Honan intraocular pressure reducer, a balloon that applies a constant force, to the eyes in ten subjects with senile cataracts. An initially significant decrease in intraocular pressure after removal disappeared exponentially with a half-time of 9.6 minutes, indicating that the benefits derived from the Honan balloon do not result from a sustained reduction in intraocular pressure. Measurements made on a phantom eye showed both marked variability and unexpectedly high intraocular pressure during typical preoperative digital massage by a group of ophthalmic surgeons. Measurements made on a cadaver eye after application of the Honan balloon showed that very high intraocular pressures may be achieved under some conditions. PMID- 3832528 TI - The therapeutic limitations of argon laser trabeculoplasty. PMID- 3832529 TI - Analytic approaches to the interpretation of automated threshold perimetric data for the diagnosis of early glaucoma. PMID- 3832530 TI - A new management system for glaucoma based on improvement of the appearance of the optic disc or visual field. PMID- 3832531 TI - Cyclodestructive surgery for glaucoma: past, present, and future. AB - When surgical attempts to control glaucoma by improving aqueous outflow are not successful, the alternative approach is usually to reduce aqueous inflow by a cyclodestructive procedure. Cyclodestructive elements that have been tried in the past include diathermy, electrolysis, and beta irradiation. Cyclocryotherapy is presently the most commonly used cyclodestructive procedure, although this operation has significant limitations, and newer techniques are being evaluated utilizing laser energy or ultrasonic radiation. Each of these procedures uses a transcleral approach, which has the disadvantages of (1) the inability to precisely quantitate the destruction of the ciliary processes, and (2) damage to adjacent tissue. Transpupillary cyclophotocoagulation minimizes these problems, but is limited to the small number of eyes in which adequate gonioscopic visualization of the ciliary processes can be achieved. An alternative approach for aphakic eyes is intraocular cyclophotocoagulation, utilizing an endophotocoagulator through a pars plana incision. Depending on the status of the eye, visualization for this technique can be accomplished either by the transpupillary route or with an endoscope. PMID- 3832532 TI - Arterial anastomosis with Schlemm's canal: a rare cause of secondary open-angle glaucoma. AB - In four patients with open-angle glaucoma, blood was present in the region of Schlemm's canal. The blood had four characteristics that distinguished it from other more common causes of blood in Schlemm's canal: it was observed with a Zeiss goniolens, a lens that has no flange, and thus was not an artifact of the examination technique; the blood could not be expelled from Schlemm's canal by raising IOP with para-limbal suction unless the pressure in the eye exceeded the diastolic ophthalmic artery pressure level; as IOP approached this high level, the amount of blood in Schlemm's canal progressively decreased, eventually diminishing to a single point of reflux that was always in the same location; and at this point the blood pulsed in and out of Schlemm's canal with each beat of the heart. These findings suggest a pathological anastomosis between a deep limbal artery and Schlemm's canal. The high arterial pressure transmitted into Schlemm's canal could, in turn, lead to an elevation of IOP. PMID- 3832533 TI - The corneal endothelium and Descemet's membrane in the iridocorneal endothelial syndrome. AB - A 39-year-old woman with progressive left unilateral glaucoma associated with corneal edema, iris changes, and peripheral anterior synechia formation underwent a left trabeculectomy and iridectomy in an attempt to control the intraocular pressure. Shortly after surgery the edema worsened despite low intraocular pressure measurements. A repeat trabeculectomy combined with a full thickness keratoplasty was performed 11/2 years later. The posterior corneal surface was found to be covered by a partially doubled layer of endothelial cells with ultrastructural features resembling epithelium. Similar cells were not noted on the surface of the initial trabecular meshwork and iris specimens, but were seen on the surface of the specimens obtained at the second trabeculectomy. The anterior and middle portions of Descemet's membrane, formed during perinatal and early adult life, appeared normal, but its posterior portion appeared abnormal. The ultrastructural changes in the endothelial cells and the abnormalities observed in Descemet's membrane suggest that the endothelial cells were initially normal but subsequently acquired epithelial-like features as they degenerated and proliferated. The continued presence of corneal edema despite the hypercellularity of the endothelium suggests that the proliferating cells were permeable to aqueous. PMID- 3832534 TI - Management of blepharospasm. AB - From 1950 through 1984, 123 patients underwent surgical treatment of blepharospasm at the Mayo Clinic. During this period, four different operations (proximal and distal neurectomy and two types of myectomy) were used. Significant recurrent or residual blepharospasm was observed more frequently (P less than 0.01), and need for subsequent operations was greater (P less than 0.01), among patients who had undergone distal neurectomy than among those who had had myectomy. These data support the view that myectomy is a more effective procedure than neurectomy. Initial results with botulinum toxin injection seem to indicate that it is an effective short-term treatment for blepharospasm. However, its long term efficacy and safety need further study, as does the role it should play in combination with myectomy. PMID- 3832535 TI - Aphakic cystoid macular edema and the operating microscope: is there a connection? AB - The literature documenting the phototoxic effect of relatively low intensity light on the retina and the suggestions by several authors that this might influence the development of cystoid macular edema in the aphakic and pseudophakic patient is reviewed. In particular, the possibility that the operating microscope may be a factor has been emphasized. A study is presented, designed to investigate the possibility that the operating microscope is a factor important in the development of cystoid macular edema. No correlation was found. The need for further investigation into other phototoxic effects from the light of the operating microscope is stressed. PMID- 3832537 TI - Dehiscences of the pigment epithelium. PMID- 3832536 TI - Retinal detachment associated with coloboma of the choroid. PMID- 3832538 TI - [UV irradiation of autologous blood in the combined treatment of lymphedema of the lower extremities]. AB - Based on the experience with the treatment of 144 patients the authors recommend to use transfusions of autologous blood subjected to UV irradiation in the complex treatment of lymphostasis of lower extremities. PMID- 3832539 TI - [Surgical procedure in joint cardiospasm and cardial hiatal hernia]. AB - In 39 patients cardiospasm was associated with a hiatal hernia or the latter was formed in the process of treatment by cardiodilatation. An analysis of results of the treatment has shown that pneumocardiodilatation under control of esophagomanometry should be considered the method of choice in the treatment of such patients. The decreased gradient of the gastroesophageal pressure up to 12 14 mm of mercury is responsible for prevention of reflux-esophagitis. Operative treatment is indicated when cardiodilatation is ineffective or the manometric control is impossible. Cardiomyotomy in combination with an "incomplete" fundoplication is preferable. There are no good reasons for performing fundoplication after Nissen in patients with cardiospasm. PMID- 3832540 TI - [Peridural anesthesia with morphine and trimecaine: an analysis of 2000 cases]. AB - Complex investigations of 2000 patients have shown that peridural anesthesia represents an adequate anesthesiologic defense of the patient from the operative stress. The potentiating effect of morphine is greater with greater doses and results in systemic elevation of sensory thresholds, suppression of the emotional component of perception of pain and a prolongation of anesthesia. A conclusion is made that in some patients operations on lower extremities and small pelvis organs should be performed under peridural anesthesia in combination with subnarcotic doses of sedative drugs. PMID- 3832541 TI - [Cardiohemodynamics and blood circulation in the mesenteric and intra mural vessels of the stomach and intestines in victims of traumatic shock during general anesthesia]. AB - The angiotensiometric method was used for studying blood pressure in mesenteric and intramural vessels of the gastrointestinal tract in 63 patients with traumatic shock and 167 patients with surgical and oncological diseases during laparotomy under conditions of general anesthesia. The value of hypotension in the intestinal vessels was found to depend on the degree of shock established before the beginning of antishock therapy and narcosis in spite of satisfactory indices of systemic hemodynamics. PMID- 3832542 TI - [Puncture tracheostomy at the prehospital stage]. AB - The article describes an instrument for puncture and cannulation of the trachea. It is an arcuate tube with a mandrin and a perforator at the end with a pricking cutting profile. The approval testing of the instrument at the prehospital stage has shown that the patency of the upper respiratory tracts may be reestablished within 30-40 sec. PMID- 3832543 TI - [Damage to the recurrent nerve during an operation for benign goiter]. AB - Damage of the recurrent nerve was found in 40 (2.5%) of 1555 patients operated upon for benign goiter. The probability of complications was higher in wider volumes of operations. The main task of prophylactics of damages of the recurrent nerves is to identify them during operation and to observe the principle of subfascial dissection and resection of the thyroid gland. PMID- 3832544 TI - [Clinical and treatment characteristics of postoperative thrombophlebitis]. AB - Clinical manifestations of thrombophlebitis were analysed in 363 patients in the postoperative period. Complex prophylactic measures of postoperative thrombophlebitis including paravasal injections of a thrombolytic mixture were shown to be most effective. PMID- 3832545 TI - [Pathological states following vagotomy]. AB - The work generalized the authors' experience with the treatment of 83 patients with pathological states after vagotomy. On 61 of them operations were performed, 22 patients were subjected to conservative treatment. Organic disorders were revealed in 48.4%, functional disturbances were found in 22.9%; 28.7% of the patients had associated disorders. The conservative treatment was not effective enough. Good long-term results after operative reconstructive-restorative operations and resections of the stomach were obtained in 96.7%. PMID- 3832546 TI - [Emergency fibrogastroduodenoscopy in the diagnosis and treatment of peptic gastroduodenal hemorrhages in the middle-aged and elderly]. AB - Urgent fibrogastroduodenoscopy was performed in 145 of 178 elderly and senile patients with bleedings from upper portions of the digestive tract, ulcerous bleedings being revealed in 92 of them. Surgery is thought to be the best method in cases with persistent bleedings and in the revealed during examination thrombosed vessels in the ulcer without active bleeding. In 33 patients not subjected to endoscopy the latter could have given better results of treatment. PMID- 3832547 TI - [Immediate results of gastric resection by Billroth I and Billroth II in peptic ulcer]. AB - An analysis of treatment of 1304 patients has shown the best immediate results to be after resection and re-resection of the stomach after Billroth-I as compared with Billroth-II: they had less amount of postoperative complications and lower lethality and maintained the passage of food through the duodenum. PMID- 3832548 TI - [Diagnosis and treatment of postvagotomy and postresection disorders in peptic ulcer]. AB - The authors have observed 361 patients with postresection syndromes and 61 patients with postvagotomy disorders. A considerable part of the patients had a combination of different disorders detected mainly by special methods of examination. Individual surgical tactics for recurrent ulcers, evacuatory disorders and dumping-syndrome gave positive results in most of 182 reoperated patients. PMID- 3832549 TI - [Comparative evaluation of the effectiveness of different variants for treating gastric polyposis]. AB - An analysis of long-term results of different kinds of treatment of 922 patients with polyposis of the stomach has been made. Endoscopic polypectomy was found to have most favorable results. Treatment of benign polyps was more effective as compared with transitional and malignant ones. In patients with multiple polyps the development of gastric cancer was observed in most cases. The authors make a conclusion that endoscopic control should be permanently performed in patients with polyposis of the stomach. PMID- 3832550 TI - [Diagnosis of different forms of pancreatitis by changes in the factors of body nonspecific resistance]. PMID- 3832551 TI - [Surgical procedure in the treatment of post-traumatic pleural empyema]. AB - Questions of pathogenesis and tactics of treatment of 62 patients with empyema of the pleura after a closed trauma and penetrating wounds of the chest are discussed. The development of empyema was dependent on the character and degree of the injury as well as on surgical errors in diagnosis and treatment of the trauma. Coagulated hemothorax was the most frequent cause of empyema. Operation was the main method of treatment, the operation of choice being pleurectomy and decortication of the lung. PMID- 3832552 TI - [Optimization of the antibiotic therapy in treating acute complicated cholecystitis]. AB - High efficiency of interstitial electrophoresis on the hepatic area after administration of kanamycin was shown on the basis of experimental (40 experiments in dogs) data and clinical examinations (52 patients). PMID- 3832553 TI - [Diagnosis and surgical procedure in acute appendicitis combined with acute diseases of the adnexa uteri]. AB - The observation and surgical treatment of 122 women aged from 16 to 44 with acute appendicitis associated with acute diseases of uterine appendages have shown the differential diagnosis to be rather difficult. In such cases the true character of the pathologic condition can be established during operation only. The histological examinations of "unaltered" vermiform processes ablated during the operations have revealed signs of acute inflammation in most of them which speaks in favour of appendectomy in acute diseases of uterine appendages. PMID- 3832554 TI - [Microflora in colonic cancer complicated by an inflammatory process]. AB - The microbiological investigation was performed in 53 patients with carcinoma of the colon, 32 of them having inflammatory complications of the tumor. High incidence of the infected state of the tumor surface, infected regional lymph nodes and regional venous blood was noted especially by enterobacteria. The bacteria isolated were found to be highly resistant to most widely used antibiotics. For the antibiotics to have a bacteriostatic or bactericidal effect, they must be used in great doses which must be often higher than therapeutically admitted ones. PMID- 3832555 TI - [Treatment of acute thromboses and embolisms of the arteries of the extremities in cardiosclerosis patients]. AB - An experience with the surgical and conservative treatment of 196 patients with acute thromboses and embolism of the extremity arteries in patients with arteriosclerotic and postinfarction cardiosclerosis has shown the conservative treatment of arterial embolism to have little effect. Results of the surgical treatment were regularly better in patients admitted to the hospital at earlier terms after acute occlusion of the vessel, with mild ischemia and the absence of a considerable atherosclerotic lesion of the extremity interrupting the major blood flow. For prophylactics of a repeated embolism of considerable significance were found to be correcting operations on the heart and the continuous anticoagulating therapy. PMID- 3832556 TI - [Acute iliofemoral venous thrombosis]. AB - Based on an analysis of immediate and long-term results of treatment of 178 patients with acute iliofemoral venous thrombosis the authors recommend thrombectomy as an early operative treatment. The operative treatment has prevented the development of the postthrombophlebitic syndrome in most patients. PMID- 3832557 TI - [Importance of the indices of immunity for predicting the course and assessing the effectiveness of the treatment in acute suppurative lactation mastitis]. AB - The examination of 47 patients with acute purulent lactation mastitis and 14 patients with the resulting sepsis has shown a decreased level of nonspecific resistance factors. Generalization of the purulent process is characterized by disturbed humoral and cellular links of immunity. The dynamic research of immunity factors can give an estimation of the effectiveness of the chosen treatment and prognosis of possible complications. The general bactericidal activity of blood may be considered one of the most informative indices showing the direction of the process. PMID- 3832558 TI - [Small intestine obstruction after gastric resection caused by phytobezoars]. PMID- 3832559 TI - [Combined profuse peptic hemorrhage and gangrenous cholecystitis]. PMID- 3832560 TI - [Rare case of sarcoma metastasis to the small intestine]. PMID- 3832561 TI - [Strangulated recurrent hernia of the obturator foramen]. PMID- 3832562 TI - [Basis for choosing the surgical treatment method in intracranial hematomas in combined craniocerebral injury and concomitant shock]. AB - A comparative evaluation of the antishock effectiveness of the ablation of intracranial hematomas by means of various surgical accesses was made. The method of mathematical analysis based on the principle of "moving averages was used. It was shown that the potential antishock effectiveness of the ablation of intracranial hematomas was maximum after using cutter openings and minimum after using the osteoplastic access. PMID- 3832563 TI - [Diagnosis and treatment of giant air cysts of the lung]. AB - Giant air cysts of the lung were found in 6 of 180 patients admitted to the hospital with spontaneous pneumothorax. The preoperative diagnosis was established in all the patients on the basis of their past history, clinical course, X-ray examination and puncture of the pleural cavity. The operative treatment of cysts of the lung is recommended. All the 6 patients were operated upon with good results (in 3 patients--lobectomy, cysts were removed in 3 patients). PMID- 3832564 TI - [Injuries to the aortic arch]. PMID- 3832565 TI - [Spontaneous rupture of a posttraumatic cyst of the liver with an intrahepatic biliary fistula]. PMID- 3832566 TI - [Clinical classification and surgical treatment of pulmonary echinococcosis in children]. AB - Based upon an analysis of clinical observations of 89 children with echinococcosis of the lungs the author proposes a classification of the disease and touches upon the surgical measures. The main operation was hydatidectomy. PMID- 3832567 TI - [Treatment of clavicular fractures in children]. AB - The authors describe a method of treatment of fractures of the clavicle with the help of closed reposition and fixation with the plaster bandage with a hook semihoop. In 92 children good results were observed within the period from 6 to 10 years. PMID- 3832568 TI - [Cleansing the focus in the combined treatment of chronic osteomyelitis in children]. AB - The authors propose an intraosseous variant of interstitial electrophoresis for local sanitation of the damaged segment in chronic osteomyelitis. The efficiency of the method was checked up in experiments and in clinic. The indications for using the method and its technique are described. The method of intraosseous electrophoresis with antibiotics for preoperative preparation and conservative treatment were used in 59 patients. PMID- 3832569 TI - [Epiphyseolysis and fractures of the distal epiphysis of the femur in children]. AB - The author has generalized an experience with the treatment of epiphysiolysis and fractures of the distal epiphysis of the femur in 46 children. Detailed characteristics of the lesions are given. Their classification is proposed which is of importance for the selection of curative methods and determination of prognosis. A simple, sparing and nevertheless rather effective method of reposition and immobilization is described. The disturbed growth of the bone and appearance of deformities were shown to depend mainly on the trauma mechanism, age of the victim, features of the fracture plane and displacement of fractures and degree of their adaptation. PMID- 3832570 TI - [Successful treatment of a newborn infant with esophageal atresia and severe suppurative-septic complications]. PMID- 3832571 TI - [Rhabdomyoblastoma of the biliary tract in children]. PMID- 3832572 TI - Isolation and characterization of the third component of bovine complement. AB - C3 was obtained from bovine serum by polyethylene glycol precipitation and chromatography on DEAE-Sephadex A-50, CM-Sephadex A-50 and Sephacryl S-200. The protein has a molecular weight of 183,000 (alpha-chain 114,000 and beta-chain 69,000). A CVF-induced bovine C3 convertase (Sepharose-CVF.Bb) cleaved C3 into C3a (11,000) and C3b (172,000) as shown by SDS-polyacrylamide gel electrophoresis. Isoelectricfocusing of C3 demonstrated at least three electrophoretic variants with pI 6.55-6.85. The isolated protein promoted the formation and action of a C3 convertase in the presence of purified bovine factors B and D. A monospecific antiserum prepared in rabbits failed to cross react with human C3 or CVF. C3c was identified as a contaminant during the isolation of C3. PMID- 3832573 TI - Suppression of immune response to sheep red blood cells in rats experimentally infected with Trypanosoma brucei gambiense. AB - A direct haemagglutination assay for antibodies to sheep red blood cells (SRBC) was used to assess the response of rats infected with Trypanosoma brucei gambiense. Whereas uninfected rats showed an efficient primary and secondary immune response to SRBC, trypanosome-infected rats displayed depressed antibody response starting about six days after infection. Infected rats failed to respond to a challenge dose of SRBC given 14 days after infection while uninfected control animals responded with an increased level of antibody production. These observations showed that T. b. gambiense infection inhibited both primary and secondary immune response to SRBC in rats. The result of this experiment is very important with regard to serological methods used to detect increasing levels of antibody production for diagnosis of diseases caused by bacterial and viral pathogens. In a concurrent trypanosome infection such increasing antibody levels would not be observed, leading to inaccurate diagnosis. Thus trypanosomiasis infection should be excluded under field conditions before the value of a serological diagnosis can be fully utilized. PMID- 3832574 TI - Changes in the concentrations of serum IgG, IgA and IgM of sows throughout the reproductive cycle. AB - The concentrations of IgG, IgM and IgA in sera collected from 3855 sows (3208 pregnant and 647 lactating) at a single time point were determined. This experimental design allowed changes in serum immunoglobulin over the reproductive cycle to be studied without bias from seasonal influence. The concentrations of the three immunoglobulins changed independently during the reproductive cycle. Serum levels of IgM and IgG began a progressive postpartal decline during the 14th-17th week of gestation. At the onset of lactation serum IgG levels progressively increased while IgM levels continued to decline, the latter reaching their lowest level during the third week of lactation. In contrast to IgM and IgG, serum IgA levels increased 35% during weeks 14-17 of gestation and continued to increase throughout lactation, reaching their highest serum levels in the third week of lactation; the serum IgA concentration at this time was twice that observed during the first 13 weeks of gestation. Results of these studies allowed the reproductive cycle to be classified into four phases on the basis of serum immunoglobulin concentrations: (1) weeks 1-4 of gestation; (2) weeks 5-13 of gestation; (3) weeks 14-17 of gestation and (4) lactation. PMID- 3832575 TI - The influence of age and breed on the concentrations of serum IgG, IgA and IgM in sows throughout the reproductive cycle. AB - The influence of age and breed on the concentrations of IgG, IgA and IgM in the sera of sows throughout the reproductive cycle was investigated in 4137 sows which had had 0-20 gestations and representing three breeds: Swedish Landrace, German Landrace and L-12 (= Swedish Landrace x Large White). Data revealed an increase in total immunoglobulins (Ig), IgM and IgG serum levels with increasing gestation number; the latter contributed greater than 80% to total Ig levels. IgG was significantly increased up to the fourth gestation, whereas IgM showed a significant increase only to the third gestation. IgA showed only minor differences. Age-dependent increases in serum IgM were ascribed to the increased probability of antigenic exposure during suckling, while failure to observe this change in serum IgA was ascribed to its role as a local Ig. Breed differences were observed to be significant for all three Ig's. It is concluded that establishment of group norms for serum Ig's should consider age and breed difference as well as stage of gestation or lactation. PMID- 3832576 TI - Preliminary identification of the human macular pigment. AB - The human macular pigment has been found to be composed to two chromatographically separable components, which are tentatively identified as lutein [(3R,3'R,6'R)-beta,epsilon-Carotene-3,3'-diol] and zeaxanthin [(3R,3'R) beta,beta-Carotene-3,3'-diol]. Chromatograms of retinal extracts, obtained by HPLC on three different stationary phases, were found to match those obtained with mixtures of lutein and zeaxanthin standards. Identical retention times were confirmed by coinjection of each of the isolated components with the appropriate standard. U.V.-visible spectra of the purified components were identical in all respects with those of lutein and zeaxanthin. Further support for our identification was obtained by the preparation and chromatographic comparison of derivatives of the macular pigment and of the standards. PMID- 3832577 TI - Physiological development of the kitten's retina: an ERG study. AB - The physiological development of the retina was followed by recording ERGs and OPs from kittens of different ages. We found that different properties of the retina attain adult values at different ages: the b-wave elicited by higher stimulus intensities became adultlike by five to seven weeks while the b-waves elicited by lower stimulus intensities required another 3-5 weeks; the implicit time for the b-waves elicited by the full intensity stimulus attained adult values by 10 weeks of age; and the oscillatory potentials did not become adultlike until 18 weeks of age. The physiological development of the ERG was related to the development of the photoreceptors and the ganglion cells as well as to the morphological development of the second order neurons. It was concluded that the physiological development, as the morphological development, proceeds in three stages: an initial slow phase during which the late receptor potential and the b-waves are first recorded; a second rapid phase, during which the amplitude of the b-waves and OPs increase rapidly; and a third slow differentiation phase during which the final development of the properties of the retina are attained. PMID- 3832578 TI - The influence of spatial frequency on the reaction times and evoked potentials recorded to grating pattern stimuli. AB - The simple reaction times recorded to sine-wave and square-wave grating stimulus patterns of both constant physical contrast and of constant suprathreshold contrast were appreciably delayed by an increase in spatial frequency from 0.5 to 10 c/deg. There was no comparable increase, however, in the peak latency of the initial visual evoked potential component, C1, recorded to the same stimulus patterns. In view of the evidence that C1 has a striate cortical origin, these results suggest that the large spatial-frequency dependent variations in RT do not reflect delays of stimulus-induced neuronal responses in the primary visual pathway from retina to striate cortex. PMID- 3832579 TI - Characterization of the color related receptor mosaic in the ground squirrel retina. AB - Light microscopic and histochemical studies reveal that the retina of the European ground squirrel (Citellus citellus L.) contains a mosaic pattern of two cone types and a small population of rods. A minority (7%) of the cones can be characterized by their ellipsoids having larger diameters and increased staining density over the majority population. Exposure to green light selectively elicited intense NBT-diformazan labeling in the major population of cones while the larger diameter cone type was labeled after blue illumination. The two cone subpopulations are probably the blue and green cone types of ground squirrel protanopic color vision. PMID- 3832580 TI - Larval and adult visual pigments of the zebrafish, Brachydanio rerio. AB - Photoreceptors of adult and larval zebrafish were assayed by microspectrophotometry to characterize their visual pigments, and to determine when the visual pigments first appear during development. Short single cone outer segments contained a pigment with a lambdamax near 417 nm. Long single cones and long members of double cone outer segments contained a pigment with a lambdamax near 480 nm. Short members of double cone outer segments contained a pigment with a lambdamax near 556 nm. Rod outer segments contained a rhodopsin with a lambdamax near 501 nm. All four visual pigment types found in adult photoreceptors were present in the earliest measurable larval photoreceptors. PMID- 3832581 TI - Differences in the neural basis of human amblyopia: the distribution of the anomaly across the visual field. AB - Spatio-temporal contrast sensitivities to horizontally-oriented Gaussian-weighted patches of sinusoidal grating stimuli were determined across the nasal and temporal visual fields of strabismic and non-strabismic, anisometropic amblyopes. The visual field distribution of the amblyopic anomaly differs in strabismic and non-strabismic, anisometropic eyes. In strabismus the peripheral region of one or both hemifields is spared; in non-strabismic, anisometropic cases the loss is evenly distributed across the binocular visual field but is not present in the monocular temporal field. These findings suggest that the non-strabismic forms of amblyopia in humans result from binocular competitive imbalance in early life. The strabismic results pose two problems for the present competitive model of amblyopia: in strabismus, amblyopia is mainly limited to central vision and shows an asymmetric distribution. PMID- 3832582 TI - Color and luminance share a common motion pathway. AB - Following exposure to a moving grating of bars differing only in luminance, a motion aftereffect (MAE) is observed on a stationary grating of bars differing only in chrominance. This suggests that the motion of equiluminous chromatic stimuli is sensed by a channel that responds to both luminance and chrominance and not by a separate channel specialized for the motion of colored stimuli. However, adding color to a low contrast luminance stimulus actually reduces its effectiveness at creating or nulling a MAE, indicating that the response of the motion pathway to color is qualitively different from its response to luminance. In addition, a chromatic stimulus demonstrates a dissociation between perceived speed, MAE speed and speed required to null the MAE that is absent for a luminance stimulus. PMID- 3832583 TI - Electrophysiological evidence for the existence of coarse and fine disparity mechanisms in human. AB - Visual sensitivity to stereoscopic disparity changes was measured both psychophysically and by means of evoked potentials. The binocular disparity of a dynamic random-dot stereogram portraying a single flat plane alternated between two values symmetrical about the plane of fixation. The threshold for disparity alternation of the stereoscopic plane was determined at alternation rates between 4 and 12 depth reversals per second (rps). Evoked potential and forced-choice psychophysical estimates of stereoscopic threshold at each reversal frequency agreed, with a mean discrepancy of only +/- 0.1 log units. Evoked potential amplitude was a linear function of log disparity up to about 15 arc min peak to peak disparity. For larger disparities, the evoked potential amplitude versus log disparity function was found to be nonmonotonic with a dip occurring at approximately 26 arc min disparity. Responses to fine disparities of less than 20 arc min lay close to one temporal phase while those evoked by coarse disparities greater than 40 arc min lay near a different phase. The data suggest that disparity processing mechanisms either undergo dynamic changes as disparity increases or that processing shifts between at least two independent mechanisms. PMID- 3832584 TI - On Pulfrich-illusion eye movements and accommodation vergence during visual pursuit. AB - When the Pulfrich illusion is perceived with stationary fixation, and visual pursuit of the pendulum is then initiated, rapid vergence changes occur which correspond to the illusory elliptical path. During steady-state visual tracking of the illusion, however, the eyes move along a planar path without systematic changes in vergence. These latter pursuit movements with monocular filter involve large fixation disparities relative to unobstructed vision (0.5 degree to 1 degree divergence); hence, it is proposed that the planar tracking path probably results from strong dominance of the oculomotor system by stimuli from the unobstructed eye. During visual tracking with monocular filter and a target moving along a nonillusory elliptical path in depth, appropriate changes in vergence occur, but comparable vergence changes also arise when the target is fully hidden from one eye. This response apparently represents a superposition of accommodation vergence upon smooth pursuit movements; similar responses also occur during monocular tracking of a target moving around a circular path in depth. PMID- 3832585 TI - Reaction times to chromatic stimuli. AB - The relative contributions of chromatic and achromatic activity to reaction time were investigated under conditions in which spatial and temporal transients were manipulated. Simple reaction times (RT) were obtained to eight photometrically matched (1 cd/m2) wavelengths between 448 and 658 nm. These stimuli were incrementally presented on a spatially coextensive 1.2 degrees white adapting field. RT was wavelength dependent for 5 or 10 cd/m2 steady backgrounds or a 5 Hz 1.2 cd/m2 flickering background. RT varied as a trichromatic saturation-like function (slowest RT at 572 nm). In comparison, RT was wavelength independent when no adapting field was present and when the 1.2 cd/m2 field was flickered at 15 Hz. PMID- 3832586 TI - A soft contact lens search coil for measuring eye movements. AB - A five turn coil of magnet wire sandwiched between two soft contact lenses served as a magnetic search coil to measure horizontal and vertical eye movements in humans. The lens was adhered to the eye for 35 min by periodically misting the eye with distilled water; during this time the records of eye position showed that the lens remained firmly attached to the eye. Using this sensor, no topical anesthetic need be applied and the lens can be worn for an extended period of time without increasing intraocular pressure. PMID- 3832587 TI - Power spectra for ocular drift and tremor. AB - Eye position during fixation has been measured without contact and the power spectrum of drift and tremor eye movements has been estimated. In the 0-40 Hz frequency range power declines with frequency roughly as 1/f2. In the 40-100 Hz frequency range the dominant spectral component is a broad spectral peak with a peak amplitude of about 6 arc sec. The shape of the broad spectral peak is dependent on the fixation direction. A model that explains qualitatively the shape of the power spectra function is presented. It is suggested that tremor eye movements are by-products of the clock-like firing of motor neurons. PMID- 3832588 TI - Sensitivity of the human neonate to short- and long-wavelength stimuli. AB - Increment thresholds for long- and short-wavelength stimuli were determined under both white and orange adaptation. The forced-choice preferential looking technique (FPL) was used to test neonates shortly after birth and again at 2 months postnatal. Results were compared to an adult control group. Neonates, 2 month-olds, and adults showed a change in relative sensitivity to the 617 and 453 nm test stimuli with a change in chromatic adaptation, indicating the existence of at least 2 separately adaptable chromatic mechanisms at birth. These results are tentatively discussed in terms of the functioning of rods and short-, middle- and long-wavelength cones. A decrease in all thresholds with age is discussed with regard to attentional differences and postnatal neural development in the visual system. PMID- 3832589 TI - Viewing distance and the sustained detection of high spatial frequency gratings. AB - Although conventional visual acuity tests measure the ability to resolve fine detail, many visual tasks demand prolonged detection. By evaluating the ability to maintain visual resolution, we observed that detection of stimuli subtending a small but constant visual angle depends on viewing distance and is probably determined by accommodative control. Detection was longest when viewing distance corresponded to the individual observer's accommodative resting, or tonus, position and fell off markedly for further distances. Since most visual assessment procedures involve a momentary detection criterion, they will not predict the ability to sustain accommodation and may thus overestimate visual resolution for prolonged viewing tasks. PMID- 3832590 TI - A theory of the primitive spatial code in human vision. AB - MIRAGE, a theory for the primitive coding of the (1D) spatial distribution of luminance changes by the human visual system is developed from a theoretical examination of the practical problems associated with the characterization of such changes. The main novel feature of the theory is that the multiplicity of spatial filters in human vision is assumed to exist principally to transmit a broad bandwidth signal of considerable redundancy: the filters are not assumed to be marked with their centre frequency or bandwidth, and are not analyzed independently. The theory is largely independent of the particular filter transfer function form. MIRAGE is applied to a range of one-dimensional luminance patterns, and demonstrates several well-known brightness illusions, and a structured grouping principle. It is finally shown to be supported by a wide range of psychophysical data. PMID- 3832591 TI - The influence of luminance on displacement thresholds for continuous oscillatory movement. AB - Displacement thresholds were determined for a sinusoidally-modulated contrast grating, having a spatial frequency of 2 c/deg, whose mean luminance could be varied. The grating underwent continuous oscillatory simple harmonic motion. Displacement thresholds were determined for frequencies of 1, 3, 5, 7 and 10 Hz using the method of limits for each mean grating luminance of 3.8, 8.9, 26, 62 and 134 cd/m2. With low oscillation frequencies a marked reduction in sensitivity is produced by reducing the mean luminance of the grating. This is not the case with higher oscillation frequencies when mean luminance has little effect upon sensitivity. PMID- 3832592 TI - The effect of practice on the oblique effect in line orientation judgments. AB - Line orientation discrimination improves with selective practice for oblique orientations and not for principal orientations. This training effect was observed with an identification task as well as with two alternative forced choice tasks. Despite the improvement for oblique orientations, just noticeable differences in orientation are still larger for the practised oblique orientation than for the principal orientations after 5000 practice trials. These findings suggest that the oblique effect in line orientation has at least two sensorial components, one of which is attributed to the meridional variations in the preferred orientation of area 17 S-cells. PMID- 3832593 TI - Eye movements and stereopsis during dichoptic viewing of moving random-dot stereograms. AB - The dynamic properties of the version and vergence system were studied in relation to stereopsis for movements of the whole visual scene. Large random-dot stereograms (30 X 30 deg arc), moving laterally, were viewed dichoptically by human subjects without a fixed visual frame of reference. Sinusoidal movements in counterphase of the two half-images constituting the stereogram induced sinusoidal ocular vergence movements. The gain of vergence depended on the frequency as well as the amplitude of stimulus movement, while the phase lag depended only on the frequency. Fusion and stereopsis were retained up to a maximal velocity of change in relative position of the two half-images between 6 and 13.5 deg/sec. Sinusoidal movement of one half-image while the other one remained stationary induced sinusoidal ocular version as well as vergence movements. For version gains were higher and phase lags were smaller than for vergence. At the retinal level, residual overall binocular disparities between the two half-images up to 2 deg arc were tolerated without loss of stereopsis. The presence of sinusoidally varying overall binocular disparities and ocular vergence movements without perception of motion in depth suggests that these variables are not adequate cues for perception of (change in) depth. PMID- 3832594 TI - Effect of localized grating adaptation as a function of separation along the length axis between test and adaptation areas. AB - Aftereffect following adaptation to localized gratings was measured as a function of the separation along the length axis between test and adaptation gratings. When the adaptation gratings were located on or near the retinal area occupied by the test grating, contrast sensitivity greatly decreased. When the adaptation gratings were spatially separated from the test grating, contrast sensitivity significantly increased. This property is similar to that which was observed in our previous study, in which the adaptation gratings were displaced from a test grating along the modulation axis. The facilitatory aftereffect of the grating adaptation can be accounted for by assuming that there may exist two mechanisms involved in the adaptation process; one is a center mechanism responsible for the detection of a test pattern, its adaptation producing a reduction in responsiveness; the other is a surround mechanism which tonically inhibits the center mechanism, its adaptation resulting in an increase in the sensitivity of the center mechanism by releasing the tonic inhibition. The spatial property of the adaptation effect may reflect the nature of spatial integration process of the center and surround mechanism. PMID- 3832595 TI - Afterimages of sinusoidal, square-wave and compound gratings. AB - Negative afterimages were observed after steady fixation of sinusoidal gratings at low spatial frequencies, and quantified using contrast-matching and cancellation methods. Afterimage contrast increased as a power function of "exposure", defined as the product of inspection contrast and inspection duration. A single function, linear on a log-log plot, describes the afterimages of gratings at different spatial frequencies, contrasts and durations. The matching method yielded a lower slope (about 0.42) than the cancellation method (0.62), probably because contrast adaptation attenuates perceived afterimage contrast in the first method, but not the second. Square-wave gratings, and those containing two or three harmonic components gave much weaker afterimages (assessed by contrast-matching) than sine-waves did. Contrast adaptation may again be responsible. Hemi-field asymmetries in contrast perception were noted. The contrast of real gratings and afterimages was nearly additive, especially at lower exposures, but the results cannot distinguish between linear filter and gain control models of "local adaptation". PMID- 3832596 TI - Apparent spatial frequency and contrast of gratings: separate effects of contrast and duration. AB - Variations in apparent spatial frequency of sinusoidal gratings were assessed using a matching method. Perceived spatial frequency increased as contrast decreased and as duration of presentation decreased (from 320 to 20 msec). The effect of duration was not produced via changes in apparent contrast (a) because the changes in perceived spatial frequency were much the same when subjective contrasts were matched as when physical contrasts were matched and (b) because reducing duration to 20 msec produced very little change in perceived contrast, despite a factor of four reduction in threshold contrast sensitivity. The effects of duration and contrast on apparent spatial frequency are therefore dissociable, but both might exert their effects via changes in the balance of centre-surround antagonism within receptive fields; the "selectivity shift" theory of these size perception phenomena is discussed. PMID- 3832597 TI - On seeing temporal gaps between gratings: a criterion problem for measurement of visible persistence. AB - Previous estimates of visible persistence based on subjects' ability to see a "blank" between brief flashes of a grating are remarkably long when compared with studies of temporal integration. We show firstly that subjects can detect gaps as short as 5 msec at low spatial frequencies, rising to about 20 msec at high spatial frequencies, and secondly that artefactual luminance transients such as might be found in tachistoscopes do not greatly increase the detection thresholds. Much longer estimates were obtained through the use of a more conservative criterion, which was subjectively ill-defined and very variable across subjects. Studies which use this method may not measure visible persistence very effectively. PMID- 3832598 TI - Optimal occluder luminance for seeing stationary visual phantoms. AB - If the central portion of a vertical grating is covered up by an opaque horizontal occluder, a phantom grating is perceived to continue across the occluded region. The phantoms can be seen even if the inducing grating is stationary, but are not seen when the occluder luminance is near to the space average luminance of the grating. Optimal occluder luminance for the perception of phantoms was measured, while occluder height and the inducing grating contrast varied. Phantom visibility was maximal when the occluder luminance was near to either the minimum or to the maximum luminance of the grating. When the occluder luminance was set between the two levels, opposite-phase illusory gratings were dominantly observed. The reciprocal relationship between the visual phantoms and the grating induction effect of McCourt (1982) is discussed. PMID- 3832599 TI - A further look at the binocular visual field of the pigeon (Columba livia). AB - The binocular visual field of the pigeon, measured ophthalmoscopically, is ovoid in shape. It is 114 degrees in vertical extent and centered and widest (37 degrees) about the eye-beak axis (i.e. the line passing through the straight edge of the beak and the midpoint of a line connecting the centres of the pupils). The area dorsalis projects 10 degrees-15 degrees below the eye-beak axis where the field is 35 degrees wide. The stereotyped peck response of the pigeon entails birds pausing twice. At the first fixation, the image of a grain is on the area dorsalis and at the final fixation the grain is centered within the widest part of the binocular field. PMID- 3832600 TI - The magnitude of longitudinal chromatic aberration of the human eye between 458 and 633 nm. AB - The longitudinal chromatic aberration (LCA) of the human eye was determined between wavelengths 458 and 633 nm for ten observers by incorporating Argon and Helium-Neon Lasers into a Badal optometer system such that tonic (or "dark focus") resting positions of accommodation could be measured under darkroom conditions. A mean chromatic range of 1.87 D was found between 488 and 633 nm. The range increased slightly to 1.91 D when the experiment was repeated under cycloplegia on a subset of three subjects. Additional wavelengths (458 and 476 nm) for a further subset (four subjects) increased the range to 2.65 D. This magnitude of LCA would support recent predictions based on Abbe and Pulfrich refractometry analyses of the dispersion of the human crystalline lens and ocular media. PMID- 3832601 TI - Measuring eye movements with a search coil: non-linear filter allows simultaneous recording of horizontal and vertical eye position by means of the phase modulation method. AB - Measuring eye position from the phase angle of the signal induced by a rotating magnetic field in a search coil presents a number of advantages. So far, however, existing schemes using this principle either record eye position in one dimension only or require two search coils. We describe here a simple analog circuit which singles out a signal of given frequency from a frequency composite without changing the signal's phase. This makes it feasible to measure horizontal and vertical eye position with a single search coil by using two orthogonal rotating fields of different frequency. PMID- 3832602 TI - The action of inhibitory neurotransmitters, gamma-aminobutyric acid and glycine may distinguish between the area centralis and the peripheral retina in cats. AB - The effects of iontophoretically applied gamma-aminobutyric acid (GABA) and glycine, and of their antagonists, bicuculline and strychnine, were compared between ganglion cells from the central and peripheral retinae of optically intact eyes in barbiturate-anaesthetised cats. The visual response of on-cells was inhibited by GABA and enhanced by bicuculline. The visual response of off cells was inhibited by glycine and enhanced by strychnine. The sensitivity of cells to the transmitters was lower in the peripheral retina than in the area centralis, whilst the sensitivity to the antagonists was similar in both regions of the retina. Cells from the area centralis were inhibited by either GABA or glycine, but never both. Cells from the periphery were less selective and were inhibited by both transmitters. PMID- 3832603 TI - Properties of the visual pigments of the moth Manduca sexta and the effects of two detergents, digitonin and chaps. AB - The three known visual pigments (P520, P450, P357) of the moth, Manduca sexta (Lepidoptera, Sphingidae), were extracted in two different detergents (2% digitonin, 6 or 12 mM CHAPS). As is the case in unextracted membranes, the metarhodopsins are quite stable in CHAPS extracts, while in digitonin the metarhodopsins of P520 and P450 decay rapidly at 15 degrees C to opsin and free retinal. The relative absorbance ratios are: 1.0:1.6 (P520:M485), 1.0:1.1 (P450:M485), and 1.0:0.8 (P357:M470). The relative amounts of the visual pigments found in digitonin extracts is 100:25:8 (P520:P450:P357); about 60 picomoles of P520 can be extracted from one Manduca retina. PMID- 3832604 TI - Binocular competitive interactions and recovery of visual acuity in long-term monocularly deprived cats. AB - Changes in visual acuity brought about by altering competitive interactions between the eyes of cats monocularly deprived (MD) from natural eye opening to 7 12 months of age were studied. In MD cats given binocular experience, median visual acuity using the deprived eye was 0.75 c/deg. If the deprived eye was given a slight competitive advantage via reverse-suture, median visual acuity reached 1.52 c/deg. Further, giving the deprived eye the greatest competitive advantage was accomplished by complete removal of the experienced eye which yielded a median deprived eye acuity of 2.3 c/deg. Obstacle avoidance and stimulus size data were also obtained. The previously published electrophysiological effects of these manipulations on striate cortical cells were noted to mirror these increases in visual acuity and this correlation was discussed, as were the effects of analogous manipulations in the monkey and man. PMID- 3832605 TI - The ganglion cell and cone distributions in the monkey's retina: implications for central magnification factors. AB - The distribution of cones and ganglion cells was determined in whole-mounted monkey retinae. Ganglion cell density along the horizontal meridian was asymmetric, being up to three times greater in nasal retina. A similar but smaller asymmetry occurred with cones. The total number of ganglion cells varied from 1.4 to 1.8 X 10(6), agreeing well with counts of optic nerve axons. The variation of ganglion cell density with eccentricity indicates the magnification factor (MF) of the retina. This was compared with MF at the dorsal lateral geniculate nucleus and at striate cortex, revealing that the relative representation of the fovea increases substantially in both thalamus and cortex. PMID- 3832606 TI - Complex visual textures as a tool for studying the VEP. AB - A method of separating components of the visual evoked potential by using complex visual textures is described. Interchange of visual textures with identical power specta and third-order autocorrelations elicits a response which may be analyzed into symmetric and asymmetric components. It is shown that the asymmetric component depends on complex attributes of form. Mechanisms that generate this component must possess nonlinear interactions among multiple areas of the visual pattern. These interactions are likely to be more complex than rectification following spatial summation. It is concluded that the asymmetric component reflects intracortical, rather than precortical, processing. PMID- 3832608 TI - Morphology of bipolar cells and their participation in spatial organization of the inner plexiform layer of jack mackerel retina. AB - Morphology of bipolar cells in the jack mackerel retina [Trachurus mediterraneus ponticus (Aleev)] was investigated by the Golgi method. Eight types of bipolar cells are described. It is the first time that cells with an unbranched main dendrite are found in fish retina. It is shown that the inner plexiform layer of the jack mackerel retina contains regular lattices, located at 5 levels and conserted in a characteristic way with the cone mosaic. These lattices are formed by swellings of bipolar cell axons. It is shown that only bipolar cells with small dendritic aborizations (less than or equal to 14 micron dia) take part in this organization. PMID- 3832607 TI - The human visual evoked potential: analysis of components due to elementary and complex aspects of form. AB - The visual evoked potential (VEP) elicited by alternation between isodipole visual textures may be separated into an asymmetric and a symmetric part. The asymmetric part reflects processing of complex attributes of form. The spatial and temporal dependence of this response is used to evaluate models for the generation of this response. The symmetric part appears to reflect processing of local luminance and contrast changes. The relation of these components to the VEP elicited by contrast reversal, contrast modulation, and the windmill-dartboard stimulus is discussed. PMID- 3832609 TI - Inner plexiform layer of jack mackerel retina: participation of amacrine and ganglion cells in its spatial organization. AB - In the jack mackerel retina (Trachurus mediterraneus ponticus) the inner plexiform layer demonstrates a very high degree of differentiation and contains not less than 25 sublayers. Investigation with Golgi method revealed many varieties of neurons, which are responsible for the structural organization of the inner plexiform layer. There are 8 types of bipolar cells, 24 types of amacrine cells and 7 types of ganglion cells with layered processes. The branching levels of the processes of these neurons were determined. Several varieties of neurons are described for the first time. PMID- 3832610 TI - Relation of the different forms of frog rhodopsin observed by isoelectric focusing and electrophoresis to a functional model of rhodopsin clusters in the disc membrane. PMID- 3832611 TI - Separate detectors for simple and complex grating patterns? AB - Grating having two sinusoidal components show a periodic variation in contrast which is visible as a "beat" pattern. The spatial frequency of the beat is the difference between the frequencies of the two components. Thresholds for a number of detection and discrimination tasks were measured using beat patterns of 1 c/deg (with components of 9 and 10 c/deg), and gratings of 1 and 10 c/deg. Temporal modulation at 6 Hz lowered detection thresholds for 1 c/deg gratings, but not for beats or 10 c/deg gratings. The effect of contrast on the range of temporal frequencies over which direction of movement can be discriminated differs for the three types of pattern: beats resemble neither low nor high spatial frequency gratings. Low and (for 2 of 3 observers) high spatial frequency gratings, but not beat patterns, are susceptible to a movement after effect induced by a low spatial-frequency grating. Beat patterns induce little or no movement after effect. We conclude that beat patterns are not detected by the same mechanisms that detect simple gratings. PMID- 3832612 TI - The low level motion system has both chromatic and luminance inputs. AB - Adaptation to moving isoluminant gratings induces a motion after-effect (MAE). Isoluminant gratings are less effective at inducing and at nulling MAEs than are luminance gratings. These results are consistent with a low-level motion detection system which operates on signals from mechanisms which show both spatial and chromatic opponency. PMID- 3832614 TI - Brightness reversal in the natural visual environment: a Venetian blind effect. AB - If a partially open Venetian blind is lighted by the sun, or by diffuse light from the sky, then the upper portion of each slat will be brightly lighted and the lower portion shaded. If an observer moves the head downward while viewing a dark object silhouetted against the sky, then the object displays a reversal of brightness, appearing brighter than the sky while the head is moving downward. Moving the head upward produces no brightness reversal. These observations in the natural visual environment are consistent with earlier laboratory demonstration under several conditions. PMID- 3832613 TI - Additivity of red chromatic valence. AB - The additivity of red chromatic valence was investigated by the hue cancellation method for 4 normal observers. Additivity held for wavelength combinations of 610 680 nm and 400-440 nm. When using 400-680 nm, additivity failure of enhancement type was found for two observers, reduction type failure for a third, and additivity, for a forth. The results suggest a nonlinear property of the red green process for some observers and are discussed in terms of the contribution of B-cones to the process. PMID- 3832615 TI - Receptive-field-like functions inferred from large-area psychophysical measurements. AB - By means of quasi-sinusoidal, circular stimulus patterns, frequency modulated to correct for the radial component of retinal inhomogeneity, we attempt to make all eccentricities within a 16-deg field contribute equally to the threshold response. Wide-field contrast-sensitivity data obtained with these frequency modulated stimuli are modeled using a canonical form of local contrast sensitivity function (CSF), scaled linearly with eccentricity. Calculating Fourier transforms of the constant-velocity, local CSF, we obtain line-spread and point-spread functions that can also be interpreted as receptive-field responses at various eccentricities. These results are compared to other data on local spatial processing in the retina. PMID- 3832616 TI - Colliding targets: evidence for spatial localization within the motion system. AB - The ability to judge the relative location of moving targets is seriously degraded if the targets move in different directions. The vernier acuity for a target in which the two components move in the same direction is not impaired until target velocity exceeds about 4 deg/sec. If the components are moving along trajectories which differ in direction by more than 15 deg, vernier thresholds rise significantly at target speeds greater than 1 deg/sec. The conditions which affect stationary vernier acuity, i.e. separation of target components, duration, and orientation, do not account for the loss in acuity. Our results suggest that localization for moving targets depends on directionally-selective motion detectors. PMID- 3832617 TI - Interaction between short- and longer-wavelength cones in hue cancellation codes: nonlinearities of hue cancellation as a function of stimulus intensity. AB - Hue cancellation experiments were carried out to test the linear additivity of chromatic valences. There were two kinds of experiments: the measurements of the yellow-blue cancellation function and of the red-green one. The opponent-color equilibria were determined as a function of stimulus intensity for mixture lights of various spectral compositions. The results of the yellow-blue cancellation functions showed that the nonlinearity of the cancellation code strongly depended on the spectral compositions of stimuli: the nonlinearity became evident under conditions producing a relative increase in the long-wavelength-cone excitation, while it was reduced under conditions producing a relative increase in the middle wavelength-cone excitation. This property could be well explained if we assume that the gain of the short-wavelength signal might be controlled by a difference signal between the long- and middle-wavelength cones. The results of the red green cancellation functions showed that the cancellation function for a violet light was nonlinear under some specific conditions, while the cancellation function for a red light remained linear. The nonlinearity of the short wavelength red response became more prominent under conditions producing a relative increase in the long-wavelength-cone excitation. It is suggested that the cone-interaction between the short- and longer-wavelength cones may be responsible for the nonlinearities of the yellow-blue and red-green hue cancellation codes. PMID- 3832618 TI - Color perception with binocularly fused adapting fields of different wavelengths. AB - By presenting to one eye a small test superimposed on a background field, and to the other eye only a similar background field of a different wavelength (arranged so that the fused percept is the test centered upon a single fused background), the color appearance of the perceived background can be changed while keeping constant the light stimulating the test eye. Measurements demonstrate that the contralateral field clearly influences the color of the test, even when the left- and right-eye backgrounds are very different in wavelength and illuminance. This change in color appearance cannot be explained (a) by simple contribution of a color signal from the contralateral eye, (b) by the perceived color of the fused background, or (c) by combining the effects of contralateral adaptation (alone) and monocular adaptation (alone). Instead, the central-mechanism response depends on the particular pair of wavelengths that are fused. The results suggest chromatic coding of neural signals arriving at the central locus. PMID- 3832619 TI - Two types of trichromatic squirrel monkey share a pigment in the red-green spectral region. AB - Microspectrophotometric measurements have been obtained for individual photoreceptors from four female squirrel monkeys (Saimiri sciureus) that had been shown behaviourally to be trichromatic. Relative to a normal human observer, two of the monkeys required more red light for a Rayleigh match; the other two required more green light than a normal human observer. In the red-green spectral region, the first type of monkey was found to have two cone pigments with peak sensitivities at approximately 536 and 549 nm, whereas the second type was found to have pigments with peak sensitivities at approximately 549 and 564 nm. By maximum likelihood estimation it was shown that the microspectrophotometric data could be described by a model that assumed only three underlying distributions, two of which were present in each type of monkey. The fit of this model was as good as one in which a "double normal" distribution was fitted individually to the data for each animal. This result is consistent with a genetic theory that postulates in Saimiri three possible alleles for a single locus on the X chromosome; the heterozygous female enjoys trichromacy because Lyonisation ensures that only one photopigment is manufactured in any given cone. PMID- 3832620 TI - Invariant tuning of motion aftereffect. AB - Motion aftereffects (MAE) to drifting gratings were measured with a cancellation technique. For a constant adapting grating, MAE cancellation velocity increased linearly with visual field eccentricity. The slope of the function was dependent upon adapting temporal frequency. MAE velocity was independent of spatial frequency (2-16 c/deg) and approximately constant when expressed as an M-scaled velocity. The MAE was broadly tuned to temporal frequency and temporal tuning was independent of spatial frequency and eccentricity. Reducing contrast over the range 1.0-0.1 reduced the magnitude of the MAE at high temporal frequencies but had no influence at low and moderate temporal frequencies. The results support a ratio model of velocity coding whose spatial reference varies with eccentricity in approximate accordance with the human cortical magnification factor. PMID- 3832621 TI - Sensitivity for structure gradient in texture discrimination tasks. AB - Recent experiments indicate that the segregation of visual structures ("texture discrimination") depends not only on the form of texture elements but also on their spacing. Structures with discriminable elements in close proximity can be segregated more easily than patterns in which the same texture elements are more widely spaced. In dot arrays with areas of different dot luminance, segregation was found to depend on both the luminance difference and dot spacing; discrimination of texture areas in coarse dot rasters required greater differences in luminance than in fine rasters. Also, in regular arrays of iso luminant line patterns, the maximal spacing between neighbouring lines for which different texture areas could still be discriminated was found to be influenced by the degree of dissimilarity between elements. For lines of a given length, texture areas with small differences in orientation became indiscriminable at smaller spacings than texture areas with orthogonal line orientations. Line length additionally had a strong effect on texture discrimination; increasing the line length for a given spacing provided easier segregation of texture areas. However, over a range of raster widths, discrimination of texture areas with a given difference in line orientation varied not with absolute values of line length but with the ratio of line length to interline spacing. Overall, the data suggest that texture discrimination in man is based on the evaluation of variation in structure over space (defined as the "texture gradient"). If local variation of structure is too small, texture areas cannot be discriminated, though differences between texture elements themselves may be apparent. As far as the dependence on variation over space is concerned, discrimination of iso luminant textures resembles the limited sensitivity of the visual system for differences in texture luminance. PMID- 3832622 TI - Velocity coding: evidence from perceived velocity shifts. AB - Measurements of the perceived velocities of moving patterns were made under a variety of conditions in an attempt to gain information concerning the way in which velocity is encoded in the visual system. Adaptation to a pattern moving in the same or opposite direction reduces the perceived velocity of a moving test pattern, but only if the adaptation pattern moves as fast as or faster than the test pattern. The aftereffect peaks at an adaptation velocity slightly higher than the test velocity and then remains constant at higher velocities. Similar results were obtained for several types of pattern. Perceived velocity reduction also follows adaptation to a flickering homogeneous field. The results can be explained in terms of a theory of velocity coding in which two channels are considered in terms of variations in the velocity sensitivities of the neurones they comprise. PMID- 3832623 TI - Bielschowsky head-tilt test--I. Ocular counterrolling and Bielschowsky head-tilt test in 23 cases of superior oblique palsy. AB - We have measured the amplitude of ocular counterrolling (OCR) and the change in vertical deviation in the Bielschowsky head-tilt test (BHT) in 23 cases of unilateral superior oblique palsy. OCR was measured with a photographical method, using limbal, conjunctival vessels as landmarks. Average OCR of the healthy eye was 5.4 +/- 2.4 (SD) deg either side, at 45 deg of body-tilt. BHT and OCR (of the healthy eye) were not related in the group as a whole. An important perturbing factor was the duration of the palsy. To clarify the relation between BHT, OCR and duration of palsy, the BHT/OCR ratio was calculated in each patient. Six cases with a palsy of presumed recent onset had BHT/OCR ratio of 0.57 +/- 0.09, while twelve cases of long-standing palsy had a BHT/OCR ratio of 1.04 +/- 0.71. This means that in cases of recent onset, the relation was relatively fixed. All high BHT/OCR ratio's occurred in long-standing palsies, whether acquired or congenital. In our opinion, disproportionately large amplitudes in the Bielschowsky head-tilt test are caused by secondary innervational changes or contractures. PMID- 3832624 TI - Bielschowsky head-tilt test--II. Quantitative mechanics of the Bielschowsky head tilt test. AB - In ten recent cases of superior oblique (SO) palsy the involved eye elevated by 8.2 +/- 3.8 deg (standard deviation) on 45 deg ipsilateral head tilt. A computer model predicted a rise to only 4.1 deg but could easily achieve 8.2 deg by including reactions in the other cyclovertical muscles, notably on overaction of the superior rectus (SR). In 17 older cases the elevation on tilt rose to an average of 15 deg. The model shows that these deviations must be due to SR overaction. The analysis suggests that SR overaction is the main cause of the rapid increase in eye elevation in recent cases and further increases in older cases. PMID- 3832625 TI - Context dependent processing in spatial hyperacuity. AB - The importance of comparison processes in spatial hyperacuity tasks was investigated by means of a new relative nonalignment discrimination task. Vernier type configuations nonaligned to either left or right, were presented in succession, and the subject had to decide which configuation exhibited a larger nonalignment. The relative nonalignment thresholds were found to be more strongly dependent on the spatial arrangement of the two lines than the thresholds corresponding to "ordinary" spatial hyperacuity performances. This context dependency is attributed to the active role played in the processing by comparison mechanisms. PMID- 3832626 TI - A high-speed point plotter for vision research. AB - An electronic interface is described that allows high speed plotting of points on an oscilloscope under the control of a computer. The storage and fast data manipulation done by the interface permit inexpensive computers of modest performance to produce complex displays which could otherwise be produced only by costly high speed computer graphics systems. PMID- 3832627 TI - Can current models of accommodation and vergence control account for the discrepancies between AC/A measurements made by the fixation disparity and phoria methods? PMID- 3832628 TI - Apparent motion from luminance change: sequence discriminators see it too. PMID- 3832629 TI - Apparent motion from luminance change: further comments on candidate mechanisms. PMID- 3832630 TI - National Survey of Family Growth, Cycle III: sample design, weighting, and variance estimation. PMID- 3832631 TI - The United Nations Decade for Women: an end and a beginning. PMID- 3832632 TI - Learning materials for heath workers. PMID- 3832633 TI - Progress in combating tropical disease. PMID- 3832634 TI - [Disorders of various parameters of the hemostatic system in chronic alcoholics]. PMID- 3832635 TI - [Abdominal injuries]. PMID- 3832636 TI - [Relative risk of skin cancer among men and women in the light of various biosocial factors]. PMID- 3832637 TI - [The Holt-Oram syndrome]. PMID- 3832638 TI - [An unusual foreign body in the parapharyngeal space]. PMID- 3832639 TI - [A case of distant metastasis of renal cancer to the thyroid gland]. PMID- 3832640 TI - [Bladder calculi in children]. PMID- 3832641 TI - [Usefulness of determining the HCG level by the passive hemagglutination inhibition test and Prognosticon All-in hemagglutination test in pathology of early pregnancy]. PMID- 3832642 TI - [Training of community nurses in the care of patients with diseases of the circulatory system]. PMID- 3832643 TI - [Surgical problems in a patient with chronic renal failure subjected to numerous surgical procedures]. PMID- 3832644 TI - [Retroperitoneal cyst simulating acute appendicitis]. PMID- 3832645 TI - [Foreign bodies in the respiratory tract or esophagus in infants and small children as the cause of protracted bronchopulmonary infections]. PMID- 3832646 TI - [Stewart's tumor of the nasal septum]. PMID- 3832647 TI - [Adverse effects of non-steroid anti-inflammatory agents. II. Adverse effects of derivatives of aryl-, heteroarylacetic and anthranilic acids]. PMID- 3832648 TI - Conceptions and misconceptions of menstruation. AB - College women were asked a series of open-ended questions about their conceptions of menstruation prior to menarche as part of a retrospective study. Their responses were rated as indicating correct information, misinformation, or lack of information. A conceptual analysis of these descriptive data reveals some of the emotional and cognitive limitations of pre-adolescence that lead ostensibly well-informed girls to harbor misconceptions about menstruation. Based on this conceptual analysis, a revised approach to menstrual education is suggested. PMID- 3832649 TI - The popular approach to women's health issues: a content analysis of women's magazines in the 1970's. AB - This study reports the results of a content analysis of three "established" and three "new" popular women's magazines. A sample of 203 articles/features on women's health topics was drawn from a stratified systematic random sample of 157 issues over a ten year period. The two types of magazines were compared for amount of coverage given to women's health issues and specific health-related themes. Health themes covered in the magazines were also compared with statistical data on serious health conditions experienced by women, and leading causes of mortality and morbidity. Established magazines were found to give more overall coverage to women's health than did the new magazines, particularly focusing on diet and exercise. However, little attention was given to the serious health problems women actually experience. Implications of results are discussed and directions for future research outlined. PMID- 3832650 TI - The effect of culture on how women experience menstruation: Jewish women and Mikvah. AB - Mikvah is a practice in Judaism consisting of ritual bathing that occurs at the end of the menstrual period. This study compared 161 married Jewish women, 82 mikvah users, and 79 non-users in order to learn how this ritual affects attitudes towards menstruation and the perception of menstrual and premenstrual distress. Women participating in mikvah, a ritual that defines them as "unclean," were expected to have more negative conceptions of menstrual cycle symptomatology and more positive menstrual attitudes than women in the same culture not participating in this ritual. These hypotheses were not supported by the findings. What was found was a similarity between the two groups in attitudes towards menstruation, frequency and type of symptoms surrounding the menstrual period, and the degree to which any of these symptoms were experienced. PMID- 3832651 TI - Psychological aspects of the pelvic exam: individual needs and physician involvement. AB - Many women are traumatized by pelvic examinations, resulting in reactions ranging from mild anxiety and embarrassment to avoiding the exam altogether. Studies which surveyed how women feel about pelvic exams are discussed and analyzed as are projects utilizing the educational pelvic exam approach. The concept of psychological preparation for pelvic exams is presented incorporating the importance of personal control. The main theme is the proposal that preparation for pelvic exams should be tailored to each individual patient. The role of the examiner is also discussed, stressing physician education and sexual conflicts involved in the performance of pelvic exams. PMID- 3832652 TI - Stroke: a personal perspective. PMID- 3832653 TI - Psychology degree examinations and the premenstrual phase of the menstrual cycle. AB - Questions are frequently raised about possible impairment of cognitive function in the premenstrual phase of the menstrual cycle. There is also concern that women may be at a disadvantage premenstrually on important occasions such as examinations. This study compared the marks on final-year psychology degree examinations in the premenstrual phase with those of the rest of the cycle. All of the 26 women students who were eligible to participate did so. Comparisons, within and between individuals, of Premenstrual and Nonpremenstrual marks, gave no indication of significant fluctuations with the cycle. Pre-examination arousal and anxiety, which were similar to the relevant published norms, did not appear to be related to the examination marks. There were no significant differences between students taking or not taking oral contraceptives. If there are any physiological and/or social-psychological effects of the cycle on high-level cognitive functioning these are presumably compensated for by the students in this situation. These findings suggest that women taking final degree examinations are not at a disadvantage during the premenstrual phase of the cycle. PMID- 3832654 TI - Teaching medical ethics in the future. PMID- 3832655 TI - On the origin of oligodendrocytes. PMID- 3832656 TI - Intracerebral hematoma after surgical correction of strabismus. PMID- 3832657 TI - The HLA antigens and leprosy in Korea. PMID- 3832658 TI - An application of discrete probability models to the number of outpatient visits. PMID- 3832659 TI - Surface properties of cell membrane in early stage of transformed cell. I. Early detection of transformed cell by concanavalin A. II. Properties of plasma membrane of transformed rat liver cell induced by 3'-Me DAB. PMID- 3832660 TI - Properties of hepatitis B virus associated DNA polymerase. PMID- 3832661 TI - Cleft lip and cleft palate in Korea--2422 cases in 20 years. PMID- 3832662 TI - International medical education. PMID- 3832663 TI - A review of medical education: problems in some Asian countries. PMID- 3832665 TI - Potentials for progress in laser medicine. AB - Lasers could come to occupy a highly important position in the armament of medicine. They are the brightest known sources of light, man-made or natural, and emit light having such properties as coherence and monochromaticity. Furthermore, lasers have the ability to deliver very brief pulses of light which can cause unique alterations in biological materials. The major obstacle to the increased use of lasers in medicine and surgery is not the availability of laser devices, but the dearth of basic information about laser-tissue interactions. We have recently demonstrated that, even in turbid tissue such as the dermis, it is possible simultaneously to induce microscopically selective thermal damage, localized to millions of selectively absorbing targets, while sparing surrounding tissues. These "targets" may be as small as organelles or as large as blood vessels. Such localized thermal damage is truly unique to pulsed laser exposures. The scope and medical utility of these lesions has yet to be fully understood. Thus, there is much research to be done in describing and characterizing laser induced injury. There is, however, ample evidence that several laser therapies could be improved by using selectively absorbed, short pulses that lead to the spatial confinement of thermal injury. Treatment of port wine stains, pigmented lesions, atheromatous arterial plaques, and the fragmentation of kidney and gall stones are examples. It should also be possible to use a variety of systems to deliver exogenous laser targets on or within individual types of cells or organelles. Such chromophores may lead to new forms of cancer therapy, for example. PMID- 3832664 TI - Phototherapy and photopharmacology. AB - The activation of 8-methoxypsoralen (8-MOP) by long-wavelength ultraviolet A light (UVA, 320-400 nm) induces the formation of interstrand cross-links in DNA. Psoralen plus UVA (PUVA) is widely used in the treatment of psoriasis, a hyperproliferative disease of the skin. A new psoralen plus UVA therapy has been developed in which the 8-MOP-containing blood of cutaneous T cell lymphoma (CTCL) patients is irradiated with UVA light extracorporeally (i.e., extracorporeal photopheresis). The first group of patients had the leukemic variant of CTCL. A regimen of two treatments on successive days at monthly intervals produced a clinical response in eight of 11 patients. In this review the properties of several psoralens (both naturally occurring and synthetic derivatives) are compared, using several assays (DNA cross-linking, inhibition of lymphocyte response to mitogen stimulation, and cell viability). The development of a panel of monoclonal antibodies that recognize 8-MOP-modified DNA is also described. These antibodies have been used to quantitate 8-MOP photoadduct levels in human DNA samples. In addition to the psoralens, the light activation of two other compounds, gilvocarcin and an insulin-psoralen conjugate, is described. PMID- 3832666 TI - Biochemical characterization of propylglyoxal bis(guanylhydrazone). Facile synthesis of monoalkylglyoxal bis(guanylhydrazones). AB - Propylglyoxal bis(guanylhydrazone) sulfate, a novel analog of the well-known antileukemic drug methylglyoxal bis(guanylhydrazone), has been prepared from 2,2 dibromopentanal, and the compound has been characterized biochemically. Although it is a powerful inhibitor of S-adenosylmethionine decarboxylase, its Ki value (0.2 microM) is considerably higher than that of ethylglyoxal bis(guanylhydrazone) (0.06 microM). The compound is only poorly taken up by tumor cells, and its accumulation is not stimulated by a prior exposure of the tumor cells to difluoromethylornithine, a compound that causes polyamine depletion. Thus, the uptake characteristics of the compound are similar to those of ethylglyoxal bis(guanylhydrazone), but in striking contrast to those of methylglyoxal and glyoxal bis(guanylhydrazones). Since the configuration of the double bonds in glyoxal, methylglyoxal and propylglyoxal bis(guanylhydrazones) has been shown to be identical, the different uptake characteristics are probably only due to differences in side chain size and/or hydrophobicity. PMID- 3832667 TI - Tumor inhibition by ferricenium complexes: systemic effect in vivo and cell growth inhibition in vitro. AB - The antiproliferative activity of divers ferricenium complexes [Cp2Fe]+X-(X- = [CC13COO]- X CC13COOH (I); X- = [CC13COOH]- X 2 CC13COOH (II); X- = 1/2 [C13FeOFeC13]2- (III); X- = [FeC14]- (IV); X- = [2,4,6-(NO2)3C6H2O]- (V)) was investigated against solid, subcutaneously growing Ehrlich ascites tumor (EAT) in vivo as well as against EAT cells cultivated in vitro as permanent suspension culture. In vivo, triple intraperitoneal injections of the complexes II (3 X 200 mg/kg), III (3 X 100, 140, 180 mg/kg) or IV (3 X 160 mg/kg) markedly suppressed tumor development thus that the sizes of treated tumors were reduced to 42-48% related to control tumors (100%); these results point to the systemic character of the antitumor action by ferricenium complexes in vivo. In vitro, all ferricenium complexes inhibited cellular proliferation to an equal extent; application of 10(-5) M diminished the increase in cell number by 20-40%, application of 10(-4) M resulted in a total cessation of cellular proliferation. In comparison to cis-diamminedichloroplatinum(II), the cell growth-inhibiting effect of ferricenium complexes was less pronounced and required 10- to 50-fold higher concentration levels to evoke equivalent cytostasis. PMID- 3832668 TI - [Mammalian spermatogenesis as a biological indicator for ionizing radiation]. AB - We have analysed spermatogenetic cells by flow cytometry to quantify effects of ionizing radiation. The radiation-induced reductions of testicular DNA synthesizing cells, primary spermatocytes, haploid round and elongated spermatids as well as the increases of numerical chromosome aberrations (abnormal diploid spermatids and aneuploidies) in NMRI inbred mice are described. Testicular weights were determined as a parameter of germ cell decrease, and histologic cross sections of the testes were analysed. Since even an exposure of 0.05 Gy (= 5 rad) may be detected by a reduction of DNA-synthesizing cells (Acta Radiol. Oncol. Radiat. Phys. Biol. 21, 349-351 (1982) [1]), the use of the in vivo system "spermatogenesis" as a biological dosimeter to monitor low dose effects and to determine RBE values of different radiation qualities is suggested. PMID- 3832669 TI - Growth response of mouse lymphoma cells to low concentrations of mercuric chloride. AB - Three growth rate experiments involving several sampling points were performed to investigate the previous finding that very low concentrations of HgCl2 inhibit the growth of murine lymphoblasts in vitro. However, results presented here do not confirm this, there being no significant differences between the three independent growth rate experiments. PMID- 3832670 TI - High yields of DNA-transfer into mouse L-cells by electropermeabilization. AB - DNA transfection in mouse L-cells was performed by means of the electropermeabilization technique (U. Zimmermann, G. Pilwat, and F. Riemann, Z. Naturforsch. 29, 304 (1974)). The plasmid pSV 2-neo used leads to neomycin resistance in stably transfected L-cells. Optimized conditions resulted in high yields of clones at relatively low DNA concentration. The influence of temperature during pulse application and during the subsequent resealing process as well as the field parameters and medium composition are discussed. PMID- 3832671 TI - Female urinary chemosignals influence scent-marking behavior in male Mongolian gerbils (Meriones unguiculatus). AB - The influence of females on the amount of scent-marking behavior displayed by male Mongolian gerbils was investigated. Males isolated from females scent mark at a low level which increases more than two-fold if females are present in the room for three weeks without direct contact with the males. A similar increase is obtained by application of pooled female urine directly onto the males' noses. PMID- 3832672 TI - [When in surgery of the locomotor system is preoperative shaving indicated?]. AB - Shaving the day before operation is safe only if it is combined by an adequate disinfection with Jodophoren and followed by sterile packing of the operation field. PMID- 3832673 TI - [Short technical contribution: video technic and sterility in arthroscopy]. AB - A new sterilizable adapter for video cameras is presented, which makes it possible to provide perfect sterility when changing the arthroscopes. PMID- 3832674 TI - [CT image analysis for surface reconstruction of the hip joint]. AB - From a sequence of planar CT-pictures of the hip joint the diagnostically relevant contours are extracted on a graphic monitor by means of an image analysis process. To enable this an image-preprocessing has been needed to improve quality of the CT-pictures. From theses contour data, a mathematical surface model of the hip joint will be derived with well-known methods to simulate osteotomy. PMID- 3832675 TI - [Ender nailing of per and subtrochanteric fractures. Results and complications]. AB - An evaluation of 84 trochanteric and subtrochanteric fractures, treated with Ender pins in the Department of Orthopaedic Surgery (University of Heidelberg) proved to be of instant success in 66 (78%) cases. A reoperation had to be performed in 10 (12%) cases, in 3 of these reoperation the pins had to be redriven. The use of Ender pins failed in 7 patients, a total hip arhtroplasty became necessary. The mortality was 14%. A third of the cases showed an external malrotation which, however, is of no relevance in older people. The intermedullary fixation with Ender pins is a useful operative procedure. Stable internal fixation can be achieved even in sever trochanteric ans subtrochanteric fractures. In case the form of the fracture, the age and the general condition of the patient are satisfactory, a total hip arthroplasty should be considered. PMID- 3832676 TI - [Relations between development of the apophyses of the ilial crest (Risser's sign) and development of the hand skeleton in girls with scoliosis]. AB - The maturation of the iliac apophysis (Risser sign) and of the bones of the hand and wrist of 34 girls with scoliosis with 46 pairs of data were analyzed to get information upon their predictive value for further growth and development of the scoliotic curve. A strong correlation was found between the Risser sign and the maturation of the hand and wrist (r = 0.74, p less than 0.005). The prognostic value of the Risser sign (r = -0.57) for further height gain is superior to chronological age only (r = -0.52), the maturation of the hand and wrist (r = 0.62) however is superior to the Risser sign. It can be assumed that this also holds for their prognostic value for the progression of the scoliotic curve. We feel that in the clinician routine for girls with scoliosis the determination of the skeletal maturity from X-rays of the hand is sufficient and with its probably unavoidable irradiation risks to the gonads the determination of the Risser sign should be abandoned. PMID- 3832677 TI - [Atypical thoracic deformities: evaluation and operative sequelae]. AB - Until 1982 we have performed 1410 chest wall corrections in our clinic. 0.5 percent were related to cleft sternum or osteocartilagineous defects, 2.3 percent to premature sternal synostosis, 0.5 percent followed the reconstruction of congenital diaphragmatic hernias. Another 17 percent were characterized by extreme flat chest, atypical anterolateral asymmetric or extreme position of the punctum maximum. Morphological parameters are taken by pelvimeter and profile measurements, operative consequences derived from the morphological typing and grading and the clinical finding. PMID- 3832678 TI - [Bone tumors and tumor-like changes in the neonatal period and in infancy]. AB - Bone tumours and tumour-like lesions occurring in newborns and infants are described presenting 5 own cases and a literature review. Age specific features in diagnosis, therapy and prognosis are discussed. Due to the rarity of these diseases a centralized registry at a national level is recommended. PMID- 3832679 TI - [Biomechanics of the metatarsophalangeal joints]. AB - Koehler-Freiberg's disease is found to most commonly manifest itself in the metatarsal head of the second ray. Occasionally it is observed to occur in the metatarsal head of the third and less commonly it is seen to appear in the other rays of the foot. An investigation into probable causes of the disorder calls for consideration of the biomechanical conditions in the region of the metatarsophalangeal joints. A review of the literature pertaining to this matter has failed to reveal any detailed information in this respect and therefore a series of experiments have been conducted involving determination of a) the ground force under the metatarsophalangeal joints and under the toes in normal barefoot walking b) the direction of the flexor tendons and such others that cross the joint and that might play an important role in exerting force between the toes and the ground, c) the geometry of the articulating surfaces and d) the forces that act between the metatarsal head and the corresponding phalangeal joint surface. It is shown that the specific loading of the MP-II joint (due to forces acting across the joint) could amount to nearly twice that to which MP-I is subjected to. This might explain the more frequent occurrence of osteonecrosis of the second metatarsal head as compared to that observed within the head of the first. Furthermore, the direction of the joint resultant force in the MP-II joint is seen to be more dorsally inclined than that in MP-I, which agrees well with clinical findings regarding the site of localized lesions. Lastly, a hypothesis which still requires closer investigation is presented to explain the development of the bone lesions that are known to occur just below the subchondral cortex. PMID- 3832680 TI - [Etiopathology of camptodactyly (case report and literature review)]. AB - First, a review on the literature about camptodactyly and its pathogenesis is given. A case report is presented on a 13-year-old girl with a camptodactyly of both little fingers. Intraoperatively it was observed that the superficial flexor tendon of the right little finger ended in the palmar aponeurosis and was then found to be without function. It is our understanding that this type of anomaly of the superficial flexor tendon of the little finger as an aetiology of camptodactyly has not been reported yet in the previous literature. PMID- 3832681 TI - [Cortical hyperostosis of the pisiform bone in stage I Dupuytren contracture in chronic alcoholics]. AB - The author examined the carpalia of 40 male alcoholics suffering from Stage I of Dupuytren's contracture. In four subjects he observed a cortical hyperostosis of the right pisiform bone on the tangential films. The hyperostosis can be ascribed to the ethanol-induced hyperlipoproteinemia type II/B. The lipoids leaving the vascular paths infiltrate the connective tissue capsule of the pisiform bone and stimulate the formation of osteoblasts at the border between bone and soft tissue. The ossification must be regarded as enteropathic hyperostosis. PMID- 3832682 TI - [Experimental studies on the effectiveness of various shin guards in soccer]. AB - These experimental studies with protective shin-guards show, whether it is possible to protect soccer players' shins effectively, even to prevent shin fractures. In simulating different forces, acting on shin-guard protected wooden rollers compared to non-protected ones, it could be shown, that injury-protection can be efficient due to stretching the acting forces over a longer period of time, so that the maximal acting force can be decisively reduced. It could be shown, that the greatest effect was seen on maximal forces of less than about 300 kp (3000 N), and that increasing the acting forces will soon reduce this effect. A comparison with forces which are able to fracture human tibial bones shown, that this effect can sometimes even be great enough to prevent tibial fractures. Shin-guards greatest effect nevertheless lies in preventing the great majority of soft tissue damage. PMID- 3832683 TI - [Cast metal spongioid bone implants in animal experiments]. AB - Spongyimplant cubes produced out of an alloying DIN 58800 are driven in an artificial produced split in the ileosacral articulation of sheeps. The animals were killed after a period of 70 til 181 days. All the implants are enclosed by bone and so bring about an ankylosis of the ileosacral articulation. In different degree the porous slices of the implant are grown through by bone. By producing spongyimplants with more porous slices the transfer of the animal experiment to human beings is justified, for example for special problems in osteosynthesis of in the arrange of the surface from artificial implants. The produced spongy implants out of metal are characterized specially by its primary stability. PMID- 3832684 TI - [Clinical results following the transgluteal and anterolateral (Watson-Jones) approach to hip prosthesis implantation]. AB - 80 total hip endoprostheses with antero-lateral (Watson-Johnes) approach are compared with 77 total hip endoprostheses with transgluteal approach (Bauer) after a period of at least one year after the operation. In all cases a cementless implanted model has been used. After transgluteal approach we found less bleeding and hematoma, but slight increased periarticular ossifications. The clinical results (pain, range of motion, distance walked, walking aid, manner of walking) were only a little different. For the technic of implantation of the cementless endoprosthesis the transgluteal approach seems to be more useful. PMID- 3832685 TI - [Experiences with the Lord cement-free total endoprosthesis]. AB - On 30 patients with non-cemented total hip prostheses by Lord, 99mTc-MDP bone scans, clinical examinations, and plain film radiographs were performed 3, 6 and 12 months postoperatively. 20 patients with clinical and radiographical uncomplicated postoperative courses revealed a more or less parallel decrease of the calculated scintigraphic activity rations over the 12 months postoperative control period. Postoperative bone scanning is a sensitive and usefull diagnostic procedure for detecting complications. PMID- 3832686 TI - [Effect of idebenone on scopolamine-induced impairment of short-term memory in rats]. AB - The effects of a novel compound, idebenone [6-(10-hydroxydecyl)-2, 3-dimethoxy-5 methyl-1, 4-benzoquinone] and cholinergic drug on short-term memory (STM) were studied in a delayed alternation task in rats. Rats were initially trained using a delayed alternation task in which a forced run to one arm of a T-maze was followed by a free-choice run. A correct free-choice response was defined as a turn toward the arm opposite to that in the forced run, and was rewarded with food pellets. When the time interval between the forced run and free-choice run was longer than 60 sec, the correct responses decreased by about 30% compared with that in no delay trials. After repeated training of the 60 sec-delayed alternation task, the effect of an anticholinergic drug scopolamine (0.1-0.5 mg/kg, ip) on the delayed alternation task was tested. The drug administered 20 min before the test significantly decreased the correct responses in a dose dependent manner. The effect of scopolamine (0.2 mg/kg, ip) was antagonized by the simultaneous administration of physostigmine (0.05-0.2 mg/kg, ip) in a dose dependent manner. Furthermore, physostigmine (0.1 and 0.2 mg/kg, ip) alone increased correct responses in the same task. Idebenone (3-30 mg/kg, ip), administered simultaneously with scopolamine, significantly improved the scopolamine-induced decrement of correct responses, with the highest efficacy at 10 mg/kg. The compound alone did not affect the number of correct responses. These results suggest that STM is closely related to the cholinergic system, and that idebenone may have an improving effect on the impairment of STM induced by a decreased cholinergic activity. PMID- 3832687 TI - Intravenous self-administration of ethanol and acetaldehyde by rats. AB - Fisher strain rats were allowed to self-administer 2, 6, and 18 microM/kg/infusion of ethanol and acetaldehyde into the jugular vein for 22 to 28 days. Thirty-three percent of the rats self-administered 18 microM/kg/infusion of ethanol. Thirty-three, 40, and 33 percent of the rats initiated self administration of 2, 6, and 18 microM/kg/infusion of acetaldehyde, respectively. It is suggested that acetaldehyde may possess stronger reinforcing effects than ethanol in intravenous self-administration by rats. PMID- 3832688 TI - Effects of diazepam and pentobarbital on discrete lever-press avoidance response in mice: baseline-dependent changes. AB - Effects of diazepam (0.5, 1, 2 and 4 mg/kg, sc) and pentobarbital (5, 10, 20 and 30 mg/kg, sc) on discrete lever-press avoidance response in the dd strain mice were investigated in consideration of the baseline avoidance levels. The dose effect relations were obtained with 4 groups of mice showing the baseline avoidance rates of 0-24% (Group 1), 25-49% (Group 2), 50-74% (Group 3) and 75 100% (Group 4). In Group 1, both diazepam (0.5-2 mg/kg) and pentobarbital (5-20 mg/kg) increased the avoidance rate without a marked change in the response rate (frequency of lever-pressings). A significant increase in the avoidance rate was observed when 1 mg/kg of diazepam and 10 mg/kg of pentobarbital were administered. In contrast, both diazepam and pentobarbital decreased the response and avoidance rates in Groups 2-4. These results suggest that the effects of diazepam and pentobarbital on the avoidance response in mice vary depending on the baseline avoidance levels. PMID- 3832689 TI - Polymorphism of EsD by isoelectric focusing: description of the new allele EsD*Kofu and phenotyping in bloodstains. AB - The polymorphism of EsD was investigated in 1115 unrelated Japanese individuals by isoelectric focusing. Besides the three common phenotypes two heterozygotes EsD 7-1 and EsD 7-2 were observed. The gene frequencies were: EsD*1 = 0.6234, EsD*2 = 0.3663, and EsD*7 = 0.0103. In addition, a rare variant was detected in a probandus living in the city of Kofu. The family analysis suggested the hereditary occurrence of a new allele EsD*Kofu. The isoelectric focusing method was successfully applied to phenotyping EsD in bloodstains; each phenotype was demonstrated at 37 degrees C for up to 2 weeks, at room temperature for up to 9 weeks, and at 4 degrees C for over 20 weeks after stain formation. PMID- 3832690 TI - [Stability of beta-HCG in old blood stains]. AB - Pregnancy was diagnosed from old blood stains by means of radioimmunoassay of beta-HCG. Up to 45 days, the age of the blood stains did not influence values, and extraction by ultrasound did not improve the results. PMID- 3832691 TI - [A new sign for the establishment of gunshot in suicide?]. AB - Two cases involving deadly bullet shots to the head are reported (entry wounds at the right temple, shots fired at absolutely close range, 7.65 or 9 mm caliber). In both cases bleeding was determined in the fissure of the right shoulder joint. This bleeding can be explained by hyperextension and extreme position of the joint at the time of the gun firing. Should further cases of bleeding be confirmed during additional autopsies, then this bleeding could be an indication of death "by one's own hand." PMID- 3832692 TI - [Short wave therapy in diabetic prodromata]. AB - Short-wave therapy has been an established form of therapy for many decades and is unanimously regarded as harmless when properly applied. The possibility of burn injuries occurring is known, yet hardly any cases have been reported. In the case under review, a diabetic, after only a short treatment, suffered very severe burns that ultimately led to the amputation of three toes. Clinical and histopathological analysis established the presence of mediasclerosis of the large leg arteries as well as microangiopathy and peripheral neuropathy. These findings explained why, despite proper application of the short-wave therapy, severe complications arose that had so far not been observed. The findings are discussed from the medicolegal and histopathological view, with indications of the special type of physical trauma. PMID- 3832693 TI - [Frontal collision in the reclining-sitting position. Medical and legal aspects]. AB - An account is given of a head-on collision involving a sleeping female who was a front-seat passenger in a sitting-reclining position and who was not wearing a safety belt. Biomechanical, clinical and radiological findings are reported (longitudinal fracture at the L3, vertebral compressions, intervertebral disc lesions, vertebral arch lacerations and incomplete paraparesis from L2 distally. In the course of several lawsuits leading up to the Federal Supreme Court, two judgments were pronounced that outline the legal obligations of the driver towards sleeping front-seat passengers. In this case, there was a conviction on account of "neglect." A district (LG) and an appellate court (OLG) acknowledged the liability of the driver for injury to person and property damages. The fact that he had not awakened the women passenger to draw her attention to the necessity of fastening the safety belt in a sitting position and in this way giving her the opportunity to make her own responsible decision was considered as "at least contributory" towards the damages sustained in the accident. The settlements regarding the private insurance liability are also derived from these rulings. PMID- 3832694 TI - Ventricular haemorrhage. AB - Our clinical experiments with a simulation of intracerebral haematomas in hypertonics and our clinical experiences lead us to the conclusions that a pure isolated ventricular haemorrhage causes according to the quantity of blood only a gradual increase of intracranial pressure. Pia's three classical types are marking points on the continual scale from haematocephalus totalis to haemorrhage. Haematoma rupture into the ventricles is to a certain degree a beneficial increase of intracranial volume reserve. Pia's types can be supplemented with the so called "pseudoventricular haemorrhage" in which the haematoma only bulges into the ventricle and is covered by ependym. Hypertonics with the bleeding into basal ganglias do not die as a result of blood bursting into the ventricles, but owing to secondary brainstem compression. Ventricular haemorrhage is therefore not decisive for the indication of an operation. In the case of a pure ventricular haemorrhage with signs of intracranal hypertension a bilateral external drainage should be carried out. PMID- 3832695 TI - [Cervical hemangioendothelioma in childhood]. AB - A report is given on the course of the disease in a 6.2-year-old girl with a cervical, histologically verified malignant haemangioendothelioma, who died two years after the appearance of the first symptoms. In connection with this case, the scarce information in the literature about this kind of tumour is analysed and differential diagnostic discussions of vascular tumours, such as the benign haemangioendothelioma, benign and malignant haemangiopericytoma, haemangioblastoma and angioblastic meningioma are presented. PMID- 3832696 TI - Clinicopathological classification of chronic subdural hematoma. AB - Clinicopathological classification of chronic subdural hematoma was made, based on a study of 135 cases; chronic subdural hematoma with a visible inner membrane (type I: 123 cases), acute subdural hematoma in chronic healing stage (type II: 8 cases), and chronic subdural effusion of hemorrhagic type (type III: 4 cases). Type I is an expanding lesion, due to repetitive hemorrhage from outer membrane. It is a traditional hematoma with a distinct inner membrane. Type II is a late healing stage of a previously unrecognized or unoperated acute subdural hematoma, and not an expanding lesion. It has a subdural granulation tissue of irregular thickness with little rebleeding tendency, but it lacks a visible inner membrane. Type III is a variant of chronic subdural effusion, in which a minimum amount of fresh blood is added to a maximum amount of xanthochromic fluids. The latter contains an extremely low level of LDH. PMID- 3832697 TI - [Clinical aspects, therapy and morphology of epidermoids in the 3d ventricle]. AB - Statistically, there is one epidermoid in the IIIrd ventricle among 10000 space occupying intracranial processes. The symptoms are uncharacteristic. The surgical accesses to the IIIrd ventricle are discussed on the basis of examples of such cases. When a foramen monroi blockade is present, the tranventricular approach via the right anterior horn appears to be advisable. The epidermoids in the IIIrd ventricle are frequently changed in a considerably regressive manner and thus cystic. As malformations they are probably identical with the so-called foramen Monroi cysts and the Septum Pellucidum cysts. PMID- 3832698 TI - The problem of cauda equina nerve root identification. AB - Ventral and dorsal nerve roots can be identified in the cauda equina partly by a combined anatomical-electrical method. The cross-section of dorsal and ventral roots in the lower thoracic and lumbo-sacral range are somewhat spherical with the exception that the large roots are more elliptically shaped. Ventral roots consist mainly of one subgroup, dorsal roots normally of several. The larger diameter of ventral and dorsal roots are about 1 mm in the lower thoracic region. It rises to about 2 mm between L 3 and S 1 and then reduces again. The dorsal roots are always slightly bigger than the ventral ones. Nerve roots can be easily identified by their rootlets. More ventral roots can be identified without having access to the rootlets by continued counting from the last distinguished rootlet, knowing that the last thick root is the S 1 root. The reduction in size from the first ventral sacral root (2 mm) to the second (1.2 mm) is so pronounced that it can normally be recognized. Dorsal roots also reduce in size in the sacral range. But because each dorsal root consists of several subgroups they cannot be counted up and identified. Of some anatomical help is the following: the dorsal roots emerging from the conus medullaris form on each side a bulk, and the top of this bulk consists mostly of the S 1 root and the medial falling phase of the S 2 root. In the liquor free cauda equina about 5 cm away from the medullaend the two bulks fall to the middle and touch each other.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832699 TI - [Diagnostic value of epileptic seizures in cerebral gliomas]. AB - On the basis of 346 glioma patients operated on in the years 1969-1983, the frequency of epileptic seizures and their importance for the diagnosis as well as the causes of the delay in clearing up the clinical picture were ascertained. Of the 226 patients with an astrocytoma, 51.5 per cent had one or several epileptic fits in the pre-operative period. For the 99 glioblastoma patients, the seizure rate was 33.7 per cent and for the 21 patients with an oligodendroglioma it was 69 per cent. Although in about 80 per cent of the cases epileptic fits were the first symptom of the disease, this important clinical sign led in only 30 per cent to a causal treatment. In another 20 per cent of the courses, the final clarification was initiated by an increase in the frequency of the fits or a change of the kind of the fit. In the remaining 50 per cent of the glioma patients it was only after the additional occurrence of neurological disturbance that the diagnosis could be verified and surgical treatment carried out. PMID- 3832700 TI - [Intracranial late abscesses following injuries caused by grenade splinters]. AB - On the basis of 6 cases of late cerebral abscesses after lesions caused by shell splinters treated by us, clinic, diagnostics and therapy of this complication are discussed in detail. In 3 patients there were no direct relations between the splinters and the abscesses so that further factors (age, vascular wall changes, and the like) must play a role in the formation of the abscesses; such vascular wall fibroses were found histologically in 3 of the examined abscess capsules. In 3 cases the bacteriological identification of the pathogens was possible. The treatment was carried out by employing puncture or extirpation or the combination of the two methods. PMID- 3832701 TI - Activation of duck prothrombin by factor Xa and thrombin. AB - Prothrombin isolated from duck sodium citrate plasma was activated in a system containing duck factor Xa and calcium ions. Polyacrylamide gel electrophoresis showed that intermediates and the final product, thrombin, of Mr in the range 21 500-52 000 were present in the incubation mixture Serine and isoleucine were found to be the N-terminal amino acids of the intermediate form 1 and thrombin, respectively. PMID- 3832702 TI - DNA repair and sensitivity of mouse embryo fibroblasts to methyl methanesulphonate and N-methyl-N'-nitro-N-nitrosoguanidine. AB - DNA repair synthesis and cytotoxicity were evaluated in early passage mouse embryo fibroblasts from five inbred strains (B10, CBA, C3H/A, DBA/2, BALB/c) and in BALB/3T3 IL-2 cells after the cultures had been treated for 3 h with methyl methanesulphonate (MMS) or N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). In the presence of hydroxyurea, the incorporation of tritiated thymidine into the MMS- or MNNG-treated cells derived from B10, CBA, C3H/A or DBA/2 mice, was, at the concentrations used, significantly higher than into controls untreated with the mutagens. Under analogous experimental conditions there was no detectable DNA repair synthesis in two kinds of cells derived from BALB/c mice. MNNG was more cytotoxic to the cells derived from BALB/c mice than to those of the four remaining strains. The sensitivity of all kinds of early passage mouse fibroblasts to MMS was similar at each MMS concentration tested. Cloning efficiency of BALB/3T3 IL-2 cells exposed to MMS at the concentration of 10(-3) or 10(-4) M did not differ from that of untreated controls. The latter cells treated with MNNG at the concentration of 10(-4) or 2 X 10(-4) M did not develop colonies. PMID- 3832703 TI - Effect of cytosol on DNA synthesis in isolated mammary gland nuclei from rabbits during pregnancy and early lactation. AB - The in vitro DNA synthesis of nuclei isolated from rabbit mammary gland was stimulated by a cytosol fraction from the same tissue. Time-course of this phenomenon was followed during rabbit pregnancy at 5-day intervals. The stimulation was shown to be physiological state-dependent in that it could be detected only in the case of cytosols prepared on day-10 of pregnancy and from day-20 or 25 of pregnancy through day-5 of lactation. Moreover, only nuclei isolated on days-15 or -30 of pregnancy responded to the exogenously added cytosol. The DNA-stimulating activity was partially characterized. It was shown to be protein-like since it was heat-labile, mostly non-dialysable and sensitive to N-ethylmaleimide and trypsin treatment. Sedimentation analysis on sucrose density gradients separated this activity into 3-4 peaks, distinct from the cytoplasmic DNA polymerase. PMID- 3832704 TI - Isolation and partial characterization of the trypsin inhibitor from the seeds of Brassica oleracea var. sabellica. AB - A trypsin inhibitor was extracted from the kale seeds with 0.01 M-HCl, precipitated with ammonium sulphate, and purified by affinity chromatography on immobilized trypsin and ion-exchange chromatography on QAE-Sephadex A-25. The inhibitor, of Mr 8 000, is composed of 64 amino acid residues and contains neither threonine nor methionine. Its isoelectric point is 8.9. In addition to trypsin, the inhibitor acts on subtilopeptidase A and shows a very weak antichymotrypsin activity. The factors modifying the arginine residues inactivate the inhibitor. A modified form of the inhibitor (with a broken reactive site peptide bond) has been isolated in pure form, and its properties were compared with those of the virgin form. PMID- 3832706 TI - Mobilization of hypothalamus acetylcholinesterase from bound to soluble fraction by electrical stimulation of the rabbit sciatic nerve. PMID- 3832705 TI - [Effect of a maternal diet deficient in vitamin B6 on the growth of suckling rats]. PMID- 3832707 TI - Visual evoked potentials in insulin-dependent diabetics. AB - The latency of pattern-reversal VEPs was studied in type I insulin-dependent diabetics without retinal and extraocular involvement. One hundred eyes of 50 diabetics (mean age 19.8 +/- 7.2 years) formed the study group; the duration of the disease ranged between 1 month and 15 years. The latencies of VEPs were progressively delayed in relation to the duration of the disease, becoming more and more evident and stabilizing after about 6 years from the onset of diabetes. The VEP alterations probably indicate alteration of membrane balance or demyelinization. PMID- 3832708 TI - Regional pathology of the small vessels and diabetic micro-angiopathy. PMID- 3832709 TI - Linear ampullary salpingotomy heals better by secondary versus primary closure. AB - The conservative surgical management of ampullary ectopic pregnancy is often performed by linear ampullary salpingotomy. The Author has studied in rabbits healing mechanisms involved following this operation with reference to either primary or secondary closure of the tubal wound. This study seems to demonstrate that the closure of the unsutured ampullary salpingotomy wound occurs with good morphological and functional result in the pregnant rabbit. PMID- 3832710 TI - Pregnancy rates after tubal surgery in different etiological groups of infertility. AB - An analysis was made of the history of 302 patients who underwent laparotomy for tubal infertility. The following potential risk factors and their relationship to the pregnancy rate and outcome of pregnancy were studied: various groups of gynecological laparotomy, salpingitis, gonorrhoea, complicated and uncomplicated appendicitis, induced and spontaneous abortion and IUD-usage. 234 of the 302 patients (77.5 per cent) had one or more of the potential risk factors in their history. Salpingitis was the most frequent risk factor (36.1 per cent). Regarding pregnancy rate after tubal surgery the most serious risk factor was a previously performed gynecological laparotomy, followed by salpingitis, gonorrhea and complicated appendicitis. We found a gradual decrease in the pregnancy rate with increasing number of risk factors. PMID- 3832711 TI - The usefulness of sequential isotopic angiography of the scrotum for study of the varicocele. AB - 132 patients were examined by Sequential Isotopic Scrotal Angiography (SISA) to determine whether or not they had primary varicoceles. The results with SISA were more reliable than those of clinical examination and scrotal telethermography. It is a rapid, simple and essentially harmless procedure that also provides pictures that can clearly present the situation to the patient. The principal indications for the examination are to confirm the presence of small varicoceles and to look for clinically non-detectable (subclinical) varicoceles. PMID- 3832712 TI - Prostaglandin E and F concentration in the fimbria of the rabbit fallopian tube increases at the time of ovulation. AB - To see if the fimbrial concentrations of Prostaglandin E (PGE) and Prostaglandin F (PGF) change in the process of ovulation, these prostaglandins were measured in the fimbriae of one group of 18 doe rabbits using the specific radioimmunoassay; 13 rabbits were bred so as to induce ovulation and 5 rabbits were not bred. The PGE and PGF in the fimbriae of the 13 bred rabbits were 105.4 +/- 18.5 pg/mg of protein and 186 +/- 26.9 pg/mg protein, respectively. In the 5 control unbred animals, the fimbrial PGE and PGF concentrations were 39.6 +/- 5.9 pg/mg protein and 111 +/- 14.7 pg/mg protein, respectively (p less than 0.05). In an additional group of 8 rabbits (2 before ovulation and 6 after ovulation), it was found that the rise in the PGE and PGF concentration association with ovulation was maximal in fimbriae harvested immediately before ovulation (8 hours-8 hours 30 postcoitally) (p less than 0.001). These findings are consistent with the hypothesis that fimbrial PGE and PGF play a role in the process of ovum retrieval in the rabbit. PMID- 3832713 TI - Effect of gossypol on immature male rats. AB - In immature male rats the body growth rate, the testis and epididymis weight were not affected by gossypol treatment (4, 8 and 40 mg/kg body weight/24 hrs. for 30 days). There was however a marked reduction in the weight of the prostate after high dose gossypol administration. Furthermore gossypol treatment did not show any effect on the histoarchitecture of the testis nor did the drug treatment have any effect on sperm motility. The plasma levels of testosterone, LH and FSH in gossypol treated animals were no different from those on the controls. PMID- 3832715 TI - Diagnosis of cervical lesions from human papova virus. AB - The impact of human papillomavirus (HPV) infection in genital pathology has been clarified relatively recently and its relevance appears to be parallel to the liberalization of sexual customs. Aside from some aspects of the infection grossly evident to the naked eye, an increasing number of sub-clinical lesions, that can be colposcopically identified as "flat condylomata" is commonly revealed by cytologic screenings. The Authors report their experience in the diagnosis of this frequent pathology in gynecologic practice, underlining the importance of more fine laboratory investigations, mostly ultrastructural and immunohistochemical. PMID- 3832714 TI - Anti-implantation activity of some indigenous plants in rats. AB - Various extracts of one hundred and eight medicinal plants were screened for their anti-implantation activity in female albino rats. Out of these, 50% ethanolic extract of Codonospis ovata Benth (PL); 50% ethanolic, acetone and benzene extracts of Puararia tuberosa DC (TUB); aqueous and methanolic extracts of Punica granatum Linn. (PX) and ethanolic and acetone extracts of Rubus ellipiticus Smith (PX) inhibited pregnancy in 70-90% of rats. Similarly ethanolic extract of Adhatoda vasica Nees (LF) and Kigelia pinnata DC (PL); ethanolic and acetone extracts of Acrostichum aureum Linn. (PL), Juniperus communis Linn. (SD), Lepidium capitatum H.f. & T. (PL); ethanolic and benzene extracts of Citrulus colocynthus Schrad (LF) and acetone extract of Codonopsis ovata Benth (PL) showed 60-70% anti-implantation activity. Extracts of a few plants VIZ. Dolichos biflorus Linn. (SD), Ferule orientalis Linn. (PL), Nerium odoratum Lamk (RT), Randia dumetorum Lamk (SD) and Ruta graveolens Linn. (PL) could inhibit pregnancy in 50-60% of rats. The rest of the plants were either inactive or showed insignificant antifertility activity. PMID- 3832716 TI - [Proliferative and functional activity in the liver of the normal and precancerous rat]. PMID- 3832717 TI - [Resectability criteria for liver tumors]. PMID- 3832718 TI - [Hepatocellular hyperpolarizing factors and regeneration after partial hepatectomy in the rat]. PMID- 3832719 TI - [Role of ethyl alcohol in the etiopathogenesis of reflux esophagitis. Review of the literature]. PMID- 3832720 TI - [Eosinophilic gastroenteritis. Observation of a case with diffuse lesions and involvement of peritoneal serosa]. PMID- 3832721 TI - Bromide intoxication due to chronic intake of a bromide containing antacid. PMID- 3832722 TI - [Extra-intestinal localization of non-typhoid salmonellosis. 10 case reports]. PMID- 3832723 TI - [Surgical treatment of chronic mesenteric ischemia]. PMID- 3832724 TI - [Partial embolization of the spleen. Apropos of a case report--review of the literature]. PMID- 3832725 TI - Oxyphenbutazone-induced sialadenitis, intrahepatic cholestasis and pancreatitis. PMID- 3832726 TI - Differential enrollment in twin registries: its effect on prevalence and concordance rates and estimates of genetic parameters. AB - In the NAS-NRC Registry, all major diseases are more common in DZ than in MZ twins. Furthermore, concordance rates for most disorders are lower in the registry than would be expected. In this article we propose a general model which seeks to explain these phenomena. The model explores the impact of traits which increase or decrease the probability of enrollment of individuals given that the registry, like the NAS-NRC, includes only pairs where both members are enrolled. If the trait decreases the probability of selection into the registry, both the prevalence of and concordance for the trait in the registry will be lower than that found in the population. A trait which increases the probability of selection has the opposite effects. However, the magnitude of these effects are a function of the population concordance. If population concordance differs in MZ and DZ twins, the effect of differential enrollment will not be the same for the two zygosity groups. The article examines the impact of differential enrollment on estimates of heritability and common environment and explores ways in which estimates of prevalence and concordance rates can be obtained which are free of the bias introduced by selection. PMID- 3832727 TI - NOR variability in twins. AB - The number of AgNOR (NOR+) and the amount of AgNOR (NORM+) were analysed by means of two multilevel analyses of variance in a total of 12 twin pairs: 3 female and 4 male MZ and 5 male DZ pairs. In the first analysis, only zygosity was controlled; in the second, chromosome types D and G were controlled as well as the interaction between chromosome type and zygosity. For NOR+ and NORM+, when chromosome types D and G are not distinguished, the within-pair variance is greater, though not significantly, in DZ than in MZ pairs; but it is highly significantly greater when chromosome type (D or G type) is under control. This confirms an important genetic determination of NOR+ and NORM+ when in the ANOVA model the D and G types are controlled. However, nongenetic factors also influence the Ag-NOR patterns, but not enough to conceal the genetically defined rDNA pattern. Indeed, about 50% of the cells transcribe their rDNA in a way not closely dependent on the rDNA background and significant intrapair differences of NOR+ pattern exist in MZ twins. PMID- 3832728 TI - Zygosity partitioning of small twin samples. AB - When the Weinberg estimate of the proportion of monozygotic pairs is quite deviant from that in the source population, it is likely to be wrong because Weinberg's difference is much less stable than the zygosity proportions. A formula is proposed for the probability distribution of possible compositions of a small sample of twins based on sex concordance in the sample and zygosity proportions in the source population. PMID- 3832729 TI - Premature contractions: are they caused by maternal standing? AB - In 33 out of 51 women studied in late gestation, the uterus was found to phasically compress the pelvic vessels and impede the venous blood flow during quiet standing. This caused a reduction of the cardiac stroke volume with resultant reduction of systemic blood pressure and a compensatory increased heart rate (range of increases 9-51 beats/min). In all cases uterine contractions (mostly subclinical) coincided with the phase of circulatory readjustment. Apparently, the contracting uterus, by changing its position and/or shape, relieves the venous obstruction and prevents decompensation. In the women displaying the uterine compression syndrome (UCS), uterine activity was markedly increased in standing compared to the left recumbent position. It was also investigated whether the UCS appeared more often and earlier in gestation in women with twins. In all 9 women with twin pregnancies (mean gestational age 28 5/7 weeks) the UCS associated with uterine contractions was apparent in the standing posture. Although at present no definite conclusions can be reached on the effect on the cervix of these contractions, quiet standing especially in twin pregnancies seems to provoke an increased uterine activity and should therefore be avoided. PMID- 3832730 TI - Discordant monozygotic twins with trisomy 13. AB - Monozygotic twins with typical trisomy 13 are reported. Despite an identical karyotype, the twins were dimorphic for the presence of an omphalocele. Reasons for the rarity of MZ twins with trisomy 13 are presented. It is suggested that the presence of a chromosomal abnormality in MZ twins may predispose to dimorphism. PMID- 3832731 TI - Is routine hospitalization in twin pregnancy necessary? A follow-up study. AB - During the years 1979-1980, a prospective study was carried out to evaluate the value and efficacy of routine hospital bed rest in the prevention of premature birth and pregnancy complications in twin gestation. This was done by comparing hospital bed rest to special antenatal care at outpatient clinic. Since the results did not support the idea of using routine hospital bed rest, this was abandoned. Because the material was rather small, the results of the changed policy of management were controlled in the present follow-up study. The material consists of 102 twin pregnancies diagnosed during the years 1982-1983. The number of deliveries before the 34th gestational week and of less than 1500 g weighing infants were still decreasing (9.0% and 3.0%). Perinatal mortality after the 24th gestational week was 2.0%. The follow-up study confirmed the unefficacy of routine hospital bed rest. Early diagnosis is the basis of the management of twin pregnancy. This allows counselling of the pregnant women, regular examinations to detect pregnancy complications, and also planning of the delivery. PMID- 3832732 TI - An assessment of perinatal mortality in twin pregnancies in Dundee. AB - An analysis of all perinatal deaths occurring in twin pregnancies in Dundee women from 1956 to 1983 was performed. The uncorrected perinatal mortality rate fell from 116/1000 births in 1956-60 to 16/1000 births in 1981-83, this fall almost entirely taking place after 1975. Causes of death were identified using the Aberdeen Classification and a reduction in deaths in all cause groupings occurred. About half of the deaths were in the Premature, Cause Unknown group and a marked decrease in deaths in this group made the largest contribution to the improved perinatal mortality rate. This fall was partly due to a reduction in the incidence of extreme prematurity and low birth weight. Changes in obstetric management which may have influenced outcome included the introduction of routine early pregnancy ultrasound scanning, the use of tocolytic drugs, intrapartum fetal monitoring, epidural analgesia and an increase in Caesarean section rate from 2% in 1956-60 to 39% in 1981-83. PMID- 3832734 TI - Arterial blood pressure--the pattern of change in twin pregnancies. AB - An epidemiological study of all primigravid twin pregnancies delivered in Aberdeen between 1950 and 1969 was performed to determine the pattern of arterial blood pressure changes. There is a greater fall from non-pregnant levels in diastolic blood pressure by mid pregnancy and a greater rise of diastolic pressure by delivery. These changes are independent of age, body size and rate of weight gain during pregnancy. The expected increased incidence of proteinuric pre eclampsia is also independent of rate of weight gain when defined for twin pregnancies. PMID- 3832733 TI - Do breech presentations in twins and singletons run different risks? AB - We have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech. PMID- 3832735 TI - Cardiac output in twin pregnancy. AB - No significant difference has been found in either stroke volume or cardiac output between twin pregnancies and singleton pregnancies. Cardiac output is less in preeclamptic twin pregnancies. PMID- 3832736 TI - Fetal alcohol syndrome in twin pregnancy. AB - In recent years, it has been realized that some infants of frankly alcoholic mothers escape the stigmata of fetal alcohol syndrome (FAS) and others have only a few of the characteristics. These infants are thought to display fetal alcohol effects (FAE). The controversy regarding the amount of alcohol a woman can safely drink during pregnancy and the effects of timing and individual physiology on producing FAS vs FAE in the infant are important questions which can perhaps be partially answered through examining twin pregnancies and offspring. Data are presented regarding the long-term growth and development of a set of dizygotic twins, one with FAS and one with FAE, delivered to a mother who drank moderate amounts of alcohol during pregnancy. The variation in the degree of abnormality found in dizygotic twins exposed to similar amounts of alcohol at the same time during gestation indicates that differences in fetal susceptibility to ethanol dysmorphogenesis are of prime importance to the expression of the fetal alcohol syndrome. PMID- 3832737 TI - A simple model of cell cycle dynamics with application to estimation of cell cycle parameters. PMID- 3832738 TI - [Effectiveness of anti-HBs immunoglobulin used after contact with infectious material]. PMID- 3832739 TI - [Preliminary evaluation of the effect of anti-HBs immunoglobulin used in medical personnel at high risk of infection with the hepatitis B virus]. PMID- 3832740 TI - [Usefulness of the detection of anti-leukocyte antibodies for predicting the reaction after transfusion of granulocyte concentrates]. PMID- 3832741 TI - [Evaluation of the indirect fluorescent antiglobulin test (PFTA) for detecting anti-platelet alloantibodies]. PMID- 3832742 TI - [Procoagulant of Guerin's epithelioma]. PMID- 3832743 TI - [Composition and properties of heparin and protamine complexes formed in the plasma]. PMID- 3832744 TI - [Acquired sideroblastic anemia. Hematological and clinical analysis of 30 cases]. PMID- 3832745 TI - [Results of a phase II study on the treatment of hairy cell leukemias with various doses of alpha-2-recombinant interferon]. AB - Hairy-cell leukemia has been shown to be extraordinary sensitive to treatment with alpha-interferon. In order to define clinically effective interferon doses associated with minimal toxicity two different dose regimens were applied in this clinical trial: firstly, a conventional dose schedule, and secondly, a biologically defined dose regimen. For dose finding in the latter group, neopterin, a GTP degradation product produced by macrophages under control of interferon, was chosen. Six patients (Group A) received conventional doses of recombinant interferon--alpha-2 (rIFN-alpha-2) 3 X 10(6) U/sqm/daily by the subcutaneous route. Five patients (Group B) were treated with the minimal dose of rIFN-alpha-2 which had previously been shown to induce maximum neopterin levels in urine. Already interferon doses in the range of 3 to 5 X 10(5) U/sqm2/daily administered subcutaneously proved to be sufficient for triggering maximum neopterin excretion in the urine. After six months of interferon treatment all patients were evaluable. At this time both doses regimens proved to be effective in terms of their anti-leukemic activity, but differed significantly in toxicity, which was only seen in Group A patients. PMID- 3832746 TI - [Significance of pancreatic polypeptide in gastrointestinal diseases]. AB - Release of pancreatic polypeptide (PP) into blood by pancreatic PP cells is closely correlated with pancreatic exocrine secretion and is thus stimulated by food intake. PP causes inhibition of exocrine pancreatic secretion and bile acid output. In insufficiently treated diabetics elevated basal and postprandial serum levels of PP are found, which return to normal when adequate treatment is administered. In patients with autonomous diabetic neuropathy insulin induced hypoglycemia leads to subnormal increases of serum PP levels. Low PP secretion is found in chronic pancreatitis only when pronounced pancreatic insufficiency is observed. In patients with duodenal ulcus significantly elevated but also normal serum PP concentrations were found. Endocrine active pancreatic tumors may cause highly increased PP levels together with other hormones and elevated serum PP levels may be used as a diagnostic indication in such rare cases. However the determination of PP serum levels is not suited as a routine diagnostic method. PMID- 3832747 TI - [Two cases of fusion of the musculocutaneous and median nerves]. PMID- 3832748 TI - [Application of silver impregnation to peripheral nerve fiber analysis in topographic anatomy--a communicating branch of the lateral sural cutaneous nerve to the sural nerve in the crab-eating monkey (Macaca fascicularis)]. PMID- 3832749 TI - [Light and electron microscopic study of lectin binding sites in human esophageal epithelium]. PMID- 3832750 TI - Multiple compartmentalization in the fiber architecture of the rat masseter muscle. PMID- 3832751 TI - Several anomalies of the cardio-vascular system found in a cadaver. PMID- 3832752 TI - [The postnatal development of the renal pelvic and calyx epithelium of the golden hamster: a scanning and transmission electron microscopic study]. PMID- 3832753 TI - [A study on the extensor digiti minimi muscle in man]. PMID- 3832754 TI - Classification of the nonstress test and fetal outcome in 1,056 pregnancies. AB - During a 2 1/2-year period, 1 056 pregnant women (1 072 fetuses) were monitored with the nonstress test (NST) in the antenatal period. Testing time was 30 minutes. The NST was classified into one of four classes: normal, suspect pathological, slight pathological, and severe pathological. In 88.5% of the pregnancies, all NSTs were normal. Suspect, slight, or severe pathological NSTs occurred at least once in 8.1%, 2.1%, and 1.3% of the women respectively. All women with a severe pathological NST had high-risk complications. Lethal malformations excluded, there were only two perinatal deaths among the tested women. In the four different classes, the frequencies of cesarean section were 11%, 17%, 41%, and 79%. One-minute Apgar scores were less than 7 in 5%, 12%, 41%, and 64%. The need for referral to neonatal intensive care was 19%, 40%, 41%, and 93% respectively. A normal NST predicted normal fetal outcome in an excellent way, while the three pathological classes appeared to represent different degrees of impending fetal jeopardy. PMID- 3832755 TI - Elevated progesterone levels in serum and ovarian venous blood in patients with ovarian tumors. AB - Peripheral serum concentrations of progesterone were measured in 27 postmenopausal women with malignant, borderline, or benign ovarian tumor and in 10 women without ovarian neoplasm. The progesterone levels were significantly higher in all ovarian tumor groups as compared with the controls. There was no difference between malignant and benign tumors. Patients with a tumor volume over 1 000 ml had higher progesterone levels than patients with smaller tumors, in both peripheral and ovarian venous blood. Mucinous ovarian tumors were associated with the highest progesterone levels, compared with other histologic types of ovarian tumor. The results indicate that mucinous ovarian tumors are able to secrete progesterone and that the stage of malignancy has no effect on this hormonal activity. PMID- 3832756 TI - Endometrial polyps and hyperplasia as risk factors for endometrial carcinoma. A case-control study of curettage specimens. AB - As part of a comprehensive case-control study, the impact of previous endometrial pathology on the risk of developing endometrial carcinoma was investigated. The study comprised 254 consecutive women with histopathologically confirmed cancer of the uterine body in a well-defined population, and their age-matched controls. Ninety-eight (39%) of the patients and 81 (32%) of the controls had previously undergone endometrial curettage. More than one previous curettage was positively associated with endometrial carcinoma (odds ratio = 2.5; 95% CL = 1.4-4.5). Endometrial abnormalities in previous curettage specimens occurred significantly more often among carcinoma patients (57%) than among controls (25%) (odds ratio = 4.0; 95% CL = 2.0-8.0). Twelve patients, but no controls, had adenomatous hyperplasia and this hyperplasia antedated the cancer diagnosis by a mean of 4.6 years. Endometrial polyps were present significantly more often in patients (20%) than in controls (10%) (odds ratio = 3.4; 95% CL = 1.3-9.3). The present results suggest that both of these conditions are risk factors for endometrial carcinoma. Among women who had undergone endometrial curettage more than 4 years after the menopause, 19 out of 30 patients, but none out of 7 controls, showed abnormality in the curettage specimens. Postmenopausal women with endometrial abnormality should thus be regarded as being at risk of developing endometrial carcinoma. PMID- 3832757 TI - Trophoblast samples suitable for long-term culture. AB - Chorionic villi were obtained by a direct vision technique. Villi without vessels (38 cases) failed to grow in vitro, irrespective of the amount of tissue. Vascular villi with an estimated weight exceeding 5 mg (71 cases) grew in vitro- with two exceptions. PMID- 3832758 TI - On the role of estradiol and progesterone in parturition. An updated proposal. PMID- 3832759 TI - Manual breast pumps promote successful breast feeding. PMID- 3832760 TI - Peritoneal tuberculosis imitating ovarian carcinoma "special category". AB - A case report, of a patient with peritoneal tuberculosis in whom the provisional diagnosis of ovarian carcinoma--"special category" was made is presented. As most gynecologists see hardly any cases of peritoneal tuberculosis nowadays, this possible diagnosis--which should always be considered--is reviewed. It illustrates the importance of a definite histopathological diagnosis. PMID- 3832762 TI - [A computerized tomography method for the evaluation of idiopathic avascular necrosis of the femoral head prior to osteotomy]. PMID- 3832761 TI - Typhoid fever complicating pregnancy. AB - Typhoid fever in pregnancy may result in infection of the fetus, with consequent abortion. Currently, it is a rare complication of pregnancy in the industrially developed countries. This report documents a case of maternal typhoid fever with septic abortion, in which trans-placental infection of the fetus caused its demise. PMID- 3832763 TI - Long-term results obtained with a silastic lunate prosthesis for Kienbock's disease. PMID- 3832764 TI - [Complete sensorimotor paraplegia following fractures of the thoracic spine from T1 to T10. Apropos of 9 cases]. PMID- 3832765 TI - [Traumatic dislocation of the hip in children]. PMID- 3832766 TI - [Varusation-derotation femoral osteotomy. Surgical treatment for Legg-Perthes Calve disease]. PMID- 3832767 TI - [Isolated fractures of the tibial diaphysis in children]. PMID- 3832768 TI - [Hyperextension of the knee and Osgood-Schlatter disease]. PMID- 3832769 TI - [Results of 56 acetabular shelf operations--with a long follow-up]. PMID- 3832770 TI - A new polymethylmetacrylate (PMMA) introduction system. Experimental tests. PMID- 3832771 TI - Entrapment of the ilio-inguinal nerve. PMID- 3832772 TI - [Influence of three cardiac glycosides on the hemodynamic effects in guinea pigs]. PMID- 3832773 TI - [Scanning electron microscope observation on the tegumental surface alterations of Schistosoma japonicum induced by praziquantel at different developmental stages]. PMID- 3832774 TI - [Synthesis of derivatives of ferulic acid]. PMID- 3832775 TI - [Thermostability of deflocculating agents and its influence on the viscosity of a barium sulfate suspension]. PMID- 3832776 TI - [Pharmacognostic study on the root of fourteen medicinal species in the genus Zanthoxylum]. PMID- 3832777 TI - [Comparative study on the effect of acetylcarnitine and carnitine on experimental hypoxic heart failure and their interactions with strophanthin K]. PMID- 3832779 TI - [Studies on the porphyrin photosensitive drug--YHPD]. PMID- 3832780 TI - [The chlorpheniramine tetraphenylborate PVC membrane electrode and its applications]. PMID- 3832778 TI - [Radioimmunoassay of qinghaosu and artesunate]. PMID- 3832781 TI - Methods for the evaluation of solid state stability and compatibility between drug and excipient. PMID- 3832782 TI - Diffusion of some low molecular weight compounds in sodium hyaluronate. PMID- 3832783 TI - Potential antiarrhythmic agents. II. Antiarrhythmic activity of basic N (substituted phenyl and benzyl)dipeptides. PMID- 3832784 TI - An in vitro model for determination of drug permeability through the cornea. PMID- 3832785 TI - Investigations of the mixing time dependence of the lubricating properties of granular and powdered magnesium stearate. PMID- 3832787 TI - Abstracts of the lectures and posters delivered and demonstrated at the 49th congress of the Hungarian Physiological Society. July 5-7, 1984, Szeged, Hungary. PMID- 3832786 TI - Studies of Swedish marine organisms. IV. Screening of biological activity. PMID- 3832788 TI - Effect of furosemide upon extracellular fluid volume depletion and kidney denervation in rats. AB - The effect of the diuretic Furosemide (4 mg/kg) is tested on rats housed in metabolic, cages. The excretory function of the kidneys is studied over a 2-hour period after Furosemide administration, according to the following parameters: diuresis, glomerular filtration, excretion and excretory functions of sodium, potassium, chlorine and total osmotically active substances. Reduction of the volume of the extracellular fluid (ECF) is induced by intraperitoneal administration of 0.3 M glucose solution in amount equal to 10 per cent of the body mass. Comparative studies are carried out in animals with intact kidneys (IK) and with bilaterally denervated kidneys (DK). The decreased ECF volume is found to limit strongly the diuretic and saliuretic effect of Furosemide. In the experimental animals with DK, the reduced ECF volume reduced the diuretic and saliuretic effect of Furosemide to a considerably lesser extent. In euvolemic animals Furosemide has potentiated effect in the case of DK. The conclusion reached is that intact kidney innervation is necessary for the Na-retaining function of the kidneys in the case of depleted ECF volume. PMID- 3832789 TI - Changes in the conductivity and in the functional refractory period of the atrioventricular node during hypoxia. AB - The experiments were carried out on preparations from rabbit right atrium, containing the sinoatrial node, the interatrial barrier, the atrioventricular node and the His-bundle. Surface electrodes were used to record the atrial and His-electrograms. The conduction time (AH-interval) was measured and the functional refractory period of the node was determined during normoxia (95% O2, 5% CO2) and hypoxia (30% O2, 65% N2 and 5% CO2) for 45 min. Hypoxia causes a considerable delay in conduction. This delay is greater for the shorter coupling intervals and at the higher frequencies of the imposed rhythm. The shifting of the conduction times towards the higher values during hypoxia is not parallel compared with hypoxia. In the case of hypoxia the refractory curve of the A-V node is situated higher than the curve during normoxia, owing to the greater duration of the H1H2 intervals. The functional refractory period is increased and shifted toward the longer coupling-intervals. The results obtained show that during hypoxia the functional refractory properties of the atrioventricular node are impaired, which, combined with the delayed conduction through it, creates conditions for serious disturbances in the function of the atrioventricular conduction system. PMID- 3832790 TI - Spatial magnitude of the normal QRS-complex in the electrocardiogram of rabbits. Velocity and acceleration of the spatial magnitude. AB - The article describes the curves of the spatial magnitude (SM) of the normal QRS complex in 52 rabbits, as well as of the velocity and acceleration of SM as a function of time. The X-, Y- and Z-recordings after McFee and Parungao are subjected to analogue-to-digital conversion and computer-calculation. The SM curve consists of two and less frequently of three peaks, the third peak having the greatest amplitude and the first peak--the smallest. The three peaks are discovered at 16, 41 and 64 per cent, respectively, of the duration of the QRS complex. The results are discussed in relation to data about other mammals and humans. The characteristic points in the curves of the recorded parameters are compared. PMID- 3832791 TI - Changes in the migrating myoelectrical complex of canine gastro-intestinal tract depending on the dietary regime. AB - Experiments were made to study the effect of vegetable protein (soya) and animal protein (meat) on the migrating myoelectrical complex (MMC) in the stomach and small intestine of dogs with chronically implanted electrodes. MMC was tested under different dietary conditions: (1) Diet No 1 comprising animal protein; (2) Diet No 2 poor in protein and diet No 3 with vegetable protein (soya). In the case of protein-deficient dietary regime (diet No 2) disturbance in MMC is observed--spike activity is constantly recorded. First phase of MMC is not observed. The transition from diet No 2 to diet No 3 at the end of the first week is accompanied by a tendency toward the formation of brief rest periods, with a considerable increase in the duration of 100% spike activity. At the end of the 30th day the different MMC phases were not well differentiated. Upon transition from protein-poor regime to diet No 1 during the second week, the different MMC of the stomach and small intestine are very well expressed. The problem of the generation and propagation of MMC is discussed. MMC is considered as a manifestation of the "biological clock" which responds to every change taking place in the organism during its interaction with the environment. PMID- 3832792 TI - Extrapolation of horizontal motion to linear targets of different orientation. AB - In a motion extrapolation task the subjects were asked to press a button at the moment of the imaginary impact between a concealed moving stimulus and a stationary target-line intersecting with the extension of motion trajectory. Horizontal motion of constant velocity was used. The target-line had two possible orientations: vertical and tilted at an angle of 30 degrees with respect to the moving stimulus trajectory. Four extrapolation distances subtending 4.5, 6.0, 7.5, and 9.0 degs of visual angle were used. The target-line was presented 2 s before the disappearance of the moving stimulus. Target-line position and orientation were chosen at random. Four out of five subjects were significantly faster in predicting the impact between the moving stimulus and the tilted target line. The results are compared to data obtained in line-segment extrapolation experiments and the existence of a common mechanism for spatial extrapolation in static and dynamic conditions is discussed. PMID- 3832793 TI - Neuropharmacological screening of newly-synthesized 2-substituted derivatives of the barbituric acid. AB - Neuropharmacological screening is applied of fourteen newly-synthesized 2 substituted derivatives of the barbituric acid (the first seven compounds contain a hydroxylamine group, the rest--a hydrazine group). The derivatives were studied using Irwin's screening test (1964), modified by Nikolova and Daleva (1968), after being introduced intraperitoneally in albino mice of both sexes. Excitatory phenomena prevail in the compounds containing the hydrazine group. The derivatives containing hydroxylamine group manifest predominantly inhibitory action of the central nervous system--hypnotic and myorelaxing activity. The intensity of the hypnotic action of the compounds is due not only to the hydroxylamine group at site 2, but also to the variation of the second substitute at site 5, with ethyl group as constant substitute. Considerable hypnotic effect is observed at the second substitute n-propyl group (HB-2) and its branching (sec. pentyl, HB-7). Two promising compounds for future more detailed studies--HB 7 and HB-2--become apparent. PMID- 3832794 TI - Glutathione reductase and glucose-6-phosphate dehydrogenase in erythrocytes treated with heavy metals. AB - Our previous study (Ribarov et al., 1982) indicated, that the level of reduced glutathione in erythrocytes treated with Ag+, Hg2+, Cu2+ and Pb2+ was decreased. In an attempt to shed light on this phenomenon in the present work glutathione reductase and glucose-6-phosphate dehydrogenase in erythrocytes incubated with heavy metals were investigated. The result obtained indicate that the glutathione reductase is significantly inactivated by Ag+, Hg2+ and Cu2+. The glucose-6 phosphate dehydrogenase activity was found to decrease only in erythrocytes incubated with Ag+ and Hg2+. No correlation between the inactivation of the enzymes tested and the decrease of the level of GSH was observed. A conclusion is made that the decrease of the level of GSH is not due to inactivation of the enzymes tested. PMID- 3832795 TI - Stabilization of cytochrome P-450 in hepatocytes by free radical scavengers of different nature. AB - The stabilizing effects of various free radical scavengers on cytochrome P-450 content in isolated rat hepatocytes were studied. It has been shown that incubation of hepatocytes in vitro leads to spontaneous degradation of cytochrome P-450 to accumulation of lipid peroxidation products, e.g. malonyl dialdehyde (MDA). Activation of lipid peroxidation in hepatocyte suspensions by the Fe2+ ADP+NADPH system results in acceleration of cytochrome P-450 degradation due to a considerable increase in the rate of MDA accumulation. There is experimental evidence about the relationship between these two processes in hepatocytes, i.e. addition of 2-ethyl-6-methyl-3-hydroxypyridine, 2, 6-di(tert)butyl-4 hydroxytoluene, and 1, 2, 3-tri-hydroxybenzene to the incubation medium leads to inhibition of lipid peroxidation and stabilization of cytochrome P-450. 2, 6 di(tert)butyl-4-hydroxytoluene is a much more effective inhibitor of lipid peroxidation in hepatocytes and a more potent stabilizer of cytochrome P-450 than the water soluble 1, 2, 3-trihydroxybenzene and 2-ethyl-6-methyl-3 hydroxypyridine. Hydroxylation of 3,4-benz (alpha) pyrene in hepatocytes is also concomitant with a decrease of MDA accumulation and cytochrome P-450 degradation. Free radical scavengers of phenolic type, both exogenously added or endogenously formed via oxidative metabolism of hydrophobic substrates are powerful stabilizers of cytochrome P-450 in liver cells. PMID- 3832796 TI - [Homosexuality in Colombia]. AB - Homosexuality in Colombia is studied from a psychological point of view. Data are presented concerning proportion of homosexual population in several cities. An investigation of the psychological aspects of homosexuals is described, based on a sample of 100 male homosexuals (ages 18 to 52) from Bogota. Adjustment and adaptation, depression, social life, relations with heterosexuals, with others homosexuals, and general life style, were among the factors investigated. Finally the legal aspects and gay liberation are presented. PMID- 3832797 TI - [Relation between the parents' mental health and the mental health of children in an urban population of Salvador-Bahia]. AB - An epidemiological study of the correlation between parent's mental status and children's psychological health was completed in a representative sample of 1516 adults and 829 children, living in a low-income area of the City of Salvador, Bahia-Brazil. Trained interviewers applied a family questionnaire (20 items on demographic and socio-economic information) and screening symptom scales to all the families (493) in the sample. The survey employed the QMPA (Adult Psychiatric Morbidity Questionnaire) and the QMPI (Child Psychiatric Morbidity Questionnaire), as instruments developed and tested especially for studies in that sociocultural setting. A second step of the survey consisted of a psychiatric examination of all suspected cases, thus allowing for an assessment of validity and reliability of both questionnaires, that showed high sensitivity, specificity and adequate overall misclassification rates. A multiple regression analysis was performed on selected variables. Results showed that mother's scores, family size and child's age are the only variables that reach significance levels to enter the regression model. Father's score showed no isolated effect on children's mental health variation even in interaction with other covariates. However, all the fitted equation explain only 16 per cent of the total regression on the dependent variable. PMID- 3832798 TI - Correlation of anthropometric measures, age, duration of postmenopause and ovarian function with postmenopausal bone status. PMID- 3832799 TI - [Anthropometric study of the physiologic bending of the axial skeleton]. PMID- 3832800 TI - Thyroid stable iodine measurement in patients with hyperthyroidism. PMID- 3832801 TI - [Hereditary intolerance to fructose in a brother and sister]. PMID- 3832803 TI - The 4.1.(-) hereditary elliptocytosis. PMID- 3832804 TI - The influence of erythrocyte deformability in three types of flow situations: continuous, continuous but non uniform, and two phases. PMID- 3832802 TI - [Chromosome changes in ascites]. PMID- 3832805 TI - [Ultrastructure of the kidney in experimental choline deficiency]. PMID- 3832806 TI - [Catheterization of the subclavian vein as vascular access for hemodialysis]. PMID- 3832807 TI - [Sweet's syndrome. A review of 35 cases]. PMID- 3832808 TI - [Prolactinomas and pregnancy]. PMID- 3832809 TI - [Sarcoidosis of the central nervous system and skeletal muscles]. PMID- 3832810 TI - Micromechanical methods to determine haemorheological parameters. PMID- 3832811 TI - Lipid fluidity of red cell membranes assessed with different fluorescent probes. PMID- 3832812 TI - The hemorheometer: a new filtration apparatus. PMID- 3832813 TI - [The second generation of very low-calorie diets]. PMID- 3832814 TI - [Clinical aspects of polycystic disease of the kidney in the adult]. PMID- 3832815 TI - [The activity of N-acetyl-beta-glucosaminidase in primary congenital hypothyroidism]. PMID- 3832816 TI - [Utilization of health services in Social Security: the neurology and nephrology specialty in the Valencia Autonomous Community]. PMID- 3832817 TI - [The natural history of disseminated renal carcinoma: presentation of 45 cases. Statistical evaluation]. PMID- 3832818 TI - [Urothelial tumors of the upper urinary tract]. PMID- 3832819 TI - [Non-functioning tumors of the adrenal glands]. PMID- 3832820 TI - [Bladder injuries: non-iatrogenic ruptures and perforations. Our experience over 20 years]. PMID- 3832821 TI - [Renal multilocular cyst. Presentation of a case]. PMID- 3832822 TI - [Multilocular cystic nephroma associated with tuberculosis and lithiasis]. PMID- 3832823 TI - [Penile metastasis of a renal transitional cell carcinoma]. PMID- 3832824 TI - [Carcinoma of the male urethra. Study of a case]. PMID- 3832825 TI - [Penile-scrotal pyodermitis vegetation and its plastic repair. A case]. PMID- 3832826 TI - [Milk of calcium calculi: a new composition]. PMID- 3832827 TI - [Surgical treatment of a case of fracture of the penis]. PMID- 3832828 TI - [Testicular metastasis of carcinoma of the breast. A case]. PMID- 3832829 TI - [Endoscopic surgery of superficial bladder tumors: a homogeneous series of 146 cases]. PMID- 3832830 TI - [Association of angiomyolipoma and renal adenocarcinoma: histologic, arteriographic and microangiographic correlation]. PMID- 3832831 TI - [Treatment of the complex irritative bladder syndrome with dimethyl sulfoxide (DMSO)]. PMID- 3832832 TI - [Intraurethral condylomata acuminata]. PMID- 3832834 TI - Oxygen transport to tissue VII. Proceedings of the 8th International Symposium on Oxygen Transport to Tissue. August 26-30, 1984, Nijmegen, The Netherlands. PMID- 3832833 TI - [Giant angioma of the penis]. PMID- 3832835 TI - Redistribution of cerebrocortical microflow during increased neuronal activity. PMID- 3832836 TI - Distribution of cerebrocortical microflow in norma- and hypertensive rats: studies in ischemia. PMID- 3832837 TI - Changes in regional cerebrovascular resistance during partial cerebral ischemia in rats. PMID- 3832839 TI - Function and electronmicroscopic structure of anterior horn cells during graduated temporary ischemia (movie film). PMID- 3832838 TI - Discriminant parameters representing cerebral cortical function during anoxic anoxia investigations. AB - In order to quantify the effect of specific drugs on the cerebral cortex an "in vivo" model has been developed for the induction and the observation of anoxic anoxia. Rabbits are used as test animals. Sensors for the assessment of local parameters are chronically implanted: ECoG electrodes are applied; pO2 electrodes are inserted into the cortical tissue. The derived somatosensory evoked potentials are used for evaluating the cerebral cortical function. Animals are cannulated with a tracheal tube, curarized and artificially ventilated. Anoxic anoxia, controlled by a special purpose microprocessor system, may then be induced and repeated in a reproducible way. During the experiments local (pO2, ECoG, SEP) as well as general parameters (ECG, heart rate, systemic blood pressure, rectal temperature) are recorded and stored on analog magnetic tape as well as digitized with the microprocessor system. The cortical pO2 is measured with a polarographic method, the SEP's are obtained on-line by time coherent averaging and the ECoG states (e.g. epilepsy during anoxia) are derived by using band-pass filters and rms detectors. Off-line the signals (pO2, heart rate, mean systemic blood pressure, temperature) are standardized and represented together with parameters derived from ECoG and SEP. SEP-waveform parameters indicating intensity (norm) and similarity with a reference SEP signal (correlation value) are used. The measuring and processing method is still being optimized; special attention is being paid towards the quality of the calculated SEP's which are to be used for the quantification of the cortical function during reference, anoxia and recovery period. As such, in order to improve the signal-to-noise ratio of the SEP's and, consequently, of the derived parameters, ECoG signals are digitized off-line and subjected to a preprocessing, implying filtering and spectral analysis procedures. PMID- 3832841 TI - Heterogeneous pO2 distribution as a consequence of the capillary network. PMID- 3832840 TI - Lumbar and thoracic spinal cord oxygen tension during aortic cross-clamping. AB - In order to investigate the changes in tissue oxygen and the efficiency of the collateral circulation in the different regions of the spinal cord (SC) during aortic occlusion, surface PO2 (sPO2) was measured on the exposed SC in the pig in the lumbar (L3-5) as well as in the thoracic (Th6-8) parts before, during and after a 45 minute occlusion. The pigs were divided into two groups: group IA: cross-clamping of the aorta immediately below the left subclavian artery; group II: occlusion of the aorta immediately above the arteria radicularis magna anterior (ARMA). In response to occlusion, the sPO2 distal to the occlusion always decreased significantly (group IA: mean lumbar sPO2 from 42.3 mm Hg to 3.2 mm Hg, mean thoracic sPO2 from 34.9 mm Hg to 3.9 mm Hg; group II: mean lumbar sPO2 from 28.0 mm Hg to 7.9 mm Hg). Mean thoracic sPO2 in group II remained constant. No statistically significant differences between the distal regions could be established. The collateral circulation in the thoracic as well as in the lumbar region was insufficient at least during occlusion. PMID- 3832842 TI - Myocardial oxygen consumption and autoregulation of the coronary vascular bed. PMID- 3832843 TI - Myocardial oxygen pressure across the lateral border zone after acute coronary occlusion in the pig heart. PMID- 3832844 TI - Distribution of mitochondria relative to capillaries in guinea pig myocardium. PMID- 3832845 TI - Oxygen supply to hypothermic isolated working heart during blood acid-base changes. PMID- 3832846 TI - In situ NADH laser fluorimetry and its application to the study of cardiac metabolism. PMID- 3832847 TI - Variability of intercapillary distance estimated on histological sections of rat heart. PMID- 3832848 TI - The effect of heterogeneity of capillary spacing and O2 consumption--blood flow mismatching on myocardial oxygenation. AB - The effect of heterogeneity of capillary spacing on myocardial oxygenation was estimated for various sizes of tissue cylinder radii ranging from 8 to 18 microns, which are the values expected from the histological measurements. Similarly, the effect of mismatching between myocardial oxygen consumption and capillary blood few was analyzed. The results are summarized in charts which demonstrate that both heterogeneities are important independent tissue oxygen determinants irrespective of the mean values of these parameters. Therefore they should be included in any future evaluation of the oxygen supply to tissue. PMID- 3832849 TI - Oxygen diffusion in a heart muscle fibre. PMID- 3832850 TI - Washout of a diluent bolus from canine hindlimb as an index of red cell transit time. PMID- 3832851 TI - Effects of intermittent capillary flow on oxygen transport in skeletal muscle studied by dynamic computer simulation. PMID- 3832852 TI - Exercise reduces diffusion distances in skeletal muscles of rabbits fed an atherogenic diet. PMID- 3832853 TI - Distribution of local oxygen consumption in resting skeletal muscle. PMID- 3832854 TI - Pyridine nucleotide fluorescence measurements with simultaneous visualization of the microcirculation in skeletal muscle. PMID- 3832855 TI - Redistribution of microcirculation in skeletal muscle during hypoxaemia. PMID- 3832856 TI - Relationship between oxygen deficit and oxygen debt in exercises of different intensity and duration. PMID- 3832857 TI - Metabolic and ventilatory responses to exercise in patients with a deficient O2 utilization by a mitochondrial myopathy. PMID- 3832858 TI - Skeletal muscle PO2 in burn shock. A clinical study. PMID- 3832859 TI - Oxygen supply and microcirculation of the beating dog heart after haemodilution with fluosol DA 20%. PMID- 3832860 TI - Oxygen affinity of hemoglobin solutions modified by coupling with NFPLP and the effects on tissue oxygenation in the isolated perfused rat liver. AB - From these liver perfusions with Hb and Hb/HbNFPLP solutions the following conclusions can be drawn: In spite of the chemical modification of the hemoglobin molecule, no rheological differences are seen. All parameters measured were sensitive to hypoxia induced by a decrease in perfusion flow rate. The NFPLP induced decrease in oxygen affinity was reflected in a higher venous PO2. These in-vivo observations are in agreement with the in-vitro measured oxygen dissociation curves. The difference in PO2 did not result in a change in the other oxygen-sensitive parameters in this model under the chosen conditions. Possible causes for these observations are: the level of hypoxia was too low the oxygen supply in the perfusions with the modified hemoglobin solutions was lower than the oxygen supply in the perfusions with normal hemoglobin. Whether or not this observation is due to an intrinsic property of the modified hemoglobin molecule remains to be established. PMID- 3832861 TI - Red cell O2 transport at altitude and altitude training. PMID- 3832862 TI - Modelling whole blood oxygen equilibrium: comparison of nine different models fitted to normal human data. AB - The ability of nine different models, prominent in the literature, to meaningfully characterize the oxygen-hemoglobin equilibrium curve (OHEC) of normal individuals was examined. Previously reported data (N = 33), obtained using the DCA-1 (Radiometer, Copenhagen), and new data (N = 8), obtained using the Hemox-Analyzer (TCS, Southampton, PA), from blood samples of normal, non smoking volunteers were used and these devices were found to give statistically similar results. The OHECs were digitized and fitted to the models using least squares techniques developed in this laboratory. The "goodness-of-fit" was determined by the root-mean-squared (RMS) error, the number of parameters, and the parameter redundancy, i.e., correlation between the parameters. The best RMS error did not necessarily indicate the best model. Most literature models consist of ratios of similar-order polynomials. These showed considerable parameter redundancy which made the curve fitting difficult. The best fits gave RMS errors as low as 0.2% saturation. The Hill model gave a good characterization over the saturation range 20%-98% with RMS errors of about 0.6% saturation. On the other hand, good characterizations over the entire range were given by several other models. The relative advantages and disadvantages of each model have been compared as well as the difficulties in fitting several of the models. No single model is best under all circumstances. The best model depends upon the particular circumstances for which it is to be utilized. PMID- 3832863 TI - Rheological factors influencing oxygen transfer in heart and brain. PMID- 3832864 TI - Carboxyhemoglobin: determination and significance in oxygen transport. PMID- 3832865 TI - Oxygen permeability of methemoglobin solutions soaked in Millipore filters. AB - For the measurement of gas diffusion through liquids, Millipore filters are an interesting and easy tool. They keep the fluid in place, and layer thickness can be determined precisely and easily. We soaked Millipore type SM filters with solutions containing 1.66 mmol/l methemoglobin to measure the oxygen permeability at 25 degrees C, and compared the results with former measurements in liquid layers. Data scattered between 1.0 and 1.5 10(-11) mol X m-1 X kPa-1 X sec-1 and a decrease with increasing KCl concentration, as found for liquid layers, could neither be confirmed nor rejected. Nitrogen/oxygen permeability ratio of 0.465 +/ 0.016 SE was in agreement with literature data. PMID- 3832866 TI - Post-exercise anemia during examination in rats. PMID- 3832867 TI - In vivo arterial platelet-vessel wall interaction and thrombosis: induction, on line registration and ultrastructural control. AB - A technique for induction and on-line quantification of local platelet thrombi in mesenteric arteries of small laboratory animals was developed and standardized in our laboratory. In the past, this model was used to study the nature of platelet vessel wall interaction in the living animal. The ultrastructure of the experimental intimal lesion and the vessel wall regeneration were assessed by transmission electron microscopy (TEM), both in normal and pathologic conditions. Scanning electron microscopy (SEM) now shows the ultramorphology of platelet thrombi on the experimentally injured arterial segment following topical superfusion with ADP, mepacrine or platelet-activating factor (PAF). The application of these substances, each with proper bio-activity, leads to distinct types of platelet thrombi. Mepacrine or PAF superfusion causes large thrombotic masses, as compared to control, ADP induced thrombi, and seems toxic for the endothelial cells. Mepacrine thrombi differ significantly from PAF thrombi in their platelet density, degree of platelet activation and in their relation to the endothelium that surrounds the experimental lesion. Furthermore, PAF superfusion induces a phenomenon of spontaneous regeneration of the thrombus after its forced embolization. This is probably due to some unknown bio-action of PAF in the vessel wall. PMID- 3832869 TI - Convection/diffusion interactions in oxygen transport: effect of flow reversal in lung airways. PMID- 3832868 TI - Determinates of the lung-surface-pO2. PMID- 3832870 TI - Hypoxic pulmonary vasoconstriction in the newborn pig--an experimental model. PMID- 3832871 TI - Oxygen tension in the fetal scalp during labour. PMID- 3832872 TI - Perfusate oxygenation and renal function in the isolated rat kidney. PMID- 3832873 TI - Regulation of reactive hyperaemia in the kidney. PMID- 3832874 TI - Control of O2 supply to the stimulated exocrine pancreas. PMID- 3832875 TI - Influence of portocaval anastomosis (PCA) on tissue PO2 of renal cortex and skeletal muscle in rats with liver cirrhosis. PMID- 3832876 TI - Extracellular pH responses to different stimuli in the superfused cat carotid body. PMID- 3832877 TI - Mathematical analysis of PO2 and local flow distribution in the carotid body. AB - A common capillary velocity of streaming blood, i.e. a common local flow combined with the geometry of the vascular elements already explains the measured left shifted PO2 histogram. A slight variation of the vascular arrangement can also explain higher PO2 values without the assumption of a very high flow in the capillaries. PMID- 3832878 TI - Membrane potential and Ca influx in hypoxic and normoxic carotid body type-I cells. PMID- 3832879 TI - Human mammary carcinomas in nude rats--a new approach for investigating oxygen transport and substrate utilization in tumor tissues. AB - A new model is presented for the study of oxygen supply and substrate utilization in human tumor tissue. In this approach human tumor material thrives in immune deficient nude rats. The host chosen allows the continuous evaluation of all relevant parameters. From the data obtained so far it is concluded that this model is a valid tool in investigation of the metabolic status of human tumors. PMID- 3832880 TI - Blood flow and oxygen supply to human mammary carcinomas transplanted into nude rats. AB - Blood flow of human mammary carcinomas heterotransplanted into immune- deficient rnu/rnu-rats is low. It decreases further with increasing tumor wet weight, the mean value being comparable to that of mammary carcinomas in patients. The O2 consumption rate of the heterotransplanted tumors decreases with increasing tumor wet weight and again is comparable to that of mammary carcinomas in patients. Furthermore, it is directly proportional to the O2 availability which in turn is mainly determined by TBF. The O2 utilization of the human mammary carcinomas heterotransplanted into nude rats is already high in small tumors and increases only slightly with increasing tumor weight. From these results and taking into account an impairment of convective and diffusive O2 transport it can be concluded that the O2 consumption rate of the tumor cells is mostly determined by the the O2 supply and not by the actual demand of the cancer cells. This finding holds true for different tumor cell lines in different species. PMID- 3832881 TI - Glucose, lactate, and ketone body utilization by human mammary carcinomas in vivo. AB - The glucose uptake rate of human mammary carcinomas transplanted into nude rats is comparable to values obtained in isotransplanted rodent tumors. The glucose uptake decreases with increasing tumor wet weight and is linearly related to the glucose availability. Most tumors release lactate, the rate being linearly related to the glucose uptake rate. Tumors use acetoacetate and beta- hydroxybutyrate as substrates. Additionally, human mammary carcinomas may have the ability for ketogenesis probably depending on the metabolic state. Using the epigastric pouching technique, human mammary carcinoma xenografts in nude rats seem to be a valid model for systematic investigations of the energy supply of human tumors. PMID- 3832883 TI - Stochastic analysis of transport phenomena in heterogeneous tissue. PMID- 3832882 TI - Oxygen supply of the blood-free perfused guinea pig brain at three different temperatures. PMID- 3832884 TI - Quantitative analysis of reflection spectra and tissue metabolites of the blood free perfused guinea pig brain. PMID- 3832885 TI - Simulation of the optical properties of an absorbing and scattering medium using the Monte-Carlo technique compared with two- and six-flux theories. PMID- 3832886 TI - Quantitative analysis of reflection spectra: evaluation of simulated reflection spectra. PMID- 3832887 TI - The calculation of hemoglobin saturation in single erythrocytes. PMID- 3832888 TI - Measurements and processing of intracapillary hemoglobin spectra by using a micro lightguide spectrophotometer in connection with a microcomputer. PMID- 3832889 TI - Regulation of cerebral blood flow (CBF) during hypoxia and epileptic seizures. AB - In conclusion, our results suggest that neither the redox state of cytochrome oxidase nor adenosine are critical factors in the regulation of cerebral blood flow during arterial hypoxia and epileptic seizures. PMID- 3832890 TI - Capillary red cell residence as a measure of tissue oxygen delivery. PMID- 3832891 TI - Development of an in-vitro method for simulation of oxygen transport in the microcirculation. PMID- 3832892 TI - Assessment of cerebral oxygenation via the conjunctiva. PMID- 3832893 TI - Oxygen transfer from gas bubble into liquid. AB - Oxygen transfer from a gas bubble into the surrounding liquid is examined by measuring oxygen pressure with Po2-needle electrodes at different distances from the bubble. From there, the mass transfer coefficient can be calculated. First measurements yielded results in the range to be expected. PMID- 3832894 TI - Proposal for using a standardized terminology on oxygen transport to tissue. PMID- 3832895 TI - The support of scientific controversy. PMID- 3832896 TI - Controversies in alcoholism and substance abuse. PMID- 3832897 TI - The effectiveness of biologic markers to diagnose alcoholism. AB - This study explored the effectiveness of biologic markers in alcoholism where correct diagnosis does not result from relatively simple inspection. After review of the use of individual biologic markers and their limitations, data is presented from a multivariate analysis of 351 young healthy male alcoholics and 339 nonalcoholic male patients in which an overall accuracy rate of 84.3% was obtained. A discussion of what biologic markers may be measuring, issues in sample selection, statistical issues and problems with laboratory variability in the use of biologic markers is presented. PMID- 3832898 TI - Is social drinking during pregnancy harmless? There is reason to think not. AB - This paper reviews the scientific evidence bearing on the safety of social drinking in pregnancy (that is, patterns or levels of alcohol intake that cannot be diagnosed as alcohol abuse or alcohol dependence). Human studies have shown an increased incidence of spontaneous abortion, greater risk for a growth-retarded infant, measurable changes in newborn behavior, differences in development at age eight months, and differences in behavior at age four years, related to patterns of social drinking during pregnancy. Animal studies and in vitro studies of human umbilical vessels add to doubts about the safety of social drinking. In view of the individual differences in susceptibility to alcohol toxicity, the only reasonable policy at this time is to recommend abstinence as the safest course for pregnant women and those planning pregnancy. PMID- 3832899 TI - Is social drinking during pregnancy harmless? AB - The last 10 to 15 years have provided a growing body of evidence that demonstrates a distinct relationship between excessive alcohol consumption during pregnancy and birth defects. In light of this voluminous quantity of research, no responsible health professional or researcher would deny that alcohol can cause fetal abnormalities if consumed chronically and in large quantities. However, close examination of the literature does not support the no threshold corollary- that is that any amount of alcohol will have a detrimental effect on the fetus. At present, it appears that only those women who consume large amounts of alcohol on a chronic basis are at risk of giving birth to children with fetal alcohol syndrome (FAS) and its associated anomalies. Prevention should be aimed at this group of women. Blanket warnings and recommendations for total abstinence may serve little purpose other than to instill unnecessary fear, anxiety and guilt in those women at little or no risk while having no affect on the real target audience; the chronic heavy drinkers. PMID- 3832900 TI - Diagnosis and management of acquired immune deficiency syndrome in intravenous drug users. AB - Acquired Immune Deficiency Syndrome (AIDS) is a clinical entity that is part of a spectrum of immune dysfunction found in specific high risk groups, among them intravenous drug users. In drug users AIDS almost always presents as an opportunistic infection, usually Pneumocystis carinii. The leading etiologic hypothesis is of a viral agent acting, it is possible, on a previously immunocompromised host. Recent research at hospitals affiliated with The Albert Einstein College of Medicine, where an unusually large proportion of AIDS patients are drug users, is described. Suggestions are advanced for the management of IV drug users with immune dysfunction. PMID- 3832901 TI - Medical and psychiatric complications of cocaine abuse with possible points of pharmacological treatment. AB - Acute and chronic medical complications of cocaine abuse are dependent on cocaine's route of administration, purity and sterility. There is a predictable sequence of events which occur during cocaine withdrawal. Cocaine can cause or exacerbate psychiatric symptoms indistinguishable from a classical psychiatric disorder. IV and freebase abuse is more likely to precipitate psychiatric symptoms. Systematic medical and psychiatric evaluation in addition to detoxification allows the detection and treatment of relapse-causing conditions. This permits more intelligent treatment decisions. Possible points of pharmacological intervention are discussed and new treatments proposed. PMID- 3832902 TI - Is the social use of marijuana dangerous or addicting? PMID- 3832903 TI - Naltrexone: its clinical utility. AB - Naltrexone is a long-acting orally-administered opioid antagonist that has demonstrated clinical utility as an adjunct in the outpatient treatment of opioid abuse. Naltrexone can be administered on a daily, twice a week or three times a week regimen, based on the clinical needs of the patient, and the therapeutic goals of the patient and therapist. Because naltrexone is unscheduled under the Controlled Substances Act, any licensed physician can prescribe this drug. This decentralized therapeutic approach for the highly motivated patient permits a ready separation between the patient's drug using friends and his or her current activities. The patients most likely to benefit from naltrexone therapy are employed, married, stabilized on low-dose methadone prior to detoxification, or detoxified from their opioid dependency 7 or more days previously, and are highly motivated to be maintained on a nonopioid chemotherapeutic agent. Naltrexone does not cure dependency. It does assist clinicians in dealing with the medical, psychological and economic problems associated with primary opioid abuse. Naltrexone will work well only when it is part of a larger therapeutic regimen which is tailored to the individual needs of the patient. PMID- 3832904 TI - [Effects of intravitreal injection of sulfobenzylpenicillin on the ERG and the VEP]. PMID- 3832905 TI - [Continuous sine-wave pressure change in perfusion system and corneal edema in the rabbit eye]. PMID- 3832906 TI - [Changes in cortisol levels in the blood and tissues of rabbit eye after intravenous administration]. PMID- 3832907 TI - [Biosynthesis of macromolecules by lens epithelial cells of cataractous mouse (Nakano mouse) cultured on plastic and type I collagen substrates]. PMID- 3832908 TI - [Comparison between the PERG and PVECP obtained with multi-channel recording in multiple sclerosis]. PMID- 3832909 TI - [Reflex mechanism of eye movement associated with blinking reflex in the cat]. PMID- 3832910 TI - Complications and mortality during treatment of fractures of the upper end of the femur in patients incl. diabetics. (Analysis of 597 cases treated in 1968-1979). PMID- 3832911 TI - Treatment of fractures of the leg in elderly patients. (Analysis of 240 cases treated in 1968-1979). PMID- 3832912 TI - Treatment of Colles' fractures in elderly patients. (Analysis of 356 patients treated in 1973-1977). PMID- 3832913 TI - Perforative peritonitis of appendiceal origin. PMID- 3832914 TI - Treatment of children's epiphyseal injuries in the elbow region. PMID- 3832915 TI - [Serum and urinary tissue polypeptide antigen (TPA) in patients with urological cancer]. AB - We measured the serum and urinary TPA in 64 patients with urological cancer, 55 patients with benign urological disease and 37 healthy volunteers. The serum TPA levels in patients with pre-treated cancer were significantly higher than those of healthy volunteers, but showed no significant difference compared to those in patients with a benign urological disease. The urinary TPA levels in patients with pre-treated cancer were significantly higher than those with a benign urological disease, but in some patients with urinary tract infection, very high urinary TPA concentrations were observed. Therefore, the determination of serum and urinary TPA may be useful in detecting urological cancer, but they were not specific tests. On the other hand, as lower serum and urinary TPA levels were observed after treatment of bladder and prostatic cancer, their determinations were considered to be useful in following up patients with these cancers. PMID- 3832916 TI - [Denervation supersensitivity of the detrusor muscle due to bladder overdistension, with special reference to the relationship between supersensitivity, and changes in the connective tissue]. AB - To investigate denervation supersensitivity of the detrusor muscle due to prolonged bladder overdistension, overdistended bladders were produced in female mongrel dogs by bladder neck obstruction for 48 hours and the dogs were sacrified 1, 2 and 4 weeks after overdistension. The sensitivity of the detrusor muscle to acetylcholine was measured using the isometric in vitro technique. The bladder wall tissues were examined with Masson's trichrome staining. The blood flow of the bladder wall was determined by the hydrogen gas clearance method. Sensitivity reached a maximum 2 weeks after overdistension, thereafter decreasing to a lower level 4 weeks after overdistension than that of the untreated detrusor muscle. A decrease of blood supply to the bladder wall, the rate being 63% immediately after overdistension, may result in a degeneration of the axon which is more fragile to ischemic changes. Subsequently axonal degeneration may be followed by denervation supersensitivity of the detrusor muscle. Remarkable fibrotic changes of the bladder wall 4 weeks after overdistension suggested a decrease of the detrusor muscle contraction to acetylcholine. PMID- 3832917 TI - [The introduction of an urodynamic technic synchronized with videocystourethrograms and its data management]. AB - The video urodynamics that simultaneously display urodynamic data with radiographic visualization of the lower urinary tract on television monitors was first described by Miller in 1967. This technique has been developed in a growing number of urodynamic laboratories in North American and European countries. The 2100 uro color video system manufactured by DISA elektronik A/S was introduced into our clinic in September in 1984. We have been aware of the lack of a satisfactory way of measuring the function of the bladder neck and posterior urethra during micturiton. But now, from our experience using this system, we conclude that video urodynamics is a comprehensive means of assessing, lower urinary tract disorders. PMID- 3832918 TI - [Serum sialic acid levels in patients with acute prostatitis or acute epididymitis]. AB - The serum sialic acid concentration in 17 male healthy adults, 11 patients with acute prostatitis and 12 patients with acute epididymitis was measured with a specific enzymatic assaykit. The concentration was studied in relation to erythrocyte sedimentation rate, total serum protein and its fraction, C-reactive protein, and white blood cell count. Blood samples were obtained from the patients immediately before antimicrobial chemotherapy and the subsequent 3, 5, 7, 14, and 28 days. The pretreatment sialic acid concentration in the patients was significantly greater than that in the control subjects (P greater than 0.001). The mean serum sialic acid concentration in the patients reached a maximum level 3 days after the beginning of the treatment, and then gradually decreased. There was a significant correlation between the daily change of the serum sialic acid level and those of the erythocyte sedimentation rate, alpha2 globulin, and alpha1-globulin. Serum sialic acid proved to be a useful biochemical marker in acute prostatitis and acute epididymitis. PMID- 3832919 TI - [Changing modality of the treatment in upper urinary tract calculi. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy]. AB - From March, 1984 to April, 1985, 70 cases of upper urinary tract calculi (73 renal units) were treated by percutaneous nephrolithotripsy or transurethro ureteral lithotripsy, mainly utilizing ultrasonic lithotrite. While in the early period of treatment, two stage procedure of creation of nephrostomy tract and percutaneous nephrolithotripsy was performed for renal and upper or middle part of the ureteral calculi, one stage procedure, nephrostomy tract formation followed by ultrasonic nephrolithotripsy is commonly used in recent cases. During this period, conventional stone surgery was seen in 6 cases of pyelolithotomy and 2 of ureterolithotomy, while 52 cases of stone surgery were performed during the earlier period (from January, 1983 to February, 1984). Renal and upper or middle part of ureteral calculi were successfully removed in 49 out of 58 cases (84.5%). Most of the patients required 1 or 2 trials of percutaneous nephrolithotripsy. Middle or lower part of ureteral calculi were removed in transurethro-ureteral approach in 11 of the 12 cases. Hematuria and fever were most common complications after treatment and 3 patients required blood transfusion after 3 or 4 sessions of nephrolithotripsy. Percutaneous nephrolithotripsy and transurethro-ureteral lithotripsy are now widely used for treatment of upper urinary tract calculi, replacing the conventional surgical treatment. Moreover, very recently, extracorporeal shock wave lithotripsy is available in Japan. To the patients with renal calculi indicative of this treatment, both percutaneous nephrolithotripsy and extracorporeal shock wave lithotripsy are introduced and either way of treatment can be chosen by the patient himself. PMID- 3832920 TI - [The ureteral stent: is it useful?]. AB - Double-J or double-pigtail ureteral stent was used in 7 cases, 6 cases for ureteral obstruction and 1 case for ureterocutaneous fistula in irradiated patients. In 5 cases ureteral stent failed to drain effectively, in 4 of these 5 cases due to stent obstruction by necrotic tissue which led to percutaneous nephrostomy in 3 cases. In 1 case the ureteral stent drained well and in another case effectiveness of ureteral stent was equivocal. We think that ureteral stent is neither safe nor effective for internal divertion except in short term use postoperatively. PMID- 3832921 TI - [Effect of recombinant alpha-interferon on advanced renal cell carcinoma]. AB - The present study was undertaken to assess the efficacy of single agent chemotherapy with alpha A-interferon or alpha 2-interferon for metastatic renal cell carcinoma. alpha A and alpha 2-Interferon were administered i.m. at a primary dose of 3 X 10(6) units/day to 13 patients. Two patients (15%) showed partial response; 1 patient (8%), minor response; 5 patients (38%), no change; 6 patients (46%), progressive disease. These preliminary observations indicate that these interferons are active antitumor agents in patients with renal cell carcinoma. PMID- 3832922 TI - [A case of adult renal hamartoma resembling congenital mesoblastic nephroma]. AB - A 35-year old man was hospitalized for left flank pain. IVP showed left non visualizing kidney with multiple renal calculi. Selective renal arteriogram revealed avascular mass in the left upper pole. The upper calyx was irregularly distorted. Left nephrectomy was carried out. Grossly, the upper pole was replaced by whitish, firm and homogeneous tumor, which was 7 X 7 cm in diameter and protruded into the upper calyx. Histologically, the tumor was composed of both epithelial and mesenchymal components. The epithelial elements consisted of cysts and tubules, and the mesenchymal elements of loosely textured fibroblasts and smooth muscle cells. Other elements could not be identified. This case was diagnosed as renal hamartoma histologically resembling congenital mesoblastic nephroma of infancy. Congenital mesoblastic nephroma is rare in adults. Continued maturation may finally transform it either to benign mixed tumor as in our case or fibromatous tumor if stroma matures dominantly. PMID- 3832923 TI - [A case of renal cell carcinoma found in traumatic ruptured kidney]. AB - A case of traumatic kidney rupture with pre-existing renal cell carcinoma in a 38 year-old male is reported. Macrohematuria appeared 48 hours after left precordial trauma in a traffic accident. Initial diagnosis at the emergency clinic was 9th rib fracture of his left chest alone and no other injury was recorded. A large mass in left abdomen was palpable at urologic OPD, however, and X-ray examination revealed a non-visualizing left kidney in IVP. After the ECHO, CT and arteriography findings gave an impression of left kidney rupture. Left nephrectomy accompanied by partial colectomy of descending colon by transperitoneal approach was performed 25 days after initial trauma. This delay was mainly due to disagreement of patient for surgical treatment because there were no subjective symptom except microhematuria and subsiding fever after transfer to the urologic section. En bloc removed specimen showed ruptured kidney with adhesiveness laterally to descending colon and harder core portion was found in midst of renal mass. Coronal slice of the specimen exhibited a renal parenchymal tumor with necrotic spots. Pathologic findings were complete kidney rupture in upper pole and clear cell type renal cell tumor was found in mid and lower pole. Also lymph nodes which obtained from left renal pedicle and para aortic margin proved no metastasis of tumor cell. Post operative clinical course was favourable without any recurrence for 15 months after surgery. Clinical incidence of type I and type II kidney trauma with pre-existing neoplastic change is considerably high, but the kidney ruptured case bearing renal cell carcinoma as a core shape is very rare.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832924 TI - [A case of renal hypertension after pyelolithotomy cured by segmental nephrectomy]. AB - A case of renal hypertension after pyelolithotomy cured by segmental nephrectomy is reported. The patient, a 39-year-old man had had pyelolithotomy performed by the lumbodorsal approach at another hospital. Two months after operation he started to complain of headache and palpitation. The blood pressure was markedly high when he visited our hospital and peripheral plasma renin activity was also elevated. Urinalysis was normal except for slight proteinuria. The excretory urogram demonstrated cortical scarring in the lower portion of the left kidney. The renal scintigram demonstrated low uptake in this area, suggesting renal infarction. Renal arteriogram showed decreased vascularity in this area. Plasma renin activity was measured on the blood drawn from the renal vein of both sides and the ratio was about 2.4, and renin activity of the segmental renal vein from the left lower portion was elevated. Segmental nephrectomy of the lower pole was performed. The blood pressure three weeks after lower pole resection was estimated to be normal and renin activity returned to an almost normal level. Discussion was made on the cause of renal hypertension after renal surgery. In this case, it was suggested that renal hypertension is caused by subinfraction due to lesions of the dorsal renal artery in surgery for renal calculus. PMID- 3832925 TI - [Emphysematous pyelonephritis: report of a case]. AB - A case of emphysematous pyelonephritis is presented. A 49-year-old male with diabetes mellitus complaining of high grade fever attack and right flank pain was referred from internal medicine. KUB demonstrated that the right ureter, pelvis and calyces were filled with gas. Anti-bioticus was given intensively and the abnormal gas shadow on plain film disappeared before RP was done, but high grade fever attack persisted and right nephrectomy was undergone. After this operation, the fever was relieved and the patient was discharged at the 30th day post operatively. A search of available literature in Japan has disclosed only 17 reported cases. Diagnostic methods, treatment, complication and etiology are discussed. PMID- 3832926 TI - [Primary localized amyloidosis of the urinary bladder: a case report]. AB - A case of primary localized amyloidosis of the bladder during a twelve-year period is described. The initial symptom was miction pain when she was 43 years old. Cystoscopic examination revealed yellowish elevated lesion with hemorrhage at the right side of the bladder neck. Transurethral resection was performed, but two years later recurrence was found at the trigonum as well as the original site. The two lesions were apart. She remained asymptomatic for the following ten years until she returned to us with bladder symptoms. Cystoscopy showed the lesion was more diffuse and the posterior wall was involved in continuity with the trigonum. Complete transurethral resection was not possible because of generalized bladder involvement. Our case illustrates the clinically benign but slowly progressive nature of amyloidosis of the bladder. Multifocal recurrence is also to be noted. Our current treatment policy is conservative treatment with careful follow-up. She is asymptomatic three months postoperatively. PMID- 3832927 TI - [A case of gas gangrene in a vesico-vaginal fistula]. AB - A case of gas gangrene is presented. The patient was a 78-year-old woman who was admitted with the diagnosis of vesico-vaginal fistula. Cystography revealed a vesico-intestinal fistula and leakage of contrast medium into the prevesical space, in addition to the vesico-vaginal fistula. Right ureterostomy was performed. Two weeks postoperatively, she complained of severe pain and swelling of her right thigh. The swelling grew rapidly and general condition became worse. A diagnosis of gas gangrene was made 8 days after her first complaint by demonstrating subcutaneous and intramuscular gas formation in X-ray. She died the next day. By the bacteriological examination, this case was non-clostridial gas gangrene. PMID- 3832928 TI - [A case of pure leiomyoma of the prostate]. AB - A case of pure leiomyoma of the prostate is reported. This disease is very rare and only 10 cases could be collected from the Japanese literature. Our case is the 11th case of this disease in Japan. A 48-year-old man was admitted to our hospital because of urinary retention. Retrograde urethrocystogram showed evidence of protrusion of the left lobe of the prostate. Excretory urogram revealed bilateral hydronephrosis and voiding cystogram revealed VUR on left ureter. Transurethral biopsy suggested benign prostatic tumor. Open resection of the tumor was performed. Histologically, the specimen removed was pure leiomyoma of the prostate. After operative treatment, disturbance of urination and hydronephrosis disappeared. PMID- 3832929 TI - [Malignant lymphoma of the testis: report of two cases]. AB - Two cases of malignant lymphoma arising from the testis are reported. One was 45 years of age, with the complaint of left scrotal swelling with dull pain and the other was 68 years of age, with the complaint of painless swelling of right scrotal contents. Microscopic findings were both malignant lymphoma of the testis, large cell and immunoblastic type in case 1 and diffuse mixed, small and large cell type in case 2 (Working Formulation, 1982). Biomedical and radiographic examinations revealed no apparent involvement otherwise. For the period of 6 months in case 1 and 2 months in case 2 following radical orchiectomy with postoperative irradiation (Lineac 4,000 rad), the patients have been doing quite well without any clinical evidence of recurrence. The literature is also reviewed briefly. PMID- 3832930 TI - [Secondary penile tumors: report of two cases]. AB - Two cases of secondary penile tumor are reported. The first was a 69-year-old man with the complaint of continuous painful penile erection. He had been diagnosed to have left lung cancer, squamous cell carcinoma, and was treated with chemotherapy as well as irradiation 10 months previously. He underwent amputation of penis and histopathologically diagnosed to have penile metastasis from the lung cancer. The second was a 60-year-old man who had been treated by Miles' operation due to rectal cancer, adenocarcinoma, 24 months previously. Autopsy demonstrated continuous invasion in a corpus cavernosum of rectal cancer which had locally recurred. We reviewed and discussed briefly 74 cases with secondary penile tumor collected from the Japanese literature. PMID- 3832931 TI - [Clinical effectiveness of KL 007 (oxybutynin hydrochloride) in urinary disorders]. AB - The clinical effectiveness of KL 007 (oxybutynin hydrochloride) was studied on patients with urinary disturbance, mostly complaints of urinary frequency, who were suffering from nervous pollakisuria, irritable bladder or neurogenic bladder. Fifty two patients were administered KL 007 three times daily at the dose of 6 mg, 9 mg, or 12 mg per day for one or two weeks. An overall clinical effectiveness of KL 007 was seen in the cases of hypertonic bladder. As to the clinical effectiveness of subjective symptoms, KL 007 improved the symptoms of urinary frequency, urinary incontinence, discomfort upon micturition, urinary urgency and sense of residual urine. Transient side effects were observed in 23 cases (41.4%), and dry mouth was most observed. No severe side effects were noticed. PMID- 3832932 TI - [A therapeutic experience with alloplastic spermatocele used in obstructive azoospermia]. AB - To perform AIH, an artificial spermatocele was inserted into the epididymis for obstructive azoospermia (probably caused by congenital defect of the spermiduct on one side and by accidental vasosection in hernioplasty on the other). The graft used was a cup-shaped alloplastic spermatocele made of silicon-dacron, developed by Wagenknecht et al. The epididymal duct was incised microscopically. The graft was sutured to the epididymal involucrum, punctured through the scrotal skin by an injection needle and aspirated spermatozoa accumulated in the internal cavity, and subjected to AIH. Postoperatively, acceleration of spermatogenesis was attempted by injecting i.m. HCG 2,000 U-HMG 150 U twice a week, but spermatozoa both qualitatively and quantatively sufficient to perform AIH could not be obtained. Spermatozoa were no longer found after two and a half postoperative months. Despite the present failure, we would like to develop a method of grafting of this kind as more precise therapeutic means through further technical improvements in grafting. PMID- 3832933 TI - [Clinical and biological impact of environmental pollen on children with pollinosis]. AB - In our area 100% of the pollen allergic children, between 1 and 14 years old, show cutaneous hypersensitivity to grass. The aim of this study was to ascertain whether children who have also a positive skin test to other pollen have a different clinical and biological seasonal behaviour than children with exclusive grass hypersensitivity. Seventy-two of these children answered a questionnaire in which they recorded the days in which they suffered symptoms of pollinosis and the kind of clinical manifestations from the first of April to the twenty sixth of July, 1984. Twenty-four patients were exclusively allergic to grass pollen and forty-eight also showed a positive skin test to other pollens. All patients were aware of and had used many kinds of symptomatic therapy. Therefore this circumstance was not taken into consideration when we evaluated the results. Sixty-one children had also received a pre-seasonal hyposensitization treatment with pollen grass extracts. The serum IgE level was determined in two moments, before and after the seasonal reactivation, in February and July. In sixty-nine cases the skin test diameters of pollen grass were also measured before and after the pollination. The follow-up questionnaire let us know whether the intensity of clinical manifestation was proportional to atmospheric pollen levels and whether the kind of clinical symptomatology was related to any immunological condition of the children. The environmental study and the clinical follow-up during the spring of 1984, of seventy-two children with pollinosis showed that the symptoms were only noticed during the weeks of grass pollination. The other pollen allergies did not cause any clinical presentation. In addition, there was no proportion between the environmental pollen levels and the intensity of the symptoms. The clinical manifestations terminated several weeks before the end of pollination in about 50% of the patients. On the contrary, the other 50% of patients maintained their clinical symptoms while a noticeable amount of pollen persisted in the atmosphere. These groups of children had neither special clinical features nor different serum IgE levels. Nevertheless, the size of the skin test decreased from February until July in the group whose symptomatology terminated before the end of pollination. The five patients who duplicated the serum IgE levels during this same period were the cases who showed clinical symptomatology during more days.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3832934 TI - [Apropos of a case of chronic eosinophilic pneumonia associated with iridocyclitis and bronchial asthma]. AB - In this study, we report the case of a 48 year-old female patient showing a clinical picture after a month's evolution consisting of cough, moderate effort dyspnoea, asthenia, anorexia and loss of weight. One year before, she had been diagnosed with bronchial asthma and she had been treated for two years with policarpine collyrium for a glaucoma simplex. The exploration only showed the existence of iris synechias in the right eye and conjunctival hyperaemia on the same side, together with basal crepitant rales on auscultation. Once we had proved the existence of a peripheral eosinophilia superior to three thousand elements per mm3 and of peripheral pulmonary infiltrates with radiographic negative for pulmonary edema, the picture was included in the so-called P.I.E. syndrome whose various etiologies were discarded subsequently. Following a pharmacological survey, a study of parasites in faeces and cutaneous tests as well as provocative tests, the specific causes of P.I.E. were discarded. According to the transbronchial biopsy and the biopsies of skin, nerve and muscle, it was unlikely that the diagnosis would be granulomatosis and/or angiitis. No evidence was found of any of the affections in which P.I.E. is regarded as a minor component. In view of the above, we thought the correct diagnosis was chronic eosinophilic pneumonia, since all the characteristics defining this picture according to Carrington were fulfilled. The treatment was started with corticoids and a clear improvement of all clinical symptoms was observed, including the ocular findings and the disappearance of radiographic pulmonary infiltrates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3832935 TI - Accountability: common sense. PMID- 3832936 TI - Speech instruction for deaf children: a communication-based approach. PMID- 3832937 TI - The structure of nonverbal intelligence in deaf and hearing subjects. PMID- 3832938 TI - Teaching self-control to dually diagnosed deaf students: promising procedures. PMID- 3832939 TI - A national survey of programs for intellectually and academically gifted hearing impaired students. PMID- 3832940 TI - A comparison of three speech intelligibility measures for deaf students. PMID- 3832942 TI - Using the scale of independent behavior with hearing-impaired students. PMID- 3832941 TI - Congenital rubella syndrome and diabetes: a review of epidemiologic, genetic, and immunologic factors. PMID- 3832945 TI - Urea formaldehyde foam insulation: defusing a timebomb. AB - With the onset of the energy crisis in the 1970's, thousands of homeowners insulated their homes with Urea Formaldehyde Foam Insulation (UFFI). The discovery that UFFI releases formaldehyde, a carcinogen and irritant, prompted various state and federal responses to this problem. This Note reviews those responses and concludes that a ban on the sale of UFFI, coupled with a removal and repurchase program, is the most effective solution from the standpoint of consumer health. PMID- 3832943 TI - Infanticide, physicians, and the law: the "Baby Doe" amendments to the Child Abuse Prevention and Treatment Act. AB - Infanticide, like most other species of homicide, is probably coeval with the human race itself. In modern Western civilization, what were formerly the most powerful incentives to infanticide have virtually disappeared. As with other social problems that affluence has seemed to solve, however, infanticide has reappeared in a new form that seems to have been made possible by affluence itself. This "new infanticide" occurs in a place whose very existence is the result of a tremendously wealthy society's devotion to its most vulnerable and least "useful" members. The modern neonatal intensive care unit, which treats, and often saves, extremely ill newborn children, who during most of history would surely have died, has proven to be a setting where many of the age-old incentives for infanticide have begun to operate again. The "new infanticide" consists of withholding food or needed medical treatment from selected infants who suffer from one or more serious, though treatable, medical problems. The national government has now enacted legislation designed to curtail the practice of infanticide by the medical profession. This paper traces the genesis of that legislation, explores the problem to which it is addressed, and evaluates its prospects for success. PMID- 3832944 TI - A moment in human development: legal protection, ethical standards and social policy on the selective non-treatment of handicapped neonates. AB - Selective non-treatment decisions involving severely handicapped neonates have recently come under renewed judicial and legislative scrutiny. In this Article, the Author examines the legal, ethical and social considerations attendant to the non-treatment decision. In Part II of this Article the Author discusses the predominant ethical viewpoints relating to this issue and proposes a new moral standard based on personal interests. Part III presents a survey of the jurisprudence relating to selective non-treatment decisions. Parts IV and V of this Article provide a critical examination of the recently enacted Child Abuse Amendments of 1984, a federal legislative initiative designed to regulate treatment decisions relating to handicapped infants. The Author suggests that the ethical standards and treatment criteria proposed in this Article may prove useful to courts seeking to balance the handicapped neonate's constitutional right to privacy with the requirements of the new federal law. PMID- 3832946 TI - Neuropeptides in the brain. AB - In recent years, there has been a remarkable increase in the identification of neuropeptides. These peptides have become known as neuropeptides, as they have been identified within neuronal structures and frequently localised to nerve terminals. Classification of newly discovered peptides is attempted according to function or structure. Although the role of the hypothalamic releasing factors is readily appreciated, the functional significance of the remaining neuropeptides is often not easily determined. However, these peptide appear to interact with conventional transmitters and may be implicated in neuropathology. PMID- 3832947 TI - Genetic implications of Rett syndrome. AB - Cytogenetic analysis in 14 girls with the Rett syndrome revealed a deletion on the short arm of the X chromosome (del(X) (pter;p22] in one, and a fragile site on chromosome Xp22 in six of the girls. Two hypotheses concerning the genetic background to the Rett syndrome are suggested; an X-linked dominant mutation theory and a two-step mutation theory. PMID- 3832948 TI - Skeletal muscle involvement in Escobar syndrome. AB - In addition to the clinical characteristics of Escobar syndrome, including an anomalous facial expression, multiple joint contractures, multiple pterygia and a short stature, two female siblings developed proximal dominant muscle weakness from birth and slowly progressive scoliosis. Biopsied specimens obtained from the paravertebral and gluteus maximums muscles at the time of spinal surgery showed variation in fiber size, increased numbers of fibers with central nuclei, interstitial fibrosis and disorganized intermyofibrillar networks with occasional core/targetoid formations. The most outstanding histochemical abnormality in both cases was an abnormal fiber type distribution (type 2 fiber deficiency) which might be the result of an abnormal or deficient neural supply to the developing muscles. The defective neural influence on the muscle is assumed to produce the above-mentioned muscle changes, inducing multiple joint contractures and scoliosis. PMID- 3832949 TI - Pneumococcal meningitis in infants. AB - A review and follow-up study of 21 Chinese infants who had pneumococcal meningitis showed a mortality of 23.8% and high morbidity in survivors. Severe meningitis and delay in treatment as reflected by the presence of coma, pneumonia, disseminated intravascular coagulation, and lumbar CSF protein of over 368 mg% and glucose of lower than 10 mg% at the time of diagnosis were associated with fatality. Although the pneumococcus was sensitive to Penicillins which were given at usually recommended dosages and duration in these infants, the morbidity in survivors was high, and seemed to be associated with the presence of focal neurological abnormalities at the time of diagnosis, slow response in fever to treatment, short duration of afebrile period before discontinuation of antibiotics, and incompletely normal CSF parameters at the time of cessation of antibiotics. Serially sterile lumbar CSF did not guarantee against recrudescence of meningitis after cessation of antibiotics. The lack of uniformity in treating and monitoring these patients and suggested management are discussed. PMID- 3832950 TI - Clonazepam monotherapy for epilepsy in childhood. AB - Sixty patients (age-range one month to 14 years) with other types of epilepsy than infantile spasms were treated with clonazepam. Disappearance of seizures and normalization of abnormal EEG with disappearance of seizures were recognized in 77% and 50%, respectively. Seizures disappeared in 71% of the patients with generalized seizures and 89% of partial seizures. Improvement of abnormal EEG was noticed in 76% of diffuse paroxysms and in 67% of focal paroxysms. In excellent cases, mean effective dosages were 0.086 +/- 0.021 mg/kg/day in infants and 0.057 +/- 0.022 mg/kg/day in schoolchildren, this difference was statistically significant (p less than 0.005). The incidence of side effects such as drowsiness and ataxia was only 5%. PMID- 3832951 TI - Analysis of fatty acids and sphingosines from urinary sulfatides in a patient with metachromatic leukodystrophy by gas chromatography-mass spectrometry. AB - The urinary sulfatides in metachromatic leukodystrophy (MLD) were analyzed by gas chromatography-mass spectrometry. Fatty acids and long chain bases were obtained after methanolysis. C22:0 and C22h:0 were major components of the fatty acids distributed in the urinary sulfatides in MLD while they were only minor components of the fatty acids in the brain sulfatides in a control subject. These results were in accordance with the report of Philippart et al. It was suggested that the urinary sulfatides originated not in the brain but in other organs. The mass spectra of the trimethylsilyl derivatives of the hydroxy fatty acid methyl esters always showed peaks at m/z (M-15-28)+ and (M-59)+, indicating that the hydroxy group was on carbon 2. Two kinds of long chain base were identified: C18 sphingosine and 3-O-methyl-C18-sphingosine. The latter compound may be a by product formed on methanolysis. PMID- 3832952 TI - Intraparenchymal meningioma in a 14-month-old infant: case report. AB - The authors report a 14-month-old infant with an intraparenchymal meningioma. At this age, intracranial tumor is an unusual cause of hemiconvulsions, and an intraparenchymal tumor localisation is even more unusual. PMID- 3832953 TI - Computed tomography of a diploic epidermoid cyst of the skull. AB - The computed tomographic (CT) and other roentgenological characteristics of a skull diploic epidermoid cyst in a 14-year-old boy with Ito syndrome, a neurocutaneous syndrome, are presented. When this boy was 3 years 10 months of age, a plain roentgenogram of the skull showed an area of decreased density in the left parietal bone. The area has grown for the subsequent 10 years plus and a characteristic sclerotic margin has become evident. CT examination showed a cystic lesion in the diploe, the outer third of high density and the inner third low density. CT allowed prediction of the operative and histological findings. It was useful not only for the diagnosis but also in the pathogenesis. PMID- 3832954 TI - Neuropathological and Golgi study on a case of thanatophotoric dysplasia. AB - Neuropathological examination of a 3-day-old female with thanatophoric dysplasia revealed abnormal sulci with polymicrogyria and neuronal heterotopia in the temporal lobes and cerebellar hypoplasia. Rapid Golgi stainings showed immature or maldeveloped neurons with short dendrites and a reduced number of spines in the cerebral cortex, and abnormal neurons with peculiar dendrites in the subcortical heterotopia. These abnormalities were predominant at the base of the large brain which occupied the hypoplastic middle and posterior cranial fossas. PMID- 3832955 TI - CT and histological findings of diffuse lipomatosis with a hemangioendothelioma: a case report. AB - A 3 1/2-year-old boy with multiple soft tissue tumors and weakness of the right lower extremity is presented. Swelling of the right lower extremity was noted at 3 weeks, and soft masses at the hip at one year and in the inguinal region at 2 1/2 years of age. Right lower extremity weakness was noted about one year and non progressive. CT scanning demonstrated characteristic subcutaneous lipomatosis with muscle involvement and a pelvic mass with positive enhancement that infiltrated into the spinal canal. Histological examination revealed diffuse lipomatosis involving muscles in the right hip mass and a lipoma with a hemangioendothelioma in the right inguinal mass. Diffuse lipomatosis combined with a lipoma and a hemangioendothelioma suggests a hamartomatous origin. PMID- 3832956 TI - The physician as expert witness. PMID- 3832957 TI - Radiation and cancer in Alaskan natives: Part 2. PMID- 3832958 TI - ATLS: what is it? PMID- 3832959 TI - Uvulopalatopharyngoplasty, (UPPP), an effective surgical treatment for cases of snoring and some cases of sleep apnea. PMID- 3832960 TI - Postnatal intrafamilial spread of: hepatitis B infection in Alaskan Eskimo infants. PMID- 3832961 TI - Prehospital care and the physician intervener. PMID- 3832962 TI - [Paraneoplastic syndromes: concept and limits. Viewpoint of the internist and the dermatologist]. PMID- 3832963 TI - [Biomechanics of cartilage: its influence in the arthrosis of aging]. PMID- 3832964 TI - [The harmfulness of tobacco]. PMID- 3832965 TI - [The skeletal and locomotor system as a curriculum subject]. AB - Anatomy cannot fail to interest the clinician. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. PMID- 3832966 TI - [Topographic studies on the pathogenesis of postoperative pareses in the area supplied by the brachial plexus]. AB - Post-operative palsies of the Plexus brachialis innervation area induced post mortem studies on the behaviour of the nerves in 11 positions of the stretched arm. The tension of the Plexus brachialis and of the Nervus ulnaris was measured. It was highest at an abduction of 90 and 120 degrees with additional retroversion. When the abduction is 90 and 120 degrees an anteversion of 15 degrees leads to an ambiguous diminution of the tension. PMID- 3832967 TI - Ultrastructure of the intrahepatic bile duct system of the one-humped camel (Camelus dromedarius). AB - The ultrastructure of the intrahepatic bile duct system of the camel was studied. Bile canaliculi are present as cavities containing numerous microvilli between adjacent hepatic cells. They are lined with cuboidal cells surrounded by a basal lamina. The lateral plasma membranes of adjacent cells form extensive evaginations below tight junctions at the lumenal surface. The basal surface is open. Collagen bundles are arranged mainly in parallel to the duct. PMID- 3832968 TI - [Prenatal ontogenesis of human surface cerebral arteries. A mesoscopic, histologic and electron microscopy study]. AB - The prenatal development of the meningeal arteries in human is studied with mesoscopic (stereomicroscopic), histologic and electron microscopic methods. In the ink injected membraneous preparation it can be shown developing and arbituarisation of the arteries, arteriols and venes in the Pia mater as a topographic study. Morphometric investigations should be done. The histologic study (on plastic semithin sections) shows the cellular composition of the vessels and the electron microscopic observations help us to differentiate the cells in the developing vessel's wall. PMID- 3832969 TI - [Anatomical study of the superior cerebral veins]. AB - The authors describe the number, courses, fixations and dispositions of the superior cerebral veins at the levels of the subdural space and of the superior sagittal sinus. It was observed that the superior cerebral veins have different courses to the superior sagittal sinus, and that these vascular walls are fixed to the intern face of the cranial dura-mater and to the lateral wall of the sinus. Frequently, the wall of the posterior vein adheres to the falx cerebri, presenting ascendant trajet to the inferior wall of the sinus. It was noted that the anterior veins open into the superolateral angle of the superior sagittal sinus, forming an acute forwards and right angle with it; the middle veins open near to the inferior angle of the sinus, with which they form an acute forwards or a right angle; the posterior veins enter the inferior angle of the sinus, forming an acute forwards angle with it. The authors confirm the superior cerebral veins draining into the superior sagittal sinus in sense favorable the current of the blood within it. PMID- 3832970 TI - [The superficial brachial artery]. AB - 100 right and 100 left upper limbs were prepared. In 83% a normal A. brachialis was found, whereas in 17% there existed an A. brachialis superficialis, which in 6% was an A. brachialis superficialis superior, in 1.5% an A. brachialis superficialis media and in 9.5% an A. brachialis superficialis inferior. The relation of those 3 main types of A. brachialis superficialis to the arteries of the forearm was examined and the percentage of each possible type of relation is indicated. PMID- 3832971 TI - [Determination of the muscle origins at the interosseous membrane of the forearm]. PMID- 3832972 TI - Prediction of the halothane (Hal) genotypes of pigs by deducing Hal, Phi, Po2, Pgd haplotypes of parents and offspring: results from a large-scale practice in Swedish breeds. AB - Results from a large-scale study, comprising 75 different breeding herds, are reported on predicting the halothane (Hal) genotypes of individual pigs by making use of the known close linkage between Hal and three electrophoretic blood marker loci (Phi, Po2, Pgd). The parents haplotypes (involving Hal and marker loci) were determined from the HAL phenotypes (halothane test results) and marker loci phenotypes of their offspring in the first one or two litters studied. In subsequent litters of the Hal-marker loci haplotyped parents, the offspring's expected Hal genotypes could be predicted on the basis of the marker loci haplotypes inherited by them. By comparing the expected and observed HAL phenotypes of offspring in subsequent litters, the predicted Hal genotype was found to be correct in 90-95% of the 4000 offspring (from Nn X Nn and Nn X nn matings) of Swedish Landrace and Yorkshire breeds studied. The order of the three marker loci was confirmed as Phi-Po2-Pgd but the position of Hal with regards to Phi could not be resolved. The recombination frequencies between the most distant loci in this region, viz. Hal-Pgd and Phi-Pgd, were estimated to be 3-4.5% and 4 6%, respectively. The easy and rapid electrophoretic techniques described in the study to phenotype PHI, PO2, PGD, also allowed phenotyping of six other polymorphic protein systems on the same gels. Thus Hal genotyping and effective parentage control can be conducted simultaneously. PMID- 3832973 TI - Trends in economic traits, halothane sensitivity, blood group and enzyme systems of Swiss Landrace and Large White pigs. AB - Pigs deriving from 150 breeding centres constituting a representative section of elite breeding herds (2496 Swiss Landrace pigs, 587 Swiss Large White pigs) were subjected to blood typing during the period 1981 to 1984. Production traits such as daily gain, feed conversion ratio, lean meat content and meat quality score were available to show the trend in these performance traits since 1978. Field data on the halothane reaction of 14 270 Swiss Landrace (SL) pigs were used to assess the porcine stress syndrome during the period 1978-1983. In SL pigs the frequency of the alleles Ha, PhiB and AdaA decreased significantly, and that of the Hc and PhiA increased during the period of the study. The frequency of the Ha allele dropped from 0.36 in 1981 to 0.20 in 1984, whereas the Hc allele rose from 0.22 to 0.37. In Swiss Large White (SLW) pigs, on the other hand, the frequency of the Ha allele increased constantly from 0.31 to 0.37 during this period. An initial frequency of 17.7% (1978) halothane reactors in SL pigs was lowered to 0.7% (1982) after five years of halothane testing. In SL pigs the meat quality scores improved regularly, whereas in SLW pigs it did not change very much. The percentage of PSE animals in the SL breed was reduced from 32.7% in 1978 to 7.1% in 1983. Because the Hal locus is associated with production traits such as meat quality, linkage disequilibria could explain the observed associations between the H and Phi types and production traits. PMID- 3832974 TI - Gene order and recombination rates in the linkage group S-Phi-Hal-H-(Po2)-Pgd in pigs. AB - Families of Czech Landrace (94 litters and 636 offspring) were tested for halothane sensitivity, A-O (S), H, PHI and PGD phenotypes. Informative matings for the estimation of recombination rates between marker loci were selected. The following recombination frequencies were established: S - Phi = 4.8% (2.5% 10.7%); S - H = 6.8% (4.3%-11.7%); Phi - H = 2.6% (0.9%-5.3%); H - Pgd = 4.4% (1.6%-8.0%). Cross-overs were observed also between S - Hal, Hal - H and Hal - Pgd, but were not found between Phi - Hal. On the basis of these results it has been possible to revise the position of the S locus in this linkage group. The most probable gene order would be: S - Phi - Hal (or Hal - Phi) - H - (Po2) - Pgd. A striking difference was found between the number of halothane-sensitive pigs (87) and HalnHaln genotypes determined by haplotyping (123). Segregation rates in 19 backcross matings and experimental matings of the animals proved that this difference is mostly due to incomplete penetrance or low expression of halothane sensitivity. PMID- 3832975 TI - Relationships between blood groups, isozymes and halothane reaction in pigs from a selection experiment. AB - German Landrace pigs (n = 1500) were halothane-tested and blood samples were taken for the determination of A-O and H blood types as well as for the determination of PHI and 6-PGD isozymes. The pigs originated from two generations (7th and 8th) of a selection experiment 'selection for activity of NADPH generating enzymes in backfat of pigs'. The selection lines are E-, E+ (selection for low and high enzyme activity), U- (selection for low ultrasonic backfat thickness) and K (control). Preliminary results show an average proportion of halothane-susceptible animals of 49%. The frequencies of halothane-positive pigs amount to 60%, 46%, 70% and 30% in lines E-, E+, U- and K, respectively. The investigation shows a non-random combination of the marker genes caused by linkage disequilibrium, especially in line E-. Recombination frequencies between the loci vary from 0% to 18%. PMID- 3832976 TI - [Enzymatic determination of urinary estrogens. A 5-year experience in a hospital milieu]. AB - The enzymatic method for urinary estrogens determination from Nicolas et al. has become a useful tool for the management of infertility problems. It can be used for: investigation of ovarian by establishing the urinary estrogens profile during menstrual cycle, useful to: understand anomalies of the spontaneous cycle, explain some therapeutic failures during IVF attempts or artificial inseminations (AID or AIC); prediction of failures during IVF attempts during spontaneous cycles, and monitoring ovarian response during stimulated cycles in order to determine the trigger with hCG; monitoring ovulation during induction of ovulation in anovulatory patients stimulated with various drugs (clomiphene citrate, pure FSH combination of FSH and LH, GnRH ou analogs...) under various conditions of prescription and administration (oral, IM, intermittent pulsatile administration with portable pump with or without hypophyseal down regulation). This technique allows also exploration of androgens after changing main androgens (delta 4 A, T, DHEA, DHEA S) into estrogens through the action of placental aromatase, as well as appreciation of aromatase activity of some tissues in the presence of androgenic substrates. This paper gives the conclusions after 5 years of practice with this method and summaries different works published by the biologists who developed the method and by the clinicians who used its results. PMID- 3832977 TI - [Biological profile of the 1st 4 hours of a thrombolytic treatment combining urokinase with lysyl-plasminogen]. AB - The authors study the biological variations which accompany an oral, thrombolytic treatment in which urokinase and lysyl-plasminogen are combined. Fibrinogen, the products of degradation of fibrinogen or fibrin, plasminogen and rapid alpha 2 antiplasmin are studied as a function of time. Two dimensional electrophoreses were carried out at precisely determined times. The combination of the two therapeutic agents causes the appearance of plasmin in the circulation, but it is neutralised by its rapid inhibitor. This therapeutic protocol entails moderate circulating fibrinolysis and may easily be monitored by determination of the circulating fibrinogen. PMID- 3832978 TI - [Creatine kinase and isoenzymes in full-term newborn and premature infants]. AB - Serum creatine kinase activity was measured during the first post-natal days in healthy full-term and premature infants. The CK isoenzymes (CK-MM, MB and BB) were separated using ion-exchange column chromatography. Total CK activity is lower for premature infants than for full-term infants at the same time-periods. However the separation of the CK isoenzymes shows that the same normal values for the CK-BB (expressed as U/l) may be used for the two groups of infants. PMID- 3832979 TI - Prediction of the secondary structure of Bowman-Birk soybean protease inhibitor from LTS sequence. AB - The secondary structure of Bowman-Birk soybean inhibitor (BBI) has been predicted from its amino acid sequence (71 residues) using the statistical method of Chou and Fasman (1974) as well as the informational method of Garnier et al. (1978). According to both methods, no alpha-helical region is predicted in BBI. Short beta-strands at 11-15, 39-43, 48-52 and 57-59 are predicted by Chou and Fasman's method, and at 11-14, 39-43, 48-52 and 57-59 by the method of Garnier et al. Predicted beta-turn tetrapeptides are residues at 1-4, 6-9, 14-17, 18-21, 24-27, 30-33, 36-39, 60-63, 63-66 and 68-71, according to the method of Chou and Fasman. These predictive results indicate that BBI consists essentially of beta-turn, beta-strand, and unordered structures, which represent about 56, 25 and 19% (by difference) of its secondary structure, respectively. The predicted reverse turn amount in BBI is very high, in comparison with that found usually in proteins. No fitting of the experimental circular dichroism spectrum (in the 195-240 nm region), which was reported by Kay (1976), has proved satisfactory when using the parameters for helical, beta-sheet, beta-turn and unordered conformations proposed by several authors. PMID- 3832980 TI - Stimulation of mitochondrial Ca2+ efflux by NADP+ with maintenance of respiratory control. AB - Experiments in this paper demonstrate that mitochondrial damage associated to NAD(P)+-induced Ca2+ efflux, is the consequence of inappropriate reaction conditions. The major findings are (i) Added oxaloacetate and acetoacetate readily oxidize NAD(P)H in intact rat liver mitochondria without causing swelling or membrane damage. (ii) Ca2+ efflux can be induced by the oxidized state of mitochondrial NADP in the presence of ATP, ADP, Pi and Mg2+, without mitochondrial swelling. (iii) Ca2+ efflux induced by NADP+ in the presence of ruthenium red causes no significant impairment of respiratory control, a sensitive measure of membrane potential. PMID- 3832981 TI - [National conference on quality control in the determination of blood lead and cadmium and on biological surveillance of the population against the risk of lead poisoning (METOS project). Rome, 29-30 November 1983]. PMID- 3832982 TI - [A new scheme of quality control in inter-laboratory evaluations]. PMID- 3832983 TI - [2 new indexes for the evaluation of results in inter-laboratory quality control]. PMID- 3832984 TI - [Evaluation of the preliminary results in the sphere of quality control programs for the determination of lead and cadmium in the blood]. PMID- 3832985 TI - [Quality control for the determination of lead in the blood: results of phase I]. PMID- 3832986 TI - [Risks of pathologies due to low doses of lead]. PMID- 3832987 TI - [Biological monitoring of a sample of a school-age population exposed to environmental lead pollution in an area adjacent to a foundry]. PMID- 3832988 TI - [Determination of exposure and effect indicators in workers in the alkylation department in a Sicilian petrochemical industry]. PMID- 3832989 TI - [Distribution of lead in the blood and hair of a children population residing in an industrial area]. PMID- 3832990 TI - [Comparison between the Italian situation and that of the countries of the European Economic Community based on the lead blood levels found in the fulfillment of the European Economic Community's directive 77/312]. PMID- 3832991 TI - [Analytical and extra-analytical problems connected with the determination of lead and cadmium in the blood]. PMID- 3832992 TI - [Evaluation of methods for the determination of lead and cadmium in the blood]. PMID- 3832993 TI - [Experience of the reference laboratory of the Ispra Community Research Center in the quality control for the determination of lead in the blood]. PMID- 3832994 TI - [Outline of the Italian program for quality control in the determination of lead and cadmium in the blood]. PMID- 3832995 TI - [The place of the Higher Institute of Health in the National Health Service]. PMID- 3832996 TI - [Relations between the Higher Institute of Health and regional and infraregional agencies]. PMID- 3832997 TI - [The Higher Institute of Health and international organizations]. PMID- 3832998 TI - [Organization of the Higher Institute of Health and trends]. PMID- 3832999 TI - [The personnel of research institutes under public employment laws]. PMID- 3833000 TI - [The program of scientific health research in relation to the national program]. PMID- 3833001 TI - [Relation between structures of research and industrial performance]. PMID- 3833002 TI - [The Higher Institute of Health in the current order and in the development of the Accounting Administrative System]. PMID- 3833003 TI - [Controls in the management of the Higher Institute of Health]. PMID- 3833004 TI - [Activities of the Higher Institute of Health and reflections on their cost]. PMID- 3833005 TI - [Organizational and managerial aspects of research in the health field]. PMID- 3833006 TI - [Familial sarcoidosis. Apropos of 22 families]. AB - Twenty-two families, the ethnic origins of which were Caucasian (16) or mixed Caribbean (6), each with two or three members suffering from sarcoidosis, were studied. The frequency of familial sarcoidosis when all races are considered is 2.4 p. 100 but it is higher in people born in the Caribbean. Clinically, this form is no different from non-familial cases but there is a tendency, especially in homozygotic twins, for the dates of revelation of the disease to be very close to each other, and for the clinical and radiological features and the evolution to be the same. A higher frequency of pairs of the same sex with equal numbers of parent-sibling and sibling-sibling pairs were observed. There was no predominance of mother-sibling with respect to father-sibling pairs. The HLA system study was too fragmented to draw any conclusion about the mode of transmission of familial sarcoidosis. PMID- 3833007 TI - [Septicemia in cirrhotic patients]. AB - The clinical features of 22 patients with cirrhosis of the liver complicated by septicaemia were studied retrospectively and compared with a control group of 52 patients with septicaemia without cirrhosis. The incidence of septicaemia was higher in the cirrhotic group (4.25 p. 100) than in the control group (0.64 p. 100). The overall incidence of cirrhosis in patients with septicaemia was 19 p. 100. Nine of the 22 cirrhotic patients and 16 patients in the control group died. Prognostic factor common to both groups of patients were: shock, coma, delayed apyrexia and the isolation of more than one infecting organism on blood culture. Poor prognostic factors specific to the cirrhotic patients were the presence of ascites, especially if infected, and signs of hepatocellular failure. PMID- 3833008 TI - [Preventive treatment of severe allergic complications caused by Hymenoptera venom. Our experience apropos of 250 cases]. AB - Out of a total of 350 referrals for allergy to hymenoptera venom over four years, 250 patients who had one or more severe systemic reactions were selected for a "rush course" of immunotherapy after confirmation of the responsible reagin (skin tests, specific IgE). The method used in the 245 patients who accepted the protocol enabled us to arrive at a maintenance dose of 100 micrograms of venom in three days. Tolerance was excellent; no serious side effects were observed; the course of immunotherapy did not have to be stopped in any of the patients. Clinical efficacy appeared to be satisfactory as no systemic reaction occurred in a fifth (50) of the patients treated who were bitten again, either spontaneously (24 cases), sometimes successfully and repeatedly (11 cases), or intentionally (26 cases). The IgG antivenom antibody was constantly raised from the first month and remained at a stable value. This harmless and effective method should be offered to patients allergic to hymenoptera venom. PMID- 3833009 TI - [Acute parasellar compression syndrome disclosing hypophyseal adenoma. 3 cases]. AB - Three cases of acute necrosis of a hypophyseal adenoma are reported with a review of the medical literature. The clinical presentation as an acute parasellar compression syndrome was the result of aseptic meningitis in 2 cases and of cavernous sinus thrombosis in the other; the usual symptoms of headaches, oculomotor paralysis and impairment of consciousness were observed. The diagnosis was suspected on clinical grounds, by the radiological changes of the pituitary fossa and confirmed by computerised axial tomography. All three patients had a favourable outcome. Surgery was only required in one case with threatening visual complications. Dissociated anterior pituitary deficiency persisted in all cases; two patients also had diabetes insipidus. In one case, the pituitary necrosis stabilised an acromegaly for a two year period. PMID- 3833011 TI - [Myocardial infarction caused by electric injury. Value of coronarography]. AB - The authors report the case of a 54 year old surgeon who received an electric shock from his diathermy equipment. The shock caused an anteroseptal myocardial infarction complicated by an apical aneurysm. The clinical course was followed up by myocardial and cavitary scintigraphy. Coronary arteriography was carried out after convalescence and showed proximal occlusion of the left anterior descending artery and an apical aneurysm on ventriculography. Myocardial infarction after electrical injury is a rare event and its pathogenesis remains controversial. Although electrical currents can damage the walls of the coronary arteries, they may also have a direct thrombogenic effect. This would appear to be the most probable mechanism in the case reported in which the myocardial lesions corresponded to acute occlusion of the left anterior descending artery, perhaps favoured by the presence of an atheromatous plaque. Coronary arteriography was the most helpful investigation in assessing the physiopathology of this rare event. PMID- 3833010 TI - [Acute poisoning by orphenadrine]. AB - From January 1974 to June 1983, the Paris Poison Control Centre collected 84 cases of overdosage with orphenadrine alone or in combination. Prior papers emphasized fatalities related to orphenadrine poisoning. This retrospective study suggests an underestimated incidence of anticholinergic drugs abuse in our country. The clinical picture of orphenadrine poisoning associates drowsiness, agitation, confusion, delirium and seizures. Anticholinergic symptoms are often noted: mydriasis, sinus tachycardia, dryness of the mouth and urinary retention. No severe cardiac disturbance was found in these patients. PMID- 3833012 TI - [Cardiac insufficiency in acromegaly. Apropos of a case]. AB - The authors report the case of a patient with acromegaly. The clinical history was dominated by left ventricular failure, for which acromegaly was the only evident cause. The cardiac index, pulmonary arterial pressure and the average pulmonary capillary pressure were measured before ablation of the hypophyseal tumour; the measurements were repeated 3 months and 8 years later. The postoperative course followed two phases: transient improvement of the haemodynamic parameters, then relapse of cardiac failure. This case confirms the possibility of a true cardiomyopathy during acromegaly; but the fact that the cardiac failure did not regress despite the decreased growth hormone levels was unusual and raises several physiopathological hypotheses. PMID- 3833013 TI - [Alcohol and the lung. Anatomical and functional consequences]. AB - The noxious effects of alcohol on the body are multiple. The lung is also a target organ in chronic alcoholic intoxication. The effects on the respiratory system may be divided into two groups: lowering of the defense functions of the respiratory system, especially to micro-organisms and a general depression of the immune system; decreased respiratory function sometimes associated with pronounced hypoxemia and decreased affinity of haemoglobin for oxygen especially during exercise. These patients have been shown to have an increased cardiac output, decreased pulmonary artery pressures and increased alveolar-capillary oxygen gradients, suggesting a porto-pulmonary shunt. From a practical point of view, hypoxemia in the alcoholic patients should not be misdiagnosed, since they can be functionally improved by domiciliary oxygen therapy. PMID- 3833014 TI - [Hypercalcemia in acute renal insufficiency caused by rhabdomyolysis. 2 unusual forms]. PMID- 3833015 TI - [Multiple myeloma associated with primary hyperparathyroidism caused by an adenoma]. PMID- 3833016 TI - [Professional burnout]. PMID- 3833017 TI - [Burn-out]. PMID- 3833018 TI - [Note on the incidence of professional burnout syndrome in nonpsychiatrist physicians]. PMID- 3833019 TI - [Burnout: an anthropological perspective]. PMID- 3833020 TI - [Resistant depressions in chronicity phase. Clinical and pharmacological aspects. Apropos of 25 cases]. PMID- 3833021 TI - [Burnout and retirement]. PMID- 3833022 TI - [Burnout in civil servants as seen in their use of sick leave]. PMID- 3833023 TI - [Institutional burnout...]. PMID- 3833024 TI - [Suicide attempts in epileptics. Study done at the day hospital for epileptics in Creteil]. PMID- 3833025 TI - [Psychopathological study of 300 cases of chronic alcoholism]. PMID- 3833027 TI - [Mental contagion]. PMID- 3833026 TI - [Professional burnout of the psychiatrist]. PMID- 3833028 TI - [Depression and gynecologic surgery]. PMID- 3833029 TI - [Difficult exercise of medical confidentiality in psychiatry]. PMID- 3833030 TI - [Psychopathology of work, psychobioecologic approach to occupational maltreatment and considerations on the prevention of maladjustment]. PMID- 3833031 TI - [Professional burnout syndrome: is there smoke without fire?]. PMID- 3833032 TI - [Psychology of professional burnout]. PMID- 3833033 TI - [Suicide and mental disease]. PMID- 3833034 TI - [Factors and prognosis of suicide and recurrence]. PMID- 3833035 TI - [Prevention of suicide]. PMID- 3833036 TI - [The external fronto-ethmoidal approach]. AB - A lateral fronto-ethmoidal approach simultaneously exposing the frontal sinus and the nasal fossae appears to be a necessity for the surgical treatment of fronto ethmoidal pathology. It is possible to fashion an osteo-plastic flap in the fronto-naso-maxillary region. The technique of the approach is described. The operation leaves no ocular functional sequelae and the scar is minimal. Twenty one operations by fronto-nasal flap approach are described, 10 for benign tumours of the fronto-ethmoidal system and 11 with the aim of re-aerating the frontal sinus for cases of complicated or iatrogenic serious sinusitis. The results are studied. The indications of the fronto-nasal flap are described: In tumour pathology, this technique must be used for osteomas and mucoceles of the fronto ethmoidal system as soon as the ethmoidal component reaches or goes beyond the middle ethmoid. If the fronto-ethmoidal lesion only involves the anterior ethmoid, it is then accessible via simple frontal flap. Inverted papillomas which require wide exposure should also be treated via this approach. In infectious pathology, the fronto-nasal flap offers the possibility, after eradication of fronto-ethmoidal lesions and calibration of the naso-frontal canal, of re aeration of the frontal sinus which seems preferable to its exclusion. The possibility of re-aeration of the frontal sinus by an osteo-plastic procedure is progress in comparison with lost bone craniotomy procedures. PMID- 3833037 TI - [Vestibular neurectomy in Meniere's disease. Results and comments apropos of 77 cases]. AB - The authors report 77 cases of vestibular neurectomy performed between 1972 and 1984 (40 male and 37 female) for incapacitating Meniere's vertigo. Neurectomy was via a sub-petrous (S.P.) approach in 55 cases, by posterior trans-labyrinthine (P.T.L.) approach in 9 and anterior trans-labyrinthine (A.T.L.) in 13 cases. A.T.L. was abandoned because of the frequency of leaks of CSF and of meningitis. The P.T.L. approach did not result in any facial paralysis, even transient. There were 2 CSF leaks, without meningitis and one of which required reoperation. For the 55 S.P. cases, hearing worsened in 22.2% with 8 cases of deafness, including three appearing secondarily. There were two transient auditory improvements. Vertigo was cured in 73 cases (94.8%) with 25.9% instability after several months. The authors stress the frequent bilateralisation of the disease and the need to reserve vestibular neurectomy for cases of longstanding incapacitating vertigo, resistant to all other treatment, as well as the value of surgery on the endolymphatic surgery provided that the criteria of indication are complied with. Medical treatment remains the essential basis, including the analysis and, where applicable, treatment of psychosomatic factors by a trained psychiatrist. Finally, when vestibular neurectomy is indicated, the S.P. approach is otologically most suitable, the P.T.L. being reserved for deaf ears or the elderly. PMID- 3833038 TI - [Arteriovenous fistulas of the cranial dura mater. Apropos of 3 cases]. AB - Three cases of arteriovenous fistulas (A.V.F.) of the cranial dura mater are reported. The authors point out that the first symptom is often in the O.R.L. field: vascular tinnitus with sometimes headaches. Diagnosis can be perform by selective arteriography. In the same time, embolization is possible. PMID- 3833039 TI - [Conditions necessary for a cure of cholesteatomatous chronic otitis]. AB - The authors present a homogeneous series of 750 cholesteatomas treated surgically between 1973 and 1984, 710 cases by a closed technique (94%) and 40 by an open technique. After dealing with the false problem of the choice between open technique and closed technique, the authors attempt to define the conditions required for successful treatment of cholesteatomatous chronic otitis, and on that basis justify their own therapeutic attitude. Excision of the cholesteatoma must be complete and as a single block, from the periphery to the point of origin of the epidermal matrix. Such excision is possible in the majority of cases without damage to the bony canal walls. The risk of residual cholesteatoma fell from 19% in 1978 to 8% in 1984. The prevention of cholesteatoma is based upon our basic knowledge of the disease. It requires avoiding damage to or repair of the osteo-membranous anatomical barrier which separate the two compartments, outer and middle, of the ear. This aim can now be better achieved by the use of tympanic homografts and recent techniques for repair of the bony external auditory canal. Recurrences (13%) are due to the ability of progression of the cholesteatoma but also, and above all, the imperfect surgery. Whilst it was long believed that complete eradication of cholesteatoma was impossible without destruction of part of the architecture of the ear, it is now known to be possible, and even represents one of the best methods for the prevention of recurrences. PMID- 3833040 TI - [Cholesteatoma of the ear. Experience with an eclectic therapeutic attitude]. AB - In the light of 702 cases of cholesteatoma seen over a 20 year period, the authors report the experience of a hospital team based upon analysis of the last 517 cases. 322 patients were treated by a conservative attitude to the bony meatus, including 120 undergoing routine revision between 14 and 24 months. 195 cases were treated by an open technique, either primarily or following massive recurrences despite the use of closed techniques. In 33% of cases, patients had already undergone at least a tympanoplasty. The authors discuss the indications of the treatment of cholesteatoma. Each patient must be considered as an individual case and whilst our preference would be for conservation of the bony meatus, certain anatomical and functional conditions make a so-called open technique necessary in 1/3 of cases. PMID- 3833041 TI - [Nosologic criteria for the classification of midfacial granulomatosis]. AB - The authors report three cases of Stewart's disease and five cases of Wegener's disease seen over a period of 10 years, during which time they saw no cases of non-Hodgkins malignant lymphoma presenting as a mid-facial malignant granuloma. On the basis of these cases together with a review of the literature, they argue in favour of the dissociation of Stewart and Wegener as well as that of Stewart and monomorphous NHML, raising the problem of the existence of the latter as an entity. PMID- 3833042 TI - [Cancer of the oral cavity without palpable adenopathy: value of external irradiation exclusively]. AB - Between 1970 and 1978, 99 patients with a squamous carcinoma of the buccal cavity without palpable lymphadenopathy were treated at the Bergonie Foundation by radiotherapy only and regularly followed up. All received a minimal dose of 40-50 Grays either to the primary node groups or the entire cervico-supraclavicular areas. Eight patients developed an isolated lymph node recurrence, in two cases only in the irradiated zone. The other 6 lymph node recurrences occurred either below the radiotherapy fields when the latter had been limited to the neck (4 cases) or at the posterior border of the field (2 cases). Secondary control was possible in two patients of the 8 by combined radiotherapy and surgery. Exclusive radiotherapy for lymph node areas up to a dose of 45-50 Grays thus protected 92% of patients from a lymph node recurrence. The methods of such irradiation and in particular the extent of radiotherapy fields are then discussed on the basis of the clinical aspects of the tumour. PMID- 3833043 TI - [A case of pemphigus vulgaris with predilection for exposed areas]. AB - A 35-year-old man with the bullous lesions on the face and forearms was reported. Histopathological studies revealed the presence of acantholysis. Direct immunofluorescent (DIF) investigation showed depositions of IgG and C3 in the intercellular space of the epidermis. While the patient was successfully treated with oral prednisolone, we tried to induce the lesion by applying middle wave ultraviolet (UVB) on the uninvolved skin of the back. After irradiation of 5 MED of UVB, deposition of IgG in the intercellular space of the epidermis corresponding to the irradiated region was revealed by DIF, but no acantholysis was observed. When the serum which had been taken before the corticosteroid administration was injected on the uninvolved skin of the back followed the irradiation of the same dose of UVB, upper dermal infiltration of neutrophils was observed in addition to the above findings. The results indicate that the possible relation between UVB and production of the lesions was not obtained, however, in view of the clinical distribution of the lesions and IgG deposits by the irradiation of UVB, we should consider the relation between pemphigus vulgaris and the light. PMID- 3833044 TI - [Histiocytoid hemangioma of the scalp]. AB - We report a case (the second from France) of histiocytoid haemangioma, an entity created by Rosai et al. (14) in 1979 to accommodate several cutaneous and extra cutaneous diseases hitherto known under other names and characterized histologically by the proliferation of vessels with peculiar "histiocytoid" endothelial cells. Our patient was a 56-year old woman who developed, within a few weeks, a slightly haemorrhagic nodule of the scalp. The histological examination, performed in a private laboratory, led to a diagnosis of cavernous angioma or angioleiomyoma. Two months after the lesion was removed, the condition recurred in the form of about 10 sessile subcutaneous nodules, 3 to 20 mm in diameter; the nodules were firm, painless, little pruriginous and sometimes ulcerated. An old-standing lymph node enlargement was palpable on the right side of the posterior aspect of the neck. The rest of the scalp was normal. Physical examination of the skin and mucosae revealed no other abnormality. These alarming lesions were suggestive of metastasis or angiosarcoma. X-ray films of the skull were normal, as were the results of blood examination; in particular, there was no eosinophilia. Histology showed a papillomatous epidermis, while the superficial and mid dermis were occupied by a lobulated vascular proliferation. The vessels were of the capillary type; they were lined with two or three layers of endothelial cells remarkable for their large indented nucleus and for their abundant eosinophilic cytoplasm bulging out into the lumen. These vessels were surrounded by fairly dense nodular masses of small lymphocytes with a few histiocytes and some neutrophils. There were no lymphoid follicles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833045 TI - [Trichorhinophalangeal syndrome. Apropos of a case]. AB - The trichorhinopharyngeal (TRP) syndrome type I (Giedion, 1966) is characterized clinically by craniofacial dysmorphism with sparse hair, pear-shaped nose and long philtrum, and abnormalities of the extremities (disabling deformities of the hands and feet). The diagnosis is confirmed by the finding, at radiology, of cone shaped epiphyses at the base of the middle phalanges. The discovery of patients presenting with other clinical and radiological abnormalities (growth retardation, microcephaly, mental retardation, multiple exostoses) has led to the individualization of a type II syndrome (Langer-Giedion, 1969). We report here a new case of TRP type I and review current data concerning the syndrome, notably the clinical and genetic differences between types I and II. Our case concerned a 43-year-old female patient who consulted for sparse, fine, brittle and very unaesthetic hair obliging her to wear a wig permanently. Examination disclosed other morphological abnormalities, including disabling deformities of the extremities (clinobrachydactyly of the hands and feet which had been present since the age of 6-7 years) and peculiar facial features with a globulous, pear shaped nose and a long philtrum. She was of small size and had no mental retardation. These clinical symptoms and the finding of cone-shaped epiphyses (type 12) at the base of the middle phalanges led to affirm diagnosis of TRP type I. The case appeared to be solitary. The TRP syndrome was individualized by Giedion in 1966. It is usually detected during the later childhood. In 1969, Langer and Gorlin reported similar features in patients who, in addition, presented with multiple exostoses (hands and feet and body skeleton).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833046 TI - [Bazex's paraneoplastic acrokeratosis, porphyria cutanea tarda, melanoderma and generalized pruritus]. PMID- 3833047 TI - [Lichen-lupus induced by quinidine]. PMID- 3833048 TI - [Botryomycoma developing on fracture osteitis. Apropos of 2 cases]. PMID- 3833049 TI - [Spontaneous or induced history of the peritoneum and peritonitis]. PMID- 3833050 TI - [Primary peritonitis of supramesocolic origin. 217 cases]. PMID- 3833051 TI - [Primary peritonitis of jejuno-ileal origin. Apropos of 74 cases]. PMID- 3833052 TI - [Primary peritonitis of colonic origin]. PMID- 3833053 TI - [Peritonitis of genital origin. 32 cases]. PMID- 3833054 TI - [Instrumental peritonitis]. PMID- 3833055 TI - Formation of halogenated aryl-polyene (xanthomonadin) pigments by the type and other yellow-pigmented strains of Xanthomonas maltophilia. AB - Based upon visible electronic absorption spectra and mass spectra, yellow pigmented strains of Xanthomonas maltophilia, including the type strain (ICPB 2648-67 = ATCC 13637) of this species, were shown to produce aryl-polyene (xanthomonadin) pigments. These pigments, which usually occurred in very small quantities, were isolated and studied as isobutyl derivatives. The most common X. maltophilia pigment (Pigment 1), which occurred in 8 of the 12 yellow-pigmented strains examined, was shown to be a monochlorinated aryl-hexaene, molecular ion (M+) 384, with the empirical formula C23H25O3Cl. Pigment 3, M+ 376, which was found as the major pigment in one strain of X. maltophilia and as a minor component in two other strains, probably is the same non-halogenated aryl heptaene reported previously in Xanthomonas populi and X. juglandis. Although all of these X. maltophilia strains originated from medical rather than phytopathogenic environments, the occurrence of these xanthomonadin pigments in non-phytopathogenic strains emphasizes the chemotaxonomic significance of these aryl-polyene pigments in the genus Xanthomonas. PMID- 3833056 TI - Role of virulence-associated plasmid in the uptake and killing of Yersinia pseudotuberculosis by resident macrophages. AB - Resistance to phagocytosis of Yersinia pseudotuberculosis by mouse resident macrophages was investigated using a highly virulent plasmid-bearing strain and its low-virulent plasmid-free derivative. It was found that plasmid-bearing and plasmid-less bacteria did not resist the ingestion step nor inhibit the oxidative burst and phagolysosomal fusion in the peritoneal macrophages. These in vitro data were further confirmed by the study of bacterial survival in infected mice. Bacteria from plasmid-bearing and plasmid-free strains were similarly eliminated during the first hours of infection in the liver and in the peritoneal cavity. Our results therefore suggest that plasmid-mediated virulence is not related to the resistance to the bactericidal activity of fixed macrophages of the reticuloendothelial system during the early phase of infection, and that plasmid encoded factors are expressed after a latency period by an unknown mechanism. PMID- 3833057 TI - Steroidogenic characteristics of the adrenal cortex of the mare studied by electron microscopy. AB - The three concentric zones of the horse adrenal cortex (zonae glomerulosa, fasciculata and reticularis) showed marked interpenetration and exhibited a different relative development according to their position in the gland. Whereas the three cortical zones each had a specific histological structure, the ultrastructure of their cells showed a certain qualitative homogeneity. The differences corresponded essentially to the relative abundance of the constituents which are generally considered typical of steroidogeneous cells: mitochondria with vesicular cristae, smooth endoplasmic reticulum and lipid droplets. Their importance increased progressively from the zona glomerulosa to the zona reticularis. In this zone, the presence of gap and septate-like cell junctions, and mitochondria with vesicular cristae in close proximity to a smooth endoplasmic reticulum with numerous dilated tubules, suggested that steroidogenesis may be the most active. Ultrastructural findings were indicative of only quantitative differences between the steroidogenic capacities of the three zones of the mare adrenal cortex. PMID- 3833058 TI - Comparative study of the surface ultrastructure of ten human breast cancer cell lines. AB - The surface ultrastructure of ten human breast cancer cell lines were studied by utilizing the scanning electron microscope (SEM). Comparison revealed that all lines were richly covered with specific surface features and were pleomorphic with many spheroidal dividing cells. Microvilli (MV) were the main and almost constant surface feature. Blebs, microridges, cauliflower-like processes and/or various cytoplasmic cell processes were also seen. Specific reproducible surface characteristics could be seen in each cell line. PMID- 3833059 TI - [Relation between the concentration of different cations in the urine and lithogenesis]. PMID- 3833060 TI - [Peyronie disease: observations on 40 cases treated with orgotein]. PMID- 3833061 TI - [Nesbit's operation in Peyronie's disease]. PMID- 3833062 TI - [Multilocular cyst of the renal sinus (nosological considerations)]. PMID- 3833063 TI - [Presence of bile pigments in urinary calculi]. PMID- 3833064 TI - [Primary megaureter: evaluation and treatment]. PMID- 3833065 TI - [Treatment of vesicoureteral reflux by endoscopic injection of teflon]. PMID- 3833066 TI - [Giant hydronephrosis in the adult. Apropos of 2 cases]. PMID- 3833067 TI - [Identification and quantification of various porphyrins as components in a peculiar type of renal calculus]. PMID- 3833068 TI - Deoxyribonuclease activity in human sperm. AB - A previous failure to detect DNase activity in human sperm sonicates was ascribed to an inadequate amount of sperm used. In the present work aliquots contained more sperm (1.5-2.5/10(6)), permitting the detection of enzyme activity. The latter was significantly higher in spermatozoa of oligozoospermic origin compared with activity in normospermic specimens. PMID- 3833070 TI - Free l-carnitine in human semen. AB - Spectrophotometrical (412 nm) readings of known amounts of 1-carnitine gave absorbancy changes with minimal interassay variations (8%) in the range of 15.6 125 microM. A 100-microliters volume of seminal plasma was needed for optimal assay repeatability; recoveries of added carnitine were linear (r = 0.998), indicating a sensitivity limit of 0.70 microgram/ml. Intraassay and interassay repeatability gave variation coefficients of 2% and 1.2%, respectively. By this method, 20 samples in duplicate were analyzed within 2 h. Carnitine levels and semen volumes were inversely correlated (r = 0.49). The ejaculated amounts of carnitine (microgram/ejaculate) were not significantly different in 16 normozoospermic subjects and in 13 oligozoospermic patients. Undetectable levels of carnitine were found in case of deferential-vesicular agenesis, and very low levels were found in cases of monorchidism, confirming the epididymides as major producing organs of the substance. Very low levels were also found in semen of men with varicocele, suggesting that seminal carnitine would be regarded as an index of androgenization. PMID- 3833069 TI - Testicular and glandular contributions to the prolactin pool in human semen. AB - The immunoreactive prolactin in human seminal plasma originates predominantly from two sources, the seminal vesicles and the testicular-epididymal axis. The following evidence supported a testicular-epididymal origin: Vasectomy reduced the content of prolactin in the ejaculates by 50%; the concentration of seminal prolactin was highly correlated (r = 0.54, p less than 0.003) with the concentration of sperm in a normal population of young and middle-aged men; and prolactin concentrations in the split ejaculates of normospermic men revealed a profile that corresponded to the sperm distribution pattern. Evidence supporting an additional contribution from the seminal vesicles included the following. The split ejaculate of an azoospermic individual coincided more with the distribution of the vesicular parameter fructose; vasectomy did not cause the disappearance of prolactin from the ejaculate; and split-ejaculate analyses weakened the possibility of a major prostatic source. PMID- 3833071 TI - Estrogen receptors in stromal and epithelial fractions of the ventral prostate of rats. AB - The cytosol from rat ventral prostates contains two estrogen-binding components that can be separated in a glycerol gradient: a high-affinity (KD = 4.2 X 10(-10) M), low-capacity (110 fmole/mg DNA) species that runs in the 8S region of the gradient, and a lower-affinity (KD = 2.4 X 10(-9) M), higher-capacity (410 fmole/mg DNA) 4S protein. Separation of prostate tissue into stromal- and epithelial-enriched fractions was associated with the disappearance of the latter component. When compared per milligram DNA stromal- and epithelial-enriched fractions contained similar amounts of the high-affinity 8S-binding protein. In vivo estrogen treatment caused a time-related disappearance of the protein from the intact cytosol presumably as a result of translocation. No major differences in the degree of binding to the high-affinity component were observed in rats of different ages. Estrogens seem to exert direct effects on both stromal and epithelial tissues of the prostate. PMID- 3833072 TI - Phosphorus-31 and proton NMR analysis of reproductive organs of male rats. AB - Phorphorus NMR spectra of the whole reproductive organs of male rats and their perchloric acid extracts indicate the presence of phosphocholine and phosphoethanolamine in the testis, glycerophosphocholine (GPC) and glycerophosphoethanolamine (GPE) in the epididymis, and creatine phosphate, GPC, and GPE in the seminal vesicles. High amounts of carnitine and inositol were observed by the proton NMR of perchloric acid extract of the corpus and cauda epididymis. Smaller amounts of these compounds were observed in the caput epididymis and vas deferens; they were totally absent in the testis. Creatine is present in high concentrations in the testis, vas deferens, and seminal vesicles. It is almost absent in all parts of the epididymis. PMID- 3833073 TI - Effects of timing of ovum recovery, cumulus cells, sperm preincubation time, and pH on in vitro fertilization in C57BL/6 mice. AB - The effects of the time of ova recovery following hCG injection, the presence of cumulus cells, duration of sperm preincubation time, and pH on in vitro fertilization in C57BL/6 mice were investigated. Significantly more ova were recovered at 14 h than at 12 h post-hCG injection. Although the number of ova recovered at 16 h was similar to that at 14 h, the percentage of ova showing degeneration increased. The presence or absence of cumulus cells had no effect on ovum fertilization rates, although sperm incubated with cumulus-intact ova underwent the acrosome reaction sooner than those incubated with ova lacking cumulus cells. Sperm motility was sustained slightly longer in the presence of cumulus-free ova than in the presence of cumulus-intact ova. The average percent fertilization of eggs combined with sperm preincubated 1 h was higher than that of sperm preincubated 0 and 0.5 h. Longer preincubation times resulted in a linear decrease in the percent motility and an increase in the percent acrosome reactions. A plot of the number of sperm attaching to the egg vs. coincubation time produced a bell-shaped curve in each case. The greatest number of sperm attaching to the egg occurred between 45 min and 1 h. When the medium was at pH 7.4, fertilization rates were higher than at pH 7.0, 7.2, or 7.6, as were the percent sperm motility and the number of sperm attached to ova. A pH of 7.6 induced 60% of the sperm to undergo the acrosome reaction immediately, and within 1 h all motility was lost. PMID- 3833074 TI - Semen LDH-X deficiency and male infertility. AB - Sperm-specific isozyme LDH-X (LDH-C4) in the semen of some infertile men with a normal sperm concentration was absent. This finding suggests a need for semen LDH X isozyme determination in the evaluation of some causes of male infertility. PMID- 3833075 TI - Seminal biochemistry and sperm characteristics in infertile men with bacteria in ejaculate. AB - Sperm examination, quantitative sperm culture, citric acid, acid phosphatase, and fructose were assayed in three groups of men: fertile controls without significant bacteriospermia (group I), infertile men with significant bacteriospermia; idiopathic infertile men (group II), and infertile men with varicocele (group III). Level of significance of bacteriospermia was greater than or equal to 10(4) germs/ml of ejaculate. In group II, motility and typical morphology percentages were lower, independently of the degree and the nature of bacteriospermia. Incidence of pathogenic bacteria was higher than in group III and linked to the degree of bacteriospermia. Fructose was unaltered in the two groups of infected men. No modification of prostatic markers was observed in any groups, except in group II, where they decreased when bacteriospermia was lower than 10(5) germs/ml and when biological pattern of semen evoked chronic prostatitis. Thus, the presence of germs in ejaculate alters the motility and the typical morphology percentages but does not result in any obvious modifications of biochemical markers of prostate and seminal vesicles. For idiopathic infertile men, it is suggested that the quantitative criterion of pathogenic bacteriospermia is a germ count greater than or equal to 10(5)/ml. PMID- 3833076 TI - Diagnostic value of vaso-seminal-vesiculography. AB - The site of obstruction was evaluated by seminal vesiculography in 24 cases of azoospermia with normal testicular biopsies. In 21 cases, obstruction was located at the level of the tail of the epididymis; in 2 cases ejaculatory duct was obstructed; and in 1 case the injected dye was arrested at the level of internal inguinal ring, at the site of previous hernia operation. Vesiculogram in 24 obstructed cases and 4 cases of chronic seminal vesiculities without obstruction showed one normal picture, four with catarrhal inflammation, and the rest with chronic interstitial vesiculities. Radiological study of a patient complaining of aspermia showed multiple congenital anomalies. The high incidence of chronic vesiculities and postinflammatory obstruction is attributed to underlying bilharziasis. PMID- 3833077 TI - Testis morphometry in varicocele. AB - This study was conducted to evaluate morphometrically the microscopic components of the testis in cases of varicocele, the leading cause of male infertility, with the aim to identify consistent differences from controls. In our specimens of patients with varicocele, the vascular and interstitial fractions, as well as the Leydig cell count, were significantly increased. Our data support the notion that the interstitium is the testicular compartment most consistently affected and that the damage to the tubules is erratic and probably late. PMID- 3833078 TI - Semen characteristics in pubertal boys. I. Semen quality after first ejaculation. AB - Semen specimens from 134 pubertal boys were examined, and some 274 assays were made. An analysis of the biological quality of semen in relation to the period of time after first ejaculation brings high values of statistical dependence of the volume of semen, its liquefaction, spermatozoal concentration, percentage of morphologically normal forms of spermatozoa, and normal spermatozoal motility on the period of time after first ejaculation. Normal figures for semen volume, semen liquefaction, spermatozoal concentration, and morphology are observed 12-14 months after first ejaculation. The percentage of normally motile spermatozoa becomes standard 21-23 months after first ejaculation. There were changes in semen characteristics from azoospermia through cryptozoospermia, oligozoospermia, and asthenozoospermia to normospermia. Azoospermia dominates until the fifth month after the first ejaculation, oligozoospermia from the sixth to the eleventh month, asthenozoospermia from the twelfth to the twentieth month, and normospermia from the twenty-first month. PMID- 3833079 TI - Semen characteristics in pubertal boys. II. Semen quality in relation to bone age. AB - Semen specimens from 134 pubertal boys were examined and compared to bone age. Normal figures for semen volume, liquefaction, sperm concentration, and morphology were observed between 15 0/12 and 16 0/12 years of bone age. The number of normally motile spermatozoa became standard at 17 0/12 years of bone age. Azoospermia was noted from 13 0/12 to 14 0/12 years of bone age, oligozoospermia from 14 0/12 to 15 0/12, asthenozoospermia from 16 0/12 to 17 0/12, and normospermia from 17 0/12 on. PMID- 3833080 TI - Semen characteristics in pubertal boys. III. Semen quality and somatosexual development. AB - The biological quality of semen in 134 pubertal boys was contrasted with somatosexual development. The absence or sparcity of pubic and axillary hair, the absence of facial hair, and infantile-type penile growth are prominent characteristics in azoospermic and cryptozoospermic boys. Sparse or meager pubic hair, absence or sparcity of axillary and facial hair, and puerile penile type are characteristics in oligozoospermia. Female or male pubic hair, meager or normal axillary hair, sparse facial hair, and puerile penile type are characteristic of asthenozoospermia. Female or male pubic hair, meager or normal axillary hair, sparse facial hair, and adult penile type are characteristic in normospermia. Along with the improvement of semen quality the area of the testis expanded and was the largest in normospermia. PMID- 3833081 TI - Technology and instrumentation for semen analyses and AIH/AID. Effect of plastic and glass on sperm motility, pH, and oxidation. AB - Many materials such as glass and different types of plastic are used today to manufacture sperm containers. The biocompatibility of such material, for human semen is usually taken for granted. This paper demonstrates that some types of materials can, however, affect seminal parameters (sperm motility, pH lipid oxidation) as a function of time, therefore introducing biases in semen analyses. Preliminary results indicate that high-quality polypropylene (or ev. polystyrene) is the best material to achieve medium- or long-time conservation of human semen. PMID- 3833083 TI - Psychometry in aging and dementia. PMID- 3833082 TI - Cadmium-induced alterations in the Siberian hamster epididymis. AB - The epididymis of sexually mature Siberian hamsters was found to consist of eight histologically distinct zones that were similar, in most respects, to those reported for other species. The notable exception to this is the presence of two types of tubules in zone 6; the typical major tubules predominate but are accompanied by smaller, contiguous, minor tubules. Following a single parenteral injection of cadmium chloride, the testes became necrotic and exhibited generalized sloughing of the seminiferous epithelium. The epididymis, on the other hand, retained their integrity following cadmium administration, although foci of degenerating cells were observed in the more proximal portions of the organ--i.e., zones 1-3. Vacular compromise is believed to be responsible for these necroses because of the severe edematous changes observed in the interstitial spaces. Evidence is presented for the localized degradation and elimination of necrotic cells from the testes as well as the epididymis. PMID- 3833084 TI - Psychometrics in aging and dementia: advances in geropsychological assessments. AB - Description, explanation and prediction of changes occurring in old age, which are based on intervention, are outlined as a basic goal in gerontological research. Appropriate psychological assessment techniques are necessary to reach this goal. The Nuremberg Gerontopsychological Inventory (NAI) is introduced as a set of psychological measurements which enable reliable, valid and sensitive evaluation of intervention-induced changes in old age. Four independent assessment levels, i.e. standardized performance tests, observer-ratings, self ratings and a personality rating are the core components of this inventory. All assessment techniques are adapted for elderly subjects. Standard scores are available for the age range 55-90 years. Interrelations between the applied independent assessment levels are reported and taken to link different aspects of intervention-induced changes. Measuring psychological performance thus gains practical significance, e.g. in terms of activities-of-daily-living. From 14 independent studies the drug sensitivity of the applied measurements is shown. Finally, some recommendations for future psychometrical research are given. PMID- 3833085 TI - Neuropsychological test performances and normal aging. AB - This study was designed to assess the relevance of normal aging to performance in a variety of neuropsychological tests, in a wide range of age groups. The battery included tests of several cognitive abilities of varying complexity (attention, orientation, memory, self-regulation, categorial ability and so on). The results showed that some tests (Orientation, Attention, Digit Span, Naming, Block Design, Self-regulation, Calculation, Weigl) are not significantly affected by aging while in others performance clearly declines with age. However, the age at onset of the decline is far from uniform. In some tests (Logical Memory, delayed recall section of Supraspan Test, Hooper Test, Finger Tapping Test) it is manifest in early middle age while in others (Faces Recognition, Set Test, Reproduction of Geometric Designs) it does not appear until much later in life. PMID- 3833086 TI - On diagnosis of dementia: psychometric investigation and clinical psychiatric evaluation in relation to verified diagnosis. AB - Patients with early as well as manifest dementia were studied in a longitudinal way with psychometric and psychiatric methods. Tests such as vocabulary, attention test, block design test, verbal and spatial memory tests, reaction time test and examination for aphasia were used as well as a qualitative analysis of behaviour and personality. The differential diagnosis of Alzheimer's disease, Pick's disease and other dementias with fronto-temporal degeneration and multi infarct dementia was based on diagnostic rating scales. Differences in cognitive profiles, qualities of behaviour and scores on combinations of psychiatric rating scales were identified for pathoanatomically verified cases with Alzheimer's disease, fronto-temporal degeneration and multi-infarct dementia. PMID- 3833087 TI - Validity of the ischemic score in degenerative and vascular dementia and depression in old age. AB - Thirty six male and 45 female patients (mean age 66 years) suffering from either dementia of Alzheimer type (DAT) or dementia of vascular type (DVT) with comparable severity and suffering from depression in old age were included in the investigation. The study was performed to evaluate the diagnostic value of Ischemic Score, EEG and CT scan of the brain in differentiating dementia types and depression in old age. The patients underwent physical, psychiatric, psychometric, neurological, neurophysiological and CT scan examinations. Clinical diagnosis and diagnosis related to Ischemic Score were consistent in 86% of DAT and in 65% of DVT. Patients suffering from DVT showed significantly higher incidence of distinct Ischemic Scale items than was found in DAT patients. The Ischemic Scale items were found to be of major importance in differentiating vascular dementia from both DAT and depression. However, it was insufficient to distinguish between the latter two. In EEG, general slowing predominated in DAT (68%), and focal disturbances in DVT (71%). Patients with DAT and depression could not be differentiated on the basis of their EEG findings. CT scans of the brain yielded a higher incidence of brain atrophy in patients with DAT (71%) and DVT (70%) as compared to depressive patients (37%). In DAT, ventricular enlargement seems to be rather disease- than age-related. Psychological testing showed abnormalities in attention and memory performance in DAT and DVT to a significantly greater extent as compared to depression. This study demonstrated that the combination of Ischemic Score and EEG was found to be most valid in differentiating DAT from DVT. Additional cranial computerized tomography and the psychological testing of attention and memory were able to confirm the diagnosis of dementia and to differentiate dementia from depression in old age. PMID- 3833088 TI - The diagnosis of dementia and other "deficitary' psychopathological syndromes in old age: reflections and recommendations of a clinical psychiatrist. AB - Clinical evaluation and staging of dementia and related disorders has been approached in various ways. Performance of subjects featuring cognitive decline has been scored on established, often lengthy psychometric and neuropsychological tests, by means of behavioural rating, and by means of various combinations of simplified psychometric and behavioural evaluations. Although concerning the assessment of the clinical aspects of cognitive decline in the elderly, broad areas of agreement among experts exist, yet there is no clear consensus on a number of assessment issues. There are, for example, different views concerning the utility of particular assessment instruments. Also are there different perspectives from which the selection of psychological performance tests can be undertaken. This paper may contribute a mite in touching the existing literature on several sore points, by formulating some relevant methodological and semantic remarks that could well form a starting point for vigorous discussion. PMID- 3833089 TI - Reliability between the five forms of the Randt Memory Test and their equivalence. AB - The Randt Memory Test (RMT), a recently developed memory test for longitudinal assessment of mild and/or moderate memory deficits provides five different parallel forms. The aim of this study was to control the reliability between forms and their equivalence. A randomized sequence of these five forms was administered to 20 young, healthy university students, balanced by sex, to exclude possible interference due to large IQ discrepancy and/or different degrees of age-related impairment. An analysis of variance for repeated measures was carried out to evaluate the between form equivalence and the possible sequential effect on repetitions. Reliability between forms was also controlled by the Cronbach's alpha. Results show a sufficient high internal consistency and stability of the RMT when used in a repeated measures model, and suggest the need to develop time related curves of the RMT scores for groups of patients with diverse memory disturbances. PMID- 3833090 TI - Reaction time in cerebrovascular disease. AB - One hundred and eight patients have been investigated clinically, by computer tomography and by measuring the reaction time (RT). Thirty six controls without histories of brain disease, normal psychiatric findings and the same mean age as the other groups, were compared with 37 stroke patients without and 35 stroke patients with dementia. The dementia was defined clinically and by a psychological test (WAIS) and by applying a deterioration index (Baxa and Pakesch, 1972). The RT was measured by the Wiener Test system (Schuhfried) using eight optic, eight acoustic and eight choice signals at random for both hands, by adding the decision and motor response time to perform a task. The stroke patients as a whole (72) had significantly longer RT than the controls. When the stroke group was divided according to degree of dementia, in almost all the measurements the RT was significantly longer in the demented group. The localisation of the infarcts with RT with dominant or non-dominant hemisphere lesions showed no significant correlation, despite the fact that RT was longer in patients with infarcts in the dominant hemisphere or in those having bilateral lesions. When IQ was measured, only a few significant correlations were found between IQ and RT. In almost all the measurements a significant correlation between RT and OI was found. It was therefore concluded that RT is an easily applicable method for stroke patients in the differentiation between dementia and normal intellectual functioning, and a useful instrument for evaluating the long term course of intellectual impairment in patients with stroke. PMID- 3833091 TI - High incidence of nonfunctioning oncocytomas in pituitary adenomas (ultrastructural study). PMID- 3833092 TI - Serum thyroid hormones in the patient under intermittent peritoneal dialysis. PMID- 3833093 TI - Decrease of cholesterol and triglycerides serum levels by metoclopramide and by sennosides. PMID- 3833094 TI - Intrahepatic transfusion. PMID- 3833095 TI - Computerized rhinomanometry: a new method for the clinical exploration of the nasal respiratory function. PMID- 3833097 TI - [The occupational outcome of diabetic children]. PMID- 3833096 TI - Danazol in refractory autoimmune thrombocytopenic purpura (ATP). A new therapeutic sequence. PMID- 3833098 TI - [Tooth and face abnormalities associated with pituitary growth hormone insufficiency]. AB - Dental and facial examination has been performed in sixty-two children with idiopathic or congenital growth hormone deficiency. Fourteen (22%) had a malformation of the upper incisors and/or of the naso-frontal bud or of the eyes, associated in five with a malformation of the brain in the prosencephalon-derived areas. Moreover, fourteen patients had some facial abnormality in an area situated near that derived from the naso-frontal bud. These associations are to be considered as a clinical marker able to call for pituitary investigation in short children. They suggest that some cases of so-called idiopathic hypopituitarism relate in fact to congenital and malformative causes. PMID- 3833099 TI - [Di George's syndrome complicated by graft versus host reaction]. AB - On the occasion of a case of Di George syndrome, complicated by a post transfusion lethal graft versus host reaction, the authors review its main clinical and biologic criteria. This case also shows that immune deficiencies should be diagnosed early in order to adopt preventive measures before transferring the patient in a specialized unit, where immunorestitution will be discussed. PMID- 3833100 TI - [Respiratory function during wakefulness and sleep in a 7-year-old child with congenital alveolar hypoventilation of central origin]. AB - Pulmonary function tests were performed in a 7 year-old girl with central alveolar hypoventilation syndrome treated with mechanical ventilation during sleep. Results showed: 1. during wakefulness decrease in residual functional capacity, in dynamic lung compliance and in lung transfer factor for CO; 2. during sleep the characteristics of the syndrome as reported in the neonatal period i.e. central alveolar hypoventilation in stages 2 and 3-4 which justified maintenance of mechanical ventilation when asleep. PMID- 3833101 TI - [Water intoxication in children. Apropos of 2 cases]. AB - The authors report 2 cases of water intoxication. These clinical cases show the importance of neurological signs during the acute period. Hyponatremia is constant and responsible for the clinical signs. A rapid treatment is necessary. PMID- 3833102 TI - [Hospitals transfers of children of Maghreb countries. Reflections on current problems and short- and long-term solutions]. AB - Every year, several thousands of North African children receive transfers to France for hospitalization. The need for these medical transfers is linked to a rapidly expending population, improving diagnostic techniques and inadequate therapeutic technology. Affected children are referred most often for cardiac and oncological diseases. Efforts have been made to discern the medical indications for such transfers, to facilitate the acceptance by social aid agencies and to provide the best possible psychosocial and educational settings for the children involved. Yet, many problems remain, such as advanced disease states and associated diseases at the time of transfer, affective disorders, worsened by the prolonged stay in hospital. Solutions must be found for these problems. Examples would include close collaboration between referred North African and French medical teams, and the existence in France of cultural environment sensitive to the needs to the North African patients. Because transfers are responsible for a high financial and affective cost, and for a dependent relationship between countries, long-term solutions must be considered and could include the transfer of technology and cooperation in research rather than medical care. PMID- 3833103 TI - [Aspects of chronopharmacology in pediatrics]. AB - Pediatric chronopharmacological findings until now have been limited to circadian changes in children 6 to 15 years old. This means that (a) data in neonates and even in infants of one year is not available and (b) other bioperiodicities with periods of several hours (ultradian rhythms) as well as several months and about one year (infradian rhythms) have not been explored in older children. Biologic time-related changes have been documented for phenytoin and theophylline with regards to pharmacokinetics and for orciprenaline and methylprednisolone with regards to effectiveness (bronchodilatation). Despite the limited number of experiments performed to date, it is already possible to admit that, (a) a chronopharmacological approach provides better precision of pharmacologic study than the conventional approach not using time-related data; (b) better therapeutics can be achieved with the help of chronopharmacological facts since an appropriate timing in administration of a medicine usually enhances its desired effects and/or reduces its undesired effects. PMID- 3833104 TI - [Post-transfusion gastrointestinal syndrome in neonatal intensive care]. PMID- 3833105 TI - [Encephalitis of infectious mononucleosis with photomyoclonus on the electroencephalogram]. PMID- 3833106 TI - [Opportunistic mycoses in pediatrics]. AB - The two most important pathologic conditions leading to mycotic opportunistic infections in children are impairment of mechanisms of defense due to immunosuppressive drugs and congenital defects of immunity. Other circumstances belong to pediatrics such as prematurity or cystic fibrosis. A few examples are chosen to illustrate these situations: congenital candidiasis, chronic mucocutaneous candidiasis, chronic dermatophytic disease, neonatal candidemia, mycotic infections in chronic granulomatous disease and aspergillosis in cystic fibrosis. PMID- 3833107 TI - [Opportunistic Toxoplasma gondii infections]. AB - In children with cellular immune deficiency, toxoplasmosis may result in severe infection, chiefly because of cerebral impairment presenting as meningo encephalitis or as a pseudo-tumoral syndrome. Allogenic bone marrow transplantation or AIDS are high risk situations. Most often it is a reviviscence of former foci toxoplasma cysts. Diagnosis is difficult because serology is not contributive. Isolation of trophozoites in the cerebrospinal fluid is rare. CAT scan and sometimes cerebral biopsy allow unquestionable diagnosis. Early treatment (pyrimethamine, sulfadiazine, spiramycine) may lead to complete recovery. PMID- 3833108 TI - [Aspergillus infection and chronic septic granulomatosis]. AB - Chronic granulomatous disease of childhood is a hereditary abnormality of phagocytic cells, frequently associated with Aspergillus infections. From 1969 to 1984, 14 of 37 children with chronic granulomatous disease have presented with pulmonary (13 cases) and/or osteo-articular (1 case) aspergillosis. The paucity of symptoms was a characteristic of these infections. Lung lesions extending to the thoracic chest wall carried the bad prognosis. Neither the Aspergillus skin test nor the Aspergillus serology could definitely confirm the diagnosis. Only broncho-alveolar lavage and biopsy with isolation of Aspergillus could confirm the diagnosis. Long-term therapy with amphotericin B alone or associated with other antifungal agents is necessary. For the past 3 years, ketoconazole prophylaxis has been used in 23 children and none of these children has developed aspergillosis. PMID- 3833109 TI - [Antiparasitic therapy in the child, the newborn infant and the fetus. Pharmacokinetics. Tolerance. Toxicity]. PMID- 3833110 TI - [Antiparasitic therapy of children in Equatorial Africa]. AB - Parasitic infections are endemic in children in Africa, making eradication an impossibility. Therapy is directed towards the individual manifesting an imbalance in the host-parasite relationship. Sanitation education is often disappointing, and until effective vaccines are developed, drug therapy remains the only worthwhile intervention. In order for a drug to be used on a mass campaign basis, financial considerations and side effects are of primary importance. Mefloquine has been shown to be a useful second line drug for chloroquine resistant strains of malaria in our Parasitology department. Benzimidazoles in a single dose are useful for intestinal nematode infections. New drugs are now available for schistosomiasis, filariasis, and protozoan infections. PMID- 3833111 TI - [Indications characteristic for different antiparasitic treatments in endemic zones]. AB - In endemic regions, certain anti-parasitic therapies are automatically prescribed when confronted with apparently benign childhood disorders. The diagnostic differentiation between a simple febrile seizure provoked by Plasmodium falciparum is often impossible, requiring the initial use of intravenous quinine. Helminth or Giardia infestations often aggravate the chronic diarrhea of malnutrition, or are revealed with corticosteroid therapy, necessitating the initiation of an appropriate treatment. In addition, the frequent association of typhoid and schistosomiasis, requires therapy for both in order to prevent relapses. PMID- 3833112 TI - Mast cell-Ito cell pairings found in the Disse's spaces in the liver of the beagle dog. AB - Ito cells (fat-storing cells), containing a few lipid droplets, appeared in the Disse's spaces of the Beagle dog liver. They ranged in diameter from 0.5 to 5 micron. The present study revealed that mast cells were also distributed in the Disse's spaces, while they were encountered only in the interlobular connective tissue in other animals. Although mast cells as well as Ito cells were distributed solitarily in the Disse's spaces, pairing of both types of cells could be frequently observed. Direct contact between both cells was verified using both light and electron microscopy. Also encountered were some peculiar figures of certain Kupffer cells engulfing the cytoplasmic processes and secretory granules of mast cells. These findings indicate a previously unknown intimate relationship between the mast cell and other perisinusoidal cells in the dog liver: the Ito cell, Kupffer cell and endothelial cell. PMID- 3833113 TI - A light and electron microscopic study of lamellated nerve endings found in the rat cheek mucosa. AB - Lamellated nerve endings in the cheek mucosa of fifteen adult Sprague-Dawley rats were studied with light and electron microscopes. Serial sections revealed that the terminal axon of the lamellated nerve endings is in the central portion, and that the inner core is made up of two stacks of lamellae. These are characterized by many corpuscles located within a single papilla, which shows structural specializations at several levels. Electron microscopy showed that the corpuscles are circular in shape and that the lamellar sheets possess a rich rough endoplasmic reticulum, mitochondria and numerous glycogen-like granules. Numerous bundles of collagen fibers and an amorphous substance are located in the interlamellar spaces. The axon terminal is characterized by the presence of neurofilaments, neurotubules and mitochondria. The capsule consists of several laminae formed by cytoplasmic extensions of perineural cells presenting many caveolae, mitochondria, rough endoplasmic reticulum profiles and microfilaments. PMID- 3833114 TI - Ultracytochemical demonstration of alkaline phosphatase activity in astrocytes and subependymal cells in the rat brain. AB - Ultrastructural localization of alkaline phosphatase activity was studied in astrocytes of the cerebral cortex and corpus callosum, and in the ependymal and subependymal cells of the lateral ventricle of normal rat brain by means of electron microscopic histochemistry employing the lead citrate method. Astrocytes exhibited alkaline phosphatase activity on the plasma membrane of the endfeet facing the vascular basement membrane and at the gap junctions, but not on other parts of the plasma membrane or in the cytoplasm. Immature astrocytes containing small bundles of filaments, a few glycogen granules and other cell organelles, exhibited alkaline phosphatase activity on the inner and outer nuclear membranes, the outer mitochondrial membrane and on portions of the plasma membrane. Thus, it was concluded that the distribution of alkaline phosphatase in astrocytes shifts from the cytoplasm and plasma membrane to the endfeet and gap junctions with cell maturation. Alkaline phosphatase activity was detected on the plasma membrane of the subependymal cells and surrounding processes, but not on the ependymal cells. PMID- 3833115 TI - Phagocytosis of spermatozoa and latex beads by the epithelial cell of the cat oviduct: combined SEM and TEM study. AB - The adult cat oviduct was viewed by SEM and TEM as spermatozoa of the same species and inert latex beads were injected into its lumen. The present study demonstrates that nonciliated epithelial cells in extensive areas of the oviduct as well as luminal macrophages are capable of actively taking up both the spermatozoa and the latex beads in the manner of phagocytosis. The epithelial cells are thus able to eliminate foreign bodies including degenerating spermatozoa in order to scavenge the lumen, though the cellular mechanisms involved in their phagocytosic activity remain to be elucidated. PMID- 3833116 TI - Electron-microscopic studies on morphological changes in the surface mucous cell during migration in the stomach of the golden hamster. AB - Morphological changes in the surface mucous cells in the gastric body of the golden hamster occurring during their movement from the lower to the upper portion of the gastric pit have been observed by using scanning as well as transmission electron microscopes. The cells have a wide base and a narrow apex in the lower and middle portions of the pit, while at the opening of the pit to the gastric lumen, they become taller and funnel-like in shape, and are characterized by well developed interdigitations and intermediate filaments sometimes associated with desmosomes. During this transformation of the cell contour, the nucleus moves towards the upper region of the cytoplasm, whereas the Golgi apparatus moves downwards to the infranuclear region. Then, there appear secondary lysosomes showing crinophagy and lipid droplets around or near the Golgi apparatus. Though the basal part of the cells is very small, no images of the detachment of the basal plasma membrane from the basal lamina could be seen even at the site of severe cell degeneration. The tall funnel-shaped cells showing these characteristics are located on the interfoveolar ridges of the underlying fibrous layer and line the free surface of the stomach. Therefore, the interfoveolar cells which have lost the activity of secretory granule production and are going to undergo physiological degeneration are thought to be highly differentiated elements as a covering epithelium to protect the underlying tissue, resembling in this respect the keratinocyte of the epidermis. PMID- 3833117 TI - Immunoregulating influence of levamisole on migration of leukocytes in vivo and in vitro in patients treated for a long time with corticosteroids. AB - Migration of peripheral blood leukocytes test in vivo and in vitro was performed in 60 patients with chronic spastic bronchitis. More than half of subjects studied were given Levamisole (Decaris, Richter). On the basis of a three-year long observation it was shown, that levamisol eliminates a depressive effect of corticosteroids on the migration of leukocytes both in vivo and in vitro. PMID- 3833118 TI - LL2 cell line derived from transplantable murine Lewis lung carcinoma- maintenance in vitro and growth characteristics. AB - LL2 is a new in vitro cell line derived from Lewis lung carcinoma passaged routinely in C57BL mice. It has been in continuous culture for more than 1 year and has survived 72 subcultivations. The cells grow in semi-suspension culture being loosely connected with a culture vessel's surface. The cell line is hypotetraploid, with modal chromosome number 72. Tumorigenicity and metastasibility of the cells are retained but lowered as compared with original in vivo tumor line. The LL2 cell line is being used in studies on phenotypic characteristics (markers) related to its pattern of growth. PMID- 3833119 TI - Enhancement by cyclophosphamide of experimental pulmonary metastases formation of Lewis lung carcinoma. I. Dose-dependence and kinetics of cyclophosphamide effect. AB - The results presented in this study indicate that treatment of mice with Cyclophosphamide prior to Lewis lung carcinoma (LL2) cells inoculation enhanced the formation of artificial lung metastases in a dose-dependent manner. At the dose of Cyclophosphamide equal to 200 mg/kg the number of lung colonies was increased by a factor varying between 8 and 32. The effect was also time dependent and it persists up to seventh day after Cyclophosphamide administration but was not visible when LL2 cells were injected 2 or 3 weeks later. Treatment of mice with Cyclophosphamide after LL2 cells inoculation did not enhance formation of tumor metastases. PMID- 3833120 TI - Characteristics of Mycoplasma strains isolated from stallion semen. AB - Eleven mycoplasma strains were isolated from the semen of 24 stallions. Eight of these strains were identified as Mycoplasma equigenitalium. Three strains which hydrolized arginine could not be identified. The growth inhibition test with immune sera against M. arginini and M. equirhinis was negative. Antibiotic sensitivity test showed that all strains were sensitive to four antibiotic of tetracycline group (oxytetracyclin, minocycline, transcycline and vibramycin). Lincomycin and gentamycin appeared to be the most active against all the strains. Comparative analysis of routine semen examination did not reveal any difference between ejaculates infected with mycoplasma and free of these organisms. However, the levels of certain biochemical components of the semen plasma (glycerylphosphorylcholine, ergothioneine, fructose and of the semen plasma (glycerylphosphorylcholine, ergothioneine, fructose and total protein) from mycoplasma-positive ejaculates were significantly lower than in the semen plasma from mycoplasma free ejaculates. PMID- 3833121 TI - [Comparison of the electrocardiographic effects of equipotent inotropic doses of amrinone and ouabain in isolated hearts of guinea pigs]. PMID- 3833122 TI - [Left ventricular dysfunction in mitral stenosis]. PMID- 3833123 TI - [Vasodilator agents and collateral coronary circulation. I. Dipyridamole. Study of the isolated heart]. PMID- 3833124 TI - [Pre-hospitalization period of the heart attack. Prospective study]. PMID- 3833125 TI - [Constrictive pericarditis after myocardial revascularization. Report of a case]. PMID- 3833126 TI - [Growth of hypoplastic pulmonary arteries with aortopulmonary anastomosis by means of a Gore Tex graft. Report of a case]. PMID- 3833127 TI - [Echocardiographic aspects of pseudoaneurysms of mitral-aortic intervalvular fibrosa. Report of a case]. PMID- 3833128 TI - [Cardiovascular reactions to cold in Antarctic]. PMID- 3833129 TI - [Reperfusion during acute myocardial infarction: questions that remain obscure]. PMID- 3833130 TI - [Two-dimensional echocardiographic study in the fetus of mothers with congenital heart diseases]. PMID- 3833131 TI - [Histological analysis of the gastric mucosa, enterochromaffin cells and gastrin producing cells in endoscopic biopsies of patients with achlorhydria]. AB - Twenty achlorhydric patients and five controls were submitted to gastric endoscopic biopsies in order to study the histological pattern of the gastric mucosa and the number of enterochromaffin (EC) and gastrin (G) cells of the antral mucosa. The histological changes of the oxyntic mucosa of achlorhydric patients were variable being the predominant pattern the severe chronic atrophic gastritis. The antral mucosa was normal in appearance or revealed mild degree of gastritis. In the most achlorhydric patients the antral EC cell number was decreased when compared to the controls and the G cell number were relatively numerous. The results of the present work are suggestive of an increased G:EC cell ratio in achlorhydric patients. PMID- 3833132 TI - [Isolated metastasis of squamous cell carcinoma of the esophagus in the terminal ileum. Report of a case]. AB - Squamous cell carcinoma of the esophagus, with isolated metastasis to the terminal ileum, is a rare finding. Only 18 of such cases have been reported in the medical literature, all of them found at necropsies. The accurate examination of the abdominal cavity, after performing a gastrostomy, showed a neoplastic lesion in the terminal ileum, which was then resected. The histopathological examination revealed the metastatic nature of the lesion. The authors emphasize the importance of a complete and accurate revision of the abdominal cavity on patients with esophagus squamous cell carcinoma. PMID- 3833134 TI - [Exercises of clinical reasoning]. PMID- 3833133 TI - [Clinical conference of the Brazilian Institute for Studies and Research in Gastroenterology]. PMID- 3833135 TI - Hemispheric contribution to vertex augmentation/reduction of the auditory evoked potential. AB - Starting off from the notion that the cerebral hemispheres differ in their processing mode, this paper reports on stimulus intensity modulation of auditory evoked potentials recorded from hemispheric leads (C3 and C4 referenced to ipsilateral mastoid processes) in a sample of 40 male Ss between 18 to 40 years of age. The experimental set up involved the recording of series of 100 trials to binaural clicks of 63.5, 74.6 and 85 dB AL. Ss who were augmenters at the vertex showed positive Amplitude-Intensity function slopes over the left hemisphere; when Ss were Reducers at the vertex, the slopes were negative on the right hemisphere. These results are interpreted in terms of attention deployment or allocation to one or the other hemispheric processing mode. This might constitute a trait-like enduring subject characteristic whose relation to traditional psychometric variables needs further exploration. The modality specificity of this phenomenon is also discussed. PMID- 3833136 TI - [Intrasellar syndrome. Analysis of 506 cases of transsphenoidal surgery]. AB - The author has performed 506 transsphenoidal surgeries but has analyzed in this study only 404 cases. There were 396 hypophyseal tumors, 4 intrasellar cysts and 4 empty sellas. Based in the symptoms presented by the patients he describes an "intrasellar syndrome", characterized by headache, visual disorders and hormonal abnormalities. He calls attention for intrasellar tumors with normal sella, as seen by x-ray. The diagnosis of these tumors were made only by endocrinological studies. At last he shows the advantages of transsphenoidal surgery in this pathology and the excellent results obtained. The mortality of his cases was only 0.2%. PMID- 3833137 TI - [Polysomnographic follow-up of sleep apneas after uvulopalatopharyngoplasty]. AB - Uvulopalatopharyngoplasty (UPPP) was performed in 12 patients with obstructive sleep apnea. Pre-surgical clinical and polysomnographic data were compared with those one to three months after surgery. Excessive daytime sleepiness was partially improved in 4 cases and completely abolished in 8. Total sleep time, sleep efficiency, number of arousals and sleep latency were similar in both evaluations. REM latency to stage 2 markedly increased on the follow-up. Stage distributions were similar in both nights except for stage 4 which was more frequently absent on the first recording. SaO2 levels below 80% were seen in 10 cases before UPPP and in 4 after it. Apnea index decreased in all cases but it reached normal levels only in 4. PMID- 3833139 TI - [Retinal periphlebitis in multiple sclerosis. Report of a case]. AB - Sheathing of peripheral retinal veins occurs in 10 to 20% of patients with multiple sclerosis and can be seen at any point in the progression of the disease. This finding may represent the retinal correlate of the vascular lesions that are present in the central nervous system of patients with multiple sclerosis. Its pathogenesis is still uncertain. In this paper it is registered the occurrence of retinal periphlebitis as one of the initial manifestations of a patient with multiple sclerosis and it is discussed the diagnostic implications of this finding. PMID- 3833138 TI - Steroid receptors in meningiomas. AB - Cytosolic estrogen (ER), progesterone (PR), androgen (AR) and glucocorticoid receptors (GR) were evaluated in 10 meningiomas using a dextran charcoal coated method. We consider as positive specific receptor values greater than or equal to 10 fMol/mg protein. In this study 20% of the meningiomas contained very low titers of specific ER. PR was detectable in 90% of the tumors, at high levels. The mean PR content of PR+ tumors was 60 +/- 38 fMol/mg prot. GR and AR were present in moderate levels, in 70% of the tumors. Competition studies demonstrated steroid specificity for these hormone-binding proteins. Female patients have a higher receptor incidence and titer. In conclusion, it can be hypothesized that the meningioma are a target tissue for steroids and that endocrine therapy may be relevant to unoperable and/or recurrent tumors. PMID- 3833140 TI - [Excessive daytime sleepiness, central type sleep apnea and myotonic dystrophy]. AB - Two cases of myotonic dystrophy with excessive daytime somnolence are described. All-night polysomnographic studies were performed revealing high number of central sleep apnea which triggered micro-arousals and awakenings leading to decrease of sleep efficiency as well as of stage 3, 4 and REM. Obstructive and mixed apneas were found in the normal range. Hypoxia was not present in both recordings. Central sleep apneas and its secondary excessive daytime sleepiness may indicate early signs of the central nervous system impairment related to myotonic dystrophy, as a multi-organ disease. PMID- 3833141 TI - [Pseudohypertrophic myopathy caused by cysticercosis. Report of a case]. AB - A 25 years old woman was admitted with a history of apparent hypertrophy of the calves, specially on the left, slight pain in the legs and difficulty in walking. Electromyography showed giant motor unit potentials with complete interference pattern. Biopsy of both gastrocnemii was performed revealing a cysticercus among inflammatory infiltrate and changes of the muscle fibers. Review of the literature disclosed 12 other reported cases. The age ranged from 10 to 35 years with a median of 25 years. Pseudohypertrophic myopathy due to cysticercosis has been found twice more common in males than in females. History of epilepsy and muscle pain occurs in about one half of the cases and muscle weakness in about one third of them. Usually there is simultaneous involvement of the upper and lower limb girdles. Myotonia is rare but subcutaneous nodules are frequently found. Our case is unique in the literature in which the pseudohypertrophy was confined to the legs and electromyography showed giant motor unit potentials. The pathogenesis of this condition is discussed and attention is called to the differential diagnosis with other pseudohypertrophic muscular conditions such as pseudohypertrophic muscular dystrophy, myotonia congenita, trichinosis, hypothyroidism, amyloidosis and glycogenosis of type I (Pompe's disease) in its juvenile form. PMID- 3833142 TI - [Leucinosis: study of a case]. AB - Report of a case of Maple syrup urine disease in a female neonate, with diagnosis at 26th day of life. The neurological picture consisted of alternating periods of hyper with hypotonicity, seizures, lethargy, poor feeding and respiratory arrest. Demonstration of elevation of plasma branched-chain amino-acids, was the most widely available confirmatory test, and the therapy with MSUD resulted in improvement of the patient. PMID- 3833143 TI - [Inclusion dermoid cyst of the anterior fontanelle: report of a case]. AB - The authors report a case of a congenital dermoid inclusion cyst of the region of the anterior fontanel, in a white boy, 6 months of age. The child had a normal clinical examination as well as normal milestones development. The skull X-Rays showed a soft tissue mass at the region of the anterior fontanel. The underlying bone was not eroded. During the operation, one could observe a cystic mass, well encapsulated, with moderately thickened walls and a small amount of a clear, colorless fluid in it. There was no fistulous tract between the cyst and the skin or the intracranial cavity. The histopathologic examination of the specimen showed a cystic structure surrounded by a stratified squamous epithelium and a few adnexal structures in it. The authors make an extensive review of the literature on the subject. They have found 135 cases published until 1984. PMID- 3833144 TI - [Intracerebral abscess: clinical treatment. Experience with a case]. AB - A case of brain abscess treated non surgically is reported. Complete clinical and radiological resolution is demonstrated. The authors conclude that in selected patients conservative management of focal intracerebral infection may obviate the need for surgical intervention. PMID- 3833145 TI - [Intraventricular meningitis as a complication of purulent meningitis. A case report]. AB - Report of a case of intraventricular hematoma as purulent meningitis complication in a child of 6 months old, without vascular malformation. The evolution was satisfactory after the surgical treatment. PMID- 3833146 TI - [Induced insanity occurring in hospitalized patients of chronic methamphetamine psychosis]. PMID- 3833147 TI - Sociocultural and psychological factors related to alcoholism among American Indians and Caucasians. PMID- 3833148 TI - [The individual differences in responses after alcohol ingestion]. PMID- 3833149 TI - [Alcohol and nutrient intakes for twelve months]. PMID- 3833150 TI - Early neonatal, neonatal, and infantile mortality risk by birth weight and gestational age. PMID- 3833151 TI - Amniotic fluid phosphatidylglycerol for prediction of respiratory distress syndrome. PMID- 3833152 TI - Oxytocin-accelerated labour with and without artificial rupture of the membranes. PMID- 3833153 TI - Placental transfer and newborn metabolism of local anesthetics when used for cesarean section under epidural anesthesia. PMID- 3833155 TI - A 5-year clinicopathological study of 2000 postmenopausal women from Northern India. PMID- 3833154 TI - Fertilization of the human egg and growth of the human zygote in vitro: the Singapore experience. PMID- 3833156 TI - Ectopic pregnancy and fertility control measures. PMID- 3833157 TI - Ovarian pregnancy--a case report. PMID- 3833158 TI - Plasma phosphorus, alkaline phosphatase and calcium levels, and bone mass of the second metacarpal in women: relation to body weight. PMID- 3833159 TI - The biologic role of sex steroid receptors in the decidualization of human endometrium. PMID- 3833160 TI - Histochemical observation of alkaline phosphatase in endometrial abnormalities. PMID- 3833161 TI - Prognostic significance of zinc in pregnancy with hepatitis. PMID- 3833162 TI - Cord blood immunoglobulin M and perinatal outcome. PMID- 3833163 TI - An independent centre of excellence? PMID- 3833164 TI - Quality assurance in The Netherlands: Part 1. An evaluation of the CBO peer review experience in hospital care. PMID- 3833165 TI - A pilot prospective hysterectomy audit. PMID- 3833166 TI - Staff-patient communications in a medical ward. PMID- 3833167 TI - Hospitalisation for childhood diarrhoea in Central Australia. PMID- 3833168 TI - Clerking the postmortem: an audit of permission for postmortem. PMID- 3833170 TI - Where have all the patients gone? PMID- 3833169 TI - Community health records and chronic schizophrenia. PMID- 3833171 TI - Unusual sign of otitis media. PMID- 3833173 TI - Nutrition counselling. PMID- 3833172 TI - Healthy living. A group experience in patient education in general practice. PMID- 3833174 TI - Quality of life: the pursuit of health. PMID- 3833175 TI - Nutrition and the general practitioner. PMID- 3833176 TI - A model of health. PMID- 3833177 TI - Pitfalls and dilemmas in the management of rheumatoid arthritis. PMID- 3833178 TI - Risk factors impinging on Vietnamese women of childbearing age in Australia. PMID- 3833179 TI - Tendon injury. PMID- 3833180 TI - Inguinal herniorrhaphy under local anaesthetic. PMID- 3833181 TI - A decision tree approach to psychodiagnostics. Personality based behaviour disorders. PMID- 3833182 TI - Atopic dermatitis in infants and children. Diagnosis and management. PMID- 3833183 TI - The immunological consequences of allogeneic rat embryo transfer. AB - Blastocysts of the PVG and DA rat strains were transferred to pseudopregnant females of the opposite strain. Those embryos of which the biological and surrogate mothers were allogeneic with respect to each other exhibited a significantly impaired rate of survival. Lymphocytes from PVG rats born following the transfer of blastocysts to DA surrogates invariably possessed anti-(PVG X DA)F1 hybrid graft-versus-host reactivity substantially in excess of that of cells from normal PVG rats. PMID- 3833184 TI - Strongyloides ratti: increase in susceptibility to infection following blockade of the mononuclear phagocyte system in female mice. PMID- 3833185 TI - Rat trypsin: purification, radioimmunoassay and age-related serum levels in normal and spontaneously diabetic BB Wistar rats. AB - A convenient procedure is described for the purification of rat trypsin. Tissue was homogenized and extracted at pH 4 and the soluble fraction purified by a two step affinity chromatography. After polyacrylamide gel electrophoresis at pH 8.8, the purified enzyme was resolved into 1 major and 2 minor bands all of which possessed trypsin-like enzyme activity. Antibodies to rat trypsin were raised in rabbits and utilized in establishing a sensitive radioimmunoassay procedure for the enzyme. The assay was adapted to study the levels of the enzyme in the circulation of normal Wistar and spontaneously diabetic Bio Breeding Wistar rats before onset of insulin-dependent diabetes mellitus in a longitudinal fashion. In the normal rat, serum levels of immunoreactive trypsin were higher in younger animals and showed a decline after weaning. This pattern was also seen in the Bio Breeding Wistar rats. In about half the number of Bio Breeding Wistar rats, serum immunoreactive trypsin levels were much higher than in normal rats. These results may imply that in some Bio Breeding Wistar rats the disease may be associated with inflammatory lesions of the exocrine pancreas. PMID- 3833186 TI - Improved detection of carcinogens by degranulation of microsomes prepared at low g force by glutathione. AB - Rat liver microsomes can be prepared by the addition of glutathione to post mitochondrial supernatant (PMS) and its subsequent sedimentation at 10,000 g. These microsomes seem to be unaffected with respect to their major components, and substantial loss of their ribosomes on treatments with various degranulating reagents shows that they contain intact ribosomes. The indices of ribosomal attachment show that these preparations contain more ribosomes per unit area of membrane surface as compared to those prepared at high g forces. High values of per cent degranulation by incubating these microsomes with coded carcinogens and failure of non-carcinogens to cause this effect show that the technique can be used efficiently for quick, inexpensive and more accurate prediction of carcinogens in human environments. PMID- 3833187 TI - Detection of two lectins in haemolymph from the oyster Pinctada maxima. AB - Two lectins were detected in haemolymph from the oyster Pinctada maxima, a macromolecular (approximately 8 X 10(6) dalton) N-acetyl-galactosamine-binding lectin and a lower molecular weight (approximately 4 X 10(5) dalton) alpha galactose-binding lectin. The macro-molecular lectin agglutinated human type A erythrocytes to a greater extent than human type B or O erythrocytes and was the major lectin detected in the haemolymph. The 4 X 10(5) dalton lectin agglutinated human type A, B and O erythrocytes to the same extent. PMID- 3833188 TI - Simulation as a tool in medical research and development. PMID- 3833189 TI - Closed-loop management of blood pressure in critically ill patients. PMID- 3833190 TI - Measurement of mechanical properties of the anterior cruciate ligament. PMID- 3833191 TI - Analogue implementation of an automatic gain control module for automatic electrophysiological signal sensing. PMID- 3833192 TI - A reusable iodine-125 seed ophthalmic applicator. PMID- 3833193 TI - Total skin electron beam therapy using a Dynaray 18 linear accelerator. PMID- 3833194 TI - Development of a salivary cortisol method for detecting changes in plasma "free" cortisol arising from acute stress in sheep. AB - A simple device for collecting saliva (mainly parotid) from sheep is described. The collection of saliva, and the assay of "free" cortisol in saliva appears to offer certain advantages over the collection of blood, and the assay of serum cortisol, for the assessment of stress in sheep. With a little experience, it is easier to collect saliva than take blood samples when sheep are passing through a race. The "free" cortisol can be measured directly in saliva, whereas in serum, it is first necessary to separate "free" from protein-bound cortisol. Basal levels of "free" cortisol of less than 10 nmol/l were recorded in saliva and blood plasma or serum in unstressed sheep which had previous experience of being handled in a race, Significant increases in salivary cortisol and "free" and total ("free" plus protein-bound) cortisol in serum were found in sheep following adrenal stimulation with synacthen, or after 30 min of stressful transport. This indicates that the salivary cortisol technique is applicable to studies of stress in sheep, and should also be useful for other ruminants. PMID- 3833195 TI - Deaths in Australian freshwater fishes associated with Chilodonella hexasticha infection. AB - The cause of the deaths of bony bream and other native fish in the Finke River near Alice Springs in winter 1984 was infection with the protozoan ciliate Chilodonella hexasticha. The parasites induced severe generalised epithelial hyperplasia in the gills, which would have compromised respiratory exchange and killed the fish through hypoxaemia. It is suggested that similar winter epizootics of ectoparasites have contributed to previous deaths of fish observed in the Finke River, in association with dry season conditions of low water temperatures and flow rates. PMID- 3833196 TI - Congenital bilateral renal hypoplasia in Large White pigs. AB - Bilateral renal hypoplasia and/or agenesis was detected in 6 of 26 pure-bred Large White piglets in 2 consecutive litters. The affected piglets were all dead at birth. The defect was characterised by a variable nephrogenic zone beneath the renal capsule and by a greatly reduced number of glomeruli which were hypertrophied. The piglets were born to the same sow but they were sired by different boars. Both boars and the sow were related through their pedigree. A genetic basis for the defect, probably involving a recessive gene defect inherited in a simple Mendelian manner, seems likely. PMID- 3833197 TI - Fucosidosis in an English springer spaniel presenting as a malabsorption syndrome. AB - A case of alpha-fucosidosis in a 2-year-old male English Springer Spaniel presented as a malabsorption syndrome without any clinical neurological abnormalities. The dog had a history of chronic weight loss, diarrhoea, mild anaemia, hypoproteinemia and reduced jejunal absorption of D-xylose. A diagnosis of fucosidosis with intestinal malabsorption was based on these findings, markedly reduced plasma fucosidase levels and the diffuse infiltration of the lamina propria and submucosa of the stomach, small intestine, Peyer's patches and mesenteric lymph nodes by macrophages with finely vacuolated cytoplasm. Cytoplasmic vacuolation was also a feature of cells of the pancreas, thryroid, parathyroid and adenohypophysis and the epithelia lining respiratory airways and the urogenital tract. Neurons of the autonomic plexuses of the gastrointestinal tract and the urinary bladder as well as those of the brain, spinal cord, spinal ganglia and retina were also vacuolated. The profound decrease in sigma fucosidase activity in the brain, liver and kidney was accompanied by a marked increase in 6 other lysosomal enzymes, especially beta-n-acetyl glucosaminidase. PMID- 3833198 TI - Mycoplasma in ears. PMID- 3833199 TI - Mycoplasma mycoides subsp mycoides in the ears of goats associated with an outbreak of systemic mycoplasmosis. PMID- 3833201 TI - An abattoir survey of neoplasms. PMID- 3833200 TI - Equine leucoencephalomalacia in New Caledonia. PMID- 3833202 TI - Diseases of deer in south eastern Queensland. PMID- 3833203 TI - Application of the comparative cervical test to the identification of false positive reactions to the bovine tuberculin caudal fold test. PMID- 3833204 TI - Inclusion body hepatitis in a tawny frogmouth (Podargus strigoides: Caprimulgiformes). PMID- 3833205 TI - Therapeutic failure of levamisole in dairy goats. PMID- 3833206 TI - Cattle blood parasites and rusa deer (Cervus timorensis). PMID- 3833207 TI - Possible pemphigus foliaceus in a horse. PMID- 3833208 TI - Primary penile and nasal transmissible venereal tumours in a dog. PMID- 3833209 TI - Viral pig diseases in Singapore that are exotic to Australia. PMID- 3833210 TI - Suspected poisoning of cattle by Claviceps spp on water couch. PMID- 3833211 TI - Diagnosis of lead poisoning in dogs. PMID- 3833212 TI - Chlamydia isolated from abortion in sheep. PMID- 3833213 TI - Tracheal populations of Mycoplasma gallisepticum after challenge of bacterin vaccinated chickens. AB - Chickens vaccinated once or twice with inactivated oil-emulsion vaccine against Mycoplasma gallisepticum (MG) or left unvaccinated were challenged intratracheally with the R strain of MG. The population of MG organisms was determined by enumerating tracheal cultures periodically up to 28 weeks postchallenge (PC). The number of organisms in the respiratory tract increased rapidly after 4 days PC, and the number tended to decrease after 4 weeks PC. Tracheal populations of MG varied considerably among individual chickens. Bacterin-vaccinated chickens had numerically lower populations of MG in their tracheas up to 8 weeks PC, but the differences were small and considered of little practical significance. PMID- 3833214 TI - Effect of social environment and oocyst dose on resistance and immunity to Eimeria tenella challenge. AB - Chickens were exposed to graded doses of a suspension of Eimeria tenella oocysts while in environments of high (HSS) or low (LSS) social stress. Both primary cellular resistance and the sensitization phase of cell-mediated immunity were higher in the HSS environment than in the LSS environment. The manifestation of cell-mediated immunity seems to be inhibited by social stress. PMID- 3833216 TI - Turkey coryza: toxin production by Bordetella avium. AB - Twelve strains of Bordetella avium representing isolates from turkeys in the United States, the Federal Republic of Germany, and the Republic of South Africa were tested for toxin production. Sterile filtered sonicates from 9 of 12 strains contained a toxin that was lethal for 7-to-10-day-old poults. Mice were also susceptible to the lethal effects of the toxin. No differences in susceptibility to the toxin were found between Beltsville small white and broad-breasted white poults. The toxin was solubilized by sonication and inactivated by heating at 56 C for 30 min. Treatment with formalin or proteolytic enzymes inactivated the toxin, indicating that it is probably a protein. The evidence suggests that the toxin is involved in the pathogenesis of turkey coryza. PMID- 3833215 TI - Effect of thimerosal concentration on the efficacy of inactivated Newcastle disease oil-emulsion vaccines. AB - Different quantities of the preservative thimerosal in inactivated Newcastle disease oil-emulsion vaccines were tested to determine the influence on the hemagglutination-inhibition (HI) response of broilers. The effect of thimerosal was measured in vaccines that had been stored for 1, 21, and 52 weeks; HI serology was conducted at 2, 4, and 6 weeks after vaccination. Mean HI titers 4 weeks after vaccination decreased at a significant rate (P less than or equal to 0.001) with increasing concentrations of thimerosal. HI titers 4 weeks after vaccination with 1-week-old vaccine were significantly (P less than or equal to 0.05) higher than those after vaccination with 52-week-old vaccine at all thimerosal concentrations tested. Titers were also significantly higher (P less than or equal to 0.05) after vaccination with 1-week-old vaccine than after vaccination with 21-week-old vaccine at all thimerosal concentrations below about 8.25 mg/ml of antigen. Thimerosal at the levels recommended in commercial vaccines does not significantly decrease vaccine efficacy. PMID- 3833217 TI - A comparison of Newcastle disease hemagglutination-inhibition test results from diagnostic laboratories in the southeastern United States. AB - A two-phase comparison was conducted using the Newcastle disease hemagglutination inhibition (HI) test to determine the variation of serologic results from poultry diagnostic laboratories in the southeastern United States. In the first phase of the comparison, most of the 17 participating laboratories in 10 states found the coded negative sera to be negative, and most found the potent sera to have the highest titers. However, there was a wide range of geometric mean titers (GMT's), from 2 to greater than or equal to 113 for the same serum samples. Each laboratory was strikingly consistent at reporting unknown but identical triplicate serum samples to have the same titer, even though the titers were frequently quite different from those of other laboratories. This observation indicated that currently used procedures yielded good reproducibility within individual laboratories but not necessarily between laboratories. In the second phase of the comparison, participants were furnished another set of coded sera, antigen, and a suggested incubation time. The implementation of the recommended incubation period reduced the extent of the lab-to-lab differences, but GMT's between labs still ranged from 11 to 95 on identical serum samples. When all laboratories used the same antigen, the average of the GMT results increased from 38 to 48, but the GMT's from the different laboratories ranged from 7 to more than 2048. Although the comparison exercise resulted in some improvement in uniformity, it was obvious that a continuing voluntary program should be initiated to certify laboratories and promote uniform test methods for specific serologic procedures using coded sera. PMID- 3833218 TI - Influence of temperature on the growth of Bordetella avium in turkeys and in vitro. AB - Effects of temperature on growth of three strains of Bordetella avium were determined in young turkeys and in vitro. Colonization of the tracheal mucosa by two virulent strains of B. avium was significantly greater in cold-stressed turkeys than in heat-stressed turkeys. The avirulent vaccine strain, ART-VAX, colonized tracheas of cold-stressed turkeys to a limited extent but failed to colonize heat-stressed turkeys. Growth rates of the three B. avium strains were determined in brain-heart infusion broth at 30, 35, 40, and 45 C. All three strains grew best at 35 C but were killed by 45 C. Compared with virulent strains, ART-VAX grew markedly less at all temperatures, and most cultures of ART VAX grew at 40 C only after a variable period of declining numbers of viable bacteria. This study indicates that temperature affects growth of B. avium in vivo and in vitro and that growth of the ART-VAX strain is fundamentally different from growth of virulent strains. PMID- 3833219 TI - Efficacy of a commercial turkey coryza vaccine (Art-Vax) in turkey poults. AB - Four laboratory experiments were designed to study the efficacy of the only available commercial vaccine for turkey coryza, Art-Vax. Poults were vaccinated either once or twice at different ages and challenged with pathogenic Alcaligenes faecalis. In another study, commercial turkeys vaccinated at 1 and 12 days of age on a commercial farm were brought to the laboratory for challenge with pathogenic A. faecalis. Both the laboratory- and field-vaccinated poults were given the manufacturer's recommended dosage of the vaccine strain. Regardless of the vaccine schedule or source of poults, the vaccine was not effective in protecting challenged turkeys from infection. Furthermore, the vaccine was not effective in protecting poults less than 3 weeks of age from disease, but it was effective in protecting poults more than 3 weeks of age from disease. These results indicate that although vaccinated turkeys older than 3 weeks of age were not susceptible to disease, they were susceptible to infection and could act as carriers of field strains of A. faecalis, thus perpetuating the risk of infection to flocks subsequently raised in the same buildings. PMID- 3833220 TI - Selection and comparison of Mycoplasma synoviae hemagglutinating and nonhemagglutinating variants. AB - Hemagglutinating (HA) and nonhemagglutinating (NHA) variants were selected from each of two strains of Mycoplasma synoviae, WVU-1853 and Neb-3S. The HA titers of antigens prepared by 100-fold concentration of broth cultures were 1:2560 and 1:5120 for the HA variants and less than 1:5 for the NHA variants. Adsorption of erythrocytes to colonies of the variants was directly correlated with HA activity. The HA and NHA characteristics were stable in vitro, and there was no change in HA titers after repeated transfers in broth medium. Comparisons of pathogenicity indicated differences between strains but not between variants of each strain. Air-sac lesions resulting from exposure to variants of strain Neb-3S were marked, whereas those resulting from exposure to variants of WVU-1853 were slight. The HA titers of isolates recovered from turkey air sacs exposed to the Neb-3S variants varied considerably, suggesting in vivo instability of the HA characteristic. PMID- 3833221 TI - Isolation of avian influenza virus (subtype H5N2) from chicken eggs during a natural outbreak. AB - Avian influenza virus (A/Chicken/Pennsylvania/83; H5N2) was recovered from the yolk, albumen, and shell surface of eggs obtained from naturally infected chicken flocks in Pennsylvania and Virginia. These findings represent the first reported isolation of avian influenza virus from the internal contents of eggs from naturally infected flocks. The need for adequate safeguards to prevent spread of the virus during commercial movement of table and hatching eggs, cracked and "checked" eggs, and egg flats and other materials is emphasized. PMID- 3833222 TI - Tritiated thymidine uptake in chondrocytes of chickens afflicted with tibial dyschondroplasia. AB - 3H-Thymidine was localized in sections of growth-plate cartilage and associated tibial dyschondroplastic lesion by autoradiography. One hour after 3H-thymidine was injected, radioactivity was found in the proliferating zone; after 48 hr it was also in the hypertrophic zone, and by 96 hr it was present in cells that were 4 to 5 mm into the lesion. This indicates that the lesion develops from the growth plate itself. The life span of the cells in the growth plate appears to be about 48 hr. PMID- 3833223 TI - Myiasis in a turkey. AB - A case of cutaneous myiasis was reported in a 3.5-month-old turkey. The bird was invaded by a very large number of maggots on its posterior half. The maggots killed the bird and consumed all the flesh within 48 hours. Microscopic examination of the maggots revealed that they belonged to Lucilia sericata (a dipterous fly). The incidence of myiasis in birds was also discussed. PMID- 3833224 TI - Investigations of toxicity episodes involving chemotherapeutic agents in Victorian poultry and pigeons. AB - This series of case reports details observations on toxicity episodes in poultry due to a variety of chemotherapeutic agents. These problems arose owing to overdosage, variation in species susceptibility, potentiation of the toxic effects of one substance by the presence of another substance, and particular disease or other on-farm factors. Ignorance and accident were responsible for some of these situations. The episodes involved monensin, salinomycin, nicarbazin, sulphaquinoxaline, dinitolmide, dimetridazole, nitrofurans, streptomycin, and 3-nitro-4-hydroxyphenylarsonic acid. PMID- 3833225 TI - Avian paramyxovirus type I infection in pigeons: clinical observations. AB - An outbreak of a neurological disease in pigeons caused by avian paramyxovirus type I occurred in the New York metropolitan area in 1984. It was characterized clinically by head tremors, paresis of the wings and legs, ataxia, torticollis, and loose droppings. Clinical pathologic evaluation revealed anemia and elevated plasma transaminase enzymes. Mortality was virtually 100% in juvenile pigeons, whereas the adults generally experienced much lower morbidity and mortality. PMID- 3833226 TI - Bacterin to control the vertical transmission of Mycoplasma gallisepticum in chickens. AB - A Mycoplasma gallisepticum bacterin was prepared and used in Mycoplasma gallisepticum (MG)-positive primary breeders to control vertical transmission of MG. Two generations were vaccinated, but the third generation was not vaccinated and was monitored serologically. Results showed no evidence of MG at 1 day, 6 weeks, 11 weeks, 16 weeks, or 31 weeks of age. This procedure may offer small breeder organizations and showbird fanciers a way to eliminate MG. PMID- 3833227 TI - Effects of bleeding on mitochondrial ultrastructure in the avian kidney. AB - Three levels of hypovolemia were produced in awake and anesthetized domestic chickens by withdrawing 2.5, 5.0, or 10.0 ml blood per kg body weight. A commercial indirect blood-pressure monitor was unable to detect significant differences between hemorrhaged birds and age-matched controls. Perfusion-fixed kidney samples from unanesthetized birds had mitochondrial low-amplitude swelling in proximal tubular epithelial cells. This response was slight at the lowest bleeding level but was definite at the middle and marked at the highest bleeding levels. PMID- 3833228 TI - Stability of the F strain of Mycoplasma gallisepticum in various diluents at 4, 22, and 37 C. AB - The stability of the F strain of Mycoplasma gallisepticum was determined in reconstituted powdered skim milk, phosphate-buffered saline, tryptose phosphate broth, and distilled water at 4, 22, and 37 C. The culture was stable for up to 24 hr in all diluents at 4 and 22 C. At 37 C, the culture was stable up to 24 hr in phosphate-buffered saline, but there was a slight reduction of viability in tryptose phosphate broth at 8 and 24 hr, and the titer was reduced in skim milk at 24 hr. In distilled water, the culture was stable up to 4 hr at 37 C. A reduced titer was observed after 8 hr, and at 24 hr the culture was no longer viable. PMID- 3833229 TI - Tibial dyschondroplasia in single-comb White Leghorn chicks fed tetramethylthiuram disulfide (a fungicide). AB - Supplementing a practical chick starter diet with 30 mg tetramethylthiuram disulfide per kg of diet produced tibial dyschondroplasia (TD) in single-comb white leghorn chicks without compromising growth or bone mineralization. The incidence and severity of the lesion increased over time, with the highest incidence (40%) occurring in 4-week-old chickens. Microscopically, the lesion was consistent with the description of TD in broilers. This is the first known report of TD in the layer-type chick, which heretofore was felt to be highly resistant to TD. PMID- 3833230 TI - Comparison of filter-paper-eluted whole blood with serum in fowl cholera serology using the enzyme-linked immunosorbent assay. AB - Two methods for collecting blood for measuring antibody activity of Pasteurella multocida were compared. Whole blood was collected on filter-paper strips, dried for 48 hr at room temperature, and then stored in sealed plastic bags at 4 C. Blood was also collected in the usual manner with a needle and syringe, and serum was harvested and stored at -20 C until tested. Eluates of whole blood, obtained by overnight elution of two 4.8-mm discs in 200 microliters of buffered saline at 4 C, were compared with conventionally harvested serum for antibody activity by enzyme-linked immunosorbent assay (ELISA). Paired samples, taken from the same bird at the same time, showed no significant difference (P less than 0.05) in antibody activity as measured by absorbance when the disc-elution process itself was considered to be a 1:20 dilution. It was concluded that eluates of blood, derived from whole blood dried on filter-paper strips, may be used as an alternative to sera in ELISA for measuring P. multocida antibody activity. PMID- 3833231 TI - American Association of Avian Pathologists 1984 summary of disease reports. PMID- 3833232 TI - American Association of Avian Pathologists awards. PMID- 3833233 TI - Probability of survival based on ELISA titer following challenge of vaccinated chickens with the X-73 strain of Pasteurella multocida. AB - The probability of survival of chickens following a challenge dose of the X-73 strain of Pasteurella multocida was calculated based on enzyme-linked immunosorbent assay (ELISA) titer. Chickens were vaccinated subcutaneously with the Clemson University strain of P. multocida. On days 3, 5, 7, 10, 12, 14, 21, and 28 post-vaccination, 10 vaccinated chickens and 5 unvaccinated controls were selected at random, bled, and then challenged with 2000 colony-forming units of X 73. The ELISA titers to P. multocida vaccination and responses to challenge were recorded. A logistic procedure predicted probability of survival related to ELISA titer. The ELISA titer and survival were highly correlated. A flock profile for each day of challenge was developed based on a probability of survival (PS) at the following levels: PS less than 25%, 25% less than or equal to PS less than 50%, 50% less than or equal to PS less than 75%, and PS greater than or equal to 75%. The antibody response of the chickens through 28 days post-vaccination demonstrated a classic response to vaccination. PMID- 3833234 TI - Evaluation of a novel rapid kit for the visual detection of Newcastle disease virus antibodies. AB - A sensitive diagnostic kit for the rapid visual detection of Newcastle disease virus antibodies is described. The kit--ImmunoComb--is based on a modification of the enzymelinked immunosorbent assay and was found to be highly sensitive for detecting local immunity as well as marginal levels of humoral immunity. Therefore, it determines status of immunity and vaccine efficiency. The assay is simple and does not require special equipment or laboratory facilities. This endows the new kit with field applicability. The effectiveness and reliability of the kit were proven by a series of field experiments. Tracheal swabs and blood samples were taken from 20 flocks (chickens and turkeys) and tested by the hemagglutination-inhibition test and by the new kit. There was high correlation between the methods where the level of antibodies in the flocks ranged between negative and very high. PMID- 3833235 TI - Evaluation of a bacteriological and mycological examination of psittacine birds. AB - Results are presented from a microbiological (bacteriological and mycological) investigation and the sensitivity tests of microorganisms isolated over a 2-year period (1983-84) from 80 fecal samples and 466 necropsies of psittacine birds. These results are correlated with signs of metaplasia of the salivary glands due to vitamin A deficiency in large parrots and with low vitamin A levels in the livers of small psittacine birds. Aerobic microorganisms were isolated from 76% of the fecal samples and 67% of the necropsies. Infections with primary pathogenic bacteria were found in less than 10% of the necropsies. Metaplasia was found in 51% of the large parrots, and the vitamin A levels in budgerigars were below acceptable levels. The possible role of a deficient diet in Psittaciformes in the occurrence of microbial infections and their treatment are discussed. PMID- 3833236 TI - Studies on orthoreoviruses isolated from young turkeys. II. Virus distribution in organs and serological response of poults inoculated orally. AB - Day-old specific-antibody-negative turkey poults were inoculated orally with cloned turkey reovirus isolate 81-68. Virus reisolations from 11 different tissues revealed widespread distribution at 3, 5, and 7 days postinoculation (PI). Virus was isolated from the intestines until 21 days PI. Virus was isolated from tendons until day 7 PI and again at day 28 PI. Reovirus serum-neutralization antibodies appeared as early as 7 days PI. All inoculated birds showed positive VN serum titers (greater than or equal to 1:20) by day 21 PI. No reovirus was isolated from control poults, and they remained antibody-negative during the entire experiment. PMID- 3833237 TI - Influenza viruses and paramyxoviruses in ducks in the Atlantic flyway, 1977-1983, including an H5N2 isolate related to the virulent chicken virus. AB - From 1977 to 1983, waterfowl migrating along the Atlantic flyway were annually monitored for orthomyxoviruses and paramyxoviruses in an area in central New York State. A total of 168 influenza isolates were obtained from 1,430 waterfowl. Twenty-four combinations of hemagglutinin and neuraminidase subtypes were detected, with as many as 12 found in a single year. One combination, an H5N2 isolate in 1982, was closely related to the virulent chicken virus that appeared in Pennsylvania in 1983. The prevalence of influenza varied greatly among the common waterfowl species: mallards 42%, black ducks 30%, blue-winged teal 11%, wood ducks 2%, and Canada geese 0%. A total of 89 paramyxoviruses were also from these waterfowl. In contrast to findings with influenza virus, the prevalence of paramyxoviruses did not differ significantly among the duck species. Serotype 1 (Newcastle disease virus) was predominant; three other serotypes were also identified. These findings indicated that ducks in the Atlantic flyway continually harbor influenza viruses and paramyxoviruses. The viruses may be a source of infection for other species. PMID- 3833238 TI - The individual and combined effects of citrinin and ochratoxin A in broiler chicks. AB - Citrinin (CTN) and ochratoxin A (OA) were fed alone and in combination to broilers from day of hatch until 3 weeks of age. Dietary concentrations of 300 micrograms CTN/g and 3.0 micrograms OA/g were used. Birds fed CTN had significantly (P less than or equal to 0.05) lower body weights than controls on days 14 and 21 and increased water consumption on days 7, 14, and 21. Birds fed OA had significantly lower body weights than controls on days 7, 14, and 21 and increased water consumption on day 14. Birds fed CTN and OA in combination had lower body weights than controls and increased water consumption during the experiment, but the alterations were intermediate in severity when compared with those in birds fed CTN or OA alone. Birds fed OA alone or combined with CTN had higher liver and kidney weights than controls, but birds fed CTN alone had only higher kidney weights. Birds fed both CTN and OA had concentrations of serum constituents similar to those in birds fed OA alone, except the levels of cholesterol and triglycerides were not significantly different from those in the controls. Histological evaluation of the kidney indicated no lesions in birds fed CTN alone, but birds fed OA, alone or in combination with CTN, had increased tubular casts and tubular hyperplasia compared with controls. These data suggest that there were no additive or synergistic toxic interactions when 300 micrograms CTN/g and 3.0 micrograms OA/g were fed simultaneously to broiler chicks for 3 weeks. However, the severe growth depression resulting from OA and the increased water consumption associated with CTN toxicosis were ameliorated when CTN and OA were fed in combination. These data may be useful in diagnosing field cases of mycotoxicosis where both CTN and OA are involved. PMID- 3833239 TI - Evaluation of protection against colonization of the chicken trachea following administration of Mycoplasma gallisepticum bacterin. AB - Twelve-week-old commercial white leghorn pullets were given one or two doses of an inactivated oil-emulsion Mycoplasma gallisepticum (MG) vaccine or kept as unvaccinated controls. At 24 weeks of age, all groups were challenged intratracheally with one of six dilutions of a low-passage R strain of MG. Three days postchallenge, the tracheas from all chickens were cultured for MG to determine the number of challenge organisms required to initiate infection. The log10 ID50 of chickens vaccinated 0, one, or two times was 2.9, 3.4, and 3.7, respectively, and the minimum infectious dose (the lowest challenge dose to infect a single bird) was 15, 150, and 1500 colony-forming units, respectively. It was concluded that the vaccine provided measurable, though limited, protection against infection under these experimental conditions. PMID- 3833240 TI - Preparation and biomedical applications of bispecific antibodies. AB - Bispecific antibodies are immunoglobulin molecules with two different antigen binding sites. They can be prepared either by chemical crosslinking of immunoglobulins with different antigen specificities or by reassortment of the polypeptide chains from two different immunoglobulins to produce hybrid molecules with dual specificity. None of the earlier methods for the preparation of bispecific antibodies assure molecular homogeneity without difficult purification procedures; recently, however, a facile and efficient method was developed which can yield pure bispecific antibodies from monoclonal antibody fragments. This new method avoids some of the problems encountered earlier by using arsenite as a dithiol complexing agent to prevent intramolecular disulfide formation and 5,5' dithiobis (2-nitrobenzoic acid) as a thiol activating agent to effect the directed recombination of two different antibody half-molecules. Bispecific monoclonal antibodies thus obtained are useful heterobifunctional reagents on account of their ability to bind two different antigens in a uniquely defined spatial relationship. They have potential applications as agents for enzyme immobilization, in the assembly of enzyme electrodes and multienzyme complexes, as reagents for two-site and homogeneous immunoassays, as electron microscopy markers for subcellular structures, and as targeting agents for cytotoxic drugs. In many of these applications, bispecific monoclonal antibodies have fundamental advantages over the heterogeneous mixtures containing hybrid antibodies that were available in the past. PMID- 3833241 TI - Protein quantitation on both branches of the Heidelberger curve by monitoring the kinetic of immunoprecipitation. AB - For every immunochemical protein quantitation, one must consider the ambiguity of concentration-dependent signals. In immunoprecipitation reactions, where such a phenomenon occurs, the problem has not yet been adequately addressed. Several methods have been cited, which claim to permit an exact concentration determination on the basis of two independent measurements. In the present paper a method is described, in which a concentration determination is unequivocally made through the simultaneous measurement of two (inter-related) reaction parameters. The maximum velocity (Vmax) of the immunoprecipitation and the time (tmax), which was required for the reaction to attain Vmax, are measured simultaneously. Specific test parameters are discussed for the routine protein quantifications. Based on the measurement of 83 samples with pathological immunoglobulins, the findings of this method are compared with those of the classical radial immunodiffusion. PMID- 3833242 TI - ChromoTimeSystem--a new generation of coagulation analyses. AB - A new system of reagents and a dedicated instrument for coagulation and fibrinolysis assays, the ChromoTimeSystem is described. All assays are performed in the Chromotimer, a microprocessor controlled 4 channel photometer which is connected to micro computer. Most of the reagents use chromogenic substrates. PT, APTT, fibrinogen, reptilase time and thrombin time are all performed with 25 microliters of sample and 250 microliters of reagent. Neither predilution nor preincubation steps are necessary improving these photometric assays in respect to practicability and speed compared to coagulometric techniques. The use of photometry in contrast to the varying physical principles of classical coagulation analysis will be a step forward into standardization. PMID- 3833243 TI - New pregnancy and placental proteins and their possible diagnostic significance. AB - In our laboratory a large number of, for the most part, new proteins have been detected by immunochemical methods in extracts from human term placentae: namely 3 pregnancy proteins (SP1, SP2 and SP3), around 40 soluble placental tissue proteins (PPs) and at least 11 different solubilized, apparently membrane associated, tissue proteins. A great deal of the new proteins has been already isolated to purity and characterized. The treatise gives an overview of what is known of the physico-chemical properties and of the possible biological role of these proteins as well as of their occurrence in tissues and body fluids. It also summarizes the possible diagnostic significance of detection and measurement of these proteins on the one hand in pregnant women, on the other hand in patients with tumours and other diseases, as far as this has been already investigated. PMID- 3833244 TI - [Pigmented lesions of the oral cavity]. AB - Pigmented lesions of the oral cavity are of multiple origin. They can be subdivided as follows: non tumoral pigmentations, non melanin pigmented tumors or tumor-like lesions, benign melanin pigmented tumors and malignant melanomas. Among non tumoral pigmented lesions, some of them show melanin deposits: they can be associated with a systemic disease (Peutz Jeghers syndrome, Addison's disease) or have a medicamentous origin, or belong to a lichen migricans. Non tumoral and non melanin pigmentations are principally due to a heavy metal accumulation or an accidental tatoo arising after tooth treatment. Peripheral giant cell granuloma, so-called giant cell epulis is the major non pigmented non melanin pseudotumoral lesion; pigmentation is due to hemosiderin deposits. In the oral cavity nevi are principally of the intramucosal type. Blue nevus, the second type in frequency, is usually located on the hard palate. Primary malignant melanomas are rare in the oral cavity, but it is--because its very bad prognosis--the most important lesion. In order to improve the survival it is necessary to do the diagnosis as early as possible. PMID- 3833245 TI - [Cutaneous and muscular lesions following acute irradiation in swine. Histological and histoenzymological study]. AB - Our present results were obtained in a histological and histoenzymological study done with an experimental porcine model of high dose local irradiation. This model was chosen to simulate accidents which occurred among humans. It enabled the determination of several post-irradiation phases. After an initial phase, with superficial lesions, ischemic necrosis occurred three weeks after irradiation. After two months, expanding necrosis became obvious in the muscular region preceded by an initial spread of vascular lesions. Histo-enzymological studies of the muscular tissue show metabolic alterations which precede histological modifications. Finally, sclerosis observed was characterized by its mutilating pseudo-sarcomatous aspect. PMID- 3833246 TI - [The validity of measuring methods for intranuclear DNA on thin sections. Theoretical and experimental study]. AB - Computer modelling is used to simulate nuclear segments obtained by random sectioning through tissue. A few more computations lead to DNA measurement simulation. Simulation results in negatively skewed DNA frequency distributions. Both the right skewness and the coefficient of variation of measurements are increasing with the ploidy level because nuclear DNA content is assumed to be related to nuclear size in the chosen model. Observed mean values are biased underestimates of expected values but are strongly correlated to the degree of ploidy. Finally, the bias introduced by measuring nuclear segments instead of whole nuclei increases the variance of measurements but contributes to less than half the experimentally observed variance. Our conclusion is that microspectrophotometry on tissue sections is a valuable method for DNA content evaluation of small clusters of pathological cells as one may find in endoscopic biopsies. PMID- 3833247 TI - [Angiolymphoid hyperplasia with eosinophilia. Optical and histo-immunological study of 5 cases with an electron microscopy study of one of the cases]. AB - 5 cases of angiolymphoid hyperplasia with eosinophilia of the skin are reported. This rare condition was initially described in 1969 by Wells and Whimster. The microscopical pattern is characterised by an atypical vascular proliferation associated with an eosinophilic and lymphoplasmocytic granuloma. In our series, immunohistological study demonstrated the polyclonality of the plasmacytoid component. Electron microscopy performed in one case shows endothelial features even in cells forming clusters without well-defined lumen. These results support the endothelial origin of angiolymphoid hyperplasia with eosinophilia. PMID- 3833248 TI - [2 cases of thyroid lipoma]. AB - Report of two cases of thyro-lipoma, a rare variety of adenoma containing fat cells. Only five cases have been reported. Embryogenic or metaplasic origin of the adipose tissue is discussed. PMID- 3833249 TI - [A case of nephrogenic metaplasia (or nephrogenic adenoma) of the bladder]. AB - Aside to a case report, we describe the nephrogenic adenoma an unusual modification of the urothelium of the bladder elicited by chronic irritation. We review the criteria of diagnosis of this disease, which only rely on histopathological examination. Though being a benign lesion, nephrogenic adenoma requires a long term follow-up. PMID- 3833250 TI - [Subacute necrotizing encephalopathy, Leigh's disease. Apropos of a case]. AB - Leigh's disease is a subacute metabolic encephalopathy characterized by bilateral and symmetrical lesions of basal ganglia, mid-brain and pons. Lesions are related to an abnormal pyruvate metabolism which mechanisms remain still uncertain. This disease is rare and the authors present a case with complete anatomic study. PMID- 3833251 TI - [Spinocellular epitheliomas infiltrated by polynuclear eosinophils]. AB - The infiltration of cutaneous squamous cell carcinomas by eosinophils is of rare occurrence. This phenomenon resembles the infiltration of other neoplasms with eosinophils. The proliferative rate of these neoplasms is then reduced. PMID- 3833252 TI - [Cerebral lesions in a case of Degos' disease]. AB - The central nervous system may be involved in Degos disease, but neuropathologic observations are still few. We report a typical case with cerebral involvement. The diagnosis was suggested by the characteristic skin lesions and vascular damage. In the central nervous system, occlusive changes of small arteries were responsible for areas of ischaemic necrosis. These foci of infarction were of varying size, age and distribution. Intestinal lesions were discrete and death was due to several cerebral infarcts. PMID- 3833253 TI - [The National Blood Program of East Germany]. PMID- 3833254 TI - [Current immunologic problems in blood transfusion]. PMID- 3833255 TI - [Autologous transfusion in an orthopedic clinic in cooperation with a district blood transfusion institute]. PMID- 3833257 TI - [Displacement of lumbar epidural catheters--an assessment of the x-ray image for location control]. PMID- 3833256 TI - [Limited isovolemic hemodilution with stroma-free hemoglobin solution in animal experiments]. PMID- 3833258 TI - [Radiocardiographic recording of hemodynamic parameters before and after atropine administration in neonates and infants]. PMID- 3833259 TI - Cellular hypoxia during hemodialysis. Demonstration of intradialytic release of purine and pyrimidine metabolites. AB - Measurement of hypoxanthine/xanthine has been suggested to be a useful indicator of cellular hypoxia. In humans it has been applied for quantitation of asphyxia in the newborn and hypoxic brain damage after cardiac arrest. To investigate if cellular hypoxia occurs during routine hemodialysis we followed leukocyte count, arterial oxygen tension and plasma hypoxanthine/xanthine in 10 stable dialysis patients. Hemodialysis was associated with transitory leukopenia and decrease in oxygen tension. Plasma hypoxanthine/xanthine increased simultaneously with the decrease in leukocyte count and arterial oxygen tension but returned to normal values at the end of treatment. The study demonstrates that routine hemodialysis, even in stable patients, is associated with cellular hypoxia. PMID- 3833260 TI - Failure of naloxone in reversal hemodialysis-induced hypotension. AB - In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial pressure sank below 90 mm Hg. In our patients, naloxone had no effect on the resting arterial pressure or on dialysis-induced hypotension. PMID- 3833262 TI - Analytical profile of Rec 15-1884-2, a new compound with expectorant activity. PMID- 3833261 TI - Continuous venous-venous hemofiltration for the treatment of fluid overload in continuous ambulatory peritoneal dialysis patients. AB - Fluid overload is not infrequent in continuous ambulatory peritoneal dialysis (CAPD) patients. In our experience, extemporaneous continuous venous-venous hemofiltration (CVVHF) was able to correct fluid imbalances refractory to high dose diuretics and hypertonic solutions. We treated 8 of 52 patients (5 females, 3 males, mean age 52 years) on CAPD from 4 to 36 months and with fluid overloads of up to 10 kg. A Biospal SCU/CAVH flat-sheet high-flux hemodialyzer employed for 10 h produced an ultrafiltration rate (QB:150 ml/min) of 11.12 +/- 4.97 ml/min. With an isotonic replacement solution, the filter provided sufficient extraction of small molecules so that CAPD could be interrupted during CVVHF. The procedure appeared well tolerated. This approach reduced the use of hypertonic dialysate, which is not devoid of side effects on ultrafiltration capacity of the peritoneal membrane. PMID- 3833263 TI - Activity of a new androstane derivative on the nitrogen metabolism: antiglucocorticoid effects. PMID- 3833264 TI - Effects of tenoxicam, a new anti-inflammatory drug, on in vitro neutrophil activation. PMID- 3833265 TI - [Densitometric determination of 6-beta-hydroxycortisol in the urine]. PMID- 3833266 TI - [A new method for the sterilization with gasous chemical agents: propylene oxide]. PMID- 3833267 TI - [A method for the instrumental evaluation of skin in cosmetology]. PMID- 3833268 TI - [Polarimetric study of Cannabis sativa L. preparations: preliminary evaluation of cannabinoid content]. PMID- 3833269 TI - [Influence of stochastic factors on bilateral symmetry]. PMID- 3833270 TI - [Occlusion and potentiation in the cardiac effects of combined stimulation of vagal nerves in the rabbit]. PMID- 3833271 TI - Screening of humoral suppression of in vitro granulopoiesis by means of serum inhibitor assay for CFU-GM. PMID- 3833272 TI - Studies on heterocyclic compounds: indol-2,3-dione derivatives. II. Biological activity of chlorinated 3-phenyliminoindol-2(3H)-ones. PMID- 3833273 TI - Studies on heterocyclic compounds: indol-2,3-dione derivatives. III. Biological activity of substituted 3-phenyliminoindol-2(3H)-ones. PMID- 3833274 TI - [Acute toxicity of (2,4,6-trimethoxy) phenyl-3 (pyrrolidinyl-1) propyl-ketone chlorhydrate (buflomedil) and of metacrylic copolymers (eudragit) both alone and in association in the mouse and rat]. PMID- 3833275 TI - [Mechanographic profile of guinea pig intestine. Relaxation]. PMID- 3833276 TI - [Effect of hepatic enzyme induction on urinary excretion of mutagen metabolites in rats treated with metronidazole]. PMID- 3833277 TI - Bombesin-like immunoreactivity in the chicken brain stem. PMID- 3833278 TI - Somatostatin-like immunoreactivity in the chicken brain stem. I. The medulla. PMID- 3833279 TI - Somatostatin-like immunoreactivity in the chicken brain stem. II. The pons and the tegmentum of the mesencephalon. PMID- 3833280 TI - [Hemispheric asymmetry in a visual recognition task. A tachistoscopic study]. PMID- 3833281 TI - [Eating habits of patients hospitalized for cardiovascular diseases]. PMID- 3833282 TI - Maintained transplantability of the Yoshida ascites tumor cells stored at -80 degrees C. PMID- 3833283 TI - Analysis of lead traces in cataractous lenses and in normal lenses by means of an anodic-stripping voltameter. PMID- 3833284 TI - Some current thoughts on anatomy. PMID- 3833285 TI - Anatomical basis of splenorenal anastomosis via the retroperitoneal approach. AB - The authors describe the anatomical basis of splenorenal anastomosis via the retroperitoneal approach. This technique can be used in cases where the transperitoneal approach is contraindicated. PMID- 3833286 TI - Anatomical principles of microsurgery of the tubal arteries. AB - Topographical relationships and size of the arteries of the mesovarium and mesosalpinx were evaluated from the point of view of their usefulness in microsurgical operations on the oviduct (tuba uterina). The results of our investigations showed that reconstitution of the continuity of the arterial vessels during oviduct transplantation seems to be anatomically warranted with respect to the uterine artery (arteria uterina). During ampullar salpingostomy the artery passing from the ovarian artery (arteria ovarica) should be saved and anastomosed with the uterine artery or its tubal branch (ramus tubarius arteriae uterinae) or with the artery passing under the serous membrane of the isthmus. Isthmic salpingostomy does not require a separate procedure in order to retain arterial blood supply to the oviduct. PMID- 3833287 TI - Anatomical study of retrosternal gastric esophagoplasties. AB - Five currently used procedures of gastric esophagoplasty were done in 5 groups of 14 embalmed human cadavers. These procedures were: whole gastric intrathoracic transposition (Kirschner's procedure) isoperistaltic gastric cone (Akiyama's procedure) isoperistaltic gastric tube (Rutkowski's or Lortat-Jacob's procedure); isoperistaltic gastric tube with resection of the lesser curvature; anisoperistaltic gastric tube with intrahilar splenectomy (Gavriliu's, Heimlich's procedure). Gastric morphometry and ascinding vascularization ability and quality of the vascular network were assessed. Injection of plastic dye was used to evaluate the vascularization of the grafts. In 13 out of 14 grafts, whole gastric transposition extended above the sternal notch, for a mean distance of 7.7 +/- 4.9 cm. This basic performance was significantly correlated to the dimensions of the greater and lesser curvatures and to the cardioxiphoid, sternal and hyosternal distances. Absent or poor injection of the distal arterial network, over a mean distance of 3.6 +/- 0.8 cm, was seen in all 14 grafts. Study of the isoperistaltic gastric cone demonstrated that the graft extended above the sternal notch in all 14 cases. The mean distance of the graft segment above the sternal notch was 5.0 +/- 3.0 cm. This basic performance showed a significant correlation only with the dimensions of the greater and lesser curvatures. Absent or poor injection of the distal arterial network of the gastric cones was seen in 9/14 cases, the mean length of the devascularized segment being 1.3 +/- 1.3 cm. Subsequent to resection of the distal zone showing poor vascularization, 13 out of the 14 isoperistaltic cones still extended above the sternal notch. The mean length of the segment above the sternal notch was 3.7 +/- 2.6 cm. All 14 isoperistaltic gastric tubes (without resection of the lesser curvature) extended above the sternal notch. The mean length of the segment above the notch was 15.1 +/- 7.1 cm. This basic performance showed a statistically significant correlation only with the minimum pylorodiaphragmatic distance subsequent to extensive Kocher's manoeuver. Of these 14 gastric tubes, 9 showed poor or no vascularization of their distal arterial network. The mean length of the poorly injected segment was 8.0 +/- 1.8 cm. Subsequent to resection of the poorly vascularized territory, 12/14 grafts were still found to extend above the sternal notch. The mean length of the segment above the sternal notch was 7.1 +/- 6.9 cm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3833288 TI - Anatomical basis of inguinal surgery in children. AB - This paper begins with a review of the embryology of the inguinal region. The authors then point out the special morphological and topographical features of the inguinal canal in male children. These observations were based on the study of 50 inguinal canals from male children. From the anatomical observations described in this study guidelines are proposed for the surgical approach and dissection of the spermatic cord used in the treatment of congenital hernias or abnormal descent of the testis. PMID- 3833289 TI - The crura of the diaphragm and diaphragmatic passage. Applications to gastroesophageal reflux, its investigation and treatment. AB - The authors report an anatomical, morphological and functional study on the diaphragmatic passage of the esophagus. This study allows to conclude that the anatomical structures of the region play an important role in gastroesophageal continence. The idea of "physiological sphincter" must be broadened and take into account the crura of the diaphragm which from a true extrinsic anatomic sphincter. The authors also insist on the dynamic aspect of this region and on the variations of pressure related to the respiratory movements. From a practical standpoint, the conclusions of this study should permit the surgeon to make a dynamic investigation of gastroesophageal reflux and adapt treatment to a more precise physiopathological mechanism. PMID- 3833291 TI - Pigmentary glaucoma: a clinical review of anterior segment pigment dispersal syndrome. AB - Sixty-eight cases (44 males, 24 females) of anterior segment pigment dispersal syndrome are reviewed. Five patients had no rise in intraocular pressure, 38 had ocular hypertension and 25 had glaucoma as shown by optic disc cupping and field loss. All cases had heavy deposition of pigment in the drainage angle together with Krukenberg spindles and/or light reflux through the iris. Other evidence of anterior segment pigment dispersal was common. The condition was commonest in young adult males, but could present at any age and in women. Medical treatment was often successful initially, but continued to control pressure in only 17 of 42 patients. Laser trabeculoplasty helped some patients. Drainage operations of various types were successful in 19 of 23 cases. Iris angiography showed evidence of vascular hypoperfusion of the iris which probably precedes pigment dispersal and suggests that the ultimate aetiology may be a congenital deficiency of the mesodermal support tissues of the iris. Some degree of iris stromal atrophy is also common and may become marked. Pigment dispersal from the pigment epithelium of the iris occurs in susceptible individuals and may be associated with the insertion of the dilator muscle. The term anterior segment pigment dispersal seems appropriate as the condition is limited to the anterior segment. PMID- 3833290 TI - A general review of anomalies of hepatic morphology and their clinical implications. AB - Anomalies of hepatic morphology, as opposed to anatomical variations, are rare. Nevertheless, knowledge of such anomalies is important since they do not always remain clinically latent. Four case studies of different types of anomalies encountered in surgical practice in the adult are reported herein. A general review of hepatic anomalies can be divided into two categories, i.e. anomalies due to defective development and anomalies due to excessive development of the liver. Such disturbances are sometimes associated with malformations of other structures, especially the diaphragm and suspensory apparatus of the liver. Defective development of the left lobe of the liver can lead to gastric volvulus. Conservely, defective development of the right lobe either remains clinically latent or leads to portal hypertension. Anomalies related to excessive development of the liver lead to formation of accessory lobes annexed to the liver. Despite their diversity of shape, size and location, such accessory lobes have common features allowing them to be considered as an entity. In most cases the accessory lobe is found in the infra-hepatic position. Riedel's lobe is the best known example of a sessile accessory lobe. Accessory lobes may also stimulate tumor. In cases where the accessory lobe has a pedicle, torsion is a common event leading to discovery of the abnormal mass. The origin of the anomalies of hepatic morphology occurring in the course of organogenesis remains to be elucidated. The use of ultrasonography should now allow identification of such anomalies prior to the occurrence of an acute complication and in the future to possibly detect them in the fetus. PMID- 3833292 TI - Laser trabeculoplasty and its effect on tonography, central visual fields, and anterior chamber depth. A preliminary study. AB - A preliminary study of ten patients with glaucoma, each of whom has undergone laser trabeculoplasty to one or both eyes, is presented. Tonography-on-treatment was performed on each patient approximately four weeks prior to laser, and repeated approximately ten weeks afterwards. Central fields and anterior chamber depth measurements before and after laser trabeculoplasty are also presented. Intraocular pressures fell by a mean of 12.34 mm (SD +/- 8.5, range 3-23) in all 12 lasered eyes. Central fields improved in ten eyes, and the anterior chamber of treated eyes became shallower by an average of 0.27 mm, compared with untreated eyes (p less than 0.05). Po/C values improved in 11 treated eyes. Very little attempt was made to alter medical treatment during the period outlined above. PMID- 3833293 TI - True exfoliation of the lens capsule. A clinicopathological report. AB - A case of true senile exfoliation of the lens capsule is reported. Electron microscopic examination of the capsule confirmed capsular delamination. The proteins in the remaining sample of exfoliated capsule and in normal capsules were analysed by polyacrylamide gel electrophoresis in the presence of the dissociating agent, sodium dodecyl sulphate, and under reducing conditions (SDS- PAGE). Densitometric scans of electrophoretograms indicated the virtual absence of a 58 kilodalton (kDa) component and approximately half the level of a 74 kDa component in the exfoliated capsule relative to normal capsule. The remaining protein components detected were of identical molecular weight and abundance compared with the normal lens capsule. PMID- 3833294 TI - Evaluation of nine hundred and sixty-seven consecutive intraocular implants. AB - We undertook a survey of all intraocular lenses (IOLs) implanted by two surgeons from 1976 up to the end of 1983. Of the 967 implants, 164 were excluded because of lack of adequate follow-up. Of the remaining 803 cases there were 104 anterior chamber lenses, 185 iris-supported lenses, and 514 posterior chamber lenses. The overall final visual acuity was 6/12 or better in 740 cases (92.2%). Of the remaining 63 cases, 32 had pre-existing disease or associated conditions not directly related to the operation. By analysing the results within each major group of IOL we found that the posterior chamber IOLs had the best final visual acuity (94.4% 6/12 or better) and fewer postoperative complications. The major problems with iris-supported IOLs were corneal decompensation and cystoid macular oedema. PMID- 3833295 TI - A review of Leiske style semi-flexible intraocular lenses 1981-1984. AB - A consecutive series of 205 patients had 237 intracapsular cataract extractions performed with the insertion of a semi-flexible intraocular lens in the period 1981-1983. The average follow-up period was 17.8 months; 87.0% of cases obtained a visual acuity of 6/12 or better after operation, compared with 80.6% of cases whose preoperative visual acuity was 6/36 or worse. Twenty-six eyes (11%) had clinical cystoid macular oedema at some stage after operation, and seven eyes (3%) had persistent cystoid macular oedema at final follow-up. Only one eye had a postoperative retinal detachment. Thirty eyes (14.1%) required treatment for elevated intraocular pressure at some time after operation. PMID- 3833296 TI - Relocation of posterior corneal rings in clinical wide field specular microscopy. AB - A clinical study of posterior corneal rings in human eyes was undertaken using the Pocklington (Keeler-Konan) contact wide field specular microscope designed by Sherrard. The method used to reproduce identical posterior corneal rings in the same human cornea, in vivo, using the contact wide field specular microscope camera, without the aid of a contact lens, is described. The technique enables the clinician to relocate and evaluate a selected area of human endothelial cells in the same eye. PMID- 3833297 TI - Human external ophthalmomyiasis caused by the horse bot fly larva (Gasterophilus spp.). AB - We report the case of a 20-year-old woman who presented with a subconjunctival maggot. The maggot was removed and identified as the larval form of the horse bot fly (Gasterophilus spp.). The patient had been grooming infected horses in a stable prior to presentation. To our knowledge, this is the first well documented case in the ophthalmic literature of external ophthalmomyiasis caused by Gasterophilus spp. PMID- 3833298 TI - Argyrol, argyrosis and the acquisition of art. AB - Argyrosis is a now unfamiliar ocular condition with the lapsing of Argyrol and other related silver compounds from the ophthalmic dispensary. It gives rise to a characteristic clinical picture in the conjunctiva and cornea. Argyrol was invented by Albert Barnes and, with the fortune he made, he was able to gather one of the greatest collections of modern art. The collection is displayed at the Barnes Foundation in Philadelphia. PMID- 3833299 TI - An evaluation of signs in ocular myasthenia gravis and correlation with acetylcholine receptor antibodies. AB - Fifteen patients with ocular myasthenia gravis were examined in detail for 21 different signs, and tested for acetylcholine receptor antibodies. The major signs of ocular myasthenia gravis included ptosis, disorders of ocular rotations, weakness of eyelid closure, "pseudosupranuclear" signs and the lid twitch sign. Acetylcholine receptor antibodies were found in eight of the 15 patients. One hundred and four normal, non-myasthenic patients were also examined for the lid twitch response, and the relationship between the lid twitch of ocular myasthenia gravis and that found in normal subjects is discussed. PMID- 3833300 TI - Methylprednisolone pulse therapy in severe anterior uveitis. AB - Six patients with severe, refractory anterior uveitis (AU) were treated with intermittent, intravenous pulses of methylprednisolone (MP). Five patients had bilateral AU and all had decreased visual acuities. AU was idiopathic in four subjects, one male had ankylosing spondylitis (HLA-B27 +) and one female had juvenile polyarthritis. All patients were initially treated with 1 g of MP intravenously (IV) on alternate days during the first week. Subsequently, patients received weekly injections of MP on a reducing dosage regime to a maintenance dose of 125 mg IV weekly. This therapy produced a rapid resolution of the signs of uveal inflammation and improved visual acuity. Two patients have been maintained on this treatment regime for over 12 months without evidence of disease relapse or serious drug side effect. Pulse MP is effective in the treatment of severe anterior uveitis and may be a useful adjunct in the management of patients with uveitis. PMID- 3833301 TI - A transconjunctival cryosurgical approach for intraorbital tumours. AB - A transconjunctival cryotechnique for the management of retrobulbar tumours is described. Fourteen retrobulbar tumours, evaluated by CT scan, were treated by this simple and minimally invasive operation. Patient's recovery is prompt and uneventful. PMID- 3833302 TI - Blepharospasm: a case study comparison of trihexyphenidyl (Artane) versus EMG biofeedback. AB - Blepharospasm is a chronic condition characterized by involuntary spasmodic closure of the eyelid(s). The present investigation empirically evaluated the relative efficacies of a current pharmacological and a psychological approach in the treatment of blepharospasm. An A-B-A-C-A single-case design was used to compare trihexyphenidyl [Artane] with EMG biofeedback. EMG activity in the frontalis muscle and number of eyeblinks were the dependent variables. The results indicated that Artane had no effect on either dependent measure and that biofeedback had a dramatic treatment effect on both dependent variables. Treatment gains were maintained at a 42-week follow-up. These results are discussed in light of the methodological considerations, the efficacy of psychological intervention, and the need for future research. PMID- 3833304 TI - Biofeedback as an adjunct to psychotherapy in the treatment of vaginismus. PMID- 3833303 TI - Contingently faded heart rate biofeedback: attempted replication of large magnitude decreases. AB - McKinney et al. (1980) reported large-magnitude reductions in heart rate (HR) from resting baseline levels, employing shaping and fading techniques and a reinforcement program in which a secondary reinforcer was awarded both contingently and immediately during training. The four male subjects in this group showed significantly greater HR decreases than a group of four males receiving beat-by-beat analogue HR feedback. The present study compared decreases in HR in 20 male subjects receiving the contingently faded biofeedback procedure to those shown by 10 male subjects for whom reinforcement was contingent on vigilant observation of a visual display, and independent of HR. The former group showed significantly greater decreases in HR that could not be attributed to elevated baseline levels. However, the decreases in HR were not as large as those reported by McKinney et al. (1980). It is argued that future research should assess variables contributing to individual differences in performance. PMID- 3833305 TI - Hepatitis delta virus (HDV) a cause of severe and fulminant acute hepatitis. AB - This report will briefly outline what has been learned since the hepatitis delta virus (HDV) was discovered. The molecular biology of HDV as well as the puzzling epidemiology are analyzed. A special attention is given to the clinical features of HDV liver disease, especially as a cause of fulminant hepatitis. The role of HDV in other severe liver diseases will be discussed. PMID- 3833306 TI - Hepatitis B. AB - Since the recognition and description of the hepatitis B virus in the early 1970s, the spectrum of disease caused by this virus has become clearly defined. Our understanding of the hepatitis B virus has rapidly increased over the past two decades due to the discovery of various serologic markers and correlation of these with clinical and epidemiological data. Advances in techniques in molecular biology, such as recombinant DNA and hybridization have also recently added impetus to hepatitis research. The word-wide consequences of acute and chronic infection have prompted intense research into the development of effective, but as yet expensive, forms of prophylaxis. PMID- 3833307 TI - Effects of sera and spleen cells isolated from partially hepatectomized rats on the growth of Walker-256 tumour. AB - Partial hepatectomy induced acceleration of tumour growth when the subcutaneous implantation of the Walker-256 tumour cells was carried out at the same time with the partial hepatectomy. The intravenous injection of serum or spleen cells isolated from partially hepatectomized rats into Walker-256 tumour bearing rats, resulted in a rapid growth of the tumour. 3H-thymidine incorporation into DNA of Walker-256 tumour cells was parallel to the weight of the tumour. Serum and spleen cells isolated from partially hepatectomized rats have the transfer ability, through activated spleen cells, to stimulate DNA synthesis in tumour cells. Serum acid and alkaline deoxyribonucleases activities were increased after partial hepatectomy, and in the serum of tumour bearing rats which received serum or spleen cells obtained from partially hepatectomized rats. PMID- 3833308 TI - Course of breast cancer disease and ABO blood groups. AB - The clinical records of 551 breast cancer patients were retrospectively analysed. Several parameters have been examined: age at presentation, distribution of stages at the time of diagnosis, incidence of any progression and "progression free" interval after primary treatment, incidence of distant dissemination and distant metastasis-free interval, cancer mortality, time of survival from presentation and time of survival from detection of distant metastases (stage at presentation being taken into account in all evaluations). The results within various ABO blood groups were compared. There were no substantial differences in these parameters within different blood groups. The possible modifications of ABH (O) isoantigens on tumour cells and the immune response to these alien antigens is discussed. PMID- 3833309 TI - [Effect of laser irradiation on collagen production by fibroblasts in vitro]. AB - The effects of the low power laser irradiation (Space Mix 5 Mid Laser) on the 3H proline incorporation in the collagenic proteins produced by two lines of normal human fibroblasts in vitro were studied. The 3H-thymidine incorporation in cultures of control and irradiated fibroblasts of the same lines was also evaluated. The obtained results show that in the experimental conditions considered, laser irradiation may have a positive effect on the production of collagen by the fibroblasts in vitro. This effect is dependent on the time of exposure, the frequency of infra-red impulses and the age of subjects from which fibroblasts were obtained. The laser irradiation in the same experimental conditions does not affect the incorporation of 3H-thymidine in the fibroblasts in vitro. Therefore, the observed increase of collagen production is not dependent on an increase of cellular population. PMID- 3833310 TI - [Fascicular arrangement of the intrinsic muscles of the thumb]. AB - The authors had realised the dissections of 30 thenar eminens with the help of optical magnifying. Its intrinsic muscles of the thumb involves several fascicles with a special insertion and innervation which their confer an accurate function. They are divided in two levels. The dorsal fascicles act on the dorsi flexion of the thumb, the palmar fascicles on the palmar flexion. The fascicles of a muscle run side by side, but the ones of the dorsal level of the adductor are intersected. PMID- 3833311 TI - [Embryonic structure of the cecal region in the chick embryo and its comparison with the human embryo]. AB - We have tried to expose some characteristics of the embryonic structure of the ceco-appendicular region in the chick embryo during its development. And so, to establish a relation between this region in the chick embryo and the same region in the human embryo. PMID- 3833312 TI - [Comparative analysis of the morphological development of the cecal region in the chick and human embryo]. AB - We have reviewed the studies made by some authors about the development of the vermicular appendix in the human embryo, and according with our own investigation line, we have tried to detail in this article a number of relations that we have found between the morphological development of the caeco-appendicular region in the human embryo and the development of the same region in the chick embryo. PMID- 3833313 TI - The use of unsaturated polyester resin solutions in preparing casts of the renal vessels. AB - A technique to prepare casts of the renal vessels using unsaturated polyester resin solutions is described. The dimensions, morphology and relations of the vessels are very well represented by the casts. The methods is economical and easy to apply and the casts can be used for both teaching and pathologic research. PMID- 3833314 TI - Studies on the peripheral pulmonary circulation time in COPD. PMID- 3833315 TI - A protective mechanism against hyperoxia induced lipid peroxidation in the lung of vitamin E-deficient rats. PMID- 3833317 TI - [The effect on extravascular pulmonary fluid of loading hypoxia and decreasing the pulmonary vascular bed]. PMID- 3833316 TI - [Clinical study on the comprehensive approach to acute exacerbations in chronic obstructive pulmonary disease (COPD)]. PMID- 3833318 TI - [A case of mediastinal polycystic teratoma with elevated CEA in the intra-cystic fluid]. PMID- 3833319 TI - [Pseudolymphoma of the lung--report of a case and study of cases reported in Japan]. PMID- 3833320 TI - Genodermatoses. PMID- 3833321 TI - The role of genetics in dermatology. PMID- 3833322 TI - Selected genodermatoses in infants and children. PMID- 3833323 TI - Histopathologic and ultrastructural findings in certain genodermatoses. PMID- 3833324 TI - Comparative genodermatoses. PMID- 3833325 TI - Xeroderma pigmentosum. PMID- 3833326 TI - Quantitative analysis of bone marrow changes during the treatment of hairy cell leukemia with interferon alpha. PMID- 3833327 TI - Intraperitoneal recombinant alpha 2-interferon for 'salvage' immunotherapy in persistent epithelial ovarian cancer. AB - Fourteen patients with epithelial ovarian cancer were treated with intraperitoneal (i.p.) administration of alpha-recombinant interferon (rIFN-alpha 2) after documentation of persistent disease at second-look laparotomy and combination chemotherapy. After therapy, 11 patients had a surgical re-evaluation which confirmed 4 complete responses (36%), 1 partial response (9%), and disease progression in 6 (55%). Five of 7 patients (71%) with minimal residual disease (MRD, i.e. less than 5 mm) had a surgically-documented response, whereas there was none in the 4 patients whose tumors were greater than or equal to 5 mm. Fever greater than or equal to 38 degrees C was seen in 58%, greater than or equal to 39.0 degrees C in 18%; nausea and vomiting in 37%, and abdominal pain in 22%. There was no consistent alteration in peripheral WBC's during treatment, while i.p. monocytes and lymphocytes showed a significant boost on day 1 after each dose of rIFN-alpha 2. Natural killer (NK) lymphocyte cytotoxicity was elevated in the i.p. cavity fluid obtained from most patients on day 1 after treatment, while blood NK values showed considerable variability. Pharmacokinetic studies showed i.p. levels of rIFN-alpha 2 were 30-1000 times blood levels. I.p. rIFN-alpha 2 may act by increasing concentrations of drug and augmenting regional host cells in patients with MRD ovarian cancer. PMID- 3833328 TI - Hairy cell leukemia: an interferon deficient disease? AB - rIFN-alpha 2 is an effective substance in the treatment of HCL. Although the complete eradication of hairy cells from the bone marrow is rarely possible, a dramatic improvement of profound cytopenias can be obtained in most patients, 12 out of 13 in this study. The response can be seen after a median treatment duration of about 2 months and appears to be independent of the presence of the spleen. Once a stable improvement of the peripheral blood values is achieved, one dose of rIFN-alpha 2 every other week may be sufficient to maintain the cell counts. The mechanism(s) by which IFN acts remain unclear. We speculate, that HCL is an IFN deficient syndrome because monocytes which are the major source of IFN alpha are severely depressed in this lymphoproliferative disorder. Following this hypothesis, the IFN therapy would be comparable to the substitution of insulin in diabetic patients. PMID- 3833330 TI - Morals and ethics in pediatric neurosurgery. Presidential address at the XIIIth annual meeting of the ISPN, Mexico City, July 17, 1985. PMID- 3833329 TI - Doxorubicin and interferon: rationale and clinical experience. PMID- 3833331 TI - Electrolyte levels in the CSF of children with nontumoral hydrocephalus. Relation to clinical parameters. AB - The levels of calcium and magnesium (by atomic absorption spectrophotometry), sodium and potassium (by flame photometry), inorganic phosphate and proteins (by spectrophotometry) were measured in the CSF of 27 children with hydrocephalus and compared with the CSF data on 10 controls, so as to study the effect of the blood brain and blood-CSF barrier alterations observed in hydrocephalus, on the CSF electrolytes. Ca (P less than 0.001), Mg (P less than 0.01) and phosphate (P less than 0.05) were found to be increased, K (P less than 0.01) decreased, and Na levels not significantly altered. Linear regression analysis of hydrocephalic patients showed a linear correlation (r = +0.62) between phosphate and proteins (P less than 0.01) and (r = +0.66) between phosphate and Ca (P less than 0.001). Comparison of control CSF electrolyte levels with those found in the CSF of hydrocephalic patients were grouped according to clinical variables: sex (F, M), age (less than or equal to 1.5 months, greater than 1.5 months), etiological variants (congenital, acquired), treated infection (no, yes), surgical treatment (no, yes), time of onset (less than or equal to 1 month, greater than 1 month), ventricular dilation (mild, severe) and intracranial hypertension (mild or severe). These comparisons showed specific increases of Mg for males (P less than 0.05), acquired hydrocephalus (P less than 0.05) and severe intracranial hypertension (ICH) (P less than 0.001), moderate decrease in the Na levels in acquired hydrocephalus (P less than 0.05) and mild ICH (P less than 0.05), specific increases of phosphate in females (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833332 TI - Laryngeal stridor associated with the Chiari II malformation. AB - Twelve patients with Chiari II malformation developed laryngeal stridor and respiratory distress. This may develop when there is acute downward or upward displacement of the malformed brain stem secondary to increased or decreased intracranial pressure. Rapidly progressive hydrocephalus and compression of the lower portion of the IV ventricle are more important factors than the size of the head at birth. For the treatment of these symptoms relief of the increase in intracranial pressure, relief of the pressure difference between intracranial and intraspinal compartments, and selection of a shunt system with a proper flow rate are important. Posterior fossa decompression did not show a favorable effect. PMID- 3833333 TI - Congenital epidermoid cysts over the anterior fontanelle. AB - Epidermoid cysts over the anterior fontanelle were once regarded as rare and exclusive to blacks. The latest reports in the literature indicate a more widespread incidence. Only a few cases have been described in Europe. The authors report three cases of epidermoid cysts in this location occurring in Spaniards. Clinical, radiological, and surgical features are briefly discussed and pertinent literature is reviewed. PMID- 3833334 TI - Brain abscess in childhood. AB - The author review 10 years' experience in managing brain abscess in childhood: 19 cases were treated in children from 1 to 18 years old. The etiology was rhinogenic in 5 cases, congenital heart disease in 5, hematogenous in 3, traumatic in 3, postoperative in 1, and unknown in 3 cases. Brain abscesses that developed by direct spread were located nearby the source, whereas metastatic abscesses (such as cardiogenic or hematogenous) in most cases spread via the vertebral-basilar system, usually developing in the parieto-occipital regions. Four of the 5 cases with multiple abscesses were cardiogenic and one hematogenous. The most important neurological signs were paresis (10 cases) and cranial nerve involvement (10 cases). Six abscesses were sterile and 6 grew aerobic and 6 anaerobic bacteria. In one case, aerobic as well as anaerobic bacteria were found. Fifteen patients were treated preoperatively with antibiotics. The treatment was operative in 17 cases. In two cases, gravely ill on admission, no surgical treatment was given. The etiology, localization, bacteriology, surgical methods, and results in those cases are discussed. PMID- 3833336 TI - Measurements of brain-stem auditory evoked potentials in infancy, childhood, and adolescence. AB - Brain-stem auditory evoked potentials (BAEPs) were measured in 38 patients between 3 months and 18 years of age. In patients with blunt head injuries (N = 28; 73.7%) no significant correlation between BAEP changes and final outcome could be established until day 36 with the exception of wave III changes in 3 children. Because various BAEP abnormalities occurred in all outcome groups and the nature of the changes was transient, we conclude that within this age group there must be a higher resistance to various lesions until irreversible impairment of brain-stem function results. In spite of this result, continuous BAEP recording in this age group appears useful, since this noninvasive investigation represents an objective assessment of topical brain-stem function. PMID- 3833335 TI - The significance of morphological details for developmental outcome in infantile hydrocephalus. AB - Sixty-four infants were selected for evaluation of hydrocephalus and associated cerebral anomalies on CT scan; initial findings are compared with follow-up results after shunt therapy and correlated with psychomotor development. Analysis indicates that initial high-grade cortical thinning, the capability of the brain to recover after CSF diversion, and size and number of associated cerebral anomalies can all be considered decisive factors in estimating prognosis in infantile hydrocephalus. PMID- 3833337 TI - Brain stem necrosis after preradiation high-dose methotrexate. AB - Both cranial radiation therapy (RT) and high-dose systemic methotrexate (MTX) are used to treat intracranial neoplasmas, but both may cause neurologic damage. MTX may be less neurotoxic if given before rather than after radiotherapy. We cared for a 5-year-old girl with a pineocytoma who had progressive brain stem dysfunction 4 months after MTX therapy, followed by local radiation therapy. CT studies were consistent with radiation necrosis that was confirmed at autopsy. MTX used in conjunction with cranial irradiation can result in severe neurotoxicity, even if the drug is given first. PMID- 3833338 TI - Meningiomas in a male fetus from a hormonally dysequilibrated mother. AB - Congenital multiple meningiomas in a male fetus of 37 cm length are reported. The tumor was histologically a highly vascular meningioma. An unbalanced level of hormones before and at the beginning of the mother's pregnancy could be ascertained, which resulted in gestational abnormality. PMID- 3833339 TI - A case of internal carotid artery occlusion successfully treated by encephalo duro-arterio-synangiosis. AB - In many cases, intracranial occlusive strokes in children are treated symptomatically, with a diagnosis of acute infantile hemiplegia. This is because angiography is more difficult in children and, even if occlusive cerebral arterial disease is diagnosed, there is no definite therapeutic procedure. A case is reported of left internal carotid artery occlusion presenting with acute infantile hemiplegia and followed by repeated transient ischemic attacks. Encephalo-duro-arterio-synangiosis--developed as an operation for moyamoya disease--was performed on this patient, resulting in a marked revascularization of the brain in 8 postoperative months with good improvement in symptoms. This suggests that the operation may be effective in chronic cerebral ischemic diseases other than moyamoya disease. PMID- 3833340 TI - [The behavior of global and regional left ventricular kinetics after acute and chronic administration of digitalis in patients with primary and ischemic cardiomyopathy. At rest and after exertion angiocardioscintigraphic evaluation]. PMID- 3833341 TI - [Effect of the cold pressor test on left ventricular performance in normal subjects and coronary disease patients]. PMID- 3833342 TI - [Non-invasive evaluation of left ventricular performance in patients with ischemic heart disease by echocardiography and systolic intervals]. PMID- 3833343 TI - [The left ventricle in ostium secundum type of interatrial defect in the adult]. PMID- 3833344 TI - [Diltiazem in the therapy of arterial hypertension: polygraphic evaluation of left ventricular performance]. PMID- 3833346 TI - [Sudden cardiac death in Holter monitoring: description of a case]. PMID- 3833345 TI - [Beta blockers and the climateric syndrome]. PMID- 3833347 TI - [Type A behavior]. PMID- 3833348 TI - Plasma levels of verapamil and its major metabolites during long-term oral treatment, in chronic stable angina. Correlation with the clinical effects of the drug. PMID- 3833349 TI - [Clinical evaluation of diltiazem in post-infarct angina]. PMID- 3833350 TI - [Effect of propafenone on left ventricular function in patients with myocardial infarct]. PMID- 3833351 TI - [Further studies on the reactivity of renal catecholamine receptors in man in water-salt depletion]. PMID- 3833352 TI - [Serial echocardiographic evaluation of the cardiotoxicity of adriamycin and therapeutic protocols]. PMID- 3833353 TI - [Suppression of complex ventricular arrhythmias with isosorbide dinitrate in a case of congestive heart failure]. PMID- 3833354 TI - [Dyslipidemia coronary risk]. PMID- 3833356 TI - [Acute administration of verapamil in stable angina: increase of the coronary reserve during the exertion test]. PMID- 3833355 TI - [Influence of isosorbide-5-mononitrate on the tolerance test to exertion in angina pectoris]. PMID- 3833357 TI - [Coronaropathy and diabetes mellitus. Clinico-angiographic comparison with non diabetic patients]. PMID- 3833358 TI - [Clinical usefulness of the determination of blood myoglobin in acute myocardial infarct]. PMID- 3833359 TI - [Use of the treadmill test in normotensives with familial hypertension]. PMID- 3833360 TI - [Angiographic demonstration of a double gigantic anastomosis between the coronary and bronchial arterial circuit]. PMID- 3833362 TI - Sudden cardiac death. PMID- 3833361 TI - The pathology of sudden death. PMID- 3833363 TI - Clinical characteristics of sudden death: implications for survival. PMID- 3833364 TI - Coronary artery spasm: a mechanism for sudden death. PMID- 3833365 TI - Mechanism of lethal arrhythmias: results of programmed electrical stimulation. PMID- 3833366 TI - Use of programmed electrical stimulation to predict sudden death after myocardial infarction. AB - The use of programmed ventricular stimulation to identify patients at risk for sudden cardiac death following myocardial infarction has not yet been firmly established. The repetitive ventricular response following extrastimuli does not appear to be useful in identifying patients at risk and should not be used to guide antiarrhythmic therapy. Similarly, the response to single and/or double ventricular extrastimuli delivered at twice diastolic threshold from a single right ventricular site during normal sinus rhythm and ventricular pacing also does not appear to be helpful in identifying patients at risk for life threatening ventricular arrhythmias. A more vigorous stimulation protocol that involves more than one right ventricular site and increased current strength may be necessary to elicit a predictive electrophysiologic response. The need for a more vigorous stimulation is suggested by two preliminary studies. Confirmation of initial reports is necessary. The predictive value of the response to programmed ventricular stimulation must be compared with other noninvasive and invasive measurements of left ventricular dysfunction and the degree of spontaneous ventricular ectopy to determine its superiority or to ascertain multiple variables that can be used together to identify those patients most likely to die suddenly after myocardial infarction. Stimulation protocols used during programmed stimulation must have sufficient sensitivity without sacrificing specificity. A concerted effort using uniform stimulation protocols in large numbers of patients is essential to resolve this important clinical problem. PMID- 3833367 TI - Electrophysiologic testing of survivors of cardiac arrest. PMID- 3833368 TI - Mechanisms and surgical management of ventricular tachyarrhythmias. PMID- 3833369 TI - Epidemiology of sudden death: insights from the Framingham Study. AB - Sudden death victims share most of the major risk factors for coronary disease in general; and the key to prevention is to reduce the risk of coronary attacks, especially by avoidance of cigarettes, correction of obesity, and reduction of blood pressure. The incidence increases with age, with sudden death incidence in women only a third that in men. By incorporating CHD risk factors into a multivariate logistic formulation, a composite estimate of risk is obtained over a wide range. A severely compromised coronary circulation manifested only by ECG abnormalities carries a high risk of sudden death. VPBs associated with sudden death often occur concurrently with ECG signs of LVH, intraventricular block, and nonspecific ST-T abnormalities. Convalescent MI patients with a low risk of sudden death are usually asymptomatic; have a normal creatinine, normal post-MI ECG, no tachycardia, a normal exercise ECG, few VPBs on monitoring, and normotension; and show no signs of cardiac failure. PMID- 3833370 TI - Ulcer management: new drugs, new questions. PMID- 3833371 TI - Bioavailability of ergoloid mesylates liquid capsule. AB - Bioavailability of two formulations of ergoloid mesylates was compared in 18 healthy men. In a randomized, crossover design, each subject received a single oral dose of six liquid capsules and six oral tablets, each capsule or tablet containing 1 mg of the active ingredient. A one-week washout period intervened between the two doses. Blood samples were drawn at intervals up to ten hours after drug ingestion and were assayed for plasma concentrations of ergoloid mesylates by a specific radioimmunoassay. The liquid capsule produced mean peak concentrations and areas under the curve (AUC) that were about 12% higher than those produced by the oral tablet; these differences were statistically significant (P less than 0.05). No statistically significant differences were observed for the other pharmacokinetic parameters, namely, time to peak concentration, apparent rate constants for absorption and elimination, and lag time. As the differences in peak concentration and AUC were less than 20%, even though they were statistically significant, the two formulations were considered bioequivalent according to FDA guidelines for bioequivalence. The therapeutic benefit that might derive from greater bioavailability of the liquid capsule has not been established. PMID- 3833372 TI - Postmarketing study of timolol-hydrochlorothiazide antihypertensive therapy. AB - A postmarketing surveillance study was conducted to determine the safety and efficacy of a fixed-ratio combination containing 10 mg of timolol maleate and 25 mg of hydrochlorothiazide, administered twice daily for one month to hypertensive patients. Data on 9,037 patients were collected by 1,455 participating physicians. Mean systolic blood pressure decreased 25 mmHg and mean diastolic blood pressure declined 15 mmHg after one month of timolol-hydrochlorothiazide therapy (P less than 0.01, both comparisons). Age, race, and sex appeared to have no influence on the decrease in blood pressure. The antihypertensive effect of the drug was greater in patients with more severe hypertension. Overall, 1,453 patients experienced a total of 2,658 adverse events, the most common being fatigue, dizziness, and weakness. Treatment in 590 patients was discontinued because of adverse events. PMID- 3833373 TI - Sedation and pain management during pacemaker implantation, electrophysiologic testing, and related procedures. AB - A technique for the management of pain and anxiety during pacemaker implantation, electrophysiologic studies, and related procedures is described. The technique involves the intravenous administration of small amounts of the narcotic agonist antagonist nalbuphine and the benzodiazepine diazepam. The small amounts of medication used induce relaxation while allowing the patient to interact and cooperate during the procedure. The absence of side effects facilitates outpatient treatment. This method of pain management not only improves the quality of patient care but also encourages earlier hospital discharge. PMID- 3833374 TI - [Seroepidemiological study of viral hepatitis among hospital staffs]. PMID- 3833375 TI - [Rotavirus enteritis in infants and children in five child care centers in Hefei City--a one-year longitudinal survey]. PMID- 3833376 TI - [Drug resistance of pathogenic bacteria, isolated from 435 acute diarrhea patients in Hiu Hau City]. PMID- 3833377 TI - [Isolation of Vibrio fluvialis from the feces of patients with diarrhea]. PMID- 3833378 TI - [Using the Bayes method of probability for the early forecast of the prevalence of epidemic meningococcal meningitis]. PMID- 3833379 TI - [Mortality analysis of malignant neoplasms and cardiovascular diseases 1979-1983 in Tianjin]. PMID- 3833380 TI - Marine natural products. XIV. Structures of echinosides A and B, antifungal lanostane-oligosides from the sea cucumber Actinopyga echinites (Jaeger). PMID- 3833381 TI - Inhibition of alpha-chymotrypsin by Suc-L-Tyr-D-Leu-D-Phe-pNA, a stereoisomer of a specific substrate. PMID- 3833382 TI - Antivertigo agents. V. Quantitative structure-activity relationships of 6-[2-(4 aryl-1-piperazinyl)ethyl]-5,6,7,8-tetrahydro-1,6-naphthyridine s. PMID- 3833383 TI - Quantitative analysis of tertiary and quaternary alkaloids in Corydalis Tuber by ion-pair high-performance liquid chromatography and its application to an oriental pharmaceutical preparation. PMID- 3833384 TI - A color reaction of 1,2-diphenols based on colored complex formation with phenylfluorone and iron(III) and its application to the assay of catecholamines in pharmaceutical preparations. PMID- 3833385 TI - Rat brain glutathione S-transferases. PMID- 3833386 TI - Increased sensitivity of aged erythrocytes to drugs and age-related loss of cell components. PMID- 3833387 TI - Synthesis and immunological effect of deacetyl-thymosin alpha 11 on low E-rosette forming cells of a rheumatoid arthritis patient. PMID- 3833388 TI - Operating conditions for the formation of pellets. PMID- 3833389 TI - Kinetic analysis of the effect of polyhydric alcohols on ampicillin degradation in the presence and absence of aldehydes in aqueous solution. PMID- 3833390 TI - Influence of wetting factors on the dissolution behavior of flufenamic acid. PMID- 3833391 TI - Studies on the effect of water-soluble additives and on the encapsulation mechanism in liposome preparation by the freeze-thawing method. PMID- 3833392 TI - Effects of particle size and stabilizing agents upon dielectric properties of water-in-oil type emulsions. PMID- 3833394 TI - Antitumor effect of oral cisplatin on certain murine tumors. PMID- 3833393 TI - Movement of granules and tablets in the gastrointestinal tract of gastric emptying-controlled rabbits. PMID- 3833395 TI - Reactions of 1-(2-chloroethyl)-1-nitroso-3-(3-pyridylmethyl)urea Narom-oxide with several biological model compounds. PMID- 3833396 TI - Studies on anticancer principles in Chinese medicines. II. Cytotoxic principles in Biota orientalis (L.) Endl. and Kaempferia galanga L. PMID- 3833397 TI - A new platelet aggregation factor from Gynostemma pentaphyllum Makino. PMID- 3833398 TI - The effects of estrogen and antiestrogen on chromatin in human breast cancer cell line, MCF-7. I. PMID- 3833399 TI - Isolation and characterization of a new 5-aminofurylthiazole from the catalytic reduction of 4-(5-nitro-2-furyl)thiazole. PMID- 3833400 TI - Detection of a new series of monoamine oxidase inhibitors. PMID- 3833401 TI - Steric effect in binding of antitumor active platinum (II) complex to nucleic acid base. PMID- 3833402 TI - Inhibitors of prostaglandin biosynthesis from Dalbergia odorifera. PMID- 3833403 TI - [Transduodenal papillotomy and divulsion of the papilla in the treatment of benign obstructions of the common bile duct (retrospective analysis of 186 cases)]. AB - An analysis is presented of 186 cases of biliary benign obstruction, treated with transduodenal sphincterotomy or dilatation-divulsion of the papilla of Vater. The morbidity and mortality rates due to specific complications were 5.4% and 1.6% respectively. No cases of post-operative pancreatitis were observed. Long-term results were re-evaluated in 46 patients after a mean post-operative interval of 18 years. The follow-up demonstrated that the result was completely satisfactory in 70% of cases; fair in 17%, with gastroenterological symptoms not likely related to the biliary disease; poor in 13%, with residual stones or stenosis of the sphincter of Oddi. PMID- 3833404 TI - [Biology and surgery: a team of disciplines or merely two disciplines? (1)]. AB - The present work questions itself about the "ideal" relation between biology and surgery, the necessarily bloody arm of medicine, namely, of that science man has been preparing, parallel with his culture, to enrich the wideness of the defensive slope of his biologic curriculum. Does the instructiveness, we were accustomed to by the university route, give a satisfactory answer? Does not the preparation of a biologic basis seem nearly the arrangement of a compulsory stage, from which to subsequently deviate also in name of technology and by means of same? Surgery can draw advantages or disadvantages from such a way? In the oncologic field it represented the introduction to the anatomical and mechanistic principles which inspired Halsted's thought about radical intervention. At the same time, a sort of dam against the biologic questions was built. Yet, to-day the first leaks occurred, and through them biology prepares itself to flood into surgery, more and more massively. PMID- 3833405 TI - [Current orientation in the surgical treatment of cancer of the thyroid]. AB - The authors reviewed their series of thyroid cancers and analyzed possible factors of the low incidence of these neoplasms in their experience. They outline the importance of total thyroidectomy which must be performed as soon as possible. Cervical lymphadenectomy must be reserved only to papillary cancers in which intraoperative histologic examination give the evidence of multiple metastasis of cervical nodes. PMID- 3833406 TI - [Benign solitary ulcer and acute diverticulitis of the cecum]. AB - The report of diverticulosis of right colon in a patient formerly operated on for perforation of caecum single ulcer appeared to the authors as a confirmation of a common etiology between both lesions. The single ulcer would probably represent a form of manifestation for the acute phlogosis of a diverticulum. PMID- 3833407 TI - [Agenesis of the gallbladder (diagnostic considerations. Apropos of a case]. AB - The authors show a case of gall-bladder agenesis, in the preoperative diagnostics of which both echotomography and T.A.C. were used. From the data of the literature, as well as from the personal experience, one can understand the preoperative diagnosis presuming gall-bladder agenesis can be placed in presence od manifestations of biliary nature added to gall-bladder nonopacity at oral cholecystography and to absence of gall-bladder at echotomography and T.A.C. The certainty diagnosis, however, can be only obtained at laparotomy with the hand exploration, with the preoperative cholangiography and eventually the selective arteriography of hepatic artery. PMID- 3833408 TI - [Traumatic chylothorax (apropos of a case following a closed vertebral-thoracic injury)]. AB - The authors report a case of chylothorax due to blunt trauma with fracture of the spine in a man aged 60. After mentioning the possible pathogenesis and clinics of the case shown, the Authors explain the treatment successfully adopted, that is, the ligature of thorax duct at his inlet in the thorax through right thoracotomy on the 5th intercostal space. PMID- 3833409 TI - [Angiomyolipoma of the kidney]. AB - Kidney angiomyolipoma, although it is a benign tumour, may originate serious complications, which can endanger the patient's life. After a reviewing of the literature, the Authors show a case they had the opportunity to observe, in which it was necessary to perform the emergency nephrectomy. In the last years the modern diagnostical techniques allowed to precociously diagnose angiomyolipoma in preclinical stage, what suggests new therapeutical strategic. PMID- 3833410 TI - [Follow-up clinical evaluation of raffia treatment of perforated peptic ulcer]. AB - The authors, analysing their casuistry of 56 cases of perforated peptic ulcer, treated with simple raffia, think this surgical act, although simple, has its own therapeutical meaning in conditions of emergency such as a peritonitic abdomen. A remote checking of such patients demonstrates the validity of said therapeutical behaviour. PMID- 3833411 TI - [Diverticulosis and diverticular disease (reference to a case of diverticular disease observed in 3 sisters)]. AB - We started from this frequent and important intestinal pathology to emphasize the above mentioned observation of three cases where it was possible to apply three different medico-surgical techniques with excellent results. PMID- 3833412 TI - [Carcinoma of the prostate: statistico-epidemiologic study at Casale Monferrato Hospital (1980-84)]. AB - An investigation on prostatic dancer is reported by AA., along a five years period (80-84) in Casale Monferrato territory (USSL 76, Piedmont) incidence rate (29,8) aid mortality data (27,7) are also reported in comparison to those reported in "Registro Tumori del Piemonte (Turin)", "Registro Tumori Lombardia (Varese)" and ISTAT (national territory). A. marking differencies among reported data, give some explanation about disagreement. AA.'s further assert that the given under-estimation of the incidence rate is due to the different diagnosis in different USSL. The over-estimation of death rate is partially given first by people come back in primitive country of origin, and second by data acquired in original countries, about death. PMID- 3833413 TI - [Involvement of the occipito-atlanto-axial articulation in rheumatoid arthritis]. AB - The authors, after reviewing the world bibliography, remember the seriousness, quoad vitam, of the atlanto-axial sub-luxation as a frequent complication of rheumatoid arthritis. They, for such reason, emphasize the importance of a precocious diagnosis, with the systematic research, in patients suffering from rheumatoid arthritis, of the clinical and radiographic signs of such a dreadful complication. PMID- 3833414 TI - [A case of concurrent subcutaneous injury of the right quadriceps tendon and the left rotular tendon in rheumatoid arthritis]. AB - Authors, after briefly remembered the etiopathogenesis, pathological and therapeutic aspects of subcutaneous ruptures of patellar and quadriceps tendons, present one case of bilateral simultaneous lesions in R.A. PMID- 3833415 TI - [Treatment of melanoma of the choroid. Current trends]. PMID- 3833416 TI - [Orbital injury in the child: radiologic and x-ray computed tomographic diagnosis (apropos of a case)]. PMID- 3833417 TI - [Macular involvement, an element of severity in peripheral uveitis]. PMID- 3833418 TI - [Diffuse retinal pigment epitheliopathy (apropos of 4 cases)]. PMID- 3833419 TI - [Electrophysiologic and sensory evaluation after unilateral implantation of an artificial lens]. PMID- 3833420 TI - [Foreign bodies fixed in the retina: therapeutic attitude. Apropos of 3 cases]. PMID- 3833421 TI - [Symptomatology and diagnosis of congenital paralysis of the VIth cranial nerve]. PMID- 3833422 TI - [Surgical treatment of unilateral paralysis of the 2 levator muscles]. PMID- 3833423 TI - [Hyperaction of the inferior oblique muscles in ophthalmologic practice]. PMID- 3833424 TI - [Our experience with several types of anterior chamber implants]. PMID- 3833425 TI - [Acute myopia and the nephrotic syndrome: physiopathogenetic aspects]. PMID- 3833426 TI - [Operation for cataract on colobomatous eyes]. PMID- 3833427 TI - [Serum and implants]. PMID- 3833428 TI - [Retinal detachment in patients operated on for cataract with implants]. PMID- 3833429 TI - [Complications, in the anterior segment of the aphakic patient, of internal tamponade]. PMID- 3833430 TI - [A case of necrotizing retinitis and 2 cases of perivasculitis]. PMID- 3833431 TI - [Technic for canine angiofluorography. Preliminary note apropos of 2 cases]. PMID- 3833432 TI - [Benign autosomal dominant hereditary optic atrophy]. PMID- 3833433 TI - [Can we verify the psychomotor theory of strabismus?]. PMID- 3833434 TI - [Horton's disease with normal sedimentation rate]. PMID- 3833435 TI - An evaluation of factors associated with proliferative diabetic retinopathy. AB - Many individual factors have been related to development of proliferative diabetic retinopathy. To evaluate possible interactions among these, a constellation of variables were studied in 22 patients with long duration of insulin-dependent diabetes mellitus for greater than 25 years, with minimal background diabetic retinopathy, and compared to 27 patients with insulin dependent diabetes mellitus for a variable duration, but with bilateral proliferative retinopathy. The patients were compatible in age at onset of diabetes (12 +/- 2 in proliferative retinopathy group vs 12 +/- 1 yr in the background retinopathy group). Following initial standard statistical analyses, data were further analysed using Logistic Regression Analysis. In the proliferative retinopathy group males were more prevalent (2.9:1), and patients were treated with larger insulin doses (0.86 +/- 0.07 vs 0.59 +/- 0.04 U/Kg B.W., p less than 0.001). Systemic hypertension and neuropathy were more prevalent (p less than 0.02 and less than 0.004 respectively), and diastolic blood pressure was higher (87 +/- 3 vs 75 +/- 2, p less than 0.01). In the same group diet was higher in carbohydrate and the ratio of polyunsaturated to saturated fats was lower (p less than 0.03, less than 0.05 respectively). HbA1 was higher (0.127 +/- 0.004 vs 0.110 +/- 0.004%, p less than 0.004), but the mean of all available plasma glucose values was not different. Impaired renal function expressed by higher BUN, serum creatinine, and urinary protein and lower creatinine clearance was observed. Nerve conduction parameters were more significantly impaired and plasma triglycerides were higher (1.74 +/- 0.2 vs 0.85 +/- 0.1 mmol/l, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833436 TI - Solid-phase radioimmunoassay for relaxin. AB - A specific radioimmunoassay (RIA) for porcine relaxin is described in the present report, which also discusses its characterization in terms of its specificity and cross-reactivity to human and rat relaxin. The antibodies used in this assay were developed in rabbits immunized against highly-purified porcine relaxin. They were adsorbed on polystyrene tubes via incubation of a 1:40,000 antibody dilution for 24 hours. NIH relaxin was utilized for iodination by the Bolton-Hunter method and for the standard curve. The RIA was sensitive from 31.3 to 8,000 pg/tube of the porcine hormone. Rat relaxin cross-reacts with the anti-body, but the displacement curve produced by purified rat relaxin was shifted to the right by two orders of magnitude when compared to porcine relaxin. Displacement of 125I porcine relaxin was also observed with the plasma of pregnant rat or woman, but about 100 times more plasma of these two species was required to produce the same displacement. No cross-reactivity was observed with human, bovine and porcine insulins. This RIA for relaxin will permit clinical evaluation of plasma relaxin concentrations during gestation and in different associated diseases. The concentrations of relaxin in human plasma obtained by this method might represent only a fraction of the actual concentration of the hormone due to low cross reactivity of the anti-porcine relaxin with human hormone. It is also possible that relaxin is present in lower concentration in the plasma of pregnant woman in comparison to pregnant sow plasma. PMID- 3833437 TI - Pulmonary edema: "whodunit?". PMID- 3833438 TI - The role of the polymorphonuclear leukocyte in the pathogenesis of the adult respiratory distress syndrome. AB - A major nonrespiratory function of the mammalian lung is that of a polymorphonuclear leukocyte reservoir. Within this reservoir, granulocytes are distributed between marginating and circulating pools. Under normal conditions these cells release little, if any, toxic metabolites. Situations which facilitate chemotactic release, activation of complement, or prolonged lowering of pulmonary blood flow lead to sequestration of large numbers of polymorphonuclear leukocytes in the lungs. If these polymorphonuclear leukocytes are then stimulated to release toxic oxygen species, proteases or other metabolites, existing defense mechanisms are overwhelmed and lung injury results. Anaphylatoxins generated by complement activation, humoral factors released from platelets or macrophages, and activation of the kallikrein-kinin and coagulation systems, may exacerbate damage to the alveolar-capillary membrane. Permeability of this membrane increases, there is interstitial and then alveolar edema, with subsequent pulmonary dysfunction. While there is little doubt that this scenario holds true for some experimental models of acute lung injury, its applicability to adult respiratory distress syndrome is still controversial. Nevertheless, adult respiratory distress syndrome does arise under conditions facilitating chemotactic factor release from macrophages (e.g. hyperoxia), in situations where widespread activation of complement occurs (e.g. sepsis, trauma, microemboli), and in shock conditions where pulmonary blood flow is often lowered. Correlations exist between adult respiratory distress syndrome and activation of complement, acute neutropenia, sequestration of polymorphonuclear leukocytes and enhanced functional and metabolic activity of granulocytes. Although these findings suggest that polymorphonuclear leukocytes are an important factor in the pathogenesis of adult respiratory distress syndrome, its precise role remains to be determined. PMID- 3833439 TI - New clinical issues in in vitro fertilization. PMID- 3833440 TI - The use of embryo cryopreservation in human IVF programmes. PMID- 3833441 TI - Psychological issues in IVF. AB - The role of psychological factors in IVF is complex. Psychological issues intertwine with physical ones, often with additive effects. The very diagnosis of infertility is likely to cause stress. In addition, the many investigations and procedures may have compounded distress. There are probably a small number of patients in whom psychological factors may induce infertility. But in the majority, psychological factors may exacerbate infertility and influence the patient's and partner's responses. Mental, sexual, marital and social adjustment may all be affected. The procedure of IVF is likely to have a further impact. A pilot study of couples entering an IVF programme revealed the women to be highly anxious and to conform strongly to feminine stereotypes. Many had received psychiatric help in the past. The idiopathic group appeared to cope less well with stress and had higher anxiety and neuroticism scores. Follow-up revealed that IVF had a profound impact on many of the women. Most had received no counselling in the interim. In those who completed questionnaires at follow-up, a differential effect was observed between the organic and idiopathic groups. State anxiety fell in the idiopathic group but so did marital adjustment. The clinician is advised to incorporate consideration of the psychological aspects of IVF into every aspect of the programme. The addition of a psycho-social team may assist the gynaecologist in this and help the couple to make an optimal adjustment. PMID- 3833442 TI - Obstetric outcome. AB - Pregnancy outcome after in vitro fertilization (IVF) is influenced by many factors, some specific to IVF pregnancies and others shared with the general obstetric population. These factors include the characteristics of infertile couples and their underlying causes of infertility, the criteria used by IVF programmes for selecting couples for treatment, the techniques of fertilization and embryo transfer, the management of the early stages of pregnancy and the high incidence of multiple pregnancy. In comparing outcomes in different IVF programmes or with naturally conceived pregnancies, careful attention must be given to definitions and to the methods used to diagnose pregnancies. Very few studies of pregnancy outcome after IVF have been published so far. The incidence of ectopic pregnancy and spontaneous abortion seems higher than in natural pregnancies. Multiple pregnancy is common in those programmes electing to transfer more than one embryo into the uterus. In one study, preterm birth and low birthweight were about three times more common than in population-based figures. As a result, higher perinatal mortality would also be expected, but no studies are yet available. The sex ratio and the incidence of major congenital malformations appear similar to natural pregnancies, but there are insufficient data to determine whether the risks of chromosomal abnormalities are altered in IVF pregnancies. Further studies are needed to confirm these preliminary results, to obtain better information about the occurrence of chromosomal abnormalities in spontaneous abortions, and to assess fetal growth. Comparisons of results would be enhanced by international agreement on terminology and definitions for pregnancy losses, particularly those occurring in the early stages of pregnancy. Couples considering in vitro fertilization as an option for treatment of their infertility should be counselled about their overall chances of achieving a pregnancy and live births, as well as about the outcome of these pregnancies. PMID- 3833443 TI - Children of IVF. AB - This chapter has reviewed issues relevant to the consideration of children conceived by in vitro fertilization. The rationale and motivation for studying these children and the factors which might be relevant to their development have been discussed. Such factors involve the child, the parents, the family as a whole and the influences of the community at large. While as yet there is a paucity of research concerning these issues, questions can be generated by reference to possible related areas, such as adoption. The authors then discussed their study of a group comprising the first families (49 children) whose children were conceived by IVF in the Monash Hospital. All children received paediatric follow-up and 33 has psycho-social follow-up. The findings do not indicate any increased risk of pathology in IVF children or in their families. However, there was a significant increase in very low birth weight children and in twins. Those children with problems tended to fall into these two groups. It is recognized that this was an unmatched group seen at an early stage in development. The significance of these findings have been discussed and issues for management raised. There was also discussion of future directions for research in this area, particularly the need for a careful, long-term follow-up study of families in which children are conceived by in vitro fertilization. PMID- 3833444 TI - Current ethical issues in IVF. AB - This article has briefly reviewed the range of public policy issues and ethical questions raised with respect to IVF. It then discussed selected issues that are now under policy debate and decision. Given the wide acceptance of IVF as a medical procedure for married couples, what variants might also be ethically defensible? IVF for unmarried couples appears defensible under specific conditions that are equally applicable to married couples. Involvement of third parties (gamete donation and gestational surrogacy) is more complex and needs case by case examination. Sperm donation appears to generate little that is ethically new when coupled with IVF but requires the same care and concern as AID. Egg or embryo donation, however, does raise new ethical questions that need close attention and continuing analysis. Freezing of human embryos also breaks new ethical ground, particularly in the options it generates beyond a narrowly defined medical domain. Certain of these options are better not undertaken without further public policy decision. Improvement of current procedures and techniques through effective clinical trials can be ethically carried out in terms of scientific and medical perspectives. However, efforts in this direction will be more effective if undertaken within a public policy framework that clearly defines acceptability during a transitional period of confidence building. PMID- 3833445 TI - Legal issues in IVF. AB - It is desirable when considering legal issues related to IVF not to restrict attention solely to the impact of laws in existence at the time the IVF technology appeared. Laws then in existence were not designed with IVF in mind. New laws are needed, particularly to deal with legal problems that will arise from 'existing' laws in relation to two unprecedented features of IVF. These are the new technology whereby fertilized human eggs may be frozen, stored and later used for childbearing, and the fact that a 'host' mother may bear an IVF embryo. This chapter has discussed legal issues in IVF by examining in succession: a number of matters of basic social concern that require attention and raise questions that should be answered before new laws are made the need for laws on IVF to rest on clear principles acceptable to the community the application to IVF of 'existing' laws in six countries (France, the United States, Canada, England, Israel and Australia) and the kinds of problem that are thereby raised new laws that have already been created in Australia specifically to regulate IVF, and new laws that are in the course of preparation in the United Kingdom. PMID- 3833446 TI - Postscript: the significance of the early human embryo--a broad perspective. PMID- 3833447 TI - Diabetic neuropathy. Proceedings of the 1st International Hvidore Symposium. PMID- 3833448 TI - Noradrenaline kinetics in diabetic autonomic neuropathy. PMID- 3833449 TI - Sympathetic defects in diabetic autonomic neuropathy. PMID- 3833450 TI - Autonomic neurophysiology in long-term diabetes. PMID- 3833451 TI - Collagen fiber formation in repair tissue: development of strength and toughness. AB - Dermal repair tissue shows a progressive increase in collagen content which may be related to the wound tensile strength. Wound strength and extensibility are lower than those found in normal skin. In animals, wounds closed by metal clips are chosen as a model to study the proliferative and remodeling phases of healing from a mechanical and morphological point of view. During the proliferative phase the low wound strength is associated with formation of collagen fibers of small diameter, later, (days 28-45) an acute change appears corresponding to the remodeling phase, with increased collagen fiber diameters observed by scanning electron microscopy and light microscopy, and increased tensile strength and toughness. By 180 days, wound strength and collagen fiber morphology were close to that observed in the normal skin. These observations show a direct relationship between collagen fiber diameter and tensile strength. In addition, packing density of collagen fibrils (determined by the birefringence retardation per unit thickness under polarized light) was unchanged until day 90, although collagen fiber diameters increased during this time. PMID- 3833452 TI - Characterization of collagens in phenytoin-enlarged human gingiva. AB - The collagen content and composition of human gingivae enlarged due to phenytoin medication were compared to normal and inflamed gingival tissues. Phenytoin enlarged gingiva contained significantly higher amounts of collagen. The ratio of type I to type III collagen was different in enlarged tissue, with less type I and an elevated amount of type III collagen present. The amount of type V collagen did not differ among normal, inflamed and phenytoin-enlarged gingivae. PMID- 3833453 TI - Cessation of epithelial cell movement at native type I collagen-epithelial interface in vitro. AB - Two foci of gingival epithelial cells from the dog were grown in culture in dishes which were coated with gingival epithelial extracellular matrix (GEEM). A streak of native, reconstituted type I collagen fibers had been placed at the midline of the dish between the two foci. The epithelial cells spread and proliferated in all directions, but their motility ceased at the collagen epithelial interface, where they piled up and formed several layers. It is concluded that type I collagen may serve as a biological barrier to stop undesirable epithelial cell movement in vivo. PMID- 3833454 TI - Normal nutritional requirements and unusual nutritional practices. PMID- 3833455 TI - Feeding the mother and infant. PMID- 3833456 TI - Follow-up studies on small for dates infants. PMID- 3833457 TI - Environmental factors affecting fetal growth. PMID- 3833458 TI - Human chromosomal heteromorphisms in Delhi newborns. IV. Inter-relationship between C-band size and inversion heteromorphisms. AB - The inter-relationship of C-band size and inversion heteromorphisms was studied in 200 Delhi normal newborns (100 males and 100 females). A significant correlation between size and inversion heteromorphisms in males (r = 0.97) and females (r = 0.98) was observed. The results suggested that the larger the size of the C-band regions so the higher was the incidence of inversion. PMID- 3833459 TI - Ultrastructure of the fibrous matrix surrounding cells of Trypanosoma melophagium in the hind-gut of the sheep ked, Melophagus ovinus. AB - A fibrous material surrounds cells of Trypanosoma (Megatrypanum) melophagium in the hind-gut of the sheep ked, Melophagus ovinus, and terminates just beyond the distal portions of the attached cells. The fibres of this extracellular matrix have a diameter of approximately 4 nm and are closely packed. Individual fibres have approximately the same orientation as adjacent fibres and usually lie parallel to the longitudinal axis of the parasite cells. PMID- 3833460 TI - Effects of corticosterone infusion on the lipogenic activity and ultrastructure of the liver of laying hens. AB - The effects of infusion of corticosterone (30 micrograms/h) for periods of 14 and 28 days on the ultrastructure and activity levels of lipogenic enzymes (fatty acid synthetase, glucose-6-phosphate dehydrogenase, malic enzyme) of the liver of laying hens, were studied. The liver and the abdominal fat pad in the corticosterone treated birds weighed significantly more than those of the control birds while the ovary and oviduct were substantially regressed in the former. Ultrastructure of the hepatocytes of the treated birds showed heavy deposition of lipid. The respective levels of total activities of the three enzymes studied were also higher in the liver of the treated birds, even though the specific enzyme activities were higher only in the case of fatty acid synthetase. PMID- 3833461 TI - [Healing of bone tissue in rabbits after administration of chlorpromazine as a calmodulin inhibitor]. PMID- 3833462 TI - [Evaluation of the muscular system in children with congenital multi-joint instability and congenital hip dislocation]. PMID- 3833463 TI - [Electrogoniometric studies of knee and foot movements in level walking of children surgically treated for congenital clubfoot]. PMID- 3833464 TI - [Porous corundum ceramics in clinical use]. PMID- 3833465 TI - [Significance of intraoperative risk factors in the process of wound healing in surgery of the locomotor system]. PMID- 3833466 TI - [Effect of levamisole on selected immunological indicators in patients with chronic post-traumatic osteitis]. PMID- 3833467 TI - [Synovectomy of the knee joint in rheumatoid arthritis]. PMID- 3833468 TI - [Causes of the limitation of motor functions in patients with rheumatoid arthritis after alloplasty of the hip joint]. PMID- 3833469 TI - [Appearance of the radiographic image of the spinal roots depending on the size of the lumbar canal in painful spinal diseases]. PMID- 3833470 TI - [Radiological evaluation of the remote results of treating injuries of the cervical vertebrae by spinal fusion by anterior approach]. PMID- 3833471 TI - [Intradural lipoma of the spinal canal]. PMID- 3833472 TI - [Non-ossifying fibroma of the patella]. PMID- 3833473 TI - [Posterior dislocation of the sternoclavicular joint]. PMID- 3833474 TI - [Bone cysts of the calcaneus (study of 14 cases)]. PMID- 3833475 TI - [Difficulties and limitations in computed x-ray tomography of lumbar spinal root compression]. PMID- 3833477 TI - [Descriptive classification of luxations and fracture-luxations of the carpus]. PMID- 3833476 TI - [Treatment of injuries with vascular lesions of the arm]. PMID- 3833478 TI - [Considerations on the mechanical characteristics of the Harrington's instrumentation used in the stabilization of fractures of the thoraco-lumbar spinal. 2]. PMID- 3833479 TI - [Association of disk hernia and vertebral neurinoma]. PMID- 3833480 TI - [Congenital extradural spinal cysts. Considerations on 2 cases]. PMID- 3833481 TI - [2 cases of fracture of the humerus caused by arm wrestling]. PMID- 3833482 TI - [Detachment of the short head of the biceps brachii and paralysis of the musculo cutaneous nerve in traumatic dislocation of the scapula and humerus (description of a case)]. PMID- 3833483 TI - [Bilateral extensor indicis propius muscle of the fingers. Case contribution]. PMID- 3833484 TI - [The hand with 5 equal fingers]. PMID- 3833485 TI - [Characteristics of the normal female pelvis among Uygur and Kazak women]. PMID- 3833486 TI - [Observation of the conversion rate of breech presentation by laser acupuncture]. PMID- 3833487 TI - [The meconium aspiration syndrome (an analysis of eight autopsy cases)]. PMID- 3833488 TI - [Rudimentary uterine horn complicated by pregnancy]. PMID- 3833489 TI - [Report of 12 cases of pregnancy in association with aplastic anemia]. PMID- 3833490 TI - [The capillary method for assessing pulmonary maturity using amniotic fluid]. PMID- 3833491 TI - [Clinical evaluation of several scoring systems for the gestational age of the newborn infant]. PMID- 3833492 TI - [A five-year survey of perinatal care in Suzhou]. PMID- 3833493 TI - [Clinical and roentgenographic evaluation of the Cooper ligament suspension operation in treating vaginal vault prolapse (analysis of 24 cases)]. PMID- 3833494 TI - [Rudimentary uterine horn (report of 4 cases)]. PMID- 3833495 TI - [Repair of a severe ureteral injury by fallopian tube graft]. PMID- 3833496 TI - [Microlymphaticovenous anastomosis in treating lymphedema of the vulva]. PMID- 3833497 TI - [Post-operative irradiation in carcinoma of the cervix]. PMID- 3833498 TI - [Ovarian tumor cells in soft agar culture: a preliminary study]. PMID- 3833499 TI - [Immunologic response to cis-platinum in ovarian malignancies]. PMID- 3833500 TI - [Fallopian tube sterilization with stainless steel clips (report of 1127 cases)]. PMID- 3833501 TI - [A clinical and laboratory study of China-made cefotaxime]. PMID- 3833502 TI - [The therapeutic effect of shen mai san injection on various clinical and hemodynamic subsets of acute myocardial infarction]. PMID- 3833503 TI - [Changes in plasma CK and CK-MB activity following permanent pacemaker implantation and its clinical significance]. PMID- 3833504 TI - [Diagnostic significance of serum C-reactive protein, mucin and transferrin levels in patients with leukemia complicated by infection]. PMID- 3833505 TI - [The determination of antithrombin III (AT III) and its clinical significance]. PMID- 3833506 TI - [Diagnostic criteria for affective disorders]. PMID- 3833507 TI - [Comparison between two sets of diagnostic criteria for manic-depressive psychosis]. PMID- 3833508 TI - [Retrospective study on the diagnostic criteria of childhood depression]. PMID- 3833509 TI - [Assessment of the mental status of manic patients tested with the Bech-Rafaelsen rating scale]. PMID- 3833510 TI - [Rating scale for the differential diagnosis of manic-depressive disorder and schizophrenia]. PMID- 3833511 TI - [DST urinary MHPG.SO4 excretion and platelet MAO activity in depression]. PMID- 3833512 TI - [Re-analysis of the diagnostic significance of the dexamethasone suppression test in depression]. PMID- 3833513 TI - [The dexamethasone test and mania]. PMID- 3833514 TI - [Comparative study on the dexamethasone suppression test in acute and chronic schizophrenia]. PMID- 3833515 TI - [Screening manic-depressive illness in chronic psychiatric patients]. PMID- 3833516 TI - [Assessment of the severity of depression]. PMID- 3833517 TI - [Affective disorders and psychosocial factors]. PMID- 3833518 TI - [Affective psychosis and mental stress]. PMID- 3833519 TI - [Atypical manifestations and misdiagnosis of manic-depressive illness]. PMID- 3833520 TI - [Effect on morphine hyperthermia of dopaminergic agents]. PMID- 3833521 TI - [Therapeutic activity of nephroton, lespenefril and furosemide in experimental azotemia]. PMID- 3833522 TI - [Neuropharmacological screening of a group of N1-substituted N4 guanylpiperazines]. PMID- 3833523 TI - [Activity of the organ enzymes of C57BL6-strain mice after adaptation to hypobaric hypoxia]. PMID- 3833524 TI - [Changes in the plasma and blood volumes and renal hemodynamics in rats with congenital diabetes insipidus]. PMID- 3833525 TI - [In vivo effects of triton WR 1339 on plasma lipoproteins and the postheparin activity of lipoprotein lipase and liver triglyceride lipase (triton hyperlipidemia in rabbits)]. PMID- 3833526 TI - The substrate specificity, tissue specificity and regulation of the 5' deiodination systems in rat liver and kidney tissues. AB - Studies were carried out to compare the 5' deiodination reactions of thyroxine (T4) and 3, 3', 5'-triiodothyronine (rT3) in rat liver and kidney homogenates. The 5'-deiodinase activity was assayed by the 3, 5, 3'-triiodothyronine (T3) produced from T4 or by the 125I-iodide released from 125I-rT3. The two 5' deiodination reactions had similar ranges of optimal pH, incubation temperature, and apparent Km, T4 1.1 and rT3 1.3 microM. However, the apparent Vmax values for T4 and rT3 deiodination reactions were 0.9 and 220 pmol/mg protein/min, respectively. Both reactions were stimulated by thiol reagent but only rT3 deiodination showed complete thiol dependence. The inhibitory effect of 6-propyl 2-thiouracil (PTU) on the 5' deiodination of rT3 was 50 times as great as that of T4. Only the 5' deiodination of rT3 was inhibited by low concentrations of calcium and magnesium. The 5' deiodination reactions in the liver and kidney tissues showed very similar substrate specificity. However, only the hepatic deiodinase activity was reduced to 60-65% of the control value after fasting, whereas the renal 5'-deiodinase activity was unaffected or even enhanced by fasting up to 72 hours. The results showed the existence of a diverse and complex 5' deiodination system in the rat tissues which is comprised of multiple similar but distinct 5'-deiodinase enzymes with respect to their substrate specificity, tissue specificity and regulation. PMID- 3833527 TI - Responses to epinephrine in patients with anorexia nervosa. AB - To examine the sensitivity to epinephrine in patients with anorexia nervosa, 20 60 micrograms/kg body weight/min of epinephrine was infused for 30 min each in 5 patients and 5 controls. The increase in pulse rate and the decrease in diastolic blood pressure were significantly smaller in the patient group. Elevated plasma GH levels in the patients were markedly suppressed by epinephrine infusion. These results indicate the beta-adrenergic function is decreased at least in the cardiovascular system in patients with anorexia nervosa. PMID- 3833528 TI - Effects of pregnancy and labor on oxytocin levels in human plasma and cerebrospinal fluid. AB - In order to investigate the significance of oxytocin in pregnancy and labor, oxytocin concentrations in plasma and cerebrospinal fluid (CSF) were determined using the specific radioimmunoassay. Plasma and CSF samples were obtained from 23 pregnant women (11 pre labor, 12 in labor), 15 nonpregnant women and 4 men at spinal puncture for anesthesia. In males and nongravidas, CSF levels of oxytocin were significantly higher than plasma levels. Plasma levels in pregnant patients pre or in labor were significantly higher than those in nongravidas. No significant difference between CSF levels in prelabor gravidas (mean +/- SE, 9.7 +/- 1.5 mu u/ml) and nongravidas (10.1 +/- 1.2 mu u/ml) was found. However, CSF levels in gravidas in labor (18.6 +/- 2.3 micromicrons/ml were significantly higher than the levels in prelabor gravidas. These results strongly suggest that oxytocin levels in human plasma and CSF are controlled by different mechanisms and that the increased oxytocin could have some specific central actions. PMID- 3833529 TI - Oro-maxillofacial development in patients with Turner's syndrome. AB - Detailed oro-maxillofacial studies using dental casts, pantomograms and cephalograms were performed in 28 patients with Turner's syndrome and compared statistically to the results from 23 normal short children. Small tooth crown size, short tooth roots and advanced dental age were characteristic of patients with Turner's syndrome. However, the incidence of peg shaped teeth, malocclusion, high arched palate and congenital anodontia were not characteristic of patients with Turner's syndrome. The coronal arch width (C.A.W.) and basal arch width (B.A.W.) were greater and the coronal arch length (C.A.L.) and basal arch length (B.A.L.) were less in patient's with Turner's syndrome. These data indicate underdevelopment of the maxilla in the forward direction forming the wide-, flat shaped facial characteristic of patients with Turner's syndrome. PMID- 3833530 TI - Changes in somatomedin activity in anorexia nervosa. AB - Somatomedin (SM) activity, GH, T3 and T4 were investigated in 6 girls with anorexia nervosa during hospitalization and at outpatient clinic. On admission, serum T3 (27-62 ng/dl) and SM activity (0.24-0.55 U/ml) were low in all cases, while basal GH was extremely high in 2 cases. A significant negative correlation was found between SM activity and basal GH during the course of treatment (r = 0.61, p less than 0.02). The change in SM activity was related to that of the serum T3 level and a significant positive correlation was found between SM activity and serum T3 (r = 0.80, p less than 0.001). These data suggest that decreased SM activity may suppress the inhibitory effect of SM on GH release and may raise the basal GH level. SM activity is one of the indicators of the nutritional condition in anorexia nervosa as well as the serum T3 concentration. PMID- 3833532 TI - Immunoreactive oxytocin synthesis in human placental tissue. AB - The change in the amount of immunoreactive oxytocin in human term placental tissue due to cycloheximide, an inhibitory agent of protein biosynthesis, was observed by a tissue culture method. The immunoreactive oxytocin content per gram tissue was 1.81 ng/g and significantly decreased to 1.17-1.11 ng/g when the concentrations of cycloheximide were at 1-10 micrograms/ml in culture medium. The total quantity of immunoreactive oxytocin including medium content was 1.82 ng/g and significantly increased to 3.06 ng/g in the control group. However, those of the groups in which added cycloheximide was at 1-10 micrograms/ml, were 1.91-1.85 ng/g and showed no remarkable changes after incubation. The data suggest that immunoreactive placental oxytocin can be synthesized in the human placenta itself rather than in other tissues. PMID- 3833531 TI - Decrease in human growth hormone (HGH) levels during transsphenoidal surgery for acromegaly as a guide for prognosis. AB - To evaluate the clinical significance of human growth hormone (HGH) dynamics during transsphenoidal microsurgery for acromegaly, serial HGH levels during the surgery were compared with the post-operative basal HGH levels in 15 acromegalic patients, retrospectively. In all patients, in whom the HGH level immediately after tumor resection was reduced below 5 ng/ml or the decreasing rate which stood for the magnitude of decrease of HGH during resection procedure was above 80%, postoperative permanent HGH levels fell to below 5 ng/ml, namely, within the normal range. The rapid radioimmunoassay (RIA) of HGH was developed by the use of high affinity antibody in order to inform the surgeons of plasma HGH levels quickly during the surgery. It is now possible to know HGH levels about 1 hour after submitting the samples. It was verified that HGH levels measured in the rapid RIA correlated well with those obtained in the conventional way. The rapid RIA method was applied to 6 patients and the correlation between HGH levels during the surgery and post operative levels was also studied prospectively. The results were essentially identical to those in a retrospective study. It was suggested that the HGH level immediately after tumor resection and the extent of the decrease in HGH during the resection procedure were good indicators of the prognosis of surgical results in acromegaly and the rapid RIA method was useful in order to judge HGH levels quickly during the surgery. PMID- 3833533 TI - Molecular mechanisms involved in the hormonal regulation of prolactin and gonadotropins biosynthesis in the pituitary gland. PMID- 3833534 TI - Release of melanocyte stimulating hormone (MSH) from the posterior pituitary lobe incubated in situ after infusion of hypertonic solution into the third cerebral ventricle in rats. PMID- 3833535 TI - [Effect of treatment with tamoxifen on serum levels of various steroid and protein hormones in women with breast cancer]. PMID- 3833536 TI - Localization by computer tomography of a primary lesion in a patient with generalized neoplastic process (case report of a patient with adrenal cortex carcinoma with feminization). PMID- 3833537 TI - Brain 5-hydroxytryptamine and plasma testosterone in L-tryptophan treated rats. AB - Loading of L-tryptophan for 7 and 21 days increased brain 5-hydroxytryptamine (5 HT) level which was associated with decreased plasma testosterone level. Human chorionic gonadotropin (HCG) administration in L-tryptophan treated rats for 21 days increased the plasma testosterone level in spite of increased brain 5-HT level. These results suggest that brain 5-HT exerts an inhibitory influence on testicular steroidogenesis by modulating the gonadotropin-releasing-factor (GnRH) release and thence pituitary gonadotropins. PMID- 3833538 TI - Glucocorticoid regulation of glycosaminoglycan accumulation in murine fibroblasts. AB - The effects of Dexamethasone (Dex) on Glycosaminoglycan (GAG) accumulation were examined in the murine fibroblast line C3H/10T1/2. Confluent cultures were treated with the hormone and then labelled with either [3H]acetate or [3H]glucosamine and analyzed for [3H]GAG content. Dex could inhibit the accumulation of [3H]GAG in a dose dependent manner with a half maximal response achieved at approximately 5nM and a maximal response at approximately 100nM. Higher concentrations failed to influence precursor incorporation further. The response was seen after 6 hours of hormone exposure and was nearly maximal by 10 hours. The incorporation of [3H]leucine into protein was unaffected by Dex treatment. 11 alpha hydrocortisone, an inactive steroid, failed to elicit a cellular response. Thus it appears that glucocorticoids regulate GAG accumulation in a rodent fibroblast line as they do in primary human skin fibroblast cultures. PMID- 3833539 TI - Biochemical properties of alkaline phosphatase from endometrial cancer cells. AB - The occurrence of alkaline phosphatase (AP) activity was examined in several human endometrial adenocarcinomas. Catalytic activities were detectable only in 10 out of 15 tumors, with no apparent correlation between elevated AP and histological type. The apparent molecular weight of the enzyme after partial purification was about 140,000 daltons. Kinetic activity, thermodynamic properties and the pH dependence of the activity were in the ranges reported for other subforms. Several other physicochemical properties were also investigated and compared with those displayed by enzymes obtained from normal human tissues. The inhibition studies show that the enzyme shares several properties with the placental form, particularly in resistance to zinc chloride and EDTA action. On the other hand, in sensitivity to uncompetitive inhibitors and to urea and ascorbic acid, it is closer to other non-Regan heat-sensitive forms. The results support the view that a polymorphism in the expression of AP in neoplastic tissues can occur. A wider spectrum of physicochemical properties is clearly needed to define better the characteristics of oncodevelopmental enzymes. PMID- 3833540 TI - Kinetic aspects of enzyme activity changes in blood plasma during canine hemorrhagic shock. AB - The kinetics of the increase in activities of eight enzymes in plasma was investigated in hemorrhagic shock in dogs (8.0 kPa, 120 min). The time-course of enzyme activity changes in shock differed between animals and depended on their sensitivity to shock. In the shock-sensitive group of dogs an exponential activity increase was already observed in the hypotension period. However, the dogs of the less shock-sensitive group showed a delay of enzyme release with significantly less pronounced elevation of all enzyme activities except creatine kinase. The initial exponential rise of enzyme activities, which approximately followed first-order kinetics, was quantitatively characterized by the release rates. There was a close correlation between the molecular weights of enzymes and their release rates during shock in both groups of dogs. The relevance of the results to mechanisms of enzyme transport from the cell into the blood is discussed. PMID- 3833541 TI - Tartrate-resistant acid phosphatase in human alveolar macrophages. AB - Tartrate-resistant acid phosphatase has been extracted from human alveolar macrophages, in which its specific activity is 10-fold that in whole lung. The apparent identity of the alveolar macrophage isoenzyme with that associated with osteoclasts suggests that both types of cell belong to the mononuclear phagocyte system. Within this system, expression of tartrate-resistant acid phosphatase appears to accompany certain kinds of differentiation. PMID- 3833542 TI - Altered glycosidase activity in the liver of rats with galactosamine-induced alpha 1-antiprotease deficiency. AB - Previous studies have shown that chronic administration of D-galactosamine (GalNH2) in rats produces alpha 1-antiprotease (AAP) deficiency and causes accumulation of aberrantly glycosylated AAP in hepatic granules. In order to examine the disordered mechanism which produces this altered glycosylation, the activities of 6 glycosidases in liver homogenates of control and AAP-deficient rats were determined. GalNH2 treatment increases acid pH glycosidase activity, while it decreases intermediate pH alpha-mannosidase and alpha-glucosidase activities. beta-D-Glucosidase, beta-D-mannosidase and beta-D-N acetylglucosaminidase activities, measured at acid pH, increase more than 2-fold in the GalNH2-treated rats compared to controls. alpha-D-Glucosidase activity measured at intermediate pH decreases 2.5-fold in the experimental rats. alpha-L Fucosidase and acid phosphatase activities are not significantly changed by GalNH2 treatment. alpha-D-Mannosidase activity can be separated into 2 fractions by ion exchange chromatography. Acid pH alpha-D-mannosidase is increased nearly 2 fold in the GalNH2-treated rats. Intermediate pH alpha-D-mannosidase optimum is decreased alpha-D-mannosidase activities have been observed in humans with AAP deficiency. alpha-Glucosidases and alpha-mannosidases play a crucial role in glycoprotein synthesis. The altered synthesis and structure of AAP in GalNH2 induced AAP deficiency may be a reflection of altered enzyme activities. PMID- 3833544 TI - Accumulation of heat-labile elongation factor 2 in the liver of mice and rats. AB - Age-related changes of polypeptide chain elongation factor 2 (EF-2) in mouse and rat livers were investigated. The percentage of heat-labile components in EF-2 was 5 to 10% in young animals and 15 to 45% in old ones. These results and other findings (Takahashi et al., in press) support the idea that decrease in translational activity in old animals is due, in part, to alterations of protein components of the translational system. PMID- 3833543 TI - The effect of endurance exercise on bone dimensions, collagen, and calcium in the aged male rat. AB - Sixteen weeks of a relatively mild running program, started at 22 months of age, lowered the body weights of 26-month-old male rats to the level of 9-month-old rats and increased the weights and the collagen densities of hind limb bones to levels greater than those of 9-, 22-, and 26-month-old sedentary rats. The densities (g/cm3) and the calcium densities (mg/cm3) of the hind limb bones decreased with age and were restored to the 9-month level by training the elderly rats to run. These data suggest that exercise is capable of inducing a compensation for, or a reversal of, age-associated bone loss (osteoporosis) and restoring the bone mineral content in aged rats to the level of those of mature young adult animals. PMID- 3833545 TI - Age-related chromatin condensation in flight muscle nuclei of the adult male housefly, Musca domestica. AB - Computer analysis of indirect flight muscle nuclei from the adult male housefly, M. domestica, has shown significant change with age in the chromatin condensation pattern. The pattern was analyzed by examining low, medium, and high density chromatin components (LDC, MDC, HDC). No significant change occurred in HDC with age, and the amount and distribution of LDC and MDC remain relatively stable between Day 1 and Day 4 post-eclosion. However, the analysis showed a significant increase in the amount of MDC with a corresponding decrease in the amount of LDC between Day 4 and Day 14. This exchange was accompanied by a significant redistribution of both components. These results are discussed with reference to the biochemical and ultrastructural profile of the flight muscle with age, and to age-related changes in the condensation pattern of specific brain and Malpighian tubule nuclei described earlier. PMID- 3833546 TI - The quantitative relationship between life span, food ingestion, egg production, mating, and flight-activity of protein-fed blowfly Phormia terrae novae females. AB - The age-dependent variations in the amount of food ingestion, egg production, and flight activity of protein-fed female Phormia terrae novae were analyzed. Also the influence of mating and forced physical performance on the time course of these parameters and on life span were tested. In virgin females, the life span with the investigated factors is generally delayed, together with mean and maximum life span. In comparison to mated females virgin females exhibit a 40% prolongation of mean life span and ingest more sugar with a later intake maximum. Their egg production starts 5 days later (Day 10) but reaches only half the amount occurring in mated females. Flight performance is generally higher in virgin females, reaching its maximum 2 days later (Day 14), with a more gradual decline instead of the sudden drop in flight performance seen in mated flies. Females receiving their food by flight only ("forced fliers") show a shorter mean life span (which is more pronounced in virgin flies). The maximum of sugar intake shifts forward to an earlier point after eclosion, and the amount is reduced by about 30% over the entire life span. Similarly, the egg production rate reaches lower values and tends to have an earlier maximum in comparison to corresponding groups that had access to sugar on the cage floor. The results further support the hypothesis that Phormia exhibits a strictly programmed aging pattern. Its time course depends on reproduction sufficiency and physical performance. Both factors act to shorten life expectation. PMID- 3833547 TI - Life span and age-related changes in activity level of the rotifer Asplanchna brightwelli: influence of curare. AB - The rotifer Asplanchna brightwelli shows a continuous decline in swimming activity through the course of its 5-day life span. This activity loss occurs at a slower rate when rotifers are treated with very low dosages (0.00025% to 0.0005%) curare. Rotifers treated with these low dosages of curare have a significantly longer life span than that of untreated control rotifers. PMID- 3833548 TI - Macromolecular structure and liquid crystallinity. PMID- 3833549 TI - Population, food and nutrition. PMID- 3833550 TI - FAO and nutrition: evolution of strategies. PMID- 3833552 TI - Land, food and people: implications for nutrition action. Food Policy and Nutrition Division. PMID- 3833551 TI - New insights into human energy requirements. PMID- 3833553 TI - Nutrition in rural development: experience from Niger. PMID- 3833554 TI - Perspective on food quality control in Near Eastern countries. PMID- 3833555 TI - Food protection in India: public sector training programmes for improved food quality and safety. II. Training for food safety: seafood exports from Kerala. PMID- 3833556 TI - Diagnostics and vaccines for parasitic diseases. Proceedings of a symposium. Stockholm, Sweden, 20-22 February 1985. PMID- 3833557 TI - [Observations on the fertility of hyperthyroid patients treated with radioactive iodine (131I) and their daughters]. PMID- 3833558 TI - [Diuresis tests by fluid load in the albino rat. Critical examination of about 7,000 tests. II: Test load with mineral water]. PMID- 3833559 TI - [Secretion dynamics of prolactin after low dose administration of dexamethasone: comparison between normal, demented and depressed elderly subjects]. PMID- 3833560 TI - [Pseudohyperaldosteronism secondary to oral brushing of 9-alpha fluoroprednisolone. Presentation of a clinical case]. PMID- 3833561 TI - [Hypertrophic myocardiopathy in the elderly: clinico-instrumental aspects]. PMID- 3833562 TI - [Antibacterial activity of mezlocillin against gram-negative and gram-positive bacteria from clinical isolates]. PMID- 3833563 TI - [Mezlocillin: antibacterial activity and clinical use]. PMID- 3833564 TI - [Clinical and microbiological evaluation of mezlocillin]. PMID- 3833565 TI - [Mezlocillin in the therapy of respiratory infections]. PMID- 3833566 TI - [Evaluation of the effects of mezlocillin in otorhynolaryngologic infections]. PMID- 3833567 TI - [Mezlocillin in the therapy of respiratory infections in aged patients]. PMID- 3833568 TI - [Mezlocillin in the treatment of nosocomial bronchopulmonary infections in high risk aged patients]. PMID- 3833569 TI - [Mezlocillin in the treatment of purulent acute meningitis. Cerebrospinal fluid concentration and clinical results]. PMID- 3833570 TI - [Mezlocillin in surgical prevention in orthopedics and traumatology]. PMID- 3833572 TI - [Mezlocillin versus cefuroxime in infections of the urinary tract]. PMID- 3833571 TI - [Short-term antibiotic prevention in abdominal surgery: effectiveness of mezlocillin]. PMID- 3833573 TI - [Evaluation of the antibacterial effect of cefsulodin against Pseudomonadaceae]. PMID- 3833574 TI - [Cefotaxime in chronic renal insufficiency]. PMID- 3833575 TI - [Urinary determination of N-acetyl-beta-glucosaminidase in patients treated with ceftezol]. PMID- 3833576 TI - [Ceftezol in anti-infection therapy in childhood]. PMID- 3833577 TI - [Use of ceftezol in the field of pneumology: its effectiveness and tolerance]. PMID- 3833578 TI - [Ceftriaxone in the treatment of exacerbated chronic bronchitis]. PMID- 3833579 TI - [Ceftriaxone in bacterial otorhinolaryngologic infections in comparison with lincomycin]. PMID- 3833580 TI - [Penetration of aztreonam in the synovial fluid]. PMID- 3833581 TI - [Renal tolerance of aztreonam evaluated on the basis of the urinary excretion of N-acetyl-beta-glucosaminidase]. PMID- 3833582 TI - Employment of azthreonam in generalized and localized infections determined by gram negative bacteria. PMID- 3833583 TI - [Aztreonam in the treatment of infections of the urinary tract in childhood]. PMID- 3833584 TI - [Clinical evaluation of aztreonam in the treatment of urinary infections in pediatrics]. PMID- 3833585 TI - [Therapeutic effects and tolerance of aztreonam in infections of the urinary tract in childhood]. PMID- 3833586 TI - [Aztreonam in children with severe infections of the urinary tract]. PMID- 3833587 TI - [Aztreonam in the treatment of bacterial infections in subjects with malignant blood diseases]. PMID- 3833588 TI - [Bolus doses of netilmicin in the treatment of infections of the urinary tract]. PMID- 3833589 TI - [Treatment with single doses of netilmicin in infections of the lower urinary tract in children]. PMID- 3833590 TI - [Netilmicin prevention and therapy in cystoscopic practice]. PMID- 3833591 TI - [Josamycin in the treatment of bacterial broncho-pulmonary complications in polychemotherapy for advanced bronchogenic carcinoma]. PMID- 3833592 TI - [Preliminary study on norfloxacin in pulmonary Pseudomonas aeruginosa infections]. PMID- 3833593 TI - [Norfloxacin in the treatment of acute infectious diarrhea]. PMID- 3833594 TI - [Effect of norfloxacin in infections of the urinary and intestinal tracts: combined effects with aminoglucosides and with tetracycline and chloramphenicol]. PMID- 3833595 TI - [Penetration and intracellular bioactivity of antibiotics. Role in the treatment of infections in children with chronic granulomatous disease]. PMID- 3833596 TI - [Therapy of colitis caused by antibiotics]. PMID- 3833597 TI - [The role of aminoglucoside antibiotics in the therapy of staphylococcal infections]. PMID- 3833598 TI - The new cephalosporins for the treatment of bacterial meningitis in children and neonates. PMID- 3833599 TI - The digestive mucosal barrier and cytoprotection. Symposium. Paris, 29-30 April 1985. PMID- 3833600 TI - Gastric erosions in the elderly: increased need for cytoprotection. PMID- 3833601 TI - The myth of the mucus barrier. PMID- 3833602 TI - [Prevention by metronidazole of gastric mucosal lesions induced by absolute alcohol in the rat]. PMID- 3833603 TI - [Gastric potential difference: effects of non-steroidal anti-inflammatory agents in the healthy volunteer]. PMID- 3833604 TI - [Spinnability: a new approach to intestinal stress and its therapy]. PMID- 3833605 TI - pH gradients in the gastro-duodenal mucous gel. PMID- 3833606 TI - Gastric mucosal hemodynamics. PMID- 3833607 TI - Prostanoids in human gastric mucosa. PMID- 3833608 TI - Regulation of mucus secretion in the intestine. PMID- 3833609 TI - [The weakness of the gastric mucosa barrier: a new concept]. PMID- 3833610 TI - Gastric mucosal injury by bile acids: the influence of phospholipids. PMID- 3833611 TI - Ethanol-induced gastric mucosal injury: sequential analysis of morphologic and functional changes. PMID- 3833612 TI - Ultrastructural changes in the gastric mucosal microvessels after ethanol. PMID- 3833613 TI - Anti-inflammatory drugs and the gastro-intestinal mucosa. PMID- 3833614 TI - [The hamster ova penetration test as a method of evaluating mammalian sperm]. PMID- 3833615 TI - [Evaluation and comparison of the results of various methods of studying urinary excretion of estriol by women in the 3d trimester of normal pregnancy]. PMID- 3833616 TI - [Results of cytological examinations conducted in Torun 1979-1983]. PMID- 3833617 TI - [Plasma antiheparin activity and low density lipoprotein (LDL) levels in parturient and puerperal women]. PMID- 3833618 TI - [Induction of labor in prolonged pregnancy by breast massage]. PMID- 3833619 TI - [Effect of partusisten administered to pregnant women with uterine hemorrhage caused by placenta praevia on the prolongation of pregnancy]. PMID- 3833620 TI - [Hysterectomy complicated by perforation of a duodenal ulcer]. PMID- 3833621 TI - [Symptoms of work fatigue in gynecologists and obstetricians]. PMID- 3833622 TI - Genital signalling and the coexistence of male vervet monkeys (Cercopithecus aethiops pygerythrus). AB - To ascertain the social significance of male genital colouration two troops of vervets, one free-ranging and one caged, were observed. It was found that genital signals were associated with intermale agonism. It is suggested that this communicatory system regulates the behaviour of competitors and may thereby have facilitated the evolution of a multimale social system. PMID- 3833623 TI - Vocal communication in lion-tailed macaques (Macaca silenus). AB - Investigations of vocal communication in captive groups of lion-tailed macaques (Macaca silenus) revealed a repertoire of 17 basic patterns. Sixteen of them were recorded and their physical parameters analysed by sonagrams. During a field study these results were verified and complemented, and additional data on the vocal behaviour of this species were gathered. The vocal repertoire of lion tailed macaques is characterized by discretely structured, mostly interaction- and situation-specific sound patterns. The fundamental characteristics of vocal communication seem to be adjusted to the acoustic conditions of the rain forest habitat as well as to the social organization in 1-male groups. In contrast to other species of the macaque genus, lion-tailed macaques are highly adapted to a strictly arboreal life in the rain forests of the Western Ghats (South India). Due to the dense vegetation in this habitat, propagation of visual signals is restricted to short distances. Vocal signals are therefore of great importance. The vocal repertoire of lion-tailed macaques differs from that of more terrestrial macaques insofar as the basic patterns show comparatively insignificant structural variations. Also, patterns were recorded which have not yet been found in any other member of the genus. PMID- 3833624 TI - Diurnal variation of several blood parameters in the owl monkey, Aotus trivirgatus griseimembra. AB - Diurnal variations in normal hemogram, total serum protein and serum iron are documented in 6 adult owl monkeys, Aotus trivirgatus griseimembra, maintained in an artificial LD 12:12 (35:0.08 lx) with light phase from 03.00 to 15.00 h Central European time. Statistically significant high amplitude rhythms occurred in total leukocyte and in eosinophil numbers with acrophases at 06.35 and 09.53 h, respectively. Erythrocyte numbers and hemoglobin concentration showed statistically significant low amplitude rhythms with almost identical acrophases. Total serum protein exhibited a 10% daily fluctuation. Serum iron concentration showed high amplitude daily variations with a 60% mean range of oscillation. PMID- 3833625 TI - Mental health of the aged in the depopulated areas of Japan. AB - Over the past 20 years from 1961, we have been conducting research on the relation between the mental and physical state of old people and the depopulation process in the mountain areas of Japan. People over 65 years old have been studied annually, with the use of Hasegawa's method and Amako's scale of grading age and Zung's depression scale mentally. For their physical checkup, ECG and blood pressure, etc. were taken. In the early stages of our study, a significant difference was observed between the people in the depopulated areas and those living in the plains. However, we have been unable to find significant differences of the occurrence of senile dementia between these two areas since 1977, nor of the physical state of the elderly since 1981. We did observe more people with a higher level of Zung's depression scale in the depopulated areas in 1984. Since Japan's economic growth slowed down by the two oil shocks has never revitalized the depopulated areas, the old people are still left alone in the mountain areas. However, they now regularly receive good meal services by local welfare committees. Supermarkets have also appeared in some villages, so that the aged have easier access to nutritious food such as meats, fruits and milk. Still, we find bedridden elderly patients more often in these depopulated areas, as well as a statistically greater incidence of suicides (r = -0.42, p less than 0.01). It is our fervent desire that more psychological support should be given to the aged in the depopulated areas, such as visits to their homes by public nurses, or more frequent phone-calls by volunteers. PMID- 3833626 TI - Relationship between sibship size and neurotic symptoms of anxiety, hypochondriasis and depression in Japanese neurotic children and adolescents. AB - Two hundred and sixty-eight Japanese aged 19 or below were studied retrospectively from their medical records to determine the relationship between the sibship size (number of siblings in the family) and the appearance of symptoms of anxiety, hypochondriasis and depression during the time period I (1955 + 1960 + 1965) and the time period II (1970 + 1975 + 1978). The results showed that only sons and either sex of a large sibship size (4 or more) possessed these three symptoms to a larger extent than only daughters and either sex of a medium sibship size (2 or 3) during both time periods. These three adult type neurotic symptoms were thought to be manifested among the children and adolescents who communicated primarily with adults and/or those who were required by their parents to exhibit adult-type behavior whether in traditional or in modern Japanese families. PMID- 3833627 TI - R-R intervals of ECG in depression. AB - ECG measurements of consecutive 100 R-R intervals were done on depressive patients. The patient group presented lower mean values for coefficients of variation (CV) at each generation than the control group (normal subjects); the differences were significant especially for the subjects 40 to 49 years of age (P less than 0.05) and for those 60 to 69 years of age (P less than 0.01). These results can probably be regarded as a significant and objective index of autonomic disturbances in depression. PMID- 3833628 TI - Chronobiological comparison of sleep-wake rhythm between chronic schizophrenia and normal control. AB - Few studies on schizophrenia with respect to the circadian alteration of the sleep-wake rhythm have been reported. We made a comparative study of the sleep wake rhythm between chronic inpatient schizophrenics with a relatively bed-prone daily life and normal subjects under the conditions of absolute bed-rest to elucidate the chronobiological features of schizophrenia. The sleep-wake rhythm of the schizophrenics differed from that of the normals in two points: A significant difference was observed in the decrease of Stage 4 during their nocturnal sleep compared with the normal subjects, becoming conspicuous with the increasing lapse of time during sleep. The distribution and amount of their REM sleep in the morning were markedly low and the latency of their REM sleep was also prolonged. These facts suggested that the smooth slide of the sleep-wake rhythm was somewhat disturbed in the schizophrenics and that they were, therefore, in a state of hyperarousal despite their bed-prone life. PMID- 3833629 TI - L-dopa-induced asterixis. AB - Three cases with the occurrence of asterixis during the administration of L-dopa were reported. Liver and metabolic functions were normal in all the patients. Upon the appearance of asterixis no other involuntary movements probably resulting from an excess administration of L-dopa were observed. Asterixis occurred accompanied by clinical symptoms such as hallucination and a mild clouding of consciousness by insomnia. Because of its reversal with drug withdrawal, asterixis seemed to be L-dopa-related. The biochemical basis of asterixis is not known but may involve the dopaminergic or serotonergic system. PMID- 3833630 TI - Measurement of platelet monoamine oxidase using three different substrates in patients with alcoholism and schizophrenia. AB - The platelet monoamine oxidase (MAO) activities in alcoholism and schizophrenia were investigated by means of simultaneous determination, using beta-phenyl ethylamine, tryptamine and serotonin as substrates. No significant difference was found between the MAO levels in the alcoholic and schizophrenic groups, when tryptamine was used as a substrate, but both groups showed lower values than the controls. On the other hand, beta-phenylethylamine, a specific substrate for MAO B used as a substrate, showed no significant difference between the alcoholic and control groups in the activities. These two groups showed higher values in MAO activity than the schizophrenic group, whereas when MAO activity was estimated using serotonin, platelet enzyme was found to be inhibited significantly in alcoholism, and the level of activities in the schizophrenics was similar to that of the controls. Moreover, the beta-phenylethylamine inhibition curve obtained serotonin as the substrate in the pooled platelets of 50 normal human subjects, and the MAO activity could not be inhibited by higher concentrations than the Km value of serotonin. These findings suggested that there might be two interacting catabolic sites having different substrate affinities in blood platelet MAO. Thus, it could be speculated that serotonergic catabolic sites of MAO in the platelets are disturbed in the alcoholics, while beta-phenylethylaminergic catabolic sites of platelet MAO are inherently vulnerable in schizophrenia. PMID- 3833631 TI - Plasma free tryptophan concentration in children with attention deficit disorder. AB - In order to examine the serotonin metabolism in children with attention deficit disorder (ADD), plasma tryptophan, which is the precursor of serotonin, was measured in 10 children with ADD and 12 normal children. The mean plasma total tryptophan level in the children with ADD was not significantly different from that of the normal children. The mean plasma free tryptophan level in the children with ADD was significantly higher than that in the normal children. There tended to be a positive correlation between the plasma free tryptophan level and the Werry-Weiss-Peters Activity Scale in children with ADD. In other words, the more severe the hyperactivity of ADD, the higher the plasma free tryptophan level. The mean ratio of plasma free to total tryptophan levels in the children with ADD was significantly higher than that in the normal children, which means that the children with ADD showed a high amount of free tryptophan in the total tryptophan level. These results suggest that there might be some disturbance in the tryptophan-serotonin metabolism in the brain of a child with ADD. PMID- 3833632 TI - Deposits of neuronal ceroid-lipofuscinosis in transitional structures--electron microscopic study. AB - Deposits of neuronal ceroid-lipofuscinosis in two cases were studied using the electron microscopy. The structure most frequently observed in both cases was a curvilinear body containing fingerprint patterns. Other structures, such as the granular pattern, zebra body-like structure and vacuole, were also observed less frequently. A loose pattern, which had an intermediate curvature between the fingerprint pattern and curvilinear body, was found for the first time. They might play an important role on the morphogenesis in the deposit of neuronal ceroid-lipofuscinosis. PMID- 3833633 TI - Olivary hypertrophy in a case with palatal myoclonus: light- and electron microscopic study. AB - This is a report on the ultrastructural finding of the olivary hypertrophy in a case with palatal myoclonus. By light microscopy two types of neuronal changes were observed in the inferior olivary nucleus, i.e. the central chromatolysis and cytoplasmic vacuolation. Both types were also recognized by electron microscopy and the cytoplasmic vascuolation was identified as the vesiculated endoplasmic reticulum. In the reactive astrocytes, mitochondria were strikingly proliferated. PMID- 3833634 TI - Morphometry of cytoarchitecture of the lateral hypothalamic area in the rat. AB - The cytoarchitecture of the lateral hypothalamic area (LHA) in rats was studied with cresyl violet-stained coronal celloidin sections and with sections of the brain impregnated by a Golgi method. Unimodality was established in the frequency distribution histogram of both the somatic cross-sectional area of the LHA neurons and somatic shape (elongation and circularity). The predominant somatic orientation was in the dorsomedial-ventrolateral direction: bimodality of the frequency distribution of somatic orientation was denied. These findings suggest that the LHA neurons examined in the present study are not subdivisible on the basis of the somatic area, shape or orientation. Although the neurons were classified into eight types based upon the dendritic pattern, those in the LHA largely consisted of only three of them; Type III (dendrites extending in two directions along the long axis of soma), Type IV (three directions) and Type VIII (four directions) jointly accounted for 97.1 percent of the total neurons examined. This finding suggests that the parameter of dendritic pattern serves an important purpose in the typing of the rat LHA neurons. The orientation of intrinsic dendrites and intrinsic axons in the LHA has also been described. PMID- 3833635 TI - A study of EEG activities during sleep-wakefulness states in rabbits by autocorrelation and power spectrum analyses. AB - A polysomnography was performed on nine rabbits with electrodes chronically implanted at the sensorimotor and visual corticies and hippocampus. The physiological sleep of the rabbits was divided into three stages: awake (W), slow wave sleep (SWS) and REM sleep (REM). For autocorrelation and power spectrum analyses, a transitional zone (T) from W to SWS was added to the fundamental three stages. No essential differences between the mean frequencies of the cortical and hippocampal EEGs were seen. The mean frequencies of hippocampal EEG were as follows: 6.4 in W, 5.4 and 2.4 in T, 2.2 in SWS and 7.3 Hz in REM. The mean peak frequency of hippocampal EEG during REM was significantly higher than that during W. PMID- 3833636 TI - The development of EEG background activities in El mouse. AB - The development of background activities of cortical EEG in El mouse, the seizure susceptible mutant strain of ddN mouse, were investigated. Furthermore, it was compared to that of the ddN control mouse. The average peak frequency of EEG background activity was much slower than that of the ddN mouse. After seizures in the El mouse were completed, the average energy distribution rates of the main frequency band, theta band, have decreased because of an increase in the delta band compared to those in seizure-free periods (the 5th to 8th week). PMID- 3833637 TI - Contrast sensitivity predicts age-related differences in highway-sign discriminability. PMID- 3833638 TI - Visual lobe area for single targets on a competing homogeneous background. PMID- 3833639 TI - The relation between the type A behavior pattern, pacing, and subjective workload under single- and dual-task conditions. PMID- 3833640 TI - The functional age profile: an objective decision criterion for the assessment of pilot performance capacities and capabilities. PMID- 3833641 TI - Lateral task segregation and the task-hemispheric integrity effect. PMID- 3833642 TI - Diastolic time intervals. PMID- 3833644 TI - Myocardial infarction in the young--a long-term follow-up study. PMID- 3833643 TI - Diastolic time intervals after exercise. PMID- 3833645 TI - Cardiomyopathy--an autopsy study. PMID- 3833646 TI - Comparison of dynamic (treadmill) and static (hand dynamometer) exercise in Indian boys and adolescents. PMID- 3833647 TI - Absent pulmonary valve--autopsy study of eight cases. PMID- 3833648 TI - The histological changes produced after injection of anticardiac serum in rats- an experimental study. PMID- 3833649 TI - Replacement of the ascending aorta for ascending aortic aneurysm. PMID- 3833650 TI - Comparison of effects of isosorbide dinitrate and hydralazine on left ventricular function by M-mode echocardiography. PMID- 3833651 TI - Left main coronary artery-right atrial fistula. PMID- 3833652 TI - Hypocalcaemic congestive heart failure--a post-parathyroidectomy complication. PMID- 3833653 TI - Clinical and investigative profile of isolated congenitally corrected transposition of great arteries. PMID- 3833654 TI - Infrahisian with Kent bundle branch block. PMID- 3833655 TI - Digitalis poisoning by an indigenous plant cardiac glycoside (thevetia nerifolia- pila kaner). PMID- 3833656 TI - High density lipoprotein cholesterol and antiatherogenic metabolism. PMID- 3833657 TI - Role of hexosemonophosphate shunt pathway in glucose metabolism in developing human foetal brain. PMID- 3833658 TI - Bleaching of photosynthetic pigments in wheat seedlings grown in presence of BASF 13.338 (4-chloro-5-dimethylamino-2-phenyl-3(2H)pyridazinone). PMID- 3833659 TI - Effects of manganese deficiency in presence of excess cobalt and vice versa on serum lipoprotein profiles of rats receiving normal and atherogenic diets. PMID- 3833660 TI - Effect of 5-thio-D-glucose on insulin receptors of liver cell membranes. PMID- 3833661 TI - Inhibition by isatin of Na+-dependent glucose and amino acid transport in pigeon intestine. PMID- 3833662 TI - Effect of altered lipid composition on amino acid uptake in Mycobacterium smegmatis ATCC 607. PMID- 3833663 TI - Low homology of repeated DNA sequences in millets. PMID- 3833664 TI - Effect of electrolytes on the heat coagulation behaviour of alpha-globulin from Sesamum indicum L. PMID- 3833665 TI - Reactivity of active site SH groups and site heterogeneity in mung bean glyceraldehyde 3-phosphate dehydrogenase: effect of coenzyme and substrate. PMID- 3833666 TI - Properties of myo-inositol-1-phosphate dehydrogenase as revealed by its fluorescence. PMID- 3833667 TI - Metabolism of glycosaminoglycans in experimental liver fibrosis. PMID- 3833668 TI - A lectin from winged bean (Psophocarpus tetragonolobus) tubers. PMID- 3833669 TI - Evidence for colchicine binding protein in Mycobacterium smegmatis. PMID- 3833670 TI - Development of mammalian tooth cultured in vitro and as transplants: a light and scanning electron microscopic study. PMID- 3833671 TI - Influences of exogenous hormones on experimental cervical carcinogenesis in mice. PMID- 3833672 TI - Influence of age on experimental cervical carcinogenesis in mice. PMID- 3833673 TI - Quantitative structure activity studies on erythrocyte binding of salicylates. PMID- 3833674 TI - Role of esterases in organophosphorus and carbamate-resistance in Indian strain of Anopheles stephensi Liston. PMID- 3833675 TI - Transformation for antibiotic resistance and haemolysin production markers in staphylococci. PMID- 3833676 TI - Chick embryotoxicity screening test--130 substances tested. PMID- 3833677 TI - Histological changes in pancreas after experimentally produced duodenal obstruction in Charles Foster rats. PMID- 3833678 TI - Low vitamin A status and 3-methylcholanthrene induced skin carcinogenesis in mice. PMID- 3833679 TI - Cell cycle of Leishmania donovani. PMID- 3833680 TI - Effect of transection of the vomeronasal nerve on the male-induced implantation failure (the Bruce effect) in mice. PMID- 3833681 TI - 7-hydroxy-4-phenyl-3(4-hydroxyphenyl)-coumarin--a new interceptive agent. PMID- 3833682 TI - Immunotherapy of Ehrlich ascites carcinoma (EAC) with antiserum to modified EAC. PMID- 3833684 TI - Estimation of cadmium in biological tissues by atomic absorption spectrophotometer--a new reagent. PMID- 3833683 TI - Protein degradation in functionally different muscles of rat during exhaustive exercise. PMID- 3833685 TI - Effect of bromocriptine on seminal vesicular and prostatic metabolism in the immature bonnet monkey Macaca radiata Geoffroy. PMID- 3833686 TI - Peroxidase enzyme in bursa of fabricius of chick and its regulation by dexamethasone. PMID- 3833687 TI - Hematological responses to sumithion (fenitrothion) in the blue-rock pigeon Columba livia Gmelin. PMID- 3833688 TI - Metabolic fate of alanine in cuticle hypodermis muscle system of the fowl nematode Ascaridia galli. PMID- 3833689 TI - Role of olfactory experience in pheromonal block to implantation (the Bruce effect) in laboratory mice. PMID- 3833690 TI - Effect of chemical radioprotectors on serum proteins of rats exposed to gamma radiation. PMID- 3833691 TI - Effect of administration of vitamin A, ascorbic acid and nicotinamide adenine dinucleotide + flavin adenine dinucleotide on severity of myocardial infarction induced by isoproterenol in rats. PMID- 3833692 TI - Ontogenetic pattern of taurine and free thiols in liver, heart and brain of rat. PMID- 3833694 TI - Phospholipid composition and ethambutol sensitivity of Mycobacterium smegmatis ATCC 607. PMID- 3833693 TI - Distribution and excretion pattern of 14C-labelled centperazine (3-ethyl-8 methyl 1,3,8-triazabicyclo [4.4.0]decan-2-one) in male albino rat. PMID- 3833695 TI - Total pancreatectomy in the lizard Calotes versicolor. PMID- 3833696 TI - Studies on possible tolerance and mechanism of gossypin analgesia. PMID- 3833697 TI - Hypermagnesaemic influence of bovine parathormone in Bufo andersonii Laurenti. PMID- 3833699 TI - Non-sporing anaerobic bacteria in human infections. PMID- 3833698 TI - A ten year study on the prevalence & geographical distribution of Salmonella bareilly phage types in India (1973-1982). PMID- 3833700 TI - Anaerobic bacteria in acute appendicitis. PMID- 3833701 TI - Cryptosporidium diarrhoea in calves & their handlers in Bangladesh. PMID- 3833702 TI - Larvivorous potential of some cypriniformes fishes. PMID- 3833703 TI - Plasma volume changes in Indian women with normal pregnancy. PMID- 3833704 TI - Plasma volume changes in Indian pregnant women in pregnancy induced hypertension. PMID- 3833705 TI - Kidney in progressive systemic sclerosis. PMID- 3833706 TI - Prognostic value of brainstem auditory evoked responses in coma due to stroke. PMID- 3833707 TI - Serum proteins & immunoglobulins in Duchenne muscular dystrophy. PMID- 3833708 TI - Erythrocyte glucose-6-phosphate dehydrogenase deficiency & thalassaemic genes in the scheduled castes of Rajasthan. PMID- 3833709 TI - Precipitating antigens of Bacteroides fragilis NCTC 2553. PMID- 3833710 TI - Therapeutic evaluation of effectiveness of cimetidine in the treatment of hirsutism. PMID- 3833711 TI - Serum magnesium levels in schizophrenia. PMID- 3833712 TI - The susceptibility of Aedes aegypti (L) larvae to a pathogenic non sexual Saprolegnia sp. PMID- 3833713 TI - Amniotic fluid aminoacids, urea, creatinine in normal and toxemic pregnancies. PMID- 3833714 TI - The effect of age on blood flow in response to the Valsalva manoeuver. PMID- 3833715 TI - Role of anaerobes and chemotherapy in brain abscess. PMID- 3833716 TI - Prognostic significance of serum creatine phosphokinase (SCPK) in acute myocardial infarction. PMID- 3833717 TI - Prevalence of tumours in Libya. PMID- 3833718 TI - Placental phosphatases in normal and abnormal pregnancies. Part-I. PMID- 3833719 TI - Placental phosphatases in acute foetal distress. Part-II. PMID- 3833720 TI - Experimental studies on some effects of repeated halothane anaesthesia. PMID- 3833721 TI - Frequency of glucose-6-phosphate dehydrogenase deficiency in individuals with normal and sickle cell haemoglobin--a preliminary study. PMID- 3833722 TI - Serum copper levels in prostatic disorders. PMID- 3833723 TI - Hydatid cyst of parotid. A case report. PMID- 3833724 TI - Localised plasmacytoma of stomach with immunohistochemical study--a case note. PMID- 3833725 TI - Pseudomonas putrefaciens as a cause of infection in burn patient. PMID- 3833726 TI - Studies on the pathogenicity of Nocardia species inoculated into mice intraperitoneally. PMID- 3833727 TI - Enterotoxigenicity of Staphylococcus aureus isolated from clinical sources. PMID- 3833728 TI - Copper induced Mallory body formation in albino mice. PMID- 3833729 TI - Study of sperm antibodies in the sera of vasectomized males. PMID- 3833730 TI - Changes in seminiferous tubules after vasectomy. PMID- 3833731 TI - Release of cardiac antigens by certain cardiotoxic agents. PMID- 3833732 TI - An unusual case of orbito-cranial gunshot wound. PMID- 3833734 TI - Ocular thelaziasis (a case report). PMID- 3833733 TI - Observations on Bell's phenomenon after levator surgery. PMID- 3833735 TI - Tubercular tarsitis. PMID- 3833736 TI - Acute hydrops in keratoglobus with vernal keratoconjunctivitis. PMID- 3833737 TI - Recurrent cavernous sinus thrombosis with bilateral orbital cellulitis (a case report). PMID- 3833738 TI - An unusual case of bilateral superior rectus palsy. PMID- 3833739 TI - Effect of hypothyroidism on intraocular pressure in rabbits. PMID- 3833740 TI - A study on ocular manifestations of sickle haemoglobinopathies. PMID- 3833741 TI - Role of aspirin in cataract surgery. PMID- 3833742 TI - Correlation between central corneal thickness and curvature (a clinical study). PMID- 3833743 TI - A profile of penetrating eye injuries. PMID- 3833744 TI - Bilateral orbital perforation--(a single bullet injury). PMID- 3833745 TI - Head injury in infancy and childhood. PMID- 3833746 TI - Granulocyte disorders. PMID- 3833747 TI - Evaluation of cutaneous response to tetanus antigen to document immunization: preliminary observations. PMID- 3833748 TI - Neonatal sepsis: correlation of maternal and neonatal factors to positive bacterial cultures. PMID- 3833749 TI - Hematological indices for early diagnosis of neonatal septicemia. PMID- 3833750 TI - Gastric pH in newborns. PMID- 3833751 TI - Norms for anterior fontanel size in Punjabi children. PMID- 3833752 TI - Study on outbreak of meningococcal meningitis. PMID- 3833753 TI - Giant hairy naevi. PMID- 3833754 TI - Asphyxiating nasopharyngeal teratoma at birth. PMID- 3833755 TI - Spontaneous fracture of femur in tubercular meningitis. PMID- 3833756 TI - Vertical transmission of hepatitis-B surface antigen from asymptomatic carrier mothers. PMID- 3833757 TI - Copper contamination of milk from brass utensils. PMID- 3833758 TI - Exchange transfusions in newborns. An analysis of 100 cases. PMID- 3833759 TI - Limb-heart syndrome. PMID- 3833760 TI - Prognosis of acute renal failure in pediatrics. PMID- 3833761 TI - The fate of your prescription. PMID- 3833762 TI - Knowledge and attitude of rural health personnel about breast feeding. PMID- 3833763 TI - Outcome of infants born to diabetic women. PMID- 3833764 TI - Acute renal failure in newborn managed with exchange transfusion. PMID- 3833765 TI - Situs inversus abdominus with intestinal atresia. PMID- 3833766 TI - Congenital toxoplasmosis. PMID- 3833768 TI - Indian childhood cirrhosis. PMID- 3833767 TI - Gastrin secreting tumor of the stomach. PMID- 3833769 TI - Phototherapy for neonatal hyperbilirubinemia. PMID- 3833770 TI - Growth of term infants in early neonatal period. PMID- 3833771 TI - W.H.O. recommended oral rehydration solution in acute diarrheal dehydration in infants. PMID- 3833772 TI - Staphylococcal empyema. PMID- 3833773 TI - Low birth weight babies in relation to nutritional status in primipara. PMID- 3833774 TI - An outbreak of measles. PMID- 3833775 TI - Management of ingested foreign bodies. PMID- 3833776 TI - Diagnosis of iron deficiency by desferrioxamine induced sideriuria. PMID- 3833777 TI - Echocardiographic detection of tricuspid valve vegetations in a child with ventricular septal defect. PMID- 3833778 TI - Cystinosis. PMID- 3833779 TI - Inhaled glass beads: problems in removal. PMID- 3833780 TI - Umbilical granuloma. PMID- 3833781 TI - Studies on low birth weight. PMID- 3833782 TI - Immunization of children. PMID- 3833783 TI - Lower respiratory tract infection in children. PMID- 3833785 TI - Sero-conversion response to Mevilin-L measles vaccine at age 6-15 months. PMID- 3833784 TI - Maternal knowledge and belief on breast feeding. PMID- 3833786 TI - A pathological study of ventricular septal defects. PMID- 3833787 TI - Assessment of nutritional status by Village Health Guides. PMID- 3833788 TI - Pulmonary function tests in healthy children. PMID- 3833789 TI - True hermaphrodite. PMID- 3833790 TI - Lymphatic cyst of the omentum presenting as ascites. PMID- 3833791 TI - Primary type I hyperlipoproteinemia. PMID- 3833792 TI - Burkitt's lymphoma abdominal variety. PMID- 3833793 TI - Study on current status of infant and childhood feeding practices. PMID- 3833794 TI - Moral judgment in middle and late adulthood: the effects of age-appropriate moral dilemmas and spontaneous role taking. AB - This was a cross-sectional study of the effects of age, sex, and moral dilemma content on adult moral reasoning. Hypothetical dilemmas were presented to sixty men and women, thirty of whom were elderly and thirty in early middle age. With education controlled there were no age or sex differences in moral maturity. Dilemma content had a significant effect on moral judgment, with a tendency for each age group to use a higher level of judgment when the situation described was age-appropriate, i.e., relevant to that group's stage of life. There was a significant age difference on a measure of spontaneous role taking: old persons made more definitive moral judgments than the younger adults, who attempted to reconcile the various points of view represented in a dilemma. PMID- 3833795 TI - Adolescent attitudes and beliefs toward aging and the elderly. AB - This article reports the results of an oral history project that used adolescents to interview elderly informants. The adolescents had considerable misinformation about aging and anxiety about the later stages of the life cycle. They also had negative stereotypes toward the elderly. The adolescents who participated in the project expressed enthusiasm for the project and admiration for the elderly they interviewed. However, participation in the project did not significantly impact upon beliefs and attitudes toward aging or the elderly. Factors that might account for these results, and implications of these results, are discussed. PMID- 3833796 TI - Biography after the end of metaphysics: a critique of epigenetic evolution. AB - This article places Erik Erikson's model of ego development against the ground of modern culture. It finds that this model fails to see the relationship between individual crises and the modern postmetaphysical world view, where the meaning of life is in question. The article suggests that Erikson's description of crisis and ego integration remains sound, but that this process should be tied to the specific problems associated with living in modern society. The article ends by returning to Erikson's original insight: that we need to locate the life cycle in the social-cultural setting in which it unfolds. This will make the study of biography at once a psychological analysis and a cultural critique. PMID- 3833797 TI - Gender roles and memory loss in old age: an exploration of linkages. AB - A framework relating gender roles, role loss, and memory is presented. For the now-old woman, her identity has usually been defined by her roles within the family; other personal touchstones have been less legitimate. In old age, when key family roles dwindle, many women who have relied on their families as sources of identity are placed in an anomic situation, especially women with limited resources. When few meaningful social roles exist in the present, memory becomes increasingly important as a link to develop and maintain the self. It is proposed that, without meaningful present roles to frame one's past experience, memory is likely to be characterized by a high frequency of nonintegrated, relatively meaningless relationships, in turn leading to a narrowing of horizons and inability to take the role of the other. Episodic memories may decay since present events have no interest and generic memory becomes impaired. A case study approach is used to examine the relationship between self-preoccupation, group affiliation, object relations, and memory loss among three older working-class women. Their speech patterns, specifically pronoun use, were analyzed and support the postulate that a high frequency of self-references indicates memory loss and paucity of present experience. PMID- 3833798 TI - The applicability of the concept of recruitment to the communications study of a nursing home: an ethnographic case study. AB - A perspective for studying institutional procedures for assigning incoming patients to available wards, and for transferring patients between and among wards, is developed. Ethnographic data collected in one extended-care facility are presented. Staff-patient and patient-patient interactions surrounding ward assignments and transfers are discussed. PMID- 3833799 TI - Nursing home nurses' attitudes, empathy, and ideologic orientation. AB - The purpose of the present research was to assess the empirical relationship of the psychosocial variables of empathy, attitudes, and ideological orientation toward treatment (custodial versus therapeutic). The sample consisted of 363 volunteers representing all levels of nursing personnel in seven different nursing homes. The data analysis indicated that a low level of empathy, negative attitudes toward the elderly, and a custodial orientation toward treatment were significantly positively correlated. Positive attitudes were not significantly correlated with empathy, orientation toward treatment, or negative attitudes. There were significant differences in empathy, negative attitudes, and custodial orientation toward treatment among the staff levels and nursing homes. However, positive attitudes varied significantly only among nursing homes. These data suggest directions for enhancing the ability of nursing personnel to interact therapeutically with elderly persons in nursing homes. PMID- 3833800 TI - Diffusion of an idea: Jellinek's disease concept in Latin America. AB - This paper examines the diffusion of Jellinek's disease concept of alcoholism in Latin America and its impact on research and prevention in those countries. After Jellinek's visit to Chile in 1956, epidemiological research in that country received a great impulse. Marconi published a series of papers where he put forward concepts of alcoholism based on Jellinek's work. These ideas were well received by alcohol epidemiologists and became standard definitions employed in a series of epidemiological studies in Chile, Argentina, Peru, Brazil, Costa Rica, and Mexico. Since then the disease concept has been the main idea governing professionals' understanding of alcohol problems in Latin America. PMID- 3833801 TI - The consequences expected from alcohol and drinking behavior: a factor analysis of data from a panel study of adolescents. AB - The consequences people expect from behavior are central to many theories. In this longitudinal study, 1,423 adolescents assessed the likelihood and desirability associated with 57 consequences of drinking beer and hard liquor. Factor analyses yielded seven factors for beer and six for hard liquor. In multivariate analyses the pleasure, psychological, and deviance factors were related to the initiation of beer drinking; the pleasure and psychological factors were associated with beginning to drink hard liquor. Among those who were drinkers when first studied, the trouble with authority factor was related to an increase in beer drinking and the psychological factor was related to an increase in drinking hard liquor. The findings are discussed in the context of earlier research on the determinants of behavior with alcohol and the value of the factors for future research. PMID- 3833802 TI - Confirmatory analyses of reasons for experiencing psychoactive drugs during adolescence. AB - This study established empirically defined reasons for experiences with psychoactive drugs by adolescents. By means of cross-validating procedures involving a series of principal component analyses of data obtained from three separate sample groups, three common motives or reasons for trying/taking drugs were derived: a tension-reduction, or coping motive; a drug-effect motive; and a peer-related motive. The implications of the findings for further research and for treatment and prevention programs are reviewed. PMID- 3833803 TI - Drinkers' use of physical availability of alcohol: buying habits and consumption level. AB - On the aggregate level, physical availability of alcohol is related to per capita consumption, prompting the question whether high availability can increase consumption net of social norms which enhance drinking. This issue is investigated using individual-level data in a high-availability urban environment. Effortless, efficient purchase of alcoholic beverages explains a small but significant amount of the variance in consumption when normative factors are statistically controlled. Qualitative factors of availability are discussed, with particular emphasis on food stores, which account for more than half this sample's purchases. PMID- 3833804 TI - The effects of marathon groups on the ways illicit drug users perceive counseling. AB - This research investigated the effects of five 16-hour unstructured marathon groups on changing the attitudes toward counseling of male and female imprisoned, illicit drug users. The attitudes of the participants of the marathon groups were compared on posttests to the attitudes of the participants of five matched, randomly selected control groups. The members of the marathon groups rated counseling higher than the members of the control groups on an evaluative semantic differential scale. They also rated many of the specific evaluative and potency adjective pairs of the semantic differential for counseling differently than the control group members. PMID- 3833805 TI - Benefits of recurrent, outpatient heroin detoxification. AB - Recurrent heroin detoxification, or the "revolving-door" process, is the treatment of choice for many addicts. Forty-five heroin addicts were detoxified 145 times (mean = 3.2 per patient) on an outpatient basis over a 3-year period and showed significant improvement in arrest and hospitalization rates but not employment or intact marriages. Another group of 74 patients who had detoxified two or more times were compared to a similar group of 61 methadone maintenance (mean maintenance time = 17.9 weeks) patients, and no significant difference was found in a variety of health, employment, and social indicators. These findings indicate that recurrent, outpatient heroin detoxification has some therapeutic benefits and provides an explanation for patient popularity. PMID- 3833806 TI - Alcoholism treatment and the relationship of Native American cultural values to recovery. AB - Native American alcoholics, Native American nonalcoholics, Anglo alcoholics, and Anglo staff were compared on demographics and the Rokeach Value Survey. The subjects were from an inpatient alcohol treatment program of a rural community mental health center located 1 mile from the boundary of a large southwestern Indian reservation. Results from this study provide evidence which supports the poorer prognostic rates of alcoholism recovery for Native American alcoholics. Evidence is also presented which suggests that Native Americans' values are measurable and significantly different from Anglo values. While the relationship between values and recovery was difficult to discern, it is suggested that the disparity in values between the two cultures is one reason why so few Native American alcoholics remained in treatment. PMID- 3833807 TI - "The next best thing": a study of problem gambling. AB - Traditionally, gamblers whose repeated losses have resulted in serious financial, psychological, and social problems have been labeled "compulsive." The prevailing "illness model" of compulsive gambling was developed by clinicians from the reports of those seeking treatment to stop gambling. However, researchers working in natural gambling settings generally have disavowed a compulsion model. Concerns over the efficacy of the traditional model and the therapeutic approach it produces are particularly salient since the proliferation of legalized gambling is expected to fuel a dramatic increase in problem gambling. Drawing upon empirical observations of ongoing gambling groups, a unique and comprehensive model of problem gambling is presented. Treatment plans generated from the new model, unlike prevailing programs, are compatible with a "controlled" regimen. PMID- 3833808 TI - Changes in self-perceptions of illicit drug abusers related to time in treatment in two residential treatment programs. AB - This research investigated the effects of two residential drug treatment programs on changing the self-perceptions of the residents over a 10-month time period. The semantic differential evaluative and potency scales of the concepts Who I Am and Who I Would Like to Be were administered to the residents of these programs on several occasions during the time they were in these programs. The results of this research showed that the residents evaluated Who I Am higher, the longer they remained in these programs. PMID- 3833809 TI - "It takes your heart": the image of methadone maintenance in the addict world and its effect on recruitment into treatment. AB - Using data gathered on 368 current methadone clients and 142 narcotics users not in treatment in structured interviews and through ethnographic fieldwork, the study examines the image of methadone maintenance treatment in the drug-using community and discusses the effect of that image on recruitment of addicts into methadone treatment. The results indicate that the image of the methadone client as a "loser," fear of the long-term effects of methadone, and the perception of treatment as an intrusion in the user's daily life make addicts often difficult to recruit and, once in treatment, ambivalent about their participation. The image of methadone is based on both misinformation about treatment and the user's contrasting of a treatment status with the stereotypic ideal of the "righteous dope fiend." Policy implications and suggestions derived from the data are discussed. PMID- 3833811 TI - Tobacco and alcohol use among urban Malaysians in 1980. AB - Data from 100 Chinese, 50 Malay, and 50 Indian adults resident in 1980 in the greater urban area of Kuala Lumpur, Malaysia, indicate a heavy use of cigarettes among males of all ethnic groups, light use among female Chinese, and none among female Malay and Indian. Consumption of other tobacco products was important only among Indian males; chewing betal quid among Indian males and also among Malay and Indian females. Alcohol use is increasing among both sexes and all ethnic groups, but Chinese and Indian groups use alcoholic drinks more frequently and in larger quantity than Malay. Beer and liquor are the most common drinks. PMID- 3833810 TI - Dealing with drugs: heroin abuse as a social problem. AB - Reported here are attitudes and perceptions regarding heroin control, prevention, and treatment obtained in a survey of community leaders in four high drug traffic and drug use neighborhoods in New York City. Studies in the past have focused on the causes and consequences of heroin use primarily from the standpoint of the drug user. Operationalizing the tenet that heroin abuse is a social problem, this study develops an ecological paradigm for analyzing the effects on neighborhoods of illicit drugs and of prevention, intervention, and treatment policies. The research was undertaken in 1981 for the New York State Heroin and Alcohol Study Commission. It demonstrates the importance of including community perspectives in policy decisions and the usefulness of a study group of community leaders as a reliable source of this information. PMID- 3833812 TI - Staff and patient predictions of success in an inpatient alcohol treatment unit. AB - Staff and patients were overly optimistic in their predictions of abstinence. Staff and patients were equally successful at predicting abstinence. When predictions of abstinence were combined with predictions of nonabstinence, staff predictions were better than patient predictions, probably because patients predicted nonabstinence less frequently. PMID- 3833813 TI - Future time perspective in alcoholics, process and reactive schizophrenics, and normals. AB - Future time perspective was investigated in alcoholics, process and reactive schizophrenics, and hospitalized medical patients. The four groups, of 24 subjects each, were compared on measures of future extension, coherence, density, and directionality based on Kastenbaum's model of future time perspective. Process and reactive schizophrenics differed only in future coherence, with reactives significantly more coherent. Both alcoholics and normals showed significantly greater future extension (on one of two extension measures) than both groups of schizophrenics. Future coherence for alcoholics and normals was significantly greater than for process schizophrenics but not greater than for reactives. Alcoholics had significantly greater future density than schizophrenics and normals. Alcoholics showed significantly greater future coherence than normals. The greater future density and coherence for alcoholics than normals appeared to be due to sampling and situational differences. These results suggested that future time perspective deficits are temporary for alcoholics and that long-range treatment goals can be appropriate for them. PMID- 3833814 TI - The association of preexisting psychosocial pathology with deaths involving propoxyphene or codeine. AB - The study utilized a sample of 94 propoxyphene- (Darvon) and codeine-related deaths that had occurred in Los Angeles County within a 1-year period (during 1979-1980). Data describing these deaths were obtained from the records of the Los Angeles County Medical Examiner's Office and from interviews with informants who had know the deceased subjects. The findings revealed the presence of extensive psychosocial pathology. High levels of prior drug abuse involving both prescription and illicit drugs were reported. Other findings included a markedly high incidence of prior drug overdoses, arrests, psychiatric disorders, interpersonal conflicts, and prior suicide attempts. PMID- 3833815 TI - The effect of a contingent monetary reward on probation referrals to a drug abuse program. AB - Faced with reductions in public funds and calls for greater accountability, substance abuse programs can possibly increase revenues through patient fees by increasing referrals from the criminal justice system. Accountability can be improved through the use of organizational behavior management techniques. This study demonstrates the utility of behavioral techniques to increase referrals and revenue in an outpatient drug abuse program. The rate of criminal justice referrals increased substantially when counselors were offered "commissions" based on patient fees. These results are discussed with respect to the practicality of behavioral techniques in the management of drug abuse programs and with regard to policy implications. PMID- 3833816 TI - Perceived helpfulness of messages on a community-based telephone support service for ex-smokers. AB - Callers to a community-based telephone support service for ex-smokers evaluated the perceived helpfulness of six categories of taped messages. These categories were: behavioral coping, cognitive coping, negative health, positive health, informational, and supportive. Supportive messages were rated as significantly more helpful than negative health, informational, and behavioral coping. The implications of these findings are discussed. PMID- 3833817 TI - An instrument to measure the activity level of the blind. AB - A questionnaire to measure the activity level of people with visual handicaps was developed in which separate components of activity are measured: "independence" and "difficulty" in performing various activities, "felt loss" in not performing the activities, and "motivation to learn" the activities. The responses of 129 veterans who completed this questionnaire were analyzed. Attempts were made to determine the reliability and validity of the scales. The questionnaire can be regarded as useful to evaluate both what patients are specifically taught and how that training effects activities not specifically taught. PMID- 3833818 TI - Vocational aspects of acquired hearing loss. AB - Although there is increasing concern about the effects of hearing loss at work and although we have developed considerable understanding of the problems of people born deaf, there has been relatively little study of those who develop a hearing loss during their working lives. If this hearing loss were profound and sudden, we would predict loss of job and isolation. Fortunately, this occurrence is rare and people usually face a longer period of declining hearing. We have interviewed 105 people with a hearing loss in an attempt to discover the extent of their adjustment and particularly their attitudes to their employment. The results, compared to hearing norms, indicate greater job satisfaction than is expected from their job conditions but also greater anxiety. This is accompanied by curtailed promotion prospects. These confirm the primary effects of hearing loss on the quality of employment life. PMID- 3833819 TI - Detecting early signs of alcohol problems: a clinical application of an interview method. AB - In this study a simple interview method to identify patients with potential alcohol problems was tested in a clinical setting. Nurses interviewed an unbiased sample of 393 patients attending practices within occupational health care. The technique used was a day by day follow back procedure covering the preceding two weeks. The time needed to accomplish the interviews varied between 2 and 15 minutes, depending on how much alcohol consumption was reported. Nurses and doctors reported that the interview was easily integrated in daily working routines. When defining the limit of high consumption as more than 200 g absolute alcohol for the two week period, 11% of the group studied (17% among men and 2% among women) were regarded as high consumers. Strategies for confronting and motivating patients for further analysis of their alcohol habits and for treatment are discussed. PMID- 3833820 TI - Synthesis and uptake of no-carrier-added 1-[11C]putrescine into rat prostate. AB - No carrier-added 1-[11C]putrescine has been prepared using a simple two-step procedure. Radiochemical yields of 1-2% at end-of-synthesis were obtained in a synthesis time of 50-60 min. The in vivo uptake of no carrier-added 1 [11C]putrescine into rat prostate was determined and compared to the uptake of no carrier-added material containing varying amounts of non-radioactive putrescine. The in vivo results indicate that the mechanism of uptake into the prostate is saturable. PMID- 3833821 TI - Effect of lipophilicity on the in vivo localization of radiolabelled spiperone analogues. AB - A series of N-alkylated and para-brominated analogues of spiperone were synthesized to ascertain the effect of lipophilicity on the in vivo localization of neuroleptics. While the IC50 for D2 receptor binding was within the same order of magnitude for these compounds, the calculated octanol-water partition coefficients varied 300-fold. When the in vivo distribution data for 77Br labelled compounds were compared with previous data for 18F- and 11C-labelled analogues it was seen that the highest cerebral uptake was for bromospiperone, but the optimum striatum-to-cerebellum and brain-to-blood concentrations were achieved by N-methyl spiperone. The implications of these results for radiopharmaceutical design or medicinal chemistry are discussed. PMID- 3833822 TI - Kinetics of iodomethylated hexadecanoic acid metabolism in the rat myocardium: influence of the number and the position of methyl radicals. AB - The methyl-branched fatty acids, if radioiodine labelled in alpha position, are potentially adapted to a selective study of FA myocardial uptake. To determine the position and the number of methyl radicals that are necessary to obtain a maximal uptake and a minimal degradation, we measured time-activity evolution of isolated and perfused rat hearts after an injection of iodinated fatty acids which are mono- or dimethylated in alpha or beta position. Except for dimethyl fatty acid, the uptake is similar for all fatty acids studied to that of the straight chain analogue; beta mono- or dimethyl fatty acids seem best adapted to a study of the uptake because alpha monomethyl fatty acids undergo a metabolic degradation and alpha mono- and dimethyl fatty acids induce ventricular fibrillations. PMID- 3833823 TI - Evaluation of radiocolloids as thrombus imaging agents. Effect of particle size on thrombus uptake. AB - Thrombus uptake values of several 99mTc labeled radiocolloids determined using an experimental rodent model of deep venous thrombosis were correlated with particle size distributions. The thrombus uptake values increased with increasing mean particle size. The 99mTc-tin colloid had the highest thrombus uptake value of any of the colloids used in this study. PMID- 3833824 TI - The metabolism of radiohafnium in marmosets and hamsters. AB - The whole body retention of 181Hf was studied in marmosets (Callithrex jacchus) and found to be closely similar to that in rats and Chinese hamsters. Limited tissue distribution studies suggest a higher uptake in liver and much lower deposition in skin and muscle in the marmoset as compared to the rat or Chinese hamster. Studies in Chinese hamsters showed that treatment with the chelating agent diethylenetriaminepentaacetic acid resulted in only a small reduction in the whole body retention of 181Hf. The absorption of orally administered 181Hf, in various chemical forms, was found to be between 0.04 and 0.13% of the ingested dose and was unaffected by age between 5 and 21 months but was increased by fasting. The measured absorption of 181Hf in Chinese hamsters and in rats was similar to that of plutonium suggesting that radiohafnium could be used as a surrogate for plutonium for selected studies in human volunteers. PMID- 3833825 TI - Placental transfer of radioactive salts in the pregnant rabbit. AB - The risks of radionuclidic contamination due to the easy transfer of water soluble ions from the circulation of the pregnant woman to her fetus, encouraged us to study whether the ease of penetration of such ions is size-dependent. Three radiochemicals--22NaCl, 99mTcO4Na and 201TlCl were injected i.v. into pregnant rabbits on the 16th day of their pregnancy, and the rabbits were killed 15, 30, 60 or 120 min later. From each rabbit the blood, heart, kidney, liver and muscle were sampled and counted as well as placenta, amniotic fluid and some fetuses. At 15 and 60 min hearts and livers were excised from selected fetuses and blood clearance, organ-to-muscle and fetus-to-placenta ratios were calculated. The results indicate that the transplacental transfer of the small radionuclide 22Na+ is faster than that of 99mTcO4- and 201Tl+, reaching equilibrium about 3 h after its injection to the pregnant rabbit. 201Tl+ demonstrated a high localization in the pregnant rabbits' and fetuses' heart and kidneys, with a similar myocardial retention in both groups. Due to the concentration of 201Tl+, in spite of its large diameter, into the fetuses' heart muscle, careful consideration should be taken when injecting 201TlCl into pregnant women for myocardial imaging. PMID- 3833826 TI - Prevalence of fleas on dogs in Anambra State of Nigeria. AB - An examination of 338 dogs for fleas in Anambra State revealed that 28.7% of the dogs were infested. While 2.1% of the dogs harboured the poultry flea Echidnophaga gallinacea, 26.3% harboured the dog flea Ctenocephalides canis. It was considered that Ctenocephalides canis could be of great public health significance in this area in view of the high population of the flea. Elimination of the flea was therefore recommended. The populations of fleas on dogs in other areas and the distribution of Ctenocephalides species of veterinary importance in Nigeria are briefly discussed. PMID- 3833827 TI - Bovine tuberculosis in Benghazi cow project (Libya). AB - Dual-tuberculin tests were performed on cows of five dairy stations in the cow project of Benghazi (Libya). 3413 cows were tested and 142 (4.26%) were found to show specific tuberculin sensitivity. Most of the reactors (7.9%) were in Abo Garar dairy station. Following the standard interpretation of tuberculin tests, 88 cow (2.6%) were retained, 51 cows (1.5%) were retested and 3 cows only (0.09%) were destroyed from all cows investigated. PMID- 3833828 TI - Intestinal helminths of domestic dogs in the Hessian Neckar Valley, Federal Republic of Germany. AB - In a small town and its adjacent villages of the Hessian Neckar Valley, Federal Republic of Germany, 155 of the officially registered domestic dogs were examined for intestinal helminths. Twenty percent of the animals proved to be infected. The highest prevalence of 5.8% could be attributed to infections with Toxocara canis. These values are well below the average rates for dogs in the larger German cities. PMID- 3833829 TI - Wall Geckos (Geckonidae) as reservoirs of Salmonellae in Nigeria: problems for epidemiology and public health. AB - An investigation was carried out to establish the occurrence of Salmonellae in household wall lizards (Gecko gecko and Hemidactylus sp.) in Nsukka, Nigeria. Twentyseven out of 90 geckos examined yielded positive Salmonella isolations, giving a carrier-rate of 30 per cent. While 2 isolates were non-typable, the other 25 strains belonged to 6 serotypes: Salmonella weltevreden (8 strains), Salmonella typhimurium, Salmonella enteritidis, Salmonella hvittingfos, Salmonella saintpaul, and Salmonella agama. Two serotypes, Salmonella weltevreden and Salmonella hvittingfoss are reported for the first time in Nigeria. The role of Geckonidae in the epidemiology of salmonellosis and the public health implications of geckoborn Salmonellae are highlighted. PMID- 3833830 TI - Survey of Anisakis larvae in marine fish of Taiwan. AB - A survey on the prevalence and intensity of larval anisakid infection in some species of marine fishes sold in the markets at Tan-shui in northern Taiwan was carried out from May to August 1980. The general infection rate was 37.7% with an average of 14.2 larvae per fish. A total of 13 species of examined fishes were found with Anisakis larvae, these were Argyrosomus argentatus, Caranx djeddaba, Diploprion bifasciatum, Evynnis cardinalis, Lethrinus haematopterus, Megalops cyprinoides, Nemipterus virgatus, Paraplagusia formosana, Plectorhinchus pictus, Rastrelliger chrysozonus, Saurida tumbil, Scolopsis vosmeri, and Trichiurus haumela. The highest intensity of Anisakis larvae was obtained in E. cardinalis with an average of 80.3 larvae per fish; the next was in N. virgatus (76.2 larvae/fish). The parasite could not be found in the other 20 species of fishes examined. PMID- 3833831 TI - Zoonotic helminths of dogs and cats at New Bussa, Kainji Lake area, Nigeria. AB - A survey of the dog and cat population at New Bussa revealed a significant high frequency of potential helminths of public health importance. This include hookworm Ancylostoma spp.; Echinococcus granulosa, Dipylidium caninum in dog; and Opisthorchis felineus, Toxocara cati and Capillaria hepatica in cat. The rural conditions of the area is an important factor in understanding the role cat and dog may play in spread of uncommon human parasites. PMID- 3833832 TI - Canine and human gastrointestinal helminthiasis of the Kainji Lake area, Nigeria. AB - An investigation into gastrointestinal helminthiasis in human and dog population of the Kainji Lake area revealed a high prevalence of helminthiasis which may be due to lack of adequate health and veterinary facilities; crowdiness and squalid environment. The prevalent parasites in humans were Ancylostoma sp, 40.33%; Ascaris lumbricoides, 44.07% and Strongyloides stercoralis 4.05%, while in dogs Ancylostoma sp, 36.95%, Dipylidium caninum, 28.26%, Echinococcus granulosus, 8.69% and S. stercoralis 5.43%. The risk of incidental occurrence of helminths of dog, D. caninum, Toxocara canis, E. granulosus are highlighted and the need to educate the community on hygiene matters in the absence of adequate health facilities are recommended. PMID- 3833833 TI - Single-stage subcutaneous breast-prosthesis implantation and modified radical mastectomy for invasive carcinoma. AB - In eighteen patients modified radical mastectomy for invasive carcinoma was immediately followed by breast reconstruction. The prosthesis was placed subcutaneously. There were no infections and no definitively lost prostheses. One prosthesis had to be replaced subpectorally after 55 days due to a small skin necrosis occurring after radiotherapy. One hematoma had to be evacuated and one small skin necrosis was excised and sutured per primam. There were no local recurrences but the follow-up is short (3 years and 4 months). Postoperative radio- and chemotherapy were not affected by the reconstruction. PMID- 3833834 TI - Operative morbidity after shunt surgery for portal hypertension. AB - The operative morbidity observed in a consecutive series of 286 patients who underwent shunt surgery for portal hypertension is reported. 149 patients out of 286 (52.1%) had a postoperative complication, which required reoperation in 11 cases (5 intestinal perforations, 2 bleeding peptic ulcers, 1 eventratio, 1 cholestasis, 1 acute pancreatitis, 1 strangulated hernia). 42 patients out of the 149 with complications died of the complication (operative mortality 14.6%). Operative morbidity and mortality appeared higher in patients operated as emergencies. Whereas elective shunts gave better results. The problem involved in preventing and treating the serious complications following shunt surgery for portal hypertension are discussed. PMID- 3833835 TI - Biliary microlithiasis and acute pancreatitis. AB - Forty-two patients with homogeneous biliary microlithiasis were studied to assess the incidence of the various clinical and anatomopathological characteristics of secondary acute pancreatitis resulting from this condition. The findings confirm that the risk of acute pancreatitis is particularly high in these patients and that the steatonecrotic form is the most common. Consequently, the authors stress the importance of thorough pre- and intraoperative investigations whenever the presence of biliary microlithiasis is suspected, and confirm their preference for the radical treatment of this disease. PMID- 3833837 TI - Rate of weight loss after vertical banded gastroplasty in morbid obesity: relationship to serum lipids and uric acid. AB - The relationship between postoperative weight loss after vertical banded gastroplasty in morbidly obese patients and preoperative serum triglycerides, cholesterol, HDL-cholesterol, uric acid and fasting plasma glucose was evaluated. The rate of weight loss, calculated as a percentage of original weight, was determined at three and six months after surgery. There was a significant correlation between rate of weight loss at three months and preoperative serum uric acid (r = -0.60, p less than 0.01). and also with the total cholesterol: HDL cholesterol ratio (r = 0.61, P less than 0.01). At six months, the rate of weight loss correlated with preoperative serum triglycerides (r = -0.54, p less than 0.02) and total cholesterol: HDL cholesterol ratio (r = 0.44, p less than 0.05). The reasons for the predictive value of these biochemical parameters is unknown and deserves further study. PMID- 3833836 TI - Lack of body iron after total gastrectomy for adenocarcinoma of the stomach: a serum ferritin follow-up. AB - The postoperative evaluation over two years of body iron stores by measurement of serum ferritin concentrations in 43 patients who underwent total gastrectomy, for adenocarcinoma of the stomach showed that more than 50% of the patients had depleted iron stores. The iron stores were often already depleted preoperatively and were only slightly reduced postoperatively according to the time since surgery. Total gastrectomy produced an acute and significant increase in subnormal, but not in normal or high, serum ferritin concentrations, for a period of three months. Some, although not all, patients presenting metastasis during follow-up showed an increase in serum ferritin concentrations. This study would indicate that empty iron stores are common in patients with adenocarcinoma of the stomach, that total gastrectomy produces an acute increase in subnormal serum ferritin values, but iron stores are not replaced during follow-up and that high serum ferritin concentrations are rarely seen in patients with adenocarcinoma of the stomach. PMID- 3833838 TI - Perforated duodenal and gastric ulcers in the Nigerian Savannah. AB - In the developing world, "pyloric stenosis" has been reported as the most frequent complication of peptic ulcer, hemorrhage and perforation being uncommon. However, in Zaria, situated in the Savannah zone of Nigeria, 74 (24%) of the 302 patients operated upon for duodenal ulcer and 29 (58%) of the 50 operated upon for gastric ulcer between 1971 and 1983 presented with perforations. In the combined group, the frequency of perforations increased from 16% in 1971-74 to 31% in 1975-78 and 45% in 1979-83. At the same time the total number of operations for duodenal ulcer has decreased. This may represent a distinctive feature of the savannah with reference to the geographical aspects of peptic ulcer surgery. PMID- 3833839 TI - Primary tumors of the small intestine. AB - From 1950 through 1984, 48 cases of primary tumors of the small bowel were treated at the First Surgical Clinic of the University, La Sapienza, of Rome. Forty-three were malignant and five were benign tumors: 13 in the duodenum, 16 in the jejunum and 19 in the ileum. Abdominal pain, weight loss and obstruction were the most common complaints at admission. Radiographic studies of the gastrointestinal tract were diagnostic in 48% of patients. Four benign tumors were leiomyoma of the jejunum or ileum, the other benign tumor was a Brunner's adenomatosis of the duodenal bulb. The tumors were adenocarcinomatous in 29% of the cases and 50% of them were located in the duodenum. The five-year survival of patients with adenocarcinoma was 11%. The fourteen lymphomas were distributed evenly throughout the small bowel: 40% of the patients with lymphoma were alive after five years. Malignant smooth muscle tumors were found in the jejunum and ileum, in these cases the five-year survival rate was 50%. All the carcinoid tumors were in the ileum. The best five-year survival rate, 66%, was seen in patients with this type of tumor. In the malignant group, the five-year survival rate after curative resections was 25% in patients with positive nodes and 75% in those without nodal involvement. PMID- 3833840 TI - The endorectal pull-through for the management of familial polyposis. AB - The standard surgical approach to multiple polyposis has been a total proctocolectomy and an end ileostomy because of the premalignant nature of the disease. This operation has been successful, but has resulted in a significant amount of psychological trauma due to the presence of an abdominal stoma. For that reason, we have utilized the sphincter-saving operation, namely, the endorectal pull-through for the definitive management of patients with familial polyposis since 1979. During the years 1979 to 1984, seven patients (4 female and 3 male), ranging in age from 10 to 30 years, have undergone an endorectal pull through at our institution. Four of these patients had previously undergone a subtotal colectomy and ileoproctostomy and were seen because of persistent polyps in the remaining rectum. The operation consisted of a total colectomy, a mucosal proctectomy, an ileoanostomy and a loop ileostomy (1 patient did not undergo a loop ileostomy). The loop ileostomy was closed about two months after the pull through procedure. There was no mortality and only one complication was seen postoperatively. This complication consisted of a bowel obstruction one week after ileostomy closure which was successfully treated with an enterolysis. Patient satisfaction has been excellent. All patients have either returned to full-time work or full-time school activity. All were completely continent immediately after ileostomy closure, both during the day and at night. The median stool frequency one year after the operation is five stools per 24 hours. Our results with this operation have encouraged us to recommend the endorectal pull through to all patients with multiple polyposis. PMID- 3833841 TI - Toxic megacolon complicating ulcerative colitis and Crohn's disease. AB - The clinical, laboratory and radiological data of 17 cases of toxic megacolon (TM) complicating either ulcerative colitis (UC) or Crohn's disease (CD), referred to the Department of Clinica Chirurgica II of the University of Bologna in a twenty year-period, are reviewed. The surgical strategies and results are compared and discussed, and the mortality and morbidity considered along with the important advances in resuscitative medicine and the employment of total parenteral nutrition (TPN). PMID- 3833842 TI - Cross over ileo-popliteal bypass through the obturator foramen: an additional route for extra-anatomic limb blood supply. AB - Complications and morbidity associated with vascular graft infections continue to be a major clinical problem. Ischemia and gangrene are consequences of limb circulation failure, especially in extra-anatomic, occluded and infected bypass prostheses. Infection of the tissue bed of such prostheses should be prevented. When it occurs, the use of the contralateral obturator foramen represents an alternative route in cases in which it is impossible to use the ipsilateral vessels. Prosthetic crossover reconstruction through the obturator foramen may be considered a safe and effective solution for patients with a limb threatening infection of the extra-anatomic graft and a damaged blood supply. PMID- 3833843 TI - One stage surgical procedures for bilateral urinary tract lesions. AB - In a selected group of bilateral urinary tract lesions of varied benign etiologies, single stage corrective surgical procedures were performed in 24 patients. The operations included lithotomies, pyeloplasties, ureteric reimplantations, ureterolysis, nephrectomies, urethral valve fulgurations and repair of vescicovaginal fistulae in various combinations. This procedure has many obvious advantages. The patient will be hospitalized only once and operated upon on both sides in one sitting, thus avoiding multiple anesthesias with their attendant risks. Both kidneys are given equal opportunity to recover simultaneously in obstructive lesions. The overall cost of treatment can be reduced considerably. There were two postoperative deaths with no significant morbidity in the series. PMID- 3833844 TI - Posterior urethral valves in Saudi Arabia. AB - Forty patients with posterior urethral valves who were managed at the King Faisal Specialist Hospital between 1977 and 1983 are reviewed. Seventy-two percent of the patients were less than one year old. Diagnosis was established by voiding cystourethrography and confirmed endoscopically. Fifteen of the 16 patients treated by primary transurethral valve ablation had a satisfactory outcome without the need for any further treatment. Cutaneous vesicostomy followed by valve ablation was performed in 15 patients. Vesicoureteric reflux occurred in 62.5% of cases and ceased spontaneously after valve ablation or temporary diversion in one third of the affected cases. Reimplantation was required unilaterally in five cases and bilaterally in four. Nephroureterectomy was performed in six patients. No hospital mortality was encountered in this series. PMID- 3833845 TI - Family dynamics of cancer patients after surgery. PMID- 3833846 TI - Different types of denial account for short and long term recovery of coronary patients. PMID- 3833847 TI - Urban patterns of psychiatric hospitalization in Israel 1972-1976. PMID- 3833848 TI - Group psychotherapy with inpatient chronic schizophrenics. PMID- 3833849 TI - Female high school students' assessment of their parents. PMID- 3833850 TI - Offspring of concentration camp survivors: a study of levels of ego functioning. PMID- 3833851 TI - Sexuality and the holocaust survivor. PMID- 3833852 TI - Joint meeting of the Sicilia and Puglia-Campania-Calabria groups of the Italian Biochemical Society. April 11-12, 1985, Messina. Abstracts. PMID- 3833853 TI - The effect of cyclosporin on murine autoreactive delayed type hypersensitivity induced with syngeneic lymphoblasts. AB - The effect of cyclosporin on an immunological autoreactive experimental model was analyzed. The experimental system consisted of X-irradiated A mice injected with syngeneic concanavalin A-induced lymphoblasts and footpad-challenged 7 days later with syngeneic lipopolysaccharide-induced lymphoblasts. 24-72 h after challenge, the footpads of these mice responded with significant swelling, accumulation of 125I-UdR or massive cellular infiltration revealed by histological examination. Since the immunological activity was transferred by Lyt-1+ T cells from the sensitized donors to naive recipients, we designated it 'syngeneic delayed-type hypersensitivity' (syn-DTH). This DTH was induced and elicited mostly by antigens of the syngeneic lymphoblasts and not by contaminants attached to them, indicating the immunological autoreactive nature of this system. Multiple doses of 60 mg/kg cyclosporin, given daily in the time interval between immunization and challenge, or on the last four days before challenge, inhibited the syn-DTH. Multiple injections of cyclosporin Before or close to the induction phase of the syn-DTH was ineffective, whereas single or multiple injections of cyclosporin close to the effector phase (the challenge time) markedly reduced the syn-DTH. Even a single injection of cyclosporin 24 h after the challenge efficiently reduced the 48-h syn-DTH. Adoptive transfer experiments revealed that T cells from X-irradiated mice immunized with concanavalin A-induced lymphoblasts and injected with cyclosporin, failed to efficiently transfer the syn-DTH response to naive recipients. Similarly, the syn-DTH response of naive X-irradiated recipient mice injected with cyclosporin, failed to be reconstituted with primed T cells derived from X-irradiated mice immunized with concanavalin A-induced lymphoblasts. Since the nonspecific footpad swelling response of X-irradiated mice challenged with lymphoblasts alone is resistant to the standard protocol of the cyclosporin treatment, we suggest that cyclosporin inhibits the ability of T cells to produce or release lymphokines at the effector phase of DTH, while phagocytic cells involved in the DTH response are not affected by it. The practical and the theoretical implications of this research are discussed. PMID- 3833854 TI - Inhibition by adenine of in vitro immunological functions of normal and adenine phosphoribosyltransferase-deficient human lymphocytes. AB - Exogenous adenine strongly inhibited mitogen-stimulated transformation, cytoplasmic immunoglobulin production, and natural killer activity of human mononuclear leukocytes at the high concentration of 1.0 mM. These inhibitions by adenine were not due to cytotoxicity, because the viability of cultured cells was not affected by adenine up to 1.0 mM. As the magnitude of inhibition by adenine of these in vitro immunological functions was similar in normal and adenine phosphoribosyltransferase-deficient cells, its inhibition was not mediated by corresponding nucleotides. Adenine at the concentration of 0.1 mM caused 50% inhibition of cytoplasmic immunoglobulin production without alternating cell proliferation or viability. This suggests that an appropriate concentration of adenine may inhibit the differentiation of B cells to plasma cells rather than affecting cell proliferation. Understanding the mechanisms of adenine inhibition may lead to new approaches for the regulation of immune responses. PMID- 3833855 TI - Immunological profile of DL111-IT, a new immunosuppressant agent. AB - The immunosuppressive properties of the non-hormonal contragestional agent 3-(2 ethylphenyl)-5-(3-methoxyphenyl)-1H-1,2,4-triazole (DL111-IT) were evaluated on different immunological functions. The compound displayed significant immunosuppressive activity on both humoral and cellular immunity when administered during the inductive phase of the immune response. In experimental models autoimmunity and skin transplantation, DL111-IT was able to reduce the production of auto-antibodies and prolong skin graft survival. The compound, even at doses much higher than those effective inhibiting immune responses, did not influence the survival time of some haematological tumors in mice. This suggest that DL111-IT does not act by a general cytotoxic mechanism. PMID- 3833856 TI - Investigations into the mechanism of immunosuppression caused by acute treatment with O,O,S-trimethyl phosphorothioate. II. Effect on the ability of murine macrophages to present antigen. AB - Acute administration of 10 mg/kg O,O,S-trimethyl phosphorothioate (OOS-TMP) for 24 h has been shown to suppress the in vitro generation of cytotoxic T lymphocyte responses and antibody-secreting cells to sheep red blood cells and to increase interleukin-2 production. Macrophages were shown to be the splenic cell population most affected by OOS-TMP pretreatment. In this report, the ability of macrophages from OOS-TMP-treated animals to function in antigen presentation was shown to be significantly decreased. In addition, macrophages from treated animals had increased phagocytic capability and interleukin-l production. However, the percentage of Ia-positive macrophages present in splenic populations was decreased following OOS-TMP treatment. A decrease in antigen presenting ability and the number of Ia-positive macrophages may explain the reversible suppression in cytotoxic T lymphocytes and antibody responses reported previously. PMID- 3833858 TI - Diurnal variations of brain noradrenaline metabolism of the methylmercury chloride-administered rat with reference to an altered circadian rhythm of paradoxical sleep. PMID- 3833857 TI - In situ labelling of vascular endothelium with fluorescent acetylated low density lipoprotein. AB - Acetylated low density lipoprotein is metabolized by a receptor-mediated process in endothelial cells. We have used the lipoprotein labelled with the fluorescent probe 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate to localize endothelial cells lining blood vessels. Following intravenous injection of the labelled lipoprotein, the vascular sinusoids and all other hepatic blood vessels were clearly labelled in cryostat sections of mouse liver. The endothelium of other organs such as brain, kidney, and testis was also brightly labelled. In addition, the lipoprotein was used to label the endothelium of bovine aorta, the vasculature in the chick chorioallantoic membrane, and the vessels in a growing murine melanoma. These results demonstrate that the fluorescent-labelled lipoprotein can be used for in situ labelling of the endothelium from large as well as small blood vessels in a variety of species. PMID- 3833859 TI - Relationship between sleep variables and urinary excretion of adrenaline in nocturnal sleep. PMID- 3833860 TI - Influence of age on cardiorespiratory responses of firefighters during exercise in the heat. PMID- 3833861 TI - Effect of urea on the simple determination of delta-aminolevulinic acid in urine. PMID- 3833862 TI - Studies on the endogenous galactose-binding lectin during early development of the embryo of Xenopus laevis. AB - Embryos of the frog Xenopus laevis at cleavage, blastula, gastrula and neurula stages contain a galactose-specific lectin. Extracts of gastrula embryos show the highest specific activity for this lectin compared to the other stages. Haemagglutinating activity of crude extracts is inhibited by lactose, alpha galactose, beta-galactose, alpha Gal(1----4) beta Gal, beta Gal(1----3) alpha GalNAc, beta Gal(1----3) beta GlcNAc, beta Gal (1----4) beta GlcNAc, and most effectively by the disaccharide alpha Gal(1----3) beta Gal. Lectin from all stages was purified by absorption to galactose-linked immunoadsorbent or by affinity chromatography on a column of p-aminophenyl-beta-D-lactoside coupled to Sepharose 4B. In order to identify a single lectin band under reducing conditions in sodium dodecyl sulphate/polyacrylamide electrophoresis SDS/PAGE, it was necessary to treat aqueous suspensions of the purified lectin with chloroform/methanol (2:1, v/v). The lectin remained in the aqueous layer and gave rise on SDS/PAGE to a distinct band of 65 500 +/- 2780 molecular weight. Aqueous suspensions of the purified lectin that were not subjected to extraction with chloroform/methanol gave rise to several bands. Isoelectric focussing of the purified lectin resulted in two bands that separated at pI 4.3 and 4.5. In aqueous solution in the presence of lactose the chloroform/methanol-treated lectin appears to be an aggregate of apparent molecular weight of 375 000; the non-treated lectin under the same conditions has an apparent molecular weight of 490 000. PMID- 3833863 TI - Cholesterol distribution in cells of the stria vascularis of the mammalian cochlea and some effects of ototoxic diuretics. AB - The distribution of cholesterol in cells of the stria vascularis of guinea pigs and gerbils has been investigated at the ultrastructural level by incubation of tissue in filipin, followed by freeze-fracture. Verification of results has been sought by using tomatin. It is shown that in the cell body region of the marginal cells, the apical and lateral membranes reacted intensely with both agents, but the membranes of the basal processes of the marginal cells did not respond significantly to either filipin or tomatin. On basal cell membranes, filipin cholesterol complexes were present at a high density, even within the strands of the tight-junctional network of these cells and occasionally within the gap junctional areas also. Complexes were present on intermediate cell membranes at a lower density than on other plasma membranes that showed a positive response. Tissue from animals that had received an ototoxic diuretic, either ethacrynic acid or furosemide, was characterized by the appearance of membrane regions with closely clustered filipin complexes, suggesting some change in cell membrane structure. At an early stage following diuretic administration, such clusters were particularly noticeable on the membranes of intermediate cells. As intercellular spaces enlarged in response to the effects of diuretics, vesicles released into the extracellular spaces appeared to be cholesterol-enriched. The results are discussed in relation to known features of the structure and function of cells in the normal stria vascularis and of the changes that follow from acute diuretic ototoxicity. PMID- 3833864 TI - Subplasmalemmal calcium-binding microregions in Acanthamoeba. AB - Acanthamoeba cells, fixed with glutaraldehyde supplemented with calcium ions, show Ca-dependent, electron-dense deposits (CaDD) at the cytoplasmic surface of the plasma membrane. The formation of CaDD is stimulated by pre-incubation and fixation of the cells in the presence of ATP. Chemical analysis of the trichloroacetic acid extracts of CaDD-containing cells demonstrates that adenosine monophosphate, pyrophosphate and inorganic phosphate are probably the compounds involved in the formation of CaDD. Treatment of CaDD-containing cells with exogenous phosphatase evokes the disappearance of electron-dense material and a fine fibrillar network can be observed inside the 'empty' CaDD. The ability to restore CaDD in the presence of calcium ions with either pyrophosphate or orthophosphate confirms the suggestion that calcium/phosphate salts may be deposited in special subplasmalemmal calcium-binding microregions. PMID- 3833865 TI - Water ordering during the cell cycle: nuclear magnetic resonance studies of the sea-urchin egg. AB - Nuclear magnetic resonance was used to measure spin-lattice water proton relaxation times (T1) during the first cell cycle in sea-urchin zygotes of packed Strongylocentrotus purpuratus. Following insemination there was a 90% increase in the T1 value. The increase in T1 at fertilization could be accounted for by the accumulation of extracellular fluid between the egg surface and the fertilization envelope. The T1 value then remained without change during the first cell cycle, except at metaphase when there was a significant 13% decrease. The lowered T1 values measured at metaphase were not related to a change in the water content of the packed cells, which remained fairly constant throughout the cell cycle. High hydrostatic pressure, low temperature and colchicine (agents that depolymerize mitotic apparatus microtubules) did not affect the T1 values in fertilized eggs. Treatment in vitro of a microtubule protein preparation with low temperature and colchicine resulted in an increased T1, which accompanied the depolymerization of microtubule protein. Since depolymerization of the microtubules associated with the mitotic apparatus by high pressure, colchicine or low temperature does not alter the T1 of water protons in the cell, it is proposed that the increased state of ordered water molecules at metaphase is maintained by nonmicrotubular factor(s) of the metaphase egg. PMID- 3833866 TI - Attachment of sponge cells to collagen substrata: effect of a collagen assembly factor. AB - Collagen, isolated from the sponge Geodia cydonium in the absence of denaturing agents, had the typical amino acid composition and was associated with the carbohydrates galactose and glucose. The resulting individual fibrils with a diameter of 23 nm, displayed a 19.5 nm periodicity with one intraperiod band. A collagen assembly factor (CAF) was identified in and partially purified from the extracellular space. The CAF reacted with antibodies against intact Geodia cells but not with antibodies against Geodia lectin and Geodia aggregation factor. In the presence of the CAF, the collagen fibrils reconstituted collagen bundles in an ordered sequence of events, which were followed by electron-microscopical and biochemical methods. Bundle formation was not dependent on the presence of the homologous lectin, glycoconjugates or aggregation factor. Homologous cells (Geodia archaeocytes) were determined to attach only to those Geodia collagen substrates that contained CAF. The attachment of these cells did not require fibronectin or Geodia lectin. Homologous glycoconjugates or NaOH-treated collagen inhibited cell attachment. Collagen from the sponge Chondrosia reniformis, even in the presence of Geodia CAF, was no appropriate substrate for Geodia cell attachment. Whether collagen is a component of cell-matrix interactions in sponge systems also in vivo is discussed. PMID- 3833867 TI - Differences in the uptake of modified low density lipoproteins by tissue cultured endothelial cells. AB - Acetylated low density lipoprotein (Ac-LDL) is taken up by bovine aortic and adrenal capillary cells but not by brain capillary cells. This indicates that the uptake of Ac-LDL is not a feature of all types of endothelial cell. A quantitative examination of lipoprotein uptake by flow cytometry showed cells in G2M took up 45% more Ac-LDL than those in G1S. Compared with confluent cultures, sub-confluent bovine aortic cells took up three times as much LDL but Ac-LDL uptake was increased by only 34%. This indicates that the Ac-LDL receptor is not down-regulated to the same extent as that for LDL. PMID- 3833868 TI - Suppression of malignancy in hybrid cells: the mechanism. AB - When malignant cells, defined by their ability to grow progressively in genetically compatible hosts, are fused with diploid fibroblasts of the same species, the resulting hybrid cells, so long as they retain certain specific chromosomes donated by the diploid parent cell, are non-malignant. When these particular chromosomes are eliminated from the hybrid, the malignant phenotype reappears, and the segregant cell is again able to grow progressively in vivo. In the present experiments the histological character of the lesions produced by the inoculation of crosses between malignant and non-malignant cells was examined. It was found, in a wide range of material, and without exception, that where one or other of the parent cells in the cross was of fibroblastic lineage, malignancy was suppressed when the hybrid cells produced a collagenous extracellular matrix in vivo; and it reappeared when genetic segregants were produced that had lost the ability to produce this matrix. These results are interpreted in terms of a general model in which it is proposed that the progressive multiplication of malignant cells in vivo is a secondary consequence of a genetically stable impairment of terminal differentiation. PMID- 3833869 TI - Detection of hepatitis B virus DNA in serum by a rapid filtration-hybridization assay. AB - A simple method for detecting hepatitis B virus DNA (HBV DNA) in serum using a filtration step for spotting sera on nitrocellulose paper followed by molecular hybridization is described. This method is rapid, sensitive, requires very small quantities of serum, and can be used for simultaneous testing of up to 96 samples in one filter apparatus. The sera tested for HBV DNA were also assayed for serological markers of HBV infection and comparison of data shows that on average 67% (30 of 45) of HBsAg- and HbeAg-positive sera contain HBV DNA, whereas 13% of HBsAg- and anti-HBe-positive sera contain HBV DNA. In general, there was a statistically significant correlation between the concentration of HBsAg in the serum and the presence or absence of HBV DNA. These results indicate that molecular hybridization is a valuable assay in addition to serological markers for identifying the possible infectivity of sera, and the simple and rapid method reported here makes the use of such hybridization technique easier. PMID- 3833870 TI - Quantitation of hepatitis B virus DNA (HBV DNA) in serum using the spot hybridization technique and scintillation counting. AB - The simple spot hybridization technique to detect HBV DNA in serum was modified to concentrate Dane particles by pelleting. This minimised interference by serum components and allowed larger volumes of sera (up to 500 microliters) to be used in serial dilution on borderline positive samples and increased the efficiency of filtering through a "Hybri.Dot' system. Quantification of HBV DNA by 32P scintillation Cerenkov counting based on serial standards of cloned HBV DNA processed through the "Hybri.dot' was easy to perform and the assay had good sensitivity (detection limit 2 pg, mode 6.25 pg), precision and accuracy. The pellet-simple spot quantitative assay proved more sensitive than those involving lengthier extraction procedures or direct application of serum to hybridization filters. Scintillation counting curves were linear over a wider range (0-800 pg HBV DNA) than optical densitometry measurements (0-50 pg) of autoradiographs. There was an excellent correlation with DNA polymerase activity (r = 0.948; P less than 0.001) but the assay proved more sensitive since HBV DNA (greater than 45 pg cloned equivalents) was detected in 4 out of 14 DNA polymerase negative sera and in 7 of 7 borderline (DNA polymerase cpm range 116-303) samples. This sensitive, quantitative HBV DNA assay should be of considerable value in studies on infectivity and effectiveness of antiviral therapies. PMID- 3833871 TI - Detection of chikungunya virus antigen in Aedes albopictus mosquitoes by enzyme linked immunosorbent assay. AB - Double-antibody sandwich and modified sandwich systems of enzyme-linked immunosorbent assay for detecting chikungunya virus antigen present in female mosquitoes, Aedes albopictus (Oahu strain), were evaluated as simple and rapid methods of selection of a highly susceptible mosquito line. Both assays were capable of detecting 3.9 X 10(1) ng (4.0 X 10(6) PFU) or more of the purified antigen. An inhibition system was less sensitive, and a direct system with adsorption of test specimens on the solid phase was not useful. Positive reactions were observed in 16 (48.5%) of 33 infected mosquitoes with with 10(6) to 10(7) PFU, which correspond to the highly susceptible group of this strain. Mosquitoes with less than 10(6) PFU were all negative, indicating the usefulness of the sandwich techniques for identifying high-titered mosquitoes. PMID- 3833872 TI - Quantification of measles virus antigens in infected CNS tissue: development of an enzyme linked immunoassay. AB - An enzyme linked immunoassay procedure has been developed which allows accurate quantification of low levels of measles virus antigens in infected central nervous system (CNS) tissues. In its development a systematic study was made of the effects of a large excess of nonviral proteins on the assay results. It was found that controls using single proteins such as bovine serum albumin were inadequate. Further, results indicate that experimental samples and viral antigen standards must be closely matched for their content of CNS tissue proteins since such proteins exert distinctive quantitative effects, both dramatic and subtle. PMID- 3833873 TI - Enzyme-linked immunosorbent assay for mumps IgM antibody: comparison of IgM capture and indirect IgM assay. AB - We have established two enzyme-linked immunosorbent assays (ELISAs) for detection of mumps IgM antibody, i.e., indirect IgM ELISA and IgM capture ELISA, for serodiagnosis of recent mumps infection. In the latter method, peroxidase conjugated monoclonal antibody to mumps virus was employed. Both methods detected mumps antibody of IgM class only in serum fractions separated by centrifugation through a sucrose density gradient. Optical density values given by both ELISAs were correlated for most sera examined. Indirect IgM ELISA, however, gave a false positive reaction for sera containing both rheumatoid factor and mumps IgG antibody, while giving a false negative reaction for sera containing high titers of mumps IgG antibody. This technique was, therefore, less reliable than IgM capture ELISA. IgM antibody detectable by IgM capture ELISA was present in all patients with mumps by the fifth day of illness and persisted for up to 3 mth in most and up to 5 mth in same cases. PMID- 3833874 TI - Characterization of the soluble immune complex (EIC) of the amplified enzyme linked immunosorbent assay (a-ELISA) and an evaluation of this assay for quantitation by reaction stoichiometry. AB - The molecular composition of the soluble enzyme immune complex (EIC) of alkaline phosphatase (AP) and anti-AP which comprises the detection system of the amplified ELISA (a-ELISA) was investigated. The EIC appeared relatively homogeneous in sucrose density gradients and sedimented as a protein of 600-650 K daltons. Based on size and the results of double-label experiments, the EIC was shown to be composed of two moles of anti-AP and three moles of AP. During reaction with substrate at pH 9.6, greater than 50% of the AP is released as free enzyme and the released enzyme has the same activity as enzyme found in the EIC. The maximum yield of EIC is produced by solubilization of the antibody-AP equivalence precipitate with a 9-fold excess of the amount of AP required for precipitation at equivalence. EICs show no significant loss of activity when stored for one year at 4 degrees C, -20 degrees C or -70 degrees C. The EIC is most stable during long term storage (five years) in 50% glycerol at -20 degrees. Over the linear region of titration curve for dimeric and monomeric M315, the ratio of AP or EIC to M315 fails to show a constant stoichiometry. Using 131I-EIC and 125I-M315, it was determined that the lack of a constant stoichiometry in the linear region was due to differences in the amount of enzyme bound. Hence, stoichiometric quantitation of the primary antibody is not possible using the current a-ELISA. PMID- 3833875 TI - [Long-lasting expansive gases in the treatment of rhegmatogenous retinal detachment associated with vitreoretinal proliferation]. AB - Thirty two eyes of 32 patients affected with rhegmatogenous retinal detachment (R.D.) associated with proliferative vitreoretinopathy (P.V.R.) were operated on with combined external and endovitreal microsurgery. Internal tamponade was carried out with SF6 in 16 eyes and C3F8 in 16 eyes. All patients were followed for at least six months after the last surgical procedure. Permanent retinal reattachment was achieved in 56% of the eyes operated on with SF6 and 60% of the eyes operated on with C3F8. Surgical success was achieved with only one operation in those eyes operated on with C3F8. In contrast, 88% of the eyes successfully operated on with SF6, had more than one operation. The overall surgical results, whatever the gas used for internal tamponade, are as follows: surgical success was achieved in 83% of P.V.R. cases grade C1 and C2 (5 cases out of 6), 73% of P.V.R. cases grade C3 and D1 (11 cases out 15), and 20% of P.V.R. cases grade D2 and D3 (2 cases out of 10). PMID- 3833876 TI - [Treatment of retinal detachment caused by posterior pole dehiscence]. AB - 20 eyes have been treated for a retinal detachment due to a posterior pole break. Three successive, different operative techniques were used: macular silastic sponge, vitrectomy plus internal tamponade by silicone oil, vitrectomy plus internal tamponade by air or by a mixture of air 60% and SF6 40%. Macular sponges obtained a good rate of retinal reattachment (83.3%) but fonctionnal results are poor (no measurable visual acuity in the macular break cases). Vitrectomy plus silicone oil does not yield better anatomical results than sponges (66.6% succes rate) but the visual function is better preserved (2 measureable visual acuities on 3 macular break cases). Vitrectomy plus gas gave us the best anatomical (100% success rate) and functional results (4 measurable usual acuities on 6 macular break cases). Retinopexy is not necessary when the vitrectomy-gas technique is used. On the contrary, retinopexy is recommended when the vitrectomy-silicone technique is used in order to remove the silicone oil as safely as possible: this causes a dilemma in the case of a macular break. We think at the present time that vitrectomy-gas is the best way to treat these particular retinal detachments. PMID- 3833877 TI - [Incidence of lipid changes in rhegmatogenous retinal detachment, retinal vein occlusion and primary chronic glaucoma]. AB - Several studies suggest that vascular factors may play a role in the pathogenesis of rhegmatogenous retinal detachment, retinal vein occlusion and primary chronic glaucoma. We explored the lipoprotein abnormalities in three groups of 45 patients suffering from each of these diseases compared to three control groups. We did not find significant abnormalities of cholesterol, cholesterol lipoproteins, nor Apolipoprotein B. The only significant abnormality was the presence of a higher rate of hypertriglyceridemia in the retinal vein occlusion and primary chronic glaucoma groups in comparison with their control group. In these two affections, hypertriglyceridemia should be systematically researched and treated. PMID- 3833878 TI - [Meridian photopic and mesopic color perimetry in normal, young and presbyopic subjects]. AB - The authors report their results of static color perimetry performed with the Harms perimeter. Photopic testing was performed among 10 young normal subjects and then with 10 presbyopes with otherwise unremarkable ocular examinations. Mesopic testing was done with 9 young subjects. Three thresholds of perception were stated: achromatic, minimally colored, and chromatic. Using photopic testing, red perception was far more sensitive in central vision, and the inverse was found in peripheral vision. Tritanomaly exists in the fovea, and at 15 degrees nasal to the fovea, the 3 color curves cross. In presbyopia, age is responsible for decreased sensation of red and green compared to white, and, all color perception disappears beyond the blind spot. The decrease in sensitivity for blue is even more significant realising a foveal tritanopia. At a lower luminance level, mesopic testing revealed an achromatic threshold for green and blue with central lowering of sensitivity. Deductions are made concerning the anatomo-physiologic mechanisms involved. PMID- 3833879 TI - [Computer management of the data of automated perimetry using Octopus 2000 R]. AB - Current perimetry involves automated, static and punctual procedures, which permit the examiner to obtain a numerical value of the sensibility concerning the points tested. Besides its precision and its reliability, perimetry can be used in data processing management due to the characteristic of easy duplication of the examinations. We use a micro-computer which is seperate from the Octopus 2000 R (Apple IIc) and the disc (OmnisII) to process the files. The study is composed of the following areas: the storage and the data processing of patient files, the transformation of numerical data a graphics display, the study of the percentage of loss of surface according to the decibel of sensibility. The data processing of files improves storage according to the criteria defined by the examiner and helps avoid inconvienent research. The graphic transformation of numerical data into isopteres of chosen sensibility improves the definition of the zones of intermediate sensibility. The calculations of the percentage of loss of surface according to the decibel of sensibility allows the appreciation of the size of defects based on depth and quantification. It is also easy to make the comparison between the two fields. PMID- 3833880 TI - [Treatment of choroid melanoma with contact curietherapy using ruthenium 106]. AB - Recently, enucleation of choroidal melanomas tends to be replaced by less radical treatments such as photocoagulation. Use of Ruthenium 106 plaques has proved to be efficient in Germany. Because the Beta rays of Ruthenium 106 have only limited tissue penetration they are used only for tumors of less than 6-7 mm thickness and less than 18 mm2 surface. This report describes 62 cases of choroidal melanomas treated with Ruthenium 106. With a follow-up period of 12 to 48 months, 32 cases had total regression, including 2 cases with metastases. 15 patients required a second procedue and 15 had additional photocoagulation. In 23 of 51 patients the visual acuity remained unchanged. In 26 patients the visual acuity decreased and 2 patients had an improvement. 13 patients with melanomas inside or close to the macular area decreased their visual acuity. PMID- 3833881 TI - [Mucoceles of the sphenoid sinus and their ophthalmological manifestations]. AB - The authors describe two cases of sphenoid sinus mucoceles, the first with a chiasmatic syndrome and the second with an oculomotor paralysis, and compare these cases with those described in the litterature. This rare benign tumor is revealed by ophthalmological complications which result from compression of adjacent structures. The main clinical findings are pain, decrease in visual acuity, proptosis, and diplopia. Plain X rays and pluridirectional tomographies are usually sufficient to make the diagnosis but CT scan is the procedure of choice for defining the extent of the lesion and thus assuring an appropriate surgical approach. The CT scan findings have been reviewed. Early and correct diagnosis is important to prevent permanent visual loss by optic nerve atrophy. PMID- 3833882 TI - [Comparative cytological study of conjunctival secretions and smears]. AB - Conjunctival cytology is a part of the biological investigations of conjunctivitis. The actual diagnostic interest of this examination has been evalued in 200 cases. The conclusion of this study is that the direct microscopic examination of conjunctival secretions is simple, fast, inexpensive, very useful, and may be indispensable, in the presence of every type of conjunctivitis. On the other hand, cytologic examination of conjunctival scrapings is of a little interest and its indication must be restricted to a limited number of cases according to the clinical context. PMID- 3833883 TI - [Ocular hypertension induced by tropicamide after treatment of the angle with argon laser]. PMID- 3833884 TI - [The TNM classification of tumors in ophthalmology]. PMID- 3833885 TI - [Arterial supply to the anterior segment of the eye. Radioanatomical study of a series of 25 human eyes]. AB - We studied the arterial vascularization of the anterior segment of 25 cadaver eyes. Arteries had been opacified by an injection of an aqueous suspension of barium. Our study has focused on the anterior ciliary arteries (ACA), emerging from the four rectus muscles. Among the numerous individual variations, we have noticed the following predominant aspects: for the external rectus muscle, the ACA is usually unique and thin, located in the superior or inferior third of the muscle. For the others rectus muscles, the ACA are rather big and frequently observed in pairs. They tend to be found on each lateral side of the muscle. By and large, the vertical ACA look bigger and more numerous than the horizontal ACA. The number, the size and the position of the long posterior ciliary arteries are quite uniform. The major arterial circle of the iris seems to be discontinuous, and is more and less made of arterial anastomoses. This study enabled us to reconsider the usual anatomical description of arterial supply of the anterior segment. The vascularization by the ACA, especially at the level of the inferior and superior rectus muscle, has to be known in order to avoid an anterior segment ischemia following strabismus surgery. PMID- 3833886 TI - [Long-term results of trabeculectomy]. AB - We have studied 93 cases of trabeculectomy, most of them performed on primary chronic open angle glaucomas, with a follow up of 2 to 11 years. Reviewing of the results point out that intraocular pressure stabilization over a long time period is correlated to the existence of an effective subconjunctival filtering bleb. Recurrence of hypertension increases with time, but most of the cases are stabilized by medical treatment, or by laser trabeculoplasty, when it is possible. Cataract producing concerns 46% of the cases, happening within one to three years in most of them. It is greatly influenced by patients age. On the other hand, effective subconjunctival filtering bleb and transient post operative athalamy are not major factors. PMID- 3833887 TI - [The vernal plaque, a complication of so-called spring conjunctivitis]. AB - The vernal ulcer is a peculiar corneal complication of vernal conjunctivitis. Clinically, the ulcer is oval, grey, and resistant to medical treatment. Histological study by light and electron microscopy reveal the lesion to be composed of fibrin deposits adherent to a well-preserved Bowman's membrane. These deposits impede lateral progression of the epithelium, thus, opposing spontaneous healing. Resolution of the ulcer can be obtained, however, by superficial keratectomy. PMID- 3833888 TI - [The Posner-Schlossmann syndrome and allergy]. AB - In 13 cases of Posner Schlossmann Syndrome, the authors have performed a systematic and full allergologic investigation. They were able to demonstrate in all cases an atopic constitution. The immunity tests in vivo associated with a rhinomanometric inhalation of the responsible allergen have shown positive responses to the pneumallergens and to the streptococcus hemolyticus by the way of a focal infection. In almost all cases secondary syndromic reactions were present. Specific desensitization carefully managed, closely supervised, makes possible in early detected cases the attacks to become less frequent and eventually to disappear. PMID- 3833889 TI - [Changes in plasma ionized calcium levels during fluorescein angiography]. AB - The authors have demonstrated a significant decrease of the plasmatic ionized calcium level in 84 patients during retinal fluorangiography likely due to a chemical bond between calcium and fluorescein. The side effects noticed during the procedure were similar to that quoted in the literature; their frequency, however, was not correlated with the decrease of the plasmatic ionized calcium level, even though the magnitude of the decrease was twice as great in the patients who experienced some trouble as in those who did not. This lack of correlation may be related to the too small patients sample. A greater frequency of side effects has been noticed in patients treated by calcium inhibitors. PMID- 3833890 TI - [Ocular cysticercosis. Apropos of a clinical case of presumed ocular cysticercosis]. AB - The study of a case of ocular cysticercosis and its angiographic analysis enables the authors to formulate some hypothesis regarding the pathogenesis of the retinal lesions. In particular the presence of a bilateral gravitational retinal epitheliopathy contrasting with the unilateral localisation of the parasite, associated to vascular alterations, suggests that the presence of the cysticercus at subretinal level may trigger an autoimmune process mainly directed against the photoreceptors. A similar process to the one experimentally observed in monkeys after S retinal antigen immunisation can be imagined. PMID- 3833891 TI - [Cerebral activation during pursuit eye movements: localization by the dichotic listening test]. AB - The level of cerebral hemispheres activation is studied here during pursuit eye movement by means of a dichotic listening test. Visual pursuit, whatever the direction, clearly activates the right hemisphere; this is probably related to the phenomenon of attention. Each hemisphere is activated by contralateral pursuit eye movement, which suggests that each hemisphere plays a role in pursuit eye movement towards that direction. PMID- 3833892 TI - [Improvement in glaucomatous perimetric deficits]. PMID- 3833893 TI - Protein electrophoretic patterns of bovine and porcine ovarian follicular fluid. AB - Sodium Dodecyl Sulphate polyacrylamide electrophoresis (SDS-PAGE) was used to reveal changes in the protein pattern of porcine and bovine ovarian follicular fluid at different maturational stages. Separate pools were made of follicles with a diameter of 1-2, 3-4, 5-6, 7-8, 9-10 and greater than 11 mm excluding hemorrhagic and cystic follicles. Prior to electrophoresis, estradiol-17 beta and androstenedione were analyzed to define the atresic or healthy state of the follicular. Glucose and total protein content of follicles fluid were determined to assess follicular metabolism. Densitometric analysis of both pig and cow follicular fluids from 3-4 mm follicles revealed a distinct band which was absent in other follicle sizes. On the other hand the protein pattern of follicular fluid of cow and pig showed differences in zones of molecular weight higher than 150,000 and lower than 30,000 dalton. This study suggests the possible existence of a common protein to both species which determines the follicle destiny towards ovulation or atresia. PMID- 3833894 TI - Comparison of a new ultrafiltration method for serum free T4 and free T3 with two RIA kits in eight groups of patients. AB - We measured serum free thyroxine (FT4) and free T3 (FT3) concentrations by a newly developed ultrafiltration (UF) method and by the Diagnostic Products Corporation (DPC) and Amersham Corporation (Amerlex) RIA methods in 173 patients divided into eight groups: 1) normal controls, II) normal elderly subjects, III) hyperthyroidism, IV) hypothyroidism, V) pregnancy, VI) critically ill, VII) chronic renal failure, and VIII) heparin therapy. The results were also compared with the free T4 index and free T3 index. FT4 (UF) and FT3 (UF) were generally normal in the elderly subjects. All methods showed elevated values in hyperthyroid patients. FT4 was normal in 7-23% of hypothyroid patients (depending on the method), and FT3 was normal in 15-27% of hypothyroid patients. Mean FT4 (UF) and FT3 (UF) were increased in pregnancy; in contrast the Amerlex RIA results were reduced in pregnancy. In critically ill patients, mean FT4 and FT3 were reduced by all methods. In heparinized patients, FT4 (UF) and FT3 (UF) were normal, but the RIA kits, especially Amerlex, gave very low values. Although the various methods gave considerably different absolute values of FT4 and FT3, there was a high degree of correlation between the ultrafiltration FT4 and FT3 and the results by the other methods. PMID- 3833895 TI - Evaluation of pituitary-thyroid axis response to acute myocardial infarction. AB - We have studied with seriated controls for a period of 9 days 18 patients admitted to our hospital for acute myocardial infarction (AMI). Slight, but non significant variations in thyroidal hormone pattern were observed: slight decrease of T3 and T4 levels, increase of reverse T3 on day 3, low free T4 levels, slight increase of TSH levels until the 3rd day. However, hormonal pattern was clearly different in patients who presented a clinical improvement (group 1a) and in patients who died for AMI (group 1b). In fact, a significant TSH increase was recorded in patients of group 1a; on the contrary, a significant decrease of TSH, T4 and free T4 concentrations was observed for subjects of group 1b, suggesting an inadequate response of pituitary-thyroid axis. In conclusion, the evaluation of thyroid hormones and thyrotropin levels can be of clinical usefulness in the management of patients with AMI. The decrease of plasma T4 and free T4 concentrations, accompanied with low TSH levels, can be associated with unfavorable course of the disease and therefore can be considered a bad prognostic sign. PMID- 3833896 TI - Is conversion of thyroxine to triiodothyronine and reverse triiodothyronine autoregulated? Studies with short term suppression of thyroid function with 3'isopropyl 3,5-diiodothyronine. AB - We investigated the effect of a 6 days course of 20 micrograms of a thyromimetic thyronine analogue 3'isopropyl, 3,5-diiodothyronine (DIIP) on serum thyroid hormone and TSH levels in 10 normal male volunteers. TSH was inhibited progressively during the 6 days of DIIP treatment. By the third day after stopping the treatment this trend had already reversed. Of the serum thyroid hormones the T3 level had decreased by 32% and was the first to increase 5 days after stopping treatment. Serum T4 fell by 35% and returned later to normal. The next effect was an increase in the T3/T4 ratio which was most marked 5 days after treatment had stopped. Kinetic studies with 125I-T3 and 125I-reverse T3 were performed at this time. In comparison to pretreatment kinetics no change in MCR was obtained. It is therefore suggested that at least part of the more rapid increase of T3 than T4 after stopping the suppression therapy reflects an increased conversion. PMID- 3833897 TI - Impaired ventilatory drive in short-term primary hypothyroidism and its reversal by L-triiodothyronine. AB - Alveolar hypoventilation is known to occur in myxedema. Reduction of hypercapnic ventilatory drive has not been reported, up to now, in patients with short-term hypothyroidism. Eleven patients with short-term hypothyroidism, before and after L-triiodothyronine (L-T3) replacement therapy, and 10 normal controls were studied. Hypercapnic ventilatory drive was assessed by the evaluation of the relation between the response of ventilation and mean expiratory flow to CO2 rebreathing and by the evaluation of ventilation and mean expiratory flow at a fixed level of carbon dioxide. In patients with short-term hypothyroidism these parameters were reduced as compared with normal controls and returned to normal after L-T3 replacement. We conclude that hypercapnic ventilatory drive is blunted by short-term hypothyroidism and normalizes following replacement therapy. PMID- 3833898 TI - Inhibition of restraint stress by systemic (Asu1,7) eel-calcitonin. AB - The effects of different doses of (Asu1,7) eel-calcitonin, iv injected, on gastric secretion were studied in conscious rats with pyloric occlusion. Moreover, we evaluated the activity of this analogue on gastric ulcer formation by restraint stress. It was found that 2.5 or 5 Ul/kg (Asu1,7) eel-calcitonin decreased gastric acid secretion and inhibited the development of stress-induced ulcers in rats. In the isolated rat stomach the peptide at the concentrations of 1 nM to 1 microM did not modify acetylcholine, histamine or 5-hydroxytriptamine induced contractions. These results suggest that this peripheral activity of (Asu1,7) eel-calcitonin does not involve a direct interference with cholinergic, histaminergic or serotonergic pathways at gastric level. PMID- 3833899 TI - Papillary adenocarcinoma of thyroglossal duct remnant. AB - The authors report the case of a 52-year-old woman who presented with an anterior neck mass, which was excised and diagnosed at pathological examination as papillary adenocarcinoma arising in a thyroglossal duct remnant. Echography and computed axial tomography of the neck were utilized to exclude the presence of thyroid gland neoplasia. The patient was discharged on suppressive thyroid therapy, and after follow-up examination at two years was found to be free of recurrent neoplastic lesion. PMID- 3833900 TI - Influence of the neonatal suppression of TSH production (neonatal hyperthyroidism) on response to TSH in adulthood. AB - Six-day treatment of neonatal rats with T3 or T4 resulted in a considerable depression of T4 production in response to exogenous TSH in adulthood. This supports the hypothetical conclusion that hormonal imprinting, i.e. the presence of the hormone and its interaction with the cell during the period of receptor maturation, is important for receptor amplification, which accounts for normal response to the hormone in adulthood. PMID- 3833901 TI - [Study of 68 microinvasive carcinomas of the cervix uteri]. AB - The authors describe two types of micro-invasive carcinomas of the cervix: carcinomas in situ with early stromal invasion and carcinomas with definite micro invasion. It is only if slices are taken every 250 microns through the cone that has been removed that a precise diagnosis of the lesion can be obtained and therefore treatment planned correctly for the illness. The following details are indispensable to decide what to do: the volume of the lesion in cubic mm, the depth of penetration in the chorion and the presence or absence of vascular and lymphatic invasion of the connective tissue of the cervix. Cytology is insufficient for accurate diagnosis and that is also true of directed colposcopy biopsies. This latter anyhow is not precise enough to evaluate what the treatment of the lesion should be. In the light of the observations that they have analysed and on reviewing the literature the authors have made a protocol for treatment. This is, for carcinoma in situ with early stromal invasion, conisation as long as the piece removed is entirely at the edges in healthy tissue is sufficient. In micro-invasive carcinomas of less than 500 cubic mm penetrating to a depth of less than 3 mm and without vascular or lymphatic invasion, total hysterectomy is the treatment of choice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833902 TI - [Obstetrical injuries of the newborn infant. Retrospective study apropos of 20,409 births]. AB - We have been able to find 291 cases of obstetric trauma when we analysed the 20,409 deliveries which took place in the Pitie maternity between 1971 and 1980. It has been shown that bony lesions did well in the long and short term but nerve lesions had a far less good prognosis. This pathology should become far less when it is possible to recognize better when the fetus is large and when such traumatising manoeuvres as high forceps and assisted deliveries of large breech babies are stopped. PMID- 3833903 TI - [Value of surgical hysteroscopy in the treatment of myomas and intracavitary fibrous polyps. Evaluation of 26 operations]. AB - Out of a total of 121 hysteroscopies carried out in this unit between December 1981 and June 1984, 26 were operative hysteroscopies. Each of these procedures consisted in removing intra-uterine structures (that could not be removed with a curette) under visual control. All cases had a normal sized or slightly enlarged uterus. There were 7 patients aged 41 years or younger and 19 older than 41. The endoscope used was the "bayonet" Wolf apparatus which is 7 mm in diameter and has two separate canals; one for insufflation and the other for introducing the 3 mm biopsy forceps. This small punch makes it possible to cut the implantation on uterine wall without needing coagulation. The tissue is then removed using a soft curette or a polyp forceps after the cervix has been further dilated. There was no case in which heavy bleeding occurred during or after the operation. Using this technique we were able to remove 18 fibroid polyps, 13 submucous fibroids (8 smaller than 2 cm in diameter and 5 between 2 and 4 cm), 3 old retained portions of placenta; removal was complete in 21 cases and only partial in 5 cases. Out of these 2 had to have hysterectomy. On the other hand abdominal myomectomy or hysterectomy could be avoided in 11 cases. This series shows how often fibrous polyps and small sub-mucous fibroids can be removed under hysteroscopic control when using this kind of apparatus and a relatively simple technique. PMID- 3833904 TI - [Analysis of a consecutive series of 421 cases of genital condylomata. Course, management and therapeutic results]. AB - The evolution of 421 cases of condylomata that have been followed seems to be less favourable than in other series in the literature. 45% of these cases became worse and 13% regressed, especially in the first year after diagnosis. Sometimes the case progresses in an atypical manner. It can be extremely rapid so that it becomes intra-epithelial carcinoma in less than a year in young patients who have not been pregnant or not had babies and who have cervical and vaginal infections and who use combined oral contraceptive pills. On the other hand it can "seesaw" with periods of worsening alternating with periods of regression. Treatment should be with local destruction using the CO2 laser if the lesion is on the exocervix or laser CO2 conisation if it is an endocervical lesion. It is important to distinguish when treatments have been incomplete. This involves some persistence of the lesion even after treatment, or recurrences which can be less or more serious than the initial lesion. 11% of the cases treated by local destruction showed that some of the lesion persisted after the treatment and that there were 13% of recurrences. After conisation on the other hand 8% of cases were shown to be incompletely treated and 3% showed recurrences. PMID- 3833905 TI - [Hypotheses concerning variations in sperm motility in peritoneal fluid]. AB - We have studied the effects on sperm motility in peritoneal fluid taken from fertile women at different times of the cycle as well as from sterile women in the pre-ovulatory phase. We have compared the effects on the movement of sperms in part in a solution of pure Tyrode and in part in a solution of Tyrode containing hydroxytoluene, which is an antioxydising agent, in order to try to find out the mechanism that immobilises sperms in these sterile women. In equal concentrations we have found that this substance can be protective against immobilisation, which itself was due to the liquids coming from abnormal pelvis, in the antioxydising agent that was used. Furthermore it was found, in liquid taken from the peritoneal cavities of fertile patients in the pre-ovulatory phase, that it behaves like a Tyrode medium to which one has added a complex antiperoxide comprised of bovine serum albumin and mercaptoethanol. This complex has been found to protect spermatozoa against loss of motility which leads to complete standstill when Tyrode solution alone is used after incubation for six hours under the conditions under which we conducted the experiment. From these observation it does seem to us that the female genital tract does undergo changes during the menstrual cycle which allow sperms to stay motile and that this is probably the same effect as the abumin mercaptoethanol complex. This equilibrium is broken when there are lesion in the pelvis such as endometriosis or inflammatory disease by secretion of peroxydising substances such as fatty acids and the oligopeptides that occur in inflammation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833906 TI - [Obstetrical mechanics. Intermediate stage and childbirth stage]. AB - It is possible to divide the classical second stage of labour--the stage of expulsion--into two different anatomical and functional parts. The one phase is the intermediate phase where dilatation of the cervix is almost complete and where there is an instinctive reflex that delivery is going to take place and this is very strong, and this is what starts off the oscillation (contra nutation) of the sacrum and full engagement. Then there is the phase of the delivery itself where the sacrum must slide and rotate, and which cannot be accomplished without perineal relaxation. The utero-sacral ligaments demonstrate at the end of pregnancy and in early labour that they are the true tendons into which the back of the gravid uterus is inserted. They take part in the oscillation of the sacrum. Low backache that occurs at the end of pregnancy and in labour is due to strong tension on the utero-sacral ligaments, when it is difficult for the head to engage, and can only be relieved when the pelvis tips forward. When delivery is taking place it is important to be rid of all expulsive efforts that may cause contraction of the anterior part of the pelvis. PMID- 3833907 TI - [Structure and function of the fetal umbilical vessels]. AB - A morphological study carried out using electron microscopy has shown that there is an endothelium in the umbilical blood vessels consisting of intercellular spaces which interdigitate with one another and that are not specialization in junction complex. The endothelial cells are rich in their typical organ structure and have pinocytotic vesicles. There media contains a muscular coat which is thicker in the artery than in the veins. The smooth muscle cells also show pinocytotic vesicles. This morphological state leads the authors to two groups of thought: There is active diffusion by a process of "plasma perfusion" from the lumen of the vessels through the vascular wall which forms a physiological system for taking up fluids which in turn is capable of providing for the energy and plastic requirements of the umbilical vessels: The umbilical arteries, because of their thick muscular tunic and because of the ability of the lumen to dilate as there is an absence of an internal elastic membrane, can function not only as tubes for conducting blood but also as organs that regulate the blood flow. On the other hand the umbilical vein, which cannot stretch and cannot retract because its wall is so thin, behaves as an organ to return the blood flow, particularly because it does have an inner limiting layer preventing over stretching. PMID- 3833908 TI - [Significance of preclinical radiologic abnormalities of the breast. Apropos of 87 histological verifications]. AB - This retrospective study was carried out on 80 patients who had abnormalities discovered on mammography without any associated clinical signs. In some patients bilateral abnormalities were found so that 87 biopsies were carried out and this gave the result that 45 of the lesions were shown to be benign, 18 lesions were borderline and 24 lesions (27.6%) were of carcinomata. The frequency of these lesions goes up to 32% if areas of microcalcification only are considered. These tumours diagnosed in this sort of way, whether they are canal lesions or lobular lesions, usually show favourable histological features as far as invasion, size and lymphatic involvement is concerned. Borderline lesions are a histological group with as yet no fully evaluated significance but it has seemed to us interesting to describe them. PMID- 3833909 TI - [Cytogenetics of human gametes: its application to the study of fertilization anomalies]. AB - A study of 100 sperm karyotypes from 8 normal subjects was carried out using the technique of in vitro hetero-specific human-hamster fertilisation. 19 of those showed some abnormality. 17% of those were hyperploidies or hypoploidies and 2% showed structural abnormalities. A study carried out at the same time on 34 hamster egg karyotypes showed 6 hypoploidies and 1 hyperploidy. In effect oa cytogenetic technique which is very similar to this one makes it possible to analyse the human oocyte karyotype. The results found in these samples of motile sperms show a higher incidence of abnormality than in other published series, but these figures can not be extrapolated to the composition of in vivo whole sperms. PMID- 3833910 TI - Infectious colitis: case reports of unusual complications. PMID- 3833911 TI - Chronic diarrhoea in Nigerian children. PMID- 3833912 TI - Observations on natural and experimental salmonellosis in dogs. PMID- 3833913 TI - Antibiotic susceptibility of fecal bacterial isolates from children with acute diarrhoea in Nigeria. PMID- 3833914 TI - Rotavirus diarrhoea in children in Chandigarh, India. PMID- 3833915 TI - A strain of urease-producing Vibrio parahaemolyticus isolated in Malaysia. PMID- 3833916 TI - Acute otitis media: a common presentation in the emergency department. AB - Acute otitis media is a common pediatric infection that requires appropriate evaluation of the young child to assure that there are no accompanying systemic infections or complications. The examination of the ear must not only assess the appearance of the tympanic membrane, but determine its mobility. Treatment should be initiated with antibiotics and symptomatic relief. Good follow-up must be arranged. PMID- 3833917 TI - Transient atrial fibrillation in a patient with acute ureterolithiasis. AB - A 34-year-old woman with symptoms associated with a confirmed ureteral calculus was found to be in atrial fibrillation on arrival at the emergency department. When her symptoms had improved, it was noted that the atrial fibrillation had reverted spontaneously to a sinus rhythm. Subsequent evaluation did not reveal a common etiology of the atrial fibrillation. Transient atrial fibrillation has been associated with many diverse conditions. It has not been previously reported in association with acute ureterolithiasis. PMID- 3833918 TI - The emergency management of caustic ingestions. AB - Controversial therapeutic issues in patients with caustic ingestions concern the reliability of symptoms and signs in predicting esophageal injury, the appropriate use of endoscopy in evaluating esophageal damage, and the use of steroids in preventing late strictures. The conclusions of this review are: The majority of pediatric caustic ingestions involve a "lick and taste" whereas adolescents and adults often ingest substantial quantities. Oral burns and dysphagia are sensitive predictors of esophageal injury; however, esophageal injury may occur in the absence of the findings. Household bleach and nonphosphate detergents represent a low risk of injury whereas button batteries greater than 20 mm in diameter and Clinitest tablets represent high risk. Endoscopy should be an elective rather than emergency procedure and should be undertaken in all symptomatic patients, and in asymptomatic patients when history indicates substantial ingestion. Steroid therapy should be considered only for patients who have deep or circumferential esophageal burns. PMID- 3833919 TI - The breakdown of an emergency system following a gas explosion in Osaka and the subsequent resolution of problems. AB - Osaka, a modern urban metropolis in Japan, experienced a tragic gas explosion in 1970 when the dispatch room of the City Fire Department was in the process of being moved to a new building. Many unforseen problems arose during this disaster: eg, there was an overall lack of leadership, confusion of communication, a need for triage, and lack of control of mass media. The Osaka Medical Association organized a committee to resolve these problems. Their conclusions and recommendations were that a control headquarters be established at the scene of disaster, the number of ambulances and EMTs be increased, disaster tags be utilized, a special radio frequency be created, and a computer aided command and control system for fire fighting and ambulance services be introduced. These recommendations have all been followed. PMID- 3833920 TI - Left bundle branch block. PMID- 3833921 TI - An alarm procedure. AB - Each disaster procedure is initiated by an alarm scheme, alerting all involved personnel, directly or indirectly in this procedure. Certain mathematical principles can be applied to calculate the number of people who can be reached within a fixed period of time, or to calculate the time needed to alert a fixed number of people. With this methodology a formidable amount of people can be reached within a few minutes. The advantages and disadvantages are further described. PMID- 3833922 TI - Lumbar puncture. AB - Lumbar puncture has been in widespread clinical use for nearly a century. It is used in emergency medicine primarily as a tool for the diagnosis of meningoencephalitis and subarachnoid hemorrhage. The development of computed tomography has changed the position that lumbar puncture has held in the diagnostic sequence of a number of clinical entities. The procedure is contraindicated if there is soft-tissue infection adjacent to the puncture site and if there are findings of increased intracranial pressure due to a mass lesion. Performance in the setting of a coagulopathy may also be hazardous. The most serious potential complication is cerebral herniation. The commonest complication is postlumbar puncture headache, which is due to CSF hypotension resulting from persistent spinal fluid leakage through the meningeal puncture site. Spinal hematoma, diplopia, and intraspinal dermoid tumor formation are less common complications. Meningitis has been found to follow lumbar puncture in children with bacteremia. The lumbar puncture is a useful test for providing information regarding the cellular, chemical, and microbiologic composition of the CSF. Fluid obtained should be evaluated for cell count, Gram's stain, bacterial culture, glucose and protein levels, and other tests as clinically indicated. PMID- 3833923 TI - 1983 Society of Teachers of Emergency Medicine debate. PMID- 3833924 TI - Diving Accident Network (DAN) PMID- 3833925 TI - The development of a screening test to distinguish occupational hearing loss (C5 dip). PMID- 3833926 TI - Evaluation of work capability: an example from American Samoa. PMID- 3833927 TI - The relation between frequency of industrial lifting and the fatigue produced. PMID- 3833928 TI - Physical strain in Swedish lorry drivers engaged in the distribution of goods. PMID- 3833929 TI - Protuberant line and median line 3-D courses studied on the backs of Japanese children, aged 13 and 14, using moire topography. PMID- 3833930 TI - Seasonal variation of sweating rate caused by exercise during thermal transient. PMID- 3833931 TI - Basic decision making in management of scoliosis. AB - Scoliosis is a lateral curvature of the spine, which may require treatment; this brief analysis details those factors weighed in the basic decision-making process. Additional technical details are presented in subsequent sections. PMID- 3833932 TI - Nonoperative treatment of spinal deformity: the case for observation. PMID- 3833933 TI - Orthotic treatment of idiopathic scoliosis and kyphosis. PMID- 3833934 TI - Preoperative assessment of the patient with a spinal deformity. PMID- 3833935 TI - Posterior fusion for idiopathic scoliosis. AB - A posterior fusion is the standard operative approach that will allow the orthopaedic surgeon to treat most scoliosis satisfactorily. The extent of fusion should be determined by the type and extent of the curve. All spines should not be fused from T4 to L4. The management of the blood loss has evolved to a very controlled situation, with the reasonable goal that no patient should be sensitized to homologous blood. Instrumentation systems provide good correction and stability to assist in providing a solid fusion. There are advantages and disadvantages to each instrumentation system, and the trade-offs should be considered for each patient. Finally, what our patients want more than anything else from these operations is safety, and we should strive to provide that for them. PMID- 3833936 TI - How to reduce complications in treatment of cervical spine trauma. PMID- 3833937 TI - Surgical management of cervical spine fractures and dislocations. PMID- 3833938 TI - Cervical spine and the shoulder. AB - Cervical spine pathosis and pain can be referred to the shoulder and can actually result in a frozen shoulder or a tendinitis pattern. Concomitant cervical spine pathosis can coexist with primary shoulder pathosis and can present a diagnostic and therapeutic dilemma. Conservative programs usually require an aggressive attack on the cervical spine, often with therapy to the shoulder. Surgical considerations rely on diagnostic acumen to sort out accurately where the predominant problem exists. The usual scenario of shoulder pain referred from the cervical spine involves an appropriate history, physical examination, selective subacromial injection, appropriate roentgenograms of the cervical spine and shoulder and finally a cervical discogram to document the level of the disorder followed occasionally by an anterior cervical fusion. PMID- 3833939 TI - Calcific tendinitis. PMID- 3833940 TI - The frozen shoulder. AB - The clinical entity of frozen shoulder has been the subject of considerable controversy concerning pathogenesis and treatment. This is a review and interpretation of the literature against the background of my personal experience and a formulation of a treatment algorithm based on a practical synthesis of these sources. The separate stages of the disease are clearly definable and must be considered in prescribing treatment for the purpose of compressing the natural history and morbidity of this self-limited though disabling condition. PMID- 3833941 TI - Lesions of the long head of the biceps tendon. AB - Lesions of the long head of the biceps tendon are generally a component of a diffuse degenerative process involving the subacromial space including the rotator cuff, bursa, biceps tendon, and possibly the acromioclavicular joint. As such, surgical approaches should be designed to treat each component not restricting the surgery to a biceps tenodesis. On occasion bony injury directly to the bicipital groove may result in an inflammatory process in the tendon or even dislocation of the tendon if there was damage to the lesser tuberosity and subscapularis tendon. In these patients biceps tenodesis and coracoacromial ligament excision is advised. The entity of a "subluxating biceps tendon" without damage to the lesser tuberosity or subscapularis is a diagnosis that we are unable to reliably arrive at. It appears that most patients with biceps instability have combined tuberosity or rotator cuff injury allowing the tendon to migrate medially. Ruptures of the long head of the biceps are generally associated with rotator cuff disease, but a localized process secondary to trauma or injections may account for some ruptures. Nearly all are managed conservatively, but the patient is followed closely and forewarned regarding possible rotator cuff degeneration. In young patients a more aggressive approach including shoulder arthrography and early repair, if a cuff tear is noticed, would be recommended if one would hopefully arrest the degenerative process. PMID- 3833942 TI - Anterior shoulder instability. AB - Techniques of reduction include direct pressure on the humeral head, leverage through the arm, and traction maneuvers. Reduction should be expeditious but gentle. The modified Stimson, abduction, and scapular manipulation methods are effective and safe--not requiring forceful pressure or leverage. Controversy continues about postreduction immobilization and rehabilitation. In younger persons (less than 30 years of age), especially athletes, the literature supports 3 to 6 weeks of immobilization followed by an extensive rehabilitation program and avoidance of sports for at least 2 to 3 months. Many factors enter into the selection of a repair method for recurrent anterior instability. They tend to favor a method that will allow identification of the pathologic condition and treatment of the Bankart lesion or capsular laxity, if present, without concomitant use of metallic internal fixation. One such repair technique is illustrated in a step-by-step sequence. PMID- 3833943 TI - Unstable shoulders in the athlete. PMID- 3833944 TI - Involuntary inferior and multidirectional instability of the shoulder: etiology, recognition, and treatment. AB - Multidirectional and inferior instability of the shoulder is not rare. Etiological factors include various combinations of (a) repetitive injuries, (b) inherent joint laxity, and (c) one or more major injuries. It is seen in athletic and active patients without generalized joint laxity and as well in sedentary patients with hypermobile joints. Standard operations for unidirectional anterior or posterior dislocations fail to correct multidirectional instability because they do not correct inferior instability and they may displace the head in fixed subluxation to the opposite side leading to severe arthritis ("arthritis of dislocations"). Proper detection depends on suspecting its possibility in all types of patients and in a wide age range as well. Helpful signs include the sulcus sign, positive apprehension test in multiple directions, stress roentgenograms and fluoroscopy, and evaluations under anesthesia. Arthroscopy may be helpful in doubtful cases, but the findings require clinical interpretation. Selection of patients with multidirectional instability for surgery is extremely difficult because it requires not only great care in determining all directions of instability and planning the repair but also determining the motivation of the patient and excluding the possibility of some other condition being present that is causing pain rather than the joint laxity. The results of inferior capsular shift have continued to withstand the test of time and, though it is more difficult than standard procedures, is considered a very helpful procedure in the treatment of these difficult lesions. The principle is to reduce capsular laxity on all three sides by shortening and reinforcing and to reduce the joint volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833945 TI - Diagnostic techniques for shoulder instability. PMID- 3833946 TI - Unrecognized dislocations of the shoulder. AB - The missed anterior dislocation is not such a diagnostic trap given that the shoulder injury is brought to the attention of a physician. Any roentgenogram will determine the diagnosis and the appropriate treatment can be implemented. The presence of an associated cuff lesion may compromise the surgical results. Missed anterior dislocations may function slightly better overall than missed posterior dislocations. PMID- 3833947 TI - Failed surgery for recurrent dislocations of the shoulder. AB - By careful dissection, the causative factors could be identified and repaired surgically in 38 previously failed procedures for recurrent anterior dislocation of the shoulder. A routine Bankart procedure was performed in 20 shoulders (in two of which a Connolly procedure was added), a Putti-Platt procedure in four, and capsulorrhaphies in four shoulders. Seven shoulders were treated with exercises with an excellent result in one and good results in four. It was most encouraging that in the patients followed from 2 to 13 years, only 5% have had recurrences. PMID- 3833948 TI - Shoulder arthrodesis and resection arthroplasty. AB - The indications for shoulder arthrodesis are changing, with paralysis from brachial plexus injuries and sepsis with cartilage loss now accounting for most of the cases. Intra-articular fusion methods, often combined with incorporation of the acromion into the fusion mass, are now the favored techniques. Fusion can be consistently accomplished (between 90% and 95% of patients) with the use of screws, but additional internal fixation with a plate can eliminate the need for prolonged cast treatment after operation. A range of arm positions is satisfactory, with positioning in abduction from 20 to 45 degrees, flexion 20 to 45 degrees, and internal rotation 30 to 60 degrees. After shoulder fusion, pain is usually but not always relieved and function is limited, especially in activities that require arm rotation. Resection arthroplasty has a long history. It is no longer used as a primary procedure. After surgery, stability is usually achieved, active abduction will be less than 90 degrees, and only one half to two thirds of patients will experience satisfactory pain relief. Current indications are essentially limited to salvage after an infected shoulder implant or failed total shoulder arthroplasty with extensive bone loss. PMID- 3833949 TI - Unconstrained shoulder arthroplasty. AB - Shoulder arthroplasty is in a stage of development that is ahead of replacement of other joints, if one considers not only movement and function but also durability. It is a difficult and demanding procedure requiring a meticulous cement and rotator cuff technique. Stability of a nonconstrained implant depends on its height and the length of the head version. Active motion depends on the rotator cuff and deltoid. Neither loss of bone nor tears of the rotator cuff contraindicate a nonconstrained replacement; however, massive defects of the muscles or bone are treated with a "limited goals rehabilitation" program to achieve stability with less motion. Shoulder replacement seems to enjoy unique durability; however, glenoid component follow-up is limited to 11 years. Up to now the incidence of reoperation for loosening of a glenoid component in 455 patients reported in four recent series combined was under 1%, and most radiolucent lines at the glenoid are believed to be attributable to errors in technique rather than loosening. Because of recent breakage of two polyethylene glenoid components, a standard-sized metal-backed glenoid component has been made available for general use and is preferred especially in active patients and those with sloping glenoids. The 600% glenoid component is no longer used; however, it is expected that the 200% component will be made available for general use after adequate clinical trial of the new holding device.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3833950 TI - Constrained total shoulder replacement. PMID- 3833951 TI - Overview for athletic upper extremity injuries. PMID- 3833952 TI - The sore wrist without a fracture. AB - The possible causes of wrist pain in a patient with normal roentgenograms are many, and the above discussion of differential diagnosis is by no means intended to be all inclusive. Rather, my intent has been to provide a checklist of some of the more likely causes as well as a systematic approach to the identification of the cause. Many of the tests described are somewhat costly (Table 31-3), and they should not be ordered indiscriminately. Rather, the need for each test is determined by a reasonable presumptive diagnosis, depending on the history, clinical examination, and routine roentgenograms (see Table 31-1). Finally, I must say that even an exhaustive work-up may not be fruitful, and occasionally the precise cause for the patient's pain is never clearly identified. Our knowledge of the wrist is incomplete, and our diagnostic tools are not infallible, but we must continue to try to sort out these difficult wrist problems. The ultimate solutions to many of these enigmas will be dependent on our ability to correlate specific signs and symptoms with appropriate diagnostic modalities and observations at the time of operation. PMID- 3833953 TI - The dangerous chip fracture in athletes. AB - Chip of avulsion fractures in the hand range in severity from dorsal cortical avulsion of the carpal triquetrium to Bennett's fracture dislocation. Recognition of the fragment's size, displacement, and relationship to an articular surface is essential for proper management. Accurate roentgenograms play a key role in this evaluation. The hands of athletes have special requirements for strength and dexterity and can ill afford the casual diagnosis and frequent undertreatment of these chip fractures that represent articular surfaces. PMID- 3833954 TI - Bony injuries about the elbow in the throwing athlete. AB - Tremendous valgus stress during the acceleration phase of pitching is the primary cause of elbow injury in the pitcher. Lateral compression injuries are usually found in pitchers in their early teens, and osteochondritis dissecans is the primary underlying cause. Severe flexion contractures and even partial ankylosis of the elbow may occur. Prognosis after surgery is generally poor. Medial tension injuries with either soft-tissue damage or bony damage usually require surgery. The medial collateral ligament should be considered the primary stabilizer against the valgus-vector overload. The medial collateral ligament or bony avulsion form the medial compartment of the elbow should be primarily corrected. Results of early surgical correction to these lesions should produce excellent results. Pitchers with extension block injuries are generally older, more experienced athletes than those without such injuries. These pitchers have had symptoms for some time with progressive loss of full extension of the elbow and increasing pain. Valgus extension overload can be surgically corrected by an open surgical approach or an operative arthroscopic approach. Basically these approaches are palliative, and progression of symptoms at a later date may be expected. Finally, the postoperative rehabilitation of any elbow problem is extremely important and should be preplanned for the specific lesion treated. PMID- 3833955 TI - Understanding shoulder pain. AB - The impingement syndrome is a frequent occurrence in the throwing athlete. Sports medicine physicians have not yet attained the diagnostic quality in the shoulder they possess about the knee. The success of treatment of the impingement syndrome is directly proportional to the accuracy of diagnosis. This improved diagnostic ability will occur when the mechanism of injury is correlated to the tissue involved and the differential diagnosis of shoulder pain in the athlete is complete. PMID- 3833956 TI - Instability of shoulder in throwing sports. PMID- 3833957 TI - Flexor tendon physiology: tendon nutrition and cellular activity in injury and repair. AB - Scientific studies of the past 20 years have done much to redefine the mechanisms by which flexor tendons heal. Several points have become increasingly clear: Flexor tendons are nourished to a greater extent by synovial fluid diffusion than vascular perfusion. Tendon cells are capable of proliferating, producing collagen, and reconstructing their own gliding surface in the absence of adhesion ingrowth. The key to a successful outcome after flexor tendon repair appears to be an early restoration of tendon continuity, reconstruction of the sheath, if possible, and early passive mobilization. This complex stimulates the tendon's intrinsic repair potential, which is contained within the cells of the tendon itself but appears to be expressed only under ideal experimental and clinical situations. PMID- 3833958 TI - Management of acute flexor tendon injuries in the hand. AB - Success in treatment of acute flexor tendon injury demands careful assessment of the wound and patient, thorough knowledge of the relevant anatomy and physiology of tendons and tendon healing, meticulous and gentle surgical technique, and careful supervision during a controlled postoperative exercise program. With conscientious attention to the principles and techniques outlined, most complications can be minimized and a good clinical outcome can be achieved. PMID- 3833959 TI - Scientific basis of rehabilitation. PMID- 3833960 TI - Rehabilitative exercises in sports medicine. PMID- 3833961 TI - Rehabilitation techniques for athletic injury. AB - In summary, the application of principles of rehabilitation to athletic injury includes efforts directed at reducing swelling and pain while maintaining the range of motion. As the range of motion increases, efforts are made to regain strength while the patient is protected from reinjury and from the stresses of returning to function. PMID- 3833962 TI - Optimizing results of total joint arthroplasty. PMID- 3833963 TI - Fractures. PMID- 3833964 TI - Abnormal growth and development of the pediatric hip. PMID- 3833965 TI - Childhood hip sepsis: improving the yield of good results. AB - With the increasing availability of well-trained orthopaedic surgeons and pediatricians, early diagnosis and effective treatment of hip sepsis is now common. Despite these advances, poor results still occur. The principle of early surgical drainage and appropriate antibiotics must continue to be emphasized. Empiric surgical drainage in cases with equivocal aspiration results is advised. Postsurgical residual subluxation remains a significant problem in subacute cases with preoperative subluxation (lateralization) and is best avoided by an anterior approach for drainage, which can include adductor or psoas release, or both, followed by cast positioning of the hip to maintain reduction. Careful and thoughtful application of the recently accepted concept of early transition to oral antibiotics can significantly reduce the psychological and economic cost of hip sepsis treatment. Hip sepsis occasionally occurs in juveniles, adolescents, and teen-agers. Because of a low index of suspicion in this age group, diagnosis and treatment are often greatly delayed resulting in a poor outcome in many patients. PMID- 3833966 TI - Successful surgical management of lateral spinal stenosis. AB - The past operative management of low back disease in the United States has been in such a morass that the medical profession and society have tended to avoid addressing the issue. As with all poorly understood disease entities the situation has changed dramatically as it has become better documented, logically comprehensible, and thus potentially treatable in an effective manner. An important key to this new understanding has been the delineation of lateral spinal stenosis as a disease process and its meaning in regard to the FBSS. PMID- 3833967 TI - The multiply operated lumbar spine. AB - In conclusion, it needs to be stressed that the physician should take an organized approach in evaluating the multiply operated spine patient. The origin of the problem in most patients is a faulty decision to perform the original procedure. Further surgery on an "exploratory" basis is not warranted and will lead only to further disability. Another operation is indicated only when there are objective findings to justify it. Multiply operated back patients need a total assessment. The cause of each patient's complaints must be accurately localized and identified. In addition to the orthopaedic evaluation, the patient's psychologic and general medical status must be thoroughly investigated. Once the spine is identified as the source of his symptoms, specific features should be sought in the patient's clinical history, physical examination, and roentgenographic studies. The number of previous operations, characteristics of the pain-free interval, and predominance of leg versus back pain are the major historical points. The neurologic examination and the presence of a tension sign are the important physical findings. Plain roentgenograms, motion films, metrizamide myelography, and computerized axial tomography have a specific place in the work-up. When all the information is integrated, the physician can separate patients with mechanical problems from those with arachnoiditis. If repeat surgery is undertaken, the approach must be a new level because the dura has no osseous protection at the previous laminectomy site. The midline scar tissue should be left intact and the nerve roots exposed laterally. Finally, the surgeon should be prepared to repair a dural tear, for this is the most common complication of a repeat laminectomy. PMID- 3833968 TI - Computerized tomography of spinal trauma and degenerative disease. PMID- 3833969 TI - Epidemiological study of postparalytic poliomyelitis cases in Pondicherry. PMID- 3833970 TI - Hypothyroidism as a possible aetiology of vitamin A deficiency. PMID- 3833971 TI - Perinephric abscess: a report of 20 cases. PMID- 3833972 TI - Importance of serum zinc and copper in pulmonary tuberculosis of childhood. PMID- 3833973 TI - Clinicopathological studies on menorrhagia. PMID- 3833974 TI - Adverse reactions to antitubercular agents. PMID- 3833975 TI - Neuroblastoma simulating tuberculous extradural granuloma. PMID- 3833976 TI - Typhoid cerebellitis. PMID- 3833977 TI - Rupture uterus in primigravida. PMID- 3833978 TI - Intrafourth ventricular cysticercosis. PMID- 3833979 TI - Term pregnancy in an accessory horn of uterus. PMID- 3833980 TI - Aftermath of Bhopal tragedy. PMID- 3833981 TI - A non-operative procedure to induce male sterility. PMID- 3833983 TI - Paracentesis abdominis as an aid to diagnosis. PMID- 3833982 TI - Breast feeding versus bottle feeding. PMID- 3833984 TI - Serum LDH in different types of malignancy. PMID- 3833985 TI - Leukaemia in and around Meerut. PMID- 3833986 TI - Pulmonary functions in tropical eosinophilia before and after treatment with diethylcarbamazine. PMID- 3833987 TI - Acute aluminium phosphide poisoning. PMID- 3833988 TI - Usher's syndrome. PMID- 3833989 TI - Solitary amyloid tumour of larynx. PMID- 3833990 TI - The current status of treatment of febrile seizures. PMID- 3833991 TI - Cast syndrome. PMID- 3833992 TI - Medical ethics. PMID- 3833993 TI - Immunoglobulin allotypes in patients in end-stage renal failure. AB - In a population of 282 Caucasoid patients in end-stage renal failure (ESRF) Gm and Km typing has confirmed a significant increase in the frequency of the Gm1,2,17;21 haplotype. This was confined to an increase in the number of heterozygous Gm(1,2,3,17;21,5,10,13,14) individuals. A concomitant decrease in the frequency of presumptive Gm(3,5,10,13,14) heterozygotes was also confirmed. Analysis of individual renal diseases revealed significant immunoglobulin allotype, phenotype and haplotype frequency deviations in those patients presenting with hypertension, glomerulonephritis or pyelonephritis. The allotype distribution in patients with physical abnormalities of the urinary-genital tract, whether congenital or acquired, was normal. PMID- 3833994 TI - Immunoglobulin allotypes in a Chinese population: comparison of haplotype frequencies with other Asian groups. AB - Two groups of Chinese individuals of the city of Wuhan in the People's Republic of China, consisting of 98 blood bank donors and 278 workers in a steel factory, respectively, have been typed for G1m, G2m, G3m, A2m and Km allotypes. The Gm-A2m haplotype frequencies as well as the Km gene frequencies appeared to be quite similar in these two groups of people, the main haplotypes being Gmaf;n;b A2m2 and Gmza;..;g A2m1. After joining the data of the two groups, the frequencies of the main Gm haplotypes and the A2m and Km gene frequencies have been compared with those of six other Asian populations. In Asia, going from the south to the north, an increasing frequency of Gmza;..;g and a decreasing frequency of Gmaf;n;b were observed. The frequencies found in the investigated Chinese population lie between the frequencies found in the Chinese from Taiwan and the Japanese. PMID- 3833995 TI - [Percutaneous fine needle cytopuncture of lymph nodes opacified by lymphography, in urogenital pathology. Apropos of 174 cases]. AB - Percutaneous fine needle puncture of lymph nodes after lymphography with contrast has been performed in 174 patients with urogenital tumors (bladder: 108, prostate: 41, testes: 25). Conducted under direct television screen control the procedure is simple to perform and provokes little discomfort for the patient, since it is painless and relatively non-traumatic. Needle puncture is a reliable technique resulting in no false positives and very few false negatives when carried out using the previously described technique (routine sampling and technical success). Combining lymphography with needle puncture is of undoubted value for detecting extension of tumor and improving choice of therapy. PMID- 3833996 TI - [Management of isolated angiomyolipoma of the kidney]. AB - Four patients presented isolated angiomyolipomas of kidney in the absence of any form of phakomatosis such as Bourneville's disease. The tumor was removed by partial nephrectomy in only one case, after histology of a fresh specimen confirming the presence of an angiomyolipoma without signs of cancer. In another patient it was impossible to perform conservative surgery because of dissemination of the angiomyolipoma throughout the kidney. Symptomatology suggestive of the disorder includes lumbar pain, kidney tumor and more rarely hematuria. Diagnosis is difficult despite availability of ultrasound and CT scan imaging, which has supplanted renal arteriography. Confirmation requires histology of a fresh specimen. Operative treatment is essential to avoid the risk of intra- and peri-tumoral hemorrhage, particularly during pregnancy. Partial nephrectomy or excision of tumor is possible when the diagnosis has been established, if excision involves healthy parenchyma and if after strict hemostasis at least one third of renal parenchyma remains. PMID- 3833997 TI - [Non-secreting malignant tumors of the adrenals. Apropos of 3 cases]. AB - Tow of three patients seen with malignant tumor of adrenals had very large lesions and the outcome was rapidly fatal. Excision of tumor was possible in the third case and the patient is in good health two years after operation. Clinical signs are infrequent and diagnosis of an adrenal lesion is mainly dependent on combined ultrasound-scan imaging, with confirmation by histology. Differential diagnosis is necessary between adrenal cortex adenoma and pheochromocytoma. Malignancy is suspected from signs of extratumoral invasion and a tumor weight of over 100 g. Histologic findings are not always specific. Treatment is almost exclusively surgical, complementary therapy being unnecessary in non-secreting pheochromocytoma. Attempts to treat malignant adrenal cortex masses by o,p-DDD have not improved prognosis. The chance discovery of a small tumor requires either routine excision of mass to prevent progression of certain malignant tumors, or simple surveillance, particularly after 50 years of age, since many of these tumors are benign: the decision for choice of therapy is a debatable subject. PMID- 3833998 TI - [Vesico-ureteral reflux in adults. Apropos of 103 cases]. AB - Case reports of 103 adult patients operated upon for vesicorenal reflux are reviewed. The majority of the patients (94%) were women, and clinical signs appeared initially after puberty in half of these, mainly as fever, abdominal pains and pyuria. Twelve of the 25 women known to have children had had serious septic accidents during pregnancy. Only 11% had two normal kidneys, 50% having bilateral and 39% unilateral kidney lesions. Of the total studied, 70% of kidneys had corticopapillary lesions, while 35% were smaller than normal. The average length of the submucous trajectory of a refluxing ureter was 3.5 mm, 95.5% of kidneys with corticopapillary lesions having a ureter ending in a short submucous trajectory (average: 3.7 mm). Of the 156 ureters operated upon by antireflux advancement, stenosis developed in 2 and residual reflux in 9, 7 of these latter corresponding to exclusively transvesical ureteral dissections. Global efficacy was 73% for this type of surgery, with 7.5% poor and 19.5% doubtful results. Conclusions drawn from this analysis were: the adverse effects of reflux during pregnancy (one out of 2 cases), the frequency of renal lesions in adults (35% of small kidneys and 70.4% of kidneys with corticopapillary lesions), the short submucous portion of these ureters--its length did not exceed that found in children with reflux--perhaps there had not been intramural ureteral growth, and the efficacy of the antireflux operation if a wide extravesical dissection is performed before the antireflux advancement procedure itself. PMID- 3833999 TI - Free autogenous muscle transplantation in urinary incontinence. PMID- 3834000 TI - [Hypercalcemia-hypocalciuria syndrome. Apropos of 2 cases]. AB - Two patients with urinary calculi presented hypercalcemia with very moderate calciuria and serum parathormone levels. These cases are used as a basis for a description of the familial hypercalcemia-hypocalciuria syndrome reported by Marx, a dominant autosomal disease in which the hypercalcemia is associated with a moderate hypermagnesemia and normal renal function. Pathogenesis is related to an increase in tubular reabsorption of Ca++ and Mg++. Surgery to parathyroids would be of no value since these glands are normal. PMID- 3834001 TI - [Evaluation of erection disorder]. AB - A multidisciplinary approach to screening for a disorder of erection has been applied over the last 7 years and involves dynamic and particularly physiologic explorations. When an organic etiology cannot be excluded during the first consultation and after a clinical examination, the basic paraclinical investigation used is the measurement of nocturnal erections (NPT). Although NPT remains the key-examination, it may be necessary to request vascular exploration, mainly study of the Doppler effect, a neurologic examination to include peripheral and autonomic nervous systems and endocrine tests. PMID- 3834002 TI - [Hematologic manifestations of cancers of the prostate]. AB - Authors study six cases of prostatic adenocarcinoma with bone marrow metastatic involvement. Hematological manifestations can be: intravascular coagulation with anemia and myelemia. The heparin permits to control the intravascular coagulation when waiting the effect of hormonotherapy, chemotherapy or radiotherapy. PMID- 3834003 TI - The present status of reconstructive venous surgery. PMID- 3834004 TI - Valvuloplasty and valve transfer. AB - The technique and results of valvuloplasty and valve transfer are presented. The rationale and theoretical background for these procedures are outlined. Results of reconstructive valve surgery have been good and justify continued application of this therapeutic modality in chronic venous insufficiency. PMID- 3834005 TI - Vein valve transplant. Indications and results. AB - The vein valve transplant has, in our experience, subjectively relieved symptoms in the majority of patients. More importantly, elevated venous pressure has been decreased in most patients. Thus, patients exhibiting signs of venous insufficiency syndrome as well as elevated venous pressure and proven valvular incompetence should be considered candidates for vein valve transplants after an unsuccessful trial of medical management. PMID- 3834006 TI - Deep venous reconstruction (1968-1984). AB - This paper describes our overall experience with venous reconstructive surgery in the past 15 years. A thorough diagnostic evaluation of the patient with advanced chronic venous insufficiency is necessary to guide the surgeon in selecting a surgical approach that will address the specific problem in each patient. The diagnostic workup will separate those with insufficiency due to valve incompetence from those with deep vein obstruction as the basis for their problem. The operations vary from vein ligations to valve reconstruction or transplantation for valve incompetence and venous bypasses for obstructive problems. An aggressive surgical attitude in chronic venous disease makes it possible to restore selected patients to full activity with symptom-free extremities rather than teaching them to live within the confines of their disease state by nonsurgical management. PMID- 3834007 TI - The femoral bypass. AB - Long-term results in 30 cases of bypass of the occluded superficial femoral vein by implantation of the greater saphenous vein into the popliteal vein have been disappointing due to degeneration of the saphenous valves within two years. The Palma operation has proven to have long-term good results in 18 of 20 cases performed by more recent techniques, but less favorable results by previous methods. Salient details of surgical management are presented. PMID- 3834008 TI - Direct reconstructive venous surgery. AB - Unilateral occlusions of the pelvic veins may be corrected by a Palma operation. In the classic Palma operation the contralateral long saphenous vein is suprapubicly led to the opposite side and is anastomosed end-to-end or end-to side with the common femoral vein of the occluded side. Just lately, spirally wall reinforced PTFE grafts showed more favourable results than Palma grafts. Circumscribed occlusions of the superficial femoral vein can be interposed by the May-Husni operation. Thereby the ipsilateral long saphenous vein is implanted end to-side into the popliteal vein. We perform the Palma operation as well as the May-Husni operation under the protection of a temporary av-fistula. The ascending venography only permits to make a statement on the morphological operability, whereas the functional operability is indicated by means of phlebodynamometry. Phlebodynamometry and plethysmography are the best means to judge the functional result of the operation which is of importance for the patient. The results of the Palma operation can be regarded as very satisfactory, provided that the morphological and functional indication for the operation was correct. The use of the endothelium protective operative technique by Robert Mays as well as the application of a temporary av-fistula yield a success that is above 80 p.c. As against that, the May-Husni operation achieves less than 50 p.c. success, even if a temporary av-fistula is established in the area of the ancle. Less favourable are the results obtained by direct restorative interventions on the subclavian vein, so that these operations should only be indicated in exceptional cases. PMID- 3834009 TI - The temporary arteriovenous fistula in venous reconstructive surgery. AB - The role of the temporary AV-fistula in venous reconstructive surgery is described. The objectives are: increase of blood flow in the proximal thrombectomised vein or in the venous graft; prevention of immediate re- or graft thrombosis; provide time for endothelial healing; promote development of collaterals in case of occlusion. The management of acute ilio-femoral venous thrombosis with thrombectomy and temporary AV-fistula is presented with results of 120 operations. No mortality due to fatal pulmonary embolism. In the prospective randomised study comparing surgery with conservative treatment follow up demonstrated 76% patent iliac veins in operated group compared to 35% in the conservative group. Ten patients with iliac vein obstruction had immediate reconstruction with PTFE graft and AV-fistula. Three grafts are still functioning after 7, 15 and 56 months respectively. PMID- 3834010 TI - Arterial obstructive disease of the lower limbs in the elderly: is angiography required? AB - A retrospective study of 61 hospitalized elderly patients with peripheral arterial disease revealed that a large majority of them presented with restpain and/or skin defects and gangrene. A palpable popliteal artery was usually indicative of severe distal disease and a poor outlook for revascularisation. In the other patients, angiography was required to clearly delineate good from poor candidates for arterial repair. Yet, only one third of the patients submitted to angiography could ultimately benefit from vascular reconstruction. PMID- 3834011 TI - Pulmonary embolism in post-mortem material with clinical correlations in 425 cases. AB - 425 patients with pulmonary emboli at post mortem were studied retrospectively with the main focus on the clinical diagnosis. The diagnosis of pulmonary embolus was made or suspected while the patient was still alive in 59 patients (14%) and was first written in the post mortem request form in 130 patients (30%). In 236 patients (56%) the diagnosis was made only at post mortem. Even in fatal emboli the diagnosis was missed in 43% of cases. A multiplicity of non specific symptoms and signs was observed with a minority of patients showing signs and symptoms considered as typical. Of 231 thrombophlebitis processes found in locations which could give rise to clinical symptoms in the lower extremities the diagnosis was noted only in 25 cases. Chest x-ray and ECG were negative in two thirds of the cases. The high rate of misdiagnosis derived from two reasons: (a) subjective factors: lack of awareness; (b) objective difficulties: lack of specificity of clinical symptoms and signs as well as of results of the routine tests (chest x ray and ECG). Since sophisticated confirmative tests for pulmonary emboli will be performed only on the basis of clinical suspicion, clinical awareness based on the observations detailed in this survey is still the cornerstone of diagnosis. PMID- 3834012 TI - Varicography. AB - Fifty patients (25 with primary untreated varicose veins and 25 with recurrence following surgery) were studied by varicography. The connections of the varicose veins with the long and short saphenous systems and through communicating veins to the deep veins are described. The low osmolality contrast medium Hexabrix was used and no complications were encountered. The authors conclude that using a low thrombogenic medium the examination is safe and the information valuable in planning management. Removal of, or damage to, the long saphenous vein, a potential future bypass conduit is no longer justified and pre-operative varicography assists in its preservation. PMID- 3834013 TI - Digital subtraction angiography of the carotid bifurcation. AB - This report described the results of digital subtraction angiography (DSA) in the diagnosis of arteriosclerotic disease of the extracranial arteries, especially the distal part of the common- and proximal part of the internal carotid arteries compared to the catheter angiography. 50 patients underwent DSA and conventional angiography. In 85% of the patients, the quality of the DSA examination was good. For the internal carotid arteries the standard sensitivity was 91% and the standard specificity 93%. In all patients both vertebral arteries were visualized on DSA. All patients underwent the non-invasive tests (OPG, Doppler, Duplex). These tests and the DSA together cannot always replace the catheter-angiography in case of carotid pathology. We started an investigation to assess in which cases the catheter-angiography can be replaced by DSA to arrive at the same diagnosis. The preliminary results indicate that replacement of the conventional angiography by DSA is possible in 80% of this patients group. PMID- 3834014 TI - The analysis of lipids and glycosaminoglycans of low-density lipoprotein glycosaminoglycans complexes isolated from normal, fatty streaks and fibrous plaques of human aortic intima. AB - The low-density lipoproteins (LDL)-glycosaminoglycans (GAG) complexes were isolated from fibrous plaques, fatty streaks and normal of human aortic intima and analysed for lipids and GAGs. The LDL-GAG complexes formed a precipitation line against antihuman apoprotein B, which is a major component of plasma LDL, and the lipids constituents of LDL-GAG complexes resembled those of plasma LDL. It might be suggested from these findings that the lipoproteins (LP) bound to GAG in arterial tissue was originated from plasma LDL penetrated into arterial tissue from circulating system. From the analysis of GAGs in LDL-GAG complexes by two dimensional electrophoresis, the % composition of GAG in fibrous plaques showed higher in chondroitin-4-sulfate (CS-4-S) plus chondroitin-6-sulfate (CS-6-S) and marked lower in dermatan sulfate (DS) when compared with those of fatty streaks. There are no differences in the % composition of hyaluronic acid (HA) in normal and atherosclerotic lesions. It would be suggested from these observations that the formation of saline extractable LDL-GAG complexes would be the early events in aortic intima when plasma LDL penetrated from circulation system and that not only DS and/or heparan sulfate (HS) but also CS-4-S and/or CS-6-S have an important role on the progression of atherosclerosis. PMID- 3834015 TI - [Muscle exercise after the anterior cruciate ligament reconstruction of the knee- Part I: The force given to the anterior cruciate ligament by separate isometric contraction of the quadriceps or the hamstrings]. AB - An attempt was made to investigate the force of the anterior cruciate ligament (ACL) in separate isometric contraction (IMC) of the quadriceps and the hamstrings by means of the analysis of two-dimensional models. In IMC of the quadriceps, the average value of the anterior drawer force (ADF) was equal to 14% of the quadriceps tension at the knee flexion of 5 degrees. The ADF decreased as the flexion angle increased. The average value of the angles, where the ADF became zero, was 45.3 degrees, and the standard deviation was 12.5 degrees. In IMC of the hamstrings, the posterior drawer force was given at the every flexion angle. CLINICAL RELEVANCE: In the early stage of the rehabilitation after the ACL reconstruction, the quadriceps exercise by IMC should be performed at the knee flexion of more than 70 degrees (average + 1.96 X S.D.). The hamstrings exercise by IMC can be carried out regardless of flexion angle. PMID- 3834016 TI - [Muscle exercise after anterior cruciate ligament reconstruction of the knee- Part II: The development of the exercise method by simultaneous isometric contraction of the quadriceps and the hamstrings, and its biomechanics]. AB - An attempt was made to investigate the stress of the ACL in the simultaneous isometric contraction (IMC) of the quadriceps and the hamstrings by means of analysis of two-dimensional models, and to estimate electromyographically the forces of those muscles in that contraction. The anterior drawer force (ADF) in the simultaneous IMC decreased as the flexion angle of the knee increased. The average value of the angles, where the ADF became zero, was 7.4 degrees. The integrated EMGs of the quadriceps and the hamstrings in the simultaneous maximum IMC were equal to 30-60% of those in separate maximum IMC. CLINICAL RELEVANCE: In the early stage of the rehabilitation after the ACL reconstruction, the simultaneous IMC of the quadriceps and the hamstrings is useful as one of the muscle exercise method, because that can be performed at the knee position near the full extension and can generate sufficient muscle force for exercise. PMID- 3834017 TI - [Basic and clinical studies on osteochondral fragment fixation using fibrin adhesive system (FAS) in cases of fracture]. AB - The healing process of osteochondral fracture was studied experimentally and clinically, using fibrin adhesive system (FAS) containing highly concentrated and freeze-dried fibrinogen, thrombin and factor XIII. Osteochondral fractures were made in the femoral condyle of the rabbit. Most of the adhered fibrin was gradually absorbed at the fracture site and at the same time was replaced with granulation tissue containing abundant capillaries, fibroblasts and osteoblasts, by the 10th day. Complete fracture healing was achieved histologically in one month. Fifteen cases of intraarticular osteochondral fractures in the hand were treated with FAS clinically. Complete bony union was obtained in all cases at 3 to 6 weeks postoperatively. The range of motion was limited in 3 cases, but was excellent in the other 12 cases. From our experimental and clinical results, it appears that FAS may produce no obstructive effects in bony healing. Management of intraarticular osteochondral fixation would be much easier by using FAS than by the conventional fixation materials such as metal screws or K-wire. PMID- 3834018 TI - [Localization of carbohydrate component in human synovial lining cells with fluorescent lectins and enzyme digestion]. AB - FITC-conjugated lectins, Con-A, DBA, GS-I, GS-II, PNA, MPA, RCA-I, SBA, UEA-I, WGA were used for demonstration of lectin bindings of human synovial lining cells, obtained from the patients with rheumatoid arthritis (RA), osteoarthritis (OA), aseptic necrosis (AN), and traumatic injury (TI). In the RA samples, GS-I binding to the cytoplasmic sites was predominantly noted and moderate SBA and MPA bindings were observed. However, PNA was not significant. In the OA samples, predominant binding was found in GS-I and SBA lectins, moderate binding in MPA and PNA. In the AN samples, binding was predominant in MPA, moderate in GS-I, SBA and PNA. After neuraminidase treatment the intensity of fluorescence increased significantly with PNA and moderately with SBA in the RA samples. These results suggested that the inflammatory lining cells produce galactose group and the content of neuraminic acids in the synovial membranes of the RA appears to be greater than in those of other diseases. PMID- 3834019 TI - [31P-NMR and HPLC studies on the energy metabolism of perfused chondrocytes]. AB - Energy metabolism of perfused rabbit ear chondrocytes was studied by using 31P nuclear magnetic resonance (31P-NMR) and high performance liquid chromatography (HPLC). Rabbit ear chondrocytes contained a relatively low concentration of creatine phosphate and high concentrations of GTP and UTP, compared with that of ATP. Concentrations of high-energy phosphate compounds and pH in the chondrocytes did not change when the oxygen concentrations of the perfusate were 95, 20 and 7%. However, high-energy phosphate compounds decreased when the perfusate did not contain oxygen, and when it contained 1.0 mM KCN or 0.1 mM dinitrophenol. A decrease in pH due to accumulation of lactate was observed simultaneously. The findings suggested that a large part of high-energy phosphate compounds in rabbit ear chondrocytes are consumed in the process of matrix production. Oxygen supply was necessary in order to maintain intracellular concentrations of these high energy phosphate compounds. PMID- 3834020 TI - [Experimental studies on the healing and restoration of gliding function of the injured digital flexor tendon. Part 9: The use of drugs to prevent adhesion formation of the injured tendon]. AB - In order to prevent the formation of restrictive adhesion without influencing tendon healing, hyaluronic acid and triamcinolone were given topically between a scarred tendon and gliding floor. The third digits of female broiler chickens were used. Three factors of tendon adhesion were elicited, namely, injury to the tendon, tendon sheath and gliding floor. Standard adhesion was established from all factors in addition to the cast immobilization. The above-mentioned procedure was used as a standard adhesion model in the following experiments. Hyaluronic acid, triamcinolone and ganglion contents were applied topically just after the above-mentioned procedure. After three weeks of immobilization, the state of tendon adhesion and tendon healing was observed. Triamcinolone, 0.05 mg, had an adhesion-preventing action, but the effective dose of this agent had only narrow limits. Hyaluronic acid, 1% and 0.5%, was more effective than triamcinolone in the prevention of adhesion and did not interfere with the tendon healing. Ganglion contents had a slight effect on the prevention of adhesion. PMID- 3834021 TI - Biochemical and immunological study of lumbar disc degeneration. AB - Proteoglycans of 18 lumbar discs obtained at surgery for lumbar disc lesion were studied biochemically and immunologically (using monoclonal antibody that recognizes core protein of annulus fibrosus proteoglycans) and compared with the results of similar studies on discs obtained at autopsy and Zielke's operation for scoliosis. Disc proteoglycans showed a decrease in extraction and hexuronic acid/protein weight ratio with age in both surgical and post-mortem specimens. Although the molecular weight of proteoglycan monomer seemed to show a slight decrease, that of chondroitin sulfate chain showed no change with age in surgical discs. The proportion of proteoglycan aggregate showed a decrease with age until 40 years old, it went up thereafter because of the loss of proteoglycan monomers. This biochemical degeneration paralleled discogramic degeneration and monoclonal antibody that recognized core protein showed a strong affinity with severely degenerated discs. Besides aging, lumbar instability seemed to exert a profound influence on the progression of degeneration. PMID- 3834022 TI - [Multiple trauma with fractures]. PMID- 3834023 TI - A quantitative analysis of regeneration from chimaeric limb stumps in the axolotl. AB - We have analysed the cellular contribution and cellular displacement which occur during regeneration from chimaeric (half triploid, half diploid) lower arms in the axolotl. In general both anterior and posterior halves contribute approximately 50% of the regenerated limb cells. Deviations from equal contribution were observed only when anterior tissue was grafted, suggesting that anterior tissue is more sensitive to grafting operations. Approximately 25% of all cells in the regenerated limb were found to be displaced to the opposite side of the limb. Cellular displacement was not random; 63% of all displaced cells were found in regions adjacent to the tissue of origin. PMID- 3834024 TI - Membrane organization in the preimplantation mouse embryo. AB - The preimplantation mouse blastocyst consists of two differentiated tissues, the trophectoderm (a structurally and functionally polarized epithelium) and the inner cell mass. The divergence of these two cell types can be traced back to a contact dependent polarization of the surface and cytoplasm at the 8-cell stage. Membrane/cytocortical organization during this preimplantation period has been studied using freeze fracture in conjunction with the sterol-binding antibiotic filipin in an attempt to discern the molecular basis and origin of these surface asymmetries. The distribution of filipin reactivity within the different membrane domains showed that the surface polarity exhibited by trophectoderm and by blastomeres of the 8-cell stage is underlain by a heterogeneity in molecular organization of the membrane/cytocortex which may originate prior to the appearance of any overt surface polarity. The results are discussed in terms of the likely basis of this membrane/cytocortical asymmetry, its probable origins and the use of the preimplantation mouse embryo as a model system for studying the assembly of a polarized epithelium. PMID- 3834025 TI - Genetic analysis of developmental mechanisms in hydra. XVI. Effect of food on budding and developmental gradients in a mutant strain L4. AB - Effect of food was examined on the budding rate and the developmental gradients of a mutant hydra strain L4. This mutant strain has very high levels of head inhibition potential gradient along its body axis (Takano & Sugiyama, 1983). It also has a reduced budding capacity when it is cultured using brine shrimp nauplii as food, but its budding capacity is significantly improved when a small amount of tubifex worm tissue is added to its diet of brine shrimp (Takano, 1984). To test whether or not this change of budding rate is correlated with the change in the levels of the head-activation or head-inhibition potential gradients, L4 animals were cultured on the diet of brine shrimp with or without addition of tubifex worm tissue and the budding rates and the gradient levels were examined in these animals. The results showed that food affected the budding rate in L4 without affecting its gradient levels. This suggests that the gradient levels and the budding rate in L4 are are uncorrelated to each other, and that therefore the high levels of head-inhibition potential are not the cause for the low budding rate in this strain (cf., Takano & Sugiyama, 1983). PMID- 3834026 TI - Retinoic acid and pattern formation in the developing chick wing: SEM and quantitative studies of early effects on the apical ectodermal ridge and bud outgrowth. AB - When retinoic acid is locally applied to the anterior margin of developing chick wing buds on ion-exchange beads, dose-dependent changes in the skeletal pattern result. At low doses, additional digits develop. At high doses, there is thinning of the symmetrical wing. Local application of retinoic acid to the apex of the bud also leads to pattern changes, but in contrast normal wing patterns are almost always obtained following application posteriorly. These effects are manifest at 6-7 days after the operation although only a brief exposure (14-20 h) to retinoic acid is required. Therefore the morphology of wing buds was studied at shorter times after the start of treatment. The local application of retinoic acid to the wing bud margin leads to changes in extent of the apical ridge that can be detected at 24 h after application. The behaviour of the apical ridge with varying doses and positions of retinoic acid application has been analysed quantitatively and dose response curves obtained. At low doses of retinoic acid, the length of the apical ridge increases or remains constant, but then progressively decreases with higher doses. The progressive obliteration of the ridge starts first near the bead and then involves more distant parts of the bud. Thus the region of the ridge affected depends on the position at which the retinoic acid is applied. We propose that these effects on the apical ridge reflect dose-dependent responses to the local concentration of retinoic acid that varies with distance from the source. At high doses, the apical ridge disappears but at low doses it is maintained. Since grafts of polarizing region tissue also have a graded effect on ridge morphology, a possible interpretation of the retinoic acid effects is that tissue adjacent to the source is converted into polarizing region tissue. Alternatively, retinoic acid may act directly on the ridge cells. The changes in the extent of the apical ridge produced by retinoic acid lead to different forms of bud outgrowth. The form of the outgrowth depends on the dose of retinoic acid, the position of application and the interaction between the effects of the local source of retinoic acid and those of the polarizing region of the host bud. These considerations give some insights into why anterior application of retinoic acid leads to the development of additional digits whereas posterior application generally gives normal wings. PMID- 3834028 TI - Contrabithorax and the control of spatial expression of the bithorax complex genes of Drosophila. AB - Cbx1 is a dominant mutation of the bithorax complex (BX-C) of Drosophila partially transforming the second thoracic (T2) segment towards the third one (T3). Molecular analysis has shown that Cbx1 arose from a transposition within the BX-C of a DNA fragment of 17 kb containing pbx+ inserted into the Ubx area. In addition to the dominant phenotype, the Cbx1 mutation produces a set of recessive homeotic transformations that we show are characteristic of the Ubx mutations. We present evidence that the dominant and the recessive transformations arise from different mechanisms and suggest the dominant transformation is caused by an alteration of the normal regulatory role of pbx+ resulting in an adventitious expression of some Ubx+ products in T2, while the Ubx phenotype is caused by the breakpoint of the insertion. PMID- 3834027 TI - Action of phorbol myristate acetate (PMA) at fertilization of mouse oocytes in vitro. AB - Phorbol ester (PMA) in concentration 5 and 10 ng ml-1 blocks cytokinesis of the second maturation division in mouse oocytes. Karyokinesis is not impaired and digynic triploid oocytes are obtained which undergo first cleavage division. Effectiveness of blocking cytokinesis is dependent on the timing of exposure of oocytes to PMA action. When oocytes are subjected to PMA at the onset of the second maturation division only 14.5% of eggs are triploid. PMA present during fertilization in vitro (about 1 h exposure to PMA) induces triploidy in 40% eggs. Extending the time of exposure of oocytes to 2 h produces 76% tripronucleate eggs. Applicability of PMA is compared with the use of cytochalasin B to induce triploidy in the mouse. PMID- 3834029 TI - Cleavage and gastrulation in the egg-brooding, marsupial frog, Gastrotheca riobambae. AB - The marsupial frog Gastrotheca riobambae has several reproductive adaptations, most prominent of which is the incubation of the embryo in a pouch on the mother's back. We have followed cleavage and gastrulation by microscopical observation and by vital staining, and have found several alterations in these processes which may reflect the reproductive adaptations. The large, yolky egg has a cap of yolk-poor cytoplasm at the animal pole which is incorporated into a translucent blastocoel roof consisting of a single cell layer. The epithelium of the yolk sac is derived from the roof. The inconspicuous blastoporal lips form near the vegetal pole from cells of the marginal region. Gastrulation movements include the epibolic stretching of the surface towards the blastopore and a contraction of the vegetal surface. The blastoporal lips close over a small archenteron, and the cells of the lips become the embryonic disc, a discrete group of small cells which give rise to most of the embryo's body. The great size difference between animal and vegetal blastomeres during cleavage, the single celled blastocoel roof, the dissociation in time between archenteron formation and its expansion, the embryonic disc and the slow development distinguish G. riobambae embryos from those of other frogs. The importance of the marginal region which produces the embryonic disc and the unimportance of the most animal region whose fate is primarily yolk sac emphasizes the role of the marginal region in amphibian development. PMID- 3834030 TI - Factors guiding regenerating retinotectal fibres in the frog Xenopus laevis. AB - I have examined the pathways of retinotectal fibres regenerating back to the contralateral tectum, and also to innervated and 'virgin' ipsilateral tecta in postmetamorphic Xenopus. The fibres were visualized by HRP labelling of either the whole optic nerve, or a selected quadrant of the retina. Most fibres grow into either the ipsilateral or contralateral optic tract, although a small proportion go down the outside of the contralateral optic nerve. In the tracts, many fibres grow superficially, close beneath the pia, but a variable proportion runs more deeply. Axonal growth is not, therefore, restricted absolutely to the subpial region in the postmetamorphic Xenopus brain. Fibres growing onto the contralateral, or a 'virgin' tectum mostly grow straight onto the rostral margin of the tectal lobe, without growing around its margin in the form of a medial or lateral brachium. Most of these fibres grow through the deeper part of the tectal layer which normally contains optic neuropil, but a proportion of them grow immediately deep to the pia. Fibres regenerating to an innervated ipsilateral tectum mostly enter either the medial or lateral brachium of the optic tract, and only leave this close to their site of termination. In the brachia the fibres run superficially under the pia, but when they leave the brachia they mostly run through the deeper retinorecipient layers. These observations provide further evidence that ingrowing optic fibres have their pathways influenced by the axons which have preceded them. PMID- 3834031 TI - Cytological analyses of factors which determine the number of primordial germ cells (PGCs) in Xenopus laevis. AB - Correlation of the number of primordial germ cells (PGCs) at stage 47 with the amount of germ plasm at the 8-cell stage and with the number of the germ-plasm containing cells (GPCCs) was analysed using two different laboratory-raised colonies of Xenopus laevis, HD and J groups. The average number of PGCs in J group tadpoles was significantly larger than that in HD group tadpoles. The amount of germ plasm in J group embryos was also demonstrated to be larger than in HD group embryos. The amount of germ plasm was related positively to the number of GPCCs at the 8-cell stage and to the resulting number of PGCs; embryos which contained larger amounts of germ plasm developed larger numbers of PGCs at stage 47. The average number of PGCs in experimentally induced triploid tadpoles was exactly two-thirds of that in normal diploid tadpoles. Furthermore, in somatic cells (e.g. epidermis, muscle, pancreas), the number of cells in the triploid was also two-thirds of that in diploid tadpoles. These findings suggest that the number of PGCs is regulated by at least two different mechanisms: first, the number of PGCs is primarily specified by the intrinsic amount of germ plasm in the fertilized egg. Second, it is regulated by an unknown mechanism which controls the total number of cells of whole embryos, such as the nucleocytoplasmic ratio. PMID- 3834032 TI - Development of gynogenetic and parthenogenetic inner cell mass and trophectoderm tissues in reconstituted blastocysts in the mouse. AB - The developmental potential of inner cell mass (ICM) and trophectoderm (TE) derived from parthenogenetic or biparental gynogenetic embryos was examined in reconstituted blastocysts with normal TE or ICM, respectively. The results demonstrate that when a normal ICM was introduced inside a trophectoderm vesicle derived from parthenogenetic or gynogenetic blastocysts, postimplantation development was characterized by the almost complete failure of trophoblast proliferation and without compensating cellular contribution from the normal ICM to the outer trophoblast lineage. Consequently, the normal ICMs also failed to develop adequately and only a few retarded embryos were detected on day 11-12 of pregnancy. In most respects, development of these reconstituted blastocysts resembled that obtained with unoperated gynogenetic and a parthenogenetic blastocyst. By contrast, an ICM from a parthenogenetic or gynogenetic embryo introduced inside a normal trophectoderm vesicle induced substantial proliferation of the trophoblast but again without a detectable cellular contribution from the ICM to the outer trophoblast lineage. However, with the improved development of the trophoblast, both the parthenogenetic and gynogenetic ICMs developed substantially better and without a detectable cellular contribution from the TE to the embryo. Almost all the embryos developed at least up to the 25-somite stage and many of them reached the 30- to 40-somite stage. Some of the most advanced day-11 and -12 gynogenones and parthenogenones yet seen have now been obtained in this way. Nevertheless, all the embryos were still smaller than the equivalent control embryos and showed signs of some tissue degeneration. The yolk sac was also suboptimal with poor blood supply and may need to be improved to obtain further improvement in the development of the embryos. The combined results demonstrate that the trophoblast proliferates very poorly even in the presence of a normal ICM, if the TE tissue lacks a paternal genome. However, ICM tissues which lack a paternal genome can develop to an advanced embryonic stage if they are introduced inside a normal trophectoderm vesicle. The results give further insight into the differential roles of maternal and paternal genomes during development of the embryo and extraembryonic tissues in the mouse. PMID- 3834033 TI - Changes in the distribution of membranous organelles during mouse early development. AB - The unfertilized oocyte, fertilized egg and early embryo (2-cell to 16-cell) of the mouse have been examined immunocytochemically for the distribution of antigens associated with the endoplasmic reticulum, the lysosomal and acidic vesicle fraction (100 kD antigen), Golgi apparatus (135 kD antigen) and coated vesicles (clathrin). The distribution of these antigens has also been examined in isolated 8-cell and 16-cell-stage blastomeres of various ages and phenotypes. Endoplasmic reticulum is detected only weakly in the oocyte and egg, but is seen abundantly at later stages both in association with the nuclear membrane and evenly distributed throughout the cytoplasm, except in regions of cell:cell apposition from which it is excluded. Intracellular clathrin is associated with the spindle in mitotic and meiotic cells. During interphase, clathrin is distributed throughout the cell until the mid-8-cell stage when it is concentrated into the apical region of the cell under the region of membrane at which a surface pole of microvilli will form subsequently. Thus, the cytoplasmic polarization of clathrin precedes overt polarization at the surface. At mitosis, the clathrin relocates to the spindle and is distributed to both daughter cells. It resumes an apical location beneath the surface pole of microvilli in polar daughter 1/16 cells, but remains dispersed in apolar daughter 1/16 cells. Both the lysosomal and Golgi antigens are distributed throughout the cytoplasm until the early 16-cell stage. In pairs of 16-cell blastomeres both antigens aggregate in a single cluster and do so whether the surface phenotype of the blastomeres is polar or apolar. The position of this cluster is not consistently related to the point of contact with the other cell in the pair but there is a suggestion that in cells with a polar surface phenotype the polar foci of Golgi/lysosomal antigens are located between the nucleus and the surface pole at earlier time points, but shift to a position between the basolateral membrane and the nucleus at the later time point. In intact 16-cell embryos also, the aggregated Golgi/lysosomal antigens of polar cells appear to localize to the basal region. The distributions of these various organelles in embryonic cells reported here show a number of differences from those reported previously for mature, differentiated cells. PMID- 3834034 TI - Cartilage morphogenesis in vitro. AB - The morphogenetic capacity of prechondrogenic mesenchyme from two developmentally distinct sources was investigated in high density micromass cultures. We confirmed an earlier report (Weiss & Moscona, 1958) that scleral mesenchyme formed cartilage sheets whilst limb bud mesenchyme formed distinct cartilage nodules. It was thus suggested by these authors that this morphogenesis was tissue type specific. However, by varying cell density at inoculation (which controls cell configuration) and by varying the relative amount of prechondrogenic mesenchyme present in cultures we found that dramatic changes in morphogenesis could be brought about. Viewed in these terms we suggest that cartilage morphogenesis in vitro is dependent on cell configuration and the presence of non-chondrogenic cell types and hence is not necessarily a function of an intrinsic morphogenetic potential of the constituent cells. PMID- 3834035 TI - Measurement of biological shape: a general method applied to mouse vertebrae. AB - A method is described for recording and analysing the projected shape of mouse vertebrae. The image of the shape is captured by a television camera, cleaned, digitized and subjected to mathematical analysis. A visual representation is obtained by reconstructing the shape in polar coordinates about its centre of area. Further statistical analysis of the whole shape is performed after a Fourier transform. This allows the shape to be represented by and reconstructed from 15 numbers. The method does not rely on homologous points or expert opinion and allows mean shapes to be constructed. It successfully distinguished between 92% of the test data, T1 and T2 vertebrae from two strains of mice. PMID- 3834036 TI - X-chromosome deletions in embryo-derived (EK) cell lines associated with lack of X-chromosome inactivation. AB - The predictions of a model for the initiation of X-chromosome inactivation based on a single inactivation centre were tested in a cytogenetic study using six different embryo-derived (EK) stem cell lines, each with a different-sized deletion of the distal part of one of the X-chromosomes. Metaphase chromosomes were prepared by the Kanda method from each cell line in the undifferentiated state and after induction of differentiation, and cytogenetic evidence sought for a dark-staining inactive X-chromosome. The results confirm the predictions of the model in that when the inactivation centre is deleted from one of the X chromosomes neither X present in a diploid cell can be inactivated, and in addition considerably further localize the position of the inactivation centre on the X-chromosome. PMID- 3834037 TI - Maintenance of function in single epithelial cells spatially isolated from similar cells. AB - We have found in an insect tissue, the Malpighian tubules of Rhodnius, instances of single epithelial cells which, as the result of a possible error in development, lie within the epithelium some distance from the main population of similar cells. This spatial separation makes it possible to measure the transport abilities of these cells. Their transport abilities were found to be the same as the cells in the main population. This finding shows that the maintenance of function in individual cells of epithelial tissues may not depend on direct contact with other similar cells. PMID- 3834038 TI - The migration of neural crest cells and the growth of motor axons through the rostral half of the chick somite. AB - We have studied the pathway of migration of neural crest cells through the somites of the developing chick embryo, using the monoclonal antibodies NC-1 and HNK-1 to stain them. Crest cells, as they migrate ventrally from the dorsal aspect of the neural tube, pass through the lateral part of the sclerotome, but only through that part of the sclerotome which lies in the rostral half of each somite. This migration pathway is almost identical to the path which presumptive motor axons take when they grow out from the neural tube shortly after the onset of neural crest migration. In order to see whether the ventral root axons are guided along this pathway by neural crest cells, we surgically excised the neural crest from a series of embryos, and examined the pattern of axon outgrowth approximately 24 h later. In somites which contained no neural crest cells, ventral root axons were still found only in the rostral half of the somite, although axonal growth was slightly delayed. These axons were surrounded by sheath cells, which had presumably migrated out of the neural tube, to a point about 50 micron proximal to the growth cones. With appropriate antibodies we found that the extracellular matrix components fibronectin and laminin are evenly distributed between the rostral and caudal halves of the somite. Neither of these molecules therefore plays a critical role in determining the specific pathway of neural crest cells or motor axons through the rostral half of the somite. PMID- 3834039 TI - Cell division during intercalary regeneration in the cockroach leg. AB - In a series of grafting operations on cockroach legs, epidermal cells from different positions or from the same position on the circumference of the femur were placed together. Where cells from different positions were confronted, new cuticular structures corresponding to the positions which would normally have lain between them were formed during the following moults. At the control junctions, where cells from the same positions were placed together, no new structures were formed. Grafted legs were examined histologically at various times after the operation. The events following grafting fell into four phases: wound healing--when epidermal cells migrated over the wound to re-establish epidermal continuity and cells adjacent to the wound divided to compensate for cell emigration; intercalation--when cell divisions took place at the host-graft borders where there was a positional discrepancy; proliferation--when the general growth of the epidermis occurred by widespread cell division; cuticle secretion- when apolysis occurred, cell division ceased, and cuticle secretion began. The results show that intercalary regeneration is associated with local cell division at the graft-host borders, and that these divisions are not confined to the normal proliferative phase of the moult cycle, but begin much earlier in the cycle, as soon as wound healing is complete. These results support epimorphic models (such as the Polar Coordinate Model) of pattern regulation, where change of positional value is tied to cell division, but they do not discount the possibility of a limited initial morphallactic phase. PMID- 3834040 TI - The effect of egg rotation on the differentiation of primordial germ cells in Xenopus laevis. AB - Eggs of X. laevis were rotated (sperm entrance point downwards) either through 90 degrees (1 X 90 embryos) or 180 degrees in two 90 degrees steps (2 X 90 embryos) at approximately 25-30 min postfertilization after cooling to 13 degrees C. The embryos were kept in their off-axis orientation and cooled until the early gastrula stage. Rotation resulted in relocation of egg constituents with slight changes in the distribution of outer cortical and subcortical components and major changes in inner constituents where the heavy yolk and cytoplasm appeared to reorient as a single coherent unit to maintain their relative positions with respect to gravity. Development of rotated embryos was such that regions of the egg which normally give rise to posterior structures instead developed into anterior structures and vice versa. Germ plasm was displaced in the vegetal dorsal-animal direction (the direction of rotation) and was segregated into dorsal micromeres and intermediate zone cells in 2 X 90 embryos and dorsal macromeres and intermediate zone cells in 1 X 90 embryos. In consequence, at the gastrula stage, cells containing germ plasm were situated closer to the dorsal lip of the blastopore after rotation--in 2 X 90 gastrulas around and generally above the dorsal lip. Hence, in rotated embryos, the cells containing germ plasm were invaginated earlier during gastrulation and therefore were carried further anteriorly in the endoderm to a mean position anterior to the midpoint of the endoderm. The number of cells containing germ plasm in rotated embryos was not significantly different from that in controls at all stages up to and including tail bud (stage 25). However at stages 46, 48 and 49 the number of primordial germ cells was reduced in 1 X 90 embryos in one experiment of three and in 2 X 90 embryos in all experiments. We tested the hypothesis that the decreased number of primordial germ cells in the genital ridges was due to the inability of cells to migrate to the genital ridges from their ectopic location in the endoderm. When anterior endoderm was grafted into posterior endodermal regions the number of primordial germ cells increased slightly or not at all suggesting that the anterior displacement of the cells containing germ plasm was not the only factor responsible for the decreased number of primordial germ cells in rotated embryos. Other possible explanations are discussed. PMID- 3834041 TI - Adolescent personality antecedents of adult cigarette smoking: a longitudinal study. AB - Comprehensive personality assessments, made independently for early and late adolescence, were employed to predict smoking onset and maximum number of cigarettes smoked per day as reported by adult smokers. Also, comparisons were made between adult smokers and nonsmokers. The results indicate that men who had been more sexually active as adolescents smoked more but that women who had been more emotionally constricted and under more conflict as adolescents were heavier smokers. Smoking started earlier for men who had showed little self-awareness and a rather macho orientation during their adolescence; early-smoking women tended to have been conventionally feminine. Personality differences between future smokers and nonsmokers were few but showed similar sex differences. The results suggest that manifesting once traditional sex-role characteristics for both adolescent boys and girls presages early onset and heavier adult cigarette smoking. Preventive antismoking educational campaigns aimed at youth might be guided by these findings because they suggest some motivational bases that may find later expression in smoking practices. PMID- 3834042 TI - Compound-stimulus information processing by 3-month-old infants. AB - According to Cohen's (1973) component-compound developmental hypothesis, before 20 weeks of age, infants do not process compound-stimulus information when presented with simple colored forms. This hypothesis was examined in the present study. Eighty 3-month-old infants were presented with novel and familiar simple colored forms (e.g., red square vs. green square). Conditions were controlled so that novelty discriminations based on component- or compound-stimulus information could be separated. Contrary to the component-compound developmental hypothesis, the results indicate that by 12 weeks of age infants encode compound-stimulus information when presented with simple colored forms. These results are discussed in terms of the property-set model of stimulus recognition (Hayes-Roth & Hayes Roth, 1977). PMID- 3834043 TI - Visual perspective taking in children: further ramifications of an information processing model. AB - Forty children between ages 6 and 8 were administered a set of spatial perspective tasks. On half of the items, children responded by rotating a duplicate of the target display; on the remainder, children reconstructed the displays to correspond to a perspective view. The displays differed as to whether they contained marked or unmarked objects. On the basis of an information processing analysis of these tasks, we predicted that the response-type variables and stimulus variables would interact in known ways. Analysis of variance results revealed a good fit with the hypothesized outcomes. Main effects were detected for age, which favored older children, and for display, which favored unmarked objects; the rotation task proved easier. Significant interactions revealed that task demands increasing task difficulty were more problematic in the construction task than in the rotation task, as predicted. PMID- 3834045 TI - Breakdowns in combinatorial reasoning: the role of memory. PMID- 3834044 TI - Aging and memory in skilled language performance. AB - The issue of irreversible decrements versus developmental plasticity with aging was explored for skilled language users. Fifteen English teachers (22 to 31 years of age) and 15 retired English teachers (50 to 83 years of age) were tested for language memory, using a 2 X 2 X 2 (Recall vs. Recognition X Meaningful vs. Nonmeaningful X Incidental vs. Intentional) design, and for overall grammar-skill memory, using speed and error measures. On the language-memory test, experimental variables (but not the age variable) were related to performance. On the grammar skill test, the older subjects showed longer completion times but no decrements in accuracy. The results provided support for developmental plasticity in language memory and suggested an optimistic view of memory for skilled content areas. PMID- 3834046 TI - Effect of pyridoxine deficiency on ornithine aminotransferase in rat kidney and liver. AB - The hepatic and renal activities of ornithine aminotransferase (OAT) [L-ornithine 2-oxoacid aminotransferase, EC 2.6.1.13] were determined in male and female rats given diet with or without pyridoxine. OAT activities were measured in the presence of pyridoxal phosphate. Diet without pyridoxine caused a decrease in hepatic OAT activity in males and no change in females and an increase in renal OAT activity in males and a decrease in females. The increased renal OAT activity in males was associated with increased immunochemically recognizable OAT, and was due to increased synthesis of OAT as shown by measurement of [3H]leucine incorporation in vivo. Thus OAT is regulated by nutritional conditions in different ways in liver and kidney. PMID- 3834047 TI - A multiple regression analysis of hemoglobin values and iron status in Japanese farmers. AB - The authors performed multiple regression analysis of hemoglobin values and the parameters related to iron dynamics. The subjects consisted of 37 farmers whose Hb, Ht, GB, SI, %-St, SFR and FEP was examined once a month for one year. 19.2% of the female farmers had anemia of which 73.8% was iron-deficiency anemia, 13.7% being latent iron deficiency. Hb, GB and FEP in males and SI, %-St, SFR, FEP in females revealed clear seasonal variations. Multiple correlation coefficient between Hb and SI, %-St, SFR, FEP as independent variables was significant in females but not in males, and the ratio of contribution (38.7%) was not very high, however, the multiple correlation coefficient was significantly high (0.622). Standard regression coefficients between Hb and SFR, FEP were significantly high (p less than 0.01). When Ht and GB were added to these 4 variables, multiple correlation coefficients (male, 0.906; female, 0.957) were remarkably high, which means serum-related variables such as Ht and GB have an undeniably important role as explanatory variables of hemoglobin levels. These standard regression coefficients showed seasonal changes. PMID- 3834048 TI - Interrelationship of some selected nutritional parameters relevant to taste for salt in a group of college-aged women. AB - Students in a women's college were investigated for taste acuity for salt, discrimination of salt concentrations in food, and anthropometrical (the body mass index, and systolic and diastolic blood pressures) and biochemical nutritional parameters (blood hemoglobin, plasma zinc, plasma copper, plasma vitamin A, plasma retinol-binding protein, urinary sodium, urinary potassium, urinary magnesium, urinary calcium and urinary zinc). Among 95 students who participated in the test for discrimination of salt concentrations, which was repeated 6 times with 5 different test samples, only 43 (45.3%) committed no mistakes. The detection threshold for taste of salt was significantly associated with neither the discriminability of salt concentrations nor any biochemical parameters. Levels of plasma zinc (PZn), urinary zinc (UZn) and plasma vitamin A (VA) were lower in the present subjects than in those reported previously. The rate of correct discrimination (RCD) was significantly correlated with PZn and VA positively, and with urinary sodium (UNa) and urinary potassium (UK) negatively. In the factor analysis to investigate the interrelationship of nutritional parameters, 6 factors with significance were extracted, among which factors 3 and 4 were related to RCD. Factor 3 had large loadings on VA, plasma retinol-binding protein (RBP) and RCD, and factor 4 was positively loaded on UNa and UK and negatively on UZn and RCD. In the stepwise multiple regression analysis (RCD being the dependent variable), significant independent variables selected were VA, UK, PZn, systolic blood pressure and UNa. From these results, the college aged women's failure in discriminating salt concentrations in food was likely to be related to vitamin A inadequacy, mild Zn deficiency and excessive intakes of Na and K. PMID- 3834049 TI - Carnosine as a histidine source: transport and hydrolysis of exogeneous carnosine by rat intestine. AB - Transport and metabolism of L-carnosine (beta-alanyl-L-histidine) were studied in rat small intestine. Carnosine administered orally was found in rat serum as well as small intestine and liver, followed by an increase of histidine. At ten minutes after carnosine infusion per os, the carnosine content of the hepatic portal vein increased with the dose. On the other hand, the histidine content increased two-fold but did not vary with the dose. These results suggest that part of the carnosine administered orally is hydrolyzed to beta-alanine and histidine in the small intestine. Carnosinase activity was present in many rat tissues and was most active in kidney in the presence of Mn2+. However, in the absence of Mn2+ carnosinase activity in small intestine was found to be the same level as that of kidney. A study has been made of the distribution of carnosinase along the small intestine of adult rat. The dipeptidase was distributed along the whole length of the small intestine with maximum hydrolytic activity in the jejunum, and was localized in the cytosol of the intestinal mucosa. Antiserum prepared against carnosinase purified from kidney inhibited the activity of small intestine as well as that of kidney. PMID- 3834050 TI - [Fluorometric assay of histamine levels in middle ear effusions of secretory otitis media]. PMID- 3834051 TI - [A study of postmortem changes of the spiral organ by scanning electron microscopy]. PMID- 3834052 TI - [Histopathological changes of the anterior wall of the maxillary sinus by aging- on the osteoblast and the osteoclast]. PMID- 3834053 TI - [Electron microscopy of the pathological nasal epithelium induced by irradiation]. PMID- 3834054 TI - [Development and clinical application of middle ear implants]. PMID- 3834055 TI - [Forward-backward tracing tympanometry]. PMID- 3834056 TI - [Psychogenic deafness in children--audiological characteristics]. PMID- 3834058 TI - Encapsulation of dexamethasone in rabbit erythrocytes, the disposition in circulation and anti-inflammatory effect. AB - The application and usefulness of resealed erythrocyte as a cell carrier of dexamethasone were studied in rabbits. The erythrocytes were loaded with water soluble dexamethasone sodium phosphate by hypotonic dilution and dialysis methods. During in vitro incubation at 37 degrees C, the level of dexamethasone held within the resealed according erythrocytes declined according to first-order function. About one half of the dexamethasone-loaded cells, when returned to circulation, disappeared within the first 24 h. However, the survival of the remaining cells in circulation followed zero order function and declined for 7-8 d after administration. The apparent half-life of the remaining erythrocytes in circulation was 8.27 d by the hypotonic dilution method and 12.8 d by the dialysis method. This indicated that the encapsulated drug had a much longer half life than when free drug (t 1/2, beta = 3.61 +/- 0.69 h) was administered intravenously. Dexamethasone phosphate entrapped within cells was slowly released from the loaded cells into plasma in in vivo circulation. When the encapsulated cells were administered to rabbits, the rabbits were protected from inflammation (the capillary permeability response) caused by histamine for approximately 2 to 5 d after administration. However by day 10 the protection was slight. This anti inflammatory effect agreed reasonably well with the in vivo survival of loaded erythrocytes. Therefore, the results indicated that resealed erythrocytes act as a slow release system in vivo. PMID- 3834057 TI - Different effects of 4-(4'-chlorobenzyloxy)benzoic acid (MII) on lipid synthesis and cell growth in human and mouse skin fibroblasts. AB - The effect of 4-(4'-chlorobenzyloxy)benzoic acid (MII), a metabolite of a new hypolipidemic agent 4-(4'-chlorobenzyloxy)benzyl nicotinate (KCD-232), on lipid synthesis and cell growth was studied in human skin fibroblasts (HSF), mouse skin fibroblasts (MSF) and other rodent-derived cell. MII inhibited sterol synthesis in both HSF and MSF in a dose dependent manner. The drug also suppressed fatty acid synthesis, weakly in HSF and markedly in MSF. The growth of MSF was inhibited by MII in a dose dependent manner, whereas that of HSF was not inhibited at all by MII up to 1 mM. The MII-mediated inhibition of MSF growth was not prevented by the addition to the medium of intermediates of the cholesterol synthetic pathway, i.e., mevalonate, squalene or lanosterol. Furthermore, the growth of several cell lines derived from rodents (L, CHL and AH109A cells) was suppressed by MII. These results suggested a possibility that the different effects of MII on the growth of HSF and MSF might be due partly to differences in the effect of MII on fatty acid synthesis between human and rodent cells. PMID- 3834059 TI - Enhanced rectal absorption of beta-lactam antibiotics in rat by monodesmosides isolated from pericarps of Sapindus mukurossi (Enmei-hi). AB - Monodesmosides, saponin A,B and C, isolated from pericarps of Sapindus mukurossi (Enmei-hi) were shown to promote the rectal absorption of beta-lactam antibiotics in rat, using an in situ loop method and an in vivo method. In the in situ loop method, monodesmosides were solubilized with a mixture of bisdesmosides, mukurozi saponin X, Y1 and Y2, each of which was isolated from pericarps of Sapindus mukurossi. The promoting functions of the three monodesmosides for the rectal absorption of antibiotics were comparable and also suppressed by Ca2+ ion coexisting in the administered solution. Unlike the case of N acylcollagenpeptides, which were also previously reported as absorption promoters, no influence of osmolarity of the administered solution on the absorption promoting action was observed. Absorption of beta-lactam antibiotics from suppositories was enhanced with the aid of either of monodesmosides without solubilizing agent. PMID- 3834060 TI - Effects of some anti-inflammatory drugs on biochemical values and on hepatic peroxisomal enzymes of rat. AB - Effects of tolmetin, diclofenac Na, fenbufen, alclofenac, aminopyrine, mepirizole, thiaramide and aspirin as a positive control, which are widely used in this country as anti-inflammatory drugs, and on body and liver weights, triglyceride and cholesterol level and hepatic peroxisomal enzymes of normolipemic rats were examined. All of these drugs except diclofenac Na affected the enzyme composition of hepatic peroxisomes. Tolmetin (100 mg/kg) and fenbufen (50 mg/kg) increased carnitine acetyltransferase (CAT) and fatty acyl-coenzyme A oxidizing system (FAOS) activities, which participate in hepatic lipid metabolism. The latter also increased the activity of D-amino acid oxidase slightly. Alclofenac (300 mg/kg) increased the activities of FAOS, CAT and carnitine palmitoyltransferase which has been known as the rate-limiting enzyme of fatty acid oxidation in mitochondria, and decreased those of catalase and urate oxidase. Aminopyrine (300 mg/kg) increased the activities of catalase and FAOS. However, none of the above drugs influenced liver weight, serum or liver lipid levels. Mepirizole (300 mg/kg) increased the activities of FAOS and CAT about 2-fold, whereas the activities of catalase and urate oxidase and serum triglyceride level were decreased. Furthermore, these drugs showed no enhancement of the biosynthesis of peroxisome proliferation associated polypeptide having a molecular weight of 80000. From these results, it is concluded that although these drugs have an influence on the enzyme composition of hepatic peroxisomes, they may not induce the peroxisome population in hepatic cells. Thus, the possibility of hepatocarinogenicity and lipid lowering effect through the peroxisome-proliferation would be excluded. PMID- 3834062 TI - Hydrolysis of salicyluric acid in rabbit intestinal microorganisms. AB - The fate of salicyluric acid (SU) after oral administration was examined in rabbits. Salicylic acid (SA) and unchanged SU were detected in the blood after oral administration of SU. However, SU only was found after intravenous administration of SU, suggesting that presystemic deconjugation of glycine was involved. After treatment of rabbits with kanamycin sulfate, complete inhibition of the formation of SA after oral administration of SU was demonstrated, indicating that the intestinal microflora was responsible for the biotransformation. Furthermore, in vitro incubation of SU with contents of gut showed that the major source of the hydrolysis was the hind gut. Based on the findings described above, the time course data for blood concentration of SU and SA after oral administration of SU have been subjected to curve-fitting by a nonlinear least squares program. The SU and SA values obtained with the simplified model containing only first-order kinetic process which is proposed by the present authors were found to agree with those obtained from experiments. PMID- 3834061 TI - Effect of ginseng-20S-prosapogenin on tissue blood flow measured by the hydrogen clearance method in sympathicotonic- or parasympathicotonic-type stressed mice. AB - An attempt was made to investigate the preventive effects of 20S-prosapogenin (20S-PG), a partial hydrolyzate of diol saponins isolated from Panax ginseng, on changes of peripheral tissue blood flow in diseased model animals with vagotonic type autonomic imbalance [SART (specific alternation of rhythm in temperature) stressed (repeated cold-stressed) mice developed by us], and sympathicotonic-type stressed mice [restraint and water immersion-stressed (R WIS) mice], using the hydrogen clearance method. Decreases in gastric blood flow in both body and pyloric regions of the stomach and increases in dermal blood in both the shoulder and lumbar region in SART-stressed mice were prevented to a considerable extent by daily treatments with 20S-PG, 2.5-10 mg/kg/d. Similarly, the marked decrease in gastric blood flow following R WIS loading was significantly blocked by 10 mg/kg/d of 20S-PG. 20S-PG had a minor preventive effect on decreases in hepatic and dermal blood flow in R WIS mice. The preventive effect of 20S-PG on changes in tissue blood flow, recognized in model animals with autonomic imbalance not only in the vagotonic state but also in the sympathicotonic state, is therefore regarded with considerable interest and may provide a clue to explain the pharmacological action of ginseng. PMID- 3834063 TI - Sulfoxide reduction catalyzed by guinea pig liver aldehyde oxidase in combination with one-electron reducing flavoenzymes. AB - The mechanism of the enhancing effect of methyl viologen (MV) and flavin-adenine dinucleotide (FAD) on sulfoxide reduction which is mediated by a combination of aldehyde oxidase (AO) from guinea pig liver and one-electron reducing flavoenzymes, such as milk xanthine oxidase (XO), was examined. The activity of anaerobic reduction of diphenyl sulfoxide (DPSO) to diphenyl sulfide (DPS) was less than 1 nmol/min/mg protein of AO preparation in a system consisting of hypoxanthine, XO and AO. However, the sulfoxide reduction by this system was enhanced about 6- and 100-fold by the additions of FAD and MV, respectively. In the system containing MV or FAD, other one-electron reducing flavoenzymes such as nicotinamide adenine dinucleotide (reduced form) (NADH) dehydrogenase, lipoamide dehydrogenase and glutathione reductase with an appropriate electron donor, could replace XO. The ability of supplemented flavoenzymes to facilitate DPSO reduction correlated with their abilities to reduce MV and FAD. When AO was omitted from the combined system, no sulfoxide reduction was observed. Stoichiometric study revealed that MV semiquinone and FADH2 were oxidized at ratios of 2 and 1 mol, respectively, per mol of DPS formed. These results indicate that either MV or FAD serves as an electron carrier from the supplemented flavoenzymes to AO, a terminal reductase of sulfoxide. PMID- 3834064 TI - Inhibitory effects of intravenous chloramphenicol sodium succinate on the disposition of phenylbutazone in horses. AB - The effects of i.v. chloramphenicol sodium succinate on the pharmacokinetics of i.v. phenylbutazone in six healthy adult horses were investigated. Administration of chloramphenicol sodium succinate to mares reduced mean (+/- SD) phenylbutazone clearance from 0.600 +/- 0.222 to 0.339 +/- 0.123 ml/min per kg and increased mean (+/- SD) half life from 244 +/- 59.8 to 371 +/- 80.8 min and mean residence time from 333 +/- 86.2 to 533 +/- 124 min. The mean steady-state volume of distribution of phenylbutazone was unchanged, with mean (+/- SD) values of 187 +/ 28.9 ml/kg in control animals and 170 +/- 32.4 ml/kg after chloramphenicol sodium succinate. PMID- 3834065 TI - The in vitro development of extended-release solid oral dosage forms. AB - A system is described for developing extended-release products, based upon predicting or simulating the entire plasma level-time curve to be expected from the administration of a controlled-release oral dosage form. Termed "biorelevant dissolution," it employs the product's in vitro dissolution behavior and the drug's pharmacokinetic parameters in conjunction with a classical pharmacokinetic model. The basic system is described along with some pertinent examples. PMID- 3834066 TI - Analysis of pharmacokinetic data using parametric models. II. Point estimates of an individual's parameters. AB - This is the second in a series of tutorial articles discussing the analysis of pharmacokinetic data using parametric models. In this article the basic issue is how to estimate the parameters of such models. Primary emphasis is placed on point estimates of the parameters of the structural (pharmacokinetic) model. All the estimation methods discussed are least squares (LS) methods: ordinary least squares, weighted least squares, iteratively reweighted least squares, and extended least squares. The choice of LS method depends on the variance model. Some discussion is also provided of computer methods used to find the LS estimates, identifiability, and robust LS-based estimation methods. PMID- 3834067 TI - Comments on mean residence time determination. AB - In a recent paper, D. O. Chanter challenged the applicability of the use of statistical moments in estimating mean residence time and proposed an alternative approach. Errors in that paper are pointed out which involve the improper equating of whole-body amount of drug with plasma amount of drug in a kinetic system. The theory for the two methods discussed by Chanter is presented in a pharmacokinetic context. PMID- 3834068 TI - The determination of mean residence time using statistical moments: it is correct. AB - The present communication seeks to end a controversy created by a recent publication regarding the applicability of statistical moment principles for determination of mean residence time of drug in the body tb. It is shown that the equation tb = AUMC/AUC is correct when applied to pharmacokinetic systems in which the total drug elimination rate is directly proportional to the drug concentration in the systemic circulation, i.e., first-order central elimination. More general equations for tb in terms of elimination rate, amount eliminated, and amount in the body are presented along with demonstrations of their utility. PMID- 3834069 TI - Mean residence time in the body versus mean residence time in the central compartment. AB - Mean residence time in the body may be determined by noncompartmental methods following any type of input process into the sampled compartment. Mean residence time in the central compartment can be determined following an intravenous bolus dose, as it requires calculation of the concentration at zero time. For any other input process the mean residence time in the central compartment can be calculated from the elimination rate constant from the central compartment if one accepts the same restrictions used to calculate mean residence time in the body. PMID- 3834070 TI - Effect of protein binding on steady-state equations. AB - Previously published steady-state equations assumed elimination of total drug. The equations have been derived to cover the case where only free (unbound) drug is eliminated. The equation for oral administration is the same in both cases. The equation for intravenous administration has the same form, but the interpretation of Km is different. PMID- 3834071 TI - The macromolecular binding of prednisone in plasma of healthy volunteers including pregnant women and oral contraceptive users. AB - The macromolecular binding of prednisone has been studied in the plasma of eight healthy human volunteers. The subjects included two control males, two control females, two females taking estrogen-containing oral contraceptives, and two females in the third trimester of pregnancy. All volunteers exhibited the expected nonlinear plasma binding of prednisolone with free fraction increasing as the total prednisolone concentration was increased. Both the oral contraceptive and pregnant subjects had increased transcortin binding capacity over the control volunteers as evidenced by their increased binding of prednisolone. Prednisone macromolecular binding, however, was not altered by either changing total prednisone concentration or transcortin binding capacity. The mean prednisone free fraction was 0.250 +/- 0.027 in the eight subjects over the concentration range 0-2500 ng/ml. The addition of prednisolone in up to a 25 fold excess did not alter prednisone's free fraction. Prednisone apparently does not bind to transcortin with the same strong affinity that characterizes prednisolone's binding, and due to albumin's extensive binding capacity, prednisone macromolecular binding is not saturable over the pharmacological drug concentration range. PMID- 3834072 TI - New method for bioavailability assessment of slow-release preparations of theophylline. AB - Variability in an individual's clearance of theophylline is an important consideration when estimating bioavailability. A method is described for compensating for this problem, using the serum concentration of theophylline and urinary excretion data on its major metabolites to make an estimation of the clearance after oral administration using the intravenous dose as reference. The method is particularly useful for assessing the bioavailability of slow-release theophylline preparations. PMID- 3834073 TI - Estimation of area under the curve for drugs subject to enterohepatic cycling. AB - A physiologically realistic model is used to provide insight into the design of sampling protocols for accurate determination of AUC(0-infinity) for drugs subject to enterohepatic cycling. Through simulation of plasma concentration-time curves for such drugs it is found that more than one peak is predicted after oral and intravenous administration of a single dose of drug, the relative magnitude of peaks is dependent on the hepatic extraction ratio for both oral and intravenous drug administration, the percent of the AUC(0-infinity) in later time intervals is also a function of the hepatic extraction ratio, and present methods for the design of sampling protocols may not provide accurate estimates of AUC(0 infinity) (especially for highly extracted drugs), because peaks are only evident at later times after intravenous administration when plasma sampling is less frequent, much of the area occurs at later times, and the amount of drug in the sampling compartment after oral administration is much lower than that after intravenous administration of drug and could be incorrectly interpreted as low bioavailability if sampling is not carried out for a long period of time. The types of oral and intravenous profiles predicted for highly extracted drugs are exemplified by data for naltrexone in the monkey. PMID- 3834074 TI - Molecular aspects of neuronal differentiation. 9th Gif lecture in neurobiology. Gif-sur-Yvette, November 29-30th 1984. PMID- 3834075 TI - Redistribution of acetylcholine receptors during neuromuscular junction formation in Xenopus cultures. AB - At the adult neuromuscular junction, acetylcholine (ACh) receptors are highly localized at the subsynaptic membrane, whereas, embryonic myotubes before innervation have receptors distributed over the entire surface. Thus sometime during development, ACh receptors accumulate to the nerve contact area. This nerve-induced receptor accumulation can be reproduced in Xenopus nerve-muscle cultures, which provides us with a unique opportunity to investigate the underlying molecular mechanism of this event. Anderson and Cohen (1977) have shown that nerve-induced receptor accumulation is, at least partly, due to migration of pre-existing receptors. It is, thus, plausible that freely diffusing receptors in the membrane are trapped at the nerve-contact region and form clusters. We tested this diffusion trap model. First, receptors in the background region are indeed predominantly mobile and those in the cluster are immobile. Second, the diffusion of receptors in the membrane is fast enough to account for the rate of receptor accumulation. Third, when receptors were immobilized by a lectin, Concanavalin A, the nerve no longer induced receptor accumulation. Thus the diffusion trap model seems adequate to accommodate these observations. Aside from this diffusion mediated mechanism, it is conceivable that newly formed receptors are preferentially inserted at the nerve contact site and these new receptors become immobilized at the site of insertion. To test this hypothesis we stained new receptors separately from old ones and quantitatively compared their distribution. For this purpose we developed a method to quantify fluorescence micrographs. We found that the ratio between old and new receptors was similar at all nerve-induced clusters examined and at the diffusely distributed region.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3834076 TI - A physiological study on acetylcholine receptor expressed in Xenopus oocytes from cloned cDNAs. AB - Nicotinic ACh receptor was expressed in Xenopus oocytes by injecting mRNAs produced from cloned cDNAs encoding the four subunits of ACh receptor of Torpedo californica. ACh responses recorded from oocytes 3 days after injection of the mRNAs were reversibly blocked by d-tubocurarine (1-2 microM), indicating that the newly synthesized receptor is of nicotinic type. The reversal potential of ACh response was found at around -1 - -5 mV. The reversal potential was not changed by removal of extracellular C1-, suggesting that the ionic channel of the newly expressed ACh receptor is permeable only to cations. Repetitive applications of ACh caused desensitization of the receptor. The rate of the desensitization was greater when the membrane potential was more negative. Subunit deletion studies showed that all four subunits are required for the formation of ACh receptors with normal ACh sensitivity. However, ACh receptors without delta subunit responded to ACh with low sensitivity. Studies on ACh receptor mutants with subunits altered by site directed mutagenesis of the cDNA suggest that the anphipathic segment is involved in the channel function of the receptor as well as the four hydrophobic segments since partial deletion of amino acids in these segments essentially abolished ACh sensitivity with relatively little change in 125I-alpha-bungarotoxin binding activity. PMID- 3834077 TI - Acetylcholine receptor distribution on regenerating mammalian muscle fibers at sites of mature and developing nerve-muscle junctions. AB - When rat soleus muscles fibers regenerated after notexin-induced damage, AChRs were present at high density on the surface of the new muscle fibers at the sites of the original NMJs, even if the intact motor axons were not present during regeneration. Some AChR molecules which were labelled with R-BgTx before notexin induced damage persisted for some days at junctional sites after new muscle fibres had regenerated. During muscle fiber degeneration, components of the muscle fiber plasma membrane appeared to remain longer in the junctional region than elsewhere. When muscles on which new "ectopic" NMJs had been forming for at least 2 weeks were damaged, AChR clusters together with sites of high AChE activity were present 2 weeks later on the regenerated muscles in the region of new NMJ formation, even if the "foreign" nerve was not intact during the period of regeneration. If ectopic NMJs had been forming for only 4 days at the time of muscle and nerve damage, neither AChR clusters nor AChE activity were detected on the regenerated muscle fibers. PMID- 3834078 TI - Structural and functional studies on N-CAM neural cell adhesion molecules. AB - The neural cell adhesion molecules N-CAM are to date the best characterized adhesion molecules of the nervous system. They have a high content of sialic acid residues which are present in the form of unusual sialic acid polymers. During development, a 3 fold decrease in the sialic acid content is observed. These changes in the degree of sialylation profoundly affect the binding properties of the molecules. A subpopulation of mouse brain N-CAM bears a carbohydrate determinant shared with other brain cell surface proteins and with the HNK-1 antigen of natural killer cells. Not only the carbohydrate side chains but also the protein moieties of the N-CAMs are heterogeneous. Three polypeptides of 180 K, 140 K and 120 K have been characterized in mouse brain. The 180 K and 140 K chains span the membrane. They differ mainly by the length of their cytoplasmic extensions. These intracellular domains are unusually long and contain phosphorylated serine residues. The 120 K chain exists in two forms, one membrane bound and one soluble. Earlier studies had shown the presence of N-CAM on neurones and astrocytes of the mouse central nervous system, whereas cultured astrocytes had been reported to be N-CAM-negative. Recent results show that N-CAM is also expressed on astrocytes in culture. To study expression and heterogeneity of N-CAM polypeptides at the mRNA and gene level, cDNA clones for mouse N-CAM have been isolated. They reveal multiple mRNA species in mouse brain. By contrast, the corresponding sequences seem to be present only a few times, perhaps only once, in the mouse genome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3834079 TI - In vivo and in vitro studies on the segregation of autonomic and sensory cell lineages. AB - Analysis of interspecific quail/chick chimaeras (made by grafting neural primordium from one species to the other) has demonstrated that the neural crest cell population, which gives rises to a large number of derivatives, including the great majority of peripheral ganglion cells, is pluripotential. When peripheral ganglia themselves are transplanted, it can be shown that many of the developmental potentialities of the parent structure are retained, their ultimate expression depending on the microenvironment in which they become located. One of the conclusions obtained from these in vivo studies, that sensory ganglia contain dormant precursors with autonomic potentialities, has been confirmed and extended by the results of in vitro investigations with dissociated 9- to 15-day embryonic quail dorsal root ganglia. Undetectable during normal embryonic development, adrenergic properties (tyrosine hydroxylase immunoreactivity, radio- and cytochemically demonstrable catecholamine production) develop in a population of small, multipolar cells after four days in culture. This differentiation is strongly dependent on the presence of chick embryo extract in the medium. Unlike the postmitotic primary sensory neurons of the ganglia, many of the adrenergic cells were found to incorporate 3H-thymidine during the culture period. These results support the contention that the latent autonomic percursors belong to the non-neuronal compartment of sensory ganglia. PMID- 3834080 TI - Motor endplates in fast and slow muscles of the rat: what determines their difference? AB - Motor endplates in fast and slow skeletal muscles have different functional and morphological characteristics, and for brevity, are termed fast and slow respectively. We have examined the terminal arborization patterns of fast fibular and slow soleus axons 3-4 and 6 months after they reinnervated old preformed endplates or formed new ectopic endplates with denervated rat soleus muscles. Ectopic endplates formed by transplanted fibular and soleus nerves were fast and slow in appearance respectively. Both the fibular and the soleus nerves formed endplates of slow appearance when they reinnervated the original endplates. The fast appearance of ectopic fibular nerve endplates was unaffected by reinnervation of the original endplates by the slow soleus nerve. Dually innervated fibres had intermediate contraction speed compared to the fast fibres reinnervated only by the fibular nerve and the slow fibres reinnervated only by the soleus nerve. Continuous stimulation of the transplanted fibular nerve at 10 Hz for 3-4 months, starting just before the onset of ectopic endplate formation, prevented the increase in contraction speed seen without stimulation. The ectopic endplates of the stimulated axons were much smaller than usual and showed some signs of fast to slow transformation, but the transformation was incomplete and varied in degree between preparations. Transplanted soleus axons were less prone to growing along foreign pathways and to forming ectopic endplates than fibular axons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3834081 TI - Sensorineural hearing loss in chronic otitis media--a statistical evaluation. PMID- 3834082 TI - Bioavailability of aspirin after oral and rectal administration in volunteers and patients with fever. PMID- 3834083 TI - Comparison of two prognostic indices in acute myocardial infarction. PMID- 3834084 TI - Preliminary report on the use of magnesium sulfate in cases of severe pre eclampsia and eclampsia. PMID- 3834085 TI - Vocal cord paralysis: rehabilitation by endoscopic injection of teflon paste. PMID- 3834086 TI - Tracheal rhinosporidiosis (a case report). PMID- 3834087 TI - Bilateral ureteric and renal pelvic invasion by metastatic oesophageal carcinoma (a case report). PMID- 3834088 TI - Primary ectopic ovarian pregnancy (report of three cases). PMID- 3834089 TI - Cervicofacial actinomycosis with upper cervical vertebral involvement and fatal meningitis (a case report). PMID- 3834090 TI - The effect of caffeine on X-ray repair of radioresistant HeLa cells. PMID- 3834091 TI - Microdosimetric distributions for nanometer-size targets in water irradiated with 60Co gamma rays: frequency distributions of total number of effective primary events produced in a target. PMID- 3834092 TI - Incorporation of tritiated water (HTO) and organically bound tritium (OBT) into phospholipids and gangliosides of rat brain. PMID- 3834093 TI - Effects of heat, release from hypoxia, cadmium and arsenite on radiation sensitivity of primordial germ cells in the fish Oryzias latipes. PMID- 3834094 TI - Radiation-induced changes in membrane hydrophobicity in liposomes. PMID- 3834095 TI - Xeroderma pigmentosum groups C and F: additional assignments and a review of the subjects in Japan. PMID- 3834096 TI - Lethal effect of thermal neutrons on hypoxic Ehrlich ascites tumour cells in vitro. PMID- 3834097 TI - Difference in the lethal effects of carcinogens/mutagens among three cultured goldfish (Carassius auratus) cell lines. PMID- 3834098 TI - Serum antibodies to LDH-C4. AB - Human sera from the WHO Reference Bank were tested by a liquid phase radioimmunoassay for antibodies to the sperm-specific form of lactate dehydrogenase (LDH-C4; LDH-X). Modestly elevated levels of antibodies were detected in about 10% of infertile males and females and in about 20% of vasectomized males, as well as in a few cases in other categories. The occurrence of this anti-LDH-C4 activity was without overt correlation with other anti-sperm antibody assays. The primary advantage of the radioimmunometric assay is its absolute specificity for a sperm antigen. These findings lend support to contraceptive vaccine development based on LDH-C4 antigenicity. PMID- 3834099 TI - "Tell me not in mournful numbers". PMID- 3834100 TI - Clinical decision making in chemical dependence treatment: a programmatic model. AB - Chemical dependence treatment has traditionally been based on either an inpatient or outpatient model. With the current emphasis on cost effectiveness, these separate approaches are being intensively scrutinized. Recent studies suggest that not all chemically dependent patients can be treated with the same model and that patient characteristics other than chemical of abuse are significant factors in retention and outcome. A program model is presented which takes into consideration clinical decision making based on patient characteristics, intensity of care and treatment modalities. PMID- 3834101 TI - Reducing the treatment drop out rate in drug abuse programs. AB - Treatment dropout is to drug abuse programs as pain is to cancer. Despite the endemic nature of the premature termination phenomenon, we have successfully reduced patient attrition from 50% to 20%. This article describes our clinical and empirical exploration into the dropout process and presents the major administrative and clinical changes that reduced our dropout rate. Once staff decide that patient dropouts are a staff problem rather than a patient problem, effective intervention can begin. PMID- 3834102 TI - Diary writing as a means to increased self-evaluation. AB - The completion of a structured diary task is considered as a means of increasing self-evaluation. Seventeen drug dependence inpatients completed 5 weeks of the diary. Change was assessed using a self-rating of self-evaluation skill and the Rotter Locus of Control Scale. Pre-post changes on both indices indicated significantly increased internalization/self-evaluation. Clinically, the diary procedure has been helpful in gathering baseline information, encouraging self evaluation habits, facilitating rapport, providing material useful in understanding cognitive style, and validating therapy progress. Clinicians are cautiously encouraged to use the diary procedure with substance dependence patients although design confounding variables limit the extent of the endorsement. PMID- 3834103 TI - What treatment for addiction can do and what it can't; what treatment for addiction should do and what it shouldn't. PMID- 3834104 TI - Identification of borderline personality disorders among substance abuse inpatients. AB - By means of a structured interview procedure, individuals with borderline personality disorders were identified among a sample of 50 patients admitted to an inpatient substance abuse treatment program. When given a series of psychological tests, borderline patients were shown to be more pathological than a nonborderline group of substance abusers in a number of areas including depression, impulse control, antisocial tendencies and reality testing. Time spent in treatment was also shorter for the borderline group. Implications for substance abuse treatment programs and the potential impact of these patients on such programs is discussed. PMID- 3834105 TI - The weekend intervention program at Wright State University School of Medicine, Dayton, Ohio. PMID- 3834106 TI - The experience of arousal: a new basis for studying arousal effects in sport. AB - Sports psychologists have for some time put forward the inverted-U-hypothesis as a useful working model of the relationship between arousal and performance. Although some emphasis in the sports psychology literature has been placed on the limitations of the hypothesis, generally the notion of an optimal level of arousal has been well received. A few authors have been less tolerant of the arguments put forward in the inverted-U-hypothesis and the restrictions of its theoretical stance. Sports psychologists have been slow to suggest or adopt diverse theoretical perspectives and consequently little real progress has been made. The danger is that this approach has become widely accepted almost without question. This review paper attempts to sum up the current position and, based on recent work, recommend alternative interpretations of arousal effects in sport. PMID- 3834107 TI - Determination of the peak power output during maximal brief pedalling bouts. AB - The purpose of this study was to propose an optimization procedure for determining power output during very brief maximal pedalling exercise. Twenty-six healthy male students (21-28 years) performed anaerobic tests on a Monark bicycle ergometer with maximal effort for less than 10 s at eight different loads ranging from 28.1 to 84.2 Nm in pedalling moment. The maximal pedalling rate was determined from the minimal time required for one rotation of the cycle wheel. Pedalling rate decreased linearly with the load. The relationship between load and pedalling rate was represented by two linear regression equations for each subject; one regression equation was determined from eight pairs of pedalling rates and loads (r less than -0.976) and the other from three pairs (at 28.1, 46.8, 65.5 Nm; r less than -0.969). The two regression coefficients of the respective regression equations were almost identical. Mean +/- S.D. of maximal power output (Pmax) which was determined for each subject based on the two linear regression equations for eight pairs and three pairs of pedalling rates and loads was 930 +/- 187 W (13.4 +/- 1.6 W kgBW-1) and 927 +/- 187 W (13.4 +/- 1.6 W kgBW 1), respectively. There was no statistically significant difference between the values of Pmax which were obtained from each equation. It was concluded that maximal anaerobic power could be simply determined by performing maximal cycling exercise at three different loads. PMID- 3834108 TI - The effects of prior exercise on the lactate and ventilatory thresholds. AB - This study examined the effects of prior exercise on the lactate (Tlac) and ventilatory (Tvent) thresholds. Ten healthy male subjects volunteered to perform one-legged cycling. Muscle glycogen reduction was achieved by cycling at 75-85% of maximal heart rate for 60-75 min, and by a low carbohydrate diet. Pre- and post-exercise tests for measuring the thresholds employed a 3-min continuous protocol in 16 W increments. Muscle biopsies (n = 3) were taken from the vastus lateralis before the 'prior exercise' (PE) ride, the post-PE threshold test, and before testing the non-exercised (NE) leg. An i.v. catheter was used for serial blood lactate concentration determination during rest and the final 30 s of each progressive load. Ventilatory gas analyses were performed every 30 s. Biopsies showed that the PE and diet regimen reduced muscle glycogen in the PE leg (46.7%) and NE leg (36.4%). Venous blood lactate and respiratory exchange ratio (R) were reduced at Tlac and Tvent in both the PE and NE leg. The VO2 at a blood lactate concentration of 4 mmol l-1 was elevated in the PE leg at Tlac (2.89 versus 2.46 1 min-1), but not in the NE leg at Tlac. These results suggest that lactate concentration at Tlac and Tvent is reduced by endurance exercise performed 24 h prior to testing, and that the central circulation plays a major role in this response. Furthermore, since blood lactate is reduced at the thresholds by prior exercise, the use of a lactate level of 4 mmol l-1 as a criterion for Tlac should be interpreted cautiously. PMID- 3834110 TI - Communications to the "sport and science" conference. 19-21 September 1985, Chichester, West Sussex. Abstracts. PMID- 3834109 TI - The design and testing of a wire velocimeter. AB - The basic principles underlying the design of a velocimeter based on an unwinding wire, for use in athletics research, are discussed. It is shown by theoretical analysis that, in order to avoid runaway effects, the tension on the wire should be either high or low but not of intermediate strength. The low tension regime is shown to be theoretically the most favourable as it combines high accuracy of speed measurements in decelerated motion with insensitivity to resonance oscillations of the wire. Practical considerations concerning the ruggedness of the apparatus, however, favour the high tension regime. A modern apparatus incorporating microprocessors and working with thin nylon wire stretched by a force of the order of 1 N, i.e. in the high tension regime, has been constructed and tested. The test results show that the velocity of decelerated motions (up to decelerations of the order of 10 m s-2) can be faithfully recorded in the velocity range 0-15 m s-1. The relative error for the measurement of constant speed up to 15 m s-1 is about one in a thousand, which is very small and practically unattainable by other methods. An application to the study of the long jump is demonstrated and validated by the use of film analysis. PMID- 3834111 TI - [32d annual meeting of the Japan Society of Anesthesiology. Abstracts]. PMID- 3834112 TI - [Enkephalin metabolism in human serum--the measurement of Leu-enkephalin-like substance in human serum]. PMID- 3834113 TI - [Monitoring of cerebral and/or spinal cord damage with somatosensory evoked potentials in surgery of thoracic aortic aneurysm]. PMID- 3834114 TI - [Uptake, elimination and biotransformation of isoflurane in dogs]. PMID- 3834115 TI - [Intraoperative changes in plasma folate and cobalamin levels in patients inhaling nitrous oxide]. PMID- 3834116 TI - [Plasma ADH levels during open heart surgery--comparison with buprenorphine diazepam-N2O-O2 anesthesia and fentanyl infusion anesthesia]. PMID- 3834117 TI - [Effects of lidocaine on plasma catecholamine levels]. PMID- 3834118 TI - [Comparison of extravascular thermal volume with portable chest X-ray and gas exchange in progressively improving pulmonary edema]. PMID- 3834119 TI - [Bile aspiration; an experimental study in rats]. PMID- 3834120 TI - [An investigation of arrhythmia during intraoperative cholangiography]. PMID- 3834121 TI - [Intraperitoneal extravasation of an irrigating solution during transurethral resection]. PMID- 3834122 TI - [Repeated chest pain--report of a case]. PMID- 3834123 TI - [Anesthetic management of an infant with laryngeal web]. PMID- 3834124 TI - [Clinical report of anesthesia for ESWL (extracorporeal shock wave lithotripsy)]. PMID- 3834125 TI - [Effects of cardiac sympathetic nerve stimulation on ischemic canine heart during GOF and GO morphine anesthesias]. PMID- 3834126 TI - [Anesthetic management of coronary patients]. PMID- 3834127 TI - [Problems in anesthesia of coronary patients]. PMID- 3834128 TI - [Clinical and experimental analysis of AIKA AM210 anesthetic system]. PMID- 3834129 TI - [Clinical experience of latamoxef in the field of neurosurgery on the penetration into the cerebrospinal fluid in the patients with postoperative meningitis]. AB - Latamoxef (LMOX) at a dose of 2 g was intravenously administered to 12 cases with postoperative meningitis and the concentrations in serum and cerebrospinal fluid (CSF) were examined up to 2 hours and the results obtained were as follows; The average serum and CSF concentrations of LMOX were 125.0 micrograms/ml, 4.33 micrograms/ml at 0.5 hour, 80.7 micrograms/ml, 4.64 micrograms/ml at 1 hour and 45.8 micrograms/ml, 3.82 micrograms/ml at 2 hours, respectively. The clinical responses of LMOX against postoperative meningitis were revealed excellent in 4 cases and good in 8 cases. No side effects were observed. LMOX was thought to be effective agent in the treatment of the postoperative meningitis. PMID- 3834130 TI - [Clinical study on the penetration of latamoxef into the pulmonary tissue in surgery of the chest]. AB - In the surgery of the chest, we are often experienced pulmonary infections, so it is considered that the grasping antibiotic levels in pulmonary tissue is very important because of the decision of antibiotic dose schedule against pulmonary infections. For this purpose, latamoxef (LMOX) at a dose of 2 g was intravenously administered to 14 cases with pulmonary cancer, 3 cases with pulmonary tuberculosis, 2 cases with pulmonary abscess and 1 case with bronchiectasis, totally 20 cases and the concentrations in serum, pulmonary tissue, bronchia and sputum were measured up to 6 hours and the results obtained were as follows; The average serum concentration of LMOX was 137.2 micrograms/ml at 1/2 hour and decreased gradually, fell to 20.3 micrograms/ml at 6 hours. The average levels of LMOX in normal alveolus of pulmonary tissue and in bronchia were 63% and 48% of the serum level, respectively. The average level of LMOX in inflammatory alveolus of pulmonary tissue was approximately 20% lower than the normal alveolus. The average level of LMOX in sputum increased gradually and appeared 4.6 micrograms/ml at 6 hours. LMOX was shown a good results on the penetration into the pulmonary tissue and its level almost exceeded the minimal inhibitory concentration against clinical isolates from sputum of respiratory tract infections. PMID- 3834131 TI - [Concentrations of clindamycin phosphate in lung tissues]. AB - There are few reports on concentrations of antibiotics in human lung tissues. The concentrations of clindamycin (CLDM) in human lung tissues were determined in 11 patients with lung tumor who were treated with the antibiotic. In the case of 600 mg drip infusion for 1 hour, the concentrations of CLDM in lung tissues were 24 micrograms/g and 23 micrograms/g, 2 and 3 hours after the start of drip infusion, respectively. In the case of 1,200 mg drip infusion, the value reached 47 micrograms/g in 2 hours and 39 micrograms/g in 3 hours. The concentrations in lung tissues were about 4-5 times higher than in blood. PMID- 3834132 TI - [Effect of fosfomycin on auditory organs and its transfer to cochlear lymph following application of its solution into a middle ear cavity]. AB - Male guinea pigs were given 0.1 ml of 2, 3 or 5% fosfomycin (FOM) ototopical solution once a day for 5 days into a middle ear cavity through artificially perforated ear drum. Kanamycin A (KM) was used at 2% ototopical solution as control drug. Four animals of each group were sacrificed under pentobarbital anesthesia to isolate the cochlea 10 days after the final application. The cochlea was washed with 0.1 M phosphate buffer (pH 7.0), followed by fixing with 2.5% glutaraldehyde and 1% osmic acid. Cochlear specimens were prepared by standard method for scanning electron microscopic observation. The scanning electron microscopic observations revealed some damages in outer and inner hair cells, such as partial deformation or loss of auditory hair in hair cells, but these damages were not correlated to drug treatments. In order to determine the transfer of FOM and KM from middle ear cavity to cochlear lymph in male guinea pigs, the cochlear lymph was collected 0.5, 1, 2 and 4 hours after an application of 0.1 ml of 3 or 5% FOM and 2% KM ototopical solution into a middle ear cavity, followed by estimating content of these antibiotics in the lymph. The results showed the peak concentration in lymph at 1 to 2 hours after an application of 3% FOM was lower than that after 2% KM, but the AUC of 3% FOM was higher than that of 2% KM. The AUC value of FOM was dependent on the applied concentration of FOM. The value of half-life time was about 4.8 hours at FOM and about 2.3 hours at KM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3834133 TI - [Fundamental and clinical studies on aztreonam in obstetrics and gynecology]. AB - Aztreonam (AZT), a monobactam antibiotic, is known to have a high activity against Gram-negative bacteria. Fundamental and clinical studies were carried out on AZT with the following results. Following 1 g of bolus intravenous injection, the transfer of AZT to uterine artery and internal genital organs was found to be satisfactory. The levels of the drug in uterine artery showed 34.28, 4.50 micrograms/ml at approximately 2, 6 hours, and those in internal genital organs showed 3-34 micrograms/g at 2 hours. Clinical efficacy was; excellent in 4 cases, good in 13 cases and poor in 1 case, with the very high overall efficacy rate of 94.4%. Abnormal laboratory findings and side effects due to the drug were not noted. PMID- 3834134 TI - [Preclinical and clinical studies on aztreonam in obstetrics and gynecology]. AB - Aztreonam (AZT), a new monobactam antibiotic, was studied in obstetrics and gynecology with the following results. The tissue concentration of AZT in the female genital organs was relatively high at the portio vaginalis and the cervix uteri followed by at the ovary and the myometrium, but the distribution to the endometrium and the oviduct was a little poor. The concentration of AZT in the pelvic dead space exudate was highest at 2 hours after intravenous injection whereas it was highest at 5 hours after intravenous drip infusion. However, there was no significant difference in the concentration between intravenous injection and intravenous drip infusion and the distribution to the pelvic dead space exudate was relatively good. AZT was clinically administered to pyometra (3 cases), puerperal endometritis (3), adnexitis and endometritis (3), pelvioperitonitis (1), Bartholin's abscess (4) and purulent vulvitis (1), a total of 15 cases with an overall effective rate of 93.3%. AZT was microbiologically effective for Gram-negative bacteria such as E. coli and K. pneumoniae, but also effective for anaerobes and some Gram-positive bacteria, etc., for which MIC of AZT is high. With regard to safety of AZT, neither side effects nor abnormal laboratory findings were reported. PMID- 3834135 TI - [Clinical effect of aztreonam in infections in obstetrics and gynecology]. AB - Aztreonam (SQ 26,776, AZT), a new monobactam antibiotic, was studied in obstetrics and gynecology with the following results. For the study of tissue penetration, 1 g AZT was administered by intravenous drip infusion for 1 hour. The concentration was high in elbow venous blood and uterine arterial blood 60 minutes after the administration. Each uterine tissue concentration other than the endometrium was as high as 26.7-31.7% of the blood level and salpinx and ovary concentration were 25.9% and 5.2%, respectively. Each tissue concentration decreased to less than 0.6 microgram/g in the uterine, the ovary and the salpinx 280 minutes thereafter. In the review of obstetric and gynecologic genital infections, clinical efficacy of AZT was "poor" for 1-endometritis, "poor" for 1 pyometra, "excellent" for 1-puerperal fever, "excellent" (1) and "good" (2) for 3 pelvioperitonitis, "excellent" for 1-parametritis and "good" for 2-infectious lymphocele with overall effective rate of 77.8% (7/9). AZT was microbiologically effective for Gram-negative bacteria, such as E. coli, K. pneumoniae, etc. As for safety, neither side effects nor abnormal laboratory findings in the examination of blood, hepatic function, renal function and urine due to AZT were reported. PMID- 3834136 TI - [Clinical efficacy of aztreonam in pelvic peritonitis]. AB - Aztreonam (AZT) was evaluated for its clinical efficacy in 6 patients with pelvic peritonitis. In all the cases, AZT was administered by intravenous injection, and the duration of treatment ranged from 4 to 12 days. Daily dose was 2 g in 4 cases, and 4 g in the remaining 2 cases. Surgical treatment was necessary in 2 cases, whereas in another 2 cases, either LMOX or ABPC was administered in addition to AZT. The clinical results was excellent or good in 5 out of 6 cases. Side effects possibly attributed to AZT were diarrhea in 2 cases and slight increase of GOT and GPT in 1 case, although they disappeared promptly afterward. PMID- 3834137 TI - [Clinical studies on aztreonam in various infections in obstetrics and gynecology]. AB - Aztreonam (AZT) was administered to 10 patients with obstetric and gynecologic infections to evaluate its clinical effect. Two-four grams of AZT per day (b.i.d.) were administered for the treatment for 4-15 days by intravenous drip infusion or intravenous injection. AZT was effective for 3 cases of pelvic peritonitis, 1 case of pyoovarium and 2 cases of Bartholin's abscess. For 2 cases of intrauterine infection, AZT was effective for 1 case, and the other case could not be judged. For 2 cases of local infection, AZT was effective for 1 case and ineffective for 1 case. Efficacy rate was 89% for the 9 cases excluding the 1 unevaluable case. Microbiological effect was determined for 4 out of 10 cases. Two strains of Haemophilus influenzae and one each of Escherichia coli, Bacteroides fragilis and Streptococcus intermedius were isolated, but all of them were eliminated for a elimination rate of 100%. Neither abnormal laboratory findings in hepatic or renal functions, etc. nor side effects were recognized. PMID- 3834138 TI - [Preclinical and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - Penetration of aztreonam (AZT) into the uterus and the adnexal tissues and usefulness and safety of AZT for obstetric and gynecologic infections were studied with the following results. By one shot intravenous injection of AZT 1 g, the uterus and the adnexal tissues showed favorable penetration with Cmax 27.0 48.5 micrograms/g, AUC 29.4-84.9 micrograms X hr/g and Tmax 0.10-0.44 hours. MIC50, MIC80 and MIC90 of AZT for Gram-negative bacteria measured prior to administration were very low being 0.10 micrograms/ml, 0.20 micrograms/ml and 1.56 micrograms/ml, respectively. Clinical effect of AZT for 30 infection cases in obstetrics and gynecology was evaluated according to an overall efficacy criteria resulting in "good" for all the cases. With regard to microbiological effect, 90.9% of the pathogens isolated prior to the administration were eliminated by AZT. During and after the administration of AZT, side effect due seemingly to AZT was not observed in subjective and objective symptoms and laboratory values. PMID- 3834139 TI - [Clinical evaluation of aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (AZT), a new monobactam antibiotic was evaluated on clinical efficacy and bacteriological response in gynecological and obstetrical infections, and the following results were obtained. AZT was given to 22 cases with obstetrical and gynecological infections at a dose of 1 g X 2 times daily and 86.4% of clinical efficacy, 45.5% of eradicated rate on diagnosis, 52.5% of bacteriological response on isolated organisms and 83.3% of bacteriological effect on cases isolated Gram-negative bacteria were assessed. Side effect incidence was very low. PMID- 3834140 TI - [Tissue penetration and clinical experiences of aztreonam in obstetrics and gynecology]. AB - Tissue penetration and clinical efficacy were studied on aztreonam (SQ 26,776, AZT) in obstetrics and gynecology with the following results. Number of cases was too small to sufficiently review the penetration into each uterine tissue, the ovary and the tube after the intravenous injection of AZT 1 g. Overall clinical effect for all the 6 cases reviewed was more than "good". Also, neither side effect nor abnormal laboratory findings were reported. From the above results, AZT was considered to be a highly useful antibiotic in obstetrics and gynecology. PMID- 3834141 TI - [Basic and clinical studies of aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (AZT), a new monobactam antibiotic, was basically and clinically applied to the field of obstetrics and gynecology, obtaining the following results. The pelvic dead space exudate level of AZT after 30 minutes-intravenous drip infusion of 1 g attained the peak of 22.66 micrograms/ml at 1 hour from initiation of infusion and thereafter declined gradually, contrasting the peak of 34.38 micrograms/ml of the cubital vein at 30 minutes. Total of 13 cases comprising 4 with intrauterine infection, 5 with adnexitis and 4 with pelveoperitonitis were intravenously treated with AZT at a dose of 1 g twice daily. The overall clinical results were excellent in 3 cases and good in 10 cases. No side effects were observed in any of the cases treated with AZT. PMID- 3834142 TI - [Clinical experience on aztreonam]. AB - Aztreonam (AZT), a new monobactam antibiotic, was studied for clinical efficacy in the field of gynecologic infection. AZT was administered at a daily dose of 2 g in 2 divided doses by single shot intravenous injection. The subjects were patients with the following infections: adnexitis (6), pelvic peritonitis (5), endometritis (1) and wound abscess (1). Good response was seen in 10 patients out of 13. The overall efficacy rate of 76.9% was obtained. Slight increase in GOT, GPT and Al-P was seen in 1 case. It was normalized on 6th day after completion of the therapy. No notable side effects were observed. PMID- 3834143 TI - [Fundamental and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - The following results were obtained through the fundamental and clinical studies of aztreonam (AZT), a new monobactam antibiotic, in obstetrics and gynecology. Satisfactory tissue penetration was not recognized in 3-5 hours after intravenous injection of 1 g. However, the concentration was more than MIC for the majority of aerobic Gram-negative bacteria in intravenous drip infusion of AZT 1 g and in intravenous injection and intravenous drip infusion of 2 g. There was no difference of serum concentration of AZT between uterine arterial blood and cubital venous blood. AZT was administered by intravenous drip infusion to 2 cases of puerperal endometritis, 2 cases (the same patient) of vaginal wall abscess, 1 case of postoperative lymphocele infection and 1 case of infected ovarian cyst suspected, and it was effective for all of them. Neither subjective/objective side effects nor abnormal laboratory findings were noted in any case. PMID- 3834144 TI - [Clinical trial of aztreonam in the field of obstetrics and gynecology]. AB - Clinical effect and safety of aztreonam (AZT) in the obstetrics and gynecology were studied in 17 cases of obstetric and gynecological infections. AZT was administered at a dose of 2 g per day by intravenous drip infusion, for 4-8 days depending on severity of the disease. The results showed that AZT was effective in 14 out of 17 cases and the overall efficacy rate was 82.4%. E. coli, Enterobacter, E. faecalis, etc. were detected in 8 out of 17 cases, and after AZT treatment other strains appeared in 3 clinically effective cases. There was a slight elevation of GOT and GPT in 1 case but no other appreciable side effect or abnormal laboratory value was observed. PMID- 3834145 TI - [Tissue penetration of aztreonam in obstetrics and gynecology]. AB - The following results were obtained by measuring serum and tissue concentrations of aztreonam, a new monobactam antibiotic. Penetration into each tissue was favorable, particularly, to the portio vaginalis, but there was no conspicuous difference of the penetration among other tissues. Serum concentration tended to decrease with the lapse of time, but the concentration in each tissue did not show a specific pattern of change due to a considerable irregularity of the measured concentrations. No specific side effect was noted. PMID- 3834146 TI - [Fundamental and clinical studies on aztreonam in the gynecological field]. AB - Aztreonam (AZT), a new monocyclic beta-lactam antibiotic was studied on clinical efficacy for infectious disease in gynecological field. At about 80 minutes following intravenous injection of 1 g dose of AZT, it penetrated well into internal genital organs at therapeutic levels. Moreover it transferred very fast and enough into intrapelvic dead space exudate, and its level was kept still as high at 12 hours after administration. AZT was given to 20 women affected with gynecological infectious disease. The outcome of AZT therapy was as follows: effective in 5 out of 6 patients (83.3%) administered intravenously and in all of 14 patients (100%) received intramuscularly. Notable adverse effects or abnormal laboratory findings were not observed except 1 case of diarrhea and 2 cases of transient and slight elevation of serum CPK and transaminases. Based on these results, we may conclude that AZT is a highly effective and a very safe antibiotic for the treatment of infectious disease in gynecological field. PMID- 3834147 TI - [Fundamental and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (AZT) was studied for the transfer into the pelvic dead space exudate in 5 patients who received radical hysterectomy due to uterocervical cancer, and for the clinical efficacy in the treatment of 5 cases of obstetrical and gynecological infections. Transfer into the pelvic dead space exudate Data analysis was performed by the simulation curves prepared from pharmacokinetic parameters using the two-compartment model. On examination, the serum concentration of cubital venous serum was found to be 53.20 micrograms/ml at 1 hour after the start of 1-hour intravenous drip infusion of 1 g of AZT. Also, the shifting concentration of the pelvic dead space exudate was found to have reached its peak value of 12.79 micrograms/ml at 3.22 hours after the start of the infusion, and still showed the value of more than 7 micrograms/ml even at 8 hours after the start of the infusion. The AUC was 112.81 micrograms X hr/ml. Clinical evaluation AZT was administered at a daily dose of 2-4 g in 2 divided doses by intravenous injection and intravenous drip infusion for 60 minutes. Clinical efficacy of the 5 patients with acute and moderate degree obstetrical and gynecological infections was; excellent in 1 case, good in 3 cases and poor in 1 case, with the overall efficacy rate of 80.0%. PMID- 3834148 TI - [In vitro activity and clinical evaluation of aztreonam in the field of obstetrics and gynecology]. AB - Antimicrobial activity of aztreonam (AZT) against 231 clinical isolates in the field of obstetrics and gynecology was determined by agar-plates dilution method. Almost of all strains of E. coli (108 strains) tested were susceptible to the concentration of 0.20 micrograms/ml of AZT. Anaerobic bacteria, however, were less susceptible to this antibiotic than to cefazolin. The concentrations of AZT were determined in serum and pelvic tissue samples obtained at various intervals after 1 hour intravenous drip infusion with 1 g. The concentrations of AZT in pelvic tissues were maximal 9.3 micrograms/g at 57 minutes but less than 0.6 micrograms/g at 3 hours or more after injection. Clinical efficacy of AZT was evaluated in 6 cases consisted of two each with Bartholin's abscess and intrauterine infection and one each with post partum endometritis and acute adnexitis. Clinical efficacies were seen in 5 cases. PMID- 3834149 TI - [Fundamental and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - Fundamental and clinical studies on aztreonam (AZT), a new synthetic monobactam antibiotic, were performed and following results were obtained. Concentration of AZT was examined in serum, internal genital tissues and retroperitoneal fluid after a single intravenous administration of 1 g dose. The venous serum level of AZT was 114.0 micrograms/ml at 10 minutes after the administration, then decreased to 7.0 micrograms/ml at 3 hours. Since concentration of AZT in examined tissues showed wide variation, it was irrelevant to calculate transfer ratio. Concentration in retroperitoneal fluid made the peak of 40.0 +/- 22.6 micrograms/ml at 1 hour after the administration, then slowly decreased to 13.4 +/- 3.2 micrograms/ml at 6 hours. Judging from above data, the transfer of AZT to retroperitoneal fluid was favorable. In clinical trial, AZT was given to 17 cases with obstetrical and gynecological infections such as endometritis, uterine adnexitis, pelvic peritonitis, parametritis and lymphocystitis. The efficacy was evaluated as excellent in 2 cases, good in 12 and poor in 3, and efficacy rate was 82.4%. No side effects were observed in any of the cases. In laboratory findings, transient elevation of liver function in 2 cases and eosinophilia in 1 case were noticed. PMID- 3834150 TI - [Fundamental and clinical studies of aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (AZT, E-0734), a new beta-lactam antibiotic, was fundamentally and clinically studied. The following results were obtained. The serum and internal genital tissue levels for AZT after 1 g intravenous injection had been kept at more than about 20 micrograms/ml and 3.0 micrograms/g, respectively, during 1 hour. AZT was administered at 1-2 g of daily dose by intravenous injection or intravenous drip infusion to 5 patients with obstetric and gynecological infections, comprising 1 of pyometra, parametritis, Bartholin's abscess, puerperal endometritis and diffuse peritonitis. Clinical efficacy was; excellent in 1 puerperal endometritis case, good in 2 cases and poor in 2 cases. Neither side effect nor abnormal laboratory finding was observed. PMID- 3834151 TI - [Fundamental and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (SQ 26,776, AZT), a new monobactam antibiotic, was fundamentally and clinically studied with the following results. Uterine and adnexal concentrations of AZT after intravenous injection of 1 g were highest 3 hours after administration in the ranges of between 18.6-23.4 micrograms/g 16.5-28.2 micrograms/g, respectively, and and rapidly decreased thereafter. Penetration of AZT into the pelvic dead space exudate was quickly recognized after intravenous injection of 1 g and its concentration 30 minutes after administration was 14.08 +/- 7.08 micrograms/ml and highest (22.35 +/- 5.85 micrograms/ml) 2 hours after administration. It gradually decreased to 8.50 +/- 2.07 micrograms/ml 6 hours after administration. Clinical effect was studied by administering 1-3 g of AZT twice a day for 3-16 days by intravenous drip infusion for 18 patients with various infections in the field of obstetrics and gynecology. Efficacy of AZT for 9 genital infection cases were excellent for 4 cases, good for 4 cases and poor for 1 case, with an overall efficacy rate of 88.9%. For 2 UTI cases, it was excellent for one case and good for the other, and for 4 pelvioperitonitis cases, excellent for 3 cases and good for 1 case. For 2 inflammation cases of the pelvic dead space, efficacy of AZT was excellent for both of them. With regard to side effect, there was only one rash case experienced. It was considered from the above results that AZT is sufficiently useful for the infections in the field of obstetrics and gynecology and also useful for various gynecologic surgery cases. PMID- 3834152 TI - [Fundamental and clinical studies on aztreonam in the field of obstetrics and gynecology]. AB - Fundamental and clinical studies were performed on aztreonam (AZT), a new antibiotic with single beta-lactam ring, with the following results. Following intravenous drip infusion of 1 g, transfer of AZT to the internal genital organs was found to be good. Transfer of AZT to exudate of pelvic dead space was also good. AZT was given to 6 cases, who had gynecological or obstetrical infectious disease. AZT was effective in the 5 cases out of 6, although it showed high MIC against bacteria isolated from the effective cases. The above results demonstrated that AZT was a safe and effective drug. PMID- 3834153 TI - [Study on transfer of aztreonam into female genital organs]. AB - Aztreonam (AZT) is a newly developed beta-lactam antibiotic for use of intravenous injection. It is the first drug in the world of monobactam series with the structural characteristic of monocyclic beta-lactam. The antimicrobial spectrum of AZT is unique, having little or no susceptibility against Gram positive organisms and anaerobes, but showing high susceptibility against aerobic Gram-negative rods including Pseudomonas. One gram of AZT was given intravenously to 32 patients prior to abdominal total hysterectomy for uterine myoma. Bilateral uterine arteries were clamped at 0.25, 0.5, 1, 2, 4, 8 or 12 hours after administration, and serum samples and uterine tissues were taken for the measurement of AZT concentration by bioassay method. Little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half-lives of both being 2.11 hours. The initial concentrations were estimated to be 68.0 micrograms/ml and 63.9 micrograms/ml, respectively. While the peak concentrations of the portio vaginalis, cervix uteri, myometrium and oviduct were obtained at about 10 minutes, those of the endometrium and ovary were at 18.2 minutes and 31.3 minutes, respectively. They were as follows; the portio vaginalis 50.0 micrograms/g, the cervix uteri 43.6 micrograms/g, the myometrium 29.8 micrograms/g, the oviduct 44.7 micrograms/g, the endometrium 27.3 micrograms/g, the ovary 29.0 micrograms/g. After showing peak, tissue levels were kept fairly high up to 3 hours, then decreased gradually as time passed up to approximately 8 hours. Judging from its favorable transfer into the uterine tissues and MICs against main clinical isolates in the field of obstetrics and gynecology, AZT is evaluated to be clinically useful in the treatment of obstetrical and gynecological infections. PMID- 3834154 TI - [Fundamental and clinical studies on aztreonam]. AB - Aztreonam (AZT), a new monocyclic beta-lactam antibiotic, was studied on the transfer into intrapelvic tissues and on the clinical efficacy in the treatment of 19 cases of obstetrical and gynecological infections. The AZT levels were examined in the pelvic dead space exudate in 6 patients who received radical hysterectomy due to uterocervical cancer. The simulation curves for AZT were well performed after the decision of the pharmacokinetic parameters using the two compartment model. Following 1-hour intravenous drip infusion of 1 g of AZT, the peak concentration of AZT in cubital venous blood was estimated 73.3 micrograms/ml at the end of infusion. The peak concentration of AZT in the pelvic dead exudate was estimated 18.6 micrograms/ml at 2.31 hours after infusion. Following intravenous 1-hour drip infusion of 1 g, the transferred level of AZT into uterine tissues was maintained at the effective concentration which means the excess level of the MIC against clinical isolates often observed in the field of obstetrics and gynecology. AZT was administered 2-4 g/day in 2 times a day by intravenous drip infusion for 60-90 minutes. The subjects were 19 patients with the following infections; pyometra (1), puerperal intrauterine infection (4), postoperative parametritis (4), pelvioperitonitis (2), purulent lymphocyst (1), acute salpingoophoritis (1), vaginal stump abscess (1), Douglas abscess (2), pelvioperitonitis + pyosalpinx (2), vulval abscess (1). Clinical efficacy was; excellent in 2 cases, good in 11 cases and poor in 6 cases. No notable side effect or abnormal laboratory finding was noted. PMID- 3834155 TI - [Clinical studies on aztreonam in infections in obstetrics and gynecology]. AB - Clinical effect was studied for aztreonam (AZT) on 2 patients being treated for malignant tumors. One-two grams of AZT was administered b.i.d. by intravenous drip infusion for 6-7 days. In case 1 with pyometra, there were excellent improvements in WBC, CRP and fever pattern. Unfavorable BUN and S-Cr. values were found, but these were considered to be side effects due to cisplatin. These improved finally, and clinical effect was also excellent. Case 2, a urinary tract infection + prophylactic postoperative administration case, was treated in combination with another drug presuming mixed infection and AZT was shown to be effective clinically and overall. No side effects in cases 1 or 2 were considered to be due to AZT. PMID- 3834156 TI - [Pharmacokinetics of aztreonam in peripheral venous serum, uterine arterial serum and intrapelvic female organs]. AB - The concentrations of aztreonam (SQ 26,776, AZT, Squibb) in peripheral venous serum, uterine arterial serum and intrapelvic female organs were determined by bioassay, using the cylinder-plate diffusion method, in 27 women with simple total hysterectomy. With an intravenous injection of AZT 1 g, the maximum levels of peripheral venous serum and uterine arterial serum were 76.39 micrograms/ml and 76.38 micrograms/ml, respectively. Also, the biological half-life (T1/2) was 1.56 hours in peripheral venous serum and 1.54 hours in uterine arterial serum. The concentration in uterine arterial serum was more than 1.8 micrograms/ml at 8 hours after injection and maintained at a high level than the minimal inhibitory concentration necessary for most Gram-negative bacteria for at least 8 hours. The concentrations of AZT in female genital organs were kept higher than the minimal inhibitory concentration against E. coli at 4 hours after injection, and the ratios of the concentrations in uterine tube and endometrium to that in peripheral venous serum were 0.40 +/- 0.18 and 0.30 +/- 0.20, respectively. Since AZT is characterized by more potent antibacterial activity against Gram-negative bacteria and the minimal side effects, intravenous administration of AZT at 1 g or 2 g per day may be an adequate dose for infections of the female urogenital tract. PMID- 3834157 TI - [Clinical experience with aztreonam in the field of obstetrics and gynecology]. AB - Aztreoman (SQ 26,776, AZT), a synthetic monobactam antibiotic, was applied clinically in the field of obstetrics and gynecology. AZT was administered by intravenous drip infusion for 6 to 8 days at a daily dose of 2 g divided in 2 times to 5 cases. Klebsiella in 1 case with puerperal endometritis, Enterococcus, Propionibacterium and Bacteroides in each 1 case with pyometra was isolated. The clinical effect of Klebsiella was excellent. Bacteroides in 1 not-examined case was good. Enterococcus and Bacteroides with pyometra was not effective. Side effects were observed in 2 cases. One case with eclampsia arised LDH and A1-P in serum and 1 case with hepatitis arised GOT and GPT in serum. PMID- 3834158 TI - [Clinical evaluation of aztreonam in the field of obstetrics and gynecology]. AB - Aztreonam (AZT) was evaluated for its clinical efficacy in a total of 10 cases, namely 3 cases of endometritis, 6 cases of intrapelvic infections, 1 case of puerperal pyelonephritis. The clinical results of AZT were as follows; excellent in 5 cases and moderate in 5 cases, the overall efficacy rate was 100%. No clinical side effect was observed, however in laboratory finding slightly elevated transaminase (GOT, GPT) was observed in 1 case. PMID- 3834160 TI - [Clinical usefulness of the simplified acidified glycerol lysis test (AGLT) in hereditary spherocytosis]. PMID- 3834159 TI - [Fundamental and clinical studies on aztreonam in obstetrics and gynecology]. AB - Fundamental and clinical studies on gynecological use of aztreonam (AZT), a new monobactam, were performed with following results. Following the intravenous administration of 1 g dose of AZT, the transfer of AZT to pelvic dead space exudate was good, in which the concentration of that was 14.9 micrograms/ml (2 hours), 15.3 micrograms/ml (3 hours) after injection. The transfer of AZT to serum of umbilical cord and amniotic fluid was excellent. In a clinical trial, AZT was given to 5 patients with obstetric and gynecological infections. The clinical efficacy was evaluated as excellent in 1 case and good in the other 4 cases. No adverse effects were observed in any of the patients treated with AZT. PMID- 3834161 TI - [Quantitation of platelet-associated IgG (PA-IgG) on neuraminidase-treated platelets]. PMID- 3834162 TI - [Detection of HLA-Bw4 antibody in an alloimmunized patient with nonlymphocytic leukemia]. PMID- 3834163 TI - [High dose cytosine arabinoside (HDCA) in children with refractory leukemia or malignant lymphoma (3 g/m2 vs 1.5 g/m2)]. PMID- 3834164 TI - [Tetraploidy in a child with non-Hodgkin's lymphoma]. PMID- 3834166 TI - [An autopsy case probably of acute megakaryoblastic leukemia associated with hypotetraploid chromosomal abnormality]. PMID- 3834165 TI - [A case of multiple myeloma producing an incomplete IgG with partial structural deletion in the heavy chain]. PMID- 3834167 TI - [A case of diffuse fasciitis with eosinophilia]. PMID- 3834168 TI - [Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL) characterized by cutaneous involvement]. PMID- 3834170 TI - [CT-map of hilar and mediastinal lymph nodes for determining N-factor of lung cancer]. PMID- 3834169 TI - [A patient with severe aplastic anemia responding to sequential immunosuppressive therapy]. PMID- 3834171 TI - [Transcatheter arterial embolization in metastatic liver tumors]. PMID- 3834173 TI - [Percutaneous extraction of biliary and urinary calculi]. PMID- 3834172 TI - [Splenic embolization in hypersplenism--comparison of steel coil and Gelfoam]. PMID- 3834174 TI - [Juvenile rheumatoid arthritis]. PMID- 3834175 TI - [Two cases of the anterior inferior cerebellar arteries arising from the internal carotid artery]. PMID- 3834176 TI - [Two cases of pulmonary sclerosing hemangioma--radiological findings]. PMID- 3834177 TI - [Localization of thrombi using the Ga-67-DFO-DAS fibrinogen]. PMID- 3834178 TI - [Modified pigtail catheter in aortography]. PMID- 3834179 TI - [Lipid metabolism in xanthoma]. PMID- 3834180 TI - [Elucidation of melanogenesis and its application to clinical diagnosis and treatment]. PMID- 3834181 TI - [Fundamental techniques of skin surgery]. PMID- 3834182 TI - [Mechanisms of drug-resistance in Staphylococcus aureus]. PMID- 3834183 TI - [Lipid peroxidation and cell damage]. PMID- 3834184 TI - [House dust mite allergy:--the skin and the mite]. PMID- 3834185 TI - [Basement membrane zone of skin tumors]. PMID- 3834186 TI - [Action mechanism of glucocorticoids]. PMID- 3834187 TI - [Antiandrogens]. PMID- 3834188 TI - [Site of action of retinoids]. PMID- 3834189 TI - [Non-steroid anti-inflammatory therapy]. PMID- 3834190 TI - Isolation of two unique fractions from the cerebrospinal fluid of Alzheimer disease patients. AB - The cerebrospinal fluid from five patients with Alzheimer disease and five age matched controls was fractionated into 7 to 9 fractions utilizing chromatographic techniques. The cerebrospinal fluid from each of the five Alzheimer disease patients contained two fractions (fractions B and C) which were lacking in the cerebrospinal fluid of the five age-matched controls. In addition, when the elution profiles of the Alzheimer disease and control cerebrospinal fluid were compared, fraction A, which was found in every cerebrospinal fluid sample studied, was eluted slightly faster in the Alzheimer disease samples than in the cerebrospinal fluid samples from the age-matched controls. Furthermore, it is believed that fraction A isolated from the control cerebrospinal fluid consists of aggregated immunoglobulin molecules and that fraction A isolated from the Alzheimer disease patients' cerebrospinal fluid might consist of immune complexes. Each of the purified cerebrospinal fluid fractions from both control and Alzheimer disease patients was studied for its ability to inhibit macrophage mediated tumor cytotoxicity as well as activate macrophages to kill tumor cells. Each activate macrophages to kill tumor cells. None of the purified cerebrospinal fluid fractions obtained from the controls could inhibit macrophage mediated tumor cytotoxicity whereas 4 of the 9 purified fractions isolated from the Alzheimer disease patients inhibited macrophage mediated cytotoxicity by more than 50%. When fractions B and C were examined for their ability to either activate macrophages or inhibit macrophage mediated cytotoxicity, it was found that fraction B inhibited macrophage mediated cytotoxicity but was not able to activate macrophages to kill tumor cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3834191 TI - Changes in zeta potential of the red cell membrane in humans during acute exposure to cold. PMID- 3834192 TI - In vitro primary IgE antibody responses by human lymphocytes. PMID- 3834193 TI - [An epidemiological study on causes of death in the residents of Kosaka, Akita Prefecture]. PMID- 3834194 TI - [Studies on the mechanism of H2S generation from the stagnated quenching water for ash in the municipal solid waste incinerator]. PMID- 3834195 TI - [Organochlorine residues in human tissues and some foodstuffs, and the role of yellowtails as an index of the residues]. PMID- 3834196 TI - [Ethane expiration among smokers and non-smokers]. PMID- 3834197 TI - [Human body density estimated by anthropometric factors. Part II. Study on schoolchildren]. PMID- 3834198 TI - [The adjuvant activity of beryllium]. PMID- 3834199 TI - [Rubella infections of the school teachers in Sapporo Municipal schools after their employment]. PMID- 3834200 TI - Electrophoretic variants of blood proteins in Japanese. VI. Transferrin. PMID- 3834201 TI - Two siblings with microcephaly associated with calcification of cerebral white matter. PMID- 3834202 TI - Clinicopathological study in a female infant with 46,XX,i(18q) showing mixed features of both trisomy 18 and monosomy 18p. PMID- 3834203 TI - Distal 15q trisomy with Dandy-Walker malformation in a female infant. PMID- 3834204 TI - Report of a patient with a ring chromosome 10: mos45,XY, 10/46,XY/46,XY,r(10)(p15.3q26.3). PMID- 3834205 TI - Partial 8 trisomy by 3:1 segregation of balanced maternal translocation t(6q+;8q ). PMID- 3834207 TI - [Proceedings of the 58th annual meeting of the Japan Association of Industrial Health. Abstracts]. PMID- 3834206 TI - An expected decrease in incidence of Wilson's disease due to decrease in consanguinity. PMID- 3834208 TI - Physicochemical properties of the mouse plasmacytoma cell membranes with modified phospholipids. AB - Earlier work from our laboratory has demonstrated that the modification of membrane phospholipid composition markedly retards secretion of immunoglobulin G1 by mouse plasmacytoma MOPC-31C cells. In the present study, we examined the physicochemical properties of lipid vesicles prepared from these cells with modified phospholipids by analyzing temperature dependence of 1H NMR signal line widths of fatty-acyl chains. The results suggest that the export of IgG1 is affected by the local microenvironment of membranes rather than the bulk fluidity. PMID- 3834209 TI - In vitro assay of cytogenetic damage induced in bone marrow cells in vivo by chemical carcinogens. AB - Bone marrow cells explanted after the host animal has been exposed to chemicals can be assayed in vitro for cytogenetic damage. Cells were grown in medium for two cell cycles in the presence of 5-bromodeoxyuridine and then analyzed for the frequency of sister chromatid exchanges and cell replication kinetics. The patterns for induction of these endpoints as assayed in vitro were very similar to those observed if the assay was performed totally in vivo. Several chemicals were tested in this system and shown to be positive; hycanthone, ethidium bromide, 4-fluoro-3-nitro-phenyl azide, mitomycin-C, 2-aminoanthracene, benzo(a)pyrene, and cyclophosphamide. Dehydroemetine, known as a nonmutagenic drug, was negative in this assay. Since this assay incorporates host metabolism, is rapid, and has a wide dynamic range, it may be useful to perform to determine the potential of chemicals to induce genetic damage. PMID- 3834211 TI - Proceedings of the 32nd symposium on toxins. Tokyo, July 22-23, 1985. Abstracts. PMID- 3834210 TI - Serotyping of dengue viruses by an enzyme-linked immunosorbent assay. AB - We have developed a sandwich enzyme-linked immunosorbent assay for serotyping dengue viruses. In this assay, we used antibody from dengue hemorrhagic fever patients for detection of flavivirus common antigens to confirm virus isolation in C6/36 cells and that from hyperimmune mouse ascitic fluids for serotyping. The anti-dengue antibody was immobilized on microplate wells for capturing of dengue antigens, which were then sandwiched with the same biotinylated antibody. Then the biotin in the solid phase was detected with peroxidase-conjugated streptavidin. We found that all the dengue strains tested were unequivocally identified by this method. PMID- 3834213 TI - [15th regional meeting of East and West Japan, Japanese Society of Nephrology. Abstracts]. PMID- 3834212 TI - [Death due to traffic accidents on the Tomei Highway]. PMID- 3834214 TI - Effects of Ba2+ on secretory K+ movement and electrical properties of the early distal tubule of Triturus kidney. AB - The mechanism of secretory supply of K+ into the diluting segment of nephron was studied in Triturus kidneys by observing Ba2+ effects on electrical phenomena related to K+ movements and other electrical properties of the segment. Ba2+ (1-2 mM) applied into the luminal fluid completely blocked K+ movement into the lumen during the stop-flow of the intraluminal K+-free solution. Also, Ba2+ inhibited transepithelial K+ diffusion potential induced by alterations in the intraluminal K+ concentration and increased transtubular resistance (Rt). A rapidly decaying time course of the K+ diffusion potential and its high peak amplitude (near the maximum expected from an imposed concentration difference) suggest that the diffusion potential was generated across the paracellular pathways. Step-changes in the Na+ concentration induced similar but smaller diffusion potentials, which were also inhibited by Ba2+. Replacement of Cl- with So2-(4) converted the time courses of both K+ and Na+ diffusion potentials to a sustained type. These suggest that the pathway has a specially high permeability to K+ and lower permeabilities to Na+ and Cl-. Triaminopyrimidine and kinetin similarly blocked K+ movement during stop-flow of a K+-free solution. The low Rt, a unique property of the segment, could be ascribed to the leakiness of the paracellular pathway from the comparison of input resistances of cells and cell surface areas between this segment and the proximal tubule. Based on these findings and other reported data, a novel mechanism of K+ supply was proposed which assumed the presence of a local pool of a high K+ concentration in the paracellular pathway and secretory movement of K+ through intercellular junctional complexes. PMID- 3834215 TI - Effects of ischemia on pressure-velocity and pressure-volume relationships in the isolated rabbit left ventricle. AB - The pressure-velocity and pressure-volume relationships were determined in the isolated rabbit left ventricle in order to evaluate ventricular function during global ischemia (low pressure perfusion) and under reperfusion after a 10 min complete coronary occlusion (reperfusion after coronary occlusion). Reducing coronary perfusion pressure, the maximum isovolumic pressure (P0) decreased, but the maximum ejection velocity (Vmax) did not. The slope of the end-systolic pressure-volume relationship (Emax) decreased without any significant change in the volume-axis intercept. On the other hand, under reperfusion after coronary occlusion, both P0 and Vmax were depressed considerably, but Emax quickly recovered to the control level. Thus, Vmax and Emax show different behavior depending on the ischemic conditions. To analyze the relaxation process under low pressure perfusion and reperfusion after coronary occlusion, the pressure velocity relations during the relaxation phase were determined by the isovelocity method. Similar to the relation for contraction phase, the relation obtained here could be adequately approximated by a hyperbolic equation. Under the control condition, the relaxation velocity was always lower than the contraction velocity at the corresponding pressure level, and the ratio of the maximum filling velocity (Rmax) to Vmax was relatively constant. Although both Rmax and Rmax/Vmax were little affected by the low pressure perfusion, Vmax and Rmax, especially Vmax, decreased when the ventricle was reperfused after coronary occlusion, resulting in an increased Rmax/Vmax. PMID- 3834216 TI - Transient intracellular calcium movement coupled with mechanical activity of smooth muscle. AB - Change of intracellular free Ca in smooth muscle was monitored using Quin 2, Ca sensitive fluorescence dye. Upon electrical stimulus, increase of light emission from the sample occurred in two phases. Procaine and caffeine inhibited and facilitated, respectively, the 2nd phase of intensity change, which coincided with the mechanical response. It is concluded that the released Ca from intracellular store sites may play a key role for the mechanical activation of smooth muscles. PMID- 3834217 TI - Decrease of extracellular fluid in dog submandibular glands during secretion under arterial clamping conditions. AB - Microscopic observations were made of volume changes in ECF of the dog submandibular glands during resting state and stimulated state without blood supply. The interlobular space, one of the compartments of ECF, decreased significantly during stimulation when blood supply was absent. The results show that the interlobular space plays an important role as a reservoir of fluid in salivary secretion.